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CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: I � qo
Documented Construction Value: $ C'd-e-aO , `yl'
a2kJob Address: V `A� �� Historic District: Yes ❑ No N
Parcel ID: 00Q " O l`E 0 Residential ZI Commercial ❑
Type of Work: New ❑ Addition 0 Alteration ❑ Repair 0 Demo ❑ Change of Use ❑ Move ❑
Description of Work:
Plan Review`Contact Person: q 5a ►� 5--T- Title:
Phone: qQ-1 -qq1 ^C)�- IFax: Email:
Property Owner Information ,
Name ��� s Phone: ��`4�
Street: Vei�\1 ev-, Resident of property?
City, State Zip: z6A 3`'1-1 t
Contractor information
Name (` 55� (-) Pr-E V4XW� SA_Lrti0 Phone: Ud'
Street: �7501 (Lb YtiW_ L-19YO-5 31LrA Fax:
City, State Zip: �� A p
3� State License No.:
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Architect/Engineer Information
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: 5ch Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records of this county, and there may be additional permits required from other governmental entities such as water
management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating cons tion and zoning.
Signature of Owner/Agent Date Signature of Contractor/Agent Date
i'5 5 W-C- � 7� el?'
Print Owne gent ame Print Contractor/Agent's Name
Signa a of No Staste gtFlWid,g, v e12atQ Signature of Notary-S
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��., DAVID CONNELC ;r THERESA EDGERTON
Y o % z ��� = Notary Public - State of Florid
r° r Notary Public - State of Florida • ` Commission # GG 170873
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sN ' Commission # GG 022961 :;�1s My Comm. Expires Feb 27.2Ce
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Owner/Agent Contractor/Agent is Personally own to
E E
Produced ID Type of ID Produced ID Type of ID
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BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ 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, 2015 Permit Application
Assure=U
'' t Hom / Services
www.assure-u.neta stroth
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Sam: 407-947-0249
Theresa: 407.970-9746
7581 Rio Pinar Lakes Blvd.
Orlando, Florida 32822
State License #CCC1326792
Financing Available
BBB.
NAME ,
STREET
CITY, _ STATE
HOME PH.1461 -9 _ WORK PH.
.Start Wrth Tnat y,„
Remove existing roof C� Shingle ❑ Tile ❑ Rock ❑ Metal ❑ Roll Additional Layers Extra per square if found .
Repair�d�.c9ayed or defective flashin s,�rafters, fascia, and sheathing at an additional $ .a.w per man hour plus materials.
)0 Per sheet 1/2" Plywood ;` 'Per foot dimensional lumber labor and materials.
Install new shingle roof in accordance with manufacturers written specifications and all applicable local codes over
new (Synthetic ❑'30# felt secured to deck or ❑ self adhesive base sheet Color
❑ 25 year 3 tab J Algae Resistant C k Color
9_30 year Architectural/Dimensional" Color
Other
4. New Eaves Drip C:4 ❑ Beige ❑ Brown ❑ Gray
Size ❑ Black ❑ White
❑Turbine Vents
a,Qff Ridge Vents 48"Color.
optional ❑Add $ ❑ Replace $
❑Center Ridge Vents Color
optional ❑Add $ _ ❑ Replace $
❑ Nail Over Ridge Vents
Other: f
r' —4> 1 tA. t/ C;ci&
New 26 Ga. Galvanized Valley Metal ft.
Galvanized Wall Flashing ft.
See #2 above
$ Additional
D Save Existing Eaves Drip
0 Lead Plumbing Boots 4" 3"9"J--1 1/2"
[Galvanized Kitchen Vents d 4" +- _ Color
❑ Skylite Domes 2x4_2x2 $ option
lowslope roof system. To -be installed
secured to deck and
6. Remove all roofing debris from premises. Drag ground with nail magnet.
Ins„ Der 4-1#-organic base
Self Adhesive basesheet ❑
7. Workmanship warranted against leaks for fiive (5) years from date of completion. Applicable Manufacturer's warranty
applies to materials. Warranty applies to reroofs only, repair warranty is limited to six (6) months unless otherwise noted.
Price Includes all permit and dump fees on whole roofs only.
_ ----^
We hereby propose to furnish labor and materials - complete in accordance with the above specifications, for the sum of: 1
dollars plus #2 and above options Iwith payment to be made as follows:
HALF DUE UPON START DATE. BALANCE DUE UPON COMPLETION UNLESS OTHERWISE NOTED.
All materials guaranteed to be as specified. All work is to be completed in a workmanlike manner.according tostandardpractices. Any alterations or deviation from above specifications
involving extra costs, will be executed only upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon, strikes, accidents or
delays beyond our control. We will not be responsible for driveway cracks or any nail related incidents. Price is based on our trucks being able to backup to building. This proposal
subject4o acceptance within 30"days amd is void thereafter at the option of the undersigned. A personal service provided through subcontractor services.
We are now accepting credit cards*
FORSj �,✓'
Authorized Signature'— Cell Phone: 407.947.0249 Septic Tank ❑Front ❑Rear �MERNdW
• • DRRESfi m
❑ Exposed ceiling of Eaves
`Additional charge may apply.
The above prices, specifications and conditions are hereby accepted. You are authorized to the work as specified. Payment will be made as outlined above.
Legal Description:
Accepted:
Signature' �
s
Owner or Authorized Agent
Signature:
Owner or Authorized Agent
1111111111111111111111111111111111111111
THIS INST UMENT REPA ED BY: \k
Name: f_Vi �`V�n'k
Address: UOL
NOTICE OF COMMENCEMENT
State of Florida
CLE�:I:E:. OF t-TRt-U):T COURT t, CONF'TROLLER
r,
CLERK'c B 2_i 8l04985
'r+:E_t:::0RDLEr 01/16;"70:E8 ij, ;::7R `.i. °i!
i;E('ORDING FEEc $10Ftsi
F:Ei"-QhC-- - i�clevory
County of Seminole
Permit Number: Parcel ID Number:
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.
DESCRIPTION OF PROPERTY: (Legal description of the property
L-j-,v- o-A 7evXT7v,,.- 3cZj
GENERAL DESCRIPTION OF IMPROVEMENT:
OWNER INFORMATION:
Address: oLOW - L-11-
Fee Simple Title Holder (if other than owner)
Vf -p— - v A---,c- Oruv�
Address: -7 5-61 (LW VI-f-CE (- VAS 0--A 6 C3'(-k--"\f6Q Ej S
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)(b), Florida Statutes.
Name:
In addition to himself, Owner Designates
To receive a copy of the Lienor's Notice as Provided in
Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement (The expiration date 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.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true
to the best of my knowledge and belief.
.�;•.Owne s Signat a ers Printed me
y 1 J�lorri a Statute:713I13(1 : " The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead."
-
Da tita,•„^ GFEUiYCi.ERK
County of�
The foregoing instrument was acknowledged before me this 1 day of C , 20 L-7
by \ lS "`f S VIy . Who is personally known to me 01
Name f person making ktatement
OR who has produced identification ❑ type of identification produced:
DAVID CONNELL
:°�� c's Notary Public - State of Florida
3•: �_. .Commission # GG,022961
My Comm. Expires Aug 21. 2020
•'�F n11fl�•
���• Bonded through National Notary Assn.
Notary Signature
121*1�a-
CITY OF
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF POLICY
FIRE DEPARTN-IENT
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
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTT
;T IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN
CODE COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNERIBUILDER) SIGNATURE: L_ DATE: ,—
E:IfiE DEPI�R� 1
JOB ADDRESS: � � 1. tl
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE ROOF SCOPE OF WORK
�Sc"/ Cv�_
STRUCTURE TYPE: 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:ONLY100SQUARE FEET oFTHE EXISTINGDECEIS PERMITTED TO BE REPLACED**
ROOF VENTH ATION: tNOFF-RIDGE O RIDGE OSOFFrF OPOWERED VENT OTURBINES
SKYLIGHTS: O YES �&NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA.
ROOF SLOPE: O LESS TITAN 2:12 O 2:12 -4:12 (4:12 OR GREATER
TYPEOF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
6SHINGLE
6WF
FL# Ol 2-l •
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
I
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
O SHINGLE
FL#
O METAL
FL#
O MODIFIED BMJMEN
FL#
O TORCH DOWN
FL#
O INSULATED
FL#
O TILE
FL#
O OTHER:
FL#