2460 Sanford Ave 01-1057 com int remodelPERMIT ADDRESS a y O
CONTRACTOR
ADDRESS
PHONE NUMBER
PROPERTY OWNER " (:?-)� Cjlt A
ADDRESS --R 4 ke 0
PHONE NUMBER
ELECTRICAL CONTRACTOR `fie-�- (�JL4.
MECHANICAL CONTRACTOR
PLUMBING CONTRACTOR
MISCELLANEOUS CONTRACTOR
PERMIT NUMBER
MISCELLANEOUS CONTRACTOR
FEE
PERMIT NUMBER FEE
SUBDIVISION
PERMIT # 0 1 ' 10S%
PERMIT VALUATIOA P 00 � —
SQUARE FOOTAGE
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DATE Q 1 -1 1 Gi
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CITY OF SANFORD PERMIT APPLICATION
Permit No.: & -105 7
Date:
2--7 — Ol
Job Address: J, W d 5g NTdt-3 Ave • Sct v 4re) 1=1 - 3 a-17'>/
Parcel No.: (Attach Proof of Ownership & Legal Description)
Description of Work: SZ-d wa I/s 12e r a IQN S
Type of Construction: Flood Zone:
Valuation of Work: $ 1 • oo p Occupancy Type: Residential a/ ommercial Industrial
Number of Stories: Number of Dwelling Units: YV*O Zoning: Total Square Footage: 130 SQ fr
Owner: .S9 to ford e re j3
Address: a, q60 S o ei 4rd 13ve- -
City: Sa N -o rState: r- L . Zip:
Phone No.: Fax No.:
Contractor: Se / e ti ,, ,-� 6, wl e on 6 P r- r,
Address:
City:
Phone No.:
State: Zip: State License No.:
Fax No.:
Contact Person:. Q kaLr• t e s W . C, A1,e se cy r ,fir • Phone No.: N0 7) 330 — / SOS
9
Title Holder (If other than Owner): 804f0 rAP n1 6 e r-y ve r s i Le- f,2 r Ca iys
Address: / SO B e5 /,'v CZ . F/ • ? a' 7 7-1—
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect: /I/ , A • 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. 1 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: 1 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 I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
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Sigfiature of Owner/Ag nt Date Signature of Contract /Agent Date
Sa�Fo�� 11.* k a'io'- It ICA'10rles w • 611411-sP"Yef}r Cktr/es fv • lr��vc e rr r Jr
Print Ov
y=LAWnt's Name Print Contractor nt's Name
OK4a")-a-o/
Si na re o Notary -State of Florida Date Signa&__ arZ--State of Florida Date
�Ken Frost
Notary Public, State DFloridayCommissionNo.CC"ItI ie. My Commission Exp. 1 EOGJ•NOTARY Fla. Notary Servttra 6
Owner/Agent is )_ Personally Known to Me or
Produced ID
"Af P41a Ken Frost
�¢ Notary Public, State of Florida
9 Commission No. CC 682692
'?or it��r My Commission Exp. 09/22/2001
141004NOTAAY Fla. Notary Servka & Bondlna Co.
Contractor/Agent is )K Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Date: '2--'2— k
Special Conditions: 4 -�' ko
CITY OF SANFORD BUILDING DEPARTMENT
OWNERBUILDER AFFIDAVIT
State law requires construction to be done by license 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
even though you do not have a license. You must supervise the construction yourself and responsible for all
wired inspections. 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 at a cost $25,000 or a less. THE BUILDING MUST BE
FOR YOUR OWN USE AND OCCUPANCY, IT MAY NOT BE BUILT FOR SALE OR LEASE. If you sell
or lease more than one building you have built yourself within 1 year after the construction is completed, the
law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an
unlicensed person as your contractor. Your construction must be done according to building codes and zoning
regulations. It is your responsibility to make sure that people employed by you have licenses required by state
law and by county or municipality licensing ordinances.
The above authority shall be restricted to those homeowners who can demostrate to the Building Department
that they have adequate knowledge and qualifications to safely perform and directly supervise the work Such
authority does not convey the right to violate any provisions of applicable adopted codes, nor is it to be
construed as exempting any such property owner from obtaining required permits and paying all fees required.
I understand that if I am not physically doing the work or physically supervising free labor from friends or
relatives that I must hire licensed contractors, i.e. electrician, plumber. mechanical (heating and air-
conditioning) etc* I further understand that the violation of not physically doing the work and the use of
unlicensed contractors at the construction site will cause the project to be shut down by the Inspector of the
City of Sanford Building Department. Additional State Statute allows for penalties up to $1.000 and up to I
year in jail I also understand that if this violation does occur that in order for job to proceed I will have a
licensed contractor come In and sign on the permit of taking the job over. I understand that if I hire
subcontractors under a contract price that they must be licensed to work in the City of Sanford Le. masonry,
drywall, carpentry. etc. All contractors licensed by the City of Sanford have workers compensation and liability
coverage and are registered with the State of Florida.
I. Vsrks Gi�.o'1� yr do hereby state that I am qualffed and capable of performing the requested
construction involve with the permit application filed.
I will assume full responsibility as an Owner/Builder Contractor, and will personally supervise do all work
alloweq b , aw on the'pe itted structure.
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OwnerBuilder Sig&ature Print applicant name here 5RN4r-) &,'bIP CkVrcl► ICA
v,-/PS Ja • C-1/✓o1�Ps�'e/qrr
Form of LD. `.7 S3 Y — t / R — (/ ai q V —D < Must be photo ID> FL ✓Q,,. �� C✓c n.s Q
Sworn and subscribed before me
ublic State of Florida
Gov vi Ken Frost
+9 Notary Public, State of Florida
0- Commission No. CC 682692
)'or now My Commission Exp. 09/22/2001
14004NOTARY Fla. Not" saw S Bontgng co. Print Name
Homestead Exemption Yes No *** No anwser requires supporting information***
(Circle One)
*489-Part H only exempts from licensing and owner doing or supervising any electrical
work on a one or two family residence. Commercial work requires a licensed contractor.
-Anchortwj-Speciit
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City of Sxr!3rcl
Model Codes nflnct:
Standard Bui:.iing Code 19�7 ed.
Standard Plumbing Code 1997 ed.
Standard Mechanical Code 1997 ed.
National Electrical Code 1996 ed.
See City Code AMENDMENTS
FL. Acces:�i r;:
SANFORD BUILDING DEPT.
THESE PLANS ARE REVIEWED AND CONDITIONALLY
ACCEPTED FOR PERMIT. A PERMIT ISSUED SHALL BE
CONSTRUED TO BE A LICENSE TO PROCEED WITH
THE WORK AND NOT AS AUTHORITY TO VIOLATE,
CANCEL, ALTER, OR SET ASIDE ANY OF THE
PROVISIONS OF THE TECHNICAL CODES. NOR SHALL
ISSUANCE OF A PERMIT PREVENT l,-IE BUILDING
DEPT FROM THEREAFTSR RFC7UIFtIN6 A CORREC-
TIAN OF ERROR$ ON THE PLANS; CONSTRUCTION
OR OTFIE(i V'§L-At ON9� b THE GdD€S.
LACCES1�� CODES;
MUST
fl�EE_I.. FLORIDA
E I1R
OFFIC_ (topy
AQUIRED
1•
PLANS REVIEWED
9ICITY OF SANFORD
0
PERMIT # oa 1051
CITY OF SANFORD ELECTRICAL APPLICATION
PERMIT NO. 0/ ` /()S 7 DATE: 2 — 7 r 101
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO INSTALL THE
FOLLOWING ELECTRICAL WORK:
OWNER'S NAME: s9 tu-'o r o) Q; b l t Ck u r O)
ADDRESSOFJOB: at-V60 Sgnt&KJ Ave. •'t10-60rd Fl • 3X 71.
ELECTRICAL CONTRACTOR: ne b ehz ';- ie -c-• RES NON-RES �
Subject to rules and regu ations of the city electrical code:
Total 4DU
By signing this application I am stating I am in compliance with the City Electrical Code
ti
is Signature
ROC-20278--L.
States License#