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HomeMy WebLinkAbout352 W Lake Mary Blvd 18-2036; INTERIOR BUILDOUTM CITY OFORD r Building & Fire Prevention Division PERMIT APPLICATION FIRE ()EPARTIMENT Application No: Documented Construction Value: $ Job Address: 1 c LA c 4LA .2tL( fo historic District: Yes No Parcel ID: Residential Commercial® Type of Work: New Addition Alterations Repair Demo ElChangeofUseMoveDescription of Work: t 0—y'" LA - .'A 1 _0_;I'k4 Plan Review Contact Person: O-4-1-e L Title: 1) V-) + e_ Phone: &. o3 2 0_7 5_6o 3f2. Fax: S(Q3 2.48`7 75 2 Email: C Gt- Q© C 00-.) Name Street: City, State Zip: Owner Information - / Phone: f il F Resident of property? : Contractor Information Name (`> LC,=ta(('ZE'+ t , ! .2C . Phone: 8( 2 C) Street: 1-1 L4 00 a ey- Fax: 6(,3 2 — '7 -7 9 2 City, State Zip: l l G' State License No.: Ce)C. (2(o I V55 Architect/ Engineer Information f Name: A, "26i lV e 7 ll l . Phone: 4W a i Street: q J 7 t24 L M 1'yM t% t ft- A) e --- Fax: City, St, Zip: z lti ' E-mail: f l.. t,/y IN e Bonding Company: Address: Mortgage Lender: _ M Address: i & - 1 PW I_4 0141WARNING 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 roust 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: 61b Edition (2017) Florida Building Code Revised: January I, 2018 Permit Application N Tf : 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 chnrge 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. 03MLt'S AFFIDAVIT: I certify that all of the be done In compliance with all applicable lave Print ownedAge 'sNarne SigasW o O ary ublic Sty of Florida Dzabeth A Pallet MY Camm,54Fan FF 201615 ofti Expoeu0-3120r20t9 ping information Is accurate and that all work will ug construction and zoning. 44WWWr4W& irsaodAgent Date 1cc G cL+1-cAA Contractor/ Agent's Notuti Ailm Q1 J ER Date 01- 121,T',` Notary Public - State of Florida Commission # GG WQ02 MV Comm EX01res Flab 19. 2021 fi4•' fttvdBd thfrti.rt7y '41!10MFlI NoleryAB3n. Owner/ Agent is < Personally Known to Me or ContractodAgen is _ Personally Known to Me or Produced ID Type of ID Produced ID T 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: New Construction: Electric - # of Amps, Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: Flood Zone: of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes No WASTE WATER: FI XO BUILDING:" . Revised: January t, 2018 Pertnit Application CITY OF FIRE ADEPARTMEN Documented Construction Value: $ Building & Fire Prevention Division 1w, PERMIT APPLICATION SOOJF ` C) NI, Application No: 43, 6-q3' co Job Address: ;e-l-V bl::L Z, Historic District: YesF]No F,71J&_/PfW-,0 F V_\J Parcel ID: ResidentialFICommerciallA Type of Work: New[] AdditionElAlteration Repair F—]Demo F—]Change of UseElMove ll IL Z"' tv, DescriptionofWork: Ln4c_rlor 'B Plan Review Contact Person: Akcc GO +-1-e_LJ Title:- Iti rl,--v Phone: 863 2 07 5-ro32— Fax: 2487175 2- Email: Name Street: City, State Zip: Owner Information Phone: AZ Rf - 1 2X00 le- ya) Resident of property? Contractor Information Name COLG "De"kfC1C)Prne.'r-4, Phone- 8(03 2 0 5-71-->8 1 Street: 1 -1 L4 00 -Pcu De-t- ed Fax:. 8(,,3 245- -7-7 g2 — Citv. State Zip: P&L-k- tq-t4 P_ State License No.: Q3C 1-2(,, t %55 — Arch itect/Engineer Information Name:& C&611Verd11vc1- Phone: q0Z. Street: qJ7'/'04 1,,.c-( ZAA)i2, Fax: City, St, Zip: 1'ztkel Alzatz Uz h E-mail: 1v v //v e rital Bonding Company: Address: Mortgage Lender:).'.-'t &-e-0-n Address: U, qWW L4 q I L 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: 61 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. O\MRIS AFFIDAVIT: I certify that all of the be done in compliance with all applicable la_,, . e 0_re m ore l 1 PrintQwaedAgc '.Name r signew 0 14te 0 Otiary t ublic State of Florida 4 Elizabeth A Porter My Commission FF 201615 Foff 40 Expires 03/20/2019 Oog information is accurate and that all work will ng construction and zoning. atu traetoiftent Date le-c- G o-+ -et a . ConttaetodAgent's Nome Notary Public — Slate of Florida Commission # GG 067002 My Comm. Expires Feb 19.2021 Bonded lhroup Natlonal NotaryAssn. DOC Owner/Agent is Personally Known to Me or Contractor/Agent is /i Personally Known to Me or Produced ID Type of ID Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building Electrical MechanicaL Plumbing Gas Roof E] Construction Type: Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes[] No # of beads Flood Zone: of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes No APPROVALS: ZONING: UTILITIES: WASTE WATER: ENGINEERING: COMMENTS: FIRE: BUILDING: Revised: January 1, 2018 Permit Application CITY OF S.k 4FOXNJL.p Building & Fire Prevention Division PERMIT AFFiICATjION FIRE DEPARTMENTi a Q LOA, Application No: Documenti $ 431 67 13'C)o Job Address: c. Li} gi,F V /t/pOY l Historic District: Yes NoZ Parcel ID: Residential Commercial© Type of Work: NewQ Addition AlterationRepair Demo Change of Use Move Description of Work: I pY Lk -'A U- Plan Review Contact Person: ke C GC,-.-'1 e J Title: 01/) rim` Phone: 863 2 0-7 5b32 Fax: S&3 248-1-752- Email: AA-cc -A cao Name Street: City, State Zip: Owner Information / Phone:., Ye Resident of property?: Contractor Information Name d l _Ca 'De,&1U(..DMe,#q - , c , Phone: Street: 1 `1 L4 OQ _P r , Fax: 81 3 24B -- -7 -7 5 2 City, State Zip: Votk %.lAU State License No.: C13C. 1240 l &55 Architect/ Engineer Information Name: „ A CA6 1V e 1 /V Phone: 'Q7 361 e-()l 2 Street: q a % % L M /, c% A A) ip, Fax: City, St, Zip: CL a f E-mail: fV_ t,& 4/N G Bonding Company: Address: Mortgage Lender:l- es c _ Address: 1 & z-S ( U,> pw 4 g q i 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, beaters, 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: 6t1 Edition (2017) Florida Building Code Revised: January 1, 2018 Permit Application N TI E: 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 permit `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 die 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. 03MRIS AFFIDAVIT: I certify that all of the be done in compliance with all applicable ll,-re Print QwnedAge 's Name Sigoatu ota fate o Flori o P eL o ary ublic State of Florida Elizabeth A Porter My Commission FF 201615 of nab Expuas 03/20/2019 oiyg infCrrmation is accurate and that all work will ag construction and zoning. Z. - //ZZ/ telKi ctor/Agont Date G o-+l-r r/Agent's Name Notary Public - Slate of Florida Commission # GG 081002 My Comm. Exolres Feb 19, 2021 BondO Ihr"n N3tlonal Notary Assn. We Owner/Agent is Personally Known to Me or Contractor/Agent is 7i Personally Known to Me or Produced ID Type of ID Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: BuildingEl Electrical Mechanical Plumbing0 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: t UTILITIES: WASTE WATER: ENGINEERING: FIRE: BUILDING: COMMENTS: 0 /E7 -4y ,40, (/ Revised: January 1, 2018 Permit Application DATE: Y3 0 /1 t BUSINESS/PROJECT NAME: ADDRESS:k- CONTACT NAME: CITY OF SANFORD BUILDING AND FIRE PREVENTION DIVISION FIRE PLAN REVIEW SERVICE FEES PHONE: 407.688.5052 PERMIT NUMBER: /F- zoic PHONE: FAX: 407.688.5051 PLAN REVIEW INFORMATION CONSTRUCTION []C/O [] FIRE ALARM [] FIRE SPRINKLER []HOOD [ ]PAINT BOOTH []TANK DOES 20% REDUCTION IN FIRE IMPACT FEES APPLY: YES NO TOTAL FEES: '76 LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: A w ` M 3- I hereby name and appoint: 34-p ha-n f e- Lc) , 0 sue an agent of: h L G -I)c-w ' Loorn 4 , 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: Street Address) Expiration Date for This Limited Power of Attorney: License Holder Name: A t-c C ('.cL+ 1-e(-A I rs State License Number: Signature of License H STATE OF FLORIDA COUNTY OF The foregoing ostrument was ; 204 lt> , by +A 4 * (-, to me or who has produced identification and who did (did Notary Seal) DONNA M07ER Notary Public - State of Florida Commission GG 067002 My Comm. Expires Feb 19. 2021 prdMf th aagt NBtfOna1 NQf®'yA%n Rev. 08.12) before me this a of—> who isersonally known an Signature Print or type name Notary Public - State of og ot, Commission No. cx My Commission Expires: ,~ jcf C e 1 as This Insnranent Prepared By: Name: David J. Wrener, PA Address: 3200 N Military Trail, 46, Floor Boca Raton, FL 33431 P8111148 FOGO # 11-20-30-518-0000-0030 NOTICE OF COMMENCEMENT Fee Owner) The undersigned hereby gives notice that improvements will be made to certain real property, and in accordance with Cbapter 713, Florida Statutes, the following information is provided in this Notice of CommencemaA I. Legal Description of Property: Lot 3, of Boulevard Plaza Subdivision Replat, according to die plat thereof as retarded in Plat Book 81, Pages 62 thrcugh 65, Public Records of Seminole County, Florida Street Address, if available: 352 W. Lake Mary Boulevard, Sanford, Florida 32773 2. General description of improvements: interior alterations of an existing space (Start Farm) 3. Owner information: Name and address: Boulevard Plata LLC, 2240 NW 1901 Street, Suite 801, Boca Raton, FL 33431 Interest in property: FEE SIMPLE 4. Contractor. 5. surety: Nameand address: GLG Development, lac.,17400 Poyner Road N., Polk City, FL 33868 Phone number. $63-207-5681 c. Fax number optional, if service by fax is acceptable) Name and address. Phone number- c. Amount of bond S Name and address: First Green Bank,18251 US .Highway 441, Mount Dora, Florida 21757 Phone member. ( ) 7. Persons within the State ofFionda designated by Owner upon whom notices or other doctrmcats may be saved as provided by Section 713.13(lxa)7., Florida Statues: Name and address: David J. Wiener, PA, 3200 N Military Trail, 4* Floor, Boca Raton, FL 33431 Phone number: (561) 989-2910 8. In addition to the above named, the Owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(l)(b), Florida Statutes: Lisa McCulloch, 3200 N MilitaryTrail, 44h Floor, Boca Raton, FL 33431(561) 989-2240 9. Expiratioadoe ofnotioeofoo went: 120 Expiration dam is ( I ) year from the date of recording unless otherwise specified above). WARNING TO OWNER: ANY PAYNWM MADE BY TIM OWNER AFTER TM EXMRATION OF THE NOME OF COpIrRlCT4rff f ARE CONSIDEM) IMPROPER PAYMBMS UNDER C71APtER TM PART L SECIM 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR WROVOUNTS TO YOUR PROPERTY. A N= M OF 00164 .iQtT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE 71% FIRST INSPf:CTIQN. IF YOU INTEND TO OBTAIN F1NAM1N0.00N MT WITH YOUR LENDER OR AN ATfORNEY BEFORE CONQAENCD40 WORK OR RBCORDR40 YOUKNOIWE OF COMAENCEWENT Signature of Owner' s Authorized Officer: Boulevard Plaza LTC, a Florida limited liability company By. Vice President STATE OF FL. OR DA COUNTY OF PALM BEACH The foregoing instrument was sworn to and subscribed before me this l day of JTme, 2018, by Jorge Morell, Vice President of Boulevard Plaza TLC, a Florida limited liability company, who is personally known to nee. JDANNE K WROSM SignattreofNotary Public: t.,t Y11 U rt1 MYCOWASSIONtFF22M (SEAL) PriatName: wet vfc+ f EXPIRES . Wy 1. 2019Bm4aTbmNMrPVW L%WWWMM Under penalties of perjury, I declare that I have read the foregohr& and that the facts stated herein are tree, to the best of my knowledge and belie[ Boulevard Plaza LLC, a Florida limited liability company J D,- A' 1 GRANT MALOY. CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK'S # 2018069923 h3K 9155 Pg 1251; (1pg) E-RECORDED 06/19/2018 11:40:10 AM 10.00 INSPECTION SEQUENCE BP# 18-2036 ADDRESS: 352 Lake Mary Blvd BUILDING PERMIT Min Max Inspection Description Footer / Setback Stemwall Slab / Mono Slab Lintel / Tie Beam I 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'1) 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) 1'I`IICAL 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 ORMMinMax Inspection Description Rough Plumb Plumbing Underground Plumbing 2nd Rough Plumbing Tubset Plumbing Sewer Plumbing Grease Trap Rough Plumbing Steam / Chill Water Rough Plumbing Final l It+tFAtx PIyI Jvlrc Min Max Inspection Description 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 Mechanical Final REVISED: June 2014 COUNTY OF SEMINOLE IMPACT FEE STATEMENT STATEMENT NUMBER: 18100005 DATE: June 13, 2018 BUILDING APPLICATION #: 18-1000529 BUILDING PERMIT NUMBER: 18-10800529 UNIT ADDRESS: LAKE MARY BLVD W 352 11-20-30-518-0000-0030 TRAFFIC ZONE:022 JURISDICTION: SEC: TWP: RNG: SUF: PARCEL: SUBDIVISION: TRACT:r 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: OFFICE TYPE USE: WORK DESCRIPTION: CITY-SANFORD BLVDTMPSTATESPECIALNOTES: 352RETW LAKE / CJMARY CT FARM FEE BENEFIT RATE UNIT CALL UNIT TOTAL DUE TYPEDISTSCHEDRATEUNITSTYPEROADS - ARTERIALS N/A ROADS - COLLECTORS N/A Q0 FIRE RESCUE N/A 00 LIBRARY N/A 00 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 SEMINOLECOUNTYROAD, FIRE RESCUE, LIBRARY AND/OR EDUCATIONAL ISSUANCE OF A BUILDING PERMIT. 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 ISSUEDWITHIN80CALENDARDAYSFROMTHEDATEABOVE j - IA Document A104r" - 2017 Standard Abbreviated Form of Agreement Between Owner and Contractor AGREEMENT made as of the day of in the year In words, indicate dav, month and year.) BETWEEN the Owner: Name. legal status, address and other information) Boulevard Plaza, LLC 3200 N Military Trail Boca Raton, FL 33431 Telephone Number: 561-989-2240 and the Contractor: Name, legal status, address and other information) GLG Land Development, Inc , General Corporation 17400 Poyner Road North Polk City, FL 33868 Telephone Number: 863-207-5681 for the following Project: Name, location and detailed description) State Farm Lake Mary Corners 352 W Lake Mary Blvd Interior renovation of existing space to include offices, rework ADA restroom, doors, VCT for flooring, painting of walls, servicing of AC unit, fire sprinkler adjustment, plumbing and electric upgrades per drawing and attached proposal Exhibit A The Architect: Name, legal status, address and other information) KL Engineering„ Inc. 427 Palm Crest Lane Lake Mary, FL 32746 Telephone Number: 407-361-8017 Fax Number: 407-332-7993 The Owner and Contractor agree as follows. ADDITIONS AND DELETIONS: The author of this document has added information needed for its completion. The author may also have revised the text of the original AIA standard tone. An Additions and Deletions Report that notes added information as well as revisions to the standard form text is available from the author and should be reviewed. A vertical line in the left margin of this docurent indicates where the author has added necessary information and where the author has added to or deleted from the original AIA text. This document has important "at consequences. Consultation with an attorney is encouraged with respect to Its completion or modification. nit. AIA Document A104TM - 2017 (fomterty A107- - 2007). Copyright 0 1936,1951, 1958. 1961, 1963. 1966. 1970, 1974, 1978, 1987, 1997. 2007 and 2017 by The American Institute of Architwit, AN rights reserved. WARNING: This AIA' Document is protected by U.S. Copyright Lew and International Treaties. Unauthorized reproduction or distribution of this AIA- Document, or any portion of it, may result in severe civil and criminal penalties, and will be t prosecuted to the maximum extent possible under "Is taw. This document was produced by AIA software at 10:29:10 on 06r l3/2018 under Order No. 4465596803 which expires on 08/0112018. and is not for resale. User Notes: (3B9ADA23) G j A date set forth in a notice to proceed issued by the Owner. X ] Established as follows: Insert a date ora means to determine the date of commencement of the Work.) Work to commence within 3 days of issuance of the building permit, If a date ofcommencement of the Work is not selected, then the date of commencement shall be the date of this Agreement. 2. 2 The Contract Time shall be measured from the date of commencement. 2. 3 Substantial Completion 2. 3.1 Subject to adjustments of the Contract Time as provided in the Contract Documents, the Contractor shall achieve Substantial Completion of the entire Work: Check the appropriate box and complete the necessary information.) X ] Not later than (30 ) calendar days from the date of commencement of the Work_ By the following date: 2. 3.2 Subject to adjustments of the Contract Time as provided in the Contract Documents, if portions of the Work are to be completed prior to Substantial Completion of the entire Work, the Contractor shall achieve Substantial Completion of such portions by the following dates: Portion of Work Substantial Completion pate 2. 3.3 Ifthe Contractor fails to achieve Substantial Completion as provided in this Section 2:3, liquidated damages, if any, shall be assessed as set forth in Section 3.5. ARTICLE 3 CONTRACT SUM 3, 1 The Owner shall pay the Contractor the Contract Sum in current funds for the Contractor's performance of the Contract. The Contract Sum shall be one of the following: Check the appropriate bar.) X j Stipulated Sum, in accordance with Section 3,2 below Cost of the Work plus the Contractor's Fee, in accordance with Section 3.3 below Cost of the Work plus the Contractor's Fee with a Guaranteed Maximum Price, in accordance with Section 3. 4 below lased on the selection above, complete Section 3.2, 3.3 or 3.4 below,) 3. 2 The Stipulated Sum shall be Forty three thousand five hundred ninety three dollars and zero cents (S 43, 543. 00 ), subject to additions and deductions as provided in the Contract Documents. 3. 2.1 The Stipulated Sum is based upon the following alternates, if any, which are described in the Contract Documents and are hereby accepted by the Owner: State the numbers ar other idenitfication a(aceepted alternates. if the hPddirg or proposal documents permit the Owner to accept other alternates subsequent to the execution q(this Agreement, attach a schedide oJ'such other alternates showing the amount for each and the date when that amount expires_) 3. 2.2 Unit prices, if any: Intt AIA Document A104' - 20171formaAy A107`* - 2007t. Copynght O 1936, 1951. 1958, 1961, 1963, 1900, 1970, 1974, 1978. 1987, 1997, 2007 and 2017 by The American Institute of Architects. AN rights religmed, WARNING; This AIA* U"umant is protected try U.S. Copyright Law and International Treaties_ 3 Unauthorized mprodu060n 0r distrihunon of this AIA Document, or any portion of h, may result in severe civil and criminal penalties, and will tre t prosecuted to the maximum extent possible under the law. This document was produced 0y AIA software at 10:29:10 on "/1312018 under Order N0. M85598803 which expires on 0810112018, and is not for resale. User Not": (389ADA23) Pro ect No: lake Mary Corners Project Name: Statefarm Owner: Woolbright Developmet Address: 2240 N. W. 19th Street, Bay-80-1 Boca Raton, FL 33431 Date: 04MV18 Prepared By: Alec Gatley Prepared For; Jhanson Old Footage: 0 Cost per Sft: ADIV/01 1 1 0 Paint 2,200q.to.05 Install VCT FlooN 3,950."o AC, Certification of Document's Authenticity AIAO Document D401 TM -2003 1, lames Hanson, hereby certify, to the best of my knowledge, information and belief, that I created the attached final document simultaneously with its associated Additions and Deletions Report and this certification at 10:29:10 on 00/13/2018 under Order No. 4465596803 from AIA Contract Documents software and that in preparing the attached final document I made no changes to the original text of AIA0 Document A 1041"t - 2017, Standard Abbreviated Form of Agreement Between Owner and Contractor, as published by the AIA in its software, other than those additions and deletions shown in the associated Additions and Deletions Report. nrre) looted) AIA Document D401 ra - 2003. Copyright 01992 and 2003 by The American Institute of Architects. All rights reserved. WARNING: This AIA' t?acurnant is Protected by U_8_ Copyright i.aw and tnw-ationai Trashes. Unauthorized repr0due8on or distribution of this A1AI Document, or any portion of it, may result In severe civN and criminat pananies, and will 00 prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 10.29.10 on 0011312018 under Order No. 4466596803 which expires on 0410112016, and a not for resale. User Notes: (389ADA23) CITY OF Sk 40RD PERMIT APPLICATION BUILDING DIVISION Application No: Documented Construction Value: $ Job Address: X2» Lak WuN 814a Historic District: Yes No Parcel ID: Residential Commercial, Type of Work: New Addition 9 Alteration 9RepairE1 Demo Change of Use Move Description of Work: a L?r"SOAA QCYVJ Gl1.cc e f Plan Review Contact Person: I Title: Phone:, Name Street: City, State Zip: Fax: Email: Property Owner Information Phone: Resident of property? : Per, wA lv ,,,e. oft a tc+oo t f CVGS Contractor Information Name Ay v\ D - VW f" Phone: SZ-1 - ? 7? Street: q Z .Deu lla of e"'_ Fax: City, State Zip: WI 0\0 ff— .'- ie4K.-1 .3 State License No.: 4C_ SO 4P!y 74/ Architect/ Engineer Information Name: Street: City, St, Zip: Bonding Company: Address: 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. Revised: June, 2018 Permit Application I`BC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 611 Edition (2017) Florida Building Code NOTICE: In addition to the requirements of this pert -nit, there may be additional restrictions applicable to this property that inay 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, I'S 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 o(the job at the tirne 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 localardinatice. 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 Pers9nally IKnown to Me or Produced ID Type of ID Signature of Contractor/Agent Date f Print Contractor/Agent's Name Signature of F!i F DateAtT uar Contracto gent, is, Personally Known to Me or Produced ID Type of ID 14 o BELOW IS FOR OFFICE UgE"ONLY Permits Required: Building [I Electrical El Mechanical F] PlumbingE] Gas El Roof El 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: YesF1 No n # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: Fire Alarm Permit: Yes [] No [] WASTE WATER: FIRE: BUILDING: Revised: June, 2018 Permit Application