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HomeMy WebLinkAbout1705 W 14 StAro FEE CITY OF SANFORD PERMIT APPLICATION r , 1 Permit # :yS — S \ Job Address: /7oS W. /yO rreeen Date: 24 -os Description of Work: SelW Co 05r %n4 104F' Historic District: Zoning: Value of Work' $ // 0 • 00 Permit Type: Building Electrical X Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical: New Service — # of AMPS 7,00 Addition/Alteration Change of Service X TemporaryPole 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 M (Attach Proof of Ownership & Legal Description) Owners Name &AAdddrress: I 9 n f lS / ?o.$ /f/• / • eX[ Pt IQy7V a 3Z7 7/ tt Phone: Contractor Name& Address:SQ.47-d E/eG%/•%C_ ZS-ZZ41-/C Z+'+ _5gL/C o a/& 7Z773 State License Number: EC .*13tV/9" Phone & Fax: //07- 32Z-/5ZL Contact Person: .770A 1210Rxf Phone: t1Z7' V/7'0W 7 Bonding Company: /d/04 ' Address: Mortgage Lender: Address: Arcbitect/ Engineer: 19• 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 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 of permit is verification that I will notify the owner of the property of the requirements Of Florida Lien Law, FS 713. i rl /7 Signature of Owner/Agent Print Owner/Agent's Name Date Signature of Notary -State of Florida Date Owner/ Agent is - Produced ID Personally Known to Me or APPLICATION APPROVED BY: Bldg: Initial & Date) Special Conditions: Zoning: ZG - oS' Date Vfs`" J- P ' ontractor/Agent' ame Signa tar of Notary -State of Florida Date JJt Poe,,o FLORENCE A. DE GRAM= MY COMMISSION # DD 16421;1 x S: November 12, 20N. Contra t is Me Meor Prodilcte ID Initial & Date) Utilities: FD: Initial & Date) (Initial & Date) f: N ; M_t r 1 i O S SQ f CITY OF SANFORD PERMIT APPLICATION Permit # : Date: Job Address: V S IN Description of Work: Historic District: Zoning: Value of Work: S µ Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical: New Service — # of AMPS 45D_ 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 #: Attach Proof of Ownership & Legal Description) Owners Name & Address: Phone: Contractor Name & Address: State License Number. Phone & Fax: Bonding Company: Address: Mortgage Lender: Address: Architect/Engineer: Address: 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 ofthe 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 of permit is verification that I ill notify the -owner of the property of the requirements of Florida Lien Law, FS 713. Si nature of IV ner/Agent Date Signature of Contractor/Agent of Notary -State of Florida Date DEBBIE BLANTON MY COMMISSION # DD 1MM91 ge£ir fiaic BditTiP3i 1134>414VYn to le or APPLICATION APPROVED BY: Bldg: Initial & Date) Special Conditions: Zoning: Print Contractor/Agent's Name Signature of Notary -State of Florida Contractor/Agent is Produced ID _ Utilities: Initial & Date) or Date Date Personally Known to Me or FD: Initial & Date) (Initial & Date) 4. 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 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. li 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. 1, , 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. OwnerBui er Signature Date Print Owner/Builder Name DEBBIE BLANTON MY COMMISSION* DD 1W91 IleW=8ll5&I,Knw t twMe r has JOTARY FL Notary Discount Assoc. Co. CITY OF SANFORD BUILDING DIVISION OWNERIBUILDER AFFIDAVIT ELECTRICAL & FIRE ALARM SYSTEMS An owner of property making application for permit, supervising, and doing the work in connection with the construction, maintenance, repair, and alteration of and addition to a single-family or duplex residence for his or her own use and occupancy and not intended for sale or an owner of property when acting as his or her own electrical contractor and providing all material supervision himself or herself, when building or improving a farm outbuilding or a single-family or duplex residence on such property for the occupancy or use of such owner and not offered for sale or lease, or building or improving a commercial building with aggregate construction costs of under $25,000 on such property for the occupancy or use of such owner and not offered for sale or lease. In an action brought under this subsection, proof of the sale or lease, or offering for sale or lease, of more than one such structure by the owner -builder within I year after completion of same is prima facie evidence that the construction was undertaken for purposes of sale or lease. This subsection does not exempt any person who is employed by such owner and who acts in the capacity of a contractor. For the purpose of this subsection, the term "owner of property" includes the owner of a mobile home situated on a leased lot. To qualify for exemption under this subsection, an owner shall personally appear and sign the building permit application. State law requires electrical contracting to be done by licensed electrical 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 electrical contractor even though you do not have a license. You may install electrical wiring for a farm outbuilding or a single-family or duplex residence. You may install electrical wiring in a commercial building the aggregate construction costs of which are under $25;000. The home or building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have wired yourself within 1 year after the construction is complete, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your electrical contractor. Your construction shall be done according to building codes and zoning regulations. It is your responsibility to make sure that people employed by you have licenses required by state la-%v and by county or municipal licensing ordinances. 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. 4 m X'"_ Owner/Buil& Signature Date Print Gvvner/Builder Name Signature of Notan--State of Florida Date Ow a M,1 IybriCi ftl 9xs M or has Pro UC'IR[S: Februa 1'3NOTARY FL Y Diacourn A.+aoe. Co.