Loading...
HomeMy WebLinkAbout229 Loch Low DrT CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION 6 2016 Application No: Documented Construction Value: $ o Job Address: 2,21 tcdl Parcel ID• .ZD-30,-S—Q hCY 6 Type of Work: New Addition Alteration Re Description of Work: l S ?fie;71 Z Plan Review Contact Person: Phone: Fax: J Gro°Covsti„ y! LopartyOwner Informationotly e Cr 44 9 Name VW LP.A Lo.v La«d Tr} a Fta.-`ilk la...W+,,•,IPhone: Street: 43f 3&,.A uves 1 5, . -e q o yp City, State Zip: .4144 &" 1 c Spa: y Ek 3 a 7/ It Name e y` S 4 Street: OK City, State Zip: AA Ak Historic District: Yes No Residential Commercial Change of Use Move Title: J Resident of property? : Contractor Information Phone: Fax: J yZ-7,State License No.: Architect/Engineer Information Name: Street: City, St, Zip: Phone: Fax: 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, 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: 5" Edition (2014) Florida Building Code Revised: June 30, 2015 Permit Application 4\'6 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 zoning. ignature of Owner/Agent ate S gnature of Contractor/Agent Date Pf CQ.S W. C Aa l Print Owner/Agent' Owner/Agent Produced ID Florida Date Siat,r'f N F rida Date MONICA JA SPE :a;.. MONICA JASPE My COMMISSION #FF184052 _ :°` EXPIRES December 28, 2018 My COMMISSION #FF184052 m `.'FBF n` •. EXPIRES December 28, 2018 crsvrrarry-T%.nown io tvie or Contractor - -4-4 Type of ID Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY F.3 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 APPROVALS: ZONING: ENGINEERING: COMMENTS: of Heads UTILITIES: FIRE: Flood Zone: of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes No WASTE WATER: BUILDING: Revised: June 30, 2015 Permit Application or County of Seminole Permit Number: Parcel ID Number: 10 •- F0 -30 -75-G (J 04 cc --016 0 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. DESCRIPTION OF PROPERTY: (Legal des ription of the property and street address if available) l'i0l ?3t::; :3/l_TI[1'dOLE C:01MTY GE ERAL D SCRIPTION OF IMPROVEMENT:BK 87 1:19 l CLERK'S x 2 1161114.12 f! I11" S % 'le"S'REt_0M],L:I :ii1,':u':?I:Ia ; iia ' :1..:_ l'! I`ZEC--01)ED L'Y lideFlore OWNER INFORMATION: Name: i .I Address: Fee Simple Title Holder (if other than owner) Name: Address: CONTRI Name: Address: Q e Persons within the State of Florida Designated by Owner upon whom as provided by Section 713.13(1)(b), Florida Statutes. Name: In addition to himself, Owner Designates aew r-_other documents may bqp COPY—MARYANNEMORSE Q CLERK. OF -rHE CIRCUIT CO&TAND % • i UEP TY L .(st4 To receive a copy of the Lienor's No ice as Provided in Section 713.13(1)(b), Florida Statutes. Expiration Date of Notice of Commencement (The expiration date 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. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. r Owner's Signature Owner's Printed Name Florida Statute 713.13(1)(g): " The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead." e MY COMMISSION #FF184052 of o?' EXPIRES December 28, 2018 State of Count of t i7y (407) 398-0153 // FloridallotaryService.corn The foregoing instrument was acknowledged before me this day of D/; `t' , 20 by1 rKc 1.d .Who is personally known to me L Name of person making statement 1 SCPA Parcel View: 10-20-30-5CU-0000-0160 Page 1 of 2 Property Record Card CFA Parcel n: p 20-30-5(,U OG00n 6r Owner: LNICSr yNF S£1P:Jfid: Gt7tAYTV, 4'ii%Tffi.kt Property Address: 229 LOC Lt tr,' _;` SAN ,;ERR Fl -:32773-5549 Parcel Information Value Summary Parcel 10-20-30 5CU-OGOO-0160 vv . 2017 Working2016 Certified f Owner I KOENIGSMANN MATTHEW R _.. Values Values Valuation Method Cost/Market Cost/MarketPropertyAddress1229LOCHLOWDRSANFORD, FL 32773-5549 Number of Buildings 1 1 Mailing 229 LOCH LOW DR SANFORD FL 32773-5549 Depreciated FT Value $ 77,365 $74,545SubdivisionName De j r lJC EN E Kt E L Precated EX Tax District' SI SANFORD -- - - - Land Value (Market) $21,000 $21,000 DOR Use Code 01 SINGLE FAMILY-_ -- - - ---- Land Value Ag Exemptions 00 HOMESTEAD(2014) -- --- ju,x m Lt v.a,i a $98,365 $95,545 Portability Adj Save Our Homes Adj $22,862 $20,567 Amendment 1 Adj E P&G Adj - $0 $0 Assessed Value $75,503 $74,978 Tax Amount without SOH: $1,101.91 2018 Ttix ii trot: urt $689.90 T'ax Esmatar Save Our Homes Savings: $412.01 Does NOT INCLUDE Non Ad Valorem Assessments Legal Description LOT 16 BLK G HIDDEN LAKE UNIT 1-D PB 17 PG 58 Taxes Taxing Authority Assessment Value Exempt Values Taxable Value I I-- _. T... __ -- ---- City Sanford $75,503 50,000 = $25,503 w,. 75,503 $50,000 ! $25,503SJWM(Saint Johns Water Management) i County Bonds $75,503$50,000 $25,503 County General Fund $75,503 $50,000 $25,503L_... Schools - - 75 503 $25,000 $50,503 Sales . Description Date Book Page Amount Qualified Vac/Imp PROBATE RECORDS 6/1/2013 ' 62 0632 $100 ' No Improved QUIT CLAIM DEED 4/1/1983 1 '9' $3,000 NomP roved WARRANTY DEED 3/1/19810 132 1t c, $47,900 Yes Improved QUITCLAIM DEED 3/1/1979 01216 $100 No Vacant I Find Comparable Sales !. Land Method Frontage Depth Units Units Price Land ValueValu_ LOT 0.00 0.00 1 $21,000.00 ', $21,000 Building Information Year BuiltiDescriptionActual/Effective ' Fixtures Bed Bath Base Area I Total SF Living SF Ext Wall € Adj Value Rep] Value Appendages 1 1980 6 - 3 2 9 1,219 1,702 1,219 $77,365 $94,061 Description Area http://parceidetail.scpafl.org/Parcel Detail l nfo. aspx?PID=10203 05C U OG000160 10/26/2016 ROOFING R US SYSTEMS, INC. PO BOX 950870, LAKE MARY, FL 32746 CCC1326878 Job Address: 229 Loch Low Dr Sanford, Fl Project Name: Lucas Evans P.O. Number: 16-229 Job Description of Propose Work Removal of the old roof system. Inspection of the roof deck. Removal and replacement of the damage/rotten roof deck, included in proposal and as needed. Additional charge at the end of the build, roof deck at $2.25 per linear foot, fascia at $2.75 per foot, and reinforcement at $3.15. Re -nailing of the roof deck as per Florida Code Building. Installation of all the roof accessories, off ridge vent, lead flashing, etc... Installation of the valley flashing as per manufacturer specification. Installation of the drip edge as per Florida Building code. Installation of the shingles according to manufacturer specification. (Architectural 30yr ) Disposal of all debri as per state regulation. Note: The propose amount includes the labor and the material, permit fees, and dump fees. Job Cost: $7,000.00500 Crockett Acceptance By: Presented By: Carlos And/or Miguel Please call Alex at 407-435-3433, if any additional questions and/or comments. MIAMI-DADE COUNTY M A M4 PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) Miami, Florida 33175-2474 BOARD AND CODE ADMINISTRATION DIVISION T (786)315-2590 F (786) 31525-99 NOTICE OF ACCEPTANCE (NOA) www.miamidade.gov/economy Interwrap, Inc. 32923 Mission Way Mission, BC, Canada V2V-6E4 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed and accepted by Miami -Dade County RER - Product Control Section to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Section (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Titanium' UDL-25 PLUS, Titanium' UDL-30, Titanium° UDL-50, UDL TT, UDL TF, UDL TTMC-300, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA renews and revises NOA No. 13-0610.01 and consists of pages 1 through 5. The submitted documentation was reviewed by Alex Tigera. APPROVED NOA No.: 14-0603.18 Expiration Date: 08/08/18 Approval Date: 06/11/15 Page 1 of 5 ROOFING COMPONENT APPROVAL Category: Roofing Sub -Category: Underlayment Material: Polypropylene SCOPE: This acceptance is for Titanium° UDL-25 PLUS, Titanium° UDL-30, Titanium° UDL-50, UDL TT, UDL TF, UDL TTMC-300, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments as described in this Notice of Acceptance, for use with approved prepared roof assemblies where ASTM D226 Type underlayment is specified and installed with prescribed approved fasteners and fastener densities. Designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code PRODUCT DESCRIPTION: NOA No.: 14-0603.18 MIAMMDADECouNTY Expiration Date: 08/08/18 Approval Date: 06/1.1/15 Page 2 of 5 Test Product Product Dimensions Specification Description Titanium° UDL-25 PLUS 48" x 250' rolls ASTM D226 Woven synthetic polymer underlayment with one Type I & II side coated with UV protected and slip resistant Manufacturing polymer stabilized polypropylene on both sides. Location #1 & #3 Titanium® UDL-30 48" x 250' rolls ASTM D226 Woven synthetic polymer underlayment with two Type I & II sides coated with UV protected and slip resistant Manufacturing polymer stabilized polypropylene on both sides. Location #1& #3 Titanium° UDL-50 48" x 250' rolls ASTM D226 Woven synthetic polymer underlayment with two Type I & II sides coated with UV protected and slip resistant Manufacturing polymer stabilized polypropylene on both sides. Location #1& #3 UDL TT 48" x 250' rolls ASTM D226 Woven synthetic polymer underlayment with one Type I & I1 side coated with UV protected and slip resistant Manufacturing polymer stabilized polypropylene on both sides. Location #1 UDL TF 48" x 250' rolls ASTM D226 Woven synthetic polymer underlayment with two Type I & II sides coated with UV protected and slip resistant Manufacturing polymer stabilized polypropylene on both sides. Location #1 UDL TTMC-300 48" x 250' rolls ASTM D226 Woven synthetic polymer underlayment with two Type I & II sides coated with UV protected and slip resistant Manufacturing polymer stabilized polypropylene on both sides. Location #2 RhinoRoof U10 42" x 286' rolls ASTM D226 Woven synthetic polymer underlayment with two Type I & II sides coated with UV protected and slip resistant Manufacturing polymer stabilized polypropylene on both sides. Location #3 NOA No.: 14-0603.18 MIAMMDADECouNTY Expiration Date: 08/08/18 Approval Date: 06/1.1/15 Page 2 of 5 RhinoRoof U15 42" x 286' rolls ASTM D226 Woven synthetic polymer underlayment with two Manufacturing Type I and II sides coated with UV protected and slip resistant Location #3 polymer stabilized polypropylene on both sides. RhinoRoof U20 42" x 286' rolls ASTM D226 Woven synthetic polymer underlayment with two Manufacturing Location 93 Type I and II sides coated with UV protected and slip resistant polymer stabilized polypropylene on both sides. Titanium UDL25 48" x 250' rolls ASTM D226 Woven synthetic polymer underlayment with two Manufacturing Location 93 Type I and II sides coated with UV protected and slip resistant ML2 polymer stabilized polypropylene on both sides. RhinoRoof RSA 36" x 67' rolls ASTM D1970 Unreinforced polymer modified bitumen material Manufacturing Location 94 adhered to the underside of a polymer -coated, ICC -ES AC48 synthetic woven sheet. The underside is backed with a release film. MANUFACTURING LOCATIONS: 1. MLI 2. ML2 3. ML3 4. ML4 EVIDENCE SUBMITTED: Test Agency Test Identifier Test Name/Report Date Intertek Testing Services 3031783 TAS 104 02/19/03 311.9607COQ-003B ICC -ES AC48 02/20/08 3124826-01 ASTM E108 02/19/08 3124826MID-007 ASTM E108 02/25/08 311801OCOQ-003 ASTM D226 02/20/08 3130639COQ-002A ASTM D226 02/20/08 3146738COQ-003A ASTM D226 06/20/11 3146738COQ-003B ASTM D 1876/ TAS 117 03/28/08 101465036COQ-001 ASTM D1970 06/27/14 100539395COQ-006 ASTM D226 06/02/14 101863861COQ-OOIA ASTM D226 10/28/14 101823107COQ-011 ASTM D226 12/09/14 Trinity ERD 115010.05.10 ASTM D4798 / D226 05/14/10 I38010.08.11 ASTM D226 08/11/11 I35520.08.11 ASTM 62523 / D1781 08/17/11 NOA No.: 14-0603.18 Expiration Date: 08/08/18 Approval Date: 06/11/15 Page 3 of 5 INSTALLATION SPECIFICATIONS: Titanium° UDL-25 PLUS, Titanium' UDL-30, Titanium° UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments 1. Titanium® UDL-25 PLUS, Titanium® UDL-30, Titanium® UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments shall be installed in strict compliance with applicable Building Code. 2. Titanium® UDL-25 PLUS, Titanium® UDL-30, Titanium® UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments shall be installed with a minimum 4 -inch head lap in a shingle layer fashion. 3. Titanium® UDL-25 PLUS, Titanium® UDL-30, Titanium® UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, and Titanium UDL25 Synthetic Underlayments shall be fastened with Miami -Dade approved corrosion resistant tin -caps and 12 gauge 1 '/4" annular ring -shank nails, spaced 6" o.c. at all laps and three staggered rows fastened 12" o.c. in the field of the roll. 4. Titanium® UDL-25 PLUS, Titanium® UDL-30, Titanium® UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments may be used with Asphaltic shingles, Wood shakes and shingles, Non-structural metal roofing, and quarry slate. Titanium® UDL-30, Titanium® UDL-50, UDLTTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25 and RhinoRoof RSA Synthetic Underlayments shall not be used as roof tile underlayments. 5. For Roof Tile applications; Titanium® UDL-25 PLUS may be used as an anchor sheet in roof tile applications when used in combination with a top membrane layer, consisting of a Miami -Dade approved TAS 103 self - adhering underlayment. (See current NOA listing of approved TAS 103 self -adhering underlayment for installation guidelines and limitations of use). 6. For fire classification of specific roof assemblies using Titanium® UDL-25 PLUS, Titanium® UDL-30, Titanium® UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments-refer to a current Approved Roofing Materials Directory for fire ratings of this product. BUILDING PERMIT REQUIREMENTS: Application for building permit shall be accompanied by copies of the following: 1. This Notice of Acceptance. 2. Any other documents required by the Building Official or applicable building code in order to properly evaluate the installation of this material. NOA No.: 14-0603,18 Expiration Date: 08/08/18 Approval Date: 06/11/15 Page 4 of 5 LIMITATIONS: 1. Fire classification is not part of this acceptance; refer to a current Approved Roofing Materials Directory for fire ratings of this product. 2. This acceptance is for prepared roofing applications. Minimum deck requirements shall be in compliance with applicable building code. 3. Titanium® UDL-25 PLUS, Titanium® UDL-30, Titanium® UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments shall be applied to a smooth, clean and dry surface with deck free of irregularities. All nails in the deck shall be carefully checked for protruding heads. Re -fasten any loose decking panels. Sweep the deck thoroughly to remove any dust and debris prior to application. 4. Titanium® UDL-25 PLUS, Titanium® UDL-30, Titanium® UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments shall not be hot mopped, refer to manufacturer's published literature for product compatibility. 5. Titanium® UDL-25 PLUS, Titanium® UDL-30, Titanium® UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments shall not be applied over an existing roof membrane as a recover system. 6. Titanium® UDL-25 PLUS, Titanium® UDL-30, Titanium® UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments shall not be left exposed as a temporary roof for longer than 30 days of application. 7. UDL TTMC-300 Synthetic Underlayment shall not be left exposed as a temporary roof for longer than 180 days of application. 8. Titanium® UDL-25 PLUS, Titanium® UDL-30, Titanium® UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments are components used in roof system assemblies. Roof system assemblies are approved under a specific Notice of Acceptance. Refer to Prepared Roofing system Product Control Notice of Acceptance for listed approval of this product with specific prepared roofing products. 9. Titanium® UDL-25 PLUS, Titanium® UDL-30, Titanium® UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments may be used with any approved roof covering Notice of Acceptance listing Titanium® UDL-25 PLUS, Titanium® UDL-30, Titanium® UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments as a component part of an assembly in the Notice of Acceptance. If Titanium® UDL-25 PLUS, Titanium® UDL- 30, Titanium® UDL-50, UDL TTMC-300, UDL TT, UDL TF, RhinoRoof U10, RhinoRoof U15, RhinoRoof U20, Titanium UDL25, and RhinoRoof RSA Synthetic Underlayments are not listed, a request may be made to the Authority Having Jurisdiction (AHJ) or the Miami -Dade County Product Control Department for approval provided that appropriate documentation is provided to detail compatibility of the products, wind uplift resistance, and fire testing results. 10. All membranes or packaging shall bear the imprint or identifiable marking of the manufacturer's name or logo and the following statement: "Miami -Dade County Product Control Approved" or the Miami -Dade County Product Control Seal as shown below. MIAMFDADE COUNTY 13...6 11. All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and Rule 61 G20-3 of the Florida Administrative Code. END OF THIS ACCEPTANCE NOA No.: 14-0603,18 MMMMADE COUNTY Expiration Date: 08/08/18 mamo Approval Date: 06/1111.5 Page 5 of 5 CITY OF SANFORD BUILDING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: /& I, n j/t hereby acknowledge that I personally inspected VRoof deck nailing and/or Secondary water barrier work at 221?-/,,OC.14 G D U% b .4 SG 1014, -> V;VLd 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 official duty shall constitute a misdemeanor of the second degree pursuant to zwvIal- Signature of Contractor Date Printed Name of Contractor License # License Type: i_1 General Building Residential Vir<oofing Contractor or any individual certified in accordance with F.S. 468 to make such an inspection. STATE OF FLORIDA COUNTY OF f94S4i06 Sw to (or af7,re*w,4 ed) and subscribed before me this , day of 6 C , 20, by who is LV,, ersonally Known to me or has Produced (type of enti ati as identification. SEAL) i ature of Nota Public 17, at ioriaa Prm /Type/Stamp am EK4!MMONICAJASPE Of Notary Public ISSION #FF184052 December 28, 2018NoWry5ervice.com