HomeMy WebLinkAbout150 Edge Water CirCITY OF SANFORD PERMIT APPLICATION
Permit # : 05
JotAdd : I sic
Description:gLWork:
Historic District: vaiueof Work: $ 1 Z sU(,)
Permit Type: Buijdia
a
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 for other than X)
Parcel #:
Owners 1
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Leoder.
Address:
Architect/Eagineer:
Address:
Attach Proof of Ownership & Legal Description)
Pho- .e:?' "7 TJ% - 3 a 3-
State License Number:
Contact Person: Phone:
Phone:
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 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.
OTIC : 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 t 's verification that 11 notify the owner of the
Signattp ofOwner/Agent Date
Print Owner/Agent's Name
j9Vj, h 31
Signature of Notary -State of Florida Date
rty f the requirements of Florida Lien Law, FS 713.
g1o5
Signature of Contractor/Agent
Owner/Agent is Personally 1pown to Me or
Produced iDrh L (o . to O P.
x--p. 5 16-7)05 APPLICATION
APPROVED BY: Bld !oning: _ Initial
Da Special
Conditions: Date
Print
Contractor/Agent's Name 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
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.
I!a I t L. SYYItI p,
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.
aAA , A "<lYn n § 8'ky!
Owner/ lder Signature Date
O M-t' 1(A I 1
Print Owner/Builder Name
Signature of Notary —State of Florida Date
Owner is Personally Known to Me or has
Produced ID
BOUNDARY
SURVEY
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R=263.84' FIELD DATE: OV11/03
L= 45.05' ADDf DRAFTER: BEK
C8= S11'26'17"W 150 EDGEWATER CIRCLE APPROVED: GKB
SANFORD, FLORIDA 32773 SCALE 1' w 30' C=45.00'
LEGAL DESCRIPTKaV' (AS FURNISFIED)
LOT 51, HIDDEN LAKE, PHASE 01 — UNIT M. ACCORDING TO THE PLAT THEREOF,
AS RECORDED IN PLAT BOOK JB. PAGES 77 AND 7E, OF THE PUBLIC RECORDS OF SEMINOLE COUNTY, FLORIDA
SURVEYOR MIFCRMATIOPI DATE I REVISION COORDINATEDBY:
PREPARED FOR
RESIDENTIAL ®,,,
BA81S OF BEARINGS
BEASIMMISMa1TNOI Lr lKO/MLm y Km a
plO M 7I4Y1 T4 m RAT.
CLIENT REFERENCE NO.: OSOM085
LAND SERVICES, INC.
2230 MCKOWEN DRIVE
NORMAN, OKLAHOMA 73072
FAX: (405) 701-1027
PHONE: (405) 701-1100
W WW.RLSNOW.COM
TITLI AFIILIAV". IS.. 1-1
I JOB ORDER NUMBER
asc SURVEYOR'S CERTIFICATE
FILE NUMBER: ABMNDB6
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CNA:C01.1f31NOTACCEIIH.E'Y-PRC'POBfT OF REVERSE CURVE
OYRn®TO AND PON nR OWLUYvl lwa o I HEREBY CERTIFY THAT THE SURVEY REPRESENTED HEREON
MEETS THE MINIMUM TECHNICAL STANDARDS FOR LAND SURVEYS
IN FLORIDA AS SET FORTH IN CHAPTER 61G 17-6, FLORIDA
HEDI SMIM
wATIaIIIDRIDACi
IECuvn FNST TRIE CONC.:CONCAETE FC: PANT OF aIRVATIRE ADMINISTRATIVE CODE, PURSUANT TO CHAPTER 472.027, FLORIDA
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K BELL, PSM 14224 O,. ITA'B OF t DATED: 02112A3 Bw.
erBr FLOOOmNEx. AREAOIm10E THE 1aoYEAR Fi000 PRATE PER FLOODZONEX.ArEA UTVOEREaIIAP FLOOD FLAK MR FIRM.
PANEL 8J Mu.N TIN SURVEYOR U&KSNOG%RANYMMYOTOMMTEYITA)1 TEESN,OTEE ACGTliAL L O E 1 O raRmN.mlcrn, w..aFea THE
ABOVE NFORYATIDN. THE IOCAL FEMA. AGENT BNOILD RNA . HE LOC BE CCWACFORIERfDD
ATN. TEDUAVB
NOT
VALID WITHOUT AN AUTHENTICATED ELECTRONIC SIGNATURE AND
AUTHENTICATED ELECTRONIC SEAL MO
SURVEY 16 PREPARED DSMRED FORTLWEUUSEANOIENEFTrof
nE PNOca IxTEo 1ETIE0II' LDALm TDTNNDPARTESMAY
IDTBE TRANIFERIED d1
At.DrED. FOR ALL
INQUIRIES CONTACT RESIDENTIALLANO SERVICES, INC.
AT 1406) 701-11m