HomeMy WebLinkAbout103 Ellen Pls
FCGM
FIRE;
A, .._,.
c Building & Fire Prevention Division
3 0 20 PERMIT APPLICATION
*zz.
Application No:
Documented Construction Value: $
Job Address: 103 I-n) U'� ,e)o��(�,�77I Historic District: Yes❑No
Parcel ID:
Type of Work: Newz Addition❑ Alteration
Description of Work:
Plan Review Contact Person: kAr
Phone: � Ijf 311-H 7 1 d Fax:
Residential Commercial❑
Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Email:
Title: C�
Property Owner Information
Name 're_'>Z a �ol � Phone: D 2 3 Y % 7
Street: 10 3 1 I e_.") (!'s,<. Resident of property?
City, State Zip: )G� STD r�) r✓_
,,1�h;,,
Contractor Information eI, �)1 o3
Name I `� Phone:; ctCJ7'
Street: M-e. Fax.•
City, State Zip: State License No.:
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Architect/Engineer Information.
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: 61h 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.
oh
SignaturJ of Owner/Agent Date Signature of Contractor/Agent Date
PrintQ.;vner/Agent's Name Print Contractor/Agent's Name
Lkj�:,& Vn,J
Signature of'Plota>°y g Date Signature of Notary -State of Florida Date
�pNY P�
ANNETTE BLAND
Notary
Public - State of Florida
,9 f Po�g
P;; ;
Co mission # GG 060623
My omm.
:.
Owner/Agen is
Ex irss Jan'16,
P 2018
Me or
Produced ID
Type of ID I t �ccl--
PyaOs�0�-3o45s0
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: Flood Zone: _
Total Sq Ft of Bldg:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
# of Stories:
Plumbing - # of Fixtures.
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: January 1, 2018
Permit Application
t T
1
OWNER BUILDER STATEMENT/AFFIDAVIT
Altamonte Springs, Casselberry, Lake Mary, Longwood, Oviedo, Sanford,
Seminole County, Winter Springs
Florida Statutes are quoted here in part for your information to indicate the authority for exemptions for
homeowners"from qualifying as contractors and to express any applicable restrictions and responsibilities.
OWNERS MUST PERSONALLY APPEAR AT THE BUILDING DIVISION TO SIGN THIS DOCUMENT
BY SIGNING THIS STATEMENT, I ATTEST THAT: (Initial to the left of each statement)
I understand that state law requires construction to be done by a licensed contractor and have applied for
an nwner-huilder hermit under an exemption from the law. The exemption specifies that 1, as the owner of "
the property listed, may act as my own contractor with, certain restrictions; even though I do not have: a
license.
I understand that building permits are not. required to be signed by a property owner unless he or she is
responsible for the construction and is not hiring a licensed contractor to assume. responsibility..
I understand that, as an owner -builder, I am the responsible party of record on a permit. I understand that I
may protect myself from potential financial risk by hiring a licensed contractor, and having the permit filed
in his or her name instead of my own name. I also understand that a contractor is required by law to be
Iicensed in.Florida and to list his or her license numbers on all permit and contracts.
I understand that I may build or improve a one -family or two-family residence or a farm, outbuilding. I
may also build or improve a commercial building if the costs do not exceed $75,000. The building or
residence must be for my own use or occupancy. It may not be built or substantially :;improved for -sale or
lease. If a building or residence that I have built or substantially improved myself is sold or leased within
in 1 year after the construction is. -complete; the law will presume that I built or substantiall°y'improved'it
4P4
for sale or lease, which violates this exemption.
I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
I understand that I may not hire an unlicensed individual person to act as my contractor or to supervise
persons working on my building or residence. It is my. responsibility to ensure that the persons whom I
employ have the licenses required by law and by city ordinance.
I understand that it is a frequent practice of unlicensed persons to have the property owner obtain an
owner -builder permit that erroneously implies that the property owner is providing his or her own labor
and materials. I, as an owner -builder, may, be held liable and subjected to serious 'financial risk for any
injuries sustained by an unlicensed person or his or her employees while working on my property. My
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner -
builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
I understand that I may, not -delegate the responsibility for supervising work to alicensed contractor who is
not licensed to perform the work being done. Any person workingon:my building who Is not licensed,
must work under my direct supervision and must be employed by me, which means that I must
comply with laws requiring the withholding of federal income tax,and social security contributions
under the Federal Insurance Contributions Act (FICA) and must provide workers' compensation
. for the employee. I understand that my failure to follow these laws may subject me to serious financial
risk.
Rev. 9.14.2009
I agree that, as the party legally and financially responsible for this proposed construction activity, I will
abide by all applicable laws and requirements that govern owner -builders as well as employers. I also
cjf�� understand that the construction must comply with all applicable laws, ordinances, building codes, and
zoning regulations.
I am of aware of construction practices and 1 have access to the Florida Building Codes.
I understand that I may obtain more information regarding my obligations as an employer from the Internal
Revenue Service, the United States Small Business Administration, the Florida Department of Financial
Services, and the Florida Department of Revenue. I also understand that I may contact the Florida
Construction Industry Licensing Board at 1-850-487-1395 or at www.myflorida.com/dbpr/pro/cilb/ for
Wl
more information about licensed contractors.
I am aware of, and consent to, an owner -builder building permit applied for in my name and understand
that I am the party legally and financially responsible for the proposed construction activity at the address
listed below.
I agree to notify the building department immediately of any additions, deletions, or changes to any of the
'provided
j
�J
information that I have on this disclosure or in the permit application package.
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person
who does not have a license, the Construction Industry Licensing Board, the Department of Business and
Professional Regulation and the building department may be unable to assist you with any financial loss
that you sustain as a result of a complaint. Your only remedy against an unlicensed contractor may be in
civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an
I
individual or firm is injured while working on your property, you may be held liable for damages. If you
obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for verifying
whether the contractor is property licensed and the status of the contractor's workers' compensation
coverage.
Property Address: 103
I, L o rtAiz—o -RD i )c , do hereby state that I am qualified
and capable of performing the requested construction involved with the permit application filed and agree to the
conditions specified above.
Sig atur o wner-Builder Date
Form of Identification f �`-' �zy �_3
(Must be Photo ID)
A violation of this exemption is a misdemeanor of the first degree punishable by a term of imprisonment
not exceeding 1 year and a $1,000.00 fine in addition to any civil penalties. In addition, the local
permitting jurisdiction shall withhold final approval, revoke the permit, or pursue any action or remedy
for unlicensed activity against the owner and any person performing work that requires-licensure under
the permit issued.
Rev. 9.14.2009
SCPA Parcel View: 31-19-31-521-OG00-0300 Page 1 of 2
+
l
's
AS
Property Record Cardjonam, cFA Parcel: 31-19-31-521-OG00-0300
�nrrxiscxxxdry Property Address: 103 ELLEN PL SANFORD, FL 32771 -
r
- . _.................
Parcel Information Value Summary
_T2017Parcel 31-19-31-521-OG00 0300 � 2018 Working Values -
Values,
Certified
-- Values Values
Owner(s) POLK, LORENZO PP _ Valuation Method 1 Cost/Market Cost/Market
o ert AMailing 103 ELLEN PL SANFORD FL 32771 Number of Buildings 1 1
P Y
r' , FL 32771-3935 _.._.__
_ Depreciated Bldg Value $61,411 $53 166
Subdivision Name WASHINGTON OAKS SEC 1 e
' Depredated EXFT Value
DOR Land Value (Market) $18 000 1 $15 000
Tax District S1 SANFORD I
Exem Code
de 00 SINGLE FAMILY Land Value A
p HOMESTEAD(2001)� Just/Market Value $79,411 $68 166
' Portability
128 47 N 58 lity Adj
r
�- �� l�j r Save Our Homes Adj $22,564 $12 488
ia.� A 4 ,gyp Amendment 1 Ad/ $0
P&G Adj $0 $0
` 18 0) i$56 847 °
y - � Assessed Value $55,678
}
TaxAmount without SOH: 595.38
$
4y 2017 Tax Bill Amount $5131.34
p 41.(j4 Tax.Estimator e
F '$' 'k g Save Our Homes Savings: $ 82.04
a c4 • Does NOT INCLUDE Non Ad Valorem Assessments
a 4 ti e C my
Legal Description
WASHINGTON OAKS SEC 1
PB16PG8
_
i
Taxing Authority Assessment Value A�Exempt Values _ Taxable Value
° County General Fund $56,847 $31,847 1 $25,000
.
Schools $56,847 $25,000 $31 847 f
City Sanford $56,847 $31,847 $25,000 0
-
SJWM(Saint Johns Water Management) $56,847 E $31,847 1 $25,000
County Bonds A $56,847 1 $31,847 i - $25,000
Sales
i �
Description Date Book Page Amount Qualified Vac/Imp.
[ WARRANTY DEED 9/1/1997 03296 0084 . $57,500 Yes' Improved
_.
WARRANTY 03140 ` 0796 I $69,000 , Yes
ARANTY DEED 10/1/1996 Improved
r, - RA ..��. m ..•...-....., ,��.. -m� _....
SPECIAL WARRANTY DEED 9/i/1996r 03140 0794 $33 100 No Improved
SPECIAL WARRANTY DEED 4/1/1996 03073 1976 $100 No Improved
' CERTIFICATE OF TITLE 4/111996 ( 03059 f 1963 $46 700 No y Improved
m _ w
WARRANTY DEED 4/1/1992 02422 1424 ffi $40 000 Yes Improved
1
(- QUIT CLAIM DEED 11/1/19902356 1914 $100 No mm Improved
1
__.m_ EE_
j WARRANTY,DD. 10/1/1991 02357 0338 $14500 (No Improved
a
WARRANTY DEED1/1/1977 �01119 1196 $100 1 No Improved
,.... t ._. _. _. .. ___._ _ ....,.... _._. _ _ ..:_.
1 1/1976_ 01093 1494 $100 No Improved
SPECIA� WARRANTY DEER --
9 Find Comparable Sales
�L
d Lan _
Method Frontage Depth mmmm----- nits Units Price Land Value -
a;
' 'http://parceld6taii.scpafl.org/Parce]DetailInfo.aspx?PID=31193152IOG000300 4/30/2018
Ilk, V CITY OF
SkNFORD.
FIRE DEPARTMENT
PERMIT #�
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
� I �
JOB ADDRESS:
STRUCTURE TYPE: 0 SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME 0 APARTMENT/CONDOMINIUM
RE -ROOF TYPE: REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF
DECK TYPE (PLEASE SPECIFY:
* *PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED * *
ROOF VENTILATION: OFF -RIDGE O RIDGE SOFFIT OPOWERED VENT OTURBINES -
SKYLIGHTS: O YES (@0 NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 2:12 - 4:12 O 4: l 2 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
SHINGLE
FL#
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
0INSULATED
FL#
OTILE
FL#
O OTHER: -
FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLICABLE**
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 412 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
SHINGLE/
FL#
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
0 OTHER:
FL#
1 �
J;
., CITYOF
Sk
'FORD' Building &Fire PreventionDivision
RESIDENTIAL RE ROOF POLICY & PROCEDURES
FIRE DEPARTMENT s
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:
o PERMIT CARD, POSTED IN A CONSPICUOUS AND WEATHERPROOF LOCATION
o COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK
a COMPLETED AND NOTARIZED INSPECTION AFFIDAVIT
a ALL FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS
(PRODUCT APPROVAL SHALL MATCH WHAT IS ON THE SCOPE OF WORK)
O 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
o 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: .
CITY OF
• SkA.q
' Building & Fire Prevention Division
_MFORD
RESIDENTIAL RE-ROOFAFFIDAVIT
FIREDEPARTMENT AP 341�
12
d RESIDENTIAL REY ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 1 U s z O z_0 ADDRESS:
0C_�1,�
.D �G AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONT OR, 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 INSTALLATIONMEETS ALL
REQUIREMENTS FORSECONDARY WATER BARRIER AND NAILING OF THE ROOF DECK, IN ACCORDANCE WITH THE HURRICANE RETROFIT
MANUAL REQUIREMENTS (BASED ON F.S. CHAPTER 553.844).
LICENSE #:
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE:
(MUST BE SIGNED BY LICENSE HOLDER OR O
A FINAL ROOF INSPECTION IS REQUIRED:
DATE:. 30 1(
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 ' — —
q � rJ
Sw to and Subscri ed before me this O day of 20 d by:
. Who is ersonally Known to me or has ❑ Produced (type of ,.
i -
identification) as, identification.
�DE6BIE B----- LAIVTON
Signature of Notary Public,
State of Florida k E .PIRES FQ r0ry,25 2Qts
v II � onJed 7hnr {doL: 1 Pu' h, Undenariters
I —:rnem x
Print/Type/Stamp Name
of Notary Public
PREPARED 5/08/18, 6:36:47 INSPECTION.TICKET
CITY OF SANFORD INSPECTOR: BUILDING
--------------------------------------------------------------------------------
ADDRESS 103 ELLEN PL SUBDIV: WASHINGTON OAKS SEC
CONTRACTOR 'PHONE'
a
OWNER JARVIS SIMEON C & ANNA,M PHONE : (407) 314-4770
PARCEL 31.19.31.521-OG00-0300
APPL NUMBER: 18-00002020 ROOFING APPLICATION
I
PERMIT: ROOF 00 ROOF — RESIDENTIAL
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
--------------------------------------------------------------------------------
BL03 01 5/08/18 BLDG FINAL -ROOF VRU #: 003187214
------------------------------------ COMMENTS AND NOTES --------- -----