HomeMy WebLinkAbout132 Conch Key Wayr� ,-' •f-� it � A� � ''
APR 'e€ CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: / y / �0
Documented Construction Value: $ 1 I 2-22 . -3 v
Job Address: �J a� C N Ck C E `{ �A 1 SA !V f�2p I-L . 3JL111 Historic District: Yes ❑ No ❑
Parcel ID: P 9 -19 - 31 -SDI - 0000 a 0 4 O Residential Q Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair Demo ❑ Change of Use ❑ Move ❑
Description of Work: (Rk - 2 V0 F
Plan Review Contact Person: � S � i� 17U� Title: 3 rm-- !9'J f C--'Fv l'a--R
Phone: Ll % -7 Fax: /V�,J Email: _W15 A
Property Owner Information
Name T/Aco� K. Al t(_I{l,MYIL
Street: 132 Co N cH KEY W A q
City, State Zip: S&1 r=o� t- L . 3 0?
Phone: Ll 0 Z- q 17 --A/ 33
Resident of property? :
Contractor Information
Name Wise �r�To mr� 1kc
Street:
City, State Zip: C)"FLO
`l t5
Phone: 7 0 %— (, ( `6 - 0099
Fax:
State License No.: C GC1 S2 �) Gq
Architect/Engineer Information
Name: t4 /,I Phone:
Street:
City, St, Zip:
Bonding Company: /J
Address:
Fax:
E-mail:
Mortgage Lender: — A44
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: 5" Edition (2014) Florida Building Code
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 ith all applicable laws regulating construction and zoning.
Signature of Owner/Agent Date Signatur f Contractor/Agent Da
S/ 1-1 9, X- �90 I CoMwL, 8'266
Print Owner/Agent's Name Print ContractorlAgent'#Name
Date
uommissron # GG 157902
My Comma Expires Nov 5, 2021
Bonded through National Notary Assn.
�
S ERR18RAZIL
"dBr�,
of Notary -State ofFl
.`� ate
Notary Public - State of Florida
c
,a 4 e My Comm. Expires Jun 25, 2018
��9:Encn4P` Commission # FF 116102
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID Type of ID i�L h f Produced ID K Type of ID r ok, )t-L�S-
33/33d
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: # of Stories:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
# of Heads
UTILITIES:
911"
Plumbing - # of Fixtures
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
r WISE Restoration Inc.
2423 S. Orange Ave
#192
iS
—Orlando,-FL.-32806------
< (877)513-6765
RESTORATION
_� S€N wiseroofingrx@gmail.com
Lic # CCC1326898
AGREEMENT
Date:1/25/18
Mortgage Company: Wells Fargo Bank NA
Client(s) Name(s): Jacob K. Adickirayil
Client Address: 132 Conch Key Way
City: Sanford State: Florida Zip Code: 32771
Client's Phone/Cell (407)417-2133 Email: JADICHIRAYIL@GMAIL.COM
Insurance Company Name: ASI
Insurance Company Contact: Kevin Ormsby Ins. Adjuster: Kevin Ormsby Phone#727-821-8765 ext. 1572
Policy#FSA28731 Claim#: 521881-171003
SPECIFICATIONS:
Loan #01994177999
6fear Off 1 Layer ❑ 2 Layer ❑ 3Layer
Ri'lVi-etal Edging/Drip Edge Color Li 41 I
❑ Install New ❑ #15 Felt Paper [1#303Felt Paper
❑ Other Repairs:'
M"Other Specify: LAMS)1JA n1 __ UvoV f-wo(z igST
cIWRe-nail decking if new code requires
❑ Shingle Type ❑ 3 Tab LYArchitectural
Clean-up & Ha away debris
Dingle Color/Nam • Pill Fl W40 D CCi2T1i 14TOED
Included: i T Permit PR 1 year Workmanship Warranty
Goosenecks Roof Stacks ❑ Off Ridge❑ Other
Wood Replacement: Homeowner will pay $45 for each
Plywood Cut, $6.75 per In ft for Facia Replacement, & $6.50
per In ft for Sistering (Supporting) Structural Members if
needed.
Ali rooTing system will tie installed according to the manufacturer's specifications and state and local code regulations.
WORK CONTRACTED:
[! "full Roof Replacement ❑ Partial Replacement ❑ Roof Repair /
Upgrade: ❑ Yes ❑ No Price of Upgrade # sq. x $ per sq. = $
TOTAL AMOUNT: INSURANCE COMPANY ALLOWANCE OF $ 1 , 2 - J PLUS ANY ADDITIONAL INSURANCE
COMPANY APPROVED SUPPLIMENTS OR UPGRADES AND DEDUCTIBLE AMOUNT.
_N.omeowner_shall-give,-endorse..over-all .-insurance_ proceed -checks -to Wise-Restoration-Inc.,-including-any-supplementor-_-
supplemental payments made by Insurance Company. Wise Restoration is authorized to do the work outlined in the scope
of work and approved by Insurance Company and listed above. Wise Restoration Inc. hereby certify that all claim funds
issued by the above Insurance company will be used to complete the repairs listed above and that the repairs will be
made in a workmanlike manner.
By my signature below, I/We agree to the terms and conditions contained in this Agreement. I acknowledge receipt of a
copy of this A t.
Homeowner(-Gx//�
Signature
Print Name
Homeowner:
Signature
Print Name
ISE Res or Inc. Rep.
Si ature
}-
Print Name
THIS INSTRUMENT PREPARED BY: 1 Mill 111111111111111111111111111111111
Name: JESSE PADUA OF WISE RESTORATION INC ;:511ii=1!%I'F Nj1L0Y i ENjNpl._E C.*0 N t Y
Address: 2423 i:)f G:i:ft+I_JTT C:ijtl>,:{ ?. Gllh1E'TitOLL_E:
. wiseresiorationinc(c_ygmail.com
c
Rj
CLERK' 2'0"1903&62
NOTICE OF COMMENCEMENT F. i."I Ji.w�}1.�� i`1 t.�;��.. .. i''ii
i,:1:CE0E-@isLac; FEES �•j_iiai 0
State of Florida REC RDEI) BY 1-idevore
County of Seminole
Permit Number: Parcel ID Number: 29-19-31-501-0000-2040
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.
DESf T&P IONe�eryRQe�RIY (LegaLde rlp �nf the property and street address if available)
i 3L uoncn Key Way 5anTOra, I-L. ;J1 / / 1
"Ar-M6I2FCRIPTION OF IMPROVEMENT:
OWNER INFORMATION:
Name: JACOB K. ADICHIRAYIL
Address: 132 Conch Key Way Sanford, FL. 32771
Fee Simple Title Holder (if other than owner) Name:
CONTRACTOR:
Name WISE Restoration Inc
Address: 2423 S. Orange Ave. #192 Orlando, FL. 32806
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:
In addition to himself, Owner Designates
Section 713.13(1)(b), Florida Statutes.
of
To receive a copy of the Lienor's Notice as Provided in
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 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 penaltiesUnowle
de re that I have read the foregoing and that the facts stated in it are true
to the best of mbelief.
JACOB K. ADICHIRAYIL
ignature Owner's Printed Name
Florida Statute 713.13(1)(g): " The owner must sign the notice of commencement and no one else may be permitted to sign in his or heostge - C`
State of i County of /� 1 ,f
The foregoing
instrument was acknowledged
/before
t �me this 6 day of. , �!r' � A-1 e�$
by b/�J—�1—< --c1r� /r`S �� 1 1 / C H-f /k / T r / . Who is personally known to me ❑
-Name of person making slate" nt 4
OR who has produced identification A type of identification produced: �f LO L- /' p
MAGDY SALAMA
t. Notary Public - Stale of F id
hti�' Commission # GG t
,,; {iutl� My Comm. Expire ov Notary Signature .____—
"':�0:,,,'hNalin�>•�I Notnry Assn.
,.,,, bon<ted Ihroug -
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
(PADUA
I hereby name and appoint: I-12 Ali 1� T-"
an agent of: OA) 1N r --
(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):
❑ The specific permit and application for work located at:
15 V, r0 ,.► c 0 )cSq 10A Y SA rJ'Fog D 1 3 -7 1
(Street Address)
Expiration Date for This Limited Power of Attorney:
L4` 5 — i
License Holder Name: Nt"
04A- �4oa?-
State License Number: C C C, 13 aL 6 Q 61 12)
Signature of License Holder: !�
STATE OF FL RIDA _ 0
COUNTY OF ` i
The oregoing 'nstru `ent w,�s a k owledged before me this � —day of
20� (C , by �-'tlC� 0-04-e—, ; who is ❑ personally known
to me or ❑ who has produced d'(OY1 CA- 1t)7KtxY t,-2S (4C,z_ ,j
identification and who did (did not) take an oath.
(Notary Sea])
(Rev. 08.12)
Signature
i
Print or type name
Notary Public - State of
as
Commission No. ;P�r'��A -, SHERRI BRAZIL
'? " Notary Public • State
My Commission Expires. of Florida
Comm. Expires Jun 25, 2018
Commission # FF 116702
5AT�P)
H 01
City of Sanford Building Division
y' Residential Re -Roof Inspection Policy & Procedures
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), certifyin BC code compliance by personal inspection.
CONTRACTOR (OR OWNER/BUILDER) SIGNATU DATF *X(F
CITY OF
SkNFORD
<D
File DEPAItTMENT
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
STRUCTURE TYPE: dSINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: l PLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
PECK TYPE (PLEASE SPECIFY): C D X
i"PLEASE NOTE: ONLYI00 SQUARE FEET OF THE EXISTING DECK PERMITTED TO BE REPLACED""
OOF VENTILATION: 0 OFF -RIDGE O RIDGE SOFFIT QPOWERED VENT QTURBINES
KYLIGHTS: O YES (NNO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 Q 2:12-4:12 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDDA PRODUCT APPROVAL
HINGLE
ta nFL#
! QKID
O METAL
FL#
0 MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
QINSULATED
FL#
TILE
FL#
O OTHER:
FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) ""IFAPPLICABLE""
ROOF SLOPE: 0 LESS THAN 2:12 Q 2:12 - 4:12 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
OSHINGLE _ ... _
FL#
0 METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
QINSULATED
FL#
TILE
FL#
Q OTHER:
FL#
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
l
PERMIT #: ADDRESS: 3 p� l� ` tl W Ay
IFL . 3;U -7 )
I M t C RA G L N E» `` C�_ , AS AM 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 , 3 12) 1 v
COMPANY / CONTRACTOR: 1/ V S 1.
CONTRACTOR SIGNATURE: ✓ _ DATE: 23 Z�I
(MUST BE SIGNED BY LICENSE HO R BU ER}
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 REFERTO THE 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 %� - ` `� - I--
Sworn to and SuWscribed before me this 11 . day of ! 1'?� � 20 /,'' by:
.Who is. ❑Personally Known to me or has D Produced (type of
�I
identification) r— N i ' �` f (_as identification.
of Notary Public
State of Florida .<..
MICHELE RAMESAR
0� .� , y ��:�� r : Notary Public - State of Florida
Printer e/Stam Name ;` Commission a GG 090456
yP P oFF My Comm. Expires Apr 25, 2021
of Notary Public ""'