HomeMy WebLinkAbout106 Balboa CtCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $ ®.
103obAddress: (oCg &Abm cA-2L&�6=r1 311 13 Historic District: Yes ❑ No ❑
Parcel ID: -3 b - Sb 3 - Q 9,00 - O 19Ci Residential Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ RepailunemoEl Change of Use ❑ Move ❑
Description of Work: RjjYLt-( ETJ4_C9 ✓LZ-f-
bUr A rti.l-t.e__oi WA LW IL. S h L,( `Le f —) -E L S 4 4 y — ttb
Plan Review Contact Person: Title:�rc�n l�
Phone: �0�-S�'7 31� �1 Fax: Email: 5-vi njwu !� [ %C.[ ,(,�
Property Owner Information
Name N S(JIM
Street: I-O(Q :B CJ b0 Cl L4-
City; State Zip:
Phone:
Resident of property? : ye
Contractor Information
i
Name N ( a 'l �' S P �U`� i S.e-Jl.Z Phone: 0'1 -
Street: (—I-,A— Fax:
City, State Zip: Ca.0 al bL L11 fA '31 10-1 State License No.: I'SZ'01` LLi
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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: 5r' Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
, I
1
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.
� M � i� 021Q� ► l�
Signature c Owne Agent Date Signature of Contractor/Agent Date
Sum.Ack 2- ocks
Print Owner/Agent's Name
,, A -e J, v� $
gnature of Notary -State of Florida 11ate
t; v'a� ARIELMENDEZ
o s `
a ,`�. o.; Notary Public - State of Florida
Commission # GG 107645
9' �o`-` My Comm. Expires May 23, 2021
w' „ �gentl3dNed throe h QeDROtkokly own to Me or
e o toay-e (t,wi- —
M(1 Aa Fjo—°S
Pr nt C tractor/Agent's Name
N �Q
Signature of Notary -State of Florida
Date
ARIEL MENDEZ
Notary Public - State of Florida
t _
Commission # GG 107645
My Comm. Expires May 23, 2021
6crdedthrouShNational Notary Assn.
Contractor/Agent is
Produced ID Type
of ID V4-5t/,T
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:
# of Heads
UTILITIES:
FIRE:
Flood Zone:
# of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
1 /24/2018
SCPA Parcel View: 10-20-30-503-0200-0190
Pai
L
P
Property Record Card
Parcel: 10-20-30-503-0200-0190
Property Address: 106 BALBOA CT SANFORD. FL 32773-5544
76.67
76-67
-{-
79
69 41
ro
cw7
'
18
.egal Description
DT 19 BLK 2
IDDEN LAKE PHASE II UNIT 1
3 24 PGS 15 TO 17
axes
- - - -
uthority
faxing Authority
- --
-
Assessment Value
Exempt Values
I ----
� Taxable Value
..ounty General Fund
$74,854 ,
$49,854
$25,000
Schools
$74,854 !
$25,000
I $49,854
ity Sanford
}
$74,854
$49,854
$25,000 j
--
SJWM(Saint Johns Water Management)
$74,854 I
$49,854
$25 000 I,
Dounty Bonds
1
$74,854 1
$49,854
$25 000 1
;ales
Description
Date
Book Page
1
Amount
Qualified
i
Vac/Im'
_
NARRANTY DEED
i 6/1/2005
05862 if 1628
$175,000 Yes
Improved
NARRANTY DEED
6/1/2003
04867 1583
$119 000 Yes
Improved
NARRANTY DEED
11/1/1993
02698 1850
_
$54,100 Yes-
l
i Improved
�
-
NARRANTY DEED
; 9/1/1993
i 02654 �1852
!
$27,000 ; No
j Improved
NARRANTY DEED
17/1/1992
02454 ! 0578
'
$67,900 Yes
Improved
NARRANTY DEED
8/1/1990 02217 0299
I
$64,000 No
Improved
OERTIFICATE OF TITLE
10/1/1989
02115 i 0208
i
$100 No
Improved
NARRANTY DEED
if 12/1/1986
O'i$05 I-1031
$62,500 Yes
! Improved
DUIT CLAIM DEED v---
i 7/1/1986
01790 0457
-
$100 No
- Improved ul
SPECIAL WARRANTY DEED
1/1/1986
1 01702 1 0431
mm
$100 No
€ Improved
Dage 1 of 2 (13 items) [1] 2
http://parceldetail.scpafl.org/ParcelDetail Info.aspx?PID=10203050302000190 1 /2
1 /24/2018
SCPA Parcel View: 10-20-30-503-0200-0190
i Land__..—.
�
Method I Frontage
Depth
(—
Units Units Price
i
Land Value
LOT
0.00 1
0.00 ,
1
$25,000.00
$25,000
Building Information
..__------- ..__--
Is Bed/Bath count incorrect? Click Here.
__ _ ._..._
__.___
___ _.. .-----------_—_—._ _._ __--
Year Built
# Description
Fixtures
—_ Actual/Effective
Bed Bath
Base Area
Total SF Living SF [ExtWall
Adj Value
Repl Value Appendages
i
1 SINGLE 1981 1 6
2 2.0
1,164
1,736 I 1,164 = CONC
$89,798
$108,190—__.___?--
Description Area
FAMILY
BLOCK
i
(
rOPEN
!
j
j PORCH
60.00
(
jI
(� FINISHED
i
i
GARAGE
-
i FINISHED
51
512.00
Permits
Permit # Description
Agency
Amount F CO Date
Permit Date
L01896 REROOF SHINGLE
ISANFORD
$2,375
3/1/2000
Extra Features
Description
Year Built
� Units Value New Cost
SCREEN PATIO 1
12/1/1990
1 1
$600--
$1,500
http://parceldetail.scpafl.org/ParcelDetaillnfo.aspx?PID=10203050302000190 2/2
NAME: Ochoa, Samuel
ADDRESS: 106 Balboa Ct. Sandford, FL 32773
PRICE: $8,000.00
HEIGHT: 16ft
PITCH: 5/12
SQUARES: 25
COUNTY: Seminole
REP: Karel
PRODUCT APPROVAL #:
THIS INSTRUMENT PREPARED BY:
Name: Smirna Perez/ Sunrise Roofing service
Address: 392 MELODY LN
CASSELBERRY FL 32707
Permit Number:
Parcel ID Number: 10-20-30-503-0200-0190
,..,., r:,:1 t ... r- ,„r
s
'../.,. _.�..,Ut (.t_llif t r.j_/i._t..E,�
;11
f:LERK'a Y 2018009801
..,,_, , .. r,
G FEE; 'i>�li:i„_lli
1KC 01� LM I: 4: ±?',t' i l k-Iem }
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.
1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
LOT 19 BLK 2 106 BALBOA CT SANFORD
HIDDEN LAKE PHASE II UNIT I
PB 24 PGS 15 TO 17
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Remove & Replace Roof with Shingles
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: OCHS, SAMUEL R 106 BALBOA CT SANFORD, FL 32773
Interest in property: Owner
Fee Simple Title Holder (if other than owner listed above)
4. CONTRACTOR: Name: Sunrise Roofing Services Phone Number: 407-542-3609
Address: 392 MELODY LN CASSELBERRY FL 32707
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
Address:
6. LENDER: Name: Phone Number:
Address:
Amount of Bond:
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.
8. In addition, Owner designates
Phone Number:
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.
r L
ignature of Owner or Lessee, or Owner's or Lessee's
Authorized Officer/Director/Partner/Manager)
State of W County of ("f\A_
sQsut I a- oC,hS
(Print Name and Provide Signatory's Title/Office)
The foregoing instrument was acknowledged before me this a 4 day of
by
wh
CITY OF
Sk�40RD.
FIRE IDEPARTMENT
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: h V!c cxAllobbCJ � I .�� �j - 'J t Ll 1
STRUCTURE TYPE: ® SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: (J REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF
DECK TYPE (PLEASE SPECIFY): �q 0-0,3 k-
* *PLEASE NOTE: ONLY 100 SQUARE FEET OF' THE EXISTING DECK IS PERMITTED TO BE REPLACED * *
ROOF VENTILATION: DOFF -RIDGE ®RIDGE 0SOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES Q NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 ® 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
SHINGLE
c iQJ1
I It's
FL#
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
OTILE
FL#
O OTHER:
FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IF APPLICABLE** /J A
ROOF SLOPE: O LESS THAN 2:12 O 2:12 -4:12 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
O SHINGLE
FL#
OMETAL
FL#
0MODIFIED BITUMEN
FL#
OTORCH DOWN
FL#
O INSULATED
FL#
O TrLE
FL#
O OTHER:
FL#
CITY OF
�FORD
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF POLICY & PROCEDURES
FIRE DEPARTMENT
PERMITTING REQUIREMENTS - NO PLAN REVIEW REQUIRED
THIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE
REQUIRED TO BE SUBMITTED AS PART OF YOUR PERMIT APPLICATION.
THE SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF
COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT.
A 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
SANFORD 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 DECK NAILING 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, PER FL PRODUCT APPROVAL
o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT APPROVAL
FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION.
jQ
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE: Z o I V
(Nota
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: —t-'"` 0
I hereby name and appoint: C(GL0, � HAJ%
an agent of:
of Company)
to be 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):
The specific permit and application for work located at:
(Street Address) Expiration Date for This Limited Power of Attorney: (I �/j l CA
License Holder Name: �( �-F,yt-s
State License Number:
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF
cc- i 33i)'1 zN
The foregoing instrument was acknowledged before me this day of I ,
200 Q, by HLaA 6(r -y who is ❑ person own
to me or�ho has produced y-,j- ,Xrf LXA-4.e as
identification and who did (did no)ke an oath.
M--�e
i ature
, J, Z�=-
ry Seal)
Print or type name
pAIE CMSt DQ of Florida
pue '.. NoCompmssion eGM-g2342021
gonCOMM
dth cu9pNatlona\NotalY Assn
(Rev. 08.12)
Notary Public - State of N --OLA
Commission No. 6 &% 01 U.14T-
My Commission Expires: 2 Z(
CITY OF
SA -4-- -0R--D---------
FIRE DEPARTi1IENT
Building & Fire Prevention Division
_.RESIDENTI4L RE-ROOFPOLICY &PROCEDURES -
PERMITTING REQUIREMENTS — NO PLAN REVIEW REQUIRED
THIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE, AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE
REQUIRED TO BE SUBMITTED AS PART OF YOUR PERMIT APPLICATION.
THE SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF
COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT.
A 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
SANFORD 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 DECK NAILING 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, PER FL PRODUCT APPROVAL
o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT APPROVAL
FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: QN& gk&6. DATE: ()I Z 61 g
CITY OF
. Sk�40RD
FIRE DEPARTMENT
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: ! O 0- e1)pQU G l nk-C6 liz'�_ 3-LT�3
STRUCTURE TYPE: O SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: & REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY):
* *PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED * *
ROOF VENTILATION: *OFF -RIDGE ORIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES O NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
® SHINGLE
cpC mep'd
FL# T: L ro (4(4U - DV -gyp
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLICABLE**
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
O SHINGLE
FL#
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
1
# 1k
Fa 1
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 18-572
ADDRESS: 106 Balboa Court, Sanford Florida
I Marla Y Flores , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, ENGINEER, 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 REQUIREMENTS (BASED ON F.S. CHAPTER 553.844).
LICENSE #: CCC1330724
COMPANY/CONTRACTOR: Sunrise Rooflnq Services
CONTRACTOR SIGNATURE: 1'&ya vn2 DATE: Z I ':i� I V
(MUST BE SIGNED BY LICENSE HOLDER OR OWNER/BUILDER)
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 VQJUS f Q
Sworn to and Subscribed before me this
T day of \)Old ely 20 _r by:
60 R`rz -Who is
Personally Known to me or has aced (type of
identification.
ti n �� �/
as
Lidentifi
ARIELMENDEZ
Notary Pub lic-StateOfFlorida
Signa a of Notary Public
Commission # GG 107645
N9 cF�_�;p My Comm. Expires May23,2021
StateofFlorida
6ondedthrough NetbnalNoteryAssn.
Print/Type/Stamp Name
of Notary Public