225 Belgian Way - BR18-004511 - REROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Y`
D U r
Application No:
Documented Construction Value: $ la, gao •00
Job Address: aa5 &P101 a 50 nfOrd , 'L 31-1Historic District: Yes No 0 Parcel
ID: IS- 20 - 31 - 505 ` 0000 - Oq 16 Residential 0 Commercial Type
of Work: New 13 Addition Alteration Repair Demo Change of Use Move Description
of Work: ,,hl lf re, rQCf Plan
Review Contact Person: Title: Phone:
Fax: Email: Property
Owner Information Name
hnd kic r ch Street:
225 eelQlu I aU City,
State Zip: SaWrd Fi 32_113 Phone:
4M - 341 - 3q(o8 Resident
of property? : l l Contractor
Information Name
WiSCQT) 07m, +hiCt-fC n I f1C Phone: 32..E - 259- Street: '_;
05 NOM) dr, . She C Fax: 8(do- tom. - -7 933 City,
State Zip: N%b0()rAP -f-L- -,-*%4 State License No.: CCU 133C"195 Name:
Street:
City,
St, Zip: Bonding
Company: Address:
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 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 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 constr tion and zoning.
l
Signature of Owner/Agent Date Sig a e Contractor/Agent ate
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Print Copf oftor/Agent's Name
of Notary -State of Florida Date
OZpPus PABLOARES MY
COMMISSION # FF 953006 Q
EXPIRES: June 1, 2020 TFpPPIOPo9ondedThruBlca{Nptary garrier, Contractor/
Agent is \ Personally Known to Me or Produced
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: ENGINEERING:
COMMENTS:
of
Heads UTILITIES:
FIRE:
Flood
Zone: of
Stories: Plumbing - #
of Fixtures Fire
Alarm Permit: Yes No WASTE
WATER: BUILDING:
Revised:
June 30, 2015 Permit Application
0.4
W P_ S C ® NCONHT12l7CT10N. INC.
305 North Drive Ste. C
Melbourne, FL 32934
Tel: 321-259-6789
Fax:866-602-7933
CCC1330785/CGC1506914
WORK AUTHORIZATION
I hereby authorize Wescon Construction, Inc. to perform repairs on my property located at: 11a5' < <"'
per the scope of repairs provided to my insurance company
for claim QV
I further authorize my Insurance Company to release payment direct to Wescon Construction, Inc. for the servicesthatareperformedinconjunctionwiththeaboveinsuranceclaim. Should the Insurance Company require directpaymenttome, I hereby request that the name, Wescon Construction, Inc. be added to the draft that will be sent tomeinpaymentofsaidclaim.
This contract and any written agreement made pursuant thereto between Wescon Construction, Inc. (hereinafterCo" or "Company") and the customers named herein on the reverses side. This contract and any written agreementwillbesubjecttoallappropriatelaws, regulations and ordinances of the State of Florida and all parties agree that inanylegalactionarisingoutoftheContractandanywrittenagreementtheproperjurisdictionandvenueshallbeBrevardCounty, Florida courts. All parties hereby waive any jurisdiction or venue defense or arguments, which mayberaised.
In the event the Customer fails to pay Company any payment when due: interest on said amount at the rate of 2% per month or the highest rate permitted by law, whichever is lesser; and the Company's reasonable attorney's fees, expert witness fees, disposition, transcript fees and all costs associated with legal filling fees.
The re-roof/repairs performed by Wescon Construction, Inc. are based on Wescon Construction Inc.'s visualinspectionoftheareaofthereportedproblem. We cannot guarantee that no additional problems and damagedareaswillbediscoveredoncerepairsbegin. Customer acknowledges and understands that, after WesconConstructionInc. commences its work, new or additional problems may be discovered and that the price and time ofcompletionmaybeincreased. Customer also acknowledges and agrees that Wescon Construction Inc. is notresponsiblefordamagesorleaksduetoexistingconditionsorexistingsourcesofleakagesimplybecausework wasstartedorperformed.
We understand that Contractor has no connection with our Insurance Company or its adjusters and that we alonehavetheauthoritytoauthorizeContractortomakerepairs.
Due to nature of work, no completion date is specified. No verbal agreements are binding.
Per final approved scope of work: (}}' . IZ 9Zd D05 . " (q( iS p DD i
The undersigned hereby assigns any and all insurance rights, benefits, proceeds and any causes of actionunderanyapplicableinsurancepoliciestoWesconConstruction, Inc, for services rendered orto be rendered byWesconConstruction, Inc. In this regard, the undersigned waives his/hers privacy rights. The undersignedmakesthisassignmentinconsiderationofWesconConstruction, Inc, agreement to perform services and supplymaterialsandotherwiseperformitsobligationsunderthiscontract, including, but not limited to, not requiring fullpaymentatthetimeofservice. The undersigned also hereby directs his/her insurance carrier(s) to release anyandallinformationrequestedbyWesconConstruction,Inc, its representatives, and/or its attorneys for the directpurposeofobtainingactualbenefitstDbepaidbyhis/hers insurance carrier(s) for services rendered or to berendered.
Insured is responsible for any amount not covered by insurance company. Company limited warranty Re -Roof 5 Years Company limited warranty Repairair 1 Y
Owner's Name: tr a chi Signature: Date: I It WesconRepresentae: Signature: Date: WesconOfficer: Signature: Date
Grant Maloy, Clerk Of The Circuit Court & Comptroller Seminole County, FLInst#2018128288 Book:9247Page:31; (1 PAGES) RCD: 11/09/2018 12:08:37 PMRECFEE $10.00
This ins tp par"'y: i
Address.L12 L1dKT i 3a13Y
NOTICE OF COMMENCEMENT
STATE OF FLORIDA Permit #: _
COUNTY OF SEMINOLE PARCEL ID N:
CERTwa COPY GRANT MAWY -
CLERK Of THE CIRCUIT COURT
AND COMP RO^LLER ; i
31.ik'{iiSillLE COUNT Y,.Clyri"ilDii
6Y -' ti DEPUTY CLERK
Dafe
THE UNDERSIGNED hereby gives notice that Improvements will be made to certain real property, and inaccordancewithChapter713, Florida Statutes, the following information Is provided in this Notice of Commencement
V 0 9 2018
I' Description of Pro erty: (Legal description ofthe property and street address if available) t_ s / % IAn1 WA 1 3sq A1 0/fyl ' 3 773I -ao -3l - s p 7 oTzo
2 General Description of Improvements: __Sln to YIP vtlf? rrD 6,r4rvtPL{ 7f
3 Owner Name: -Z-1nitGC.-c A
Address: s,
Interest in property:
Name & Address offee simple titleholder: (ifotherthan owner)
4 Contractor's Name:
Address
5 Surety Name: Phone:
Address: rfrl
Amount ofBond:
b Lender Name: 4d Phone:
Address: W
7 Persons within the State ofFlorida designated by Owner upon who notice or otherdocuments maybe served as provided bySection
713,I3(I)(a) 7. Florida Statues: Name: Phone:
Address:
8 In addition to himself or herself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes: Name: n 1.4 Phone:
Address: •
L 7 -
0
9 Expiration Date ofNotice ofCommencement: • / [/ #-% ! Zd
the =pimtion dote is 1 yeaf from date ormcording unlcss a dlfrermt date is spceificQ
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 6 SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORECOMMENCINGWORKORRECORDINGYOURNOTICEOFCOMMENCEMENT.
Verlticntt n Pursuant to S4tclion4 2 Florida statutel
Under ties ofptxjury; I decla ave read the foregoing and that the facts stated in it are true to the best of my knowledge and belief.
ignati re of0 er orOwner I rize Signatory's Title/Office Officer/
Di or/Partner/ Msa lj , ,,, I,, Theforegoin instrument was acknowledged before me this _ day of t/Q" "r"i , 20, by c
B- ,
Jb a1 name
of person) as lti (type of authority, ...e.g. officer, trustee, attome in fact) or name
of party on behalf of whom instrumigit executed). SEAL)
rf
PABLOARES Signature Public, State of Florida io
iat. MY COMMISSION # FF 998006 EXPM-
June 1, 2020 Printor Elommisirned NaofNotwy Public P60.BAw-uewdNvysenlcasPersonallyKnownoProducedIdentificadop'I September 2017
PreventionBuildinandFireL
D City -of Sanford
Product Approval Specification Form
Permit #
Project Location Address 32 3
As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the
information and product approval number(s) on the building components listed below if they are to be
utilized on the construction project for which you are applying for a building permit. We recommend that
you contact your local product supplier should you not know the product approval number for any of the
applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in
accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product
Approval can be obtained at www.floridabuilding.org.
The following information must be available on the jobsite for inspections:
1. This entire product approval form
2. A copy of the manufacturer's installation details and requirements for each product.
Category / Subcategory Manufacturer Product
Description
Florida Approval #
include decimal)
1. Exterior Doors
Swinging
Sliding
Sectional
Roll Up
Automatic
Other
2. Windows
Single Hun
Horizontal Slider
Casement
Double Hun
Fixed
Awning
Pass Through
Projected
Mullions
Wind Breaker
Dual Action
Other
June 2014
Category / Subcategory Manufacturer Product
Description
Florida Approval #
including decimal)
3. Panel Walls
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles Fri
Underla ments L 322- R
Roofing Fasteners
Nonstructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Built up roofing
System
Modified Bitumen
Single Ply Roof
Systems
Roofing slate
Cements/
Adhesives /
Coating
Liquid Applied
Roofing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels
Roof Vents
Other
June 2014
Category / Subcategory Manufacturer Product
Description
Florida Approval #
include decimal)
5. Shutters
Accordion
Bahama
Colonial
Roll up
Equipment
Other
6. Skylights
Skylights
Other
7. Structural
Components
Wood Connectors /
Anchors
Truss Plates
Engineered Lumber
Railing
Coolers/Freezers
Concrete Admixtures
Precast Lintels
Insulation Forms
Plastics
Deck / Roof
Wall
Prefab Sheds
Other
8. New Exterior
Envelope Products
Applicant's Signature V StT ,V V o
Applicant's Name
Please Print)
June 2014
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
I hereby name and appoint:
an agent of: pC .
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:
R n W1 Q 11.1'1 00," GanfOrd Ft., 3277.3
Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name: Kgq OVG
State License Number: CCC 33%1 g5
Signature of License Hold . - h'=--
STATE OFF RIDA
COUNTY OF )-%, 4
The foregoing i tr ment w rcknowledged before me this day ofA, 2001L, by '"' 1 ow who is ersonally known
to me or o who has produced as
identification and who did (did not) t,49 an oath.
Notary Seal)
otYP stc PABLOARES
MY COMMISSION # FF 998006
EXPIRES: June 1, 202011-
ftio-, Bonded Thna Budget Notary SerrJ a
Rev. 08.12)
S
Print or type name
Notary Public - State of _
Commission No.
My Commission Expires:
NTORD
FIRE DEPARTMENT
JOB ADDRESS:
Li01`]uI0611.1
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
STRUCTURE TYPE: dSINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: G&PLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): Ph U w O Qd
PLEASE NOTE. ONLY 100 SQUARE FEET OF THE EXISTING DECKIS PERMITTED TO BE REPLACED**
ROOF VENTILATION: dOFF-RIDGE O RIDGE O SOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES 2NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: MAIN
ROOF AREA ROOF
SLOPE: O LESS THAN 2:12 O 2:12-4:12 64:12 OR GREATER TYPE
OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL SHINGLE
FL# 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
TORCHDOWN FL# 0INSULATED
FL# O
TILE FL# 0
OTHER: FL#
XNFORD
OF
Building &Fire Prevention Division
RESIDENTM4L REROOFPOLICY & 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 (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.
JZCONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE:
CITY OF
Building & Fire Prevention DivisionSFORDRESIDENTMLRE-ROOFAFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #; I V— ADDRESS: Qa15W
Sword . ) 2-7 3
I Kr i t Novo '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 #:nrr1. A, R30-1 96
COMPANY / CONTRACTOR:=
D- MUST1M.
p
1 _
CONTRACTOR SIGNATURE: DATE:
BE SIGNED BY LICENSE L
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 (MWfRTECT OR ENGINEER) TO CERTIFY, BASED ON PERSONAL
INSPECTION, THE INSTALLATION OF ALL ROOFING COMPONENTS.
STATE OF FLORIDA COUNTY OF 0 t, Ncd
Sworn to and Subscribed before me th s3 §Rk day of 20 A by:
wpyo . Who is jxersonally Known to me or has Produced (type of
iden as identification.
Sigjafure of Notary Public
State dfjqori a
A 1
XPEF.
Ty
QF t
FAc:DAltiw"s
M"f Cr1Ui:i5 dCV OFF S33335
1, 2'23
a.,d:lrrje='I = 7 =ors
Print ype/Stamp Name
of Notary Public