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HomeMy WebLinkAbout344 W Lake Mary Blvd 18-4140; PLUMBINGCITY O iVo 2 SA 4FORDPERMIT APPLICATION BUILDING DIVISION Application No: Documented Construction Value: $ Job Address: 39Li W. Lgkf. U a, ni AIVA Aanfonl. VL_U-1'13 Historic District: Yes No[9-'*" Parcel ID: - Zo -3o - 6Z3 -000 -0oin Residential Commercial 21" Type of Work: New Addition Alteration Repair Demo Change of Use Move Description of Work:3elecatp NWH FrorY bafhr6om in Int„ndq KraZnS}a11'hPw 19a*% FiXlurrs, incluAinQ i-oilel-, SfnrK and Faucet . TreyiAe AtA ft CAU Y1QW Su p_p ivlt'S, rO+P,WAKi riA.SptinYbQli AT%C1 a %s BPS • J' Plan- Review Contaet,-Person: 51261Q Gorne2 Title:pidm ylisFrdliyeQ si6 o Yi- Phone& 8 -8t00. 2050 Fax 321-F14-0a0I Email:PerrniiS (0A61S lz •COrb Property Owner Information Name, bou1-eyetrr JQZa LLC Phone: Street:' 3a00 nl : M i L I nj 70- "STE 'A00 Resident of property? :Ovid S. Vdieter City, State Zip:'J3pc.0. aA-o VL .3A A31 Contractor Information Name bBk Ir)c . lornP rnrrYn4 Phone: 3$t_g _ t-o O- a.ozn Street: She i Rd Fax: 321 - 4 ICI - 0 01 City, State Zip: rr L 3XI l3 State License No.:, GF,'1UJC!(R Name: Street: City, St, Zip: Bonding Company: Address: Architect/ Engineer 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 NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that maybe 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. Signature of Owner/Agent Print Owner/Agent's Name Date Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID Signature of Contractor/Agent Date bI i KJW (w Print Contractor/Agents Name , Date ///Oto/t0 SHEILAEDO: 9039BM6MYCOMMISSION # EXPIRES: July 2BandedThmNotlryPaa6= IL 1 _ . , onally 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: Total Sq Ft of Bldg: Min. Occupancy Load: Flood Zone: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: Fire Alarm Permit: Yes No WASTE WATER: BUILDING: Cy` t.Vol? BUILDING DIVISION 0 moo z 0" PERMIT APPLICATION Application No: f 8 Lf I g V Documented Construction Value: $_ ZZS-V Job Address:AUl4 Nnl. L 1[p Ockni AVd :Qrffoyr .V1_ U-1-73 Historic District: Yes No[q' Parcel ID: - 000 -.odd n Residential El Commercial [" Type of Work New Addition eration Repair Demo El Change of Use Move Description of Work lit irr4o e i&+ V q-hmny.line av,d provide alltnfW dui/om linakrial JV QCrntnoclait mvi V-aid roohn • cat suplpty /rctuYn riltg . staPaly anditAral new eXhQu Sk invf c1rie.V at laundn.1 YYVN Plan Review Contact Person: GQmeZ Title: clminis4riaA• ye- k %i6}aY4 Photte8mv -8(00- 20.50 Fax:3214JI4 - Da01 Email: IPEI &S t®o oDPk - C O m Property Owner Information Name _ou1eyciIrd ?1o,1cx LLC Phone: Street: 3 aoo N . P i 1 i i la x-y TQ L sT , 400 Resident of property? : bw i me r City, State Zip: 12)o coy : c } nkaT V L 333 311 1 Contractor Information Name VB C It'1C . l _ r rilolotir.Sp. Phone: Street:. .9S 5 Sh'P1 Rd Fax:321 -4ILA - 0Q01 City, State Zip: hQar F L 3-113 State License No.: (I AC 1815 21 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. I - - FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date. 61 Edition (2017) Florida Building Code 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. OWNERI APFIDAVIT: 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. Q 4 h 1s Signature of Owner/Agent Date Signature of Contractor/Agent Date Print Owner/Agent's Name Print Contractor/Agents Namyl Signature of Notary -State of Florida DateDate SHEILAEGOMEZ R W COMMISSION # FF 9039% YEXPIRES: July 27, 2019jf j • Bonded 71uu WW Pubk Underwram Owner/Agent is Personally Known to Me or Sol ally Known to Me or Produced ID Type of ID. Produced ID 1 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: COMMENTS: 1 PO1tU l r 1 W7-. I AiI j-Ov 2 s3 ma PERMIT APPLICATION r Application No: 1 a 9-1141 Documented Construction Value: $ W. — Job Address:_ %A W. Lal[P' U Qry A_.San+ ?, Historic District: Yea No Parcel ID: l(- 2 n -?i n - 5Z3 -000 - ool o Residential Commercial 2" Type of Work: New Addition Q AlterationEl Repair Demo Change of Use Move Description of Work: f4i new ?uixel, nl\ hnKe4af fell-li j 10 t;io A; i W&Ng- 7tl.a Viosy M,0 tt-g -jr O( kog- wall W'W 9)X Wift;Pew foA%A wifi b AS, S,111ainlny:fSlam eF Plan Review Contact Person: 5h6laGoM Title: Aam hi5imiive ,-.sn+ Phone& 6-860- 2056 Fax:321-4I- Oa0 I Email: 'Verrnifn (&"Qnhej< :Corn Property Owner Information Name 2a L. L-C. Phone: Street:. 3a00'W-;. ;Will jN TQL'STF 400 Resident of property? :bwiyle City, State Zip: 2.)Qi VL A.A y 1 I Contractor Information Name l Bk Inc / = —j Tnra ,r Phone: a$tg - Ff to O - c10,1j0 Street: 3q $ ' S ShP;1 RA Fax: 321 - L4ly - 0361 City, State Zip: _ Q.hn.r i EL `3a-i a State License No.: E C. 1 ?SO O 10 Q-1,01 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. IV FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 6`s Edition (2017) Florida Building Code NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that maybe 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. Signature of Owner/Agent Print Owner/Agent's Name Date Sign u of Contractor/Agent Print Contractor/Aeent'i Name Signature of Notary -State of Florida Date Date / I. si tJ1'EOOMLZ I<- MY COMMISSION a FF 803866 EXPIRES: July 27, 2019 ttmMea ThN ni7tary Pubfle-UneeNr Owner/Agent is Personall Known to Me ory .on, rator geq is- Personally,Known to Me or Produced ID Type of ID Produced ID Type of ID- - BELOW IS.FOlt .OFFICE USE ONLY Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type: Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: Flood Zone: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: UTILITIES: ENGINEERING: FIRE: COMMENTS: Fire Alarm Permit: Yes []No WASTE WATER: BUILDING: S N UkU pY OF SXNFORD BUILDING DIVISION1 S.t. t g11 OCT 0 3 2018 PERMIT APPLICATION Application No: I 0 --- I Y/ P Documented Construction Value: $ 3a, d oO bo Job Address: &LI W • Lake -Marl yA Sciy,6r A , L .32TI3Historic District: Yes No@ Parcel ID: J L j0-fin -523 -y000 -onto Residential Commercial Type of Work: New Addition Alteration ,J Repair Demo El Change of Use -Move i filllllhmn Description of Work: Plan Review Contact Person: Sim; (aGnrIne 7 Title: Mmi niSfm6ie KSS i5ftint Phone: 3S(o- Moo -aO,90 Fax: 3a1-J14q -oa01 Email: Ve rm i k, @AQObY.-com Property Owner Information Name3ouleyo rc.k P1 QZQ LI--C- Phone: Street: 6?AO N Mi11 Qnj I (ZL SR-_40o Resident of property?:`)(avid t . Wffn-er- City, State Zip:A j ct±9n f FL 5% ?,1 Contractor Information Street: , qg 5 - She 1 l R d Fax: A?- L - 414 - COO City, State Zipbe_ 10Q El- &1-1 13 State License No.:I5309 Architect/ Engineer Information Name: Tr\p_ Lam- %( oigo Street: SVs Mal A S f ea SX]" City, St, Zip: uAg A 1 F1 3`I b 1$ Bonding Company: Address: Phone: _ 1 -123 3- q 14 U D Fax: % a- J 3- Q S SS 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 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 1 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 regttlrt.^d 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. SignaturcofOwnerlAgent Date signature of ContractorlAgent Date Owner/Agent is — Personally Known to Me or Produced ID I. a ID s USA MARIEVEtAZOUR:iL7.'SkEZMYCOhLMISSIONNlaG006926 Print MY 00MMi5S10N # FF 9039E EXPIRES. Jury 27. 2019 9oflM Ttw Notary N* VWeW Produced ID Type of ID June 28. PubliCUndO BELOW IS FOR OFFICE USE ONLYEiandedThruNotaryPublicUndemrtete 5Y/$ Date ly Known to Me or Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type: Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: Flood Zone: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: Fire Alarm Permit: Yes []No WASTE WATER: BUILDING: — LIALake Mary Corners I Sanford, Florida 110 - 356 W. Lake Mary Boulevard Sanford, Florida 32773 1MO JO O W. LAKE MARY BOULEVARD This site plan is anacnea for nlprmational purposes Only and is not a warranty, representation or agreement that the Shopping Center o lne parting areas. roadways. access points, s10ewDlks, pudoings or Ome- imp—mehls wlil no as Shown hereon, or that :.'le occupants snows hereon 111 be in the Shooting Center J. W. LAKE MARY BOULEVARD 110-120 130 140 150.160 170-18D 190 200 Wing Stop T Mobile Tile S Carpet Casa Lupda Restaurant China Wok Neighborhood Advance Tax Dentistry 2.000 1.000 1.000 1.500 2.000 1000 1,000 210 Distinctive Available 1.005 220 Parva Colombian Bake 7SO 230 The Nadx Spa 1.500 250 E-Posi 260 Available 252.282 Available 292 HairMastero 300 LA Fitness 308 Fresh Piocuce and Fruits 314 Learning City 750 900 3.348 1.750 34.200 15.580 7,594 318 Japanese Steakhouse 3,567 322 Advanced Nutrition 618 332 Papa John's 1'400 342 Available 1,00S 344 348 352 356 Injury Health Center Express Professional Staffing State Farm Insurance Trustco Bank 1.021 000 1121 1.720 TOTAL SOUARE FEET: 88.329 DBKJL CONSTRUCTION & SERVICE SOLUTIONS Exclusions, Exceptions and Special Conditions: 1) Permitting as required shall be paid at actual cost plus $100 per permit. To be paid by owner via a change order at actual cost. 2) Any engineering or professional services beyond typical product engineering that if required, owner will be charged actual cost of engineering, any contractor incurred general conditions costs, and if applicable mobilization/demobilization costs plus 20% for profit and overhead. 3) Any customer specifications for materials may warrant a change order. 4) All pricing only valid If above scope is accepted by the local municipality. 5) Any items not specifically mentioned or called out with the context of this scope of work, including but not limited to concealed damage components relating to items being addressed, any finish work unless specified, work required beyond this scope of work to satisfy any person(s) including and not limited to any municipality or governing agency. Any additional work will be addressed via a change order as required or desired. 6) If any environmental hazards are found unless specifically covered in the above scopes of work such as but not limited to the presence of mold, asbestos or lead, a change order will be issued for additional work required to cover these items. 7) If any significant delays due to extreme weather conditions, customer directed delays or any municipal or governing delays out the control of DBK, Inc. an additional management and overhead change order will be submitted for approval to allow work to proceed. Note: The price quoted in this proposal is for the scope of work described above and is valid for 30 days from date of proposal. Any modifications to this proposal of any kind may warrant a price alteration. After 30 days, DBK, Inc. reserves the right to re -negotiate any and all aspects of this proposal. On acceptance of this proposal, a 50% deposit is required before work can begin. All list work listed on page 1 will be completed in a substantial and workman like manner. Any alterations or deviation from the plans and specifications will be executed only upon written orders for same. All agreements must be In writing via another contract or change order. Owner is to carry fire, tornado, and other "acts of God" insurance. DBK, Inc. agrees to abide by all Federal and State Workmen's Compensation laws and maintain General Liability Insurance. Respectfully submitted DBK, Inc. By: Yr V`i/ 1 Title: ACCEPTANCE: By signing below, sending an email response indicating approval or acceptance, and/or agreeing or indicating acceptance of this proposal in any way, you are testifying that you are authorized to accept and approve this proposal on behalf of the organization and/or person it is directed 'TO" under "CUSTOMER" and/or you are legally acting on the owner's behalf and accept full responsibility on his or her behalf of accepting this proposal. By doing so, you are hereby authorizing DBK, Inc. to furnish all material, equipment and labor unless (unless otherwise specifically specified above) required to complete the work described in the above proposal for which the undersigned agrees to pay the amount stated in said proposal and according to the terms thereof if payment terms are not stated above or stated signed contract, the undersigned agrees to pay all invoices submitted to the "CUSTOMER" In any way, by the CONTRACTOR", without retention, and within 30 calendar days from date of submittal by the "CONTRACTOR". Any invoices not paid in full within 30 calendar days from submittal to the "CUSTOMER" or their representative(s) shall be charged a penalty of 1% of the total contract amount per 10 calendar days from due date. "CUSTOMER" also agrees to pay any and all legal and other fees necessary to collect unp Id bills and/or past due balances as defined above. l Company Name: u4k kl Date: t. l Customer Representative Narr(e: / 111MEM v ( printed) Customer Representative Name( 11 I-L LA4 Y1 I KI ( 8 12 & (signature) Revision Response to Comments City of Sanford Building & Fire Prevention Division Ph: 407.688.5150 Fax: 407.688.5152 Email: building@sanfordfl.gov Permit # 6 q 19 7 Submittal Date Project Address: Contact: nK-C-L ca_ Q1 Email: (Vdev\As Trades encompassed in revision: Building 0 Plumbing Electrical Mechanical Life Safety Waste Water Fax: General description of revision: ROUTING INFORMATION Department Approvals Utilities Waste Water Planning Engineering Fire Prevention 0 Building r SFORDOCT 0 3 20i8XR PERMIT APPLICATION BUILDING DIVISION(' J / Application No: L kDocumentedConstructionValue: $ 310 Ob C° Job Address: Sqq W • LQ1Q_ KAQ r aVa An4or A , k .32T13Historic District: Yes No@-' Parcel 1D: - 26 -30 -5221 - 0000 - On10 Residential Commercial Type of Work: New Addition Alteration ,J Repair Demo Change of Use Move Description of Work: DI - D C Plan Review Contact Person: )rrV1P7 Title: F'Ctmini fY(,nVel tS5iSfont Phone: 3%(o K(v0- 20,90 Fax: Z5a 1-,444 - 090 1 Email; Ff Irm i'%S @ QOOIitC. rc rn Property Owner Information Name %cu 1eyA rcLJ azcl LLC_ Phone: Street: &= N Mi t 1lnw 1 (ZL SR. Ova Resident of property? : ayA Wf Q aeCity, State Zip:&2kc rc (Sct-bn 0 FL 5 ?,1 Contractor Information Name 1Z31G inC /Ibav 41o1omf t1 6maSO Phone: $(n- $'(ou- ao60 Street:, SW g - She 11 R cl Fax: a2 l - 41 t-4 -COO City, State Zipbe_ b otjc j; K 1 _ State License No.: _ G Go' 1.r)U _CS3 Oq Architect/Engineer Information Name: 2 l,un2 G ( ol,t_t0 Street: Sys Main S f eel R1titn}-e= D_ City, St, Zip: Bonding Company: Address: Phone: / I ' 13 3 - C1'-1 U 0 Fax: a- 33- gsss- 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'h Edition (2017) Florida Building Code NOTICE: In addition to the requirements of this permit. there maybe additional restrictions applicable to this property that maybe 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 1 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. Io g yl r SignaturY of clwner/Agent Date Signature of Contractor/Agent Date Owner/Agent is Personally Known to Me or Produced ID T Pe ID USA MANE VELAZQUEZ P' 4 MY COMMISSION # GG 0069M Mriko l o wv-.> t f oso Print C nlraclorlA its Na Due slllauEco WCOMMISSION#FF rK.;tji EXPIRES: July 21, 2019 JlfhEC+ BonGdilwWls7HAkUrdcmlrn ct to ersonally Known to Me or Produced ID Type of ID EXPIRES: June28,2020 BELOW IS FOR OFFICE USE ONLYBondedThntNotaryPublicUndemrilets Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type Occupancy Use: Total Sq Ft of Bldg. Min. Occupancy Load: Flood Zone: of Stories: New Construction: Electric - # of Amps . Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: Fire Alarm Permit: Yes No 400/0' y WASTEWATER: BUILDING: clrof w SXRUORD OCT 0 3 2018 PERMIT APPLICATION 3: BUILDING DIVISION Application No: Documented Construction Value: $ 31 d O b Job Address: ')l.}Uj n1;Lnse KAo rg aya otrj6r . t ,32"1"13Historic District: Yes No@/ ParcelID I-?0-0 -52 - uoo0 -Ot110 Type of Work: New Addition Alteration ,J Repair El Description of Work: Residential Commercial lJ Demo Change of Use Plan Review Contact Person: tShei In nm 7 Tide: M iniSft'Cj%I e Ahs Phone: 3Vo - MO- 210h)b Fax: _3a 1- y4q - oao I Email: R rmiiS @ AoDBK.com Property Owner Information Name 6oLj ke_ /0 rCj I? j az4 LLC- Phone: Street: b2clo N M i Ua I M _ - ,zigo Resident of property?: ;)QyiA J . WE e rick - City, State Zip:. Sct ion , EL 5 ?,I Contractor Information Name MY, in(-- &Ck g516mfLO6rY)MSO Phone: $to- $(Du- a060 Street:,- iQIS 5, Shell R A Fax: _a2 L - L41 to - COO City, State Zip-De10Qom; E 1 _ bp-113 State License No.: C. G(1.cjt) A09 Architect/ Engineer Information Name: T\2 l,-%tfl2 ( ou_to Phone: Street: S bS"Amn S fe 1-IL D ` Fax: -) ? - 33 - q s ss City, St, Zip: %A-e%n I FI 2 9b `l K 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. 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: 61h Edition (2017) Florida Building Code NOTICE.: In addition tothe requirements of this permit. there maybe additional restrictions applicable to this property that maybe 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 1 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' SIpFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be done in coitioince with all applicable laws regulating construction and zoning. J IOti) b Signature of Owncr/Agent Date Owner/ Agent is Personally Known to Me or Produced ID I rF 7lw a QUEZ e ID IJSAMARIEVELAnMY coMMISSION A G Ir Signature of Contractor/Agent Date pu, t'.ololy. 't7dr nDlO Print Contractor/Acuu's NaniO W COMMISSION 1 FF 9= EXPIRES: July 27.2019 Bonded fluu Mim RAk Urdem Produced ID Type of ID EXPIRES: June28.2020 BELOW IS FOR OFFICE USE ONLY BondedThruNotaryPublicUndemrilersR! t Py/ r Daie Known to Me or Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type: Occupancy Use: Total Sq Ft of Bldg. Min. Occupancy Load: Flood Zone: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes []No # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: Fire Alarm Permit: Yes No WASTE WATER: j BUILDING: a y la CITY OF OCT 0 3 2018SANFO$ PERMIT APPLICATION BUILDING DIVISION g . j (A/ Application No: ` Documented Construction Value: $ 31 b Ob Cc Job Address: ZI1..4LL QsP_ &AQ rlb1VA w6r . L ,32T13Historic District: Yes[] No@-' ParcelID: 1 1-?0-317 -523 - 000O -OnJ0 Type of Work: New Addition Alteration ;L--I Repair Description of Work: Residential Commercial Demo Change of Use Move Plan Review Contact Person: 3bd Q C Arlan 7 Title: Aa wini3irn6j - A 5i-5fw+ Phone: 3%(o- Moo- 2,O,90 Fax: 3;)1-J4fq -Oaol Email:P.rrniJ5 @QODBK.Corir Property Owner Information Name SouleyyrC hJ a74 LLC- Phone: Street: 6200 N Mi l4ayil I i2L_ 5R. 4X0 Resident of property? Quid 3. Wf e n-e City, State Zip:rc (moll f EL b?11 Contractor Information Name DBK Tine Likka6lomfto6vrraso Phone: 2)86- SLpo- a060 Street: 3Qfs S - Shell RA Fax: 99- i - 41 to - COO City, State ZipbCba t 1 _ Sad 13 State License No.: _ L G0, 1;55-309 Architect/Engineer Information Name: 'T" n2 G ( out0 Street: SSS" MW A tee , City, St, Zip: t/ AtjI %n I Bonding Company. Address: Phone: _) 3 3 - q 14 n 0 Fax:-) 33- RSSS 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 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, slate agencies, or federal agencies. Acceptance of permit is verifrcatiott 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 Um 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. SignatureofOwner/Agent Date Signature ofContractar/Agent Date Owner/Agent is Personally Known to Me or Produced ID I' a ID USAMARIE VELAZOUEZ MY COMMISSION R GG 0069n a•rf4.o l o NVIC.D rt9f l;"Vt10so Print(' ntractor/A ti s Na Date rry BHl]IAEGOM MY CQMOS10N # FF EXPIRES: July 27.2019 A'r'h¢ 8onded1buIttayRAScUedewbrt CEO-r1AgCIIL IS rergolially Known to Me or Produced ID Type of ID r = EXPIRES: June28.2020 BELOW IS FOR OFFICE USE ONLYBondedTlwNotaryPublieUndarnrilers Permits Required: Building Electrical [Mechanical Plumbing Gas Roof Construction Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: Flood Zone: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: UTILITIES: ENGINEERING: COMMENTS: Fire Alarm Permit: Yes No WASTE WATER: FIRE / l BUILDING: DATE: _ / 01 /,q, BUSINESS/PROJECT NAME:: ADDRESS: 7 / Gt/. Zqh, /4, CONTACT NAME: CITY OF SANFORD BUILDING AND FIRE PREVENTION DIVISION FIRE PLAN REVIEW SERVICE FEES PHONE: 407.688.5052 FAX: 407.688.5051 PERMIT NUMBER: PHONE: PLAN REVIEW INFORMATION IZCONSTRUICTION [ ]C/O [ ] FIRE ALARM [ ] FIRE SPRINKLER []HOOD [ ]PAINT BOOTH [ ]TANK DOES 20% REDUCTION IN FIRE IMPACT FEES APPLY: YES NO TOTAL FEES: 71^ffo P1z SXR.UORD OCT 0 3 2018 PERMIT APPLICATION BUILDING DIVISION Application No: Documented Construction Value: $ 31 b Ob c Job Address: ?)llurinl • LC]l(e KJIa rq IVa a l6r . L .32T13Historic District: Yes No@ Parcel ID: Type of Work: New Addition Alteration ,J Repair Description of Work: Residential Commercial Demo Change of Use Move a - Plan Review Contact Person: 3bdIQ G nry1 7 Title: MmMintrAye Ats iSfCtnt Phone:3%(n-fC(n0-010,50 Fax: 3a1-y44 -0901 Email:Fermii-, @aoUBK•corn Property Owner Information Name 6otule_yct cd ill az4 LLC- Phone: Street: _&w N Mi i I QYL II? _ EL- 400 Resident of property?: `J yA r Wi Q ne City, State Zip:ZCXx, &tAgh , FL 5?!1 -,%1 Contractor Information Name JBK inC /hQA616MfA-JY0TrL)W Phone: 3$(p- RLyo- ao60 Street: 3Qcs S - Shell RA Fax: _rP2 l -141 L4 - W6 1 City, State Zipb_ bn n. , K 1 _ State License No.: C C t 15b 3Qq Architect/Engineer Information Name: U%AA-L ! ou-P Street: _S s Main S feet Slit f f . D City, St, Zip: %At%A I Bonding Company: Address: Phone:) a1 -133 - qq Un Fax ^/ c,D- ?S3- gSss 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 permlt must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and air conditioners, etc. N FBC tO5.3 Shall be inscribed with the date of application and the code in effect as of that date: 6'h Edition (2017) Florida Building Code NVOTICF.: In addition to the requirements of this permit. there maybe additional restrictions applicable to this property that maybe 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 1 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. Signalurc of Owner/Agent Date Owner/Agent is P_rseonallyKnowntoMeor Produced ID 1' a ID USAMAWEVElAZOUEZ MY COMMISSION # GG 006926 yl s Signature of Contractor/Agent Date p cc +A%o l i) NNA..) EI d 10 Print CrintractorlAecal s Nanf% MY COMMISSION I FF 9039E EXPIRES: Jury 27.2019 9ondsd 7A,u Notay Pubse undenn Produced ID Type of ID E*IRES:June 28,2020 BELOW IS FOR OFFICE USE ONLYBandedThruNotarypublicUndemrteray/ r Date Ily Known to Me or Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type: Occupancy Use: Total Sq Ft of Bldg. Min. Occupancy Load: Flood Zone: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: /o_ /;" . 1011 UTILITIES: ENGINEERING: FIRE: Fire Alarm Permit: Yes No WASTE WATER: BUILDING: COMMENTS: / r oft with lt-A-r IHfc*:'or 6a3A(-0-t oi- f-Ae 9/24/2018 SCPA Parcel View: 11-20-30-523-0000-0010 Property_Record Card P R Parcel: 11-20-30-523.0000-0010 ra.wauoaxrv,rt a Property Address: 318 W LAKE MARY 308 B 314 BLVD SANFORD. FL 32773 rParcel Information ^- -— Value Summa Parcel 111-20-30-523-0000-0010 - 2018 Working 2017 Certified Owner(s) BOULEVARD PLAZA LLC J —' Values Values Property Address 318 W LAKE MARY 308 & 314 BLVD SANFORD, FL 32773 Vluation Method Income Income Naumber of Buildings 5 5 Mailing 3200 N MILITARY TRL STE 400 BOCA RATON, FL 33431-6310 Subdivision Name BOULEVARD PLAZA SUBDIVI.$10 - Depreciated Bldg Value Depreciated EXFT Value Tax District S4-SANFORD- 17-92 REDVDST Land Value (Market) DOR Use Code 16-RETAIL CENTER -ANCHORED - -- `- Land Value Ag Exemptions Just/ MarkotValue$4.515,389 $4.469.405 Portability Adj Save Our Homes Adi $0 $0 Amendment 1 Ad/ $0 $0 P& G Adj $0 $0 Assessed Value $4.515,389 $4.469.405 Tax Amount without SOH: $85,104.00 2017 Tax Bill Amount $85,104.00 1. r4,, J >' Tax Estimator Save Our Homes Savings: $0.00 1 ((( J . t TRIM Notice 1J=eJpDoes NOT INCLUDE Non Ad Valorem Assessments Legal Description - - - - -- - . - - -- - - - - - -- - - - _ ,-- -- -- . - •----- LOT 1 BOULEVARD PLAZA SUBDIVISION REPLAT PB 81 PGS 62-65 Taxed - - - Taxing Authority Assessment Value I Exempt Values Taxable Value County Generel Fund $4.515.389 $0 3 Schools $4.515.389 $0 City Sanford $4,515.389 SO SJWM( Sainl Johns Water Management) $4.515,389 $0 County Bonds $4.515,389 $0 Sales"- . - _ .- __! - •- - -- -- ------ - ----- ---, - --- _- T-- , --, - -- . --- _ ; -_--- --- iDescription — Gate - - p I Book Page T Amount Qualified p ard7" r:11-k Land Methods _ r---- F j SQUARE FEET Building Information No Sales Vea/ Imp 4. 515.389 4, 515,389 4. 515.389 4. 515.389 4. 515,389 attage R_ Deplh --- rUnits Units Price - Land Value !I 0. 00 0.00 478076 $6.17 $2,954.510 Year Built qDescriptionStories Total SF Ext Wall AdJ Value Rapt Value Appendages Actual/Effective j 1 MASONRY 2000 1 57.712 FACE BLOCK - MASONRY $2,624.071 $3.342.765 i Description . • Area I http:// parceldetai1.scpaf1.org/ParcelDetailInfo.aspx?PID=11203052300000010 1/2 http://parceldetai1.scpaf1.org/ParcelDetailInfo.aspx?PID=11203052300000010 1/2 REVISION1 o-31-18RevisionCityofSanford Response o Comments ` Building & Fire Prevention Division Ph: 407.688.5150 Fax: 407.688.5152 Email: building@sanfordfl.gov Permit # it — l Submittal Date l Project Address: Y Y:- J- U1J Contact: ill.. SOON I-_ 1- Trades encompassed in revision: P" Building IZ Plumbing f Electrical Mechanical Life Safety Waste Water Department Utilities Waste Water Planning Engineering Fire Prevention Building Fax: CD 4 w eva ao General description of revision: C0 0-/ or ROUTING INFORMATION Approvals h Q b 9/24/2018 Detail by Entity Name DIVISION Or CORPORATIONS 9 1:;1r)!i r/f Y ti !J org o r«r r:ili,rrtf ';r«r rr/ 1•lnrrd l :::•1, Ir.. Department of State / Division of Corporations / Search Records / De all By 2QOffl ent Number / Detail by Entity Name Florida Limited Liability Company BOULEVARD PLAZA LLC Ong Information Document Number L16000075091 FEI/EIN Number 36-4836289 Date Filed 04/15/2016 State FL Status ACTIVE Principal Address 3200 N. MILITARY TRAIL 4TH FLOOR BOCA RATON, FL 33431 Changed: 07/12/2017 Mailing Address 3200 N. MILITARY TRAIL 4TH FLOOR BOCA RATON, FL 33431 Changed: 07/12/2017 gistered Agent Name 8, Address WIENER, DAVID J 3200 N. MILITARY TRAIL 4TH FLOOR BOCA RATON, FL 33431 Address Changed: 06/23/2017 Authorized Person(rz) Detail Name & Address Title President Stiller, Duane J 3200 N. MILITARY TRAIL 4TH FLOOR BOCA RATON, FL 33431 I Title VP. Secretarv. Treasurer http://search.sunbiz.org/Inquiry/corporationsearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder=BOULEVAR... 1 /2 9/24/2018 Detail by Entity Name Tyriver, Soraya 3200 N. MILITARY TRAIL 4TH FLOOR BOCA RATON, FL 33431 Title VP Morell, Jorge 3200 N. MILITARY TRAIL 4TH FLOOR BOCA RATON, FL 33431 Annual ReRorts Report Year Filed Date 2017 04/17/2017 2018 03/05/2018 Document Imagel 03/05/2018 — ANNUAL REPORT 04117/2017 — ANNUAL REPORT 04/1512016_— Florida Limited bahildy, View Image in POF format View image in PDF format View image in PDF format http://search.sunbiz.org/Inquiry/corporationsearch/SearchResultDetail7inquirytype=EntityName&direcUonType=1 nitial&searchNameOrder-BOULEVAR... 2/2 COUNTY OF SEMINOLE KIN 0 5 2018 IMPACT FEE STATEMENT STATEMENT NUMBER: 18100008 DATE: November 05, 2018 F BUILDING APPLICATION #: 18-10000885 BUILDING PERMIT NUMBER: 18-10000885 UNIT ADDRESS: LAKE MARY BLVD W 344 11-20-30-518-0000-0030 TRAFFIC ZONE:022 JURISDICTION: SEC: TWP: RNG: SUF: PARCEL: SUBDIVISION: TRACT: PLAT BOOK: PLAT BOOK PAGE: BLOCK: LOT: OWNER NAME: ADDRESS: APPLICANT NAME: BOULEVARD PLAZA LLC ADDRESS: 3200 N MILITARY TRL STE 400 BOCA RATON FL 33431 LAND USE: MEDICAL OFFICE TYPE USE: WORK DESCRIPTION: CITY-SANFORD SPECIAL NOTES: 344 W LAKE MARY BLVD / INJURY HEALTH CENTER / RETAIL TO ME/ICAL OFFICE FEE BENEFIT RATE UNIT CALC UNIT TOTAL DUE TYPE DIST SCHED RATE UNITS TYPE ROADS-ARTERIALS N/A 00 ROADS -COLLECTORS N/A 00 FIRE RESCUE N/A 00 LIBRARY N/A SCHOOLS N/A 00 PARKS N/A 00 LAW ENFORCE N/A 00 DRAINAGE N/A 00 00 AMOUNT DUE .00 PERSONS ARE ADVISED THAT THIS IS A STATEMENT OF FEES DUE UNDER THE SEMINOLE COUNTY ROAD, FIRE/RESCUE, LIBRARY AND/OR EDUCATIONAL ISSUANCE OF A BUILDING PERMIT. PERSONS ARE ALSO ADVISED THAT ANY RIGHTS OF THE APPLICANT, OR OWNER, TO APPEAL THE CALCULATION OF ANY OF THE ABOVE MENTIONED IMPACT FEES MUST BE EXERCISED BY FILING A WRITTEN REQUEST WITHIN 45 CALENDAR DAYS OF THE DATE ABOVE BUT NO LATER THAN CERTIFICATE OF OCCUPARY OR OCCUPANCY. THE REQUEST FOR REVIEW MUST MEET THE REQUIREMENTS OF THE COUNTY LAND DEVELOPMENT CODE. COPIES OF RULES GOVERNING APPEALS MAY BE PICKED UP, OR REQUESTED, FROM THE BUSINESS OFFICE• 1101 EAST FIRST STREET, SANFORD FL, 32771; 407-665-7356. PAYMENT SHOULD BE MADE TO: SEMINOLE COUNTY OR CITY OF SANFORD BUILDING DEPARTMENT 1101 EAST FIRST STREET SANFORD, FL 32771 PAYMENT SHOULD BE BY CHECK OR MONEY ORDER, AND SHOULD REFERENCE THE COUNTY BUILDING PERMIT NUMBER AT THE TOP LEFT OF THIS STATEMENT. THIS STATEMENT IS NO LONGER VALID IF A BUILDING PERMIT IS NOT ISSUED WITHIN 60 CALENDAR DAYS FROM THE DATE ABOVE DBKJL CONSTRUCTION & SERVICE SOLUTIONS B. Scope of work DBK will provide all material, labor and equipment to accommodate the below listed scope of work. Demolish existing drywall partition wall, act ceiling / grid and existing flooring. Repair and prep existing drywall at walls and open ceiling. Construct interior drywall partitions as per the represented floor plan design. Provide medical grade electrical rough wiring per code to accommodate space, including all necessary outlets, switches. Provide and install (5) pre -hung hollow core, wood doors and brushed nickel finished hardware at specified locations per plan. Include 2 'h" colonial door casing to finish at each side. Provide and install (1) pocket door at reception area location, and (I ) bam door at Dr. Office. Frame and drywall ceilings at Exam, Dr. Office, Message, Laundry and Bathroom adding (9) total recessed can light fixtures as per proposed RCP. Provide and install custom wall panels at wall spanning between Dr. Office and Laundry rm approximately 23' in length). Panels spec'd as Art 3d Wave. Finish, texture and paint drywall ceilings and walls. Colors and finish to be determined by client. Prep and paint exposed ceilings at main areas. Color and finish to be determined by client. Prep and paint all trim molding and doors with semi -gloss finish. Color to be determined by client. Prep existing floor, supply and install LVP (Luxury Vinyl Plank) throughout space excluding existing bath the flooring. LVP spec'd as Engineered Floors, L2520 Cascade, 0830 Weathered Chestnut finish. Provide and install 4" cove base throughout area to finish. Provide and install standard grade base cabinetry with level I granite tops at (2) separate locations Message and Exam rooms. Provide and install custom reception desk consisting of (2) base cabinets on either side of knee hole with level 1 granite top. Provide and install transaction shelf at reception window opening. Provide and install new bathroom sink and faucet with floating granite vanity top to accommodate ADA compliance. Provide and install (1) new, standard grade toilet and seat including new wax ring and Johnny bolts. Provide and install (2) wall sconce light fixtures and (1) recessed can light fixture at existing bathroom. Ceiling light fixtures at remaining open areas are spec'd as Modem LED acrylic pendant fixtures, stainless wave, lamp bar. Quantity based on (8) fixtures as depicted on proposed RCP. Provide and install (3) additional specialty track light fixtures as depicted on proposed RCP. Fixtures are spec'd as 4', suspended track lighting with directional heads and black finish. Goy+f-ar- ?c % ce' t 2alo00.M DB YJ' A CONSTRUCTION & SERVICE SOLUTIONS August 29, 2018 Injury Health Center 356 W Lake Mary Blvd. Lake Mary, FL 32773 Tenant Interior Fit Out Contact: Amy Ross Phone: 407-398-9635 The price set forth in our proposal covers the cost to execute and supervise the interior renovations requested for the new Injury Health Center location as described below. Architectural plans, engineering and permitting are included within this proposal. A. General Owner responsibilities Provide Parking spaces for workers Provide Space for Dumpster, Storage Container and Port-o-lets DBK Responsibilities Provide necessary daily supervision and coordination with project management daily report to owner agent. Provide Dumpster, Storage Container, Port-o-lets and any necessary equipment. Architectural / Engineered drawings included. Permit ices included. s Grant Vtaloyy, Clerk Of The Circuit Court & Comptroller Seminole County, FLInst #2018131531 Book:9251 Page:1550-1551; (2 PAGES) RCD: 11 /19/2018 02:12:1 REC FEE $18.50 CERTIFIED COPY GRANT IVIALOY CLERIC OF THE CIRCUIT COURT AND COMPTROLLER SEMINOLE COUNT`; FLORUDA ; '4 This Instrument Prepared Ely- , BY 3 :n - DEPUTY CLERK Name David J. Wiener. PA L Date Address: 33200 N. Military Trail. r• Floor (i a Q ' JO ' a1J _ iJ p G0 - C, 01r 0BocaNOV 19 2010, Permit N _ 1 f5— 41 `1 D Folio III NOTICE OF COMMENCEMENT For Work Performed By or For Tenant) The undersigned hereby gives notice that improvements 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 Legal Description of Property: A leasenold interest in a portion of the Rea Property more partiarlady described on Exhibit W annexed here% Street Address if available: ( pc1, E-e3 2. General descripbon of improvements: oonstructionbnstallation of improvements to leased premises consisting of the following: 3. Owner information: R a. Name and address of Tenant): b. Interest in property. LEASEHOLD C,. 0ocht t f S NOTE: In accordance with Section 713.10(3) of the Florida Statutes the undersigned does hereby certify that the following is a true and correct copy of the provision of the Lease prohibiting liaiblity for improvements made by the Lessee: Pursuant to the provisions of Section 713.10, Florida Statutes, notice Is hereby given that under no circumstances shall the Interest of Landlord In the Leased Premiess or Shopping Center be subject to any mechanic's, laborers or matertalman's lien or any other lien or charge on account of or arising from any contractg or obligations of Tenant and all such parties must look exclusively to Tenant to obtain payment for same. c. Name and address of FEE SIMPLE title holder. Boulevard Plaza L.L.C. 3200 N. Military Trail. 43, Floor, Boca Raton, FL 33431 4. Contractor. a. Name and address: IDU r J (1C - _ b. Phone number,! jL '; 6 0 , C S D c. Fax number: '511 4 r 4 i?l r 1.. (optional, if service by fax is acceptable) 5. Surety- 1 ? A. a. Name and address: /` /..._.__._ b. Phone number. _.... _. c. Amount of bond $ 6 Lender. a. Name and address: ILI/ b. Phone number: 7 Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statute — a. Name and address: b. Phone number: 8. In addition to the above named, the Owner designates the following persons to receive a copy of the Lienors Notice as provided in Section 713 13(1)(b), Florida Statutes (a) _. „ ; and (b) David J. Wiener, PA, 3200 N. Military Trail, 41P Floor. Boca Raton, FL 33431. 9. Expiration date of notice of commencement , 20 __ Expiration date is 11 J year from the date of recordng unless otherwise specified above). WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE ExPIRAT'ON OF THE NOTICE OF CONWENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713. PART 1, SECTION 713.13. FLORIDA STATUTES. AND CAN RESULT W 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 DOCUMENT RECEIVED WITH BLACKED OUT AREAQ Book 9251 Pagge 1551 Instrument# 2Q18131531 Name: _ STATE OF FLORIDA Title. COUNTY OF The foregoing instrument was sworn to and subscribed before me this JA day of N o. 20 19,by-MMV 9 5G of _ _ a who is personally known to me or has p as identification. SHW E. GOMEZ 1 MY COMMISSION 1 FF 9MMSEAL) ''+ Si nature of No n• 61, :i'•5:, EXPIRES: a 9 tart Public: tuy 27.20+` Print Name: "MAIJamoadrmwwyn,orc ur ... _S3 VERIFICATION PURSUANT TO SE'C Under penalties of perjury. I declare that I have read the foregoing and that the fads stated herein are true, to the best of my knowledgeandbelief. Exhibit "A" legal Description PLEASE USE ONLY ONE, OF THE TWO LEGAL DESCRIPTIONS LIS'I'ED BELOW OR YELLOW FOR THE FOUR BAY BUILDING OR ® AND TO THE PROPERTY RE.I.A•I•ING 'I'0 WIIERF: "I'Iih WORK IS BEING DONE BEFORE YOI: SIGN AND RECORD. L:ACil l.I;GAI. IS I IIGI II.IGI ITI?D AS TO WI [ICI I IT Dr•.SCRIBF.S. 4 Bay Building Folio # 11-20-30-518-0000-0030 Lot 3, Boulevard Plaza Subdivision, according to the plat thereof as recorded in Plat Book 58, Pages 47 and 48, Public Records of Seminole County, Florida. 00-CUMENT RECEIVED WITH BLACKED OUT AREAS INSPECTION SEQUENCE BP# 18-4140 ADDRESS: 344 West Lake Mary Blvd. BUILDING PERMIT Min Max Inspection Description Footer / Setback Stemwall Slab / Mono Slab Lintel / Tie Beam / Fill / Down Cell Sheathing — Walls Sheathing — Roof Roof Dry In 10 Frame Insulation Rough Firewall Screw Pattern 20 Drywall / Sheetrock Lath Inspection Building Ceiling Air Barrier Insulation Roof (Com'l) Building Ceiling Grid Final Roof Final Stucco / Siding Final Insulation Final Firewall Final Door Final Window Final Utility Building Final Screen Structure Final Pool Screen Enclosure Pre -Demo Final Demo Final Single Family Residence Final Commercial — 1000 Final Commercial — Addition / Alteration Final Commercial — Change of Use Final Building (Other) ELECTRICAL PERMIT Min Max Inspection Description Electric Underground Footer / Slab Steel Bond Electric Ceiling Rough Electric Wall Rough 10 Electric Rough Pre -Power Final Temporary Pole 1000 Electric Final tfMBING PERMIT Min Max Inspection Description 10 Rough Plumb Plumbing Underground Plumbing 2"d Rough Plumbing Tubset Plumbing Sewer Plumbing Grease Trap Rough Plumbing Steam / Chill Water Rough 1000 Plumbing Final MECHANICAL PERMIT Min Max Inspection Description 10 Mechanical Rough Mechanical Fire Damper Framing Mechanical Ceiling Rough Mechanical Fire Damper Annular Space Mechanical Insulation Wrap Mechanical Fire Damper Angle Light / Water Test Ck Welds Mechanical Grease Duct Wrap 1000 Mechanical Final REVISED: June 2014