118 Placid Woods Ct; 17-1875; ROOFi
J U N 2 1 2017
k
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: i 2 `1
Documented Construction Value: S -7 7S_Q ,
Job Address: " ?16t!jA Vy 06AS a • S(Ar 32 81istoric District: Yes No [)V Parcel
ID: b 2 ZO —3 SN-0000 _ -70 Residentiaod Commercial Type
of Work: New DAddition Alteration RepairNZ Demo Change of Use Move Description
of Work: IL Plan
Rgviiew Contact Person: M+ OV)CO3 07.0AL Title: elyiCYrvl __ Phone: " d ` 7 `
V I-6 7Fax• Email:Q 5 (M VOn6'a fepI Property Owner Information
f Namemav-L4
Holaod
Phone:'"107 -q31 V6s6 Street: T1 N
0 + • Resident of property? : AS City, State Zip:
Contractor Information qb
J "% (Name
I C
V ( "1 U/I!U%i Phone: 7 `q / — `' q5 Street: , Fax: City,
State Zip: /
kj do i // Jf L' b azStateLicenseNo.: (i C 1330 J? Name: Street: City,
St,
Zip:
Bonding Company: Address:
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: 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. ,,
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Agent Date
Prin ontractor/Agent's Name
a L-1-
Signature of Notarv-State_of Florida Date
ANNETTE BLAND
Notwy Public - State of fiorids
za s= Commbsion s 00 0008Y3na . My Comm. Expires J 1
Owner/Agent is Personally Known to Me or Con Personall A to Me or
Produced ID Type of ID Produced ID ype
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: # of Stories:
New Construction: Electric - # of Amps Plumbing - # of. Fixtures
Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING:
COMMENTS:
Revised: June 30, 2015 Permit Application
PERMIT # `
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: I
STRUCTURE TYPE: YINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: PLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): t/Z 67JALb PLEASE NOTE.
ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED"x ROOF VENTILATION:
aoFF-RIDGE O RIDGE O SOFFIT OPOWERED VENT OTURBINES SKYLIGHTS: O
YES 02QO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL : MAIN ROOF
AREA ROOF SLOPE:
O LESS THAN 2:12 O 2:12-4:12 Q 4:12 OR GREATER TYPE OF
ROOF MANUF(A CTURER FLORIDA PRODUCT WHINGLE r /
1 Il \/ IWAPPROVALFL#
i
O
METAL
FL# O MODIFIED
BITUMEN FL# O TORCH
DOWN O INSULATED
FL-"' FL#
O
TILE
FL# O OTHER:
FL# ROOF EXTENSIONS (
PORCHES PATIOS. ETC.) "YAPPLICABLE"" ROOF 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
O MODIFIED
BITUMEN FL# FL#
O
TORCH
DOWN FL# O INSULATED
O TILE
FL# FL#
O
OTHER:
FL#
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.
xXProjects 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 y pe onal inspection.
CONTRACTOR (OR OWNERBUILDER) SIGNATURE:
r DATE: /
THIS INSTRUM NT P EPARE BY: I I III ll llll llli iiii fifil fill fill
Name: 1
Address: L
GRANT MALOYr SEMINOLE COUNTY
CLERK. OF' CIRC:UI7 COLif:1 & COrIPTROLI._ER
6—L BK k"JUS P3 202 (11`9s
CLERK'S T 2017062638
NOTICE OF COMMENCEMENT
RECORDED >1FEES $1_10- 1:v»y3»4t f l",
RECORDING FEES •1ii,iJil
RECORDED BY tsmith
Permit Number -
Parcel ID Number. O -L U — 30 —GZ - 0 d66 — U0-70 -
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 OF PROPERTY: (Legal descripti n of the property and street address if available)
L-o -j () dC ?T71 e 15 e P LiS (,o 5 -+ &(o
it VCR C 61 V46VA ,-FL 3L7-73
2. GENERAL DESCRIPTION OF IMPROVEMENT: , /
c — Yo OT
3. OWNER INFORMATIOW ORLESSEEINFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT - Name
and address: JyIU'"1 Huhn A -id-plawl V bbW 64. S« n d , •z 7 7 Interest
in property: Fee
Simple Title Holder (if other than owner listed above) Name: H
S.
SURETY (If applicable, a copy of the payment bond is attached): Amount
of Bond: S.
LENDER: Name: Phone Number: Address:
7.
Persons within the State of Florida Designated by Owner upon whom notice or other documents maybe served as provided by Section 713.
13(1)(a)7., Florida Statutes. Name:
Phone Number: S.
In addition, Owner designates of to
receive a copy of the Lienors Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number: 9.
Expiration Date of Notice of Commencement (The expiration 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. of
owner L see, or Ownefs or Lessee's (Print ame anc Provide signatory's Title/Office) o(
riz ed Otfi !pi aor/Partner/Managefj C
o ,(// /' l % State
of ,Inu,,u,
e r `
County of )V .' lI , v `^ The
foregoing instrument was acknowledged before me this J (ice Q day of l 120 ( -7 by
Cti `(J Who is personally known to me G OR ame
of wss jn making statement Y
y ... who
has produced identification of identification produced: L H4
uLgj':f F;"
y GRACIELA GAGNE z
MY COMMISSION !F FF965949 GRPN OV EXPIRES
April 25. 2020 407)
98-0153FlarkalloU a0rt1 or
Note ignaWINL•0 - NY C.
NQ OMp 1Q Nay F- Qv OAL
1
LIC # CCC1330939
LIC # CRC1331435
PROPOSAL SUBMI
STREET
CITY, STA
HOME PH
Licensed & Insured
First in Oualby
First in Service
First in Satisfaction
Ins. Co, e Cur I" C
Tel.# g-7-7 —_S I —
Claim # t) a J
800-411-0920 Adj. Name
6767 Hoffner Avenue
Orlando, Florida 32822
u T14v I'to F
Tel. #
rFax
PC V S
dE
DATE
SPECIFICATIONS FOR LABOR AND MATERIAL
Q Tear Off Shingles: Layers
Ox/Professionaliy Install: Brand 1 cLw, .,, Type t!-C -% % Color c l-°
fa 'New Valleys Ft.
C I'n tall: 0 30 lb. Felt 0 Peel & Stick Q Synthetic Underlayment .
r seal, sidewalls, counter and wall flashings Re -Use Drip Edge C'Drip Edge
1-1/2' 2' 3' 4' or Plumtbing Vents
e lation:. Goose Necks Off Ridge Vents Ridge Vents Color lPLC-
P3 Renail Plywood Sheathing to Code
0 Skylight 2 x 2 4 x 4
a/Pywood replaced at $60 - per sheet (f needed)
O'Clean-up and haul off all job related trash oil yard with ma netic roller 0^"Protectyard and shrubs
A--n A it i l\-? r - U .n C -I?-1 _t-I ll\\/
1INi
iA GI L Atlantic
Roofing is not responsible for }ire -existing structural conditiohs. Buyers
agree they have seen, read & understand all terms & conditions of this contract & agree to be bound by same. ALL
ROOFS HAVE A 5 YR LABOR WARRANTY CONTINGENT
This
proposal is contingent upon the Insurance company paying for damages. This proposal will be VOID only if claim is disallowed by Insurance company. Propertyowner's out-of-pocket expense Is not to exceed the deductible amount. The insurance company will determine and set the price of the claim. YOU,
THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE IF THIS
TRANSACTION. BY SIGNING ABOVE. PROPERTY OWNER AGREES TO PROCEED WITH THE WORK AS PER PROPERTY -LOSS WORKSHEET
WHEN RECEIVED. We
propose to hereby furnish materials and labor, complete In accordance with above specifications for the sum of the insurance as per the insurance company
loss s a she r wh6 is incp rated herein and Tirade a part hereof by reference, to include customary profit and overhead when multiple trade
incurred S l P m2nt n completion of Uch trade. Authorized
Signature' Must
be approved by company owner. No other rk eicpressed'or implied verbally. All changes to be in writing and accepted before commencement of changes.
NOTE: This proposal may be wdhdryh by us if not within 30 days. ACCEPTANCE
OF PROPOSAL- The abo specifications ndlti a sfactory d are hereby accepted. You are authorized to do the work
as specified - a— l Payment
will be made as outrrne abod Date
r
g City of Sanford
Building and Fire Prevention
2=
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ! ADDRESS: P /S
I r7( Ciy44L I Q:!!t — , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, ENGINEER, kkCHITECT, 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, O 7 3 '
COMPANY /CONTRACTOR:
CONTRACTOR SIGNATURE: ;& DATE: -1
MUST BE SIGNED BY LICENSE HOLDER 0R OWNER/BUILDE
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
Sworn to and Subscribed before me this 1qe&day of 20 by:
j&.4 (JY+ 60y '0-- Who isov-usonally Known to me or has Produced (type of
JI
identification) _ as identification.
ignatu a of Notary Public
State of Florida
CKDOLAN
MY COMMISSION FF 071532
Print/Type/Stamp Name EXPIRES: December 27, 2017
of Notary Public fATFOFFl PO Bor&d Thru Budget Notary Services