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Home My WebLink About127 Drew Ave'•.; SIV CITY OF SANFORD r DEC 8 2016 BUILDING & FIRE PREVENTION t ' PERMIT APPLICATION Application No: Documented Construction Value: $ 8,DO Job Address: /a 7 Mg-(/ 1We Historic District: Yes ❑ NX Parcel ID: 3/ / / —:35—oT,ot9 -0,03 Residential Commercial ❑ Type of Work: New ❑ Addition ❑ Alteration ❑ Repair Demo ❑ Change of Use ❑ Move ❑ Description of Work: Xk-"k4D r— 51 /11r91PS Plan Review Contact Person: 7— ll /Title:-��/"2� FS• Phone: V07- 227774ax: V -_77k' )3 mail: Property Owner Information Name A%i9_01I7 0�0/Iy/ 5 -All ° VO /LsfJ/1 Phone: Street: /al % ,,%zoe7 J Resident of property? City, State Zip: S'�A%<dl11� „ `L- .3.2 %71 Contractor Information Name /l� T G�/yel� (oiYsf7"�Yi Phone: ,/U7 (f9� _7A ^ 2 7 Street: �t� bee/?/_s 4 -e Fax: 70 7— O /.3_::�S City, State Zip: �� /�� .3200 State License No.:7J7D Name: Street: City, St, Zip: Bonding Company: Address: 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. 1 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 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 regu)ating ruct n an Signsture -0--SI :2 Owner/Agent•: e Produced 1D :• Date \ wn to Me or Signature of Produced •••M1981p•'ry�� * • iO m S • 9FF 173.190. Q_ BELOW IS FOR OFFICE USE ONLY Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Construction Type: Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: �.. (A 61 f6 Date Known to Me or Gas ❑ Roof ❑ Flood Zone: # of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes ❑ No ❑ WASTE WATER: BUILDING: Revised: June 30, 2015 Permit Application SCPA Parcel View: 31-19-31-525-0,100-0030 http://parceldetaii.scpafl.org/ParceiDetailinfo.aspx?PID=3119315250... Property Record Card �� Parcel: 31-19-31-525-0,100-0030 Owner. JOHNSON MARVIN d CHRISTINE A� �oournv,rvaro. Prop" Address: 127 DREW AVE SANFORD, FL 32771-3958 Parcel Information I I Value Summary Parcel 31-19-31-525-0J00-0030 Owner JOHNSON MARVIN b CHRISTINE Property Address 127 DREW AVE SANFORD, FL 32771-3958 Mailing 127 DREW AVE SANFORD, FL 32771-3958 Subdivision Name WASHINGTON OAKS SEC 2 Tax District S1-SANFORD DOR Use Code 01 -SINGLE FAMILY Exemptions 00-HOMESTEAD(1994) O 0 (0 i 0 0 0 I Legal Description LOT 3 BLK J WASHINGTON OAKS SEC 2 PS 16 PG 87 Tax Amount without SOH: $616.25 2016 Tax Bill Amount $545.82 Tax Estimator Save Our Homes Savings: $70.43 I0 I I • Does NOT INCLUDE Non Ad Valorem Assessments • Seminole County GIS Taxes ! Taxing Authority Assessment Value 2017 Working 2016 Certified 1 i $13,500.00 $13,500 City Sanford Values Values Valuation Method I Cost/Market Cost/Market ! $57,640 �1 - Number of Buildings 1 j $57,640 Depreciated Bldg Value $53,812 $52,059 Depreciated EXFT Value $1,000 ' s1,000 Land Value (Market) $13,500 T 513,500 Land Value Ag - i Just/Market Value •• $68,312 $66.559 Portability Adj I I 1$10'672 Save Our Homes Adj $9,320 Amendment 1 Adj-- P&G Adj $0 1$0 Assessed Value $57,640 $57,239 Tax Amount without SOH: $616.25 2016 Tax Bill Amount $545.82 Tax Estimator Save Our Homes Savings: $70.43 I0 I I • Does NOT INCLUDE Non Ad Valorem Assessments • Seminole County GIS Taxes ! Taxing Authority Assessment Value Exempt Values Taxable Value 1 i $13,500.00 $13,500 City Sanford $57,640 $33,140 � $24,500 SJWM(Saint Johns Water Management) ! $57,640 $33,140 i $24,500 County Bonds j $57,640 $33,140 1 $24,500 County General FundA- $57,640 $33,140 1 $24,500 — - - - i Schools $57,640, $25,500' $32,140 - ------------- - - Sales Description Date Book Page Amount Qualified Vadimp SPECIAL WARRANTY DEED --- —__ J 1/1/1976 — — 101096 10508 —1— $100 No Improved SPECIAL WARRANTY DEED 11/111974 ; 010401 ! $100 No Improved i Find Comparable Sales Land F i Method Frontage Depth Units Units Price Land Value LOT I 1 i $13,500.00 $13,500 Building Information — - - - Is Bed/Bath count incorrect? Click Here.---- - - - - — - - - -- - - - - # Description Year Built Actual/Effective,g Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages 1 ! SINGLE 1974 5 I 2'1,0621 1,062' 1,394 ! 1,062' CB/STUCCO I $53,812 I $69,886 Description Area FAMILY ! ; FINISH i 1 1 of 2 12/6/2016 10:26 PM Pat Lynch Construction LLC 909 Dennis Avenue Orlando, Florida 32807 NOTICE TO PROCEED Subject: IFS Contract for Roof Replacement Services for Residential Properties. PO 9 39491 *** Total Order 58.850.00 JOB ADDRESS% 127 DREW AVENUE, SANFORD, FL 32771 PARCEL ID #: 31-19-31-525-0100-0030 CONTACT PERSON: CHRISTINE JOHNSON PHONE: (321) 420-2214 The services provided by your firm shall begin on 12/09/2016 and shall reach final completion the (301 calendar days from Notice to Proceed date (January 9. 2017). as described in the contract documents. The timely and accurate performance of the work set forth in the contract documents is important to the County. It is also a primary consideration for the contractor selection on future projects. ` Please acknowledge below, retain a copy for your records and return the original to the Seminole County Community Development Office. DO NOT start the job until the required permits have been obtained and the work is scheduled. Please email a digital copy of the ROOF permit to: lalbelo@seminolecountvfl.sov Upon completion of work please notify the Construction Project Manager and submit a*copy of the inspection final. We are glad to have you as part of the County's project team and we look forward to a successful project. Sincerely, .CAGY e 4044, Construction Project Manager Community Development Seminole County Government Phone: 407-665-2385 Fax: 407-665-2399 www.seminolecountyfk.gov ACCEPTANCE OF NOTICE Acceptance bove "NOTICE TO PROCEED" is hereby acknowledged, this 91 Day of December. 2016 y Title: f/ /� N THIS INSTRUMENT PREPARED BY: Name: Address: NOTICE OF COMMENCEMENT Permit Number. Parcel ID Number. 1111111111111111111111111111111111111111 �MARYANNE MORSE► SEMINOLE COUNTY W_P9 CIRCUIT COURT & COMPTROLLER 675 (1P9s) CLERK'S T 2416127660 RECORDED 12/48/2016 0250:56 PM RECORDING FEES $10,00 RECORDED BY hdevore 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. DESCRIP NOF R PERTY: (Le al des on of thgpro a and street address �' a ail ble) /a 2. GENERAL DESCRIPTION OF IMPROVEMENT: 3. OWNER INFORMA Elm Name and address: Interest in property: Fee Simple Title Holder (if other than owner listed above) Name: S. SURETY (If applicable, a copy of the payment bond is attached): Name: Address: Amount of Bond: 6. LENDER: Name: Phone Number. Address: 7. Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes. Name: Phone Number. Address: 8. In addition, Owner designates of to receive a copy of the Lienors Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number. 9. 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. State of The foregoing by wrier or Lessee, or Ownees or Lessee's (Print Name and Provide Signalorys TiUe/Office) Olficer/Director/PaMer/Managw) County of was acknowledged before me this day of 20 C yy V n _ n S0M Who isers�known0 OR lame of person making who has produ6ed Identification 0 type oj, identificatl IMPM COPY— RYANNE MORSE CLERK H IR U' COURTAND COM raOL ER EMIR lLE CL' D o, _ _ _ _ _ DEPUTY CLERK Flc-ida Building Code Online http://www.floridabuilding.org/pr/pr app_4tl.aspx?param=wGEVXQ... mil RegulationBusiness &Professional �1 70-111 db USSCIS Nome ' tng In i User Registration I Mot Topic Submit Surcharge : Stats a Fac.�s I Pubtlmtbre i F8C StagSCLS Ste Map I UnkS Searchd �Product Approval �6r, USER: Public User EmQyR Aw-zPY- l e -nu >P� or AooEatbn Search > 6MI.{&(.gn & > Applbtknt DeUD FL # FL1956-R12 Application Type Editorial Change Code version 2014 Application Status Approved 'Approved by DBPR. Approvals by DBPR shall be reviewed and ratified by the POC and/or the Commission If necessary. Comments Archived Product Manufacturer Address/Phone/Email Authorized Signature Technical Representative Address/Phone/Emall Quality Assurance Representative Address/Phone/Email Category Subcategory Compliance Method Certification Agency Validated By Referenced Standard and Year (of Standard) Equivalence of Product Standards Certified By TAMKO Building Products, Inc. PO Box 1404 Joplin, MO 64802 (417) 624-6644 Ext 2305 keni_eden@tamko.com Kern Eden ketTi_eden@tamko.com Kerri Eden PO Box 1404 Joplin, MO 64802 (417)624-6644 Ext 2305 kerrl_eden@tamko.com Roofing Asphalt Shingles Certification Mark or Usting UL LLC Robert J. M. Nleminen, PE Validation Checklist - Hardcopy Received Standard ASTM D3161 ASTM D3462 ASTM D7158 Year 2009 2009 2008 I of 4 12/6/2016 10:39 PM FloFida Building Code Online Product Approval Method Date Submitted Date Validated Date Pending FOC Approval Date Approved Summary of Products http://www.floridabuilding.org/pr/pi app_dtl.aspx?param=wGEVXQ... Method i Option A 09/17/2015 10/06/2015 10/09/2015 2 of 4 12/6/2016 10:39 PM FL # Model, Description Number or Name 1956.1 Elite Glass -Seal A three tab asphalt shingle. Limits of Use Certification Agency Certificate Approved for use in FL1956 R12 C CAC FL1956 R1 C CAC Tamko Sery Conf FL 1956 2015.pdf HVHZ: No FL1956 R12 C CAC UL certification 10-11-12.odf Approved for use outside Quality Assurance Contract Expiration Date HVHZ: Yes 09/17/2018 Impact Resistant: N/A Installation Instructions Design Pressure: N/A FL1956 R12 II Glass Seal Elite Glass Sealapp instpdf Other: Asphalt shingles Verified By: Robert Nieminen 59166 shall be used only on roof Created by Independent Third Party: No slopes of 2:12 or greater. Evaluation Reports Nails must be used as the Created by Independent Third Party: method of attachment. 1956.2 Glass -Seal A three tab asphalt shingle. Limits of Use Certification Agency Certificate Approved for use in FL1956 R12 C CAC FL1956 R11 C CAC Tamko Sery Conf FL 1956 2015.pdf FL1956 R12 C CAC UL certification 10-11-12.pdf HVHZ: No Approved for use outside Quality Assurance Contract Expiration Date HVHZ: Yes 09/17/2018 Impact Resistant: N/A Installation Instructions Design Pressure: N/A FL1956 R1211 Glass Seal Elite Glass Seal apo inst.odf Other: Asphalt shingles Verified By: Robert Nieminen PE 59166 shall be used only on roof Created by Independent Third Party: No slopes of 2:12 or greater. Evaluation Reports Nails must be used as the Created by Independent Third Party: method of attachment. 1956.3 Heritage A dimensional asphalt shingle. Limits of Use Certification Agency Certificate Approved for use in FL1956 R12 C CAC FL1956 R11 C CAC Tamko Sery Conf FL 1956 2015.odf FL1956 R12 C CAG UL certification 10-11=12 n" HVHZ: No Approved for use outside Quality Assurance Contract Expiration Date HVHZ: Yes 09/17/2018 Impact Resistant: N/A Installation Instructions Design Pressure: N/A FL1956 R12 II Heritage D F J P app inst. Other: Asphalt shingles FL1956 R12 t Heritage F app inst. &f shall be used only on roof FL1956 R12 11 Heritage T ago inst.odF slopes of 2:12 or greater. Verified By: Robert J. M. Nieminen FL 59166 Nails must be used as the Created by Independent Third Party: No method of attachment. Evaluation Reports Created by Independent Third Party: 1956.4 Heritage 30 A dimensional asphalt shingle. Limits of Use Certification Agency Certificate Approved for use in FL1956 R12 C CAC FL1956 R11 C CAC Tamko Sery Conf FL 1956 2015.odf FL1956 R12 C CAC UL certification 10-11-12.pdf HVHZ: No Approved for use outside Quality Assurance Contract Expiration Date HVHZ: Yes 09/17/2018 Impact Resistant: N/A Installation Instructions Design Pressure: N/A FL1956 R12 II heritage 30 app in april 10.odf Other: Asphalt shingles FL1956 R12 11 heritage 30 ago inst f april 10.pdf shall be used only on roof Verified By: Robert Nieminen PE 59166 slopes of 2:12 or greater. Created by Independent Third Party: No Nails must be used as the Evaluation Reports method of attachment. Created by Independent Third Party: 2 of 4 12/6/2016 10:39 PM Florida Building Code Online http://www.floridabuiiding.org/pr/pr app dti.aspx?param=wGEVXQ... 11956.5 Heritage 50 I A dimensional asphalt shingle. Limits of Use Certification Agency Certificate Approved for use in FL1956 R12 C CAC FL1956 RI C CAC Tamko Sery Conf FL 1956 201S.pdf FL1956 R12 C CAC UL certification 10-11-12.pdf HVHZ: No Approved for use outside Quality Assurance Contract Expiration Date HVHZ: Yes 09/17/2018 Impact Resistant: N/A Installation Instructions t Design Pressure: N/A FL1256 R12 II heritage 50 13pp inst aoril 10.odf Other: Asphalt shingles FL1956 R12 II heritage 50 app Inst f april 10.odf shall be used only on roof Verified By: Robert Nieminen PE 59166 slopes of 2:12 or greater. Created by Independent Third Party: No Nails must be used as the Evaluation Reports method of attachment. Created by Independent Third Party: 1956.6 Heritage A dimensional asphalt shingle. Premium Limits of Use Certification Agency Certificate Approved for use in FL1956 R12 C CAC FL1956 RI1 C CAC Tamko Sery Conf FL 1956 2015.pdf HVHZ: No FL1956 R12 C CAC UL_ certification 10-11-12.pdf Approved for use outside Quality Assurance Contract Expiration Date HVHZ: Yes 09/17/2018 Impact Resistant: N/A Installation Instructions Design Pressure: N/A FL1956 R12 II Heritage Premium D P aop inst.pdf Other: Asphalt shingles FL1956 R12 11 Heritage Premium F app pst.Ddf shall be used only on roof FL1956 R12 II Heritage Premium T app inst.pdf slopes of 2:12 or greater. Verified By: Robert Nleminen 59166 Nails must be used as the Created by Independent Third Party: No method of attachment. Evaluation Reports Created by Independent Third Party: 1956.7 Heritage A heavy weight dimensional asphalt shingle. Vintage Limits of Use Certification Agency Certificate Approved for use in FL1956 R12 C CAC FL1956 RI C CAC Tamko Sery Conf FL 1956 201S.pdf FL1956 R12 C CAC UL shingle matrix.pdf HVHZ: No Approved for use outside Quality Assurance Contract Expiration Date HVHZ: Yes 09/17/2018 Impact Resistant: N/A Installation Instructions Design Pressure: N/A FL1956 R12 Il Heritageyintaoe -sm ins -df- Other: Asphalt shingles Verified By: Roberti. M. Nieminen PE 59166 shall be used only on roof Created by Independent Third Party: No slopes of 2:12 or greater. Evaluation Reports Nails must be used as the Created by Independent Third Party: method of attachment. 1956.8 Heritage Hip and ridge shingles Vintage 12 x 12 Hip and Ridge Limits of Use Certification Agency Certificate Approved for use in FL1956 R12 C CAC FL19S6__RII- C CAC Tamko Sery Conf FL 1956_2015.odf HVHZ: No FL1956 R12 C CAC UL shingle matrix.pdf Approved for use outside Quality Assurance Contract Expiration Date HVHZ: Yes 09/17/2018 Impact Resistant: N/A Installation Instructions Design Pressure: N/A FL1956 R12 11 TAMKOM HeritageB 12 x 12 Hip and Ridge Application Instructions.pdf Verified By: Robert J. M. Nleminen PE 59166 Other: Asphalt shingles shall be used only on roof Created by Independent Third Party: No slopes of 2:12 or greater. Evaluation Reports Nails must be used as the Created by Independent Third Party: method of attachment. 1956.9 Heritage A dimensional asphalt shingle. Woodgate Limits of Use Certification Agency Certificate Approved for use in �L�956 R32 C�AL19gb�C CAC Tamko�ery Conf FL 1956 2Q}5.pdf FL1956 R12 C CAC UL certification 10-11-12.pdf HVHZ: No Approved for use outside Quality Assurance Contract Expiration Date HVHZ: Yes 09/17/2018 Impact Resistant: N/A Installation Instructions Design Pressure: N/A FL1956 R12 II Heritage Woodgatg D aop inst.ndf Other: Asphalt shingles FL1956 R12 11 Heritage Woodgate F app inst.pdf shall be used only on roof Verified By: Robert Nieminen 59166 slopes of 2:12 or greater.I Created by Independent Third Party: No 3 of 4 12/6/2016 10:39 PM Florida Building Code Online http://www.floridabuilding.org/pr/pr app dti.aspx?parwn=w(jEVXQ... Nails must be used as the Evaluation Reports method of attachment. Created by Independent Third Party: 1956.10 Heritage XL A dimensional asphalt shingle. Limits of Use Approved for use in I Certification Agency Certificate FL1956 R12 t CAC FL1956 R11 C_CAC_ Tamko Sery Conf FL 1956 2015.Ddf HVHZ: No FL1956 R12 C CAC UL certification 30-11-12.Ddf Approved for use outside Quality Assurance Contract Expiration Date HVHZ: Yes 09/17/2018 Impact Resistant: N/A Installation Instructions Design Pressure: N/A FL1956 R12 11_heritage xl apD inst d aonl 30.pdf Other: Asphalt shingles FL1956 R12 II heritage xi pp—tg--f-_ap_rj1-10.pdf shall be used only on roof Verified By: Robert Nleminen PE 59166 slopes of 2:12 or greater. Created by Independent Third Party: No Nails must be used as the Evaluation Reports method of attachment. Created by Independent Third Party: 1956.11 1 Hip and Ridge Hip and ridge shingles Shingles Limits of Use Certification Agency Certificate Approved for use in FL1956 R12 C CAC FL1956 R11 C CAC Tamko Sery Conf FL 1956 2015.pdf FL1956 R12 C CAC UL Certification 10-11-12.od HVHZ: No Approved for use outside Quality Assurance Contract Expiration Date HVHZ: Yes 09/17/2018 Impact Resistant: N/A Installation Instructions Design Pressure: N/A FL1956 R12 II 12.25x12 Hio and Ridge.Ddf Other: Hip and Ridge FL1956 R12 11 12 x 12 Hip Ridge Application Instructions.Ddf shingles shall be used only FL1956 R12 II 12-1-4x12 HioRidge Sealant Dab Illustrations.pdf on roof slopes of 2:12 or FL1956 R12 Il 12x12 HioRidge Sealant Dab lllustrations.odf greater. Nails must be used Verified By: Robert Nieminen 59166 as the method of Created by Independent Third Party: No attachment. Evaluation Reports Created by Independent Third Party: 0 0 The State of Florida Is an AA/EBD employer. Copyright 2007-2013 State of Florida .:: Privacy Statement :: AccessblRy Statem Under Florida taw, email addresses are public records. 9 you do not want your e-mail address released in response to a pubic -records request, do not send electronic mad to this er tty. instead, contact the office by phone or by traditional mast U you have any questions, please contact 850.487.1395. *pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, Oversees licensed under Chapter 4S5, F.S. must provide the Department with an email address if they have one. The ema8s provided maybe used for offdal communlcetlon wth the fir -r - .However emaa addresses are public record. IT you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the pubic. To determine r you are a licensee under Chapter 455, F.S., please click h=. Product Approval Accepts: v I ®=:z - Credit Card Safe 4 of 4 12/6/2016 10:39 PM TAMVO BUILDING PRODUCTS AppReation Instructions for HERITAGW 30 LANINATBD ASPHALT SHINGLES Dallas, TX • Tuscaloosa, AL a Phillipsburg, KS • Joplin, MO THESE ARE THE MANUFACTURER'S APPLICATION INSTRUCTIONS FOR THE ROOFING CONDITIONS DESCRIBED. TAMKO BUILDING PRODUCTS, INC. ASSUMES NO RESPONSIBILITY FOR LEAKS OR OTHER ROOFING DEFECTS RESULTING FROM FAILURE TO FOLLOW THE MANUFACTURER'S INSTRUCTIONS. THIS PRODUCT IS COVERED BY A LIMITED WARRANTY, THE TERMS OF WHICH ARE PRINTED ON THE WRAPPER. IN COLD WEATHER (BELOW 40°F), CARE MUST BE TAKEN TO AVOID DAMAGE TO THE EDGES AND CORNERS OF THE SHINGLES. IMPORTANT It is not necessary to remove the plastic strip from the back of the shingles. 1. ROOF OCCK These shingles are for application to roof decks capable of receiving and retaining fasteners, and to inclines of not less than 2 in. per foot. For roofs having pitches 2 in. per foot to less than 4 in. per foot, refer to special instructions titled "Low Slope Application". Shingles must be applied properly. TAMKO assumes no responsibility for leaks or defects resulting from improper application, or failure to properly prepare the surface to be roofed over. NEW ROOF DECK CONSTRUCTION: Roof deck must be smooth, dry and free from warped surfaces. It is recommended that metal drip edges be installed at eaves and rakes. PLYWOOD: All plywood shall be exterior grade as defined by the Engineered Wood Association. Plywood shall be a minimum of 3/8 in, thickness and applied in accordance with the recommendations of the Engineered Wood Association. SHEATHING BOARDS: Boards shall be well -seasoned tongue - and -groove boards and not over 6 in. nominal width. Boards shall be a 1 in. nominal minimum thickness. Boards shall be properly spaced and nailed. 2. UNTILATION Inadequate ventilation of attic spaces can cause accumulation of moisture in winter months and a build up of heat in the summer. These conditions can lead to: 1. Vapor Condensation 2. Buckling of shingles due to deck movement. 3. Rotting of wood members. 4. Premature failure of roof. To insure adequate ventilation and circulation of air, place louvers of sufficient size high in the gable ends and/or install continuous ridge and soffit vents. FHA minimum property standards require one square foot of net free ventilation area to each 150 square feet of space to be vented, or one square foot per 300 square feet if a vapor barrier is installed on the warm side of the ceiling or if at least one half of the ventilation is provided near the ridge. If the ventilation openings are screened, the total area should be doubled. IT IS PARTICULARLY IMPORTANT TO PROVIDE ADEQUATE VENTILATION. S. FASTSI ERS WIND CAUTION: Extreme wind velocities can damage these shingles after application when proper sealing of the shingles does not occur. This can especially be a problem if the shingles are applied in cooler months or in areas on the root that do not receive direct sunlight. These conditions may impede the sealing of the adhesive strips on the shingles. The inability to seal down may be compounded by prolonged cold weather conditions and/ or blowing dust. In these situations, hand sealing of the shingles is recommended. To insure immediate sealing, apply 4 quarter -sized dabs of TAM -PRO° Premium SBS Adhesive or TAMKO Tam -Seal Adhesive on the back of the shingle 1 in. (25mm) and 13 in. (330mm) in from each side and 1 in. (25mm) up from the bottom of the shingle. Press shingle firmly into the adhesive. For maximum wind resistance along rakes, cement shingles to the underlayment and each other in a 4 in. (102mm) width of TAM -PRO SBS Adhesive or TAMKO Tam -Seal Adhesive. Caution: Apply ONLY a thin uniform layer of adhesive less than 1/8 in. (3mm) thick. Excessive amounts can cause blistering of the shingles and may soften the asphalt in certain underlayments resulting in the asphalt flowing, dripping and staining. Shingles must also be fastened according to the fastening instructions described below. Correct placement of the fasteners is critical to the performance of the shingle. If the fasteners are not placed as shown in the diagram and described below, this will result in the termination of TAMKO's liabilities under the limited warranty. TAMKO will not be responsible for damage to shingles caused by winds in excess of the applicable mph as stated in the limited warranty. See limited warranty for details. FASTENING PATTERNS: Fasteners must be placed 6-1/8 in. from the bottom edge of the shingle, penetrating through the common bond, and located horizontally as follows: 1) Standard Fastening Pattern. (For use on decks with slopes 2 in. per foot to 21 in. per foot.) One fastener 1 in. back from each end and one 13-1/2 in. back from each end of the shingle for a total of 4 fasteners. (See standard fastening pattern illustrated below). STANDARD FASTENING PATTERN FASTENERS NAIL ZONE COMMON BOND 6-1/8° [EXPOSURE 5 -SW 14 �— 12-1/2'-+•- 12-3/8' -+- 12-1/2" H - Central District 220 West 4th St., Joplin, MO 64801 800-641-4691 11/09 Visit Our Web Site at Northeast District 4500 Tamko Dr., Frederick, MD 21701 800-368-2055 Southeast District 2300 35th St., Tuscaloosa, AL 35401 800-228-2656 tamko.eom Southwest District 7910 S. Central Exp., Dallas, TX 75216 800-443-1834 Western District 5300 East 43rd Ave., Denver, CO 80216 800-530-8868 1 '. i woL. #. WE ,i—WI+W?. wg "±;.a.•. .. 6---m . tt-, �'+��-• •.�-^ � -.---.1 TAMKO'' BUILDIIRG PRODUCTS (CONTINUED from page 1) HERITAGW 30 LAMINATED ASPHALT SHINGLES Dallas, TX • Tuscaloosa, AL • Phillipsburg, KS • Joplin, MO 2) Mansard Fastening Pattern. (For use on decks with slopes greater than 21 in. per foot.) One fastener 1 in. back from each end and one fastener 8-1/2 in. back from each end and one fastener 16 in. back from each end for a total of 6 fasteners per shingle. (See Mansard and High Wind Fastening Pattern illustrated below.) MANSARD AND HIGH WIND FASTENING PATTERN FASTENERS NAIL ZONE COMMON BOND 6- [EXPOSURES -SW i° -M j.a-�avh-r-e7�« r�ra��-1/1'�T-vY+j jrr 3) High Wind Fastening Pattern. (For High Wind Application requirements) One fastener 1 in. back from each end. One fastener 8-1/2 in. back from each end and one fastener 16 in. back from each end for a total of six (6) fasteners per shingle. In addition to this shingle fastening pattern requirement for High Wind Application, TAMKO also requires the use of the following TAMKO products: TAMKO felts or underlayments; TAMKO Moisture Guard Plus underlayment at all eaves, rakes, and valleys; TAMKO or TAM -PRO cements and coatings products where required; TAMKO ventilation where required, TAMKO starter shingles if available in area, and TAMKO Hip and Ridge shingles installed on all hips and ridges. Along rakes, cement shingles to the underlayment and each other in a 4 in. (102 mm) width of TAM - PRO SBS Adhesive or TAMKO Tam -Seal Adhesive. Also, see local building codes for proper nailing application. High Wind Application is offered on new construction or complete tear -off applications only. It is not offered for recover applications. If High Wind Application requirements are not followed, the High Wind Application Warranty MPH, as stated on Table I in the Limited Warranty, reverts to the Standard Application Wind Warranty MPH limit. (See Mansard and High Wind Fastening Pattern illustrated above.) NAILS: TAMKO recommends the use of nails as the preferred method of application. Standard type roofing nails should be used. Nail shanks should be made of minimum 12 gauge wire, and a minimum head diameter of 3/8 in. Nails should be long enough to penetrate 3/4 in. into the roof deck. Where the deck is less than 3/4 in. thick, the nails should be long enough to penetrate completely through plywood decking and extend at least 1/8 in. through the roof deck. Drive nail head flush with the shingle surface. = aT mw aw ww wdmm m ow"". aooto0 •sve.n _ sauna. 1N• nom6ul oawuaiwn Ineft"8% tooday.cu and twm autn anlnyo swaoee oonotnuon wto aw" -Ch-•w STAPLES: If staples are used in the attaching process, follow the above instructions for placement. All staples must be driven with pneumatic staplers. The staple must meet the following minimum dimensional requirements. Staples must be made from a minimum 16 gauge galvanized wire. Crown width must be at least 15/16 in. (staple crown width is measured outside the legs). Leg length should be a minimum of 1-1/4 in. for new construction and 1-1/2 in. for reroofing thus allowing a minimum deck penetration of 3/4 in. The crown of the staple must be parallel to the length of the shingle. The staple crown should be driven flush with the shingle surface. Staples that are crooked, underdriven or overdriven are considered improperly applied. Properly Driven Improperly Driven ISM tatda�iven overtirNcn tyootted nI -DO&Ing x� CAUTION: ALL FASTENERS MUST BE DRIVEN INTO THE NAIL ZONE/COMMON BOND AS SHOWN IN THE DIAGRAM ABOVE. 4. DNDSRLAYMBNT UNDERLAYMENT. An underlayment consisting of asphalt saturated felt must be applied over the entire deck before the installation of TAMKO shingles. Failure to add underlayment can cause premature failure of the shingles which is not covered by TAMKO's limited warranty. Apply the felt when the deck is dry. On roof decks 4 in. per foot and greater apply the felt parallel to the eaves lapping each course of the felt over the lower course at least 2 in. Where ends join, lap the felt 4 in. If left exposed, the underlayment felt may be adversely affected by moisture and weathering. Laying of the underlayment and the shingle application must be done together. Products which are acceptable for use as underlayment are: - TAMKO No. 15 Asphalt Saturated Organic Felt - A non -perforated asphalt saturated organic felt which meets ASTM: D226, Type I or ASTM D4869, Type I - Any TAMKO non -perforated asphalt saturated organic felt - TAMKO TW Metal and Tile Underlayment, TW Underlayment and Moisture Guard Plus* (additional ventilation may be required. Contact TAMKO's Technical Services Department for more information.) In areas where ice builds up along the eaves or a back-up of water from frozen or clogged gutters is a potential problem, TAMKO's Moisture Guard Pluse waterproofing underlayment (or any specialty eaves flashing product) may be applied to eaves, rakes, ridges, valleys, around chimneys, skylights or dormers to help prevent water damage. Contact TAMKO's Technical Services Department for more information. TAMKO does not recommend the use of any substitute products as shingle underlayment. S. APPLICATION INSTRUCTIONS STARTER COURSE: A starter course may consist of TAMKO Shingle Starter, self-sealing 3 -tab shingles or a 9 inch wide strip of mineral surface roll roofing. If self-sealing 3 -tab shingles are used, remove the exposed tab portion and install with the factory applied adhesive adjacent to the eaves. Attach the starter course with approved fasteners along a line parallel to and 3 in. to 4 in. above the eaves edge. The starter course should overhang both the eaves and rake edges 1/4 in. to 3/8 in. (Continued) Central District 220 West 4th St., Joplin, MO 64801 800-641-4691 11/09 Visit Our Web Site at Northeast District 4500 Tamko Dr., Frederick, MD 21701 800-368-2055 Southeast District 2300 35th St., Tuscaloosa, AL 35401 800-228-2656 tamko.com Southwest District 7910 S. Central Exp., Dallas, TX 75216 800-443-1834 Western District 5300 East 43rd Ave., Denver, CO 80216 800-530-8868 2 1!TAMK011 B011601NO PRODUCTS (CONTINUED from page 2) HERITAW 30 LAMINATED ASPHALT SHINGLES Dallas, TX • Tuscaloosa, AL • Phillipsburg, KS • Joplin, MO SHINGLE APPLICATION: Start the first course with a full size shingle and overhang the rake edge 1/4 in. Cut 10-3/8 in. from a full shingle to form a shingle 29 in. long. Use this to start the second course (see diagram below). Cut a 23 in. long shingle to start the third course. Use the remaining 16-3/8 in. piece of shingle to start the fourth course and use the remaining 10-3/8 in. piece to begin the fifth course. Continue up the rake in as many rows as necessary using the same formula as outlined above. The butt of the shingle should be aligned with the top edge of the sawtooth of the underlying shingle for a 5-5/8 in. exposure (see shingle application drawing illustrated on this panel). When you make your final cut at the roof's edge, flip any pieces that are 8 in. or longer back onto the roof. These pieces can be worked in anywhere without creating zippers or color variations. NOTE: Do not align joints of shingle courses when working in cut pieces. Joints should be no closer than 4 in. from one another. 1 220 West 4th St., Joplin, MO 64801 800-641-4691 11/09 Visit Our Web Site at Northeast District 4500 Tamko Dr., Frederick, MD 21701 800-368-2055 I10,3/e ropcal 2300 35th St.. Tuscaloosa, AL 35401 800-228-2656 courses 7910 S. Central Exp., Dallas, TX 75216 800-443-1834 Western District 23" 800-530-8868 9" 16-318' rano Full 23' 5th cowse 23' 16.918" 41h course &.It 3rd coursetnd course49.toCour" 10%V8,• �— esus —� 1Cu you vu Arno e1r9b b aMe 71 aro • 103r .lmouc Cu n seesm wos b mus a Mr and 0103rlcnpuc zs- i'0ie /17 2q eo0�n •u1 a nib blh Saye. .Tha1 br you m'. 21'. 1e 3T aro 10 3r b1g0u Asymonrca uree Yuebs.arnwam make ars Carus 3. Comrs,e""v Y.. "a 11 sb mm. I~ YM -row Isar tm9 W W as cods ease. &P W/ Oboes om M r a br9a back omy ae roar. Thm Olaale—be.0AW n m,.Ma.one C."W9 aWm or cdvy awm. rlose: Do 141 allp pnls ol sldnys rn,rsee wMn.selna a M yaaa..,bbe, e11a40 a ro loser con �• Yea oro ensU.r. S. LOW SLOPS APPLICATION On pitches 2 in. per foot to 4 in. per foot cover the deck with two layers of asphalt saturated felt. Begin by applying the felt in a 19 in. wide strip along the eaves and overhanging the drip edge by 1/4 to 3/4 in. Place a full 36 in. wide sheet over the 19 in. wide starter piece, completely overlapping it. All succeeding courses will be positioned to overlap the preceding course by 19 in. It winter temperatures average 25'F or less, thoroughly cement the felts to each other with TAM -PRO or TAMKO Plastic Roof Cement from eaves and rakes to a point of a least 24 in. inside the interior wall line of the building. As an alternative, TAMKO's Moisture Guard Plus° self -adhering waterproofing underlayment may be used in lieu of the cemented felts. 9. MANSARD ROOF OR STEEP SLOPS ROOF If the slope exceeds 21 in. per foot (60), each shingle must be sealed with TAM -PRO SBS Adhesive or TAMKO Tam -Seal Adhesive immediately upon installation. Spots of cement must be equivalent in size to a $.25 piece and applied to shingles with a 5-5/8 in. exposure, use 6 fasteners per shingle. See Section 3 for the Mansard Fastening Pattern. S. RE -ROOFING Before re -roofing, be certain to inspect the roof decks. All plywood shall meet the requirements listed in Section 1. Nail down or remove curled or broken shingles from the existing roof. Replace all missing shingles with new ones to provide a smooth base. Shingles that are buckled usually indicate warped decking or protruding nails. Hammer down all protruding nails or remove them and refasten in a new location. Remove all drip edge metal and replace with new. If re -roofing over an existing root where new flashing is required to protect against ice dams (freeze/thaw cycle of water and/or the backup of water in frozen or clogged gutters), remove the old roofing to a point at least 24 in. beyond the interior wall line and apply TAMKO's Moisture Guard Plus® waterproofing underiayment. Contact TAMKO's Technical Services Department for more information. Measurements will vary when nesting over an existing 5 in. exposure single roof: Call TAMKO Technical Services for further information. The nesting procedure described below is the preferred method for reroofing over existing metric size shingles with a 5-5/8 in. exposure. See description below: Starter Course: Remove the tabs and an additional portion from the head of a full size shingle so that its height is equal to the exposure of the existing shingles. Position the resulting strip over the existing roof edge (with the factory -applied adhesive strip along the eaves). Cut approximately 6 in. from the rake end and apply the remaining portion at the eaves. Continue the starter strip by applying full length shingle strips cut to height as above, evenly along the existing roof at the eaves. The existing roof should overhang the eaves far enough to carry water off into the gutter. If this is not the case, cut and apply the starter strip so that it will provide sufficient overhang for proper drainage. First Course, Remove an amount from the butt edge of a full-size shingle so that the remaining portion of the shingle fits between the butts of the existing third course. This course must also be applied evenly along the eaves edge of the new starter strip. (Continued) Central District 220 West 4th St., Joplin, MO 64801 800-641-4691 11/09 Visit Our Web Site at Northeast District 4500 Tamko Dr., Frederick, MD 21701 800-368-2055 Southeast District 2300 35th St.. Tuscaloosa, AL 35401 800-228-2656 tamkoxom Southwest District 7910 S. Central Exp., Dallas, TX 75216 800-443-1834 Western District 5300 East 43rd Ave., Denver, CO 80216 800-530-8868 _ _ ,~ I TAMKOJ, BUILDING PRODUCTS (CONTINUED from page 3) HERITAGIr 30 LAMINATED ASPHALT SHINGLES Dallas, TX • Tuscaloosa, AL • Phillipsburg, KS • Joplin, MO Second and Succeeding Courses: Remove 10-3/8 in. from the rake end of the first shingle in the second course, and continue with full width shingles for the remainder of the course, placing the top edge of each new shingle against the butt edge of the old shingle in the course above. This method should create an exposure of 5-5/8 in. after the first course. When beginning the succeeding courses continue to follow the Heritage application instructions. (See section 5). Drip NE 9. VALLEY APPLICATION Over the shingle underlayment, center a minimum 36 in. wide sheet of TAMKO Nail-Faste, Moisture Guard Pluse or a minimum 50 Ib. roll roofing in the valley. Nail the felt only where necessary to hold it in place and then only nail the outside edges. IMPORTANT: PRIOR TO INSTALLATION WARM SHINGLES TO PREVENT DAMAGE WHICH CAN OCCUR WHILE BENDING SHINGLES TO FORM VALLEY. After valley flashing is in place: • Apply the first course of shingles along the eaves of one of the intersecting roof planes and across the valley. Note: For proper flow of water over the trimmed shingle, always start applying the shingles on the roof plane that has the lower slope or less height. • Extend the end shingle at least 12 in. onto the adjoining roof. Apply succeeding courses in the same manner, extending them across the valley and onto the adjoining roof. • Press the shingles tightly into the valley. • Use normal shingle fastening methods. Note: No fastener should be within 6 in. of the valley centerline, and two fasteners should be placed at the end of each shingle crossing the valley. • To the adjoining roof plane, apply one row of shingles vertically facing the valley and 2 in. back from the valley centerline. Note: For a neater installation, snap a chalkline over the shingles for guidance. • To complete the valley, apply shingles on the adjoining roof plane by positioning the tip of the first shingle of each row at the 2 in. point from the centerline where the edge of the vertical shingle has been applied, covering the vertical shingle. FOR ALTERNATE VALLEY APPLICATION METHODS, PLEASE CONTACT TAMKO'S TECHNICAL SERVICES DEPARTMENT. M.m..n36'vrlda Sheena U''oeOwwo of Na Fast. MOWWO +1 Grad PND or 50 b. or fairta roll roofing \/I\ Extra no In ad of "Vie Wdat.irman Pbw to of sHrpb on the cdoo of "MUC111=91dfa tax = 00rom awom" 10. HIP AND RMOC FASTENING DETADa No faner'" wtddrf 6' of mGeW Apply the shingles with a 5 in. exposure beginning at the bottom of the hip or from the end of the ridge opposite the direction of the prevailing winds. Secure each shingle with one fastener on each side, 5-1/2 in. back from the exposed end and 1 in. up from the edge. TAMKO recommends the use of TAMKO Hip & Ridge shingle products. Where matching colors are available, it is acceptable to use TAMKO's Elite Glass -Seal shingles cut down to 12 in. pieces. Fasteners should be 1/4 in. longer than the one used for shingles IMPORTANT: PRIOR TO INSTALLATION, CARE NEEDS TO BE TAKEN TO PREVENT DAMAGE WHICH CAN OCCUR WHILE BENDING SHINGLE IN COLD WEATHER. Direction of prevailing wind -tart 5" exposure • ••i �\moi ��Fistener t51 exposure THESE ARE THE MANUFACTURER'S APPLICATION INSTRUCTIONS FOR THE ROOFING CONDITIONS DESCRIBED. TAMKO BUILDING PRODUCTS, INC. ASSUMES NO RESPONSIBILITY FOR LEAKS OR OTHER ROOFING DEFECTS RESULTING FROM FAILURE TO FOLLOW THE MANUFACTURER'S INSTRUCTIONS. TAMKOO. Mofstute Guard Plus®. Nail Fast®. TAM -PROD and HentageO are registered trademarks of TAMKO Building Products. Inc. Information included in these application Instructions was current at time of printing. To obtain a copy of the most current version of these application instructions, visit us online at lemko.com or tall us at 600.841-4691. Central District 220 West 4th St., Joplin, MO 64801 800-641-4691 11/09 Visit Our Web Site at Northeast District 4500 Tamko Dr., Frederick, MD 21701 800-368-2055 Southeast District 2300 35th St., Tuscaloosa, AL 35401 800-228-2656 tamko.Com Southwest District 7910 S. Central Exp., Dallas, TX 75216 800-443-1834 Western District 5300 East 43rd Ave., Denver, CO 80216 800-530-8868 4 ACORU® CERTIFICATE OF LIABILITY INSURANCE °�'1 t, is " THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE .OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder -in lieu of such endorsement(s). PRODUCER HERITAGE INSURANCE SERVICES LLC PO BOX 1506 PALMETTO. FL 34220 gre" GABEA.CLEMENTS PHONE 9417231400 FAX 9417131440 (AVC. No): ADDRESS: certificates@heritage4la.com Y AFFORDING COVERAGE MAIC I INSURER A: ARCH SPECIALTY INSURANCE CO (A+ - XV) 21199 11114=7 INSURED PAT LYNCH CONSTRUCTION LLC 909 DENNIS AVE ORLANDO, FL 32807 INSURER e: INSURER C: INSURER O: INSURER E GENERAL AGGREGATE $ 2A00,000 INSURER F: ' ` S COVERAGES CERTIFICATE NUMBER: REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO7WITHISTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TR OF INSURANCE ADMTYPE swan SUBR POLICY NUMBER POLICY DDI EFF POLICY EXP LIMITS A coMMERCIALGENFRALLWBIUTY CLAIMS#AADE 0 OCCUR Y Y AGL2B5732 11/14/2016 11114=7 EACHOCCURREI'M s 2•0001000 PREMISES I occurrence)$ 100,000 MED OP (Am' one Person) S 5,000 PERSONAL d ADV NARY $ 2,0001000 GENL AGGREGATE LIAR APPLIES PER POLICY 10 �T F]LOC OTHER GENERAL AGGREGATE $ 2A00,000 PRODUCTS - COMPIOP AGG $ 2,000,000 ` S AUTOMOBILE LIABILITY ANY AUTO OWNERS OONLY SCHEDULED AUTOAUTOS SOS ONLY NON4D O� Ea CONS"MLE LIMIT $ BODILY INJURY (Per parson) S BODILY NARY (Per acddent) $ eeddPR ryenlDA� S S UMBRELLA UAS Opp EXCESS UAB CLAIMS -WADE EACHOCCURR NCE $ AGGREGATE S DED RETENTION S WORKERS COMPENSATION AND EM PLOYERS' LIABILITY YIN ANY PROPRIETOWPARMERIE)EECUTIVE Q tED7 OFFKXWMEMBER EXAD (Mandatory In NH) I Yes, describe under DESCRIPTION OF OPERATIONS below NIA PSER TE ER E L EACH ACCIDENT $ F -L DISEASE- EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES (ACORD 101, AddHional Romarha Schedule, mey bo attached It Moro space Is roqulrod) CAvtificate holder is included as an additional insured on a blarlW basis as required byw itten contract (WQ GL0100 00 0715). A waiver of subrogation applies In f nar of certificate holder on a blanlet basis as required bywritten contract (00AGL0106 00 0213). Coverage is primaryand non-contributoryas required bywriroen contract (OD AGLO103 00 02 13), A designated pdicyaggregate applies on a blanW basis as required bywritten cordract (CG 25 0305 09). A 30 daynctice of cancellation applies (e>eW 10 days for non payment). City of Sanford 300 North ParkAw Sanford, FL 32772 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR® REPRESENTATIVE O 1988-2015 ACORD CORPORATION. AD rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD City of Sanford Roof Permit Application Checklist All permit application packages must be complete prior to acceptance. You must check each box to the left or indicate n/a on this submittal. A complete application package shall include the following: e -/Building Permit Application completed, signed and notarized. Application must include correct address and complete parcel I.D. number. Copy of applicable contractor's license issued by the State of Florida (if the contractor is the applicant). D A site specific notarized power of attorney shall be required from the licensed contractor if he/she appoints an employee of his/her company to sign the permit application as the contractor. Certificate of insurance indicating worker's compensation insurance coverage and naming the City of Sanford as certificate holder, or a copy of a worker's compensation exemption issued by the State of Florida (must be submitted with each application if contractor is the applicant). O Completed and signed Owner Builder Statement / Affidavit (if the owner is the applicant). These guidelines were compiled to assist the applicant in preparing a roof permit application and may not be complete. The applicant is required to meet all City of Sanford, state, and federal code requirements. CITY OI' SANFORD BUILDING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: /2V 6 I, /irl'g g l hereby acknowledge that I personally inspected oof deck nailing and/econdary water barrier work at and have determined that the work (J&bSite Address)- Z2 was done according to the Hurricane Mitigat� etro"f t 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 pe mans of him official duty shall constitute a misdemeanor of the second degree pursuant to — //, �. 4 Date Printed Name of Contracto License # License Type: ffbeneral Mudding MZesidential %o oofing Contractor ffbr any individual certified in accordance with F.S. 468 to make such an inspection. STATE OF FLORIDA COUNTY OF SW o to (or affir ed) and subscribed before is day o , 2016_, by who is � � ersonally Known to me or- ash roduced (type of identification) as Signature of Notary Puftc �1RA 3p'w�i P� F, 4 S to of Florida ••''•••••'••''''� 2 ;• 25 o Print/'Type/Sta p Name 9*.-" y s of Notary Public $, OF 173590 3