HomeMy WebLinkAbout202 Clearlake CirCITY OF SANFORD
_ 3 2018 E BUILDING $ FIRE PREVENTION
1A4 PERMIT APPLICATION
Y - Application No: `
Documented Construction Value: $ , � _ 60
Job Address: (2I e& 6' L.CJ,(e C1 T-C_I e- Historic District: Yes ❑ No ❑
Parcel ID: 0of % b C) QQCx:) 0 9 (o C) Residential ❑ Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work:
I
Plan Review Contact Person: (IhC3LS �eS Cv_1 Title: NzDb 'e_c
Phone'.407 52 7- L,(D Fax: Email: Gm i V 5'k �, C° L • ��
Property Owner Information
Name `� c U l n _ n +-k Q_ Phone: LXcS1 5`7 D 'T2'4'3
Street: ).& O G t') . DR Resident of property? : /Jb
City, State Zip: (30 o_y4 9 , 4:--C 32�s'ca�
Contractor Information
Name �'���� QS K V"�t (�.SC4� Phone: C-D % - 3 3 2 - 32�
Street: V l o v"c�-q n b (( Pam. R• Fax:
City, State Zip: A -3 '-1-7 01 State License No.CCC C-) 5S) LIT
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company:
Address:
Mortgage Lender: /, 1 1
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 TIiE�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
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: 5" Edition (2014) Florida Building Code
Revised!.1une 30, 2015 Pennit Application
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 constructioti 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.
XS�4gn,,,c of Owner/Agent • tc Signature of Contractor/Agent Date
*�o
DateKIMBERLYG6MEZ
otary Public -State of Florida
Commission R GG 91593
y Comm, Expires Apr 6, 2021
# 1�lk I-C
"19 17 /,7
_ CARLY WOOD
MY COMMISSION # GG046341
EXPIRES November 09, 2020
Owner/Agent is Personally Ki0own to Me or p q� Contractor/Agent is Personally Known to Me or
Produced ID Type of ID U C.l� � Produced ID Tyre of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Gas ❑ Roof ❑
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use: Flood Zone:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads
APPROVALS: ZONING: UTILITIES:
COMMENTS:
# of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
ENGINEERING: FIRE: BUILDING:
Revised: June 30, 2015 Permit Application
Ve propose hereby to furnish material and labor - complete in accordance with the above specifications for the sum of:.
$ Five thousand four hundred dollars Dollars
with payments to be. made as follows:.' 0-2, i s due utpor material delivery balance uponC j)L
Any alteration or deviation from above specifications involving extra costs Respectfully
will be executed only upon written order, and will become an.eidra charge submitted�
over and above, the estimate. , All agreements contingent upon strikes,
accidents; or delays beyond our control. Note this propo§al may be_wdhdrawn.tiy us if not accepted within days.
��LCE�1t�TCCE'Of � CO�lO��Y ,
The above prices specifications and conditionsare satisfactory and are
hereby.accepted You are authorized to do the work as specified.
Payments will be.ade as outlined above. Signature
m
Date of Acceptance t� f Signature
,J _ -
THIS INSTF
YMENT PREPAgfD BY: ,
Narw Cs-C-42 r, " K �M «� GR -, :�T NAL_OY s ::31E1 PAOL_E +��OUN l Y
Address: EE`K OF C:IR.CUIT COURT & COMPTROLLER
t "� )
CLERK'S T 2017125903
NOTICE OF COMMENCEMENT RE`0RDED 12 1.'0{{..7 `,'e{ P;j
RE,C.ORDING FEES *1.0.01{
State of Florida REt_ORDED '.Y hij avor e
County of Seminole
Permit Number: Parcel ID Number:da �� r -�y `�_
poop G 4U
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.
DESCRIPTION OF PROPERTY: (Legal desgription of the property and street address if available)
.�a 2 C1 ea ti- )-A-Le Ccfcle
S' di.l� siocc� � Cr.
GENERAL DESCRIPTION OF IMPROVEMENT:
FORMATIOftI;�[� (
e 14
f del
Address:« 06 04 1 W12--O ohV b (Z
Fee Simple Title Holder (if Aot er than owner) Name:_
Address: /" 1 4-
CONTRACTOR: L
^, Name: n-0 Q S i' 1 V.
�1J Address: J�!0 h-,c- e.
-7 O
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served
as provided by Section 713.13(1)(b), Florida Statutes.
Name: 1.���C s Ei \`"ram
Address &&,-'� t� %. { cl``n__otl ¢� I2 L . 3 7`7e 1
In addition to himself, Owner Designates �LCk c! �C G`a 1�'0 of
q ID ; IM-C,I r,,f, l r Gti DP- A-u-+io9!@*Ilcz�-49receive a o y of] the Lienor's Notice as Provided in
Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Camneqlcernent (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 I, 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 1 have read the foregoing and that the facts stated in it are true
to the best of my knowledge and belief.
4
�713
er s Signature Owner's Printed Name
AFlorida Statute .13 "The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead."
State of " OK County of
The foregoing instrument was acknowledged before me this ZO day of1201-1
by Who is personally known to me ❑
Name of person making statem�e t ,y,
O who has produced identification L�l type of identification produced: (��' -j z000 �`f CI'�j�O(]
aVl PµY pre i4: SAMANTIIAAPARICIO
Notary Public - State of Florida Notary ign ture
My Comm. Expires Jul 29, 2018
%FOF r�.�P� Commission # FF 446182
OF
,
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: o;?0__3 Cflela�_
STRUCTURE TYPE: Q'SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: VREPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING' ROOF)
DECK TYPE (PLEASE SPECIFY: - 1'j � � k Q Q At k ICI
**PLEASE NOTE: ONLY 100 SQUARE FEET dF THE EXISTING DECK IS PERMITTED Tb BE REPLACED**
ROOF VENTILATION: O OFF -RIDGE QK� GE O SOFFIT OPOWERED VENT O TURBINES
SKYLIGHTS: O YES �TO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 (�12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
SHINGLE
FL#r-
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLICABLE**
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
HINGLE
FL#
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
t CITY OF Building & Fire Prevention Division
S��FORD RESIDENTIAL RE -ROOF POLICY & PROCEDURES
Fir;E otPnliT�IE�T
PERMITTING REQUIREMENTS - NO PLAN REVIEW REQUIRED
THIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE
REQUIRED TO BE SUBMITTED AS PART OF YOUR PERMIT APPLICATION.
THE SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF
COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT.
A PERMIT WILL NOT BE ISSUED WITHOUT THESE DOCUMENTS. COPIES WILL BE MADE TO POST ON THE JOB SITE.
**PROJECTS LOCATED IN THE SANFORD HISTORIC DISTRICT WILL REQUIRE PLAN REVIEW AND APPROVAL BY THE
SANFORD HISTORIC PRESERVATION BOARD
INSPECTION POLICY & PROCEDURES
A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMILY, TOWNHOUSE,
MOBILE HOME, APARTMENT AND/OR CONDOMINIUM) RE -ROOF PERMITS.
THE FOLLOWING IS REQUIRED TO BE PROVIDE ON THE JOB SITE:
• PERMIT CARD, POSTED IN A CONSPICUOUS AND WEATHERPROOF LOCATION
• COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK
• COMPLETED AND NOTARIZED INSPECTION AFFIDAVIT
• ALL FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS
(PRODUCT APPROVAL SHALL MATCH WHAT IS ON THE SCOPE OF WORK)
• DIGITAL PHOTOGRAPHS (MUST INCLUDE THE PERMIT NUMBER OR ADDRESS IN EACH PICTURE)
o EACH PLANE OF THE ROOF, SHOWING THE UNDERLAYMENT INSTALLED
o ROOF DECK NAILING PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER) .
o ROOF DECK NAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHOWING SIZE OF NAILS)
o UNDERLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
o DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE OR RULER)
o SHINGLES INSTALLED, NAIL PATTERN AND LOCATION OF NAILS
• SKYLIGHTS (IF APPLICABLE)
o DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL
o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT APPROVAL
FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR OR OWNER/BUILDER) SIGNATURE: �-�` ���� DATE: Apt 'd, 7" 17
CITY OF
g��"FORD
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF AFFIDA VIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: / 7ADDRESS: ';)dD CA pQ C LQ- Cj_j'
Ln I . �L
I �--{ 1 q,/r5 /4/, Al ( P-se-A ) AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
_ROOFING CONTRACTOR ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
FOR C77FORMATION IS TRUE AND ACCURATE AND THAT ALL ROOFING COMPONENTS LISTED ON THE SCOPE OF WORK AT THE
ABOVE REFERENCED ADDRESS HAVE BEEN INSTALLED IN ACCORDANCE WITH THEIR PRODUCT APPROVALS AND ALL APPLICABLE CODE
REQUIREMENTS - SPECIFICALLY FLORIDA BUILDING CODE, EXISTING BUILDING. IN ADDITION I CERTIFY THE INSTALLATION MEETS ALL
REQUIREMENTS FOR SECONDARY WATER BARRIER AND NAILING OF THE ROOF DECK, IN ACCORDANCE WITH THE HURRICANE RETROFIT
MANUAL REQUIREMENTS (BASED ON F.S. CHAPTER 553.844).
LICENSE #: Cic- G �� l
COMPANY / CONTRACTOR:JV)a f_ e_C t,
CONTRACTOR SIGNATURE: DATE:
(MUST BE SIGNED BY.LICENSE HOLDER OR 0WNER/BUILDER)
A FINAL ROOF INSPECTION IS REQUIRED:
THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINAL ROOF INSPECTION,
ALONG WITH DIGITAL PHOTOGRAPHS OF EACH PLANE OF THE ROOF SHOWING IN DETAIL ALL COMPONENTS (DECKING,
UNDERLAYMENT, FLASHING, DRIP EDGE ATTACHMENT) WITH THE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON THE DECK
FOR EACH INSPECTION. THE PHOTOGRAPHS MUST INCLUDE A RULER OR MEASURING DEVICE TO CONFIRM ALL NAIL SPACING AND
OVERLAPS, INCLUDING DRIP EDGE AND VALLEY FLASHING. PLEASE REFER TO THE RE -ROOF POLICY AND INSPECTION PROCEDURE
PAPERWORK FOR FURTHER EXPLANATION OF ALL REQUIREMENTS.
"FAILURE TO FOLLOW ALL REQUIREMENTS WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION FEE AS
WELL AS REQUIRING A DESIGN PROFESSIONAL (ARCHITECT OR ENGINEER) TO CERTIFY, BASED ON PERSONAL
INSPECTION, THE INSTALLATION OF ALL ROOFING COMPONENTS.
STATE OF FLORIDA COUNTY OF �swi no (Qi
Sworn to and Subscribed before me this day of V ece m rXP-- 20 1 by:
CI RM h r Ol M! 1 . Who is 41fersonally Known to me or has ❑ Produced (type of
i n 'f o� as identification.
gnature of Notary Public ;o;►'^;; CARLY WOOD
State of Florida MY COMMISSION # GG046341
:� aaal:s,9_;j
I �400� EXPIRES November 09, 2020
(JOY
Print/Typ Stamp Name
Of Notary Public
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