HomeMy WebLinkAbout112 Wax Myrtle Dr 17-1486; ROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERM T APPLICATION
Application No:
Documented Construction Value: $ 10,100
Job Address: 112 WAX MYRTLE DR SANFORD, FL 32773-5640 Historic District: Yes No 0
Parcel ID: 11-20-30-508-0000-0460 Residential Q Commercial
Type of Work: New Addition Alteration Repair 0 Demo Change of Use Move
Description of Work: Re -roof Owens Corning FL10674 Techwrap FL17194 28 sq's 7/12 pitch
Oakrige Desert Tan Lifetime Warranty
Plan Review Contact Person: Jasper Contractors
Phone: 407-278-7788 Fax: 800-337-3361
Title:
Email' permit@jasperinc.com
Property Owner Information
Name Oscar & Cecilia Canonizado Phone:
Street: 112 WAX.MYRTLE DR
City, State Zip:
SANFORD, FL 32773-5640
Resident of property? :
Contractor Information
Name
Donald Bouchard
Phone:. 407-278-7788
Street: 3203 S Conway Road Suite 201 Fax: 800-337-3361
City, State Zip Orlando, FL 32812
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
yes
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 WITIi 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°i 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 ofthis county, and there maybe 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 constriction 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
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Kct l 5/22/2017
Signature of Contractor/Agent Date
Print
5,2i; l
of Florida Date
SKYLAR B AMKRAUT
Commission tt FF 127890
My Commission Expires
June 01, 2018i
Owner/Agent is Personally Known to Me or Contii-&tor l n to Me or
Produced ID Type oflD- Produced ID Type of ID k_
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas Roof Q
Construction Type:
Total Sq Ft of Bldg:.
Occupancy Use: Flood Zone:
Min. Occupancy Load: of Stories;
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No 0
APPROVALS': ZONING:
ENGINEERING:
COMMENTS
UTILITIES: WASTE WATER:
FIRE: BUILDING:
Revised: June'30, 201;5 Permit Application.
mw
e,
u e
r{,I ni3 JAS P_E:
Shincir I
t Iw":. I:I)t)I1 11'1 'el l'sll'SI (r)1 IIt1(
I
r
r '. }y 71 S
L. . ,1._I _,
10,100 -
jw-1,rAj1y4 I Tm an, Liol J$Vrut 10 wIN for it holrorof I rulati, 1116 clill(I act Nitall lit tioidoliu
o" ut „L 11;.4.n r.6;1f, ICI n,lit. G,( r1t, Full RUA 14cl du ccn tc. tit I)ult= I li.wr.', 1a. rini z;u'..anl III It{Iu.;n- 1s411:=.. hcneln, ,uhl uNin
r-r: : 1.. i I, _' , :; _, i„ f,,, II.1 .r.1 ... ,•I .In.l1 ,Iclll lu: IrnnL_1 t.1 J i ull k.,.+'I?t-1,l l •Ircnl 1 : ;.Ikr. r!',,-.. .I +sr7kn rn ctt
1 ni It r_rI•nrn <II-.I,-r ;I11,7'I: 171.17c g_I:==. "n -e@:^r'I,c It[Il,nln ,r, trt'111w1x,1 uo,!'rtlil. f'liliirac5
ni5a I. - 1 Tr-i Itt r l t- ,-rnf Itn11 aPl u,l ,r t»11trr= I qu-,Ertl h} litsncr 111 II•.
J. ,I ,:,i? l cI:r, i. k, 'es d tt,, m r,r.nn-ri I a ti - I . ] 1 ,cr h i] In d'r r ,:r11_ I lip ma Pn,;tcy
1' rap L_ 1. I.. I_C," 1 ir s-. € ..,'l 1!1h-oil II 411_III I,t. Ile li :);['Al ,l t i r L L.•r II V=i a_1111 f16 Ill Ji I,.... 171 i Sri: r :1!`5 l+fq'hn'i ill r
r ar^ T!j I , r1-.2 Il.°,t. hjlttl II(11 <I, r s IrcJI,y u tit ,,,. n1 t,,. ( 1, 11 tul 1 ' I rtc61 Sni Ih i .;t ept" Iredu
tittle __ W "I,,-r ,,11d I it i„y r I n_t ' nirl ail t u. et e r,.. r• tell 1;'t 0-C-71dlc OLdIt.alllc Ill ll=_
I I I '.I 1 IcP!tcn,nl 11`p.In I lt,tn•.,Litc tIr I,ItI iti rc h•rreJ h. <.pt]c ,tnit,l tlu,t r .)u' a: tF,r
I e f1i tl } iliac, rI- iisIi ur lirtutuse lu pax, H,Ir«s Of. repute :nrr or tilt I,(Ilie lu vretncc t]tJuCIIItlt• q.piIC,tticu, I i I I Ir
lit _ t lit I t the dc,luutlhlc lul,lu t uul rl lan t In- 'll u.mull: ,1,d.twtlLit HE I -
kill IN I lfl.l_, Fl US AI'pt WAIlLL SAI.(IS' 1 t x[f.}
8.7r,;4+..I 4t._7itOkl/.+.I-]Ir' 7-a_.l*:: n1e..t1u0,or1,-111. lt1 yy'' 1
x
I I I114ltl 1:]-- 1 ...r w y
ttnlliol)
Itl'N11•!V! ^C11}Dl,l_F 114,.r1al f l ! -
1_i I E U'jh if MII:'I III Mill (1 ililk, 1 1•nrl ILnsrIV fill (,7,11FIl;l fit the e Qi[t LTdcC Nra C. ul,urcrl •f
Pitt, ,111„tiu,, , e 'l. rlayc ,,,d Fty,Ihlr I ]J=,p_r u, I.7 c'il of i'r c,lull
itXl" ar1pll I;' Jehl Intl i- , c t • I' ,1r 4cr,j tlu: Until ( I e,. Ih i tJI an u1u111s1ul.:Z!r 1cI11r11 1kf blkk 1:,-i.ty1 In WiL C•_r s d' s t "IrIC lr, , CLiK7r1 i.,1 rl.{, .17,11i of UrIIL.C` PTICL I{Sl,ow" ' t II1liCl,l 11111a )ll Imi IL_, 01361Yrlo1: 1 11rll' "M 1
F!. 1j I i 111" 1t Icol 1<ur6 and
mi tip r"rer I rnr ii .Il .r:d au,t , 1] . t tilt:- ,lull (irn,111tc llti 111JL:n ]j,,7 l•rcc, tc. h nl ;C, 14 t:1ei t4 qta Irr a 'IJr, r 11 _
r1 to r!u r l -,.1" rtt` riurnt titr;r•1 411;a11 till r1 1_,.• 1111 ;,lu 1I rc.1 Iir.;r;ut i rur p III , a lru YI _Ypgxl,zlm;tb_Iv st [i7 I I f3
r• „E
Idle
lrt tY,
wTlfl i1 .
zx1-1-_. com1.1ro,
tart . 1 't , I r z
Ih}Itcr '. Ue l ruhl,n u1 I h ro" I 1. _
IIr 1I I . I Yifx L_ (: n ri, 1 I rbl.r itigli 1 ),91 t'r ; If11i11.111 Ct l lll I ll li I.1.1.11M)Y1IOtUONtil:It '
C JNti I(I( IION R1_(_L !'Iat1'1l°N[I f` tl
t1}:'
s 1. ! f' I
U l 1131I I I:D %NM1 1, 11 t1 IIIAN',MI.tlll_I FROM 1111, FLORIDA 110tI'1:M1VIRY LfI 511 f i C1(}' ItI:C(rl'! 1t1 1
d af) II l O1 LUtiI t1C)tL.1 l) s .1 I'1t('),I1'f 1 I'I:1il'C)I{ a1P;l} (+'+I)h_12 (ll tiL.0 1 IIFKI f[II LC3SS ftf i,1 1- IL," I )
t(i~I s.1'1-t` lllf.lr ", I[ll:tl l(i': O1 1L+11It11? t ON-1 1-'4\4' Ill ,\ L1(;F^v l`_II [ I`OILRMI\FOR \1rA l I Ali (it I I III
141 ( M IR)i I I`NI) 111) VILIN(, A ( I A INI, t l)N I A( I i I I L Fl.t)itIbA r Ifz(-Cfl(1.1' Iti`I)I-S'IFI1 1U
LN111'`GIIto tlal)AI IIII HiLI.C)1t'IM, 111 1.11110%1 N1'NIM-It,k\ib,l1[llthrtiti; t_'eln,tructiean lndustri Ijet-osiog li 1ard: 2htrl Illelrstune luri(1,
Itrllithas'sve, IA, 3?19e)-103'7,t'34O)•U71-13e15 1()4: If Oliltier ll rig lerrrtin;rte' Il C rCJ I,
1(0 ill Jaspe'I, (I%%rtcr Isar do set hefurc midoi!lrt oll tlrc ill IIIINine4'. dxa rifler C'c,ntrac-t ise%rcLit rel_ Oitjicr +hall rcccnc
a full re'fnntl of :111 dCPn%ils. C1 `ne•r ma alm) rescind Cunt)act befiu•c ntitlni>;lel ou tile° 11)ird hil-Wh>% fb_s after the cirlitrnC 1 is cxccuted
aftr.'r Ilrllificalliull Crelnl insurcr(s) that tilt ClAilll fin' p 'iiIRI •tit olk frill t:owraet IcI. Gee r, dvm l in ss loedt fir in port. All 4s Filter)
notices Of canre'llatloo. rcgardll;ss of Mison, Sjoi ll Ire: prrstlrrrr3:rcl OF tli:1j., `ec1 it, ,Inyper`, ccrp,)rah. office. 1690 I(,.!bert+ Boulr;.nrl Soile° 112, I c trtrrs
ntie, (1 30144. (.VsC1' 1,1„VI WN I W1:PI10NS: File tIircc 13) d., rl lirconctNofoen M11-ti 'N0T AI'PI,F ltr cOlitracts for emergency himic
repairs ns time it of 11lc.tsMcltt[`. 1_ Or%nell hilt re_ad and unficrtraod all stuterncnts, leads yrald Condilions
Iif the "I(ouf Re111aecnit, rlt C`t,IitIaI, :Tel a1;rrC t r 1Il tituik;arc uccchlabiv and san rictt,rs'. 1 furls lindcrOand that (
Ills C ontract, constlltlte', III(, cnlirr "p-vVmrt%l 1i,1%scen Ihe j';erlrr'% ,ztrad rhJI art% fur Ill (11J0"V) iIr it111 rulinl)s lrl
Illis (enitrart locust lie uaadv in ssriiilrgsled a; rCCtl a Im Ir% Ir1I111 It.0 tl,:., party rcpre't:n]> and %,arr:rr)t+ tit lhr t-lhu IIrAI it has
the full 1n1%%t.l• anti utr11110; lrl In Coll irllit till` eirnlrae t anti Thal it I> P,r`I r:r1 e Ilf,;lrrealYh iI) arcurijanrr xilll its trims. i _ `i ;_ -_— — •;
is t'k to
PREPARED BY:
Name:
Address:
au i3rl
NOTICE OF COMMENCEMENT
GRANT MALOYr SEMINOLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLER
BK 8918 P!3 667(1F9s)
CLERK'S v 11171350755
RECORDED 05/22/2017 09:5044 611
RECORDING FEES r'10-00
RECORDED BY tsnlith
Permit Number: /+, f O
Parcel IDNumber: i 2 r) - (')' C)"=r.(2C)0
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)
2.
re -roof
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: ^
Name and address: / _
Interest in property: Owner
Fee Simple Title Holder (if other than owner listed above) Name:
4. CONTRACTOR:
Address: 3202 Suite 201 Orlando, FL 32812
5. SURETY (if applicable, a copy of the payment bond is attached):
Phone Number.•.
6. LENDER: Name:
Phone Number.
Address:
7-278-7788 s a
Y \
W
Amount of Bond:
F-
T®
C=)
C`16
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents maybe served as provided by
713:13(1)(a)7., Florida Statutes.
Name:
Phone Number:
8. In addition, Owner designates
of
to receive a copy of the Lienoes Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number:
s_ Fxoiration 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 ARECONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER713, PART 1, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THEJOBSITEBEFORETHEFIRSTINSPECTION.. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signature of Owner or Lessee, or Owner's or Lessee's
Authorized Officer/oireclor/PartnedMonager)
o sc r CG i i'1 iza
Print Name and Provide Sfgnatory's Lille/Office)
State of '7_ 1fl,() (" lit _ County of 'SP 44 Ana ---' —
The foregoing instrument was acknowledged before me this day of. 11AQ(20
by
Name or person making statement
who has produced identificationl}type of identification produced:
Who is personally known to me O OR
SKYLAR B AMI<RA I ITUT
IL nog Commission 11 FF 127890
I911r:Commission Expires NotarySignaturc
o, June 01 2018
LUMTED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 5/22/2017
1 hereby name and appoint: Skylar Amkraut, Rachel Holcomb, Karla Almodovar, and Ana Chavez
an agent of: Jasper ContracOirs
N—orc-nway)
to be my lawful anomey-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:
112 WAX MYRTLE DR SANFORD, FL 32773-5640
Sara Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name: Donald Bouchard
State License Number a c1331153
Signature of License Holder.
i
STATE OF FLORIDA
COUNTY OF sem,o-
The foregoing instrument was acknowledged before me this 2 j day of May
200 17 , by D-aid B-d-d who is o personally known
to me or is who has produced DL
identification and who did (did nof),tak j an oath
Notary Seal
YLAR B AMKRAO oion4FF12789commiss
MY commssioo Expires
a ' june 01, 2018
Rey. 08.12)
Print or type name
Notary Public - State of F(---,
Commission No. I V 1 k U
My Commission Expires: U)
as
Scanned by CamScanner
City of Sanford
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. I 007 -* I 41?J(0 ISSUE DATE: ®S o 41 a e
go)
CONTRACTOR:
JOB ADDRESS:
TYPE OF WORK:
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 1 1 -7
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
TO SCHEDULE AN INSPECTION:
Dial 407.792.6069 or 855.541.2112
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
Final Roof Inspection Code 111
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
REVISED: 04-17 Inspection Line: 407.792.6069 or 855.541.2112
ot
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS:
112 WAX MYRTLE DR SANFORD, FL 32773-5640
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: D OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT
SKYLIGHTS: O YES xO NO 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
OTURBINES
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
xO SHINGLE Owens Corning FL# 10674
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
O INSULATED 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#
O OTHER: FL#
City of Sanford Building Division
7 w 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:
PermitCard, 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: ATE:
5 / 2 2 / 2 017
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 . . . 17-00001486 Date 5/22/17
Property Address . . . . 112 WAX MYRTLE DR
Parcel Number . . . . . . 11.20.30.508-0000-0460
Application description . ROOFING APPLICATION
Subdivision Name . . . .
Property Zoning . . . . . SINGLE FAMILY
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 985895
Permit pin number 985895
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 #: n ^ ADDRESS: 1_j i J_) C_S YYI Ay- e Dr
I cJ " , 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 , 33 1 i C 3
COMPANY/CON
CONTRACTOR SI
MUST BE SIGNED
TRACTOR: eY Y
GNATURE: / DATE: l J
f 3 U
BY NS-EHOLDER OR WNE UIL
A FINAL ROOF INSPECTION IS REQUIRED:
THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINAL ROOF INSPECTION,
ALONG WITH DIGITAL PHOTOGRAPHS OF EACH PLANE OF THE ROOF SHOWING IN DETAIL ALL COMPONENTS (DECKING,
UNDERLAYMENT, FLASHING, DRIP EDGE ATTACHMENT) WITH THE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON THE DECK
FOR EACH INSPECTION. THE PHOTOGRAPHS MUST INCLUDE A RULER OR MEASURING DEVICE TO CONFIRM ALL NAIL SPACING AND
OVERLAPS, INCLUDING DRIP EDGE AND VALLEY FLASHING. PLEASE REFER TO THE RE -ROOF POLICY AND INSPECTION PROCEDURE
PAPERWORK FOR FURTHER EXPLANATION OF ALL REQUIREMENTS.
FAILURE TO FOLLOW ALL REQUIREMENTS WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION FEE AS
WELL AS REQUIRING A DESIGN PROFESSIONAL (ARCHITECT OR ENGINEER) TO CERTIFY, BASED ON PERSONAL
INSPECTION, THE INSTALLATION OF ALL ROOFING COMPONENTS.
STATE OF FLORIDA COUNTY OF
Sworn to and Subscribed before me this 30 day of rri 20 t l by:
W / VLy 5 "I Who is Personally Known to me or has Produced (type of
id tifi ation) as identification.
Signatu e o otary Public
State of for da
Sl ar Amkraut
Print/Type/Stamp Name
of Notary Public
a,'Ju •,,, SIMAR B AMKRAUT
Cc mmissipn N FF 127890
Ay Con)mission Expires
d OF f ' June 01 , 2018
L"41TED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: . J - ?,O "
I hereby name and appoint: Scott Meixsell, James Allen, Michael Watts, Jacob Horst
an agent of Jasper c
of C-4—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 locat at:
I V ATT) haft kr&t RL
Expiration Date for This Limited Power of Attorney: I I
License Holder Name: ,b
State License Number. CCC1331153
Signature of license Holder.
STATE OF FLORIDA
COUNTY OF s
The foregoing incmrTnent was acknowledged before me this %day o ,
200, by oonam d who is o personally khown
to me or m who has produced ot_
as
identification and who did (did not) take an oath.
Si Skyi gut
Notary Sea])
SKYLAR B A WRAUT
ae`
Commission 8 FF 127890
My Com irs"on Expires
June 01 , 201 8
Rev. 08.12)
Print or type name
Notary Public - State of F
Commission No. k1A -Ol (
My Commission Expires:
Scanned by CarnScanner