128 Kaywood Dr; 17-1904; ROOFf ' CITY OF SANFORD
F1 JuN 'a 0 BUILDING & FIRE PREVENTION
D PERMIT APPLICATION
I3Y:_ -
Application No: r 7. 1904
oa
Documented Construction Value: $ CD o
Job Address: 128 Kaywood Drive, Sanford, FL. 32771 Historic District: Yes No
Parcel ID: 32-19-30-5GS-0000-0810 Residential Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: Roof Replacement -
Pulling permit to final out Expired permit # 02-2007
Plan Review Contact Person: Justin Shelton Title: Roof Replacement Manager
Phone: 321-441-2300 Fax: 321-441-2313 Email: swilliams@collisroofing.com
Name Stacey Raymond
Property Owner Information
Phone:
Street: 128 Kaywood Drive Resident of property? :
City, State Zip: Sanford, -'FL. 82771
Contra,cttr Information
Name Collis Roofln.g,,lnc Phone:
Street: P.O. Box 520668
Fax:
City, State Zip: Longwood, FL. 32752
Name: n/a
Street:
City, St, Zip:
Bonding Company:
n/a
Address:
yes
321-441-2300
321-441-2313
State License No.: CCC058022
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender: n/a
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: 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 additionai,permits required from other governmental entities such as water
1
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.
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
STEPHANIE J WILLIAMS
r+;State of Florida -Notary Public
Commission # GG 008373
My Commission Expires
tabor K wn to Me or
Produced ID_Type ol Iv
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:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
of Stories:
Plumbing - # of Fixtures.
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #:
I, J. Douglas Lanier hereby acknowledge that I personally inspected
X Roof deck nailing and/or X Secondary water barrier work
at 128 Kaywood Drive, Sanford, FL. 32771 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 herein are true and accurate to the best of my belief and that I fully
understand that making any false statements in writing with the intent to mislead a public servant in the
performance of his or her official duty shall constitute a misdemeanor of the second degree pursuant to
Section 837.06 F.S.
Signature o ont aciti r Date
J. Douglas Lanier
Printed Name of Contractor
CCC058022
License #
License Type: ] General Building 0 Residential XRoofing Contractor
i or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF Seminole
Sworn to ( r affirmed) and subscribed before me this _Da_ day, of S 20 02 , by
who is X Personally Known to a or has Produced (type of
identifieAti as identification.
SEAL)
Signao Flori 4"
rP is STEPHANfEWILLIAMS
State EL*2,-n"
State of Florida -Notary Public
Stephanie J. Williams commission # GG 008373
My commission Expires
Print/Type/Stamp Name October 29, 2020
of Notary Public
BP502I03 CITY OF SANFORD
Inspection Inquiry - Inspection Selection
Property address . . . . . 128 KAYWOOD DR
Parcel Number 32.19.30.5GS-0000-0810
Application number . . . . 02 00002007
Application type . . . . . ROOFING APPLICATION
Type options, press Enter.
1=Select
Opt Str/Seq Pmt/Seq -Inspection Type
000 000 ROOF 00 ROOF DRY -IN
000 000 ROOF 00 CLOSED/EXPIRED OVER 180 DAYS
F3=Exit Fll=View 2 F12=Cancel
6/22/17
14:47:58
Seq Insp Result/Date
0001 LILLY AP 8/20/02
0001 BLDG CA 1/04/06
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