HomeMy WebLinkAbout2047 Clydesdale Cir,AAR 2018 MY OF SANFOR
BUILDING &,RRE PRE VENUO
PERMfT APFUCAM
P
App&aOm No: I �) � q
=ME,? MIN
of Work: New A d Demo D change of use El
Dc5cftptjoA Ot Work-
-mysenAare
Plait Revie*w Contal-t Peron:
Phone: Fou
hmmkb
Contractor Inforrantion
TNx: 140-IRS-1 WJOZ(7�
City, State 2*, State Ltc� N( CCC t
ArchitectfrEngineer lnforrnatjoia
Name: Phone:
Street-
01)", St, zip: E-mail:
Deltding Company
MOrtgage Lender.
Address: A4dre�,s:
APPfimtion � hcrc4,%, nud4 tO ObtftiD I PCMil 10 40 tht X�Wk i)vld iln=lbliow as indicottd. I ceftifY that no work- or irwouafion jjay
OOuMwDccd))rim to tftr, ofa rwtmit and that pl) %ve-;., niff, former[ to Tm,�,tuxttlurcisIzv's:rc,&Ullmc
in ibs jwistktinm I UWItmtnnd thzt a separutept�rwjtwuA be secured for deebito a4ng cons;ion
fumaOest bo,'JtM ht;Aer-:F, tanks., a�d zits' vmdMoPcrv,, etc, ,I WOI44 PhMbtn& sigm, vrclls� roul-,
FPC 1K3 ShnO be jo-;trfbed rMh the date of *pp pnd the to & of a z" Or that dut&: 50 EAltion (101-t) Florida Baildi-q (�O&
,tac e
RJunc_,*q4,20],5
NXIFICE3 Jn additiort 1,) tt� rcoremut.,; of this,thcr,_ al;ly be additiowl rcstrictiutoc uprgmblc to this propefty tLv rmy bo-
fbund. i1t lbt� V&jc rc(,f dLs
_Lx)Td , cOUATY, aM Ux-fa otivy bc additi(,�I;pcim
,tj its , rcqut d, from oibcr ga,Tmmc;jj
atct
Aoc4cqII,Incc of pc qpj 1. i g ,crjrI cajion that I vtfl OOtifY the MOW Of the 1?(Ol"Ty of tht requITcnwntq of J.'Jgrila Laev, ps -715
TIM CiIY Of Sadord rcquims pqmcM of p
'n urd�`r tO` ca1c,'dilt 4 Fbn MVIM cbwp ec VmtmL-J tccpi _d
c. a*d uill c, o�,w%idcrod tly-t I�Latc4 W "Suction in ft
Tbe setwi, wnstribmkm value xvin be rigured b.q_-;c4 on the t�tvrm [CC, Vat ilxte of ft job �11 (k ti Of su
uatimn TabIc in effeu ;at the tihit.
.wl,
tlx-, Ivru I is i,
iwrdm}vitamlordia;Shoud cakulafid chwgs figtucd off tlycxwutcd CMllzct n
a CS L(4t %viJ] be,a c —ocl arc actm, cttustre uc�
pjj�AJO YOuf 't fct:3� Afhtm the pc-rrmt, is L�_.
OWNE UA�A'T; I CeTtIfY that 211 Of the foregoing, iofortuati,on,is,11ccirrate and, tb_at,,alYwqrk, will
be done ill tompliAlIce with all applkable taws regulating cons*vction Slid 01tim.
A-ml
t pw'
-STAWQFFLI0"A
Camr,# M44221
0IAtItT/A,ftU is —Personally KpQ,�yn to Me tar
Produced fl) TyW of ID
m
NOTAFeMGM
Cm 170m2"w
C011tr=10rAgent 'Knourn to P Qduccd ID TyW of ID
IJCETJSE,,0NL-V
]Pel-mits Required- 8 ildi
, . Ul in-gEl uttectticaiD MocharticoJF1 Pfumbing[] Gas
Construction Type. U,,�C:
Occupancy Flood Zone:
Total Stl Ft of Bldg: 811-11- 10MUpabeyLoad:
# or stories:
NeW Constmetion: Elmtric,- # OfAmm��, I I
Pill mbiftg - iq 0f,FIIJIctureS_____J
fire Spiwer pmnlit! Yft 11 No D 0, of Hea
ire A 0 F I%mi Pcmit. Yes N
APPOVAL& I-ONNG: UTJIIM$,, 'WASTE' WATER-
ENCAINEERINT(k, FIRE. BUILDING:
COINIMENTS:
Rc-v*Ucd.. June, -_10. 1015
A —A Avpfi Zito
Sub r
OFFICE PHONE 407-951-6050
OFFICE FAX 407-951-;024
www. roof army. corn
Date: 11/22/2017
Contact Name: James 11 mer
Contact No.: (407)-267-I 47
Contact Email: bclla915f 6@gmail.com
Location: 204 Clydesdale Cir. Sanford, FL
Job Type: Residential — a�.00f Replacement
Roof Replacement/Installation Agreement:
This price includes labor drid/or material only necessary to perform this job. Price is based upon all work being
completed throughout con,ecutive business days.
All material is guaranteedo be as specified, and all work to be performed according to scope and specifications as
noted or; in the absence roof, acceptable standard practice and completed in a substantial workmanlike manner
for the total sum mentionk above. Roof Army, LLC reserves the right to substitute materials of similar quality and
price should originally specified materials no longer be available. Warranties and guarantees for material used to
complete the above refereced job are limited to the manufacturer/distributor warranties and no other warranties or
guarantees are implied.
Any changes to work i
Contractor concerning
FLORIDA'S LIEN LAW:
ACCORDING TO FLORIDA'S
ON YOUR PROPERTY OR R
THEIR CLAIM FOR PAYME
CONTRACTOR OR A SUB
SUPPLIERS, THOSE PEOPLE
ALREADY PAID YOUR CON
HAVE A LIEN ON YOUR PI
WILL TO PAY FOR LABOR
HAVE FAILED TO PAY. T
PAYMENT IS MADE, YOUR
PERSON OR COMPANY TI--I
COMPLEX, AND IT IS RECO'.
FLORIDA ►IOVIEOWNERS'
requested by Owner/entity in writing. Owner/entity agrees to deal directly with
z-s and not work crews, subcontractors or vendors.
:)NS'IRUCTION LIEN LAW (SECTIONS 713.001-713.37, FLORIDA STATUTES), THOSE WHO WORK
VIDE MATERIALS AND SERVICES AND ARE NOT PAID IN FULL HAVE A RIGHT TO ENFORCE
'AGAINST YOUR PROPERTY. TIIIS CLAIM IS KNOWN AS A CONSTRUCTION LIEN. IF YOUR
INTRACTOR FAILS TO PAY SUBCONTRACTORS, SUB -SUBCONTRACTORS, OR MATERIAL
HO ARE OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE
:ACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR, YOUR CONTRACTOR MAY ALSO
PERTY. THIS ME3ANS IF A LIEN IS FILED YOUR PROPERTY COULD BE SOLD AGAINST YOUR
IATERIALS, OR OTHER SERVICES THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY
PROTECT YOURSELF, YOU SHOULD STIPULATE IN THIS CONTRACT THAT BEFORE ANY
)NTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN RELEASE OF LIEN FROM ANY
HAS PROVIDED TO YOU A "NOTICE TO OWNER." FLORIDA'S CONSTRUCTION LIEN LAW 1S
4ENDED TI-TAT YOU CONSULT AN ATTORNEY.
RECOVERY FUND:
PAYMENT MAY BF. AVAU,A 3LE FROM TIII FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND IF YOU LOSE
MONEY' ON A PROJECT P " ORMED UNDER CONTRACT, WHERE THE' LOSS RESULTS FROM SPECIFIED VIOLATIONS OF
FLORIDA LAW BY LICENSFi CONTRACTOR. FOR INFORMATION ABOUT THE RFCOVERY FUND AND FILING A CLAIM,
CONTACT THE FLORIDA CONSTRUCTION INDUSTRY I..ICFNSING BOARD AT THE FOLLOWING TEI..F.PHONE NUMBER AND
ADDRESS: 1940 N NIONROE grT. TALLAHASSEE, F.L. 32399 - P: 850.487,1395.
Main Office: 669(Rarold Ave. Winter Park, FL 32789 1 Phone: (407) 951-6050 1 Fax: (407) 951-6024
RoofArmy.com 1 License # CCC1330970
i
w-
OFFICE PHONE 407-951-6050
OFFICE FAX 407-951-6024
i IV
Scope of Work:
1. Tear off existing roof.
2. Inspect decking. Water i+amagect broken, deteriorated or rotted decking will be. replaced and charged accordingly.
Plywood decking is repi wed at $55.00 per sheet: I "x6" decking at $3.70 per foot, 1 "x8 " decking at $4. 60 per fool, I "xl0 "
decking at $5.50 per foo and I "xJ2 " decking at $6.40 per foot. "the first 2 sheets will be provided free of charge
3. Re -nail roof deck with 8 3 round head; ring shank nails.
4. Provide and install all new drip edge. Color: _ TBD
5. Provide and install _3 new Bullet boots. Color: TBD
6. Provide and install _3 new Gooseneck. Color: TBD
7, Detach and Dispose alu inum off ridge vents.
8. Provide and install .new hingle Over Ridge Vents.
9. Detach and remove gutt rs for duration of roof installation.
*Roof Army will attach i Pid reset gutters if salvageable once detached
10. Detach _I_ dish sates ite and reinstall after roof replacement.
*Roof Army is not respoi siblefor signal calibration 2
1 l: Provide and mechanical) fasten _RhittnRoof synthetic underiayment.
12. Provide and install 30 S _Certainl'eed Landmark Architectural_ shingles, according to manufacturer's specifications.
These shingles carry A r arranties: Lifetime Manufacturer Warranty, 10-Year SureStart Protection, 10-Year Algae -
Resistance Warranty, & 30-MPH Wind Warranty. Color:
13. Roof Army to provide a 10-Year_ transferable workmanship warranty.
la. Roof Army to furnish sp cified material and labor.
15. Roof Army to furnish a hilding permit. This includes the scheduling of all necessary inspections.
16. Clean up and haul off all rooting debris from property.
17. Protect property using tarps to the best of our ability. Roll yard with magnetic nail bar to ensure removal of nails
1.8. A complimentary Wind iti =a n wilt be provided following the completion. of the roof replacement
Total price for work m ntioned above: $11,696.67
FINAL TOTAL:
Main Office: 669 Harold Ave. Winter Park, FL 32789 ( Phone: (407) 951-6050 1 Fax: (407) 951-6024
itoofArmy.com I License # CCC1330970
THIS INV
Nanx:.,j
Address:
ml, ,#, , , , Is
Pilltilrait Number
Pwoel ID Number:
"!* WAcrizianed r4reW qrvc-. riotxt
UkiviritV k4orrn3tion is provided in the
1. DEZCFV%M OF PROPERTY;
2-
3. OWNER INFORMATHM OR LET
Ninc ard
Irtems., oft
Am SilmPW TMO Holder ,-if con t
4. ODKMACTOR- Narnt-
SURFTY J* appocaboo. a copy of
A6dr=r..
6, LENDER: Mairm.
7. la"50i'm WWI" The StM of FkH
713.113(iXotiT. Florida Sb&m&
Name,
B. Its vddtioxt Owner de%ion3tes
to receive a copy of the L ww's h
S. Expe-4!ion Ebtc of Noticc of Ccnw
crckck.! I cz
"Wo"'eert `iiiit Lm to C4!dvin rtul ptoperty, and n accondarnc vatj r-hapter'113. Flooda Flt*uA, t,,,
Nce of Corrrmnce"rio.
31 ooxwaon a fed pmmrof am mtc*l *ktm it usi-Able,
IWORKATION IF THE LESSEE COWrRACTFD FOR THE MWIROVEME, HT:
% ..c-
OyMer faced ai*ow) NdthC
.1111 LA L -
he paymcm bored in attoctgo- 4
Art* Ofeord:
Fliorm Wnbcr
DoeignaW by Owner upon wtxm nctm Or ~ docaMilints Voy be served as pitcritidicial by 301:1110ft
Ft— No-b-
01
.14 Vwolded in Sirction 713 13(17)Ch), Florw-A St Litr%, Vtiory riijwce.
-
isspecilied)
lVA'wjLWL-W-0mo%-'m. ANY PAYswVjNrs wrx BY TKE OM;CR AFTER )111. UXPIKAMIN OF THE NOTIC:E OF COMMENCrUll-Ul - A - R , L
CONSSDCRED IUPROPfR PAYVI-
.NI " UNDER CHAPTER 713. PART1. SECTION 713 1--k H2OR-DA STATUTES. A40 CAN nrt;j-,.-r v�i ycxiR
PAYFWC TWICE FrA lUPA0VCJAENT�, 10 YGUR PROPERTY A NOr.C=l Or COMMENCEMENT MUST UL R'Lr-0H--f,0 ANl KrVrfl) ON ThE
JOB s'Tt FIEMRE ThE FIRST INSPrCTION ,F fOU INTEND TO OBTAIN FINANCING. CONSULT WIT" YoUR tI&.N?'*,R C'R AN ATTORNEY
BFFr4RF MUME*40NGWORK IOR RtCORzxjuYOUR .,c.,,.cF cwC0umE-SlCE.%lF-,JT.
State of Courtly of
The lo"pactim lintobvimmyt was acknotil oft l~ j dory .,
by I --A — who is permnlay kvmwn to mJ OR
w1to hae pmauced WefklWms* _,'� of Mooriltillication Vaduo0d:
k%xkb-m Ortiz
C-=-SLATE FLORMA
• =rJ F1 244221
ll:�
Expk*o e!24=19
GRANT MALOY, CLERKOF CIRCUIT COURT SEMINOLE COUNTY FL
CLERK'S # 2018022959 PK 9083 Fig 1234-1 (lpg) E-RECORDED 03/01/2018 0935:45 AM
10.00
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. I R-13A ISSUE DATE: OA • • 1
CONTRACTOR:
JOB ADDRESS:
k_ViNAr6TdVy*Tz OLTa=tdp_4PJK�wlIIII\:l'1Iz
PROTECT FROM WEATHER • I
• 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:P0 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 111
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
F
vs 'FORD
RIWDENTIAL RE-ROYP POLICVA� j-Ro(.EV(,jRF4V
�RZ Ulf pl;4"tTme2q-,
DES rxxljmEa,-r
TV.n scom (o WORK ly,
THAT-W 1j,
A TIPk,,Nqrxrrj. 1:. NCI-F nF.
"PR(lPECTSIA)CATED
C ,�AXTORD 11 LIZTORI(: pf
MOB-mE Z,
PERUT
UUMP I JOIED RES
COMPLETED o,,Ni)
(PV')!XICTAffxkf)v,\L
- r)lr.rT'Ai Dw-
.0, VRI P J;rX3
0 S'AlNf;!,u
S.KYUGHMOFAM
o, DlcrTAL C.
-, DjOnALP
PAJI-4;RF, TO F(iusm
tD",'T-9ACrQQ (,*.
'PFR"f NO PL.-,..Nr RX-Vinv Rf'.041"IREID
AiXXVC,'MR77 OFarr.
RISMT",AL REAx)v,0,cnpjop,DAS PAF Y;t,K?,rT APPUCAnty,
r i ,; a i fo PRCq)( r-
,o Nk:MU -A-PlISROWDA VAII., FM ALL Rfx)^
0 R NSTA [,VD o.k; - m Jw Mo-InLT,
-)ST 0%4 14
SAN PvTD JljsTf)Kpf- V -M( 01) ',PJ� 1�1
-Vll(,IIN WIARD a r-'I' W'LL PS' I -'IN REVIEW ANI)AjTRC)VA[,. 13yT1IF
& pitOCE6uDiF-
s-i ITIF CWLY INSPEC 1')N'RFckjfkPo t-T.)p, krcrojw
PZ,-RCK)v ftw4rrS.
To BE PROIPTYP ow me: foe,,,, rT..-
;VP) NA 00,'l'—WV0'JS ANT) W'ZA-.qfERPR(,XT I=A-,TON
V--N-nAL RR-R(xv SoM� ()F WORK
;f'TA?j7FJ) DI-SPECMN AMDAVI't
7HCT APPROVAL AND CX)RIzF-s;posT
iilM-L.MA,TV.J g(.Opt OF,%,[)R$:)
'nL'i (mm r,'4c,
IF'' or" "'3fp R(,XN;- SHOWINQ THE (NOE-PlAYINIIIIsIr M.KTuLpr.)
SpNCIN0, (DiClIONG A?Jr ,S[--RDzG OR RULF-1.1)
T,
t4LNT J>A-f--f'kRN & SPACTUC.: ((NCLIJTqKG A NUAS(Tkfr�+t;
N'AlAy-YATE ACITMENT (N'CI-L1IXr4C" A IMA-MRING. DEVIcl. ()R
M-. NAJI- PAT-IEXrA,41) I.C.-
,V.A,7
'-IIVINC I
F.k FL PPRODUCTAPPRi)VL
VIT P OV
OR
RV PERSaNAL
ac)
CITY
g� SkA.14
• i i:;�, r®' J`
DEPARTMENTFIRE
JOB ADDRESS:
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
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):
**PLEASE NOTE: ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED * �
ROOF VENTILATION: OOFF-RIDGE O RIDGE OSOFFIT OPOWERED VENT
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: l 2 OR GREATER
O TURBINES
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#
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#
FIRE INSPECTIONS
CITY OF SANFORD
407.562.2786
BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS
300 N PARK AVE
855.541.2112
SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
Page 2
Application Number . . .
. . 18-00001319 Date 3/13/18
Property Address . . . .
. . 204 CLYDESDALE CIR
Parcel Number . . . . . .
. . 18.20.31.505-0000-0080
Application description .
. . ROOFING APPLICATION
Subdivision Name . . . .
. .
Property Zoning . . . . .
. . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1037514
Permit pin number 1037514
----------------------------------------------------------------------------
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
----------------------------------------------------------------------------
1000 111 BL03 FINAL ROOF /_/_
�-1 CITY OF I
�T)1rN Building & Fire Prevention Division
RESIDENTIAL RE-ROOFAFFIDAVIT
I
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 1�J - k "� � fA
ADDRESS: 20U NP— -
I 0� - Q C) , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
(ROOFING CONTRACTOR, NGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
REGOING INFORMAT N 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 #:
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE: _
(MUST BE SIGNED BY LICENSE
% , S
IWNE DER)
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: 04 1 ZG 1 It
THIS SIGNED AND NOTARIZED AFFH)AVTr 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
Sworn to and Subscribed before me this 0. day of J: 201'_ by:
Who is VJ Personally Known to me or has ❑ Produced (type of
i ifi do )
kA�'� -
nature of ota Public
State of F7ori
Print/Type/Stamp Name
of Notary Public
as identification.
CECILIA GOMEZ
MY COMMISSION # GG089337
-y EXPIRES April 02, 2021