HomeMy WebLinkAbout1223 Randolph StCITY OF SANFORD
BUILDING & FIRE PREVENTION
Q�'� PERMIT APPLICATION
i
'4F Y:Application No:
Documented Construction Value: $ 6 0 o O
Job Address: P 4 0 1 pk S'- Historic District: Yes ❑ No
Parcel ID: 1/ - iq - sz-vCf -0100 - o I Lf-0 Residential 91- 'Commercial ❑
Type of Work: New ❑ Addition ❑ nAlteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work:
Plan Review Contact Person:
Phone: Fax: Email:
Property Owner Information'
Title:
Marne OL U Phone: �O 22--4s'
/Street: Resident of property?
City, State Zip:
_-1, , Contractor Information,,
y
Name �'t !_ 1J Phone %..
Street: (0 1 .� o k 0-IcQLI Fax:
City, State Zip: C K `157-D o -rlc- 3 D-91 ( State License No.: CCG 1
Arch itectlEng ineer 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
11
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`h 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.
7
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 constyuctioMnd zoning.
l / 7 ' �t�
gnus a re of Contractor/Age Date
C w &-n
Print Con ctor/Agent's Name
J 01
Signature ofloridaANNE77E M BLA4ffc to
?�-`- (votary Public - State of Florida
Commission # GG 170900
f.1y Comrr. Expires Jan 16. 2022
C. ccc :'rC,.yr Na-icra NC:ari Assn,
Owner/ ent is Contractor/Agent is Personally Known to Me or
-ProdOed ID Type of ID Produced ID Type of ID
COLLEEN 0. KING
a_ Commission # FF 244523
Expires June 28, 2o,s BELOW IS FOR OFFICE USE ONLY
aided-TAm Troy Fain Insurance 800-W,7019
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing[]
Construction Type: Occupancy Use:
Gas ❑ Roof ❑
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:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
CONTRACT AGREEMENT
T ' agreement is made on this day of Ape; 20 between
al q�) J!�� of L-,>� S�� ��
Name Address City
u l S- 53 (Contractor)
Stater Zi ' Phone
and J�z �'1 of
Name Address City
31�?-69a-�taoS (Client)
State Zip Phone
The above contractor will perform the following work as described in this agreement for
in compensation from the client.
Job Description.: A,� 8 �P�S o.� � uj of
Work to commence. on-COAPf�'1 ZotKnd is estimated to be completed on 461 k ' Zd t
Date Date
Contractor:
Signature"
Print
Client:
Si a ure
U-Okr\,N-\ ?It-cr,
Print
Date:�� 4 f 2-6 f Fr
Date: � 1418
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 1�( -[ 0 C
f
I hereby name and appoint:�`S
an agent of: C ge pry , nL
' (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 per t and application for work located at:
l 3 O(a
(Street Address)
Expiration Date for This Limited Power of Attorney:. 4441 30, Z0 ! P
License Holder Name: n A Y" r/ 0 /A r e_�
State License Number:
Signature of License H
STATE OF FLORIDA
COUNTY OF `5ejminble
The foregoing instrument was acknowledged before me this q'' day of' i ,
Zot3 , by who is ersonally known
'to me or ❑ who has produced as
identification and who did (d' not take an oath.
n (iA
(Notary Seal)
CASSANDRA C GORDON
4F '•• ° GG 187167
ee Expires FetxuM 25, 2022
°�oFf��' �dTA^'9"°p°tNo�Ysarlces
(Rev. 08.12)
Print or type name
Notary Public - State of V1
Commission No. Gq 1%71 i 6 _1
My Commission Expires: cad
THIS INSTRU ENT PREPA�ED BY:
►
Name: (�f -qi _ ( j ^ L' rS
Address: S -7 HV 6-r t-2•C Sr7'
NOTICE OF COMMENCEMENT
Permit Number:
.parcel ID Number: 3/ Zoo-- O I L( O
►►�1iII ltltt iil�l Illil I�III NIID IIII III
GRANT MALOY, SEMINOLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLER
BK 9107 P9 1524 (1Pss)
CLERK'S 4 2018038.843
RECORDED 114/1►1/2013 12:53:4.0 PI--1
RECORDING FEES $10.00
RECORDED BY tsmith
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 PROPERTY: ( gal description of the roperty and street
/�a3 do 1A fir-, sir
2. GENERAL DESCRIPTION OF IMPROVEMENT:
r /3 OWNER INFORMATION OR LPSSEE INFO AT N IF TKE LESSEE CONTPACTED FOR THE
V Name and address:
Interest in property:
3Z 7%
Fee Simple Title Holder (if other than owner listed above) Name:_
Address: l
4. CONTRACTOR: Name: b62 ( ! brLd-�_ Phone Number: rt O'-) — 6 qA— 0-7 ASS
Address: '6Y3 7C`Jvr^r" i2r) ,4.00, sc-c
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
Amount of Bond:
6. LENDER: Name: Phone Number:
Address:
7. 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)(a)7., Florida Statutes.
Name: Phone Number:
8. In'addi'tion, Owner designates
of
to ref eive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number:
9. Expiration Date of Notice of Commencement (The expiration 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
BWFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
A A :hn :4
( ign ture o er r Less o er s or Lessee's F (Print Name and P vide S' natory's e/Office)
Autho' edI/ cer/Direc r/Pa er/Manager)
St� to ' of �t
County of
The foregoing instrument was acknowledged before me this 1� day of 2
by I Who is personally known to me O OR
Name of person making state nt
.who has produced identification ❑ type of identification produced:
ira t�P c�ac u� I �CvU �T
W. JAMES RANKIN
*'MYCOMMISSION9FFA7982
EXPIRES: July 1, 2018
*O r� Booded1bru Budget NoNryServices
City of Sanford Building Division
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), certifyini F de compliance by personal inspection.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE:
i
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
Jos ADDRESS: 0 9 3 441N,00 / p h
STRUCTURE TYPE: ® SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: C?REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
ORE -COVER (NEW )ROOF INSTALLED OVER
�EXISTING
jROOF)
E,
DECK TYPE (PLEASE SPECIFY): �/� 0 U-0 1 Imo - 'f- a,
*'PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED * *
ROOF VENTILATION: ®OFF -RIDGE O RIDGE OSOFFIT [POWERED VENT OTURBINES
SKYLIGHTS: O YES NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
----------------------------------------------------------------------------------------------------------------------------- -------------------------------------
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12-4:12 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
® SHINGLE
'S-O
FL#
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.) **IFAPPLICABLE**
ROOF SLOPE: O LESS THAN 2:12 O 2:12-4:12 ® 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#
0INSULATED
FL#
O TILE
FL#
0 OTHER:
FL# -
l
Building & Fire Prevention Division
RESIDENTIAL RE-ROOFAFFIDAVIT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: / O ' 7 ` ADDRESS: 10- a"3
I 19'rY `I L- C, r< ` , AS A(N) GENEyRAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTO , ENGINEER, ARCHITECT, OF,F.S. CHAPTER 468 BUII,DING 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 #: Lc C -- 121 ?--1 , K
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE: "' 1 DATE: I f I C ZV 1
(MUST BE SIGNED BY LICENSE HOLDER OR OWNERIBUILDER)
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 duty �i
Sworn to and Subscribed before me this 1 day of AIOY 20 by:
L �,�►' Who is ❑ Personally Known to me or has P4roduced (type of
ide ' ication) �—� �— as identification.
Sig ature f N ary Pub is
Stat f Florida Pa` P�e''a
_•'a°w MELODY b.'!
Notary Public -State of Florida
Commission # FF 902089
Print/Type/Sta p Name 44% ;,,�� My Comm, Expires Ju121, 2019
of Notary Public