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Home My WebLink About115 Orion WayAug.24. 2015 3:07PM SENEZ ROOFING No.2220 P. 2 y QITY OF SANFORD BUILDING & FIRE PREVENTION r n PERMIT'APPLICATION Application No: / 7 0 Documented Construction Value: $ Job Address; j. ,r ; Q Parcel TD: Historic District: Yes 0 No Q 3b - S a . S t0Ro Zoning; Description of Work: Qv r t') ar. Plan Review Contact Verson: Title: Phone: Fax: E-mail: 1 Property Owner Information Name k-T Phone: Street:. airi Wct LA City, State Zip: Resident of property? 3 Contractor Information Name Street: City, State Zip: Name: Street: City, 81 Bondin A,ddres Phone: --7'7K Q r6 Fax: - —7IS-333 State License No.: itect/Engineer information Phone: Fax: E-mail: Mortgage Lender: Address: Building Permit b PERMIT INFORMATION Square Footage: —11Construction e: PNo. of Stories: No. of Dwelling Units: Flood Zone: Electrical New Service — No. of AMPS: Mechanical ( buct layout required for new systems) Plumbing New Construction - No. of.Fixtures: Fire Sprinkler/Alarm 4' No, of heads: . Shall be inscribed with the date of application, its ofh thatdate (Code 2010 FHC) 731.135(5)(6) Florida'Statutes. REV07.14 and the code in effect \ Aug.24. 2015 3:07PM SENEZ ROOFING No.2220 P. 3 Application is hereby made to obtain a permit to do the woik 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 tomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. I understand that a separate permit . must.be secured for electrical work, plumbing, signs,.wells, pools, furnaces, boilers, heaters, tanks, andairconditioners, etc. OWNER'S AFFIDAVIT: Z certify that all of the foregoing information is accurate and that all work -willbedoneincompliancewithallapplicablelawsregulatingconstructionandzoning. . WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF'COMMENCEMENT 1VIAYRESULTINYOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICEOFCOMMENCEMENTMUSTBERECORDED .AND POSTED ON THE JOB SITE BEFORE THEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOURLENDER'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 requiredfromothergovernmentalentitiessuchaswatermanagementdistricts, state,agencies, or federal agencies. Acceptance of permit is verification that I will notify the owner of the property of the requirements of FloridaLienLaw, •FS 713. The City of Sanford requires payment of a plan review fee. A copy of the executed contract is required in ordertocalculateaplanreviewcharge. 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 thepermitisreleased. Signature of Owner/Agent Date Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/Agent, is Produced ID, ' • Signature of Contractor/Agent Dare Name NEW S. ESPINOSA Notary Public - £tate of Florida My Comm. Expires Jun 2. 2016 Commission # EE 203953 Bonded Through Natlopal Notary Assn. Personally Known to Me or Contractor/Agent is Personally Known to Me or Type of ID Produced ID Type of ID APPROVALS: ZONING: UTILITIES: WASTE WATER: ENGINEERING: FIRE: BUILDING: COMMENTS: Shall be inscribed with the date of application and the code in effect a9 of that date (Code 2010 F$C) 731.135(5)(6) Florida Statutes, REV 07.14 Aug, 24. 2015_ 3:07PM.__,..SENEZ ROOFING Est, 1973 SENEZ ROO.FING., LLC Painfin>?.& insulation TRUST - VALUE - INTEGRITY Toll Free; 1-866-350-4050 Office: (366) 774-4950 • F6X (386) 775-3338 1060 E. INDUSTRIAL DR. ••Suite K ORANGE CITY, FLORIDA'32763 FULLY LICENSED & INSURED STATE CERTIFIED #CCC1327898 www.senezroofing.com No_2220.=P,_ 4 6Sio PROPOSAL / INVOICE SUBMITTED 'TO: DATE: NAME: STREET 1/.U i d'f CITY: eyi-Lva.: 'I 3 -7 PHONE: fQ - .SN i ^ 5s,75" EMAIL: 0112, COLORS: Shingles: ^1_,_ Rubber . Cust. Int. Drip Edge "._N Vents WE HEREBY SUBMIT SPECIFICATIONS AND -ESTIMATES FOR:R 1. Tear off existing roof and haul all debris off site. Clean job site thoroughly, and Magnet ground for nails.. 2, Repla .p any rotted wood decking. Truss and fascia wood work may, be extra. Aliminum work not included. 3. nstall new felt paper dry -in, & ` Install- peel and stick, x !!fRe-fasten decking, 4. Fi place drip edge with all new painted drip edge;. Cement in all eaves and rakes with quality roof cement. 5. Install valley lining in all valleys — Cement in shingles over lining. -- California Closed Cut Valley. 6. Replace lead boots -and goose necks on all existing vents and pipes. Paint to match venting or drip edge, 7.. Replace (A existing' skylight(s) with new skylights(s). (A0 Flash Chimney. (,-Cricket Chimney. 8. Install new asphalt Architecl •s_ hingles — AR (algae/fungi resistant) — lifetime manufacturer's warranty, 9. Each -shingle is nailed with six 11/4'•' roofing nails 10. Replace ( G ) lengths of ridge vent. Replace ) off -ridge vents. 11. Low Pitch 1369L install Peel-n-Stick dry -in, and Single -Ply. Modified -Roll -Rubber -Membrane -12 Yaar Manufacturer' s warranty. Replace drip edge with all new painted galvanized drip edge. 12. All materials used and work installed is properly applied in accordance with current Manufactures, State, and County CodesandSpecifications: Senez gets the- roofing permit and schedules appropriate roof inspections. All specified work completed is fully.guafanteed for five (5) years. Roof material carries standard,manufacturer's warranty. ALL MONEY IS DUE UPON COMPLETION OF WORK: Please make check payable to: SENEZ ROOFING Total Cost of•all Work: $ . 0 Deposit $ all taxes and fees are included) price reflects cash or check payment) • A 4% conVenlertce fee will apply to all Credit Card transactions. WE HEREBY PROPOSE TO FURNISH LABOR AND MATERIALS -COMPLETE IN ACCORDANCE WITH THE ABOVE SPECIFICATIONS, FOR THE SUM OF $ ANY EXTRA WORK, MATERIALS, OR SPECIFICATIONS THAT ARE HAND WRITTEN ON THISCONTRACTAREINVALIDUNLESSINITIALED•gY•CUSTOMf:R AND BY THC OWNER/PRESIOENT OF SENEZ ROOFING, LLC. 1) Please remove vehicles from driyaway and garage/carport by 12 noon the day b f e the job. Remove any items on walls and furniture and check that all fixtures In house orportrhesaresecurethatmayfallorbounceoffduetobangingvibration/whileAfi g, we are not responsible. Please have yard mowed prior to job start to help with magnet pickupofnails.4 Customer is responsible for. removal of anything around the house thable (.e.: ornaments, bird baths, hanging plants, etc.), removal of anything attached to the roof/deoking inside the attic and outside prior to lob start and reinstallationents after job completion (i.e.: solar, satellites, air conditioning components, alarms, pipesetc.), CoveringfumitureorIlooringbelowskylightopeningsandre•instaything dial must be removed to propeyiy repair any rotted,wood areas (.e.: fascia, soffit, aiding, guitars, etc.) / AUTHORIZED AGENT (PRINT & NOTE: THIS PROPOSAL MAY BE ACCEPTANCE OF PROPOSAL: THE ABOVE PRICES, SPECIFICATIONS AND CI SPECIFIED. I HAVE READ, UNDERSTAND, AND FINAL INSPECTION BY THE MUNICIPALITY F FULL IS DUE IMMEDIATELY UPON COMPLETIO IS FOUND BENEATH FIRST LAYER OR IF 07E ESTIMATE WAS PRODUCED. ACCEPTED: PRINT& PRINT & SIGNATURE DRIVERS LICENSE # THIRTY ( 30) DAYS. DATE: IRE SATISFACTORY AND ARE HEREBYACCEPTED, YOU ARE AUTHORIZED TO DO THE WORK AS HE TERMSAND , ONDITIONS SECTION ON THE REVERSE SIDE OF THIS FORM. COMPLETION OF THEPERMITISISUEDISNOTCAUSETODELAYPAYMENTTOSENEZROOFING, PAYMENT IN D WORK ri t'RAICES ARE SUBJECT TO CHANGE IN THE EVENT OF ADDITIONAL ROOFING COiTR7HAWASNOTEVIDENTORDISCLOSEDBYHOMEOWNERATTHETIME) THIS 7 DATE: / 1877 - Aug:24._ 2015` 3:08PM-20-3SENEZ ROOFING50 D6LVN1JolaniaOtT CFi4 Property Record Card Parcel: 02-20-30.520.0000.0560 Owner: WALTER SABINA EMiNOIC°a4UPTt E4A7tilUil Property Address: IIS DRI014 WAY SANFORD, FL 32773 Parrel: o2-Zo-3o-52o-0000-0560 Property Address: 115 ORION WAY Owner: WALTER SABINA Mailing: 115 ORION WAY SANFORD, FL 32773.4417 Subdivision Name: PLACID WOODS PH 1 Tax DSW= SI-SANFORD Exemptions: 00-HOMESTEAD (20D7) DORuse Code: 01-5INGLE FAMILY Legal Descriptlon LOT 56 PLACID WOODS PH I PS 51 PGS 23 THRU 29 Taxes No. 2220pa,P- _5if2 I Value summary I 2015 Working 2014 Certified Values Values Valuation Method Cost/Market Cost/Market Number of Buildings 1 1 Depreciated Bldg Value 70,670— 63,805 Depreciated EXFT Value 600 651 land Value (Market) — 18,000 18,DOD Land value TMarkeA9__ Just/t Value gy 270 82,456 » ` x Portability Adj-- Save Our Homes Adj .. 27,604 — 16,319 Amendment I Adis Assessed Value 66,666- - - 66,137- Tax Amount without SOH: $843.74 2014 Tax Bill Amount $625.28 Tax Estimator TRIM Notk:e Help t Save Our Homes Savings: $218.46 X - • Does NOT INCLUDE Non Ad Valorem Assessments Taxing Authority Assessment Value Exempt Values Taxable value County General Fund 66,666 41,666 25,000 Schools _ 66,666 25,000 41,666 dry Sanford 66,666 41,666 S,agD SIWM(Safnt lohn, Water Management) 66,666 41,666 25,000 County Bonds _ 66,666 1 $41,60 23,006 Sales Description Date Book Page Amount Qualified VacAmp WARRANTY DEED 12/1/2006 06530 1459 198,000 Yes improved WARRANTY DEED 6/1/2005 05804 0082 174,900 Yes Improved FINAL3UDGEMENT 8/1/2002 04492 0826 100 No Improved WARRANTY DEED — - 6/1/2000 - 03875 1892 84,900 Yes _ - improved ` SPECIAL WARRANTY DEED 10/1/1997 10327903317 1738 81,200 Yes Improved WARRANTY DEED 7/1/1997 1310 103,500 No Vacant Find Comparab:e Sales within this Subdivision Land Method Frontage Depth Units Units Prke Land Value LOT 1 181000.00 1$18,000 Building Information http://www.scpafl.org/PareelDetaillnfo.aspx?DID=02203052000000560 8/24/2015 li flf 1 No, 2268M P. 211M hil iigiAug,31. 2015 2:08PM SENEZ ROOFING Pennit No. Tax Parcel Number 0-,, — ::)Q - '2,0 —0000 NOTICE OF COMMENCEMENT State of Florida County Of.aelsla ,no` the edUNDERSIGNED hereby elves notice,ihat improvemont will be made 10 certain realilroper(y, and in accordance w111n Chapter 713, Florida Statules, the following Infarmail 4isNrovided16 (Ills NBlice of Commencement •• 1. Description ofProperly:ILtgWd"CrIPllonofdleprop"IvrvJ5"MICOMM ll.vaheble.f Y N wa A, 2. General desc(pllon of Improvement: 3. Owner information or Lessee information if the Lessee contracted for the improvement: a. ' Name end Address b. IntC'J4)nt rperry c. Name and address of fee •Simple titleholder pf other than'ownar) hlAP r NINI !E: HOWEr , H:'r111S111._E: GOUNI'' Ci..EM OF C74:E L4;'r' C:01,1F.'T & ;JOi' P s.CrL -U-,' CLERK'S r 201'1ll9`67` RECORDED Ai': fiEC:ilhO" % I FEtS i.U,LIG RE.CORDU B hlievrlre 4• a. Contractor: -Name and address YA O( ao' >- u icy( ?Jr•5 I ^ i Ei<1'iF1=QCo i-MaR: DYCLi ge ' I 3.710 cLF Ko.=Tu" rGOURTAN%) b. i'' n( raclOr' s phone tuber — T1q—t'I'Cl5'O LE i., 1' , Iri; SEMINOLc Surely (if applicable, a copy of the a d) ti5. menl on 19 all ch) P yerg'a. NameandaddressIL-ZIEP LtT1(CLLRK b. Phone number C. Antoun ofbond 00 3.12015 AUGn V0. a. Lellder; Name and address Ill. lender' s pllono number . Served as provided by Section 7.13.13(1)(3)77. Persons withintheStaleofFloridadesignatedbyOwneruponwhomnoticesorolllerdocumentsmaybeFlorldn'Stalules: a, • Name and address b. phone numbers of designated persons: 0. a. in addition 10 himself. Ownerdesignates w of the Lienor's Notice as provided In seclion.713.13(1)(b), Florida Statutes.Of to receive a copy b. Phone number 9. Expiration dale of Notice of Commencement (the expRation data is 1 year from the dale of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY -THE OWNERAFTER THE EXPIRATION OF TILE NOTICE OF COMMENCEMENT ARE CONSIDERED. IMPROPER PAYERTSDNDCHAPTER713, PART I, SECTION713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMEN STOYOURPRPERTY. AN OTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON Y11E INSPECTION. IFOBSITE BEFORE 7HE FIRST D OBTAFINNN . CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YO NOTICECOME , Slgl ure of Br GrZosse , or Owner's or LesSga's riled Office rfoircctorfParinerfManager ($ectloh713.151111e)) signato of face State or - 11 i ..Gl County of tare forgoing instrument was acknowledged boloro me this Y\d day of Q (..c .—Ls by C, of a rliy..;e.g. , lruslco, attorney in ran) r L la-aluraot1114rypublic• Stale of Flaldo t2m po or Stamp Name al roolery Publk ' Personally Known OR X. Produced ID ERICKA SENEZ 0'11votaryPublic - Slate of Florida a My Comm. Expires Peb 28. 2018 ; Commission # FE 096066 r r , Type of l0 produced 1(<_ en Vofusla County Permit Canler pax / 380-a22.5774 Aug.24, 2015 3;06PM, SENEZ ROOFIN o.2220 P. 1 Senez Roofing 1060 E: Industrial Dr. Orange .City, Fl. 32763 www.senezroofina.com E-mall: info senezroofin .com Office: (386) 774-4950 Fax: (386) 775-3338 Fax Cover -Sheet Attenton:1- -r -Ir From: Company to: -So Date: i S•. Fax number: -f on- Co —S15,-)- Pages: Re: COMMENTS: i NOTICE: This is privileged and confidential and intended only for the person named above. If you are not that person, then any use, dissemination, distribution or copying of this is strictly prohibited, and you are required to notify me immediately by calling or faxing me (collect if need be) at the numbers above. City of Sanford 4uilding &Fire Prevention Division r 1-1 14ak4ARe-Roof Permit ar PERMIT NO. AT* 01(P 9" ISSUE DATE: CONTRACTOR:S.AR JOB ADDRESS: TYPE OF WORD Z. Post this Permit iri a conspicuous p l5ce 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 ROOF DR Y-IN INSPECTION IS REQ UIRED * * * For Inspection procedures, please refer to the re -roof inspection guidelines provided to you when the permit is issued. The Mitigation Affidavit will not suffice as an alternative to receiving a dry -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 TO SCHEDULE AN INSPECTION: Dial855.541.2112 Provide the items requested during the message The type of inspection requested must be scheduled under the appropriate permit type Follow the prompts PLEASE NOTE: Inspections scheduled by 3:30 p.m. will be conducted the next business day. If you experience difficulty, please call 407.688.5150 Monday - Thursday 7:30 am - 5:30 pm for assistance. AUTOMATED INSPECTION SYSTEM CODES ROOF Roof Dry In 116 Mitigation Affadavit 129 Final Roof 111 Miscellaneous Notes: Miscellaneous Sheathing - Roof 106 Insulation - Roof 119 REVISED: OCTOBER 2014 Inspection Line: 855.541.2112 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 Page 2 Application Number . . . . . 15-00002692 Date 8/31/15 Property Address . . . . . . 115 ORION WAY Parcel Number . . . . . . . . 02.20.30.520-0000-0560 Application description . . . ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . MULTIPLE FAMILY Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 910083 Permit pin number 910083 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 / / V IP CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: Documented Construction Value: $ Job Address: Historic District: Yes No Parcel ID: Residential Commercial Type of Work: New Addition Alteration Repair Demo Change of Use Move Description of Work: Plan Review Contact Person: Phone: Fax: Name Street: City, State Zip: Name Street: City, State Zip: Name: Street: City, St, Zip: Bonding Company: Address: Title: Email: Property Owner Information Phone: Resident of property? : Contractor Information Phone: Fax: State License No.: 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: 5tn 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 in compliance with all applicable laws regulating construction and zoning. Signature of Owner/Agent Print Owner/Agent's Name Date Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID Signature of Contractor/Agent Date Print Contractor/Agent's Name Signature of Notary -State of Florida Date Contractor/Agent is 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: Occupancy Use: Flood Zone: - Total Sq Ft of Bldg: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes No WASTE WATER: BUILDING: 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 in compliance with all applicable laws regulating construction and zoning. Signature of Owner/Agent Print Owner/Agent's Name Date Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID Signature of Contractor/Agent Date Print Contractor/Agent's Name Signature of Notary -State of Florida Date Contractor/Agent is 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: Occupancy Use: Flood Zone: - Total Sq Ft of Bldg: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: UTILITIES: ENGINEERING: FIRE: COMMENTS: of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes No WASTE WATER: BUILDING: Revised: June 30, 2015 Permit Application El Job Address: Parcel ID: Type of Work: New Addition Description of Work: Plan Review Contact Person: Phone: Name Street: City, State Zip: Name Street: City, State Zip: Name: Street: City, St, Zip: Bonding Company: Address: CITY OF SAIVFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: Documented Construction Value: $ Historic District: Yes No Residential Commercial Alteration Repair Demo Change of Use Move Title: Fax: Email: Property Owner Information Phone: Resident of property? Contractor Information Phone: Fax: State License No.: Arch itectlEngineer 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: 5" Edition (2014) Florida Building Code Revised: June 30, 2015 Permit Application is ae. one 0712312015 12:32 City of sanfora - bu 1 2 4 r V tr-ax)aviunao lu t1.uv41vv1 CITY OF SANFOR:D BUILDING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: / J y';)-( 9 hereby acknowledge that I personally inspected Roof deck nailing and/or OAecondary water barrier work at ` 'e,' ' and have determined that the work Job Site Address) was done according to the Hurricane Mitigation Retrofit Manual. (based 'on 553.844 F.S.) s f I certify that my statements herein are true and accurate to the best of my belief and that I bully 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. J 9/ iS Signature of Contractor Date Y'olelz' exlaq7y k' Printed Name of Contractor 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 COUNTY OF w r to (or firmed) and subscribed before me -this 1 day of4, 20_ S , by P/L , who isdPersonally Known to m6 or has Produced (type of i t Pica ' n) as identification. SEAL) - J A Q ture oi'p try Public Print/ Type/Stamp ofNotarypublic4 i err t [ Jr I A' NEIDY S. ESPINOSA I 777Notary Public -State of Florida Expires Jun 2, 2016 41 My Comm. Commission # EE 203953 rj' l p 1 ; ;° : Bonded Through National Notary Assn.