HomeMy WebLinkAbout127 Pinefield Dr (2),tM,at. 31Z7
CITY OF SANFORD
BUILDING S FIRE PREVENTION
PERMIT APPLICATION
Application No: I 8 't
Documented Construction Value: $
Job Address: IZ1 9kY%7 f)A Z)Y Historic District: Yes ❑ No 2
Parcel ID: -6Z- n - $N - 56 • Oc)00 - 11 10 ResidentialR Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration A Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: reroof of primary dwelling. gaf timberline asphalt shingles. FL10124-09.
AA�0. 1 1-I `I72
Plan Review Contact Person: GIA Title: am a-5 Malin(
Phone:' 401 Ab1. 3tb�) Fax: Email: tDP�(1jY1�(t"��(i$"tiU(�idn �[pryl
Property Owner Information
Name C_ ouro Phone:
Street: Im f 1Pi� or Resident of property?
City, State Zip: CIYDt 3 Su 3 -n �
Contractor Information
Name American Hero Construction Phone: 4074873183
Street: 719 Waltham Ave
City, State Zip: Orlando FL 32809
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Fax:
State License No.: CCC1330757
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 (late of application and the code in effect as of that date: 5`h 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.
Sianatttre tf OwneriAgenl Date
-Tmca t Young _--
Print Owner/Agent's Name
3 21 18
grtature of Notaty-State of F nda Date
Owner/Agent is Personally Known to Me or
Produced ID ✓ Type of 1D FWL-
EMILEE STEVENS
Commission A GG 43415
MY Commission Expires
octobsr 31, 2020
e of ContractodAgent Date
P
Print Coajent s Hama
OT 2 In- `le)
tgnature of Notary -State of Florida Date
Contractor/Agent is 6 Personally Known to Me or
Produced ID _ Type of ID MILEE STEVENS
mmission N GG 43415
FOIL. OFFICE USE ONLI(..y Commission Expires
OOtobor 31. 2020__
Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Gas[] Roof ❑
Construction Type:
Occupancy Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑
APPROVALS: ZONING:
COMMENTS:
# of Heads
UTILITIES:
ENGINEERING: FIRE:
Flood Zone:
# of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: June 30, 3015 Permit Application
St'C1 oo' l-, COi A -A
THIS IN TRUMENT PlittPARED B
Name: oxy an 1Atm rOtIstYUG�l0f1
Adidrees: 5660 AanSF i Rti2
cry fill :M09
11110111
1• • • .,
1 ,yet
Permit Number.
Parcel ID Number. 3 7 - `a - 1 — 5 1 S 0am " 1170
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.
1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
L*-*-_ll - c et�.� [ _a1 �,•�.�e 1 P 136 ,7 y Gs J-
2. GENERAL DESCRIPTION OF
3. OWNER INFORMATION OR LESSEE INFORMATION Ir THE LESSEE CONTRACTED FOR THE IMPROVEMENT.
Name and address: Trt«; L,[Y-s
Interest In property: IW 1(W.Al"
Fes Simple Title Holder (if other than owner listed above) Name:
Address: !�
4. CONTRACTOR: Name: f-ObP- rt Ph e10.1n Pion Number. H01 tle,1 3i? 3
Address:5g 0 04wSd _014,e Orla.Y-6o FL ?)UCcj
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
Address: Amount of Bond:
S. LENDER:
Address:
Phone Number.
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents maybe served as provided by Section
713.13(1)(a)7., Florida Statutes.
Name: Phone Number:
Address:
8. In addition, Owner designates
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number:
8. Expiration Date of Notice of Commencement (The expiration 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 1, 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.
L-,(SVWAn of Ovrw or Laaae, at Ownses or Usaw'
IWawr@ed OMoerlDlrecbrtPw,eMvtar,agerl
State of Fwi6& County of
(Print Name and PrONda Sq uWs Tttl )o0m)
The foregoing instrument was acknowledged before me this U 3 day of LAMA .20
by �raL.l �0:/yt A- Who is personally known to me ❑ OR
Nano of ����maldnp statement {;
who has produced identification C type of Identification producFed: _ DL—
,m
"•����: EMILEE STEVENS
a
•= Commission M GG 43415
My Commission Expires Natarysgna
October 31. 2020
M
GRANT MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL
CLERK'S # 2017050275 BK 8917 Fig 1361; (1 pg) E-RECORDED 05/19/2017 08.26.47 AM
10.00
Sanmk�e (Ok,l,)
THIS INAT,�R�UMENT PREPARED B
Name: Dxyall 1-I►2m ric stwdlon
Addrs,im: 5660 tAanSel
Uri O , IM09
NOTICE OF COMMENCEMENT
Perm)t Number.
Parcel ID Number: 37—IS — 3 1
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
1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
f_ o.Ar- l 1 -1c_ _le.-,.4 (_a If--- �L. —.e 1 P 15 a2 D IS. S -:iS $ �-(o
t GENERAL DESCRIPTION OF
3. OWNER INFORMATION OR LESSM INFORMATION IV THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address:Trtu,; 1'7-7- 4-c-" 20";,ae 'S
Interest In property: OW ojj� "' J
Fes Simple Title Holder (if other than owner listed above) Name:
Address:
4. CONTRACTOR: Name:QaDQrt PI)e1lk.ln Phone Number.
Address: 5850 PDY) t PNe Or la.l ldo FL-
6. SURETY (If applicable, a copy of the payment bond Is attached):
Amount of Bond:
6. LENDER: Name: Phone Number.
Address:
T. Persons within the State of Florida Designated by Owner upon whom notice or other documents maybe served as provided by Section
713.13(1)(a)7., Florida Statutes.
Name: Phone Number.
Address:
8. In addition, Owner designates
to receive a copy of the Lienor's Notice as provided in Section 713.13(t)(b), Florida Statutes. Phone number:
9. Expiration Date of Notice of Commencement (The expiration 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 1, 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.
C-ISIgnam of owns or Umsm or Owners or L.esaea'
lWawRzed omc4r1o4recUWPanrrrn fanegml
State of Fl Vtl County of
jy. CL buln"I
(Pnnt Name a10 ProNda &rgrutorlra T0N016a)
The foregoing instrument was acknowledged before me this U 3 day of
by �raLA yQi� Who is personally known to me ❑ OR
Name of c � onawng stawrora
who has produced identification LY�type of Identification produced:
71(2o
EMILEE STEVENS
Commission N GG d3a15
My Commission Expires N«erysigna
October 31. 2020
GRANT MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL '
CLERK'S # 2017050275 BK 8917 Pg 1361; (1pg) E-RECORDED 05/19/2017 08:26:47 AM
10.00
TO A 4 M1 11A �, 12 C�e&,'N,41
1 ftcu
Mortgage Company:
Loan Number-: —
American Hero
Construction LLC.
5850 Hansel Avenue,
Orlando,, FL 32809
Fax: 1 (888)-420-0825
Telephone: 407-487-3183
Cert Residental CRC133 1195
Cert Roofing CCC1330757
Date: Homophone:.
Name:
Address: 1'�� P IVP 0�,P 1 ci V-Q- (hers}
�n aA, stpie: -r� ,zii:i: E hied
.-D,iekriptloWo�fwork ,to bedonean e(thiscontf-act-
1. "HERO" and Home Owner agree that this contract ii4tilland void unless the insurance company approves the
claim for full roof replacement. ___.T
". I , hereby hire and authorize American Hero Construction, LLC., to perform
repairs oil my property located at the address written above.
s, American Hero Construction has authorization to complete the work described per the scope of repairs provided to my
insurance company for the claim filed at the address listed above.
,t. The price of this job is to be dictated by the loss sheet agreed to by the insurance carrier. Home Owner will provide "HERO"
a copy of the insurance carrier's loss sheet at time of' receipt.
y -o Construction LLC., fbr the servi.
.)I . I aUthOliZe In Insurance Company to release payment direct to American I -lei ces
that are performed in conjunction With the above insurance claim. Should the IIISUranee Company recjuiredirect payment to
in(!, I hereby re(ILICSt that tile llarne, American Hero ConSti-LiCti011 I.W., be added to the draft that will be sent to tile in the
payinclit of said Claim. If payment is made directly to the Owner/Agent/Insured(s), it shall be endorsed over to American
Hero Construction I.I.0 upon receipt.
(;. 1, Owner/Mortgagor grant authorization for Ivlortgage Company to speak with Americtun
Hero Consti-LICti011 IJC'On Matters including, but not limited to, the claim status & draws. (Mortgage paid it) full —)
7, It is the Owner's responsibility to pay all Insurance -Deductibles. Owner's outof pocket expense Will not (!XC,c(!d the
(61tictiblP aIIIOLnIt its Stated on insurer's, loss beet The Deductible on the inSUrance conipany's loss'shect shall overrule
Deductible listed here DeChIptibie: ,s must be paid ill full.
111SUlance colllpany.GTO"-- _Fa___r_W Phone:
Policy Number 950 -P Y- ff6,99:1-14
Claim Number: S
Date Or Loss: D • Type of Daniage:
Upon insurance COITIpally approval arid subject to the terms and conditions herein. Aincrican HeroConstrUCti011 agrees to
furnish ill materials and provide the labor necessary to perfbrni the full roof replacement which shall take place following
Owner's insurance company's approval, approximately within 30 days, conditions permitting
kkanuaF cturer: CProdUCt Lin Color:
k F
Warranties to be given 16r work done: io Yr. Contractor Labol, Systems Plus GAF Golden Pledge (50 yr.) No Ex
Ord --
This contract constitutes Nit accord and agreement of lha,parties, aad no otherunderstanding, verbal or 61henvise ,,shall be"binding unless in
writing, signed by both patties, 7his contract is subject to approval by'an,officer"of
working days from the date of the contract
-You the Suyar may cancer this transaction anytime prior to midnight of the third business day after'the.date cf.this transaction."
,in MMOSS Whereof Putr-haset(S) each acxnorvleUgn raceipt of a ccniplatod copy of,tr is,coniracC and all dlsclostrre�soll the day and :yet`�� first
above wnnan
In signi!W this docionent I acknowledge that the scope oj'work to be performed and all contracts
signed have been ewj)1ained to ine and I am in agreement with.
APPROXIMATE STA13TING OATE:
Agent
Accepted on
'chaser.
By,
Att(horized'Sigriatp Purchaser
D,ON'T'SIdN IF BLANK, k6MEOWNEk:1S�tkiffLED Td:CbOYJ&.°THE j:64TRAdj, THE_7II&,b OIXIN61S16NAtUkE-
CITY OF
Building & Fire Prevention Division
S FORD RESIDENTIAL RE -ROOF POLICY & PROCEDURES
fIR�
I. DEPARTMENT�
PERMITTING REQUIREMENTS -NO PLAN RIVIF,W REQUIRED
THIS DOCUhfF, f (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE
REQUIRED TORE 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 TI IESE DOCUMENTS. COPIES WILL REMADE TO POST ON THE JOB SITE.
"PROJECTS LOCATED Ly TTIE SAVFORD 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 RF..SIDFPTIAL (SINGLE FAMILY, TOWNHOUSE,
MOBILE HOME, APARTMENT AND10R CONDOMINIUM) RE -ROOF PERMITS.
Tim, FOLLOWING IS REQUIRED TO BE PROVIDE ON THE JOB SITE:
• PERMIT CARD, POSTED IN ACONSPICUOUS AND WEATHERPROOF LOCATION
• COMPLE•TED RESIDENTIAL RE -ROOF SCOPE OF WORK
• COMPLETED AND NuFARILED INSPECTION AFFIDAVI f
• ALI. FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS
(PRODUCT APPROVAL SHALL MATCH WHAT IS ON TIIE SCOPE OF WORK)
• DIGITAL PHOTOGRAPHS (MUST INCLUDE THE PERMIT NUMUFR OR ADDRESS IN EACH PICTURE)
o EACH PLANE OF THE ROOF, SHOWING THE UNDERLAYMEV i 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)
* DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE OR RULER)
o SHINGLLS 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 R> QUI]LED FLASHING. PER FL PR(3DUC T APPROVAL
FAMT-TRE TO FOLLOW THESE SPECIFIC GUEDELMES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER}, CLRTIFYING FBC: CODE COMPLLAUNCB BY PERSONAL. LNSPECTTON.
CONTRACTOR (OR O-WNERJBIJU DER) SIGNATURE: _,�__ _.__ _ DATE: ✓ `�
City of *,�tr�ford Building Divisicm
Rv,.i(antial R(:-I�ooI' Scatpv col` Wier
,tj
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Ptt}tMI\'t>itI.1,3'fet ttt''—;tit,y %Wfzlli ;ri% I'w:t'g1tat't.. 1 0"g'Rr+1%
4k`it ItCllt�; °��: •: 4, /j���,'� {t 1 t�,e�'�9 tit �*s�=s0i�a. ! ,kto��s, 1`b��y2�',..s [ �3�¢�ua�� 3.1 ;�.�
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4
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CITY OF
&�'FORD Building & Fire Prevention Division
FIRE DEPARTMENT Re -Roof Permit °d
PERMIT • /i
CONTRACTOR: AMA?ea C 4� // i
JOB ADDRESS:
:tell•
• Post this Permit and all required documents in a conspicuous place outside
• Digital Photographs are required - please follow re -roof policy and procedures guide
• All trash, debris and dumpsters must be removed from job site at final inspection
• Permit expires six (6) months from date of issue
ROOF
INSPECTION TYPE APPROVED REJECTED INSPECTOR
FINAL ROOF
FAILURE TO FOLLOW THE RESIDENTIAL RE -ROOF POLICY & PROCEDURES WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION
FEE AND MAY REQUIRE AN AFFIDAVIT, SIGNED AND SEALED, FROM A REGISTERED FLORIDA DESIGN PROFESSIONAL
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.
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. FBC 105.3.3
REVISED: 4-17 Inspection Line 407.792.6069 or 855.541.2112
TO SCHEDULE AN INSPECTION:
• Dial 407.792.6069 or 855.541.2112
• Provide the items requested during the message
• The type of inspection requested must be scheduled under the appropriate permit type
• Follow the prompts
PLEASE NOTE: Inspections scheduled by 5:00 p.m. will be conducted the
next business day. If you'experience difficulty, please call 407.688.5150
Monday - Thursday 7:30 am - 5:30 pm for assistance.
AUTOMATED INSPECTION SYSTEM CODES
Final Roof Inspection Code III
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
REVISED: 04-17 Inspection Line: 407.792.6069: or 855.541.2112
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 'b —I , GG ADDRESS: 1 7-1 Dr
I l `o bel(+ P UOX"n , 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 C- 1 3 ,JV J 1
COMPANY/CONTRACTOR: A1fYvMcex_n N,e,Yo Gonsmcti-on Pk¢JLoe\
CONTRACTOR SIGNATURE:
(MUST BE SIGNED BY LICEP
OR OWNER/BUILDER)
A FINAL ROOF INSPECTION IS REQUIRED:
DATE:
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 Q rGZ LV" A^
Sworn to and Subscribed before me this day of 1' OL 20 1b by:
tZQbe, - r i �tArl . Who is V<rsonally Known to me or has ❑ Produced (type of
identification) n
02� Q )
Signature of Notary Public
State of Florida
6M- IVzSkA'enS
Print/Type/Stamp Name
of Notary Public
as identification.
°A EMILEE STEVENS
Commission # GG 43415
• My Commi,
4 • 3.4n E,r,pifflc �.
J.
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