2655 Park Ave; 17-2402; SHEDCITY OF SANFORD
U- IV BUILDING & FIRE PREVENTION
F D AUG 0 7 2017 PERMIT APPLICATION
gY Application No: N
Documented Construction Value: $ 5w, 01a
Job Address:Xs J • F( 3"H%to is District: Yes No 2- Parcel
ID Type
of Work: New Addition Alteration Repair Description
of Work: ,Qi Ill bA Residential
E Commercial Change
of Use Move Plan
ReviewContact-P'ers. :ram l
lz-'
D Tc Title: e.%-3
Lf/— ? 3, a Email: j Property
Owner
Information Name Der-
Jc_ C^ I 5 "' Phone: Ya - /` 30.;l ` Street: So
444 7"k Resident of property? City, State
Zip: YgAJ ,J 3 Contractor Information
Name Phone:
Street: Fax:
City, State
Zip: State License No.: Architect/Engineer
Information Name: Street:
City,
St,
Zip: \ Bonding Company:
Address: Phone:
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: 5" Edition (2014) Florida Building Code Revised: June
30, 2015 Permit Application
NOTICE: In addition to the requirements of this permit, there may be additional.restriciions 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 [CC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges 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 in compli a with all applicable laws regulating construction and zoning.
Signature of O
T
gent Date Signature of Contractor/Agent Date
Print Own /Agent's Na e Print Contractor/Agent's Name
r - '
ell 1117,
S ature of N ary-State of Florida DatJ Signature of Notary -State of Florida Date
Si) LISA ANTONINI
Notary Public State of Florida
My Comm. Expires May 21, 2018
o , Co fission # FF k5242er%Agl diWis Fersonall Known t Me or Contractor/Agent is Personally Known to Me or
u d ype of Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING. 8 , hUTILITIES:
ENGINEERING: FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
COMMENTS: a ) (,,M C 11 10,K IZ ' did ujdr Mrn;munl %• 5' c( lik
Revised: June 30, 2015 Permit Application
SCPA Parcel View: 01-20-30-506-0000-2710 Page 1 of 2
Property Record Card
P'
Parcel: 01-20-30-506-0000-2710
Owner: BRINSON DERRICK L
AOJUTA: COlNr1; ra.ovoow
Property Address: 2655 SPARK AVE SANFORD, FL 32771
1O
TD
0 3
ounSeminole GIS
Value Summary
2017 Working 2016 Certified
Values Values
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 65,717 58,835
Depreciated EXFT Value
Land Value (Market) 16,000 16,000
Land Value Ag
Just/Market Value " 81,717 74,835
Portability Adj
t
Save Our Homes Adj 11,571 6,132
Amendment 1 Adj
P&G Adj 0 0
Assessed Value 70,146 68,703
Tax Amount without SOH: $589.00
2016 Tax Bill Amount $542.00
Tax Estimator
Save Our Homes Savings: $47.00
Does NOT INCLUDE Non Ad Valorem Assessments
LOTS 271 & 273
FRANK L WOODRUFFS SUBD
PB3PG44
d Taxes
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund 70,146 50,146 ' 20,000
Schools 70,146' 30,000 40,146
City Sanford 70,146 Y 50,146 20,000
SJWM(Saint Johns Water Management) 70,146 50,146 . 20,000
County Bonds 70,146 50,146 : 20,000
Sales
Description Date Book Page Amount Qualified Vac/Imp
WARRANTY DEED 1/1/2005 05590 0686 121,700 Yes Improved
WARRANTY DEED 2/1/1988 01931 0056 53,800 Yes Improved
ADMINISTRATIVE DEED 9/1/1987 01886 0254 4,500 No Vacant
WARRANTY DEED 5/1/1981 01338 0893 4,100 - No Vacant
Find Gornparab18 Stale --
Land
Method Frontage Depth Units Units Price Land Value
LOTi 0.00 0.00 1 16,000.00 ; 16,000
Building Information
Is Bed/Bath count incorrect? Click Here.
Description
Year Built Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages
Actual/Effective
1 1988 6 2 2.0 1,169 1,476 , 1,169 $65,717 , $74,678 Description Area
http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=01203050600002710 8/7/2017
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
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
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
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 I 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.
v
I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
r
L-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.
A 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.
nderstand 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
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
1, f
and c,
9,4-AffOAI
of performing the requested
Owner -Builder
R
Form of Identification
Must be Photo ID)
do hereby state that I am qualified
involved with the permit application filed and agree to the
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
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47
SANFORD, FLORIDA32771 `` 1 il iii CERTIFIED TO: _ LLOIS EGAL
DESCANDWF'f273FRANK L WOODRUFF'S SUBDMSION. ACCORDING 0 t'j F M Ty i` REPUBLK NATIONAL T(iLENBEl COMPANY OLD TO
THE
FIAT THEREOF AS RECORDED IN PLAT BOOK 3. PAGE 44, OF : C9T°•. COIMCRY MADE HOME LOANS its THE A
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2 City of Sanford
Shed / Gazebo Permit Application Checklist
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:
Building Permit Application completed, signed and notarized. Application must include correct address
and complete parcel I.D. number.
0 Copy of a contract, signed by the contractor and the property owner, indicating the documented
construction value of the project.
Copy of applicable contractor's license issued by the State of Florida (if contractor is
applicant).
A site specific notarized power of attorney shall be required from the licensed contractor if
he/she appoints an employee of his/her company to sign the permit application as the contractor.
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).
Completed and signed Owner Builder Statement / Affidavit (if owner is applicant).
Two (2) site plans indicating proposed location and distances to property line(s).
Shed or Gazebo 10'x 12'or less:
Completed and signed Statewide Product Approval Specification Form.
Two (2) copies of manufacturer's installation instructions.
2) Two copies of a, legible drawing showing all framing details, foundation details, and meet all
applicable code requirements (if applicable)
Commonly accepted construction practices with appropriate tie downs or;
ANSI / AF & PA WFCM wood frame construction manual for one and two family dwellings.
WPPC Guide to wood construction is high wind areas.
Florida State Department of Community Affairs Approved Building.
Shed or Gazebo greater than 10' x 12' :
Two (2) sets signed and sealed engineered drawings. Wind design data required on drawings per
FBC 1603.1.4 to meet 129 mph ultimate design wind speed for risk category I buildings.
Completed and signed Statewide Product Approval Specification Form.
Two (2) copies of manufacturer's installation instructions.
Florida State Department of Community Affairs Approved Building.
These guidelines were compiled to assist the applicant in preparing a Shed / Gazebo permit application and
may not be complete. The applicant is required to meet all City of Sanford, state, and federal code
requirements.
Revised: February 2015
i
CITY OF
A? , SkNFORD Building & Fire Prevention Division
FIRE DEPARTMENT
RESIDENTIAL SHED AFFIDAVIT
120 SQUARE FEET OR LESS)
PERMIT #: / ADDRESS: 4(p-g ! /C-
I/i HEREBY AFFIRM THAT ALL OF THE FOREGOING
INFORMATION IS TRUE AND ACCURATE. THE SHED TO BE INSTALLED ON THE PROPERTY LISTED ABOVE WILL BE REQUIRED TO MEET THE
FOLLOWING: INSTALLED TO MEET ALL MANUFACTURER REQUIREMENTS, PROPERLY TIED DOWN PER MANUFACTURER
RECOMMENDATIONS, AND LOCATED ON THE PROPERTY IN ACCORDANCE WITH THE APPROVED SITE PLAN. SITE BUILT SHEDS MUST
ADHERE TO COMMON CONSTRUCTION PRACTICES. I UNDERSTAND THAT FAILURE TO PROPERLY LOCATE THE SHED IN THE APPROVED
LOCATION WILL BE A VIOLATION OF CITY CODES AND COULD RESULT IN THE SHED HAVING TO BE RELOCATED OR TAKEN DOWN AT THE
OWNER'S EXPENSE.
FJ LICENSED CONTRACTOR
LICENSE #:
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE: DATE:
HOMEOWNER (OWNER/ ILDE )
OWNER/BUILDERNAME: / `r
OWNER /BUILDER SIGNATURE: DATEC t
PLEASE NOTE"
THE BUILDING DEPARTMENT WILL NOT CONDUCT ANY INSPECTIONS ON SHEDS SIZED 120 SQUARE FEET OR
LESS. THIS AFFIDAVIT MUST BE PROVIDED, SIGNED AND NOTARIZED, AT THE TIME OF PERMIT SUBMITTAL AND
WILL SUFFICE AS THE FINAL INSPECTION APPROVAL FOR THE SHED.
STATE OF FLORIDA COUNTY OF , yen C.//Jc&
Sworn to and Subscribed before me this 7 R
day of S 7L 20 1-7 by:
r
L %'f l i("- •I/ //737 Who is Personally Known to me or has Produced (type of
identification) G L as identification.
natu of Notary Public
State of Florida
P ' tam Natoli" ""' of b2 bii tary Pu lic - State o1 Florda
r, _
y Comm. Expires May 21, 201 Zev.
y<..__.' Commission # FF 125242
Effective: August 1, 2017