175 Lakeside Cir - BR17-000201 - ReRoof13
za
MIAUNI
Plan Review Contact Person: Debhie Title:
Phone: 407.696.7663 Fax: 407.695.7664 Email: staff ro services.colrl
Property Owner Information
Name Jason Hawk Phone:
Street: 17bjaKe3id2_Qir_ Resident of property? : -_yes__
City, State Zip:
Contractor Information
Name --Roof TDp-Services -oLCentral fi—inc,— Phone: 407.696.7663
Street: _1150 Fax: 407.6951664
City, State Zip: venter prins. FL 32708 State License No.: GfC1,12fi6Zq_
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company: Mortgage Lender:
Address: Address:
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 ofa permit and that all work will be performed to meet standards ofall 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, 3015 Permit Application
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 Ilorida Lien Law, FS 711
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 0 er/ nt Date
eZ11)1t-11k- 4c-Z4-c11-
tPr4wner/Agent's Name
Z/ y--
ignature a
Owner/Agent is Personally Known to Me or
Produced ID _= Type of ID 4
Sign
o'
aturcof Contractor/Agent Date
Krista I A lAr — —t. I —
signature of tXfary,
t" X
Contractor/Agent is X Personally Known to Me or
Produced ID _ Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building[] Electrical[] MechanicaIE] PlumbingE] 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
Irmo
APPROVALS: ZONING: UTILITIES:
ENGINEERING: FIRE:
ROINGFORM
Fire Alarm Permit: Yes R NO X
WASTE WATER:
Revised: June 30, 2015 Permit Application
UiFK#m
JOMW, CIA
M, A
Parcel Information
Propqrty Re-qord Card
Parcet 11-20-30-5KS-0000-0110
Owner: HAWK JASON W
Property Address: 175LAKESIDE CIR SANFORD, FI-32773 Value
Summary Parcel
11-20-30-5KB-0000-0110 Owner
HAWK JASON W Property
Address 175 LAKESIDE CIR SANFORD, FL 32773 Mailing
175 LAKESIDE CIR SANFORD, FL 32773.4522 Subdivision
Name LJIDDER LAsEU-jji UNI 7 Tax
District SI-SANFORD DOR
Use Code 01-SINGLE FAMILY Exemptions
00-HOMESTEAD(2001) 2017
Working 2016 Cert[fied Values
Values Valuation
Method Cost/Market Cost/Market Number
of Buildings 1 1 Depreciated
Bldg Value 83,523 80,214 Depreciated
EXFT Value 1,001 1,051 Land
Value (Market) 21,000 21,000 Land
Value Ag Anvma6ke
t-VaLume -'* 105,524 102,265 Portability
Adj Save
Our Homes Adj 31,109 28,367 Amendment
1 Adj P&
G Adj 0 0 Assessed
Value 74,415 73,898 Tax
Amount without SOW $1,23661 2016jux
B ILI j6mgLint $681.74 1d&
9-qt-a1-11t2-rSave
Our Homes Savings: $554,87 Taxing
Authority Assessment Value Exempt Values Taxable Value City
Sanford 74,415 49,415 25,000 SJWM(
Samt Johns Water Management) 74,415 49,415 25,000 County
Bonds 74,415 49,415 25,000 County
General Fund 74,415 49,415 25,000 Schools
74,415 25,000 49,415 Sales
Description
Date I Book Page Amount Qualified Vacdmp QUIT
CLAIM DEED 1/1/2016 0627 100 No Improved SPECIAL
WARRANTY DEED 3/1/2000 03 844 2987 82,300 No Improved CERTIFICATE
OF TITLE 1/1/2000 03791 1502 100 No Improved SPECIAL
WARRANTY DEED 12/1/1999 03792 1628 100 No Improved WARRANTY
DEED 5/1/1996 9103.2 Q3M 79,900 Yes Improved WARRANTY
DEED 3/11/1989 QZUKI 2847 72,800 Yes Improved WARRANTY
DEED 10/111988 t 20jj 1537 252,800 No Vacant Land Method Frontage Depth
Units
Units Price Land Value LOT 0.00 0,
00 1 21,000.00 21,000 http://parceidetaii,scpafl.org/
Parcf,4Detailinfo.aspx?PID=1120305KBOOOOOI10 112
1/1312017 SCRAParcel View: 11-20-30-5KB-0000-0110
Building Information
Description 1 Year Built Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Ad j Value Rept Value AppendagesActuallEffective
J-
I SINGLE 1989 6 1 2,() 1,272 1,548 1,272 SIDING $83,523 94,376 Description Area
FAMILY GRADE3
GARAGE 264.00FINISHED
OPEN
PORCH 12.00
FINISHED
Permits
i Permit # I Description AgencyAmount CO Date Permit Date
01249 ADDITION - RESIDENTIAL SANFORD 2,000 3/1/2003
04994 ADDITION -RESIDENTIAL RESIDENTIAL COUNTY 1,815 5/31/2000
01972 ADDITION -RESIDENTIAL SANFORD 975 5/1/1996
Extra Features
Description i Year Built Units Value New Cost
SCREEN PATIO 1 12/1/2003 1 801 1,500
PATIO 1 12/1/1989 1 200 500
http://parceidetail.scpafl,org/PareelDetaillrifo.aspx?PID=1120305KB00000110 2/2
i,ii'Y i i 11(.e i¢ 1 COUNTYTY
I'i.(._i_:0R D171) i_ 1-.
t,
1..'/ _I_ l'i 1C AllPermit
i Y following
information is provided in this Notice of Commencement. 1.
DESCRIPTION OF PROPERTY: (Legal description of the property and street address ifavailable) 2,
GENERAL DESCRIPTION `• r
is property,
3.
OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name
and address: Interest
in w •• Address,
4.
CONTRACTOR* Phone Number: Address:
1150 Belle Avenue, Suite #1060, Winter S.
SURETY Of applicable, a copy of the payment bond Is attachedy Name Address:
Amount of Bond: LENDER:
6. Phone Address:
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:
M
j
I aturis of Owmer Lesse Owners ssee's (Print Name and Provide Slgnatory°s T tle/O k ce) 8
Authorised officer/Diractor/Partner/Manager) State
of bounty of 20
Thatoregoininstrumentwsacknowledgedbeforemethisdayofciby
Who is personalty known tome O OR Namrr
of person making statement"'} t who
has produced Identification type of Identification produced:" sr((++''
fi
rr' jj''e !! ((
as }}//{at(.^
y_ss
aa:ar.:r i31-.
Vli1Vi,iHP YBON k; N
F
v. Septetn3e
4, 2017 I
hru hiuC Yy Public Undeortter a
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 01-13-17
1 hereby name and appoint: — be IOL,C-
an agent of:
Name ofCwa7mpanyl 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
All permits and applications submitted by this contractor, or
The
specific permit and application for work located at: 175
Lake Street
Address) Expiration
Date for This Limited Power of Attorney: State
License Number: CC1326679 Signature of
License flolde The foregoing
instrument was acknowledged before me this 13thdayof4gngaIy_, 2017 , by
Kristal A. Win ate who is X personally known to me
or o who has produced as identification and
who did (dictno)Aake7n oath. Q Signs '
Notary
Seal)
Jessica Mendez Print or
type name A 4
JESSICA MENDEZ Notary Public - State of Florida AA MY
COMMISSION # GG 019116 Commission No. i EXPtRES:
August 3,2020 My Commission
Expires: 0 Borded TWuNot" Pubft Undww rs Rev, 8/
06/13)
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #:__0
hereby acknowledge that I personally inspectedk" r s ta clt
xRoof deck nailing and/or E Secondary water barrier work
at and have determined that the work17S- L
Job Sitete 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 7.06 F.S.
Signature of Contractor Date
e
Xrt.1-o-t A,
Printed Name of Contractor License #
License Type: 0 General I '] Building El Residential/A-Roo ring Contractor
I1 -1 or any individual certified in accordance with,F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF Ce--VvN i 'n o le-.
Sworn to (or affirmed) and subscribed before me this -IY±- day of %JA AJ. 20/7 by
rt.sjw .4 . WIVI,14je who is X Personally Known to me or has D Produced (type of
identification as identification.
a11, "'
m -
14- (SEAL)
Signature of Notar3&ublic
State of Florida
Print/Type/Stamp a
of Notary Public