196 Sir Lawerence Dr - BR18-002561 - REROOFCITY OF
SkNFORD'
FIRE DEPARTMENT
Building & Fire Prevention Division
PERMIT APPLICATION
Application No: / P " 07s o f
Documented Construction Value: $ 5! , 9 3a , o o
Ci
Job Address: AI./V t-F n/ J) Historic District: Yes No U
519 e,K-D/ - 2'773
Parcel ID: / _,9_o _ ,zi _ a o oy - o SQ6 o Residential Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work:
Plan Review Contact Person: Title:
Phone: Fax: Email:
Property Owner Information
Name 2 / Y , c/ &o DI 7Al A,'.- Phone:
Street: 1 c) C 5; iA A A w c.J -b /Z ' Resident of property?
City, State Zip: 3.2_ - 73
Contractor Information
Name !7Ay t
S
0& n/S re i,?r- Phone: 5'9 ) -- ( `' - 7 Z 3 2 l-"
i:vc-GyPe, --- *T i NC_2 Street:
oel:p e2 sZ / a! c o/> Fax: *O7 - 6 ' o 9e City,
State Zip: yil/G Goo oy , yG State License No.: C Yq4 Architect/Engineer
Information Name: NIA
Phone: Street: City,
St,
Zip: Bonding Company:
Address: 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: 611 Edition (2017) Florida Building Code Revised: August
I, 2017 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 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: 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.
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature ofNotary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
e-
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
0,0
Signature of Notary -State of Florida Date
ad.>,mraea+so
DEBBIE BLANTON
MY COMMISSION it FF 178648
EXPIRES: February 25, 2019
Donded Thru NDIaq Pubk UiderwMars
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas[] Roof or
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
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
f O
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: August 1, 2017 Permit Application
I 11/111111 1111111111 I1111111((11111111 1111
THIS INSTRUMENT PREPARED BY: '
Address: t4
062 -7 ;z ca
NOTICE OF COMMENCEMENT
Permit Number.
GRANT MALOYr SEMINOLE COUNTY
C:LEI;I: OF CIRCUIT COURT h COMPTROLLER
BY, 9146 P3 601 (iP3s)
CLERK'S T 2018063648
RECORDED O6/05/2018 02:07:33 F
RECORDING FEES $11.00 ARECORDEDBYHevorePO i
Parcel ID Number. to - Q o _ 30 _ Sol o 0 o a _ o 860
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordancefollowingInformationisprovidedInthisNoticeofCommencement.
1. DESCRIPTION OF PROPERTY: ( egal description al the property and street address tif9G5/2 L'4 ,„&'. by cr.. _ a . _
2. GENERAL DESCRIPTION OF IMPROVEMENT:
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: 3Z 7 %3Nameandaddress: Z //0" K' /e%1i/Tf / ". 1 i 5/ s? / i9r,JoPE,
Interest in property:
Fee Simple Title Holder (ifother than owner listed above) Name:
Address!
4. CONTRACTOR:
Address: _1iY
S. 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 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: Phone Number:
Address:
8. In addition, Owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1 xb), 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 ARECONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTENT BTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEYBEFORECOMMENCINGWORKORRECORDINGYOURN9TICEOFCMENCEMFNT_
SlWoem o1 or Lenba/ a i Issses's (Pdtnl Name and ploNde IAuUwriaedlricerlpbrectorsrrrepeh
State of R / Q /y County of E M 1 O L
The foregoing Instrument was acknowledged before me this day of vh a 20
by V 1 - Z PA 011
Who Ispersonally known ORNameofpersonwownpstato0
who has produced Idenournuon U type of identification produced:
1100 BIAIR GIBSON
N*qPUbk -Stile ofFblda
CommkVmIGGoalelo
o< AlpComm E*m Ater20. 2D2I
eodre taaq trea rraap,drn
RAY'S CONSTRUCTION & DEVELOPMENT INC.
1720 Sunwood Dr.
Longwood, FL 32779
State Certified General Contractor Lie. # CG-CO62885
State Certified Roofing Contractor Lie. # CCC 1328741
State Certified Home Inspector Lie. # Hl 1521
State Mobile Home Installer Lie. # IH 1025439
Tel # 321-689-8282 Fax # 407-671-698
Proposal
Proposal submitted to: Work to be performed at:
Name: Zipay, Judith H.
Address: 196 Sir Lawrence Dr.
City, state: Sanford, FL 32773
Phone # 407-709-1618
Address: Same
City, state:
Date of plans:
Architect:
We hereby propose to furnish the materials & perform the labor necessary for the completion
of Roof Replacement.
I . Remove existing shingles, underlayment and dispose properly.
2. Remove and Replace damaged plywood @ 65.00 a piece. as needed.
3. Install 14 rolls of underlayment.
4. Install 27 SQ. of Arch. Shingles,
5. Install ridge cap.
6. Install starter.
7. Install valley metal and peel stick.
8. Install ridge vents.
9. Remove and Replace all drip edges.
10. Install new lead boots.
11. Install new vents
12. Dumpster/ fees.
13. Permit
Note: Life time warranty on material and one year labor excluding natural disaster
All material is guaranteed to be as specified, and the above work to be performed and
Completed in a substantial workmanlike manner for the sum of:
EIGHT THOUSAND EIGHT HUNDRED THIRTY $8,830.00
Respectfully submitted
R.S.
Per
30
Note - This proposal may be withdrawn by us if not accepted within days.
Any alteration or deviation from above specifications involving extra costswillbeexecutedonlyuponwrittenorder ,and will become extra charge
over and above the estimate. All agreements contingent upon strikes,
accidents,or delays beyond our control.
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are herebyaccepted.
You are authorized to do the woi
signal
signature
Date: 6-5-18
CITY OF
w 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
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: a _- vLa-Sr DATE:
ifCITY OF
SkNFORD,
FIRE DEPARTMENT
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: ("I (O l `DSOI.i 611 CSC= _ JU,!Z44 , 0' t 77,3
STRUCTURE TYPE: O/SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: 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: ONLY TOO SQUARE FEET OF THE EXISTING DECK IS PERMITTED TORE REPLACED"
ROOF VENTILATION: DOFF -RIDGE RIDGE OSOFFIT 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 (D 4/ 12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE
G /LrA"ri T 2 FL# al-2 If
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
O INSULATED FL#
O TILE FL#
OOTHER: 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#
O INSULATED FL#
O TILE FL#
O OTH ER: FL#
CITY OF
16 S ORD
FIRE DEPARTMENT
Building & Fire Prevention Division
PERMIT APPLICATION
Application No: I V - C\ ScZ'
Documented Construction Value: S 3000.00
Job Address: 2219 S. Magnolia Ave Sanford, FL 32771 Historic District: Yes No
Parcel ID:36-19-30-526-0B00-0060 Residential Commercial
Type of Work: New[] Addition Alteration Repair Demo Change of Use Move
Description of Work: Repipe water distribution system from point of entry to all fixtures.
Plan Review Contact Person: Title:
Phone: Fax: Email:
Property Owner Information
Name Peltz, Bobbi Jo Phone: 386-479-7322
Street: 2219 S. Magnolia Ave Resident of property? u
City, State Zip: an or
Contractor Information
Name Harvey Baker Plumbing, Inc Phone: 407-859-3572
Street: 1019 28th St Fax: 407-648-5181
City, State Zip: Orlando, FL 32805 State License No.: CFC 056875
ArchitecVEngineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company:
Address:
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: 61° 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. J
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 ofthe 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.
Signature ofOwncr/Agent Date
Pn'nt Owncr/Agcnl's Name
Stb aturc of Notary -$talc lorida Date
Notary Public State of Florida
Thairies J Otero
My Commission GG 169705
q E at I I
Owner/Agent is r
Produced ID Type of ID I'VC YS / c,-
gcnt Date
ye K
Name
G - S-a
of Notary-SiSlc o`t Florida Date
ytr` Notary Public State of Florida
Thalries J Otero
My Commission GG 169705JExpires12/19/2021
Contractor/Agent is IN We -it Improehom
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:
New Construction: Electric - # of Amps,
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: January I, 2018 Permit Application
Harvey Baker Plumbing, Inc.
1019 28th St.
Orlando, FL 32805
Name / Billing Address
Michael & Bobbi 10 Peltz
2219 Magnolia Ave S
Sanford FL 32771
82G-qI 91- 37-Z
Proposal / Contract
Date Estimate #
5/31/2018 2058
I Job Address / Project Name I
Peltz, Michael & Bobbi 10
2219 Magnolia Ave S
Sanford, FL 32771
Item Description oty Cost Total
Permits Pull Plumbing Permit. File Notice ofCommencement.
Obtain Final Inspection.
Labor-R Hand dig trench from meter to point of entry. Install new 3,000.00 3,000.00
3/4 PVC water service line in trench. After inspection,
cover trench to rough grade. Repipe water distribution
system from point of entry to all fixtures. Repipe
includes: New PEX water piping, new shut off valves to
all sinks, toilets, water heater, icemaker and washing
machine. Install new shut off valve at point ofentry.
Install three (3) new outside hose bibbs. Install new
thermal expansion valve at water heater. Cut
drywall/plaster and tile as needed for installation of new
piping.
Exclusion Not responsible for sod or landscaping. Not responsible
for drywall or tile repair. No faucet, fixture, or supply line
repair or replacement included. Not responsible for
clean-up ofdust (drywall). "This estimate is for the
above described work only. Any work performed that is
not outlined above would be an additional charge.••'•If
payment is made with a credit card, there is a 3%
processing fee.**
Estimate good for 30 days. Total $3,000.00
State Certification:
CFC056875
Federal ID: 20-4190696
Phone # 407-859-3572
Fax # 407-648-5181
E-mail marcia@harveybakerplumbing.com
Web Site www.harveybakerplumbing.com
Customer Signattir
Print Name' mu #,x
AUTHORIZATION TO PROCEED WITH PROPOSED, WORK 1, the
undersigned, am owner/authorized representative/tenant of the premises at which
the work mentioned above is to be done. I hereby authorize you to perform said
work, and to use such labor and materials as you deem advisable. A monthly service
charge of 1 '/2% per month or 18% per annum will be added to any invoice which is
not timely paid. In the event of legal action to collect payment under this
agreement, 1 agree to pay reasonable attorney's fees and costs. 1 also agree to pay
any reasonable bank fees or costs charged if my check fails to clear. I have read,
agree to, and have received a copy ofthe contract All parts will be removed from
premises and discarded unless otherwise specified.
THIS INSTRUMENT PREPARED BY:
Name: Harvey Baker Plumbing,Inc
Address °1
NOTICE OF COMMENCEMENT
Permit Number:
Parcel ID Number. 36-19-30-526-01300-0060
GRANT 11ALGY1 SE11INCLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLER
BY 9146 P9 801 (iP9s)
CLERK'S T 2018063688
RECORDED 06/05/2018 02:32:.:4 PM
RECORDING FEES $10.00
RECORDED BY hdevore •=-
0 p 1Q
The undersigned hereby gives notice that improvement will be made to certain real property, and in a
following information is provided in this Notice of Commencement.
1. t r8%Pj1g ek PROPERTY: (Legal description of the property and street address if available)
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Repipe
3. OWNER INFORMATION OR LESSEE INFORM ON IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: Peitz, Bobbi Jo 2219 agnolia Ave Sanford, FL 32771
Interest in property:
Fee Simple Title Holder (if other than owner listed above) Name:
Address:
4. CONTRACTOR: Name: Harvey Baker Plumbing, Inc Phone Number. 407-859-3572
Address: 1019 28th St Orlando, FL 32805
S. 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 of Florida 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: 1
8. In addition, Owner designates 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)
the
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.
Signature of Owner or Lessee, or Owner's or Lessee's (Print Name and Provide Signatory's Title/Oltloe)
Authorized 011lcedtilrector/Partner/Manager)
State of •491--C1 I 6-ldek— Countyof O'canQA(f,
The foregoing Instrument was acknowledged before me this S day of ne .20
s
by ( t7 / 6 1t Who Is personally known to me 0 OR
Name ofperson rwidal; statement alrwhohasproducedIdentificationItypeofIdentificationproduced: FL 4 "fV,,r FCfe 17 fe
00 Notary Public State of Fonda
Thairies J Otero N nature
My Commission GG 169705
a w Expires 12/19/2021
City of Sanford
BUILDING bIVISION
RE: Permit # /
Inspection Affidavit
I !:-:Zz /2 e A ,licensed as a(n) Contractor* /Engineer/Architect,
please print name and circle Lic. Type) FS 468 Building Inspector*
License #; L c (:::n-
On or about :Fe , I did personally inspect the roo
Date & time)
deck nailing and/or secondary water barrier work at
circle one) (Job Site Address)
Based upon that examination I have determined the installation was done according to the
Hurricane Mitigation Retrofit Manua ased on 553.844 F.S.)
Signature
STATE OF FLORIDA
COUNTY OF tYl roG
Sworn to and subscribed before me this ay of Owprn! pu 2001$
Bygm 2yrLo G't'c Lctu'k—
Notary Public, State of Florida
iDwhIque Williams
Statery Public
of Flodit
l nn QIGUP Il i I Ii=
iNy Commission Expires (Print, type or stamp name)
at 0212W2020
Commission No. FF965200 Commission No.: F7V-CAI o-- 7M
Personally known
Produced Identification
Type of identification produced. F11w i cin 1R,fi.Pd I A r Pr F•&
General, Building, Residential, or Roofing Contractor or any individual certified under 468 F.S. to make such an
inspection. Include photographs ofeach plane ofthe roofwith the permit # or address # clearly shown marked on the
deck for each inspection.