HomeMy WebLinkAbout216 W 15 StMAR 14 ?
CITY 4F
ORD
Building & Fire Prevention Division
PERMIT APPLICATION
FIRE DEPARTMENT Application No:
Documented Construction Value: $ 11,500.00
Job Address: 216 W.15th Street, Sanford, FL.32771 Historic District: Yes❑NoF�
Parcel ID:36-19-30-300-006A-0000 Residential❑✓ Commercial
Type of Work: New❑ Addition❑ Alteration Repair❑ Demo Change of Use❑ Move
Description of Work: Residential Shingle Roof Replacement. Remove damaged shingles
install synthetic underlayment 17491.1 with TAMKO heritage shiglesFL#1956.3
Plan Review Contact Person:, Larry J. Meyers, Certified Roofer Title: President
Phone: 407-568-0834 Fax: 407-568-8689 Email:Larry@LMRoof.com
Property Owner Information
Name Eugene Wor Rita Holcomb Phone: 407-416-3784
Street: 216 W. 15th Street Resident of property? : Yes
City, State zip: Sanford, FL. 32771
Co_ ntractor Information
Name Larry Joe'Meyers Phone: 407-568-0834
Street: 18601 Sabal 'Street Fax: 407-568-8689
City, State Zip: Orlando, FL.32833 State License No.: CCC057260
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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 date of application and the code in effect as of that date: 6' Edition (2017) Florida Building Code
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 appVage laws regulating construction and zoning.
s ft'vib'.4 —`
Si a re of Con ctor Agent Dat#te
Print Eonra tor/ ent'
l
Sig atu of Notary -State of FI ida Date
01'AY Puk,
4 E RALEY ?o"'Ay polo ELIZABETH A. BRALEY
* * MY COMMISSION i FF 137024 * * MY COMMI
EXPIRES: June 29, 2018
Owner/fYgdh'As B0i1dedT%W6ft4l,S pwn to Me or Con a„ X�PIRE ' ��y Known to Me or
Produced ID Type of.lD Produced ype o
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Gas[] Roof ❑
Date
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:
CITY .01'
NAXPORD Building & Fire Prevention Division
RESIDENTL4L RE ROOF POLICY & PROCEDURES
FIIJIk 0F_PioR1'14tNT
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 STI'E.
**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.
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CONTRACTOR (OR OWNERBUILDER) SIGNATURE: =f / Y DATE: J l
Sk�FORD
FIRE DEVARIMENT
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NOTICE OF COMMENCEMENT CLEWS 1 20180,27730
RE'C +rD €33f18t2012 02:07:tjv Pn
State of P'106(la KL Uj,V HG Fi F
County of Sorttyr ott," h C f%'QZD 9y '-d1;ar,0
Permtt Numper; Parcel fD irriber: --.
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C11 Fer 713, FC ida"Motes, the follawir i4fotm;7Wn n proAdoxt ih M Mlia t: Of Ctar-Mcm nL
OWNER UNP0RMAYI(>M- .
FPC crimple Title HOtder (A Oflhei M;m orm0) Name:
Pcrwq* % tthcln the SW6 of F-Jorid3 itc a29c9 by Ut+t1e� UQ�6#i t�iebm u � or oft�uc tfttCtttYle�lt3 asyy tx scror _
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u- cp`tratlon Oita *1 NoCiev of Ctvnmmccmcni J Mo iq)rVr (,o,) dg(. j: 1 year fiam date pS nor Ordirtg unitr:: a
dtff4reot date as spetikd)
ANY PAYMENTS MADE BY THE CltWtt AFTER THE, OF THE NQTIC F
COtvltkEr4C3;'r40ar ARE COU�MDZEEREO IMPROPER PAYI/ZtM WZDM't CHApTLR 713, PfriRT C, .` E TVJ713,13,
FLOPMA ST. TVJ`ES AND CAN RESULT It? YOUR PAYING T�%TCE I'OR M1PT{ fdENTY TO YMR PROiIERT Y_ A
NOTICE' OF WAIRICIEWENT MUTT BE, RECORt� Sj A.ND posTED ON THr; jM SITE BEFORE THE FIR.$T
IN i' GTFOti. IF Y(1tJ G*lTF tl TO t "r'P!N A°"MAN1W4G, CONSULT ixOTHYOUR UNDER OR AN AlTTQP-,4EY
BEFORE''OOMMENCtAGIVORr, 010 RECORDING YOUR NOTJOE OF
CCIFrtF 'r tatter T.
Un ft.r prn;1fjcs of perjury, 1 decisrL tttat 1 'vi: r0-4d the foregofng and that ttvu f itt* ,rtjtcd (n it are b e
tq thc. mst of y knoviledcge 4ns� x dfIc
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fh*R4t1' t+¢�t!cmr to ..zp� e: Sti a+•ttt,�:�:r�;"
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County of .�-�,%i4�`
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by �% Who i ps r-.grealry k!?Ov.l to rr
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OR'who hjr, produew Identiricatioxk 0 type of identihcati'on pr uced.'
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La"y 3, meyevs, inc.
18601 Sabal Street
Orlando, Florida 32833
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Pl-vone: 407-W.-0834
r lo I OF11,40.
Marth 9, 2018
TO-, Eugorr, "m4or Rita hWxvM* 11 121 � VV 1$111 �`"° Vlftrltt FL, rl I * nk2'irjMtnb0aUj0=- I
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js: 11ta hercry roWio 0 tlnlish lab� nlptedat;. cqtript=iI, in-,Lrranm Lvms, ctriniLs and durr(p
In= in ao=ftm� v.vh mte ---d local Widing cccle� 10 the atv*'a iverenow rrcf---Tj M rolcots:
$hiNtc Hoof kcplaccm ent:
R---Mo�-S of enve eAr�;N (�-,jT*pd foul " tranSpori 0 to ap apprcmij cecciolvien wn� dvMr,-ite-.
VAWxvd, Is o'sarg-0 in odallian, to arim. hc;ein, Wn charf- % S50 f --t ( , We p
"�L Pe !!Iw of plywonycl. *in I (COfly Ml de0j, 9
acccfdimp to 0":Llfr8al hurrit'arte mEvalion codrm�
My in t4ing !.etl -a! hand un4a, Wymehl x; a x: ncmi j ry wit& bwrn, Ilk -ail! r%,,tace
neff proauct.
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ciw= qnc'nee M=- HVIM. euldins code 61h Ectzon, 01r P&Wircr=ft - SEC 20 1 1_ Wfiplion Picnisiam:
efte tfivm- Ax* 30, 20 IS.
Our Price- $tI4M.00,(Efinvcn Thnd Rve 44tandr6d Doft.j Larry Me*Mv,, RWW owns vJI 0*
baMWe of Ir- eccnFact 13 02i 0 it) air , A Mov) wowl I mft mvry crTan 0 zwm 01 0:--mztqr,,, I.;xry M,-gTrr- Apni rino tetom 10
I'm rl IT-= pcuiphcradamage tamed by cdnst;u=n amilyto qmM PWLol diveways, "'p(Aven, air cordfionkv ulks
oritemisaidawuv.' Tivemmv-4-no 4= RX au ccr� m4wo-trom nofk,�aTncni 0 ctx t try raff. Imeeices
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ACCORDING TO FLORIDA'S CONSTRUCTION LJEN* LV� (SECT;WS 7Q.%d--7'13X, FLORMA $TATVTESj THOSE Vn4O
WORK 0 "1 YOUR PRWIERTY OR PSOVIOZ WMEAtALS AND SEMCES AND At XTO PAID 04 FULL 14AVE A RIGKT TO
ENFORCE, TfICIR CLAIM FOR PAYMCNT AGAINST YOUR PROPERTY. THIS CILAW fl5�VNqlJW AS A, PON5TFWCTION LIEN.
IF YOUR CQNTRAGTOI`I OR A: SUBCONTAA&CKI FA.11,19 I'D PAi SUBCONTRACTORS., StiOSUBCONTRACTORS,0A
IMATEAtAi SUPPLtERS , THOSE- PEOPLE AVRO ARE OVIED WDINEY MAY LOOK TO YOUR PROPUM FOR PAYIzzlIT, EVEN
If YOU -HAVE kiREAVY PAID YOUR COMMACTOR IN IrULL. IF YOU FAIL -TO PAY;YOUA CONTRACTOA, YOU aO ALSO
HAVE A LIEN PLACED ON YOUR PROPERTY. THIS NTARSIF A L`N IS FILED YOUR PROPERTY COULD BE SOLD
AC AT*N.I;T YOUR WI „r,"TO PAY F0 R LAB OP, IAATV-H LAL_t-A OTHER SE WX ES THAT YOUR CONTRACTOR OR
SUBCONTRACTOR &AAY,HA%'F- FAILED TO PAY. TO PROTECT YOURSELF, YOU SHQUlP5TIPVLATE IN TH15 CONTRACT
THAT 6FFQRF-,A-NY PAYMENT M MADE, YOUR CON`rAA.CTOA to RE-OUMED TO PROW)fi YOU AFITH A LIEN RELEASE
Vk'011 ANY PERSON OR COMPANY T14AT HAS PROVIDED TO YOU ANOTICZ TIP QWNEFr, FLORIDX$CONSTRUCTION
LIEN LAW IS COMPS FX, AND rr ri fjeCO&I?4MNDZD THAT YOU CC(NSJULT AN ATTORNEY:
Tewns: Vie of 16,0W, to or'Onrrnat ,criaL and cmmmeenct the work. The - ICI arpeeofV250,00
pkir, emy aAlitknal wooff'm`w-k i3 due up= nwe*on or me jot)The job is considmd oomptctcat the ppprov.11 of
ttk,e final Roof inspection, by the mtinicip�lity for wbfrh it Prnfinq pevfilt hal Lxell issued. Mate6alsvWtsntics and
Lim kelct s by thaseprOV5dihq a Notice t0owl-tv w4lttc exrb."lilgod fmppymcnt in furl#. Wrcarawtaccertcredit
cards at insurnvroo d1orks" %Vc do a=jr, Permnel chocks, tylkmey OT&rs, Cashiers Clhecks,of 00 only,
If the above tern'r. arc lrcrvtr,\', plca,-c -Ign below Aral return the original to us- We Lhank you for allerwin-2 us to
off,Cr cAir:;e-rvb='t--3 you and tlOpe try work with you on yoLorpra, M., We are rArn5cjr4ntiaor, wqrkvr, and want to, give
you the best job oassible" All -wori,, wfl tu-, pf-%rfqmrd within G'GIM qui&,Il.n—.
Aoceptafice of Proposal* The ibove spric4'WntIrAv5, pripcs --ad ccnditiorre� are saii`factccy utd ace hereb accepted,
IN contract is, valid when t-Xo-cuLed by " parties,
U.-TY 1 Mevers". Iftc. Ow nC r W AnIr-hp n-. qd Aq crA
CITY C?
��My� �D Building &Fire Prevention Division
RESIDENTIAL RE -ROOF POLICY& PROCEDURES
i
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 COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE: J— /3 -av! g
JOB ADDRESS: �_`
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
i �i" , end
L7 7 J
STRUCTURE TYPE: (D SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: 40 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 SQUA EOF THE EXISTING DECK IS PERMITTED TO BE REPLACED * "
ROOF VENTILATION: 0 OFF -RIDGE ORIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES 0 NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 — 4:12 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
QD SHINGLE
T
FL# 5 o 90
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
OINSULATED
FL#
O TILE
FL#
OTHER: ftn4f
j{
1FL#
ROOF EXTENSIONS (PORCHES: PATIOS, ETC.) **1PAPPLICABLE**
ROOF SLOPE: O LESS THAN 2:12 2:12 — 4:12 O 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
O SHINGLE
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CITY OF
O DEPf Building & Fire Prevention Division
RESIDENTIAL RE-ROOFAFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: — cJ (✓ i ADDRESS:,1
*ci 'Z I
I " v , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING "RACTOR, ENG R, 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 #:
COMPANY
CONTRACT
(MUST BE
/CONTRACTOR:
OR SIGNATURE: DATE: '�(�✓ t6.7
SIGNED BY LICENAOER'OC7'd(0 DER)
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 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 15em i n a1P,,
Sworn to and Subscribed before me this day of _ 20 by:
Y Who is ersonall wn to me or has 0 Produced (type of
identification)-----\ as identification.
�,,Rr o& ELIZABETH A. BRALEY
Sign a of Notary Publi ?o �,�
State rida * " 1 MY COMMISSION # FF 137024
I _ EXPIRES: June 29, 2018
Nr77 FIO�`Bonded Thru Budget Notary Services
Print/Type/Stamp Name
of Notary Public