HomeMy WebLinkAbout114 Golfside Cir (3)rr _ CITY OF SANFORDIDBUILDING &FIRE PREVENTION
JAN `N8 2016 PERMIT APPLICATION
Application No:
Documented Construction Value: S A C 7 Or--) . QJ
R
Job Address: AN (- C .3-St p C, lR. Historic District: Yes No b
Parcel ID: _ 04- 20- 30 - 5l - 6000- DLt&o Residential Commercial
Type of Work: New Addition Alteration Repair P Demo Change of Use Move
Description of Work:
Plan Review Contact Person: R U?EH: Title: c2UfVlal
Phone: L32i 2? - 27z)Z Fax: C 7 g23- Q Email:_ M4 DL{' 23 A4L - co t-f
Property Owner Information
Name Phone a „
Street: f - 501k j C;i.: _.. [Resident of -property?
City, State zip: iy=tp.,,J- ;3;2773 _ , •• T •••
4p
ontractorinformation ,mo
y3 1n%31\+ Name _ty kX.11 11 1 1— jam aPlion'e"I 2-70Z
5 C S —j' Fax-, Street:
City, State Zip:'eS'tA%L' icense No.: l3ZSa28
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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 OFCOMMENCEMENT.
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 constructioninthisjurisdiction. 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: 51h 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 proper12 that may be
found in the public records of this county, and there may be additional permits regquired from other governmenta?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 constviietion. and 'zoning.
Signature/of Owner/Agent Date Signature of ntractor/Agent Date
2±2 V li" ve
Print Owner/Agent's Name Print Contractor/Agent's Name
AG nD,
Signattre-e otary-S fFlo 'da '%\t NA ` / ",e'
Signature(of 0 -S t o
O•••""•••.: A /// Notary Public State of Florida
NO Tq 1••• i ? Virginia McCue
i .t My Commission FF 174327
w My • i oFper" Expires 05/20/2017
IQ
Owner/Agent is Person ajjy bw _ lo res; Contractor/Agen is Personally Known to Me or
Produced ID Type of a 1 292 • Produced ID Type of IDL 11
BUG ••••• `
BEL'4,F'(2 OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas Roof
Construction Type: Occupancy Use:
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:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
i i ON
Revised: June 30, 2015 Permit Application
THIS INSTRUM_E T PREPARED BY:
Name: Mfg- W—I TERMODAL CORPORATION
Address?31 CYPRESS TREE COURT, ORLANDO FL 32825
t
NOTICE OF COMMENCEMENT
Permit Number. t (,— 31 D
Parcel ID Number: 04-20-30-513-0000-0460
MARYANNE MORSEr SEMINOLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLER
BK 8623 P9 1591 (1P3s)
CLERK'S g 2016009912
RECORDED 01/28/2016 12:21:01 PM
RECORDING FEES $10.00
RECORDED BY hdevore
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)
LOT 46 MAYFAIR CLUB PH 1 PB 53 PGS 7 & 8- ADDRESS 114 GOLFSIDE CIR, SANFORD, FL
2. GENERAL DESCRIPTION OF IMPROVEMENT:
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: GAINES ZACHARY P, 114 GOLFSIDE CIR 7 _
Interest in property: OWNER r f
Fee Simple Title Holder (if other than owner listed above) Name: NSA L. % A t; V
Address: a o rr
co
4. CONTRACTOR: Name: MAXIMA INTERMODAL CORPORATION Phone Number. 407 823 8890
U.
N
Address: 531 CYPRESS TREE COURT ORLANDO FL 32825
5. SURETY (if applicable, a copy of the payment bond is attached): Name: NSA s O
Address: Amount of Bond: J
6. LENDER: Name: NSA Phone Number:
v An
Address: m
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: NSA Phone Number:
Address:
8. In addition, Owner designates NSA 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)
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.
J
Sibnature of Owner or Lessee, or Owner's or lessee's
Authorized Officer/Director/Partner/Manager)
ZCLL)V 0V'--; C-- kk'
nt Name and Provide Signatory's Title/OfToo)
State of I t I C" County of J'! ( n6& '
n
The foregoing instrument was acknowledged before me this 5 1
day of 20
by v (n ho personally known to me OR
Namm eofpersonmakingstateent /' who
has produced identification type of identification produce_ % C C a
My Co mm. NO. "
CU18 a
o"
FI.Q 1111111
r
allied
a'
american
Allied American Adjusting
11932 Sheldon Rd
Tampa. FL 33626
GAINES-45121-SUPPL
Roof
1 Roof'I
I 2782.69 SurfaceArea27.83 Number of Squares 234.
44 Total Perimeter Length 57.94 Total Ridge Length 1
93.48 Total Hip Length DESCRIPTION
QUANTITY UNIT COST RCV DEPREC. ACV 1.
Digital satellite.system - Detach & 1.00 EA 25.13 25.13 0.00) 25.13 reset
2.
Digital satellite system - alignment 1.00 EA 75.38 75.38 0.00) 75.38 and
calibration only 3.
Remove 3 tab - 25 yr. - comp. 27.83 SQ 48.30 1,344.19 0.00) 1,344.19 shingle
roofing - w/out felt 4.
Asphalt starter - peel and stick 234.44 LF 1.85 433.71 61.89) 371.82 5.
3 tab - 25 yr. - comp. shingle 30.67 SQ 173.80 5,330.45 1,005.73) 4,324.72 roofing -
w/out felt Includes
10%waste. 6.
Roofing felt - 30 lb. 27.83 SQ 31.25 869.69 118.89) 750.80 7.
R&R Drip edge 234.44 LF 2.41 565.00 81.59) 483.41 8.
Re -nailing of roof sheathing - 2,782.69 SF 0.19 528.71 11.13) 517.58 complete
re -nail 9.
R&R Flashing - pipe jack - 6" 5.00 EA 51.59 257.95 41.12) 216.83 10.
R&R Continuous ridge vent- 30.00 LF 7.82 234.60 33.60) 201.00 aluminum
11.
R&R Roof vent - off ridge type - 1.00 EA 117.44 117.44 11.75) 105.69 4'
12.
Roll roofing 2.00 SQ 85.81 171.62 42.26) 129.36 Protect
valley with rolled roofing per code. 13.
R&R Valley metal 34.00 LF 4.91 166.94 22.30) 144.64 Totals:
Roofl 10,120.81 1,430.26-8,690.55 General
Conditions DESCRIPTION
QUANTITY UNIT COST RCV DEPREC. ACV 14.
Dumpster load - Approx. 20 yards, 1.00 EA 372.01 372.01 (0.00) 372.01 4
tons of debris 15.
General clean -up 3.00 HR 28.51 85.53 (0.00) 85.53 GAINES-
45121-SUPPL 1/5/2016 Page:.i
Security Firsta Insurance -
Insuring Florido Homes
J anuary 11, 2016
Zachary P Gaines
Sonja Gaines
114 Goldside Circle
Sanford, FL 32773-4775
Insured Name
Insured Location
Policy Number
Policy Effective Date
Policy Expiration Date
Claim Number
Cause of Loss
Date of Loss
Initial Loss Report Date
Jqo
Zachary P Gaines & Sonja Gaines
114 Golfside Cir, Sanford, FL 32773
SFIH7978039-04-0170
March 23, 2015
March 23. 2016
45121
Wind -Other
August 31, 2015
September 21, 2015
Dear Zachary Gaines and Sonja Gaines:
o to F s (01,k -- GA F
Security First Insurance provides coverage for the above Insured and Location, subject to
all of the terms and conditions of the policy. Allied American Adjusting, LLC is the
claims administrator for Security First Insurance and acting on their behalf in the
handling of your. claim. This letter will confirm the claim adjustment and payments under
the loss settlement provision of your policy.
Coverage A Coverage B Coverage C Coverage D
Dwelling Other Personal Additional Total
Structures Property Living
Expense
Gross Loss 10828.65 0 10828.65
Less Recoverable
Depreciation 1430.26 1430.26
Less Non
Recoverable
Depreciation
Less Advances &
Prior Payments 546.24 0 546.24
Less Deductible 1000.00 1000.00
Payment 7852.15 0 7852.15
PHONE: 386-673-5308 1 FAX: 386-673-5408 1 140 SOUTH ATLANTIC AVENUE j ORMOND BEACH i FLORIDA i 32176
www.SecurityFirc-tFlorida.com
ram'" r City of Sanford
Roof Permit Application Checklist
All permit application packages must be complete prior to acceptance. You must check each box to the
left or indicate n/a on this submittal. A complete application package shall include the following:
J2 Building Permit Application completed, signed and notarized. Application must include correct address
and complete parcel I.D. number.
E] Copy of applicable contractor's license issued by the State of Florida (if the contractor is the
applicant).
Ri A site specific notarized power of attorney shall be required from the licensed contractor if
he/she appoints an employee of his/her company to sign the permit application as the contractor.
i Certificate of insurance indicating worker's compensation insurance coverage and naming the City of
Sanford as certificate holder, or a copy of a worker's compensation exemption issued by the State of
Florida (must be submitted with each application if contractor is the applicant).
i Completed and signed Owner Builder Statement / Affidavit (if the owner is the applicant).
These guidelines were compiled to assist the applicant in preparing a roof permit application and may not be
complete. The applicant is required to meet all City of Sanford, state, andfederal code requirements.
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 01 6160
I hereby name and appoint: A&2ut Lee Lk
an agent of: M&X 1 MA
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:
11 C o s - C ctt
Street Address)
The authorization for the above referenced shall expire on:
Expiration Date for This Limited Power of Attorney:
License Holder Name:Q>
State License Number:
Signature of License H
STATE OF FLORIDA
COUNTY OF S,p,u,z
The foregoing instrument was ac nowledged before me this a& day of ,
200_, by who is per Nallyown
to me or who has produced e O ==0 as
identification and who did (did not) take an oath.
Signature
Notary Seal)
Print or type name
Notary Public - State of oM
Commission No.
My Commission Expires: ZFsb'FF
ayp"ku'v"4B
Rev.
08.12)
Q
10;_
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: / 4 — 3 -3'0
I, S-R.R- hereby acknowledge that I personally inspected
Roof deck nailing and/orxSecondary water barrier work
at AA C-QVPi %% is t.L 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
perform a hi r her official duty shall constitute a misdemeanor of the second degree pursuant to
Sectio 6 F
0\\-2A
Signature of Co ract - Date
C'CC1SZSaZg
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
e t is y of , 20 ., by
Personally Known to me Jr as roduced (type of
identification.
Print/Type/Stamp Name
of Notary Public
KEMEOONTAE K. TILLMAN
Notary Public - State of Florida
My Comm. Expires Jul 10, 2016
Commission # EE 215440
Bonded Through National Notary Assn.