HomeMy WebLinkAbout1003 W 9 St Re roofR ,
:D
JUN 18 2012
13Y:
Application No: Documented Constr
Job Address:
Parcel ID: _af�l i�'& y i 3y
Description of Work: 1 =
CITY OF SANrUKU
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Value:
Historic District Yes ❑ No 0
Zoning:
Title:
Plan Review Contact Person:
Fax: E-mail:
Phone: Property Owner Information
Name
Ot �� G r^ Phone: 61
13300
�..y Ste' Resident of property? :
Street: 3 `
City, State Zip:
Contractor Information "S
NameLf 5 Phone:
- ZIA Fax:
Street: p C��--
o'-State License No
City, State Zip:
Architect/Engineer Information
Phone -
Name:
Fax:
Street: E-mail: —
City,, St, Zip:
Bonding Company:
Mortgage Lender:
Address:
Address:
PERMIT INFORMATION
Building Permit ❑
Square Footage:
Construction Type: No. of Stories:
No. ofbwelling Units: Flood Zone:
Electrical 0 Plumbing ❑
New Construction - No. of Fixtures:
New Service — No. of AMPS-
Mechanical ❑ (Duct layout required for new systems) Fire Sprinkler/Alarm 0 No. of heads:
e
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 CONEdENCEMENT 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 COMWNCEMENT.
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 1 will notify the owner of the property of the requirements of Florida
Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated c exceed the documented
construction value when the executed contract is submitted, creditwiwi be ied to our permit fees when the
permit is released.
Signature of er/Agent Dace
� — t-1—/Z
Date
RUDY F KELSICK-PETERSEN
MY COMMISSION # EE093796
EXPIRES May 21, 2015
(407) 398-0163 Floridamwryserviceix m a.L�
Owner Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
RUDY F KELSICK-PETERSEN
MY C" }IuIMISSION # EE093796
43,,• EXPIRES I•.1:3y 21, 2015
398-0ib3 •• +•'aWotar;5en^.Ce.com
Contraci"or777errt'
Produced ID
UTILITIES:
FIRE:
Date
of Florida Date
_ Personally Known to Me or
Type of ID
WASTE WATER:
BUILDING:
RP,/ 11 f1R
'Tax Folio No. III S --Di 50
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
The undersigned hereby gives notice that improvement
will be made to certain real property, and in accordance
with Chapter 713, Florida Statutes, the following
information is provided in this Notice of Commencement.
1.
MKWM NORSE, CLERK OF CIRWIT MW
lalm .E COm
DR 077M Pg L%l; Qpg)
CLERKII S 0 201240 1 i1 10
RECOM 0611W2012-1 02%lat47 PH
DINS Fly 10.0
lIaECMDM BY T Smith' COPY
..r CEgIFIED
NE m000511RT
11Nri
;r1 ERK
�ARYOF CIRCUIT FLORIDP
_ �, r ,
Q n0�
2. General description of improv ent: (�-�- — UGPI6Y �J� m Nam/" '�" to tt ��
y `
It
3. Owner information: Name: Qnt--�=a - 6300t 027 f� ci4a0 A C;Mn -
Address: (I) n 3W Oil-
b. Interest in property: _ (fig) n rz:--gS
c. Name and address of fee simple titleholder (if other than Owner): Name:
Address:
4. Contractor Name: i _ Phone number: 3
c. Address: S- - t- %J
5. Surety Name
Address:
b. Amount of bond: $
6- Lender: Name:
Address:
b. Lender's phone number:
7.a. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes: Name:
Address:
8.a. In addition to himself or herself, Owner designates of to receive a copy'of the
Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes.
b. Phone number of person or entity designated by owner.
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different
date is specified)
on of property: (legal description of the property, and street address if available)
1 A > . c t -1-11 S i - S �tr, i=o tub
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,
SECTION 713.13- FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. ANOTICE 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF
Signature 6 Owner or Owner's Authorized Officer/Director/Partner/Manager Signatory's Title/Office
The forag'om a was acknowledged before me this day of , (year) , by (name of person) as (type of
autho>iYiy, mg,'L�ttt ,astee, attorney in fact) for (name of party on behalf of whom instrument was executed) .
Person lly Known '"'OR Produced Identification Type of Identification Produced
verification pursuant to Section 92.525. Florida Statutes: Under penalties of perjury, I declare that I have read the foregoing and that
the facts sta ed 'n "t a a to the best of my knowledge and belief.
44
Signature o atural Person Si�n Abo a Y► -.,,
g11 `1 t i1V; i ,t+ RUDY F KELSIGK PETERSEM
Rev. date 3/2008 t K��nhka`G ei: ' MY COMMISSION # EE093796 NAME !I� EXPIRES May 21, 2015
Ililil R_ 3 r n i 407 388-0163 FlordallotarySen4ce.com
1�
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: �' 1 11 �
I hereby name and appoint:4- (3 Q,4 S el'
f\ 1 r\
an agent of:
to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things
necessary to this appointment for (check only one option):
❑ All permits and applications submitted by this contractor.
The specific permit and application for work located at:
(street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name:
State License Number
Signature of License F
STATE OF FLORIDA
COUNTY OF
The foregoing instr lent wa acl o�vledged before me this l t day of Me v,
200 'Z , by &g, /� who is ❑ Rersonally know„
to me or ❑ who has produced
identification and who did (did not) take an oath.
Signature
(Notary Seal)
;: DAVID T MURA
N! # DD879454
sQ,•'' EXPIRES ApdI 12, 2013
(407)398.09C3 FlorMallolaryServke.—
(Rev. 3/27/07)
Print or type name
Notary Public - State of /
Commission No.
My Commission Expires:
as
VAN
Wt L A N'-S
ROOFING.INC.
445 Douglas Ave, Ste 2205E
Altamonte Springs, FL 32714
CONTRACT
Commercial & Residential
"Home of the FREE Roof Inspection"*
www.alansroofinginc.com
LICENSE NO.000046942
•/�v v CITY --5 yy e
IM.HOME
BRAND OF A _ P ., /�,.r9,ss/t'A-/—�)>I1 -
Orlando: (407) 774-2158
Toll Free: (800) 309-5667
Fax: (407) 774-2891
V OR COUNTY /��A"PERMIT SQ. RENAIL WOOD
�1. PULL A CITY SQ. OF OLD TILE
c� So- OF FLAT ROOF
�2. TEAR OF
]' F � ` � � SQ. OF OLD SHINGLES � r� Y� . i% •
LAYzr11 I'll ERS— SQ-TILE
ER
3. DRY IN WITH 30# FELT'
Ay ALLEY AL FT 55# SELF ADHERING UNDERLAYMENT FT. METAL OVER RIDGE
INSTALL COLOR
5: INSTALL FT. ALUM J-2LU-'—FT STEEL DRIP EDGE
FT PAN/FT. L. FLASHING
�_ FT OF R.V. � QTYJ FT. OFF RIDGE VENT— -
PLUGS �J f ��COLOR
(�J 5/NSTAWREPLACE ,
1—} 7 REPLACE 1'A IN. -2 IN• 3 IN. LEAD BOOTS—�41N• -in I - GRV'S ELEC. RISER
8! STARTER STRIPS / ti<,04tw-00
' 9. LAY�� r SQ. OF NEW FIBERGLASS SHINGLES � FT- H.R.
_LG. DEAD VALLEY n ~
❑ 1%INSTALL SMJ �-6.�• � > 1 6>r rift TP,^
11. INSTALLTARGH `�Rp'OfG'LAYEROFIN�U TION
ACRYLIC SFA LOW I-SG�SASHING
❑ 12. INSTALUREPLACE 2 X 2 2 X 4 4 X 4 SKYLIGHTS DOMES CM
❑ 13. HAUL OFF ALL TRASH AND RUN MAGNET AROUND GROUNDS
❑ 14. ALL WOOD WORK WILL BE EXTRA PER ATTACHED WOOD BILL
❑ 15. SPECIAL INSTRUCTIONS
r1 /' e _ - • _f fir_., ; q,_;-7�-n�A4tsei�`,'lS i ilit�3' i s' N
ALAN'S ROOFING INC.
❑ 1 CnNDUCT ANY Oft ALL
TOTAL DUE UPON
COMPLETION
3
ACCESS:6ustomeragreestoailowaccess to the propertyand reak¢esthat heavy equipment is being used.
Contractorshali not be liable for, without limitation, damage to driveways, sidewalks, lawns, sprinklersystems, gardens, septic systems and arty other structures thereof, as a result of rooftop or job deihrerles.
DAMAGE. ETC.: Should customer become aware of damage to property by Contractor, his agents, or employees during the courso of Installation of the roof, said damage shall be brought to the attention or the
Contractor priorto the time of payment for the roof In question. It Customer falls to notify Contractor of said damage, within 5 working days of occurrence, then shall waive all rights against Contradorconcemirg said
damage. Alan's Roofing, Inc. is notresponsibleforroofingnailspenetratingAlCfinesintheatUQ
DELAYS, ETC.: Hereby acknowledges that Contractor may be subject to delays o-lonod by inclement weather, labor disputes. end material supply shortageswhich a,%boyoml tho control of the Contractor and
hereby accepts delays occasioned by one or an of these circumstances In the installation of his roof. Further agrees to pay Contractor an amount to qual 10% of the mtill contract price shoutd this contract be
cancelled forany reason priorto theinioation of work on roof, but aftermidnight of thethird business day aftersigning. j
PAYMENT CONTRACT. Customer hereby agrees that if the amounts due and owning hereunder are not paid when due, also shall be liable to slices of '!" a uding, but not limfted to, reasonable
attorney'sfees and costs. which a ts,togetherwithall sums and owing hereunder. shall bare Interest at1%%per month.
ACCEPTANCEPROPOSAL•Thre,spearxati000999sss��+dcondiaonsaresansfaaoryand SALESMAN SIGNATURE
hereby accepted. All contrftptsy�afesu 'ectiO a r
CUSTOMER SIGNATURE `rJJ���✓/��.i DATE�-MANAGEMENTAPPROVAL
Construction Industries Re ' v ry Fund: Payment may be available from the construction industries recovery fund if you lose money on a project performed undercontract, where the loss
results from specified violations of Florida Lawby aState Licensed Contractor. For information aboutthe Recovery Fund andtiling acialm, contaetthe FloddaCILBsithefollowing telephone
numberand address:850-487-1395, Ftodda Construction Industry Licensing Board,1940 N. Monroe Street, Tall4hassee, FL32399.