HomeMy WebLinkAbout124 Carmel Bay DrA Q Co�� CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $ 7 /�
Job Address: _/2j1 L ,L tr/ ,& ,/ �, �e1 277/ Historic District: Yes ❑ Not
Parcel ID: 33 /9-- O ' 67 - 0000 - O Residential Commercial ❑
Type of Work: New ❑ Ad ditiowEJ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: Aa1 l¢ sA,,,r-1,,—
Plan Review Contact Person: _
%/P,� �,� Title:
Phone: 3a1-312-65-9�ell
Fax: Email:
Property Owner Information
nn
Name 114c, ern09-
Phone:
Street: /_2hy A,,,ne
Resident of property? : r PS
City, State Zip:
2 2 2/
Information
/
Name �x7 �����.—�'oo,-�
�Contractor
,[�s' ass, lee. Phone:
Street:
Fax:
City, State Zip: Gc%„`T�, r�/L, 1279-_ State License No.: CCC 13313a3
Architect/Engineer Information
Name:
Phone:
Street:
Fax:
City, St, Zip:
E-mad:
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: 51' 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.
Signature of Owner/Agent Date
Print Owner/Agent'JiTame
BRITNI BAILEY
?it'Pr v 4�
e of Florida -Notary Public
Commission # GG 104152
My Commission Expires
May 14. 2021
Owner/Agent is ersona y own to Me or
Produced ID V Type of ID . L
ci
Contractor/Agent Date
Pr ontraetor/Agent's Name
Signa o at -S to f or' a a
ANNETTE M BLAND
e` Notary Public - State of Florida ' Commissior # GG 170900
My Comm. Expires Jan 16.2022
S� r`
�Na7cra Nowy Assn.
Contrac or gen 1s ersona y own 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
2/3/2018
SCPA Parcel View: 33-19-30-519-0000-0340
Property Record Card
Parcel: 33-19-30-519-0000-0340
Property Address: 124 CARMEL BAY DR SANFORD, FL 32771
_. -_. _ _-_____ _ _ -7-7 -_-_.__----- --._ _._._..-__ _._--- ___ ._. ._ . 11 _. _.-._ _..-_--_.
Parcel Information Value Summary
Parcel
33-19-30-519-0000-0340
Owner
BALASUBRAMANIAN, LAKSHMANASWAMY
PERNA, VIDYA
Property Address
124 CARMEL BAY DR SANFORD, FL 32771
Mailing
628 FANNING DR WINTER SPRINGS, FL 32708
Subdivision Name
MONTEREY OAKS PH 2 REPLAT
Tax District
31-SANFORD
DOR Use Code
01-SINGLE FAMILY
Exemptions
2018 Working
2017 Certified
Values
Values
Valuation Method
Cost/Market
Cost/Market
Number of Buildings
1
1
Depreciated Bldg Value
$162 590
i $153,207
- Depreciated
Depreciatee d EXFT Value
t $701
-
1 $751
Land Value (Market)
--
--
$40,000
! $40,000
- --
Land Value Ag
-
Just/Market Value
$203 241
r$193 958
-
1— -
Portability Adj
Save Our Homes Ad'/
-- — -
$0
--- —
$0
Amendment 1 Adj
T $22 033
$29 178
P&G Adj
$0
$0
-- - -
Assessed Value
$181,258
1 $164,780
Tax Amount without SOH: $3,329.33
2017 Tax Bill Amount $3,329.33
Tax Estimator
Save Our Homes Savings: $0.00
* Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description
LOT 34
MONTEREY OAKS PH 2 REPLAT
PB 58 PGS 22-23
Taxes
Taxing Authority
Assessment Value Exempt Values
Taxable Value
County General Fund
$181,258
$0
$181,258
Schools
$203,291
$0
$203,291
City Sanford
$181,258
$0 j
$181,258
SJWM(Saint Johns Water Management)
$181,258
$0 !
$181,258
---- y -
Count Bonds
- $181258 --
,
$O
$181,258
i Sales
Description
Date
Book
Page
Amount
Qualified
Vac/Imp
WARRANTY
WARRANTY DEED
9/1/2006
. 06412
1639
$270,000
Yes
Improved
-
WARRANTY DEED
11/1/2005
06001
T 1164
$252,900
r Yes
Improved
QUIT CLAIM DEED
1/1/2003
04701
0945
$60,000 t No
Improved
SPECIAL WARRANTY DEED
4/1/2001
04067
0842
$118,900 Yes
Improved
---- ---------. __.__.._ _ . _.
WARRANTY DEED
-
1/1/2001
_.__._
04006
-
0928
_ - ----
$284,000 1 No
- -
Vacant
Find Comparable Sales 1
Land
Method Frontage
Depth
Units
Units Price
Land Value
LOT 1
$40,000.00
$40,000
Building Information
�Is Bed/Bath count incorrect? Click Here.
http://parceldetaii.scpafl.org/ParcelDetaillnfo.aspx?PID=33193051900000340 1 /2
THIS IN
'A PREPD BY: �7 j
Name: z r c✓�Co J�t�t�`t r�S' lnC_
Address: „
r - n (0, rich
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number:
11111 fill 1111
t! t1[Ir 1 "Ltli; Hi THOLE t:ili,lp.I'ry
t�:I..I:F.K OF r_:IRC 11): i 3 iJLJF' iF.
CLERUSx2018024i330
_ _
,.t - yl2 i-1-1'
Parcel ID Number:
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.
JPTION/OF PROPERTY: (Legal description of the property and street address if available)
T ?`f
p16 .S"Y & f ;72.- Z3
GENERAL DESCRIPTION OF IMPROVEMENT:
OWNER INFORMATION:
Address: 121 -
Fee Simple Title Holder (if other than owner)
397
39721
Persons within the State of Florida Designated by Ownerupon 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)
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 I have read the foregoing and that the facts stated in it are true
to the b s of my knowledge and belief.
Owner's Signature
VFlo
Owner's Pr ed 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 stead."
State of ,i:it>6'•UL Countyof G,. M • A.-O \z-
The foregoing instrument was acknowledged before me this S�&—day of ►���fJ��) C,
byC-7eWZ,Who is personally known to me ❑
Name of person making statemt t
OR who has produced identification IJ type of identification produced:
E=1-
NI BAILEY
rida;NotaryPublfcion"#,QG 104152mission Expires
y 14, 2021
4�
If
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 3 12 11
I hereby name and appoint:
C tc_fi,. CQa (2—y, d—r
an agent of Pr-1
(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 it and applicationho'r'
work located at:
L7.M.
01-1-, / A./
Address)
Expiration Date for This Limited Power of Attorney: y�Va<
License Holder Name:
State License Number:
Signature of License 11
STATE OF FLORIDA
COUNTY OF'�""`"� —
The foregoing instrument was acknowledged before me this "74 dday of
200_LV_, by A/1,,,, Ca. t�� who is kpersonally known
to me or ❑ who has produced
identification and who did (did not e an oath.
ignatu e
(Notary Seal)
F,F,
BRIT^I BAILEY ��,State of Florida -Notary Publ r•_ ComM'ssiarj # GG 104152 I
OQ`
a My Commission Expir
May 14, 2021
,a
(Rev. 08.12)
Print or type name
Notary Public - State of
Commission No. CIC-1 Ilygh -z
My Commission Expires: 2
PM
Next Generation Restorations, Inc.
6965 University Blvd,
Winter Park, FL 32792
Lic # CCC1331323
PH: 321-317-6594
Fax : 407-209-3533
www. nextgenrestorations, com
Name: Vidya Perna
Phone: 4'0796.7219i3 rc-
Date: 12/15/17
Address: 124 Carmel Bay Drive
City: Sanford- M�
Zip: 32771
Salesman: Randi
Contact Phone #: 4074038 94
Job #
Material: Certianteed Landmark
Color: to be determined �.
Pitch 5/12
x
1. Pull city_ county_x_ Permit x_ Sq. Renail Wood
x
2. Tear off 30.48 sq old shingle -_ Sq old the x
x
3. Dry in synthetic underiayment x one layer two layer _ peel stick
x
4. Install Galy. valley metal _ LF x self adhering valley
x
5. Install --- Alum drip edge x_ Steel drip edge = -_ Pan Flashing _ L. Flashing I
x
6. Install all accessories to match
x
7. Replace 1.5 22.0 1 3.0 Lead boots 4" GRV 2 10" GRV 1 riser—
x
8. Starter Roll _x Starter strips
x
9. Install 30.48 Sq shingle x cap 3-tab / Perf / Hip -& Ridge / Meta130
10. Install sm dead valley Ig dead valley modified Liberty
11. Install — TPO --- Layer of insulation --- TBAR / Seam Tape
12. Install / Replace _ 2x2 2x4 4x4 Skylights acrylic domes / sfa cm / fixed
x
13. Haul off debris and run magnet thru work areas
x
14. All wood is additional $45 per sheet of plywood and $2.25 per ft of Fascia
2 sheets included
15. Next Generation Restorations Has my permission to contract with an engineer of its choice for any
x
and all inspections required under local or state law.
x
116. Other specifications price includes up to one sheet plywood
Total Contract Amount
- $9, 444.00
All Pricing good for 30 Days Deposit
$8 648 00
�C�O
Balance due upon completion
--$6 996-00
(�oo o
Access : Customer agrees to allow access to the property and realizes that heavy equipment Is being used. Contractor shall not be liable for, without limitation, damage to driveways, sidewalks, lawns, sprinkler
septic systems, and any other structures thereof, as a result of rooftop or job deliveries.
Damage Etc.: Customer shall be responsible for removal, reinstallation and calibration of satellite dishes. Should customer become aware of damage to property by Contractor, his agents, or employees during the
course of Instagation of the roof, said damage shall be brought to the attention of the Contractor prior to the time of payment for the roof in question. N Customer falls to notify Contractor of said damage, within 5
working days of occurrence, then shall waive all rights against Contractor concerning said damage. Next Generation Restorations, Inc. is not responsible for roofing trails penetrating A/C or water Imes in the attic.
air assets including shelves, ceiling tans, tools, cars and other valuables to avoid damage from vibration, breakage and/or detachment of parts etc.
Delays, Etc.: Hereby acknowledges that Contractor may be subject to delays occasioned by inclement weather, labor disputes, and material supply shortages or other causes which are beyond the control of the
ereby accepts delays occesloned by one or all of these circumstances in the installation of the roof.
Payment of Contract : Customer hereby agrees that all amounts due for this work shall be paid upon completion of Installation. Any amounts unpaid will bear interest at a rate of 1 1/2% per month. Contractor shag
all coats of collection including any and all Attorneys' fees.
Right to Cancel : If this is a Home Solicitation sale, and you do not want the goods or services, you may cancel this agreement by providing wrllten notice to the seller in person, by telegram or by mall. This notice
must indicate that you do not want the goods or service and must be delivered or postmarked within 48 hours of you signing this agreement If you cancel this agreement, the seller may rwt keep all or part of any
down payment. IF THIS IS NOT A HOME SOLICITATION CONTRACT: Once the contract is signed, you are bound to N by the laws of the State of Florida. N in the event you breach or attempt to cancel this contract,
shall be entitled to any and all lost monles from the contract.
e of Proposal: The above prices, specifications and terms and conditions of this contract are hereby accepted.
An contracts are subject to Next Generation Restorations, Inc. approval. Customer agrees to allow Next Generation Restorations, Inc. to use photos, letters of recommendation, etc, to be used for advertising
purposes. In case arry, one or more of the provisi na contained herein shall be invalid, illegal or unenforceable in any respect, the validity, legality and enforceability of the remaining provisions and other application
Customer Signature Salesman Signature
Date Date
Management Approval
Date
Construction Industries Recovery Fund: Payment may be available from the construction industries recovery fund if you lose money on a
project performed under contract, where the loss results from specified violations of Florida Law by a State Licensed Contractor. For
information about the Recovery Fund and filing a claim, contact the Florida CILB at the following telephone number and address: 1-850-
487-1395. Florida Construction Industry Licensing Board, 1940 N. Monroe St. Tallahassee, FL 32399.
Quote Date
2/7/2018
7829
SANFORD CASH SALES
Sunniland Sanford 401
1735 St. Rd. 419
Longwood, FL 32750
Office: (407) 322-2421
Fax: (407) 324-4421.
Email: Sanford@SunnilandCorp.com
Sale
SANFORD
Q6814
k L,PP V
Pg1of1
NEXT GENERATION RESTORATIONS
124 CARMEL BAY DR
SANFORD, FL
NET 30 DAYS
SHIP:
2/6/2018
Sales Person
Contact
Number
TALE
MC
105
BD
CT LANDMARK 30AR WEATHERWOOD
519622
105
27.00
2,835.00
35 SQ
6
BD
CT H&R WEATHERWOOD
519684
6
45.00
270.00
3
BD
STARTER
512479
3
37.00
111.00
3
BX
COIL NAIL GENERIC 1-1/4 INCH
750017
3
30.00
90.00
2
EA
FLASHING CEMENT
533800
2
32.00
64.00
3
BX
NAIL EC24 2-3/8 INCH SENCO DECKING NAIL
750112
3
42.00
126.00
1
RO
VENT OMNI LOMANCO 30FT
546242
1
67.50
67.50
1
EA
VENT 4 FT GALV ROOF PAINTED
546202
1
39.50
39.50
WHITE
2
EA
4 IN BATH VENT PAINTED
546498
2
17.00
34.00
WHITE
1
EA
VENT KITCHEN 10 INCH PAINTED GALV
546504
1
22.00
22.00
2
EA
STACK 1 1/2 LEAD
544712
2
9.75
19.50
2
EA
STACK 2 IN LEAD
544713
2
10.25
20.50
4
RO
MIDSTATE QUICKFELT 10 SQ
521444
4
68.50
274.00
3
BX
RH SIMPLEX 1 IN PLAS HD
744298
3
22.00
66.00
27
PC
EAVE DRIP 6 IN 26 GA WHITE GALV
543806
27
7.15
193.05
1
EA
FREIGHT
999998
1
35.00
35.00
Sub Total Tax Grand Total
$4,267.05 $296.24 $4,563.29
Quote is valid, for 30 days. If delivery is included in price quote, every attempt will be made to deliver and roof load the materials. If roof load is too
difficult or too dangerous, materials will be delivered curbside. If more than one delivery is required, additional charges may, apply. All deliveries
are made at the customers risk including, but not limited to, damages to sidewalks, driveways, buildings, trees, shrubbery, lawns, and septic tanks.
All items are sold as is and without express or implied warranty by Sunniland, including but not limited to warranties for fitness or merchantability.
Returns must be approved by Sunniland and are subject to a 20%n Restocking fee. In the event of dispute, venue shall be in Seminole County, FL.
CITY OF
SkXFORD
11111 •
O:ADDRESS:
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
3,
STRUCTURE TYPE: IQ 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:
* *PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED"
ROOF VENTILATION: g)* RLDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES kNO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 —4:12 /5-4:12 OR GREATER
TYPE OF ROOF
MAN�UIFACTURER�%
FLORIDA PRODUCT APPROVAL
SHINGLE
�ej t/W�e�: pl
FL# ,! 3
O METAL
FL#
0MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IF APPLICABLE"
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#
OINSULATED
FL#
O TILE
FL#
O OTHER:
FL#
CITY OF
r ' Building & Fire Prevention Division
-SA- -o- - RESIDENTIAZRE7ZOOFPOLICY&PROCEDURES-
FIRE DEPARTMENT
PERMITTING RE, QUIREMENTS -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: DATE:
-s- `�