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112 Hughes Ave 15-2571 (re-roof)
CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: Z ! d52( Documented Construction Value: $e`J" Job Address: Historic District: Yes No 'aw Parcel ID: s ', J ©l%/t% Residential Commercial CM 1 e of Work: New Addition Alteration Re air Demo Chan e of Use Move Type P ' g Description of Work: t— ( ( zy' S Plan Reviieeww Contact Person: % j / ' Title: S . Phone: 7G%'ao 7 %%/' Fax: Email: Property Owner Information Name edP/' Phone: Street: ,`.G ADS Ale Resident of property? City, State Zip: .4/> lfd A_ 302?71 Contractor Information Name ' Ly i L O cam/ Phone: Ab 277,/ Street: Fax•s'Z City, State Zip: d0111dzhG 3z__SO State License No.: d&adya.390 Name: Street: City, St, Zip: Bonding Company: Address: 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: 5t6 Edition (2014) Florida Building Code RavigM- hmr In 9015 Prnnit Annliratinn 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 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 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 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 be done in compliance with all applicable laws regulating.ei Signature ofOwner/Agent Date , Sign Print Owner/Aeent's Name Signature ofNotary -State Print accurate and that all work will Signatureo'Notary- a e o rida - * '"Y'U bFF 173590 p Z9 : #FF 173690 8of • ` Owner/Agent is sonally +r 1plgl S Contractor/Agent is Persona Produced ID Type of ID Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type: Occupancy Use: Flood Zone: _ Total Sq Ft of Bldg: Min. Occupancy Load: New Construction: Electric - # of Amps. Fire Sprinkler Permit: Yes No # of Heads Il Q -T1W4VM11]W*WiIL 0; ENGINEERING: COMMENTS: UTILITIES: of Stories: Plumbing - # of Fixtures. Fire Alarm Permit: Yes No WASTE WATER: BUILDING: Rnvigp& bmP 10 ?01 S Prrmit Annliratinn s SCPA Parcel -View: 31119-31-525-OA00-0070 http://www.scpafl.org/ParcelDetaillnfo.aspx?PID=3119315250A... Clcnrld Jolx aori. C:F;4 PROPERTY APPRAISER SEAANgl1? COUNTI: FLORIDA Parcel:31-19-31-525-0A00-0070 Property Record Card Parcel: 31-19-31-525-DAD0-0070 Owner: KNIGHT REBECCA Property Address: 112 HUGHES AVE SANFORD, FL 32771 Property Address: 112 HUGHES AVE Owner: KNIGHT REBECCA Mailing: 112 HUGHES AVE SANFORD, FL 32771-3901 Subdivision Name: WASHINGTON OAKS SEC 2 Tax District Sl-SANFORD Exemptions: 00-HOMESTEAD (1994) DOR Use Code: 01-SINGLE FAMILY Legal Description LOT 7 BLK A WASHINGTON OAKS SEC 2 PB 16 PG 87 Taxes Taxing Authonty Assessment Value Exempt Values Taxable Value County General Fund 58,651 33,651 25,000 Schools 58,651 25,000 33,651 Cty Sanford 58,651 33,651 251000 S3WM(SantJohnsWater Management) 58,651 T $ 33, 651 25,000 County Bonds 58,651 33,651 25,000 Sales Des xxption Date Book Page Amount Qualfed Vac/Imp WARRANTY DEED l 1/1/1973 100989 10488 17,400 Yes Improved rno uomparaDe saes wurn ms b"ivrson Land Method Frontage Depth Una Unts Price Land Value LOT j 1 13,500.00 1 $13,500 Building Information I DesaotiDn Y earBult Live I Fixtures Base Area I Total SF I Living SF I EA Wal I Adj Value Repl Value Appendages 1 of 2 7/14/2015 1:53 PM Pat Lynch Construction LLC 909 Dennis Avenue Orlando, Florida 32807 NOTICE TO PROCEED Subject: IFB Contract for Roofing Repair and Replacement Services for Residential Properties. PO # 36705 ***Total Order $6350.00 Address:112 Hughes Ave Sanford FL 32771 Parcel ID #:31-19-31-515-OA00-0070 Contact person: Rebecca Knight Phone Number: 407-323 2108 The services provided by our firm shall begin on 071612015 and shall reach final completion 30 days from Notice To Proceed, as described in the contract documents. The timely and accurate performance of the work set forth in the contract documents is important to the County. It is also a primary consideration for the contractor selections on future projects. Please acknowledge -below, retain -a copy for your records and return the original to the Seminole County Community Development Office. Do not start the job until the required permits have been obtained and the work scheduled. Please email a digital copy of Roofing permit to: isandlev@seminolecountyfl.gov Upon completion, please notify the Construction Project Manager and submit a copy ofthe inspection final. ti We are glad to have you as part ofthe County's project team and we look forward to a successful project. Sincerely, Construction Project Manager CommunityDevelopment Seminole CountyGovemment Phone. • 407-665-2376 Far 407-6652399 wwwseminolecoun o,&.00v R ACCEPTANCE OF NOTICE is hereby acknowledged, this day of Title: K 5 I City of Sanford Roof Permit Application Checklist All permit application packages must be complete prior to acceptance. You must check each box to the left 'r 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. Copy of applicable contractor's license issued by the State of Florida (ifthe contractor is the applicant). A site specific notarized power of attorney shall be required from the licensed contractor if E J/ he/she appoints an employee of his/her company to sign the permit application as the contractor. Certificate of insurance indicating worker's compensation insurance coverage and naming the City of Sanford as certificate holder, or a copy of a worker's compensation exemption issued by the State of Florida (must be submitted with each application if contractor is the applicant). Completed and signed Owner Builder Statement / Affidavit (if the owner is the applicant). These guidelines were compiled to assist the applicant in preparing a roofpermit application and may not be complete. The applicant is required to meet all City ofSanford, state, andfederal code requirements. ifiii RIC.0 iiiii €sli THIS INSTRUMENT PREPARED BY: Name: A Address: 3Zgc7 NOTICE OF, COMMENCEMENT State of Florida County of Seminole Permit Number: 11NItYM,IHE 110F,-•Ei 611111t•H?i_[: t:t I1Pd!' ERR, t :. rr•. 1F C]:IiC:ili C:I:tIJF:'i P-g t 1 (1 f'.-g4 CLERK'Sro 2015188707 RE f.tl L-I. M, I:C fJRt1::I'aG I"t•:I:.S *1,li,tjlt I:ECOR ED BY Parcel ID Number: 5c ^31 —SZS— a" QQ-M 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) GENERAL DESCRIPTION OF IMPROVEMENT: A own Nam Addr Fee Simple Title Holder (if other than owner) Name: Address: CON Nam Addr 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: 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 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 best of my knowledge and belief. 4z - W.. Willfis.1". Owner's Sign.016re Owne s Pri@ 1) SAM,liifr Florida Statute 713.13(1)(g): " The owner must sign the notice of commencement and no one else may benitte.6GtB q jrgj igF7"'stead." AUG o AR NNE MORSEv' eCIRCUIT COURT AND s LER COUNTY, FLORIDA 1; h s ccoo to SAW,S'I' m9" z; n•Inw2c: Q CLERK ACORa CERTIFICATE OF LIABILITY INSURANCE ATE (MM/DDIYYYY) r03/24/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: Ifthe certificate holder is an ADDITIONAL INSURED, the policy Iles) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER FrankCrum Insurance Agency, Inc. 100 South Missouri Avenue Clearwater, FL 33756 CONTACT NAME: PHONE(A/C, No, Ext : 143OD-277-1620 x4800 FAX A/C No): 2 797-0704 E-MAILADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: Frank Winston Crum Insurance Co. 11600 INSURED FrankCrum UC/F Pat Lynch Construction LLC 100 South Missouri Avenue Clearwater, FL 33756 INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 313343 REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEENISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIESDESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSRD SUBR Wvo POLICY NUMBER POLICY EFF MMIDDNYYY) POLICY EXP MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO RENTED PREMISES Ea otxLtrena: COMMERCIAL GENERAL LIABILITY CLAIMS -MADE =OCCUR MED EXP(Any we person) PERSONAL d ADV INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG POLICY PROJECT LOC AUTOMOBILE LIABILITY COM a accidentBINEDSINGLE LIMIT ANY AUTO BODILY INJURY Perperson) ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) HIREDAUTOS NON -OWNED AUTOS P er accidentROPERTY DAMAGE S UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCURRENCE S AGGREGATE EXCESSLIARDED I RETENTIONS A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N WC2015000OO 01/01/2015 01/01/2016 X WC STATUTORY OTH- EL EACH ACCIDENT 1,00,0DO ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? 0 N/A Mandatory In NH) Ifyes, describe under EL DISEASE -EA EMPLOYEE 1000000 DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT S1.000.000 a. f,EtDESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks, Schedule, If more space is required) Effective 11/25/2013, coverage is for 100% of the employees of FrankCrum leased to Pat Lynch Construction LLC (Client) for whom the client is reporting hours to FrankCrum. Coverage is not extended to statutory employees. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE City of Sanford PO Box 1778 Sanford, FL 32772 1988- 2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD CITY OF SANFORD BUILDING SERVICES r Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: hereby acknowledge that I personally inspected oof deck nailing and/or Secondary watrbarrier work at j/a 4%061- 5 &-0- and have determined that the work Job Site Address) was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.) I certify that my. -statements herein are true and accurate to the best of my belief and that I fully understand that making any false statements in writing with the intent to mislead a public servant in the peXfefmance o his or hTr_ duty shall constitute a misdemeanor of the second degree pursuant to Min 01RWF/cpi"__ 'c 4 Printed Name of • A • License Type: General Building Residentia 468 00fing Contractor or any individual certified in accordance with S. to make such an inspection. STATE OF FLORIDA COUNTY OF-1 Sworn to (or affirmed) and subscribed before me this day of20, by who is;F Iersonally Known to me or has Produced (type of identification) as identification. SEAL) Signature of Notary Pub-11c State of Florida Print/ Type/Stamp Nam ` .• oMMlssj SpF9of Notary Public a*uarY2tttts a