HomeMy WebLinkAbout1021 W First StCITY OF SANFORD PERMrr APPLICATION
zSPermit # : l.S ' i (P y3 Date: Lo
Job Address: 10 Z t W E"' I Q S T 5-C q eeT
Description of Work:
Historic District:
P L A C-C X 67r nrc-Ker F ucE
Zoning: Value of Work: mom
Permit Type: Building x 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 X Industrial Total Square Footage: 1 31 S
Construction Type: # of Stories: I- # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: Z 5 ' % - 3o SA " 0 77.0 0 — 0 c) Z At (Attach Proof of Ownership & Legal Description)
Owners Name & Address:
rL1.144aJ T V ^I' V-401-AS 40. W l L-K Phone:
401 3 ZS - S o 0 3 Contractor
Name&Address: W&te TD 6 1: N0013E IL 6fDNPhone &
Fa:: Bonding
Company: Address:
Mortgage
Lender: N Address:
Architect/
Engineer: Address:
State
License Number: Contact
Person: Phone: Phone:
Fa::
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
ore 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
rust 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 `
t i 'fi on at I will n the owner ofZ
e
rperty
of
the requirements of Florida Lien Law, FS 713, Signature
of Owner/Agent •ji
Date.
Signature of Contractor/Agent Date Prim
er/Agent's Name Print Contractor/Agent's Name Si -
is o on Date Signature of Notary -State of Florida Date DEBBIE
BLANTON COMWISSION #
DD t8MI XPIRES:
February 25, 2007 4/&APer q $y&grA A ud"r Contractor/Agent is — Personally Known to Me or FJ
L (o/Ial - lo3Y- S 3- Prodaeea
ID APPLICATION
APPRME*A dg:1 V 7 Anin . O I hilities: FD: Initial &
Date) (Initial & D ) (initial & Date) (Initial & Date) Special
Conditions: q
00
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 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,
or ce building co es, and zoning regulations.
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.
41,4 3 LZ, -
Owner/Builder Signs a Date
Arc No[ kS ,4r2ccl/c/G
Print Owner/Builder Name
Signature of Notary —State of Florida Date
DE961E SLANTON
Owner isEID y I nowv_n1% VI@
c::rr Druary 25, 2007Produced
FEET OF THE EAST 167. 44 FEET OF LOT 2, BLOCK Z, TO WN OF SANFORD, AS RECORDED IN PLAT
113, PUBLIC RECORDS OF SEMINOLE COUNTY, FLORIDA. LESS AND EXCEPT THE SOUTH 17.7 FEET.
STATE ROAD _46 _ _ _ _
WEST I s t STREET
N 9000'00" E
C
R6C 6/B l R 6700 SZT J R
100 11
1. 0 ON
IO TO
POPLAR AVE
N
I NI
3J DIRT DRIVE L°+
NOT LOCATED pp 17.0
i;
eTO
0 r,m 1.0
5
h
e
b
W
33 1.
b
N r0 CONE
ON UNS
67.00
DIRT DRIVE
NOT LOCATED
1H_0
9
J67.44
7 OiT l
0.3 OFFI 4 „I
S6T I R 6700 SL7 L R
N 895537" W
E OF PAVEAMYT
2n d STREET
UMUJLINMLTLK—J)UU I I CSC WALKER INC.—LAND SURVEYOR
ULO Ho
NOTES
PLAT I. THE UNDERSIGNED DOES HEREBY CERTIFY THAT THIS SURVEY MEETS THE MINIMUM TECNNICN
MON STANDARDS SET FORTH BY ME FLORIDA BOARD OF PROFESSIONM. LAND SURVEYORS IN CHAPH
I.R. PPEIONROO 61C17-6 FLORIDA ADMINISTRATIVE CODE PURSUANT TO CHAPTER 472-027. FLORIDA STATUTES
C.M. C C.— M..—T 7, UNLESS EMBOSSED WITH SURVEYOR'S SEAL. THIS SURVEY IS HOT VA D AND 15 PRESENTED TO,
SETR[GIR
I.
REcO""IT E. 6r10 PURPOSES ONLYFROM TITLE INFORMATION FURNISHED TO TIE SURVEYOR. THEREJ. HIS SURVEYINFORMADONLWASPREPARED P.
CIIING
O.C. vgNT OF C[WI 1.1MExr MAY BE OTHER RESMICTIONS OR EASEMENTS THAT AFFECT THIS PROPERTY. CF
T 4, NO UNDERGROUND IMPROVEMENTS HAVE BEEN LOCATED UNLESS OTHERWISE SHOWN. R.
COTNNL A dsC M-wAx S. THIS SURVEY IS PREPARED FOR ME SOLE BENEFIT OF MOSS CERTIFIED TO AND SHOULD NOT RELIED
UPON BY ANY OTHER ENTITY. d[
MN. MENT
m — [
BREVARD
CD[.NrY OFFICE 1113
5. U.S. I B. DIMENSIONS SHOWN FOR THE LOCAOON OF IMPROVEMENTS HEREON SHOULD NOT BE USED TO U_
R. WD. IO. FUFY CIIANFINK RNC[ MOOD
rEI ROCR[
CDGE. R J]!
JJ J71-6J1-1o37 RECONSTRUCT
BOUNDARY UNES. 7.
ELEVATIONS, IF SHOWN. ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM Or ISYV, UNLESS c
iJ. COxdl[
7[ naoL PpNr
a uwvAlre[ J71-
6J6-1I04 (FAX) OiHCRwISE NO tCD. THE
SOUTH RAW LINE SR 46 r.
iB
rover
Ix TA7wac, LB
5710 6. BEARINGS BASED ON _ S 90'00'00' £ A/
C eii
eP[Mallo uE a 117T coweTrox[
A S
5A BEARING BCIN P.
U. Y RDE •.1-1 UdITR3 • d[MxAR [Sur RIduS