HomeMy WebLinkAbout333 Springview DrVlj' CITY OF SANFORD
BUILDING & FIRE PREVENTION
UG 112015 PERMIT APPLICATION
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BY. Application No: C)15 410
Documented Construction Value: $• -
23
Job Address: `` S`„ iye')c.11'h Historic District: Yes ElNo ElParcelID: - It? "' 2 ^ ' SM- 0000- d 0 V Residential [A Commercial
Type 'of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: o'iwj goof 1 o nLAC1E'4 fy-K
Plan Review Contact Person: Title:
Phone: Fag: Email:
Properly Owner Information
Name ' ,) Ci` `CS Phone: b -a q2%—
Street: uLiL F4 -kIn
City, State Zip:SAAII-Y p FImo, L-113
Resident of property? :
Contractor Information
Name one -.W4) 35'7 3 lJ
Street: Fax:
City, State Zip: ,.n . rL 41;L 3?1 State License No.: (cc,. 6l 14
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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 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 sir conditioners, etc.
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: P Edition (2014) Florida Building Code
4 _
Revised: June 30, 2015 Permit Application
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
inanagemeni districts, state agencies, or federal agencies.
Acceptance of permit is verification that 1 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 submitta€.
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.
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Signature o er/Agent Date i of ntractor/Agent Date
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Nade-45- --voddl ehvma—
Print Owner/Agent's Name Print Contractor/Agent's N
g- -sops
Signature of Not o Flori Date §rgnature of Notary- of Fl,a Date
Owner/Agent is I,- Personally Known to Me or Contractor/Agent is Personally Known to Me or.
ea W Produced ID Type o
ANMHO p: ANTHONY VELEZ
w COMMISSION k FF901259 '': •'= MY COMMISSION k FF901261
EXPIRES July 19. 2019 EXPIRES July 19. 2019
F
LOW IS FOR OFFICE USE -ONLY '
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type: Occupancy Use: Flood Zone:
Total Sq Ft of Bldg: Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING:
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COMMENTS:
Revised: June 30, 2015 Permit Application
J111Y14A
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RESTORATION
FL LIC# CCC1329471
AGREEMENT 56rVice- fl-flafte
888-99-RHYNE[Z0n# 13301.Zcf
4 9 6 3
REP: -
PHONE: s ?
OWNER 'Di. u -.C-66rAore,DATE _
qn- V I ".'n vl i.,.a .a f):.'t'a CLL PHONE
Cry,:;\ I STATE oy..• I ZIP
We hereby submit scope of work for:
E)
EMAILADOREss
o Tear Off ' c b4tm N Jooj d/
o # of Squares Off l
o Recover roof With
o # ofSquares On S r
o Shingle/ Color 4aZ M
o - Protect ProvertvasNeeded Daily
o Decking Type_Lt
o Underlayment D
o Metal Edge Color
o Valley Type
o Hip and Ridge
o Nails CAA. yi
o Pipe Flashings
o Ventilation GG Vew
o Seal around all vents, flashings and pipes
o Furnish all materials, labor and necessary permits
o Delivery instructions
o Year Roofing Workmanship Warranly
WORK PHONE
HOME PHONE
CLEAN ALL GUTTER DEBRIS
HAUL OFF CONSTRUCTION DEBRIS
ROLL MAGNETS THROUGH YARD
LIEN WAIVERS PROVIDED UPON FINAL PAYMENT
MlS aplavde a sot of
Fly 'weval
Qef
Terms: The undersigned (Customer) herby agrees to the proposed
scope of work and the contract price. The company agrees to
famish all materials, labor and necessary permits upon receiving
the deposit which la equal to 40% of the contract price and the
Company also agrees to complete the Agreed Scope of work within
but no later than 7 days ofthe date ofthe signing of this Agreement
Eat
TR:Raplaceme
me the balance of the contract price will be due.
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Roof4iispeilr 3'•Ta Iy
Total s -1 -5 -00.6 -
Accepted
O .°a
Accepted by O By:
Date:
1) FLORIDA CONSTRUCTION LIEN. ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAW (SECTION 713.001-71337, FLORIDA STATUTES), THOSE WHO WORKONYOURPROPERTYORPROVIDEMATERIALSANDARENOTPAID—IN•FiJLL HAVE A RIGHT TO ENW RCETHEiR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. THIS CLAiM B (WDWN AS A CONTRACTOR LIEN. IF YOUR CONTRACTOR OR A SUBCONTRACMR FAILS TO PAY SUBCONTRACTORS, SUB -SUBCONTRACTORS, OR MATERIAL SUPPLIERS OR NEGLECTS TO MAKE OTHER LEGALLY REQUIRED PAYMENTS, THE PEOPLE WHO ARE OWEDTHE MONEY MAY LOOK TO YOUR
PROPERTY FOR PAYMENT, EVEN IF YOU HAVE PAH) YOUR CONTRACTOR IN FIR_ iF YOU FAIL TO PAY YOUR CONTRACTOR, YOUR CONTRACTOR MAYALSO HAVE
A LIEN ON YOUR PROPERTY. THIS MEANS iF A UEIV IS FILED, YOUR PROPERTY COULD BE SOLD AGAINST YOUR WILLTO PAY FOR LABOR, MATERIALS OR OTHER
SEAiTICESTHAT YOUR CONTRACTOR OR SUBCONTRACTOR MAY HAVE FAILED TO PAY.TO PROTECT YOURSELF, YOU SHOULD SRPUtATE IN THIS CONTRACT THAT
BEFORE ANY PAYMENT IS MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN RELEASE OF LIEN FROM ANY PERSON OR COMPANY
THAT HAS PROVIDEDTOYOUA'NOTICETOOWNER.' FLORIDA'S CONSTRUCTION UEN LAWISCOMPLE(ANDISRECOMMENDED THAT WHENEVER ASPECIFICPROBLEMARISES, YOU CONSULTAN ATTORNEY.
2) FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND. PAYMENT MAYBE AVAILABLE FROM THE FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY
FUND IF YOU LOSE MONEY ON PROJECT PERFORMED UNDER CONTRACT, WHERETHE LOSS RESULTS FROM SPECIFIED VIOLATIONS OF FLORDA LAW BY A
LICENSED CONTRACTOR. FOR INFORMATION ABOUT THE RECOVERY FUND AND RUNG A CLAIM, CONTACTTHE FLORIDA CONSTRUCTION INDUSTRY LICENSING
BOARD ATTHE FOLLOWING TELEPHONE NUMBER AND ADDRESS: CILB,1940NORTH MONROEST..,B42,TALLAHASSEE, FL32399.
3) ANY CLAIMS FOR CONSTRUCTION DEFECTS ARE SUBJECrTO THE NOTICE AND CURE PROVISIONS OF CHAPTER 559, FLORIDA STATUTES.
4) BUYERS RIGHT TO CANCEL.• This 6 a home solicitation sale, and if you do not want goods or services, you may cancel this Agreement by
Providing written notice to the seller in person, by telegram, or by mail. This notice must indicate that you do not want the goods or
services and must be delivered or postmarked before midnight on the third business day after you sign this Agreement. If you cancel this
Agreement, the seller may not keep all or part of any cash down payment. By signing this Agreement you agree that you have also been
provided notice of this right to cancel orally in addition to the writing contained herein.
THIS IN T UMENT PR ARE BY:
Name:
Address: '
it
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number:
l if 11l l I I 1 11111111 1141 f l
MARYAN'NE i'IORSE€ SENINOLE C0Uf.-1F,,1
r LERK OF CIRCUIT COURT « COI' PTROLLERR_ 2 525 F's 1054 (1.Pss)
CLERK'S a 2015038133
RECORDED 08/11/2'015 01 --2"?' 13 I T;
RL_COR[ LNG FEES; $1.0.00
RECORDED BY h:jevor•:a
Parcel ID Number: 119 —2. a - -5v - So % - O n 00 - 0 030
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: (Le al description of the proQperty and street address if available)
Lo l Less LY To Fa-, Wit F -D 41T/7
W e_m,R -r- 333 SaR .__._,:R,_, 57,4-+a =,.& r, _ Gj 2 2777
GENERAL DESCRIPTION OF
OWNER INFORMATION:
Name: a_ _ -e,tn 1ri.1' /1?4 lb
Address: 33'3 JP2.•n CsV le_>. `SIC . AaD>!-2, EL " _3277,3
Fee Simple Title Holder (if other than owner)
Address:
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served
as provided b cti n 713.13(1)(b), Flo 'da Statutes.
Name: / J 7(,'!- -
In addition to himself, Owner Designates
Section 713.13(1)(b), Florida Statutes.
of
To receive a copy of the Lienor's 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)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13,
FLORIDA STATUTES, AND CAN 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalt' of perjury, I declare that I have read the foregoing and that the facts stated in it are true
to the bep y kgoyyle¢ggand belief.
Owners Signature Owner's Printed Name
Flkrida'Stalute 713.13(1)(9): "The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead'
State of
AtOylac\,
County of
The foregoing instrument was acknowledged before me this
t Q qday of , 20
by bw0-A SLCKLJV.rs Who is personally known to me
Name of person making statement
OR who has produced identification type of identification produced:
of FCA
Kriric-COPY-MARYANNEMORSE i
KRISTELS WALKER
CLER O THEClo'UITCOURTAND
x iq
MY COMMISSION #FF016969 s'• t ct
y. Notap!Sig atufeLLEF rr y•;!r o
FOFM1OP ' EXPIRES May 13. 2017 s;1+ct SEMI! OLE CO N' Y, FLORIDA
07) 398.0153 Florid9Notary$ervige,corn _ 1r + — r1 U 1019 DEPUTY CLERK
UP a BY
City of Sanford
Roof Permit Application Checklist
All permit application packages must be complete prior to acceptance. You must check each box to the
left o indicate n/a on this submittal. A complete application package shall include the following:
Building Permit Application completed, signed and notarized. Application must include correct address
and complete parcel I.D. number.
fid' Copy of applicable contractor's license issued by the State of Florida (if the contractor is the
applicant).
A site specific notarized power of attorney shall be required from the licensed contractor if
he/she appoints an employee of his/her company to sign the permit application as the contractor.
7 Certificate of insurance indicating worker's compensation insurance coverage and naming the City of
Sanford as certificate holder, or a copy of a worker's compensation exemption issued by the State of
Florida (must be submitted with each application if contractor is the applicant).
Completed and signed Owner Builder Statement / Affidavit (if the owner is the applicant).
These guidelines were compiled to assist the applicant in preparing a roof permit application and may not be
complete. The applicant is required to meet all City of Sanford, state, and federal code requirements.
CITY'OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: 0-S 6`0
I, 'plhereby acknowledge that I personally inspected
81froof deck nailing and/or D Secondary water barrier work
at ) J
Job Site
and have determined that the work-
was
ork
vas done according to the Hurricane Mitigation Retrofit Manual- (based on 553.844 F.S.)
1
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I certify that my statements herein are true and accurate to the best of my belief and that I fully
understand that malting any false statements in writing with the intent to mislead a public servant in the
performance of his or her official duty shall constitute a misdemeanor of the second degree pursuant to
Section 8i*6 F.S.
of Contractor Date
cc-(, i 3a9 4 71
Printed Name of Con ctor License # '
License Type: J General J Building U Residential W Roofing Contractor
F1 or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF Ole -
Sworn to or affirmed) and subscribed before me Ois_ _ day of AU -20 1-5 by
rp who is ersonally Known tom or has U Produced (type of
identification) as identification.
SEAL)
Signature of Notary Public
State of Florida
MY
14NY VE LEZ
COMMISSION k FF9p12N
Print/Type/S amp Name 153 EXPIRES July 19.2019
of Notary Public
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