219 Odham Dr 17-1789; FENCEA
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
D" JUN 15 2017 F.
Y. -,A Application No:
Documented Construction Value: cc)
Job Address: Jkjy.Sqt^Historic District: Yes No
1 l
Parcel ID: Residential [" Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: Y c,J d {WC h• ^d
a
Plan Review Contact Person: i Iy,P %fY r
U
Title: dcAl ksr ._ (- Phone: (
77-'7( D— Fi!%S Fax: Email: J , r.tJ A l, k a< , Cd Property
Owner Information Name
I
1
A Phone:(-( Street:
a- l CI 7 ` kv., v-_ Resident of property? : S City,
State Zip: Sc-,44 , rl 3>>-7 3 Contractor
Information Name
Street:
City,
State Zip: Name:
Street:
City,
St, Zip: Bonding
Company: Address:
Phone:
Fax: ..#.,
State
Licens N& .a In y,, Architect/
Engineer Information 1, r,t+iza,r,,,;rM•` ;K , ,. Phone:
r
Fax:
E-
mail: Mortgage
Lender: Address:
WARNING
TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED
AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
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. FBC
105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5ch Edition (2014) Florida Building Code Revised:
June 30, 2015 Permit Application
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 I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculatedcharges figured off the executed contract exceed the actual construction value, credit
will be applied to your permit fees when the permit is issued. OWNER'
S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be
done ' compliance with all applicable laws regulating construction and zoning. gnat
wner/Agent Date Signature of Contractor/Agent Date Print
caner/Agent's Name Print Contractor/Agent's Name r
Signature
of Not -State of Florida ate Owner/
Agent is Personally K} C to e or Produced
ID tom —Type of ID trl Signature
of Notary -State of Florida Date Contractor/
Agent is Personally Known to Me or Produced
ID Type of ID Electrical
Mechanical Plumbing[] Gas Roof Construction
Type: Occupancy Use: Total
Sq Ft of Bldg: Min. Occupancy Load: New
Construction: Electric - # of Amps Fire
Sprinkler Permit: Yes No # of Heads APPROVALS:
ZONING: (pL16[(7 UTILITIES: COMMENTS
ENGINEERING:
FIRE: Flood
Zone: of
Stories: Plumbing - #
of Fixtures Fire
Alarm Permit: Yes No Ok
to install approx. JiDo linear feet of 6' high privacy
fence and t gate(s) as shown on plan.
Fence shall be constructed with finished
side facing outward. WASTE
WATER: BUILDING:
Revised:
June 30, 2015 Permit Application
I
OWNER BUILDER STATEMENT/AFFIDAVIT
Altamonte Springs, Casselberry, Lake Mary, Longwood, Oviedo, Sanford,
Seminole County, Winter Springs
Florida Statutes are quoted here in part for your information to indicate the authority for exemptions for
homeowners from qualifying as contractors and to express any applicable restrictions and responsibilities.
OWNERS MUST PERSONALLY APPEAR AT THE BUILDING DIVISION TO SIGN THIS DOCUMENT
BY SIGNING THIS STATEMENT, I ATTEST THAT: (Initial to the left of each statement)
I understand that state law requires construction to be done by a licensed contractor and have applied for
an owner -builder permit under an exemption from the law. The exemption specifies that I, as the owner of
C
the property listed, may act as my own contractor with certain restrictions even though I do not have a
license.
I understand that building. permits are not required to be signed by a property owner unless he or she .isSresponsiblefortheconstructionandisnothiringalicensedcontractortoassumeresponsibility.
I understand that, as an owner -builder, I am the responsible party of record on a permit. I understand that I
may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed
in his or her name instead of my own name. I also understand that a contractor is required by law to be
licensed in Florida and to list his or her license numbers on all permit and contracts. .
I understand that I may build or improve a one -family or two-family residence or.a farm outbuilding: I.
may also build or improve a commercial building if the costs do not exceed $75,000. The building or
j residence must be for my own use or occupancy. It may not be built or substantially improved for sale or
lease. If a building or residence that I have built or substantially improved myself is sold or leased within
in 1 year after the construction is complete, the law will presume that I built or substantially improved it
for sale or lease, which violates this exemption.
I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
I understand that I may not hire an unlicensed individual person to act as my contractor or to supervise
p persons working on my building or residence. It is my responsibility to ensure that the persons whom I
employ have the licenses required by law and by city ordinance.
I understand that it is a frequent practice of unlicensed persons to have the property owner obtain an
owner -builder permit that erroneously implies that the property owner is providing his or her own labor
and materials. I, as an owner -builder, may, be held liable and subjected to serious financial risk for any
injuries sustained by an unlicensed person or his or her employees while working on my property. My
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner -
builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
I understand that I may not delegate the responsibility for supervising work to a licensed contractor who is
i not licensed to perform the work being done. Any person working on my building who Is not licensed
must work under my direct supervision and must be employed by me, which means that I must
comply with laws requiring the withholding of federal income tax and social security contributions
under the Federal Insurance Contributions Act (FICA) and must provide workers' compensation
for the employee. I understand that my failure to follow these laws may subject me to serious financial
risk.
Rev. 9.14.2009
I agree that, as the party legally and financially responsible for this proposed construction activity, I will
abide by all applicable laws and requirements that govern owner -builders as well as employers. I also
understand that the construction must comply with all applicable laws, ordinances, building codes, and
zoning regulations.
I am of aware of construction practices and I have access to the Florida Building Codes.
I understand that I may obtain more information regarding my obligations_ as an employer from the Internal
Revenue Service, the United States Small Business Administration, the Florida Department of Financial
Services, and the Florida Department of Revenue. I also understand that I may contact the Florida
forConstructionIndustryLicensingBoardat1-850-487-1395 or at www.myflorida.com/dbpr/pro/cilb/
more information about licensed contractors.
I am aware of, and consent to, an owner -builder building permit applied for in my name and understand
oon that I am the party legally and financially responsible for the proposed construction activity at the address
1
listed below.
I agree to notify the building department immediately of any additions, deletions, or changes to any of the
information that I have provided on this disclosure or in the permit application package.
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person
who does not have a license, the Construction Industry Licensing Board, the Department of Business and
Professional Regulation and the building department may be unable to assist you with any financial loss
that you sustain as a result of a complaint. Your only remedy against an unlicensed contractor may be in
civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an
individual or firm is injured while working on your property, you may be held liable for damages. If you
obtain an owner -builder permit and wish to hire a licensed contractor, .you will be responsible for verifying
whether the contractor is property licensed and the status of the contractor's workers' compensation
coverage.
Property Ad
I, _
and 6 of performing the
specified above./
of Owner -Builder
Form of Identificatio
do hereby state that I am qualified
ion involved with the permit application filed and agree to the
Must be Photo. ID)
5-
Date
A violation of this exemption is a misdemeanor of the first degree punishable by a term of imprisonment
not exceeding 1 year and a $1,000.00 fine in addition to any civil penalties. In addition, the local
permitting jurisdiction- shall withhold final approval, revoke the permit, or pursue any action or remedy
for unlicensed activity against the owner and any person performing work that requires licensure under
the permit issued.
Rev. 9.14.2009
r
w
Ok to install approx. 100 linear feet of 6' high
PLAT OF SUl privacyfence and. gate(s) as shown on
eOY1770n01 o170/ , plan. Fence shall be constructed with
DESCRIP. wn
finished side facing outward.
Tne Southwester]_, ,.7.00 feet of Lot 20 Block "E", REPLAT OF SX1ORA UNITS ] I Z recorded in
Plat Book 17, Pa(ies ll and I' Public Records of Selainole County, Florida, said Southwesterly
17.0-0 feet beinri treasured oer?endicular to the Southwesterly ling' of said Lot. M.
ALSO Lot 19 Block "E" of said REPLAT OF SA.NORA UNITS 1 2.
LESS the Southt'/esterly 32.00 feet of said Lot 19 Block "E", said Southe!esterly 32.00 feet
measured nPrpendirular to the Southwesterly line of said lot 19.
ALSO LESS: Begin at the most Easterly corner of said Lot 19 Block "E", thence S51°32'55"W,
63.12 feet along the Southeasterly line of said Lot 19 Block "E" to the Southerly line of19, thence West 6.00 feet along said South line; thence North 19.97 feet; thence
u rNE+s a J.-- oTzo, N70 49' 35"E, 58.69 ft. DUTN STE,eL_y'uE r_F,
q to the Point of
Begi nni ng.
W V I W Q o 3oy e 6
h W y Fdo^91 P ..rrO, fb \ wL iC)
N
x,
N ti On
6c,
nl
Q Ent bSGG{ U
0 750 m
W
a f 57 98' u
20 , /
8N15Lo ,lam 5T2 1ZY GONG. yyv
m 3 o
v
a
AV
Q)
1 iq
S3i q
0 S h
U h h U y//
8U ° V
Q
P37riC "' ro
o vYOIarc LAWYETiZS ITLE INSURANCE
U
NOTES
T %' LIT 1 L . gs hq •T `3c'
p.Pe w.h cop /i/o ZODS
VKC = Co L •Z-7' F = Z - Z /%r oi6oundoi,'s.r,Py,
Qc 17a50 22" -NOQp_62 O 0.pOt '_ j B or,; bosedon or
GHo2D > ARING S $Z`03.2 ? Based on the Federal Erne
y l(
8' w
r :anagement Agency flood hazor
1`J p c(C1 rGS : 2 l4 imndary map, the bw ding site
M shown hereon DOES NOT LIE
p p H A p R V within the loo year flood hazard i t ae
area.
LAND SVRVErORS 7-24-8 F/NAL
NE _
crRr/FICArE- NOrc, Or - O7 8r FO(A"7-.ION
JCAVOATE r2-I'D-80 STAKED SCALE
4
Q__ INC.s Mol volyd unless can.Aed CERTIFIED CORRtc"f
M,rA an "Osseo
848 E. LAKE STREET (S. R 427)
Surwrtrt ieo/. % /
LONGWOOD, FLORIDA 32750 ThIs v,-e y mterf the minrrlirm fecMyrf:ol r
TELE?NONE' (305) 831-3633 °,on dora3 oer torch oy th# Pgrioo a o o r d DOMINICK F. CAVONEE
of Lond 5urve yore, punuonr to sec Non
47j_027, iionoo srururts.
REGISTRATION No, 20M j
F;i7n/ .5-86i7n2 .593363 t psfo r