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HomeMy WebLinkAbout125 Pine Isle Dr 17-1389; ROOFCITY OF SANFORD, BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No / 7 ` / 5 to? Documented Construction Value: $ 12, 90,0 Job Address: 125 PINE ISLE DR SANFORD, FL 32773-7435 Historic District: Yes No R Parcel_ID: 10-20-30-511-000;0-0890 Residential x Commercial Type of Work: New Additio Alteration Repair Demo Change of Use MoveEl Description of Work: re -roof Owens Corning FL10674 Techwrap FL17194 Oakridge Desert Tan Lifetime Warranty Plan Review Contact Person: Phone: 407-278-7788 Name VELAZQUEZ BLANCA. Street: 125 'PINE ISLE DR Skylar Amkraut Fax: 800-337-3361 Title: Email: permit@ j asperinc,.. com Property Owner Information City, State Zip: SANFORD, FL 32773 Name Jasper Contractors Phone: Resident of property? : yes Contractor Information Street: 3203 S Conway Road Suite 201 City, State Zip: Orlando, FL 32812 0. 11 407- 278 77 Phone - 88 Fax: 800-337-3361 State License No.: CCC1329651 Architect/ Engineer Information Name: Phone: Street: Fax: City, St, Zip: E-mail: Bonding Company: Address: 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. 1 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 I'emiit Application, n 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, 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 Signature of Notary -State of Florida Date Ko llqa- .-'k Sl It \ 0-- Signature of Contractor/Agent Date Yz.vm MWtOWL 111/n Date SKYLAR B AMKRAUTyP4q Commission P FF 127891, My Commission Expires Y Owner/Agent is Personally Known to Me or C °e Ju.n a 01 O - . L own to Me or Produced ID Type of ID Produced ID x Type of ID 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: UTILITIES: WASTE WATER: ENGINEERING: FIRE: BUILDING: COMMENTS: Revised: June 30, 2015 Permit Application LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 5/11/2017 I hereby name and appoint;skylar Amkraut, Ana Chavez, Karla Almodovar, Rachel Holcomb an agent of Jasper Contractors Name to be my lawful 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): Thespecific permit and application for work located at: 125 Pine Isle Drive SANFORD, FL 32773 Street Address) Expiration Date for This Limited Power of Attorney: 11112018 License Holder Name: Michael Stephen State License Number: CCC1329651 Signature of License Holder: ' STATE OF FLORIDA COUNTY OF Seminole The foregoing instrument was acknowledged before me this. 20017 , by Michael Stephen to me or m who has produc identification and who did Notary Seal) Print or type name 11 day of May who is o personally known Notary Public - State of tcRAut' AMt r YLARt27890tCommissionNo. jj mmiss, on A FF co ? My Commission Lxpiress Expires , Ly MY Commission oQ 018 June012iRcv. 08. 12) as E"4'tU k:. f:`etluuirl Dr. C\ hl_ t_'S(17 trot Conway Rd:, Ste 201 0,tando. Ft, 3^Ctj 4071 7s• ??33 MAI) Aj %- J.ttt 1 l'a in f64Q-iA;jrrmC.on r- rnalls r—i JASPER FL Contctor's Licensor CCCIJ29651 Jt CCC1331133 Account iNanttper: r b'j Contact M: ANumber,: proceeds underAssignmentofInsuranceBenefitsfortheFull. Roof Replacement ,Only: hereby assign any and all insurance rights,. benefits and anyapplicabic insurance policies io Jasper Cmtructors, Inc. (" JA5pa" ), the scope of which shall be limited tort Full Roof Replacement. 1 make this assignment and authorization in consideration of in_Tcr's agreement, to perform services supply materials and othemise perform its obligations under this Contract - including not requiring full terymcnt at the time of service. I also herebv direct my Insurers) to -release any and all information requested by Jasper. or itsrepresentati.etsl. (or the direct purpme of obtaining actual benefits to be paid by my insurer(s) for set%iccs rendered. In this regard. 1 %%ai%C my primacyrights. If payment is made directly to the O%vPc0Agent/Insured(s), it shall he endorsed over to Jasper immediately upon receipt. 1 Wee that an)' portion ofwok, dcxductible& betterment or additimal work requested by the undersigned, not covered by insurance, must be paid by the undersigned on the day of insmilation. Deductible: It is the Owner's rcsoonsibility to gv a tmnce deductibles. Owner's out-of-pocket expense will not exceed the deductible amount. as stated, on insurer's low. sheet (the "Loss Sheet'), UNLESS replaccmctitircpair of deteriorated decking is required by code andtor Owner requests optional upgades. Jasper CANNOT pay: wahi, rebate, or promise to poy.'ts'aive or rebate any or all of the insurance deductible applicable to the insurance claim for payment of work. in the event of a discrepancy. the deductible amount stated on the insum's Loss Sheet shall overrule deductible amount disclosed. Deductible: sio o o nIl1ST BE PAID IN FULl, P U PPLI BLE SALES TAX . _ (initial) MORTGAGE AUTHORIZATiON: L Owne/hlortsagw, grant authorization for UU MI D Mortgage Co. to speak with Jasper on manors including but not limited to -the -claim and draw status, (initial) PAYMENT SCHEDULE: OHncr agrees to pay Jasper based on the following schedule: (i) Deposit in the amount ofS due upon signing this Lrontract: (ii) the Conran Price. less the Deposit and any applicable depreciation retained by Omvner's insurcr(s), plus upgrade corm due and payable to Jasper upon completion of j work being performed: and, (iii) the remaining Contract Price (equal to any applicable depreciation andior change orders) due and Mable to Jasper upon completion of work performed In the event of a pending inspection, no more than 246 of Contract Price may be withheld until inspection has passed. Optional: [ 1PGR.ADE ITUM: QTY: PRICE: TOTAL: S Replacement Work and Price. Upon insurers approval and subject to the Taints and Conditions herein. Jasper 4grcc3 to furnish all materials and ! provide the tabor nccessan` to perform the full roof replacement %hich shall take place follo%ing Owner's insurance company's approval, appm-cimately within 30 days, conditions perrrlining. Owner's Declaration of intent: Otcncx ackrtowledge` and agrees that, upon approval by'insuratnce°company for a full roof replacement. Jaspe shall perform the roof replacement upon receipt of funds from Uwncr's insurance company. FLORIDA HOMEOWNERS' CONSTUCTiON RECOVERY FUND PAYMENT, UP TO A LIMITED AMOUNT, MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND IF YOU LOSE,MONEY ON A PROJECT PERFORMED UNDER CONTRACT, WHERE 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 terminatethe 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 alter notification from insurers) that the claim for payment on roof contract has been denied, in whole or in part. All written notices of cancellation, reprdless of reason, shall be postmarked or delivered to Jasper's corporate office: '1690 Roberts Boulevard, Suite IM 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, Terms and Conditions of the "Root Replacement Contract" and agree that all details are acceptable and satisfactory. I further understand that this Contract constitute the entire agreement between the parties and that any further changes or alterations to this Contract must be made to writing and agreed upon by both parties. Each party represents and warrants 10 the other that it has the lull power and authority to enter into the contract and that it ladle od eaforceaable in accordance with its ftrms. 21-1- 7 ,2/,/7 Authorized Jasper Representative Date O"er 1:1105 Scanned by CamScanner THIS INSTRUMENT PREPARED BY: GRANT11ALOYP ;iEl7I1dOLE COUNTY Name• Jasper Contractors CLERK OF CIRCUIT COURT % CONPTROLLER Address: 3203 S Conway Road Suite 201 E'K 910 Ps, 1827 (1P9s) Orlando FL 32812 CLERM S T , 2017046782 RECORDED OF., (i/2017 12;36a:56 PM p COMMENCEMENT RECORDING FEES $10.00 NOTICE OF COMMENCEMENT RECORDED. BY .ecknnro u2s zs Permit Number: Parcel ID Number: 117 7 Off, ©Db-- The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 7113, Florida Statutes, the following information is provided in this Notice of Commencement. 2. re -roof 3. OWNER INFORMATION OR LESSEE INFORMATION IF THELESSEECONTRACTED FOR THE IMPROVEMENT; Name and address: QY1 Gy Q, C.l Zql tZ J P1 Yid 1 S 1 r JI "1 Y d t F-l- 3 Interest in property: vwi roi Fee Simple Title Holder (if other than owner listed above) Name: 4. CONTRACTOR: Name:. JasperUC Address:.3203 S Conway Road FL Phone ,Number: 407-278-7788 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: 8. in addition, Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(6), 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. Azv..r.- r) a try Signature of Owner or L e, or 0 ees or Lessee's Authorized Officerl t torlPartn r/Manager) o n ca Vf ,r ,j (A L PrintName and Provide Signatory's Tiue/Office) r— O 74 State of County of .%'%';a of The foregoing instrument"was acknowledged before me'this day of _` , 20 ! r by i ytV L IUII-F/I t Z , Who is personally known to me OR p Name of person making statement j Q who has produced identificationp/type of identification produced: at SIMAR B AMI( RAUT I.Commisston A FF 127-890 my Commission Expires June 01 , 2018 City of Sanford Building & Fire Prevention Division Re -Roof Permit Card NoAdft PERMIT NO. Ila-1557 ISSUE DATE: • • 77 CONTRACTOR:, JOB ADDRESS: MSp e 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 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: 125 Pine Isle Drive Sanford, FL 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: DOFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES SKYLIGHTS: OYES ONO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: 49752 MAIN ROOF AREA ROOF SLOPE: O LESS THAN 2:12 O 2:12 — 4:12 Q 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL Q SHINGLE Owens Corning FL# 10674 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# OINSULATED FL# O TILE FL# O OTHER: FL# a D' 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 requite 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) o 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,Iuler 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 patters 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: ATE: SJ11/2017 FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING,INSPECTIONS 300.,N PARK AVE 855.541.2112 SANFORD FL 32771 DRI7EWAYS-SIDEWALK 407.688.5080 Page 2 Application Number . . . 17-00001389 Date 5/16/17 Property Address . . . . . 125 PINE ISLE DR Parcel Number . . . . . . . 10.20.30.511-0000-0890 Application description . . ROOFING APPLICATION Subdivision Name . . . . . Property Zoning,. . . . . . PUD Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 984500 Permit pin number 984500 Required Inspections Phone Insp Seq Insp# Code Description Initials Date 1000 111 BL03 FINAL ROOF L City of Sanford Building and Fire Prevention RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #: I ADDRESS: N) GENERAL, BUILDING, RESIDENTIAL, OR TOR, 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 #: (7- .0 C I '?)s 1 t C COMPANY/CONTRACTOR: CONTRACTOR SIGNATURE: DATE: MUST BE SIGNED BY LICENSE ER R/BU 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 c-''-t'i 1 Sworn to and Subscribed before me this C'k day of J 200 by: Scfl -tr ` Vim jj U1 Who is Personally Known to me or t Produced (type of identification) as identification. (_ Signature oaNary Public State of F q h AnAraut SICYLAR B qMKRAUT Print/Type/Stamp Name =* o .` M mmission # FF 127890 of Notary Public v Commission Expires June 01 , 201 8