163 Long Leaf Pine Cir 05-502 FenceCITY OF SANFORD PERMIT. APPLICATION
Permit #: SOA t Date:
l 1 / a Y{ 1 C V Job
Address: 1 fF 3 4o v.a ECL P. v11e Ctrr C H o r ar! FL 3 a -7 73 Description
of Work: FEn Ce C.JOod (o -Po,!74 C90
Historic
District: Zoning: Value of Work: $JUDO Permit
Type: Building Vl*" 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 #:
Owners
Name & Address: C 4 160
Contractor
Name & Address: Phone &
Fax: Bonding
Company: Address:
Mortgage
Lender: - Address:
Architect/
Engineer: Address:
Contact
Person: Attach
Proof of Ownership & Legal Description) Cirl.
Phone: 3o'Zl —aCD3' Sgv State
License Number: Phone:
Fax:
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. 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 I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. ca.
tmo s (L t 1 Laqlo Signature
of Owner/Agent Ci Date Signature of Contractor/Agent Coo
s . c. o Print
Owner/Agent's Name Print Contractor/Agent's Name t
Date Signature of Notary -State of Florida DEBBIE
BLANTON MY
COMMiSSION # DD 188491 e
y/4/o APPLICATION
APPROVED BY: Bldg: h CA A. CN II (a / fGan4ig: UtInitial & Date)
Special Conditions:
Contractor/Agent
is Produced ID _
Utilities: Initial &
Date)
Date Date
Personally
Known
to Me or FD: Initial &
Date) (
Initial & Date)
Fti r
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 1 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 own
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 that
you built or substantially improved it for sale or lease, which is a violation of this exemption. You may
not hire an unlicensed person to act as your contractor or to supervise people working on your building. It
is your responsibility to make sure that people employed by you have licenses required by state law and
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, (-6
Q,1,0 (, S. (,c J tPN'c?, do hereby state that I am qualified and capable of performing the
requested construction involved wd0the 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.
a A --2C - f .) .h,e I I I g jCQq
Owner/Builder Signature Date
Print Owner/Builder Name
liIa91/vy
Signature of Notary —State of Florida Date
DEBBIE BLANTON Owner
i dMMin wtojMe84g,a Produe I
EXPIRES: February 25,2007 180-3-
NOTARY FL Notary Discount Assoc. Co.
Ir-' .- '— --
PLAT OF SURVEY
DESCRIPTION: (AS FURNISHED)
LOT 59, HIDDEN LAKE VILLAS PHASE IV, ACCORDING TO THE PLAT THEREOF,
AS RECORDED IN PLAT BOOK 28, PAGES 26-28, OF THE PUBLIC RECORDS OF SEMINOLE COUNTY, FLORIDA
1I
I
LOT 69 yy 15 crr
I1
SET 1/2 IRON ROD 1
k CAP LD 16393
1 _
doLdol2
0
LOT 68
LOT 58
ADJOINING RESIDENCE
NOT INCLUDED
a S CBW Is
15'
J
E 106.9 5'
0.2' ON
34'S' ..6
TWO STORY
CONCRETE BLOCK
151.
E
A/C 0& WOOD FRAMED
NRESIDENCE N163
ONE UNIT) _
90 o LOT 59
L.4 P ' 11.4
L + P s8.7' —
UT NCRE IE COo PATIO
1IS ..11.4: VFENCEmSET
I/2 IRON RDD - I 0.
3' ON ( 1
r
I
I\I I 84'55'15 L k
CAP LB M6}9} CBW Is BUILDING I$ O.
A' ON 0.
5* ON 1LOT
67 / x
I
LOT 60 6
CERTIFIED
TO: CAROLS.
WINGO BROKERS
TITLE OF LONGWOOD, I, LLC. AMERICAN
PIONEER TTrLF INSURANCE COMPANY I
HAVE EXAMINED THE F.I.R.M. COMMUNITY PANEL NO
120294 0045 E DATED4/17/95 AND FOUND THE
SUBJECT PROPERTY APPEARS TO LIE IN ZONE X. AREA
OUTSIDE OF THE 100 YEAR FLOOD. BEARINGS
SHOWN HEREON ARE BASED ON THE
NORTHERLY LINE OF LOT 59, BEING
S 84'55'15 W PER PLAT. FIELD
DATE:) 12/13/01 REVISED: SCALE:
I" = 3C FEET APPROVED
BY: GKB JOB
NO. ASM34779.dw9 DRAWN
BY: RTH 2,
1,7' -7 0 1DRIVE -'•
N l /
6
9 04FND -K--
CUT NO NUMBER
T 1 11DwlpuiC $ 0.
5ON
G=2'IB'OB' R-955. 76'
L=38.40'
1 CB=NCH'
40'
55 W II C=38.
40'
O O R=
955.
76 L=38.34 6=2'17'
55" CL=38.34 CB=N 03'
58'57" W LEGEND: O DENOTES
FND
1/2- IRON ROD LB LAND SURVEYING BUSINESS NO NUMBER LS
LAND SURVEYOR R DEN TES
RADIUS PRM PERMANENT REFERENCE MONUMENT o OENO ITS
DELTA ANGLE PC!" PERMANENT CON1RD. POINT L OE NOTE$
ARC LENGTH PI POINT OF INTERSECTION CB CHORD BE
Pi POINT OF
TANGENCY PC POINT OF
CURVATURE RIGHT OF WAY
LINE CLF CHAIN LINK FENCE P) PER PLAT
WF WOOD FENCE M) MEASURED 1YP
TYPICAL FNO FOUND A/
C AIR CONDITIONER CBW CONCRETE BLOCK
WALL CONCRE IE RP
RADIUS POINT OI IU OVERHEADMIILITY
LINE I. THE SURVEYOR.
HAS NOT ABSTRACTED THE LAND SHOWN HEREON
FOR EASEMENTS. RIGHT OF WAY, RESTRICTIONS
OF RECORD WHICH MAY AFFECT THE
TITLE OR USE OF THE LAND 2. NO UNDERGROUND
IMPROVEMENTS HAVE BEEN LOCATED EXCEPT AS
SHOWN. 3. NOT VALID
WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF
A FLORIDA LICENSED SURVEYOR AND MAPPER. ORLANDO,
FLORIDA 32801 (
4071 426-
7979 FOR 11 THE
FIRM
GALEN K. BE
L PSM 14294 N DATE
Nov 17 04 11:29a
11/01/2004 07:13 4078301157
i
Nov 0104 02: 18P COPYMAX
154 UMORD
HIDDEN LAKE VILLAS HOMWWNERS ASSOCIA APPROVAL
FORM K=
ral CORtrol Committee .Approval for Iaaprovcumnis to Exterior or Vidden Lake CarltonNotetlInatn"
Oax Please compktc the toning "rormatiou and waik or ta=, tWs
farm to the address bd ow. Upon approval, a siRnM copy wiH be forwarded
to yMu Viwta) iesPexttott by an A rebitectrral Contrd Coaamiti Mcmbrr,
Mnoeiation Board Member or Managing Agent may be ttcoeasary.
Print):
Cn.
re naatess:
fo !Pj A n & 1,- -
o - --- EL O 1 rdL3 3 IJ boneNumber
t O-71(v"7 94 Fax Number --.-.!a, Date r ! L( 3w ato3SSol>( ya-tDa s? P +t
of Ineprnvement pyaaT:>L : COLA o- ly AURA-
XOM&
I FENCBS ADDITIONS: Applieaat must mbmit dtxwing on Plat or Sumy of property
sbawingit is 16" from rimer property fine. prvWde drawing:
D of
APPQeaat
Oftl to. Sanford Ridden Lake ViAos HOA, Inc. P. O.
Box 1992 Sanford,FtorW*
3rn2-Idl2 Paz. qn-`
3-22-o-496 fled by
regrew etative of ACC or ItIOD Board
Or Managing Agent Signature S .
9f. Fef1Ce- '
MUST' n4 encnOCiC.% o \-U Ease-:f\
erj aoea. 0 p.
2
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