128 Walnut Crest Run; 18-3533; RE-ROOFCITY OF SANFORDAUG ' 6 2018 BUILDING & FIRE PREVENTION
BY. PERMIT APPLICATION
F D ¢
Application No: O 5:323
Documented Construction Value: $ 11,300
Job Address: 128 WALNUT CREST RUN SANFORD, FL 32771 Historic District: Yes No 0
Parcel ID: 22-19-30-502-0000-0980 Residential Q Commercial
Type of Work: New Addition Alteration 7 Repair Demo Change of Use Move
Description of Work: Re Roof Owens Corning FL 10674-R13 15216-R3 Techwrap 17194-R2 30 SQ 7/12 Pitch
Driftwood Supreme 25 Years
Plan Review Contact Person: Skylar Amkraut Title: Admin
Phone: 407-278-7788 Fax: 800-337-3361 Email: Permit@Jasperinc.com
JOSEPH, AMANDA Property Owner Information
Name JOSEPH, ANDY Phone:
Street: 128 WALNUT CREST RUN Resident of property? : Yes
City, State Zip: SANFORD, FL 32771
Contractor Information
Name Jasper Contractors Phone: 407-278-7788
Street: 4185 S Orlando Dr Fax: 800-337-3361
City, State Zip: Sanford, FL 32773 State License No.: CCC1331153
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: 5'h Edition (2014) Florida Building Code 0-
Revised: June 30, 2015 Permit Application A 0 .
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, ill
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: -- --
08/16/18
Signature of Omer/Agent Date Signa re orCont c or Agent Date
Rudith Goico
Print Owner/Agent's Name P4t Contract or/Ag is me
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
PA LWj":
ANA C H A F Z
State of Florida -Notary Public
Commission #GG 112152
My Commission Expires
mm June 06.2021
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 # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised:lune 30, 2015 Permit Application
DocuSign Envelope ID: 5BFOF38F-DD06-4568-8lF8-E2B85103EBCC
JASPER
JasporRoof.com
800) 337-3361 Fax
info@jasperinc.com FL Contractor's License:
CCC1329651 & CCC1331153
ROOF REPLACEMENT CONTRACT
Account Manager: Joseph Palladino
Contact #: (407) 335-6239
Company: Security First
Policy #:P000092001
Claim #: 142647
Mortgage Comnany Information
Company: Mr Cooper Mortgage
Loan Number: 0407167584
owner(s): Amanda Joseph
Phone: 4076837417
Address: 128 Walnut Crest Run Alt Phone: 4072742772
City:
Sanford StftE. Zip Code: 32771 Shingle Color:
Email:
ajoseph828@yahoo.com
Roof RCV Amount/ Contract Price:
11,300
Drip Edge Color:
If Owner's Insurance Comnany does not agree to nay for a full roof renlacement. this contract shall he voidable.
Assignment of Insurance Benefits for the Full Roof Replacement Only: I hereby assign any and all insurance rights, benefits and proceeds under any
applicable insurance policies to Jasper Contractors, Inc. ("Jasper"), the scope of which shall be limited to a Full Roof Replacement. I make this assignment
and authorization in consideration of Jasper's agreement to perform services, supply materials and otherwise perform its obligations wider this Contract,
including not requiring full payment at the time of service. I also hereby direct my insurer(s) to release any and all information requested by Jasper, or its
representative(s), for the direct purpose of obtaining actual benefits to be paid by my insurer(s) for services rendered. In this regard, I waive my privacy
rights. If payment is made directly to the Owner/Agent/I.nsured(s), it shall be endorsed over to Jasper immediately upon receipt. I agree that any portion of
work, deductibles, betterment or additional work requested by the undersigned, not covered by insurance, must be paid by the undersigned on the day of
installation. Deductible: It is the Owner's responsibility to pay all insurance deductibles. Owner's out-of-pocket expense will not exceed the deductible
amount, as stated on insurer's loss sheet ("Loss Sheet"), which is hereby incorporated by reference as the Scope of Work ("SOW"), UNLESS
replacement/repair of deteriorated decking is required by code and/or Owner requests optional upgrades. Jasper CANNOT pay, waive, rebate, or promise
to pay, w ' Dgr rebate any or all of the insurance deductible applicable to the insurance claim for payment of work. In the event of a discrepancy, the
deducti 11 amo ed on the insurer's Loss Sheet shall overrule deductible amount disclosed. Deductible: s500.00 MUST BE PAID
IN FUL _Wnitial).
PAYME E: Owner agrees to pay Jasper based on the following schedule: (i) Deposit in the amount of $ • 00 due upon signing this
contract; (ii) the Contract Price, less the Deposit and any applicable depreciation retained by Owner's insurer(s), plus upgrade costs, due and payable
to Jasper upon completion of work being performed; and, (iii) the remaining Contract Price (equal to any applicable depreciation and/or change orders)
due and payable to Jasper upon completion ofwork performed. In the event ofa pending inspection, no more than 2% of Contract Price may be withheld until
inspection has passed.
Optional: UPGRADE ITEM: RATE: UPGRADE ITEM: RATE:
Replacement Work and Price: Upon insurer's approval and subject to the Terms and Conditions stated herein, Jasper agrees to furnish all materials and
provide the labor necessary to perform the full roof replacement which shall take place following Owner's insurance company's approval, approximately
within thirty (30) days, conditions permitting. Owner's Declaration of Intent: Owner acknowledges and agrees that, upon approval by insurance company
for a full roof replacement, Jasper shall perform the roof replacement upon receipt of Loss Sheet from Owner's insurance company.
FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND
PAYMENT, UP TO A LIMITED AMOUNT, MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS'
CONSTRUCTION RECOVERY FUND IF YOU LOSE MONEY ON A PROJECT PERFORMED UNDER CONTRACT,
WHERE THE LOSS RESULTS FROM. SPECIFIED VIOLATIONS OF FLORIDA LAW BY A LICENSED CONTRACTOR.
FOR INFORMATION ABOUT THE RECOVERY FUND AND FILING A CLAIM, CONTACT THE FLORIDA
CONSTRUCTION INDUSTRY LICENSING BOARD AT THE FOLLOWING TELEPHONE NUMBER AND ADDRESS:
Construction Industry Licensing Board: 2601 Blairstone Road, Tallahassee, FL 32399-1039, (850) 487-1395
CANCELLATION: If Owner elects to terminate the services of Jasper, Owner may do so before midnight on the third business
day after Contract is executed. Owner shall receive a full refund of all deposits. Owner may also rescind Contract before midnight
on the third business day after the contract is executed after notification from insurer(s) that the claim for payment on roof
contract has been denied, in whole or in part. All written notices of cancellation, regardless of reason, shall be postmarked or
delivered to Jasper's corporate office: 1690 Roberts Boulevard, Suite 112, Kennesaw, GA 30144. CANCELLATION
EXCEPTIONS: The three (3) day right of cancellation DOES NOT APPLY to contracts for emergency home repairs as time is of
the essence.
I, Owner, have read and understand all statements, Terms and Conditions of the "Roof Replacement Contract" and agree that all details
are acceptable and satisfactory. I further understand that this Contract constitutes the entire agreement between the parties and that any further
changes or alterations to this Contract must be made in writing and agreed upon by both parties. Each party represents and warrants to
the other that it has the full power and authority to enter into the contract and that it is binding and enforceable in accordance with its
terms. DocuSigned by: Signed by:
3/15/2018 1 7:38 PM EDT F 3/15/2018 1 7:38 PM
A4wimn er Representative Date &Doa3C84CB._, Date
DocuSign Envelope ID: 5BFOF38F-DD06-4568-8lF8-E2B85103EBCC
TERMS AND CONDITIONS: Acceptance of Terms: I, Owner, hereby agree to retain Jasper for a full roof replacement on the Terms and Conditions
stated herein. I further agree to provide Jasper with the Scope of Loss/ Loss Sheet generated by my insurer and authorize and grant full access to the
property for the purpose of staging and completing all agreed upon work. Supplemental Claims: Jasper reserves the right to file a supplemental claim with
Owner's insurance in the event that the estimate is incorrect and/or additional damage is discovered after commencement. The supplemental claim
amount(s), in addition to any depreciated amounts held back by the insurer, are immediately due to Jasper upon receipt. Commencement of Work: Work
shall commence at Jasper's discretion. Jasper shall not be liable for delay in, or failure to perform due to: labor controversies, strikes, fire, weather, Acts of
God, war, governmental actions, inability to obtain materials from usual sources, delays caused by and/or as a direct result of Owner's insurer or other
circumstances not listed which are beyond the control of Jasper. Noise Pollution and Vibrations: Prior to installation, it is the sole responsibility of Owner
to remove any and all items which are not secured to walls including, but not limited to items on mantles, shelves or other areas susceptible to vibrations, as
these may fall. Jasper shall not be liable for noise pollution and/or vibrations due to the performance of work contracted herein, or damages resulting to
person(s) or property as a result of performance of work. Homeowners Association: It is the sole duty of the Owner to secure approval from the Homeowners
Association for any and all items necessary for Jasper to complete the work listed herein, including but not limited to shingle color, type, brand, etc.
Construction Debris: Upon completion of work, Jasper will make reasonable efforts to remove debris from the property, including but not limited to, a
general clean-up of construction -related debris and a magnetic sweep of the eve line and walkways surrounding the project area. As Jasper cannot guarantee
the removal of all nails and/or debris, it shall not be liable for resulting damages. Landscaping: While Jasper will make reasonable efforts to cover the lawn
and/or shrubbery, it is the sole responsibility of Owner to remove and/or safeguard any and all plants, shrubbery, lawn ornaments, furniture and/or valuables.
Jasper cannot guarantee the safekeeping of these items nor shall it assume liability for damages. Timely Payment: It is Owner's responsibility to ensure
prompt payment from mortgagee and/or insurer. Jasper must be paid immediately upon receipt of funds or, if funds have not been received from the Insurance
and/or Mortgage Company, not to exceed thirty (30) days from date of install. If Jasper is not paid within the requisite time period, all promotions, advertising
specials, and/or discounts shall be voided. Owner shall also be responsible for any collection fee(s) incurred. Force Majeure: Jasper shall not be liable for
any natural and/or unavoidable catastrophes that interrupt the expected course of events and restricts Jasper from fulfilling its obligations herein, such as,
but not limited to: excessive wind, hail, ice, rain, extreme weather conditions, fire, war, governmental actions or other Acts of God. Labor Warranty: Jasper
shall provide to Owner a two (2) year, non-transferrable warranty on labor as long as the Contract Amount is paid in full to Jasper within ninety (90) days. Please
see "Two Year Labor Warranty" for additional details and exclusions; Warranty is hereby incorporated by reference. Jasper is not responsible for
any damage to the roof or premises due to, but not limited to: leaks, cracks, fissures, etc. caused by excessive wind, ice, hail, snow or any other Act of God
during the warranty period. In the event of an extreme weather condition or Act of God which warrants an insurance claim, Labor Warranty shall be
voided. Ongoing Work: Jasper shall not be liable for damages from fires, windstorms, rain or other hazards as is normally covered by Homeowner's
Insurance or Builder's Risk Insurance. Jasper shall not be liable for any and all water intrusion or damage to property, premises or its contents which may
occur during installation, including but not limited to: water intrusion due to rising waters or wind driven rain, as well as water intrusion caused by pipes
which are not to current code; regardless of "grandfathered" code status. This contract and the Warranty provided herein, shall not be assigned or
transferred by either party, except by written instrument signed by both parties. Manufacturer's Warranty: All materials used are subject to Manufacturer's
Limited Shingle Warranty. Any defect of materials is covered, and subject to, the manufacturer's warranty specifications; this shall void Jasper's
Warranty. Pre -Existing Materials: Repair of deteriorated decking, "waves" in decking, fascia boards, roof jacks, ventilators, flashing, chimneys, gutters or
other such materials (unless otherwise expressly stated in the Loss Notice or Contract) are not included. Decking or planks shall be replaced as required by
code and Owner authorizes an additional charge of $75.00 per sheet of decking or $25.00 per plank. Should Owner elect to replace any and/or all of
these pre-existing materials, Owner shall be charged for both material(s) and labor. Jasper shall be liable neither for the replacement of, nor for any damages
arising from, Owner's election to retain these pre-existing materials. Pre -Existing Conditions: Jasper shall not be responsible or liable for issues due to
improper ventilation, deteriorated decking, "waves" in decking, appearance ofroof due to irregularities in underlying structure or other pre-existing, structural
defects. Shingle Color Change: Should a shingle color change be requested after the installation has been scheduled, a $175.00 express shipping fee shall be
charged by Jasper to Owner. This fee MUST be paid on day of installation. Minimum Contract: Jasper reserves the right to terminate any Contract if
Contract Price does not exceed $7,048.00. Severability: The invalidity or unenforceability of any provisions of this Agreement shall not affect the
validity or enforceability of any other provision of this Agreement, which shall remain in full force and effect. BINDING ARBITRATION: If a dispute
arises from or relates to this contract or the breach thereof, and if the dispute cannot be settled through direct discussions, the parties agree to endeavor first
to settle the dispute by mediation administered by the American Arbitration Association under its Construction industry Mediation Procedures before
resorting to arbitration. The parties further agree that any unresolved controversy or claim arising out of or relating to this contract, or breach thereof,
shall be settled by arbitration administered by the American Arbitration Association in accordance with its Construction Industry Arbitration Rules and
judgment on the award rendered by the arbitrators may be entered in any court having jurisdiction thereof. The statute of limitations on all disputes which
arise from or relate to this contract or a breach thereof shall be one (1) year from the date of signing Roof Replacement Contract. Claims shall be heard by
a panel of three (3) arbitrators. The mediator shall not be empanelled as an arbitrator. The place of arbitration shall be Atlanta, Georgia. The arbitration
shall be governed by the laws of the State of Georgia. All deposits, fees and expenses of the mediation and/or arbitration, including required traveling and
other expenses or charges of the mediator and/or arbitrator, shall be bome by the initiating party. Depositions shall be limited to a maximum of 25 per party
and shall be held within 180 days of the making of a request. Additional depositions may be scheduled only with the permission of the arbitrators, and for
good cause shown. Each deposition shall be limited to a maximum of eight (8) hours duration. Any dispute regarding discovery, or the relevance or scope
thereof, shall be determined by the arbitrators, which determination shall be conclusive. The arbitrators will have no authority to award punitive,
consequential or other damages not measured by the prevailing party's actual damages, except as may be required by statute. hi no event shall an award in
arbitration exceed the amount of the Roof Replacement Contract. Any award in an arbitration initiated under this clause shall be limited to monetary damages
and shall include no injunction or direction to any party other than the direction to pay a monetary amount and shall not exceed the roof RCV amount/
Contract Price. The award shall not include pre or post judgment interest. The award of the arbitrators shall be accompanied by a reasoned opinion.
Notwithstanding any language to the contrary in the contract documents, the parties hereby agree: that the Underlying Award may be appealed pursuant to the
AAA's Optional Appellate Arbitration Rules ("Appellate Rules"); that the Underlying Award rendered by the arbitrator(s) shall, at a minimum, be a reasoned
award; and that the Underlying Award shall not be considered final until after the time for filing the notice of appeal pursuant to the Appellate Rules has
expired. Appeals must be initiated within thirty (30) days of receipt of an Underlying Award, as defined by Rule A-3 of the Appellate Rules, by filing a
Notice of Appeal with any AAA office. Following the appeal process the decision rendered by the appeal tribunal may be entered in any court having
jurisdiction thereof. Except as required by law, neither party nor an arbitrator may disclose the existence, content or results of any arbitration hereunder
without the written consent of both parties. Should either party disclose the existence, content or results of any arbitration hereunder, that party shall forfeit
any and all damages awarded as a result of arbitration. Damages: To the extent permitted by law, in no event shall Jasper, its officers, directors,
shareholders, representatives, employees, attorneys, affiliated entities or insurers be liable to Owner for any incidental, indirect, punitive, special or
consequential damages arising out of or related to the performance, nonperformance or termination of Contract. Cancellation Fees: Should
owner elect to cancel the Contract outside of the statutory three (3) day time frame, a cancellation fee shall apply to compensate Jasper for its
time, expense and professional services which were rendered to Owner. The fee shall be 25% (twenty-five percent) of Contract, but shall not exceed
2,500.00. DS
Grant Maloy, Clerk Of The Circuit Court & Comptroller Seminole County, FL
Inst #2018093995 Book:9191 Page:1966; (1 PAGES) RCD: 8/16/2018 2,57:03 PM
REC FEE $10.00
IN
THIS INSTRUMENT PREPARED BY: `
ua7 i> Name: JASPER CONTRACTORS Address:
4185 S ORLANDO DR SANFORD,
FL 32773 C
O` O i S NOTICE
OF COMMENCEMENT Permit
Number. Parcel
ID Number: 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. 1.
DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available) 2.
GENERAL DESCR Re -
Roof 3.
OWNER INFORMA Name
and address Interest
in property: OF
IMPROVEMENT: OR
LESSEE INFORMATIOMIF THE FOR THE IMPROVEMENT: Fee
Simple Title Holder (if other than owner listed above) Name: Address:
4.
CONTRACTOR: Name: JASPER CONTRACTORS' Phone Number. 407-278-7788 Address:
4185 S Orlando Dr, Sanford, FL 32773 5.
SURETY (If applicable, a copy of the payment bond is attached)- Name: Address:
Amount of Bond: 6.
LENDER: Name: Phone Number. Address:
7.
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)(a)7., Florida Statutes. Name:
Phone Number. 8.
In addition, Owner designates of to
receive a copy of the Uenoes Notice as provided in Section 713.13(1)(b), 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) 77(
WARNING
O OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER713, 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
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. or
Owner's or Lessee's (Mt Name and PVMe Signatory's rMe/OfBce) Authorized
Officer/ Vctor/Partrner/Managar) State
of County of The
foregoing instrument was cknowledged before me this (O day of 20 byWho
is personally known tome O OR 12M or
oerson MAN Statement w who has
hype of identification produced: GOICOICO v`
Y•
Aef:;_
Statery
Public Co178413Myxpires 0f`
022
um
SEMINOLE COUNTY MULTIJURISDICTIONAL
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 08/16/18
I;hereby_name_an.d_appoint: Rudith Goico,_Adreanna_Ocaso,_SkylarAmkraut,_Amanda Cieplinski __._______--_-__
an — - - - agent of: JASPER CONTRACTORS
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):
All permits and applications submitted by this contractor.
Or
The specific permit and application for work located at:
128 WALNUT CREST RUN SANFORD, FL 32771
Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder.Name: Donald Bouchard
State License Number: CCC1331153
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF Seminole
The foregoing instrument was acknowledged before me this 16 day of August ,
20 18 by Donald Bouchard who is 0 personally known to me or
who has produced DL as identification
and wh di `( id not) take an oath. /
t
V
Signa ure of Notary Print or type Notary name
Notary Public - State of 0, C1
o YPJI,- ANA CHAVEZ Commission No. .l `.
a° o-State of Florida -Notary Public /
commission n GG 112152 My Commission Expires: (0My'Commission Expires
iiiiA June 06, 2021
S FORD
CITY OF
FIRE DEPARTMENT'
4!7S !
Building & Fire Prevention Division
PERMIT NO. ISSUE DATE:
CONTRACTOR:
I pJOBADDRESS'
00
TYPE OF,;WORK:
Re -Roof Permit Card
PROTECT OM WEATHER
Post this Permit and all required documents in a conspicuous place outside
Digital Photographs are required - please follow re -roof policy and procedures guide
All trash, debris and dumpsters must be removed from job site at final inspection
Permit expires six (6) months from date of issue
FROOFCTION TYPE APPROVED REJECTED INSPECTORLROOF
FAILURE TO FOLLOW THE RESIDENTIAL RE -ROOF POLICY & PROCEDURES WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION
FEE AND MAY REQUIRE AN AFFIDAVIT, SIGNED AND SEALED, FROM A REGISTERED FLORIDA DESIGN PROFESSIONAL
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAYRESULTINYOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OFCOMMENCEMENTMUSTBERECORDEDANDPOSTEDONTHEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTICE: IN ADDITION TO THE REQUIREMENTS OF THIS PERMIT, THERE MAY BE ADDITIONAL RESTRICTIONS APPLICABLE TO THIS PROPERTY THAT MAY BE FOUND IN THEPUBLICRECORDSOFTHISCOUNTY, AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,
STATE AGENCIES, OR FEDERAL AGENCIES. FBC 105.3.3
Inspection Line 407.792.6069 or 855.541.2112
REVISED: 4-17
TO SCHEDULE AN INSPECTION:
Dial 407.792.6069 or 855.541.2112
Provide the items requested during the message
The type of inspection requested must be scheduled under the appropriate permit type
Follow the prompts
AUTOMATED INSPECTION SYSTEM CODES
Final Roof Inspection Code III
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)
nderlayment-Pattern-& Spacing-(including-a-measur--ing-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
REVISED: 04-17 Inspection Line: 407.792.6069 or 855.541.2112
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
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: 08/16/18
PERMIT # (} 35 s s
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: 128 WALNUT CREST RUN SANFORD, FL 32771
STRUCTURE TYPE: O SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: O REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY:
PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED
ROOF VENTILATION: Q OFF -RIDGE O RIDGE O SOFFIT OPOWERED VENT
SKYLIGHTS: O YES O NO 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
O TURBINES
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
Q SHINGLE Owens Corning FL# 10674-R13
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#
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
Page 2
Application Number . . . . . 18-00003533 Date 8/16/18
Property Address . . . . . . 128 WALNUT CREST RUN
Parcel Number . . . . . . . . 22.19.30.502-0000-0980
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1071265
Permit pin number 1071265
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 BL03 FINAL ROOF / /
At City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY-IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT##: I S' ADDRESS: lwcu fot C'/ S
ay, T 0 V-d Z? -1 I
O V \ Co = 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 #:
CCC1331153 COMPANY /
CONTRACTOR: JASPER
CONT T TORS c
CONTRACTOR
SIGNATURE: DATE: O MUST
BE SIGNED BY LICENSE HOLDER OR O UILDER) " 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 SEMMOLE Sworn
to and Subscribed before me this day of 20 JK by: C
W C- C,( rK) . Who is Personally Known to me or has % Produced (type of identification)
DL as identification. Signat
a of 1 iotary Public ayP / SKYLAR 8 AMKRAUT o`
P °/ State of Florida -Notary Public StateofPfoWdaiCommission # GG 220805 1GL
c t My commission Expires June
022 Print/
Type/Stamp Name of
Notary Public
LUMTED POWER OF ATTORNEY
Akamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:.-.
I hereby name and appoint: Scott Meixsell, James Allen, Chris Gardner, Juan Lozano, Paul Padgett
an anent of Jasw cO"tractom
N—or c—p-Y)
to be my lawful attomey-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 applwf
ication
for work located at: L $
IN (1111 1 CrUt V&L sven ) a
Expiration
Date for This Limited Power of Attorney: License
Holder Name: y a CU A 10 0 cj& a, i' , State
License Number. CCC'33 ts3 Signature
of LicenseHolder 1 K f
tSTATE
OF FLORIDA COUNTY
OF sems,ole The
foregoing instrument was acknowledged before me this'll day of:QSA 200_
KK. by Dona tm,ard who is o personally own to
me or ® who has produced a- as identification
and who did (did not) take an o th. Signature
Notary
Seal) -SL/(1 ` SKYLAR
B AMKRAUT pYPU / State of Florida Notary Public commission #
GG 220805 ay
My commission Expires June
01, 2022 Rev.
08.12) Print
or tvne name Notary
Public - State of S-- L Commission
No. -1,2- Qs — My
Commission Expires: Z Scanned
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