2525 Georgia Ave; 18-3515; ROOFCITY OF
ORD
FIRE DEPARTMENT
AUG 5 2o1s
Building &Fire Prevention Division
PERMIT APPLICATION
Application No: 9+ ` 35 I5
Documented Construction Value: $ 6890
Job Address: 2525 Georgia Ave, Sanford, FL 32771 Historic District: Yes No
Parcel ID: 01-20-30-504-3500-0170 Residential Commercial
Type of Work: New[] Addition Alterations Repair Demo Change of Use Move
Description of Work: Remove and replace roof
Plan Review Contact Person: Robert Wormley
Phone: 321-303-0766 Fax:
Name Paul Piciocchi
Street: 1050 Plaza Dr., Ste G
Title:
Email: wormleyroofinginc@gmail.com
Property Owner Information
City, State Zip: Kissimmee, FL 34743
Phone: 407-483-1013
Resident of property? : No
Contractor Information
Name Wormley Roofing Phone: 321-303-0766
Street: 2473 N John Young Pkwy Fax:
City, State Zip: Orlando, FL 32804
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
State License No.: CCC1325558
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 ofthat date: 61h Edition (2017) Florida Building Code
Revised: January 1, 2018 Permit Application
NOTICE: In addition to the requirernencs of this permit, there may be additional restrictions applicable to this property that tray be
found in the public records Of this County, and there may be additional pernlitS rtqUiTed from other governmental entities sucli as water
manaverrient districts- state acncics, or federal agellclics. Acceptance
of permit is verification that I will notily° the rfvner of the propem, of the requirements of Florida Lien Law. FS 711 The City
of Sanford requires payment of plan review fiee at the LiTTIC of permit submittal.: copy orthe executed contractis 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 lCV, Valuation '['able in effect at the fire the permit is issued, in accordance with local.
ordinance. Should calculated char. -es figured off,, the executed contract exceed tbie actual construction value, credit will be
applied to your pen -nit fees whenthe permit is issued, OWENS 41TIDAVIT: I
certify thatall of the foregoing information is accurate Lie done i'd,
mpliance with allapplicable laws regulating construction and zoning. Print Cfvii(r'A--
mWs Name natureOf NU411-V-
suaie Date SUSAN C. BLACKBURN MY
COMMISSION 9 GG51337
EXPIRES: Demnber 09, 2020
wner,N- oent is
ersonally Known to N-le. or Produced. IDype of,
11) Sig griaiuic ofCantractorAgent Hilt
Contractor. Agem's
Larne Emma Vi t J—
u to A _y Campbell M,
IC or, 140&' Expires Commission GG
184707 0211112022Contractor.,"Agent is - V
Pers( Produced ell T v
c of pBELOW IS FOROFFICE
USE ONLY Permits Required: Building R
ElectricalF] Mechanical [] Plumbing[] Z7, Construction Type:__„ OccupancyUse:
Total Sr{ Ft of
Bldg: Min. Occupancy Load: New Construction: Electric - 9
ofAmps __ Fire Sprinkler kler Permit: Yes
n No [] 4 of 1.1eads APPROVALS: ZGNENG: 111.41-ITIES: —
ENGINEERING: FIRE: CONINI.ENTS: Plumbing - #
of Fire
Alarm that
all work
will WA)
lig, N Known to
Meor
n
Roof n Flood Zone:
d Stories: Yes [-
j No
Fj WASTE,
WATER.: BU,I,LD.
ING:— P,,
uviwdL j4111wry1, 20
is' Pernift Application
Grant Maloy, Clerk Of The Circuit Court & Comptroller Seminole County, FL
Inst #2018093398 Book:9190 Page:1656; (1 PAGES) RCD: 08/15/2018 02:28:49 PM
REC FEE $10.00
CERT, IFIM COPY GRI AINT MALCIl
CLER;r LF Ti iE CIRCUIT COURT
SEIM INOLE COtsIIT'f; FL t.//
THIS INSTRUMENT PREPARED BY:
Name.'Emma Cam belp_ f = 3YAddress: 2473 N JOH N' YOUNG . ARRWA
ORL O FL 32t304 Oate
NOTICE. OF COMMENCEMENT
State. of. Florida
County of Seminole
Permit Number: Parcel 10 Number., 01-20-30-50473500-0170
I
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, I
DESCRIPTION OF PROPERTY: (Legal description of the property and street address ifavailable) .
LOT 17 BLK 35 i
DREAMWORLD
PB' 4 PG 99 2525 Georgia Ave. Sanford, FL. 32771
GENERAL DESCRIPTION OF IMPROVEMENT: .
Remove and replace roof.
OWNER INFORMATION:
Name: Paul Piciocchi I
Address: 1050 Plaza Dr., Ste G, Kissimmee, FL 34743
Fee Simple Title Holder (if other than owner) Name:_ _
Address:
i'
CONTRACTOR: i
Name: ROBERT WORMLEY / WORMLEY ROOFING INC
Address: 2473 N JOHN YOUNG PARKWAY, ORLANDO FL 32804
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:
Address:
In.addition to himself, O:+mer Designates I of
To receive a copy of the Lienor's Notice as Provided in
Section 713.13(1Nb), Florida Statutes.
Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording
different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF "
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOU
NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEF(
INSPECTION.) YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR
BEFORE COM -NCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Un/pIties of perjury, t declare that I have read the:foregoing and that the facts stat
to o and belief.
Oymer'sSignavreovfors Pri,e..3_Nome
Flan Statuto713A3(1)L9) The vane, must signthe notice of u^mnKncem nt and no onoelsemay be pemlked to sign in
State of County of
The f%°ggotl g instrument waslyack»owledged before'me thi day of
by Who is
Name of person making statoment
OR who has produced identification type of Identif
hR't\P.'.1f f1F1f'y
My
AN
COMIC.
BLACKB( RN MY
1337 COMSSION. # GG51337 EXPIRES:
I)gcemti609, 2030 PRE
NOTICE OF CTION
713.13, PROPERTY.
A E
THE FIRST N
ATTORNEY In
it are true or
her st:_at. v
4c personallyknownto 'me I 20
i
Advanced Manap_ement Specialists, Inc.
Specific Power of Attorney
Known All Alen by These Presents
That Paul Piciocchi
Owner(s)")
By these presents do make, constitute and appoint Broker or Broker's agent(s) of Advanced Management Specialists, Inc. ("Designee")
Owner's true and lawful attorney for Owner in Owner's name, place and stead for all matters pertaining to the property located at;
2525 Georgia Avenue Sanford, Florida 32773
PROPERTY)
including but not limited to access to and exclusive control and possession of the property, signing of all necessary documents related to the
care, custody and management of the Property and its fixtures and furnishings including, but not limited to, signing agreements and
contracts for all utilities, maintenance services, Insurance, and care and maintenance of furnishings. Giving and granting unto said Designee
said attorney power and authority to do and perform all and every act and thing whatsoever requisite and necessary to be done on and
about the Property as fully, to all intents and purposes, as Owner might or could do if personally present, except that Designee shall have
NO AUTHORITY to convey or mortgage the Property or grant any option, rights, contracts, or other interests, liens or claims in the
properly, other than contractors' liens arising from the provisions of materials or services to the Property. Owner grants Designee with Hill
power of substitution, unless and until the revocation of this Power of Attorney by written notice to Designee, hereby ratifying and
confirming all that Designee or its substitute shall do or cause to be done by virtue hereof. Owner hereby agrees to indemnify and hold
Designee harmless from each —Tat t every act which Designee shall do on behalf ofOwner under grant of authority created hereby.
owner$ Le W atura
Co•Owner's Lega Signature(if appitca a)
Gam"'
yrt ness
Witness
State of kbf cl County of D( t'tUQ-
The foregoing instrument was acknowledged before me this k 1 S day of t US 20L_6 by
pcy ` 1P C_ \ i_D t _ " who is/are personally known to me or has produced identification.
rWTypeofIdentificationproduced: kd
Notary Public
Seal: CANOACEMONTOYA
PublicColorado0094001912
2017xpiresFebG,
Page 19
Landlord Initials Landlord initials Agent Initials
WORMLEY ROOFING, INC.
2473 N. John Young Parkway • Orlando, FL 32804 Office: (321) 303-0766
www.wormleyroofing.com office@wormleyroofing.com
Professional Contractor *State Lic. CCC1325558•Fully lnsured•Over 38 Years Experience
INVOICE TO
Advanced Management
Specialists, Inc
ADVANCED MANAGEMENT
SPECIALISTS
1050 PLAZA DRIVE
SUITE G
407-483-1013
KISSIMMEE, FL 34743
NO. DESCRIPTION
1 New Shingle Roof
PROPOSAL
JOB ADDRESS
Advanced Management
Specialists, Inc
2525 Georgia Ave
Sanford, FL 32773
ESTIMATE NO. 1203
DATE 05/03/2018
Proposal good for 30 days.
AMOUNT
2 Remove existing shingle roof system to wood deck
3 Inspect decking and re -nail to code.
4 Any wood deck repair is an additional charge per the following;
Plywood deck replacement is $30 per sheet plus cost of materials.
Board/Plank deck replacement is $3 per linear foot plus cost of materials.
5 Provide and install approved underayment.
Underlayment Type:
6 Provide and install new 26 gauge drip edge.
COLOR: L') n l k—
7 Provide and install new lead boots, goosenecks and flashing where needed.
Color varies depending on shingle color.
8 Provide and install Starter Strips, and True Hip & Ridge.
9 Provide and install algae resistant architectural shingles.
Brand: -AN-1 G 5 Color: WoveMge p)
10 Provide and install GAF Cobra 3 shinglventsv 11
Remove and properly dispose of roofing debris from the job site. 12
50 year Limited Lifetime warranty on the shingle is provided by Atlas. Algae resistance warranty is provided
by Atlas and backed by 3M. 13
Wormley Roofing Inc. will provide a 5 year workmanship warranty. PRICING
INCLUDES ALL APPLICABLE FEES AND PERMITS. We
look forward to working with you! 6,
890.00 TOTAL $
6,890.00 All
Materials are guaranteed by the manufacturer. All work will be completed according to standard roofing practices and current building codes.
Any alteration or deviation from the above specifications, will be only upon written orders and will become a written change — over and
above this agreement. Although we will exercise all due cautions, we cannot be responsible for existing cracked driveways or damages
due to rain, hail, wind or any acts of God. Any leaks that occur during the agreed workmanship period will be repaired by Wormley
Roofing Inc. Any repairs or alterations by others during the workmanship warranty period will void the warranty and Wormley
Roofing Inc. will not be hold responsible .
Acceptance of Proposal: THE ABOVE PRICES, SPECIFICATIONS, TERMS AND CONDITIONS OF THIS PROPOSAL ARE
SATISFACTORY AND ARE HEREBY ACCEPTED AND IS CONSIDERED A BINDING CONTRACT. WORMLEY ROOFING,INC. IS
AUTHORIZED TO DO THE WORK AS SPECIFIED.
A 1/3 DOWN PAYMENT OF PROPOSED AMOUNT IS REQUIRED, TOTAL DUE UPON COMPLETION OF JOB, **PLUS COST OF ANY
ADDITIONAL WOODWORK. OWNER ACKNOWLEDGES THAT HE/SHE HAS READ THE ROOFING PROPOSAL AND HAS
RECEIVED A LEGIBLE COPY OF THIS AGREEMENT SIGNED BY CONTRACTOR, INCLUDING ALL TERMS AND CONDITIONS
HEREIN INCLUDED, BEFORE ANY WORK WAS COMPLETED.
Accepted By:
WRl Approval:
Down Payment
Amount:
Date Accepted:
Date Approved:
Date Received:
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
I hereby name and appoint: Emma Cam
an agent of: Wormley Roofing
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):
The specific permit and application for work located at:
2525 Georgia Ave, Sanford, FL 32771
Street Address)
Expiration Date for This Limited Power of Attorney: 1 /30/2030
License Holder Name: Robert Wormley
State License Number:
CCC1325558
Signature of License Holder:
STATE OF FLQRIDA
COUNTY OF
The foregoing instrument was acknowledged before me this ay of ,
2003, by who is ersonally own
to me or o who has produced as
identification and who did (did not) take an oath.
Notary Seal)
w Notary
a.
Public State of Florida
Emma Victoria CampbellMyCommissionGG184707Expires02/11/2022
Rev. 08.12)
6 . r 1'7aT
Enrfias CAffiViDPA),
Print or •
Notary Public - State of 1 o
Commission No.(A 1612H10-7
My Commission Expires: 1 —L
CITY OF
Building & Fire Prevention DivisionORDRESIDENTIALRE -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 (1F 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: /
CITY OF
PERMIT # SANFORD
FIRE DEPARTMENT Building &Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
Jos ADDRESS: 2525 Georgia Ave, Sanford, FL 32771
STRUCTURE TYPE: (2) SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: 0 REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): 1121 1 Q It A (N b ad
PLEASE NOTE: ONLY IOO SQUARE FEET OF AfE E STING DECK ISPERMITTED TO BE REPLACED
ROOF VENTILATION: O/OFF-RIDGE RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: OYES 9 NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 Qf 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
0 SHINGLE Atlas FL# 16305-R6
O METAL FL#
OMODIFIED BITUMEN FL#
O TORCH DO WN FL#
OINSULATED FL#
O TILE FL#
OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETCH) **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#
OTORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
CITY O'F
Ski(" Building & Fire Prevention Division
RESIDENTIAL RE -ROOF AFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: V 1 151 S ADDRESS: 2525 Georgia Ave, Sanford, FL 32771
I Robert Wormley , 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#: CCC1325558
COMPANY / CONTRACTOR: Wormley RoQf n
CONTRACTOR SIGNATURE: DATE: a7 - 1-2
MUST BE SIGNED BY LICENSE HOLDER OR 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
Sworn to and Subscribed before me thisday of S 20 J_ by: Who
is l Personally Known to me or has Produced (type of iden '
cation) as identification. 11
ig
re of N tary Pu lic State
of Florid A
E pry State
of Floridaia CampbellnGG184707Print/Type/Stamp am 2022 of
Notary Public