HomeMy WebLinkAbout103 Woodfield CtN _ •
Btrildillg & Fire Prevention Division
PERMITAPPLICATION
Applcatioiii No,: --------------
Documented Construction Value: S 8,900
Job Address: 103 Woodfield Court, Sanford, FL 32773
:Parcel ID;
1`0-20-30-505-0000-0630 Historic District: Yes1]Nol
ResidentialD Commercial
Type of Work: Ne o Addition❑ .Alteration® Repair❑ DemoF Change -of Vse7 Move
Description of Work residential shingle reroof
Plan Review ContactTers_on: Laura Hodges Title: Office Manager
Phone:, 407-650-0013
Fax:" 321 972-8839 Email: Ihodges@hodgesbrothers.net
Property Owner Information-
,Name: Cynthia A Beldus Phone:(407)314-8771
Street: 103 Woodfield Court -
- Resident of property? ;. Ye5
City, State zip:,"Sanford, FL 32773
Contractor
Information-
Name Hodges Brothers Inc Phone407-650-=0013
501 H�8"mes Avenue :..
Street: Fad. 321-972-8839
'City, State Zip. Orisndo,, FL 32&105 CCC �042845°
State License No.
Archi#ecVEngineer Information
Names Phone:_
St
reet: Fax:
City, St Zip:
E-mail:
Bonding Company: Mortgage.Lender:.,_
Address: Address:
WARNING"TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TVS'ICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF. COMMENCEMENT ;MUST 'tiE
RECORDED AND POSTED ON THE, TOB SIZE 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"madeto 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 Imeet standards of all laws regtilor in constructionas
in this jurisdiction: I understatid that a separate permit must be.secared for electrical work, plumbing,.: signs, wells, pools,
furnaces, boilers,,heaters, tanks, and air conditioners,. eta
BC 105.3 Shall be'imeribed with tbe,date of application and the code in effett as of that date: Wh Edition (2017).Florida Building Code
Revised. January 1, 2018'
Peinit 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 frorn other governmental enti
management districts, state agencies, or federal agencies. ties such as water
AceePtance of'permii is xerification 'that T 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 co srequired
in order to calculate a plan review charge, and will be considered the estimated construction vapuepafy oftti a job at the t meact of submittal.
The actual constriction 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 willebe applied to your permit fees when the perrtiit is is"sbed.
OWNER'S AFFIDAVIT:. I certify that all of the tor
be, done information is accurate ante that all work evil`
done .11 compliance with all applicable laws regulating construction and zoning.
group e of OwnerlAgent pate
Print OwlenlApent's`.Nv
5ignuture of Contractor_ Date
Pnnt Contractor/Agent's Name `� ,
Me, or
BELOW IS OR ®FFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing[] Gas Roof
e., O
'Construction `Tv ❑
Type:, ccupancy, Use: Flood -Zone:
Total Sq Ft of`Bldg:_ Min: Occupancy Load:
P y # of Sto "rigs:.
New. Construction: Electric # of Am p _s
Plumbing - # of Fixtures
Fire Sprinkler Permits Yes ❑ No ❑ # of Heads
Fire Alarm Permit: Yes ❑ No
Revised. January 1,20I8-
Permit Application
103 WOOD
SANFORD
FL 32773
4.)
5.)
HODGES BROTHE RO
OFING OOFING PROPUN IOSACOTPUCT
AIL R
EDate Es
888 Bonita Avenue
I Estimate
" '
I/10/ 1 0 �i
New Smyrna Beach, FL 321,69 1/10/2018 2248
CCC042845 / COC-1518,169
CRT
Description
ILY
ing permit and required inspections:
wfdown to wood deck:Ri7nail wood deck in
da Building Co&lrequirements, ifneeded.
he Wood will, be -made
1, - 11 1 11 lde- and replaced Alicre
4Q.00 per hour plus materials.
R/XE400fihg underlayment.
meta I., vents, stacks andflashihg; using 26
al.,
d architectural dimeq'i'onalahiugles.
rill be removed daily:'
work -Hod VA
gesgiothcislnlc� 111furnishatwo
CINDY BALDUS
103 WOODFIELD CRT
SANFORD, FL,321,73
Qty Rate
8,900.00
Total
8900.00
'Payment dueupon Completion c_� Quote
-Credit card payments titill incur a 2.25%,fee. Not responsible for cracks in cfliriilingj's is based on our vehicles
ability to back up to building., however; we are not responsible be an
for crack's in driveway. There additional charge if we are unable to utilize
driveway., A finance charge of 1.5% Per month 0 8% annum) will be added to unpaid accounts 3W d I ay§'fr6j-h date of invoice. Should collection
action, he necessary, customer agrees to pay reasonable attorneys
fees and courts costs', including any appeal costs. This proposal is subject to
acceptance within 60 days. We do notacceptor undertake any liability herein for delay or inability to perform due,to fire, strikes, Acts of God, o I f the
cicments,. or of the,public a ythoriiies. nor do we accept or undertake any liabilityfor damage,O'flo$s of materials on work pertc)rnied due to acts Or
omissions o ,fi third, parties. Any mot'pen6trations ma&afte
r cornplefion of contract will vo d all warraxities.
This contract is valid when signed and accepted.
Please sig
n and retum Proposal contractto us:
ACCEPTED BY:� j j Total $8,900-00
Total
Phone* Fax # E-mail
Web Site
407-1650.6013 321-972-8839 infoi0abodgesbrothers.net
wwwhodgesbrotliers.nct
TXIS INSTRUMENT PREPARED BY:
mom: Hodges Brothers Inc. Laura Hodges
Address: 501 Hames Avenue. Orlando. FL 3 805 _
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number:
Parcel ID Number: 10-20-30-505-0000-0630
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 63 _
GROVEVIEW VILLAGE 1ST ADD REPLAT
PB 26 PGS 4 TO 6 103 Woodfield Court, Sanford, FL 32773
GENERAL DESCRIPTION OF IMPROVEMENT:
residential reroof
OWNER INFORMATION:
Name; Cynthia A Baldus
Address: 103 Woodfield Court, Sanford, FL 32773
Fee Simple Title Molder (if other than owner) Name:
CONTRACTOR:
Name: HodgeS Brothers Inc.
Address: 501 Hames Avenue, Orlando, FL 32805
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.
Nome:
Address:
In addition to himself, Owner Designates of
To recehm a copy of the Lienor's Notice as Provided in
Section 713.13(1xb), Florida Statutes.
Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording undoes 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 1 have read the foregoing and that the facts stated in it are true
to the best of my ktnovAedge and belief.
�n1�,e. Ck"�9.�
' 0 0%nees Slenabse —�— Owner's Printed Name
Floriea Statute 713.13(1 Jig): ' The owner must sign the rWtice of Commencement end no one efse may be permitted to sign in his or her area&-
r
State of (- lt}v1�_ County of
The foregoing Instrument was acknowledged before me this r day of I--,i'.' 1
by i \ i i Aj }1a b Qk a.1U. r`z Who Is personally known to me ❑
1 Name d person making stattern
OR who has produced Identl8cation L7 type of identification produced: 1 Y + l cze) ��{--
�, - z
KIMBERLYR.PAUL
MY COMMMISSION it GG 00g?'.? f Notary ngo eb"
P ? EXPIRES: July 6 2020
•.,oY:t$. adlded TV" Notary PuNk U ndetwnters i
GRANT MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL
CLERK'S # 2018040683 BK 9110 Pg 1347; (1pg) E-RECORDED 04/13/2018 09:08:23 AM
10.00
CITY OF
NA100RD
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. ! 6 a* I a" (4 ISSUE DATE:L9 Jo 77.
I
CONTRACTOR: *d&?es AlvwMer-i
JOB ADDRESS:' ®O —42! C.OA
TYPE OF WORK: M
2
PROTECT FROM WEATHER
• 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:
0 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 pin 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
CITY OF
Building & Fire Prevention Division
SkNFORD RESIDENTIAL RE -ROOF POLICY & PROCEDURES
FIDE DEPARTMENT
ENT'
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 (1F 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: �— e- DATE: 4/13/18
CITY OF
kNFO------
�,.
�^?
DEPARTMENTFIRE
JOB ADDRESS: 103 Woodfield Court, Sanford, FL
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
STRUCTURE TYPE: & SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: 0 REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF
DECK TYPE (PLEASE SPECIFY: 1 /2" Plywood
**PLEASE NOTE: ONL Y 100 0 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED
ROOF VENTILATION: 0 OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES ® NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 (0 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
(SHINGLE
CertainTeed Landmark Series
FL# 5444-R12
O METAL
FL#
O MODIFIED BITUMEN
FL#
O TORCH DOWN
FL#
O INSULATED
FL#
O TILE
FL#
OOTHER: Underlayment
Atlas Roofing Corp.
�FL# 17322-R3
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#
0 OTHER:
FL#
'CIITY OF
"RD
NANFO Building & Fire Prevention Division
` RESIDENTIAL RE-ROOFAFFIDAVIT
FIRE DEPARTMENT
T
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ADDRESS:
I , 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 #:
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE:
(MUST BE SIGNED BY LICENSE HOLDER 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.
M11 1►:ll CI[/J:n no 1C/] 3117:1EK/11RI"1 910
Sworn to and Subscribed before me this day of 20 by:
Who is ❑ Personally Known to me or has ❑ Produced (type of
identification) as identification.
Signature of Notary Public
State of Florida (SEAL)
Print/Type/Stamp Name
of Notary Public
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.'1112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
------ ---------------------------------------------------------------------
Page 2
Application Number . . . . . 18-00001842 Date 4/17/18
Property Address . . . . . . 103 WOODFIELD CT
Parcel Number . . . . . . . . 10.20.30.505-0000-0630
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . SINGLE FAMILY
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc .
Phone Access Code 1044767
Permit pin number 1044767
----------------------------------------------------------------------------
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
----------------------------------------------------------------------------
1000 111 BL03 FINAL ROOF _/_/_
0
XNTORD
Y OF
Building & Fire Prevention Division
RESIDENTIAL RE-R OOF A FFIDA VIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 18-1842 ADDRESS: 103 Woodfield Court, Sanford, FL
Carl Curtis Hodges , 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 #: CCC 042845
COMPANY / CONTRACTOR: Hodges Brothers Inc. Carl C. Hodges
CONTRACTOR SIGNATURE: � e- � DATE:
(MUST BE SIGNED BY LICENSE HOLDER OR OWNERIBUILDER)
A FINAL ROOF INSPECTION IS REQUIRED:
THIS SIGNED AND NOTARIZED AFFIDAVIT, MUST BE PROVIDED AT THE !OB 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 Seminole
Sworn to and Subscribed before me this day of April 2018 by:
Carl Curtis Hodges . Who is (Personally Known to me or has 0 Produced (type of
identification)
Signature of Notary Public J
State of Florida
Laura L. Hodges _
Print/Type/Stamp Name
of Notary Public
as identification.
[E,
LHODGESMYC
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