HomeMy WebLinkAbout124 Rockhill Dr7JUN 2 9 2'015
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CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: / S- of Documented Construction Value: $ 31 q ` A • aP3
Job Address: l n?,y CQC 11 I Dr. S " -rd, FL. J2711Historic District: Yes No
Parcel n): 66 - I Ll - >U - Zoning:
Description of Work: Krr QQjr- _
I
Plan Review Contact Person: I+h Snn H-i'1 Title: l(C l)C."ton GinGi9e
Phone: 4D1-Lo-7-7-L4(,D3 Fax: 140'7-(P7i-7(Q(PL1 E-mail: Mer l+hs(R5IQ amdr1CQ.
IJ Cana
Property Owner Information
Name 1 R1Qtr`(-aoyy Phone: 321-GIGS7M
Street: Resident of property?: Nd
City, State Zip: S AAQrrrl, F L 327'7 j
Contractor Inforrpation
Name Q CrmertCA,1nC.
in Ed cof Phone: ti 07 - (D-7 -2 -i (D(D
Street: _::ID!5 3 -tLa- 1- C+. Fax: q I)-7' ?-7- 7(0(D1
City, State Zip: Lj n4r'X Oa - 1 EL 342-7qa State License No.: M133044 T Name: Street:
City,
St,
Zip: Bonding Company:
Address: Building
Permit
Square Footage: —
12P No. of
Dwelling Units: Electrical New
Service -
No. of AMPS: Architect/Engineer
Information Phone: Fax:
E-
mail:
Mortgage Lender:
Address: PERMIT
INFORMATION
Construction Type:
qerOOP No. of Stories: 1 Flood Zone:
Mechanical (Duct
layout required for new systems) Plumbing New
Construction -
No. of Mures: 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 FBQ 733.135(5)(6) Florida State tes. 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 released.
rr
S gn f owner/Agent Date f Signa Contractor/Agent Date
Co La2 I inio''t nl-Al 0rj Sd Print
Owner/Agent's Name Prin ontractor/Agent's Name Signature
of Notary -State of Flo ' Date Signkwe of Notary -State o a Date aPpY"°
4:: MEDITHSMITHEREDITH SMITH o: c;: MY
COMMISSION #FF137903 `N MY COMMISSION #FF137903 o?;°
EXPIRES Jul 1 , 2018 wFOFF oP; EXPIRES July 1, 2018 153
FloddallotarvService.com o103 Florldallot ervice.com ent
is Personally Known to Me or ID
FL L TypeofID 12l(037501'g48'7U0 APPROVALS:
ZONING: ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
is
I-' Personally Known to Me or 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
THIS INSTRUMENT PREPARED BY: ! 111iii 11111211 0,111 IiIII 11111 11il III
Name: _Sali'i" IIARYFrNNc NORSEr SENINOLE COUNTYAddress: -1045R Sfiaoc L-t C1-. CLERK O'r CIRCUIT COURT & C:ONPTROLLER
t-'n-cr2Lrr., FL 3a7?-2 R W 97 Ps 1248 QPss)
CLERK'S 2015070346
NOTICE OF COMMENCEMENT RECORDTNIIFEES/$1.10. t,12:5,:53 il C:
iaF.alraG FEES11t,i z RECORDED
BY hdevore Permit
Number: C1.
ParcelIDNumber: 33 - I9 - 3h - 51 lD - OCdO - 112 r 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: (Legal description of the property and street address if available) L
Ia car 914.2 7 L4 1
a L4 2OC Khilj D> : 5aL , FL 3,2 -7 -71 2.
GENERAL DESCRIPTION OF IMPROVEMENT: 3.
OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPPROVE NT: r
2 Nameandaddress: 4 1 I 1QTYi 12r £ t'-1"S a1i C.,KII r San (f f L &,7-7 -7 1 Interest
in property: Fee
Simple Title Holder (if other than owner listed above) Name: i Address:
CONTRACTOR:
Address: —
1 L 5.
SURETY (If applicable, a copy of the payment bond is attached): Name: Number:
Address:
Amount of Bond: 6.
LENDER: Name: Phone Number: Address:
Persons
within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section 713.
13(1)(a)7., Florida Statutes. cp
THE COGI Name:
Address:
CLERK OFTHEr4l UITCOLIRyAND ` 4; 8.
In addition, Owner designates to
receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone 9.
Expiration Date of Notice of Commencement (The expiration is 1 year from date of CLFRK
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. igna
ure of Owner or Lessee, or Owner s or Lessee's (Print Name and Provide Signatory's Tide/Orrice) Authorized
Officer/Director/Partner/Manager) State
of F l o r idta Countyof The foregoing
instrument was acknowledged before me this day of J l) 0 c , 20 J by I
1 L 1 QA i 1 1 Z7 rtSr i-i Who is personally known to me OR Name of
person making statement + — who has
produced identification\Wtype of identification produced: 1 Jl 9 2 c)44 — PAYP°°' MEREDITH
SMITH
MY'COMMISSION #
FF137903 N Q= N to e 49•'FOFr
o EXPIRES July 1, 2018 407) 998
11153 FlorldallotaryServlce.com
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: (D - B-1 J
I hereby name and appoint:erCC
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):
The specific permit and application
1(gLI ejrY T_.h i 1)
street
Expiration Date for This Limited Power of Attorney:
License Holder Name:
State License Number:
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF (0.*
The foregoing MM
ent was
200, by
to me or o who has produced
identification and who did (did
Notary Seal)
µ........ i LYNN-MARIE ANELLO
Notary Public -State of Florida
My Comm. Expires Sep 20, 2015
Commission # EE 100558
Rev. 08.12)
Si
located at:
before me this jydy of
who i"ersonally known
oath.
Print or type name
Notary Public - State of
Commission No.
My Commission Expires:
as
Category / Subcategory Manufacturer Product
Description
Florida Approval #
including 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 L y- p ILI
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 /
Coatis
Liquid Applied
Roofing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels
Roof Vents
Other
June 2014
Detail by Entity Name Page 1 of 2
Detail by Entity Name
Lim
A INVESTMENTS L.L.C.
cument Number
I/EIN Number
to Filed
ective Date
Event
t Date Filed
9 WHOOPING CRANE CT
NFORD, FL 32771
iilina Address
a WHOOPING CRANE CT
NFORD, FL 32771
3ERTSON, KATHLEEN A
WHOOPING CRANE CT
IFORD, FL 32771
ame & Address
e MGR
BERTSON, KATHLEEN A
i WHOOPING CRANE CT
VFORD, FL 32771
Report Year
2013
2014
2015
L04000094438
861131886
12/20/2004
01 /01 /2005
FL
ACTIVE
REINSTATEMENT
01 /05/2011
Filed Date
01 /25/2013
01 /08/2014
01 /06/2015
http://search. sunbiz.orglInquiry/CorporationSearchISearchResultDetail?inquirytype--Entity... 6/29/2015
SCPA Parcel View: 33-19-30-516-0000-1280 Page 1 of 2
DavidJohrnson.CM Property Record Card
PROPER Y Parcel: 33-19-30-516-0000-1280
APPRAISER Owner: CAPTIVA INV LLC
SEMINOLECOUNW. FLORIDA Property Address: 124 ROCKHILL DR SANFORD, FL 32771
Parcel: 33-19-30-516-0000-1280
Property Address: 124 ROCKHILL DR
Owner: CAPTIVA INV LLC
Mailing: 769 WHOOPING CRANE CT
SANFORD, FL 32771
Subdivision Name: COUNTRY CLUB PARK PH 2
Tax District: Sl-SANFORD
Exemptions:
DOR Use Code: 01-SINGLE FAMILY
Value Summary
2015 Working
Values
2014 Certil
Values
Valuation Method Cost/Market Cost/Marke
Number of Buildings 1 1
Depreciated Bldg Value 112,670 107,368
Depreciated EXFT Value
Land Value (Market) 28,000 28,000
Land Value Ag
Just/Market Value
140,670 135,368
Portability Adj
Save Our Homes Adj 0 0
Amendment 1 Adj 5,718 12,684
Assessed Value 134,952 122,684
Tax Amount without SOH: $2,
2014 Tax Bill Amount $2,
Tax Estimator
Save Our Homes Savings:
Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description
LOT 128
COUNTRY CLUB PARK PH 2
PB 54 PGS 22 THRU 24
Taxes
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund 134,952 0 1;
Schools 140,670 0 1
City Sanford 134,952 0 1;
SJWM(Saint Johns Water Management) 134,952 0 It
County Bonds 134,952 0 1:
Sales
Description Date Book Page Amount Qualified Vac/Imp
QUIT CLAIM DEED 3/1/2005 05683 1103 100 No Improved
WARRANTY DEED 2/1/2005 05618 0724
0594
182,000
122,400
Yes Improved
SPECIAL WARRANTY DEED ` 6/1/1999 03674 Yes Improved
WARRANTY DEED 3/1/1999 03612 0426 23,500 No Vacant
http://www. scpafl. org/ParcelDetaillnfo. aspx?PID=3 3193 051600001280 6/29/2015
O
AE4
JA Edwards of.4merica, Inc.
Your Roorng 5periaii ;ry
AGREEMENT SUBJECT TO INSURANCE COMPANY APPROVAL
Customer: Jj l l q A %. "J-%kze o RoO prtS6 Date:
Property Location: 1 oGKvi 1 -, rDay:7db
City: Zip: c3 ok-1 i Evening:
E-Mail: J01 l) ro 6RV-t j J l .23 Q j,,d'r yl p.i LoU4
ROOF SPECIFICATIONS Brand: Q, Gn- style: Color: 0
Rid e M rial: R / R alley pen losed Tear -Off: 1 / Vents: Box / Shingle Over lumintun F It: R / R
Ice & Water Shield: Code Pitch:_ Story& / 3 Walkout: Yes /Po
Roof Accessories to be replaced new and/or painted to match shingle color.
Drop Instructions: r to XA—
CATIONS Brand:
Style: Straight Lap / Dutch Lap 4.5" 5" other:
Elevation being s' ooking at house from street): row Back Right
Color:
ECIFICATIONS Color: Homeowner Initials:
Special Ins tru ctions:
enw TERMS
1nllr trlGpCt ` 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.
Unless otherwise "agreed in writing, your out-of-pocket costs will be limited to your insurance deductible amount. However, you must promptly pay JA Edwards of America Inc. all
amounts you receive from your insurance company. Ifyou 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 JA Edwards of America Inc. Once signed 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.
Your signature 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 and
bael of 1keYs Aereem t. First
Check: / Z3 / / Check # Date Date
Balance
Dhe: S Check #
Dale Inc.
Rep) Date Agreed Price: $ cl 4 .Zg plus
additional supplements & permit fees
paid by insurance company 7058
Stapoint Court - Winter Park, FL 32792.Office: 407-677-7663 - Fax: 407-677-7664
ems 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.
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
City'of Sailford
Residential Re -Roof
F D 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
i
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: 15 —az_)0- - 7
I, hereby acknowledge that I personally inspected
Woof deck nailing and/or Secondary water barrier work
at l p? 2OC I I `J 1'. Sc (J , ? 77 i 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 Contractor 7
1-15 Date
CcC'
l33n4gLl License #
License
Type: General Building Residential Roofing Contractor or
any individual certified in accordance with F.S. 468 to make such an inspection. STATE
OF FLORIDA COU TY OF O fa ngt__ Sw
r to (or of rmed) an s bscribed before me thisJ_14,*- day of 3 Qj , 20 15 , by who
isrsonally Known to me or Has Produced (type of ides i
cation) as identification. Signature of
Nota State of
Florida Print/Type/
Stamp Name of Notary
Public Revised: February
2015 MEREDITH SMITH
MY COMMISSION #
FF137903 EXPIRES July
1, 2018 407) 399.
0153 FlorldallotaryService.com