1210 W 19 Ct - BR17-003289 - ROOFb CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
i
1 2017 Application No: 7-3 C(
d Documented Construction Value: $ 6
Job Address: . A oJ Historic District: Yes No
Parcel ID: Residential Commercial
Type of Work: New Addition Alteration epair Demo Change of Use. MoveEl
Description of Work:
Plan Review Contact Person:
Phone: Ufl 7 -2-7 Z -3Q 2 Fax:
r
Email:
Title: n 1? r
Property Owner Information
LNameserPhone: z`6 7 ` 02 % )- 3 o
Street: WeST % h
Resident of property?
City, State Zip: of n fc r F19-7 7 1 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: 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: 51h Edition (2014) Florida Building Code Revised:
June 30, 20B 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 ofthis 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 ofthe 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 requiredinordertocalculateaplanreviewchargeandwillbeconsideredtheestimatedconstructionvalueofthejobatthetimeofsubmittal.
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.
Si tureofOwner/Agent Date Signature of Contractor/Agent Date
BSc —J(-) Jf-
Print Owner/Agent'sName. Print Contractor/Agent's Name
7
OSHA CA..Dt '-
Notary Public - State ut
Commission # FF 91553
My Comm. Expires Sep 3, 2019
londed p i I d nMe or L
TypeofID -432-34--)zc-? Signature
of Notary -State of FloridaDate 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: Flood
Zone: of
Stories: New
Construction: Electric. - # of Amps Plumbing - # of Fixtures Fire
Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No APPROVALS:
ZONING: ENGINEERING:
COMMENTS:
UTILITIES:
WASTE WATER: BUILDING:
Revised:
June 30, 2015 Permit Application
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
7-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 parry 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
I
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
or 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
mploy 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
HA
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
J 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
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.myflorida.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. S Lc.
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: / 2 e 1 `} h C • S G h E(1 J:J 3 '0
I, 1 pS e
and capable of
conditions spec
Signature
above.
Le r n a VA d e Z . , do hereby state that I am qualified
the requested construction involved with the permit application filed and agree to the
Form of Identification
Must be Photo ID)
Date
1`7
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
h.?C1ez 6
AFFIDAVIT OF BUYER (S) OF REAL ESTATE
STATE OF FLORIDA )
SS:
COUNTY OF SEMINOLE )
depose(s) and says:
This concerns the purchase and sale of real property in Seminole
County.
2. I (We) am (are) the purchaser(s) of certain improved residential real
property in Seminole County pursuant to a Contract for Purchase and
sale dated
3. I (We) have executed said Contract for the purchase of said property,
located at „ _ , _ /I . /-
11 address),
further identified in the records of the Seminole County Property
Appraiser under parcel identification number:
c3 (9" ' S I '• ( 1 - O C(Q the legal description of
which is:
S,n
4. The closing date for the sale of said property, pursuant to the Contract
is
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6. This affidavit is being executed for the purpose of identifying me (us
as buyers under the contract to assist in our application Boy ad + 1 to CO C1 C7 a
valorem tax exemption on homestead property for 20 and as
such, shall be recorded in the Public Records of Seminole County. 1 _ • C7 ... -w.
a
kY+tI SW'mot
1'.7 -rrFF gsClioon
A.i.k t\ iY, k-LO 1 N' _ g , r
y
BY
Pate -
FURTHER AFFIANT SAYETH NOT.
SES:
C, j,G'l r
Name:
Signature:
q,_0
Printed Name:
AFFIANT:
CL 4 ec-
Signature:
Printed Name:
IYIA Moot
Name:
RN and SUBSCRIBED before me this
ANT (S) ARE PERSONALLY KNOWN
AS IDENTIFICATION.
Nota y Public -State of Ffdida
My Commission Expires: S, 3,
day of v , 201=1.
PRODUCED
9 ,.. P .,, USNA CALDEYRO
Notary Public - State of Florida
5 : ; • Commission # FF 915539
My Comm. Expires Sep 3, 2019
7
Bonded through National Notary Assn.
i
r City of Sanford Building Division
Residential Re -Roof Inspection Policy & Procedures
PERMITTING REQUIREMENTS — NO PLAN REVIEW REQUIRED
This document (signed) along with an accurate and completed Residential Re -Roof Scope of Work are requiredtobesubmittedaspartofyourpermitapplication.
The Scope of Work must include all applicable Florida Product Approval numbers for all roof components thatwillbeinstalledontheproject.
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 SanfordHistoricPreservationBoard
INSPECTION POLICY & PROCEDURES
A Final Roof Inspection is the only inspection required for Residential (Single Family, Townhouse, MobileHome, Apartment and/or Condominium) Re -Roof Permits.
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 of work)
Digital Photographs (must include the permit number or address in each picture)
o Each plane of the roof, showing the underlayment installed
o Roof Deck Nailing Pattern & Spacing (including a measuring device or ruler)
o Roof Deck Nails used (including a measuring device or ruler showing size of nails)
o Underlayment Pattern & Spacing (including a measuring device or ruler)
o Drip Edge & Valley Attachment (including a measuring device or ruler)
o Shingles installed, nail pattern and location of nails
Skylights (if applicable)
o Digital photographs showing all installation components, per FL Product Approval
o Digital photographs showing all required flashing, per FL Product Approval
Failure to follow these specific guidelines will result in an affidavit provided by a Florida DesignProfessional (architect or engineer), certifying FBC code corn iance by personal inspection.
fCONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE:
F = D PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS:
STRUCTURE TYPE: INGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: `'J PLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY):
PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED * *
ROOF VENTILATION: O OFF -RIDGE O RIDGE O SOFFIT OPOWERED VENT
SKYLIGHTS: O YES (!NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12-4:12 O 4:12 OR GREATER
O TURBINES
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
HINGLE FL#
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IF APPLICABLE**
ROOF SLOPE: O LESS THAN 2:12 O 2:12-4:12 O 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O SHINGLE FL#
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
O INSULATED FL#
O TILE FL#
0 OTHER: FL#
SCPA Parcel View: 36-19-30-518-0100-0060 Page 1 of 2
Property Record Card
PfGsd6JaMwn`GFA Parcel: 36-19-30-518-0100-0060
Owner: GISCHLER VICTOR E
A MhW4M1,00k^1YProperty Address: 1210 W 19TH CT SANFORD, FL 32771 Parcel
Information Parcel
36-19-30-518-0100 0060 Owner
GISCHLER VICTOR E Property
Address 1210 W 19TH CT SANFORD, FL 32771 Mailing
711 S MYRTLE AVE SANFORD, FL 32771-2522 Subdivision
Name SAN SEM KNOLLS 1ST ADD W
Tax
District S1-SANFORD DOR
Use Code 01-SINGLE FAMILY Exemptions
Legal
Description SAN
T6 BLK 1 LOTSEM
KNOLLS 1 ST ADD 13
PG 65 Value
Summary 2018
Working 2017 Certified Values
Values Valuation
Method I Cost/Market Cost/Market Number
of Buildings 1 1 Depreciated
Bldg Value 41,485 1 $39 165 Depreciated
EXFT Value 5,600$5,600 Land
Value (Market) 18 000 $15 000 Land
Value Ag Just/
Market Value *' 62,085 $59,765 Portability
Ad1 Save
Our Homes Ad1 0 $0 Amendment
1 Ad1 0 I $0 P&
G Ad1 0 $0 W
Assessed
Value 62,085 $59,765W Tax
Amount without SOH: $1,138.02 2017
Tax Bill Amount $1,138.02 Tax
Estimator Save
Our Homes Savings: $0.00 Does
NOT INCLUDE Non Ad Valorem Assessments Taxes
Taxing
Authority Assessment Value Values Taxable Value County
General Fund 62,085 so! 62,085 Schools
5 $62080 62,085 City
Sanford 62,085 0 , 62,085 SJWM(
Saint Johns Water Management) 62,085 0 62,085 County
Bonds 62,085 $0 62,085 Sales
Description
Date Book age eZAmount Qualified Vac/Imp WARRANTY
DEED 1/1/1976 01102 1338 $17,900 3 Yes Improved Find
Comparable Sales Land
Method
Frontage Depth Units Units Price Land Value LOT
0.00 l 0.00 1 € $15,000 00 I 15,000 Building
Information Description
Year Built Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages Actual/Effective 1 ,
SINGLE 1962 51 2 1.0 [ 973 1,268 973 CONC $41,485 $65,074 Description Area FAMILY )
BLOCK OPEN
PORCH k , t 111
jUNFINISHED 24.00 http://
parceldetail.scpafl.org/ParcelDetaillnfo.aspx?PID=36193051801000060 11/8/2017
SCPA Parcel View: 36-19-30-518-0100-0060 Page 2 of 2
3 UTILITY
FINISHED
CARPORT ._.._
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Permits
Permit # Descriptions Agency Amount CO Date Permit Date
No Permits
Extra Features
Description Year Built Units Value New Cost
POOL 1 12/1/1979 1 ! $5,600 j $14,000
http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=36193051801000060 11 /8/2017