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HomeMy WebLinkAbout105 Madden Avebu i ib4kj 6) - or . n CITY OF SANFORD BUILDING & FIRE PREVENTION AUG 7 2016 PERMIT APPLICATION Application No: 1 (p - a3 1. o Documented Construction Value: $ Job Address: ,CJV 11411. toca2") /fu Historic District: Yes No Parcel ID: Residential Commercial Type of Work: New Addition AlterationA Repair Demo Change of Use Move Description of Work: e 4c)a F TI- ,<„ e, Plan Review Contact Person: 414 r- e Title: Phone:Z,/b% 7oV.2'Sy/ Fax: 4/,67 35_ Property Owner Informationt el Name ©f . //U//% Phone: 3,q6 - 7& ® s % Street: .MAjd Pn; / "'"" _'" ""`r't "M Resident of property? /+ ff P syj c133r City, State Zip. Ca 1 Confra'ctor `Information Name /° 5,rsIV Street: -of City, State Zip: a Name: Street: City, St, Zip: Phone Fax: 6-2 zz 15VI 4607 35`7 `ion State License No.: 132 Cob ; / Architect/Engineer Information Phone: Fax: E-mail: Bonding Company: Mortgage Lender: Address: 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: 5" Edition (2014) Florida Building Code Revised: June 30, 2015 Permit Application 0 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may-r e 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 of Owner/Agent Date Signature of Cont actor/Agent// Date Goa f -o Print Owner/Agent's Name Print Contractor/Agent's Name t, Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID uSsy (iFN Ew p 9 S, -006 of E+prida Date 09LiLO N U9toZ'9tWtfubRINr. 1 e110 Pll M M9 - 3I14nd AmoN 1100S 3113NN1 Contractor/ Agent is Personall nown to Me or Produced ID Type of ID F L I 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: of Heads UTILITIES: FIRE: Flood Zone: of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes No WASTE WATER: BUILDING: Revised: June 30, 2015 Permit Application F LSHENTERPRISES INC. Dba: ABOVE ALL ROOFING 3519 Wading Heron Terrace Oviedo, FL 32766 Phone: 407-722-1541 Fax: 407-359-4069 CCC 1326699 ROOF ESTIMATE Project Address: C"*-v "f— J Date: -7 19-16 'R 1. Remove existing shingles, vents, boots & drip edge. 2. Nail deck per Florida building code. 3. Install Dry -in per Florida building code. 4. Install dri edge, vents and b ts. -- 5. Install — . r 4 `shingles to the Florida building code. Labor & Materials Woodwork $45.00 per man hours -+- materials Total Estimate: 1!5"' - Years workmanship warrant y Notes: Customer signature: i i lil !i)i lali! Iilli a ill Iiiil IIII lili This instrument prepared by: 1Iit!r.';i::-.31:l11:••NJ. L.. F:: Address- 43371 a.) #-,o- 'i 'E r'I..t,._iK `c.' i:: t:1 .'3.:; ai`I NOTICEOFCOMMENCEMEN \ „I t ,:.i.: i STATE OF FLORIDA Permit 0: COUNTY OF SENMOLE PARCEL ID #: Via_- ,;[ " 30 THE UNDERSIGNED hereby gives notice that improvements 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. Description of Property: (,,egal deseription of the property and street U S` /, , , - - f- er : /~ L 2 General Description of Improvements: -a ?ec 3 Owner Name: S'e'r2 I r J t ? Address: 16 Interest in property: © L--) Y °' 1s if available) Name & Address of fee simple titleholder: (if other than owner) 4 Contractor's Name: Address, 5 Surety Name: Address:: b Lender Name: Address: 5(, -- 7& u _ V- 7 A0 ip' h 6.e& 17st•-e- Phone: i—(,0 2 '72 Z Phone: Amount of Bond: Phone. 7 Persons within the State of Florida designated by Owner upon who notice or other documents may be served as provided by Section 713. 13(1)(a) 7. Florida Statues: Name: Address: Phone: 8 In addition to himself or herself; Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713. 13(1)(b), Florida Statutes: Name: Address: 9 Expiration Date of Notice of Commencement: Phone: the expiration date is I year from date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER TfI E;TIRATION OF TIA. NOTICE OF COMNTENCEIviENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CIiAPTER 713, PART L SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A ?NOTICE ; pF CO? -IN ENCENfENT JAUST BE RECORDED AND POSTED ON 1TiE 70B SITE BEFORE THE FIRST u4sPECTION. IF YOU INTEND TO OBTAIN FIDNA.NCIING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COtIAgNCING WORK OR RECORDING YOUR 1NOTICE OF COIvr1IGNCr,'TNT. Verification Pursuant to Section. 92525. Florida Statutes Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are the to the best of m'r k-nowledge and belief. Signature of Owner or Owner's Authorized Signatory's Title/Office Officer./ Director / Partner / Manager The foregoing instrument was acknowledged before me this cC7 day of name ofperson) as F t L',r \1z-r ___(type of authority, ..,e.g- officer, trustee, attorney in fact) for party on behalf a whom instrument was executed). SEAL) titnre of No±ary Publiq, 'fate of Fiori LAURA COLYAR L NotaryPublic - State of Florida Commission # FF 925212 My Comm. Expires Oct 25,2019 knded tttr * Ilia W Notary Alm September 2014 Prins Type or Stamp Cot _ ' ione=d Name of N my Public Ferronalky ~ mown or Profi ced Identification M\ 1 oFtNe q CERT, nf0 CC)py MARYANNF MORS TANDCLERICOFTVICCIRCUITCOURCOMP7ROLLC FLORI rttl o, :::: `: r SEMI OLE ' 13 1G 7 241 AUG 7 26'6 City of Sanford Roof Permit Application Checklist 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). I-`' 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 federal code requirements. CITY OF SANFORD BUILDING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: 1--23VO I, Z') hereby acknowledge that I personally inspected Roof deck nailing and/orAecondary water barrier work' at J d(:A v J"U, SG '' and have determined that the work Job Site Address) was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.) It I 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 Sectio .06 F.S. ignature of Contractor Date 11_) c 5 CSC /3 Z l 6 ;7 Printed Name of Contractor License # License Type: General Building ResidentialRoofing Contractor or any individual certified in accordance with F.S. 468 to make such an inspection. STATE OF FLORIDA COUNTY OF, Sworn to (or affirmed) and subscribed before me this /Y day of 20 A, , by who isxPersonally Known to me or has Produced (type of identifi Yon) as identification. SEAL) S t e o o ary 'b is St Lk of',Fllorida 1, I, S MA MAUCK I` 1 1 N t V Mdic - 8We of FWWa Co 1 0 FF I N438 Print/Type/Stamp Name My Comm. E*m Jon 11, 2019 of Notary Public 8 nWft0ghltptlana **ffyAssn.