910 Holly Ave; 17-2168; ROOFJUL 18 2017 CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: 11 cT U
Documented Construction Value: $
Job Address: `7 / D id 140 Cc-y AO-e . e/ Li,,Y IW Historic District: Yes No [
Parcel ID: '• / 9 • d • ./ a • / //. ( U y O Residential Ef Commercial
Type of Work: New El Addition Alteration Repair Demo Change of Use Move
Description of Work: .Zo 1/ e" 0'6 AeS
Plan Review Contact Person: L Title: 664J.i,,f t=72
Phone: Fax: 4o % • ,3d( i'S Email: Qd coc/c c04in s -c- 6eJ1Sdd H -17&-
Property Owner Information
Name LL4 za %/ C..(_t ,A"_ss
Street: 9/ O A
City, State Zip: 12-0C- 3 'Z 7 % J Phone: .
y D 7 - 24. • ( 9 X)- Resident
of property? Contractor
Information Name
ApuC ac OQc)Ori^j S Phone: IOC 9S,41Street:
dUO G. Jr2 EYIG' A-t- e 2 Fax: V d ) IFS 5-)- City, State
Zip: U 4 - orb-- 3 o2 -7 1 State License No.: (fLLO l- S-6/ Architect/Engineer
Information Name: &)A
Phone: Street: Fax:
City, St,
Zip: Bonding Company
Address: E-
mail:
A Mortgage
Lender: d/,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. 1 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: 51' Edition (2014) Florida Building Code Revised: ,Tune
30, 2015 Permit Application t 4.
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 ettect 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.
v
a vaff,, 7
Signa eofOwner/Agent r Date
print Owner/Agent's Name
fib
S',V 16ture f j f2 of plori to
Notary Public - State of Florida
Commission; FF 221706
My Comm. Expires Apr16,2019ENO
signa ofcontr for gent Date
A.,0oQf-4J ,40c9d`
Print Contractor/Agent's Name
DONALD RASH
Notary Public - State of Florida
Commission A FF 221706
Fov My Comm. Expires Apr 16, 2019
Owner/Agent is Personally Known to Me or Contractor/Agent is erlso—nTM17Rnown to Me or
Produced ID Type of ID Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas[] Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
THIS INSTRUMENT PREPARED BY:
Name: ADCOCK ROOFING
Address: 800 S. FRENCH AVE.
SANFORD, FL 32771
NOTI6E OF COMMENCEMENT
Permit Number:
25 19- 30-512-1111-0040
GRANT NLOY, SEI1INOL_E COUNTY
1-1.RK OF CIRCtilT COURT & COPIPTROLLER
Bk Y 9-54 F'3 132fI ( I P 9 S )
CLERK'S T 2017072382
RECORDED' 07/1:1; 20171111
RE(t,ti,' ING FEES $1F —00
RECORDED BY hdev, ')'e
Parcel ID Number: -
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)
LOT 4 BLK 11 TR 11
A C MARTINS ADD
PB 1 PG 98
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Re -Roof
3 OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: WILLIAMS ELIZA A- 910 HOLLY AVE SANFORD FL 32771-2420
Interest in property: OWNER
Fee Simple Title Holder (if other than owner listed above) Name:
Address:
4. CONTRACTOR: Name: Adcock Roofing —
Address: 800 S. French Ave., Sanford, FL 32771
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
6. LENDER:
Phone Number: 407-322-9558
Phone Number:
Amount of Bond:
Address:
7. 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)(a)7., Florida Statutes.
Phone Number:
8. In addition, Owner designates
to receive a copy of the Lienor's 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)
of
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARECONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
n
Signature of Owner or Lessee, or Owner's or Lessee's
Print Name and Prowde Signatory's Title/Ofrice)
Authorized Officer/Director/Partner/Manager)
State of --Pub k ICounty of A(.-I 'D £ The
foregoing instrument was acknowledged before me this , / 2 day of _ \ / LL L y 20 by &
14 7-4- ( C. ! 4 S Who is personally known to me OR Name
of person making statement who
has produced identification type of identification produced: DONALD
RASH Notary
Public - State of Florida Commission #
FF 221706 My
Comm. Expires Apr 16, 2019 Notary
1A
fit'
1b,
June 23, 2017
ADCOCKROOFING 800
French Ave. Sanford, 0
i. 8 / 0 • • STATECCCO22501
Name:
Eliza Williams Address:
910 S. Holly Ave. City:
Sanford, FL 32771 Email:
ESTIMATE
SCOPE
OF WORK: COMPLETE ROOF REPLACEMENT Phone: (
407) 322-6922 Cell: (
407) Fax: (
407) 1.
Remove old existing roof on complete house. 2.
Re -nail decking as per building code. 3.
Dry in with new layer of synthetic underlayment. 4.
Install new 30-year architectural shingles. 5.
Install new drip edge; 26 gauge, painted galvanized. 6.
Install new kitchen and bathroom vents. 7.
Install new lead flashings on plumbing pipes. 8.
Install new ventilation to match existing. 9.
Secure all permits. 10.
Clean up & haul away debris. V
11.
Inspections included. 60 Labor &
Materials.-<$ 646-'0'0 b -)
v Extra —
Bad wood & flashings: Time & Materials - $70.00 per sheet plywood; 2 x 4 and fascia - $4.50 ft.; Warranty:
30 Years on Materials from Manufacture 5
Years on Workmanship Andy
Adcock, Owner Andy
Adcock
L
r
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 co a compliance by personal inspection.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE: o /-7
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: `I I D H04.
STRUCTURE TYPE: (3 19INGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: O REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY):/' p L q w000
PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DEck IS PERMITTED TO BE REPLACED * *
ROOF VENTILATION: OOFF-RIDGE RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES ()/NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 Q'2:12 - 4:12 O 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE L FL# 9'255-, /
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
O INSULATED FL#
OTILE FL#
O OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLICABLE**
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 FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
O INSULATED FL#
OTILE FL#
0 OTI4ER: FL#
SCPA Parcel View: 25-19-30-512-1111-0040 Page 1 of 2
Property Record Card
Acoy*PPMR
wson,CFA Parcel: 25-19-30-512-1111-0040
Owner: WILLIAMS ELIZA A
scna cxi..crx;v. Property Address: 910 HOLLY AVE SANFORD, FL 32771-2420
Parcel Information
Parcel 125 19 30-512-1111 0040
Owner WILLIAMS ELIZA A
Property Address 910 HOLLY AVE SANFORD, FL 32771 2420
Mailing 910 S HOLLY AVE SANFORD, FL 32771-2420
Subdivision Name MARTINS ADD A C
Tax District S1-SANFORD
DOR Use Code ( 01-SINGLE FAMILY
Exemptions! 0 EAD(1994)
i
Seminole County GIS
Value Summary
Values...-..-....-.. 2017 Working 2016 Certified
Values
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 61,278 59,108
Depreciated EXFT Value i $263 275
Land Value (Market) 16,570 16,570
Land Value Ag
Just/Market Value " 78,111 75,953
Portability Adj
i-.. .._......,_.....__g..._.
Save Our Homes Adj 24 467
I
23,412
Amendment 1 Adj
P&G Ad' 0 i $0
Assessed Value 53,644 52,541
Tax Amount without SOH: $699.14
2016 Tax Bill Amount $510.32
Tax Estimator
Save Our Homes Savings: $188.82
Does NOT INCLUDE Non Ad Valorem Assessments
Year Built
k Description Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages
Actual/Effective
1 SINGLE 1978 61 2 1.5 936 1 1,261 ( 1,261 CB/STUCCO E $61,278 j $7 6 Description Area
FAMILY j FINISH
BASE SEMI ` 325.00
j FINISHED l
http://parceldetail.scpafl.org/ParcelDetaillnfo.aspx?PID=25193051211110040 7/18/2017
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILIjNG, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT##: 1 j ADDRESS: b 4/ 0-
I 'C- /V nL' P(A / -yd &0 C,Y (/-- _ _ , 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 #: Cc- C 0 1y / COMPANY /
CONTRACTOR: kl 4 L CONTRACTOR
SIGNATURE: DATE: I —G — 7 MUST
BE SIGNED BY LICENS OLDER OWNER/BUILDER) 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 5; WU VIO L_ Sworn
to and Subscribed before me this Z day of 7—k 20 _3)by: Ct?
D G! ( —5 Who is &Wersonally Known to me or has Produced (type of ideutificalion)
Sure
of Notary Public State
of Florida Print/
Type/Stamp Name of
Notary Public as
identification. KINA.
0 RAN Nof
Public- a
State
of Florida Ceram
soon ; FF 22T706 I1y.
omm 001resApr16,2019