HomeMy WebLinkAbout111 Longleaf Pine Cirb CITY OF SANFORD
Wvf BUILDING & FIRE PREVENTION
1 2015 PERMIT APPLICATION
Application No: q a
Documented Construction Value: $ O cD
Job Address: 1 , (M ,Q c; r I Historic District: Yes No W
Parcel ID: 1 - 2,0 30 - Gu , - Oo 0'0 "0 Residentialg Commercial
Type of Work: New Addition Alteration Repair Demo /Change of Use Move
Description of Work: YLO Q,-( JG.('U rz,w -
Plan Review Contact Person: C O .I acl k 6inertZC L_ Title: r e.;'u „.'1`
Phone: Fax: Email: kv,p (t,( YOzi,h 1 - cap,,` .
Property Owner Information
Name '7 1J U C, V" q k_',
Street: t 5 o Y c
City, State Zip:
Phone: '(4 0 9 6 ? - 6T ,
Resident of property? :
Contractor Information
Name -(,l 'I,t9, _QJ V (
Street: L M. ( h
City, State Zip:
Name:
Street:
City, St, Zip:
Bonding Compary
Address:
Phone: 3 $y i ( al .
Fax:
State License No.: (?Q(2 (3 Z 9 73D
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: 51h 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 zoning.
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
i
Signature o C uFak VAAgent Date
Print Contractor/Agent's Name
D K //. o /. /
Signature of Notary -State of Florida Date
pgBLANTON
N° = MY COMMISSION # FF 172648
EXPIRES: February 25, 2019
Bonded Thru Notary Public Underwriters
Contracto s Personall n to Me or
Produced ID Type of ID—
e&/,?.. a I as-'(a6
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use: Flood Zone:
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:
COMMENTS:
FIRE: BUILDING:
Revised: June 30, 2015 Permit Application
N 1101101111a.1111M 111111111111111 lull fill
THIS INSTRUMENT PREPARED BY:
Name: Empire Roofing Services
Address: 4 Audubon In Flaqler Beach FI 32136
NOTICE OF COMMENCEMENT
Permit Number:
Parcel ID Number: 11-20-30-509-0000-0850
I'1t'iRYtli'IhIE 110R L-'f SEMINOLE C-OUNT`f
CLERK OF ClRCLUJ C:OLMI— & C:ONPTROLLEitBI8379
C.LEfh'S u• 20161.1J657
IiI::C:ORULIi 1.1 /1 i1/2016 113:26.18 Ail
R'EC.'ORD11,16 FEEL; 1>].+Iniiil
1.11:.l.'OI'll ED i'- i ilCli"J]f':
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: (Legal description of the property and street address if available)
Lot 85 Hidden Lke Villas Ph4 111 Long Leaf Pine Cir Sanford FI 32773
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Complete roof replacement
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: Shirley Huaman Trust 105 N Virginia Ave Sanford FI 32771
Interest in property:
Fee Simple Title Holder (if other than owner listed above)
4. CONTRACTOR: Name: Empire Roofing Services Phone Number. 386-804-4109
Address: 4 Audubon In Flagler Beach FI 32136
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
Address: n/a Amount of Bond:
6. LENDER: Name: Phone Number:
Address:
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents maybe served as provided by Section713.13(1)(a)7., Florida Statutes.
Name: n/a Phone Number.
8. In addition, Owner designates 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 ARE
CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, 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.
0Q, &,, R-(z aim alr l
gnatuF6.of Owner or Lessee, or Owner's or Lessee's (Print Name and Provide Signatory's TiUe/Office)
Authorized Oticer0rector/Partner/Manager)
State of "A A County of
The foregoing instrument was acknowledged before me this day of [yi7-7J NJ fi Gt 20 toy
by r'-e e , + Iu ok viA g3 PA Who is personally known to me P/ORNameofpersonmakingstatement ! /
who has produced identification typdof identification produced:y/
DwIss Rabarb
NOTARY FUBW
STATE OF qA%M
Cariny lt FF/4ti"Ip
Expira %&i
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MORSE sffi
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e'.!)', •' COMPTROLLER
SEMINOLE COU F f',t;` ';` 1,
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Mailing Address: 4 Audubon Ln Flagler Beach FI 32136
Phone:386-804-4109 Fax:386-626-8770
State License #:CCC1328730
Fully Insured
Company Name: Elite Realty Services Contact: Carolyn S. Davis Date: 9-21-2016
Project Name: 1 I I longleaf Pine Cir Phonel: 407-687-8665 Cell Cell:
Street: 11 I longleaf Pine Cir Phone 2: Salesman
City, State,: Sanford FL Fax / e-mail: Salesman Phone:
JVt$ JYELIPILA I10NV i SINGLE FAMILY RESIDENTIAL X COMERCIAL BUILDING
TYPE OF EXISTING ROOF: ASPHALTSHINGLE ROOF CONDITIONS: OLD/BAD
RE -ROOF: RECOMMENDED NEW CONSTRUCTION: N/A REPAIR: N/A COATING: N/A
NEW SINGLE FAMILY RESIDENTIAL: ROOF SLOPE: 5:12
NEW ROOF COVER: CERTAINTEED ARCHITECTURAL SHINGLES COLOR: SAME WARRRANTY: LIFE TIME
1 1/2"LEAD BOOTS YES 2" LEAD BOOTS N/A 3" LEAD BOOTS N/A 4" J.VENTS YES 10" J.VENTS N/A
DRY -IN SYNTETIC YES DRY -IN PEEL STICK N/A VALLEY YES WALL FLASHING YES TURBINES N/A
DRIP EDGES -COLOR 21/2" BROWN RIDGE VENTS YES OFF RIDGE VENTS N/A SKYLIGHTS:N/A
DESCRIPTION:
REMOVE EXISTING SHINGLE ROOF AND UNDERLAYMENT
RE -NAIL WOOD DECKING ACCORDING TO FL BUILDING CODE 2010
DRY IN WITH APROVED SYNTETIC UNDERLAYMNET AND PEEL STICK ON THE VALLEYS
REPLACE ALL VENTS AND EAVE DRIPS AROUND ENTIRE PERIMETER
INSTALL CERTAINTEED ARCHITECTURAL SHINGLES LIFE TIME WARRANTY
NOTE: PERMIT,HAULING DEBRIS AND 5 YEARS OF WORKMANSHIP WARRANTY IS INCUEDED ON THIS CONTRACT
Woodwork is, included in price: (Lab & Mat) Yes _X_ NO
Sheets of plywood included N/A WOODWORK PRICE WILL BE EXTRA :N/A
PAYMFNT TO RR. MADF. AS FOLLOWS: UPON COMPLETION
THIS PROPOSAL EXPIRES IN: 60 DAYS TOTAL: $ 6,800.00
DATE
COSTUMER AUTHORIZATION CONTRACTOR SIGNATURE
Q
6L4 y ,/
i
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #:
I,_ hereby acknowledge that I personally inspected
Goof deck nailing and/or Secondary water barrier work
at 1 ,_Vvt. 4a (' >i tQ Ck and 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
Printed Name of Contractor
Date
C?C' t3z&n-3
License #
License Type: General Building Residential,lKRoofing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF
Sworn tp (o affirmed) and subscribed before me this day of r J , 20 , by
who is N-fersonally Known to me or has [IProduced type of
identification as identification.
SEAL)
Signatur' otary Public .134seselW21 W
State ofFlorida ptiptk.-S, ofF28pi
Mod
talon • Go 025
Co Ires Oct 5, 2020E)tPrint/Type/Stamp Name Mg elMo 001100
of Notary Public ''•