HomeMy WebLinkAbout311 San Lanta Cir011% CITY OF
UR1
FIRE DEPARTMENT
Building & Fire Prevention Division
2018 PERMIT APPLICATION
AG "J
-- Application No:
!-3�5
Documented Construction Value: $ Sb o
Job Address: Jan C t- l � �. Historic District: Yes ❑ No [9
Parcel ID: -?(— 1 j — 3/ S_ors— 00 0 O — O V 6 d Residential Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: P-4
Plan Review Contact Person: Title:
Phone: Fax: Email:
Property Owner Information
Phone: 'a -� a 4-t
-C" 3
treet: � I �C`l�. d�-0:��-�-o` � Resident of property?
City, State Zip:O-V��i
Contractor Information
Name (1 �� Phone: �-lo� ul S—S336
Street: Fax:
'City, State Zip: Cl��, _ ��$�� State License No.:
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company: Mortgage Lender:
Address: 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: 01 Edition (2017) Florida Building Code
Revised: August 1, 2017 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.
�� � 4' ,-ac6 � 1laVik
S ignatuVe of Owner/Agent Date
Prin�L� A ent's Name
Eo�
MA ALAPAAY • r 0lIC��b . 2Q21Date
, Banded ihrouyh Naliunai Noiary hssn
Signature of Contractor/Agent Date
Pr' 'Cgntractor/Age is Name
, nAJ 5- 6Z2-/78
Signature of Notary -State of Florida Date
�l�Y AU•
Owner/Agent is Personally Known to Me or cobtMt@r
Produced ID Type of ID &I-D L I? 32611 f;' "b I � O Produced ID
ANNETTE BLAND
Notary Public - State of Florida
CnmmiSSion # GG 060623
My Comm. Expires Jan 16-20tf
Type
BELOW IS FOR OFFICE USE ONLY
to Me or
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:
Flood Zone:
# of Stories:
Plumbing - # of Fixtures
# of Heads Fire Alarm Permit: Yes ❑ No ❑
UTILITIES: WASTE WATER:
FIRE:
BUILDING:
Revised: August 1, 2017 Permit Application
SEMINOLE COUNTY MULT/%UR/SDICT/ONAL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
0,41
Seminole County, Winter Springs
Date:
I hereby name and appoint:
an agent of: cgu..j r �I
(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):
❑ All permits and applications submitted by this contractor.
Or
The specific permit and application for work located at:
3/ 1 ��t
(Street Address)
Expiration Date for This Limited Power of Attorney: -J W-'e f 20 k
License Holder Name: \�`1 � C ( 6r,,t-t,,
State License Number: cc_c_ 1 1
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF 5ecc����(e.
The foregoing instrument was acknowledged before me this day of cL
20_ T , by who is ersonally known to a or
❑ who has produced
and who did (did not) take an /oath.
&,- C l
Signature of N tary
otr+`;P CASSANDRA C GORDON
r Commission # GG 187167
(1�1 gea"M Febnm 25. 2M
1. OF FCO k"W nn&4gg Nfty sovim
as identification
Gssandra C. Gordor>
Print or type Notary name
Notary Public - State of
Commission No.
My Commission Expires:
N
THIS INST EN REP BY
Name: f YS
Address:
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number:
Parcel ID Number:
I '!lI i :Qii-f _. %l)hif''1'F;1i...Lt:f;'
�U%% -t.' 1:1
C.LERK'S T 2CII8058355
--1 �- 31-Sc-6- 0000--dcir6o
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.
DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
GENERAL DESCRIPTION OF IMPROVEMENT: e. --
/cN ER IN(F O�RMAT},ON:
Address: <�i' 1 -J U/V-,
Fee Simple Title Holder (if other than owner) Na
CONTRACTOR:
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.
In addition to himself, Owner Designates
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,)Lbave read the foregoing and that the facts stated in it are true
to the best of my knowledge and belief'.":: `
Owner's Signature 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 County of S I?iVl "AAA
The foregoing instrument was acknowledged before me this % 7 — day of 20
by � P,C4 I f h � 1� e0�j� � c Who is personally known to me ❑
NNNa�e of person making ,vnt
/
OR who has produced identification 0type of identification produced: % Lii L �I � Z 04 Z j! fi GI I
T
SEMI Q�P'�
MAGDY SALAMA
11 ota Y P is - SI®te o orida
y' r .r�:, fly , o m
;'r''` Bonded through National Notary Assn.
This agreement is made on this 4�9" day of %Yl 20 between
4-1-61 ) l lc of
Name Address City
t'lc (Contractor)
State.--- Zip Phone —
and ��s-Q"-� 1�1�`oows of
Name Address City
61 3;)m1 L(0,-) - 3;L�1_66k5 (Client)
State Zip Phone
-;m k &q. i-�\A. 6rae-
The above contractor will perform the following work as described in this agreement for $ / S020
in compensation from the
Job Description.: ,ne% 05 cr,� 'in vs.,,
4z
au -I fain Cie
Work _to commenceon d'J l �nd is estimated to be completed on !�� ' 7_d t�
Date Date
Contractor:1 , . ; Date: �``�
fSignature
� J�
Print
Client:
_ ignature �n
Print
Date: • 7I
SCPA Parcel View: 31-19-31-505-0000-0460
Page 1 of 2
http://parceldetail. scpafl.org/ParcelDetailInfo.aspx?PID=31193150500000460
5/22/2018
PERMIT # 1 2 ` 2_3�5
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: J It �� �� 6- ae
STRUCTURE TYPE: ®SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O 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): / / y &; 0o')
**PLEASE NOTE: ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED * *
ROOF VENTILATION: D OFF -RIDGE ®RIDGE OSOFFIT OPOWERED 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 FLORI/DA¢PRODUCT APPROVAL
SHINGLE
4rti C
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.) **IFAPPL/CABLE**
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#
O INSULATED
FL#
O TILE
FL#
0 OTHER:
FL#
I`
` City of Sanford Building Division
•r
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), certifyi FBC code compliance by personal inspection.
r l CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE: 'rA t 2,0