2621 S Marshall Ave - BR18-004765 - REROOFCITY OF
S FOR'(' PERMIT APPLICATION BUILDING
DIVISION Application
No: 00 Ll -7 0 Documented
Construction Value:$ Job
Address: L(OD !JW(1_41N(t\"\\J Historic District: Yes [I No0- Residential
9-Commercial El Parcet1l):kJ-20-7')0 Type
of Work: NewEl AdditionEl Alteration RepairE] Demo [I Change of UseEl Move [I Description of Work.---C_
ck( 6\0 v Co' '0Q \t\J Plan Review Contact Person:
Title:- Nyt-n Phone: _11-1- 't
Jl Fax: 1'1-"I L_2 Email: \ 64 Property Owner Information Name
LkAM UL: lV
k Phone: -4)1 - Street: Resident of property?: City,
State Zip: )60 vt '(
Ck Contractor Information Name -k',-de,( _
0 2
1Cklwf\ _\Z_'V\"<\tAPhone: 21 Street: Fax: City, State Zip: (
I ON \
ij , L3'_L1 a4 State License No.: ("(1'k ~71> I Architect/Engineer Information Name: c 1
Phone: Street: City,
St, Zip: Bonding Company:
iv-\
f\ 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 thisjurisdiction. 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
NNQTICL,: In addition to the requirements of this permit, there may he 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.
zbqb 611 l L r t t
Signature of owner/Agent Date sigc ture of C i . Agent Date
Print Owner/Agent's Name ....
a //vADIS
Signauu'e o 3WAw* Date
Nobtty Pttbk, Stalle at FkAle
My Q®mm, Eon Oec. 20, 2021
Owner/Agent is Personally Known to Me or
Produced ID _/ Type of ID r Vtf,$L1(* 14t
Print Contra - , Agent's Name
RtJD A. MALii
t+o" PW*,, $We of Florida
MY Cotttttt. E*w Oct.16, 2021
Signature of Notary -State of Florida Date No, GG 151918
Contractor/Agent isv-' Personally Known to Me or
Produced ID Type of ID
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:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Grant Malo , Clerk Of The Circuit Court & Comptroller Seminole County FL
Inst#20181y41515 Book:9267 Page:1541; (1 PAGES) RCD: 12/17/2018 3:35:14 PM
r` THIS INSTRUMENT PREPARED BY:
m Name: Parlament Rooflr]g & Construc tiott
Address: 12880 Automobile Blvd. Suite L
Clearwater, FL N776g
NOTICE OF COMMENCEMENT
Gate `CLERK
Permit Number:
Parcel ID Number: Q -L700- o2ao
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 ofCommencement.
OF PROPERTY: (Le ai description of the property and street address ifavallable)
yJr e ar"\ ",lyr 1 t C-t R G
2. lNE DESCRIPTION OF IMPROVEMENT:
CI]r-w
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: LA -\cW Leo 1di 1a21 *40,r2L\ 7o l A\k,
Interest in property: 0*Af\21'
Fee Simple Title Holder (if other than owner listed above)
Address:
4. CONTRACTOR: Name: Pariament Roofing & Construction Phone Number. (72711571-4110
Address: 12880 Automobile Blvd, Suite L. Clearwater, FL 33762
5. SURETY (If applicable, a copy of the payment bond is attached): Name: NA
Address: Amount of Bond:
6. LENDER: Name: \tPr 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: tVpFt Phone Number.
Address:
S. In addition, Owner designates Nit of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1xb), 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 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.
Ajrny, V Lind(, M. L pvd/ /OwIlev- jj
Signatureort?wner ee ar sorLessee's (Print Name and vide Signatory'sTiderOfece) Authortted
OMrector edManager) State
of Florida County
of SEMINOLE ti
The
foregoing Instrument gw asacknowledged before me this I L ( day of 1 / c 4 Wl bt r 20 by
I ! Ll r - I 1 _ 0 Pc11 CI r Who Is personally known to me _ OR Name
of person% ng statement Who
has produced Identification l ! Type of identification produced: Aftst__ ..
MATTHEW
WM. RAxMle Noq
Ilu"MR-TIM 04
City of Sanford
Building and Fire Prevention
Product Approval Specification Form
Permit #
Project Location Address k ',,") . M
As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the
information and product approval number(s) on the building components listed below if they are to be
utilized on the construction project for which you are applying for a building permit. We recommend that
you contact your local product supplier should you not know the product approval number for any of the
applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in
accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product
Approval can be obtained at www,floridabuilding.org.
The following information must be available on the Jobsite for inspections:
1. This entire product approval form
2. A copy of the manufacturer's installation details and requirements for each product.
Category / Subcategory Manufacturer Product
Description
Florida Approval #
include decimal
1. Exterior Doors
Swinging
Sliding
Sectional
Roll Up
Automatic
Other
2. Windows
Single Hung Z
Horizontal Slider Z
Casement Z
Double Hung
Fixed
Awning
Pass Through
Projected
Mullions Z
Wind Breaker
Dual Action
Other
June 2014
Aw
Category / Subcategory Manufacturer Product
Description
Florida Approval #
includin decimal)
3. Panel Walls
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver z
Glass block z
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles
Underlayments A" 10tA
Roofing Fasteners
Nonstructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Built up roofing
System
Modified Bitumen
Single Ply Roof
Systems
Roofing slate
Cements/
Adhesives
Coating
Liquid Applied
Roofing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels
Roof Vents
Other
June 2014
Alp
Category Subcategory Manufacturer Product
Description
Florida Approval #
include decimal)
5. Shutters
Accordion
Bahama
Colonial
Roll up
Equipment
Other
6. Skylights
Skylights
Other Z`,
7. Structural
Components
Wood Connectors
Anchors
Truss Plates
Engineered Lumber
Railing
Coolers/Freezers
Concrete Admixtures
Precast Lintels
Insulation Forms
Plastics
Deck / Roof
Wall
Prefab Sheds
Other
8. New Exterior
Envelope Products
Applicant's Signature
Applicant's Name
Please Print)
June 2014
AO 1211-i-pq,018 SCPA Parcel View: 01-20-30-504-2800-0230
CfA4'M6
va
Parcel Information
P E2 P9 _rtY_Rk9Q DOS and
Parcel: Parcel: 01-20-30-504-2800-0230
Property Address: 2621 MARSHALL AVE SANFORD, FL 32773-5018
Value Summary
Parcel 01-20-30-504-2800-0230 2019 Working 2018 Certified
Values Values
Owner(s) LEOPALDI, LINDA M
Valuation Method Cost/Market CostlMarket
Property Address 2621 MARSHALL AVE SANFORD, FL 32773-5018 Number of Buildings 1 1
Mailing 2621 S MARSHALL AVE SANFORD, FL 32773-5018 Depreciated Bldg Value 77,997 74,764
Subdivision Name, qHEbMW_QLD Depreciated EXFT Value 976 936
Tax District Sl-SANFORD Land Value (Market) 25,000 25,000
DOR Use Code, 01 -SINGLE FAMILY Land Value Ag
Exemptions 00-HOMESTEAD(2003)Jus&'MarketValc,e$103,973 100,700
Portability Adj
Save Our Homes Adj 24,928 23,281
Amendment I Adj
P&G Adj
0
0
0
0
Assessed Value 79,045 77,419
4j Tax Amount without SOH: 1,109.43
r Ax_D_i1L_ Arnoy_nt 672.45
RX tlM QP
Save Our Homes Savings: 436,98
Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description
LOTS 23 + 24 BLK 28
DREAMWOLD
PB 4 PG 99
Taxes
Taxing Authority Assessment Value Exempt Values TaxableValue
County General Fund 79,045 50,000 29,045
Schools 79,045 25,000 54,045
City Sanford 79,045 50,000 29,045
SJWM(Saint Johns Water Management) 79,045 50,000 29,045
County Bonds 79,045 50,000 29,045
Sales
Description Date Book Page Amount i Qualified Vac/Imp
WARRANTY DEED 6/1/2002 445 0iz-8 79,900 Yes Improved
WARRANTY DEED 111/1973 Q2275 MQ 24,000 Yes Improved
Land
Method Frontage Depth Units Units Price Land Value
LOT 0.00 0.00 1 $25,000.00 25,000
Building Information
tsL A/11,1111 C,111111 cl Hele
Year BuiltDescriptionActual/Effective Fixtures Bad Bath = Base Area Total SF Living SF Ext Wall Adj Value Rapt Value Appendages
1 SINGLE 1970 5 2 L5 1,170 1,978 1,450 CONC $77,997 $108,329 Description Area
http://parceldetail.sepafl.org/Parcel Detail Info.aspx?PID=O1203050428000230 1/2
SCPA Parcel View: 01-20-30-504-2800-0230
AV 12/17/2018
FAMILY
Permits
BLOCK GARAGE 299.00FINISHED
UTILITY 117.00FINISHED
OPEN
PORCH 112.00
FINISHED
ENCLOSED
PORCH 280.00
FINISHED
Description Year Built
SCREEN PATIO 1 12/1/1989
WOOD UTILITY BLDG 6/1/1989
Units Value New Cost
1 $600 $1,500
140 $376 $941
http://parceldetail.scpafl.org/ParcelDetail Info.aspx?PI D=01203050428000230 2/2
SEM 11VOLE COUNTY MUL T171UR 15DICTIOAIA L
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: I
I hereby name and appoint: L,' fx-\,
an agent of: Parlament Roofing & Construction
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 thisappointmentfor (check only one option):
El All permits and applications submitted by this contractor. Or
21 The specific permit and application for work located at:
Street
Expiration Date for This Limited Power of Attorney: vZ
License Holder Name: Peter E. Wozniak
State License Number: C C C 1 3 2 7 3 5 1
Signature of License H(
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before me this V) day of 1
20 by who is 3;1:rersonally known to me or
0 who has produced
and who g)d did not e a oath.
Signature of otary
as identification
Print or type Notary name
ROS A. HAL&, Notary Public - State of 1()i (k Ct
NAY PWAC, ftft of FWiftMyCOM- &Pk" OCt 16, 2021 Commission No.
No. GG 151gie
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
Horne, 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 c e compliance by personal inspection.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE t_ .,,.^ n._ DATE: 1 i
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: f\J2__ `GMC) (A, -1-13
STRUCTURE TYPE: 0 SINGLE FAMILY RESIDENCE/TOWNHOUSE 0 MOBILE HOME 0 APARTMENT/CONDOMINIUM
RE -ROOF TYPE: 0 REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
0 RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY):
PLEASE NOTE: ONLY IOO.VQUARE FEET OHE EXIVTINC, DECK IS PERMITTED TO HE REPLACED**
ROOF VENTILATION: OOFF-RIDGE *RIDGE OSOFFIT OPOWFRED VENT TURBINES
SKYLIGHTS: SKYLIGHTS: 0 YES 0 No IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN &OOF AREA
ROOF SLOPE: 0 LESS THAN 2:12 02:12-4:12 0 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE FL# JA-0
OMETAL FL#
0 MODIFIED BITUMEN FL#
0 TORCH DOWN FL#
OINSULATED FL#
0 TILE FL#
0 OTHER: FL#
ROOF EXTENSION$ (PORCHES, PATIOS, ETC.) **1FAPPI ICABLE** f4r
ROOF SLOPE: 0 LESS THAN 2:12 02:12-4:12 0 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
0 SHINGLE FL#
0 METAL FL#
0 MODIFIED BITUMEN FL#
0 TORCH DOWN FL#
OINSULATED FL#
OTILE FL#
0 OTHER: FL#
City of Sanford
Building and Fire Prevention
RESIDENTIAL. RE -ROOF INSPECTION AFFIDAVIT
MAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: :!)g \ S- ( LA-10' ADDRESS:
AS A(N) GENERAL, BUILDING RESIDENTIAL OR
ROOFING CONTRACTOR,1:NGINEER, 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 Al THE
ABOVE REFERENCED ADDRESS HAVE BEEN INSTALLED IN ACCORDANCE WITH THEIR PRODUCT APPROVALS AND ALL. APPLICABLE CODE
REQUIREMENTS -SPECIFICALLY FLORIDA BUILDING CODE, 17XISTING 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 REQUIREMEN"TS (BASED ON F.S. CHAPTER 553.844).
LICENSE
COMPANY / CONTKAC fOR: , \ 1G( }-?\ { \ t t \l' t l i tit t 2. T t Z_ ev (xa_
CONTRACTOR SIGNATURE: DATE:
MUST BE SIGNED BY LICENSE HOLD R OR OWNER/BUILDER)
f
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 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 1 1
Sworn to and Subscribed before me this -21 day of 6K 20 by:
t'`}0\fir" "`_ t i tl x . Who is rsonally Known to me or has Produced (type of
identification) as identification.
Si atu a 4Noiiiry Public _ "'' 'R, JONNA JOL EEN IEMiEUXStateofFlorida (SEAL) ? '. MY COMMISSION # FF225721
EXPIRES April 30. 2019c-._i `-ice`. WC/11HACh:t Fkr'id»No:»tiService.carPrint/Type/Stamp Name
of Notary Public