HomeMy WebLinkAbout123 Walnut Crest RunCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: I d la
Documented Construction Value: $ 11,400
Job Address: 123 WALNUT CREST RUN SANFORD, FL 32771 Historic District: Yes ❑ No x❑
Parcel ID: 22-19-30-502-0000-1580 Residential Q Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration El Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: Re Roof Owens Corning FL 10674-R13 15216-R3 31 SQ 7/12 Pitch
Driftwood Oakridge LIFETIME
Plan Review Contact Person: Skylar Amkraut
Phone: 407-278-7788 Fax: 800-337-3361
THANGYAH, SCHWARTZ
Name SCHWARTZ, MALINI M
Street: 123 WALNUT CREST RUN
City, State Zip: SANFORD, FL 32771
Name Jasper Contractors
Street: 4185 S Orlando Dr
Title: Admin
Email: Permit@Jasperinc.com
Property Owner Information
Phone:
Resident of property? : Yes
Contractor Information
Phone: 407-278-7788
Fax: 800-337-3361
City, State Zip: Sanford, FL 32773 State License No.: CCC1331153
Architect/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 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 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.
cceptance 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. _
Signature of Owuer/Agent Date
Print 0%vner/Agent's'Name
Signature of Notary -State ofFlorida Date
Owner/Agent-is Personally Known to Me or
Produced ID Type of ID
04/04/ 18
signaturgeofContractor/Agerit Date
Rudith Goico
Name
SKYLAR 8 AMKRAUT
Commission # FF 127890
,«
'my 'Comrnission Expires
June 01, 2018
Contractor/Agentis Personally Known to Me or
Produced ID ype of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbii g❑ Gas❑ Roof ❑
Construction Type: Occupancy Use: Flood Zone:
Total Sq Vt 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
RENOI
SCPA Parcel View: 22-19-30-502-0000-1580
f
0 Jo ,CIA
9*%HR
(a041[lrY �w
Property Record Card
Parcel: 22-19-30-502-0000-1580
Property Address: 123 WALNUT CREST RUN SANFORD, FL 32771
Parcel Information
Parcel 22-19-30-502-0000-1580
THANGYAH,SCHWARTZ
Owner
SCHWARTZ, MALINI M
-- _ ........-............ ....._..._....---
- ----- ------------- --- .......
Property Address 123 WALNUT CREST RUN SANFORD, FL 32771
Mailing 1647 SONG SPARROW CT SANFORD, FL 32773-7025
Subdivision Name PRESERVE AT LAKE MONROE
Tax District S3-SANFORD-WATERFRONT REDVDST
DOR Use Code 01-SINGLE FAMILY
Exemptions
iI
I -i-
n
00
u(
J
�`r
ICJ
Seminole County GIs
Building Information
Value Summary
.._.___- _ - _ __
_ ...._._..
2018 Working
2017 Certified
Values
Values
Valuation Method
Cost/Market
Cost/Market
Number of Buildings
1
1
Depreciated Bldg Value�l$231,164
$195,733
i Depreciated EXFT Value
$11,769
$12,286
Land Value (Market)
$40,000
$34,000
.__ _ _--- _ -.
1---'
Land Value Ag
..__
_I
Just/Market Value
$282 933
$242,019
1 Portability Adj
Save Our Homes Adj
$0
$0
Amendment 1 Adj
$16,712
$0
� P&G Adj
$0
$0
Assessed Value
$266,221
$242,019
Tax Amount without SOH: $4,608.41
2017 Tax Bill Amount $4,608.41
Tax Estimator
Save Our Homes Savings: $0.00
Does NOT INCLUDE Non Ad Valorem Assessments
# Description Year Built Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value ,Appendages
Actual/Effective
1 SINGLE 2004 13 4 3.0 1,532 ' 4,081 3,479 CB/STUCCO $231,164 $242,692
E - , Description Area
� FAMILY FINISH
http://parceldetail.scpafi.org/ParcelDetailInfo.aspx?PID=221 93050200001580 1 /2
S380 E. Colonial Dr.
Orlando, 1:1.:+2807
3203 Conway Rd., Ste.
Orlando, FL 32312
(•107) 278-7788
(800) 337-3361 Fax
intii tr i;i. icnn� of
y, VISA 1=.�1
Owner�s)
Address
City_ (
201 JASPER,
FL Contractor's License:
CCC 1329651 R: C CC 1331153
R(x)F REPLACI'111�N7• CONTRACT
Account Manager:
Contact JP: IVT-''`•!
Compq
Policy »:il1G•Q ;�'o,00 .ilk
Clalm ti: / ,' 1 L"Jg „��7�3 �75,t—
Moneaee Commis Information
Company: -�' ",/� �•r
[,Iran Numbtar- 2Y� I jo 1 i 27
r•none
Alt Phone: e
Stale: Zr Code; shingle Color: J
---' �' ,,, I'' .roar/
EmailC: lttittf RCV Amount/ Contract Pncc: Drip Edge Color
11,400
if Owner's Insurance nniflans• dots not aer'eg to uav fir a full roof reolacement this contract shall be voidable,
Assignment of Insurance Benefits for the Pull Roof Replacement Only: I hereby assign any and all Insurance rights. benefits and procceds undo
any applicable insurance policies to Jaspei Contractors, Inc, ("Jasper"), die scope of u4irch shall be limited to a Full Roof P�eplaccmerrt'' 1 make this assig me:t
and authorization in considetation of Jasper's agreement to perform services, supply materials and otherwise perform its obligations under this Crnuzct
including not requiring lull payment at the time of service. 1 also hereby direct my insurer(s) to release any and all mformation requested by Jasper, or its
reprtse:itativc(s), for the direct purpose of o'btaming actual benefits to be paid by my insurer(s) for semces rendered. In this reprard. I waist my prTsary
rights. Kpaynient is made directly to the it shall tx endorsed over to Jasper immediately upon, receipt. I a .cc that any portion of
work, deductibles, betterment (T additional work requested by the undersigned, not an•crtd by insurance, must be paid by the undersigned an the ey of
installation. Deductible: It is the Owner's respunsthiitty ro av �11 insurance deductibles. Owner's out-of-pocket expense will rat exceed the deduarblc
Aaamount, as stated rut inquer's loss sheet (the "loss Sheet-), UNLESS rcphicaucnt'rcpaii of dtteiunated (lcckmg is required by code ardor 0,Aner regt.esti
ptimai upgrade,., Jasper CAN`N01' pay, strive, rebate,; or promise, to pay, waiie or rebate any or all of the insurance deductible applicable to the
insurance claim for pa%,iicnt of wo iti In the ev'cra of a discrepancy, the dWuctible amount stated on the msurcr's Loss $h stall 0,.=Tule dcdi.=1 s?e
amount disclosed. Deductible: S jv� DIUSI' BE PAID IN F111.1 , PLUS APPLICABLE SAIYS TA. I. �1 �� (initial)
*IORTGAGL AUTII0RI7 VI-I0N- 1, (NiieriNtorigagor, grant autboriratiio� for !Mortgage -A Co. to speak th
asper on matters including but not limited So, tale elaun and draw status,: �� (initial) PAYNI F:NT SCIIEDf:LE- Ow er asp to
pay Jasper based on the following schedule: (i) Deposit in the amour aftr S �� ^clue upon signing this contract. (!e) the Conaa:t Price.
c_cs the Deposit and any applicable depreciation retained by Owner's instuer(s), plots upgrade costs_ due and payable to Jasper ttpcsi cmnpleim cf
,ork beitrg performed, and. (iu) the remaining Coritmct Price (equal to any applicable depreciation and orr change orders) due and pxiyabic to Jasper a;cx
completion of work performed. Ire the event of a pending inspa-tion, no more than 2°e of Contract Price may be withheld until "insMtion I+i paL,ed
Optional: UPGRADE iTEM: QTY: PRICE TOTAL- S
Replacement Work and Price: Upon insurer's approval and subject to the Tents and Conditions herein. Jasper agrees to finish all raterali art'
provide the labor necessary to perform the frill reef rt.`placcinctit which shall take place following Owner's insurance company's approval, aMoximateiy
within 30 days, conditions peTinitting. Owner's Declaration of Intent: Owner acknowledges and agrees that, upon approval by ms=rance CoEviny for 3
full roof replacement, Jasper shall perform rite roof replacement upon receipt of fund.% front Owner's insurance company.
FLORIDA IIONIEOWNERS' CONSTUCTION RECOVERYFUND
PAYMEIN 1', UP TO A LINMITFD AMOUNT, MAY BE AVAILABLE FROM THE. FLORIDA HOMEOWNERS'
CONS] RI (` i (ON RECOVERY FUND IF YOU LOST: 11ONf'1' ON A PROJECT PERFORMED UNDER CONTRACT.
WHERE THE LOSS RESULTS FROM SPECIFIED VIOL VHONS OF FLORIDA LAW BY A LICENSED CONi"RACTOR.
FOR INFORMATION ABOUT THE RECOVERY FUND AND FILING A CLAIM, CONTACT THE FLORIDA
CONSTRUCTION iNDUSTRY LICEINSING BOARD ATTHE FOLLOWING TELEPHONE NUMBER AND ADDRESS:
Construction Industry Licensing Board: 2601 1llairstone Road, Tallahassee, FL 32399-1039, (850) 487-139-5
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 clay after the contract is executed after notification from 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 EXCEPTIONS: 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 nil sta(enien(s. Terms and Conditions of the "Roof Replacement Contract" and agree
that all details are acceptable and satisfactory. I `further understand that this Contract constitutes tileentire agreement between the
parties and that any further changes or alterations to this Contract must be [nude 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.
Authoriiet asper Representative Date
--
Own r'
Date
Scanned by CamScanner
323z
THIS INSTRUMENT PREPARED BY:
Name: Jasper Contractors
f �# Address: _ .93130 F rolrinisl Drivo
Orlando, FL 398(17 _
NOTICE OF COMMENCEMENT
11111 fill! 111111111 fill 1I 1
GRaitl• I��iLiJ f r SEr`fThfOLt GOUi! � �'
GLER1€ 17F CIRCUIT C:DLJRT t: COMPTROLLER
is 1 it ( I p s)
CLERK' S g ?Ct3 ETj359T15
RECORDED11TJfi. i'1.1�Yf liy r�Iii) ['i RECO(if�ING FEESt'
RECORDED e • j *-iii,i,lj
I:D-v ..r ,devore
Permit Number.
Parcel ID Number: } .�Q —00-0 SgO
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 PROPERTY: (Legal description of th property and street address if available)
Lffr t ��, �s
rP e�ve 0.T rd o n ( o 13 b-2
2. GENERAL DESCRIPTION OF IMPROVEMENT:
rE C —R-40�
3. OWNER INFORMATIOj OR LESSEE It ORMAT- IIOiN IF T? E LE SSEE CONTRACTE3FOR THE IPPROYEMENT: ^ V n
i
Name and address: C i2�% I f%%' K i
Interest in property
Fee Simple Title Holder (if other than owner listed above) Name:
Address:
4. CONTRACTOR: Name: Jasper Contractors Phone Number. 407-278-7788
Address: 5380 E Colonial Drive Orlando, FL 32807
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 may be served as provided by Section
713.13(i)(a)7., Florida Statutes.
Name: Phone Number.
Address-
B. In addition, Owner designates Of
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)
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 1. 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.
(Signalu of Owner or Lessee, or Owners or ee
-
s
(Pont Nam and Provide Signatmys TitlrJOtfice)
` Authorized Ofi7cedDkegorlParinerlManager)
State of \ O - k County of ,>� t, a( \
The foreoin Instrument was ac�nowledged befo me this_ 1 - I day of
by um —
Name of person making staieo,ent
who has produced identification%type of identification produced:
ANA CHAVEZ
State; otflorida-Notary Public
Jy ;` Commission lI GG 112152
My Commission Expires
June06.2021
C 1�L
LUMTED POWER OF ATTORNEY
-Xitamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 04/04/ 18
Karla Almodovar, Rudith Goico, Skylar Amkraut, Rachel Holcomb
I hereby name and appoint: Ana Chavez and/or Michelle Monsalve
an agent. of: Cont-tOs
(Narm orc«fflpany)
to be my laafil 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:
123 WALNUT CREST RUN SANFORD, FL 32771
(Sven Address)
Expiration Date for This Limited.Power of Attorney: 1/1/2019
License Holder Name: Donald Bouchard
State License Number. ccc'33"53
Signature of License Holder.
STATE OF FLORIDA --)
COUNTY OF s
The foregoing instrument was acknowledgedbefore me this 04 day of April
200 18 , by Dormid d who ,is o personally known
to me or ® who has produced tx as
identification and who did (did not) take an oath.
VKA
Signature
(Nosy Sea]) ky_ar Amlcraut
SKYLAR B AMKRAUT �+
Commission q FF 127890
My Commission Expires
, ",
W' June O1, 2018 i
Z7
(Rey. 08.12)
Print or type name
Notary Public - State of FL
Commission No. 127890
My Commission Expires: 6/1/2018
Sr:anneri by (',nmScanner
'y"4mj«hCITY OF
`y1l FORD
FIRE DEPARTMENT
Building & Fire Prevention Division
Re -Roof Permit Card
P• ERMIT NO. ®V ' (0 L ISSUE DATE: ��•
CONTRACTOR:
JOB ADDRESS: /��•� c4ej
of X4.,,ao
TYPE OF WORK: kew leQo _.�c
PROTECT FROM WEATHER I
• 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
1 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: 04/04/18
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: 123 WALNUT CREST RUN SANFORD, FL 32771
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: (2)OFF-RIDGE ORIDGE OSOFFIT OPOWERED VENT
SKYLIGHTS: OYES ONO 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
O SHINGLE
Owens Corning
FL# 10674-R12
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
O INSULATED
FL#
O TILE
FL#
OOTHER:
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#
O TORCH DOWN
FL#
O INSULATED
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
-- ---- Page 2
Application Number . . . . . 18-00001669 Date 4/04/18
Property Address . . . . . . 123 WALNUT CREST RUN
Parcel Number . . . . . . . . 22.19.30.502-0000-1580
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1042498
Permit pin number 1042498
----------------------------------------------------------------------------
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
----------------------------------------------------------------------------
1000 111 BL03 FINAL ROOF _/_/
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ' U _ I u u � ADDRESS: _ W (,nm CAW YIL►
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:
CONTRACTOR SIGNA7
(MUST BE SIGNED BY
JASPER CONTRATORS
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: v `
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 1 day of � 20 �f by:
ho is ❑ Personally Known to me or has 4Y Produced (type of
as identification.
SI<YLAR B AMKRAUT
' Vdni
Cgo'mm�ssion #i FF 12
7890
s' My Commission Expires
r
June 01 , 201 8
of Notary Public
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: f
1 hereby name and appoint: Scott Meixsell, James Allen, Chris Gardner, Juan Lozano, Paul Padgett
an agent of: Jasper C0"tac1ors
(N— ofComp-y)
to be my lawful attomey-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:
la3 VU UVIVLA a re.SA VWn.
(Sum Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name o d
�- v�c�ar^d.
State License Number. OCC1331153
Signature of License Holder
STATE OF FLORIDA
COUNTY OF s
Theo going instrument was acknowledged before me this 1 day of �KkWA,
200, by ova Bm&md who is o personally Known
to me or u who has produced DL as
identification and who did (did not) take,an putt.
(Notary Sea]) NMI'( l/Vy Y ��
" "--�SI<YLAI— Z MKRAUT
Commission"FF 127890
- P My CoiYirnlssion Expi
res
June 01, 2018
(Rev. 08.12)
Print or type name
Notary Public - State of IR,
Commission No. k1.1
My Commission Expires: U .- k- I.
A.
Scanned by CamScanner