HomeMy WebLinkAbout1000 Stonebrook Dr BLDG 4 18-445543)SXNFORD
Y OF
NOV 0 5 2013 PERMIT APPLICATION
BUILDING DIVISION
Application No: LAS S
Documented Cogstru t o,4Ya� t � 7. G 4 D
Job Address: 10r)r) L` br)t3o rc)p V_ Or. . 1&804� 4 44 Historic District: Yes NoB
Parcel ID: 02— 20-'50 — 51°1 - O CO1 - 0000 Residential ❑ Commercial
Type of Work: New 0 Addition ❑ Alteration ❑ Repair ❑ Demo[] Change of Use ❑ Move ❑
Description of Work: s- tnal-e_ QC4 Qn,41Llronlp'r i
Plan Review Contact Person:
Phone:
Fax:
Property Owner Information
Name SV0nCby-0dL
(r ar,
,3 AipS ILC.
Phone: LLtr7 • 4G t . -6 8 t0
Street: 'Z->2_-1-7 W LIi InQ
Fpn PQr V- CI r cls
Resident of property?: h1 a
City, State Zip: Q larN
O R_
a2-7 GS
Contractor Information
�l
Name
Phone: 40-1. 2 -LO. t503
Street:2IB14 Wrt8"A. Qek.
441,tOt2
Fax: '9Zt• 23c1. tq_1
City, State Zip: C I teAo
et.
32'I (.5
State License No.: ti C' C I -62901-19
Name: i,� /k -
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
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.
w
L a
FBC 105.3 Shallbe inscribed with the date of application and the code in effect as of that date: 61h Edition (2017) Florida Building Code
NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that maybe 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 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 AFFIDA,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 N
Signature o . atary!Stale of Florida
C9 ok---
Signature of Contractor/Agent Date
,. #A
Print Cogtractort's Name
101 pl a
Date
Z A MY COMMISSION 0 GG 04867.8
EXPIRES: December 9, 2020
Bonded s�ictary Pule .!
Owner/Agent is Personally Kn /Agent is Personally Known to Me or
Produced ID Type of ID Produced ID Type of ID
BELOW IS FOR OFFICE. USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing ❑ Gas ❑ Roof ❑
Construction Type: Occupancy Use:
Flood Zone:
Total Sq Ft of Bldg: 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:
COMMENTS:
ENGINEERING:
UTILITIES:
FIRE:
WASTE WATER:-
BUILDING:
ATER
BUILDING:
DocµSign Envelope tD:,550130B9-EAE7-4D64-BB1F-0F816M935F2
EXffiBIT A
SCOPE OF WORK
Full Shingle RoofReplacement—Buildings3,4, and 9:
1. Priorto mobilization, perform on-site pre -construction meeting with
management to determine general guidelines for work.
2 Establish staging area to locate job box (if needed), portable toilets, and surplus materials.
3 Perform the required safety inspection and installation of all safety equipment
per OSHA and current Performance Roofing guidelines.
4. Performance Roofing will provide full time supervision for the duration of
your reroofing project.
5. Remove existing single layer of shingle roofing and all accessories from roof.
Remove all existing shingle fasteners from decking.
CL Inspect existing decking. Remove and replace up to 10 (ten) sheets of
damaged plywood decking per building. Any additional rotten or
deteriorated plywood will be replaced onadditionalchangeorderbasiswith
ownerapproval.
7. Clean and inspect flashing along walls to prepare for new roofing system (flashing
that is secured behind siding or stucco will not be replaced. Replacement of
damaged flashing may be completed at unit cost pricing).
R Mechanically fasten new ASTM 06757 roof underlayment over the entire roof area to
properly dry -in roofing system.
9 Fabricate and install new L -flashing where missing at fascia return to roof line
transition to prevent wind-blown water intrusion.
10L Install Owens Corning Weatherlock G self -adhered :underlayment in all valley
locations to properly flash areas.
11. Install new pre -painted galvanized cave drip to perimeter of roof in owner's
choice of available standard colors.
1Z Install new lead pipe boots to properly flash plumbing penetrations and
new painted galvanized gooseneck vents.
13 Install new Owens Corning Starter Strip Pius starter shingles and new Owens
Corning Oakridge Dimensional shingles over the entire roof area in owner's
choice of available standard colors.
14 Cut ridge and install new Owens Coming VentSure shingle -over ridge vents at
peaks of roofto provide ventilation.
15. Complete roofing system by installing Owens Corning Pro Edge Hip and Ridge
Accessory shingles at all hips and ridges for proper wind lifts and warranty
applications.
16. Includes obtaining necessary permit to complete scope.
17. Performance Roofing will Iawfully remove and dispose of all debris and rubbish created by the above
proposed scope of work.
ROOF SYSTEM COVERED BY OWENS CORNING PREFERRED PROTECTION ROOFING SYSTEM
LRArIED WARRANTY
• Increases manufacturers Tru Protection Period (non pro -rated material warranty) to
20 -
YEARS on Owens Corning Oakridge Dimensional shingles.
• Preferred Protection Workmanship Warranty included for 10 years.
• Warranty is transferable one time.
PERMIT #
j City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: (�i�r�.�Y[�'�tC. �� .:31•
STRUCTURE TYPE:. O SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME (APARTMENT/CONDOMINIUM
RE -ROOF TYPE: &REPLACEMENT (TEAR OFF EXISTINGROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY):
**PLEASENOTE: ONLY100 SQUARE FEET OFTHE TING DECCISPERMITTED TO BEREPLACED**
ROOF VENTILATION: eOFF-RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES OINO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN RooF AREA
ROOF SLOPE: O LESS THAN 2:12 02:12-4:12 e4-.12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
&SHINGLE
7
FL# 10 L -1 L4 3
OM's
FL#
0MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
O INSULATED
FL#
OTILE
FL#
(26OG
THER:
FL# -i a .e 4 74
I"
ROOF EXTENSIONS (PORCHES. PATIOS. ETC.I **IFAPPLICABLE**
ROOF SLOPE: O LESS THAN 2:12 02:12-4:12 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
O SHINGLE
FL#
O META-
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
O INSULATED
FL#
TILE
FL#
1O
00THER:
FL#
CITY OF
Building & Fire Prevention Division
S.,&i4FOR-DRESIDENTIAL RE-
ROOFPOLICY &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 CONDOMmum) 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: /A61 a
y�NFORD� •
-`00 • ,
=BUILDING DIVISION
0C i 0 1 2018
PERMIT APPLICATION
Application No:
Documented Construction Value: $ -5-7, b 4 D —
Job Address: 100r) 0.s Ont_b rocD k Dr. . UciG14v-4 Historic District: Yes❑ NoO
Parcel ID: 02 - 2 D - *50 — 5 161 - O G O 1 - 0000 Residential ❑ Commercial 9
Type of Work. New [3 Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: Sit trl 1'c' Q"o K P :C L1ro rn2r%+
Plan Review Contact Person:
Phone:
Fax:
Email:
Property Owner Information
Title:
Name ane brOclG ®r lnr*A_ o ,CfAr ILC_ Phone: 40-7 • 401 t tO
Street: E,217 W Z tngkon Poxv, Ct t Glle- Resident of property?: N a
City, State Zip: Or l e rne, FL SZ -7 GS
^ Contractor Information
Name l G*prrr10.nC.2 ?on{' nq Phone: 40-7. ZIO. 1S03
Street: -2-1914 Wr L9N}S IZA. # 10t2. Fax: 3 21- 23q. l d-13
City, State Zip: 32"1 LS State License No.: CCC t 32419-741
Architect/Engineer Information
Name: ► /A- Phone:
Street:
City, St, Zip:
Bonding Company:
Address:
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: 61h Edition (2017) Florida Building Code
NOTA[ F: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that maybe found in the public
records of this county, and there may be additional permits required from other governmental entitles 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 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 construction and zoning.
Signature of Owner/Agent Date Signature of Contractor/Agent Date
PrintOwner/AgenPs Nam Printeo tractor, 94at's Name Q
Signature of otary-State of Florida a. [>a„, .�,.;. �.rabNotary-State of Arida Date
kkMARIELS D.YR:EVEOC
MIELSDded Thor Notary Public nder•aiters �i
Owner/Agent is _Personally Kno oniract4r/Agent is["Personally Known to Me or
Produced ID Type of ID Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing ❑ Gas ❑ Roof ❑
Construction
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:
City of Sanford
Building and Fire Prevention
v n
Product Approval Specification Form
Permit #
Project Location Address 1000 HIAA JA- 4
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.floddabuilding.ora.
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 Florida Approval #
Description include decimal
1. Exterior Doors
Swinging
Sliding
Sectional
Roll U
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(including
Florida Approval #
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
-Owens Cornln
Q.V-r'6%C t tn1enstona
F L I -LA 12_1
Underla ments
TFL L-1 yZp. Q
Roofing Fasteners
UI
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
Roofinq S stems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels
Roof Vents
Ow&n S corntn
V re.
"' t0 1S8 -W7
Other
June 2014
Category Subcategory
Manufacturer Product Florida Approval#
Description include decimal
5. Shutters
Accordion
Bahama
Colonial
Roll u
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
Applicant's Name
(Please Print)
June 2014
Grant Maloy, Clerk Of The Circuit Court & Comptroller Seminole CountyFL
Inst #2018123003 Elook:9238 Page:1653; (1 PAGES) RCD:10/25201812:42:08 PM
REC FEE $10.00
j, THIS INSTRUMENT PREPARED BY:
Name: Daniella Acevedo
Address
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number.
CERTIFIED COPY GRANT MALOY
AND OF THE CIRCUIT COURT t
SFtii`. Lr.^7DyLLER
141 FLORIDA
BY UTYCLERK
Oate
Parcel ID Number. 02-20-30-1 MC01-0000
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.
I hiHl1 1 l: OF PROPERTY: (Legal description of the property and street address if available)
iing�a SC epi�acemen�- Inge 3,4 & 9
OWNER INFORMATION:
Name: Stonebrook Orlando ADIS., LLC
Address: 5277 Wellington Park Circle, Orlando, FL 32839.4626
Fee Simple Title Holder (if other than owner)
CONTRACTOR:
Name: Performance Roofing LLC
Address: 2784 Wrights Rd. Ste. 1012, Orlando, FL 32765
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)(b), Florida Statutes.
Name:
In addition to himself. Owner Designates
To receive a copy of the Lienors Notice as Provided in
Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement (The expiration date 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 108 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.
Under5t=!
that I have read the foregoing and that the facts stated In R are true
to the lef.
S,�a� tree Asa F ✓�t�.7
1QSnvv.PMflodk4ar7e
Mores Statute 713.13(l)(g):'The wmermoat sign me ratite d commencement aid no one Noe row b Mnnifted to sign in he or her stead.'
Stateof 41o.vd0. Countyof SPn-r+.r,ott-
The foregoing instrument was acknowledged before me this -10day of _ 00,600,61100v`e.29 LS
by CV\a& .. 52�,FQT W t.. Who is personally known to me L7
Name d Parson making NawmeN
OR who has produced identification ❑ type of identification produced:
fpt' MARIELS D.ACEVEDO
MYCOMMISSIONp GG 668828
EXPIRES: December9,202Dr+'1°a
„? n7;•• awdWTlw NotoYPuMkI1Me)imbn
r\
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT#: I Q)— /4455 ADDRESS: (cc7 9�-lnnebrmV_ Dr • '"U 4+
-'+)()/
i-
I ,AnndrPA,. I -A. Ci
ROOFING CONTRACTOR, ENGINEER, AR
FOREGOING INFORMATION IS TRUE AND
-'hl()l-J13a1v
, AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
IE AND THAT ALL ROOFING COMPONENTS LISTED ON THE SCOPE OF WORK ATTHE
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
COMPANY/CONTRACTOR:
CONTRACTOR SIGNATURE:
(MUST BE SIGNED BY LICENSE
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: ( k I a
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,
I NDERLAYMENT, 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,rn�r>o('G
Sworn to and Subscribed before me this "L. day ofNa VF P tEF_20 (g by:
of Notary Public
?ersonally Known to me or has 0 Produced (type of
as identification.
lam]D. ACEVEDO
MY COMMISSION # GG 048628
`- '�" EXPIRES: December 9,2020
?o �:;?,"••�' BondedThru Notary Public Underwriters