106 Holloway Ct - BR18-002924 - WINDOWSCITY OF
Ski4FORD.
FIRE DEPARTMENT
Job Address:l W Vw\\bV"Aa\( a
Parcel
Type of Work:
Description of Work:
1111f
JUN 1 2 Zola
Building & Fire Prevention Division
PERMIT APPLICATION
Application No: 1 g ' Z(o L/3
Documented Construction Value: $ 1 Z `7(,p O
Sarhya 3z 111 Historic District: YesE]Ndi5
W'10 Residential5CommercialEl
IfPlanReviewContactPerson:_ Ya 'A CSC4 -fi,l M(/V Title: d wn
Phone: `TV 1- -7JZ.-12, (p2 Fax: ` 07- 6-79' 11123 Email: rMTy01kh0-1"ks0f16C-ep I.
G&-"
Property Owner Information
Name [ \UI e)( F'ScO%my
Street: W
City, State Zip: F1 1
Name [ I(Al XCA_3_D
Street: I
City, State Zip:
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Phone: 3a 1 - 510 008-1 Resident
of property? : Contractor
Information ttc-
Phone: Fax:
L! 'Cg 70r `IZ State
License No.: = 13GO4049 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 alllaws 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: 6iD Edition (2017) Florida Building Code Revised:
January I, 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 ofpermit is verification that I will notify the owner of the property of the requirements ofFlorida 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 ]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
be done in compliance with all applicable laws regulating construction and zoning.
cof g Signature
of Ow t ate raln
Sc d Dai d PrintOwner/Agent's Name Ice
a
re of of ry-Star o Florida Date nu
Notary Public State of Flonda Tiffany
Burleson . MyCommissionGG173997 Expires
01/09/2022 Owner/
Agent ersonally Known to Me or Produced
ID Type of ID L
e116 Signature
of Contractor/Agent Date F
r6 YI U S.v J A `^O1 V Prim
Contractor/Agent's Name I
u /
te--, AA<
Notary Public State of Florida Tiffany
Burleson M
My Commission GG 173997 3 °r
n. Expires 01/09/2022 Contractor/
Agent is,2!Zersonally 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: Occupancy Use: Flood Zone: Total
Sq Ft of Bldg: Min. Occupancy Load: # of Stories: New
Construction: Electric - # of Amps Plumbing - # of Fixtures Fire
Sprinkler Permit: Yes No APPROVALS:
ZONING: ENGINEERING:
COMMENTS:
of
Heads UTILITIES:
FIRE:
Fire
Alarm Permit: Yes No WASTE
WATER: BUILDING:
Revised:
January I, 2018 Permit Application
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: (e i 'k 0 1.'k
I hereby name and appoint:
an agent of. l,'CJI 1 t t oa 1 JI,J L
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):
The specific permit and
r\
ap lication for work located at:
1 Nln Nn1 k N .7 r.-t
Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name: Fiay\G z CO
State License Number: C C-C' J 0O C5>7
Signature of License Holder.
STATE OF FLO
COUNTY OF LOCA-
The foregoing instrument was ac wledged before me this day of 1/0 ,
20b) , by ,, U who is onally known
to me or o whohas proa cu ed- identification
and who did (did not) take an oath. Si
e Notary
Seal) Print
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pi4fi WIFIFy 6Ublit State of Flonda i
Tif Ay Burleson yix Mye6MR116e10n oc 173997 Notary Public - State of OI 3aj
y° 5 reatll/09/2022 Commission
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GRANT HALOY-r RENIHOLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLER
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CLERK'S av 2018064362
RECORDED 06/06/2(118 I12,12,-,-9 IFA
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My Commission GG 173997
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Central Homes Roofing Sales Representative
1182 N. Ronald Reagan Rd. Irene Gerena
Longwood, FL 32750 (321) 662-2281 i - t407) 732-7262 G
centralhomesirene@gmail.com I
Ruben & Anna ESCOBAR
106 Holloway Ct. Lstunarte:#; ' ' 12027Sanford, FL 32771 •'' :;;, i- - 1 5/4/2018
0 .,+ a% :i• . ..K.'; .. : f- t a ..(i' : . .;e,' iesaipt+oD!'-
Scope Otwork, Removal
Tear off and haul away the existing shingle roof system (one layer). An additional 35/
sq. for removal of each unforeseen additional roof layer will be added. Roof
Sheathing Inspection it Inspect the roof sheathing fastening system and supplement (re -nail). Underiayment ;
Su - _.__ • pplyand install one layer of Rhino Synthetic felt undedayment. Ventilation ;
i Supply and install new Shingle Over Ridge Vents and/or 4' Off Ridge Vents for - proper
ventilation. Drip
edge Supply and install new 2 h" cave drip - - — - - - -- _-- ----- Pipe
Jacks ! Supply and install Bullet Rubber boot flashing for plumbing stacks Valleys
Supply and install a self -adhered peel & stick modified underlayment in all valleys Certainteed
Landmark per square Certainteed Landmark Architectural Shingies per square -- Permits/
Inspections We will obtain and pay for a permit and obtain all required inspections Dumpster/
Haul away debris ; i Upon completion, all roofing debris willbe picked up and taken away. Warranty
7 year workmanship warranty on labor - - — - - - - - - - SATELLITE
DISH CLAUSE-C in l-Homes will,dehach the•satellite-dish.: is -the -- - . - cesponsibiRty.af tt e homeowner tq call'the.servioe pmovider andschedulethere.ignstallatiLons and the caLbration of the saiUite dish after the roof is complete " Shingle
Color: s,Obh a S%M C-Drlp Edge.Color . Vents. Color i3 j'at` Payment
Terms: I, THE HOMEOWNER AGREE TO PAYTHE tiatance due uponcompletionTof sbope ofiwo-& DUE -TO OUR "NO•MONEY UP FRONT" POLICY, WE ASK-FOR'PAYMENI' WMEDI/1TELY AFTER T9I(SCOPE^OF; -.Gf, SrCOtiAPL'•ETe5 PLEMOyyl7 HOWS,1•k. OF THE i y.. SCOPEAMOUNTIFYOUAREWAfiINGFORFINALWSPECTION, CLE/@IWNG OF'AW-i, gRT OF:Y,OURPi2OP92Z1(; OR3tNA + G FOR I SMALLREPAIRSTOGUTTERS, SCREENS; ETC. Central Homes.must payrotu.suppOwswWwrorkam-bri iiediatelyto dvoid-liens•on your. property. H you're waitingon insurance proceedsweask that -you pay deducdWea6iffrrit efieolc:upon completion *Vwooiii, We-w'Wwait for 1 youtoreceivefinalinsuranceproceeds, '
1 1
Homeowner Name 1`ik e^ tS L J 3&r —
12,760.06mm
Homeowner Signature Date S J
Tord1 $12,760.06
Central Homes Rep. - ---
S P E C I A L I N S T R U C T I O N S
Payment Terms: I, THE HOMEOWNER AGREE TO PAY THE balance due upon completion of scope ofwork. DUE TO OUR "NO MONEY UP
FRONT" POLICY, WE ASK FOR PAYMENT IMMEDIATELY AFTER THE SCOPE OF WORK IS COMPLETE. PLEASE WITHHOLD 10% OF
THE SCOPE AMOUNT IF YOU ARE WAITING FOR FINAL INSPECTION, CLEANING OF ANY PART OF YOUR PROPERTY, OR WAITING FOR
SMALL REPAIRS TO GUTTERS, SCREENS, ETC. Central Homes must pay our suppliers and workers immediately to avoid liens on yourproperty
A surcharge of 3.5% will be added to above price if paying with a credit card.
Any unforeseen decking repairs and/or wood rot repair will be done at a cost of $55.00 per sheet of plywood and/or $5.00 per lineal foot of fascia.
This proposal is null and void if not accepted within 10 days of the date referenced in this proposal due to price volatility in asphalt -related products.
I have read and accept the Additional Terms and Conditions printed on the back ofthis page. The prices, specifications and conditions of this
proposal are satisfactory and are hereby accepted and Central Homes LLC is authorized to do the work as specified. Payments will be made as
outlined in this proposal.
CITY OF
SANFORD RESIDENTIAL RE -ROOF
Fire Prevention Division
ROOF POLICY & PROCEDURES
FIRE DEPARTMENT I g - 7-t-P 43
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: lip 1 U I '
ifCITY OF
Skl4FORD
FIRE DEPARTMENT
JOB ADDRESS: I V Mk
PERMIT # I - - 2-V+.
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
j a a71-1
STRUCTURE TYPE. INGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: /<EPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF (INSTALLED OVER EXISTING ROOF)
PIVWDECKTYPE (PLEASE SPECIFY):
PLEAsE NOTE. ONLY IOO SQUARE FEEf OF THE EXISTING DECK IS PERMITTED TO BE REPLACED**
ROOF VENTILATION:)81)FF-RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES _ 'f O IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 OX4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O SHINGLE 1 l/1 FL# J'1 - era
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 M ETAL FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
0INSULATED FL#
O TILE FL#
O OTHER: FL#
CITY Of
Building '&• Fire Prevention DivisionSkNF011D. RESIDENTIAL RE. -ROOF AFFIDA VI T
fiAE DEPARTMENT ,
RESIDENTIAL RE -ROOF: INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: g — a (o 3 ADDRESS: L0 (s A Lj10Wy_\" CT
r
h1 F• 2 3 a -'1-1 1
CZ,AI',G S C 7 Y rLVY1I t-t+l , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, ENGINEER, ARCHITECT, OF F.S. CHAPTER468 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 M C-CC k a)0 t G 0 Ci
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE: DATE:
MUST BE SIGNED BY LICENSE HOLD R OR OWNER/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 Eijjl r'dOL.0
Sworn to and Subscribed before me this day of 20 _ by: :Iml
1'l - Who is )(Personally Known to me or has 0 Produced (type of
ASiente
ificatio) as identification.
at e o otary Public n $ Notary Public State Of Florida
of FI da ?° 2/1 ,11, Tiffany Burleson
ot! D 4
C mmiss on GG 173ta87
P 1nt ype/ tamp ame '
l
of Notary Public
y o
Expires 01/09/2022