HomeMy WebLinkAbout717 W 1 StJob Address:
EVEIVE
MAR 2 2 2016
BY
4
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: 0
Documented Construction Value: $
jcee-.,-,z-Historic District: Yes No
Parcel ID: ~ p5-00 Residential Commercial El
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work:--V9
r 4
Plan Review Contact Person: . /r
Phone: -07—q,11_a5_00 Fax: Email:
i I
Title:
Property Owner Information -
7Name 'C_a14 Phone: Z%/
Street: Resident of property?
City,State Zi
rl
Contractor Information
Name ig o f1 T
T—,ytCt ]"!! /c 1h l'1C Phone: %
Street: 16105- r
1T 4, P al- Fax:
City, State Zip: zy 1 rl41 612o L F.W6P State License No.: :5 '<r
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 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
n F
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. — - —I t,
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. /" ^ A
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
S nat a ofContractor/Agent Date
X 0 9 /A/
Print Contractor/Agent's Name
Signature 1r
DEBBIE BLANTON
MY COMMISSION Y FF 178648
o€ EXPIRES: February 25, 2019
Bonded Thru Notary Public underwriters
Owner/Agent is . Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID Type of ID Produced ID Type of ID
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
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
of Heads Fire Alarm Permit: Yes No
UTILITIES: WASTE WATER:
FIRE: BUILDING:
Revised June 30, 2015 Permit Application
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Customer Name:
P.O.4412
Masimo Construction, Inc.
Masimo_ Construction, Inc. Roofing Contract/Proposal
Address: 1049 Blackwood Street
Altamonte Springs, FL 32701
Phone: . (407) 922.0500
State -Certified Roofing Contractor - CCC1328033
State -Certified General Contractor'- CGC1509848
Brad P0IIack, Contractor , ,
11-11
00dr-(1-(-f
Insurance Co.
Adjuster:
Claim #:
Phone:
Date: _2_/
Address: / l l ''% t/t/A — _ [
Home'Phone: !/ ! '7 f i Cell:
Aq / _ Clty/State/ZIP:
Work Phone:
SPECIFICATIONS OTHER PROPERTY CONDITIONS
Ar Remove root to existing dock layers. Cl Icemater shield Yes No
Each additional laY er S rS q. (f 00 9q. Ft.) El Existing Water Damage Yes No
xRe-nail existing dock to moot uplift codes. Existing Driveway Damage Yes No
install _ metal dripedge aroundg ptlrimcterof r
Skylights:
61natall lead boots to pipes-1%" 2`" _y, Leaks•
Install Gooseneck vents 41"— tp" Interior Damage:
W Hurricane M111gai onRetrofit Emergency Repair Yes No
04ply ASTM 30# Felt Paper to plywood dock. Tapered insulation Yes No
00 Apply _Sq.,FL,o1'META' HINGLESlTILE/SHAKES/FLAT
Style ' —"'= Y-
WORK INCLUDES:
Remove trash from roof, utters and yard. gofrootobeinstalled:
t7Q + , Color: ` -e Pitch:J t
j Protect landscaping where applicable. `
Ll Manufacturer of roofing system- 1 Roll yard with magnetic roller.
Install ridge vent along peak of roof: Addt'l. t Furnish permit r
11 2 year warranty
Additional charges of $70 per "sheet if decking replacement Is needed which Is only visible upon toar-off existing roofing materials
WE PROPOSE
f
To furnish material and labor complete in accordance with sneciTicatlons above for the'sum of $
SPECIAL INSTRUCTIONS P_ AYMENT SCHEDULE
PRIOR50% DOWN PAYMENT TO'ORDER.ING MATERIALS "
PAYMENT IN DULL UPOMCOMPLETIOIV i : ', ' s
EARNEST DEPOSIT: ,$500.00 0 $1000 00 S
DOWN PAYMENT S lov
FINAL PAYMEr$T S
TOTAL06t
1
EPTANCE OF AG + EMENT
This agreemenris subject to insurance YZ approval and does not oblig t he ho m eown6r or Masimo Construction, Inc. in any way unless
It is approved by the insurance company and accepted by Masimo Cons u isn„ c.y signing this agreement you authorize us to negotiate
the repairs at a price agreeable to the insurance company and Masimo C nstrucHo c. at NO ADDITIONAL COST TO YOU EKG p7 FQR THE
INSURANCE QEDUCTIBLE AND AS'PROVIDED ELSEWHE E IN THIS dREEME he final price agreed on between the insurance company
and Masimo Construction, Inc. shall become the final contract price and Masimo Construction, Inc. will receive all insurance proceeds for the
work completed by Masimo Construction, Inc.
THREE'DAY`RIGHT OF RESCISSION
THIS WRITTEN AGREEMENT HEREBY SERVES AS NOTICE'THAT I MAY CANCEL THIS
AGREEMENT -AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE '
OF THIS AGREEMENT.
Owner Signatur Date 200_ Sales Rep.
Accepted by Masimo Construction, Inc. Representative
i Insurance Carrier _ Claim No.
Events beyond the control of Masimo Construction, Inc. may cause delays to the projected start date or estimated time of completion. Such delays
do not constitute abandonment and are not included in -calculating time frames for payment or performance. THE TERMS AND CONDITIONS ON
THE REVERSE SIDE OF THIS PAGE ARE A PART OF THIS AGREEMENT.
WHITE - HOMEOWNERS COPY YELLOW - SALESMANS COPY PINK -- OFFICE COPY
This contract -and any agreement made pursuant thereto Is between Masimo Construction, Inc. hereinafter referred' to as theContractor, and the customers) named herein on the reverse side will be subject to all appropriate laws; regulations and;
ordinances of the State of Florida and upon the following items and conditions.
1. All contracts are subject to approval of our credit department and office without exceptions. The person executing this
contract must obtain the'approval of the officer of the Contractor for this contract to be effective under any. conditions.
2. SHOULD DEFAULT BE MADE IN PAYMENT OF THIS CONTRACT, CHARGES SHALL BE ADDED FROM THE DATE THEREOF
AT A RATE OF ONE AND ONE HALF (11/2) PERCENT PER MONTH (18% PER ANNUM) WITH A MINIMUM CHARGE OF $2.00
PER MONTH, -AND IF PLACED IN THE HANDS OF ATTORNEY FOR COLLECTION, ALL ATTORNEY FEES AND LEGAL AND.
FILING'FEES SHALL BE PAID BY CUSTOMER ACCEPTING SAID CONTRACT.
3. The Contractor shall have no responsibility for damages from rain, fire, tornado, windstorm; or other perils,•as,Is normally
contemplated to be covered by HOMEOWNERS INSURANCE or BUSINESS RISK INSURANCE or unless a specified•writteh
agreement is made therefore prior to commencement of the work.
4. The quotation on'the face hereof does not Include expenses or charges for bond insurance premiums or costs beyondnormalinsurancecoverageandanysuchadditional, expenses, premiums or costs shall be added to the amount of the
contract.
5. Replacement of,deteriorated decking, fascia boards, roof jacks, ventilators, flashing or -other material unless otherwise
STATED IN THIS CONTRACT, are NOT INCLUDED and will be charged as an extra on a time and material basis.
6. This proposal will expire 30 days from the date accepted unless extended in writing by the Contractor. After thirty {30) days, the Contractor reserves the right to revise our price in accordance with the costs in effect at the time. -
7. The Contractor shall not be liable for failure of performance due to labor controversies, strikes,.fires, weather, and inabilitytoobtainmaterials'from usual sources, or any other circumstance beyond the control of the Contractor, whether of a similar
or dissimilar nature.
8. If roofing and shoat metal work is involved,'It is understood and agreed to that our standard roof guarantee, a copy of
which is available in our office, shall be acceptable and that all terms and provisions therein -shall prevail, unless otherwise
specifically agreed to in writing prior to the commencement of the work.
9. The Contractor Is not responsible for any damage on or below the roof due to leaks by excessive wind driven rain, Ice or hail
during the. period of the warranty. EXCESSIVE WIND IS 50 MPH OR GREATER. THE WARRANTY IS NONTRANSFERABLE. _
10. if material' has to be reordered or restocked because of a cancellation by the customer, there will be a RESTOCKING FEE
equal to fifteen (15) PERCENT of the contract price as liquidated damages, not as a penalty,- and the Contractor agrees to
accept such as a reasonable and just compensation for said cancellation._
11. This contractor warranty shall not be assigned except by or with written' permission of the Contractor.
12. IF THiS CONTRACT CANCELLED BY CUSTOMER LATER THAN THREE (3),DAYS FROM EXECUTION, the customer shall
pay to the Contractor fifteen (15) percent of -the contract price as liquidated damages, not as a penalty, and the Contractor
agrees to accept such as a reasonable and just compensation for said cancellation.
13. THIS CONTRACT CANNOT -BE CANCELLED ONCE WORK IS COMMENCED EXCEPT BY MUTUAL WRITTEN AGREEMENT
OF THE PARTIES.
14. PAYMENT ARRANGEMENTS ARE TO BE AGREED UPON ON THE FRONT OF THIS CONTRACT Other arrangements must
be discussed with credit manager.
15. If any provi.slon of this, contract should be hold to be invalid or unenforceable, the validity and enforceability of the remaining
provisions of this contract shall not be affected'thereby.
16. ANY REPRESENTATIONS, STATEMENTS, OR OTHER. COMMUNICATIONS, NOT WRITTEN ON THIS CONTRACT ARE AGREED
TO BE IMMATERIAL, and not relied on'by either party, and do not survive the execution of the contract.
17. The maximum liability for the Contractor shall be'the original cost of labor and materials for the repair which customer
agrees shall be' a liquidated sum, under any event default of Contractor herein.
18. During the duration of the work the homeowner's insurance will be responsible for any interior damage as long as the
Contractor has taken appropriate action to.protect the roof during the repair of the roof.
19. If'there are any solar panels on the roof, the Contractor will not be responsible for damage during the repair, so homeowner
agrees to have a solar panel company take the'appropriate action if necessary.
20. The Contractor is not responsible for. the construction problems of your home. If pointed out and Contractor is notified, we
will try to assist you on correcting them on a time and material basis.
21. Total balance must be paid upon job completion. Completion does not entail final inspection.
THIS INSTRUME T PREP RED BY:
Name: o
r f Address:
L
NOTICE OF COMMENCEMENT
Permit Number:
Parcel ID Number..2 /9_-30_j -G —0?/D - 6D
IlIIII !11l1 Ilill lilll 11111 II!!I IIl1 I!!I
MARYANNE 11ORSE SEMINOLE COU1,4TY
CI..FRK OF CIRCUIT COURT & CONPTROLLER
BK -3h54 Pq 18152 (1F'gs )
CLERK'S T 2016030471
RECORDED 03/22/2016 02:53: U I. F'M
RUORDING FETES $10.00
RECORDED BY hdevore
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, thefollowinginformationisprovidedinthisNoticeofCommencement
1. DESCRIPTION OF PROPERTY: (Leal description of the property and street address if
q u00%,Kir-1 iUN ur IMPROVEMENT:
3. OWNER INFORMATION
Name and address
Interest in property
IF
Fee Simple Title Holder (if other than owner listed above) Name.
4. CONTRACTOR: Name:
Address /41G 4- 3Z2!
5. SURETY (If applicable, a copy of the payment bond is attached): Name
Address A/ Aq
FOR
Phone Numberd
Amount of Bond.
6. LENDER: Name /
Phone Number
Address
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 _
Phone Number:
Address ,
8. In addition, Owner designates
to receive a copy of the Lienor's Notice as provided in
of
713 13(1)(b), Florida Statutes Phone number-
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 YOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTYANOTICEOFCOMMENCEMENTMUSTBERECORDEDANDPOSTEDONTHEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEYBEFORECOMMENCINGWORKORRECORDINGYOURNOTICEOFCOMMENCEMENT
Under penaltieA 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 andbelief.
LOB, /_. q(slonuofer or Lessee or Owner's or Lessee's (((((((Pont
Name and Provide Signa ry's Title/Office) zedOcer/Director/Partner/Manager) State
of , CJ Countyof.5 1e 7;rj The
foregoing instrument was acknowledged before me thiis day of 4 arc-` Zp by
0i,111 Who is personally known to me 0 OR Nameofpefsoffrifakingstatement ^` who
has produced identificatiori type of identification produced: / Lam. L u.,,,
DONNA t IIIANNETTE 1.
Notary Public - State of Florida "CERTIFI e
Commission N FF 951485 ` `7 461 t ' "' T+'F c 2020
MOR.
F
My Comm. Expires Jan 19, COMPTROI. ou qN Notary Si aturn... 9 Bonded
through National Notary Assn. 1 WOLFOUNTYSury /
t /fit .,rlF q
QB I \lNt A
20 DEPtIryCLERK I
0-
tii,
SEMINOLE COUNTY MULTI%URISDICTIONAL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
I hereby name and appoint: O .\ 1/
1
r
an agent of:
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.
O
The specific permit and application for work located at:
Street Address)
Expiration Date for This Limited Powerof Attorney: /
License Holder Name: & IC/62
State License Number:
Signature of License H(
STATE OF FLORIDA /
COUNTY OF S4-24 ,1r ci/4-2
The foregoing instrument was acknowledged before me this _&2-Lday of
20_jZ , by /ar 62Ila who isx—personally known to me or
who has produced
and who did (did not) take an oath.
Signature of Notary
DONNA l BARNETTE
Nofuy'Pdit -rSjM* of)floridA
Comm calm I ff 951485
Nq CoM. Ettplfa Jm 19, 2020
n 8W*d tWW0 N*1WA1 Noluy Assn
as identification
a2l).ri,02 2"?1,Y)&Z'6'
Print or type Notary name
Notary Public - State of f/d a
Commission No.
My Commission Expires:
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #:
hereby acknowledge that I personally inspected
Roof deck nailing and/or>4econdary water barrier work
at '7 / i (/CAPS .
Sf S/ 1n7'o G and have determined that the work
ob 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
Sect tiyp 037.06 F.S.
3a 6
Signature of Contractor Date
0 AW 6 K Gcc /-qc--;2, 3
Prini-ed 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 OFF ( . /-e- ,
y/j 1
Sworn to (or affirmed) and subscribed before me this day of ,' J A'YL , 20, by
OA/ /) P , who is-f17'Personally Known to me or has Produced (type of
id 'fication) as identification.
SEAL)
ignature of Notary Public DONNA L ftAWTTE
State of Florida NMV k • fWft of FWWa
Print/Type/Stamp Name
of Notary Public
Cowowb R OS1 15
M Co a. bomj o tN. M0
aM N NNR Mtn,
3