122 Sandpoint Ct - BR18-004412 - REROOFNOU 0 1 201:8 U CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $ 13100CD
Job Address: 1 - !—O0AI?UtY4- C' , r F 132--)Mistoric District: Yes No
Parcel ID: Residential X Commercial
Type of Work: New Addition Alteration El Repair Demo Change of Use Move
Description of Work: Q,11_4c we. rn, V Icx 46+rich p5 1Ur -YL3
Plan Review Contact Person: Skylar Amkraut
Phone: 407-278-7788 Fax: 800-337-3361
Title: Admin
Email: Permit@Jasperinc.com
Property Owner Information
Name D24ric c( ,)empsew Phone:
Street: 12;Z Sgr Ga;7i rl C Resident of property? : Yes
City, State Zip: 'SRiI t —1 32-121
Contractor Information
Name Jasper Contractors
Street: 300 Colonial Center Parkway Suite 130
City, State Zip: Lake Mary, FL 32746
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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" 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 ofpermit 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 .ofsubmittal.
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, pennit,fees when the permit is issued.
OWNER'S AFFIDAVIT:I certify that all of the foregoing information is accurate and that all work will
b.e_done-incompliance-with-all-applicable-laws-regulating- construction-andzoning. ------- - ----
l3i
Signature of Owner/Agent Date signs re of Cont or Agent Date
Rudith Goico
Print Owner/Agent's Name P It;Con tractor/Ag f's me
Signature of Notary -State of Florida Date Sig
AfJA CHA Z1pµY PVBc -,,;State of Florida -Notary Public
Commission # GG 112152
My Commission Expires
June 06, 2021
Owner/Agent is Personally Known to Me or Contractor/Agent is/ Personally Known to Me or
Produced ID Type of ID Produced ID of ID :.
BELOW IS FOR OFFICE USE ONLY
Permits Required Building.. Electrical Mechanical Plumbing[] Gas Roof 0
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
Flood Zone:
of Stories:
New Construction: Electric - #-of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit:, Yes No # of Heads Fire Alarm Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
COMMENTS>
UTILITIES:
FIRE:
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permii Application
SEA41NOLE COUNTY MUL TIJURISDICTIONAL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood; Sanford,
Seminole County, Winter Springs
Date: )o /?> i lip,
Rud
an agent, of: JASPER CONTRACTORS
Name of Company)
ski
to be my lawful attorney -in -facto act for me to apply for, receipt for, sign for and do all things necessary to this
appointment for (,check artilly one option):
All permits and applications submitted by this contractor.
Or
El The specific permit and application for work located at:
0:2 '--0(AjP"5)r4 C4,9M4
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 31 day of 0 C-Four 1
20 by Donald Bouchard who is El personally known to me or
91 who has produced, DL as identification
and ,wrfi d not). take an oath.
J-Signa ure of Notary Print Pr type Notary name
Notary Public - State of '".L-7-ck 0--
E"4N,-V ANA GHAVI Z
State of Florida -Notary, Public Commission No. tD
q,ommi"!pn:# GG, 112162tfy'Cb My CommissionExpires: (0mmissionExpires
June O6,2021
10/31/2018 SCPA Parcel View: 10-20-30-507-0000-0500
Daatsi t a ai, I:FA j Property Record Card
Parcel: 10-20-30-507-OOOG-0500
air F Property Address: 122 SANDPOINT CT SANFORD, FL 32771
Parcel Information Value Summary
Parcel 10-20-30-507-0000-0500 2019 Working 2018 Certified
Values Values
Owner(s) DEMPSEY, PATRICIA A Tenants in Common 50.00 - -- w
DEMPSEY TRACY L Tenants in .Coammon :50.00 Valuation Method Cost/Market Cost/Market
Property Address j 122 SANDPOINT CT SANFORD, FL 32771 Number of Buildings 1 1
Mailing 868 TURTLEMOUND DR CASSELBERRY FL 32707 Depreciated Bldg Value ;
u$
117,930 $112 511
Subdroision Name GROVEVIEW VILLAGE 3RD ADD REPEAT Depreciated EXFT Valuea
m.
Land Value (Market) $30,000-$30 000
Tax District l SIISANFORD 9 l DOR
Use Code LE FAMILY I Land Value Ag Just/
Market Value *` $147,930 $142,511 Exemptions _
Portability
Adj 1dw
Save
Our Homes Adt $0 $0 Amendment
1 Adj j $9 098 $18 300 I
P&G Adj $0 i $0 Assessed
Value $138,832 $126,211 Op
Tax Amount without SOH: $2,471.80 1,
1 1 2018 Tax Bill Amount $2,471.80 c „
6 I Tax Estimator Tal
a Save Our Homes Savings: $0.00 Does
NOT INCLUDE Non Ad Valorem Assessments
10/31/2018 SCPA Parcel View: 10-20-30-507-0000-0500
Is Bed/Bath count incorrect? Click Here.
Description Year Built I Fixtures i Bed 1 Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value I AppendagesActual/Effective I
j 1 SINGLE 1984 6 3 2.0 1,434 1,971 1,434 ' CONC 117,930 9 $139,562 Description Area
FAMILY BLOCK
GARAGE 525.00EFINISHED
OPEN
PORCH 12.001
t FINISHED
Permits
Permit # Description Agency Amount CO Date Permit Date
No Permits
1Permit data does not originate from the Seminole County Property Appraiser's office Fordetails orquestions concerning a permitplease contact the building department ofthe tax districtIn which the properly Is located. `
Extra Features
Description Year Built Units Value New Cost
No Extra Features
http://parceldetaii.scpafl.org/ParceiDetaillnfo.aspx?PID=l0203050700000500 2/2
t 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 resu It 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: /o/
f
PERMIT # Z
City of Sanford Building Divisionm
Residential Re -Roof Scope of Work
JOB ADDRESS:2.Z/D%/ C f !G7i?TUyCY l" 2
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: (DOFF -RIDGE ORIDGE OSOFFIT OPOWEREDVENT OTURBINES
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
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#
erk Of The cuit Court & SeminoleGrant
201812
154
Book:9241rPage:1 69; (1 PAGES)rRCD 10/31 20181 ounty,
FL nst90:
43:16 AM REC FEE $10.
00 a= . i THIS
INSTRUMENT PREPARED
BY: LL ri,V
Name: JASPER CONTRACTORSCoAddress: 300 Colonial
Center Parkway Suite 130 Lake Mary, FL
32746 Permit Number: Parcel
ID Number:
10 --}-O —5Lj:! GD -- —Q'T. ' ice S' F 5 (,-.-)
5 e'q The undersigned hereby
gives notice that improvement will be made to certain real property, and In accordance wlthChapter 713, Florida Statutes, the following information is
provided in this Notice of Commencement. 1. DESCRIPTION OF
PROPERTY: (Legal description of the property and street addressif available) 2. GENERAL DESCRIPTION
OF IMPROVEMENT: Re -Roof 3.
OWNER INFORMATION
OR LEGE INFORMATI N IFTHE LESSEE CONTRACTiED FOR THE IMPROVEMENT: Name and address: Q2
I/1 )7't CA,p j tZ'—n k Interest in property. Fee
Simple Title Holder (
if other than owner listed above) Name: Address: 4. CONTRACTOR: Name:
JASPER
CONTRACTORS Phone Number: 407-278-7788 Address: 300 Colonial Center
Parkway Suite 130, Lake Mary, FL 32746 5. SURETY (if applicable,
a copy of the payment bond Is attached}: Address: Amount of Bond:
S. 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(i)(a)
7., Florida Statutes. Name: Phone Number. Address:
8. In addition,
Owner
designates of to receive a copy
of the Uenor's Notice as provided In Section 713.13(1)(b), Florida Statutes. Phone number: 9. Expiration Date of
Notice of Commencement (Theexpiration is 1 year from date of recording unless different data is specified) WARNING TO OWNER: ANY
PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER
CHAPTER 713, PART 1, 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 (et.. Dc nW
14Se Signature of Owner or
Lessee, or Owner'sLessee's (Print Name and Provide Sigrmtorys Mtle/OfT ) Authorized Officar/DirectorrPartnerlMa eq State
of ell iR County
of 1) day The fore oing
instrumentwasacknowledgedbeforemethisIdayof /l C-/ 20 /' by - 'ALCl('Who is, personalty
known to me 0 OR Name of person making stateme whohasproducedidentification type of
Identification produced: RUDI TH O O State of
Florida -NotaryPublic Commission
it GG 178413 Notary Signature
My Commission Expires t `"TRIED COPY
GR,1JNT I'v . OY January 24. 2022 ( tlVtliLE l - .
fIORIDA BY DEPUTY
CLERIC 1---- Z
DocuSign Envelope ID: 60EF2FF7-6E8B-487E-BE -- -"—" "-----""
300 Colonial Center Parkway STE 130
Lake Mary, FL 32746
407)278-7788
321) 348-9154
813)867-7898
863)808-4434
info@jasperinc.com
VI nrrcj
FL Contractor's License:
CCC1329651 & CCC1331153
RnnF 12FPlr.ACFNffNT CONTRACT
JPalladino Account
Manager: Jose
Contact: (
407) 335-6239 Insurance
Com an Inrmation Company:
eop es rufost Policy#:
Bf150719703 Claim#:
Mortgage
Com paan , Information Company:
Bank America Loan
Number:234271321 Owner(
s): pat Dempsey Phone:
407-925-9285 Address:
122 Sandpoint Court Alt Phone: 4073534028 City:
Sanford State: Zipzip code: 32773 Shingle Color: *OC Supreme - Bro Email:
tracy.eruz@yahoo.com Roof RCV Amount/ Contract Price: Drip Edge Color: *Drip Edge - Brow 13.
00 If
Owner's Insurance Company does not agree to pay for a full roof replacement, thus contract Man De votaaDie. 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 under 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, waive or 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
a t stated on the insurer's Loss Sheet shall overrule deductible amount disclosed. Deductible: $3781.00 MUST BE PAID IN
FUL (initial). PAYME
EDULE: 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 LossSheet 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 onthethirdbusinessdayafterthecontractisexecutedafternotificationfrominsurer(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 changesoralterationstothisContractmustbemadeinwritingandagreeduponbybothparties. 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 cuSigned
by: DocuSlgned by: W
10/18/2018 1 10/18/2018 I 3:23 PM EDT oi lwu'•C 3:22 PM u0`
iRTtd'V& Representative Date wrier Date
DocuSign Envelope ID: BOEF2FF7-6E8B-487E-BBF7-58C847BB7600
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 I
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. "I
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 guaranteetheremovalofallnailsand/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. Pleasesee "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 Godduringthewarrantyperiod. 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 arc not to current code, regardless of "grand fathered" 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'sLimitedShingleWarranty. 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 damagesarisingfrom, Owner's election to retain these pre-existing materials. Pre -Existing Conditions: Jasper shall not be responsible or liable for issues due toimproperventilation, deteriorated decking, "waves" in decking, appearance of roof 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 ifContractPricedoesnotexceed $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 disputearisesfromorrelatestothiscontractorthebreachthereof, 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 thereofshallbesettledbyarbitrationadministeredbytheAmericanArbitrationAssociationinaccordancewithitsConstructionIndustryArbitrationRulesandjudgmentontheawardrenderedbythearbitratorsmaybeenteredinanycourthavingjurisdictionthereof. The statute of limitations on all disputes whicharisefromorrelatetothiscontractorabreachthereofshallbeone (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 andotherexpensesorchargesofthemediatorand/or arbitrator, shall be borne 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 scopethereof, 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. In 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 postjudgment 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 hereunderwithoutthewrittenconsentofbothparties. 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: ShouldownerelecttocanceltheContractoutsideofthestatutorythree (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
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: i —I ADDRESS:
e /rrlZr , /! ( 3
I (b)AAZ—(tBfZ9!7k-"XY- `/ , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, THEREBY 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:
CONTRACTOR SIGNATURE:
MUST BE SIGNED BY LICE1
CONTRATORS
OR
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: 11 1 t1
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.
9I :
STATE OF FLORIDA COUNTY OF SEMINOLE
Sworn to and Subscribed before me this day of ' 20 L by:
01 5-15;6 G 1- Who is personally Known to me or has N Produced (type of
identifica26DL ® as identification. f
Signa
of Notary Public State,
Florida ('RUQ1T H G O I C O N;. ,.
State of Florida Notory Public 1*=
Commission # GG 1 78413 P,^
y C;ommission [xpires Print/
Type/Stamp Na a t F „,' < a a n u a ry 2 n, 0a' -J of
Notary Public_ I,
Q,
SEA41NOLE COUNTY A&L Ti JuR ISDICTIOAIA L
Altamonte Springs, Casselbe"Try, Lake Mary, Longyvood,'Sanford
Seminole County, Winter Springs
Date: 1141
Scott Meixsell, Chris Gardner, James Allen, Joshua Collazo, Desmond Roberts, Jovanni Bracero & Edwin
I hereby nam-O-and appointVa zquez_.... . . . . ...... . ........
an agent of:, PER, CONTRACTORS
tviame Ul uUmparly)
to [Wrny lawful attorney -in -fact to,jact. for me to apply for, receipt for, sigh for and do a'li"thingsr necessary to this
appointment: for (check only one option):
All permits and applications submitted by this contractor.
Or
0 The specific permit and application for work located at.
z__Z1 S9XIWA02Y71
1 /yj I S 191.1-2 A:D1r_Wr r- / 3 ?_
Expiration Date for This Limited Power of Attorney:- 1/1/2019
License, Holder -Name-: DOnald. Bouchard
State Lic ense Number: CCC 331153
Signature of License HbI
STATE OF FLORIDA
COUNTY OF SEMINOLE
0Theforegoing, instrument was acknowledged before me this ,day ofd -
20 18 by DONALD BOUCHARD who is IN personally known to me or
0 who has produced as identification
and Whig`dO id hot) take an oath.
Sign. re F N Print or type Notary name _
t
1, - — , "
z,
zANACHAVE;
jca° of Florida -Notary Public
0PpmTis i,on,#GG 112152
P, r., My'Corhriiission Ex pires
June 06,,2021
Spe
Notary Public - State of Lv'k-0-ri, 0 C-
Comm ission. No.,
My Cc mlmissibn Expires: tt 1 (0