HomeMy WebLinkAbout403 San Marcos Ave (3)Permit #: 0 (.0) a& 3
Ob Address: t.
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Description of Work:
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Historic District:
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Zoning:
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CITY OF SANFORD PERMIT APPLICATION ^\ -1)
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Vlue of Work: $ 4?00
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Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
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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 I
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 #:
Of Name & Address:
V A,-,-%- C_> — —
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer
Address:
Attach Proof
State License Number:
Contact Person: Phone:
Phone:
Fax:
Application is hereby made to obtain a pennit 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. 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: 1 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.
NOTI E: 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 t at I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
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Signature f w r/A Dale Signature of Contractor/Agent
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Print Owner/Agent's Name Print Contractor/Agent's Name
Signature of Notary -State of Florida Date Signature of Notary -State of Florida r
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DEBBIE BLANTON
Owner/Age I i AJp P rsondily KnoWi6Mppf166491
Prod uc ID r j:•rI1R,ES: Fart-T5,
FL Not¢^ D—' c nM. oc. Co.
APPLICATION APPROVED BY: Bldg: Zoning:
Contractor/Agent is
Produced ID _
iI
Date
Date
Personally Known to Me or
Date) (Initial & Date) (Initial & Date)
Special Conditions:
O1
Initial & Date)
CITY OF SANFORD BUILDING DIVISION
OWNEWBUILDER 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 I 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,1 7(-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.
Flint Owner/Builder Name
F/;J_Jo y, CEf?31E ELAN TON
fOv # DD 18rr391SignatureofNotary —State of Florida Date
r t...rr : Febn:aryc5. _C07
1 `1: wt'OTA1,V F: N.;c/ Dkcccrtl.'L^,&oe. Co.
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Owner is Personally Known to Me or has
Produced ID
PURCHASER'S AFFIDAVIT
BEFORE ME, the undersigned authority, personally appeared W. Fernando Escobar and Ana
Gabriela Martinez, husband and wife, who, being duly sworn according to law, depose and say as
follows (as used in this Affidavit, the terms "Affiant" and "Affiants" shall include all parties executing this
Affidavit):
1. That Affiant
a) Has agreed to purchase from (Seller); Georgia M. Dunwoody, a single person and Fred
E. Brooks, a married man, and
b) Will execute a mortgage to Pinnacle Financial Corporation d/b/a Tristar lending
Group encumbering the following described property:
LOT 3 AND THE NORTH 6.21 FEET OF LOT 4, BLOCK 3, FAIRVIEW, ACCORDING TO THE PLAT THEREOF
AS RECORDED IN PLAT BOOK 4, PAGE 71, PUBLIC RECORDS OF SEMINOLE COUNTY, FLORIDA.
2. That, to the actual knowledge of Affiant, there are no parties who have any interest in said property
other than the Seller and there are no facts actually known to Affiant which could give rise to a claim
being adversely asserted to any of said property, and Affiant has been delivered exclusive possession of
said property, free and clear of the rights of any tenant or other occupant, EXCEPT:
NONE
3. That, other than as shown in Item 1, Affiant has entered into no agreement, contract or
commitment for the sale, lease, mortgage, option or creation of any other encumbrance of said property,
EXCEPT:
NONE
4. That there are no unrecorded easements or rights -of -way affecting all or any portion of the property
to the actual knowledge of the affiant.
5. That, to the actual knowledge of Affiant, there have been no improvements, repairs, additions or
alterations performed upon said property within the past 90 days for which payment has not been made
in full; that the Affiant has not entered into any agreement or contract with any party for the furnishing
of any labor, services or material in connection with any improvements, repairs, additions or alterations
within the past 90 days, and that there are no parties actually known to Affiant who have any claim or
right to a lien for services, labor or material in connection with any improvements, repairs, additions or
alterations on said property.
6. That there are no actions or proceedings now pending in any state or Federal Court to which the
Affiant is a party including, but not limited to, proceedings in bankruptcy, receivership or insolvency, nor
are there any judgments or liens of any nature which constitute or could constitute a charge or lien upon
said property.
7. That there are no matters pending against the Affiant that could give rise to a lien that would
attached to the property between the disbursing of funds and the recording of the interest to be insured,
and that the Affiant has not and will not execute any instrument that would adversely affect the title or
interest to be insured.
Page 1 of 2
1016 - 1078328
Boundary
Survey
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GRAPHIC SCALE LOT 2 BLOCK 3
BLOCK 3
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FND I/2" IRON FND 1" IRON
w ` ROD NO NUMBER PIPE NO NUMBER
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73
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A/C C_ < -y LOT 15
w 101* LOT 3 ? BLOCK 3
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d O GRIM: _ 34.6' _
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N. 6.21 FEET OF LOT 4, BLOCK 3 _
F/ FND I"CIRON R N89'59'22"E 111.00' 1 PPIPE INORFROM10ER
PIPERENNNDER OF
T 4 LOT 16
BLOCK 3 BLOCK 3
NOT INCLUDED
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bFNO 1/2" IRON
ROD NO NUMBER
POL OF LOT 5
BLOCK 3
RLS # 06-01-2202
CLIENT 4: 1016-1078328
ADDRESS
403 SAN MARCOS AVENUE
CONCRETE FIELD DATE. 2/1108
DRAFTER ENS DRAFTING
SANFORD FLORIDA 32771
APPROVED. MAC
LCUAL DESCRIPTIONIAS FURNISHED) SCALE 1" . 30' LOT
3 ANO THE NORTH 6.21 FEET OF LOT 4. BLOCK 3. FAIRVIEW, ACCORDING TO THE PLAT THEREOF. AS
RECORDED IN PLAT BOOK 4 PAGES 71 OF THE PUBLIC RECORDS OF SEMINOLE COUNTY. FLORIDA. 9ASIS
OF BEARINGS BEARINGS SHOWN HEREON ARE RARFI-) ON THE FASTER[ Y I INF OF SAID PROPERTY FIFING N 00'00'00" E ASSUUED COORDINATED
BY. P.
MAPPNG
SE VICES, RESIDENTIAL ` 1 >
I INC.
2908
LAKEVIEW DRIVE, LAND SERVICES, wc. SUITE
128/132 r• •'•(,yf,7Lt! CASSELBERRY,
FLORIDA 621 24TN Avenue S.W. 32730
NORl4AN, OKIAHOMA 7wse s TEL: (
407)834-1206 FAX: (406) 701-1001 , HONE (
405) 701-1100 WWW.
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