Loading...
HomeMy WebLinkAbout176 Clear Lake Cir 17-1596; ROOFCITY OF` SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: / ._ l'T 9 _(o Doculnen ed Constraction Value: $a Z CI S Job Address: 1-1 tp C- t£'a-y" LCL1(-e b 1', 5C10-_tpvd , EL Historic District: Yes No Parcel Il?: Residential N 'Commercial Type of Work: New Addition Alteration Repair M Demo Change of Use Move Description of Work: Q_e - 'F bye Z 1 SO -1 ire Di tcV-) ',A Mn- AAAq Plan Review Contact Person: _ i ( A A \c)\ o1AA'V ' Title fj \A CXT't((; Y Y Phone i ' 2 -~l DFax: R; Cis _ 3 -1 - S_-3W Email: v Y'a Y 1 (.- t` hC 1 Cy Property Owner Information Name Ary) C !g Street: i l C.0 C teC_.+ - l_[x Ci r City, State Zip: Sc;e_ fn nv e C= i_.. 3 Phone:_ Resident of property? Contractor Information Name Phone: Street: 610) S C.CSYIuxi" V-6 23u) t--e `ZD 1 Fax: City, State Zip: C)r t('LV , -L. 32b12 State License No.: CC C 133 1S"3 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: 5`h Edition (2014) Florida Building Code n,.:ii-A. T. . zn, ,)nrs. Permit Annlication NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may befoundinthepublicrecordsofthiscounty, 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 1 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 requiredinordertocalculateaplanreviewchargeandwillbeconsideredtheestimatedconstructionvalueofthejobatthetimeofsubmittal. 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 pen -nit 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. V, al 1- _ 5/31/2017 Signature of Owner/Agent Date Signature of Contractor/Agent Date. Print Owner/Agent's Name Print Contractor/Q ent's Name % 5-31-2017 i 1 % Signature of Notary -State of Florida. Date Signature ofNot -State of Floiida Date e,K SI<Y A B AM missionission 8 FF r27B90 n: N1v Commission Expires 8 Owner/Agent is Personally Known to Me or Contractor A,r— Me or Produced ID Type of ID Produced Type of ID N-) l BELOW IS FOR OFFICE USE ONLY Permits Required Building[ Electrical Mechanical Plumbing[] Gas Roof Construction Type: Occupancy Use: Flood Zone: Total Sq Ft of Bldg: Min. Occupancy Load: # 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 WASTEWATER: FIRE: BUILDING: R—kprl• nine 30. 7015 Permit Application 78 TR' lip i A S P EAn1 1-0 042 00 1 sill, PASS _xn I Ill WOO' A ( C iliji VISA ! t000 1; REITM PlIll 'N•I if 07's 1 RAC 11' IM 10q", I US J, I's lwnlratice Coll Iltit avccc jjjl Lot' [I fiJI ruid r A linslivolict. Rentfif-s Ior Illy Full Roll Rephicefliclit Only: I I1+r h c, , ,riv 'Ilat 'Ih vo.aall.x liplo_hcnclha aril I I-_ j,,, pw CjNmn, ow w"c A wMch WA W h"Mild it, It h:li [Owl fli, ny a ppi;Cali1v In.ijrari:c [NIIWWS 0 -111 W " WWAIT; MW 'Wn"vc Paul L:%jo rt It the tiMC LI!! rvll., .11 .(t hc10,y, ilfcct nl, t'l ;Wl :III if14-1,' 1!, , re jlljl`JC 11 tl:-I It' ria".1tWILI! jn-CCtl 10 Ill'-v `tali - rs littA 00 li jt: Lla-)' 4A WoFk, ]Cfid(tidcs, bc1,rcrn,, ,cn! I-oldiflo-,I v."Irlr. 1c,411c"fl-Il 11%, 111c f,01 0,1.k,rcsj hV llhfll;illc, 1101"I h.-,- lIMIrr vcque-sk AMOTH, as suund on MWKCA 00 :.Beer NO to 111 t pt'llonal opgaics ko'll-cr CANN01 jojojlkisL t,,- ;III (lf YOM 0" On M-0-1 1 hr-,-I MCM11c dcdliclihic foF Pa. MI 01 Ono A lilt- kI_:Jwt11tc tw"till, _ "I I J, r III PMD IN I yi ill vi I ',AIS_.11 I Ax 6rtflialt mii-tial djscRl,cd Di L. Co vo A(, -10 -AillR'rf. E "ORIZA1 N 1, hqv On moms Mchidmg bm am WMA n 1W don MA 1!.!v. (Hqeii, PIYMLN I '4111r_ WIN U) III, I! IiW l ray J-pa bmed 'M dw MPIwtiv dlcdoll, 0JI- Dqlosir ard, aw, appljoAk. on, AU Wd P .:F _!IvIi 01 j-! A _iiti f.ay-a'DIC W Ja tipff UP011 smik bay paymn, W Win JW Myon"" I Imam III wn cTion A and Vrieo- 1, it lurtoi,;L v,ICL , appro,--,I, vrm tdr ILAL1IX)T 10 p'-i-Imin 0!1: Il 11 1.1"! I d ifflin 11 ij:tY2•, pyanot i,w. O%s nvr',,, Du,,LIF,ifilllll III.fllU f jj tip.,ii h,, insaance CoTripkinv litt iW " I'A rqphlc-ulro, japa Soo py"Wil ril, lt-;J rqrli :I! .-lit 11-11 1111 :r !_Jltc Ill ORIDA HOMI. MN 1-,iW* (,,I ION, FUND UP '10 zk l_ 1\'IFI 1A) "tN101 %'I PSI Al BI XtjI_F I-ItONl 1 'IF F1EOHl11:4 Jit'sS I'KL' C I ION RECOVERY FUND if I'M 1-4 sIST N.MNIA WN A 1,11(MEGI I'V11FO1 MED I NDER CONTRWI. RIDA LAW BY A LICFN`,LD CONTR,('TOK- WHI HIT I HE LOSS RESILT-I's, VRONII StIL,( IFIL11 \ 1( 11 .11 1 JON11 01- FL -1 'IM 0 z ECONTRV I t N 1) ND VILLN6 MNl, CONTAC VL I I D,' 10 R I N FOR NI AT] ON A B 0 11 T 'I'll F It I] 41110M, !\LA 'D AIMIZI'SS: CONW F RUCTIO\ INDUS'l RY LICLN"IN(; B0,WI) A'I I III, JBI 1, AS I C Industr't uccliAngBoard: 201.11 Blairstulic italad. F L 3' 2399-1031 {850I 487-1395 VION: If Or= cucts too ternflninit, lilt scrices (If Jasper, OANuvr tug so behlre n6dni}ja on flic lhird Iyu-%itics all deposits, si own" my also rescind Contracthi widnighl 1) alai Mir Cavrao is executed, (Ill t1cr shall roix6ve a full ITfill"d ilf ( ts lit,- luo Elie ct)IIIj-,Icj is (,ccutcd after 11011ific-I tion front insmircrOO 1.11141 IlW clairli Site thitif businvis', day 21TOr trreavon. OWN Ile postill21-ked 4?F deli" di ni,,d, in wholc or in All "t-i(tvil nof-iccs of convellittioll. regardless (I -cc ill dil office: 1690 Roberts Bolituvard, Suite 112! GA 31)144 (kNCLI-LA410N F\CF.V'Tl()`sS: 1 'lit' till o4can"Ikoon DOFQ WI •%EoM y to cunuRch for uinnulvnv holul., rtl)ail-s as lime is (If the t-Ilaric1. I)IoLi rc4-A , ind IoniJL-saml ah sWWMcM% "S and condilb"% 14 AV -Roal tand that this the cntlli c Ill I i, 1%, c c Fit di-lAik 1"o-, 14cceiitAdc 'trill undel's ;IrI III (Ilvilver cljttllg.- lot- I(, this ( lie nj:idoc in vi. riling and n9reed UP" 10 k"o h prift I It af it hate i lit, lull jon\ er mid it( 1)(11-it (4) Vfktut injo Illt oml rtil'-1 jild 0-; ti 4 1 rr;l If 1 0 A It h V I tav(L, lit It tlltIt it tcl III,- f-I 111i 1 111 li i I 1f6 I IIi'ifa it l f' THIS INSTRUMENT PREPARED BY: G, / L/l;`G('G1.Ct[,11 I MALOY r SEMINOLE . COUNTY came: Jasper Contractors V CLERK OF-CIRC JIT COURT & 011PTROLLER Address: 3203 S Conway Road Suite 201 2K 8923 F'9 683 (IP9s-) Orlando, FL 32812 CLERK'S T 2017053903 a a 19 5 RECORDED 05/31/2017 10:38:39 AM T ` c ` i y/R/ n/c@ o RECORDING" FEES $10.710 NOTICE OF COMMENCEMENT RECORDED BY tsmith Permit Number: rr Parcel ID Number. Dix —ao— Jc7 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. PESCRIIPTION OF R PERTYi (Legal description of the grope a stre t add s If av ilable) 2. GENERAL DESCRIPTION OF IMPROVEMENT: re -roof 3. OWNER INFORMAT NOR LE SppSE INFORMATION IF THE LESSEEf CONTRAC1TE,D, FOR THE IMPROVEMENT:0 2 Name and address: [V1 N (A Oac 7'1(n f . a ( t C36 3 d l 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: 3203 S Conway Road Suite 201 Orlando, FL 32812 5. SURETY (If applicable, a copy of the payment bond is attached): 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. 8. In addition, Owner designates Phone Number: 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 Owner's or Lessee's (Pant Name and Provide SignatorysTi a Of ce Auihodzed Ofricer/Director/Partner/Manager) r-- p State of ' 1" I Cl./ County of n' q The fore oing instrument was acknowledged before me this 1 dayof Q,t,l, / \ .201— by t "\ r ` f l , Who is personally known to me O OR T Name o persa6 making staTement identification who hasproducedtypeofidentification produced: HT 051 r SICY.L, PR B AMI<R tuConiniission (! FF 127890 My Commission Expires ! or. June 01. ZO18 w,.,.. .:..r-•.,..n. ar,,..-,..>•:..-vim. F4.. LUMTED POWER OF ATTORNEY Mtamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 5/31/2017 I hereby name and appoint: Karla Almodovoar, Ana Chavez, Skylar Amkraut, Rachel Holcomb an ap-ent of: Jasper Contactors unc of Company) to be my laA-H attomev-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): IR The specific permit and application for work located at: 176 Clear Lake Circle Sanford, FL Sv= Address) Expiration Date for This Limited Power of Attorney: 1-1-19 License Holder Name: Donald Bouchard State License Number. CCC1331153 Signature of License Holder. LX97 STATE OF FLORIDA --) COUNTY OF The foregoing instrument was acknowledged before me this 31 day of May , 200 17 , by Dwwd Boodard who is o personally known to me or im who has produced a as identification and who did (did not) take an oath. Signature Sky Amkraut Notary Seal) St<YLAR 8 AMiCRAUT Commission It FF 127890 My Comrn.ission Expires June 01, 2018 l Rev. 08.12) Print or type name Notary Public - State of . Commission No. 1-1-1 My Commission Expires: CO- 1 —1 Scanned by CamScanner City of Sanford Building & Fire Prevention Division Re -Roof Permit Card PERMIT NO. / " 9 ISSUE DATE: 060. 0 / • / / CONTRACTOR: J JOB ADDRESS: 7(4o ' Nwr (2*00;" 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 INSPECTION TYPE APPROVED REJECTED INSPECTOR FINAL ROOF F I I 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 3:30 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 111 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 PERMIT # City of Sanford Building; Division Residential Re -Roof Scope of Work JOB ADDRESS 176 Clear Lake Circle Sanford, FL STRUCTURE TYPE: 0 SINGLE FAMILY RESIDENCE/TOWNHOUSE 0 MOBILE HOME 0 APARTMENT/CONDOMINIUM RE -ROOF TYPE: 0 REPLACEMENT (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 ISPERiVITTED TO BE REPLACED' ROOF VENTILATION: 0 OFF-RRDGE Q RIDGE Q'SOFFIT QPOWERED VENT QTURBINES SKYLIGHTS: 0 YES IDNO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL MAIN ROOF AREA ROOF SLOPE 0 LESS THAN 2:,12 0 2:12 - 4:12 (D 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL SHINGLE Owens Corning FL# 10674 0 METAL FL# 0MODIFIED BITUMEN FL# 0 TORCH DOWN FL# 0 INSULATED FL# Q TILE FL# 0 OTHER: FL# ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) "YAPPLICABLE** ROOF SLOPE: 0 LESS THAN 2:12 0 2:12 - 4:12: 0 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL 0 SHINGLE FL# Q METAL FL# 0 MODIFIED BITUMEN FL# 0TORCH DOWN FL# 0 INSULATED FL# O T LE FL# 0 OTHER: FL# City of Sanford Building Division Residential Re -Roof Inspection Policy & Procedures PERMITTING REQUIREMENTS— NO PLAN REVIEw REQUIRED This document (signed) along withan 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 OWNERBUILDERYSIGNATURE: DATE: 5/31/2017 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 . . . . . 17-00001596 Date 5/31/17 Property Address . . . . . . 176 CLEAR LAKE CIR Parcel Number . . 02.20.30.5GJ-0000-0030 Application description . . . ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . MULTIPLE FAMILY Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 987016 Permit pin number 987016 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, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #: ADDRESS: 0 C Iltnjr C Q /D_ I , 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 ##: cc c COMPANY / CONTRACTOR: CONTRACTOR SIGNATURE: DATE: (9- 1— I:1 MUST BE SIGNED BY LICENSE HOLDER OR OWNER/BUILDER) A FINAL ROOF INSPECTION IS REn UUIRED: 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 SP`()(1\n0l't—f Sworn to and Subscribed before me this ___ day of )&f Uz 20 —aby: ewtiff ation) V Signature of otary Public State of Flo i S 1 Amkraut Print/Type/Stamp Name of Notary Public Who is Personally Known to me or has Produced (type of as identification. Y(Ig i SI(YLAR B AM KRAUT Commission q FF 127890 My Commission Expires June 01, 2018 F ` D PERMIT # City of Sanford Building Division 4 Residential Re -Roof Scope of Work JOB ADDRESS: 176 Clear Lake Circle Sanford, FL STRUCTURE TYPE: 0 SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM RE -ROOF TYPE: Ox 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: ONLY I00 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED" ROOF VENTILATION: DOFF -RIDGE QRIDGE OSOFFIT OPOWERED VENT OTURBINES SKYLIGHTS: O YES ONO 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 D SHINGLE Owens Corning FL# 10674 O METAL FL# O MODIFIED BITUMEN FL# O TORCH DOWN FL# OINSULATED FL# OTILE FL# O OTHER: FL# ROOF L' XTENSIONS (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# OTORCH DOWN FL# O INSULATED FL# O TILE FL# O OTHER: FL#