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HomeMy WebLinkAbout811 Palmetto AveCITY OF SANFORD PERMIT APPLICATION MIDI Application # : (� ` � i Submittal Date: QAI (� Job Address: rA1,ttc7"%O ,dyf– S)sA1- Or_D Fc-- Value of Work. $ :2 n Parcel ID: Zoning: Historic District: Description of Work: ly' &AeD ow t—c!t!Glr_ AUK&- P4 PC4•i ` L; rJ F Square Footage: ....................•................................................................................................... Permit Type: Building ❑ 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 Plumbing/New Residential: # of Water Closets Occupancy Type: Residential 'A Commercial ❑ Industrial ❑ # of Gas Lines Plumbing Repair –Residential ❑ Commercial ❑ Occupancy Use Group(s): Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required ) ........................................................................................................................ Property Owner: BU 1 TVA /J Contractor: Address: fr]I PAL*tLrT Ivy Address: Sio,.jFyyt0 F -L 3Z?31 Phone: 4U7 Lf3U'70Uj E-mail: (VIVI'y , A�V�C_�•s��'•' ^` Phone: 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. I certify that no work or installation has commenced prior to the issuance of a permit and that all work willbe 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. /00 ___ Accceptance it is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713 -., 7-r -0 7 moi$ re o r/Agent Date Signature of Contractor/Agent Date F Rev 07.07 -Ju r,l_ o c -i l gy�� Print Owner/ gent's Name Print Contractor/Agent's Name �otary-FTWK.. Signat1'� //,r Date Signature of Notary -State of Florida Date • ' t GGMMis ° �i • • aouar, s'`Ja • t 'e" moo•, T'n�_ Owner/Agent is (trtoi�rt tD Ike oto/` Contractor/Agent is Personally Known to Me or _��efson`jly Produced ID � . ' syn Produced ID _ APPROVALS: ZONING: ZZI \\�\ FD: '�NaliIIIm0l ENG: BLDG: S ecial Conditions F Rev 07.07 -Ju r,l_ o r CITY OF SANFORD HISTORIC PRESERVATION BOARD APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS P.O. Box 1788, Sanford, FL 32772-1788 Phone: 407.302.5805 Fax: 407.330.5679 TO: THE HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD, FLORIDA 0 Downtown Commercial Historic District ❑ Residential Historic District 0 This application is filed in response to a notice from the Code Enforcement Department ADDRESS OF PROPERTY: _ Sj ( ?;4L E---rTo p i :5M Fo2tD �--L 3 Z? 7 ) Signature: Mailing Address: /3-11 PA LMS T -,M Phone: 40"1- q30-7001 Fax: Print Name: B l l (-y,d N A �r SAA! �rof-0 4--� 37 7 7 � Signature: Print Name: 9;.)/ ey" Mailing Address: PA f �a,J FpP.Ij F'�>Z7-71 Phone: Q-7 430 r-70 Fax: I certify that all info .o�ta� this application is true and accurate to the best of my knowledge. Applicant/Owne Date: 7 — 1'7— Z001 Please use the attached criteria checklist as a guide to completing the application. Incomplete applications cannot be reviewed and will be returned to you for more information. You are encouraged to contact the preservation planner at 407-330-5672 to make sure your application is complete. Description of Proposed Work/Application Category: (Check all that apply) ❑ Site Improvements/driveway/walkway ❑ Storage shed ❑ Moving structures ❑ Replacement windows or doors ❑ Underskirting ❑ Awnings ❑ New construction/additions ❑ Signs ❑ Demolition ❑ Roofs/gutters/downspouts ❑ AC/Mechanical Fences/Gates/Pergolas ❑ Replacement siding/flooring/porch ❑ Paint ❑ Other Completely describe the entire scope of work: all changes in material, color or location to the exterior of the building, where on the property the work will occur and how the work will be accomplished. For large projects, an itemized list is rfx,ommended. Attach additional pages if necessary. l BOA D ©/vPee-rt 2 Y Li^/f- Z 2' ► - � k via l A 1,-J6,4 s�� � r' A rho s �f CJs A Certificate of Appropriateness is valid for six months unless otherwise noted Historic Preservation Board Meeting Date: Application is Approved V Conditions: Signed OFFICIAL USE ONLY Staff Review Date: Approved with Conditions Date: -7/010 Denied ***This Certificate must be prominently displayed on the building when work is in progress*** Requirements for Certificate of Appropriateness Application FUQL IC RECORD'S OF 5FIV.INOL E I COUNT Y, FL ORIUIq I_oT 7 FC 1/2' 160M PIPE FO REBAR 8 C,9P Ho * N 90°00'00' E I- �\ 9.5 117.001. - .3 - -- ❑ /C PAD 26 0 5.7 STEPS i 0 GARAGE o � 20 0 0 v V- 20 (ll _LOT- �_' 1_OT9 L1.1 S 90000'00" W% SET 17F8AR 8 117.00 _ FD RHAR i-OT9 NO CER TIFIED T0: WILLIAM G RYAN HARRY G, REID FIDELITY NATIONAL TITLE /` T v I/ /l /7 -r/) A n r r� 2 STY RES o 'o b '-- 5.7 o v co z 24.00' - 9 o_ 5 16.3 �j STEPS i 0 GARAGE o � 20 0 0 v V- 20 (ll _LOT- �_' 1_OT9 L1.1 S 90000'00" W% SET 17F8AR 8 117.00 _ FD RHAR i-OT9 NO CER TIFIED T0: WILLIAM G RYAN HARRY G, REID FIDELITY NATIONAL TITLE /` T v I/ /l /7 -r/) A n r OWNER BUILDER STATEM ENT/ iFF1DAVIT 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) P,4 Property Address: _ $l ( Py4 Lirnc , T o /9�/C An1$1( iv l'-JrFL 3 2? `7 f3 Z? `7 r do hereby state that I am qualified and capable of performing the reque ted construction involved with the permit application filed. Form of I 7--i , 0 7 Date r- • o""4Musrro ) _` ••�� �a y 16 -t, �A% A violation of this exempt AHa thisdem�a' &'tghe first degree punishable by a term of imprisonment not exceeding 1 year and �5000fie i&additie� to any civil penalties. In addition, the local permitting • ,, ' -,. jurisdiction shall withholrspPr`afk?rr l�he permit, or pursue any action or remedy for unlicensed activity against the ownerG tUS? Poing work that requires licensure under the permit issued. (Rev. 4/20/07) //1//STAT . i iilll 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 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. P,4 Property Address: _ $l ( Py4 Lirnc , T o /9�/C An1$1( iv l'-JrFL 3 2? `7 f3 Z? `7 r do hereby state that I am qualified and capable of performing the reque ted construction involved with the permit application filed. Form of I 7--i , 0 7 Date r- • o""4Musrro ) _` ••�� �a y 16 -t, �A% A violation of this exempt AHa thisdem�a' &'tghe first degree punishable by a term of imprisonment not exceeding 1 year and �5000fie i&additie� to any civil penalties. In addition, the local permitting • ,, ' -,. jurisdiction shall withholrspPr`afk?rr l�he permit, or pursue any action or remedy for unlicensed activity against the ownerG tUS? Poing work that requires licensure under the permit issued. (Rev. 4/20/07) //1//STAT . i iilll