HomeMy WebLinkAbout140 Rose Hill TrCITY OF SANFORD
BUILDING & FIRE PREVENTION
X{PERMIT APPLICATION
Application No: VVV
Documented Construction Value: $ 3,900.00
Job Address: 140 Rose Hill Trail, Sanford, FL 32773 Historic District: Yes ❑ No ❑X
Parcel ID: 18-20-31-503-0000-0210 ❑ Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair 0 Demo ❑ Change of Use ❑ Move ❑
Description of Work: complete roof tear off & replacement
Plan Review Contact Person: Rebecca Smith Title: Omer/Officer
Phone: 321-363-3871 Fax:
Email: inf6(a_)x1r8roofing.com
Property Owner Information
Name Rosemarie Capogreco Nolan Phone: 925-384-6409
Street: 140 Rose Hill Trail Resident of property?: yes
City, State Zip: Sanford, FL 32771
Name XLR8 Roofing
Street: 485 Specialty Pt
City, State Zip: Sanford, FL 32771
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Contractor Information
Phone: 321-363-3871
Fax:
State License No.: CCC1331278
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: 50' 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 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 zoning.
liq Al",
Signature of Owner/Agent Date Signatureof Contractor/Agent, ate
0111-1y Gi R, 0-4mk�;)/ 11_0�y
Print Owner/Agent's Name Print Contractor/Agent's Name
Signature of Notary -State of Florida Date Si natu e a �' Date
BECCASMITN
#; MY COMMISSION # FF 9t9994
o EXPIRES: March 10, 2b20
s q:r 9ondod Thru Notary Public Underv+riters.
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID Type of ID Produced, ID Type of lD
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:
Flood Zone:
# of Stories
New Construction: Electric - # of Amps Plumbing # of Fixtures
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads Fire Alarm. Permit: Yes ❑ No ❑
APPROVALS: ZONING:
ENGINEERING
COMMENTS:
UTILITIES: WASTE WATER:
FIRE: BUILDING:
Revised: June 30, 2015 Permit Application
o Property Record Card
JW
PARParcel: 18-20-31-503-0000-0210
MUR
srvrxa=crx.m'ry Property Address: 140 ROSE HILL TRL SANFORD, FL 32773
Parcel Information Value Summary
Parcel 18-20-31-503-0000-0210 2018 Working 2017 Certified
_ LL— Values Values
Owner(s) CAPOGRECO, ROSEMARIE
----- ----- - ----- ------------- Valuation Method CostiMarket Cost/Market
Property Address 140 ROSE HILL TRL SANFORD FL 32773 Number of Buildings 1
Mailing 140 ROSE HILL TRL SANFORD, FL 32773-7237
--.--- Depreciated Bldg Value $113 666 $98 698
Subdivision Name ROSE HILL
_ Depreciated EXFT Value $788 $825
Tax District S1-SANFORD e
Land Value (Market) $30 000 $30 000
DOR Use Code 01-SINGLE FAMILY
Land Value Ag
Exemptions 00-HOMESTEAD(2000) �� _ ��� _ _ —
Just/Market Value $144 454 $129 523
— --- _ .
Portability Ad1
._
rJ0JQ� Save Our Homes Ad1 $58 650 1 $45 484
% Amendment 1 Ad1 $0
P&G Adj_._ $o __-- $0
llI r Assessed -..$$5,804 $84039
.........
_
9r� ^e Li 1
�� �� „� Tax Amount without SOH: $1,678.00
0 2017 Tax Bill Amount $812.00
(� Tax Estimator
01-
miiSave Our Homes Savings: $866.00
a50
�0 $O4 Does NOT INCLUDE Non Ad Valorem Assessments
Seminole County GIS
Legal Description
LOT21
ROSE HILL
PB 54 PGS 41 & 42
Taxes������
Taxing Authority
Assessment Value
Exempt Values Taxable Value
County General Fund
$85,804
$50,000
$35,804
Schools
$85,804
$25 000
$60 804
City Sanford
$85,804
$50 000 (
$35,804
SJWM(Saint Johns Water Management)
_.
..
$85,804 I
$50 000 E
$35,804
County Bonds
$85,804
$50 000 3
$35,804
Sales
Description
Date
Book Page
Amount
Qualified Vac/Imp
WARRANTY DEED
8/1/1999
03718 0236
v
$103,000 Yes Improved
SPECIAL WARRANTY DEED
9/1/1998
03496 1719
$1,456,500 TNi Vacant
j Find Comp* hte ataa •.
t
Land
�
Method Frontage
I Depth
Units
Unds Pnce
Land Value
LOT
i
1
$30,000.00
$30,000
Building Information
# Description Year Built Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages
Actual/Effective
...._... ........ _
1 ' SINGLE 1999 8 21 2_0 j 1,253 `: 1,808 1,253 ` CB/STUCCO $113666 , $121,568 }Description Area
FAMILY FINISH
Permit No
Tax Parcel Number
r�, GR(41T VIALOr r SEMINOLE COUNTY ' L V -?�) 9b''QQQ0-Q2k0 NOTICE OF COMMENCEMENTC:LERK OF CIRCUIT COURT 2 COI'{PTROLLER.
State of Florida PI. 9129 F'q 1930 (1h'3 S )
CLERKS a 'ttt18►!.,3007
RECORDED 05.11;/201u i_r?Q�
'X �I'{"I
The UNDERSIGNED hereby gives notice that improvement will be made to certain real RECORDING I F ES71 I CIS !a/
Ra ,
property, and in accordance with Chapter 713, Florida Statutes, the following -information RECORDED B,'
is provided in this Notice of Commencement -
1. D�e cription� of Property; (Legal der ption of the property, and street address if applicable.)
2. General description of improvement «< '
RE -ROOF IN
3.Owner information (or Lessee information if the Lessee contracted for the improvement):
a. Name: RO S 21,Rc/Z��
Address: I 1 v (Z c 2 /-� 1 [—t_ '�-}� j�1( Sf�,liFc�{/Lc� ( i FOR CLERK'S OFFICE�It1 E • LY
b. Interest in property: Q
a Name and address of fee simple titleholder (if other than owner):
4. Contractor Information`
a. Name: XLR8 Roofing
Address: 485 Specialty Point, Sanford, FL 32771
b. Contractor's phonenumber. 321-363-3871
5. Surety (i f applicable, a copy of the payment bond is attached):
a. Name:
Address:
b. Phone number.
c. Amount of bond: $ .00,
6. Lender Information:
a, Name:
Address:'
b. Lender's phone number.'
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may
served as provided by Section 713.13(1)(a)7., Florida Statutes:
a. Name:
Address:
b. Phone numbers of designated persons:
8.1n addition to himself, Owner designates,
a. Name: of to receive a copy
of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes.
b. Phone number
9. Expiration date of Notice of Commencement (thee)piraliondate is 1 yearfrom the data of recording unless a diKeerentdate 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 COMMENCEMENTe/--
Lessee, or Owner's or Lessee's
Signatory's Tide/office II
L,�s" `fin- LARRY JONES "PEARSON
State ofL•�I Counfyof� ''c MY COMMISSION#GG005628
�+ EXPIRES June 26, 2020
The forgoing instrument was acknowledged before me this day of ' 20 by ! y" Rtaryservlrs.com
i' U01
(Type of authority e.g, officer, trustee, attorney -in -fact)
__.
E__
Sigof Notary Public -State of Florida
Personally Known OR �<, Produced ID
Print, Type or Starylp Name of Notary Public y
Type of IDProduced _N t 5-0`?a3-(5S• 5 (1 '0
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 5/14/18
I hereby name and appoint: Paula Rodriguez/Dion King
an agent of. XLR8 Roofing & Construction, LLC
(Name of Company)
to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things
necessary to this appointment for (check only one option):
CK The specific permit and application for work located at:
140 Rose Hill Trail Sanford FL 32773
(Street Address)
Expiration Date for This Limited Power, of Attorney: _ 12/31/18
License Holder Name: David Hambley
State License Number: CCC1331278:
Signature of License Holder: --
STATE OF FLORIDA
COUNTY OF 5 EH f 1\jQL-E-
The foregoing instrument was acknowledged before me this I14hday of.MOY ,
20� 8 , by t)fj\j1 l D f n- H i?� (_ Y who is personally, known
to me or ❑ who has produced as
identification and who did (did not) take an oath.
'� REB�GCASM�TF1
b1Y COMM15S10N # FF 969994
EXPIRES'• March ti0, 2020
gpr�ded Thru Nc
pu6licUnde�'
(Rev. 08.12)
Signature
Print or type name
Notary Public - State of FL -
Commission No. motpeffiq --
My Commission Expires: �—1 Q - W
i'40RD
FIRE DEPARTMENT
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. 19 � g 9 ISSUE DATE: ® ®,•
CONTRACTOR: X4LoR jq00h8A!9 -
JOB ADDRESS: lye> em4t k*;
I I W -re
TYPE OF WORK:
PROTECT FROM WEAT
• 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 5:00 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 pm for assistance.
AUTOMATED INSPECTION SYSTEM CODES
Final Roof Inspection Code III
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
FIRE IirPARTMFNT
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF POLICY & PROCEDURES
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 FO.L.LOWING 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 GUI.D.ELINES 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: /
DEPARTMENTCITY OF
SkNFORD
FIRE
JOB ADDRESS: 140 Rose Hill Trail, Sanford, FL 32773
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: O REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): Plywood
* *PLEASE NOTE: ONL Y ] 00 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED
ROOF VENTILATION: ® 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 ® 4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
® SHINGLE
IKO
FL# NOA No.: 16-0329.13
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#
OOTHER:
FL#
°FIRE INSPECTIONS ,CITY OF SANFORD
407.562.2786 BUILDING & FIRE PkEVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
----------------------------------------------------------------------------
Page 2
Application Number . . . . . 18-00002296 Date 5/17/18
Property Address . . . . . . 140 ROSE HILL TRL
Parcel Number . . . . . . . . 18.20.31.503-0000-0210
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . SINGLE FAMILY
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1051606
Permit pin number 1051606
----------------------------------------------------------------------------
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
----------------------------------------------------------------------------
1000 Ill BL03 FINAL ROOF _�_/_
296
CITY OF
AS ---------- ORD 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 #: 1q - uq\o ADDRESS: 140 Rose Hill Trail
Sanford, FL 32773
I David Hambley , 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 #: CCC1331278
COMPANY / CONTRACTOR: XLR8 Roofing & Construction, LLC
CONTRACTOR SIGNATURE: A DATE: 23�I
(MUST BE SIGNED BY LICENSE HOLDER 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 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 5EN I ND L E-
Sworn to and Subscribed before me this dday of MAY 20 tS_ by:
DAV i t7 JI&I BLEY. Who is 3Personally Known to me or has ❑ Produced (type of
identification) as identification.
4;� rPu' F&BECGASMITH
Signature of No P Ic ;i:...q,;••, I #PP969994
g gP ° MY COMMISS �N 10, 2020
State of Florida *" EXpIFtES. March,
Bonded Thru Notary Public Undo
pq�� 'ola S2I
Print/Type/Stamp Name
of Notary Public