Loading...
101 Lacosta Ct - BR18-004761 - COVER PORCHe¢; ct^O$tj NCO • BUILDING DIVISION PERMIT APPLICATION Application No: Lf l Documented Construction Value: $ Job Address: zi I & y Ilia _ y 1f - = 7 - Historic District: Yes NoRl Parcel ID: LO. - 17Residential E Commercial Type of Work: New F Addition Alteration Repair Demo Change of Use Move Description of Work: Plan Review Contact Person: X s c, , _R6Q- Title: Phone: -Ai;'? - ' 1 7 4 - ( Fax: Email: & C4hv'tCl Property Owner Information r Name A" 5n'Q p s> Phone: 7- '4 ? { Street: 2' 3 i Li ) Resident of property? City, State Zip: 77 Contractor Information Name Phone: Street: Fax• City, State Zip: State License No.: Architect/Engineer Information x Name: O'' ctr-o'ci - `' Phone: 2 2- 7 f Street:'t' r Ca t t '? Fax: City, St, Zip: T:: ( 7 2 7 7-3 E-mail: Bonding Company: Address: 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. 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: 6" Edition (2017) Florida Building Code 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 Florida Lien Law, FS 713. 1' 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 "fable 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. ca Signature of Owner/Agent Date C L Prot Owner/Agent's Name of Notary -State Owner/Agent is Personally Produced ID _ Type of ID Date Signature of Contractor/Agent Date Print Contractor/Agent's Name H. r 1 i/, ature of Notary -State of Florida Cd cP or #0.-2453sc Cor2ractor/Agent is tictuced ID Date Personally Known to Me or Type of ID Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type: Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: Flood Zone: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes []No APV(IOVALS: ZONING: i W14 UTILITIES: WASTE WATER: ENGINEERING: COMMENTS: FIRE: BUILDING: 5r I ZZ-N Ok to install 5` x 46` (230 square feet) screen enclosure as shown or, plan. Scree enclosure shall not encroach into any _ easements. Subject property is located in Sr2-1it zoning district and has two front yards with a minimum building setback of 25feet. The Screen enricisure meets the ode and rear" yarn' sptbarr€ Ft p€, ,.:..r'a enclosure hinting Hidden Lake does not meet _ front yard setback a5 it is set back 24 - from, the property #site. However, it fs 1510 or less of the minimum required. In addition, the new screen enclosure does not exceed past the existing footprint of the current structure. Grant Maloy, Clerk Of The Circuit Court & Comptroller Seminole County, FL Inst #2019009591 Book:9289 Page:148: (1 PAGES) RCD: 1/28/2019 11:35:28 AM REC FEE $10.00 THlS1NSkUMENT PRE Y:Name:z ©' Address. ... $ * td+ NOTICE OF COMMENCEMENT State of Florida County of Seminole Permit Number. Parcel ID Number. ([ _2-0-30' 5 W' C0b"174 0 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. DESC(2©` O O PO RTy; (Legal des on of prop and street address if aallablo) GENERA DESCRIPTI(ONOFf MPi QYEMENT: V Address: a 1 16, Q A, 111R 1 Y 4)•t -,F % 7 Fee Simple Title Holder (if other than owner) Name: Address: Address: Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provi ed by Sectio nt} 713. 13(1)(b), Florida Statutes. Name: v` rvt(,t.'t e' - 'n sot't o In addition to himself, Owner Designates ` of To receive a copy of the Lienor's Notice as Provided In Section 713. 13(1)(b), Florida Statutes. Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a different dateisspecified) 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. Under penalties of perjury,) declare that I have read the foregoing and that the facts stated in It are true to the b of my 0 edge and belief. OwWsSignatur4,owner' s Printed Name Florida Statute 713.13(1)(g): ' The r must sign the notice of commencement and no one else may bepermitted to sign In his or her stand' State of 000-Cb, County of_&eMinQL.Q. t` j The foregoinginstrumentwasacknowledgedbeforemethisdayof1I'll I tT 20 1 by D . i I `>' ( Who is personally known to me Jame of person makingstate"t OR who has produced identification Ytype of Identification produced:. Elf) Notary Pubbo State of HordeTara V1(aienMyCommtssonGG145708Qxpirea01l22/ 2022 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 license. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed 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 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 and contracts. permit 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 I 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. t; 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 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 I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern owner -builders as well as employers. I also understand that the construction must comply with all applicable laws, ordinances, building codes, and k zoning regulations. I am of aware of construction practices and I have access to the Florida Building Codes. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, the Florida Department of Financial Services, and the Florida Department of Revenue. I also understand that I may contact the Florida Construction Industry Licensing Board at 1-850-487-1395 or at www.myforida.com/dbpr/pro/cilb/ for more information about licensed contractors. I am aware of, and consent to, an owner -builder building permit applied for in my name and understand that I am the party legally and financially responsible for the proposed construction activity at the address listed below. I agree to notify the building department immediately of any additions, deletions, or changes to any of the information that I have provided on this disclosure or in the permit application package. Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Construction Industry Licensing Board, the Department of Business and Professional Regulation and the building department may be unable to assist you with any financial loss that you sustain as a result of a complaint. Your only remedy against an unlicensed contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is property licensed and the status of the contractor's workers' compensation coverage. Property Address: C -O` , f L72 "k do hereby state that I am qualified and capable of performing the requested construction involved with the permit application filed and agree to the f l -7 fo2 ate Form of Identification - Must be Photo IQ) A violation of this exemption is a misdemeanor of the first degree punishable by a term of imprisonment not exceeding 1 year and a $1,000.00 fine in addition to any civil penalties. In addition, the local permitting jurisdiction shall withhold final approval, revoke the permit, or pursue any action or remedy for unlicensed activity against the owner and any person performing work that requires licensure under the permit issued. Rev. 9.14.2009 16 CITY OF SANFORD SCHEDULE C: AREA AND DIMENSION REGULATIONS ZONING DISTRICT MAP SYMBOL AREA AND DIMENSION UNIT OFRESIDENTIALRES/OF COMMERCIAL INDUSTRIAL AGR MEASURE REGULATIONS SR -IAA SR-lA SR -I SR-2 MR-1 MR-2 MR-3 RMOI RC-1 GC-2 SC-3 RI-1 MI-2 AG Min. Parcel Area 10,000 7,500 6,000 43,560 10,000 10,000 10,000 10,000 10,000 10,000 None 10,000 10,000 43,560 Sq. FeetRequired2) Minimum Parcel 20 20 20 100 35 35 35 35 35 35 None 35 35 20 Feet Frontage on a Street Min. Parcel Width at 85 70 60 100 100 100 t00 75 75 None 75 75 100 Feet Building Line 3) Min. Front Yard 25 25 25 30 30 30 30 25 25 None 25 25 35 Feet Requirement 3) 2) Min. Side Yard t0 10 7.5 20 20 20 20 10 20 None 15 15 20 Feet Requirement 3) Min. Rear Yard 20 20 20 20 20 20 20 20 20 None 20 20 35 Feet Requirement 3) 2) Open Space 50 50 50 50 50 50 50 30 25 25 None 20 20 None of Parcel Area Maximum Building 35 35 35 35 35 35 35 50 35 50 100 50 50 35 Feet Height 3) 3) 3) Floor Area Ratio NA NA NA NA NA NA NA 35 35 35 2.0 50 50 NA Floor Area/ Lot Size Minimum Living Area One Family 1,500 1,200 700 700 700 700 Sq. FeetTwoFamily700700700700Sq. Feet Accessory Rear 4 4 4 4 4 4 4 4 4 None 4 4 4 Feet Buildin Setback 1) 1) 1) 1) 1) 1) 1) 1) 1) 1 1) 1) 1) Land Use Capability See Schedule J — Landscape, Buffer and Tree Protection Requirements Planned Development See Schedule D — Planned Development Project Regulations Project Requirements 1) Accessary buildings are not permitted in required front yards or required side yards when such side yard abuts a street. Also, in addition to a building setback of four (4) feet, all accessory buildings which are greater than 15 feet in height shall be set back an additional one (1) foot from the side and rear parcel line for each foot or fractional portion thereof, of height over 15 feet. 2) Except for one -family dwellings, all other uses shall have a minimum required parcel area of five (5) acres, minimum required front yard of 100 feet, minimum required side yard of 50 feet and a minimum required rear yard of 100 feet 3) Building heights may be increased pursuant to Schedule E, section 16.0, D. 4. Ord. No. 4337 C-1 03/23rr015 SECTION 2.0 BASE BUILDING LINE A. Base building lines are hereby established for the streets listed below. B. All base building line requirements and distances shall be measured from the centerline of the existing or proposed street right-of-way unless otherwise provided for by these land development regulations. Where a base building line requirement differs with a minimum front yard requirement of these regulations for a particular use, the greater Of the two (2) requirements shall prevail. C. The entire area between the existing street right-of-way line and the base building line shall be deemed a front yard and shall be unoccupied and unobstructed by a portion of the principal building from the finished grade to the sky, or below the finished grade, except where such occupancy, obstruction or encroachment is specifically permitted by these land development regulations. SECTION 2.1 DESIGNATED RIGHT-OF-WAY LINES Designated right-of-way lines are hereby established for the streets specifically listed below. The purpose of the designated right-of-way lines shall be to reserve sufficient space for the future circulation of vehicular traffic and to reduce the undesirable and adverse impact of noise, congestion and related safety hazards associated with the intensified use of land resulting from new growth and development. All designated street right-of-way lines shall be located and measured from the centerline of the existing or proposed street right-of-way. ALL DISTANCES AND LOCATIONS SHALL BE MEASURED FROM THIS SCHEDULE SHALL BE APPLICABLE TO PORTION(S) OF STREET CENTERLINE OF EXISTING LOCATED IN CITY OF SANFORD OR PROPOSED RIGHT-OF-WAY(') BASE BUILDING DESIGNATED NO. NAME FROM TO LINE R-O-W LINE REQUIRED Feet) Feet) 1. Eastern Beltway (SR 417) I-4 Lake Jessup 3) Existing 2. U.S. 17-92 (Orlando Drive) CR 427 Lake Mary Boulevard 140 Existing 3. U.S. 17-92 (Orlando Drive) Lake Mary Boulevard Airport Boulevard 140 Existing 4, U.S. 17-92 (Orlando Drive) Airport Boulevard Park Drive 100 . Existing 5. U.S. 17-92 (French Avenue) Park Drive I-4 2) Existing 6. SR 46 West I-4 Persimmon Avenue 175 Existing 7. SR 46 West Persimmon Avenue U.S. 17-92 3) Existing Ord, No. 4337 C-2 03/23/2015 Iddoolh CITY OF S,k 4FORD FIRE DEPARTMENT Building & Fire Prevention Division ALUMINUM STRUCTURES PERMIT GUIDELINES All permit application packages must be complete prior to acceptance. You must check each box to the left or indicate n/a on this submittal. A complete application package shall include the following: Building Permit Application completed, signed and notarized. Application must include correct address and complete parcel I.D. number. Co of a contract, signed by the contractor and t operty owner, conI cti va o ro' ida. O A ite specific notarized po a rney shall be refrom th icsecractor if heAke a Dintsa yee of his/her sign the permit application as the contractor. tificate of ' rice indicating work ' _compensa ' verage an in e City of Sacertificate r py of a worker's compensation exemption issued by the State of Florida (must be submitted with each application if contractor is the applicant). Ow r Builder Statement / Affidavit (if the owner is the applicant). ust be signed in person at the Building Department) o (2) site plans indicating proposed location. Two (2) copies of the signed and sealed engineered drawings. Wind design data required on drawings per FBC fa03.1. 4 to meet 129 mph ultimate design wind speed for risk category I buildings OR Two (2} yes of previously mastered filed plans. Indicate all details and options that apply. Two .2) copies of a site specific layout for the structure with minimum I /8" per foot scale. Include all f ing sizes and types. Include any electrical devices to be added. Two (2) copies of Florida Product Approval, including manufacturer installation instructions and product For Sunrooms — must designate specific Sunroom Category on the signed and sealed plans, in accordance with FBCR R301. 2.1.1.2 These guidelines were compiled to assist the applicant in preparing an aluminum structure permit application and may not be complete. The applicant is required to meet all City of Sanford, state, and federal code requirements. Effective: August 1, 2017 BOUNDARY SURVEY SCALE : 1' - 30' RT li`6,-L+;& COORDINATED BY: MTC INC 1520 PERKINS ROAD BELLE ISLE, FLORIDA. 32809 . TEL: (407) 463-9019 E-MAIL-MTCINC21 QGMAIL,COM LEGEND: A/C -AIR CONDITIONER, BB=BEARING BASIS, SLOG -BUILDING, C-CALCULATED, CS CONCRETEBLOCK, CH=CHORO, CHBRG CHORD BEARING, CM=CONCRETE MONUMENT, CNA-CORNER NOT ACCESSIBLE, CONC CONCRETE, COV=COVERED, CPP=CONCRETE POWER POLE, D=DESCRIBED, DIBAA =DOING BUSINESS AS, DE -DRAINAGE EASEMENT, DUE DRAINAGE AND UTILITY EASEMENT, EDP EDGE OF PAVEMENT, EOW=EDGE OF WATER, F-FIELD, FF ELEV =FINISHED FLOOD ELEVATION, ID -IDENTIFICATION, IR=IRON REBAR, IP=IRON PIPE, L=ARC LENGTH, LS LANOSURVEYOR, LB-LANDSURVEYING BUSINESS, M=MEASURED, NR=NOT RADIAL, OR -OFFICIAL RECORDS, P=PLAT, PC -POINT OFCURVATURE, PCP -PERMANENT CONTROL POINT, PI -POINT OF INTERSECTION, POO POINT OF BEGINNING, POC=POINT OF COMMENCEMENT, PRM-PERMANENT REFERENCE MONUMENT, PT-POINTOF TANGENT, R=RADIUS, RAO=RADIAL, RES RESIDENCE. RAW =RIGHT OF WAY, SAW SIDEWALK, TOO -TOP OF BANK, TX=ELECTRIC TRANSFORMER BOX, UR=UTILITY ROOM, LIE UTILITY EASEMENT, WF=WOOD FRAME, WPP W000 POWER POLE SYMRnLS: 0 'UNLESS 1/2' I.R. 6 CAP PSM S144 UNLESS OTHERWISE NOTED FOUND 4X4 MONUMENT NO ID NO ELEVATIONS SHOWN HEREON HIDDEN LAKE80' N1DE PUBLIC RIGHT OF WAYASPHALTROADWAY) CURVE TABLE CURVE LENGTH I RADIUS DELTA CHORD BEARING CHOR C1 55,31 1 479.19 7• N79'2048 W 55.28 C2 42.03 25.00 98'1913 N27 53 82 W 37.25 C3 21.03 1 25.00 4811 N49721 41 E 20.41 C4 11.29 1 50.00 12'58 06 N81'S1 52 E 11.25 T AV Ok to install 5` X 46' (230 square feet) screen enclosure as shown on p)an. Screen enclosure shall not encroach into any easements. Subject property is located in Sit-1A zoning district and has two front yards with a mininnurTn building setback of 25 feet. The Screen enclosure meets the side and rear yard setback but, the screen enclosure fronting Hidden lake does not meet front yard setback as it is setback 24'-6" front the property line. However, it is 15% or less of the mininnurn required. In addition, the new screen enclosure does not exceed past the existing, footprint of the current structure. SURVEYOR' S NOTES 1. THIS SURVEY IS BASED ON THE LEGAL DESCRIPTION AS PROVIDED BY THE CLIENT. Z. THIS SURVEYOR HAS NOT ABSTRACTED THE LAND SHOWN HEREON FOR EASEMENTS, RIGHTS OF WAY OR RESTRICTIONS OF RECORD WHICH MAY AFFECT THE TITLE OR USE OF THE LAND. 3. DO NOT RECONSTRUCT PROPERTY LINES FROM INTERIOR IMPROVEMENTS. ( BUILDINGS, FENCES ECT...I 4. NO FOOTINGS OR OVERHANGS HAVE BEEN LOCATED EXCEPT AS SHOWN, 5, NO UNDERGROUND IMPROVEMENTS OR UTILITIES HAVE BEEN LOCATED EXCEPT AS SHOWN. 6. NO WETLANDS ANWOR OTHER NATURAL FEATURES RAVE BEEN LOCATED EXCEPT AS SHOWN. 7. THIS SURVEY SHALL NOT BE USED FOR DESIGN OR CONSTRUCTION WITH OUT PRIOR WRITTEN AUTHORIZATION FROM THE SIGNING SURVEYOR. 8. BEARINGS SHOWN HEREON ARE BASED ON THE NORTH EAST LINE OF LOT 174, BEING S14'17'53-W, PER PLAT. FND 5/8Ip iRNOZ" A_ Q Q FND 4X4 MONUMENT BOOK 25, PAGE(S) 66-69, OF THE RED BY PROPERTY ADDRESS: 101 LA COSTA COURT SANFORD, FLORIDA, 32771 CERTIFY TO: XXXXXX F600D ZONE j FOR TIP ON:_ MAP NUMBER: 12117 C007 70FDATE: 09/28/2007 ZONE: X FOR INFORMATIONAL PURPOSES ONLY AND IS NOT CERTIFIED.) SURVEYORS CERTIFICATE I HEREBY CERTIFYTHAT THE SURVEY OF THE HEREON DESCRIBED PROPERTY WAS PREPARED UNDER MY DIRECT SUPERVISION AND MEETS THE MINIMUM TECHNICAL STANDARDS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN CHAPTER 5J-17-0.050 THROUGH 5J-17-0.052, FLORIDA ADMINISTRATIVE CODE, PURSUANT TO CHAPTER 472.027, FLORIDA STATUTES. CERTIFIED BY: SCALE 1 INCH = 30 FT. 9/ 29/2018 BOUNDARY 9/23/2018 JOB NO. JON M. SHOEMAKER PSM 5144 MTC-311 4857 MYRTLE DR. ORLANDO, FL32829 TEL:( 407)463-9019 FIELD BY: ALM CHECKED BY: NOT VALOWfDIIX)TTHE SWT)REANDTHESECTR KORWED SEAL OFARORKAICMDKWO ANDK*RER' DRAWN BY: CC JMS 112/2018 Florida Building Code Online IRFCORD SCIS Horne UV In User R"tstratfon Hot Topics Submit SurchaMe Stab d Facts K*k*Oww FOC Staff acts Ske map Links Search d, uct Approval *r 4 = Public LOW 4QRUFA011AJZ > Apiplilcotion DaUff FL * Application Type Code Version Application Status Comments Archived Product Manufacturer Address/Phone/Emall Authorized Signature Technical Representative Address/Phone/Email Quality As Representative Address/Phone/Email Category Subcategory Compliance Method FL7621-R4 Revision 2017 Approved Elite Aluminum Corporation 4650 Lyons Technology Parkway Coconut Creek, FL 33073 954) 949-3200 dkOdoklmengineerIng. net Frank Bennardo frank0engineeringexpress.com Bruce Peacock 4650 Lyons Technology Parkway Coconut Creek, FL 33073 954) 949-3200 bpeacock@elltealuminum.com 41 8 - 4 7 6 1 Roofing Products Introduced as a Result of New Technology Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report - Hardoopy Received Florida Engineer or Architect Name who developed the Frank L. Bennardo, P.E. Evaluation Report Florida License PE-0046549 Quality Assurance Entity QAI Laboratories Quality Assurance Contract Expiration Date 04/30/2021 Validated By Troy Bishop, P.E. Validation Checklist - Hardcopy Received Certificate of Independence Referenced Standard and Year (of Standard) Equivalence of Product Standards Certified By Sections from the Code Florida Licensed Professional Engineer or Architect W621 R4 Eauly &gUbtj& 104.11.2 1708.3 hffrm*/^-wWahttiWlnnewn1nr1nr arvn IM2018 Florida Building code Online Product Approval Method Date Submitted Date validated Date Pending FBC Approval Date Approved Method 2 Option B 08/18/2017 DS/18/2017 08/23/2017 10/10/2017 Summery of products FL # Model, Number or Name 7621.1 _ OSS / Aluminum Skin Limlts of Use Approved for use In HVHY: No Approved for use outside HVH,Z: Yes Impact Resistant: No Design Pressure: N/A Other: For outdoor patio construction only. For use outside the HYHZ only. See installation Instructions for allowable span/load combinations. Description PS Foam Core Composite Roof Panels Installation Instructions Verified By: Frank L. Bennardo, P,E. PE0046549 Created by Independent Third Party: Yes Evaluation Reports E"1 Created by Independent Third Party: Yes 07-1124 The State of Florida Is an AA(EEO employ*. :: eftyAQL. ffi ;: :: IS&bgW tsM" Under Florida law, small addresass are public records. If you do not want your e-mail address released in raslmnsa to a public -records rewast, de not aeW electronic mall to this entity. Instead, contact the affeee by phone or by traditional mail, If you have any qtmsticm, please contact 850.487,1395. RPursuarrt to Section455.275(A), Florida Statutes, affective October 1, 2012, licensees Ilow" l under Chapter 455, F.S. must provWo the Department with an emaif address Ifthey haveone. The emalis provided may, be vW for official communication with the Ikens". However *nail addreeses we public record. If you do not wish to supply a personal address, please provide the Department with an ornall address which can be made available to the public. To determine If you are s Icanses under Chapter 455, F.S., plaase dick hKL. Prodk"IAppmvel Accepts: Credite Safe hftr\a•ffarui,iahirll'lir n nmfnrf..R ne.n eltl oa..v7n...aa.........f_'C\l11r1..ARw.Ai.....u...Cdl+r...f\r}1»oA ooE r.at t_._.. .u.n... , lllRs 1< PERMIT A Application No: Documented C;o struction Valuct job Addnnm- IlistoricDistrk1:Y`es0NoE1 Parcel It): Residential El commercial Q, Type of Work: New El Addition El Attention E31fiepairEl DemoE] Change of Use [I MoveEl Description ofWork: C-,a--"C.,)L QA3 ------- Plan Review Contact Person: Phofte! Fax - Pro rtyOwner information Name e , 1 7Phone:ei Resident o(proper1y?:__._. City, State Zip: Contractor Information Phone Street (4, i _ 3 City, StateL V_ State LicenseNo.: Architect/Engineer information Name. Phone. Street! ---- — ---- Fax! —_ City, St, 7ip.. Vmail: Bonding Company: Mortgage Lender: Address Addrtw.______. WARNINCTOOWNFAt. YOUR FAILVRE10 RECORD A NOTICEOFCOMMENCFAEN't MAYRESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NO' " icF. OF commmumExt mvsr RE. RECORDED AND Posm,o ON Tim, ionSm. twrokc -rHE Fjwt wspvctiolii. IF YOU IMTENOTO ORTAIN FINANCING, CONSU11' WITH Yt)VRI,FNDF, RORANATTORNEY OIii'ORKRF,CORt)IW.Yt)VRNOTICE OFC.OMMF.N(:F.Mfxi' Apl4k,.lioui,, ticmiqniik io,"aia A 1v ... iln, do Ilk, %,nk and imAatUfiom as iiulkil,,d, to tIa ;,Alunl —it dw A _ k Wdl tw reltiWMA al amcl siaruho,ls or all 13— in lhk ju"klkiil. I buidttumw that i wpianat p"mh nnim be wund (" dftakat wvatk, plun&n& sagas, wvlk panda, rat wim bikm "tiem laA%, akd.,Jr tomiWomm etc. r UKC aEq+(20171 FhW6U unjtdjnx(:,wlcNfU'14,1I. a Wili— I. III, Nniftowl", 40*, F-mil, that wary beIi.n.1 in ttw I"44k fromothera,r 'Mwimp-Wol '1060" 'C"I tify lb" [—I—I) of fl. 14-nti IJ,. PS 7),4. flu ( if of "'Icons tvfnwrrt of apfan "'W" 1,, 44 11W tine` ed IxYtwa InI4,101A A (11PY f the ""Wd -air^j I, t,,pjjr,4fin"t'd "n"l— Ihm "'lov W 16-Iob"I Ifiv linw,.( I —MA, 4n. Umb kxA inrjivhnc 3hcntkl cakoLs"l aknp,Lure cl041the^cxvula1cr.4"Ittesuvcltnj —a,,ink fkm "t." ' "Ail "ll I".aptdictl)"' f""'A lece "111 OU'lWfinil QbMJC i- I certify that all of the foregoing i0tol'M4110" is accurate and that all work will he OraPlimcc with all applicable laws regulatingconstruction and - in compilim, AA"" Irstc I'li-14 111011, kWA - hair A• t- M"z.- EXPIRE$ A09wM17, 2040 Owncr(Agera is Pemonally Kaiowri to Nic or Confraclor/Agvia is Proatnxil 11) j,yin,"f1j) I'Mmmally Known to I Ate or proIlmed 11) -------- -- --- Type of 11) RELQWB My Permils Required. tioildiog El iiiectril:ai Mechanical 11 Plumbing 11 (;as El Roof D Cons4ructionType --------- Occupancy Use. 1-1004 Zone-, TotalSq Ft of Min. Occupancy --itofstorim New Constntdion:FJcctric-* o(Amps_ ...... , It ofl'ixtures Fire Sprinkler Permit. Yes F-1No [ * of HeadsFire Alarm Permit: Ycs El No a - APPROVALS: ZONING: . tj, jjLF1*1F*S: - , -- WAl"T" WATER: COMMENTS: ENGINEERING:_._ FIRM:..__ BUILDING: AIWA Contractor Registration Application P. 0. Box 1788, Sanford, FL 32772-1788 Phone: 407.688.5150 Fax 407.688.5152 Email: building(q),sanfordfl.gov Date. Business Name: (NC QAJ Business Mailing Address: —1Le-----4A)- xtc-2t-2 City: —6-State: Zip: r-, Business Phone: (p- Fax: Ld 4C Name of Qualifier on State License: CIA, 0,66" l XY} State License Classification: State License Number: ac I q icant's Signature A registration fee is not required. We do not mail confirmation of registration. State Certified Contractors: State license from Department of Business and Professional Regulation. Certificate of workers compensation insurance AND general liability with the City of Sanford listed as the certificate holder. If faxed or entailed it MUST come from the insurance agent/company. Certificates from contractor's offices are not accepted. Copy of valid business tax receipt State Registered Contractors: State license from Department of Business and Professional Regulation. Current Seminole County Comp Card Certificate of workers compensation insurance AND general liability with the City of Sanford listed as the certificate holder. If faxed or entailed it MUST come from the insurance agent/company. Certificates from contractor's offices are not accepted. 9 Copy of valid business tax receipt Specialty Contractors Certificate of workers compensation insurance AND general liability with the City of Sanford listed as the certificate holder. If faxed or entailed it MUST come from the insurance agent/company. Certificates from contractor's offices are not accepted. Copy of valid business tax receipt Control # City Registration # Rev, 07.16 Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: I hereby name and appoint: led DU 6 '1_14-e- an agent of t, CA ot tv A_ il t* r Nameof 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): F]`- The specific permit and ap lication for work located a 7 Street Address) Expiration Date for This Limited Power of Attorney:_ License Holder Name: State License Number Signature of License I STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this/? day of ' k-' —, 20t_. , by who is Rji6rsonally known to me or o who has produced identification and who did (did not) take a h. Signature Notary Seal) STEVEN P 14OPKINS MY COMMISSION# FF904588 EXPIRES Au" 17,2019 F1wKWNQW1ySWW_* WM Print or type name Notary Public - State of C1 Commission No. Cir,c;t4 i_ali My Commission Expires: as Rev, 08,12) Grant Maloy, Clerk Of The Circuit Court & Comptroller Seminole County, FLlnst#2018'144821 Book:9273 Page:89; (1 PAGES) RCD: 12/27/2018 3:35:02 PM RE,C FEE $10.00 THIS INSTRUMENT PfitEPARED BY. Name: Addresi•_ !I' Prioed NOTICE OF COMMENCEMENT Permit Number. Parcel ID Number. 50D — 0 12D '00"$0 The undersigned hereby gtvas 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 OF PROPERTY: (Legal description of the property and street address if available) 6) -7 aZ 3 27 -7 2 GENERAL DESCRIPTION OF INIP&OVEMENT: eh-L welgoe 3. OWNER IN#6RmATiQN OR LESSEE IkFORM&ION IF TA LESS CONTRACTED FOR THE IMPROVEMENT. Name and address: lAq Lo!i (4, ry-A LLC Interest in property. i Fee Simple Title Holder (if other than owner listed above) Name: Ak CONTRACTOR. Name: 0"V-L 0141A-e MCLL-n W% Phone Number. Address. tcpou zN00 ( R' - 12) 2 x n I L,-,) -7 5. SURETY (ifapplicable, a copy of the payment bond Is attached): Name: 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 713.13(1)(a)7., Florida Statutes. Name: Phone Number. 8. In addition, Owner designates of to receive a copy of the LienWs Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number 9. Expiration Date of Notice of Commencement (The expiration is I year from date of recording unless a different date is specified) WARNING T_Q 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. SiW%ahirw ofOwner oF Losses. or owner's or Lessee's (Prim Norm and pfowde, s4F%!!W0 ntwofte) fut"ized Offi—AW-1-1pa—M-090r) State —County of 016LI140e The foregoinginstrument was acknowledged before me this eeftAe,- day of o2 7 20 le by Cle,11 . Who is personally known to me "R Name of person mawq stawrent who has produced Identification 0 type of identification produced: ISet, STVAN P 140PIV STEVEN P No MY COMMISSION p F. MYCOMM ISSION 0* EXPIRES August 17