HomeMy WebLinkAbout120 Carmel Bay Dr6As
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
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14
BY'
Documented Construction Value: $ (/1/:2 9
Application No: % 6 -A 9 7
Job Address: (', .r,-ct 09Vj ),t_ la'ap Historic District: Yes No Parcel
ID: -i 1- 30-5"1 q O.nr-_ cs3 / 3
77 Residential
Commercial Type
of Work: New Addition Alteration ® Repair Demo Change of Use Move Description
of Work: Plan
Review Contact Person: 5JJE1LllL AI Title: Vlr-.- A)O/,, 7' Phone:
3a 1-a'39-909 Fax: 'a2 1- 92a- V if 7 / Email: Sgn-i i 1 rr'e-pjy[ i c-. can 4a e'i , Property
Owner Information Name
G I .cf-L • OAO -z ( V 1 lid -cm rJ'A G/1 c. -) Phone: _A J-q -a 10 - o Street: /
a a C9&tne-t. aA-I M_t 4E Resident of property? : } City,
State Zip: Contractor
Information Name /
a7C/dn-. ,D st7/L4 /J(*.— C,l UU? G.(_ t` Phone: 3a-1-9.7 col" VC)9 Street: /
JSH4A,f(AAY— Fax: q;a City,
State Zip: ,4 007iS D92.1AA T _ /Ct.0,4f*)*'/ State License No.: ' C/'9 242 7 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 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. 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: 5th 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 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.
Signature of Owner/Agent
Print Owner/Agent's Name
Signature of Notary -State
Date
Date
1Z4 //'z / do"Z-tq'l'(0
Signa n tor/Agent Date
Print Contra HA ent's Name
S ature of Notary -State of Flo
r w Notary Public State of Florida
Linda W PigozziLtMycommissionFF 043588'
4 Expires 08107/2017
Agent is Personally Known to Me or Contractor Agent is Per pally Known to Me or
AID Type of ID Produced ID Type o
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 # of Heads
APPROVALS: ZONING: UTILITIES:
ENGINEERING: FIRE:
COMMENTS:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
sa
axiom
CONTRACTING GROUP
For Roofing It Just Makes Sense...
1025 Sunshine Lane, Altamonte Springs, FL 32714
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
1 t
MR/MRS/MS L ise. a ro5a- HOME# (— r i o - 6 7 3 V/'A4t' ?A, GI
STREET
c
110 Cn,t"IMP11 ko y 1D .
CITY n"T"s-.-)
STATE eI ZIP 3X77I
SHINGLES & RIDGE: CERTAINTEED LANDMARK
Driftwood
Weathered Wood
BumtSienna
UNDERLAYMENT
Synthetic Felt
Other (Charges may apply)
GUTTERS
Cobblestone Gray
Colonial Slate
Georgetown Gray
Detach & Reset as necessary
New
VENTILATION
R1 Ridge Vent
P Off Ridge Vents
GOOSE NECKS
CELL #
ORIGINAL AGREEMENT/CONTRACTDATE (Z 23 I5-
Heather Blend
Sunrise Cedar
Moire Black
VALLEY
Ice & Watershield
0 Valley Metal
4" Goose Neck f QTy
10" Goose Neck QTY
Color
Charcoal Black Silver Birch
Mojave Tan Pewter
Resawn Shake Other
Drip Edge
Rjl 2.5" Painted, Color
Other
PLUMBING STACKS ROLL ROOFING
JX 1-1/2" Lead QTy
i? 2" Lead -A* I QTY
fiRj 3' LeadQTY
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: $ 1n . 3_
T
t-i, 7 f >'
PAYMENT SCHEDULE IS AS FOLLOWS
Down Payment Due: $
Upon Roof Completion: $ /Og& 9 6 (Includes Deductible)c+^d COd-e-
Depreciation Amount Due: $ S! ') L4-Inrc.q Pn;aF n Gz
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:
Homeowner i/ Date 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 LLC.
3t5/ S
Axiom Contr ingGroup Authorized Representative Date
NOTE: This CONTRACT becomes part of and in conformance with the existing Agreement/Contract
E
SEMINOLE COUNTY MULTI -JURISDICTIONAL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: /'j9, t
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:
Street
Expiration Date for This Limited Power of Attorney: 12-31-16
License Holder Name: Clifford A. Miller
State License Number: CCC1329763
STATE OF FLORIDA
COUNTY OF SF_m no ot_ie_
The foregoing instrument was acknowledged before me this/9-;'—' day of 1 ~
20 16 , by ( t F,f'1Qo A_ 1'i! c Lt 2 who is-"rsonally known to me or
who has produced as identification
a ho did not) take an oath.
Signature of Rotary 10 W- ` Print or type Notary name
r ru
1_1Notary Puth+ ~late of Florida
Qc ozzi Notary Public -State of ) L na4 DH
Linda w 9 p43599'
vy F.xP'reS mg 11712017t4 Commission No. 6lGOy3 5? 9
Of My Commission Expires:
l
1t PROPE'
CY Parcel: 33-19-30-519-0000-0320 APPRAISER
Owner: OROSZ LISEL SEMINOLE
COUNTY, FLORIDA Property Address: 120 CARMEL BAY DR SANFORD, FL 32771 I
Parcel:33-19-30-519-0000-0320 I Property
Address: 120 CARMEL BAY DR Owner.
OROSZ LISEL Mailing:
PO BOX 470250 LAKE
MONROE, FL 32747-0250 Subdivision
Name: MONTEREY OAKS PH 2 REPLAT Tax
District: Sl-SANFORD Exemptions:
DOR
Use Code: 01-SINGLE FAMILY - Legal
Description LOT
32 MONTEREY
OAKS PH 2 REPLAT PB
58 PGS 22-23 Taxes
Value
Summary 2016
Working 201.1 Certified Values
Vakies Valuation
Method Cost/Market Cost/Market Number
of Buildings 1 1 Depreciated
Bldg Value V $120,718 $116,352 Depreciated
EXFT Vakue T
Land
Value (Market) $28,000 $28,000 Land
Value Ag ; 4--
Just/
Market Value $148,
718 $144,352 Portability
Adj Save
Our Homes Adj $0 I $0 Amendment
1 Adj $0 j $3,562 Assessed
Value $148,718 j $140,790 Tax
Amount without SOH: $2,893.24 2015
Tax Bill Amount $2,893.24 Tax
Estimator Save
Our Homes Savings: $0.00 Does
NOT INCLUDE Non Ad Valorem Assessments Taxing
Authority Assess mt Value Exempt Values Taxable Value County
General Fund 148,718 $0 ; 148,718 Schools
148,718 0 ' 148,718 City
Sanford SJWM(
SaintJohns Water Management) 148,
718 0 ' 148,718 148,
718 0 ! 148,718 County
Bonds 148,718 0 I 148,718 Sales
Description
Date Book Page Amount Qualified Vac/Imp WARRANTY
DEED 10/1/2003 j 05088 10001 159,900 Yes Improved SPECIAL
WARRANTY DEED 4/1/2001 04067 0824 124,900 Yes r Improved WARRANTY
DEED 1/1/2001 04006 0928 A _ - --
284,
000 No Vacant nd
Comparab;c a_ ,'. - -. ' Land
Method
Frontage Depth Units Units Price Land Value LOT
I 1 $28,000.00 $28,000 Building
Information Description
Year
Built Fixtures
Base Area Total SF LivingSF Ext Wall Ad' Value Rep[ Value PActual/Effective ] ep Appendages 1
I SINGLE 2001 ` 7 1,874 2,530 1,874 CB/STUCCO $120,718 $127,407 j FAMILY
FINISH I Description Area j
I i SCREEN
i 4
PORCH 240 FINISHED
I
I GARAGE
IIIiIIIiIIIIBiIIIiIIIIIiIIilfiBlllllllli
THIS INSTRUMENT PREPARED BY: NARYANNE NURSE, SENINOLE COUNTY
CLERK OF CIRCUIT COURT t CONPTROLLERName: AXforr GOr.17.t, C7 n/cr.. _yam _ Eft; 861 F'3 139+ (1P a) Address: 'OB S Sc JsN,..r1LC r/L
CLERK'S g 2016006508 RECORDED
11f20f2016 01 57:45 1-•I•t RECORDING
FEES $10.00 NOTICE
OF COMMENCEMENT RECORDED BY [idevorra Permit
Number: Parcel
ID Number: q - ` S - i (o -a 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) 02o
04,-IrIe L >/ /L'./!%E 7(Z!73'.7 '7 Lo
7 32 lnoA 7rr2EY 6f91--A5 Pi4Q-3 12-23 SW, /A/CIGE 'CroU { 2. GENERAL
DESCRIPTION OF IMPROVEMENT: OR 0oF
R6Pj-.+CGfviC 7.1 3. OWNER
INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and
address: 1- (SGI. 020SZ /?O. 2502( q%OZSO /-- AtOtl12DC, Ft 3.2(V7 Interest in
property: 6Ca)AjA1G Fee Simple
Title Holder (if other than owner listed above) Name: 4. CONTRACTOR:
Name: Xr/1 C 1C'?.1 1C'T/r1%t G4CAtI2 Phone Number: -,?;019 ~%a-Y09' V Address: _Z o;
pS11 ) W 1-,X- Lri,,tX % t'%A.''l c'ftlL 012 / ^6W dL-(= 32-71 '`/ 5. SURETY (If applicable, a
copy of the payment bond Is attached): Name: Address: Amount of Bond: 6.
LENDER: Name: Phone Number:
Address: Persons within the State
of
Florida Designated by Owner upon hoffi—notice or other documents may be served as provided by Section 713.13(1)(a)7.,
Florida Statutes. Phone Number: 8, in addition,
Owner designates
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. nature of Owner or Lessee,
opgwners or Lessee's (Print Name and Provide$iayry TitlglOfficeO s Authorized Officer/Director/P ner/Manager) ((. (( ..//'fix ((,]y r,, 7 State of hO12-4 De)
County of Si0/ j/^_0LP-7' The foregoing instrument was acknowledged
before me this day of ) /* _ 20Z by \) 1 tZCf% j,* t)?=
CD Who is personally known to me OR Name of person maldng statement
t who has produced identification - of
Identification produced: yD a .. 76'/ y=sa a - v Y"01 THE Ca101i' TRTIFIED
COPY— MARYANN MORSE LERK
OF Ti+_ CIR( 1TICOU
r AND : • G(t9 f qr I-0MPTR0t _ER t yo `,
E•a• SEMINOLE 'OU it , .0131 BY
DEPIJTY CLERK I Notlry
Signature
ro Notary
Public
Stale of
Florida 164 Linda W Pigozzi My
Commission FF 043599' Expires
00107/2017 JAN 2
02016 '
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: (2 9-7
o
hereby acknowledge that I personally inspected
Roof deck nailing and/or Secondary water barrier work
at 1/act , y f 6C - --r77 land 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 officia duty shall constitute a misdemeanor of the second degree pursuant toSection866F.S.
II
Signature of ontractor Date
uc,c
Printed Name of Contractor License #
License Type: General Building Residential ing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF '&"AI .jo u
Sworn to (or affirmed) and subscribed before Ne this 2 day of y , 20 /6 , by
I u p- , who i rsonally Known to me or has Produced (type ofidentification) as identification.
I-- (
SEAL)
Signatur Notary Ra blic
State Fl ida
Print/Type/Stamp ameu"lli ^ `r.()y7%L indallotary Public
W PgStat of FloridaofNotaryPublicyCommissionFFo43599xpires08/07/2017
3