422 Summerlin Ave; 17-2471; ROOFAUG 1 2017
y 4
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $ 77 S--& . 00
Job Address: Y2A JtLMA •e4ci-'i ALA wllo L rL40 Historic District: Yes No
Parcel ID: &U. /C/ - d3 /. as. b660 - DL/O Residential Commercial Type
of Work: New a Addition Alteration Repair Demo Change of Use Move Description
of Work: e6(3 N-?O tze'!Zw AACA't-CC uzq(.. ii rham Plan Review
Contact Person: Aioi/ Ab&o Title: a ciy Phone: Y%7
9 J / , O ;J_ Fax: 2 -93-I A Email: n Property Owner
Information
Name tt/ye
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Phone: r a % / 7 n Street: 7Z
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U-m t'L(c n . t Resident of property? City, State Zip:
4 L d -7-7 p,.%D /L / h Contractor Information
Name ,
l1a F_
o o& Phone: Q 7 • ` 1 Street: Boo (,-/ -Owc,
C,>L.- -(-- Fax: L/O % ' J- 1 1 City, State Zip: ,
f-_ ).L1.7 State License No.: CC ,1_ O a-.2- Sb/ Architect/Engineer Information
Name: /J Street:
City, St,
Zip:
Bonding Company: AJ /
a Address: Phone: Fax:
E-
mail:
Mortgage
Lender: Address:
J /-I
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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:.5'h Edition (2014) Florida Building Code Revised: June 30,
2015 Penn it Application
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OWNER'S AFFIDAVIT: I eel-tifN, that all of the foregoing information is accurate and that all work mvill
be done in compliance with all applicablic lairs repilating construction and zoning,
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1"A"M 11,10M. ADCO C K
Notary PWk •- State Of Florida DONALD RASH
C011111111118111ilm 0 fill013492 Notary Public —State of Florida
Commission # FF 221706myCOMM. Expires Jul 29. 2020IR My Comm. Expires Apr 16,2019Bortmlko* National Notary Assn.
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BELOW IS FOR OFFICE USE ONLY
Permits Requireo-, BuHdir-?,
Construction t""el. Flood Zone:
Total Sq F1 of Bldg! Nlin, Occupatio Load:
Ne>i Construction: Electric - 4 of Amps
Fire Sprinkler Permit:
APPROVAI.S: 7(
1
i ii
C 0 N'l IN. I E NTS:
if Stories:
Plumbing - 4 (if Fixtures
Fire Ala rrn Permit: Yl-s [_1 No[]
July 20, 2017
800 French Ave. Sanford, FL 32771
407) 322-9558 * (407) 330-9333 (Fax)
adcockroofingl Obellsouth.net
www.adcockroofingl@bellsouth.net
ESTIMATE
Name: Edie Little Phone: (321) 217-5599
Address: 422 Summerlin Ave. Cell: ( )
City: Sanford, FL 32771 Fax:
Email: elittle6l@cfl.rr.com
SCOPE OF WORK: COMPLETE ROOF REPLACEMENT
1. Remove old existing roof on complete house.
2. Re -nail decking as per building code.
3. Install new 25-year fiberglass or 30-year architectural shingles.
4. Install new Modified Bitumen on the low slopped portion of the roof.
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.
11. Inspections included.
Labor & Materials: $7750.00 (30 Year Shingles)
Extra — Bad wood: Time & Materials - $70.00 per sheet plywood; 2 x 4 and fascia - $4.50 ft.
Warranty: 25/30 Years on Materials from Manufacture
5 Years on Workmanship
Andy Adcock, Owner
Andy Adcock
THIS INSTRUMENT PREPARED BY: (31--ZA 1T 11ALOY r SEMINOLE GOUh•ITYName: ADCOCK ROOFING
Address: 800 S. FRENCH AVE. CLER};. OFe:lF,:( UiT COURT C:(fiFTF:ni_.l.,E i
SANFORD, FL32771 BK 87711 1*,Si 1669 O.P'a )
CLERK'S T 2017081843
iL(::SF:L'tE:C ila,'`1 '21;i17 12a;?(? :32 P11
NOTICE OF COMMENCEMENT 'CORD{ ,`'BY je_, ]nr,,
t_t
Permit Number:
Parcel ID Number: 30-19-31-525-0000-0640
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 64
FORT MELLON
PB3PG69
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Re -Roof
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: WALKER AGNES R LIFE EST (LITTLE EDITH) 422 SUMMERLIN AVE SANFORD, FL 32771-2256
Interest in property: OWNER
Fee Simple Title Holder (if other than owner listed above)
4. CONTRACTOR: Name: Adcock Roofing Phone Number: 407-322-9558
Address: 800 S. French Ave., Sanford, FL 32771
5. SURETY (If applicable, a copy of the payment bond Is attached): Name:
6. LENDER:
Address:
Phone Number:
Amount of Bond.
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.
8. In addition, Owner designates
Phone Number:
of
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)
WARNING TO OWNERANY 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. Signature
of Owner or Lessee. or Owner's or Les,re'S c
C cn
s R1010'rice) PrintNameandProNdeSig.+nulY Authorized
OfficeriDlrectorlParnee/Vanagerj 98 State
191a\ County 4
ofof
The foregoing
instrument was acknowlelveq before me this 14 day of Lei k 20' • 7 G'r a b t
L[ r" % y t Who is onall own to me O OR r- ' 4 ` .>v; Name
of
person making Statement', who has
produced identification type of identification produced: Cl. a r— 1
zv
n
pue" MARJOW
4 MARIF AOCOCIc u L,Notary
r'.,blic - State of 11wida Fi, va^S,o a,:ire c t
I)20 NuyP, oe MARJIF rnn° r gPr OCK On"? o gssn. aQ`l R
Notary PubliL
State ut Florida p J r Commisswn #
GG 013492 q My
Comm lxl-Ps Jul 29. 2020?: 4 I Per
rncrat
NotaryAssn. u d cwn
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 FB Ide compliance by personal inspection.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE: 2.e3,1 7
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: 7 Z p4U1 j l. / V /L&I 7.77
STRUCTURE TYPE: (D,KGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: U REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): //pZ It .0j_V Cj0y/% PLEASE
NOTE: ONLY 100 SQUARE FEET OF THE EXIYTING DECK IS PERMITTED TO BE REPLACED" ROOF
VENTILATION: DOFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES SKYLIGHTS:
O YES ONO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: MAIN
ROOF AREA ROOF
SLOPE: O LESS THAN 2:12 (Y2:12 - 4:12 (313'12 OR GREATER TYPE
OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL SHINGLE
nl)&o FL# O
METAL FL# MODIFIED
BITUMEN Aq-1d—IILZE4 FL# C OTORCH
DOWN FL# O
INSULATED FL# O
TILE 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# O
OTHER: FL#
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 1 —1-2 l / ADDRESS: 44' - e.Y t",
W %'vz. ,, 14-4o Lz Fk , 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 #: L e-
COMPANY / CONTRACTOR: A dX N /V o ye,,-.)
CONTRACTOR SIGNATURE: DATE:
MUST BE SIGNED BY LICENSE HOLDER OR ER/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 Cf&4y1 14 0
Sworn to and Subscribed before me this day of 20 % by:
142_j /Jl/,G'c.- ,4Y, c Who istD-Personally Known to me or has Produced (type of
id as identification.
Signs ure of Notary Public
State of Florida _
C tWYPf/ D
Notary pu'"
LD RASH
bli_StateoFFlorida
Print/Type/StampName '•; ' Commiss-nYFF22U06
My Comm. Ex TresofNotaryPublicP Apr16,2019