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Home My WebLink About112 London FoglAN 12 2016 0i• Job Address: CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: r 6 C 7 Documented Construction Value: $ }Ob - 2z Parcel ID: rn- / 9 _moo- s 11Z -cnc>. 0a Type of Work: New Addition Alteration n a Historic District: Yes No 7Re4dential [Commercial Repair Demo Change of Use Move Description of Work: )Qr oojc - CCRr/i- -7- Plan Review Contact Person: QJAEzV L nI Title: (%1 rl Phone: 30 1Fax: ; l - tea- S%lF% l Email: _ Sri i I1 rr'e1,Zx r cam, Property Owner Information Name t)A-,)„n Phone: VO-7-cjL;;-/- c) Street: f'l L) / Resident of property? : y r City, State Zip: s`hJ o/zo hA-XzAo7 ?% 7 Contractor Information GpL09AY— Phone: 3-1-C)"7 p -yoq z Fax: 20 / - 9'72 —1/ V7 / City, State Zip: )4 /- 1 OJ7FS ' Gft / AL _ ICC. State License No.: o'r" C Architect/ Engineer Information Name: Street: City, St, Zip: Bonding Company: Address: Phone: Fax: 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 FURST 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 NOTiZ E: 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 m 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 a rq A /-V/ 2 Print Contr Renvs Name SignatZofNobaWry-State' Date a baf to 09 ry Notary Public State of Florida Lindam PiqOzzl F My Commission FF 043899' or Expires 0010712011 O wy rsonally Known to Me or Contractor/Agent is Per nally Known to Me or Produced ID Type of ID Produced ID --Type o I - 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: Flood Zone: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No APPROVALS: ZONING: ENGINEERING: COMMENTS: of Heads Fire Alarm Permit: Yes No UTILITIES: WASTE WATER: 121:7 1i BUILDING: Revised: June 30, 2015 Permit Application axiom BUSINESS CONTRACTING GROUP For Roofing It Just Makes Sense... 1025 Sunshine Lane, Altamonte Springs, FL 32714 1 Office: 321-9724094 Fax: 321-9724471 www.axiomcontracting.com FL License# CCC1329763 Solar License# CVC56964 EIN:27-5097304 Locations: Jacksonville, Margate, The Villages CONTRACT/BUILD CONFIRMATION MR/MRS/MS I /rtv I'rl 1Gh.r STREET I I :)-. .n) r CITY 'S STATE f ZIP 3 2^-"1 1 1 SHINGLES & RIDGE: CERTAINTEED LANDMARK HOME # CELL# qI%7"'32+1^ I I q. Q ORIGINAL AGREEMENT/CONTRACT DATE /Z Driftwood Cobblestone Gray Heather Blend Charcoal Black Silver Birch Weathered Wood Colonial Slate Sunrise Cedar Mojave Tan Pewter Bumt Sienna Georgetown Gray Moire Black Resawn Shake Other UNDERLAYMENT 27. Synthetic Felt Other (Charges may apply) GUTTERS Detach &-Reset as necessary New VENTILATION A Ridge Vent Off Ridge Vents GOOSE NECKS 4" Goose Neck --I_QTY 10" Goose Neck QTY Color VALLEY S Ice & Water shield Valley Metal PLUMBING STACKS P 1-1/2" Lead QTy 2" Lead 3' Lead I CITY Drip Edge t t 2.5" Painted, Color Wvtil Other ROLL ROOFING Mw Job Description and Additional Items ( i.e. Solar Panels, Interior, Chimney Flashing, Skylights etc. ) 2-Ply Peel-n-Stick Other Color TOTAL CHARGE FOR ABOVE LISTED WORK: $ ZOO. cl PAYMENT SCHEDULE IS AS FOLLOWS Down Payment Due: $ Upon Roof Completion: $ f oe>t> O U (Includes Deductible) Depreciation Amount Due: $ Axiom has the right to supplement the insurance company for any and all additional damages or missed items. When supplements are approved, customer agrees to pay that money to Axiom Contracting Group LLC. The work listed above is to be performed under the same conditions as specified in the original Agreement/Contract unless otherwise specified. Customer acknowledges explanation of Florida Supplier Lien Rights letter (see back of Contract). AUTHORIZED BY: l Awa Homeowner l ate Homeowner Date We hereby agree to furnish labor and materials — complete in accordance with the above specifications and in conjunction with the original Agreement/Contract at above stated price. Please make all checks payable to Axiom Contracting Group I.I.C. 9 ? / Axio Contracting Gro Authorized Representative Date NOTE: This CONTRACT becomes part of and in conformance with the existing Agreement/Contract Iu1111111111110111111111111111Illllll4 THIS INSTRUMENT PREPARED BY: MARYAI' NE MORSE, SEMINOLE COUNTY cCLERK OF CIRCUIT COURT & COMPTROLLER Name: /lo,'t 3.(7}Qlnitr G2•c r p BK 6i.2 F'a 8S (1 s? Address: /O;p 3' S,U1 !'HI,.lIt IF r4.jx CLERK' S P 2t116(1? sT 2a01 3 7/i RECORDED 01/i_i812016611:2i :,W AN RECORDING FEES $10n00 NOTICE OF COMMENCEMENT ---sue 1AEaDED BY htaevore Permit Number: Parcel ID Number: ,_1cl-20 S1-3 —0us4 —00'710 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. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available) 11 a L_QAXz'n C• 1,t k 1 Yam.. rl /'7+M lz. 15cn,", 21 . -2-7 2. GENERAL DESCRIPTION OF IMPROVEMENT: W 40 d/- 3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and address:n1 /4"` G IAj`f6'`b Interest in property: _r) 1,', Fee Simple Title Holder (if other than owner listed above) Name: Address: 4. CONTRACTOR: Name:MAL G-(..fP_I C Phone Number: !Z -917 2 —1/6 PSG Address: Y' Sc/-)JH 1 (J Y /fit -r4/ I6VrC .rn/24A%.j /'L( IL4i0 4 5. SURETY ( If applicable, a copy of the payment bond is attached): Name: Amount of Bond: 6. LENDER: Name: _ Phone Number: Address: 7. Persons within the State of Florida Designated by Owner upon whom notice or other do uments may be served as provided by Section 713.13( 1)(a)7., Florida Statutes. _ Nam 8. In addition, Owner designates to receive a copy of the Lienp Phone Number: as provided in Section 713.13(1)(b), Florida Statutes. Phone number: 9. Expiration Date_QiAlottce 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. 7Dou'.1 DSIgnaturi of er or Lessee, or Owner's or Lessee's (Print Name and Provide Signatory's Title/Office) Authorized MIDlrector/ Partner/Manager) State of ),- County of Sir,, + i "'D CDC The foregoing Instrument was acknowledged before me this ^ day of KAEF' M z&::Z; e 20 S— by Who is personally known to me OR Name of person making statement t who has produced identificatiog,t e of Identification produced: 23.-^' % - 9 f Ot r/ hFmFiED COPY - MAR- fAN E NIOR ? ' `•','r; o CLERK 0€ rh!E f':, '1T COURT PID ; r a 3 t 4 t ° y,J', yet SENIlNOLE C UM L Ri - +r+t1, ; '• .e—nn r ru Notary Public State 0f Fondai BY i iJ 8 2 S Linda W Pigozzi DEPUTY CL < My Commission FF 043599' of*. Expires 08107/ 2017 a Is EM/NOLE COUNTY MuLTI%URISDICTIONAL LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: I hereby name and appoint: Jay Baker an agent of. Axiom Contracting Group, LLC 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): All permits and applications submitted by this contractor. Or The specific permit and application for work located at: a COA/43nA) / zQQI T14-41402o , 4Loz4A,4 Street Address) Expiration Date for This Limited Power of Attorney: 12-31-16 License Holder Name: Clifford A. Miller State License Number: Signature of License H( STATE OF FLORIDA COUNTY OF _S= ei , ^in t jc— The foregoing instrument was acknowledged before me this Pf day of , 20_t,, by nAA FFOn/o f4. ,Mf Le_.,52 who is ersonally known to me or EJwho has produced woo dirdi),take an oath. 62 Le—!Signaftu- re of Kbfiarf as identification L I^I_AI,,()'00 10- z J Print or type Notary name Notary Public - State of /'C_fa/ 4 OA R Notary Public State of Florida LindaWpigozziCommissionNo. F/-0V qS99 My Commission FF 043599 Expires08/W/2017 My Commission Expires: CITY OF SANFORD BUILDING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: I - a N S0 I, a hereby acknowledge that I personally inspected woof deck nailing and/or 0 e ary water barrier work at J. - ion - -y r- t'. `-'laFz k,1- c__ and have determined that the work Job Site Address) was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.) I certify that my statements herein are true and accurate to the best of my belief and that I fully understand that making any false statements in writing with the intent to mislead a public servant in the performance of his or her official duty shall constitute a misdemeanor of the second degree pursuant to Section837.06 F.S. 74 6 Signatur f ontrac or Date Printed Name of Contractor License # License Type: General Building Residential C!-hoofing 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 -L5"Ll day of `' "'' `" , 20 / f5! , by L' Uf6)49 A M t.0 _ , who is sonally Known to me or ha Produced (type of identification) I as identification. Signa f Notary P is S t f F !t) Y rrmr/ type/,tamp of Notary Public SEAL) 5NE] tateofFloridazzinFF 043599 ,017 I