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Home My WebLink About317 E 22 Str'MECEEVE tic'' 1JV tiY•r a7 CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: 3-7 7 q Documented Construction Value: S I 1l Job Address: l Sa pD V ( 1 Historic District': Yes No Parcel ID: Residential ba Commercial Type of Work: New Addition B Alteration 0— Repair Demo Change of Use Move Description of Work: - t Iti , - _ _ S It Plan Review Contact Person: Title: Phone: Fax: Email: Property Owner Information Name "A) t'J Phone: 00, V 33 Street: ( ) E 2 al*jp J l Resident of property? : L14E5 City, State Zip: Name Street: City, State Zip: _ Name: Street: City, St, Zip: Bonding Company: Address: Contractor Information Phone: Fax: State License No.: Architect/Engineer Information Phone: Fax: E-mail: VMortgageLender: &(—, N' 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: 5" 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 propertythat may be found in the public records of this county, and there may be additional permits required from other governmental entities such as w`Atermanagement 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/Ag to Signature of Contractor/Agent Date o / W,d 5 t A YA) A) Print OwneMeent's Name Signature of 1PkyPyY",,, ANNETTE BLAND Notary Public - State of Florida commission # GG 060623 My Comm. Expires Jan 16. 20181 Owner/ Agent-is---,,u HTr—s7onal y 'nown to Me or Produced ID Type of ID F L_ n L Print Contractor/Agent's Name Signature of Notary -State of Florida Date Contractor/ Agent is Personally Known to Me or Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type: Total Sq Ft of Bldg: Occupancy Use: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes No APPROVALS: ZONING: ENGINEERING: COMMENTS: of Heads UTILITIES: FIRE: Flood Zone: of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes No WASTE WATER: BUILDING: Revised: June 30, 2015 Permit Application M OWNER BUILDER STATEMENT/AFFIDAVIT Altamonte Springs, Casselberry, Lake Mary, Longwood, Oviedo, Sanford, Seminole County, Winter Springs Florida Statutes are quoted here in part for your information to indicate the authority for exemptions for homeowners from qualifying as contractors and to express any applicable restrictions and responsibilities. OWNERS MUST PERSONALLY APPEAR AT THE BUILDING DIVISION TO SIGN THIS DOCUMENT BY SIGNING THIS STATEMENT, I ATTEST THAT: (Initial to the left of each statement) I understand that state law requires construction to be done by a licensed contractor and have applied for an owner -builder permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a 1 license. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the is hiring licensedconstructionandnota contractor to assume responsibility. I understand that, as an owner -builder, I am the responsible party of record on a permit: I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed W in his or her name instead of my own name. I also understand that a contractor is required by law to be licensed in Florida and to list his or her license numbers on all permit and contracts. I understand that I may build or improve a one -family or two-family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my own use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within in 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease, which violates this exemption. I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction. I understand that I may not hire an unlicensed individual person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the licenses required by law and by city ordinance. I understand that it is a frequent practice of unlicensed persons to have the property owner obtain an 1 owner -builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner -builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner - builder and am aware of the limits of my insurance coverage for injuries to workers on my property. I understand that I may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on my building who Is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers' compensation for the employee. I understand that my -failure to follow these laws may subject me to serious financial risk. Rev. 9.14.2009 PERMIT # ) , 3 9 City of Sanford Building Division Residential Re -Roof Scope of Work JOB ADDRESS: Y! '; \/ 1) s-T Y404—N-D41LUC-o I STRUCTURE TYPE: 0 SINGLE FAMILY RESIDENCE/TOWNHOUSE 0 MOBILE HOME 0 APARTMENT/CONDOMINIUM RE -ROOF TYPE: &REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) 0 RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF) DECK TYPE (PLEASE SPECIFY): ::S:4 t:— 4 q /C l- PLEASE NOTE: ONLYI00 SQUARE FEET OFTHE EMSTING DEC IS PERMITTED TO BE REPLACED"" ROOF VENTILATION: Q OFF -RIDGE E) RIDGE 0 SOFFIT OPOWERED VENT OTURBINES SKYLIGHTS: 0 YES (N0 IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: MAIN ROOF AREA ROOF SLOPE: 0 LESS THAN2:12 102:12-4:12 0 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL 0 SHINGLE FL# O METAL FL# O MODIFIED BITUMEN FLY 0 TORCH DOWN FL# 0INSULATED FL# TILE FL# C, (] OTHER: I ` Nt,'/t 1 c FL# I N3 O':; t-S , -k ROOF EXTENSIONS ( PORCHES, PATIOS, ETC.) "IFAPPLICABLE" ROOF SLOPE: 0 LESS THAN 2:12 0 2:12-4:12 0 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL 0 SHINGLE FL# Q METAL FL# 0 MODIFIED BITUMEN FL# 0 TORCH DOWN FL# INSULATED FL# 0 TILE FL# 0 OTHER: I FL# CITY OF Building & Fire Prevention Division S,&NFO-D" RESIDENTIAL RE -ROOF POLICY & PROCEDURES FIRE DEPARTMENT PERMITTING REQUIREMENTS -NO PLAN REVIEW REQUIRED AND COMPLETED IRESIDENTIAL RE -ROOF SCOPE OF WORK ARE THIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE REQUIREDTOBESUBMITTEDASPARTOFYOURPERMITAPPLICAT THE SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT. A PERMIT WILL NOT BE ISSUED WITHOUT THESE DOCUMENTS. COPIES WILL BE MADE TO POST ON THE JOB SITE. PROJECTS LOCATED IN THE SANFORD HISTORIC DISTRICT WILL REQUIRE PLAN REVIEW AND APPROVAL BY THE SANFORD HISTORIC PRESERVATION BOARD INSPECTION POLICY & PROCEDURES A FINAI-ROOF INSPECTION IS THE ONLY INSPECTION REQUIRE FFPO TS ENTIAL (SINGLE FAMILY, TOWNHOUSE, MOBILE HOME, APARTMENT AND/OR CONDOMINIUM) RE THE FOLLOWING IS REQUIRED TO BE PROVIDE ON THE JOB SITE: PERMIT CARD, POSTED.IN A CONSPICUOUS AND WEATHERPROOF LOCATION COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK COMPLETED AND NOTARIZED INSPECTION AFFIDAVIT ALL FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS PRODUCT APPROVAL SHALL MATCH WHAT IS ON THE SCOPE OFE WORK) OR ADDRESS IN EACH PICTURE) DIGITALPHOTOGRAPHS (MUST INCLUDE THE PERMIT NUMB 0 EACH PLANE OF THE ROOF, SHOWING THE UNDERLAYMENT INSTALLED SPACING ( INCLUDING A MEASURING DEVICE G SIZE oROOFDECKNAILINGPATTERN & OF NAILS) o ROOF DECK NAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHOWING o UNDERLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICEORR RULER) o DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE ) o SHINGLES INSTALLED, NAIL PATTERN AND LOCATION OF NAILS SKYLIGHTS ( IF APPLICABLE) o DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT,APPO APPROVAL o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT VAL INS C MPLIANCEBYAFFIDAVIT OPERSONAL INSPECTION- VIDED BY A FLORIDA PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC COD — - - - DATE: I 1- 4 CONTRACTOR (OROWNER/ BUILDER) SIGNATURE: