314 E 18 St - BR18-004719 - REROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: i
Documented Construction Value: S
Job Address: „` { l t rt k r`c!" 1 Historic District: Yes No Q
Parcel ID: (-,a Residential Q Commercial
Type of Work: New Addition Alteration El Repair Demo Change of Use Move
Description of Work: l"2 (3 elFi 1L
C r r Gt rt {- ,
Plan ReviewContact Person: Skylar Amkraut Title: Admin
Phone: 407-278-7788 Fax: 800-337-3361 Email: Permit@Jasperine.com
Property Owner Information
Name Phone:
T
Street: ?,l C t Resident of property? : Yes
City, State Zip:f'-l
Name Jasper Contractors
Street: 300 Colonial Center Parkway Suite 130
City, State Zip: Lake Mary, FL 32746
Contractor Information
Phone: 407-278-7788
Fax: 800-337-3361
State License No.: CCC1331153
Architect/Engineer 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. 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: 51' Edition (2014) Florida Building Code
Revised: June 30, 2015 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 I will notify the owner of the property of the requirements of Florida Lien Law, FS 713,
The City of Sanford requires payment ofa 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.
f «
Signature of Owner/Agcnt Date Signa re of Cont or Agcnt hate
Rudith Goico
Print Owner/Agent's Narne P At Contractor/Ag it's me
Signature of Notary -State of Florida Date Sig turFkxida
YR' AI4A CHA Z
Say, State of Florida -Notary Public
Commission If GG 112152
My Commission Expires
nuaJune 06. 2021 Owner/
Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or Produced
ID Type of ID Produced ID _ Type of ID 4t_ 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: Flood
Zone: of
Stories: New
Construction: Electric - # of Amps Plumbing - # of Fixtures Fire
Sprinkler Permit: Yes No # of Heads APPROVALS:
ZONING: UTILITIES: ENGINEERING:
COMMENTS:
FIRE:
Fire
Alarm Permit: Yes No WASTE
WATER: BUILDING:
Revised:
June 30, 2015 Permit Application
12/6/2018 SCPA Parcel View: 36-19-30-509-0F00-0050
I—i, CrA Property Reccard Card
AMUR Parcel: 36-19-30-509-0F00-0050
PV 00VNTY, aL Property Address: 314 E 181FH ST SANFORD, FL 32771 Parcel
Information Parcel
36-19-30-509-0F00-0050 Owner(
s) BHIMSINGH, NARINESINGH Property
Address 314 E 18TH ST SANFORD, FL 32771 Mailing
314 E 18TH ST SANFORD, FL 32771-3807 Subdivision
Name M)RKHAM PARK H Ia iTS Tax
District S1-SANFORD OOR
Use Code 01-SINGLE FAMILY Exemptions .,
u
i
I
Legal
Description LOT
5 BLK F MARKHAM
PARK HEIGHTS PB
1 PG 78 Taxes
Taxing
Authority County
General Fund Schools
City
Sanford SJWM(
Saint Johns Water Management) County
Bonds Sales
Description
WARRANTY
DEED 1/1/2006 Land
Method
FRONT
FOOT & DEPTH Building
Information Value
Summary 2019
Working 2018 Certified Values
Values Valuation
Method Cost/Market CosttMarket Number
of Buildings 1 1 Depreciated
Bldg Value 44,396 43.071 Depreciated
EXFT Value 1,272 1,200 Land
Value (Market) 16,200 16,200 Land
Value Ag Just/
Market V,aE 61,868 60,471 Portability
Adj Save
Our Homes Adj 0 0 Amendment
1 Adj 0 200 P&
G Adj 0 0 Assessed
Value 61,868 60,271 Tax
Amount without SOH: $1,132.51 291€
3 Tax €3ii Amount $1,132.51 Tax
Estimator Save
Our Homes Savings: $0.00 Does
NOT INCLUDE Non Ad Valorem Assessments Assessment
Value Exempt Values Taxable Value 61,
868 $0 _ $61,868 61,
868 $0 $61,868 61,
868 $0 $61,868 61,
868 $0 $61,868 61,
868 $0 $61,868 Book
Page Amount Qualified Vac/Imp 6
07913 110,000 Yes Improved Frontage
Depth Units 90.
00 87.00 Units
Price Land Value 0 $
300.00 $16,200 Description
Year Built Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages Actual/Effective 1
SINGLE 1923/1950 3 T 10 1,008 1,334 1,008 SIDING $44,396 $93,465 Description Area FAMILY
GRADE 3 ENCLOSED
126.00 http://
parceldetaii.scpafl.org/ParceiDetailinfo.aspx?PID=3619305090F000050 1/2
DocuSign Envelope ID: A3F7D9C6-50BF-4637-8ED3-3FC616519D3B'
300 Colonial Center Parkway STE 130
Lake Mary, FL 32746
407) 278-7788
321)348-9154
813)867-7898
863)808-4434
info@jasperinc.com
i/!
FL Contractor's License:
CCC1329651 & CCC1331153
ROOF REPLACEMENT CONTRACT
Account Manager:
chard Dorman
Contact: 407-868-7439
Insurance Company Information
Company; Progressive
TRPolicy#: A TOM-
Clairn#: 609046
Mortgage Compan Information
Company: Dttec t prevtous y(-ireen Tree)(services (
Loan Number:
Owner('): Narinesingh Bhimsingh Phone.
Address: 314 East 18th Street Alt Phone: 4078328732
City: Sanford Stag Zip Code: 32771 Shingle Color: *QC Supreme - Anti
Email: Bobbhimsin hine ahoo.comBobbhimsinghinc@yahoo.com Roo RC Amount/ CP Contractrice: Drip Edge Color: Drip Edge -Whit ue
6"
If
Owner's Insurance Company does not agree to pav for a full roof replacement. this contract shall be voidable. Assignment
of Insurance Benefits for the Full Roof Replacement Only: I hereby assign any and all insurance rights, benefits and proceeds under any applicable
insurance policies to Jasper Contractors, Inc. ("Jasper"), the scope of which shall be limited to a Full Roof Replacement. I make this assignment and
authorization in consideration of Jasper'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) to release any and atl information requested by Jasper, or its representative(
s), 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 Jasper immediately upon receipt. 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.
Deductible: 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 ("Loss Sheet"), which is hereby incorporated by reference as the Scope of Work ("SOW"), UNLESS replacement/
repair of deteriorated decking is required by code and/or Owner requests optional upgrades. Jasper CANNOT pay, waive, rebate, or promise to
pay, waive or rebate any or all of the insurance deductible applicable to the insurance claim for payment of work. In the event of a discrepancy, the deductibl
a nk to d on the insurer's Loss Sheet shall overrule deductible amount disclosed. Deductible: S 1000.00 MUST BE PAID IN
FUL / /idal). PAYME
E: Owner agrees to pay Jasper based on the following schedule: (i) Deposit in the amount of S • 00 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
Jasper upon completion of work being performed; and, (iii) the remaining Contract Price (equal to any applicable depreciation and/or change orders) due
and payable to Jasper upon completion of work performed. In the event of a pending inspection, no more than 2% of Contract Price may be withheld until inspection
has passed. Optional:
UPGRADE ITEM: RATE: UPGRADE ITEM: RATE: Replacement
Work and Price: Upon insurer's approval and subject to the Terms and Conditions stated herein, Jasper agrees to furnish all materials and provide
the labor necessary to perform the full roof replacement which shall take place following Owner's insurance company's approval, approximately within
thirty (30) days, conditions permitting. Owner's Declaration of Intent: Owner acknowledges and agrees that, upon approval by insurance company for
a full roof replacement, Jasper shall perform the roof replacement upon receipt of LossSheet from Owner's insurance company. FLORIDA
HOMEOWNERS' CONSTRUCTION RECOVERY FUND PAYMENT,
UP TO A LIMITED AMOUNT, MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS' CONSTRUCTION
RECOVERY FUND IF YOU LOSE MONEY ON A PROJECT PERFORMED UNDER CONTRACT, WHERE
THE LOSS RESULTS FROM SPECIFIED VIOLATIONS OF FLORIDA LAW BY A LICENSED CONTRACTOR. FOR
INFORMATION ABOUT THE RECOVERY FUND AND FILING A CLAIM, CONTACT THE FLORIDA CONSTRUCTION
INDUSTRY LICENSING BOARD AT THE FOLLOWING TELEPHONE NUMBER AND ADDRESS: Construction
Industry Licensing Board: 2601 Blairstone Road, Tallahassee, FL 32399-1039, (850) 487-1395 CANCELLATION:
If Owner elects to terminate the services of Jasper, 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 roof contract
has been denied, in whole or in part. All written notices of cancellation, regardless of reason, shall be postmarked or delivered
to Jasper's corporate office: 1690 Roberts Boulevard, Suite 112, Kennesaw, GA 30144. CANCELLATION EXCEPTIONS:
The three (3) day right of cancellation DOES NOT APPLY to contracts for emergency home repairs as time is of the
essence. I,
Owner, have read and understand all statements, Terms and Conditions of the "Roof Replacement Contract" and agree that all details are
acceptable and satisfactory. I further understand that this Contract constitutes the entire agreement between the parties and that any further changes
or alterations to this Contract must be made in writing and agreed upon by both parties. Each party represents and warrants to the
other that it has the full power and authority to enter into the contract and that it is binding and enforceable in accordance with its tARMtuSi
ned by: DOCUSip.ed b Z
11/21/2018 12:14 PM EST 11/21/2018 ( 12:13 PM u
M&JEV8r Representative Date r c" Date
Grant Maloy, Clerk Of The Circuit Court & Comptroller Seminole County, FL
Inst #2018138238 Book:9262 Page:757: (1 PAGES) RCD: 12/7/2018 2:38:56 PM
REC FEE $10.00
THIS INSTRUMENT PREPARED BY:JIL/u tjA:Name: JASPER CONTRACTORS 'C.
Address: 300 Colonial nter ParkwaySuite 130
Lake ary, L
5 tj .
NOTICE OF COMMENCEMENT
Permit Number:
10fir, ' aParcelIDNumber. {F"q" - SQ9 - `5 b
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance withChapter 713, Florida Statutes, the
following information is provided in this Notice of Commencement.
1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Re -Roof
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE 1 PROVEMENT:
Name and address: i r 1 y7 -n ) 3
Interest In property. OWNER
Fee Simple Title Holder Of other than owner listed above) Name:
Address:
4. CONTRACTOR: Name: JASPER CONTRACTORS Phone Number: 407-278-7788
Address: 300 Colonial Center Parkway Suite 130, Lake Mary, FL 32746
5. SURETY (If applicable, a copy of the payment bond is attachedk Name:
Address: Amount of Bond:
8. LENDER: Name: Phone Number.
Address:
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents maybe served as provided by Section
713.13(1)(a)7., Florida Statutes.
Name: Phone Number
Address:
8. In addition, Owner designates of
to receive a copy of the Uenor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number:
9. Expiration Date of Notice of Commencement (rho expiration Is 1 year from dale of recording unless different date is specified)
WA WNG TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE
CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, 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.
algAuM or or aa, or oiansrs ar Nti - (Pdnt Nana and Pmvido algnabW* nW0flIw)
fAuQadzad
IParnagM
State of _--/m, „ 1 C my of " m . L
The tore oing+Instrument was acknowledged before me this . day of 0
by %1 ft /2 t ..a Cft.re I 7?.l.-r t/.fn Who Is personally known to me OR
who has produced Identification Ey type of Identification produced:
RUDITH GOICO
State of Florida -Notary Pubi
Commission tl GG 178413
My'Commisslon Expires
January 24, 2022
F\_
SEA41NOLE COUNTY MUL TI-JUR ISDICTIONAL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: - 10 I 1 '6
I hereby name and appoint: Rudith Goico, Adreanna Ocasio, Skylar Amkraut, Amanda Cieplinski
an agent of: JASPER CONTRACTORS
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 All permits and applications submitted by this contractor.
Or
0 The specific permit and application for work located at:
E--
Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name: Donald Bouchard
State License Number: CCC1331153
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF Seminole
The foregoing instrument was acknowledged before me this DLOday of—de," 20
lby Donald Bouchard who is 0 personally known to me or 91 who
has produced DL and wr\(
rid I not) take
an oath. A 11
J A-e- Sig-n7aure
ofNotary vvl"" ANA
CHAVEZ State of
Florida -Notary Public Commission# GG
112152 K4Y Commission
Expires June 06,
2021 as identification
C1 Print
or
type Notary name Notary Public -
State of Commission No.
My Commission
Expires:
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 root, 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 resu It 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: '_
F' D PERMIT #
City of Sanford Building Division
Residential U.--Ufknf Scope of Work
JOBADDRESS: /?4-6
STRUCTURE TYPE: Q SINGLE FAMILY RESIDENCE/TOWNHOUSE 0 MOBILE HOME 0 APARTMEN-11CONDOMINIUM
RE -ROOF TvpF: (DREPLACEIVIENT(TEAR OFF EXISTING ROOF AND REPLACE" WITH NEW COMPONENTS)
0 RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TvpF (PLEASE SPECIFY):
PLEAsE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK 1,V PERMITTED TO BE REPLACED
RoOFVFNTII.,ATION: (DOFF -RIDGE 0 RIDGE OSOFFIT 0POWFRFD VENT OTURBINES
SKVIAGIIITS: 0 YES (2)NO IF YES, PI.F.ASF PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: 01,L,.SS'['[-IAN2:12 0 2:12-4:12 (D4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
2) SHINGLE Owens Corning FL# 10674-R13
0 METAL FL#
0 MODIFIED BITUMEN F1,#
OTORU-i DOWN FL#
0 INSULATED FL#
0,1,11"E, FL#
00THER: I F41
ROOF EXTENSIONS (PORCHES, PATIOS, Vrc.) **IFAPPLICABLE * *
ROOF SLOPE: 0 LESS THAN 2:12 02:12-4:12 0 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
OSHINGLE FL#
0 METAL F1,#
0 MODIFIED BITUMEN F1,#
OTORCI-I DOWN FL#
OINSULATED FL#
FL#
00THER: FL#
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: J - C ADDRESS: A
I l i.,S — , AS A(N) (iENERAL, 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 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 #: CCC 1331153
COMPANY / CONTRACTOR: rrssJASPER
CONTRATORS (!-
CONTRACTOR SIGNATURE: ` ia ...,. iDATE: c)J
MUST BE SIGNED BY LICENSE HOLDER OR OWNEWR911LDER
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 SEMINOLE
Sworn to and Subscribed before me this day of CA - cc_ 24U_ t.. by:
DL
Signatury of Notary
State of Florida
Print/Type/Stamp Name
of Notary Public
Who is Personally Known to me or has X Produced (type of
as identification.
R DITH GOICQ
o`'"xF `r 'state of Florida-NotatY Public
Commission # GG 178413
r MY commission Expires
R;,;` January 24, 2022
Ea
7
SEA41NOLE COUNTY MUL TI-IUR ISDICTIONA L
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
Scott Meixsell, Chris Gardner, James Allen, Joshua Collazo, Desmond Roberts, Jovanni Bracero & Edwin
I hereby name and appointyazquez
an agent of: JASPER CONTRACTORS
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):
El All permits and applications submitted by this contractor.
Or
El The specific permit and application for work located at:
Street Address)
Expiration Date for This Limited Power of Attorney: 1/1/2019
License Holder Name: Donald Bouchard
State License Number: CCC1331153
Signature of License Holder:
STATE OF FLORIDAINOLECOUNTYOFM
The foregoing instrument was acknowledged before me this _day of
20 18 by DONALDBOUCHARD who is IN personally known to me or
0 who has produced
and wrN(rid not) take an oath.
SiginTaTure of Notary
1101 ANA CHAVEZa0/ L'--State of Florida -Notary Public
Commission # GG 112152
My'Commisslon Expires
June 06, 2021
as identification
Print or type Notary name
Notary Public - Sta,te off Ch
Commission No. Ll.coq
My Commission Expires: (0