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Home My WebLink About1112 S Bay AveFEB 12011 CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: / Documented Construction Value: Job Address: Historic District: Yes No S—' Parcel ID: ZS 136 Cs' (i. c-SCoZoning: Description of Work: J,CU_> VO j C. sjr Plan Review Contact Person: ,(, ,,., E,/ r ho-4 tr Title: ``c t11 ' Phone: 4O1-?IZ-r G4 Fax: 4Cn-'71Z-Ig1U E-mail: S ch 6C<c_1eon-7 Property Owner Information Name I t i r oN F G Phone: 4 n- 63 5^ ct Z'4 Street: I 117- S • '.'1Gc.t.1 AV f, Resident of property? : t City, State Zip: t"an-Yyy -d l2 3Z7i 1 Contractor Information Name 64 , i If Phone: Street: I ( Do) Q jgz L Lne?m JUG Fax: -1 G City, State Zip: 6 f 1 Gj 4j o I State License No.: Name: Street: City, St, Zip:' Bonding Company: Address:: Architect/ Engineer Information Phone: Fax: E- mail: _ Mortgage Lender: Address: PERMIT INFORMATION Building Permit l z,- Square Footage: Construction Type: No. of Stories: No. of Dwelling Units: Flood Zone: Electrical New Service - No. of AMPS: Mechanical (Duct layout required for new systems) Plumbing New Construction - No. of Fixtures: Fire Sprinkler/ Alarm No. of heads: s 1 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 done in compliance with all applicable laws regulating construction and zoning.. WARNING TO OWNER: YOUR FAILURE TO RECORD ANOTICE 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. 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 Owner/Agent Date Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID APPROVALS: ZONING: ENGINEERING: COMMENTS: Signature of Contractor/ ge Date PjLnt Contractor/ ent's Name I SAMANTHA L FURBOTER ftlY COMMISSION # DD8651,?,^'r EXPIRES March 01, 201 Contractor/Agent is V Personally Known to Me or Produced ID Type of ID UTILITIES: WASTE WATER: FIRE: BUILDING: Rev 11.08 POWER OF ATTORNEY Date: I hereby name and appoint _ h , C40 of ADT Security Services to drop off and pick up permits at the G 11 r Building Department on my behalf for a LOW VOLTAGE SECURITY permit for wort: to be performed at a location described as. - Parcel —'3G— Subdivision 1 Address of job Owner (, f 6 I2 F i v nelli EF0001121 Type or Print Name of Certified Contractor Signature of The foregoing instrument was acknowledged b by G G i who is personally kn n to me/who oduced as t entt tcatton an id not take oath. State of Flor' unty of E A"An, ary Public, Seminole C Florida me this 47, day of 20 L AMANTHAj#DD OTER' MY COMMISS6593' EXPIRES M013qflorg COPY CustNo-UNKNOWN JobNo- UNKNOWN RESIDENTIAL SERVICES CONTRACT CONTRACT DATE: Z- / 2 I J ofzk TOWN NO: vS1 SZ CUSTOMER NO: LUICN I' IdIIE'9b JOB NO: LEAD SOURCE: vkw^5'1'2 7 L .... t viT' 2''l ,• h LAW Y ADT Security Services, Inc. (ADT) Customer Name T o You" or "Your") 1 ctWe" orQ"Us"or( "Our") Office Address 16I0 i{ cl I n Address I lV d r_T-sCity P C> Affinity Name & No. rCiC `5j7 8 State / Zip i 3z Tax Exempt No. I QCa Z)f,k6aProtected Premises' Telephone Tax Expire. Date 4- qC5QU,?O Traditional Phone Other (Qualified) Other (Non -Qualified) el: 1- 800=ADT-ASAP 1-800-238-2727 Alternate Telephone 1 ! 0 _ 535 9zy G (Circle one) Home rk w/ ext.IF tcrk FAMILIARIZATION PERIODISAlternateTelephone2qaq. Zj3S-- 9z3 (Circle one) Home w/ ext. REJECTED INITIAL HERE EMAILI rt rc— . C_ c iy Communications Authorization: You hereby authorize ADT to furnish information and/or updates regarding your security rystem and new ADT and/or third party products and services available to ADT customers to the contact information provided by you. You may unsubscribe or opt -out by emailing donotcontact®ad . com or by calling.888-DNC4ADT 888-362-4238). Initial here Confirmation of Appointments: You hereby expressly authorize ADT to call you using an automated calling device to deliver a prerecorded message to set/confirm a servicerinstallation appointment at the telephone number{s) shown above. Initial here System Ownership: mer-Owned ADT-Owned ^^ 22222i ffiXStandardMonthly Service, Burgla Monthly Service Charge Service includes Customer Monitoring Center Signal Receiving and I Municipal Construction Permit Fee Customer to obtain construction permit Notification Service for Burglary, Manual Fire, and Manual Police Emergency • Standard Monthly Service, Fire/Smoke Detection - Other Installation Price Service includes: Customer Monitoring Center Signal Receiving and Notification Service for Fire, Manua) Fire, and Manual Police Emergency Taxable Amount Carbon Monoxide Flood Low Temp Non Taxable Amount Medical Alert Connection fee Safewatch Celiguard° Sales Tax on Installation' Securi Link° tY TotalInstallation Charge* RFZtended Limited Warranty/Quality Service Plan (QSP) Deposit Received C C9-> /T C ! Guard Response Service Balance Due upon Installation' Monthly Recurring Municipal Fee (Subject to change based on local law) If applicable sales tax not shown, it will be added to your first invoice. o r^ i Customer to obtain and ay for municipal alarm use permit Other I, Total Monthly Service Charge InitiaUAnnual Recurring Municipal Fee -billed separately Initial/ Subject to change based on local law) Annual Fee Customer to obtain and pay for initial/annual municipal alarm use Estimated Start Date permit. Your failure to obtain and provide ADT with your municipal alarm use permit registration number could result in no municipal fire/ oo ice response to an alarm from your premises and/or a fine. I Estimated Completion Date YOU ACKNOWLEDGE AND ADMIT THAT (1) WE HAVE EXPLAINED TO YOU THE FULL RANGE OF EQUIPMENT AND SERVICES AVAILABLE TO YOU; (2) ADDITIONAL EQUIPMENT AND SERVICES OVER THAT DESCRIBED HEREIN ARE AVAILABLE AND MAY BE OBTAINED FROM US AT AN ADDITIONAL COST TO YOU; ( 3) YOU HAVE CHOSEN AND HAVE CONTRACTED FOR ONLY THE EQUIPMENT AND THE SERVICES DESCRIBED IN THIS CONTRACT (4) THE INITIAL TERM OF THIS CONTRACT IS FOR THREE (3) YEARS, AND (5) YOU SHOULD MANUALLY TEST YOUR SYSTEM MONTHLY WITH ADT AS WELL AS UPON ANY CHANGE TO THE TELEPHONE SERVICE IN YOU&PREMISES TO CONFIRM PROPER TELEPHONE LINE SEIZURE AND THAT SIGNAL TRANSMISSION IS FUNCTIONING PROPERLY BY CALLING ADT AT 1-800-ADTASAP (AND FOLLOW THE PROMPTS). WE ARE NOT A SECURITY CONSULTANT. YOU ACKNOWLEDGE AND ADMIT THAT BEFORE SIGNING YOU HAVE READ THE FRONT AND BACK OF THIS PAGE IN ADDITION TO THE ATTACHED PAGES WHICH CONTAIN IMPORTANT TERMS AND CONDITIONS FOR THIS CONTRACT YOU STATE THAT YOU UNDERSTAND ALL THE TERMS AND CONDITIONS OF THIS CONTRACT, INCLUDING, BUT NOT LIMITED TO, PARAGRAPHS 5, 6, 7, 8, 9, 10 AND 22. YOU ARE AWARE OF THE FOLLOWING: NO ALARM SYSTEM CAN GUARANTEE PREVENTION OF LOSS; HUMAN ERROR IS ALWAYS POSSIBLE; WE MAY NOT RECEIVE ALARM SIGNALS IF THE TELEPHONE LINE OR OTHER ALARM TRANSMISSION SYSTEM IS CUT, INTERFERED WITH, OR OTHERWISE DAMAGED OR IF TELEPHONE OR ELECTRICAL SERVICE IS UNAVAILABLE FOR ANY REASON. THIS CONTRACT REQUIRES FINAL APPROVAL OF AN ADT AUTHORIZED MANAGER BEFORE. ANY EQUIPMENT/SERVICES MAY BE PROVIDED. IF APPROVAL IS DENIED, THIS CONTRACT WILL BE TERMINATED AND ADT'S ONLY OBLIGATION TO YOU WILL BE TO NOTIFY YOU OF SUCH TERMINATION AND REFUND ANY AMOUNTS PAID IN ADVANCE. SECOND ANDTHIRD PAGES ACCOMPANf'Q1S PAGE WITH ADDIThONAI TERMS AND CONDITIONS e.: Rep. ID No.: COST ER'S APB V L• ' DA Rep. License No. (If Requir a in Signatu fired NOTICE OF MNCELLATION. YOU, THE CUSTOMER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. 1 Of 6 Office Copy 02010 ADT Security Services, Inc (08/10) it -z? AID Seminole County Property Appraiser Get Information by Parcel Number Page 1 of 1 P t M'9 E'11TH S7q, m r" DAVID Jci N CFA, ASA PRY 7 27B APPRAISER, 1IQl:E Fl[xs7 si. 9ANF6R'b . L3277t-146B' m mP 2 ip 7D407-665 '7506'- 7A In r VALUE SUMMARY VALUES 2011 2010 Workinq Certified GENERAL Value Method Cost/Market Cost/Market Parcel Id: 25-19-30-5AG-130G-0030 Number of Buildings 1 1 Owner: REID TYRONE, Depreciated Bldg Value 31,032 32,900 Mailing Address: 1112 S BAY AVE Depreciated EXFT Value 0 0 City,State,ZipCode: SANFORD FL 32771 Land Value (Market) 12,816 12,816 Property Address: 1112 BAY AVE Land Value Ag 0 0 Subdivision.Name: SANFORD TOWN OF Just/M_arket Value 43,848 45,716 Tax District: S1-SANFORD Portablity Adj 0 0 Exemptions: Save Our Homes Adj 0 0 Dor: 01-SINGLE FAMILY Amendment 1 Adj 0 0 Assessed Value (SOH) 43,8481 45,716 Tax Estimator 2011 TAXABLE VALUE WORKING ESTIMATE Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund 43,848 0 43,848 Amendment 1 adjustment is not applicable to school assessment) Schools 43,848 0 43,848 City Sanford 43,848 0 43,848 SJWM(Saint Johns Water Management) 43,848 0 43,848 County Bonds 43:8481 0 43,848 The taxable values and taxes are calculated using the current years working values and the prior years approved millage rates. SALES Deed Date Book Page Amount Vac/Imp Qualified 2010 VALUE SUMMARY SPECIAL WARRANTY DEED 12/2009 07312 0745 $16,000 Improved No 2010 Tax Bill Amount: 918 CERTIFICATE OF TITLE 08/2009 07240 0211 $100 Improved No 2010 Certified Taxable Value and Taxes WARRANTY DEED 11/2005 06005 0864 $36,800 Improved No DOES NOT INCLUDE NON -AD VALOREM ASSESSMENTS WARRANTY DEED 03/1980 01268 1443 $20,000 Improved Yes Find Comparable Sales within this Subdivision LAND LEGAL DESCRIPTION Land Assess Method Frontage Depth Land Units Unit Price Land Value PLATS: Fick. :":' FRONT FOOT & DEPTH 64 117 .000 225.00 $12,816 LEG LOT 3 BLK 13 TR G TOWN OF SANFORD PB 1 PG 115 BUILDING INFORMATION Bid Num Bid Type Year Bit Fixtures Base SF Gross SF Living SF Ext Wall Bid Value Est. Cost New Building. 1 SINGLE FAMILY 1968 3 660 660 660 CONC BLOCK $31,032Sketch 35,772 NOTE: Appendage Codes included in Living Area: Base, Upper Story Base, Upper Story Finished, Apartment, Enclosed Porch Finished, Base Semi Finshed Permits NOTE: Assessed values shown are NOT certified values and therefore are subject to change before being finalized for ad valorem tax purposes. If you recently purchased a homesteaded property your next ear's property tax will be based on JusUMarket value. http://www.scpafl.org/web/re_web.seminole_county_title?parcel=2519305AG 130G0030&... 1/28/2011 DATE (MM/DDIYYYY) CERTIFICATE OF LIABILITY INSU CE 11rsr2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER GO IAL;I NAME: PHONE I FAXA/C No Ext:(_12) 345-5000 _ (AIC No): Marsh, Inc. 1166 Avenue of the Americas L New York, NY 10036 ADDRESS: PRODUCER I CUSTOMER ID #: INSURERS} AFFORDING COVERAGE NAIC # INSURED INSURER A: AGCS Marine Insurance Company (Allianz) j ADT Security Services, Inc. INSURER B: CHARTIS CASUALTY COMPANY 3160 Southgate Commerce Blvd INSURER C: Commerce & Industry Ins Co. Ste 38 INSURER D: Illinois National insurance Co. Orlando , FL 32806 INSURER E: Nat'l Union Fire Ins Co. of Pittsburgh, PA j United States INSURER F: New Hampshire Ins. Co. rnVFRArAFR RFRTIFIRATF NI WIRER- R77Rf15 - A RFVI1;;Ir7N NI It1ARFR• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRLTR 1 TYPE OF INSURANCE ADDLISUBRI POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXPMM/DD/YYYY I LIMITS F iGENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY I-- CLAIMS -MADE OCCUR OWNER'S & CONTRACTOR'S I I j I GL 4360884 (Primary GLj I i 10/1/2010 110/1/2011 EACH OCCURRENCE j $1,000,000.00 DAMAGE TO RENTED I PREb11SES Ea occurrence) $1,00G,000.00 MED EXP (Any one person) $10,000R0 PERSONAL & ADV INJURY $1,000A00.00 I GENERAL AGGREGATE $2,000,000.00 c , j GEN'_ AGGREGATE LIMIT APPLIES P_R: x POLICYPRE ICI LOC PRODUCTS - COMP/OP AGG j $2.000,000.00 E E E F AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS I HIRED AUTOS NON -OWNED AUTOS CA 3976576 (VA) CA 3976575 (AOS) CA 3976577 (MA) CA 3976624 (NH) (Primary AL) 101112010 10/1/2010 10/ 1/2010 j 10/1/2010 10/1i2011 10/1/ 2011 10/ 1/2011 10/ 1/201 t 1 COMBINED SINGLE LIMIT j $1,000,000.00 Each accident) I BODILY INJURY (Per person) j FBODILYINJURY (Per accdent),l PROPERTY DAMAGE Per accident) i NEW HAMPSHIRE (CSL) 250. 000 I, UMBRELLA LIAB (OCCUR EXCESS LIAB CLAIMS -MADE( I I I I EACH OCCURRENCE AGGREGATE DEDUCTIBLE RETENTION $ PRODUCTS - C. MPIOP AGG I i NEW H,4MPSHIRE (CSL) 6 C D E F WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE oFFlCER/MEMBER EXCLUDED? I Mandatory in NH) Ifyes, describe under DESCRIPTION OF OPERATIONS below I N / A I I WC 026149517. A, A, WC 026149514 (FL) WC 026149516 (MI) WC 026149513 (CA) WC 026149518 (MA, ND, NY, OH, WA. WI,_WYL 10/ 1/2010 10/ 1/2010 10/ 112010 10/1/ 2010 110/1/2011 10/1/ 2010 1 10/1,12011. 10/ 1/2011 10/ 1/201-I 10/ 1/201 I X I WC STATU- OTH-' T RY LIMIT R I E.L. EACH ACCIDENT j 2,OOQ000. DO E.L. DISEASE - EA EMPLOYEE',, 2,000,000. 00 E.L. DISEASE - POLICY LIMIT 2,000,000. 00 A A IRental Builder's Risk/installation/Contract Works Equipment/Contractor' s Equipment nk 1Tr I IOC OC & OCW 91128600 OCW 91128600 W 1151112011 5/ V2010 I5/112011 5/1/ 2010 I5/ 1/2011 51112011 USD $ 1,000,000.00 perjobsiie USD $ 1, 000,000.00 perjobsiie conveyance DESCRIPTION OF OPERATIONS ( LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Please refer to attached ACORD 101 for further remarks. CERTIFICATE HOLDER CANCELLATION City of Sanford 300 N Park Ave Sanford, FL 32771 United States SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE MARSH USA INC, BY: Franklin H. 11—k, Global Marine 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD Generated b-V EXIGIS LLC. 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