HomeMy WebLinkAbout2830 Central DraClf{ -' CITY OF SANFORD
SEP 2 J 2016 ; BUILDING & FIRE PREVENTION
PERMIT APPLICATION
BY:
Application No: -- C
Documented Construction Value: $ J' ?®O. 00
Job Address: 3O Cep,6 I , 5anQ /7
Parcel ID: 06— 10 — 3 1 — 505 OC06 zOO 70
Type of Work: New Addition
Description of Work:
Plan Review Contact Person:: Vf l'
Phone: 3 J' 3 — Fax:
Historic District: Yes No
Residential Commercial
Alteration kA Repair Demo Change of Use Move
15 --j c le -s
er-
Tittlle: / /
Email: ,Wl fll(O'tYeAbwl/41 JS7 UlC tadl,(a41
Al f
Property Owner Information
Name 1 AISN e Phone: ("y07) -V () - 97 7
Street: 3,7 5 La krn I Resident of property?
City, State Zip: LOV1 wood rG 3),779
r r
Contractor Information
1 10?-d?dONameillArneVIacDic• Phone: %%J "
Street: S MoL-5-Al-e Ln, Fax:
City, State Zip: 0do wCGd, FL -3290 -4 State License No.: (CC056 (3J
Arch itect/Eng1neer Information
Name: to w_
Street:
City, St, Zip:
Phone:
Fax:
E-mail:
Bonding Company: Mortgage Lender:
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. 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.
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
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.
L /
Signa i of Owner/Agent Date
r
Signatur of Contractor/Agent Date
fbvi ) cf— // ,
Print wner/A ent's Name P Print Contractor/Agent's N e
lhtg li
sign1a 4 i atJ Signature of N -State of Flori a I Date
KOBY RAM
MY COMMISSION M FF924596 ry,i 8Y CRAMEXPIREctober05. 2019 MY COMMISSIONS FF924596
q" • E IBES October 05. 209140/)398-0113 F NwryServlcs.corr
140/)398-01 D3 floAdalloroV9WVke.CW
Owner/Agent is Personally Known to Me or Contractor/Agent is V Personally Known 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: 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
APPROVALS: ZONING: UTILITIES:
ENGINEERING:
COMMENTS:
FIRE:
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 9 ?5 -jG
I hereby name and appoint: I&d `/ 9/Z14/ q
an agent of: ry c
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):
l The specific permit and application for work located at:
V 3 v 04-- Nrrrfi1L aVe. 5,or v ret ?2'773
S reet Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name:
State License Number: 6CC' 05-6 6 S" ?--
SignatureSignature of License Holder:
STATE OF FLORIDA
COUNTY OF 5&M 6 X10
The foregoing instrument was acknowledged before me this 0 day of ;
20 f __, by 6oyea A M GN i c 6 who ismpersonally known
to me or who has produced
identification and who did (did no tae oath.
Signatur,
Notary Sea])
KCBY CFWG
MY COMMISSION t FF9245%
EXPIRES October 05. 2019
NQS! -01!y F'brMeNpterygervioe,pr•
Rev. 08.12)
6 bV Cm "q
Print or type name
Notary Public - State of
Commission No.
My Commission Expires:
as
Property Record Card
Parcel: 06-20-31.505-OCOO-0070
Owner: DENLiNGER APRIL
Property Address: 2830 CENTRAL. DR SANFORD. FL 32773
Legal Description
LOT 7 BLK C
WOODMERE PARK 2ND REPLAT
PB 13 PG 73
Taxes
jTawngP thority 1 Assessment Value Exempt Values Taxable Value
0 55,086CountyGeneralFund55,086:
Schools 55,086 0 55,086 i i
City Sanford 55,086 0 55,086 ;
SJW4Saint Johns Water Management) 55,086 0
E
55,086
County Bonds 55,086 0 55,086
Sales
Description Date Book Page Amount TQualrfled Vac/Imp
WARRANTYDEED
W. .... ..... _
6/1/2016 08728 0696 30,000 Yes Improved
QUIT CLAIM DEED 10/1/2015 08588 0240 100 No Improved
QUIT CLAIM DEED 2/1/2015 08418 0304 100 No Improved
QUIT CLAIM DEED 12/1/1993 73 1) 100 ( No Improved
WARRANTYDEED 1/1/1988 01929 0003 41,500 Yes Improved
WARRANTYDEED 1/1/1973 00980 1900 17,600 Yes Improved
f-- _........ ........., _,, .....
WARRANTYDEED 1/1/1973 00080 1700 17,600 Yes Improved
f
Land
Method Frontage Depth i Units
m
Units Price Land Value
1 11111111111111111111111111111111 Iiil fill
THIS INSTRUMENT PREPARED BY: NAI YANNE NORSEr SEMINOLE COUNTY
Name: April Dehlinger CLERK OF CIRCUIT COURT & COM"TROLLER
Address:
FL LK 806 i''y 91?8 (1h'ss)
CLERK'S Y 2016101999
RECORDED 0?/29i2016 10:30:12 0111
NOTICE OF COMMENCEMENT REC:OR(iRIG FEES $1.0.00
RECORDED BY tsmlth
State of Florida
County of Seminole
Parcel ID Number: 06-20-31-505-01300-0070PermitNumber: l
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 its provided in this Notice of Commencement.
DLb pTtLK6pff6B A p dpXKpVUeKff pLyAar pl et 11dZsjjvaiIable)
2830 Gentral Dr. bantord,
ANERA DESCRIPTION OF IMPROVEMENT:
e-roo`f
OWNER INFORMATION:
Name: April Dehlinger aFtME p ltf
Address: 275 Lakay PI. Longwood, FL 32779-1
Fee Simple Title Holder (if other than owner) Name:
we1FDCd
0
pUR A fitAddress: C
LEiky Q"
61Rs UIT G ,rti i wwNCLERK
t.ER
CONTRACTOR: co n?R
EGO'
WR A `
Names• Killarney Contractors, Inc. «N,tNO _
ca
Address: 355 Mashie Ln. Orlando, FL 32804
Persons within the State of Florida Designated by Owner upon whom notice or othe–f-do—cuments may be served
as provided by Section 713.13(1)(b), Florida Statutes.
Name:
Address:
In addition to himself, Owner Designates of
To receive a copy of the Lienor's Notice as Provided in
Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a
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.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true
to the bestIf my krlowled a an belief.
At April Dehlinger
J Owner's Si' ature Owner's Printed Name
Florida Statute 7 3.13(1)(g): " The owner must sign the', o ice of commencement and no one else may be permitted to sign in his or her stead."
State of 00/1'd (/\County of e%'l't"tl0 le
Q j
The foregoing instrulmentasacknowledged before me this day of J C/ `! 120
IC
by J 1 1 ,A /!(G F 1 Who is personally known to me
Name of person making stat ment
OR who has produced identification . type of identification produced:
KOBY CRAIG
E MY;
pC A,c
City of Sanford
Building and Fire Prevention
Product Approval Specification Form
Permit #
Project Location Address ell rd , R- 3' 7 7
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.floridabuilding.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 Florida Approval #
Description 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
lune 2014
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 Owe eflf 1 r Gtr rkl le
Underla ments er N rhodG j
Roofing Fasteners
Nonstructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Built up roofing
System
Modified Bitumen
Single Ply Roof
Systems
Roofing slate
Cements/
Adhesives /
Coating
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 up
Equipment
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
Please Print)
June 2014
RINITY ERDi
EVALUATION REPORT
Interwrap, Inc.
32923 Mission Way
Mission, BC V2V-6E4
Canada
SCOPE:
EXTERIOR RESEARCH & DESIGN, LLC.
Certificate of Authorization #9503
353 CHRISTIAN STREET, UNIT #13
OXFORD, CT 06478
PHONE: (203) 262-9245
FAX: (203) 262-9243
Evaluation Report 140510.02.12-112
FL15216-R2
Date of Issuance: 02/17/2012
Revision 2: 04/27/2015
This Evaluation Report is issued under Rule 61G20-3 and the applicable rules and regulations governing the use of
construction materials in the State of Florida. The documentation submitted has been reviewed by Robert Nieminen,
P.E. for use of the product under the Florida Building Code and Florida Building Code, Residential Volume. The
products described herein have been evaluated for compliance with the 5th Edition (2014) Florida Building Code
sections noted herein.
DESCRIPTION: RhinoRoof Underlayments
LABELING: Labeling shall be in accordance with the requirements the Accredited Quality Assurance Agency noted
herein.
CONTINUED COMPLIANCE: This Evaluation Report is valid until such time as the named product(s) changes, the referenced
Quality Assurance documentation changes, or provisions of the Code that relate to the product change. Acceptance of
this Evaluation Report by the named client constitutes agreement to notify Robert Nieminen, P.E. if the product
changes or the referenced Quality Assurance documentation changes. Trinity I ERD requires a complete review of this
Evaluation Report relative to updated Code requirements with each Code Cycle.
ADVERTISEMENT: The Evaluation Report number preceded by the words "Trinity IERD Evaluated" may be displayed in
advertising literature. If any portion of the Evaluation Report is displayed, then it shall be done in its entirety.
INSPECTION: Upon request, a copy of this entire Evaluation Report shall be provided to the user by the manufacturer or
its distributors and shall be available for inspection at the job site at the request of the Building Official.
This Evaluation Report consists of pages 1 through 3.
Prepared by:
y
Robert J.M. Nieminen, P.E.
Florida Registration No. 59166, Florida DCA ANE1983
The facsimile seal appearing was authorized by Robert Nieminen,
P.E. on 04/27/2015. This does not serve as an electronically signed
document. Signed, sealed hardcopies have been transmitted to the
Product Approval Administrator and to the named client
CERTIFICATION OF INDEPENDENCE:
1. Trinity IERD does not have, nor does it intend to acquire or will it acquire, a financial interest in any company manufacturing or
distributing products it evaluates.
2. Trinity I ERD is not owned, operated or controlled by any company manufacturing or distributing products it evaluates.
3. Robert Nieminen, P.E. does not have nor will acquire, a financial interest in any company manufacturing or distributing products for
which the evaluation reports are being issued.
4. Robert Nieminen, P.E. does not have, nor will acquire, a financial interest in any other entity involved in the approval process of the
product.
5. This is a building code evaluation. Neither Trinity I ERD nor Robert Nieminen, P.E. are, in any way, the Designer of Record for any
project on which this Evaluation Report, or previous versions thereof, is/was used for permitting or design guidance unless retained
specifically for that purpose.
TRINITYI ERD
ROOFING COMPONENT EVALUATION:
1. SCOPE:
Product Category: Roofing
Sub -Category: Underlayment
Compliance Statement: RhinoRoof Underlayments, as produced by Interwrap, Inc., has demonstrated compliance with the
intent of following sections of the Florida Building Code through testing in accordance with applicable sections of the following
Standards. Compliance is subject to the Installation Requirements and Limitations / Conditions of Use set forth herein.
2. STANDARDS:
Section Properties Standard Year
1507.2.3, 1507.5.3, T1507.8, Unrolling, Breaking Strength, Pliability, Loss ASTM D226 2006
1507.8.3, 1507.9.3, 1507.9.5 on Heating
Nail -On Tile Foam -On Tile Metal
Wood Shakes Slate or
1507.2.3, 1507.5.3, 1507.8.3, Unrolling, Tear Strength, Pliability, Loss on ASTM D4869 2005
1507.9.3 Heating, Liquid Water Transmission,
No No Yes Yes No
Breaking Strength, Dimensional Stability
3. REFERENCES:
Entity Examination Reference Date
ITS (TST1509) Physical Properties 100539395COQ-006 10/27/2011
ITS (TST1509) Physical Properties 100539395COQ-002 10/27/2011
ITS(TST1509) Physical Properties 100539395COQ-006 03/14/2014
ITS (QUA1673) Quality Control Inspection Report 11/17/2014
4. PRODUCT DESCRIPTION:
4.1 RhinoRoof U2O is a multilayered polymer woven coated synthetic roof underlayment intended as an alternate to ASTM
D226, Type I or Type II felt or D4869 Type II felt. RhinoRoof Underlayment is available in 42 -inch wide rolls, and can be
produced in various other sizes.
S. LIMITATIONS:
5.1
5.2
5.3
5.4
5.5
5.6
5.6.1
This is a building code evaluation. Neither TrinityJERD nor Robert Nieminen, P.E. are, in any way, the Designer of
Record for any project on which this Evaluation Report, or previous versions thereof, is/was used for permitting or
design guidance unless retained specifically for that purpose.
This Evaluation Report is not for use in the HVHZ.
Fire Classification is not part of this Evaluation Report; refer to current Approved Roofing Materials Directory or test
report from accredited testing agency for fire ratings of this product.
RhinoRoof Underlayments may be used with any prepared roof cover where the product is specifically referenced
within FBC approval documents. If not listed, a request may be made to the AHJ for approval based on this evaluation
combined with supporting data for the prepared roof covering.
Allowable roof covers applied atop RhinoRoof Underlayments are follows:
y r _,r. TAaLE Roo l cai Ott 0' Fria,
Underlayment
Asphalt
Nail -On Tile Foam -On Tile Metal
Wood Shakes Slate or
Shingles Shingles Simulated Slate
RhinoRoof U20 Yes No No Yes Yes No
Exposure Limitations:
RhinoRoof Underlayment shall not be left exposed for longer than 30 -days after installation.
6. INSTALLATION:
6.1 RhinoRoof Underlayments shall be installed in accordance with Interwrap, Inc. published installation instructions
subject to the Limitations set forth in Section 5 herein and the specifics noted below.
6.2 Install RhinoRoof Underlayments in compliance with manufacturer's published installation instructions and the
requirements for ASTM D226, Type I or II or D4869, Type II underlayments in FBC Sections 1507 for the type of
prepared roof covering to be installed.
Exterior Research and Design, LLC. Evaluation Report 140510.02.12-112
Certificate of Authorization #9503 FL15216-R2
Revision 2: 04/27/2015
Page 2 of 3
7.
8.
9.
RINITY 3 ERD
6.3 Re -fasten any loose decking panels, and check for protruding nail heads. Sweep the substrate thoroughly to remove
any dust and debris prior to application.
6.4 RhinoRoof U20:
6.4.1 Fasteners:
For exposure < 24 hours, corrosion resistant fasteners may be 1 -inch roofing nails with a 3/8 -inch diameter head, or
those noted in 6.4.2. The use of staples is prohibited.
For exposure > 24 hours up to maximum 30 days, corrosion resistant fasteners shall be minimum 1 -inch diameter
plastic or metal cap nails or FBC HVHZ nails & 1-5/8" diameter tin caps (with the rough edge facing up). The use of
staples is prohibited.
6.4.2 Single Laver; Roof Slope > 4:12:
End (vertical) laps shall be minimum 6 -inches and side (horizontal) laps shall be minimum 4 -inches. Refer to Interwrap,
Inc. recommendations for alternate lap configurations and/or the use of sealant under certain conditions.
For exposure < 24 hours, use of every -other fastening location printed on the surface is acceptable. For exposure > 24
hours up to maximum 30 -days, use of every fastening location printed on the surface is required.
When batten systems are to be installed atop the underlayment, the underlayment need only be preliminarily attached
pending attachment of the battens on the same day. Battens shall not be positioned over cap nails. If this occurs,
remove the cap nail and patch the hole in accordance with Interwrap published instructions.
6.4.3 Double Laver; 2:12 < Roof Slope < 4:12:
End (vertical) laps shall be minimum 12 -inches and side (horizontal) laps shall be minimum half -sheet -width plus 1 -inch.
Double layer application; begin by fastening a half -width plus 1 -inch starter strip along the eaves. Place a full -width
sheet over the starter, completely overlapping the starter course. Continue as noted in 6.5, but maintaining minimum
half -width plus 1 -inch side (horizontal) laps, resulting in a double -layer application.
BUILDING PERMIT REQUIREMENTS:
As required by the Building Official or Authority Having Jurisdiction in order to properly evaluate the installation of this product.
MANUFACTURING PLANTS:
Contact the manufacturer or the named QA entity for information on plants covered under Rule 61G20-3 QA requirements.
QUALITY ASSURANCE ENTITY:
Intertek Testing Services NA Inc.-ETL/Warnock Hersey — QUA1673; (604) 520-3321
END OF EVALUATION REPORT -
Exterior Research and Design, I.I.C. Evaluation Report 140510.02.12-R2
Certificate of Authorization #9503 FL15216-R2
Revision 2:04/27/2015
Page 3 of 3
Kieea 'mey 00Mtractors, File. Florida Certified; Roofing License # CC C056852
355 Mashie Lane Orlando FL 32804 Florida CertifiedBuilding License # CB 0045636
407-254-0877 – Fax: 407-254-0876 - Cell: 407-908-2820 e-mail: kcigm@bellsouth.net
PraP09440 8 00i"tiact
Proposal Submitted to:
CUSTOMER: ADDRESS: CITY STATE: ZIP PHONE #:
SCOPE OF WORK: 2 year warranty on workmanship; see manufacture's specific material warranty
Sloped Roof:
K Remove existing roof covering to sheathing and re -nail sheathing to 2014 FL building code
Install ASTM approved synthetic underlayment; Install "peel & stick" Secondary Water Barrier
Install standard 30# _ felt underlayyrn``ent; Install ridge vent; 4' off ridge vent; _ bath vent; _ kitchen vent
Install new lead vent stack covers; ! Install new galvanized metal drip edge color TBD
Install 3 tab fiberglass; 25 year _; 30 year _ shingles — color TBD
Install Architectural "Limited Lifetime" fiberglass shingles — color TBD
Install `other" type of shingles the metal
Clean site and remove debris
Remo existing roof covering to decking and re -nail sheathing to code
Install 43Wbase sheet; Install galvanized drip edge (color TBD)
Install TAS Modified Bitumen System; Install SA SBS Modified Bitumen system —granulated with color TBD
Install built up f systems with:
Install 75 ase sheet; Install plys of ply IV or ply V
Install galvan d gravel stop and flashing as required; Install pitch pans _; drain covers ; scuppers _
Slag roof with ro ' stones (400 lbs. Per 100 sq. it.)
Install lead vent stack covers bath vents- ; kitchen vents color TBD
Install IPO; EPDM; _ P Urethane; Acrylic Single Ply System
Clean site and remove debris
NOTE: Access to the building is implied. We WILL inspect the decking, fascia and rafter tails for existing damage: if found we will
replace the damaged wood at a rate of $ 35.00 per man-hour plus material cost. This amount will be above the Contract Sum stated.
WE PROPOSE to furnish material'and labor .for the above-specified work for the sum of
Dollars ($
Payment Schedule: t/ -°d -y d•r g'yv
This proposal is good for 15 days and may be voided thereafter at the option of the contractor. All material is guaranteed to be as specified. All work will be
completed according to standard building practices and in a timely manner. Any alterations or deviations from the above specifications involving additional costs will
be executed upon oral and/or written orders and will become an extra charge item over and above the Contract Sum, Although we will exercise all due caution, we
cannot be held responsible for breakage of sprinkler systems, or cracked driveways and/or walks.
Acceptance of Proposal: The above prices, specifications and conditions are hereby accepted. Killarney Contractors, Inc., is authorized to do the work as
specified. Payment will be as noted. I agree that if Killarney Contractors, Inc., is required to take any action to enforce this contract,1. shall pay Killarney Contractors,
Inc., attorney's fees and costs, whetter or not suit is fled. Ventre in any lawsuit shall be in Orange County Florida. The Owner also agrees to pay 1.5% interest per
month on the unpaid balance. A /'
Accepted By: k --1E Date: —1/A 9/11
Submitted By: Dater /6
City of Sanford
Roof Permit Application Checklist
All permit application packages must be complete prior to acceptance. You must check each box to the
let or indicate n/a on this submittal. A complete application package shall include the following:
Building Permit Application completed, signed and notarized. Application must include correct address
and complete parcel I.D. number.
Copy of applicable contractor's license issued by the State of Florida (if the contractor is the
applicant).
A site specific notarized power of attorney shall be required from the licensed contractor if
he/she appoints an employee of his/her company to sign the permit application as the contractor.
Certificate of insurance indicating worker's compensation insurance coverage and naming the City of
Sanford as certificate holder, or a copy of a worker's compensation exemption issued by the State of
Florida (must be submitted with each application if contractor is the applicant).
Completed and signed Owner Builder Statement / Affidavit (if the owner is the applicant).
These guidelines were compiled to assist the applicant in preparing a roof permit application and may not be
complete. The applicant is required to meet all City of Sanford, state, and federal code requirements.