HomeMy WebLinkAbout166 Brushcreek DrCITY OF
ORD
Building & Fire Prevention Division
PERMIT APPLICATION
FIRE DEPARTMENT Application No:
# Documented Construction Value: $ 9,060.00
VJob Address: 166 BRUSHCREEK DRIVE SANFORD FL 32771 Historic District: Yes No
Parcel ID: 33-19-30-514-0000-0270 Residential Commercial❑
Type of Work: New❑ Addition❑ Alteration❑ Repaira Demo ❑ Change of Use❑ Move❑
Description of Work: REROOF
Plan Review Contact Person: HAROLD COOKE
Phone: 407-448-1569 Fax: 407-568-6508'
Title: VP
Email: CDRSEABEE@AOL.COM
Property Owner Information
Name 2017-2 IH BORROWER LP Phone: 407-743-6947
Street: 1717 MAIN ST STE 2000 Resident of property? : NO
City, State Zip: DALLAS TX 75201
Contractor Information
Name D&H CONSTRUCTION SERVICES OF CENTRAL FL Phone: 407-448-1569
Street: 20439 SHELDON STREET Fax: 407-568-6508
City, State Zip: ORLANDO FL 32833 State License No.: CCC1330424
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company:
Address:
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,
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: 6te Edition (2017) Florida Building Code
Revised: January 1, 2018
Permit Application
NOTICE: In addition to the requirements of this pernut, 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 z in
Signature of Owner/Agent Date Signature of Contract r/Agent Date
, ,
Print Owner/Agent's Name 11 Print Contractor/Agent's Name
V Signature of Notary -State of Florida Date
"Ay Pt/8 BRIAN CHRISTIE
* * MY COMMISSION t FF 903544
EXPIRES: July 26, 2019
+rFOF �oc`O� Bonded Thru Budget Notary Semite$
Owner/Agent is rsonally Known to Me or
Produced ID Type of ID
Signature of No -State of Florida Date
t�aYP`° BRIANCHRISTIE
* * MY COMMISSION t FF 903544
EXPIRES: July 26, 2019
Bonded Thru Bucket Notary Smkes
Contractor/Agent is 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 ❑ # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Flood Zone:
# of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes ❑ No ❑
UTILITIES: WASTE WATER:
I 1'
BUILDING:
Revised: January 1, 2018 Permit Application
1 Pj141f�_10_L
MM"=_ 0OWTY, AQkr.A
Parcel Information
Property Record Card
Parcel: 33-19-30-514-0000-0270
Property Address: 166 BRUSH CREEK DR SANFORD, FL 32771
Parcel
33-19-30-514-0000-0270
Owner
2017-2 IH BORROWER LP
Property Address
166 BRUSHCREEK DR SANFORD, FL 32771
Mailing
1717 MAIN ST STE 2000 DALLAS, TX 75201-4657
Subdivision Name
COUNTRY CLUB PARK
Tax District
Sl-SANFORD
DOR Use Code
01 -SINGLE FAMILY
Exemptions
�j
Lo
ME
Sp -
LO
V17—OVIOM"711� ole County G
Value Summary
2018 Working
2017 Certified
Values
Values
Valuation Method
I Cost/Market
Cost/Market
Number of Buildings
i
Depreciated Bldg Value $145,342
$137,008
Depreciated EXFT Value $14,440
j $14,110
Land Value (Market)
$38,000
j$38.000
Land Value Ag
Just/Market Value
$197 782
1$189.118
Portability Adj
Save Our Homes Adj
Iso
!$o
Amendment 1 Adj
$0
P&G Adj
I$0
i $o
Assessed Value
$197,782
1$189,118
Tax Amount without SOH: $3,601.00
2017 Tax Bill Amount $3,601.00
Tax Estimator
Save Our Homes Savings: $0.00
* Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description
_
— ------
LOTT
k7
C T
UN COUNTRY CLUB PARK
laj P
PB 50 PGS 63 THRU 66
Taxes
Taxing Authority
Assessment Value Exempt Values
FT-,61e Value
County General Fund
$197,782 I
$o $197,782
Schools
, $197782
$0, $197,782
City Sanford
$197,782
so, $197,782
SJWM(Saint Johns Water Management)
i
$197,782
$197,782
County Bonds
$197,782
$o i $197,782 ]
Sales
--- --------- - --------
Description
Date
Book
Page Amount
Qualified Vac/Imp
SPECIAL WARRANTY DEED
j 11/1/2017
i 09023
1809
$100 ij No
Improved
SPECIAL WARRANTY DEED a
8/1/2014
08321
i^0545
$100 1 No
Improved
IyWARRANTY DEED
¢ 3/1/2013
08002
1338
$177,500 Yes
Improved
SPECIAL WARRANTY DEED
12/1/1996
03176
------------
1376
$102,500 Yes
Improved
WARRANTY DEED
9/1/1996
03141
1563
$22,000 Yes
Vacant jj
Find CompamWo Sales
Land
— -------- --
Method �Frontage
Depth
Units
Units Price
Land Value
LOT
11
$38,000.00
$38,00011
Building Information
Is Bed/Bath count incorrect? Click Here.
# Description Year Built Fixtures
Actual/Effective
Bed Bath Base Area Total SF
Living SF Ext Wall
Adj Value Repl Value Appendages
1 SINGLE 1996 1 7 3 i 2.0 1,462 =
2,198 1,712 CB/STUCCO $145,342 $157,980
Description Area
i FAMILY
FINISH
ENCLOSED
PORCH i 250.00
FINISHED
GARAGE
451.00
FINISHED
OPEN
3 PORCH 5.00
i
FINISHED
Permits
Permit # Description
Agency
Amount CO Date
Permit Date
00207 REPLACE 2.5 TON HEAT PUMP
ISANFORD
$4,335
10/22/2008
01596 12-6" X 266" IN GROUND, GUNITE SWIMMING POOL & SPA
iSANFORD
$25,218
3112000
01817 'SCREEN ENCLOSURE FOR INGROUND SWIMMING POOL
ISANFORD
i. $3,007
3/1/2000
03136 NEW -RESIDENTIAL
iSANFORD
$80.449 12/19/1996
9/111996
Extra Features
Description
Year Built
Units Value New Cost
SCREEN ENCL 2 i 1/1/2000
1
$2,000,
$5,000
POOL 111/2000
1
$12,000:
$20000
GAS HEATER 1/1/2000
j 1
$4401
i
$1,100
Construction `1 Services of
w Central Florida LLC
PremierD&H", "Your
im
20439 Sheldon St., Orlando, FL 32833
407-448-1569, (FAX) 407-568-6508
dandhconstructionservices@outlook.com
CCC1330424
January 8, 2018
To: 2017-2 IH BORROWR LP
1717 MAIN STREET STE 2000
DALLAS TX 75201
Job Address: 166 BRUSHCREEK DRIVE WAY SANFORD FL 32771
Scope of Work: REROOF SHINGLES SFR
Provide all supervision, materials, labor and equipment to complete the following:
1. Remove existing shingles and underlayments down to decking, approximately 25 squares.
2. Remove all old, valley metals, boots and eave drip.
3. Clean and inspect decking for rotten, molded or deteriorated decking.
4. Re -nail deck per Florida Building Codes to meet Hurricane retro-fits.
5. Clean and inspect flashings along walls (if applies) to prepare for new roofing system. (flashing that
is pinned behind stucco or siding will not be replaced unless specifically requested by owner.
6. Install UL 15 lb felt to entire roof deck to properly dry in roofing system.
7. Install Whip 100 or equal to all valleys and around all pipe penetrations to properly seal.
8. Install 26 gauge painted drip edge to entire perimeter in owners choice of color.
9. Install new lead boots as needed.
10. Install new lifetime shingles in owners color choice.
11. Install starter strips at all eves to properly bond shingles together.
12. Clean out all gutters clear of debris.
13. Remove all debris and dispose of lawfully.
14. All trash to be thrown in trailer from roof.
15. Take all necessary precautions to shrubs, driveway, sidewalks, ect.
16. Includes all necessary permits to complete scope of work..
17. Includes 7 year workmanship warranty.
LUMP SUM PRICE: $ 9,060.00
OPTION: NONE REQUESTED
EXCLUSIONS:
l . Any item not specifically stated in this scope of work. Bid includes no bond.
2. Replacement of any damaged plywood will be an additional charge of $2.00 per square foot. Unless
stated otherwise.
3. Replacement of any damaged 1 x decking will be an additional charge of $4.00 per linear foot. Unless
stated otherwise.
4. Replacement of any damaged 1 x fascia will be an additional charge of $8.00 per linear foot. Unless
stated otherwise.
5. Replacement of any 2x4 trussing will be an additional charge of $5.00 per linear foot. Unless stated
otherwise.
CLARIFICATIONS/ ASSUMPTIONS:
1. Due to the ever increasing cost of supplies, this proposal is only good for 10 days. Proposal will be
re -calculated after 10 days to reflect appropriate material escalation.
PRESENTED BY: Harold (Hop) Cooke
ACCEPTANCE OF PROPSAL:
The above pries, specifications and conditions are satisfactory and are hereby accepted. You are hereby
authorized to do the work as specified. Payment will be made upon terms of invoice.
Authorized Signature Date
THIS INSTRUMENT PREPARED BY:
Name: Michael Denmon
Address: D&H Construction Services of Central FL
20439 Sheldon Street Orlando FL 32833
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number:
6RAN'r MAL0•f'r SEMINOLE COUNT'.
��C7:LERK OF C):RCLIIT C:HU ?_ CONPTROLLER
CLERK'S AV2018026957 RECORDED 013 12121.11 V 119, 2 v 1 J Ail
RECORDING FEES $10.00
RECORDED BY tste i t.h
Parcel ID Number: 33-19-30-514-0000-0270
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 27 COUNTRY CLUB PARK PB 50 PGS 63 THRU 66
166 BRUSHCREEK DRIVE SANFORD FL 32771
GENERAL DESCRIPTION OF IMPROVEMENT:
ReRoof
OWNER INFORMATION:
Name: 2017-2 IH BORROWR LP
Address: 1717 MAIN ST STE 2000 DALLAS TX 75201
Fee Simple Title Holder (if other than owner) Name:
CONTRACTOR:
Name: D&H Construction Services of Central FL
Address: 20439 Sheldon Street Orlando FL 32833
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)
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 best of my knowledge d belief.
WILLIAM REDDING
r Owners Signature Owners Printed 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 FLORIDA County of P17omt, -
The foregoing instrument was acknowledged before me this day of 20
by WILLIAM REDDING Who i
. s personally known to me
Name of person making statement bC1�,°ji,'�
OR who has produced identification ❑ type of identification produced:
t°A": •`48�4 BRIAN CHRIS11E
# * MY COMMISSION f FF 903544
EXPIRES: July 26, 2019
N,'rFOF �oP�r Bonded Thru:Budget Notary Servim
City of Sanford
Building and Fire Prevention
Product Approval Specification Form
Permit #
Project Location Address 166 BRUSHCREEK DRIVE SANFORD FL 32771
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
Certainteed
Landmark Asphalt Shingles
FL5444-R12
Underla ments
CERTAINTEED
Underlayment 30 lb Felt
FL11288-R16
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
GAF
RIDGE VENTS
FL6267-R14
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 Michael Denmon
(Please Print)
June 2014
CITY of
Building & Fire Prevention Division
ORD RESIDENTIAL RE -ROOF POLICY & 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 FBC CODE CO IANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE: l
0
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: 166 BRUSHCREEK DRIVE SANFORD FL 32771
STRUCTURE TYPE: O SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: O REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF
DECK TYPE (PLEASE SPECIFY: 5/8 OSB
* *PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED" *
ROOF VENTILATION: OOFF-RIDGE ORIDGE OSOFFIT OPOWERED VENT OTURBINES
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 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
OQ SHINGLE
CETRAINTEED
FL#5444-R12
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
0INSULATED
FL#
O TILE
FL#
O OTI IER:
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#
O INSULATED
FL#
O TILE
FL#
O OTHER:
FL#
�. D' City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT#: 1 ADDRESS: 166 BRUSHCREEK DRIVE
SANFORD FL 32771
I M I C H AE L D E N M O N , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
OOFING CONTRACTOR ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
F fION 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#: CCC1330424
D&H CONSTRUCT)" SERVICES
COMPANY /CONTRACTOR: _
CONTRACTOR SIGNATURE: /per' DATE: V
(MUST BE SIGNED BY LICENSPOROLDER 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 INA 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
Sworn to and Subscribed before me this _
MICHAEL DENMON Who is
identification)
':?- n tureLo Notary Public
State of Florida
PriWrype/Stamp Manic
of Notary Public
day of
20 l by:
Known to me or has 0 Produced (type of
as identification.
1�ar P6B BRIAN CHRIS11E
* * MY COMMISSION # FF 9M44
40e"EXPIRES' 11l 26,2019
of no' Bonded ihru Budget Notary Services