HomeMy WebLinkAbout229 Belgian Way; 17-2720; ROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: S 101 too
Job Address: Z -ia s District: Yes No
Parcel ID: S -SO S- Ci300 9 Residential,K Commercial
Type of Work: New Addition Alteration El Repair Demo Change of Use Move
Description of Work: P-e - i 00+ OL,eCff, COIL n\ n!;C 4 1 ICY n-71-W
S '-'t 2s tr
Plan Review Contact Person: '?_ eA r a h Title: vv -Cccgh
cp mra
Phone: &71Fax: 800 33 33Jr \ Email: V- Property
Owner Information Name
t+h (Ylt'.lel Scrl Street:
A City,
State Zip: sCa:1`-1b>' —_d . EL J Phone:
Resident
of property? : Contractor
Information Name (
Y1(1(. 1CL1'C'>! Phone: c
Street: '
7 : ' ('J!'ll FrJC 1 C S Z( Fax:C-- 3 i- - 33 Lo 1 City,
State Zip: (5—c. jor[ n . l ?D A. L State License No.: C C C 1 j \ V Arc
hitedt/Engineer-Information Name:
Phone: Street:
Fax: City,
St, Zip: E-mail: Bonding
Company: Mortgage Lender: Address:
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: 511 Edition (2014) Florida Building Code Revised:
June 30, 2015 Permit Application 1
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records of this county, and there may be additional permits required from other governmental entities such as water
management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time -of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zonin
I ) ` -I 1-1
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature orNotary-State of Florida Date
Signature
Contractor/Agent's Name
KARLA M ALMODOVAR
W-4
State of Florida Notary PublicCommission#GG111330
My Commission Expires
a#1 June 04. 2021
Owner/Agent is _ Personally Known to Me or
Produced ID Type of ID Produced ID Type of ID
BELOW .IS_ FOR_OFFICE._USE_ONLY _._ _..._..
q , FA -
to Me or
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type: Occupancy Use Flood Zone:
Total Sq Ft of Bldg: 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
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING:
COMMENTS:
Revised: June 30, 2015 Permit Application
IrPAN R
EGN.NpJ: CpliV IY f71It'IE]A
Parcel Information
Property Record Card
Parcel: 18-20-31-505-0000-0890
Owner: MASTERSON JUDITH
Property Address: 229 BELGIAN WAY SANFORD, FL 32771
Parcel 18-20-31-505-0000.0890
Owner MASTERSON JUDITH
Property Address 229 BELGIAN WAY SANFORD, FL 32771
Mailing 229 BELGIAN WAY SANFORD, FL 32771-
Subdivision Name BAKERS CROSSING PHASE i
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions OD-HOMESTEAD(2015)
r
L$ 92 48
4e
92
17
4t
4 t5 4
q' 427 az
41. eminale Cqunty GIS
Value Summary
2017 Working
Values
2016 Certified
Values
Valuation Method Cost/Market I Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 157,491 132,434
Depreciated EXFT Value 1,100 1.150
Land Value (Market) 34.000 32,000
Land Value Ag
Just/Market Value •• 1 192,59.1 165,584
Portability Adj
T I
Save Our Homes Adj 29,350 5,701
Amendment 1.Adj,
P&G Adj 0 D
Assessed Value 163,241 l 159,683
Tax Amount without SOH: $2,505.00
2016 Tax Bill Amount $2,391.00
Tax Estimator
Save Our Homes Savings: $114.00
TRIM Notice Help
Does NOT INCLUDE Non Ad Valorem Assessments
5380 E. Colonial Dr.
Orlando, FL 32807
3203 Conway Rd., Ste. 201
Orlando, FL 32812
407) 278-7788
800) 337-3361 Fax
mfo(a jasperi iicore
ISA 0 m—'
I /
og
Y- '
JASPER'
JasporRoor.com
FL Contractor's License: -
CCC1329651 & CCC1331153
ROOF REPLACEMENT CONTRACT
Account Manager:
Contact,#': 110 7 33s- ej % 3
Company:
Policy #:
Claim M
Loan Number:
Owner(s):
J lh . a
Phone:.
3 .,6 3 7 ?
Address: Alt Phone:
City: UV
C
CG>r
State: Zip Code: S1h gle C}lor-
G f 2 ; 6P.1V wo'J
Email:
sOKT
e I l So 1^ 5 Roof RCV Amount/ Contrac Price: Drip Edge C lord errks e 10 4--
If Owner's insurance Company does not agree to nay for a full roof replacement, this contract shall be 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 Owner/Agent/Insured(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'py. all insurance deductibles. Owner's out-of-pocket expense will not exceed the deductible
amount, as stated on insurer's loss sheet (the "Loss Sheet'j, UNLESS replacemendrepair of deteriorated decking is required by code and/or Owner requests
optional upgrades. Jasper CANNOT pay, waive, rebate, or promise to pay, waive or rebate any or all of the insurance deductible applicable to the
insuranceclaimfor payment of work In the event of a discrepancy, the deductible amount stated on the insurer's Loss Sheet shall overrule deductible amount
disclosed. Deductible: $ jnQ0.QQ -MUST BE PAID IN FULL, PLUS APPLICABLE SALES TAX (initial) MORTGAGE
AUTHORIZATION: I, Owner/Mortgagor, grant authorization for Mo g ge Co. to speak with Jasper
on matters including but not limited to, the claim and draw status. _(initial) PAYMENT SCHEDULE: Owner agrees to pay
Jasper based on the following schedule: (i) Deposit in the amount of $ due upon signing this contract; (ii) the Contract Price, less
the Deposit and any applicable depreciation retained by Owner's i surer(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. -- UPGRADRITEM: _
QTY:._ ____ ____ ^_ __PRICE: - -- _— _ .._.TOTAL: $-- Replacement
Work and Price: 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, approximately within
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 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) 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 isexecutedafter notification from insurers) 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 APPL-Y-to-contracts-for emergency`Nome repair`s as tuneis of t)f 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 party
represents and warrants to the other that it has the full power and authority to enter into the contract and that it is binding and
enforceable in accordance with its terms. AutQ representative
Date Owner Date
1-3a1 lour Y111 Iasi
THIS INSTRUMENT PREPARED BY:
Name:_ Jasper Contractors
Address: 538f1 F Cnlnnial Drive
Orlanrin FI 19SO7
NOTICE OF COMM EiICEMENT
Permit Number:
5
Parcel ID Number `:)—t: o—
l-fl,I IIA OY? SENIHO1 E COUNTY
I OF C 1 Ki iJ fT C UU4;T cs CfJCIF'TFiOLI_ER
Bb. I , 14-1116 (Ws;
t::LERE05 v 2CII709253
ilr.(:1 i'ri' ii b lrl *r ?li, . 1 _1)t, .*.18 rill
i:CC(li'i.+ll`I FEES J.iJ.illii
t-[: •rI .COF ErEL} i=i 'hd;aurar;.
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. GENERAL DESCRIPTION OF IMPROVEMENT: _
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT,
Name and address `.U \`1 NV — ( CX P LOwu\ Oa\,l SC1( (-(-6 l L
Interest in property:. Owner
Fee Simple Title Holder (if other than owner listed above)
Address:
4. CONTRACTOR: Name: Jasper Contractors
Phone Number. 407-278-7788
Address:, 5380E Colonial Drive Orlando, FL 32807
5. SURETY (if applicable, a copy of the payment bond Is attached):Name:
nuuress: 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 maybe served as provided by Section713.13(1)(a)7., Florida Statutes.
Name: Phone Number.
8. In addition, Owner designates of
to receive a copy of the Lienors Notice as provided in Section 713.13(1)(b), Florida Statutes.; Phone number.
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 ATTORNEYBEFORECOMMENCINGWORKORRECORDINGYOURNOTICEOFCOMMENCEMENT.
SI ature of Owneror Lessee, or Ownees or Lessee's (rint Name and Provide Signatorys TiUefOffite)
Authorized OB"icerrDirectorrPartnerAtanager)
State of V County of
I
Y // /\ ( t The foreg tng in tru et was a' k owledg d before/me this day of tni \eJ ' 20 \
by: 1 v1lPt tCf4 C Who is personally known to me O OR
Name of person Idng statement
twhohasproducedidentification ' type of identification produced:
a SKY: -AR 8E7AMKRAUTCommissioNotary SignatureMy CommisJune0 Y
i
LEMTED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: CI ' I" - t--i"
I hereby name and appoint: Rachel Holcomb, Skylar Amkraut, Karla Almodovar Ana Chavez
an anent of JaqwOor"ct°s
N—rc—wor)
to be my lanfiil 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:
Suva Ad )
Expiration Date for This Limited Power of Attomey
License Holder Name: Donald Bouchard
State License Number. CCC1331153
Si®ature of License Holder.
STATE OF FLORIDA
COIUNTYOF
e The foregoing instrument was acknowledged before me this Ii day of
200_Lj, by Da-wd tad who is o personally known
to me or is who has produced D1- as
identification and who did (did not) take an oath.
WX A
Signature .
Notary seal) kcy ar A n raut
Print or type name
F.
1
SKYLAR B AMKM RAUT
Commission tt FF 127890MyCommissionEkpires
June 01. 2018 jay'
Rev. 09.12)
grRnneci by Camgranner
Notary Public : State of FL
Commission No. 127890
My Commission Expires: 6/1/2018
CITE" OF
r
SA NFORD Building & Fire Prevention Division
FiRE DEPAATMENT Re -Roof Permit Card
PERMIT NO. /1--a c O ; D ISSUE DATE: 01. ILI.
CONTRACTOR: ® I
JOB ADDRESS: Odle /10
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 I I I
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
TM: 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 Approvalshall 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 (includin gg 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 OWNERIBUILDER) SIGNATURE: f( 4,
c L %Ajh. J _ DATE: J ` , '
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS
STRUCTURE TYPE: ( SINGLE FAMILY RESIDENCE/TOWNHOUSE, Q MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: (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 IOO SQUARE FEET OF THE E,YISTINC DECK IS PERMITTED TO BE REPLACED"
ROOF VENTILATION: Q OFF -RIDGE 0 RIDGE QSOFFIT QPOWERED VENT QTURBINES
SKYLIGHTS: O YES O NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL#;
VAIN ROOF AREA
ROOF SLOPE: Q LESS THAN 2a 12 Q 2:12 — 4:12 A4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE r k"'1^0\ FL# i - .
Q METAL FL#
Q MODIFIED BITUMEN FL#
0TORCH DOWN FL#
Q,INSULATED. FL#.
Q TILE FL#'
Q OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) "IFAPPLICI BLE"
ROOF SLOPE: Q LESS THAN 2:12 Q 2:12 — 4:12 Q 4:12, OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
0 SHINGLE FL#
Q METAL FL#
O MODIFIED BITUMEN FL#
0TORCH DOWN FL#
0INSULATED FL#
Q TILE FL#
0 OTHER: 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 . . . . 17-00002720 Date 9/14/17
Property Address . . . . . 229 BELGIAN WAY
Parcel Number . . . . . . . 18.20.31.505-0000-0890
Application description . . ROOFING APPLICATION
Subdivision Name . . . . .
Property Zoning . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1002427
Permit pin number 1002427
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 BL03 FINAL ROOF / /
l '0/-'
V
LEMTED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: q 0-\ q V_
I hereby name and appoint: Scott Meixsell, James Allen, Michael Watts, Jacob Horst, Ricardo Prito, Paul Padgett
anagent oP C--actors Name
oreompany) 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): 1P
The specific t and a plication for work located at:. Expiration
Date for This Limited Power of Attorney: — 1 l — I . License
Holder Name: I J o n w d bmcwrd. State
License Number. ecc1331153 Signature
of License Holder. - STATE
OF FLORIDA COUNTY
Of s The
foregoing instrument was acknowledged before me this day of ; 200_
n, by omtdd Boua"d who is o pers own to
me or m who has produced tx as
identification
and who did (did not) take an oath. Sigmft
Notary
Seal) lar
Amkraut Print
or type name Notary
Public -State of SKYLARBAUiKRAUTp _
i"L"13 C CommissionNFF127890CommissionNo. M
Commission Expires vo
1 2018 My Commission Expires:t 1 r,. June o<<. Rev_
08.12) Scanned
by CamScanner
i'
j City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: L " 10 ADDRESS: q j jA Wak
J
Y-\fcxd 3
I / AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
RO FING CONTRACTOR, EN61NEER, 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-C-C 1 _` \ \ R22
COMPANY / CONTRACTOR: v
CONTRACTOR SIGNATURE: DATE: l I
MUST BE SIGNED BY LICENSE HOLD O
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 aW ,A(--.,
Sworn to and Subscribed before me this day of 20 n by:
Who is Personally Known to me or has rroduced (type of
identific Ition) as identification.
SignaturroANotary Public
State of SW&r AmluaUt
Print/Type/Stamp Name
of Notary Public
SI(YLAR B AMKRAUT
g w Commission S FF 127890
My Commission Expires
June 01, 201 8