HomeMy WebLinkAbout204 Friesian WayC,
RECEIVED
MAY 16 2011 .D CITY OF SANFORD
BUILDING & FIRE PREVENTION
BY PERMIT APPLICATION
Application No: —) 4 9 I Documented Construction Value: $ 6o
Job Address: ?—Oq Fin i' FS ('aln Historic District: Yes NAEO '
Parcel ID:C 60- D-70 Zoning:
Description of Work:
Plan Review Contact Person: Q Aenlj XL CAT,f Title: MI
Phone: Fax: I % _ -L; E-mail: gj u rix G
Property Owner Information
Name F_ A I f VA /
1
Phone:
Street: 77 -2 M PYl1 %' a 6A AA Cj ' . S Resident of property?: 00
City, State Zip: F I P&S G .TX 7 qc,
Contractor Information
Name 9-i'%P.C Phone:
Street: 6 1(420 S(A," vyl!E A&i, 81( Fax:
City, State Zip: (
7)(-1 ct'rj a , 1Z, 'aj?g State License No.: Mo(jt( Z
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Building Permit IlT"*
Square Footage:
Architect/Engineer Information
Phone:
Fax:
E-mail: _
Mortgage Lender:
Address:
PERMIT INFORMATION
r
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:
4
Applicatic
work or ii
meet stani
must be s
air condil
is hereby made to obtain a permit to do the work and installations as indicated. I certify that no
allation has commenced prior to the issuance of a permit and that all work will be performed to
ds of all laws regulating construction in this jurisdiction. I understand that a separate permit
ured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and
lers, 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 JIN 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 IOR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTICE: n 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 o 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 01er/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:
Rev 11.08
UTILITIES:
FIRE:
Sign' re of C Date
f_0y7CkC_MCkr1A 1n
Z
Contra'o r/Agent's Name
13 11
i ature of Notary -State of FI Date
SAMANTHA L FURBOTER
My COMMISSION'# DDMI39
EXPIRES March 01, 2013
4'tR7 t
Contractor gen t na y own to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
POWER OF ATTORNEY
Date: i3
I hereby name and appoint I'1 h rGlit/1
of ADT Security Services to drop off and pick up permits at the
Building Department on my behalf for
a LOW VOLTAGE SECURITY permit for work to be performed at a location described as:
Parcel i —Zo --) 1.,5C6-6 666— 67 6 U
Subdivision
Address of job J
Owner
The fo:
by
who is
asi en
State o
U
George Manginelli EF0001121
Type or Print Name of Certified Contractor
s'
Signature o Certified Contractor
was acknowled&ed before me this )3 day of 20
to me/wlio produced
did not take oath.
of
Public, Seminole Cfeainty, Florida
SA AA9 "A L URBOTLIR
E4'y COMMISSION'# bOM139
EXPIRES March 01, 2013y96O1G3F
k,o t
A
RESIDENTIAL SERVICES CONTRACT (ACTIVATICIF) III I I IIIIIII I I IIIIIIIIiIIII 111IIlUl
r 524OUE03
CONTRACT DATE: l 1. 1 9. TOWN NQ; (i.. [USTO I I'd 1trR nln• Lsna cauaCr,
Aril aewnxv Services_ Inc. 1ADT)
We•' Qr -Un- v, -Our') Orrice AMI-P55
Te-1:-1-100-AD ;ASAP}
1-800-238-2 27
IFAMICIARIZATION PER 1 ROEC:
TED'INITI,AL HERE • Nb
WIIICI rvame )yy)
t !
11 /r H\
I vu, vI `•I uur r 1 ' d i.: '\, : •.1 "7i I\, /•f ( I.. ' .+ 4ddress
G L "rl r : J _y l' ;1 .,_. LA,•. " Ity `
vi, ,l , -
f Affiniiy
Name & No. Mate /
Zip' . Tax Exempt No. rbtettAd•
Premises' Telephone —,,Ul., jr 3 - (I , Tax Expire: Date Traditional
Phone Other (Qualifies) 1:1 Other (Non -Qualified) k1ternate
Telephone 1 , / 1i2 - ' (!'fir (Circl'e one) Home / ell brk wi/ qt. Alternate
Telephone 2 EMAIL
r_
uu may unsuosaloe or •gGt 1nrl7P
ADT to rall ynu using an uual
Inge Circle
one) Home / Cell / Work w/ exir IiU
2131i%itoiit [a tt"mmi,i u mi aoiYu`rvi " ' '"z `
i ': _„'-`.". l__ _ ...
µu1 Clio+:=ao auLnrtiai Here__..—_ . eteA
ee1Hnry rim ira !n rleinrgr q Frargcordod n1eCCgtlo }o ectlrnn i.n+ n nrr,I"Rn leUntn,,. MUnirlpal
Censtruction Permit flee , , -A
Customer
io• obtain cdnstructibn permit LJ
MIMI_ - Installation
P-ice y7axable
An ount —f'- f, ---
Non-Taxab a Amount ------ i'
Cbnnettion r-e Sales
Tax oh 'istallation* Total
Installa:ion Charge ' -"+ u, r
Deposit
Rece ved' p •,! •1;y v,.; J.J Balance
Due .rpon Installation* IJ r7thP.
r e • / xIT
appucaoiE sales cax not snows; it will be added to your TirSt involce. TotalMolnthtyServiceCharge a `_ ii:
itial/Annual Recurring Municipal Fee -billed separately Initial/ - Subject
to change based on coal law) Annual Fee Estimated
S' art Date LlCustomertoobtainandpayforinidaUarihualmunicipalalarm.use _t .... I;
ermlt. Your failure to obtain and provide ADT with your municipal alarm
use permit registration number could result in no munldpal fire/ yy(_
I)
olitQQe[[r e(s poyynse t cra((n alarrm i(
fr
oAmy(ourpre{minses (and/or as fiHnee../F ETsWti
m a Jtet
dC
ytmpll etiFon Daajt e(J
Hb1
111VIVHL DTYIVIK I 114t/ ?FIiV`.TIJV KIt`IHI 17CaG\1CKL'PrV HPf K4?TILFTt GY:•7i" It7TnnrTi BQi'JSbI/+rhr ll YI(VIGI+(i7 Hla/4L I IC71V7iL 3i 1 YOIU; (
3) YOU HAVE CHOSEN AND HAVE CONTRACTED FOR ONLY THE EQUIPMENT AND T1E SERVICES DESCRIBED IN THIS CONTRACT; (4) THE SYSTEM IS
AtDT-OWNED FOR ADT INSTALLED EQUIPMENT" AND/OR ADT CONNECTION TO THE PREMOUSLY INSTALLED EXISTING ALARM SYSTEM; (5) THE INITIAL TERM
OF THIS CONTRACT IS FOR THREE (3) YEARS; AND (6) YOU SHOUW MANUALLY TEST YOUR SYSTEM MONTHLY WITH ADT AS WELL. AS UPON AW
CHANGE TO THE TELEPHONE SERVICE IN YOUR PREMISES TO 'CONFIRM PROPER TEL :PHONE LINE SEIZURt AND THAT SIGNAL TRANSMISSION IS FUMCTIONING
PROPERLY BY CALLING APT AT 1-800-ADT-ASAP (AND FOLLOW THE PROMPT:). WE ARE NOT A SECURITY CONSULTANT. YOI11
ACKNOWLEDGE AND ADMIT THAT BEFORE SIGNING YOU HAVE READ THE FRONT ANP BACK OF THIS PAGE IN ADDITION TO THE ATTACHED PAGES VVMI%
jl CONTAIN IMPORTANT T 1`05 AND CONDITIONS rOR TH13 CONTRACT, YOU 3TM•C'n SAT YOU VNDCRSTAND ALL TI IL TCRM2 AND CONDMONi Or 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 GWP
RANTEEPREVENTION OF LOSS; HUMAN ERROR IS ALWAYS POSSIBLE; WE MAY NOT RECEIVE ALARM SIGNALS IF THE TELEPHONE LINE OR OTHER ALARM THI
i CONTRACT REQUIRES FINAL APPROVAL OF AN APT AUTHORIZED MANAGER BEFORE A NY EQUIPMWUSERVICES MAY BE PROVIDED, IV APPROVAL IS DEMIED,
THIS CONTRACT WILL 13E TERMINATED AND ADT'S ONLY OBLIGATION TO YOU WIU- :1E TO NOTIFY YOU OF SUCH TERMINATION AND REFUND ANY AMOUNTS
PAID IN ADVANCE. SECOND
AND THIRD PAGES ACCOMPANY THIS PAGE WITH.ADD•TIONAL TERMS AND CONDITIONS includes:
Customer Monitor" Center 5 lion
Service for Burglary', Manual Fire, a ndard
Monthly Serv;gvj Firs indudes:
Customer Monitoring Center tioti :
guise for Flre, Manual Fire, and oh
Monoxide 0 Flood Le local
Alert 81I/ $
eltnce Inq
and 10
c_eEmergency _ 1 _ r c•.r DELac:
Y,ii'sn lying
and. lee
Emer en _ r
Limited
Warrant / uality service Plan (QSP) xmthly
Recurring Municipal Fee (Subject to change based on local law) Customer
to obtain and pay for municipal alarm use permit ' ADTqRep.:
R
I5ep-_'
Rep:
License No. (If Required): APPROVAL:
D 1TE: r
Seminole County Property Appraiser Get Information by Parcel Number Page I of I
I
PARCEL DETAIL
D"10 JOHNSON. CFA, ASA
PROPERTY
TR.-4TA BELGIAN WAY
I
13 12 11 Im
71 101 1W ' 93 V., 5"
APPRAISER 9
710W7011 173 1
4
14 SEMINOLE
COUNTY FL- L 1101
E. RRST ST SANFcmD :
3 FL277t-i4w e
FIRES [AN WAY TR
G 407.
665-7508 ea I
F VALUE
SUMMARY VALUES
2011
2010 Workinq
Certified GENERAL
Value Method Cost/Market Cost/Market Parcel
Id: 18-20-31-505-0000-0700 Number of Buildings 1 1 Owner:
NGUYEN DUKE P Depreciated Bldg Value 88,031 96,348 Mailing
Address: 12220 PELLICANO DR APT 1802 Depreciated EXFT Value 0 o CIty,
State,ZIpCode: EL PASO TX 79936 Land Value (Market) 24,000 24,000 Property
Address: 204 FRIESIAN WAY SANFORD 32773 Land
Value Ag 0 0 Subdivision
Name: BAKERS CROSSING PH 1 4ugjthlMarket-)
Lalue 112.031 120,348 Tax
District: Sl-SANFORD Portablity
Adj 0 0 Exemptions:
Save
Our Homes Adj 0 0 Dor:
01-SINGLE FAMILY Amendment
1 Adj 0 0 Assessed
Value (SOH) 112,0311 120,348 Tax
Estimator 2011
TAXABLE VALUE WORKING ESTIMATE Taxing
Authority Assessment Value Exempt Values Taxable Value County
General Fund 112,031 0 112,031 Amendment
I adjustment Is not applicable to school assessment) Schools 112,031 0 112,031 City
Sanford 112,031 0 112,031 SJWM(
Saint Johns Water Management) 112,031 0 112,031 County
Bonds! 112,0311 01 112,031J 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 WARRANTY
DEED 11/2005 06025 1271 $269,000 Improved Yes 20
J_Q Tax Bill Amount: 1.608 WARRANTY
DEED 08/2004 05438 1357 $182,000 Improved Yes 2010
Certified Taxable Value and Taxes WARRANTY
DEED 05/2002 04431 003a $132,800 Improved Yes DOES
NOT INCLUDE NON -AD VALOREM ASSESSMENTS WARRANTY
DEED 02/2002 04327 0084 $375,000 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 24,000.00 $24,000 LOT 70 BAKERS CROSSING PH 1 PB 60 PGS 27 - 29 BUILDING
INFORMATION Bid
Num Bid Type Year Bit Fixtures Base SF Gross SF Living SF Ext Wall Bid Value Est.
Cost New
BuildinSketg
1 SINGLE FAMILY 2002 8 1,725 2,196 ch 1,
725
CB/STUCCO FINISH $88.031 91,461 Appendage / Sqft
OPEN PORCH FINISHED / 12 Appendage I
Sqft GARAGE FINISHED/ 459 NOTE; Appendage
Codes included in Living Area: Base, Upper Story Base, Upper Story Finished, Apartment, Enclosed Porch Finished.Base Semi Finshed
Permits 1NOTE:
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 year's property tax will be based on Just/Market value. http://www.
scpafl.org/web/re—web.seminole—County_title?parcel=l 8203150500000700&c... 5/12/2011
A " CERTIFICATE OF LIABILITY INSURANCE DATE119/20rrYYY) 11/912010
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.
1166 Avenue of the Americas
New York, NY 10036
GUNIALANAME:
PA CONNe Ext ; 2 ac No):
L
ADDRESS:
PRODUCER
CUSTOMER D
INSURERS AFFORDING COVERAGE NAIC $
INSURED INSURER A: AGCS Marine Insurance Company (Allianz)
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
United States INSURER F: New Hampshire Ins. Co.
COVERAGES CERTIFICATE NUMBER: 827805 -A REVISION NUMBER:
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.
INSR
LTRWvnTYPEOFINSURANCE
ADDL SUER
POLICY NUMBER
POLICY EFF POLICYMMUD EXP LIMITS
F GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE F OCCUR
OWNER'S & CONTRACTOR'S
GL 4360884 (Primary GL) 10/1/2010 10/1/2011 EACH OCCURRENCE 1.000,000.00
DO TRENTED
PREMISES Ea occurrence 1,000,000.00
MED EXP (Any one person) 10,000.00
PERSONAL & ADV INJURY 1,000,000.00
GENERAL AGGREGATE Z000,000.00
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY JFCTPRO- LOC
PRODUCTS - COMP/OP AGG 2,000,000.00
E
E
E
F
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
CA3976576 (VA)
CA 3976575 (AOS)
CA 3976577 (MA)
CA 3976624 (NH) (Primary AL)
10/1/2010
10/1/2010
10/1/2010
10/1/2010
10/1/2011
10/1/2011
10/1/2011
10/1/2011
COMBINED SINGLE LIMIT
Each accident
1,000,000.00
X
BODILY INJURY (Per person)
BODILY INJURY (Per accident
PROPERTY DAMAGE
Per accident) X
X NEW HAMPSHIRE (CSL) 250,000
UMBRELLA LIAR
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
AGGREGATE
DEDUCTIBLE
RETENTION $
PRODUCTS - COMP/OP AGG
NEW HAMPSHIRE (CSL)
B
C
D
E
F
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE
O a CERIMEMBERdatorynNH)
EXCLUDED?
If yes. describe under
DESCRIPTION OF OPERATIONS below
NIA
WC 02614951710/1/2010
WC 026149514 (FL)
WC 026149516 (MI)
WC 026149513 (CA)
WC 026149518 (MA, NO, NY, OH,
WA, WI WY)
10/1/2010
10/1/2010
10/1/2010
10/1/2010
10/1/2011
10/1/2011
10/1/2011
10/1/2011
10/1/2011
X WCSTATU- I OTH-
E.L. EACH ACCIDENT 2,000,000.00
E.L.DISEASE- EA EMPLOYEE 2,000,000.00
E.L. DISEASE - POLICY LIMIT Z000,000.00
A
A
Builder's Risk/installation/Contract Works
Rental Equipment/Contractor's Equipment
Blanket Transit I I
OC & OCW 91128600
OC & OCW 91128600IOC & OCW 911286DO
5/1/2010
5/1/2010
5/1/2011
5/1/2011
USD $1,000,000.00 per jobsite
USD $1,000,000.00 per jobsite
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
Please refer to attached ACORD 101 for further remarks.
ltl a: 110leftll_3iLaJ aJ a:I
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.
AUTHORIZEDREPRESENTATIVE i
t 1 MARSH
USA INC. BY: Fmnkr. Haliodc, Gbbe1 Marine 1988-
2009 ACORD CORPORATION. All rights reserved. ACORD
25 (2009/09) The ACORD name and logo are registered marks of ACORD Generated
by EXIGIS LLC. For more information visit www.exigiB.COM.