2395 Stevens Ave 17-1205; ROOFIna0EriV" ort
APR 2 7 2017 "1
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value:$
Job Address: Historic District: Yes [I No 0
Parcel ID: 5 2_1 0000— 0 116 Residential [K Commercial
Type of Work: NewEl AdditionD AlterationEl Repair, 14 DemoF] Change of Use R Move Description of
Work: 1<t— O-P O-P Qrj rW rQ OKf I I I'OQ Plan Review Contact
Person: Krisl-inf i_an-t- Title:('}-Picr- lqdwi 0. Phone: Fax: Email:
KL An+0CWti'aiwid _00 P-corl,) LjProperty Owner
Information
Name 3-e-
5'ema muy'Mo Phone: 140-1- (old- 2,3-12. Street: 2--M
S+eyen S PNP-- Resident of property? City, State Zip: S
Cxn t cl IF L 3 -7 Contractor Information NameNQrb0nW'1df-
V4xill Phone:
4n - 1713 -13 Z3 Street: 5] I—L4
POY-+ CCnCor&r Ln Fax: City, State Zip:O
dandc) I EL_ 32-1809 State License No.: CfC t 3 J 165 Name: Street: City, St,
Zip:
Bonding
Company: Address: Arch
itect/En
gineer
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, plumbingj signs, wells, pools, furnaces, boilers, heaters, tanks,
and air conditioners, etc. FBC 1053 Shall be
inscribed with the date of application and the code in effect as of that date: 5'h Edition (2014) Florida Building Code Revised: June 30, 2015
Permit Application
PERMIT#
City of Sanford Building DivisionBuilding'
Residential Re -Roof Scope of Work
JOB ADDRESS:. S-k Z , I4P, . Sa, of b / EL 9 2_.- 11 STRucruRETYPE: (
D SINGLE FAMILY RE-SIDENcE/ToWNHOUSL 0 MOBILE, HOME 0APARTMENT/COND0MINIUM RE -
ROOF TYPE:: 40 REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE. WITH NEW COMPONENTS) 0
RE-COVI',R (NEW ROOF. INSTALLED OVER EXISTING ROOF) DECK
TYPE (PLEASE SPECIFY): cz) =i_, ce PLF-
Asi.*NoTF.-02N'IYIOOSoU,IREFFETOFWI FXISTI`G, DECK IS PERAIITTrD TO BE REPLACED" RoOFVENTILATION:
DOFF -RIDGE FRIDGE OSOFFIT OPOWERED VENT OTURBINES SKYLIGHTS:
0 YES 4D No 117 YES, PLEASE PROVIDE FLoR1DA,PRODucT APPROVAL 9: MAIN
ROOF AREA ROOF
SLOPE: 0 LESS THAN 2:12 0 2:12 -4:12 4:12 OR GREATER TYPE
OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL SHINGLE
FL# )PwD OMETAL
0
MODIFIED BITUMEN FL# 0
TORCI I DOWN FL# 0
INSULATED FL# OTILE
FLft 00THER:
FLN ROOF
EXTENSIONS (PORCHES, PATIOS. ETC.) "IFAPPLICABLE" ROOF
SLOP F: 0 LESS THAN 2:12 0 2:12-4:12 0 4:12 OR GREATER TYPE
OF ROOF MANUFACTURER FLORIDAPRODu(:'r APPROVAL OSHINGLE
FL# OMETA
L FL# OMODIFILD BrIumEN
FL# 0TORCH DOWN
F L# INSULATED F
L"' 0 0TfLEFL#
00THER: FLft
1-Traces
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), certifying FBC code compliance by personal inspection.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: `. / DATE:
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.
r I I
SJgnature of Own Agent to aturc of ContractodAgent /1
Date
JeSPJ.
lQ /j ri SOY% Q U rG Print
Owner/Agent's Name Print Contractor/Agent's Name KRISTINE
LANT Commission
@ GG 23892 My
Commission Expires August •
23, 2020 KRISTINE
LANT Commission #
GG 23892 My
Commission Expires August -
23, 2020 Owner/
Agent is Persona y nown to Me or Contractor/Agent is V Personally Known to Me or Produced
ID Type of ID L D L Produced ID Type of ID BELOW
IS FOR OFFICE USE ONLY Permits
Required: Building Electrical Mechanical Plumbing Gas Roof Construction
Type: Occupancy Use: Total
Sq Ft of Bldg: 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
State of Florida
County of Sengnoe
Fenno NWAW. Pawd ID number: — 0
The undersigned hereby ghres notice tlud hWoaenierit will be made to ce = rest property. and In accordance vim
Chapter 713. Floods Statutes, ft folln ny Intormd m is provided to tiffs Notice of COrWrOmemerd.
RESCF4MC N OF PROPER: agar =Ww prop Y
P Q 7 qaLqr1l `F bpi -!
Fee Sh% to TRIO NOMW (If COW Own awry Name
Address:
Persons wltt b the State of Rands Oast puftd by Owner upon wh= nation, at other doarments may be served
as provided by Section 713.13(1)6t Banda Stab Am
In addtion b WWI. Oa m Designates
Secgon 713.13(%). Fladda Sfax.
of
TO receive a copy of tha UeWs Notice as Pcovided in
Expiration Data or Notice of Co neat (Tire exphadon daft Is 1 you ham date of recordbtg unless a
diEFerent dabs Is spedflo)
WARNIAra To OWNER. ANY PAYMENTS MADE BY THE OM(ER AFTER THE EXPIRATION OF THE N0710E OF
coumacBamT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 71% PART 1, SECTION 71&13.
FLORIDA STATUTES. AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A
NOTICE OF COMMENCEMENT MUST BE RECORD® AND POSTED ON THE JOB SITE BEFORE THE FIRST
INFECTION. IF YOU INTEND TO OBTAIN FINANCINQ CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under pen of perjury. ) d'edsre that 1 have need the foragdag and than the fads daW In it are true
to the fny atrdtlauef
o r Io /fvri
Ot"ftPejONama
FbdQ•stnam.77113(1Jt•nosammantialgathe- Acsdaaaa mmKdsadnocoatismaybapamdiodtoago6rGbortoaa!Q>b
st9w Id COumaf 6ramg
The foregoW4 4iabumwd was wArowaledged before me this amday of
byj 2glon1Gt MQ i i1U . who IsPersonally known tome namedg 1,
AP stdoffod idenl OR
whohasprodieopdkadon [I type of IdecdIftagon produced: (n L-
tJLoa..m...+ .
6 . a --
e
KRISTINE LANTCommission0
00 23992 adz SWAD06 g My
Commission Expires i August
23, 2020 GRANT MALOY,
CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK'S #
2017041085 BK 8901 Pg 0951; (1pg) E-RECORDED 04/27/2017 08:19:36 AM 10.00
Nationwide General Contracting
5724 Port Concorde Lane
Orlando, FL 32809
Phone:(407)'906-9898
Fax:888-473-2030
This Agreement Subject to
Agreed Upon Price with Insurance
GENERAL CONTRACTOR AGREEMENT
Nationwide General Contracting, LLC and Home Owner agree that this contract is null & void unless the
property's, insurance company approves full roof replacement.
I- (property owner/agent), authorize Nationwide General Contracting,
LLC as my General Contractor to review with my insurance caner, by joint inspection, for any property damage
at:
I
FA
On this day of, ;,g / _.
I understand that Nationwide General Contracting, LLC will act as my General Contractor to obtain appropriate
property damage scope and repairs. Scope and repairs are to comply with all Local, State, National building codes.
Upon reaching an agreeable price/scope with the insurance company Nationwide General Contracting, LLC will
proceed with the repairs prescribed by the insurance company. I, authorize my insurance company to discuss mat-
ters directly with Nationwide General Contracting, LLC as my General Contractor, however, not as my legal rep-
resentatives nor public. adjuster
Nationwide General. Contracting, LLC agrees to act in the best interest,of the property owner/agent in obtaining
property damage scope and repairs, but in .no, way bears liability for such damage.
Property owner/agent agrees to allow Nationwide General Contracting, LLC to perform any repairs, as their 'Gen-
eral Contractor, prescribed by the insurance company at prices-detennined by the insurance company, inclusive of
overhead and profit, with no additional cost to the property owner/agent except for the deductible.
Material and labor specifications along with Final Agreement will follow upon insurance company price approval.
PROPERTY OWNER:
PROPERTY AGENT:
Printed
PHONE NUMBER: (I-1M) 6Y07 f .2 S (WK)
INSURANCE COMPANY:
POLICYNUMBER: PD O a l8 7 .2
INSURANCE CLA
TEAM MEMBER:
Signature
City of Sanford
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. I I ISSUE DATE: 1 ~ 1 I
CONTRACTOR:
JOB ADDRESS: I
TYPE OF WORK: RS9 0 0
NO
I PROTECT FROM
WEATHER Post this
Permit and all required documents in a conspicuous place outside Digital Photographs
are required - please follow re -roof policy and procedures guide All trash,
debris and dumpsters must be removed from job site at final inspection Permit expires
six (6) months from date of issue ROOF INSPECTION
TYPE
APPROVED REJECTED INSPECTOR FINAL ROOF
FAILURE TO
FOLLOW THE RESIDENTIAL RE -ROOF POLICY & PROCEDURES WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION FEE AND
MAY REQUIRE AN AFFIDAVIT, SIGNED AND SEALED, FROM A REGISTERED FLORIDA DESIGN PROFESSIONAL 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: 4-
17 Inspection Line 407.792.6069 or 855.541.2112
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ADDRESS: ?_3"l 5 S tC\ft__ )S1 1k\[&
SD nFL 32.,-7.% 1 1 ' '
U AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR ROOF
N RACTO ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE FOREGOING
INFORMATION IS TRUE AND ACCURATE AND THAT ALL ROOFING COMPONENTS LISTED ON THE SCOPE OF WORK AT THE ABOVE
REFERENCED ADDRESS HAVE BEEN INSTALLED IN ACCORDANCE WITH THEIR PRODUCT APPROVALS AND ALL APPLICABLE CODE REQUIREMENTS —
SPECIFICALLY FLORIDA BUILDING CODE, EXISTING BUILDING. IN ADDITION I CERTIFY THE INSTALLATION MEETS ALL REQUIREMENTS
FOR SECONDARY WATER BARRIER AND NAILING OF THE ROOF DECK, IN ACCORDANCE WITH THE HURRICANE RETROFIT MANUAL
REQUIREMENTS (BASED ON F.S. CHAPTER 553.844). LICENSE #:
C 0 C l7 11 Sb COMPANY/
CONY CONTRACTOR
SIGN MUST
BE SIGNED B RACTOR:
NMni inf1C 2 goyiw ATURE: DATE:
Y LICE
OLDER OR OWNER/ DER) A FINAL
ROOF INSPECTION IS REQUIRED: THIS SIGNED
AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINAL ROOF INSPECTION, ALONG WITH
DIGITAL PHOTOGRAPHS OF EACH PLANE OF THE ROOF SHOWING IN DETAIL ALL COMPONENTS (DECKING, UNDERLAYMENT, FLASHING,
DRIP EDGE ATTACHMENT) WITH THE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON THE DECK FOR EACH
INSPECTION. THE PHOTOGRAPHS MUST INCLUDE A RULER OR MEASURING DEVICE TO CONFIRM ALL NAIL SPACING AND OVERLAPS, INCLUDING
DRIP EDGE AND VALLEY FLASHING. PLEASE REFER TO THE RE -ROOF POLICY AND INSPECTION PROCEDURE PAPERWORK FOR
FURTHER EXPLANATION OF ALL REQUIREMENTS. FAILURE TO
FOLLOW ALL REQUIREMENTS WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION FEE AS WELL AS
REQUIRING A DESIGN PROFESSIONAL (ARCHITECT OR ENGINEER) TO CERTIFY, BASED ON PERSONAL INSPECTION, THE
INSTALLATION OF ALL ROOFING COMPONENTS. STATE OF
FLORIDA COUNTY OF 0 Qj nQ Sworn to
and Subscribed before me this day of MG 20 J__I_ by: J012 ainsh.
Who is kpersonalty Known to me or has 0 Produced (type of identification) Signature
of
Notary Public State of
Florida 6(_S
h '1p LrA V)_f Print/Type/
Stamp Name of Notary
Public as identification.
KRISTINE LANT
Commission # GG
23892 My commission
Expires August 23,
2020