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HomeMy WebLinkAbout1614 W 16 StCITY OF SANFORD BUILDING & FIRE PREVENTION. MAR a _.. PERMIT APPLICATION2016. BY: Application No: Documented Construction Value: S . Job Address: ,X 11,IL/ Cik 1 - jnn " 04", Historic District: Yes No El ParcelfID: X 3Lf - l •- 3^ ! 5A 0 Acu, _ odn Residential,© Commercial Type of Work: New Addition Alteration 0' Repair Demo Change of Use Move ' Description of Work: . 1 1 Plan Review Contact Person: It Dilc,5 , . ' Title: OUR" Phone: 7 ' ' ( •, Fax ^ Email: pq S' - C 0 Vh Property Owner Information - - I Name X _ i1tlN Ain' S Phone: S ' (p 3 - gs 1J Street: 1 jn I y (o `% Resident of property? : City, State Zip: r'`z1(..,L t MMID:)Contra bgrr Information Name n••• Phone: f-10 -3 i `1 CUO Street: S Fax: City, State Zip: 5(State License No.: CC -_ 1.3 a 6, S fo Name: Street: City, St, Zip: Bonding Company: Address: 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 constructioninthisjurisdiction. I understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and air conditioners, etc. I FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 51h Edition 0614) Florida Building Code Revised: June 30, 2015 Pennit Application I 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. 2 Signature of Owner/Agent - Date Print Owner/Agent's Name Signature of Notary -State of Florida Date n A141- " , 4 11b / Signature of Co nt; c r/Ag nt Date c 6 G Prin t c r/ en Name Sig tore of Notary -State of Florida Dat REBEKAH C MORELAND MY COMMISSION *FF135176 EXPIRES June 23, 2018 Owner/Agent is Personally Known to Me or Co F i tWrit i toridaN el rWCno n to M Qr Produced ID Type of ID Pro uce _ Type of ID D 1 V G IC., 1 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: COMMENTS: Revised: June 30, 2015 ENGINEERING: UTILITIES: FIRE: Flood Zone: of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes No WASTE WATER: BUILDING: Permit Application I 5' . LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: /(6 I hereby na1 an agent of: 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 Ad ress) Expiration Date for This Limited Power of Attorney: License Holder Name: % --7'C,%VNCW--L: -e— State License Number: Signature of License H STATE OF FLORIDA COUNTY OF The foregoing instrument was ackpowledged before me this -- day of fnacA\ , 200_kt.,O_, byTc,--,,eA c c, el who is personally known to me or p-who has produced as identification and who did ( diiigieznature 2at Notary Seal) cr h c Y REBEKAH C MORELAND t MY COMMISSION #FF135176 EXPIRES June 23, 2018 407) 39"153 F(oridallota Servlce.com Rev. 08.12) Print or type name Notary Public - State of 7j o+t Commission My Commission Expires: V461 State Certified Roofing Contractor Lic. #CCC1326590 Name Phone Email. ag"MOONDY p N 0 F C Is uc Keeping You Covered For over 25 Years Address. Office 407-321-1054 Cell Phone 407-314-0160 Andyland874@msn.com Specifications: y , a } (V '; Auto Gs;tw 77 ram, . cY _ fit, 1 Ij R LcW i {;yV Estimated Work Completion Date 3/ 4 /j_ within 3 day(s) from inception (weather permitting) In consideration of the said work and services to be done by the contractor, the homeowner agrees to pay the contractor the sum of on completion of said work. Terms: L .- 0 a deposit; and on completion of said work The homeowner hereby certifies that they have read and understand this agreement, that the terms and conditions and the meaning thereof have been explained to him and that theyfullyunderstandthem, that there is no understanding between parties verbal or otherwise than that contained in this agreement, and that the owner shall maintain no action on any new substituted contract except the same be in writing, and that no statements, promises, commitments or representations not contained in this agreement have been made by thecontractor, or any'of his agents to 0 the same be reduced to writing and be signed by the contractor. It is further agreed that if the homeowner cancels this contract at any timebeforecommencementofthework, through no fault of the contractor, then the liquidated damages arising from costs and expenses necessarily incident to the business of the contractor in connection with this contract amount to the sum of 25% of the total contract which said sum the homeowner undertakes and agrees to pay forthwith. It is also said that the contractor shall not beheld liable for re -adjustment of satellite dishes. It is also said that the contractor shall not be liable for delays caused by strikes, weather conditions, and delay in obtaining materials or causes beyond the contractor's control. The contractor hereby assumes no liability for any resultant damage to premises or materials located on premises from work herein contracted. It is also said that the contractor shall not be liable for material delivery vehicles on homeowner's premises. In witness whereof, the homeowner has hereunto signed his name this day of 2015 Andrew S. ones, s. I 12015 -1 r l 4 C1)a41 %e, I S AcceptedbyCONTRACTtoAcceptedbyIHOMEOWNERDate Notice* CONSTRUCTIOALINDUSTRY RECOVERY FUND. Payment maybe available from the construction industries recovery fund if Oryou lose money on a projec performed under contract, where the loss results from specified violations of Florida law by a State -Licensed Contractor. For informatittabout the -recovery fund and filing a claim, contact the Florida Construction Industry Licensing Board at the followingtelephonenumberandaddress: 1940 N. Monroe St. Tallahassee, FL. 32399 850.487.1395 OFIAP, P,g0 S !. L CgEEHfD" d'Y.PPP REBEKAH C MORELAND! fice; MY COMMISSION #FF135176 or' hAf'f EXPIRES June 23, 2018 407) 398-0153 FbridallotaryServlce.com 874 East 20th Street, Sanford, Florida 32771 F' ' J0111 US OI 4 AndvJonesRoofino. com SCPA Parcel View: 34-19-30-5AK-OA00-0190 Pagel of 2 CSC C)av a lchr»cn. cr^ Property Record Card ROPERTY Parcel: 34-19-30-5AK-OA00-0190 APPRAI5ER Owner: DANIELS JUDY L MINOLE0OUI YY.FLORIDA Property Address: 1614 W 16TH ST SANFORD, FL 32771 Parcel:34-19-30-5AK-OA00-0190 Property Address: 1614 W 16TH ST Owner: DANIELS JUDY L Mailing: 1628 BOARDMAN AVE WEST PALM BEACH, FL 33407 Subdivision Name: SMITHS M M 2ND SUBD (Bl P101) Tax District: Sl-SANFORD Exemptions: DOR Use Code: 01-SINGLE FAMILY 42 IV Sales x 20 21 Value Summary 2016 Working Values 2015 Certil Values Valuation Method Cost/Market Cost/Mark( Number of Buildings 1 1 Depreciated Bldg Value 37,484 36,472 Depreciated EXFT Value Land Value (Market) 8,700 8,700 Land Value Ag Just/Market Value 46,184 45,172 Portability Adj Save Our Homes Adj 0 0 Amendment 1 Adj 0 0 Assessed Value 46,184 45,172 Tax Amount without SOH: $ 2015 Tax Bill Amount $ Tax Estimator Save Our Homes Savings: Does NOT INCLUDE Non Ad Valorem Assessments Description Date Book Page Amount Qualified Vac/Imp FINAL JUDGEMENT 6/1/1996 03086 1927 100 No Improved ADMINISTRATIVE DEED Find rmmn—hlc Cnlne —H-k;.. tti;.. 2/1/1992 02393 1456 18,100 No Improved Land http://www.scpafl.org/ParceiDetaillnfo.aspx?PID=3419305AKOA000190 3/7/2016 SCPA Parcel View: 34-19-30-5AK-OA00-0190 Page 2 of Method Frontage Depth Units Units Price Land Value FRONT FOOT & DEPTH 50 142 0 $174.00 Building Information escriptionYear ilt Actual Effective Fixtures Base Area Total SF Living SF9 Ext Wall Adj ValueTRepl Value 37,484 $49,979 Appendages 1 SINGLE FAMILY 1971 5 1,197 1,624 1,197 CONC BLOCK Description I GARAGE FINISHED OPEN PORCH FINISHED Permits Permit # Extra Features Type Agency Amount CO Date Permit Date No data to display http://www.scpafl.org/ParcelDetaillnfo.aspx?PID=3419305AKOA000190 3/7/2016 IJ THIS INSTRUMENT PREPARED BY: Name: A pn Addre'ss:' NOTICE OF C Lt)I Ihi i Yi. Cit11-1'(w,lu.E r OMMENCEMENT Permit Number: pt TNf 111 CEO COPY- MARYANNE MORSE ERK OF TH QIRURTANDParcelIDNumber: L— ( ( /DQ RO .E ;'•1;3;• The undersi ned hereb llb3EMINO 11,0e co9ygivesnoticethatimprovementwillbemadetocertainrealproperty, and in ac or e Florida StaffAes.tyk efollowinginformationisprovidedinthisNoticeofCommencement. 1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available) BY,L 2 x Atw",I 3-/g- D - <_ ,2ADl,9- 6 2. GENERAL DESCRIPTION OF IMPROVEMENT: 3. OWNER INFORMATION OR jLES5.EE INFORMATION IFNameandaddress- X UW J J'I I I L tS Interest in property: k % /o (1) 1 i0 eifY CONTRACTED FOR THE IMPROVEMENT: Fee Simple Title Holder (if other than owner listed above) Name:_ Alld Address. 4. CONTRACTOR: Name. Phone Number: 1 D ) - 3 /Lj Address: 7 r i 5. SURETY (If applicable, a copy of the payment bond is attached): Nam 6. LENDER: Name Address. Phone Number: Amount of Bond: 7. Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section713.13(1)(a)7., Florida Statutes. Name 8. In addition, Owner designates Phone Number: of 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 ARECONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY IBEFORE COMMENCING WORK OR R CORDING YOUR NOTICE OF COMMENCEMENT Ign ure of Owner or Le ee, or Ow s or Lessee's L thonzed Officer/Dlr ctor/Partner/Manager) Pnnt Name and Provide Signatory's TitlelOfrice) State of F-\t County of ?04. The foregoing instrument was acknowledged before me this Y day of I V \(;l l c Q1i , 20 by 161 S Name of person ing statement — Who is personally known to me OR who has produced identification t pro uced ("- O Ci1 DANIEL S AZER i MY COMMISSION #FF011561 19/ EXPIRES May 12, 2017 FloAdeNoteryS°rvlo°,com 1 34E1•O1 Notary Signature . City of Sanford Roof Permit Application Checklist All permit application packages must be complete prior to acceptance. You must check each box to theleftorindicaten/a on this submittal. A complete application package shall include the following: Building Permit Application completed, signed and notarized. Application must include correct addressandcompleteparcelI.D. number. Copy of applicable contractor's license issued by the State of Florida (if the contractor is theapplicant). 7J 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 ofSanfordascertificateholder, or a copy of a worker's compensation exemption issued by the State ofFlorida (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 roofpermit application and may not becomplete. The applicant is required to meet all City of Sanford, state, andfederal code requirements. CITY OF SANFORD BUILDING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: A— " I' oe hereby acknowledge that I personally inspected Roof deck nailing and/or,KSecondary water barrier work at l h — 11 16 /Y 7l ,S -- ( fand have determined that the workJobSiteAddress) — was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.) 1 certify that my statements herein are true and accurate to the best of my belief and that I fullyunderstandthatmakinganyfalsestatementsinwritingwiththeintenttomisleadapublicservantinthe performance of his or her official duty shall constitute a misdemeanor of the second degree pursuant toSection837.06 F.S. Signature of r or Date Printed Na e 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 l<:, Sworn to (or affirmed) and subscribed before me this day of (xNorck , 20 ND byr , who is Personal y Known to me or has produced (type of jide c io) .r as identification. SEAL) gnature of Notary Public t eofFor;da Print/Type/Stamp Name " REBEKAH C MORELAND of Notary Public MY COMMISSION #FF135176 EXPIRES June 23, 2018 407) 398-0153, FloridallotaryService.com