HomeMy WebLinkAbout391 Fairfield DrCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: I 2) I ao
Documented Construction Value: $ 13, Llq
1-7
Job Address: )tlt�C�i C�CA f/l Historic District: Yes ❑ No ❑
Parcel ID: s8a - 101 3) —S� (per ('jam--Q�(nQ Residential] Commercial ❑
Type of `York: New ❑ Addition ElAlteration ❑ Repairg Demo El Change of Use ❑ Move ❑
Description of Work: rercN- •-I'-,eatr ojW ,e r 41 1r-4 4-
Plan Review Contact Person:�cnS Title:[.
Phone: '07 — aI1[o3 Fax: _36 o�iU 3�3y Email: �bUCPiC�I�f'�oa-Fi r� �4 t%•Corn
Property Owner Information
Name �ll� 1r- �QZe =, Phone: �ZIA
:1 V % '-41I -7 —/ZI/3
Street: �-eu ch c:. Icl pr Resident of property? : l
City, State Zip: _mot m-1ccl -PL S1P-7721
Contractor Information
Name
Street: ! to
City, State Zip:
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Phone: 3s2i— 8H-8(9;)-5
Fax: c35 D ^ B 40 -43S39
State License No.: C.W le' aaC rc3b
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 IMPROVEtNIENTS 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
CO NItMENCEivIENT.
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: 51h 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 [CC 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 0wner,`A;ent
Date
O&L,' 3� S/"v
Signature of Contractor/A,ent Data
0
Print Owner,'Agent's Name Print Contractor/agent's ! )e
Signature of Notary -State of Florida— - l3fte '�' —
rY Sign't re„,o.f N.tatary: a e,.oti,Flo.6id. a La
,
t7tlCl<HAM
YFF Ii'1210 ..
^nJ .on FF 172210
Expires *I
K XW
P'd.7 mi ;Sian Expires
reuud, :i5 )3 I 28, Z0�8 cF: .J..
�tobr3r 28, 2018
Owner/Agent is Personally Known to N[e or Contractor/Agent is Personally Known to [vie or
Produced ID Type of ID Produced [D Xpe of [D
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Gas❑ Roof ❑
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Flood Zone:
Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑
APPROVALS: ZONNG:
ENGINEERING:
COMMENTS:
# of Heads
UTILITIES:
FIRE:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDIING:
Revised: June 30, 20t5 Permit Application
2/28/2018
SCPA Parcel View: 32-19-31-516-0000-0460
Property Record Card
Parcel: 32-19-31-516-0000-0460
Property Address: 391 FAIRFIELD DR SANFORD, FL 32771
Parcel Information
� Parcel 32 19 31516-0000-0460
REZA, ZAHIDUR
Owner
KRASNIQI, ALBULENA
�!! Propertydress '.: 391 FAIRFIELD DR SANFORD, FL 32771
Mailing 391 FAIRFIELD DR SANFORD, FL 32771
Subdivision Name j CELERY LAKES PHASE 2
Tax District S1-SANFORD
DOR Use Code 01 SINGLE FAMILY
I Exemptions 00-HOMESTEAD(2017)
it
�,.
11
LOtV�
5}
e
Seminole Coi.inty 11,S'
I_
j Value Summary
2018 Working
2017 Certified
Values
. Values
Valuation Method
Cost/Market
Cost/Market
Number of Buildings
1
1
Depreciated Bldg Value
$128,724
µ $121,263
Depreciated EXFT Value
y$338
$350
Land Value (Market)
$34,000
$30,000
Land Value Ag
just/Market Value "
$163,062
$151,613
Portability Adj
Save Our Homes Adj
$8,265
$0
Amendment 1 Adj
$0
P&G Adj
$0
-
$0
Assessed Value
$154,797
$151,613
Tax Amount without
SOH: $2,099.00
20' Tax Bill
Amount $2,099.00
'Tax Estimator
Save Our Homes Savings: $0.00
Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description
LOT 46
CELERY LAKES PHASE 2
PB 65 PGS 29 & 30
Taxes
Taxing Authority
Assessment Value
Exempt
Values
Taxable Value
County General Fund
$154,797
$50,000
' $104,797
Schools
$154,797 ;
$25,000
< $129,797 -
City Sanford �
�
$154,797 ��
$50,000
$104,797
1 SJWM(Saint Johns Water Management)
$154,797
$50,000
$104,797
County Bonds
$154,797
$50,000
$104,797
Sales
_
j Description
Date
Book
Page 7 Amount
I Qualified
v Vac/Imp
WARRANTY DEED
9/1/2016
08182
1101
$189,000 '; Yes
Improved
j CERTIFICATE OF TITLE
4/1/2016
0867'
1882
$117,900 I No
Improved
SPECIAL WARRANTY DEED
9/1/2005
i 0592.7
1149
$175,100 Yes
Improved
i Firm Comparablo Saba j
t a
Land
Method Frontage
Depth
( Units
Units Price
Land Value
LOT
1
$34,000.00
$34,000
Building Information
# I Description IYear Actua Effecuilt tive I Fixtures Bed 'Bath Base Area I Total SF Living SF Ext Wall Adj Value Rapt Value Appendages
http://parceldetail.scpafl.org/ParcelDetailinfo.aspx?PID=32193151600000460 1/2
2/28/2018
SCPA Parcel View: 32-19-31-516-0000-0460
I SINGLE
2005 7 4
2,0 2,021
2,470 2,021 i CB/STUCCO $128,724
$134,790
Description
Area
FAMILY
FINISH
GARAGE
389.00
FINISHED
OPEN
PORCH
60.00
.... . . . . ............................
FINISHED
I
Permits
Permit #
Description
Agency
Amount CO Date
Permit Date
00203
HVAC CHANGEOUT
SANFORD
$4,252
10/30/2013
01980 NEW - RESIDENTIAL
.............. ............ ................. . ....... ................
SANFORD
............. - ......................
$89,394
..................... .................... ................ .................. ...... .............
2/2/2005
Extra Features
Description
Year Built
Units Value
New Cost
PATIO 1
6/1/2005
...........
................ ........................
1 $338
...............
...............
$500
http://pa rceldetail.scpaf I.org/Parce]Detai I Info.aspx? PI D=321931 51600000460 2/2
1410 Emerson Street, Leesburg, FL 34748
Phone: 352-314-3625 • Toll Free: 855-314-3625 • Fax: 352-240-3439 • www.covenantrnc.com
State Roofing License: CCC1329936 • License: CGC037504
SALES CONTRACT
Covenant Roofing & Co struction, Inc. agrees to furnish all materials and labor necessary to do the modernization work at the following address:
/
Name �4 i (,(f ��Z�j Phone 7' D7 T�% W_7 Phone (w)
Address �q� t` qi f��� �Dlate—
City - SQ/I re r`� State �ip J? / /1
Email
In accordance with specifications given below:
REROOF:
A. SHINGLE ROOF
1. REMOVE OLD ROOF TO WORKABLE SURFACE.
2. RENAL ROOF DECK WITH RING SHANK NAILS.
3. REPLACE ANY ROTTED WO WITH ST NDA D SHEATHING @ $ —7— PER FOOT AND $ '70 PER SHEET OF PLYWOOD, IF ANY. (Initial)I--^ -� ��DQ
4. INSTALL UNDERLAYMENT OVER ENTIRE ROOF. a %�
5. INSTALL FHA/VA EAVES DRIP. COLOR
6. INSTALL NEW VALLEY METAL AND FLASHINGS AS NECESSARY.
7. INSTALL N WF� LE9D BO�TS OVER VENT PIPES AND RESEAL VENTS.
8. INSTALL E FIBERGLASS SHINGLES. COLOR ),l
9. INSTALL EET OF RIDGE VENT$ 0VEikf0VT, COLOR d1MG�rf
10. CLEAN-UP JOBSITE OF ALL WORK DEBRIS AND HAUL AWAY ALL RELATED DEBRIS AND LEAVE JOB SITE CLEAN.
?dI' CONTRACTOR WILL CINATE RE ML AND RE ST ELATION OF RELAgRIPHERAL9� AS (BUT NOT L ED TO) SOLAR U S, KYLIGHTS�H
AND AIR NDITIONER TC. RE ND REINSTA EXISTING S FIT AND FA @ $4.25 PERCC IN ADDITION T RACT PRICEUIRED. TH �I��' FOR
SUCH W R WILL BE I DITION TO TRACT P ND HEREI A PROVED H MEOWNE (Initial)
12. ALL WORK COVERED BY A 5 YEAR WORKMANSHIP ARRANTY.
1. Contract Documents. This contract consists of this document, extra work/wood authorizations, if any, and if payments
hereunder are to be financed, all financing documents. No promises other than those specifically set forth in the contract
documents shall be recognized by either party. The entire understanding and agreement of the parties is contained in the
contract documents.
2. It is understood and agreed that this contract shall not become binding upon Covenant Roofing & Construction, Inc. until it is duly
approved, accepted, signed and witnessed by an officer or officers of the Seller.
3. Work on the job described in the contr t o ents will commence on approximately Af�' and be
completed on approximately _. The recited dates are approximations and are subject to scheduling
difficulties of Seller, labor and/or material shortages, acts of God and other events not foreseen by Seller. Seller reserves
the right to employ any sub -contractor for the completion of the work described in the contract documents.
4. Covenant Roofing & Construction, Inc. reserves the right to substitute materials of equal or greater value and kind. Any required
materials such as fire retardant plywood, tongue and groove board, etc. will be billed on a time and material basis. All other
changes required by New Jurisdictional Code Enforcement Laws may result in additional charges.
5. Interest at the rate of eighteen (18%) per cent per annum will be charged on all balances not paid as per the terms specified
above. Reasonable attorney's fees will be charged to the Purchaser if it is necessary to place this contract in the hands of an
attorney for collection, and this charge becomes a part of the contract and obligation of the Purchaser to pay.
6. Parties agree that this agreement shall be construed according to the laws of the State of Florida and any action brought
thereon may be brought in the State of Florida. Venue is hereby agreed to be in Lake County Florida.
7. BUYERS RIGHT TO CANCEL (SOLICITED SALES ONLY) If you do not want the goods or services, you may cancel
this agreement by providing written notice to the seller in person, by telegram, or by mail. This notice must Indicate that you
do not want the goods or services and must be delivered or postmarked before midnight of the third business day after you
sign this agreement.
8. Both worker's compensation and public liability insurance are carried by the Seller and they are applicable to the work to be
performed.
9. It is understood and agreed that the buyer hold harmless, Covenant Roofing & Construction, Inc., for any damages that may
occur to the buyer's driveway(s) during delivery of materials and/or removal of the work related debris that may be required
to perform this home improvement contract. Furthermore, the buyer herein gives permission for typical delivery vehicles and
typical waste removal vehicles to enter said driveway(s) for the purpose of expediting this sales contract.
10. Contractor will coordinate removal and reinstallation of roof related peripherals such as (but not limited to) solar units, skylights,
T.V. dishes and air conditioners, etc. The cost for such work will be in addition to contract price and approved by homeowner.
11. Covenant Roofing & Construction, Inc. shall not be held responsible for damage to electrical lines, water lines, refrigerant lines
or other mechanical components that have been improperly installed near roof decking and may be damaged while performing
installation of roofing materials. Villages Roofing & Construction, Inc. shall not be responsible for any additional costs due to
roof decking that may have old materials adhered in such a way that requires redecking of structure.
12. Construction Industries Recovery Fund payment may be available from the CIRF 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 Construction Industry Licensing Board at the
following telephone number and address: 7960 Arlington Expressway, Suite 300, Jacksonville, FL 32211-7467 or call (904)
727-6530.
13. Chapter 558, Florida Statutes contains important requirements you must follow before you may bring any legal
action for an alleged construction defect in your home. Sixty days before you bring any legal action, you must
deliver to the other party to this contract a written notice referring to chapter 558 of any alleged construction defects
and to consider making an offer to repair or pay for the alleged construction defects. You are not obligated to accept
any offer which may be made. There are strict deadlines under this Florida Law which must be met and followed to
protect your interests.
Contract Price $ _1 7 of/
Homeowner Portion
(Plus Total from Item No. 3 above)
UPON COMPLETION
00
/��.�le
Executed in triplicate, one copy of which was delivered to, and receipt is hereby acknowledged by Buyer,
this � day of �Qxear,1V 20__L _.
T
Approved and Accepted: �
a.
b.
NOTICE TO OWNER
Do not sign this home improvement contract in blank.
You are entitled to a copy of the contract at the time you sign. Keep it to pr t your rights.
(Seal) (X) (Seal)
(Dealer -Seller) r Ign e)
BY (X)
(Title)
SALESMAN
(Seal)
(Purchaser Sign Here)
FORD PRESS, INC. 352-787-4650 (mike)
Limited Power of Attorney
Date —�&
I hereby name and appoint Robert Horne of Covenant Roofing and Construction, Inc. to be my
lawful attorney in fact to acl for me and apply to A[ —a2dD
for a r40-(1 permit for the address below:
Joseph E. Rayl, Contractor License #CCC1329936
Sworn to and subscribed before me this S day of lam' � , 201
By Joseph E. Rayl who is personally known to me or _ produced
identification.
411fi-a
otary Public, State of Florida
My Commission expires:
as
LAURA WESTMAN
=U ,? Commission # GG 100690
MY Commission Expires
May 02, 2021
I"
�,�>�,r, �,►rt ����� jIr1I ll�tl Il�l� Illr ll
After recording, return to:
Covenant Roofinq
1410 Emerson St. Leesburq, FL 34748
Permit No.:
Tax Folio No.: 3' jef — 3 - 5-A.,— 6 - 6V(40
GRANT MAI_OYF 5011NOLE COUNTlr
.! Ftl: i.1F C1f�C:IJ17' COURT tz COMPTROLLER
,.
ii f+ ;'11;" F"I 761, i.1F'ss,,
CLERK'S `: 2C11802b113
RECORDED C?3/1:jB!21-11u
`'f:.(:=')RGTNG FEESfl"I,CICI
RECOf DED BY ndevor a
Notice of Commencement
State of Florida
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 the Property: (legal description of the property/and treat address iiiff/available) p Q / / /�
Legal Description: / A r `7 L (i //_ / U (G r G� /' {'1GSf. .2 d U (iJ ��ITS / 'f
Street Address:
2. General Descrip ion of Improvement
0 <00
3. Owner's Information or Lessee information if the lessee contracted for the improvement:
Name: 7_G,k 1 1Y r i / eo-7 i-
Address: qq/ A,,, 34tn
Interest in Property:0 y y1_ C.l
Name & Address of fee simple titleholder (if different than owner):
4. Contractor Information
Name: Covenant Roofinq & Construction, Inc. Phone No.: 352-314-3625
Address: 1410 Emerson St. Leesburo. FL 34748
5. Surety (if applicable, a copy of the payment bond must be attached):
Name
Address:
6. Lender Information:
Name:
Address:
Phone No.:
Amount of Bond: $
Phone No.:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section
713.13(1)(a)7., Florida Statutes:
Name:
Address:
Phone No.:
8. In addition to himself or herself, Owner designates of
to receive a copy of the following Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes: Phone No.:
9. Expiration date of notice of commencement (the expiration date will be 1 year from the date ofrecording 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 YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECGRDING YOUR NOTICE OF COMMENCEMENT.
RTIF IEG COPY GRANT MAI.OY
I_ERK OF THE CIRCUIT COURT
i ;v?PT .1 R. Signature of Own nerd OfficeNDirectoNPartner/Manager
a 018 Signatory's Title/Office
Gflib-foregoing.inst ument-wasacknowiedged before me this day of 20 , by Zq�T �r as
for who
Type of authority (i.e. otficer, trustee, attorney in fact) // Name of party on behalf of whom instrument was executed
is personally known or produced �G �� �(% (a �Q as type of identification.
RNEN
AMESGG1295050, 2021 Signature of ota ate of Flonda (print ty or stamp commissioned name of Notary Public)
Notice of Commencement- BF29 (Updated 8.19.16) Astatula, Clermont, Eustis, Fruitland Park, Howey in the Hills, Groveland, Lady Lake,
Lake County, Leesburg, Mascotte, Minneola, Montverde, Mount Dora, Tavares, Umatilla
JOB ADDRESS:
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
171
STRUCTURE TYPE: x
SINGLE FANCILY RESIDENCE/TOWNHOUSE O LMOBILE HOME O ,MARTMENT/CONDO�,VILNIU�[
RE -ROOF TYPE: C%CREPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY):
"PLEASE IVOTE: O/VLY I00 SQUARE FEET OF THE EXISTLVC DECK IS PER,,WTTED TO BE REPLACED"
ROOF VENTILATION: OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES ONO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
-----------------------------------------------------------------------------------------------------------------------------
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 -4:12 to 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT
SF{NGLE
"'� �
/APPROVAL
FL# 540L/ . /
O METAL
FL#
O MODIFIED B ITUMEN
�FL#
O TORCH DOWN
FL#
O INSULATED
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#
O MODIFIED BITUMEN
FL#
OTORCH DOWN
FL#
O INSULATED
FL#
O TILE
FL#
0 OTHER:
FL#
CITY OF
SANFORD Building &Fire Prevention Division
RESIDENTIAL RE -ROOF POLICY & PROCEDURES
•y
FIRE DEPARTi4IEN T
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 OWNERIBUILDER) SIGNATURE: DATE: '" 5 W
Wit"•`
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PER,\,fIT #: I� " I� 0 ADDRESS: n 1 Vaj C-�.QW T3,C
�baaforJ 34721
[ Yl n , ,AS AM GENERAL BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, NGLNEER, ARCHITE , OF F.S. CHAPTER 463 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
FOREGOING INFORMATION IS TRUE AND ACCURATE .AND TH AT ALL ROOFING COMPONENTS LISTED ON THE SCOPE OF bkORK AT THE
ABOVE REFERENCED ADDRESS HAVE BEEN N'STALLED IN ACCORDANCE WITH THEIR PRODUCT APPROVALS AND ALL APPLICABLE CODE
REQUIREMENTS — SPECIFICALLYFLORIDA BUILDING CODE, EXISTING BUILDING. IN ADDITION [ CERTIFY THE INSTALLATION MEETS ALL
REQUIRENIENTS FOR SECONDARY WATER BARRIER .AND NAILING OF THE ROOF DECK, N ACCORDANCE WITH THE HURRICANE RETROFIT
NLkNVU.AL REQUIREMENTS (BASED ON F.S. CHAPTER 553.344).
LICENSE #:
CON[PANY/ CONTR_-1CTOR:
CONTRACTOR SIGNATURE:
('NIUST BE SIGNED B`i LICENSE HO DW-,
INAL ROOF INSPECTION IS REOUIRED:
DATE:
q Iq �
THIS SIGNED AND NOT.-\ D .AFFIDAVIT MLST 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 CONIPONENTS (DECKING,
UNDERL.AYNIENT, FLASHING, DRIP EDGE ATTACHMENT) WITH THE PERMIT N'UNIBER OR ADDRESS CLEARLY MARKED ON THE DECK
FOR EACH INSPECTION. THE PHOTOGRAPHS NIUST IVCLLDE A RULER OR MEASURING DEVICE TO CONFIRJI .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 FOLLO'�N ALL REQUIREMENTS WILL RESULT IN _\ FAILED INSPECTION, A RE -INSPECTION FEE AS
WELL AS REQUIRING A DESIGN PROFESSIONAL (ARCHITECT OR ENGINEER) TO CERTIFY, BASED ON PERSONAL
INSPECTION, THE [NSTALLATION OF .ALL ROOFING COMPONENTS.
STATE OF FLORIDA COUNTN' OF Late
0 rn to and Subscribed before me this day of 20 � by:
V Who isk�ersonaliy Known to me or has - Produced (type of
identification) as identification.
at re of Notar ' Pub is LINDSAY DUCKHAM
. ,'`-
te of Florida
`*e Commission N FF 172210
MY Commission Expires
Y��!i 7�,1�' I ,� ,l �i�"l��i� •., �rt�,.• October 28. 2018
Print/Type/Stargp Name
of Notary Pub •