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HomeMy WebLinkAbout2214 S Sanford AveP, ECIEIV ED OCT 8 2616 CITY OF SANFORD BUILDING & FIRE PREVENTION Bx: .J PERMIT APPLICATION Application No: J (0 Documented Construction Value: $ % Job Address: ZZ14 .9- y,4-'VA:2540 04 Historic District: Yes No Parcel ID: 9 & - 19 - 30- S-Zeo - OA 00. 00 40 Residential ® Commercial Type of Work: New Addition Alteration Repair Demo Change of Use Move Description of Work: 1(2W0X'*8Mn1—'LL&P LANO,d1A 9AW 0001 r JPS 4-t L 5-¢ ¢ - Plan Review Contact .Person: i L U rteff _ 1\1.1.Ui I (.0 Title: Phone: X 407 _ q D2i -232C)Fax: Email: x CI C i7Z11 S bCJ%1 h e -i Property Owner Information Name 606AN & 6(LMAf_r n.l Street: ZZ/¢ S SkiUKD" s d City, State Zip: S. iWiep 3 Z 777 % Phone: Resident of property? : Contractor Information Name 04L XAI'aY u/J1 14C%?iQ.S rC-tJC, Street: 3 S FiS/-f1G` N City, State Zip: ©4L4,JQ6 F4 3280¢ Phone: Fax: State License No.: e W 45_44g.i 2 Architect/Engineer Information Name: /V 4 Phone: Street: City, St, Zip: Bonding Company: 01/A Address: 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. t 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: 5th 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 construction and zoni Signature of0,Amer/Agent Date Signature ontractor/Agent Date I Scl:l t c t / Print Owner/Agent's Name e of Notary-Stalof Florida D e 11(14/V I C O Print Contractor/Agent's Name Sig azure (Notary-tateo lorida ate Owner/Agent is Personally Known to Me or Contractor/Agent ' Personally Known to Me or Produced ID Type of ID Produced lD Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building Electrical Mechanical Plumbing Gas F] Roof Construction Type: Total Sq Ft of Bldg: Occupancy Use: Flood Zone: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes No # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes No WASTE WATER: BUILDING: eviSe0' Stuin16 J& 2b13 Niiliit A{ Fml lw Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: I,4 460Aedw ,1oN/C'D hereby acknowledge that I personally inspected 4.Roof deck nailing and/or K,Secondary water barrier work at Z2 / *' 5- - S/¢NYVWA /V% and have determined that the work Job Site Address) was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.) I certify that my statements herein are true and accurate to the best of my belief and that I fully understand that making any false statements in writing with the intent to mislead a public servant in the performance of his or her offici4uty shall constitute a misdemeanor of the second degree pursuant to Section 837.06 F.S. — / jI Signature of Con#tom Date ae-//., 1&0 6j/0a 0-02e0s-6 es -z. Printed Name of Contractor License # License Type: General 0 Building Residentiao—<Roofing Contractor or any individual certified in accordance with F.S. 468 to make such an inspection. STATE OF FLORIDA COUNTY OF O's cfnI Q Sworn to (or affirmed and subscribed before me this day of ,' , 20 V , by Cje,orne [A. M , who is Personally .Known to me or has r_ roduced (type of i tific ion) as identification. re of N6thry Public Print/Type/Stamp Name of Notary Public , pn Pu Notary Public State of Florlde Jakayla M Jacobs My commission FF 999615 a? ofnd Expires 0610712020 3 Florida Certified Roofing License # CC 0056852 355 Mashie Lane Orlando FL 32804 Florida Certified Building License # CB 0045636 407-254-0877 — Fax: 407-254-0876 Cell: 407-9.08-2820 — e-mail: kcigm@bellsouth.net ppo OS40 00jttra cA Proposal Submitted to: CUSTOMER: ADDRESS`. CITY STATE: ZIP PHONE #: 6&n 6t't.4*ier1iy 22/1y , OW)OV449 w A 3 277/ SCOPE OF WORK: 2 year warranty on workmanship; see manufacture's specific material warranty Sloped Roof; Remove existing roof covering; to sheathing and re -nail sheathing to 2014 FL building code Install ASTM approved synthetic underlayment;_ Install "peel & stick" Secondary Water Barrier Install standard 30# _ felt underlayment; Install ridge vent; 4' off ridge vent; _math ventJX kitchen vent Qnstali new lead vent stack covers; K, Install new galvanized metal drip edge..color TBD Instal 13 tab fiberglass; 25 year _; 30 year _shingles - color TBD Install Architectural "Limited Lifetilne" fiberglass shingles - color TBI? Install "other" type of shingles _`_ _the metal Clean site and remove debris Re . ove existing roof covering to decking re -nail sheathing to code Instal # base sheet; Install galvanized r1kedge (color TBD) Install T BS Modified Bitumen System; _ In 1.1 SA SBS Modified :Bitumen system –granulated with color TBD Install built,, roof systems with: Install base sheet; Install plys of pty I or ply V Install gals zed gravel stop and flashing as required; tall pitch pans drain covers ; scuppers _ Slag roof with ling stones (400 lbs. Per 100 sq. ft.) install lead vent.stack covers bath vents ; kitchen vents colo BD Install _ TPO; _ EP DIM; _ VC; _Urethane, —Ac rylic – Single Ply stem Clean site and remove debris fascia and rafter tails for existing: damage: if i cost. This amount will be above the Contract S t?iN F¢-N ©•vim 4--,c4y 14-7,v Dollars Payment Schedule: Z, This proposal is good for 15 days and may be voided thereafter at the option of the contractor. All material is guaranteed to Be as specified. All work will be completed according to standard building practices and in a timely manner. Any alterations or deviations from the above specifications involving additional costs will be executed upon oral and/or written orders and will become an extra charge item — over and above the Contract Sum. Although we will exercise all due caution, we cannot be held responsible for breakage of sprinkler systems, or cracked driveways and/or walks. Acceptance of Proposal: The above prices, specifications and conditions are hereby accepted. Killarney Contractors, Inc., is authorized to do the work as specified. Payment will be as noted. J agree that if K:illarney Contractors, inc., is required to take any action to enforce this contract, I shall pay Killarney Contractors, W., attomey's fees and costs, whether or not suit is filed. Venue in any lawsuit shall be in Orange County Florida. The Owner also agrees to pay 1.5% interest per month on the unpaid balance. r—' Accepted By: Date: Submitted By: Date: lolls -11(461(46 Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: —10- 1 hr -1-4 I hereby name and appoint: j—AK—A-YLA -Tt+ -C 0 3 _45 an agent of: Kt. (2-:3 0") 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: 22. (4{ 54AJ1909-4? Aux - Street Address) Expiration Date for This Limited Power of Attorney: A- 34, - 1Z. License Holder Name: State License Number: Signature of License Holder: STATE OF FLORIDA COUNTYOF Or4note- 0 The foregoing instrument was acknowledged before me this 20&j by _G&Ar"— to me or L;iowho has proclucel Ro,6&0- b6,itr C. A -f; +; A 6n did (did not) take an oathU. I Iti " itVan Notary Seal) Rev. 08.12) 80' day of &40 be-, Print or type name Notary Public - State- ofF/o "4 Commission No. Tif qjq660 My Commission Expires: ilLa Q4.10 SCPA Parcel View: 01-20-30-517-0000-0050 Property Record Card Owlaf9f'CfA Parcel: 01-20-30-517-OCOO-0050 Owner: GERMAIN MICHAELA S Property Address: 117 SHANNON DR SANFORD, FL 32773 Parcel Information Parcel 01-20-30-517-0000-0050 Owner GERMAIN MICHAELA S Property Address 117 SHANNON DR SANFORD FL 32773 Mailing 127 STONE GATE S LONGWOOD, FL 32779 - Subdivision Name SOUTH PINECREST Tax District S1 ANFORD DOR Use Code 01 -SINGLE FAMILY Exemptions 01 U Seminole County GIS Page 1 of 2 Value Summary 2017 Working 2016 Certified Values Values Valuation Method Cost/Market Cost/Market I Number of Buildings 1 1 Depreciated Bldg Value $33,655 $32,837 1I Deprecated EXFT Value p. $ 1 231 $ 301 Building Information Description Year Built IFixtures Bed (Bath I Base Area Total SF Living SF I Ext Wall Adj Value Repl Value Appendages Actual/Effective 1 SINGLE 1955 3 2 1_0 1,068 , 1,448 1,068 ; CONC $33,655 $61,190 Description Area FAMILY BLOCK 56.00 http://parceldetail.scpafl.org/ParcelDetaillnfo.aspx?PID=01203051700000050 10/18/2016 Land Value (Market) $12,000 12,000 Land Value Ag Just/Market Value $46,886 46,138 Portability Adj Save Our Homes Adj ` $0 Amendment 1 Adj $0 0 P&G Adj $0_.__.0-____..__-, Assessed Value $46,886 46,138 Tax Amount without SOH: 924.86 2016 Tax Bill Amount 924.86 Tax Estimator Save Our Homes Savings: 0.00 Does NOT INCLUDE Non Ad Valorem Assessments Building Information Description Year Built IFixtures Bed (Bath I Base Area Total SF Living SF I Ext Wall Adj Value Repl Value Appendages Actual/Effective 1 SINGLE 1955 3 2 1_0 1,068 , 1,448 1,068 ; CONC $33,655 $61,190 Description Area FAMILY BLOCK 56.00 http://parceldetail.scpafl.org/ParcelDetaillnfo.aspx?PID=01203051700000050 10/18/2016 SCPA Parcel View: 01-20-30-517-0000-0050 Permits Permit # Description Agency Amount CO 01542 ADDITION - RESIDENTIAL SANFORD 500 00960 ADDITION - RESIDENTIAL SANFORD 569 Extra Features Description Year Built Units w _Value SHED 10/1/2006 1 , SCREEN PATIO 1 10/1/ 2006T Page 2 of 2 OPEN PORCHFINIS FINISHED CARPORT 261.00 III UTILITY 63.00 UNFINISHED s Permit Date 3/20/2006 12/14/2004 New Cost 280 f 951 500 1,500 http://parceldetail.scpafl.org/ParcelDetaillnfo.aspx?PID=01203051700000050 10/18/2016 Comments Archived Product Manufacturer Address/Phone/Email Authorized Signature Technical Representative Address/Phone/Email Quality Assurance Representative Address/Phone/Email Category Subcategory Compliance Method Florida Engineer or Architect Name who developed the Evaluation Report Florida License Quality Assurance Entity Quality Assurance Contract Expiration Date Validated By Certificate of Independence Referenced Standard and Year (of Standard) Equivalence of Product Standards Certified By Sections from the Code Atlas Roofing Corporation 2000 RiverEdge Parkway Suite 800 Atlanta, GA 30328 770)946-4571 mcollins@atlasroofing.com Meldrin Collins mcollins@atlasroofing.com Roofing Underlayments Evaluation Report from a Florida Registered Architect or a Licen: Professional Engineer i,e' Evaluation Report - Hardcopy Received Zachary R. Priest PE -74021 UL LLC 12/31/2020 Locke Bowden W Validation Checklist - Hardcopy Received FL16226 R2 COI ATL13001.2 2014 FBC Product Evaluation Re FINAL.pdf 1507.2.3 nnn llfl n4zny nnrnm=wGFVXOwt.Dag... 1/21/201f orida Building Code Online 1507.2.8 1507.3.3 1507.4.5.1 1507.4.5.2 1507.5.3 1507.5.3.2 1507.7.3 1507.7.3.2 1507.8.3 1507.8.3.2 1507.9.3 1507.9.3.2 1507.9.5 1518.4 Product Approval Method Method 2 Option B Date Submitted 04/19/2015 Date Validated 04/20/2015 Date Pending FBC Approval 04/23/2015 Date Approved 06/22/2015 Summary of Products Page 2 of FL # Model, Number or Name Description 16226.1 Gorilla Guard EverFelt Spec 30 ASTM D 6757 & ASTM D 226, Type II underlayment Limits of Use Installation Instructions FL16226 R2 II ATL13001.2 2014 FBC Product ovalApprovedforuseinHVHZ: Yes Approved for use outside HVHZ: Yes Report - FINAL.pdf Impact Resistant: N/A VerifiedBy: Zachary R. Priest 74021 Design Pressure: N/A Created by Independent Third Party: Yes Other: See evaluation report for limits of use Evaluation Reports FL16226 R2 AE ATL13001.2 2014 FBC Product Eve Report - FINAL.pdf Created by Independent Third Party: Yes 16226.2 SUMMIT & SUMMIT 60 Synthetic underlyaments for steep slope roofing Limits of Use Installation Instructions FL16226 R2 II ATL13001.2 2014 FBC Product EvalApprovedforuseinHVHZ: Yes Approved for use outside HVHZ: Yes Report - FINAL.pdf Impact Resistant: N/A Verified By: Zachary R. Priest 74021 Design Pressure: N/A Created by Independent Third Party: Yes Other: See evaluation report for limits of use. Evaluation Reports FL16226 R2 AE ATL13001.2 2014 FBC Product Evi Report - FINAL.l) Created by Independent Third Party: Yes Back Next Contact Us :: 1940 North Monroe Street Tallahassee FL 32399 Phone: 850-487-1824 The State of Florida is an AA/EEO employer. Copyright 2007-2013 State of Florida.:: Privacy Statement :: Accessibility Statement :: Reft Under Florida law, email addresses are public records. If you do not want your e-mail address released in response to a public -records requ electronic mail to this entity. Instead, contact the office by phone or by traditional mail.. If you have any questions, please contact 850.487. to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Departmer address if they have one. The emails provided may be used for official communication with the licensee. However email addresses are publdonotwishtosupplyapersonaladdress, please provide the Department with an email address which can be made available to the public. you are a licensee under Chapter 455, F.S., please click here . Product Approval Accepts: sQcurity. =cs 5vzny9nnrnm=WCTFVX0wt.D01;... 1/21/2011 CREEK TECHNICAL SERVICES, LLC I IMITATIANS ATLAS ROOFING CORPORATION Underlayments 1) Fire Classification is not within the scope of this evaluation. 2) Wind uplift resistance in not within scope of this evaluation. 3) Installation of the evaluated product shall comply with this report, the FBC, and the manufacturer's published application instructions. Where discrepancies exist between these sources, the more restrictive and FBC compliant installation detail shall prevail. 4) Deck substrates shall be clean, dry, and free from any irregularities and debris. All fasteners in the deck shall be checked for protrusion and corrected prior to underlayment application. 5) The roof deck shall be constructed of closely fitted sheathing for new or existing construction. Roof deck shall be installed in accordance with FBC requirements. 6) All underlayments shall be installed with the roll length parallel to the eave, starting at the eave, and lapped in success courses installed up the deck in a manner that effectively sheds water from the deck. End laps shall be staggered between courses in accordance with the manufacturer's application instructions. 7) Roof coverings shall not be adhered directly to the underlayment. 8) The underlayment may be used as described in other current FBC product approval documents. 9) The underlayment shall be exposed on the roof deck for a maximum 30 days unless otherwise stated. 10) All products listed in this report shall be manufactured under a quality assurance program in compliance with Rule 61G20-3. CnMa1 IANC -'F STATEMENT The products evaluated herein by Zachary R. Priest, P.E. have demonstrated compliance with the 2014 Florida Building Code as evidenced in the referenced documents submitted by the named manufacturer. V%111111111111 PaYpq 2015 03 3 0 09:12:02No74021 ' 04'00' STATE OF .' 41J„ 0 '• ': 4 O Fi 104'. , % Zachary R. Priest, P.E. 0 N q; ?` `` Organization No. Florida l on No. 021 ANE9641 CERTIFICATION OF INDEPENDENCE CREEK Technical Services, LLC does not have, nor will it acquire, a financial interest in any company manufacturing or distributing products under this evaluation. CREEK Technical Services, LLC is not owned, operated, or controlled by any company manufacturing or distributing products under this evaluation. Zachary R. Priest, P.E. does not have, nor will acquire, a financial interest in any company manufacturing or distributing products under this evaluation. Zachary R. Priest, P.E. does not have, nor will acquire, a financial interest in any other entity involved in the approval process of the product. END OF REPORT ATL13001.2 FI -16226-R2 Page 3 of 3 This evaluation report is provided for State of Florida product approval under Rule 61G20-3. The manufacturer shall notify CREEK Technical Services, LLC of any product changes or quality assurance changes throughout the duration for which this report is valid. This evaluation report does not express nor imply warranty, installation, recommended use, or other product attributes that are not specifically addressed herein. CREEK TECHNICAL SERVICES, LLC ATLAS ROOFING CORPORATION Underlayments Gorilla Guard® EverFelt Allowable roof coverings: Asphalt shingles, metal roof panels and shingles, Spec 30 - Continued wood shakes and shingles, and slate shingles. Clay and concrete tiles are allowable when installed with ASTM D 6830, ASTM D 249 organic cap sheet, or other approved underiayments in accordance with FBC requirements. Summit® ASTM D 226, Type If alternative underlayment made from inorganic, woven polypropylene fabric dual -coated with resin for steep slope roof applications. Rolls are a nominal 48 -inch wide by 250 -ft long. Unless otherwise noted, the following application details shall be followed for New and Existing construction. Deck: In accordance with FBC requirements; New construction in the HVHZ shall be in. 19/32 in. plywood Min. slope: 2:12 and in accordance with FBC requirements Attachment for 2:12 to 4:12: Mechanically fasten to deck in accordance with Manufacturer's published application instructions and FBC requirements; Min. 24 in. head lap and 12 in. end lap. Attachment > 4:12: Mechanically fasten to deck in accordance with Manufacturer's published application instructions and FBC requirements; Min. 4 in. head lap and 12 in. end lap Allowable roof coverings: Asphalt shingles, metal roof panels and shingles, wood shakes and shingles, and slate shingles. Summit® 60 ASTM D 6757, ASTM D 4869, Type II and ASTM D 226, Type II alternative underiayment made from inorganic polypropylene fabric with woven polymeric scrim for steep slope roof applications. Rolls are a nominal 48 -inch wide by 250 -ft long. Unless otherwise noted, the following application details shall be followed for New and Existing construction. Deck: In accordance with FBC requirements; New construction in the HVHZ shall be in. 19/32 in. plywood Min. slope: 2:12 and in accordance with FBC requirements Attachment for 2:12 to 4:12: Mechanically fasten to deck in accordance with Manufacturer's published application instructions and FBC requirements; Min. 24 in. head lap and 12 in. end lap. Attachment > 4:12: Mechanically fasten to deck in accordance with Manufacturer's published application instructions and FBC requirements; Min. 4 in. head lap and 12 in. end lap Allowable roof coverings: Asphalt shingles, metal roof panels and shingles, wood shakes and shingles, and slate shingles. ATL13001.2 FI -16226-R2 Page 2 of 3 This evaluation report is provided for State of Florida product approval under Rule 61 G20-3. The manufacturer shall notify CREEK Technical Services, LLC of any product changes or quality assurance changes throughout the duration for which this report is valid. This evaluation report does not express nor imply warranty, installation, recommended use, or other product attributes that are not specifically addressed herein. CREEK' TECHNICAL SERVICES, LLC EVALUATION REPORT Manufacturer: Atlas Roofing Corporation 2000 Riveredge Parkway, Suite 800 Atlanta, GA 30328 770) 612-6267 http://www.atlasroofing.com Manufacturing Plants: Meridian, MS Calgary, Alberta Canada Gujarat, India Quality Assurance: UL LLC (QUA9625) SCOPE Category: Roofing Subcategory: Underlayments Code Sections: 1507.2.3, 1507.2.8, ATL -101-02-01 1507.3.2, 1507.8.3, Properties: Physical properties REFERENCES 2006 Entity PRI Construction Materials Technologies (TST5878) PRI Construction Materials Technologies (TST5878) PRI Construction Materials Technologies (TST5878) PRODUCT DESCRIPTION AND APPLICATION Certificate of Authorization No. 29824 17520 Edinburgh Dr Tampa, FL 33647 813) 480-3421 2014 FLORIDA BUILDING CODE Issued March 30, 2015 1507.3.3, 1507.4.5.1, 1507.4.5.2, 1507.5.3, 1507.5.3.2, 1507.7.3, 1507.8.3.2, 1507.9.3, 1507.9.3.2, 1507.9.5, 1518.4 Report No. Standard Year ATL -033-02-01 ASTM D 226 2006 ATL -101-02-01 ASTM D 6757 2007 Mechanically fasten to deck in accordance with ASTM D 226 2006 TAS 117(B) 1995 in. end lap. ASTM D 1781 1998(2012) ATL -134-02-01 ASTM D 6757 2007 and FBC (HVHZ) requirements; Min. 4 in. head lap ASTM D 226 2006 Attachment (Non-HVHZ) > 4:12: ASTM D 4869 2005e1 Gorilla Guard® EverFelt ASTM D 6757 and ASTM D 226, Type 11 mechanically fastened underlayment made Spec 30 from asphalt -saturated organic felt reinforced with glass fiber for steep slope roof applications. Rolls are a nominal 36 -inch wide by 72 -ft long. Unless otherwise noted, the following application details shall be followed for New and Existing construction. Deck: In accordance with FBC requirements; New construction in the HVHZ shall be in. 19/32 in. plywood Min. slope: 2:12 and in accordance with FBC requirements Attachment for 2:12 to 4:12: Mechanically fasten to deck in accordance with Manufacturer's published application instructions and FBC requirements; Min. 19 in. head lap and 6 in. end lap. Attachment (HVHZ) for > 4:12: Mechanically fasten to deck in accordance with Manufacturer's published application instructions and FBC (HVHZ) requirements; Min. 4 in. head lap and 6 in. end lap. Attachment (Non-HVHZ) > 4:12: Mechanically fasten to deck in accordance with Manufacturer's published application instructions and FBC requirements; Min. 2 in. head lap and 4 in. end lap ATL13001.2 FL16226-R2 Page 1 of 3 This evaluation report is provided for State of Florida product approval under Rule 61 G20-3. The manufacturer shall notify CREEK Technical Services, LLC of any product changes or quality assurance changes throughout the duration for which this report is valid. This evaluation report does not express nor imply warranty, installation, recommended use, or other product attributes that are not specifically addressed herein. CCE 10172016_0004.jpg https:Hmail.google.com/_/scs/mail-static/_/j s/k=gmail.main.en.OyLt... CITY OF SANFORD BUILDING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit t#: 60 A d I h t_4_.... hereby acknowledge that 1 personally inspected Roof deck nailing and/or K$econdary water barrier work at j' N,' and have determined that the work Job Site Address) was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 i .S.) T certify that my statements herein are true and accurate- to the best of my belief and that 1. fully understand that making any false statements in writing with the intent to mislead a public servant in the performance of his or her official duty shall constitute a misdemeanor of the second degree pursuant to Section 837.06 F.S. Signature of Cont eto - Date Printed Name of Contractor License License Type::: General Building ResidentiaV<Roo ring Contractor LA or any individual certified in accordance with F.S. 468 to make such an inspection. STATE OF FLORIDA COUNTY OF , Sworn to or affil me) nd s scribed before me this day of '20 b , by 7 , who is Personally Known to me or has rotluced {type of id ' tifi • ' n) as identification. SEAL) Si i ture ofNdtary Public v St t . f For` . , Print/Typei' tamp Name of Notary Public rasa Notary Pubk State of Florida Jakayla M Jacobs My Cie mthisms on FF 999616 a ,l i o,or zozo 3 1 of 1 10/27/2016 3:04 PM