HomeMy WebLinkAbout615 2 Stdt fi 2 62016
MAS E® ( '' CITY OF SANFORD
01.14 1 = I:ILD.ING-.. FIRE PREVENTION
PERMIT APPLICATION
D r ,
Application No: I (P _ '$0"I
e
Doc 4onYructionmented Value: $ . k
Job Address: Historic District: Yes Nox
Parcel ID: 30 - %..1' - 3 /- 5'/,2, - 0000 -Q®3a ResidentialK Commercial
Type of Work: New 1l—Addition Alteration Repair Dgmo Change of Use Move
y
Description of Work:
Plan Review Contact Person: A a G l` Title: aW l? e/`
Phone: Tf L 7CJl --7569f Fax: Email:
Property Owner Information `
Name m,05 ' P eil G Phone: 'O?'- G% g- .3%S 411'c K
Street: Q `3! ]?'r e t' Resident of property? : O ®P/
City, S ate ip:
r " 3
Z Contractor Information
14
Name Si rlo - o/?STr't(CI /Eon Phone: - 76/ -^ Z r
Street: 16100_ 3 'face- ,/i o r -f j Fax: —
T
City, State Zip: G 0K4 /--/- a 7 State License No.: 13930
Architect/Engineer Information
Name: & Phone:
Street: Fax:
City, St, Zip: E-mail:
l
Bonding Company: 4Mortgage 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: 51 Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
NOTICE: In addition to the requirements of this permit, there may be additional res ' ""s applicable to this property that may be
found in the public records of this county, and there may be addtttona perms s required from other governmental entities such as water r
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
Print Owner/Agent's Name
Date Sign r of Contractor/A ent Date
PrVit Contractor/A¢ent's Name
Signature of Notary -State of Florida Date Signatur of otary-State of Florida Date
PRY j'be4 ANNETTE SCOTT
Notary Public - State of Florida
My Comm. Expires Jan 16.2010
Commission # FF 071760
onded Th .. Owner/Agent is Personally Known to Me or Contr.eta rwpomm t Meor
Produced ID Type of ID _ Produced ID Type of II3 L i
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas F] Roof
Construction Type: _ Occupancy Use: Flood Zone: -
Total Sq Ft of Bldg: Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
Masimo Construction, Inc.
masirno
Roofing
Address: 1049 Blackwood Street
Altamonte Springs, FL 32701
Phone: . (407) 922-0500
S'tate•Certified Roofing Contractor -aCCC1328033
State -Certified General Contractor - CGC1609648
Brad.Poilack, Contractor
Cus o Name V _ a
Home Phone: Cell:
el Remove roof to existing deck layers,
Q Each additional layer S (Sq. (100 9q. Ft.)
Ro-nall existing dock to meet uplift codes.
Xinstali _. metal drip edge around pdrlmeter of roof.
Install load boots to pipes I%"
U Install Goosonock vents A" 10"
Hurricane Mitigation Retrofit
AppiyASTM 301E Felt paper to plywood deck.
Jif Apply3 4 Sq. FL of METAUSHINGLEWTILEISHAKEs I.AT
jd Style of roof to be Installed:
Color: Pitch:. .
0 Manufacturer of roofing system: F
Q Install ridge vent along peak of roof: Addt'l.
q07'-6 1T=!;5/7
P.O.
Co.nsiruotion, lnc. '
Contract/Proposal
Insurance Co. Z
Adjuster:
Claim #: .
Phone-
P,o
til er
4 I' v Date: `
C CitylState2iP: -7,Z
Work Phone:
v ncr, rrwrcr r'r ,uvivvl t ivlva
ce/Watert3hlold—Yes No
Q Uluting-Water Damage Yes No
El Existing Driveway Damage—You No
Q Skylights:
Q Leaks,
Q interior Damage:. -
D Emergency Repair Yos - No
Q Tapered Insulation Yes No
WORK INCLUDES:
Remove trash from roof, gutters and yard.
Protect landscaping where applicable.
Pollyard with magnotto rollor.
Furnish permit
2 year warranty
Additional charges of $70 par sheet If docking replacement is needed which Is only visible upon toar-off existing roofing materials.
WE PROPOSE
To furnish material,and labor complete in accordance with s.pocifications above for 06 sum of $ --
SPECIAL INSTRUCTIONS: PAYMENT SCft-J m'E
50% pOWN PAYMENT PRIOR TO ORDE4NG MATEXUAL S
PA'i AWNT I -N ULL UPON COMPLE ION
r:AR$EST D POSIT.; 500.00 U $1000.00 b\,$
DO` ,' N PAYMrNT S
ACCEPTANCETANCE OF AGREi .N.IIENT
This agroemont is Subject to insurance company approval and does not obligate the homeowner or Masimo Construction, Inc. in anyway unless
it is approved by the Insurance company and accepted by Masimo Construction, Inc, By signing this agroament you authorize us to negotiate
the repairs at a price agreeable to the insurance company. and Masimo Construction, Inc. at NO ADDITIONAL COST TO YOU. EXCE['ZFOR THE
INSURANCE DEDUCTIBLE AND AS PROVIDED EL, EWHER_E-IN THIS AGREEMENT. The final, price agreed on between the insurance company
and Masimo Construction, Inc. shall become the final contract prJco and Masimo Construction,, Inc. will receive all-Insuranco-orocoods for the
work completed by Masimo Construction, Inc.
THREE DAY RIGHT OF RESCISSION
THIS WRITT G EEMENT HEREBY SERVES AS NOTICE THAT I MAY CANCEL. THIS
AGREEMENTAT Y I PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE
OF THIS AGREEMENT.
Owner Signature _ —_ Dat 0 200 Sales Rep.,— -
Accepted by Masimo Construction, Ined resentative X
Insurance Carrier Claim No.
Events beyond the control of MasJmo Construction, Inc. may cause delays to the projected start date or estimated limo of completion. Stich 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 - OFFir.F Cr)av
i`
0
THIS 114 PREPA71ED BY,
Name:
5T "I"M _'' r I
Address' I .
1
4:4;"
4
NOTICE OF COMMENCEMENT
Porrntt Numbo,Ro-m=o/-.5-z-g- moo -ct;?q.`
6-1
Parcel 10 Number.
1111111111 [fill 11111111
MRYANNE NORM SEHINGLE cnowry
CLERKS :CIRCUIT COURT
CLERK'S -4 20
1
16111-90
1
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RECORDED W-11/21.1,16, 11-:24:134m: AIII
RECORDED P -Y Kdevopa
This undersigned h-reby,qivr-' notice that knpro IVemenk Will, bs'rnade to'=tak' rem and i,- Ror.&j 5Wt ir-S. &6
7
follo,dving Infannarrion'les provided in M4 Notice of cr mrnenti;in&nt
1. DESCRIPTION OF PROP'qTY {Legs 41F 0 lion o' the Ptcveny and adnrasq ff avauttle). S
C
4 4
I K r91577, 07' Z---4-11
2.- GENERAL DIESCRJPTION QF 11
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3. OWNER INFORMATION RL SSEEINFORMATIONIFS FIE LE
Name and addrew': r_1-z1zf 'La a/I I in 12
InIerpa in Property:
Felt Simple Title MalderTf-b ret I eme., Ii5t eDOV$' t4a'mC:.
4. CONTRACTort: wqme- P". 0
S. SURE—TY (If applicable, 0 COPY Of thepaymentband , is attache MaMS7
An OUnt 04 Sand:
Phone K'LLrnbeT:
6, LENDER: Name:
Address:
may he servedarlwhomnoticeorcrateraocumunted as provided by Suctilor.
parsonswithin1.1w,StatO Of Florida CosIgnatod by own,r ijpo
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Phone Number.
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a. In addhilan: 0.vner dct;
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Itho.1-Ierto - es Notice d in'S eejoA 71:3,12(1)(b). FIcdd:.-'S' talttj-- Phone number
to fpor'-e a copy 13 proide .
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9. Expir Von 06!0 of of'Cbrnmcaternent, (The abxpirat en "a
MENCtIAENT ARE
tVA,qNIA)Q TKI QMMER.' ANY PAYIAENTS MADE SY THE 014-NER AFTER THE EXPIRATION OF THE 46TICE OF' -CONI UL I UEN,Ts ut-IDER CHAPTER 745, PART,I. SECTION 71113. FLORIDA: STATUTES. AND CAN RESULT IN V0CONSIDEREDIMPROPER- PAY. OT(GI--'OF C014141ENCEMENT p.jUST 13E RECORDED AND POSED ON TAr-- PAYING M'CE- FOP., II,4PR0\1ElAENT,5'TO YOUR PROPER7Y, 1 N Kbj4Cj.,c-.-CONSULT WITH YOUR Lr=N,-.,)Eq, OR AN ATTORNEYYOUINTENDTOd6TAI0 jJOBSITEI)E-:roRr- THE FIRST INSPE:CTIONBEFORECOMM-SNCI G ORK OR RECORDING YOUR NOTICE OF COMUMENGE-AFENT,
led in It aro true to tho'bUst Of TnYkno,Wlaiiqa and
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CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: /6 — 0000 gg!
hereby acknowledge that I personally inspected
at
Roof deck nailing and/or Secondary water barrier work
Ili
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
Sectio 837.06 F.S.
Iola -2114
Signature of Contractor Dat
Printed Name of Contractor License #
License Type: General Building Residential)<toofing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF Sem ! Ole
Sworn to (or affirmed) and subscribed before me this _ day of o , 20 J,/,, by
Po4=K , who isXPersonally Known to me or has Produced (type of
identif0tio,go _ -r as identification.
oft"m JOHN R. BYRNEC0MffJWbn6FF 992414
EXPhU May 15, 2020
royFdo 4rovrm+ce 800 36b7019