HomeMy WebLinkAbout180 Brushcreek Dr; 17-1821; ROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: I -' l R a--!
Documented Construction Value: $ \ . 3(00
Job Address: t, a %&- a\nCrcc. S c,,,,4.rd L 323-7IHistoric District: Yes No
Parcel Ill: 33 - Iq - 30 -516Mb - L'boo Residential Commercial Type
of Work: New Addition Alteration Repair XDemo Change of Use Move Description
of Work: Plan
Review Contact Person: Title: Phone:
Fax: Email: Property
Owner Information Name
QC J he.(.a Phone:%to-i -14' '- 60LO Street:
l( 'dr s ncrce ,, Resident of property? : Y-r—
S — City,
State Zip: L. 31A-1-1 f
Contractor
Information Name
C'v,6evV C_r,oN-. Phone: 31` - (.-+$ 7 Street:
15130 t vvvw trcec\ my-wL Sy,tc Ei Fax: S( f,, tb6`Z -'733 City,
State Zip: n_1e000,rr..., 3j-i b1 O State License No.: CCC 13.30 igArchitect/
Engineer Information Name:
1.1 V Phone: Street:
Fax: City,
St, Zip: E-mail: Bonding
Company: y,:* Mortgage Lender: Address:
Address: WARNING
TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAI' 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 VOU 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. l 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 inscrihed with the date of application and the code in effect as of that date: 5" Edition (2014) Florida Building Code Revised:
June 30. 2015 pemiit Application
t- 77,77 7 9,
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 711.
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 0micr/Agent Date of Contracnx/Agent
Print 0%vner/Agent-s Name Print ContractQriAvenfs Name
Signature ofNotarv-State of Florida Date Sienatie of Notary -State of Florida Date r
vp ro!;,,.
a4c PABLOARES W
COMMISSION 0 FF 99M EXPIRES:
Jute 1.2D20 Bonded
Thru Budget Notary Services Owner/
Agent is _ Personally Known to Me or Contractor/Agent is Personally Known to Me or Produced
ID Type of ID Produced ID Type of ID BELOW
IS FOR OFFICE USE ONLY Permits
Required: Building [_ r.tectrical Mechanical Plumbing Gas Roof Construction
Type:_ _ Occupancy Use: Total
Sq Ft of Bldg: 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 Perrot Application
INSURED: Paul Jahelka ESTIMATOR: Kristen Novo
PROPERTY: 180 Brushcreek Dr, Sanford FL 32771
PHONE #: 407.765.0047 E-MAIL: speedwaypj@hotmail.com
INSURANCE COMPANY: Modern USA / American Traditions CLAIM #: AH108539
WORK TO BE PERFORMED
SHINGLE RE ROOF:
PROVIDE ALL NECESSARY PAPERWORK, PERMITTING, AND INSURANCE
REMOVE AND HAULAWAY ALL DEBRIS
REMOVE FELT AND 3 TAB SHINGLES
RE NAIL DECK AS NECESSARY TO MEET CURRENT CODES
INSTALL 1 LAYER OF UNDERLAYMENT
INSTALL NEW 26 GAUGE EAVES DRIP. COLOR:
REMOVE AND REPLACE CONTINUOUS RIDGE VENT SHINGLE OVER STYLE
INSTALL HIP AND RIDGE CAP
INSTALL ASPHALT STARTER -UNIVERSAL STARTER COURSE
INSTALL NEW SHINGLES:
INSTALL NEW LEAD STACK FLASHINGS ON ALL PLUMBING PROJECTIONS.
INSTALL NEW GOOSENECKS
REPLACE UP TO 3 SHEETS OF PLYWOOD
32 SQ HIGH SLOPE
FORA TOTAL OF..................................................................................................................................$11,360.00
LIMITED WARRANTY: 5 YEARS MANUFACTURER WARRANTY: 2 5 YEARS
ALTERNATES/ UPGRADES WILL BE COLLECTED FROM HOMEOWNER DIRECTLY AND IN WRITING
PAYMENT UPON ACCEPTANCE BY INSURANCE COMPANY
We hereby propose to furnish all labor and materials necessary for this job. All work to be completed in a substantial workmanlike
manner. Any deviation from specifications or scope listed above will become an extra charge. Contract is valid for 30 Days of
submission.
Authorized Signature:
Officer of Wescon Construction
Acceptance of Proposal. The above price and scope of work are satisfactory and are hereby accepted. You are authorized to do the
work as specified. Payments will be made as outlined above.
DATE: SIGNATURE:
5130 Commercial Drive • Ste. H • Melbourne, FL • 32940 • (321) 259-6789 • (866) 602-7933Fax
CCC1330785/ CGC1506914
WWW.WESCONCONSTRUCTION.COM
1
THIS INST rNT REP BY: GRANT MALOYr SEMINOLE COUNTY
Name: to CLERK OF CIRCUIT COURT & COMPTROLLER
Address: SKI 8928 Pa 1366 (1Pss )
n. CLERK'S: 2fj17O57482
Tc RECORDED 06/09/2017 01:45:33 PM
NOTICE OF COMMENCEMENT
RECORDING FEES JtJ
RECORDED BY de_kenrkenro
Permit Number:
Parcel ID Number: 3 - i - _ Si-y000 I bbb
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)
C. it ( A e
2. GENERAL DESCRIPTION OF IMPROVEMENT:
S, jin
3. OWNER INFORMATI(UANN_OR LESSEE INFORMATION IF EnLESSEE C TRACTEI1I1D FOR THE IMPROVEMENT:
Name and address: I A L- tt4. 1 ;3ftJ51()Lti41 U1(L" 17An,ei) _12ti 32-7-7
Interest in property:
Fee Simple Title Holder (if other than owner listed above) Name:
Address:
4. CONTRACTOR:
Address: 5
Phone Number:
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 maybe served as provided by Section
713.13(1)(a)7., Florida Statutes.
8.
9.
Phone Number:
In addition, Owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number:
Expiration Date of Notice of Commencement (The expiration is 1 year from date of recording unless a different date is specified)
WARNINGS 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 f~
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
t
LAO OF?
PggI Ja e114
Signature of Chvne Le see, or Owner's or Lessee's (Print Name and Provide Signatory's Title/Office)
Authorized Officerfureaor/ParmedManager)
sc
State of 1"L Countyof q
LIACL * TheforegoinginstrumentwasacknowledgedbeforemethisidayofJby
f% Who is personally known to me OR ~-: -D c. Name
of personmaking statement / , / q
D Q
who
has produced Identification E3'/tvoe of identification produced: D vbv,/ r \ (c)l = PABLOARES
otRNP.0MY
COMMISSION ti FF 94M EXPIRES:
June i, 2020 i
Ortto
So uBtbgetNotary:etvicos J
Z UrU<
Uj Vlca
City of Sanford
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. /100 1941 ISSUE DATE: ®& • 14TO ® 7
CONTRACTOR:
JOB ADDRESS: I o0o 6ttcshoireewlc &**,o
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
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 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
City of Sanford Building Division
Residential Re -Roof Inspection Policy & Procedures
PER i'fTINc RE:QUIRFNIFNTS-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 iipan affida vit provided by a Florida Design Professional (
architect or engineer), c ' F
A. e^Vance by personal inspection. i
Co
T RAC [`t R (OR 04VN RIBUIL DE. CONSIGhATUR} , DATE:--
D
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Rork
JOB ADDRESS: %r6Q PrGf ^ old S,_,6,Do,r-d FL 3A 7 ?V
TRl'ITI=RE Tl'P6://
77
INGLE FA\IILI° RF,SIDENCFITON'NHOUSF. O MOBILF HOME O APAKIMENTICONDOMINIUM
RF-R(x)F Tl•Pv: p@ RLPI ACI-,FIFV"I` (TES\R OFF EXISTING ROOFAND RI'PLACE NTFFI NEN' COMI'ONI:N'I'S) O
RF-COVER (NE\V ROOF INSTALLED OVER EXISTING ROOF) DECK
T%-PE (PLFISF. SPECIt1): PLEASE
NOTE: ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS P£R.MITTED TO BE REPL4CED"* ROOF%*
FNTII.ATION: DOFF -RIDGE RIDC,E OSOFFIT . OPOII'ERFUVENT OTURBINES SKYLICUTS:
O YF5 ?""O IF YES, PLEASE PROVIDE FLORIDA PRODI!ci, APPROVAL #: IAIN
ROOF AREA ROOF
St.OPE: O LESS THAN 2:12 0 2:12 - 4:12 V:12 OR GREATER TI"
PE OF ROOF 1IANltF'ACTURER FLORIDA PRODUCT APPROVAL SFIINGLE
p FL# O
NIET.ALFL# O
NIODIFIED FIM MEN FL# O
TORCH DO1a;` FL# O
INSULATED FL# O
TILE F L# OOTHER:
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 T%,
PF.Of ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL. O
Sm'.GI.E FL# O
b1ETAL FL# O
N40DIFILD BITUMFN FL# O
TORCH DOWN FL# OINSULATIM
FL# O
TILE FL# OOTHER:
FL# k
P!'R,,\III #:
City{ of Sanford
Buildint) and Fire Prevention
RusIDENT1AL RE -ROOF 1NSPFI TICIN AFFIDAVIT
NAILING", SHEATHING], DRY -IN, FLASHING. AND ALL FINAL ROOF COVERINGS
v t)Rt s: y<ta wsin..0 t
T-ec_?CtvA_N Q . AN AIN) cilihlfRrll._ Ill ILDING. RI'Sll>I-.N-EIAI..OR
Rt)OiIXGC0N, I'RAk-r0R I.NCi1NFER, rARC)IIrFCT. o: F.S: CHAPri:R 468 I31bILiww, INSPECTOR. I HEREBY %AFFIRxNI. T'IIAT ALL 01: THE
V0IZFk-4M\6 IXFORMA11 A IS TREE AND \ND I1IA'I' AL1. I.IS IF) ON 14W SCOVI-. OF WORK AT T11F:
AWAII, RFVVRF\CFD \DDRUSS 11.AVE BEEN INSI3A1111) IN ACCORDANC Wt ill EFIEIR PRODU Y APPROV'A1 S AND ALL AI'PI..IC ABI.E CODE
RE (rClKE tlIATS, - SPEct WICALI.A 11ORIDA II(aI1.1)ING C t?I)I. (.AIS`1IN(j M 11A)ING. IN ADDITION I CFR"Eil"Y" 1 HI: INS I ALI ATI( IN MEETS AEI.
FE 1.14RFZ1E\ FS FOR, SF-CONDARl N'.A'ITR BARRIf'R AN"I? NA I IJ NG OE 'I) It ROOF DFC K. IN ACCi)R)ANC E WITII FI IL 1It IRRICANE RETROFIT
MANUAL Rrot,!IREMIA S I BASED UN F.S. CH \PELR 5`3.844),
LICENSE
CtiN1P\N.`:'CON tR\C 1.R:
CONYRAA roR StCiNf\YI RE f DATE: Y
0, ST 1i<_11(a.\FDE3V"1.1t.L3 SI it)L9#'.t2OR0WX`{RJ3UIIDER)
A F h,At_ RC)OF 1\SPEC-I ION IS RFOITRED:
Tnis SIGNED AND NOT yRILED.AFFIDAVIT ML`S1` BE PROA'iDEDAT'FHEJOR SEFE ATTHE TIME OF THE FINAL ROOF INSPECTION.
ALONG WIT11 DIGITAL P IOTCK:R.API OF IACII PLANE OFT IE ROOFSI IOW ING IN DETAIL ALE COMPONENTS (DFCKIM ,
LNDERL\VNIE\T, FL. ANHLNG. DRIP EDGE .ATTA(:HMENT) \PITH TIIE PERMIT NUMBER OR ADDRESS (LEARLY MARKED ON THE DECK
FOR LWII I.NNPECrit)N. THE PHOEOGRAPIIS MV,J4 IN( LkDE _A RIA.Vk OR MEASURING DEVICE:TO CONFIRM ALI,NAII. SPA(T,*': AND
OVERL WS. N(: ENDING DRIP EDGE AND VALEEV F i.ASHING. PLE,=ASE kFFEk l'O'filE RE -ROOF POI,1C:1":1AD 1ASPE(`YIO\ PROCE tiRE
PAPER\WORK FOR FI R'1`HFSR F:XPI VN,%I"ION OF AI.i. Rt QOfiRF\IE. IS.
FAILURE TO FOLLOW ALL REQUIREMENTS WILL RESULT IN A FAILED INSPECTION, A REANSPECTION FEE AS
NVELL AS REQUIRING A DESIGN PROFESSIONAL {ARCHITE(-.:T OR ENGINEER) TO CERTIFY, BASED ON PERSONAL INSPECTION.
THE INSTALLATION OF ALL ROOFING COMPONENTS. STATE
OF FLORIDA COi NTY OF r Sworn
to and Subscribe(] before me this 5.__ day of 10- 20 i 7 by: who
is -Pcrsonally Known to me or has Produced (type of identification)
as identification. Signature,
6f Notary Public State
of Florida PABCOARES
MYCOMMISSION#
FF61M PrintiT\
pe;'StampName EXP>RES:.)"1,20H Of
NOtaR` Public ec, 8=wTfryBu wh0wYSwvIM
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 . . . . . 17-00001821 Date 6/15/17
Property Address . . . . . . 180 BRUSHCREEK DR
Parcel Number . . . . . . . . 33.19.30.518-0000-1600
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 989582
Permit pin number 989582
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 BL03 FINAL ROOF / /
A City,, of Sanford
BUi(dino and Fire Prevention
RESIDENTIAL RE-RooF INSPECTION .= mDAN'IT
NAILING, SHEATHING, DRl'-IN, FLASHING, AND ALL FINAL ROOF COVE:RINCS
ADDRIS
I 1.-tcoCwN_ _.. " 0_IS\l\IGItNIRAI..RfnulNti.RISIDENIIA1.OR
R+x1f!\c;t+.}NrxAt l.s.clL\mIR4oSI4!!nl)IM,INSPI:CI OR. I I IVREBY \FUM.'IIIATAIA OFTHE
I+)CF60I\(iI\+-(}x\I,\Ilt+\IS'lRt'FA\111('t1AMI:1\DIIIA1'AI.I.R001I\GCOMPONF\ISIISII;1)ON IIII SCOPE(11:WORKAt THE
h-AI-RF FRF\CEDADDRFSSIIA\I BFI.NI\SCALLIDINACUOROANtI RIMIfII:'IRI'xOD!JCI'APPROVALS•\NDALLAPPLICABLE CODE RLQL'
IR! M1 VIS - SPTC IFR'AL1.1 1 i-OPID-\ Iltll DINO ('ODF. (:XIS tl\ti IWILDIN6. IN ADDITION I Cl R IIfY TI II INS I At-[Al'ION MEETS At Ft ;?
t lRt.\Ili\T F(R F.CO\U\Rl \\ \1'!:R Kr1KR!tR.\\DNA!1.1\iil)1 fill R(M)F DFi F:.IV:1C('URD;1\CF Wlilt 1111 IIURRICANFRETROFIT Ltcrmr
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f l!i >It \FD l31 I,h TALI it)Li)f -R OR O+\?!.!. itt:ll DliR) A
FI\:\I. R(x)F IV,-PF( Ito\ IS RFQI IRF.D: TIt1S
SIGNED AND NOT \RIZED AFFIDAVIT Nil SiBE PROVIDED AI ri L .108 m'I EAT TIIE TIME OF THE FINAL ROOF INSPECTION. LONG w1T11
DRA TAL PEIM MR \PIIS OF G\CIf PLANE. OF TII E ROOF SIIO\\ING IN DETAIL AI., COMPONE:NI'S (DECKING. LNDERL\l
NIM. FI tSHt\(;, DRIP EDGE ATT \CH V Ef t) M [Tit 1'11E PER\III' Nl'\IBER ORADDRESS CLEARLY MARKED ON THE DECK FOR F_\(
ll I\SPE:('Till\. THE ['1101 MR %PIIN \11 SI I\( IA DE A Rl LE:R OR ME %NI RING !EA WE TO ( OSFIRM :ILL NAZI. SPACING AND OVERLAPS, INCLUDING
DRIP EDGE A\D \ALI.E1 FI.ISIllm-1. PI.FSNI: RLFER I'O THE RE -ROOF POI.I( 1' AND INSPE:CIION PROCEDURE P %PFR\\
ORR FOR FIR'THER EYPI-\N \PION OF.U.I. REQUIREMENTS. H_VRE
TO FOLLOW ALL REQUIREMENTS M H.LRESULT IN A FAILED INSPECTION, A REANSPECTION FEE AS WELL AS
REQUIRING A DE:SIC\ PROFESSIONAL (ARCHITECT OR ENGINEER) TO CERTIFY. BASED ON PERSONAL INSPECTION. THE
INSTALLATION OF ALL ROOFING COMPONENTS. STATE OF
FLORIDA COUNTY OF Sworn to
and Subscribed before me this day of )- -- 20 11 by: kNb fi.
61N Who is :4111 sonalis Known to me or has _ Produced (type of identification) as
identification. Signature,& Notary
Public State of
Florida TlMIMIARES MYCOLUESSIMIJIFF9M
PrinUType'
Stamp
Name '+} EUVIES:Am1.21120 of Notary
Public'5 dp 1IMMPruBudpk atbYSerrbs