HomeMy WebLinkAbout1011 W 12 StPermit No.:
CITY OF SANFORD PERMIT APPLICATION
Date:
Job Address: -MCI ln/EsY
Permit Type: Building Electrical Mechanical Plumbing Fire Alarm/Sprinkler
Description of Work:
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Additional Information for Electrical & Plumbing Permits
Electrical: Addition/Alteration _Change of Service _Temporary Pole _New AMP Service (# of AMPS )
Plumbing/Resideutial: Addition/Alteration New Construction (One Closet Plus Additional)
Plumbing/Commercial: Number of Fixtures Number of Water & Sewer Drainage Lines Number of Gas Lines
Occupancy Type: _Residential Commercial _ Industrial Total Sq Ftg: Value of Work: $ UDr>
Type of Construction: Flood Zone: Number of Stories: Number of Dwelling Units:
Parcel No.: (Attach Proof of Ownership & Legal Description)
Owner/Address/Phonw, /(5/&- L t464e �R TL���� G ZL
Contractor/Address/Phone:
Contact Person:
Tidi.Holder (If other than Owner):
Address:
Bonding Company:
Address:
Mortgage Lender:_
Address:
ArchiteatEngineer
Address:
State License Number:
Phone & Fax Number:
Phone No.:
Fax No.:
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 regords 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 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
Signa a of Owner/Agent Date
,- 1lYs ES
t wner/Agent's. e
gn a of Notary -State of Florida Date
WR f,MIAS.0 # �
EVIREVOWbOl 1Z 05
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personallyown to Me or Contractor/Agent is Personally Known to Me or
oduced IDL , e Produced ID
APPLICATION APPROVED BY: Date: U�
Special Conditions:
CITY OF SANFORD BUILDINGDIVISION
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 presun:je that.
you built or substantially improved it for sale or lease, which is a violation of tlus exemption. You roay
not hire an unlicensed person to act as your contractor or to supervise people working on your buildling. 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, 5 ES `24411,
gS , do hereby state that I am qualified and capable of performing the
reque ted 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 is Personall , Known to Me or has
Produced 1D F117L Sad Ri -) _Lw, (-(U%0
Owner uilder SignatureDatea
o,
y
X
Print ner/Builder Name,
m m
N T
s...
S19-na re of Notary—State of Florida Date
.Z C iii
Owner is Personall , Known to Me or has
Produced 1D F117L Sad Ri -) _Lw, (-(U%0
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DEMOLITION
'Building Division Acknowledgement
A. Permit Application
B. State Forms
C. State Statutes/Contractor Licensing
Public Works Acknowledgement
A. Sidewalk Closing
B. Street Use/Closing
1. Walkways — Protection — Width
2. Barricades — Protection — Width
3. Fencing — Protection — Width - Height
4. Curb Protection/Sidewalk Protection/Street
5. Storm• Sewer Protection
C.' Dust Control
Police Department Acknowledgement
A. -Traff c Control .
B. Crowd Control/Security
Utility Department Acknowledgement
A. Water, Sewer — Capped off, Sealed
B. Water for Dust Control (Meter)
Engineering & Planning Acknowledgement
A. Historic District
B. Zoning Issues
Address of Job: \0\\
Additional Comments:
012
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04/03/2003 09:52 4073022540 SANFORD PD
S—ecd-00-S jcb/VM FROM
DEMOLITION
Building Division Acknorviedgement
A. Permit Application
B. State Forms
C. State StatutcafCOntractor Uc ening
Public Works Acknowledgement
A. Sidewalk Closing
B. Street Use/Closing
1. Walkways - Protection .- Width
2. Barricades - Protection - Width
3. Fencing - Protection - Width - Height
4. Curb Protec tiOWSidewalk Protection/Street
5. Storm Sewer Pratection
•.�. Aust Control
Police Department Acknowledgemu+t
A. Traffic Ccomral
B. Crowd Con"Llsewrity
Utility Department Acknowledgement
A. Water, Sewer - Capped WX Sealed
B. Water far Dust Control (.Neter)
PAGE 01
P. f
Engineering & Planning Acknowledgement
A. Historic District
B. Zoning Issues
AcldrM Of Joh:
Additional Comments:
DEMOLITION
Building Division Acknowledgement
A. Permit Application
B. State Forms
C. State Statutes/Contractor Licensing
Public Works Acknowledgement
A. Sidewalk Closing
B. Street Use/Closing
1. Walkways — Protection — Width
2. Barricades — Protection — Width
3. Fencing — Protection — Width - Height
4. Curb Protection/Sidewalk Protection/Street
5. Storm Sewer Protection
C_ .Dust Control
Police Department Acknowledgement
A. 'Traffic Controi
B. Crowd ControUSecurity
Utility Department Acknowledgement
A. Water, Sewer — Capped off, Sealed
B. Water for Dust Control (Meter)
Engineering & Planning Acknowledgement
A. Historic District
B. Zoning Issues
Address of Job: \�\
Additional Comments:
DEMOLITION
Building Division Acknowledgement
A. Permit Application
B. State Forms
C. State Statutes/Coniractor Licensing
Public Works Acknowledgement
A. Sidewalk Closing
B. Street Use/Closing
1. Walkways — Protection — Width
2. Barricades — Protection — Width
3. Fencing — Protection — Width - Height
4. Curb Protection/Sidewalk Protection/Street
S. Storm. Sewer Protection
C_ Dust Control
Police Department Acknowledgement
A. Traffic Control
B. Crowd ContrOUSecurity
Utility Department Acknowledgement
A. Water, Sewer.— Capped off, Sealed
B. Water for Dust Control (Meter)
Engineering & Planning Acknowledgement
A. Historic District
B. Zoning Issues
Address of Job:
Additional Comments:�\'`�
3
Seminole County Property Appraiser Get Information by Parcel Number Page 1 of 1
PARCEL DETAIL
1 ''
RA
W.12TH
2003 WORKING VALUE SUMMARY
GENERAL
Value Method: Market
Parcel Id: 25-19-30-511-0000-0020 Tax District: Si -Number
SANFORD
of Buildings: 1
Depreciated Bldg Value: $15,427
RAINES ULYSSES &
Owner: MARY Exemptions:
Depreciated EXFT Value: $0
Address: 25 GABRIEL AVE
Land Value (Market): $8,010
City,State,ZipCode: MAITLAND FL 32751
Land Value Ag: $0
Property Address: 1011 12TH ST W
Just/Market Value: $23,437
Subdivision Name: STENDIFORDS ADD
Assessed Value (SOH): $23,437
Dor: 01 -SINGLE FAMILY
Exempt Value: $0
Taxable Value: $23,437
SALES
2002 VALUE SUMMARY
Deed Date Book Page Amount Vac/Imp
2002 Tax Bill Amount: $481
CERTIFICATE OF TITLE 03/1984 01535 1681 $100 Improved
2002 Taxable Value: $22,701
Find Comparable Sales within this Subdivisia
LAND
Land Assess Method Frontage Depth Land Unit Land
LEGAL DESCRIPTION
Units Price Value
LEG LOTS 2 + 3 STENDIFORDS ADD PB 1 PG 110
FRONT FOOT & 100 117 .000 90.00 $8,010
DEPTH
BUILDING INFORMATION
Bid Num Bid Type Year Bit Fixtures Gross SF Heated SF Ext Wall Bid Value Est. Cost New
1 SINGLE FAMILY 1935 3 1,429 1,144 SIDING AVG $15,427 $32,478
Appendage / Sgft UTILITY UNFINISHED / 49
Appendage / Sgft SCREEN PORCH UNFINISHED / 77
Appendage / Sgft ENCLOSED PORCH UNFINISHED / 63
Appendage / Sgft SCREEN PORCH UNFINISHED/ 96
NOTE: Assessed values shown are NOT certified values and therefore are subject to change before being finalized for ad valorem tax
purposes.
"* If you recently purchased a homesteaded property your next ear's property tax will be based on Just/Market value.
http://www. scpafl-orglpls/weblre_web. seminole_county_title?parcel=25193051100000020,... 4/10/2003