HomeMy WebLinkAbout1309 Mellonville Ave�(f
Permit # • (] (�l
•--Job Address: �o rnt
_ Description of Work: to
CITY OF SANFORD PERMIT APPLICATION
Date: w
Historic District: Zoning: ._Value of Work: $ 3S0 CY
Permit Type: Building—V_ Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
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 or Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required fat: a6ter than x)
Parcel #:
ae & Address:
C.
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender: .
Address:
Architeet/Engineer:
Address:
'X R I I o MV ilk.
IV-4-tv
(Attach Proof of
Phone: 407—
State
07" -
State License Number:
& Legal Des riptian)
2-6 :
Contact Person: Phone:
Phone:
Fax:
t
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 price 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 tcparate
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. 1, z,ws 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, 0l 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 ve�rifc tit will n the owner of the property of the requirements of Florida Lien Law, FS 713.
ty
e of Owner/Age Date Signature of Contractor/Agent Date
C, kcv
Print Owner/Agent's Name Print Contractor/Agent's Name
0 y
i atureo otary- tate o on a Date Signature of Notary -State of Florida Date
DEBBIE BLANTON
MY COAdMISSION # DD 188491
EXPIl1[S: February 25, 2007
1-800-3-WCMRV,genF to Verson 11 I ow to Me or Contractor/Agent is —Personal) Known to Me or
L ixount Y
DducecL[ y •S3, )ST ` t9 — Produced ID
APPLICATION APPROVED BY: BldJJLZoning: Utilities: FD:
I B,t�a�e� �V (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions: 111 ' js
'*.Ly{'xtk"', or',gy,tslro
- 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 directs
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 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 r:i- y
not hire an unlicensed person to act as your contractor or to supervise people wofking 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 world -ug
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' conaperi.sation
for that employee, all as prescribed by law. Your construction must comply with all applicable laws,
ordinances, build=,-do
egulations.
�C hereby state that I am qualified and capable of performing the
requested construction 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.
o7j)a A --s 9._ e -0
Owner/Builder Signature {, Date J %
-:T L/4, it LL A �k W m, -a V
Print Owner/Builder Name
tDE
te of"F on ate BIANTOION # DD 188491 ruary 25, 2007��v- ham=(W or has
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No.
State of Florida
County of Seminole
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
CERI-IFIED CUPf
IVAR1. Description of property: (legal description of the property and street address if available) --.. Yf'
F
C' :U11
ISDCi OV- I oNv
D�ID�
2. General description of improvement: - 7>
3. Owner information
a. Na e and address c "-+� cJ . 6' � a "? ( A Iib
b. Interest in property 0 L0 4P-✓
c. Name and address of fee simple titleholder (if other than Owner)
4. Contractor
a. Name and address (� N
61
0
b. Phone number
Surety
a. Name and address
b. Phone number _
c. Amount of bond _
Lender
a. Name and address
Fax number
Fax number
b. Phone number Fax number
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as c„ -
provided by Section 713.13(1)(a)7., Florida Statutes: %=
a. Name and address
b. Phone number Fax number
8. In addition to himself or herself, Owner designates of
to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes.
a. Phone number Fax number
9. Expiration date of notice of commencement (the expiration date is 1 yerf�om4e date of recor ' g u e,�ss a different
date is specified)
Signa ,e o er Y 9
Swo to, (or affirmed) and sub sc 'bed before me this day of
10
Personally Known OR Produced identification_
Type of Identification Produced
THIS�1�l�T UMENT PREP RED BY: ' ';w .�
NAME`� � k , c�' f�.�t/I
` Si rre of Notary Public, State of Florida _
Commission Expires: �)A D D R. a U `v v ;
��, GLS � .`��� 1 �� ; `.'� #,.J...••'�� -#
(-IAUN O`KELLY D FRUTY CLARK