HomeMy WebLinkAbout211 W 18 StCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
3,0 JL� Documented Construction Value: $ a50. D
w �/
Job Address: // 1.t/, BS Z : Historic District: Yes ❑ No Ek
Parcel ID: 36 -/ 9 -3D - 566 _ 6600 _ O ?/ o Residential 0' Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work:
Plan Review Contact Person: -)zB6'eT IV . 3'qkr3e)U.ee Title: )n &-9
Phone•-467--3-93-Fax:
Property Owner Information
Name M4,eV T k- -91929�54c,e Phone: 44 % -3.a - 5-i q6
Street: ! // k/. /8 Resident of property? : t°S
City, State Zip: 919N/—'-4a D
DD Contractor Information
Name _XD ezewT f'11. &4$ &,e Phone: 4d7-5.25-2j 9'3
Street: a // W Fax: ----
City, State Zip: S,q A.) Cvr-J 3--2 72. State License No.: CeCQ '16:P1
Arch itectlEngineer Information
Name: Phone:
Street: A Fax:
City, St, Zip: J—N��q /'-� —E-mail:
Email:
Bonding Company: 1A 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
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: 5th Edition (2014) Florida Building Code
I
Revised: June 30, 2015 Permit 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 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.
Signature of Owner/Agent Date
Date
�,A. car--- IV Yr
Print Owner/Agent's Name Print Contractor/Agent's Name
k2z��,
Signature of Notary -State of Florida Date SIgnature of Notary,State,of Fdorida:a.-w.f �g
r ;c•„, .,s l�r,.trr 176ac
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID Type of ID Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Gas ❑ Roof ❑
Construction Type: Occupancy Use: Flood Zone:
Total Sq Ft of Bldg: Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads Fire Alarm Permit: Yes ❑ No ❑
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING:
COMMENTS:
Revised: June 30, 2015
Permit Application
...............................
i
NOTICE OF COMMENCEMENT
State of Florida
County of3Lin-'
Permit Number Tax Parcel Number: 4KL
i
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. _Description of
and street address if available)
2. General Description of Improvement: "Pp g.8�'r
3. Owner Information:
a. Name and Address: MAP-)(
b. Interest in Property: lC'Oee S jrn tG
c. Name and address of fee simple title holder (if other than owner):
'• i
4. Contractor: Name and Address: Ro8G2 T IV. 13*R30,ece a �$ t) e:S CA IZJ• VQ G �
a. Phone No.403
7-03— �3�3 Fax No. M4 Hill 111It 11111 liffilawl
i
5. Surety: Name and Address: Al 6RANT MALOY' SEMINOLE C.0IJN1'Y R
a. Phone No. Fax No. f:l FRY. OF CIRCU
b. Amount of Bond: $ .00 gp, gi 161 P9 6" 1 a''
CLERK'S T 2tt18007261 n�
6. Lender: Name and Address: RECORDED � �_�� i! i�p
a. Phone No. Fax No. h• h
KMk..URV"U AP
7. Persons within the State of Florida designated by Owner upon whom notices or other docur o
provided by Section 713.13 (1)(a)7., Florida Statutes: C�c2;C -F ,'•'
a. Name and Address: /� D Ale pC":74
•/-fST1;V /,I 1
b. Phone No. Fax No. cctu,it`%`
8. In addition to himself, Owner designates No nl E of
To receive a copy of the Lien Notice as provided in Section 713.13(1) (b), Florida Statutes.
a. Phone No. Fax No.
B1
9. Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of tecording 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.
lY�
X "Si re of Owner Print Name of Owner 0 6t'
STATE OF FLORIDA, COUNTY OF )Me u�
Affirmed and subscribed before me this day of 20 by IM&RyAL_ who is
Personally known to me or who has produced ( e of "DidIndn.
(�dCcit,; p4�v FARHANA CHOWSignature of Notary Public State of Floridallotary Public -Stati ,_n�-/,/ Commission FFAQ ft _Qic�s/�t/"7, t%� Y '%;f,'o<<;;�:�'� My Comm. Expires J
Print, Type or Stamp Name of Notary
�• C
._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._..
CITY OF
• `' l� �T Building & Fire Prevention Division
��.N��� RESIDENTIAL RE-ROOFPOLICY & PROCEDURES
FIRE DEPART\1ENT
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: 2__2j_A
CITY OF
PERMIT #
S.,kNFORD-
Building & Fire Prevention Division
F i R E D E PA Ii T iM E N T RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: % ►
STRUCTURE TYPE: �INGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: PLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (N//EW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY):. A fo
""PLEASE NOTE: ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED
ROOF VENTILATION: DOFF -RIDGE RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES O'1QO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 GK'I 2 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
GLE
Q
FL#
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: (LESS THAN 2:12 O 2:12 - 4:12 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
O SHINGLE
FL#
O METAL
FL#
ODIFIED BITUMEN
I I
7 %a n T e e
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
0 OTHER:
FL#
State Certified:
'
800 MEISCH ROAD
SANFORD, FLORIDA 32771
State Certified:
GENERAL CONTRACTOR
ROOFER
#CGC010734
407-323-7583
*CCC017531
Commercial
Residential Industrial
Additions
PROPOSAL SUBMITTED TO
oGc
PHONE
�7�x?a-Si 9/0
DATE
/ it /,I
STREET JOB NAME
CITY, STATE AND ® CODE/ 3a7 JOB LOCATION
ARCHITECT DATE OF PLANS IJOBPHONE
We hereby submit specifications and estimates for.
S OD T---'
01 /�d 4ae-24 e g P e ra S
s Z �' d V✓ -6e r - �Ir
/yet,-) / n o At 4' / Ts�cs
COL � Ve�,� t •
/n�fl Y��'��%CC,7�Ud7� /i']�I (�/'i1� /•An iOnro_�lQrs� CG.��O- �P/i�
Or- Vropose herebytof urnish mviterial and labor —complete in accordance with above specifications, forthe sum of:
dollars ($
All material is guaranteed to be as specified. All work to be completed in a workmanlike man-
nerZ
according to standard practices. Any alteration or deviation from above specifications
Involving extra costs will be executed only upon written orders, and will become an extra Auttlofted ,�j{_
charge over and above the estimate. All agreements contingent upon strikes, accidents or Signature
delays beyond our control. Owner to carry fire, tornado and other necessary Insurance. Our
workers are fully covered by Workmen's Compensation Insurance. NOTE: This proposal may be
withdrawn by us if not accepted within days
,;ktteptttnte of 14uposal—The above prices, specifications
and conditions are satisfactory and are herebyaccepted. You are authorized to Signature
do the work as specified. Pay ent will be made as outlined above.
Date of Acceptance: f �_�/S Signature
4
CITY OF
SkNFORDBuilding & Fire Prevention Division
RESIDENTIAL RE-ROOFAFFIDAVIT
I llil: 7E PAlITME NT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVFRNGS
PERMIT #: P..�f j ADDRESS: � L] �6 / 0
I �9&4;r l,(, O/-f��C(� , 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
FOREGOING INFORMATION 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 #: C (__0 D/ ;1s31
COMPANY/CONTRACTOR:
CONTRACTOR SIGNATURE: DATE:
(MUST BE SIGNED BY LICENSE HOLDER OR OWNER/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 Sf-In / Y) D / 'f—
Sworn to bscribed before me this o� j day of �yo_n i 20 �by:
C (0 r
--UOTza�t�, . Who is ersonally Known to me or has ❑ Produced (type of
identifica . n) as identification.
ignature of Notary Public
State of Florida
Print/Type/Stamp Name
of Notary Public
L(407)
CAROLE PROODIANMY COMMISSION #FF169830
EXPIRES October 20, 2018
398-0153 FloridallotaryService.com