HomeMy WebLinkAbout814 Catalina Dr (3)CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value:
Jo-b Address: n/a, 1�) ?-- I I , Historic. District: Yes 0 No 0
Parcel ID: �J . 1 - CC)(),C) . 101 o -Residential R1 Commercial F1
Tyne of Work: New F1 Addition 1-1 Alteration R Repair 0 Demo F1 Change of Use F1 Move 11
Description of Work:
Plan Review Contact Person: t
V I t an 4a i Title:
Phone: ja3, 37q3 Fax: Email:h+cVhoro6d'1ian ka I'/
Property. Owner Information
Name 0+1/1 �' I f' i rk n a up's V6 Phone: 4r� - 3-1 9331
Street: 0&1 ' i byz_ , 'le
Wing Resident of property!
City, State Zip: 3 t1' C7 "3QqQ1
Contractor Information
Namel�l Phone: An,(Q,0 3?1,0
Street: Fax:
City, State -Zip: t l State License No.: U2_333/)ZJ2!�
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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: 51h 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 executedcontract,ils 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 ac e, that all work will
be done in compliance with all applicable laws regulating construction 3nd zoni
b Signature of Owner/AgenV ate
r -,/r? al 4/s , 0 -0�v I
�- I
Date
JOSEPH PAUL HORSCH 0
MYCCVMISSI0N'#GG08&W
EXPIRES: Marelh 23,2021
Bonded TM Bodo NotaiySer�
Owner/Agent, is 'Personally Known to Me or
Produced ID Type of ID
Agent
0
- i i L L I A N 5 hAR�RiS
' Slate of Flotida-MotarY P'Lil
*F' Comrnission#GGII 2796
My Commission Expires 33
.dune O6,2021
ra'- S, s_ na yow - to Me or
z own'
to
ID Type of ID
Permits Required: BuildingF] ElectricalF] Mechanical PlumbingF] Gas[] RoofF]
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Flood Zone:
Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps — Plumbing - # of Fixtures
Fire Sprinkler Permit: YesF] NoF] # of Heads . - Fire Alarm Permit: YesE] NoF]
APPROVALS: ZONING.
ENGINEERING:
7043MMM
UTILITIES: WASTE WATER:
mm
Revised: June 30,2015 Permit Application
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BREVARU COUNTY OFFICE
j
321-452-9223
To � � � �:�� �
ORANGE & 5EMtNOLE COUNTY OFFICE
407-9.69-3810
VOLUSIA COUNTY OFFICE
386-233-3244
NAME: —,AM Ro cuJS t tMt c k„u bn
DATE 04 O .Ton
STREET: Siq #il- NO mokt':7 40,4A
CCC1330489
CITY/STATE/ZIP: 1 #:rL sm)
HOME PHONE:
CELLPHONE: (#jp7) - 11
EMAIL:
ROOF ,. Due Caroxakenrta rout homy xtedor, shrubs and landscaping.
Includes labor to remove existing roof and haul o W.
-
' Is, O
includes Dumpster. Roll off:dumpster for paver driveways.
#ncludes i+,specting deck for damage and renalling to code with 8Dring Shank nails.
Includes saving gutters, so" fascia on existing home_. (Some damage may occur in construction). �
includes replacing ridge vents.- C'.* is t 04A OW C443.V014 ovr %3r4f1t fior"' tf
- 411+,'�� tNt
Includes r$placingexisting drip edge In, choice of color. DRIP EDGE COLOR
I C 11f
includes 1 1/*' roofing collated naffs.
includes installing new shingles in choice of color. SHIWGLE COLOR *41 tra TNT It C
Tpf^G t"1 t'Mrt
micludes rpladng all head boats and goose vents (does not Include gas related vents)>- i[ YS
Includes new gahranized metal in all valleys,
QA?
Includes Starter Shingle and Ridge Cap per Code.
f
Inciudes o6talning and posting permit With local Jurisdiction.
includes njagneticailvgweealnRlob s ts: cteanlnaout autters;and hauling awav debris:
MATERIAL RCti L ASPHALT LIFETIME SHINGLES 130MPH
^'� { i q
T"xed tat' C <
.30L8.XELi.
UNDERLAYMEMC.,�'�'��(,.Bt.iTlcs..',7, �5kfl-fE+E'F ('j�� ,.
~AEI, ttla4. ` w.Ita, wdtt,;ITen+I 4�Iber s}ar�
• ; y
P !
IftCtUtYES LABOR AND DUIv1PSTER Tp i�MCVE LAYER(S) OF SHINGLES..
B R AND
ADDITIONAL LAYERS WILL COST $'iI`IS PERLAYER ADD€TIONALLAYERS, INT
Deterioratgd existing decking replaced at $ 6I per sheet of plywood
Deterioratidexisting decking replaced at$ perfinearh, WOOD ACKNOWLEDGMENT INT"
R T-Jax
'
,Does not include painting to match fir. ;L ,p, p�.. p (j yapi,,J AND 4 0
Tat
n lt m
e�p
sm% t
WARRANTIES Worry -Free Gold 7 yrnon-prorated WORKMANSHIP ihCttA W
,,.
Worry -Free Platinum Isyrallinclusive $,art
year morunip warranty
CUSTOM6 WAIVES INTERIOR DAMAGE PRE -INSPECTION - Customertnh
(Any rpterier damage which occurs during construction will=not be coverer(,
_ n"st-
_���
+.,br.r Montty Payment
1. MER'S DECLARATION" dirlN'1`041: ChAlnO ackrrotJ(edges and a s
that th re participatinon the Insurance Recovery Guarant og+am and
,w
upon appro of roof replacement by owners insurance tidir Total Home
Rooftngshall pa [he hoof replacement work oth partles will=bt
1`Z tnpa.5 k114i1%RESX fr . ,. . $`� Y�� . • .
nbroagh Welts Pargo Rook with approved credit.
bound by the terms D is$agreement.
� t
-'- r
-Fhtane" 1»uxt be caatpfere Prior t'stan a/piol •
oF
2. Both parties agree that � nr,� ho BOWnors
.Insusance=provjder.that� , �,£'A'�����..:
ttrci unless otherwise agra . in vrn
t
me'1450fing ate
�
" `
� sue' Project own ust�ay 7HR full
am'�aurtt Qf � atab(e Insurance check "� �i`P.+
� ,, ---
plus'first
Customs Sig lure'. ate:
i
!HAVE READ AIVO UPIDERSTAND TIiIS PROPOSAL, THE TERMS ANq CONDIfr10N5, AND ALL DOCUMENTS REFEiACEO THEREIN AND AGREE TO BE BOUND
By 7H IRTERMS:-
ACCEPTANCE OF.PROPOSAL* The above prices, their specifications and conditions are satisfactory and are hearby accepted. Contractor is authorized to do the
waYfcas sjiacified: By signing Customer acknowledges that Customer Is owner of zi+a proRrrtywhora work irw as Perm;'roes.
ALL PAYMENTS. ARE DUE UPON COMPLETION OF THE PRojecr.
Any delay in payments may roult In 14%,interest per 30 days.
Wind Mitigations are not considered part of the project but offered as a service to our customers through a third party.certified licensed Inspection
company and shajl not be used as reason for any delay of final payment.
This agreement constitutes the entirecontract by and between contractor and owner and parties are not bound by oral expressions or representation by any
3�
THIS INSTRUMENT PREPARED BY; {(
Name: TOTAL HOME ROOFING. ��t 1
Address: 165 W ST RD 434 Winter Springs. FL 32708 �, Ini i �,� f r �i ij i � C (}#J t� _ _ t i `14# '� J.i•6L•+til COURT & ti:01"iPTROLLER
SK -`.i 16 FRS 1639 (1Pgs I
CLERK'S t 2018644949
NOTICE OF COMMENCEMENT RECORDED I.14/25/21113' 0 s11:,11FEES i-10.0i-1
State of Florida i;EGOi [: i BY hclevor
County of Seminole
Permit Number: Parcel ID Number. �✓�'«"�� `5! `6000 `to10
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.
(Legal description of the property and street address'if available)
GENERAL DESCRIPTION OF IMPROVEMENT:
re -roof ONLY
OWNER INFORMATION:
Kinm . -r TAAATMV t -%eSAA1dk13W-1 . TENAIrf4e A 3o3'A 1&1Sk.z
Fee Simple Title Holder (if other than owner) Name:
Address:,
Name:
Address. —
In addition to himself, Owner, Designates of
To receive a copy of the Lienors Notice as Provided in
Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a
different date Is specified)
OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
ENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13,
FUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A
OMMENCEMENT MUST BE RECORDED AND• POSTED ON THE JOB SITE BEFORE THE FIRST
IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
MENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under (penalties of perjury, I declare that l have read the foregoing and that the facts stated in it are true
to the b t of wledg rid belief,
at ie
3r tY�II �J"� .'
Owner's Printed Name I
Florida St _ 13.13{t)( : "The owner must sign the notice or commencement and no one else may be permitted to sign in his or her stead.'
State of FLORIDA County of SEMINOLE
The foregoing Instrument was acknowledged before m+
rt
by .aI i M 1?lav►oWS
NarAeofperson making statement
OR who has produced identification 5d type of identifi
�o1 Y"au�4JOSEPH PAUL HORSCH It
c
* My COMMSSION # GG 0%W
o� EXPIRES: March 23. 2d21
'''rF p� ft�p Bondod TCtu Btld2ai.CbtflrY Services
0
Date: i}
l hereby name arui appoint L�. i V y i
Of TO'fAL.HOME.ROOFING to be my -lawful attorney.
In fact to act for me and,.apply to the l Sullding Department for a
For e to b..jperformedat alocationdespihed
A
Subdivision:
- a . .a.-
W
State of Fl
county of
M
ment was-acknnwieclged before ne this _ Aday of of 20 1
who is personally known to me.
�� F� Notary Public State of Ftoaaa
MAGARTHUR .
a moo` 2 Cbs trt,TS iota GO 149292
�tp€reiU1712021.
t
x CITY OF
SA�4FO
FIRE DEPARTMEN
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. 9 ISSUE DATE: 100 1 11P
l _ �
CONTRACTOR: � �r' 1-kmeRoo-li"m;
JOB ADDRESS: / CA:talloA
TYPE OF WORK: P
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:
• 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 I I I
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.
fic guidelines will result in an affidavit provided by a. Florida
Failure to follow these speci
..Design Professional (Architect or Engineer), certifying FBC code compliance by personal inspection
REVISED: 04-17 Inspection Line: 407.792.6069 or 855.541.2112
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF POLIC Y & PR 0 CED UPCES
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.
**PR03'ECTS LOCATED IN THE SANFORD HISTORIC DISTRICT WELL REQUIRE PLAN REVIEW AND APPROVAL BY THE
SANFORD HISTORIC PRESERVATION BOARD
1NSPECTION 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 CONSPICUOUS AND WEATHERPROOF LOCATION
• COMPLETED RESIDENTIAL RE=RoOF Scopt OF WORK
• COMPLETED AND NOTARIZED, INSPECTION AFFIDAVIT
• ALL FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS
(PRODUCT APPROVAL SHALL MATCH W14AT IS ON THE SCOPE OF WORK)
0 DIGITAL PHOTOGRAPHS (MUST INCLUDE THE PERMIT NUMBER OR ADDRESS IN EACH PICTURE)
• EACH PLANE OF THE ROOF, SHOWING THE UNTDERLAYMENT INSTALLED
• ROOF DECK NAILING PATTERN, & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
• ROOF DECK NAILS USED (INCLUDING A MEASURING DEVICE OR RULER S140WING SIZE OF NAILS)
• UNDERLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
• DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING'DEVICE OR RULER)
• SHINGLES INSTALLED, NAIL PATTERN AND LOCATION OF NAILS
* SKYLIGHTS (IF APPLICABLE)
• DIGITAL PHOTOGRAPHS SHOWING ALL, INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL
• DIGITAL PHOTOGRAPHS SHOWING ALI, REQUIRED FLASHING, PER FL- PRODUCT APPROVAL
FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT BY A FLORIDA DESIGN
ROFESS IONAL (ARCHITECT, OR ENGINEER), CERTIFYING FBC CO COMPL,14-.<C'EBY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: z DATE: -AWPIt.T-
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF, WORK
JOB ADDRESS' f 14
STRUCTURE TYPE:, SINGLE FAMILY RESIDENCE/TOWNHOUSE 0 MOBILE HOME 0 APARTMENT/CONDOMINIUM
RE-ROOFTYPF.- ',oREPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
0 RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY):
" PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PER,411TTED TO BE REPLACED"
ROOF VENTILATION: (OFF -RIDGE 0 RIDGE OSOFFIT 0POWERFD VENT OTURBINEs
SKYLIGHTS: 0 YES �NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: 0 LESS THAN 2:12 02:12-4:12
4:12 OR GREATER
TYPE OF ROOF
MANUFACTURER
FLORIMA"PRODUCT APPRONIAX,
SHINCLBMmfr)s
caynlp'o
FL# 10 U-3/47 (213,
0 METAL,
FL#
MODIFIED BITUMEN
FL#
0 TORCH DOWN
FL#
0INSULATED
FL#
FL#
_oTILE
00THER:
FL#
ROOF EXTENSIONS (PORCHES, PATIOS. ETC.) "IFAppLicABLE"
ROOF SLOPE: &LESS THAN 2:12 02:12-4:12 0 4:12 OR GREATER
TVPF OF ROOF
MANUFACTURER
FLORIDA PRODUCT APPROVAL
0 SHINGLE
FL#
OMETAL
FL#
(2$MODIFIFDBITUMEN
tD -v-ui
FL# 115 � 3 - (2-1 q
0 TORCH DOWN
FL-#
0 INSULATED
FL#
OTILE
FL#
00THER:
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
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Page 2
Application Number . . . . .
Property Address . . . . . .
Parcel Number . . . . . . . .
Application description . . .
Subdivision Name . . . . . .
Property Zoning . . . . . . .
18-00001997
814 CATALINA DR
31.19.31.512-0000-1010
ROOFING APPLICATION
MAGNOLIA HEIGHTS
SINGLE FAMILY
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Date 4/26/18
Additional desc . .
Phone Access Code 1047067
Permit pin number 1047067
----------------------------------------------------------------------------
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
----------------------------------------------------------------------------
1000 111 BL03 FINAL ROOF / /
Al CITY Ofti Building & Fire Prevention Division
3 S,�J4IORD RESIDENTIAL RE-ROOFAFFIDAVIT
FIREDEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHINGS DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: O r 1 "(� ADDRESS: g ` , a
I b btya+ 'DG n 0y 0r 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 1 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: —nI al Q
CONTRACTOR SIGNATURE: DATE:
(MUST BE SIGNED BY, LICENSE HOLDIKOR OWNER/BUIIASER)
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 n o Lc
Sworn to and Subscribed before me this t day of J20 t<2 by:
tV 1 "61 Who is lAtersonally Known to me or has ❑ Produced (type of
identification)
Signture of Notary Public
Sta a of Florida
� 11110.4-� CI S
Print/Type/Stamp Name
of Notary Public
as identification.
JILLIAN S 4H RIIS
State of Florida Notary Fublic
Commission'4%d Ti2296
My Commission 02xpires
"I June 06,
1