124 Wilson Bay - BR18-004479 - REROOFJob Address:
Parcel ID:12 11`( M3 rn,949
v
Type of Work: New addition
Description of Work:
tt14ks
Application No: L D" LH 1 9
Documeut d Construction Valuer $/ 5
Historic District: Yes No
Residential Commercial
Alteration Repair Demo 0 Change of Use Move Q
Plan Review Contact Person:
Phone: 8sU 79-!b eA0 Fax: email: ckYod scut,
Property Owner Information
Name Qi SSPy f- Phone: =I? 5--
Street: 2> 4 LO k\ ?
City, State Zip:
Resident of property? :
Contractor Information
Name L UU"r5 'rie live ck*s-t u.frk,
Street:7
City, State Zip: 6
0
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Phone:`7 F'J
Fax:
State License No.: CCC 139- cf S S-4
Architect/Engineer Information
Phone.
Fax:
E-mail:
Mortgage .Lender:
Address:
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYINGTWICEFORMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED ANDPOSTEDONTHEJOBSITEBEFORE ;THE FIRST INSPECTION. IF YOU INTEND TO OI3TAIiV FINANCING, CCQNSUITWITHYOURLENDERORANATTORNEYBEFORE ,RECORDING YOUR NOTICE OF COjMMENCFM1 NT
Application is hereby made to Obtain a permit to do the work and installations as indicated_ 3 certify, that no work or installation 11a5 cQmmenccd priertotheissuanceofapermitandthatallworkwillbeperfgrmedtpmeetstandardsofalIlativ;; regulating et7nttlticti¢R In 11$ jttri ilxCl t)n. I understandthataseparatepermittrustbesecuredforelectricalwork, pauatabiatg, signs, wells, Fools, furnaces, boilers, hearers, tanks, and air conditioners, etc.
FBC I05.3 Shalt be inscribed with the.date ofapplication and the code in effect as ofthat date: Vb Fdition (2017j Florida Building Code
NOTICE. In addition to the requirements ofthis permit, there .may be additional roirictipns applicable to this property.that maybe fpttnd in the ptihtic
records of this county, and there maybe additional permits required from ether gpvernmental entities such as water inanagetnent districts, state
agencies, or federal agencies.
Acceptance of permit is verification that I yyjll notify the owner cif the :property of :the requirements of Florida Law, F$ 713.
The City ofSanford requires payment of a plan review fee at the time stf permit submittal._ A copy of the executed contract is required 1hi order to
calctiiate a plan:rcvieiv charge and,trill he considered the estimated constructi(,m value nfthe i hat .the time pf.stib111 11 . The actual construction value
will be figured based on the current ICC Valuation `['able in effect at the time the permit isicrued, in accordance vvith local ordinance_ hould calculated
charges figured offthe executed contract exceed the actual ennstruction value, credit will he applied t<t your permit fEc when the permit i,5 sst(ed,
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 regugating constructioltt and zoning.
Si ature of 0wri (Agent Date
goes5''3kAtr'g d"
Print
fCKvner/
Agent's Name
Signature ofNotary•State of i istra
qnrP BRETTTHOMAS
Commission # FF 993549
a`.-' Expires May 17, 2020
dSdThtuTroyFaMlnaurance8003WIDt9
Owner/Agent is P
Produced ID Type of ID
z
SiQnitprevC pnttactc,r/. nt Date
rCturS U
ROW C:qn(r@rlgr/t gelals i flinr
Signaturr of 1Nvtary-Statc.(fI i
Commission # FF 993549
Expires May 17, 2020
Bonded Thru Troy Fain lnsurarm 8004W7019
Contractor/Agent is ..mmmmit n0 W...
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas El Roof
Construction 'Type: _ Occupancy Use: Flood zone:
Total Sq Ft of Bldg: Min. Occupancy Load: # ofStories:
New Construction: Electric - # of Amps Plumtbbr g - .# of Fixtures
Fire Sprinkler. Permit: Yes ®No # of Heads Fire A ax n 'et~> la!t; Yes No
APPROVALS: ZONING: UTILITIES:
ENGINEERING:
COMMENTS:
FIRE:
WASTE WATER:
BUILDING:
4-1-
Altamonte Springs, Casselberry, Lake Marry, Longwood, Sanford,
Seminole County, Winter Springs
Date:yOi
I hereby name and appoint: 'ay u- (yksatin,1 kcv- K:
1-1
a s., S
an agent of: Ll
5R
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):
0 The specific permit and application for work located at:
Street address)
Expiration Date for This Limited Power of Attorney: 1 U/ 4 / 19
License Holder Name:—FriWi S LA CX4tad
State License Number: Cf C 1'3 cj 5: q
Signature of License Holder: —
STATE OF FLORIDA
COUNTY OF 5u)tytXe
The foregoing instrument was acknowledged before me this P day of dg,66e.—
204 , by '--b 4 who is "ersonally known
to me or o who has p uced
identification and who did (did not) take an oath.
Notary Seal)
N e rtmars
Cammiss # FF 99M
Expires May 17, 2020
By*dThrairoyFt1n1nannapdDOtiWT019
Rev. 08.12)
a
Print or type name
Notary Public - State of F;vorjg—,_
Commission No.gg3
My Commission Expires:/rlsa
FRI
Gra't MalOOt,,rr Clerk Of The Circuit Court &
Inst #2018121942 Book:9237 Page:350;
REC FEE $10.00
r Seminole County FL
RCD: 10/23/2018 9:49:51 AM
This Instrument Ptepa ed By:
Permit No.
STATE OF Florida
COUNTY OF' —` ;
THE UNI)MSIGNED hereby 9Kes
Chapter 713, Florida StsU ts, the A
1, Description ofproperty; (legal de
2 Knotal descriptipn ofirnproverm
3. Owner informatbn or Lessee into
a,' Name and address;
4 h*rest in properly:
G Name and address offee Simi
4. Contractor.
a, Name end address: Uoyd Roo
b; Phone number:850 728 8101
S, Surety (if applicable. a copy of the
a. Name and address NIA
b, Phone number. NIA
c, Amount of bond $
8, Leader:
A. Name and address: NIA
h PhOna MmberMA
7. Persons within the State ofFlorida
by Section 713.13(1)(a)7., Florida
a, Name andaddress;WA
h Phone numbers of designated
8. In sdd6on to himsell Owner desig
713.13(1)(b), Ftgriom SamAos: a. NameandaddressvA
b, Phone number of person orent g,
Expiratim date of no od on e Is
specified); 11jr I WARNING
TO OWNER: ANY i COMMENCEMENT
ARE CONS11 FLORIDA
STATUTES, AND CAN NOTICE
OF COMMENCEMENT INSPECTION.
IF YOU INTEND I COMMENCING
WORK OR RECOI was
behalf
ofwhom Instrument was exectA arnrrrom.
ii 2020
FSRI:nTH0iY4A$ s,
t 8an6d
tMay17. IaI...
M 90AQedTMu7rovFetnr... NOTE
Thts stab 0rri .,wf.r.l_rtf tr and a
NOTICE
OF COMMENCEMENT 2Z-)
q-30-503-coot,-z 3v Tax
FolioNo. that
tmpmvement will be made to certain teat property, and in accordance wfth iInfomratlanisProvidedbythisNoticeofCarmnaneemerILat
at property, and street address it available) rme,
vC, a1 L".(, MOYIV-0,9-1x"i pg tal vt5 v a ) if
theLessee contracted for theimprovement: din
t vek- M) `Z-W W I so n lba4 CT order.
fd ditferentfrom owner Osted above): and
Construction4740 Marren DrTallahnsee Florida 32308 bond
is allachtQ; by
Owner upon whom notices or other doarmentsmay beserved as provdedthe
Bowing persOn(s) to r8reive a copy of theLienoes Notice as provided in Section byOwnerWA
the
expiration date will bet year from the date of recordintjunions a different date TS
MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF IWrROPER
PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, r
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A BE
RECORDED AND' POSTED ON THE JOB SITE BEFORE THE FIRST IN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE OURNOTICEOFCO `NLLCEMENT.. t
tuuna
reoofOJ nor or Lassos. or Owner's or lessee's Afittlafted
Ot5eerlDireciw/PartnedManager Signatory'
s Title/Otfice, W
before me this A day of G , 2 (year) by rofPerson) as _ --r (rype" of mfamfor (name of party on ignsh
a of Notvffubrm — State of Florida AmT
N;dworr Commissioned Na" of Notary PublicNumber Personally
Known `or Produced Idenlilicat form
was revised by the 2012 Florida LeWstature an
eftective date of October 1.2012.
CH Y OF
Building Fire Prevention DivisionU, ORD RESIDENT L RE -ROOF AFFIDA VIT
RESIDENTIAL.. RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL. ROOF COVERINGS
PERMIT #: ADDRESS: *; Lf w,l'Son c
L57ad
I I v i L- c c/ AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, IWGINEER, 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 FORSECONDARY WATER B.ARRIF.R AND NAILING OF THEROOF DEM IN ACCORDANCE WITH THE HURRICANE RETROFIT
MANUAL REQUIREMENT'S (BASED oN F.S. CI-LAPTER 553.844).
LICENSE #:
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE:
MUST BE SIGNED BY LICENSE HOLDER OR
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: t% /
THIS SIGNED AND NOTARIZEDAFFIDAVIT MUST BE PROVIDED AT THEJOB 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 N-4IL SPACING AND
OVERLAPS, INCLUDING DRIP EDGE AND VALLEY FLASHING. PLEASE REFER TO THE RE -ROOF POLICY AMID INSPECTION PROCEDURE
PAPERWORK FOR FURTHER EXPLANATION OF ALL REQUIREMENT&
FAILURE TO FOLLOW ALL REQumEmmNTS 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-Snnuy,L-e-
Sworn to and Subscribed before me this j?2 day of &A!w #r ZU _Q by:
S ou CL Who is ersonafly Known to me or has Produced (type of
identification)
Sre dArNotary Public
State of Florida
Print/Type/Stamp Name
of Notary PubHe
as identification.
00.*% BRETrTHOMAS
Gommission # FF 993549
Expirea May 17, 2020
9t; c°• 30AM TMUTroy Fain insurano 800-3W7019
tom-
e
00FING &CONSTRUCTION
4.740 Mahan Dr. J "s a 1 S
Tallahassee, FL 32308
Work Authorization & Direction of Payment
Date: ,
Name:
Addre<
Phone
Both Lloyd Roofing and Construction, Inc. (LRC) and the homeowner agree to the following: 1. Contract: Omer authorizes LRC to be their contractor and grants all work orders to LRC, inc
all proceeds upon receipt of payment from the insurance company.
20 Estimate: Both LRC and Owner agree that, per this contract, if the insurance company apprc
the claim LRC will perform the work listed in the estimate for the dollar amount agreed upo
both I.RC and the insurance company.
3. Additional Damages'and/or Upgrades Owner agrees that they are responsible for any damn
that are not covered under the insurance policy -and that amount will be collected by LRC. T.
owner is also responsible to pay LRC directly for any upgrades chosen by the owner.
4, Payment: Owner authorizes a- T Insurance company to pay a
proceeds due LRC, under their policy directly to Lloyd Roofing and Construction, Inc. and am
mortgage company named.
5. Deductible:, Owner a e to pay Lloyd Roofing and Construction, Inc. their deductible in the
amount of . upon completion of all roofing work_
Insurance Company:
Claim Plumber: ___
ACCOROIEG TO FLOIWA'S CONSTRUCTION LIEN LAW jSECTION5 713.001.713.37, FLORIDA STATUTES,, THOSE WHO WORK ON YOUR PROPERTY O ' PR04IDE MATTOMSERVXMANDARE140TPAID1WFULLHAVEARIGHTTOENrOft—ef- NE1R CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. TiiIS CLAIM IS MOWN AS A CONSTi
UFW. IF YG?UR CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SUSIONTRACTORS, SUB -SUBCONTRACTORS, OR MATERIAL SUPPLIERS, THOSE PEOPLE Wim AR
WHEY MAY,LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN 1F YOU HAVE ALREADY PAID YOUR CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR,
COKMCTOlt MAY ALSO HAVE A LIEU ON YOUR PROPERTY. THIS MEWS IF A LIEN IS FILED YOUR PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LAE
MA3'ERAU, M OTHER SQVjC6 TOT YOUR CONTRACTOR OF A SUBCONTRACTOR MAY HAVE FAILED TO PAY,. TO PROTECT YOURSELF, YOU SHOULD STIPULATE ! CORi RACT THAT BEFORE ANY PAYM.niT IS MADE, YOUR CONTRACTOR IS REQUIRED To PROVIDE YOU WITH AWRITTEN RELEASE OF 1.191 FROM ANY PERSON OR C
THAT HAS PWVM TO YOU A "WTICE TO OWN" ." FLOPJDA'S CONSTRUCTION LIEN LAW IS COMPLbt:AND IT IS RECOMMENAED THAT YOU CONSULT AN ATTOi
G7Y OF
SANFORD Building.&Fire Prevention Division
RESIDENTIAL RE -ROOF POLICY & PROCED URES
FIRE DEPARTMENT
PERMITTING REQUIREMENTS - NO PLAN REVIEW REQUIRED
THIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE
REQUIRED TO BE SUBMITTED AS PART OF YOUR PERMIT APPLICATION.
THE SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF
COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT.
A PERMIT WILL NOT BE ISSUED WITHOUT THESE DOCUMENTS. COPIES WILL BE MADE TO POST ON THE JOB SITE.
PROJECTS LOCATED IN THE SANFORD HISTORIC DISTRICT WILL REQUIRE PLAN REVIEW AND APPROVAL BY THE
SANFORD HISTORIC PRESERVATION BOARD
INSPECTION POLICY & PROCEDURES
A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMILY, TOWNHOUSE,
MOBILE HOME, APARTMENT AND/OR CONDOMINIUM) RE -ROOF PERMITS.
THE FOLLOWING IS REQUIRED TO BE PROVIDE ON THE JOB SITE:
PERMIT CARD, POSTED IN A CONSPICUOUS AND WEATHERPROOF LOCATION
COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK
COMPLETED AND NOTARIZED INSPECTION AFFIDAVIT
ALL FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS
PRODUCT APPROVAL SHALL MATCH WHAT IS ON THE SCOPE OF WORK)
DIGITAL PHOTOGRAPHS (MUST INCLUDE THE PERMIT NUMBER OR ADDRESS IN EACH PICTURE)
o EACH PLANE OF THE ROOF, SHOWING THE UNDERLAYMENT INSTALLED
o ROOF DECK NAILING PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
o ROOF DECK NAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHOWING SIZE OF NAILS)
o UNDERLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
o DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE OR RULER)
o SHINGLES INSTALLED, NAIL PATTERN AND LOCATION OF NAILS
SKYLIGHTS (IF APPLICABLE)
o DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL
o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT APPROVAL
FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE. DATE:
CITY OF
A 'FOIIS,,"N
mw Building cat Kre Prevention Division
RESIDMVTML R&ROOFSCOPE OF W0JW
JOB ADDRESS:
STRucruRE TYPE: SINGLE FAMILY REsm-NCEITOWNHOuSE O MOBILE HOME O APARTMENTlcONDt}lmILw
RE -ROOF TYPE: REPLAcajENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW CO,\iPONENTS)
RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): _:Py qkLrA
PLEASENOT'E. ONLY100 SQUAREFE-F-usTINGDECKIs PERM TTFD To BEREFIACED
ROOF VENTILATION: DOFF -RIDGE 94IDGE QSOFFIT OPOWERED VE1IT OTURBR IFS
SKYLIGHTS: OYES NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVA# L _
MAIN ROOF AREA --
ROOF SLOPE: O LEss THAN 2:12 O 2:12 - 4:12 4:12 OR GREkTER
TYPE OF ROOF MANUFACTURER FLORIDA PROIDucr APPROVAL
HiNGI E FL# U 11 i Oq
6N%TAL FL#
OMODMMBMMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
OTR,E FL#
0OTHER: FL#
ROOF EXTENSIONS (PORO HN PATIOS ETC) **IFAPPLlC4BLE**,
ROOF SLOPE: O LESS TxAN 2:12 0 2:12 - 4:12 0 4:12 OR GREATER
TYPE OF ROOF AiUvTWACl'URFR FLORIDA PRODUCT APPROVAL
O SIIINGIY- FL#
OMETAL FL#
OMODMM BTIUMEN FL#
O TORCH Dow, FL#
OINSULATED FL#
OTRX FL#
OOTHER: FL#