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HomeMy WebLinkAbout612 Sanford Ave 17-71; ROOFCITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: 11 -- Documented Construction Value: $ 14 C00 0 0 Job Address: 612 SANFORD AVENUE Historic District: YesEl No [11 Parcel ID: 25-19-5AG-0801-0030 Residential 2 Commercial F Type of Work: New[] AdditionEl Alteration 12 RepairEl DemoEl Change of UseEl MoveE1 Description of Work: REMOVE AND REPLACE EXISTING SHINGLE ROOF SYSTEM Plan Review Contact Person: ROBERT WORMLEY Title: Phone: 321-543-2834 Fax: Email: wormleyroofing@aol.com Property Owner Information Name FOXEN OF ORANGE CO TRUSTEE FOB JAMES LEE Phone: 407-312-4800 Street- 444 SANFORD AVE City, State Zip: SANFORD FL 32771 Resident of property?: NO Contractor Information Name ROBERT WORMLEY / WORMLEY ROOFING INC Phone: 321-543-2834 Street: 2473 N JOHN YOUNG PARKWAY City, State Zip: ORLANDO FL 32804 Fax: State License No.: CCC1325558 Architect/ Engineer Information Name: Phone: Street: Fax: City, St, Zip: E- mail: Bonding Company: Address: Mortgage Lender: Address: WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAVING 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 I M-3 Shall be inscribed with the date of application and the code in effect as of that date: 5" Edition (2014) Florida Building Code Revised: June 30, 2015 Permit Application 4 11 T Co THIS INSTRUMENT PREPARED BY: Name: ROBERT DUCHARME / WORMLEY ROOFING IN 11ARYNINE 1101'I'SEY SENINOLE C0[JITFY Address: g_YOUNG PARKWAY CLERK OF C1'RCL11T COURT & COVIPI'ROLLER' QRLAtIDO FL 32804 B11% 8832 Ps 373 CLP:j,-,, CLERK'S 4 2016133828 NOTICE OF COMMENCEMENT RECORDED 12/20'20H 1.13'I' 1 1.2 A 1-1 R.ECORDING FEH"$-10.00 State of Florida RECORDED BY jer-keni-o County of Seminole Permit Number: Parcel ID Number: 25-19-30-5AG-0801-0030 The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available) LOT 3 BLK 8 TR 1 TOWN FO SANFORD PB1 PG 59 612 SANFORD AVENUE, SANFORD FL 32771 GENERAL DESCRIPTION OF IMPROVEMENT: REMOVE AND REPLACE EXISITNG SHINGLE AND METAL ROOF SYSTEM OWNER INFORMATION: Name:_ FOXEN OF ORANGE CO INC TRUSTEE FBO JAMES LEE Address: 440 SAANFORD AVE, SANFORD FL 32771 Fee Simple Title Holder (if other than owner) Name: Address: CONTRACTOR: Name:_ ROBERT WORMLEY / WORMLEY ROOFING INC Address: 2473 N JOHN YOUNG PARKWAY, ORLANDO FL 32804 Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section 713.13(1)(b), Florida Statutes. Name: Address: In addition to himself, Owner Designates of To receive a copy of the Lienor's Notice as Provided in Section 713.13(1)(b), Florida Statutes. Expiration Date of Notice of Commencement (The expiration date Is I year from date of recording unless a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT, Under pepa ies o ip rj NIt' f ,I declare that I have read the foregoing and that the facts stated in it are true to the be§t of m fk,n6yA1I age and belief. 7W7 wn 9 Signature Owner's Printed Name F 1 Statute 713-.13(l)(g): 'The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead," % J LIA4/. State of Flot-woc, County of The foregoing Instrument was acknowledged before me this ZU day of 20, 01J by Who is personally known to me ©— Name of person making statement OR who has produced IdentificationEl type of Identification produced: ? ROBERT DUC r HAR HARMES 1 0 MyCOMMISSION #FF166490 Notary Signature c m 6 01 EXPIRESDecember6, 2018 407) 300-0163 r-loridallotaryservice.com 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 complian5g*th all applicable laws regulating construction and zoning. ROBERT DUCHARME MY COMMISSION #FF166490 EXPIRES December 6. 2018 40t) 0153 F (of tdallotaryserwCe. corn' Own-e-r7Agent is K Personally Known to Me or Produced ID Type oflD signature of Contractor/Agent Date ROBERT WORMLEY Print Contractor/Agent's Name i Sign K ROBERT DUCHARME MY COMMISSION #FF166490 EXPIRES December 6, 2018 3 FlortdallotaryService,corn Contractor/Agent is _X_ Personally Known to Me or Produced ID __ Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building[] Electrical[] MechanicaIR Plumbing[] GasE] 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: YesEl NoR 9 of Heads.- Fire Alarm Permit: Yes [] No R APPROVALS: ZONING: UTILITIES: WASTE WATER: ENGINEERING: FIRE: BUILDING: 3105, 11KI&I, Revised: June 30, 2015 Permit Application 4131011 City of Sanford Building and Fire Prevention J Jll;IIIIIIJ III l1illill Jill Permit # Project Location Address 612 SANFORD AVENUE, SANFORD 32771 As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the information and product approval number(s) on the building components listed below if they are to be utilized on the construction project for which you are applying for a building permit. We recommend that you contact your local product supplier should you not know the product approval number for any of the applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product Approval can be obtained at wwwjlo, i The following information must be available on the jobsite for inspections: 1. This entire product approval form 2. A copy of the manufacturer's installation details and requirements for each product. Category / Subcategory Manufacturer Product Description Florida Approval # include decimal 1. Exterior Doors Swinging Sliding Sectional Roll Up Automatic Other 2. Windows Single Hung Horizontal Slider Casement Double Hun Fixed Awning Pass Through Mullions Wind Breaker Dual Action Other June 2014 Category f Subcategory Manufacturer Product Florida Approval # tDescriip_. on decimal 3. Panel Walls includin Siding Soffits Storefronts Curtain Walls Wall Louver Glass block Membrane Greenhouse E.P.S Composite Panels Other 4. Roofing Products Asphalt Shingles ATLAS PRISTINE FL16305-R4 Underla meats ATLAS GORILLA GUARD FL16226-R2 Roofing Fasteners Nonstructural Metal Roofing Wood Shakes and Shingles Roofing tiles Roofing Insulation Waterproofing Built up roofing System Modified Bitumen Single Ply Roof Systems Roofing slate Cements/ Adhesives / Coating Liquid Applied Roofing Systems Roof Tile adhesive Spray Applied Polyurethane Roofing E.P.S. Roof Panels Roof Vents Other June 2014 Category Subcategory 5. Shutters Manufacturer Product Description Florida Approval # include decimal Accordion Bahama Colonial Roll up Equipment Other 6. Skylights Sqlights Other 7. Structural Components Wood Connectors Anchors Truss Plates Engineered Lumber Railing Coolers/Freezers Concrete Admixtures Precast Lintels Insulation Forms Plastics Deck / Roof Wall Prefab Sheds Other 8. New Exterior Envelope Products Applicant's Signature Applicant's Name Please Print) June 2014 City of Sanford Roof Permit Application Checklist All permit application packages must be complete prior to acceptance. You must check each box to the left or indicate n/a on this submittal. A complete application package shall include the following: Building Permit Application completed, signed and notarized. Application must include correct address and complete parcel I.D. number. 0 *`-Copy of applicable contractor's license issued by the State of Florida (if the contractor is the applicant). Y A site specific notarized power of attorney shall be required from the licensed contractor if he/she appoints an employee of his/her company to sign the permit application as the contractor. 6 ju (, i, 111-A Certificate of insurance indicating worker's compensation insurance coverage and naming the City of Sanford as certificate holder, or a copy of a worker's compensation exemption issued by the State of Florida (must be submitted with each application if contractor is the applicant). ll-Ix Completed and signed Owner Builder Statement / Affidavit (if the owner is the applicant). These guidelines were compiled to assist the applicant in preparing a roof permit application and may not be complete. The applicant is required to meet all City of,'aqford, state, and federal code, requirements. WORMLEY ROOFING LICENSE #CCC1325558 2473 N. John Young Parkway Orlando, FL 32804 Roofing Proposal I 321-303-0 EI wormleyroofing@aol.com I Name / Address I JAMES ROSS LEE 444 S SANFORD AVE SANFORD FL 32771 browser] 02@aol.com Description Ship To 612 SANFORD AVE SANFORD FL 32771 RAIN,HAILWIND, OR ACTS OF GOD. ANY LEAKS OCURRING DURING THE GUARANTEE PERIOD WILL BE REPAIRED BY WORMLEY ROOFING INC. ANY REPAIR OR ALTERATION BY OTHERS DURING GUARANTEE PERIOD WILL VOID WARRANTY AND WORMLEY ROOFING WILL NOT BE RESPONSIBLE. PAYMENT TERMS: 1/3 DOWN. CUSTOMER APPROVAL: WRI APPROVAL: DATE: ATEZI.- Total Date Estimate # 11/3/16 3056 Total P.O. No. 612SA 8,900.00 Page 2 CITY OF SANFORD BUILDING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: 2Z 1, ROBERT WORMLEY hereby acknowledge that I personally inspected VRoof deck nailing and/or VSecondary water barrier work at 612 SANFORD AVE, SANFORD FL 32771 and have determined that the work Job Site Address) was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.) I certify that my statements herein are true and accurate to the best of my belief and that I fully understand that making any false statements in writing with the intent to mislead a public servant in the performance of his or her official duty shall constitute a misdemeanor of the second degree pursuant to Section 837.06 F.S. Signature of Contractor ROBERT WORMLEY Printed Name of Contractor Date CCC1325558 License A License Type: H General 1], Building 11 Residential VRoofing Contractor i I or any individual certified in accordance with F.S. 468 to make such an inspection. STATE OF FLORIDA COUNTY OF ORANGE Sorn to (or affirmed) and subscribed before me this q ' day of T , J _ A 20 -o by7k ey s [I Produced (type ofLLwhoisVPersonallyKnowntoorhas ilentificat*) as identification. 7- (SEAL) Signature of Notary Public State of Florida ROBERT DUCHARME Print/Type/Stamp Name of Notary Public ROBERT DUCHARME 166490MyCOMMISSION #FF 2018EXPIRESDecember6, 40-1)31 Flondallo A "OfVJCQ Com M,0153 ,M,0153Enn 12