HomeMy WebLinkAbout150 Mayfair Ct__CITY__OF-SANF-ORD .-
ECEIAVE BUILDING & FIRE PREVENTION
PERMIT APPLICATION
FEB 0 6 2018
Application No:
BY'--
Documented Construction
/� - -7 ?4--
Value: $,
5 �
Job Address: 1b 0C4Historic District: Yes ❑ No
Parcel ID: 000b— ResidentialN] Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair V., Demo ❑ Change of Use ❑ Move ❑
Description of Work:c-
Plan Review Contact Person��,
Phone: 1�-�q� pi Fax:
Title:_
Email:0.�j ioe��Ra� C Clot. C
Property Owner Information
NamePhone:
Street:_ Resident of
City, State Zip: 'it N6
Name
Street:
City, State Zip:
Contractor Information
Phone:
Fax:
p'erty?I :
State License No.:
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company:
Address:
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: 51h Edition (2014) Florida B ilding Code
Revised: June 30, 2015 Permit Applica ' Uv
I ��
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. e
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
The done in , omp i ce with all applicable laws regulating construction and zoning.
a � c�
Signature of Owner/Agent Da a Signature of Contractor/Agent Date
Print Owne Agent's Name dF
� d
LISA ANTONINI
. -
Notary Public -State of Florida
My Cowrn. Expires May 21, 2018
Commission # FF 125242
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Own r n s e " o c e or Contractor/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:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Flood Zone:
# of Stories:
Plumbing - # of Fixtures,
# of Heads Fire Alarm Permit: Yes ❑ No ❑
UTILITIES: WASTE WATER:
I14M
BUILDING:
Revised: June 30, 2015 Permit Application
W
e
OWNER BUILDER STATEMENT/AFFIDAVIT
Altamonte Springs, Casselberry, Lake Mary, Longwood, Oviedo, Sanford,,
Seminole County, Winter Springs
Florida Statutes are quoted here in part for your information to indicate the authority for exemptions for
homeowners from qualifying as contractors and to express any applicable restrictions and responsibilities.
OWNERS MUST PERSONALLY APPEAR AT THE BUILDING DIVISION TO SIGN THIS DOCUMENT
BY SIGNING THIS STATEMENT, I ATTEST THAT: (Initial to the left of each statement)
I understand that state law requires construction to be done by a licensed contractor and have applied for
an owner -builder permit under an exemption from the law. The exemption specifies that 1, as the owner of ,
L
the property listed, may act as my own contractor with certain restrictions even though I do not have a
license.
I understand that building permits are not required to be signed by a property owner unless he or she is
responsible for the construction and is not hiring a licensed contractor to assume responsibility.
I understand that, as an owner -builder, I am the responsible party of record on a permit. I understand that I
may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed
in his or her name instead of my own name. I also understand that a contractor is required by law to be
licensed in Florida and to list his or her license numbers on all permit and contracts.
I understand that 1 may build or improve a one -family or two-family residence or a farm outbuilding. I
may also build or improve a commercial building if the costs do not exceed $75,000. The building or
residence must be for my own use or occupancy. It may not be built or substantially improved for sale or
lease. If a building or residence that I have built or substantially improved myself is sold or leased within
in I year after the construction is complete, the law will presume that I built or substantially improved it
for sale or lease, which violates this exemption.
1 understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
I understand that I may not hire an unlicensed individual person to act as my contractor or to supervise
persons working on my building or residence. It is my responsibility to ensure that the persons whom I
employ have the licenses required by law and by city ordinance.
I understand that it is a frequent practice of unlicensed persons to have the property owner obtain an
owner -builder permit that erroneously implies that the property owner is providing his or her own labor
and materials. I, as an owner -builder, may be held liable and subjected to serious financial risk for any
injuries sustained by an unlicensed person or his or her employees while working on my property. My
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner -
builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
I understand that I may not delegate the responsibility for supervising work to a licensed contractor who is
not licensed to perform the work being done. Any person working on my building who Is not licensed
must work under my direct supervision and must be employed by me, which means that I must
comply with laws requiring the withholding of federal income tax and social security contributions
under the Federal Insurance Contributions Act (FICA) and must provide workers' compensation
for the employee. I understand that my failure to follow these laws may subject me to serious financial
-
risk.
Rev. 9.14.2009
7
e
r
I agree that, as the party legally and financially responsible for this proposed construction activity, I will
abide by all applicable laws and requirements that govern owner -builders as well as employers. I also
understand that the construction must comply with all applicable laws, ordinances, building codes, and
zoning regulations.
I am of aware of construction practices and I have access to the Florida Building Codes.
I understand that I may obtain more information regarding my obligations as an employer from the Internal
Revenue Service, the United States Small Business Administration, the Florida Department of Financial
Services, and the Florida Department of Revenue. I also understand that I may contact the Florida
Construction Industry Licensing Board at 1-850-487-1395 or at www.myflorida.com/dbpr/pro/cilb/ for
�+
more information about licensed contractors.
I am aware of, and consent to, an owner -builder building permit applied for in my name and understand
that I am the party legally and financially responsible for the proposed construction activity at the address
listed below.
1 agree to notify the building department immediately of any additions, deletions, or changes to any of the
information that I have provided on this disclosure or in the permit application package.
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person
who does not have a license, the Construction Industry Licensing Board, the Department of Business and
Professional Regulation and the building department may be unable to assist you with any financial loss
that you sustain as a result of a complaint. Your only remedy against an unlicensed contractor may be in
civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an
individual or firm is injured while working on your property, you may be held liable for damages. If you
obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for verifying
whether the contractor is property licensed and the status of the contractor's workers' compensation
coverage.
Property Address:
I r)2= �, ,a_oys--QA� , do hereby state that I am qualified
and capable of performing the requested construction involved with the permit application filed and agree to the
conditions specified above.
Signature of Owner -Builder
_ 1 IL$
Date
Form of Identification
(Must be Photo ID)
A violation of this exemption is a misdemeanor of the first degree punishable by a term of imprisonment
not exceeding 1 year and a $1,000.00 fine in addition to any civil penalties. In addition, the local
permitting jurisdiction shall withhold final approval, revoke the permit, or pursue any action or remedy
for unlicensed activity against the owner and any person performing work that requires licensure under
the permit issued.
Rev. 9.14.2009
SCPA Parcel View: 33-19-30-505-0000-0260
Page 1 of 2
frAavid son, CFA
CCR Property Record Card
P P Parcel: 33-19-30-505-0000-0260
vncv-xx.iecaxvrv. a.anso� Property Address: 150 MAYFAIR CT SANFORD, FL 32771
Parcel
33-19-30-505-0000-0260
Owner
LAURSEN, BELINDA
Property Address
150 MAYFAIR CT SANFORD, FL 32771
Mailing
150 MAYFAIR CT SANFORD, FL 32771
Subdivision Name
MAYFAIR VILLAS
Tax District
S1-SANFORD
DOR Use Code
04-CONDOMINIUM
Exemptions
00-HOMESTEAD(2007)
112.29 ICo.nt:y
C)
N
N W 26
Semi
2018 Working
2017 Certified
Values
Values
Valuation Method
; Cost/Market
Cost/Market
Number of Buildings
1
1
Depreciated Bldg Value
$108,075
j $108,075
- _
Depreciated EXFT Value
$2,000
$2,000—
Land Value (Market)
Land Value Ag
_.- - -.. _-..._.... _..
_ +-----. - _
r .. _-.- ---_
;
Just/Market Value *`
1 $110,075
_
$110,075
Portability Adj
Save Our Homes Adj
$18,381
$20,267
Amendment 1 Adj
I $0
i
P&G Adj
1 $0
1 $0
Assessed Value
$91,694
$89,808
Tax Amount without SOH: $1,308.14
2017 Tax Bill Amount $922.22
Tax Estimator
Save Our Homes Savings: $385.92
' Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description
--- - ---
LOT 26
MAYFAIR VILLAS
PB 22 PGS 9 & 10
Taxes
Taxing Authority
Assessment Value
Exempt Values
Taxable Value
County General Fund
$91,694
$50,000
1
$41,694
Schools
$91,694
$25,000
$66,694
City Sanford
$91,694 ,
$50,000
$41,694
SJWM Saint Johns Water Management)
$91,694
$50,000
$41,694
County Bonds
$91,694
$50,000
$41,694
Sales
Description
Date
Book
Page
Amount
Qualified
Vac/Imp
QUIT CLAIM DEED
• 9/1/2010
07454
1 0620
°
$37,500 i No
t Improved
QUIT CLAIM DEED
11/1/2007
06859
1361
$100 + No
Improved
CORRECTIVE DEED
p 11/1/2007
06860
: 1660
1
$100 1 No
; Improved
QUIT CLAIM DEED
11/1/2006
06569
1083
$100 ' No
Improved
QUIT CLAIM DEED
4/1/2006
06193
1748
$75000 No
Improved
AY DEED
WARRNT
j 8/1/1997
; 03285
1537
$75,000 ' Y es
Improved
WARRANTY DEED
1 8/1/1994
02816
0881
$100 I No
Improved
WARRANTY DEED
4/1/1993
02578
1943
1
$70,000 Yes
, Improved
WARRANTY DEED
12/1/1982
01427
0728
$52,500 , Yes
Improved
Find Gornpafabl'e dales
Land
Method Frontage Depth Units Units Price Land Value
LOT 0.00 0.00 1 $0.10
http://parceldetail.scpafl.org/ParcelDetaillnfo.aspx?PID=33193050500000260 2/6/2018
SCPA Parcel View: 33-19-30-505-0000-0260
i Building Information
Page 2 of 2
Is Bed/Bath count incorrect? lick Here.
#
Descr ption
Year Built Fixtures Bed
Actual/Effective
Bath
Base Area
Total SF
Living SF
Ext Wall
Adj Value
Repl Value Appendages
1 CONDOS } 1982 6 i 3 2_0 1,238 1,825 1,238 CONC
$108,075 $108,075
BLOCK
S
!
Description Area
GARAGE 575.00
1
FINISHED
i
OPEN PORCH I'
4
FINISHED 12.00
t Permits
Permit #
Description
Agency
Amount
CO Date
Permit Date
02764
SCREEN ENCLOSURE
' SANFORD
$5,850 ,
9/19/2017
01809
REROOF
SANFORD
$2,300 i
4/1/1996
Extra Features
http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=33193050500000260 2/6/2018
THIS IN UME T PR RED OL
Name: �.
Address:
1U
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
GRANT MALOYr SEMINOLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLER
PIK 9070 Ps 1054. (1P3s)
CLERK'S T 2018014030
RECORDED 02/I_ibf2012, 112:44:12 PM
RECORDING FEES $10.00
RECORDED BY jeckenro
Permit Number: Parcel ID Number: 33- 1k aB oDuiz) — 6�'(Pz)
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.
OF PROPERTY: (Legal description of the property and street address if available)
Ri4it14:7_1111111»N01i1[e1:Le]Ahii17ZePl_ i� it 1M
OWNS
Name
Addre;
Fee Simple Title Holder (if other than owner) Name:
Address:
CONTName: CTOR:��� n
Name: \ �
Address:
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 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 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 JOB SITE BEFORE THE FIRST x
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 o_
to the best of my knowledge and belief.
Owners Signaturb Owner's Printed Name a H O
`Florida St lute 7_13.131� g): " The w e must sign the notice of commencement and no one else may be permitted to sign in his or her stead. v w
pl-
O. i1/ C)
�hau
u,
State of F 1 n,- ci c,_.. County of S n�, :., r, �
O p 0
cc
G
The foregoing instrument was acknowledged before me this Ca day of fir_ - a r, 11-.6
by P6 , n d ct. L_ Who is personally known to me ❑ _ ., . y .
Name of person making statemen`
OR who has produced identification D type of identification produced: t>L. U, D
SEAT_ � , .�•l,�V }- ,- V.� .� ,ISG
�v -Notary Signature
J7 z,, 4- G) " k
CITY OF
Building & Fire Prevention Division
._-SF'O_ _.._ RESIDENTIAL 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 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: 4 ` DATE: A\B
JOB ADDRESS:
PERMIT # I I '
City of Sanford Building Division
Residential Re -Roof Scope of Work
N'
STRUCTURE TYPE: V 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 (PLEASE SPECIFY:
* *PLEASE NOTE: ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED *'
ROOF VENTILATION: O OFF -RIDGE RIDGE SOFFIT OPOWERED VENT
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 41�4:12 OR GREATER
O TURBINES
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
SHINGLE
FL#
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
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#
O TORCH DOWN
FL#
O INSULATED
FL#
O TILE
FL#
O OTHER:
FL#
Building & Fire Prevention Division
RESIDENTIAL RE-ROOFAFFIDAVIT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: / ADDRESS: \Slz�
I\_�y% CiWo 1 , 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 #:
COMPANY/CONTRACTOR:
CONTRACTOR SIGNATURE: DATE:
(MUST BE SIGNED BY LICENSE HOLDER OR OWNER/BUILDER
A FINAL ROOF INSPECTION IS REQUIRED:
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, 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
Sworn to and Subscribed before me this day of �\ `^f 20 by:
State of
off Florida
(V Vf_V�
Name
of Notary Public
Who is personally Known to me or has ❑ Produced (type of
identification.
\\�����`�gRANDF ,r
:�OQMember? F�•
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