HomeMy WebLinkAbout181 Venetian Bay Cir (3)Job Address:
CITY OF SANFORD
BUILDING & FIRE PREVENTION
�s s PERMIT APPLICATION
FEB 0 2 2018
LJ Application No: —to 5
Documented Construction Value: $ _''101 Q U9
Historic District: Yes ❑ No, 1
Parcel ID: chi 5 9- DW) " (D D 2 Residential Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair a Demo ❑ Change of Use ❑ Move ❑
Description of Work:
3Lc s4, , U I v;)- CD A,
P!nn Review Con!act PerEgn:
���,�
��aMc�Yi�e.
-- Title' ?RAUCi1c)[l
Phone:
Fax:l (Y1--�DT1-1WOt4
Email:_- OfC40.i"l ci. C-0
I
Property Owner Information
Name Phone::�Q - 4 5
Street: If/ VZ41 e �1 � �jla CI (, � Resident of property? Uk5
City, State Zip: Ca(Z CS , F--(- 3-20 -1
Contractor Information
Name �l � V, C GFS C) CD, , �f)C - Phone:
Street:' 005 Fax: tJ D i
-� City, State Zip: State License No.: _C CCU Y-) b��4_
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company: Mortgage Lender:
Address: 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: 5th Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records of this county, and there may be additional permits required from other governmental entities such as water
management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
OWNER'S AFFIDAVIT: 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.
�otopr Pu"' PETER JAMES ARCOMONE
MY COMMISSION # GG 035010
EXPIRES: October 2, 2020
N�lEOF F�o�`a: Bonded Thru Budget Notary Services
Owner/Agent is Personally Known to Me or
Produced ID _ Type of ID lf�_ V:)(--
Signa ,nc o.- Gontracto-/hgeant
�v��r
Prin ntractor/Agent's t
Signature of Notary -State of Florida Date
�p"Ixy Pu", PETER JAMES ARCOMONE
* MY COMMISSION # GG 035010
oQ EXPIRES: October 2, 2020
9TF0F F`p? Bonded Thru Budget Notary Services
Contractor/Agent is _)_� 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:
Flood Zone:
# of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads Fire Alarm Permit: Yes ❑ No ❑
,APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING:
COMMENTS:
Revised: June 30, 2015 Permit Application
THIS INSTRUMENT PREPARED BY: R---�et; Nvc. \-- C*
Name: JA Edwards of America, Inc
Address: 7058 Stapoint Ct.
Winter Park FI. 32792
Permit Number: ` f�
Parcel ID Number:
GRANT 19ALOYv SEI'IINOLE.COUNT'
CLERK OF CIRCUIT CCOURT & COI'IFTROLLER
BK 9065 Po 1333 (1Fss)
CLERK'S v 20180IC1541
RECORDED
RECORDING FEES `I:•10.00
RECORDED BY jeckenro
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. DESCRIPT 0 OF PROPERTY: (Legal description of the property -and st eet addre s i available)
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Re -Roof
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: V" i ( VPn2 k. mil? .3 2-
interest in property-. Fee Simple Title Holder (if other than owner listed above) Name:
4. CONTRACTOR: Name: JA Edwards of America, Inc. Phone Number: 407.677.7663
Address: 7058 Stapoint Ct. Winter Park FI. 32792
S. SURETY (If applicable, a copy of the payment bond is attached): Name:
6. LENDER:
Address:
Phone Number:
Amount of Bond:
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents maybe served as provided by Section
713.13(1)(a)7., Florida Statutes.
Phone Number:
Address:
8. In addition,,Owner designates. of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number:
9. Expiration Date of Notice of Commencement (The expiration 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.
(Sign ufi of Owner or Lessee, or Owners or Lessee's
utthorized Officer/Director/Partner/Manager)
G ,
State of , 1 011 C la County of M1
The foregoing instrument was acknowledged before me this
by ZE S 1 FC� oLej
Name of person making statement
who has produced identification `l.type of identification produced
VPUg PETER JAMESARCOMONE
bkyE�( t"'hi G'202010
+XPiRc : i? oLe,
R' Sernoes
p.. Bonded 7111 Budget Notary
FOFVl
T—
�1
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
I hereby name and appoint:
an agent of:
(Name of Company)
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):
The specific permit and application for work
t �_ % . _ , I r1 n /— >
'--'(Street Addrdss) n
Expiration Date for This Limited Power of Attorney:
License Holder Name: C Y—a `_� �tJi SC Ins v.�C—c
State License Number:
Signature of License 11
STATE OF FLORIDA
COUNTY OF
=L 3a TI I
The foregoing instrument w s a knowledged before me this 12jday of (A C.r) ,
200 N % , by Cf�_a who is personally known
to me or ❑ who has produced as
identification and who did (did take an oath.
(Notary Seal)
RENEE C, COLLINS
* ' . Commission # GG 17M
Nl G Expires January 7, 2022
B.-,60 R. SWO NCt y "ImS
(Rev. 08.12)
Signature
_* C#e1sT1At -- 0144-lAtr
Print or type name
Notary Public -State of W IDI
Commission No. ' ' 172 49q
My Commission Expires: / 2.
AGRErU- NT SUBJECT TO INSURANCE COMPANY APPROVAL
Clastolmer: �ir1 G 7 Date. I/F
Property Location: Day:
City: Zip: Evening:
E-Mail: /�'g
ROOF SPECIFICATIONS Brand:6AF Style: Color:
Ridge Material R / ey: Open Close Tear-O . 1�/ 2 Vents: Box / Shingle Over / Aluminum Fel®R/
Ice &Water Shiel :Per Cod Pitch: Story 1 / 2 / 3 Walkout: YesAbW
* Roof Accessories to replaced new and/or painted to match shingle color.!
Drop Instructions•
SIDING SPECIFICATIONS Brand: Style: Color:
Style: Straight Lap / Dutch Lap Exposure: 4" 4.5" 5" other:
Elevation being sided (looking at house from street): Front Left Back Right
Drop Instructions:
GUTTER SPECIFICATIONS Color:
Special Instructions:
Homeowner Initials:
TERMS
1. By signing this Agreement, you authorize JA Edwards of America Inc. to be present during the insurance adjustment and negotiate the settlement with your insurance company.
2. Unless otherwise agreed in writing, your out-of-pocket costs will be limited to your insurance deductible amount. However, you must promptly pay JA Edwards of America Inc.
all amounts you receive from your insurance company. If you desire material upgrades or other work done on your property, you will incur additional out-of-pocket expenses.
3. This Agreement is not valid or binding on any party unless and until it is signed by both you and JA Edwards of America Inc. Once signed by you and JA Edwards of America Inc.
JA Edwards of America Inc. will be awarded with the job described above and the scope and price of the work will be set forth in the insurance adjuster's summary.
4. Your signature below provides your agreement to all the terms and conditions set forth on the front and back of this Agreement. Please carefully read the entire front
and back of this Agreement.
5. Homeowner agrees to assignment of benefits to Contractor (JA Edwards of America) for payments from insurance company to
facilitate timely payments to contractor for all works approved in insurance scope.
ASSIGNMENT OF INSURANCE BENEFITS: I, the policyholder, named insured or authorized representative, hereby assign any and all insurance
benefits, rights, proceeds and any causes of action under any applicable insurance policies to JA Edwards of America for services rendered or to
be rendered by JA Edwards of America and, in the regard, waive my privacy rights. This assignment is given in consideration of JA Edwards of
America's agreement to perform services as described above, including not requiring full payment at time of service. I also hereby direct my
insurance carrier(s) to release any and all information requested by JA Edwards of America, its representative(s) and/or its attorney for the
purpose of obtaining benefits to be paid by my insurance carrier(s) for services rendered or to be rendered and authorize JA Edwards and my
carrier(s) to communicate as needed with each other in this regard.
Believe the appropriate insurance carrier is:
First Check: $
`) 7
Check # Date
Signature (Customer) Date
Balance Due: $
Check # �! %Date
Sig - e (JA Edwards ofAmerica Inc. Rep) Date Agreed Price: $ / Ut
plus additional supplements & permit
fees paid by insurance company
CITY OF
ORDBuilding & Fire Prevention Division
RESIDENTIAL RE-ROOFAFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ADDRESS: ll V P,C� P (C�n \- J�L�I C
I b c N o � o sumt. r , 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 #: Q C): J i FD4 \
COMPANY / CONTRACTOR: , �N PI tp(_ { d S D" N-tX6 o� W-� C
CONTRACTOR SIGNATURE:
(MUST BE SIGNED BY LICENSE HOLDER OR OWNER/BUILDER)
A FINAL ROOF INSPECTION IS REQUIRED:
DATE:
THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINAL ROOF INSPECTION,
ALONG WITH DIGITAL PHOTOGRAPHS OF EACH PLANE OF THE ROOF SHOWING IN DETAIL ALL COMPONENTS (DECKING,
UNDERLAYMENT, 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
identification)
Signature of Notary Public
State of Florida
Print/Type/Stamp Name
of Notary Public
20 by:
Who is ❑ Personally Known to me or has ❑ Produced (type of
as identification.
Propeft RecordCard
Parcel: 23-19-30-502-0000-078:0
Owner: PARKER BEN JOYCE P & PAUL
Property Address: 181 VENETIAN BAY CIR SANFORD, FL32771
A
'20 2
%I U es
t ".0
Valuation Method
CosbfMarket Cost/Market
Number of Buildings
Depreciated Bldg Value
....... .. . . ... ... ...... ....
$1 U,856 $155,394
Depreciated EXFT Value
Land Value (Market)
$3 7,000 $37 G 00
Land Value Ag
Just%larket Value
.$201,856 1192,394
Portability Adl
Save Our Homes Adj
$0
Amendment I Adj
$0
P&G Adj
$0 $0
Assessed Value
$201,856 $192,394
Tax Amount without SOH: $3,663.48
2017 Tax Bill Amount $3,663.48
Tax Estimator
Save Our Homes
Savings: $().00
* Does NOT INCLUDE Non Ad Valorem Assessments
LOT 78
VENETIAN BAY
PB 63 PGS 84 - 88
CITY OF
Sk�40R-D
PERMIT #
Building & Fire Prevention Division
FIRE DEPARTMENT RESIDENTL4L RE -ROOF SCOPE OF WORK
JOB ADDRESS: _ l n wn e"1 an
STRUCTURE TYPE: SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: REPLACEMENT CHAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF
DECK TYPE (PLEASE SPECIFY):
"PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECKIS PERMITTED TO BE REPLACED"
ROOF VENTILATION: O OFF -RIDGE O RIDGE O SOFFIT OPOWERED VENT OTURBINES
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 �4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
SHINGLE
C M 1\
FL# l 0 »-q
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
0INSULATED
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#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
CITY OF
-Ski4FORD Building &Fire Prevention Division
L
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 OWNER/BUILDER) SIGNATURE: DATE: � I . 1 O
PERMIT #: U - Co% ADDRESS: F-TI /HIV ION C I P1
i L1 ErZAl D I kiM 'AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
FINZi-CONiRA NGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
FOREGOING INFORM —ATM 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 #: C C 0 J5' r752
COMPANY / CONTRACTOR: CONTRACTOR SIGNATURE: DATE: ?=// 41 " 8
(MUST BE SIGNED BY LICENSE HOLDER OWNER UILDER)
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 5A-M
Sworn to and Subscribed before me this 14 day of 20 l by:
6LA- �C.' ! h�t3ElZ Who is Y'Versonally Known to me or has ❑ Produced (type of
identification) as identification.
o"Ay ruRENEE C. COLLIN$
a Commission 9 GG 172994
Signature of Notary Public * .
State of Florida N9 \�= Expires January 7, 2022
rEOFwoe SaidadThNBudgetNotary
RWekj2 �/� a6Y-eA_1.P
Print/Type/Stamp Name
of Notary Public