HomeMy WebLinkAbout105 Wornall DrCITY OF SANFORD
�► BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: a,
Documented Construction Value: $ 10,600
Job Address: 105 WORNALL DR SANFORD, FL 32771 Historic District: Yes ❑ No 0
Parcel ID: 33-19-30-514-0000-0030 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 Techwrap 17194-R2 27 SQ 7/12 Pitch
Driftwood Oakridge LIFETIME
Plan Review Contact Person:
Skylar Amkraut Title: Admin
Phone: 407-278-7788
Fax: 800-337-3361 Email: Permit@Jasperinc.com
Property Owner Information
Name Jean DeBarros
Phone:
Street: 105 WORNALL DR
Resident of property? : Yes
City, State Zip: SANFORD, FL 32771
Contractor Information
Name Jasper Contractors
Phone: 407-278-7788
Street: 4185 S Orlando Dr
Fax: 800-337-3361
City, State Zip: Sanford, FL 32773 State License No.: CCC1331153
Architect/Engineer Information
Name:
Phone:
Street:
Fax:
City, St, Zip:
E-mail:
Bonding Company:
Address:
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.
Acceptance of perinitis Verificatioii'thatTwill notify the -owner of the property of the requirements of Florfda 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_z_oning. �.—
Signature of Owner/Agent Date
Print Owner/Agcnt's Name
Signature of Notary -State of Florida Date
�,. 05/15/18
Signatur of Contractor/Age t Date
Rudith Goico
'SKYLAR 8 AMKRAUI
Commission p FF 127890
'mycommis"sion Expire's
June;01 . 2018
Owner/Agent'is, Personally Known to 'Me or Contractor/Agent is. Personally Known to Meor
Produced ID Type of ID 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:
`Plumbing - # of Fixtu
# of Stories:
Fire Alarm Permit: Yes ❑ No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
Doci,;%Sign Enveiope ID: FBF756DB-BA07-4366-91C2-5D2F33725EBC,
(800)337-3361 Fax
info a jasperinc.com
r
JASPER'
JpsperRoof,cam
FL Contractor's License:
CCC1329651 & CCC1331153
ROOF REPLACEMENT CONTRACT
Account Manager: Joseph Palladino
Contact #: (407) 335-6239
Insurance Comp.
Company: American Tra rtions
Policy #:Ath1062389
Claim#: Ahl10440
Mortgage Company Information
Company: Wells Fargo Bank
Loan Number:
Owner(s). Jean Debarros
Phone:
Address: 105 Wornall Drive
Alt Phone: 4078737428
City:
S WE
Zip Code:
32771
Shingle Color:
Sanford
*OC Oakrid e -Driftwood
Email:
jmp2ba@gmail.com
Roof RCV Amount/ Contract Price:
10.600
Drip Edge Color:
1 *Drip Edge - White 6"
If Owner's Insurance Company does not agree to pay for a full roof replacement, this contract shall he voidable.
Assignment of Insurance Benefits for the Full Roof Replacement Only: I hereby assign any and all insurance rights, benefits and proceeds under any
applicable insurance policies to Jasper Contractors, Inc. ("Jasper"), the scope of which shall be limited to a Full Roof Replacement. I make this assignment
and authorization in consideration of Jasper's agreement to perform services, supply materials and otherwise perform its obligations under this Contract,
including not requiring full payment at the time of service. I also hereby direct my insurer(s) to release any and all information requested by Jasper, or its
representative(s), for the direct purpose of obtaining actual benefits to be paid by my insurer(s) for services rendered. In this regard, I waive my privacy
rights. If payment is made directly to the Own er/Agen On sured(s), it shall be endorsed over to Jasper immediately upon receipt. I agree that any portion of
work, deductibles, betterment or additional work requested by the undersigned, not covered by insurance, must be paid by the undersigned on the day of
installation. Deductible: It is the Owner's responsibility to Day all insurance deductibles. Owner's out-of-pocket expense will not exceed the deductible
amount, as stated on insurer's loss sheet ("Loss Sheet"), which is hereby incorporated by reference as the Scope of Work ("SOW"), UNLESS
replacement/repair of deteriorated decking is required by code and/or Owner requests optional upgrades. Jasper CANNOT pay, waive, rebate, or promise
to pay, waiveDgr rebate any or all of the insurance deductible applicable to the insurance claim for payment of work. In the event of a discrepancy, the
deductibl unt stated on the insurer's Loss Sheet shall overrule deductible amount disclosed. Deductible: $3100.00 MUST BE PAID
IN FUL (initial).
PAYME HEDULE: Owner agrees to pay Jasper based on the following schedule: (i) Deposit in the amount of 00 due upon signing this
contract; (ii) the Contract Price, less the Deposit and any applicable depreciation retained by Owner's insurer(s), plus upgrade costs, due and payable
to Jasper upon completion of work being performed; and, (iii) the remaining Contract Price (equal to any applicable depreciation and/or change orders)
due and payable to Jasper upon completion of work performed. In the event of a pending inspection, no more than 2% of Contract Price may be withheld until
inspection has passed.
Optional: UPGRADE ITEM: RATE: UPGRADE ITEM: RATE:
Replacement Work and Price: Upon insurer's approval and subject to the Terms and Conditions stated herein, Jasper agrees to furnish all materials and
provide the labor necessary to perform the full roof replacement which shall take place following Owner's insurance company's approval, approximately
within thirty (30) days, conditions permitting. Owner's Declaration of Intent: Owner acknowledges and agrees that, upon approval by insurance company
for a full roof replacement, Jasper shall perform the roof replacement upon receipt of Loss Sheet from Owner's insurance company.
FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND
PAYMENT, UP TO A LIMITED AMOUNT, MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS'
CONSTRUCTION RECOVERY FUND IF YOU LOSE MONEY ON A PROJECT PERFORMED UNDER CONTRACT,
WHERE THE LOSS RESULTS FROM SPECIFIED VIOLATIONS OF FLORIDA LAW BY A LICENSED CONTRACTOR.
FOR INFORMATION ABOUT THE RECOVERY FUND AND FILING A CLAIM, CONTACT THE FLORIDA
CONSTRUCTION INDUSTRY LICENSING BOARD AT THE FOLLOWING TELEPHONE NUMBER AND ADDRESS:
Construction Industry Licensing Board: 2601 Blairstone Road, Tallahassee, FL 32399-1039, (850) 487-1395
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 day 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.
I, Owner, have read and understand all statements, Terms and Conditions of the "Roof Replacement Contract" and agree that all details
are acceptable and satisfactory. I further understand that this Contract constitutes the entire agreement between the parties and that any further
changes or alterations to this Contract must be made 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 if' is binding and enforceable in accordance with its
terms. Doeusigned by:
DocuSigned by:
3/22/2018 1 9:52 AM EDT @ 3/22/2018 9:52 AM
i�bb �per Representative Date a3fi@3eFi�3B4iE... Date
� t��ttt Eu�t 11111 Illii 11111 illll INI I�lI
THIS INSTRUMENT PREPARED BY: 6
Name: JASPER CONTRACTORS �Vot - �;tn
Addregs: 3203 S CONWAY ROAD SUITE 201
ORLANDO. FL 32812_
NOTICE OF COMMENCEMENT
Permit Number.
Parcel ID Number. 30— '51 q— aVO " 030
GRANT MALOYr SEMINOLE COUNTY
CLERK OF CIRCUIT COURT 6 COMPTROLLER
BK 9129 P9 150E (1Pss)
CLERK'S T 2019052858
RECORDED 05/10/2018 11:43fl-12 till
RECORDING FEES $10.00
RECORDED BY 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.
1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
RE -ROOF
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: ,JeGihixs�U� u/��hs���lT/Y�, ,L11
Interest in property: OWNER
Fee Simple Title Holder (f other than owner fisted above) Name:
4. CONTRACTOR. Name- JASPER CONTRACTORS Phone Number. 407278-7788
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. 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
T13.13(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(1Xb), 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 PA MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE
CONSIDERED IMPROP AY E T5 DER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR
PAYING TWICE FOR IMPRO ME YOUR PROPERTY. A NOTICE OF COMMENCEMENT.MUST BE RECORDED AND POSTED ON THE
JOB SITE BEFORE THE FIRS. IN TI IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WO OR e, RD YOUR NOTICE OF COMMENCEMENT.
(Signature orO
AuthoredrinerOor Lesse�1Pa, or or L 's - - (Pdnt Name aad Prevtde Sigreleq/s )
thcer1Directo 'er agar)
State of
of
The foregoing instrument was acknowledged before me this day of �`�lw) . 20
by 1'-�I rj 6Q rr-0 S Who is personally known to me O OR C�
Name of person malting statement
R u
who has produced identification Ql) type of Identification produced:
RU-DITH GOICO GC'y
Pe° T State of florids-Notary Public
.- Commission # GG 178413
My Commission Expires
�nnrr` January 24, 20z2
Altamonte Springs, CasselIberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 05/15/18'
Karla Almodovar, Rudith Goico, Skylar Amkraut, Rachel Holcomb
I hereby name and appoint: Ana Chavez and/or Michelle Monsalve
an agent of J-p-c_V a0,5
O — of Company] _. .
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:
105 WORNALL DR SANFORD, FL 32771
(Strop Address)
Expiration Date. for This Limited Power of Attorney: 1 /1 /2019
License Holder Name- Donald Bouchard
State-,
tate License Number. CCC1331153
Signature of License Holder Aill
STATE OF FLORIDA
COUNTY OF s-li -'o(
The foregoing instrument was acknowledged before me this 15 day of May ,
200 18 ;by Donald Bm drad who is o personally known
to me or is who has produced a as
identification and who -did (did not) take an oath
Signature 1
(Notary Seal) Skylar Amla�aut
SKYLAR B AMKRAUT �t
` Commission 9 Ff 127890 i
- My CommissionEires
June 01. 2018
(Rev. 08.12)
Print or type name
Notary Public State of FL
Commission No. 127890
My con -In ion Expires: 6/1/2018
Snannpri by (;amScanner
5/15/2018 ' SCPA Parcel View: 33-19-30-514-0000-0030
osvlcaolarsa,,cFn Property Record Card
FPFR Parcel: 33-19-30-514-0000-0030
teasccx�rY ac+r�mA Property Address: 105 WORNALL DR SANFORD, FL 32771
Value Summary
2018 Working
2017 Certified
Values
Values
Valuation Method
Cost/Market
_ Cost/Market
Number of Buildings
1
1
Depreciated Bldg Value
..... .... -
$125,905
$114,327
i
Depreciated EXFT Value
$1,100
$1,150
Land Value (Market)
$38,000
$38,000 1
Land Value Ag
Just/Market Value "'
$165,005
$153,477
Portability Adj
Save Our Homes Adj
$39,658
$30,708
Amendment 1 Adj
$0�
P&G Adj
$0
$0
Assessed Value
$125,347
$122,769
Tax Amount without SOH: $2,134.00
2017 Tax Bill Amount $1,549.00
Tax Estimator
Save Our Homes Savings: $585.00
' Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description
LOT 3
COUNTRY CLUB PARK
PB 50 PGS 63 THRU 66
Taxes
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund $125,347 $50,000 $75,347
Schools $125,347 ( $25,000 $100,347
City Sanford $125,347 $50,000 $75,347
SJWM(Saint Johns Water Management) $125,347 $50,000 I $75,347
_. __.
County Bonds $125,347 $50,000 $75,347
Sales
Description Date I Book Page Amount Qualified Vac/Imp
WARRANTY DEED 9/1/2013 08135 0548 $146,300 Yes m j Improved
WARRANTY DEED 5/1/2010 07384 1371 $124,000 No Improved
WARRANTY DEED 7/1/2002 04468 0008 $136,000 Yes Improved
SPECIAL WARRANTY DEED 2/111997 03203 1705 $88,300 `' Yes Improved
WARRANTY DEED 1/111997 03189 1151 $22,000 i No Vacant
.......... 1 ...._... -._.. ..............-.-....... ....._...... ...... -. ................ ..........
_- __-.......- ..................
Find Comparabla Saks
( -Land
Method Frontage Depth Units Units Price Land Value
LOT 1 $38 000.00 j $38,000
Building information
Is Bed/Bath count incorrect? Click Here
1/2
http://pareeldetail.scpafi.org/ParceiDetailinfo.aspx?PID=3319305140000003O
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.
OS/1 S/1 g
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE:- DATE:
CITY OF
I Sk�FORDBuilding & Fire Prevention Division
FIRE DEPARTMENT Re -Roof Permit Card
PERMIT NO. ' $` ISSUE DATE:
CONTRACTOR:
JOB ADDRESS: 10
r
TYPE OF WORK: ' / a441 le
PROTECT FROM WEATHER
• 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
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
r BUILDING INSPECTIONS 390 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
----------------------------------------------------------------------------
Application Number . . . . . 18-00002271 Date 5/16/18
Application pin number . . . 990295
Property Address . . . . . . 105 WORNALL DR
Parcel Number . . . . . . . . 33.19.30.514-0000-0030
Application type description ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Application valuation . . . . 10600
----------------------------------------------------------------------------
Application desc
reroof/shingles
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
debarros, jean JASPER CONTRACTORS INC
105 wornall dr 1690 ROBERTS BLVD
SANFORD FL 32771 STE 112
(904) 775-4137 KENNESAW, GA 30144
(770) 615-4269
--------------------- Structure Information 000 000 ------------- - --------
Roof Type . . . . . . . . . FIBERGLASS SHINGLES
----------------------------------------------------------------------------
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1051317
Permit pin number 1051317
Permit Fee . . . . 117.00
Issue Date . . . . 5/16/18 Valuation . . . . 10600
Expiration Date . . 11/12/18
Qty Unit Charge Per Extension
BASE FEE 40.99
11.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 77
-----------------------------------------------------------------------I
Special Notes and Comments
All projects within the City shall use
WastePro for debris removal. Please
contact WastePro at 407.774.0800.
Normal hours for inspections are from
7:30 through 4:30 Monday through
Thursday. Please be aware you must
contact the Building Official to
schedule a Friday or after hours
inspection. This is required since not
every inspector is licensed to do every
type inspection. Communication is the
key, so please contact the Building
Official if you have any questions at
407.688.5058 or at
dave.aldrich@sanfordfl.gov
-------------------------------------------------------------------------
Other Fees . . . . . . . . . 01-APPLCTN FEE -BUILDING 25.00
01-BLDG-PLAN REVIEW 33.00
01-BLDG DCA SURCHARGE 2.00 ,
01-BLDG DBPR SURCHARGE 2.63
------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 117.00 .00 .00 117.00
Other Fee Total 62.63 .00 .00 62.63
Grand Total 179.63 .00 .00 179.63
----------------------------------------------------------------------------
FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE
PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS.
NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED.
NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED.
CITY OF SANFORD
#+� CUSTOMER RECEIPT
Oper: BLANDA Type: OC Drawer: 1
Date: 5/16/18 01 Receipt no: 124401
Year Number Amount
2018 2271
105 NORNALL DR
SANFORD, FL 32771
BP BUILDING PERMIT RECEIPTS
$179.63
2018 2272
135 ANDREWS RD
SANFORD, FL 32773
BP BUILDING PERMIT RECEIPTS
$169.48
AC 016936
Tender detail
CC CREDIT CARD $349.11
Total tendered $349.11
Total payment $349.11
Trans date: 5/16/18 Time: 9:30:01
PERMIT # V - 2' -' -7
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: 105 WORNALL DR 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 ]VOTE: OAT Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED
ROOF VENTILATION: (DOFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
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
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
Q 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#
L�� l
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE-RoOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT#: ' W- ( ADDRESS: (CS VVUwalti CV,
1 iI �CJ� �\ Cil� ��'�-y'LJ1%� 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 #: CCC 1331153
COMPANY/CONTRACTOR: JASPER CONTRATORS �
CONTRACTOR SIGNATURE: DATE: v
(MUSTBE SIGNED BY LICENSE HOLDER OR OWNER/BUILD
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 SEMINOLE
Sworn t Subscribed before me this day of 20 L 0 by:
Who is ❑ Personally Known to me or has X Produced (type of
identifica ioi DL as identification. ,on`BSKYLAR B AMKRAUT tiPar G•�:
State of Florida -Notary Public
Commission # GG 220805
Signat of otary P My Commission Expires
" June.01, 2022
State o Flori a
Print/Type/Stamp Name
of Notary Public