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HomeMy WebLinkAbout103 London Fog WayCITY OF SANFORD BUILDING & FIRE PREVENTION FEB 2 2 2016 PERMIT APPLICATION rrA lication No: / - -- ut. Documented Construction Value: $ go/ 40 Job Address: I Ina LQs 1&Zc-7 uk5-1 y An F ( Historic District: Yes No Parcel ID: 3 -q _ '3 SI ? O c, Oa 4 0 Residential [Commercial Type of Work: New Addition Alteration OJ Repair Demo Change of Use Move Description of Work: 22.cor- - CE2T1i-ja1TEfo *mayY, rr- urn uN, y i Plan Review Contact Person: EfLII L n I Title: t>Jr.- dalcn azat7T Phone: 3 Fax: ; I _ q 2a- V (F"7 l Email: SI'i i I I rr'C-ox r cam, cam. e; Property Owner Information C0 Name :rHsy 2A.S Lj&G J Phone: *CZ 9 a--.) _ 9 3 3 -1 Street: cQ S Q-R J QQA,) >Q G tj'9 'Y Resident of property? City, State Zip: I6e=L-IQT0/3 3,;r7-7 / Contractor Information Name LL(' Phone: -30J-9-7'P- V09 o Street: C S' S'o.k)q W f- Ll-*-)i\,K Fax: q0 / - 9%- V 7 / City, State Zip: L%%/ti+C07oS 992JAILS' _ ICC. 7 y State License No.: Or C 7L 7 Architect/ Engineer Information Name: Street: City, St, Zip: Bonding Company: Address: Phone: Fax: 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: 5111 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 zoning. Signature of owner/Agent Print Owner/Agent's Name Signature of Notary -State Agent is d ID Date JI." i 1 gentDate A Print ContracWr/Agent's N4n1$ Date a_ /L— / ti 40 rt, Notary public State of Florida ap Linda W Pi90zzl My Commission FF 043599' w EXpims 08/07/2017 Personally Known to Me or Contractor/Agent is Per nally Known to Me or Type of ID Produced ID Type o BELOW IS FOR OFFICE USE ONLY Date Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type: Total Sq Ft of Bldg: Occupancy Use: Min. Occupancy Load: Flood Zone: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No APPROVALS: ZONING: ENGINEERING: COMMENTS: of Heads UTILITIES: FIRE: Fire Alarm Permit: Yes No WASTE WATER: BUILDING: C Revised: June 30, 2015 Permit Application x • SEMINOLE COUNTY MULTI -JURISDICTIONAL LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 0 o? a -I - I hereby name and appoint: Jay Baker an agent of: Axiom Contracting Group, LLC 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): All permits and applications submitted by this contractor. Or The specific permit and application for work located at: O 3 t CAIRN C—nc,— /I!j S-i+-Jy,W &a-ealJ/a 1-227 0 S eet Address) Expiration Date for This Limited Power of Attorney: License Holder Name: Clifford A. Miller State License Number: CCC132.9763 Signature of License Holder: STATE OF FLORIDA COUNTY OF _ h U 12- 31-16 The foregoing instrument was acknowledged before me thir,7-"-day of ay 20—( _, by 0AAirFocQ A. Mt U-KIZ who is aown to mee who has produced i en i Wa ho did (di ot) take an oath. 41 Signature of tary 11 r Pu Notary Public Slate of Florida Linda W PI9OZ2i My Commission FF 043599' NOF Expires 08107/2017 Pnnt or type Notary name Notary Public - State of fl 2 OA Commission No. FI-0 `-2 59 9 My Commission Expires: 8-17- 13-O J717- J7 axiom T 'M0 CONTRACTING GROUP BBB' For Roofing It lust Makes Sense... 1025 Sunshine Lane, Altamonte Springs, FL 32714 Office:321-972-4094 Fax: 321-972-4471 www.axiomcontracting.corri FL License# CCC1329763 Solar License# CVC56964 EIN:27-5097304 Locations: Jacksonville, Margate, The Villages CONTRACT/BUILD CONFIRMATION MR/MRS/MS /4lenna S 2.)r'c STREET /O SS d CITYS. STATE Fr ZIP 3Z7-t I SHINGLES & RIDGE: CERTAINTEED LANDMARK Driftwood Weathered Wood Burnt Sienna UNDERLAYMENT Synthetic Felt Other (Charges may apply) GUTTERS HOME # 4b7- 36a- - '1333 CELL # ORIGINAL AGREEMENT/CONTRACTDATE /A/ bG. Cobblestone Gray Heather Blend Colonial Slate Sunrise Cedar Georgetown Gray Moire Black Detach & Reset as necessary New VENTILATION 5d Ridge Vent Off Ridge Vents GOOSE NECKS 4" Goose Neck . !?: QTY 10" Goose Neck QTY Color Charcoal Black Mojave Tan Resawn Shake VALLEY 9 Ice & Water shield Valley Metal PLUMBING STACKS 12 1-1/2" Lead 52- QTY 2" Lead QTY 42 3'Lead I_QTY Silver Birch Pewter Other Drip Edge 91 2.5" Painted, Color 11 f Other ROLL ROOFING 7 2-Ply Peel-n-Stick Other Color Job Description and //Additional Items (i.e/. Solar Panels, Interior, Chimney Flash /hing, Skylights etc. ) 4i-on Wt / k7o- /-ollior% t'..f tG, M'rG MP '7 J`a.C.t J-i^ i'!.o /M!'i rI)a i/C ['l I']"('• .A G all" l-I s 4 J j // Ile - TOTAL CHARGE FOR ABOVE LISTED WORK: $ *1-4 99 PAYMENT SCHEDULE IS AS FOLLOWS Down Payment Due: Upon Roof Completion: $ S'oca "Q (includes Deductible) Depreciation Amount Due: $ Z.-7ti 3 6-7 +Z Axiom has the right to supplement the insurance company for any and all additional damages or missed items. When supplements are approved, customer agrees to pay that money to Axiom Contracting Group I.I.C. The work listed above is to be performed under the same conditions as specified in the original Agreement/Contract unless otherwise specified. Customer acknowledges explanation of Florida Supplier Lien Rights letter (see back of Contract). AUTHORIZED BY: Homeowner Date Homeowner Date We hereby agree to furnish labor and materials — complete in accordance with the above specifications and in conjunction with the original Agreement/Contract at above stated price. Please make all checks payable to Axiom Contracting Group I.I.C. Z/3l/b Axiom Contracting Group Authorized Representative Date NOTE: This CONTRACT becomes part of and in conformance with the existing Agreement/Contract 6 THIS INSTRUMENT PREPARED BY: Name: Axiom Contracting Group, LLC Address: 1025 Sunshine Lane Altamonte Springs, Florida 32714 NOTICE OF COMMENCEMENT Permit Number: Parcel ID Number: —anonnon —OQ A o I IIIIl1 I!!I! !Ilit iIIN Ititi iiltl t(((iti MARYANNE MORSEY SEMINOLE COUNTY CLERK OF CIRCUIT COURT h COMPTROLLER' e K 8628 Ps 782 (Pg a ) CLERK'S Y 2016012815 RECORDED 02/05/2016 12 s 23:2'r PM RECORDING FEES $],t -00 RECORDED BY hdevore 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) l C7 a a Mz y fR, 2 0 arc g /ed s'o /16 s 3 a -r. ,z q i ) O2 (_ ,r<_g:20a1 & r- r, rA! $'ra •.> ! z. r9 3 a77 21 2. GENERAL DESCRIPTION OF IMPROVEMENT Residential ReRoof 3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and address: T OMArS 4-L .J L _4 , LQA IOE J % f2y Y /. a 7 r Interest in property: 4)W&Xll Fee Simple Title Holder (if other than owner listed above) Name: 4. CONTRACTOR: Name: Axiom Contracting Group, LLC Phone Number: Address: 1025 Sunshine Lane, Altamonte Springs, Florida 32714 5. SURETY (If applicable, a copy of the payment bond is attached): 6. LENDER: Name: Phone Number: Address: 7. Persons within the State of Florida Designated by Owner 713. 13(1)(a)7., Florida Statutes. 8. In addition, Owner Amount of Bond: notice or other documents may be served as provided by Phone Number: 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) IN - h 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. Signature of owner or Lessee, or Owner's or Lessee's irnm Name and Provide Signatory's Title/Office) Authorized Officer/Director/Partner/Manager) State of 6 A" 1neC County of /111Mo L_t The foregoing Instrument was acknowledged before me this 3 day of,.412 `/ , 20 by OM.a- S L c.A S Who is personally known tome OR Name of person making statement who has produced identification "e of Identification produced: o00 po, Notary Public State of Florida Linda W Pigozzi y, A< My Commission FF 043599' oF Expires 08/07/2017 M Ku W CITY OF SANFORD BUILDING & FIRE PREVENTION r D PERMIT APPLICATION Application No: / a - 5_Z) Documented Construction Value: $ ?'S Co. 00 Job Address: 1 C lf-mo 11 U. Historic District: Yes No Parcel ID: 09-.0Q-50-521-000D-IQ3d Residentialo Commercial Type of Work: New Addition Alteration 56 Repair Demo Change of Use Movc Description of Work:.Re - rQQf-_QCRI Q) e 2 , Jh inn FL1 D Plan Review Contact Person < t00MA Y1WIA ML YAM I / Title: 1't M' i A Phone: 1 rt Fax: WD- 3 31- 3'3LO ( Email: f>A I l Izrpen n• Lbwl Property Owner Information // yy/yNameLokArck, -(-, - I _ _ Pltone: `fib-7 3(LJ _rr rr C[L*A q: Street: 10 61if-M610 CV. Resident of property?: k('GS City, State Zip:, rdb ad EC 32223 Contractor Information Name t'7ls'ixx rr( birlirado rE Phone: qm- a 1 1 i fft Street: 6? r - Cot C) n I cd ) r Fax: MD' 3 97 -; S 62.1 City, State Zip: Of i(W0 f-i__ W0_: State License No.: 6Cc ( 301ah11 Name: Street: City, St, Zip: Bonding Company: Address: 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. 1 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: 5" Edition (2014) Florida Building Code Revised: June 30, 2015 Permit Application Scanned by CamScanner i'QUI is In addition to the requirements of this permit, there may be additional restrictions applicable to this property Ihat,may be a 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 1 Hill notify the owner of the property of the requirements of Florida Lien Law, FS 713. Tic 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 1CC Valuation Table in effect at the time the permit is issued, in accordance with local ordinance. Should calculated charges figured offthe 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 clone in compliance with all applicable laws regulating construction and zoning. a -va•l Signature of( wer/Agent Date ig/nnlwrcorCnnunctor/Agent Date A N^.." .nr, - -- Bill r i 1An1' /. N1.ru:ar- •-.l •- hhF - - j Print Quno/Agent's Name I ' { actor/Agent's Nn c I Sigtetlurc of NiHary-Slate ot'1'Irnida Date Si attire ' Notary -Stale of Florida 1 plc BRIANA i•''6A "' MN MY COMMISSION N FF942988 EXPIRES Dooember 13 2019 I140r)708. 01W ItakerrotrrryfMVK tM' 1 Owner/Agent is Personally Knowm to.Me or Contractor/Agent is ' Personally nown'to Me or Produced ID Type of ID Produced ID Type, ID BELOW IS FOR OFFICE USE ONLY 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: Reis- M: June 30.2013 Permit Application ie`;"'..t.' s,+;•;!'.yh`.-.rdYti.4'ti t{..-,t R.' 4S<,r,_ L__._ a.}.. "'-•" E_., .av_ -- S`'-_1..-Sa.•Ls l"-'+si.:ir'.•'t'u: .-i:.t «'`yt Y•r_..yji.'i --e..r.t' a.. ,.. ..e ... Scanned by CamScanner THIS INSTRUMENT PREPARED BY: Name:_ ')(ISpfY (Onf cfoy-S (41101S Address: 5380 E COLONIAL DR ORLANDO FL 32807 NOTICE OF COMMENCEMENT Permit Number: Parcel ID Number. y ' (`% rr ?jo - Doc) 0- 10 30 I ill1 illll IIIII IIIII IIIII llllf IIII IIII MARYAHUE HORSE, SEWIOLE COWITY CLERK OF CIRCUIT COURT h COMPTROLLER13.1% 8637 Pi, 136 ill`as! CLERK'S 4 2016018786 RECOROEV 02/'72/2016 10:1.i ill t)M RL.CORI)DIG I'EES 1.10.00 RECORDED UY hdevuro The underslgnod hereby gives notice that knprovement will be made to certain real property, and In accordance with Chapter 713, Floddo Statutes, thefoliowdngInrormatlonIsprovidedInthisNoticeofCommencement. 1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available) 2. GENERAL DESCRIPTION OF IMPROVEMENT: RE -ROOF 3. OWNER INFORMATION 11'' O''R- s" LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: _ Name and address: LQLAfd (S C n rgrnG`, l 1) IVC i"1 V SG n(t) I -'I h`L• 3d 7? Utterestin property; _ ( -m n y Fee Simple Title Holder (it other than owner listed above) Name: Addiuss: 4. CONTRACTOR: Name: JASPER CONTRACTORS Phone Number: 407-278-7788 Address: 5380 E COLONIAL DR ORLANDO FL 32807 S. SURETY (if applicable, a copy of the payment bond Is attached): Name:, Address: Amount of Bond: a. LENDER: Name; Phone Number Addioss: 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. I , Name: Phone Number. Address: 8. In addition, Owner designates to receive a copy of the Lienor's Notice as prdvided 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. S"hre of Dww or L*zv6c or Ow reft or tsuare (Pdn Name and Prwkia SO=W& ftVrm) Auti,onzed axgro State of FL County of SEMINOLE r j The foregoing Instrument was acknowledged thisbeforeme " day of i cb . 20 42 by 1 Au rd 6 6- Ou-y ) P 0 S Who Is personally known to me 0 OR Name ar person ma xog w— who has produced identification 6 type of identification produced: DL 7i; SAMANTHA MURRAY MY ComMISSION 8 FF944322 EXPIRES December 18. 2010 r10h 9E0•5 ' Hatay sip aj :i`iHs°ttttr Scanned by CarnScanner r t:) vld Jolvnion. Cl--A Pro, ccord Card PROPERTY Parcel: 02-20-30-523-0000-1030 APPRAISER Owner: CAMPOSLOURDES FI,?AiNOL(-tMJNtY,FIOnnA PropertyAddress:1SOGLEASONCVSANFORD,FL32773 Parcel: 02-20-30-523-0000-1030 Value summary 1 Property Address: 150 GLEASON CV 12 1 lor lrig 2015 Certified Owner: CAMPOS LOURDES ! - Y-- -_ - - Values -- Values -- t Mailing: 150GLEASON CV Valuation Method Cost/Market Cost/Market SANFORD, FL327T3-4451 I t Number of Buildings 1 1 Subdivision Name: PLACID WOODS PH 2 Tax District: Si-SANFORD i Depreciated Bldg Value $87,937 $77,744 Exemptions: DD-HOMESTEAD (2005) i '; Depreciated EXFT Value DOR Use Code: 01-SINGLE FAMILY I Land Value (Market) $18,000 ;18,000 Land Value Ag Just/Market Value $105,937 $95,744 04v Portability Adj 4' :• :! Save Our Homes Ad) $34,507 $24,811 Amendment 1 Adj AssessedValue -_ $71,430--$70,933 - o TaxAmountwRhoutSOH: $1,127.18 2015 Tax Bill Amount $673.30 t K 1 Tax Estimator Save Our Homes Savings: $454.08 k' . =: i • Does NOT INCLUDE Non Ad Valorem Assessments Legal Description - LOT 103 i PLACID WOODS PH 2 i PB S8 PGS +6 Taxes Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund $ 71,430 46,430 25,008 j Schools $71,430 25,000 46,430 I City Sanford $71,430 46,430 25,000 i S]WM(SaintJohns Water Managem Q $71,430 46,430 25,000 County Bonds $71,430 46,430 25,000 Sales --- - - ---- -- r Description - - -- Dam Book Page 1 Amount Qualified Vac/Imp WARRANTYDEED B/1/20D4 05451 0506 $140,000 Yes Improved SPECIAL WARRANTY DEED 4/1/2001 04054 0858 $88,900 Yes Improved Find Comparable Sales within this Subdivision - Method Frontage - Depth Units j Units Pricej Land Value LOT 1 $18,000.00 I- - - - 18, 000 Building Information r # t Description : Year .#t Fixtures Base Area Tota l SF- Living SF Ext Wag Adj Value 1 ActuaVEfiecWe'_i--i-.--•---. Repl ValueFAppendages 1 SINGLE 2001 6 - ' . 1,292 ; 1,680 f 1,292 CB/STUCCO $87,937 1 -` FINISH 92, 810 description Area FAMILY Scanned by CarnScanner LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 1 U\\A 1 v T hereby name and appoint: Samantha Murray an agent of Jasper Contractors N=e 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: Expiration Date for This Limited Power of Attorney:, License Holder Name: tdic.rl AV— StfPatf-n3 State License Signature of License Holder: STATE OF FLORIDA COUNTY OF 1 The foregoing instrument was ac wl ed before me this iday of • OALA 204_(_O, by \-Ai PAO "A who is o personally ImownP to me oMwho has produced as identification and who did (did not) take an oath. Signature Notary Seal) BRIANA MCCLEAN MY COIF tSS10N # PF9429 9EXPIRESfiber13201 IOr -0lea Rev. 08.12) i' d r ran a. M* Mkt. Print or type name Notary Public - State of Commission No. My Commission Expires: Scanned by CarnScanner Jasper Contractors, Inc. 5380 E. Colonial Dr. Orlando, FL 32807 407)278-7788 800) 337-3361 Fax JasperRoof.com infoRiasperinc. org m' BICr_Y!CFd JASPER JasparRoofxom Contractor's License # CCC1329651 ROOF REPLACEMENT CONTRACT Account Manager QJ G(A 1\ o Contact # q10-1--51(Q 550 Insurance Com Information CompanyC: 55 L Policy # ' m s Claim # C r cbCdWS2 `i S Mortgage Conivany Information Company 1 'S b1C,CS , Loan Number S S Owner( s): Phone'gQ-7— 3 J, J ^ Wirl Address: o G e)46p IS Co-ic Alt Phone: 461 — 3 Z9-612(P City: e: Zip c el . Shingle Colo,, , c K Email: LOV• SO(. ®@ i'AOO 7 ,C©n Roof— R8C800_00 amount: Drip Edge CoVIo Jr: 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/AgenvTnsured(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 replacementJrepair 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: $ ICX1Y-) MUST BE PAID IN FULL, PLUS APPLICABLE -SALES TAX (initial) MORTGAGE AUTHORIZATION: I, Owner/Mortgagor, grant authorization for 4E rIC SeIE iW ortgage gspeakwith Jasperonmattersincluding, 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 o $ 1 due upon signing this contract; (ii) the Contract Price, less the Deposit and any applicable depreciation retained by Owner's ' 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 maybe withheld until inspection has passed. Optional: UPGRADE ITEM: 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. 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 is executed after notification from insurer(s) 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: 1955 Vaughn Road, Suite 209, Kennesaw, GA 30144. CANCELLATION EXCEPTIONS: The three (3) day right of 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 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 nter into the contract and that it is binding and enfor able in accor nce w'th its terms. A th izd Jasper epresentative Date O er Date TE AND CONDITIONS: Acceptance of Terms: I, Owner, hereby agre to retain Jasper for a full roof replacement on the terms and conMons 'ons stated herein. I further agree to provide Jasper with the Scope of Loss Report generated by my insurer and authorize and grant full access to the property for the purpose of staging and completing all agreed upon work. Supplemental Claims: Jasper reserves the right to file a ti\ pplemental claim with Owner's insurance in the event that the estimate is incorrect and/or additional damage is discovered after Florida Building Code Online PQV_),- VI Rage 1.of 2 us nesys y`, foQf s ga oS at gul,ti oi i`^.i`+L•JS'2v1'E.tthC:K,Y..,.-.Si:.' `..4&ti.;t,;`v"...5?'.,i't acts H-6 Log In Use, Registration mot Topics I Submit Surcharge I Slats & Facts usine tI 0 USER: public User Regulati/ A 1 M n > VrWwu t or ADOIIfation Search > Auolicatton List > Application Detail FL # FL3794-114 Application Type Affirmation Code Version 2010 Application Status Approved Comments Archived Product Manufacturer Address/Phone/Email Authorized Signature Technical Representative Address/Phone/Email Quality Assurance Representative Address/Phone/Email Category Subcategory Compliance Method Certification Agency Validated By Referenced Standard and Year (of Standard) Equivalence of Product Standards Certified By DE ifQi1i;" c SU7itiErg ',ageR sr16{Q;S',cSLS'W4'iReFg Lomanco, Inc 2101 West Main Jacksonville, AR 72076 501)982-6511 acartee@lomanco.com Andrew Carter acaf'ter@lomanco.com Andrew Carter 2101 West plain Street Jacksonville, AR 72076 501)982-6511 Ext361 acarter@lomanco.com Andrew Carter 2101 West Main Street Jacksonville, AR 72078 501)982-6511 Ext361 acarter@lomanco.com Roofing Roofing Accessories that are an Integral Part of the Roofing •System Certification Mark or Llsting Miami -Dade BCCO - CER Miami -Dade BCCO - VAL Standard Year Miami -Dade TAS 100 (A) 1995 trll dfi n; :7a: ii:ere are no ihang!, Ili 0M tQNa 1-k)rida f .+ilrll?cr Cn e :hkh affen' n)Va Product(s) and r tlr.?;'and, dtloxc %r tl n"VY http://www.floridabuilding.org/pr/pr app_dtl.aspx?param=wCTF,VXO"4T)ne]7rr'Dt.V^..--nT , MIAM1-DADS am, MIAMI-DADS COUNTY BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT (BNC) PRODUCT CONTROL SECTION BOARD AND CODE ADMINISTRATION DIVISION 11505 Sw 2G Street, Rdum 208 Miami. Florida 33175-2474 NOA T (7SG) 315- 2590 F (78G) 315-25 NOTICE OF ACCEPTANCE www.miamidNde " ovlbuElding! Lomanco, Inc. 2101 WestmainStreet Jacksonville, AR 72076 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted hasbeenreviewedandacceptedbyMiami -Dade County BNC - Product Control Section to be usedinMiamiDadeCountyandotherareaswhereallowedbytheAuthorityHavingJurisdiction - AHJ). This NOA shallnot be valid after the expiration date stated below. The Miami -Dade County Product Control Section (In Miami DadeCounty) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product ormaterialtestedforqualityassurancepurposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, orsuspendtheuseofsuchproductormaterialwithintheirjurisdiction. BNC reserves the right torevokethisacceptance, if it is determined by Miami -Dade County Product Control Section that this productormaterialfailstomeettherequirementsoftheapplicablebuildingcode. This product is approvedasdescribedherein, and has been designed to comply with the Florida Building Code including the High VelocityHurricaneZoneoftheFloridaBuildingCode. DESCRIPTION: 135 Roof Vetit, Lomancool 2000 Power Vent LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -DadeCountyProductControlApproved", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicablebuildingcodenegativelyaffectingtheperformanceofthisproduct. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/ormanufactureoftheproductorprocess. Misuse of this NOA as an endorsement of any product,, for sales, advertisingoranyotherpurposesshallautomaticallyterminatethisNOA. Failure to comply with any section ofthisNOAshallbecauseforterminationandremovalofNOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date maybedisplayedinadvertisingliterature. If any portion of the NOA is displayed, then it shall be done in itsentirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be availableforinspectionatthejobsiteattherequestoftheBuilding -Official. This renews NOA# 06- 0501.11 and consists of pages I through 4. The submitted documentation wasreviewedbyAlexTigera. APPEl0VE0 NOA No.. 11- 0602.02 Expiration Date: 08/17/ 16 Approval Date: 08/17/ 11 Page 1 of 4 ROOFING COMPONENT APPROVAL ia_ RoofingSub-Cate"rv„ Ventilation Material: Aluminum TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT: Produe Dimensiont Test Product s 3 ecification Description 135 Roof Vent, 9" x 28,5" TAS 100 Powered Roof Vent, with fan andtncoo12000Power Vent thermostat with a aluminum hood. Vent MANUFACTURING LOCATION 1. Jacksonville, AR EVIDENCE SUBMITTED: Test Agrencv/Identifier Name Re port Date PRI Asphalt Technologies, Inc. TAS I00 A LOM-011-02-01 04/05/06 MtAMI-WDECOU1VTy NOA No.: 11-0602.02 Expiration Date: 08/17/16 Approvai Date: 08/17/11 Page 2 of APPROVED APPLICATIONS Cutout: Vent must be located 18 'from ridgeline. At chosen location and centered betweentworoofrafters, cut a 14" diameter hole through shingles and sheathing boards. Using marked position as center point; scribe a circle that is the same diameter astheventthroatopening. Starting with the drill hole cut vent hole. Installation: Vents should be evenly spaced on the rear slope of the roof. Remove roofing nails from top row of shingles so the flashing of the roof vent willslideundershingles. Apply approved roof cement around the edge of the hole. Carefully slide base of vent under shingles with arrow facing up. Make sure thethroatoftheventiscenteredoverventhole. Fasten the base to roof decking atcomers, and approx. 4" o.c. 1" from the outside edge of the flange and 1" fromstackevery45" with approved roofing nails, keeping heads of nails tinder shingleswherepossible. Use a minimum of 32 nails and shall be of sufficient length topenetratethroughroofsheathingaminimumof '/2". See details drawings herein. Seal all seams and nails with roofing cement. Net Free Area: Refer to manufacturers published literature LIMITATIONS: 1. Refer to applicable building codes for required ventilation. 2. 135 Roof Vent, Lomancool 2000 Power Vent, thermostat and wiring shall be installed incompliancewithLomanco, Inc. published instructions, and in accordance with applicable BuildingCodes. 3. This acceptance is for installations over asphaltic shingle roofs only. 14. 135 Roof Vent, Lomancoo12000 Power Vent, shall not be installed onthan33feet. roof mean heights greater 5. All products listed herein shall have a quality assurance audit in accordance with the FloridaBuildingCodeandRule9B-72 of the Florida Administrative Code aMMMJ.DADECain NOA No.: 11-0602.02 Expiration Date: 08/17/16 Approval Date: 08/17/11 Page 3 of 4 DCTAIL DRAWINGS 135 Roof Vent, Lomancool 2000 Power Vent PART 8 I ITEM I REO I DESCRIPTION _ I NATEF.IAL MAT 0"<01-541 i 1 DOME 032t.0025 X 2850 X 28,50 5005-0 AL F.7.SQp07.01-.507.. 2 t BASE 039f,0475 X 70 X 73 5005-0 AL 1.340r0201-503 3 1 RAINSHIELD f}:gt.007; X 1%50 !f 19,50 500;-0 AL y1 Sp0410-501 4 3 1 BRACKET IG CA, X 1.250 X 7.580 CAM STEEL 195i0201-507 5 1 SCREEN 028 X 5 X 41.375-8)(8 MESH PERM-A-KOTE 1404000165 6 12 RIVET 3/16C X 7/32 OVAL H0. AL 1405D00281 7 3 SCREW i14 X 112 WNW) TYPIEM -AB- 7INC RLT END OF THIS ACCEPTANCE NOA No.:.11-0602:02P1IAh71CfADECOUN7YExpirationDate: 08%17/16 Approval Date: 09/17/11 Page 4 of 4 Florida Building Code Online Pagel of 3 rT ' : i'.i+t J 3'K., wYyyyyz 1 i7 t r I$. t L '+ c a .r * Z..f'.,:?;.0 { • Wi''S.. _ -f Q: a sc u t3Y's`..t'-st z r?v':+• sf 'I,r ,`a`r ': 'yti,?' Florida NpanUser Registration fiat Topics submit Surcharge StatsazitjSCISH=e Log In Product Approval tretrlirJ. . W3IRDa1.g AOP,Rajl(gt9Jf5 CrrGE Busineso,*') ) ) & Facts Publications FSC Staff gas Site M30 I Unks Sca.rch Regulation iF,!USER: Public User Name el5drZM 8r,M 1 mmmmmmusmam MoFToF 3r7s' secrter`exr. , Application Type FL3792-R6 Code Version Affirmation Application Status 010 Comments Approved Archived Product Manufacturer Address/Phone/Email Authorized Signature Technical Representative Address/Phone/Email Quality Assurance Representative Address/Phone/Email Category Subcategory Compliance Method Certification Agency Validated By Referenced Standard and Year (of Standard) Equivalence of Product Standards Certified By Lomanco, Inc 2101 West Main Jacksonville, AR 72076 501)982-6511 acarter@lomanco.com Andrew Carter acarter@lomanco.com Andrew Carter 2101 West Main Street Jacksonville, AR 72076 501)982-6511 Ext361 acarter@lomanco.com Andrew Carter 2101 West Main Street Jacksonville, AR 72078 501)982-6511 Ext361 acarter@lomanco.com Roofing Roofing Accessories that are an Integral Part of theRoofingSystem Certification Mark or Listing Miami -Dade BCCO - CER Miami -Dade BCCO - VAL Standard Miami -Dade TAS 100 (A) Year 1995 i'`I T+filrrr, Char; r'a. arC e Ile r1c:C FL "••ic rtr, Prt:drect(5) an.9 nry BJtiriir. , a:rtC with the itG;:• fliqYd9 http://vwvW.floridabuilding.org/Pr/pll-aPP—dtl.asPx?varam=WrTrvyn,.,+n--,,- City of Sanford Building & Fire Prevention Division Re -Roof Permit Card PERMIT NO. AP'O' %1?1> ISSUE DATE: ®. CONTRACTOR: JOB ADDRESS: TYPE OF WORK: ITO I 2 Post this Permit in a conspicuous place outside PROTECT FROM WEATHER Approved plans must be posted with permit for inspection Leave all work uncovered until inspected Permit expires six (6) months from date of issue or last approved inspection A R OOF DR Y-IN INSPECTION IS REQ UIRED * * * For Inspection procedures, please refer to the re -roof inspection guidelines provided to you when the permit is issued. The Mitigation Afflidavit 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 111 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 . . . . . 16-00000570 Date 2/22/16 Property Address . . . . . . 150 GLEASON COVE Parcel Number . . 02.20.30.523-0000-1030 Application description . . . ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . MULTIPLE FAMILY Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 929455 Permit pin number 929455 Required Inspections Phone Insp Seq Insp# Code Description Initials Date 10-1000 129 BL29 MITIGATION AFFIDAVIT 10 116 BL15 ROOF DRY -IN 1000 111 BL03 FINAL ROOF / /