HomeMy WebLinkAbout508 W 12 St` f
Permit # :�
7<Job Address:
Description of W
Historic District:
CITY OF SANFORD PERMIT APPLICATION
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 Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #
Yowl
& Address:
Contractor Name & Address:
Phone & Fax:
Bonding Company -
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
(Attach Proof of Ownership & Legal Description)
hone:
State License Number:
Contact Person: Phone:
Phone:
Fax:
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. 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 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 that 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
�'r ( an C2y3ur I-�--O3
• SVLl re of wner�gent � Date Signature ofContractor/Agent
01
Print Owner/Agent's Name Print Contractor/Agent's Name
•• • * � C„P1n_S. P•13rch 23, _Ou4
'r'�"t`pQ�' [3onncCTtr,6u8y::�o'aryS+";:ce5
Owner/AProdug nNis= Pers ally Known to Me or
ced 1D�irD L52Z��L Isti '�2 J
APPLICATION APPROVED BY: Bldg: Zoning:
(Initial & )
Special Conditions:
t
Date
Signature of Notary -State of Florida Date
Contractor/Agent is _ Personally Known to Me or
Produced I D
(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 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 awn
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 thw.
you built or substantially improved it for sale or lease, which is a violation of this exemption. Yoe: rn-a-y
not hire an unlicensed person to act as your contractor or to supervise people working on your. bui.116.3i3,. It
is your responsibility to make sure that people employed by you have licenses required by state law :aced.
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'�% . Le( f\ CMtC 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/Builder Signature Date
<) (,01
Print Owner/Builder Name
�rr-` • rl 8 -
Oniature ol• ' Notary–State of orida Date 1- "�—„
JO AWN R!!. JOHNSON
y * MY COMMISSION # CC 921808
EXPIRES: March23.?J04
•`� v>°' Bonded TeruBW INowr
IS _ __ PCI•.l'On811\- known w \1e ur has i`
1690 TALL OAKS HUAU
DELAND, FLORIDA
32720 (407) 399-2044
L O T 8
') I
41.0'
II S.89.5158E. 7560'
I
II
1 I
o WEST 75.60 FEET
1 W I DF LOT 9
Ii ND INCL UDED
1�
0 S 10 20 40
GRAPHIC SCALE
I 3 A/C `
o 'KI UNIT 9.4' h 12.0'
1 Q 1 -STORY
— — — — — — — — — — — — — — — — — — — --- 0.9'— WOOD —
I R V FRAME
1 �
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qo
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1
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W
1 v
I
RES #508
EAST 41.40 FEET
OF LOT 10 w
WEST 75,60 FEET 2
OF LOT 10 ~
z NOT INCLUDED
0
2
I I '
I I N.89'5158'W. 75.60'
L_
I... .........41,0' ..------------------
COVERED 5.
PORCH
WOOD `r
STEPS
CONC
WALK
41.401' . '.COW wAtls.. .
N,89'51'58'W,
EDGE OF PAVEMENT
a 9'
0
CIS
O
ti
J
J
Q
v -
I
0
0
L—_
1. BEARINGS BASE
E. LINE OF SUE
AS BEING NORTi
2. UNDERGROUND
MEWS NOT LOC
J. SUBJECT TO EA
AND RESTRIC7I0
RECORD.
4. SUBJECT PROPI
IN ZONE 'X' (A
MINIMAL FLOODI)
FLOOD INSURAN
MAP PANEL NUA
120294 0045 E
DATED 4/17/95
5. DATE OF FIELD
6/21/03.
DESCRIPTION:
THE EAST 41.4
TIER 8, FLORIL
E. R. TRAFFORD
AS RECORDED
PUBLIC RECOR
CER71f1ED TO: l HI
JOHN B. LANCASTER, ✓R. THAT
MIN4
SET
KAMPF TITLE AND BOAF
GUARANTY CORP. CHAF
ADMIT
S, 89'51 '58'E,
�
a 41,40" FENCE
vi I ON LIKE
mmmiq
x 6' WOOD
10' PRIVACY FENCE
O1
METAL SHED I
ON CONC
X
EAST 41.40 FEET x
OF LOT 9 I
0
o
0
0
i
I 3 A/C `
o 'KI UNIT 9.4' h 12.0'
1 Q 1 -STORY
— — — — — — — — — — — — — — — — — — — --- 0.9'— WOOD —
I R V FRAME
1 �
Ll
qo
I °
1
I�
W
1 v
I
RES #508
EAST 41.40 FEET
OF LOT 10 w
WEST 75,60 FEET 2
OF LOT 10 ~
z NOT INCLUDED
0
2
I I '
I I N.89'5158'W. 75.60'
L_
I... .........41,0' ..------------------
COVERED 5.
PORCH
WOOD `r
STEPS
CONC
WALK
41.401' . '.COW wAtls.. .
N,89'51'58'W,
EDGE OF PAVEMENT
a 9'
0
CIS
O
ti
J
J
Q
v -
I
0
0
L—_
1. BEARINGS BASE
E. LINE OF SUE
AS BEING NORTi
2. UNDERGROUND
MEWS NOT LOC
J. SUBJECT TO EA
AND RESTRIC7I0
RECORD.
4. SUBJECT PROPI
IN ZONE 'X' (A
MINIMAL FLOODI)
FLOOD INSURAN
MAP PANEL NUA
120294 0045 E
DATED 4/17/95
5. DATE OF FIELD
6/21/03.
DESCRIPTION:
THE EAST 41.4
TIER 8, FLORIL
E. R. TRAFFORD
AS RECORDED
PUBLIC RECOR
CER71f1ED TO: l HI
JOHN B. LANCASTER, ✓R. THAT
MIN4
SET
KAMPF TITLE AND BOAF
GUARANTY CORP. CHAF
ADMIT
A. U. S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
SETTLEMENT STATEMENT
Kampf Title & Guaranty Corporation
200 West First Street
Sanford, Florida 32771
407-322-9484 fax: 407-330-5062
B. TYPE -OF LOAN
L1. O FHA 2. F-1FMHA 3. FX CONY. LININS.
4. VA S. ❑ CONV. INS.
0. Frle Number: 7. Loan Number:
56922
i. Mongage Ins. Case No.:
t. rvvi z. j nlsjorm tsjurntsnea to give you a statement oj actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked
(p.o.c.) were paid outside the closing. They are shown here for informational purposes and are not included in the totals
JOHN B. LANCASTER, JR.
D. Borrower:
508 W. 12TH STREET
SANFORD, FLORIDA 32771
RICHARD BEEN and KELLIE BEEN
E. Seller:
179 WoodRidge Trail
Sanford, Florida 32771
RICHARD BEEN and KELLIE BEEN –�"—
F. Lender:
179 Woodridge Tr.
Sanford, Florida 32771
508 W. 12th Street
G. Property:
Sanford, Seminole County, Florida 32771
The East 41.1 feet of Lots 9 and 10, Block 13, E. R. TRAFFORD'S MAP OF THE TOWN OF
SANFORD, Book 1, Page 56 through 64, inclusive, Seminole County, Florida
H. Settlement Agent:
Kampf Title & Guaranty Corporation
Place of Settlement:
200 West First Street, Sanford, Florida 32771
1. Settlement Date:
June 30. 2003