HomeMy WebLinkAbout139 Pinefield Dr (3)-CITY OF
i1 S IU
Building & Fire Prevention Division
PERMIT APPLICATION
FJRE'1',)EPARThAENT
Application No: 18-�EB
Documented Construction Value: $ 01 V 00 • Cab
Job Address:o� V�P&iAW \y . sonflad Historic District: Yes DNoa
Parcel ID: 32 - �cl - 3 I -515- 6000 - � 2Zn ResidentialzCommercialF—I
Type of Work: NewAddition❑ Alte>nation� Repair Demo❑ Change of Use[] Move❑
Description of Work:
Plan Review Contact Person: a01\C/1 SCQ n Title: W
Phone•g6-1- -73Z- 71W- Fax: M-;� 7ff /Z 3 Email: JV) , 1N1Gf1 - aM
Property Owner Information
Name �1Q�IY Nas ( Phone: 3clqb,
Street: f t, fi�� W -DlY Resident of property?
City, State Zip: �UnYd r r ?j21
Mt�
Contractor InformationName ,MVM U C' Phone: `7 01- -7 32 - 7 2 b Z
Street: I kft l� WV1 humIvd Fax: (M_1S-11�— q1 Z3
City, State Zip: U . 50 State License No.: 1. 13 30b 0q
Architect/Engineer Informa ' n
Name: hone:
Street:
City, St, Zip:
Bonding Company:
Address:
/ 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: 6t' 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.
511t1i6
Signature of Owner/Agent I Date
Sc� ArAd
Print Owner/Agent's Name
$>�tuyy�iSfl�b}ary- of Florida - to
�� ��// U o, _ Pys� �o�ary Public State Of
? Tiffany Burleson
My Commission GG 1
*1oraA Expires0110912022
Owner/Agent is /personally Known to Me or
Produced ID Type of ID
Signature of Contractor/Agent Date
Print Con tractor/AQents Name
of
=cry nps� Notary Pubhc State of Florida
Tiffany Burleson
e a My Commission GG 173997
°r�OF aQ Expires 01/09/2022
Contractor/Agent 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:
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
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: !�S
I hereby name and appoint:
an agent of: 'Cyi ram tM ✓VL Cs�
(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:
V3°iice-
(Street Address)
Expiration Date for This Limited Power of Attorney: S1 D a � \ 9
License Holder Name: �"'Q.,Aw c-� S� �rt�✓�-�
State License Number: (2- CSC 13 3
Signature of License Holder: Q
STATE OF FL(
COUNTY OF a&e, r ; v-jc,L
The foregoing instrument was acknowledged before me this may ofma ;
20�t , by'F-taY'C SC0 I>'-' 1MC/ who isl,2r-plersonalldmown
to me or ❑ who has produced as
identification and who did (did not) take an oath.
1
(Notary Seal)
Print or type
h
E,=
lic State of Florida Notary Public - State ofrleson Commission No.ission GG 173997/09/2022 My Commission Expires:
(Rev. 08.12)
11111111111111111 fluff 111111111111111111
THIS INSTRUIli PREPARED BY:
Name: Triana Torres
Address' one eagan v
Longwood, FL 32750
Permit Number.
Parcel ID Number. TL- L UCH C7 Z2 U
GRANT MALOY, SEMINOLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLER
BY 9136 Pq 1065 QP9s)
CLERK'S v 2018057422
RECORDED 05/21/2018 01:-71:05 F'11
tNG FEES $10. iCi
RECORDED BY hilevore
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the
following informadon is provided iinnYthis Notice of Cpommenoementp�ty
1. D�t"Pnot; 'L2 PROP (Legal and slireet
l;Q �XV �1�Gt1G�S Y hG e, address ViVilebl�o
2. GENERAL DESCRIPTION OF
3. OWNER INFORMA
Name and address:
Interest in property:
Fee Simple Title Holder ('d other than owner fisted above) Name:
Address:
4. CONTRACTOR: Name: Central Homes, LLC phone Number:----497 732 7262
Address: 1182 N. Ronald Reagan Blvd., Longwood, FL 32750
S. SURETY (N applkable, a copy of the payment bond is attached): Name:�
Address: Amount of Bond:
6. LENDER Name: Phone Number.
Address:
7. Persona wtthin the State of Florlda Designated by Owner upon whom notice ar otwr documents may be served as pnwkied by Secdon
713.13(1)(a)7., Florida 8tatutm. i.
Phone Number.
8. In addition. Owner designates of
to receive a copy of the Uenof s Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number.
9. Expiration De* of Notice of Commencement (The expiration is 1 year from date of recording unless a different data 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 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST SE RECORDED AND POSTED ON THE
JOB SITE SEFORE THE FIRST INSPECTION. IF YOU INTEND TO 08TAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
(SW&U" of Owner or Lessee, or Oww's or Lessee's
Audwirrd Of w/DeacrodPWONrAftn"or)
State of �(„�0 (jI OC Couri
(Print Nerve VW PM040 3iynetcrya TOM 0 5m)
The for/e1g��oing instrument was admawledged before the this _ _ L� day of
by 1 «►- U Y Who is Dersonaliv overt to me BOOR
Name of pammn mdaN stowro M
who has produced Identl =Ion 0 type of identMention produce
EOF
pti¢ Notary Public State of Florida
Tiffany Burleson
My Commission GG 173997
0.�? Expires 01/09/2022
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CITY O
SAW- Building & Fire Prevention Division "ORDRESIDENTIAL RE -ROOF AFFIDA VIT
FIRE DEPARTMENT
RESIDENTIAL RE -Rolf INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: — 3 $ ADDRESS:
I 1PRA µC. \S -0 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 THE HURRICANE RETROFIT
MANUAL REQUIREMENTS (BASED ON F.S. CHAPTER 553.844).
LICENSE #: C.0 (_ 13 __'50(Q 0q
COMPANY / CONTRACTOR: C EST e ✓-L V\nYyl t S_„ L LC •- 4— *.av�\C l S F;,11 vo," A
CONTRACTOR SIGNATURE: eA a DATE: (0a
(MUST BE SIGNED BY LICENSE HOLD R OR OWNER/BUILDER)
A FsN T Rn()F TNSPEC'Tin'i'„iS;RE0iti1RFD:___ --. __._. _ _
\THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINAL ROOF INSPECTION,
ALONG WITH DIGIT'.AL PHOTOGRAPHS OF EACH PLANE Or 1'HE•ROOF SHOWING IN DETAIL ALL, COMPONENTS (DECKING,
UNDERLAYMENT, FLASHING, DRIP EDGE ATTACHMENT) WITH-1 I 'HE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON THE DECK
FOR EACH INSPECTION. THE PHOTOGRAPHS MUST IN'CLUFI 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.
r:
;.
STATE OF FLORIDA COUNTY OF ✓C E1'nk V*OL.G
Sworn. to and Subscribed before me this _ day of V'A G
20\� by:
�--Zd�W CwS�o \wlVl� Who isKPersonally Known to me or has ❑ Produced (type of
identification)
j/ Sjn#ture i6�' Notary Public.
`/ State of FWrida
Print/Type/Stamp Name
of Notary Public -
as identification.
Z
Notary Public State of Florida,
TiffanyBurleson
My Commission GG 173997Expires01/09/2022 '
R
CITY OF
S--------ORD + Building & Fire Prevention Division
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.
1,0
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: —+1-::11\—\';�-� DATE: 5 1 V
O
CITY
S.Lk
4 ORD
DEPARTMENTFIRE
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: 13C4 pi(1Q,f iW ��( SClY1go`cd
STRUCTURE TYPE: C2(SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: VREPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY: ld► V IN, vi"
* *PLEASE NOTE: ONLY 100 SQUARE FEET OF THE §FX1STfNbDECKfS PERMITTED TO BE REPLACED"
*
ROOF VENTILATION: OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT
SKYLIGHTS: O YES (2rNO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 (24.12 OR GREATER
O TURBINES
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
SHINGLE
` �!
)i��C1Ci1
FL#ig1 yu. 1
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
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 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
O SHINGLE
FL#
O METAL
FL#
O MODIFIED BITUMEN
FL#
OTORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
0 OTHER:
FL#