HomeMy WebLinkAbout116 Oak View PlJUN 29 2015
F CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: a a Documented Construction Value: $ 53A& 99
Job Address: _I_Ito 004 Viet-W`P1 • Sa oy-d , R_ 3X?73 Historic District: Yes No
Parcel ID: 10.00. 30 y 11.E • 0330 Zoning:
Description of Work: Ver OOP
Plan Review Contact Person: rYler&& -Ih Title:oc;bon 1 pan
Phone: 4D-7 - (o77-•7LoCA.3 Fax: k•7-(o77-7(a(07 E-mail: rner t-15 e, 1QCC?f-Lt fYleYiCC
Coro
Property Owner Information
Name QM `P_nreZ Phone: 4b-7'5il0-)0q_7
Street: 1 j CD 0oX Vicup`010 Ce Resident of property?
City, State Zip: sa 1Q rd, EL 3,Q i'2 3
Contractor Information
Name Ado-M Couph I Phone: q0j - I n77 - 7 (0(03
v
Street: t Fax: 4 M - La ? 7- 7 IP (a-3
City, State Zip: Lo 0jf,r 0,rK, EL 3,Z-79a State License No.:
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company:
Address:
Building Permit PD
Square Footage: a -7
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type: 9-Cr-OCYL No. of Stories: i
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:
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
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 ;elease4.^
Print QhvneVAeent's Name
Date
asit
q -
15 Print
D-
5-A -15 q1 of
Notary -State of Floroda ' Date o'""'
e• MEREDITH SMITH MY
COMMISSION #FF137903 EXPIRES
July 1, 2018 Pr.
edced ID p L Type of ID 20 3 - 74 336 - o APPROVALS:
ZONING: UTILITIES: ENGINEERING:
COMMENTS:
MS
of
Notary -State Date
Date
MEREDITH
SMITH MY
COMMISSION #FF137903 GXPIRF.)'
uly 1, 2018 153
wnunn 7•-••---- 7
ersonally Known to Me or Type
of ID WASTEWATER:
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
THIS INST UMENT PREPARED BY:
Name: alrXed dig Stm+h
Address: -705B Sta'D6i0-Y C*
LUin+rPart-, FL 3a-19a
NOTICE OF COMMENCEMENT
Permit Number:
Parcel ID Number: 10 -020 - 23t) - 511- Ott - 0330
MARYANNE MORSEr SEMINOLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLER
eK 8479 P9 1173 (09s)
CLERK'S p 1-015058778
RECORDED 06/02/2015 12:58:33 PM
RECORDING FEES $10.00
RECORDED BY tstbith
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.
1. DESCRIPTION OF PROPERTY: the property and street addressif 2.
GENERAL DESCRIPTION OF IMPROVEMENT: ^ b0
3.
OWNER INFORMATION OR ` LESSEE NFFOORMATION IFTHE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and
address: Rayrnl nt Yti'c. 1 D Ul I1S-Pl . ` anPor Ai V L-- 32 -7 -13 Interest in
property: pijoncx- Fee Simple
Title Holder (if other than owner listed above) Name: 4. CONTRACTOR:
Name: k H tr-jiW(Jl1'(X5 0-3` H11T1Lr I(;U IT>,c. Phone Number: 1-1 O /'tD r 1- /Cd LP Address: l
5.
SURETY (
If applicable, a copy of the payment bond is attached): Name: Address: Amount
of Bond:LIVIII 6. LENDER:
Name: Phone Number: Address: N
N
a
7.
Persons
within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by SetRion CJ 713.13(
1)(a)7., Florida Statutes. Z oYc Z Name: Phone
Number: Address: 8.
In
addition, Owner designates of G to receive
a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number o s 9. Expiration
Date of Notice of Commencement (The expiration is 1 year from date of recording unless a different date is specified) 0 rx
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 T5 R RECORDING YOUR NOTICE OF COMMENCEMENT. n or
Owners
o ee' (Print Name and Provide Signatorys lltle/Office Authorized State
of
n (D r I d C L Countyof ( J Ir(Al e, T The foregoing
instrument
was acknowledged before me this I S+ day of v U ne , 2015 by Va\) M0
2- Name of person
making statement who has produced
identification type of identification produced: 2'pYPues= - MEREDITH
SMITH s MY COMMISSION #
FF137903 EXPIRES July 1,
2018 407),398•0153
FloridallotaryService.com Who is personally
known to me OR
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: (,0'l-1r5
I hereby name and appoint: rflPr sm,+y)
an agent of:
Name of Company)
to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things
necessary to this appointment for (check only one option):
po The specific permit and application for work located at:
Street Address)
Expiration Date for This Limited Power of Attorney: CO - I - I LD
License Holder Name:
State License Number:CCCI D4L LI
Signature of License Holder: q9
STATE OF FLORIDA
COUNTY OF traoX
The foregoing instrument was acknowledged before me this (
S+
day of J Une, ,
200_ 5, by A&M CoUoh1i o who is''ersonally known
to me or who has produced as
identification and who did (did not) t oath.
Slgnat e
Notary Seal)
OlP0.Y PVB i LYNN-MARIE ANELLO
Notary Public - State of Florida
My Comm. Expires Sep 20, 2015
h4 n1P,
Commission # EE 100558
Rev. 08.12)
Print or type name
Notary Public - State of _
Commission No.
My Commission Expires:
Category/ Subcategory Manufacturer Product
Description(including
Florida Approval #
decimal
3..Panel Walls
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles Ft 101 c2q - QILI
Underla ments
Roofing Fasteners
Nonstructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Built up roofing
System
Modified Bitumen
Single Ply Roof
Systems
Roofing slate
Cements/
Adhesives /
Coating
Liquid Applied
Roofing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels
Roof Vents
Other
June 2014
r
A
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 or 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'.
f
Copy of a contract, signed by the contractor and the property 'owner, indicating the -documented
construction value of the project.
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.
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).
For Re -Roof Permits other than asphalt shingle, wood shake or wood shingle, please provide two (2)
copies of Florida Product Approval and Manufacturer Installation Instructions for the roof covering
product and the underlayment.
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, andfederal code requirements.
Revised: February 2015
r City of Sanford
Residential Re -Roof
Hurricane Mitigation Inspection Process
1. Roofing contractor shall be responsible for the protection of contents and structure at all
times.
2. An in -progress inspection shall be scheduled after the old roof has-been removed and
the dry -in is complete. All components of the dry -in must be in place. To schedule an
inspection, call 407.688.5151.
3. For roofs using an entire peel and stick dry -in, a nailing affidavit shall be required to be
posted on jobsite at time of in -progress inspection.
4. A minimum of one hundred (100) square feet of the new roof component shall be installed
at time of inspection. Up to fifty percent (50%) of the new roof may be installed, but all
flashing and valley metal shall remain exposed for inspection.
5. The contractor shall contact the inspector the day of the scheduled inspection between
7:30 a.m. and 8:30 a.m. to coordinate the inspection time. Please call 407.688.5061 or
5063
6. At time of inspection the inspector shall, at his or her discretion, select location(s) for
inspection.
7. A representative of the contractor shall be on job site to facilitate any necessary repairs.
8. After the inspection is conducted, the contractor will make any necessary repairs and
proceed as directed by the inspector.
9. For approved inspections, the inspector shall collect the required affidavit for filing with the
permit application.
The above shall serve as the inspection process to meet requirements per Florida Statute. Any and all
suggestions to better serve the contractor needs will be considered.
Revised: February 2015
JAFA
JA Edwards ofAmerica, Inc.
Your RooFng specialisti.
AGREEMENT SUBJECT TO INSURANCE COMPANY APPROVAL
Customer: Date: :
Property Location: (ter O A'K l ?"66, Day: S I -
City: qJ , , i L Zip: 3oZ,' Evening: C -
E-Mail:
ROOF SP ICATIONS Brand: A Style: -i Color: AK `Smr-6w-ot
Ridge Materi R / Valley: Open Close Tear-Ot 2 Vents Bo Shingle Ove Aluminum
Ice &. Water Shie er Co Pitch: s Storyij/ 2 / 3 Walkout: Yes I N On,, e 66,5
Roof Accessories to be replaced new and/or painted to match shingle color. ,
J
nJ
Drop Instructions: F i 6ky Sl 6
buvwJ Jti
SIDING SPECIFICATIONS Brand:
traight Lap - utch Lap Expos
street): Elevation being sided (looking at se fro
Drop Instructions:
GUTTER
Special
TERMS
NS Color:
J rA
Style: Color:
5"' other:
Left Back Right
t3 SZ
Homeowner Initials:
1. By signing this Agreement, you authorize JA Edwards of America Inc. to be present during the insurance adjustment and negotiate the settlement with your insurance company.
2. Uuless otherwise agreed in writing, your out-of-pocket costs will be limited to yourinsurance deductible amount However, you must promptly pay JA Edwards of America Inc.
all amounts you receive from your insurance company. If you desire material upgrades or other work done on your property, you will incur additional out-of-pocket expenses.
3. This Agreement is not valid or binding on any party unless and until it is signed by both you and JAEdwards of America Inc. Once sfgried by you and JA Edwards of America Inc.
JA Edwards of America Inc. will be awarded with the job described above and the.scope and price of the work will be set forth in the insurance adjuster's summary.
4.You ignature below provides your agreement to all the terms and conditions set forth on the front and back of this Agreement. Please carefully read the entire front
d ba of this Agr m nt.
First Check: 5——`
S qlAI Check # Date
fature (Customer) Date
Balance Due: S
Check # Date
nSignature (JA EdwardsofAmericaInc. Rep) Date _
I
Agreed Price: $ 3 Z 'A(,4/?
JV "
r
plus additional supplements &permit
ees paid by insurance company
7058 Stapoint Court - Winter Park, FL 32192.Office: 407-677-7663 - Fax: 407-677-7664
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: 1 J 1;2 :2 (-(C)
I, A— r i a ii'i hereby acknowledge that I personally inspected
J
IQ Roof deck nailing and/or Secondary water barrier work
at I !" ("'n K 7F27-7-?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 to
Section 837.06 F.S.
Contractor
Printed Name of
Date
License #
License Type: General Building ResidentialI oofing Contractor
or any individual certified in accordance with F. 468 to make such an inspection.
STATE OF"FLO RIDACOUNSworto (d before me is day of Jv1y , 20 15 , by
Ada Irn CC), , who is ersonally Known to me or has Produced (type of
ide >t icatias identification.
f (SEAL)
igna ure of Nota:yPdblic
State of Florida
Et4o, MEREDITH SMITH
MY COMMISSION #FF137993
Print/Type/Stamp Name ExPIREs July I,20 s
of Notary Public •t)15l FlaridaNataryService.com
Revised: February 2015