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HomeMy WebLinkAbout106 Belgian Way (2)g; JAN 11-1018 CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT A�PPLICATION F L Application No: 1 8 / © 6 Documented Construction Value: $ 13,520 Job Address: 106 Belgian Way Sanford Parcel ID: 18-20-31-505-0000-0190 Historic District: Yes ❑ No* Residential ❑■ Commercial ❑ Type of Work: New ❑ Addition ❑ Alteration ❑� Repair ❑ Demo ❑ Change of Use ❑ Move ❑ Description of Work: Tear off existing roof and install new asphalt shingles. Plan Review Contact Person: Title: Phone: Name Pedro Vasconcellos Street: 106 Belgian Way Fax: City, State Zip: Sanford, FL 32773 Name Covenant Roofing Street: 1410 Emerson St. Email: Property Owner Information City, State Zip: Leesburg, FL 34748 Name: Street: City, St, Zip: Bonding Company: Address: Phone: 386-503-2329 Resident of property? : Contractor Information Phone: 352-314-3625 Yes Fax: 352-240-3439 State License No.: CCC 1329936 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' Edition (2014) Florida Building Code Revised: June 30, 2015 Pennit 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: 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. n1t4 t i c) Lr Signature of Owner/Agent Date Signature o .ontractor/Agent 6ate , 1-7laid-r t. f-,jL-11" 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 Agent's p` ' Y Ul!C!<HAW Commission # FF 172-2 10 p'Ay Commission Expires October 288 Contractor/Agent is X 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 1 /4/2018 SCPA Parcel View: 18-20-31-505-0000-0190 i Property Record Card Oav Jo9alwa' CFA Parcel: 18-20-31-505-0000-0190 i �Owner: VASCONCELLOS PEDRO & COLEMAN MELANIE . saw r�o4wrv, Property Address: 106 BELGIAN WAY SANFORD. FL 32773 Parcel Information Parcel 18-20-31-505-0000-0190 t Owner VASCONCELLOS PEDRO & COLEMAN MELANIE Property Address 106 BELGIAN WAY SANFORD, FL 32773 Mailing 1106 BELGIAN WAY SANFORD, FL 32773 Subdivision Name BAKERS CROSSING PHASE 1 Tax District S1-SANFORD DOR Use Code 01-SINGLE FAMILY Exemptions 00-HOMESTEAD(2016) Value Summary 2018 Working 2017 Certified Values i Values Valuation Method I Cost/Market cost/market Number of Buildings t—_-------- _..___.._..__W 1 _ ._.._.. 1 Depreciated Bldg Value I $137,308 ___-_ �.._.......----------- -. _._.- .. $129,456 •: Depreciated EXFT Value _.._a i _.__-------- __._— Land Value Market $34,000 - I (Market) � _.___ I $34,000 Land Value Ag '" j Just/Market Value $171 308 $163,456 Portability Adj i.._.,._..........__._.._........_..___..._...__..._._...x,.._.._..---------....__.........._...._.._.-,.._,.....__...__,.._.......... Save Our Homes Adj $10,069 I $5,533 Amendment 1 Adj $0 P&G Adj $0 $0 Assessed Value $161,239 $157,923 Tax Amount without SOH: $2,324.61 2017 Tax Bill Amount $2,219.25 Tax Estimator j Save Our Homes Savings: $105.36 i ' Does NOT INCLUDE Non Ad Valorem Assessments Legal Description LOT 19 BAKERS CROSSING PH 1 PB 60 PGS 27 - 29 I Taxes Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund I $161,239 ! $50,000 $111,239 Schools $161,239 $25,000T $136,239 _..._ ..__._._...___._._....._.._..__._...._..___----..___.___-----.._..._..........._.._.__._.._.._.._t..... City Sanford ___..._...._....... .._ ._..__......___._ _ _._._-----__..._ � I $161,239 $50,000 _.._ �._----- _------._ _ $111,239 SJWM(SaintJohns Water Management) $161,239 If $501000 I $111,239 County Bonds $161,239 ' $50,000 $111,239 Sales Description Date Book Page I Amount Qualified Vac/Imp WARRANTY DEED i 5/1/2015 08481 1805 $167,000 Yes Improved WARRANTY DEED 7/1/2005 05849 1323 $100 No Improved WARRANTY DEED 5/1/2003 04868 029 a $159,300 Yes Improved WARRANTY DEED 15/1/2001 ; 04087 1765 $24,500 Yes Vacant Find ompan" Sales i Land Method Frontage Depth 1 Units I Units Price Land Value j LOT 1 $34,000.00 j $34,000 Building Information Year Built # Description Actual/Effective Fixtures Bed Bath Base Area Total SF Living SF ( Ext Wall Adj Value Rep[ Value Appendages 1 SINGLE 2003 8 . 3 2.0 ! 1 747 2,307 . 1,747 CB/STUCCO $137,308 $144,535 — ! ! Description. Area FAMILY FINISH OPEN 24.00 http://parceldetai l.scpafl.org/Parcel Detaillnfo.aspx? PI D=18203150500000190 1 /2 r� 1 /4/2018 SCPA Parcel View: 18-20-31-505-0000-0190 Permits FINISHED SCREENm mm PORCH 91.00 FINISHED — .._.—.....----- -_ _---- __.. GARAGE 445.00 FINISHED Permit # Description I Agency Amount I CO Date Permit Date 01019 PAD PER PERMIT 106 BELGIAN WAY I SANFORD $78,730 1 5/13/2003 2/1/2003 L-- --...........__......:..........._----- ----------------- ._............_...........---- ------- __..,....,,,-------------- _--- .._........_...,,,,,,,,.,------------------- ............- ----__..__-----_........_-----'------ __.---.--------------.....__._-----___.. .......................... ......... Extra Features Description Year Built Units Value ( New Cost No Extra Features http://parceldetail.scpafl.org/ParceiDetaiilnfo.aspx?PID=l8203150500000190 2/2 1410 Emerson Street, Leesburg, FL 34748 • State Roofing License: CM 329936 • License: CGC037504 Phone: 352-314-3625 • Toll Free: 855-314-3625 • Fax: 352-240-3439 • www.covenantrnc.com SALES CONTRACT Coven oo 'rig 8 Construction, I c ag to furnish all inaterials and la¢p r necessary to do the modernization workr at the following address: Name e- N, 31L " i�PM1ona (w) 9, "` Q ate 11L Address city , State—J_L__Zip Email G V i — 7 t In accordanc with specifications given below: REROOF: A. SHINGLE ROOF 1. REMOVE OLD ROOF TO WORKABLE SURFACE, 2. RENAIL ROOF DECK WITH RING SHANK NAILS, 3. REPLACE ANY ROTTED W04 WITH ST AF f}EIING d $ PER FOOT AN', I PER SHEET OF PLYWOOD, IF 4. INSTALL CN UNDERLAYM' , ,•!ER ENTIRE ROOF. 5. INSTALL FHA/VA EAVES DRIP. UALOR IIX 6. INSTALL NEW VALLEY METAL AND FLASHING$ AS NECESSARY. 7. INSTALL NEW LEAD BOOTS OVER VENT PIPES AND RESEAL VENTS , 8. INSTALL YEAR FIBERGLASS SHINGLES. COLOR 9. INSTALL FEET OF RIDGE VENT AT S@Q$flEFtFUOT. COLOR 4 10. CLEAN-UP JOB SITE OF ALL WORK DEBRIS AND HAUL AWAY ALL RELATED DE6 IS AND LEAVE JOB SITE CLEAN. 11. CONTRACTOR WILL COORDINATE REMOVAL AND REINSTALLATION OF ROOF RELATED PERIPHERALS SU T LIMITED AND AIR CONDITIONERS, ETC. REMOVE AND REINSTALL EXISTING SOFFIT AND FACIA d SC25 PER F ON 0 CONTF SUCH WORK WILL BE IN ADDITION TO CONTRACT PRICE AND HEREIN APPROVED BY HOMEOWNE 4 12, ALL WORK COVERED BY A 5 YEAB WORKMAWHIP WARRANTY. ITS, TV DISH THE COST FOR $ -----' -- ----- i. Contract Documents. This contract consists of this document extra work/wood authorizations, if any, and if payments Permit $----- 200-00----- hereunder are to be financec, all financing documents. No promises other than those specifically set forth in the contact documents shelf be recognized by either parry. The entire understanding and agreement of the partes Is contained in the contract documents. 2. it is understood and agreed that the contract shall not became bird ni; upon Covenant Roofing s Construction, Inc. until it is ddy Total $ approved, accepted, signed and witnessed by an officer or officers of the Seller j j �, y� -------------- 3. 'Work on the lob described in will canmence on approximately .(=1 U" LPand be completed on approximately The recited dates are approximations and are subject to scheduling difficulties of Seller, labor and/or material shortages, acts of Gal and other events not foreseen by Seller. Seiler reserves the right to employ any sub -contractor for the completion of me wait described in the contact documents. 1/3 Deposit $ --- 4. Covenant Roofing 8 Construction, Inc. reserves the right to substitute materials of equal or greater value and kind. Any required --------- materials such as fire retardant plywood, tongue and groovy board, etc. will be billed on a time and material basis. All other changes required by New Jurisdictonal Code Enforcement taws may result in additional charges. 5. Irfte85t at the rate of eighteen "t8%) per cur t per an xu will t mad on all balances not paid as per the terms specified j above. Reasonable attorneys times will b e charged to the hahurnaser tit s necessary to pie this contact in the bards of a Subtotal $ ---� f ---- ahomey for collection, and this charge becomes a pat of the contract atd ObllgatOn Of t7e Purchaser t0 pay. 6. Parties agree that this agreement shall be construed according to the laws of the State of Floridaand any action brought thereon may be brought in the State of Floda. Verwe Is hereby aped to be ll Lake County Florida 7. BUYERS RIGHT TO CANCEL (SOUCITED SALES ONLY) If you do not want the goods or services, you may cur oel l this agreernent by providing written notes selle to the r in , by t a by . This rooe must Irkfi tw youBALANCE DUE $ -- d not want the goods a services and must be defrvaed or postmarked ore madmidnight of me trod bxasmess clay aft you (Plus Total from Item No. 3 above) th war compensation and public liability insurance are carded by the Selax and they are applicableto the work to be UPON t' under stood and altered that t e tnryer told b armless Co ova ant Rooting 8 Canbtui on, ins., is arty damages that may to the �rya's drrveway(s} arrkg dal'Nay of materials ardior removal of the wok rebted that may be re)und to perform tit s Iwme improvement contract. Furthermore. t e yrye here n g were perm to typuxl defivay 7 vehicles and typical waste removal varnJoles ro ehter said drdueway(s) is the po?mse of expedrong this saw contract a w n word mate err ova ad ethsta ladon of oof wed per pherals such as (d t wt a tied to) sole units, skylights, V. d sh�s a d at caditrers, arc. The teat fa such work ri n be l dditbn to contract p ire ad app oved by homeowner. i . Roofing 8 CastucGon, I x. Imes, refrigerant linens a other mechanical components that have been improperty installed near o decking ad may be danced while performing insadai�n of WIN materials. Covenant ttoorrg a construction, Inc. shall not be responsible for arty tlonai costs due to roof dedu ng that may have oil materials adhered m such a way tat requires redaidng of strum tore. 12. Construction Industries Recovery Fund paymert be avail from the GRF if you Jose money on a project performed under contact, wham the loss rests from violations of Florida law by a state-ficensed contactor For information about the recovery fund and filing a claim, contact ft FloridaConstruction Industry Lieensfrg Board at the following telephone number ad address: 7960 Arlington Expressway, Suite 300, Jacksonville, FL 32211-7467 or can (904) 727-6530, 13, Chapter 558, Florida Statutes contains important requirements you must follow before you may bring any legal action for an alleged construction defect in your home. Sixty, days before you bring any legal action, you must deliver to the other ro this contract a written notice re" to chapter 558 of any allaged construction defects and to consider ma�g an offer to rew a pay for the anted cons r uton detects. You are not obligated to accept any offer which may be made, mere are strict deadlines under this Florida Law which must be met and followed to protect your Interests. Execule4 to triplicate, a copy of which as delivered to, and receipt is hereby acknowledged by Buyer, this day of , 2( Approved and Accepted: NOTICE TO OWNER a. Do not sign this home improvement contract in blank. b. You are entitled to a copy of the contract at the time you sign. Keep it t t t your rights (Seal) (X)J. �--�--� (Seal) (Dealer -Seller) (P chaser Ji n Here) BY (X) (Seal) le) (Purchaser Sign Here) SAMWAN FORD PRESS, INC. 352-787.4M A L—Wt SA-1 r2)Jc.KttRrn Crav�v� 1.�-{(Gi�' (iF'i'-NT I'IALOYr SEI1:tNOLE COUNTY r,(, 3`1v CLERK OF CIRCUIT COURT & COMPTROLLER NOTICE OF COMMENCEMENT BK 9i [5 r P3 1219 (1 h's s ) CLERK'S 2018004731 STATE OF Florida RECORDED 01/12/201.8 12:1.2:32 PM COUNTY OF Seminole RECORDING FEES $10.00 ItHORDED BY hdevare 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 property, and street address if available) 18-20-31-505-0000-0190 Lot 19 Bakers Crossing PH 1 PB 60 PGS 27-29 106 Belgian Way, Sanford, FL 32773 2. General description of improvement: Residential reroof 3. Owner information: CtSCc�nre 11u5 PV a. Name and address: Pedro VaReencef aT b. Phone number: 1 386-503-2329 c. Name and address of fee simple titleholder (if other than owner): NA 4. Contractor: a. Name and address: b. Phone number: 5. Surety: a. Name and address: b. Amount of bond $_ 6. Lender: a. Name and address: NA Covenant Roofing and Construction, Inc. 1410 Emerson Street, Leesburg, FI 34748 352-314-3625 c. Phone number: 0000000000 b. Phone number: NA 7. Persons with the State of Florida designated by Owner upon whom notices or other documents Florida Statutes: a. Name and address: NA b. Phone number: NA 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Florida Statutes: a. Name and address: NA b. Phone number: NA AND COMPTROLLER )(a)7, 20ib 9. Expiration date of notice of commencement (the expiration date is one (1) year from the date of recording unless a different date is specified) ONE YEAR 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 0 CO G YOUR NOTICE QF COMMENCEMENT. of Owner or Owner's Authorized Officer/Director/Partner/Manager Signatory's Title/Office The foregoing instrument was acknowledged before me this ZA day of G'�V ( by P2647) URSCOfI w (o S (name of person) as 0 uj,4e, r (type of authority, ...e.g. officer, trustee, attorney in fact) for p;) rtid( (name f-p behal om in ent was executed). r • CIA ANNE LEMAY - Signature of Notary Public — State of Flo ' a •., PATRICI ;'•,; Print, type, or stamp commissioned name otary Public •'c MY COMMISSION 0 FFWI"S EXPIRES Augus106, 2019 Personally Known �� OR Produced Identification 440739"153 vwaona. Type of identification produced Verification pursuant to Section 92.525, Florida Statutes Under penalties of perjury, I declare that I have read the foregoing and that tl ac s 4ated in it are true to the,, e,1� 15my knowledge and belief person signing above City of Sanford Building ,1si3 ; ',, and d Fire e Prevention .s, Product Approval Specification Form Permit # Project Location Address 106 Belgian Way Sanford 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 Hung Horizontal Slider Casement Double Hung 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 Certainteed Landmark 5444-R12 Underlayments FT Synthetics 20853-R2 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 Applicant's Name Pp ZTW/j (Please Print) June 2014 Limited Power of Attorney Date C 1 l V I hereby name and appoint Robert Horne of Covenant Roofing and Construction, Inc. to be my lawful attorney in fact to act for ny and apply to ) F02 0 fora permit for work to be performed at a location described as: Address of job: %0(,0 &-7,616 Joseph E. Rayl, Contractor Jic6n—se #CC)C1329936 Acknowledged: Sworn to and subscribed bef e me this �� / of J A , 20 1�,/ Lf By Joseph E. Rayl who is personally known to me or _ produced as Aidentiation. LAURA W ESTMAN ommission # GG 100690 lic, State of Florida %yauu`�A�,S My Commission Expires May 02, 2021 My Commission expires: 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 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: Z PERMIT # City of Sanford Building Division Residential Re -Roof Scope of Work JOB ADDRESS: 106 Belgian Way Sanford 32773 STRUCTURE TYPE: (@) SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM 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): 1/2" Plywood **PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERIVIITTED TO BE REPLACED ** ROOF VENTILATION: Q OFF -RIDGE Q RIDGE QSOFFIT QPOWERED VENT QTURBINES 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 Q 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL Q® SHINGLE Certainteed FL45444-R12 Q METAL FL# Q MODIFIED BITUMEN FL# Q TORCH DOWN FL# Q INSULATED FL# Q TILE FL# Q OTHER: FL# ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IF APPLICABLE** ROOF SLOPE: O LESS THAN 2:12 O 2:12-4:12 O 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL Q SHINGLE FL# Q METAL FL# Q MODIFIED BITUMEN FL# Q TORCH DOWN FL# Q INSULATED FL# Q TILE FL# 0 OTHER: FL# City of Sanford Building and Fire Prevention RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #:18 _qC0 ADDRESS: 106 Belgian Way Sanford, FL 32773 ,Joseph Rayl 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#: CCC1329936 COMPANY/CONTRACTOR: Covenant RoofI CONTRACTOR SIGNATURE: (MUST BE SIGNED BY LICENSE A FINAL ROOF INSPECTION IS REQUIRED: DATE: THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TINIE.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 OF ALL ROOFING COMPONENTS. STATE OF FLORIDA COUNTY OF Lake Sworn to and Subscribed before me this day of / 2018 by: Joseph Rayl Who is❑✓ Personally Known to me or has ❑ Produced (type of ide i�ication) as identification. Sig ure of otary iblic St a of Florida Lindsay Duckham Print/Type/Stamp Name of Notary Public �DDCI:NAM `aw„ LtNDSA 172210 6 � Commission IFExGires +_ MY Con.misslo 2018 I ` October - ��