HomeMy WebLinkAbout518 Millonville AvePermit # : 05 ' 1 O (oG
Ipb Address:
description of Work:
Historic District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
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Date: J/ 161-
OO1D r-f, CI—
Galue of Work: $ 2so, DO
Permit Type: Building V Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fiktures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential Commercial
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
of Water & Sewer Lines # of Gas Lines
Plumbing Repair — Residential or Commercial
Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name & Address: A
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Attach Proof of O Tership & Legal Description)
Phone: y c, 7- 3 30 - c? J %
State License Number:
Contact Person: Phone:
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.
3
Signatureof Owner/A gennt Date Signature of Contractor/Agent
Print Owner/Agen't's Name Print Contractor/Agent's Name
3•lb • gnaturef No -State of Florida Date Signature of Notary -State of Florida
20'IPRV P1je c JO ANN M. JOHNSON
k * MY COMMISSION # DD 285622
F P!t '- " arch 2
or Contractor/A ent is _ Personally Known to Me orOwner/A ent t ,.c P on lly + g y
roduced ib , L D I ' OS ' Z g _ Produced ID
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APPLICATION APPROVED BY: Bldg: i Zoning:
Initial A Mhe)
Special Conditions:
Utilities: FD:
Date
Date
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.
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.
OwnerBuilder Signature Date
Punt Owner/Builder Name
AMSSION #DD265622ON
Si afore of Notary—S t of Flo qr oateEXPIRES: March 23 2006FoPFLoaBandedlhruBudgetNotaryServices
Owner is Personally Known to Me or has
Produced ID .,},c.jc._
BQUNDARY SURVEY
LEGAL DESCRIPTION: LOTS 22 AND 23 (LESS THE SOUTHEASTERLY 5 FEET OF LOT
23), BLOCK'3', FAIRVIEW, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN
PLAT BOOK 4, PAGE 71, PUBLIC RECORDS OF SEMINOLE COUNTY, FLORIDA.
THE ABOVE REFERENCED PROPERTY IS LOCATED IN ZONE "X" AREA OF MINIMAL
FLOODING AS PER F.I.R.M. COMMUNITY PANEL NUMBER 12117C0045E, SEMINOLE
COUNTY, FLORIDA. MAP DATED APRIL 17, 1995.
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CERTIFIED TO: ZIMMERMAN, KISER & SUTCLIFFE, P.A.
FIDELITY NATIONAL TITLE INSURANCE
COMPANY OF NEW YORK
OHIO SAVINGS BANK, its successors and/or assigns
ROBERT A. HANSEN & ANNA M. HANSEN
518 MELLONVILLE AVENUE
LEC ND: I.R. -IRON ROD I.P. - IRON PIPE C.M. - CONCRETE MONUMENT FND. - FOUND CONC. - CONCRETE COY. - COVERED ENT. - ENTRANCE S.W. -SIDEWALK SCR. -SCREEN
U.E. - UTILITY EASEMENT I D.E. - DRAINAGE EASEMENT I ESMT. - EASEMENT I P.C. - POINT OF CURVATURE I P.T. - POINT OF TANGENCY I P.O.B. - POINT OF BEGINNING - DELTA
R = RADIUS I L = LENGTH T = TANGENT CHO. = CHORD I BRG. - BEARING P.O.C. = POINT OF COMMENCEMENT I P.O.L. - POINT ON LINE I P - PLAT I M - MEASURED D =DESCRIBED
C.L.F. = CHAIN LINK FENCE COR. - CORNER BLK. = BLOCK TYP. - TYPICAL A/C - AIR CONDITIONER N - NAIL k DISC ENCL - ENCLOSURE SAN. - SANITARY N =NORTH
PROPERTY CORNER ( - FOUND CONCRETE MONUMENT
S - SOUTH I E - EAST I W - WEST I P.C.P. - PERMANENT CONTROL POINT 4P) - FOUND PRqnTY CORNER I ( - SET
B.O.B. - BASIS OF BEARING
NOTES: (1). BEARINGS ARE BASED ON RECORD PLAT. (2). THE SURVEY SHOWN HEREON WAS SURVEYED BY THE LEGAL DESCRIPTION PROVIDED BY THE CLIENT.
3). ROOF OVERHANGS AND FOOTERS HAVE NOT BEEN LOCATED. (4). NO IMPRCVEMENTS OR UNDERGROUND UTILITIES HAVE BEEN LOCATED EXCEPT AS SHOWN.
5). THIS SURVEY IS NOT VAUD WITHOUT EMBOSSED SEAL. (6). THIS SURVEY IS NOT VAUD FOR ANY REAL ESTATE TRANSACTIONS 90 DAYS BEYOND THE FINAL
SURVEY DATE SHOWN. (7). THE SURVEYOR HAS NOT ABSTRACTED THE LANDS HEREON FOR EASEMENTS OR P,;GHTS-OF-WAY OF RECORD. (5). THERE MAY BE ADDITIONAL
RESTRICTIONS THAT ARE NOT RECORDED ON THIS PLAT THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. (9) ALL BEARINGS / ANGLES AND DISTANCES
ARE PLAT AND MEASURED UNLESS NOTED OTHERWISE.
I. HEREBY CERTIFY THAT THIS MEETS OR EXCEEDS THE
MINIMUM TECHNICAL ST ADS FORTH BY THE FLORIDA
BOARD OF LAND SUR OR ANT TO SECTION 81G17,
PREPARED FOR: -------._.-_.___,_._._-_.____..
ROBERT A. & ANNA M. HANSEN
LOT SURVEY DATE:
FOUNDATION DATE:
FINAL SURVEY DATE: 1 / '/ O s
FLORIDA ADMINSTR VE URSUANT TO SECTION PREPARED BY:
DRAAVN DATE., 11 s / O D ` 427.027, FLORID STA
SCALE: ROB DEFOOR & ASSOCIATES, INC.
PAGE 1 OF 10Z- .. Cos,,CHARLES
P.O. BOX !?63 ,. APOPKA,.F" 3270.4 / (407) 880-9G11 / 427 KNOLL TREE SJp.1. TV; - ,.
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