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HomeMy WebLinkAbout2011 Adams Ave; 18-3555; ROOFBUILDING DIVISION AUG 2 0 2018 PERMIT APPLICATION Application No: / Y `-3 ` 5,5 Documented Construction Values $ 6,045.80 job Address: 2011 ADAMS AVE Historic District: Yes NoM Parcel ID: 31-19-31-504-1100-0070 Residential n Commercial ' Type of Work: New Addition Q Alteration Repair. Demo n Change of Use Move Description of Work: REROOF TEAR OFF COMPLETEI..Y TO DECKING AND COVER WITH OC OAICRIDGE SHINGLES FL10674 Plan Review Contact Person: 'rODD RHYNE _ Title: PRESIDENT Phone: 407-277-4963 Pax:. 229-329-4104 Email; PE RMITTING@RIIYNERES`1'ORATION.CUM Property Owner Information Name ALFRED M ZICCARDI _._.., phone: 321-262-5823 Street: 2011 ADAMS AVE Resident of property? YES City,. State Zip: SANFORD, FL 32771 Contractor Information Name RHYNE RESI'OR.ATION phone: 407-277-4963 Street: 6731 NARCOOSSEE RD #1130 Fax• 229-329-4104 City, State Zip: ORLANDO, FL 32822 State License No.: CCC1329471 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 TENDER 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 thatall work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that separate permit trust be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and air conditioners, etc: FBC 1053 Shall be inscribed with the date of application and the code in effect as of that date: 61' Edition (2017) Florida Building Code NOTICE In addition to the requirements of this permit, there maybe 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 Print Owner/Agent's Name Signature of Notary -State of Florida Date Of CI 126377 My Corr , :X.tr25 Owner/Agent is _ Personally Known to Me or Produced ID Type of ID Produced ID Type of lib BELOW IS FOR OFFICE USE ONLY Date Permits Required: Building Electrical Mechanical Plumbing Gas Roof Construction Type:, Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: Flood Zone: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures_.__^___ Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes []No APPROVAI;S: ZONING: COMMENTS: UTILITIES: ENGINEERING: FIRE: WASTE WATER: BUILDING: Nvlqq' 407-27-RHYNE 7 4 9 b 3 REP: AA N j FL t;.IC#)CCC1329471 PHONE: / "7 o 1` _'76 J 3 7 OWNER / , J^•+ _ /__ E _; P DATE ' 3 !- ... MAIL ADDVESS STREET j CFU PHONE V oRK PHONEA4--f Ve_1 LT-jPCITY ti fon srarE F 1 32 r7f l { iOML PHONE. We hereby submit scope of work for: 0 LEAN ALL GUTTER DEBRIS AUL OFF CONSTRUCTION DEBRIS o Tear Off /t 15 +tl OLt. MAGNETS THROUGH YARD o # c Squares Off '``N` WAIVERS PROVIDED UPON FINAL PAYMENT o Recover roof wi7# ' Cl iMISC SPECS o # of Squares On r Shingle/ Color Q.0d o Protect Property a Needed Daily o Decking Type + P n % O e G Underfayenent %^2- Metal Edge Color rQ q Valley Type /l)n! Terms: The undersigned (Customer) herby agrees to the proposed scope of work and the contract price. The company agrees to Hip and'Ridge furnish all materials, labor and necessary permits upon receiving a Nails /fLf — (1 the deposit which is equal to 40% of the contract price and the balance dqe upon completion of roof. Insurance Claim s: Rhyne o Pipe Flashmgs (L restorati ptoallinsuranceceks floVentilationf 1 0 A* !^t ZR.of Replacement V ` g. w Seal around all vents, fiasf'ings and pipes o Furnish all materials, labor and nec ary perm',ts Q Roo#Repair b Delivery Instructions f jj 0Aa, Total $ Year Roofing Workmanship Warranty tcl' Accepted by Owner By: p c.c,.:I—I/ Date: `- f TOLL-FRt* (888)99., t 1 F NE Repair 1) 2) 3) s£tlUn wt !)13I, iwtWASl,tiiUif3KMSQ 7NOwQK tKIYQUq HlOKRtYQR YRQ•RM Mx*OP+KSJ.MPNR nQTPAill yH Yl1i HAY£RRY311TM[t1f(%fF.)WMtIK•MtWRGTWMmC1VOO.1W/COtIIAM;t(1( f ..NN PAT1U SUKSMtiRR(1WS.SJKCO4" CTOKOKy tVoNT*FVO%WYMW1RNO'A uuYMYOOAOTMERiEQ4 RfSprAYMFNireFI(IEYOV NKYf OIIgYf COM1PACTdR Glll'N.TYpJfl R T6PkY YRk1RCQNTRMTOR,YtWYCGNTWt,('YOK MAY RI3Q IMYE AtIC}l Ot1YWKP1lgFCRjY. }fp}MkANYR MAmuits be omit 9tYifg MAT YgIK(OMpAGiOaf)?6ORLOgTKKKTOR MAY NAVE FJAMTO MY T9T WEVYOVR214P, YQiI AtWtDsl?PttutE-m msti <OMIWCT nE+tf t YlNMWAn EW *rum FROMMl PEMOH OK-9viY'MRTHOW (OMYOUA—na TOOWH 1 ROp10" LptPfWn' 0£N Eaw n£uM>KyY.umisY. T iROM, tft(%KOx u;wT(;S(!!yMS`4Ylil5TR; 'ekN@LCtJYERi lUtiDp?'JV lS 1ti EMR1kY/NIA KRI f!';'7tE.)tSOdMSb I;N (k^.:IF?uCt, bTKFRi TM. t0u..0 Tti t;u--it, KO"u TE24 1010i KEU[t,: CJNiA!:'.1`E tlQkWtCNiTKtMTrtri NH'Y,Kikr Ur.IN51lG iGY XU P'rryR(pUCMWN: I[Uf SR,#`-ti}ipu(R t{O WRRISS AR 1?ApEX!1'M Y rlr,£eY•OTM RQn4.YrNr£nA£.rK4 yYQ[ISUr tHKtUSPK,rtOWOA LTARiTFS,. r#+v#n. rawi •40.I.K......,.i Mir •1£'i..M er.x•aner o£M1r ielL i+Rr.enn KYts+rRrurt erM:n+PThbmiHrnwtirN4fv MN YRu1tR nM want Rx KgpPaw ampr. m tMl AR#emwzlf yd11fMK1 MYrRpeertwnR M IaOrr mFyq££nR tl v R+rr etanY qrh dvan,_I+YrnsnE itytgnKK 0is f;irY•nnrtVwr •[^r wiy,phat ab ar<n NV WdM Mtrca Grant.Maloyy Clerk Of The Circuit Court & Comptroller Seminole County FL lnst #2018095253 Book:9194 Page:1245; (1 PAGES) RCD: 08/18/201 01:58:37 PM REC FEE $10.00 0.H THIS INMuimENT PREPARED $ Marne— RHYNE RE TORATIOt+t V%j . Addrexs fififDO; NOTICE OF COMMENCEMENT PannibNumber..— Parcel ID Number. - _ . -1 s l &- 1O v 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 Nolict± of Commenopment_ t, pF$CWPTKIN OF PROPERTY;:{Legal rtascriPttare pf the property and sir eetatJdress available) 2. Gtr4eRALtwsc (P ToN ortRIIpR6v9MFNT: REROOF S. OWWR INFORMATION OR LESSEE INFORMATION IF THETHE LESSEE CONTRACTED MRnT14E IMPROVEMENT` and addles: AA-(i 7—I..lf c r -i-- — ` . -;- -f3jg ti 7 7 i Interest in pmerty:.-Q j — Fee Simple Title Haller (irother thw owner 0sfed above) Name; / 4. CONTRac-TOR Name RHYNE RESTORATION j Pho:te Numb. 407 2774963 Address: 10338 MIDDLEWICH DR- ORLANDO, FL 32832 ... 5_ SURETY (Vappffeable; a copy Gf the payment bond Is attached). Alidre5s_. Amount of Bond: 6. LEl4t7ER- Name;,,,4,•,l !3k_ _-__._ Phone Number: Address: T. Persons within the State of fforkla Designated by Owner upon whom notice or other documents may be served a; provided by Section 713.13(i)(a)7, Florida Statutes. Nome % -- Phono Number_ Address . _ S. In addition, Owner designates j of - to receive a Copy of the Uenois Notice as provided in Section 713.13(1)(b), Florida Statutes, Phone number. 9. exposition Date of None of Commencement Crho expiration is 1 year from date of recording unless a d0erentdate is spetdiled) NtAtG TO OWAI ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARECONS110REDIMPROPERPAYMENTSUNDERCHAPTER713. PART I. SECTION 713.13, FLORIDA STATUTES. AND CAN RESULT IN YOURPAYINGTWICEFORIMPROVEMENTSToYOURPROPSTrY. A NOTICE 0•P COMMENCEMENT MUST BE RECORDED. AND POSTED ON THEJOB. SITE BEFORE THE .FIRST INSPECmQN. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE 'COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT - of arU=R%Vr'o—tftmt-e--s tt•ntrcvueandt+twdasgnaw!Y'sttndl7t5eel rfP2ttctt+dtumtmgtg) State of County of I 1 Ttte f rtstrnm twasacknowledged befo .this dayof --+ by parttonalfytttto to me 0 OR who has produce Y OF Building & Fire Prevention DivisionISXNFORDRESIDENTMRE-ROOF.POLICY & PROCEDURES f ME DE ;1r01TMEN I' 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 ALI, 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 SITTE. PROJECTS LOCATED INT11E SANFORD HISTORIC DtmicT WILL REQUIRE PLAN REVIEW AND APPROVAL R i'THE SANFORD HISTORIC PRESERVATION BOARD INSPECTION POLtCY & 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 INsPFcriON AFFIDAVIT ALL FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS PRODUCT APPROVAL SHALL MATCH WHAT IS ON THE SCOPE OF WORK) DIGITAL PHOTOGRAPHS (MUSTINCLUDE TIIE PERMIT NUMBER OR ADDRESS IN EACH PICTURE) EACH PLANE OF THE ROOF, SHOWING THE UNDERLAYMENT INSTALLED ROOF DECK NAILING PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER) ROOF DECK NAILS USED (INCLUDING A MEASURING DEVICE ORRULER SHOWING SIZE OF NAILS) UNDERLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER) DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE OR RULER) SHINGLES INSTALLED, NAIL PATTERN AND LOCATION OF NAILS SKYLIGHTS (IF APPLICABLE) o DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL 0 DIGITAL PI-10TOGRAPHSSHOWING ALL REQUIRED FLASHING, PER FL PRODUCT APPROVAL. FAILURE TO FOLLOW TRESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED RV A FLORIDA DESIGN PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION. CONTRACTOR (OR OwNER/BUILDER) SIGNATUR DATE: 8/14/2018 CITY OF f` SkNFORD JOB ADDRESS: 2011 ADAMS AVE PERMIT #'f6sE7 Building & Fire Prevention Division RESIDENTIAL REROOF SCOPE OF WORK STRUCTURE TYPE: O SINGLr,. FAMILY RESii)ENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM RE -ROOF TYPE: dREPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) O RE-COVER (NEW ROOF INSTALLED OVER. EXISTING ROOF) DECK TYPE (PLEASE SPECIFY): ^19/32°PLYWOOD PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING.DECII IS PERUM ED TO BE REPLACED** ROOF VENTILATION: Q`OFr•-RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBrNES SKYLIGHTS: OYES Q(NO If YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL. #: MAIN'ROO.F AREA ROOF SLOPE: O LESS THAN 2:12 Q(2: I2 -4:12 O 4:12 OR GREATER TYPE OF ROOF MANUFACI'UitER FLORIDA PRODUCT APPROVAL ySHINGLE OWENS CORNING FL# 10674 O METAL FL# OMODIFIED BFI-UMEN FL# O TORC'II DOWN FL# OINSULATED FI A OTILE FL# 0 OTIMR: FL# ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IF APPL[CA.BLE** ROOF SLOPE: O LESS THAN 2 12 02:12 - 4:12 Q 4:12 OR GREATER. TYPE. OF ROOF MANIJFAC.-FURER FLORIDA PROD cr APPROVAL 0 SHINGLE' FL# O METAL FL# O MODIFIED BITUMEN FL# 0TORCH DOWN FL# 0INSULATFI) FL# O TILE FL# O OTHER: FL# CITY OF Sk 4FORD FIRF DEPARTMENT PERMIT • CONTRACTOR: JOB ADDRESS: TYPE OFXORK: 4W Building & Fire Prevention Division Re -Roof Permit Card ISSUE DATE: PROTECT FROMJNEATHER 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 THEPUBLICRECORDSOFTHISCOUNTY, AND THERE MAY BE ADDITIONAL.PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. FBC 705:3.3 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 I I I 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 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 . . . . . 18-00003555 Date 8/22/18 Property Address . . . . . . 2011 ADAMS AVE Parcel Number . . 31.19.31.504-1100-0070 Application description . . . ROOFING APPLICATION Subdivision Name . . . . . . BEL-AIR Property Zoning . . . . . . . SINGLE FAMILY Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 1072065 Permit pin number 1072065 Required Inspections Phone Insp Seq Insp# Code Description Initials Date 1000 111 BL03 FINAL ROOF / / CITY OF " kNFO Building & Fire Prevention Division RESIDENTL4L RE ROOFAFFIDAVIT FIRE DIPARTIMENT RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERIN GS PERMIT #: A— 3 ,ir j^ ADDRESS: L ( Iv 1Y— I 1) 4Z4 YI V 6 , 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 #: r"a, I i COMPANY /CONTR CONTRACTOR SIGN MUST BE SIGNED B A FINAL ROOF INSPECTION IS REQUIRED: DATE: -og- d-I - 18 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 Sworn to and Subscribed before me this or-day of 20 by: Who is& kersonallv Known to me or has Produced (type of identifica ' ) as identification. Si o ary Pu lie St to f F 'da v =RSov No:arY Pub;c Sia,e of Florida s. » = M Comm. Exp'res Ju', 2C. 2C21PtfIYPe/Stamp Name °:p. F Y ,_ I' m c ,,C: Sr. of Notary Public sc ded