HomeMy WebLinkAbout126 Sanora BlvdCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $
Job Address: 1 !2,U SClnDra owct • SonT U M I O— Historic District: Yes ❑ No
Parcel ID• MUS lFiD V� v Residential Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: CC:- WD-�
Plan Review Contact Person:
Phone:
Fax:
Email:
Property Owner Information
Title:
Name A�{oNo &dml. Phone: 40e7A�9
Street: ` �� C��1 YV �� Resident of property?: Elmo
City, State Zip: (Wad (--t sze N S
Contractor Information /�
Name ` S `K-�JAon Phone: Ab
Street: Q 1 Fax: J46 1 CeO(eS;7'
City, State Zip 1 i 2`1 � State License No.:Cm
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company:
Address:
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. 1 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`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.
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 1CC 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.
a&o�0-1 04� �-i /f .*7 % S
Signature of Owner/Agent Date
l-7 f
Print Owner/Agent's
Signat o a -Star Date
taar ° Notary Public State of Florida
Lesley G Garza
Q My Commission GG 009517
Expires07/07/2020
Owner/Age'
Produced ID Type of ID
Sig at e of Contractor/Agent Date
(d
Print Contractor/ en '
ida Date
�1ft�
�� a Notary Public State JFloridaLesleyGGarzaMY Commission GG
aRa �Exires7107/202tyContractor M,Me or
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: June 30, 2015 Permit Application
HERITAGE
Conitruction &'Roofing Inc.
1544 Semincila Blvd. Suite 136
Casselberry, FL 32707
PH: 407-366-6000
r-,X:407-366-6065
ln.fo@Heritagecr.com
CGC1505045 CCC1326650
�,wvihl S PC(,
ROOF REPLACIP.MENT CONTRACT
' "-'—
Account M er: V
Contact: *7 7 16 6 1
INSURANCf COMPANYINFORMATION
Company: b6cUr4nt--..
Policy #:
Claim#:WA
MORTGAGE COMPANY INFORMATION
61 Company:
Loan Number:
Owncr(s): A
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Le A5LJOIJ
mwed
Phone:
Address:
I1L�m
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Of (114 �nvlorm elvd.
Cell:(v7�
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City
State: Zip Code:
Email:
manufacture:
Style:
color.
Roof CRV:
If Owner's Insurance Company does not agree to pay for a full roof replacement, this contract shall be voidable.
Assignment of Insurance Benefits for the Full Roof Replacement Only: I hereby assign any and all insurance rights, benefits and proceeds
under any applicable insurance policies to Heritage Construction & Roofing, Inc. ("Heritage"), the scope of which shall be limited to a Full Roof
Replacement. I make this assignment and authorization in consideration of Heritage's agreement to perform services, supply materials and otherwise
perform its obligations under this contract, including not requiring full payment at the time of service. 1 also hereby direct my insurer(s) to release any
and all information requested by Heritage, its representative, or its attorney for the direct purpose of obtaining actual benefits to be paid by my insurer(s)
for services rendered. In this regard, I waive my privacy rights. If payment is made directly to the &.vner/Agentlinsured(s), it shall be endorsed over to
Heritage immediately upon receipt I agree that any portion of work-, deductibles, betterment or additional work requested by the undersigned, not
covered by insurance, must be paid by the undersigned on the day of installation. Deductible: It is the Owner's responsibility to pay all Insurance
Muctibles. Owner's out-of-pocket expense will not exceed the deductible, amount, as stated on insurer's loss sheet, UNLESS replacement/repair of
deteriorated decking is required and/or Owner requests optional upgrades -Heritage CANNOT pay, Waive, rebate, or promise to pay, waive or rebate all or
any part of the insurance, deductible applicable to the insurance claim for payment of work. In the event of a discrepancy, the deductible amount stated on
the insurer's Los Sheet shall 6verrule'deductible listed below:
Deductible: , MUST BE PAID UN FULL, PLUS ANY APPLICABLE SALES TAX Initials)
rviORTGAGEAUTIRIORIZATION. 1, Owner/ Mortgagor, grant authorization for Mortgage Co. to speak with
Heritage Construction & Roofing, on matters including, but not limited to, the claim and payment status.
PAYATENT SCHEDULE: Owner agrees to pay Heritage based on the following pay schedule: (i) Deposit in the amount of S
due upon signing this contract; (ii) the Contract Price, less the Deposit and any applicable depreciation retained by Owner's insurer(s), plus Upgrade
Costs, due and payable to Heritage upon completion of work being performed-. and, (iii) the remaining Contract Price (equal to any applicable
depreciation and/or change orders) due and payable to Heritage upon completion of work per -formed. In the event of a pending inspection, no more than
2% of Contract Price may be withheld until inspection has passed. Optional: UPGRADE ITEM: QTY.-
PRICE: S TOTAL: $ Replacement Work, and Price: Upon
insurer's approval and subject to the terms and conditions herein, Heritage agrees to furnish all materials and provide the labor necessary to perform the
full roof replacement which shall take place following Owner's insurance company's approval, approximately within 30 days, conditions permitting.
Owner's Declaration of Intent: Owner acknowtedges and agrees that, upon approval by insurance company for a full roof replacement, Heritage shall
perform the roof replacement upon receipt of funds from Owner's insurance company. CANCELLATION: If Owner elects to terminate the services of
Heritage, Owner may do so before midnight on the third business day after Contract is executed. Owner shall receive a full refund of all d"sits. Owner
may also rescind Contract before midnight on the third business day after the contract is executed after notification from insurer(s) that the claim for
payment on roof contract has been denied, in whole or in part. All written notices of cancellation, regardless of reason, shall be postmarked or delivered
to Heritage's corporate office: 1544 Serninola Blvd., Suite 136, Casselberry, Florida 32707. CANCELLATION EXCEPTIONS: The three (3) day right
of cancellation DOES NOT APPLY to contracts for emergency home repairs as time is of the essence. 1, Owner, have read and understand all statements,
terms and conditions of the "Roof Replacement Contract" and agree that all details are acceptable and satisfactory. I further understand that this contract
constitutes the entire agreement between the parties and that any further changes or alterations to this contract must be made in writing and agreed upon
by both parties. Each party represents and warrants to the other that it has the full po and authority to enter into the contract and that it is binding and
em%r-deabde in accogd2ke with its terms. A
d
MIM11101-!Z'� Representative D at
Print'Name
TERMS AND CONDITIONS: Acceptance of Terms: 1, Owner, hereby agree to retain Heritage for a full roof replacement on the terms and conditions
stated herein. I further agree to provide Heritage with the Scope of Loss Report generated by my insurer and authorize and grant full access to the
property for die purpose of staging and completing all agreed upon work. Supplemental Claims: Heritage reserves the right to file a supplemental claim.
with Owner's insurance in the event that the estimate is incorrect and/or additional damage is discovered after commencement. The supplemental claim
amount(s), in addition to any depreciated amounts held back by the insurer, are immediately due to Heritage upon receipt. Commencement of Work:
Work shall commence, at Heritage's discretion. Heritage shall not he liable for delay in, or failure to perform due to: labor controversies, strikes, fire,
weather, Acts of God, war, governmental actions, inability to obtain materials from usual sources, delays caused by and/or as a direct result of Owner's
insurer or other circumstances not listed which are beyond the control of Heritage. Noise Pollution and Vibrations: Prior to installation, it is the sole
responsibility of Owner to remove any and all items which are not secured to walls including, but not limited to, items on mantles, shelves or other areas
susceptible to vibrations, as these may fall. Heritage shall not be liable far noise pollution and/or vibrations due to the performance of work contracted
herein, or damages resulting to person(s) or property.
1`a
THIS INSTRUMENT PREPARED BY: /�
,Name: Heritage Construction & Roofing IN 1n Vlg7 y G VI< &'1
Address: 1544 Seminola Blvd. Suite 136
Casselberrv. FL 32707
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number:
�_�� *= ; 'iiiai_l:''i : E:i'fThi%}1_= _'•11��(j 3
CLERK'S v 201804.2714
.
Dr
ii{::r.Ur•.l_%L. .3Y
Parcel ID Number: 'Ll/,JI V v �7 Ljriw VVs-o
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.
GENERAL DESCRIPTION OF IMPROVEMENT:
Y-.t� _ ie.CJU
OWNE INFORMAT OW
Name: Amm s) ll
Fee Simple Title Holder (if other than owner) Name
Address:
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:
Address:
In addition to himself, Owner Designates
of
To receive a copy of the Lienor's Notice as Provided in
Section 713.13(1)(b), Florida Statutes.
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 penalties of perjury, I declare that I have raad the foregoing and that the facts stated in it are true
to a of my knowledge d belief.
t
Owne s Sig ture 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 her stead."
State of P l County of Se-NN 1 "'NO t o
The foregoing instrument was acknowledged before me this day of �,Lpc� 1 20,
by i2� (`i�� (% L_���� t A Who is personally known to me ❑
Name of person making statement
OR who has produced identification type of identification produced: '()C")o _q0- a`a_O
rV
Notary public Stateof FloNdaLeerGarza
CERT1FIEpCOPY �nnyc�,ission009517.Expices;a7im�o�,
SUNK)
SY
City of Sanford
Building and Fire Prevention
Product Approval Specification Form
Permit #
Project Location Address I (Uf Scmo a �j� Id • QQY)ft O f—L 3 *2n J
v
As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the
information and product approval number(s) on the building components listed below if they are to be.
utilized on the construction project for which you are applying for a building permit. We recommend that
you contact your local product supplier should you not know the product approval number for any of the
applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in
accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product
Approval can be obtained at www.floridabuilding.org.
The following information must be available on the jobsite for inspections:
1. This entire product approval form
2. A copy of the manufacturer's installation details and requirements for each product.
Category / Subcategory
Manufacturer
Product
Description
Florida Approval #
include decimal
1. Exterior Doors
Swinging
Sliding
Sectional
Roll U
Automatic
Other
2. Windows
Single Hun
Horizontal Slider
Casement
Double Hun
Fixed
Awning
Pass Through
Projected
Mullions
Wind Breaker
Dual Action
Other
June 2014
Category / Subcategory
Manufacturer
Product
Description(including
Florida Approval #
decimal
3. Panel Walls
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles
Y-�
Underla ments
Roofing Fasteners
Nonstructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Built up roofing
System
Modified Bitumen
Single Ply Roof
Systems
Roofing slate
Cements/
Adhesives /
Coating
Liquid Applied
Roofing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels
Roof Vents
Other
June 2014
Category / Subcategory
Manufacturer
Product
Description
Florida Approval #
include decimal
5. Shutters
Accordion
Bahama
Colonial
Roll u
Equipment
Other
6. Skylights
Skylights
Other
7. Structural
Components
Wood Connectors /
Anchors
Truss Plates
Engineered Lumber
Railing
Coolers/Freezers
Concrete Admixtures
Precast Lintels
Insulation Forms
Plastics
Deck / Roof
Wall
Prefab Sheds
Other
8. New Exterior
Envelope Products
Applicant's Signati
Applicant's Name
(Please Print)
June 2014
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: j
I hereby name and appoint: t4V\A-V�N�/
an agent of: ��I?�`M.�1 `� i�� k konC
(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 ermit and application fo work located at:
v
(Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name: James T. Welding
State License Number: CCC132650
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF e--v -, % no e
The foregoing instrument was acknowledged before me this P day of April ,
200_j(�, by & % 111 who is ersonally known
to me or ❑ who has produced as
identification and who did (did not) takearr
(Notary Seal) LC5 [e,;� &C^CZ
Print or type name
Notary Public - State of
Commission No. G&c"GG1c t l
My Commission Expires:
(Rev.OR.l2) RN
StateofFlorida
rzaon
Ion G
VG009517