164 Pine Isle Dr - BR18-002540 - REROOFCITY OF
SIANFORD
FIRE DEPARTMENT
Building & Fire Prevention Division
PERMIT APPLICATION
Application No• ' $ - 9-510
Documented Construction Value: $•
Job Address:\( ,t1P 1e
cl)`
i'. sasno Historic District: Yes Nun
Parcel TD: \n Residentia%Commercial
Type of Work: NewpAddition Alteration Repair Demo Change of Use Move
Description of Work:
Plan Review Contact Person: Y -\ Title:
It
j'X
Phone: ()-1C4(pD3%\ Fax: Email: K,wndm. T
Pro erty Owner Information G'
r /,, '(
Ykce-; > - o
Name Phone:zz1 —lQ- `"1 — 9!p
Street: - Q'(- Resident of property?
City, State Zip: 2
Contractor Information
Name J 6 kk Phone: AO-1 "1
nn c1' 1
Street: Fax:
City, State Zip: State License No.: f^ _(_: B2 350
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Architect/Engineer 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: 6t° Edition (2017) Florida Building Code
Revised: January I, 2018 Permit Application l i G w
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.
5-2.3— Va
ig c of Owner/Agent Date Sig azure of Co ro for nt Date
CnJtwncjr/
A'
sNamfNotary -State o Date
CLINT ROTH
MY COMMISSION p FF213269
EXPIRES MMh 24, 2019
No/1M-c e3
Owne
a"
Me or
Produced ID Type of ID 14ef fS a L
Pri on ctor/
ZZ 5- —+
Sign re ofNo rate of Flon a Date
Produced ID
b3
CUNT ROT14
MY COMMISSION p FF213269
EXPIRES March 24,209
BELOW IS FOR OFFICE USE ONLY
of ID
Known to Me or
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 # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures,
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised- January 1.2018 Pemnt Application
I —
CUSTOMER AGREEMENT / CONTRACT PROPOSAL
J&M Restoration Services Inc.
Central Florida Office
1970 Corporate Sq. Suite D
Longwood, FL 32750
r I Phone 407.060.1011 Fa: 171.4177.Mtt7
Custom Nn21 _Z_AJ ONe a # FL License+CG 1525663 Sales Rep
InsuraJdiJyryQ% CJ(/J/
D / 7 Date
City IV! 7J n' 3l alma
f/ O 3 Insu y /
m
Home phone Policyrop OO O/5z, b S 3 Adjusler Phone •
Cdh 25/ -Q Mortgage Company Mortgage Company a
Finall Loan a e f LossW1ndOHail Jj/U/-/tIG 1•U
Scope of Work
Removal and disposal ofexisting Restoration system down to
the wood deck Includes: shingles, underlayment, drip edge, pipe boots, ridgelof ridge vents, valley metal
til Re -nail wood deck with (Id ring shank nails, per city code
10 Install new underlaymcnt
29 Install new drip edge, roof vents, and replace pipe flashing
F Protect landscaping, driveway, and other household
components not associated with project
O Rem , Jdit xisting satellite dishes '(Not. These mayneedtrrewlibratedbysatellitepmviderp
D A Sol torwill remove and reinstall solar panels and
solar t drig systems as needed to perform tear offircroof
Additional Wood work 2 sheets will be replaced for free and
S70 er yet after that. SS per Linear foot of lumber
Driveway Cracks boil Stains
Ceilings Stains Mold
Dumpster fDrfvesvay
Shingle f
Brand) (Color)
Upgrade Cost
IDrip
Color)
7 . VV
Gi Total Investment Summary
It isagreed upon the amount ofthe contract shall be based on the amount equal to full
Deductible replacement cost value as stated on insurance "scope ofloss" including deductible and all
In the event of a discrepancy, the deductible
P uptd ,
supplements,charges unlesscruise noted. amount
stated on the insurers Scope of Loss shall
overrule Deductible listed. Owner Bid
Price Due
to theunique nature of repairsrelated to insuranceclaim[, this contract does not include an eapliaprice beauu the final scopehas net been agreed upon withtheinsurer. ReaddngagreementonthefullscopeofrepairsinvohetconsiderablethinecoCompany's pert we will no proceed with this phase unless you agree to allow us to do the work one
the scope Isagreed upon ByAgning this agreement you authoriae1& M itnteralon serrates, lot toreach agreementon the price and scopeofrepairson yourbehalf IBM RestorationServices. Inc. agrees to bid the work using the primary dsmance Industry pricing dstuhae (xactimste) bared on the scope of work agreed upon with your insurer. IncludinggeneralcontractormarkupataetorawInsuranceindustryenter (20%markup on XocdmateLim items). Any substantialadditions or deductionsto the scopeorwork willbehandledbywrittenconstructionchangeorders. No cabal contracts agreed to. AO items agreed upon must be In wriu% IF YOUR INSURANCE COMPANY DENIES YOUR
CLAIM, THIS AGREEMFNTICONTMCT SHALL BECOME NULL AND VOID. XQnCE
TO INSURANCE CONTAM. AISIGNMFM OF CLAIM. COVENAM OF AYMFNrr, Owner
hereby aslg,n anyand all insurancerights, benefits, proceeds and amownofaction undoany appholsle insurancepolicies, which cover shedamage to the propert) the Companyistorepairpouuanttothisronuaa.Owner further auhgm and sutihorises Company to seek mimmbunemcm from Owners Insurance wrier fur payment owed 10 CompanyforservicesscndtredortoberenderedbyCompanyvlatheinitiationofachidactionInacoupofcanpetcntyurLdictionorothermeansofrevery. In this regard. Ownerwaivesprivacyrights. Oweer makes this assignmentin considerationof Company) agreementto perform servicesandsupplymaterials andotherwise performits obligationsunderthiscostraRincludingnotrequiringfullpaymentatthebaseofserA[tOwner also hereby directs owners insurance carrier(s) to release arty and all Infomatson requested
by Company. Itsrepresenative andfor lea Attorney for the dirt purpose of obtaining arilbenefits to be paid by Owner's Insurance carrier($) for sirvba renderedortoberendned. Acceptance OfTcma
The stimspecifiotknt sempeofwomk and eonditionsam satisfactoryand are here)ysaapted.Itis agreed uponthat the ammoa ofcontractshag be based ontiwamountequaltofullreplacementcanvalue (RCV) as stated onthe iuntmoee'stope of loss' includingdeductible and all upgrmdn. supplements. cxtraVe angel unless otherwise noted
I&M Restoration Sarlres, Inc. is hereby andwriaed to do the work as specified abasm along with Xaetlmate adman scope of work and missing item; from rmhnanrc loss
report Owmer asbewledger reading, urdcntarding andamyt; the oddidorul semis and conditions on the bacitof this form. "wi; Right to Cancel . Uttar bum wishea toonlongerreceivethegoodsorCaviarprermtedbummaycancelthisagreementbyprovidingwrittennoticeto)&M Restoration Serv)nca. loc. in person. byTdegaphor byMailThisnobamugIndicatethattheWMdoemotwanthegoodsorsrnietsandmunbedeliveredorpostrnarkebeforemidnightofthethbd(^ business day after the agreement1ssignedcomerp
I&M
Project Manager AdditionalOwner Approval By Jigaing
this [enlrarl. You agree le all rrrrss n franc end aerk of chi..........
SCPA Parcel View: 31-19-31-508-1300-0120 Page 1 of 2
p/`
APPRAISER
sc o+ouroountrv, norm
Parcel Information
Property Record Card
Parcel 31-19.31-508.1300-0120
Properly Address, 456 ROSALIA DR SANFORD, FL 32771
Value Summary
Parcel 31-19-31-508-1300-0120
Owner(s) REVICZKY, JUSTIN C - Tenancy by Entirety _
NETTLES, REVICZKY SARAH - Tenancy by Entirety
Property Address 456 ROSALIA DR SANFORD, FL 32771
Mailing 456 ROSAILA DR SANFORD, FL 32771
Subdivision Name SAN LANTA 2ND SEC
Tax District S7-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions OD-HOMESTEAD(2016)
54
11 " 12
T
98 1 53.71
r 54
J
W
14CD
54.02 54.08
54
1
54.04
2018 Working 2017 Certified
Values Values
Valuation Method i Cost/Market Cost/Market
Number of Buildings 2 2
Depreciated BldgValue 140,133 5726,093
Depreciated EXFT Value i $600 600
Land Value (Market) 46.656 41,990
Land Value Ag
Just/Markel Value " 187,389 168,683
Portability Adj
Save Our Homes Adj 29,165 13_713
Amendment 1 Adj 0
P&G Adj -- 1 $O - - -- I $0
Assessed Value 158,224 154.970
Tax Amount without SOH: $2,424.12
2017 Tax Bill Amount $2,163.01
Tax Estimator
Save Our Homes Savings: $261.11
Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description
LOTS 12 13 + 14 BLK 13
2ND SEC SAN LANTA
PB4PG39
Taxes
Taxing Authority Assessment Value Exempt Values TaxableValue
County General Fund 158,224, 50,000 , 108,224
Schools - - - - 158,224 25.000 133,224
City Sanford 158,224 50,000 108.224
SJWM(Saint Johns Water Management) 158,224 50,000 108.224
County Bonds-- -- -- -- 158.224I 50,000 108,224I
Sales
Description Date Book Page Amount Qualified VactImp
WARRANTY DEED 2/1/2015 08424 1893 199,900 Yes Improved
WARRANTY DEED 12/1/2012 07936 0494 164,900 ; Yes Improved
SPECIAL WARRANTY DEED 4/1/2012 07754 1 1565 70.000 No Improved
SPECIAL WARRANTY DEED 3/1/2012 07754 1564 100 ; No Improved
CERTIFICATE OF TITLE 12/1/2011 07688 1794 100 I No Improved
WARRANTY DEED 8/1/2005 05956 1687 318.600 t Yes Improved
WARRANTY DEED 7/1/2004 05409 1 0343 208.000 ; Yes Improved
WARRANTY DEED - 2/1/2003 04735 0465 167.600 Yes Improved
WARRANTYDEED 11/1/2002 046t5 0230 115,000 Yes Improved
WARRANTY DEED 1/1/1973 00995 j 063U 23.800 t Yes Improved
Find Comparable Sales
Land
Method Frontage Depth Units Units Price Land Value
http://parceldetail.scpafl.org/ParceiDetaillnfo.aspx?PID=3 l 193150813000120 6/4/2018
THIS INSTRUMENT PREPARED BY:
Name QZ 3 yk
Address: 3b
c
NOTICE OF COMMENCEMENT
Permit Number: /
7 Parcel ID Number. - Gy — 50- 511 - QCM-y%440
GRANT MALOYr SEMINOLE COUNTY
CLERK OF CIRCUIT COURI h COMPTROLLER
BK 9135 P9 14E1 (1P9s)
CLERK'S v 2019056720
RECORDED 05/18/2018 01:09:42 F11
RE(.01**DIHG FEES $10.00
RECORDED BY hdevow*
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 QF.PROPERTY: ifavallable)
r3z-1-13
2. GENERAL E SCRIP ON OF IMPROVEMENT:
3. OWNER INFORMATION OR LESSEE INFORMATION_ IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: W1,7t-e-n ttOn ct)* - \ ny nn \SIP- ur. Dcnkb -6 ia—i ij
Interest in property: tL Lme r
Fee Simple Title Holder (if other than owner listed above) Name:
4. CONTRACTOR: Name: 3DA ng Phone N..uppmber.
Address: rl c72%
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
Address: Amount of Bond:
6. LENDER: Name. Phone Number.
Address:
7. Persons within the State ofFlorida Designated by Owner upon whom notice or other documents may be served as provided by Section
713.13(1)(a)7., Florida Statutes.
Name: Phone Number.
Address:
S. In addition, Owner designates
to receive a copy of the Llenoes Notice as provided in Section 713.13(1xb). Florida Statutes. Phone number:
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.
Lhuren goneuc--
of ar or t nw. s or Leasoo a (Print Name an Provide S toys T,ea/lMw)
fir)
State of t OHa.- County of c ely l inn le
The foregoing Instrument was acknowledged before me this 14Y day of K&'j 20
1 i 1 I
by Who Is personally known to me 0 OR
who has produced Identification-pe of Identification produced:
CLIt4T ROTH ` VR >1n ;
ciP+t : FF2132E9 G ,¢tt Ct3 i ]'
MY COMMISSION p Stl ,tEt.
zy_l EXPIRES March24,2019 `ErKnAP11°n 1E1t FORlO' "`.'.,-ate
v CLE1tKcwnNoiaryJ OE t
CITY OF
Skl FORD Building & Fire Prevention Division
FIRE DEPARTMENT Re -Roof Permit Card
PERMIT NO. l=401540 ISSUE DATE: td 5 8
CONTRACTOR: •
JOB ADDRESS: r
TYPE OF WORK:5 {Uq
PROTECT FROM AATHER
Post this Permit and all required documents in a conspicuous place outside
Digital Photographs are required - please follow re -roof policy and procedures guide
All trash, debris and dumpsters must be removed from job site at final inspection
Permit expires six (6) months from date of issue
OOF
ECTION TYPE APPROVED
AL ROOF
INSPECTOR
FAILURE TO FOLLOW THE RESIDENTIAL RE -ROOF POLICY & PROCEDURES WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION
FEE AND MAY REQUIRE AN AFFIDAVIT, SIGNED AND SEALED, FROM A REGISTERED FLORIDA DESIGN PROFESSIONAL
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.
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. FBC 105.3.3
REVISED: 4-17 Inspection Line 407.792.6069 or 855.541.2112
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
Application Number . . . . . 18-00002540 Date 6/05/18
Application pin number . . . 243720
Property Address . . . . . . 164 PINE ISLE DR
Parcel Number . . . . . . . . 10.20.30.511-0000-0740
Application type description ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Application valuation . . . . 10500
Application desc
REROOF
Owner Contractor
HONEYCUTT, LAUREN J & M ROOFING SERVICES INC
164 PINE ISLE DR 1970 CORPORATE SQUARE
SANFORD FL 32773 SUITE D
321) 624-0596 LONGWOOD FL 32750
407) 960-3931
Structure Information 000 000 ----------------------
Roof Type . . . . . . . . . FIBERGLASS SHINGLES
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1055110
Permit pin number 1055110
Permit Fee . . . . 117.00
Issue Date . . . . 6/05/18 Valuation . . . . 10500
Expiration Date . . 12/02/18
Qty Unit Charge Per Extension
BASE FEE 40.00
11.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 77.00
Special Notes and Comments
All projects within the City shall use
WastePro for debris removal. Please
contact WastePro at 407.774.0800.
Normal hours for inspections are from
7:30 through 4:30 Monday through
Thursday. Please be aware you must
contact the Building Official to
schedule a Friday or after hours
inspection. This is required since not
every inspector is licensed to do every
type inspection. Communication is the
key, so please contact the Building
Official if you have any questions at
407.688.5058 or at
dave.aldrichosanfordfl.gov
Other Fees . . . . . . . . . 01-APPLCTN FEE -BUILDING 25.00
01-BLDG PLAN REVIEW 33.00
01-BLDG DCA SURCHARGE 2.00
01-BLDG DBPR SURCHARGE 2.63
Fee summary Charged Paid Credited Due
Permit Fee Total 117.00 .00 .00 117.00
Other Fee Total 62.63 .00 .00 62.63
Grand Total 179.63 .00 .00 179.63
FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE
PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS.
NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED.
NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED.
CITY OF SANFORD
CUSTOMER RECEIPT seeOper: BLANDA Type: OC Drawer: IDate: 6/05/18 01 Receipt no: 135764
Year Number Amount20182540
164 PIN[ ISLE DR
SANFORD, FL 32773
BP BUILDING PERMIT RECEIPTS
179.63
AC 017826
Tender detail
CC CRIDIT CARD $179.63Totaltendered $179.63Totalpayment $179.63
Trans date: 6/05/18 Time: 12:46:04
CITY OF
SkNF0RD Building &Fire Prevention Division
RESIDENTLAL RE -ROOF AFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, ANDALL FINAL ROOF COVERINGS
PERMIT #: ADDRESS: \(qq t'ry 1 1P, _j y-
a IsCC'r
I M\ l P \ Y-1. nP VA P C , 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 Wfl'H THEIR PRODUCT APPROVALS AND ALL APPLICABLE CODE
REQUIREMENTS - SPECIFICALLY FLOR DA BUILDING CODE, EXISTING BUILDING. IN ADDITION I CERTIFYTHE 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 #:
l ` ` , ( 1 2 q COMPANY /
CONTRACTOR: CONTRACTOR
SIGNATURE: DATE' MUST
BE SIGNED BY LICENSE HO E O UILDER) A
FINAL ROOF INSPECTION IS REOUIRED: 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 CONFIRMALL NAIL SPACING AND OVERLAPS,
INCLUDING DRIP EDGEAND 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 X_YYI f1li Sworn
to and Subscribed before me this day of 20 by: Who
isorsonally Known to me or has 0 Produced (type of VSaureo
catio
as identification. 7F
otary
Pu lc Alkk'- CLINT ROTH State
of Florida r• MY COMMISSION # FF213269 Print/
Type/Stamp Name of
Notary Public EXPIRES
Merch 24.2019 dGn
14y f' 53 ilaklONda sere cuir
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 CONDOMM M) RE -ROOF PERMITS.
THE FOLLOWING 1S 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 UNDERLAYM ENT 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: 5 - L-1- IT
CITY OF
SkN40RD
FIRE DEPARTMENT
JOB ADDRESS:
PERMIT # I a 5gC)
Building A Fire Prevention Division
RESIDENTIAL REROOF SCOPE OF WORK
STRUCTURE TYPE: WNGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: wEPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): Y2. I ' -P,Lh 0
PLEASE. NOTE. ONLY IOO SQUARE FEET OF THE. EXISTING DECK IS PERMITTED TORE REPLACED**
ROOF VENTILATION: OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES &O IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL M
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 0 2:12 - 4:12j :12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
HINGLE l l't FL#
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
OINSULATED FL#
OTILE FL#
O OTHER: FL#
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
OSHINGLE FL#
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
OINSULATED FL#
OTILE FL#
0OTHER: FL#
CITY OF
S / FORD Building & Fire Prevention Division
1'11) RW RESIDENTIAL RE-ROOFAFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHHjEAATTMNG, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 1 i - / L V ADDRESS: \ (-QLf--R1rw 1s1ea)o
P1 3 2-27 i
I Nk &0 6 ) pe "k e e AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, ENGINEER`,CHITECT, OF F.S. CHAPTER 468 BURRING 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 BURDING. 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).
T.IfFNCF ii• 1 l \ , ( 1 [ _ Il [ J q
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE: DATE:
MUST BE SIGNED BY LICENSE HO O UILDER)
A FINAL ROOF INSPECTIONIS 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 (DECIMG,
UNDERLAYMENT, FLASHING, DRIP EDGE ATTACHMENT) WITH THE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON THE DECK
FOR EACH &SPECTION. 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 REQUIREMENT'S.
FAILURE TO FOLLOW ALL REIQUIRRMENTS WILL RESULT IN A FAILED INSPECTION, A RE-INSPEMON 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 25 day of Jane 20 %i by:
III clue/ llnI_ble4 -Who rsonally Known to me or has D Produced (type of
i
11catio
as identfication.
111
e c CLINT ROTH
State of Florida i . * `In ON A F9213269MYCOMMISSI
Um- 2A41S *.Iiil' EXPIRES Merch 24, 2019
PrinVlypelStamp Name 461).c53 ,Na.
of Notary Public