106 E Woodland Dr - BR18-004798 - REROOFfit . _ • U
r r
PERMIT APPLICATION
Apphc4tiion No:
Documented Construction Value: $ J 00
Job Address: / r_1 Ik 4 t Historic District: Yes Noa
Parcel ID: / ` ! ) % - Q 0 C q ` } Residential FT Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work:
Plan Review Contact Person:
Phone: Fax: Email:
Property Owner Information
a
1Name _ i Phone:
Street: C 1 ' , 1 Resident of property?
City, State Zip: 0 4
Name
Street:
City, State Zip:
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Contractor Information
Phone:
Fax:
State License No.:
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: 6" Edition (2017) Florida Building Code
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that maybe 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.
of owner/Agent
caner/Agent`s Name
Date
of Flori 4ANJERlCA JpNNSDate
c Notary Public . Slate of florldaCommission # GG 0?9868MyCommExpiresSep13. 202
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Owner7A e t nttoor Contractor/Agent is Personally Known to Me or
Prr7luced ID Type o ID Produced ID Type of ID
UqW_*_()AM Q4
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type: Occupancy Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING: UTILITIES:
ENGINEERING:
COMMENTS:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes []No
WASTE WATER:
BUILDING:
OWNER BUILDER STATEMENT/AFFIDAVIT
Altamonte Springs, Casselberry, Lake Mary, Longwood, Oviedo, Sanford,
Seminole County, Winter Springs
Florida Statutes are quoted here in part for your information to indicate the authority for exemptions for
homeowners from qualifying as contractors and to express any applicable restrictions and responsibilities.
OWNERS MUST PERSONALLY APPEAR AT THE BUILDING DIVISION TO SIGN THIS DOCUMENT
BY SIGNING THIS STATEMENT, I ATTEST THAT: (Initial to the left of each statement)
I understand that state law requires construction to be done by a licensed contractor and have applied for
an owner -builder permit under an exemption from the law. The exemption specifies that I, as the owner of
r? the property listed, may act as my own contractor with certain restrictions even though I do not have a
license.
I understand that building permits are not required to be signed by a property owner unless he or she is
f, responsible for the construction and is not hiring a licensed contractor to assume responsibility.
I understand that, as an owner -builder, I am the responsible party of record on a permit. I understand that I
may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed
in his or her name instead of my own name. I also understand that a contractor is required by law to be
V licensed in Florida and to list his or her license numbers on all permit and contracts.
I understand that I may build or improve a one -family or two-family residence or a farm outbuilding. I
may also build or improve a commercial building if the costs do not exceed $75,000. The building or
residence must be for my own use or occupancy. It may not be built or substantially improved for sale or
lease. If a building or residence that I have built or substantially improved myself is sold or leased within
t in l year after the construction is complete, the law will presume that I built or substantially improved it
for sale or lease, which violates this exemption.
I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
I understand that I may not hire an unlicensed individual person to act as my contractor or to supervise
persons working on my building or residence. It is my responsibility to ensure that the persons whom I4
employ have the licenses required by law and by city ordinance.
I understand that it is a frequent practice of unlicensed persons to have the property owner obtain an
owner -builder permit that erroneously implies that the property owner is providing his or her own tabor
and materials. I, as an owner -builder, may be held liable and subjected to serious financial risk for any
injuries sustained by an unlicensed person or his or her employees while working on my property. My
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner -
builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
I understand that I may not delegate the responsibility for supervising work to a licensed contractor who is
not licensed to perform the work being done. Any person working on my building who Is not licensed
must work under my direct supervision and must be employed by me, which means that I must
comply with laws requiring the withholding of federal income tax and social security contributions
under the Federal Insurance Contributions Act (FICA) and must provide workers' compensation
for the employee. I understand that my failure to follow these laws may subject me to serious financial
risk.
Rev. 9.14.2009
I agree that, as the party legally and financially responsible for this proposed construction activity, I will
abide by all applicable laws and requirements that govern owner -builders as well as employers. I also
t , understand that the construction must comply with all applicable laws, ordinances, building codes, and
t` zoning regulations.
I am of aware of construction practices and I have access to the Florida Building Codes.
I understand that 1 may obtain more information regarding my obligations as an employer from the Internal
Revenue Service, the United States Small Business Administration, the Florida Department of Financial
Services, and the Florida Department of Revenue. I also understand that I may contact the Florida
Construction Industry Licensing Board at 1-850-487-1395 or at www.mytlorida.com/dbpr/pro/cilb/ for
more information about licensed contractors.
I am aware of, and consent to, an owner -builder building permit applied for, in my name and understand
that I am the party legally and financially responsible for the proposed construction activity at the address
listed below.
I agree to notify the building department immediately of any additions, deletions, or changes to any of the
information that I have provided on this disclosure or in the permit application package.
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person
who does not have a license, the Construction Industry Licensing Board, the Department of Business and
Professional Regulation and the building department may be unable to assist you with any financial loss
that you sustain as a result of a complaint. Your only remedy against an unlicensed contractor may be in
civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an
individual or firm is injured while working on your property, you may be field liable for damages. If you
obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for verifying
whether the contractor is property licensed and the status of the contractor's workers' compensation
coverage.
Property Address:
and capable of performing the
conditions specified above. A
nature of
M
do hereby state that I am qualified
I construction involved with the permit application filed and agree to the
Form of Identification
Must be Photo ID)
Date
J
A violation of this exemption is a misdemeanor of the first degree punishable by a term of imprisonment
not exceeding I year and a $1,000.00 fine in addition to any civil penalties. In addition, the local
permitting jurisdiction shall withhold final approval, revoke the permit, or pursue any action or remedy
for unlicensed activity against the owner and any person performing work that requires licensure under
the permit issued.
Rev. 9.14.2009
Grant Malo , Clerk Of The Circuit Court & Comptroller Seminole County, FL
Inst #20181Y44708 Book:9272 Page:1622; (1 PAGES) RCD: 12/27/2018 1:46:50 PM
REC FEE 10,00 _
FTHIS INS T EPAR BY: Y,, Name:
Address•
s*M¢
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number. Parcel ID Number.
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.
OWNER
e c, v r
Address: t v tP t, Il CA24 rkyV4 v t cad r~ " i '-' ac. 1 1 - .7
Fae Simple Title Holder (if other than owner) Name:
Address:
CONTRACTOR:
Name:
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
Section 713.13(1)(b), Florida Statutes.
of
To receive a copy of the Uenoes Notice as Provided in
Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a
different date is specified)
WARN/MQ 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 COMMENCE71,he'facts
NT
Under penalties of perjury. I dec th t I have read the foregoing and thstated in It are true to
the bes o knowledge a beti,, 3i
t t a a tL f't t GN C u to Owner'
s Signature Owner's Printed Name Florida
Statute 713.13(lft:' The own moat sign the notice of oommertoemeru arM no one else may be permitted to sign In hisor her stead' State
of 0V\A County of V— b The
foregoing instrument was acknowledged before me this day of byljjVIOL
J \-t' Who Is personally known to an Name or
Person makktgstelernant / OR who
has produced Identification El type of Identificati(p produced: V'lllb tµr p4•.,.
SHANJERICAJOHNSON Notary Public - State of Florida s dCommission * GG 029868 o, MyComm. Expires Sep 13. 2020 w 4-
uv
77
Jot) ADDRESS: 16) (`_ el, I
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
STRUCTURE TYPE: OSINGLE; FAMILY Ri-Isil)ENCE/ToWN[IOUSE 0 MOBILE HOME 0 APARTMENT/CONDOMINIUM RE -
ROOF TYPE: 0 REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) 0
RE-COVER (NEW Rom INSTALLED OVER EXISTING ROOF) DECK
TYPF (PLEASE SPECIFY): L) PLEAsE
NOTE: ONLY 100SQUARFEET F THE EXISTING DECK IS PERMITTED TO BE REPLACED" ROOF VENTILATION:
DOFF -RIDGE 0 RIDGE 0SOFFIT OPOWERED VENT OTURBINES SKYLIGHTS: OYFS
NO IF YES, PLEASE I)ROVIDE. FLORIDA PRODUCT APPROVAL 9 Yu MAINROOF
AREA ROOF SLOPE: (
0 LESS THAN 2:12 02:12-4:12 0 4:12 OR GREATER Tv1'E
OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL 0 SHINGLE-,
FL# OMETAL FL#
0 MODIFIED
BITUMEN FL# 25TORCH DOWN
FL# 33 INSULATED FL# 0
OTILE FL# 00THER:
FL# ROOF
EXTENSIONS (PORCHES,
PATIOS, ETC.) **IF APPLICABLE" ROOF SLOPE: 0
LESS TUIAN 2:12 0 2:12-4:12 0 4:12 OR GREATER TYPE OF ROOF
MANUFACTURER FLORIDA PRODUCT APPROVAL 0 SHINGLE-, FL9
0 METAL FL#
0MODIFIED BITUMEN FL#
OTORCH DOWN FL# OINSULATED
FIA T11,F, FL9
0 OOTI-
IER: FL#
City of Sanford Building Division
Residential Re -Roof Inspection Policy & Procedures
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 F C codot,plia/ttca by personal inspection. CONTRACTOR (
OR OWNER/BUILDER) SIGNATURE: l 'G' DATE: