HomeMy WebLinkAbout2390 Stevens AveCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
5 rMARO 2 zoos
j Application No: - (o 6
Documented Construction Value: $ I'3 , '3 cQ
Job Address: c)39 d S�( yl �4 3,2 2-9' ( Historic District: Yes ❑ No ❑
Parcel ID: nom— njo Residenti Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of lNe n MnvP n
Plan Review Contact Person:
Phone:
Title:
Email:d,{ W ,sCro
/�
Property Owner Information C,)"K-W oc' �� i
6 Name �CLj� (P.yl r�m e\
Street:(�cc�-I'Q�Mm
City, State Zip: cat nzkj �--��-
Fax:
Phone: etZ330-3�Sg
Resident of property? :
Contractor
' Information nJ
Name (, J� Y��TM cWl� Phone. — t
Street: 3 �S Fax: (�(o
City,� T—
State DUY� (L 3�� State License No.:
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'h Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
jD
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.
Signature of Owner/Agent Date Signature o ctor/Agent ate
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
o, ,%y au,
Nam, T
O
9fFOF F`���
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
:c, 5A_ n f/ b I-,
Print
Signature o90Nc
PABLO ARES
MY COMMISSION # FF 998006
EXPIRES: June 1, 2020
Bonded Thru Budget Notary Services
�\ 3 �� I
of Florida P 2_,fk .••4o
1 * MY COMMISSION # FF 9980tf8
N� or EXPIRES: June 1, 2020
9lFoc rL6, Banded Thru Budget Notary Services
Contractor/Agent is
Produced ID
Personally Known to Me or
Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing[] Gas Roof ❑
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
Flood Zone:
# of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
111111118111911111111111111igloo 11111101
THIS INSTRUMENT PREPAREDLY: 1 ;� ; ;? ;`i,1i._O i SEMIHOLE C:OUPITY
Name: e6✓inl 4)1LKW-S0r�J CQFJ<. oc/ &Af5r�rcx770,d 1 CI_Ef:l; OF C3:RGI.IIT COURT & COMPTROLLER
Address: dl. 9ij5:? F_ 91 (1Pgs)
M�� anutnlE, "=C- 3.74'3 CLERK'S Y 20180ri757",
REGOUEG 01/22'2016' 11-5*i'e All
R,ORDING FEES 510,00
NOTICE OF COMMENCEMENT iE�"ORDED BY hdevurr,
Permit Number.
Parcel ID Number. '31-1 q -31 -ja7- ooap - cog o
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 the property and street address If available)
�r G ceoA►2 rile I?eKar ? 363 26S cite 2-7 0 Q4
:1390 -srEta=nrs Ave
Sant Egge,0 0 FL..
2. GENERAL DESCRIPTION OF IMPROVEMENT:
s N1.AJ6 C- QE - 2yor-
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: Lr4W46A/Cf /? Riepti tr a390 SzEyL,,9 All SAN;:;UA F,- 3a77
Interest In property. a,—' aEAP
Fee Simple Title Holder (If other than owner listed above) Name: h(�A
Address:
4. CONTRACTOR: Name:LJF.ScotJ COnJSMUcrio,J Phone Number 3, l 2Sl- &795
Address:30S- AlaefN /-),2- SrB C A)ywouxAla- c7�- - 3a9?5l
5. SURETY (if applicable, a copy of the payment bond Is attached): Name:_ ,lj/4
Address: Amount of Bond:
6. LENDER: Name: AN 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: ZA Phone Number.
Address:
6. In addition, Owner designates Al/a of
to receive a copy of the Lienors Notice as provided in Section 713.13(1 xb), 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) / ' 10
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.
�Z�2 4 - Lr4e,4> /Z.,-�je-<! ft-b WJ
(Signature of Owner or r Owners oil s (Print Name and Provide Signatorys TndOnce)
Authodzed 0fAcw0nwtodPwtnerrAbmgag.
State of /"-- Countyof
The foregoing Instrument was acknowledged before me this I day of �/� `BUR ~/ 0 I'
by
who has produced identification l7"type of Identification produced:
tµ►Y vn "
e 0-
PABLOARES
-
SEAT
MycommISSION#FF91 W6
m„ c�
EXPIRES: June 1, 2D20
�10FF��`
BondedTWBudgetNota�ySorVkes
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
I hereby name and appoint: << S I t V,
an agent o£ 1-: 4; co 1�
(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 t:
(Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name: )644 frl�, Xpya
State License Number: eO W,07
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF &c<..4pt.io
The foregoing instrument was acknowledged before me this f day 9ff�il
20t�1 , by k&mr" P/b who is personally known
to me or o who has produced as
identification and who did (did not) take an oat .
(Notary Seal)
*arrue
PABLOARES
MYCOMMISSION4509M
r
EXPIRES: June 1,2020
�OFFb���C
Bonded 7tnBudget Notary Servites
(Rev. 08.12)
Signatlafe
Print or type name
Notary Public - State of
Commission No.
My Commission Expires:
Product Approval Specification Form
Permit # / �—/ / (
Project Location Address oZ 3q U \fat-s
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
1. Exterior Doors
Manufacturer
Product
Description
Florida Approval #
(include decimal
Swinging
Sliding
Sectional
Roll U
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
3. Panel Walls
Manufacturer
Product
Description
Florida Approval #
including decimal)
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles
Underla ments
FL _
Roofing Fasteners
Nonstructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Built up roofing
System
Modified Bitumen
Single Ply Roof
Systems
FL ,24;7�_
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
5. Shutters
Manufacturer
Product
Description
Florida Approval #
(include decimal
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
(Please Print)
June 2014
WORKAUTHORIZATION
Inc. to r orm repairs
interest on
per month
additional
completion, may be increased-,,Nstomer,also acknowledges
'responsiiile for
damages orleakt, Clue . oexistingconditions
started or performed.
at:
comPATTY
visual
Inc is not
Weluiderstand , 'At contractor 'has no connection th nsurance— orfits.-�adjiutem gild, that we alone
n wi Company
Our
.have the authority to authorizeCohiractor tumake repairs.
Due 'to,nature of w'o'rk,,,n-o.cotnol,6ti'on.elgt6 is specified. No verbal agreements are binding..
.7'"fE7"ict
P,, final Mnini-h-170 l
and any causes 'of action
,to,
'carrier(s) for semices
insured is responsible. fbrira ---l-I.-I...t. not covered by insurance - 11 compan ny,amoun covere , y
Cimpany.liraited warranty 'ge-Robf5—Y,&
I - m,- Company limited W.—ArrAnty Repair . Y&w-
SCPA Parcel View: 31-19-31-527-0000-0090
Page 1 of 2
1211,
PAPPP
FX-hCN XE COUNTY. FLORIDA
d
Legal Description
LOT 9
CEDAR HILL REPLAT
PB 63 PGS 96 97 & 98
Taxes
Property Record Card
Parcel: 31-19-31-527-0000-0090
Property Address: 2390 STEVENS AVE SANFORD, FL 32771
�S 5� 6$ 52
09
le County GIS
Value Summary
2018 Working
Values
2017 Certified
Values
Valuation Method
Cost/Market
Cost/Market
Number of Buildings
1
1
Depreciated Bldg Value
$135,364
$127,587
Depreciated EXFT Value
Land Value (Market)
$32,000
$30,000
Land Value Ag
Just/MarketValue"
$167,364
$157,587
Portability Adj
Save Our Homes Adj
$70,232
$62,453
Amendment 1 Adj
$0
P&G Adj
$0
$0
Assessed Value
' $97,132
$95,134
Tax Amount without SOH: $2,203.00
2017 Tax Bill Amount $1,014.00
Tax Estimator
Save Our Homes Savings: $1,189.00
Does NOT INCLUDE Non Ad Valorem Assessments
Taxing Authority
Assessment Value
Exempt Values
Taxable Value
County General Fund
$97,132
$50,500
$46,632
Schools
$97,132
$25,500
$71,632
City Sanford
$97,132
$50,500
$46,632
SJWM(Saint Johns Water Management)
$97,132
$50,500
$46,632
County Bonds
$97,132
$50,500
$46,632
Sales
Description
Date
Book
Page
Amount
Qualified
Vac/Imp
SPECIAL WARRANTY DEED
4/1/2010
07374
0291
$108,000
No
Improved
SPECIAL WARRANTY DEED
3/1/2010
07374
0290
$100
No
Improved
CERTIFICATE OF TITLE
1/1/2010
07326
1756
$100
No
Improved
WARRANTY DEED
5/1/2006
06255
1217
$267,500
Yes
Improved
CORRECTIVE DEED
7/1/2004
05395
1088
$100
No
Vacant
SPECIAL WARRANTY DEED
1/1/2004
05164
1033
$122,706
No
Vacant
Find Compambl.5aiea1
Land
Method
Frontage
Depth
Units
Units Price
Land Value
LOT
I
1
I $32,000.00
$32,000
Building Information
Is Bed/Bath count incorrect? Click Here.
# i Description I I Fixtures I Bed I Bath I Base Area I Total SF I Living SF I Ext Wall Adj Value I Repl Value I Appendages
http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=31193152700000090 3/5/2018
SCPA Parcel View: 31-19-31-527-0000-0090
Page 2 of 2
Year Built
Actual/Effective
1
SINGLE
12006
8
4
2_0
1,872
2,494
1,872
CB/STUCCO
$135,364
$141,372
i FAMILY
f
FINISH
Description
Area
GARAGE
437.00
j
E
FINISHED
OPEN
PORCH
135.00
FINISHED
OPEN
PORCH
50.00
i
FINISHED
Permit #
Description
Agency
Amount
CO Date Permit Date
01862
, PAD PER PERMIT 2390 STEVENS AVE
SANFORD
' $150,000
1 1/23/2006 12/7/2005
Extra Features
Description Year Built Units Value New Cost
No Extra Features
http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=31193152700000090 3/5/2018
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 . . . . . 18-00001163 Date 3/05/18
Property Address . . . . . . 2390 STEVENS AVE
Parcel Number . . . . . . . . 31.19.31.527-0000-0090
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . SINGLE FAMILY
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1035674
Permit pin number 1035674
----------------------------------------------------------------------------
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
----------------------------------------------------------------------------
1000 111 BL03 FINAL ROOF _/_/_
p City of Sanford
F }
CSC. ti "`44
Y. WD Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. 1741615 ISSUE DATE: 3 0 5 •® r
CONTRACTOR:
JOB ADDRESS:
PROTECT JUVROM 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 MAYBE ADDITIONAL RESTRICTIONS APPLICABLE TO THIS PROPERTY THAT MAYBE 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: February 2017 Inspection Line 855.541.2112
TO SCHEDULE AN INSPECTION:
• Dial855.541.2112
• Provide the items requested during the message
• The type of inspection requested must be scheduled under the appropriate permit type
• Follow the prompts
(PLEASE NOTE: Inspections scheduled by 3:30 p.m. will be conducted the
next business day. If you experience difficulty, please call 407.688.5150
Monday - Thursday 7:30 am - 5:30 pm for assistance.
AUTOMATED INSPECTION SYSTEM CODES
ROOF
Final Roof 111
Miscellaneous Notes:
;EVISED: FEBRUARY 2017 Inspection Line: 855.541.2112
CIMY dF
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF POLICY & PROCED • "r URES
�ti� t9PAf�TMENT
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:
PERMIT # ��(p
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS:
STRUCTURE TYPE: /v %SINGLE FAMILY RESIDENCE/TOWNHOUSE Q MOBILE HOME O APARTMENT/CONDOMINNM
RE -ROOF TYPE: �EPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): T iN Vzjz-�
* *PLEASE NOTE: ONLY 100 SQUARE FEET 011THE EXISTING DECK IS PERMITTED TO BE REPLACED * *
ROOF VENTILATION: 96 F-RIDGE O RIDGE O SOFFIT OPOWERED VENT
SKYLIGHTS: O YES Z'0 IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12
9 4:12 OR GREATER
O TURBINES
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
SHINGLE
FL# 4--
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
OTHER:
- v %�
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#
OINSULATED
FL#
O TILE
FL#
0 OTHER:
FL#
F
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING9 SHEATHINGS DRY-INq FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: iq — d03 _ ADDRESS: 9 3�0 5 4e-ve'ws A/e
Sa v`,RY-dt- 3 a }�4- (
I V1 N 613 , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
OOFING CONTRACTO NGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
FO ATION 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
COMPANY / CONTRACTOR: Ce,\+L N C,6 J_kt C"f Z
CONTRACTOR SIGNATURE: DATE:
(MUST BE SIGNED BY LICENSE H LDER OR OWNS UILDER)
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 � I `� v q-4.
Sworn o and Subscribed before me this 4-1--day of ` f/ (�✓t/�� 20 iby:
tJ. Who is rsonally Known two meorhas ❑ Produced (type of
as identification.
1rRY Pue . KRISTIN A MORtEY'
Signat i e of otary P lic �� Commission # GG,t61894?
State of lorida
A
Expires November 2O�261 1 V U /\ 1 9�OF F��P` 6MM Thtu BOO Wa y,4. "cps'
Print/Type/Stamp Name J \
of Notary Public