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Home My WebLink About120 Conch Key Way�! CITY OF SANFORD BUILDING PREVENTION E NtIIT APPLICATION Application No: I 4 T Documented Construction Value: $ 13,612 Job Address: 120 Conch Key Way, Sanford, FL 32771 Historic District: Yes ❑ No ❑ Parcel ID: 29-19-31-501-0000-2010 Residential ER Commercial ❑ Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ® Demo ❑ Change of Use ❑ Move ❑ Description of Work: Hurricane ReRoo€ Plan Review Contact Person: Randall Bryant Title: Contractor Phone: 877-617-7663 Fag: Email: Corporate@RestoreGroup.com Property Owner Inforfation Name Kuriakose Ebbytnon Phone: 877-617-7663 Street: 120 Conch Key Way Resident of property? : Yes City, State Zip: Sanford, FL 32771 Contractor Information Name Restore Group, LLC Phone: Street: 522 S. Hunt Club Blvd. #149 Fag: 877-617-7663 City, State Zip: Apopka, FL 32703 State License No.: CCC1330470 Architect/Engineer Information Name: Street: City, St, Zip: Bonding Company: Address: Phone: Fag: 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: 5t° Edition (2014) Florida Building Code Revised: June 30, 2015 Pemrit 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, qate agencies, or federal agencies. Acceptance of permit iverification 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 exmuW 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 i 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 eompliabee with all applicable laws regulating construction and zoning. Si ofOwner/Agent ' Date Signature of ContractulAgent Date J Print Owner/Ag t: s N I Print onttactor/Agent's Name Si 0 -ANT //�.��w ft�00 U6684 { ray, GG UM Was 27,2021 t�aQediero rrintaa�oalfOpJ!)6.70fi aaamedmotaor�arr�aaoo.�rme Owner/Agent is �Hlea�s,o,nally Known to or Contractor/Agent is x Personally Known to Me or ';rE" Produced ID _� of ID _ -�c Fl. 1)%U o Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY i Permits Required: $uilding [] : ` Electrical ❑ Mechanical ❑ Plumbing[:] Gas[] Roof ❑ i 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 Perm i : Yes ❑ No ❑ # of Heads Fire Alarm Permit: Yes ❑ No ❑ i APPROVALS: ZONjNG: UTILITIES: WASTE WATER: I ENGINEERING: FIRE: BUILDING: I COMMENTS: I -- Revised: June 30, 2015 Permit Application SCPA Parcel View: 29-19-31-501-0000-2010 http://parccldctail.sepatl.org/ParcelDctaillnfo.aspx"PID=29193 ISO 1000... Property Record Card 0 Parcel: 29-19-31-501-0000-2010 owner: KURIAKOSE EB13YMON Property Address: 120 CONCH KEYWAY SANFORD, FL 32771 Parcel Information i Value Summary Parcel 29-1931501-0000-2010 Owner I KURIAKOSE EBBYMON Property Address 120 CONCH KEY WAY SANFORD, FL 32771 Mailing 120 CONCH KEY WAY SANFORD, FL 32771 Subdivision Name CELERY KEY Tax District S1-SANFORD DOR Use Code 01-SINGLE FAMILY Exemptions 00-H0MESTEAD(2006) Legal Description LOT 201 CELERY KEY PB 64 PGS 85 - 96 Taxes —�-- 2018 Working 2017 Certified Values Values Valuation Method _ t Cost/Market �------------- Cost/Market -------.._---_- Number of Buildings— 1 1 1 Depreciated Bldg Value 3 $130 265 $122,765 Depreciated EXFT Value Land Value (Market) 1$31,500 1$31,500 Land Value Ag i Just/Market Value" $161,765 $154,265 Portability Adj 1 Save Our Homes Adj 1 $62 773 �$57,309 Amendment 1 Adj P&G Adj --- !so $0 w $0 Assessed Value 1 $98,992 $96,956 O Tax Amount without SOH: $2,149.58 2017 Tax Bill Amount $1,058.34 s Tax Estimator Save Our Homes Savings: $1,091.24 Does NOT INCLUDE Non Ad Valorem Assessments Seminole County GIS Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund $98,992'. $50,000 $48,992 Schools $98,992 $25,000 $73,992 City Sanford $98,992 $50,000 $48,992 SJWM(Saint Johns Water Management) $98,992 $50,000 $48,992 County Bonds $98,992 $50,000 $48,992 Sales Description Date Book Page Amount Qualified Vac/Imp — WARRANTY DEED 1 9/1/2005 06093 1205 $257,800 Yes Improved And Comparable Sales Land._._.__ Method Frontage Depth : Units Units Price Land Value LOT 1 $31,500.00 $31,500 Building Information a Bed/Bath count incorrect? Click Here. Year Built # Description Actual/Effective Fixtures Bed Bath Base Area Total SF Living SF j Ext Wall Adj Value Repl Value Appendages 1 SINGLE 2005 8 4 2_0 1,955 1 2,510 ' 1,955 CB/STUCCO $130,265 $136,403 I Description Area FAMILY FINISH 1 of 2 1/3/2018, 10:29 AM PROPOSAL - CONTRACTW'p 522 S. Hunt Club Blvd. #149 Apopka, FL 32703 Phone: (877) 617-ROOF (7663) Fax: (866) 282-2771BBB Email: Support@RestoreGroup.com Start with Trust r=; Web: www.RestoreGroup.com Certified Roofing Contractor License # CCC1330470 Customer Name: Ebbymon Kuriakose Address: 120 Conch Key Way Home Phone: City: Sanford County: Seminole ROOFING SPECIFICATIONS ❑ Type of Roofing System: Asphalt Shingle ❑ Manufacture: Owens Corning - Total PROtection ❑ Style/Model: LifeTime Duration TruDef ❑ Shingle Color: ❑ Tear Off: YES .# Layers:1 Type: ❑ Underlayment: OC ProArmor - Synthetic Underlayment ❑ Valley Material: OC Ice & Water Shield Membrane ❑ Ridge Cap: OC Ridge Cap Shingles ❑ Flashing: Chimney & Walls Pipe Stacks: Replace Boots ❑ Ventilation: OC VentSure Ridge Vent ® Ice & Water Shield: OC Ice & Water Shield Membrane Application: Roof Valleys, Walls, Chimney, & Openings Gutter Cleanout: El Protect Landscape Where Needed: ✓ Roller Magnet for Nails: ED Furnish Permit if Required: Q ® Company limited workmanship warranty: 2 .years SPECIAL ATTENTION AREAS Existing Damage toDriveway(s)?: YES=NO—_ Skylights: YES O Count:= Action: - Existing Leaking: YESDWhere? Interior Damage: YESIIWhere? Replace Plywood at $ 55 per sheet (if needed) *** 3 sheets/boards included with each project *** DISCLAIMERS: RGLLC is not liable for electrical vents and equipment; Removal or installation of solar panels; Satellite alignment; Incidental and consequential interior cl +5; Un-Stable Driveways; & Awnings INITIALS: X TTii Email Address: Ebbiee@hotmail.com Mobile Phone: (407) 718-6787 State: FL Zip: 32771 Work Pho SCOPE OF WORK / SPECIAL INSTRUCTIONS "Remove and Replace Roof on entire home with Premium Owens Corning Roofing System Black drip edge Customer's Out of Pocket Expense For Project Not To Exceed $500.00. All Insurance Funds For Claim Will Be Paid Over To Restore Group LLC. PAYMENT SCHEDULE PAY BY: Insurance Check, Personal Check, Cash (Management Only) Current Approved Insurance Funds toward Project: $ Supplement Items (permit, components, etc): General Contractor's Overhead & Profit (20%): Misc Expense Items: customer out -of -Pocket Expense = Additional Work Requested: $ TBD $ TBD Current Agreement Amount (subject to increase): $ ** Any upgrade(s) or additional work requested by customer that is not approved by the insurance company is the customer's responsi- bility and will become part of this agreement. PAYMENTS MADE TO RESTORE GROUP LLC DATE Deductible 1 st Payment Progress Payment / / - Final Payment AMOUNT RGLLC REP. $ 500.00 INSURANCE PAYMENT [—]CUSTOMER AGREES TO ENDORSE AND PAYTO RESTORE GROUP INSURANCE CHECKS RECEIVED FOR SERVICES ACKNOWLEDGEMENT PERFORMED BY RESTORE GROUP, WITHIN 1 WEEK OF RECEIPT OF PAYMENT(S) FROM INSURANCE COMPANY. TERMS This agreement,DOES NOT OBIIGATETHE PROPERTY.0WNER OR RESTORE GROUPRESTOR�ATION IN ANY WAY UNLESS IREPAIRS AREj IRPROVED BY PROPERTY OWNERS,INSURAN'CECOMPANY. This agreement authorizes RGLLC to pursue repairs to the damaged property at a "price agreeable" to the insurance company and RGLLC. Unless upgrades or other services are requested, there will be NO C®SI TO,THE HOMEOWNER EXCEPT FOR�THE INSURANCE DED.U:CTIBLE When "price agreeable" is determined the final contract price for selected repairs under specifications above shall become $TBD (insurance proceeds for contracted services). If requested by RGLLC, final payments will be paid to RGLLC separately after each trade has been completed. ®® Customer understands and agrees that any monies received from the insurance company related to work performed by RGLLC such as general contractor's overhead & profit and/or supplements will be paid to Restore Group. CUSTOMER INITIALS: X - You the buyer, may cancel this transaction at any time prior to midnight on the thi si ss day of this transaction - Customer Acceptance: Date: / / - By: X RGLLC Representative: Rod Scroggins Insurance Company: ASI RGLLC Rep Signature: Insurance Claim #: 514892-171003 RGLLC Management: Insurance Adjuster: Agreement Details and Common Sense Explanations Legal Explanation 1) Any contract is subject to approval by our managerial staff 2) We shall have no responsibility for acts of God, vandalism or other damage that would typically be covered under a homeowner's insurance policy during the repair process Common Sense Explanation If an estimating or other mistake is made and we are going to lose our shirt on the deal, we want to be able to cancel the contract. We are great at storm related repairs, but we cannot stop them from happening. If a tornado, hurricane, or some other peril happens when we are repairing your home, we are not responsible for the additional damage. 3) Replacement of rotten decking, fascia, etc. discovered If we tear your roof off and find unseen damage, we during the repair process, unless otherwise noted, is not included. are going to notify you and, with your permission, we With your approval an additional charge may be incurred. will contact your insurance company and see if they will cover it. In the event it is not covered we will notify you of the price for the replacement/repair. We promise to never try and retire off of unseen damage. We will charge a very fair price for the repairs. 4) We will not be responsible for material shortages, labor strikes, If all of the shingle -making machines break down, there is weather delays or anything out of the normal or out of our nothing we can do about it. If it rains for two weeks control. straight, there is nothing we can do about it, etc. If there is nothing we can do about it, there is nothing we can do about it. 5) You have 72 hours to cancel your contract. 6) If part of this contract is unenforceable or invalid, the remaining portions will still be in effect. 7) We are not responsible for existing poor construction techniques/problems on your property. 8) Warranty on roof or siding replacement is 2 years. 9) The price on the front of contract is valid for 7 days from offer 10) Your roof will be installed in accordance with the job info packet and the specs listed on the front of the contract. 11) We will take all legal mean necessary to collect our money The law says 72 hours. Law or not, we don't want to put a roof on a house that a customer does not want us to do. We like happy customers. We have no idea why anything on this contract would not be enforceable; it is as straight -forward as they come. But, if something isn't, the rest of the contract is. If it wasn't built right to begin with, we are not responsible for fixing it; unless we said we would on the contract. Why 2 years? Because that is a fair & honest warranty period. If your roof is going to leak it will be after the first good blowing rain. We take care of our customers. We have gladly done "no charge" repairs on roofs well beyond the 2 year warranty period and it was usually on problems that were no fault of ours (damage since replacement). However, it is a perceived liability issue when you have lots of warranties out there. Unfortunately, just like we have to put all this stuff on the back of the contract to keep the lawyers happy, we have to do this for the bean counters. Bottom line is that our installation techniques go well beyond code and we stand behind our work. Roofing is a petroleum based product. It fluctuates like gas (the gas you put in your car). The prices never reduce though. We go above and beyond on every installation and the steps are clearly laid out in writing. We are proud of our attention to detail. Pretty simple: we complete repairs and you pay us the price we agreed upon. If you don't, we will call you every night at dinner time and probably also file a lien. We will be honest and straight forward with you. Please be the same with us. r - - �.4 t xs it" —re—, NOTICE VP COMMENCEMENT i State of Florida, County of Orange The urldelSigned hereby gMes notice 00 impraAment will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following Inknnatlon is provided in this Notioe of Comrnencernent 1. Demon of I�1 of the property, and stn�et address if available) LO 2111. C IF: pe 64 8 86-96 2. General deserintion of Intanw«na d 3. Owner iMbnpation or Lessee h4aanation N the Lie contracted for the improvement Interest in Property OWNER Nanw and address of fee simple titleholder (E different from Owner tried above) Name Address 4. Contractor Name Restore Group LLC Telephcne Number 877-617-7663 S. Sun* (if applicabW a copy of the payment bond Is atlached) Name Telephone Number Address Amount of Bond $ 6. Lender Name Telephone Number Address 7. Persons wWdn the Strata of Florida designated by Owner upon whom notices or other docu ments may be owed as p vvlded by §713.13(1)(a)7, FloAda Stdtetes. Name Telephone Number Address 8. In addition to hYnsell or het"K Owner dsaigrwtss the following to recelve a copy of the Uenoft Holies, as provided In §713.13(1)(b), Florida Statutes. Name Telephone Number Address 9. Expiration data of rtotioe of cononencentud (the expiration date will be 1 year from the date of reoorfit rg unless a df etlt date is spectfled) W/ARMW TO 01NNER ANY PAYMENTS YAOE BY THE OWNER AFTER 1lrE EXPIRATION OF THE NOTICE OF ARE CONSWERED IMPROPUt PAYMENTS UDDER CHAPTER 713. PART L SECTION 713.13. FLiONIDA STATUTES. AND CAN RESULT IN YOUR PAYINIi TWICE FOrt INPROVIINEM TO YOUR PROPERTY. A NOTICE Of MUST 8E RECONDED AND POSTED ON THE JOB SITE BEFORE 7W FM I INSPECTIOK IF YOU INTEND TO OBTPA RNANC119% CONSULT WM Yol/t I!!" OR AN ATfOR:IEY BEFORE COMENCING WORK Olt RECDOW ID YOUR NOTICE OF Sigma d Omw or Lessee, or OwiWs or Lessees Audwtmd �Ul �1 SiSrretay6 TWeafte The faregoing irnsbumernt was acknowledged before me this C.T� day of la/�7 bya"MI n 6�Y (gS-e of person as for ar audwft e.g., omo, Casa w aNlosoey in tact rimne d pwty on bdmU dreom kebww t wns aoecaMed �Tii�.l.l e W n sgnatore ar Golan► Pubsc - vtaDa ar Flalaa Personally Known OR Produced O '� JI1 tl 11K tIIt1DNlT Type of ID ftoducedRnMa kaom;.� i18611 umme EV. Date--, aX/D3 aolq esdeOAwTapFatstaa os iINID Form In - sated: 01rM4 GRANT MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK'S # 2018002341 BK 9053 Pg 1941; (1pg) E-RECORDED 011081201810:2Z56 AM 10.00 Permit Number: Property Address: AFFIDAVIT 1'ax Folio N iiber:.Qq-19-31-Syl -Ovoo � ofv 7r- V-0 CONCH KEY WAY. SANFORD STATE OF FLOWDA COUNTY Before me, the undersioned authcxity. duh, authorized to take ackno%%IeJaments and administcroath.. personally al2gn .nnor% � i IcL. KMe- (hereinafter Afliant).wlioalier being dub sworn. deposes and says: I . Afliant is the (check cute): _I_ O%�neroltheabove described propem: the Owner's Authorized Agent 2. A Notice of Commencement. as required pursuant to Section 7 13. 13 of the Florida Statutes, has been filed for recording in the official public records of _.. County. Florida. as it relates to improvements to he made to tha certain real property described herein. I A copy of said recorded Notice of Commencement is attached hereto. Alliant Sitmature• (� Print Name: oC6L� ,_r► S%.orn to and subscribed belore me on this day of-NCVy'% 2o. -1 bsOoloq eyo Vj-kv'ta K &%,e- who is penonall,% known tqpe or has p�rde �' �i. L.4C, as identification. v3lC, Notary Public Signa(a Print Name: \ly Commission Expires: JIJUE W. gQYANT Com- sion OGG 146694 E-* irft -tqmmW 27, 2lttt &MW111ftTayFAtn=,V,N GRANT MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK'S # 201800234213K 9053 P9 1942; (1pg) E-RECORDED 01/080018 10:22:56 AM 10.00 LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 12/08/2017 1 hereby name and appoint:. CHRISTI BRYANT an agent of RESTORE GROUP, LLC (Name afc«mpany) 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): E6 All permits and applications submitted by this contractor. O The specific permit and application for work located at: (Street Address) Expiration Date for This Limited Power of Attorney: 12/08/2018 License Holder Name: RANDALL BRYANT State License Number: CCC 1330470 Signature of License Holder: q,"jV STATE OF FLORIDA COUNTY OF SEMINOi.E The foregoing instrument was acknowledged before me this _&b_day of JANUARY 200201g by RANDALL BRYANT who is tiNpersonally known to me or o who has produced as identification and who did (did not) take an oath. Ai nature p , (Notary Seal) �J t L I, C � r h Print or type name JIi1.EWARYMT .r #(G1B1 EXPkUSepea*er27.2M eos"nn'r"r*ms.Ma U"M (Rev. 3/27ro7) Notary Public - State of H 01 j `" ' Commission No. & G I "-i My Commission Expires: oZ- 1p Z X d }CITY OF ORD Building & Fire Prevention Division RESIDENTIAL RE -ROOF POLICY & PROCED URES 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/BUMDER) SIGNATURE: DATE: 01/12/2018 4 CITY OF DEPARTMENTORD FIRE JOB ADDRESS: 120 Conch Key Way, Sanford, FL 32771 PERMIT # Buildng & Fire Prevention Division RESIDEN774L RE -ROOF SCOPE OF WORK STRUCTURE TYPE: ® SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM RE -ROOF TYPE: (D REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF) DECK TYPE (PLEASE SPECIFY): Wood SheetS * *PLEASE NOTE. ONLY100 SQUARE FEET OF THE EXISTING DEC%IS PERMITTED TO BE REPLACED ROOF VENTILATION: DOFF -RIDGE ®RIDGE OSOFFTT OPOWERED VENT OTURBINES SKYLIGHTS: OYES QNO 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 PRODUCT APPROVAL GSHNGLE Owens Coming - Duration FL# 10674.1 METAL FL# OMODIFIED BITUMEN FL# OTORCH DOWN FL# OINSULATED FL# OTILE FL# OOTHER: FL# ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) * *IFAPPLICABLE* * ROOF SLOPE: O LESS THAN 2:12 Q 2:12 - 4:12 O 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL O SHINGLE FL# OMETAL FL# OMODIFIED BITUMEN FL# OTORCH DOWN FL# OINSULATED FL# OTILE FL# QOTHER: FL# Y OF ss-�NFORD Building & Fire Prevention Division RESIDENTIAL RE ROOF AFFIDAVIT FIAE DEPA.RTMENT RESIDENTIAL RE -.ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #: d ADDRESS: 120 Conch Way Sanford, FL 32771 I Randall Bryant , 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 1S 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 1330470 COMPANY / CONTRACTOR: estore GroiXr1,,LC CONTRACTOR SIGNATURE: DATE: / (MUST BE SIGNED BY LICENSE HOJ.DER OR OW UILDER) A FINAL ROOF INSPECTION IS REOUIRED: THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIE 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 Seminole Sworn to and Subscribed before me this LDday of 20 by: Randall Bryant Who is EX Personally Known to m r has ❑ Produced (type of id tification) as identification. � W Si�nature of Notary Public State of Florida Print/Type/Stamp Name of Notary Public .:%%•. JULIEW.BRYANT Commission # GG 146684 Expires September 27, 2021 Bonded TIn Troy Fain Wuma 8 OMS."19'