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HomeMy WebLinkAbout2260 Trillium Park Lnof (e! as CITY OF.SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Pp ! / 1AIicationNo: Documented Construction Value Job Address: a% rk__ L",v-- Historic District Parcel 1D: Id -026-3Q-5-Iq- 00106 - 49,550 Zoning: Description of Work: 'srnc l air»ly.i tQ e c Tou nhornES - Plan Revie > Contact Person: V(CJt 1 C' Title. eXmif 3ord-z)'U<' Phone: 411)7 95-0-aX,9 Fax: F 89Y7 E-mail: y!V-u.rre,rq drhbt'4an •e v,ri I Property Owner Information Name r-on 1i1C. Phone: ktD'-I - f50- S DO Street:Jr1 0 1 /-e ms Y'O(. , lode Resident of property`.' City, State Zip: et.) 3a 2 Contractor Information Name 54-Ve_n C q Phone: Ltb 7 - Y -5b - Ya 6 O Street: 5850 ! Yd . , Fax: City, State Zip: Or%Mdo ., /::L3,Va9 State License No.: /025 alb Architect/Engineer Information Name: &nn Street:, City, St, Zip: oApj-MI)n-f Bonding Company: Address: Building Permit O Square Footage: No. of Dwelling Units: Electrical New Service - No. of AMPS: Phone: d 10 Fax: E-mail: Mortgage Lender: &1-4 Address: PERMIT INFORMATION Construction Type: 14 No. of Stories: Flood Zone.- Mechanical one: Mechanical (Duct layout required for new systems) Plumbing 0 New Construction - No. of Fixtures: Fire Sprinkler/Alarm No. of heads: s lo, 33- - G 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: 1 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. Signature of wncr;'Aa Date am I Cc S, t X101 Print OwnevAgent's Name o114111v Signa t'u s of Honda Date VALERIE L. FURRER Commission DD 668238 Expires May 25, 2011 RIM" ftnddd fhib Troy fO Murano 800-385.7019 Owner/A-ent is /Personally Known to Me Q Produced ID Type of ID APPROVALS: ZONING: ENGINEERING: COMMENTS: Rev 11.08 UTILITIES: FIRE: Print Contractor/Agent's Name SiLnawre of Notary -State of Florida Date VALERIE L, FURRER Commission DD 668238 a CXplres May 25; 2011 00 104 Tart, NY twin inswanoo eMaos•io19 Contractor/Agent is Personally Known to Me or Produced ID Type of ID WASTE WATER: BUILDING: /O S?o /u r kS rw q Y CITY OF SANFORD- BUILDING &.FIRE PREVENTION,: PERMIT APPLICATION Documented Construction Value: S /S3, q7 6"DApplicationNo: Job Address: I,& a Historic District: Yes No Parcel ID: 4o2 ,oZd-307 jq6,0010 49,5 U Zoning: Description of Work: rr ale ' ra-'r0& ' Q. 4g d Tai nho/YleS - Plan Revie.;. Contact Person.(CJf P11one:: SO -,5a8, Fax -d29,5-- 89rpq E-mail: _I rre_r a d r r4,og Property Owner Information Name T. _j r_ on 1-t \C . Phone: Street: 5M / . ra . ,Le -9 {>Q(, , (oD6 Resident of property? City, State Zip: 6r- Jay) etc, Contractor Information Name '54e-ven V"J-I)q Phone: L[6 7- b'S6 -Sad o Street: 585D l , Ca. LF -,e 1 Yd Fax: Riee - 0i9.5-- City, State Zip:, Orl o-od-o State License No : Architect/Engineer Information e i j1 c@Nam.rrl tc.r1 Phone: ?,,!Sa 2q, _-6110u Street:, Fax: City; St, Zip: 1r^dY1nT'11 I- Z- 31`l. E-mail: Bonding Company: A Address: Building Permit O Square Footage: /,57,9-5'_ No. of Dwelling Units: Electrical Mortgage Lender: Address: PERMIT INFORMATION Construction Type:c5VP- I No. of Stories: Flood Zone: New Service - No. of AMPS: Mechanical (Duct layout required for new systems) Plumbing New Construction - No. of Fixtures: Fire Sprinkler/Alarm No. of heads: V Application is hereby made to obtain a permitto do the work and installations as_ indicated. - 1 certify that no work.or installation has commeneed 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 MAS' 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 f-om 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 Ipast 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 wrle.iAe Date Lo" I I i Cm f--- o 0( Print OwneirAeent s Name Siena t11v-State of Flolida Date VALERIE L. FtJRRER Commission CLQ 668238 s Fr n* EXOM falay 25 201111dgyp,;, R ndo fhrU Tmy 900-305-7079 Owner./A(,ent is /Personally Known to Me or_ Produced ID Type of ID APPROVALS: ZONING: ENGINEERING: COMMENTS: Rev 11.08 iv Contractor/Agent is Personally Known to Me y Produced ID Type of ID UTILITIES: ASTE WATER: FIRE:. BUILDING: Signature of Notary -State of Floida Date tins t elL &w: V ALE RfllE URRE(}R) 9 FEU 1Lri i/`.,rl tl f flJJ f+J! {w'lJ W6(7f'.JO fi 3ty Expires luiav 25, 2011 9g[j';Irl1 TPS tu7LICGurfillCO t'G'd•'vG•701A Contractor/Agent is Personally Known to Me y Produced ID Type of ID UTILITIES: ASTE WATER: FIRE:. BUILDING: 3 3 - CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: I . Documented Construction Value: S 1,5-30 0q7 00 Joh Address: (oD I,^ //,i'u m =L. L l - historic District: Yesf] No Parcel ID: X02 -old 3D- s"/q_ 6,9,00 — 09,E6 Zoning: Description of Work:'r',% ayri>'lytfa c DLc7nho/Y1eS Plan Reviei-: Contact Person: klex i 121 Title- ertn'lOporXilk 'L< Phone: l7 SSD -5a8"?- Fax: (' yr S 8gr-1 E-mail: Vtrr2r,q dr)7b' o/).E,e'rr Property Owner Information Name 4—ty r4c,-) 1 i1C . Phone: `7 - .,a5"6 -SabC3 Street: S S 1 L e e- Jl° , .. #CoO Resident of property? City, State Zip: Contractor information Name -54e -yen -q Phone: ,YS6 -Sao 0 Street: 85 C-) —7-5)YGl Lv Fax: o 9S-g g 9 Cite, State Zip:. (,fir ,4-nd a State License No.: Arch itect/E'ngineer Information Name: Phone: &!sa' Street:/a 1 SSS Fax: City, St, Zip:E-Z-E-mail Bonding Company.- 1Mortgage Lender: tl/t' Address Address: PERMIT INFORMATION Building Permit Square Footage: /S j Construction Type:,5FP, 114 No. of Stories. - No. of Dwelling Units: Flood Zone: Electrical Plumbing New Service - No. of AMPS: New Construction - No. of Fixtures: Mechanical' (Duct layout required for new systems) Fire Sprinkler/Alarm 0 No. of heads: Application is hereby trade 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,.,hcaters, 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 alt„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 as water management districts; state agencies, or federal agencies. Acceptance of permit is verification that 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713. f 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. SiDnature of wner'A9 Date Lam' I 1 ccr-1 Print Owner Anent s Name Sisna N” t;m'- tate ort 1c ri to DateN" tvm'-State orl lc ri la Date N° LI VAERIE L. FURRER Comr(iission DD 668238 tn f E' Ip, rots May 25, 2611I) 'H k.ontlatl Thal ?vy hilllnpu^nm 3 PpU-385-70!9 Owner/Agent is V Personally Known to Me n-_ Produced ID Type of ID APPROVALS: ZONING: ENGINEERING COMMENTS: Rev 11-08 Ae-ye.n Print ContraetodAgent's Name Signature of Notary -State of Florida Date VALERIE L, VALERIE FURRER br slon DD 668288 w L-XPlr33 day 25:2-011J,, t Hop,10Itn Tf, l u n y crrneo PoO.9&s•7o19 Contractor/Agent is Personally Known to Me or Produced ID Type of ID UTILITIES: %r MIS) -I WASTE WATER: FIRE BUILDING`. ix a OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: #439 Documented Construction Value: $ /53, o97, o© Job Address: aloD L.^, u m 1L L.<</1-- Historic District: Yes 0 N. I Parcel. ID: Xo7 -,PO 30 Woo - X 950 Zoning: f Work: 3I rale_ Description of, ra_m l'( li f Ct} Tou h{o/Y1ES Plan Revie,-- Contact Person: Ahle e-- . Title— Fax: - 95- $9,19 E-mail: Vjrrer,c 'drhbr4dn.,' Property Owner Information Name , . 11 J o r4 -or) 1i\L' . Phone: '7 - 50 -SaDC3 Street: JySD ! %e 'L 9l dd . , :-ff 6,06 Resident of property? : City, State Zip= Qr'/ov1 et L 3ab 23 Contractor Information Name. 5j'e-Ve-ny[a/t,lq Phone: Ltb 7- b'Sb - Sad o' Street: ."5850 ! , r Le -.e-- 1 >'d . LP b0 Fax:{ City, State Zip:, Or/aj)d-o 4 /::i 3 D9 State License No.: Architect/Engineer Information Name: je m&f)n Street:, _.0 oZ ISSN City, St, Zip: t—ie rbYlnnt. 3+1j Bonding Company:Wit 1A Address' Phone.- Fax: hone: Fax: E-mail: Mortgage Lender: A114 Address: 1 PERMIT INFORMATION Building Permit [J Square Footage: / Construction Type:t'5k !) No. of Stories: - No. of Dwelling Units: Flood Zone: X (See- Aj(clr.e Electrical..,[] '. Plumbing New Service - No of AMPS: Ne -vv Construction - No. of fixtures. - Mechanical.,[] (Duct layout required for new systems) Fire Sprinkler/Alarm No. of heads: 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 ali'laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, beaters, 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 1agencies, 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 wner'Ae Date Signature Agent W', I I i cuy) F--- P) t SYI p of Prin%t Owner Agent's Name Signa Ntvv-State of Honda Date Y" VALERI L. FIJRRER Ccmnis.ssion DID 668238 Ex ireG May 25, 2011 f. orid9tl-YMdl rar l Iri n,urai q H00-385-7019 - Owner/A-ent is /Personally Known to Produced ID Type of ID Print Contractor%A,gent`s Name Signature of Notary -State of Florida Date tiny nt c VALERIE L FIJRRER s . 4` ,.. n;nmission DD 668238 r,Y. Iw,Plros Mia"', 95 20i1 aFl ,1 9urd d *tlrN?M Rut IrFCra,^,c0 (iCC fi5901A . Contractor/Agent is Personally Known to Me or Produced ID Type of ID APPROVALS: ZONING-Ako.I'IO UTILITIES: WASTEWATER: ` COMMENTS: Rev 11.08 ENGINES Io_-"uq-/GO FIRE: BUILDING:` City of Sanford Planning and Development Services 8171Engineering - Floodplain Management Flood Zone Determination Reauest Form Name: 0. 2 f i _ Firm: 0 t z— Address: $6 S0 -T . Cz .Lem f3l cl. Sw 1 Coco City: State: (_ Zip Code: 3z8Z"L Phone: yo 7.8ro • S, -B z Fax: L?4G • 29S•Y9,69Email: 11LXtr kr e c1r '6 c k C' . W X Property Address: - n Property Owner: -t-) , (Z, VAzo r-6 v Parcel identification Number: I a • 10 - 3o • coop 09 So Phone Number: qo -t - >a,So 5200 Email The reason for the flood plain determination is: New structure Existing Structure (pre -2007 FIRM adoption) El Expansion/Addition Existing Structure (post 2007 FIRM adoption) Pre 2007 FIRM: adoption = finished floor elevation 12" above BFE Post 2007 FIRM adoption = finished floor elevation 24" above BFE (Ordinance 4076) a, 9 a OFFICIAL US'E O.IVLY 4,3 Flood Zone }( Base Flood Elevation: Datum: FIRM Panel Number: I2o 29 4 Oo7t7 . F Map Date: 9 • Z -v p -( The referenced Flood Insurance Rate Map indicates the following: The parcel is in the: floodplain floodway A portion.of the parcel is in the: floodplain floodway The parcel is not in the: , floodplain floodway The structure is in the: floodplain floodway The structure is not in the:floodplain floodway If the subject property is determined to be flood zone `A', the best available information used to determine the base flood elevation is: Revie V Date: 10 • ZG TAEngr-Files\Elevation Certificate\Flood Zone Determination Request Form.doc SEMINOLE COUNTY !I/MUL TI—JUR ISDICTIONAL OYM Altamonte Springs, Casselberry, Lake Mary, Longwood, Oviedo, Sanford, Seminole County, Winter Springs Date: 1 l 1 1( l Project Name: Building Permit #: Windsor Lakes Project Address:W t l ((,( u 1_U Electrical Permit #: In consideration for authorizing the appropriate utility company to energize the facility, we agree with and understand the following: 1. The facility will not be occupied until a certificate of occupancy has been issued. 2. If the jurisdiction hereafter finds that the facility has been occupied before a certificate of occupancy has been issued, the jurisdiction will have the unilateral right to direct the utility to terminate electrical service without notice. Furthermore, we understand and agree that should the jurisdiction exercise such right, the jurisdiction will not be responsible for any damages or costs which may result from the exercise of such right. Also, in the event any third party claims damages from the exercise of such right, we agree to jointly and individually indemnify and hold harmless the jurisdiction from all such damages and costs, including attorney's fees. 3. The building or structure shall be weather tight and secure. The electrical wiring in the area designated for pre -power shall be complete and in safe order. All electrical services associated with the area will be 100% complete unless specifically approved by the electrical inspector. 4. Interior electrical rooms shall be lockable, if electrical panels are in an area that cannot be locked by doors, the panels shall be equipped with a locking mechanism (approved by the AHJ). The licensed electrical contractor or his licensed representative shall hold the keys(s) for such access to electrical panels to prevent energizing. circuits other than those that are safe. 5. If provided, the fire sprinkler system must be operational, per the local AHJ requirements, with water. on the system prior to pre -power. 6. This pre -power approval is valid for a maximum of 180 days from date of approval. 7. Check with the local jurisdiction for fees associated with pre -power. Lar . Thompson Steve R. Young _ Joe Strada Pri e of Owner/Tenant Print Na Gen o tr for Print f 1. Contractor Signature of Owner/Tenant Signre of Ge - ontr r gna of EI. Contractor CBC1252T EC13003715 Gen. Contractor License # E1. Contractor License # JURISDICTION I EMPLOYEE NAME: JURISDICTION: CALLED INTO: Progress Energy Florida Power and Light on Rev. 3/27/07) U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program Al. Building Owner's Name D R HO A2. Buildino Street Address ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. OMB No. 1660-0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION Forrinsur.'anceCgm'pa_ny Uses , jhl Suite, and/or Bldg. No.) or P.O. Route and Box No. City SANFORD State FL ZIP Code 32773 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 89, WINDSOR LAKE TOWNHOMES EAST A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: tat. 28'46'05T' Long. -81°16'630" Horizontal Datum: NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1A A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 0 sq ft a) Square footage of attached garage. N/A sq ft b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? Yes ® No d) Engineered flood openings? Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community NumberI B2. County Name I B3. State CITY OF SANFORD 120294 SEMINOLE FLORIDA B4. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12117CO070 F Date Effective/Revised Date Zone(s) AO, use base flood depth) 9-28-2007 9-28-2007 X N/A 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. FIS Profile FIRM Community Determined Other (Describe) B11. Indicate elevation datum used for BFE in Item 69: NGVD 1929 NAVD 1988 Other (Describe) N/A B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes ® No Designation Date N/A CBRS ORA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: Construction Drawings' Building Under Construction' Z Finished Construction A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized 304-22-01.ELEV=45.941' Vertical Datum NGVD1929 Conversion/Comments Conversion to NAVD'88 Datum (A.031 Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 43.8 ,feet meters (Puerto Rico only) b) Top of the next higher floor 54.2 ® feet meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) N/A. feet meters (Puerto Rico only) d) Attached garage (top of slab) N/A. feet meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 43.5 0 feet meters (Puerto Rico only) Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 43.2 ® feet meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 43.3 (D feet meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A. feet meters (Puerto Rico only) structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation - information. / certify that the information on this Certificate represents my best efforts to interpret the data available. l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. F ". Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a LA licensed land surveyor? Yes No L/ , Name JAMES W. BOLEMAN License Number 6485 Title PROFESSIONAL SURVEYOR & MAPPER Company Name American Surveying & Map ress 1030 N. ORLANDO AVE, STE B City WINTER PARK State FL ZIP Code 32789 Signature Date Telephone (407) 426-7979 FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. Insurance Com an Use Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. P oI cyNuber„ t 42360TRILLIUMPARKLANE,.., City SANFORD State FL ZIP Code 32773 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner. Comments Surveyor is only responsible for Sections A - D. Item B1: Community name & number is based on property appraiser's website and the FIRM. Item C2.e: The Elevation shown is for the A/C unit. Sod is not installed yet. This document is not valid if photographs are removed or omitted. i ti re Date Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is feet meters above or below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is feet meters above or below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor elevation C2.b in the diagrams) of the building is feet meters above or below the HAG. E3. Attached garage (top of slab) is feet meters above or below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is feet meters above or below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? Yes No Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the;applicable item(s) and sign below. Check the measurement used in Items G8 and G9. G1. The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. G3. The following information (Items G4 -G9) is provided for community floodplain management purposes. G4. Permit Number I G5. Date Permit Issued I G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: New Construction Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: feet meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: feet meters (PR) Datum G10. Community's design flood elevation feet meters (PR) Datum Local Official's, Name_ Title Community Name Telephone Signature - Date Comments Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 2360 TRILLIUM PARK LANE City SANFORD State FL ZIP Code 32773 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View' and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. Building Photographs Continuation Paoe For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 2360 TRILLIUM PARK LANE City SANFORD State FL ZIP Code 32773 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." ADDRESS: 2360 TRILLIUM PARK LANE SANFORD FLORIDA 32773 FOR THE BENEFIT AND EXCLUSIVE USE OF: DR NORTON BOUNDARY & AS -BUILT SURVEY DESCRIPTION: (AS FURNISHED) a LOT 89, WINDSOR LAKE TOWNHOMES AS RECORDED IN PLAT BOOK 70, PAGES 44-51, OF THE PUBLIC RECORDS OF SEMINOLE COUNTY, FLORIDA Z 1" = 20' TRACT A, GRAPHIC SCALE COMMON AREA O 10 20 COVERED j ENTRY 1 0.5' 15.2' -J WALK IS /. 1.1' S. i'''; '..,:.g' S/W.;.•..•• I I IIIIII I I I I I I I I I I I I I I I I I I I I 43 6 15.33' I 15 33' I 15.33- I 15 33' I 1 L-------L-------L-- 15.33- --16-7'7- 15.0'. — — - WALK IS 1.3' S. S89'22 41 W 16.17' PRC 62 o, \ 24.0' INGRESS/ EGRESS EASEMENT No y I o O I vO m PIPFgs CR\. o\ TRACT 'A' --- I------- S COMMON AREA / I 3.33' I o V PT 261.95' _ O 89'22'41"E 265.28' PI CB,Iro -4S!/+ O \ / / a``6 INNTERLINE OF OGRESS/EGRESS ^' OAS6 0. \ e'I 00 ag19 EASEMENTcl q s SAO \ \ % r \ / / PC Cc` g0pb / s — — — — — NOTES: \ 24.0' INGRESS/ 1. ALL DIRECTIONS AND DISTANCES HAVE \ ./ / EGRESS EASEMENT BEEN •,FIELD VERIFIED, INCONSISTENCIES HAVE 4p, BEEN NOTED ON THE SURVEY, IF ANY.j Lebo ! S / 2. PROPERTY CORNERS SHOWN HEREON WER, / SET/FOUND ON 03-25-11, UNLESS OTHERWISE\ SHOWN. \ PI 3. THE SURVEYOR HAS NOT ABSTRACTED THE \ LAND SHOWN HEREON FOR EASEMENTS, RIGHT OF LEGEND WAY, RESTRICTIONS OF RECORD WHICH MAY \ AFFECT THE TITLE OR USE OF THE LAND. \ CENTERLINE u FOUND NAIL do DISC RIGHT OF WAY UNE LS /2494 4.N UNDERGROUND IMPROVEMENTS HAVE BEEN / I EXISTING ELEVATION SET 1/2" IRON ROD AND CAP LOC93 A/C AIR CONDITIONER D T ADELTAAANGLE 5. BUILDING TIES SHOWN HEREON ARE 0 CONCRETE (P) PER PLAT NOT TO BE USED TO RECONSTRUCT THE C CHORD LENGTH PC POINT OF COMPOUND CURVE CURVATURE PCC POINT OF BOUNDARY LINES. C.B. CHORD BEARING C8W CONCRETE BLOCK WALL PCP PERMANENT CONTROL POINT - CNA- CORNER NOT ACCESSIBLE PI POINT Of INTERSECTION 6. ELEVATIONS SHOWN HEREON ARE BASED ON PK PARKER KALON 4573601 CP CONCRETE PAD POC POINT ON CURVESEMINOLECOUNTYBENCHMARKNCSCONCRETESLABPOLPOINTONLINE AS BEING 46.22' PER NGVD 1929. C/w CONCRETE WALK PRC POINT OF REVERSE CURVATURE EE.M.A.-FEDERAL EMERGENCY MANAGEMENT AGENCY PRM PERMANENT REFERENCE MONUMENT 7. THE FINISHED FLOOR ELEVATION OF THE D R M IDENTIFICATIFLOOD ON PSMRATEMAP PSM PROFESSIONAL SURVEYOR AND MAPPER PT POINT OF TANGENCY L ARC LENGTHSTRUCTURELOCATEDATTHEABOVELOCATION LB LICENSED BUSINESS R RADIUS LEGAL DESCRIPTION, MEETS OR EXCEEDS THE RP RADIUS POINT LS LICENSED SURVEYOR S/W SIDEWALK REQUIREMENTS` SET FORTH IN THE CITY OF (M) MEASURED TYP TYPICAL SANFORD CODE CHAPTER 18. SFC 18-4-(A) OHU OVERHEAD UTILITY LINE UP UTILITY PAD I HAVE EXAMINED THE F.I.R.M. COMMUNITY PANEL NUMBER 16.17' 120294 0070 F. DATED 09-28-07 AND FOUND THAT THE THIS BOUNDARY SURVEY 1S NOT VALID ti N89'22'41 "E 100 YEAR FLOOD PLAIN. THE SURVEYOR MAKES NO RAISED SEAL OF A FLORIDA LICENSED GUARANTEES AS TO THE ABOVE INFORMATION. PLEASE as"A SURVEYOR AND -MAPPER. CONTACT THE LOCAL F.E.M.A. AGENT FOR VERIFICATION. 3.5'x3.5'',.' 15.33' T- T -------T------ T ------- 1 15.33' 1 15.33' 1 15.33' 1 16.17' L: 1 s.o' — - 0.5' A/C EdI I I I I COVERED'o 4.0j F== 1 REVISED: U F?' G ENTRY.'.^ I 11.7' 1 I I I I I I I I I I APPROVED BY: JB LOT i L91T ; 92T i LOT i LOT FOR JOB NO. 0100403 LOT 89 FOUNDATION/FINAL 90T II II II 93I 94 II DRAWN BY:(407) PLOT PLAN 10-13-10 BW of I( nIz y JAMES W. BOLEMAN PSM 6485 DATE N O l OLnomTWOSTORY j z v A CONCRETE cj BLOCK I v 0 I I I I I- DLpLOT95 z n IO O -' m WOOD FRAME I g __:0 RESIDENCE 1 CO la 1u IN cnlo IN Al9 m If i m I Z I>- FINISH FLOOR I I Frl Iv 81 01u M 11A01S I 810 C; olv 0lr I Iv a DVI ELEV.=44.83' III O Im C 10 m Im I Im I to to COVERED j ENTRY 1 0.5' 15.2' -J WALK IS /. 1.1' S. i'''; '..,:.g' S/W.;.•..•• I I IIIIII I I I I I I I I I I I I I I I I I I I I 43 6 15.33' I 15 33' I 15.33- I 15 33' I 1 L-------L-------L-- 15.33- --16-7'7- 15.0'. — — - WALK IS 1.3' S. S89'22 41 W 16.17' PRC 62 o, \ 24.0' INGRESS/ EGRESS EASEMENT No y I o O I vO m PIPFgs CR\. o\ TRACT 'A' --- I------- S COMMON AREA / I 3.33' I o V PT 261.95' _ O 89'22'41"E 265.28' PI CB,Iro -4S!/+ O \ / / a``6 INNTERLINE OF OGRESS/EGRESS ^' OAS6 0. \ e'I 00 ag19 EASEMENTcl q s SAO \ \ % r \ / / PC Cc` g0pb / s — — — — — NOTES: \ 24.0' INGRESS/ 1. ALL DIRECTIONS AND DISTANCES HAVE \ ./ / EGRESS EASEMENT BEEN •,FIELD VERIFIED, INCONSISTENCIES HAVE 4p, BEEN NOTED ON THE SURVEY, IF ANY.j Lebo ! S / 2. PROPERTY CORNERS SHOWN HEREON WER, / SET/FOUND ON 03-25-11, UNLESS OTHERWISE\ SHOWN. \ PI 3. THE SURVEYOR HAS NOT ABSTRACTED THE \ LAND SHOWN HEREON FOR EASEMENTS, RIGHT OF LEGEND WAY, RESTRICTIONS OF RECORD WHICH MAY \ AFFECT THE TITLE OR USE OF THE LAND. \ CENTERLINE u FOUND NAIL do DISC RIGHT OF WAY UNE LS /2494 4.N UNDERGROUND IMPROVEMENTS HAVE BEEN / I EXISTING ELEVATION SET 1/2" IRON ROD AND CAP LOC93 A/C AIR CONDITIONER D T ADELTAA ANGLE 5. BUILDING TIES SHOWN HEREON ARE 0 CONCRETE (P) PER PLAT NOT TO BE USED TO RECONSTRUCT THE C CHORD LENGTH PC POINT OF COMPOUND CURVE CURVATURE PCC POINT OF BOUNDARY LINES. C.B. CHORD BEARING C8W CONCRETE BLOCK WALL PCP PERMANENT CONTROL POINT - CNA- CORNER NOT ACCESSIBLE PI POINT Of INTERSECTION 6. ELEVATIONS SHOWN HEREON ARE BASED ON PK PARKER KALON 4573601 CP CONCRETE PAD POC POINT ON CURVESEMINOLECOUNTYBENCHMARKNCSCONCRETESLABPOLPOINTONLINE AS BEING 46.22' PER NGVD 1929. C/w CONCRETE WALK PRC POINT OF REVERSE CURVATURE EE.M.A.-FEDERAL EMERGENCY MANAGEMENT AGENCY PRM PERMANENT REFERENCE MONUMENT 7. THE FINISHED FLOOR ELEVATION OF THE D R M IDENTIFICATIFLOOD ON PSMRATEMAP PSM PROFESSIONAL SURVEYOR AND MAPPER PT POINT OF TANGENCY L ARC LENGTHSTRUCTURELOCATEDATTHEABOVELOCATION LB LICENSED BUSINESS R RADIUS LEGAL DESCRIPTION, MEETS OR EXCEEDS THE RP RADIUS POINT LS LICENSED SURVEYOR S/W SIDEWALK REQUIREMENTS` SET FORTH IN THE CITY OF (M) MEASURED TYP TYPICAL SANFORD CODE CHAPTER 18. SFC 18-4-(A) OHU OVERHEAD UTILITY LINE UP UTILITY PAD I HAVE EXAMINED THE F.I.R.M. COMMUNITY PANEL NUMBER 120294 0070 F. DATED 09-28-07 AND FOUND THAT THE THIS BOUNDARY SURVEY 1S NOT VALID SUBJECT PROPERTY LIES IN ZONE "X" AREA OUTSIDE THE WITHOUT THE SIGNATURE AND THE ORIGINAL 100 YEAR FLOOD PLAIN. THE SURVEYOR MAKES NO RAISED SEAL OF A FLORIDA LICENSED GUARANTEES AS TO THE ABOVE INFORMATION. PLEASE SURVEYOR AND -MAPPER. CONTACT THE LOCAL F.E.M.A. AGENT FOR VERIFICATION. BEARINGS SHOWN HEREON ARE BASED ON THE WESTERLY LINE OF LOT 89 AS BEING SOO'37'19"E, PER PLAT FIELD' DATE:) 11-18-10 F== 1 REVISED: U F?' G1' = 20 FEET Q MAPPINGa INC. O a4 Z9 2011 SCALE: APPROVED BY: JB CERTIFICATION OF AUTHORIZATION NUMBER LB#6393 FOR JOB NO. 0100403 LOT 89 FOUNDATION/FINAL 1030 N. ORLANDO AVE, SUITE B THE OS-25-11/CC WINTER PARK, FLORIDA 32789 DRAWN BY:(407) PLOT PLAN 10-13-10 BW 426-7979 WWW.AMERICANSURVEYINGANDMAPPING.COM JAMES W. BOLEMAN PSM 6485 DATE NMI FORM 1100A-08 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Florida Department of Community Affairs Residential Performance Method A Project Name: DR Horton - Cascade Street: _.lvd--rr.JIihcM PQ.rl LQ/)e City, State, Zip: , FL, Owner: Cascade Townhome Design Location: FL, Orlando Builder Name: Existing (Projecte Permit Office: JAvF.fQ Permit Number: 3 9 Jurisdiction: a- Concrete Block - Int Insul, Common 69is'ao 1. New construction or existing Existing (Projecte 9. Wall Types (2097-3 sqft.) Insulation Area 2. Single family or multiple family Mulli-family a- Concrete Block - Int Insul, Common R=4.1 788.67 112 b. Frame - Wood. Exterior R=11.0 684.67 112 3. Number of units, if multiple family 1 c. Concrete Block - Int Insul, Exterior R=4.1 624.00 112 4. Number of Bedrooms 3 d N/A R= fP 5. Is this a worst case? Yes 10. Ceiling Types (743.0 sgft.) Insulation Area 6. Conditioned Floor area (h2) 1415 a. Under Attic (Vented) R=30.0 743.00 ft' Z wndows(178.0 sGtt.) Description Area b. NIA R= ft' a. U -Factor: Dbl, U=0.55 178.00 fl' e. N!A R= ft2 SHGC: SHGC=0.2.9 11. Ducts b. U -Factor: NIA It, a. Sup: Attic Ret Attic AH: Interior Sup. R= 6. 283 h2 SHGC: 12_ Cooling systems c- U -Factor: N/A ft' a_ Central Unit Cap: 30.0 kBtu/hr SHGC: SEER: 14 d. U -Factor: NIA It, SHGC: 13. Heating systems e. U -Factor N/A ft' a. Electric Heat Pump Cap: 30.0 kBtu/hr SHGC: HSPF: 8.2 8. Floor Types (743.0 sgft.) Insulation Area 14. Hot water systems a. Slab -On -Grade Edge Insulation R=0.0 743 -GO WEF: a. Electric Cap: 40 gallons b. N/A R= ft2 0.92 c. NIA R= ft2 b. Conservation features None. 15. Credits Pstat Glass/Floor Area: 0-126 Total As -Built Modified Loads: 28.70 PASSpSSTotalBaselineLoads: 33.68 @'f1JJ 1 hereby certify that the plans and specifications covered by this calculation are in compliance with the Florida Energy Code. PREPARED BY. DATE: I hereby certify that this building, as designed, is in compliance with the Florida Energy Code. OWNER/AGENT: U 'Gk._, JUC DATE / 0 [ L4 to - - Review of the plans and specifications covered by this calculation indicates compliance with the Florida Energy Code. Before construction is completed this building will be inspected for compliance with Section 553.908 Florida Statutes. BUILDING OFFICIAL: DATE: s' C)' T it E S 74l l C7 si:3.b WT Compliance requires certification by the air handler unit manufacturer that the air handler enclosure qualifies as certified factory -sealed in accordance with N1110.A-3. 10/1212010 3:04 PM EnergyGauge® USA - FlaRes2008 Page 1 of 5 j re fre6 r)Ll i ))e_tuns -to vQ:1Ft f=u r r Iof+ n, tc.-5 5SD`T.G-Lee-Blvd 41,tO QCICvyo , 1` j 3 3a ertntt No Tax Folio No. I-p=j- I-DoDD-1/SSC NOTICE OF COMMENCEMENT Stare of Florida, County, of' Seminole 11111N1IIIIoil MINRINI II IN 11IN11NIR011111111IN11111 MARYANNE FRSE, CLERK OF CIRCUIT COURT SEMINOLE.COUNTY BK 07463 Pg 0655; ( 1 pg ) CLERK"'S # 20101 2-0069 RECORDED i0/15/`20 08_146i AM - RECORDING FEES I0.00 RECORDED BY T Smith The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance With Chapter 7.13, Florida Statutes, the following information is provided in this Notice of Commencement. 11 r / I Description of operly .,(legal description of the property, and street address il'a\ ailable) 2. Gev-,al description of improvement: 6;n ile— -Ve Y)'A ' ' ej -7bt,3t'lhzv-ne. 3. Owner information: Name: ), r2, Address: 1876 -7. 6 ild. f, _5_!;i 3 b. Interest in property: lli e_ 6itje c- Name and address of fee simple titleholder 01 -other than Owner): Name: Address: 4. Contractor Name:°• '• >> 1- C Phone number.Ly c. Address: 5956 iG' L,ec'Pm A-&e20,D/%i h %Z_ .ov 5. Surety Name- y/4 Address: b. Amount of bond 6. Lender: Name: F000 Address:., d! b. Lender's phone number: CLE 7.a. Persons within the State of Florida designated by Owner upon whom notices or other documents. • tlg-vits ® provided by Section 713.13(l)(a)7., Florida Statutes: Name: Address: 8.a. In addition to himself or herself, Owner designates of _ to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. b. Phone number of person or entity designated by owner: 9. Expiration date of notice of commencement (the expiration date is 1 year fi-om,the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRA•fION OF THE NOTICE `OFCOMN/lENCEMENT ARI CONSIDERED IIVIPROPER 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 EIIZST SPFCTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR . LENDER OR AN A, I . EY BEFOR_ E COMMENCING WORK OR RECORDING YOUR NOTICE OF ENCEC1M S naturc of Owner or C uthoriced Officer/Director/Partner/Manager Signatory's Title/Office The foregoing instrument was acknowledged before me this % t`` day of Ap e), (year) , by (name of person) as (type of authority, :.-. e.g. officer, trustee; attorney in fact) for (name of party on behalf of whom instrument was executed) . V Lt:RIEI 'F;JiBR 13 SI -_AL) (oilinic5tCnl l(76$?)$ Slgriature of Notary I'ubIic << kododT 5lroyF1ay ', 2U11 N,.. dad T ini Troy Fain In.luni u 600.385-7019 Pelsorially 300 3a5- r019PersonallyKnownORProducedIdentificationTypeof Verification pursuant,to S or L.2, Florida Statutes: Under penalties of perjury, I declare that I 11 e read the foregoing and that the fac stated i h` the best of my knowledge and belief. Signatureof Natural refiling Above Rev. date 3/2008 Y LIMITED POWER OF ATTORNEY r... .. ,_......,..an agent of- State f State License Number: Signature of License H STATE OF FLORIDA COUNTY OFQVQf)ef- j The foregoing instrument was acknowledged before me this /*tdiy of.CQ O 200() , by Skeye0 Q . who is dpersonally known lo -me -or who has produced identification and who did (did not) take an oath. Notary C`\\\ IllilII1NGZ1.E Blt izy, Z :0 M SSIONF:9di i, 9 11P 0 y : #DD 962209 4"B N tQ.' F eo STA` We\.3/27!( In61l:111%li I ignature DANIELLE GHAT/( Print or type name Notary Public - State of Commission No. My Commission Fxpires: C - (gyp /0 as STATEMENT RECEIVED BY: (] SIGNATURE: (/ PLEASE PRINT NAME) DATE: /,-2,(p NOTE TO RECEIVING SIGNATORY/APPLICANT: FAILURE TO NOTIFY OWNER AND ENSURE TIMELY PAYMENT MAY RESULT IN YOUR LIABILITY FOR THE FEE. *** DISTRIBUTION: 1 -BLDG DEPT 3 -APPLICANT 2 -FINANCE 4 -LAND MANAGEMENT NOTE** PERSONS ARE ADVISED THAT THIS IS A STATEMENT OF FEES DUE UNDER THE SEMINOLE COUNTY ROAD, FIRE/RESCUE;_ LIBRARY AND/OR EDUCATIONALISSUANCEOFABUILDINGPERMIT. PERSONS ARE ALSO ADVISED THAT ANY RIGHTS OF THE APPLICANT, OR OWNER; TO APPEAL THE CALCULATION OF ANY OF THE ABOVE MENTIONED IMPACT FEES MUST BE EXERCISED BY FILING A WRITTEN REQUEST WITHIN 45 CALENDAR " DAYS OF THE RECEIVING SIGNATURE DATE ABOVE BUT NOT LATER THAN CERTIFICATE OF OCCUPANCY OR OCCUPANCY. THk REQUEST FOR REVIEW MUST MEET THE REQUIREMENTS OF THE COUNTY LAND DEVELOPMENT CODE. COPIES OF RULES GOVERNING APPEALS MAY BE PICKED UP, OR REQUESTED, FROM THE PLAN IMPLEMENTATION OFFICE: 1101 EAST FIRST STREET; SANFORD FL, 32771; 407-665-7356. PAYMENT SHOULD BE MADE TO: SEMINOLE COUNTY OR CITY OF SANFORD BUILDING DEPARTMENT 1101 EAST FIRST STREET SANFORD, FL 32771 PAYMENT SHOULD BE BY CHECK OR MONEY ORDER, AND SHOULD REFERENCE THE COUNTY BUILDING PERMIT NUMBER AT THE TOP LEFT OF THIS STATEMENT. THIS STATEMENT IS NO LONGER VALID IF A BUILDING PERMIT IS NOT*** ISSUED WITHIN 60 CALENDAR DAYS OF THE RECEIVING SIGNATURE DATE ABOVE DETAIL OF CALCULATION AVAILABLE UPON REQUEST, CALL 407-665-7356. EMINOLECOUNTYOFSTATEMENIMPACTFEESTATEMENT 7% OS,3) J STATEMENT NUMBER: 10100004 DATE: October 19, 2010 BUILDING APPLICATION #: 10-10000417 tT BUILDING PERMIT NUMBER: 10-10000417 UNIT ADDRESS: TRILLIUM PARK LANE 2260 12-20-30-514-00.00-0950 TRAFFIC ZONE:022 JURISDICTION: SEC: TWP: RNG: SUF: PARCEL: SUBDIVISION: TRACT: PLAT BOOK: PLAT BOOK PAGE: BLOCK: LOT: OWNER NAME: ADDRESS: APPLICANT NAME: D.R. HORTON, INC. ADDRESS: 5850 T.G. LEE BLVD., # 600 ORLANDO FL 32822 LAND USE: TOWNHOME UNIT TYPE USE: WORK DESCRIPTION: CITY-SANFORD SPECIAL NOTES'. 2260 TRILLIUM PARK LN / LOT 95 / TWNHM FEE BENEFIT RATE UNIT CALL UNIT TOTAL DUE TYPE DIST SCHED RATE UNITS TYPE ROADS-ARTERIALS CO -WIDE ORD Condominium* 379.00 1.000 dwl unit 379.00 ROADS -COLLECTORS N/A Condominium* 00 1.000 dwl unit 00 FIRE RESCUE N/A LIBRARY CO -WIDE ORD 00 Condominium* 54.00 1.000 dwl unit 54.00SCHOOLSCO -WIDE ORD 2,450.00 1.000 dwl unit 2,450.00PARKSN/AN/A. LAW. ENFORCE N/A 00 DRAINAGE N/A 00 00 AMOUNT DUE 2,883.00 STATEMENT RECEIVED BY: (] SIGNATURE: (/ PLEASE PRINT NAME) DATE: /,-2,(p NOTE TO RECEIVING SIGNATORY/APPLICANT: FAILURE TO NOTIFY OWNER AND ENSURE TIMELY PAYMENT MAY RESULT IN YOUR LIABILITY FOR THE FEE. *** DISTRIBUTION: 1 -BLDG DEPT 3 -APPLICANT 2 -FINANCE 4 -LAND MANAGEMENT NOTE** PERSONS ARE ADVISED THAT THIS IS A STATEMENT OF FEES DUE UNDER THE SEMINOLE COUNTY ROAD, FIRE/RESCUE;_ LIBRARY AND/OR EDUCATIONALISSUANCEOFABUILDINGPERMIT. PERSONS ARE ALSO ADVISED THAT ANY RIGHTS OF THE APPLICANT, OR OWNER; TO APPEAL THE CALCULATION OF ANY OF THE ABOVE MENTIONED IMPACT FEES MUST BE EXERCISED BY FILING A WRITTEN REQUEST WITHIN 45 CALENDAR " DAYS OF THE RECEIVING SIGNATURE DATE ABOVE BUT NOT LATER THAN CERTIFICATE OF OCCUPANCY OR OCCUPANCY. THk REQUEST FOR REVIEW MUST MEET THE REQUIREMENTS OF THE COUNTY LAND DEVELOPMENT CODE. COPIES OF RULES GOVERNING APPEALS MAY BE PICKED UP, OR REQUESTED, FROM THE PLAN IMPLEMENTATION OFFICE: 1101 EAST FIRST STREET; SANFORD FL, 32771; 407-665-7356. PAYMENT SHOULD BE MADE TO: SEMINOLE COUNTY OR CITY OF SANFORD BUILDING DEPARTMENT 1101 EAST FIRST STREET SANFORD, FL 32771 PAYMENT SHOULD BE BY CHECK OR MONEY ORDER, AND SHOULD REFERENCE THE COUNTY BUILDING PERMIT NUMBER AT THE TOP LEFT OF THIS STATEMENT. THIS STATEMENT IS NO LONGER VALID IF A BUILDING PERMIT IS NOT*** ISSUED WITHIN 60 CALENDAR DAYS OF THE RECEIVING SIGNATURE DATE ABOVE DETAIL OF CALCULATION AVAILABLE UPON REQUEST, CALL 407-665-7356.