1021 Pecan Ave - BR08-000771 (FENCE) DOCUMENTSr
fPhone:.`Xi4(E-mail:
R-2
Bonding Company:
Address
Architect/Engineer:
Address:
Plan Review Contact Person:
Phone: State License Number:
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 i
NOTICE OF COMMENCEMENT.
NOTICE: In addition to a equ' ments of permit, may be dtheremnal restrictions applicable to this property that may be found in the public records of
this county, and there ma e a i s r Aire o e tal entities such as water management districts, state agencies, or federal agencies.
r
I n e owner of the property of the requirements of Florida Lien Law, FS 713.
T wner/AAgent Date Signature of Contractor/AgentSig _ re o
DateOg .
Pr er/Agent's Name Print Contractor/Agent's Name
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
MY COMMISSION # DD62966,-
Owner/Agent is 1, Kms"" n'W I ' ry25, Oil Contractor/Agent is _Personally Known to Me or
Produced ID RTvzr _ Produced ID
APPROVALS: ZONING: UTIL: _ FD: ENG: BLDG:
Special Conditions:
Rev 07.07
s
CITY OF SANFORD PERMIT APPLICATION
T Submittal Date: Application # : !`
Job Address: e of Work: $ c-
Da
Parcel ID: Zoning: Historic District:
Description of Work: L wi A
f...................................................................................................................
40ja 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 Q
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: • •
r
r
Contractor:
Address: D Address:
fPhone:.`Xi4(E-mail:
R-2
Bonding Company:
Address
Architect/Engineer:
Address:
Plan Review Contact Person:
Phone: State License Number:
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 i
NOTICE OF COMMENCEMENT.
NOTICE: In addition to a equ' ments of permit, may be dtheremnal restrictions applicable to this property that may be found in the public records of
this county, and there ma e a i s r Aire o e tal entities such as water management districts, state agencies, or federal agencies.
r
I n e owner of the property of the requirements of Florida Lien Law, FS 713.
T wner/A Agent Date Signature of Contractor/AgentSig _ re o
DateOg .
Pr er/Agent's Name Print Contractor/Agent's Name
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
MY COMMISSION # DD62966,-
Owner/Agent is 1, Kms"" n'W I ' ry25, Oil Contractor/Agent is _Personally Known to Me or
Produced ID RTvzr _ Produced ID
APPROVALS: ZONING: UTIL: _ FD: ENG: BLDG:
Special Conditions:
Rev 07.07
s
ti
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.
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.
1 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 I HIRE, I MUST DEDUCT F.I.C.A.,
WITHHOLDING TAX, AND PROVIDE WORKERS' COMPENSATION INSURANCE.
L,S / do hereby state that I am qualified and capable of
perfor ing the requested construction in olved with the permit application filed.
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)
1/2" 1.P.
NOTH LINE OF THE S.1/2 OF L 0 T 22
Q
J cr)
11 g LESS THE N. 50.00'
89'46'26' M.
W
5. J'
D.
FD. 5/8" x—x— x—x—xtx
147.75'
x—x—xx—x1. R. 15220
O i9070'51" M. II
x
I
k\
X
x
i I
co
O
t :. v.
N o 36.7'
N
11. 99' 2J.3
1021
N
12.0' _ 48.0'
1J. 87'
89'49'09" M.
oh, :_
AIC +' • '
FD. •:•
5/8" l.R. 1.7'
90'04'00" M 147 75' D. I
1 FD.
Cod
1/4' 1.P.
147.74' A4.
r.x—x--x—x--x--x—
5.4'
x—x--x--xT FD.
I" L P.
0.1'
a .
8949'09" M I N
I W
LV2 O
O
20.0' I N 2
10.0' I W
h METAL
TAL
2
SHfO o M£I W
SHED 4,
I o
o ti
I
BOVF
N
GRWND
I N
POOL I '
9070"51" M.
0.2'
x—x—x—x--x—x—x—x 14725"
147. 74' M.
2. J"
FD. 5/8"
I. R. 15220
W. 11th STREET
BOUNDARY SURVEY
SURVEYORS CERT/F/CA170M
I HEREBY CER 77FY THAT THIS BCUWARY SUR I•EY
IS A TRUE AND CORRECT REPRESEN TA RON OF A
SURREY PREPARED UNDER Aly DIRECRON.
NOT VALID IN IHOUT AN AUTHENTICATED ELECTRONIC
SIGNATURE AND AUTHEN77CA TED ELECTRONIC SEAL,
OR A RAISED EMBOSSED SEAL AND SIGNATURE.
SIGNED)
CLYDE 0. AICNEAL, PROFESSIONAL SURVEYOR AND MAPPER 12881
PAGE 2 OF 2 PAGES
SERVING
MOST FLORIDA COUNTIES
TARGET SURVEYING, INC.
LB #6135
5601 CORPORATE WAY SUITE 210 STATEWIDE NUMBERS
WEST PALM BEACH, FL 33407 PHONE (800) 226-4807 -
PHONE (561) 640-4800 FACSIMILE (800) 741-0576
FACSIMILE (561) 640-0576
p -
y 9n(
REVISION
PERMIT# V8 DATE
PROJECT ADDRESS 0 I 0620-,
CONTRACTOR[
PHONE # 3 '` (jFAX #
CONTACT PERSON ,,--{,
DESCRIPTION OF REVISION (U f ; 0V-) c
UTILITY DEPT
FIRE PREVENTION
PLANNING
p20
BUILDING