HomeMy WebLinkAbout103 Sugar Maple CtCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $ 9351.00
'q4ob Address: 103 Sugar Maple Court, 32773 Historic District: Yes ❑ No
Parcel ID: 36-19-30-506-0000-1320 Residential 0 Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair® Demo ❑ Change of Use ❑ Move ❑
Description of Work: Reroof 2688 SF of Asphalt Shingle area
Plan Review Contact Person:
Liz Waters Title: office Manager
Phone: 407-240-1225
Fax: 407-240-1483 Email: lizdrs@hotmail.com
Property Owner Information \
Name William Latham
Phone: 321-446-9490
Street: - _103 Suga Maple Court,
Resident of property? : yes
City, State Zip: Sanford F1, 32773
Contractor Information
Name DRS of Central .Florida, Inc. Phone: 407-240-1225
Street: 6107 Anno Avenue
Fax: 4047-240-1483
City, State Zip: Orlando, FL 32809
State License No.: CCC057239
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: 5" 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 accur and that all work will
be done in compliance with all applicable laws regulating con ctio and z ing.
Signature of Owner/Agent Date Signature of Contractor/Agent Date
W ,11 Iiam l,O�Iq I
Print Owner/Agent's Name
I I kh 1A 3k
Signatur of Notary-StateofFlorida Date
s Elizabeth Waters
s� NOTARY PUBLIC
a � STATE OF FLORIDA
/VLLZ" z Comm# GG123242
OWner/Rent 1SCXpire$,ersona� y own to Me or
Produced ID �_ tT'ype of ID ( L
Richard Rao
Print Contractor/Age is Name
3
Signature Notary,,§t of FWi eth ers Date
�' o� NOTARY PUBLIC
STATE OF FLORIDA
Comm# GG123242
�r�HCE19�0 Expires 7/11/2021
Contractor/Agent is x 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.
Flood Zone:
# of Stories:
Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads Fire Alarm Permit: Yes ❑ No ❑
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING:
COMMENTS:
FIRE:
BUILDING:
Revised: June 30, 2015 Permit Application
Property Record Card
CFA Parcel: 11-20-30-508-0000-0680
Property 103 SUGAR MAPLE CT SANFORD, FL 32773-5629
oa�•a��• - -- - -- - - - - -- -
Parcel Information - Value Summary
2018 Working 2017 Certified
Values Values
Valuation Cost/Market Cost/Market
Method
Number of 1 1
Buildings
Depreciated
$94,682
$89,304
Bldg Value
Depreciated
$1,200
$1,200
EXFT Value
Land Value
$25,000
$25,000
(Market)
Land Value Ag
Just/Market
Value'*
$120,882
$115,504
Portability Adj
Save Our
$44,029
$40,232
Homes Adj
Amendment 1
$0
Adj
Legal Description
LOT 68
HIDDEN LAKE PH 3 UNIT 4
PB 28 PGS 1 & 2
Taxes
Taxing Authority
Assessment Value
Exempt Values
Taxable Value
County General Fund
j $76,853
$50,000
$26,85:
Schools
$76,853
$25,000
$51,85,
City Sanford
$76,853
$50,000
$26,85:
SJWM(Saint Johns Water Management)
$76,853
$50,000 ;
-
$26,8&
County Bonds
$76,853
$50,000-!!
$26,85:
Sales
_
Description
Date
Book
Page
Amount
Qualified
Vac/lmp
SPECIAL WARRANTY DEED
8/1/2012
07834
1361
$70,000
No
I Improved
CERTIFICATE OF TITLE
4/1/2012
07754
0918
$50,100
No
I Improved
WARRANTY DEED
4/1/2005
05701
1312
$164,900
Yes
Improved
WARRANTY DEED
3/1/2003
04778
1373
$116,000
Yes
Improved
_ _............
WARRANTY DEED
111/1984
01519
0981
$59,000
Yes
-__
Improved
Find Comparable Sales
Land
Method
Frontage
I
Depth
Units
Units Price
Land Value
LOT
0.00
0.00 1
1
$25,000.00
$25,001
Building Information
- --------------- --- --- -- - -- - - ---------
Is 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 SINGLE 1984 61 3 1,2361 1,7321 1,236 1 CONC $94,682 $111,064 Description Area
FAMILY I BLOCK
GARAGE 480.00
` FINISHED
Florida 32809
of�,rstrit .rtarttrr►,H, 6107 Anno Avenue a Orla® do, 407-240-1483
Tel: 407-240-1225 Fax: Date
Roofln Contractor cC-c057239 phones contractor cJ-Ci 154133 02J21 %2018
321.446.9490
To:
Job A`ame-'Location
William Latham 103 Su ar Ma le Ct Sanford, Fl 32773
103 Sugar Maple Ct Claim lob Phone
Sanford, Fl 32773
#
We Hereby Submit this work authorization estimate for::
SCOPE OF WORK ales at the above referenced location
Removal and installation of 2bys mroof shin code. (New code effective 10/01/07
1 Strip eacisdng roof system down to smooth na -1 ble surface. (1 layers of shingles)
er
2, Re -nail all existing plywood decking p
gleroof(ilayer)
3, Install30, D226.feltpaperonshirt
e w edge metal (color white
4- Install all n)
5 - Install all new peel n stick valley liner
6. Install all new gooseneck vents
7. Install all new shingle over-'dge'lent'
g. Install all new lead boots
Initial if you want to chang
g• Install all new 30-year architectural fungus resistant roof shingles e to peel n
10. Clean up and dispose of all associated debris
upgrade to modified peel n stick underlayment instead of 309 is $481.00
11, Additional price to upg 100 2 sq roil)
stick instead of 30r felt. (peel n stick used will be Carlisle wip
SPECIAL COIr�> FIONS ears warranty on workmanship. tem. Standard Industry Practice.)
DRS to provide owner with a flue for 5
DRS to pull all necessary permits far the project,
• ace in driveway for dumpster for removal of existing and installation of new roof system
per LF for IX and 2%wood
Standard Industry Practice) Owner to provide necessary space er sheet installed of %,* plywood products, and $6.00 p
{}caner to provide necessary space in driveway for roof top material delivery, (
products,
deck replacement woll be odproducts. (Labor ndmaterials)separately at the rate of if nc essary
products, 58.00 on 3X and up
1 Note: Price is only good uriti4141arch 0'• March 5's there'ceill be a 10-15% prlGe Increase on all roofing materials across the hoard.
ecifications, for the sum of.
AND SEVENTY
We Propose hereby to complete in accordancee'W itb above spr�
dollar,$8`8�v
EIGHT THOUSAND EIGHT HUNDRED
M l
payment to be made as follows: Authorized Signature
100% UPON COMPLETION
}eted in a workmanlike manner according to standard practices. Any S�1aTi� Waters
All work to be comp P g costs will be executed
e over and above the estimate. note : Thi> proposal may be 5 days
alteration at deviation from above s ecifications involvin extra w�thdrawv by � if not accepted rr7thin
only upon written ordets, and wtill become an ertta charg
Ail agreements contingent upon-Ltnk sc C'omoensatioiillnsuran oe dour control. Our
svorxers----
0 Insurance Claims Only
All work scope and ! or costs specified in this
of the customer's
are subject fa or contingent upon the approvalappoints DRS
insurance company. The undersigned further
and permits DRS to negotiate with
Roofing as its representative
insurance company for settlement of the insurance claim. If there
is a difference of work scope and / or costs,ag
DRS may negotiate a
reasonable replacement and / or replaceeiment DRS will not start reed
cost mutuay
between DRS and the insurance Company- insurance company.
work until work is approvedb b' the
Date of 2/21/18
Acceptance
Signature
Insurance
111111111111111111111111111Hill fill fill
THIS INSTRUMENT PREPARED BY: GRANT IIALOY o SEMINOLE COUNTY
Name: Katerin Burgos
Address: 6107 Anno Avenue, Orlando FL 32809 t�LE(i OF CIRCUIT Pg s - t� CUt1F'TRUL.LE(;
BK 90°�' f's 1C111 (1F'3s;�
CLERK'S A 2018026807
NOTICE OF COMMENCEMENT F :`:�=� �(��IFEES $10. "22"2.-, Al"I
t r r t= il,0il
RECORDED BY t ssm i t h
State of Florida
County of Seminole
Permit Number: Parcel ID Number: 1 1-20-30-508-0000-0680
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 68 HIDDEN LAKE PH 3 UNIT 4 PB 28 PGS 1 & 2 103 SUGAR MAPLE CT.
SANFORD, FL 32773
GENERAL DESCRIPTION OF IMPROVEMENT:
Reroof 2688 SF of Roof Shingles
OWNER INFORMATION:
Name: William Lathani
Address: 103 Sugar Maple Ct. Sanford FL 32773
Fee Simple Title Holder (if other than owner) Name:
Address:
CONTRACTOR:
Name: DRS of Central Florida, Inc.
Address: 6107 Anno Avenue, Orlando FL 32809
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 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)
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 o perjury, I declare that I have reac
to the best of my�dge a
Owner's Sign fure
Florida Statute 713.13(1)(g): " The owner must sign the notice of comm
State of 0 Countyof A0
The foregoing instrument was acknowledged before me I
by ji� I I I' M ` 0E A-M
Name of person making staterpent
OR who has produced identification type of identifici
o�tARyq 6 NIizabeth Waters
OTARY PUBLIC
z o STATE OF FLORIDA
COmm# GG 123242 Notary ignature
El �Expires 7/11/2021
Product Approval Specification Form
Permit #
Project Location Address 103 Sugar Maple Ct.Sanford FL 32773
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 Up
Automatic
Other
2. Windows
Single Hung
Horizontal Slider
Casement
Double Hung
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
Atlas
Pinnace
16305.1-R6
Underlayments
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 up
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 Richard Rao
(Please Print)
June 2014
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
I hereby name and appoint: Henry Johnsoin
an agent of: DRS of Central Florida, Inc.
(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):
:K� The specific permit and application for work located at:
11.2 20th Street, Sanford FL 32771
(Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name: Richard Rao
State License Number:
Signature of License H
STATE OF FLORIDA
COUNTY OF Seminole
Th regoing instrument was acknowledged before me this _Vday of �G S
20 _ , by Richard Rao who is rxpersonally known
to me or ❑ who has produced
identification and who did (did not) take an oath.
(Notary Seal)
Elizabeth Waters
Rot R soy, NOTARY PUBLIC
STATE OF FLORIDA
0 Comm# GG123242
�` NCE1g11b Expires 7/11/2021
(Rev.08.12)
Signaore
Elizabeth Waters
Print or type name
Notary Public - State of
Commission No.
My Commission Expires:
as
ItCITY OF
SkNFORDRESIDENTIAL REBuilding & Fire Prevention Division
-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 AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING ODE COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE:
SikiNFOR-D
FIRE k�
r
DEPARTMENT
PERMIT #
Buil(ling & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: 103 Sugar Maple Ct. Sanford FL 32773
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)
� tI
DECK TYPE (PLEASE SPECIFY): V- O
* *PLEASE NOTE: ONLY I00 SQUARE FEET O THE EXISTING DECK IS PERMITTED TO BE REPLACED""
ROOF VENTILATION: O OFF -RIDGE O RIDGE OSOFFIT 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 )e4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
SHINGLE
FL# I -
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
f 1 �/
OOTHER: N O-L
e,G
7�
vL� 1 Yi,S O VFL#
Q�
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
Building & Fire Prevention Division
-S ------- r%-JRD RESIDENTIAL RE-ROOFAFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT#: 1 " 060 U Q-1s ADDRESS: 3 SU far- 0 uf? (2 C:�--
sa np—o cq
AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR NGINEER, ARCHITECT, OF F.S. CHAPTER 4'6'8 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 — SPECII-ICALLY FLORIDA BUILDING CODI3-0EXISTING 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#: LC&OS .7 23Q
COMPANY / CONTRACTOR: (Z
CONTRACTOR SIGNATURE: _
(MUST BE SIGNED BY LICENSE
r 1 d a ) ri
OWNER/BUILDER)
A FINh'G ROOF INSPECTIONAS'REQUIRED. - -
DATE: /
THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINAL ROOF INSPECTION,
ILONG 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 TOIFOLLOW ALL REQUIREMENTS WILLLRESULT IN A FAILED INSPECTION, A RE -INSPECTION FEE AS
WELL AS REQUIRING A DESIGN PRO FESSIONAL'(ARCHITECT OR ENGINEER) TO CERTIFY, BASED ON PERSONAL
INSPECTION, THE INSTALLATION OF ALL ROOFING COMPONENTS.
STATE OF FLORIDA COUNTY OF
rn to and Subscred before me this day of'T%i�Ci �Ci6t 20 /9 by:
.11
Who irsonally Known to me or has ❑ Produced (type of
identi cation) as identi.fication.-
FV'
M/ I 'T t(-A %4
4
Signatu a of Notary Public
Stf of orida RygS .1 Elizabeth Waters
1 2 A ice..J q� NOTARY PUBLIC
%� a s STATE OF FLORIDA
Print/Type/Stamp Name �, Comm# GG123242
of Notary Public `��NCE 19�� Expires 7/11/2021
r.