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HomeMy WebLinkAbout111 W 12 St (2)Permit # : © Iq 2,6r) Job Address: 6u / Zm CITY OF SANFORD PERMIT APPLICATION I%— Date: �6 - o1 .3 —O 33 Description of Work: Q i r QQ ,t) (,Vood 2ow1( cl Aurae-' ` r�-rts�r TC �!/t�U V TWO t� Historic District: C e S Zoning: Value of Work: $ J z), If 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 Calc. 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 Commercial Industrial Total Square Footage: Construction Type: #`of/�Stoo+ries: j� j C r # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #:— "I -3o-. A G —' 1/�T 6 '1� j -006o 6 V (Attach Proof of Ownership & Legal Description) Owners Name & Address: Be 44v A. A 11 P ( _ _ Contractor Name & Address: Phone: W0 -7), 3A,3 -3 z State License Number: Phone & Fax: Contact Person: Phone: Bonding Company: Address: Mortgage Lender: Address: ArchitecUEngineer: 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 addj on 0 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, an they may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. is verification /hat I wilynggAthe owner of the property of the requirements of Florida Lien Law, FS 713. ature f / gent Date Signature of Contractor/Agent Date PnntOwr/.Agents,Name .,. Print Contractor/Agent's Name uac iit ,. ��I4>IJ 91 ., i nature ofyl�`ota C�r�a�te g� ��-, � � Date Signature of Notary -State of Florida Date r0� 5or.di�c; r t,rlt�ttJ� rjc .i_s ,O /Agent is _ Person ly nown to Me or `� // `l'lvJ Contractor/Agent is Personally Known to Me or Produced IDS—'� 1`44` Produced ID r AW APPLICATION APPROVED BY: Bldg: Zoning: (Initial 8 ate) Special Conditions: (initial & Date) Utilities: FD: (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: svpe7 vision themselves of all work not performed by licensed contractors, when building or improving (arm outbuildings or one -family or two-family residences on such property for the occupancy or use or 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. Pie 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 preswr, that you built or substantially improved it for sale or lease, which is a violation of this exemption. . not hire an unlicensed person to act as your contractor or to supervise people working on is your responsibility to make sure that people employed by you have licenses required by stat,. lav Sr,.d 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 th e ployee, all as prescribed by law. Your construction must comply with all applicable laws, or es, building codesjand zoning regulations. ereby state that I am qualified and capable of performing the ved with the permit application filed. >ume full responsibility as an Owner/Builder Contractor, and will personally supervise all work by law on the permitted structure. .03 Signature Date Print Owner/Builder Name S 2- S ,nature of Notary—Stat of-lorida Date Jd�/tr`"d4ER tu�svw�N !I I, * MY OOMIA!SS # OG n� FQ8 P Ener (l 11) _ oL `'�K[ ,C'�o,_ or has 4 RAY VALDES _ --- TAX CERTIFICATE....SALE OSi B%2003 TAX, ILL 2002 REAL E.ST.ATE NUNIDER 006779 SEMINOLE COUNTY TAX COLLEC70R _ NOTICE OF AD VALOREM TAXES AND NON -AD VALOREM ASSESSMENTS M. •1 Mae ==41 FOURTH INSTALLMENT ALLEN BETTY ANN LEG,:E 1/2 OF LOTS b + 7 BLK 14 2820 S PARK AVE TC 4 SANFORD FL 32773 5439 TOWN OF SANFORD Piss 1 PG 60 PAD: 111 W 12th ST AFTER MARCH 311 CERTIFIED FUNDS ONLY TOTAL MILLAGE 21. S AD VALOREM TAXES r 163.71 277.69 212.88 15.13 6.83 17.06 693.30 Please Retain this Portion for your Recorc NON -AD VALOREM ASSESSMENTS 0.00 Please :OMBINED S TAXES AND ASSESSMENTDetach _ . _ . 693 30 See reverse side for important information _AndReturix with RMC A9YA1/►It MAR 1 -MAF! 31 APR 1 -MAY 27 •TAXES DELINOU NT AFTER MARCH 31 e. 2003. payment e PAY ONLY AD COUNTY 4.9989 SCHOOL 88.4790 CITY SANFORD 6.51000 SJWM .4620 COUNTY BONDS .2086 SCHOOL BONDS .5210 TOTAL MILLAGE 21. S AD VALOREM TAXES r 163.71 277.69 212.88 15.13 6.83 17.06 693.30 Please Retain this Portion for your Recorc NON -AD VALOREM ASSESSMENTS 0.00 Please :OMBINED S TAXES AND ASSESSMENTDetach _ . _ . 693 30 See reverse side for important information _AndReturix with RMC A9YA1/►It MAR 1 -MAF! 31 APR 1 -MAY 27 •TAXES DELINOU NT AFTER MARCH 31 e. 2003. payment e PAY ONLY CITY OF SANFORD HISTORIC PRESERVATION BOARD APPLICATION FOR A CER TIFI CA TE OF APPR OPRIA TENESS P.O. Box 1788, Sanford, FL 32772-1788 Phone: 407 330-5672 Fax: 407 330-5679 If It -- RP RATO 1�'f� {{AA e _ Property Address: lI f u1 2n` 5 Property Owner '� n�'� ,�..,, nn 34-77 r Mailing Address: �� 5 • PAgg &t— Phone Number. (4�-33'3 q 33 Fax Number. Agent: Address: Phone Number. Fax Number. Downtown Commercial Historic District: ElResidential Historic District: Describe all changes in material, color or location to the exterior of the building and property: El Applicant's Date: Date: Owners' Signature OFFICIAL USE ONLY Staff Review Date: Historic Preservation Board Meet' g Date: Application is Approved Approved with Conditions Denied —. Conditions: Signed: