135 Sterling Pine St; 18-4098; RE-ROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
p !
Application No: 0
Documented Construction Value: $ l01 9co
Job Address: District: Yes No 0
Parcel ID: Residential Q Commercial
Type of Work: New Addition AlterationEl Repair De./mo Change of Use Move Description
of Work: 2e4! omnI Corm F- echwra
e 1_,& So %f 2 e, &_A dr,4huc d s ` erne ;7-S &r-sPlan
Review Contact Person: Skylar Amkraut Title: Admin Phone:
407-278-7788 Fax: 800-337-3361 Email: Permit@Jasperinc.com I
Property
Owner Information Name
1;half G luce n a Street:
54-• City,
state Zip: Sny-y nr . - 3-02 3 Phone:
Resident
of property? : Contractor
Information Name
Jasper Contractors Phone: 407-278-7788 Street:
300 Colonial Center Parkway Suite 130 City,
State Zip: Lake Mary, FL 32746 Name:
Street:
City,
St, Zip: Bonding
Company: Address:
Fax:
800-337-3361 Yes
State
License No.: CCC1331153 ArchitectlEngineer
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: 511 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.
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 pen -nit 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 perinitfees 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]aws-regulating construction-and--zoning:-
signature of Owner/Agent
Print Owner/Agent's Name
Signature of Notary -State ofFlorida Date Signa
re of Cont, c or Agent Date Rudith
Goico A14A
CHAVErZ aYAA'
r,State of Florida -Notary Public Commission #
GG 112152 My
Commission Expires in,+`
June 06, 2021.. Owner/
Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or Produced
ID Type of ID Produced ID V Type of ID t 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 Plumbing — # of Fixtures Fire
Sprinkler Permit: Yes No APPROVALS:
ZONING: ENGINEERING:
COMMENTS
of
Heads Fire Alarm Permit: Yes No UTILITIES:
FIRE:
WASTE
WATER: BUILDING:
Revised:
June 30, 2015 Permit Applicalion
800) 337-3361 Fax
info@jasperinc.com FL Contractor's License:
CCC1329651 & CCC1331153
Il5A
ROOF REPLACEMENT CONTRACT
Account Manager: Joseph Palladino
Contact #: (407) 335-6239
Company: Universal Property & Casualty
Policy #:1501-1701-8931
Claim #:
Mortgage Company Information
Company: Loan Care
Loan Number: 0026600874
Owner(s):
Fernanda Lucena
Phone:
Address: 135 Sterling Pine Street A1tPhone: 321-247-1227
City: Sirr. Zip Code: 32771 Shingle Color:
Sanford OC Supreme - Driftwood
Email:
fe ur eggla yhoo.com Roof RCV
Amount/ Contract Price: Drip Edge Color: Drip Edge -
White 611 If Owner'
s Insurance C'omnany does not agree o Bay for a full roof replacement_ 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 under 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 hi this regard, I waive my privacy rights. If
payment is made directly to the Owner/Agent/hisured(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,
wai Dgr 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 amo
stated on the insurer's Loss Sheet shall overrule deductible amount disclosed. Deductible: $2500.00 MUST BE PAID IN FUL
tial). PAYME E:
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.
1, 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: DocuSigned by: _ 6/14/
2018 1 6:31 PM EDT 6/14/2018 1 6:30 PM ED- duper Representative
Date @JE897134C9.. Date
Grant Malo , Clerk Of The Circuit Court & Comptroller Seminole County, Fl-
Inst#20181y11752 Book:9221 Page:51; (1 PAGES) RCD: 10/1/2018 10:36:15 AM
RECC FEE $10.00
THIS INSTRUMENT PREPARED BY:
rName: _ Jasper Contractors
Address: 515 18th Street
Orlando FL 32805
DoZ3l s
NOTICE OF COMMENCEMENT
Permit Number:
Parcel ID Number: ) b— -21 • 1I =0 — 05-'30
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. DE§CRIPTION OFY_ROPERTY: (Legal description of the property and street address )f available)
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Re -roof
3. OWNER INFORMATION OR LESSEE INFORM T10N IF THE LESSEE CONTRACTED FOR T E IMPROVEMENT:
c
Name and address: feY4,QnrtGL
Interest in property: Owner -- _— " — vet` ,-•t
Fee Simple Title Holder (if other than owner listed above) Name:
4. CONTRACTOR: Name: Jasper Contractors Phone Number. 407-278-7788
Address: 515 18th Street Orlando FL 32805
5. SURETY (If applicable; a copy of the payment bond is attached):
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 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 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.
F-o9ijA& A
SIgnaturoof Ovmer or.Lasrae, or Qwners or Le{see'e (Print tJamagnd r'oJrde , I`S gnalorys T1UefOffiea)
WlhorizedOfrKedDiractorlPartnerfManager)—. --------"---- -- — ---
State of Florida County of L c
The foregoing Instrument
l
was acknowledged befgre rrre, this -) day of 71= , 20 :.
by k, j %/. Who is personally known to me OR
Name of person making statement
who has produced identification 3SI type of identification produced:
ELIDA GARCIA
y pI*
k Nary Pubuc, State of Flodda
Commissign8 FF 205311 Notary ' nature
My tx MnL expires Apt 12, 201 g
SEA41NOLE COUNTY MUL TI-JUR ISDICTIONAL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood,,Sanford,
I
Seminole County, Winter Springs
Date: ol/1,8
I' RUdith GoiCo. Adreanna Ocasio, Skvlar Amkraut, Amanda Ciei)linskiheEebyname--and-appoint:
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):
EY- All permits and applications submitted by this contractor.
Or
0 The specific permit and application for work located at:
Address)
Expiration Date for This Limited Power of Attorney: n1-01 -- 19)
License Holder,Name: Donald Bouchard
State License;Number: CGC1331153
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF Seminole
The foregoing instrument was acknowledged before me this L91 day of 1Q-14ok>P-
20 1 by Donald Bouchard who is El personally known to me or
IZI who has produced. DL
and wrfi d not) take an oath.
ANA CHAVEZ
State of Florida -Notary Public
zz Commissi,on#GG112152
14 y t6iiYrnission ExpiresgWJune06,2021
as identification
Print or type Notary name
Notary Public - State of
Commission No.
My Commission Expires: Ct co
F _
s
D City of Sanford Building Division
r ` 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 resu It 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:
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: % 3 s Y /1Q / / ST , S r ' +Z Z77 3
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: ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED "
ROOF VENTILATION: (DOFF -RIDGE O RIDGE O SOFFIT 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
O SHINGLE Owens Corning FL# 10674-R13
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH 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#
OTORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAIILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
j
PERMIT #: t v— qO q D ADDRESS: , J sAe f `\ y\q, R e,
I Q- 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 / (nXT-F0 A r M V
CONTRACTOR
MUST BE SILT
JASPER CONTRATORS
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: yj U lir
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
and Subbed fore me this day of 20 1V by:
Who is Personally Known to me or has ffi Produced (type of
identifica n
DL
as identification.
Si ature of Notary Public
LF
RUDIT H G O I C OateofFloridaeofFlorida -Notary P
1 'commission # GG 17841yCommissionExpiresjanUafy24, 2022
P nt/Type tamp Name
of Notary Public
SEMINOLE COUNTY MULTI JURISDICTIONAL
I i _ , , ;, t ice, i i i ;• • ' d 1
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
tt-
I
Seminole County, Winter Springs
Date:
Scott Meixsell, Chris Gardner, James Allen, Joshua Collazo, Desmond Roberts, Jovanni Bracero & Edwin
hereby -name. and._app-ointKazquez .. _ ___ ......... ........ _-- ___ _. ... --._ ___ ._____
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):
All permits and applications submitted by this contractor.
Or
The specific permit and application for work located at:
r <<v-_ ;oi-tie. s,
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
ECOUNTYOF
4 32?-7 3
The foregoing instrument was acknowledged before me this Aday of
a
20 18 , by DONALD BOUCHARD who is IN personally known to me or
who has produced
and wh di ( id not) take an oath. lu A_
Signa ure of Notary 6
CHAVEZEZStatery
PublicCom112152o`,?."tvlyxpires1
as identification
Print or type Notary name
Notary Public - St ate of .(-S l o"
Commission No. (--I, ;,q
My Commission Expires: t
o (
0