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Home My WebLink About293 McKay BlvdJA N p 9 f� CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: ) g` 3LIO Documented Construction Value: $ 719 0 Job Address: 2-93 t&I(Ay ?)1vd, 5clr)f01-4 -r-L 31171 Historic District: Yes ❑ No ❑ Parcel ID: 3t - A3-31-52`i 0000 — 0570 Residential [Commercial ❑ Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑ Description of Work: 'Re Q_ppc n 5�)ki qks Plan Review Contact Person: Title: SUPe'f V' is O'l( Phone: u 67_ 15C J0 L4 4, Fax: Email: irOO�ir)aplCmee-SLLcCPgmC(il.eorr) Property Owner Information Name CO.yr105 lmene2 Street: _2 M- M C KQU `bl\yd City, State Zip: S.np,3 * 1 31171 Phone: Resident of property? : ,yeS Contractor Information Name I�Ot�Clng`}��oneerS LL e T Street: T • 6 SOX 180012 City, State Zip: Casselbe rr4 F-- 3V718 Name: Street: City, St, Zip: Bonding Company: Address: Phone: J46T 7 5 Q 74-LI 4 Fax: State License No.: CCc-132.9030 Architect/Engineer Information Phone: 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: 51 Edition (2014) Florida Building Code Revised: June 30, 2015 Permit Application J14fq I n 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 com liance with all applicable laws regulating construction and zoning. Signature of Owner/Agent Date Sign f Contractor/Agent Date AhVGoS �ih2 is r'.1 C,::,r) Print Owner/Agent's Name "'! LaA y i' 1 ignature of Notary -State of Florida Date State of Florida County of Seminole Print Contractor/Agent's Name Signature of Notary -State of F@rida Date The foregoing instrument was acknowledged before me this 20`l' day of November, 17, Carlos Jimenez, who is personally known to me. Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or Prod co Produced ID My CowM�sSloN * MUM M r PEREZ COMMISSION # G0071486 EXP"tES Novwnbw 09. 2019 ••w EXPIRES February 09, 2021 �nOI H6-0153 AM 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 ❑ # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: Flood Zone: # of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes ❑ No❑ WASTE WATER: BUILDING: Revised: June 30, 2015 Permit Application LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: I / S1 9 8 I hereby name and appoint: Jofge 1��Ye-Z an agent of: *Ro oO -Ir)q '?ior cc4-s LLG. (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 located at: 7-93 to c ICay 'bl i d , ScIn ord r-L 32-1 "71 Address) Expiration Date for This Limited Power of Attorney: License Holder Name: 3 C %f eJ C on �,c State License Number: C CC 132303 G Signature of License Holder: STATE OF FLORIDA COUNTY OF Sennlrnle--- The foregoing instrument was acknowledged before me this X day of 3CM`'° , 200 1g , bye T oye-J Co4c— who is ❑ personally known to me or 0who has produced identification and who did (did not) take an oath. (Notary Seal) ALBA L PEREZ MY COMMISSION # 00071466 •�•, ,, EXPIRES February 09.2021 (Rev. 08.12) Signature Alba `—k-UeZ Print or type name Notary Public - State of _ Commission No. My Commission Expires: as SCPA Parcel View: 31-19-31-527-0000-0570 Page 1 of 2 4, CH1 `es`v+otEc�+rrY won Parcel Information Property Record Card Parcel: 31-19-31-527-0000-0570 Owner: BENCON JACKELINE & JIMENEZ CARLOS JR Property Address: 293 MCKAY BLVD SANFORD, FL 32771 Parcel 31-19-31-527-0000-0570 Owner BENCON JACKELINE & JIMENEZ CARLOS JR Property Address 293 MCKAY BLVD SANFORD, FL 32771 Mailing 293 MCKAY BLVD SANFORD, FL 32771 Subdivision Name CEDAR HILL REPLAT Tax District DOR Use Code S1-SANFORD 01-SINGLE FAMILY - Exemptions 00-HOMESTEAD(2005) GIS Legal Description LOT 57 CEDAR HILL REPLAT PB 63 PGS 96 97 & 98 Taxes Value Summary _.._._.------__------- __. 2018 Working Values 2017 Certfied Values Valuation Method Number of Buildings ; Cost/Market Cost/Market 1 1 Depreciated Bldg Value $129,448 i $121,977 Depreciated EXFT Value { t Land Value (Market) $30,000 ; $30,000 Land Value Ag Just/Market Value" $159,448 $151,977 Portability Adj-- - �-- --- -----._----..._- Save Our Homes Adj $65,864 $60,318 Amendment 1 Adj # $0 P&G Adj !so $0 Assessed Value $93,584 ; $91,659 Tax Amount without SOH: $2,106.02 2017 Tax Bill Amount $957.47 Tax Estimator Save Our Homes Savings: $1,148.55 ' Does NOT INCLUDE Non Ad Valorem Assessments Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund $93,584 $50,000 j $43.584 Schools $93,584 j $25,000 + $68,584 City Sanford $93,584 j $50,000 $43,584 SJWM(Saint Johns Water Management) $93,584 ! $50,0002 $43,584 County Bonds $93,584 t $50,000 ` $43,584 Sales Description Date Book Page Amount Qualified Vac/Imp SPECIAL WARRANTY DEED 8/1/2004 05423 1824 $121,900 I Yes I Improved CORRECTIVE DEED 7/1/2004 05395 1084 $100 No Vacant WARRANTY DEED 1 2/1/2004 1 05209 1033 $341,800 No Vacant Find Comparable Sales Land Method Frontage Depth Units Units Price Land Value LOT i 1 $30,000.00 $30,000 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 Repl Value Appendages Actual/Effective 1 j SINGLE i 2004 7 ! 3 = 2.01 1,874 2,290 : 1,874 CB/STUCCO $129,448 $135,903 - - Description Area i FAMILY FINISH I i 36.00 http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=31193152700000570 11/9/2017 Cedar Hill Hoineowners Assn, Inc. 3112 W. Lake Mary Blvd Lake Mary, FL 32746 ADDRESS SERVICE REQUESTED NOTICE OF ARCHITECTURAL APPROVAL Carlos Jimenez 293 McKay Blvd Sanford FL 32771 Dear Carlos Jimenez: December 08, 2017 RE: 293 McKay Blvd Your Request for Architectural Change as been approved. Specifically, you have approval to proceed with the following: Installation of new roof in Pristine Black by Pinnacle We reserve the right to make a final inspection of the change to make sure it matches the Request you submitted for Approval. Please follow the plan you submitted or submit an additional Request form if you cannot follow the original plan. Zn You must follow all local building codes and setback requirements when making this change. A Building Permit may be needed. This can be applied for at the County offices. This approval is effective for one year from the date of the approval. If the installation of your improvement begins after this deadline you will need to re -submit. Construction of your improvement must be completed within 90 days from the date of starting the work. If you need an extension please contact our office. Our approval here is only based on the aesthetics of your proposed change. This approval should not be taken as any certification as to the construction worthiness or or structural integrity of the change you propose. Be aware that you are responsible for contacting the appropriate Utility Companies before digging. We appreciate your cooperation in submitting this Request for Approval. An attractive Community helps all of us get the full value from our homes when we decide to sell. Sincerely, Debbie Young, LCAM Telephone: Fax: 407-333-7767 E-Mail: debbie.young@premierrngmtcfl.com ARCHITECTURAL REVIEW APPLICATION CEDAR HILL HOMEOWNER'S ASSOCIATION, INC. THIS FORM IS TO BE COMPLETED BY THE HOMEOWNER AND SUBAUrrED TO THE ARCFiREC7U I . REVIEW COMMITTEE FOR APPROVAL PRIOR TO ANT OF ANY WDRIC PLEASE ALLOW THIRTY CA DAYS UPON RECEIPT FOR A DECISION FROM THE ARC_ IF YOU �NILL BE USING HEAVY EQUIPMENT LE., DUMP TRUCK BOBCAT, FORK LIFT, FRONT END LOADER. ETC-, IT LS THE RESPONmilm OF �WHOMEONER TO TAKE PRECAUTIONS TO ENSURE NO DAMAGE IS DONE TO ROADWAYS, SmEUVAUCS, AND ANy OTHER COMMON WILL BE HELD RESPONSIBLE FOR RESTORING SUCH AREAS TO THEIR ORIGINAL STATE 2lF?d�.''d't O€On.i:s )R �' a^tm°g �2y a rm _C 3132 Iy2T L.`iT-ke Mary Ft h/d z L:die .TVJa! f. FL ,37, 6 u:3 3 % u': PMP" J� ��11`i 5(� s I��x Lot# S- Mw%V Address_ If dafersd fi=n Pmperty Adder Pleesedtedc ayw live ntn,,, i Coiueroatioih�, Porgy 1. Raidenft Names - - — - - - - Propenl/ Address: 2.Ct 3 L)C'• k LqPhow -- _ May the amh ladwal Review Comrnittee Contact you for ctsM on of quesrons? _ No yes eanaM address •ICL .4i (W h —/e 1` &�Mcx)ct�y(r��c v Note: THE FOLLOWING ITEMS NEED TO BE SUBMITTED ALONG WITH THIS FORM: 1) PLOT PLANIPROPERTY SURVEY SHOWNG LOCATION OF MODIFICATION: 2) DRAWING AND COLOR SAMPLES Pie rile the tolMaiumg, a applicable:. - - -mctpaw start Date: ,1i ,^ , � contractor �-r,Ck(ICASOLIIC-e 7L'Q1Q�f�Arcn� Phone- 40-1 _ �� j - �S 6-1 r Color Se� (attach actor sanrph-, denote body, tnm color of any same endasure and dell hoarhow pool meat w,U be sveerred fmm vieur) Pfan-Poft -u&t faoe b-mrd- (deW styAh, matemK size and plat plan to be included) —Landscaping Phan Gur Proled sudhas saeen roan or roan addition. Colors and maw must be detaded- NOTE: � Requests and alperations must conform to all local Zoning and Building Regulations, You are required to obtain the required permits If your request's approved if your request is denied by the ARC. You may appeal to the Beard of DbeCtDM for rwAw. If all required materials or information ib not included with this form at the tone of submission, the time period does not apply for approvaliTmapproyal. If work does not commence within gp days of approval you must resubmit Ire ►equest.for approval or request an wtIo hsion in writing to the ARC Committee for approval. ARCHITECTURA REVIEW COAMIIITTEE Approved: Signature Date Disapproved: Sigtghtra COMMENTS BY AIRC Date �n.m. Date Received by e=c Date Mailed to M 2* g Address: Date Subnumw to ARC: Date MatTed Certified: ,� DEC 0 5 2017 u PERMIT #: CITY OF SANFORD Building & Fire Prevention Division RESIDENTLAL RE-R OOF A FFIDA VIT FIRE DEPARTMENT RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS ADDRESS: 233 Mc&A4 'blQd, SCInfatcl Tl 3011 I J are'c1 Conk— , 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 #: C CC. 1313030 COMPANY/CONTRACTOR: 1(`;C,U loq I)0he—c�f5 LLC- CONTRACTOR SIGNATURE: DATE: (MUST BE SIGNED BY LICENSE HOLDS 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 e;rn i n o It - Sworn to and Subscribed before me this day of 20 la by: -3are(4 C0 h — Who is 1 Personally Known to me or has ❑ Produced (type of identification) Signature of Notary Public State of Florida Print/Type/Stamp Name of Notary Public as identification. AlBA L PEREZ MY COMMISSION # GG071486 ".5611 EXPIRES February 09, 2021 THIS INSTRUMENT PREPARED BY: Name: Edinson Perez Address: P.O Box180972 Casselberr; FL 3271$ State of Florida County of Seminole Permit Number: Parcel ID Number: ta'RfiN 11ALO-* ^ 'li_1'Il:i`401-E COUNTY CLERK OF CT:Rt llTT' C;gl_)RT 1, COMPTROLLER 2`,'l:l_<=F P, 1.;;01i C1Pss) CLERK'S u 217118002895 RECQRDE*D i'11/00/201.. I.li:S;'e::l All REC:ORfil:i'GpFEES d>1.C1.CICI RECORDED, VAS .jeckenro 31-19-31-527-0000-0570 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 57 293 MCKAY BLVD SANFORD FL 32771 CEDAR HILL REPLAT PB 63 PGS 96 97 & 98 GENERAL DESCRIPTION OF IMPROVEMENT: Re Roof 28 Sq shingles OWNER INFORMATION: Name: Carlos Jimenez Address: 293 MCKAY BLVD SANFORD, FL 32771 Fee Simple Title Holder (if other than owner) Name: Address: CONTRACTOR: Name: Roofing Pioneers LLC Address: P.O Box 180972 Casselberry FL 32718 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 Section 713.13(1)(b), Florida Statutes. of To receive a copy of the Lienor's Notice as Provided in 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 NOT COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPE NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATT 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 a to the beef p� knowled a and belief. Owners SignaW Owner's Printed Name Florida Statute 713.13(1)(g): " The owner must sign the notice of commencement and no one else may be permitted to sign in his or her st State of 0 -(� I D PF County of �� r— U i_C The foregoing instrument was acknowledged before me this 26day of J v L1 �% < , 20 by 8tl,L-0 J ) 1 ML N C� . Who is personally known to me,® Name of person making statement OR who has produced identification ❑ type of identification produced: MEussA PWDA MY COMMISSION # Flrf3Se4t8 EXPIRES November ". 2019 CITY OF Building & Fire Prevention Division SFORD ANRESIDENTIAL RE -ROOF POLICY & PROCEDURES //\ FIRE DEPARTMENT C �. y V PERMITTING REQUIREMENTS — NO PLAN REVIEW REQUIRED AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE THIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE 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 REQUIREDOOF PERRESI ENTIAL (SINGLE FAMILY, TOWNHOUSE, MOBILE HOME, APARTMENT AND/OR CONDOMINIUM) RE 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 APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS • ALL FLORIDA PRODUCT (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 DECKNAILING PATTERN &SPACING (INCLUDING A MEASURING DEVICE SIZE OF NAILS) o ROOF DECKNAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHOWING 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 (1F APPLICABLE) o DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULTODE COMPLIANCE BY PERSONAL INSPECTION. INAN AFFIDAVIT PROVIDED BY A FLORIDA ESIGN PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC C -- - - -- - -----.._--—•------------ _------•-- DATE: v( '_ d�e'- CONTRACTOR (OR OWNER/BUILDER) SIG CITY OF 'SAj4011 PERMIT # Building & Fire Prevention Division RESIDENTIAL RE -ROOF SCOPE OF WORK JOB ADDRESS: 233 Mc" bW I S anf CoYC1 F-L. 3 L1 7 1 STRUCTURE TYPE: �INGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM RE -ROOF TYPE: Oi�`PLACEMENT (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: OFF -RIDGE ORIDGE OSOFFIT OPOWERED VENT 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 O TURBINES TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL O SHINGLE Was FL# � C505 O METAL FL# O MODIFIED BITUMEN FL# OTORCH DOWN FL# OINSULATED FL# O TILE FL# O OTHER: FL# ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **1FAPPLICABLE** 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# 0 OTHER: FL# CITY OF Building & Fire Prevention Division ...&�FORD RESIDENTIAL RE ROOFAFFIDAVIT FIRE DEPARTMENT RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #: l .25 ADDRESS: 233 1SIn nE,r d 'FL I jQre_-3 Coy 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 #: CC- 1319050 COMPANY / CONTRACTOR: r-0 0. f I r)Cyt t" I0 nC e4_S LL.C. CONTRACTOR SIGNATURE: (MUST BE SIGNED BY LICENSE OWNER/BUILDER) A.FINAL ROQF INspx.CTION-IS-REOi+IRED: u- DATE:. -1 / 1 u 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 5Cr` )Ii 1`r—' Sworn to and Subscribed0Persbefore me this ,day of ��I��% ►� 20 18 by: �CIY> GD4r_ Who is onally Known to me or has ❑ Produced (type of identification) Signature of Notary Public State of Florida A-Ibca��C-�r-e2 Print/Type/Stamp Name of Notary Public as identification. ALBA L`PEREZ XMY COMMISSION # GG071486 EXPIRES February 09, 2021