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HomeMy WebLinkAbout122 Pine Isle DrCITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: G 5 - d Documented Construction Value: $ 9,700 Job Address: 122 PINE ISLE DR, SANFORD, FL 32773 Historic District: Yes No Parcel ID: 10-20-30-511-0000-1090 Zoning: 31SO FT Description of Work: SHINGLE RE -ROOF, 7/12 PITCH, RHINO UNDERLAYMENT Plan Review Contact Person: TITIA BUNCOME Title: Phone: 407-278-7788 Fax: E-mail: PERMIT@JASPERINC.ORG Property Owner Information Name ROSENDO MARINEZ Phone: 407-324-3828/LAogZ%Z—Ci S,.y Street: 122 PINE ISLE DR Resident of property?: HOME -OWNER City, State Zip: SANFORD, FL 32773 Contractor Information Name JASPER CONTRACTORS Phone: 407-278-7788 Street: 5380 E COLONIAL DR Fax: City, State Zip: ORLANDO FL, 32807 State License No.: CCC1329651 Architect/Engineer Information Name: Phone: Street: Fax: City, St, Zip: E-mail: Bonding Company: Mortgage Lender: Address: Address: PERMIT INFORMATION Building Permit $] Square Footage: 31 Construction Type: RE -ROOF No. of Stories: ONE No. of Dwelling Units: Flood Zone: Electrical New Service — No. of AMPS: Mechanical (Duct layout required for new systems) Plumbing New Construction - No. of Fixtures: Fire Sprinkler/Alarm No. of heads: q Shall be inscribed with the date of application and the code in effect as of that date (Code 2010 FBQ 731.135(5)(6) Florida Statutes. REV 07.14 \\ n Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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. 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. 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. 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. A copy of the executed contract is required in order to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the plan review fee based on past permit activity levels. Should calculated charges exceed the documented construction value when the executed contract is submitted, credit will be applied to your permit fees when the permit is released. Signature of Owner/Agent Dat ROSENDO MARINEZ Print Owner/Agent's Name Signature of Notary -State of Florida Date aw'ur, TITIA N BUNCOME Commission f FF 224168 L,ag My Commission Expires Owner/Agent is Personally K710 a or Produced ID X Type of ID DL APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: 16-1— Signatu fContractor/Agent ate / 411 .et 4khhir:t Print Contractor/Agent's Ame a-4 1J.11/K.t d i 7 Signature of Notary -Slate of Florida Dal TITIA N BUNCOME Commission N FF 224168 My Commission Ex ices April 23. 2019 Contractor/Agent is Persoffa-I y nown to Me or Produced ID. Type of ID DL WASTE WATER: BUILDING: X Shall be inscribed with the date of application and the code in elTect as of that date (Code 2010 FBC) 731.135(5)(6) Florida Statutes. REV 07.14 Jasper Contractors, Inc. 5380 E. Colonial Dr. Orlando, FL 32807 407) 278-7788 800) 337-3361 Fax JasperRoof.com infu(a'iasperine.org 70D0 Account Manager ClAgLO r.... ..... , Contact # qb_1— S I (o - S 50'7 Insurance Co m an Wormation Company ' JASPER Policy # 5 A 1_-S q 3'-10 J swr 100f.com Claim # "zi'321 :l,_T Contractor's Liccnse it CCC 1329651 ROOF REPLACEMENT CONTRACT Mortgage Company Information Company C AAS&_r- Loan Number Ic{"1 R 12 5C'o2(o Owner(s): 056,Axv) ( E Phone: 07- L17 K -&018 Address: 2- 0-2-Ncs S t. Alt Phone: City: S A IJ Po State: 3Zco1 eJ Shingle Color. p Email: Qo1E Roof RCV amount: Drip Edge Color: w waryA1L (oAA If Owner's Insurance Company does not agree to pay 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, its representative, or its attorney 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 pay all Insurance Deductibles. Owner's out-of-pocket expense will not exceed the deductible amount, as stated on insurer's loss sheet, UNLESS replacement/repair of deteriorated decking is required and/or Owner requests optional upgrades. Jasper CANNOT pay, waive, rebate, or promise to pay, waive or rebate all or any part of the insurance deductible applicable to the insurance claim for payment of work. In the event of a discrepancy, the deductible amount stated on the insurer's Loss Sheet shall overrule Deductible listed above. Deductible: $ 1000 MUST BE PAID IN FULL, PLUS APPLICABLE SALES TAX (initial) MORTGAGE AUTHORIZATION: I, Owner/Mortgagor, grant authorization for GIN S Mortgage to peak 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 pay 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 insurer(s), plu! Upgrade Costs, due and payable to Jasper upon completion of work being performed; and, (iii) the remaining Contract Price (equal to and applicable depreciation and/or change orders) due and payable to Jasper upon completion of work performed. In the event of a pendinl, inspection, no more than 2% of Contract P ' may be withheld until igW.tion has passed. Optional: UPGRADE ITEM: QTY: PRICE: $TOTAL: $ Replacement Work and Price: Upon ' sutrer's approval and subject to the terms and conditions herein, Jasper agrees o furnish all material and provide the labor necessary to pe orm 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, Jaspe shall perform the roof replacement upon receipt of funds from Owner's insurance company. CANCELLATION: If Owner elects to terminate the services of Jasper, Owner may do so before midnight on the third business da after Contract is executed. Owner shall receive a full refund of all deposits. Owner may also rescind Contract before midnight on th third business day after the contract is executed after notification from insurer(s) that the claim for payment on roof contract has bee denied, in whole or in part. All written notices of cancellation, regardless of reason, shall be postmarked or delivered to Jasper corporate office: 1955 Vaughn Road, Suite 209, Kennesaw, GA 30144. CANCELLATION EXCEPTIONS: The three (3) day right cancellation DOES NOT APPLY to contracts for emergency home repairs as time is of the essence. I, Owner, have read and understand all statements, terms and conditions of the "Roof Replacement Contract" and agree that f details are acceptable and satisfactory. I further understand that this contract constitutes the entire agreement between the parties at that any further changes or alterations to this contract must be made in writing and agreed upon by ,both parties. Each par represents and warrants to the other that it has the full power and authority to enter into the contract and that it is binding at enforc b e in accordance with its terms. 2 ft AuorizedJasperRepresentativeateOwnerPERMS AND CONDITIONS: Acceptance of Terms: I, Owner, hereby agree to retain Jasper for a full roof replacement on the terms a conditions stated herein. I further agree to provide Jasper with the Scope of Loss Report generated by my insurer and authorize and grant f access to the property for the purpose of staging and completing all agreed upon work. Supplemental Claims: Jasper reserves the right to fill Scanned by CamScanner THIS INSTRUMENT PREPARED BY: Name: Titia Buncome Address: 5380 E Colonial Dr Orlando FI 32807 NOTICE OF COMMENCEMENT Se,trArd Permit Number: I IIIIII IIIII Illlf IIIII flflf flllf f flf f f MARYANNE MORSE, SEMINOLE COUNTY CLERK OF CIRCUIT COURT & CONF'TROLLERBK8529Ps1567 (1Pss) CLERK'S r 2015090881 RECORDED 08/13/2015 01.16.07 t'M RECORDING FEES $10.CiCi RECORDED BY hdevere Parcel ID Number: 10-20-30-511-0000-1090 The undersigned hereby gives notice that Improvement Wit 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 avallabie) 2. GENERAL DESCRIPTION OF IMPROVEMENT: Re -Roofing 3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and address:e051!Q%t,)rp / A r—\N ram- 7, 122 PINE ISLE DR SANFORD, FL 32773 Interest In property: Fee Simple Title Holder (if other than owner listed above) Name: Address: 4. CONTRACTOR: Name: Jasper Contractors Phone Number: 407-278-7788 Address: 5380 E Colonial Dr Orlando A 32807 5. SURETY (If applicable, a copy of the payment bond is attached): Name: Address: 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 Section 713.13(1)(a)7., Florida Statutes. Name: Phone Number: 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: 9, 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 ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. 6&,-Al kqcgi — r Signature of Owner or Lelfta, or OLLftre or LeaOea's (Print Name and Provide Slgn2tor7r9 ntlefOrfice) Auftdzed Officer/Director/Partner/Manager) State of FL County of SEMt5NOLE The foregoing Instrument was acknowledged before me this 2 day of ) (IILi , 2015:'• by N-le MID M6Q AP,.-- __ Who is personally known tome[] OR Narne of person making statement who has produced IdontificationX) type of Identification produced: DL TITIA N BUNCOME Commission N FF 224168 MY Commission Expires April 23, 2019 9 6 11 it tJ u City of Sanford Building & Fire Prevention Division Re -Roof Permit Card PERMIT NO. / 5 so 02 (Of 3 IF ISSUE DATE: OR,, /9' CONTRACTOR: ,der W • i Ste-U 0'1•Or JOB ADDRESS: TYPE OF WORK: ne.. Ssle Post this Permit in a conspicuous place utside PROTECT FROM WEATHER Approved plans must be posted with ITermit for inspection Leave all work uncovered until inspected Permit exaires six (6) months from date of issue or last approved inspection A ROOF DR Y-IN INSPECTION IS RE UIRED * * * For Inspection procedures, please refer to the re -roof inspection guidelines provided to you when the permit is issued. The Mitigation Affidavit will not suffice as an alternative to receiving a dry -in inspection. ROOF INSPECTION TYPE APPROVED REJECTED INSPECTOR MISCELLANEOUS INSPECTION TYPE APPROVED REJECTED INSPECTOR ROOF DRY - IN MITIGATION AFFIDAVIT FINAL ROOF 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: October 2014 Inspection line 855.541.2112 TO SCHEDULE AN INSPECTION: Dial855.541.2112 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 3:30 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 ROOF Roof Dry In 116 Mitigation Affadavit 129 Final Roof III Miscellaneous Notes: Miscellaneous Sheathing - Roof 106 Insulation - Roof 119 REVISED: OCTOBER 2014 Inspection Line: 855.541.2112 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 . . . . . 15-00002638 Date 8/19/15 Property Address . . . . . . 122 PINE ISLE DR Parcel Number 10.20.30.511-0000-1090 Application description ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . PUD Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 909499 Permit pin number 909499 Required Inspections Phone Insp Seq Insp# Code Description Initials Date 10-1000 129 BL29 MITIGATION AFFIDAVIT 10 116 BL15 ROOF DRY -IN 1000 Ill BL03 FINAL ROOF _/_/_ LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 12/1 /2015 I hereby name and appoint: Scott Meixsell an agent of: Jasper Contractors Name 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: 122 Pine Isle Dr street Address) Expiration Date for This Limited Power of Attorney: License Holder Name: Micheal Stephen State License Number: CCC1329651 Signature of License B STATE OF FLORIDA COUNTY OF 12/31 /2016 The foregoing instrument was acknowledged before me this 200 ,by to me or who has produced identification and who did (did not) take an oath. Notary Seal) NOTARY PUBLIC STATE OF FLORIDA Cotm* FM73M I C. Expires 8/5/2019 Rev. 08.12) day of , who is personally known A" Signature G Print or type name Notary Public - State of F I - Commission No. FF-©----3 3 (.o My Commission Expires: 5 f /'1 as T CITY OF SANFORD BUILDING SERVICES Residential Re -Roof 0 Hurricane Mitigation Inspection Affidavit Permit #: S — 2 U-2 Z I, SCo ,I SP A' hereby acknowledge that I personally inspected Roof deck nailing and/oriSecondary water barrier work at 12.2. P k AP_ tSI-e- Pi( and have determined that the work Job Site Address) was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.) I certify that my statements herein are true and accurate to the best of my belief and that I fully understand that making any false statements in writing with the intent to mislead a public servant in the performance of his or her official t< shall constitute a misdemeanor of the second degree pursuant to Section 837. 3 - IS Signature of Contractor Date Sca M1'4 Li / 2 Printed Name of Contractor License # License Type: General Building Residential Roofing Contractor or any individual certified in accordance with F.S. 468 to make such an inspection. STATE OF FLORIDA COUNTY OF ,Q w% rl Q k Sworn to or affirmed) and subscribed before a this day ofyj&v- , 20 6-by SC4fi3OKSttj , who is ;Personally Known to me or has Produced (type of identi ication) :Z1/ as identification. , ( SEAL) Signature of Notary Public State of Florida Amara pW** Dm 21 R T) 2. S ey% C NOTARY PUBLIC Print/Type/Stamp Name 0STATE OF Fl-ORM of Notary Public Cam* FF9V= E*m 815/2019 Revised: February 2015 CITY OF SANFORD BUILDING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #• ICJ —'2(9j hereby acknowledge that I personally inspected OL Roof deck nailing and/or Secondary water barrier work at 112- '1 je & and have determined that the work Job Site Address) was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.) I certify that my statements herein are true and accurate to the best of my belief and that I fully understand that making any false atements in writing with the intent to mislead a public servant in the performance of his or her of ial duty shall constitute a misdemeanor of the second degree pursuant to Section 837_9" Signature of Contractor Printed Name of Contractor j1 b % Date CCC_l'!LJi[71 License # License Type: 0 General 0 Building 0 Residential j-Roofing Contractor or any individual certified in accordance with F.S. 468 to make such an inspection. STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subscribed before me this /a ' ay of 56*014-- , 20 _, by y s k , who is Personally Known to me or has 0 Produced (type of identification) 0 C as identification. SEAL) Signature of Notary Public M of Florida G y LC o MN•Q Print/Type/Stamp Name of Notary Public _ YIT a N B CNUOME Commission # FF 224168 My Commission Expires April 23, 2019 Revised.• February 2015