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2421 Orange Ave - B R18-004267 - REROOFk A ikORlj rC • OCT I 6 1018 PERMIT APPLICATION Application No: Documented Construction Value: $ _ Job Address: aa `I (72MC le ,7't t' . , Historic District: Yes El NoE Parcel ID: Residential 201commercial D Type of Work: New [. Addition Q' Description ofWork Ag_"' Plan Review ConttacctPerson: Piione:3 Z I Ig`(01? Fax.. ff'Repair [:]. DemoO` Ch4nge of Use 0 1Vlove Q 21IM-Em''E" EA12 Property Owner Information Name 'fitt e V Ea a Phone: Street: Or Resident of property?: e City, State Zip: }'FL S2M I Name 1-\ Street: . City, State Zip: Name: Street: City, St, Zip: _ Bonding Company: Address: Contractor Information I QD Fax: F--P4 State License No.: CcU s l z 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 permitto do the work and installations as indicated. I certify thatnowork or installation -hascommenced 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 secored'for`elettrical` work, plumbing" signs; wells, pools, furnaces, boilers, heaters, tanks, and'air conditioners, etc. 01 L V FBC.t05J Shall:be:inscribed with the date of apptication•and,the code in effect as•of thatdaW 6"' Edition.(20I.7) Florida -Building Code 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 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 ofthe 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 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. Signature of Owner/Agent Date Print Owner/Agent's Name k . '17)II(di6CJAVISignature o ontractor/Agent Date a Print Signature of Notary -State of Florida Date Si V P I%, ANNETTE BLAND Notary Public - State of Florida Commission # GG 060623 Owner/ Agent is Personally Known to Me or oiYC,Qa`sr/gA nR. ExpiresY@PsWnlfll8 nown to Me or Produced. ID Type of ID Produce y e BELOW IS FOR OFFICE USE ONLY Permits Required: Buildin qg F1.Electrical El Mechanical Plumbing Gas Roof Construction Type: Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: Flood Zone: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: Fire Alarm Permit: Yes No WASTE WATER: BUILDING: Grant Maloyy, Clerk Of The Circuit Court & Comptroller Seminole County, FLInst #2018'(18921 Book:9232 Page:1124; (1 PAGES) RCD: 10/16/2018 10:26:06 AM REC FEE $10.00 THIS INSTRUMENT PREPARED BY: Name: Address: Permit Number. Parcel ID Number. -?I 19'"31--,570 CER.PF • - -SY C;!??AITMALOY CLE AND BY I ' Oate ---- 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: Ronal description of 2. GE RAL DESGRI 710N IMPROVEME lOFNT: Q t Z 3. OWNER INFORMS) Name and address: A Interest in property: U w IF THE .IIEESSEE CONTRACTED FOR n 41 v _'? A// , Fee simple Title Holder (if other than owner listed above) S. SURETY (if applicable, a copy of the payment bond is attached): Name: Address: Amount of Bond: 6. LENDER: Name: WOVE, Phone Number. Address: a. F4. 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(1)(a)7., Florida Statutes. 8. In addition, Owner designates Phone Number 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 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. jq Signature of Owner or Lessee, or Owner's or Lessee's (Print Name and Provide Signatory's Title/Office) Authorized Officer/DirectorfPartnerNanager) O State ofCounty of f The I' egoing instrument was acknowledged fore me this day of G 201 d 11`—'- by C A ) rL A n X ) 0- Who is personally known to e OR m aeof person mm g stateent .I who has produced Identification C pe of identification produced: l U(`l o `J ( I Y r5 KATHLEEN MARTIN KIRKMAN i MY COMMISSION * GG 22053E Notary Signature EXPIRES: May 21. 2022 E WAY n%j%jr11MU MIMLJ r1r.1V1%jLjQL_L.11MU 02 N Hwy 1 Ste 14 Beach,Ormond 3217,1 9 !e 6;e a e,: o x Proposal submitted to:Jo-, c,-n 4 e_ L Ai Street: D i ,, City, State, Zip: Lc A4 rJ Claim # wf 1CCOOr TISA S 1LhLLi u asa www°floridapreferred roofer.com Phone: © S 5 Job Name: Job Location: Insurance Co: SPECIAL INSTRUCTIONS: EJ Exisitng T j' 1, a n e— Repair kReplaoe With er " rn t tp' St le of Shingle p' Color of Shingle iq v e- Install Felt p j Valley Type Ef Replace Plumbing Jacks Metal Edge Size Color ' a / Eaves And/or Rakes VeEl ntsGalvanized Nails, 6 Per Shingle patio or Flat Roof 5 i- 5 o s z r osS') / Er Exisiting # Of La ems Tear Off: Yes lEf No Roof Pitch Z p' Manufacturer's Limited Warranty Year Guarantee on Labor tiers Cleaned Of Roofing Debris ET e Way Roofing To Furnish All Material and Labor can Up and Haul Off All Trash From Roof P otect Landscape Where Needed II Yard With Magnetic Roller P rmit Fumished by One Way Roofing Insurance Papers Provided ADDITIONAL INFORMATION: 1 3e, e Y_ 04- 1 om C f `S Ja r} — e3 . S c 1s d fi©i tnC%c z- 7 14 we+i S7a /tee' S tc ' One Way Roofing will invest its time and expertise in assisting the Nom xownor with their insurance claim, This propoea- tTSexmUhyani uponiho insurer= camperty. n u on -the Insurance company paying for the root, and will be voided only It the claim Is disallowed by the Insurance company. Neither tho Homeowner nor One Way Rooting will be otbigotad Wass the repairs are approved by Homeowner' s insurance company. The Insurance company will determine and eel the price of the claim; the Homeowner agrees to allow One Way Roofing to complete the work as specified on the Insurance Loss shoat, for stated replacement costs. Thar* shall be no additional cost to the Homeowner. The Homeowner's outofpoast expense shall not exceed the deductible amount We hereby prupose to furnish materials and labor, complete in accordance vAh the aboe InFifications, forthe sum of: 7 Dollars S$ Payment to be made as follows: The first ineurnace check due upon acceptance of contract. Balance of the roof loss due upon completion of work and receipt of insurance proceeds. Balance of any k due pon completion of those prof ts. Proposal written by: ,, lyy` "t'.5 1 f— !z Date: i Z0 —/ 6 Cell Phone: l t Acceptance of P osel• The above to s and condltions and those contained on the reverse side are satisfactory end h by accepted, One Way Remodeling is out rized to Ipt; 5 the rlf, and will be specificed by any i ran ompany. Payment will ade as specified. h / u om Signature Date Cust or Signature Date PLEASE READ IMPORTANT NOTICE A TERMS ON REVERSE rE. r, cv c 1. C / ' y s a G/}s ctl e eo,,y 10l4t Federal law requires that we give you the following notice of Ilen rights afforded ,to persons or companies furnishing labor or materials for the improvement of real property. NOTICE Notice of cancellation: You, the buyer, may cancel this purchase any time prior to midnight of the third business day after the date of this purchase. The contract on the face hereof and any agreement made pursuant thereto between One Way Roofing and Remodeling, herein after "the company" and the customer(s) will be subject to all appropriate laws, regulations and ordinances and to the following special terms and conditions. 1. It is agreed that the amount of the contract shall be the amount equal to the replacement cost value as stated on the Homeowners Insurance Loss Sheet if applicable. 2. The company has the right to order excess material. These materials will not be charged above the agreed -up- on price. All excess material belongs to the company. 3. Supplements paid by the insurance company for additional labor and materials needed beyond the original scope of repairs shall be paid directly to the company. 4. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from the above specifications involving extra costs will be Supplementsily upon written change orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents, or delays beyond our control. Owner to carry fire, tornado, and other necessary insurance. 5 This agreement constitutes the entire agreement between the company. It may be changed Only by written instrument signed by both parties in an email or text. 6. If any provision of this agreement should be held to be invalid or unenforceable, the validity and enforceability of the remaining provisions of this agreement shall not be affected hereby. 7. Any prepresentation, statements or other communications not written in this contract are agreed to be immaterial, and not relied on by either party, and do not survive the execution of this contract. 8 The company is not responsible for any damage below the roof due to leaks, wind in excess of 60 mph, ice, hail, or pre-existing or future construction defects caused by storms or lack of maintenance during the period of warranty. g Should default be made in payment of this contract, charges shall be added from the date thereof at a rate of eight percent (8%) per annum, with a minimum charge of $2.00 per month, and if placed in the hands of an attorney for collection, all attorney fees, costs and legal filing fees shall be paid by the customer accepting said contract. 10 These conditions shall be considered a part of any contract entered into, including the contingent agreement when the work is approved and will be paid for by the insurance company, the same as if they were included therein. 11 Homeowners agreement to the contingency statement on the front of this contract holds the entire contract to the valid and binding as long as the insurance company approves to pay the Homeowner for the loss. 12 The dollar amount of the contract is the amount allowed by the insurance company for the approved scope of loss, plus any agreed -upon upgrades and the deductible, if applicable. 13 The final payment in full shall not be held up while awaiting city inspection of the work. The company agrees to meet or exceed all city inspection requirements. Thank You Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: d I hereby name and appoint: P-4- an agent of: 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 oueel Huuress) Expiration Date for This Limited Power of Attorney: License Holder Name: V ` (a State License Number: C V nt 1 o1'ao N"O ale- Signature of License Holder: oaaq M C d STATE OF A CQ COUNTY OF The foregoing instrument was acknowledged before me this 4 day of_, 200 1 , by 'Cl who is personally known to me or who has produced QZ as identificzltion and who did (did not) take an oath. Signature NotAGE K A TPUBLIC STATE OF COLORADO NOTARY ID 20054029852 MY COMMISSION EXPIRES 07129/2021 Rev. 08. 12) Print or type name Notary Public - State of Commission No. ? X0—VTL My Commission Expires: CI 2. 2,1 PERMIT # — `A Do —7 City of Sanford Building Division Residential Re -Roof Scope of Work STRUCTURE TYPE: SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM RE -ROOF TYPE: 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: (YO'FF-RIDGE Q RIDGE Q SOFFIT QPOWERED VENT SKYLIGHTS: O YES Q-W- IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: MAIN ROOF AREA ROOF SLOPE: O LESS THAN 2:12 O 2:12-4:12 O 4:12 OR GREATER Q TURBINES TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL DISHINGLE cenc FL# 1_) Y t Q METAL FL# D V40DIFIEDBITUMEN FL# Q TORCH DOWN FL# QINSULATED FL# Q TILE FL# Q OTHER: FL# ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLICABLE** ROOF SLOPE: Q<ESS THAN 2:12 Q 2:12-4:12 Q 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL T_ CYSHINGLE FL# 14 O METAL FL# D' ODIFIED BITUMEN FL# Q TORCH DOWN FL# O INSULATED FL# Q TILE FL# 0 OTHER: FL# CITY OF Building & Fire Prevention DivisionSkNFORDRESIDENTIALRE -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 WiI.LBE INSTAL LED 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"FIISTORIC DISTRICT WILL REQUIRE PLAN REVIEW ANDAPPROVAL BY THE SANFORD HISTORIC PRESERVATION BOARD INSPECTION POLICY & PROCEDURES A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMILY, '`OWNHOUSE, 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 W14AT IS ON'TLTE SCOPE OF WORK) DIGITAL PHOTOGRAPHS (MUST INCLUDE THE PERMIT NUMBER OR ADDRESS INEACH 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 Ft PRODUCT APPROVAL FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN PROFESSIONAL (ARCIIITECT OR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION. CONTRACTOR (OR 'OWNEW UILDEk) SIGNATURE:c"JacY DATE: , F City of Sanford Building and Fire Prevention RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT C 16 ADDRESS: . Ei 3'a3a I I mc"l 11 Wr EC l , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR ROOFING CONTRACTOR, ENGI EENGIEENR, ARCHITE , 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 #: CCC 1 3 Q-3 COMPANY/CONTRACTOR: CONTRACTOR SIGNATURE: .Idly / ' ! DATE: MUST BE SIGNED BY LICENSE HOLDER OR OWNER/B Ir DER) 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 OFALL ROOFING COMPONENTS. STATE OF FLORIDA COUNTY OF Uzl p Sworn to and Subscribed before me this ( -7_ day of 20 by: A A. Who is personally Known to me or has Produced (type of Identification) as identification. Sign ure of Notary Pu lic State of Florida Notary Public State of Fkvft Printfrype/ Stamp Name Crystal Anne Smith of Notary Public War") MY Commission GG 266522 Expires 1OJ1412022