HomeMy WebLinkAbout107 Rockhill Dr (2)CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
NOV 161016 Application No:
Documented Construction Value: $ 9-1
Job Address: /&97 big 3,;r� ( Historic District: Yes ❑ No 2L
Parcel ID: 33 19 30 S 4 /2000 2730 Residentiala Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ R1epailrp[Demo ❑ Change of Use El ElMove
Description of Work: ��� �edO
Plan Review Contact Person: M (fie- CQ -r4 S'/7 P— Title: /
Phone: 777- 0.5-? Fax: Email: !JJ 7<f12ZI
Ede
Property Owner Information �2
Name (�ie Ede ( M4 v7 Phone:
Street: /o `7 kve K4 ( i ( cl�i - Resident of property? : rWW4 tt'1_S
City, State Zip: �i,gir �oC L 3277/
II
Contractor Information
Name '1'(L �. `f' ox4k 60 Phone: 7 — 777 —119S'7
40
Street: �7(�7 �� h�•� Fax:D 7 —
City, State Zip: State License No.: 6<fe-^ 133,152 3 S
Architect/Engineer Information
Name: 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. 1 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
NOTICel i &c ition 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 1 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
Signature of Notary -State of Florida Date
At //t,�
0 3 /f/ .1
Signatuh of Contractor/Agent Dath
6a
Print Contrac or/Agent's Name
Signature of Notary -State of Florida Date
��r •� STEPHEN PATRICK DOLAN
* MY COMMISSION i FF 071532
EXPIRES: December 27,207
BoWed rm Budget Notiry Wyk"
Owner/Agent is Personally Known to Me or Contractor/Agent is V Personally Known to Me or
Produced ID Type of ID Produced ID 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
APPROVALS: ZONING: UTILITIES:
ENGINEERING: FIRE:
COMMENTS:
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
A:: :: Licensed & Insured
::
*First in Quality
ATLANTIC * First in Service
* First in Satisfaction
Roofing & Construction.. 800-411-0920
LIC # CCC1330939
LIC # CRC1331435
PROPOSAL SUBMITTED TO
STREET
6767 Hoffner Avenue
Orlando, Florida 32822
Ins. Co.
Tel.# c ZO -0)
Claim # 270,0 l 6 U
Adj. Name
Tel. #
Fax #
Po l ; C_V .sp- P -_
c4e l .4- h
r - JOB #
CITY, STATE, ZIP ��\v� -fb Cd r -L 3271
HOME PHONE (3 2d
SUBDIVISION
BUSINESS PHONE
DATE /40 "3 /'1 /e
SPECIFICATIONS FOR LABOR AND MATERIAL
f Shingles: a cLayers(� _ _{�
onally Install: Brand �_rlI h � e� elType �f �1 Color ��%i "• U G
Heys Ft.
30 Ib. Felt O'Peel & StickSynthetic Undedayment f _
sidewails, counter and wall flashings O Re -Use Drip Edge O Drip Edge
2' 3' 4' or Plumbing Vents
FR
ation:, GooseNecksOff Ridge Vents Ridge Vents Color "Q `►� �w•
enail Plywood Sheathing to Code
O SI�1ight 2 x 2 4 x 4
�Ibwed replaced at $60 -per sheet pf neeM-11
Clean-up and haul off all )ob related trash yard with magneilc rollerProtect yard and shrubs
4
• Atlantic Roofing is not responsible for pre-existing structural conditions.
• Buyers agree they have seen, read & understand all terms & conditions of this contract & agree to be bound by same.
• ALL ROOFS HAVE A 5 YR LABOR WARRANTY
CONTINGENT
This proposal is contingent upon the Insurance company paying for damages. This proposal will be VOID only if claim Is disallowed by Insurance company.
Property owner's out-of-pocket evense is not to exbeed the deductible amount. The Insurance company will determine and set the price of the claim.
YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE IF
THIS TRANSACTION. BY SIGNING ABOVE, PROPERTY OWNER AGREES TO PROCEED WITH THE WORK AS PER PROPERTY -LOSS
WORKSHEET WHEN RECEIVED.
We propose to hereby famish materials and tabor, complete to accordance with abo a specifications for the sum of the Insurance as per the Insurance
company loss scope sheet for which is Inc a her by r noe, o include customary profit and overhead when multiple
trade incurred $ t'wxy. r r'V om n ac e. —�—
1 l , 9 � w� 7 ,� `J o �sts db
Authorized Signature'
`Must be approved by company owner. No other work expressed or Implied verolly. AD cyanges, to be in writing and accepted beton; commencement of
changes. NOTE: This proposal may be withdrawn by us If not accepted within 30 days.
ACCEPTANCE OF PROPOSAL- The above prices, specifications and condllions are satisfactory and are hereby accepted. You are authorized to do the
work as specified. .(P�d�- -� Date C 3
Payment will beemade as outline above X _�,
.D. ' City of Sanford
Building and Fire Prevention
Product Approval Specification Form
Permit #
Project Location Address /0 % ffoc�-� � ( ( 33-77 (
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.floridabuilding.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 ' Florida Approval #
Description I (include decimal)
1. Exterior Doors
Sliding
Sectional
Roll Up
Automatic
Other
2. Windows
Single Hung
Horizontal Slider
Casement
Double Hung
Fixed
Awning
Pass Throuqh
Mullions
Wind Breaker
Dual Action
Other
June 2014
Category / Subcategory
Manufacturer
Product
Description(including
Florida Approval #
decimal
3. Panel Walls
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles
g-,,4 j4--ecv,
- 9W-, DY
Underla ments
aS— k5 --
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
Category / Subcategory
Manufacturer
Product
Description
Florida Approval #
include decimal)
5. Shutters
Accordion
Bahama
Colonial
Roll u
Equipment
Other
6. Sk lights
Skylights
Other
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 �ti e 1 !? +✓
(Please Print)
June 2014
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 114v / /
I hereby name and appoint: ,w l "�n
an agent of: 4744r e:�a G
ie or Company)
to be my lawful attorney-in-fact to act for me to apply for, receipt for, sign for and do all things
necessary to this appointment for (check only one option):
0 The specific permit and application for work located at:
(Sireet Address)
Expiration Date for This Limited Power of Attorney: J S�
f
License Holder Name: Ht ie (Q'=� /I C__;7
State License Number: eec 133 09 3 9
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF Ori
The foregoing instrumgnt was acknowledged before me this %lo 'day of 11.1)V , -6
2001& , by U•l(e ( � � K � who i�ersonally known
to me or o who has produced
identification and who did (did not) take an oath.
Signature
(Notary Seal)
ri
ae';R ••° STEPWN PATRICK DOLAN
* * W COMMISSION f FF 071532
EXPIRES: December 27, 2017
s'' 37=d a 80*0 ihru BWO Nobry Serriae
(Rev. 08.12)
Print or type name
Notary Public - State of F,1Y(d"-A"
Commission No. r-(-0*11 �77
My Commission Expires: lr3 • -'�7- )7
as
N
THIS INSTRUMENT PREPARED BY:
Name: M .e ,17 -e
Address: (s -_'_Z
NOTICE OF COMMENCEMENT
Permit Number. / 1
Parcel lDNumber: 33 �� -3
'13 �a0 0730
i 11119111111111111111111100111@911111181
I'I ;l1YTtl'1hIE �iOR SE r '301 HOLE COWi l'Y
CLERK OL CIRCUIT' COURT & COMPTROLLER
61' 8,20. .'j 1591 01:'3s)
)
CLERK'S a 2016119233
RECORDED 11/16/2016 10:16:27 tall
R;i_CORDING LEES .11.1.00
rCo1;�i-D 13Y hlj:aVor2
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
2. GENERALDESCRIPTION OF IMPROVEMENT:
of t propand s3)L:-7 less if
3. OWNER INFORMAT16N OR LESSEE4l1FORMAT/SON IF THE LESSEE COON1
Name and address: T" SAG /Mf1,� /0 % ✓� o
Interest in property: Mkla a -
Fee Simple Title Holder (if other than owner listed above) Name:
4. CONTRACTOR: Name:_
Address: 10-21,2
5. SURETY (If applicable, a
the payment bond is attached): Name:
Phone Number:
Address: Amount of Bond:
6. LENDER: Name:. Phone Number:
Address:
EA
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section
713.13(1)(a)7., Florida Statutes.
Name: Phone Number:
Address:
8. In addition, Owner designates of
to receive a copy of the Lienors 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 dale 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 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.
(Signature of Owner or Lessee, or Owners or Lessee's (Print Name and Provide Signatory's Title/Orrice)
Auarorized Officer/Director/Partner/Manager)
State ofI�I D r l G1G1L County of ✓'A M�—
The foregoing Instrument was acknowledged before me this day of �� �Vol— , 20
by
Name of person making statement
who has produced Identificationtf-4ype of identification produced: k
li;:
GRACIELA. GA
MY COMMISSION N FF985949
EXPIRES April 25, 2020
NOV
Who Is personally known to me O OR
\o
6 201b
CERTIF'EO COPY- MARYANNE MORSE
CLERK OF TF>F--"CUftOURT AND
DE P1 RY C FPK
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: 1 3 0 0 1 7
I, 14 i l f la p ( (`��� hereby acknowledge that I personally inspected
WRoof deck nailing and/ortxSecondary water barrier work
at 10 17 V ot" _k �( I C , 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
Section 837.06 F.S.
/K�C4_/
Signatuk of Contractor Date
14 40�� r oer- * 13319939
Printed Name of Contractor License #
License Type: 0 General 0 Building 0 Residential0(soofing Contractor
0 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 thisdayof
'20 by
who is"rsonally Known to me or has 0 Produced (type of
identiflegiXipp) as identification.
SEAL)
ignature'of Notary Public
St oLf Florida•►�Y :�a
: .. �. STEPHEN PATRICK DOLJW
MY COMMISSION r FF 071532
����' EXPIRES: December 27,2017
Print/Type/Stamp Name
Bated fru Budget Notary Semites
of Notary Public
3