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Qraiit No.: CITY OF SANFORD PERNUT APPLICATION Date: X403 Permit Type: _X_ Building Electrical Mechanical Plumbing Fire Alarm/Sprinkler Descrlption, of Work: ( r -J f2M L -t- ..r Additional Information for Electrical & Plumbing Permits Addition/Alteration _Change of Service Temporary Pole New AMP Service (# of AMPS ) Addition/Alteration New Construction (One Closet Plus Additional) Number of Fixtures Number of Water & Sewer Drainage Lines Number of Gas Lines Occupancy Type: 8.9esidential Commercial _ Industrial Total Sq Ftg:6�J Value of Work: $' Type of Construction: (A�ao� Flood Zone: Number of Stories: Z Number of Dwelling Units: Parcel No.: (Attach Proof of Ownership & Legal Description) Owner/Address/Phone: 1 GI?�4 � Vt. >e�/J Contractor/Address/Phone: State License Number: Contact Pte: Phone & Fax Number: _ Title.Holder (If other than Owner): Address: Bonding Company: Address Moitgege Lender: Address• Art:hitect/Engineer Phone No. Address• 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. w. 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 verificatio that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. 3 Signatur Agent D e0Signature of Contractor/Agent Date IA ame ' St aiure of Notary -State of lorida to ......... Melissa Dunklin Commission #0163723 ..:Expires: Dec 20, 2005 ";►dit!;:�' Bonded Thru Atlantic Bonding Co.. Inc Owner/Agent is Personally Known to Me or _ Produced ID Print Contractor/Agent's Name Signature of Notary -State of Florida Date Contractor/Agent is Personally Known to Me or Produced ID APPLICATION APPROVED BY: IM Date: l Special Conditions•. �1 I CI�Y IfL OF SANFO" RESERVATIONBOARD ICA TION FOR A 9F APPROPRIATENESS 8, Sanford, FL 32772-1788 0-5672 Fax: 407 330-5679 Address: Z UJ Mailing Address: 4)'-L- 6F2-&.,-Jf NA"WPhone Number: -5t!Q-`t T2zW Z> : �-- Fax Number: Agent: i5li-15 Phone Number. Address: Fax Number. Sr OAk�-4W Downtown Commercial Historic District: ❑ Residential Historic District: M Describe all changes' in material, color or location to the exterior of the building and property: ��'� /�C /'► " � Off% /Z � �� 1/�.C� �,--fi��--� , Applicant's Signature �G-� Date: .� 3 Owners' Signature Date: OFFICIAL USE ONLY Historic Preservation Board Meeting Date: 31A 16'2-) Staff Review Date: Application is Approved V Approved with Conditions Conditions: Signed: Date: 31M o Denied W 12 TH ST ( 66' PAW ) PAVED - -- F�PIPE ! O UD YJ FDREBAR(NO>fJ FD IRON PIPE lDOUDNEYJ • � Ili.uv 9 LOT 2 _ 20.5 h •0�h "> r) s� = 20' 0 ELEV - ELEVATION W - NAIL AND DISK a -BLOCK FD - FOUND J o 20.5 2 8. 3 10 0 - POINT OF COMMENCMENT o GARAGE IRON PIPE STY - STORY CB - CHORD BEARING R - N 2 S T Y RES Q �' RIGHT OF WAY 0 - "' f 1200 `y O f 18.7 PROPERTY LINE C - 36 a `Pp. POINT OF CURVE L - LENGHT BLDG - BUILDING `S>_ - CONCRETE P -PLAT ...n rn.e urnnr, r -n n nnt- Mnni in 3t . KII IMRGR 117.00 K FD IRON PIPE lDOUDNEYJ FD IRON PIPE (DOUDNEY) LOT 2 SCALE 1" = 20' LEGEND: ELEV - ELEVATION N&D - NAIL AND DISK BLK -BLOCK FD - FOUND POB - POINT OF BEGINNING ESMT - EASEMENT ESMT - EASEMENT POC - POINT OF COMMENCMENT IP - IRON PIPE STY - STORY CB - CHORD BEARING R - RADIUS � - CENTERLINE R/W - RIGHT OF WAY 0 - DELTA X -X -X - FENCE PL - PROPERTY LINE C - CHORD RES - RESIDENCE PC - POINT OF CURVE L - LENGHT BLDG - BUILDING CONC - CONCRETE P -PLAT ...n rn.e urnnr, r -n n nnt- Mnni - Mnt`II IMCNIT 3t . KII IMRGR C C ti 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 presurr,e that you built or substantially improved it for sale or lease, which is a violation of this exemption. You rna.y not hire an unlicensed person to act as your contractor or to supervise people working on your. build-ing. 11. is your responsibility to make sure that people employed by you have licenses required by state law arid. 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, �L� �✓C��2 do hereby state that I am qualified and capable of performing the requested co(stru—cti–ol 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. 12-zp_�Ia"o 4,4 -os "'W111" OwnerBui der Sr,96ature / DateAs Print Own Builder &ame WW 4&6tary—State of Florida Date 0 0. Owner is Personally Known to Me or has Produced ID