HomeMy WebLinkAbout174 Brushcreek DrApplication No: _ V7 1
cl1/(J
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Documented Construction Value: $ 10790.59
Job Address: 174_ arushrrAAk Dr Historic District: Yes No
Parcel ID: 33-1"0-514-0000-0310 Zoning:
Description of Work: RE -Roof
Plan Review Contact Person: Dehra Dean Title: Qtjaiofipr
Phone: _4o7_330-7665 Fax: 407-33t}_7661 E-mail: cirfeanaZpmgljardraqtoration.rnm
Property Owner Information
Name
Street:
City, State Zip: Ranfnrd Ft 39771
Phone:
Resident of property? :
Contractor Information
Name 2=11ard Restnmflnn Phone: 407-330-2663
Street: _199.-9n ra_n.}ral park Dr Fax: An-7 4Qrt -7QCA
City, State Zip: sanford. FL 39771 State License No.:
Name:
Street:
City, St, Zip:
Bonding Company: _
Address:
Building Permit 03
Square Footage:
No. of Dwelling Units:
Electrical
Architect(Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type. C No. of Stories: 1
Flood Zone:
New Service — No. of AMPS:
Mechanical (Duct layout required for new systems)
Plumbing
New Construction - No. of Fixtures:
Fire Sprinkler/Alarm No. of heads:
Shall be inscribed with the date ofapplication and the code in effect as of that date (Code 2010 FBC) 731.135(5)(6) Florida Statutes. REV 07.14
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, beaters, 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 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:
UTILITIES:
FIRE:
16,
Signature of Contractor/Agent Date
1 i- .4 -a f
Print CooftSiiIWA266`0 Name
CINDY A. DUNN
Notary Public - Stale of FloridaMYComm. Expires Apr 22. 2018Commission # FF 1152P'1
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
Shall be inscribed with the date of application and the code in effect as of that date (Code 2010 FBC) 731.135(5)(6) Florida Statutes.
REV 07.14
Permit Number:
FoliolParCe11D#: / / 11ARYANNE PIURSEP SE111HOLE COUNTY'
CLERK OF CIRCUIT COURT x L-Utif TROLL.E:i; Prepared by: Proguard Restoration U, 85,13 Ps 1663
1220 Central Park Dr. CLERK'S r 20/5080604
Sanford, FL. 32771 RECORDED 07/2+/2 115 10:19: i7 AN
Return to: Proguard Restoration 11-CORDING FEES tiU.i C
1220 Central Park Dr. RECORDED BY hdevorc
r q NOT1 E OF COMMENCEMENT
State of Florida, County of+ 4,e,.g 16t, j
The undersigned hereby gives notice that improvement will be made to certain real property, and In accordance
with Chapter 713, Florida Statutes, the following infprfnation is provided in this Notice of Commencement.
1. DpsSgtipn of pt4pgrty _%al deoft lon of tKelbrooerNe and street Rrjdraac if amiailohicl
2. -General de
RE -ROOF
3. Owner in"
Name.1,A
Improvement
Interest in Proper4y
Name and address of fee simple titleholder (if different from Owner listed above) hi -
Address
4. Contractor
rd Restoration, Inc. Telephone Number407=330-7663anfrnlDnrlrrlrQ....i . m on^ A -
S. Surety (if applicable, a copy of the payment bond is attached)
Name Telephone Number
Address Amount of Bond $ 6. Lender
Name Telephone Number
Address
7. Persons within the State of Florida designated by Owner upon whom notices or other documents maybeservedasprovidedby §713.13(1)(a)7, Florida Statutes,
Name
Telephone Number
Address
8. In addition to himself or herself, Owner designates the following to receive a copy of the Llenor'sNoticeasprovidedin §713.13(1)(b), Florida Statutes.
Name Telephone NumberAddress
9. Expiration date of notice of commencement (the expiration date may not be before the completion of
construction and final payment to the contractor, but will be 1 year from the date of recording unless adifferentdateisspecified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENTARECONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN { :• RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BERECORDEDANDPOSTEDONTHEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CON4UlTWITHYO R LENDER OR AN ATTO5 NEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMSjjt-
q9ature or vwner or 1.esS88, g ,ftnsr's or Lessee's Authorized Officer/Dlrector/Partner/Manager Signatory's Title/office
foregoing instrument was acknowledged before me this 41' day of "y /!]by ,,,
month/year name of personas - for aTeofae.g., car, trustee, att ey in fact Name of party on behalf of whom instrument was execute E j Q
o
Signature of Notary Public - State of Florida Print, type, or stamp commissioned name of Notary Publi¢ 8 I
C ZPersonallyKnown •'R Produced ID
y
o JTypeofIDProduced ("Y'
LLOYD CHANDLER FORTSON E o W
MY COMMISSION #FF179587
EXPIRES November 3%i2ota lw'i u ,w >
40 39MIS3 Floc tNo ervlse.com
Form content revlaed:10117112
PROGUARD RESTORATION; 9
W&re Q aPiry Comes pfrst"
BBB 1220 Central Park Drive, Sanford F, 32771 -
T-- ` 'Ph: 407-330-7663 • Fax: 407-330-7661 - r
State Certified # CCC1330234
w.proguardrestoration:cornPROPOSAL / CONTRACT "• - - _ - , ,,,, _ - ..
Date !
Submitted To t' j- - ' -- - _ _ :_ , ` •'.
Address
City,, State Zip
PH# li . Sc 7Sl PH# Email - Job
Address We
Hereby Submit Specifications And Estimates For: Remove
existing layer roof. Each additional layer at $ Install ` ;,z itll.z underlayment /
base ply, per square: Install
valley liner in all valleys throughout where needed.. t Install
new soil stack flashings (boots). .^ QInstallnewroofventsorbtheroofdeck, color Installroof,
F) Replace- any rotten or damaged wood on the roof y `
per
sheet of l f deck for $ per foot, or $ Plywood (if needed) - Additional
work scone nr infArm f;^_. .._ ,L All
work scope and/or costs specified In this contract agreement issubjecttoorcontingentupontheapprovalofthecustomer's Insurancecompany. The undersigned further appoints PROGUARD RESTORATION (hereinafter referred to as "PROGUARD") as its representative
and permits PROGUARD to negotiate with the Insurance compnayforsettlementoftheinsuranceclaim. If there is a difference of workscopeand/or costs, PROGUARD may negotiate a reasonable replacement
and/or replacement cost mutually agreed between PROGUARD andtheinsurancecompany. PROGUARD will not start until work is ' approvedbytheinsurancecompany. INSURANCE'
COMPANY.' I
Contract
Amount: r% >— ,- - - -
U.
S, Dollars ( $ -- Payment
to be -made upon completion or as follows: All
payments to be made payable to PROGUARD RESTORATION only ACCEPTANCE
OF PROPOSAL Theaboveprices, -specifications and conditions of this contract are satisfactory and are hereby accepted. I / We have read and understand thetermsandconditionslocatedonthebackofthisdocument / contract agreement. PROGUARD RESTORATIONS hereafterreferredtoas "PROGUARD") is authorized to do the work as specified and in acc5r ance with the terms and conditions and stipulationsofthiscontractagreement. Payment will be made as stated 'above. Authorized
ft^nature ,j' ` Print
Name l r l 114 .1 a ,' .Sales 4!1" ` r-
Title
r""Mnr,4 - _
City of Sanford
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. /
ft a V at q ISSUE DATED / • 9.7 ,5
CONTRACTOR:
JOB ADDRESS:
M41 •:, 7
y , 6'r 14.s A 0, te.&k IF
Post
this Permit in a conspicuous place outside PROTECT FROM WEATHER Approved
plans must be posted with permit for inspection Leave
all work uncovered until inspected Permit
expires six (6) months from date of issue or last approved inspection A
R OOF DR Y-IN INSPECTION IS RE UIRED * * * For
Inspection procedures, please refer to the re -roof inspection guidelines provided to you when the permit is issued. The
Miti ate ion (davit will not suffice as an alternative to receiving a drv-in inspection. ROOF
INSPECTION
TYPE APPROVED REJECTED INSPECTOR MISCELLANEOUS
INSPECTION
TYPE APPROVED REJECTED INSPECTOR ROOF
DRY -IN MITIGATION
AFFIDAVIT FINAL
ROOF 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. FBC 105.3.3 REVISED:
October 2014 Inspection Line 855.541.2112
I
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
T-------------------------------------------------------------------
Page 2
Application Number . . . . . 15-00002429 Date 7/27/15
Property Address . . . . . . 174 BRUSHCREEK DR
Parcel Number . . 33.19.30.514-0000-0310
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 906594
Permit pin number 906594
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
10-1000 129 BL29 MITIGATION AFFIDAVIT
10 116 BL15 ROOF DRY -IN
1000 111 BL03 FINAL ROOF _/_/_
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: -y' ?-LA ZQ
hereby acknowledge that I personally inspected
oof deck nailing and/or 144econdary water barrier work
at -I IL4 y 1nC j t'l`lP and have determined that the work
Job Site Address)
was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.)
I certify that my statements herein are true and accurate to the best of my belief and that I fully
understand that making 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 toSection837.06 F.S.
An
Signature of Contractor
I/
P itriedNamedfContractorCCr I,3 02 0
License #
License Type: General J Building Residential CYRoofing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF ,( l'p i n t7 y e,
orn to (or affirmed) and subscribed before me this 1?1_ day of , 20 j by
who is i-rsonally Known to me •has Produced (type of
ide u i r) — as identification.
Signature of Notary Public
State of Florida
Print/Type/Starr[] L °
v :` -
GINDY A. DUNN
Notary Public - State of FloridaofNotaryPublicN;l My Comm. Expires Apr 22, 2018
OF ilOp`Commission # FF 115280
Revise& February 2015