HomeMy WebLinkAbout2020 William Clark Avelil—TA W V+n PF"3 LIMIM IL
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
F
Application No: r _ q (710
Documented Construction Value: $ To. oQ
Job Address: V V 1 (k1QV'AClilft AK Historic District: Yes No
Parcel ID: 3 (p - q - 15ab - Q=D - L-)q 0 Residential R Commercial
Type of Work: New Addition Alteration'N Repair Demo Change of Use Move
Description of Work: e- V-04 dcpU 0(0 agT9=b l 1q6 -FL `,2
Plan Review Contact Person: SQ((Q( rn f V Title: 1
Phone• 4y_ a ]&_ 2W Fax: - Email:
w
Property Owner Information
Name .Y as Phone:
Street: at)C-0 \, M A1M QCI G ffitf Resident of property?
City, State Zip: Saya i E-&,
Contractor Information •
p
Name art CC6DMT-CCCfDC Phone: bq a 1 S' -7 ! U
Street: % ae Fax: X6 a - 3 3 3- 3 3 lei
City, State Zip: %la t7d o pt _ Sagd--T State License No.: CLL 13a'qWJ
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. 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. 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: 51h Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records of this county, and there may be additional permits required from other governmental entities such as water
management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permit Submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual constriction 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 Date ignature of Contractor/Agent Date
Print Owner/Agent's Name Print to rac r/Agent's Name
yx—
Signature of Notary -State of Florida Date Signature 14ota -State oMorida Da
BRIANA MCCLEAN
MY COMMISSION # FF9d25 88
EXPIRES December 13 2019
t40r)393.01p1 F1orW Notn Semcectxr
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Kn wn to Me or
Produced ID Type of ID 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:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
lasperContractors, Inc• 53g0 );.
Culwninl r. p1 "- !
S /r' f Accmnnthln1rHgai""(!tip .5=-•• •-7 Orlmufo,
F1.32807 4P7)
27s•7711 Insurance c--alllmr:wv Inforu,ntion Jaspe
337-
33G1 Fes JasperRt
ufcuru AiJt-( D(J/I fX:Q Ihdicy N / z. JASPERs- mforriittspcn
nn i urg gy —,S — n i.rw.n°nr uo-n Clmm 4SCgQG 5 %r` .-... 2
l 7r j`j C'umrecyor 1I (9 s (•itcnrc n (((I lieocl rVISA
O
Jlnrt='a='e (:Oat rota lorormalion Company
Owners /
r`" — RUUI kI;I't,A('1i 11;\`I' ('ONI RA(,— I
Pan Noodle] nttrnone:
Ent"
a'il -b
i/
Shin le ColiroRoof RCV(.j)m r)) /1Drip ! Imurnocc
Conr into' furs nnf a MU00
sgnmrnt
ur Insurance Itcnefih far rhr pull Ranf Rcpincenhcnt Onlyfl hrrch vsi'nan}a-this
contract nd
all msuranccltiglns Ixnetitsall betmttlpnxcrtlJondcranynpplll0instuancepoliciestoJasperCodmctors, Inc. (•'Jae IlalkeChicaSSlgnn,ent a scone
Orikillih shall tic y
Ind
nutho,izntimn in consi Imitron of Jasper's ngr.e ncntlthrterl rm sea a > supply mntrndted to s anJlr tloor cnt7tscpprrformttl6obligationsunderthiscontract, including no reyurring till lennnent nt the Inns ofiserv"cc I all') hcrrhy darer my insurer(s) to rcle.nsr ant= ani' idi ""'notationrss
rcyucstcd by Jasper, its rcimseutnuve. or its :nlorncy for dnr direct purpose of obhY dig equal Ixner(s to Inc paid by in, inaurcr(
s) fix services rendered.
In this reveal, 1 waive 111). ,
naic • 1, plus Ir w_nnem it made ducal} to the Ur.ucrl;\bent, s
to h t
p
a ,
h% , endorseduser,, lasper inuncdratcly upn rcrri n. I a •her that any ,mhrnh M`w. k, do 'na(le cs,
betterment rn additional am k reyneslcd b} Qr undersigned. not n)vcrrd by insunncc. must hctp od by the Undersigned on the day of raaall les, Urrluctible: 1 is the x ttmItion
munt• ns stator 1sur r' YLSINImic , Ip rj • oft hlpllrlh CI CI1(I tenhleY (itt rrf S orrt-lri•prH 1 Ct CCprO C 1VdI nOt rlleed the dl'(11lCIIbIi onmaurer's loss sheet, UNI_I:SS rtyrlaccncemlrepai, of drhrnmrmcd dttikmg is required :uufor Qunrr requests apurm:l tnpgrndcs• dusper CANNtT pay,
waive. rebate, or promise In pav, x;dr'e nr abate all nr ran part of the Insurance cdeductiblerques s pbcrbli to
dro insurance claim fix pa}lnent of work. h, tlhe event of a I Isc,epancy,
the deductible amomt stated on the insurer's Lu„ Sheet chat Deductible. 3overrule Ucductil)Ic lintel above. D
Jasper
on Ct3
s
1'110RlVw%'PION: I, O%vo rlWlralg:hgur, grant audurrirauon lur 1L:ST Ill: PAID 1\ FULL, 1'LCS Jasper
on matters including• but not linnitcd to, the claim and draw Sloane PAl'D1EN F SCI11%DULE: Ouatar agrees
to pay J:utxr based on the fidlorrin . u lil, %
ia r lortgugr
CO. to easel r,nl n appiupolsigning
this contract; {ii) rhr Coalmen Prier. Ira+ he UeptnIt and any applicable dcprtrmuon rctmncl by O,.urr's uradr plot 61 Y
schedule, UI Dcposn m the atnPunt$ _ (tniti:df IJpgIcab Costs- due and pa}:nblc m Jasper upon completion ot'rvork beinb perfermcd; tool. (tit) rhr rcmauning Contract 1'r,cc (cctual u+ on( out Oapplicabledepreciation
nsinnrL'or chnngc txdcrs) due and payable to Jns Jasper uptic tal:
no msrre L.' 12°
0 of C oamcr Ilurcr_- may
bewithheld until insp lion has passcvlP poi complcnionofntxkprrfannrdInrhreventof :rOptional: UPCIIL\D ITL:h1:Replacement e
orklabo
two Price: Us:rpprosaland
subjrxt (o tine ienns, couchhn h`erein, as per I pRicr
S- /d r()TAt. 5.. ^' At. - andprovidethelabornecessarytoperformtheFuRroofreplaceneatwhichShulltakeplacefollo,ung (hrtter's agreestcmnprunv s apprUwa approximately within
30 days, conditions permining per mires
insurance fl
amen ;
ill mmcn a ( Owner'
srmdie
roof a Intent: tuner acknoulcdbcs and agrees that, ulxan approval by imurance cotupan} for a full nooCrcpfacrment. Jngx^ shall performil]e rrxrf replaccmenl upon reecipt of funds from tamer's Insurance cmnpan;. CANCELLATION: ifOwnerelectstoterminatethesenicesIf .lasper. tuner may do str before midnight un rhr third 6usinesc clad after Contractisexecuted. Owner shall receive a full refund of all deposits, owner may also rescind Contract btrure midnight an flit. third businessdayafterthecontractIsexecutedafternotirncatiunfrominsurer(s) that fhe clninr far pr}mint tin roof irribu contract
ha.
hreti denied, a
whole or in part. All written notices of cancellation, regardless or reason, shall be postmarked or delivered to Jusper• corporate office: 1955 Vaughn Road, Suit notices 209,
Kennesaw,
CA 30144. CANCELLATION EXCF.pI'IONS: The three (3) rtuy ri(;h, d' cancellation DOESNOTAPPLYt(fcontracts for emergency home repairs us tune is of the essence. 1, Owner, have read and understand all statements. terms and conditions of the "Roof Replacement Contract" and agree that ad details areacceptableandsatisfactory. I further understand that this contract constitutes the entire agreement between the parties and that anyfurtherchangesoralterationstothiscontractmustbemadeinwritingandagreeduponbyhull, parties. rash part' represents aarrantsto
the other that it has the full power and nuthorhy to enter into the contract and that it is hindimt an cabl rccardancc.
rwithits
terms. 1. !011 AuthcperRepresentative
the Miter Date TIONS: Accef TtTERM '`AND CONDIptance of I, OwUcr, hereby agree to retain Jasper for a full roof replacement oo die tenus all l$ conditions siated herein. f further
agree to provide Jasper with the Scope or Loss Report generated by my insurer and authorize and gram full access to the property forthepurposeofsingingandcompletingnllagreeduponwork. Supplemental Claims: Jasper reserves the right to rile l; supplemental claim with 0\vller'
S insurance in the event that the estinwte is incorrect andfor additional d,'una;c is discovered AP Scanned by CamScanner
Altamonte Springs, Casselberry, Fake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 2- --S--
I hereby name and appoint: Samantha MtuTay
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):
O The specific permit and application for work located at: _t
Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name:t rf , (,14 (A 9. — 5-tf p q erg
State License Number:
1
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before me this day of ,
200 , by who is o personally known
to me or o who has produced as
identification and who did (did not an oath.
4.
Si a
Notary Seal) 4"na`C(eyt
Print or type name
BRIANA MCCLEAN
MY COMMISSIor4 # F0942988 Notary Public -State of
EXPIRES December 13 2019 CorilnliSSlOri NO.
4! FWw r+a •`°" My Commission Expires: i40h 39a•0 '09
Rev. 08.12)
0
I'i 1 ifllil 1!I!I II!!! Illil Iflii itlll 1i11 lltl
THIS INSTRUMENT PREPARED
1(
BY:
JName: VIM? - C ^ h"Mc, CfD rS LI -loci L4Address. 5380 E COLONIAL DR OR" ANDO FL 32807
NOTICE OF COMMENCEMENT
Permit Number.
MARYANNE MORSEr SEMINOLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLER
BK 8629 P9 L04 (IP9s)
CLERK'S T 2016013477
RECORDED 02/08/2016 10:45:06 AM
RECORDING FEES $10.00
RECORDED BY hdevoi-e
Parcel ID Number. ID-1 G 31) -`)W 1- 0 ro -- ocl 00
The undersigned hereby gives notice that improvement will be made to certain real property, and In accordance with Chapter 713, Florida Statutes, thefollowingInformationIsprovidedInthisNoticeofCommencement
1. DESCRIPTION OF
of the Property and street address If available) 1 , r
2. GENERAL DESCRIPT)ON OF IMPROVEMENT:
RE -ROOF
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT -
Name and address:
Interest in property:
e. '-CMrT cd "EC -?--)- 7 7/
Fee Simple Title Holder (if other than owner risted above) Name:
Address:
4. CONTRACTOR: Name: JASPER CONTRACTORS Phone Number. 407-278-7788
Address: 5380 E COLONIAL DR ORLANDO FL 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 may be served as provided by Section713.13(1)(a)7.. Florida StabAus.
Name:
Phone Number:
Address:
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.
Signature of Owner or Lessee, or Owner's or Lessee's ° (Print Name and Provide Sigmtorys TttielOrfice)
Authorized 0MCedo1iador1PatWNffM9er)
State of FL County of SEMINOLE /
The foregoing Instrument was acknowledged ( -before me this \J day of f'I/ g-
by_ °'1 c - n .Lf aS kt,(- Who Is personally known to me O OR
Name of person ITWW g ctatemo ,
who has produced Identification 6 type of identification produced: DL
SAMANT HA MURRAY
MY COMMISSION # FF944322' j
EXPIRES December 165019 I
W
6Rflt°
tEBEr--
SE F
CLERK OF
COMPTRO
SEMINOLE yrit i tieZ®18 By DEPUTY CLERK
Florida Building Code Online
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Jr .t
FL #
FL3794-R4
Application Type Affirmation
Code Version 2010
Application Status Approved
Comments
Archived
Product Manufacturer
Address/Phone/Email
Authorized Signature
Technical Representative
Address/Phone/Small
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 the
Roofing System
Certification Mark or Listing
Miami -Dade BCCO - CER
Miami -Dade BCCO - VAL
Standard
Miartil-Dade TAS 100 (A)
Year
1995
I , .. :d +ttr sera. :N •.•I,, try; :Y
llttP://Www.floridabuilding.org/pr/pr_app_ dtl.aspx?param=wCTF.VXO utn„epeyot,v-..---nr . r...
u
1 aan>= ``
c
MUIXII-DADS COUNTY
BUILDING AND NEIGHBORIIOOD COMPLIANCE DEPAR7:N•IENT (BNC) PRODUCT CONTROL SLCTIO,V
130ARD AND CODE ADMINiSTRA770N DIVISION 11305 SW 26 Street. Room 203
Miami. Florida 33175-2474 NOTICE OF ACCEPTANCE (
NOA) 1' (7S6) 315-2590 F (786) 315-2599 waw mi•mid•
u1e uv/builtlino/ Lomanco, Inc 2101Westmain
Street JacksonAlle, AR 72076
SCOPE: This NOA
is
being issued under the applicable rules and regulations governing the use of construction materials. The documentation submittedhasbeenreviewedandacceptedbyMiami -Dade County BNC` - Product Control Section to beusedinMiamiDadeCountyandotherareaswhereallowedbytheAuthorityHavingJurisdictionAHJ). g ThisNOAshall
not be valid after the expiration date stated below. The Miami -Dade County Product Control Section (In MiamiDadeCounty) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this productormaterialtestedforqualityassurancepurposes. If this product or material fails to perform in the acceptedmanner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the Ilse of such product or material within their jurisdiction. BNC reserves the righttorevokethisacceptance, if it is determined by Miami -Dade County Product Control Section that thisproductormaterialfailstomeettherequirementsoftheapplicablebuildingcode. This product isapprovedasdescribedherein, and has been designed to comply with the Florida Building Code including the HighVelocityHurricaneZoneoftheFloridaBuildingCode. DESCRIPTION: 135 Roof
Vent, Lomancool 2001) Power Vent LABELING: Each unit
shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved", 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 theapplicablebuildingcodenegativelyaffectingtheperformanceofthisproduct. TERMINATION of this
NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any sectionofthisNOAshallbecauseforterminationandremovalofNOA. ADVERTISEh'IENT: The
NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration datemaybedisplayedinadvertisingliterature. If any portion of the NOA is displayed, then it shall be done initsentirety. INSPECTION: A copy
of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall beavailableforinspectionatthejobsiteattherequestoftheBuildingOfficial. This renews NOA#
06-0501.11 and consists of pages I through 4. The submitted documentation
was reviewed by Alex Tigera. MIArtEwE COUW NOA
No.: 11-0602.02 tNEW Expiration Date:
08/17/16 Approval Date: 08/
17/11 Pane I of
4
ROOFING COMPONENT APPROVAL
RoofingSub -Category: Ventilation
Material: Aluminum
TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT:
Test ProductProductDimensionsSpecificationDescription
135 Roof Vent, 9" x 28.5"
Lomancoo12000 Power
Vent
MANUFACTURING LOCATION
1. Jacksonville, AR
EVIDENCE SUBMITTED:
Test Aaencv/Identifier
PRI Asphalt Technologies, Inc.
TAS 100 Powered Roof Vent, with fan and
thermostat with a aluminum hood.
Name
TAS 100(A)
Report Date
LOM-011-02-01 04/05/06
M AM1•oUNTY NOA No.: 11-0602.02MEMOExpirationDate: 09/17/16
Approval 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 [tole 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. Fastest the base to roof decking atcorners, and approx. 4" o.c. I" from the outside edge of the flange and I" fromstackevery45' with approved roofing nails, keeping heads of nails uuder shingleswherepossible. Use a minimum of 32 nails and shall be of sufficient length topenetratethroughroofsheathingaminimumof %". See details drawings herein. Seal all seams and nails with roofing cement.
Net Free Area: Refer to manufacturers published literature
LIMITATIONS:
I . Refer to applicable building codes for required ventilation.
2. 135 Roof Vcnt, 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. 4.
135 Roof Vent, Lomancoo12000 Power Vent, shall not be installed on roof mean heights greaterthan33feet.
5. All products listed herein shall have a quality assurance audit in accordance with the FloridaBuildingCodeandRule913-72 of the Florida Administrative Code
MIAMI•DApE :OUNW NOA No.: 11-0602.02
Expiration Dine: 08/17/16
Approval Date: 08/17/11
Page 3 of
ri
DIE TAIL DRAWINGS
135 Roof Vent, Lomancool 2000 Power Vent
H nItT } 17Ers REQ C'fSCRIFTICN
U"<Ct—g[tt
0701-5.^,7 2
I UGv£ C32t'302:• x 28--Ct x 2350 tl t:SQp
070I—:if}.3
r
1
P.AFE 0.S7t.r..r•.:•+g x JA x 5OW —0 AL I;Ix
U•1'(:—bit 4
R: RaSHIELI; r•7i:;97L ;: 19 !,il x 15 -J) °•—t) AL y;-S i
0701-507 5
S
t
HHACKCT 16 CA Y 129 tt 1 *0 CALV. >TEEL 98p
SGREEI, 02E9 x 5 r .tT 375—azs MESH 0ERM—A—Kr.TE404001,SS r 17 @1VE7 1j'o2 'e 7/.i? • :AL IM AL 1L';+
t?JU221 7 i CREW t /:' HWUtt.t TY"EM "AT' ANC KT END
OF THIS ACCEPTANCE NOA
No.: 11-0602.02 h11AM1DADECOLINTY )
aspiration Date: 08117/16 Approval
Dutc: 08/17/11 Page
4 of 4
Florida Building Code Online
th . • :s1..."s ',.,-,., try,.. ;i .h .t4 : `f' .r:
rii tiLld r1;3f11t,.nlrt BCIS Home ^ -
u
of - lOq In user Registration Hot Topics Submit SvrdrorgeBusines • & )
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of 3 vd
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goprQval N 1t > Ftpiva or gORGcatlon 3f
CY a
cb >g npli i 1 n US > Application Detail Ir
Y Pal
NORe 4M FL3792-R6Affirmation ApplicationTypeCode
version Application
Status 2010
Comments
Approved Archived
Product
Manufacturer Address/
Phone/Emall Inc 1
210101We 2WestMainJacksonville, AR
72076 501)982-
6511 acarter@lomanco.com
Authorized Signature
Andrew Carter
acarter@lomanco.com
Technical Representative
Address/Phone/
Email Andrew Carter 2101 West
Main Street Jacksonville, AR
72076 501)982-
6511 Ext361 acarter@lomanco.com
Quality Assurance
Representative Address/Plione/
Email Andrew Carter 2101 West
Main Street Jacksonville, AR
72078 501) 982-
6511 Ext361 acarter@lomanco.com
Category Roofing
Subcategory
Roofing
Accessories that are an Integral Part of the Roofing SystemComplianceMethod
Certification Mark
or Listing Certification Agency
Validated By
Miami -Dade BCCO - CER Miami -Dade
BCCO - vAL Referenced Standard
and Year (of Standard) Standard Year
Miami -
Dade
TAS 100 (A) 1995 Equivalence of
Product Standards Certified By
http://W
vw.floridabuilding.org/pr/pr app_dti.aspx?naram=wC;Fvyn..,tr,%-- n, _
City of Sanford
Building & Fire Prevention Division
PERMIT NO.
CONTRACTOR%
JOB ADDRESS: C
TYPE OF WORK:
Post this Permit in a conspicuous place o
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 apl
Re -Roof Permit Card
ISSUE DATE: aq. 0 4? •
PROTECT FROM WEATHER
A ROOF 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 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 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 . . . . .
Property Address . . . . . .
Parcel Number
Application description . . .
Subdivision Name . . . . . .
Property Zoning . . . . . . .
16-00000446
2020 WILLIAM CLARK AVE
36.19.30.520-0000-0900
ROOFING APPLICATION
PINEHURST
SINGLE FAMILY
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Date 2/08/16
Additional desc . .
Phone Access Code 928127
Permit pin number 928127
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 / /
t-i
i
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: I l , 4 q o'
I, '58 . Y-3 25 V hereby acknowledge that I personally inspected
Roof deck nailing and/orKsecondary water barrier work
at 90 9_0 V Vl\U_,M (a)Jk - 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 erein are true and accurate to the best of my belief and that I fully
understand that making any filse statements in writing with the intent to mislead a public servant in the
performance of ' o ` o icial duty shall constitute a misdemeanor of the second degree pursuant to
Section 837.
Si!ature of 6ontractor vl._ Date
T',
xjt (f 2,1 6S'I
Printed Name of Contractor License #
License Type: fl General BuildingBuilding>6 Residential'_[N&oofing Contractor Li
or any individual certified in accordance with F.S. 468 to make such an inspection. STATE
OF FLORIDA COUNTY OF —SCM . Swo
n to (or affirmed) aqd subscribed before me this day of ab , 20 I (, by who
is Personally Known to me or has'Produced (type of identification) -
V as identification. SEAL)
nature
of Notary Public State
of Florida Print/
Type/Stamp Name of
Notary Public ;;P SAMANTHA MURRAY My
COMMISSION 0 FF944322 EXPIRES
December 16, 2019 40/
388-0'S3 fbrftlallou 9ervlpo. Revised:
February 2015
f
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: Z -`f- - ( U
I hereby name and appoint: Jimmy Allen, Scott Meixsell, Luis Rios
an agent o£ 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 s ecific permit ands application for work located at: Hr-ac,\ -1r\1(ll n knn ( ira <<
Expiration Date for This Limited Power of Attorney:
License Holder Name: KI IJ rl 3Ty-Pta e4d
State License Number:
i
Signature of License Holder:
STATE OF FLORIDA
COUNTYOFF The
foregoing instrument was acknowledged before me this 0 day of.2_=,b , 201
a, by M,,'C O, t 0 Ss -p Inman who is o personally known to
me or o who has produced as identification
and who did (did not) take an oath. signature
Notary
Seal) 4':
SAMANTHA HURRAY I••"` '
R'
MY
COMMISSION # FFS44322 EXPIRES
December 16.2019 a
440i1398-
0'b3 Fbr4y40t&SONka.eom Rev.
08.12) Print
or type name Notary
Public - State of l Commission
No, f (3 a My
Commission Expires: -((o (Q