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216 Meadow Hills Dr - BR18-004484 - REROOFI/ CITY OF Building & Fire Prevention Division wSjkj4FORD NOV Q 5 2018 PERMIT APPLICATION FIRE DEPARTMENT Application No: Documented Construction Value: $ 9975.00 Job Address: 216 MEADOW HILLS DR SANFORD, FL 32773 Historic District: Yes NoPl' Parcel ID: 10-20-30-5CS-OF00-0030 Residential Commercial Type of Work: New[] Addition Alteration Repair Demo Change of Use Move Description of Work: Re -Roof; 30 Year Arch Shingles Plan Review Contact Person: Andy Adcock Phone: 407-322-9558 Title: Owner Fax: 407-322-9592 Email: adcockroofingl @bellsouth.net Property Owner Information Name DEIR, GORECKI SUSAN Street: 216 MEADOW HILLS DR City, State Zip: SANFORD, FL 3277f Name Adcock Roofing Street: 800 S. French Ave., City, State Zip: Sanford, FL 32771 Name: NA Street: NA City, St, Zip: NA Bonding Company: Address: NA NA Phone: (407) 547-7849 Resident of property? : Contractor Information Phone: 407-322-9558 Fax: 407-322-9592 Yes State License No.: CCCO22501 Architect/Engineer Information Phone: NA Fax: NA E-mail: NA Mortgage Lender: NA Address: NA 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. 1 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: 01 Edition (2017) Florida Building Code c NOTICE: Iii addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records ofthis 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 ofthe 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 1CC 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. gnature ofOwner/Agent Date s r n •z'o r"c% P i Agent's Name Signature of Notary -State of Florida Date DONALD RASH Y Notary Public -State of Florida Commitfion # FF 221,706 My.Sms°5, Expires Apr 16, 2019 ature of2!!5r/Agent Date Print Cav&ir,nt's Name 2otaa Pis; DONALD RASH Notary Public - State of Florida MvCO rr'EY res Ap?16019 Owner/ o Me or Contractor/Agent is Persona Produced ID J,,- Type of ID p Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Date Known to Me or Permits Required: Building Electrical Mechanical Plumbing Gas[] Roof Construction Type: Total Sq Ft of Bldg: Occupancy Use: Flood Zone-, Min. Occupancy Load: # 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: WASTE WATER: FIRE: BUILDING: CITY OF Ski4FORD Building & Fire Prevention Division RESIDENTIAL RE -ROOF POLICY & PROCEDURES U VFIREDEPARTMENT 4 9(/ 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: /(' S' -2-o 1 ,f Grant Malo , Clerk Of The Circuit Court & Comptroller Seminole Count, FLInst #20181y26578 Book:9244 Page:541; (1 PAGES) RCD: 11/6/2018 16:35:12 AMRECFEE $10.00 THIS INSTRUMENT PREPARED BY: Name: ADCOCK ROOFING - ANDY ADCOCK Address: 800 S. FRENCH AVE. SANFORD, FL 32771 Permit Number: Parcel ID Number. 10-20-30-5CS-OF00-0030 The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available) LOT 3 BLK r HIDDEN LAKE UNIT 1-15 PB 17 PG 54 2. GENERAL DESCRIPTION OF IMPROVEMENT: Re -Roof 3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and address: DEIR, GORECKI SUSAN• 216 MEADOW HILLS DR SANFORD FL 32773 Interest in property: OWNER n " wee Simple Title Holder (if other than owner listed above) Name: f vil1ddress• 4. CONTRACTOR: Name:_ Adcock Roofing Phone Number: 407-322-9558 Address: 800 S. French Ave., Sanford, FL 327711 5. SURETY (If applicable, a copy of the payment bond is attached): Name: Address: Amount of Bond: 6. LENDER: Name: Phone Number. Address: . 7. Persons within the State ofFlorida Designated.by Owner upon whom notice or other documents may be served as provided by Section713.13(1)(a)7., Florida Statutes. Name: Phone Number. Address- 8. In addition, Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number. 9. Expiration Date of Notice of Commencement (The expiration is 1 year from date of recording unless a different date is specified) 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 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. Signature &Cfwneror Lessee, orOwner's or Lessee's Authorized Of6cer0rector/PartnerMlanager) Print Name and Provide Signatory's Titie/Otffce) State of t .'112 .I.b %c Countyof 21A I kLG L The foregoing instrument was acknowledged before me this day of 20 by L l / V . L `L Who ispersonally known Name of person making statement who has produced identification type of identification produced: r '' ar¢,•., DONALD RASH NotaryPubiic- StateafFodda r• .. t. , Commission9 {F 221706 0 <<s tors;,,+' My Comm.ExiiuesApr16,2019 Not 800 French Ave. adcockroofinr www.adcockrooflng.com STATE CERTIFICATION CCCO22501 October 31, 2018 ESTIMATE Name: Susan Gorecki Phone: (407) 547-7849 Address: 216 Meadow Hills Dr. Cell: (407) City: Sanford, FL 32773 Fax: (407) Email: suegoreckil@outlook.com SCOPE OF WORK: COMPLETE ROOF REPLACEMENT 1. Remove old roof on complete house. 2. Re -nail decking. 3. Dry in with new layer of synthetic underlayment. 4. Install new 30-year architectural shingles. 5. Install new (2x2) skylight. 6. Install new drip edge; 26 gauge, painted galvanized. 7. Install new kitchen and bathroom vents. 8. Install new lead flashings on plumbing pipes. 9. Install new ventilation — install (2) new off ridge vents. 10. Secure all permits. 11. Clean up & haul away debris. 12. Inspections included. Labor & Materials: $9975.00 Extra — Bad wood: Time & Materials - $70.00 per sheet plywood; 2 x 4 and fascia - $4.50 ft.. Warranty: 30 Years on Materials from Manufacture 10 Years on Workmanship Andy Adcock, Owner Andy Adcock 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): ' /a " 12 Ly w no n PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTAGDEcikis PERMITTED TO BEREPLACED * * ROOF VENTILATION: OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT 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 (D/4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL O SHINGLE r}'i FL# O METAL FL# O MODIFIED BITUMEN FL# OTORCH DOWN FL# O INSULATED FL# O TILE FL# O OTHER: FL# ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLICABLE** ROOF SLOPE: O LESS THAN 2:12 Q 2:12 - 4:12 O 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL O SHINGLE FL# O METAL FL# O MODIFIED BITUMEN FL# O TORCH DOWN FL# O INSULATED FL# O TILE FL# 0 OTHER: FL# CITY OF Building & Fire Prevention DivisionSkORDRESIDENTIALRE -ROOF POL ICY & PROCEDURES FIDE DEPARTMENT j NT 1 - yct 9/ 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: rant Maloy, Of The Court omptroller Seinole County, FLcuitInt# 018125178 Book 9244rPage:541 8(1PAGES) RCDn11/6/ 018 10:35:12 AM REC,FEE $10.00 THIS INSTRUMENT PREPARED BY: Name: ADCOCK ROOFING - ANDY ADCOCK Address: 800 S. FRENCH AVE. SANFORD, FL 32771 Permit Number. Parcel ID Number: 10-20-30-5CS-OF00-0030 The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available) LOT 3 BLK F HIDDEN LAKE UNIT 1-15 PB 17 PG 54 94 GENERAL DESCRIPTION OF IMPROVEMENT: Ike -Roof OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and address: DER, GORECKI SUSAN• 216 MEADOW HILLS DR SANFORD FL 32773 Interest in property: OWNER Simple Title Holder (if other than owner listed above) CONTRACTOR: Name: Adcock Roofing Phone Number: 407-322-9558 Address: 800 S. French Ave., Sanford. FL 3277'i 5. SURETY (if applicable, a copy of the payment bond is attached): Address: Amount of Bond: 6. LENDER: Name: Phone Number. Address: 7. Persons within the State of Florida Designated. by Owner upon whom notice or other documents maybe served as provided by Section 713.13(1)(a)7., Florida Statutes. Phone Number. 8. In addition, Owner designates to receive a copy ofthe Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number: 9. Expiration Date of Notice of Commencement (The expiration is 1 year from date of recording unless a different date is specified) 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 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. Ir (Signaturo er or Losses, is or Lessee's (Print Name and Provide Signatory'sTille/Office) Authorized Officer/Director/Partner/Manager) State of _._112 _[ h % County of Q1AA The foregoing instrument was acknowledged before me this day of _ - _ `r J \ T 20 :' by —S 62 V n Whois personally known to Name ofperson making statement e C), , who has produced identification type of identification produced: ''\ DONALD HASH Notary Public -StateofFlorida Commission # FF 221706 My Comm,EnpiresApr18,2019 Notaryst r t,' Phcv& y CITY O SkNFORD Building & Fire Prevention Division RESIDENTIAL RE-ROOFAFFIDAVIT TIRE OEPARTMENT RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #: _I ADDRESS: 21 1W eq /W 4._, j7 &zt f Av (—o c),(- '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#: 6G L b a:-'s-z / I COMPANY/CONTRACTOR: +^I 6 f4r Vl- I CONTRACTOR SIGNATURE: DATE: /I b 7 MUST BE SIGNED BY LICENSE HOLDER 2LC11yNER/BUILDER) e14 ;oo Pam/ THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINA 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 Sej4A01,ZL G Sworn to and Subscribed before me this ! day of PQ0 J 20 11s' by: l i,,J.P AQ QL_>J--- . Who is Personally Known to or has Produced (type of ide n) as identification. State of Florida vi. Ir L1 rint/Type/Stamp Name of Notary Public a r My Co m.Exores. DONALD RASH Notary Public -State of Florida Commission # FF 221706 My Comm. Expires Apr 16, 2019