115 Meadow Blvd - BR18-002691 - REROOFCITY OF SANFORDJUN13BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: -1 8- 1;
Documented Construction Value: $ 700d
Job Address: me -Lao".) &Vci Historic District: Yes No
Parcel ID: ', 3, i- -30- 50 8 - OOCO - OL1_)c5t'Z> Residential [X Commercial
Type of Work: New Addition Alteration IN Repair Demo Change of Use Move
Description of Work: Re-/'oz,--,-'
Plan Review Contact Person: Ar)+k ,,, (`r ctrz a Title:
Phone: Fax: Email:
Property Owner Information '
Name / 8^0_ f: i e ci, Phone: Lfo7-73 3 - 141(o
Street: jlx t'1P Qdow &W Resident of property?
City, State Zip: ILL "52-" 1
Contractor Information
Name Heritage Construction & Roofing Phone: (407)366-6000
Street: 1544 Seminola Blvd. Suite 136 Fax: (407)366-6065
City, State Zip: Casselberry, FL 32707 State License No.: CCC132650
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
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. 1 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: 5" Edition (2014) Florida Building Code
Revised. June 30, 2015 Permit Applicalion
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 1 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: 1 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.
6/13/f
Signature of Owner/Agent --ojp Date Si aturc of Contractor/Agent Date
Print
o°s Notary Public State of Florida
i Lesley G Gana
or Expires
009517
es 07/07/2020
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of
YYY T . - -
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G
Garza My
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cc° Expires 07107I202' Owner/
Agent is Personally Known to Me or Contrac s Personally Known to Me or Produced
ID Type of ID Produced 1D TypeoflD BELOW
IS FOR OFFICE USE ONLY Permits
Required: Building Electrical Mechanical Plumbing[-] Gas[:] Roof Construction
Type: Occupancy Use: Total
Sq Ft of Bldg: Flood
Zone: Min.
Occupancy Load: # of Stories: New
Construction: Electric - # of Amps Fire
Sprinkler Permit: Yes No # of Heads APPROVALS:
ZONING: ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Plumbing - #
of Fixtures Fire
Alarm Permit: Yes No WASTE
WATER: BUILDING:
Revised:
June 30. 2015 Permit Application
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 6/G l (i
I hereby name and appoint: 4r+Vx v 69GIC7—Qn,
an agent of kA-Q Es*cn :q e G/nib ,
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):
D' The specific permit and application for work located at:
kq Me c,a a.,. awa• sc, ,fo(d Gl.
street Address)
Expiration Date for This Limited Power of Attorney: 3Cl tn 4 S
License Holder Name: So--V-—
State License Number:
Signature of License H
STATE OF FLORIDA
COUNTY OFF, e
The foregoing instrument was acknowledged before me this j1day of ,
200, by ^ v. who is t sonally known
to me or o who has produced
identification and who did (did not) a
Notary Seal)
ow Pot Notary Pabbc Stale of FlOntla
Laley G Garza
My Commission GG 008517
ti 8fv Pp1fes07/07/2020
Rev. 08.12)
1--eslQ* „r c w
Print or type name
Notary Public - State of t=
Commission No. G,r ciP S[7
My Commission Expires:
1111111111111111111111111 H 1111111111111
THIS INSTRUMENT PREPARED BY:
Name: Heritage Construction &Roofing ,.,{nGv i
Address: 1544 Seminole Blvd. Suite 13fi
Casselheay- FL 32707
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
GRANT MALOYr SEMINOLE COUNTY
CLERY. OF CIRCUIT COURT 6 COMPTROLLER
BK 9150 P9 227 (1P9s)
CLERK'S : 2018066170
RECORDED 06/11/2018 03:02:18 PM
RECORDING FEES $10.00
RECORDED BY hdevore
Permit Number: Parcel ID Number: 33 —1 ci _3n —so k_,,—, {cvbo
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.
OF PROPERTY: (Legal description of the property andA.- .. % A — ^ -- I-- e
GENERAL DESCRIPTION OF IMPROVEMENT:
j2-e—('vg4-*
Fee Simple Title Holder (if other than owner) Name:
Address:
CONTRACTOR:
Address:
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)(b), Florida Statutes.
Name:
Address:
In addition to himself, Owner Designates of
To receive a copy of the Lienoes Notice as Provided in
Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement (The expiration date 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.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true
to the best of my knowledge and belief.
T Z. , 42" FrAeA R1 p'ollOwner'sTkgnature Owner's Printed Name
Florida Statute 713.13(1)(9): ' The owner must sign the notice of commencement and no one else may be permitted to sign in his or her steed.'
State of ` County of
The foregoing Instrument was acknowledged before me this __LL_ day of T hP 20
by Who Is personally known to me
Name of person making statement
OR who has produced Identification type of identification produced: _ , r Q`hC.
a llotary Public State of Florida
Lesley G GarzaMyCommissionGG009517
Expires07/07/2020
City. of Sanford B611ding0lilsion
r ResidenthdRe-Roof Inspection Poflcy & Procedures
PERMITITNC'REQUIREMENTs --NO. PLAN REVIEW REQUIRED
This document (signed) along with.an.accuiiate and.completed :Residential ke-Roof Scope of Work are required
to be` saniitted.as part of yovi permit-ipplication..
The -Scope ofWork must include all applicable Florida Product Approval'iiumbers•for all roofcomponents that
will.be installed on the project.
A permit will not be issued withoiit these documents... Copies will be made to post on the job site.
Projects located in the'Sanford Historic District will.require plain ivview and approval'by die Sanford
Historic Preservation Board '
INSPECTION POLICY & PROCEDURES'
A Final Roof Inspection. is the only inspection required for'Residential (Single Family, Townhouse; Mobile
Home, Apaitinent and/or -Condominium) Re -Roof Permits.
The Following is required'.to be*provide,on'the job site:
Permit Caid,_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 ofthe'roo& showing the underlayment installed
o 1 Roof leak Wail Pattern dt Spacing (including a measuring devicx or. ruler)
o Roof Deck Nails used (includiiig.a measuring device or ruler showing size of nails) '
o ' Underlaymeiit Pattern & Spacing (including*a measuring device'or railer) '
o Drip Edge'&'Valley Attachment (including:a,incesuiiag device oi'ruler)
o Shingles installed;: nvR'pattem' and location of nails
o Digital.photographs showing all inntallation components,.per FL,Product Approval
o Digital photographs showing aU, required flashing; ,per- FL Product Approval
Pailure .to follow these apeefflo guidelines will result4n'sn affidavit provided by a Ylorida :Design
Professional (architect or engineer), certifying F$C code eompliance'by personial'irispection.
3WMAC'rOlt ((YtOWNER/BUII DER} StotrATURE: "DATE:
w
city of S"brdStMding-DiWon•
Residen.tW.Re-RoofSeope'of Work
JO$ADDRBSS:: l 5. /o.c,rJc 1G
STRUCTURE TYPE: SWOLE FAMILYRESIDENCEfr04NH0USE . Q M08111 HOME '.. Q APARTMWr/CONDOMRiWM
RF,ROOF TYPE: -o:RMPLA (TBAR•OFF wanw0 ROOF•AND REPLACE WITH NEW'COMPONmm)
ORE-Covm (NMROOF W TALLEDOVER'E WMOROOF)
DECK 7W9 (PLEASE SPECIAv): r
PLE4SENOM ONLYIOOSQUARE.F6LTOFTHEMU$nNOAKZISPSR n7ZDTOX*ERL'PIACED**
ROOFVIZMMATION:' QOFF4t1DOE RIDCOB ,'OS6" fQPowERBD'VENT QTURBWES ' SKYUCHTS:
k YES Q NoIF YES, PLMM' PROvmE FLoR1DA PRODUCT APPROVAL #: • MA*-
RbOPAREA - - ROOF §
wimt. •Q Lsss •THAN 2i l2 Q-2:12'= d:12: ' 4:12 OR G' REATER ; . TYPE'
OF ROOF MANUFACTURER rFl:ORIDA PRODU4T %\PPROVAL . sim
c;Le : > as Fes. 3 S • Q b QIrIOD1P®
BI[VMEIi FU QTORCH-
DOWN FIB OTILE
FL# Q
OTHER: FL# RA[
1F B.rrrtvttfN R.lPoltcN 9.•PA7708. ETt:.I'*ilFAPPLGBLE•* ' RWiSLOPE: • ,
Q LESS THAN 2:12 -0,2:12 =4:12' ..0 4:12 OR-OREATBR . TYPZ
OF ROOF : MANUPACrURBR FLORIDA PRODUCT APO"VA1:, Q'
SHIwLE' Fl l O.
METAL'. n _ FIA Fly
Q1't7RCH'DOwta QINSULATED
FLO
Heritage Construction & Itoofmg Acc Mgr:
1544 Seminola Blvd. Suite #136 HERITAGE INSURANCE COMPANY INFOF#AATION
Casselberry, FL 32707 C:onstruction&Roofing Company: Cj.
CGC 1505045 / CCCI 326650 Policy: u ttS6Sti1? -0 It
1 Roof Replacement Contract Claim#: ZA t ICL CS f-s
Mortgage: 041111110,
Owner(s): 6ej PH: o _ lil(
Address: 45'O lei% Cell: .. oj2o2 • ?
City: ; 40 State: Zip: Email: ri j; Eef
Manufacturer: Color. CRV: p r _ .,eo— FOP*
Type: 3T CArchitecturaldM Tile Metal Flat Boot
lacks: i K"2" 3" 4" Other Goose
Neck Vents: ZC7 4" Bath 6" Dryer 1 10" Kitchen Gas Ridge
Vents: J LF Off Ridge Vents: PCs. Chimney
Flashing: e%_ LF Skylights: ZX2 ZX4 ZX6 Solar
Panels: # Sise Satellite Dish: Ai If-V- R&R No Reset Gutters
Spiked: Y N Replacement: ow/A- LF Down Spouts If
Owner's Insurance Company does not agree to pay for roof replacement, this contract shall be voidable. Direction
To Pay, For the Roof Replacement and Interior Damages but not limited to: I hereby assign any and all Insurance benefits and proceeds under
any applicable Insurance policies, Assignment of Insurance Benefits and give direction to pay: Heritage Construction & Roofing, Inc. ("Heritage"), the
scope of which shall Include but not be limited to a Roof Replacement. 1 make this assignment and direction to pay authorization in consideration of
Heritage'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) and Mortgagee(s) to release any and all information requested by Heritage, its representative,
or its attorney 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 Owner/Agent/Insured(s), it shall be endorsed over to Heritage Immediately upon receipt within
48Hrs. 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. DEDUCTABLE: 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, UNLESS replacement/repair of deteriorated decking Is required
and/or Owner requests optional upgrades. Heritage CANNOT pay, waive, rebate, or promise to pay, waive or rebate all or any part of the Insurance
deductible applicable to the Insurance claim for payment of work. In the event of a discrepancy, the deductible amount stated on the Insurer'
s Loss Sheet shall qver rule deductible listed below. Deductible: 3Ci MUST BE PAID IN FULL ON DAY OF INSTALL, plus any
extras, upgrades, S&Z (Initials) MORTGAGE
AUTHORIZATION: 1, Owner / •Mortgagor, grant authorization for Mortgage Co. to speak with Heritage Construction &
Roofing, on matters Including, but not limited to, the claim and payment status. PAYMENT
SCHEDULE: Owner agrees to pay Heritage based on the following pay schedule: (i) Deposit in the amount of S 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 Heritage upon completion of work being performed; and, (Ili) the remaining Contract Price (equal to any applicable depreciation and/
or change orders) due and payable to Heritage upon completion of work performed. In the event of a pending inspection or punch work, no more than
2% of Contract Price may be withheld until final inspection has passed. REPLACEMENT WORK AND PRICE: Upon Insurers approval and sub)ect to the
terms and conditions herein, Heritage agrees to furnish all materials and provide the labor necessary to perform the full roof replacement and any Interior
work or work relating to loss sheet, which shall take place following Owner's Insurance company's approval, approximately within 30 days, conditions
permittin er s claration of Intent: Owner acknowledges and agrees that, upon approval by insurance company for a Roof, Interior, Exterior
replac nt, g hall perform the roof replacement and Interior or Exterior work upon receipt of funds from Owner's Insurance company,
g4nejefrees (Herltagpy Acting as their Licensed General Contractor and is entitled to the profit and overhead allowed by 41w
1 l(a A V, 21,1k- Authorized
Heritage Wresentative Date Owner Date Print
Name PrIA'Na-M By
Signing this agreement, I, Homeowner/agent agree to the terms and conditions listed therefore on front and Back of this agreement. CANCELLATION:
If Owner elects to terminate the services of Heritage, 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 Interior/roof damage has been denied, In whole. All written notices
of cancellation, regardless of reason, shall be postmarked or delivered to Heritage's corporate office: 2544 Seminola Blvd. Suite #136, Casselberry,
Florida 32707. CANCELLATION EXCEPTIONS: The three 13) day right of cancellation DOES NOT APPLY to contracts for emergency home repairs as time
Is of the essence. I, Owner, have read both front and back and understand all statements, terms and conditions of the "Contract' and agree that all details are
acceptable and satisfactory.
City of Sanford
Building and Fire Prevention
RESIDENtL4L'RFr466F'INSPEGTION AFFIDAVIT',
NAILING, SHEATIIING, Mir IN, FLAS G,: AND ALL"FINAL ROOF COVERINGS
PERMrr #: 1 - Z%GI ( ADDRESS: 115 mQ der.- 61,/ Ci
I _S°Wl^4L_.S' 4tn AS A(N) +4 BUILDINO, RESIDENTIAL, OR
ROOFING CONTRACTOR; EMINEEB, ARCHTIECT,.OP F.S. CHAPTER 468BUILDING INSPECTOR. I HEREBY APFDtM, THAT ALL OF THE
FORE06IkO INFORMATION 1S.TRUE AND ACCURATE ANDTHAT ALL ROOFING ;COMPONENTS LISTED ON THE SCOPE OF WORK AT THE
ABOVE'RRIWM CED ADDRESS HAVE BEEN INSTALLED IN ACCORDANCE WTI B THEIRTI ODUCT APPROVALS ANDALLAPPLICABLE CODE
REQUIREMFNI'S —SPECIFICALLY FLORIDA BUILDING CODE, ExIsTlNOBUIL'DING'. IN ADDr1]ON ICERTIFY THE WSTALLATI,ON MEETS ALL
REQUIREIrMM FOR SECONDARY WATER BARRIER AND NAILING OF THE ROOF DECK, IN •ACCORDANCE Wrf'HMR'HURKICANt RBTROFTT.-
MANUAL REQUIREMENTS (BASED ON F.S. CHAPTER SSjA4). '
LICENSE'#: C--i i ( 0`? ',• . ,
COMPANY I CONTRACTOR: t JG O 4-
CO MtACTOKSIONATURE: DATE:
MUST BBSkwb BY'Ik& OR OWNBR/BUILDER)
AZwA;L ROOF INSPECTION IS REQUIRED:
THIS SIGNED AND NOTARIZED AFFIDAVITMUST BL,PROIM VIDEDATTHEJOBSITEATTHETEOF THE FFRALROOF INSPECTION, ALONG
WITH DIGITAL FHOTO'CRAPHS OF EACWIt.ANE OF THB"HOOF SHOWING•1N!DEUIL ALL'CaMPOftNTS (diCKINO, UNbntLAYMENI',
FLASHING, DR1P,EbGE ATTACuMBN7) WITH THE PERMIT NUMBER -OR ADDRESS CLEARLY MARKED ON THEDECK"' FORXACH
DVSPECIYOK THE PHOTOGRAPHSMUST INCLUDE A•RUI:ER OR MEAStbMG DEVICE -TO CONFIRM: ALLNAIL SPACING AND - OVERLAPS,
INCLUDING. DRIP EDGE AND VALIXY FLASRING: ftTASE' REFSR.7'O'THE RE -ROOF POLICY'AND. vamc ION PROCSDURB PAPERWORK
FOR FURTHER EXPLANATION OF ALL REQUIRI&MERM FAILURE
TO FOLLOW ALL„REQUIREMENTS WILL'RESOLi!.IN•A.FAIL;BD.IN,iSr-Wn0N,•A A INSPECTION FEE AS WELL,
AS REQUIRING A DESIGNPROFESSIONAL,,(ARCAITECT•OWENGINEER) TO 7F!7Y, BASSI ON.PBRSONAL INSP$
CTION; THE IN$'I•ALLATION•OF ALL' ROOFING'COMPONENTS., ' STATE•
OF FIARIDA COUNIT OF-.L° Sworn:
to and.SobaerMed belore•me-this'Z day -of Utnvye ?A by: ; 1
Wtio b Rally Knmrn to Iee or'has O Produced (type of Identifies
m identification. tun
of ry State
of Florida .. i iL) Notary PutdkStateofFlalda Lew• •
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