HomeMy WebLinkAbout222 Pinefield Dr 17-1301; ROOFMAV - 4 2017 t
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $ G),IN) - CQ
Job Address: a T)i (le_4-3
j fkl - C G Historic District: Yes No
Parcel ID: LR - -: 1 1 - d Q'(^ Residential Commercial
Type of Work: New Addition Alteratioqjo Repair Demo Change of Use Move
Description of Work:
Plan Review Contact Person: ` akh-VIM Title:
PhoneL1-3023. Fax: Email: l I'M50( Property
Owner Information Name
Phone: Street:
C (,l j^f1.. 1 V Resident of property? City,
State Zip: T_
Contractor
Information Name -
R;:;l1 Phone:
Street: Fax:
City, State
Zip: State License No.: C Architect/Engineer
Information Name: Phone:
Street: City,
St,
Zip: Bonding Company:
Address: 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" 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 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.
t
Signature of Owner/Agent Date Signature of Contractor/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Pri4t Contractor/Agent's Name
ytwwdwh_
of Notary -St e f Florida Datet
LINDSAY DUCKHAM
Commission # FF 172210
My Commission Expires
October 28, 2018
tor gent is ersonally Known to Me or
Produced ID Type 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
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
5/4/2017 SCPA Parcel View: 32-19-31-515-0000-0490
y
nm fuE GUtxJlG r
Parcel Information
Property Record Card
Parcel: 32-19-31-515-0000-0490
Owner: PEREZ ANNA & RIVERA FREDDIE
Property Address: 222 PINEFIELD DR SANFORD, FL 32771
Parcel 32-19-31-515-0000-0490
Owner PEREZ ANNA & RIVERA FREDDIE
Property Address 222 PINEFIELD DR SANFORD, FL 32771
Mailing 222 PINEFIELD DR SANFORD, FL 32771-
Subdivision Name CELERY LAKES PHASE 1
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions 00-HOMESTEAD(2014)
8 } 50 50 50 50 4.1.11
t, m
51CN
v
75 50 50 50 50 66
Seminole County GIS
Legal Description
LOT 49
CELERY LAKES PHASE 1
PB 62 PGS 75 & 76
Taxes
Value Summary
2017 Working
Values
2016 Certified
Values
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 120,946 105,034
Depreciated EXFT Value 338
a
350
Land Value (Market) 30,000 23,000
Land Value Ag
Just/Market Value "^ 151,284 128,384
Portability Adj
Save Our Homes Adj 35,330 14,815
Amendment 1 Adj
P&G Adj 0 0
Assessed Value 115,954 113,569
Tax Amount without SOH: $1,760.00
2016 Tax Bill Amount $1,463.00
Tax Estimator
Save Our Homes Savings: $297.00
TRIM Notice Help
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund 115,954 50,000 65,954
Schools 115,954 25,000 90,954
City Sanford 115,954 50,000 65,954
SJWM(SaintJohns Water Management) 115,954 50,000 65,954
County Bonds — — _— 115,954 50,000
1 $
65,954
Sales
Description Date Book Page Amount Qualified Vac/Imp
WARRANTY DEED 9/1/2013 08124 11112 137,500 Yes Improved
QUIT CLAIM DEED 14/1/2013 08022 0718 78,800 No Improved
CERTIFICATE OF TITLE 2/1/2013 07968 0787 100 No Improved
a
SPECIAL WARRANTY DEED 055751211737 1/2004 149,400 Yes Improved Find
Comparable Sales Land
Method
Frontage Depth Units Units Price Land Value LOT
i 1 $30,000.00 1 $30,000 Building
Information Is
Bed/Bath count incorrect? Click Here. Description
Year Built Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value I Rep[ Value I Appendages http://
parceidetai l.scpafl.org/Parcel Detai I lnfo.aspx?PID=32193151500000490 1/2
5/4/2017 SCPA Parcel View: 32-19-31-515-0000-0490
Permits
Permit # Description Agency Amount CO Date Permit Date
02409 NEW - RESIDENTIAL SANFORD 89,394 i 12/21/2004 4/30/2004
Extra Features
Description Year Built Units Value New Cost
PATIO 2/1/2004 1 I $338 i $500
http://parceldetail.scpafl.org/Parce]Detaillnfo.aspx?PID=32193151500000490 212
0
1410 Emerson Street, Leesburg, FL 34748
Phone: 352-314-3625 • Toll Free: 855-314-3625 o Fax: 352-240-3439 • www.covenantrnc.com
State Roofing License: CCC1329936 • License: CGC037504
SALES CONTRACT
Covenant Roofing & Construction, Inc. agrees to furnish all materials and labor necessary to do the modernization work at the following address:
Name r/A9 !Z
o
f GZ Phone '
r%?/ 9 69 Phone(w)
Address? l//J/+ f r' Date
City .,P ,74A d State —,C dip
Email
In accordance with specifications given below:
REROOF:
A. SHINGLE ROOF
1. REMOVE OLD ROOF TO WORKABLE SURFACE.
2. RENAIL ROOF DECK WITH RING SHANK NAILS.
3.
4. NSTALLE ANY ROTTED WOOD WIT TANDAREPLAC SH ,THING @ $ PER F00T AND $ PER SHEET OF PLYWOOD, IF ANY. ,0 (Initial) Jnf4 l dUNDERLAYMENTOVERENTIREROOF.
5. INSTALL FHANA EAVES DRIP. COL R
6. INSTALL NEW VALLEY METAL AND FLASHINGS AS NECESSARY,
7. INSTALL N LBOOTS OVER VENT PIPES AND RESEAL VENTS.
8. INSTALLIBERGLASS SHINGLES. COLOR9. INSTALLF RIDGE VENTMWPWVT. COLOR
10. CLEAN-UP JOB SITE OF ALL WORK DEBRIS AND HAUL AWAY ALL RELATED DEBRIS AND LEAVE JOB SITE CLEAN.
CAC OR W DINATE R 0 AND R ST TION RELATE HERALS C S (BUT N L ITED TO) SO UNITS, SPK TS, TV ISANDCONDITIORS, ETC. REMO AND REINST EXISTING S IT AND FACT $4.25 PER FO IN ADDITION T ONTRACT P IF REOU THE CO ORSURKWILADDITIONTCTRACTPNDHEREIOVEDB0EOWNER (I dal)
12. ALL WORK COVERED BY A 5 YEAR ORKMANSHIP WARR NTY
1. Contract Documents. This contract consists of this document, extra work/wood authorizations, if any, and if payments
hereunder are to be financed, all financing documents. No promises other than those specifically set forth in the contract
documents shall be recognized by either party. The entire understanding and agreement of the parties is contained in the
contract documents.
2. It is understood and agreed that this contract shall not become binding upon Covenant Roofing & Construction, Inc. until it is dulyapproved, accepted, signed and witnessed by an officer or officers of the Seller.
3. Work on the job described in the co a dd ents will commence on approximately and be
completed on approximately ..gc f—. The recited dates are approximations and are subject to schedulingdifficultiesofSeller, labor and/or material shortages, acts of God and other events not foreseen by Seller. Seller reserves
the right to employ any sub -contractor for the completion of the work described in the contract documents.
4. Covenant Roofing & Construction, Inc, reserves the right to substitute materials of equal or greater value and kind. Any required
materials such as fire retardant plywood, tongue and groove board, etc. will be billed on a time and material basis. Al other
changes required by New Jurisdictional Code Enforcement Laws may result in additional charges.
5. Interest at the rate of eighteen (18%) per cent per annum will be charged on all balances not paid as per the terms specified
above. Reasonable attorney's fees will be charged to the Purchaser if it is necessary to place this contract in the hands of an
attorney for collection, and this charge becomes a part of the contract and obligation of the Purchaser to pay.
6. Parties agree that this agreement shall be construed according to the laws of the State of Florida and any action brought
thereon may be brought in the State of Florida. Venue is hereby agreed to be in Lake County Florida.
7. BUYERS RIGHT TO CANCEL (SOLICITED SALES ONLY) If you do not want the goods or services, you may cancel
this agreement by providing written notice to the seller in person, by telegram, or by mail. This notice must Indicate that you
do not want the goods or services and must be delivered or postmarked before midnight of the third business day after yousignthisagreement.
8. Both worker's compensation and public liability insurance are carried by the Seller and they are applicable to the work to be
performed.
9. It is understood and agreed that the buyer hold harmless, Covenant Roofing & Construction, Inc., for any damages that may
occur to the buyer's driveway(s) during delivery of materials and/or removal of the work related debris that may be required
to perform this home improvement contract. Furthermore, the buyer herein gives permission for typical delivery vehicles and
typical waste removal vehicles to enter said driveway(s) for the purpose of expediting this sales contract.
10. Contractor will coordinate removal and reinstallation of roof related peripherals such as (but not limited to) solar units, skylights,
T.V. dishes and air conditioners, etc. The cost for such work will be in addition to contract price and approved by homeowner.
11. Covenant Roofing & Construction, Inc. shall not be held responsible for damage to electrical lines, water lines, refrigerant lines
or other mechanical components that have been improperly installed near roof decking and may be damaged while performinginstallationofroofingmaterials. Villages Roofing & Construction, Inc. shall not be responsible for any additional costs due to
roof decking that may have old materials adhered in such a way that requires redecking of structure.
12. Construction Industries Recovery Fund payment may be available from the CIRF9 you lose money on a project performed
under contract, where the loss results from specified violations of Florida law by a state -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: 7960 Arington Expressway, Suite 300, Jacksonville, FL 32211-7467 or call (904) 727-6530.
13. Chapter 558, Florida Statutes contains important requirements you must follow before you may bring any legal
action for an alleged construction defect in your home. Sixty days before you bring any legal action, you mustdelivertotheotherpartytothiscontractawrittennoticereferringtochapter558ofanyallegedconstructiondefects
and to consider making an offer to repair or pay for the alleged construction defects. You are not obligated to accept
any offer which may be made. There are strict deadlines under this Florida Law which must be met and followed to
protect your interests.
Contract Price $ _10 0Qe_0Q___
Homeowner Portion $
Plus Total from Item No. 3 a>bomw
UPON COMPLETION
Executed in triplicate, one copy of which was delivered to, and receipt is hereby acknowledged by Buyer,
this _92 day of alrclA —, 20
Approved and Accepted:
NOTICE TO OWNER
a. Do not sign this home improvement contract in blank.
b. You are entitled to a copy of the contract at the time you sign. Keep it to protect your rights.
Seal) (X) (Seal)
Dealer -Seller) (Purchaser n Her )
BY (X) (Seal)
Titl (Purchas gn Here)
LESMAN FORD PRESS, INC. 352-787-4650 (mike)
111113111111111111111111111111111 1111111 11H 11111
After recording, return to:
Covenant Roofing & Construction, Inc. SOC
1410 Emerson St. Leesburg, FL 34748
Permit No.:
Tax Folio No.:
GR',ANt- 1 I•IALO f r SEl"l1HOLE COUNTY
CLERK OF' C'):RClJT. T COUR.1' & COVIf•'T OOLLU,
CLERK'S v 2011044005
RECORI)EH) I iF; i 14/2017
RL.(::ORDIINtl FEES' '0.1).O l
kDC1.11RDEIJ BY, Jeck—enl-,
Notice of Commencement
State of Florida
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.
Description of the Property: (legal description of the property and street address if available)
7LegalDescription: Lo- 9 6 e)e- r,z Le, PA
Street Address: o292,Z) t n e- At o C FL 30 %-]
2. General Description of Improvement
Reroof
3. Owner's Information or Lessee information if the lessee contracted for the improvement:
Name:
Address:
r
Interest in Property: cz&we-i—
Name & Address of fee simple titleholder (if different than owner):
4. Contractor Information
Name: Covenant Roofing & Construction, Inc.
Address: 1410 Emerson St. Leesburg, FL 34748
5. Surety (if applicable, a copy of the payment bond must be attached):
Name:
Address:
6. Lender Information:
Name:
Address:
Phone No.: 352-314.3625
4-
X
l7Vw
cr _
Z
Phone No.: w
Amount of Bond: $ z 01, v
uW 00
Phone No.: x o
W J (V
L1 V Q Lev
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section
713.13(1)(a)7., Florida Statutes:
Name:
Address:
8. In addition to himself or herself, Owner designates
Phone No.:
of
to receive a copy of the following Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes: Phone No.:
9. Expiration date of notice of commencement (the expiration date will be 1 year from the 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 YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR CORDING YOUR NOTICE OF COMMENCEMENT.
S, nature of Owner or Lessee, or Owner's Les s Authorized OfficedDirectorlPannedhfanager
r
Signatory's Title/Office
The foregoing instrument was acknowledged before me this o? ,? day of 20L, by 4 wv F MS, as
for who
Type ofauthorily (i.e. officer, trustee, attcrneyin fact) Name of party on behalfof whom instrument was executed
is personally known or produced 6 e9,r3.S 0&9 as type of identification.
Si11ir"
Micl,101 H. .. . iicl-
Signature of Notary Public-SfateofFl da(rinttypeorstampcommissionednameofNotaryPublic)
111 ''!.'r R0NNoTAR'rc,;ii
31-1Go
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0
GV
410
O
Q
Notice of Commencement - BF29 (Updated 05!1312013)
Astatula, Clermont, Eustis, Fruitland Park, Howey in the Hills, Groveland, Lady Lake,
Lake County, Leesburg, Mascotte, Minneola, Montverde, Mount Dora, Tavares, Umatilla
Limited Power of Attorney
Dat
I hereby name and appoint Robert Horne of Covenant Roofin and Constructio , Inc. to be my
lawful attorney in fact to act for me and apply to "
fora permit for work t e performed at a location described as:
Address of job:
Owner and Add
Joseph E. Rayl, Contractor License #CCC1329936
Acknowledged:
Sworn to and subscribed Tore me this q day of CJ\1 20aByJosephE. Rayl who ispersonally known to me or _ produced
id ratification.
f 0Q ' •" LINDSAY DUCKHAM
L" •°'
F `'
Commission # FF 172210
otary Public, t e of Florida Pr My Commission Expires
October 28, 2018
My Commission expires:
as
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESSJS&'kfy:AiAA 7bc, 5QSocc 3 PA.
STRUCTURE TYPE: ®SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: ® REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): ` I Cl)`I [i i awl -
PLEASE NOTE: ONLY 100 SQUARE FEET OF'HkIhGSTING DECK IS PERMITTED TO BE REPLACED**
ROOF VENTILATION: O OFF -RIDGE ® RIDGE O SOFFIT OPOWERED VENT O TURBINES
SKYLIGHTS: O YES ®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
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE,` FL#
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IF APPLICABLE**
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#
O INSULATED FL#
O TILE FL#
O OTHER: FL#
1 , .
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: aL DATE: raLA % io l l
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: 3 as
I , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTVACTOR, 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 #:
COMPANY
CONTRACT
MUST BE S
CTC
CONTRACTOR:
OR SIGNATURE: DATE:
IGNED BY LICENSE OWNER/BUILDER)
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 :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 XAhe_ -
Sworn to and Subscribed before me this day of 20 _[;;4-by:
Who isyPersonally Known to me or has Produced (type of
Xtification) _ as identification.
r....e
tureofNo a Public LINDSAY DUCKHAM
of Florida Commission N FF 172210
5* My Commission Expires
October 28, 2018
Tune/Star D Name
of Notary Public