HomeMy WebLinkAbout144 Belgian WayCITY OF
Building & Fire Prevention Division .k�40RDPERMIT APPLICATION
Application No:
Documented Construction Value: $
yv Job Address: 144 Belgian Way Historic District: Yes❑No�
Parcel ID: 18-20-31-505-0000-0230 Residential Commercial❑
Type of Work: New❑ Addition❑ Alteration❑ Repair Demo[] Change of Use❑ Move❑
Description of Work: re -roof with asphalt shingles
Plan Review Contact Person: Jan Tukker Title: Pres.
Phone:407-767-6912 Fax:407-767-7165 Email:lg@jtiroofing.com
Property Owner Information
Name Walter Tierno & Viviana Arango Phone:
Street: 114 Belgian Way
City, State Zip: Sanford Florida 32773
Name Jan Tukker, Inc.
Street: 406 Hermitage Drive
Resident of property? : yes
Contractor Information
City, State Zip: Altamonte Springs, FI. 32701
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Phone: 407-767-6912
Fax: 407-767-7165
State License No.: CCC1325756
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
Revised: January 1, 2018 Permit Application
t
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'%4&
be done in compliance with all applicable laws regulating construction and
/""61, to «G (),, s-1 I zf f I?
Signature of Owner/Agent V Date
Print O r Agent's Name: --_-
of
lY'P;'-
LORRAINE GAETA
Notary Public - State of Florida
My Comin-Expires Jan 25, 2019
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Cornrnission # FF 165086
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Owner/Agent is -Personal°lye
Produced ID Type of ID
and that all work will
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ignature of ontractor/ ent Date
rint Cont c /Agent's Name
i tore of y of tate o O'rill Date '
°env/'y LORRAINE GAETA
Notary Public - State of Florida
My Comm. Expires Jan 25, 2019 4
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OF ' Cornmissio # FF 165086
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Contractor/Agent is ersonally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing[]
Construction Type: Occupancy Use:
Total Sq Ft of Bldg:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Gas[] Roof ❑
Flood Zone:
# of Stories:
Plumbing - # of Fixtures.
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: January 1, 2018 Permit Application
SCPA Parcel View: 18-20-31-505-0000-0230
Page 1 of 2
4, Property Record Card
Parcel: 18-20-31-505-0000-0230
Lam, �y Property Address: 114 BELGIAN WAY SANFORD, FL 32773
Value Summary
2018 Working
Values
2017 Certified
Values
Valuation Method
Cost/Market
Cost/Market
Number of Buildings
1
1
Depreciated Bldg Value
$151,516
$138,720
Depreciated EXFT Value
$313
$325
Land Value (Market)
$37,000
$34,000
Land Value Ag
Just/Market Value "
$188,829
$173,045
Portability Adj
Save Our Homes Adj
$12,150
$0
Amendment 1 Adj
$0
P&G Adj
$0
$0
Assessed Value
$176,679
$173,045
Tax Amount without SOH: $2,507.00
2017 Tax Bill Amount $2,507.00
Tax Estimator
Save Our Homes Savings: $0.00
Does NOT INCLUDE Non Ad Valorem Assessments
http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=l8203150500000230 5/11/2018
ROOFING 2,
JTI Roofing Contract
Address: 406 Hermitage Drive Insurance Co.
Altamonte Springs, FL 32701
C, Adjuster:
Ph"one/Email: (407) 767-6912/ljones@jtiroofing.com Claim #:
State -Certified Roofing Contractor - CCC1325756 Vtl �/ `�. Phone:
State -Certified General Contractor C C 36067�- �a n
Jan Tukker, Contractor 9 n
Customer Name: Date:
Address:
Home Phone L.
Em '1.
ss:
a
ITEM
TYPE
TY
AMOUNT
TOTAL
Tear -off shingle
Replace shingle
Replace underlayment
Hurricane Retrofit
Steep
2nd Story Charge
Valley Material
Drip Edge
Vents 1"
Vents 2"
Vents 3"
Goosenecks 4"
Goosenecks 10"
Flat Roof
Interior/Exterior
Skylights
Solar Panels
✓ Remove Trash from Roof, Gutters and Yard
✓ Roll Yard with Magnetic Roller
✓ Protect Landscaping Where Applicable
✓ Delivery/Special Instructions:
4739
Work Phone:
le,r
ITEM
TYPE
QTY
AMOUNT
TOTAL
Ridge Vent
Off -Ridge Vents
Decking
Lead Boots
Debris Removal
Wood
Shingles -Manufacture: Style:
Type:. Color:
Warranty
Labor
Roof
I
b/
.Insurance Co.
Initial/Estimated
Date:
$
Amount
Insurance Co. Agreed
Date:
$
Amount
Upgrades
Insurance Supplement
$
TOTAL
Date:
$
c
PAYMENT SCHEDULE
50% DOWN PAYMENT PRIOR TO ORDERING MATERIALS
PAYMENT IN FULL UPON COMPLETION
EARNEST DEPOSIT: ❑ $500.00 ❑ $1000.00 ❑ $
DOWNPAYMENT $ FINAL PAYMENT $
JAN TUKKER, PRESIDENT
TERMS: THIS AGREEMENT IS "SUBJECT TO" INSURANCE COMPANY APPROVAL. JTI ROOFING IS
AUTHORIZED TO PERFORM WORK AND RECEIVE FULL AMOUNT OF INSURANCE PROCEEDS, INCLUDING
OVERHEAD AND PROFIT, ONLY UPON APPROVAL BY INSURANCE COMPANY.
ACCEPTANCE OF AGREEMENT
The above prices, specifications and conditions of this agreement are satisfactory and are hereby accepted. I/We have read and understand the terms and conditions
located on the back of this document/agreement. JTI Roofing is authorized to do the work as specified and in accordance with the terms, conditions and stipulations
of this agreement. Homeowner hereby authorizes Insurance Company and/or Mortgage Company to make payment for completed repairs directly to Contractor and
mail insurance proceeds to Contractor. Homeowner hereby assigns to Contractor their rights to any insurance proceeds from Insurance Company for goods and
services as described in the specifications.
THREE DAY RIGHT OF RESCISSION
THIS WRITTEN AGREE T HEREBY SERVES AS NOTICE THAT I MAY CANCEL THIS AGREEMENT AT ANY
TIME PRIOR TO MIDNI T OF HE THIRD BUSIN SS DAY AFTER THE DATE OF T IS G NT.
Homeowner Approval:A (it,O C:k (CAA Date:
Contractor Approval:
Date:
67
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THIS INSTRUMENT PREPARED BY:
Name: Lorraine Gaeta
Address: 406 Hermitage Drive _
Altamonte Springs, FI. 32701
NOTICE OF COMMENCEMENT
Permit Number:
GRANT MALOY, SEMINOLE COUNTY
CLERK OF' CIRCUIT COURT & COMPTROLLER
BK 9136 P9 513 (1Pss)
CLERK'S 4 2018057174
RECORDED 05/21/2018 11:31:53 All
RECORDING FEES $10.00
RECORDED BY hdevore
Parcel ID Number: 18-20-31-505-0000-0230
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 PROPERTY: (Legal description of the property and street address if available)
Lot 23 Bakers Crossinq Ph1 Pb 60 Pq 27-29
114 Belgian Way Sanford FI. 32773
2. GENERAL DESCRIPTION OF IMPROVEMENT:
re -roof with asphalt shignles
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: Walter A Tierno & Viviana Arango Joint Tenants with right of surviorship
Interest in property: 114 Belgian Way Sanford FI. 32773
Fee Simple Title Holder (if other than owner listed above) Name:
Address:
t�j 4. CONTRACTOR: Name: Jan TUkker, Inc. Phone Number: 407-767-6912
j✓' Address: 406 Hermitage Drive Altamonte Springs FI. 32701
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
Address: Amount of Bond:
6. LENDER:
Address:
Phone Number:
7. 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)(a)7., Florida Statutes.
Phone Number:
Address:
8. In addition, Owner designates
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number:
9. Expiration Date of Notice of Commencement (The expiration is 1 year from date of recording 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 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.
/-V.ti1/t,C, bAYu,1yl\/( G►')CA _k a ��j D
Signature pOvmeMor Lessee, or owners A Lessee's (P(jy,4Name;andP,rovide.Signato, s ige/Orfice)
Aut &2i dd Officer/Drectoi/Partner/ n er)
State of G " County o �
i
The foregoing instrument was acknowledged before me this day of VV\-QIJA 201
by t V 1 Q/`,� �� �wY`j 0 Who is personally known to me ❑ OR
Name of person making statement
who has produced identificationx type of identification produced:
.j h
S A,�L kb
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Notary Signature
CITY OF
Building & Fire Prevention Division
it RESIDENTL4L RE ROOF POLICY & PROCEDURES
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 PROVIDEON 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',
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING
IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN
CODE COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNERIBUILDER) SIGNATY/RE / / DATE: d ` ��
d
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JoB ADDRESS:
STRUCTURE TYPE: GLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: 0REPLACEMENT (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 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED **
ROOF VENTIL.ATION:XFF-RIDGE O RIDGE OSOFFIT OPOWERED VENT
SKYLIGHTS:' O YES(( '' A,
0 IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 Q 2:12 - 4:12
2(4-12 OR GREATER
OTURBINES
TYPE OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
SHINGLE
FL# Old k Z
O METAL
FL#
O MODIFIED BITUMEN
FL#
0 TORCH DOWN
FL#
O INSULATED
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#
O INSULATED
FL#
O TILE
FL#
O OTHER:
FL#
CITY Of
I SkNFORD
II�IIIII ■
DEPARTMENTFIRE
Building & Fire Prevention Division
RESIDENTIAL RE-R OOF A FFIDA VIT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
�j
PERMIT #: ✓ ADDRESS:
I , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
)R, ENGINEER, ARCHITE T, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
TION 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 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 REANSPECTION 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 O,\!=i%'�" /
Sworn to and Subscribed before me this fi= day of by:
Who is rerso,ally Known to me or has ❑ Produced (type of
as identification.
'figure of Notary Public v
S to of Florida
int/ ype/Stamp Name
of Notary Public
LGRRAIIIE
r ' I..�I.a.
DIotary Public - 5tate nl
_ 0, N Ceram. Expires Jan 25. 2 ).i <`• Commission # FF 165066 'I
CITY OF
SkNFORD
FIRE DEPARTMENT
Building & Fire Prevention Division
RESIDENTIAL RE-R 0 OF A FFIDA VIT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
233�MY "j 44�
PERMIT #: ADDRESS:
T '
I - __ �� . AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOF G CON R, ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
FORE G 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 #:
CONTRACTOR SIGNA'
(MUST BE SIGNED BY
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: ' Z 1 1
THIS SIGNED AN +N( ARIZED 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 O
Sworn to and Subscribed before me this 7_ day of _ 20 T9y:
Who �epersonallly Known to me or has ❑ Produced (type of
i ti cati as identification.
jj f ,, U JARPINE GAETA
Cl P:i L
Public - State of Florida
Si ature of otary Publ, w C,rn.m. Expires dan'�. �019
State of Florida y (A1�) 166086
� FF
rint ype/Stamp Name
of Notary Public