HomeMy WebLinkAbout1921 S Maple Avetl J .t Tu+4 1l
Documented Construction Value: $ ' r17.1}
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
n
Application No:
Job Address; l 1 S p/ /%y C. Historic, District: Yes No .
Parcel ID: 3 G r 3 d— .500= Dy. O Residential,2 CommercialEl Type
of Work: New AdditionEl Alteration Repair pl Demo Change of Use MoveEl Description of Work:
F6n-( e S Plan Review Contact
Person: Title: Phone: Fax: Email:
Property Owner Information
Name IYfu l
he"', D-p ki rCeri z') Phone: 0 7 - 76 -6 Street: 1(., Z
7 4 Yey,r woo, c/ t Resident of property? : /V e5 City, State Zip:
Oil! Contractor Information Name
Street: City,
S
Phone:
n (M
I
Fax: /
V State
License No.
CCC UD_ -Do- I Architect/Engineer Information
Name: y Phone:
Street: City, St,
Zip:
Bonding Company: Address:
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 ccrtifythat 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 inthis 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
Owner/Agent is Personally Known to Me or ' Contractor/Agent is Pc
Prodiuced 1D Type°of ID Produced ID Type
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 Liel.Law, FS 7 13.
The City of Sanford:requires payment of a plan review ;fee at the time of permit .submittal. A copy of the executed. con tract. is required
in order to calculate a_plan review charge and will be considered the estimated construction value of the job at tlic time of submittal.
The --actual construction value will be figured based onrthe current ICC Valuation Table, in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges'figuredi 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/Agmtt Date " natiirco Coutrxtor]Ag--eiint6ate-
II?at/
Print 0%vner/Agent's Name': liint ContractorlAgcni's Name
c-11- see
signature of Notary -State ofr Date VSignature o Notar ,-bate of Florida .
DEBBlE BLANTON
COMMISSION178f 4a
EXPIRES;: Felyua^125, 2019
Bonded Thr cUnd,rV rs
sonally Kiiown to Me or
tf ID' t
1 ai'
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building[] Electrical Mechanical PlurnbingQ 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 QNo # of Heads Fire Alarm Permit: Yes:.[] No[] APPROVALS:
ZONING': ENGINEERING:
COMMENTS:
UTILITIES:
WASTE WATER: FIRE:
BUILDING: Revised:
lime 30, 2015 Permit Applicatiqn
Tred Fletcher
804 Leonard St.
Brooksville, FL 34601
Matthew DeVincenzo
1631 E. Harwood St.
Orlando, FL 32803
407-766-1925
LynCcD-FamilylsBusiness.com
1921 Maple Avenue, Sanford, FL 32771
SCOPE OF WORK $5,600.00
Remove shingles and other roofing material.
Repair roof sheathing and structure as needed
Re -shingle to code
Matthew F.. DeVincenzo
Sep 30 16 08:04a LeppertEngineeringCorp 8585972009
IIIBIIIIIIIIIIIIIIIIII II1119111119111i11
THIS INSTRYMENT PREPARD 9Y:
Name: 6aHlie•% V'^r-riMARYANNE NORSEr SEMINOLE COUNTY Address: +
CLERK OF CIRCUIT COURT & C:OMPTROLLER c,a rr BK
8777 P:us NOTICE
OF COMMENCEMENT CLERK'
S T 9/30/_I016 RECORDED1191sl]/?ii1,5 02s1.8;07 1'I'1 RECORDING
FEES $18.50 State
of Florida RECORDED BY ,ier_ kenro County
of Seminole Parcel
ID Number: Permitkumber:
The
undersigned hereby gives notice that improvement will be made to certain real property, and In accordance with Chapter713,
Florida Statutes, the following information is provided in this Notice,at Commencement. DESCRIPTION
QF,FSROPE13xY: (Legal dajcrin of theXr perZa street address if available) GENERAL
SCRIPTION gF-ti,11 PROVEMENT: OWNER
INFORMATION; <z Name:
Gt`t 1Re< s p i f YL L1 h%, Address:
Fee
Simple Title Holder (if other than owner) Name: Address:
Persons
within the State of Florida Designated by Owner upon whom notlFe or other documents may be served as
provided by Section 713.13(1)(b), Florida Statutes, Name:
Address:
In
addition to himself, Owner Designates To
receive a a opy of the Lienoes Notice as Provided in Section
713.13(1)(b), Florida Statutes. Expiration
Date of Notice of Commencement (The expiration date Is 1 yea:• 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 COMMENCEMENTARECONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER713, PART I, SECTION 713.13, FLORIDASTATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS70 YOUR PROPERTY.A NOTICEOFCOMMENCEMENTMUSTBERECORDEDANDPOSTEDONTHEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCIN(3, CONSULT WISH YOUR LENDER OR AN ATTORNEY BEFORE'
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under
penalties of perjury, t declare that I have read the foregoing and that the facts stated In it are true to
the bes of my knowledge agd belief. owner
SignatureOwnefx PrintedName Florida Statute
713.130)(9): -The owner must sign Iho notice of commencement and no one :ise maybe permitted to sign In his or her stead' State of
County of The foregoing
Instrument was acknowledged before me this day ,f 120 by Who
is
personally known to me Name of
person making statement OR who
has produced identification type of identification produced:,. 0+ THE
Ca'ii Notary Signature CRyM MAARYANNE
MORSE CLERK OF
THE CIRCUIT COURT AND s E.°y ff('L
ifzGJ( COMPTROLLER it ,•
SEMMOLE COUNTY,
FLORIDA thtt,-, 8Y leti
Q.
Ss
UaYOL _ Cm 1 SEP 3
0 2016
Sep 30 16 08:04a LeppertEngineeringCorp 8585972009 p.3
A notary public or other officer completing this certificate verifies only the
identity of the individual who signed the document to which this certificate
is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of--:;i. ,-j '"i1-:-ErC,
Subscribed and sworn to (or affirmed) before me on this Z 4. day of - C,02T tom: i30Z ,
proved to me on the basis of satisfactory evidence to be the person who appeared
before me.
Signature (Seal)
OPTIONAL INFORMATION
DESCRIPTION OF THE ATTACHED DOCUMENT
PiDZ -F °tic_7 Cf4-7
Title or description of attached document) !
C -i ) i / 1^1 F-- 'F'c7v TT.J r2 0
Title or description of aftarhed document continued)
Number of loages / Document Date L1,
Additional information
2015 Version ww.v.NolaryClasses.com 800-873-9865
OFFICIAL SEAL
G. D. OLER
NOTA?T PUBLIC-CALIFORNIAm
WNW. NO. 2041437
I SAKI DIEGO COUNTY
MY COMM. &P. SEPT 15. 2017
INSTRUCTIONS
The wording ofall Jurats completed in CoMmia after January 1, 2015 must be in the form
as set forth within this Juraf. There are no exceptions. Ifa Jurat to be completed does not
fellow ttus lbar, the notarymusi correct the verbiage by using ajuraf stamp containing tho
correct wording or attaching a separate jural form such as this one wflh does contain the
proper wording. In addition, the notary must require an oath or afBrmallon from the
document signer regarding the tndhhriness of the contents of the document The
document must be signed AFTER the oath or affirmation. If the document was previously
signed, it must he resigned In frond of fhe notary public during the jural process.
State and county information must be the stale and county where the
document signer(s) personally appeared before the notary public.
Date of notarization must be the date the signers) personally
appeared which must also be the same date the jurat process is
completed.
Print the name(s) of the document signer(s) who personally appear at
the time of notarization.
Signature of the notary public must match the signature on file with the
office of the county clerk.
The notary seal impression must be clear and photographically
reproducible. Impression must not cover text or lines. If seal impression
smudges, re -seal if a sufficient area permits, otherwise complete a
different jurat form.
Additional information Is not required but could help
to ensure this jurat is not misused or attached to a
different document.
Indicate title or type of attached document, number of
pages and date.
Securely attach this document to the signed document with a staple.
Oct. 31. 20161'11:18AOM AMSCOT F I NANC I OL No. 624012 . P. 2 2i2 —
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit
I
hereby acknowledge that [ personally inspected
15"Roof deck nailing and/or 0 Secondary water barrier work
at ] 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 f 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 sec ad degree pursuant toSection837.06 F.
Signature of Contractor Date
C.GC 1 /
Printed Name of Contractor License #
License Type: General Building D Residential oofing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE of ltL®xlDa, COUNTY OF p
S oorn to or affi ed) and subscribed re me thisbefoday of6 20 by who
is 0 Personally Known to me or has q Produced (type of ficatiort)
U un as identification. SEAL)
Signature
of Notary public State
of Florida • Print/
Type/Stamp Name of
Notary Public Dawna
Peres NOTARY
FUSLIC STATE
OF FLORIDA ca"
Mo G0036196 Eim1res
10I512020 3
Received
Time Oct.31. 2016 10:23AM No.6239 Received
Time Oct,31, 2016 11:13AM No.1834
4D7-