163 Long Leaf Pine Cir; 17-2300; ROOF0
CITY OF SANFORD
ff •
BUILDING & FIRE PREVENTION
W PERMIT APPLICATION
JUL 2 7 2017 ' ' Application No• / -- d U6
Vr: •
j _ Documented Construction Value: $ 2,000.00
Job Address: 163 Long LEaf Pine Circle, Sanford historic District: Yes No
Parcel ID: 11-20-30-509-0000-0590 Residential ® Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: Roof Replacement Owens Corning Supreme Asphalt Shingles - 24 squares
Plan Review Contact Person:
Phone: 321-441-2300
Name J. Douglas Lanier
Street: 907 Arabian Ave.,
Stephanie Williams
Fax: 321-441-2313
Title: Admin
Email: swilliams@collisroofing.com
Property Owner information
Phone: 321-441-2300
Resident of property? :
City, State Zip: Winter Springs, FL. 32708
Contractor Information
Name
Street:
Collis Roofing, Inc.
P.O. Box 520668
City, State Zip: Longwood, FL. 32752
n/a
Name:
Street:
City, St, Zip:
Bonding Company:
n/a
Address:
Phone: 321-441-2300
Fax:
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: 511 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.
7/a 4 /1 >
Sig lure of Owner/Agent Date
3 aV)Le1q> )11t1k_)-(__
Print Owner/Agent's Name
Signature of`Nt aS3"it1'PiifWENG1' S_A,-ATS Date
Notary Public - State of Florida
Commission # FF 937709
My Comm. cxVires Mar 16, 2020
C1 •'%;Sf. ;:•• Rnndedthrounh National NMary Assn
is
Produced ID
Known to Me or
Type of ID
Signs re of Contractor/Agent Date
J. Douglas Lanier
Print Contractor/Agent's Name
Signature of Notary -State oktlbrida Date
1
00, 4" WENDY STAATSWENDYSTAATS
Notary Public - State of Florida
Commission # FF 9377 99
My Comm. fires Mar 16, 20?0
pit'rhContractor/..AgeRi'it § . I'drsoiially fKnown to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
Gas Roof
Flood Zone:
of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
7/25/2017 SCPA Parcel View: 11-20-30-509-0000-0590
i
blmson,CFA
scn acxr cxxmnv, r-u rawn
I
Parcel Information
Property Record Card
Parcel: 11-20-30-509-0000-0590
Owner: LANIER J DOUGLAS & JOYCE A
Property Address: 163 LONG LEAF PINE CIR SANFORD, FL 32773
Value Summary
Parcel 11 20 30-509 0000-0590
Owner LANIER J DOUGLAS & JOYCE A
r -.- -- Property Address 163 LONG LEAF PINE CIR SANFORD, FL 32773
Mailing 907 ARABIAN AVE WINTER SPRINGS, FL 32708-
Subdivision Name HIDDEN LAKE VILLAS PH 4
Tax District S1-SANFORD
DOR Use Code 0103-TOWNHOME
Exemptions
10011WW
Seminole County GIS
Legal Description
LOT 59
HIDDEN LAKE VILLAS PH 4
PB 28 PGS 26 TO 28
Taxes
2017 Working 2016 Certified
Values Values
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 95,174 81,546
Depreciated EXFT Value 901 951
Land Value (Market) 20,000 16,000
Land Value Ag
Just/Market Value'* 116,075 98,497
Portability Adj
Save Our Homes Adj 0 i $0
Amendment 1 Adj i $22,081 13,048
P&G Adj 3..$0 0
Assessed Value 93,994 85,449
Tax Amount without SOH: $1,811.00
2016 Tax Bill Amount $1,811.00
Tax Estimator
Save Our Homes Savings: $0.00
Does NOT INCLUDE Non Ad Valorem Assessments
3 Taxing Authority Assessment Value Exempt Values Taxable Value
I County General Fund 93,994 0 93,994
Schools 116,075 0 116,075
City Sanford 93,994 0 93,994
SJWM(Saint Johns Water Management) 93,994 0 93,994
County Bonds 93,994 0 • 93,994
Sales
Description Date Book Page Amount Qualified Vac/Imp
SPECIAL WARRANTY DEED 6/1/2010 07397 0180 55,000 No Improved
SPECIAL WARRANTY DEED 4/1/2010 07397 0179 100 No Improved
CERTIFICATE OF TITLE 3/1/2010 07357 0680 100 No Improved
WARRANTY DEED 5/1/2007 06699 1376 194,000 Yes Improved
WARRANTY DEED 4/1/2002 04396 1264 85,000 Yes Improved
WARRANTY DEED 1/1/1985 01610 1999 61,500 Yes Improved
kFind Comparable Sales.
Land
Method Frontage Depth Units Units Price L Value
LOT 0.00 0.00 1 20,000.00 { 20,000
Building Information
http://parceldetai1.scpafl.org/ParcelDetail Info.aspx?PI D=11203050900000590 1 /2
Florida's Largest Residential G
Roofing Specialist! Longwood 1- 41-2300
Melbourne 321-751-8850
pLaeersedOLLI St. Augustine 904-810-9657 Fcutory
I maned Lakeland 863-682 5700 BBB
Q Insured OEMQ
FaCtOY? CeYtl ed info@coZlisroofireg.
eom • wwzacollisroofi'ngcom R0FINGFlondaStateCertifiedRoofingContractor # CCCO58022 ROOFING
CONSULTANT/ESTIMATOR r
ESTIMATOR'
S CELL PHONE # PROPOSAL
PREPARED FOR PHONE DATE NAM "
WORK PHONE CELL PHONE J
STR
F,T / cam (
f /ln E-
MAIL CI
STATE ZI JOB
LOCATION CITY STATE ZIP EXISTING
ROOF CONDITION COMPLETE
ROOF PREPARATION - SERVICES PROVIDED TO HELP YOU AVOID HASSLES AND TO PROTECT YOUR HOME COLLISRO.
C?FING°SOLUTION,#1 Financing
Months same as Cash, % APR Manufacturer
Warranty PREPARATION ear
Full Workmanship Warranty PF-e-fnspection with our factory trained Project Managers. LLlVWe'
care taken to protect home exterior, shrubs and landscaping. Remove/
Replace El Enhanced Mfr's Obtain and post local permits in accordance with local laws. W
rrant ay/ JY5;KEM Color
Style e ve existing roof system to expose decking. Customer
Initials I pect decking for rotten and/or deteriorated wood and replace as needed per pricing schedule below. Renail
roof deck per current codes Solution #
1 Subtotal $ WOOD
REPLAC NT COSTS: Cust Initials Plywood,
per she 1 decking $ per linear foot. COLLISROOFING -, OLUTION #2 linear
foot. Fascia (pine/spruce) $(cedar) $_ per Manufacturer
Warranty UNDEF LAYMENT Dry -
In with underlayment. Year
Full Workmanship Warranty Install rubberized leak barrier waterproof membrane in the following areas. Remove/
Replace Enhanced Eaves Skylights Valleys vent Pipes Mfr'
s Warranty Chimney Crickets Low Slope Other Color
Style Install modified bitumen in dead valleys and low slope areas. Customer
Initials FL INGS hAlinch Solution #2 Subtotal $ Install color galvanized or aluminum metal drip edge at eaavv
s & rake edges. Customer's Initials F
ATI LOW SLOPE SYSTEM ;'"; „ ._ I II all new lead pipe boot flashings. II
all new 26 gauge galvanized, pre -formed valley metal. In
Inpff all new galvanized kitchen and/or bath fan vents. Year
Manufacturer Warranty place
skylight. Year
Full Workmanship Warranty VENTILATION 74' nstall ridge vents # Shingle Over Aluminum Color
Style Install off ridge vents # Install other venting # Customer
Initials Color Customer's Initials RIDGE
Flat /
Low Slope Subtotal $ Install premium high definition ridge (required by manufacturer for enhanced wind coverage) 0
Install standard ridge OTHER
SERVICES CLE - UP lean
1445`ul away all debris to approved facility Solar
PV El Hot Water netically
sweep job site out gutters IF
Inspection performed by factory trained Project Manager Insulation
LV-flelease of lien and written warranty provided at time of payment. Windows
The contractor agrees to commence work hereunder within thirty (30) days after the last to
occur of the following: (1) the Contractor has received a notice to proceed from the Owner,
and (2) the materials required are available to Contractor. Contractor agrees to prosecute
work thereafter to completion and to complete the work within a reasonable time,
subject to such delays as is permissible under this contract. All material is guaranteed
as specified. All work will be completed according to standard roofing practices.
Any alteration or deviation from the above specifications involving extra costs will
be executed only upon written order and will become an extra charge item -over and above
this agreement. Although we exercise all due caution, we cannot be responsible Solution
Number $ for cracked driveways, damages from rain, hail, or any act of God. Any leaks due to workmanship
and materials occurring during the Guarantee period will be repaired per Flat /
Low Slope $ our written Guarantee. This agreement constitutes the entire contract by and between Contractor
and Owner and the parties are not bound by oral expression or Other $
representation by any party or agent of either party. The above pricing, specifications and
conditions are hereby accepted. You are authorized to do the work as specified. 50%
DRAW DUE AT TIME OF DRY IN INSPECTION FOR JOBS OVER $15,000 AND THE
BALANCE OF EACH PHASE DUE AT TIME OF COMPLETION. In case of late TOTAL
INVESTMENT $ payment
or default, a charge of 1.5% per month will apply on all balances over 30 days Customer
Initials old. I agree that if Collis Roofing, Inc. is required to take any action to enforce this contract
I shall pay Collis Roofing Inc.'s attorney fees and costs, whether or not a suit is filed.
The price quoted for this proposal shall be good for thirty days or for such longer period at the sole option of the Contractor. 036651
Contract # DATE
CUSTOMER SIGNATURE Reorder
MBF 407-657-7414 CR-U01 04/15 ORIGINAL
TERIVIS AND CONDITIONS
I Collis Roofing, Inc. ('Contracltoi') assumes no re.sponsibility for structural integrity of the roof deck or of the building on which the roofing
is to be installed, oust om ei represents all structures to be in sound condition capable of withstanding normal rooting construction and operations,
Collis Roofing is riot responsible for any roof or structural related issue that may occur as a result of combining a sealed aVac system
wifti a self -adhered underayntent, 2.
Customer is solely responsible for providing Contractor prior to the cornmencing of construction with such water. electricity, or other utility
as may be required by the Contractor to affect the work covered by this contract. Customer hereby grants to kGc)ntractorthe right
to display signs and advertising at the project site. 3.
Where colors are to be matched, contractor small make every reasonable effort using standard colors and Materials, but does not guarantee a
perfect rnatcri, 4,
This proposal and contract is based upon the work to be performed by Contractor not involving asbestos -containing or toxic materials arid '
uhat such materials will not be encountered or disturbed during the course of performing this work, in the event that such materials are
encountered, Contractor shall be entitled to reasonable compensation for all additional expenses incurred as a result of the presence
of asbestos -containing or toxic materials, 5,
Customer shall be entitled to order changes and the contract price shall be adjusted accordingly, Upon removal of the existing roofing, conditions
which require additional work, Such as rotten or deteriorated wood, termite damage, or deficiencies in existing roofing underlayrnents
are sornetimes encountered. If the scope of work outlined on the 'lace of this proposal does not G0nTe.Mp!aT9 Such conditions,
Contractor will promptly report the condition to the Customer and take such steps as are reasonably necessary arid Prudent
to protect the building. Unless otherwise noted in this agreement, the price quoted does not include., removing or replacing fascia,
trim. sheathing_ rafters. structural niernbars, siding, masonry, vents, dry -in fell., caulking, metal -edging or flashing of any type. Additionally,
if it is determined that the rote',' has multipip layers of preexisting roofing material or any alteration to or deviation from the I - specifications
described on the front side ol this proposal involving extra costs will be billed as an extra charge on a timc arid material basis,
Replacement of detenoiated wood will not be optional for the security of warranties and will be supplied as disclosed on contract,
This is above and beyond the roof'nent will be 11 1gquoteanddoesriotrequirisanadditionalsignature, All wood replac, 1 considered authorized
unless cap is specified in writing b'y homeowner. 6. Contractor
shall no be responsible for loss, damage or delay caused by circumstances beyond its reasonable control, including but not limirteld,
to acts of God, weather, accidents, fire. vandalism regulation, strikes, failure or delay of transportation, shortage of or inability to ,)
brain materials, actsol testier or agents of Owner. Contractor is not required ro remove water from the ;oof. if the roof' ed to
be unleaded due to hicli- viinds or 3lorms, Gustorner agrees to reirnburse, Gointractor 'or labor ,and equipment costs for unroading and
reloadina the roofs(s), if gut-ce;- and/or downspouts live to be removed to facilitate a re -roof, Cont,'actor shall riot be held responsible for
any damago cause.,d by rornoval and/or irc-installation of_ gutter anf_-Vor downspot,its. Contractor shall be solely re,ponsible
lot the repair of any andl aidarnage caused by Contractor in perforl-nance, or the, ,Juties onder this contract, If Contractor disnovers a -dii"on
that is causie g' daimage to property or the sn-icture,, of a horrie, or reven-s r"onMipto, frorn r,on-loleting its
o-ties hereunder"on4,mc,,r-,,r shark oritar;t Custorner T Contractor shrAl nniain
and maintain in,";i-vance coverage as mflected on the "Irisutanes, Checklist" which is r-nade part otthis contract. Custorner is to carry
prooeirty and casuaflly instirar)CP, inClUding coverage ror fire, wind darnage and vandalism, 8, Customer actuvviedu,es
that re -roofing nnay cause vibration, dis4urbance, dust crdebris to fall 'into the interior. Customeragroes a,rnove or iprotc,-,,ct ipiroporty directly
below he roof in order to i-ninimiZe potentia interior damage. Contractor shall ble responsible Tra g'E', is earn , I move
or prorec, distu banre da, or 'oss to in"C'nor "prope'rty thiat Custon-isr did not re -1 prior tic cmnimtnc, rriont of roofing rt , ocrations, Customer shall nolify ten
law of re-roofino and he nee,d lis provild"n ProkECflon unden-ier J-th areas being re roofed. Cust,:'lner agrises to hold Contractr r
harmiess f imm, of 'enamts "M"ici ?,,,!e;,e not so notifie'd an'd did rirovide protection, 9. Contlrad'or and Customer are corna"
itted to _aolirigl proluptly so, tilat, roof are not a sou-ce of poiendal interior rnold grov0h. Custoroer will rnakc, periodic lin-spociions f.,,-)
r sig; S of wate, F r inuusiori a—1 ac' nrornofly, lriciticlinqnoticetoContractorifCustonnekh-lieves Nare -,,o rr-;olleaks, to
cot-ec the condition. Upon re,ciakving noticG, C(Xltra'001`VJ!; "T,ake re.pairs promptly so that water ontry through the roofing insta!lel-d by Conklracl
or is not a sclirce Of moistur(,-,_ Cn,ntractor is rLpt respionst!e 'cr indoor wr quality, To the exient th, h d i, at 6'ontrac or
did ,)of causedarnagetothierooftatanetheOCCLM'en'le Or e)(i1-,0SU,1,'e lo nold, r ,Iide,, ungi, spores, and for any other r1azardous chemical or b olooiccal aqeili, Customer
shail hold harrnk,)ss and iride-nnih, Contractm frorn claims ai ising out of or rolating to property dar-argo, neSorl,,il ink;
ry,, illness, allorgii-I reactions disease and iordeall resull,-,g frorn the occil(rence or exposure to mold, mildprw, furmil -spocps, and."r:r,
any other ha.zardous chernicad or biok,gicai agents. If Custorrrerf?ils to rnake pe'iodic ir!spections 'or sign of water inmUsion and."(
Dr fails to iact promptly (ins lux notice to Contractor) 0',hen Cat. stomer h_elil:lves 'there are roolf leaks, the Custorner shall hold hai'l-
riiess and 'Mdomnify Contractor from clairns arising cut of or relating to property damage, personal injury, illness, alierciic roacfions disease and/or death
resulting frcrn the occurrence or exposure to mold, mildoovi, fungi, spores. and/or any otner hazardous chemical or bioc!
ogica.! ilgents, 10Contractor is not restiarvSible for adequacy of claining or
ponding as a result of the onginal roof design for the building, Contractor does not p(ovide engineering, consulfing, architectural or design services,
arid it is no', the intent of th, Contractorto alterthe original drainage or pending design for Ime, roof. It is the Owner'
s responsibility to retain a iiconscd architect or enginner to deterri-tine proper design and code compliance 4, it drjsinn; to alter the original
dMining or polrding designs. Contractor is not responsible for the original roof design, and shall nit after the draining or ponding scheroes for, '
the, buildings. Any change in spe6fication orconstruction necessary to conform to existing or future building codes, zoning laws, or regulations
of the inspecting Public Authorities shall be k Nl!ed as an extra charge on a 'Lima arid friaterial basis.
onsidered additional wet W be 1, Contractor's work ip,,ifll be warranted by Contractorin :accord retie withits
standard warranty. A copy of Contractor's standard v..larranty is attached or, if not, will be lurnishicd upon request. Contractor SHALL NOT BF LIABLEE'
FOR SPECIAL 01:3 PUNITiVE DAIvIiAGES. Notwithstanding any contrary la, iguage in the standard warranty. "Custcrner agr see 'hat it small
notify Contractor \,Jthin five `5) days of discovering any leaks due to the rorrlinci systenn and/or the Contractor's scope
of work pursuant to tbis Contract, Custonner's failure, to timely notify Contractor of a ieai< due to the, roofing system and/or Corrtrautor`
s scope of work pursuant ti-i this contract, as required by this paragraph, shall absolve Contractor of ANY liability for damages created as a result
of that leak or systen-, failure, Nothing in this paragraph or contract shall extend Contractor's responsibility beyond the time lirriits crif the
warranty and/ or Florida Statute, Custorrier and Contractor agree that Contractor's Habilily for all damages found to be due
to a leak, in the roof :rya tern and,/or onlractcii's scope of work pursuant to this contract shall be limited to no snore
than "S I 5000.00 par occurrence. if an individual or entity other than Collis Roofing Inc, Performs roof cleaning on the Coilis Roofing applied roof, any
and all viarranfies will be void. 12. Customer acknowledges and understands vdhilc the Contractor is actively completing the work under the contract,
the work environment, including all roof areas, is a dangerous environruent. Custorrier agrees riot to interfere 'with, the
contractor frorn performing the duties under this contract. Custarrior agrees riot to enter the work environment while work
is being performed under this contract. I& This contract shall bo governed by Florida law and any action filed by
either party
as a result of a dispute resulting front or arising out of this contract or the transactions con tern plated hereby shall only be filed in the
Circuit Court in and for Seminole County Florida. 14, Contractor will provide a written release of lien, upon request, following receipt of final payment
on the contract, r E V
THIS INSTRUMENT PREPARED BY:
Name: Stephanie Williams
Address: Collis Roofing, Inc.
P.O. Box 520668, Longwood. FL. 32752
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
GRANT MALOYr SEMINOLE COUNTY
CLERK OF CIRCUIT COURT & COMFTROLLER
BK 8961 P3 301 (1Psa)
CLERK'S 4 2017076165
RECORDED ii7/ 27/2017 i 11: 59: 04 PM
RECORDING FEES $10.00
RECORDED BY .ieckenro
Permit Number: Parcel ID Number: 11-20-30-509-0000-0590
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.
DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
LOT 59 HIDDEN LAKE VILLAS PH 4 PB 28 PGS 26 TO 28
163 LONG LEAF PINE CIR SANFORD, FL 32773
GENERAL DESCRIPTION OF IMPROVEMENT:
Roof Replacement
OWNER INFORMATION: /
Name: C)cUQ laC l lclt
Address: 907 ARABIA AVE WINTER SPRINGS, FL 32708
Fee Simple Title Holder (if other than owner) Name: Owner
Address:
CONTRACTOR:
Name: Collis Roofing, Inc.
Address: P.O. BOX 520668, Longwood, FL. 32752
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served
as provided by Section 713.13(1)(b), Florida Statutes.
Name: n/a
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 best of my knowledge and belief.
J lx)IQS Pc--
Owner's Signature Owners Printed Name
d. Statute 713.13(1)(g): "The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead."
State of -f- \0 r 1 d Cf County of
The foregoing instrument was acknowledged
by tc) UIQ a ( Lcct P c
Name making statement
i lion producORwhohasproducedidentifiedio4l,El,typ3''pfld ri jf
A
p: Notary Public - Stzte of Florida E
Commission # FF 937709
try mCom. Expires Mar 16, 2020
Buntleo!n;nw1h National NdKV Assn.
before me this aL (_ day of J U 1 20 `
Who is personally known to mel9p
Notary
v--
CO
N
J " 1 CC
oI
O w"^u"'a Gam.
J W
it v
V'
t
aCr
U
a W J= Q
Or+-2
vZ:
CC LAJ
C1 V < CA
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 7/25/2017
I hereby name and appoint: Ray Henderson
an agent of. Collis Roofing, Inc.
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):
The specific permit and application for work located at:
163 Long Leaf Pine Circle, Sanford, FL. 32773
Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name: J. Douglas Lanier
State License Number: CCCO58022
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF Seminole
The foregoing instrument was acknowledged before me this a --)day of ,
20Wk') by J. Douglas Lanier who is 21 personally known
to me or who has produced as
identification and who did (did not) take an oath.
WENDY STAATS
Notary Public - State of Florida
Commission # FF 937709
qw + PQc My Comm. Expires Mar 18, 2020
Bonded through National Notary Assn.
Rev. 08.12)
Signature ,J
s
Print or type name
Notary Public - State of _
Commission No.
My Commission Expires:
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 1S 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)
0 EACH PLANE OF THE ROOF, SHOWING THE UNDERLAYMENT INSTALLED
0 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)
0 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 (1F APPLICABLE)
o DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL
0 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; 7/25/2017
vr-' r cif
r`
PERMIT #
SSE' City of Sanford Building Division
Residential Re -Roof Scope of Work
JoB ADDRESS: 163 Long Leaf Pine Circle, Sanford, FL.
STRUCTURE TYPE: 0 SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE:. e) REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): 1 /2" Plywood
PLEASE NOTE. Oft Y 100 SQUARE FEET OF THE EXIST= DECK IS PERMITTED TOBEREPLACED*x
ROOF VENTILATION: 0OFF-RIDGE ® RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: OYES (E) NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL#:
MAINROOFAREA___------------_---__--- ------------------------------------_____._.---._._.-------------.......___..-_.-----------
ROOF SLOPE: O LESS THAN 2:12 O 2:12 -4:12 (2) 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE Owesn Corning Supreme FL# FL10674-R12
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH DowN FL#
OINSULATED FL#
OTILE FL#
OTHER: Underlayment Owens Corning FiberglasTA° Reinforced Felt FL# FL12536-R3
ROOF EXTENSIONS(PORCHES. PATIOS ETC. **IF PPLICIBLE**
RbOF SLOPE- O LESS THAN 2:12 O 2:12 -4:12 O 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O SHINGLE FL#
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
OINSULATED FL#
OTILE FL#
0 OTHER: FL#
a
s City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY- ws FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT: ADDRESS: _ 163 Long Leaf Pine Circle, Sanford, FL. 32773
I J. Douglas Lanier AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, 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#: CCC058022
COMPANY/CONTRACTOR: Collis .RgAing1jpe-/ J-Rouglas Lanier
CONTRACTOR SIGNATURE: _
MUST BE SIGNED BY LICENSE
A FINAL ROOF INSPECTION 1S REQUIRED:
DATE: — )
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 R0017 SHOVING 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 Seminole
Sworn to and Subscribed before me this cr,-I
0 day of \-- 20 17 by:
J. Douglas Lanier Who 10 Personally Known to me or has O Produced (type of
Identification) as identification.
Signature of Notary P bllc MIE(10Y STAATS
State of Florida 20+
a o, Owl rok - S1sls of jor d'
Commission + FF 931W
My Comm. Expires Mar 16, 2020
iF OF F'• Bwdedt rouph National Wxy Assn. PrintlPme/S mti Name """
of Notary Public