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1701 Mellonville Ave (2)
NOV 2 9 20% D CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: 1(0- 5 � 8 �' Documented Construction Value: $ 10,583.00 Job Address: 1701 MELLONVILLE AVENUE, SANFORD, FL 32771 Historic District: Yes ❑ No S Parcel ID: 31-19-31-504-0100-0010 Residential [3 Commercial ❑ Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑ Description of Work: Residential reroof, Certainteed Modified Bitumen Roofing System Plan Review Contact Person: Laura Hodges Title: Office Manager Phone: 407-650-0013 Fax: 321-972-8839 Email: Ihodges@hodgesbrothers.net Property Owner Information Name Nanva G. Concepcion Phone: 407421-3451 Street: 1701 MELLONVILLE AVENUE, SANFORD, FL 32771 Resident of property? : yes City, State Zip: Contractor Information Name Carl Curtis Hodges, Hodges Brothers Inc. Phone: Street: 501 Hames Avenue, Orlando, FL 32805 Fax: City, State Zip: Name: Street: City, St, Zip: Bonding Company: Address: 407-650-0013 321-972-8839 State License No.: CCC 042845 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. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must. be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and air conditioners, etc. FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5" Edition (2014) Florida Building Code Revised: lune 30, 2015 Permit Application � I So 0 � 5 NOTICE: In addition to the requirements of this permit, there may be addit)onal restr,;ctions applicable to this property that may be found in the public records of this county, and there nay 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. 4q� ►i i ature of er Agent Date Signature of Contractor/Agent Date r l�Q n ✓a. Com-, ,�►,,`� Gu -I �r� ��� Print Owner/Agent's Name Print Contractor/Agent's Name Notary-Statte, of FI CMYON t;+Y FISSION 0 FF 067066 r_•YPIRES: October 28, 2017 aomted Thro Notary PAft tAndewtm Owner/Agent is Personally Known to Ye or Produced ID ✓ Type of ID ,CZ D14 - BELOW L Signa ure of Notary -State of Flori Date l/1URA L IHIM98 • W COAtNNION Y FF OR420 891M. oadtdlErrMat�lAh6C adAtR. r9 Known to Me or Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY 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: I'ii:�l BUILDING: 1C Revised lune 30, 2015 Permit Application ' CIaTV OF SANFORD 1 BUILDING AND FIRE PREVENTION DIVISION L 300 N. PARK AVENUE SANFORD, FLORIDA 32772 PHONE: 407.688.5150 , FAx: 407.688.5152 PLAN REVIEW COMMENTS Application Number: 16-3186 Date: 12/6/2016 Project Description: Torch Down Roof Contact Name: Laura Hodges Job Address: 1701 Mellonville Ave Contact Email: Ihodges(a)hodgesbrothers.net This is a general overview for code compliance in accordance with the minimum plan review required by the Florida Building Code. It is not a complete detailed review. The comments noted in this review must be addressed before the plans can be approved. Changes to plans shall be submitted on the same size format as the original submittal — changes in letter form are not permitted. All references to FBC Chapter I are as amended by City of Sanford ordinance viewable on our website at www.sanfordfl.gov. Provide two conies ofaffected Plan sheets and/or supplemental information as requested. Permit submittals will not be accented without two conies. COMMENTS: 1. Installation instructions from the Florida Product Approval are required to be provided. For FL#16717, there are 130 different systems for installation on wood decks. The exact system number that will be used needs to be highlighted and only that page needs to be provided for review. Two copies are required. FBC 107 Any error or omission in this plan review shall not be construed to grant approval of any violation of any of the adopted codes or municipal ordinances of this jurisdiction. Office meetings with the plans examiner to discuss comments will require an appointment, arranged by Phone or email prior to arrival. Respectfully, Steve Fiorey, CBO Residential Plans Examiner HODGES' BROTHERS INC CONSTRUCTION & ROOFING ♦tr��! 888 Bonita Avenue ��i New Smyrna Beach, FL 32169 CCC042845 / CGC1518169 Proposed Work Location Attention: NANVA CONCEPCION 1701 MELLONVILLE AVE. SANFORD, FL 32771 Phone: (407) 421.3451 Joe Sandley, Construction Project Manager Community Development Division Seminole County 534 West Lake Mary Blvd. Sanford, FL 32773 PROPOSAWCONTRACT Date Estimate # 10/18/2016 1828 I Description I Oty I Rate I Total Hodges Brothers will obtain permits and order necessary inspections for proposed work. I.) Remove existing roof and take to disposal area. 2.) Dry roof in with fiberglass base sheet 4.) Install galvanized metal trim around the perimeter of the roof. 5.) Install torch down system over the base sheet 6.) Trash and debris will be removed daily. 7.) Hodges Brothers will furnish a three (3) year workmanship warranty and a twelve (12) year manufacturer warranty upon completion of work. Remove and replace existing soffit and damaged wood. 7,475.001 7,475.00 3.108.001 3,108.00 Payment due upon completion of contracted work. Not responsible for cracks in ceilings. This price is based on our vehicles ability to back up to building; however, we are not responsible for cracks in driveway. There will be an additional charge if we are unable to utilize driveway. A finance charge of 1.5% per month (18% annum) will be added to unpaid accounts 30 days from date of invoice. Should collection action be necessary, customer agrees to pay reasonable attorney's fees and courts costs, including any appeal costs. This proposal is subject to acceptance within 60 days. We do not accept or undertake any liability herein for delay or inability to perform due to fire, strikes, Acts of God, of the elements, or of the public authorities, nor do we accept or undertake any liability for damage or loss of materials on work performed due to acts or omissions of third parties or the above mentioned causes. and through no fault on the part of Hodges Brothers Inc. I This contract is valid when simtned and accepted by both parties. I Please sign and return proposal contract to us: W; ACCEPTED BY: We look forward to working with you. Total Phone # Fax # E-mail Web Site 407-650.0013 321-972-8839 info©hodgcsbrothers.net www.hodgesbrActs.net $10,583.00 THIS INSTRUMENT PREPARED BY: Name: HODGES BROTHERS INC. Address: 888 BONITA AVENUE NEW SMYRNA BEACH. FL 32169 NOTICE OF COMMENCEMENT State of Florida County of Seminole Permit Number: Parcel ID Number: 31-19-31-504-0100-0010 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 N available) LOT 1 + W 17 FT OF LOT 2 BLK 1 BEL -AIR, 1701 MELLONVILLE AVENUE, SANFORD, FL 32771 GENERAL DESCRIPTION OF IMPROVEMENT: RESIDENTIAL REROOF OWNER INFORMATION: Name: NANVA G. CONCEPCION Address: 1701 MELLONVILLE AVENUE, SANFORD, FL 32771 Fee Simple Title Holder (if other then owner) Name: Address: CONTRACTOR: Name: HODGES BROTHERS INC. Address: 501 HAMES AVENUE, ORLANDO, FL 32805 Persons within the State of Florida Designated by Ownor upon whom notice or other documents may be served as provided by Section 713.13(1)(b), Florida Statutes. Name' Address. In addllion to himself, Owner Designates 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. V041- penaitles of p rjury, I declare that I have read the foregoing and that the facts stated in it are true to est of my owle ge and belief. J Al) Ila- lir eimejwdio/� s S naturar Ia e Flo tNs 773.13(1)(g): 'The owner must sign the ndko of commencement and no one Nie may be permitted to agn n his or her stead' State of County of The foregoing Instrument was acknowledged before me this I'-;_ day of IUoAor.)twr 20 by _No r\aa G Cerv+a t�e.o r1 . Who is personally known to me ❑ Name of person making staltmerr OR who has produced Identification type of Identification produced: F� COR1YON -0.1N.,9Y(XMWI4SIp(1 FF08M6 �'3 . EXPIRES: Wallet 20,1017 ' er.rrn..N+wnerourn.+.r I Notary Signalure MARYANNE MORSE, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK'S # 2016122640 BK 8811 Pg 1961; (1pg) E -RECORDED 11/28/2016 02:47'02 PM 10.00 LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 11/28/16 I hereby name and appoint to-er %,-,e,- n dodges an agent of: Hodges Brothers 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): The specific permit and application for work located at: 1701 MELLONVILLE AVENUE, SANFORD, FL 32771 (street Address) Expiration Date for This Limited Power of Attorney: License Holder Name: Carl Curtis Hodges State License Number: CCC 042845 Signature of License Holder: STATE OF FLORIDA COUNTY OF 11/17/2017 The foregoing insrumenl was acknowledged before me this day of 20ID , by C. who is`o personally known, to me or o who has produced — as identification and who did (did not) take an oath. LAURA L HOOGEG W COAiA6SSIOH 1 P 964420 lIoYIPVay,�fclh�rd�l (Rev. 08.12) (Signature Print or type name Notary Public - State of Sc.vh Commission No. I`F 95 �olp My Commission Expires: Sja/,aCn.� RECORD COPY Page 1 of 2 N SCIS Home I Log In I User Registration Hot Topics I Submit Surcharge I Stats a Facts I Publications I FOC Staff I SCIS Site Map I Links I Search Fl "da 3 r Product Approval Approval US USER: Public User s�siaaiw Product Approval Menu > Product or AoplkaUOn Search > Application Us > Application Detail FL # Application Type Code Version Application Status Comments Archived Product Manufacturer Address/Phone/Email Authorized Signature Technical Representative Address/Phone/Email Quality Assurance Representative Address/Phone/Email Category Subcategory Compliance Method Florida Engineer or Architect Name who developed the Evaluation Report Florida License Quality Assurance Entity Quality Assurance Contract Expiration Date Validated By Certificate of Independence Referenced Standard and Year (of Standard) Equivalence of Product Standards Certified By FL477-R7 Revision 2014 Approved C�7 SANFORD BUILDING DIVISION A PERMIT ISSUED SHALL BE CONSTRUED TO BE A LICENSE TO PROCEED WITH THE WORK AND NOT AS AUTHORITY TO VIOLATE, CANCEL, ALTER OR SET ASIDE ANY OF THE PROVISIONS OF THE TECHNICAL CODES, NOR SHALL ISSUANCE OF A PERMIT PREVENT THE BUILDING OFFICIAL FROM THEREAFTER REQUIRING A CORRECTION OF ERRORS IN PLANS, CONSTRUCTION OR VIOLATIONS OF THIS CODE CertainTeed Corporation -Roofing 18 Moores Road Malvern, PA 19355 (610) 651-5847 mark.d.harner@saint-gobain.com Mark Harner mark.d.harner@saint-gobain.com Mark D. Harner 18 Moores Road Malvern, PA 19355 (610)651-5847 Mark.D.Harner@saint-gobain.com REVIEWED FOR CODE COMPUANCE PLANS EXAMINER Roofing 12. -T — I �P Built up Roofing DATE Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer © Evaluation Report - Hardcopy Received Robert Nieminen PE -59166 UL LLC 07/03/2017 John W. Knezevich, PE 10 Validation Checklist - Hardcopy Received FL477 R7 COI 2015 01 COI Nieminen.Ddf Standard ASTM D2178 ASTM D3909 ASTM D4601 ASTM D4897 FM 4470 FM 4474 #16-3186 12/7/2016 00\01NG SANFORD �Al y"RR.Srp�i Year 2004 1997 2004 2001 1992 2004 12/7/2016 Page 2 of 2 Sections from the Code Product Approval Method Date Submitted Date Validated Date Pending FBC Approval Date Approved Method 1 Option D 03/16/2015 03/23/2015 03/26/2015 06/22/2015 FL # Model, Number or Name Description 477.1 Flintglas Built -Up Roof Systems Built Up roof Systems Limits of Use Installation Instructions Approved for use In HVHZ: No FL477 R7 II 2015 03 FINAL Al ER CERTAINTEED BUR FL477- Approved for use outside HVHZ: Yes R7.Ddf Impact Resistant: N/A Verified By: Robert Nlerninen PE -59166 Design Pressure: +N/A/ -430 Created by Independent Third Party: Yes Other: 1.) The DP listed in this application relates to Evaluation Reports one specific assembly. Refer to the ER Appendix for all FL477 R7 AE 2015 03 FINAL ER CERTAINTEED BUR FL477- assemblies and max design pressures. 2.) Refer to ER R7.Ddf Section 5 for Limits of Use. Created by Independent Third Party: Yes Bach Nost Contact Us :: 2601 Blair Stone Road, Tallahassee FL 32399 Phone: 850-487-1824 The State of Florida Is an AA/EEO employer. Copyright 2007.2013 State of Florida.:: Privacy Statement •: Accessibility Statement :: Refund Statement Under Florida law, email addresses are public records if you do not want your e-mail address released in response to a public -records request, do not send electronic mall to this entity. Instead, contact the office by phone or by traditional mall. 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 emads 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 If you are a licensee under Chapter 455, F S , please click bete . Product Approval Accepts: Credit Card Sate 12/7/2016 QOTRINITYIERD APPENDIX Z: ATTACHMENT REQUIREMENTS FOR WINO UPLIFT RESISTANCE 771 Table Deck Application Type Description Page - 1A Wood New or Reroof (Tear -Off) A-2 Mech. Attached Anchor Sheet, Bonded Insulation, Bonded Roof Cover 4 18 Wood New, Reroof (Tear -Off) or Recover 8 Mech. Attached Base Insulation, Bonded Top Insulation, Bonded Roof Cover 5 1C Wood New, Reroof (Tear -Off) or Recover C Mech. Attached Insulation, Bonded Roof Cover S 10 Wood New, Reroof (Tear -Off) or Recover 0 Prelim. Attached Insulation, Mech. Attached Base Sheet, Bonded Roof Cover 5-6 IE -1 Wood New, Reroof (Tear -Oft) E Non -Insulated, Mech. Attached Base Sheet, Bonded Roof Cover 7 3E-2 Wood New, Reroof (Tear -Off) or Recover E Non -Insulated, Mech. Attached Base Sheet, Bonded Roof Cover 8 2A Steel or Conc. New, Reroof (Tear -Off) or Recover B Mech. Attached Base Insulation, Bonded Top Insulation, Bonded Roof Cover 9 2B Steel or Conc. New, Reroof (Tear -Off) or Recover C Mech. Attached Insulation, Bonded Roof Cover 30 2C Steel or Conc. New, Reroof (Tear -Off) or Recover D Prelim. Attached Insulation, Mech. Attached Base Sheet, Bonded Roof Cover 11 3A Concrete New or Reroof (Tear -Off) A-1 Bonded Insulation, Bonded Roof Cover 12-13 38 Concrete New or Reroof (Tear -Off) F Non -Insulated, Bonded Roof Cover 13 4A LWIC New or Reroof (Tear -Off) A-1 Bonded Insulation, Bonded Roof Cover 14 48 LWIC New, Reroof (Tear -Off) E Non -Insulated, Mech. Attached Base Sheet, Bonded Roof Cover 15-16 5A CWF New or Reroof (Tear -Off) A-1 Bonded Insulation, Bonded Roof Cover 17 58 CWF New or Reroof (Tear -Off) A-2 Mech. Attached Anchor Sheet, Bonded Insulation, Bonded Roof Cover 18 SC CWF New, Reroof (Tear -Off) or Recover C Mech. Attached Insulation, Bonded Roof Cover 19 50 CWF New, Reroof (Tear -Off) E Non -Insulated, Mech. Attached Base Sheet, Bonded Roof Cover 19 6A Gypsum Reroof (Tear -Off) A-1 Bonded Insulation, Bonded Roof Cover 20 68 Gypsum Reroof (Tear -Off) A-2 Mech. Attached Anchor Sheet, Bonded Insulation, Bonded Roof Cover 21 6C Gypsum Reroof (Tear -Off) C Mech. Attached Insulation, Bonded Roof Cover 21 60 Gypsum Reroof (Tear -Off) E Non -Insulated, Mech. Attached Base Sheet, Bonded Roof Cover 22 7A Various Recover A-1 Bonded Insulation, Bonded Roof Cover 22-23 The following notes apply to the systems outlined herein: 1. The roof system evaluation herein pertains to above -deck roof components. Roof decks shall be in accordance with FBC requirements to the satisfaction of the AHf. Wind load resistance of the roof deck shall be documented through proper codified and/or FBC Approval documentation. 2. Unless otherwise noted, fasteners and stress plates for insulation attachment shall be as follows. Fasteners shall be of sufficient length for the following engagements: Wood Deck: OMG #14 Roofgrip with Flat Bottom Plate (Accutrac), OMG HD with OMG 3 in. Galvalume Steel Plate, Dekfast #14 with Hex Plate or 3" Round Insulation Plate, Tru -Fast HD with MP -3 Plates or FlintFast #14 Fastener with FlintFast 3" Insulation Plates. Minimum %-inch plywood penetration or minimum 1 -inch wood plank embedment. D Steel Deck: OMG #12 or #14 Roofgrip with Recessed or Flat Bottom Plate (Accutrac), OMG #12 Standard or HD with OMG 3 in. Galvalume Steel Plate, Dekfast #12 or #14 with Hex Plate or 3" Round Insulation Plate, Tru -Fast OP or HD with MP -3 or FlintFast #12 or #14 Fastener with FlintFast 3" Insulation Plates. Minimum is -inch steel penetration and engage the top flute of the steel deck. D Concrete Deck: OMG #14 Roofgrip with Recessed or Flat Bottom Plate (Accutrac), OMG HD or CD -10 with OMG 3 in. Galvalume Steel Plate, Dekfast #14 or DekSpike with Hex Plate or 3" Round Insulation Plate, Tru -Fast HO or CF with MP -3 or FlintFast #14 Fastener with FlintFast 3" Insulation Plates. Minimum 1 -inch embedment. Fasteners installed with a pilot hole in accordance with the fastener manufacturer's published installation instructions. 3. Unless otherwise noted, insulation may be any one layer or combination of polyisocyanurate, polystyrene, wood fiberboard, perlite or gypsum -based coverboard that meets the QA requirements of F.A.C. Rule 61G20- 3 and is documented as meeting F8C 1505.1 and, for foam plastic, FBC 2603.4.1 or 2603.6, when installed with the roof cover. Exterior Research and Design, U.C. d/b/a Trinity I ERD Evaluation Report 033260.06.10-R2 for FL477-R7 Certificate of Authorization #9503 Revision 2:03111/2015 Prepared by: Robert Nieminen, PE -59166 Appendix 1, Page 1 of 23 TRINITY I ERD 4. Minimum 200 psi, minimum 2 -inch thick lightweight insulating concrete may be substituted for rigid insulation board for System Type D (mechanically attached base sheet, bonded roof cover), whereby the base sheet fasteners are installed through the LWIC to engage the structural steel or concrete deck. The structural deck shall be of equal or greater configuration to the steel and concrete deck listings. 5. Unless otherwise noted, insulation adhesive application rates are as follows. Ribbon or bead width is at the time of application; the ribbons/beads shall expand as noted in the manufacturer's published instructions. ➢ Hot asphalt (HA): Full coverage at 25-30 lbs/square Ashland Pliodeck (A -PD): Continuous Y inch wide ribbons, 12 -inch o.c. Ribbons of subsequent layers shall be perpendicular to those in the layer below. Dow Insta-Stik (0 -IS): Continuous Y. to 1 inch wide ribbons, 12 -inch o.c. D Dow Spray -N -Grip (D -SG): Full coverage D Millennium One Step Foamable Adhesive (M-OSFA): Continuous Y. to %-inch wide ribbons, 12 -inch o.c. ➢ Millennium PG -1 Pump Grade Adhesive (M -PGI): Continuous % to %-inch wide ribbons, 12 -inch o.c. D OMG OlyBond 500 or OlyBond Green (08500): Continuous Y. -inch wide ribbons, 12 -inch o.c. (PaceCart or SpotShot) ➢ 3M CR -20: Continuous 2.5 to 3.5 -inch wide ribbons, 12 -inch o.c. ➢ Note: When multiple loyers(s) of insulation and/or coverboard are installed in ribbon -applied adhesive, adhesive ribbons shall be staggered from layer-to-loyer a distance of one-half the ribbon spacing. ➢ Note: The maximum edge distance from the adhesive ribbon to the edge of the insulation board shall be not less than one-half the specified ribbons spacing. 6. Unless otherwise noted, all insulations are Flat stock or taper board of the minimum thickness noted. Tapered polyisocyanurate at the following thickness limitations may be substituted with the following Maximum Design Pressure (MDP) limitations. In no case shall these values be used to 'increase' the MOP listings in the tables; rather if MDP listing below meets or exceeds that listed for a particular system in the tables, then the thinner board listed below may be used as a drop-in for the equivalent thicker material listed in the table: Ashland Pliodeck (A -PD) @ 12 -inch o.c. MDP -105.0 psf (Min. 1.0 -inch thick) Ashland Pliodeck (A -PD) @ 6 -inch o.c. MDP -277.5 psf (Min. 1.0 -inch thick) D Dow Insta-Stik (0 -IS): MDP -120.0 psf (Min. 1.0 -inch thick) D Millennium One Step Foamable Adhesive (M-OSFA): MOP -157.5 psf (Min. 1.0 -inch thick) ➢ Millennium PG -1 Pump Grade Adhesive (M -PGI): MDP -157.5 psf (Min. 1.0 -inch thick) ➢ OMG OlyBond 500 (08500): MDP -45.0 psf (Min. 0.5 -inch thick Multi -Max FA -3) ➢ OMG OlyBond 500 (08500): MDP -187.5 psf (Min. O.5 -inch thick ISO 95+ GL) ➢ OMG OlyBond 500 (08500): MDP -315.0 psf (Min. 0.5 -inch thick ENRGY 3) ➢ OMG OlyBond 500 (08500): MOP -487.5 psf (Min. 0.5 -inch thick ACFoam II) ➢ 3M CR -20: MOP -117.5 psf (Min. 1.0 -inch thick) 7. Bonded polyisocyanu rate insulation boards shall be maximum 4 x 4 ft. 8. For mechanically attached components or partially bonded insulation, the maximum design pressure for the selected assembly shall meet or exceed the Zone 1 design pressure determined in accordance with FBC Chapter 16, and Zones 2 and 3 shall employ an attachment density designed by a qualified design professional to resist the elevated pressure criteria. Commonly used methods are RAS 117 and FM LPDS 1-29. Assemblies marked with an asterisk* carry the limitations set forth in Section 2.2.1.5.1(a) of FM LPDS 1-29 for Zone 2/3 enhancements. 9. For fully bonded assemblies, the maximum design pressure for the selected assembly shall meet or exceed critical design pressure determined in accordance with FBC Chapter 16, and no rational analysis is permitted. 10. For mechanically attached components over existing decks, fasteners shall be tested in the existing deck for withdrawal resistance. A qualified design professional shall review the data for comparison to the minimum requirements for the system. Testing and analysis shall be in accordance with TAS 105 or ANSI/SPRI FX -1. 11. For existing substrates in a bonded recover or re -roof installation, the existing roof surface or existing roof deck shall be examined for compatibility and bond performance with the selected adhesive, and the existing roof system (for recover) shall be capable of resisting project design pressures on its own merit to the satisfaction of the AHJ, as documented through field uplift testing in accordance with ASTM E907, FM LPDS 1-52, ANSI/SPRI IA -1 or TAS 124. 12. For Recover Applications using System Type 0, the insulation is optional; however, the existing roof system shall be suitable for a recover application. Exterior Research and Design, I.I.C. d/b/a Trinity I ERD Evaluation Report C33260.06.10 -R2 for FL477-117 Certificate of Authorization N9503 Revision 2:03/11/2015 Prepared by: Robert Nieminen, PE -59166 Appendix 1, Page 2 of 23 ��TRINrryjERD 13. Unless otherwise noted, a Flintglas* Built -Up Roof Cover consists of one of the following. Systems shall be surfaced in accordance with CertainTeed requirements to meet the fire resistance requirements of FBC 1505.1. System Type Description 1 Three or four plies Flintglas Ply Sheet Type IV or Flintglas Premium Ply Sheet Type VI applied in hot asphalt at 25 Ib/square with flood coat & gravel or approved roof coating. 2 One ply Glasbase, All Weather/Empire Base, Flexiglas Base or Flintlastic Base 20 followed by two or three plies Flintglas Ply Sheet Type IV or Flintglas Premium Ply Sheet Type VI applied in hot asphalt at 25 Ib/square with flood coat & gravel or approved roof coating. 3 Two or three plies Flintglas Ply Sheet Type IV or Flintglas Premium Ply Sheet Type VI, followed by Flintglas Mineral Surface Cap or Flintlgas Mineral Surface Cap CoolStar applied in hot asphalt at 25 Ib/square. 4 One ply Glasbase, All Weather/Empire Base, Flexiglas Base or Flintlastic Base 20 followed by two or three plies Flintglas Ply Sheet Type IV or Flintglas Premium Ply Sheet Type VI, followed by Flintglas Mineral Surface Cap or Flintlgas Mineral Surface Cap CoolStar applied in hot asphalt at 25 Ib/square. 5 Yosemite Venting Base applied in hot asphalt in 24 -inch diameter spots in grid with spots spaced 30 -inch o.c. followed by two or three plies Flintglas Ply Sheet Type IV or Flintglas Premium Ply Sheet Type VI applied in hot asphalt at 25 Ib/square with flood coat & gravel or approved roof coating. 6 Yosemite Venting Base applied in hot asphalt in 24 -inch diameter spots in grid with spots spaced 30 -inch o.c. followed by one or two plies Flintglas Ply Sheet Type IV or Flintglas Premium Ply Sheet Type VI, followed by Flintglas Mineral Surface Cap or Flintlgas Mineral Surface Cap CoolStar applied in hot asphalt at 25 Ib/square. 7 Black Diamond Base Sheet or Flintlastic UltraGlass SA self -adhered, followed by two or three plies of Flintglas Ply Sheet Type IV or Flintglas Premium Ply Sheet Type VI applied in hot asphalt at 25 Ib/square with flood coat & gravel or approved roof coating. 8 Black Diamond Base Sheet or Flintlastic UltraGlass SA self -adhered, followed by one or two plies Flintglas Ply Sheet Type IV or Flintglas Premium Ply Sheet Type VI, followed by Flintglas Mineral Surface Cap or Flintlgas Mineral Surface Cap CoolStar applied in hot asphalt at 25 Ib/square. 14. "MDP" =Maximum Design Pressure is the result of testing for wind load resistance based on allowable wind loads. Refer to FBC 1609 for determination of design wind loads. Exterior Research and Design, U.C. d/b/a Trinity I ERD Evaluation Report 033260.06.10-R2 for FL477-R7 Certificate of Authorization #9503 Revision 2:03/11/2015 Prepared by: Robert Nieminen, PE -59166 Appendix 1, Page 3 of 23 QOTRINITYIERD TABLE 1E-1: WOOD DECKS — NEW CONSTRUCTION or REROOF (Tear -Off) SYSTEM TYPE E: NON -INSULATED, MECHANICALLY ATTACHED BASE SHEET, BONDED ROOF COVER System Deck Base Sheet Roof Cover MDP Base Fasteners Attach No (See Note 1) (psf) CONVENTIONAL SYSTEMS: W-18 Min. 19/32 -inch thick exterior Glasbase; Flexiglas; Flintlastic Base 20; All Weather / Empire 32 ga., 1 -5/8 -inch dia. tin caps with 9 -inch o.c. at 4 -inch lap and 12 -inch o.c. in two, equally System 1, 2, 3 or 4 -45.0 grade plywood Base or Poly SMS Base 11 ga. annular ring shank nails spaced, staggered center rows 11NS191 Min. 115`/32=inch plywood atlmax Glasbase; Flexigla�F,lintla'sticl (13_in'�11 it chL_g, _2T -Simples „� ,., , e (6 inch ostia_ 3_i�ch]la.p andl6,;inch`To�inlfourt equallyf (`S.ystem 112, 3 or 4 -5265 Base 20TAIILWeather / Empire f .. 24 -inch spans spaced, staggeed center rows Base or Poly SINS Base IvletalEOap Nails W-20 Min. 19/32 -inch plywood at max Glasbase; Flexiglas; Flintlastic 32 ga., 1 -5/8 -inch dia. tin caps with 8 -inch o.c. at 4 -inch lap and 8 -inch o.c. in three, equally System 3 or 4 52.5 24 -inch spans Base 20 or Poly SMS Base 11 ga. annular ring shank nails spaced, staggered center rows W-21 Min. 19/32 -inch plywood at max Glasbase; Flexiglas; Flintlastic 32 ga., 1 -5/8 -inch dia. tin caps with 8 -inch o.c. at 4 -inch lap and 8 -inch o.c. in three, equally System 3 or 4 60.0 24 -inch spans Base 20; Poly SMS Base 11 ga. annular ring shank nails spaced, staggered center rows W-22 Min. 19/32 -inch plywood at max Glasbase; Flexiglas; Flintlastic 32 ga., 1 -5/8 -inch dia. tin caps with 6 -inch o.c. at 4 -inch lap and 6 -inch o.c. in four, equally System 3 or 4 -82.5 24 -inch spans Base 20; Poly SMS Base 11 ga. annular ring shank nails spaced, staggered center rows W-23 Min. 19/32 -inch plywood at max Glasbase; Flexiglas; Flintlastic 32 ga., 2 -5/8 -inch dia. tin caps with 4 -inch o.c. at 3 -inch lap and 4 -inch o.c. in four, equally System 3 or 4 -105.0 24 -inch spans Base 20; Poly SMS Base 11 ga. annular ring shank nails spaced, staggered center rows HYBRID SYSTEMS: W-24 Min. 19/32 -inch thick exterior Glasbase; Flexiglas; Flintlastic Base 20; All Weather/ Empire 32 ga., 1 -5/8 -inch dia. tin caps with 9 -inch o.c. at 4 -inch lap and 12 -inch o.c. in two, equally System 8 -45.0' grade plywood Base; Poly SMS Base 11 ga. annular ring shank nails spaced, staggered center rows W-25 Min. 15/32 -inch plywood at max Glasbase; Flexiglas; Flintlastic Base 2 All Weather /Empire Min. 1 -inch long, 12 ga. Simplex 6 -inch o.c. at 3 -inch lap and 6 -inch o.c. in four, equally System 7 or 8 52.5 24 -inch spans Base; Poo ly SMS Base Metal Cap Nails spaced, staggered center rows W-26 Min. 19/32 -inch plywood at max Glasbase; Flexiglas; Flintlastic 32 ga., 1 -5/8 -inch dia. tin caps with 8 -inch o.c. at 4 -inch lap and 8 -inch o.c. in three, equally System 8 -52.5 24 -inch spans Base 20; Poly SMS Base 11 ga. annular ring shank nails spaced, staggered center rows W-27 Min. 19/32 -inch plywood at max Glasbase; Flexiglas; Flintlastic 32 ga., 1 -5/8 -inch dia. tin caps with 8 -inch o.c. at 4 -inch lap and 8 -inch o.c. in three, equally System 8 -60.0 24 -inch spans Base 20; Poly SMS Base 11 ga. annular ring shank nails spaced, staggered center rows W-28 Min. 19/32 -inch plywood at max Glasbase; Flexiglas; Flintlastic 32 ga., 1 -5/8 -inch dia. tin caps with 6 -inch o.c. at 4 -inch lap and 6 -inch o.c. in four, equally System 8 -82.5 24 -inch spans Base 20; Poly SMS Base 11 ga. annular ring shank nails spaced, staggered center rows W-29 Min. 19/32 -inch plywood at max Glasbase; Flexiglas; Flintlastic 32 ga., 1 -5/8 -inch dia. tin caps with 4 -inch o.c. at 3 -inch lap and 4 -inch o.c. in four, equally System 8 -105.0 24 -inch spans Base 20; Poly SMS Base 11 ga. annular ring shank nails spaced, staggered center rows Exterior Research and Design, LLC. d/b/a Trinity IERO Evaluation Report 033260.06.30-R2 for FL477-117 Certificate of Authorization #9503 Revision 2:03/11/2015 Prepared by: Robert Nieminen, PE -59166 Appendix 1, Page 7 of 23 CITY OF SANFORD 13UIL'DING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: 1(x— 3 1 I, Carl Curtis Hodges hereby acknowledge that I personally inspected P/Roof deck nailing and/or 0 Secondary water barrier work at 1701 MELLONVILLE AVENUE, SANFORD, FL 32771 and have determined that the work (Job Site Address) was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.) I certify that my statements herein are true and accurate to the best of my belief and that I fully understand that making any false statements in writing with the intent to mislead a public servant in the performance of his or her official duty shall constitute a misdemeanor of the second degree pursuant to Section 837.06 F.S. Signature of Contractor Carl Curtis Hodges Printed Name of Contractor 12/13/16 Date CCC 042845 License # License Type: 0 General 0 Building 0 Residential WRoofing Contractor 0 or any individual certified in accordance with F.S. 468 to make such an inspection. STATE OF FLORIDA COUNTY OF %22m I rk> ,0. Swo�y;n to (or affirmed) and subscribed before me this day of .ber , 20 by whe-is&Z Persona y Known to me or has 0 Produced (type of identification) as identification. (SEAL) Signature ofotary c LAW L HO State of Florida +uV COWAMM DUS Print/Type/Stamp Name of Notary Public t.: EMRES: Wy 3.20m0 eft W�WFfUoOMrdbrl }Crry oF O v Date: 10/20-2016 Building Permit Application Job Site Address or Parcel ID #: 606 E. Amelia Street, Orlando, FL 32803 �SS'-moi Job/Project Name: 606 E. Amelia Street reroof Property Owner Name: Sallie L. Douglas Phone: Address: 606 E. Amelia Street, Orlando, FL 32803 Business Owner Name: Phonew Address: Fee Simple Titleholdees Name (if other than owner): Fee Simple Titleholdees Address (if other than owner: Contractor Name: Carl Curtis Hodges Lic # CCC 042845 Address: 888 Bonita Avenue New Smyrna Beach, FL 32169 Email: Ihodges@hodgesbrothers.net Contractor Company Name: Hodges Brothers Inc. Contractor Company Address: 501 Hames Avenue, Orlando, FL 32805 Primary Contact Name: Laura Hodges Company Name: Hodges Brothers Inc. Email: Ihodges@hodgesbrothers.net Phone: 407-650-0013 Digital Plans Applicant Name: Laura Hodges Company: Hodges Brothers Inc. Email: Ihodges@hodgesbrothers.net Phone: 407-650-0013 Bonding Company: Bonding Company Address: Arch itect/Engineees Name: Architect/Engineer's Address: Mortgage Lender's Name: Mortgage Lender's Address: Work Description: residential reroof, Metal Sales Corporation, 5 V Crimp Aluminum, FL 11560.R2 GENERAL Type Of Work (subtype — select one): O New O Addition O Alteration' O Site Work OFence Fw(Roof OAccessory Structure O Tent t(Repair/Replace' O Sign O Billboard's ' : 1 O Change of Use O Swimming Pool O Solar O Foundation .Only , ' , ' O Dumpster'Enclosure/Pad O LEED (mertified OSilver UGold . platinum) ,. 'Requires separate scope of work.' 2itequires Re -roofing Supplement form New Jobs created? OYes QWo DUnsure Plan Review Type: O Commercial WResidential 1 or 2 units O Residential 3 or more units Related to Code Enforcement Action? (YIN) N Estimated Construction Cost: $ 14,000 Note: Owner furnished equipment and materials must be included in Estimated Construction Cost If the estimated cost of this job is greater than $2,500 a certified copy of the recorded Notice of Commencement must be filed with Permitting Services prior to scheduling your first inspection. ECONOMIC DEVELOPMENT DEPARTMENT • PERMITTING SERVICES DIVISION CITY HALL • 400 SOUTH ORANGE AVENUE • FIRST FLOOR • P.O. BOX 4990 0 ORLANDO, FLORIDA 32802-4990 PHONE 407.246.2271 • FAX 407.246.34200 htip://www.cityoforlando.neVcermits Page 1 of 3 .w CITY OF SANFORD BUILDING SERVICES Residential Re -Roof Hurricane -Mitigation Inspection Affidavit Permit #:/ C, w J/ 6 1, Carl Curtis Hodges hereby acknowledge that I personally inspected G%Roof deck nailing and/or ❑ Secondary water barrier work at 1701 MELLONVILLE AVENUE, SANFORD, FL 32771 and have determined that the work (Job Site Address) was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.) I certify that my statements herein are true and accurate to the best of my belief and that I fully understand that making any false statements in writing with the intent to mislead a public servant in the performance of his or her official duty shall constitute a misdemeanor of the second degree pursuant to Section 837.06 F.S. <f'— Signature of Contractor Date 12/13/16 Carl Curtis Hodges CCC 042845 Printed Name of Contractor License # License Type: 0 General ❑ Building ❑ Residential WRoofing Contractor ❑ or any individual certified in accordance with F.S. 468 to make such an inspection. STATE OF FLORIDA COUNTY OF _ 62iYhv,�:,IsL. Swo n to (or affirmed) and subscribed before me this .1 day of , 20 I , by E's' (I . whe4s.M PersonaDy Known to me or has ❑ Produced (type of identification) as identification. (SEAL) Signature of- otary c State of Florida ay�r Print/Type/Stamp Name of Notary Public t�leroNo0al�lkdMrdNr VOLORIDGE INVESTMENT MANAGEMENT, LLC SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS This notice explains how you can continue to defer federal income tax on your retirement savings in the VOLORIDGE INVESTMENT MANAGEMENT, LLC 401(1) PLAN (the "Plan") and contains important information you will need before you decide how to receive your Plan benefits. All references to 'the Code" are references to the Internal Revenue Code of 1986, as amended. This notice summarizes only the federal (rot state or local) tax rules which apply to your distribution Because these rules are complex and contain many conditions and exceptions which we do not discuss in this notice, you may need to ednsult with a professional tax advisor before you receive your distribution from the Plan. A. TYPES OF PLAN DISTRIBUTIONS Eligibility for rollover. The Code classifies distributions into two types: (1) distributions you may roll over ("eligible rollover distributions') and (2) distributions you may not roll oyer.. See "Distributions not eligible for rollover' below. You also may receive a distbution under which pan of the distribution is an eligible rollover distribution and pan is not eligible for rollover. A rollover is a payment by you or the Plan Administrator of all or pan of your benefit to another plan or IRA that allows you to continue to postpone taxation of that benefit until it is paid to you (except for a rollover from a pre-tax account to a Roth IRA, described in the last paragraph of Section 8 below). The Plan Administrator will assist you in identifying which portion of your distribution is an eligible rollover distribution and which portion is not eligible for rollover. Plans that may accept a rollover. You may roll over an eligible rollover distribution (other than Roth 401(k) plan deferrals and earnings) either to a Roth IRA (provided for distributions before January I, 2010, your adjusted gross income for the taxable year of the distribution does not exceed $100,000 and you are not married filing a separate income tax return), to a traditional IRA or to an eligible employer plan that accepts rollovers. An "eligible employer plan" includes a plan qualified under Code §401(a), including a 401(k) Plain, profit sharing plan, defined benefit plan, stock bonus plan (including an ESOP) or money purchase plan; a §403(a) annuity plan; a 403(b) plan, and an eligible §457(b) plan maintained by a governmental employer (governmental 457 plan) Special rules apply to the rollover of after-tax contributions and of Roth 401(k) deferrals See "After-tax contributions and Roth 401(k) plan deferrals" below. YOU MAY NOT ROLL -OVER ANY DISTRIBUTION TO A SIMPLE IRA OR A COVERDELL EDUCATION SAVINGS ACCOUNT (FORMERLY KNOWN AS AN EDUCATIONAL IRA). Deciding where to roll over a distribution. An eligible employer plan is not legally required to accept a rollover. Before you decide to roll over your payment to another employer plan, you should find out whether the plan accepts rollovers and, if so, the types of distributions it accepts as a rollover. Even if a plan accepts rollovers, it might not accept rollovers of certain types of distributions, such as after-tax amounts If this is the case, and your distribution includes after-tax amounts, you may wish instead to roll your distribution over to an IRA or to split your rollover amount between the employer plan in which you will participate and an IRA. You also should find out about any documents you must complete before a receiving plan or IRA sponsor will accept a rollover. If an employer plan accepts your rollover, the plan may restrict subsequent distributions of the rollover amount or may require your spouse's consent for any subsequent distribution. A subsequent distribution from the plan that accepts your rollover also may be subject to different tax treatment than distributions from this Plan. Check with the administrator of the plan that is to receive your rollover regarding subsequent distributions and taxation of the amount you will roll over, prior to making the rollover. Distributions not eligible for rollover. An eligible rollover distribution means any distribution to you of all or any portion of your account balance under the Plan except- (1) a distribution which is pan of a series of substantially equal periodic payments; (2) a required minimum distribution; (3) a hardship distribution; (4) an ESOP dividend; (5) a corrective distribution; or (6) a loan treated as a distribution Substantially equal periodic payments. You may not roll over a distribution if it is pan of a series of substantially equal payments made at least once a year and which will last for (1) your lifetime (or your life expectancy), (2) your lifetime and your beneficiary's lifetime (or life expectancies), or (3) a period of 10 years or more Required minimum distributions. Beginning in the year in which occurs the later of your retirement or your attainment of age 70'h, the Code may require the Plan to make "required minimum distributions' to you. You may not roll over the required minimum distributions. Special rules apply if you own more than 5%of the Employer. Hardship distributions. A hardship distribution is not eligible for rollover. ESOP dividends. Cash dividends paid to you on employer stock held in an employee stock ownership plan cannot be rolled over. Corrective distributions. A distribution from the plan to correct a failed nondiscrimination test or because legal limits on certain contributions were exceeded cannot be rolled over. /.Dans treated as taxable "deemed" distribution. The amount of a plan loan that becomes a taxable deemed distribution because of a default cannot be rolled over. However, a loan offset amount is eligible for rollover, as discussed in Pan C. below. Ask the Plan Administrator if distribution ofyour loan qualifies for rollover treatment. After-tax Contributions and Roth 401(k) plan deferrals After-tax/rollover into an /RA You may roll over your after-tax contributions to an IRA (including, for distributions after December 31, 2009, a Roth IRA) either directly or indirectly. For distributions before January I, 2010, you may roll over your after-tax contributions to a Roth IRA, provided your adjusted gross income for the taxable year of the distribution does not exceed $100,000 and you are not married filing a separate income tax return. The Plan Administrator will assist you in identifying how much of your paymen If you roll over after-tax contributions to an IRA, it is your responsibility to keep track of, and repon to the IRS on the applicable fortes, the amount or these after-tax contributions. This will enable you to determine the nontaxable amount of any future distributions from the IRA. Once you roll over your after-tax contributions to an IRA, you may NOT later roll over those amounts to an employer plan, but may roll over your after-tax contributions to another IRA. After-tax/rollover into an employer plan You may DIRECTLY roll over after-tax contributions from the Plan to another qualified plan (including a defined benefit plan) or to a 403(b) plan if the other plan will accept the rollover and provides separate accounting for amounts rolled over, including separate accounting for the after-tax employee contributions and earnings on those contributions. You may NOT roll over after-tax contributions from the Plan to a §403(x) annuity plan, or to a governmental 457 plan. If you want to roll over your after-tax contributions to an employer plan that accepts these rollovers, you cannot have the after-tax contributions paid to you first. You must instruct the Plan Administrator to make a direct rollover on your behalf. Also, you may not first roll over after-tax contributions to an IRA and then roll over that amount into an employer plan. Roth 401(k) plan deferrals. You may roll over an eligible rollover distribution that consists of Roth defarals and earnings (whether or not it is a "qualified" Roth distribution) either (1) by a direct rollover to another Roth 401(k) plan, or to a Roth 403(b) plan, provided the Roth 401(k) plan or the Roth 403(b) plan will accept the rollover, or (2) by a direct or 60 -day rollover to a Roth IRA. Alternatively, you can roll over the taxable portion of a non-qualified Roth distribution by a 60 -day rollover to a Roth 401(k) plan or to a 403(b) plan. See Section C. "Taxation of Roth deferrals" and -60 -day rollover option" below 30 -Day Notice Period/Waiver. After receiving this notice, you have at least 30 days to coitsider whether to receive your distribution or have the distribution directly rolled over. If you do not wish to wait until this 30 -day notice period ends before your ale -tion is processed, you may waive the notice period by making an affirmative election indicating whether or not you wish to make a direct rollover. Your distribution then will be processed in accordance with your election as soon as practical after the Plan Administrator receives your election. B. DIRECT ROLLOVER Direct rollover process You may elect a direct rollover of all or any portion of an eligible rollover distribution. If you elect a direct rollover, the Plan Administrator will pay the eligible rollover distribution directly to your IRA or to another eligible employer plan (or, in the case of a distribution of Roth deferrals, to a Roth IRA, a Roth 401(k) plan, or a Roth 403(b) plan) which you have designated. Alternatively, for the cash portion of your distribution, if any, the Plan Administrator may give you a check negotiable by the mistecor custodian of the recipient eligible employer plan or IRA To complete the direct rollover, you must deliver the check to that trustee/custodian A direct rollover amount is not subject to taxation at the time of the rollover, unless the direct rollover is from a pretax account to a Roth IRA. Except for a direct rollover of a pre-tax amount to a Roth IRA, the taxable portion of your direct rollover will be taxed later when you take it out of the IRA or the eligible employer plan. Depending on the type of plan, the later distribution may be subject to different rax treatment than it would be if you received a taxable distribution from this Plan. If you elect a direct rollover, your election form must include identifying information about the recipient IRA or plan. Treatment of periodic distributions If your Plan distribution is a series of payments over a period of less than ten years, each payment is an eligible rollover distribution. Your election to make a direct rollover will apply to all payments unless you advise the Plan Administrator of a change in your election. The Plan might not let you choose a direct rollover of your distributions for the year are less than $200. The $200 limit may apply separately to Roth distributions and pre-tax distributions Splitting a distributiodsmall distributions If your distribution exceeds 5500, you may elect a direct rollover of only a pan of your distribution, provided the portion directly rolled over is at least 5500. If your distribution is 5500 or less, you must elect either a direct rollover of the entire amount or payment of the entire amount. Change in tax treatment resulting from a direct rollover. The tax treatment of any payment from the eligible employer plan or IRA receiving your direct rollover might be different than if you received your benefit in a taxable distribution directly from the Plan. For example, B you were bom before January 1, 1936, you might be entitled to ten-year averaging or capital gain treatment, as explained below. However, if you roll over your benefit to a 403(b) plan, a governmental 457 plan, or an IRA, your benefit no longer will be eligible for that special treatment. Seethe sections below entitled "10% penalty tax if you are .under age 59'/3' and "Special tax treatment ifyou were born before 1936 " Taxation of direct rollover of pre-tax distribution to Roth IRA. If you directly rollover a pre-tax distribution to a Roth IRA, the taxable portion of the distribution is subject to taxation for the taxable year in which the distribution occurs (except that a special taxation rule applies to distributions during 2010 that you roll over to a Roth IRA, under which the distribution can be subject to taxation ratably during 2011 and 2012). For distributions before January I, 2010, you may not roll over a distribution from a pre-tax account to a Roth IRA if your adjusted gross income for the taxable year exceeds 5100,000. However, the adjusted gross income limit on direct rollovers from a pre-tax account to a Roth IRA does not apply to distributions after December 31, 2009. C. DISTRIBUTIONS YOU RECEIVE Taxation of eligible rollover distributions The taxable pornon of an eligible rollover