HomeMy WebLinkAbout415 S Palmetto Ave (4)"J CITY OF SANFORD PERMIT APPLICATION
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rmit # : 0 /�% Date: / / �/,9
Job Address: _` /� 5, 10C. TT--->
Q Description of Work: o -r Inert4-- X,90 f--,�HI0C-4e px/T r.-Af-cg 1
Historic District: c°6i+ Zoning: Value of Wor $ SZ�'
Permit Type: Building A_ Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of ServiceTemporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Cald. 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 for other than X)
Parcel #: (Attach Proof of Ownership & Legal Description)
1 Owners Name & Address: -TF,114-
Phone: e/07 -3 -1 -
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
State License Number:
Contact Person: Phone:
Architect/Engineer: Phone:
Address: Fax.
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 aR applicable Taws regulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUI T IN VoIits. 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, thele 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.
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Signature of Owner/Agent Date. Signature of Contractor/Agent
Name
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Date
AMY COMMISSION # DD 188491
EXPIRES: February 25,18
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APPL[CAT ON APPROVED : B dg: Ver /'.� Zoning:
(Initial Dft��V�
Special Conditions:
Print Contractor/Agent's Name
Date
Signature of Notary -State of Florida Date
Contractor/Agent is — Personally Known to Me or
Produced ID
Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date)
CITY OF SANFORD BUILDING DIVISION
OWNER/BUILDER AFFIDAVIT
CONSTRUCTION CONTRACTING
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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 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 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.
All
I,/-- , do 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.
Owner/Bui er Signature Date
Print Owner/Builder Name
4Sinature *fWft#k0ffMfl" EMB001 4. 41/��
Owner is Personally Known to Me or has
Produced ID
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CITY OF SANFORD
HISTORIC PRESER VA TION BOARD
APPLICATION FOR A '
CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788; Sanford, FL 32772-1788
Phone: 407 330-5672 Fax: 407 330-5679
In addition to a Certificate of Appropriateness, a building permit may be required. Check with the Building
Department: 407 330-5660. A Certificate of Appropriateness may be required for projects that do not require
a building permit. '
This Certificate must be prominently displayed on the ounaing wnen wurn rs In
1. General Information
Property Owner: 9i e 6 A,gze " Tef9L Property Address: / s" _S
Mailing Address: oZ ro 11 le 7y A !4✓ Phone Number: D 7 -
Agent:
Address:
�f}'r/fD'20FG 31.773 Fax Number: Axp'ele-
Phone Number:
Fax Number:
❑ Downtown Commercial Historic District: -4;tI'Zesidential Historic District:
❑ This application is filed in response to a notice from the Code Enforcement Department
1 certify that all information contained in this application is true and accurate to the best of my
knowledge.
Applicant: /� i �-� Owner:
Date: q11_7 /U V Date:
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.
A Certificate .of Appropriateness is valid for six months unless otherwise noted
OFFICIAL USE ONLY
Historic Preservation Board Meeting Date:
Staff Review Date:
Application is Approved Approved with Conditions Denied
Conditions.:
lyl-�/l�"1'/�/a
Signed: Date:
FASHA ENG\ iistoric Preservation Board\#Certificate of Appropriateness.doc 1.
2. 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
lsi�t 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 recommended. Attach additional pages if
necessary.
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3. Documentation: In order to be reviewed by either the staff or the Historic Preservation Board, applications must be
complete. The documentation listed below must be submitted with the application form. 11•copies of all drawings larger than 11" X
17" and 11 copies of all photos must be submitted.
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Paint: Color samples of all colors must be submitted.
`
Fences/Gates/Pergolas/ Sheds:
• A site plan of the property showing the location of the fence, gates and/or pergola. The plan must show the property's
dimensions.
• A picture of the proposed structure. This can be an elevation drawing, sketch, brochure or photo of an existing shed,
fence, gate or pergola provided that the dimensions are included.
• A description of the materials that will be used in the project.
• Photos of the yard(s) in which the structure will be placed. (11 copies of each photo must be submitted).
New construction/additions
• Elevation drawings to scale of each facade indicating proposed alterations or additions. Drawing must clearly depict the
existing building and the proposed changes.
• Site plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposed
addition, location of all exterior ground and roof mounted equipment..
• Description and/or samples of materials to be used.
• Where applicable, drawings and site plan of other improvements such as fences, walkways, lighting, decks, etc.
• Photos (11) of existing structure.
Awnings/ Signs
• Sketch or elevation drawing of the building facade with proposed sign/awning.
• Dimensioned drawing of awning/sign.
• Sample of colors.
Site Improvements/driveway/walkway/AC/Mechanical
Site plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposed
improvements.
Description and/or samples of materials to be used.
Note: AC/Mechanical equipment must be screened by shrubs.
F \.SHA ENG\Historic Preservation BoardVCertificate of Aooronriateness.doc 2.