HomeMy WebLinkAbout121 Venetian Bay Cir - BR18-002541 - REROOFCITY OF
0 AT ORDBuilding &Fire Prevention Division
j PERMITAPPLICATION
FIRE 0EPARTMENT
Application No: psi I
Documented Construction Value: S di , 97 6-1,
Job Addre
Parcel ID:
Type of W4
Description of Work:
FZLD Historic District: YesRNo1L,7nJI
Residential Commercial
Demo Change of Use Move
o14-
Plan Review Contact Person: Title:
Phone: Fax: Email E,; eGr_kWSe-f-oft,) 40.k j
Property Owner Information Name
A 11 I SYYI Pt',1 Phone: O 0 Street:
Resident of property? City,
State Zip: 3a Contractor Information
Name S
Phone: (3 0U 9 2 o - 1 5 Street: ciL
Fax: City, State
Zip: -7 so State License No.: CCC 132,91475 ArchitecVEngineer 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 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,
beaters, tanks, and air conditioners, etc. FBC 105.
3 Shall be inscribed with the date of application andthe code in effect as of that date: 61 Edition (2017) Florida Building Code Revised: January
I, 2018 Permit Application j qQ 93
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may befoundinthepublicrecordsofthiscounty, and there may be additional permits required from other governmental entities such as watermanagementdistricts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property ofthe requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment ofa plan review fee at the time ofpermit submittal. A copy ofthe 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.
51 1 8
Signature ofOwner/A t Date
IPCILu l 57r, eo l
Print Owner/Agent's Name
Signature ofNotary -State ofFlorida Date
5- 31 - $ 6k
Signature of Cantractor/Agent Date
eP LA b,-h C-A Vartc-,s
Print Contractor/Agent's Name
c2.yy.. Ulo. k 3 i , ZO 1
Signature of Notary -State of Florida Date
DESPA ADMA DEeRA ADowil
CWM0ft tolt18e220925 cann stal:c 09?s
o„a itoneratlrYBrebetrtoYgrtlta M o•rti 1lt e»mauapnweagt>ra
Owner/Agent is Personally Known to Me or Contractor/Agent is , Personally Known to Me or
Produced ID _> Type of ID FILL Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas Roof
Construction Type: Occupancy Use:
Total Sq Ft of Bldg:,
Flood Zone:
Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING: UTILITIES:
ENGINEERING: FIRE:
COMMENTS:
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: January 1, 2018 Permit Application
NOTICE OF COMMENCEMENT
PernrkNumber:
Parcal ID Nwnber: 3 9 ZO So 3, 00/y') Adapt)
The undersigned hereby Bivee ratite tltat trtprsYerttert wtU be made to certain red pvperty, and In accordance vAh Chapmr713. Flarga Statutes, theloUowingiMamadonbprovWedintitleNoHoaofCammerlcernerR.
1. CRIPTION OF PROPERTY:QXtasel a addess E svelte Lr)*- '
7Q Vp n0 (3 Mrs — S9 2.
GENERAL DESCRIPTION OF PAPRO E EN . _ ,2mf 3.
OWNER INFORMATJQN OR NVOIRMATION W THE LESSEE CONTRACTED FOR THE Name
end attires:_ t6" 1 -;,m ea [ 1 a, Ve n chan kJav Cf r' . Sri ,3 i & rd 4-i. 3 a 7 7 Interest
In poperiy. FP & S t VV%j2 e Fee
Sbopie T HImHolder (if cetar then owner tietad above) Nana• —.. ti.
SURETY (If q*Bcd M, a copy of the payment borW Is alksdtsd): Nwns: '.e Amount
of Bond: 6.
LEADER: Name: Phone Number T.
Persons vddit the Sots of FloridaOeslpruuted by Owner upon vtrhom nothce er othasdocumoftmay bo servap as provided by liatdton 713.
13(1Kap.. Florida8tabutm Nema
Phone Number: Ate:_
S.
M addOlon, Owner designates of b
recoWe a copy ofthe Llsnor's Nonce as provided In Section 713.13(lIXb), FbrWa 1Slahtfes. Phone nuMber: S.
EvIrstlon Dale of NoSoeof Cam mencemen4 (The e)puatlon is 1 year from date of mcw&V tadm a dilterarddde b apedRed) 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 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING
TWICE FOR IMPROVEWENTS TO YOUR PROPERTY. A NOTICE OF COMMENCENI]ENT 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
OOMMENCING WORK OR REOORDWG YOUR NOTICE OF COMMENCEMENT Rull
Swyeat-j (DL0092::) Blpnrewd
RI+.Slaa.dOarlAOLetlMti rraNm.udvmddsffip eoi alddrm) A%*=
t xd State
of pt— County of s rvt m ul e The
foropdng instrument was acknw&ledped baforo me this day of 1Vl a! j - ALJ L by
who
hue pnodnoed id a 1111cd, type of klentiftlGOP p.edn,o.d: rev' •
ft Notay P.boe state or FlM:da 7
ZACHARY SCHAUBHUT y
N4 Commission GG 16048 wow6.Fkes IM502021 Who
is peraonsUy lowwn to me O OR GRANT
MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK'
S # 2018062659 BK 9144 Pg 1646; (1pg) E-RECORDED 06/04/2018 09:34:46 AM rMIT,_,
1
CCC 1329475TLMNKEYCBC057917
CONSTRUCTION & MAINTENANCE, INC.
VISIT US ON THE WEB AT. WWW.CHOOSETURNKEY.COM
OFFICE: (904) 900-1069 • FAX (904) 66.9651
5991 Chester Ave. Ste. 105 Jacksonville, FL 32217
AFcouiArnanager. @chooseturnkey.com
Billing Name i a LA 1 JM e Z Ihsurance, Company: A4T 1 G
Address: 1 cl I V (vne i-1 r Claim#:
City: S;4hpor State FL Zip a -11 1 Policy# _
Homeowner Tel. #: a0a 14147 ,59L40 Homeowner Email: '
Adjuster #: Fax #: Adjjustter Email:
Re•Roof Installation Root Over . Rry epalir
Llmsurance Claim Stories
gResidential []commercial Builder [-]Realtor Q ioof Pitch i r'l Olemove
existing roof and haul away. Additional charge [anstall new shingles _____Arch 3 Tab for
more than 1 layer $60 per square / per layer i shingles, $
15 per layer of felt _25 yr _ 30 yr 50 yr ._Specialty Roof anstall
new felt Oty:3 fC 115Type: r VN I f10 Peel
and Stick Oty: Type: Onstall
new plumbing boots: 1 1/2" L 2" 3"
4" Install
new eave drip: Oty:a. *olor: ,(L Skylights-
Siz ' Oty: Qlhstall
New Valley _ Metal Flashing Chimney
Flashing Kitchen/Bath V Qpff
Ridge Vents 4' 6' Ridge
Runner Shingle
Colon QManufacture/$
tyle i7t.1-19(15 ('(' Total
Roof Square count 37 • (e 1 _including Ridge Cap Plywood
Include (1) Sheet, $60 per sheet addl orl0 LF of 1 x6, 5
per linear ft of nominal lumber Ridge
Cap o? • 4 M- Flat
Roofs Plys underlayment,
Oty f
of sq. ft. ( ` 3AII
trash to be hauled away upon completion We
will pull permit Disclosure:
Contractor is not responsible for any items being damaged inside or outside of home. Homeowner must take due care of any and all hems that
may be damaged upon installation of new roof. 1 1 Notes /
Interior We
Propose to furnish material and labor as described above for the sum of: $ 2 9 .] 2 WARRANTY:
10 YEARS LABOR ON ALL ROOFS. Manufacturer's Warranty: I 60%
deposit required, 40% upon substantial completion N
payment is made by credit card, a cony lence of 3% will be charged. , Note:
This proposal may be withdrawn by us if not accepted within 301 60 F190 days Our
workers are fully covered"by Workers Compensation Insurance. Contractor has the right to change material selections as needed from
manufacturer to comparable color selections. The
undersigned hereby assigns any and all insurance rights, benefits, proceeds and any causes of action under any applicable insurance policies
to Turnkey Construction & Maintenance, Inc. ("Contractor") for services rendered or to be rendered by Contractor. In this regard, the
undersigned waives his/her privacy rights. The undersigned makes this assignment in consideration of Contractor's agreement to
perform services and supply materials and otherwise perform its obligations under this contract, including, but not limited to, not requiring
full payment at time of service. The undersigned also hereby directs his/her insurance carrier(s) to release any and all information requested
by Contractor, its representatives, and/or its attorneys for the direct purpose of obtaining actual benefits to be paid by his/her insurance
carrier(s) for services rendered or to be rendered. Acceptance
of Proposal: By signing this Proposal, the below Customer(s) agrees to pay Contractor the total amount indicated above for
performing the des bed work. The Customers) further agrees that he or she understands, has received and signed the Additional Terms
and Conditiopg'arld Legal Disclosures, whlo are Incorporated herein. Signature
r TumKey
JI
CITY OF
SkNF0RD
FIRE DEPARTMENT
PERMIT #
Building & Fire Prevention Division
RESIDENTUL REROOF SCOPE OF WORK
JOB ADDRESS: 191 Van P.-h Q.YI
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):Piiyw ooc) ck[C _f;1 nc PLEASE
NOTE. ONLY 100 SQUARE FEETOF THE EKIS77NG DECKtjPERMITTED TO BE REPLACED" ROOF
VENTILATION: ®OFF -RIDGE ORIDGE OSOFFIT OPOWEREDVENT OTURBINES SKYLIGHTS:
O YES ® NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: MAIN
ROOF AREA ROOF
SLOPE: O LESS THAN 2: l 2 O 2:12 - 4: l 2 ® 4: l 2OR GREATER TYPE
OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL SHINGLE
flyr,in' FL# 1 obi H - O
METAL FL# 0MODff1ED
BITUMEN FL# OTORCH
DOWN FL# O
INSULATED FL# OTILE
FL# OTHER:
Ow
S -n n Eno
uncle-r FL# 11 b 0 a - R ROOF
EXTENSIONS (PORCHES, PATIOS, ETC.) "t"IFAPPLICABLE" ROOF
SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 O 4:12 OR GREATER A \ 1 A TYPE
OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL O
SHINGLE FL# O
METAL FL# O
MODIFIED BITUMEN FL# OTORCH
DOWN FL# OINSULATED
FL# O
TI.E FL# 0
OTHER: FL#
CITY OF
S.kBuildingV40RD Fire Prevention Division
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 THATWILL BE INSTALLED ON THE PROJECT.
A PERMIT WILL NOT BE ISSUED WITHOUT THESE DOCUMENTS. COPIES WILL BE MADE TO POST ON THEJOB 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 PERMITNUMBEROR 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)
DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL
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:
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
Application Number . . . . . 18-00002541 Date 6/05/18
Application pin number . . . 932227
Property Address . . . . . . 121 VENETIAN BAY CIR
Parcel Number . . . . . . . . 23.19.30.502-0000-0720
Application type description ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Application valuation . . . . 12972
Application desc
REROOF/SHINGLES
Owner Contractor
SMEAL PAUL TURNKEY CONSTRUCTION MAINTEN
121 VENETIAN BAY CIR 5991 CHESTER AVE
SANFORD FL 32771 SUITE 105
202) 497-2040 SANFORD FL 32771
904) 900-1069
Structure Information 000 000 ----------------------
Roof Type . . . . . . . . . FIBERGLASS SHINGLES
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc .
Phone Access Code 1055128
Permit pin number 1055128
Permit Fee . . . . 131.00
Issue Date . . . . 6/05/18 Valuation . . . . 12972
Expiration Date . . 12/02/18
Oty Unit Charge Per Extension
BASE FEE 40.00
13.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 91.00
Special Notes and Comments
All projects within the City shall use
WastePro for debris removal. Please
contact WastePro at 407.774.0800.
Normal hours for inspections are from
7:30 through 4:30 Monday through
Thursday. Please be aware you must
contact the Building Official to
schedule a Friday or after hours
inspection. This is required since not
every inspector is licensed to do every
type inspection. Communication is the
key, so please contact the Building
Official if you have any questions at
407.688.5058 or at
dave_aldrichosanfordfl.gov
Other Fees . . . . . . . . . 01-APPLCTN FEE -BUILDING 25.00
01-BLDG PLAN REVIEW 39.00
01-BLDG DCA SURCHARGE 2.00
01-BLDG DBPR SURCHARGE 2.93
Fee summary Charged Paid Credited Due
Permit Fee Total 131.00 .00 .00 131.00
Other Fee Total 68.93 .00 .00 68.93
Grand Total 199.93 .00 .00 199.93
FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE
PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS.
NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED.
NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED.
4
C OF SANFORD DWG
00 N PARK A
ANFORD, FL 32 1
SALE
41D: 945' Store: 46% c 290
REF 0007
3atch 002 RRN: 146b60
361.05 8 10:10:56
ttlt: B
Invocet: 2541
Tram ID: 0605MDBM013E4
APPR CODE: 393213
MASTERCARD Manual CNP
AMOUNT $199-.93
CITY OF
a*a CUSTOMERSANFORDRECEIPT a** Oper: BLANDA Type: OC Drawer: 1Date: 6/05/18 01 Receipt no: 135657
Year Number Asount20182541
121 VENETIAN BAY CIR
SANFORD, FL 32711
BP BUILDING PERMIT RECEIPTS
199.93
AC 383213
Tender detail
CC CREDIT CARD $199.93Totaltenderedf199.93Totalpayment $199.93
Trans date: 6/05/18 Time: 10:10:07
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 . . . . . 18-00002541 Date 6/05/18
Property Address . . . . . . 121 VENETIAN BAY CIR
Parcel Number . . . . . . . . 23.19.30.502-0000-0720
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1055128
Permit pin number 1055128
Required inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 Ill BL03 FINAL ROOF
CITY OF
Sik 4FORD Building & Fire Prevention Division
FIRE DEPARTMENT Re -Roof Permit Card
PERMIT NO. 18-as!j 1 ISSUE DATE: W
CONTRACTOR: _r
JOB ADDRESS: QL • ' r
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
OOF
INSPECTION TYPE APPROVED REJECTED INSPECTOR
FINAL ROOF
FAILURE TO FOLLOW THE RESIDENTIALRE -ROOFPOLICY & 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 BEADDITIONAL 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 10S.3.3
REVISED: 4-17 Inspection Line 407.792.6069 or 855.541.2112
CITY OF
Sk 4FORD Building & Fire Prevention Division
RESIDENTUL RE -ROOFAFFIDA VIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ' V / ADDRESS: III Ve.J e`f "C'.) r
G.wl r t•d If % o 7 7%
I die I i,61tVL %lam f , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING COTRACTOR, 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 #: C« 0 1 q r 7/,1-
COMPANY/CONTRACTOR: {1 C 7 `VC I`f i -rilri ke C(j ktTr uc I1o.j /
CONTRACTOR SIGNATURE: / / DATE:
MUST BE SIGNED BY LICENSE HOLDER OR OWNER/BUILDER)
A FINAL ROOF INSPECTION IS REOUIRED:
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 FLORmA COUNTY OF OfL4S o.
Sworn to and Subscribed before me this I I day of ;J„A KP_ 20 J? by:
I %,Spa to LGiyGt r tef7t 5 . Who is or"personally Known tome or has 0 Produced (type of identification)
as identification. Signature
of Notary Public State
of Florida • Notary Public State of Florida Eno
I6 U{/
180946Z
ofGGGWPrint/Type/
Stamp NameON 0% of Notary
Public