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Home My WebLink About109 Hazel Blvd (2)Permit #, Historic District: RECEIVED CITY OF SANFORD PERMIT APPLICATION _ SEP 1 5 2009 �� i Date: J V I1_.x 7 4—(nr Zoning: Value Permit Type: Building Electrical Electrical: New Service — # of AMPS Mechanical: Residential Non -Residential Plumbing/ New Commercial: # of Fixtures Plumbing/New Residential: # of Water Closets Occupancy Type: Residential Commercial Construction Type: # of Stories: Parcel #: Contractor Name & Address: Phone & Fax: Bonding Company: Address: Mortgage Lender: . Address: Architect/Engineer: Address: Mechanical Plumbing Fire Sprinkler/Alarm Pool Addition/Alteration Change of Service Temporary Pole Replacement New (Duct Layout & Energy Calc. Required) # of Water & Sewer Lines # of Gas Lines Plumbing Repair — Residential or Commercial Industrial Total Square Footage: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Contact Person: (Attach Proof of Ownership & Legal Description) Phone: State License Number: Phone: Fax: 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 pennit and that all work will be perfonned 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. 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 f permit is veritic ron at t will notify the owr er of the property of the requirements of Florida Lien Law, FS 713. natu toes O vier/Agent Date Signature of Connector/Agent Date 7s N Print Contractor/Agent's Name � g •l • S Vi,i natu pt "ot; y-St4kg da Date Signature of Notary -State of Florida Date * �lYCOtI SIGNgDD28N 22 s P EXPIRES: March 23, 2008 �r�oF F�0'x Bonded Thro Bldge Ow aer/Agent is Persona _Y ON"* t+'le or Contractor/Agent is Personally Known to Me or Produced ID t. t]Sfk`� '� 9 �� Produced ID APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD: (Initial & Date) (Initial & Date) (Initial & Date) (Initial &Date) Special Conditions: =I CITY OF SANFORD BUILDING DIVISION OWNER/BUILDER AFFIDAVIT CONSTRUCTION CONTRACTING Owners of property when acting as their own contractor and providing direct, onsite supervision themselves of all work not performed by licensed contractors, when building or improving farm outbuildings or one -family or two-family residences on such property for the occupancy or use of such owners and not offered for sale or lease, or building or improving commercial buildings, at a cost not to exceed $25,000, on such property for the occupancy or use of such owners and not offered for sale or lease. In an action brought under this part, proof of sale or lease, or offering for sale or lease, of any such structure by the owner -builder within 1 year after completion of same creates a presumption that the construction was undertaken for purposes of sale or lease. This subsection does not exempt any person who is employed by or has a contract with such owner and who acts in the capacity of a contractor. The owner may not delegate the owner's responsibility to directly supervise all work to any other person unless that person is registered or certified under this part and the work being performed is within the scope of that person's license. For the purposes of this subsection, the term "owners of property" includes the owner of a mobile home situated on a leased lot. To qualify for exemption under this subsection, an owner must personally appear and sign the building permit application. 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 $25,000. 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 I 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. do hereby state that I am qualified and capable of performing the requested co ruction 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. ,N I S '(-)T- Owner is Personal y Known to Me or has Produced ID C D 53 D G• --1S Z :7 -3 -SI -AD -c) f RI -11"I : RTMOF.-NTG_CORP FAX NO. : 4078312802 Dec. 11 2001 01 : 40PM P8 1 Y AN 1 MATION SURVEY `r PLAT OF SURVEY RATE.NAP N0, 12i294 0045-E CITY IF SANFUtD RORI ' DESCRIPTION LBOlti D cow _ ooNaKre ecocx wu _ u� FD" ar - oow sr= uoMNcxT _ PC Y 1-F[REDY•:�E m. THAT -.10. RUM IS. TRX AND ct tiLT.70 THE BEST tF ItY.laQVIEDGF 'ADTED TMT : . /n/Gyl LOT 9, HAZEL GLEN, PUBLIC RECORDS OF SEMINOLE COUNTY, FLORIDA. Ayfff oc - rE^s�i1D1T AS RECORDED IN PLAT BOOK 33, PAGE 63, _ e-carruc war _ �r � r _ noow cicr rn _Roo per SECTM4.472x27 FLD-4DA .STATUTES. RMI N - >� RW yy _ K '"" 2012 E. Rob{vsxon St. o - a PC - PWMT OF CIN1MitA4C Ptf/ YfAA.� Ci BELWIP.0 P'CC - pow P° COHYD� /��S z p� _ ppy,� q — WOWFRANK - A. RAY (407) 894-6314' � w4� w GROVEVIEW VILLAGE .- P ,Qp a: PLAT BOOK 19, 6 � PACE 4.5 AND $ £ g � ai �` � LOT 88 LOT 87 � � �'y FNS/%"IP S D' 47' DD '• W .90.0/1 00050130" W 80.00 MEAS �[qT h fcVO /%4'iP s zoos _ 14-120D5 o S ^ U. E, � o•ro' t7.5' � 0 r Al301/E LOT � g� L � �1 GROUND yr � W Q A0401-zi a II 0 0 vim . 0 or; Q o� p 10• � c / it f 5 ' r �• � LOT 8 LOT 10 salty Reece �:,s' 3 • vI W : w / STORY QLOrk' tib ADDRESS /09 0 N rn 00 i0. it' 38. Go' I W °Q 3 � � i 3.9 :�. Ce D CP r• / 9.9' Z Z V 77� CW v Cam;. 10 MEAS. z4). zi "WA! a 249.19 PUT 10 Ui a'�'N N 00'50'300_ E80:0 Por FND i�/�'IP r3 fN0 /%a'I zi zoos � LS 2005 E/la ZS•do' N c� � f ,VN/D� HAZEL BOULEVARD ( 50' RIW) k cs zoas - i = 1 Y AN 1 MATION SURVEY r JEFFERY S. & STACY LYNN DUNN; RATE.NAP N0, 12i294 0045-E CITY IF SANFUtD RORI r LBOlti D cow _ ooNaKre ecocx wu _ u� FD" ar - oow sr= uoMNcxT _ PC Y 1-F[REDY•:�E m. THAT -.10. RUM IS. TRX AND ct tiLT.70 THE BEST tF ItY.laQVIEDGF 'ADTED TMT : . /n/Gyl '-'CWT TE607-6 Ayfff oc - rE^s�i1D1T THIS 4t+lEY LEETS o STAI¢K2DS' AT REQUIRED YY . CHAPTER ff T13 FLUtW MVM OF.t.NO StRYEYfRS Pt it5lY1R TT) !I+ /!�GU/( _ e-carruc war _ �r � r _ noow cicr rn _Roo per SECTM4.472x27 FLD-4DA .STATUTES. O� (A17id0 1110. N - >� RW yy _ K '"" 2012 E. Rob{vsxon St. o - a PC - PWMT OF CIN1MitA4C Ptf/ YfAA.� Ci BELWIP.0 P'CC - pow P° COHYD� /��S n� Y�,��J,,,� p �,.�,r,. v9 O'rland /,J"lor"aVI�80a7 p� _ ppy,� q — WOWFRANK - A. RAY (407) 894-6314' � w4� w