717 Santa Barbara Dr 17-1660; ROOFL.
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Ig I. CITY OF SANFORD
JUN 0 5 2017 ,' a BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: — (n
Documented Construction Value: $ k 4.5 QQ —
Job Address: j i1 Gy a "?CaV DU,Yo__ Historic District: Yes No o
Parcel ID: Residential W Commercial
Type of Work: New Addition Alteration Repair :"
9
Demo Change of Use Move
Description of Work:ica1P Gp
Plan Review Contact Person: U ' U v e ws3 Title:
Phone:62-\ (oG (j WIt Fax: Email• E V\e a i (-Il'1(, - (opt
Property Owner Information
Name
I kA« LAN P KA,S V o q e- n Phone: C Co T
Street: % SOO J • IW W P_.A Ab TSy C Resident ofs ro, er ? City,
State Zip: C V-`l " ., 211 9 aLV
4 1!:z re rul to ,l iQ '-
FL .01g 2'1 .Rtt';v- nr •4"'a:, ,!. ContractorInformation' Name
6-Oy\7 o.\\-,b Street:
City,
State Zip: Name:
Street:
City,
St, Zip: Bonding
Company: Address:
Phone:-
Fax:
State
License No.: Architect/
Engineer Information Phone:
Fax:
E-
mail: Mortgage
Lender: Address:
WARNING
TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED
AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Application
is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced
prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in
this jurisdiction. 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
Al
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 w*h all applicable laws regulating construction and zoning.
06 -05-V
Sigrrat [
aeo
f O er/Agent Date
0 A Ci 0 Jrco Y6.S
Printgivner/Agent's Name
w`,i•i,4;, ANNETTE BAND
Notary Public State of Florida
Commfaslon # GG 060623
y ; r
Y Comm. M Ex es Jan 16. 2011
Produced ID Type of ID
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
to Me or Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
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
City of Sanford Building Division
Residential Re -Roof Inspection Policy & Procedures
PERMITTING REQUIREMENTS — NO PLAN REVIEW REQUIRED
This document (signed) along with an accurate and completed Residential Re -Roof Scope of Work are required
to be submitted as part of your permit application.
The Scope of Work must include all applicable Florida Product Approval numbers for all roof components that
will be installed on the project.
A permit will not be issued without these documents. Copies will be made to post on the job site.
Projects located in the Sanford Historic District will require plan review and approval by the Sanford
Historic Preservation Board
INSPECTION POLICY & PROCEDURES
A Final Roof Inspection is the only inspection required for Residential (Single Family, Townhouse, Mobile
Home, Apartment and/or Condominium) Re -Roof Permits.
The Following is required to be provide on the job site:
Permit Card, posted in a conspicuous and weatherproof location
Completed Residential Re -Roof Scope of Work
Completed and Notarized Inspection Affidavit
All Florida Product Approval and Corresponding Installation Instructions
Product Approval shall match what is on the scope of work)
Digital Photographs (must include the permit number or address in each picture)
o Each plane of the roof, showing the underlayment installed
o Roof Deck Nailing Pattern & Spacing (including a measuring device or ruler)
o Roof Deck Nails used (including a measuring device or ruler showing size of nails)
o Underlayment Pattern & Spacing (including a measuring device or ruler)
o Drip Edge & Valley Attachment (including a measuring device or ruler)
o Shingles installed, nail pattern and location of nails
Skylights (if applicable)
o • Digital photographs showing all installation components, per FL Product Approval
o Digital photographs showing all required flashing, per FL Product Approval
Failure to follow these specific guidelines will result in an affidavit provided by a Florida Design
Professional (architect or engineer), certi i g F co co liance by personal inspection.
CONTRACTOR OR OWNER/BUILDER SIGNATURE: V DATE: o- 5 - IO ( )
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: In ;()V+G \JM Y' L.h(.._ 'S(10/ ko C l_ 3 n t
STRUCTURE TYPE: 0 SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: (p REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): M V j V\\M0C*A I )C
PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECKIS PERMITTED TO BE REPLACED"
ROOF VENTILATION: O OFF -RIDGE RIDGE O SOFFIT OPOWERED VENT
SKYLIGHTS: O YES IT NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 2:12-4:12 O 4:12 OR GREATER
OTURBINES
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE FL#
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) "IFAPPLICABLE"
ROOF SLOPE: LESS THAN 2:12 O 2:12 - 4:12 O 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O SHINGLE FL#
TAL FL#
ODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
w._
Acknowledgement
We/I have carefully reviewed the ALTA Settlement Statement and find it to be a true and accurate statement of all receipts and
disbursements made on my account or by me in this transaction and further certify that I have received a copy of the ALTA
Settlement Statement. We/I authorize First Signature Title, Inc. to cause the funds to be disbursed in accordance with this
statement.
Claudia Contreras Virgen Date Trevor Hampton / Date
444--
Holly Allison
Sharon Hampton Date
13
Date
Copyright 2015 American Land Title Association File # 176774
All rights reserved. Page 3 of 3 Printed on: 05/31/17 1:54 PM
American Land Title Association ALTA Settlement Statement - Combinec
Adopted 05-01-2015
File No./Escrow No.: 176774 First Signature Title, Inc.
Print Date & Time: 05/31/171:54 PM ALTA Universal ID:
Officer/Escrow Officer: Holly Allison 330 Waymont Court
Settlement Location: First Signature Lake Mary, FL 32746
Title, Inc.
330 Waymont Court
Lake Mary, FL 32746
Address: Lot 28, Block 18, Plat Book 3, Page
717 Santa Barbara Drive
Sanford, FL 32771
Claudia Contreras Virgen
Trevor Hampton and Sharon Hampton,
nder: Wells Fargo Bank, N.A., ISAOA
ment Date: 05/31/2017
rsement Date: 05/31/2017
ional dates per state requirements:
J. Ff.r„
u'i
i_3..tCredoTO i,
lT'9i,$J !
k. i, x j+ FA Y ' 1 '.i«} ;.t }! g 3 r
u f. itia 7;}i, w?:,.,, 1. ($ I t yyDe r ir;lpt drt ,t ' e,t'; ",.n,' :," al, 3i4 'Cblfl t,f>lv
LEA ,,,9,r „ l,if, n^iPFr+'ir'Ik°3 h'P L ^ ..
1,
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r,., i .z3r b.; .,kt„?,'>,"5.,_ s ,. , l,, .„3 3
Financial
yi ,+ 1-',t.,, a3ii.".vs.
5.'st,., # t [. S ?B rrQwer/Bt ye
4dr yvi+ g s Debit
i'16hf`4 f?', ;.:.
a." '#
CredixrAr
7drsSellRIMI
77,500.00 Sale Price of Property 77,500.00
Deposit 1,500.0
Loan Amount 75,175.0
Pro rations/Adjustments
407.40 Adjustment for Owner's Policy Paid by Seller 407;4
542.50 Portion of Doc Stamps Paid by Seller 542.5
800.00 Seller Credit 800.0
Loan Charges to Wells Fargo Bank, N.A., ISAOA
0.125% of Loan Amount (Points) 93.97
Processing 985.00
Prepaid Interest ($9.27 per day from 05/31/2017 to
06/01/2017)
9.27
Other Loan Charges
Appraisal $472.00 Borrower -Paid Before Closing
Credit Report $14.94 Borrower -Paid Before Closing
Tax Service Fee to Wf Re Est Tax Svc 78.00
Impounds
Homeowner's Insurance $61.00 per month for 3 mo. 183.00
Property Taxes $60.51 per month for 9 mo. 544.59
Copyright 2015 American Land Title Association File # 176774
All rights reserved. Page 1 of 3 Printed on: 05/31/17 1:54 PM
OWNER BUILDER STATEMENT/AFFIDAVIT
Altamonte Springs, Casselberry, Lake Mary, Longwood, Oviedo, Sanford,
Seminole County, Winter Springs
Florida Statutes are quoted here in part for your information to indicate the authority for exemptions for
homeowners from qualifying as contractors and to express any applicable restrictions and responsibilities.
OWNERS MUST PERSONALLY APPEAR AT THE BUILDING DIVISION TO SIGN THIS DOCUMENT
BY SIGNING THIS STATEMENT, I ATTEST THAT: (Initial to the left of each statement)
I understand that state law requires construction to be done by a licensed contractor and have applied for
c
an owner -builder permit under an exemption from the law. The exemption specifies that I, as the owner of
the property listed, may act as my own contractor with certain restrictions even though I do not have aY
license.
I understand that building permits are not required to be signed by a property owner unless he or she is
responsible for the construction and is not hiring a licensed contractor to assume responsibility.
I understand that, as an owner -builder, I am the responsible party of record on a permit. I understand that I_,.
may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed
in his or her name instead of my own name. I also understand that a contractor is required by law to be
licensed in Florida and to list his or her license numbers on all permit and contracts.
I understand that I may build or improve a one -family or two-family residence or a farm outbuilding. I
may also build or improve a commercial building if the costs do not exceed $75,000. The building or
residence must be for my own use or occupancy. It may not be builtor substantially improved for sale or lease.
If a building or residence that I have built or substantially improved myself is sold or leased within in
I year after the construction is complete, the law will presume that I built or substantially improved it for
sale or lease, which violates this exemption. I
understand that, as the owner -builder, I must provide direct, onsite supervision of the construction. I
understand that I may not hire an unlicensed individual person to act as my contractor or to supervise persons
working on my building or residence. It is my responsibility to ensure that the persons whom I have
the licenses required by law and by city ordinance. employI
understand that it is a frequent practice of unlicensed persons to have the property owner obtain an owner -
builder permit that erroneously implies that the property owner is providing his or her own labor and
materials. I, as an owner -builder, may be held liable and subjected to serious financial risk for any injuries
sustained by an unlicensed person or his or her employees while working on my property. My C
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner - builder
and am aware of the limits of my insurance coverage for injuries to workers on my property. I
understand that I may not delegate the responsibility for supervising work to a licensed contractor who is not
licensed to perform the work being done. Any person working on my building who Is not licensed must
work under my direct supervision and must be employed by me, which means that I must comply
with laws requiring the withholding of federal income tax and social security contributions under
the Federal Insurance Contributions Act (FICA) and must provide workers' compensation for
the employee. I understand that my failure to follow these laws may subject me to serious financial risk.
Rev.
9.14.2009
I agree that, as the party legally and financially responsible for this proposed construction activity, I will
abide by all applicable laws and requirements that govern owner -builders as well as employers. I also
understand that the construction must comply with all applicable laws, ordinances, building codes, and
zoning regulations.
e
I am of aware of construction practices and I have access to the Florida Building Codes.
I understand that I may obtain more information regarding my obligations as an employer from the Internal
Revenue Service, the United States Small Business Administration, the Florida Department of Financial
J Services, and the Florida Department of Revenue. I also understand that 1 may contact the Florida
Construction Industry Licensing Board at 1-850-487-1395 or at www.myflorida.com/dbpr/pro/cilb/ for
more information about licensed contractors.
I am aware of, and consent to, an owner -builder building permit applied for in my name and understand
C that I am the party legally and financially responsible for the proposed construction activity at the address
C, listed below.
I agree to notify the building department immediately of any additions, deletions, or changes to any of the
information that I have provided on this disclosure or in the permit application package.
Licensed contractors are regulated by laws designed to protect the public: If you contract with a person
who does not have a license, the Construction Industry Licensing Board, the Department of Business and
Professional Regulation and the building department may be unable to assist you with any financial loss
that you sustain as a result of a complaint. Your only remedy against an unlicensed contractor may be in
CG civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an
individual or firm is injured while working on your property, you may be held liable for damages. If you
obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for verifying
whether the contractor is property licensed and the status of the contractor's workers' compensation
coverage.
Property Address:
1, _GCK U CA,ka
and capable of performing the
conditions soaified above.
Signature of Owner -Builder
V A 1 do hereby state that I am qualified
ested construction involved with the permit application filed and agree to the
U
Date
Form of Identification
Must be Photo ID)
A violation of this exemption is a misdemeanor of the first degree punishable by a term of imprisonment
not exceeding 1 year and a $1,000.00 fine in addition to any civil penalties. In addition, the local
permitting jurisdiction shall withhold final approval, revoke the permit, or pursue any action or remedy
for unlicensed activity against the owner and any person performing work that requires licensure under
the permit issued.
Rev. 9.14.2009