HomeMy WebLinkAbout368 Fairfield Dr; 17-2413; ROOFAUG - 8 2017
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: l A L11 J
Documented Construction Value: $ 12,321.00
Job Address: 368 Fairfield Dr. Sanford, FL 3277 Historic District: Yes No
Parcel ID: 32-19-31-516-0000-0500 Residential Commercial
Type of Work: New Addition Alteration I Repair Demo Change of Use Move
Description of Work: Tear off existing roof and install new asphalt shingles.
Plan Review Contact Person: Title:
Phone:
Name Jeffrey Broge
Fax: Email:
Property Owner Information
Phone: 321-262-2855
Street: 368 Fairfield Dr. Resident of property? : Yes
City, State Zip-: 8a6-ford, F,L 32771
Contractor Information
Name Covenant --Roofing. &-Construction.,.Inc. Phone: 352-314-3625
Street: 1410 Emerson St. Fax: 352-240-3439
City, State Zip: Leesburg, FL 34748 State License No.: CCC1329936
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company: Mortgage Lender:
Address: 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
S 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 Pennit 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.
Signature of Owner/Agent Date Signature of Contractor/Agent ate
Print Owner/Agent's Name P nt Contractor/Agent's Name
0 0 lei w IS l
Signature of Notary -State of Florida Date Si ature of Not State of Florida Date
lINDSAY DUCKFiAMrtre •,,
Ste+ Commission p FF 172210
My Commission Expires
Oc ber 28, 2018
Owner/Agent is Personally Known to Me or Co wn to Me or
Produced ID Type of ID Produced ID 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:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING: UTILITIES:
ENGINEERING: FIRE:
COMMENTS:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
8/7/2017 SCPA Parcel View: 32-19-31516-0000-0500
Property Record Card
JWMM'CFA Parcel: 32-19-31-516-0000-0500
IIrPSATH% Owner: BROGE JEFFREY
wm"Otcom*rtyAorauan
Property Address: 368 FAIRFIELD DR SANFORD, FL 32771
Parcel Information
Parcel
Owner
32-19-31516-0000-0500
BROGE JEFFREY
Property Address 368 FAIRFIELD DR SANFORD, FL 32771
Mailing
Subdivision Name
368 FAIRFIELD DR SANFORD, FL 32771-
CELERY LAKES PHASE 2
Tax District S1-SANFORD
DOR Use Code 01SINGLE FAMILY
L
Exemptions 00-HOMESTEAD(2014)
Value Summary
f....... - --
2017 Working 2016 Certified
values Values
Valuation Method I Cost/Market CosUMarket
Number of Buildings
Depreciated Bldg Value 133,622 I $116,076
Depreciated EXFT Value 350 $363
i Land Value (Market) 30000 $23,000
Lund Value Ag
Just/Market Value i $163,972 I $139,439
j Portability Adj
Save Our Homes Adj 38,463 $16,511
r Amendment 1 Adj
P&G Adj 0 i $0
Assessed Value 125,509 $122,928
Tax Amount without SOH: S1,882.00
2016 Tax Bill An7QUnt S1,551.00
Tax Estimator
Save Our Homes Savings: $331.00
Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description
LOT 50
CELERY LAKES PHASE 2
I PB 65 PGS 29 & 30
Taxes
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund 125,509 j 55,000 70,509
Schools I 125,509 1 30,000 95,509
City Sanford 125,509 55,000 70,509
SJWM(Samt Johns Water Management) 125,509 55,000 70,509
County Bonds 125,509 I 55,000 70,509
Sales
Description Date Book Page Amount Qualified Vac/Imp
WARRANTY DEED 3/1/2013 i 08003 0658 134,800 j Yes Improved
SPECIAL WARRANTY DEED 10/1/2012 708971'15 78,000 No j Improved
CERTIFICATE OF TITLE 3/1/2012 07730 10932 100 No Improved
QUIT CLAIM DEED 3/1/2012 07735
M
0618 S100 I No Improved
SPECIAL WARRANTY DEED 11/1/2005 06026 0134 254,000 Yes Improved
Fitt=' Comparable Sates
Method Frontage Depth Units I Units Price Land Value
LOT
J
1 30,000.00 30,000
Building Information _
Is Bed/Bath count incorrect? Click Here.
http://parceidetail.scpafI.org/ParcelDetaiIlnfo.aspx?PID=32193151600000500 1/2
8/7/2017 SCPA Parcel View: 32-19-31516-0000-0500
Description BuiR Fixtures Bed Bath Base Area Total SF Living F Ext Wall Adj Value Repl Value Appendages
LAal/Effective I
fi "SITGCE"'"- i 2005 9 2 " 1 T20 mm'""""'2 680-"2 2 5u CB75rUCc$fi3 22"'—$'T39';3"T8" Description Area
FAMILY FINISH i
GARAGE
FINISHED
441.00
OPEN
i PORCH 24.00
FINISHED
j j I UPPER
STORY 1095.00
FINISHED
Permits
Permit # 1 Description Agency Amount CO Date Permit Date
01688 ADDITION -RESIDENTIAL SANFORD $1,500 3/30/2006
02836 NEW -RESIDENTIAL SANFORD $98,032 3/23/2005
Extra Features
http://parceldetail.scpafl.org/ParcelDetailinfo.aspx?PID=32193151600000500 2/2
1410 Emerson Street, Leesburg, FL 34748 • State Roofing License: CCC1329936 • License: CGC037504
Phone: 352-314-3625 • Toll Free: 855-314-3625 • Fax: 352-240-3439 • www.covenantrnc.com
SALES CONTRACT
Covenant Roofing & Construction, Inc. agrees to furnish all materials and labor necessary to do the modernization work at the following address:
Name -:I Phone -32-.1 - ` Phone(w)
Address --S G -K ,-a; rAk' C f ('- J-> ,- Date 7
cityci ; h.(;; c,
Stated Zip _3`
Email wtZ-Ul,'t .. n ?Cvo—)
In accordance withtspecifications given below:
REROOF:
A. SHINGLE ROOF
1. REMOVE OLD ROOF TO WORKABLE SURFACE.
2. RENAIL ROOF DECK WITH RING SHANK NAILS.
3. REPLACE ANY ROTTED W,Q OD WITH STANDARD SHEATHING @ $ PER FOOT AND $ X PER SHEET OF PLYWOOD, IF AN i (Initial)
4. INSTALL Sq ir, k-- ?P _ UNDERLAYMENT OVER ENTIRE ROOF.
5. INSTALL FHA/VA EAVES DRIP. COLOR ''7^+ '
6. INSTALL NEW VALLEY METAL AND FLASHINGS AS NECESSARY
7. INSTALL NEW LEAD BOOTS OVER VENT PIPES AND RESEAL VENT
8. INSTALL .4 o YEAR FIBERGLASS SHINGLES. COLOR
9. INSTALL —a) FEET OF RIDGE VENT AT<$&. -PER- T. COLOR—
10. CLEAN-UP JOB SITE OF ALL WORK DEBRIS AND HAUL AWAY ALL RELATED DEBRIS AND LEAVE JOB SITE CLEAN.
11. CONTRACTOR WILL COORDINATE REMOVAL AND REINSTALLATION OF ROOF RELATED PERIPHERALS SU(, H AS (BUT NOT LIMITED TO) SOLAR UNITS, SKYLIGHTS DISH
AND AIR CONDITIONERS, ETC. REMOVE AND REINSTALL EXISTING SOFFIT AND FACIA @ $4.25 PER, 0 DITION TO CONTRACT PRICE, IF REQUIRED. THE COSTCO
SUCH WORK WILL BE IN ADDITION TO CONTRACT PRICE AND HEREIN APPROVED BY HOMEOWNER. (Initial)
12. ALL WORK COVERED BY A 5 YEAR WORKMANSHIP WARRANTY.
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 duly
approved, accepted, signed and witnessed by an officer or officers of the Seller.
3. Work on the job described in the contract documents will commence on approximately -14:3 af' and be
completed on approximately C c . The recited dates are approximations and are subject to scheduling
difficulties of Seller, 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. All 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 you
sign this agreement.
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 performing
installation of roofing materials. 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 CIRF if 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 Arlington 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 must
deliver to the other party to this contract a written notice referring to chapter 558 of any alleged construction defects
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 $
Homeowner Portion $ 0101,61. u[>
Plus Total from Item No. 3 above)
UPON COMPLETION
Executed in triplicate, one copy of which was delivered to, and receipt is hereby acknowledged by Buyer,
this day of % , 20 1 7
If
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) Zell , (Seal)
Dealer -Seller) (Purchaser Sign Here)
BY W (Seal)
Title) (Purchaser Sign Here)
4Z -- fI I
SALESMAN
FORD PRESS, INC. 352-787-4650 (mike)
Return to: Covenant Roofing & Construction Inc.
1410 Emerson St.
Leesburg, FL 34748
t31'\til`IT' I'l(I.OY r ; i:.t'17:0LE C:OUI T Y
C:i._E:i i;. OF C TRt:UI. T I_CillRT & I IJI`If:1'ROL_L_ER
BK "6 "' 1F
CLERK'S Y 2017079995
RE::CQRD1P-1G FEES $10.0 l
ril";::QFtGtE'. t`d-tt-i,,,p
NOTICE OF COMMENCEMENT
State of Florida, County of
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. De cri tion of propert (legal description of theproperty, and street address 'f available)
50 /dery % .kc1 P c P S J-
2. General descri tion of improvementrovement
G rnc-),
3. Owner information or Lesse information if the Lessee contracted for the improvement
Name`s rcf-
Address ,
Interest in Property•;,;,
Name and address of fee simple titleholder (if different from Owner listed above)
Name
Address
4. Contractor
Name Covenant Roofing & Construction, Inc. Telephone Number 352-728-8818
Address 1410 Emerson St., Leesburg, FL 34748
5. Surety (if applicable, a copy of the payment bond is attached)
Name Telephone Number
Address Amount of Bond $
6. Lender
Name Telephone Number
Address
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may
be served as provided by §713.13(1)(a)7, Florida Statutes.
Name Telephone Number Y
Address
8. In addition to himself or herself, Owner designates the following to receive a copy of the
Notice as provided in §713.13(1)(b), Florida Statutes.
Name Telephone Number
Address a
9. Expiration date of notice of commencement (the expiration date will be 1 year from the date of,rRort
unless a different date is specified)
w
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCE-MEI'j -
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 B !
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSc
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCE IIET•
V ji/ LQuW uGsn
ig
a of 16wner or Lessee, or Owner's or Lessee's Authorized Officer/Director/Partner/Manage r Signatory's Title/Office The
foregoing instrument was acknowledged before me this QL day of Sl/ 7 by 1-_.(4V mont
year name of p rson as
0 for Type
of authority, e.g., officer, trustee, attorney in fact Name of party on behalf of whom instrument was executed ZZZ,
0
o ary Public — State of Florida Personally
Known OR Produced ID Type
of ID Produced _i3600 — /,34-/- i93-- Cfd- —0 Print,
type, or stamp commissioned name of Notary Public iy;.:
JONATHAN L HOLIDAY MY
COMMISSION # FF228443 EXPIRES
May 16. 2019 t10I1]
A8-0'b] Fbrin•Na•ySsrvicertrr Form
content revised: 01/23/14
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 8/8/1 7
I hereby name and appoint:
an agent of. Covenant Roofing & Construction, Inc.
Name of Company)
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):
The specific pq nit and application for work located at:
Street Address)
Expiration Date for This Limited Power of Attorney: 8/8/2018
License Holder Name: Joseph Rayl
State License Number: CCC1329936
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF Lake
The foregoing instrument was acknowledged before me this 8 day of August ,
20017 , by Joseph Rayl who is x personally known
to me or who has produced , as
identification and who did (did ncl) ,take an oath.
Notary Seal)
fr I`eQ. LINDSAY DUCKHAM
Commission # FF 172210
My Commission Expires
rr„r•r... October 28, 2018
Rev. 08.12)
UPnature 0
Lindsay Duckham
Print or type name
Notary Public - State of
Commission No.
My Commission Expires:
D
t
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 de m liance by personal inspection.
CONTRACTOR (OR OWNER/BUILDER) SIGNATUR ' DATE:8 l
Y
5
D
PERMIT #
j City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: 368 Fairfield Dr. Sanford, FL 32771
STRUCTURE TYPE: O SINGLE FANIILY 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): 1 /2" Plywood
PLEASE NOTE: ONL Y IOO SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED **
ROOF VENTILATION: DOFF -RIDGE O RIDGE 0SOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES O NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12-4:12 (W 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
OQ SHINGLE Certainteed FL45444-R10
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
O INSULATED 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#
0 OTHER: FL#
4
S City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 0 — QN—::s ADDRESS: 368 Fairfield Dr.
Sanford, FL 32771
I Joseph Rayl
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#: CCC1329936
COMPANY/CONTRACTOR: Covenant Roofi
CONTRACTOR SIGNATURE: _
MUST BE SIGNED BY LICENSE
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: O hl I
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 Lake
Sworn to and Subscribed before me this day of Pki20 by:
Joseph Rayl ,
Who is Personally Known to me or has Produced (type of
tification) as identification.
fd ) (I
tante
ature of N t ry _u c
LINDSAY DUCKHAMofFloriopax °°e'y
C scion N FF 172210
Lindsay Duckham
Print/Type/Stamp Name
of Notary Public
a
ommi
a My Commission Expires
P4 October 28, 2018