HomeMy WebLinkAbout127 Brushcreek DrJob Address_
Parcel ID:
Type of Wort
Description of Work:
r 91, r-
Plan Review Contaclt Person:
BUILDING &
PEI
M 0 9 2016
Application No:
Documented Construction Value: $
Lf Ai-storic Di:
U OResidential
Mo Change
Phone: 6q q -T j Fax: Email:
Title:
Property Owner Information `
Name -% r\ 1)- OV& Phone: — Lt2
3
Street: .a 1 yC i - r "'
Resident71jResident of property
City, State Zip: to , 1.. 3VE
Contractor Information
Name Phone: L
cpf` t'`pStreet: WU kj - — S a Fax.
City, State Zip:%AZ ' State License No.:
ArchitecttEngineer Information
Name: Phone:
Street: Fax:
City, St, Zip:
Bonding Company:
Address:
E-mail:
Mortgage Lender:
Address:
ITY OF SANFORD
IRE PREVENTION
JIIT APPLICATION
14
ict• es ElNo ElCommercial
Use Move
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 RECORD t 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 la s regulating construction
in this jurisdiction. I understand that a.separate permit must be secured for electrical work, plum ing, signs, wells,. pools,
furnaces, boilers, beaters, tanks, and air conditioners, etc.
FBC 1053 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
lu Itraww9 n t ti
J
I
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable t( this property that may be
found in the public records of this county, and there may be additional permits required from other govemmental 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 th 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
be done in compliance with all applicable laws regulating construction and zoning.
Sign of Owner/Agent Date
is
Produced ID
o . 2n.
KRISTIN MATT9GLY \
Notary Public - State of Florida
My Comm. Expires Oct 19. 2018
Commission # FF 169553
or
Type of ID
Signature of Contractor/Agent
a . , . k
Print Name
Signature ofNotary-V SSON FROSTSARY
NOTARY PUBLIC
STATE OF FLORIDA
a
Comm# FF187199W
ICE 19 ® Expires 1114/2pe
Contractor/Agent is Persor
Produced ID Type of 11
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing
Construction Type: Kt-- ro o- Occupancy Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
that all work will
0 L Date, 2
Known to Me or
RoofE3---/
l Zone:
of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COAD1ENTS:
UTILITIES:
Fire Alarm Permit: I Yes No
WASTE WATER:
G:
Revised: June 30, 2015 Permit
i
THIS INSTRUMENT PREPARED dY: I Mill 1111
a"P e,
11 11111
Names Megram Construction
Address tW'z A=-Flaaaa?itRa-STE—tOsivtatlana-r'>-,t2 r i"ii•RY1 i'WNIL.. 11t01R.3E.i S 1°
t
1NOLjr Cl
ERK.ii i t_II )ill L: ;.1
NOTICE OF COMMENCEMENT CLERK
i?'t ? 11:i(e
132
I s a:
RECORDING t=EEC y:i i.iIO
State of Florida RECORDED BY r dtetn,
County of Seminole
7
Permit Number: I —
I
1 !" Parcel ID Number: 33-19-30-516-0000-0960
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with
Chapter Florida the innffoprrmmaa ion Iss provided iingthis Noticeof Commencement. p7113, pSStaattutteRs, follligoaw in"'g
L 1
I&V C% I t Y C+LIJti F'AKtC F'rto i'13 04 f't
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p (p yIMPROVEMENT:
i
Ge oTi annOOsear rele
OWNER INFORMATION:
Name: LENA M DELGENIO
Address: 127 BRUSHCREEK DR. SANFORD FL 32771
Fee Simple Title Holder (if other than owner) Name:
Address:
CONTRACTOR:;
Name: MEGRAM LLC
Address. 467 LAKE HOWELL RD STE 108 MAITLAND FL 32751
Persons within the State of Florida Designated by Owner upon whom notice or other documents may a served
as provided by Section 713.13(1)(b), Florida Statutes.
Name:
Address:
In addition to himself, Owner Designates of
To receive a copy of the Lienor's Notice as rovided in
Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unlss a
different date Is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THEINOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTpON 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 off yy nnwtridge an belief.
q
Owner's Signature Ownefs'Prin d flame oa
Florida Statute 713.13(1 Xg): ' The owner must sign the notice of commencement and no one else may be permitted to sign in his orher stead: i
State of County of V ;VY , \1 t V
The foregoing instrume t was acknowl e/d'g edbeeffore me this day of itL(AIAD 20
by `Ib Y I, v Who is personally known to me
Name of person making t ent 1 ')')
OR who has produced Identificationtype of identificatio produced: IYY_""1ll /) KRISTIN
MATTINGLY O2. . _
Notary
Public - State of Florida My
Comm. Expires Oct 19. 2018 i ,,
oFF
q,. Commission # FF 169553 UN
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Wjfl .awmultIWWI PXIVIIKF R19=9IRIO1117A11WTANXI .I1r l 1 LIMITED POWER
OF ATTORNEY Altamonte Springs,
Casselberry, Lake Mary, Longwood, Sanford, Seminole County,
Winter Springs Date: ` U
I hereby
name and appoint: _I— V \ V V k/ an agent
of. I \WrU U C/ 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): Ci The specific
permit and application for work located at: Street Address) Expiration
Date for
This Limited Power of Attorney: License Holder Name:
State License Number:
C C & [ 3 1"l 0-'l U Signature of License
Holder: STATE OF FL
RIDA COUNTY OF. Qi
The foregoing 'nstrument
was acknowledged before me this da Y of 200I u ,
by who is ersonally known to me or
who has produced identification and who
did 4id not).take an oath. Signature Notary Seal)
L
5av-' Print or type
name MADISON FROST NOTARY
PUBLIC Notary
Public -State of IF L STATE OF FLORIDA
Commission No. Icj,-1 Cc mm# FF187199
My Commission Expires: -t n pires 1/4/
2019 vIro MADISON FROST
NOTARY
PUBLIC Rev.
08.12)
STATE OF FLORIDA Comm# FF187199Expires 1/
4/2019 as
e It rMit
Megram Construction
Servf wyrorhra since 0.07
Homeowner, j G8 Date V ( J
Property Location:
State: 'L- tip: f Evening:
Emwl:
ROOF SPECIFICA%TIONS Errand: Style: J-4pior:
Includes Complete Tear -Off, Down To Decking. Tear -Off i 2 Valley: Open Cios
Ice& WaterSMeld: Per[ode Story 2 / 3 Drip Edge: All Eaves & Rakes Color.
All off -ridge Vents / boxvents/ pipe bootsto replaced new. Cotor: Cove
AllMaterialDropInstrucUom
CONTRACT INCLUDES SCOPE OF WORKAS LISTED IN THE 14SURANCE ESTIMATE, UNLESS OTHERWISE EXCLUDED
AS FOLLOWS:
Special Instructions:
Tr t ' r,a n.. o-.ter _
Ifdeddnsklov6dtorwArereplacementlnUerto a nalWWesurfaoe,Mepam In replaceitwrthlike ndfgwptycurreatly
ontheroof. MearamVANmakeeveryetfwttosupplementwkhthetnwranaCompanYtocovertheaddhimulmst Hfawever litts
not always crnrW fn some polices or by some carters. tf it h not. Megram wW cover up to two shoats of ded bV aced the Homeowner
w1lberesponsible for anyremainder atacost of: 0s8-SW.4D/d"wt Plywood-$45.0015heet Meeramwoprovldephotodocumanmtton Of all sectioes
requiring replacement TERMS 1. UnlessoftWseagreed
inwriting
yourout-of-pocketcostswillbe limited to your insurance
deductible amount However, you must promptly pay Megram Construction
all amountsyou receWe from your insurance company.
Ifyou desire material upgrades or other work done on your
property, you will Hncure addittanal out-afpocket expenses. 2. This Agreemeetisnot
vatidorbindngunkuand
untNttIssrgnedby bosh you and Megram Constnrctlom Once
signed by both partite. Mepram Construction will be awarded
with the job outlined in thft amtram 3. Your
sivutwo below provides your
agreement to all the terms and condttions set forth on this lymment,
and the proeeedkg'Generat Temrs and Conditions' page that follows.
Srpwture tHomtoweerl Agreed Price: $ -7 73
Plusa&gwns%
upplemenes6pe uses pid b/
the W*wmxe caTwmr
Pay Schedule ACV Chedc Amount: $ First
Payment Check: $
Check ;>t Balance
Dw84ore Work Eiegins: $
Supplement Check:
Pending Supplement
Suppkments ictwo
k WN pertomiedvAtbtaddad to
tlt&Av* d Pe", kafth
final payments are due upon
completion
of all trades and upon recelvbsg the
d*preciaom checktrom the 0nurmoa oompany. C) •/y%
Sr Oats l 0-
14 'r We
46?
talia Howell Rd. SuWe
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Ma'Umdt FL 32751' OMoc 407.704MW'rax: 2.Q"2%.7rX 1091a&56054.20#206-TempreTensmirt33617'Oifkr.
31332 2734'fax:1.177J96.78% BO N.US rtwr l UAIt
lb' Fort Pkrp FL 34l46 `0ffi= 722N 3259' Fax:1JRJK7VX L10=05W UCKSCUMI W0=133MG2
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: 147 4f71
hereby acknowledge that I personally inspected
Roof deck nailing and/or B'Secondary water barrier work
at _ /0 7 6AO A GiedK 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
Section 837 06 F.S. /
Signa a of Contracto ,. Date
ffl(ffA_l LCc(33al 02_
Printed Name of Contracto License #
License Type: General 0 Building Residential 2/Roofing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OFC16_m
yvorn to (or affirmed) and subscribe efore me I<s ( 14t—_ day of 6ru a , 20 he , by
who is Personally Known to me or has Produced (type of
identi cation) as identification.
SEAL)
Signature of Notary Public
State of Florida
n 5 Rf AMY MADISON FROSTPrint/Type/Stamp Name NOTARY PUBLIC
of Notary Public STATE OF FLORIDA
COMM# FF187199E19eExpires1/4/2019
3
i {
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: Ca— o g-oL(v
I hereby name and appoint:`
an agent of: Iy yWAM
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
7e
to this appointment for (check only one option):
specific permit and application for work located at:
12.1
Street Address)
Expiration Date for This Limited Power of Attorney: l' %-7
License Holder Name:
State License Number:
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before me this day of eel hk ,
200_[Cg__, by 41 a who is mfersonally known
to me or who has proZ(dino
e
identification and who take an oath.
Notary Seal)
MADISON FROST
NOTARY PUBLIC
STATE OF FLORIDA
a ' r Comm# FF187199
E is Expires 1/4/2019
Rev. 08.12)
Signature
Print or type name
Notary Public - State of 4-f(,
Commission No. >fS-1(a-1
My Commission Expires: t
as