HomeMy WebLinkAbout102_104 W 23rd Stll l 1 01111111n'
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E EI E BUILDING &
CITY OF SANFORD
FIRE PREVENTIONm
JAN 2 5 2016 PERMIT APPLICATION
Application No: a
Documented Construction Value: $
Job Address: "1)A eig (lei oZ.3rz> -,,S+ Historic District: Yes No
ParcelID: /} S - c yLs —U t 6 C3 Residential W Commercial Type
of Work: New Addition Alteration Repair Demo Change of Use Move Description
of Work: 141 ! 30 t'-oeg Plan
Review Contact Person: Title:'w'"r Phone: #
o-7 I-Y&&, S Sri' oL Fax: !!67 3 l 3 4 2 Email: rH ocr Fs25D b isc v ln. h Property
Owner Information Name
M'a- oe.- M-JSON Phone: 407 Da12 Street:
10 q W 9-3ty 25A Resident of property? City,
State Zip: 5mA&o-V--)15T--\ ap-77/ Contractor
Information Name
1b Rom' ('. - i n _ Phone: G/67 3 # Q 15'c5 %!? Street: /
Z4 b Z-o Fax: 416? 34d? / VF g City,
State Zip: Gr_ytLowa_ S'K 11z73oZ State License No.: CCC 1336166 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. 1 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'h Edition (2014) Florida Building Code Revised.
June 30, 2015 0
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.
Si n re of caner Agen ate_...".„ ,
Owner/Agent's Name
Date
r
Signature of Contractor/Agent Dat
t
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
JULIE M. BOWEN
Notary Public, State of Florida Y'ey¢= DEBBIEBLANTON
Commission# EE 167400 MY COMMISSION # FF 178648
25, 2019Mycomm. expires Feb. 07, 2016i:+'a EXPIRES: February
Bonded Thru Notary Public Underwriters
Owner/Agent is Personally Knowp to Me or
Produced ID _ Z Type of ID O-01-
Contract
Produced ID
a y nown to Me or
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
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
of Heads
UTILITIES:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures,
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
u
t, vim. ee3laepc s':
D R and G„ INC.
1260 Saratoga Ln. /
Geneva, Florida 32732 O
Lic. # CCC 1330 006
NAME INO-41' f- /(/ J0-1- JOB NAME
STREET l Dy G'- S%— STREET
CITY /1'1 ,
l
CITY
PHONE L!f% ° O° PHONE
D R and G. INC
Phone 407-841-5831
407-322 - 8221
Fax 407-349-1398
DATE l / /,? / /,,/,
ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAB
SECTIONS 713.001-713.37, FLORIDA STATUTES), THOSE WHO
WORK ON YOUR PROPERTY OR PROVIDE MATERIALS AND
ARE NOT PAID IN FULL HAVE .A RIGHT TO ENFORCE THEIR
CLAIM FOR PAYMENT AGAINST YOUR PROPERTY THIS CLAIM
IS KNOWN AS A CONSTRUCTION LIEN. IF YOUR CQNTRACTOR
OR SUBCONTRACTOR FAILS TO PAY SUBCONTRACTORS
SUB -SUB CONTRACTORS, OR MATERIAL SUPPLIERS OR
NEGLECTS TO MAKE OTHER LEGALLY REQUIRED PAYMENTS
THE PEOPLE WHO ARE OWED MONEY MAY LOOK TO YOUR
PROPERTY FOR PAYMENT, EVEN IF. YOU HAVE PAID YOUR
CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR
CONTRACTOR, YOUR CONTRACTOR MAY ALSO HAVE A LIEN
ON YOUR PROPERTY THIS MEANS IF A LIEN IS FILED YOUR
PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR
LABOR, MATERIALS, OR OTHER SERVICES THAT YOUR
CONTRACTOR OR SUBCONTRACTOR MAY HAVE FAILED TO
PAY. FLORIDA'S CONSTRUCTION LIEN LAW IS COMPLEX AND
IT IS RECOMMENDED THAT WHENEVER A SPECIFIC PROBLEM
ARISES YOU CONSULT AN ATTORNEY.
Customer Initials
Date
Page 1 of 2
GAT, 25 YEAR 1 30 YEAR 1 40 YEAR I Color
TAMKO
OWENS CORNING D R and G, Inc. hereby proposes to furnish all material and labor, to complete
all work in a professional manner. This price includes removing one layer of
CERTAINTEED roofing only, unless otherwise stated. This contract may be subject to material
price increases.
I
MAGNETS WEEP YARD Workmanship 2 YR 5 YR. 10 YR.
6 NAILS PER SHINGLE Eve Drip 2.5` 3" Lead Stacks 4"3"2' 1/ "
Valley Metal 6 r "v ARoof Vents f'a FELT
15 30 Ridge Vent 1/0/ Gravel Stop Kitchen
Vent 2 x 4 Skylight HAUL
AWAY TRASH Bathroom Vent El x 2 Skylight Rotten
Wood RENAIL
LOOSE DECKING 1/2 X,Plywood - $4 per s Boards $7 5_running ft. All
rotten wood is i votedabove. D 09 I
OOFING A HOT TAR RO , IF THE
OL OOF IS STUC O THE HOT TAR ROOFS BITEC SINGLE PLY ROOFS DECK,
THE H OW AGREES TO PAY
D R AN C -FOR ANY 75#
Fiberglass Base Felt g 75# Fiberglass Base Felt ADDITIO _
LABO F MOVING 43#
Base Felt Smooth Surface PI
y IV Fiberglass Felt Granulated Surface 0OFING. Rock
5 yr Workmanship Workmanship
10yrt
Wh
nes,a_rQp f_deck will be renailed with 8 D ring shank nails to bring it up to the new Florida Building Code. .2—O l
040
PAYMENT
DUE ON COMPLETION Js` O"l s G D /oZjy G^.0Z) I
Accept This Contract eAte a Date_ Contractor
shall pay all valid bills and charges for material and labor arising out of the contract and will hold Owner of the property free and
harmless against all liens and claims of lien for labor and material filed against the property. The
Contractor shall not be responsible for damage to existing walks, curbs, driveways, structures, cesspools, septic tanks, sewer lines,
water or gas lines, arches, shrubs, lawn, trees, clotheslines, telephone and electric lines, overhead plumbing, etc., by the Contractor
of supplier incurred in the performance of work or in the delivery of materials for the job. Owner hereby warrants and represents
that he shall be solely responsible for the conditions of the building site over which the Contractor has no control and subsequently
results in damage to the building or injury to persons or property. Unless
otherwise noted in this agreement, the price quoted does not include removing or replacing fascia, trim, sheathing, rafters, structural
members, siding, masonry, vents, caulking, or flashing of any type. If during the course of work, it should become apparent that
any Such portion of the structure should be repaired or replaced, Owner may authorize Contractor to do such additional work, and charge
Owner for the additional labor and materials required plus a reasonable profit. Where
colors are to be matched, Contractor shall make every reasonable effort to do so using standard colors and materials, but does not
guarantee a perfect match. Any
controversy or claim arising out of or relating to this contract shall be settled by arbitration in accordance with the Rules of the American
Arbitration Association and judgment upon the award rendered by the Arbitrator(s) may be entered in any Court having jurisdiction.
Should either party hereto bring suif in Court to enforce the terms of this agreement, any judgment awarded shall include court
cost and reasonable attorney's fees to the prevailing party plus interest at the legal rate. Page
2 of 2
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #:
hereby acknowledge that I personally inspected
Roof deck nailing and/or Secondary water barrier work
at t3 /vY Zr4S-[— and have determined that the work
fob Site Address)
was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.)
I certify that my statements herein are true and accurate to the best of my belief and that I fully
understand that making any false statements in writing with the intent to mislead a public servant in the
performance of his or her official duty shall constitute a misdemeanor of the second degree pursuant to
Section 837.06 F.S.
Signature of Contractor
Printed Name of Contractor
to
r rc 133o t n6
License #
License Type: General Building Residential 0-(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 this Z(o day of s0oAQ0_ fM , 20 tc. , by
GK1dAra Ao rri s, who isonally Known to me or has Produced (type of
identitAcatio as ntification.
SEAL)
Signature of otary Public
Q+o*n of VInvirlo
Print/Type/Stamp Name
of Notary Public
o-YO Notary Public State of Florida
Tricia B Frazer
Q My Commission FF 190793
pFµo Expires 02/272019
THIS INSTR MENT PREPARED BY:
Name: S
Address: (7
NOTICE OF COMMENCEMENT
Permit Number:
Parcel ID Number:
11 i t a g a i 1111i
iitiRr':N NIF IL FIC L> {r:Ilil lti_i.: (iilrl} t
r i t'F`I4 OF CIRI ,111T C*-OURT i4 ;_:Ot'iPH-MLLER
CLERK'S u` 2ii16007663
n -
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 IMPROVEM NT:
r • 'C-o0
3. OWNER INFORMATION'OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: MGd-. t t ,se /l /0 4 1/ a`Z.i c-1 TIt CAu.c -T—U t 2 ?'?l
Interest in property:
Fee Simple Title Holder (if other than owner listed above) Name:
Address:
4. CONTRACTOR: Name: bP. r a TItiL Phone Number y67.c1 615 79
Address:
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
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.
8. In addition, Owner designates of
to receive a copy of the Lienor'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) If
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.
Under penalties of perjury, I declare that i have read the foregoing and that the facts stated in it are true to the best of my knowledge and
belief.
v-
g ature of ovaf6KGr Lessme a or Les6ealfi Authorized
Officer/Diree o arinerlManager) and
Provide Signatary's State
of County of The
foregoing instrument was acknowledged before me this t7" ° day of by
fL Name
of persr making statement who
has produced identification* type. of identification produced JULIE
M. BOWEN 0~
1y
pG c
Notary Public, State of Florida Commission#
EE 167400 My
Comm. expires Feb. 07, 2016 Who
is personally known to me OR Cn o
z tu
G02T Z
Ocr v
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Notary
Signature O ru ry O C1LL0
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