HomeMy WebLinkAbout104 Oak View Pl; 17-2686; RE-ROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: / - o? & y
Job Ad,`dress: 104 Oak View PI.
Parcel ID:10-20-30-511-0000-0390
rTy ' of Work:- New Addition Alteration Rep_'O) 0
mDescritofWoresidential re -roof Historic
District:Yes No Q Residential!
Commercial Demo
Change of Use Move Plan
Review Contact Person: Stephen Barnett Title: President Phone:
407-647-9420 Fax: 407-629-5720 Email: permits@carrolibradford.com Property
Owner Information Name
Alex Stoughton Street.
104 Oak View PI Resident oiF= ro er Yes = p.P.t3',•" tC1ty
SiAte;Z: Sanford, FL 32773 Contractor
Information Name
Carroll Bradford, Inc Phone 407-647-9420 a`
Street: 4776 New Broad Street, Suite 201 Faz: 407-629-5720 City,
State- p: - Orlando, FL 32814 State L cense'No;: CCC1330656 Arch
itectlEngineer Information Name:
Street:
City,
St, Zip:, Bonding
Company: Address:
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. 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: 511 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 con afrU 4nd"zoning.
15'
StDate; Signatureo,'ontractdr`#A' it: Date Q Alt
j -. x
Pnnt Owner/Agant's'N be Print;Coritiactor/Agent'§ Name / o ; o r
yState of'Flcgi AH ROBINSON D, gnnture 0 Notary -State of Florida Date x o a =' Pubiic
State y ,
Notary of Florida m o fi
Commission= Gi. 026363 m
Poly
Ccmm. Expires Aug 31, 2020 z m o 0 11f'(
iF r4 j'.1
l
Bonded through National Notary Assn s Owner/
Agent is Personally Known to Me or Contractor/Agent is Z` Personally Known f of r Produced
ID' Type of;ID. 'Ptdddded D Yp T" e.aof 1Dr; 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
SCPA Parcel View: 10-20-30-51'l-0000-0390 http://parceidetail.scpafl.org/ParceiDetailInfo.aspx?PID=1020305110..:. pBOXR t'r.LL^
Yh.
n t`l3UiYY, tYi`}ii}A Parcel Information Property Record
Card Parcel:
10-20-30-
511-0000-0390 Owner: STOUGHTON ALEX D
Property Address: 104 OAK
VIEW Pl. SANFORD, FL 32773 Parcel 10-20-30-
511-0000 0390 Owner STOUGHTON ALEX D
Property Address Mailing Subdivision
Name 0
104
OAK VIEW
PL SANFORD, FL 32773 104 OAK VIEW PL
SANFORD, FL 32773- e ____._...----- _----- ..__------- _ ............ STERLING WOODS Tax
District
S1-SANFORD
DOR Use Code Exemptions
01-SINGLE FAMILY
00-
HOMESTEAD(2016) Legal
Description LOT 39
STERLING WOODS
PB 54
PGS 93
THRU 95 Taxes Value Summary 2017
Working
2016 Certified
Values Values Valuation Method
Cost/Market
Cost/Market Number of Buildings Depreciated
Bldg Value 139,
507 133,792 Depreciated EXFT Value Land
Value (Market) 25.
000 25,000 i n Land Value
AgJust/
Me ,rket'Value •'
164.507 n $158,792 Portability Adj Save Our
Homes Adj
i $2.380 40 Amendment 1 Adj P&
G Adj 0
0 Assessed Value 162.127
158.792: I, Tax Amount without SOH: $
2,369.73 20fS Tix 81I6Amount $2,
369.73 Tax Estimator Save Our
Homes Savings: $
0.00 Does NOT INCLUDE Non
Ad Valorem Assessments Taxing Authority Assessment Value
J Exempt Values Taxable Value iii SM(SaintJohn. Water
Management)
JW 162.127 50,000 112127 County Bonds 162,127
50,000 112,127 County General Fund 162,
127 50,000 112,127 Schools 162,127 25,
000 137,127 City Sanford 162.127
50,000 112,127 Sales Description Date Book
Page
1 1 Amount Qualified
Vac/
Imp WARRANTY DEED 6/1/
2014 I 08292 1291 175,
000
Yes Improved SPECIAL WARRANTY DEED 4
11/1/2010 07482 0260 120,000 No Improved CERTIFICATE OF TITLE 10/
1/2010 07464 0737 i 100 No Improved
i
SPECIAL WARRANTY DEED 81112010
i 07482 0259 100 No Improved QUIT CLAIM DEED 3/
1/2005 05679, 1659 57,600 No Improved WARRANTY DEED 4/1/
2002 04387 0655 140,900 Yes Improved SPECIAL WARRANTY DEED 8/
1/2000 03922 0928 121,900 Yes Improved WARRANTY DEED 12/1/
1998 03576 0571 157,500 No Vacant Find Comparable Sales Land
Method I FrontageDepth
1111
Units l UnitsPrice
TLand Value LOT 1 25,000
00 25 000 I of 2 8/
8/17, 8:58 AM
CARROLL BRAD1"ORU, INC.
Cf3C1260310 - CCC1330656
PROPOSAL
Date
I'ru!Crlyl,ucatluu: ;
r '
1!.;.'.
IJ_._i:, ,'.,1 .L l---- --._ Day Phone /%Ur/' ivr r/' 21 1. _ UM L7H
lip: Evening Phone: M H
l
s: M14:ril: - Y i i1 it-UL r L .l_Q_.'- 'V3.(;, .,-f fJ"J. Eton Approval Needed: Yes No I
luloF srEcurlcn•rloNs - Ilrnnd: r~I1_ — _
Cunstruction'I'ype: UNew Construction C Wllnove tic Replace
fear -Off Layers: jhil U2 U11cel tx Sticic
l.cad Pipes: U1,5"___^_ U2"-5__ U3" _ G4"
Ventilation: Type i_4n Ofy. J_1__- Color
Kitchen/Hatli Vents: 4" 10" Color___ ---
Replace Flat Roof: UYes )_YNo Color
Solar: Description____
Stylc:._L, , , tw Color: _
Story: M 2 Pitch: l
Valley: Open (1(Closed
Underlayment: Synthetic OFelt
Drip Edge: OColor
Skylights: Sire —" Type Qty.
Lumber: Size Type Qty.
Misc.
Warranty: Standard System: n "t6 _ Delivery Notes:
GUTTER SPECIFICATIONS: Size
SIDING SPECIFICATIONS: Lap Size (Exposure):
Color Lineal Feet
Prim Size: .__
Downspouts
Finish: Smooth OWoodgrain
Special Instructions:_ X'1' b • r ft L+.in, a jkit0LILa A„dt'i'r i/ryri i I-C 11 19 T TTT.,
TERMS
I.
Uy signing Ihls Agreement, you authorize Carroll Bradford, Inc. to perform the work as specified above and agrre to the payment schedule as listed on this Agreement 2.
Any rdteratinns or tievlatlons front this Al;reernent wlll not he executed unless otherwise agreed upon in writing by both parties 3.
Your -,ggoaenr belnw provides youragreement to ali the term: and conditions set fortis on the fmrit and back of this Agreement. Please carefully read the entire front and back of this Agreement. 4.
Thr; propu mai may he withdrawn by Carroll Bradford, Inc, if not accepted within 30 days. Agreed
Ili -ice: $ _r )CJ. To be paid as follows: Deposit: $ .__
Due at time of Agreement (Check # Date Balance: $ ` _ _ _
J
Due
at the time of Completion (Check # Date S1r
nulanr (!.'rc;nrnrcr'J !Jute t Si/jnnhrre (currol! Bradford Rep) Date OW
ANDO: 4776 New Broad Street, Suite 201, Orlando, Florida 32814 . Office: 407-647-9420 • Fax: 407_629-5720
Permit Number:
Follo/Parcel ID •#: 10-20-30-511-0000-0390
Prepared by: Joel Newton
Return to:-Ca-U Bradford. Inc
4776 New Broad Street, Suite 201
Orlando. FL 32814
NOTICE OF COMMENCEMENT
i I lii i 1 11 ill l Ilili 1111i HE I
GRANT 11ALOYr SEIIINOLE COUN'rY
CLERK OF CIRCUIT COURT & COMPTROl.1-ER
BK 8973 Ps 1647 (IPSS)
CLERK'S T 2017033871
RECORDED 08/18/2017 lil:in):4'i FTI
RECORDii.iG FEES $10,,01
RECORDED BY ,ieckenro
State of Florida
The undersigned hereoy 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)
Lot 39 Sterling Woods PB 54 PGS 93 THRU 95 104 Oak View PI.
2. General description of improvement
residential re -roof
3. Owner Information or Lessee information if the Lessee contracted for the improvement
Address. 104 Oak.View PI..Sahford, `FL 32773?
Interest in Property owner
Name and address of fee simple titleholder (if different from Owner Ilstedabove)
Name
Address
4. Contractor
Name Carroll Bradford, Inc Telephone NumPer 407.647-9420
Address 4776 New Broad'Straat. Suite 201 Orlando, FL 32814
0 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 T,eiephore Number
Address
8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's
Notice as provided in §713.13(1)(b), Florida Statutes.
Name "Telephone Number .
Address
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 N
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
0 W V7 eA,— tt-1
ignature of Owner or Lessee, or Owner's or Lessee's Authorized Officer/Director/Partner/Manager Signatory's Title/Office
The foregoing Instrument was acknowledged before me thisL4day of . I by t l () DWvl&
v for Signs
re of Notary:Publlc— Slate of Florida Personal
ly.Known OR Produced ID Type
of I6,Produce'73 Form
content revised: 01/23/14 m
yea ., name of, person r Name
of party on behalf of whCstrument was executed' f_.
Print,
type, or stamp corlimissioned name, of Notary Public t a W
I LL. G
4
r
SARAH ROBINSON Public -
State of Florida s•
commission I Ofi 026363 r O ` Alyl
COMM. Eaplres Aug 31, 2020 r W f
Bonded through National NotuyAssn. v <r.
CITY OF
S FO, L
FIREADEPARTMEN Building & Fire Prevention Division
Re -Roof Permit Card
7PERMITNO. ! t,12 `/ L ISSUE DATE: 09-0137
CONTRACTOR: (larroll r'O`
JOB ADDRESS: I ®r ® aA
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 5:00 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
Building & Fire Prevention DivisionSXR"FORD RESIDENTIAL RE -ROOF POLICY & PROCEDURES
FIRE DEPARTMENT
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: DATE: 5 —I
CITY OF
SkNFORD
FIRE DEPARTMENT
JOB ADDRESS: 10 q 0(A k Y I e V v ? `-
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
STRUCTURE TYPE: C>SINoI_E FAMILY RESIDENCENOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: O REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (KNEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): F ( y Vy D 0 4
PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED **
ROOF VENTILATION: DOFF -RIDGE JORIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES nNO 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 NUFACTURERMANUFACTURER FLORIDA PRODUCT APPROVAL
CISHINGLEA FL# 10 1 '1-1
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
TILE FL#
10OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, GTC.) *M-APPL/CA13LE**
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#
QMODIFIED BITUMEN FL#
OTORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786
1 1 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
Page 2
Application Number . . . . . 17-00002686 Date 9/07/17
Property Address . . . . . . 104 OAK VIEW PL
Parcel Number . . . . . . . . 10.20.30.511-0000-0390
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1001791
Permit pin number 1001791
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 BL03 FINAL ROOF / /
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF AFFIDA VIT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: I / —2 ( ADDRESS: 7 omlm V I-t"_)
Jo 1A 01 tOA to 1 V I W1 AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, ENGINEER, ARCHITECT, OF F.S. CHAPTER 46.8 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 #: C * L (' 3 O
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE:
MUST BE SIGNED BY LICEN
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: 2 1 l
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.: Olga
Sworn to and Subscribed before me this 2.1 da o20 b Yy: 10
Vl I",1q 1:t. Who is,Wersonally Known to me or has Produced (type of identific
tion) as identification. afore
of Notary Public State
of Florida s
I V 2 b t 1 S Print/
Type/Stamp Name 0Notary
Public SARAH
ROBIN ION Notary
Public - State of Florida Umfi115slon >=
GG 026363 sac
OF
F ' My
Comm. Expires Aug 31, 2020 Bonded
through National Notary Assn.