HomeMy WebLinkAbout104 W Wind Ctt
`n CITY OF SANFORD PERMIT APPLICATION
Application # : — 1 6 Submittal Date:
Job Address: I 1�7��-a ( �S�rd1 �� Value of Work: $ '2-19
Parcel tD:1 n zo �o ( k)OD o ago Zoning:
Description of Work:
Historic District:
Square Footage: I(D,3 r7
Permit Type: Building ❑ Electricalk! Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool Sign ❑
lie 20"A. e.S
Electrical: New Service- # of AMPS 2 O " , S Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Mechanical: Residential ❑'*' Non -Residential ❑ Replacement ❑ New ❑ (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential 2— Commercial ❑ Industrial ❑
Construction Type: # of Stories: # of Dwelling Units:
# of Gas Lines
Plumbing Repair -Residential ❑ Commercial ❑
Occupancy Use Group(s):
Flood Zone: (FEMA form required )
.................. S ....................................................................................................
Property Owner: 1't Contractor:
A ress: 1Qq Address:
a,►fuv-6+ PL 3 -7 .3
Phone: y d % 3O.)� 3 V F y E-mail: Ph ne f' CqM State License Number:
Bonding Company:
Address:
Arch itect/Engineer:
Address:
Plan Review Contact Person:
Mortgage Lender:
Address:
Phone:
Fax:
Phone: Fax: E-mail:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. 1 understand that a separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
I
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING; CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of
this county, and there may be:additional permits required from other govemmental entities such as water management districts, state agencies, or federal agencies.
Acceptance of pf rmit is verification I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
A_� n
Signature of Owner/Agent Date Signature of Contractor/Agent
Print et ent's Name
Si ture of Nota -State of Florida Date
�pQA o IVY WHITTEN
Nota+y Public. State of Florida
My comm expires June 28, 2009
No. DD445863
O�vne /A afiPy -
oduced iD ��A e.S t,� c e---:5
APPROVALS: ZONING:
Special Conditions:
Rev 02/2007
UTIL: FD:
Print Contractor/Agent's Name
Date
Signature of Notary -State of Florida Date
Contractor/Agent is _ Personally Known to Me or
Produced ID
ENG:
BLDG:
Seminole County Property Appraiser Get Information by Parcel Number Page 1 of 2
.................. ................
3 6* 3i 3 BaYi C51t;.CPA, AaA
PROPERTY
APPRAISER
..............................
............................
..........................
407
2007 WORKING VALUE SUMMARY
GENERAL
Value Method: Market
Parcel Id: 10-20-30-504-0000-0080
Number of Buildings: 1
Owner: GALLAGHER STEVEN M
Depreciated Bldg Value: $156,839
Mailing Address: 104 WESTWIND CT
Depreciated EXFT Value: $600
City,State,ZipCode: SANFORD FL 32773
Land Value (Market): $33,000
Property Address: 104 WESTWIND CT SANFORD 32773
Land Value Ag: $0
Subdivision Name: RAMBLEWOOD UNIT 2
Just/Market Value: $190,439
Tax District: S1-SANFORD
Assessed Value (SOH): $177,556
Exemptions: 00 -HOMESTEAD (2006)
Exempt Value: $25,000
Dor: 01 -SINGLE FAMILY
Taxable Value: $152,556
Tax Estimator
SALES
Deed Date Book Page Amount Vac/Imp
Qualified
WARRANTY DEED 04/2005 05706 0053 $185,000 Improved
Yes
2006 VALUE SUMMARY
QUIT CLAIM DEED 07/2003 04995 1762 $100 Improved
No
Tax Amount(without SOH): $2,918
SPECIAL 10/1999 03741 1223 $74,000 Improved
WARRANTY DEED
No
2006 Tax Bill Amount: $2,918
SPECAL
Save Our Homes (SOH)
$0
WARRANTY DEED 08/1999 03712 1190 $100 Improved
No
Savings:
CERTIFICATE OF
2006 Taxable Value: $148,225
TITLE 05/1999 03655 0454 $100 Improved
No
DOES NOT INCLUDE NON -AD VALOREM
QUIT CLAIM DEED 06/1992 02448 0049 $100 Improved
No
ASSESSMENTS
WARRANTY DEED 10/1982 01415 1930 $70,300 Improved
Yes
Find Comparable Sales within this Subdivision
LEGAL DESCRIPTION
J... .......
PLATS: Pic..k...
LAND
LEG LOT 8 ( LESS BEG NE COR RUN S 8
Land Assess Land Unit
Land
DEG 36 MIN 16 SEC W 52.59 FT S 51 DEG 37
Method Frontage Depth Units Price
Value
MIN 46 SEC W 10.74 FT
LOT 0 0 1.000 33,000.00
$33,000
N 8 DEG 36 MIN 16 SEC E 60.98 FT ELY ON
CURVE 7.36 FT TO BEG) RAMBLEWOOD
UNIT 2
PB 24 PG 25
BUILDING INFORMATION
Bid Bid Type Year Fixtures Base Gross
Living
Ext Wall Bid Value Est. Cost
Num Bit SF SF
SF
New
1 SINGLE 1982 8 872 2,070
1,629
WD/STUCCO $156,839 $174,265
FAMILY
FINISH
Appendage l Sqft GARAGE FINISHED/ 441
Appendage l Sqft UPPER STORY FINISHED / 757
NOTE: Appendage Codes included in Living Area: Base, Upper Story Base,
Upper Story Finished, Apartment, Enclosed
Porch Finished,Base Semi Finshed
Permits
http://www.scpafl.org/web/re—web.seminole—county title?parcel=10203050400000080&c... 5/11/2007
Curve Delta Angle
N(J-rfS:
Boundary LAND
1 3403538"
1. THIS SURVEY, WAS PREPARED FROM TITLE INFORMATION FURNISHL-b TO THIS SURVEYOR. THERE MAY
SURVEYORS
2 28008'37"
BE OTHER RESTRICTIONS OR UNRECORDED EASEMENTS THAT AFFECT THIS PROPERTY.
And LB 4565
3 8°24'46"
2. NO UNDERGROUND IMPROVEMENTS HAVE BEEN LOCATED UNLESS OTHERWISE SHOWN.
Mapping
3. THIS SURVEY IS PREPARED FOR THE SOLE BENEFIT OF THOSE CERTIFIED TO AND SHOULD NOT BE RELIED
Associates, Inc.
UPON BY ANY OTHER ENTITY.
4. DIMENSIONS SHOWN FOR T HE LOCATION OF IMPROVEMENTS HEREON SHOULD NOT BE USED TO
109 WEST ORANGE STREET
RECONSTRUCT BOUNDARY LINES.
5. BEARINGS ARE BASED ON RECORD PLAT DATUM AND ON THE LINE SHOWN AS BASE BEARING (BB).
ALTAMONTE SPRINGS, FL
32714
B. PROPERTY HEREON LOCATED IN ZONE ' AE.,'. PER F.I.R.M. COMMUNITY PANEL NO, 120289 0045 E DATED 04-17-95.
PH (407) 6961155
Curve Delta Angle
Radius
Arc
1 3403538"
50.00
30.39
2 28008'37"
50.00
24.56 I
3 8°24'46"
50.00
7.34
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PLANS EVitwe�
CITY OFANFOR-4
CERTIFIED T0:
STEVEN GALLAGHER
WATSON 71TLE SERVICES, INC.
AWE MORTGAGE &a AMERICAN MORTGAGE ARMIT
NETWORK OF FLORIDA
OLD REPUBLIC NATIONAL TITLE INSURANCE CO.
SCALE 1' = 30'
DESCRIPTION (AS FURNISHED): LOT 8, RAMBLEWOOD, UNIT II, ACCORDING TO THE PLAT THEREOF, AS
RECORDED IN PLAT BOOK 24, PAGE(S) 25, OF THE PUBLIC RECORDS OF SEMINOLE COUNTY, FLORIDA.
LESS THE FOLLOWING DESCRIBED PARCEL; BEGINNING AT THE NORTHErAST CORNER OF SAID LOT 8
_ - _ _ ._ __ _ .....-. �...... r• r.r r.. n rrrr TIJrI.I /+C DI IAI
-"by 17 2006 1:26Pm HP LRSERJET FAX 407--228-6443
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.Aquatic Innovations, Inc.
7033 Stapoint, Ct Unit G
- Winter Park, FL 32792
I 407-67141950 Fax: 407-671-6449
Pool Location: Pool Installation Information
It is essential that the a ea selected for your pool has a level and firm bass. Avoid areas with Vee roots
and stumps. Your pool
'all must be located 10' from any overhead power lines or you must have the
power lines moved pri r to installation. Youroolover p
tic sprinkler ]ides, onde and lines or anv obstacles that would interfere will] the tanks, drain fields,
lOQLtiOa must meet all cal, county and state requirements installation. Your pool
Ground Prep2ration:1
Yottr grass (if any) willlbe removed and your site leveled up to a 1Q",
20.00 per inch, Oval P Is $25.00 per inch. Excessive off grade may require excavundlationRto be POols
determined by contract and an estimate will be provided. This does not include having the ex(_Ay
1h
eh
hauled. This will be ass ssed prior to the start of your installation on your installation date. Please note:
Any off grade is mrasur from low side to high side. All earth will he removed so that
sitting oa a firm four on and settling will not occur, Above ground pools arc not your pool is
recessed in tine ground. £ter your ground is raked and treated with a vegetation herb id..tti proedtovdetl
sand will be applied M on or builders sand is recommended for the foundation directly under your
Litter. This sand is cleanand, which should not harm your liner.
Sand Recommendatiors:
12' 1 yard Saad Suppliers:
15'yard I Rinker Materials Sanford 407-322-8862
I Kissimmee 866-260.9530
18' 1 yard
24' 2 yards Winter Park 407-67`-2134
Florida Water Garden
27'&. 30' 2 yards 407-679-7787
12x24' 2 yards I Central Rock & Supply, Inc. 407-423-1632
15x24'2 yards Rockscapes 407-808-2376
1SOY 3 yards
This sand can be
Purch%�d from one of the suppliers listed above or from a locil landscaping company.
Have the sand delivered ¢s close as possible to the pool location but not in it If this is not possible then
in front of your home not blocking a path to the pool site. Please note: All the sand delivered may not be
used. Your installer will 1l a able to make that determination. Your installation includes Patio -block for the
vertical supports of your pool and filter system. Your filter system will be placed 5' from your pool wall.
Your electrician will n to make the electrical connection to the pump after the col
place. Please do not schedule your electrician the carne day we install the pool. Most elechiciareistwillis � to
give you a free quote. Up_J6n completion of your installation, your pool will bu filling with water, It takes
approrrimately 24 hours W fill your pool. Your pump should not be turned on until your pool is full of
water. Chemicals can be dad at this time. Information:
If we obtain your permit,ou are required to use our recommended licensed e:lectrician. Proper elmtri"
conna-ticns are required r your pump. Extension cords are not permitted" Permits must be posted on
the job site prior to your ipstallation. Permit requirements differ from each jurisdiction. We will need the
required documents from }'ou to obtain your permit. if you are not the homeowner, the will need a
notarized letter from the hbmeowncr allowing us ro install a pool on the property. Permit fres are paid to
Aquatic innovations in advance and are nun -refundable. It takes approximately one veeck ti get a permit
a 17 2006 1:26Pm HP LASCRJET FAX 407-228-6443
p.3
I
I
processed, so the 80oner YOU get the required documents to our office the sormc; we vhill ire sole to install
Your pool. The permit m st be obtained prior to scheduling your installation dare. Per ruts may seem like
a burden, but keen in mild td they are mice to protect you, the consumer. Only a licensed contractor would
to able to obtain a Pers n rrtt for you. Unlicensed installers are usually not current with up 'to date state and
local building codes s th a they properly insured making you responsible as the: homeowner for any
injuries or incidentals tht occur on your property.
Scheduling; I
YOU permit trust be obtained prior to scheduling your installation date. Theee dates arc tentative until
confirmed the day befor It is important
the day. Your pool, sand d permit iusttbeht ton site prior to he inave a phone stallation amr that id sometin reached st be home;
at the: time of your utstall tion.
Ground Treatment:
If we are preparing yo V round we will apply a vegetation herbicide purchas,.d (ry customer. The
Product we use a the has
product available for vinyl liner pools however, it doss not cover tree roots,
insects or carry a vegctati n warranty We obtain the best possible results by using this product and
highly recommended it. you are doing your own ground re and tree
pumbased at Recreations Factory Warehouse or prep tmeot, this product can be
Out. Please do not spread ltia to top of your upon request prior to Your installation we can bring it
Your liner is put in your gess. It is applied after your ground is prepared and before
pool. After your inst til"4n is finished, WC recommend that you keep the grass away #'tom your potml wail
approximately 1 foot to Prevent grass front ow
Florida Statues: ` ing in the pool area from the outside,
New ;safety Act laws eamj into effect October 1, 2000. These requirements Stelae hat if your pool wall is
48 inches above grade on 411 sides and has a removable ladder then you meet dle barrier option. If you
have off grade on one ion{your pool because
earth removed an addition'
S' your yard is sloped then you would need to have the
1 from your pool wall to tnsintain a 48" barrier on all sides. Please do oat
confuse this with your petit requirements. Tbese laws came in to effect to help prevent small childrea
elderly adults from dro i tug.
nequirt:meats. You still must comply with your local building department
re
Fences;
Ifyour building department requires fences, the fence must be put up prior to your installation. ]£your
building ou do
does mot require fences, your pool wall must remain above, grade 48 inches on al l
sides. nay: do not meet this requirement you then must obtain a fence or screen enclosure,
Warranty:
Your installation carries a �0-day labor warranty against defects caused by faulty workmanship from the
date of installation. This tv�rranty does not aver the material of the pool wall, Parer, filter system, pump
or any accessories purchaseid with the pool, as each item has it's own manufacnme's v
not cover electrical' gas lira hook ups, or any work done ansnrY. This does
cover damage caused by v by other contractors This warranty does not
dalism, liners pua..turcd by objects, improper mainternrnce, leaving pool
r
empty or misuse. Buyer sh Id contact seller in order to obtain performance of its warranty obligations.
This warranty does not cov any optional, additional items or services that Wer^ not contracted or paid
to Aquatic Innovations, Inc. Please Note; Tbis warrant, is null and void if your electrical=mutection has
not been completed to code and if your pool has not had a final inspection.
i
Thank -you for letting us sere you W'e hope you have many years of enjoyment with your new pool!
MW
AEton[ A_1-IUNAL
WAREHOU
3206 ED Colonial Dr.
Orlando, FL, 32803
Phone OV) 291-1600
Fax (407) 898-3662
To whom it may concern:
of
has purchased an above ground pool on
Please refer to the chart'below to determine the approximate amount of water necessary
the pool to the required level : to.fil.
52" pools:
15'--5,300 gal. 7 18'--0a�?
'-=13 600 I. �_ 6-1g- 21 10,400 gal.
24 .
gal. 27 '= 17,2000 gaL• 33'--25,700 gal.
12x24'--6,800 gal. 16x32'--12;100 gal. 2lx42'--20,100 gaI.
48" pools:
2'--.,,400 gal. 15'--5,000 gal. 181--7,300 gal.
'
_1 9,900 gal. 24'--13 000 gal. 27'--16,300 gal.
12x24' -6,500 gal.
If I may be of special assistance_,
please do not hesitate to call.
Size of pool:
8'
12'
15'
18'
20'
24'
28'
33'
11' x 18.5-
12'x
8.5'12'x 24'
15'x 25'
15' x 30'
18' x 33'
18' x 38'
48" tall # of Gatlons:
1,700
3,500
5,300
7,600
9,400
13,60o
18,500
25, 700
6,600
9,200
10,200'
13,700
17,500
20,500
Sincerely,
5 t" t0all # of.Gallons: ,
2 00
3,, 800
5,700
18,200
10; 000
14,600
20,000
N/A
6,100
8,500 .
11, 000
14,800
18,900
22.100
C„QNGRATULATIONSI I
Congratulations! You now have your very owns 'mm;n___� .x.ol it oert saying that your pool will provide you with years of
great fun and enjoyment for you and your family. However, as with all good things, ownership also brings some basic responsibilities
such :u proper initial installation of the swimming pool and=0qu-i-m-e-K-90- starchemistryto protect against
oontamination, and supervision of your loved ones a estnvited t here in your swimming fun-
INSelect a swiny site that complies with local zoning lationper clearance from overhead or buried wires. Be euro to
read i,ho m:uwfac,�turets' installation manuals carefully. ake notes in the margin and highlight important items or areas that you do
not filly contactnderstand. Should you have any questions after careful reading of the manual, please feel free to contact us for clarification.
Be sure to obtain all necessary building permits and to comply with all national and local municipal codes before you start installation -
Pay specie? note to the manufacturers' instructions reIlation sites built up and leveled with new loose fill, all over leveling
the yool, coving wall lock system -n crmmer ' a on. If you on, please give us a call Remember, proper
installation is a must for
Before installation of the
of your pool and prAervation of your warranty.
NUT GRAS& g2!NS AND VF,GATATIQN GROWTH
a should treat the swimming pool installation site with a chemical
ran grass, tree roots and other vegetation. Be sure to follow the herbici
DAMAGE TO POOL LINERS CAU:
WAP.EHOUSE OR THE ORIGINAL
VEG
to prevent problems with
;ions carefully.
OC�D$Y REC
Regardless of who installs your pool ALL TRICAL WIRING AND K BE TED IN ' UANUL
WITH THE NATIONAL. ELECTRICAL CODE any local code requirements. This is your rosponstbiliry.
RacWarehouse under no cirtivmstancos offers to provide electrical installation of any type. Our staff and any other installers are
forbidden by company directive as well as by law from performing any sort of electrical installation. It is YOUR RESPONSIBILTY
TO OBTAIN ALL NECESSARY PERMITS AND TO COMPLY WITH THE NATIONAL ELECTRIC CODE and all applicable
local codes. The manual provided with the fitter pump will specify the voltage and amperage requirements necessary to operate your
fitter pump. it is critical that the proper voltage and sufficient amperage be available. Low voltage could damage your equipment.
Unoer no circumMces should vote filter oumy or any other pool owipirent be operated in c9lijunction with Any temnorarY wiring or
r,tx elision cord regardless of how heavy duty it may be ALL ELECRTICAL CIRCUITS USED IN CONJUNCTION WITH YOUR
POOL SHOULD BE EQUIPPED WrM A GROUND FAULT INTERRUPTER AS PROVIDED FOR IN THE NATIONAL
ELECTRIC CODE. YOUR FAILURE TO HAVE ELEC S PROPERLY INSTALLED COULD LEAD TO
ELECTRICAL SHOCK AND DEATH.
g,QQ'� CHEMICALS
Swimming poo] chemicals provide the means to fain pure clear water proper use is critical to pool water safety and
quality. Read the label directions careMy. For be our water to ReeWarehouse for FREE WATER ANALYSIS AND
TESTING. PROPER CHEMICAL BALANCE IS A MUST. Improper water balance will damage and corrode the best pool frame,
will and filtration equipmeri4 and may cause rapid liner deterioration. It is highly recommended that you have your water
pmfessioc:ally tested on a biweekly basis at ReeWsrehouse. This service is free of charge. Use only manufacturer recommended
ch zinc tablets in an automatic chemical feeder. Although substitutes may look similar, chances are they will perform difrerently and
MY well be a hazard NEVER MIX CHEMICALS. As with any household chemicals you are responsible for the safe transport and
storage of swimming chemicals. Always check the condition of chemical containers. Be sure that the cap or lid is secure before
transport. YOU MUST KEEP CHEMICALS OUT OF F CIiIl DREN• It is critical that Yot'read and follow the
m+uiufacnuers' instructions carefully. If you any question porting to the sTota or use of any swimming Pool chemicals
please call RecWarehottse for advice
REVENTAIJU MAINTANCk
Prol)crfy rnajoWning your swimming pool related equipment will provide years of ee swimming fun. However, as with
most things, some preventative maildenartce is all manuals carefully and follow their
recommendations. Prompt action is critical; for e ordri develop, act immediately to repair the problem.
Even the slightest continual drip of pool water cause majorpr Iems overs parte e.
xc�.nrnf�1=0RD"9
Contmon Sense should tela you that st is foolish p or diva intf wet PING OR DIVING INTO AN ABOVE
GROUND POLL IS VERY DANGEROUS AND SERIOUS INJURY OR DEATH. Above ground
pools are meant for swimming fim only, and not dangerous horseplay, jumping, or diving. It is your sole responsibility as a pool
owner to utonitor all swimming activities and to post the NO JUMPING/DIVING warning signs provided with your pool- You must
ori all times supervise Loved ones and guests to prayers
in from roughhousing, fooling around, clowning and all types of horseplay
such as jumping or diving into your pool. As the owner you aro responsible for the security of your pool at all times.
I DAVE READ ANDAUNIDD&QSTAND TE O QIIIREN"rS AND RESPONSLBILTIES
ATE
STO`IER NAME SA
LESPERSON
CI STO-AER SIGNATURE
WA1K1t11UU,C ACKNOWLEDMENT OF RELEASE OF POOL AND SPA
SAFETY INFORMATION AND RELEASE OF CLAIMS
(Florida Only)
(To be signed by customer when purchasing a pool or spa)
Effective October 1, 2000, Florida statutes Chapter 515, the Residential Swimming Pool Safety
Act (the "Act'), requires all residential swimming pools and spas to meet certain safety
requirements designed to minimize drowning or near drowning incidents.
In addition, Section 515.33 of the Act requires a licensed pool contractor, home builder, or
developer, upon entering into a contract with a buyer for the sale or construction of a pool, to
provide the buyer with the following:
A document. containing the safety requirements of the Act (which document may be a
copy of the act itself); and
A copy of the safety publication produced by the Florida Department of Health, pursuant
to Section 515.31(2) of the Act, providing information on drowning prevention and the
responsibilities of pool ownership.
Although RecWarehouse is not a "licensed pool contractor", "home builder", or "developer", it
has decided to distribute the safety documents referenced above as a service to its customers. The
distribution of these documents does not in any way constitute an admission by RecWatehouse
that it is subject to any requirements or restrictions placed upon "licensed pool contractors",
"home builders", or "developers".
By signing below, you are affirmatively stating that you have received from RecWarehouse both
of the documents referenced above, and that you release RecWarehouse from any liability
resulting from your failure to comply with all safety requirements presented therein.
1 HAVE RECEIVED FROM RECWAREHOUSE A DOCUMENT CONTAINING THE
SAFETY REQUIRMENTS OF THE ACT, AND A COPY OF THE SAFETY PUBLICATION
PRODUCED BY THE FLORIDA DEPARTMENT OF HEALTH PROVIDING
INFORMATION ON DROWNING PREVENTION AND THE RESPOSIBILTTIES OF POOL
OWNERSHIP. FURTHERMORE, I UNDERSTAND AND AGREE THAT COMPLIANCE
WITH ALL SAFETY REQUIREMENTS AND PRECAUTIONS PRESENTED IN THE
DOCUMENTS SHALL BE SOLELY MY RESPONSBILITY, AND THAT COMPLIANCE
WITH ALL SAFETY REQUIRMENTS AND PRECAUTIONS PRESENTED IN THE
DOCUMENTS SHALL BE SOLELY MY RESPONSIBILITY, AND THAT
RECWAREHOUSE SHALL NOT BE HELD LIABLE IN ANY WAY FOR MY FAILURE TO'
PROPERLY COMPLY ,
Customer Signa Date
City of Sanford
Owner/ Builder Affidavit
Construction Contracting
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as the owner of your property, to act as your own
contractor with certain restrictions even though you do not have a license. You must provide direct, onsite
supervision of the construction yourself. You may build or improve a one -family or two-family residence
or a farm outbuilding. You may also build or improve a commercial building, provided your costs do not
exceed $75,000. The building or residence must be for your own use or occupancy. It may not be built or
substantially improved for sale or lease. If you sell or lease a building you have built or substantially
improved yourself within 1 year after the construction is complete, the law will presume that you built or
substantially improved it for sale or lease, which is a violation of this exemption. You may not hire an
unlicensed person to act as your contractor or to supervise people working on your building. It is your
responsibility to make sure that people employed by you have licenses required by state law and by
county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to
a licensed contractor who is not licensed to perform the work being done. Any person working on your
building who is not licensed must work under your direct supervision and must be employed by you,
which means that you must deduct F.I.C.A. and withholding tax and provide workers' compensation for
that employee, all as prescribed by law. Your construction must comply with all applicable laws,
ordinances, building codes, and zoning regulations.
I,iTQ , do hereby state that I am qualified and capable of performing the
requeste construction involved with the permit application filed.
I will assume full responsibility as an Owner/Builder Contractor, and will personally supervise all work
allo ed by law on the permitted structure.
(IVU�ld /1- "/0__�
caner/B ilder Signature Date
Owner is Personally Known to Me or has Produced ID
Signature of o tate of Florida Davw..,.
My Commissionmxpires:° rS E�BI�BA' ;
�....
y MY COMMISSION # DD629096
sY?ItRES: February25, 2011
FI. Notary Discount Assoc. Co.
'u:
CITY OF SANFORD BUILDING DIVISION
OWNERIBUILDER AFFIDAVIT
ELECTRICAL & FIRE ALARM SYSTEMS
An owner of property making application for permit, supervising, and doing the work in connection with
the construction, maintenance, repair, and alteration of and addition to a single-family or duplex residence
for his or her own use and occupancy and not intended for sale or an owner of property when acting as his
or her own electrical contractor and providing all material supervision himself or herself, when building
or improving a farm outbuilding or a single-family or duplex residence on such property for the
occupancy or use of such owner and not offered for sale or lease, or building or improving a commercial
building with aggregate construction costs of under $75,000 on such property for the occupancy or use of
such owner and not offered for sale or lease. In an action brought under this subsection, proof of the sale
or lease, or offering for sale or lease, of more than one such structure by the owner -builder within 1 year
after completion of same is prima facie evidence that the construction was undertaken for purposes of sale
or lease. This subsection does not exempt any person who is employed by such owner and who acts in
the capacity of a contractor. For the purpose of this subsection, the term "owner of property" includes the
owner of a mobile home situated on a leased lot. To qualify for exemption under this subsection, an
owner shall personally appear and sign the building permit application.
State law requires electrical contracting to be done by licensed electrical contractors. You have applied
for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to
act as your own electrical contractor even though you do not have a license. You may install electrical
wiring for a farm outbuilding or a single-family or duplex residence. You may install electrical wiring in
a commercial building the aggregate construction costs of which are under $75,000. The home or
building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or
lease more than one building you have wired yourself within 1 year after the construction is complete, the
law will presume that you built it for sale or lease, which is a violation of this exemption. You may not
hire an unlicensed person as your electrical contractor. Your construction shall be done according to
building codes and zoning regulations. It is your responsibility to make sure that people employed by you
have licenses required by state law and by county or municipal licensing ordinances.
I, s , do hereby state that I am qualified and capable of performing the
requested onstruction involved with the permit application filed.
I will assume full responsibility as an Owner/Builder Contractor, and will personally supervise all work
allowed by law on the permitted structure.
Own rBuilder Signature Date
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Signature of Notary—State of Florida Date
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Owner is Personally Known to Me or has
Produced ID
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