HomeMy WebLinkAbout2616 Hartwell Ave - BR19-00002 - REROOFApplication N
Documented Construction Value:
PERMIT APPLICATION
I /1") 6 '.—
job S&^ —1 NojobAddress: to I (P 4 Vrj' F/ .3-2 7 13 Historic District: Yes
J
Parcel I D: Residential RCommercialEl
Type of Work: NewEl AdditionF] AlterationE] Repair [j DemoEl Change of UseEl MoveEl Description of Work:
A P-Ilrc'?o ' - Plan Review Contact
Person: Phone: Fax: Email:
Title: Property Owner
Information
Name Phone:/-0'
D--2 Street: /f Har'
I'lot qr Resident of property?: lak wji 'dnL City, State Zip:
I kNF3I- TM
Street: City, State
Zip:
Name: Street: City,
St,
Zip:
Bonding Company: Address:
Contractor Information
Phone:
Fax: State
License
No.:
Architect/Engineer Information
Phone: Fax: E-
mail:
Mortgage
Lender: Address:
WARNING TO
OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE
JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT Application is hereby
made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance
of a permit andthat all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate
permit must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and air conditioners, etc.
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date:6"' Edition (2017) Florida Building Code
NO'l`ICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that maybe found in the public
records of this county, and there may be additional permits required from other governmental entities such as water management districts, state
agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required in order to
calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal. The actual construction value
will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in accordance with local ordinance. Should calculated
charges figured off the executed contract exceed the actual construction value, credit will be applied to your permit fees when the permit is issued.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be
done in compliance with all applicable laws regulating construction and zoning.
f_
Signature of owner/ / ' ate + `
Print owner/Agent's Name
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature ofNotary ev , , , a DEBBiE BIANfNe Signature of Notary -State of Florida Date
AAv COMMISSION # FF 17861d
y # ,= FORE& February 25, 2019 ^
Bonded Thru Notary Public undemrilers
Owner/Agent is 7° ersonally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID Type of ID Produced ID 'Type of ID
e ,TI C d._
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plunbing 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:
fi
OWNER BUILDER STATEMENT/AFFIDAVIT
Altamonte Springs, Casselberry, Lake Mary, Longwood, Oviedo, Sanford,
Seminole County, Winter Springs
Florida Statutes are quoted here in part for your information to indicate the authority for exemptions for
homeowners from qualifying as contractors and to express any applicable restrictions and responsibilities.
OWNERS MUST PERSONALLY APPEAR AT THE BUILDING DIVISION TO SIGN THIS DOCUMENT
BY SIGNING THIS STATEMENT, I ATTEST THAT: (Initial to the left of each statement)
I understand that state law requires construction to be done by a licensed contractor and have applied for
an owner -builder permit under an exemption from the law. The exemption specifies that 1, as the owner of
the property listed, may act as my own contractor with certain restrictions even though I do not have a
license.
I understand that building permits are not required to be signed by a property owner unless he or she is
responsible for the construction and is not hiring a licensed contractor to assume responsibility.
I understand that, as an owner -builder, I am the responsible party of record on a permit. I understand that I
may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed
in his or her name instead of my own name. I also understand that a contractor is required by law to be
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licensed in Florida and to list his or her license numbers on all permit and contracts.
I understand that I may build or improve a one -family or two-family residence or a farm outbuilding. I
may also build or improve a commercial building if the costs do not exceed $75,000. The building or
residence must be for my awn use or occupancy. It may not be built or substantially improved for sale or
lease. If a building or residence that I have built or substantially improved myself is sold or leased within
in I year after the construction is complete, the law will presume that I built or substantially improved it
for sale or lease, which violates this exemption.
I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
I understand that I may not hire an unlicensed individual person to act as my contractor or to supervise
persons working on my building or residence. It is my responsibility to ensure that the persons whom I
employ have the licenses required by law and by city ordinance.
I understand that it is a frequent practice of unlicensed persons to have the property owner obtain an
owner -builder permit that erroneously implies that the property owner is providing his or her own labor
and materials. 1, as an owner -builder, may be held liable and subjected to serious financial risk for any
injuries sustained by an unlicensed person or his or her employees while working on my property. My
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner -
builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
I understand that I may not delegate the responsibility for supervising work to a licensed contractor who is
not licensed to perform the work being done. Any person working on my building who Is not licensed
must work under my direct supervision and must be employed by me, which means that I must
comply with laws requiring the withholding of federal income tax and social security contributions
under the Federal Insurance Contributions Act (FICA) and must provide workers' compensation
for the employee. I understand that my failure to follow these laws may subject me to serious financial
risk.
Rev. 9.14.2009
w
11
I agree that, as the party legally and financially responsible for this proposed construction activity, I will
abide by all applicable laws and requirements that govern owner -builders as well as employers. I also
a understand that the construction must comply with all applicable laws, ordinances, building codes, and
zoning regulations.
I am of aware of construction practices and 1 have access to the Florida Building Codes.
I understand that I may obtain more information regarding my obligations as an employer from the Internal
Revenue Service, the United States Small Business Administration, the Florida Department of Financial
Services, and the Florida Department of Revenue. I also understand that l may contact the Florida
Construction Industry Licensing Board at 1-850-487-1395 or at www.mytlorida.com/dbpr/pro/cilb/ for
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more information about licensed contractors.
I am aware of, and consent to, an owner -builder building permit applied for in my name and understand
that I am the party legally and financially responsible for the proposed construction activity at the address
listed below.
I agree to notify the building department immediately of any additions, deletions, or changes to any of the
i; information that I have provided on this disclosure or in the permit application package.
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person
who does not have a license, the Construction Industry Licensing Board, the Department of Business and
Professional Regulation and the building department may be unable to assist you with any financial loss
that you sustain as a result of a complaint. Your only remedy against an unlicensed contractor may be in
civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an
individual or firm is injured while working on your property, you may be held liable for damages. If you
obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for verifying
whether the contractor is property licensed and the status of the contractor's workers' compensation
coverage.
Property Address:
1, , do hereby state that I am qualified
and capable of performing the requested construction involved with the permit application filed and agree to the
conditions specified above.
Signature of Owner-Bui
Form of Identification
Must be Photo ID)
Date
2, - Z, 2, 6 / ,_
A violation of this exemption is a misdemeanor of the first degree punishable by a term of imprisonment
not exceeding I year and a $I,000.00 fine in addition to any civil penalties. In addition, the local
permitting jurisdiction shall withhold final approval, revoke the permit, or pursue any action or remedy
for unlicensed activity against the owner and any person performing work that requires licensure under
the permit issued.
Rev. 9.14.2009
CITY OF
Building & Fire Prevention DivisionSNFORDRESIDENTIALRE -ROOF POLICY& PROCEDURES
FIRF., DEPARTNIENT'
PERMITTING REQUIREMENTS -NO PLAN REVIEW REQUIRED
Ti-iis DOCUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE,
REQUIRED TO BE SUBMITTED AS PART OF YOUR PERMIT APPLICATION.
THE:SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF
COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT.
A PERMIT WILL NOT BE ISSUED WITHOUT THESE DOCUMENTS. COPIES WILL BE MADE TO POST ONTHE JOB SITE.
PROJECTS LOCATED IN THE SANFORD HISTORIC DISTRICT WILL REQUIRE PLAN REVIEW AND APPROVAL BV'FIIE
SANFORD HISTORIC PRESERVATION BOARD
INSPECTION POLICY& PROCEDURES
A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMILY, TOWNHOUSE,
MOBILE HOME, APARTMENT AND/OR CONDOMINIUM) RE -ROOF PERMITS.
THE FOLLOWING IS REQUIRED TO BE PROVIDE ON THE; JOB SITE:
PERMIT CARD. POSTED IN CONSPICUOUS AND WEATHERPROOF LOCATION
COMPLETED RESIDENTIAL RF-Root, ScoPtI., OF WORK
COMPLETE[) AND NOTARIZED INSPECTION AFFIDAVIT
ALL FLORIDA PRODUCT APPROVAL AND CORRESt'ONDING INsTALL.."T'ION INSTRUCTIONS
PRODUCT APPROVAL SHALL MATCH WHAT IS ON THE SCOPE OF WORK)
0 DIGITAL PHOTOGRAPHS (MUST INCLUDE 1`1 It-" PERMIT NUMBER OR ADDRESS IN EACH PICTURE) EACH
PLANE OF THE ROOF, SHOWING THE UNDERLAYMENT INSTALLED Rom,
DECK NAILING PATTERN & SPACING (INCLUDING A MEASURING DEVICE. OR RULER) Root:
DECK NAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHOWING SIZE OF NAILS) UNDI".
RLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER) DRIP
EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE OR RULER) SHINGLES
INSTALLED, NAIL PATTERN AND LOCATION OF NAILS 0
SKYLIGHTS (IF APPLICABLE) o
DIGITAL III 10TOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL o
Dl(,ITAI,PHOTOGRAPHS SHOWING AI,I,REQUIRED FLASHING, PER FL PRODUCT APPROVAL FAILURE
TO FOLLOW THESE; SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN PROFESSIONAL (
ARCHITECTOR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION. CONTRACTOR (OR
OWNER/B(ji[,Dt--,R)SIGNA-rt)Ri>r' 4
r ,
DA:-t,)
PERMIT #
ti City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS:
S,rittwi,tim TYPE: 0 SINGLE FAMILY RESIDENCE/TOWNHOUSE: 0 M01111,E HOME 0 APARTMENIXONDOMINIUM
RE -ROOF TYPE: 0 REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
0 RE-COVER (NEW Roo[,'[ NSTA LLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFN'):____
PLEASE NOTE: ON1. Y 100 SQUARE FEET OF T11F EXISTING DECK IS PERMITTED TO BE REPLACED"
ROOF VENTILATION: ®OFF -RIDGE 0 RIDGE OSOFHT OPOWU-',R[-D VENT OTuRBINES
SKV1,1(.11TS: OYES &NO lf,'YES, PLEASE PROVIDE FtORIDAPRODUCT' APPROVAL #: MAIN
ROOF AREA ROOF
SLOPE: Q LESS THAN 2:12 02:12-4:12 0 4:12 OR GREATER TYPE
OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL SHINGLE
1 S 1,r FL4 41 3 0
ME,rAL, FL# j)
MODIFIED BITUMEN FL# OTORCH
DOWN FL# OINSW,ATED
FL# OTILE FL#
00HIER: FL#
Rom, EXTENSIONS (
PORCHES, PATIOS, ETC.) **IFAPPLICABLE** Rom, SLOPE:
0 LESS THAN 2:12 02:12-4:12 0 4:12 OR GREATER TYPE OF
ROOF MANUFACTURER FLORIDA PRODuci, APPROVAL SHINGLE FL#
0 METALFL#
0 0MODIFIED
BITUMEN FL# 0TORCH DOWN
FL# 0 INSULATED FL#
FL# 0T11_E
OOTIIER: FL#
omptroller Seminole County F
nst # 01 0 2I43 Book 9275 Page.8618(1CPAGES) RCD: 1/2/2019 1:54:14 PM
REC FEE $10.00
C _Ri
THIS 1 TRIT PREPARED BY:
Name:I:iVisi i-s , Add s. ,,
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number. 00000 a•" Parcel lD Number.
The undersigned hereby gives notice that Improvement will be made to certain real property, and In accordance withChapter713, 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) lv !-Far--Fr.. r G?,r.,.e. ,
St tr. tofu FI 3 a.-7 7
GENERAL DESCRIPTION OF IMPROVEMENT:
OWNER INFORMATION:
Address: Lo wt
Fee Simple Title Holder (If other than. Owner) Name
Address
CONTRACTOR:.
Address:
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be servedasprovidedbySection713.13(1)(b), Florida Statutes.
Name: /U / 4r
In addition to himself. Owner Designates
To receive a copy of the Uenor's NOWe as Provided in
Section 713.13(1)(b), Florida Statutes.
Expiration Data of Notice of Commencement (The expiration date is 1 year from date of recording untass adifferentdateisspecified)
1413lYflVQ TO OWMEA ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OFCOMMENCEMENTARECONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER713. PART 1, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. ANOTICEOFCOMMENCEMENTMUSTBERECORDEDANDPOSTEDONTHEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEYBEFORECOMMENCINGWORKORRECORDINGYOURNOTICEOFCOMMENCEMENT.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in Itare truetothebestofmyknowledgeandbelief.
Ovmafa Prin a
Florida Statute 715.13(1)(g). * Theownermus pnaw notke ofoommanoammd and rw one 01" maybe pennMed tosign InNsorherstead.•
State of _ f" IA A_ County of
The foregoing instrument was acknowledged before me this -a_0.J_ day of Tc r, .-;
7, e i
by car M Q 0 9L Who Is personally known to me Noma of parson makbg atatanuo
OR who has produced Identification L7 type of Identification produced: _Q L M 53 A = 14 5 (a » (p$ o _ d
11 JUDITH A. ECKENROTH
State of.Florida•Notary Publica"ice
Commission I GG 223599-
My Commission'Expires Now krfe
May 30. 2022