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Job Addresses i<GY VI ood Dr.
Parcel ID: 9 i3l ' c C 0(.90 Zi
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
OApplicationNo: _ I b
Documented Construction Value: $ ) 5, &3d - -3 t
Historic District: Yes No 2'
Residential 2—I'Commercial ElTypeofWork: New Addiitiionn LidAlteration Repair Demo Change of Use Move
Description of Work: KC r
Plan Review Contact Person:
Phone: Fax: Email:
Title:
Property Owner Information
j
Name mo ra,Tr'k(?1 Grr1 Phone:
Street: 11"1 1! X wa'01 1 J I ° Resident of property?
City, State Zip: 5"&r)•_ EL, >tV ll
Contractor Information
Name ftoci ue.(u-) ofa4-1Cif%
Street: 34J 6 A\le
City, State Zip: ,5C•L do
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Phone: 2
Fax:
State License No.: 6nc' 1,3' -_o-3-fI
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT 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: 51' Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records 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 pen -nit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit wilt be applied to your permit fees when the permit is issued.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning.
Signature of Owner/Agent Date
Debt (z- /k sec
Print Owner/Agent's Name
of Notary-S ate of orida Date
1 a Notary Public State of Florida
Jennifer QuakenbushYMyCommissionGG156878
Expires 10/31/2021
Produced ID Type
or
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
of Florida Date
Notary Public State of Florida
Jennifer Quakenbush
My Commission GG 156878
dS Expires 10/31/2021
Cont s ter•_ o_ a
Produced ID Type of ID _
BELOW IS FOR OFFICE USE ONLY
to Me or
Permits Required: Building Electrical Mechanical Plumbing[] Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps,
Fire Sprinkler Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
of Heads Fire Alarm Permit: Yes No
UTILITIES: WASTE WATER:
FIRE: BUILDING:
Revised: June 30, 2015 Permit Application
PROGUARD RESTORATIONWhereQualityComesFirst"
B 3601 Celery Ave, Sanford FL. 32771
Ph: 407-330-7663
State Certified # CCC1330234
PROPOSAL/CONTRACT www.proguardrestoration.com
Date
Submitted To_____M Cn i C CA Address
L City
State Email
Ii1 ' ; Job
Address We
Hereby Submit Specifications d Estimates For: move
existing roof to deck: ';hinqle_ eplace
all rotten or damaged wood on roof deck 1xperLF: $ 4.00 plywood per sheet: $ 55.00 Replace
roof under ayment' Replace
roof: ITIONAL
WORK INSURANCE
CLAIMS ONLY All
work scope and/or costs specified in this contract agreement issubjecttoorcontingentupontheapprovalofthecustomer's insurancecompany. The undersigned further appoints PROGUARD RES- TORATIONd
permits `hereinafter
PROGUARD
toerred to as ' o
negotiate with insurance suurancecompanyfor seve t- tlementet- tlementoftheinsuranceclaim. If there is a difference of work scope and/or costs, PROGUARD may negotiate a reasonable replacement and/or replace- mentcostmutuallyagreedbetweenPROGUARDandtheinsurancecompa- ny. PROGUARD will not start until work is approved by the insurance companv. eplace
roof valley liner: Weathe eplace
roof soil stacks: 1 Replace
roof vents:Lv1, Repfac
drip ed e color: Color
S' X PE /,
INFORMATION X
G
r.
Contract
Amount: Insurance Claims - Insurance
allowance lus su lements as needed U.
S. Dollars ( $ ! 1 f Payment
to be made upon completion or as follows: INSURANCE
COMPANY All
payments to be made payable to PROGUARD RESTORATION only The
above prices, specifications and conditions of thi s
contract
a e satisfactory ooand are hereby accepted. I / We have read and understand SAL
the
terms and conditions located on the ba of this document / contract agreement. PROGUARD hereafterreferredtoas "PROGUARD") ' a ihorized to do the work as specified and in acco e with the terms d nditions and 11Stipulations
of this contract agreeme t. ay e t will be made as stated above. AuthorizeC
ig atur Print
Name Title
V 0(.Uq, S
Grant Maloyy, Clerk Of The Circuit Court & Comptroller Seminole CountyFL Inst #2018108501 Book:9216 Page:512; (1 PAGES) RECFEE $10 00 RCD: 9/20/2018 2:14:07 PM Permit
Number. Folio/
Parcel ID #: Prepared
by: Pro 641
Monroe Rd to:
641
I
G NOTICE F C MMENCENIENT StateofFlorida, County of tty}{j(p The
undersigned hereby gives notice that 'improvement will be made to certain real property, and in accordance withChapter713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Des riptio propert (le al de sc tio? e rtndreet addre s if available) 2. General
description f Improvement RE -ROOF
3. Owner
in orma Ion or L Name eYss
a •
i13formati
iftheLeseecontracteorthimproventAddressInterestin
Property
Name and address
of fee simple titleholder (if different from Owner listed above) Name Address 4. Contractor
Address
641 Monroe
Rd Sanford FL, 32771 Telephone Number 407-330-7663 5. Surety ((f,
applicable, a copy of the payment bond is attached) Name IV KKAddressTelephoneNumber
6. Lender Amount
of Bond $ Name NA 7.
Persons within
the State of Florida designated by Owner upon be served _asprovidedby §713.13(1)(a)7, Florida Statutes. Names IVH TelephoneNumberor
other documents
may Address Telephone Number
8. In addition
to
himself or herself, Owner designates the following to receive a copy of the Lien Ws Notice as rovidedIn §713.13(1)(b), Florida Statutes. Name WA 9. Expiration date
of notice of commencement (the unless a different
date is specified) Telephone Number 1
year from
the date of recording WARNING TO OWNER:
ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE of COMMENCEMENT ARE CONSIDERED IMPROPERPAYMENTSUNDERCHAPTER713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AN PR; ON TH JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT rjH YOUR EDRORANRNEYBEFORECOMMENCING
WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. S19 hire of
Owner or Lessee r O er's or L see's Authorized Officer/Director/Partner/Manager Signatory's TlUelOffice The foregoing instrument
Was acknowledged before me this of addaY i_ by >i(t, + 1 fJC j?orl1 L as m
n
year name pf pe son Type of autho ,
e ff for V C`
jq.+,rn trust tlorney infactNameofpaonbeafofwhominstrumtevnL,.v`/as executed State nnowp —%-7OR
Produced
ID Produced V Print,
type, or
stamp commissioned name of NotaryPublic CERTIFIED COPY GRANT MALOY
CLERK OF THE IP
A OURT AND C01,4P U _
R Form content revised;01/
23114 5 E M WILE 0-f(, ORIDA DEPUTY CLERK Utz . $" RYAM
S. CIUAKEN13USH
DIY
COliiOhtlB OON ft
FFSOT139 EXP11 ES At," Oe,
2019 Nor zeo,di
CITY OF
S.,FORDBuilding &
Fire Prevention Division
RESIDENTIAL RE -ROOF POLICY & PROCEDURES
FIRE DEPARTMENT
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 INA CONSPICUOUS AND WEATHERPROOF LOCATION COMPLETED
RESIDENTIAL RE -ROOF SCOPE OF WORK COMPLETED
AND NOTARIZED INSPECTION AFFIDAVIT ALL
FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS PRODUCT
APPROVAL SHALL MATCH WHAT IS ON THE SCOPE OF WORK) DIGITAL
PHOTOGRAPHS (MUST INCLUDE THE PERMIT NUMBER OR ADDRESS IN EACH PICTURE) o
EACH PLANE OF THE ROOF, SHOWING THE UNDERLAYMENT INSTALLED o
ROOF DECK NAILING PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER) O
ROOF DECK NAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHOWING SIZE OF NAILS) o
UNDERLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER) o
DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE OR RULER) o
SHINGLES INSTALLED, NAIL PATTERN AND LOCATION OF NAILS SKYLIGHTS (
IF APPLICABLE) O
DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL o
DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT APPROVAL FAILURE
TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN PROFESSIONAL (
ARCHITECT OR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION. CONTRACTOR (
OR OWN ER/BUILDER)SIGNATURE: T LiL _ DATE: 1 01V-15
CITY Of
M
PERMIT #
FORD
FIRE DEPARTMENT RESIDENTIAL
Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: 1[fI/ Wood F) p - -rot 1 it
STRUCTURE TYPE: VINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: PLACEMENT (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 SQUA E FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED
ROOF VENTILATION: O OFF -RIDGE G 4DGE O SOFFIT OPOWERED VENT OTURBiNES
SKYLIGHTS: O YES Q 10 IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 — 4:12 V 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
G(SHINGLE n } " FL#
O METAL FL#
Qi MODTFMD BITUMEN i n~ FL#
O TORCH DOWN FL#
O INSULATED FL#
O TILE FL#
O OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLLCABLE**
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#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
CITY OF
Skil4FORDBuilding & Fire Prevention Division
RESIDENTIAL RE ROOFAFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT ADDRESS: 119 i[,/wand D
I De-b-_t A De_at-1 1 , 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 13EEN 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 #:
COMPANY / CONTRACTOR: (`t (,
j
V Ako4liew
s4 IJr -L-+ _ CONTRACTOR SIGNATURE: DATE:
MUST BE SIGNED BY LICENSE HOLDER 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 yam wo J f
Sworn to and Subscribed before me this I day of e 20 met' by:
Qe I J a A Dean . Who is <rsonally Known to me or has Produced (type of
identification) as identification.
ignature o otary Public
State of Florida
Print/Type/Stamp Name
of Notary Public
jC;
A¢ avo, Notary Public State of Florida
Jennifer Quakenbush
o` My Commis3ion GG 156878
ofa. Expires 10/3, 021