HomeMy WebLinkAbout116 Rockhill DrCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Applicationlicatiion No:
Documented Construction Value: $ ar3u7 ., 00
Job Address: C% ' i lr -4rd Historic District: Yes No
Parcel ID: 33 --i q- 3 v S ld ;b600 - 13Z0 Residential Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work:ij
Plan Review Contact Person:Title:""1 C
Phone: ---7q(,O Fax: 401--641 - " Email: 15"0 L44
f
Property Owner Information
Name ?,AG( -, Ut Phone: ''1- c f 3 ~ 'Z 1 '1- Z-
Street: ma .>G, i t r j) r Resident of property?
City, State Zip:t/tt-2 -
Contractor Information
Name -1086 C%Uwc-( C t G-ti' ;.:(-rc- Phone: g01'4z0 - `iq 0U
Street: I S(1 ty 6 ti,.,4e'_ Cl ossorn.'-1 Fax:
City, State Zip: /)r k nGt.y ft, 3z- 8b q State License No.: (2! C 3 2 07 -61
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Architect/Engineer information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
WARNING TO OWNER: YOUR FAILURE TO RECORD A. NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
Application is hereby made to obtain a permit to do the work and installations as indicated. 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 regulati ng 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; 51h Edition (2014) Florida Building Code
Revised: June 30, 2015 A ' to j ( 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
be done in compliance with all applicable laws regulating c
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Print
Signature
ion is accurate and that all work will
in a d zoning.
i l< r
Date
ri
Name
SONJA M ROBERTS
MY COMMISSION # FF970513
EXPIRES March 10, 2020
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID Type of ID Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas[] Roof
Construction Type: Occupancy Use: Flood Zone:
Total Sq Ft of Bldg: Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
uiiioi mil uou imp iuomiii loll ut
THIS INSTRUMENT PREPARED BY:
Name: TAG General Contractors, Inc.
Address: 1517 N Orange Blossom Tr
Orlando, FL 32804
NOTICE OF COMMENCEMENT
Permit Number:
I _,2D—1 1 q
Parcel ID Number:. 33 _ 0 '20 S -
I I',fih Z I'ilFiL1J'(F `;;r,t13.1,10l-E (_OUIT '
CLEr?(:. OF C,:1:KUI:T COURT & c:(_IMPIT.OLLER
l.Et;IC'S y 2U171"ON
RECORDED 12/1. /201- 01. t' 37 v 1 Pr-1
fG CC J 1lri)_C:,.).DLNG FEE...
rtE( OM)EC' BY Jec- enro
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the
following information is provided in this Notice of Commencement.
1. DESCRIPTION OF P j0PERTY:' (`Legal desc ''ptio% of th property and street address available) // / C y y 40 ;3 l : f%%T/ ri/9 L'J /?tzl " // , —Y $ T f' YJJ r / /
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Re -roof
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: P'O' eL Pr kg-- tV3 J V_ V-0C%CH rLt_ N'-
Interest in property:C%t-
Fee Simple Title Holder (if other than owner listed above)
4. CONTRACTOR: Name: TAG General Contractors, Inc. Phone Number: 407-420-7900
Address: 1517 N Orange Blossom Tr Orlando, FL 32804
5. SURETY (If applicable, a copy of the payment bond is attached): Name:
Address: Amount of Bond:
6. LENDER: Name: Phone Number:
Address:
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents maybe served as provided by Section
713.13(1)(a)7., Florida Statutes.
Name: _ Phone Number:
8. in addition, Owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. Phone number:
9. Expiration Date of Notice of Commencement (The expiration is 1 year from date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE
CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, .FLORIDA STATUTES, AND CAN RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT'MUST BE RECORDED AND POSTED ON THE
JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO'OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signature of Owner or Lessee, or Owner s or La'ssee's (Print Name and Provide Sig tory's Title/Office)
oz—
Authorized
State of tit C County of 4 l(
The foregoing instrument was ackn wledged before me this 3 day of Dec
by fl ( Who is personally known to me OR
Name of persorTmaking statement
who has produced identification type of identification produced:
LAARY JONEu PEARSON
MY COMMISSION #'GG005628
s UPIRES June 26, 2020
Notary
Mom;
C
TAc ral Contru
1517 N Oarn e Blossomtrs t TlailOrlando
pD, I'
32844 7-
420-7900 Faxt407-60}-7997 FL
License CG 6164 iiuofing CCG1328779 PLA ATNvo,
Nti. tam GenerahCOntractors
lnc. AGREEMENT
I '
CF. COMPANY APPkUVAL OC' PAYM1'kEN7' CYFS)/ NU INST(A THIS
AGREEMENT ISSUDJECT TO INSURANCE CUSTOMER
1 't lQ SPECIAL INSTRUCTIONS S
rtirFT j \ C fc -t I L-t- CITY
t Y`rh _ Sl ZIP F.
MAIL ADDRESS fA,'1e 4/1%L VIAL' Project
Manager ),A1E-8'---Q-•—Aqz 1
spr,,
ci FIcATIONs NtANtiFtie
CURI R C1C St ttNGLt L STYLE
OF SHINGLE COLOR
OF SHINGLE C
VALLL:Y+ g.
VENTS ZSTYLE P,
JEAR OFF YES LAYER (t) l ;s t-
PITCFIQ STORY ST FLCPERtvllt'
F RNISHED ,?J REPLACEALL BOOT JACKS 2q YN`
I HE`ftC UNDERLAYMENT (TICE & WATER SHIELD Sa' l
ST
OAYM EN1 65tt"r?if a ' 5FC
OND
PAYNI N C`_R' FINAL
PAYMENT
DUE AFTER ROOF COMPLETED Al ROLL
YARD WITH MAGNET jRO,LLER 17 6:
11ROt'
ECTLANDSCAI'E WHERE NEEDED XDRIPEDGE KEEP; PLACE COLOR T1 LL TERMS w
tug General
Contractors Ine is cansid r d to be a cenlfteil rooting unnracf8r CC C J 32R779 and (hntn C p[ tractor Ct C 4r,1 CA4 I HIS CON I It ACT DSJt S NOT 1713t IC .A'I'IS THE PI2OPIRCY:C)1('N R Olt "tiagcGcilcni[ 4nmractl2r>° tEi AI.Y K`AY I3N1 LSS 11 1S Arl ItOV'LD 6Y 7 flh !RC)PI ftT OWNERS INSURANC{ CCSAAPANY Anil rx r mnnnn.ore t'iun.e dl 1'f-1i7R1J4\"'1'ei(' l'(7 PI1RSIll.I'HI', PROPERTY ERTY
DNLRS' HEST INTEREST FORPRUYitICI Y 1(t YI.ALUNIVN I tm ar 1, ,> • COMPANYAND "TAC' wiTH"
NO ADDITIONAL COSTTOTIIEPRC)1?LRINOWNTRo'n-tER-rilAN'THE INSIIRANCGDIDUCTI.42II WIIEN'IIICI?AGRCEAnIE" HAS BEEN I)FTIiRMINCDITSHALL, EFCOML 1111 [FINAL CONTR.AC.L AMOUNT AND TIIG I ROI L'R"I'ti OR`NI:I2,ADTIIfJR17f•:S I AG" 1`O OBTAIN LAANDANDNIN11RIAI IN ACCORDANCE W111-1 THEPRICEAGREEABLE" AND SPECIFICATIONS SET Otfl HERIN- AND ON THE MWERSI SIDE HERE RLOF TO ACGOA4PI,ISII'rH6RI PLAC
E%-IENT Olt REPAIR 11IERFFORI TAG" ACTING 'AS YOLJR'CONI RACTOR WILL BE EN11 t LEDI;O ALL INSURANCE PROCEEDS IN ACCORDANCEWITH THIS ACRFLNtbNT. ALL IRILLSARESUMMTOCHANFY'Ull, I HE BUYER, MAY CANCEL THIS.I URCHASF A I ANY'rlME PRIOR TO MIDNIGHT OF TIIr. THIRD .
DUSINI1SS DAY AFTERT}IL DATrs OF THIS AGREEMENT. 'I AG GENERAL 'CONTRACTORS IN-4IMS ILL IIARR9NTIES, EXPRESSED OR IMPLIED IVARRANTk' OF
MERCHANTABILITY OR FITNESS FOR A PARTICL'LAR,.PURTO POSE E,A'CEPT.AS
SPECIFICALI
1' b:PRES'SED ON THE REVERSE SIDE OF THIS AGREr;
mENT. IF FOR A,'A`Y REASON THIS ROOF IS NOT COVERED BV INSURANCE ANIL THE 110r11EO WNER WOULD LIKE US 7'0 PROCEED 01-THTHE-IVORK
IT WOULD BE ME' R!'S'POv.VIRILITYOFTIIE HO.tlEOu9VER TO PiIT IN' FULL FOR THE ROOV - - SIGA' REL.OIF'/FYOU IVOCILD STILL
L/tiE US TO PROCEED l3'ITH THE 3t'ORfi:4N'D }OU{I'fLL P-1.1' FOR IORR-b OFTHL WORK QU 71, . Bj UA°DERMND ROOF ISNOT COVERED
B. I INSUR:-I YCE AND IAGRER TO PAY IN FULL FOR ROOF I CU IER.14AS READ ANDAGRLESTO .ALL TERNISAND CON 70ti5 ON F O\T 3 [14ClC O ' THIS ,4GREEIl1ENT. . ct sToti p , ACCEPTED BY HOMEOWNER(S) ON:
DATE
t i ! ._ 6 CO-OWNER: DATE BY k TAG
REPRESF,NTATIVE: DATE 1 ! / BY
R-- Insurance Companc.741J- ,,`-tC,&,Aj Pohcv
N L c7 Chum #„=1 tL_-.4 At Maned i Denied,'Pending Insurance Phone Email FaN Adjusier Phone
Email lwpecuon Date— .1,
i(m e 1 {, Deductible ` MortgugcPR- L.cxl Y`
si
Lcu tJ C77%_Ihe ','777"f%jT
SCPA Parcel View: 33-19-30-516-0000-1320 Page 1 of 2
Property Record Card
w aoinna`crnParcel: 33-19-30-516-0000-1320
R Owner: REID PAMELA M
kal;Md1J(M_Cf.Xykd1Y. fi.f i3CM
Property Address: 116 ROCKHILL DR SANFORD, FL 32771
Parcel Information Value Summary
Parcel 33-19-30 516 0000-1320 - - - 2018 Working 2017 Certified
Values Values
Owner REID PAMELA M
Property Address 116 ROCKHILL DR SANFORD, FL 32771
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 1
Mailing , 116 ROCKHILL DR SANFORD, FL 32771- -- 3- -
Depreciated Bldg Value $167 013 $157 428
Subdivision Name COUNTRY CLUB PARK PH 2 - --
Depreciated EXFT Value $1 375 $1,438
Tax District S1-SANFORD _ _....... - -- - - -
Land Value (Market) $38,000 d $38,000
DOR Use Code 01-SINGLE FAMILY ...,- -
Land Value Ag
Exemptions ------- - _
m Just/Market Value *' ( $206,388 1 $196,866
Portability Adj
Save Our Homes Adj $0 $0
50 50 50 50 Amendment 1 Adj $0__ $5 085 _.
P&G Ad/ $0 $0
Assessed Value $206,388 $191,781
Tax Amount without SOH: $3,685.20
L 2017 Tax Bill Amount $3,685.20
a Tax Estimator
Save Our Homes Savings: $0.00
50 50 50 50 50
Does NOT INCLUDE Non Ad Valorem Assessments
Seminole County GIS
Legal Description
LOT 132
COUNTRY CLUB PARK PH 2
PB 54 PGS 22 THRU 24G _U
Taxes
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund $206,388 $0 $206,388
Schools $206,388 , $0 $206,388
City Sanford $206,388 $0 k $206,388
SJWM(Saint Johns Water Management) $206,388 [ $0 $206,388
County Bonds $206,388 [ $0 $206,388
Description T Book Page Amount Qualified Vac/Imp
WARRANTY DEED 4/1/2017 08903 1370 t $233 500 ( Yes Improved
WARRANTY DEED 1/1/2005 05605 1 1865 $214 000 Yes Improved
SPECIAL WARRANTY DEED 9/1/2000 03928 C 1275 $121,900 j Yes Improved I
WARRANTY DEED 5/1/2000 t 03867 1579_ - $23 500 Yes Vacant - - „-
LSFind Comparable Sales _
Land
Method Frontage Depth Unds Pnce Land Value _
LOT 1 $38,000.00 $38,000
Building Information
Year Built I
k D,____Actual/Effective Fixtures Bed Bath Base Area Total SF Living SWall Adj Value FExtRepl Value Appendages a-..—
z-.._..., .._....1.._ 3 1
j 2000 8 4 2.0 1,891 s 2,348 1,891 $167,013 $177,673 Description
Area http ://
parceldetail. scpafl. org/ParcelDetailInfo. aspx?PID=3 3193 ... 12/20/2017
City of Sanford Building Division
Residential Re -Roof Inspection Policy & Procedures
PERMITTING REQUIREMENTS — NO PLAN REViEw REQUIRED
This document (signed) along with an accurate and completed Residential Re -Roof Scope of Work are required
to be submitted as part of your permit application.
The Scope of Work must include all applicable Florida Product Approval numbers for all roof components that
will be installed on the project.
A permit will not be issued without these documents. Copies will be made to post on the job site.
Projects located in the Sanford Historic District will require plan review and approval by the Sanford
Historic Preservation Board
INSPECTION POLICY & PROCEDURES
A Final Roof Inspection is the only inspection required for Residential (Single Family, Townhouse, Mobile
Home, Apartment and/or Condominium) Re -Roof Permits.
The Following is required to be provide on the job site:
Permit Card, posted in a conspicuous and weatherproof location
Completed Residential Re -Roof Scope of Work
Completed and Notarized Inspection Affidavit
All Florida Product Approval and Corresponding histallation Instructions
Product Approval shall match what is on the scope of work)
Digital Photographs (must include the permit number or address in each picture)
o Each plane of the roof, showing the underlayment installed
o Roof Deck Nailing Pattern & Spacing (including a measuring device or ruler)
o Roof Deck Nails used (including a measuring device or ruler showing size of nails)
o Underlayment Pattern & Spacing (including a measuring device or ruler)
o Drip Edge & Valley Attachment (including a measuring device or ruler)
o Shingles installed, nail pattern and location of nails
Skylights (if applicable)
o Digital photographs showing all installation components, per FL Product Approval
o Digital photographs showing all required flashing, per FL Product Approval
Failure to follow these specific guidelines will result in an affidavit provided by a Florida Design
Professional (architect or engineer), certifying .F. BC code compliance by personal. inspection.
CONTRACTOR (OR OwNr:R/BUILD1_1R) SIGNAIURE:
y: `
r L 1 [ w.-:IDi 7! : I '.
CITY OF
r19E 0tPAPIT;,1Eill I JOB
ADDRESS: 1 f b Zti ( PERMIT # r
31 '
Cl Building & Fire
Prevention Division RESIDENTIAL RE -
ROOF SCOPE OF WORK F Y
RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMNIU 4 STRUCTURE TYPE:
SINGLE AMIL RE -ROOF
TYPE: 916, PLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) O RE-
COVER (NEW ROOF INSTALLED OVER EXISTING ROOF) DECK TYPE. (
PLEASE SPECIFY): Rvia,,. PLEASE NOTE:
ONLY 100 SOUARE FE T OF THE EXISTING DECK IS PER,'bIITTED TO BE REPLACED ROOF VENTILATION:
DOFF -RIDGE RIDGE OSOFFIT OPOWERED VENT OTURBINES SKYLIGHTS: O
YES (O'NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL#: MAIN ROOF
AREA ROOF SLOPE:
O LESS THAN 2:12 O 2:12 - 4:12 Q4:12 OR GREATER TYPE OF
ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL SHINGLE 5
r f S %1'r FL# 1 3U• O METAL
FL# 0 M.
ODIFIED BITUMEN FL# I O
TORCH DOWN FL# OINSULATED FL#
O TILE
FL# OTHER: {I
IC LT d 1 L FL# l Z ' Z 1- ROOF EXTENSIONS (
PORCHES PATIOS 'ETC.) **IFAPPLICABLE** ROOF SLOPE:
O LESS THAN 2:12 O 2:12 - 4:12 O 4E 12 OR GREATER TYPE OF
ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL O SHINGLE
FL# O METAL
FL# O MODIFIED
BITUMEN FL# O TORCH
DOWN FL# 0INSULATED FL#
O TILE
FL# O OTHER:
FL#
CITY OF
IS'ORD Building & Fire Prevention Division
FIRE DEPARTMENT Re -Roof Permit Card
PERMIT NO. ® 311 q ISSUE DATE: 12.20,11
CONTRACTOR: TA 6 G uer4l Nd&ac&D
JOB ADDRESS: I I (A 7R "76 1 r
TYPE OF WORK: 7R&1T;;J1A4f1eS
PROTECT FROM WEXTHER
Post this Permit and all required documents in a conspicuous place outside
Digital Photographs are required - please follow re -roof policy and procedures guide
All trash, debris and dumpsters must be removed from job site at final inspection
Permit expires six (6) months from date of issue
alien
INSPECTION TYPE APPROVED REJECTED INSPECTOR
FINAL ROOF
FAILURE TO FOLLOW THE RESIDENTIAL RE -ROOF POLICY & PROCEDURES WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION
FEE AND MAY REQUIRE AN AFFIDAVIT, SIGNED AND SEALED, FROM A REGISTERED FLORIDA DESIGN PROFESSIONAL
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.
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. FBC 105.3.3
REVISED: 4-17 Inspection Line 407.792.6069 or 855.541.2112
CITY OF
4 r. Building & Fire Prevention DivisionORD- RESIDENTLAL RE -ROOF AFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ADDRESS:
71 I
P OrI (Qj , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR OOFING
CONTRALTO ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE FOREGOING
INFORMATION IS TRUE AND ACCURATE AND THAT ALL ROOFING COMPONENTS LISTED ON THE SCOPE OF WORK AT THE ABOVE
REFERENCED ADDRESS HAVE BEEN INSTALLED IN ACCORDANCE WITH THEIR PRODUCT APPROVALS AND ALL APPLICABLE CODE REQUIREMENTS —
SPECIFICALLY FLORIDA BUILDING CODE, EXISTING BUILDING. IN ADDITION I CERTIFY THE INSTALLATION MEETS ALL REQUIREMENTS
FOR SECONDARY WATER BARRIER AND NAILING OF THE ROOF DECK, IN ACCORDANCE WITH THE HURRICANE RETROFIT MANUAL
REQUIREMENTS (BASED ON F.S. CHAPTER 553.844). LICENSE #:
COMPANY/
CONTRACTOR: A A CONTRACTOR
SIGNATURE: DATE:[ 7 12 MUST
BE SIGNED BY LICENSE HOLDER OWNE LDER) A
FINAL ROOF INSPECTION IS REQUIRED: THIS
SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINAL ROOF INSPECTION, ALONG
WITH DIGITAL PHOTOGRAPHS OF EACH PLANE OF THE ROOF SHOWING IN DETAIL ALL COMPONENTS (DECKING, UNDERLAYMENT,
FLASHING, DRIP EDGE ATTACHMENT) WITH THE PERMIT NUMBER OR ADDRESS CLEARLY MARKED ON THE DECK FOR
EACH INSPECTION. THE PHOTOGRAPHS MUST INCLUDE A RULER OR MEASURING DEVICE TO CONFIRM ALL NAIL SPACING AND OVERLAPS,
INCLUDING DRIP EDGE AND VALLEY FLASHING. PLEASE REFER TO THE RE -ROOF POLICY AND INSPECTION PROCEDURE PAPERWORK
FOR FURTHER EXPLANATION OF ALL REQUIREMENTS. FAILURE
TO FOLLOW ALL REQUIREMENTS WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION FEE AS WELL
AS REQUIRING A DESIGN PROFESSIONAL (ARCHITECT OR ENGINEER) TO CERTIFY, BASED ON PERSONAL INSPECTION,
THE INSTALLATION OF ALL ROOFING COMPONENTS. STATE
OF FLORIDA COUNTY OF l Sworn
to and Subscribed before me this2Z day of Dr 6d-,-- 20 0 by: em
14 1Jl'e_ Who is Personally Known to me or has Produced (type of id
en 'fication) _ as identification. Signat
a of Notary Public SONJA M ROBERTS State
of Florida MY
COMMISSION # 0,
202013 p•;;,EXPIRES March 10, 2020 Print/
TyW/Stamp Name of
Notary Public