HomeMy WebLinkAbout312 Appaloosa Ct17-2786; ROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
D PERMIT APPLICATION
Application No:
Documented Construction Value: S C,h
Job Adtlress: n CI CC jG ON 3QCr0- ,CCtt -L '1 J historic District: Yes ElNo
Parcel ID: 1 6-,i(-31-5o)-Cc6(j-- CJSL- 1 Residenlial® Connnercial
Type of Work: New Addition Alterathn Repair Denio Change of Use M0vc
Description of Work:
1 /
Mt`)
I Plan Review Contact Person: c C C\Q, {- _-C)0A1 J Title: ( 1 IP \ II Ct C
Fax: M ?3-1 53(01 Email _W\(@, '6SKul
Property Owner Information
Name -Aqtl)l Ct 4%wMak Phone:
Street: 1 \QPCt`CoSQ C- Resident of property?
City, State Zip: 3G(V (,(-6 , C—L
Contractor Information
Name D,'A)66- Vwot,, acd Phone:Li01
Street: 5@0r- S . mc\OQN Q6 3\-e owl Fax: T M City,
State Zip: 1ikrl da -(::L State License No.: CC , t33 tt 53 Arch
itect?Engineerinformation _ . _- _..__ _-. _ .____.._ _ -- 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 constntction 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
105J 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 Scanned
by CanlScanner
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done lit cumplialice with 1111 llppllcable reguluting cnnslruciloll fill([ Zuu111g. lint
lhttt.Y ;\1cttCa Name aignatulr
of \,tan ralc of I Iwida hate 0\\
1lcr/Agent is _ Personally Known to Me or Pi
duccd ID Type of ID Slpunl%
10 ill t •m%uu InllApetit Fill, MW
t'oultaedo(Age nVis Name Sipnutnlc
orNowy-Sh%o of 11o11d.t 17010 KARLA
M ALMODOVAR i°YpUB:State of Florida -Notary Public E
Commission GG 111330 Ec
Oa My Co mission Expires Cu111ructur/\
hcnl ix ____ t' ;vutH+1y'i\-1o1\a to Julia, 2021 1'
Itulucctlll) Typ BELOAV
IS.1 OR.01 F10E,USE--ONLy..___ Permits
Required: Building Electrical Mechanical 1'lumbingE] Gas Roof Construction'
1'ype: Oecupsuley Use: Mood Zone: Total
Sq Ft of Bldg: 1lin. Occupancy Load: # of Stories: New
Construction: Electric - # of amps 1'1nn-bing - # of Matures Fire
Sprinkler Permit: Yes No It of Heads hire Alarm Pernilt: Yes No APPROVALS:
ZONING: UTILITIES: WASTE WATER: ENGINEERING:
FIRE: BUILDING: CON-
UMENTS: Rct•
iscd: June 30, 2015 I'ennil Applicuilon Scanned
by CaluScanner
9/14/2017
SCPA Parcul View: 18-20-31.506.0000.0840
ea p+ crn
P mgdyRecorJ Gard
Parcel: 18-2D-31.506-0000.0840
A R Owner. PANCHAL HEMANT & r'ANCtIAI TEJALA
cc%.:ix nrv:w
Property Address; 312- APPALOOSA CT SANFORD. FL 32773
Parcel Information
Parcel 18-20.31-506-0000.0840
Owner PANCHAL HEMANT & PANCHAL TEJAL
Property Address 312 APPALOOSA CT SANFORD, FL 32773
Mailing 312 APPALOOSA CT SANFORD, FL 32773
Subdivision Name BAKERS CROSSING PHASE 9
Tax DistrictSl-SANFORD DOR
Use Code 01-SINGLE FAMILY Exemptions
00-HOMESTEAD(20171 Value
Summary 2017
Working 2018 Certiried Values
Values Valuation
Method i Cost/MarkeI COSVMdrket Number
o Buildings I1 I1 Depreciated
Bldg Value S168 464 i 5142781 Depreciated
EXFT Value S338 350 Land
Value (Market) 34,000 I S32,000 Lend
Value Ag jist/
MnrkntV111 — 202,802 S175,131" Portability
Adt Savo
Our Homes Adj 0 50 Amendment1Ad) SO P8GAdj
s0 SO Assessed
Value I 202,802 S175,131 Tax
Amount without SOH: $3,510,DO 2016
Tax Bill Amount $3,510.00 Tax
Estimator Save'
Our Homes Savings: $0,00 TRIM
Notice }Ir12 Taxing
Authority Assessment Value Exempt Values Taxable Value County
General Fund S202,802I w,,000 S152,802 Schools
202,
802 25.000 S177,802 City
Sanford— S202,802 S50,000 S152,802 SJWM(
Saint Johns Water Management) 202,802 I $50,000 S152,802 County
Bonds 202,802 SSO,000 I 152,802 Description
Date Book Page Amount Qualified Vaclimp SPECIAL
WARRANTY DEED 11011/2015' 22 B63— 11Q7 I $194,900 No Improved CERTIFICATE
OF TITLE i !
5N/
2015' 28470 0945 100 No Improved CERTIFICATE
OF TITLE 9/1l2014 08336 100 No Improved WARRANTY
DEED 611/2005 D5807 0-4S9n "
j220,
000 Yes improved WARRANTY
DEED 3/112004 j 05304 0029 198,900 Yes Improved WARRANTY
DEED 81112003 04999 1 4 218,001)' No Vacant Method
Frontage Depth Units Units Price Land Value LOT
I 1 34,000.00I S34,000 htip:
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ss191111acill of 111.ru1•anee lienc(Its for the Full hoof Rephtcentcill Only I hail y ssigal all)' and all IIIsla:trKE rights, lactlefits and proeeedslutuler'- nh) .tpplicnlde in•;utinlce iaalicies to Aspet C'lnnrat:I'll s, tile. ("Llsler" )• tilt scope orwhich shall be filifilird ton Full Roo i clilacernent. I make this assimment- i •and uuthari%atit.,t in comidnatnnt oft;lalhY'A ;Itrrccluc,tt to purlilfill Services, supply lllalalals alit] othcrwsc perform its obltg'attrals under dns•Contrkt. imchl ling nut requiring till p a3luent at Ilse time of Service i also hachy direct illy illsurn(s) to release any and all mrorimfio l rcyuestcd by Ja*r; or its, rc(acsrin trice(%), rill file direct pullithe of oblaiuiug, actual Ix•nctils Ill be pnill by lily instncr(s) fear seviccs rclldcrcd. In this regard, I waive my pii)?q; 611,1115. if pa},lnt•lil is tilde. dually to the Uwnahlg;aiL`Imliretl(s), it shall lie elldoisnt over to Jasper immediaicly upon receipt. I a &T cc than any portionsvrrk, dtillictiblcs, bcttcrnlait tar adddinual work requested by the undelsigllcd, nut covered byiusta,.ulcc, IntIst be p{ill by tllc UniteTSi R1Cd On [hC day Ofinstallatirnt. 1)cdac[ihle: t is the ()ielJiis cspwsnsibdity tit 13' alIlls" M'1—c' ISLI c111tICS_. O"iler'S out-of•pockct capcu.ac will pot exceed the deductible', alrinulu, its Stated 041 ti11„rer'S toss abect (life ' "Loss Sheet"), UNLESS nplacl.•InenUrcpair oftletcrioraled decking is repaired by code -,I'- (}.cner i*L4q,0 Csi . Optional opgradcs. Jusper CANNOT tiny, mane, rebute, or prundse to pay, vvalve or rebate any or sill or the insurance dedtxtlblc applicable vibeinsuranceclaimlilrpayvlantof %cork. oil [he event of a discrepancy, the tltduclible amount state' on the ir&rer's Loss Sheet shall override.deduciiblc.` arnount disclosed. Deductible: S D
l - a -MUST IIF: PAID IN FULL, PLUS Al SA[,F;S'1'AX Cntlla!)t111ORTG.IGF AU-1-110Rl%ATION 1 UMncN\1"Itta,or, grant nutilt-4izition fur_riy!%(S ey, longagc l'o:an sppk dith'Ilaspcioilmautrsrlcludnl; but not limited to, file claim and cb:iw status. l
iuitiafj! AYM[;7V't' SCIIEDUIM Oxvna agees rot1ieyaaspertiacalon [lie rnllowing schedule: (i) Uclxisit in the amount ofS_, 'ADO (luc upon signing this nmtracr, (fi) the ConCaet.fl'ncc,I
I
Iess•lhe Dc;losit and ant applicable dcPuantifnl retained by (ht,ier's insurer(s), phi upgrade costs, due and liable to Jas uH'rxk helm lcrfi rmel; ,Imo (fit) file remaining Price P , per pen cornpleitan og1 ( Contact I act (equal to any applicable depreciation a uUor change orders) due and payable -to laspesaueompletitinofworkptvfimnrd. In the c liPt , aldinapinsion, Ito more than 2% or Contract Price ma • be withheld unfit imlion has [ass Uvptlortal: UT'(iRAD1i ITC4L 7+Lei > , Q.FY; _ PRICE 2 ) TOTAL: Ssp b
Z
Replacement WorkandPrice: Upon insurer's approval and subject to the Terms and Coud,u(ns t:acin, Jasper agrees to furnish a1C; nu coals and provide thelabornecessarytoperformdiefillroofreplscenierltwitiehshalltakeplaceiollo%nlg O%ncr s insurance company's a ova 1 _-i. FP 1,,1FProzlmtel -... .. _.. within i0days, conditions ptrmitling .Owner's.I)trlaralion of Intent: O%ikr acknowledges 5iid agres that, upon approval by instrrancc ecnn fore I fullmofreplace:uenf, Jasper shall perform [lie roof replacement upon receipt or fnids flout Owncr's Insurancee eompally, P-nY PAYMEN-l',
UP'1'0 A LUN111 A) AMOUNT'. MAY BE AVAILABLE Alil 1 FROM THE FLORIDA I1OMEO NE FLORIDA 110MF
OWNF RS' CONS l UC l'i01 RF COVk ItY FUND COS fRU(
i'14Y RECOVI?RY FU(\D 11 110U L,USh NI ONl'Y OV :1 PRIME C'f PERFORMED l \DER COR"TR1Cf° ( WiIERt;'i'IiF;LOSS RhSC11 rS FROM SPECIFIED VIOLATIONS OF FLORIDA LAW BY A LICENSED CONTKACTUIi ? FOR i\'F01231A'170N AiJOU'I''I'Ht; RECOVERY FUND AND FILING A CLAL\I, CONT'AC 1" r1IE I 1 ORID " > I COfiSTRUCFI0NINDUSTRYLICENSING. BOARD Al'TIiE FOLI-OWING 'FELEf1[ONE NUMBER AND st . ConstructionIndustryLicensingBoard: 2601 Illairstone Road,'fnllahassee, Fl. 32399-1039, (8S0) 487 1395 ' ( "XI CELLA'FIOfN: if Owner elects to terniinnic the services of Jusper, Owner play do so before midnight on the ttiudtbusin sn , fir: x tr)
ay aftcr'Contracl Is executed. Owner shall receive a full refund of all deposits. Ulmer nnny also rescind Contract before'midn g6l of life thiid'business (Illy after (lie contract is executed after notification from insurer(s) that the claim for payment on roof canli, 1{ lien
dihied
ill whole or in part. All written notices of cancellation, regurdless of reason, shall be postrilarked nr delisercii 110Jasper,: r~carporute 'office' 1690 Roberts Boulevard, Suite 112, Kennesaw, GA 30144• CANCPI.i.ATiON F.\CEPT1ONS The Ihre QQ friglit.ofcancellationDOiSNOT'; PPI,Y to contracts fnr ernergency battle repairs as time is of the essence. s I a
I FOnncr,-ha e read and understand all stalentents, Perms and Conditions of the "Roof Itcpincetncnt Contrast and fag e»iI hutsallldetatlsareacceptableandsatisfaetnry. I further understand (lint this Contract constitutes (he entire ligreement betKceit L k prliesandahaIanyfurtherchangesoralterationstothisContractmustbemadeinwritingandagreeduponb ' bath roil . Mcot paHy,'represents and warrants to the other flint it has the full power and authority to enter Into. the contract sad. I ihln'dingYand''enforceable in accordance with its terms. at l Scanned by
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m nncg (•oumnnv does mil ii[Ir'ec to lima fnr n frill rtNlfrt(lurctucul this c nrlr rot aliall ta. s'tii l•ihle l ss191111acill of
111.ru1•anee lienc(Its for the Full hoof Rephtcentcill Only I hail y ssigal all)' and all IIIsla:trKE rights, lactlefits and proeeedslutuler'- nh) .tpplicnldein•;utinlce iaalicies to Aspet C'lnnrat:I'll s, tile. ("Llsler" )• tilt scope orwhich shall be filifilird ton Full Roo i clilacernent. I make this assimment- i •anduuthari%atit.,t in comidnatnnt oft;lalhY'A ;Itrrccluc,tt to purlilfill Services, supply lllalalals alit] othcrwsc perform its obltg'attrals under dns•Contrkt. imchl lingnutrequiringtillpa3luentatIlsetimeofServiceialsohachydirectillyillsurn(s) to release any and all mrorimfio l rcyuestcd by Ja*r; or its, rc(acsrintrice(%), rill file direct pullithe of oblaiuiug, actual Ix•nctils Ill be pnill by lily instncr(s) fear seviccs rclldcrcd. In this regard, I waive my pii)?q; 611,1115. if pa},lnt•lil is tilde. dually to the Uwnahlg;aiL`Imliretl(s), it shall lie elldoisnt over to Jasper immediaicly upon receipt. I a &T cc than any portion svrrk, dtillictiblcs, bcttcrnlait tar adddinual work requested by the undelsigllcd, nut covered byiusta,.ulcc, IntIst be p{ill by tllc UniteTSi R1Cd On [hC day Of installatirnt. 1)cdac[ihle: t is the ()ielJiis cspwsnsibdity tit 13' alIlls" M'1—c' ISLI c111tICS_. O"iler'S out-of•pockct capcu.ac will pot exceed the deductible', alrinulu, itsStated041ti11„rer'S toss abect (life ' "Loss Sheet"), UNLESS nplacl.•InenUrcpair oftletcrioraled decking is repaired by code -,I'- (}.cner i*L4q,0 Csi . Optionalopgradcs. Jusper CANNOT tiny, mane, rebute, or prundse to pay, vvalve or rebate any or sill or the insurance dedtxtlblc applicable vibe insurance claimlilrpayvlantof %cork. oil [he event of a discrepancy, the tltduclible amount state' on the ir&rer's Loss Sheet shall override.deduciiblc.` arnount disclosed. Deductible: S D l - a -
MUST IIF: PAID IN FULL, PLUS Al SA[,F;S'1'AX Cntlla!)t 111ORTG.IGFAU-1-110Rl%ATION 1 UMncN\1"Itta,or, grant nutilt-4izition fur_riy!%(S ey, longagc l'o:an sppk dith'I laspci oilmautrsrlcludnl; but not limited to, file claim and cb:iw status. l iuitiafj! AYM[;
7V't' SCIIEDUIM Oxvna agees rot1 ieyaasper tiacalon [lie rnllowing schedule: (i) Uclxisit in the amount ofS_, 'ADO (luc upon signing this nmtracr, (fi) the ConCaet.fl'ncc,I I Iess•
lhe
Dc;losit and ant applicable dcPuantifnl retained by (ht,ier's insurer(s), phi upgrade costs, due and liable to Jas u H'rxkhelmlcrfirmel; ,Imo (fit) file remaining Price P , per pen cornpleitan o g 1 ( Contact I act (equal to any applicable depreciation a uUor change orders) due and payable -to laspesau eompletitin ofworkptvfimnrd. In the c liPt , aldin a pinsion, Itomore than 2% or Contract Price ma • be withheld unfit imlion has [ass Uvptlortal: UT'(iRAD1iITC4L7+Lei > , Q.FY; _ PRICE 2 ) TOTAL: Ssp b Z Replacement
Work
and Price: Upon insurer's approval and subject to the Terms and Coud,u(ns t:acin, Jasper agrees to furnish a1C; nu coals and provide the labor necessarytoperformdiefillroofreplscenierltwitiehshalltakeplaceiollo%nlg O%ncr s insurance company's a ova 1 _-i. FP 1,,1FProzlmtel -... .. _.. within i0 days, conditionsptrmitling .Owner's.I)trlaralion of Intent: O%ikr acknowledges 5iid agres that, upon approval by instrrancc ecnn fore I full mof replace:uenf, Jasper shall perform [lie roof replacement upon receipt or fnids flout Owncr's Insurancee eompally, P-nY PAYMEN-l', UP'1'
0 A LUN111 A) AMOUNT'. MAY BE AVAILABLE Alil 1 FROM THEFLORIDAI1OMEO NE FLORIDA 110MF OWNF RS'
CONS l UC l'i01 RF COVk ItY FUND COS fRU( i'14Y
RECOVI?RY FU(\D 11 110U L,USh NI ONl'Y OV :1 PRIME C'f PERFORMED l \DER COR"TR1Cf° ( WiIERt;'i'IiF;LOSSRhSC11rSFROMSPECIFIEDVIOLATIONSOFFLORIDALAWBYALICENSEDCONTKACTUIi ? FOR i\'F01231A'170NAiJOU'I''I'Ht; RECOVERY FUND AND FILING A CLAL\I, CONT'AC 1" r1IE I 1 ORID " > I COfiSTRUCFI0N INDUSTRY LICENSING. BOARD Al'TIiE FOLI-OWING 'FELEf1[ONE NUMBER AND st . Construction Industry LicensingBoard: 2601 Illairstone Road,'fnllahassee, Fl. 32399-1039, (8S0) 487 1395 ' ( "XI CELLA'FIOfN: ifOwnerelectstoterniinnictheservicesofJusper, Owner play do so before midnight on the ttiudtbusin sn , f ir: xtr)ay aftcr'
Contracl Is executed. Owner shall receive a full refund of all deposits. Ulmer nnny also rescind Contract before'midn g6l of life thiid'business (Illyafter (lie contract is executed after notification from insurer(s) that the claim for payment on roof canli, 1{ lien dihied ill
whole
or in part. All written notices of cancellation, regurdless of reason, shall be postrilarked nr delisercii 110Jasper,: r~carporute 'office' 1690RobertsBoulevard, Suite 112, Kennesaw, GA 30144• CANCPI.i.ATiON F.\CEPT1ONS The Ihre QQ friglit.of cancellation DOiSNOT'; PPI,Y to contracts fnr ernergency battle repairs as time is of the essence. s I a I FOnncr,-
ha e read and understand all stalentents, Perms and Conditions of the "Roof Itcpincetncnt Contrast and fag e»i I hutsallldetatls areacceptableandsatisfaetnry. I further understand (lint this Contract constitutes (he entire ligreement betKceit L k p rlies andahaIanyfurtherchangesoralterationstothisContractmustbemadeinwritingandagreeduponb ' bath roil . Mcot paHy,'represents andwarrantstotheotherflintithasthefullpowerandauthoritytoenterInto. the contract sad. I ihln'dingYand''enforceableinaccordancewithitsterms. at l Scanned by CamSCanller Scanned
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q.2BT2-4
TNI'S INSTRUMENT PREPARED BY:
Name: Jasper Contractors
Address: 5380 F (;nlnnial nriyp
nrlando FI 32807
NOTICE OF COMMENCEMENT
i f if f fll if f i Milli iilll111 1 llif I lf
GRANT MALOYr SEMINOLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLERBK8991Ps1171QP9s)
CLERK'S Y 2017094331
RECORDED 09/19/2017 02 09:39 PH
RECORDING FEES $10.00
RECORDED BY ,ieckenro
Permit Number:
n nParcelIDNumber: 1 9
The undersigned hereby gives notice that Improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, thefollowinginformationisprovidedInthisNoticeofCommencement.
1. DESCRIPTION OF
2. GENEAAL DESCRIPTION OF IMPROVEMENT:
3. OWNER INFORMATPM OR
Name and address:_` q
of the property and street
1 CA "Nose 2 c3-q
IF THE LESSEE CONT CTED FOR THE IMPROVEMENT:
i2 'pn., I r"ncI n-I- c,:
Interest in property: Owner
Fee Simple Title Holder (if other than owner listed above) Name:
4. CONTRACTOR: Phone Number: 407-278-7788
Address: 5380 E Colonial Drive Orlando, FL 32807
5. SURETY (if applicable, a,copyof the payment bond is attached): Name:
6. LENDER:
Address:
Phone Number:
Amount of Bond:
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section713:13(1)(a)7., Florida Statutes.
Name:
Phone Number.
Address:
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.
S. 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 ARECONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER713, PART I, 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 ATTORNEYBEFORECOMMENCINGWORKORRECORDINGYOURNOTICEOFCOMMENCEMENT.
Signature of Owner or Lessee, or Owners or Lessee's
Authorized Officer/Director/Partner/Manager)
UAR l t ftnc nV.
Print Name and ProvideSignator/s Tige/Office)
State of f1 (11 I(/_ Count of Z/Ul/l.1 l.t/ ( %
F`
l vY /
The foregoing instrument was"acknowledged before me this day of l{i{ {
n t`aQ0l 73
by. , if I
T
Who is personally known to me O OR -C
Name of person mafangstatement .,7 0
who has produced identification type of identification produced: __ , )LJ .c: i c1
S5 _.i .h
NATALIE ANN DOYLE O rx:rx' C)
b'sState.of Florida -Notary Public Q
Commission It GG 104918 Notary ignature u+0 it) pMyCommissionExpires4rr/or F%X May 15, 2021 {
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MUTED POWER OF AT'I`tJRNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: '` 5-
i hereby name and appoint' Kai In Almotlovor, Skylar Amkraut, Ana Chavez, Gina MCDOnal$ k Itachci I1olcQmb
an agent of: Cionrxim
x or compsnY)
to be my lawful 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):
and
J(L SF'n1
Saes AddretQ
Expiration Date for This Limited Power of Attorney: ! '
License Holder Name: Donald 0ouchard
State'License Number. OCCIM1153
Signature ofLicense Holder:
STATE OF FLORIDA 4
COUNTY OF srnna:a
r,
The foregoing insu meat was acknowledged before me this—Dlayof2011:, by MI -Id naudcrd '
tome or a who has produced tx
who is 0 persona y known
as
identification and who did'(did not) take an oath
Signature
Notary Seal) Y ar Amlaut
Not or type name
AIA K Notary Public - State of Ft. sKYLAR B AMKRAUT
s Commission No. 127890CommissiunnFF1271190i
r My Commission Exnlra3 My Commission Expires: 6/1/2018
NM,•M
f .Tune 01. 2018
Rcv. 08.12)
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CITY OF
SkNFO
FIRE DEPARTMEN
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. / 7 -o a 7 ?(o ISSUE DATE: D q Joov / 7
CONTRACTOR: er
e
JOB ADDRESS:-'3OL A A ®O's Q. CA
TYPE OF WORK: 11
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 III
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
Fx D m,RM1'r #
City of Sanford Building Division
ResidentiAl Re -Roof Scope of Work
JOB ADDRESS: S'
STRUCTURE 7'1TE: /SINGLE FAMILY RESIDENCEfrowmIOUSE 0 MOUILE h10h1E 0 APARTMENT/CONDOMIN1UM
RF.-ROOF TYPE' (YREPLACENIENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVL•R (NEW ROOF INSTALLED OVER EXISTINGROOF)
DECK TYPE (PLEASE SPECIFY):
PLFASF NOTE ONLY 100 SQUARE FEET OF THE rXISTING DMIS I'ERUITTED TORE REPLACED * * ROOFVEKrIL%
T10N: 00FF-I21DGE 0RIDGE OSOFFIT OPOWEREDVENT OTURBINES SKYLIGHTS:
O YES ONO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL 11: MAIN
ROOF AREA ROOF
SLOPE: O LESS THAN 2:12 0 2:12 - 4:12 4:12 OR GREATER TYPE
OF ROOF MANUFACTURER FLORIDA PRODucrAPPROVAL OSIIINGLE
n CSC llC FL#'C O
METAL FL# 0
MODIFIED BnUMEN FL# O
TORCII DOWN FL# OINS,
ULATED_ ___ _ ....___. _ .. FL# O
TILE FL# 0
On IER: FL# ROOF
EXTENSIONS (PORCHES PATIOS FTC) **lFAPPLICABLE** ROOFSLOPE:
OLESSTIIAN2:12 02:12-4:12 0 4:12 OR GREATER TYPE
OF ROOF 11 TANUFACTURF.R FLORIDA PRODUCT APPROVAL O
SI INGLE FL# OMETAL
FL# OMODIFirD
BnUhIEN FL# OTORCH
DOWN FL# O
NSULATED FL# OTILE
FL# 0
0 ER: FL# Scanned
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F' D
City of Sanford Building Mvision
u Residential Re-Rooflnspection Policy & Procedures
PERNIM ING REQU11t1:NIENTS—No PLAN 14 vam ltr(211111Ep
This document (signed) along with an accurate and cumlileted Residcntial Re -hoof Scope of Work are requiredtobesubmittedaspartofyourpermitapplicalion.
The Scope of Work must include all applicable Florida Product Approval numbers for all roof components thatwillbeinstalledontheproject.
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 tine SanfordHistoricPreservationBoard
INSPECTION POLICY & PIt0 CEUUItES
A _F.inal_Roof inspection is the only inspection required for Residential (Single Family, Townhouse, MobileHome, 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 sliall match.what.is-on the scope ofwork)
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: DATE:
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FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.211? SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
Page 2
Application Number . . . . . 17-00002786 Date 9/20/17
Property Address . . . . . . 312 APPALOOSA CT
Parcel Number . . 18.20.31.506-0000-0840
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1003045
Permit pin number 1003045
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 BL03 FINAL ROOF _/_/_
sr
rt : City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ' ADDRESS: P11 P` Q 1 Gc-La C-f
IyGrAJ/t P AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, ENGINES , 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-LC \3 Vs
COMPANY / CONTRACTOR: C`nS
Q
CONTRACTOR SIGNATURE: DATE: `{
MUST BE SIGNED BY LICENSE
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 PE%MIT 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 (a__V_n i1i(7A2
Sworn to and Subscribed before me this day of __20E-f—by:
Who is Personally Known to me or hasroduced (type of
identification) as identification.
AV zu : ,cam V ' ;,pY.AVe KARLA M ALMODOVAR Signature
of Notary Public `;State of Florida -Notary Public Commission #
GG 111330 StateofFloridaOFMyCommissionExpiresJune
04,2021 Print/
Type/Stamp Name of
Notary Public
LBUTED POWER OF ATTORNEY
Mtamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
1 hereby name and appoint; Scott Meixsell, James Allen, Michael Watts, Jacob Horst, Ricardo Prito, Paul Padgett
an agent of Jasper Contractors
Dame of C—P-y)
to be my lawful 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):
0 The specific permit and application for work located at:
Street Address)
Expiration Date for This Limited Power of Attorney: \- , - 15
License Holder Name: CQ o
State License Number. CCC1331153
Signature of License Holder:
i
STATE OF FLORIDA
COUNTY OF s—re
mn
The foregoing instrument was acknowledged before me this lay of
200_a, by ooaid t waiard who is o personally known
to me or ci who has produced a-
as
identification and who did (did not) take an oath.
Signature
Notary Sea]) V1—(/i
Print or type name
KARLA M ALMODOVAR Notary Public - State ofiYpUBoc,,-;State of Florida -Notary Public
Commission # GG 111330 Commission No. i C3 c)
o M Commission Expirest;, v My Commission Expires: 2
June 04, 2021
Rev. 08.12)
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