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10/04/2010 10:35 4073020226 ADCOCK PAGE 01/02
RECEIVED
DEC 16 2010 CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
G
Application No: I S—DDocumented Construction Value: $ '_5.1OC? Job
Address: _ /1 .! Historic District: Yes No Parcel
ID: Zoning: Description
of Work: _Aa& Playa
Review Contact Person: jCf4 Title: Phone:
VO 71- 11,1 •rfFag: E-mail: Property Owner
Information Name G;
Phone: Z 09 Street: A
LIZ Q Vt Resident of property?: City, State
Zip: ..%i/ .7 Z T 7/ j Contractor
Information
Name Ir,
a d Q ! l Phone: (
4
if 7. 1 Street: 0
D /CG P &C a d..e Fax.: f 0 7 City, State
Zip: ..l"akYD ICl 2 i l State License No.: C C CO 2 ZSOJ Name: Street:
City,
St,
Zip: Bonding Company:
Address: Building
Permit
0 Square Footage:
ZZ _rk No. of
Dwelling Units: Electrical New
Service --
No. of AMPS: Architect/Engineer
Information Phone: Fax.:
E-
mail: -- -- -
Mortgage Lender:
Address: PERMIT
INFORMATION
Construction Type:
ttaf No. of Stories: Flood Zone:
Mechanical (Duct
layout required for new systems) Plumbing New
Construction -
No. of Fixtures: Fire Sprinkler/
Alarm No. of heads: U- l
5
10/04/2010 10:35 4073020226 ADCOCK PAGE 02/02
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.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be dome in compliance with all applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR E< WROVEMENTS 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 CONMENCEMENT.
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. A copy of the executed contract is required in order
to calculate a'plan review charge. If the executed contract is not submitted, we. reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
signature of Date
ipt` 4°
ROBERT RAY ADCOCK
Notary Public -State of Fiorida
s W My Comm. Expires Jun 18, 2013
Commission 4: DO 900428
Vwner/A,gent is - — MsM or
Produced ID _ Type of ID
uo. - J 7-
APPROVALYsoS$ZONING: k2 UTILITIES: ENGINEERING:
COM
MEA: ?-Q-r Rev
11.08 FIRE:
Signature
of ontraetor/Agent Date Print
Contractor/Agent's Name Signature
of Notary -State of Florida Date jy
rovv,1SSi0N • DD629V E?;"
RES: e-_.wry 25, 2G! I cF (
NARY FL No=)' scout A'5a ('0 Contractor/
Agent is t/ Personally known to Me or Produced
lb Type of ID WASTE
WATER: BUILDING:
1151111 to no it not of III it flu of II® If ofI If ifftl it fit 11pill 011111 g6i
THIS INSIR MENT Pf PA IBY: WYANNE MORS"E, CLERK OF CIRCUIT COURT
1
Name: G I 0 SE141M LE COUNTYAddress00907497P1306r • (1 ) I +M
SENIINC7LE
C OL[NTY g
y`, 9
P S
itate of Iorl 8 FLORIQA'S NATURAL CHOICE C-.L_E RK I S .# `Cf 1 c i 1' 4 44C-)8 3 RECORDED
1211612010 12152:33 PH i RECORDING
FEES 1040 RECORDED
by T Eaaith NOTICE
OF COMMENCEMENT t^
p / C/} Permit
Number Parcel ID Number (PID) 'C__ __ rg .J J !7 ` V ids, , 00d 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 strreet addre`ss j'
rrf
available) C.
GENERAL
DESCRIPTION OF IMPROVEMENT t air OWNER
INFORMATION c. • ,( A Name
and address: l
CONTRACTOR'
1
Name
and address: f7 d c , V Q mjib
C 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
and address: In
addition to himself, Owner Designates of Section
713.15(1)(b), Florida Statutes. To
receive a copy of the Lienors Notice as Provided in Expiration
Date of Notice of Commencement: The
expiration' date is 1 year from date of recording unless a different date is specified. b W4PjVlNG
TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTERTHEEXPIRATION OF THE;.NOTICE OF f COMMENCEMENT ARE
CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER713, PART I, SECTION 713.13,, FLORIDA STATUTES,
AND CAN RESULT IN YOUR PAYING TWICE FOR;IMPROVMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE ,FIRST INSPECTION. IF
YOU INTEND JO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING
WO K OR RECORDING YOUR.NOTICE OF COMMENCEMENT: STAT OF
FLORIDA / . / j COU
OF
SEMINOLE OWN SI
E .., + i r
OWNERS
PRINTED NAME v NOIT
E.
Per Florida Stat a 713.130) (g), owner must sign.....: and no one else may be permitted to sign in his or her stead." The oregoing
instrument wasPL44 nowledged
before /
me this day of e 20 6 by - . " i
G l a Who is personally known to me Name of
person making statemenE, ORwho'has
produced identification t/ type of identification produced VERIFICATION PURSUANT
TO SECTFK92.625, FLORIDA STATUTES. UND R
PENALTIES OF PER URY, I EC, RE THAT I HAVE READ THE FOREGOING AND THAT THE FACTS STATED IN IT AREUE TO
THE BEST;O MY K OWL E AND'BELIEF. UY IG' ATURE
OF NATURAL 7ERSON SIGNINGABOVE AR ROPERT, RAY
ADCOCK'
Notary Public - State
of Florida S My Comm. Expires'
Jun 18, 2013 ` Notary Signature ` Commission a DO
900428 t
ADCOCK ROOFING
800.Frencb Ave, Sanford, FL
cmr rar
4 7) ; 22-955 * ( 30-93 (Fax)
October 25, 2010
ROOF ESTIMATE
Td'm vs
To: Mr. Rucquio Phone: (407) 323-9809
Address: 715 S. Myrtle Ave. Fax: ( )
City: Sanford, FL 32771 Mobil: ( ) , r ,
SCOPE OF WORK: Reroof Replacement Estimate
1. Remove old roof on complete house.
r
2. Re -nail decking as per code.
3. Install new 0 year architectural hingles over new 15# felt. (Double layer).
4. Chimney has to be re- as ed and counter -flashed at extra charge.
5. Install new Modified Bitumen Roof System on flat roofs.
6. Install new drip edge.
7. Replace all vents and stacks.
8. Pull all county permits.
9. Clean up & haul away debris.
Labor & Material - Back Flat - $975.00 QA-IfZ66
Top Flat - $130.0.00
30 Year Architectural Shingles - $3640.00
25 Year Fiberglass Shingles - $3430.00
Andy Adcock
0
CITY OF SANFORD HISTORIC PRESERVATION BOARD
APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788, Sanford, FL 32772-1788
Phone: 407.688.5145 -,Fax: 407.688.5141
Answer all the questions on this form ,and submit all required attachments. Incomplete applications will not be
reviewed.. If you have questions about application,. requirements contact the Historic Preservation Officer at
407.688.5145 to ensure your application is complete. A building .permit may be required for the activity detailed
below. Please contact the Building Department at 407.688.5150 for more information. Failure to obtain a building
permit may result in fines and/or double permit fees:
1. GENERAL INFORMATION
Downtown Commercial Historic DistriResidential Historic District Its this a retroactive request? - Yes No
Is this application filed in response to. a Notice of Violation from the Code Enforcement Department? Yes to
Property Address: + f'C %) G%! Q'
Property Owner Information
Print Name:'i
Mailing Address: rf• ; O .,
Phone: 0_,a'V4 9 ID9 Fax: Email:
Signature:
Applicant/Agent Information'"
Print Name: r'
Mailing Address: 1b.0
Phone:, I - 7.9Z .f.(' Fax: Email:
Signature:
I certify that all,in rmation coiita' ed in s pplication is true and accurate to the best ofmy knowledge Applicant/
Owner Signature: 0
Would you like to receive 'e n . s regarding Historic Preservation and Community Planning:within your community? 2.
APPLICATION CATEGORY (Checkall that apply) Proposed improvements
will affect the'following elevations: North J] South , East West Site Improvements/
Driveway/WalkwayG ,'Storage Shed Replacement Siding/Floor/Porch Replacement VVindows
or Doors Underskirting Signs/Awnings°' New Construction/
Additions;; ` Paint` Fences/Gates/Pergolas vl oofs/
GuttersfDownspouts °'` AC/Mechanical'. Other =. 3. DESCRIPTION
OF PROPOSED WORK . Completely describe
the entire 'scope of work, including changes in; material` and color, and methods that will be used to .. accomplish the
proposed works For large,projects an „itemized list is required. Use the reverse side if necessary. OFFICIAL USE
ONLY A plhoatiorr ReceivedF dl'I1i. i e y
pit
Historic Preservation
Board Meeting Date: Approved. Denied (
6o7nditions Noted Below) x N
DEC
16
201'0 u e
e % r
ff }
y I R ( t- pff Signatur Date: : ' °
i