Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutROOF1403-0174-ApplicationContact Person:
City of Parkland
Building Permit Application
www..ciitvofparrkland.ors �] (y
1 D �a
Phone #: fc9 i,"9)4i E-mail: f-.11'1 \ �t Vti
ALL OF THE FOLLOWING MUST BE FILLED IN BY APPLICANT, ACCORDING TO F.S. 713.135
Company Name R C rn Q L63 iL oof 1(.1 6I k-
Business Address I b9 5 � �� � Ln Date
Master Permit Number,4 ,//03.7),/ 7 Y
3120 1 ��
City State Zip
\-301)C rl-bq 3)3-17
Property Owner's Name ( {/�\,,, ?
Owner's Street Address
City
2fl4)\coo
Ph ne #
(9s ?SS- 1I
6L9P o\.)--\, "It')
State Zip Phone #(1 Sc�) �j L 1.) ) 2
Job Site Address �1 9`1 Cj b ltd
Lot
Work Description: I&be _, Co- its
Construction Value %j ?, 310 u DO
Engineer's Name
Engineer's License #
Phone #
Architect's Name
Architect's License #
Block U Phone #
Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of permit
and that all work will be performed to meet the standards of all laws regulating construction in the City of Parkland, Florida. I understand that a separate permit may be
secured for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, BOILERS, TANKS, AIR CONDITIONERS, ROOFING, SHUTTERS, ETC.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT
Contractor } r+
Notification E-mail: C r /11' 1 ` ��.� �`� ���, • i)~�
Privy acne of Oticialifier ilder:
:JI S , ?rill
License number:
Signature of
caL
/ f
�, /
On this l;Q day of !VI� 11 , 20 0\ , t�efore me, the undersigned
Notary Public of t Statq f Florida, personally appeared
i
��>nbiT and whose name is subscribed to and within
the instJment, and he/she acknowl¢dges that
,he/she executed it.
NOTARY PUBLIC, STAft OF FLORIDA
L./.;t, v / /�
PRINTED NAME OF NOTARY IUBLIC
C] Personally known to me
C] Oath taken
NOTARY PUBLIC SEAL OF
OFFICE:
Application Approved By:
Permit Officer
E
La)( C
9- Produced identification
O Oath not taken
MARILYN BLANCETT
\,� ; Notary Public - State of Florida
t4-0\':•_ My Comm. Expires Oct 30, 2015
Commission # EE 132703
Bended Th rn irh N�tippal N'ta,y Acsa.
Property Owner
Notification E-mail: (' G- AC)` 1( i
Print Name of Property Owner:
Owner's Address:
.61A0 \rJ b TerV'
Signature offerty Owner:
rf 1 Ct-41, ) ,,r 1,(c
On this'7 day of TL.13114111', 20 t i , before me, the undersigned
Notary Public of the State of tlorida„personally appeared
se, ,ame is subscribed to and within the
he/she executed it.
instrument
NQT Y PUBLIC, STATE QpiORIDA
PRINTED NAME OF NOTARY PUBLIC
* Personally known to me ❑ Produced identification
❑ Oath taken O Oath not taken
NOTARY PUBLIC SEAL
OF OFFICE:
Date:
s'( Notary Public State of Florida
Robert J Chambers
My Commission EE009596
or no Expires 07/18/2014
Electrical Contractor:
Business Address:
License #: Estimated Construction Value:
Phone #: Notification E-mail:
Qualifier Signature: Print Name:
The foregoing instrument was acknowledged before me thus day of ,20 ,by the above named person
who is personally known to me or who produced as identification who did/did not take an oath
Notary Public: My Commission Expires:
Plumbing Contractor:
Business Address:
License #:
Phone #:
Qualifier Signature:
Estimated Construction Value:
Notification E-mail:
Print Name:
The foregoing instrument was acknowledged before me thus day of
who is personally known to me or who produced
Notary Public: My Commission Expires:
Mechanical Contractor:
Business Address:
License #:
Phone #:
Qualifier Signature:
,20 ,by the above named person
as identification who did/did not take an oath
Estimated Construction Value:
Notification E-mail:
Print Name:
The foregoing instrument was acknowledged before me thus day of
who is personally known to me or who produced
Notary Public: My Commission Expires:
,20 ,by the above named person
as identification who did/did not take an oath
Landscaping Contractor:
Business Address:
License #: Estimated Construction Value:
Phone #: Notification E-mail:
Qualifier Signature: Print Name:
The foregoing instrument was acknowledged before me thus day of ,20 ,by the above named person
who is personally known to me or who produced as identification who did/did not take an oath
Notary Public: My Commission Expires:
Other Contractor:
Business Address:
License #:
Phone #:
Estimated Construction Value:
Notification E-mail:
Qualifier Signature:
The foregoing instrument was acknowledged before me thus day of
who is personally known to me or who produced
Notary Public: My Commission Expires:
Print Name:
,20 ,by the above named person
as identification who did/did not take an oath
PERMIT TREE
City of Parkland
PERMIT NO
SUB -PERMIT
SUB -PERMIT
SUB -PERMIT
ROOF1403-0174
PERMIT TYPE
STATUS
FEES CHARGED FEES PAID BALANCE DUE
DESCRIPTION
APPLIED ISSUED
JOBVALUE OWNER
REROOF
APPROVED
$936.50
$37,300.00
REROOF CONCRETE TILE & FLAT DECKS
03/20/2014
$90.00
TOTALOf ALL FEES
$846.50
CHARLES,GLENN M & HEATHER
PERMITS
FEES CHARGED
FEES PAID
BALANCE DUE
JOBVALUE
1
$936.50
$90.00
Driritcrl• Crirl3.. !1A Arril 1111A
1 of 1
$846.50
$37,300.00
r20 0•Ces
'WRAF RA!
Blank
Page
••14solist444,k,
INSTR # 112134632, OR BK 50589 PG 57, Page 1 of 1, Recorded 03/03/2014 at 03:05
PM, Broward County Commission, Deputy Clerk 1026
Permit k Folio #
NOTICE OF COMMENCEMENT
The undersigned hereby gives notice that Improvement will be made to certain real
property and N accordance with Chapter 713, Florida Statutes, the fobowhg information
is provided In this Notice of Commencement : . on ww, reser b „we
% re
1. Legal Description of Property: Lot BKKkG Unit 4 Bldg M ❑Lengthy legal attached
SubdivNbn lCeWyMnnnkirm p.\)Zj:) CS
Street Address If available:. 61/�0 AO hit -1 -AQ
'C` 1 �(Up ,-O'�/_
2. General description of Improvement : R..e r ry-'� I l o \ T \ 1 fit is O
.JJ14
3. a. Own., name and address:
b. Interest M prop.Ny:
o. Name and address of fee simple
titleholder l# other than Owner):
4. a. Contractor name and address:
b. Contractors phone number
5. a. Surety name and address:
b. Surety• phone number:
c. Amount of bond:
9. a. Lender name and address:
b. Lenders phone number:
IUI
1101i4 \a1LFc O.
7 Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.1311X.17., Florida Statutes:
Name:
Address:
b. Phone number.
Pt
9, a. In addltlon to himself or herself, for Owner desgnaNs
b. Phone number of person or entity designated by owner
e. Expiration date of notice of commencement
W .tetee a copy of Lamont Notice per Sateen 713.13(1Xbj, Florida
She e,0rarim des e 1 pow from the dee of nced.) 0600 a ekflren dee m rpadLW)
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
Signature(s) of NI r rileyAugtorized rlD1.ctor/ParherManeg.r
,,‘,...:)D,
. 1 C110.4-.-.1:...2 By
egrit Name (1 a 112,1,E ' eB► Nam.
Tltle1Ofdc.
Title/Office
STATE OF FLORIDA
COUNTY OF BROWARD I` ����
The Nuego��rrrr �i�ru�mnn was acknowledged before me thist1 day of
°y Nt+tzYT C�1 A � /
3Individually, or ❑ n for /
3 Personally known or ❑ produced the following type ofklelKcador
Sgnature of Notary Public:
Print Nams:LA(t_T
(SEAL) 11
VERIFICATION PURSUANT TO S5CTfON 92.525. FLORIDA STAMFA
Under sena/ties of perjury, I declare that I have read the foregoing end
that 91e tech stated In It are we, to the best of my knond.dge and bele.
sgna l of Ow as or Owner(syy�jwiised ONk*DirectortPartne
�B✓ ! r 7 f / lC G 1LTi% By
cy itrn.- o K
fyrwen flv.alnoc. nmc. of wrmedwwr .m07 307 roc
1,19
33-0-7b
r -.l
1 \L
Y /1
(Certifier's Letterhead)
RE -STRAPPING AFFIDAVIT
OWNER Heather Charles
PROPERTY ADDRESS 6280 N.W. 96th Terrace, Parkland 33076
PERMIT NUMBER
I hereby certify that:
X The existing roofing framing to wall connections are a minimum of 1/8 inch by 1 -inch strap
nailed with 3 16d nails minimum.
Approved strap ties or right angle gusset brackets with a minimum uplift capacity of 500 lbs
have been installed connecting the roof framing to the wall below.
A copy of this affidavit has been delivered to the homeowner. This affidavit is required for houses that
have an assessed value of $300,000.00 •r more or the structure.
Qualifier's signature
Name (Please Print)
License number
Richard A. Petrillo
CGC1508179 - General Contractor
(Florida Professional Engineer, Registered Architect, Licensed
General Contractor, Building Contractor, Residential Contractor or
persons certified in the structural discipline under FS 468
excluding Standard Roofing Inspector.)
The foregoing instrument was acknowledged before me this
day of
irg , 20/4, by C//14%Zt if l b (Namqmeof Person Acknowledging)
who is personally known to or who producedz., r %;)(1 5.74/(type of ID)
as identification who did l di take an oath.
Notary Public Signature
My commission Expires:
Rev 09/08
%NearillballhoilbodbodlixiYodboillimairde
,,., JASON M. VILLENA
Notary Public - State of Florida
My Comm. Expires Dec 19, 2014
Commission # EE 49996
14....41, .0* :oft,