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122 Lakeside Cir - BR18-003004 - REROOFJUL Q 2018 CITY OF j;; S,kNFORD ' Building &Fire Prevention Division PERMIT APPLICATION FIRE DEPARTMENT OApplicationNo: o Documented Construction Value: S L , Job Address: 1(. a S( C i Cl C Historic Distric : Yes No Parcel ID: —— 30 - S k13 - o Bt O - 36 o Residential Commercial Type of Work: New[]Addition aRepairAlteration© Demo Change of Use Move Description of Work: Ve - V'M f-- Plan Review Contact Person: 1 I _rre\ Title: Py1 Phone: Lko-1- 'S3 -5 Fax: L('1 4e) 13 Email: Lev QooF•:, FC e e Mt: t•- Property Owner Information Name I Q fdyl Street: GkL 510 F. ; r City, State Zip: S Cm r-, I%L Phone: L( 6-I - uCl -'7 afI Resident of property? Contractor Information _ Name o• Cr e,\.\ L tki Phone: Street: Vt1'% ki\Z 5 AC laol Fax: C,(- City, State Zip: (o V-A 'PC State License No.: CCU' ( 3 3 (21 Architect/Engineer Information Name: A Phone: Street: Fax: City, St, Zip: E-mail: I/ V FZ / I Bonding Company: A Mortgage Lender: 'f Address: 1v r 1 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 m 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: 61D Edition (2017) Florida Building Code Revised: January I, 2018 Permit Application # I ` 1 •y 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 cWpliance with all applicable laws regulating construction and zoning. ignature orContra or/Agee Date rl vnw.a/ ov I IVd=' RLIINSURARAN Owner/Agent is -) Personally Known to Me or Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY of ID 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 # of Heads Fire Alarm Permit: Yes No APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: WASTE WATER: BUILDING: Revised: January 1, 2018 Permit Application SCPA Parcel View: 11-20-30-5KB-0000-0360 Page 1 of 2 Q4& CIA APP ars+ora oas+rr. cwrmx Parcel Information Property Record Card Parcel: 11.20.30-SKB-0000-0360 Property Address: 122 LAKESIDE CIR SANFORD. FL 32773 Parcel 11-20.30-SKS-OOOO-0360 Owner(s) ESTAGROSE, VERONICA L Property Address 122 LAKESIDE CIR SANFORD. FL 32773 Mailing 122 LAKESIDE CIR SANFORD, FL 32773- Subdivision Name HIDDEN LAKE PH 3 UNIT 7 Tax District St-SANFORD DOR Use Code 01-SINGLE FAMILY Exemptions 00•HOMESTEAD(2014) 6'0 \ Q v GIS Legal Description LOT 36 HIDDEN LAKE PH 3 UNIT 7 PB 38 PGS 79 d 60 Taxes Value Summary 2018 Working Values 2017 Certified Values Valuation Method Cost/Market Cost/Market Number of Buildings 1 1 Depreciated Bldg Value 97,132 79.430 Depreciated EXFT Value 1,700 1.750 Land Value (Market) 30,000 25,000 Land Value Ag Just/Market Value " 128,832 106,180 Portability Adj Save Our Homes Adj 49,973 28.943 Amendment 1 Adj 0 P&G Adj 0 0 Assessed Value 78.859 77,237 Tax Amount without SOH: $1,233.00 2017 Tax Bill Amount $682.00 Tax Estimator Save Our Homes Savings: $S51.00 Does NOT INCLUDE Non Ad Valorem Assessments Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund 78,859 50.000 28.859 Schools 78,859 25,000 53,859 City Sanford 78,859 50,000 28,859 SJWM(Saint Johns Water Management) 78,859 50,000 28,859 County Bonds 78.8591 50,000 28,659 Sales Description Date Book Page Amount Oualified Vadlmp WARRANTY DEED 11/1/2013 08170 0304 82,000 No Improved WARRANTY DEED 9/1/2005 05919 1678 173.000 Yes Improved WARRANTY DEED 11/1/1997 03332 0937 73,000 Yes Improved WARRANTY DEED 7H/1988 1 01982 0096 SW,900 Yes Improved WARRANTY DEED 151111988 1 01957 1 1003 1$212,600 1 No Vacant Find Comparable Sales Land Method Frontage Depth Units Units Price Land Value LOT 10.001 0.001 1 1 $30,000.00 1 $30,000 Building Information ft I Description I Year Buffedrve I Fixtures I Bed I Bath I Base Area I Total SF I Living SF Ext Wall I Adj Value I Rapt Value Iill AppendagesActuallE http://parceidetail.scpafl.org/Parce]DetailInfo.aspx?PID=l 120305KB00000360 7/9/2018 THIS INSTRUMENT PREPARED BY: Name: Matt Thomson Address: 1426 E Semoran Blvd Sul e 1 Apopka,FL 32703 NOTICE OF CO^MMENCEMENT Permit Number 3.V Parcel ID Number _ p - 'Z (`s ti L l rf c G C ;' (i The undersigned hereby gives notice that Improvement wka be made to certain real property, and In accordance with Chapter 713, Florida Statutes, thetollo" information is Provided in this Notice of Cornrwncorneni. 1. DESCRIPTION OF PROPERTY: (Legal descapllcn Of the IOPeny and strcel 6110cult ovaUabl.) Lc;-} Ito. N:c -A L L e- Gt r a 2. GENERAL DESCRIPTION OF IMPROVEMENT: re roof 3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: { Name and address 1 % P c, n , c —; C>- - t' 1 L +f < Jr• c r Sn,rrry c: > d r3 Interest in property: owner Fee Simple Title Holder (it other then owner listed above) Address: a. CONTRACTOR: Name: Darrell Lewis (Lewis Rooffnq) Phone Number: 407-538-5175 Address: 1428 E Semoran Blvd Suite 109 ADoDke FL 32703 _ SURETY (It applicable, o copy of the payment bend Is attached): Name: NIA Address' 6. LENDER: Name: NIA Phone Number. Address: Amount of Bond: 7, Persons within the Slate of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section713.13(1)(a)7., Florida Statutes. Name. NIA Phone Number Address: S. In addlion, Owner designates NIA of to receive a ropy ofthe Lfenor's Notice as provided In Section 713.13(1)ft Florida Statutes. Phone number: 9. Expiration Date of Notice of Commencement (The expiration is 1 year (torn date of recording untess a different dote is specified) ANY PAYMENTS E OY THEONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER 7113, PARTAFTERER ECTION 7'113, FLORIDA TION OF SATUTES, AND NOTICE OF COMMENCEMENT t RESULT EN YOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEYBEFORECOMMENCINGWORKORRECORDINGYOURNOTICEOFCOMMENCEMENT. i t 15gnaron of ONrar a Lsaee, a Ornxrh or lessees 1prhl Name and Pteade Sipnabrys T!"1011ce) NMaveootAarQntbNaMtrlMrnagnl ( , State of County of v r The foregoing Instrument was acknowledged before me this day of J Vn e 0 " J by t G `1 I C i> G ew Who Is personally known toekuwnTattllDWIOTMI rwhohasproducedIdentificationOtypeofIdentmcaUonproduced: v A WALKER o 10SHUA COMMISSION 9 GGISOD34 rS°"'a' Puetic EXPIRES Oct.10, 2021ar.ra o rL0404 BONDED THROUGH RU INSUILAM COMPAW GRANT MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK'S # 2018076516 BK 9165 Pg 1698; (1pg) E-RECORDED 07/03/2018 08:43:30 AM10.00 LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: I-; I hereby name and appoint: o&A- T NO MSc an agent of: 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): NXThe specific permit and application for work located at: 1a LAKc.S Je• c.c,- Sr-\A4, EL- 3a'173 Su -cut Addttss) Expiration Date for This Limited Power of Attorney: S— I License Holder Name: [)o, f r r,\\ -J • 7 State License Number: Signature of License STATE OF FLORIDA COUNTY OF AJG C The foregoing instrument was acknowledged before me this day o , 2041_, by b o- ff sn L ewho is personally known to me or o who has produced identification and who did (did not) take an oath. Si tore JOSHUA A WALKER NOTARY COMMISSION A GG150034 Print or type name PUBLIC EXPIRES Oct.10, 2021 STATEOFFLORIDA SONOEGINROWN Notary Public - State of RUINSURMaCOMVA - Commission No. GC- IScO 3c.1My Commission Expires: 10—% -11. Rev. 08. 12) as CITY OF SANFORD Building &Fire Prevention Division RESIDENTIAL RE -ROOF POLICY & PROCEDURES FIRE DEPARTMENT 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 FATLURE 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: ( v CITY OF SANFORD FIRE DEPARTMENT PERMIT # Building & Fire Prevention Division RESIDENTIAL RE -ROOF SCOPE OF WORK JoB ADDRESS: , . v` Lo gyp. S f j e - C r c ( e • I ?--11 -3 STRUCTURE TYPE: INGLE FAMILY RESIDENCE%TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM RE -ROOF TYPE: REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) COVER (NEW ROOFINSTALLEDOVER EXISTING ROOF) DECK TYPE (PLEASE SPECIFY): 05 1/ PLEASE NOTE: ONLY 100 SQUARE FEET OF Z GE MSTINGDECK IS PERMITTED TO BE REPLACED** ROOF VENTILATION: OOF -RIDGE OSOFFIT OPOWERED VENT OTURBINES SKYLIGHTS: O YES O 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 SHINGLE A • Md;rL FL# 101 7LI -f-Z'ao O METAL FL# O MODIFIED BITUMEN FL# OTORCH DOWN FL# OINSULATED FL# OTILE FL# OTHER: r L / AFe T b `( FL# CD ROOF EXTENSIONS (PORCHES. PATIOS. ETC.) **IF APPLICABLE" 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# O INSULATED FL# OTI LE FL# 0 OTHER: FL# Name: 00010 - ame . Property Address 122, 14V310f DK. Phone Number 67, W, 161, Email: I J V L, Ob p I W• 4KEWIS ROOFING AGREEMENT SUBJECT TO INSURANCE APPROVAL TERMS 1. By signing this agreement, you authorize Lewis Roofing to meet your Insurance Company's representative for the above named property. 2. This agreement does not obligate you or Lewis Roofing in any way unless the loss/damage is covered by the insurance company. 3. This agreement guarantees the homeowner will have zero out of pocket expense above the deductible set forth in the policy. (upgraded materials will be additional) 4. You authorize Lewis Roofing to access your property for the purpose of taking accurate measurements for the estimate. 5. If successful in recovering insurance compensation for the loss, Lewis Roofing will be awarded with the job outlined in the insurance adjusters summary. Property Notes: Ins Homeowner Signature 4;;;2 Lewis Roofing Representative P Ig2SZ-7 Avw/&Q te Print Name Owl 80nAc Print Name FL State License # CCC1331279 www.lewisroofinqfl.com 1408 E Semoran Blvd. Suite 109 Apopka, FL 32703 Office 407-703-7705 Fax 407-603-7305 13 /61 Date y- 3-/g Date CITY OF SkNFORD Building & Fire Prevention Division RESIDENTIAL RE -ROOF A FFIDA VIT FIRE DEPARTMENT RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILINGt SHEATHINGS DRY-INq FLASHING9 AND ALL FINAL ROOF COVERINGS PERMIT#: Q ADDRESS: l (d L e <,d e- c, r I G r -,em C "I J J AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR OOFING 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#: C cc -33 (a 1 . COMPANY / CONTRACTOR: ' rf c l CONTRACTOR SIGNATURE: . DATE: Z /mil MUST BE SIGNED BY LICENSE HOI R 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 Sworn to and Subscribed before me this O/ day of 20 1 by: hG re, l o Lj J . Who is Personally Known to me or has O Produced (type of identification) as identification. AP4 Sidnalt,afrev of Notary Public SJhjVof Florida Print/Type/Stamp Name of Notary Public OSHUA A WALKER NOTARY COMMISSION # GG150034 PUBLIC TA-EA'E OFF EXPIRES Oct. 10, 2021 FL :4Rto J BONDED THROUGH 14W, RLI INSURANCE COMPANY