HomeMy WebLinkAbout140 Wornall Dr (2)MAR 15 '2a18
Building & Fire Prevention Division
PERMIT APPLICATION
Application No: 1842) P-)_
Documented Construction Value: $ —1 , —lq3 • H U
Job Address: t`ID 1 �/Y ' Historic District: Yes ❑No`
Parcel ID: 3 ) �� �y f UV 60UC U ResidentiaCommercial[]
Type of Work: Ne�*4ddiitiion Alteration❑ Repair ❑ Deemo ❑ Change of Use❑ Move ❑
Description of Work: \" `W ` �A_� A
k (aU Title: C VVL/-
Email: Cff )NYG� l(x!e l
Property Owner Information (�
Name
Street:
City, State Zip: Cso_f _'(Y t
Phone: q ai - g013 - &a 10
Resident of property? :
Contractor Information
Name �G�C`CASCb WV'kay l C`C"h-YGtlj 11Q hone: `�v{-73a 7a&a
Street: w N R 6, `aid Rfa 0 `V Fax: 4cri - S-1a- L1 /�3
City, State Zip: F 1 a-156 State License No.: CCG- t 33C)(OC)q
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Phone:
Fax:
E-mail:
Mortgage Lender:
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: 6« Edition (2017) Florida Building Code
Revised: January 1, 2018 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
'rYokY)Gisoo - T-16kIQ VU
Pri caner/Agent's Name
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g to of tary-State(fFlo'Kda'
=°vsY P,4 Notary Public State o lorid,
Tiffany Burleson
a . My commission GG 173997
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Signa[ re of Date
f::�Var1Gj-5LV �01 �"tGt lJ
PrinL.�ontractor/Agent's Name
uate Notary Pubic State of. Florida
.+�Y Pw
:° `� Tiffany Burleson
M commission GG 173997
f'�fOrn°�a Expires01109/2022
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Owner/Agent is sonally Known to Me or Contractor/Agent X.— 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:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
# of Heads
UTILITIES:
FIRE:
Flood Zone:
# of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: January 1, 2018 Permit Application
.,:.z 1_
Tunela Connell�!5,j q 1 /,I-1044
—
14OVoinalDr.,
Sanford, FL32771 1 /30/2018_ _
Homeowner Name U
Homeowner, Signature
Central Homes Rep.1C�
Sub3Tota1 �' $7,748.40 i
` Totals
'
Permit Number:
Parcel ID Nfmfber: 1 -OLI(P b
The undersigned hereby gives race that improvement wf@ be made to certain real property, and In accordance with Chapter 713, Florida Statutes, the
fdlaaiog information is provided in tins Notice of Commencement.
f. DESCRIPTM PROPERTY: (Legal descri • street a
of the property and ddress if ava e)
LOF Coun- N CAvb porr rC tPR CIO AS la3 - - ev We
Y a
2, GENERALDESCRIPTM OF IAAPROVEMENT: --
RESMENTLAL RE -ROOF
3. OWNER DWOFMATM OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE WROVEMENT;
Name and address.. tfw o. ` t an< ', NO WOY ne l l 'I>Y . So► n- b Y ok 3p—n 1
Interest in property. Wvnk/YI
Fee Slnlpis TWO Haldef (0 other than owner listed above) Name:
Address:
a coNTRAcTOR: Name: CENTRAL HOMES, LLC Phone Number: 407-732-7262
Address: 1225 SENNETT DR. #111, LONGWOOD, FL 32750
S. SURETY Of epUabl , as Copy of t he payment bond is atlmehod):
6. LENDER:
Addfass:
Am rd of ond:
Phone Number
7. Persofm w!lhin the Stabs of Fiorida Designated by Owner upon whom notice or other decurnwrts may bo served as provided by Section
715.13:(i�a)T., f%loiidasfagrbss. n
Phone Number: _
� n_
8. In addition. Owner designates
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number:
9. F-)Viration Date of Notice of Commencement (The expiration is 1 year from dale of recording unless a different date is specified) / V gEl
WARWNG TO OtMNER ANY PAYMENTS MADE BY THE OWNER AFTER THE EMRATION OF THE NOTICE OF COMMENCEMENT ARE
CONSIDERED PAPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR
PAYING TNIiCE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE
JOB STTE 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.
X —F, , 1 ,,,4 -- (0-Y-\&-("Px cvn za l Sty rK
d «me. or Orator's (W Uo 's (Pmt Now one Provide Slpnews 7i soffi e)
Auftitted eD
stm Of fl A a cewit,,of S"Y-� ; r 6 V, T� �W
The for ng Ir4VURWA was opknowtedged before me this D day of r r,-/O% - 20
by I ILA 'LA VA L . Who is personally known to me o OR
No" er r eneen erolaq smmngrx
who has produced kleWAcaffort type of Identifladon produced:
a
aorary pubic State Of Florida
T,Hany 6urlesonMy Cemrrosswn GG 173997
Expires 01109/2022 1.
GRANT MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL
CLERK'S#2018025381 BK 9087 Fig 0857; (1pg) E-RECORDED 03/07/2018 11:08:02 AM
10.00
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 3� k5\ �g
I hereby name and appoint: � (XAe 5 \ Ch
an agent of: CeJ�-wo ,\Cjws l—k-G
(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:
�'Ao v\10 VMk k 'D<- - 30,nfoy-d .
(Street Address)
Expiration Date for This Limited Power of Attorney: 3 130 1 �;
License Holder Name: h—CA`nG5G0 'DaLN CX0
State License Number: C- C C k3 J 0 (,G DCI
Signature of License Holder:
STATE OFF FLORIDA
COUNTY OF�YY�V-,'
The foregoing instrument was acknowledged before me this
200 , by �rr�ncscc� '�� Mrtiy
to me or ❑ who has produced
identification and who did (did not) take an oath.
�� (B
N@I % ublic Stateurleson of Florida
= p
c My Commission GG 173997
Expires01/09/2022
(Rev. 08.12)
jf�__day of A40 rr/p) ,
who is personally known
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Print or type ame
Notary Public - Statgg of
Commission No.
My Commission Expires: l
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PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: NO M1 W 'Dv . �wA 'fO k-6 . `
STRUCTURE TYPE: DINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: �.$.EPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): l l y y 'I ��cd
* *PLEASE NOTE: ONL Y 100 SQUARE FEPT OF THE EXISTING DECK IS PERMITTED TO BE REPLACED * *
ROOF VENTILATION: 40FF-RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES XNO 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
O SHINGLE
1
Mir
L# `�%'
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
O INSULATED
FL#
O TILE
FL#
O OTHER:
FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IF APPLICABLE**
ROOF SLOPE: O 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#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
L
yCITY OF
Building & Fire Prevention Division
S ORD RESIDENTIAL RE -ROOF POLICY & PROCEDURES
FIRE DEPARTMENT
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:
i
A
CITY OF
Building & Fire Prevention. Division
RESIDENTIAL RE -ROOF AFFIDAVIT
FI13E DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: p I U v ADDRESS: NO V"4 0� V)a 1` Or
I_U`(G5C61 r^V 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 THEHURRICANERETROFIT
MANUAL REQUIREMENTS (BASED ON F.S. CHAPTER 55553.844).
LICENSE #: ciM
COMPANY / CONTRACTOR: CfAcaya\ f fG►YN G,SC O
ql j/
CONTRACTOR SIGNATURE: �J DATE: /S
(MUST BE SIGNED BY LICENSE HOLDER OR OWNER/BUILDER)
i
i
A FINAL ROOF INSPECTION'IS REOUIRED:
THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIIIED AT THE JOB'.SITE AT THE TIME OF THE FINAL ROOF INSPECTION,
-ALONG 'WITH DIGITAL PHOTOGIL.F113O. cr::Ci3F. . c I',TIIi-.. 0. ;.O,FII I.:,I3ET_.iL.AL_(eM_.L3\_N., (I1ECI{IWC: ----- __.....
UNDERLAYMENT, FLASHING, DRIP EDGE ATTACHMEINT) WITH THE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON THE DECK 6
FOR EACH INSPECTION. THE PHOTOGRAPHS MUST INCLUDE A RULER ORMEASURING 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.
I
"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.
a CQ
i STATE OF FLORIDA COUNTY OF. �JrYI 1 nOLA,
Sworn to and Subscribed before me this day of h 2019 by:
T'^ kN CI`�w ". Who is�_Personally Known to me or has a Produced (type of
identification) as identification';
ur f . otarl ublic
5 to of Florida 4 a :': L
l tsoy 1
Print/Type/Sta p Name
of Notary Public E
Notary PubhC State of Florida
Tiffany BurlesoMy Commission GG 173997
Expires 01/09/2022