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Home My WebLink About149 Pine Isle DrCITY OF SANFORD r Irk BUILDING & FIRE PREVENTION F JAN 1 PERMIT APPLICATION : D2 2016 Application No: Documented Construction Value: $ /O, Job Address: 1419 9 /N8 t . SApttr u 79-3Historic District: 'Yes No Parcel ID: 1(2 -, _ _ID - _3 /l - OOvo — //o Residential EJ Commercial Type of Work: New ED- Addition Alteration Repair Demo Change of Use Move Description of Work:: jz-/ SQ p— w 5WOL s Plan Review Contact Person: Title: -hiPIW16 Phone.% 2 900 Fax: YO? - 3$z, -9%yl Email: Property Owner Information Name k,& P_Aj4 L • 6a X Street: /'/ 9 . o4i b% City, State Zip: t---L J R 7 215 Phone: Resident of property? U70 Contractor Information Name Phone: 4-0 `% - L Street: 4/ 50- /V. I_1U)`% /'% -,?cA cS '*0 / 09 Fax: "-/O % - 3 9 - 2201 City, State Zip: tb J ' State License No.: 6a,6 %L5ala a % 9 Architect/ Engineer Information Name: 1114 LA Phone: Street: Fax: City, St, Zip: E-mail: Bonding Company: N lf Mortgage Lender: 19 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 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, 2013 Permit Application '1 ; i 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 ofthe 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 ofthe 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 0%vner/Agent Date lDeborcLh 1,. C6k P nt caner/Agent's Name LINDA MCCANDLESS Notary Public - State of Florida My tiu wi. Expires Sep 2, 2017 yi• 0ommnsion # FF50456 y „,``` ,,: n 1 N:A:yh+?,ili,Y•: Go,aryAssn. or Produced ID Type of ID Signature of Contractor/Agent Date Russ, klo es Pri Co tractor/Agent's Name l to a of Notary -State of Florida Date LINDA MCCANDLESS Notarypublic:State of Florida --•- — - i; MY W M!11. Expires Sep 2, 2017 om is, FF 50956 Contrac o{Qge t i "'" P&' bhAllyl Kho*tt Me or Produced ID Type of 1D BELOW IS FOR OFFICE USE ONLY Permits Required: Building Electrical Mechanical Plumbing Construction Type: Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: Gas Roof Flood Zone: of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes No WASTE WATER: BUILDING: Revised: June 30, 2015 Permit Application I I!1 III IH111,11MININNINII THIS INSTRUMENT PREPARED BY: 'F:?='.{' ',;;= °` r 'hl':fai •:u+ if i Name: LINDA MCCANDLES,S,i(}s_'i iAddress: 495 N HWY 17-92, STE#103 LONGWOOD, FL 32750 ;.LE,RK'$ r 217116004414 NOTICE OF COMMENCEMENTt-i Permit Number: Parcel ID Number: 10-20-30-511-0000-1160 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) LOT 116 STERLING WOODS PB 54 PGS 93 THRU 95 149 PINE ISLE DRIVE 2. GENERAL DESCRIPTION OF IMPROVEMENT: REROOF 34SQ ARCH SHGLS• 3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and address: DEBORAH L COX, 149 PINE ISLE DRIVE, SANFORD, FL 32773 Interest in property: FEE SIMPLE Fee Simple Title Holder (if other than owner listed above) Name: N/A Address: CIZJ 4. CONTRACTOR: Name: RUSS NOYES ROOFING INC Phone Number: 407-388-7700 Address: 495 N HWY 17-92, STE#109, LONGWOOD, FL 32750 5. SURETY (If applicable, a copy of the payment bond is attached): Name: N/A Address: Amount of Bond: 6. LENDER: Name: N/A Phone Number: Address: 7. 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)(a)7., Florida Statutes. Name: N/A Phone Number: Address: 8. In addition, Owner designates N/A of to receive a copy of the Liendr'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) NIA 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. Signature of Owner or Lessee, or Owner's or Lessee's (Print Name and Provide Signatory's Tide/Office) Authorized Offoer/Direct&/PaMer/Manager) State of ' i 1 :' County of\ 7Y, \f)o— The foregoing instrumeent was acknowledged me this 1 day of S / N U L IC Y , 20f by ) F r t1 liQ Who is personally known to rn LoNamo'of person making statement who has produced Identification type of identification produced: r N.,.,fir„:9c.,:r!bo+_RI iR-dh..,£tt...c'41.. t'"'tr,, LINDA MCCANDLESS 1 •'kttary Pubic . State of Florida i:ly ^fir !:apirts Sep 2, 2017 q' tt•.•of:ryg..v.ucgF•,rriy">'ifb".•iT '7:W,>..rry,»• .e JAM 13 r n Lie#CCC 1326879 Friday, December 4, 2015 Debbie Cox 149 Pine Isle Drive Sanford, FL 32773 407-7194338 We propose to supply all labor, materials, permitting, supervision and equipment necessary to complete the Reroof project for the aforementioned address. All roofing systems designed and installed by our certified installers will exceed the Florida Residential Building Codes and meet the standards of our exclusive Rhino Roofing, Installation System. These systems are in place to ensure you're receiving the highest standard for installation practices in the industry. Remove existing roof system and haul away all debris. Inspect al I wood decking and fascia board for defects. Install new wood decking and fascia board as needed at ( no additional cost) Renail entire roof deck with 2 3/8" 8-D ring shank nails to current wind mitigation building codes. Install sei f adhering underlayment along all eaves, ridges, valleys, hips, walls, and penetrations. Install newprepainte'd 2 Y2`fact cave drip -_-- — -- -- ---- Install new 16" metal'flashutg in all roof valley transitions. install all new lead pip boot'llashings Willi squiirel guard's and filii vents: Install 30 feet of"cap over" style ridge vents for proper attic ventilation. BARE BONES PACKAGE: GAF ('Timberline HD ) %yyith 30# UL rated felt underlayment and a ( Systems Plus ) Lifetime warranty. 10,610.00 WC, (initial) or $ 336.00 per month (initial) PREMIER ROOF PACKAGE: GAP ( Timberline I -ID ) with Tiger Paw synthetic underlayment and the( Golden Pledge )Lifetime warranty. 11,970.00 ( initial) or $ 379.00 per month ( initial ) Contractor will clean up all debris and magnet sweep work area at the end of each work day. Lifetime Workmanship and Leak Guarantee with continuous Overhead Care Club Membership, And _IOYear_ without membership. ALL PAYMENTS ARE DUE UPON COMPLETION. ALL PRICES ARE BASED OFF OF CASH OR CHECK PAYMENTS. ALL CREDIT CARD PAYMENTS WILL BE SUBJECT_ TO A 3% SERVICE FEE AND ALL MONTHLY PAYMENTS INCLUDE FINANCE CHARGES. Thank You for considering us. Russ Noyes Master Premium Craftsman 495 N HWY 17-92 #1091 LONGWOOD FL 32750 1407.388.77001386.957.4005 1 FAx: 407.388:7701 RUSSNOYES@YAHOO.COM I WWW.RUSSNOYESROOFING.COM Lic#CCC 1326879 ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAW ( SECTIONS 713.001- 713037, FLORIDA STATUTES ) THOSE WHO WORK ON YOUR PROPERTY OR PROVIDE MATERIALS AND ARE NOT PAID IN FULL HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. IF YOUR CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SUBCONTRACTORS, SUB - SUBCONTRACTORS, OR MATERIAL SUPPLIERS, THE PEOPLE WHO ARE OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE ALREADY PAID YOUR CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR, YOUR CONTRACTOR MAY ALSO HAVE A LIEN ON YOUR PROPERTY. THIS MEANS IF A LIEN IS FILED YOUR PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR, MATERIALS, OR OTHER SERVICES THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FAILED TO PAY. TO PROTECT YOURSELF, YOU SHOULD STIPULATE IN THIS CONTRACT THAT BEFORE ANY PAYMENT IS MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE-YOU WITH A=WRITTEN RELEASE--OF=LIEN=--FRONT;-ANYyPERSON=OR -- -- - COMPANY THAT HAS PROVIDED TO YOU A "NOTICE TO OWNER." FLORIDA'S CONSTRUCTION LIEN LAW IS COMPLEX, AND IT -IS RECOMMENDED THAT YOU - CONSULT AN ATTORNEY. Owner Signature TERMS AND CONDITIONS iz-zs-1s Date All materials are guaranteed by the manufacturer. All work will be completed according to standard roofing practices and current building codes. Any alteration or deviation from the above specifications, will be only upon written orders and will become an extra charge item - over and above this agreement. Although we will exercise all due caution, we cannot be responsible for cracked driveways, damages clue to min, hail, wind, or acts of God. Any leaks occurring during the guarantee period will be repaired by Russ Noyes Roofing Inc. Any damages clue -to leaks are not the responsibility of Russ Noyes Roofing INC. ALL SUi4IS NOT PAID WHEN DUE SHALL EARN INTEREST AT THE RATE OF 1!A% PER WEEK UNTIL.PAID AND CONTRACTOR SHALL BE ENTITLED TO RECOVER ALL COST OF COLLECTION INCLUDING ATTORNEY'S FEES, IF CONTRACTOR IS NOT PAID. THE TERNIS AND CONDITIONS SET FORTH ON THIS PROPOSAL ARE A PART OF THIS PROPOSAL. THIS PROPOSAL MAY BE REVISED OR WITHDRAWN BY RUSS NOYES ROOFING INC. IF NOT ACCEPTED WITHIN 30 DAYS. JURISDICTION AND VENUE FOR ANY DISPUTE SHALL BE IN ORANGE COUNTY, FLORIDA. ACCEPTANCE THE PROPOSED PRICES, SPECIFICATIONS, TERMS AND,CONDITIONS ARE SATISFACTORY AND HEREBY ACCEPTED. YOU ARE AUTHORIZED TO PROCEED WITH THIS WORK. PAYMENTS WILL BE MADE AS INDICATED ABOVE. D h- --- x-----_--112--rs _ Sigiiature and Date 495 N HWY 17-92 #109 1 LONGWOOD FL 32750 1 407.388.7700 1 386.957.4005 1 FA: 407.388.7701 RUSSNOYES@YAHOO.COM I WWW.RUSSNOYE5ROOFING.COM City of Sanford IPA Building and Fire Preventionr.:. Product Approval Specification Form Permit # Project Location Address L `3a As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the information and product approval number(s) on the building components listed below if they are to be utilized on the construction project for which you are applying for a building permit. We recommend that you contact your local product supplier should you not know the product approval number for any of the applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product Approval can be obtained at www.floridabuiildin.g.org. The following information must be available on the jobsite for inspections: 1. This entire product approval form 2. A copy of the. manufacturer's installation details and requirements for each product. Category/Subcategory Manufacturer Product Description Florida Approval # include decimal) 1. Exterior Doors Swinging Sliding Sectional Roll U Automatic Other 2. Windows Single Hun Horizontal Slider Casement Double Hun Fixed Awning Pass Through Projected Mullions Wind Breaker Dual Action Other June 2014 wrawauw il Category/ Subcategory Manufacturer Product Description(including Florida Approval # decimal 3. Panel Walls Siding Soffits Storefronts Curtain Walls Wall Louver Glass block Membrane Greenhouse E.P.S Composite Panels Other 4. Roofing Products Asphalt Shingles Tm n rL- inlay-:21 Underla merits 30* Fle- aato FL- Ail Roofing Fasteners n, L : 0 tIz-o3 Nonstructural Metal Roofing Wood Shakes and Shingles Roofing tiles Roofing Insulation Waterproofing Built up roofing System Modified Bitumen GAV L, berz SA, FL - 5 .. 'iZ Single Ply Roof Systems Roofing slate Cements/ Adhesives / Coating i Ar nA1Z 19 AsphA4 &_VAeV4 Liquid Applied Roofing Systems Roof Tile adhesive Spray Applied Polyurethane Roofing E.P.S. Roof Panels Roof Vents Other June 2014 Category/Subcategory Manufacturer Product Description Florida Approval # include decimal 5. Shutters Accordion Bahama Colonial Roll u E ui ment Other 6. Skylights Skylights Other 7. Structural Components Wood Connectors / Anchors Truss Plates Engineered Lumber Railing Coolers/Freezers Concrete Admixtures Precast Lintels Insulation Forms Plastics Deck / Roof Wall Prefab Sheds Other 8. New Exterior Envelope Products Applicant's Signature Applicant's Name R w s s QoHes Please Print) June 2014 1 _ .,. Wes... .,,,. u w a yu wn 1 ''m 'r' v r l .. ,,, r . . SCPA•Parcel View: 10-20-30-511-0000-1160 Page.1 of 2 v,, Drivld Johnson. CFA , Property Record Card PROPERTY Parcel: 10-20-30-511-0000-1160 vAPPRA[5ER Owner: COX DEBORAH L SE: NOLECOUN Y, FLMIDA Property Address: 149 PINE ISLE DR SANFORD, FL 32773 Parcel: 30-20-30-511-0000-1160 Property Address: -149 PINE ISLE DR Owner: COX DEBORAH L Mailing: 149 PINE ISLE DR SANFORD, FL 32773 Subdivision Name: STERLING WOODS Tax District: Sl-SANFORD i Exemptions: 00-HOMESTEAD (2001) DOR Use Code: 01-SINGLE FAMILY d 1A 4- 1418 i Value Summary I 2016 Working 2015 Certified Values Values Valuation Method Cost/Market Cost/Market Number Of Buildings 1 1 Depredated Bldg Value 115,678 111,415 Depreciated EXFT Value 701 751 Land Value (Market) 18,000 18,000 Land Value Ag Just/ Market Value 134, 379 130,166 Portability Adj Save Our Homes Adj 33,529 30,116 Ij Amendment 1 Adj Assessed Value 100,850 100,050 Tax Amount without SOH: 1,827.72 2015 Tax Bill Amount 1,214.82 Tax Estimator SaYeOuCHo1L SaYings:-------:5612,90_ Does NOT INCLUDE Non Ad Valorem Assessments Legal Description LOT 116 j STERLING WOODS PB 54 PGS 93 THRU 95 Taxes c Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund 100,850 50,000 50,850 I Schools 100,650 25,000 75,850 City Sanford 100,850 50,000 50,850 S3WM( Saint Johns Water Management) 100,850 50,000 50,850 County Bonds 100,850 50,000 50,850 Sales 4 Description Date Book Page Amount Qualified Vac/Imp SPECIAL WARRANTY DEED 7/1/2000 03898 1889 $111,000 Yes Improved I1 WARRANTY DEED 3/1/2000 03828 0476 $315,000 No rant Fred Comparable Sales within this Subdivision Land Method Frontage Depth I Units Units Price Land Value I LOT I1 $ 18,000.00 18,000 Building Information E Year Built i' Description Actual/Effective Fixtures Base Area Total SF Living SF Ext Wall ' Adj Value Rep] Value Appendages 1 SINGLE 2000 7 1,617 2,092 1,617 CB/STUCCO $115,678 122,411 Description FAMILYFINISHArea GARAGE 415 FINISHED 1 http:// www.scpafl.org/ParcelDetaillnfo.aspx?PID=10203051 10... 12/31/2015 City of Sanford Building & Fire Prevention Division Re -Roof Permit Card PERMIT NO. I to — 01 W (P ISSUE DATE: elm _ . at _ . 0"h r CONTRACTOR: JOB ADDRESS: TYPE OF WORK: 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 aooroved 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 Miti atg ion 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 11 1 I I li I I I I I I I I It I FTRR TNRPRCTTnVQ CITY OF SANFORD BUILDING 300 N• PARK AVE SANFORD, FL 32771 SALE MID: 9450 Store: 4616 Term: 2902 REF#: 00000003 Batch #. 022 RRN: 601420411677 01/14/16 15:08:53 AVS: NO MATCH CVC M Trans I): 306014725337356 APPR CODE- 880812 VISA Manual CNP 8460 AMOUNT $339.90 APPROVED I AGREE TO PAT ABOVE TOTAI AUOUNT IN ACCORDANCE WITH CARD ISSUER'S AOREEUENT MERCHANT AGREEMENT IF CREDIT VOUCHER) RETAIN THIS COPY FOR STATEUENT VERIFICATION MERCHANT COPY CITY OF SANFORD BUILDING & FIRE PREVENTION6Ns300NPARKAVE SANFORD FL 32771 K 407.688.5080 L-------------------------------------------------- 16-00000268 Date 1/14/16zY' . . . 15,6416 143 ANDREWS RD 18.20.31.503-0000-0470 ription ROOFING APPLICATION SINGLE FAMILY 1 • • • . 8524 Contractor RUSS NOYES ROOFING INC 495 N HWY 17-92 #109 LONGWOOD FL 32750 407) 388-7700 1 000 000 REROOF/SHINGLES FIBERGLASS SHINGLES RESIDENTIAL ROOFING PERMIT 926022 926022 103.00 1/14/16 Valuation 8527/12/16 Qty Unit Charge Per BASE FEE Extensio 9.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 40.0 63.0. Special Notes and Comments All projects within the City shall use WastePro for debris removal. Please contact WastePro at 407.774.0800. Normal hours for inspections are from 7:30 through 4:30 Monday through Thursday. Please be aware you must contact the Building Official to schedule a Friday or after hours inspection. This is required since not every inspector is licensed to do everytypeinspection. Communication is the key, so please contact the Building Official if you have any questions at 407.688.5058 or at dave.aldrich@sanfordfl.gov Other Fees -------------------- 01-APPLCTN FEE -BUILDING 01-BLDG PLAN REVIEW 25.00 01-BLDG DCA SURCHARGE 27.00 2.33 01-BLDG-DBPR SURCHARGE 2.32 ited ----- Fee summary Chargedg Paid Credited Duee- 00 PermitPermit Fee Total 103.00 Other Fee Total 59.65 103.00 00 .00GrandTotal159.65 56.65 00 .00 159.65 FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE-------- PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS. NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED. NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED. CITY OF SANFORD CUSTOMER RECEIPT #+* Oper: SCOTER Type: OC Drawer: 1 Date: 1/14/16 01 Receipt no: 58258 Year Number Amount 2616 266 149 PINE ISLE OR SANFORD, FL 32773 Bp BUILDING PERMIT RECEIPTS189-25 2016 269 143 ANDREWS RD SANFORD, FL 32773 BP BUILDING PERMIT RECEIPTSI.65 AC 990912 h Tender detail #339.90CCCREDITCARD $339.90Totaltendered $339.90Totalpayment Trans date: 1/14/16 Time: 15:89:12 130.25 i E _ uihlti PEfil1lT ftEL'£IPTS CC .AItD I.66 $159.65 To- nr ered $339.90 roWi Payment $339.90 13.39.90 TTanS date: 1/14/i6 Time: 1:r:39:12 4: CITY OF SANFORD BUILDING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: I& - of(¢ (p I,1 ,2 I> S I\L e,-5S hereby acknowledge that I personally inspected Goof dec k nailing and/or Secondary water barrier work at / 199 L c )k t vim_ \So.,N n P—fl 7 L 3 9,7 gland have determined that the work Job Site Address) I' 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 duty shall constitute a misdemeanor of the second degree pursuant to Section 837.06 F.S. et 3-a 8 - i(-q Signature of Contract Date ASS ziZ Y(1, 16a6(?2 g Printed Name of Contractor License # License Type: General Building Residential Q4I oofing Contractor or any individual certified in accordance with F.S. 468 to make such an inspection. STATE OF FLORIDA COUNTY OF e O , Sto (or firmed) and subscribed NO:) before me this day of , 20 by MSQ,3 , who is 0-Personally Known to me or has Produced (type of i e t ication) as identification. c SEAL) ttg ature of Notary Public State of Florida Print/ Type/Stamp Name F"'-rb,, LINDA MCCANDLESS of Notary Public Notary Public - State of Florida My Gumrn. Expires Sep 2, 2017 y:' Commission # FF 50456 Bonded Trrough National Notary Assn. 73