HomeMy WebLinkAbout134 Wornall DrCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: p2�
Documented Construction Value: $ 11,300
Job Address: 134 WORNALL DR SANFORD, FL 32771
Historic District: Yes ❑ No x❑
Parcel ID: 33-19-30-514-0000-0430
Residential Q Commercial ❑
Type of Work: New ❑ Addition ❑ AlterationEl
Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: Re Roof Owens Corning FL 10674-R13 Rhino 15216-R3 34 SQ 7/12 Pitch
Driftwood Oakridge Lifetime
Plan Review Contact Person: Skylar Amkraut
Title: Admin
Phone: 407-278-7788 Fax: 800-337-3361
Email: Permit@Jasperinc.com
Property Owner Information
Name Randall J Pawlowski
Phone:
Street: 134 Wornall Dr
Resident of property? : Yes
City, State Zip: Sanford FL 32771
Contractor
Information.
Name Jasper Contractors
Phone: 407-278-7788
Street: 4185 S Orlando Dr
Fax: 800-337-3361
City, State Zip: Sanford, FL 32773
State License No.: CCC1331153
Architect/Engineer Information
Name:
Phone:
Street:
Fax:
City, St, Zip:
E-mail:
Bonding Company:
Mortgage Lender:
Address:
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 additi6na.l, restrictions applicable to this property that may be
found in, the" of 'this -1courity, ,and 'there maybe additional permits required from other governmental entities such
It as water
managementts,state agenci6s,,dr,fiMeral a2encies.,
t requi r meiFlorida�
Acceptanc-e-,dfpermit'is eiiftati6nwih I'Wilth6fif.y'fht,,owilet-o'fthe pr'op�drt-o' f,-h e its of'FI i1da Lien Law, FS'7 11
The City of Sanford teq'ijifes payment of a,plan review fee, at the time,of permit submittal. Acopy of the,executed contract is requited
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 effe,c(at the time, the permit is . issued, in
accordance with local, ordinance. Should talculated charges figured off the executed contract exceed the''actual construction value,
credit'WiThe applied to y.6qrpermit ,fees when, thepermitlis issued.
I certify that,all of'the.
Signature olTOW11WAgent Datd:
Print,Qwner?Agent's,Narne:
Signature ofNotaxy-State-pf , Florida. Date
information i& accurate and that all Work Will
01.12.18
-Signaf6rg"ofContractor/Age 4,i Date,
Rudith Goico
Name
- 'OF -3 2 180JQ
Commission # - .
'KtY,Cohirh i's-s,ion Expires
June 01. 201`8 _
Owner/Agent -is Personally Kriown to'Me^- or Contractor/Agent. is Persortally Known to: W or
Produced ID Type of ID Produced ID, YP, e of ID
BELOW IS FOR. OFFICE USE ONLY,
Permits Required: Building El Electrical.F] Mechanical,[] PjumbingE] GasF] Roof'0
,Construction Type:.
Occupancy" Use::
Flood Zone:
Total -Sq Ft ofBldgi Min. Occupancy Load: #of Stories:
New Construction: Vlectric, -# of Amps g- - Plumbing Wof Fixtures
Sprinkler Permit: Yes [] No]n' # of Heads Fire, Alarm -Permit: YesF] No
APPROVAL& ZONING-.'
COMMENTIS:,
1JTrL1TIES:, WASTE WATER. -
ENGINEERING:. FIRE': BUILDING:-
Revised: June30,101:5, Permit Applicatio6
1/12/2018
SCPA Parcel View: 33-19-30-514-0000-0430
a cta Property Record Card
Parcel: 33-19-30-514-0000-0430
Property Address: 134 WORNALL DR SANFORD, FL 32771
seaati[x�scasnv ate_
Parcel
33-19-30-514-0000-0430
Owner
PAWLOWSKI, RANDALL J
Property Address
134 WORNALL DR SANFORD, FL 32771
Mailing
134 WORNALL DR SANFORD, FL 32771-7758
Subdivision Name
COUNTRY CLUB PARK
Tax District
S1-SANFORD
DOR Use Code
01-SINGLE FAMILY
Exemptions
00-HOMESTEAD(1999)
Legal Description
LOT 43
COUNTRY CLUB PARK
PB 50 PGS 63 THRU 66
Taxes
Taxing Authority
Assessment Value
Exempt Values Taxable Value
County General Fund
Schools
$135,230
$135,230
$50,000 $85,230
$25,000 $110,230
City Sanford
$135,230
$50,000 $85,230
SJWM(Saint Johns Water Management)
......... ..........
County Bonds
$135,230
..
$135,230
$50,000 $85,230
$50,000 $8 5,230
Sales
Description
Date
Book
Page
Amount
Qualified
Vac/Imp
WARRANTY DEED
1/1/1998
03365
1824
$108,000
Yes
Improved
SPECIAL WARRANTY DEED
WARRANTY DEED
12/1/1996
9/1/1996
03176
03141
1361
1562
$105,900
$22,000
Yes
Yes
Improved
Improved
Fund Cwnparadta sedan
Land
Method
Frontage
Depth Units Units Price
Land Value
LOT
1 $38,000.00
$38,000
Building Information
I. Year Built
# Description ;Actual/Effective Fixtures ; Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages
http://pareeldetail.scpafl.org/ParcelDetailInfo.aspx?PlD=33193051400000430 1/2
5380 F. Colonial Dr.
Orlando, FL 32807
3203 Conway Rd., Ste, 201
Orlando, FL 32812
(407)279-7788
(800) 337-3361 rax
infota jasperine.nrg
ED VISA .
wl�
JASPER
JasparRoor.06(n
PL Contractor's License:
CCC1329651 & CCC1331153
ROOK REPLACE MENT CONTRACT
Account Manager,"oe "'c
Contact
Company;, 1.1-r lam✓
Policy 0: d t C Gs ,, 0/ - -.
Claim tl: / �S R I !/
Molloape Corriglany Information
Company:
Loan Number:
Owner(s):
Pho c 3 ;7 C t/
Address:
All Phone:
City:
State:
Z' � Code:
Sht Ric Co r.
Emai (�?
` 1 j (c',` Z �. � (! � v ►tom
Roof RCV Amount/ Contract Price:
11,300
Drip Ed c Color.
G, ei , .
If Owner's Insurance Comnans does not agree to ono for it full tool reRtaeemcnt. Him contract via,. ..,,..d
Assignment of Insurance Benefits for the Full Roof Replacement Only: I hereby assign any and all insurance rights, benefits and proceeds under
any applicable insurance policies to Jasper Contractors, Inc. ("Jasper"), the scope of which shall be limited to a Full Roof Replacement. I make this assignment ;
and authorization in consideration of Jasper's agreement to perform services, supply materials and otherwise perform its obligations umda this Contract,
including not requiring. full payment at the time of service 1 also'hu:reby direct my insurer(s) to release any and all information requested by lasrxT, or itx
rcpresentativc(s), for the direct purpose of obtaining actual benefits to be paid by my,insuucr(s) for services rendered. In this regard, I waive MY pri-cy
rights. If payment is made `directly to the Owner/AgaiOnsured(s), it shall be endorsed over to Jasper immediately upon receipt. 1 agree that any partial"
of
work, deductibles,' betterment or additional work requested by the undersigned, not covered by insurance, must be paid by the undersipet on the day of
installation. Deductible: It is the Owner's responsibility to nay all insurance deductibles. Owncr's out-of-pocket expense will not exceed the deductible
amount, as stated on insurer's loss sheet (the "Loss Sheet"), UNLESS replacement/repair of deteriorated decking is required by code and'or O•.%ner requests
optional upgrades. Jasper CANNOT pay, waive, rebate, or promise to pay, waive or rebate 'any or all of the insurance deductible applicable to the
insurance claim for payment of work] In the event of a discrepancy, the deductible amount stated on die insurer's Loss Shc crrule deductible
amount disclosed. Deductible: S > I�� 0 C) MUST BE PAiD IN FULL, PLUS APPLICABLE SALES TAX (initial)
MORTGAGE AUTi1ORMATiON: 1, Owner/Mortgagor, grant authorization for 1 Mortz Co. to sport with
Jasper on matters including but not limited to, the claim and draw status. (initial) PAYMENT SCHEDULE: Owns agrees to
pay Jasper based on the following schedule: (i) Deposit in the amount of s due upon signing this contract: (t) the Contract Price.
less the Deposit and; any applicable depreciation retained by nwaier's suurer(s), plus upgrade costs, due and payable to Jasper upon completion of
work being performed, and, (iii) the remaining Contract Price (equal to any applicable depreciation and/or change orders) due and payable to Jasper upon
completion of work performed. In the event of a pending inspection, no more than 2% of Contract Price may be withheld until inspection has passed_
Optional: UPGRADE ITEM: QTY: PRICE: TOTAL: S
Replacement Work and Price: Upon insurer's approval and subject to the Terms and Conditions herein, Jasper agrees to fi¢aish all matenals and
provide the labor necessary to perform the .full roof replacement which shall take place following Owner's insurance company's approval, approximately
within 30 days, conditions permitting. Owner's Declaration of Intent: Owner acknowledges and agrees that, upon approval by insurance company for a,
full roof replacement. Jasper shall perform the roof replacement upon receipt offunds from Owner's insurance company.
FLORIDA HOI•IEOWNERS' CONSTUC'I'ION RECOVERY FUND
PAYMENT, UP TO A LIMITED AMOUNT, MAY BE AVAILABLE FROM TIIE: FLORIDA 1L0�1EONV\ERS'
CONSTRUCTION RECOVERY FUND If YOU LOSE ?MONEY ON A PROJECT PERFORMED UNDER CONTRACT,
WHERE TILE LOSS RESULTS FROM SPECIFIED VIOLATION'S OF FLORIDA LAW BY A LICENSED CONTRACTOR.
FOR INFORMATION ABOUTTHE RECOVERY FUND AND FILING A CLAIM, CONTACT THE FLORIDA
CONSTRUCTION INDUSTRY LICENSING BOARD ATTHE FOLLOWING TELEPHONE NUMBER AND ADDRESS:
Construction Industry Licensing Board: 2601 Blairstone Road, Tallahassee, FL 32399-1039, (850) 487-1395
CANCELLATION: If Owner elects to terminate the services of Jasper, Owner may do so before midnight on the third business
day after Contract is executed. Owner shall receive a full refund of all deposits. Owner may also rescind Contract before midnight on
the third business day after the contract is executed after notification front insurer(s) that,the claim for payment on roof contract has
been denied, in whole or in part. All written notices of cancellation, regardless of reason, "shall be postmarked or delivered to Jasper's
corporate office: 1690 Roberts Boulevard, Suite 112, Kennesaw, GA 30144. CANCELLATION EXCEIYI'IONS: The three (3) day
right of cancellation DOES NOT APPLY to contracts for emergency home repairs as time is of the essence.
1, Owner, have read and understand all statements, 'Perms and Conditions of the "Roof Replacement Contract" and agree
that all details are acceptable and satisfactory. I further understand that this Contract constitutes the entire agreement between the
parties and that any further changes or alterations to this Contract must be made in writing and agreed upon by both parties,
Each party represents and warrants to the other that it has the full power and authority to enter into the contract and that, it is.
binding and enforceable in accordance with its terms.
tju iorized Jasper Representative Date Owner Date
Scanned by CamScanner
11111111111111111111111111111111 fill Lill
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THIS INSTRUMENT PREPARED BY:
Name: Jasper Contractors
Address: &*;Rn P Cnlnnial nrkh%
43111&(#
NOTICE OF COMMENCEMEN'
Permit Number:
Parcel ID Number.
The undersigned hereby gives notice that Improvement will be made to certain
following information Is provided in this Notice of Commencement.
1. DESCRIPTION OF PROPERTY; (Legal Sesaription of the property and shei
2. OENERAL DESCRIPTION OF IMPROVEMENT:
3, OWNER INFORMATION 1
*Olt LESSEE INFORINA71ON IF TH�SS
Name and address: RA" W 11 "/ % . /".fit. e
wivist 1n properly. —
Fee Simple Title Bolder
above) N
..; v e-
A•. CONTRACTOR- Name %laspur %,onuacmrs
Address; 5380 E Colonial Drive Orlando, FL 32807
5. SURETY (If appricabte, a copy of the payment bond Is athached):
8. LENDER:
Address:
7. Persons within the State of Florida Designated by Owner upon whom
713.13(i)(a)7., Florida SW ntas.
8. In addition, Owner designates
to receive a copy of the UenOes Notice as provided In Section 713.13(1)(bl
9. Facpiradon Date of Notice of Commencement (the expiration is 1 year from i
GRANT IIALOYr SEMINOLE COUNTY
CLERK OF CIRCUIT COURT h COMPTROLLER
BK 9057 Ps 1282 (1Pss)
CLERK'S 4 2018004785
RECORDED 01/12/2018 01:70:35 PM
RECORDING FEES $1 CI, 00
RECORDER BY hdevo:,e
property, and In accordance with Chapter 713, Florida Statutes, the
'•.T'ED FORTHEIMPA
i-
Phone Number. 407 278-7788
Amount of Bond:
Phone Number.
or other documents may be served as provided by Section
Phone Number.
of
Me Statutes. Phone number
Of recording unless a dit%rent date Is specltied)
ONSIN6 TO I n�tA1IFJi' ANY PAYMENTS MADE 13Y THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE
CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECT ION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF;OMMENCEMENT MUST B!A RECORD®/tIVD POSTED ON THE
JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN N ING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMME NT_
kitk
�i
Augmitzed
State of ELV f—klDA County of
The foregoing Instrument was acknowledged before me this
by __ ,gWOA,U, �S. �wLOx.Ae_t
who has produced identification O We of Identification produced:
Y....(JOLLY A. DYKES A.
Notaiy'PuW-StateofRodaCEF.TI£#?C�GfGF.;t':-1�CommissiontGG 1092VCLER? OFT14;..1;> 1)1�,.MyCamm.ExpiresMay30,2021 A, CONIPit ` . Bocdaama�nUiucnatnotaryAm� S N ?,'FLORtG
day of _ XC e_V".N0ea' yp 1-1
�,. Who. Is personally known to me tYoR
Mr. z g ;2 .__.��;_��I;
Date
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 01.12.18
Karla Almodovar, Rudith Goico, Skylar Amkraut, Rachel Holcomb
l hereby name and appoint: Ana Chavez and/or Michelle Monsalve
an- Agent of Jasp-Conractors
to be my lav6fitl attorney-in-&tt,to act for me to apply for, receipt for, sign for and do all ihings'
necessary to this ,appointment for (check only one -option):
The -specific permitand.application.for work.located at:
134 WORNALL DR SANFORD, FL 32771
(Smc Address)
Expiration Date for This Limited Powerof Atiotney:. 1 /1 /2019
LiceoSe;Ilolder Maine: Donald Bouchard'
.State License. Number: ,CCC1331153
Signature of License
STATE OF FLORIDA
COUNTY OF '-§ a,o .
The foregoing instrument was acknowledged before me this 12 day of January
200, l 8 . , by.. _ D-Wd e«-h-d who is a7 personally known
to me or ® who has produced off,
identification and wbo dit(did not) take an:oath—.
(Notary Seal)
SKYLAR B AMKR•AUT Ili
c commission p FF 127890 �
., •_ �.
MY Commission Expires
�o.�• June 01, 2018
(Rev. 08.12)
Skylar Amkraut.
Print or type name
Notary Public = State of Ft
Commission.No. 127890
Mrc6mrm ion Expires: 6/1/2018
SrnnnPcl by CamScanner
CITY OF
3A 140
FIRE DEPARTMEN
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. o ISSUE DATE: 01/4 / ®�
CONTRACTOR:N
JOB ADDRESS: /.34 lvo r r cz.. 1
1 4T000`0
TYPE OF
PROTECT FROM WEATHER
• Post this Permit and all required documents in a conspicuous place outside
• Digital Photographs are required - please follow re -roof policy and procedures guide
• All trash, debris and dumpsters must be removed from job site at final inspection
• Permit expires six (6) months from date of issue
ROOF
INSPECTION TYPE APPROVED REJECTED INSPECTOR
FINAL ROOF
FAILURE TO FOLLOW THE RESIDENTIAL RE -ROOF POLICY & PROCEDURES WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION
FEE AND MAY REQUIRE AN AFFIDAVIT, SIGNED AND SEALED, FROM A REGISTERED FLORIDA DESIGN PROFESSIONAL
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.
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, FBC 105.3.3
REVISED: 4-17 Inspection Line 407.792.6069 or 855.541.2112
r -.
TO SCHEDULE AN INSPECTION:
• Dial 407.792.6069 or 855.541.2112
• Provide the items requested during the message
• The type of inspection requested must be scheduled under the appropriate permit type
• Follow the prompts
PLEASE NOTE: Inspections scheduled -by 5:00 p.m. will be conducted the
next business day. If you experience difficulty, please call 407.688.5150
Monday - Thursday 7:30 am - 5:30 pm for assistance.
AUTOMATED INSPECTION SYSTEM CODES
Final Roof Inspection Code III
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
REVISED: 04-17 Inspection Line: 407.792.6069 or 855.541.2112
- g
�F D
City of Sanford Building Division
Residential Re -Roof Inspection Policy & 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: ° DATE: 01.12.18
w
JOB ADDRESS: 134 WORNALL DR SANFORD, FL.32771
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
STRUCTURE TYPE: O SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: O 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: ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED'
ROOF VENTILATION: O OFF -RIDGE O RIDGE O SOFFIT OPOWERED VENT
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
® 4:12 OR GREATER
O TURBINES
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
(D SHINGLE
Owens Corning
FL# 10674-R12
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IF APPLICABLE**
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#
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
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Page 2
Application Number . . . . . 18-00000425 Date 1/16/18
Property Address . . . . . . 134 WORNALL DR
Parcel Number . . . . . . . . 33.19.30.514-0000-0430
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1025360
Permit pin number 1025360
----------------------------------------------------------------------------
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
----------------------------------------------------------------------------
1000 111 BL03 FINAL ROOF / /
El
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOFS COVERINGS
PERMIT #: . /� ADDRESS: l VlV �� V/� (%� � rl ru
I , 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#: CCC1331153
COMPANY / CONTRACTOR: JASPER CONTRACTORS
CONTRACTOR SIGNATURE: DATE:
(MUST BE SIGNED BY LICENSE HOLDER OR Q 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 SEMINOLE
Sworn to and Subscribed before me this %day ofVA1 20 yy:
Who is ❑ Personally Known to me or has X Produced (tvDe of
entification.
SKYL`AR B AMKRAUT
Commission
N FF 127890
o
._
_ My Commission Expires
OF f op June 01 , 2018