100 Mayfair Ct 12-2403 (reroof)..thy
Application
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Documented Construction Value: $ 6' V00• 0a
Job Address: _JD0 �y �a, 4 94o�+ l f( 32 9 7l Historic District: Yes ❑ NoAK
Parcel ID: 3 3 -3-0 - Sy c- D C) 0 --0 a I o Zoning:
Description of Work:
r /� U r
�Q r _
Plan Review Contact Person: 3V_L? � Title:
Phone: .3 9y - 2b I(- �f ( (3 � Fax:
E-mail: _Q�-•n�&-v -to n1,A
I I Property Owner Information
Name Phone:
Street: 100 (L - Resident of property? : Z _s
City, State Zip:
nn Contractor Information
Name f t-' e" A4) Oro 0 1,. h c Sk i ki (c" Phone: 96 - 9 0 'f
Street: 9 2 4 eo 4,,- Fax:
City, State Zip: %( L ,-,, 4�-L 3 z ri 3 State License No.: �' e ( Z 8 9 3 C
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Building Permit ❑
Square Footage:
No. of Dwelling Units:
Electrical ❑
New Service - No. of AMPS:
Architect/Engineer Information
Phone:
Fax:
E-mail: _
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type:
Flood Zone:
Mechanical ❑ (Duct layout required for new systems)
e3I?
d U Al
No. of Stories:
Plumbing ❑
New Construction - No. of Fixtures:
Fire Sprinkler/Alarm ❑ No. of heads:
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.
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 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.
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.
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Si atur of tractor gent Date
Print Contractor/Agent's Name
0q./v./Y
DEBBIE BLANTON
Notary Public - State of FJ
My Comm. Expires Feb 25
='9Fo o Commission # EE 601
Bonded Through National Notar
Contractor/Agent is Personally Known to Me or J
Produced ID Type of ID t-� : a/a s I a
WASTE WATER:
BUILDING:
Rev 11.08
Elf ;
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r
0
, N a
SEMCrs ru
Mailing Address: 928 Potomac Ave Deltona, F132738
Phone:386-804-4109 Fax:386-626-8770
State License #:CCC1328730
Fully Insured
Company Name:
dJov �`L� C.'�� r�
Contact:
"-Ioh�
Date:,
�..�-f 2
Project Name:
Phone1:
Cell:
Street: "
Phone 2:
Salesman:
City, State, Zip: ;
Fax / e-mail:
Salesman Phone:
JU-U JY_EU1FJ1UA'1'10NS
PC
SINGLE FAMILY RESIDEN•yL4,L N C;UMERC IAL BUILDING IJ
TYPE OF EXISTING ROOF: (z La S '3 . -, , i,p CONDITIONS:
RE -ROOF: 7c,r, 4 - AJ
NEW CONSTRUCTION:
iJ �A REPAIR:1e` `A-j/' COATING: +0%4
REPLACE WITH NEW:
ROOF SLOPE:'
T
NEW ROOF COVER: A':
C+A:. l COLOR: '. ,� t^," ;i MANUF. WA NTY: aC A,)
11/2"LEAD BOOTS 1,
2" LEAD BOOTS
3" LEAD BOOTS 4" J.VENTS 10" J.VENTS
DRY -IN FELT DRY -IN PEEL STICK _; f
VALLEY 14 `.* WALL FLASHING (c1 TURBINES
DRIP EDGES -COLOR
RIDGE VENTS
: + 'OFF RIDGE VENTS z) /r`l SKYLIGHTS �3
DESCRIPTION:
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4Y 1Q6 '.l
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NOTE: PERMIT, CLEANING, HAULING DEBRIS, SCH INSPECTIONS AND 5 YEARS WORKMANSHM WARRANTY ARE INCLUEDED IN EVERY EMPIRE
ROOFING SVC JOB EXEPT IF SOMETHING DIFERENT IS ESPECIFIED.
Wood work is included in price: (Lab & Mat) Yes ;` No
Sheet ofplywood included 0;" A sheets. WOODWORK PRICE WILL BE EXTRA
PAYMENT TO BE MADE AS FOLLOWS: r + ),
>> d
THIS PROPOSAL EXPIRES IN:
DATE'
/COSTUMER AUTHORIZATION
TOTAL: 6,��
CONTRACT..OR SI�NPTURE
THIS INSTRUMENT rwF-PA P—D BY:
Name: Empire Roofing Services
Address: 928 Potomac Ave Deltona FI 32738
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number:
Parcel ID Number:
MARYANNE MORSE, CLERK OF CIRCUIT COURT
SEMINOLE COUNTY
BK 07851'Pg 0001; (Ipg)
CLERK'S # 2012106999
RECORDED 09/10/2012 11:10:28 AM
RECORDING FEES 10.00
RECORDED BY T Smith
33-19-30-505-000-0010
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.
DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
Leg Lot 1 Mayfair Villas PB 22 Pgs 9 & 10
100 Mayfair Ct Sanford, FI 32771
GENERAL DESCRIPTION OF IMPROVEMENT: Y
Complete Roof Replacement
�� Y pNN OOVR1
C�E(tK Of pUN�' E�0
OWNER INFORMATION: SEM1,
Name: Elizabeth G Bridges
Address: 100 Mayfair Ct Sanford, FI 32171
Fee Simple Title Holder (if other than owner) Name: c
Address: N/A J
CONTRACTOR:
Name: Empire Roofing Services, Lic
J Address: 928 Potomac Ave Deltona, FL 32738
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)(b), Florida Statutes.
Name: N/A
Address:
In addition to himself, Owner Designates N/A 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 date is specified) N/A
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 best of my knowledge and belief.
CS
1, CLI(3Gif C� /R l�C--S
Owner's Si nature Owner's Printed Name
Florida Statute 713.13(1)(g): " The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead."
State of 7-L County of �
The foregoing instrument was acknowledged before me this d day ofP)�tA, , 20
by 2c,h _ �t �_ Who is personally known to me
Name of person making
OR who has produced
i�''F OF F`Qp`�•
en :ficatio produced:
,$SET PEREZ
Notary Public - State of FI2p12
My comm. Expires Dct u,
Commission # DD
Nota Signature
Ulty of Sanf&d
BUILDING DIVISION
RE: Permit # - 2140
Inspection Affidavit
�j
16 L ,licensed asCn)C�ontractor*gineer/Architect,
(please print name and circle Lic. Type) T—,,--4n L?uilding Inspector*
License #; (.C.� l-3.2 0o �% 3
On or about q- j - `Z V : 00 FXf , I did personally inspect the roo
Date & time _
deck naaling and/or secondary water barrl�r work at OD 0-
(ctrct�on`T`� (Job Site A ress)
ff
Based upon that examination I have determined the installation was done according,to the
Hurricane Mi 'gati-or�t Retrofit Manual (Based on 553.844 F.S.)
S' atur
Jam_........ '
STATE OF FLORIDA
COUNTY OF
Sworn to and subscribed before me this w) day of _ ��- ,fie: ._. • 20®'7
L% By 10QD4woLs �-
.........
Y.P., LISSE1 pEREZ
:Notary public -State o1 F1201id
oMm
Expires Oct 5,
'�r9r oP:� M Corn scion # DD 828396
.•
Persona ly knowr�'` or
Produced Identification
Type of identification produced.
Notary Public, State of Florida
(Print, type or st gwaimc)
Commission No.:
* General, Building, Residential, or RoofingContractor or any individual certified under 468 F.S. to make such an
inspection. Include photographs of each plane of the roof with the permit # or address # clearly shown marked on the
deck for each inspection.