HomeMy WebLinkAbout339 Hidden Lake Drnt
CITY OF SANFORD
.BUILDING & FIRE PREVENTION
PERMIT APPLICATION
�.vApplication No:
Documented Construction, Value: $ 1,C 1) , 3 - _
Job
Address:' Historic District. Yes O'No
F1
,Parcel ID: 11 - 2 67 3b ::Ik'10 'Residential [T*CoffimerChql El
Type of'W6rk: New 2AdditiOnEl ME] teration,❑ RepairEl Demo El Chancre of Usef], 'Move El
Description ofWork"
-
Plan Review Contact 'Son-,
H-hclt, m, Title':
Phone: 6�if 0:Q Email: _j]
4' rVj CA 'p,_r I
0
Pfoperty.Ow,ner Inforenathon,
Na.me:
phone -.-
Street:
Fax:
city"St;`Zip: :
E-mail:
Do d/ing Company:
Mr'Lender:
Address:
Address:
WARNING TO, OWNER: YOUR FAILURE, TO RECORD,, A NOTICE OF COMMENCEMENTMAY RESULT IN YOUR
,PAYING TWIC ' E FOR IMPROVEMENTS" TO YOUR PROPERTY. A NOTICE OF C6 M'MENCEME'NT MUST
ST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING,,CONSULT WITH YOUR LENDER OR
'COMM ENCENI ENT. ANATTORNEY BEFORE RECORDING YOUR NOTICE "OF
Application is hereby made to, obtain a permit to Jo, the kvoek,and'ingta]l,�tions as indicated. I certify . 11 1 1 , I I I I , I I that no work or installation has
commenced prior to the issuance of a pailnit and that Lill work will be oerforri'led'10 meet standards of all laws
act nlating'consnniction
in this jurisdiction. J understand that A spparaft p-ermit, must, be secured for eleetri al IV
P electrical work, plumbing, signs wells, pools,
furnaces', boilers, heaters, tanks', and air conditioners, "etc.
"I t.
FRE 105.3 Shall be inscribed with the date of application and the code in -ida Ruilding Code -effect as of that,datt. 51h Edition (2014) Hot
Revised. June 30,2015
Permit Application
NOTICE:, In addition to: the, requirements of this permit, there may be additional. restrictions 'appiicAblc to this -property
that maybe
found in the public records ofthiscounty,and there may be additional permits reqik'iecd, from other governmental entities such asWater
,management districts, state agqncies, or f6deral agencies
Ac6eptarice,of"permit,is, verification that I will notify the. owner of the property ofthe requ,irements ofFlorida ,Lien L4wPS7'13,
The City of Sanford requires payment of a plan reviewke, at the time of permit submittal. A copy of -the executed contract is ie�quired,
in, order to calculate a plan review chargeconsidered the a u
—and,will,beco 1 0 esfiftiated'con�truction v I e,,ofthe job at, t'
c figured based; the current ICC Valuation Table, in effect The actual construction.vailue Will be f he time ofzsubmittal.,
accordance, with I at: the time the perrnit is issued, in
h
i , local ordinance, Should 'calculated, charges timured off,, the exectutd,,contract,'6iceed, the actual construction value,,
credit,w,ill be applied -,to your permit feeswhenthe permit is issued.
OWNER' S, AFFIDAVIT,: I certify thai all of the foregoing information- is, accurate and that all work will
be done in comphapce.,with, all appli6ble,'Iaws regulatingconstruction tion,tkid zoning.
Me -or a,' -
Produced 10,
Permits, Ptequire& Bii'i'ldingF] Electrical,[] Mechanical ❑ Plumbing[] Gas'—] Roof
F
Construction, Type: 0'ecupancy Use: Flood Zone:
T-,btal:Sq A, of , Bldg: Min. Occupancy Load: # of Stories:
New Construction: Electric— i0 of Amps Plumbing - # of Fixtures
Fite, Sprinkler Permit: Yes D N:0E1 # OfHdads Fi
re Alarm Permit. Yes ❑ No,❑
APPROVALS: 'ZONINGUTILITIES: 'E WAST WATER:
ENGINEERING: FTRE:
COMMENTS:,
BUILDING:
Revised: lune,30, 201 5
Permit,Appl icapion
�.
Description
Gate
_..
Book
Page
Amount 9yalifie r
t
Vac/ImpiV,ARRANTYDEED
12/1/1991
562,500 Yes
Improved I
WARRANTY DEED
1/111887
�r
- .
�t
�...
S56,000 Yes
improved
mproved
` WARRANTY DEED
._... __
111111982
r`��j.
r
.,
� -
552,900.. Yes
_.
;
......
... .... ..
��'
_....
Improved
,....
Land:
Method Frontage
. .... 9
Depth
Units
Units Price L and Value
LOT
.:-_.
OCO
`u300�
a 60 .
..
1, 000
s3a000
Building information
Permits
http;//parceldetaii.scpafl;org/Pa,rcelDetailinfo.aspx?PI
D=1120305 FU000O1810
1/2
j)}r ;;1 ;L TOTAL CON -TRACT AMOUNT
is: Sao for 30` ldays _;Ith
DEPOSITACCESS:,Customer agrees to allow aCCess'io the property and realrzes,that heavy egwpment tieing used.
Contractor ureshas not beliable for, without hmitatton,damage to driveways, sidewalks, lawns,spnnkter systems, gardens, septic systy
otherstructures thereof, as a resultof rooftop'orjob del"nreries. ' B��NCE DUE.UPQHDAMAGEfTC.: Customer shallbe responsible for removal, remstallaliortand recalibration of satellite dishes.: Should customer bere of damageto propertyby Conimc#or, his agents; or employees iiuring the course ofinstallation of tha roof, said damage shaft be be 'COMPLETIONattention a the Contractor car orto the time of payment for the roof in question, if Customer fails'fo'notify Contractor of said damagworking days of occunence then shalt waive all rights against Contractor conceming said damage. Alan's Roofing is.not responsfing nails penetrating A/C lines,in the attip 9 9 n$ nd other valuablesto avoid damage fmm vibration, breakagerandlor detacmoparts, etc::.
protect their assets inctud n shelves, ceiti fans tools a
DELAYS, ETC,: Herebyacknowledges that Contractor maybe subject to,delays occasioned by inclement vYeafher, tabordisputes, and'matenal soppy shortages or other causes which,are beyond. the control of the
Contractor and hereby accepts delays occasioned by one or all of these circumstances in the installation of tfieroof.
pAYMENT.OF CONTRACTrCustomarheieby agrees that all'amountsdoe for this work shall be paid vpogcompletetion of Installation. amounts unpaid will interest a rate t 11296 permonth. Contractor shall: ,
be entitled to all costs of collection including attorneys' tees. Sr
RIGHT TO CANCEL: if this is a'Home Solicitation Sale, and if you do not want the goods or services, you'may cancel this. agreement by providing written notice'to the seller in e=n,.b telegram, r
must indicate that you do notwant the goods. or service and.must be delivered or postmarked before midnight of the third business day after,you stgn this agreement. If you care this a y 'g ' o by mail This notice s. lF or pan of any cash down payment ,greement,'the'seller may not keep , IF THIS o :NOT A HOME SOLICITATION CONTRACT:`Once it is signed, you are bound to it by the laws,of the: State of Florida, If in the; event ypu,breach of mpt to ca 'I this contract,.the Con tractor. shaft be
entitled to all lost profits from ttte contract
ACCEPTANCE PROPOSAL: The above prices; specifications and cpnditionsare satisfactory and hereby accepted.
i�
All contracts are subject to Alan's Roofing, Inc. management approval. Customer agrees to allow Alan's Roofing, Inc..
to use photos, letters ofrecommendation, satisfactions forms; etc. to be used for advertising poryoses-.
In case any one or mole of the provisions contained herein shaft be invalid, illegal or unenforceable in any raspect,the 4atidity; }
legality and. eniarceabifiry of marring provisio etur7her appticatron thereof shallnot in ,any"way tie aff cted r dried. SALESMAN SIGNATu E
ff
CUSTOMER SIGNATUREiF. }`"'� DATE MANAGEMENTAPPROVAL. H
Iz
Construction Industries Recovery Fund: Pa ' rit may be available, from the construction industries recovery fiend if you lose' money on a project performed under' contract, where the
loss results from spec fled violations of Florid�aiaw by a State Licensed Contractor. For information about the Recovery Fund and filing a Claim, contact the Florida CILB at the fofiowing
telephone number and address: 850 487-4395: Florida Constniction,lndustry,Ligensing Roard 1940 N: Illonroe, Street, Tallahassee, Ft 323g9, 1 1
Produa , �if" Approva.1 $poc idation Fool
p6thlit #
Project Location Address F -tid di. 6 L, -a �, e
'As, requiredby Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the
"product approval ,numbot'(s),dri the building c0n)WnOnts Iii�ted below if they are
,information and
utilized on theJo be,
- constructiorl, project, for which' you;are applying fora, building permit. -
you contact, yt. We m0n)rnend that
our, local product should not.kn 'th d— t
applicable listed product Be aware ow, Ppro uc approval number for any of the
are that windows; skylights, and exterior,.Ooqr,,s-,rn
'Cod I I _Utt be tested in
accordance with the Florida 'Building e, Section 1714.5, More, 'i nforrnat*n,about Statewide, Product
Approval can be obtained at www.florida bu i I'd
The following information mutt lbb,a mailable on the jobtitefor inspipr,.tions-
1,, This entire. prbdtj'ct pppoval form;
2. A copy of the, manufacturer's: installation, doti4lls,' entt, for
:each, I �an requirem, , II
-00ch.,pirdduct
IJ upe 20 14
June 201.4
Applicant's Signature
Applicant's Name
(Please Print)
Rinc 2014'
Permit Number:
Folio/Parcel ID#' (/- 2.6 3^ - Stu=Odoo-1P1 Z)
Prepared by: Tabitha McAuley
Return to: Alan's Roofing'
145 E Sandpiper St, Apopka, FL
32712
Gl irai il,iL++i clt. f- €1+JI•If i
C:L.E.6K GF C I.R.C1.11 i• C-'0UlE r :l Ill'T'F siLLs is
.b%..
CLERK'S v 2013055L41
I,'tt OI-M,i U 0`5/ 1 15 1 '�, it2 _r _0 1-"11
i�ECt)t 1aIHG FEE:i xs:iratiit
NOTICE OF COMMENCEMENT
State of Florida, County.of Orange
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).
2. General description of improvement
fZe - 2 obf slit Iri t
3. Owner Information or Lessee information if the, Lessee contracted for -the
,Name,, De 1 o ,- Q S TFa C
Ihte,rest;in Property
Name and'address,of fee simple titleholder (if different from Owner listed above)
Name
Address .
4. Contractor _
Name Alan's Roofing
Telephone Number407-774-21;58
Address 145 E' Sandpiper St, Apopka; FL 32712
Surety (if applicable, the
a copy of payment bond is attached)
Name
Telephone Numb'.
Address
Amount of Bond
_.
Lender
YName
-JA----
Telephone Number,
7.
111
91
Persons within.the State of Florida designated by Owner upon whom notices or of
be served as provideO'by §713,.13('1)(a)7, Florida °Statutes.
Name Telephone Number
In addition to, himself or herse'
Notice as provided in §713.13(
Name
Address
Expiration date of notice of co
unless a different date is sDecifie
ner designates the following to receive a copy of the
Florida Statutes.
Telephone: Number,
:.ement (the expiration date will be 1 year from the date ;of recording
WING TO OWNER:, ANY PAYMENTS MADE BY THE'OWNER,AFTER THE EXPIRATION OF THE NOTICE.OF COMMENCEMENT
CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN
ULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
ORDER AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
i YO�J.f2 LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signature of Owner or Le )e, or Owners or Lessee's Authorized Officer/Director/Partner/Manager Signatory's Title/Office
The foregoing instrument was acknowledged before rre this day of Mo,,u by DC' /a r d' J uc o
asfor
Type of authority, e:g., officer, trustee, attorney in fact
Signature of Notary Public - State of FI '+ a
Personally Known �XOR Produced ID
Type of ID Produced
Form content revised: 01/23M4
L.,j 1re b
month ar name of person
Name of party on behalf ;of whom instrument was ekecute �..'
Print, type, oustamp"commissioned name of Notary
Pub icr
+=Z5
TABITHA MCAULEY
'.
State of Florida -Notary Public',
i-
= _ Commission # GG 125800
M Commission Expires
Y July'18, 2021'
�°'
0
9
CITY OF'
E �A FORD
wilding & Fire Prevention Division
FIRE DEVIARTMEINTRe-Roof Permit Card
IPop7303,® /
PERMIT NO. ISSUE DATE:..lr
CONTRACTOR: A /a4i akoot�GA �NL.
� � �
JOB ADDRESS:3ddpA-
TYPE OF WORK: '
T 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:
• 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
Y 0 r.
x 3 x
r
Building & Fire PrevenliUn Division
RESIDENTT.4L RE -ROOT POLICY & PROCEDURES
PERMITTPR: 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 FE MITAPPLICATION.
THESCOPE OF WORK MUST INCLUDE, ALL APPLICABLE FLO.RIDA'P,' -CT APPROVAL NUMBERS EOR-AGL ROOF
COMPONENTS THAT WILL"BE;INSTALLED ON THE PROJECT.
A PERMIT WILL NOTBEISSVED WITHOUTTHESE DOCUMENTS. 'COPIES WILL BE MADE TO POST ONTHE'JOB"SITE.
*PROJECTSLO"GATED IN THE SANFORD•HISTORIC"DISTRICT WILL REQUIRE PLAN"REVIEW` AND APPROVAL BY THE
SANFORD HISTORIC PRESERVATION'BOARU
iNSPEC7ION P'OLICY &.PROCEDtlRES
A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED -FOR RESIDENTIAL (SINGLE FAMILY TOWNHOUSE;
MOBILE,Ho Mt, APARTMENT AND/OR'(CONDOMINIUM) RE -ROOF PERMITS:
THE FOLLOWING IS REQUIRED TO BE:PROVIDE ON TI IE JOB "SITE:
e" PE"RMIT'CARD, POSTED IN A'CONSPICUOUS AND WEATHERPROOF LOCATION
:0 COMPLETED"RESIDEN:TIAL RE -ROOF "SCOPE OF WORK;:
oCOMPLETED AND"NOTARIZED INSPECTION AFFIDAVIT
e A"LL.FLORIPA, RODUCT 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 EACIITICTURE)
o; .EAcA'PLANlE OF THE ROOF, SHOWING THE UNDERLAYMENT;INSTALLED
o ROOF DECK NAILING,PATTFRN"& SPACING (INCLUDING A MEASURING DEVICE OR RULER)
O ROOF DECK'NAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHO,WINGSIZE 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`
0 SKYLIGHTS(IFAPPLICABLE)
;DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL
DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHINGPER FL PRODUCT APPROVAL
FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGI
PROFESSIONAL (ARCHITECT OR ENGINEER); -CERTIFYING FBC CODE CONtPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE:�y-
DATE:
Ct1, Ty 0"#
SJ�NFOPERMITRD
Building,,& Fire Prevention Divnisio
RESIDENTIAL RE -POOP SCOPE O'F'WORK
JOB ADDRESS:
STRUCTURE TYPE: OS<.GLEFAMILY REISIDLNCF-,/ToI,NiiooSE O'MOM,LEROME� 0 APARTMEN,
T/CONDOM IMUM
AE'k00F'tYPE1: PLACEMENT (TEAR OFF EX[STING'ROOF D ANREPLACE WITH NEW'COMPONENTS
�No-COVER (NEW, ROOF INSTALLED' . OVER EXISTINGI I ROOF)
**Pf1EAS,FJ,V0TE. .&VLT 100A?UARE,FEET 01,- T11C,,EXjSTjjVGDF CK IS PERMITTED TO, BE, Rl,,PLA CiP
R06VVENTILATION: (a-0I-F-'RJDGE �o KIPIGIE OSOFFIT OPOWER'IzD'-VrNT 0TtjPBiNF-S
S KYLIG tS'-,'OYES ON-b IF- E'S-PLE1A.SE,PRO.'VfDE'F L,01RIDAPRODUCT APPROVAL#:,
----------
,7 --------------------------- ----------------------------------
----------- ----------------------------
--------------- -------
MkiNA60FAIREA
R,OQFS,LOftl: 0'jLE'SSTHAN2-'1I1 0212 -4:1, 2 0-4"*.'12, OR GREATER
ROOF EXTENSIONS (PORCHES; PAt,469, ETC.) "JFAPPLICABLE**
ROOF SLOPE,: 0 LESS ,THAN 12:12 02�12-4:12 0 4:'11 OR GREATER
TYPE',OF,IROOF
N! I AN I UFACTUREk
FLO'p'1'DA PRODUCT APPROVAL
-OSHINGLE
FU
0 METAL
FL#
Wojflb PITUMEN
..0
FL#
0 TORCH DOWN
0,-INSULATED
FL1#
0-TIL'E
FL#
ZOTHER:
FL#
City ®f Sanford
Building and Fire Prevention
NAILING,
�.r �g�RE�SS�E-�NTIAL ROE- ®� O+�FgINSPECTIOIN AFFIDAVIT
l�lAI ,ING, SHEATMNG3 DRY—m, FLASHING, AND ALL FINAL ROOF COO RMS
ADDRESS: 3 (d I-4 i:r)14.e, 11 L 1-,: 0 r
ROOFING COAITR.gCTOR, AS A(N) GENERAL, ]BUILDIN'G, RESIDENTIAL, OR
EATGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFF
FOREGOING INFORMATION I5 TRUE AND ACCURATE AND THAT IRM, T ALL OF THE
ALL ROOFL'VG COMPONTENTS 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 RSPECIFICALLY FLORIDA BUILD CODr' EXISTING BUTLDTNG. IN ADDTTTON I CERTIFY THE INSTALLATION MEETS ALL
REQUIREMENTSFOR SECOT\TDARY WATER BARRIER AND NAILING OF THE ROOF DECK, IN ACCORDANCE WITH THE HURRICANE RETROFIT
MANUAL REQUIREMENTS (BASED ON F.S. CHAPTER 553.844).
LICGNSG #: <- C. Cr L/ (- 2 41
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE: _
(MUST BE SIGNED BY LICENSE
OR OWNER/BUILDER)
A .FINAL ROOF INSPECTION IS REQUIRED:
DATE:
THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIN4IE OF THE FINAL ROOF INSPECTION,
ALONG WITH DIGITAL PHOTOGRAPHS OF EACH PLANE OF TILE ROOF SRO WLVG N DETAIL ALL COMPONENTS (DECKI�iG,
Ui�NllERLAYiV1ENT, FLASHING, DRIP EDGE ATTACHMENT) WITH THE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON THE DECK
FOR EACH INNSPECTION. 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 EXPLAiNATION OF ALL REQUIRENVIENTS.
*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
INSPECTIONS THE INSTALLATION OF ALL ROOFING COMPONENTS.
STATE OF MORIIDA COUNTY OF �G •sr1:z �t
Sworn to and Subscribed before me this day of 20 by:
Who is [ 1 Personally Known to me or has - Produced (type of
identification { ,
--, � � `C- as identification.
Signature of Notary Public
State of Florida
ocJ�d✓t ! P ixaz o $o09Y ° Notary Public State of Plodda
Print/Type/Stamp Name David T Mura
Q My Commission GG 114730
of Notary PublicoFfl Expires 07/24/2021