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HomeMy WebLinkAbout202 Bradshaw Dr (2)CITY OF SANFORD BUILDING & FIRE PREVENTION JAN 201$ '+ PERMIT APPLICATION Application No: Documented Construction Value: $ SQ QC� Job Address: v �raG�►/l!(W �IZ J� Historic District: Yes ❑ No R Parcel ID: .1�— let" 5D— 5.2,;?-8F00-005— Residential V Commercial ❑ Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ;9 Change of Use ❑ Move ❑ Description of Work: filyt A0 41 1V41 Plan Review Contact Person: Title:00ah—OA, v /lJ Phone: Fax: Email: f #A b1�jd�7L '-S�r'• Property Owner Information p Y Name 4blf r �ene: Street: �. �D�)cylr/0[ 0/ /,►, Resident of property? : Ei— City, State Zip: Contractor Information Name rM* i Phone: Street: .2my Ct3 d)0Vt_ Fax: City, State Zip: State License No.: 01i -' 59-30 3!5%rS Architect/Engineer Information Name: ri /V Phone: Street: Fax: City, St, Zip: E-mail: Bonding Company: Mortgage Lender: Address: Address: 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. 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 V 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. FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5ch Edition (2014) Florida Building Code Revised: June 30, 2015 Permit Application (/ JC 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. The 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 review charge and will be considered the estimated construction value of the job at the time of submittal. The actual construction value will be figured based on the current ICC Valuation Table 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. 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. Signa f er/Agent Dat 0, c, f�e-jui►deZ Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID Signa o Co for/Agent bate g,e, f'cm wd e 2 Print Contractor/Agent's Name of Notary -State ,�— DEBBIE l,l.A k�; i 176646 0 cotiln'11SSIC 25 2019 EXPIRES. February ,.. . .,c�� Bonded Thru Not_ ary Pubk U iderwrilefs v: u; Contractor/Agent is Personally Known to Me or Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Gas❑ Roof ❑ Construction Type: Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes ❑ No ❑ APPROVALS: ZONING: ENGINEERING: COMMENTS: Flood Zone: # of Stories: Plumbing - # of Fixtures # of Heads Fire Alarm Permit: Yes ❑ No ❑ UTILITIES: WASTE WATER: BUILDING: Revised: June 30, 2015 Permit Application 1 /22/2018 SCPA Parcel View: 35-19-30-522-OF00-0050 Property Record Card Parcel: 35-19-30-522-OFOO-0050 Property Address: 202 BRADSHAW DR SANFORD, FL 32771 _ ....._. .....___._ . _....... .... ...... Parcel Information ----------- _ _ ------------ Parcel 35-19-30-522-OF00-0050 — Owner HABITAT FOR HUMANITY OF SEMINOLE COUNTY & GREATER APOPKA FLORIDA INC Property Address 202 BRADSHAW DR SANFORD, FL 32771 — Mailing PO BOX 181010 CASSELBERRY, FL 32718-1010 — Subdivision Name COUNTRY CLUB MANOR UNIT 3 - Tax District S1-SANFORD- DOR Use Code 01-SINGLE FAMILY Exemptions 34-CHARITABLE/CIVIC(2018) e'J nift 0 ., .% 9 Seminole County GIS Value Summary 2018 Working 2017 Certified Values I. Values 1 Valuation Method Cost/Market Cost/Market Number of Buildings 1 i 1 ---- ..._--- _-- _.... Depreciated Bldg Value $48,164 ° $45,463 Depreciated EXFT Value $288 $288 Land Value Market $12 500 $12,500 Land Value Ag Just/Market Value °" $60,952 ; $58 251 Portability Adj Save Our Homes Adj I $0 .._..... f $17,205 Amendment 1 Adj $0 P&G Adj $0 i $0 Assessed Value $60,952 $41 046 Tax Amount without SOH: $520.00 2017 Tax Bill Amount $296.00 Tax Estimator Save Our Homes Savings: $224.00 Does NOT INCLUDE Non Ad Valorem Assessments Legal Description LOT 5 BLK F COUNTRY CLUB MANOR UNIT 3 PB12PG76 Taxes Taxing Authority ;Assessment Value Exempt Values Taxable Value County General Fund — $60,952 $60,952 ; $0 Schools .. $60,952 $60,952 l $0 City Sanford ....... - --- _.... $60,952 ______ $60,952 ; $0 SJWM(Saint Johns Water Management) $60,952 $60,952 $0" County Bonds $60,952 $60,952 ', $0 Sales --- r Description Date i Book Page Amount r - Qualified I Vac/Imp l QUIT CLAIM DEED 12/1/2017 09039 1881 $100 No Improved QUITCLAIM DEED 10/1/2004 05580 0184 _.... _.... $100 No — j Improved WARRANTY DEED 1/1/1975 _.--_..-_.� 01066 0626 $100 No Improved Find comparAW10Saks -__-_-- _ Land .. I Method 1 Frontage . _ Depth Units Units Price _.__., __ ..__ Land Value _.. LOT 0.00 0.00 1 $12 500.00 1 $12,500, Building Information Year Built # Description Fixtures 1 Bed Bath Base Area Total SF Living SF 1 Ext Wall Adj Value Repl Value Appendages Actual/Effective I http:Hparceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=3519305220F000050 1/2 v THIS INSTRUME PREPARED BY: Name: 114 Address: ! ! fD NOTICE OF COMMENCEMENT State of Florida County of Seminole Permit Number: taEi'1!'•1T i'1i=f4._i}''�`;� `_;i�f`i7.i�113LE:. C:1aU{d�l'r� C:L.ERX 01- C .F,,CLJ1T MURT & :1=iMPTROLI-ER UERK 6 0 201801.7046 Parcel ID Number: // I —30— " °2;?—drop'0QJ 0 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. OF PROPERTY: (Legal description of the property DESCRIPTION OF IMPROVEMENT: f.fin, &�/ 0kr1r AGA1*ix�0 rr�tirc�ld dt/tec�J OWNER I FORM ION: Address: Fee Simple Title Holder (if other than owner) Name: Address: S-e*-Co.r Address: Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by S ion 713.13(1)(b), Florida Statutes. Name: N►�I-c-e feeh,& l,de- Address: !;'&AL IM LL6 "✓0-' In addition to himself, Owner Designates To receive a copy of the Lienor's Notice as Provided in Section 713.13(1)(b), Florida Statutes. Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a different date Is specified) 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 1, SECTION 713.13, FLORIDA STATUTES, AND CAN 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to th be f y k ledge and belief. er's Signature Owner's Printed Name Florida Stutt 713.13(1)(g):' The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead' State of County The foregoing Instrument was acknowledged before me this .23 day of UW71 t.20 y Who is personally known to me� Name of person making statement OR who has produced identification Cr �\ p El of Identification produced: GAYLE L Fli]u11NG �e ` MY COMMISSION t fF 930910 / a EXPIRES: November 26, 2019 Bondod Th i ! fty Public Undmrtiten Notary Signature , `�lA01-'.(ley 0 FI.OR(DA-� March 2013 Florida Department of NOTICE OF Environmental Protection DEMOLITION Division of Air Resource Management RENOVATION TYPE OF NOTICE (CHECK ONE ONLY): ❑ ORIGINAL ❑ REVISED ❑ CANCELLATION TYPE OF PROJECT (CHECK ONE ONLY): 6PDEMOLITION ❑ RENOVATION IF DEMOLITION, IS IT AN ORDERED DEMOLITION? ❑YES ❑ NO IF RENOVATION: IS IT AN EMERGENCY RENOVATION OPERATION? ❑YES ❑ NO IS IT A PLANNED RENOVATION OPERATION? []YES ❑ NO 1. Facility Name Address City A Building Size 19* (Square Feet) Prior Use: ❑ School/College/University Present Use: ❑ Schoo College/University II. Facility Owner Address )WO.'41X ir'lo/ Zip 3%7? if County .S L/1' A4te, Consultant Inspecting Site # of Floors _L_ Building Age in Years Residence ❑ Small Business ❑ Other ❑ Residence ❑ Small Business ❑ Other KQIb k/i4;)M4) • Phone (67) (of&—rIT(- City State ez Zip sa72 III. Contractor's N e Phone (Ito &,16 is - DEP Form 62-257.900(1) Effective 10-12-08 Page 1 of 2 OR ASBESTOS ❑ COURTESY City 01U111111,010,1a State f t Zip S J;�?0 Is the cont actor exempt from licensure under section 469.002(4), F.S.? ❑ YES ❑ NO IV. Scheduled Dates: (Notice must be postmarked 10 working days before the project start date) Asbestos Removal (mm/dd/yy) Start: Finish: Demo/Renovation (mm/dd/yy) Start: Finish: V. Description of planned demolition or renovation work to be performed and rpethods to be employe includin demolition or renovation techniques to be used and description of affected facility components.�� ho adit. . h & �lL fy i<pLfiui Procedures to be Used (Check All That Apply): ❑ 1 Strip and Removal ❑ Glove Bag []I Bulldozer []I Wrecking Ball ❑ I Wet Method ❑ Dry Method ❑ I Explode ❑ 1 Bum Down OTHER: VI. Procedures for Unexpected RACK - VII. Asbestos Waste Transporter: Name Address Citv Vill. Waste Disposal Site: Name Address City IX. RACM or ACM: Procedure, i Phone �) State Zip Class State Zip analytical methods, employed to detect the presence of RACM and Category I and II nonfriable ACM. Amount of RACM or ACM' X. Fee Invoice Will Be Sent to Address in Block Below: (Print or Type) square feet surfacing material linear feet pipe cubic feet of RACM off facility components square feet cementitious material square feet resilient flooring square feet asphalt roofing Name: Address- city - .'State/ Zip: , 'Identity and_d t certify that the during the dem tion or renovation and=evidence that`the required training has"Been a"C60mplished'by this peison iivill Ib available"for hours. ' r (Dat ned Aerator) (Gate} tie•on-site ion during I , t?EP U5E ONL . YostmaWDate_Receroed ID# ; . . . i_Tr&ey /s - CEP F - 6� Z5� - - - ,,rs* • GAYU L FlFMING �� wit ) MY COMMISSION p rF 930910rS� �/70)Jn "ec" 1D-12-0B pap? 0/2 EXPIR ES: November 26 2019 Bonded Thru �otaryPubre Undenmters Instructions The:state asbestosremoval program requirements oUs' 376:60; l= S ;;and the renovation orm deolition notice requirements of the National Emission Standards_for Hazardous AirPollutants(NESHAP); 40 COk Part 61, Subpart'M, as embodied in -Rule 62=257, F.A.C., are included on this form. law). If the niotice it revis ofn pleasindicate Minwtich entries nhave been Chang r a .courtesy notice,(e , not`'required by g ed or "added. Check,to Indicate whether th6 project is=a:demolition.or a renovation: If you checked demolition, was ,;ordered by.the`Sta' or a=local goyernment.agency? tf so, in addition to -the information;requiredonthe form, the owner/operator must provide" the name of the agency ordering the demolition, the title of the person acting. on behalf of the agency; the authority for the agency to order -the demolition the date of the =order and the:date ordered to: egin. A:copy of`.the order rriust.also,'tie attached to the gotifcation"= If you checked renovation, is it an;emergency renovation operation? If so, in'additionto the information required on the form,the owner/operator mustpcovide the date and hour the emergency occurred,, the description, of the sudden, unexpected'eyentandaan explanation of,how the event caused unsafe -conditions arwould cause;equipment damage cr.an unreasonabie;financiat burden_ If you checke r' enRy ion and it is a.'pianned renovation operation; . please note that the notice is effective for period not,to exceed a calendar year of January 1 through. December'3,1. . Complete the-facility.inforrriation This section :describes, the facility where the renovation ar demolition is scheduled. This address will, be used.by the Department=,inspector to locate the project site. Provide the name, of the'consultant or firm that conducted the asbestos --site survevAnspection. For "prior use" check the appropriate box to indicate whether the prio ,use of hefacility is that of_a school, college, or.urnversityresidence, as "residential dwelling" is. defined in Rule 62-257.1166, F.A.C_; small business, as defned,in s. 288.763(1); F.S.; or other If "`other" is checked, identifythe use. Please follow the'same instructions:for "present use ,11.1 Complete the facility ;owner information., Ill. Complete.the contractor information. IV. List separately-the'scheduled startand firnsh dates,`(month/daylyear) far both the asbestos removal portion of'the . project and the renovation. or demolition portion of the.:project: V: Describe and check the--nc�ithods and,procedures to be used for A';planned,de,molition or renovation.,.Include ;a description of the affect,e act l ty components: (Note.. The NESHAP_for asbestos; which is adopted and incorporated by reference in Rule 62=204.800, F'.A.C., requires obtaining Department -approval prior to using a dry, removal -method, in accordance with.40 GFR sechorn61.145(3)(c)(i).) VI. Describe the procedures to be.used in the;event unexpected RACM is found or previously nonfriabWe asbestos. . material.becomes crumbled, pulverized, or reduced, to powder.after start -of the,project. VIt: Complete the asbestos�waste ransporter infom�ation: Florida Lfmitdd (Spe ia',!!'' Power of Attorney,Torrn Pursuant to C,hapter;-709-,Power,of Attorney and Similar;lnstruments` li RichTracey'of Capital Development Group; City of Altamonte County of Seminole, State of Florida ("Principal".), hereby grant M`el Fernandez:of Habitat for Humanity of Serer Co & Greater Apopka, City of Altamonte, County of Seminole, State of Florida ("Agent") a limited power of attorneys Under' this Limited Power of Attorney, my.Agent has my permission and authorization fo' act in my stead and, on my behalf for the following specific acts: any- and all responsibilities; including�all,;permitting-related to 202 Bradshaw. Drive; Sanford, FL 32771. . . MyAgentalso has my permission and -a ithorization'to perforrhi i nyl identaLacts necessary to accomplish the specific acts, set forth above: I may revoke this LimitedTower of Attorney`at any time,:h`owever, a third partyis entitled to rely on this,Limited Power Attorney:lf such; third:;party has not received anotice of revocation. IN WITHESSWHER.EOF;1`have:executed.this; Litmited Power of.Attorney.onthis 23rd day of January, 2018'. CAPIT-6 OP ID- JR DATE(MMIDDIYWY) 01/2212018 .4COR®' CERTIFICATE OF LIABILITY INSURANCE 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(ies) must have ADDITIONAL INSURED provisions or 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 407-859-3691 N NTACT Steven E. Buckner The Hilb Group of Florida, LLC dba Newman Crane & Associates 5639 Hansel Ave. PHONE 407-859-3691 FAX 407-857-0409 (A/C, No, Ext): (Arc, No): E-MAIL pvolgt@hllbgroup.COm Orlando, FL 32809 -ADDRESS: Steven E. Buckner INSURERS AFFORDING COVERAGE NAIC N INSURERA: National Builders Ins. Co. 16632 INSURED Capital Development Group Inc. INSURERB: 249 Maitland Ave. Ste. 2000 INSURERC: INSURER D: Altamonte Springs, FL 32701 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUB WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX] OCCUR PKG 0027593 11 10/0512017 10/05/2018 EACH OCCURRENCE $ 1,000,000 pRMrSES(EaQ'c 'ren eAGETO RENTED $ 100,000 MED EXP (Any oneperson) 5,000 GEN'L PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY jpeT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS- COMPIOP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTO ONLY LNUOTOS ONE COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Perperson) $ BODILYBODILY INJURY Per accident $ PROPERTY DAMAGE Per accdent $ UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below N I A WCV002777212 10l05I2017 - 10105/2018 X PER 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 I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) P`CDTICII"ATC UnI ncD f Allr^FI 1 ATInN CITYS-1 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 Department 300 North Park Ave. AUTHORIZED REPRESENTATIVE Sanford, FL 32771` ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1/22/2018 DBPR - TRACEY, RICHARD J; Doing Business As: CAPITAL DEVELOPMENT GROUP INC, Certified General Contractor 2:10:38 PM 112212018 Licensee Details Licensee Information Name: TRACEY, RICHARD 3 (Primary Name) CAPITAL DEVELOPMENT GROUP INC (DBA Name) Main Address: 249 MAITLAND AVE STE 2000 ALTAMONTE SPRINGS Florida 32701 County: SEMINOLE License Mailing: 249 MAITLAND AVENUE #2000 ALTAMONTE SPRINGS FL 32701 County: SEMINOLE License Location: 249 MAITLAND AVE, STE 2000 ALTAMONTE SPRINGS FL 32701 County: SEMINOLE License Information License Type: Certified General Contractor Rank: Cert General License Number: CGCO21914 Status: Current,Active Licensure Date: 12/23/1992 Expires: 08/31/2018 Special Qualifications Qualification Effective Construction Business 02/20/2004 Alternate Names View Related License Information View License Complaint 2601 Blair Stone Road, Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer. Copyright 2007-2010 State of Florida. Privacy Statement Under Florida law, email addresses are public records. If you do not want your email address released in response to a public -records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. *Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. Please see our Chapter 455 page to determine if you are affected by this change. https://www.myfloddalicense.com/LicenseDetaii.asp?SI D=&id=OFA22DD3DADDE0087DBAC4D634l A45E2 1 /1