HomeMy WebLinkAbout1101 Rinehart Rd 17-3355 (a) CHANGE TO CHECKOUTCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
e
Application No:
Documented Construction Value: $ 31,400.00
Job Address: 1 101 Rinehart Road Historic District: Yes No X
Parcel ID: Residential CommercialEl Type
of Work: New Addition Alteration Repair Demo Change of Use Move Description
of Work: Plan
Review Contact Person: Laura I ewallen Title:permit coordinator Phone:
479.f,:3:3.,q951 Fax: Property
Owner Information Name
Cnm'c RAnl FstntP Rij,;i_np-ge Tri i-t Phone: 479.273.4000 Street:
2001 SF 1 Oth Street Resident of property? : City,
State Zip: RentonvillP AR 79712 Contractor
Information I
Name
tbd ACe_ &_ _rvi e es 0 —` MC, Phone: 7J9' ,FFG _W— /DD Street: _ ` !-
i"c . kt7rl Sp1'1'x JS I fIe 5,rret/ 3f Fax: 720 0 9 City,
State Zip: <:ck i , . C%% State License No.: C_r3c Architect/
Engineer Information Name:
pb2 architecture + engineering Phone: 479 3545 Street:
2809 Aiax Avenue, Suite 100 Fax: City,
St, Zip: Rogers AR 72758 E-mail: In irn lewnilPnt7o ph2nP cnm Bonding
Company: Mortgage Lender: n/a 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: 5111 Edition (2014) Florida Building Code Revised:
June 30, 2015 Pennit Application
ETS
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; c pliance with all applicable laws regulating construction and zoning.
ign ure of Own gent Date Signature o tracto gent '. Date
4nn ,,r,ll n , , AU Vvt'x
coDY . k(%
Print Owner/Agent's Name Print Contra or/Agent's e 1
A Iki _ 71 1
signature of Notary -State of-WoFtda aq4 Date (han.He of Not
p LAN ON
HEATHER EDMISTON /^-- F1lYCOMON # F 178648 f c
WASHINGTON COUNTY / 2019fFebamod; EXPIRES:
NOTARY PUBLICwARKANSAB UriutaryPrcUnderwriters
My Cotrffjsw n Exphe Not rAw 22.2018BYfrdedsh
Comniftio o No.123r.M
Owner/ gent Personally Known to Me or Contractor/A ent is Persoiall rirown to Me or
Produce Type of ID Produced ID Type of D
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building electrical Mechanical Plumbing Gas Roof
Construction Type: o2Q Occupancy Use: /i%P.cCa,v CF Flood Zone:
Total Sq Ft of Bldg: N Min. Occupancy Load: N # of Stories: dwr,
New Construction: Electric - # of Amps 4`6 Plumbing - # of Fixtures Alyve5
Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No
APPROVALS: ZONING: UTILITIES: WASTE WATER:
sm0
ENGINEERING: FIRE: BUILDING:
COMMENTS:
r£ O
Revised: June 30, 2015 Permit Application
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: ! 1-/3
Documented Construction Value c
Job Address: f'.Gir 7 I Historic District: Yes No
Parcel ID: Residential Commercial tK
Type of Work: New Addition El Alteration ill Repair D.emo Change of Use Move u
Description of Work:
Plan Review Contact Person: Title:
Phone: Fax: Email:
Property Owner Information
Name N\ is Phone: `A(D .- S0 _
Street: R11y9hQf f Fza Resident of property?
City, State Zip: " ` ,! 30
Contractor Information
Name J DN Co 0TQC7ba Ks Phone.. c_7 ~ L c7C
Street: R 10q Nk+w6 rK t)I \S`' Fax:
City, State Zip: _P 1a I'1, 3G eA01 040 1 Lae State License No.:
t
Architect/Engineer Information
Name: /-T! C t' ed. `To u i I IU G Phone:
Street: r r } `' 1 ,% Fax: -
City, St, Zip:
Bonding Company:
Address:
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
ui 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 ]it effect as of that date: 51" Edition (2014) Florida Building Code
Revised: June 30, 2015 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 constriction 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.
u e das Ii- Signature
of Own/Agent I Date V'
lute) icy L' _ . 10Cb.-..t 6lacm--'
l »- o 1 *
6— OREPlttA K
VON BLS REN NOTARY -8YAn
MY CQMMISS
IQN UC 9XP!
29
MAY 3'1010 -1 Signature of
Contractor/Agent Date Print Contactor/
Agent's Name Signature of
Notary -State of Florida Date Owner/Agent
is Personally Known to Me or Contractor/Agent is Personally Known to Me or Produced ID
f_ Type of ID t y 1"'S Lt ce.a`L-- 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: Revised:
June
30, 2015 Permit Application
11619 Bell Fountain Road, Dawson, IL 62520
217) 670-1261 FAX (217) 670-2454
spacage@msn.corn
CONSTRUCTION AGREEMENT BETWEEN PRESTIGE CONTRACTING, INC. & JDH Contracting
Project: #44785-605 Sanford, Florida
General Contractor: Space Age Construction 11619 Bell Fountain Road, Dawson, IL 62520
Subcontractor: JDH Contracting Co 9109 Network Drive Plainfield, IN 46168
Work: 'All Electrical work nerplans and specs
Start Date: TBD
I. The Work. Subcontractor will furnish all labor, materials, tools, equipment, supplies, permits and inspections
needed to perform the work in a workmanlike and efficient manner acceptable to Owner and Prestige
Contracting, Inc., who shall be the sole judges of quality of materials and work. If materials or work are
unacceptable, Prestige Contracting, Inc. has the right to terminate subcontractor's contract and remove
subcontractor from the project, at the subcontractor's expense. Prestige Contracting, Inc. has the right to
correct defects and deduct their costs from the amount owed the subcontractor and to collect from subcontractor
any cost of correction of the defects in excess of the amount owed subcontractor. Prestige Contracting, Inc. has
the right to deduct any costs from the amount owed the subcontractor for Prestige Contracting, Inc.'s down
time due to subcontractor's unacceptable work.
2. Scope of Work. To complete all Electrical work per plans and specs. Night work included
3. Time of Start and Finish. Subcontractor will start the work TBD, 2017 and will finish the work no later than
TBD, 2017. If subcontractor fails to complete work by contract finish date, unless due to problems beyond his
control, Prestige Contracting, Inc. will charge subcontractor $250.00/day until subcontractor has completed the
work, to be deducted from subcontractor's payment. If subcontractor fails to perform work in a timely manner
during the course of the project and/or fails to complete work by contract finish date, Prestige Contracting, Inc.
has the right to terminate subcontractor's contract and remove subcontractor from the project, at the
subcontractor's expense. Prestige Contracting, Inc. has the right to deduct from amount due subcontractor
expenses accrued due to subcontractor's failure to perform work in a timely manner.
4. Contract Amount & Payment. Subcontractor will perform the work for $125,000.00 (One Hundred Twenty -
Five Thousand Dollars and no cent). Subcontractor will receive payment 30 (thirty) days after completion of
work, final inspection by project management, receipt of invoice, W9, copy of the permit, before and after
pictures of the work if applicable, shop drawings if subcontractor is doing fire protection work, and lien release
by Prestige Contracting, Inc.. Subcontractor must provide Prestige Contracting, Inc. with their labor rate
schedule. If Prestige Contracting, Inc. does not receive a copy of the permit, Prestige Contracting, Inc, has the
right to revoke the contract.
5, Tax Withholding
Payments for nonresident subcontractors working outside of their own states may be required by state and/or
local law to be withheld until nonresident subcontractor shows that state and local taxes owed by subcontractor
have been paid and/or'the subcontractor has been bonded as required by state or local statutes. Subcontractor is
responsible for all federal, state and local taxes relating to performance or completion of the work, including all
federal, state and local unemployment taxes and federal and state income and social security taxes to be
withheld from wages. Prestige Contracting, Inc. is authorized to file, on behalf of subcontractor, all reports,
returns or other documents required of subcontractor by any governmental authority which subcontractor has
failed to file. Subcontractor authorizes and empowers Prestige Contracting, Inc. to pay on behalf of
Page 1
P+enb/. hitecture
gineering
2809 Ajax Avenue Suite 100
Rogers, Arkansas 72758
Phone: 479.636.3545
DATE: November 14, 2017
TO: City of Sanford Building & Fire
Prevention
Attention: Joy Deen
300 N. Park Avenue
Sanford FL 32771
JOB #: 2017.1282.02/60.REIMB
RE: Sam's Club 4785-208 SCO
1 101 Rinehart Road
Sanford FL 32771
We are sending you the following information on the above referenced project for your use.
Please call if you have any questions.
Thank you.
COPIES
5 sets of plans
1 application
DESCRIPTION
If enclosures are not as noted, please notify us immediately.
Si d,
Laura Lewallen, permit coordinator
direct: 479.633.8951
laura.lewallen@pb2ae.com
xc File
Shipping
via: UPS Next Day Air
pb2 a+e p.o. box 2076 rogers ar 72757
a
INSPECTION SEQUENCE
BP# 17-3355
ADDRESS: 1101 Rinehart Road -
BUILDING PERMIT r. t
Min Max Ins ection 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
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 -
Final "Commercial — Addition / Alteration
Final Commercial— Change of Use
1000 Final Building (Other) self checkout
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 1 Electric Final
PLUMBING PER IT G ,
Min Max Inspection Descri tion
Rough Plumb
Plumbing Underground
Plumbing 2nd Rough
Plumbing Tubset
Plumbing Sewer
Plumbing Grease Trap Rough
Plumbing Steam / Chill Water Rough
Plumbing Final
MECHANICAL PERMIT ! _ „
Min Max Inspection Descri tion
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
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
S
I hereby name and appoint:
an agent of: VcxCf— y Y\kw S :nc -
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):
I The
kOLI—L .emu--)
Expiration Date for This Limited Power of Attorney:
License Holder Name:
State License Number:
Signature of License Holder:
C
STATE OF Ii3
COUNTY OF l
The foregoing instrument was acknowledged before me thiscX day of &)IyQ-j ,
20®L $ , by 7 1 j }(, (Qd who is personally known
to me or who has produced as
identification and who did (did not) take an oath.
sE ignature
o
Ue0c .
Q ; Print or type name COUN-
0 `Notary Public - State of C") P Commission
No. W-Q)3a-Jp)F4CQ My
Commission Expires: cA Rev.
08.12)
I-
STATE OF FLORIDA.
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395
2601 BLAIR1 STONE ROAD
TALLAHASSEE'' FL 32399-0783
STEWART JOHN DAVID
PLACE SERVICES INCORPORATED
95 HICKORY SPRINGS INDUSTRIAL DR
CANTON GA 30115
Congratulations! With this license you become one -of the nearly
one million Floridians licensed by the Department of Business and
Professionals Regulation. Our professionals and businesses range.
from architects to yacht brokers, from boxers to barbeque
restaurants,' and they keepFlo nda`s'economy strong. Every
day we work to improve the way we do business in order to
serve you better. For information about our services, please log
onto.www.myflor.1da.license.com. There you can find more informationaboutourdivisionsandtheregulationsthatimpact- you,.
subscribe to department'newsletters" and learn more about the
Department's initiatives. Our•
mission at the'Department is: License Efficiently,. Regulate Fairly.
We constantly strive,to serve you better so 1.
tha
f you can serve
your customers. Thank you for doing business in Florida, and
congratulations on your -new licenser DETACH
HERE Rwcx
grnrr r OVFRNOR JONATHAN ZACHEM, SECRETARY ISSUED:
112104/2017 DISPLAY AS REQUIRED BY LAIN SEQ # L171204NUU14
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: V?Q
ameS
I hereby name and appoint: Q
an agent of: Y\ou
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):
CThe
1 `
specifAc permit and application for work located at:
Street Address)
Expiration Date for This Limited Power of Attorney: C. 'Lo\%
License Holder Name: b ao)\n !)AtU aC A State
License Number: Signature
of License Holder: F-
C'
ifSTATE
OA COUNTY OF
C VL t o The foregoing
instrument was acknowledged before me thisdo day of &l'l , 200 (g ,
by , O S CQCK-)'4who is n--Personally known to me or
who has produced identification and who
did (did not) take an oath.- S`SEA.s
N cii4
Signature
iota, ...... m,oUP;'
I
m = Print or
type name Notary Public - State
of \'1f Commission No. V`
J- &a 1 b4 Lp My Commission Expires:
U 151 OA Rev. 08.12)
as
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (850):487-1395
2601 BLAIR STONE ROAD
TALLAHASSEE FL 32399-0783
PLACE, TROY STEVEN
PLACE SERVICES, INCORPORATED
679 EVANS COOK ROAD
CANTON GA 30115
Congratulbtions! With this license you become one of the nearly
one million Floridians licensed by the Department of Business and
Professional Regulation. Our professionals and businesses range
from architects to,.yacht brokers,.from boxers to barbeque
restaurants, and they keep Florida's. economy strong.
Everyday we work to improve the way we do business.in order
to serve you better.. For information about our services, please
log onto www.myfloridalicense.com. There you can find more
information -about our divisions and:the regulations that impact
you, subscribe to department newsletters and learn more about
the Department's initiatives.
Our mission at the Department is: License Efficiently, Regulate
Fairly. We constantly strive to serve you better so that you can
serve your customers. Thank you, fordoing business in Florida, and
congratulations on your new licensel DETACH
HERE RICK
SCOTT, GOVERNOR MATILDE MILLER, INTERIM SECRETARY ISSUED:
02109/2017 DISPLAY AS REQUIRED BY LAW SEQ # Ll 702090000501
THIS INSTRUMENT PREPARED BY:
Name:
Address:
Permit Number: /
l
Parcel ID Number:
v
l illiff Ilffl Ilfli fl l IIIII Ilidl till illl
GRANT MALOYP SEMINOLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLER
BY. 9143 Fes 530-531 QP9s)
CLERK'S t 2018061603
RECORDED 05/30/2018 03:51:42 PM
RECORDING FEES $18.50
RECORDED BY hdevore
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.
1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
5+art * H-18'S-2.Ots Iotakcct Qf 1101, f2cnekiark 2A. Sanracjk. FL 37-171
See. Ai}acheet Exh: bi F A
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Self Ghtcacowt- 2unod.&A
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: $a.rn'S —Xi-- 2001 Sr-- t Cf - St• lUenhonvi 11t , AR -72"71(.o
Interest in property: Ownec
Fee Simple Title Holder (if other
4. CONTRACTOR: Name:
Address: 95 Spd6q&-
5. SURETY (If applicable, a copy of the
6. LENDER:
Address:
listed above) Name: 14/A
Is attached): Name: O/A
Phone Number: U-1Fs- ER-0 - L4777
Amount of Bond: WA
Phone Number: 0/6
44
7. Persons within the State of Florida Designated by Owner upon whomLnotice or other documents may be served as provided by Section
713.13(1)(a)7., Florida Statutes.
Name:_ )& Phone Number: N/R
Address: 14A 8.
In addition, Owner designates A C" Hof, to
receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Stat e- 'ho' a number: N/A 9.
Expiration Date of Notice of Commencement (The expiration is 1 year from date of recording`I tiibss a different date is specified) ftlay 9. 2O19 v.
WARNING
TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION Ot-rtttE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA.SitAT*bTES, AND CAN RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST J EtCORDED 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. Signature
of owner or Lessee, or Owner's or Lessee's (Print Name and Provide Signatory's Tide/Offoe) Authorized
Offioor/Director/Partner/Manager) State
of PX.nY. -Q County of The foregoing
instrument was acnowlsdged before me this — I day of by 7 'J^-
F )l Who Is personally known to mWPR Name of person
making statement who has produced
Identification type of Identification produced: CRYSTAL UPHOFP NOTARY
PUBt.1BantonCounty, Ark®
nsasp myCommission Number 1235/030 6 Oj,E
Notat
Signature —UU
Book9143/Page530 CFN#
2018061603 Page 1 of 2
ADDENDUM TO CONSTRUCTION CONTRACT BETWEEN WALMART AND CONTRACTOR
Remodel Special Projects)
THIS ADDENDUM TO CONSTRUCTION CONTRACT BETWEEN WALMART AND CONTRACTOR
Addendum") is made and entered into as of the Effective Date and the terms and provisions hereof, along with any
exhibits or schedules attached hereto shall become a part of the Contract for all purposes.
1. Scope of Addendum; Defined Terms. Except as expressly provided in this Addendum, the
Contract shall remain in full force and effect. Should any inconsistency arise between this Addendum and the Contract
as to the specific matters which are the subject of this Addendum, the terms and conditions of this Addendum shall
control. All capitalized terms used in this Addendum and not defined herein shall have the meanings set forth in the
Contract.
2. Article 1 General Provisions
1.1 PROJECT SPECIFIC TERMS
1.1.1 EFFECTIVE DATE:
1.1.2 PROJECT:
May 23, 2018
Store # 4785
Sequence # 208
Site/Address # PQZO
Purchase Order # 34793838
Permit Purchase Order # 34793839
General Reimb. Purchase Order # 34793850
Audit Purchase Order # 34793851
SAP Project Definition # USSP-144485
1.1.3 WALMART: Wal-Mart Stores, Inc.
1.1.4 WALMART'S CONTRACT ADMINISTRATOR: Tyler Blackard
1.1.5 CONTRACTOR:
Physical Address: Realty Contracts Administration
Attention: Contracts Admin
Department: 8974
2001 SE IOt' Street
Bentonville, AR 72716-5570
Place Services, Inc.
Vendor# 1000565043
Contractor represents that it is a Corporation duly organized, validly existing and in good standing, under
the laws of the State of Georgia and that, to the extent required by applicable law, Contractor has
qualified as a foreign business eligible to conduct business in the State where the Project is located and
under the laws of all other jurisdictions where the nature of its business or the nature or location of its
assets requires such qualification.
1.1.6 CONTRACTOR'S SUPERINTENDENT(S): Daniel Gardner
1.1.7 ARCHITECT: PB2 Companies LTD.
1.1.8 CONTRACT SUM: 18,615.00
1.1.9 RETAINAGE: Ten Percent
1.1.10 DATE OF COMMENCEMENT: 6/24/2018
1.111 CONTRACT TIME: 6/29/2018
2. 1.4.15 COMMENCEMENT OF WORK AND RELATED DELIVERABLES:
The following is added as additional text to 1.1.15:
Remit by electronic form designated by Walmart to the Contract Administrator within ten (10)
business days of award of the Contract:
Subcontractor Listing
Remit by email to the Contract Administrator within ten (10) days of award of the Contract or
one (1) week after the Pre -Construction Meeting, whichever occurs first:
Performance and Payment Bonds (with County recordation stamp visible
3. 3.4 WARRANTY
3.4.1 Contractor warrants to Walmart that all materials and equipment furnished under this Contract
will be of good quality and new unless otherwise required or permitted by the Contract Documents, that the Work will be
free from any defects or deficiencies in, workmanship or materials, and that the Work will conform with the requirements
of the Contract Documents. Work not conforming to these requirements, including substitutions not properly approved
and authorized, shall be considered defective: Contractor's warranty does not cover damage or failure of materials to the
extent caused by any abuse; modification, improper "or insufficient maintenance or improper operation by Walmart. If
required by Walmart, Contractor shall furnish satisfactory evidence as"to the kind and quality of materials and equipment
to be employed in the performance of the Work. All manufactured articles, materials, and equipment shall be stored,,
applied, installed, tested connected, erected, used, cleaned and conditioned by Contractor as'directed by the manufacturer
unless otherwise specified in the Contract Documents.
3.4.2 Contractor warrants all Work to be free from defects or deficiencies in workmanship for a
period of one (1) year following the completion of all of the Work and the acceptance thereof by Walmart (the "One -Year
Warranty Period"). The Work shall not be deemed to .be completed by .Contractor andaccepted by Walmart until Contractor
is entitled to submit an invoice for the Final Payment of the Contract Sum in compliance with the provisions herein.
Contractor shall correct any defects or deficiencies in workmanship identified by Walmart and, reported to Contractor
within the One -Year Warranty Period at no cost to Walmart, and such defects or deficiencies in workmanship shall
be corrected within ten (10) days following such notification to Contractor by Walmart. Labor and materials required" to
correct such workmanship defects or deficiencies (including, without limitation, repairs and replacement materials) will be*
ee of charge during the One -Year Warranty Period. Walmart will require.the equipment manufacturer to provide replacement
parts for original equipment manufacturer parts that are defective or deficient while the Work is being performed
and for a one (1) year period after, the grand,opening date of the store on the Premises. Contractor shall obtain all
replacement parts directly from the equipment manufacturer. In the event Contractor fails to correct, such• defects or
deficiencies in workmanship to Walmart's satisfaction (which is determined in Walmart's sole discretion) within such ten
10) day period, Walmart shall have the right, without prejudice to any other right or remedy that Walmart may have under
this Contract, at law or in equity, to (x) correct the defects at Contractor's expense or (y) furnish or cause to be furnished
the necessary supplies or equipment and/or employ or cause to be employed the necessary workmen to remedy the defects
at the expense of Contractor. Contractor shall, within ten (10) days from receipt of an invoice therefor, reimburse Walmart
for any and all costs and expenses incurred in correcting such defects.
3.4.2.1 In addition to, and not in limitation of, Contractor's obligations during the One -Year Warranty
Period set forth in paragraph 3.4.2 above, during the ninety (90) day period after the "grand opening" date of the Project,
Contractor shall service all refrigeration equipment (including materials and parts) installed on the Premises, including
without limitation, refrigeration equipment installed by contractors other than Contractor (the "90-Day Warranty Period"
and collectively with the One -Year Warranty Period, the "Warranty Periods"). Contractor's obligations during the 90-
Day Warranty Period include, without limitation, all labor, parts and refrigerant within the scope of the Contract
Documents. Contractor shall obtain all replacement parts directly from the equipment manufacturer in accordance with
the provisions of paragraph 3.4.2. Contractor shall provide service on all refrigeration equipment and correct any defects
or deficiencies identified within the 90-Day Warranty Period at no cost to Walmart, and such defects or deficiencies shall
be corrected within ten (10) days following identification thereof. Labor and materials required to service the equipment
and correct such defects or deficiencies (including, without limitation, repairs and replacement materials) will be free of
charge during the 90-Day Warranty Period. In the event that Contractor fails to service the equipment or to correct such
defects or deficiencies to Walmart's satisfaction (which is determined in Walmart's sole discretion) within such ten (10)
day period, Walmart shall have the right, without prejudice to any other right or remedy that Walmart may have under this
Contract, at law or in equity, to (x) provide such service or correct the defects at Contractor's expense or (y) furnish or
cause to be furnished the necessary supplies or equipment and/or employ or cause to be employed the necessary workmen
to provide such service or remedy the defects at the expense of Contractor. Contractor shall, within ten (10) days from
receipt of an invoice therefor, reimburse Walmart for any and all costs and expenses incurred in correcting such defects or
providing such service.
3.4.2.2 In addition, Contractor shall provide the following supplemental warranty services. Contractor
shall provide warranty and service on equipment and materials installed regardless of whether that equipment or materials
was furnished to the project by Contactor. These warranty service obligations shall include failures during installation and
for ninety (90) days beyond store grand opening date. These warranty service obligations shall also include labor, parts,
and refrigerant for repairs to equipment covered under the Specifications. Walmart will require equipment manufacturer
to furnish replacement parts for failures of OEM parts during installation period and for one (1) year beyond store grand
opening date. Contractor shall be responsible for obtaining replacement parts from equipment manufacturer. Walmart will
not pay additional costs associated with repair or replacement of materials and parts during the warranty period. Additional
costs attributed to equipment failures shall be handled directly with the manufacturer. The supplemental warranty service
obligations do not alter or change, but supplement, the one (1) year warranty obligations mentioned above. Refer to
Walmart's Refrigeration Specifications, section 1.06(A).
3.4.3 As a condition to Final Payment for the Work, Contractor shall deliver to Walmart two (2)
clean, complete and readable copies of all guarantees and warranties on equipment and materials furnished by all
manufacturers and suppliers to Contractor and all Subcontractors, together with duly executed instruments properly
assigning the guarantees and warranties to Walmart, and shall also deliver to Walmart two (2) clean, complete and readable
copies of all related manufacturer's instructions, maintenance manuals, replacement lists, detailed drawings and any
technical requirements necessary to operate and maintain such equipment and materials or needed to maintain the
effectiveness of any such warranties.
3.4.4 Contractor shall provide a "Contractor's Statement of Warranty" at Final Completion. The
Contractor's Statement of Warranty" shall be on Contractor's letterhead, signed by an officer of Contractor and shall state
that: (1) the Work performed complies with paragraph 3.4.1 of this Contract, and (2) all Work, materials and equipment
furnished under this Contract shall be free from failure under ordinary usage for a period of one (1) year from the date of
Substantial Completion as defined in paragraph 5.2.2.
4. 5.2 SUBSTANTIAL COMPLETION
5.2.1 Timely completion of the Work is of the essence in this Contract and by execution of this Contract,
Contractor confirms that the Contract Time is a reasonable period for completion of the Work on the Project.
5.2.2 "Substantial Completion" of the entire Work is hereby defined as the last to occur of the following:
1) Contractor procures and delivers to Walmart all certificates, permits, approvals and consents with respect
to Contractor's Work required under applicable law for occupancy and use of the Project (except such
certificates, permits, approvals or consents that cannot be procured due to the fault of Walmart, in which
event this condition shall not apply to such extent);
2) the Work is properly and sufficiently complete in accordance with the Contract Documents to allow
Walmart to occupy and utilize the Project for its indicated purpose, subject only to minor punch list items
that would not, in Walmart's discretion, interfere with Walmart's intended operations; and
3) the Project site has been left in a thoroughly clean condition, all boxes, crates, etc. have been hauled off
of and away from the Project site at Contractor's expense, and Contractor has thoroughly washed and
cleaned all glass, replaced broken glass, cleaned hardware, removed paint stains, spots; smears, marks
and dirt from all surfaces, cleaned fixtures and washed tile floors and all exposed concrete so as to present
clean work to Walmart for acceptance.
5.2.3 Contractor shall be deemed to have achieved "Substantial Completion" of a portion of the Work which
Walmart agrees to accept separately only upon satisfaction of the requirements set forth in subparagraphs 5.2.2(2) and
5.2.2(3) above as applicable to such portion of the Work.
5.2.4 Warranties required by the Contract Documents shall not commence until the date of Substantial
Completion of all of the Work, except and only to the extent that any discrete portion of the Work is actually used or
occupied by Walmart for its indicated purpose on an.earlier date (in which case the warranties shall be deemed to have
commenced on the date of such use or occupancy with respect to that discrete portion only). The term "day" as used in
the Contract Documents shall mean calendar day unless otherwise specifically noted.
5.2.5 When Contractor considers that the Work, or a portion thereof which Walmart agrees to accept
separately, is Substantially Complete, Contractor shall so notify Walmart in writing, and Walmart and Contractor shall
perform a punch -list inspection and audit that shall consist of a per square foot assessment/measurement of the Work, and
Contractor shall prepare and submit to Walmart for Walmart's approval a comprehensive list of items to be completed or
corrected. Following receipt of Contractor's list, Walmart will conduct a review to determine whether the Work, or
designated portion thereof, is Substantially Complete. If Walmart's inspection discloses any item, whether or not included
on Contractor's list, which indicates that the Work is not Substantially Complete, Contractor shall, before Substantial
Completion shall be deemed to have been accomplished, complete or correct such item upon notification by Walmart.
Contractor shall then submit to Walmart a request for another inspection to determine whether Substantial Completion has
been accomplished. When the Work, or designated portion thereof which Walmart agrees to accept separately, is
Substantially Complete, Walmart and Contractor shall establish the date of Substantial Completion and prepare, on a form
provided or otherwise acceptable to Walmart, a punch -list of. Work remaining to be completed which shall fix the time
within which Contractor shall finish all such punch -list items. Failure to include an item on the punch -list does not alter
the responsibility of Contractor to complete all Work in accordance with the Contract Documents.
5.2.6 Subsequent to Substantial Completion of the Work and during Walmart's initial occupancy and use of
the Project, Contractor shall schedule and conduct with Walmart a complete review, demonstration and operational
shakedown of all equipment and mechanical and electrical systems installed by Contractor on the Project and shall also
review the operation and maintenance of such systems with Walmart's maintenance contractors. Subsequent to this review,
Contractor, with reasonable promptness and without increase in the Contract Sum, shall make all adjustments or corrections
and shall balance all systems in order to make all equipment and systems perform as required by the Contract Documents
and to reflect the actual use and occupancy of the Project by Walmart. If necessary or requested by Walmart, Contractor
shall require the Subcontractor responsible for any such equipment or system to participate in the review and/or to perform
the adjustments, corrections or balance required by this paragraph.
5. 5.3 FINAL COMPLETION
5.3.1 As used in the Contract Documents, "Final Completion" shall mean, and "Final Payment"
constituting payment of retainage withheld from Contractor pursuant to paragraph 1.1.13, less amounts which Walmart
is permitted to withhold pursuant to paragraph 6.3.1 or other provision of the Contract Documents) shall not be due to
Contractor until after:
1) the Work, including all Change Orders, has been fully and properly completed in accordance with the
requirements hereof, including but not limited to satisfactory operation of all equipment and systems,
completion of the final audit and punch -list inspections (including a Work evaluation form if required
by Walmart) and performance of all punch -list Work;
2) this Contract has been fully performed except for Contractor's responsibility to correct nonconforming work
as part of its warranty obligations, and to satisfy other requirements, if any, which necessarily survive
completion of all Work and payment of retainage;
3) the Final Payment Application, together with all required documentation, has been submitted to and
approved by Walmart;
4) all maintenance and operations manuals and all warranties and guarantees (and assignments thereof),
and all other closeout documents and other documentation required to be submitted to Walmart pursuant
to the Contract Documents have been submitted to Walmart, in each case in a form satisfactory to
Walmart as determined in Walmart's sole discretion;
5) issuance of all required approvals and certificates by any authorities with jurisdiction over the Project
including final and unconditional certificates of occupancy and, if applicable, a final letter of acceptance
for the fire protection system from the jurisdictional authority rating and fire prevention bureau and from
Walmart's insurance carriers);
6) delivery of as -built plans and specifications to Walmart;
7) delivery of all safety documentation required by the Contract Documents completed in a manner
satisfactory to Walmart in its sole discretion;
8) Contractor delivers to Walmart a written consent of its performance and payment bond surety to the
reduction of retainage;
9) removal of all rubbish, tools, scaffolding and surplus materials from the Project site; and
10) correction of all property damage that is the responsibility of Contractor pursuant to the Contract
Documents.
11) satisfaction of all closeout requirements set forth in Specifications Sections 01740 and 01770
5.3.2 In addition to the items specified in paragraph 5.3.1, the Work will not be considered Finally Complete,
and Final Payment shall not be due and owing and shall not be made, unless and.until Contractor submits to Walmart the
following, along with, and as part. of, its final Application for Payment: (1) a "Subcontractor Final Unconditional
Waiver," in the form attached as Exhibit 5.3.4, signed by each Subcontractor who may be entitled to a lien against
Walmart's property; (2) a "Contractor Final Unconditional Waiver signed by Contractor and in the form attached as
Exhibit 5.3.2 ; (3) an affidavit that all payrolls, bills for materials and equipment, and other. indebtedness connected with
the Work for which, Walmart or Walmart's property might be responsible or encumbered (less amounts withheld by
Walmart) have been pai& or otherwise satisfied; (4) a certificate evidencing that insurance required by the Contract
Documents to remain in force after Final Payment is currently in effect and will not be canceled or allowed to. expire until "
at least thirty (30) days' prior written notice has been given to Walmart; (5)"a written statement that Contractor knows of
no substantial reason that the insurance will not be renewable to cover the period required by the Contract Documents;
6) written consent of the Project surety or sureties, if any, to Final Payment; (7) as -built record drawings as defined by
paragraph 3.9; (8) maintenance stock;.(9) keys; (10) training/in-service on the operation of new systems and equipment;
and (11) if required by Walmart, other data establishing payment, the satisfactionof obligations and the absence or release of
liens, such as receipts, releases and waivers -of liens, claims, security interests or encumbrances arising out of this Contract,
to the extent and in such form as may be designated by Walmart. If any such lien on the Project remains unsatisfied
or arises after Final Payment is made to Contractor, Contractor shall be responsible to cause=such lien to be removed
of record as required by (and subject to the requirements and rights of Walmart as may be set forth in) paragraph 6.
2.9 below. 5.
3.3 Upon receipt of Contractor's final Application for Payment and written, notice from Contractor that the Work
is ready for final inspection and acceptance, Walmart will promptly make such inspection to determine whether the conditions
listed in this Contract as precedent to Contractor's being entitled to Final Payment have been fulfilled, and the Work
is Finally Complete as defined herein. 5.
3.4 Unless otherwise agreed by Walmart inwriting, neither the issuance of any, progress payment or certificate for
payment nor Final Payment, nor the partial occupancy nor use of a portion; of the Work shall constitute acceptance of
Work not complying with the requirements of the Contract Documents.:: Acceptance of Final Payment by Contractor and
any Subcontractor shall constitute a waiver of all claims by Contractor and such Subcontractor. 5. Modification.
Except as specifically modified by, this Amendment, the terms and conditions of
the Contract shall remain in full force and effect and nothing in this Addendum shall modify or'
alter the rights and obligations of the parties under the, Contract, except as otherwise set.` forth herein.
6. Construction
of this Addendum. The headings.of the sections and subsections of this Addendum are
inserted as a matter of convenience and for reference purposes only and in no respect define, limit
or describe the scope of this Addendum or of the intent of any section or subsection hereof.
EXHIBIT 1.1.8
Contract Documents
1. The "Specifications" are
Bid. Documents, to include, but not be limited to, plans and specifications, issued at out to bid
within Walmart's electronic bidding tool or as modified by Addenda.
2. The "Drawings" are:
Bid Documents, to include, but not be limited to, plans and specifications,'issued at out to bid
within Walmart's electronic bidding tool or as modified. by Addenda.
3- The "Addenda" are: (list addenda by name, date, author and design discipline)
N/A
4.. The following additional documentation:"
LL
a. EXHIBIT 1.1.9
SPECIAL CONDITIONS
Issued at Out to Bid or as Modified by Addendum)
EXHIBIT 1.1.14
ALTERNATES AND UNIT PRICES
Alternate # Accepted/Rejected? Description Amount ($)
One Rejected Cost of Bonds 400.00
EXHIBIT 1.1.16
MILESTONE COMPLETION DATES
Contractor shall perform the work such that the following portions of the work are completed within
the corresponding time limits set forth herein:
L
EXHIBIT 1.1.20
INSURANCE COVERAGES AND LIMITS
The coverages and limits of liability contained in Contractor's insurance policies required pursuant to paragraph 7.1 shall
of the Contract shall be not less than those specified below.
1) Commercial General Liability: combined single limit for bodily or personal injury and property damage
of not less than $1,000,000 each occurrence, $2,000,000 annual aggregate. Such insurance shall include
the following coverages: (1) premises/operations; (2) independent contractors; (3) products/completed
operations (for a period of not less than five (5) years following completion of Contractor's operations
at the Project site); (4) contractual liability, insuring all liability assumed by Contractor pursuant to this
Contract; (5) personal injury liability; (6) personal and advertising injury; (7) medial payments, bodily
injury and property damage; (6) explosion, collapse and underground hazards.
2) Worker's Compensation: statutory limits or, if no statutory limits exist, with minimum limits of
1,000,000 per occurrence;
3) Employer's Liability: $1,000,000 per occurrence;
4) Automobile Liability (owned, non -owned and hired): minimum combined single limit for bodily injury
and property damage of $1,000,000 each occurrence and annual aggregate;
5) Umbrella/Excess Liability: minimum limits of $2,000,000 each occurrence/aggregate. Such certificate
of insurance shall explicitly denote the excess nature of the umbrella/excess liability policy in respect of
underlying Commercial General Liability, Automobile Liability, and Employer's Liability and shall state
policy follows form; and
6) Coverage for Walmart's contingent liability for claims which may arise from operations under this
Contract, which coverage can be afforded by adding Walmart as additional insured on general liability
insurance coverage.
EXHIBIT 4.1
CHANGE ORDER DELIVERABLES/COMPENSATION
Issued at Out to Bid or as Modified by Addendum)
TABLE OF CONTENTS
Change Requests Procedures and Instructions-2014.03.24
Change Requests Submittal Workbook-2014.03.24
Change Requests Unforeseen Condition or Time and Material Forms-2014.03.24
Change Requests Mixed Crew Hourly Labor Rate Workbook-2014.02.24
a
Blanton, Deborah
From: Riley, Sandra <SRiley@seminolecountyfl.gov>
Sent: Friday, December 15, 2017 12:49 PM
To: Heidi Neven
Cc: Blanton, Deborah; Johnson, JoAnn; Bland, Annette
Subject: RE: Sam's Club - Electrical Work in Sanford
Good Morning,
The scope of work you have described for the Sam's Club is all electrical for the interior, and you will not have any
additional Seminole County Impact Fees for the work described.
Please let me know if you have any questions.
Best Regards,
so,vL. 0_, RUey
Program Manager I Electronic Plan Review Administrator
Seminole County Building Division
1101 E. First St. Sanford FL 32771
407-665-7474
Other Helpful Links:
Planning & Development I Building Permitting I ePlan Applicant User Guide ( How to Apply Online Guide for Building
Permits I ePlan Video Tutorials I ePlan Login Page I Planning & Development Review Division Processes I Bldg Div
Forms and Applications
From: Heidi Neven [mailto:hneven@rjmartin.netj
Sent: Friday, December 15, 2017 10:41 AM
To: Riley, Sandra <SRiley@seminolecountyfl.gov>
Subject: Sam's Club - Electrical Work in Sanford
Hi, Sandy -
It was a pleasure speaking with you earlier about the potential of a Road Impact Statement needed for Seminole County.
Per our conversation, we are the electrical contractor that will be disconnecting and reconnecting existing power and
data to replace existing belt -fed registers for new self -checkout registers inside the Sam's Club at 1101 Rinehart Road in
Sanford, FL.
Please let me know if you need any further information.
Thank you!
Heidi
Heidi Neven
Project Coordinator
RJMartin C.3
f9
NATIONAL CONTRACTING
I
cgKf ti
22841 Aurora Road 225 Seven Farms Drive
Bedford Heights, off 44146 Suite 203
P, 216,662.7100 Daniel Island, SC 29492
F:216.662,7195 P:843.352.9820
F 843,352.9821
WWW.R1iW4ARTIN,NET
Sao
r
R rt 11
t
CITY OF SANFORD
BUILDING & FIRE PREVENTIONVJUIPERMITAPPLICATION
Application No:
Documented Construction Value: $ 31,400.00
Job Address: 1 101 Rinehart Road Historic District: Yes No X
Parcel ID: Residential Commercial X
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Property Owner Information
Name Snm'C Ppnl Fetnta Ri icina5c Truct Phone: 479,273,4000
Street: 2001 SF 1 Oth Street Resident of property? : no
City, State Zip: RPntnnvillP A R 79719
Contractor Information
Name tbd Phone:
Street:
City, State Zip:
Fax:
State License No.:
Architect/Engineer Information
Name: r)b2 architecture + enaineedna Phone: 479 A-jA 354.S
Street: 2809 Aiax Avenue, Suite 100 Fax:
City, St,.Zip: Rogers AR 72758
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 dat 5'h Edition (2014) Florida Building Code
Revised: June 30, 2015 "`+ + Pennit 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 c pliance with all applicable laws regulating construction and zoning.
ign ure of Own gent - Date -- Signature of Contractor/Agent _ Date _
AUCA eUJAU_t)4 - &
Print Owner/Agent's Name
Signature of Notary -State ofIeFidR Date
HEATHER EDMISTON
WASHINGTON COUNTY
NOTARY PUTiW-ARKANW
My Camrkslon Expires November 22, 21118
Comniselon No.1237.M
Owner/ gent Personally Known to Me orProduceTypeofID
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING: UTILITIES:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTEWATER: 4 11 ZVll
ENGINEERING: FIRE: BUILDING:
COMMENTS:
CITY OF SANFORD
BUILDING & FIRE PREVENTION
u Y,
r 4 1if U i PERMIT APPLICATION
t Application No:
Documented Construction Value: $ 31,400.00
Job Address: 11 01 Rinehart Road Historic District: Yes No El
Parcel ID: Residential Commercial X
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: changing som f the manned checkout to selfcheck
d - D
Plan Review Contact Person:- Laura Lewallen Title: pe mit-coordinator - -
Phone: 479-633-R951 Fax:
Property Owner Information
Name Snrn'g Rpnl FStntp Ri iciness Triict Phone: 479,273,4000
Street: 2001 SE 1 Oth Street Resident of property?: no
City, State Zip: Rentonville AR 79719
Name
Street:
City, State Zip:
Contractor Information
Phone:
Fax:
State License No.:
Architect/Engineer Information
Name:gb2 architecture +engineering Phone: 479 l,3h 4.9
Street: 2809 Ajax Avenue, Suite 100 Fax:
City, St, Zip: Rogers AR 72758
Bonding Company:
Address:
Mortgage Lender: n/a
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. 1 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: 51h Edition.(2014) Florida Building Code
Revised: June 30, 2015 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 c pliance with all applicable laws regulating construction and zoning.
ign ure of Own gent J Date - - Signature of Contractor/Agent Date
Aut2.la 2W AUK - &O-I-K
Print O%vner/Agent's Name
gnature of Notary -State o "naA4 Date
HEATHER EDMISTON
WASHINGTON COUNTY
NOTARY PUBW-ARKANSAS
My Cwn Won ExpUee No wbw 22, 21118
Corrur laelon No.12373M
Owner/ gent Personally Known to Me or
Produce Type of ID
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing , Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use: Flood Zone:
Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING: 6r— - ICp ° i. TILITIES:
ENGINEERING:
COMMENTS:
FIRE:
Plumbing - # of Fixtures.
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
r R?a
e
o
QCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $ 31,400.00
Job Address: 1 101 Rinehart Road Historic District: Yes No X
Parcel ID: Residential commercialFil
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: changing some of the manned checkout to selfcheck,
Plan ReviewContactPerson:- Laura 1-6wallen - - - - - —---Title:-oermit coordinator - - Phone:
479-633-8951 Fax: C. MeMrs- •u Property
Owner Information Name
Snm'c RPr±I FctntA Ri ieing55 Tri M Phone: 479,273,4000 Street:
2001 SF 1 Oth Street Resident of property? : no City,
State Zip: RPntonvillP AR 79719 Contractor
Information Name
tbd Phone: Street:
City,
State Zip: Fax:
State
License No.: Architect/
Engineer Information Name:
pb2 architecture + engineering Phone: 479 63l, -j54..s Street:
2809 Aiax Avenue, Suite 100 Fax: City,
St, Zip: Rogers AR 72758 E-mail: Int irn lewnllPn @lDh9nP cnm Bonding
Company: Address:
Mortgage
Lender: n/a 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: 51h Edition (2014) Florida Building Code Revised:
June 30, 2015 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 ]CC 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 c pliance with all applicable laws regulating construction and zoning.
Sign -lure of Own gent J Date -- Signature.of Contractor/Agent Date
AUWLA ewAU_kl - &-C
Print
Owner/
Agent's Name
2L A- -0
ignature of Notary -State of-G eFida r,s Date
HEATHER EDMISTON
WASHINGTON COUNTY
NOTARY PUBIJC - ARKANSAS
My CmunlWon ExpIree November 22, 2019
ConunWafan No.12379588
Owner/ gent Personally Known to Me orProduceTypeofID
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING: UTILITIES:
ENGINEERING:
COMMENTS:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
ASTE WATER:
FIRE: 1 -01 /1,4 ) BUILDING:
Revised: June 30, 2015 Permit Application
CITY OF SANFORD BUILDING AND FIRE PREVENTION DIVISION
FIRE PLAN REVIEW SERVICE FEES
PHONE: 407.688.5052
FAX: 407.688.5152
DATE:: PERMIT NUMBER. 17-
BUSINESS/PROJECT NA E:
ADDRESS: ,^j.e
CONTACT NAME: HONE:
PLAN REVIEW INFORMATION
INSTRUCTION [ ]C/O [ ] FIRE ALARM [ ]FIRE SPRINKLER [ ] HOOD [ ]PAINT BOOTH [ ]TANK,
IMP
TOTAL FEES. 5
tit atz, a;3
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $ 31,400.00
33s S
Job Address: 1 101 Rinehart Road Historic District: Yes No X
Parcel ID: Residential Commercial X
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: changing some of the manned checkout to selfcheck
Plan Review Contact Person: Laura Lewallen -- - -Title: _permit -coordinator --
Phone: 47963:3-R951 Fax: OMIT.-", -.•...- ...
Property Owner Information
Name gym c Ranl Fctnta Ri jeinP_S4 Tn ict Phone: 479.273.4000
Street: 2001 SF 1 Oth Street Resident of property?: no
City, State Zip: RPntonvillP A R 72719
Contractor Information
Name tbd Phone:
Street:
City, State Zip:
Fax:
State License No.:
Architect/Engineer Information
Name: gb2 architecture + enaineerina Phone: 479 AAA -i54'S
Street: 2809 Alax Avenue, Suite 100 Fax:
City, St, Zip: Rogers AR 72758 E-mail: Ini irn lewallenOlDhine cnm
Bonding Company:
Address:
Mortgage Lender: n/a
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 -wor"k,-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: 51h Edition (2014) Florida Building Code
Revised: June 30, 2015 y np,-- I p 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 c pliance with all applicable laws regulating construction and zoning.
iSignlure of Own g gent - Date -- - - Signature of_Contractor/Agent Date
Print 0%vner/Agent's Name Print Contractor/Agent's Name
3gnature off Notary -State of-&4err SAS Date
HEATHER EWWON
WASHINGTON COUNTY
NOTARY PUBLIC-ARKAtSAS
My Com *slon Expires November 22, 2M9
Comnieelon No.123MM
Owner/ gent X_ Personally Known to Me or
ProducedZD Type of ID
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No
APPROVALS: ZONING: UTILITIES: / ///6-/%ASTE WATER:
ENGINEERING:
COMMENTS:
FIRE: BUILDING:
Revised: June 30, 2015 Permit Application