HomeMy WebLinkAbout136 Brushcreek Dr 17-377; RE-ROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: i / - 31-7
Documented Construction Value: $ , 6% • ( S
Job Address: ( 36 Uri,.S1-CrCC /C r Historic District: Yes No
Parcel ID: 33 - 11 - 30 - 516 UUO - 14-7 l-) Residential [`Commercial
Type of Work: New a Addition Alteration Repair Demo Change of Use Move
Description of Work: I pear 0-i z
Plan Review Contact Person: e",(_„
Title: ('i Ce /w+C/
Phone: f0= {Z?Cjtt Fax: 40-6ol-Z1qct7 Email: 0-& 4nel-/od4CC0_
Property Owner Information
Name /-+'lrQ J l-Jy Phone: -(D7-'-O t{
Street: 13C bfus e( t: ` bi' Resident of property?: L
City, State Zip: /G, fL 32-1 `7 I
L
Contractor In
Name1A 47,e Gt' 'f iGG S c Z4__X APICPhone: _ `401 - YZO -W 0 J Street:
S r Fax: ((tJ') - 601- "I q--(-1 City,
State Zip:Of"') 1'L i SU6 /1 State
License No.: C.(-C 13 Z 8?'7 Cl 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, beaters, 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: 51 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 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: 1 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 ofOHner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Matt'.&L-7z
Signature
ofConA,,1,4
tractor/Agedtr Date
Print Contrac r/Agent's Na c
Signature o
SONJA M ROBERTS
y MY COMMISSICN N FF970513
EXPIRES March 10.2020
Me? 3RA-0 53 flwot:.Yu:. .:»r.rw :w. •
Owner/Agent is Personally Known to Me or Contractor/Agent is VPersonally 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:
Total Sq Ft of Bldg:
Occupancy Use: Flood Zone:
Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes[] No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
DIRE:
Plumbing - # of Fixtures,
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30.2015 Permit Application
TAG General Contractors Inc.
r .
r
517 19T"Street
Orlando, F'l. 32805
Orlando 407.420.7900 Fax: 407-601.7997 0
FL License CGC-061644 Roofing CCC•1328779 ATLASGeneralContractorsInc. WWWABRrooLcoln
AGREEMENT
THIS AGREEMENT IS SUBJECT TO INSURANCE COMPANY APPROVAL OF PAYMENT PS NO INITIALCUSTOMER
STREET SPECIAL INSTRUCTIONSCreaJy
CITY -vlb' /d ST / 4- ZIP 32%7/ M fi:r, y(! dpv:.zc% 5,51r t
CELL f'07-6 Y `0?X/ H011E
EMAIL ADDRESS />'Ndi,.,/j,1.L Jam 6--w-7 4t,-1
Project Manager
SPECIFICATIONS
6 MAtYUFACfURER OF SHINGLE 14,-1gs
O'ITYLE OF SHINGLE
0 COLOR OF SHINGLE•w!
EKALLEYS t-v/ -Y'
Q VENTS SCa Hobe* 0 STYLE
J6 TEAR OFF 0 YES IAYER (2) e rFP.4,YmENTOPITCH162STORYySI950,%
PERMIT FURNISHED $ REPLACE ALL BOOT JACKS FINAL PAYMENT DUE AFTER ROOF COMPI.FrED
i6 SYNTHETIC UNDERLAYMENT %I ICF & WATER SHIELD [.,ROLL YARD WITH MAGNE"1' ROLLER
6] PROTECT LANDSCAPE WHERE NEEDED N DRIP EDGE KEEP/ REPLACE. COLOR
TERMS:
tog Grnerd Contnuws the, iiconsldercd•w be oieuetilt roo/ln0 conumOr CCC 1321[Mjarid Ge` aV-Conmc ajCGGL0 l644 THIS GOK I'ItAGr DOES N"OBLIGATETHEPROPERTYOWNERURTagl'Genera boo&&- W(AN'Y WAY UNLESS fr is APPRO%FD BY;THE PROPERRJON FJtS L\SURiI\CF CO IPAXY and or
HO IFOWNFR AND ACCF 1!Q Bl- rog[General Conu"rs.'IBv sibm G lr IS AGREEAF-NT THE 6PERTLY, Oti _IRRFAUTHORIZFSITAG-1TOIPURSVE THEPROPERTYOUN-ERS IfEST INTEREST FOR PROPEERTI REPLACE IF.\T OR REPAIR AT'A -POCEF AGRcFaB fi- TO THE PROPERTY /TERS INSURANCE
COMPANY AND TAG-1VTTH NO ADDI TIONAL COST TO THE PROPERTY OWNER OTHER THAN THE. INSURANCE DEDUCTIBLE_ WHEN 'PRICE AGREEABLE'
HAS BEEN DETERMINED IT SHALL BECOME THE. FINAL CONTRACT AMOUNT AND THE PROPERTY OWNER AUTHORIZES 'TAG' TO OBTAIN LABOR AND
MATERIAL IN ACCORDANCE WITH THE 'PRICE AGREEABLE' AND SPECIFICATIONS SET OUT HERI.N A.ND ON THE REVERSE SIDE HEREOF TO
ACCOMPLISH THE REPLACEMENT OR REPAIR. THEREFORE TAG' ACTING AS YOUR CONTRACTOR WILLBE wTITLED TO ALL INSURANCE PROCEEDS IN ACCORDANCE NTrH
THIS AGREEMENT. ALL PRICES ARE SUBJECT TO CHANGE YOU. THE BUYER. MAY CANCEL THIS PURCHASE AT ANY TIME PRIOR TO MIDNIGHT
OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS AGREEMENT. TAG GENFRALCONTRACTORS I.\C.DISC/.US/S All WAR"WIES, EXPRESSED OR
IMPLIED n:4RR4A7T OF dIERCHAATAB1LrFV OR FITNESS FOR A PARTICULAR PURPOSE EYCEPT AS SPECIFIC.ILLY EXPRESSED ON THE REVERSE
SIDE OF THIS AGR£EVENT. IF FOR ANT REASON THIS ROOF IS NOT COVERED BY INSURANCE AND THE HO.sI£OHiV£R WOULD UIiE US T'OPROCEED {PITH THE WORK IT WOULD BE THE RESPONSIBILITY OF THE. HOMEOWNER TO PAY IN FULI. FOR THE ROOF. SIGN BELOW
IF YOU WOULD STILL LIRE US TO PROCEED RTTH THE WORK AND YOU HTU. PAY FOR I . OF THE WORK QUOTED. By I fG
UNDERSTAND ROOF IS NOT COVF,RF,D BY INSURAA'CE AND G E TOFIN FOR ROOF. CUSTOMER HAS READANDAGREESTOALLTERNSA\D CO\DI \S .' FR / Q C OF 19AGRF.EI1fEAT. ACCEPTED BY HOMEOWNER(S)
ON: DATE 1/ I SDI ICe BY X CO.OWNER: DATE / I
BY x TAG REPRESENTATIVE: DATE L
J 4L BY X Insurance Company Policy I
Claim I •ppn-cd r Denied / Pending Insurance Phone Email Fa%
Adjuster Phone Email Inspection
Date Time Deductible Mortgage Lneal Y/
N Loan a Phone
THIS INSTRUMENT PREPARED BY:
Name: TAG General Contractors Ina
Address:_ 700 Hourglass Dr
Orlando. FL 32806
NOTICE OF COMMENCEMENT
Permit Number.
Parcel ID Number. —s117—t70M)^ I%-i'70
ttirl. C ktilf ED C6PY • Gp,nf(MAbCLfRY.Of w} t CIP.CL11t
AND CCNIPi
SEMI .
U
o PUTY CLERK
8Y 6 In,t
The undersigned hereby gives notice that improvement will be made to captain real property, and in accordance with Chapter 713, Florida Statutes. thefollowinginformationIsprovidedinthisNoticeofCommencement.
1. D BCRIP / • i F PR E TY g I d og the an e Ore 1 eval lagl.)
PGS ZL 241
I /./
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Re -roof
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name end eddress: inla>/ew L e— v y /36 C3tih CrPe /r D:'
Interest in property: DI nCJ
Fee Simple Title Holder (a other than owner listed above) Name:
Address:
4. CONTRACTOR: Name: TAG General Contractors, Inc. Phone Number: 407420-7900
Address: 1700 Hourglass Dr. Orlando, FL 32806
S. SURETY (11 applicable, a copy of the payment bond Is attached): Name:
Address: Amount of Bond:
6. LENDER: Name: Phone Number.
Address:
T. Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section713.13(1)(e)7., Florida Statutes.
Name, Phone Number:
Address:
S. In addition. Owner designates of
to receive a copy of the Lienols Notice as provided in Section 713.13(1)(b). Florida Statutes. Phone number.
9. Expiration Date of Notice of Commencement (The expiration Is I year from date of recording unless a different date Is specified)
WARNINr TO OWNFR• 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 IMP OVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THEJOBSITEBEFORETyIRSTPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEYBEFORECOMWORECORDINGYOURNOTICEOFCOMMENCEMENT.
6t,y
Frw WaNd am Vrmile SigraftrO T1110*15 .1
State of RoaAA County of
The foregolnpiensstrumentt was acknowledged before me this day of
by _ r " 1'w Jy Who Is personally known to me 5/0R
NiR10r Iasi•, Y41 1U111,Ir
who has produced Identification O typo of Identification produced:
ge.
SONJA M ROBERTS
MY COMMISSION M FF97DS/3
EXPIRES March 10.2020
14704114117 r.„u,w,• +u.. mom•
MARYANNE MORSE, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL
CLERK'S # 2016129379 BK 8824 Pg 0367; (1pg) E-RECORDED 12114/2016 09:44:59 AM
10.00
City of Sanford
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. / 7a, .17 7 ISSUE DATE: 04- D ?. 1 7
CONTRACTOR: *4 19 Ak
JOB ADDRESS: 13 rkSh ere. ek Uve TYPE
OF WORK: PROTECT
FROM WEATHER Post
this Permit and all required documents in a conspicuous place outside Digital
Photographs are required - please follow re -roof policy and procedures guide All
trash, debris and dumpsters must be removed from job site at final inspection Permit
exaires six (6) months from date of issue ROOF
INSPECTION
TYPE APPROVED REJECTED INSPECTOR FINAL
ROOF FAILURE
TO FOLLOW THE RESIDENTIAL RE -ROOF POLICY & PROCEDURES WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION FEE AND
MAY REQUIRE AN AFFIDAVIT, SIGNED AND SEALED, FROM A REGISTERED FLORIDA DESIGN PROFESSIONAL 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. 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. FBC 105.3.3 REVISED:
February 2017 Inspection Line 855.541.2112
TO SCHEDULE AN INSPECTION:
Dial855.541.2112
Provide the items requested during the message
The type of inspection requested must be scheduled under the appropriate permit type
Follow the prompts
PLEASE NOTE: Inspections scheduled by 3:30 p.m. will be conducted the
next business day. If you experience difficulty, please call 407.688.5150
Monday - Thursday 7:30 am - 5:30 pm for assistance.
AUTOMATED INSPECTION SYSTEM CODES
ROOF
Final Roof 111
Miscellaneous Notes:
REVISED: FEBRUARY 2017 Inspection Line: 855.541.2112
f '
City of Sanford Building Division
Residential Re -Roof Inspection Policy & Procedures
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 SanfordHistoricPreservationBoard
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 OWNERIBUILDER) SIGNATURE: DATE: Z
D PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOBADDRESS: !36 gruck Izei-_ br
STRUCTURE TYPE: G(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 (PI.F.ASF. SPECIFY): - LN LA) Wot
PLEASE NOTE.- ONLY 100 SQUARE FEET dr THE EXISTING DECK IS PERMITTED TO BE REPLACED
ROOF VENTILATION: eoFF-RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES 01<0 IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 (4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCTAPPROVAL SHINGLE
l!i s FL# 6 3os- /. METAL
FL#
0MODIFIED
BITUMEN FL# 0TORCH
DOWN FL# O
INSULATED 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# OTORCH
DOWN FL# O
INSULATED FL# O
TILE FL# Q
OTHER. FL#
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
Page 2
Application Number . . . . . 17-00000377 Date 2/08/17'
Property Address . . . . . . 136 BRUSHCREEK DR
Parcel Number . . . . . . . . 33.19.30.516-0000-1470
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 972117
Permit pin number 972117
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 BL03 FINAL ROOF _/_/_
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: ' I,' { _ ? r 4
I, fV1.m. hereby acknowledge that I personally inspected
@'Roof deck nailing and/or /Secondary water barrier work
at and have determined that the work
Job Site Address) I I
was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.)
I certify that my statements herein are true and accurate to the best of my belief and that I fully
understand that making any false statements in writing with the intent to mislead a public servant in the
performanp of his or her official duty shall constitute a misdemeanor of the second degree pursuant to
Secti
eA
Signature Contractor Date
iRal-1w CXX,*43Z5AZy
Printed Name of Contractor License #
License Type: 0 General 0 Building 0 Residential 0 Roofing Contractor
0 or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF seedZ-
Swot (or affirmed) and subscribed before me this 3L day of n 20 / 7 , by
11 , a who is 0 Personally Known to me or bas* oduced (type of
Ve
ti) f2rn'tebg 3/1 ni /i en as identification.
SEAL)
a re of tary Public
State of Florida '
LADONNA'RUPP
yL Notary PUOIIC • State of jPrint/Type/Stamp N e •COmml11aloe # FF 968ofNotaryPublica0omno10h11nAlWWa`
4
3
D City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: l I - 3-7-7 ADDRESS: 13 ll!:: 6a45 C L o rLe- Dr
I fIrm 1 (2LI-4 Mi0l 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 #: LCC
COMPANY/CONTRACTOR
CONTRACTOR SIGNATURE
MUST BE SIGNED BY LICE
A FINAL ROOF INSPECTION IS REOUFRED:
1,1wle-
DATE: ((
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, FLASMNG, 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 004 n4e_
Sworn ttoo/
13'
and Subscribed before me this `t L day of /" 4 CA 20 by:
g I o'xw Wk—. Who is Personally Known to me or has 0 Produced (type of
identification)
O
as identification.
r- _A
Signatur f Notary Public ,!"'"';: SONJA M R OBERTSStateoforida &
el
z''c Mr COMMISSION# FF970513
p! ,,,•EXPIRES March 10.2020
04C7o39A-0+g3 flwKIONUW. 9wvr y„• Print/T /Stamp Name
of Notary Public