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HomeMy WebLinkAbout3515 S. Mellonville Ave 18-4722-�yF ORp F^OF uDIVISION E.57. 15.1 PERMIT APPLICATION JO I� -voy"1 zz Application No. U� Documented Construction Value: 5 Job Address: 5 I 'I ovty t 1fAve,Historic District: Yes ❑ No❑ Parcel ID: o Z 0- 3 1 3 U 0— O ISA - C 0 0 0 Residential 0 Commercial ❑ Type of Work New ❑ Addition ❑ Alteration ® Repair ❑ Demo[] Change of Use ❑ Move ❑ Description of Work Plan Review Contact Person:L K Titte:_e. nn Tt -) GCI 1 Phone:4ol- 095 3 59 Fax: Email: aII ( cd pYV1C�a�U` a1yN\t7l Property Owner Information Name Co r n e_� I Phone: Street: t I S N\1 I o t114t I e h" -e- City, State Zip: r 0� TFL Resident of property?: Contractor Information O Name Phone: L101- Street: 1U1-Street: o� City, State Zip:1� Y Innn fl n �280� o Name: Street: City, St, Zip: Bonding Company: Address: Fax: State License No.: CEL 14 a to a 3 g Architect/Engineer Information Phone: Fax: E-mail: Mortgage Lender. Address: WARNING TO OWNER: YOUR FAILURE'r0 RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NO'rICE 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 Appheduon i,'.ache made to ("am a permit m do the work and ins'tallatlons a. indicat,d 1 ,, rw% that no work or installation has conuneuccd prior to the issuance of a permit and lhat all work will be performed to meet standard. 01:111 I.ur1 rcgtdating 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, C FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 61 Edition (2017) Florida Building Code NOTICE:in addition to the requirements of this permit, there may be additional restrictions applicable to this property that maybe found in the public records of this county, and there may be additional permits required from outer governmental entities such as water management districts, state agencits, or federal agencies. Acceptance of permit is verification that I will notify the owner of the property of the requirements of l-lorida Lien Law, I -S 713. 1 -he City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required in order to calculate a plan rcview charge and will be considered the estimated construction value of the job at the time of submittal. The actual construction value will be figured hased on the current ICC Valuation "fable in effect at the time the permit is issued, in accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value, credit will be applied to your permit fees when the permit is issued. ONN"NER'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. rZ Signature of Owner/Agent Date �-- �% 5 e- Y Print Owncr/Agent's Name -ItZAj-- - �LtLl Signature Notary -State of Florida D to Owner/Agent is Personals Known to Me or 4015 P421 t4otary Pubuc stab of FkxWa MYRNA L STEELE • My Commlasion GG 107356 EvIM 091lsM2i BE W1 OF Signature of ContraetortAgent Date �\�i I � I a 1A C� Print Contractor/Agent's Name 'P�" 1 141 lJ "' Signal of Notary -State of Florida Date Contractor/Agent is�— Personally Known to Me or Produ .► _ Notary Public 8100 of FWMa 5 MYRNA L STEELE �mmteaton 30107866 WN 09/18/2021 - - — Permits Required: Building ElElectrical ElMechanical ElPlumbing [IGas [IRoof Construction Type: Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTI 1,ITIES: FIRE: Flood Zone: # of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes ❑ No ❑ WASTE: WATER: BUILDING: P To(o- �,;- o 1A 8797 P', 1d; Vol mera t rI ►; �' ., C �1 '(� ire, m 2311 Henderson Drive, Unit A o Orlando, FL 32806 4 Phove: 40 -8� �-35 Q � Fax:G4ti7-898-5258 License # Trl-,a26'38 - rj. vdtiv.e neral p'l4mbitag.net x- '11 /o 1 ar, r - Name _Ll'oe_ Address State, Zip Code(� ne i � � � _ J � X3 2nd Phone Gate Cede CRY EmailI U1 G _ b„ 7 1 f;epresentati'ee `�'� Method of Payment Check Cash Credit (3%-5% fee added for credit cards) 1 STORY ❑ 2 STORY ® FLAT ROOF �,LURN PEX PIPE With Brass Fittings 25 year manufacturers warranty -transferable 10 year labor warranty - transferable Price includes labor & materials. Drywall repair included, textured and ready for paint. Payment due in full at completion of re -pipe. Re -piping of hot and cold water lines completed in 1 clay. Drywall repair and inspection on 2nd business day. (finless Building Department states otherwise. Vie leave no control of time of inspections) Painting, tile, wallpaper repair, etc. NOT included in price. Drywall cuts Dept a ini /have read and fu//y understand _ the terms and conditions. Signature FIXTURES QTY NEW MAIN I=T HOSE BIB WATER HEATER WASHING MACHINE I LAUNDRY TUB UTILIrrSINK KITCHEN SINK ICE MAKER DISHVJASHEF{ BAR SINK ISLAND SINK TOILET Comments: - BIDET ---- o!�4t-ACvn-----r��AAt" wk�\ --- - -- --•--- kteS WLAVATORY SINK .�------- SM ER ----- ---- ��� G! — 1 t ---- TUB ------------------.. _____. -- OUTDOOR SHOWER ------------------(-- SUMMER KITCHEN --- OTHER 9 Recommendations: SUB TOTAL --- --- ---------- ---S�'V.r�--- tom- Vit,. DEPO ------------------ /' �-"� -- - - TOTAL AMOUNT D 4 TOTAL s A a t 47 rte. SEMINOLE COUNTY MuLTI~11RISDICTIDNAL LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 11/13/18 I hereby name and appoint: Alex McGilloway an agent of: Emerald Plumbing (Name of Company) 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. Or ❑ The speck permit and application for work located at: (Street Address) Expiration Date for This Limited Power of Attorney: License Holder N State License Number: William Cuddv CFC 1426238 Signature of License Holder: 11/13/20 STATE OF FLORIDA COUNTY OF Ncta The foregoing instrument was acknowledged before me this _day of �Q\j P AA o-Pl✓ 20-1_, by sA who is P, personally known to me or D who has produced and who did (did not) take an oath. v4v',� �-'bv �Qk Vi nature of Notary R Notary Public State of Florida `fi MYRNA L STEELE III c My commission GG 107355 e Expifes0911612021 as identification �Am vrvi (A - (�A -f -e_ I Tint or type Notary name Notary Public - State of Commission No. 1C� 3S- My Commission Expires: q `" /b _ 2-1 H 10 ACOREY CERTIFICATE OF LIABILITY INSURANCE (MMIDDIYYYY DA TE ' OF INSURANCE 1/3/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Raquel Gonzalez Insurance Office of America, Inc. PHONE FAX •407-788-3000 AIC No): 407-788-7933 1855 West State Road 434 ADDDDRIESS: rag uel.gonzalez@ioausa.com Longwood FL 32750 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Ohio Security Insurance Company 24082 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a PRO. F] LOC OTHER: INSURED EMERPLU-01 INSURER 8: The Hanover American Insurance Company 36064 Emerald Plumbing of Central Florida, Inc. B 2311 Henderson Dr. Unit A INSURER C: Builders Mutual Insurance Company 10844 INSURER D: Orlando FL 32806 INSURER E: 3!712018 INSURER F: BODILY INJURY (Per person) $ COVERAGES CERTIFICATE NUMBER: 382642672 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRTYPE LTR OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDOlYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Btkt AI,Blkt WOS BKS57676632 1112018 1/1/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Eaoccurrence $ �.� MED EXP (Any one person) $15,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a PRO. F] LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNEDSCHEDULED AUTOS AUTOS NON-OWNED X HIRED AUTOS X AUTOS X B1kt Al X B1kt WOS AZJ9485191 3!72017 3!712018 COMBINED SINGLE LIMIT $ Ea accident 500,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident PIP $10,000 UMBRELLA LIAB EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? Y� (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A WCP103046504 1112018 1/1/2019 X STATUTE ER E.L. EACH ACCIDENT $ 500.000 E.L. DISEASE - EA EMPLOYEE $ 50D,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached K more space Is required) CERTIFICATE 14nLDFR CANCELLATION ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Sanford Building Dept. 300 North Park Avenue AUTHORIZED REPRESENTATIVE q11 I Sanford FL 32772 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ACoRo® CERTIFICATE OF LIABILITY INSURANCE DATE {MM/DDIYYYY) 1(MMIDD8 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Insurance Office of America, Inc. 1855 West State Road 434 Longwood FL 32750 CONTACT NAME: Raquel Gonzalez PHONEFAX 0 : 407-788-3000 AIC Nol: 407-788-7933 a DRESS: ra uel. onzalez ioausa.com INSURER(S) AFFORDING COVERAGE NAIC 0 1/1/2018 INSURER A: Ohio Security Insurance Company 24082 EACH OCCURRENCE $1,0DD,000 INSURED EMERPW-01 Emerald Plumbing of Central Florida, Inc. 2311 Henderson Dr. Unit A INSURER 8: The Hanover American Insurance Company 36064 INSURER C: Builders Mutual Insurance Company 10844 INSURER D: Orlando FL 32806 INSURER E : PRODUCTS - COMP/OP AGG $ 2,0D0,000 INSURER F: B COVERAGES CERTIFICATE NUMBER: 382642672 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDMfYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR X Blkt AI,Blkt WOS BKS57676632 1/1/2018 1/1/2019 EACH OCCURRENCE $1,0DD,000 DAMAGE PREMISES Ea occurrence $ 300,000 MEQ EXP (Any one person) $15,000 PERSONAL & ADV INJURY $1,000,000 GEWL AGGREGATE LIMIT APPLIES PER: POLICY E] JET 7 LOC OTHER: GENERAL AGGREGATE $ 2,0D0,000 PRODUCTS - COMP/OP AGG $ 2,0D0,000 $ B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS X Blkt Al X Blkl WOS AZJ9485191 3/712017 W 2018 COaBINED SINGLE LIMIT $ ident) 500,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ PIP $10,000 UMBRELLA UAB EXCESS LIAB —d OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y❑ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A VYCP103046504 1/1/2018 1/1/2019 X I PER I OTH. STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Sanford Building Dept. 300 North Park Avenue AUTHORIZED REPRESENTATIVE Sanford FL 32772 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY FI dopr STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD THE PLUMBING CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES CUDDY, WILLIAM EMERALD PLUMBING OF CENTRAL FLORIDA INC 2311 HENDERSON DRIVE UNIT A ORLANDO FL 32806 LICENSE NUMBER: CFC1426238 EXPIRATION DATE: AUGUST 31, 2020 Always verify licenses online at MyFloridal-icense.com _5- �t� Do not alter this document in any form. 'moi 11`tt'� This is your license. It is unlawful for anyone other than the licensee to use this document. Tax Collector Scott Randolph Local Business Tax Receipt Orange County, Florida 2018 EXPIRES 9/30/2019 1803-0000130 1803 PLUMBING $40.00 13 EMPLOYEES : 5000 BUSINESS OFFICE $30.00 3 EMPLOYEES TOTAL TAX $70.00 CUDDY WILLIAM PREVIOUSLY PAID $70.00 TOTAL DUE $0.00 EMERALD PLUMBING OF CENTRAL FL INC CUDDY WILLIAM 2311 HENDERSON DR STE A 2311 HENDERSON DR #STE A ORLANDO FL 32806-1901 U - ORLANDO, 32806 PAID: $70.00 0098-00825694 7/5/2018 Tax Collector Scott Randolph Local Business Tax Receipt Orange County, Florida This local Business Tax Receipt is in addition to and not in lieu of any other tax required by law or municipal ordinance. Businesses are subject to regulation of zoning, health and other lawful authorities. This receipt is valid from October 1 through September 30 of receipt year. Delinquent penalty Is added October 1. 2018 EXPIRES 9/30/2019 1803-0000130 1803 PLUMBING $40.00 13 EMPLOYEES 5000 BUSINESS OFFICE $30.00 3 EMPLOYEES TOTAL TAX $70.00 v �~ PREVIOUSLY PAID $70.00 `� L► .. ti `ly CUDDY WILLIAM TOTAL DUE $0.00 ��%• `��` EMERALD LM PLUMBING OF CENTRAL FL INC CUDDY U 1ORLANDO 3080 R #STE A ��'ro�,\,, �1t`�� 2311 HENDERSON DR STE A ORLANDO FL. 32806-1901 PAID: $70.00 0098-00825694 7/5/2018 This receipt is official when validated by the Tax Collector. Orange County Code requires this local Business Tax Receipt to be displayed conspicuously at the place of business in public view. It is subject to inspection by all duly authorized officers of the County. octaxcol.com I B a V octaxcol