400 Casa Marina Pl - BR08-001002 (FENCE) DOCUMENTS (2)CITY OF SANFORD PERMIT APPLICATION
Application #: ' Submittal Date:
Job Address: 400 1u2 c Qa e J Value of Work: O$ .0 o CgZ7
Parcel ID: Zoning: Historic District:
Description of Work: t hSi a1I pt<<° Square Footage:
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Sign
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Cale. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential Commercial Industrial
Plumbing Repair — Residential Commercial
Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
Property Owner: iqn(Sl= oY" M e.,/Z Contractor:
Address: pd 0- , C,& rl aV r r a CY CC— Address:
3
Phone-. —3-J T' 70g E-mail: 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 verif lion [hat I wthe o ner of the property of the requirements of Florida Lien Law, FS 713. illnotifyu
o Signature
of Owner/Agent Pfate Signature of Contractor/Agent Date t
O \ 1K e Print
Contractor/Agent's Name Signature
of otary-State of Florida Date Signature of Notary -State of Florida Date MY
COMMISSION # DD629096 aF
EXPIRES: February 25, 2011 I-
DiMI-'-Np U1RY FL Notary Discount Assoc. Co. a, ,
Owner/
Agent is rpeNonally Known to Me pr Produced
ID + /](• s(n APPROVALS:
ZONING: Special
Conditions: Rev
07.07 UTIL:
FD: Contractor/
Agent is _ Personally Known to Me or Produced
ID ENG:
BLDG: W,
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)
I UNDERSTAND AND AGREE TO THE EXEMPTION PROVISIONS OF FLORIDA STATUTES 489.103
AS LISTED ABOVE.
I HAVE ACCESS TO THE ADOPTED CODES.
I 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.
YL - THIS STRUCTURE IS NOT BEING BUILT WITH MY INTENTION TO SELL, RENT, OR LEASE.
I UNDERSTAND THAT THERE IS NOT STATED A TIME FRAME TO SELL, RENT OR LEASE AN
OWNER BUILDER STRUCTURE WITHOUT BEING INVESTIGATED.
I UNDERSTAND THAT FOR ANY UN -LICENSED PERSON 1 HIRE, I MUST DEDUCT F.I.C.A.,
WITHHOLDING TAX, AND PROVIDE WORKERS' COMPENSATION INSURANCE.
Property Address: q(YU CO' Sce V L e e , c o re , -1:7
L 3&-7 7
do hereby state that I am qualified and capable of
performing the requested construction involved with the permit application filed.
Date
Y
µV.YV.4Gyy4!.1rM'ie.. M•4 'WLwN.^M`h-wM'IDEBBIEBL.NT SY
Form of Identification s MY COMMISSION 009096 e-
Must be Photo ID) N,;
NEXPIRES; Febru3
W-}-NOTARY
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. 4/20/07)
CELERY KEY HOMEOWNERS ASSOCIATION, INC.
Architectural Control. Committee
Date: Lot# Phase#
Property Owner: _.. & j 0 R) 7
Property Address:
Telephone%2
Architectural Review Application for:
Other
Swimming Pool Exterior Paint Colors Eencing
ATTACHMENTS FROM PROPERTY OWNER:
Written request describing addition, change o Cinsta llatio\
Property survey showing where addition or installation is to be located
Specifications (Copies of plans indicating dimensions, materials made of, color, samples,
pictures and brochures)
NOTE: Please be advised that work CANNOT be started until the ACC has provided a written
approval of the application.
1T++++++ 1-iT+;-+++++++++++++++++++++++++++++++++++++++++++++T'T-T T+++++++++++
FOR USE BY THE ARCHITECjTURAL CONTROL COMMITTEE
Request received forward to ACC ` / to owner
The A.CC's decision on the plans submitted is as follows:
Approved with the following comments:
You must obtain any permits that are required.
Denied
INFORMATION RECIEVED IS INCOMPLETE —required information is:
Control Committee
21zo/dy
DATE
z. - Z--0 - -'s,
Grid and Drawing Notes
Notas de cfiba lit) y cuadriculas
all
I+
h lltuntrnaa
imtaLlrnodt__
04'
d
Oq'
I I
tVP
a
IJII'
i f
I10
20
104'
n
AI
2011' ,
xi
401
Epttam,
0
F—
gal
1
16
Ib
II
IIl
I
YI to 27
Ilnd ita0lr A A`dmt-Y4 6 II! IV! IY Ifld
I of -rows A b d -• 7 rt o i
1 of somom
0G q2 qtl tnnnAtlfid9) 1 2.„„,6
pe font fanoo ( n p1a lag
W! 011 i with f 119II C nanaltmeal
Iwn horlaontat `"'
I I
61na Uarnndao
rgup _.__
riNdbkb a IIIif 1tWIC n
Lan th of Isnca 00 84' 100' 132' _ 180' l no' lun I, h nathtn ON tq CoLvt „, r,,,.,t _
NumYarW mia to I4 18 9! 26 30 JA Il nMH" du rrdr 79N _,.,
Poata II IB to v d7 11 _'If"I Iu
pg(y1 1t. 18 l<t 2,, 2f JI 1f IIIHidnr AxnfI IN1,
ro,,
11 »................... fa lXtlORalO A0 D0 r2 110 In14 l ul I tl lrn qll ! roO no l!PS trial r.
@ *or" 4 0 Q tl II _ 17... ,_ 1d 1.119IttdNn5{hl Ifflo a
w
Tuhao of pomam 2 2 . Y eJadute 0o Ctmgvtio,
fLyp a(catkr I0SAQMI "2 90 —All AIi 0n n7 7o Ihln4mf nvn+lup
l0 1n II Ora II Ililllm!41r!IQuLn1a
91e foot 0 pis Ids
oaaklons I Bti l trna
witl'1 thraa I " t .11 11 IPaFngtlA!1
Lontl01 of form 10' 01' lob 132, 1 8' utfr 701Idt ,1190f 0 ttp 117 potp--- ,,,,, Nunihor
of oencla 10 IA 18 22 29 y;1n JA LI Ijnmrc! Ug P15!
ll i8 10 7..9 21 ifuoitope
If IB—10--25 ROu
hrockete00 Bn i08 132. 1g0, tq0 AnA !o>ilnml I io lnllmtnt®ntaal"„ Beao
of ecmwo 0 o i1 In l0 10_21 4onitdlMN Tutwa
of Gamut 2 2 2 3 5 4 n 1 IuL a l i t wt i„ ,•,,,„M,. Cin
o nFormUreta (60P) 22 30 30 OB 50 82^ 70 Ikhwn ,rt eIT01tF, ,srµ,,,,,,,,,,,,_ Baoe
oP toa rsvul (1 11 'To , 12 14 18 lu 11 l u dt lu t tf m,9l tx 0nitlb All
calculations nro approxlmato Todos log ch1ctdon non aprtlxlrnaflt