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Home My WebLink About101 Crown Colony Way (2)06 -�i Job Addre Parcel ID: CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: Is - _11 Documented Construction Value: $ I� Historic District: Yes ❑ No Z Residential X Commercial ❑ Type of Work: New ❑ Addition ❑ Alteration M Repair ❑ Demo ❑ Change of Use ❑ Move ❑ Description of Work: Plan Review Contact Person: U Al Phone: - Fax: Property Owner Information Name NARM M ��Qr Phone: Street: Resident of property? City, State Zip: Name Street: City, State Zip: Contractor Information ''��-�1 Phone: C'J I- Z Fax: ��t l_ State License No.: Architect/Engineer Information Name: k)A Street: City, St, Zip: Bonding Company: 1�A Address: Phone: Fax: E-mail: Mortgage Lender: AAA 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: 5"' Edition (2014) :Florida Building Code Revised: June 30, 2015 Permit Application 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 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 information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. 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 D Signature of C ntractor/ ent Dat Print Contractor/Agent's N ne Signature of Notary -State of orida Date TRISSA S KELLY MY COMMISSION # GG135698 •��'�{y'AY: EXPIRES August 17, 2021 Contractor/A Personally Known to Me or Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Gas❑ Roof ❑ Construction Type: Total Sq Ft of Bldg: Occupancy Use: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes ❑ No ❑ APPROVALS: ZONING: ENGINEERING: COMMENTS: Flood Zone: # of Stories: Plumbing - # of Fixtures # of Heads Fire Alarm Permit: Yes ❑ No ❑ UTILITIES: WASTE WATER: FIRE: BUILDING: Revised: June 30, 2015 Permit Application 2/1 /2018 SCPA Parcel View: 33-19-30-5QS-0000-0640 omid b ,CFA Property Record Card Parcel: 33-19-30-5QS-0000-0640 n�4icouvrv,F Property Address: 101 CROWN COLONY WAY SANFORD, FL 32771 90.01 cil w —4 N L � Seminole County GIS I Legal Description LOT 64 CROWN COLONY SUBDIVISION PB 61 PGS 76 - 78 Taxes - Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund $105,818 $50,000 $55,818 Schools $105,818 $25,000 $80,818 City Sanford $105,818 m $50,000 $55,818 SJWM(Saint Johns Water Management) —� $105,818 $50,000 $55,818 County Bonds $105,818 $50,000 $55,818 FSales Description Date Book Page Amount Qualified Vac/Imp SPECIAL WARRANTY DEED 12/1/2003 05156 1554— WARRANTY DEED 8/1/2003 04985 0279 $143,900 E $640,000 Yes No Improved Vacant Find--- Comparable Bain Land Method Frontage Depth Units Units Price Land Value LOT 1 { $40,000.00 1 $40,000 Building Information # Description Year BuiltActual/Effective Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages 1 SINGLE ! 2003 7 3 2.0 1,617 2,053 1,617 CB/STUCCO $145,601 $153,264 Description I Area FAMILY ` FINISH http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=3:31 9305QS00000640 1 /2 2/1/2018 SCPA Parcel View: 33-19-30-5QS;0000-0640 GARAGE 415.00 FINISHED OPEN PORCH 21.00 FINISHED Permits Permit # Description Agency Amount CO Date Permit Date 01500 02095 KITCHEN REMODEL SCREEN ROOM ON EXISTING CONCRETE SLAB SANFORD SANFORD $45,336 $3,950 5/30/2017 2/24/2005 02552 PAD PER PERMIT 101 CROWN COLONY WAY SANFORD $73,766 12/29/2003 8/4/2003 Extra Features Description Year Built Units Value New Cost SCREEN PATIO 1 11/1/2005 1 $851 $1,500 http://parceldetaii.scpafl.org/Parcel Detail Info.aspx?PID=3319305QS00000640 2/2 COLLIE ROOFING, INC. INSURANCE P.O. Box 520668 Longwood, FL 32752-0668 A r(,{ a tw GJ w Ph. (321) 441-2300 Fax # CC ^ f Lic. CCCO580058022 Date: 11December 7, 2017 1 Phone: 407-754-8433 Attention: Adam Mazur I Email: Ammazur75O�,Hmail.con1 Job Address: 101 Crown Colon Way —Sanford 32771 Collis Roofing, Inc. proposes to supply the labor and materials necessary to apply your roofing as follows: A) Remove old shingles and underlayment and dispose of properly. If existing ice and water barrier is encountered during removal an additional layer of synthetic underlayment will be applied over existing without removal to bare deck. B) Inspect existing decking for water damage and re -nail according to code with 8d ring shank nails. C) We will remove and replace rotten or deteriorated wood as indicated on page 2 of this contract. (Note: Wood replacement is not included in the total below). D) Collis Roofing, Inc. will provide all applicable permits. l . Supply and install code approved underlayment to deck using simplex nails. 2. Supply and install code approved valley liner and preformed 26ga galvanized metal along all valleys per manufacturer specifications. 3. Supply and install code approved 2 '/: fig lvanized painted eave drip and secure to the roof deck with nails around all eaves and rakes (Dnp eded e'coior XMla 4. Secure the eave metal with mastic and then apply Starter shmgles at all eave s with the seal strip at the edge of the roof. 5. Supply and install all flashings for plumbing penetratro� of oW , 6. Supply and install kitchen and bath exhaust vents , C,ol`or 7. Supply and install Hip and Ridge shingles as required. 8 Supply and install code approved roof vents as required. 9 Supply and nstall Architectural shingles per manufacturer's specifications and all applicable building codes (Sh�4 � e color--f�t�54� F _ 10. Build cricket and install flashing at chimney. I l:'tSupply and install new 6" seamless gutters to replace existing I2 (C�10 orb, _Collis Roofing Inc. will supply a 5 year workmanship coverage warranty upon completion. A manufacturer's warranty shall be furnished if called for above. The above work shall be performed in a substantial workmanlike manner for the sum of. Architectural Laminate Shingles 130NWH — S 12 300 Approved by Universal Deductible amount for Universal claim# 1702FL24004586 - $ �C7 0 0 U�Blessaddtfaol�wo�rkor�upgrades�arr�e�eque�st�, t�l>�eo®�i�racto, r agrees pt olectw�ll be completed W�ITH,�;;1`, �(D, C4iST��T®=:TDE OUST®MEItEX�EP�'T�T�EE�INSIJRANCEDEIDUC�+TiBI�E-J Canceiiat o 01 replacement contracts will be subject to a $500.00 fee for administrative expenses. Initial ( A' With payment to be made as follows: In Insurance check and deductible by commencement: Balance upon completion. Respe Date: Collis ctfully s bmill d: Joey McVay G f" 10pproved By: ) � � Roofing, Inc. ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAW (SECTIONS 713.001-713.37, FLORIDA STATUTES), THOSE WHO WORK ON YOUR PROPERTY OR PROVIDE MATERIALS AND ARE NOT PAID IN FULL HAVE A- RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. IF YOUR CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SUBCONTRACTORS, SUB -SUBCONTRACTORS, OR MATERIAL SUPPLIERS, THE PEOPLE WHO ARE OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE ALREADY PAID YOUR CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR, YOUR CONTRACTOR MAY ALSO HAVE A LIEN ON YOUR PROPERTY. THIS MEANS IF A LIEN IS FILED YOUR PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR, MATERIALS, OR OTHER SERVICES THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FAILED TO PAY. TO PROTECT YOURSELF, YOU SHOULD STIPULATE IN THIS CONTRACT THAT BEFORE ANY PAYMENT IS MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN RELEASE OF LIEN FROM ANY PERSON OR COMPANY THAT HAS PROVIDED TO YOU A "NOTICE TO OWNER." FLORIDA'S CONSTRUCTION LIEN LAW IS COMPLEX AND IT IS RECOMMENDED THAT YOU CONSULT AN ATTORNEY. Page 1 of 4 Initial 11111111111111111 Ili1111111111111111 fill GRANT 11ALOYy SEMINOLE COUNTY C1...ERK OF CIRCUIT COURT & COVIPTROLL_ER 13l< Qit7O Pq 1.16 (11"ssi C:LERK'S A 2018013706 RECORDED 02/136/201S Ij943,';;;__N- Al RECORDING FEES; $!0.00 RECORDED B1Y t srtl i th Permit Number: Parcel ID Number: The undersigned hereby gives notice that improvement Willi be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. DrESC�1P AN pF PROPERTY: (Legal description of the property and street address if available) 2. GENERAL DESCRIPTION OF IMPROVEMENT: um/ & aMLIA 3. OWNER INFORMAT O OR LESSEE INFORMATION JIF T EAESSIEE CONT CTED FOR THE IMPROV MENT: Name and address: Interest in ' property:. Fee Simple Title Holder (if other than owner listed above) Name: Address: 4. CONTRACTOR: Name: . Phone Number: Address: PO.®x 520689 5. SURETY (If applicable, a cojongW"fnid att3 : JA Address: Amount of Bond: 6. LENDER:Name:AAA Phone Number: Address: 7. 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)(a)7., Florida Statutes. Name: Phone Number: 8. In addition, Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number: 9. Expiration Date of Notice of Commencement (The expiration 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. 44", /* &,, vlt�//q zdaztIK— — (Signature of Owner or Lessee, or Owner` Lessee's (Print Name and Provide Signatory's Title/Office) Authorized Officer/Director/Partner/Manager) State of ty � County of ��Nmw@Uk 1 j The MA(�im oiinnginstrument was acknowledged before me this 1, day of I 20 1 byM M Lvcz� �� _ Who is personally known to e ❑ OR Name of person making statement n who has produced identifrcation�type of identification produced: MMQQ�__) l I , J1 >0.�•°�� TRISSA S KELLY * .MY COMMISSION # GG135698 ",� • • oa°c EXPIRES August 17, 2021 N A ®® �`i! CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 12/15/2017 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: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 CONTACT NAME: PHOFrank Ext: 800-344-4838 FAX AICNNo, No; (954)943-5417 H. Furman, Inc. E-MAIL ADDRESS: 1314 East Atlantic Blvd. INSURER(S) AFFORDING COVERAGE NAIC# P. 0. BOX 1927 INSURERA:Flrst Specialty Insurance Corp34916 Pompano Beach FL 33061 INSURED INSURERB:NOrth River Insurance Company 21105 C:American Guarantee & Liability Ins 26247 Collis Roofing Inc -INSURER INSURERD:FRSA Self Insurer Fund N/A P. O. Box 520668 INSURER E : 1 INSURER F: Longwood FL 32752 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN iSSUED TO THE INSURED NAMED 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDIYP ICYYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ❑X $ 50,000 A CLAIMS -MADE OCCUR PREMISES (Ea occurrence) X MED EXP (Any one person) $ EXCLUDED Contractual Included X IRG200225803 1/1/2018 1/1/2019 X XCU & Broad Form PD Incl PERSONAL & ADV INJURY $ 1,000,000 GENIAGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 RO POLICY ECT LOC $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO B ALL OWNED SCHEDULED X 1337427954 1/1/2018 1/i/2019 BODIL\' INJURY (Par accident) $ AUTOS AUTOS NON -OWNED X X PROPERTY DAMAGE Per accident $ HIRED AUTOS AUTOS Personal In ury Protection $ 10,000 X UMBRELLA LIAB X OCCUR AUC914077Ill 1/1/2018 1/l/2019 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 C EXCESS LAB CLAIMS -MADE Umbrella is Follow Form of DED RETENTION $ g the L WORKERS COMPENSATION X PER OTH- STATUTE ER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE EXCLUDED? N❑ N I A E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 D OFFICER/MEMBER (Mandatory in NH) 870033379 1/1/2018 1/1/2.019 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: Re -Roof Fleet Services Bldg. City of Sanford is listed as an Additional Insured as respects to General Liability, Auto Liability and Umbrella Liability as required by written contract. Umbrella is follow form over the GL, AL and EL. CERTIFICATE HOLDEK L ANL rLLA I IVN cathy.lotempio@sanfordfl.g City of Sanford P.O. Box 1788 Sanford, FL 32771 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 Dirk DeJong/JC ACORD 25 (2014/01) INS025 (201401) U 1V6t$-ZU14 AL UKU l UKt-UKA I IUN. All rl9rt15 r65UFVeU. The ACORD name and logo are registered marks of ACORD LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: �. I hereby name and appoint: an agent of: Ray Henderson Collis Roofing, Inc. (Name of Company) to bo my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things necessary to this appointment for (check only one option): rii and application for work located Expiration Date for This Limited Power of Attorney: License Holder Name: J. Douglas Lanier State License Number: CCC058022 0 Signature of License Holder: STATE OF FLORIDA !\!1� q,T- OF Seminole l VU1N1 I Vr The foregoing instrument was acknowledged before me this day of� 20�, by J. Douglas Lanier who is � personally wn to me or ❑ who has produced identification and who did (did not) take an oath. n Signature (Notary Seal) Print or type name Notary Public - State of Commission No. My Commission Expires: (Rev. 08.12) as TIRISSA S KELLY ;moo•. �: MY COMMISSION 9 GG135698 'Y,'F'of fro' EXPIRES August 17, 2021 F ,D 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 or indicate n/a on this submittal. A complete application package shall include the following: C� 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 (if the contractor is the applicant). 52,/ A site specific notarized power of attorney shall be required from the licensed contractor if 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 cony 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 roof permit application and may not be complete. The applicant is required to meet all City of Sanford, state, and federal code requirements. r lisp City of Sanford Residential Re -Roof F D Hurricane Mitigation Inspection Process 1. Roofing contractor shall be responsible for the protection of contents and structure at all times. 2. An in -progress inspection shall be scheduled after the old roof has been removed and the dry -in is complete. All components of the dry -in must be in place. To schedule an inspection, call 407.688.5151. 3. For roofs using an entire peel and stick dry -in, a nailing affidavit shall be required to be posted on jobsite at time of in -progress inspection. 4. A minimum of one hundred (100) square feet of the new roof component shall be installed at time of inspection. Up to fifty percent (50%) of the new roof may be installed, but all flashing and valley metal shall remain exposed for inspection. 5. The contractor shall contact the inspector the day of the scheduled inspection between 7:30 a.m. and 8:30 a.m. to coordinate the inspection time. Please call 407.688.5061 or 5063 6. At time of inspection the inspector shall, at his or her discretion, select location(s) for inspection. 7. A representative of the contractor shall be on job site to facilitate any necessary repairs. 8. After the inspection is conducted, the contractor will make any necessary repairs and proceed as directed by the inspector. 9. For approved inspections, the inspector shall collect the required affidavit for filing with the permit application. The above shall serve as the inspection process to meet requirements per Florida Statute. Any and all suggestions to better serve the contractor needs will be considered. 2 1 RD V � 6 s : 11 CITY OF Building & 14IPe-Mvenccvrc "J'" RESIDENTIAL RE IZOOFPOLICY & PROCEDURES PERMITTING REQUIREMENTS — NOT LAN REVIEW REQUIRED HIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE ROOF SCOPE OF WORK ARE SQUIRED TO BE SUBMITTED AS PART OF YOUR PERMIT APPLICATION. HE SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF OMPONENTS THAT WILL BE INSTALLED ON THE PROJECT. 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 )ANFORD HISTORIC PRESERVATION BOARD INSPECTION POLICY & PROCEDURES A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMILY, TOWNHOUSE, MOBILE HOME, 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 DECKNAILING 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, PERFI,PRAODP COT APPROVAL o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULCODE COMPLIANCE BYOVIDE PERSONAL INSPECTS N•,D BY A FLORIDA ESIGI�I PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC r oot^ DATE: CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: PERTIIT # City of Sanford Building Division ?� Residential Re -Roof Scope of Work JoB ADDRESS: STRUCTURE TYPE: KSiNGLEFAmiLYPEsiDENcElToWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM RE -ROOF TYPE: REPLACEM (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) RE- OVER (NEW ROOF INSTALLED OVER EXISTING ROOF) DECK TYPE (PLEASE SPECIFY): "PLEASENOTE: ONLYI00 SQUAR&E4tFTHE EX/STING DECK.ISPERMITTED TO BEREPLACED" ROOF VENTILATION: OFF -RIDGE Q RIDGE QSOFFIT QPOWERED VENT OTURBINES SKYLIGHTS: O YES XNO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: MAIN ROOF AREA ROOF SLOPE: 0 LESS THAN 2:12 Q 2:12 — 4:12 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL 36 SHINGLE FL# y RA 0 METAL FL# O MODIFIED BITUMEN FL# 0 TORCH DOWN FL# QINSULATED FL# O TILE . FL# Q OTHER: FL# ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) ""IFAPPLICABLE"" ROOF SLOPE: p LESS THAN 2:12 0 2:12 — 4:12 O 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL O SHINGLE FL# 0 METAL FL# Q MODIFIED BITUMEN FL# Q TORCH DOWN FL# INSULATED FL# 0 ThLE FL# 0 OTHER: I FL# ,_ CITY OF , A Bui[d' k , ire Prevention Division __-- _--- ----- — -- ---- --------- -------_--RESIDE t� RE:RO.OF_AFF_ID_AVIT -- FIRE DEPARTMENT RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #: ADDRESS: � ' f 1 1 , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR NTRACTOR ENG E R, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE FOREGOING INFORMATION IS TRUE AND ACCURATE AND THAT ALL ROOFING COMPONENTS LISTED ON THE SCOPE OF WORK AT THE ABOVE 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 REQUIUIREEMENTS (BASED ON F.S. CHAPTER 553.844). LICENSE #: l l COMPANY / CONTRACTOR: o CONTRACTOR SIGNATURE: �QL "� DATE: (MUST BE SIGNED BY LICENSE HOLDER O OWNE UILDER) A FINAL ROOF INSPECTION IS REQUIRED: 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 REFER TO 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 (ARCHITECT OR ENGINEER) TO CERTIFY, BASED ON PERSONAL INSPECTION, THE INSTALLATION OF ALL ROOFING COMPONENTS. STATE OF FLORIDA COUNTY OF Sworn to and Subscribed before me this 16 day of 20 by: State of Florida Print/Type/Stamp Name of Notary Public Who i4Personally Known to me or has D Produced (type of as identification. , 4PAr•PVB' TRISSA,S KELLY MY COMM(9SlON # GG135698 EXPIRES August 17, 2021