HomeMy WebLinkAbout335 Lusitano WayCITY OF SANFORD
EE E �'qV BUILDING & FIRE PREVENTION
PERMIT APPLICATION
FEB - 7 2018
�/� Application No:
BY.-!_�_
Documented Construction Value: $ 15,100,
Z _
Job Address: ��rj ��n \� UU �' -1-7Z ( Historic District: Yes ❑ No ❑
Parcel ID: Residential ❑ Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: ��nN
Plan Review Contact Person: &61 ne_V� 'Orlo Ll. Title:
Phone: ad'�-�(o�-�yq_?j?5 Fax: Email:
Property Owner Information
Name Awwl -CL c)�Q QUtXIg Phone: Bo'-3'�g-5r1r1a
Street: 33 ,15 �, 1p Resident of property? : 7 e 5
City, State Zip: a , 3-J-711
Contractor Information
Name XRC_ U-01
Street: 401q
City, State Zip: AA06, F
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Phone:
Fax:
State License No.: c.0 13aq[ a io
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: 51h 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 regulati istruction and/oning.
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Date
Print Contractor/Agent's Name
,)32��ka.t�
,
ignature of Note
""'
•'.;lT;t.Y� .' Jfr�
DEBBIE BLANTON
i
N� # rF 178648
a. a:
�.
E fp;RES: F ebrL9 25, 2019
ry
�)
�Dnded Thru Notary Pubic Underwriters
Contractor/Agent is
Personally K wn o Me or
Produced ID
Type of ID
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:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
# of Stories:
Plumbing - # of Fixtures_
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
c�a
- Scxm+o�Eoourn'r.Ftrxao�
Parcel Information
r
Property Record Card
Parcel: 18-20-31-506-0000-1340
Property Address: 335 LUSITANO WAY SANFORD, FL 32771
Parcel
18-20-31-506-0000-1340
Owner
COLLINS, STEPHEN B
COLLINS, JADE C
Property Address
335 LUSITANO WAY SANFORD, FL 32771
Mailing
335 LUSITANO WAY SANFORD, FL 32773-6887
Subdivision Name
BAKERS CROSSING PHASE 2
Tax District
S1-SANFORD
DOR Use Code
01-SINGLE FAMILY
Exemptions
+ 0
50
50
ru,
E "
50
50
50
Legal Description
LOT 134
BAKERS CROSSING PHASE 2
PB 62 PGS 97 - 99
Taxes
50
35 �9
J
�
z
i
50
i
60
GIS
Seminole County
Taxing Authority
Assessment Value
Exempt Values Taxable Value
County General Fund
$181,569
$0 ; $181,569
- ------ -- — --- -
Schools
-- - --
$181,569
-- -- -
$0 I $181,569
i City Sanford
$181,569
i $0 ' $181,569
i SJWM Saint Johns Water Management)
9 )
$181,569
$0 $181,569
County Bonds
_
I $181,569
------------ --- $0 I ---- — -- $181,569
Sales
Description
Date Book
Page
Amount
Qualified
Vac/Imp
WARRANTY DEED
WARRANTY DEED
1 6/1/2017 08950
12/1/2006 06541
0446
1280
$225,000
$100
I Yes
No
Improved
Improved
WARRANTY DEED
2/1/2004 05207
0219
$100
No
Improved
WARRANTY DEED
1/1/2004 05199
1648
$169,100
i-----------
Yes
Improved
WARRANTY DEED
1 8/1/2003 04999
1294
$218,000
---.—.
I No
Vacant
Find Cwnperabh Sates
Land
Method Frontage Depth Units Units Price Land Value
LOT $34,000.00 $34,000
Building Information
Is Bed/Bath count incorrect? Click Here.
1111111111111111111111111111111111111111
GR-ANT f°IALOYP SEI`'INOLE COUNTY
CLERK OF CIRCUIT COURT & C:OIPTROLLER
THIS INSTRUMENT PREPARED BY:
Name: COLLINS, STEPHEN BCOLLINS JADE C
Address -
Permit Number.
.i (Ip9s)
CLERK'S v 2018011685
RECORDED 02/01/2018 Ciy 1i3:sE rjP1
RECORDl'NG FEES $10.00
RECOI<TED BY hdevore
Parcel ID Number: 18-20-31-506-0000-1340
The undersigned hereby gives notice that improvement will be made to certain real property, and In accordance with Chapter 713, Florida Statutes, the
following information is provided in this Notice of Commencement.
1. 4E$CRIPTION OF PROPERTY: (Legal description of the property and street address if available)
13AKERS CROSSING PHASE 2
LLCM II 3344 - ,
FL 3277
2. GENERAL DESCRIPTION OF IMPROVEMENT:
ReRoof
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: STEPHEN & JADE COLLINS; 335 LUSITANO WAY SANFORD, FL 32771
Interest in property:
Fee Simple Title Holder (if other than owner listed above)
4. CONTRACTOR: Name: XRC,LLC Phone Number: 407-960-5933
Address: 4019 W. 1st St. Sanford, FL 32771
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
Address: 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 maybe served as provided by Section
713.13(1)(a)7:, Florida Statutes.
Name: Phone Number.
6. In addition, Owner designates
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)
WlARNING 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.
ure ry'
of Owner or Losses, or Owner's or Losses's (Print Name and Provide Signatory's Title/Office)
( At wdzed offtcer0reclor/Partner/Monger)
State of County of S9 n e
The foregoing instrument was acknowledged before me this 3 day of I (-1ak1Qb.L _. 2020 �9
by ]Y, 6P C 0- 1--I,, aY1 5 Who Is personally known o me ❑ OR
Name of parson making statement who has produced identiflcationKttype of identification produced: /ii ).� �'S �t
iQ 4_1 V5
t RUTH-ANN RUBIN
NOTARY PUBLIC
STATE OF FLORIDA
CEisTiFiEO C-&Y GE ANT C: ,1L(?Y ' Comm# GG159793
CL Rk X THE CIRCUIT C(�UR? �< y '" fie=
Expires 11/13/2021
�p / r
tl\ � �-
S>rl. `vCLE 'Ul' TY, FLOWDA \1tl,V- 7�'^
BY ' d�Ty' j
Dote
lii -1 .,arm Cif! --
Notary Signature
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 02 (.) J-0 � 8
I hereby name and appoint: bn l-' 4no-1,Lan agent of: X RC L-al^
(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:
3755 1 1 Aw - FL 3a-7.7 1
(Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name:
State License Number: CGC
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF N
The foregoing instrument was acknowledged before me this 1 — day of ,
20$�6--, by QU ppwl who is Xpersonally known
to me or ❑ who has produce
identification and who did (did not) take an oath.
Signature
(Notary Seal)
Print or type name
t RUTH-ANN RUBIN
NOTARY PUBLIC Notary Not Public -State of
STATE OF FLORIDA Commission No.
? Comm# GG159793
Expires 11/13/2021 My Commission Expires: 1 13
(Rev. 08.12)
as
City of Sanford
=-..s Building i 'ire Prevention
r ,
Product Approval Specification Form
Permit #
Project Location Address 3?,5 i✓Witcmrj Way Sanford fFL 32111
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 Hun
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
cerionie-ed
UndMaM
f L 5 - l l
Underla ments
r fn i
hino oof
f L I 21(o
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 2014
Category / Subcategory
Manufacturer
Product
Description
Florida Approval #
(include decimal)
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 MrIftu w Am I
(Please Print)
June 2014
CITY OF
Building & Fire Prevention Division
SkiI40RD 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 OWNER/BUILDER) SIGNATURE' -1 DATE: 1131 I oo o
cCITY OF
SkNFORD
{4 _9
FIRE DEPARTMENT
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOBADD"SS: 3'35 pus itano Nay Sanford j Et 3217I
STRUCTURE TYPE: SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: OREPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): V w "Q
**PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED
ROOF VENTILATION: DOFF -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 (2(4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
SHINGLE
C e rti a n� e d
FL#
O METAL
FL#
O MODIFIED BITUMEN
FL#
OTORCH 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#
OTORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
Brent & Jade Collins
Job ##52461 - Brent & Jade Collins
335 Lusitano Way
Sanford, FL 32773
Item Description
Eagleview Report Eagieview Report.
Estimate # s 180189
Date 1 /26/2018
Qty Price + Amount
1.00 $75.00 $75.00
Roofing Permit Roof Permit - Obtain Permit with City / County, Record 1.00 $385.00 $385.00
Notice of Commencement with County. Meet with
inspectors for required inspections.
Item Description Qty Price
Roofing CertainTeed LandMark Make it your own. 1.00 $0.00
When does your house become a home? When the place
you live in begins to reflect the life you're living. When
every change, big or small, makes it more your own.
Choosing a new roof is your opportunity to make a major
impact on the look of your home- and we're here to help.
So you can be confident that your new roof will enhance
and protect your home for year to come.
CertainTeed Shingles Color
Roofing Demo Shingles 1 Layer
Roofing Synthetic Undedayment
Roofing Re -Nail Decking
Roofing Starters
Roofing Eave Edge
Paint
Roofing Valley Metal
Roofing Lead Boot 2
Roofing Vent Exhaust Cap 6 / 8
Roofing Ridge Cap
Integrity Roof System
Preparation of Scope of Work: Re -roof
Time to Complete Scope of Work: 7 Days
Roof System over 4% pitch. Shingles are missing in
several locations. Remove damage roofing system.
Remove drip edge flashing. Check decking system and
re -nail per code. Install CertainTeed Shingles
A. Remove existing roofing system. One Layer
B. Check the decking system, remove damaged materials
and re -nail per code. Install new material as needed.
C. Remove existing drip edge.
D. Install underayment.
E. Install metal and undedayment in the valley.
F. Install accessories. Lead Boots, Goose Necks, ect.
G. Install starters.
H. Install shingles.
I. Install hip and ridge.
J. Install vent system.
I. Keep a clean and safe working area
J. Owner to supply a staging area for: Dumpster, electric
and water hook up.
K. Contractor to supply all equipment to install to
CertainTeed specifications
L. All sq ft will be determined at start of job with a
representative from XRC.
M. 10 Year Warranty Labor *** - Manufacture Limited Life
Time Warranty ***
Amount
$0.00
CertainTeed Integrity Roof System® which is comprised
of underlayments, shingles, accessory products and
ventilation all working together. The Integrity Roof System
is designed to provide optimum performance --no matter
how bad the weather conditions are.
CertainTeed Shingles (color )
34.00
$225.17
$7,655.78
Remove Tear off shingles.
29.50
$56.37
$1,662.92
Felt Undedayment
29.50
$38.53
$1,136.64
Re -Nail Per Code with 2 3/8" Ring Shank Nails. Per sq.
29.50
$24.03
$708.89
Starters
251.00 "
$1.73
$434.23
D-style Eave Edge 2 114 - 26 Gauge Color
253.00
$2.89
$731.17
Paint - 1 coat.
1.00
$0.75 ;
$0.75
All valleys in roof shall be covered with metal. Metal shall
24.00
$5.34 ;
$128.16
be attached to the sheathing or decking.
R & R Flashing - Pipe Jack -Lead Boot 2"
3.00
$78.97
$236.91
Roofing -R & R Exhaust cap - through roof - 6" / 8"
3.00
$87.43
$262.29
Ridge Cap
190.00
$5.75
$1,092.50
Item
Description
Qty [
Price I
Amount
Roofing Vent Off Ridge 4'
Off Ridge Vent 4' - W - Br. - BI.
3.00
$110.33
$330.99
Roofing Wood Replacement
Replacement of bad wood with owners approval as
1.00
$0.00
MOO
follows: Plywood - $85.00 per 4x8xl/2; Board Sheeting
$8:00 per linear foot; Rafters $6.00 per linear foot: Fascia
$8.00 per linear foot. Additional layers of shingles will be
$35.00 per square foot.
Roofing Dump Fee
Debris Haul Away - Dumpster / Trailer Code 30. Per 1
1.00
$385.00
$385.00
week.
Room Master
Garage
1.00
$0.00
WOO
Stain/Mold blocking primer
Stain/Mold blocking primer
20.00 `.
$1.00
$20.00
Paint
Paint. 1 coat.
625.00
$0.75
$468.75
Floor Protection
Plastic and tape used to protect floor.
625.00
$0.27
$168.75
Note on Estimates
NOTE: Estimate are based upon what could be visually
1.00 "
$0.00
$0.00
seen at the time of inspection, any unforeseen damage
will result in a change order and possible additional
charges.
Payment Ins / Comp Certificate
Direction of pay.l authorize my Mortgage Company and /or
1.00
$0.00
$0.00
Insurance Company to make direct payment to XRC LLC,
for thank and all work on the estimate and for any and all
supplemental work(if applicable).
Content Manipulation
Content Manipulation
1.00
$47.17 '
$47.17
Mask / Prep
Mask Floor / Prep for repairs.
1.00
$0.66
$0.66
Sub Total $15,931.56
'total $15,931.56
S P E C I A L I N S T R U C T I O N S
The estimated fee is valid within 7 days from the date of this proposal; therefore, this proposal shall be considered as a legal and binding
document within those 7 days. A review estimate fee will be done after 7 days if the proposal is not signed and returned. All deposits are non-
refundable. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any
alternations for deviation from the agreed upon specifications involving extra costs will be executed only upon written orders, and will become an
extra charge over and above the estimate. All agreements are contingent upon strikes, accidents, or delays beyond our control. Owner is to carry
fire, tornado and other necessary insurance. All materials remain property until payment is received in full. If litigation arises out of this contact, the
prevailing party will be entitled to its attorney fees and costs. The venue of any litigation arising from this contract shall be Seminole County,
Florida.
Authorized Acceptance Signature
Date of Acceptance
Note: This proposal may be withdrawn if not accepted within 7 days.
CITY OF
SkNFORD
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF AFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ADDRESS: 3 2F L u S I 1 a nd way
S0,n+ord, F1 32-7-1
1 .1 a f-h f W & W I 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 #: C C C I D 91 Z b
COMPANY / CONTRACTOR: ^_RIC / I M U tfu vV /Wpf I I
CONTRACTOR SIGNATURE: ��� '—� DATE: I O I I v
(MUST BE SIGNED BY LICENSE HOLDR*$I�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�day of 20 \8 by:
Who is Personally Known to me or has ❑ Produced (type of
identification)
as identification.
Signature of Notary Public RUTH-ANN.RUBIN
jStaa of Florida a� �LRr NOTARY PUBLfC 4
r a -STATE OF FLORIDA
Comm# GG159793
Print/Type/Stamp Name si E 19�� Expires 11/13/2021
of Notary Public