HomeMy WebLinkAbout104 Cedar Height CtPermit # : v
Job Address: b\
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
9 3 Date:
Zoning:
Permit Type: Building Electrical
Electrical: New Service — # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets _
Occupancy Type: Residential Commercial
Construction Type: # of Stories:
G., A
Value of Work:
Mechanical Plumbing Fire Sprinkler/Alarm Pool
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Cale. Required)
of Water & Sewer Lines # of Gas Lines
Plumbing Repair — Residential or Commercial
Industrial Total Square Footage:
of Dwelling Units: Flood Zone. (FEMA form required for other than X)
Parcel #:
1 ` 1 (
Attach Proof of Ownership & Legal Description)
Owners Name & Address: W CAN, - Amer )u
W LCd1MZ t 4-,Jq+ Gr - T(J(.4/4 PL 12%%) Phone: 1107- 3UZ- V?rY
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Contact Person:
State License Number:
Phone:
Fax:
Phone:
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 of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. 1 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 the ay be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
Acceptance :firm a ficatHionthat 'that ill notify the owner of the property of the requirements of Florida Lien Law, FS 713.
Signature of Owner/Agent Dale Signature of Contractor/Agent Date
PeAnalure
r/Agen Name
Sif Notary- a oFFierad Date
rt, DEBBIE BLANTO
V — :O ' M r COMMISSIO"
I, EXPIRES: FPf91
Owner/Agent is ersonalCr/
APPLICATION APPROVED BY: BI
i rat
Zoning:
B te)
Special Conditions:
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, W' 4,411% /Q440/ 0"F- , 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.
Owner uilder Signature Date
i 7 _4_. j 0_1 —tQ
Print Owner/Builder Name
f \ Dc dlc BLANTON
MY C SS'ON # W lW91
Signature of Notary=State of Flohdi --Date
W/Wvw.1.•v iv vim%
Owner is Personally Known to Me or has
Produced ID
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HEREBY CERTIFY, TIIAi 11115 UOUNDAItY SURVEY, SUOJCCT TO TIIC SUpVCYOR•S NOTE CONTAINEDHEREONMELTSTHEAPPLICAULCMINI16UMTECHNICALSTANOAROS- SET FOIi II DYTHErI,ORIUA DOAI(D OF I`ItOFCSS10NAl 5VISYfYO!(5 AND MANICIIS IN (:IIAl-.10 6IC17-G, FLORIDA AUMINISIItAIIVC COLIC PURSUANTTOCHAPTER472.C'7, STA'i FLORIDA UT;. S. wf' /
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JAMES
JAY JILES pSM JU7 4tIN
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TEU 14: P2 FAX 407 786 3103 REGENCY PROF IIGNT 10001/001
The Preserve at hake Monroe
I10MEOWNEWS ASSOCIA710N, INC.
1'E TION A PLICA N
OWNEM NAUM, j„) : i e, _ 51. n L v.i DAT& $ t l0 s"
ADDRESS:
07. 302 - Y4SY
IN M-1AIL, 'TYPE OF ALT'BMTION AND dATERIALS• TO BE USED:
C<< fir_
QF MORE SPACE IS REQUnM, PLEASE A1't'ACI4 TO TMS FORM THANK YOU)
An application roquwUng approval for any alteration wbieh ooaus outside the exterior walls of the
building and is, therefore, t ommon clement, guirr pi ACCOMPAIIMb BY A _M TCH
INDICATING ON YOU1t LOT• SURVEY: LOCA'I'YON, SI7,E An TYPE OF CONSTRUCTION
AND OTHER FERTINE-NT INFORMATION AS MAY BE NFCFSSARY
If approval is gra W4 it is not to be construed to cover approval of any County or City Code ltoquiremeats.
A building permit from the appropriate building department is needod on most property aluntlaw and/or
improvements. The Ard6tcaml Review Board sball have no liability or obligation to determine whctha
such improvwneat, alteration and addition comply with any applicable law, rule, regulation. code or
ordinance.
As a condition precedent to granting approval or any request for a change. alteration or addition to an
existing basic structurc, the applicant, chair hires and ms'tgm thereto, bcmby assume sole responsibility for.
the repair, maintenance or replacement of any such chango, alteration or addition. IT IS UNDERSTOOD
AND AGREED THAT Tire Pros" at IAke Monroe IIomeowners' Association, Iuo. AND CENTEX
HObW ARE NOT REQUIRED TO TAKE ANY ACTION TO REPAM REPLACE OR MAINTAIN
ANY SUCH APPRIOVED CHANGE, ALTERATION OR ADDITION, OR ANY STRUCTURE OR ANY
OTHBRPROPER.W. THE HOMEOV MM AND ITS' ASSIGNS ASSUM>rS ALL RESPONSIBILITY
AND COST FOR ANY ADDITION ORCHANOE AND ITS FUTURE UPKEEP AND MAINTBNACE.
DATES: t 0 OVVNSR'S SIGNATURES;
ACTIMOD
THE ASSOCIATION:
DAAPPROVED: -MOT APPROVED:
SEP 0 6 Z005
AT' n- FOIL THE
Areldtamnal Review Board $y.
X/ `"
14
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r-,
Regency ProWtonal Management
407 Wekiva Springs Rd. Ste. 205
Longwood, FL 32779
407-786-51OW407-796-5105 (fax)
Ait., CIA. -
Sy4-
S E P 2 7 2005
JAN 05,2006 03:45P REGENCY PROFESS 407 786 5105 page 1