HomeMy WebLinkAbout115 Lakeside Cir7CEIVEDJA272011BCITYOFSANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: ,,- 0. 1.1 Documented Construction Value: $_ Zf . G U
Job Address: I I L-0, 6,iY'• Historic District: Yes No
Parcel ID: (_ 7.0 -76 - 7)66 `G0UG- 05 Z6 Zoning:
Description of Work:
Plan Review Contact Person: ,t J1n b2 r b a r Title:
Phone: 40- 7 17 -l?(jLf Fax: +0- 71 Z• 1$ I b E-mail: f 7-'S'
Property Owner Information
Name (41V(A Phone:
Street: I r, e'A Resident of property?
City, State Zip: n rY I 3 Z77 3P
Contractor Information // //
Name / s f I Phone: ` 61-71 2-1 -7CJL4
Street: /' I br) c 1twG f,( VG Cn,-0- U Fax: 4. (j7 _`71 7-
City, State Zip: Od M _,3 ZS-0(42 State License No.:
Architect/Engineer Information
Name: Phone:
Street:
City, St, Zip:
Bonding Company:
Address:
Fax:
E-mail:
Mortgage Lender:
Address:
PERMIT INFORMATION
Building Permit
4 `'
YIK;
Square Footage: Construction Type:
No. of Dwelling Units: Flood Zone:
Electrical
New Service - No. of AMPS:
Mechanical 0 (Duct layout required for new systems)
Plumbing
No. of Stories:
New Construction - No. of Fixtures:
Fire Sprinkler/Alarm No. of heads:
a,
y..
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 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.
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
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
l'I MMFNTS•
Rev 11.08
Signature ofContracto D to
r
PritContractor/A ent's
NamjAAA401ek1lIla"Xk4k 1/ZZ f l
dig shire of Notary -State of F V(dA- I Date
YF ;; .:' l;As IT FIA L FURBOTER
MY COMMISSION # DD865138
EXPIRES March 01, 2013
Contractor/Agent is V Personally Known to Me or
Produced ID Type of ID
UTILITIES: WASTE WATER:
FIRE: BUILDING:
POWER OF ATTORNEY
Date:
I hereby name and appoint al-rl `Tr c •
l
of ADT Security Services to drop off and pick up permits at the
J.
r Building Department on my behalf for
a LOW VOLTAGE SECURITY permit for work to be performed at a location described as:
Parcel ZU^
Z)
0'(C>C(--6j,
Subdivision (—),'(,(d
Address of job
Owner 1-', V
George Manginelli EF0001121
Type or Print Name of Certified Contractor
r
Signature of Cei i ied ctor
The foreaoing instrumeiv was acknowledcr j before me this
by
who is personall nown tome/ io produced _
as identi ication an w o did not take oath.
State of Floi I
Cg.ty of r'\y/1M I /1 (1I f,
lyry Public, Seminole Cotidi&/, Plorida
SAMANTHA L FURBOT
MY COMMISSION # DD865138
EXPIRES March 01, 2013139"153
FloNdeNotp rySemic e.com
day of 20([
M.71 RESIDENTIAL SERVICES CONTRACT
CONTRACT DATE:
I _
TOWN NO: 4 191 CUSTOMER NO: JOB NO: LEAD SOURCE:
i CusN ADTSecurityServices, Inc. (ADT) E ("You" tomer
or "
Yoame ur")
AC
jc LYE (.vAC-"? DY VA4e1 We" or "Us"
or "Our") Offic,5 Address 3 6J s
L4fNh4 IL Go., . mac iAddresQs / LAKES 0 t:(+ !city
An. 0,2 'Affinity Name & No. I State /Zip
F
C_ 7 73 Tax Exempt No. i Protected Premises'
Telephone
f Tax Expire. Date Traditional Phone Other (
Qualified) Other (Non -Qualified) Tel: 1-800-
ADT-ASAP 1-800-238-2727 I Alternate Telephone 1 L% .7 $Ll S// i Circle one) Home Work w/ ext. IF FAMILIARIZATIO ER
I I Alternate Telephone 2 7 3 /fie. (Circle one) Home Work w/ ext. REJECTED INITIAL ERELAiLe12:2aiU J Communications Authorizat n:
You hereby authorize ADT to furnish information and/or updates regarding your security system and new ADT and/or third party products
and se ices available to ADT customers to the contact information provided by you. You may unsubscribe or opt -out by emailing donotco_ntactQ_adt.co_m or by calling 888__DNC4ADT (888-362-4238)_ initial here :_ "wow=' Con"firmation of
Appointments: You hereby expressly authorize ADT to call you using an automated calling device to deliver a prerecorded message to set/confirm aservice/installation appointment_at the_ , lephone numbers) shown above. Initial here R _ E System Ownership M
Customer -Owned ADT-Owned VfStandard Monthly Service,
Burglary jMonthly Service Charges Mu icipal Construction Permit Fee Service includes: Customer
Monitoring Center Signal Receiving and Lustomer to obtain construction ermit mm Notification Service
for
Burglary, Manual Fire, and Manual Police Emergency j N t/ i Other Standard Monthly Service,
Fire/Smoke Detection ! i Installation Price i % Service includes: Customer
Monitoring Center Signal Receiving and !---------------------------------------------- --- -------------- ------ Notification Service for
Fire, Manual Fire, and Manual Police Emergency v — - > Taxable Amount Carbon
Monoxide Flood
Low Temp Non -Taxable Amount — Medical Alert Connection
Fee Safewatch Cellguard® (/li
ti Sales Tax on Installation' - SecurityLink®- - Total Installation
Charge* ! / - r ---- -- - F--- - -- - - Extended
Limited Warranty/
Quality Service Plan (QSP) , N l/ ' Deposit Received i f_ Guard Response
Service - - ------ J Balance Due
upon Installation g Monthly Recurring MunicipalFee (Subject to change based on local law) __ Customer to obtain
and pay for municipal alarm use permit "If applicable sales tax not shown, it will be added to your first invoice. Other Total Monthly
Service
C_harqe-- Initial/Annual 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 i 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/ police res onse
to an alarm from our remises and/or a fine. I Estimated Completion Date P - - — -- --y ' - - - --------i------- --- -- -- p YOU ACKNOWLEDGE AND
ADMIT THAT: (1) WE HAVE EXPLAINED TO YOU THE FULL RANGE OF EQUIPMENT AND SERVICES AVAILABLE TO YOU; (2) ADDITIONAL EQUIPMENT ANDSERVICESOVERTHATDESCRIBEDHEREINAREAVAILABLEANDMAYBEOBTAINEDFROMUSATANADDITIONALCOSTTOYOU; (3)
YOU HAVE CHOSEN AND HAVE CONTRACTED FOR ONLY THE EQUIPMENT AND THE SERVICES DESCRIBED IN THIS CONTRACT, (4) THE INITIAL TERM OF THISCONTRACTISFORTHREE (3) YEARS; AND (5) YOU SHOULD MANUALLY TEST YOUR SYSTEM MONTHLY WITH ADT AS WELL AS UPON ANY CHANGE TOTHETELEPHONESERVICEINYOURPREMISESTOCONFIRMPROPERTELEPHONELINESEIZUREANDTHATSIGNALTRANSMISSIONISFUNCTIONINGPROPERLYBYCALLINGADTAT1-800-ADT-ASAP (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 IMPORTANTTERMSANDCONDITIONSFORTHISCONTRACT. 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 OFLOSS; HUMAN ERROR IS ALWAYS POSSIBLE; WE MAY NOT RECEIVE ALARM SIGNALS IF THE TELEPHONE LINE OR OTHER ALARM TRANSMISSION SYSTEM-IS-CUT,--INTERFEREDWITH, OR OTHERWISE DAMAGED OR_I_F_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 WILLBETERMINATEDANDADT'S ONLY OBLIGATION TO YOU WILL BE TO NOTIFY YOU OF SUCH TERMINATION AND REFUND ANY AMOUNTS PAID IN ADVANCE. SECOND AND THIR Re .
ID No,AND
A CONDITIONS Te .: -- --- - - -- ---- - - ------ - - -
3. Rep. License
No. (
If
Required): .Or _ ----- ___- __ -__ ina ignature Required i NOTICE OF CANCELLATION
YOU,
THE CUSTOMER, MAY
CANCEL THIS TRANSACTION AT ANY TIME PRIOR BUSINESS DAY AFTER THE
DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF EXPLANATION OF THIS RIGHT.
TO MIDNIGHT OF THE
THIRD CANCELLATION FORM FOR AN
1 of 6 Office
Copy 02010 ADT Security Services, Inc. (08/10)
cosz CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDD/YYYY)
11/912010 v 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 Marsh, Inc.
NAME:
PHONE I
FAX
AC No E
212) 345-000 (AlC,No): L ADDRESS: 1166
Avenue
of
the Americas New York, NY
10036 PRODUCER CUSTOMER ID INSURERS
AFFORDING COVERAGE
NAIC INSURED INSURER. A:
AGCS Marine Insurance Company (Allianz) I I ADT SecurityServices,
Inc. 3160 Southgate Commerce
Blvd Ste 38 INSURER
B: CHARTIS
CASUALTY COMPANY INSURER C: Commerce &
Industry Ins Co. INSURER. D: Illinois
National Insurance Co. Orlando , FL 32806
INSURER E: Nat'l Union Fire Ins Co. of Pittsburgh, PA United States INSURER
F: New Hampshire Ins. Co. i C TICIP`ATC \
II IMBGO- S V fxllti - a KPV111 UIV IYUMMIMM vTHIS 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. INSR I LTRPOLICY
TYPE OFINSURANCEADDLISUBRiPOLICYEFF
NUMBER MWDD/YYYY
POLICY EXP MMlDD/
YY i
LIMITS F
GENERAL
LIABILITY
i y` I COMMERCIAL
GENERAL LIABILITY GL 4360884 (Primary
GL) 10/1/201C 10/1/2011 EACH OCCURRENCE I $1,000,000.00 DAMAGE TO RENTED
PREMISES (Ea occurrence)
I W1,0007000.00 MED EXP (Any
one person) 10,000.00 11 CLAIMS -MADEIOCCURIPERSONAL & ADV INJURY
i1,000,000.00 OWNER'S &CONTRACTOR'
S j j 1
I j GENERAL
AGGREGATE 2,000,000.00 c GEN'L
AGGREGATELIMIT APPLIES PER: PRODUCTS - COMP/OP AGG I $2,000.000.00 Y j POLICY,,
I PRC' I i LOC I E E E
F
I
AUTOMOBILE
r—
LIABILITY ANY
AUTO
ALL
OWNED AUTOS
j I CA
3976576 (
VA)
10/1/2010 CA 3976575 (AOS)
10/1/2010 CA 3976577 (MA)
10/112010 CA 3976624 (NH) (
Primary AL) 10/1/2010 10/1/2011
10/1/2011
10/1/2011
10/1,2011
COMBINED SINGLE LIMIT
Each accident] i,
000,000.
OD 1 BODILY INJURY (
Per person) BODILY INJURY (Per
accident), I SCHEDULED AUTOS
I PROPERTY DAMAGE X HIRED AUTOS
j Per accident) I X I
NON -OWNED AUTOS NEW HAMPSHIRE (CSL) 25D,DDD JI UMBRELLA LIAB
EXCESS
LIAR 7
OCCUR CLAIMS -
MADE
I
I EACH
OCCURRENCE
AGGREGATE
DEDUCTIBLE RETENTION
S
PRODUCTS -
COMP/OP
AGG I i II
I NEW HAMPSHIRE (CSL)
B C D
E
F
WORKERS
COMPENSATION
AND
EMPLOYERS' LIABILITY
Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED?
Mandatory in NH)
If yes, describe
under DESCRIPTION OF OPERATIONS
below N / A I
0 614
51 (
l. A, ) 110/1/2010 WC 026149514 (FL)
110/1/2010 WC 026149516 (MI)
110/1/2010 WC 026149513 (CA)
1 10/1/2010 WC 026149518 (MA,
ND, NY, OH, 110/1/2010 WA, WI, WY)
10/1/2011
10/1/2011
10/1/2011
10/1/2011
10/1/2011
IX TNCY L
M T 'OTH-I ER E.L. EACH
ACCIDENT 2,000,000.00 I E.L.
DISEASE - EA EMPLOYEE 52,000,000-00 E.L. DISEASE -
POLICY LIMIT 2,000,000-00 A A Builder'
s
Risk/
installation/Contract Works Rental Equipment/Contracior'
s Equipment I Blanket Transit
OC & OCW 91128600
5/1/2010 OC & OCW 91128600
5/1/2010 I OC & OCW
91128600 511/20101 5/1/2011
5/1/2011
1 U$1,
000,
000.00 per jobsite USSID D $1,000,000.00 Der jobsite 1.00 .000,
00De,conveyance DESCRIPTION OF OPERATIONS /
LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Please refer to
attached ACORD 101 for further remarks. ro TlclrnTc ur11
ncQ CANCFI I ATIr)N SHOULD ANY OF
THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Sanford
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 300 N Park
Ave ACCORDANCE WITH THE POLICY PROVISIONS. Sanford, FL 32771
AUTHORIZED REPRESENTATIVE United
States MARSHUS.4
1NC. BY: Franklin Hallock, GImM M.— David Kono, Casualty
Pr ram i P V 1yK8-LUuy
AI uml.) I.VRr Vt[HIIVfY. All 1`19rIC5 reserveu. ACORD 25 (2009/
09) The ACORD name and logo are registered marks of ACORD Generated by EX_
IGIS LLC. For more information crisit www-.exigis.com.
Seaninole County Property Appraiser Get Information by Parcel Number Page l of 1
rg1 R pp1r®®yTam,/
a-YYZZ i''ppVY-Lit.`iC'a®®.
BE#71NOLE t:OUNTY,,FL.-
40
t,s-, E4. ..y"
titJtFrwsr. t1s.
k a t
BAN
FORQ FL 3277t-1468 4f77
66i5; 7508 4: J VALUE
SUMMARY VALUES
2011
2010 Working
Certified GENERAL
Value Method CosUMarket CosUMarket Parcel
Id: 11-20-30-5KB-0000-0520 Number of Buildings 1 1 Owner:
ALVAREZ FREDDIE & JACQUELINE Depreciated Bldg Value 83,543 88,506 Mailing
Address: 115 LAKESIDE CIR Depreciated EXFT Value 638 675 City,
State,ZipCode: SANFORD FL 32773 Land
Value (Market) 18,000 18,000 Property
Address: 115 LAKESIDE CIR SANFORD 32773 Land
Value Ag 0 0 Subdivision
Name: HIDDEN LAKE PH 3 UNIT 7 Just/
Market Value 102,181 107,181 Tax
District: S1-SANFORD Portablity
Adj 0 0 Exemptions:
00-HOMESTEAD (2004) Save
Our Homes Adj 0 0 Dor: 01-SINGLE FAMILY Amendment
1 Adj 0 0 Assessed
Value (SOH) 1 102,1811 107,181 Tax
Estimator 2011
TAXABLE VALUE WORKING ESTIMATE Taxing
Authority Assessment Value Exempt Values Taxable Value County
General Fund 102,181 50,000 52,181 Amendment
1 adjustment is not applicable to school assessment) Schools 102,181 25,000 77,181 City
Sanford 102,181 50,000 52,181 SJWM(
Saint Johns Water Management) 102,181 50,000 52,181 County
Bonds 102,181 50,0001 52,181 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 CORRECTIVE
DEED 01/2005 05592 0453 $100 Improved No 2010
VALUE SUMMARY WARRANTY
DEED 09/2003 05018 0195 $123,000 Improved Yes FINAL
JUDGEMENT 03/1998 03386 0370 $100 Improved No 2010
Tax Bill Amount: $1,344 WARRANTY
DEED 08/1995 02955 1693 $77,000 Improved Yes Taxable
2010CertifiedTaxableValue and Taxes WARRANTY
DEED 04/1989 02063 1570 $77,800 Improved Yes DOES
NOT INCLUDE NON -AD VALOREM ASSESSMENTS WARRANTY
DEED 05/1988 01957 1003 $212,600 Vacant No Find
Comparable Sales within this Subdivision LAND
LEGAL DESCRIPTION Land
Assess Method Frontage Depth Land Units Unit Price Land Value PLATS. Pick ..: LOT
0 0 1.000 18,obo.00 $18,000 LEG LOT 52 HIDDEN LAKE PH 3 UNIT 7 PB 38 PGS 79 & 80 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 1988 6 1,533 2,130 1,533 SIDING AVG $83,543 $91,806 SketchAppendage /
Scift SCREEN PORCH FINISHED / 182 Appendage /
Sgft GARAGE FINISHED / 400 Appendage /
Sgft OPEN PORCH FINISHED / 15 NOTE:
Appendage Codes included in Living Area: Base, Upper Story Base, Upper Story Finished, Apartment, Enclosed Porch Finished,Base Semi
Finshed EXTRA
FEATURE Description
Year Bit Units EXFT Value Est. Cost New FIREPLACE
1988 1 $638 $1,500 NOTE:
Assessed values shown are NOT certified values and therefore are subject to change before being finalized for ad valorem tax purposes. ifyou
recently purchased a homesteaded property your next ear's property tax will be based on Just/Market value. http://www.
scpafl.org/web/re_web.seminole_county_title?parcel=l 120305KB00000520&... 1 /27/2011