HomeMy WebLinkAbout222 Clydesdale CrJAN
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
e q_ 55 (
Documented Construction Value: $ G 7 SO
Job Address: C it s 40�c C. 4. Historic District: Yes ❑ No ❑
Parcel ID: j$ -y -3(- 5 06 -0000-0?3 0 Residential Commercial ❑
Type of Work: New ❑
Addition ❑ Alteration LEI Repair ❑
Demo ❑
Change of Use ❑ Move ❑
Description of Work:
O-Q.., c g ir 4—%1 g4c.c Z 700 fy'Pl'
PVir��f
ycs� S
Plan Review Contact Person:
Phone:
Fax:
Email:
Title:
c Property Owner Information
Name iiH Jt A,(V 5 1A � v N Phone: y'o -7-✓' 7S' 68`? 3
Street: 2 2 2 C 1 y c s Jkl't- ` C; fit. Resident of property? : g
City, State Zip: SAA Cot, J , Ft- 3 2 7 7
Contractor Information
Name P(l t ti I<0 o t ' HS O—(f-W c-14Ai Phone: i�(D ? - 5 7�-
Street: S 6 �''�'� c Fax:
City, State Zip: oJ a-x J. State License No.: c L c- o s 7 SqY
Architect/Engineer Information
Name: Phone:
Street:
City, St, Zip:
Bonding Company:
Address:
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 Permit Application /'j ( 3 �-v 2—
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.
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
�-- 'L--- `/���
Signature of Contractor/Agent 6ate
Print ontractor/Agent's Name
Signature of Notary -State of Florida Date
^<; E ANNETTE M BLAND
Notary Public - State or Florica
Corrmissior n GG 1709CC
-'9 Nty Comm. Expires Jar 16.2C22
Contract /A 6h 1s `Persona1LyJX to to Me or
Produce ID type o
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Gas[] Roof ❑
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 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
Premiere Roofing and
"Above all, it's a Premiere iob!"
POWER OF ATTORNEY
To: i S 9, � rg� Date:
I hereby name and appoint Team K- 5 Brian Kirby; Tim O'Malley; Aaron Hallich; Frankie
Jamarillo; Eric De Dios and David Weed to be my lawful attorney in fact to act for me and
apply for a Roofing permit to be performed at a location described as:
Section Township Range
Parcel ID
Project Location
Owner's Name
Owner's Address
Lot Block Subdivision
��"%0-31-SOla- peUO-073o
And sign my name and do all things necessary to this appointment.
Signature of Contractor
ichael A. Morgan C 057594; CBC056687
Acknowledge:
Michael A. Morgan is personally known to me.
Sworn and subscribed before me this S day of Jam'`- , 2dr
Notary Public, State of Flori �gpRvgs Jonathon Thomas
o� NOTARY PUBLIC
°�
My commission expires �Z !STATE OF FLORIDA
= Comm# GG141189
s�NCE 19�� Expires 9/18/2021
5611 Carder Rd., Orlando, FL 32810 Tel. 407-578-6893 Fax 407-704-8967
F120 Lie. # CCC-057594 www.prcroofservices.com
Premiere Roofing and
iy
"Above ull, it's a Frenriere job!"
_ ....... _
Insured Name; PC' hi Ulm �. , 0 tL ! Date: f'4 f. l? 2Z7.
Address: 2-2-2-CL_Ae kLe Ci � .Claim#: rn Q6 6 7?
j o
City, State, Zip fFJ 0. t "L J 2 77_ Phone #:
This contract/agreement describes the scope of work for your property
.ROOFING SPECIFICATIONS
off roof coverings areas: Sloped Flat
[- Upgrade surcharge:
/Tear
t roof deck. Re -nail up to code.
_ Install new fiberglass shingles: 3-tab Architectural
—K{11,
t� Tory in with underlayment paper.
Brand Style:
C„ a,,LLVvlv!-
C 1 I tstall new metal at valleys. drip and rake edges.
_ Color
( nstall all new plumbing stack flashings.
__ Install a Modified Bitumen _Membrane Roof System.
L'�1 [nstail new gooseneck roof vents.
Solar Panels: ca. n&R R&R
dU Install new attic roof vents:
Skylights Flashings: D&R R&R
Others:
- Skylights: D&.R R&R
SCREENS / LANAI SPECIFICATIONS
I GUTTERS SPECIFICATIONS
Replace screens. walls SF RoofSF
❑Gutters: LF. D&R R&R
Enclosure Super Gutters: LF. D&R R&R
❑ Downspouts: LF. D&R R&R
Enclosure Frame. D&R R&R
Others:
Lj Others:
INTERIOR SPECIFICATIONS
. i Ceilings T-Temum R-Repair P-Paintim,
Walls T-Texture R- Repair P-fainting
❑ Flooring Carpet Wood file
❑ Others:
AUDITIONAL SPECIFICATIONS:
CLARIFICATIONS:
L THIS CONTRACT IS FOR .ALL WORK TO BE PERFORMED BY PRC AS PER SCOPE OF WORK AND
PROCEEDS FROM INSURANCE COMPANY UNLESS OTHER\VISE STATED.
2. Owner responsible for Law and Ordinance / Ratted wood if not covered by insurance company.
3. If it becomes necessary to detach and reinstall gutters, PRC CANNOT BE RESPONSIBLE FOR THE FINAL
CONDITION OF THE GETTERS.
4. Deteriorated or unsuitable wood members to be replaced if needed at an additional cost as follows:
a. Sheathina: $ 75.00 per sheet of plywood S 4.50 per LF up to Ix8 / S 5.50 for Ix10 and 1a12.
b. Fascia and Structural Wood Members: S 7.50 per LF (no paint included).
STANDARD FEATURES
4• PRC to furnish labor and materials.
PRC to furnish building permit as needed. All work to conform to today's local building codes.
e- General clean up and haul off all work related debris from property.
•,• PRC provides the following workmanship warranties: Roof: 4-years All others: 17year
PAYMENT TERMS: The Owner's deductible due upon acceptance and signing of this contract.
13 3 On Commencement day, Payment of completed trade; Balance on Completion.
F221
5611 Carder Rd., Orlando, FL 32810 Tel. 407-578-6893 Fax 407-704-8967
Lie. fr CCC-057i94 u_t**; a "es[p ate_+_n?.con? ;yam+w:Ircr;rirfsen-ices.com
SCPA Parcel View: 18-20-31-506-0000-0730
Page 1 of 2
Property Record Card
Parcel: 18-20-31-506-0000-0730
Property Address: 222 CLYDESDALE CIR SANFORD, FL 32771
..Information. .. _ ..
Parcel Value Summary
Legal Description
LOT 73
BAKERS CROSSING PHASE 2
PB 62 PGS 97 - 99
Taxes
u
2018 Working
2017 Certified
Values
Values
Valuation Method
Cost/Market
CosUMarket
I.. ..
Number of Buildings
.. �.
1
..,
1
Depreciated Bldg Value
$134,244
m a
$126,581
Depreciated EXFT Value
Land Value (Market)
$34,000
$34,000
Land Value Ag
Just/Market Value "
$168,244
$160,581
l Portability Adj
$33,744!
Save Our Homes Adj
$38,743
[ Amendment 1 Adj
$0
P&G Adj
$0
$0
Assessed Value
$129,501
$126,837
Tax Amount without SOH: $2,269.85
2017 Tax Bill Amount $1,627.32
Tax Estimator
Save Our Homes Savings: $642.53
Does NOT INCLUDE Non
Ad Valorem Assessments
Taxing Authority
i Assessment Value
Exempt Values
Taxable Value
County General Fund
$129,501
$50,000
$79,501 1
m
Schools
$129,501
$25,000
$104 501 '
City Sanford
$129,501
$50,000
$79,501 ?
SJWM(Saint Johns Water Management)
$129,501
$50,000
$79,501 13
County Bonds
$129,501
$50,000
$79,501
Sales
3 Description. Date
' Book Page
Amount
Qualified
' Vac/Imp
WARRANTY DEED 4/1/2016
08675 0460
$187 000 Yes
Improved
'
(� WARRANTY DEED 3/1/2004
_
05281 0474
$16 1,100 Yes
Improved
WARRANTY DEED 11/1/2003
05103 0539
$811,000 No
Vacant
Find Comparable Sales
Land
Method Frontage Depth
Units
Units Price (Land Value
LOT
1
$34,000.00
$34,000
Building Information
Is Bed/Bath count incorrect? Click Here.Year _
uilt
# Description . Actua6/Effective Fixtures Bed Bath " Base Area Total SF Living SF ' Ext Wall Adj Value Rep[ Value Appendages
._._...._�._ .-_ I .._... __._.�.. ._...%__._�� ._...
1 SINGLE 2004 8 3 2.0 ,l 1,725 2,196 1,725 CB/STUCCO $134,244 $140,939 Description Area
FAMILY FINISH
12,001
http://pareeldetall.sepafl.org/PareelDetallInfo.aspx?PID=18203150600000730 1/18/2018
SCPA Parcel View: 18-20-31-506-0000-0730
Page 2 of 2
OPEN
PORCH _.
FINISHED
GARAGE 459.00 I t I
FINISHED
Permits
Permit # Description Agency
( Amount CO Date i Permit Date
_.. _. _ _ . _ __ _______ __ ._____. __.__. _ __:______
00155 NEW - RESIDENTIAL SANFORD
... .......... .. ...... __ ........ .................... _.............
$79 765 3/19/2004 10/16/2003
Extra Features
^Description Year Built
' Units Value New Cost
.
........... _ ____.._.. ....... _ ......... __ ._.. _ _.
PATIO NO VALUE 5/1/2004
... .................................... ....... ........... .. .....
1 $0
http://parceldetall.scpafl.org/PareelDetaillnfo.aspx?PID=l 8203150600000730 1/18/2018
THIS INSTRUMENT PREPARED BY:
Name: Premiere Roofing and Carpentry
Address: 4Il c4kou, Fd
32
NOTICE OF COMMENCEMENT
Permit Number.
Parcel ID Number: 14'- ;LO " 31 'SO to -06G0 0-130
f•LERK S' 20180068aV7
rtra: l.�('t.l; ��i: �1.L' i•J !'�.,'1l.0 ;:i .1 ,��, .L Cr��}::r ('�i�;
d: '
i:; ��t:.E_� � I0„iJ0
.1
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 O PROPERTY: egal descriptio of the property and street ddress if available)
a29 d1y7.es9(^1.0 Qrr, 073 19a1�crs L-oct. �.,,� Pl-t�ge Z i% U2 P65 9-7-44
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Re -Roof
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPR VEMEeNT:
Name and address: �3 rt'il1 iZl�l V S 1 CI, /� a� a �iN alest'e !�/"r' s�►� rec , rL— 3 Z Z 7 1
Interest in property: ®w► e-r
Fee Simple Title Holder (if other than owner listed above) Name: SAw.k.
Address:
4. CONTRACTOR: Name: Premiere Roofing and Carpentry Phone Number: 407-578-6893
Address: 5611 Carder Rd Orlando, FL 32804
5. SURETY (If applicable, a copy of the payment bond Is attached): Name:
Address:
II) 6. LENDER: Name: Phone Number:
Address:
7. Persons within the State of Florida Designated by Owner upon whom notice or other do
713.13(1)(a)7., Florida Statutes.
Name: Phone
8. In addition, Owner designates
Of
Amount of Bond:
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number:
Uri Y, FLORIDA
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 SITq BEFORE THE FIRS� INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE ICOMMENCING WORK ORnRECORDING YOUR NOTICE OF COMMENCEMENT.
State of
-
er s or.L"asses c (Pi rit Name and'wdo We sidriatory's Title70ffice),
County of 44 , W% 0 t- q�
The foregoing Instrument was -acknowledged before me this ) s day of J 6�►� , 20
by �(� W1.OV1 S 191A-0 r\_ Who Is personally known to me ❑ OR
Name of person making statement
who has produced identification type of identification produced: 11�L
y�!pRY&,, Jonathon Thomas
o� NOTARY PUBLIC
x '--STATE OF FLORIDANotary signature
w Comm# GG141189
Expires 9/18/2021
Commercial Contacts:
Jason Kirby 407.492.7639
& jason.kirby@expeditepermit.com
9.0pWOp/l1B///COO.6001%OO,L.11C, Amanda Horst 407-469-5599 xt 353
amanda.horst@expeditepermit.com
Commercial Runner Worksheet
Job Name: ABM - 7-11 Clermont
Job Address: ABM Office Sanford
Jurisdiction:
Runner Task List
1. Pick up at ABM Sanford
1450 Church St. #1000
Sanford, FL
Permit Number:
Bldg Dept Contact:
This Section Must be Completed by all runners except from the Corporate Office
Track ALL Fees Below
Mii7a�i��iC■C;
Date Received
Date Pulled
Date Pulled
Review Time
Amount F'ala oV K5 Nala Dv otners
Date Submitted
Date Delivered
NOTICE TO ALL RUNNERS
1. All runners will either meet with or call the commercial office for a briefing prior to leaving with the work.
2. All information must be recorded on the Bue Sheet (Corporate Office) or this form (All other runners). I.E.
review times, Bldg Dept staff contacts, dates, permit numbers, etc)
3. All runners will contact the Commercial office prior to leaving the Building Dept to confirm completion of
work.
4. All runners except for the corporate office will email copies of this form, all receipts, and any other
documents to the commercial office immediatly after completion of the work. DO NOT WAIT UNTIL YOU
RETURN TO THE OFFICE
CITY OF
Building & Fire Prevention Division
S',kNFORD RESIDENTIAL RE -ROOF POLICY & PROCEDURES
FIRE DEPARTtvIENT
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: 2 DATE: ! Z- l o
CITY OF
PERMIT #
&k�40RD
Building & Fire Prevention Division
NRE, D E PA R TN ENT RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: 222 Clydesdale Cir.
STRUCTURE TYPE: 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): 1 /2" Plywood
**PLEASE NOTE. ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED
ROOF VENTILATION: OFF -RIDGE O RIDGE 0SOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES 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
GAF
FL# 10124.1
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
O INSULATED
FL#
O TILE
FL#
OTHER: Underlayment
GAF
FL# 10626.1
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 TrLE
FL#
0 OTHER:
FL#
CITY OF
SAS® Building & Fire Prevention Division
1® RESIDENTIAL RE-R0OFAFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: u�� ADDRESS: ?LW M A� AfT,
�a.�ord► , �L ?v2�1
I P�y ` ` 1ao A-\e0a&ni , 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:
(MUST BE SIGNED BY LICEI
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: g
a/
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 N
Sworn to and Subscribed before me this day of�6)20 by:
o- Who is`50ersonally Known to me or has ❑ Produced (type of
as identification.
of Notary Public
mm Ciss on GG164771
Expires: December 3, 2021
oFft��
It ok
Bonded thru Aaron Notary
15(' �f_ne-1 Dck vv-\Q- S E ate
CITY OF
SkNFORD Building & Fire Prevention Division
RESIDENTIAL RE -ROOF A FFIDA VIT
FIRE DEPARTiME.NT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: k�_`_J 1 ADDRESS: 222 Clydesdale Cir.
Sanford, FL 32773
I Michael Morgan . 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 #: CCC057594
COMPANY / CONTRACTOR: P
r
emiere Roofilnq an/dCar ent
CONTRACTOR SIGNATURE: L��%�t"ifi%�j 6'� �2m�,�'l DATE: Li I 'r'
(MUST BE SIGNED BY LICEN
A FINAL ROOF INSPECTION IS REOUIRED:
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
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