HomeMy WebLinkAbout120 Anderson Ave - BR18-004453 - REROOFCITY OF
s S
FIRE DEPARTMENT
Building & Fire Prevention Division
PERMIT APPLICATION
Application No: 8 '
Documented Construction Value: $
Job Address: / o '//l(bY1 • , 3 Historic District: Yes No
Parcel ID: _ i _ JI o1-S-' ®/D a Dlo b Residential Commercial
Type of Work: New AdditionEl, Alteration aRepairE] Demo Change of Use Move
Description of Work: 66 j-6n % -) h
Plan Review Contact Person: Title:
Phone: Fax: Email:
Property Owner Information
Name J uacme_ 6,kou CONO ti : e_z h'Phone- `y - ' d o3 Street:
w°-0 C1 ' Resident of property? : DuOtX-e- City,
State Zip: Gi1'L,- • 3 7 I Contractor
Informations; Namedhone:
Street:
9. Q fJCy- Q1oak(F 'Fax: City,
State Zip: Lau :bitro-e (9. 21li— q7 =' State License No.: 13 3S Architect/
Engineer Information Name:
Street:
City,
St, Zip: Bonding
Company: Phone:
Fax:
E-
mail': -
MortgageLender: 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 MIDST 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: 6" Edition (2017) Florida Building Code Revised:
January 1, 2018 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 ofthe requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment ofa 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 zoning.
T (l h ,i C e i [ v 14 l fj > L GCA el I / 8'
Signature of Owner/Agent Date Signature of Contractor/Agee D to
c z L k:) 4. kw, I
Print Owner/Agent's Name I VPrint Contractor/ ent's Name
PVe JULIA P JENSENto, State of Florida Notary Public
Commission # GG 186518
My Commission Expires
February 15, 2022
Im
JULIA P JENSEN
State of Florida -Notary Public
Commission # GG 186518
e'
5 ,,,°, 1' OF NJyCommission Expires February
15, 2022 Owner/
Agent .is Personally Known to Me or Contractor/ gen is ersona y own o Produced
ID _' Type of ID 1X I,(J , h LeAS'e Produced ID Type of ID BELOW
IS FOR OFFICE USE ONLY 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:
of
Heads UTILITIES:
Flood
Zone: of
Stories: Plumbing - #
of Fixtures Fire
Alarm Permit: Yes No WASTE
WATER: FIRE:
BUILDING: or
Revised:
January 1, 2018 Permit Application
2
THIS IN UMENTPREPE BY:
J
1 381111 lllll filly 1111111111 milli gull fillNameItMAILto-
Address: tl 11i',1_0`P SEI'f2MLt" i_l7UhIT`(
1 CI..Efti; OF CIRCUIT COURT f. COhlf'1
n'
ROLLER
1•I`: O57 I NOTICE
OF COMMENCEMENT R CORD~[ff07'2Ci/201g,_Ilig-`01- All RE:
C(ORL+IIdG FEES '.i-10.0fi StateofFloridaRECORDEDOfhrl,vcir,2 CountyofSeminole ) Permit
Number. Parcel ID Number. p ?/ %
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. DFSCI;;
IPTION OF PROPEI TY: (Legal description of the property and street address if available) GENERAL
DESCRIPTION OF IMPROVEMENT: OWNER
INFORMATION: TT _
j n f Name: - e. cam• t:f.A. e'j / (1Y11 Le YJ A J Address: /
A R.rt 144JO . _G i r,-A,-,J. I . 'z 2 Fee
Simple Title Holder (if other than owner) Name - Persons
within the State of Florida Designated by Owner upon whom notice or other documents may be served as
provided by Section 713.13(1)(b), Florida Statutes. Name:
In
addition to himself, Owner Designates of To
receive a copy of the Lienor's Notice as Provided in Section
713.13(1)(b), Florida Statutes. Expiration
Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a differentdateisspecified) WARNING
TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA
STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE
OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.
IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under
penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to
the best of my knowledge and belief. Owner'
s Signature Owners Printed Name y- __. Florida
Statute 713.13(1)(g): "The owner must sign the notice of ncement and no one else may be permitted to sign in his or her stead.' State
of Countyof The foregoing
instrument was acknowledged before me this 9 99 day of l)L`j 20 W v ;, m by sSUZl1tNE %
7Who is personally known to me EUOF- , L. NameofpersonmakingstatemetORwhohas
produced identification type of identification produced: - L # b—„Z a4 '' b G JUL A P
JENSEN G IrO Sl
1`Y PUB
i o cr-:SlateofFiorida•Notary Public Commission p GG
186518 (70,w oFf"A c -
My CommissionExpires Not ,gn re February 15, 2022
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: // ,S - / 3'
I hereby name and appoint: 1 1 c l Ct S CeSCI
an agent of:
of Company)
to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things
necessary to this appointment for (check only one option):
The specific permit and application for work located at:
t 2n f rYio 1-< "t i--tnrn ;rN ,t 1`0
Street Address)
ll
Expiration Date for This Limited Power of Attorney: `k CS Cl,
License Holder Name:
State License Number: C.C-c-
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF SEM(mcL(---
The foregoing instrument was acknowledged before me this 5 day op / &VCM8e'-P'
200 $ , by fsl" I+IwES who is 5Kpersonally known
to me or o who has produced
identification and who did (did not) take an oath.
Spilclr—e
NotarySeal) r,
JULIA P JENSEN State
of Florida -Notary Pu blicCommission #
GG 186518 My •;
ommission Expires ill4n `Februaf 1 5, 2022 Rev.
08.12) luuli -'
r: JEt-i,s!L-nPrint
or type name Notary
Public - State of l-f_0'R tbA Commission
No. My
Commission Expires: p2_1 i zo z as
Reliable Construction & Roofing, LLC
In Association with A & G United Roofing, LLC
PO Box 176 Sanford, Florida 32772
Office: 321-890-7602
Email:
Contractor's License # CCC1331335
ROOF REPLACEMENT MUTUAL AGREEMENT
Homeowner Name: _t(,iat e"t- W 3s Phone Number: A10 - f6 — 303
Address: Jab "USA & / Email:
City: 'Sa*-)fd State: C-1• Zip: 31_11 k
Insurance Company: Policy No: 9 & , -` t ' / f- /
Claim No: "` Deductible: T O Driveway Obstructions:!u
Shingle Color: Drip Edge Color: - Roof Pitch:5- /#-of Squares: _
Scope of Work: In accordance with the scope of work and damag/Stimate specifications provided by
my/our insurance company, for the complete sum of J _ Reliable Construction & Roofing
is hereby authorized to furnish all labor and materials fort a work included in this claim. I/We will not
seek out other contractors to do the work associated with this claim. Any insurance proceeds disbursed
as a result of this claim will be used to complete the repairs to the above listed property, as follows:
Remove all existing layers/shingles and tar paper down to wood
Replace rotted or damaged wood decking at L sheet
Apply synthetic roof underlayment to decking
Install new 30 year architectural/dimensional style shingles
Install new box roof vents _ shin le-over ridge vents
Install Hip and Ridge cap shingles Standard _Enhanced _ N/A
Install 2" and 3" boot collars around vent pipes
Install new pipe flashings _ 3-in-1 Lead
Install new metal valleys_ Closed _ Open
Protect property daily, as needed, and dispose of ail
debris properly
Clean jobsite and gutters with magnetic broom and/or
roller
Furnish all labor, materials, and necessary permits
Existing driveway damage _yes —NAO
Interior Damage:
Emergency repair and /or tarps _Yes YIKO
Notes:
Exclusions: Any upgrades or changes to the scope of work NOT included in this claim by my/our insurance company will require
additional funds from the me/us the insured. I/We hereby agree to make additional payment for any and all additional work
requested.
Owner: Vv V Date: li
Reliable Construction &Roofing, LLC: _Q L Dater 1d
M-
12
Plywood : $50 per sheet (4'x8')
Plank wood : $50 per board (1"x10"x10')
Fascia: Outdoor Treated Pine $20 per board (1"x6"x8')
Cedar$25
Aluminum soffit replacement after facia work: $10 per foot
On occasion, when removing the shingles and underlayment of your old roof, we may find rotten wood. In
some cases insurance will cover it. However, in other cases they will not. I understand, as the homeowner,
that I will be responsible for these additional costs for wood replacement if my insurance does not cover it.
Date:
PERMITTING REQUIREMENTS - NO PLAN REVIEW REQUIRED
THIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE
REQUIRED TO BE SUBMITTED AS PART OF YOUR PERMIT APPLICATION.
THE SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF
COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT.
A PERMIT WILL NOT BE ISSUED WITHOUT THESE DOCUMENTS. COPIES WILL BE MADE TO POST ON THE JOB SITE.
PROJECTS LOCATED IN THE SANFORD HISTORIC DISTRICT WILL REQUIRE PLAN REVIEW AND APPROVAL BY THE
SANFORD HISTORIC PRESERVATION BOARD
INSPECTION POLICY & PROCEDURES
A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMILY, TOWNHOUSE,
MOBILE HOME, APARTMENT AND/OR CONDOMINIUM) RE -ROOF PERMITS.
THE FOLLOWING IS REQUIRED TO BE PROVIDE ON THE JOB SITE:
PERMIT CARD, POSTED IN A CONSPICUOUS AND WEATHERPROOF LOCATION
COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK
COMPLETED AND NOTARIZED INSPECTION AFFIDAVIT
ALL FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS
PRODUCT APPROVAL SHALL MATCH WHAT IS ON THE SCOPE OF WORK)
DIGITAL PHOTOGRAPHS (MUST INCLUDE THE PERMIT NUMBER OR ADDRESS IN EACH PICTURE)
O EACH PLANE OF THE ROOF, SHOWING THE UNDERLAYMENT INSTALLED
O ROOF DECK NAILING PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
o ROOF DECK NAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHOWING SIZE OF NAILS)
o UNDERLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
o DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE OR RULER)
o SHINGLES INSTALLED, NAIL PATTERN AND LOCATION OF NAILS
SKYLIGHTS (IF APPLICABLE)
o DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL
o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT APPROVAL
FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE:
PERMIT #
JOB ADDRESS:
Building & Fire Prevention Division
RESIDENTL4L RE -ROOF SCOPE OF WORK
STRUCTURE TYPE: fNGLE 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 SQUARE FEET
ROOF VENTILATION: S4FF-RIDGE
EXISTING DECK IS PERMITTED TO BE REPLACED * *
ORIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES O NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE
1t, _C1/Yln G l FL# 00 0 (.0 c
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLICABLE**
ROOF SLOPE: O LESS THAN 2:12 O 2:12 — 4:12 O 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O SHINGLE FL#
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
OTILE FL#
O OTHER: FL#
Fl-,
Z)ANFORD Building & Fire Prevention Division
RESIDENTIAL RE ROOFAFFIDAVIT
0ft. E0E04 R`itu' N,_T RESIDENTIAL
RE -ROOF INSPECTION AFFIDAVIT NAILING,
SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #:
l " G y'S ADDRESS: 00 RYlIA-1--on fv
y_ I <7t_ I
Lb he._S , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR ROOFING
CONTRACTOR, ENtINEER, 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 #:
U—A , l; 1 +
J
35_ COMPANY /
CONTRACTOR: CONTRACTOR
SIGNATURE: MUST
BE SIGNED BY LICENSE HOLDER OR A
FINAL ROOF INSPECTION IS REQUIRED: DATE:
7 C2l)10 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 WELL 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 5EMtN0LE Sworn to
and Subscribed before me this . ) 7 day of 24 19 by: CIAF=1/
111NES . Who is N/ersonally Known to me or has Produced (type of identification) as
identification. ature of
1 ary ublic tateofFlori a
jJLIA P JENSEN State of
Florida -Notary Public UL)A `
NS(-.Commission # GG 186518 Print/Type/
Stamp Name -' 1,, My Commission
Expires February 15,
2022 of Notary
Public
41e) '72-:Z