HomeMy WebLinkAbout117 Gleason CoveDocumented Construction Value: $ 8,120
Job Address: "µ 117 G'LEASON CV, SANFORD FLr32773 Historic District: Yes ❑ No
Parcel ID• 02-20-30-523-0000-1430 Residential V Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: RE -ROOF / -Il.�g 2 m IC)r o i-d Ski')U(® f-e S 12e�1 e_ e_ W i i4n
�� �-rc.v A-��r4 s � �ryv �4Gl-G ,S 1., �'�t L•�1,� s �'/ //�'�o. S"-�S�
Plan Review Contact Person:
Phone: 407 403 1596
Name EDWIN ENCARNACION
HUGO AGUILERA Title: ROOFER SUPERV
Fax: Email: TRUTEKWATERPROOFING@GMAIL.COM
Property Owner Information
Phone: 407 687 4204
Street: 117 GLEASON CV, SANFORD FL 32773 Resident of property`.' : YES
City, State Zip: SANFORD FL 32773
Contractor Information
Name TRU-TEK WATERPROOFING INC Phone: 407 885 3805
Street: 11621 GRAND BAY BLVD, CLERMONT FL 34711 Fax: 407 885 3805
City, State Zip: State License No.:
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Architect/Engineer Information
N/A Phone:
Fax:
E-mail:
N/A
CCC 1331331
Mortgage Lender: N/A
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 1.05.3 Shall be inscribed with the date of application and the code in effect as of that date: 51h Edition (2014) Florida Building Code
Revised: June 30, 201 5 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 71 1.
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 constructs oning.
/—Z t
S ' 71re of ow Date Signature of Contractor/Agent Date
eDep+ to
Print Owner/Agent's Name Print Contractor/Agent's Name
mature of Notary -State of Florida Date nature of Notary -Slate of Florida Date
N1
�O rr Notary Public Stets of Flonda ova x4� N=Stateof FlondaJulio C Veras : JMy Commission FF 952974 y r 952974a Expires 01/21/2020 '�tapd'p E
Owner/Agent Is PP orally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID ✓ Type of I �r�- Produced ID � Type of ID� DL
BELOW IS FOR OFFICE USE ONLY
PermitsRequired: Building❑ Electrical❑ Mechanical[] Plumbing❑ Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
Flood Zone:
# of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes ❑ No ❑
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
# of Heads
UTILITIES:
FIRE:
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: ,tune 30. 2015 Permit Application
f CFa Property Record Card
16
Parcel: 02-20-30-523-0000-1430
ans Property Address: 117 GLEASON CV SANFORD, FL 32773
Parcel Information
Parcel
02-20-30-523-0000-1430
Owner
ENCARNACION, EDWIN
RODRIGUEZ, DIANA I
Property Address
117 GLEASON CV SANFORD, FL 32773
Mailing
117 GLEASON CV SANFORD, FL 32773
Subdivision Name
PLACED WOODS PH 2.
Tax District
S1-SANFORD
DOR Use Code
01-SINGLE FAMILY
Exemptions
00-HOMESTEAD(2003)
+ 40 40 0 40
z 4 141
40 40 45 45 40
Seminole County GIS
Legal Description
LOT 143
PLACID WOODS PH 2
PB 58 PGS 4-6
Taxes —�
Amendment 1 Adj i $0
P&GAdj --- -- .__ $0 $0
Assessed Value
��$76,465 ($74,892
Tax Amount without SOH: $1,789.00
2017 Tax Bill Amount $639.00
Tax Estimator
Save Our Homes Savings: $1,150.00
" Does NOT INCLUDE Non Ad Valorem Assessments
Taxing Authority
1
Assessment Value Exempt Values
Taxable Value
J
County General Fund
$76,465 1
$50,000 i
$26,465 J
Schools
i $76,465 1
$25,000
$51,465
City Sanford
--___-.---- _
_ -- ��— $76,465 y $501000
$26,465
SJWM(Saint Johns Water Management)
! $76,46851,
$50,000 1
$26,465
County Bonds
; $76,465
$50,000 1
$26,465
sales
Description Date Book Page Amount Qualified VaGlmp
SPECIAL WARRANTY DEED 1 6/1/2001 04130 0980 $92,500 Yes j Improved
Find Comparable Sales
Land
Method Frontage
Depth Units Units Price Land Value
LOT i
j 1 i $28,000.00 ! $28,000
Building Information
s Bed/Bath count incorrect? Click Here
# Description Year Built Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Rep] Value Appendages
ActuaVEffective
1 1 SINGLE 2001 6 ; 4 ! 2.0 1,406 1,880 j 1,406 CB/STUCCO j $124,469 $131,713 j
— — , 1 Description Area
FAMILY I FINISHGARAGE
j
FINISHED 266.00
1 200.00
Tru TekWaterproofing Inc.
11621 Grand Bay Blvd. • Clermont, FL • 34711
Name P, t7� �i�z-'
Address1 / 7 ( o-►t) ev- (/
City/State/Zip S'dt4CA2cT22,72
Phone
407-885-3805 • TruTekWaterproofing@gmail.com
Licensed & Insured • #CCC1331331
RE -ROOF SPECIFICATIONS
We hereby submit the following proposal:
TO 3-TAB SHINGLE
_ Tear of existing
_ Remove existing slope roof to a cleaDworkable surface.
_ Replace all rotten sheathing and cia.
_ Re -nail existing roof deck p BC 3401.8 (h)
_ Tin tag 30# base sheet. M
_ Peel & Stick
_ Replace all lead cks and metal vents.
_ Install Class " fungus resistant fiberglass shingles in choice of color
_ Color of S gles to be
_ Shingl o have a minimum 25 year manufa
_ Slope roof to have a 5 year warranty against
due to workmanship.
TO CEMENT TILE
_ Tear off existing
Remove existing slope roof to a clevrworkable surface.i"
Replace all rotten sheathing.
_ Re -nail existing roof deck pe BC 3401.8 (h)
_ Tin tag 30# base shee_ t. A M �- -- -
_ Peel & Stick "
Replace all eave do ` ;etal with new galvanized eave drip metal.
_ Replace all lead cks`and metal vents.
Hot mop 90# m neral surface roll roofing over base sheet.'
_ Install flat or double roll cement tile in choice of color.
_ Color and manufacturer of tile to be: Category #1
—Tile to be installed with Poly -Foam AH-160'roof tile adhesivef
_ Slope roof to have a 10 year warranty againstdeaks''ddueto workman
Repair
TO DIMENSIONAL SHINGLE O l Tear of existing
Remove existing slope roof to a clean w rkable surface.
Replace all rotten sheathing and fascia.
Re -nail existing roof deck per SFBC 3401.8 (h)
Tin tag 30# base sheet. ASTM
Peel & Stick
Replace all lead stacks and metal vents.
Install Class "A" fungus resistant fiberglass shingles in choice of color.
Color of Shingles to be
__ Shingles_to,ha.ve-a-minimum 40 year manufacturers warranty.
Slope roof to have a 5 year warranty against leaks due to workmanship.
LAI'lJLUN
' .Tc�r nff cvic4inn
I Replace all rotten sheathinc
I Re-naii existing roof dec
i Tin tag 75# base ?
_E Peel & Stic
Repla eave drip metal
R ce all lead stacks and
_ Replace flashing to slope rc
i'Peel &,-Stick Base
Peel•&-Stick•Membrane
_ Flat roof -to have a 5 yea(w
id- (Insulation �.
to a clean workable surface.
3401.8 (h)
--_y,
vith,new galvanized eave drip metal
netal ,vents.f• k
,fas necessary.
rranty against leaks due to workmanship.
Other m _�
..:_ . -
Clean up and remove -roofing materials upon completion of work. _Secure all permits as necessary-for-the=above,
10 Year Warranty on Labor on all Re -Roofs
We propose hereby to furnish material and labor - complete in [accordance with above s ecifications, for thesum f_
-el
lL� 0 4 /Y,C 4,,,.,O /�iC.e k tA,^JIDiA,%i/ rinlinmL.1Z
PAYMENTS TO BE MADE AS FOLLOWS: % DOWN AND / % UPON COMPLETI
Finance charge per month on unpaid invoices after 30 days after completion of job.
All work will be completed in a workmanlike manner according to standard practices. Any alterations
additional cost and will be performed only in event of a written order executed by the authorized parties.
under the terms of this agreement is contingent upon any strikes, accidents, or death beyond our control
Owner to carry fire, tornado, liability and any necessary insurance.
Authorized
Note: This proposal may be withdrawn by us if not accepted within 15 days
Acceptance of pro osaI - The above s, specifications and conditions are satisfactory and are hereby
specified. Pa n ill be made as utli d above.
Signature Signature
Date of Acceptance
res.
/ 00
s shall be at
roofing, Inc.
uthorized to do the work as
Tru Tek Waterproofing Inc.
STANDARD TERMS AND CONDITIONS OF THIS CONTRACT
1. Tru-Tek Waterproofing, Inc. guarantees that all materials furnished will be of standard quality, type
and condition and will be installed, built or applied where applicable in a good and workmanlike manner,
said labor and material guaranteed against material defects for a period of year(s) from
date of installation, the liability of Tru-Tek Waterproofing, Inc. for defective material, work or installation
under this guarantee is limited to the replacement or correction of said defect.
2. Due to the nature of the work and use of hot asphalt, owners must assume responsibility for
removing vehicles, closing windows, closing or removing awnings and any other objects that tar
may fall on or drip or and cause damage to. If tar falls or drips on the paint or stucco, Tru-Tek
Waterproofing, Inc. will do its best to remove the tar but the owner will be responsible for any touch-up
(re)painting.
3. The buyer agrees to afford Tru-Tek Waterproofing, Inc. with water and electricity.
4. We cannot assume responsibility for any damages done to the roof by plumbers, electricians, air
conditioning repairmen or any other tradesmen.
5. The prevailing party shall be entitled to recover all costs including reasonable attorney's fees in
the event that any dispute arises under this contract, this shall apply whether suit be instituted or
not. All delinquent accounts shall bear interest at a rate of 18% per annum.
6. WE DO NOT GUARANTEE our roofing against leakage due to fire, hail or tempest, nor to
punctures made by fastening or wire fixtures, nor the erection of any hatchway, penthouse,
flagpole, pipe or other structure, support or brace subsequent to the completion of our work.
7. WE DO NOT GUARANTEE AGAINST LEAKS CAUSED BY TERMITE INFESTATION.
8. In the event that a lien is filed for non-payment, the homeowner will be invoiced an additional
$50.00 and $25.00 for removal of same at the final payment of this contract.
9. WE DO NOT GUARANTEE AGAINST IMPROPER BUILDING OR FLOOR DECK
CONSTRUCTION.
10. WE DO NOT GUARANTEE against any acts of nature or winds above 30 miles per hour.
11. Customer must be aware that in the event that their roof goes through a hurricane all Warranty
& Guarantee are voided.
Iv
11 111 Hill 1111`1111111111111111 fill 11111
THIS INSTRUMENT PREPARED BY:
Name: TRU-TEK WATERPROOFING INC
Address: 11621 GRAND BAY BLVD, CLERMONT FL
34711
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number:
i`{ T i°h;:...s_1 t
iii= + IR :UI T Gf)!_}RT r. C: VIPTROLLER.
CLERK'S � 2018012h51r
( L';_:iJi?[;r:IJ 0 i- I
-EC0R1"`G FEES
,,
!t!_:;'. R�;_1'. i s i flcl{ ',tur t
Parcel ID Number: 02-20-30-523-0000-1430
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.
DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
LOT 143 PLACID WOODS PH 2 PB 58 PGS 4-6
117 GLEASON CV, SANFORD FL 32773
GENERAL DESCRIPTION OF IMPROVEMENT: _A A RE ROOF / C.Q-%i_ �/�_ % Of-U ,S ✓>Q
it . o.. I ... -A., t. e G1_ _ _ r o�l �� 2nC'� t7 t--
OWNER INFORMATION:
Name: EDWIN ENCARNACION
Address: 117 GLEASON CV, SANFORD FL32773
Fee Simple Title Holder (if other than owner) Name: N/A
Address:
CONTRACTOR:
Name: TRU-TEK WATERPROOFING INC
Address: 11621 GRAND BAY BLVD, CLERMONT FL 34711
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:
Address:
In addition to himself, Owner Designates
N/A
of
To receive a copy of the Lienor's 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 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 OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true
to the b b y-k a d belief.
0 %"s
Sin re Owners Printed Name
Florida a 3.13(1)(g): "T owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead."
State of ',Z,t'( - County of �b4tc-e f
�/Jt1yQ-2
The foregoing instrument was acknowledged before me this day of 20 �b 4
by ❑ `A� �J l�/.. .Who is personally known to me
Name
person making
OR who has produced f identification statement
e/of identification produced:
P L�yp P
c00.4e =State of Flonda? `Ay 952974oiR 0
ro_gn_.qn-,;qa-nnnn_1dan
Waterproofing
POWER OF ATTORNEY
Date: Z//'t 8
I hereby name and appoint J V AO 42140&0k) 2111,ey'l# $r4xd'4
of-/P- to be my lawful attorney -in -fact to
act for me, and apply to the Division of Building Safety fora �c'JDE= AtN permit
for work to be performed at a location described as:
Parcel ID #: Section Township Range Subdivision Block Lot / TJ
(15 Digit Parcel Number)
Subdivision Name:?ZACM LkJ(DOLS Ma 1�� _?C�s
Owner of Property:0A) W 1 M C PVCAy N 6gCi O KD
Project Address: I I')r C-1 I e 14so ►D CV,
City: GAA11�IRb,HL Zip Code:a244.;
and to sign my name and do all things necessary to this appointment.
JACO O PORTILLO
(Contractor Na (Ty e or Print)
(Contractor Si ature)
CCC#1331331
(Contractor's License Number)
The foregoing instrument was a�i nowledge4 before me this
who is personally known to me or who produced
as identification and who did not take an oath.
JULIO C. VERAS
Notary Pub is (Print name)
ary Public (Signature)
Seal
day ofTeV) ,Prr-
�n ► Notary Public State of Flonda
s° Julio C Veras
my commisvon FF 952974
' Expires 0112112020
Tru-Tek Waterproofing, Inc.
11621 Grand Bay Blvd Clermont, FL 34711 1(407) 885-3805 1 Trutekwaterproofing@gmail.com
CITY OF
Building & Fire Prevention Division
` &k14FORD RESIDENTIAL RE -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 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 OWNERBUILDER) SIGNATURE: DATE: I . Zz r-
CITY OF
{SkNFORD!PERMIT #
Building &Fire Prevention Division
{ 1; E E} A R ' ` RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: J (� �r /SeAt-SD >V G 1/
STRUCTURE TYPE: SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: PLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): ('U vto a
* *PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED**
ROOF VENTILATION: QPf -KIDGE Q RIDGE SOFFIT QPOWERED VENT QTURBINES
SKYLIGHTS: O YES ONO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 -4:12 :12 OR GREATER
TYPE OF ROOF
MANUFACTURERS
FLORIDA PRODUCE APPROVAL
O SHINGLE
/! �u �,�
FL# 30 S 2 S
O META-
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
Gr6HER: 2 ru h c. ! `L
/L14 P
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 TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
CITY OF
SkNFORD
Building &Fire Prevention Division
RESIDENTLAL RE-ROOFAFFIDAVIT
r1f2E DEPART EP: i
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: / g— y e— ADDRESS: //� � ) Cy
I "z-Iweo I ( �0 � `/ 0 , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, ENGIN ER, 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 REQUIRENJIENTS (BASED ON F.S. CHAPTER 553.844).
LICENSE #: It?
COMPANY/CONTRACTOR: Wf�i/�1lZl���. j►,
CONTRACTOR SIGNATURE: _
(MUST BE SIGNED BY LICENSE
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: �Z3
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,
d UNDERLAYMENT, FLASHING, DRIP EDGE ATTACHMENT) WITH THE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON TIY-F 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 I %ROCEDURE
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 tjN PERSONAL
INSPECTION, THE INSTALLATION OF ALL ROOFING COMPONENTS.
STATE OF FLORIDA COUNTY OF �G
Sworn to and Subscr' ed before me this day of t4�rI L 20 I0by:
7toWho is ❑ Personally Known to me or has �ucede of
identification =- as identification.
S' ature of Notary Public
State of Florida :"' C — JUL1O C VERAS
MY COMMISSION # FF952974
0 01
���a ,,. •' EXPIRES January
-0Q7i 1A8-0 `53 rY 21, 2020
Prmt/T ype/Stamp Name
of Notary Public