116 N Summerlin Ave; 17-2967; ROOF2017
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: 1 ,i— a !(a-7
Documented Construction Value: S (o 06
Job Address: / % (d AJ e5l't A[.LP Historic District: Yes No
Parcel ID: 130 ' / 9' I? tzu g • 0.5b() • O / 1 (7 Residential P Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: EX-o cr 'f (S4!1 /? ^^0 Y,Lt %J `/
c 1
Plan Review Contact Person: A" Yl / AD" Cje—, Title:
Phone: y6r •% •3.2j_ - 03-S-k Fax: 41d7 _a. y's 9a Email: Q c.,cl•z'in_ l So fl,.heE-
Property Owner Information
CJ
Name l.rl & i, e 4 3 Phone:
Street: l f 6 Al - A_ tt " Resident of property?
City, State Zip:
Contractor Information
Name A-o&o ck- keo G Phone: LIP " JdA ' 9S51-
Street: goo cr F.YL2h a- *,.<- Fax: Vd7 ,3 J_ - • 9S_ J-
City, State Zip: J , _o 2/) • r L-_-. 3.)-? -7/ State License No.: C C C)
Architect/Engineer Information
Name: N 4
Street:
City, St, Zip:
Bonding Company: AI A
Address:
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: 5th 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.
4
Acceptance of permit is verification that I will notify the Owner of the propene' 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.
6
signature of Owner/Agent Date SignatureofCont r/Aeent Date
S—•
s
IwSomt'%')l r' 4 S Ea C.l —
PrintOvner/Agent`s Nance Print ,ontractor/Agent's . lame
Sign:fture sienatu
Mto
Date
py.,, MARJORIE AAARIE:
eF
K
i° 'ot Notary PuDtic • Statda z°;oASHCommissionG.; te of Florida
Ny Comm. Expires J20 ,PF 221706r,Apr 16, 2019BondedthroughNationassn.
Owner/A en is e o 1 or Contractor/Agent isto Me or
Produced I Type of ID Produced ID
y
Type of ID
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: M.in. 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:
COMMENTS:
FIRE: BUILDING:
Revised: June 30. 2015 Permit Application
September 19, 2017
ADCOCK ROOFING
800 French Ave. Sanford, FL 32771
407) 322-9558 * (407) 330-9333 (Fax)
adcockroofingl@bellsouth.net
www.adcockroofing@bellsouth.net
ESTIMATE
Name: Susan Pantelias Phone: (407) 324-2318
Address: 116 N. Summerlin Ave. Cell: (407)
City: Sanford, FL 32771 Fax:
Email: sspsanfi@yahoo.com
SCOPE OF WORK: COMPLETE ROOF REPLACEMENT— CARPORT ONLY
1. Remove old roof on carport, only.
2. Re -nail decking as per new building code.
3. Dry in with new layer of synthetic underlayment as per new building code (July 2015).
4. Install new 30 year architectural shingles — Rustic Cedar.
5. Install new drip edge; 26 gauge, painted galvanized.
6. Secure all permits.
7. Clean up & haul away debris.
8. Inspections included.
Labor & Materials: $3600.00
Extra — Bad wood: 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
lb
THIS INSTRUMENT PREPARED BY:
Name: ADCOCK ROOFING
Address: 800 S. FRENCH AVE.
SANFORD, FL 32771
v
Permit Number:
Parcel ID Number: 30-19-31-504-0500-0110
GRANT NALOYY OEMINOI-E COUHT`t'
iR CIRCUIT COURT t,. COMPTROLLER
CLERK'S tt 2017101018
REC:ORDE-D 10/09/201.7 12: d'6:1'? PI'1
RLt:a_tt.l:'JIG BEES $10.00
REC:OFZDED RY iid: yore
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)
LOTS 11 + 12 BLK 5
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Re -Roof
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:ia-
Name and address: tIAN I LLIAS JUJAN; "I "I b N
Interest in property: OWNER
Fee Simple Title Holder (if other than owner listed above)
4. CONTRACTOR: Name: Adcock Roofing Phone Number: 407-322-9558 -5
Address: 800 S. French Ave., Sanford, FL 32771
5. SURETY (If applicable, a copy of the payment bond is attached): Name: r •_T -% <
Address: Amount of Bond:
6. LENDER: Name: Phone Number:
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.
Name: Phone Number:
Address:
8. In addition, Owner designates 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 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.
Signature of Owner or Lessee, or Owners or Lessee's
Authorized Orricer/Director/Partner/Manager)
State of CW I2-W /a County of S l_?t/t vy.7t_t—
I 5 11 o`n ( ( cts
Print Name and Provide Signatorys Title/Office)
The foregoing instrument was acknowledged before me this CSJ day of . , , 20
by - _ _ ",I &12t2 Who is`personall 1 n tome OR
Name of person making statement
who has produced identification type of identification produced:
MARJORIE MARIE ADCOCK
Notary Public - State of FloridaY
Commission #r GG 013492 t
k ,.•r My Comm. Expires Jul 29. 2020 Notary Signature
rr Bonded through National Notary Assn.
SCITY
OF
F0
FUZE DEPARTWN
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: / / rP Ai eK
STRUCTURE TYPE: +SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): IZ. /) "'o ZV W 064
PLEASE NOTE: ONLY I oO SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED * *
ROOF VENTILATION: DOFF -RIDGE ORIDGE OSOFFIT OPOWERED VENT OTURBINES N
SKYLIGHTS: O YES C)'O IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 — 4:12 Q r12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
INGLE IAI),lkO FL# f O METAL
FL# O MODIFIED
BITUMEN FL# O TORCH
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# O TORCH
DOWN FL# O INSULATED
FL# O TILE
FL# 0 OTHER:
F L#
CITY OF
Building & Fire Prevention DivisionSORDRESIDENTIALRE -ROOF POLICY & PROCEDURES
FIRE DEPA 2T,IIENT
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 CODE COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE: /0 ° .2 - 10 1
CITY OF
Y,{, S a
a. \\
FORDD
FIRE DEPARTMENT
Building & Fire Prevention Division
RESIDENTIAL RE-R OOF A FFIDA VIT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT 7 ADDRESS: N • A.r -
J .Z_ 7 7 l
A-V-4-D-uj 4vyD Ga 0- , 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#: e 6-L.0 Z-2-5S01
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE: /"— DATE:
MUST BE SIGNED BY LICENSE HOLDER WNER/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 50yk I Y1.OLL
Sworn to and Subscribed before me this 6, day of Z>C-t—20 7 by:
id 'on)
re of Notary ublic
State of Florida
Print/Type/Stamp Name
of Notary Public
Who is 6fiersonally Known to me or has Produced (type of
as identification.
E
P`
DONALDRASH
Notary Public - State of FloridaCommission#FF221706
My Comm. Expires Apr 16, 2019