HomeMy WebLinkAbout130 Borada RdCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: (o — 3 0 �9
Documented Construction Value: $ it 0 00
Job Address: _130 6 o r U d o� d. s Q n Fo r d 3 2 7 73 Historic District: Yes ❑ No ❑
Parcel ID: 1 it -Z O- 3 0- 5 F S- 0 0 0 0 Residential Z Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: R -C r 0 0 f Z 6 S q A S p h Q 1 f S h i n 9 I f S
Plan Review Contact Person: J U rrl f S B-CH Title: o W n -e r 1( o m r000r
Phone: 401 0 11 Z rO (0 6 Fax:. -40-1 (0 715 6 Z 6 Email: J Q me Se W 1 n tt C fur r r0 Of (n T f
Jog p Property Owner Information
Name o g R 0 d r 1 u -o z Phone: 0 4�
J
Street: X 3 0 6 0 V a G Resident of property?: S
City, State Zip: SQ' f po r Q 32-713
Contractor Information
Name 111 +Y part f o of I'n - J (A meJ 1 ) Phone: 401 (0 7 Z ro rO 6
Street: 3500 A 10 M 01 AVf 4-f F0 Fax: +0 7 0 715 6 Z 6
City, State Zip: W 01-K K FQ r K I FL 327 q,? State License No.: C(0 3 Z �V
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
ArchitecVEngineer Information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction
in this jurisdiction. 1 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 dale: 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 regulating construction and zoning.
Jigature i� 6. of weer/A Dat
a_\CV_4t1_ u
nn caner/Agent's ame
Signature of Notary -State of Florida Date
pill &N N01M P5/1
State d Fbrlde
Andree
+� FF 942693
aMY1019
Owne Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Signature o ractor/Agent Date
JC660 wh;
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
;;•:"•
DEBBIE BLANTON
'f' = MY COMMISSION ti FF 178,648
a= EXPIRES: February 25, 2019
%I jo ?rd Bonded TAN WWI Public Undemdt m
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
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:
Flood Zone:
# of Stories:
Plumbing - # of Fixtures,
# of Heads Fire Alarm Permit: Yes ❑ No ❑
UTILITIES: WASTE WATER:
FIRE:
BUILDING:
Revised- June 30, 2015 Permit Application
Il/rs-/rE
Winter Park Roofing, Inc
State Certified Roofing and Residential Contractor
CCC1328879/CRC132968O
• Roof Proposal
407-671-2666 Fax:4O7-671-5626
Customer name
Address ��� l%0020'4 ro), �G�ci``�� �L 7,017;
Phone ' 9� 'r7� r� Email J°Sf 79 t 60 /" /i - Co P►
Roof pitch q II 9
Removal -handard_non-standard Describe:
We will use tarps to protect ground covering and customer's property.
We will tear off and dispose of all existing roofing material down to the bare deck.
We remove and replace all rotted roof decking at no additional charge.
We will re -nail entire deck as per FI. code using 8d ring shank nails.
We will replace all metal including drip edge (color optional), lead pipes, and vent pipes.
We will install Owens Corning Pro Armor synthetic underlayment.
We will install Owens Corning, CertainTeed, or GAF shingles (6 nail per code) color and manufacturer
TBD by customer.
Install starter shingles on all eaves and rakes.
All gutters will be cleaned at job conclusion.
We will magnet and provide daily clean up and keep property clear of roofing debris removing dumpster
at job conclusion.
We will add proper amount of roof ventilation at no additional cost.
Contractor will provide all necessary permitting paperwork and provides wind mitigation upon customer
request. �/ I /
Any special notations: 1& W11/ \P /iWt� 7►^'t W P(r� k fro' V'th7 1 y Alid 1114-v// -&g /(f Q
Customer to provide solar company to remove and re -install solar system if present.
Start date to be customer choice 2 weeks out from signed contract date.
Job duration 2-3 days weather and inspections permitting.
3500 Aloma Ave F17 Winter Park FI 32792
www.winterparkroofing.net
Winter'Park Roofing, Inc
State Certified Roofing and Residential Contractor
CCC1328879/CRC1329680
Roof Proposal
407-671-2666 Fax:407-671-5626
Note: Replacement of all standard vent pipes, edge metal, valley base and debris removal included in this proposal.
With our standard services comes gutter cleaning, as well as daily clean up and magnetic sweeping. SATELLITE
CUSTOMERS MUST MAKE PREVIOUS ARRANGEMENTS WITH SATELLITE COMPANY IN THE EVENT OF LOSS OF
SIGNAL,
All material is guaranteed to be as specified. All work to be completed in craftsman -like manner, according to
standard and accepted practices. All material to be installed according to current codes and mitigation, as deemed
by each county/city building regulatory divisions and manufacturer specs. Local regulations may exceed
manufacturer standards.
Under Terms of this binding contract, the labor warranty does not become effective until all payments due have
been remedied in full. No additional work, not specified on this contract, will be done without a signed change
order, unless freely given. Therefore, this contract constitutes the entire understanding of the parties, and no
other understanding, collateral or otherwise, shall be binding until in writing, signed by both parties.
Replacement of non -typical roofing materials such as: Deteriorated decking, fascia boards, roof jacks, ventilators,
special flashing, stucco etc., unless otherwise stated, are not automatically included in this contract. These line
items must be specified above. Due to the nature of these items, they are not under our warranty.
Any accidental and incidental interior damages incurred during the removal/installation process will be properly
handled, and do not void this contract. Contractor is not liable for any interior damages, or affected interior
contents, incurred ninety days past the completion of stated project. Signatures on this contract represent
understanding and acceptance of these policies. Winter Park Roofing is not responsible for damages caused by
delivery from Material Supplier. Modern readily obtainable lumber shall be used to replace any decayed wood.
WPR is NOT responsible for damage or damage caused by improperly installed plumbing, electrical, or A/C that
does not meeting building code. Unless contracted, estimate good for sixty days after issuance.
Winter Park Roofing, Inc. will provide a 10 year workmanship warranty upon final payment.
We hereby propose to furnish material and labor, complete in accordance with the above specification,
for the sum of $ �r Cod` oe
Payment as follows:$ %down + $ for materials and permit. Remainder
of $ 17, ox '� due upon completion.
Owner contractor
3500 Aloma Ave F17 Winter Park Fl 32792
www.winterparkroofing.net
Customer Name:
WINTER PARK ROOFING INC
ROOF MEASUREMENT AND SPECIAL INSTRUCTION FOR REROOFING
{ddqvtt
Referred by
Address: (� 6a✓�' �� Sa ��d 3 X77 `3
Phone
Email:
to 791tevxk'Com
P ! I jI VII 3P
Pitch Stories Valle Eave
Present material/ a4rd-nonstandard removal? ' ` qy( MytA-
Vents
I I / .' I J L .1, �� ►
Satellite dish/ solar panels
Wood replacement -PLANK OR CDX?
floury„
Skylights/ridge
Life expectancy
-W � J (1q (4+f -e Wt KApj o ✓
Measurements:
/VI
Special Instruction:
t -f-0 r��
/ .190 \-,,'
. aFf �Cyr r
THIS INSTRUMENT PREPARED BY -
Name: WINTER
Y:Name:WINTER PARK ROOFING
Address: 3500 ALOMA AVE STE F17
WINTER PARK. FL 32792
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number.
Parcel ID Number:
MARYf NNE HORSEY SEMINOLE COUNTY
CLERY, OF CIRCUIT COURT & COMPTROLLER
BK 8905 P3 1800 (IFgs)
C'LERK'S : 2016118779
RECORDED it/15/2016 01:06:19 PN
RECORDING FEES $10.00
RECORDED BY hdevcire
10-20-30-5FS-0000-1220
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 description of the property and street address if available)
LOT 122
Mail ele]4,11IMMIX: :
PB 25 PGS 64&65
GENERAL DESCRIPTION OF IMPROVEMENT:
REROOF 28SQ ASPHALT SHINGLES
OWNER INFORMATION:
Name: JOSE RODRIGUEZ.
Address: 130 BORADA RD SANFORD, FL 32773
Fee Simple Title Holder (if other than owner) Name:
9
43
co
a ,J
D �1
o g VO4
CONTRACTOR:
Name: WINTER PARK ROOFING- JAMES BELL
' 5 Z
7
Address: 3500 ALOMA AVE STE F17 WINTER PARK, FL 32792
P _ t
O i K
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served
LL c) d
as provided by Section 713.13(1)(b), Florida Statutes.
_
W g
Name:
r
t' ` I
Address:
In addition to himself, Owner Designates of
To receive a copy of the Lienor's Notice 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 7 Zbstof nowledge and belief. ,
J� 20 dn4 LA
Owner'sSi lure (Tuner's Printed Na
Florida Statute 713.13(1)(g): a er must sign the notice of commencement and no one else may be permitted to sign in his or her stead'
State of t --k 02 t OPr County of Oc `
The foregoing instrument was acknowledged before me this day of /J o qe" Ali 20
by ZoS 2 Who is personally known tome
Name of perfth making statement
OR who has produced identification ❑ type of identification produced:
puw EF
Publics of Floritta
,
R 942893
9 Notary Signature
SEM INOLE COUNTY MULTI IURISDICTIONAL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 10/18/16
I hereby name and appoint: JOSHUA WHITE
an agent of: WINTER PARK ROOFING, INC.
(Name of Company)
to be my lawful attorney-in-fact to act for me to apply for, receipt for, sign for and do all things necessary to this
appointment for (check only one option):
❑✓ All permits and applications submitted by this contractor.
Or
❑ The specific permit and application for work located at:
(Street Address)
Expiration Date for This Limited Power of Attorney: 10/18/2017
License Holder Name: JAMES BELL
State License Number: CW132887
Signature of
M
STATE OF FL
COUNTY OF
The foregoing instrument was acknowledged before me this Jday of
20 UP , by Jahns PY I I who is personally known to me or
O who has produced
and who did (did not) k an oath.
&*�
Signa re Notary
BETHANY E. DUNN
Notary ►ubtle . State of Florida
My Comm. Expires Jun 5. 2019
Commission # FF 130057
as identification
'5ft an u E din n
Print or typd Notary name
Notary Public - State of
Commission No. iir- i3 U 05 —7
My Commission Expires: ) ki n -c, 5.2018
fl, D City of Sanford
Building and Fire Prevention
Product Approval Specification Form
Permit #
Project Location Address 13 0 5 0 r U d U P- d - S 61 n FO r d F L 3 Z l -73
As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the
information and product approval number(s) on the building components listed below if they are to be
utilized on the construction project for which you are applying for a building permit. We recommend that
you contact your local product supplier should you not know the product approval number for any of the
applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in
accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product
Approval can be obtained at www.floridabuilding.org.
The following information must be available on the jobsite for inspections:
1. This entire product approval form
2. A copy of the manufacturer's installation details and requirements for each product.
Category / Subcategory Manufacturer Product Florida Approval #
Description include decimal
1. Exterior Doors
Swinging
Sliding
Sectional
Roll U
Automatic
Other
2. Windows
Single Hun
Horizontal Slider
Casement
Double Hun
Fixed
Awning
Pass Through
Projected
Mullions
Wind Breaker
Dual Action
Other
June 2014
Category/ Subcategory
Manufacturer
Product
Description(including
Florida Approval #
decimal
3. Panel Walls
'Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles
A F
I M b -C V I I rY 44 D
10 1 z1f. I
Underla ments
owns (orning
PrO Af rYIQr
1-1,4z I
Roofing Fasteners
Nonstructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Built up roofing
System
Modified Bitumen
Single Ply Roof
Systems
Roofing slate
Cements/
Adhesives /
Coating
Liquid Applied
Roofing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels
Roof Vents
Other
June 2014
Category/ Subcategory Manufacturer Product Florida Approval #
Description include decimal
S. Shutters
'Accordion
Bahama
Colonial
Roll u
Equipment
Other
6. Skylights
Skylights
Other
7. Structural
Components
Wood Connectors /
Anchors
Truss Plates
Engineered Lumber
Railing
Coolers/Freezers
Concrete Admixtures
Precast Lintels
Insulation Forms
Plastics
Deck / Roof
Wall
Prefab Sheds
Other
8. New Exterior
Envelope Products
Applicant's Signature
Applicant's Name
(Please Print)
June 2014
Florida Building Code Online
Page 1 of 2
Business & Professional Regulation
>z
SCIS Home Log In User Registration Hot Topics Submit Surcharge stats b Facts Publications FBC Staff SCIS Site Mao Links search
db
a
h1■I�Sl USER-
Product Approval
� SER• Public User
Product Approval Menu > Product or Aooliwuon Search > Application List > Application Detail
FL # FL17420-R2
Application Type Revision
Code Version 2014
Application Status Approved
Comments
Archived
Product Manufacturer Owens Corning
Address/Phone/Email One Owens Corning Parkway
Toledo, OH 43659
(740)404-7829
greg.keeler@owenscorning.com
Authorized Signature Greg Keeler
greg.keeler@owenscorning.com
Technical Representative
Address/Phone/Email
Quality Assurance Representative
Address/Phone/Email
Category Roofing
Subcategory Underlayments
Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed
Florida Professional Engineer\
4 Evaluation Report - Hardcopy Received
Florida Engineer or Architect Name who developed Zachary R. Priest
the Evaluation Report
Florida License PE -74021
Quality Assurance Entity QAI Laboratories
Quality Assurance Contract Expiration Date 12/31/2020
Validated By Locke Bowden
J Validation Checklist - Hardcopy Received
Certificate of Independence
Referenced Standard and Year (of Standard)
Equivalence of Product Standards
Certified By
I
Sections from the Code
Product Approval Method
FL17420 R2 COI OCR14004.2 2014 FBC Eval Report ProArmor
FINAL.odf
1507.2.3
1507.2.8
Method 2 Option B \
http://www.floridabuilding.org/pr/pr app_dtl.aspx?param=wGEVXQwtDgtCUGgvjQiz6G... 11/8/2016
Florida Building Code Online
Date Submitted
04/19/2015
Date Validated
04/20/2015
Date Pending FBC Approval
04/22/2015
Date Approved
06/23/2015
Date Revised
10/19/2016
Summary of Products
Page 2 of 2
FL #
Model, Number or Name
Description
17420.1
ProArmor
Synthetic underlayment for use with asphalt shingles In
steep slope roofing
Limits of Use
Installation Instructions
Approved for use in HVHZ: No
FL17420 R2 11 QCR14004.2 2014 FBC Eval Report
Approved for use outside HVHZ: Yes
ProArmor F1NAL.Ddf
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
FL17420 R2 AE OCR14004.2 2014 FBC Eval Report
ProArmor FINAL.pdf
Created by Independent Third Party: Yes
Contact Us : • 2601 Blair Stone Road, Tallahassee Fl. 32399 Phone: 850-487-1824
The State of Florida K an AA/EEO employer. copyright 2007.2013 State of Florida... Privacy Statement :. Accessibility Statement : Refund Statement
Under Florida law, email addresses are public records If you d0 not want your e-mail address released in response to a public -records request, d0 not send
electronic mad to this entity Instead, contact the office by phone or by traditional mad If you have any questions, please contact 850.487.1395. *Pursuant to
Section 455 275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S must provide the Department with an email address if
they have one. The emalls provided may be used for official communication with the licensee. However email addresses are public record If you do not wish to
supply a personal address, please provide the Department with an email address whish can be made available to the public. To determine if you are a licensee under
Chapter 4ere
55, F s , please click h
Product Approval Accepts:
® l ! -tan
Credit Card
Sate
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CREEK
TECHNICAL SERVICES, LLC
EVALUATION REPORT
Certificate of Authorization No. 29824
17520 Edinburgh Drive
Tampa, FL 33647
(813) 480-3421
Manufacturer: OWENS CORNING ROOFING AND ASPHALT LLC
1 Owens Corning Parkway
Toledo, OH 43657
(800) 438-7465
www owenscornino.com
Quality Assurance: Quality Auditing -Institute Ltd. (QUA7628)
SCOPE
Category:
Subcategory:
Code Sections:
Properties:
REFERENCES
Roofing
Underlayments
1507.2.3, 1507.2.8
Physical properties
2014 FLORIDA BUILDING CODE
Issued April 13, 2015
Entity Report No. Standard Year
PRI Construction Materials Technologies (TST5878) OCF-227-02-01 ASTM D 226 2006
PRI Construction Materials Technologies (TST5878) OCF-227-02-01 ASTM D 4869 2005el
PRODUCT DESCRIPTION AND APPLICATION
ProArmor'"° ASTM D 226, Type II synthetic underlayment for use in steep slope roofing applications.
Unless otherwise noted, the following application details shall be followed for New and
Existing construction. See manufacturer's installation instructions for further detail.
Roof Deck: The roof deck shall be constructed of closely fitted
wood sheathing for new or existing construction.
Plywood deck shall be installed in accordance with
FBC requirements. Roof decks shall have no more
than '/a" gap at abutting joints.
Min. slope: 2:12 and In accordance with FBC requirements
Attachment method: Mechanically fasten the underlayment to the deck in
accordance with FBC requirements and the
manufacturer's installation instructions with a
minimum 3 -inch head lap and 4 -inch end lap. For
slopes less than 4:12, the underlayment shall be
installed with a 22 -inch headlap over the underlying
course.
Allowable roof coverings: Asphalt shingles.
OCR14004.2 FL17420-R2 Page 1 of 2
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
LIMITATIONS
OWENS CORNING ROOFING AND ASPHALT LLC
ProArmor"
1) This evaluation report is not for use in the HVHZ.
2) Fire Classification is not within the scope of this evaluation.
3) Wind uplift resistance in not within scope of this evaluation
4) 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.
5) 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.
6) The underlayment may be used as described in other current FBC product approval documents.
7) Roof coverings shall not be adhered directly to the underlayment.
8) The underlayment shall not be installed over existing roof coverings.
9) The underlayment shall be installed starting at the eave in horizontal layers such that the laps shed water
from the deck. The first layer shall cover the entire bottom edge of the deck. End laps shall be staggered a
minimum of 72 -inches from the preceding course.
10) The underlayment shall be exposed on the roof deck for a maximum duration of 30 days.
11) All products listed in this report shall be manufactured under a quality assurance program in compliance with
Rule 61 G20-3.
COMPLIANCE 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.
,�����Ilr►riii�i
ptY R.
.`% G1:P•
IX
No 74021
� r
0 STATE OF :4J
F�
,0 N A,
CERTIFICATION OF INDEPENDENCE
2015.04.1
3 12:11:22
Zachary R. Priest, P.E.
Florida Registration No. 74021
Organization No. ANE9641
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
OCR14004.2 FL17420-R2 Page 2 of 2
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.
Florida Building Code Online Page 1 of 2
SCIS Home Log In User Registration Hot Topics Submit Surcharge Stats 8 Facts Publications FSC Staff SCIS Site Map Links Search
H rida
r
Product Approval
h * USER: Public User
' Product Approval Menu > Product or Aoohwuon Search > &2RLQj,= gU > Application Detail
FL # FL10124-1119
Application Type Revision
Code Version 2014
Application Status Approved
Comments
Archived
Product Manufacturer GAF
Address/Phone/Email 1 Campus Drive
Parlsppany, NJ 07054
(973)872-4421
lindareith@tnnityerd.com
Authorized Signature Beth McSorley
lindareith@trinityerd.com
Technical Representative Beth McSorley (current)
Address/Phone/Email 1 Campus Drive
Parsippany, NJ 07054
(973)872-4421
bmcsorley@gaf.com
Quality Assurance Representative
Address/Phone/Email
Category Roofing
Subcategory Asphalt Shingles
Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed
Florida Professional Engineer
Evaluation Report - Hardcopy Received
Florida Engineer or Architect Name who developed Robert Nieminen
the Evaluation Report
Florida License PE -59166
Quality Assurance Entity UL LLC
Quality Assurance Contract Expiration Date 03/03/2017
Validated By John W. Knezevich, PE
J Validation Checklist - Hardcopy Received
Certificate of Independence
Referenced Standard and Year (of Standard)
Equivalence of Product Standards
Certified By
Sections from the Code
FL10124 R19 COI 2016 01 COlLipminen.pdf
Standard
ASTM D1970
ASTM D3161
ASTM D3462
ASTM D7158
TAS 107
Year
2009
2009
2009
2008
1995
http://www.floridabuilding.org/pr/pr_app_dti.aspx?param=wGEVXQwtDquracBeVCbd... 11/14/2016
Florida Building Code Online
Product Approval Method
Date Submitted
Date Validated
Date Pending FBC Approval
Date Approved
Summary of Products
Method 1 Option D
08/26/2016
08/26/2016
08/30/2016
10/13/2016
Page 2 of 2
FL #
Model, Number or Name
Description
10124.1
GAF Asphalt Roof Shingles
Fiberglass reinforced 3 -tab, laminated, 5 -tab and hip/ridge
asphalt shingles
Limits of Use
Installation Instructions
Approved for use in HVHZ: No
FL10124 R19 II 2016 08 FINAL ER GAF Asphalt
Approved for use outside HVHZ: Yes
Shinoles FL30124-1119.0
Impact Resistant: N/A
Verified By: Robert Nieminen PE -59166
Design Pressure: N/A
Created by Independent Third Party: Yes
Other: Refer to ER, Section S.
Evaluation Reports
FL10124 R19 AE 2016 08 FINAL ER GAF Asphalt
Shinoles FL10124-1119.0
Created by Independent Third Party: Yes
Brick NOxI
Contact Us .: 2601 Stair Stone Road, Tallahassee FL 32399 Phone: 850.487.1824
The State of Florida is an WEED employer. Copyright 2007.2013 State of Flonda. - • Privacy Statement : • Accessibility Statement • • Refund Statement
Under Florida law, email addresses are public records. If you d0 not want your a -mad address released in response t0 a public -records request, d0 not send
electronic mad to this entity. Instead, contact the office by phone or by traditional mad If you have any questions, please contact 850.487:1395. *Pursuant to
Sedan 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S must provide the Department with an email address if
they have one. The emails provided may be used for official communication with the licensee. However email addresses.are public record. If you do not wish to
supply a personal address, please provide the Department with an email address which can be made available to the public. To determine of you are a licensee under
Chapter 455, F S., please clock beg-,.
Product Approval Accepts:
etna
Crede Caid
Safe
http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDquracBeVCbd... 11/14/2016
r
TRINITY,ERD
EVALUATION REPORT
GAF
1 Campus Drive
Parsippany, NJ 07054
EXTERIOR RESEARCH & DESIGN, LLC.
Certificate of Authorization #9503
353 CHRISTIAN STREET, UNIT #13
OXFORD, CT 06478
PHONE. (203) 262-9245
FAX: (203) 262-9243
Evaluation Report 01506.01.08-R21
FL10124-1119
Date of Issuance: 01/03/2008
Revision 21: 08/26/2016
SCOPE:
This Evaluation Report is issued under Rule 61G20-3 and the applicable rules and regulations governing the use of
construction materials in the State of Florida. The documentation submitted has been reviewed by Robert Nieminen,
P.E. for use of the product under the Florida Building Code and Florida Building Code, Residential Volume. The
products described herein have been evaluated for compliance with the 51" Edition (2014) Florida Building Code
sections noted herein.
DESCRIPTION: GAF Asphalt Roof Shingles
LABELING: Labeling shall be in accordance with the requirements the Accredited Quality Assurance Agency noted
herein.
CONTINUED COMPLIANCE: This Evaluation Report is valid until such time as the named product(s) changes, the
referenced Quality Assurance documentation changes, or provisions of the Code that relate to the product change.
Acceptance of this Evaluation Report by the named client constitutes agreement to notify Robert Nieminen, P.E. if the
product changes or the referenced Quality Assurance documentation changes. Trinity(ERD requires a complete
review of this Evaluation Report relative to updated Code requirements with each Code Cycle.
ADVERTISEMENT: The Evaluation Report number preceded by the words "Trinity IERD Evaluated" may be displayed in
advertising literature. If any portion of the Evaluation Report is displayed, then it shall be done in its entirety.
INSPECTION: Upon request, a copy of this entire Evaluation Report 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 Evaluation Report consists of pages 1 through 6.
Prepared by:
Robert J.M. Nieminen, P.E.
Florida Registration No. 59166, Florida DCA ANE1983
CERTIFICATION OF INDEPENDENCE:
1. TrinitylERD does not have, nor does it intend to acquire or will it acquire, a financial interest in any company manufacturing or
distributing products it evaluates.
2. Trinityl ERD is not owned, operated or controlled by any company manufacturing or distributing products it evaluates.
3. Robert Nieminen, P.E. does not have nor will acquire, a financial interest In any company manufacturing or distributing products for
which the evaluation reports are being issued.
4. Robert Nieminen, P.E. does not have, nor will acquire, a financial interest in any other entity involved In the approval process of the
product.
S. This is a building code evaluation. Neither Trinity lERD nor Robert Nieminen, P.E. are, in any way, the Designer of Record for any
project on which this Evaluation Report, or previous versions thereof, is/was used for permitting or design guidance unless retained
specifically for that purpose.
-
;-44-1— 1,%-
0.
The tacsimde sealappecrnse was authorized by Robert theminen,
PE on0X/16/2016 This does not serve as .anelectronlcallyslgned
document. 9Rned, stated hardcomes have been transmitted to the
Product Approval Adr•nmslrawr and to ine named client
CERTIFICATION OF INDEPENDENCE:
1. TrinitylERD does not have, nor does it intend to acquire or will it acquire, a financial interest in any company manufacturing or
distributing products it evaluates.
2. Trinityl ERD is not owned, operated or controlled by any company manufacturing or distributing products it evaluates.
3. Robert Nieminen, P.E. does not have nor will acquire, a financial interest In any company manufacturing or distributing products for
which the evaluation reports are being issued.
4. Robert Nieminen, P.E. does not have, nor will acquire, a financial interest in any other entity involved In the approval process of the
product.
S. This is a building code evaluation. Neither Trinity lERD nor Robert Nieminen, P.E. are, in any way, the Designer of Record for any
project on which this Evaluation Report, or previous versions thereof, is/was used for permitting or design guidance unless retained
specifically for that purpose.
TRINITY ERD
ROOFING SYSTEMS EVALUATION:
1. SCOPE:
Product Category: Roofing
Sub -Category: Asphalt Shingles
Compliance Statement: GAF Asphalt Roof Shingles, as produced by GAF, have demonstrated compliance with the
following sections of the Florida Building Code and Florida Building Code, Residential Volume through testing in
accordance with the following Standards. Compliance is subject to the Installation Requirements and Limitations /
Conditions of Use set forth herein.
2. STANDARDS:
Section
Property
Standard
Year
1507.2.4, R905.2.3
Physical Properties
ASTM D1970
2009
1507.2.5, R905.2.4
Physical Properties
ASTM D3462
2009
1507.2.7.1, R905.2.6.1
Wind Resistance
ASTM D3161
2009
1507.2.7.1, R905.2.6.1
Wind Resistance
ASTM D7158
2008
1507.2.7.1, R905.2.6.1
Wind Resistance
TAS 107
1995
3. REFERENCES:
Entity
Examination
Reference
Date
GAF (PDM 1915)
Letter of Equivalency
Seal -A -Ridge Impact Resistant IR
01/13/2012
PRI (TST 5878)
Physical Properties
GAF -025-02-01
03/27/2002
PRI (TST 5878)
ASTM D3462
GAF -059-02-01
09/02/2004
PRI (TST 5878)
ASTM D3462
GAF -080-02.01
05/25/2005
PRI (TST 5878)
Physical Properties
GAF -324.02-01
12/01/2011
PRI (TST 5878)
Wind Driven Rain
GAF -407.02-01
01/21/2013
UL (TST 1740)
ASTM D3462
93NK6295
11/29/1993
UL (TST 1740)
ASTM D3462
99NK43835
01/12/2000
UL (TST 1740)
TA5107
94NK9632
03/29/2000
UL (TST 1740)
ASTM D3462
OINK06632
02/02/2001
UL (TST 1740)
ASTM D3161, TAS 107
OINK9226
05/21/2001
UL (TST 1740)
ASTM D3161
01NK37122
12/18/2001
UL(TST 1740)
ASTM D3462
OINK37122
12/19/2001
UL (TST 1740)
ASTM D3161, TAS 107
02NK12980
04/10/2002
UL (TST 1740)
ASTM D3161, TAS 107
02NK30871
09/09/2002
UL(TST 1740)
ASTM D3161
03CA5367
03/11/2003
UL (TST 1740)
ASTM D3462
03NK26444
10/17/2003
UL(TST 1740)
ASTM D3462
04NK13850
06/07/2004
UL (TST 1740)
ASTM D3161
04NK13850
06/23/2004
UL(TST 1740)
ASTM D3161
04NK30546
03/10/2005
UL(TST 1740)
ASTM D3462
04 422009
05/06/2005
UL (TST 1740)
ASTM D3161
04NK22009
05/09/2005
UL (TST 1740)
ASTM D3462
05NK27924
02/10/2006
UL (TST 1740)
ASTM D3161
05NK27924
02/11/2006
UL (TST 1740)
ASTM D3161, D3462
06CA18077
06/05/2006
UL (TST 1740)
ASTM D3161, D3462
06CA18074
06/16/2006
UL (TST 1740)
ASTM'D3161,D3462
06CA35251
10/18/2006
UL(TST 1740)
ASTM D3462
06CA31603
12/01/2006
UL (TST 1740)
ASTM D3161, D3462
06CA41095
12/27/2006
UL (TST 1740)
ASTM D3161
07NK05228
03/13/2007
UL (TST 1740)
ASTM D3161
06CA31611
04/04/2007
UL (TST 1740)
ASTM D3161
06CA61148
04/09/2007
UL (TST 1740)
ASTM D3161, D3462
07CA31742
11/08/2007
UL (TST 1740)
ASTM D3161, D7158, D3462
08CA06100
03/13/2008
UL (TST 1740)
ASTM D3161, D3462
07CA55908
04/01/2008
Exterior Research and Design, LLC. Evaluation Report 01506.01.08-R21
Certificate of Authorization #9503 FL10124-R19
Revision 21: 08/26/2016
Page 2 of 6
TRINITY ERD
iaiibf
Examination
Reference
Date
UL (TST 1740)
ASTM D3161,D3462
09CA10592
03/26/2009
UL (TST 1740)
ASTM D3161, D3462
09CA06856
05/15/2009
UL (TST 1740)
ASTM D3161, D7158, D3462
09NK06647
08/01/2009
UL (TST 1740)
ASTM D3161, D7158, D3462
09CA27281
08/27/2009
UL (TST 1740)
ASTM D3161, D7158, D3462
IOCA35554
03/05/2010
UL (TST 1740)
ASTM D3161, D7158, D3462
1OCA13686
05/15/2010
UL (TST 1740)
ASTM D3462
IOCA07264
05/27/2010
UL(TST 1740)
ASTM D3462
1OCA11953
10/29/2010
UL (TST 1740)
ASTM D3161,D7158,D3462
1ONK11951
10/30/2010
UL (TST 1740)
ASTM D3161, D7158, D3462
IONK12070
11/04/2010
UL(TST 1740)
ASTM D3161, D7158, D3462
08CA06100
01/30/2010
UL (TST 1740)
ASTM D3161, D7158, D3462
IOCA53934
03/31/2011
UL (TST 1740)
ASTM D3161, D7158, D3462
1.1CA48924
10/22/2011
UL(TST 1740)
ASTM D3161, D7158, D3462
11CA47919
12/03/2011
UL (TST 1740)
ASTM D3161, D7158, D3462
11CA48408
12/08/2011
UL(TST 1740)
ASTM D3161, D7158, D3462
11CA48725
12/09/2011
UL, I.I.C. (TST 9628)
ASTM D3462
12CA34891
10/12/2012
UL, LLC. (TST 9628)
ASTM D3161, D71S8, D3462
12CA58151
02/35/2013
UL, I.I.C. (TST 9628)
ASTM D3161
12CA38083
02/26/2013
UL, I.I.C. (TST 9628)
ASTM D3161
13CA32332
06/18/2013
UL, LLC. (TST 9628)
ASTM D3161
13CA37934
08/02/2013
UL, I.I.C. (TST 9628)
ASTM D3161, D7158, D3462
4786875675
07/17/2015
UL, LLC. (TST 9628)
ASTM D3161, D7158, D3462
4787434542
05/17/2016
UL, LLC. (QUA 9625)
Quality Control
Inspection Report, R21, Mobile, AL
12/28/2015
UL, I.I.C. (QUA 9625)
Quality Control
Inspection Report, R21, Myerstown, PA
02/23/2016
UL, I.I.C. (QUA 9625)
Quality Control
Inspection Report, R21, Tuscaloosa, AL
02/26/2016
UL, I.I.C. (QUA 9625)
Quality Control
Inspection Report, R21, Michigan Cty, IN
03/02/2016
UL, I.I.C. (QUA 9625)
Quality Control
Inspection Report, R21, Shafter, CA
02/18/2016
UL, I.I.C. (QUA 9625)
Quality Control
Inspection Report, R21, Savannah, GA
02/24/2016
UL, I.I.C. (QUA 9625)
Quality Control
Inspection Report, R21, Minneapolis, MN
02/09/2016
UL, LLC. (QUA 9625)
Quality Control
Inspection Report, R21, Mt. Vernon, IN
02/09/2016
UL, LLC. (QUA 962 5)
Quality Control
Inspection Report, R21, Baltimore, MD
03/01/2016
UL, LLC. (QUA 9625)
Quality Control
Inspection Report, R21, Tampa, FL
02/29/2016
UL, I.I.C. (QUA 962 5)
Quality Control
Inspection Report, R21. Dallas, TX
02/17/2016
UL, LLC. (QUA 9625)
Quality Control
Inspection Report, R21, Ennis, TX
02/03/2016
UL, I.I.C. (QUA 9625)
Quality Control
Inspection Report, R21, Fontana, CA
03/03/2016
4. PRODUCT DESCRIPTION:
4.1 Asphalt Shingles:
4.1.1 Marquis® WeatherMaxm, Royal Sovereign' and Sentinel° are a fiberglass reinforced 3 -tab asphalt roof
shingles.
4.1.2 Camelota, Camelot" II, Fortitude'", Glenwood-, Grand CanyonO, Grand Sequoia', Grand Sequoia's IR,
Grand Sequoia° ArmorShield", Monaco', SiennaL, Timberline0° American Harvest', Timberline"
ArmorShield'" II, Timberline* Natural Shadow*, Timberline HD°, Timberline@ Cool Series°, Timberline Ultra
HD® and Woodland® are fiberglass reinforced, laminated asphalt roof shingles.
4.1.3 Slateline® is a fiberglass reinforced 5 -tab asphalt roof shingle.
4.2 Hip & Ridge Shingles:
4.2.1 Seal-A-Ridgem Ridge Cap Shingles, Seal-A-RidgeO IR Impact -Resistant Ridge Cap Shingles, Seal -A -Ridge°
ArmorShield" Ridge Cap Shingles and Timbertexl Premium Ridge Cap Shingles are fiberglass reinforced, hip
and ridge asphalt roof shingles.
Exterior Research and Design, LLC. Evaluation Report 01506.01.08-R21
Certificate of Authorization u9S03 FL10124-R19
Revision 21: 08/26/2016
Page 3 of 6
TRINITY ERD
4.3 Accessory Starter Strips:
4.3.1 Pro -Start® Eave/Rake Starter Strip Shingles and WeatherBlocker'" Premium Eave/Rake Starter Strip Shingles
are starter strips for asphalt roof shingles.
4.3.2 QuickStart® Peel & Stick Starter Roll is a is a mineral -surfaced, fiberglass -reinforced, self -adhering SBS
modified bitumen starter strip, nominal 9 -inch x 33 ft roll, for use with asphalt shingles with exposure of 6 -
inch or less.
4.3.3 StarterMatch'" Sharter Strip Shingles are color -coordinated starter strips for use with Grand Canyon' and
Grand Sequoia® series asphalt shingles. StarterMatch'" are installed as the second starter for Grand
CanyonO and Grand Sequoia® series installations.
5. LIMITATIONS:
5.1 This is a building code evaluation. Neither Trinity I ERD nor Robert Nieminen, P.E. are, in any -way, the
Designer of Record for any project on which this Evaluation Report, or previous versions thereof, is/was
used for permitting or design guidance unless retained specifically for that purpose.
5.2 This Evaluation Report is not for use in the HVHZ.
5.3 Fire Classification is not part of this Evaluation Report; refer to current Approved Roofing Materials
Directory for fire ratings of this product.
5.4 Wind Classification:
5.4.1 The GAF asphalt shingles noted in Section 4.1 are Classified in accordance with FBC Tables 1507.2.7.1 and
R905.2.6.1 to ASTM D3161, Class F and/or ASTM D7158, Class H, indicating the shingles are acceptable for
use in all wind zones up to V,Sd = 150 mph (V,,,, = 194 mph). Refer to Section 6 for installation requirements
to meet this wind rating.
5.4.2 The GAF hip & ridge shingles noted in Section 4.2 are Classified in accordance with FBC Tables 1507 2.7.1
and R905.2.6.1 to ASTM D3161, Class F, indicating the shingles are acceptable for use in all wind zones up to
V,Sd = 150 mph (V,,,, = 194 mph). Refer to Section 6 for installation requirements to meet this wind rating.
5.4.3 Classification by ASTM D7158 applies only to exposure category B or C, as defined in FBC 1609.4.3, and a
mean roof height of 60 feet or less. Calculations by a qualified design professional are required for
conditions outside these limitations. Contact the shingle manufacturer for data specific to each shingle.
5.5 All products in the roof assembly shall have quality assurance audit in accordance with the Florida Building
Code and F.A.C. Rule 61G20-3.
6. INSTALLATION:
6.1 Underlayment:
6.1.1 Underlayment shall be acceptable to GAF and shall hold current Florida Statewide Product Approval, or be
Locally Approved per Rule 61G20-3, per FBC Sections 1507.2.3, 1507.2.4 or R905.2.3.
6.2 Starter Shingles or Starter Strip:
6.2.1 Installation of Pro -Start Eave/Rake Starter Strip Shingles, WeatherBlocker Premium Eave/Rake Starter Strip
Shingles and QuickStart Peel & Stick Starter Roll shall comply with the GAF current published instructions.
6.3 Asphalt Shingles:
6.3.1 Installation of asphalt shingles shall comply with the manufacturer's current published instructions, using
minimum four (4) nails per shingle in accordance with FBC Sections 1507.2 or R905.2, with the following
exceptions:
Camelot, Camelot II, Grand Canyon, Grand Sequoia, Grand Sequoia IR, Grand Sequoia ArmorShield, and
Woodland require minimum five (5) nails per shingle.
➢ Slateline requires minimum six (6) nails per shingle.
Exterior Research and Design, I.I.C. Evaluation Report 01506.01.08-R21
Certificate of Authorization #9503 • FL10124-1139
Revision 21: 08/26/2016
Page 4 of 6
TRINITY ERD
6.3.2 Fasteners shall be in accordance with manufacturer's published requirements, but not less than FBC 1507.2.6
or R905.2.5. Staples are not permitted.
6.3.3 Where the roof slope exceeds 21 units vertical in 12 units horizontal, special methods of fastening are
required. Contact the shingle manufacturer for details.
6.4 Hip & Ridge Shingles:
6.4.1 Installation of Seal -A -Ridge Ridge Cap Shingles, Seal -A -Ridge IR Impact -Resistant Ridge Cap Shingles and Seal -
A -Ridge ArmorShield Ridge Cap Shingles shall comply with the manufacturer's current published instructions
with a minimum two (2) nails, minimum 3/8 -inch head diameter, per shingle and nominal 0.25 -inch diameter
beads of Henkel "Loctite PL S30 Roof & Flashing Sealant".
11.5' Sealant
1• (292 mm) 1' /Sellante
(25m) (25 1 Enduil d•omncherte
/ I
012' .
(305 mm)
Nall
Claw
65/8' . 7 518' Clouer
(168. 194 mm)
1
12'
(305 mrn)
6.4.2 Installation of Timbertex Premium Ridge Cap Shingles shall comply with the manufacturer's current
published instructions with a minimum two (2) nails, minimum 3/8 -inch head diameter, per shingle and
beads of Sonneborn NPI Gun Grade Polyurethane Sealant or Henkel PL Roofing and Flashing Sealant.
.23 r7r; {2�nn�.' ••L. : r' .••car. `c
9
1229 olln;
1!•
•.3.335 ,yr t
6.4.3 Fasteners shall be In accordance with the manufacturer's published requirements, but not less than FBC
1507.2.6 or R905.2.5. Staples are not permitted.
Exterior Research and Design, I.I.C. Evaluation Report 01506.01.08-R21
Certificate of Authorization #9503 FL10124-R19
Revision 21: 08/26/2016
Page 5 of 6
TRINITY ERD
7. LABELING:
7.1 Labeling shall be in accordance with the requirements the Accredited Quality Assurance Agency noted
herein.
7.2 Asphalt shingle wrappers shall indicate compliance with one of the required classifications detailed in FBC
Table 1507.2.7.1 / R905.2.6.1.
S. BUILDING PERMIT REQUIREMENTS:
As required by the Building Official or Authority Having Jurisdiction in order to properly evaluate the installation of
this product.
9. MANUFACTURING PLANTS:
Contact the named QA entity for information on which plants produce products covered by Florida Rule 61G20-3 QA
requirements.
10. QUALITY ASSURANCE ENTITY:
UL LLC—QUA9625; (847) 664-3281
- END OF EVALUATION REPORT -
Exterior Research and Design, LLC. Evaluation Report 01506.01.08-1121
Certificate of Authorization 119503 FL10124-1119
Revision 21: 08/26/2016
Page 6 of 6
WINTER PARK ROOFING, INC.
MATERIAL ORDER FORM
DATE
CUSTOMER
ADDRESS
SUPPLIER
BRAND
DELIVERY DATE
PROJECT SIZE
POLY QTY.
SPECIALTY ITEMS
DRIP EDGE QTY
CAP QTY
STARTERS
DECK NAILS QTY WPR
COIL NAILS QTY WPR
FELT QTY
LEAD STACKS
TAR
SIMPLEX WPR
VALLEY
T
Work Order Permit #
Permit official Crew
Customer name
Address
phone
Roof color/ metal color
Job Size
$ Per Sq.
DAY ONE
Customer contact
INSPECTION
Pictures
Wood
Nail sweep
Extra materials
Satellite/Solar
Skylights
Wind mitigation
Special instructions
DAY TWO
Type of Venting
NOTES FOR THE OFFICE (this is where you can do your numbers)
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: 16-3069
James Bell
hereby acknowledge that I personally inspected
0 Roof deck nailing and/or 0 Secondary water barrier work
at 130 Borada Rd. 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 cethat my statements herein are true and accurate to the best of my belief and that I fully
unde to that making any false statements in writing with the intent to mislead a public servant in the
perfo an a of his or her official duty shall constitute a misdemeanor of the second degree pursuant to
Section 3 6 F.
Z" 16-
ign re Contractor Date
eQC.13AWYck
Printed Name of Contractor License #
License Type: 0 General 0 Building 0 Residential 0 Roofing Contractor
0 or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF DX a X100n, —
w rn to (or a irmedl) and subscribed before me thi day of , 20 �, by
�I , who is Versonally Known to me or has 0 Produced (type of
iden ds identification.
(SEAL)
Sig1fature of Not bhY
State ofFlorida
Pir_finf/fjpe79iani'o Name BETHANY E. DUNN
of Notary Public
'' ' ` �: Public - State of Florida
. ; ; .: Notary
- My Comm. Expires Jun 5. 2010
.P
Commission Commission N FF 130057