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HomeMy WebLinkAbout808 Catalina Dr\ CITY OF SANFORD PERMIT APPLICATION Application # : Con 4 5 3v Submittal Date: / Job Address: �0 � GA/J �{ /¢ hll:�,-/J /2 -fiZ i ),,' Value of Work: Parcel ID: Zoning: Historic District: Description of Work: /06�- �d/� Square Footage: ........................................................................................................................ Permit Type: Building 0..Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑ Electrical: New Service — # of AMPS Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑ Mechanical: Residential ❑ Non-Resident.ial ❑ 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 Ca/ Commercial ❑ Industrial ❑ Occupancy Use Group(s): Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required) ....................................... Property Ownerp� ..�T�L.....� ... � ��L�'7 ................Contractor: ............................................ ........ .. Address: 0 4 �L���✓�!!.•�� % �• Address: Phone:, &% 3,Z l/U3C E-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. I 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. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. 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 permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. Signature Owner/Agent Date Signature of Contractor/Agent Date C� y0.' O, GI�.�7 Name Signature of Notary -State of Owne�gent is _ -'Produced ID APPROVALS: ZONING: Special Conditions: Rev 07.07 NMI M TERRA APPL'NG ky PVe"''i �Notary Public -State of Florida 2„ : • `My Commission Expires Jul 29, 2008 oP, Commission # DD 342309 wed By National Notary Assn, UTI L: FD: Print Contractor/Agent's Name ature of Notary -State of Florida Date tractor/Agent is Personally Known to Me or Produced ID ENG: -*H3 BLDG: 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: Sw-;,t/)4W, I, do hereby state that i am qualified and capable of performing the requested construction invoWed with the permit application filed. , ; // � -2 Date Form of Identification con-IM1ss1oN a DD6z9o96 (Must be Photo ID) oF� EXPIRES: February 25, 2011 I -900 -7 -NOTARY Fl. Notary Discount Assoc. Co. A violation of this exemption is a misdemeanor of the first degree punishable by a er o 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) 1 UNDERSTAND AND AGREE TO THE EXEMPTION PROVISIONS OF FLORIDA STATUTES 489.103 AS LISTED ABOVE. I HAVE ACCESS TO THE ADOPTED CODES. 1 AM FAMILIAR WITH THE CODE PROVISIONS. 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: Sw-;,t/)4W, I, do hereby state that i am qualified and capable of performing the requested construction invoWed with the permit application filed. , ; // � -2 Date Form of Identification con-IM1ss1oN a DD6z9o96 (Must be Photo ID) oF� EXPIRES: February 25, 2011 I -900 -7 -NOTARY Fl. Notary Discount Assoc. Co. A violation of this exemption is a misdemeanor of the first degree punishable by a er o 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) TUN -,8-2007 14:43 FROM:SENEZ ALUMINUMIORLAN 1407:'2301358 Permit Number —_ (5 1 ),10 Parcel Identification Number 0-T-90--31 -Sly - b'eGO _YI7D Prepared byp, /IAV 1aj I V tcs'iZf�� Return to: r�/ t . i,L Lt � r d , CL 32-7 I NOTICE OF COMMENCEMENT State of Y 1 d G County of n01 f 1111191'fll}1111 u Ilii U 111 IN 111110 111it 11111 Iii 11111 MARYANNE MORSE, CLERK OF CIRCUIT COURT SEMINOLE COUNTY BK 06734 Pg 0926; (Ipg) CLERK'S # 2007091465 RECORDED 06/21/2007 02:24:37 PM RECORDING FEES 10.00 RECORDED BY H DeVore The undersigned hereby gives notice that improvement(s) will be made to certain real properly, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. t. Description of property (legal description of the property, and street address it available) _Qq L(nt+ gp oIci p,3CCS-ij ItC, 1©wn home t. en al description of Improvement(s) lin-c,Ya1I Y-000- 3. Owner Information Name Qncy 'Vcscor-, Telephone Number 4073;k-3. aalq Address ),3Q VrlLler Rd • Fax Number Interest in Property: 4. Fee Simple Title, Holder (it other than owner shows above) Name Telephone Number Address Fax Number 5. Contractor n Named � ne-z_.AW mind__-) Address I Ip CCrTtrCt_I R -t' IL t]V . t d , PL_ 5. Surety (if any) Name Address 7. Lender (if any Name Address Telephone Number L�0-1• 3a3. aalq Fax Number L01. 3--D 3 - Telephone Number Fax Number Amount of bond S Telephone Number Fax Number S. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by 713,13(1)(&)7. Florida Statutes. Name Telephone Number Address Fax Number 9. in addition to himself or herself, Owner designates the following to receive a copy of the L'Ienor's Notice as provided in 713.13(1)(b), Florida Statutes. Name Teiephone Numbar Address Fax Number 10. Expiration date of notice of commencement (if expiration date is one year from the date of recording unless different date is specified): _.._ XD. %� •l�-�.�-- te *g1ried Signature o caner {J�Q per 7.3.13(1)(g). "owner must sign ... and no one else may be permitted to sign in his or her stead" S or 10 and subsori�e/(,before me this ___� _ day of LL t Zo ry by Tin tov X\ (�� rr np > _ who is personatly known io me OF produced l t 1 I [ZLi1L1 as identification. SEAL Signature of Notary Notary Public State of Florida 23.20 (9104) x'ae'R Mosley My Commission DD672921 Ex Ires 0710612011