HomeMy WebLinkAbout112 Oak View PlAUG 19 201
CITY OF SANFORD
BUILDING & FIRE PREVENTION
1 PERMIT APPLICATION
F D BY:
Application No: (D
Documented Construction Value: S
Job Address: J N9, 0p4 V1CW "'P1. Historic District: Yes No
Parcel ID: I D D - I l - DL D - 03 rJC7 Residential 5 Commercial
Type of Work: New Additio-nn Alteration Repair EP Demo El Change of Use El Move
Description of Work: 'rOo 2sh%laalts
Plan Review Contact Person: mn S604r) Title: l?ft)'dud on (Y afnaelr
Phone: 3,2 L4 - (moo - Fax: q0 7 - (a -7'7 --UA Email: reef 10C( anier I CA . Corn
Property Owner Information
Name M I Chad ? 1 r+le Phone: 4 0-7 - % - 59 4a
Street: i?_1. Resident of property? : qe'z
City, State Zip: SanPo C EL &2-7 -K5
Contractor Information
Name A Glu- IAS OP Aff-c' 1 CCL (1C . Phone: 407- (O-7-7 -1 Co (03
Street:-? D5R 0061(
c
C-• Fax: 40%- (o-71 `Wlo
City, State Zip: l i ii Y i'(,1(State License No.: CC 3,3 D4 L) t4
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 air conditioners, etc.
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5th Edition (2014) Florida Building Code
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
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 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 submittal.
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 compliance 'th all applicable laws regulating construction and zoning.
lgnature of Owner/Agent Date
V
Si e f Contractor/Agent Date
MIChaei `Plr
Print Owner/Agent's Name
Date
In.
15
o"""°"eI": MER6131TH SMITH
MY COMMISSION #FF137903
9o;F EXPIRES July 1, 2018
407 390.0109 PIC' rid Moin Servlco.nom
Owner/Agent is Personally Known to Me or
Produced ID Type of ID'DL#
POq-55(v-(oD-C31-C>
Name
7 as
E!!t#
FF137903
MITH Date
EXpIF1ES July 1, 2018
Contractor/Agent is )Q Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps•
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTEWATER:
BUILDING:
Revised: June 30, 2015 Permit Application
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: i-03- 15
I hereby name and appoint: ffe f cA ah SrYl 4-h
an agent
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):
p) The specific permit and application fo work located at:
Iis Dad Vim) 21 2, EL. 3a-7
Street Address)
Expiration Date for This Limited Power of Attorney: -7-,2 9 - I (o
License Holder Name:
State License Number:
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF n r e
The foregoing instrument was acknowledged before me this o ay of JO I j,
20015 , by 0 rn L ut:lnjifl who is)iersonally known
to me or o who has produced as
identification and who did (did not)) an oath.
JU /I . - &W, W -
SWa3lWe
Notary Seal) YNN-MARIE ANELLO
Print or type name Notary Public - State of Florida
Nr9l:oe My Comm. Expires Sep 20, 2015
Commission EE 100558NotaryPublic - State
Commission No.
My Commission Expires:
Rev. 08.12)
THIS INWrP. Q,TMi I RED BY:
Name: L,(''P1 rY1t'1
Address: Ot
Y
NOTICE OF COMMENCEMENT
Permit Number.
I 1111H 101M iiiii WHI i1iii 1,1111! 111i 411
MARYANNE MORSEP SEh1INOLE COUNTY
CLERK OF CIRCUIT COL1R1' & COMPTROLLERBK8525F's 35-T (1F'9-4;
CLEWS v 201508787715Ct87877
RECORDED 08 /11/2015 10:2 1 :16 Fit"
RECORDING FEES $10.0o
RECORDED BY ihdevijI, ?
Parcel ID Number. • I o ., ao- ,3n-*,511 - Oi"-y--)n - O3SD
The undersigned hereby gives notice that improvement will be made to certain real property, andt accordance with Chapter 713, Florida Statutes, the
follovAn inforrilation is provided in this Notice of Commencement9p
1. DESCRIPTION OF PROPERTY: (Legal description of the property and COPY-MARYANNE MORSE
2. GENERAL DESCRIPTION OF IMPROVEMENT: 2c / EBEPfJT1
LERK 3.
OWNER INFORMATION OR LESSEE INFORMATION IF (THE fL-E SSEE CONTRACTED FOR THE IMPAOVEMFNT: Name
and FL 3.?i Interest
in property: OI O ntCir Fee
Simple Title Holder (if other than owner listed above) Name: 4 4.
CONTRACTOR: Address: -
70: C-t- S.
SURETY (If applicable, a copy of the payment bond is attached): Name: Phone
Number. Address:
Amount of Bond: 6.
LENDER: Name: Phone Number. Address:
7.
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. Name:
Phone Number. Address: -
8.
In addition, Owner designates of to
receive a copy of the Lienor's Notice as provided in Section 713.13(1 xb), Florida Statutes. Phone number. 9.
Expiration Date of Notice of Commencement (The expiration 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 1, 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. Signature
of Owner or Lessee, or Owners or Lessee's (Print Name and Provide Slgwtory's Title/oftice) Auttwrtzed
Of icedUreatorMartnedManager) State
of El ar, I do, County of The
foregoing Instrument was acknowledged before me this - i " day of 3 L j j 20 5 by
1 Ct I 1 'f'1 Who is personally known tome OR Name
of person rna" statement _ _ A n t r , i -- . / — — —, t i\ who
has produced Identification of identification produced: MEREDITH
SMITH MY
COMMISSION #FF137903 EXPIRES
July 1, 2018 407)
3se•a153 FlorldallotnryServlce.com
8(10/2015 SCPA Parcel View:10-20.30.511-0000.0350
Qavld Johnson, CFA
PROPER'Y
A PPRA,ISER
S,EMItUOLE COlNJT1; FLORIOA
I Parcel:10-7A-30.511-0000.OM
F'
Property Record Card
Parcel: 10-20-30-511-0000-0350
Owner: PIRTLE MICHAEL R
Property Address: 112 OAK VIEW PL SANFORD, FL 32773
Properly Address: 112 OAK VIEW PL
Owner. PIRTLE MICHAEL R
Mailing: 112 OAK VIEW PL
SANFORD, FL32773-7426
Subdivision Name: STERLING WOODS
Tax District: Sl-SANFORD
Exemptions: 00•HOMESTEAD (2001)
DOR Use Code: 01-SINGLE FAMILY
qk• `»'
i '}:
xr' n.fY
r'r'
r
r',.
F
rs ` 36.7= = 37.
Tax Amount without SOH: $1,560.82
2014Tax Bill Amount $1,148.28
Tax Estimator
Save Our Homes Savings: $412.54
Does NOT INCLUDE Non Ad Valorem Assessments
Value Summary
2015 Working
Values
2014 Certified
Values
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 111,741 106,466
Depreciated EXFr Value
Land Value (Market) 18,000 12,000
Land Value Ag
Just/Market Value
129,741 118,466
Portability Adj
Save Our Homes Adj 31,210 20,717
Amendment 1 Adj
Assessed Value 198,531 97,749
httpJ/www.scpaff.org/Parcel Detaillnfo.aspx?PID=10203051100000350 1/2
City of Sanford
Building and Fire Prevention
Product Approval Specification Form
Permit #
Project Location Add FL 3a-7-7:!
As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the
information and product approval number(s) on the building components listed below if they are to be
utilized on the construction project for which you are applying for a building permit. We recommend that
you contact your local product supplier should you not know the product approval number for any of the
applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in
accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product
Approval can be obtained at www.floridabuilding.orq.
The following information must be available on the jobsite for inspections:
1. This entire product approval form
2. A copy of the manufacturer's installation details and requirements for each product.
Category / Subcategory Manufacturer Product
Description
Florida Approval #
include decimal
1. Exterior Doors
Swinging
Sliding
Sectional
Roll U
Automatic
Other
2. Windows
Single Hun
Horizontal Slider
Casement
Double Hun
Fixed
Awning
Pass Through
Projected
Mullions ,
Wind Breaker
Dual Action
Other
June 2014
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 FL 101 a y - 12l4
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 /
Coatin
Liquid Applied
Roofing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels
Roof Vents
Other
June 2014
Category/Subcategory Manufacturer Product
Description
Florida Approval #
include decimal
S. Shutters
Accordion
Bahama
Colonial
Roll u
Equipment
Other
6. Skylights
Skylights
Other
7. Structural
Components
Wood Connectors /
Anchors
Truss Plates
Engineered Lumber
Railing
Coolers/Freezers
Concrete Admixtures
Precast Lintels
Insulation Forms
Plastics
Deck / Roof
Wall
Prefab Sheds
Other
8. New Exterior
Envelope Products
Applicant's Signature
Applicant's Name
Please Print)
June 2014
oSTATE OF FLORIDA DEPARTMENT
OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION
INDUSTRY LICENSING BOARD 1940
NORTH MONROE STREET TALLAHASSEE
FL 32399-0783 COUGHLIN,
ADAM JA
EDWARDS OF AMERICA, INC. 2261
MULBRY DRIVE WINTER
PARK FL 32789 Congratulations!
With this license you become one of the nearly one
million Floridians licensed by the Department of Business and Professional
Regulation. Our professionals and businesses range from
architects to yacht brokers, from boxers to barbeque restaurants, and
they keep Florida's economy strong. Every
day we work to improve the way we do business in order to serveyoubetter. For information about our services, please log onto www.
myfloridalicense.com. There you can find more Information about
our divisions and the regulations that Impact you, subscribe to
department newsletters and learn more about the Department's initiatives.
Our
mission at the Department is: License Efficiently, Regulate Fairly. We
constantly strive to serve you better so that you can serve your customers.
Thank you for doing business in Florida, and
congratulations on your new license! DETACH
HERE 850)
487-1395 STATE
OF FLORIDA DEPARTMENT
OF BUSINESS AND PROFESSIONAL
REGULATION CCC
1330444 ISSUED: 05/01 /2014 CERTIFIED
ROOFING CONTRACTOR COUGHLIN,
ADAM JA
EDWARDS OF AMERICA, INC. IS
CERTIFIED under the provisions of Ch.489 FS. Expiration
date : AUG 31.2016 L1405010000496 9
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
nd complete parcel I.D. number.
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).
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.
JA Edwards of America, Inc.
Your hoofing sperialistl
AGREEMENT SUBJECT TO INSURANCE COMPANY APPROVAL
Customer: (' 1 I l f lii i-', " Date: r l ,llLj
r\
DaY - f ; • Property Location: j i(il l i f' d i 4j y: 67
City: / r" t Zip:
J' 2)
Evening: n? - c
E-Mail: , E`'2i !1Y"' IQ0'-•1 C1
ROOF SPECIFICATIONS Brand: 4 G' style:_ Color:
Ride a ert t losed TeanOff: 1 / 2 Vents Box S /-Alu ninum Felt• -\
g Ey: 6getrtG ( i
Ice & Water Shield: Per Code Pitch: "Z Story. 1 2 / 3 - a otif: Yes? No
x Roof Accessories to be replaced new and/or painted to match shingle color.
1
Drop Instructions:
SIDING SPECIFICATIONS Brand: Style: Color:
Style: Straight Lap %
hou
sure: 4" 4.5" 5" other:
Elevation being sided (looking at -fr`street): Front Left Back Right___—`_
Drop Instructions: ! l
GUTTER SPECIFICATIONS Color:
Special Instructions
TERMS
Homeowner Initials:
A
I. 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. 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 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
andack of, this Agreement. o ,
Signature (
Customer) Signature (
JA Erhvards ofAmerica Inc. Rep) Date
Date
First
Check: $ . ? i / 1 / vs Check #
C C , J
Date
Balance
Due: $ 7 fool Z•`'1 _ i Check #
Date Agreed
Price.- $ 19 y & N Z_1 plus
additional supplements & permit fees
paid by insurance company 7058
Stapoint Court • Winter Park, F132792.Office: 407-677-7663 • Fax: 407-677-7664
J•'
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: ',.J —r;2(D 4 E-T
I, 1' hereby acknowledge that I personally inspected
toof deck nailing and/or Secondary water barrier work
N A
at 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 8-32X6 F.S.
9220
Date
CCIC l 3 304L44
Printed Name of Contractor License #
License Type: General Building Residential paoofing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF Y
Swor to (or affirmed) and subscribed before me'tl is _g t day of 1 Ga • , 2015, by
a aril (' pt nhoki() , who is yersonally Known to me or has Produced (type of
irinnAifira*innl as identification.
Sienhture of
State of Florida
Print/Type/Stamp Name
of Notary Public
MEREDITH SMITH
MY COMMISSION #FF137903
oFEXPIRES July 1, 2018 407)
398.0159 F190dallotn"OrVIC0,com