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Home My WebLink About117 Belgian Way - BR17-002856 - ROOFCITY OF SANFORDU0V BUILDING & FIRE PREVENTION SEP 2 2017 PERMIT APPLICATION gy; Application No: ss Documented Construction Value: $ 15,125.00 Job Address: 117 Belgian Way Sanford, FL 32773 Historic District: Yes No Parcel ID: 18-20-31-505-0000-0120 Residential ® Commercial Type of Work: New Addition Alteration X Repair Demo Change of Use Move Description of Work: Tear off existing roof and install new asphalt shingles. Plan Review Contact Person: Title: Phone: Fax: Email: Property Owner Information Name Ulyssis Bravo Phone: 407-620-8435 Street: 117, Belgian Way Resident of property? : Yes City, State Zip: Sanford, FL 32773 i..Name Street: Covenant Roofing 1410 Emerson St. City, State Zip: Leesburg, FL 34748 Name: Street: City, St, Zip: Bonding Company: Address: Contractor Information Phone: 352-314-3625 Fax: 352-240-3439 State License No.: CCC1329936 Architect/Engineer Information 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. 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: 5rh 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 ether governmental entities such as water management districts, state agencies, or federal agencies. Acceptance of permit is verification that I will notify the owner ofthe property of the requirements ofFlorida 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 constructi n and zoning. Signature of Owner/Agent Date Signature o ontractor/Age Date Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID Contractor/Agent's Name iqlxll z- Date LINDSAY DUCKHAMt Commission # FF 172210 My Commission Expires October 28, 2018 Contractor/Agent is " Personally Known to Me or Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building Electrical Mechanical Plumbing Gas[] Roof Construction Type: Total Sq Ft of Bldg: Occupancy Use: 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 Permit Application City of Sanford 1 ,1Prevention y _ Product Approval Specification Form Permit # Project Location Address 17 Belgian Way Sanford As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the information and product approval number(s) on the building components listed below if they are to be utilized on the construction project for which you are applying for a building permit. We recommend that you contact your local product supplier should you not know the product approval number for any of the applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product Approval can be obtained at www.floridabuildin.g.org. The following information must be available on the jobsite for inspections: 1. This entire product approval form 2. A copy of the manufacturer's installation details and requirements for each product. Category / Subcategory Manufacturer Product Description Florida Approval # include decimal) 1. Exterior Doors Swinging Sliding Sectional Roll Up Automatic Other 2. Windows Single Hun Horizontal Slider Casement Double Hung Fixed Awning Pass Through Projected Mullions Wind Breaker Dual Action Other June 2014 Category/ Subcategory Manufacturer Product Description Florida Approval # including decimal 3. Panel Walls Siding Soffits Storefronts Curtain Walls Wall Louver Glass block Membrane Greenhouse E.P.S Composite Panels Other 4. Roofing Products Asphalt Shingles Certainteed Landmark 5444-R11 Underla ments SDP Inc Palisade 5325-R6 Roofing Fasteners Nonstructural Metal Roofing Wood Shakes and Shingles Roofing tiles Roofing Insulation Waterproofing Built up roofing System Modified Bitumen Single Ply Roof Systems Roofing slate Cements/ Adhesives / Coating Liquid Applied Roofing Systems Roof Tile adhesive Spray Applied Polyurethane Roofing E.P.S. Roof Panels Roof Vents Other June 2014 Category/Subcategory Manufacturer Product Description Florida Approval # include decimal 5. Shutters Accordion Bahama Colonial Roll up Equipment Other 6. Skylights Skylights Other 7. Structural Components Wood Connectors / Anchors Truss Plates Engineered Lumber Railing Coolers/Freezers Concrete Admixtures Precast Lintels Insulation Forms Plastics Deck / Roof Wall Prefab Sheds Other 8. New Exterior Envelope Products Applicant's Signature Applicant's Name / *9 IP NL Please Print) June 2014 9/26/2017 SCPA Parcel View: 18-20-31-505-0000-0120 Pro eprt ''Record Card CAA Parcel: 18-20-31-505-0000-0120 Owner: BRAVO UI YSSIS A 100MITY, e Property Address: 117 BELGIAN 'MAY SANFORD, 2773 Parcel Information Parcel 18-20-31-505-0000-0120 Owner I BRAVO ULYSSIS A Property Address 117 BELGIAN WAY SANFORD, FL 32773 Mailing 162 PINE ISLE DR SANFORD, FL 32773 Subdivision Name BAKERS CROSSING PHASE 1 Tax District S1-SANFORD DOR Use Code 01-SINGLE FAMILY Exemptions.., Legal Description LOT 12 BAKERS CROSSING PH 1 PB 60 PGS 27 - 29 Value Summary 2017 Working 2016 Certified Values Values Valuation Method Cost/Market Cost/Market Number of Buildings 1 1 Depreciated Bldg Value 135,702 128,586 Depreciated EXFT Value Land Value (Market) 34,000 32,000 Land Value Ag uSU f .,„et V ,ue$169,702 160,586 j Portability Adj I Save Our Homes Adj 0 0 Amendment 1 Adj PSG 0 i.$ 0 ...._._- 0 Adj 0 Assessed Value 169,702 160,586 Tax Amount without SOH: $3,219.00 2016- Tr -a 8111 Amount $3,219.00 Tax Estimator Save Our Homes Savings: $0,00 TRH ,1 Notice Does NOT INCLUDE Non Ad Valorem Assessments Taxes Taxing Authority Assessment Value Exempt Values Taxable Value E i County General Fund 169,702 0 169,702 Schools 169,702 0 169,702 itCitySanford 169,702 0 169 702 SJWM( Saint Johns Water Management) 169,702 0 169,702 County Bonds 169,702 0 169,702 . Sales Description I Date Book Page Amount Qualified Vac/Imp WARRANTY DEED 10/1/2014 08353 r~ Q mm 163, 700 . Yes Improved T QUIT CLAIM DEED 4/1/2006 06232 019 100 No Improved WARRANTY DEED 7/1/2003 1q_`. a7 160,100 Yes a Improved WARRANTY DEED 3/1/2003 04766 6t58 281,500 No Vacant Fin: Coo—parablo Sales I Land Method Frontage Depth Units Units Price Land Value LOT 34,000.00 34,000 Building Information Is Bed Bath count incorract'? Click Here, Description Year Built Fixtures Bed Bath Base Area Total SF m Living SF ! Ext Wall Adj Value Repi Value Appendages http:// parceidetail.scpafl.org/ParcelDetailinfo.aspx?PID=l 82031505000001201 /2 9/26/2017 SCPA Parcel View: 18-20-31-505-0000-0120 Actual/Effective 1 : SINGLE 2003 8 3 2.0 mmmm~ 1,740 % 2,579 1,740 CB/STUCCO $135,702 142,844 Description Area FAMILY FINISH SCREEN PORCH 332.00 FINISHED OPEN PORCH 42.00 FINISHED GARAGE 465.00FINISHED Permits Permit # i Description Agency Amount CO Date Permit Date 01435 PAD PER PERMIT 117 BELGIAN WAY iSANFORD 86,718v 6/20/2003 3/1/2003 Extra Features Description Year Built Units Value New Cost No Extra Features http://parceldetail.scpafl.org/ParcelDetailinfo.aspx?PID=18203150500000120 2/2 U ND5" DQWt7cn-) if::^1i1 I'(t'li..l;'''r 301:E1'i011 COUNTY t:.0URT 4:011P T ROL.E_E_R After recording, return to: Covenant Roofing and Construction. Ina 1410 mereon St. Leesburg, FL 34748 Permit No.: Tax Folio No.: Notice of Commencement State of Florida 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 the Property: (legal description ofthe property and street address if availabl Legal Description: W 1.. '64, kris f ,rC 55" nc 'P Street Address: I1: 9L1 Qy, , )G,V n er L 3`)-) 2. General Description of Improvement At j Reroof 3. Owner's Information or Lessee information if the lessee contracted for the improvement: Name: l,,! 1 S A (- G, D Address: 11 (J EL 30 Interest in Property: fl wn t e- Name & Address of fee simple titleholder (if different than owner): 4. Contractor Information Name: Covenant Rooting and Construction, Inc. Address: 1410 Emerson St Leesburg, FL 34748 5. Surety (ifapplicable, a copy of the payment bond must be attached): Name: Address: _ 6. Lender Information: Name: Address: Phone No,: 352.314-3625 Phone No.: Amount of Bond: $ Phone No.: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section713.13(1)(a)7., Florida Statutes: Name: Address: Phone No.: 8. In addition to himself or herself, Owner designates of to receive a copy of the following Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes: Phone No.: Expiration date of notice of Commencement (tile expiration date will be i 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 YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signature of Owner or Les ae, or Owner's or Lessee's Authorized 0/l cer1Direclor1Pariner1Manager e- Signatory's Tille/Office ' The foregoing instrument was acknowledged before me this day of A"A 20_/ by l,e„ For—"'V" who Type ofauthority (i.e. officer, trustee, attorney in fact) Name oftearly an behalf o1 whom instrument was executed is personally known or produced CA P1 1? 13 3 Millrl _ as type of identification. CE'RTt t GRANT MALOY CLEI K 0, CUIT COURT AND O r I_L 9 inned name oNotary Public) NT }A ary P — State of a peorsla pcam sry Gate = 1*1.:_7/EXP1MR EANoticeofCommencement — BF29 (Updated 05/1312013) LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 9/26/17 I hereby name and appoint: --k— k— an agent of. covenant Roofing 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 permit and application for work located at: 117 Belgian Way Sanford Street Address) Expiration Date for This Limited Power of Attorney: License Holder Name: Joseph Rayl State License Number: CCC1329936 Signature of License Holder: STATE OF FLORIDA COUNTY OF Lake The foregoing inistry6ent was acknowledged before me this 26 day of September 20017 by Jose4yrRayl to me or who has producec' identification and who did (d Notary Seal) LINDSAY DUCKHAM Commission # FF 172210 k .= 3. My Commission Expires October 28, 2018 Rev. 08.12) Lindsay Duckham Print or type name Notary Public - State of Commission No. My Commission Expires: who is e personally known UN 1410 Emerson Street, Leesburg, FL 34748 • State Roofing License: CM 329936 • 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 lv sr s I le.1 f Phone 1/0 7 24 Phone (w) Address ( 11-7 PfajQ /1 y Date City d / State Zip ;77-7 Email / /y ( 4 r CA %M In accordance with rpeicifi6ations given below: REROOF: A. SHINGLE ROOF 1. REMOVE OLD ROOF TO WORKABLE SURFACE. I 2. RENAIL ROOF DECK WITH RING SHANK NAILS. ` 3. REPLACE ANY ROTTED WOOD WITH STAN D HEATHING @ $ PER FOOT AND $ PER SHEET OF PLYWOOD, IF ANY. (Initial) 4. INSTALL UNDERLAYMENT OV R ENTIRE ROOF. 5. INSTALL FHANA EAVES DRIP. CO OR 6. INSTALL NEW VALLEY METAL AND FLASHINGS AS NECESSARY. 7. INSTALL 8. INSTALL ABOOTS RESEAL VENTS. O& IBERGLASS SHINGLES. COLORCD r6 JSFo7i (!'i"/ 9. INSTALL FEET OF RIDGE VENT t E$6. COLOR P&J N 10. CLEAN- UP JOB SITE OF ALL WORK DEBRIS A D NAUL AWAY ALL RELATED DEBRIS AND LEAVE JOB SITE CLEAN. il lp COYAR WILL CO DIN E REMOVAL ND NSTALLATI OF R F RELATE ERIP RALS SUCt1NAD7D%T0 LIMITED TO 0R UNITS, SK HTS, TV.ANNDITIONERS, T . REMOVE AND STALLEXISTIN FIT AND FACIA 25 PER FOOT CONTRACT FjA CE, IF REQUITHE COSUWILL BE INAIONTOCONTfRICEANDHERPROVEDBYHWNER. ial) 12. ALL WORK COVERED BY A 5 YEAR WORKMANSHIP WARRANTY. Contract Price $ 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 contr 11QQ ents will commence on approximately and be completed on approximately VAP 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 shallbe 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 mustbe delivered or postmarked before midnight of the third business day after you Q t Q signthis agreement. H me0 j r PortlOn 8. Both worker' s compensation and public liability insurance are carried by the Seller and they are applicable to the work to be US ot`"afom item No. 3 above v performed. UPON COMPLETION9. 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) duringdelivery of materials and/or removal of thework relateddebris 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 driveways) 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. 1;1,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 moneyon 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. Executed in triplicate, one copy of which was delivered to, and receipt is hereby acknowledged by Buyer, this _ day of re 4V5plc! 20. 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 protec your hts. Seal) (X) / Seal) Dealer -Seller) Purchaser Sign Here) BY (X) eltit)/ Z>_1_ eSALMANSeal) Purchaser Sign Here) FORD PRESS, INC. 352-787-4650 (mike) PERMIT # /I - 7is_lp City of Sanford Building Division Residential Re -Roof Scope of Work JOB ADDRESS: 117 Belgian Way Sanford STRUCTURE TYPE: O SINGLE FAM[LYRESIDENCE/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): 1/2" Plywood PLEASE NOTE: ONL Y 100 SQUARE FEET OF THE EAISTING DECK IS PER&HTTED TO BE REPLACED ** ROOF VENTILATION: O OFF -RIDGE O RIDGE O SOFFIT 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 0 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL QSHINGLE Certainteed FL45444-R11 O METAL FL# O MODIFIED BITUMEN FL# O TORCH DOWN FL# O INSULATED FL# O TILE FL# Q OTHER: FL# u 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# 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 code compliance by personal inspection. CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE: 1 I 9 e City of Sanford Building and Fire Prevention RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT#: aD(y ADDRESS: 117 Belgian Way Sanford I Joseph Rayl , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR ROOF G:CONTRATOR 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: CONTRACTOR SIGNATURE: MUST BE SIGNED BY LICEI Covenant R DER) ph Rayl A FINAL ROOF INSPECTION IS REQUIRED: DATE: q. n n- THIS SIGNED AND NO-6111ZED 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 i Sworn to and Subscribed before me this day of 20Uby: Joseph Rayl Who is Personally Known to me or has Produced (type of ide ificati n) R as identification. pY Py LINDSAY DUCKFiAM Si iat re of Notary u lic Commission a FF 172210 ate of Florida .` My Commission ExpiresI .y Lindsay Duckham Print/Type/Stamp Name of Notary Public