HomeMy WebLinkAbout107 Splitlog PlApplication No:
Job Address:
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
CZDocumentedConstructionValue: S " AP
107 SPLITLOG PL SANFORD FL 32771 Historic District: Yes Nor
Parcel ID: 33-19-30-514-0000-0670 Zoning:
Description of Work: RE RQOF
Plan Review Contact Person: Pe k "..Is < d I,.t., c Title: egs--o1w Phone:
f l. f2% -03o7 Fax: E-mail: 9 cow. Lor
Property
Owner Information Name
BRIAN WYLIE Phone: (407) 687-8266 Street:
107 SPLIT -LOGPLACE Resident of property? : QWNER City,
State Zip: RAKIFnRn FI 32771 Contractor
information Name
TAG GENERAL CONTRACTORS. INC. Phone: (407) 617-8066 Street:
1700 HOURGLASS DR Fax: (407) 601-7997 City,
State Zip: ORLANDO FL 32806 State License No.: CGC61644 Architect/
Engineer Information Name:
Phone: Street:
Fax: City,
St, Zip: E-mail: Bonding
Company: Mortgage Lender: Address:
Address: Building
Permit Square
Footage: No.
of Dwelling Units: Electrical
New
Service — No. of AMPS: PERMIT
INFORMATION Construction
Type: No. of Stories: Flood
Zone: 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, poops, furnaces, boilers, heaters, tanks, and
air conditioners, etc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate anA 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
Print oNmer/Agents Name
Date
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
COMMENTS:
UTILITIES:
Signature o 'ontractor/Agent Date
Print ' tractor/Agent's Name
a -)-/ P /J,--
Signature of Not -State of Florida ate
p pSliYE.EVI
r 8SlOt1
V.2016
ttoeo.et++a
Contract gent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
ENGINEERING: FIRE: 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 1NSTRU ENT FREPAR
4DY: Name: (1 °•;;:
f;;:,::: ;,.,r.:. c hint
Address:
IT
C:t.F.EKKrS 20-iF L4.208
iii:.....1.:)L'.L: :.rr.tti,.i.r...i
NOTICE OF COMMENCEMENT _ _ - 14 ,,n lU
i%:•'.:i? t f? f3Y
Permit Number: / /}
Parcel ID Number — - Q o o — 1, q
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.
2. GENERAL DESCRIPTION OF IMPROVEMENT:
C.F aoF
3. OWNER INFORMAVRN OR LESSEE INFORMA-qON IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: %atJ J •. W :a: Sp..LO QCe. aa Fer.D• <. dl l t
Interest in property:
Fee Simple Title Holder (if other than owner listed above) Name:
4. CONTRACTOR:
Address: k1 'Zi
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
NLsnber: `401 -6 n - $0 b
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.
Address:
8. In addition, Owner designates
Phone Number:
of
to receive a copy of the Llenor's Notice as provided in Section 713.13(1)(b), 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 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. l'
6' (Signature of Owner ee, rr Owner's or Lessee's
Autiwdzed otflcer0rectaf/PartnerlManager)
Print Name and ProWde oratory's Tlge101fl"IT,
State of 1 County of .?••, zc....,e,_.e c'
The foregoing Instrument vpas acknowledged before me this day of _
by xn'i. K > f` ! c.; Who Is
of person ma" statement
who has produced Identification type of Identification produced:
unqn* PATRW A A. MANN
NIY COI,rtAOSSION S FF 110411
s - ar EXPIRES: Apd 7.20185,190 Bonded'Rnu Nomry Pu* Undarrrtkm
known to me 43"bl
R
4
Nathq Signature yar
LINIITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 7,. /—/
I hereby name and appoint: Dennis Thomas
an agent of: TAG General Contractors Inc.
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 for work located at:
Street Address)
Expiration Date.for This Limited Power of Attorney: 06/20/2016
License Holder Name:_ Anthony Moore
State License Number: CGC061644
AV
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before me this day of
200-, byrjy ,.,• who is personally known
to me or o who has produced
identification and who did (did not) take an oath.
Signature
Notary Seal)-Dneol—n- E "Eve' —
Print or type name
Notary Public - State of
Commission No. /2.72. k-o:-
My Commission Expires: -
Rev. 08.12)
as
F +„_
C97
4
MA,4 Orlando, FI 32806
TAG General Contractors Inc. 1 REFERRED
2875 S Orange Ave.
CONTRACIORSuite500/1615
401, 4U5 , Tampa 813-693-1950 Fax: 1-866-740-9216
General Contractors Inc. Orlando407-617-8066
V _ taerooicom
AGREEMENT
THIS AG MENT IS SUBJECT TO INSURANCE COMPANY APPROVAL OF PAYMENT / NO INITIAL
CUSTOMER
ES
p J • W l (_ \ -lZ
STREET
CITY Siz" FOND ST F L ZIP 3311
HOME f,Iiffll
CELL y 01-• (*23-) -$ a lob FAX
E-MAIL ADDRESS
SOURCE
PROJECT MANAGER
SPECIFICATIONS
0,YrANUFA6TURER OF SHINGLE
USTYLE OF SHINGLE R
ErCOLOR OF SHINGLE
V,,e rO&,.P„>zo W 00 0
V*LLEY
BENTS STYLE
BAR OFF YES LAYER (S)
D-PITCH S' ka 2 STORY
E PERMIT FURNISHED REPLACE ALL BOOT JACKS
30 OUND FELT E"IC^E & WATER SHIELD
S,. • h1ti..C.
REMOVE ROOF TRASH FROM ROOF, GUTTERS & YARD
B-MTECT LANDSCAPE WHERE NEEDED
SPECIAL INSTRUCTIONS
1v sp k
PAYMENT SCHEDULE
y
FIRST PAYMENT 50% M
SECOND PAYMENT 50a46
FINAL PAYMENT DUE AFTER ROOF COMPLETED
CUSTOMER AGREES TO PAY US 25®/
OF THE INSURANCE APPROVED DOLLAR AMOUNT
IF CUSTOMER CANCELS AFTER THE INSURANCE
9-ROLL YARD WITH MAGNET ROLLER
l _
APPROVES PAYMENT FOR THE DAMAGE.
B-DRIP EDGE KEEP / REPLACE -COLOR
TERMS:
Tag General Contractors Inc. is considered to be a certified roofing contractor CCC 1328779 and General Contractor CGC 061644.. THIS CONTRACT DOES NOT OBLIGATE
THE PROPERTY OWNER OR "Tag General Contractors" IN ANY WAY UNLESS IT IS APPROVED BY THE PROPERTY OWNERS INSURANCE COMPANY and or
HOMEOWNER AND ACCEPTED BY "Tag General Contractors." BY SIGNING THIS AGREEMENT THE PROPERTY OWNER AUTHORIZES 'TAG" TO PURSUE THE
PROPERTY OWNERS BEST INTEREST FOR PROPERTY REPLACEMENT OR REPAIR AT A "PRICE AGREEABLE" TO THE PROPERTY OWNERS INSURANCE
COMPANY AND "TAG" WITH NO ADDITIONAL COST TO THE PROPERTY OWNER OTHER THAN THE INSURANCE DEDUCTBLE. WHEN "PRICE AGREEABLE"
HAS BEEN DETERMINED IT SHALL BECOME THE FINAL CONTRACT AMOUNT AND THE PROPERTY OWNER AUTHORIZES "TAG" TO OBTAIN LABOR AND
MATERIAL IN ACCORDANCE WITH THE 'PRICE AGREEABLE" AND SPECIFICATIONS SET OUT HERIN AND ON THE REVERSE SIDE HEREOF TO
ACCOMPLISH THE REPLACEMENT OR REPAIR. THEREFORE "TAG" ACTING AS YOUR CONTRACTOR WILL BE ENTITLED TO ALL INSURANCE PROCEEDS IN
ACCORDANCE WITH THIS AGREEMENT. ALL PRICES ARE SUBJECT TO CHANGE. YOU, THE BUYER, MAY CANCEL THIS PURCHASE AT ANY TIME PRIOR
TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS AGREEMENT. TAG GENERAL CONTRACTORS INC.DISCLAIMS ALL WARRANTIES,
EXPRESSED OR IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE EXCEPT AS SPECIFICALLY EXPRESSED ON
THE REVERSE SIDE OF THIS AGREEMENT. IF FOR ANY REASON THIS ROOF IS NOT COVERED BY INSURANCE AND THE HOMEOWNER WOULD LIKE US
TO PROCEED IVITH THE WORK IT WOULD BE THE RESPONSIBILITY OF THE HOMEOWNER TO PA YIN FULL FOR THE ROOF.
SIGNBELOW IF YOU WOULD STILL LIKE US TO PROCEED WITH THE WORKAND YOU WILL PAY FOR 100% OF THE WORK QUOTED.
I \ UNDERSTAND ROOF IS NOT COVERED BY[rVSURANCE AND I AGREE TO PAYIN FULL FOR ROOF.
CUSTOMER HAS READ AND AGREES TO ALL TERMS AND CON VS ON THE BACK OF THIS AGREEMENT.
ACCEPTED BY HOMEOWNER(S) ON: DATE S BY X
CO-OWNER: DATE / / BY X
TAG REPRESENTATIVE: DATE / a / \ S BY X
INSURANCE CO. CLAIM NO. ADJ DA I W I I NIL
v Lip e4r... Gv t4g3 3
City of Sanford
Building & Fire Prevention Division
Re -Roof Permit Card
7 PERMIT NO. /%5 A al S iw ISSUE DATE: 4 j
C 11cam.
CONTRACTOR: 7-0
JOB ADDRESS:
wg:;
TYPE OF WORK:RIC #f0
i /o 41 140/
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 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 . . . . . 15-00002255 Date 7/07/15
Property Address . . . . . . 107 SPLITLOG PL
Parcel Number . . . . . . . . 33.19.30.514-0000-0670
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 904482
Permit pin number 904482
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
1, ' ,2 hereby acknowledge that I personally inspected
Roof deck nailing and/or Seconda water barrier work
at %7 Spz HC& Cf i
and have determined that the workJobSiteAddress)
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 fullyunderstandthatmakinganyfalsestatementsinwritingwiththeintenttomisleadapublicservantinthe
performance of his or her official duty sball constitute a misdemeanor of the second degree pursuant toSection837,90.S.
of Date
Printed Name of Contractor License #
License Type: General 0 Building 0 Residential Roofing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF
Sworn to (or affirmed and subscribed before me day of 20 b
who is ersonally Known to me or has Produced(typefidentifationasidentification.
w. (SEAL)
Signature of Not ry Public
State of Florida
Print/Type/Stamp Name
of Notary Public
27.208
PUWMn
3
llill 1
1
s
a
Ju1.17.2015 11:22 AM TAG General Contractors I 4076017997 PAGE. 1/ 2
CITY OF SANI+ORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigatioh Inspection ,Affidavit
Permit #:
1, 10 hereby acknowledge that 1. personalty inspected
t'Roof deck nailing and/or Q Secondag water barrier work
at lo7 SPA" -HC&
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 statOMOnts herein are true and accurate to the beat of my Relief and that I follyunderstandthatmakinganyfalsestatemcntainwritingwiththeintenttomisleadapublicservantisthe
performance of his or her of miai duty shall constitute it mbdemeanor of the second degree puratiant toSection837,00.S. A
Date
yyEw ALaAZ6 !3PrintedNameofContractorLicense #
License Type; N'GCnaral d Building q Residential Woofing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection,
STAVE OF FLORIDA COUNTY OF
Sworn to or affirmed and subscribed before e _ day of , 20 ,
A who is emonally V,aown to we or bas 17 Produced (type ofi+denti tion) as identiilatlon.
Signature of No ry Pub[ic (
SEAL)
State of Florida
1-11vtom
Printf ype/stamp Rame
of Notary public