HomeMy WebLinkAbout103 London Fog Way (2)irf V'FD CITY OF SANFORD
BUILDING & FIRE PREVENTION
D
MAR 2 4 2016 PERMIT APPLICATION
Q
Application No: (o- Q d 1
Documented Construction Value: $ 0// 9' 7
Job Address: /L3 3 (-U& jo4w is:a Historic District: Yes No B'
Parcel ID: '33- 1 9- 3d-- Residential Commercial
Type of Work: New Addition Alteration L J Repair Demo Change of Use Move
Description of Work:
Plan Review Contact Person: Q FQyL 1'I'1 - Title: th rx
Phone: 3;9 1-Q"7 Q-9Q9 Fax: 1- 9 23- V Y- 7 l Email: SA, i 11 rr'L,c c-, cam, ,let 'n ,
Property Owner Information
c
Name 1 1 T*y Aq6iji? Phone:
Street: —
r
QE:3 C_06000,.) J!c} 1A),9!!V Resident of property? -
City, State Zip: _ '.3%7
Contractor Information
Name 8 A(OM cc.n 1'-Jr' C—A<14 LL C Phone: 3-1- 9 7 5) " 90c) z
Street: S 'T )-jSk4 &I f_ [may Fax: '?o / - 9?a - u
City, State Zip: )4 UJ71-' A k s _ f-L
y
State License No.: C<" C
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 zomn .
Signature of Owner/Agent Date `Sigr;a—ftuiVbf Contractor/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Date
Print ContractS? gent's Name
V Notary Public State of Florida
t' Linda W Pigozzi
My Commission FF 043599'
OF Expires 08/07/2017
y-/y
Agent is Personally Known to Me or Contractor/Agent is Pe nally Known to Me or
d ID Type of ID Produced ID Type ofID
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:
Flood Zone:
of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
of Heads
UTILITIES:
FIRE:
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
ilk
axiom
CONTRACTINGG GROUP ShingleMaster
For Roofing It Just Makes Sense... CwtolOnd
1025 Sunshine Lane, Altamonte Springs, FL 32714
Office: 321-972-4094 Fax: 321-9724471 tt-tvtt,.axiomcontractine.cont
FL License# CCC1329763 Solar License# CVC56964 EIN:27-5097304
Locations: Jacksonville, Margate, The Villages
Veal CONTRACT/BUILD CONFIRMATION
MR/MRS/MS `4=F-r1*ft 7GInP tica HOME# qO i
STREET / 03. CELL #
CITY <"r" .i /
STATE r l ZIP 1-7'! I ORIGINAL AGREEMENT/CONTRACT DATE ! .
SHINGLES & RIDGE: CERTAINTEED LANDMARK
Driftwood
Weathered Wood
Burnt Sienna
UNDERLAYMENT
V Synthetic Felt
Other (Charges may apply)
GUTTERS
Cobblestone Gray Heather Blend Charcoal Black Silver Birch
Colonial Slate Sunrise Cedar Mojave Tan Pewter
Georgetown Gray Moire Black Resawn Shake Other
Detach & Reset as necessary
New
VENTILATION VALLEY Drip Edge
15' Ridge Vent Ice & Water shield 2.5" Painted, Color
Off Ridge Vents En Valley Metal Other
GOOSE NECKS PLUMBING STACKS ROLL ROOFING
1ysl4" Goose Neck QTY 1-1/2" Lead QTY 2-Ply Peel-n-Stick
10" Goose Neck QTY 2"Lead v QTY Other
Color 3' Lead _ I Color
Job Description and Additional Items ( i.e. Solar Panels, Interior, Chimney Flashing, Skylights etc. )
TOTAL CHARGE FOR ABOVE LISTED WORK: $
r
PAYMENT SCHEDULE IS AS FOLLOWS
Down Payment Due: $
Upon Roof Completion: $ /`i 4/.3 Yi (Includes Deductible) v:e:v f/t;
r AL
Depreciation Amount Due: $ i 71 A U />G' L) LV/)c9,,? G 0
kZ nrw1JJ:1 (W F"O. ^^'
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:
z!, 3.17-11>
Homeowner 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 paypble to Axiom Contracting Group LLC.
3117
Axiom Contracting G oup Aut6i ized Representative Date
NOTE: This CONTRACT becomes part of and in conformance with the existing Agreement/Contract
Aiilk $EM/NOLE COUNTY MULT/%UR/SD/CT/ONAL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 1- d Ll -1(e
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:
MW
Expiration Date for This Limited Power of Attorney:
License Holder Name: Clifford A. Miller
State License Number:
Signature of License He
STATE OF FLORIDA
COUNTY OF S?--, AAn L-4—c
Address)
12-31-16
The foregoing instrument was acknowledged before me this ZO-kday of
20_1_(p_, by -jA FFacep R. Mt WC1L who ' known to me or
who has produced as identification
an did (did take an oath.
L j../lo A- Ly P i bezZ Signature
of N / ,"Ov y—C, 2/ Print or type Notary name Notary
Public - State of %L.c OA 500
ateofFlorida / ' 6
zi
Commission No. I-0 7 FF
043599 017
My Commission Expires: 7- ail 1%
111 11111111 illll Ildll ttdi! 111 ii i
lliaR't+l•IL4L flu;,SE r ':I:ttL'1'I+7i..L C'i)Iltll-`t
THIS INSTRUMENT PREPARED BY:
t f:f;i, ,f; ; ]E t, i_)I i,fl!If I b is+it'If Tf.Ol.l-FR
Name: Axiom Contracting Group, LLC
Address: 1025 Sunshine Lane t E:RE: ,S Y-)A161i.s12`1:1f: Altamonte Springs, Florida 32714 _ ++ , i -: , , ". E.c 11
NOTICE OF COMMENCEMENT sgEm/--tD..
C)f;f
Permit Number:
Parcel ID Number: '33- / °i —005-0
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)
L C7 r 7Y
ch ( +^ rIn d-4 Fc t-2. i l, -77 /
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Residential ReRoof
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: f_ 17ji Strj.lf} ; /0 3 LOJnr.J c—
Interest in property: 0-1,)nj14-2
Fee Simple Title Holder (if other than owner listed above) Name:
Address:
4. CONTRACTOR: Name: Axiom Contracting Group, LLC Phone Number:
Address: 1025 Sunshine Lane, Altamonte Springs, Florida 32714
Yb 5. SURETY (If applicable, a copy of the payment bond is attached): Name:
321-972-4094
Address: Amount of Bond: n,
6. LENDER:
Address:
Phone Number: Q
7. Persons within the State of Florida Designated by Owner upon whom notice or other
713.13(1)(a)7., Florida Statutes. l
Nam
8. In addition, Owner designates
r
Phone Number:
of
S.
may be served as provided by Se
1
to receive a copy of thh lellor'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.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in It are true to the best of my knowledge and
belief.
Signature of Owner or Lessee, or Owner's or Lessee's (Print Name and Provide Signatory's Title/Office)
Authorized Officer/Director/Partner/Manager)
State of 11: 2 o>— County of ./h r
The foregoing instrument was acknowledged before me this 1'725:1- day of 1;9A2 C±d 20
by17.-/ 'j- j1%/T Who Is personally known to me OR
Name of person making statement
who has produced Identification type of Identification produced: L %-S SRV) -S/'3 —L-_ 2 `2 i--CS
T
A X: - qyr rC' Notary Public State of Florida
40-cf, Linda W PigOzzi No Signature (^( Z
aMyCOn'Imt55ton FF 443599'%
OFFd• ExPrree 0810712017
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17nvld Johr»on. CFn Property Record Card
PROPERTY Parcel: 33-19-30-513-0000-0350
APPRAISER Owner: SCHENA KEITH M 6 ROBYNN A
SeMiNp.F. cOuNiv, q.OHiOn Property Address: 103 LONDON FOG WAY SANFORD, FL 32771
Parcel: 33-19-30-513-0000-0350
Property Address: 103 LONDON FOG WAY
Owner. SCHENA KEITH M & ROBYNN A
Mallirg: 103 LONDON FOG WAY
SANFORD, FL 32771
SubdMslon Name: MAYFAII OAKS 331930513
Tax District: SI-SANFORD
Exemptions: 00-HOMESTEAD (2005)
DOR Use Code: 01-SINGLE FAMILY
2016 Working
Values
2015 Certificsl
Values
Valuadcn Method Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 114,223 112,268
Depreciated EXFT Value 3,137 3,270
Land Value (Market) 32,000 2B4O00
Land ValueAg I
Just/Market Value
149360 143,538
Portability Adj
Save Our Homes Adj 34,837 29,811
Amendment 1 Adl
Assessed Value 114,523 113,727
Tax Annunt without SOH: 2,099.86
2015 Tax C,1 Amount $1,493.16
I
Tex Estimator
Save Our Homes Savings: 606.70
Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description
LOT 35
MAYFAIR OAKS
PB 50 PGS 38 THRU 41
Taxes
Taxing Authority Assessnent Value Exempt Values Taxable Value
County General Fund 114,523 50,000 64,523
Schools 114,523 25,000 89,523
City Sanford 114,523 W,000 64,523
S3WM(Saint Johns Water Management) 114,523 W 000 64,523
County Bonds 114,523 f50,000 11,523
Sales
Desorption Date Bode Page Amount Qualified Vac/Imp
WARRANTY DEED 30/1/2003 05134 1455 165,000 Yes Improved
ImprovedWARRANTYDEED11/1/1998 03550 0622 108,100 Yes
Find Comparable Sales vothin this Subd,vmon
Land
Method Frontage Depth Units Units Price Land Value
LOT 1 32,000.00 32,000
Building Information
M Descriptor
Year Built Rxbires Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages
Actual/Effecdve
1 SINGLE 1998 8 1,564 2,014 1,%4 CB/STUCCO 114,223 $122,164
Description Area
FAMILY FINISH
OPEN
PORCH 30
FINISHED
GARAGE 420
L_ I FINISHED
Permits
Pemit * Type Agency Amount CO Date PemR Date
01139 AddMw - Residential
02355 Adddion - Residential
F
02636 New- Residential
Sanford
Sanford
Sanford
0
400
70,989 11/17/1998
2/22/2002
5/1/1999
8/1/1998
Extra Features
Description Year Built Units Value New Cost
ALUM GLASS PORCH
COVERED PATIO 1
10/1/2002
10/1/2002
296
1
2,603 $4,004
534 $1,000
I CC' V
AR:2
tvFD City of Sanford
Roof Permit Application Checklist
M4 2016 i
2Z_ 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: Building
Permit Application completed, signed and notarized. Application must include correct address and
complete parcel I.D. number. Copy
of applicable contractor's license issued by the State of Florida (if the contractor is the applicant).
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. 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). 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, and federalcode requirements.
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: /(- 909
I, Ct.eIC 0.?I cu/ hereby acknowledge that I personally inspected
trKoot deck nailing and/or ondary water barrier work
Wo 3 L Q, lea,) /,br, khq_-_y _0231717 land 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.
1 % 6
4 t. -Z a- 4/-4
Signs ' r ontractor Date
ct-4 moiso A rl / c 132 6? -7
Printed Name of Contractor License #
License Type: General Building Residential oofing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF
oe pSwornto (or affirmed) and subscribed before ay I , 20 by
who isonally Known to me r has Produced (type of
identif ti ) i iica ion.
SEAL)
1gnature of Nota ublic
State of Florida
lj%i¢ (,/ G z Z / RUE] Stete of
FloridaozziPrint/Type/Stamp Name on FF 043599'
of Notary Public /2017