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HomeMy WebLinkAbout107 Shannon Dr (2),a - CITY OF SANFORD JAN� 1 20% BUILDING & FIRE PREVENTION PERMIT APPLICATION By Application No: I $r -283 Documented Construction Value: $ Job Address: 10] Sh `Y1CJn -D Y - S�r)Ma1. F Historic District: Yes ❑ NoZF Parcel ID: (��2 Z� j�"0 �D?j (5 Residentiaecommercial ❑ Type of Work: New'P Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑ Description of Work: e'k ._ ��c fbO*— Plan Review Contact Person: a nc\SCo _(� I! ` \mot Title: D W Phone:` (R- 73 2, 11 LO Z- Fax: " n g7S- q 1 Z ,I Email:ce nty i f fna om c P rna i I- GU M al ! r1 Property Owner Information j Name y� ( I m Phone: `7 U //�7 ✓ 7 7- 9 5G4 2 Streedm . SyV)0\_Xy_\ _DResident of property? City, State Zip: Sri d 3 Contractor Information Name MCA �X,U 1/� l �(V�� Phone: `40 �) 2 �Zig 2- Street: 1 • \,,!�NO l� �G /�a n% 61 Fax: 46 n1-5-5 ` q1 Z aJ City, State Zip: llr State License No.: ac - i 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: 5' Edition (2014) Florida Building Code Revised: June 30, 2015 Permit Application ^ q `O\ 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 1CC 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 o wner/Agent Date signature of Contractor/ gent Date S �� F aah co Print Owner/Agent's Name Print Contractor/Agent's Name W'--K OLA. - k\S-\\4 Signature ofNotarv-State of Florida Date MARIA T. BUTCHER `= MY COMMISSION # GG101540 '►q..4 EXPIRES May 04, 2021 Owner/Agent is Personally Known to Me or Produced ID /f �� Type of ID vkx k \ S' � 12 Signature rf4T--- - abe-df Plebe} �,•�• MARIA T. BUTCHER r1n`c MY COMMISSION # GG101540 ,9'�irtl EXPIRES May 04, 2021 Contractor/Agent is R 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: # 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 /5/2018 SCPA Parcel View: 01-20-30-517-OD00-0030 Property Record Card CFA Parcel: 01-20-30-517-OD00-0030 i Owner: HANSON STEVEN B Property Address: 107 SHANNON DR SANFORD, FL 32771 Parcel Information Parcel 01-20-30-517-ODOO-0030___.__ Owner HANSON STEVEN B Property Address 1107 SHANNON DR SANFORD, FL 32771 Mailing107 SHANNON DR SANFORD FL 32773-5447 , , Subdivision Name €SOUTH PINECREST Tax District S1-SANFORD DOR Use Code j 01-SINGLE FAMILY Exemptions 00-HOMESTEAD(1997) Value Summary E..................................................................................................................................................................... _......,,.... 2018 Working _...............,,,,,,,,,,,..,............,,,,.,.,,,,,.. 2017 Certified Values Values Valuation Method Cost/Market Cost/Market ..__..........................,.........................................................,...................................__............. Number of Buildings .. _.............................................................. ....1... _.. _............................ .............................................................................................................. Depreciated Bldg Value 1 $63,054 $59,398 Depreciated EXFT Value .... .................. ..............................................................................................................................................:.................._..._........._..................... $400 . .- $400 Land Value (Market) i.,,........._,.............................. ......................................................... $15,000 5................ ,........ ,,..,.,.....,,.,....,.,............. $15,000 b...................,.....,,,,,,,,,.,,,,.,....,,............... Land Value Ag .................. ................................ ........................... ;..... ,,.,..._.,._...........................,,.......,.,.,;,,..,.,.,..,.........................................,,....... Just/Market Value "" $78,454 1 $74,798 _,,.,,.....__.,.........._......_................__.._„..._.._......._...___._...._..........,,,,,,,,,,,, Portability Adj ,,,,,,,,_,.,.,,.,,...._._...__.............._..._.. ........................................................................._,_.__....,..,....,.,............._L....._.............__,._..__..,,...,,.............,,,,,. Save Our Homes Adj 1 $11,043 $8,774 Amendment 1 Adj ............................................................................................................................ i $0 _. _........................... _. _.... _. _...... _............................ .. _. P&G Adj .......... _......;..................... _ _,......... $0 .............. $0 _....__..._._..............._._..... Assessed Value i $67,411 $66,024 Tax Amount without SOH: $638.94 2017 Tax Bill Amount $581.31 Tax Estimator Save Our Homes Savings: $57.63 * Does NOT INCLUDE Non Ad Valorem Assessments Legal Description ............................................_._...._....._._......___.................................................................,.....,.,.,...................._.._._...... ..... ................................................. ............ __. _. . ......................................................................................................................... _._.... _.......................................... _....................... .................................. ....................................................... ......_.........._ ..__....... LOT 3 BLK D SOUTH PINECREST PB 10 PG 10 Taxes ..................................................................................................................._.,.............._..............__.................,.,.........,...,............. Taxing Authority ...._........................................................................................................-__....,.........._. Assessment Value ....... ............................,..................................................,.........._..._.__...__.._.__.._...._,.........._......................................................................... Exempt Values I Taxable Value County General Fund .......-_..............................................................-...___.....................................z.................,,...............,...,..._..,._.............,,..,,.,....,........................:.....--...........................,.,..,.,,.,,,.,..,,.......................................... $67,411 ` --------------- $42,411 $25,000 ...................... ...___............,,,..,,..,,,,,,.,...__.._................................................................ Schools ..._ ....,, ,,,,,,,,,,, „ $67,411 $25,000 $42,411 _.._._._. _._.—_--- .,,..--_................—..._.____......._......................_............_....,._....__.._..._.......................................__..................._.__.._.._._...........,......._._,.,._,,...,............................._...._......-_....._- .__......_.........,,.,_ ___.._....... ,,....... €.............. City Sanford $67,411 $42,411 $25,000 SJWM(Saint Johns Water Management) .. ......................................................................__....._.....,..._.............................._.....,,,.,,,,.,.............._....!..._...................................-._._.._._.__.................................... $67,411 $42,411 i $25,000 .................................................._.........._..._...........................................,........,.......,...,....................................................................................._.._...........................................,..,......................._..._......_..._._.__._P.._._...........,,.._.,,,.................,,.._....._............................._.-...._-..;-._........-_.......................................__................,,,...........,,.,,,, County Bonds $67,411 I $42,411 $25,000 Sales ..._.._.......___.__.............................__....._.__........................._........................._......................____.._,_.._......._..._..,.,..................................._..._..............................,.,...................................................................__................................._.....__.._... Description Date Book Page Amount ._................._...........................................,....,...........___._........ 1 Qualified i Vac/Imp f ��� . - WARRANTY DEED 5/1/199603077 0249 - ;,...................,,.,,.......,.,..,....,,,.,.,,.,....... $61,000 ;Yes Improved .-...................................................................................__.............................._.,_..v...............,,.,,,,.,,,,,,,,,......_..._....._..._.......__ ADMINISTRATIVE DEED 1/1/1975 .................................................... 21054 0601 $20,000 Yes Improved Find Compambhl U s Land .............._...._.__._...............................__............_.._....._.........................................__._. Method Frontage ..............................__.........._....................,...........,...,...............______...._.._...._...........,...,,.....,...,.,.,,..........,.,.....,...,..,,..........._................................,...........,,,,,,,,,,,,......................_.._..___ Depth Units .......... i Units Price .._..___......................................_...... _...._._...................._ Land Value _.._..._................... ...., LOT 0.00 i 0.00 1 $15,000.00 $15,000 Building Information j'1 Year Built i # I Description 3 Actual/Effective Fixtures Bed Bath ! Base Area Total SF Living SF Ext Wall (Adj Value ':. Repl Value I Appendages 1 i SINGLE 1957 5 3 1_5 1,334 1,924 1,649 CONC ( $63,054 $109,659 i DescriptiA on rea http://parceldeta il.scpafl.org/Parcel Detail I nfo.aspx?P I D=O120305170D000030 1 /2 liffill OVUM;] Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 5 I hereby name and appointU V U an agent of.- R z L\V C-.,/ (Name 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): TA spe fic ermit and ap lication for work locate at: Expiration Date for This Limited Power of Attorney: License Holder Name: YJ ` '� 1 c \S C ©:D—N M U State License Number: C Signature of License Holder: STATE OF FLORIDA COUNTY OFS Em I wa >`t- �J ob 6101 The foregoingigstrument was acknowledged before me this 200 t% , by k—&4-wcj:s vnW� to me or ❑ who has produced identification and who did (did not) take an oath. (Notary Seal) ElubMARIA T. BUTCHERMY COMMISSION # GG101540EXPIRES May 04,2021�" 1 (Rev. 08.12) Signature 5 day of S �-y-4 , who impersonally known �✓�-�2. �-- � � V TC Ih1p'L_ Print or type name Notary Public - State of Commission No. My Commission Expires: as �1 THIS I RUMENT RED EI Name: l aae4.., Addi,ess: 4-4w L yp NOTICE OF COMMENCEMENT `•..f i''.�'u �l l v u..t 1_. ;._� i` ,�'.1 .i. r+(J i.L t.l_!Jf`i i r' 0;_h�' r'RK11 21:{131J02113 Permit Number. Parcel ID Number: ��— o� O 0�100 -,Ott-! 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. IESCRIPT9IO O egal description o the pro erty street addr ss if avail 3 OWNER sRI LESSEE INFORMATION IF THLESSEE CONTRACTED FOR IMPROVEMENT: Name and ddes,a�"r7_IS'T Interest in property: O t.J' kQS, Y — Fee Simple Title Holder (if other than owner listed above) Name: 4. CONTRACTOR: Name: ) T n ,� r� Phone Number: yl Address: 'N 1 ► 1 pZ o (1 / V D ���" t V U : ��l Vl7 WOU I 3 5. SURETY (If applicable, a copy of the payment bond is attached): Name: Amount of Bond: 6. LENDER: Name: 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. 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. (Signal re o ner o essee, or Owner's or Lessee's (Print N and Pro de Signatory's Ti a/Office) Au OrW Officer/Director/Partner/Manager) State of County of SEmt V40CF The foregoing instrument was acknowledged before me this by �-,kYVIPJM !' 4VAI.L'50hl N of persoIcing statement who has produced identification Ca type of identification produced: C "T ROOFING CONTRACTOR WORKMANSHIP WARRANTY 1) 2) 3) Roof Owner: Francisco Acosta Roof Address: 1630 Furey Rd. Orlando FL 32828 Warranty begins: 1219/17 Warranty ends: 12/19/24 4) Warranty: Contractor warrants to Owner that it applied the roofing materials to the above -described roof in accordance with (a) the written specifications of Roofing Materials Manufacturer and (b) good roofing industry practices, in effect on the date application commenced. Subject to the following terms, conditions and limitations, Contractor will, during the term of this Warranty, at its expense, repair or cause to be repaired leaks in said roof which are the result of defects in Contractor's workmanship. Upon expiration of the term of this Warranty, without notice from Owner of some defect, Contractor shall have no further obligation to make repairs at Contractor's expense under any provision of this Warranty and Owner shall not make any further demand or claim against Contractor concerning Contractor's workmanship, or the roofing materials installed, provided that Contractor promptly commences and diligently proceeds with the correction and repair of all such defects covered by this Warranty which are called to Contractor's attention in the manner set forth in paragraph 8 below during the term of this Warranty by Owner. 5) Terms, Conditions and Limitations. This warranty does not cover any leaks in the roof caused by: the acts or omissions of other trades or contractors; lightning, winds of peak gust speeds of 55 m.p.h. or higher measured at 10 meters above ground, hail storm, flood, earthquake or other unusual phenomenon of the elements; structural settlement; failure, movement, cracking or excess deflection of the roof deck; defects or failure of materials used as a roof substrate over which the roof system is applied; faulty condition of parapet walls, copings, chimneys, skylights, vents, supports or other parts of the building; vapor condensation beneath the roof; penetrations for pitch boxes; erosion, cracking and porosity of mortar and brick; dry rot; stoppage of roof drains and gutters; penetration of the roof from beneath by rising fasteners of any type; inadequate drainage, slope or other conditions beyond the control of Contractor which cause ponding or standing of water; termites or other insects; rodents or other animals; fire; or harmful chemicals, oils, acids and the like that come in contact with the roofing system and cause a leak or otherwise damage the roof system. If the roof fails to maintain a water -tight condition because of damage by reason of any of the foregoing, this warranty shall immediately become null and void for the balance of its term unless such damage is repaired by Contractor at the expense of Owner. 6) Notification by Owner. During the term of this warranty, if the roof leaks, Owner must immediately notify Contractor by telephone of such leaks, and promptly confirm such telephone notice by written notice to Contractor. Events Which May Void Warranty. This warranty shall become null and void: (a) Unless Contractor receives notice from Owner during the term of this Warranty in accordance with paragraph 8 above of any leaks and is provided an opportunity to inspect, and if required by the terms of this warranty to repair the roof; (b) If work is done on such roof, including, but without limitation, work in connection with flues, vents, drains, sign braces, railings, platforms or other equipment fastened to or set on the roof or if repairs or alterations are made to said roof, without first notifying Contractor in writing and giving Contractor the opportunity to make the necessary roofing application recommendations with respect thereto, which recommendations are complied with. Contractor shall be paid for time and materials expended in making recommendations or repairs occasioned by the work of others on the subject roof; (c) If any area of the roof is used as a promenade, walkway or work area or is sprayed or flooded, unless such use was originally specified with a defined area and the specification is noted in paragraph 14 below. 8) Transferability. This warranty shall accrue only to the benefit of the original owner named above. It is not transferable to any other person, except with the prior written consent of Contractor. 9) No Other Warranties. NO OTHER EXPRESS WARRANTY IS GIVEN BY CONTRACTOR TO OWNER. THE REPAIR OF THE SUBJECT ROOF IS THE EXCLUSIVE REMEDY. THERE ARE NO WARRANTIES THAT EXTEND BEYOND THE DESCRIPTION ON THE FACE HEREOF. ALL IMPLIED WARRANTIES, AND SPECIFICALLY THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR ANY PARTICULAR PURPOSE ARE EXPRESSLY EXCLUDED AND DISCLAIMED. This warranty is separate and apart from any warranty that may be issued to Owner by the Roofing Materials Manufacturer. CONTRACTOR EXPRESSLY EXCLUDES AND DISCLAIMS ANY RESPONSIBILITY TO OWNER IN CONNECTION WITH OR ATTRIBUTABLE TO THE ROOFING MATERIALS AND ANY SUCH ROOFING MATERIALS MANUFACTURER'S WARRANTY. 10) Incidental or Consequential Damages. UNDER NO CIRCUMSTANCES SHALL CONTRACTOR BE LIABLE TO OWNER OR ANY OTHER PERSON FOR ANY INCIDENTAL, SPECIAL, CONSEQUENTIAL OR OTHER DAMAGES INCLUD-ING, BUT NOT LIMITED TO, LOSS OF PROFITS OR DAMAGE TO OR LOSS OF USE OF THE BUILDING OR ITS CONTENTS, WHETHER ARISING OUT OF BREACH OF WARRANTY, BREACH OF CONTRACT OR UNDER ANY OTHER THEORY OF LAW. 11) Payment to Contractor. This warranty shall not be or become effective unless and until Contractor has been paid in full for said roof in accordance with the agreement pursuant to which said roof was applied. 12) Additional conditions or exclusions : By: Francisco Dalmau Contractor INSURED :ANDREW KAPALKO LOCATION : 6605 MANSOUR LN : PORT ORANGE, FL 32128-6011 COMPANY : Florida Farm Bureau Insurance P.O. Box 147033 Gainsville, FL 32614 DATE OF REPORT DATE OF LOSS POLICY NUMBER CLAIM NUMBER OUR FILE NUMBER ADJUSTER NAME 10/16/2017 09/11 /2017 HO 8617886 09P00553847 09P00553847 JUSTIN JOHNSON Estimate Section:; Roof Quantity Description 7Unit Cost RCV DEP ACV 34.7 SO Remove Composition Shingles $40.00 $1,388.00 $1,388.00 Includes debris removal, dump fees and dumpster rental 39.7 SO Replace Composition Shingles $290.00 $11,513.00 $11,513.00 Complete re -roof cost to bring roof up to code, inculding but not limited to felt, drip edge, flashing, vents, re -nail decking, permit, fees, ect Totals For Roof $12,901.00 $0.00 $12,901.00 Repair Item Totals $12,901.00 $12,901.00 Applicable Sales Tax $471.10 $471.10 Estimate Grand Totals $13,372.10 $13,372.10 Policy Deductible - ($4,600.00) ($4,600.00) BUILDING FINAL TOTALS . $8,772.10 $8,772.10 SIMSOL® Page: 1 Form cEST-1n.o 9 INSURED :ANDREW KAPALKO LOCATION : 6605 MANSOUR LN PORT ORANGE, FL 32128-6011 COMPANY : Florida Farm Bureau Insurance P.O. Box 147033 Gainsville, FL 32614 DATE OF REPORT DATE OF LOSS POLICY NUMBER CLAIM NUMBER OUR FILE NUMBER ADJUSTER NAME : 10/16/2017 : 09/11 /2017 : HO 8617886 :09P00553847 :09P00553847 : JUSTIN JOHNSON ESTIMATE TOTAL PAGE ITEMS RCV DIFF ACV Repair Item Totals $12,901.00 $0.00 $12,901.00 Applicable Sales Tax $471.10 $0.00 $471.10 Rate:6.5000% (Includes M,E) Estimate Grand Totals $13,372.10 $0.00 $13,372.10 Less Deductible ($4,600.00) ($4,600.00) BUILDING FINAL TOTALS $8,772 10 $0.00 $8,772 10 Sates Tax Legend: M - Materials, E - Equipment Florida Farm Bureau Casualty Insurance Company or Florida Farm Bureau General Insurance Company (Florida Farm Bureau) has prepared this itemized estimate to repair the covered damage to your property. If you have hired a person to make repairs and that person has questions concerning this estimate, you or the person you have hired to make the repairs should contact your adjuster promptly. Depending upon the complexity of your repairs, this estimate may or may not include an allowance for general contractor's overhead and profit. If you have any questions regarding general contractor's overhead and profit, please contact your adjuster before proceeding with repairs. Any person you have hired to make repairs is hired by you and works for you not Florida Farm Bureau. Florida Farm Bureau does not guarantee the quality or the workmanship of any person you have hired and does not guarantee that the repairs will be accomplished within any specific timeframe. "Any person who knowingly and with intent to injure, defraud, or deceive any insurance company files a statement of claim containing any false, incomplete or misleading information is guilty of a felony of the third degree." (F.S. 817.234) SIMSOL® Foml M--m.o Total Page INSURED :ANDREW KAPALKO LOCATION : 6605 MANSOUR LN : PORT ORANGE, FL 32128-6011 COMPANY : Florida Farm Bureau Insurance P.O. Box 147033 Gainsville, FL 32614 DATE OF REPORT DATE OF LOSS POLICY NUMBER CLAIM NUMBER OUR FILE NUMBER ADJUSTER NAME STATEMENT OF LOSS CLAIM RECAPITULATION Policy Information Policy Type: HOMEOWNERS Policy Number: HO 8617886 Policy Term: 02/18/2017 to 02/18/2018 Coverage Amount: Coverage Deductible: R/C Status: Estimate of Loss: Coverage A - Building $230,000.00 $4,600.00 Not Applicable R.C.V.: Depreciation: A.C.V.: Less Deductible: Claim Payable: Statement of Loss Summary : 10/16/2017 : 09/11 /2017 : HO 8617886 :09P00553847 :09P00553847 : JUSTIN JOHNSON $13,372.10 $0.00 $13,372.10 $4,600.00 $8,772.10 R.C.V.: $13,372.10 Depreciation: $0.00 A.C.V.: $13,372.10 Less Deductible: $4,600.00 Claim Payable: $8,772.10 SIMSOLO Soy-1n.0 Page: 1 /sCITY Of Sk�40RD k DEPARTMENT PERMIT # Building & Fire Prevention Division RESIDENTIAL RE -ROOF SCOPE OF WORK JOB ADDRESS: STRUCTURE TYPE: OISINGLE 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): C `-A W O O p **PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED * * ROOF VENTILATION: ®OFF -RIDGE O RIDGE 0SOFFIT OPOWERED VENT OTURBINES SKYLIGHTS: O YES ® NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: MAIN ROOF AREA ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 16 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA/PRODUCT APPROVAL ® SHINGLE 1 (} I� (I' m ( FL# 1 O METAL FL# O MODIFIED BITUMEN FL# O TORCH DOWN FL# O INSULATED FL# O TILE FL# OOTHER: 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# OTORCH DOWN FL# OINSULATED FL# O TILE FL# 0 OTHER: FL# CITY OF Building & Fire Prevention Division r u FO S, /� N RESIDENTIAL RE -ROOF POLICY & PROCEDURES X%." FIRE DEPARTMENT PERMITTING REQUIREMENTS — NO PLAN REVIEW REQUIRED ARE THIS DO CUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK 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 RBQUI OOD PERMITS - MOBILE ENTIAL (SINGLE FAMILY, TOWNHOUSE, HOME, APARTMENT AND/OR CONDOMINIUM) --ROOF THE FOLLOWING IS REQUIRED TO BE PROVIDE ON THE JOB SITE: PERMIT CARD, POSTEDIN 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 SPACING (INCLUDING A MEASURING DEVICE OR R o ROOF DECKNAILING PATTERN &E OF NAILS) o ROOF DECKNAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHOWING o UNDERLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER) o DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE OR R) o SHINGLES INSTALLED, NAIL PATTERN AND LOCATION OF NAILS SKYLIGHTS (1F APPLICABLE) PER FL PRODUCT APPROVAL o DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION HIMGOp R FL PRODUCT APPROVAL o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLA FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN,AC COMPLIANCE YFFIDAVIT OPER OVAL INSPECTIOVIDED BY A FLORIDAN DESIGN FA PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC CODE -Y -- DATE: CONTRACTOR (OR OWNER/BUILDER) SIGNAT 'V$ Building & Fire Prevention Division RESIDENTIAL RE-R OOF A FFIDA VIT RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #: I� 3� 3 ADDRESS: l Q-1 5 Vk A h11V�VJ� R-- S A w FORS I t= L 3 q'1'73 \ 9-"6AC t5 C.E�10-k-vvI4lA _ 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 #: C_-_ Cr_ 13 S,0(,. 0 9 � COMPANY / CONTRACTOR •u � c- !.E .- �(o of zs f �`�'-^ *'-4 C'\,s cf�'- ) CONTRACTOR SIGNATURE: ILA/��� DATE: ` �3 (MUST BE SIGNED BY LICENSE HOLD 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 Sworn to and Subscribed before me this 2 3— day of OAJ 20 k p by: D14%-AM4,A . Who is Personally Known to me or has ❑ Produced (type of j tification) as identification. re f Notary Public e of rida CAYN V l�l,J Print/Type/Stamp Name of Notary Public a 4t.i[:1 a llotary Public State of Florida Tiffany BurlesonMy Commission GG 173997 Expires Op10912022