905 13 St West - BR11-002078 - ROOFAUG 0 9 2011
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: Documented Construction Value: $ 3,2a0, 00
Job Address: C! S / .3iCf1---7 1'
1) WjL4:X_ Historic District: Yes
Parcel ID: 3 ro-- / 9 —3 o r S / S — oa no u mA v Zoning:
No L9_
Description of Work: , o L&:a;j 13 cig f ..A_ ./1% "'e S D 3
C
Plan Review Contact Person: Title:
Phone: Fax: E-mail:
Property Owner Information
a
Name Phone:
Street 0 Resident of property?
City, State Zip: _'_1_'&x,1
Contractor Information
V
Name 0211 L 4— Phone: " 7 7 — a s or *
0 0
Street: o Fax:
q
City, State Zip:
u 3 a i 63tate License No.: ( eC' c V
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Phone:
Fax:
E-mail:
Mortgage Lender:
Address: Address:
PERMIT INFORMATION
Building Permit X
Square Footage:y U Construction Type: No. of Stories:
No. of Dwelling Units: Flood Zone:
Electrical O
New Service — No. of AMPS:
Mechanical 13 (Duct layout required for new systems)
Plumbing IJ
I
New Construction - No. of Fixtures:
Fire Sprinkler/Alarm O No. of heads:
Application is hereby made to obtain a pen -nit 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, beaters, tanks, and
air conditioners, etc.
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.
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.
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 govenunental 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. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
Q %x
Signature of Own /Agent ate Signature ofContractor/Agent Date
Print Owner/Agent's Name Print Contractor/Agent's Name
6- 0—i es,rd irl. $-q-1
Signature of Notary -State of Florida U Date Si ature 0 -State Site bri-yate Rhonda
B Flagler My
Commission EE017303 34Qglra! 10/19/2014 Owner/
Agent is Personally Known to Me or Produced
ID Type of IDar+wna. beorw 4e"rO' APPROVALS: ZONING:
ENGINEERING: COMMENTS:
UTILITIES:
Contractor/
Agent
is Personally Known to Me or Produced ID
Type of ID WASTE WATER:
BUILDING: Rev
11.
08
A
r
PROPOSAL Page No.
Charles Coleman, Inc. of
State Certified Roofing Contractor
License #CCCO24429
140 East Michigan Avenue • Orange City, Florida 32763
386-774-2556
2247
pages
PROPOSAL SUBMITTED TO: PHONE: DATE:
NAME (-' B NAME:
STREET -J STREET:
CITY: CITY: STATE:
STATE:j , 'f % The use of a credit card does not give any warranty.
We hereby submit specifications and estimates for:
l
1101
Note: Bad wood replaced at cost plus 15%! (Labor and Material
We hereby propose to furnish labor and.matteriaisX complete ih1accordance'witth.'the-above:•specifications,"fo thesumof:-
r\ Ck " dollars ($ 3 P (I U ® ) with payment to be made as follows:
r
w
All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or
deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over -and above the
estimate. All agreements c ntingent upon strikes, accidents, or delays beyond our control. This proposal subject to acceptance within
days and is void thereaftyf9atithe option of the ygdersigned. The use of a credit card does nokgive any warranty.
Authorized Signature
6" ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are hereby accepted You are' authnriced to do work as specified. Payment will be made as outlined
above. ACC ESP T— / l Date •U . Signaturenature
Date Signature
INIINMNNUNMNAA IN iIN11NlINAl11111111N
THIS IN TR MENT REPARED BY: MARYAME MOR51:,, CLERK CF CIRWIT CtW
NaL SWNOLE COMITY Addres
aIj . RX 07613 Pg 0701; (lpg) SEMINOLE
COUNTY CLERK'S a 2033084033 State
of Florida FLORIDA'S NATURAL CHOICE RECO ED 08/09/2011 09,44243 AM REMIND
FEES 10.00 FUMM
8Y T Smith Permit
Number NOTICE
OF COMMENCEMENT Parcel
ID Number (PID) 3 6- 19 '-30 -Ws 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. OF
PROPERTY (Legal description of the property and street address f available) L
S 0 ii -10-- ,4- '71 / 0 .o ._t'-6- o,-/ n M U-7yr"VGENERAL
DESCRIPTION OF IMPROVEMENT OWNER
INFORMATION Name
and address: CONTRACTOR
Name
and address: r
Persons
within the State of Florida Desic by
Section 713.13(1)(b), Florida Statutes. Name
and address: In
addition to himself, Owner Designates J-
S -77R s Section
713.13(1)(b), Florida Statutes. Expiration
Date of Notice of Commencement: The
expiration date is 1 year from date of reco by
Owner upon whom notice or other documents may To
receive a copy of the Lienor's unless
a different date is ii1n
of to
0
4 To\ 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 IMPROVMENTS 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 ORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. ST
E OF F IDA COUNTY OF SEMINOLE OWNERS
SIGNATURE OWNERS PRINTED NAME NOTE:
Per Florida Statute 713.13(1) (g), owner must sign...... and no one else may be permitted to sign in his or her stead." The
foregoing instrument was acknowledged before me this 9)h day of 44'wj , 20L! by
Who is personally known to me Name
of person making staterflent OR
who has produced identification V • Lb type of identification produced VERIFICATION
PURSUANT TO SECTION 92.525, FLORIDA STATUTES. ARDER
UE T LT
E O MST
O JMY KNOWLEDGE AND BELIEFI DECLARETHATIEREADTHEFOREGOINGANDTHATTHEFACTSSTATEDINITSIGNATURE
OF NATURAL O
T /', R) (SEAL) Pb.
FJLIG p01v
Notary Public State of Florida Rhonda
8 Flogler a
My comm.e61on Fr-n,7aoa a,
w QW@d tt)ifanol4 Notary
Signatu