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CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: / S/ ' 4.�
I
Documented Construction Value: $ 1 -72 J. L,�,, 5
/2
Job Address: � ��% Historic District: Yes ❑ No E
Parcel ID: ��"l —"�� �0-i7i�7�(,� b Residential Commercial ❑
Type of Work: Newo Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: �e" r] �i c ou RP, rov-F
Plan Review Contact Person: r 1 an(,i SC0 :�Q21 "XAU Title: OwyNR_-y-
Phone:cri FaxAM- 813 -y 113 Email: CR_. ct\ IGMRS O`�fl Cea,� ° i . Coy^
Property Owner Information
Name �Ada r-I JU t Phone: TO7- ` l q(o - ON
Street: (30, F�A'((' f 1 �j d d r . Resident of property?
City, State Zip:JC� nMyd , ri 1 3 2�-7-7
�
Contractor Information �7 "
Name I rVi I ►C� rY�Phone: LI I3Z
ito �n G1S �✓ �ly
Street: � 1132_ N V OWat� r4 B I V(- Fax: _4 W Y 7 R `7123
City, State Zip: I ON6 KdCcA 3 2 State License No.: (. /330( OC%
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: 5th Edition (2014) Florida Building Code
Revised: June 30, 2015
Permit Application
l NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records of this county, and there may be additional permits required from other governmental entities such as water
management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning.
Si ti re of Owner/Agent Da
� nu� C'& :bW"V
Print Owner/Agent's Name
Date
-d� 4-A--- -K11
Signature f Contractor/Agent 0ote
-D(21 Mau
Print Contractor/Agent's Name
Date
HEATHER M. LARKIN '��"Y ""e''• HEATHER M. LARKIN
o`opy '�'' MY COMMISSION # GG 045148
?' MY COMMISSION # GG 045148
��P EXPIRES: November 6, 2020
EXPIRES: November 6, 2020 goF ;Z�.• Bonded Thru Notary Public Underwriters
Bonded Thru Notary Public Underwriters
Owner/Agent is Personally Known to Me or Contractor/Agent is'Y Personally Known to Me or
Produced ID Type of ID Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required
Construction Type:
Total Sq Ft of Bldg:
Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Gas ❑ Roof ❑
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. r —
THIS INSTRUMENT PREPARED BY:
Narne: TRIANA TORRES
Address: 1182 N. RONALD REAGAN BLVD.
LONGWOOD, FL 32.750
Permit Number. i
Parcel ID Number:_ Z
ss>,ssr 511111118115 5lfif 1111111111 lilt fill
GRANT i' ALOY; SEhiIiaOLE COUNTY
CLERIC OF CTRC61T COURT & COMPTROLLER
OK 9060 Ps {r1 (1p9s)
CLERK'S Or 201800S457
RECORDED, r-11/1a/2r_i18 1-11-43-54 F•11
RECORDING FEES $40.Citi
RECORDED BY hdevure
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 a roperty and street address if available
2. GENERAL DESCRIPTION OF IMPROVEMENT:
RFSIDEUTIAI RF-RnnF
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: % d; .eEGiGt S{'U�i'; ��/ 3 Fa r f ie l d SGC,�) f d _
Interest in property:
Fee Simple Tide "older (if other than owner listed above) Name: N /lac
Address: N 1 " _
4. CONTRACTOR: Name:_ .PKITRAI HnnnFc i i r. Phone Number: 407-732-7262
Address: 1182 N. RONALD REAGAN BLVD. LONGWOOD, FL 32750
5. SURETY (If applicable, a copy of the payment bond is attached):
S. LENDER:
Address:
Amount of Bo/nd: 1 V //'�
Phone Number. N n
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., Flori Statutes. A ! q—
Name: r-j A _ Phone Number.
8. In addition, Owner designates
of
to receive a copy of the Llenors 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) !U /%-
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.
Ja_
.1f, ' X y i 1(SlgFzwre of Omer cr fes9ee. or s orLessee i
Authorized OffioerA iractu/P Manager)
State of 1 vV� ` \ Countyof
The for3goig instrument was
by
who has produced identification ❑
a �1 S �- PprJ I�
(Print Nam and Picifte
Dwledged before me this day of 1 A �J UM ► tiY .20 1�
Who is personally known tome OR
fang uatemenl fj./'
type of identification produced:
'�l"" MARIA T. BUTCHER
`c MY COMMISSION # GG101540
',?;,y4��.' EXPIRES May 04, 2021
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: ys-
I hereby name and appoint: Ho-z-o ®(Dj
an agent of: L
(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):
The specific permit and application for work located at:
v1 c` IT)Y . Sc llftTT1 f5--1 . 32 -1
(Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name: T Y (►"C 15 C Cu -Dw mu,
State License Number: UT 133C�cil
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF' l l
The foregoing instrument was acknowledged before me this Vl of " S 4ill ,
200 l $ , by it -c; ,,,,.a,,. who is ❑personally known
to me or ❑ who has produced as
identification and who did (did not) take an oath.
(Notary Seal)
v HEATHER M. LARKIN
'�' it • •: MY COMMISSION # GG 045148
EXPIRES: November 6, 2020
•'•rMCf �'�P•• Bonded Thru Notary Public Underwriters
(Rev. 08.12)
Signature
Leo. x LosIJ-) i t-1
Print or type name
Notary Public - State of Niat
Commission NoPll 5 14
My Commission Expires:
CITY OF
Building &Fire Prevention Division
S FORD RESIDENTIAL RE -ROOF POLICY & PROCEDURES
FIRE DEPARTMENT
PERMITTING REQUIREMENTS — NO PLAN REVIEW REQUIRED
THIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE
REQUIRED TO BE SUBMITTED AS PART OF YOUR PERMIT APPLICATION.
THE SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF
COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT.
A PERMIT WILL NOT BE ISSUED WITHOUT THESE DOCUMENTS. COPIES WILL BE MADE TO POST ON THE JOB SITE.
"PROJECTS LOCATED IN THE SANFORD HISTORIC DISTRICT WILL REQUIRE PLAN REVIEW AND APPROVAL BY THE
SANFORD HISTORIC PRESERVATION BOARD
INSPECTION POLICY & PROCEDURES
A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMILY, TOWNHOUSE,
MOBILE HOME, APARTMENT AND/OR CONDOMINIUM) RE -ROOF PERMITS.
THE FOLLOWING IS REQUIRED TO BE PROVIDE ON THE JOB SITE:
• PERMIT CARD, POSTED IN A CONSPICUOUS AND WEATHERPROOF LOCATION
• COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK
• COMPLETED AND NOTARIZED INSPECTION AFFIDAVIT
• ALL FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS
(PRODUCT APPROVAL SHALL MATCH WHAT IS ON THE SCOPE OF WORK)
• DIGITAL PHOTOGRAPHS (MUST INCLUDE THE PERMIT NUMBER OR ADDRESS IN EACH PICTURE)
o EACH PLANE OF THE ROOF, SHOWING THE UNDERLAYMENT INSTALLED
o ROOF DECK NAILING PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
o ROOF DECK NAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHOWING SIZE OF NAILS)
o UNDERLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
o DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE OR RULER)
o SHINGLES INSTALLED, NAIL PATTERN AND LOCATION OF NAILS
• SKYLIGHTS (IF APPLICABLE)
o DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL
o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT APPROVAL
FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNERBUILDER) SIGNATURE: De-t� DATE: \\s `�
. �3t...CITY OF
f
s�SANFORD
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: 3 ► 3 r i rfi u d C_W . Soy 1" �rd . F 1. 32 -1-1)
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): phi no , sv 2 i (ig 2-
* *PLEASE NOTE: ONLY 100 SQUARE FEET OF THE 1EXISTING DECK IS PERMITTED TO BE REPLACED **
ROOF VENTILATION: Qa OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES 0 NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 (0 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDAPRODUCTAPPROVAL
® SHINGLE % Ted
(
FL#-
I
O METAL
FL#
0MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLICABLE**
ROOF SLOPE: O LESS THAN 2:12 O 2:12-4:12 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
O SHINGLE
FL#
O METAL
FL#
O MODIFIED BITUMEN
FL#
0TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
e • o
Central Homes Roofing
Sales Representative _
1182 N. Ronald Reagan Rd.
Jacob Lee �
Longwood, FL 32750
���
(407) 708-8122 re r
(407) 732-7262
centralhomesjacoblee@gmail.com 9 Homes
t,
Raheeda Fisher
313 Fairfield Dr
Estimate # 1372
Sanford, FL 32771
Date 1216/2017
Item
Description
Scope of work
Removal.
Tear off and haul away the existing shingle roof system (one layer). An additional
S35/sq. for removal of each unforeseen additional roof layer will be added.
Roof Sheathing Inspection
Inspect the roof sheathing fastening system and supplement (re -nail).
Underlayment
Supply and install one layerof.Rhino Synthetic, felt underlayment.
Ventilation
Supply and install new Shingle Over Ridge Vents and/or 4' Off Ridge Vents for
proper ventilation.
Drip edge
Supply and install new 2'/2" eave drip
Pipe Jacks
Supply and install Bullet Rubber boot flashing for plumbing stacks
Valleys
Supply and install a self -adhered peel 8 stick modified underiayment in all valleys
Certainteed Landmark per square
Certainteed Landmark Architectural Shingles per square
Permits/Inspections
We will obtain and pay for a permit and obtain all required inspections
Dumpster/Haul away debris
Upon completion, all roofing debris will be picked up and taken away.
Warranty
7 year workmanship warranty on labor
Shingle Color; A)A- W
t.Drip Edge Color: UN kQi Vents Color:.- 'AaK1-_
HoirLeowner Ne
Sub Total $7,725.65
.. It�prrnr ."
o eowner:rgrstur
Date
�-
Total $7,725.65
Central Homes Rep. !it
'11tik"L't-1
ti
CITY OF
&�FORD Building & Fire Prevention Division
RESIDENTIAL RE -ROOF AFFIDA PIT
FIDE [APARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
X �
PERMIT #: lJ ADDRESS:313 rw (f, 6fryY .
I VA_0�" Ic� (� t1.(11 1WA V , 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 #: P. r-. V 33Woq
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE: q Q— DATE: Z
(MUST BE SIGNED BY LICENSE HOLISER 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 Sl `" '\W)W
Sworn to and Subscribed before me this 01 day of kV W 20 1 O by:
�AVA� (,A'W' AV. Who is ❑/Personally Known to me or has ❑ Produced (type of
identification) as identification.
g ature f N tary Public
tate of F orida
T► q-TA vy 3ur i o�
Print/Type/S amp Name
of Notary Public
P,p " Notary Public State of Florio;,
01
Tiffany Burleson
My Commission GG 173997
"OF Expires 01/09/2022
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