HomeMy WebLinkAbout2004 Hartwell DrCh;(_ &1Vk:." CITY OF SANFORD
AUG 0 8 2016 BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: I (" XQ `)
Documented Construction Value: $ 4J, 0 oy Job
Address: ZOO Ay -G"40cl F1 Historic District: Yes No Parcel ID:
3 G - 19- 30- W ilk/- 0000 - 00 2 0 Residential Commercial Type of
Work: New . Addition Alteration Repair Demo Change of Use Move Description of
Work:2 - Plan Review
Contact Person: nei e_ P.Qe,-- Title: Phone: 72 !
23 9 213 % Fax: Email: Property Owner
Information Name '_IV42' .
1. _Ieo" Phone: Street: Zyoy /#
Ci'e1WI°/1 t \./ City, State
Zip: a ion Name Street
Resident
of
property? : Contractor Information
C'Ai
I PA rn t % c T? v y . Phone: 330 Cher. /
f 6vrr2 1/2. Fax: 7212,77213
City, State
Zip: Ca/ Z::7/ 22X 2 State License No.: CCC 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 1053
Shall be inscribed with the date of application and the code in effect as of that date: 5" Edition (2014) Florida Building Code
r OTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
R bund in the public records,of this cdunty, and there may be additional permits required from other governmental entities such as water
manage nent 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.
z &1i:
Sig fOwner/Agent Date
Y1 Dk 4 4cp LaM.d c - m
Pri Owner/Agent's Name
Signature
WA0MINIIN4MWLL/4M
16"'01 Inv UO3 `WAO0
M M Otis - del Ail"11
3TWA130 Y510 W4411A
Owner/Af21m'I_
Produced ID Type of ID
Signa Contractor/Agent Date
Print Contractor/Agent's Aar n
EXPIPE®; ' — n rr a06L8
Bonded Thru Not ry 6dl3lio Ilnd
020
Contractor/Agent is _— Personally Known to Me or
Produced ID t- Type of ID —
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type: Occupancy Use: Flood Zone:
Total Sq Ft of Bldg: Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING:
COMMENTS:
Luis
Property Record Card
Parcel: 36-19-30-544-000{;-0020
Owner: DELEON JUAN F & YOLANDO A
zxc,:4c,tcrrYFa..nra
I Property Address: 2004 HARTWELL AVE SANFORD, FL 32771-4252
LOT 2
TWENTY WEST
PB16PG36
is . A i1:r:
LOT 0.00
Seminole G I S :, µ
0.00 1 10,000.00 10,000
is Bed/Bath count Incorrect? Click Here.
Descript Year Built
Actual/Effective €
Fixtures Bed Bath BaseArea Total SF Living SF Ext Wall Ad1 Value Re' plV lue Appendages
ter, a
V
1 -SNGLE 1971 5 2 15 945 1,528 1,231 CONC $48,065 64,086 Description AreaFAMILYBLOCK,,,,, Y
i ENCLOSED
PORCH i 198.00
FINISHED
ENCLOSED:^
PORCH 88.00
i FINISHED
OPEN .....
i
PORCH 88.00
FINISHED
UTILITY
209.00
FINISHED
i milli i l l IIIII iilll Illli Ilfll liil IIIIPermitNumber:
Folio/Parcel ID #: 3 30 - `(- UP®o -0020
Prepared by: (i ye (-Anc pG-
Return to: 7 3 3y C Fe_bo,4 P- O(r.
O -1 O"a. FL 3 2- 62-i
rt;}1:'`1•i1 11+• `1:L.l::L4::: J}• { i
JU F l,1E''I P:.LIL.L..E:a:
r:l..t:t°i. i; 201.60"31828
i:.:E::`3
NOTICE OF COMMENCEMENT
State of Florida, County of Orange
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)
voW Hkrf' we C1 GLvd. Secad 6L 7-71
2. Gene r I description of improvement
C - R0, i -' A jq 11< P+ J't)I n1es 3.
Owner information 76r Lessee information if the tessee contracted for the improvement Name •'(.
A., bel.,n Address
2 oo H f:fti e- f 1--d A va -fg,d 6o,—A FL 72-+7 1 Interest in
Property Din/n4V- Name and
address of fee simple titleholder (if different from Owner listed above) Name Address
4.
Contractor
Name ca,
ep 4 O'n Cu C+,,C, Telephone Number 321- 2 3 21 3 R Address 1
S,o c1qeUe4 14-.)60v4 f c(<. < r rl"o Al 3 2 6 2 5. Surety (
if applicable, a copy of the payment bond is attached) Name Telephone
Number Address _Amount
of Bond $ 6. Lender
Name Telephone
Number Address 7.
Persons
within the State of Florida designated by Owner upon whom notices or other documents may be served
as provided by §713.13(1)(a)7, Florida Statutes. Name Telephone
Number Address 8.
In
addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as
provided in §713.13(1)(b), Florida Statutes. Name _ Telephone
Number__ _ Address 9.
Expiration
date of notice of commencement (theexpiration date will be 1 year from the date of recording unless a
different date is specified) 1i Z6(_Y o !. _ 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. Signaj'ure
of Owner or Lessee, b( Owner's or Le#ee's Authorized Officer/Director/Partner/Manager The foregoing
instrument was acknowledged before me this day of t1C ty!' by mont /year
as Type
of
authority, e.g., officer, trustee, attorney in fact Signature ofNotary
Public — State of Florida Personally Known —/_
OR Type of
ID Produced_ 201t t-
ERt; or- orm content
revi for Signatory'
s
Title/Office name of
person Name of
party on behalf of whom instrument was executed c, a
Print, type,
or stylinp commissioned name of Notary Public Produced ID ,,,
OLGA'DELVALLE p41MF floe,
NotaryPublle - Slats of FWW 4.• h,
My Comm: E*rss Aug 20, 2018 py_ N
p Y NN RSEti'„A,Im Commission. M FF 152737 ECIRCUIT OU
ND ia •u+ BodThtQghl 10112iNoteglAlan. Pj 4 ••.•
Wr 6 e
Product Approval Specification Form
Permit #
Project Location Address
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.floridabuildin_q 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 Manufacturer Product
Description
Florida Approval #
including decimal)
3. Panel Walls
Siding: v
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles oft,
Underla ments WiLej virnf M H XvIt"L 09 2 .
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
Catdgory / Subcategory Manufacturer Product
Description
Florida Approval #
include decimal)
5. Shutters
Accordion
Bahama
Colonial
Roll u
Equipment
Other
6. Skylights
Skylights
Other V
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 F-IlRe rt5;,
Please Print)
June 2014
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #:
hereby acknowledge that I personally inspected
Roof deck nailing and/or Secondary water barrier work
at 20 (5 / t/L W f c q41and 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 consti a misdemeanor of the second degree pursuant to
Section 837.06 F.S.
1-6
Signatur onfiactor Date
FSZ, pe 6AAJ 4F'Od CCc /3Z (f3 6 1
Printed Name of Contractor License #
License Type: General Building Residential VRoofing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF yan U uol /
Swor to,(or affir d) and subscribed before me this P day of Nil , 20, by
who is N Personally Known to me or s Produced (type of
ident' tion) as identification.
SEAL)
Signature 6f Notary Public
State,Florid
Print/ /Stamp Name
of Notary Public
OLGADELVALLE
Nolan Pubk - Stdo of RwWF4b, Y Comm: EXPIM Aug 20.2014
COmmlaslN # Pf 152737
anek0lhouph NOtery Assn.
3