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HomeMy WebLinkAbout218 Friesian Way (3)CITY OF SANFORD BUILDING & FIRE PREVENTION �1 PERMIT APPLICATION Application No: d 7 Documented Construction Value: $ 11,700 Job Address: 218 FRIESIAN WAY SANFORD, FL 32773 Historic District: Yes ❑ No 0 Parcel ID: 18-20-31-505-0000-0770 Residential ❑x Commercial ❑ Type of Work: New ❑ Addition ❑ Alteration El Repair ❑ Demo ❑ Change of Use ❑ Move ❑ Description of Work: Re Roof Owens Corning FL 10674-R13 15216-R3 34 SQ 7/12 Pitch Beachwood Sand Oakridge LIFETIME Plan Review Contact Person: Skylar Amkraut Title: Admin Phone: 407-278-7788 Fax: 800-337-3361 Email: Permit@Jasperinc.com Name BESAW, MAX Street: 218 FRIESIAN WAY Property Owner Information Phone: Resident of property? : Yes City, State Zip: SANFORD, FL 32773 Contractor Information Name Jasper Contractors Phone: 407-278-7788 Street: 4185 S Orlando Dr Fax800-337-3361 City, State Zip: Sanford, FL 32773 State License No.: CCC1331153 Architect/Engineer Information Name: Phone: Street: Fax: City, St, Zip: Bonding Company: Address: 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: 5'" 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 nofify 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._._._ signature of Owner/Agent Print Owner/Agent's Name Date 04/10/18 Signatur of ComractodAgerit Date Rudith Goico Name Signature of Notary -State of Florida Date Signature of State, of Floda_ SKYLAR B AMKRAUT �P P✓: _ Commission #i FF 127890 i - My'Commission Expires •o June.01, 2018 Owner/Agent is Personally Known to Me of Contractor/Agent is Personally Known to Me or Produced ID Type of ID Produced ID ype of ID 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: 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: ENGINEERING: COMMENTS: UTILITIES: WASTE WATER: FIRE: BUILDING: Revised: June 30, 2015 Penitit Application 4/10/2018 ear D JaMsc�, GFA. �txxxrrv, rt,cx�a�n SCPA Parcel View: 18-20-31-505-0000-0770 Property Record Card Parcel: 18-20-31-505-0000-0770 Property Address: 218 FRIESIAN WAY SANFORD, FL 32773 Value Summary 201188 Working 2017 Certified Values Values Valuation Method i Cost/Market Cost/Market Number of Buildings �, 1� 1 .......... Depreciated Bldg Value $137,463 $125,916 Depreciated EXFT Value Land Value (Market) w_..._ $37 000 _ ; $34,000 Land Value Ag j Just/Market Value "" $174,463 $159,916 Portability Adj Save Our Homes Adj $66 494 $54 168 Amendment 1 Adj $0 P&G Adj - ----------- $0 _ . _ $0 Assessed Value i $107,969 $105 748 Tax Amount without SOH: $2,257.18 2017 Tax Bill Amount $1,225.75 Tax Estimator Save Our Homes Savings: $1,031.43 ' Does NOT INCLUDE Non Ad Valorem Assessments Ac)J 5380 E. Colonial Dr. Orlando. 1:1. 32807 3203 Conway Rd., Ste. 201 Orlando, FI.32812 (407) 278-7788 (800) 337.3301 Fax iniu�rrj�t, rritu.orc .. .. __ .- JASPER Jcspor faool.cow Ft. Contractor's i.icense: CCC1329651 & CCC1331153 ROOF REPLACEMENT CONTRACT Account Mtttnageva, Contact 4; ECG` 7 5 ? `5 6, �I Company: e, i, 5 I Claim Mortgage1 y 111fuLluatiM Company: l..oan Number: '7o Owner s). - Phone: 14 -7— Address: Alt Phone:: City: State: Zip Code: Shingle Cptor: Email: Roof RCV Amount' Contract 1'nce: Dnp Edgc Color: PSix J 111,700 - '\ 121 If Owne 's InsurancR'orripanyvoidable, Assignment of Insurance Benefits for the hull Roof Replacement Only: I herebyassign any and all insurance rights, buiefits and proceeds under any applicable insurance policies to Jasper Contractors, Inc. ("Jasper"), the scope of miuch shall be limited to it Y'ulI Roof Replacement 'I make this assignment and authoriation in consideration of- Jasper's agreement to petfonn services, supply materials and otherwise perform its obligations under this Contract, including not requiring full payment at the time of service. I also hereby direct my insurer(s) to release any and all information requested by Jasper, or its representative(s), for the direct purpose of obtaining actual benefits to be paid by my insurer(s) for services rendered. In this regard, I w'ai�c my privacy rights. if payment is made directly to the Ow7redAgcnt1Insured(s), it shall be endorsed over to Jasper immediately upon receipt. I agree that any portion of work, deductibles, beitcmuru or additional work requested by the undersigned, not covered by insurance. must he paid by the undersigned on the day of installation. Deductible: it is the 0%vuer's responsibility to pav all insurance deductibles. Owner's out-of-pocket expense will not exceed tite deductible amount, as stated on insurer's loss sheet (the "Loss Sheet"), UNLESS replacanent/repair of deteriorated decking is required by code and, or Owner requests optional upgrades. Jasper CANNOT pay, waive, rebate, or promise to pay, waive or rebate "any or all of the insurance deductible applicable to rite insurance claim for payment of work. in the event of it discrepancy, the deductible amount stated on the insurer's loss Sheet overrule deductible amount disclosed. Deductible: S r' C> U M1JST BE PAID IN FtJLI_ PLUS APPLICABLE SALES TAX (/f Onitial) MORTGAGE AUTHORIZATiON: 1, Owttcr/Mortgagor, grant authorisation Wr Mortgage Co. to speak with Jasper on matters including but not limited to, the claim and draw status.` (initiaq 1'AYhIENT `SCiFEDULE: Owner agrees to pay Jasper based on the following schedule: (i) Deposit at the amount of �n cu duc upon signing this contract; (it) the Contract Price, less the Deposit and any applicable depreciation retained by Owner's insurer's), plus upgrade costs, due and payable to Jasper upon completion of work being performed; and, (iii) the remaining Contract Price (equal to any applicable depreciation and/or change orders) due and payable to Jasper upon completion of work performed. In the event of a pending inspection, no more than 2% of Contract Price may be withheld unill inspexticxt has passed. Optional: UPGRADE ITElv1: QTY: PRICE: TOTAL: S Replacement Work and Price: Upon insurer's approval and subject to the Terms and Conditions herein, Jasper agrees to furnish all materials and provide the labor necessary to perform the full roof replacement which shall take place following Owner's insurance company's approval, approximately within 30 days, conditions permitting. Owner's Declaration of intent: Owner acknowledges and agrees that, upon approval by insurance company for a full roof replacement, Jasper shall perform the roof replacement upon receipt of funds from Owner's insurance company. FLORIDA HOMEOWNERS' CONSI'UCTION RECOVERY FUND PAYMENT, UP 1'0 A LIMITED AMOUNT, MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND IF YOU LOSE `MONEY 'ON A PROJECT PERFORMED UNDER CONTRACT, WiIERE THE LOSS RESULTS FROM SPECIFIED VIOLATIONS OF FLORIDA LAW BY A 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: Construction Industry Licensing Board: 2601 Blairstone Road, Tallahassee, FL 32399-1039, (850) 487-1395 CANCELLATION: If Owner elects to terminate the services of Jasper, Owner may do so before midnight on the third business day after Contract is executed. Owner shall receive a full refund of all deposits. Owner may also rescind Contract before midnight on the third business day after the contract is executed after notification from insurer(s) that the claim for `payment on roof contract has been denied, in whole or in part. All written notices of cancellation, regardless of reason, shall be postmarked or delivered to Jasper's corporate office: 1690 Roberts Boulevard, Suite 112, Kennesaw, GA 30144. CANCELLATION EXCEPTIONS: The three (3) day right of cancellation DOES NOT APPLY to contracts for emergency home repairs as time is of the essence. 1, Owner, have read and understand all statements, 'Perms and Conditions of the "Roof Replacement Contract" and agree that all details are acceptable and satisfactory. i further understand that this Contract constitutes the °entire agreement between the parties and that an}' further changes or alterations to this Contract must be made in writing and agreed upon by both parties. Each party represents and warrants to the other that it has the full power and authority to enter into the contract and that it is binding and enforceable in accordance with its terms. J uthorized Jasper Representative Date O Scanned by CamScanner 1111111111111111111111111111111111111111 ( THIS INSTRUMENT PREPARED BY: j� Name: JASPER CONTRACTORS �orCO Address: 4185 S ORLANDO DR SANFORD, FL 32773 1q, -'511 NOTICE OF COMMENCEMENT uR>4.H' AI-OYF SfM11°1OLE COUNTY �_I..ERt OF CIRCUIT COURT & CONIFTROLLF.R BK 9107 Fs 1688 (1i'gs) CLERK'S t 2018038911 RECORDED !_i5.r 10.1201,8 03: C u 7 1M RECORDING FEES $10.00 RECORDED BY itdevore Permit Number: Parcel ID Number. — go 3 — Sow �d�— 01 no 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) _ 103 ter) p6S z-t- D121 2. GENERAL DESCRIPTION OF IMPROVEMENT: Re -Roof 3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and address: Qz�t aLL J 219 Grlcaiar'') 3 Z773 Interest in property: OWNER Fee Simple Title Holder (if other than owner listed above) Name: Address: 4. CONTRACTOR: Name: JASPER CONTRACTORS Phone Number: 407-278-7788 Address: 4185 S Orlando Dr, Sanford, FL 32773 5. SURETY (If applicable, a copy of the payment bond is attached) : Name: Address: Amount of Bond: 6. LENDER: Name: Phone Number: Address: 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. Name: Phone Number. Address: 8. In addition, Owner designates of to receive a copy of the Lienoes 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. (Signature of Owner or Lessee. or Owners or Lessee's AuUwrized Orficer/DirectoNPariner/Manager) (Print Name and Provide Signatory's Tide/Otfice) State of � County of —Cw"In� The foregoipg instrument was acknowledged before me this day of �.201U by Name of person making statement who has produced IdentificationiK type of identification produced: ANA CHAVEZ 4t`aY 1'�. M 6A State WFrorida-Notary Public •= Commission # GG 112152 'F"�� My Commission Expires 'nrnr`� June 06, 2021 't. LIMITED POWER OF ATTORNEY .Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 04/10/18- Karla Almodovar, Rudith Goico, Skylar Amkraut Rachel Holcomb I hereby name and appoint: Gina Mebonald & Rachel Holcomb an agent of: Jasw c0ftrac1o,s (::—orc—pa-y) to be my lawf d 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): The specific permit and ap lication for work located at: 218 FRIE IAN WAY �ANFORD, FL 32773 ($veer Addrm) Expiration Date for This Limited: Power of Attorney: 1 /1 /2019 License Holder Name: Donald Bouchard State License Number. ecc'33t1s3 Signawre of License Holder_ STATE OF FLORIDA -� COUNTY OF The foregoing inst ent was acknowledged before me this 10 day of April , 200 18 by m-wd B—td who is o personally known to me or ® who has produced a as identification and who did (did not) take an oath. h Signature `d (Notary Sea]) Skylar AmVaut Print or type name SKYLAR B AMKRAUT �+ Commission # FF 127890 Ij �. My Commission Expires 1 (Reny. 08.12) Notary Public - State of FL Commission No. 127890 My Commission Expires`. 6/1/2018 Scanned by C.amScanner s aCITY i t / SANFORD FJRE� DEPARTMENT Building & Fire Prevention Division Re -Roof Permit Card PERMITII o /14 "1 ISSUE DATE: p q /, 0/ F CONTRACTOR: J",oee 0o i s • JOB ADDRESS: a �1 Fro cost asn TYPE OF WORK: 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 WSPECTION 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 P City of Sanford Building Division Residential Re -Roof Inspection 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 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: 04/10/18 PERMIT # City of Sanford Building Division Residential Re -Roof Scope of Work JOB ADDRESS: 218 FRIESIAN WAY SANFORD, FL 32773 STRUCTURE TYPE: O 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: * *PLEASE NOTE: ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED ROOF VENTILATION: 0 OFF -RIDGE O RIDGE O SOFFIT OPOWERED VENT SKYLIGHTS: O YES O 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 O TURBINES TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL Q SHINGLE Owens Corning FL# 10674-R12 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# 0INSULATED FL# O TILE �M FL# 0 OTHER: FL# FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 ---------------------------------------------------------------------------- Page 2 Application Number . . . . . 18-00001747 Date 4/11/18 Property Address . . . . . . 218 FRIESIAN WAY Parcel Number . . 18.20.31.505-0000-0770 Application description . . . ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . PUD Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 1043538 Permit pin number 1043538 ---------------------------------------------------------------------------- Required Inspections - Phone Insp Seq Insp# Code Description Initials Date ---------------------------------------------------------------------------- 1000 111 BL03 FINAL ROOF / / City of Sanford Building and Fire Prevention RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING,t�, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #: �L ADDRESS: I ` �` ( '�W -- C � � _ 7-- , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR OOFING CONTRACTO NGINEER, 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 FLORMA 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 #: CCC1331153 COMPANY/CONTRA CONTRACTOR SIGNA (MUST BE SIGNED B J ER CONTRATORS CTOR: --- - T E: DATE:tie Y LI SE HOLDER OR E UILDE 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 SEMINOLE Sworn to and Subscribed before me this All day of 4 "A 20 L by: �`kQ_1Qz l�'�^' Personally Known to me or has N Produced (type of identification) DL as identification. Signature of Notary Public {x � " ' AR State of ,�K�:LA M ALMODOV State of Florida -Notary Public t-. Commission, # GG 111330 Mm My Cor,nmission Expires 2021 _ Print/Type/Stamp Named F,%�;;;; _rune 0117 _ H 1 , _,. Ei ,u•G7 L r ::eS:PS-'S51s. of Notary Public LEVIITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, �( Seminole County, Winter Springs Date: �11slI" I hereby name and appoint: Scott Meixsell, James Allen, Chris Gardner, Juan Lozano, Paul Padgett an agent of: Jasper Contractors (Nameaf f-apany) to be my lawfW attomey-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): 0 The application for work located at: Expiration Date for This Limited Power of Attorney: License Holder Name: ILL State License Number. CCC1331153 Signature of License Holder STATE OF FLORIDA COUNTY OF sern-Ae The foregoing instrument was acknowledged before me 2day o, 200_VL by Dome E -o who is o perso y known to me or ® who has produced DL as identification and who did (did not) take an oath. (Notary Seal) KARLA M ALMODOVAR oP ,state of Florida fJotary Public Commission # GG 11 1330 - - ",ar,� Ivry Commi sionnnExpires t; �L CF �111 F1 r�u e ,i_ -- �Ya'Ji+'rtdi�.✓�.<iiiir�:�Yu'S�-:1..f2nL.Y .: .., (Rev. 08.12) Signature Akld6ay- Print or type name I , Notary Public -State o j Y'01a Commission No. i My Commission Expires: 2 Scanned by CamScanner