100 Oak View Pl; 17-2534; fenceCATly €. F
FORD
FIRE DEPARTMENT
Building & Fire Prevention Division
RESIDENTIAL FENCE PERMIT APPLICA7ION
Application No: / /) `,-)- 6-3 V
Documented Construction Value:
Job Address: 10V Ce ill d;%-gt_j 4— Historic District: Yeg ' N®
Parcel ID: 3 0 - b I 1 - 0000
Plan Review Contact Persom. "-A4j7- te--e-vl -e— Title:
Phone: 1102 %W D D Fax: ]Emai: 16,f e P---La R W, jy-e 7 Q
Residential
Fence Information Type
of Fence: Wood I Metal PVC/Vinyl Iron. , Other Fence
Height: ]Feet ## Gates: _ Total Linear ]Feet: Additional
Information: D`
Fences
with a height of over 6 feet will require signed & sealed structural engineering" Property
Owner Information Name
I .ett 'd G- C, -e vx -0-- Phone: Ll O"? % (02 C'o /•' street: % 00 (
D 1C V L2 tau Resident of property? City, State
Zips: —5av13 dro EL 5J-7? .? / 0 Street
City,
State
Zip): Fence Contractor
Information Phon Fax:
Please Dote.:
The
Building Department does notperform site inspections on Residential Fence permits. A signed
and notarized pence Affidavit is required to be submitted along with this permit application. Please
see the attached Fence Permit Submittal Guidelines. 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. Effective: August 1,
2017
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: 51n Edition (2014) Florida Building Code
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.
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.
cS 116- l
nature of O Agent Date
4117
LISA ANTONINI
Notary Public - State of Florida
My Comm. Expires May 21, 2018
Commission # FF 125242
owner/Agent is - - Fefsonafly Known t Me or
Produced ID lam— Type of ID f-L (
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID _
BELOW IS FOR OFFICE USE ONLY
PLAN REVIEWAPPROVAL: PLANNING: 253111
1-1 HISTORIC:
COMMENTS: M
Effective: August 1, 2017
ciry OF
Sk 4FO-,
FIRE DIEPARTMEM,
Building & Fire Prevention Division
FENCE PERMIT SUBMITTAL CHECKLIST
RESIDENTIAL ONLY)
All permit application packages must be complete prior to acceptance. You must check each box to the
left or indicate n/a on this submittal. A complete application package shall include the following:
Fences must be compliant with the City Land Development Regulations, Schedule F
UP"""Fence Permit Application completed and signed. Application must include correct address and complete
parcel I.D. number.
Copy of a contract, signed by the contractor and the property owner, indicating the documented
construction value (if the contractor is the applicant)
Copy of the Business Tax Receipt (if the contractor is the applicant).
e/' Owner/Builder Statement/Affidavit
Certificate of insurance indicating worker's compensation insurance coverage and naming the City of
Sanford as certificate holder, or a copy of a worker's compensation exemption issued by the State of
Florida (must be submitted with each application if contractor is the applicant).
Indicate the number of linear feet, height, number of gates, and type of material on application.
A Two (2) copies of site plan indicating where the fence will be located on the property.
Fence Affidavit, signed and notarized
Repairs
No Permit is required for Fence Repairs. A Fence Repair is qualified by one or more of the following:
Replacing individual slats; no more than 10% of the entire fence
Replacing a section; no more than 3 sections of the entire fence. A section is defined by the fencing
material between 2 posts.
Replacing a post; no more than 4 posts total. Posts must be placed in or directly around the removed post
without encroaching on neighbor's property.
Replacing a gate
Please contact the Building Division if you have any questions on Fence Repairs*
These guidelines were compiled to assist the applicant in preparing a fence permit application and may not be
complete. The applicant is required to meet all City of Sanford codes and requirements.
Effective: August 1, 2017
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
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 is
responsible for the construction and is not hiring a licensed contractor to assume responsibility..
I understand that, as an owner -builder, I am the responsible party of record on a permit. I understand that I
ay 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
residence must be for my own use or occupancy. It may not be built or substantially improved for sale or
ase. 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
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
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
n 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
Construction Industry Licensing Board at 1-850-487-1395 or at www.myflorida.com/dbpr/pro/cilb/ for
more information about licensed contractors.
I am aware of, and consent to, an owner -builder building permit applied for in my name and understand
that I am the party legally and financially responsible for the proposed construction activity at the address
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 Address:
I, 1'L-DjufJ ?t(' l \,1
and capable of performing 1
conditions specified above.
Signature of OvOV6r-Builder
AA
do hereby state that I am qualified
requested construction involved with the permit application filed and agree to the
Form of Identification
Must be Photo ID)
Date
I
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
PLAT OF BOUNDARY SURVEY for: MXRONDA HOMES INC.
DESCRIPTION: L.O•T 41. 'STERLING WOODS
RECORDED IN ,PL.nT BOOK 64 PAGE(S) 9? 4/Xi "_ PUBLIC RECORDS OF SEMINOLE COUNTY, FLORIDA
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SURVEYOR'S NOTES:
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CERTIFIED TO:
Robert J. & Diana L. Greene,
Pinnacle Financial Corp.
Kampf Title & Guaranty Corp.
Adnoram Title Company, Inc.
Chicago Title Insurance Co.
2. O - DIAMETER IRON PIPE WIT AP No. LS OS uND
5, _NAIL DISK No.:bn.4g•diZ.O2oroc S, -
DIAMETER IRON ROD WIT! CAP 14 t 1jo.GvG'_[L FLOOD
CERTIFICATION: S.
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