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218 E 28 St
V=Z Value: $ 6 o OO, 00, Job Address: -:2 l8 E • 3Q r-, •22 mod,, FL Parcel ID: X )- r/,. 36- 6-019- O Coo- 0106 CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION FEB 11 2016 Application No: BY'=== DWumented Construction Historic District: Yes No Residential 9 Commercial Type of Work:' New ,'Addition •A tei ation Repair Demo Change of Use Move Description of Work: re - roD-P 6 A F' T , (er i h B fl j "; in g /cs Plan Review Contact Person: cb' tU b 1 p_d y b © r) Title: /n a/L, Phone: LID J-&qKv-76&3 Fax: <1-02-6,257=76,ee/ Email:-P_P<8 t`CX r psertllcPs, Nt Property Owner Information Name,L lanr , Me4wc,1 o + Scaft Gro rclov) Phone: '46 7- $7 S' 6 7 k 7 Sheet: al$ l=- $ ` Resident of property? : LA Ch-- City, State Zip: L h rr ci, FL 3 4z 71 Contractor Information Name OG-Zop e,ru CCc°s r'x` f Phone: Y67- to ? 6-766 .3" , Street: 11. o L01(e A u e • 1/ ! 0 (4, o Fax: q 0? -- 6 9 S"- 76111/ 3.a2v$ r /3 a isCity, State Zip: t_s i (.r p.5,+ l State License 1l0.: C CC 7,9 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 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: 51h Edition (2014) Florida Building Code Revised: June 30.2015 Permit Application 9h NOTICE:` In addition to the requirements of this permit, there may be additional restrictions applicable to this property, that may be found in 'tha 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 Date Print Owncr/Agent's Name Signature of 3.P of FIMY C0Wi t.: it FF G2225 4ate a• EXPIRES: Sep!ember 4, 2017 Bonded Thru Notary Pubis Undermaers Signature of Contractor/Agent t. U Date st- C A. 1.JU4oL Print Contractor/Agent's Name m- 4 '-' nay..a.ak...c:v :rlVira..V a-,sxws rRr'.p Signature of Notary-Statcof Fit I r,°°' Datq;; t;ttfty;,;t; i•Pl My j Wrrlal(,T;JI:Srl Mh°C:'IhVkrrG } Owner/ Agent is personally Known to Me or Contractor/Agent is 'A— -Personally Known to Me or Produced I Type of ID Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building Electt7cal Mechanical Plumbing[] Gas[] Roof Construction Type: Occupancy Use: Flood Zone: Total Sq Ft of Bldg: Min. Occupancy Load: of Stories: r) New Construction: Electric - # of Amps Plumbing - # of Fixtures i .t Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No r "`• r APPROVALS: ZONING: UTILITIES: WASTEWATER: ENGINEERING: FIRE: BUILDING: COMMENTS: f Revised: June 30, 2015 Permit Application 1r i Illl! I1111 III1 Illf ILIII I I llll II 1 THIS INSTRUMENT PREPARED BY: Name: ?l1ic {/ L at MARYANNE HORSE, SEMINOLE COUNTY Address: I130, ae ra tm61C CLERK OF CIRCUIT COURT & COMPTROLLER W(v)' e r Q 2r7n ts, FL 5 !CS' BK 8632 P9 185 (1P9s) State of Florida CLERK'S $ 2016015373 NOTICE OF COMMENCEMENTECORDED 02/11/2016 IOQBV55 All RECORDING FEES $10.00 Permit Number Parcel ID Number (PID) , IiGGC fiDE_?Y) 13v reU v0 _ 610 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) A f /0 70 Fr- 0 F_ v /5 r- 7' OF LOT- S" F/C E /11.-2rkl,<<<,t rk 14P r< Af 2. GENERAL DESCRIPTION OF IMPROVEMENT: 0CT 3. OWNER INFORMATION: Name and address: be,601-cd, 11)g hcc 1, k c) i-e iv ii , 1 L-" . / S `- ". SC! n rJ, /=zL Interest in property: _ R UJ >> eA— Name and address of fee simple titleholder (if other than Owner): 4. CONTRACTOR' (name, address and phone number): ?r)'D ; / la -3r' I'(-t t c e'er c` I I Sr_: (. I I %y 5. SURETY: Name, address and phone number: Amount of bond $ 6. LENDER: (name. address and phone number): 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by section 713.13(1)(a)7., Florida Statutes: (name, address and phone number): 8. In addition to him/herself, Owner designates of to receive a copy of the Llenor's Notice as provided In Section 713.13(1)(b), Florida Statutes. 9. Expiration date of notice of commencement (the expiration date is 1 year from the 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 1, 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. STATE OF FL_''— il r COUNTY OF SEMINOLE OWNERS SIGNATURE OWNERS PRINTED NAME The foregoing Instr4ln-ent was acknoyyr_"ledged before me this day of F , 201 by V,0;-a.,C% e-oL h (ro Who Is personally known to me tom/ OR who has produced Identification __-type Identification produced VERIFICATION PURSUANT TO SECTION 92.525, FLORIDA STATUTES. UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING AND THATTHE FACTS STATED IN IT ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF, SIGNATURE OF NATURAL PERSON SIGNING ABOVE Print, Type or Stamp Commissloned Name of Notary Public gy t+J:61Th'L'2'i9Q.T..'t£SaiP. T•i:.2:l.SIlILY'T..'•= w`.V.^FS:l:.t4^. rSwC<L'F"w vC:C=•.-:'I a:.Ca 'S ..Y tY-4 seal) Notary Signature itjEY C',?!"J Saitl K[M^Y.136Ti!'.'cAv^J[TxtQy g_._ ' tit F COPY -MARYIN 10KE Cf IMF Co. Il i Er d OF THE Ci. T' - AND v ti C i i M SE HOLE CO ': FEB i LORIDA EPUT1` tt.l l LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: o2— fI- //,/ I hereby name and appoint: an agent of: R© 0 -P 7-3 p e r u ! c es 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: Street Address) Expiration Date for This Limited Power of Attorney: a - (D " 17 License Holder Name: 1' d'1 S State License Number: C C C 1 3-26, C, 7 9 Signature of License Holder. A - 7 1111- STATE OF FLORIDA COUNTY OF ae o i rn o 66 The foregoing instrument was acknowledged before me this day of Fet p 20V 4o , by gam[ s % Ljj n T te- who is *ersonally known to me or who has produced identification and who did (did not take an oath. Signature Notary Seal) Sha Ke E M'Ot Print or type name s SHANE MO AEI EMERY MY COMMISSION # FF 13M EXPIRES: Jury Z 2018 1ff h Bonded iem ferry Pudic undembrz Rev. 08.12) Notary Public - State of'-1 ort do --- Commission No. F F 1 a My Commission Expires: `7 Z / 9 as I f1 !I I I I I I I III I RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF.BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION —INDUSTRY LICENSING BOARD ,v _ gay CCC1326679 s The -ROOFING -CONTRACTOR Named'below IS CERTIFIED 1 Und'e r,fhe:V ovisions of Chapter 4& FS. M Expiration>date: AUG`34; 2016 - w NGATE,_KRISTALANN E.N--TROOFTOPSERVICESQC UTE#101. R"AL' F, PWINTERSRISFL31901200aG-; ISSUED: 07/ 27/2014 DISPLAY AS REQUIRED BY LAW 0l? 91 0 9 SEQ # L1407270002024 1 Issue Date: 12/9/2015 MidDRSA FLORIDA ROOFING, SHEET METAL & AIR CONDITIONING CONTRACTORS ASSOCIATION, INC. 1-800-767-3772 • FAX (407) 671-2520 CERTIFICATE OF INSURANCE ISSUED TO: COPY PROVIDED TO: City of Sanford Building Department 300 N. Park Ave. P.O. Box 1788 Sanford, FL 32772 Attention: Purchasing Manager Roof Top Services of Central Florida, Inc and 1200 Belle Avenue #101 Winter Springs, FL 32708 Roof Top Services of Central Florida, Inc and Clear Vue Skylights This is to Certify that: 1150 Belle Ave. Suite #1060 Winter Springs, FL 32708 being subject to the provisions of the Florida Workers' Compensation Act, has secured the payment of compensation by insuring their risk with the FLORIDA ROOFING, SHEET METAL & AIR CONDITIONING CONTRACTORS ASSOCIATION SELF INSURERS FUND, 4099 Metric Drive, Winter Park, FL 32792. COVERAGE NUMBER: 870-033597 EFFECTIVE DATE: 1/1/2016 EXPIRATION DATE: 1/1/2017 LIMITS Workers' Compensation: Statutory - State of Florida Employers' Liability: $1,000,000.00 Each Accident 1,000,000.00 Disease, Each Employee 1,000,000.00 Disease, Policy Limit REMARKS: Non -cancelable, without 30 days prior written notice, except for non-payment of premium which will be a 10 day written notice. This certificate is issued as a matter of information only, is not a policy and of itself does not afford any insurance. Nothing contained in this certificate shall be constructed as extending coverage not afforded by the policy(ies) shown above or as affording insurance to any insured not named above. This provides coverage for Florida policyholders and Florida domiciled employees only. c By: By: Brett Stiegel, Administrator Debra Guidry, CPCU, Un erwriting Manager FRSA-SIF FRSA-SIF 2/10/2016 SCPA Parcel View: 36-19-30-509-OE00-0100 Dfavid JoFu son,CFiA Property Record Card PROPERTY Parcel:36-19-30-509-OE00-0100 APPRAISER Owner: MEHOCHKO DEBORAH K & GORDON SCOTT T ET AL SEMINOLECOINJT/ taC+RiDA Property Address: 21S E 18TH ST SANFORD, FL 32771 Parcel: 36-19-30-509-OEOO-0100 Property Address: 218 E 18TH ST Owner: MEHOCHKO DEBORAH K & GORDON SCOTT T ET AL Mailing: 21818TH ST E SANFORD, FL 32771 Subdivision Name: MARKHAM PARK HEIGHTS Tax District: Sl-SANFORD Exemptions: 00-HOMESTEAD (2011) DOR Use Code: 01-SINGLE FAMILY v Comm c a J k , Legal Description LOT 10 & E 70 FT OF S 15FT OF LOT 5 BLK E MARKHAM PARK HEIGHTS PB1PG78 Taxes Value Summary 2016 Working Values 2015 Certified Values Valuation Method Cost/Market Cost/Market Number of Buildings 1 1 Depreciated Bldg Value 28,950 26,472 Depreciated EXFf Value 1,000 1,000 Land Value (Market) 15,617 15,617 Land Value Ag Just/Market Value 45,567 43,089 Portability Adj Save Our Homes Adj 5,234 3,036 Amendment 1 Adj Assessed Value 40,333 40,053 Tax Amount without SOH: $357.97 2015 Tax Bill Amount $296.18 Tax Estimator Save Our Homes Savings: $61.79 Does NOT INCLUDE Non Ad Valorem Assessments Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund 40,333 25,500 14,833 Schools 40,333 25,500 14,833 City Sanford 40,333 25,500 14,833 SJWM(Saint Johns Water Management) 40,333 25,500 14,833 County Bonds 40,333 251500 14,833 Sales ' Description Date Book Page Amount Qualified Vac/Imp QUIT CLAIM DEED 1/1/2015 08410 1420 12,800 No Improved QUIT CLAIM DEED 6/1/2005 - 05979 TT 1239 100 No Improved WARRANTY DEED 9/1/1996 03134 0507 100 No Improved SPECIAL WARRANTY DEED 3/1/1993 02566 1250 50,800 No Improved SPECIAL WARRANTY DEED 12/1/1992 02539 0992 58,700 No Improved CERTIFICATE OF TITLE 12/1/1992 02522 0767 1,000 No Improved WARRANTY DEED 12/1/1986 01799 0808 62,000 Yes Improved WARRANTY DEED 7/1/1984 01565 0134 37,000 Yes Improved WARRANTY DEED 7/1/1982 01320 0441 100 1 No Vacant Find Comparable Sales within this Subdivision http://www.sepaf .org/ParceiDetaiI lnfo.aspx?PID=3619305090E000I OO 1/2 2/10/2016 SCPA Parcel View: 36-19-30-509-OE00-0100 http://www.scpafl.orgIParcelDetail Info.aspx?PID=3619305090E000100 2/2 n City of Sanford Building and Fire Prevention Product Approval Specification Form Permit # Project Location Address)' I ? 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 U Automatic Other 2. Windows Single Hun Horizontal Slider Casement Double Hun Fixed Awning Pass Through Projected Mullions Wind Breaker Dual Action Other June 2014 Category / Subcategory 3. Panel Walls Manufacturer Product Description Florida Approval # including decimal Siding Soffits Storefronts Curtain Walls Wall Louver Glass block Membrane Greenhouse E.P.S Composite Panels Other 4. Roofing Products Asphalt Shingles she, )9D I 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 Applicant's Name Please Print) June 2014 k11'L Z tzQJ A , Wz/ 3 CITY OF SANFORD BUILDING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: y 9 f, k1I, F C S tit 01 h 2 hereby acknowledge that I personally inspected Roof deck nailing and/or Secondary water barrier work at - i s, E - ) ? 1- S>1 , sq-t,To rc 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. 114 - tA Signature of Contractor Date Krt-s-1%.-I A, 1j, cue / 3 a A Printed Name of Contractor License # License Type: General 0 Building Residential Roofing Contractor or any individual certified in accordance with F.S. 468 to make such an inspection. STATE OF FLORIDA COUNTY OF '3e._m t ri c9(e- Sworn to (or affirmed),and subscribed before me this day of , 201- , by er [atnd A -We ti TV-s-- , who is"A'Personally Known to me or has roduced (type of identification) as identification. SEAL) Signature of Notary Public State off Flor'da/ 1G(11 « • _ yejy DWRAHPUBM Na 3` * MYCOWISIONWO& Print/Type/Stamp EXPIRES: Septernbar 4, 2oi7 of Notary Public " ' &