HomeMy WebLinkAbout211 Woodmere Blvd - BR18-004372 - REROOFIs
PERMIT APPLICATION
BUILDING DIVISION I L
Application No: 1
Documented Construction Value: $
Job Address: 2/ / aq (),brK _re— 5 IyJ, Historic District: Yes Nov Parcel
ID: Residential f4 Commercial Type
of Work: New Addition Altera 'on Repair f9 Demo El Change of Use move t.
Description
of Work: Plan
ReVio w Contact Pers/on r
l 1j f Title:
neJ 1 - Phone:
l // y J ax: L / il: Property
Owner Information 3'3.3 • 3 3 3 Nartte
A e.i 'A m r- Phone: Street: .
l- ' ! Resident ofproperty?: City,
State Zip: LI Q UCH L %346 Contractor
Information / U
Na ---° " . Phone: 7 ^ ) — b % / hA
Street: v[t' Fax: -/ '26 2::: City,
State Zip: 2170 dtate License No.: e &134T Lo rchitect/
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 COMMENCEMENT Application
is hereby made to obtain a permit to do the work and installationsas 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 alllaws 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 ofapplication and the code in effect as of that date: 6'" Edition (2017) Florida Building Code
NOTICE: In addition to the requirements ofthis 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 isverification that I will notify the owner of the property ofthe 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 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 ValuationTable in effect atthe time thepermit is issued, inaccordance 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,,
J b
Signature of Owner/Agent Date
A.L.AVJ sa-cw-,2LJOG,. Tr4A
Print Owner, Agent's Name
Signature ofNotary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type ofID
Agent
Print G. td r/Agcni's Flami
e/zq ia
ign re ofNotary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
LORRAINE GAETA
R OFFICE USE ONL Notary Public - State of Florida
My Comrn. Expires Jan 25, 2019
J OPEA ,`,' Commission # FF 165086
Permits Required: Building Electrical Mechanical
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
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
Fire Alarm Permit: Yes No
WASTE WATER:
FIRE: BUILDING:
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document
to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California 1
County of V 67A/ J}
On 0- /9 before me, C ,vv h^'1 ? ! V S 641/11-6`
Date Here Insert Name and Title of the Officer
personally appeared *A_-
Nome(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity
upon behalf of which the person(s) acted, executed the instrument.
KENNETH N.RUSHING
Notary Public - California Z
z Ventura County
Z Commission # 2188279
My Comm.r 28, 2021
Place Notary Seal and/or Stamp Above
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature
Signature of Notary Public
Completing this information can deter alteration of the document or
fraudulent reattachment of this form to on unintended document.
Description of Attached Document
Ir
Title or Type of Document: a
Document Date: / 0 _ f 9 lit' Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
Corporate Officer — Title(s):
Partner — Limited General
Individual Attorney in Fact
Trustee Guardian of Conservator
Other:
Signer is Representing:
Signer's Name:
Corporate Officer —
Partner — Limite
Individual
Trustee
El Other
Signer is Representing
d
Title(s):
General
Attorney in Fact
Guardian of Conservator
di_.-zr`_i`'f'd.r.N''"a``_'.`:'&a 3'?.s"`_-a+;;r;dzf
G2017 National Notary Association
M1304-09 (09/17)
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 5
I hereby name and appoint: 14— /YN ryI v"
an agent of. L .IOU111-
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):
All permits and applications submitted by this contractor.
The specific permit and application for work located at:
Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name:
State License Number:
Signature of License Holder:
STATE OF FLORIDA
COUNTY O
The fXgoing m5rument was
20 , by
to me or o-wlte-htts prodtteed
identification and who did (di(
Notary Seal)
LORRAINE GAFTA Notary
Public - State of Florida is 1
Gomm. Expiresin2. 2619 Commission # FF
165086 Rev. 3/
27/07) 32 before
me
this day of 16 whoisXersoidlly
known as tirtint
or
type name Notary Public -
Sta fG Commission No.
My Commission
Expires:
ROOFING
JW t,a
5k nk,v_
LPN? 51 3 9
JTI Roofing Contract
Address: 406 Hermitage Drive Insurance Co.
Altamonte Springs, FL 32701 Adjuster:
Phone/Email: (407) 767-6912/lg@jtiroofing.com Claim #:
State -Certified Roofing Contractor - CCC1325756 Phone:
State -Certified General Contractor - CGC036067
Jan Tukker, Contract j
Customer Name: AJ S!k4w(ep, _r
Address: i 4-q F,1 Y Nr C- Q2kye— Tko,A&n(A0^6 City/State/ZIP
Date: /09,/
Home Phone: /Ge"{ 0 t (P : Work Phone:
Email:
Project Address: vt `i wpCk C l/Y1'Q.('t—
nn
CJ C SAnAV7L —' ;} 42% 3
SPECIFICATIONS/PRICE BREAKDOWN
ITEM TYPE QTY AMOUNT TOTAL
Tear -off shingle
Replace shingle
Replace underlayment b ga -
Hurricane Retrofit
Steep
2nd Story Charge
Valley Material
Drip Edge
Vents 1"
Vents 2" i
Vents 3"
Goosenecks 4"
Goosenecks 10"
Flat Roof N 0
Interio xte
Skylights
Solar Panels
u
Notes:. lea
L
et. X S w 5
N= e 2 ;A Z*/ /
Remove Trash from Roof, Gutters and Yard
Roll Yard with Magnetic Roller
Protect Landscaping Where Applicable
Delivery/Special Instructions:
ITEM TYPE QTY AMOUNT TOTAL
Ridge Vent coh
Off -Ridge Vents
Decking
Lead Boots
Debris Removal
Wood
Shingles -Manufacture:/' Style:
Type:
t ,
Color:
Warranty Labor Byes
Roof 30 V j
Ins e Co.
Initi timated
Am unt
Date:
Insurance Co. Agreed
Amount
Date:
Upgrades
Insurance Supplement
TOTAL Date:
PAYMENT SCHEDULE
ENT PRIOR TO ORDERING MATERIALS
PAYMENT IN FULL UPON COMPLETION
EARNEST DEPOSIT: $500.00 $1000.00 $ S- ,
DOWNPAYMENT $ FINAL PAYMENT $
JAN TUKKER, PRESIDENT
TERMS: THIS AGREEMENT IS "SUBJECT TO" INSURANCE COMPANY APPROVAL. JTI ROOFING IS
AUTHORIZED TO PERFORM WORK AND RECEIVE FULL AMOUNT OF INSURANCE PROCEEDS, INCLUDING
OVERHEAD AND PROFIT, ONLY UPON APPROVAL BY INSURANCE COMPANY.
ACCEPTANCE OF AGREEMENT
The ahove prices, specifications and conditions of this agreement are satisfactory and are hereby accepted. I/We have read and understand the terms and conditionsloca;o on the back of this document/agreement. JTI Roofing is authorized to do the work as specified and in accordance with the terms, conditions and stipulationsoftiu. Homeowner hereby authorizes Insurance Company and/or Mortgage Company to make payment for completed repairs directly to Contractor and
mail insure nce proceeds to Contractor. Homeowner hereby assigns to Contractor their rights to any insurance proceeds from Insurance Company for goods and
services as described in the specifications.
THREE DAY RIGHT OF RESCISSION
THIS WRITTEN AGREEMENT HEREBY SERVES AS NOTICE THAT I MAY CANCEL THIS AGREEMENT AT ANY
TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS AGREEMENT.
Homeowner Approval: A&' - Date:( ! ' - B ^f I
Contractor Approval: Date: /a/,, - l !t
Gran. Malo', Clerk Of The Circuit Court & Comptroller Seminole County, FLInst #20181y23793 Book:9240 Page:264-265; (2 PAGES) RCD: 10/29/2018 10:25:21 AM
REC FEE $18.50
THIS INSTRUMENT PREPARED BY:
Name. Lorraine Gaeta
Address: 406 Hermitage Dnve
Altamonte Springs, Florida 32701
NOTICE OF COM.W. AENCEMENT
CERTIFIED COPY GRANT MALOY
CLERK OF TH =w'RC'tl;T Ct ,Ijpl- ANDC0 •(
BY
Date !`
Permit Number:
Parcel ID Number. _ 06-20-31-505-6E00-0060
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 PROPERTY: (Legal description of the property and street address if available)
2. GENERAL DESCRIPTION OF IMPROVEMENT:
re -roof with asphalt shingles
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: Alan Satteriee Trust 1458 El Monte Drive Thousand Oaks CA 91362
Interest in property: Fee Simple
Fee Simple Title Holder (If other than owner listed above)
Address:
4. CONTRACTOR: Name: Jan Tukker, Inc. Phone Number. 407-767-6912
Address: 406 Hermitage Drive Altamonte Springs Florida 32701
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
Address: Amount of Bond:
6. LENDER:
Address:
Phone Number.
T. Persons within the State of Florida Designated by Owner upon whom notice or other documents maybe served as provided by Section
713.13(1)(a)7., Florida Statutes.
Name: Phone Number.
8. In addition, Owner designates Of
to receive a copy ofthe Liences Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number.
8. Expiration Date of Notice of Commencement (The expiration is 1 year from 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 WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signature of Omer or Lessee, or Owners or Lessees (PrintNome and ProNdoSignatory* Tgleloffte)
Authorized OracedDiredadPartmenfManager)
State of County of
The foregoing Instrument was acknowledged before Is day of .20
by . Who is personally known to me OR
Name ofpersm meting t
who has produced Identification O ofIdentl cation produced:
SEAL +
Notarysionatare
Book 9240 Page 265
Instrument# 2018123793
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document
to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of 1-A/(1/4Q* I
On A) r r' l9" before me, tJi 6PPi4- /U keV5 ljz,u
Date Here Insert Name and Title of the Officer
personally appeared
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity
upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the
KENNETH N.RUSHING laws of the State of California that the foregoing
Notary Public - Caliromia LL,
paragraph Is true and correct. Ventura County b
Commission'2188279 WITNESSMyComm. Expires Mar28.2t)2t my hand and official seal.
Signature
Place Notary Seal and/or Stomp Above Signature of Notary Public
yr r wr h
Completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: _ A d`Tlrni ,lr Ca A,,f Nri—
Document Date: 16 - ( 9 — 4r Number of Pages: t'
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
Corporate Officer — Title(s):
Partner — Limited General
Individual Attorney In Fact
Trustee Guardian of Conservator
Other:
Signer Is Representing:
2017 National Notary Association
Signer's Name:
Corporate Officer — Title(s):
Partner — Limited General
Individual Attorney in Fact
Trustee Guardian of Conservator
Other:
Signer is Representing:
M1304-09 (09/17)
CITY OF
NANFORD'
FIRE DEPARTMENT
PERMIT # — 14 3 7 L.
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS:
STRUCTURE TYPE: GLE 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): I
PLEASE NOTE: ONLY 700 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED"
ROOF VENTILATION: DOFF -RIDGE W'RfDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS TIIAN 2: 12 2 -4:12 O 4:12 OR GRE ATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE l ' J' FL#
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED 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#
OINSULATED FL#
O TILE FL#
0 OTHER: FL#
CITY OF
Building & Fire Prevention DivisionSkNFORDRESIDENTL4LREROOFPOLICY & 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 INA 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 RES AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN PROFESSIONAL (
ARCHITECT OR ENGINEER), CERTIFYING FBC DE COMPLIANCE BY PERSONAL INSPECTION. CONTRACTOR (
OR OWNER/BUILDER) SIGNATURE: DATE: (d
SCPA Parcel View: 06-20-31-505-OE00-0060 Page 1 of 2
Property Record Card
Parcel: 06-20-31-505-OE00-0060
Property Address: 211 WOODMERE BLVD SANFORD, FL 32773
Parcel Information
Parcel 06-20-31-505-OE00-0060
Owner(s) OATTERLEE, ALAN - Trustee
Property Address 211 WOODMERE BLVD SANFORD, FL 32773
Mailing 1458 EL MONTE DR THOUSAND OAKS, CA 91362-2124
Subdivision Name WOODMERE PARK 2ND REPLAT
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions
a
wrr
i 61 •1 •1 6 1
ifi t Iri
Value Summary
2019 Working 2018 Cert
Tax Estimator
Save Our Homes Savings: $0.00
Does NOT INCLUDE Non Ad Valorem Assessments
Values
ified
Values
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 40,385 38,988
Depreciated EXFT Value 800 800
Land Value (Market) 17,088 17,088
Land Value Ag
Just/Market Value " 58,273 56,876
Portability Adj
Save Our Homes Adj 0
t
0
Amendment 1 Adj 3,486 7,070
P&G Adj 0 0
Assessed Value 54,787 --- 49,806
http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=0620315050E000060 10/29/2018
r CITY Of
SkNFORD
FIRE DEPARTMENT
Building & Fire Prevention Division
RESIDENTIAL RE-R 0OF A FFIDA VIT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT#: gV ADDRESS: Zit W19 )i) W`d
AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
LX4?,,<TOR, ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
FOREG RMATION 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 #: l _
CONIPAN 1' / CONTRACTORS , CONTRACTOR
SIGNATURE: DATE: MUST
BE SIGNED BY LICENSE }iOLDER O WNER/B DER) vv
A
FINAL ROOF INSPECTION IS REQUIRED: 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-'5_efflC4'2ok' Sworn
to and Subscribed before me this day of OC, 20 g by: Who
is Personally Known to me or has Produced (type of i
ntificatn as identification. Si atu
a of Notary Public tat e
o Florida LORRAINE G Notary Public
Flo ateof rmt/ a/
Starr Name My comrn.
Expires Jan 25, 2019 YP P `
3''' commission ; FF
165086 of Notary
Public