HomeMy WebLinkAbout313 Poinsetta DrJp,14 17 2018 ! }r',13
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CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: / So
i o, ye,
�10 Job Address: 3 e"'ag x Historic District: Yes ❑ No I,dQ
Parcel ID: jam- -O - 3p -IE-173 - p2Cn - OI Residential'K Commercial❑
Type of Work: New ❑ Addition ❑ Alteration ❑ -Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work:
Plan .Review Contact Person:
Phone:
Fax:
Documented Construction Value: $
Title:
Email:
Property Owner Information
Name
Street:
City, State Zip:
Phone:
Resident of property`' :
Contractor Information
�.
Name _ � Phone.00- -
Street: Fax:
City, State Zip: c(State License No.: 00C
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Architect/Engineer Information
Phone:
Fax:
Mortgage Lender:
Address:
WARNING TO OWNER: YOUR FAH.,URE 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: 511 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 fronl 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 [CC 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
!gulatmg construction and zoning.
Signature�-,oate ofFlorida Date
GARRETTA MILLER
NOTARY COMMISSION # GG50450
PUBLIC EXPIRES November 28, 2020
STATE OF
bde
FLORIDA BONDEDTHROUGH
Owner/Agent_ S LerSN R Ecid
Produced ID Type of 1D f-
Sigi fture of Contractor/Agent Date
Q t
Print n ctor/Agent's Name
of Florida
Date
GARRETT A MILLER
COMMISSION # GG50450
V
EXPIRES November 28, 2020
BONDED THROUGH
WINSURANCE COMPANY
Produced ID Type of ID
Me or
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 l Ieads Fire Alarm Permit: Yes ❑ No ❑
UTILITIES: WASTE WATER:
FIRE:
BUILDING:
Revisedi June '0, 201 i
Permit Application
J
SDPS, Inc.
Water Mitigation, Roofing & Restoration
6735 Conroy -Windermere Rd. Suite # 416, Orlando, FL 32835
Phone: 407-930-4262 Ext 1 Fax: 866-907-0060 office@stormdamage.pro
FL Roofing Lie. # CCC1330569 Tax ID# 46-3715685
CONTRACT for SERVICES
I n s u r e d
doer
phone
0 f
Claim#
Address
-
e'-f `f 0.
Email
r�er CG- P- C�
City/state
7.. i p —2
Deductible
$
Insurance Company
_
Policy Number
Mortgage .Holder
Date of Loss
Type of Loss
j ]
Contract for Services
1, the Insured/Ilomeowner/Agent for the property site listed above, authorize SDPS, Inc. (Hereinafter referred to as SDPS) to enter my property,
fiimish materials, supply all equipment and perform all labor and reasonable services necessary to preserve and protect the property from
further damage. Homeowner agrees to immediately provide SDPS all insurance check payments and adjuster reports or letters from the insurance
company. IF THE CLAIM IS APPROVED ALL MITIGATION AND RESTORATION WORK RELATED TO THIS CLAIM WILL BE
CONTRACTED TO SDPS OR A SUBCONTRACTOR SELECTED BY SDPS. ALL WORK WILL BE DONE AT THE PRICE BILLED
BY SDPS TO THE INSURANCE COMPANY WITHOUT ANY ADDITIONAI. COST TO THE .INSURED/HONIEOWNERAGENT
(except insurance deductible and voluntary upgrades). SDPS WILL ONLY DO THE .REP.AiR WORK THAT SDPS IS LICENSED TO DO
AND/OR WORK TIIAT iS APPROVEA) 13Y THE INSURANCE COMPANY. SDPS will not do any Restoration work until full payment
is received, only mitigation and/or drying work will be done prior to .full payment.
INSURANCE PAYMENTS:.I acknowledge that i am a trustee for the benefit of SDPS of insurance proceeds paid for SDPS's work. if payment is
made directly to me by the insurance company, then I agree to endorse payment over to SDPS within three (3) working days. Any and all charges not
reimbursed by an insurance company are the sole responsibility of the Owner/Agent and are to be paid upon completion of the work. Payment terms
to SDPS are Net-30 days and interest of 1.5% monthly are charged on any unpaid balance. SDPS requests direct payment fi•om Insurance Company.
Cancellation Conditions:
Florida law allows 72-hours from the time of signing this contract to cancel without penalty. Any time after that, these provisions will apply:
if 1, the Insured/Homeowner/Agent, decide to cancel or refuse to provide SDPS with the insurance report and insurance check(s), Homeowner/Agent
shall compensate SDPS within 48 hours for services rendered:
1. All mitigation/temporary repairs/dry-out services that remain unpaid.
2. All OVERHEAD and PROFIT SDPS would have expected from fidfiliment of this contract. The maximum allowable OVERHEAD and PROFIT is
capped at 20% of the RCV "Replacement Cost Value" of SDPS's Estimate for the Claim(s).
3. S500 for the "Loss Assessment'. Loss Assessment includes: labor, personnel, time and fuel for services including: damage inspection, photographs
for evidence, measurements, Xactimate report, consultation and correspondence with the insured and die insurer.
Mitigation work will be done to preserve and protect the above mentioned property from further wind, hail, storm and water damage.
STOP WORK -HOLD HARMLESS: In the event SDPS is not allowed to perform its recommended procedures and/or drying, tarping, or sealing
equipment is removed prematurely, 1, the Insured/Homeowner/Agent for the property site listed above, agree to release and hold SDPS harmless,
and indemnify SDPS against all claims or actions that may result from such procedures.
BRIEF NOTES ON THE OBSERVED DAMAGE TO PROPERTY & PROPOSED MITIGATION:
IT IS A FELONY FOR THE INSURED TO PROFIT FROM INSURANCE PROCEEDS, SDPS WILL NOT TAKE PART IN
SUCH ILLEGAL ACTIVITY.
2.6 e
Page 1 of 2
(The below paragraph is required by Florida law)
ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAW (SECTIONS 713.001-713.37, FLORIDA;
STATUTES), THOSE WHO WORK ON YOUR PROPERTY OR PROVIDE MATERIALS AND
SERVICES AND ARE NOT PAID IN FULL HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR
PAYMENT AGAINST YOUR PROPERTY. THIS CLAIM IS KNOWN AS A CONSTRUCTION LIEN.
IF YOUR CONTRACTOR OR SUBCONTRACTOR FAILS TO PAY SUBCONTRACTORS, SUB -
SUBCONTRACTORS, OR MATERIAL SUPPLIERS, THOSE PEOPLE WHO ARE OWED MONEY
MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE ALREADY PAID YOUR
CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR, YOUR CONTRACTOR
MAY ALSO HAVE A LIEN ON YOUR PROPERTY. THIS MEANS IF A LIEN IS FILED YOUR
PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR, MATERIALS, OR
OTHER SERVICES YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FAILED TO
PAY. TO PROTECT YOURSELF, YOU SHOULD STIPULATE IN THIS CONTRACT THAT BEFORE
ANY PAYMENT 1S MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A
WRITTEN RELEASE OF LIEN FROM ANY PERSON OR COMPANY THAT HAS PROVIDED TO
YOU A "NOTICE TO OWNER." FLORIDA'S CONSTRUCTION LIEN LAW IS COMPLEX, AND IT
IS RECOMMENDED THAT YOU CONSULT AN ATTORNEY.
If any provision of this agreement,shall be held invalid or unenforceable the remainder of this agreement shall not be afl'ected thereby and shall continue to be valid. If
any disputes arise between the Insured[Homeowner/Agent and SDPS, all disputes will be handled in Orange County Florida. SDPS will be compensated for all legal
fee's including attorney fees, including any fee's incurred in litigating the amount of fees incurred, regardless of «iio is the prevailing party.
A,
Signature(s):
Signature: Date:
Agent/Represe!taw
SDPS, Inc.
FLORIDA HOMEOWNERS' CONSTRUCTION
RECOVERY FUND
PAYMENT, UP TO A LIMITED AMOUNT, MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS' CONSTRUCTION
RECOVERY FUND IF YOU LOSE MONEY ON A PROJECT PERFORMED UNDER CONTRACT, WHERE THE LOSS RESULTS
FROM SPECIFIED VIOLATIONS OF FLORIDA LAW BY A LICENSED CONTRACTOR. FOR INFORMATION ABOUT THE
RECOVERY FUND AND FILING A CLAIM, CONTACT THE FLORIDA CONSTRUCTION INDUSTRY LICENSING BOARD AT THE
FOLLOWING TELEPHONE NUMBER AND ADDRESS:
Division of Professions
Construction Industry Licensing Board
2601 Blair Stone Road
Tallahassee, FL 32399-0783
Phone: 850.487.1395
Page 2 of 2
--•• ..,.� isfllli w!!AI lljf� �l'�� ����
GRANT MALOYa SEHINOLE COUNTY
CLERf,, OF CIRCUIT coURr
PK 4C►3's ps 147b (1F'aR & Coh(F'TROLLER
CLERK'S 1no-zbEb
Permit Number torCURDEp i 2f1
4C 1/17/2ti1E ii
ECORDING FEES fiCr"Ciiij l
RECORDED !?Y tsm i th 0RPNX M 0
p,-�,T,'
CL1,R p� 1P v,(0�0�10 y CIEF`c.
QNO GO OEP
NOTICE OF COMMENCEMENT
State of Florida, County of Yp 6 ce
The undersigned hereby gives notice t improv improvement will be made to certain real property, and in ac dance
with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. eKri tion of ro erty (le al description of the ropecty, and street addr ss if la e)
�;,C11p: � r �-, t ja i K c �rn , ar -� �'6 `i
2. General description of improvement
3. Owner irwt"ation or Leese information if the Lessee contracted for the improvement
Interest in Property OyJ Y/6 - "
Name and address of fee simple titleholder (if different from Owner listed above)
Name
Address
4. Contractor (�-
Name `t' a CG
elephone ber — gz Q
Address �11
Ico j
5. Surety (if applicable, a copy of the yment bond is attached)
Name
Telephone Number
Address h f
Amount of Bond $
6. Lender
Name Telephone Number
Address
7. Persons within the State of Yforlda designated by Owner upon whom notices or other documents may
be served as provided by §713.13(1)(a)7, Florida Statutes.
Name Telephone Number
Address
8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's
Notice as provided in §713.13(1)(b), Flo id StatutQs.
Name Telephone Number
Address
9. Expiration date of notice of commenceme (the expiration. date may not be before the completion of
construction and final payment to the contractor, but will be 1;year from the 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.
UnderpenaIty of erjury, I declare that I have read the foregoing notice of commencement and that the
fac s fed in
re true to the best of my knowledge and belief.
§rfr�' er of Lessee, or Owner's or Lessee's Authorized Officer/Director/Partner/Manager \ Signatory s rifle/Office/The/foregoing instrument was acknowledged before me this 6rday of I I`6 by
month/year name of person
as C-r' for 5c-L-C
Type of authority, e''.g., officer, trustee, attorney in fact Name of party on behalf of whom instrument was executed
l^ �q2�► /4. / vIrL2
Signs re of Notary Public — State of Florida Print, type, or stamp commissioned name of Notary Public
Personally Known OR —Produced ID ?S GARRETT A MILLER
NOTARY COMMISSION # GG50450
/
Type of ID Produced 1z��L2 S �� �'S E PUBLIC EXPIRES Noe b r 2 2
STATE of Form Rp8k Wr#6rgj.C2 1
FLOWA
......... .
Date: N / '2� I vs
t. ............... .. . .......
I hereby name and appoint to be my lawful attorney in
fact to act for me and ap permit for work to be
performed at the location described as:
2a 4 -]�-A � Q-7Vn,3
................
(:Address of Job)
(Owner of Property)
And to sign my name and do all things necessari, to this appointment.
-13 \ occl' \��a . . ..... . ......
. ....... ................... .... . . r In d Name of Contractor and License Number)
in c - Name
�) �-ontllc
STATE OF FLORIDA
COUNTY OF Ot-2-ANG—
'3 73�i
The foregoing instrument was acknowledged before me this—Y day of J 20 V(
by .AT A rJ ki:,6, who is personally known to me or has El produced
take an oath.
Signature of Notary Public. State ofFlorida
G,42kzrr A
Print/Type/Stamp Name of Notary Public
(type of identification) as identification and who did
(SEAL)
GARRETT A MILLER
NOTARY
COMMISSION # GG50450
PUBLIC
STATE OF
EXPIRES
EXPIRES November 28, 2020
=
1
FLORIDA
'0 T OU
BONDED THROUGH
R L, IN, , U 'C COMPANY
LI INSURANCE COMPANY
Y
October 2009
CITY OF
NFORD Building & Fire Prevention Division
SkRESIDENTIAL 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 A F AVIT PROVIDED BY A FLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYIP1 i.�C C MPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGN URE- DATE: �r
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
STRUCTURE TYPE: JINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: eiEPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF
DECK TYPE (PLEASE SPECIFY): w "
**PLEASE NOTE: ONL Y 100 SQUARE FEET O THE EXISTING DECK IS PERMITTED TO BE REPLACED
ROOF VENTILATION: (Z)/OFF-RIDGE O RIDGE OSOFFIT 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
64:12 OR GREATER
O TURBINES
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
(D,'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#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
CITY OF
Ski!I40RD
DEPARTMENTFIRE
Building & Fire Prevention Division
RESIDENTIAL RE-ROOFAFFIDAVIT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FIN
AL ROOF COVERINGS
PERMIT #: } �, ADDRESS: � r3 1ri
Q CIS K�� C' , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
TRACTOR, ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
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#: CCU
COMPANY / CONTRACTOR: 1'1C� �� �(
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 O�
Sworn to to and Subscribed before me this day of k_'C.i:a2C,MAk 20 t '9 by:
5G Ij,,k A Who is 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.
(SEAL)
GARRETT A MILLER
NOTARY
COMMISSION # GG50450
PATE O
STATE OF
EXPIRES November 28, 2020
FLORIDA
BONDED THROUGH
RLI INSURANCE COMPANY