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Home My WebLink About121 Lake Ada CirCITY OF SANFORD PERitIIT APPLICATION Application 11: M - Z3 4 1 Submittal Date: _ /-07 Job Address: / .� �� ld �� a. �� Value of Work: $ Parcel ID: Description of Work: 1 --'1:- f'zk 0 Zoning: Historic District: Square Footage: ........................................................................................................................ Permit Type: Building 116 Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑ Electrical: New Service — # of AMPS 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 # of Gas Lines Plumbing/New Residential: # of Water Closets Plumbing Repair —Residential ❑ Commercial ❑ Occupancy Type: Residential qO Commercial ❑ Industrial ❑ Occupancy Use Group(s): Construction Type:: -.6 J&9-1tof Stories: /_ # of Dwelling Units: Flood Zone: ' (FEMA form required) Property Owner: V z ►yi ��+' a Contractor: Address: t' Z het. 4,e "g-, C 4 C,% __ Address: 3 z 7% 3 Phone: q0 7 3,Z YE9_9gE-mail: Phone: State License Number: Bonding Company: Address: Architect/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. I 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. ' 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 governmental entities such as water management districts, state agencies, or federal agencies. Acceptance of it is verification that 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713. Signature of Owner/Agent Date Signature of Contractor/Agent �) A/ Gno-w Pri t Owner/Agent's Name Print Contractor/Agent's Name A/ j ) i lure otary-State of Florida Date Signature of Notary -State of Florida Date Date tD'EI3$T IMLANTON ` MY COMMISSION # DD629096 0' EXPIRES. February 25, 2011 1 -800.3 -NOTARY FI. Notary Discount Assoc, Co. Owner/Agent is Personally Known t4 e r Contractor/Agent is _ Personally Known to Me or Produced ID T -TV_ CD_i l Z? _ Produced ID APPROVALS: ZONING: Special Conditions: Rev 02/2007 UTIL: FD: ENG: BLDG: w OWNER BUILDER STATEMENT/AFFIDAVIT Altamonte Springs, Casselberry, Lake Mary, Longwood, Oviedo, Sanford, Seminole County, Winter Springs Florida Statutes are quoted here in part for your information to indicate the authority for exemptions for homeowners from qualifying as contractors and to express any applicable restrictions and responsibilities. OWNERS MUST PERSONALLY APPEAR AT THE BUILDING DIVISION TO SIGN THIS DOCUMENT FSS 489.103 Disclosure Statement 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 supervision 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. BY SIGNING THIS STATEMENT, I ATTEST THAT: (Initial to the left of each statement) Property Address: �.Z l ��-� d�� n�� c qtr Fo��l Gam% 3 2 77 3 I, 0 �c'1� �`N /� (rv�o�c/ do hereby state that I am qualified and capable of performing the requested construction involved with the permit application filed. Signature (-L 0 7 Date Form of Identification L 0_,L/_0 MY COMiIlSSIO DIM'ONA MY COMMISSION # DD629096 (MuA be Photo ID) EXPIRES: Februaty 25, 2011,, OF F 1300 -3 -NOTARY FI. Notary Discamt km;m. Co. A violation of this exemption is a misdemeanor of the first degree punishable y a erm o imp iso a not exceeding 1 year and a $1,000.00 fine in addition to any civil penalties. In addition, the local permitting jurisdiction shall withhold final approval, revoke the permit, or pursue any action or remedy for unlicensed activity against the owner and any person performing work that requires licensure under the permit issued. (Rev. 4/20/07) I UNDERSTAND AND AGREE TO THE EXEMPTION PROVISIONS OF FLORIDA STATUTES 489.103 ✓�� AS LISTED ABOVE. I HAVE ACCESS TO THE ADOPTED CODES. I AM FAMILIAR WITH THE CODE PROVISIONS. %1_� I HAVE ADEQUATE KNOWLEDGE AND QUALIFICATIONS TO SAFELY PERFORM AND DIRECTLY SUPERVISE THE WORK. THIS PROPERTY IS NOT AN APARTMENT, CONDOMINIUM OR RENTAL PROPERTY. THIS STRUCTURE IS NOT BEING BUILT WITH MY INTENTION TO SELL, RENT, OR LEASE. I UNDERSTAND THAT THERE IS NOT STATED A TIME FRAME TO SELL, RENT OR LEASE AN OWNER BUILDER STRUCTURE WITHOUT BEING INVESTIGATED. I UNDERSTAND THAT FOR ANY UN -LICENSED PERSON I HIRE, I MUST DEDUCT F.I.C.A., WITHHOLDING TAX, AND PROVIDE WORKERS' COMPENSATION INSURANCE. Property Address: �.Z l ��-� d�� n�� c qtr Fo��l Gam% 3 2 77 3 I, 0 �c'1� �`N /� (rv�o�c/ do hereby state that I am qualified and capable of performing the requested construction involved with the permit application filed. Signature (-L 0 7 Date Form of Identification L 0_,L/_0 MY COMiIlSSIO DIM'ONA MY COMMISSION # DD629096 (MuA be Photo ID) EXPIRES: Februaty 25, 2011,, OF F 1300 -3 -NOTARY FI. Notary Discamt km;m. Co. A violation of this exemption is a misdemeanor of the first degree punishable y a erm o imp iso a not exceeding 1 year and a $1,000.00 fine in addition to any civil penalties. In addition, the local permitting jurisdiction shall withhold final approval, revoke the permit, or pursue any action or remedy for unlicensed activity against the owner and any person performing work that requires licensure under the permit issued. (Rev. 4/20/07) Seminole County Property Appraiser Get Information by Parcel Number Page 1 of 1 PARCEL Dr-TIPAOL Davis JoHNsoFiXFA, ASA PROPERTY APPRAISoER SE MINOLE COUNTY FL \. ,.. ..-, � ✓, 1101 E. FIRsT,ST SANFORD,. FL 3.2771-146B 407-6! 57715 2007 WORKING VALUE SUMMARY GENERAL Value Method: Market Parcel Id: 11-20-30-512-0000-1080 Number of Buildings: 1 Owner: GROW VERLIN N & DOROTHY L Depreciated Bldg Value: $141,339 Mailing Address: 121 LAKE ADA CIR Depreciated EXFT Value: $5,537 City,State,ZipCode: SANFORD FL 32773 Land Value (Market): $33,000 Property Address: 121 LAKE ADA CIR SANFORD 32773 Land Value Ag: $0 Subdivision Name: HIDDEN LAKE PH 3 UNIT 5 Just/Market Value: $179,876 Tax District: S1-SANFORD Assessed Value (SOH): $86,180 Exemptions: 00 -HOMESTEAD (1994) Exempt Value: $25,000 Dor: 01 -SINGLE FAMILY Taxable Value: $61,180 Tax Estimator SALES 2006 VALUE SUMMARY Deed Date Book Page Amount Vac/Imp Qualified Tax Amount(without SOH): $2,458 SPECIAL 12/1988 02030 0484 $58,900 Improved Yes 2006 Tax Bill Amount: $1,163 WARRANTY DEED CERTIFICATE OF Save Our Homes (SOH) Savings: $1,295 TITLE 11/1987 01902 1092 $1,000 Improved No 2006 Taxable Value: $59,078 WARRANTY DEED 10/1985 01682 0631 $67,400 Improved Yes DOES NOT INCLUDE NON -AD VALOREM ASSESSMENTS Find Comparable Sales within this Subdivision LAND LEGAL DESCRIPTION Land Assess Frontage Depth Land Unit Land PLATS: Pick... El Method Units Price Value LEG LOT 108 HIDDEN LAKE PH 3 UNIT 5 PB LOT 0 0 1.000 33,000.00 $33,000 29 PGS 40 & 41 BUILDING INFORMATION Bid Bid Type Year Bit Fixtures Base SF Gross SF Living SF Ext Wall Bid Value Est. Cost New Num 1 SINGLE $141,339 $154,469 1985 6 1,300 1,760 1,300 FAMILY BLOCKCONC Appendage / Sgft OPEN PORCH FINISHED/ 20 Appendage / Sgft GARAGE FINISHED/ 440 NOTE: Appendage Codes included in Living Area: Base, Upper Story Base, Upper Story Finished, Apartment, Enclosed Porch Finished,Base Semi Finshed EXTRA FEATURE Description Year Bit Units EXFT Value Est. Cost New POOL GUNITE 1989 450 $4,950 $9,000 COOL DECK PATIO 1989 305 $587 $1,068 NOTE: Assessed values shown are NOT certified values and therefore are subject to change before being finalized for ad valorem tax purposes. *** If you recently purchased a homesteaded property your next ear's property tax will be based on Jusf/Market value. http://www.sepafl.org/web/re_web.seminole_county_title?parcel=11203051200001080&cp... 6/l/2007