303 Placid Lake Dr - BR17-000257 - ReRoofCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
JAN 2 5 2017 1 Application No:
Documented Construction Value: $
2
Job Address: Historic District: Yes El No
Parcel Iesi en in ommercia D: type
I
of
Work: :New Addition 11 Alter ationF Repair Demo 11 Change of UseEl Move 11 77
Description,ot'Work: Plan
Review Co Title: jcoly
mail: pax: Phone: 4 Property
Owner Information Nance
z; es' Phone: 7Street:
Resident of property? 7
City, State Zip: Contractor
Information Name
17 Phone: C
Fax: Street: 7"?
State License No,: City, State Zip: -r-7Arch
itect/Eng i neer Information Name:
Phone: Street:
Fax: City,
St, Zip: E-mail: Bonding
Company: Mortgage Lender: Address:
Address: WARNING
TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVE MENTSTo YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED
AND POSTED ON TIIEJOB 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,
bbilers, heaters, tanks, and air conditioners, etc. FBC
105.3 Shot] be inscribed with the date of application and the code in effect as of that date: 5'11 Edition (2014) Florida Building Code
0
NOTICE: In addition to the requirements of this, permit, there may be additional restrictions applicable to this property that may be
fbtmcl in the public records of In is 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 lees when the permit is issued.
OWMER'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.
Sia'Wttffe ofOwner"Agent Date
Pi int Owner/Agent's Name
Signattire of Notary -State of Florida Date
Owner/Agent is .......... Personally Known to Me or
Produced ID Type of ID
7
Sign, gn, tire Cantractor/Agerit D to
Print Con tor/Agent's Name
Signature of Notary -State of Florida Date
y "J8, STEPHEN PATRICK DOLAN
MY COMMISSION # FF 071532
EXPIRES: December 27, 2017
Bonded Thru Budttvt NQtsrif SKYis Contractor/
Agent is — Personally Known to Me or Produced
ID Type of ID BELOW
IS FOR OFFICE USE ONLY Permits
Required: Building[] Electrical El Mechanical[] PlumbingGasF] Roof E] Construction Type:---
Occupancy Use: Flood Zone4: - Total Sq
Ft of Bldg:_.__ in. Occupancy Load: # of Stories: New Construction:
Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler
Permit: Yes [] No [] APPROVALS: ZONING:
ENGINEERING: COMMENTS:
4
of
Heads 1 ----- Fire Alarm
Permit: Yes [] NoE] urILITIES: WASTE
WATER: 1 `1
R I: BUILDING:
SCPA Parcel View.- 02-20-30-520-0000-0020 Page I oil' 2
Cos
IGNOWAX CXXWIY momwk
Parcel Information
Prop,rty RpqordCaTd1
Parcel: 02 20-30-51,, 0000 0020
Owner: ZAMOR SABRNA
PropertT Address: 3,02 ill;,KE DIR SANFORD, FL 327-7',
Parcel 02-20-30-520-0000-0020
Owner ZAMOR SABRINA
Property Address 303 PLACID LAKE DR SANFORD, FL 32773
Mailing 303 PLACID LAKE DR SANFORD, FL 32773
Subdivision Name PLACID VOOODS PH
Tax District SI-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions 00-HOMESTEAD(2016)
ter mmole (,',owdy GIS
Legal Description
LOT 2
PLACID WOODS PH I
PB 51 PGS 23 THRO 29
Taxes
Taxing Authority
Schools
City Sanford
SJWM(Saint Johns Water Management)
County Bonds
County General Fund
Lana
Value Summary
2017 Working 2016 Certified
Values Values
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 84,467 80,891
Depreciated EXFT Value
Land Value (Market) 18,000 18,000
Land Value Ag
Value1_..1.._1___.111.. 102,467 98,891
Portability Adj
Save Our Homes Adj 2,884 0
Amendment 1 Apt
P&G Adj 0 0
Assessed Value 99,583 98,891
Tax Amount without SOH: $1,168,98
2016"a 6,fl m` $1,1%98
ax E, svnnai,Q
Save Our Homes Savings: $0.00
Does NOT INCLUDE Non Ad Valorem Assessments
99,583
99,583
99,583
99,583
99,583
AMMEREMME
25,000 $74,583
50,000 $49,583
50,000 $49,583
50,000 $49,583
50,000 $49,583
Method Frontage Depth Units Units Price Land Value
LOT $18.000,00 $18,000
Building Information
Is Bed'Bath count ncotrecj? CUck Here
Description Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Apt Value Repi Value i Appendages
littp:llparceldetail.scpafl.org/Parcell)etaillilfo.aspx?PID=02203052000000020 1/20/2017
Licensed & Insured
First fn Quality
First in Service
Firg in Safisfaclion
Ins. Co,
Claim#
Adj. Name
LIC # CCC 1330939 6767 Hoffner Avenue Tel. #
LIC # CRC1331435
Orlando, Florida 32822
7 t" I '-dr
t
DATED__-3PROPOSALSUBMITTEDTOSTREET -
e JOB CITY,
STATE, ZIP 'Atl 01 T 7-17SUBDIVISIONHOME PHONE /^
r USINESS PHONE EyTear Off
Shingles: _ Layers Eal'rofessjonally
Install: Brand Vl+% for Type oAlLLIC-16f 16 0 0"New
Valleys Ft. 111 2"Install:
0 30 to. Felt 0 Peet & time @,'Synthetic Undedayment eseal, sidewalls,
counter and wag flashings C3 Use Drip Edge Erl5rip Edge New 1-
1 /2* _ 2" - X - 4* or-'! lurnbl'ng =ens YV'antifafion:
GooseNecks - Off Ridge Vents _ Ridge Vents - Color bLo-iL bc-_ Z/Renail
Plyw' bad Sheathingto Code U Skylight
2x24x4 3"Plywood
replaced at $60 - per sheet Cif needed) Ca tleant-
up and haul off all job related trash Ur<,ill yard it maTedc roller EfProted yard and shrubs Atlantic Roofing
is not responsible for pre-existing structural condifions. Buyers agree
they have seen, read & understand all terms & conditions of this contract & agree to be and by same. ALL ROOFS
HAVE A 5 YR LABOR WARRANTY gas= 1
propertyownees
o"i-pocket expense is not to exboed the deductible amount The Insumnse company voill determine and set the price of the claim. YOU, THE
BUYEP, 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 ROCEED VOTH THE WORK AS PER PROPERTY -LOSS WORKSHEET VMEN
RECEIVED. We propose
to hereby fumish materials and labor, complete in accordance with above specifications for the sum of the insurance as per the insutance company loss
swpe sheet ibr Which is I ad herein and made a pad hereof by reference, to include customary pmfft and overhead when multiple trade incurred
Il 0 4= Psymerlt uport completion of ea h trade, ed ' natu
AM a
111111111111111111111111111111111 IN fill
THIS INSTRUME T [PREPARED BY:
Name:
Address:
I1f".1LO Y7 `IIIHOLE COUHI'Y
T LERK 0F CIRC'UU CUM' &
U: (1PO
CLEW' u 2017008090
tECORDED C11 /2 4,,/21117 11 " 35' 2 f)II
111,11" C0RD I Nk-i :FE1:L'
RE(,'0NDE--D BY
Permit Number:
Parcel ID Number:
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.
2. GENERAL DESCRIPTION OF IMPROVEMENT:
3. OWNER INFORMAT1bN OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR T E IMPROVE MEWN:
V , ly / -
26-11
I -
Z -6 _" I 2 3Nameandaddress: 1 / ---
Interest in property:
igammumitimn, n I
4. CONTRACTOR: Name/
Address:
a
S. SURETY (if applicable, a copy of the payment bond Is attached): Name:
Address: 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 Section
Florida Statutes.
Name: Phone Number:
8. In addition, Owner designates a
9. Expiration Date of Notice of Commencement (The expiration is I 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.
y-
Sguro e of14or (
Signat e ofOwner or Lessee, or Owner's or Lessee's &—C—(
Innr 1.. and Pr.,nde
Authorized Officer/Director/Partner/Manager)
State of County of
The foregoing instrument was acknowledged before me this day of lei 610? 2b-f2
by
Name ofperson making staten
who has produced identification P-Wo of Ide
5m 1114111 M02
E— — n proucZdd: EL_Z5 te O- -O 04VFLZS60-
Icy 0- &S-660-0 C1\
A
N 22", "'!"'U" i J
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117 - -3 '27"?
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,floridabuildigipq!19:I
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,
Cate —gorylS—ubcat-'e—g—or-y—'--F--Va—n6Tactu—rer Product Florida A proval # (
i cluDescription (include decinmal)
1. Exterior Doors
Slidin
2. Windows
Lngle_!jLjn
Horizontal Slider
Double _!lung—
4
Awnin
MIRM
Wind Breaker
Dual Action
6—ther
category Subcategory Manufacturer Product Florida Approval
Descriotion (includinq decimal)
Panel Walls
idin
soffits
storefronts:
Curtain Walls
Wall Louver
Class block
Membrane
Greenhouse
E.P.S composite
Panels
Other
4. RooyfiAn Products
Ap halt ahin les
Underlanents _ Roofing
Fasteners Nonstructural
Metal
Roofing Wood
Shakes and Roofinq
tiles _ _w
Roofing
Insulation
Water
roofin Built
up uroofing Modified
Bitumen ModifiedPly
Roof ysterns
Roofte
Cements/ Adhesives /
Coatin
Liquid
Applied
Roofinjg S
ystems RoofTile
adhesive spray
Applied
Polyurethane Roofin
E.
P.
S. Roof_mm Panels
Roof
Vents .,
Other
d\\
ent
Other
k Ipqhts Other
Compqneqs
Connectors
Anchors
Truss-
Plates En2!
mber_ Raili
Coolers/
Freezers Concrete
Admixtures Precast
Lintels ---- Insulation
Forms Plastics
Wall
Prefab
Sheds IN
T ARAILYMMO-
0-11f<#0 0
Please
Print) June
2014 9
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
I Seminole County, Winter Springs
Date- r7A"( -- - ---- ---- --
I hereby narne and appoint: . .....
t)I'Coinpany)
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):
The specific permit and application for work located at:
Expiration Date for `this Limited Power of Attorney -
License Holder Name:
State License. Number :C. C) a
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF _J,rP
rhe foregoing instrurn nt was acknowledged before one this vlyfday of 200
j, e— who is identification
to
me or i--j who has produced as identification
and who did (did not) take an oath. Signature
Notary
Seal) Print
or type name d".
STEPHEN PATRICK DOLAN MY
COMMISSION # FF 071532 EXPIRES:
Demo* 27,2017 0,
Boded Thar Srp4 Not" Services Notary
Public - State of Commission
No, My
Commission Expiresj,:_--/
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #:
11 hereby acknowledge that I personally inspected
Roof deck nailing and/or,'NSelcondary water barrier work
at C11 611 t and have determined that the work
Job Site Address)
was done according to the Hurricane Mitigation Retrofit Mannal. (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 ofthe second degree pursuant to
Section 837.06 F.S.
If
Signaturk of Contractor Date
Printed Name of (ontractor License # License
Type :_ General i4 Building E] Residential b&oofing Contractor or
I anyndividual certified in accordance with F.S. 468 to make such an inspection. STATE
OF FLORIDA COUNTY OF Swor
ft, (or a firmed) and subscribed before e tl s I day of e t( 20 4-Iby who
i ei sonally Known to me or has 0 Produced (type of id
qbift,atoni) 0 , 1,,ation as identification. SEAL)
Signature
of Notary Public State
of Florid' Frint/
1 ype/S tampName N, STEPHENPg€KDOL IcA,,j ofNotaryPublic * My COMMISSION # FF 071532 140,3, EXPIRES: December 27,2017 eOF
Mdez Bonded Thru Budget Notary Services