HomeMy WebLinkAbout124 Kelly Cir0'
�F
ox ' ! {h:RR 2 ! 601V
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: S 10,800
Job Address: 124 KELLY CIR SANFORD, FL 32773 Historic District: Yes ❑ No x❑
Parcel ID: 12-20-30-511-0000-0580 Residential ❑x 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 22 SQ 7/12 Pitch
Plan Review Contact Person: Skylar Amkraut Title: Admin
Phone: 407-278-7788
Fax' 800-337-3361 Email: Permit@Jasperinc.com
CHELLBERG,CHRISTOPHER
Name CHELLBERG, JENNIFER
Street: 124 KELLY CIR
City, State Zip: Sanford FL 32773
Name Jasper Contractors
Street: 4185 S Orlando Dr
City, State Zip: Sanford, FL 32773
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Property Owner Information
Phone:
Resident of property? : Yes
Contractor Information
Phone: 407-278-7788
Fax: 800-337-3361
State License No.: CCC1331153
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: 51' Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
�F
ox ' ! {h:RR 2 ! 601V
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: S 10,800
Job Address: 124 KELLY CIR SANFORD, FL 32773 Historic District: Yes ❑ No x❑
Parcel ID: 12-20-30-511-0000-0580 Residential ❑x 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 22 SQ 7/12 Pitch
Plan Review Contact Person: Skylar Amkraut Title: Admin
Phone: 407-278-7788
Fax' 800-337-3361 Email: Permit@Jasperinc.com
CHELLBERG,CHRISTOPHER
Name CHELLBERG, JENNIFER
Street: 124 KELLY CIR
City, State Zip: Sanford FL 32773
Name Jasper Contractors
Street: 4185 S Orlando Dr
City, State Zip: Sanford, FL 32773
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Property Owner Information
Phone:
Resident of property? : Yes
Contractor Information
Phone: 407-278-7788
Fax: 800-337-3361
State License No.: CCC1331153
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: 51' 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 regulatine, construction and zoning. _
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
17
- 02/20/18
Signatu ofContractor/Age t Date
Rudith Goico
Print:Confractor/Agent's Name
SKYLAR B AMKRAUT
Commission N FF 127890
o�
My Commission Expires
June 01, 2018
Contractor/Agent is Personally Known to 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
# of Stories:
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
5.180 F_
32_03 Comi al,Rd_ Sic. it) I
Orlmillo, R 12
(4071 ) 211
.. . . ......
Q'
'13.
-21
z
ii
E R
13 1153
.4
Tit, f
J_
C I I o
ortili.j n,,
1= Ljig 1 R00111 CONTRACT
owne I Is),
L
Mt Illairr,
k
City.
�7
k &-4, c)
ell-
.. .... .. . .
. rl [I 1,14t;
10,800
Assignment of himirmice Itetielils 1*01. the Full 161411, a11Y.md .111 111.1fir :ljw.: fly'llm.
Tiny ArPlIZ.117lle 1I)SIIr!Ult 1-0110,7,-; tO bjw-1 I. '1111WAC I'll Ito. Ch1q,er"). Ile e nl k0lidt klifill ly. 1111111rd tot hill Pool,
and . C C Moll [(I PL-00.1-111 :111d rllllcml�l! pCrjl-,,nT lt!t
lutllon-�-M,111 it, k70IIsI,!MIl 1,131 Of I 's it!,' V
incluJing not li;%jull-illtz billlm\lllcilf al the emir of "Crvwc I :list, W-I :Iiv direct III\, III ICICxx ,illyliful .111 Infl7rmomn febyIT E13e,
rcplrsoltalm,_A for tits'loth 1)111110sc ill' ol,lmllllnl lk;lkkil 1'rilcills ill be Imill ll)- my 111,11rci(') for renders,!. In thee rcg_rd, I W.'z I
I!*payment is Illailk: dirtvtiv to the shall be t-,11domll tl%cr to 1111mcd1:110Y jjpi•ti rcccip(, I ti,ji any p0r;!(-TT r717
AXITI,. Ictlu.rthlrs, Mterniclit or ml-Ittioll-wi \V0tK 10,111c'sti7d Il)the it lidel'; wI I M, 11.11 cl,vtrrd lay insurmcc,11111st fir: h.,, llir ;Ij-, cd -,it thr, dY
fit
(it thc LIV,�;C11MC
installation. Deductible: It is the"I 0III-0E-r:kcI explm-le will 11 clime mill. or all of life illmmincv. (ICIluclihie ti --%rl
ammint, as g,it aicki InslifCC., lo's sheet title 'Los, Sltvct"). UNI F.I�s lujilaCCITICIlUCIIAll 01 kICICtiIlI,.IfktI decking is rc quircil I)v F V
-
grades, Jasper CANNO 11' lwy. waive, Mime, or proullic tit pity, i%:ilvr itor I
der
insurance claim for pmweilt of lImuk.. In file event of 11 Illsovimilcy, 111C drdtictillic firnollill Amctj ,it the insuicr'i Ligt tiIlccl Iljli 'ryc��Plc _k
,
aniount thscloscil. Deductible: S o 0 ou — NIUST ilFULL,, P
AID IN FULILUS Al"I'LICAIIII-l' ASALFS TAX f ) - \,—
MORTGAGE AUTII0HN' 1Z,1LTIo: I. 0micri\lorilmillIf. tlyallt , - -,-- V 0, in vpC--k with
Illillow mil it'll [,;I g�q�
Jasper on Inatter, iuclildillp but not himicil ill, Iliv Chill) I mill I drmv S1.1111s (InItizil) VAYMEN'r SCIIIIEDU'LEOwner to
pay JaspcT IxLik\j kill (lie (ollowlig sclicillili:7 (1) MI'Alli'll in 111C amollill III's 0- ---dtic 11pilli signitil" lll;a; ccittir-.1ctj lit) the C-)nr;..,:, P7cc.
less the Deposit alltil tlijy applicable delirccintion Ict'lilletl by i)mjer*,, ins"rcdN rlus llpgrlIic C(jq%, title and pa)-,iblc it, ja�pizr iii-on car pIct-cri or
N\,QTk Iving, perfortlicki, and, (till the reill;jinnig. t,'ontniet Price icillial to Any ;1111111Cahle 41q,tecimll,li ;t1jil-illt change orders) t1u,- x�,d r_a):jblc lo Lmptr upinn
completion of Work lierfortilehl, In (Ile dentkit, :1 pendhgt IIIq%vtjoli• mi more flimi 2N. of Colltrilcl Price may be %sitlillclil "I'll] inspccz cm Optional: LIPGRADI: ITEM: QTY: PRICE, — TOTAL: S
Replacentent Work and Price: Upon insill-Li's arptoval and slibiccl it) Tile Terms :11111 Colldiliofjs it * cfcin, Jasper agrees to furnish all ma(muks -ind
PTU%-Idc tile IjKVr iiLccssary it, lict-lorill the litli rokIfrephevitent shish shall tAe place rolli-ini, Owicrs insurance conip2ny's approval. apprr_(u—-CIY
Nxithin " daNN• conditions PLIll'iIIIIII., Owner's Declorittion tit' Intent: 0mici :ick-nov%-Icdj:r_, and agrees ili:it. upe.if Li 0 nipproi-il by insumnc-_ con rrT: - v I, r a
full roof replacement. J;k-.Itr shall periZmi the roo(i-cphcellicill ilpm, r,,eilit of imid, from Owicir's,
I'J.OJJJJ).% I JONI F(M'N ERS' (,' ( I _RY
- ONSTUCTION REC )\ 1: FUND
PAYMENT. UP TO A J.JjNJJ*J'J-.I1 AMOUNT. MAY Ill., J-'JjOjIlJ 'f*llt-' FLORIDA 1110MEOWNERS'
C0jNS,I*IjUC'1'10jNI RECOVERY FUND IF YOI,I LOSE NIONEY ON A PROJECT 111,11FORNIED UNDER CON-MACT.
WHERE THE LOSS RESULTS 1--RoNl spj?CJFIEI) VIOLATIONS OF FLORIDA LAW HN' A LICENSED CONTRAc-r'011.
FOR INFORMATION ABOU'l' IZJ'COVEHY FUND AND FILING A CLAIM. CO3N-I*,%cJ, 'riu. FLORIDA
CONSTRILICJj\1J)J,)S'J'JZN' LICENSING BOARD ATTIll' FOLI-ONNIING .TELF11110NE NUMBER AND ADDRESS:
Construction Industry Licensing 11tilli-ti: 2t)0I I'llidirstone Road.1 rillahvissce, FL 32349-1031 . j.4501 487 - 1395
CANCELLATION: if OiN ner elects to terillillille tile set -vices of U%Iwir, Owner may tit) so before midnight on the third btasiness
day after Contract is C.-tIcellteil. Owner shall receive it Full refund of Till deposits. Owner cony also rescind Contract licifore midnight on
the third business (hill, after the c(introct is exectifed Ilf(el. Illitiricillion from insurer(s) that the chifin for paviiient on roof contract has
been denied, it, whole or in part. All written notice,.; of cancellation, regardless of reason, shall he postmarked or delivered to,jasper's
corporate ofrice: WHI Roberts Ilmlleviird, Suite 112, Kcillivsmv, GA 30144. CANCELL,VHON EXCEPTIONS: The thrLv (3) day
right of cancellation DOES jqyl, %J1JIJ_Y to cooitracls rill* emergencN, home: relmlr% 'is little is ill' tile essence.
1. Owner, have rend and fill derstil fill fill stalcluctits, Terms IIII(I ('jintlitiom of the "Hoof Replacement Contract" and agree
that all detnils tire acceptable and smisrimor\ rill-Illet' I'll derst it [ill thal tills Contract constitutes the entire agreement between the
parties and that an)- further challges or "Iterations if) tills C1,11111-11471 IntIts't be nmile in writing anti agreed upon by built partie;.
Each party represents and warrants to the (filter t1ml It has the (till power and allthority to enter into the contract and that It is
binding find enrorecuble lit ficenirdfince trhh Its terms,
uthonm nspe'r Representative Date
Scanned by CamScanner
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 02/20/18
Karla Almodovar, Rudith Goico, Skylar Amkraut Rachel Holcomb
I hereby name and appoint: ft�s1MW' Gina Mcbonald & Rachel Holcomb
an agent of: JasperContraao.'s
(Name or Company)
to be my laafiil 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:
124 KELLY CIR SANFORD, FL 32773
(SvW Address)
Expiration Date for This Limited Power of Attorney: 1 /1 /2019
License Holder Name: Donald Bouchard
State License Number. CCC1331153
Signature of License Holder.
STATE OF FLORIDA
COUNTY OF semi
The foregoing instrument was acknowledged before me this 20 day of February ,
200 18 _ by oorwa Boudwd who is o personally known
to me or ci who has produced Ix as
identification and who did (did not) take an oath.
,�)
Sign
ature
(Notary Sea]) Sky ar AMRraut
Print or type name
S1 YLAR B AMKRAUT
`yo•! Iti i
commission N FF 127890
My Commission Expires
a:
June 01, 2018 ,
(Rev. 08.12)
Notary Public State of FL
Commission No. 127890'
My Commission Expires: 6/1/2018
Srannt-d by CamScanner
STHIS INSTRUMENT PREPARED BY:
'dame: JASPER CONTRACTORS
Address, 3203 S CONWAY ROAD SUITE 201
ORLANDO. FL 32812
A� 41. Gks 1 �gg�cw��+c @�'T
N OTICE O •COMMENCEMEN ET
NOTICE
Number. - v a. q®as
Parcel ID Number: 17�--a aJ3y- S ) ) — t7OM-- CH J D
GRANT MALOYr SEMINOLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLER
8K 9078 Pq 391 (11='9s)
CLERK'S A 2018019371
RECORDED 02/20/2018 11:14;56 AN
RECORDING FEES $10.00
RECORDED EY hdevore
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the
following Information is provided in this Notice of Commencement.
OF PROPERTY: (Legal description of the property and street address if available)
2._ GENERAL-DESC$IPTt01t OF_IMQROVEMhN.T.•
RE -ROOF
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: JP-f1r%AT t' �%e)L%K-a 17 Ll 11-6< , l Cit r Sa �rj l �?_-7 -12,
Interest in property: OWNER
Fee Simple Title Holder (if other than owner listed above) Name:
Address:
4. CONTRACTOR: Name: JASPER CONTRACTORS Phone Number: 407-278-7798
Address: 3203 S CONWAY ROAD SUITE 201 ORLANDO FL 32812
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
Address: Amount of Bond:
6. !.ENDER: 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(1)(a)7., Florida Statutes.
Name: Phone Number.
Address:
8. In addition, Owner designates of
to receive a copy of the Lienoes Notice as provided in Section 713.13(i)(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 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.
(stgnalure o ei or Lessee, or Owner's or Lessee's
Autlrari Officer olreetor/PorineWenager)
-Tern '-2- chefr-�
(Print Name and Provide Name and Provide Slgnalor/s�ce)
State of C I County of
The forgoing instr}llent was ack QwledgeV before me this �r� day of t l �`-�► , Zp L�
by
- ----- D
who has produced identification] type of identification produced:
Who is personally known tome 0 OR
2/20/201'8
SCPA Parcel View: 12-20-30-511-0000-0480
I0Md doMloa,CFA
P�IPIM
Sri COUNTY, PUORKaA
Property Record Card
Parcel: 1 2-20-30-511 -0000-0480
Property Address: 124 KELLY CIR SANFORD, FL 32773
Legal Description
LOT 48
MONROE MEADOWS
PB46PGS16&17
Taxes
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund — j �$95,652 $0 $95,652
Schools $100 785 $0 ° $100 785
City Sanford $95 652 $0 ` $95,652 j
SJWM(Saint Johns Water Management) $95,652 I $0 $95,652
County Bonds $95,652 $0 $95,652
Sales
Description Date Book Page Amount Qualified VaGlmp
WARRANTY DEED 2/1/2006 06160 0025 $202 000 j Yes Improved
FEE SIMPLE DEED 2/1/2004 05228 1334 $100 j No Improved
........... . _...... __..—__ _ __
WARRANTY DEED 12/1/2003 05151 0491 $118 900 Yes Improved
WARRANTY DEED 1 11/1/2000 03968 1795 $83,000 Yes Improved
WARRANTY DEED _ — ; 9l1/1995 02979 1337 $74,800 Yes Improved �—
Find comparalAo
Land
Method Frontage Depth Units Units Price Land Value
LOT 0.00 1 0.00 1 1 € $20,000.00 $20,000
Building Information
http://parceldetail.scpafl.org/Parcel DetaiIInfo.aspx?PI D=12203051100000480 1 /2
CITY Of
�)ANFuRD
a,
FIRE DEPARTMENT
PERMIT NO.
CONTRACTOR: 7:5t
JOB ADDRESS: %0;�4
TYPE OF WORK:
Building & Fire Prevention Division
Re -Roof Permit Card
da -I
ISSUE DATE: 9
LZQ
PROTECT FROM WEATHER
M11
• 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
. 9 RO.Aft
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: 124 KELLY CIR SANFORD, FL 32773
STRUCTURE TYPE: Q 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: O OFF -RIDGE O RIDGE O SOFFIT OPOWERED VENT
SKYLIGHTS: O YES O NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
--------------------------------------------------------------------------------------
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 — 4:12 Q 4:12 OR GREATER
OTURBINES
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
0 SHINGLE
Owens Corning
FL# 10674-R12
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
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#
0 OTHER:
FL#
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: 02/20/I 8
s�
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 1_q5� ADDRESS: l —1 �AkA
Uf-\W ?Mel
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 cc k� ` l J"�)
COMPANY/CONTRACTOR:
CONTRACTOR SIGNATURE:
(MUST BE SIGNED BY LICENSE HOLDER
A FINAL ROOF INSPECTION IS REQUIRED:
(� DATE: � I
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 LK&I20 _T
-1 Who is ❑ Personally Known to me or has Produced (type of
ident' I ion
as identification.
Signature o otary Pu is
.. �.;•_-
`
Stat of on a
� ,, p
��%n_nuss
SKYLAR B AWRAUT
on H FF I27890
Expires
Comm;ss�on
�
June 01 2018
Print/Ty p tamName
of Notar ublic