109 Willowbay Ridge St; 18-4161; RE-ROOFOCT 0 4 2018 CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Fa D
Application .No: (U ,
Documented Construction Value: $ q -720,00
Job Address: 10 Mhwbaq Rjdats -- SQ*rd fL 3DI I Historic District: Yes No
Parcel ID: 22- 101 - Z 502 - 0000 _ Iq$O Residential Z Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: uhjpQ re - IfGC3,
Plan Review Contact Person: j :1 - 2-rl - 6i n Title:
Phone: Fax: Email: , C(,,
Property Owner Information
Name . t homas D01 W Phone: q01 - 1115 Street:
10 UJ W)kii ha t j RIdoe S4 , Resident of property?: City,
State Zip: R_ 327111 Contractor
Information Name
Iiskn NOY0 Phone:?621 -(a5q- (CM9 Street:
305 North CI r. D+e C . Fax: 8 G(o - (0 a - - lq 33 City,
State Zip: M-eJW )tne t FL 32g3L4 State License No.: CCC 13301S5 Architect/
Engineer Information Name:
Street:
City,
St, Zip: Bonding
Company: Address:
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: 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 ofthis county, and there shay 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 [CC 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/Agent Date oatufeof::EntractorAg I paie
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
s Name
0—I —1 V
Signeture KNotary-State of Florida Date
o.tstyptBlc /
PABLOARES
MY COMMISSION # FF 998MG
m oQ EXPIRES: June 1, 2020
OF FvoP BondedThru Budget Notary Services
Contractor/Agent is 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:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Flood Zone:
of Stories:
Plumbing - # of Fixtures.
of Heads Fire Alarm Permit: Yes No
UTILITIES: WASTE WATER:
FIRE: BUILDING:
Revised: June 30, 2015 Permit Application
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 1013110
I hereby name and appoint:
an agent of: eS Vr—) CQr1(;tYU C--lUn nC
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):
Cd The specific permit and application for work located at:
v (Street Address)
IA A /17 AExpirationDateforThisLimitedPowerofAttorney:
License Holder Name: Krl5 \ e N oV o
State License Number:
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF fiftGAQ
19fJ
The foregoing instru ent was cknowledged before me this 3 day of 04 ,
200_LL, by mjf1n 000 who is personally known
to me or o who has produced as
identification and who did (did not)
tarl_:
Sign e
Notary Seal) L
Print or type name
2ocrRYp B c PABLOARES
MY COMMISSION # FF 908006
m ae EXPIRES: June 1, 202041ek"P\ Bonded ThruBudget Notary Services Rev.
08.12) Notary
Public - State of Commission
No. My
Commission Expires:
Grant Malo , Clerk Of The Circuit Court & Comptroller Seminole County, FLInst#20181y11789 Book:9221 Page:188; (1 PAGES) RCD: 10/1/2018 11:12:35 AMRECFEE $10.00
CER-IR:DCOPYCLERY, (IF TI4E CMCqUIT 1'Q'0
711s fns ant p pared by: S t i 0 1- =r,
Name: (ri'jt '
lq • ` r LERiC
addrrss: 305 D/ C UJi t art 1 BY
NOTICE. OF COMMENCEMENT qatC-
STATE OF FLORfDA Permit d:
COUNTY OF SEMINOLE PARCEL ID ti:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and inaccordancewithChapter713, Florida Statutes, the following information is provided in this Notice ofCommencement.
1 Description of Property: (Legal description of the property and street address if available)
as - 30 - Sda - ooD /9J4 6 -5rl. 2 General Description of Improvements: Ie
3 Owner Name: b L Phone: ' 07.
Address: !1) G.rl b,ae , S fl c 3a
Interest in property:
Name & Address offee simple titleholder: (ifother than owner)
4 Contractor's Name: Ll%QSCo L Phone: 10 J. a?S9. p7,49Address: 365 /Vortr7l Dk r %/
iaBo r2y/ `L -?d43gSSuretyName: Phones
Address: %/ Amount ofBond: $
6 Leader Name: A Phone:
Address: 1177F-
7 Persons within the State ofFlorida designated by Owner
713.13(1)(s) 7. Florida Statues: Name:
Address:
8 In addition to himself or herself, Owner designates the fo
713.13(1)(b), Florida Statutes: Name: ---
7
Address.-
9 Expiration Date of Notice of Commencement:
who notice or other documents may be served as provided by Section
Phone:
ving Person(s) to receive a copy of the Lienor's Notice as provided in Section
Phones
date is I yabr 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 ARECONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB. S[TEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORECOMMENCINGWORKORRECORDINGYOURNOTICEOFCOMMENCEMENT.
Verifiention Pursuant to Section 92_„525 Florida Statutes
Under penalties ofper ury, I declare that I have read theforegoing and that the facts stated in it are true to the best ofmy knowledgeand belief.
Donn r
Signature ofOwnt r or ' ees Aut w— Signatory's Title/OfficeOfficer1Director / Partner / Manager
QTheforegoinginstrumentwasacknowledgedbeforemethisdayof20LU ,,, by —jLN
name ofperson) as _ (type ofauthority, ...e.g. officer, trustee, attorney in ct) for
name of party on behalfofwhom Instrum was executed).
SEAL)
os R ?ePAeI OAREs Signature
ofNo Public, State of Floridaa *
W COMMISSION d FFS88006 a
s EXPIRES: June 1.2020 oPrint, Type or Stamp Commissioned Name ofNotttry Public UAaaadedTlruamyetNoynsrrerPersonallyKnown or Produced Identification September 2017
CITY OF
Building &Fire Prevention DivisionSkORDRESIDENTL4LRE -ROOF POLICY & PROCEDURES
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), CER7(tFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGNA DATE: P I
CITY OF
Sk ORD
FIRE DEPARTMENT
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOBADDRESS:10q Vlowbom Pdae s+. SnnfoM . T-L :?2-711
STRUCTURE TYPE: &SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: gREPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF
DECK TYPE (PLEASE SPECIFY:
PLEASE NOTE: ONL Y IOO SQUARE E
ROOF VENTILATION: Q OFF-RIDGE
d
OF THE EXISTING DECK IS PERMITTED TO BE REPLACED"
O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 Q 2:12-4:12 d4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
XSHINGLE Q' a FL# Rig 3 5 _
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 (C) 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#
OINSULATED FL#
O TILE FL#
0 OTHER: FL#
a®
W P_ S C ao r%T
305 North Drive Ste. C
Melbourne, FL 32934
Tel: 321-259-6789
Fax: 866-602-7933
CCC1330785/CGC1506914
WORK AUTHORIZATION
I hereby authorize Wescon Cons c 'on, Inc. to perform repairs on my property located at:
110F 5 p r the scope of repairs provided to my insurance company
7 for claim #
I further authorize my Insurance Company to release payment direct to Wescon Construction, Inc. for the services
that are performed in conjunction with the above insurance claim. Should the Insurance Company require direct
payment to me, I hereby request that the name, Wescon Construction, Inc. be added to the draft that will be sent to
me in payment of said claim.
This contract and any written agreement made pursuant thereto between Wescon Construction, Inc. (hereinafter
Co" or "Company") and the customers named herein on the reverses side. This contract and any written agreement
will be subject to all appropriate laws, regulations and ordinances of the State of Florida and all parties agree that in
any legal action arising out of the Contract and any written agreement the proper jurisdiction and venue shall be
Brevard County, Florida courts. All parties hereby waive any jurisdiction or venue defense or arguments, which may
be raised.
In the event the Customer fails to pay Company any payment when due: interest on said amount at the rate of 2%
per month or the highest rate permitted by law, whichever is lesser; and the Company's reasonable attorney's fees,
expert witness fees, disposition, transcript fees and all costs associated with legal filling fees.
The re-roof/repairs performed by Wescon Construction, Inc. are based on Wescon Construction Inc.'s visual
inspection of the area of the reported problem. We cannot guarantee that no additional problems and damaged
areas will be discovered once repairs begin. Customer acknowledges and understands that, after Wescon
Construction Inc. commences its work, new or additional problems may be discovered and that the price and time of
completion may be increased. Customer also acknowledges and agrees that Wescon Construction Inc. is not
responsible for damages or leaks due to existing conditions or existing sources of leakage simply because work was
started or performed.
We understand that Contractor has no connection with our Insurance Company or its adjusters and that we alone
have the authority to authorize Contractor to make repairs.
Due to nature of work, no completion date is specified. No verbal agreements are binding.
LAJ
Per final approved scope of work: ( C'" (.
a 14)
tOMl 0MOUN .00
The undersigned hereby assigns any and all insurance rights, benefits, proceeds and any causes of action
under any applicable insurance policies to Wescon C onstruction, Inc, for services rendered or to be rendered by
Wescon Construction, Inc. In this regard, the undersigned waives his/hers privacy rights. The undersigned
makes this assignmentin consideration of Wescon Construction, Inc. agreementto perform services and supply
materials and otherwise perform its obligations under this .contract, including, but not limited to, not requiring full
payment at the time of service. The undersigned also hereby directs his/her insurance carriers) to release any
and all information requested by Wescon Construction,Inc, its representatives, and/orits attorneys forthe direct
purpose of obtaining actual benefits to be paid by his/hers insurance carriers) for services rendered or to be
rendered.
Insured is responsible for any amount not covered by insurance company.
Company limited warranty Re -Roof 5 Years Company limited warranty Repair 1 Year
Owner's Name s I Signature: _ Date: - +
Wescon Representative: Signature: 4111 Date:-
L 1 -, Wescon Officer: 41c, Signature: „_ Date: 9 1
CITY OF
ORD Building & Fire Prevention Division
RESIDENTIAL RE-ROOF AFFIDA VIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 1 1 ` ( ADDRESS: I + VV 1 l 1DW WL I 1 C 9
Z fzsrd :PL 3219 I
I 1 I S N OV O 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 4: ` LE O M96
COMPANY / CONTRACTOR: Qms+m "
CONTRACTOR SIGNATURE: DATE:
MUST BE SIGNED BY LICENWO& OWNER/BUILDER)
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 MCA"
Sworn to and Subscribed before me this S day of 1'141LIr 20 b by:
v M . Who is Xpersonally Known to me or has Produced (type of
identification), as identification.
SignaturArNotaryPublic ;;rpue", PABLOARES
State of Vlorida = ° ° MYCOMMISSION # FF 9990 6, I I
EXPIRES' June 1, 2020
BoAded7Wu Budget Notary Services Print/
Type/Stamp Name of
Notary Public