121 Wornall Dr - BR17-002763 - ROOFJ
CITY OF SANFORD
AQnIM BUILDING & FIRE PREVENTION
n SEP it,9 20V PERMIT APPLICATION
Application No: /7 - ) 7&-5-
Documented Construction Value: $ d 8 0
Job Address: 1 )_ ky V O (' 1y '0(-. Historic District: Yes No Parcel
ID: 3^J — \ 9 - 3 0 - S N -0000 - 0 k k O Residential [Commercial Type
of Work: New Addition Alteration Repair [K Demo Change of Use Move Description
of Work: - oo F -- Plan
Review Contact Person: A,y.b\l lA ow ,A- tz-0 Title: Phone:
4 0 -7 - 9 9 - LA 3 Sd Fax: Email: A ' `'
Property
Owner Information Name
JOMeS Yy • Y A N N M R- 14 C -t Phone: Q -7 - 319 Street:
12\ Wo rN A l -Dc- Resident of property? : Vt S City, State
Zip: 30q-11 1 Contractor Information
Name n
i., oNgI T_,I L Phone: Street: 110
e, k J<H I- Fax: City, State
Zip: U ryl A-r of 32- 7 9-Y StateLicense No.: C C C 13 a 7 0'92, Architect/Engineer
Information Name: Phone:
Street: Fax:
City, St,
Zip: E-mail: Bonding Company:
Mortgage Lender: Address: 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: 5t° Edition (2014) Florida Building Code bt 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 ofpermit is verification that I will notify the owner of the property of the requirements ofFlorida 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.
7
Signature of Owner/Agent Date
Aiv-P S W ,'q n cP
Print Owner/Agent's N
7
Signs a ofM-Stat'e.lfFlorida Date
Paul A Hmwwd Jr
NOTARY PUBLIC
STATE OF ORIDA
11
Owner/Age s N&Wnown to Me or
Produced ID Type of ID
Signature ofContractor/Agent Date
Print Contractor/Agent's
Q
atu ofNot - tate of Flori Date
Paul A. Hmod Jr
NOTARY PUBLIC
STATE OF FLORIDA
Conur# 00024311
Contractor/Agen wn to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
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
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
of Heads
UTILITIES:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
ti fCity of Sanford
Building 1 Fire Prevention
Product Approval Specification Form
Permit #
Project Location Address 21 w oc N P.- S P N- 40 C' J 3 2 7 "1 1
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.onq.
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 U
Automatic
Other
2. Windows
Single Hun
Horizontal Slider
Casement
Double Hun
Fixed
Awning
Pass Through
Projected
Mullions
Wind Breaker
Dual Action
Other
June 2014
Category / Subcategory Manufacturer Product
Description
Florida Approval #
including decimal)
3. Panel Walls
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles 0U)V115 4 e St,;oq 1-e 5 d 741. /
Underla ments c- R mok aF S N r I. 1
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
Category / Subcategory Manufacturer Product
Description
Florida Approval #
include decimal)
5. Shutters
Accordion
Bahama
Colonial
Roll u
Equipment
Other
6. Skylights
Skylights
Other
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 , c- h S a fJ
Please Print)
June 2014
PropeM. Record Card
Parcel: 33-19-30-514-0000-0110
Owner: PRINCE JAMES W & ANN M
Property Address: 121 WORNALL DR SANFORD, FL 32771
Value Summary
Parcel 33-19-30-514-0000-0110
Owner PRINCE JAMES W & ANN M
Property Address 121 WORNALL DR SANFORD, FL 32771
Mailing
Subdivision Name
1121 WORNALL DR SANFORD, FL 32771-7759
COUNTRY CLUB PARK
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions 00-HOMESTEAD(2000)
64.41 50 50 50
50 50BZ 1
Seminole County GIs C I
2017 Working 2016 Certified
Values Values
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 j 1
Depreciated Bldg ValueY 130,488 121,066
Depreciated EXFT Value i
Land Value (Market) 38,000 32,000
Land Value Ag
Just/Market Value " 168,488 153,066
Portability Adj
Save Our Homes AdjSave
F
53,571 $40,513
Amendment 1 Adj
P&G Adj 0
Assessed Value 114,917 112,553
Tax Amount without SOH: $2,254.00
2016 Tax Bill Amount $1,442.00
Tax Estimator
Save Our Homes Savings: $812.00
TRIM Notice Help
Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description. ` R
LOT 11
COUNTRY CLUB PARK
PB 50 PGS 63 THRU 66
Taxing Authority I Assessment Value Exempt Values Taxable Value
County General Fund j 114,917 50,000 i 64,917
Schools 114,917 25,000 ; 89,917
City Sanford 114,917 ; " 50,000 64,917
SJWM(Saint Johns Water Management) 114,917 $50,000 I1 64,917
County Bonds i
ss
114,917
1.______
50,000 64,917
I _
Sales
77"`
Description ' ' t 77 Date Qualified4Book " g :'' VaeJlmp
SPECIAL WARRANTY DEED 1/1/1999 03584 1 0597 111,200 Yes i Improved
WARRANTY DEED 10/1/1998 03517 0292 22,000 j Yes Vacant
Landdx
777--,-",' fir. .*'
Method ;, Frontage Depth Unds Units Price Land Ualue
LOT i 1 38,000.00 38,000
Building Informatronr., s
http://parceldetaii.scpafl.org/ParceiDetaillnfo.aspx?PID=33193051400000110 9/13/17, 6:03 PM
Page 1 of 2
1 (SINGLE S 1999 7 3 20 , 1,468 2,070 1 1,468 CB/STUCCO $130,488 i $139,559 } pescnpbon AreaiFAMILY ( FINISH
SCREEN
j ?
PORCH
FINISHED
162.00
405.00GARAGE
FINISHED
i #
OPEN
PORCH 35.00
j LyFINISHEDiii
aEsa... Permits ,
awsacxffi..axmv.,C 3Exis`.C.`-J""^'a'-i+Y.e1i.si
5 , S"t`+s' ,.',, '.
t .5'? 5 ,.,f 5 rj r, F-fiyrv", Y L 3" a- _ wy.%` `s x} t ( K:, k } ' :a 5,''' "`S"i'J`i :'3t '.3f 3!' '£
j 00980 !ERECT WOODEN FENCE t SANFORD i $550 " ' 1/1/1999
00124 k 165 SQ FT SCREEN PORCH PERMIT #99 124 SANFORD s $25,000 j 9/1/1998 '
00123 1910 SQ FT; PERMIT #99-123 SANFORD $108,661 1/20/1999 9/1/1998-.____..-_
3y y '¢ ^'.,
Descri tion „ r Y40}
4NYearBwltxqrUmtsUalueNewCost, G rp
No Extra Features
http://parceldetaii.scpafl.org/ParceiDetaillnfo.aspx?PID=33193051400000110 9/13/17, 6:03 PM
Page 2 of 2
THIS :NSTRN RED eNamAdd
NOTICE
OF
COMMENCEMENT State of
Florida County of
Seminole Permit Number:
GRANT NALOYP
SEMINOLE COUNTY CLERK OF
CIRCUIT COURT t. COMPTROLLER GK 8991
Pg 1082 (1Pgs) CLERK'S
Y 2017094304 RECORDED 09/
19/2017 01 a 24. 32 i=11 RECORDING FEES $
11:.00 RECORDED BY ,
ieckeivo Parcel ID
Number: 33-1 1 3 0—,51 1 —60x' W/O 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. DESCRIPTIO OF PR
PERTY: (Legal descrl tion of the pr erty and street address if available) L -r II o N i ft CLyBOLJC/ ' p8 5-6 PG5 G 3 — 66 2/ w o /
D <,4/Y r 1L 3 77 I GENE'AL DESCRIPTION
OF IMPROVEMENT: K> - lZ 00
F NmE n dIN
6L, en Address: / Z / w01C1y/
f// D le S /-- h1-P6 2.0 t— C— 3 A7-7 I Fee Simple Title
Holder (if other than owner) Name: CONTRACTOR: Name: Address: %
3
G
0 A 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: In addition
to
himself, Owner Designates of To receive a
copy of the Lienor's Notice as Provided in Section 713.13(
1)(b), Florida Statutes. Expiration Date of
Notice of Commencement (The expiration date is 1 year from date of recording unless a different date isspecified) 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. Under penalties of
perju 1 declare that I have read the foregoing and that the facts stated in it are true to the best
of my know dge nd beUef. Owners Signature Owners
Printed Name Florida Statute 713.
13(1)(g): "The owner must sign the notice of commencement and noone else may be permitted to sign in his or her stead." y I^ • .1 ..
J3
x U State of County
of The foregoing instrument
was acknowledged before me this day of Pl x ca 20 /
W by
J M
e5 Pr I C e-- Who is personally known to me i 95 Name of personmakingstatementt -+ OR who has
produced identification type of identification produced:' cam' ZD J
Z L1J
a d
PAWA.Alm mdJr
l J LU
5 Q
o0
WTARY PIr IC
otary ' nat e a w STATE OF rUjm c.,4.
oirAPMM
ti 0 CV
QW
w
cn
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: W / — / %
I hereby name and appoint: P//;y/ / ")A-/Zo
an agent of:
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):
The specific permit and application for work located at:
Street
Expiration Date for This Limited Power of Attorney: 9- /9- / 8'
License Holder Name:
State License Number:
Signature of License E
STATE OF FLORIDA
COUNTY OF a , /,---
The foregoing instrument was acknowledged before me this /I day of ,
200. 11_1 by .JA-ck5,!,,-;) Ste,: 4-1, who is ersonally known
to me or who has produced
identification and who did (i
Notary Seal)
Pad A. Howard Jr
NOTARY PUBUC
STATE OF FLMDA
Canndt GGM11
Expires 9/4/2020
Rev. 08.12)
1W G//lO -fir
Print or type name
Notary Public - State of rl___
Commission No. 66
My Commission Expires: ' o
as
CITY OF
C Building & Fire Prevention Division
S ORD RESIDENTIAL RE --ROOF POLICY &PROCEDURES
i
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: DATE: 9 / /
s 4K aCITY OF
rySkI40RD PEWMT # /-7 a763
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: FL -
STRUCTURE TYPE: a SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: PLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): a yL -O o o D
PLEASE NOTE: ONLY 100 SQUARE FEET of THE EXISTING DECKIs PERMITTED TO BE REPLACED**
ROOF VENTILATION: OFF -RIDGE O RIDGE O SOFFIT OPOWERED VENT O TURBINES
SKYLIGHT'S: O YES
MAIN ROOF AREA
40 IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER' FLORIDA PRODUCT APPROVAL
HINGLE W eN5 Corm FL#
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLICABLE*'
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 412 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O SHINGLE f eNS /rjl, lq FL# Id 171,
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
CITY OF
O RD Building & Fire Prevention Division
I RESIDENTIAL RE-ROOFAFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ` 7 - a' / b 3 ADDRESS: L 1
Si}N o & %— 12-7 -
I JAC-* 'd0 11 1 )n 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 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 #: L c c 13 27oEZ
COMPANY/CONTRACTOR:
CONTRACTOR SIGNATURE:
MUST BE SIGNED BY LICE
fie
Q
DATE: / 7 -7
NSE HO OR OWNER/BU E )
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, DRH' 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 REQUHEMENTS.
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 3Pri1 I z-2
Sworn to and Subscribed before me this 97 day of { 20 / -7 by:
Who is eTersonally Known to me or has Produced (type of
as identification.
ot" Pu
S f r
Paul A. Howard jrJ NOTARY PUBLIC
Print/Type/ tamp Name STATE OF FLORIDA
of Notary Public
Cort r k 000243t1
Expires 9V4/2020