317 Willowbay Ridge St; 18-3812; ROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: ( -- _ R / I—,
Documented Construction Value: $ 10,900
Job Address: 317 WILLOWBAY RIDGE ST SANFORD, FL 32771 Historic District: Yes No x
Parcel ID: 22-19-30-503-0000-2090 Residential x Commercial
Type of Work: New Addition Alteration x Repair Demo Change of Use Move
Description of Work: Re Roof Owens Corning FL 10674-R13 Rhino 15216-R3 Techwrap 17194-R2 24 SQ 7/12 Pitch
Driftwood Oakridge Lifetime Warranty
Plan Review Contact Person: Skylar Amkraut Title: Admin
Phone: 407-278-7788 Fax: 800-337-3361 Email: Permit@Jasperinc.com
Property Owner Information
Name CHOPDE, PRASHANT Phone:
Street: 317 WILLOWBAY RIDGE ST
City, State Zip: SANFORD, FL 32771
Name Jasper Contractors
Street: 4185 S Orlando Dr
City, State Zip: Sanford, FL 32773
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Resident of property? : Yes
Contractor Information
Phone: 407-278-7788
Fax: 800-337-3361
State License No.: CCC1331153
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: 5`h 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 ofthe 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.-- -- - ____-__ _..-....-__-_
09/06/18
Signature of Owner/Agent Date Sign re of Cont c or Agent Date
Rudith Goico
Print Owner/Agent's Name Pit Contractor/Agq is me,
Signature of Notary -State of Florida Date
Pia ANA CHAV Z a °,.
State.o Florida -Notary Public Commission #
GG 112152 orP
M Commission Expires YPn11111
June 06, 2021 Owner/
Agent is Personally Known to Me or Contractor/Agent iss Personally Known to Me or Produced
ID Type of IDProduced 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: of
Heads UTILITIES:
Flood
Zone: of
Stories: Plumbing - #
of Fixtures. Fire
Alarm Permit: Yes No WASTE
WATER: ENGINEERING:
FIRE: BUILDING: COMMENTS:
Revised:
June 30, 2015 Permit Application
9/6/2018
j 6_.. ,CIA
P
sse rrr.
Parcel Information
SCPA Parcel View: 22-19-30-503-0000-2090
Property Record Card
Parcel: 22-19-30-503-0000-2090
Property Address: 317 WILLOWBAY RIDGE ST SANFORD, FL 32771
Parcel 22-19-30-503-0000-2090
Owner(s) CHOPDE, PRASHANT - Tenancy by Entirety Trustee
CHOPDE, MADHURIMA - Tenancy by Entirety Trustee
Property Address
Mailing
317 WILLOWBAY RIDGE ST SANFORD, FL 32771
317 WILLOWBAY RIDGE ST SANFORD, FL 32771
Subdivision Name PRESERVE AT LAKE MONROE UNIT 2
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions 00-HOMESTEAD(2006)
Legal Description
Value Summary
i 2018 Working 2017 Certified
Values Values
Valuation Method Cost/Market Cost/Market
umber of Buildings 1 1
epreciated Bldg ValueF 180,331 160,919
epreciated EXFT Value 1,688 1,750
Land Value (Market) 40,000 34,000
Land ValueAg
JustlMarket -Value--'* 222,019 196,669
Portability Adj
Save Our Homes Adj 89,467 66,843
Amendment 1 Adj 0
P&G Adj 0 0
Assessed Value 132,552 129,826
Tax Amount without SOH: $2,957.00
2017 Tax Bill Amount $1,684.00
Tax Estimator
Save Our Homes Savings: $1,273.00
TRIM Notice Help
Does NOT INCLUDE Non Ad Valorem Assessments
LOT 209
PRESERVE AT LAKE MONROE UNIT 2
PB66PGS10&11
Taxes
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund 132,552 50,000 82,552
Schools 132,552 25,000 107,552
City Sanford
SJWM(Saint Johns Water Management)
132,552
132,552
50,000
50,000
82,552
82,552
County Bonds 132,552 50,000 82,552
Sales
7-
Description 1 Date Book I Page Amount Qualified Vac/Imp
QUIT CLAIM DEED 5/1/2017
WARRANTY DEED 12/1/2005
08931
06073
0401
0665
100
311,300
No
Yes
Improved
Improved
Find Compaarablo Sates i
Land
etlod Frontage Depth Units Units Price$
40000.00
Land Value
40,000
Building Information
Description Year Built I Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Rep[ Value AppendagesActual/Effective
1 SINGLE 1 2005 1 9 4 1 2_5 'I 1,042 3,026 2,476 CB/STUCCO $180,331 $188,828 Description Area
http://parceldetaii.scpafl.org/ParcelDetail lnfo.aspx?PID=22193050300002090 1 /2
800)337-3361 Fax
info@jasperine.comjasperinc.com FL Contractor's License:
CCC1329651 & CCC1331153
V15A ROOF REPLACEMENT CONTRACT
Account Manager: Joseph Palladino
Contact #: (407) 335-6239
Company: American Strategic Insurance (ASI)
Policy #: Flp318074
Claim #:
Mortgage (_omw Information
Company: Home Point Financial
Loan Number: 10020000243
Owner(s): Prashant Chopde
Phone:
Address: 317 Willowbay Ridge Street Alt Phone: 4077182529
City: SWE Zip Code: 32771 Shingle Color:
Sanford OC Supreme - Driftwood 3 T
Email: pchopde@gmail.com
Roof RCV Amount/ Contract Price:
10,900
Drip Edge Color:
1*Drip Edge - White 6"
B)
IfOwner's Insurance Comes does not agree to pay for a full roof replacement. this contract shall be 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/Insured (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, waivepgr rebate any or all of the insurance deductible applicable to the insurance claim for payment of work. In the event of a discrepancy, the
deductibl TyunL stated on the insurer's Loss Sheet shall overrule deductible amount disclosed. Deductible: s500.00 MUST BE PAID
IN FUL I `_ (initial).
PAYME F: 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 of work performed. In the event of a 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:
217L:24
igned b:
4/23/2018 1 6:30 PM EDT 4/23/2018 1 6:30 PM
tae er Representative - Date &eFA8040E... Date
Grant Malo , Clerk Of The Circuit Court & Comptroller Seminole County, FL
Inst #20181y01656 Book:9204 Pagel569; (1 PAGES) RCD: 9/6/2018 9 28:08 AM
REC FEE $10.00
i.
THIS INSTRUMENT PREPARED BY: I _ ti
Name: JASPER CONTRACTORS Q,,i 3 1, c7l [n
Address: 4185 S ORLANDO DR
SANFORD, FL 32773
R17i KW1
NOTICE OF COMMENCEMENT
Permit Number.
Parcel IDNumbor:
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. DES)CR)PTfO^ OF,,PROPERTY: (Legal description of the property and street address If available)
2. GENERALDESCRIPTION OF IMPROVEMENT: Re -
Roof 3.
OWNER INFORMATION OR LESSEE INFORMATION IF THE -LESSEE CONTRACTED FOR THE IMPROVEMENT: Name
and address: {7i-a5,dn i0 J l] (,(Ji l.(OC[17 1 tG r GP.>' Interest
in property: OWNER rj Fee
SimploTltie•Holder (if other than owner listed above) Name: 4.
CONTRACTOR: Name: JASPER CONTRACTORS Phone Number. 407-278-7788 Address:
4185 S Orlando Dr, Sanford, FL 32773 8..
SURETY Of applicable; a copy of the payment bond Is attached):.Name: Address:
Amount of Bondi 6.
LENDER: Address:
Phone
Number 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 Address:
8.
In addition, Owner designates of to
receive a copy of the Llenor's Notice as provided in Section 713.13(1)(0), Florida'.Stalutes. Phone number. 9.
Expiration Date of Notice of Commencement (The expiration is I year from date of recording unless a different date is specified) WARNING
TO OWNER rANY 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. C
0, Signature
of Ovmer lessee, or Ownersor Lessee's Authorized
OfficanDirector/PeMer/Manager) Print
Name and ProvideSlgnstorys TldelOrfice) State
of T I County of l d l Lfi g(X tJ The !
Mnstrument
was' acknowledged befo reeme this ?. day ofby : ,dpWhoispersonallyknowntome OR Name of
person making statomamt who has
produced identification type of identification produced: _ 11 -N Q, SKYLAR 8
MKRAUT ommissi OFF
1278 J0 A _ wp
h . Co fission Expires p ;moo,,.,
o`' ne 01, 201 8ol 1'r
SKYRC Yr:
StateofFlorida -Notary Commission 9
GG 22, F«+_v
My Commission Exp rrr+++` June
01. 2022 N'
SEMINOLE COUNTY MUL TI-JUR ISDICTIONAL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 09/06/18
I ___1 9 - her l:y-,name-.and-.:appoint: Rqdith .2ico, Adreanna Ocasio Skylar Amkraut, 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):
U All permits and applications submitted by this contractor.
Or
0 The specific permit and application for work located at:
317 WILLOWBAY RIDGE ST 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 Hold
STATE OF FLORIDA
COUNTY OF Seminole
The foregoing instrument was acknowledged before me this 06 day of September I
20 18 , by Donald Bouchard who is 0 personally known to me or
DO who has produced DIL
and wrfd not) take an oath.
J_
ANA CHAVEZ
z p State of Florida -Notary Publicr'c
52
s
Commission n GG 112152
4 My Cbh rinissi6h Expires
June 06, 2021
as identification
Print or type Notary name
Notary Public - Sta.te of
Commission -No.
0MyCommissionExpires: CGS
SPIIAORO r
rBUILDINGDIVISIONBuilding & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. / 8 do 3 P 2" ISSUE DATE: D 96 0 &' /or
CONTRACTOR: J G
JOB ADDRESS: ,3
TYPE OF WORK:
lo"106a% K114 LAW
FROM
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 ROOF
INSPECTION
TYPE APPROVED REJECTED INSPECTOR FINAL
ROOF 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 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. 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. FBC 105.3.3 REVISED:
4-17 Inspection Line 407.792.6069 or 855.541.2112
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
PLEASE NOTE: Inspections scheduled by 500 p.m. will be conducted the
next business day. If you experience difficulty, please call 407.688.5150
Monday - Thursday 7:30 am - 5:30 pm for assistance.
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)
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
REVISED: 04-17 Inspection Line: 407.792.6069 or 855.541.2112
r
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.
DATE: 09/06/18CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: w
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: 317 WILLOWBAY RIDGE ST SANFORD, FL 32771
STRUCTURE TYPE: Q 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: ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED'
ROOF VENTILATION: Q OFF -RIDGE O RIDGE O SOFFIT OPOWERED VENT
SKYLIGHTS: OYES ONO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12-4:12 Q 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#
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 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#
OINSULATED 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 SANFO_RD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
Page 2
Application Number . . . . . 18-00003812 Date 9/06/18
Property Address . . . . . . 317 WILLOWBAY RIDGE ST
Parcel Number . . 22.19.30.503-0000-2090
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1075803
Permit pin number 1075803
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 BL03 FINAL ROOF _/_/_
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
N(AIILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: (J 1 ADDRESS:
I \'a_2_Q 11 &Zi , 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 CONTRATORS
CONTRACTOR SIGNATURE' DATE:
MUST BE SIGNED BY LICENSE HOT, E 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 SEMINOLE
Sworn to and Subscribed before me this 20 day of iby:
Who is Personally Known to me or has N Produced (type of
identific ion) DL
S' nature of Notary Public0
State of Florida
6VIce Print/
Type/Stamp Name of
Notary Public as
identification. RUDITH
GOICO StateofFlorida -Notary public I?LCommissionff r ooGa178 1 MyCommissionExpiresJanuary24, 2p22
SEMINOLE COUNTY MULT!%URISDICTIONAL
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
6 -Joj
Scott Meixsell, Chris Gardner, James Allen, Joshua Collazo, Desmond Roberts, Jovanni Bracero & Edwin
I hereby name and appoint. zquez
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):
Expiration Date for This Limited Power of Attorney: 1/1/2019
License Holder Name: Donald Bouchard
State license Number: CCC 1331153
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF SEMINOLE
The foregoing instrument was acknowledged before me this day of S e.
20 18 by DONALD BOUCHARD who is IN personally known to me or
who has produced
and wh di '( id not) take an oath.
I n ,Iil: 1 r r r Z7
LANACHAVEZZa*p State y Public
sy Com12162
y pires
as identification
Print or type Notary name
rI
Notary Public - State of ` t.(S" Cam,.
Commission No.
My Commission Expires.- lLa
o lQ t 1