309 McKay Blvd; 18-3811; ROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: / ( - _ go
Documented Construction Value: $ 11,700
JUU L-]UUI-CNN:
309 MCKAY BLVD SANFORD, FL 32771 Historic District: Yes No x
Parcel ID: 31-19-31-527-0000-0530 Residential x Commercial
Type of Work: New Addition AlterationEl Repair Demo Change of Use Move Description
of Work: Re Roof Owens Corning FL 10674-R13 Rhino 15216-R3 Techwrap 17194-R2 24 SQ 7/12 Pitch Brownwood
Supreme 25 Years Warranty Plan
Review Contact Person: Skylar Amkraut Phone:
407-278-7788 Fax: 800-337-3361 Name
BURGESS, SHELEEN D Street:
309 MCKAY BLVD Title:
Admin Email:
Permit@Jasperinc.com Property
Owner Information Phone:
Resident
of property? : Yes City,
State Zip: SANFORD, FL 32771 Contractor
Information Name
Jasper Contractors Street:
4185 S Orlando Dr City,
State Zip: Sanford, FL 32773 Name:
Street:
City,
St, Zip: Bonding
Company: Address:
Phone:
407-278-7788 Fax:
800-337-3361 State
License No.: CCC1331153 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: 5t' Edition (2014) Florida Building Code Revised:
June 30, 2015 Permit Application
NOTICE: In addition to the requirements of this pert -nit, 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 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 [CC 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
b.e -done in_compliance-with..all-•applicable -laws regulating -construction -, and -zoning:----- --- - - - -----
09/06/18
signature of Owncr/Agent Date Sign a re ofGont c or Agent bate
Rudith Goico
Print Owner/Agent's Name Pit Contractor Ag is me
Signature of Notary -State of Florida Date
1,,RY'P4e i A(4A .CHAWZ
2c HState of Florida -Notary Public
Comm'ission # GG 112152
My Commission Expires
June O6, 2021
Owner/Agent is Personally Known to Me or Contractor/Agent is
ypPersonally
Known to Me or
Produced ID Type of ID Produced ID Te of LD 4 1
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use: Flood Zone:
Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Plumbing - # of :Fixtures
Fire Alarm Permit: Yes No
UTILITIES: WASTE WATER:
FIRE-: BUILDING:
Revised: June 30, 2015 Permit Application
9/6/2018 SCPA Parcel View: 31-19-31-527-0000-0530
sE+or er15 waaJnn
Parcel Information
Property Record Card
Parcel: 31-19-31-527-0000-0530
Property Address: 309 MCKAY BLVD SANFORD, FL 32771
Parcel 31-19-31-527-0000-0530
Owner(s) BURGESS, SHELEEN D
Property Address 309 MCKAY BLVD SANFORD, FL 32771
Mailing
Subdivision Name
309 MCKAY BLVD SANFORD, FL 32771
CEDAR HILL REPLAT
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions 00-HOMESTEAD(2005)
00
Legal Description
LOT 53
CEDAR HILL REPLAT
PB 63 PGS 96 97 & 98
Taxes
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund
Schools _..
City Sanford
T
102,743
102,743
102,743
50,000 9 $52,743
25,000 $77,743
50,000 $52,743
SJWM(Saint Johns Water Management) 102,743 50,000 $52,743
County Bonds 102,743 50,000 $52,743
Sales
Description Date Book Page 1 Amount Qualified j Vac/Imp
CORRECTIVE DEED 7/1/2004 05395 1084 100 No Vacant
SPECIAL WARRANTY DEED -- 6/1/2004 05340 1621 — 129,900 Yes Improved
WARRANTY DEED 10/1/2003 05142 1238 540,000No Vacant Find
Comparabla Land
Method
Frontage Depth Units Units Price and Value LOT
0.00 0.00 1 $32,000.00 32,000 Building
Information DescriptionYear
ActuaEffective „Fixtures '
uilt
Bed
Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages 1
SINGLE 2004 9 3 i 2 5 1,120 2,659 2,215 CB/STUCCO $148,907 $156,333 http://
parceidetaii.scpafi.org/ParcelDetailinfo.aspx?PID=31193152700000530 1 /2
800) 337-3361 Fax
infogjasperinc.com FL Contractor's License:
CCC1329651 & CCCI331153
ROOF REPLACEMENT CONTRACT
Account Manager: Joseph Palladino
Contact #: (407) 335-6239
Company: State Farm
Policy #:80s493649
Claim #:
Mortgage Company Information
Company: Mr Cooper Mortgage
Loan Number: 0596705061
Owner(s):
Sheleen Burgess
Phone:
Address: 309 McKay Boulevard Alt Phone: 4072475731
City: S tp tE. Zip Code: 32771 Shingle Color:
Sanford OC Supreme - Brownwood
Email:
teachsugarleen@bellsouth.net
Roof RCV Amount/ Contract Price:
11,700
Drip Edge Color:
Drip Edge - Brown 6"
If Owner's insurance Comnany does not agree to glav for a full roof renlacement. this contract shall he voidable.
Assignment of Insurance Benefits for the Full Roof Replacement Only: I hereby assign any and all insurance rights, benefits and proceeds under any
applicable insurance policies to Jasper Contractors, Inc. ("Jasper"), the scope of which shall be limited to a Full Roof Replacement. I make this assignment
and authorization in consideration of Jasper's agreement to perform services, supply materials and otherwise perform its obligations wider this Contract,
including not requiring full payment at the time of service. I also hereby direct my insurer(s) to release any and all information requested by Jasper, or its
representative(s), for the direct purpose of obtaining actual benefits to be paid by my insurer(s) for services rendered. In this regard, I waive my privacy
rights. If payment is made directly to the Own er/Agent/Insured(s), it shall be endorsed over to Jasper immediately upon receipt. I agree that any portion of
work, deductibles, betterment or additional work requested by the undersigned, not covered by insurance, must be paid by the undersigned on the day of
installation. Deductible: It is the Owner's responsibility to pay all insurance deductibles. Owner's out-of-pocket expense will not exceed the deductible
amount, as stated on insurer's loss sheet ("Loss Sheet"), which is hereby incorporated by reference as the Scope of Work ("SOW"), UNLESS
replacement/repair of deteriorated decking is required by code and/or Owner requests optional upgrades. Jasper CANNOT pay, waive, rebate, or promise
to pay, waiveDgr rebate any or all of the insurance deductible applicable to the insurance claim for payment of work. In the event of a discrepancy, the
deductibl
Ir(
tated on the insurer's Loss Sheet shall overrule deductible amount disclosed. Deductible: $2327.00 MUST BE PAID
IN FUL initial).
PAYME DULE: Owner agrees to pay Jasper based on the following schedule: (i) Deposit in the amount of$- 00 due upon signing this
contract; (ii) the Contract Price, less the Deposit and any applicable depreciation retained by Owner's insurer(s), plus upgrade costs, due and payable
to Jasper upon completion of work being performed; and, (iii) the remaining Contract Price (equal to any applicable depreciation and/or change orders)
due and payable to Jasper upon completion of work performed. In the event of a pending inspection, no more than 2% of Contract Price may be withheld until
inspection has passed.
Optional: UPGRADE ITEM: RATE: UPGRADE ITEM: RATE:
Replacement Work and Price: Upon insurer's approval and subject to the Terms and Conditions stated herein, Jasper agrees to furnish all materials and
provide the labor necessary to perform the full roof replacement which shall take place following Owner's insurance company's approval, approximately
within thirty (30) days, conditions permitting. Owner's Declaration of Intent: Owner acknowledges and agrees that, upon approval by insurance company
for a full roof replacement, Jasper shall perform the roof replacement upon receipt of Loss Sheet from Owner's insurance company.
FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND
PAYMENT, UP TO A LIMITED AMOUNT, MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS'
CONSTRUCTION RECOVERY FUND IF YOU LOSE MONEY ON A PROJECT PERFORMED UNDER CONTRACT,
WHERE THE LOSS RESULTS FROM SPECIFIED VIOLATIONS OF FLORIDA LAW BY A LICENSED CONTRACTOR.
FOR INFORMATION ABOUT THE RECOVERY FUND AND FILING A CLAIM, CONTACT THE FLORIDA
CONSTRUCTION INDUSTRY LICENSING BOARD AT THE FOLLOWING TELEPHONE NUMBER AND ADDRESS:
Construction Industry Licensing Board: 2601 Blairstone Road, Tallahassee, FL 32399-1039, (850) 487-1395
CANCELLATION: If Owner elects to terminate the services of Jasper, Owner may do so before midnight on the third business
day after Contract is executed. Owner shall receive a full refund of all deposits. Owner may also rescind Contract before midnight
on the third business day after the contract is executed after notification from insurer(s) that the claim for payment on roof
contract has been denied, in whole or in part. All written notices of cancellation, regardless of reason, shall be postmarked or
delivered to Jasper's corporate office: 1690 Roberts Boulevard, Suite 112, Kennesaw, GA 30144. CANCELLATION
EXCEPTIONS: The three (3) day right of cancellation DOES NOT APPLY to contracts for emergency home repairs as time is of
the essence.
I, Owner, have read and understand all statements, Terms and Conditions of the "Roof Replacement Contract" and agree that all details
are acceptable and satisfactory. I further understand that this Contract constitutes the entire agreement between the parties and that any further
changes or alterations to this Contract must be made in writing and agreed upon by both parties. Each party represents and warrants to
the other that it has the full power and authority to enter into the contract and that it is binding and enforceable in accordance with its
terms. Docusigned by:
f X r 4,
DocuSigned by:
6/20/2018 1 10:13 AM EDT 6/20/2018 1 10:12 AM El
tLA er a esentative Date KOC6464... Date
Grant Maloyy; Clerk Of The Circuit Court & Comptroller Seminole County, FLInst #20181,01659 Book:9204 Psge:1572; (1 PAGES) RCD: 9/6/2018 9.28:11 AM
REC FEE.$10.00
THIS INSTRUMENT PREPARED BY
Name: JASPER CONTRACTORS
Address: 4185 S ORLANDO DR
SANFORD, FL 32773
CY2 33s
NOTICE OF COMMENCEMENT
Permit Number.
ParceilD Number:3 1 1 q )—SZ`)— —(530
The undersigned hereby gives notice that Improvement will be made to certain real property, and in accordance with Chapter713. Florida Statutes, the
following information is provided in -this Notice ofCommencemenl.
1. 'DESCRIPTION OF PROPERTY: (Legal description of the property -and street address if available)
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT.,
NameAnd address: SIBL-p-f1. h rc S &kyoq I_IVt SpI1ror01O _.2-771 I
nterest.In Fee
81mole71tle Holder (if other than owner listed above) Names 4. "
CONTRACTOR: Name: JASPER CONTRACTORS Phone Number. 407-278-7788 Address:.
4186 S Orlando Dr, Sanford FL 32773 S.
SURETY (if applicable, a copy of the payment bond.is attached) rNmme: 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. 8.
1n 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'specl(ied) WARNING'
TO OWNER: ANY PAYMENTS MADE' BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713i 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. Signature
of Owneftrassea, or Owneerjrct Lessee's. TrInt Name and Provide Slgnstw/s Tit!4 .We) Aulhodzed
Oflfcer/Uector/Partne n ery State
of F County of The
foregoing; instrument was acknowledged before me this 31 day of 20 by
thej e P K1 r e S Who is personally known to me OR Name
or parson'makmg statement who
has produced Identification type of identification RUDITH
GOICO State
orzF1&ida-Notary Public Commission
a GG,178413 My
Commission Expires rrtn,
t:° January24, 2022
SEA41NOLE COUNTY MUL TI-IUR ISDICTIONA L
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
I
Seminole County, Winter Springs
Date: 09/06/18
name. -anal. -appoint:...- Rudith Goico, Adreanna Ocasio, Skylar Amkraut, Amanda _Ciep[inski
an agent of: JASPER CONTRACTORS
Name of Company)
to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do, 811 things necessary to this
appointment for (check only one option):
x _All 'permits and —applications ---submitted "-b--y,-t-h--i-s contractor. r.
Or
El The specific permit and application for work locatedat: 309
MCKAY BLVD SANFORD, FL 32771 Street
Address) Expiration
Date for This Limited Power of Attorney: License
Holder.Name: Donald Bouchard State
License Number: CCC1331153 Signature
of License Holder: STATE
OF FLORIDA COUNTY
OF Seminole The
foregoing instrument was acknowledged before me this 06 day of September 20
18 by Donald Bouchard who is 0 perscinally known to me or N
who has produced DL and
wrfd not) take an oath. I —AANA
CAVE Z e
of Florida -Notary b li, c ANA
CHAVEZ Stat
Public qStateofPublicCommission
GG 112152 C
on E xp, res om'm iS;i j
0 t 1 M'
Corvi mission Expires June
06, 20)2l as
identification CAV
Print
or type Notary name Notary
Public, - State of o' Commission
No. L-I. A My
Commission Expires: (0
CITY OF
pp
BUILDING DIVISION Building IX Fie Prevention Division
Re -Roof Permit Card
PERMIT NO. ISSUE DATE: 09,0 * /X
CONTRACTOR: Ja e r
JOB ADDRESS: 43 0!9 /ne... , V
TYPE OF WORKA e.. &.00
PROTECT FROM WEATHER
Post this Permit and all required documents in a conspicuous place outside
Digital Photographs are required - please follow re -roof policy and procedures guide
All trash, debris and dumpsters must be removed from job site at final inspection
Permit expires six (6) months from date of issue
ROOF
INSPECTION TYPE APPROVED REJECTED INSPECTOR
FINAL ROOF
FAILURE TO FOLLOW THE RESIDENTIAL RE -ROOF POLICY & PROCEDURES WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION FEE
AND MAY REQUIRE AN AFFIDAVIT, SIGNED AND SEALED, FROM A REGISTERED FLORIDA DESIGN PROFESSIONAL
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.
NOTICE: IN ADDITION TO THE REQUIREMENTS OF THIS PERMIT, THERE MAY BE ADDITIONAL RESTRICTIONS APPLICABLE TO THIS PROPERTY THAT MAY BE FOUND IN THE PUBLICRECORDSOFTHISCOUNTY, AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE
AGENCIES, OR FEDERAL AGENCIES. FBC 105.3.3
REVISED: 4-17
Inspection Line 407.792.6069 or 855.541.2112
TO SCHEDULE AN INSPECTION:
Dial 407.792.6069 or 855.541.2112
Provide the items requested during the message
The type of inspection requested must be scheduled under the appropriate permit type
Follow the prompts
PLEASE NOTE: Inspections scheduled by 5:00 p.m. will he conducted the
next business day. If you experience difficulty, please call 407.688.5150
Monday - Thursday 7:30 am - 5:30 pm for assistance.
AUTOMATED INSPECTION SYSTEM CODES
Final Roof Inspection Code 111
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
REVISED: 04-17 Inspection Line: 407.792.6069 or 855.541.2112
City of Sanford Building Division
Residential Re -Roof Inspection Policy & Procedures
PERMITTING REQUIREMENTS — No PLAN REv1Ew 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: 09/06/l E
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: 309 MCKAY BLVD SANFORD, FL 32771
STRUCTURE TYPE: O SINGLE 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):
PLEASE NOTE. ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED
ROOF VENTILATION: Q OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES O NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 — 4:12 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
Q SHINGLE Owens Corning FL# 10674-R13
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED 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#
OMETAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
O TILE
M
FL#
0 OTHER: FL#
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
Page 2
Application Number . . . . . 18-00003811 Date 9/06/18
Property Address . . . . . . 309 MCKAY BLVD
Parcel Number . . . . . . . . 31.19.31.527-0000-0530
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . SINGLE FAMILY
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1075795
Permit pin number 1075795
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 BL03 FINAL ROOF / /
D City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FIN A,{L ROOF COVERINGS
PERMIT #: M ADDRESS: /
I , 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#:
CCC1331153
COMPANY / CONTRACTOR:
JASPER CONTRATORS
CONTRACTOR SIGNATURE:
MUST BE SIGNED BY LICEP LDER)
A FINAL ROOF INSPECTION IS REQUIRED:
DATE:
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 SEMINOLE
Sworn to and Subscribed before me this.0 day ofNA dco by:
DL
Sig)$Offa of Notary Public
St e o lor+idalj `.
Print/Type/Stamp Name
of Notary Public
Who is Personally Known to me or has N Produced (type of
as identification.
FF.. RUDITH GOICO
State of Flarida-Notary Public
Commission # GG 178413afMCyOmmissionExp
January 24, 2022
gym.
SEMINOLE COUNTY MULTI%URISDICTIONAL
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: IIC) k r
Scott Meixsell, Chris Gardner, James Allen, Joshua Collazo, Desmond Roberts, Jovanni Bracero & Edwin
l...hereby _name_..and..-appointyazque....z.
an agent of: JASPER CONTRACTORS
Name of Company)
to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things necessary to this
appointment for (check only one option):
x
All permits a11
nd
applications submitted by this contractor. Or
The
specific permit and application for work located at: Street
Address) Expiration
Date for This Limited Power of Attorney: 1/1/2019 License
Holder.Name: Donald Bouchard State
License Number: CCC1331153 Signature
of License Holder: STATE
OF FLORIDA COUNTY
OF SEMINOLE cn
1 ^ The
foregoing instrument was acknowledged before me this ay of \ KJ 20
18 by DONALD BOUCHARD who is N personally known to me or who
has produced and
wh di fd not) take an oath. Signa
ure of Notary o
PpY PVei ANA CHAVEZ State
of Florida -Notary Public Commission'
GG 112152 o
My commission Expires June
06, 2021 as
identification Print
or type Notary name Notary
Public - State of l.C l ( C "' Commission
No., 6-1 .LA My
Commission Expires: 'u