2850 Empire Pl - BR17-003163 - ROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: 3
Documented Construction Value: $
CEO Job Address: CSC..: Historic District: Yes D No.
Parcel ID: l (D" ` C — _ 0' 61 c c Residential IT -Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use. MoveEl
Description of Work: --
Plan Review Contact Person: G.K' s --- Title:
Phone:4&- . Email:
Name
Property Owner Information
Phone: ( ° ' v d
Street: Q .
City, State
Resident of property? : S
Contractor Information
Name Phone.
Street: Fax:./
City, State Zip: / State License No.:
Architect/Engineer Information
Name: Phone:
Street: Fax: Ion
City, St, Zip: E-mail: _
Bonding Company: Mortgage Lender:
in
Address: Address: V v
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
Permit Application
j9 -
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 ofthe requirements ofFlorida 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.
U. ( —7
Name.
U 5G: F7
1Y P'',84, . ANNETTE BLAND
Notary Public State of Florida
Commission # GG 060623
OF My Comm. Expires Jan 16, 2018Fly
Owner/ e o ownto -Me or
Produced ID Type of ID
Signature ofContractor/Agent Date
Print Contractor/Agent's Name
Signature ofNotary -State ofFlorida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type ofID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing
Construction Type: Occupancy Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
of Heads
UTILITIES:
Gas[] Roof
Flood Zone:
of Stories:
Plumbing - # of Fixtures.
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
OS
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.
1 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.
1
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:
i
do hereby state that I am qualified
and capable of performing the requested cons uction involved with the permit application filed and agree to the
cr7s specified above.
of Owner -Builder
Form of Identification
Must be Photo ID)
Date
Io 3O I l-;:
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
c
L
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
r 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 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 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.
YL 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
Cemploy 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. 1, 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
F, D
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), certifyin C code compliance b
7perso1
ins
OWNER/BUILDER)
ec tion.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE.-
PERMIT # — 4' 3
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS:
STRUCTURE TYPE
RE -ROOF TYPE:
INGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): I i( I Z
PLEASE NOTE: ONLY 10.0 SQUARE FEET OF THE EXISTING DECK IS PE
ROOF VENTILATION: O OFF RIDGE O RIDGE O SOFFIT
TO BE REPLACED"
OPOWERED VENT
SKYLIGHTS: O YES O IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: ESS THAN 2:12 O 2:12 - 4:12 O 4:12 OR GREATER
TURBINES
TYPE 9F ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE FL#
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
O INSULATED FL#
O TILE FL#
O OTHER: FL#
ROOF EXTENSIONS PORCHES PATIOS ETC. "IFAPPLICABLE"
ROOF SLOPE: ICJ LESS THAN 2:12 Q 2:12 - 4:12 O 4:12 OR GREATER
TYPE Offy'kOOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE FL#
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
I J THIS INS MENT PREPARED BY:
Name:U% r
Address: ' 150 ' ,-n i re
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number: (I — 31
111111111 1 111111111111111111111111111111
GRANTIIr;LOYg SEMINOLE COUNT'r'
CLERK OF CIRCUIT COURT & COMPTROLLER
CLERK'S x 2017149361
RECORDED 12'01:04 F'11
RECORDING FEES ` 1171.00
RECORDED BY Hevore
Parcel ID Number: ( )1 (0
y
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance. w tp
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
0
GENERAL DESCRIPTION OF IMPROVEMENT:
P
Fee Simple,Title Holder (if other than owner) Name:
CONTRACTOR:
Address:
P
Persons 4vlthin the State of Florida Designated by Owner upon whom notice or other documents may be served
as provided by Section 713.13(1)(b), Florida Statutes.
Name:
Address:
In addition to himself, Owner Designates of
To receive a copy of the Lienors 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 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 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, I declare that I have read the foregoing and that the facts stated in it are true
to the bes my knowledge and b f.
Owner's Signature Owners Pdnted Name
rid. Statute 713.13(1)(9): "The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead.'
State of t 0 ("1 A A County of
The f-o-r[egoing instrument was acknowledged before me this day of (r)C Q 1V _ 20
r)
by I C C2 60 (1,L( Who Is personally known to me
Name of person making statement
OR who has produced identification type of identification produced:
o*"'••, ANNETTE BLAND
Notary Public - State of Florida
y
O Ccriimission #t GG 060623 4 Notary signature
My Comm. Expires Jan 16, 2018hn„q
SCPA Parcel View: 06-20-31-505-OD00-0100 Page 1 of 2
Property Record Card
Parcel: 06-20-31-505-OD00-0100rPXPMROwner: GRANT JARVIS L & BRIDGET W
ARPJdL1e fXX.NIY flOrtUA Property Address: 2850 EMPIRE PL SANFORD, FL 32773
Parcel Information
Parcel
Owner
06-20-31-505-OD00-0100
GRANT JARVIS L & BRIDGET W
Property Address 2850 EMPIRE PL SANFORD, FL 32773
Mailing 2850 EMPIRE PL SANFORD, FL 32773-5291
Subdivision Name WOODMERE PARK 2ND REPLAT
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions 00-HOMESTEAD(1996)
Value Summary
2018 Working 2017 Certified
Values Values
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 65,183 61,491
Depreciated EXFT Value 1,688 1,738
Land Value (Market) 15,450 15,450
Land Value Ag
Just/Market Value " 82,321 78,679
Portability Adj
Save Our Homes Adj 32,827 30,203
Amendment 1 Adj 0
P&G Adj 0 0
Assessed Value
T
49,494 48,476
Tax Amount without SOH: $710.31
2017 Tax Bill Amount $447.01
Tax Estimator
Save Our Homes Savings: $263.30
Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description
LOT 10 BILK D
WOODMERE PARK 2ND REPLAT
PB 13 PG 73
Taxes
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund 49,494 25,000 24,494
Schools 49,494 25,000 24,494
City Sanford 1 49,494 25,0001 24,494
SJWM(Saint Johns Water Management) 49,494 25,0001 24,494
County Bonds 49,494 25,000 24,494,,
Sales
Description Date Book Page Amount Vac/Imp
SPECIAL WARRANTY DEED 2/1/1995 02887 1458 43,000 ENo 1 Improved
SPECIAL WARRANTY DEED 11/1/1994 02859 0398 100 Improved
CERTIFICATE OF TITLE 11/1/1994 02852 1303
rn - $
1,000 No Improved
WARRANTY DEED 12/1/1990 02253 43,00 Improved
WARRANTY DEED 11/1/1989 02130 0824 54,000 ` Yes Improved j
WARRANTY DEED 7/1/1986 01756 1382 45,000 Yes _ Improved
Find Comparable Sales
Land
Method Frontage Depth Units Units Price Land Value
FRONT FOOT & DEPTH 62.001 117.00 i 0 $280.00 1 $15,450
Building Information
Is Bed/Bath count incorrect? Click Here. _ _
Description Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages1
http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=0620315050D000100 10/30/2017
4)1 J
o City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
k -
PERMIT#: y ADDRESS:
A
I f%/ v , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
GROOR4 CONTRACTOR, ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE FOGOING
INFORMATION IS TRUE AND ACCURATE AND THAT ALL ROOFING COMPONENTS LISTED ON THE SCOPE OF WORK AT THE A
OVE REFERENCED ADDRESS HAVE BEEN INSTALLED IN ACCORDANCE WITH THEIR PRODUCT APPROVALS AND ALL APPLICABLE CODE REQUIREMENTS —
SPECIFICALLY FLORIDA BUILDING CODE, EXISTING BUILDING. IN ADDITION I CERTIFY THE INSTALLATION MEETS ALL REQUIREMENTS
FOR SECONDARY WATER BARRIER AND NAILING OF THE ROOF DECK, IN ACCORDANCE WITH THE HURRICANE RETROFIT . MANUAL
REQUIREMENTS (BASED ON F.S. CHAPTER 553.844). LICENSE #: .
1 / COMPANY /
CONTRACTOR: /!/t/ /// s E
CONTRACTOR
SIGNATURE: MUST
BE SIGNED BY LICENSE LDER OR A
FINAL ROOF INSPECTION IS REQUIRED: DATE: ((/
l.-
THIS
SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINAL ROOF INSPECTION, ALONG
WITH DIGITAL PHOTOGRAPHS OF EACH PLANE OF THE ROOF SHOWING IN DETAIL ALL COMPONENTS (DECKING, UNDERLAYMENT,
FLASHING, DRIP EDGE ATTACHMENT) WITH THE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON THE DECK FOR
EACH INSPECTION. THE PHOTOGRAPHS MUST INCLUDE A RULER OR MEASURING'DEVICE TO.CONFIRM ALL NAIL SPACING AND OVERLAPS,
INCLUDING DRIP EDGE AND VALLEY FLASHING. PLEASE REEF PTO THE RE —ROOF POLICY AND INSPECTION PROCEDURE PAPERWORK
FOR FURTHER EXPLANATION OF ALL REQUIREMENTS. FAILURE
TO FOLLOW ALL REQUIREMENTS WILL RESULT IN A FAILED INSPECTION,A. RE -INSPECTION FEE AS WELL
AS REQUIRING A DESIGN PROFESSIONAL (ARCHECTOIt 'ITENGINEER) TO CERTIF'Y, BASED ON PERSONAL INSPECTION, THE
INSTALLATION OF ALL ROOFING COMP,.ONENTS. aa. 5
STATE OF
FLORIDA COUNTY OF ino Sworn to
and Subscribed before me this `'C day of 20 by: Who -is [
J Personally Known to me or has WProduced (type of z Identifi ion)
y x v' I V w as identification. C Signature
of
Notary State of
Florida v °( ANNETTE 1) COLON Notary Public •
State of Florida mmi$Sion #
FF 9756,24 PrintfFype/Stamp
riw, My Comm. Ezpifas May 20, 2020 of Notary
Public