704 Palmetto Ave; 17-2097; ROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Applica-fio-n No-.-, 1`7 -
I
a 0 9 7
Documented Construction Value: $ 6190-0
Job Address: 70V 4vlf- 5opr0et) Historic District: Yes F1 No
Parcel ID:.a Y- / _ 0 7 0'' -00 o'\,O Residentia4K CommercialEl Type
of Work: New n AdditionFl AlterationEl Repair 0 DemoE] Change ofUsen Moven Descriptionof'Work:
F\'0-P,_QC)F Slk-{0 6 ( -6 1 Plan Review
Contact Person: Title: #;IJ4 6 C-,P- Phone: qO-
7 Email: Propertv Owner
Information Name o
ne- 6 0 fu 0 Iq 'Phone: Street: -017
on - -
C7,77-
CD (167 Resident of property? 7 City, State
Zip: 54VF4262,Z) z le`_- 32721 Contractor Information
o&krl.
tic) 7 --a-S- J Natn'V0_ykeQ--1)-e_ e'c S 0 e_c_t 0- 1 t AS Phone: Street: 5-
0 / (,::2 CC—(E7/'f 8 T?) L-V b - Fax- -J ?, / - City, State
Zip: A-(_T1-A-Vy1(Qtj SP6-S > 6( _32-2/V State License No.: C_ C C (0 C Architect/Engineer
Information Name: phone:
Street: City,
St,
zip: Raliding Company
All A Address: Fax:
E-
mail:
Ntiart,yage
Len -der: A-) 1A 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 RECORDEDANI) POSTED
ON THE JOB SITE BEFORE THEFIRST INSPECTION. IF YOUIN',rEND 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 pernat and that all work will be performed to meet standards of all laws regulati fig construction n thi s
jut-isdiotion.. .1 understand that a separate be secured for Oecltncal 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 RevisLd: June 30,
201 S Permit Application
N10TICEt 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.
Acce}stance of permit is verification that 1. will notify the owner of the property of the requirements of Florida Lien :Law, F S 713.
The'City of Sanford requires payment of a plan review fee at the time of permit submittal.. A copy of the eaccuted contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of thee job at the time of submittal.
The actual construction value will be figured based on the current'ICC ValuationTable in effect at the time the pernut 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 cons ruction and zoning. 7/
1 7 S
gnature of`Owncr/Assent Date Sidiature nrContractor: }/Date Print
Owner/Agent's Name Prink,Contractor/Agent's NirneTT X
jy ` 4ibnatttY} of !>q,Vrt, tate'of Florida- )af ( r T + lorida Date a
RICHARD EHF ESMAPI O••e••••Oeee•e
I
a
Notary Public - State of Florida .: MY
Comm. Expires .lrin 12, 2018 . .. commission
1r FF 131938, My Comm: Expires Cn October
17, 2020 Owner/
Agent is Personally Known to Mc=c r C;otit q ( 6r t'is4 ersolially Known to Me or Produced
iD _ Type of ID S — i (5v;ueg d ID e of TD L J OF
BELOW
IS FOR OH. C__NLY 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 APPROVALS:
ZONING: 96 7 ' (1 - / UTILITIES: ENGINEERING:
FIRE: COMMENTS
Fire
Alarm Permit: Yes No WASTE
WATER: BUILDING:
Reviscd:
Junr3o, 20t5 Ptxrnit Aoliicaliml
Answer all the questions on this form and submit all required attachments. incomplete applications will notbereviewed. if you have questions ahoutl application requirements contact the Historic Preservation Officerat40.688.5745 to ensure your application is complete.
General Information
Downtown Commercial Historic District [] Residential Historic District is this a retroactive request? Eyes El
Is this application filed in response to a Notice of Violation from the Code Enforcement Department? i Yes QNo
Proposed improvements mil affect the following elevations: North South East West
Property Address: 704 PALTVW, TTO AVE SANFORD FL 32771
Property Owner Information.
Print Name:•
Mailing Addi
Phone: 407
ApplicanUAgent Information
Print. Name: R"AELDAIYIi"
Mailing Address: 473 CITRUS LN, MAITLAND FL 32751
Phone: 4076812950 Email: DAIv1A8C0N8TRUCTI0NI@qMAII Signature:
BY SIGNING BELOW YOU ACKNOWLEDGE THAT A BUILDING PERMIT MAY QUIRED FOR THESCOPEOFWORKLISTEDBELOW.I YOU MUST CONTACT THE BUILDING DEPARTMENT TODETERMINEIFABUILDINGPERMITISREQUIREB, FAILURE TO osymN. A BUILDING PERMIT ORDEVIATIONFROMANAPPROVEDCERTIFICATEOFAPPROPRIATENESSV1_L RESULT IN A STOPWORKORDER, DOUBLE PERMIT FEES69I
AND
POTEN'PIAL FINES. BY SIGNING BELOW, YOU ALSO. ACKNOWLEDGE
THAT THE INFORMXtION CONT, AI4ED - IN THIS APPLICATION IS TRUE AND ACCURATETOTHEBES' YOUR K14OWLED8E_ Signature:
Date:
j— Yes,
1 wosnid you fa the enralis regarding Historic Presetvatfi5M and Corms un ty Plan ning Within your corntnuniiy. Description
of proposed work Completely
describe the entire scope of work, tnduding changes in riaterialand color, and methods that will be. used to
accomplish the proposed work. For large prgeets an itemized list is required. Use the reverse side if necessary. i
HISTORIC
PRESERVATION BOARD-. 300 N. ParitAvenue q Sanford, Florida 32771 •407.688.5145 0 vW w.sanfor&pov/HP
Oty of Sanford
Building and Fire Prevention
Permit #
Project Location Address I C) (-I ! t Uc;, xS4k-)-FD(2-b i 4:7L 3 Z-7- I
As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the
information and product approval number(s) on the building components listed below if they are to be
utilized on the construction project for which you are applying for a building permit. We recommend that
you contact your local product supplier should you not know the product approval number for any of the
applicable listed products. Be aware, that windows, skylights, and exterior doors must be tested in
accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product
Approval can be obtained at www:floridabuildinq.orq,
The following information must be available on the jobsite for inspections:
1. This entire product approval form
2. A copy of the manufacturer's installation details and requirements for each product.
Category/Subcategory
1. Exterior boors
Manufacturer Product
Description
Florida Approval #
include decimal)
Swinging
Sliding
Sectional
Roll U
Automatic
Other
2. Windows
Single Hun
Horizontal Slider
Casement
Double Hun
Fixed
Awn i n
Pass Throu h
Projected
Mullions
Wind Breaker
Dual Action
Other
June 20'14
Category! Subcategory
3, Panel Wall
Manufacturer Product
Description
Florida Approval #`
includin decimal)
Siding._
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles
C_9 ScS / _Hle-_ UnderlamentsRoofin
Fasteners ,. C_
1& 2 2 -rs' 3 Nonstructural
Metal
Roofing Wood
Shakes and Shingles
Roofing
tiles Roofing
Insulation
Waterproofing
Built
up roofing System
Modified
Bitumen Single
Ply Roof Systems
Roofin
slate Cements/
Adhesives
Coating
Liquid
Applied Roofing
Systems Roof
Tile adhesive
Spray
Applied Polyurethane
Roofing
E.
P. S. Roof Panels
Roof
Vents Other
June
2014
Catego' / Subcategory
5. Shutters
Manufacturer. Product
Descri tion
Florida Approval #'
include decimal)
Accordion
Bahama
Colonial
Roll u
Equipment
Other
6. Skylightshts
Sk li hts
Other
7. Structural
Components
Wood Connectors /
Anchors
Truss Plates
Engm neered Lumber _
Railin
Coolers/Freeze:rs
Concrete Admixtures
Precast. Lintels
Insulation Forms
Plastics
Deck / Roof
Wall
Prefab Sheds
Other
8. New Exterior
Envelope Products
Applicant's Signature
Applicant's Name
Please Print)
June 2014
Y
Permit Number: J ODD ]
Folio/Parcel Identification Number:
to:
ZC 0fi_Q dT 11A1 O f r SE NIHOLC COUH ( r Of' {]
RC'llil C01JRT f: C;0t1PTR0L ER OEM
89:37 (q 1932 CLERK'
S Y 2017062527 RECORDED
0,1/21/201.7 11 22.'`i1 eal1 L'
1 E.E '0RD1hfG FEES $11J. 0 i
R ORDED 1't' jecl-enro NOTICE
OF COMMENCEMENT State
of Florida, -County of Orange 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 description of the property, and street address if available) or.
z-ar 2- ny; r '7' z 'TV1t)1U rU/'l),/—L 2.
General description of improvement 3.
Owner information or Lessee information if the Lessee contracted for the improvement Name &, ,
P&". /;,,d- Interest
in Propen'y Name
and address of fee simple titleholder (if different'from Owner listed above Name
4.
Contractor Name,
tea % /G c= .D Jr i11 S Ec j„/Sri Telephone Number U 7 —, _-)Sd- X/ Address
e6Sc IU 1-3te1AA- 64i/D L j:/.L s'S -71 5.
Surety (if applicable; a copy of the payment bond is attached) Name ,/ /'„
Telephone Number Address %
Amount of Bond $ 6.
Lender / Name_
Telephone Number Address
7. '
Persons within the -State of'Florida designafed-by awn r upon"whom notices ordttiet documents'rnay be
served as provided by §713.13('t)(a)7, Florida Statutes. Name
Telephone Number Address
8.
1
In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice
as provided in §713.13(1)(b), Florida,Statutes. Name
Telephone Number Address
9.
Expiration, date of notice of commencement (the expiration date may not be before the completion of construction
and final payment to the, contractor, but will be 1 year from' the 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 1, 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
penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts
stated in it are true to the best of my knowledge and belief. i t1.1 Si
nature of Owne essee, or Owners or Lessee's Authorized Officer/DirectorlPartner/Manager Signatory's Title/Offgs q ``^Z,n a-
The
foregoing instrument was acknowledged before me this LC day of, by Q0 / % monthlyear
name of person as
posetJPO A 0 for Type
of a h rity, ., officer, trustee, attorney in fact Name of party on behalf o whom instrument was executed aap,-
3 f Signa
otary Public —State of Florida P tiF`E r, or st: L8M tfil&d?iddrd6ae of Notary Pul liG Notary
Public - State of Florida F',
Personally
nowne./OR Produced ID r a commission # FF 223631 u ;
Z M
Comm. Expires Jul 14 2019 TypeofIDrocFOF,`°p Y p' Z
w t``
Bonded through National Notary Assn. evisedrSWtlembpr
26. 2Q11
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: ' / 0
STRUCTURE iYPE: C SNGLE FANULY RESIDL-:NCEITowNHOUSE O MOBIL I10VIE 0 APARTVfENTiCONDONiNWM
RE -ROOF TYPE: EPLACEIIENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTNG ROOF)
DECK TYPE (PLEASE SPECIFY):
PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED**
ROOF VENTILATION: D OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT QTURBINES
SKYLIGHTS: O YES O 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
RoOFEtTENSIONS(PORCHES PATIOS ETC) **IF iPPLIC4BLE**
ROOF SLOPE: O LESS THAN 2:12 O 2:12 -4:12 Q 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O SHINGLE
FL#
O METAL
FL#
QMODFRED BITUMEN FL#
OTORCT-1 DoWN FL#
O INSULATED
FL#
O TILE
FL#
O OTHER: FL#
II - 'a697
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 rffsult in an affidavit providyd--by a Florida Design
Professional (architect or engineer),
CONTRACTOR (OR OWNER/BUILDER)
inspection.
DATE:
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 7 - p` 09 / ADDRESS: 7D / / / / L-,W577 ,7—D y Se9W - I >
5
u a - AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR ROOFING CONTRACTOR,
ENGINEER, ARCHITECT, OF F.S. C TER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE FOREGOING INFORMATION
IS TRUE AND ACCURATE AND THAT ALL ROOFING COMPONENTS LIST ED 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
C / ,.3c;)L < & 0/ COMPANY / CONTRACTORN
p/" i 3Uny l/ V CONTRACTOR SIGNATURE:_
DATE: ilIZ-z— MUST BE
SIGNED BY LICE LDER OR O R U A
FINAL
ROOF INSPECTION IS REQUIRED: THIS SIGNED
A OTARIZE 'A . FFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINAL ROOF INSPECTION, ALONG WITH
DIGIT L 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 (ARCHI.TECT OR ENGINEER) TO CERTIFY, BASED ON PERSONAL INSPECTION, THE
INSTALLATION OF ALL ROOFING COMPONENTS. STATE OF
FLORIDA COUNTY OF t^ ' " Sworn to
and Subscribed before me this day of /-jo " W' 20 7 by: Ss u%
iJar- Who is Personally Known to me or has Zproduced (type of identific 'on)
T / LJpknr as identification. r 1H11111/ SNYpF i
Sign Lure
o Notaiy Public State of
Florida s o ff J
Print/Type/
Stamp Name PU moo" of
NotaryPublic7, elo,