HomeMy WebLinkAbout100 N Somerset CtCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
3 Documented Construction Value: $ g, y00, Ua
Job Address: lDD N, Sor►z er5e+ Ca., f Historic District: Yes ❑ No Er
Parcel ID: U -7- a 0 - 3) - S o(6- oo00 - O 3 2 O - Residential 2'Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: l ecoof t..w; 4-k '9 g Ssus.res o-F =Ko c..-,brnJSe i49 Sh S.,sJes
Plan Review Contact Person:
g cber+
Title:
G wner
Phone: yo7 gW gES 4
Fax: 4i67682
8554 Email:
rh �roo-�'S
U ya�,oa . CoY►-1
Property Owner Information
Name 42 1(arrC,h S i h e k Phone:
Street: Sgi,53o 2)z PL� Qu-ee.,,,s UJ),,q*__ 0AE461A Resident of property?
City, State Zip: New llorK AJ y I1 yZ7
Contractor Information
Name Phone: 1407 K30 SSS`i
MID FLORIDA ROOFING, LLC Fax: 407 GSSY
Street: PO BOX 522 fSL S
City, State Zip: OD FL 32752-2610 State License No.: GGG 0S7 8'34/
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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: 51h 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.
Signa ure of Owner/ jgent Date Signature of Contractor/Agent Date
J<GrrdA 1; ► n
Print O,xvner/Agent
Signature o N r -State of F
PC
NOTARY PUBLIC
STATE OF FLORIDA
Comm# FF104514
4s I Expires 3/20/2018
Owner/Agent is /Personally Known to Me or
Produced ID y Type of ID P Y 4-
6ber4- A S�oemcl�
Print n ctor/Agen ' ame
Z
Si r of Notary- ate of Florida D e r
l� ar JOEL HANCOCK
NOTARY PUBLIC
STATE OF FLORIDA
Comm# FF224497
CE 1g*' Expires 4/27/2019
Contractor/Agent is J/ 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:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
# of Heads
UTILITIES:
FIRE:
Flood Zone:
# of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
SCPA Parcel View: 07-20-31-506-0000-0320
Page 1 of 2
Property Record Gard
Parcel: 07-20-31-506-0000-0320
Property Address: 100 N SOMERSET CT SANFORD, FL 32772
Value Summary
2018 Working
2017 Certified
Values
Values
Valuation Method Cost/Market
Cost/Market
Number of Buildings 1
1
Depreciated Bldg Value $88,276
$83,275
Depreciated EXFT Value
Land Value (Market) $20,000
$20,000
Land Value Ag
JustiMarket Value i $108,276
$103,275
Portability Ad/
Save Our Homes Ad/ $0
$0
Amendment 1 Adj $0
$4,681
P&G Ad/ $0
$0
Assessed Value $108,276
$98,594
Tax Amount without SOH: $1,908.13
2017 Tax Bill Amount $1,908.13
Tax Estimator
Save Our Homes Savings: $0.00
Does NOT INCLUDE Non Ad Valorem Assessments
_....... ........
Legal Description
-
LOT 32
!
I
BRYNHAVEN 1ST REPLAT
PB39PGS20&21
__— .._......._ _.._ _._.._.._.__ ._.. ....... __.._ .._......_.
Taxes
Taxing Authority
Assessment Value
Exempt Values
Taxable Value
County General Fund
$108,276
$0
$108,276 !
SChools
$108,276
$0
$108,276 I
City Sanford
$108,276
$0
_
$108,276 I
SJWM(Saint Johns Water Management)
$108,276
$0
....
$108,276 i I
County Bonds
$108,276
$0 1
$108,276 !
Sales
_.....I
.........
................._.
ij
Description Date
Book ;Page
Amount
Qualified
Vac/Imp
!(
QUIT CLAIM DEED 10/1/2002
04595 1627
$100 i No
Improved
_UIT CLAIM DEED 2/1/1995
02E3'C 1761
$32,100 No
Improved
( I
WARRANTY DEED 8/1/1990
C2214 0154
;
$75,000 Yes
Improved
€ f
(, FInd CommpambI Salad
.....
Land
Method Frontage t Depth
Units
Units Price
Land
Value
LOT 0.00 !
0.00 :
1
:,—
$20,000.00 i
$20,000
Building Information
Year Built I E
# Description Fixtures Bed Bath j Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages
ActuallEffective
1 j SINGLE 1989 [ 6 ! 31 2 0 ; 1,1701 1,677 t 1,1701 CB/STUCCO $88,276 =. $99,747 Description Area
FAMILY FINISH
459.001
http://parceldetail.scpafl.org/PareelDetaillnfo.aspx?PID=07203150600000320 2/9/2018
r—
i
❑ Replace underlayment with the following: ❑ 151b Felt ❑ 301b Felt ❑ Titanium ❑ PolyGlass TU Plus I S k,
Install new roof using: Architectural Shingles ❑ 3 Tab Shingles ❑ Concrete Tile ❑ Clay Tile ❑ 5V Crimp ❑ St ding Seam ❑ DECRA
O \� r
Manufacturer/Style: '✓ ' t7 _ Color.
Ll Install _ new 4ft off -set ridge vents ($80 each) Total $ ❑ Install new 10ft ridge vents ($50 each) Total $ .-
Replace 2' x 2' skylight: Qty: ❑ Replace 2' x 4' skylight: Qty: Total $ (included in price below)
Upon completion, Mid Florida Roofing will remove all job -related debris, garbage and excess materials from job site and will use magnet for nails,
ples, simplex, etc.
l ❑ Customer requests that Mid Florida Roofing remove and discard existing solar heating panels prior to commencement of installation. If this option is
not checked, customer is responsible for removal of solar heating panels prior to commencement of installation. Customer is also responsible for
re -installation of solar heating panels when roof work has geen completed, if this option is not checked.
SPECIAL INSTRUCTIONS:
If payma:nt is not made under the terms of this contract, Mid Florida Roofing, Inc. reserves the right to place a lien on the above mentioned property and
a finance charge of 5% per month will be added to the unpaid accounts 30 days from date of agreed payment of this contract. Should collection action
be necessary, the person on this contract shall pay all court costs, attorney fees and appeal costs (if any). This contract is valid for one month from tn.e
date of acceptance and approval by Mid Florida Roofing, Inc. Mid Florida Roofing, Inc. reserves the right to cancel all or part of this contract at any time.
The State of Florida has a construction recovery fund. -
WARRANTY: Includes manufacturer's material warranties and five year workmanship warranty unless otherwise specified in special instructions above.
PAYMENT TERMS: Full payment is due upon completion of the work described on this contract, unless otherwise agreed upon in writing between
customer and Mid Florida Roofing, Inc.
AV
Accepted: ✓�ffi C 1:
ustomer / Date:
Cn ure Srg
Approval: , date: TOTAL PRICE _ $ �_
ov VO')
----------- - -- ------
f'- -7Z
A'Li
THIS INSTRUMENT PREPARED BY:
Name: Robert H. Shoemaker
Address: PO Box 522610
Longwood. FL 32752
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number:
GRANT MALOYP SEMINOLE COUNTY
CLERK OF C:IRC:UIT COURT is COMPTROLLER
BK 9091 B9 1261 (1P9s)
CLERK'S 4 2018028455
RECORDED 03/15/2018 08:06:!58 oN
RECORDING FEES $1.0.00
RECORDED BY ,ie kenro
Parcel ID Number: 07-20-31-506-0000-0320
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 32
BRYNHAVEN 1ST REPLAT
PB 39 PGS 20 & 21 100 N Somerset Court Sanford, FL 32772
GENERAL DESCRIPTION OF IMPROVEMENT:
Reroof
OWNER INFORMATION:
Name: Karran Singh
Address: 89-80 212 PL Queens Village New York, NY 11427
Fee Simple Title Holder (if other than owner)
CONTRACTOR:
Name: Mid Florida Roofing
Address: PO Box 522610 Longwood, FL 32752
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:
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) 6/10/18
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.
Under penalties of perjury, I declare that 1 have read the foregoing and that the facts stated in it are true
to the best of my knowledge and belief.
Karran Singh
Signaltwb X V Owner's Printed Name
Florida Statute 713.13(1)(g): "The owner must sign the notice of commencement and no one else may be: pe-mitted to sign in his or her stead
State of Fl ory dc, County of Ser►t• ihoj-e-
The foregoing instrument was acknowledged before me this day ofin
ji
C7 is
by Karran Sin k Who is personally known to me ❑ -3 CD
Name of person making to nt /(�
OR who has produced identification type of identification produc d\ / "
C`'
a�SpRYgs� JONAS WONDER
cP �� NOTARY PUBLIC
G
STATE OF. FLORIDA
+ a� Notary Signature iY i s >
Comm# FF104514 \ ,,, _, �: ,;,,, >- ,
�uv.;;n mG
E 3 Expires .'319n!angg
m
In —
E=
o=v
City of Sanford
Building and Fire Prevention
Product Approval Specification Fora
Permit # 1'e-roo f
Project Location Address / 00 N, Sornerse+ C+, Ste.•,-Pord1 FIL 3277Z
As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the
information and product approval number(s) on the building components_ listed below if they are to be
utilized on the construction project for which you are applying for a building permit. We recommend that
you contact your local product supplier should you not know the product approval number for any of the
applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in
accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product
Approval can be obtained at www.floridabuilding.org.
The following information must be available on the jobsite for inspections:
1. This entire product approval form
2. A copy of the manufacturer's installation details and requirements for each product.
Category / Subcategory
Manufacturer
Product
Description
Florida Approval #
(include decimal)
1. Exterior Doors
Swinging
Sliding
Sectional
Roll U
Automatic
Other
2. Windows
Single Hun
Horizontal Slider
Casement
Double Hun
Fixed
Awning
Pass Through
Projected
Mullions
Wind Breaker
Dual Action
Other
June 2014
Category/Subcategory
Manufacturer
Product
Description
Florida Approval #
including decimal)
3. Panel Walls
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles
= KO
CC-PnbrzJ e AK
F�- -7oo6,— ✓Zlo
Underla ments
TeWry.
—1 o
L 5—AA
Roofing Fasteners
Nonstructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Built up roofing
System
Modified Bitumen
Single Ply Roof
Systems
Roofing slate
Cements/
Adhesives /
Coating
Liquid Applied
Roofing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels
Roof Vents
Other
June 2014
Category/Subcategory
Manufacturer
Product
Description
Florida Approval #
include decimal
5. Shutters
Accordion
Bahama
Colonial
Roll u
Equipment
Other
6. Skylights
Skylights
Other
7. Structural
Components
Wood Connectors /
Anchors
Truss Plates
Engineered Lumber
Railing
Coolers/Freezers
Concrete Admixtures
Precast Lintels
Insulation Forms
Plastics
Deck / Roof
Wall
Prefab Sheds
Other
8. New Exterior
Envelope Products
Applicant's Signature
Applicant's Name ��� berf
(Please Print)
June 2014
2 -to =1
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: ;Zh01;'0)8
I hereby name and appoint: lei aber+ S)<urg
an agent of: %%id Flor;d"
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:
IGO N, Somersef couri- S,, ,�ForJ , FL 32772.
(Street Address)
Expiration Date for This Limited Power of Attorney: 6 �jo%,?o/g
License Holder Name: gnber-i 14• SA6Cmo`I<e,r
State License Number: C C C OE-7 F5 3/
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF Sew;vat e
4
The foregoing instrument was acknowledged before me this day of Feekv-vy
20�6 , by gaberr-'N. Gheem-leer who is e ersonally known
to me or ❑ who has produced as
identification and who did (did not) tajr<a% oath.
(Notary Seal)
�S Rys JOEL HANCOCK
NOTARY PUBLIC
—STATE OF FLORiCA
J Comm# FF224497
.0 ' Expires 4/27/2019
(Rev. 08.12)
Si at re
Print or type name
Notary Public - State of _
Commission No.
My Commission Expires:
' CIiYt}F:
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF POLICY & PROCEDURES
F ,r
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: Z DATE: 2 ��`
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: /OU N. SomerS2f C ou4 SG,,,, -Fo rd , FL S2-77 Z
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) 1
g fcl uc.h:tCd
DECK TYPE (PLEASE SPECIFY): I% Xg' yl/'AAwwd de4,3 d ✓�ing S�►�J<rlci1S //�'C'
**PLEASE NOTE: ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLA. ED *"
ROOF VENTILATION: D OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES (20�0 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
KO coo-n r1JSe A9
FL# JUO(o—/?/,C
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
OOTHER: uv►decIc,.ne,,.,4-
T-ecL LJeq T—i57.o
FLU 1-7)9q—n2
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#
0MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
O INSULATED
FL#
O TILE
FL#
O OTHER:
FL#
�uilding 8, Rre.PrevMdon,Divkvi0't1
RESIDENTIAL RE I -ROOFAFFIDAVIT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHINGS DRY-INq ]FLASHING, AND ALL FINAL ROOF COVERINGS
I'S -7 -7
PEP,Mi!r#: ADDRESS: /00 Somer5e+ 64v.rt
/11
hober+m, -�>Aoem-:Xe .. . ........................ . . ..... ... . AS A(N) GENERAL, BUILDING, RES IDENrLAL,,6R
Roc)RNG--cON,t,(z,(\c,,roR..ENGINEER, ARCHITECT, OF F.S. CHAPTER 46.8 BUILDING INSPECTOR, I HEREBY, AFTIRM,'MAT ALL OF TI-fL
FOREGOING INFORMATION ISTRUE, AND ACCURATE. AND TI IAT ALL R(K)FING COMPONENTS LIST ON "IHESCOPE OF, WORK ATTHE
ABOY RFFERENCED,.,bDRESS RAVE BEEN INSTALLED IN ACCORDANCE WITHLILIR PRODUCT APPROVALS AND ALL APPLICABLE CODE
REQU ]REM E-N-1-S.-'SPECIFICALLY F LCRI DAB tj I LDING CODI_ EX Is'll NG BUILDING. LDING. IN ADDITION I CERTIFY THE INSTALLATION MEETS ALL
REQUIREMEN-IS FOR SECONDARY WATER BARRIER AND NAILING OFTHE, ROOF DECK, IN ACCORDANCE WITH THE HURRICANE RETROFIT
MANUAL. REQUIREMENTS (BASED ON�F& CHAPTER 553.844).
LICENSE #:.CCC QS7 8-Sq
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE' DATE,: 3-2Z-71
(MUST "BESIGNER BYLICENSEI-IOLDER 0ROWNER/BUIL.DFR)
A FINAL ROOF INSPECTION IS REQUIRED"
THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITEAT THE TIME OF THE FINALROOF INSPECTION,
ALONG WI'F1l'D[61'1'AL,1.1110'1,,OGILkP[IS OF EACH PIANE OF" I .'HE ROOF SHOWING IN DETAIL ALL ,COMPONENTS :(DECKING
UND.EkLAYMENT, FLAS I HING, DRIP EDGE ATTACHMENT). WITH TILE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON THE DECK
FOR EACH INSPECTION.
EC-06N. THE PHOTOGRAPHS
APHS MUST INCLUDE A RULER.ORMEASURING DEVICE TO CONFIRM ALL NAIL SPACING AND
OVERLAPS, INCLUDING DRIP EDGE AND VALLEY FLASHING. PLEASE REFER TU'I'im RE -ROOF POLICY ANWINSPECTION, PROCEDURE
PAPERWORKIFOR Ft:!R"l'HEREXPLANATION ,orA[.I.. RFQUIRFMENTs.
**FAILURETO 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'I'BASED ON PERSONAL
,INSPECTION, THE INSTALLATION OF ALL ROOFING COMPONENTS.
STATE OF; FLORIDA COUNTY OF
Sworn to and -Subscribed before me this 20 119 by:
Who is 9-PIrsonally Known to me or has 0 Produced (type of
ident , ification) as identification.
S 'n ure of Notary'Public
sState of Florida
JOEL HANCOCK
Print/Type/Stamp Name 91,42:• NOTARY PUBLIC
E! 1�
of Notary Public TATE OF FLORIDA
Comm# FF224497
4k___ S Expires 4/2712019