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HomeMy WebLinkAbout218 Pinefield DrCITY OF SANFORD �r DEPARTMENTFIRE z� Building & Fire Prevention Division PERMIT APPLICATION Aq � I � -A. 33 �' y�,, Application No• �7 b 7Y a� Documented Construction Value: S — IXRO'= Job Address: l I� O—A em Y, Historic District: Yes ❑ No H Parcel ID: Residential [Y Commercial ❑ Type of Work: New ❑ Addition ❑ Alteration ❑ Repair Dd-4Ye_m_­o`V Change of Use ❑ Move ❑ Description of Work: C e Plan Review Contact Person: 'A Phone: 14 1 - 3 a. l - 1 3l0 p0A n i ee_ Title: U_ Fax: Email: �� Q.� 14 GU Property Owner Information Name ()Y1n1'e' Phone: q q l) 3-Al- I3 b 0 Street: g L11 e �i P,l (� rr. Resident jof property S - 4 City, State Zip: C Contractor Information Name Street: City, State Zip: Name: Street: City, St, Zip: Bonding Company: Address: Phone: Fax: ` State License No.: Arch itectlEngineer 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: 6" Edition (2017) Florida Building Code OD Revised: August 1, 2017 Permit Application A T 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. A aim, ))aid �5- a' -I E Signature of Owner/Agent Date tom► u Print Owner/Agent's Name .-z1. V�& ?0ignata ry- tate M HNSON Date z MY f 284 EXPIRES:IMa�h 3, 2020 Boded Thtu Notary Public underwriters Owner/Agent is Personally Known t Me or Produced ID � L Type of ID -F � L, Signature of Contractor/Agent Date Print Contractor/Agent's Name Signature of Notary -State of Florida Date 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: # of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads Fire Alarm Permit: Yes ❑ No ❑ APPROVALS: ZONING: UTILITIES: WASTE WATER: ENGINEERING: FIRE: BUILDING: -;F- f.4918 COMMENTS: Revised: August I, 2017 Permit Application REQUIRED U4SPECTION SEQUENCE: B� ,IDLING PIE ` Mlln . Mai{ llns ection DDescri fIlon. Footer / Setback Stemwall Foundation / Form Board Survey Slab / Mono Slab Pre our Lintel / Tie Beam / Fill / Down Cell Sheathing— Walls' Sheathing— Roof Roof Dry In Frame Insulation Rough In Firewall Screw Pattern Drywall / Sheetrock Lath Inspection Final Solar Final Roof Final Stucco / Siding Insulation Final Final Utility Building Final Door Final Window Final Screen.Room Final. Pool Screen Enclosure Mobile Home Building Final Pre -Demo Final Demo Final Single Family Residence Final. Building (Other) Address: Min Max. Ins ection Description Electric, Underground Footer / Slab Steel Bond Electric Rough T.U.G. Pre -Power Final Electric Final ..: Min Mays �ggg gam" Dns2ection DDeseII'll2tion Plumbing Underground Plumbing Sewer Plumbing Tub Set Plumbing Final ihl YlGj�l: i471't11L. QYiE11.LLJ�PiGll`17LL.LL� }. 1 $ -' - 4 a i ,• ., Min Max.. Ins ection DDesc riRtionk ` Mechanical Rough Mechanical Final Min Max 011, l ims eetion. DDescri Lion Gas Underground =as Gas Final REVISED: June 2014 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 owner -builder permit under an exemption from the law. The exemption specifies that I, as the owner of j� 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 �� licensed 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 I year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease, which violates this exemption. I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction. 1 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 U 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 a licensed contractor who is not licensed to perform the work being- done. Any person working on 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 IQ�I 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 understand that the construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. I am of aware of construction practices and I 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 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 information that I have provided 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 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 Addre 1 � P t,n(2 I, qt ,CAL f _ )-)O-&-V-- , 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. Signature 6f Owner -Builder Date Form of Identification (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. to Rev. 9.14.2009 r r "jn4r. 0, µ y F 350 N. ALAFAYA TRAIL ORLANDO, FL. 32828 (321) 235-3600 6331 00097 12266 05/16/18 06:51 PM ORDER ID:-H61-7z99:0>2 RECALL AMOUNT 1574.00 SUBTOTAL 1,574.00 SALES TAX 102.31 TOTAL $1,676.31 XXXXXXXXXXXX5456 DEBIT USD$ 1,676.31 AUTH CODE 481872 Chip Read Verified By PIN AID A000000O042203 Debit TVR 8000048000 IAD 0310601003220000000000000000000000FF TSI 6800 ARC 00 11111111111111111111111111111111111111 6331 97 12266 05/16/2018 56-1 THE HOME DEPOT RESERVES THE RIGHT TO LIMIT / DENY RETURNS. PLEASE SEE THE RETURN POLICY SIGN IN STORES FOR DETAILS. BUY ONLINE PICK-UP IN STORE AVAILABLE NOW ON HOMEDEPOT.COM. CONVENIENT, EASY AND MOST ORDERS READY IN LESS THAN 2 HOURS! *************************************** ENTER FOR A CHANCE TO WIN A $5,000 HOME DEPOT GIFT CARD! Tell us about your store visit! Complete our short survey and enter for a chance to win at: www.homedepot.com/survey PARTICIPE EN UNA OPORTUNIDAD DE GANAR UNA TARJETA DE REGALO DE THD DE $5,000! Comparta Su Opinion! Complete la breve encuesta sobre su visita a la tienda y tenga la oportunidad de ganar en: www.homedepot.com/survey User ID: GVLR 31152 24918 Password: 18266 24821 Entries must be completed within 14 days of purchase. Entrants must be 18 or older to enter. See complete rules on website. No purchase necessary. Page 1 of 1 SPECIAL SERVICES CUSTOMER INVOICE Store 6331 ALAFAYA TRAIL Phone: (321) 235-3600 350 N ALAFAYA TRAIL Salesperson: ES144T ORLANDO, FL 32828 Reviewer: GCH2779 This is only a QUOTE for the merchandise and services printed below. This becomes an Agreement upon payment and an endorsement by a Home Depot register validation. Name Phone ®. MERCED PEREZ GILBERTO (407) 259-5187 Address 1244 WINDMILL GROVE CIR Phone Company Name city ORLANDO Job Description bonnefille windows argon State FL zip 32828 County ORANGE Page 1 of 3 No. H6331-79902 QUOTE is valid for this date:05/16/2018 We reserve the right to limit the quantities handise MERCHANDISE AND SERVICE SUMMARY sold to customers W07 SKU # 0000-515-664 Customer Pickup /Will Call S.O. MERCHANDISE TO BE PICKED UP: S/O SILVER LINE BLDG REF # S01 ESTIMATED ARRIVAL DATE: 1 PRD S s ..QT ON# E S0101 0000-243-260 3.00 EA NA / 50 SERIES BLOCK SINGLE -HUNG - 2111 B,C EQ / 50 SERIES BL C Y $233.30 $699.90 SINGLE -HUNG - 2111 B C #1 S0102 0000-243-260 1.00 EA NA / 50 SERIES BLOCK SINGLE -HUNG - 2111 B,C EQ / 50 CK A Y $176.75 $176.75 SINGLE -HUNG - 2111 B C #2 S0103 0000-243-260 1.00 EA NA / 50 SERIES BLOCK SINGLE -HUNG - 2111 B ERIES BLOCK A Y $168.86 $168.86 SINGLE HUNG - 2111 B,C #3 S0104 0000-243-260 1.00 EA NA / 50 SERIES BLOCK SINGLE-HU C EQ / 50 SERIES BLOCK A Y $168.64 $168.64 SINGLE -HUNG - 2111 B,C(#4 o S0105 0000-243-260 1.00 EAJ NA / 50 SERIES BLOCK Sl G - 2111 B,C EQ / 50 SERIES BLOCK A Y $168.64 $168.64 SINGLE -HUNG- 2111 B, S0106 0000-253-304 1.00 EAJ NA / 70 SERIE D UBLE GLIDING-8700 , ACT / 70 SERIES BUCK A Y $191.21 $191.21 DOUBLE 00 #6 SCHEDULED PICKUP DATE: Will be schedule r roal of all S/O Merchandise $1,574.00 ® WILL -CALL MERCHA UP Will -Call items in the store for 7 days only. Check your current order status online at www.homedepot.com/orderstatus III111 golag lag N�AI�II� I ,_3PECIA.L SERVICES CUSTOMER INVOICE - Continued Name: MERCED PEREZ Page 2 of 3 No. H6331-79902 TOTAL CHARGES OF ALL MERCHANDISE & SERVICES i !i ® I ® $1,574.00 Policy Id (PI): �r� � A: 90 DAYS DEFAULT POLICY; SALES TAX $102.31 TOTAL $1676.31 BALANCE DUE $1 676.31 'The Home Depot reserves the right to limit / deny returns. Please see the return policy sign in stores for details.' m 0 e n — — — . — — — — — Page 3 of 3 NO. Hb;J;J1®1WVU1 The Horne Depot Special Services . Will Call/Direct Ship/Delivery Returns: Except where prohibited by law, all returned Special Order Merchandise is subject to a fifteen percent (15%) restocking fee. Custom made goods are not returnable. Will Call: The Home Depot Store will call the number provided on the invoice when your order is available. A Will Call held at the store for over thirty (30) days shall be subject to the abandoned property laws in your state. Direct Ship: Direct Ship merchandise will be sent by the vendor and/or manufacturer to the address on the invoice. Delivery: The Home Depot shall arrange for its delivery agent to deliver the merchandise to the address identified on the invoice pursuant to the following terms and conditions: Roads Notice: The delivery address must be accessible by vehicle over roads and bridges rated to handle up to and including (40) forty ton loads. If any portion of delivery agent's route must traverse a section of road that is not rated to handle a forty ton load or heavier, Customer will be responsible for seeking a waiver, at Customer's expense, from the appropriate governmental authority. If Customer is unable to obtain a waiver, delivery service will not be available to the delivery address. Unattended Drop: If Customer will not be present to accept the delivery, and the delivery can be left unattended, please initial below: ----- ________ By initialing here, I authorize The Home Depot and its delivery agent to leave the merchandise unattended following delivery, and I accept full responsibility for any resulting loss of, or damage to, the merchandise. Outside Deliveries Only: If you are purchasing merchandise designated by The Home Depot for outside delivery only, your purchase does not include delivery of the merchandise beyond curbside; however, additional services may be available to deliver the merchandise to a location that you designate. In that event, you will be presented with the following waiver at the time of delivery, which you must sign as a condition of receiving any additional delivery services: In consideration of the delivery of the merchandise that I purchased from The Home Depot ("Merchandise") to a location designated by me at my request, I, , on behalf of myself and my agents, successors, and assigns, hereby RELEASE AND FOREVER DISCHARGE, WITHOUT CONDITIONS, Home Depot U.S.A., Inc. and its affiliates, employees, officers, directors, managers, agents, contractors and any other person working through or under it (hereinafter collectively "The Home Depot"), from any and all claims, causes of action, demands, liabilities, damages, costs and expenses, of every kind and nature, whether known or unknown, suspected or unsuspected, which exist now or in the future (hereinafter "Claims"), relating and/or arising out of the delivery of the Merchandise. I FURTHER EXPRESSLY, FULLY, AND UNCONDITIONALLY ASSUME ANY AND ALL RISKS AND FULL LIABILITY FOR ANY RESULTING PERSONAL INJURY, DAMAGE TO PROPERTY OR DAMAGE TO MERCHANDISE WHICH MAY GIVE RISE TO CLAIMS AGAINST ME AND/OR THE HOME DEPOT. I HAVE FULLY INFORMED MYSELF OF THE NATURE OF THE RISKS INHERENT IN THE DELIVERY OF THE MERCHANDISE AND VOLUNTARILY AGREE TO ALLOW DELIVERY OF THE MERCHANDISE ONTO MY PREMISES. I HAVE CAREFULLY READ AND COMPLETELY UNDERSTAND THIS RELEASE AND ASSUMPTION OF RISK FORM BEFORE SIGNING IT. This agreement shall become effective upon my signature and shall be governed by the laws of the State of Georgia. If you choose not to utilize additional delivery services beyond curbside delivery, you will not be required to sign the above waiver. Accepted by: X 05/16/2018 :Customer's Signature Date fro n �" � � RECORD COPY 6 a c li 3A� Leo WED FOR i PI ANf COMPLIANCE C ATE A PERM T ISSUED SHA L BE CONSTRUED TO BE A LICENSE TO PROCEED V lITH THE WORK AND NOT AS AUTHO RITY TO VIOLA E, CANCEL, ALTER OR SET ASIDE At IY OF THE PRO OSIONS OF THE TECHNICAL CODES, NOR SHALL ISSL ANCE OF A PERMIT PREVENT M THEREAFTER THE UILDING OFFI fAL FRO gUILDi\ REQUIR NG A CORREC ION OF ERRORS IN PLANS, 1% CONS FRUCTION OR IOLATIONS OF THIS CODE SAN gRTM�� �>N ##18-2339 398 East Dania Beach Blvd. // nA\\ 1131UILDING DROPS Suite338 A Perfect Solution in Every Drop! Dania Beach, FL 33004 . 6 954.399.8478 PH Certificate of Authorization: 29578 954.744.4738 FX contact@buildingdrops.com !M` it` 1� Of Silver Line Windows & Doors V1 Series/70 Series Single Hung Window (2907/4907) Extruded Vinyl Window w/Flange for Florida Product Approval Current Florida Building Code Method: 1— D (Engineering Evaluation) Category: Windows Sub — Category: Single Hung Product: V1 Series/70 Series Single Hung Window (290714907) Material: Vinyl Product Dimensions: Refer SWD020 for Dimensions Prepared For: Andersen Corporation 100 Fourth Bayport,00 Prepared by: Hermes F. Norero, P.E. Florida Professional Engineer # 73778 Date: 09/24/2017 Contents: Evaluation Report Pages 1— 4 Digitally signed by Hermes F. Norero, P.E. Reason: I am approving this document Date: 2017.10.27 20:52:43-04'00' F O .AO 7 141 T Hermes��!�kil�r�o� P.E. Florida No. 73778 // A\,\ BUILDING DROPS FL#: FL14911 A Perfect Solution in Every Drop! Date: 0 4/2017 Certificate of Authorization: 29578 Report Noo:: 5143 Manufacturer: Andersen Corporation Product Category: Windows Product Sub -Category: Single/Triple Hung Compliance Method: State Product Approval Method (1)(d) Product Name: V1 Series/70 Series Single Hung Window (2907/4907) Scope: This is a Product Evaluation Report issued by Hermes F. Norero, P.E. (FL # 73778) for Andersen Corporation based on Method 1d of the State of Florida Product Approval, Florida Department of Business and Professional Regulation - Florida Building Commission. Limits of Use: Hermes F. Norero, P.E. does not have nor will acquire financial interest in the company manufacturing or distributing the product or in any other entity involved in the approval process of the product named herein. This product has been evaluated for use in locations adhering to the current Florida Building Code. See Installation Instructions SWD020, signed and sealed by Hermes F. Norero, P.E. (FL # 73778) for specific use parameters. 1. This product has been evaluated and is in compliance with the current Florida Building Code, excluding the "High Velocity Hurricane Zone" (HVHZ). 2. Product anchors shall be as listed and spaced as shown on details. Anchor embedment into substrate material shall be beyond wall dressing or stucco. 3. When used in areas requiring wind borne debris protection this product complies with Chapter 16 of the current Florida Building Code and does require an impact resistant covering. 5. Site conditions that deviate from the details of drawing SWD020 require further engineering analysis by a licensed engineer or registered architect. 6. See Installation Instructions SWD020 for size and design pressure limitations. Hermes F. Norero, P.E. Florida No. 73778 Page 2 of 3 /J/24A\\ 0BUILDING P FL#: FL14911 A Perfect Solution in Every Drop! Date: 0 4/2017 Certificate of Authorization: 29578 Report Noo:: 5143 Quality Assurance Entity: The manufacturer has demonstrated compliance of products in accordance with the Florida Building Code for manufacturing under a Quality Assurance Entity through Window and Door Manufacturers Association (FBC Organization #QUA2515). Performance Standards: The product described herein has been tested per: Referenced Data: © AAMA/WDMA/CSA 101/I.S.2/A440-11 1. Product Testing performed by Architectural Testing, Inc. (FBC Organization # TST1795) Report #: ATI E5613.01-109-47 Report Date: 03/03/2015 Report #: ATI G1000.01-109-47 Report Date: 08/08/2016 Report #: ATI C7073.01-109-47 Report Date: 06/17/2013 Report #: ATI G8077.01-109-47 Report Date: 03/29/2017 Report #: ATI D2935.01-109-47 Report Date: 12/30/2013 Report #: ATI G0996.01-109-47 Report Date: 08/02/2016 Report #: ATI C4709.01-109-47 Report Date: 01/11/2013 Report #: ATI D5514.01-109-47 Report Date: 03/18/2014 2. Quality Assurance Entity Window and Door Manufacturers Association (FBC Organization #QUA2515) Installation Method: Please refer to installation instructions, SWD020, for anchor methods, selection, spacing, edge distances, embedment's and further details of installation. Design Pressure: Please refer to installation instructions, SWD020, for mull combination grouping, configurations, and corresponding design pressures. Hermes F. Norero, P.E. Florida No. 73778 Page 3 of 3