HomeMy WebLinkAbout158 Pinefield DrFEB 12 2018
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: / f' R/
Documented Construction Value: $ ,00
�V Job Address: P'i n-�� e`C� �1r'Y� ` Historic District: Yes ❑ No ❑
Parcel ID: Residential ❑ Commercial ❑
Type of Work: New ❑ Addition ❑ Alterations Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: Of mod—--t`puy— OQ( y�(�p,( "�_ ' 4Q1aL'r_
tAjtfkt- AYO
Plan Review Contact Person: ��.I_[,�� Title:
Phone: �-� ��(py�Fax: s �ttU— l Email: f`Y1("6 1Z° rrt
I ,, Property Owner Information
Name "Met) D (�2 Phone:
Street: (f)j< n e4 J E ( Dr 4m" Resident of property? : S�
City, State Zip: �rn4�jer,( R, ,3,—M J
Contractor Information
Name Phone: V 5D— '11(4-3�a ;
Street:'<�qL�
/ L� � / Fax: c�5� —0L V - 2S 3
City, State Zip: 7`State License No.: CCL (3_ Z j5&(:?
rchitect/Engineer Information
Name: Phone:
Street:
City, St, Zip:
Bonding Company:
Address:
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 NIUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINAINCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
CONINIENCENIENT.
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`h 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 l 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 [CC 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 constru and zoning.
t ai qi 12
Signature of Owner%Agent Date Signature of Contractor./.went Date
Print Owner/Agent's Name )Pri;tractor/nt's Name
Signature ofNotary-State of Florida Date State of Florida Date
fill
ommi ;;ion # FF I722 i0 1
.�,��z My Commissi% Expires
" - Octck�er 2G18
Owner/Agent is Personally Known to Me or — nown to ale or
Produced ID Type of [D Produced 1D Type of [D
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbinb❑ Gas ❑ Roof ❑
Construction Type: Occupancy Use: Flood Zone:
Total Sq Ft of Bldg: Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads Fire Alarm Permit: Yes ❑ No ❑
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING:
COMMENTS:
Revised: June 30, 20 15 Permit Application
SCPA Parcel View: 32-19-31-515-0000-0290
Property Record Card
Parcel: 32-19-31-515-0000-0290
Property Address: 158 PINEFIELD DR SANFORD, FL 32771
Value Summary
__....--- _------------ ---- ----
----------------- ----
2018 Working
----- -
2017 Certified
Values
Values
I Valuation Method
Cost/Market
Cost/Market
i Number of Buildings
1
1
Depreciated Bldg Value
$143,445
$135,165
! Depreciated EXFT Value
$1, 335 ;
$1,418
Land Value (Market)
$32,500
$32,500
Land Value Ag
JustAlarket Value "'
$177,280
$169,083
Portability Adj
Save Our Homes Adj
$29,952
$24,785
j Amendment 1 Adj
$0
I P&G Adj
$0
$0
__ -------__.
Assessed Value
$147,328
$144,298
Tax Amount without
SOH: $2,431.74
2017 Tax Bill
Amount $1,959.80
Tax Estimator
Save Our Homes Savings: $471.94
Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description
j LOT 29
CELERY LAKES PHASE 1
PB 62 PGS 75 & 76
Taxes
Taxing Authority
Assessment Value
Exempt Values
Taxable Value
County General Fund
$147,328
$50,000
$97,328
i Schools
$147,328
$25,000
$122,328
City Sanford
$147,328
$50,000
$97,328
SJWM(Saint Johns Water Management)
,. - ___------
$147,328 1
$50,000
$97,328
County Bonds
$147,328
$50,000
$97,328
Sales
3 Description
i Date
Book
Page Amount
! Qualified
Vac/Imp
WARRANTY DEED
11/1/2014
08362
1193 $172,900
Yes
Improved
SPECIAL WARRANTY DEED
4/1/2004
05236
0-152 �$153,000
Yes
Improved
IRnd ComparableSales
Land
Method Frontage
Depth
Units
I Units Price
Land Value
LOT
1 $32,500.00 =_
$32,500
Building Information
Year Built
a # Description i Actual/Effective Fixtures Bed Bath :Base Area ;Total SF Living SF Ext Wall Adj Value i Repl Value Appendages
! i
FD. cripti.n Area1 SINGLE 2004 11 4 £ 3.0 1,228 : 3,216 i 2,804 i CB/STUCCO $143,445 ! $150,598
I
FAMILY FINISH
http://parceldetail.scpafl.org/ParceiDetaillnfo.aspx?PID=32193151500000290 1/2
2/2/2018
SCPA Parcel View: 32-19-31-515-0000-0290
OPEN 18.00
PORCH
FINISHED
UPPER
STORY 1576.00
FINISHED
GARAGE '394.00
FINISHED
Permits
Permit # Description
Agency
Amount
CO Date Permit Date
02700 6' WOOD FENCE
SANFORD
$1,044
7/29/2004
02752 CONCRETE & 15 X 30 SCREEN W/ALUMINUM ROOF
SANFORD
$1,688
7/29/2004
00039 NEW -RESIDENTIAL
..........-..- ---
SANFORD
__----- _..._. ._....._ -- --
$120,698
._'.. _.....
3/5/2004 10/6/2003
-_------ .................
Extra Features
Description Year Built
Units
Value
New Cost
SCREEN PATIO 6/1/2004
1
$1,335 $2,500
http://parceldetail.scpafl.org/ParcelDetaiIInf0.aspx?PID=32193151500000290 2/2
1410 Emerson Street, Leesburg, FL 34748 • State Roofing License: CCC1329936 • License: CGC037504
Phone: 352-314-3625 • Toll Free: 855-314-3625 • Fax: 352-240-3439 • www.covenantrnc.com
SALES CONTRACT
Covenant Roofing & Construction, Inc. agrees to furnish all materials and labor necessary to do the modernization work at the following address:
Name C�>v1�' C e��' it��� Phoned' %- �`Ll) _%7`7 Phone (w)
Address lS,:tf rfr1ed ie.0 Date
City +� z"'ra State zip _ 0-771
Email
In accordance with specifications given below:
REROOF:
A. SHINGLE ROOF
1. REMOVE OLD ROOF TO WORKABLE SURFACE.
2. RENAIL ROOF DECK WITH RING SHANK NAILS.
3. REPLACE ANY ROTTE W OD WITH STANDARD SHEATHING @ $ PER FOOT AND $ PER SHEET OF PLYWOOD, IF AN Initial)
4. INSTALL UNDERLAYMENT OVER ENTIRE ROOF. S 1�ee+S
t
5. INSTALL FHAN EAVES DRIP. COLOR _ %�
6. INSTALL NEW VALLEY METAL AND FLASHINGS AS NECESSARY.
7. INSTALL NEW LEAD BOOTS OVER VENT PIPES AND RESEAL VENTS
8. INSTALL —YEAR FIBERGLASS SHINGLES. COLOR %%i
9. INSTALL yC— FEET OF RIDGE VENT AT $679� FOOT. COLOR
10. CLEAN-UP JOB SITE OF ALL WORK DEBRIS AND HAUL AWAY ALL RELATED DEBRIS AND LEAVE JOB SITE CLEAN.yyr, L +�
11. CONTRACTOR WILL COORDINATE REMOVAL AND REINSTALLATION OF ROOF RELATED PERIPHERALS SUCH AS (BUT NOT LIMITED TO) SOLAR UNITS, SKYLIGHTCTV.DISH,1-91
ANDAIR CONDITIONERS, ETC. REMOVE AND REINSTALL EXISTING SOFFIT AND FACIA @ $4.25 PER F 0 "IN DDITION TO CONTRACT PRICE, IF REQUIRED. TR
SUCH WORK WILL BE IN ADDITION TO CONTRACT PRICE AND HEREIN APPROVED BY HOMEOWNER. (Initial)
12. ALL WORK COVERED BY A 5 YEAR WORKMANSHIP WARRANTY.
1. Contract Documents. This contract consists of this document, extra work/wood authorizations, if any, and if payments
hereunder are to be financed, all financing documents. No promises other than those specifically set forth in the contract
documents shall be recognized by either party. The entire understanding and agreement of the parties is contained in the
contract documents.
2. It is understood and agreed that this contract shall not become binding upon Covenant Roofing & Construction, Inc. until it is duly
approved, accepted, signed and witnessed by an officer or officers of the Seller.
3. Work on the job described in the contractdo-Qumentswill commence on approximately P01}!> and be
completed on approximately t. The recited dates are approximations and are subject to scheduling
difficulties of Seller, labor and/or material shortages, acts of God and other events not foreseen by Seller. Seller reserves
the right to employ any sub -contractor for the completion of the work described in the contract documents.
4. Covenant Roofing & Construction, Inc. reserves the right to substitute materials of equal or greater value and kind. Any required
materials such as fire retardant plywood, tongue and groove board, etc. will be billed on a time and material basis. All other
changes required by New Jurisdictional Code Enforcement Laws may result in additional charges.
5. Interest at the rate of eighteen (18%) per cent per annum will be charged on all balances not paid as per the terms specified
above. Reasonable attorney's fees will be charged to the Purchaser if it is necessary to place this contract in the hands of an
attorney for collection, and this charge becomes a part of the contract and obligation of the Purchaser to pay.
6. Parties agree that this agreement shall be construed according to the laws of the State of Florida and any action brought
thereon may be brought in the State of Florida. Venue is hereby agreed to be in Lake County Florida.
7. BUYERS RIGHT TO CANCEL (SOLICITED SALES ONLY) If you do not want the goods or services, you may cancel
this agreement by providing written notice to the seller in person, by telegram, or by mail. This notice must Indicate that you
do not want the goods or services and must be delivered or postmarked before midnight of the third business day after you
sign this agreement.
8. Both worker's compensation and public liability insurance are carried by the Seller and they are applicable to the work to be
performed.
9. It is understood and agreed that the buyer hold harmless, Covenant Roofing & Construction, Inc., for any damages that may
occur to the buyer's driveway(s) during delivery of materials and/or removal of the work related debris that may be required
to perform this home improvement contract. Furthermore, the buyer herein gives permission for typical delivery vehicles and
typical waste removal vehicles to enter said driveway(s) for the purpose of expediting this sales contract.
10, Contractor will coordinate removal and reinstallation of roof related peripherals such as (but not limited to) solar units, skylights,
T.V. dishes and air conditioners, etc. The cost for such work will be in addition to contract price and approved by homeowner.
11. Covenant Roofing & Construction, Inc. shall not be held responsible for damage to electrical lines, water lines, refrigerant lines
or other mechanical components that have been improperly installed near roof decking and may be damaged while performing
installation of roofing materials. Villages Roofing & Construction, Inc. shall not be responsible for any additional costs due to
roof decking that may have old materials adhered in such a way that requires redecking of structure.
12, Construction Industries Recovery Fund payment may be available from the CIRF if you lose money on a project performed
under contract, where the loss results from specified violations of Florida law by a state -licensed contractor. For
information about the recovery fund and filing a claim, contact the Florida Construction Industry Licensing Board at the
following telephone number and address: 7960 Arlington Expressway, Suite 300, Jacksonville, FL 32211-7467 or call (904)
727-6530.
13. Chapter 558, Florida Statutes contains important requirements you must follow before you may bring any legal
action for an alleged construction defect in your home. Sixty days before you bring any legal action, you must
deliver to the other party to this contract a written notice referring to chapter 558 of any alleged construction defects
and to consider making an offer to repair or pay for the alleged construction defects. You are not obligated to accept
any offer which may be made. There are strict deadlines under this Florida Law which must be met and followed to
protect your interests.
Contract Price $ _ /
Homeowner Portion $
Plus Total from Item No. 3 above)
PO TION
Executed in triplicate, one copy of which was delivered to, and receipt is hereby acknowledged by Buyer,
this 3 I day of ��}�i,°/ , 20_L_.
Approved and Accepted: NOTICE TO OW
I
NER
Do not sign this home improvement contract in blank.
You are entitled to a copy of the contract at the time you sign. Keep it to protgjt_Your rights.
(Seal) l�L,_> : c 7 S 04�4,4j;" (Seal)
(Dealer -Seller) A (Purchaser Sign Here)
BY
(Title)
SALESMAN
W
(Seal)
(Purchaser Sign Here)
FORD PRESS, INC. 352-787-4650 (mike)
Permit Number:
Folio/Parcel ID #: 3 ' 19' - S / S- D 55G - Aa9 0
Prepared by:
✓iNOS" T Cle;f-VA0,
Return to: Covenant Roofing & Construction Inc.
1410 Emerson St.
Leesburg, FL 34748
GRO MT hls-1L.I �Y r SEI1:[PIULh t:01J1a'i'Y
CLERK OF' (:IRC:LIl:t C:0UR,i
13K 9074 Pq 164 (IF -as
CL.ERK'S �x 2018016400
RECURDED 1=121/12/201
RL.::C0RD1HG FEE ; a t.1;1, 1111
RECURDED BY tsmith
NOTICE OF COMMENCEMENT
State of Florida, County of
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 properly (legal description of die property, and street address if available)
2. Gener I description of imOrovement
�e,L('Xl�
3. Owner information or Lessee information if the Lessee contracted for the improvement
Name g .s20,104e
Address /eft .rk,1reld � �,n �✓ �L 3z7, r
Interest in Property Z-
Name and address of -fee simple titleholder (if different from Owner listed above)
Name
Address
4. Contractor
Name Covenant Roofing & Construction, Inc. 'Telephone Number 352-728-8818
Address 1410 Emerson St., Leesburg, FL 34748
5. Surety (if applicable, a copy of the payment bond is attached)
Name Telephone Number
Address Amount of Bond $
6. Lender
Name Telephone Number
Address
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may
be served as provided by §713.13(1)(a)7, Florida Statutes.
Name Telephone Number
Address
8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's
Notice as provided in §713.13(1)(b), Florida Statutes.
Name Telephone Number
Address
9. Expiration date of notice of commencement (the expiration date will be 1 year from the 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.
of Owner or Lessee, or Owner's or Lessee's Authorized Officer/Director/Partner/Manager Signatory's Title/Office
The foregoing instrument was acknowledged before me this
as OwAt— for
Type of authority, e.g., officer, trustee, attorney in fact
t 'o Public — State of Florida
i day of I j by
month/year name of person t%, LU
!l wo,
Name of party on behalf of whom instrument was executed 0 c=
a �-
If
u'
Print, type, or stamp commissioned name of Notary PutLgi ,u
Personally Known OR Produced ID 4 d
Type of ID Produced C'i'S3- o�9-t3 ::►^• JONATHAN L HOLIDAY UA
. MY COMMISSION k FF228443' w
WN: �F� EXPIRES May 16. 2019
I10/1:1k[i-C•y5 FWsdallowySarviceccxr
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Form content revised: 01/23/14
City of Sanford
Building and Fire Prevention
Product Approval Specification Form
Permit #
Project Location Address 157K 1)4-P (A D-- c�-a Y,41 Nrri .
As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the
information and product approval number(s) on the building components listed below if they are to be
utilized on the construction project for which you are applying for a building permit. We recommend that
you contact your local product supplier should you not know the product approval number for any of the
applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in
accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product
Approval can be obtained at www.floridabuilding.org.
The following information must be available on the jobsite for inspections:
1. This entire product approval form
2. A copy of the manufacturer's installation details and requirements for each product.
Category / Subcategory
Manufacturer
Product
Description
Florida Approval #
(include decimal)
1. Exterior Doors
Swinging
Sliding
Sectional
Roll Up
Automatic
Other
2. Windows
Single Hun
Horizontal Slider
Casement
Double Hung
Fixed
Awning
Pass Through
Projected
Mullions
Wind Breaker
Dual Action
Other
June 2014
Category / Subcategory
Manufacturer
Product
Description
Florida Approval #
(including decimal)
3. Panel Walls
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles
Underlayments
NVnC5
>l
_ Izz
Roofing Fasteners
Nonstructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Built up roofing
System
Modified Bitumen
Single Ply Roof
Systems
Roofing slate
Cements/
Adhesives /
Coating
Liquid Applied
Roofing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels
Roof Vents
Other
June ?0 14
Category / Subcategory
Manufacturer
Product
Description
lorida Approval #
F�(7inclucludedecimal)
5. Shutters
Accordion
Bahama
Colonial
Roll up
Equipment
Other
6. Skylights
Skylights
Other
7. Structural
Components
Wood Connectors /
Anchors
Truss Plates
Engineered Lumber
Railing
Coolers/Freezers
Concrete Admixtures
Precast Lintels
Insulation Forms
Plastics
Deck / Roof
Wall
Prefab Sheds
Other
8. New Exterior
Envelope Products
Applicant's Signature
Applicant's Name
(Please Print)
June?Ol4
Limited Power of Attorney
Date �D
I hereby name and appoint Robert Horne of Covenant Roofing and Construction, Inc. to be my
lawful attorney in fact to acttt-for me and apply to
for a j2i t�,b permit for the address below:
G: 5 -g P/A r- - --�" 0/-
Joseph E. Rayl, Contractor Lj"n& #CCC1329936
Acknowledged:
Sworn to and subscribed befo�r% me this � day of f' % , 20��
By Joseph E. Rayl who is vpersonally known to me or _ produced
identification.
My Commission expires:
as
Lti`st' Y i7LtGl si . " x
ion k F F t p t�
CITY OF
Building &Fire Prevention Division
SkNFORD RESIDENTIAL RE -ROOF POLICY & PROCEDURES
FIRE DEPART�4IEN
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.
DAT
CONTRACTOR (OR OWNERBUILDER) SIGNATURE: E: `�
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
•:ADDRESS: 1 rw e art J-`
STRUCTURE TYPE: 4-SNGLE 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 EXISTNG ROOF)
DECK TYPE (PLEASE SPECIFY):
"PLEASE [VOTE: ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PER,WTTED TO BE REPLACED { {
ROOF VENTILATION: DOFF -RIDGE RIDGE OSOFFIT OPOWERED VENT OTURBNES
SKYLIGHTS: O YES ( NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
V(aN 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
C1�'
FL# `i I
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
O INSULATED
FL#
OBILE
FL#
O OTHER:
FL#
ROOF EXTENSIONS (PORCHES, PATIOS. ETC.) **IFAPPLIG-IBLE**
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 IV[ ETAL
FL#
O MODIFIED BITUMEN
FL#
OTORCH DOWN
FL#
O INSULATED
FL#
O TILE
FL#
O OTHER:
FL#
City of Samford
Buildinc, and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, :AND ALL FINAL ROOF COVERINGS
PERMIT #: I a - 'S 19,
[ j
ROOF[N(
;GINEER,
FOREGOING INFORMATION IS TRUE .A-`
ADDRESS: ��� pil adle Ict py-
c�C�i. Y �-► V 1� mil. 1 C� e����
AS AM GENERAL, BUILDING, RESIDENTIAL, OR
CT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
R ATE AND THAT ALL ROOFING COMPONENTS LISTED ON THE SCOPE OF WORK AT THE
ABOVE REFERENCED ADDRESS HAVE BEEN INSTALLED IN :A000RDA-NCE WITH THEIR PRODUCT APPROV.-BLS AND .ALL APPLICABLE CODE
REQUIREMENTS — SPECIFICALLY FLORIDA BUILDING CODE, EXISTING BUILDING. [N .ADDITION I CERTIFY" THE INSTALLATION MEETS .ALL
REQUIRESIENTS FOR SECONDARY WATER BARRIER AND NAILING OF THE ROOF DECK, ICI ACCORDANCE WITH THE HUR-RICANE RETROFIT
.MANUAL REQUIREX,IENTS (BASED ON F.S. CHAPTER 553.84-1).
LICENSE #:
CO"\'IP.ANY /
CONTRACT(
(MUST- BE S
DATE:
THIS SIGNED AND NOTARIZED AFFIDA , IT AIUS-r BE PROVIDED AT THE JOBS IT EAT THE TIVE OFT HE FINAL ROOF INSPECTION,
.ALONG WITH DIGITAL PHOTOGR.APHS OF EACH PLANE OF THE ROOF SHOWING IN DETAIL .ALL COMPONENTS (DECKING,
UNDERL-AY:NIENT, 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 REQUIRENIENTS.
"FAILURE TO FOLLO�k ALL REQUIREMENTS WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION FEE AS
WELL AS REQUIRING A DESIGN PROFESSIONAL (ARCHITECT OR ENGINEER) TO CERTIFN', BASED ON PERSONAL
INSPECTION, THE INST.ALLATiON OF ALL ROOFING CO:.IPONENI'S.
STATE OF FLORIDA COUNTN' OF ��"�•
Sworn to and Subscribed before me this day of KI20 -by: AU
Who is 1! Personally Known to me or has - Produced (type of
fication) as identification.
Si dafure of Notd ry Public _
ate of Florida LINDS ,�*°""�:WAY''� DUCKHAM
* Commission S FF 172210
My
_ ropK011,,' October 28 2018 xpires
Print/Type/Starr ame
of votary Public