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HomeMy WebLinkAbout154 Golfside Cird1 7 CITY OF SANFORD BUILDING & FIRE PREVENTIONJAN042016PERMITAPPLICATION Application No: Documented Construction Value: $ Job Address: GJ `'1 5 Ic 12— Historic District: Yes No Parcel ID: ResidentiaL2—Commercial Type of Work: New Addition Alteration Repair Demo Change of Use Move Description of Work: eQ of Plan Review Contact Person: Title: Phone: Fax: Email: Property Owner Information Name V-oLk-)3 Phone: Street: 0 L<Zk_ CLq_ Resident of property? City, State Zip: SPl" n -_b'C6 f. C-- L Name Street: City, State Zip: Name: Street: City, St, Zip: Bonding Company: Address: Contractor Information Phone: l 46-- '6 9 - Fax: - r7T-3-7 State License No.: UA_)50'4 _7- 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. 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: 511 Edition (2014) Florida Building Code DO Revised: June 30, 2015 Permit Application I it), l lmrnn'>. G Yt7 d'A I'4@I'Illlt lll I ll ll+w 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 OivnedAgent Date ram: l oMk-t Print Own r/Agent's Name ROSE A SMITH MY COMMISSION # EE871629 EXPIRES March 24, 2017 53 Date 5- fsvv (S Signature of Contractor/Agent Dat tybonz Rt Print Contractor/Agent's 7" Date DOSE A SMITH MY COMMISSION # EE871629 PIRCS March 24, 2017 com Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or Produced ID Type of IDS • L. Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type: Occupancy Use: Flood Zone: Total Sq Ft of Bldg: Min. Occupancy Load: # of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No APPROVALS: ZONING: UTILITIES: WASTE WATER: ENGINEERING: FIRE: BUILDING: COMMENTS: Revised: June 30, 2015 Permit Application 12/15/2015 C7,vid John3on. CFi I PROPERTY i?1 PPiR SiER s INaLscauivt'Y t.oalDa SCPA Parcel View: 04-20-30-513-0000-0110 Property Record Card Parcel: 04-20-30-513-0000-0110 Owner: DOMBROWSKI RAYMOND A & DOROTHY Property Address: 154 GOLFSIDE CIR SANFORD, FL 32771 Parcel: 04-20-30-513-0000-0110 E Property Address: 154 GOLFSIDE CIR Owner: DOMBROWSKI RAYMOND A & DOROTHY Mailing: 154 GOLFSIDE CIR I SANFORD, FL 32773-4765 1 Subdivision Name: MAYFAIR CLUB PH 1 ! i i Tax District: Sl-SANFORD I ' Exemptions: 00-HOMESTEAD (1999) DOR Use Code: 01-SINGLE FAMILY Value Summary 2016 Working 2015 Certified Values Values Valuation Method Cost/Market Cost/Market f Number of Buildings 1 1 ; f Depreciated Bldg Value 143,033 138,159 ! Depreciated EXFf Value 600 651 Land Value (Market) 25,000 25,000` i Land Value Ag Just/Market Value 168,633 $163,810 Portability Adj Save Our Homes Adj $43,416 $39,587 Amendment 1 Adj ; f Assessed Value $125,217 $124,223 1 Tax Amount without SOH: $2,512.42 2015 Tax Bill Amount $1,706.76 Tax Estimator Save Our Homes Savings: $805.66 Does NOT INCLUDE Non Ad Valorem Assessments Legal Description LOT 11 MAYFAIR CLUB PH 1 PB53PGS7&8 Taxes Taxing Authority Assessment Value i Exempt Values Taxable Value County General Fund 125,217 50,000 $75,217 Schools 125,217 25,000 $100,217 City Sanford 125,217 50,000 $75,217 W SJWM(Saint Johns Water Management) 125,217 50,000 $75,217 CountyBonds 125,217 50,000 $75,217 Sales f Description Date Book Page Amount Qualified Vac/Imp w._._.. _.-......_._._ _ ..._.__._..: I . ..... __...____ .. __.._._.__.__.. SPECIAL WARRANTY DEED 8/1/1998 03482 1017 122,100 Yes Improved i Find Comparable Sales within this Subdivision r..__--•-•-..._....__----._....._..- Land_.__-_-______._._.....___.__.. Method Frontage Depth Units ! Units Price Land Value II LOT 1 25,000.00 $25,000 Building Information I Base Area Total SF Living SF Wall !Adj Description IActual/Effective l/EffectiveIFxtvres i. ........... Value F Repl^Value Appendages 1 SINGLE - ' 1998 9 FAMILY Ext n ^ A 1,120 2,583 2,142 CB/STUCCO FINISH 143, 033 $ 152,977 Description Area OPEN I i PORCH ? 21 3 http:/ twww. scpafl.org/ParcelDetaillnfo.aspx?PID=04203051300000110 1/2 LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: Q- 3b ` ( S I hereby name and appoint: PQo, vi an agent of: Name 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): D,-, The specific permit and application for work located at: Street Address) Expiration Date for This Limited Power of Attorney: lei -j /, LS License Holder Name: [hDOON r4WI kQ State License Number: Signature of License H STATE OF FLORIDA COUNTY OF &Ck' The foregoing instrument was Wowle ged before me this'5Uday of 'bg 2001 ' $, by I OOS I -> I Wi c9 I/` who is-e rsonally known to me or o who has produced as identification and who d did not) take an o Signature Notary Seal) Print or type name R® SEA $IUfIiH Notary Public - State of _ MY COMMISSION # EE871629 Commission No. EXPIRES March 24, 2017 My Commission Expires: 407) 398 0153 FloridallotaryService cam Rev. 08.12) Product Approval Specification Form Permit # Project Location Address 1 60I:p (Cb As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the information and product approval number(s) on the building components listed below if they are to be utilized on the construction project for which you are applying for a building permit. We recommend that you contact your local product supplier should you not know the product approval number for any of the applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product Approval can be obtained at www.floridabuilding.org. The following information must be available on the jobsite for inspections: 1. This entire product approval form 2. A copy of the manufacturer's installation details and requirements for each product. Category / Subcategory Manufacturer Product Description Florida Approval # include decimal) 1. Exterior Doors Swinging Sliding Sectional Roll Up Automatic Other 2. Windows Single Hung Horizontal Slider Casement Double Hun Fixed Awning Pass Through Projected Mullions Wind Breaker Dual Action Other June 2014 Category / Subcategory Manufacturer Product Description Florida Approval # including decimal 3. Panel Walls Siding Soffits Storefronts Curtain Walls Wall Louver Glass block Membrane Greenhouse E.P.S Composite Panels Other 4. Roofing Products Asphalt Shingles CA lvr Underla ments Roofing Fasteners Nonstructural Metal Roofing Wood Shakes and Shingles Roofing tiles Roofing Insulation Waterproofing Built up roofing System Modified Bitumen Single Ply Roof Systems Roofing slate Cements/ Adhesives / Coating Liquid Applied Roofing Systems Roof Tile adhesive Spray Applied Polyurethane Roofing E.P.S. Roof Panels Roof Vents Other June 2014 Category / Subcategory Manufacturer Product Description Florida Approval # include decimal 5. Shutters Accordion Bahama Colonial Roll u Equipment Other 6. Skylights Skylights Other 7. Structural Components Wood Connectors / Anchors Truss Plates Engineered Lumber Railing Coolers/Freezers Concrete Admixtures Precast Lintels Insulation Forms Plastics Deck / Roof Wall Prefab Sheds Other 8. New Exterior Envelope Products Applicant's Signature l1 V-z- Applicant's Name Please Print) a.—aS P-, ( dl4 (ker- June 2014 THIS INt TRU ENT 4 12_D BY: Name- I L F`Vv Address: • Q- 9' NOTICE OF COMMENCEMENT I`ARYAHNE NORSEr SEMI110LE COUNTY CLERK OF CIRCUIT COURT & COMPTROLLER BK 86U7 Pa 3'ru CLERK'S 2015141203 RECORDED 1`/.70/2015 01:13: =gib PM RECORDING FEES kii!,tji! RECORDED BY hdevore Permit Number: y G O ' l Parcel ID Number: , - "I — 5(-) r / —d cUO (N — lJ 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. DEt_ScC R-PTION PROPERTY: (Legal scription of the prooperty street address f liable) 6 7(2aerr VI- 2. GEA ERVC)bVRIPTION OF IMPROVEMENT: 3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONT CTED FOR THE InR,•,O VfE1MENT: Name and address:k ,U o'coa' tr LSd \ 15n,5 C '4 `I La C V I Interest in property: Fee Simple Title Holder (if other than owner listed above) Name: Address: 4. CONTRACTOR: Name:• Phone, Number: 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 c%ume-ht`s may be served as provided by SpgtioRQtt 7713. 13(1)(a)7., Florida Statutes.iERTIFIED COPY RYANNE ORSE t;" pf 11 X ' Name: PhonL%LN.WterNr arr ., COMPTROLLE Address: t E C LINTY, F I rfyo F""`°.•e: 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 umber: 9. Expiration Date of Notice of Commencement (The expiration is 1 year from date of recording unless a different date is speci ' sI 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. 4" 0AdA J ignature of Owner or Lessee, or Owner's Ar Lessee's (Print Name and Provide Signatory's Title/Office) Authorized Officer/DirectodPartner/Ma ger) State of !FL County of 0M 20 s The foregoing instrument was acknowledged before me this L1 day of Jb , by 5 1 CS t5 )P _. Who is personally known to me O OR Name of person making statement who has produced identification F'type of identification produced: —C/a IUafA A SMITH _ - - @` r MYCOMMISSIONitEE871R.^.1 : 0;.A ?i r :SMITH !'lVoteAYSigaatur- r ZM. 1TH s2oci?° EXPIRES March 24, 2DI-7 .rt _.;'tN # EE871629 :+o r 407) 39R-0i53 „i += 3E87162R NotaryservicoCo:• ' na ry. RES March 24, 2017 iM .- r,. ,= • ;•,. 2017 407 30ft- 0159 Flor!tlnNolnrySnrvice earn) 39 ......... ..._ i 140r39Et016;< = ,n„t. <_,ry re corn CITY OF SANFORD BUILDING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: I k -7 L'T4 0M S C6 a— hereby acknowledge that I personally inspected 0 Koof deck nailing and/or econdary water barrier work of 1 Sa oL P S i t)F r i 2 SA-nll=n 2©k C—L 3Z771 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. o M V, 11 +11(p Signature of Contractor Da e Tk+ cw iors `j , N E Lee- G C. L O5 'Z-q-7-7 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 S EM' r,1 0 L6 Sworn to (or affirmed) and subscribed before me this 4*rlf day of , CAA-P- , 20 1 t-P , by TN o v_AR e. k J fi 0, , who is personally Known to me or has Produced (type of jdeu i icatio as identification. SEAL) Signature of-INotary Public State of Florida Print/ Type/Stamp Name ;;P;; RASE A SMITH of Notary Public A. MY COMMISSION # EE871629 EXPIRES March 24, 2017 407) 39' "153 FlorideNotarysenke com 3