HomeMy WebLinkAbout2618 Marshall Ave (2)CITY OF SANFORD PERMIT APPLICATION ]
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Permit # : 0 -) ' Date:
Job Address: c9 U 19i n k t j /,.at ri L-c i + z 79t Yam/ i j?
Description of Work:
Historic District: 0 Zoning: Value of 5. 06 .de),
Permit Type: Building 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 Cale. 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 %C Commercial Industrial Total Square Footage:
Construction Type: _ # of Stories: _J__ # of Dwelling Units: Flood Zone: (FEMA form required for other than IO
Parcel #:
Owners Name & Address:
Contractor Name & Address:
A
Attach Proof of Ownership & Legal Description)
Phone: 41cq` 3 t,
State
License Nd'mber. 17 Phone &
Fax: 7 3 J ' 3 T Contact Person: Lc t=n l l Phone: tic'? Bonding
Company: _ Address:
Mortgage
Lender: _ Address:
Architect/
Engineer: Address:
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. 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. Acceptan ;
p it is venfica Est' will notify the owner of the property of the requirements of Florida Lien Law, FS 713. r -
ature
of Owner/Agent to Signature of Contractor/Agent Pri
r/Agent's Name Signatur
Date DESBIE
BLANTON My (
ti,d,A41JSION # DD 188491 Own
gen ` ori ll 9 fiftcqo2W 7 l Prucbw
LF. Print
Contractor/Agent's Name Signature
of Notary -State of Florida Date Contractor/
Agent is Produced
ID _ APPLICATION
APPROVED BY: Bldg JZonmg: Utilities: htitial &
Date) (Initial & Date) Special
Conditions: 1
Personally
Known to Me or FD:
initial &
Date) (Initial & Date) a..-_.____
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CITY OF SANFORD BUILDING DIVIS
OWNER/BUILDER AFFIDAVIT
CONSTRUCTION CONTRACTIN i. 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 responsibilityfor 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. 11
I,
rl Wl/-''t ; 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. jr/
Builder Signature Date Print
Owner/Builder Name A,
r /03_/ of N
8ri9da Dateig
Y ;SI
D84R4O1 EXPIRES: February25,
2007 wr fs PerstrnAlYto
Me or has Produced ID 1, '