HomeMy WebLinkAbout100 Casa Marina Pl; 17-3018; RE-ROOFX 1
CITY OF SANFORD.
1
t m BUILDING & FIRE PREVENTION
C 429352
PERMIT APPLICATION
Application No. % 1 — 3 d / f
Documented Construction Value: $ 15,700
Job Address: 100 Casa Marina Place Sanford FL 32771 Historic District: Yes No
Parcel ID: 29-19-31-5014000-0420 Residential Q Commercial
Type of Work: New Addition Alteration Q Repair Demo Change of Use Move.
Description of Work: mroof Owens Corning FL•10674-R12 Techwrap FL17194-i21 42 squares 7/12 pitch Supreme pditwood
25 year warranty
Plan Review Contact Person: Rachel Holcomb
Phone: 407-278-7788 Fax: 8OD-337-3351
Title. admin manager
Email: pennit@jasperinc.com
Property Owner Information
Name Vanessa Rivera and Armando Rivera Jr
Street, 100 Casa Marine Place
City, State Zip: Sanford, FL 32771
Name Jasper Contractors
Street: 3203 S Conway Rd
City, State Zip: Orlando, FL 32B12
Name:
Street:
Phone:
Resident of property? :
yes
Contractor Information
Phone: 407-278-7788
Fax, 800-337-3351
State License No.: CCC1331153
ArchitectlEngineer Information
Phone:
Fax:
1% ft 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
COb MENCEMENT.
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 woxk will be performed to meet standards of all laws regnlid ng construction
In this jurisdiction. I understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools,
furnaces, boilers, beaters, 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: 51h Edition (2014).Florids BuOdingCode
Revue&: June 10, 2015 Permit APPkafim
NOTICE In addition to the requirements of this permit, there may be additional restrictions applicable to ibis 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 requ irements 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 exeeated 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
aocordance 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 of0medAgent pate
Print ovmer/Agents Name
Sigatare of Notary-Swe o£florida pate
6k&n Date
ko,
G -1 I MAUT
pate Coiss
pn N FF 12789U ussion
Expires 1,
2018 g Owner/
Agent Is Personally Known to Me or Contractor/Agent is Personally Known to Me or Produced
ID Type of ID Produced ID Type of M BELOW
IS FOR OFFICE USE ONLY Permits
Required: Building Electrical Mechanical Plumbing Gas Roof Construction
Type: Occupancy Use: Flood Zone: a :
i= 'eat New
Construction: Electric - # of Amps Plumbing - # of Fixtures Fire
Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No APPROVALS:
ZONING: ENGINEERING:
COMMENTS:
UTILITIES:
WASTE WATER -- BUILDING:
Revised:
June 36,2A15 PeratitApplicadw
10/1212017 SCPA Parcel View: 29-19-31-501-0000-0420 Property Record Card
On 0Johmon'CFA
Parcel: 29-19-31-501-0000-0420 Owner: RIVERA VANESSA
M & ARMANDO JR CO tO Property
Address: 100
CASA MARINA PL SANFORD, FL 32771 Parcel Information Value
Summary Parcel 29-19-
31-501-0000-0420 Owner RIVERA VANESSA
M & ARMANDO JR Property Address 100
CASA MARINA PL SANFORD, FL 32771 Mailing 100 CASA
MARINA PL SANFORD, FL 32771 Subdivision Name CELERY
KEY Tax District S1-
SANFORD DOR Use Code
01-SINGLE FAMILY Exemptions 00-HOMESTEAD(
2006) 2017 Working Values
2016 Certified
Values
Valuation Method
Cos!/
Market Cost/Market Number of Buildings
1 1 Depreciated Bldg Value
132,225 130,135 Depreciated EXFT Value
i $350 363 Land Value (Market)
32,000 28,000 Land Value Ag
i Just/MarketValue" j $
164,575 158,498 Portability Adj Save
Our Homes
Adj I $46,449 ^^ 42,802 Amendment 1 Adj
P&G Adj
so 0 Assessed Value 1$
118,126 115,696 AF Tax Amount
without SOH: 2,363.00 2016 Tax Bill
Amount 1,505.00 Tax Estimator Save
Our Homes
Savings: 858.00 TRIM Notice Helo
Does NOT INCLUDE
Non Ad Valorem Assessments Seminole County GIS
http://parceldetail.sepafl.
org/ParceiDetaillnfo.aspx?PID=29193150100000420 1/2
Account Manager.
SM E. Coioaial Dr. r Contact M yo2- ?35•
Orlando, FL 32807 t norr. "QnV Inrai'motion
r
3203 Conway Rd., Ste. 20l Company
Orlando, FL 32812 f—JSAP ER Policy #:
407) 278.7788 JenperrRoof.oent Claim N: I
ja"P361 fax
t fi G a. ctinc.oIn Fl. Contractor's License:
J Cc Pa,J111 ,44— may;
z ®
CCC132%51 & CcC1331153 Leoart Number:
ROOF REPLACEMENT CONTRACT
n.,,,...., Phanc:
T,6 r:1
L
Code:
Amunsl contract Price: I Drip
bad-tY-sxeA [J,iaA ` C ir%1 1 $15,700
if Oh-ttel^'s Insurance Company dR not a» to glay for a full roof rsIlf ace rent. this contract shall be voidable.
Assignment of Insurance Benefits for the Fall Roof Replacement Only:1 hereby assign any and all insurance rights, benefits and proceeds tinder
any applicable insurance policies to Jasper Contractors, Inc. ("Jasper"), the scope of which shalt be limited to a Full Roof Replacement. 1 make this assignment
and authorization in consideration of Jasper's agr=Fwnt to perform services, supply materials and otherwise perform its obligateons under this Contract,
including not requiring full payment at the time of service I also hereby direct my insurers) to release any and all information requested by Jasper, or its
rrpresentative(s), for the direct purpose of obtaining actual benefits to be paid by my insura(s) for services rendered In this regard, I waive my privacy
rights. If payment is made directly to the Owner/Agentlbtstaod(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, nix covered by insurance, must be paid by the undersigned on the day of
ittollation. Deductible: it is the Owner's resoonseltilitty to m all insurance deductibles. Owner's out-of-pocket expense will not exceed the deductible
amount, as stated an mstrer's loss sheet (the -Loss Sheet'), UNLESS replaeementlrepair of deteriorated decking is required by code and/or Owner requests
optional upgrades. Jasper CANNOT pay, walvv- rebate. or promise to pay, waive or rebate any or all of the Insurance ded ble applicable to the
insurance claim for payment of k_ In the event of a discrepancy, the deductible amount stated on the msarer's Loss override deductible
amount disclosed. Deductible: S d • C3CJ MUST BE PAID IN FULL, PLUS APPLICABLE SALES T f nitiail
MORTGAGE AUTHORiZATIO : L Owiter/Motrtgagor, grant auilt ex Mortgage Co. to speak with
Jasper on mattes including but not limited to, the claim and draw sta(initial) PAYMENT SCHEDULE: Owner agrees to
pay Jasper based on the following schedule: (i) Deposit in the amount ofs due upon signmg this contract; (ii) the Contract Price,
less the Deposit and any applicable depreciation retained by Owner's lnsurer(s), phi upgrade costs, due and payable to Jasper upon completion of
work being pafarmed; and (iii) the remaining Contract Price (equal to any applicable depreciation and/or change orders) due and payable to Jasper upon
conipkxion of work perlbrmed in the event of a pending inspection, no more than 2% of contract Price may be withheld until inspection has passed.
Optional: UPGRADE Tmht- _ QTY: PRICE: TOTAL: $
Replacement Work and Pricer Upon insurer's approval and subject to the Terms and Conditions 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, approxhaiady
within 30 days, conditions perntitnng Owner's Declaration of Intent: Owner acknowledgesand agrees that, upon approval by insurance erouepany for a fall
toof replacement, Jasper shall perform the roof replacement upon receipt of funds from Owner's insurance company. FLORIDA
HOMEOWNERS' CONSTUCTION 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) 497-1395 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 Wore midnight on the
third business day after the contract is executed after notification from lnsurer(s) that the claim for payment on roof contract has been
dented, In whole or in part. All written notices of cancellation, regardless of reason, shall be postmarked or delivered to Jasper's corporate
ofltce: 16" Roberts Boulevard, Suite 112, Kennesaw, GA 30144. CANCELLATION EXCEPTIONS: The three (3) day tight
of cancellation DOES NOT APPLY to contracts for emergency home repairs as time is of the essence, 1,
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
ptuty represents and warrants to the other that it has the frill power and authority to eater into the contract and that it is binding
and enforceable In accordance with its terms. a
C?
17 trthorized
Jasper Representative Date Owner Da. ifi
Scanned
by CamScanner
j THIS INSTRUMENT PREPARED ej,y.Q o 1 Name: Jas er Contrat:lora `v Addroael
NOTICE
OF COWNCEMENT I
t lll tll NNt il i iIlil I)f f# 11)f fllf t0i3R1
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1,69 QF3si CLERK'
S aw 2417102759 ItiECQRG
I; 10/12f2017 11:1042, Ali F.::
IfiDll S F'tES :14.frf1 F:
ECtJRGc EY hd=• .tr? Permit
Number. Parcal
ID Number. — O no
underslgned hereby gives notice that I nprovement will be meda to certain real property, and in accordance with Chapter 7f 3. Florida 6101 140, fire followtnoInformationisprovided. In this Notice of Commencement, 1.
DESCgIPTIQ O"ltpPERTY:11-sgat desctfatlon Of the proaerW and street address If 2.
GENERAL DESCRIPTION OF IMPROVEMENT. , 3.
OWNER Noma
and Interest
in OR
LESSEE INFORMATION IF THE FORTHE IMPROVEMENTS Foe
Simple Title Holder (n other than owner listed above) Name• Address
4.
CONTRACTOR: Noma; JSSper ContrSdors phone Number. 407 278-7788 Address:
5380 E Colonial Drive Orlando, FL 32807 S.
SURETY {If applicable, a copy of the psymont bond Is attachady Nome Address;
AmourdorBond: S.
LENDER: Nome: Phone Number: Address:
7.
Persons within tho Sthts of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section TiS
iS(i)(a)T, Florida Statutes. Name,
Phone Number: Address'
w S.
In addition. Owner designates of to
receive a copy of the Lisnots Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number. 9.
Expiation Date of Notice of Commencement (The evhfion Is 1 year from data of recorfti; unless a diirerent date Is speaf4 WARM_
NG Tr1 OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE STIRATTDN OF THE NOTICE OF CObMiEN B04T ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713. PART 1. 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. Slat
levismorown or t p3dN raesndProvrtlaSlpnemysr aj AuNmtrM0lAadDYodmlPa innRAaneyerj
t ,p
State of
County of The fo
going Instmme t was ac(t gwiedged before me this r+f day of `! - Y 02 \ 1 by y
r trxA ( V L w e. c Cl. _. Who Is Personally known to ma O OR Nam of
prone 9tawnlug who has
produced Identification tT type of Identification produced: rH ANA
CHAVEZ c Steio,.
oi Florida•Notery Public 5 5
Commission a GG 112152 My Commission
Expires June 06,
2021 CtQ Lei
Scanned
by
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429352
LEMTED POWER OF ATTORNEY
Mtamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date_ 10.12.17
1 hereby name and appoint Karla Almodovar, Skylar Amkraut, Ana Chavez, Gina McDonald & Rachel Holcomb
an agent of- JasperCm&ackks
Nam orcompany)
to be my lawfW 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 at:
100 Casa Marina Place Sanford FL 32771
Sma Address)
Expiration Date for This Limited Power of Attorney: 01-01-2019
License Holder Name: Donald Bouchard
State License Number: COCIMI153
Signarure of License Holder-
STATE OF FLORIDA
COUNTY OF se&a06
The foregoing instrument was acknowledged before me this 12 day of october
200 17 by owridd 0--d,aa who is o personally known
to me or w who has produced DL as
identification and who did (did not) take an oath_
Signature
Homey Seal)
ar taut
Print or type name
SkYLLLAAR 8 AMKRAUT
Commission N FF 127890
yqkR
hMyCommissionExpires
June 01. 20184knroan
Rev. 68.12)
Notary Public - State of FL
Commission No. 127890
My Commission. Expires: 6 /2/2018
ScannPcl by CFimScanncar
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. / 7 3 V J u ISSUE DATE: /V • / v /YW—
CONTRACTOR: Jaszw
asInap^ JOB ADDRESS: %
0/ ,
o,
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
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 5:00 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
City of Sanford Building Division
Residential Re -Roof Inspection Policy & Procedures
PERMITTING REQUIREMENTS - NO PLAN REVIEw REQumED
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), cc ying FBC code com 1' ce by personal inspection.
1
f®Y 0CONTRACTOR (OR OWNER/BUILDER SIGNATURE: DATE:
PERMIT #
429352
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: 100 Casa Marina Place Sanford FL 32771
STRUCTURE TYPE: O SINGLE FAMILY RESIDENCEMOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: Q 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: ONLY 100 SQUARE FEET OF TYPE EXISTING DECK IS PERMITTED TO BE REPLACED **
ROOF VENTILATION: O OFF -RIDGE O RIDGE O SOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES ONO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 — 4:12 (D 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE owens corning FL#10674-R12
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
OTRE FL#
OOTHFR: 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 META, FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
OTILE FL#
O OAR: FL#
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 . . . . . 17-00003018 Date 10/13/17
Property Address . . . . . . 100 CASA MARINA PL
Parcel Number . . 29.19.31.501-0000-0420
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . SINGLE FAMILY
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1007004
Permit pin number 1007004
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 EL03 FINAL ROOF _/_/_
I-7-S o/c6/
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs.
Date: l 1.2 - i_--
I hereby name and appoint 'Scott Meixsell, James Allen, Michael Watts, Jacob Horst, Ricardo Prito, Paul Padgett
an. a Gent of_,asper L oneatxors
Xk— of C-np-y)
to be my lawful attomey-in-fact to act for me to apply for, receipt for, sign 'for and do all things
necessaary to this appointment for (check only one option):.
The specific permit and application for work located at:
A
Expiration Date for This Limited Power of Attorney. 1 ' -
License Holder Name:
State License Number. ccc1331;153
Signature of License Holder._
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before me this )__day of N MO (%
204_0: by °o°aid Bouchwd who is o personally known
to me or lg who has produced a
as
identification and who did (did not) take amoath.
Notary Seal)
Skylar Amkraut
Print or type name
V
L s ' 7< R A U 1' Notary Public - State ofµ, a 127 890CommissionMyCommissiontxirb
01 z 01 s
No. 21 (5
My Commission Expires. UJune ,
44i711\ .R
Rev. 08.12-)
Scanned by CamScanner
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, S HEAQT HING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS '*,
fl ' C N fl a ` 0 PERMIT #: >I ` ADDRESS:! V `' G V}Ci&
Woo R_ 3q-1-1 I
I ",)C c e' V , 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 WrnI THE HURRICANE RETROFIT
MANUAL REQUIREMENTS' (BASED ON F.S. CHAPTER 553.844).
LICENSE #: r C( f" J' II COMPANY /
CONTRACTOR: L I (A L, I U' 11
CONTRACTORSIGNATURE: — DATE: G'' MUST
BE SIGNED BY LICENSE HOLD OR OWNER/BUILDER) 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 StAA&A AO. j i Sworn
to and Subscribed before me this day oc MW kA__ 20 by: Who
is Personally Known to me or hawroduced (type of identif
cat' n) as identification. Signatu
otary Public State
of lori a + arA
Ix aut a°" SI<YLAR B AMI<RAUT o ° Print/
Type/Stamp Name of
Notary Public QkM1
Commission # FE 127890 o,`
MY COmlllissiOn Expires June
01 2018