112 Pamala Ct - BR17-002731 - ROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
F D'
y ' ""
Application No % - Z73
Documented Construction Value: $ 10D
a
Job Address: r .-,G L"t" L-- 4 ; S c:^'\__( -I- Historic District: Yes No 9L
Parcel ID: 7 j 101 3 S)5_I 2- T& 0 o p C- O Residential 0 Commercial
Type of Work: New Addition Alteration Re air ElDemo Change of Use Move
Description of Work: & - a°F'; ""
Plan Review Contact Person: Jl" C_ « > Title:
Phone: cll 3 Fax: Email:
Property Owner Information
Name e t ` 1r^ s Phone: I `'' -- - ( - 41 y 'Z"
1
Street: a?- j f Resident of property?
City, State Zip:
Contractor Information
Name
Street:
City, State Zip:
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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: 5ch 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 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 Age tt Date
Jy v 2 S Print
Owner/A ent's Name Florida
Signature
of Contractor/Agent Date Print
Contractor/Agent's Name Signature
of Notary -State of Florida Date s•
4i JOANN M. JOHNSON MYCOMMISSION # FF 956284 FaEXPIRES: March 23, 2020 Rf,R` Bonded Thru Nota Public Unde It r own to Me or Contractor/Agent is Personally Known to Me or Produced
ID Type of ID P-C- P L 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: # of Stories: New
Construction: Electric - # of Amps Plumbing - # of Fixtures Fire
Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No APPROVALS:
ZONING: UTILITIES: WASTE WATER: ENGINEERING:
FIRE: BUILDING: COMMENTS:
Revised:
June 30, 2015 Permit Application
CITY OF
Building &Fire Prevention DivisionSkNFORD ' , RESIDENTIAL REROOFAFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAI/LING, SHEATH' INS, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: / _ v// ADDRESS: l 0 fa_y1_
I jo j/ , C'e- C jVU-t'g 1 :f , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THATALL 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 ##:
COMPANY / CONTRACTOR:o v.n- W 11 e
c
CONTRACTOR SIGNATURE: DATE:
MUST BE SIGNED BY LICENSE ER OR ERBUILDER)
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 ifYl % 0 l
Sworn to and Subscribed before me this Lrday of nkja20 L C by: Who is
O Personally Known to me or has D Produced (type of iden 'fication) /
as gnature ofNet6y
ublic State of
Florida Print/Type/
Stamp Name of Notary
Public identification. r `+ ;
TINA
P,
KENDRICK IVdtary PUb1it -
Sale of Florida Commissior °: GG
156317 V,` My
Comm. Expires Jar 16. 2022 BMW Mmugh
NationalNotary Asr.