2540 S Palmetto Ave; 18-3551; ROOFCITY OF
ORDts
FIRE DEPARTMENT
Building & Fire Prevention Division
PERMIT APPLICATION
Application No: / k- 3 S
Documented Construction Value: $ 5', 8b $ r C1 0
Job Address: 2590 5 --pal tneft AgVcr)uQ. 5an4r FL 3 2 7T3 Historic District: Yes Nov
Parcel ID: ZO r --50 0 -) 2, U0 Residential Commercial
Type of Work: Newm Addition Alteration Repair Demo Change of Use Move
Description of Work: 010*t-kA]Tla Of t @ ?pa- "
Plan Review Contact Person: aa_Title: 6A
Phone: ` 07-110-0(,45 Fax: Email: IYl t%ae1 Si-l im pi-a m i
Property Owner Information
Name '5bZtinne W l i(S Phone: _ *T7-31Lt_- q5'3 c7 Street:
Q5LfO 5 . /R1 mei'g0AVt0_ Resident of property? : S City,
State Zip: 51r)-61-o Fi_ 3 L'1 Z 3 ii Contractor
Information
Name ag5(,
g1 l Ylf1'-ynyzzemed- Phone: 4a7- q 11--ol qS Street: J )
f d -:d-- U0 771 Fax: City, State
Zip: mrM 5i-- 3 21 1 ( State License No.: 6CZ t 3.?532 Architect/Engineer
Information Name: AIA
Phone: Street: City,
St,
Zip: Bonding Company:
i J 4 Address: Fax:
E-
mail:
Mortgage Lender:
IJAr 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,
beaters, 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: 61 Edition (2017) Florida Building Code Revised: January
1, 2018 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.
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 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.
Sign f er gent D e
print Owner/Agent'sName
Signature of Notary -State of Florida Date
Ov.
Donna Wilhelm
NOTARY PUBLIC
STATE OF FLORIDA
Comm# GG207966
Expires 8/11/2022
Owner/Agent is Personally Known to Me or
Produced ID v7"__ Type of ID T71an au 'PL
Signature of Contractor/Agent Date
Fran )<1'riJ,)c ecr
Print Contractor/Agent's Name
aaLay_ il1h
Signature of Notary -State of Florida Dite
y Donna Wilhelm
NOTARY PUBLIC
STATE OF FLORIDA
i Comm# GG207966
N E 19 8 Expires /2022
Contractor/Agent is Personally Known to Me or
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
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
of Heads
UTILITIES:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: January I, 2018 Permit Application
1 !lIQ11111111 I[tl I1lI lull lull llll llll
THIS INSTRUMENT PREPARED BY:
Name: Donna Wilhelm GRANT11A1_OYr SEMIhIOLE COUNTY
Address: ,
C:l...f_Ri OF CIRCUIT COURT h COMPTROLLER
BY. 9138 Ps 1755 (11`9s )
CLERK'S T 2018058946
RECORDED 05/23/2018 171•"45°wre- I'I1
NOTICE OF COMMENCEMENT
RECORRECORDEDRECORDEDDED
FEES $
iCI.t C EC
L't htievore Permit
Number. ! Parcel
lD Numbl er: l 01— .')D "30— S 06 —D OO o -. /; (P O 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) Lof-
J (o r N YZ D-f- v t 12 $ 1--(On K (_ aovd -u-64S sob(d 1F133 PGA y 5'
111 r e +-bn Ay xn-6-d EL 3 2 7-7 3 I 2.
GENERAL,
DESCRIPTION OF IMPROVEMENT: [ Rr-V
tt "' — f-f f' ` Ut 3. OWNER
IN ORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and
address: S O ZG niy t I S 0 S • Pat m e- fb ,4-ye Sq rr(O' c D P-Lr 3 D--T7 Interest in
p operty: Owner Fee Simple
Title Holder (if other than owner listed above) Name: NA Address: -- 4.
CONTRAC
IOR Name: Coastal Improvement Phone Number: 407-961-0645 Address: 321
Montgomery Road Suite 160771 Altamonte Springs FL 32716 5. SURETY (
If applicable, a copy of the payment bond is attached): Name: NA Address: -- Amount
of Bond: -- 6. LENDER:
Name: NA Phone Number: -- Address: i
I !
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., Florlda Statutes. Name: NA
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) -- I I
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
BEF REI 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. i i
1
ure
of
er or Le e, or Owne s o see's (Print Name and rowde Signatory's Authorized Officer/
Director/Partner/Manager) State of
County of 115erh r nthQ The foregoing
it strument was, acknowledged before me this / $ day of M a 201. by ZGi
ryx-e— W S Who is personally known to me OR Name of
rson statement f$' who has
produced Identification type of identification produced: Wilhelm NOTARY
PUBLIC
Do vryl XDonna STATEOFFLORIDAComm# GG207966
11SExpires8/11/
2022
r-
Permit #
City of Sanford
Building and Fire Prevention
Product Approval Specification Form
Project Location Address 5 q 0 S pal - &k forL 27 23 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.floridabuilding.org. 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 Manufacturer Product Description
Florida
Approval # include
decimal 1.
Exterior Doors Swinging
Sliding
Sectional
Roll
U Automatic
Other
2.
Windows Single
Hun Horizontal
Slider Casement
Double
Hun Fixed
Awning
Pass
Through Projected
Mullions
Wind
Breaker Dual
Action Other
June
2014
Category / Subcategory Manufacturer Product
Description(including
Florida Approval #
decimal
3. Panel Walls
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E. P. S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles Gee li- 40 emild. FL 4-
Underla ments ens ODre, ty, Pro.-&Qol- Z 0 -eR
Roofing Fasteners
Nonstructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Built up roofing
System
Modified Bitumen
Single Ply Roof
Systems
Roofing slate
Cements/
Adhesives /
Coating
Liquid Applied
Roofing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels
Roof Vents RtQkL1,-VfOf5S
Other
June 2014
Category / Subcategory Manufacturer Product
Description
Florida Approval #
include decimal
5. Shutters
Accordion
Bahama
Colonial
Roll u
Equipment
Other
6. Skylights
Skylights
Other
7. Structural
Components
Wood Connectors /
Anchors
Truss Plates
En ineered Lumber
Railing
Coolers/Freezers
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)
iT
June 2014
SEMINOLE COUNTY MULTI%URISDICTIONAL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 3arwo(q 5-1 Z0/9
hereby name and appoint:
I
I y ` chae l o uct 'so'Y7
an agent of: COGtS'it 1 Yi piol ry fir" c or O a t)')
Name of Co pany)
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):
EAll permits and 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: _V eCC m bar 310 Z o f s
t
License Holder Name: -FI'Qn K I 6Ke' '
State License Number: 666_13a
Signature of License Holder:
STATE OF FLORI . A
COUNTY OF qr 7ina(/
The foregoing instrument was acknowledged before me this 5 day of 'JGnGk: '4
20 18 by -F—ra,-i who is sonally known to me or
who has produced
and who did (did not) take an oath.
0>vr L iG-- _
Signature of Notary
Zt,R Donna Wilhelm
NOTARY PUBLIC
S STATE OF3F,URIDA
Comm# GG201966
E
b Expires 8/11/2022
as identification
l A e Zfyz
Print or type Notary name
Notary Public - State of 10(le)<
Commission No. Gj Za 7rl 6,G
My Commission Expires: 8' /I-ZZ
TAL
IMPROVEMENT
ROOFING DIVISION
Please Print
CONTRACT
RESIDENTIAL AND COMMERCIAL
License No. CCC1325824
ORLAN DO: 407-961-0645
JACKSONVI LLE: 904-442-5202
321 Montgomery Rd Suite 160771
Altamonte Springs, FL 32716
coastal improvement.com
NAME ( / e- PHONE YU7 3I ,' %SVDATE
5>j x!' J 773
ADDRESS 5 MAIC7 C i ! CITY ZIP CODE
SALESPERSON / ` CONTACT PHONE Z/ 7 %C %L S
M. HOME OUSE
OTHER CO ERCIAL JOB #
BRAND
OF CTDESCRIPTIONPRODUCTC c G( COLOR / J 1 3' lGh PITCH
1, PULL A CITY OR COUNTY PERMIT ` SQ. RENAIL WOOD
2. TEAR OFF: SQ. OF OLD SHINGLES SQ. OF FLAT ROOF ` SQ. OF OLD TILE
3. DRY IN: REINFORCED FIBERGLASS UNDERLAYMENT Q.l LAYER 2 LAYERS SYNTHETIC ``—PEEL & STICK
4. INSTALL. LF GALV. VALLEY METAL Z e LF SELF ADHERING VALLEY LINER ---LF METAL OVER RIDGE
S NSTALL: LF ALUM. DRIP EDGEI 77LF STEEL DRIP EDGE COLOR w ' LF PAN FLASHING LF L. FLASHING
6. INSTALL/REPLACE:?PLF OF R.V. —L4'- PLUGS =4FT_ OFT OFF R.V. COLOR LF VENT SURE
7. REPLACE: =1 1/2 IN. 2 IN._3 IN. L 41N. LEAD BOOT 4 IN. GRV _101N. GRV ELEC. RISER
8. Y7STARTER ROLL o
STARTER
STRIPS CIRCLE ONE 9.
LAY SQUARE OF 16- NEW FIBERGLASS SHINGLES BUNDLES OF CAP 3-TAB / PERF / HIP & RIDGE 10.
INSTALL: SM. DEAD VALLEY LG. DEAD VALLEY _ FLINTLASTIC LIBERTY 11.
INSTALL: TPO -' LAYER OF INSULATION ' e LF TBAR / SEAM TAPE 12.
IN TALL/REPLACE: _ -kX2 ---'-)-X 4 --=7r- SKYLIGHTS ACRYLIC SFA FIXED GLASS DOMES
CM CLASSIC 13.
AUL OFF ALL TRASH AND RUN MAGNET AROUND GROUNDS 14.
ALL WOOD WORK WILL BE EXTRA PER ATTACHED WOOD BILL 15.
COASTAL IMPROVEMENT CORPORATION HAS MY PERMISSION TO CONTRACT WITH AN ENGINEER OF ITS CHOICE TO CONDUCT
ANY OR ALL INSPECTIONS THAT MAY BE REQUIRED UNDER LOCAL OR STATE LAW 16.
SPECIAL INSTRUCTIONS: TOTAL
CONTRACT AMOUNT PRICE
IS GOOD FOR 30 DAYS DEPOSIT T1,17'e ACCESS:
Customer agrees to allow access to the property and realizes that heavy equipment is being used. Contactor
shall not be liable for, without limitation, damage to driveways, sidewalks, lawns, sprinkler systems, gardens, septic systems and any BALANCE DUE UPON otherstructuresthereof, as a result of rooftop or job deliveries. DAMAGE
ETC.: Customer shall be responsible for removal, reinstallation and recalibration of satellite dishes. Should customer become aware of COMPLETION damage
to property by Contractor, his agents, or employees during the course of installation of the roof, said damage shall be brought to the attention of
the Contractor prior to the time of payment for the roof in question. Coastal Improvement Corporation has first right to cure any damage. If Customer
retains the services of another Contractor to repair said damages, it is at the Customer's own expense. If Customer fails to notify Contactor of said damage within 5 working days of occurrence, then Customer waives all
rights against Contactor concerning said damage. Coastal Improvement Corporation is not responsible for roofing nails penetrating A/C and/or plumbing lines in the attic. Customer agrees to secure and protect their assets including
shelves, ceiling fans, tools and other valuables to avoid damage from vibration, breakage and/or detachment of parts, etc. DELAYS,
ETC.: Customer hereby acknowledges that Contractor may be subject to delays occasioned by inclement weather, labor disputes, and material supply shortages or other causes which are beyond the control of the Contactor
and hereby accepts delays occasioned by one or all of these circumstances in the installation of the roof. PAYMENT
OF CONTRACT: Customer hereby agrees that all amounts due for this work shall be paid upon completion of installation. Any amounts unpaid will bear interest at a rate of 1 1/2% per month. Contractor shall be entitled
to all costs of collection including attomeys' fees. RIGHT
TO CANCEL: If this is a Home Solicitation Sale, and if you do not want the goods or services, you may cancel this agreement by providing written notice to the seller in person, by email, or by U.S. mail. This notice must indicate
that you do not want the goods or service and must be delivered or postmarked before midnight of the third business day after you sign this agreement. If you cancel this agreement, the seller may not keep all or part of any
cash down payment. IF
THIS IS NOT A HOME SOLICITATION CONTRACT: Once this contract is signed, you are bound to it by the laws of the State of Florida. If in the event you breach or attempt to cancel this contract, the Contractor shall be entitled
to all lost profits from the contact. ACCEPTANCE
PROPOSAL: The above prices, specifications and conditions are satisfactory and hereby accepted. All
contacts are subject to Coastal Impr ment Corporation's management approval. Customer agrees to allow SALESPERSON SIGNATURE Coastal
Improvement Corporation to us photos, letters of recommendation, satisfaction mis, etc. to be used for
advertising purposes. MANAGEMENT
APPROVAL CUSTOMERSIGNATUREDATEConstruction
Industries Recovery Fund: Payment may be available from the construction industries recovery fund if you lose money on a project performed under contract, where the loss results
from specified violations of Florida Law by a State Licensed Contractor. For information about the Recovery Fund and filing a claim, contact the Florida CILB at the following tele- phone
number and address: 850-487-1395. Florida Construction Industry Licensing Board,1940 N. Monroe Street, Tallahassee, FL 32399. 15-06
CITY OF
Building & Fire Prevention DivisionSANFORDRESIDENTIALRE -ROOF POLICY& PROCEDURES
FIRE DEPART&iENT
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:
CITY OF
S,kNFORDPERMIT #
Building & Fire Prevention Division
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: 25qO S. l mz Ptv nv tnfcr L 3Z'17
STRUCTURE TYPE: V JINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: &iEPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF
DECK TYPE (PLEASE SPECIFY): / )( (p
PLEASE NOTE. ONLY 100 SQUARE FEET OF ;THE XISTING DECKIS PERMITTED TO BE REPLACED"
ROOF VENTILATION: DOFF -RIDGE G RIDGE OSOFFIT OPOWERED VENT
SKYLIGHTS: O YES 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
OTURBINES
TYPE ROOF FLORIDA PRODUCT APPROVAL
SHINGLE
MANUFACTURER
b r4 "4, FL# 5LI94
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#
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#