2616 Marshall Ave - BR08-001012 (REPLACE FENCE) DOCUMENTSCITY OF SANFORD PERMIT APPLICATION
rs— I — Application # : + Submittal Date:
Job Address: ZCo/lo ,V'MAe S14A-L- &l/t Value of Work: $ 00C) Parcel
ID: n
Historic
District: Description
of Work: f I'GA i F n/e if Square Footage: Permit
Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Sign j:
Electrical:
New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole Zoning:
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 Commercial Occupancy
Type: Residential Commercial Industrial Occupancy Use Group(s): Construction
Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required ) Property
Owner: JI+M6S wF 'j>T -fp_ Contractor: Address: ;-
Mi4,,Q_':WALL. A-U6E Address: S
4,v Fib rL 3 Z 7 -7 3 Phone:
4/07 32-7 16SS E-mail: J /-J?A1T1V_AWlE%1V> , 600 Phone: State License Number: Bonding
Company: Address:
Architect/
Engineer: Address:
Plan
Review Contact Person: Mortgage
Lender: Address:
Phone:
Fax:
Phone:
Fax: E-mail: 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. 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. 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. cRJ
Z-z7% S
gnature of Owner/Agent Date Signature of Contractor/Agent Date O /
A is N e Print Contractor/Agent's Name Signature
of Notary , o, 13Signature of Notary -State of Florida Date a MY
COMMISSION #
DD629096 OF EXPIRES:
February
25, 2011 1-8IX1-
3-NOTARY R. Notary Discount Assoc. Co. Zllf Owner/
Agent
is Personall Known to e Produced ID
f a • cei
I APPROVALS: ZONING:
UTIL: FD: Contractor/Agent
is Produced ID
ENG: Personally
Known
to Me or BLDG: Special
Conditions:
Rev 07.
07
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
FSS 489.103 Disclosure Statement
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 $75,000. 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 supervision 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.
BY SIGNING THIS STATEMENT, I ATTEST THAT: (Initial to the left of each statement)
LA,rI UNDERSTAND AND AGREE TO THE EXEMPTION PROVISIONS OF FLORIDA STATUTES 489.103
AS LISTED ABOVE.
I HAVE ACCESS TO THE ADOPTED CODES.
14 WO 1 AM FAMILIAR WITH THE CODE PROVISIONS.
I HAVE ADEQUATE KNOWLEDGE AND QUALIFICATIONS TO SAFELY PERFORM AND DIRECTLY
SUPERVISE THE WORK.
THIS PROPERTY IS NOT AN APARTMENT, CONDOMINIUM OR RENTAL PROPERTY.
THIS STRUCTURE IS NOT BEING BUILT WITH MY INTENTION TO SELL, RENT, OR LEASE.
4o I UNDERSTAND THAT THERE IS NOT STATED A TIME FRAME TO SELL, RENT OR LEASE AN
OWNER BUILDER STRUCTURE WITHOUT BEING INVESTIGATED.
J.
J I UNDERSTAND THAT FOR ANY UN -LICENSED PERSON I HIRE, I MUST DEDUCT F.I.C.A.,
WITHHOLDING TAX, AND PROVIDE WORKERS' COMPENSATION INSURANCE.
Property Address: Z & /4 t,,lo0-s/-JAt4__ A j F 5,4Vr49,2A FL _;5L7-'1 15
I, 'i A VL65 W, Betl.-TC" JR- , do hereby state that I am qualified and capable of
performing the requested construction involved with the permit application filed.
Date
Form of Identification
Must be Photo ID)
z/zV46
A violation of this exemption is a misdemeanor of the first degree punishable by a term"ofi i "t not
exceeding 1 year and a $1,000.00 fine in addition to any civil penalties. In addition, the local.?er fitting
jurisdiction shall withhold final approval, revoke the permit, or pursue any action or remedy iaipHnlicensed
activity against the owner and any person performing work that requires licensure under the permit issued.
Rev. 4/20/07)
LOT 21
BLOCK "29"
LOT 20
BLOCK "29"
SET 1/2- IRON ROD
AN11 CAP LB#6393
FEFtr;E. IS 0.4' NORTH
AD 0.2' WEST
FEIICE IS 0.4' NORTH
AND 0.2' WFST
PAD IS 1.1' EAST
AND 0.2' NORTH
Wff
0 ' n
00
V I
D 0
0
rn 1I
W N
C
70
M 1'1
0
ON
LINE
I
0.9'
ON ts.e'x1Ls')
METAL STIED
4 ON CONCRETE
o -
m I
DI
Z m I
I
I
I
I
SE 1 I/2- 1170N R00
AND CAP 111p6393
FEIICE 15 1.1' NORTH
AND 0.6' EAST
LOT 19
BLOCK "29"
LO1 11
BLOCK "29"
N 89'49' 55" E
122.79' MEASURED
123.13' PLAT
0.2' 0.3
O F OFT
COVERED CONCRETE --
AREA PAD
45.1'
ONE STORY CONCRETE
BLOCK RESIDENCE #2616
t
A
0
0
d
4 5,1'
CONCRETE
DECK 1.6
ON
SE 1/2- IRON ROD
AND CAP L9#6393
WALK IS ON LINE
CONCRETE
j
DRIVE
4.
0r OZ
S 89'49'55" W
n % r+nr& ) Ar— A C'I I 17D I22.62 `IVII-NJU I- 122,
97' PLAT LOT
13 BLOCK "
29" CERTIFIED
TO: COAST
TO COAST TITLE SERVICES, GUARANTEE
TITLE AND TRUST, AMERICAN
FIDELITY, EXPRESS FUNDING, JAMES
AND BRENDA PRATT. I
HAVE EXAMINED 11AE F.LR.M. COMMUNITY PANEL NO.
120294 0005 B DATED 9/17/80 AND FOUND THE
DWELLING LIES IN ZONE C AREA OF MINIMAL FLOODING.
BEARINGS
SHOWN HEREON ARE BASED ON THE
WEST LINE OF MARSHALL AVENUE. BEING
SOUTH 00-00`00" EAST AN ASSUMED DATUM. FIELD
DATE:) 7/11 /94 REVISED: SCALE:
1"--
30 FEET APPROVED
BY: 1AD 0
0
LOT
12 BLOCK "
29" SET
1/2- IRON ROD AND
CAP LBM6393 WALK
IS ON LINE I
A A 00 (L U
Z D
n
caTmoI
RECOVERED
1/2- IRON ROD AND
CAP NOT LEGEDLE PC
N
U)
D
r
LEGEND:
R
DENOTES RADIUS RP
RADIUS POINT h
DENOTES DELTA ANGLE L
DENOTES ARC LENGTH A/
C AIR COND111ONER CENTERLINE
RIGHT
OF WAY LINE CONCRETE
I"
B LAND SURVEYING BUSINESS LS
LAND SURVEYOR PRM
PERMANENT REFERENCE MONUMENT PCP
PERMANENT CONTROL POINT Tt'
P TYPICAL PC
POINT OF CURVATURE PT
POINT OF TANGENCY PRC
POINT OF REVERSE CURVE CB
CHORD BEARING PI
POINT OF INTERSECTION CBW
CONCRETE BLOCK WALL t AMERICAN
SURVEYING & MAPPIN] 300
NORTH PARK AVENUE SUITE 202 WINTER
PARK, FLORIDA 32789— (
407) 539-2274 1,
THE SURVEYOR HAS NOT ABSTRACTED THE LAND
SHOW11 HEREON FOR EASEMENTS, RIGHT OF
WAY, RESTRICTIONS OF RECORD WHICH MAY
AFFECT THE TITLE OR USE OF THE LAND 2.
NO UNDERGOUND IMPROVEMENTS HAVE BEEN LOCATED
EXCEPT AS SHOWN. 3.
REPRODUCTIONS OF THIS SURVEY ARE NOT VALID
UNLESS SEALED WITH THE EMBOSSED SURVEYOR'
S SENL. This
is to cer ify that we have performed a
field survey f ttte hereon scribed property,
for lh purpose on described, that
this dra w1 is esentation of that
survey and e Minimum Technical
S pur unnt to Section 472.
0 I a 'totes. JOB
NO. ASM50'
73 DRAWN
BY: SGR
BRETT
A. MOSCO TZ, PLS # 5011