111 Kelly Cir - BR17-003032 - REROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: / 9 X
Documented Construction Value: $ 4,900X
Job Address: 111 KELLY CIRC SANFORD FL 32773 Historic District. Yes No Lr
Parcel ID: 12203051100000610 Residential iCommercial
Type of Work: New Addition Alteration Repair
n(DD,emo Change of Use ElMove
Description of Work: REROOF ASVQAJ_T SW46Wb f* ' A >W_-4_27Plan
Review Contact Person: Phone:
321 2392702 Name
CARMEN MARTINEZ FELIPE
SENRA Title: CONTRACTOR 407
277 0424 Email: MAROLA123@AOL.COM Property
Owner Information Phone:
407 416 2334 Street:
111 KELLY CIRC SANFORD FL 32773 Resident of property? : YES City,
State Zip: SANFORD FL 32773 Fax:
Name
MAXIMA INTERMODAL CORP Street:
2348 BUCKINGHAM RUN C City,
State Zip: ORANDO FL 328 Name:
Street:
City,
St, Zip: Bonding
Company: Address:
N/
A Contractor
Information Phone:
3212392702 OURT
Fax: 407 277 0424 28
State License No.: Architect/
Engineer Information Phone:
Fax:
E-
mail: Mortgage
Lender: Address:
CCC
1325928 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: 5« 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.
t.
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 info 'is accurate and that all work will
be done in compliance with all applicable laws regulating co tA at nd zoning.
L10AID11 J
i mar otuf Owner/Agent to
a ((
Print-Owner/Agent's Name_--,
of -Florida = t
LARRY E. RENUVALES
Notary Public -State of Florida
Commission # FF 191870
My Comm. Expires Jan 21, 2019
Notary-State Owner/
A etY t'rr'si3aFwt'fo Produced
ID i Type of ID L441
1 Date
Print
Contractor/Agent's Name knx /
0..'7 Signature
of Not State of Florida Date P`
DE681E CLANTON NlY
CowtVIISSION # FF 178648 EX
PIR`S: February 25, [019 Uondod
I1vu Witany Public Underwriters Contractor/
Agent is Personal l own to Me or Produced
ID Type of ID QiV'
p • ` i Z'o 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 # of Heads APPROVALS:
ZONING: ENGINEERING:
COMMENTS:
Revised:
June 30, 2015 UTILITIES:
FIRE:
Flood
Zone: of
Stories: Plumbing - #
of Fixtures Fire
Alarm Permit: Yes No WASTE
WATER: BUILDING:
Permit
Application
if your contractor or subconlraclor fails to pay subcontractors, suhsubcontraclors, or material suppliers, those
people who are owed money may look In your property for payment, even if you have already pair) your
contractor In full. if you rail to pay your contractor, your conlactor may also have a lien on your property. thismeansIf" lien Is filed your property could be sold against your will to pay for labor, materials, or other
services "or contractor or a subcontractor may have failcd if, pay, to protect yourself, you should stipulate inthiscontractthatbeforesoypaymentismade, ,your contractor is required to
provide you with a written release of lien from tiny person or company that has provided to you a "notice toowner." flarlda's construction lienlaw is complex, and it is recommended that you consult an attorney.
Ilameowner (sl r — — — — Date. 0 /11
Wituened andagreed Date: by MAXIMA LC agent: _
STATEMENT OF CLIENT / INSURED
t
COMES NOW, /L
1 q Gj-Ei, (Clientlinsured who states as follows:
I . I am over the ageofeighteen (1 S) and I am competent to lcsufy as to the facts and matters set forth hereinandIamnotrepresentedbycounsel.
2. 1 am the insured at Address: I 1 k2(4 L tt fL _ I am makingthisStatementbasedonmypersonalknowledgeofthematterscontaiherein.
3. 1 contracted with MAXIMA LC for repair services performed and/or to be performed related to roofdamage.
4. This contract included a written Assignment of Insurance Benefits. It was my intention to assignment anyandallbenefitsand/or payments under my insurance policy to MAXIMA I.0 for work they performed orwillperform. I am satisfied with MAXIMA I.C.
5. It is my intention to honor my contract for services with MAXIMA I.C. In the event my insurancecompanypaysmeforworkperformedortobeperformedbyMAX1141AI.0 I will remit those funds toMAXIMAI.0 in accordance to our contract for services.
b: The information containe in this statement is true to the best of my knowledge.
Client Ins d
Date
THIS INSTRUMENT PREPARED BY:
Name: FELIPE SENRA
Address: _2348 BUCKINHAM RUN COURT, ORLANDO FL
32828
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number:
GRANT MALOY, SEMINOLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLER
BK 9007 F's 337 (Pss )
CLERK'S a 2017103871
RECORDED 10/16/2017 11. ov: no f1h1
RECORDING FEES $10.00
RECORDED BY tsmith
Parcel ID Number: 12-20-30-511-0000-0610
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.
DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
LOT 61 MONROE MEADOWS PB 46 PISS 16 & 17ADDRESS 111 KELLY CIR
SANFORD, FL 32773
GENERAL DESCRIPTION OF IMPROVEMENT:
RE ROOF
OWNER INFORMATION:
Name: CARMEN MARTINEZ
Address: 111 KELLY CIR SANFORD, FL 32773
Fee Simple Title Holder (if other than owner) Name: N/A
CONTRACTOR:
Name: MAXIMA INTERMODAL CORPORATION
Address: Z349 r' ucxj&<Mw tili T .Fi- 3Z$2$
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 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 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 perjury, I declare that I have read the foregoing and that the facts stated in it are true
to the best of myXrjowledge and belief.
VIE' v1.thrv. l tOsSignatureOwnersPrintedName
Florida Statute 713_j3(1)(g): " The owner.sign the notice of commencement and no one else may be permitted to sign in his or her stead.'
day of
Name of 0er n making statemen
OR who has produced identification P type of identification
ti5
F D
z . ' 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 requiredtobesubmittedaspartofyourpermitapplication.
The Scope of Work must include all applicable Florida Product Approval numbers for all roof components thatwillbeinstalledontheproject.
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 SanfordHistoricPreservationBoard
INSPECTION POLICY & PROCEDURES
A Final Roof Inspection is the only inspection required for Residential (Single Family, Townhouse, MobileHome, 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 ofthe 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 wi It in an affidavit provided by a Florida DesignProfessional (architect or engineer), certi i C code compliance by personal inspection.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE: bQ I
r
F D PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: 1 K G -4,
STRUCTURE TYPE: INGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
1 ) DECK TYPE (PLEASE SPECIFY): /a pwwoyy/
PLEASE NOTE: ONLY 100 SQUARE FEET OF THE (STING DECK IS PERMITTED TO BE REPLACED"
ROOF VENTILATION: DOFF -RIDGE RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES VNO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 — 4:12 4.12 OR GREATER
TYPE F ROOF FLORIDA PRODUCT APPROVAL
SHINGLE
MANUFACTURER
FL# 6LAL44 C:'
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
O INSULATED 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 O 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O SHINGLE FL#
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
O INSULATED FL#
O TILE FL#
0 OTHER: FL#
R:° t'4m"pf'd i=:;•.ly y , s ` > . w C.l o.r.:.Irf;i..'$ri?S2s•2
Ana o 43004p
n Hti a IHiuu M'xpd i01di
Se°Mte'ber>252017 `°#°
Carmn''Amenca Chacin Martinez and Ariadna Ebel Carmen SantosT1Kety'Cir`
Sanford, FL 32773-7338
RE: Claim Number: GP17001668
Policy Number: FLHP0018101
Policy Period: 01/23/2017-01/23/2018
Date of Loss: 09/10/2017
Loss Location: 111 Kelly Cir Sanford, FL 32773-7338
Type of Loss: Hurricane/Water/INInd
Carmen America Chacin Martinez and Ariadna Del Carmen Santos:
In response to the above -reported loss, on behalf of Guifstream Property and Casualty Insurance
Company ("Gulfstream"), this correspondence reports to you on the findings of our investigation into the
loss, our conclusions on coverage, and our position concerning the damages claimed.
Attached is a summary of our adjustment on your claim, which totals $6,676.35. This amount reflects the
damage to the dwelling as follows: ,
Dwelling Other Structures Personal Property Loss of Use Total
Claim Adjustment 5 766.90 909,45 6,676.35
Less Deductible 2,834.00 2.834.00
Recoverable Depreciation 0,00 126.17 $0.00 126.17
Net Claim Payment 2,932.90 78128 3,716.18
LIMITS OF LIABILITY 19,141.700,00 2,834.00 $70,850.00 $14,170.00
The above summary adjustment in the amount of $6676.35 is for the damage to the dwelling. For that
damage, our check in the amount of $3716.18 (net of deductible) is enclosed so that you can start making
repairs, Please see the detailed estimate enclosed for your revEew:
It is important that you make these repairs as soon as possible. Should you not repair or replace your
damaged property, and subsequent damages occur due to your not having repaired or replaced your
property, then coverage for subsequent damages would be excluded by your policy and your policy could
be subject to non -renewal.
If the Loss Settlement provisions of your Policy provide that we pay for repairs or replacement of
the loss to your dwelling and other structures and/or personal property based on replacement
cost value (meaning without deduction for depreciation), subject to circumstances in which the
Initial payment may be at actual cash value (depreciation deducted), our payment of replacement
cost value before actual repair or replacement is completed (or before work is performed and
expenses are incurred) does not waive the actual cash value provisions of your policy in the
future for this or any other claim that may arise.
Any person wlto knowingly and wide intent to In,Iure, defraud or deceive any insurer, files a statement of claim or an
application containing any false, incomplete, or misleading Information is guilty ofafelony ofthe thud degrea
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94l746 5495 l
Estimate: IR14 11700388
Area: Main Level
Roo[i
Coverage, Dwelling
Living Room
Coverage: Dwelling
Fence
Coverage: Other Structures
Area Subtotal: plain Level
Coverage: Dwelling
Coverage: Other Structures
Subtotal of Areas
Coverage: Dwelling
Coverage: Other Structures
Total
IRM 1700388
Recap by Room
4 R91.49
4,891.49
765.74 11.69%
100.00% = 765.74
891.18 13.61 %
100,00% - 891.18
6,548.41 100.00%
86.39% = 5.657.23
13.61% = 891-18
6,548.A 1 100.00%
86.39% = 5,657.23
13.61%0 = 891.18
6,548.41 100.00%
9/20/2017 Page: 7
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City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 3'O Z ADDRESS:
AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOF TRACTOR, ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
FO 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 REQUIREMENT'S (BASED ON F.S. CHAPTER 553.844).
LICENSE #: WCi 132!Sq ?—
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE:
00
MUST BE SIGNED BY LICENSE HOLDER OR
fil
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: 1 `'4' 1 1/
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 tltlof
Sworg to and Subscribed before me this - Jq day of 20 by:
tr-S "s Who is Personally Known tome or has t Produced (type of
identification y ` J `5 ' a ? 9sIdentification.
Signa ure of N tary Public v"P"•,, WIA PLATAStateofFlorida ` N t'''DAL.) Soaryui- fate of Flonda
Commission N GG 039597
My Comm. Expires Oct 11, 2020
Print/Type/Stamp Name '` h"'• Bonded through National Notary Assn.
of Notary Public