HomeMy WebLinkAbout102 Maplewood DrNov. 22. 2016 2:31 PM SENEZ ROOFING No. 6525 P. 2/6
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CITY.OFUNP RD
B�1LQING &:FjR RRVENTIdN
I7 APPLIaATION
.. �v�curjien�edC'onstj�lcct'ign:VATv�1 �, `7� � .
Jbb A,ddSrOit .� fY ,�1>r�ol�( J) r.. HistOr�C�istcictr.�tes.[� 'Nti []
RWdejmt!k1 Commercial.
Type of 1'Vprla New 0 ,i4ddifiq>t. Itersfn .telraiC emo:1. hngk* Q><'Use ❑ Move
Descript`iori,of•Woi.kt .�1'✓ P lI
PlanRolt c.offcactPerm
.. ...... 'Title;
Phone:....Fax; _ tmai1:: .
Prop�rfy'�.wn�!t�lnfa.Ima�iotl� � . � •• .� � .' � .
risme: _ .pAline;;-7--� '7 3--(� Sq�
:Street: Vim) �'' • 'Re3tdetiXt ol'�rppet•ty?
' � � t:csr.IfratatiTl�rifo�rnafion � ' � � ..
S:tre'st': 1' u'
•c►ty,•sftlt� zpl. • . .
Statoticense
'Infgi�r�iatlon �� �'
`street: ._ � ��.. � :._.__........._:.._:... �?ax=•� , � � : .
Cityr -Stl Zip:• �'-mnil: .
Sonditig :CotnpAny:. go" eLen tlir:
Address: Address;
WAP.M. TO OWNAlt: YALiR�Ai�I:OKI3'Cd 1ZB�d1�A A�'NQ`�I�`Eo.t?F CQNIIYtRKCEn�9N`#`KAY�9U4�T IN YOUR
UYIND -T IM k,0 !KP9 '1�'�. K.F•l'4xS TO X1011.1 RRort .-TY. :4 NOTIC -ft.:COIvIMI;NCEMEN7' MUST BE
RECORIIED'AND~AOSxED QN TIIL;�OB:61'I'1$EROItI';1'A>�FIRSI.INSPLG'1'ION.,IF �iOU INTEND ?0 OBTAIN
FINANCINGr CONSULT WITH YOUR LENDEW OR AN &T..r0AMDY- DE110IMMECQ13RI.NG YdUXi. NOt1'ItrE '0r
•coM�»1��I�1�`.
.A}rplidstitnt is lterobjranx8e. to o61aiD •a geriniCio .tlu ttit: wok andipsiullaticrtti:nz•flidl�afed: I• aertitX tltat:nt) work�or.lnsttillation;has
svmmenc_ed prior io 4ht: isivanct d►Fa:pt Emit �gd'iKet all work v�ill b's Qerfoto:ed tn.meet;stapdards`af a11:1aws asgula4rng.ognstcuction
:10 thin j4d,poictio'ry 1. understand •tl►ol:.n: AapArAtp. p¢�mtt 1nuatsbe i��ufe� `r0 ll��tMCg .}Y4IIS; .p�ilinf;ing, slgrii, Wells, h0019,
`tornnces; boilers; beaters; tnnk�; Arid oit ceriQitionetr;:eta:.
"C,1114.1 Stell bf inleriNed iv .tbe,d4te. Qf sppliFgt jon•a!!4 Ibe cpdo in•eftfet ss•of that ostc: Vk..jdition (,2914) Florlda Building. Code
Rlyiset Tyne JO; "..IJ PAYIt AO it:alion
Nov. 22. 2016 2: 31 PM SENEZ ROOF [N6. . No. 6525 P. 3/6
'SQECE:Yn edditien to -the 4reqtfireroent90'thls odxmit; tiieie:rn 08 illdtio>la1 �e trioti it3.ap liC�lj(s to•,tliu ptbpet�y'th6t'm ' be
found in the imbliic records of this county, and there may be.adtlltfoital.perhiitt requited f'om.olher-ovenlmewal endtibS gttch as watat "
managemenl.districts,. state:aseoeibs, pr' federar.agenoies. -
Acclotance.of" rmitis.vefitiiptiairlltotPwllfiddlythepwnerpftlLeorppert' * lhe:requfrempx%ts'ofFloiWaImnlaw,W713.
The City o££Sanford'requires payment oi''a•plinseview feo at•theillme bf permit submhtJt..Atopy. of:the,:executed contrsct(s iequjred'
in order toval'eailate a pian revJew char a and'will be considercir tc•edimsted tonsuucticin yalue a%ihojob at thenime of submittal.
Thn actual .0QUI gWO.A•Y.elue v4AE a Ogurcd Wed wn: helcutrect•10 Valuation:Tablain<effect.,et:thollinw4ha permii is,issued, lit
cr:eo'rdgnce• wff i jorp l otdihauca. '•8boit14 Agured -off Aq-executetj'.eontron-.'excee0hcectytil constntAon valve.
credit wlh.ltesapplled to.yaur perMii fees.vJiiari Itis penriit is ibsy¢a,.
0WN1rR'S AT'1+'IbA'VY1':;It Pty-tWarail iaiilte brepoirrg in1'ormit'tlon is s'ccurate:snrl that elf work will'
be doire 14,compltat►ce %y1th•alf ahrlicabld:le�vs re�til'at[tig.eonb'truetioa aed zoning.
. go •D1t0: • �• 51,6A6Nfe:0fCanttdclD�lttglnY: •• •• • nate.. "
jgnpiursvi3Oyv7at/A .nt;. .
"I lownei/Agends Nome : '•P{i�� . Itayto. ?AB"t'pW&p1Q
signe!4c o.64a ory-siti or norida QptC: . • 916petii ed 81Ary�$t 0 Of bl idi Dile
gA, c .ICY
' - ''�"x'�'+� EXhlr<•r_SGctooar.27..2C.te l
Owner/Agent 1s. 'Personally KMow.n td Ma or Ctit'it 6.1tAj n�' 0 Nsoria�ly.1i ow.n to Me:'ox
produced. ID: Type•ofID "'Produced'1D : Type of ID
ME: ay
Permits l equked:. $iiildfhg Eleetticdl.-wAlknied(0'••
•Construclibn Type:. D CupAilcy X)sp:.. F..looi�.•Zonm
Tota) $q FtoYHl8. Mir.Oocupuii
Ncw'Cpnstrtccllona. l;leefrk.r Wpf,Ampa f0r.TIA reg
Tire;Sprritxlc�er.Bermlt; Ytt ;xQ.D 0aA0affs :T",'te:A141 InTorthih Yes d No*[]
.APPROVALS,'. ZON.WG;
• ENGINEBRII\1�,' ' •� .FIRS:. ' ' • "$Ut1:l'7I11YG:
itaJiSed::,lUrie 30;7A.1�5. • " •Permit Appliulipn
Nov.22. 2016 2:31PM SENEZ ROOFING
1 EEgRarty Record Card
��rert� � Perotl: 33.19-30.6EM-0000-0020
Owner, HOFFMAN GEORGE A JR
Kwr0.ae0urrr AgllEi�
i Properly Atldrtae: 102 MAPLEWOOD OR SANFORD, FL 32771
ParC01 Information Value Summary
Parcel ; 33.19.3p•5EM4C0D4M0
Owner' HOFFMAN GEORGE A JR
Property Address ; 102 MAPLE WOOD OR SANFORD, FL 32771
102 MAPLEWOOD DR SANFORD. FL 32771.3886 _ -
Subdivision New 1 IOXLLWLQl OF LQCH ARBOR SECTION•O
Tau District: 51-SANFORD
DOR Use Code 01 -SINGLE FAMILY
--- Exempdons 00-HOMESTgAD(1994)
No.6525 P. 4/6
Tex Amount without SOH: $2,231.52
2Qw1X e!n A!1X0I $1,658.26
Save Our Homes Sawmill: $573.26
• Does NOT INCLUDE Non Ad Valorem Assessments
Logal Description
2017 Workktg
2010 CMITIeO
values
Values
Valuation Melhod
1 Cosl/Merkel
CosUMerkel-
Number►
_..-
w-
Depredated Bldg Value•.
3112,284
i $108.097
Depreciated E%FT Value
I $9.750
1 59.800
Land Value (Manceq _
1534,000- --
1 $34,000 - - _..
Land Value Ag
PB 21 PG 40
�-. r..;_—_...—_=•-'-.--� _-�..--:..-_=—=ter..-•�_._._
.. _._..�._.�..St51.897^...-.__
ul�Mor ��;,-+��•5158.031
... ... - ... =.... vex==='=-•-•---=:_;,,===-�.-
-=�c-�.-__
Taxes
POrtabllily Adi
Save Our Homes Ad)M.�.
$31871
•
$28.59?
Amendment 1 Ad)
..
_ w
P&G Ad)So
assessed Value- ^
:S124163 _
; $123,300 -
Tex Amount without SOH: $2,231.52
2Qw1X e!n A!1X0I $1,658.26
Save Our Homes Sawmill: $573.26
• Does NOT INCLUDE Non Ad Valorem Assessments
Logal Description
LOT 2 BLK C
IDYLLWILDE OF LOCH ARBOR
SEC 6
PB 21 PG 40
�-. r..;_—_...—_=•-'-.--� _-�..--:..-_=—=ter..-•�_._._
=-c:=-_.
... ... - ... =.... vex==='=-•-•---=:_;,,===-�.-
-=�c-�.-__
Taxes
r
Taxing Authority
Assessment Value
Exempt Values Taxable Value
City Sanford
I
$124,183 i
$50.000 `
$74.163
SJWM(Salnl Johns Water Management)
t
$124,1631
$50,0001
S74.153
`O nILSondx _........_.._.._;:_........=.`»�'..._.......
_
V
t �~.-_.--••
.$124,1631
Vy $SO,ODD
$74.163
County General Fundr
5124,163
.� $50,00D �M �
�S74,153
I
�
-
_
__-
-599.163,
S--chools
$124,1631
$25.000-1
Sales
Bescription
it
Book
Page
Amount
QuallOed Vsd1mp
1 QUITCLAIM DEED
1 1/112003
; 047e
0574
-_
5100
No Improved
FINAL JUDGEMENT
i 311120022M
i $100
• No Improves
j WARRANTY DEED : 21111983
! M498910
S72,SOp
Yes j Improved
No ----_- -- Improved
j QUIT CLAIM DEED
�
1 101111982
---
WARRANTY DEED
110/1/1979
7 i e9~
i
$60.500
Yes Improved
FAVI Cempalab» SaNs
1
Land
'i
_^
Ii
Method Frontage
Depin
Unlla
Unita Prke
Lend Value
_M__�
3X000
$34.000
Building Information
_
Is 9ed19eth count incorrect? Click Here_
a 1 Dascnpo.-1Fw-1-- Bed 1 Bath I Esse Area Total SF I Living SF l Ext Wall i Ad) Value I Repl Value' Appendages
Nov. 22. 2016 2:32PM SENEZ ROOFING Soit�►al-
Est.
0000 1973
SENEZ ROOFING, LLC
Painting & insulation.
TRUST - VALUE + INTEGRITY
Toll Free: 1-866-350.4050
Office: (386) 7744950 - Fax (386) 775-$338
1060 E. INDUSTRIAL DR. - Suite K
ORANGE CITY, FLORIDA 32763
FULLY LICENSED &INSURED
STATE CERTIFIED #CCC1327898
www.senezroofing.com
652500 P. 5/6,,
PROPOSAL / INVOICE SUBMITTED TO: DATE:
NAME: C7Z'G r4 e
'STREET:
CITY: 5c" *n
PHONE: ilP7,222 -651(, l
EMAIL:
'//12' COLO - S• Shingles n r: Rubber
ciao
Cust. Int. Drip Edgep�_ Vents
WE HEREBY SUBMIT SPECIFICATIONS AND ESTIMATES FOR:
1. Tear off one layer of roof and haul all•.debris off site. Clean job site thoroughly, and Magnet groundQT9Aft& A
2. Replace any rotted vygd{et:king, Tr and fascia woodwork mybe extra. Aluminum work not included.
3. 2L= Install no fell.papi396-in. x-.:ranstall peel and stick. x _ Re -fasten decking.
4. Replace dgp�bge with all new palntj i grip edge. Cement in all eaves and mikes with quality roof cement.
5. instki �'c�l'lley lining in. -all va4l?y5„am
Cent.irti shingles over lining. -California Closed Cut Valley.
6, �$4e lace lead boots and hoose necks on -all existing vents and. pipes. Paint to match venting or drip edge.
7. -Replace (r ),pAtlfle skylights) with new -7.7- skylights(s). (--"ash Chimney.. (--*) Cricket Chimney.
8.Install net (asphaltEp�tjshingles--AR (algae/fungi resistant) - lifetime manufacturer's wartanty.
9. Each shingle Is nailed with six 11/0 roofing nails. ; . • : , i..
10. Replace.(,') lengths of ridge vent, Replace (—) off -ridge vents.
11. Low Pitch Roof: Install. Peel -n -Stick dry -in, and Single -Ply Modified-Roll-Rubbopl Membrane -.12 Year
Manuf`acturer's warranty. Replace drip edge with all new painted gelvanize&hrip edge.
12. All materials used and work installed is property applied in accordpnt�erin41h current Manufactures, State, and County
Codes and Specification-Senez gets the roofing permit and tiedujes appropriate roof Inspections. All specified
work completed is fully guaranteed for five (5) years. Roof matd 'al carries Standard manufacturer's warranty.
ALL MONEY IS DUE UPON 06MPL'ETION-00 WORK:
Please -make check -payable to: SENEZ R OFING
Total poptrgLtall rk .. g', . G�Ci Deposit $ UCj(). UU
(911't'9�t and reqs are Included)
(pdce reflects dash or check payment) f rJ .,� LG. ri--
A 4% convenience fee•wIILBpply to all, CriVIt Card transactions.
WE HEREBY PROOSEgTO FURNISH-IMOR AND MATERIALS -COMPLETE IN ACCORDANCE WITH THE A13OVE SPECIFICATIONS; FOR THE
SUM OF $ "� 6 ' - ANY EXTRA WORK, MATERIALS, OR SPECIFICATIONS THAT.ARE HAND WRITTEN ON
THIS CONTRAC ARE INVALID UNLESS INITIALED BY CUSTOMER AND BY THE OWNER/PRESIDENT OF SENEZ ROOFING, LLC.
1) PMase remove vehlows; nom driveway and garagarcarport by 12 noon the day before the Job, Remove any Items on walls end furniture and check that ell foduras in house
or porches are secure that may ILII or bounce off due to banging vibration wNle rooting, we are not responsible. Please have yard mowed prIor to lob start to help will► magnet
PWWP Of na113.
2) Customer is responsible for removal of anything around the house that Is breakable p.e.: ornaments, biro bathe, hanging planta, etc.), mnwal of anything attached to the
roo9deckshg tnelde the aft and outside prior 10lob start and relrWaaatlon or adluslmenis after job completion 0.0.: solar, satellites, air conditIoning eomponan!s, alarms. pipes,
etc.). covering furniture or Mooring below skylight openings and twinstallation of anything that Must be removed to properly repair any rotted wood areas o.a.: fascia, somt,
sklirg, gaffers, etc.) ..
614
AUTHORIZED AGENT (PRINT & SIGN);' n� 4y ei i DATE:
NOPE: THIS PROPOSAL MAY BE WITHDRAWN BY US IN THIRTY (30) DAYS.
ACCEPTANCE OF PROPOSAL:
THE ABOVE PRICES, SPECIFICATIONS AND CONDITIONS ARE SAT smarOFIY AND ARE HEREBY ACCEPTED, YOU ARE AUTHORIZED TO 00 THE WORK AS
SPECIFIED. I HAVE READ. UNDERSTAND, AND AGREE TO THE TERMS AND CONDITIONS SECTION ON THE REVERSE SIDE OF THIS FORM. COMPLETION OF
FINAL INSPECTION BYTHE MUNICIPALITY FROM WHERE THE PERMIT IS ISSUED IS NOT CAUSE TO DELAY PAYMENT TO SENEZ ROOFING. PAYMENT IN
FULL IS DUE IMMEDIATELY UPON COMPLETION OF SPECIFIED WORK. THESE PRICES ARE SU13JECTTO CHANGE IN THE EVENT OF ADDITIONAL ROOFING
IS FOUND BENEATH FIRST LAYER OR IF OTHER bAApAGE IS ENCOUNTERED WAS NOT ED�N� ��LOSEO BY y4MEOWNER ATTH�TIMET>JIS
ESTIMATE WAS PRODUCED. _ fj// S/
ACCEPTED: PRINT & SIGNATURE
PRINT 8 SIGNATURE DATE:
DRIVERS LICENSE 0
Nov.22. 2016 2:32PM SENEZ ROOFING
Permit No.
No -6525 P. 6/6
Tax Folio No. 3 3-111- 3 O • 5 Errs -OCoo -Ooz-o
NOTICE OF COMMENCEMENT
State of
County of °`Ntrl nOiC
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 ofProperty: (legal descrtptlon of the property, and street address If avallable) 1 6 '� YY`,ple�QOC#
--;L3�i% L '�yltw\\ P6
Or
LAJ, 1eGc.. �c (�-w6a - �L (e P 6 ?1 L4 a
LISA A
J
2. General description of improvement: re- v^eo.r
rn Fjrnr-;^r•I
"r'r" o 7.1 -f
(.�vc
o�
3. Owner information:��„r�r
G -e IL,
:nx•;0�m::Ta
ITI i'1'1 (ii �J Li
-n
Or.
rro
c• `►w
a. Name and address: lc) v� vp'leadcad
L" r,
b. Interest,lnproperty; S`''''¢^� 7 -7-11
{ "''.' w x+ :a
fir-,, Y'
41 o.1 Co. o C rel
c. Name and address of fee simple titleholder (If other then owner):
c.
IN ,;.
4. Contractor: a. Contractor name and address:den{ ►^ I).,;);"
V M
i ko
) 4
`� r'
b. Contractor's phone number:
�"lb3
-)
5. Surety a. Surety name and address:
b. Phone.number:fN
IA
c. Amount of bond:
;
6. Lender: a. Lender's name and address:
� �
Fl
b. Lender's phone number:
7. a. Persons within the -State of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes: (name and address) .
b. Phone numbers of designated persons:
8, a.. In addition to himself or herself, Owner designates of
to receive a copy of the
Lienors -Notice as provided in Section 713.13(1)(b), Florida Statutes.
b. Phone number of person or entity designated by owner:
9. Expiration date of notice of commencement (the expiration date is 1 year from the 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 7EY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
COMMEN E
(Signature of Owne or Ownpluthorized dfiyfr/QIf ct r/ artner/Manager) (Signatory's TIUe/Office)
The foregoing instrument was acknowledged before me this -2S day of _10 ,-.;10\ Le , by
ear) (na e • ! person)
as for k °r
(type ally, .. , e.g. off r, Ostee, attomey In fact) (name of party on boalf of whom instrument was executed)
�S
point, Type, ar stamp
(Signature o N taQffic - State of ). Gommltflorkd Name of Notary ►nbllc
Personally Known OR Produced Identification._X_ Type of Identification Produced. i j Cck) le
LISA A
;-
;•r, JAY
F
"- M'/ COMMISSION, t/ rr•830314
EXPIRES Octobor?.2.2019
t -•
Lt.'`.o.-.lam 1b_......►',.__.W.idprporexServ;m.Wa.
V :; ,.
Nov.22. 2016■ 2:31PMwSENEZ ROOFIN
o. 6525P. 1/6
Senez Roofing.
1;060 E: Industrial Dr.
Q range .City, F1.32763
www.senezroofing.com
E-mail: infoaa,senezroofing com
Office: (386) 774-4950
:'-:Fax: (386) 775-3338
Fax Coven Sheet
Attention:-rrr:%*k -,vrc, From:
Company to: SorXQ� Date: '
.Fax number: 04 Pages:
CO1vMENTS-
NOTICE: This is privileged and confidential and intended only for the person named above. If
you are not that person, then any use, dissemination, distribution or copying of this is strictly
prohibited, and you are required to notify me immediately by calling or faxing me (collect if need
be) at the numbers above.
City of Sanford
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. 1 1 2- 3 1!1 ( ISSUE DATE: /1 • 4220 /
(V
CONTRACTOR:
JOB ADDRESS: /0 A I
TYPE OF WORK: RPoo
• 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 ROOF DR Y -IN INSPECTION IS REQUIRED * * *
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 receivindry-in inspection.
ROOF
1NSPF.CTIONTYPF. APPROVED RFJF.CTFD INSPFCTOR
MISCELLANEOUS
INSPECTIONTYPF APPROVED RFJECTED 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:
• Dial 855.541.2112
• Provide the items requested during the message
• The type of inspection requested must be scheduled under the appropriate permit type
• Follow the prompts
PLEASE NOTE: Inspections scheduled by 3:30 p.m. will be conducted the
next business day. If you experience difficulty, please call 407.688.5150
Monday - Thursday 7:30 am - 5:30 pm for assistance.
AUTOMATED INSPECTION SYSTEM CODES
ROOF
Roof Dry In 116
Mitigation Affadavit 129
Final Roof III
Miscellaneous Notes:
Miscellaneous
Sheathing - Roof 106
Insulation - Roof 119
REVISED: OCTOBER 2014 Inspection Line: 855.541.2112
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
-----------------------------------------'-----------------------------------
Page 2
Application Number . . . . .
Property Address . . . . . .
Parcel Number
Application description . . .
Subdivision Name . . . . . .
Property Zoning . . . . . . .
16-00003146 Date 11/22/16
102 MAPLEWOOD DR
33.19.30.SEM-0000-0020
ROOFING APPLICATION
IDYLLWILDE OF LOCH ARBOR SEC 6
SINGLE FAMILY
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 963223
Permit pin number 963223
----------------------------------------------------------------------------
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 / /
RE: Pennit # ' �J—
City of Sanford
BUILDING DIVISION
Inspection Affidavit
I
IS Qz , icensed as a(n) Contractor ngineer/Architect,
(please print name and circle Lic. Type) uilding Inspector*
License #; 0 CC 1 30,-7Pq F)
On or about � I I %2S f 1 Lp J(�a�o, I did personally inspect the roo
(circle
at Ica o 1 )e.( I y ,
(Job Site Address
Based upon that examination I have determined the installation was done according to the
Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.)
I D
----
Signature'.
STATE OF FLORIDA
COUNTY OF C� WOIC(n
Sworn toand subscribed before me thiatld y of fj�' 200JO
`tSA A JAY
'= MY COMMISSION li FF930314
+g, I EXPIRES October 22. 2019
.r.:7iPH-f,r;3 rlaidANo.,ryStr�i��.on���.,
Personally known or
Produced.Identi cati n
Type of identification produced.
Notary Public, State of Florida
1 - Lim' -Ac A,
Print, type or stamp name)
�
Commission No.:F
* General, Building, Residential, or Roofing Contractor or any individual certified under 468 F.S. to make such an
inspection. Include photographs of each plane of the roof with the permit N or address # clearly shown marked on the
deck for each inspection.