HomeMy WebLinkAbout203 W 17 St 17-1520; ROOFECGI af'
F CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: '
Documented Construction Value: $ (0sm
Job Address: La3 UU 1`1 t~S .(fvc F- 3a i`1 Historic District: Yes No
Parcel ID: ;(7` 19-30 - 506 - 0o0o- 03h0 Residential Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: Q e 1 ScX I CC.. S1r, ; 1 511 P-ItC„ z ,S fQ k
Plan Review Contact Person:
Phone: Fax: Email:
Title:
Property Owner Information
Name Te_q rY k e c S e c e, Phone: 56 r - ' 6), 617q
Street: c,O3 W . n t1^ St . Resident of property?
City, State Zip: _C--
yA%K-
Contractor Information
Name Nr'AfV_W Q'_F_t Phone:
Street: Aik NEP'l Fax:
City, State Zip: (Y\wm o F L 9 a ( State License No.: CC-c 131-1 3 8 3
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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: 5`h Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application O
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 th ual 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 infor io c rate and that all work will
be done in compliance with all applicable laws regulating cons on a zoning.
C)X, 1,4 S- -I
Signatdre of O er/Agent Date
jf,;ftV 1i0VVCXIS1DPC i'`i .
Print Owne /Agent's Na?he
rmd , 4 qtv- 5/3 - 0
Signature of Notary -State of Florida Date
1-17 l
Date
kiim Pee-'
Print Contractor/Agent's Name 5474 ?
Signature of Notary -State of Florida Date
2otrF. ?becc MARKFREW t FY Pu4 MARK FREWMYCOMMISSION # FF 150736 * - * MY COMMISSION # FF 150736
u
EXPIRES: August 15, 2018
e
EXPIRES: August 15, 2018
r-; •oe Eo-dedThruBudgetWaryServices
9;BOF 7'Personally
d Thru Budget Notary Services
Owner/Agent is Personally Known to Me or Contractor/Agent is Known to Me or
Produced ID Type of ID F(-D L Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas[] Roof
Construction Occupancy Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
Flood Zone:
of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING: UTILITIES:
ENGINEERING: FIRE:
COMMENTS:
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
SCPA Parcel View: 36-19-30-506-0000-0360 Page 1 of 2
Property Record Card
r Parcel: 36-19-30-506-O000-0360
Owner: ALLEN BLANCA & VANDERPOOL DOUGLAS J
i`Y-LXxrrv, Fr.r.»iaA
Property Address: 203 W 17TH ST SANFORD, FL 32771
Parcel Information Value Summary
Parcel 36-19-30-506-0000-0360
Owner ALLEN BLANCA & VANDERPOOL DOUGLAS J
Property Address 203 W 17TH ST SANFORD, FL 32771
Mailing 816 TOMILSON TER LAKE MARY, FL 32746-
Subdivision Name SANFORD HEIGHTS
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions
2017 Working 2016 Certified
Values Values
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 106,327 98,934
Depreciated EXFT Value
Land Value (Market) —
350
18,095
363
15,134
Land Value Ag
124,772Just/Market Value
Portability Adj —
114,431
Save Our Homes Adj— 0 0
Amendment 1 Adj 0 I $0
Assessed Values _ 124,772 - 1 $114,431
Tax Amount without SOH: $2,294.00
2016 Tax Bill Amount $2,294.00
Tax Estimator
Save Our Homes Savings: $0.00
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund 124,772 i $0 I $124,772
Schools 124,772 0 124,772
SJWM(Saint Johns Water Management) 124,772 0 124,772
County Bonds j $124,772 0 124,772
City Sanford 124,772 0 124,772
Description Date Book Page Amount Qualified Vac/Imp
WARRANTY DEED 1/1/2012 07705 1 1527 85,000 No Improved
QUIT CLAIM DEED
QUIT CLAIM DEED
10/11/2010
7/1/2007
467
06757
1455
W
1957
94,500
100
No
No
Improved
Improved
WARRANTY DEED 8/1/2005 05875 0652 ( 225,000 Yes Improved
WARRANTY DEED 2/1/2004 Oi52220153145,000 No Improved
WARRANTY DEED 10/1/2003 1 05222 0150 E 145,000 No Improved
CORRECTIVE DEED 12/1/1997
12/1/1997 J-03345 0283 ?
03345 0285
100 No Improved
94,000 Yes ImprovedWARRANTYDEED
WARRANTY DEED 11/1/1995 1 02996 i 0816 100 No Improved
WARRANTY DEED 8/1/1995 02962 0433 ( 45,000 Yes Improved
Page 1 of 2 (13 items) 1) 2
http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=36193050600000360 5/22/2017
Prepared by and return to
First Signature Title, Inc.
330 Waymont Court
Lake Mary, FL 32746
File Number: 176679
Space Above This Line For Recording Data)
Warranty Deed
This Warranty Deed made this 28th day of April, 2017, between Blanca Allen alk/a Bianca Allen, a single woman
and Douglas J Vanderpool, a single man, whose post office address is 1930 Snook Drive, Deltona, FL 32738, grantor,
and Jeffry Morgan Hopfensperger and Alicia Anne Hopfensperger, husband and wife whose post office address is 203
W. 17th Street, Sanford, FL 32771, grantee:
Whenever used herein the terms "grantor" and "grantee" include all the parties to this instrument and the heirs; legal representatives, and
assigns of individuals, and the successors and assigns of corporations, trusts and trustees)
Witnesseth, that said grantor, for and in consideration of the sum of TEN AND NO1100 DOLLARS ($10.00) and other
good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged,
has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land,
situate, lying and being, in the Seminole County, Florida, to -wit:
The East 1/2 of Lot 36, and 37, Less the East 20 feet of Lot 37, SANFORD HEIGHTS ADDITION, according
to the plat thereof recorded in Plat Book 2, Pages 62 and 63, Public Records of Seminole County, Florida.
Parcel Identification Number: 36-19-30-506-0000-0360
The land is not the homestead of the Grantor under the laws and constitution of the State of Florida and neither the
Grantor nor any person(s) for whose support the Grantor is responsible reside on or adjacent to the land.
Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining.
To Have and to Hold, the same in fee simple forever.
And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the
grantor has good right and lawful authority to sell and convey said land; that the grantor hereby fully warrants the title to said
land and will defend the same against the lawful claims of all persons whomsoever and that said land is free of all
encumbrances, except taxes accruing subsequent to December 31, 2016.
In Witness Whereof, grantor has hereunto set grantor's hand and seal the day and year first above written.
Warranry Deed - Page t
A1®TDREW PEE'T INC.
14507 Josair Dr a Orlando, FL 32826
Lic # CCC1327383
Licensed • Insured
A Family Tradition Since 1937"
Orlando
407) 268-3178
Andrew Peet Inc. agrees to furnish all materials and labor necessary to
do modernization work on the premises located at the following address:
Name Tt_;JFTY 1 op c_n c` c-
Address A01 W. Irk
Job Address SAttiy Phone
6-61- q6#N 6l -71 City _-
An fae City
Date
S-43-17 Zip
AM 71 Zip
In
accordance with the specifications given below: REROOF
WITH SHINGLE ROOF AS FOLLOWS: k
1. Remove I layers of roofing to a smooth workable surface. Each additional layer at $__per square. V
2. Replace any bad wood for $4.00 per Lft for Ix, $6.00 per Lft for 2x. $60.00 per sheet of 4x8 Decking. YY
3. Install Eaves Drip. CircleOne:, Brown - White - Black - Mill - Beige - Reuse 4.
Install ice and water shield in valleys. Circle: Ye No v
5. Install SY"'*L"'" lb.
Base felt. / V6.
Install Valley Metal New Reuse A.
Chimney Step Flashing New, ' Reuse 7B. Chimney Counter Flashing New Reuse 8A.
Wall Step Flashing New —Reuse 8B. Wall Counter Flashing New Reuse 9.
If Flashing cannot be reused, an additional amount may be added as necessary. y
10. Soil Stack Bogts New Reuse Yll.
Install L:rLt;mvyearshingles. Manufacturer C.i;c}-:r< Te&& Color
Style L(4r rn •At y, Jj/
12. Install Roof Ventilation, 750s, Lft Ridge Vent, Lft Shingle over Vent, or power
vents, 3 2' x 4' Off -Ridge Vents. Electrical hook up to be an additional charge. 13.
Clean up all work -related debris. Haul away, leave job site clean. Additional
information: Up tv io <4,i s a yr o nrz Gast if Rimed INSURANCE
CLAIMS ONLY: All
work specified in this sales contract is subject to the approval of the Insurance Company.
This agreement becomes binding to the undersigned as soon as the Insurance
Company approves the scope of the work, and is for entire Insurance proceeds
plus any deductibles, bad wood, extra work, and supplements. The final
price may be adjusted up or down from the sales agreement. If contractor cannot
replace entire roof for insurance proceeds plus deductible, agreement is void.
Insurance
Company Executed
by the Buyer this day of 00
Total
Cash Price $ L22L_ Down
Payment OR Upon
Delivery of Materials $
Cash
Upon 00 Completion
of Job $ 6, Soo Plus
Total for Wood from Item 2 and Item 9) Approved
and Accepted a.
Do not sign this home improvement contract in blank. b.
You are entitled to a copy of the contract before performance commences on your home. Keep it to protect your legal rights. c.
I/We have read and understand the terms and. conditions located on the back of this document, which are incorporated herein by reference
and made part of this legal and binding Agreement. DIRECTION
OFJOINT PAYMENT I
hereby authorize and direct you, my homeowners insurance company, to issue payment jointly to the insured and also to Andrew Peet Inc. Assignee")
and any applicable mortgage company(s), such sums as may be due and owing for all damages payable under the subject contract
of insurance, with the exception of damages payable under the Contents and Additional Living Expenses applicable lines of insurance.
Additional
Terms: This agreement does not obligate the Customer to Andrew Peet Inc. (hereinafter "Contractor"), in any way unless the insurance
provider approves the claim or a court of competent jurisdiction orders the insurance carrier to provide coverage and payment for the
damage(s) suffered by customer. Unless additional work or upgrades are requested, the Contractor agrees project will be completed WITH
NO COST TO THE CUSTOMER EXCEPT THE INSURANCE DEDUCTIBLE. Claitntt
Policy# Signature _ Date:_1 Acceptance
of Proposal: The above specification and conditions are satisfactory and hereby accepted.
Andrew Peet Inc. is authorized to begin the work as specified above after receipt of intention
of full payment from my insurance company. BUYER'S RIGHT TO CANCEL: Signature X Date: You
have the right to rescind this contract within 3 business days after the date you sign it by notifying
the contractor in writing that you are rescinding the contract. Signature X 4?l.oe.&= Date: ' Andrew
Peet Inc. Representative
1111111111111111111121 18181allda lilt ,a.. Name: Mdc1L Address:
p z r,M sae c Oclwndo
5
Permit
Number: Parcel
ID Number: _36- A-30-506 -0000 d36U GRANT
1`1tiLOY o S011HOLE C:OUHT Y CLERK
OF CIRCUIT COURT & C0rj1,:TROLLER. CLERK'
S t 21317050353 RECORDED
05/22/2017 11"43 RECORDING
f-E_17S a:l.l.I,tJIJ RECORDED
BY bsrl i th 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) t/
I of Lao- IL a,,a 1-1 6_c-4C F tea+\ Sanfn A (ap .,mac oaa Dr_L2 1L,C. AV1n nIL C11C CI 2. GENERAL
DESCRIPTION OF IMPROVEMENT: T\GSU_
0 - 3. OWNER
INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and
address: J'?-4 E cy_ e re S R c a C • r.o 11 l"1}t' S t oe D771 Interest in
property: Fee Simple
Title Holder (if other than owner listed above) Address: 4.
CONTRACTOR:
Name- Andrew Peet Phone Number.
Address: C1 .
5. SURETY (
If applicable, a copy of the payment bond Is attached): Name: Address: Amount
of Bond: 6. LENDER:
Name: Phone Number: Address: 7.
Persons
within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section 713.13(
1)(a)7., Florida Statutes. Name: Phone
Number: 8. In
addition, Owner designates of to receive
a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number. 9. Expiration
Date of Notice of Commencement (The expiration is 1 year from date of recording unless a different date is specified) WARNING TO
OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER
PAYMENTS UNDER CHAPTER 713, PART 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 - /, /J/"
r" 7 e.-C
F F v c Signature Ovmer
or Less , or 0 er s or Lessee's (Print Nam and Provide Signa rys Title/Office) Auth 1
d
OfricerlDire
orlPartne anager) t State
of
F OS ; &k County of Se cq tNu \1C_ (fin The
foregoing
Instrument was acknowledged before me this l g i-k day of M otY 20 ! by Who is
personally known to me OR who has produced
identification C type of identification produced: 1j o` i iv
iFi I iE'IN klY COMUSSION f
FF 150738 EXPIRES: August 15,
2018 MAiX AfFOF'i FLOP
O
eo
CE iIF1Eti COS
CQryU COURTyQ^Notary Signature lRC ' ( CLERK OF
pjRO
LER cw•c ANO CdM UN`
FtOR10A wN .. K SE b
VIA'
2011
The East rh of Lof 36 and Lot 37 (LESS East 20 feet), "SANFORD
HEIGHTS" ADDITION TO SANFORD ORANGE CO. FLA..
according to I b e plat thereof, as recorded in Plot Hook 2. Page(s) 63.
ofthe Public Records of Seminole County, FL..
Community number: 120294 Panel: 0070
Suffix: F F.I.R.M. Date: 912812007 Flood Zone: X
Dale offield work: 412112017 Completion Date: 412IJ2017
Certified to:
Jeffry Morgan Hopfen.sperger; Alicia Anne Hopfensperger; First
Signalure 7'ifle, Inc.; Old Republic National Title Insurance Company:
Primary Residenlial Mortgage, Inc., its .successors and/or assign., as
their interests may appear.
70.00'(D) 70.13'!
90.0'0'(P) o n89'32'28"(M)- o
A2.8' CONC CHHENT
b 1.2.NCOACMMENT Iy
ENECROIiIIII 1,
110
17.
53' ONC
ENCROACHMENT - SCALE:
1 "=30' I
rT I.
cD REMAINDER
N 3 LOT
37 I
I ^ d
I
O o m I
O O1 0 r
o I
T I
L 00,
g 1 09
I FIP
1" FIR
1/2" CORNER
SWK IS LOT
LOT 38 I 0.4'OFF BLOCK
CORNER(P) I 20.00'(D) 80.
00'(P) 80.08'(M) CONC:
m.L 6.
5' 1.4'.•'30.2'. TWO
STORY RESIDENCE
FIP
1' 0.
51ON-----_r_
on
n'n'tal I I
S'
X3" A/
C 1 III
I
I
I
11
1O 1 I
rn 1 It
i
EAST } N REMAINDER LOT37oI
NIiaLOT36sLOT 36 a
v
1
4O I Im
O I
I
g0 2 I I
3.232'X4.0' I PERGOLA
I 9
90.4W.F. PSI ow0}
O 9I os wco ¢ `
pO.F'oJ14'X4' ko 1
a' 30.00'CONC 8 40.
00'(D) I (D) - ( . 5'
CONIC - o.
00'(o) 70.10'(M) FIP
1" I SWK
IS 30.00' I 0.
2'OFF (D) I ff
ORO=ELECTRICAL FACILITY 2' CONIC CURB WEST
17th STREET This
survey or the copies thereof T- EVANS STREET(P) are
not valid without the signature and
the original raised sear of a 50' R/W (IMPROVED) 21.0' ASPHALT Florida
licensed surveyor and mopper.
LEGEND
0-
0- Wire Fence D.E. Drainage Easement P.E. Pool Equipment o-
O- Wood Fence D.U.E. Drainage & Utility Easement P.O.S. Point of Beginning Overhead
Utilities D/W Driveway P.O.C. Point of Commencement P.
P. Power Pole ESMT Easement P.C.C. Point of Compound Curve 8
W.M. Water Meter E.O.P. Edge of Pavement RC. Potnt of Curvature m
Electrical E.O.W. Edge of Water P.I. Point of Intersection Asphah
ENCR Encroachment PR.C. Point of Reverse Curvature Block
Wall F Field P.T. Point of Tangency Brick/
Pavers FD Found P.O.L. Point on Line Concrete
FD N&D Found Nail & Disk P.L. Property Line Covered
Area F.C.M. Found Concrete Monument R. Record Z
Cantor' ne F.I.P. Found tron Pipe R/W Right of Way Q
Central Angle/Deha F. .R. Found Iron Rod S.I.R. Set Iron Rod .& Cap Line
Break Not To Scale L Length SWK Sidewalk A/
C Air Conditioning L.B. Licensed Business TEL Telephone Facilities B.
R. Bearing Reference M Field Measured TO.B. Top of Book B.
M. Bench Mark M.H. Manhole TYP. Typical CAN
Cable Riser O.R.B. Official Records Book U.E. Utility Easement C
Calculated ONPL On Property Line W.F. Wood Fence C.
L.F. Chain Link Fence PG. Page W.G. Witness Corner CH
Chord P.V.C. Vinyl Fence C.
B. Chord Bearing PVMT Pavement CONC.
Concrete P.C.P. Permanent Control Point C.
M. Concrete Monument P.R.M. Pemnumen ranent ReferenceMotCOVCovered
P Plat D. Description
or Dead P.B. Plat Book Property Address:
203 West
17th Street Sanford, FL
32771 1rt Rrvranifiratirn
Arms I ir,---
i.v..11 14. Unless otherwise noted, flood zone 1. Legal
description provided by others. information pan, ad by others. . 2. There
may be additional easements and/or 15. Septic tank and drainfieids shown hereon restrictions either
recorded or unrecorded not am APPROXIMATE only and are based upon shown hereon
Ifiet. may affect this property. visual location only. No attempt has t'- 3. Underground
pomons of footings, foundations made to verity their location. Client must or other
improvements were not located. consult with the appropriate utility location 4. Building
ties am to the face of the wail, company to confirm the actual location. 5. Only
visible encreachments located. 16. The closumof structures may not be precise due 6. No
identificatfon found on Property corners to buildag impedeciiam and decomlive finishes. unless noted.
17. Pools and/or patios may be drawn as an 7. Dimensions
shown are plat and measured approximation and hot fully dimensioned unless Otherwise
noted. due to irregular shape. 8. This
is a BOUNDARY SURVEY unless 18, Fence locateas along property line may be otherwise noted.
exaggersted far clarity. 9. Not
valid unless sealed with the signing 19. The nature, extent or existence of riparian surveyors embossed
seal, rights is not addressed hereon. 10.Noiille
commitment used in the preparation 20. Thii-ymeetsJl ,p6cab4eaccly Ma ts. of this
document unless noted otherwise. s the W m 21. ThissurvVL.-dFWd.
11. All
lines are natnkial unless othemiseroted. Techmo98y thsF rd 12. This
survey is not to be used for permitting of Pmie 17, at FWda or for
construction of any kind. Atllt nl fT FLS al.er mY
it .. Ralph Swerdfoft
egisterM tnntl Surveyor No. 3+V11 Xavier Frank
Aguirre Re"Mu eC Swv4yprar d Mapper No. 67W 1 R
71'i9
Z
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 coUipliance by personal inspection.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: _ DATE: `7
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: () l rli fr/ 1(orref 1,G— 3.) -77l
STRUCTURE TYPE: ,SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: 1. 5REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF
DECK TYPE (PLEASE SPECIFY:
PLEASE NOTE: ONLY ;
OFF-RIDGE
UARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED"
ROOF VENTILATION: O RIDGE OSOFFIT OPOWERED VENT
SKYLIGHTS: O YES
MAIN ROOF AREA
1? NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
ROOF SLOPE: O LESS THAN 2:12 O 2:12 —4:12 O 4:12 OR GREATER
O TURBINES
TYPE OF ROOF MANUFACTURER FLORIDA APPROVAL
SINHGLE C(ol Ito Tc_&
PRODUCT
FL# Ii Etf ' I
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#
SEA41NOLE COUNTYMULTI%URISDICTIONAL
r 1 ,. ,r get ,, '
S a•F ," P A t , ,:
Y
Altamonte Sp 'rings, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
I hereby name and appoint: NUM, PM ;
an agent of. nc ccv eei c1G
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 thisappointmentfor (check only one option):
All permits and applications submitted by this contractor.
0
The specific permit and application for work located at:
0103 U). I`l
1,' St. Sanfo,d L 3MI
Street
Expiration Date for This Limited Power of Attorney:
License Holder Name: NO AA ,GVJ Q C-c,+,
State License Number. CCU 1311
Signature of License Holder.
STATE OF FLORID,(
COUNTY OF Se
The foregoing instrument was acknowledged before me this i' * day of Nlg
20 1L , by who is 4a'personally known to me or
who has produced
as identification
and who did (did not) take an oath.
MQr4 G ; P
Signature of Notary
o pRY P B MARK FREW
kOMMISSION # FF 150736
EXPIRES: August 15, 2018N'
rFOFF`OP Bonded Thru Budget Notary Services
MctrK F-re L r
Print
or type Notary name Notary
Public - State of Commission
No. My
Commission Expires:
ii
OF
J
ID City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 11 -000 0 t6)10 ADDRESS: a3 W 17 } St.
5 f of A FL. 3).7 I
I Ve\,/ P
AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING ( T R, ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
FOREGOING INFORMATION IS TRUE ANDiACCURATE 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 #: . GG t3 . 3&3
COMPANY / CONTRACTOR:
CONTRACTOR SIGNA'
MUST BE SIGNED BY
A FINAL ROOF INSPECTION IS REQUIRED:
DATE:
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 SCon: d 0 Sworn
to and Subscribed before me this day of Tr -A!) E.- 20 _a by: A);
e w ep—fi . Who is Personally Known to me or has Produced (type of identification)
a
Signature
of Notary Public State
of Florida Ma
r K rre cI/ Print/
Type/Stamp Name of
Notary Public as
identification. v;
a 4:
r NARK; REN MY
COMMISSION # FF 150736 N,
oT EXPIRES:
August 15, 2018 Bonded
Thru Sud9e( Notary Services