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Home My WebLink About125 Anthony DrCITY OF SANFORD EGEOVER BUILDING FIRE PREVENTION DEC 2 7 2017 PERMIT APPLICATION ippiication No: 7OkBy. 61 Documented Construction Value: $ 7t 0 00 Job Address: 12S- 614,horlV 'M V,_kdMq, R.4 j?'7-7:3 Historic District: Yes [] No El Parcel ID: 10 - 1 2Z)-30 -Sb 1 0130 Residential Commercial Type of Work: NewF1 AdditionD AlterationD RepairEl DemoEl Change ofUse F MoveEl Description of Work: k-60- _"ic_ - Eah "U'Myb q qgLtt S6,!v (,awj &I V1 vo Plan Review Contact Person: LOA16 0, 61 Phone: 70 *3- q-7b q Fax Title: 'qn h Email: kW:TQA! ge(r)elm'( - wyi U U I V Property Owner Information Name NA I W t ' ohn L Phone-, 7, 1 - 22 7 _L6 0 rio(dh Street: 12- 5- AA40h94== byiLe_ Resident of property? : It's City, State Zip: Contractor Information NamefAkj- U- PC03 & t, IM_& Ara, (yu • Phone: 321-203-L(7()q Street: *7 30 kW AY04 Fax: City, State Zip: ikoanmL 1)n" I State License No.: Architect/Engineer Information Name: Phone: Street: Fax: City, St, Zip: E- mail: Bonding Company: Mortgage Lender: Address: Address, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT, Application is hereby made to obtain a permit to do the work installations as I Application rim indicated. I certify thatnoworkor 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: 511 Edition (2014) Florida Building lode , 11 Revised: June 30, 2015 Permit Application I NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be fecund in the public records of this county, and there lnay 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 pen -nit 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, its 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. Stgnature of own gent Date ok, aqo old s; Print Owner/Agents Name gna e of Notary -State of Flor' a Dateh A% YENIFER M. PAMZO REYES MY COMMISSION # GG 089185 EXPIRES: April 2, 2021 Bonded Ttw Notw y Pok Underwrkers Owner „ gen 1s ^ Persona y nown to Me or Produced ID _ _:< _ Type of ID P L D L. t atur of Contractor/ gent Date LA, 1'ani kwtk Ant Contractor/Agent's Name Signature ofNotary-state of Florida Date Ot vas •., MIRK-i^-JAEN MY COMMISSION Fr 9i4924 Bolldad Yi,SLiN.;I feu,JlK; atWolWi e ! wn to ,,or 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 Fire Alarm Permit: Yes No APPROVALS: ZONING: UTILITIES: WASTE WATER: ENGINEERING: FIRE: BUILDING: COMMENTS: Revised: June 30, 2015 Permit Application 0 THIS INSTRUMENT PREP Name: DAY ROOFING Address. - NOTICE OF State of Florida YV MENCE E1 T Ii ll!#llit l ll I I i:_ N.l.l' OL_E l:011I'I T r ii . n..:: „3:: CC) til.'Jc : Li I; County of Seminole Permit Number: _ Parcel ID Number: i b 30 -SZ f '_ Q060- 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, DESCRIPTI N OF.PRO PERTY: LOT ( C5nl Le al de ri tion of the g rty nd stre t address if avails le) C pt't(( I 3L- 7 7f G NERAL D SCRIPTI OF IMPROVEMENT: ii OWNER) ' INFORMATION: Name: Address i Y 1: r 1 L N9 n 32'7 Fee Simple Title Holder (If other t n owner) Name::_ _ Address: CONTRACTOR: Name: DAY ROOFING INC Address: , 730 MAITLANDJAVENUE ALTAMONTE SPRINGS, FL 32701 Persons within the State of as by Section 7131i13(1)(b), FloridaDesignated by Owner upon whom notice or other documents may be served providedFloridaStatutes. Name: I! Address: I In addition to himself, Owner fjgsignates of To receive a copy of the Lienor's Notice as Provided in Statutes. Section713.13(1)(b), Florida Expiration Date of Notice of Commencement (The expiration date is 1 from date different date is specified) year of recording unless a 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 BEFORE COMMENCING WORK TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalties of perjury, t declare that I have read the foregoing and that the facts stated in it are true tothebestofmykowdgeandbelief. Owner' s Printed Name iiowner must sign the notice of commencement and no one else may be permitted to sign in his or her stead.` ii s S gnature Florida Statute 713.13 1 g); "The State of I li County of 1J The foregoing instrument was ac kjnoowlle d,, adJbefore me this g ^ 3 dayof Dee—?4,,m. 20 by s-`+ b4 Who is personal) known to me yN^ Name of person`jmak;ng statement c. OR who has produced ident f11 lcation Jype of identification produced: - asti ?_ R YENIFER M. P/WIZO REYES MY COMMISSION # GG 089185 0 EXPIRES: AprA 2, 2021 Notary ignatu &A-- j Bolded 1tYlJY Pub{c lhdelM fRefa 730 Maitland Avenue Altamonte Springs, FL 32701 Office: (407) 557 - 8533 24 Hr: (407) 810 - 2757 Fax: (407) 574 - 3563 321) 203 - 4704 License # CCC 1329833 SALES CONTRACT Day Roofing, In . agrees to wish all m tgdials and labor necessary to dp the modernization work at the following address: rk ho . -1 r .J_ Phnn;2nl\_'a°I -35`*0 Alt Phone: City: `&W CC`X g+ _ JCaie: r 1 lln Lm ----------- a-rY•I —+ Email:J a ,4 mo I ky p clnaa AAed .e r. ' C- • c 011 County: S ' + In accordance with the specifications given below: taNF u d ANEW CONSTRUCTION J REROOF REPAIR PITCHED ROOF 1 f n E VEOLDROOFTOWORKABLESURFACE. ROOF DECK WITH RING SHANKNAILS. PLACEANYRO TENWOODWRHSTANDARDSHEATHING@$5.00PERLINFALFOOT AND $75.00PERSHEETOFPLYWOOD, IFANY+_ ROOFINGUNDERLAYMENTNAILEDTOWOODDECKWTHSIMPLE)( NAILS. INSTALLSECONDARY WATER BARRIERIPEEL N STICK ROOFING UNDERLAYMENTTOENTIRE ROOF DECK SURFACE. ifQ T LNEWVALLEYMETALINVALLEYSANDREPIACEFLASHINGA$NECESSARY. STALLNfINLEAD BOOTSOVERSOILSTACKSANDREPLACEALLPURPOSEVENTS. INSTALL PROTECTNECOVERSOVERLEADBOOTS@$ 50.00EACH. , M"'k KS fl R.e B) cur lC ATTIC VENTILATION. CLEAN-UPAND HAULAWAY Ant RELATED DEBRISAND LEAVE JOB SITECLEAN. 13 CONTRACTORWILLCOORDINATE THE REMOVALAND REINSTALLATION OF ROOF RELATED PERIPHERALS SUCH AS (BUT NOT LIMITED TO) SKYLIGHTS, SOLAR UNITS, T.V. DISHES, AND/ORAIR CONDITIONERS, ETC.SUCH COST ISADDITIONALTOCONTRACT PRICE. LOWSLOPEDORFLATROOF REMOVEOLDROOFTOWORKABLESURFACE. RENAIL ROOF DECKWITH RING SHANKNAILS. REPLACE ANY ROTTENWOODWITHSTANDARD SHEATHING @$5.00 PER LINEAL FOOT AND $75.00 PER SHEET OF PLYWOOD, IF ANY. INSTALL UNDERLAYMENT NAILEDTO WOOD DECK WITH SIMPLEX NAILS. INSTALLSWRIPNS UNDERLAYMENTTO ENTIRE ROOF DECKSURFACE. INSTALL NEW LEAD BOOTS OVER SOILSTACKS AND REPLACE ALLPURPOSEVENTS. INSTALL PROTECTIVE COVERS OVER LEAD BOOTS @ $50.00 EACH. INSTALL EAVE DR] PS AROU ND THE PERIMETER OF THE ROOF. INSTALL COLOR: CLEAN- UP AND HAULAWAY ALL RELATED DEBRIS AND LEAVE JOB SITE CLEAN. 11 CONTRACTOR WILLCOORDINATETHE REMOVALAND REINSTALLATION OF ROOF RELATED PERIPHERALS SUCH AS (BUT NOT LIMITEDTO) SKYLIGHTS, SOLAR UNITS, T.V. DISHES, AND/ORAIR CONDITIONERS, ETC. SUCH COST IS ADDITIONALTO CONTRACT PRICE. 1.Caaracti)—ads. This adradmnsistsdthedc=&t,exaawatNood'sky1igmauthorizations, dany.Nop+onisesofhert m howsperffoiysoforth Contract Price $ 4 S G0.01D hthead2ddoamenlsshadbemagniudbYadwparty. Themdheurder"d mdaQmmntda6pm6esaantainWmtamdnddDmmmts. 2.hismdwsWdadagmaddWthaanhaddWnotbeameb*VupmoayRooti4hcudgdisdtdyappmw4 pad.sigadadwonsmdbyw d6araalfioers dNeSelhr. 3 XIMdesmbWintheantmddooarentsri6camtenamappreumalely and be m ieted onxim approately Tham emdWdatesappo;iia sadarest*dlosdmdWumgdi16AftoiSeller,laborandIVnWerial Sh*Uges,acts fCodand Permit $ 2¢ othaawasofmmseenbySella.Sellermserwsthedgmmemp"arysubadmda fathemnoe6onturfheconp%t ondthemrkdesaibed in he contract documents. CDayRoofing Inc, resawstherigbm stbsfimmmafedaadequal agreaarvalueandlindinorderto satisfylhe reGdremaiaspecified by New lunsdchond -y Code Edorament Laws which myresuhinadditionalcharges. Subtotal $ T DIOO 5. interest ddghi m(18%) peradperenmrmaehbecharged wagb.1ramsnotpaid as per the tam specified above. Reasonable adomey'sfees will adargedmme Purchaserdhaneasserymplace this admdat dinthehadsatmmeyforodledim. and this dtagebecom eapan ofthis contract and obligation dinePurchaser topay. 6.io tasagree that thisayeement4Wbe mnslmdedaccording mMe laws dtheState of Florida and any action brougldtheremmay be brought in the State of C7 Florida. Vence is hereby agreed be in Seminde County, Florida. ' 4Q% Qe SR $ • 7 D 7 • Q 7.ByersItightToCanc"youdon'tswdthe good orsamoes, you may cancel hdsagreemantbypmd6ngwritten notice to m the sell" in Person. area p0 to phone within 36 hours of signingthiscontract. 1 Both worker'scompensagm and pubichahhyinsurance am carded by the Segerandtheyam applicable tothe work to be pedomted. 9. naardersLoodandayamlhalnnb,yerhddLanrdess, oayRooErg.mcmraneanmgestiwrrdghtomamwya'adnwaay(a)aiavgtremgraieaa rre0aialsanarorniemrrwaldwarkmtuedaebathaardgtammvmedmpataminaLraakrvmwrnadararad.Frxmemaxa,mabyahamingi" BALANCE DUE $ L-10 pemdssimfarfypicalda8wrywiddeardtypicdwasferemowl vehidestoerdersaiddriveway(s)torihe purposedmrpediBngiNsalasmnlmd. fO. Setlerwipaa6netelherarrowlandminstagatigndrodmlamdpendramasuchaslbNrolgmAadm)adamhs,N.dishesandairaMiBonas, acm (Plus Total from wood addition, it purc, aser rmeds m replea existing skylights n wig be din additional ast+o the purchaser. replaced and #13and # 11 tmbbtoran 11. DayRofirg,hc snag ndbehemrasponsidemrtlledamapemeadriadmm,watalhes, rahigemdlirresoro8rarmachenaicarporedathd,forann from above) fad hYxoperlyinayleOneazrodderlinpadrreyj6badamspedphhpalmdngmstaladmdrodagmaedalxDayibang,IncshagnotWrespoY UPONCOMPLETIONOFROOFINSTALLATIOlftr(i addtional cost due m roddectingthal rripld heveag metenal adwred'm sorb a waYthatrequves re-0eckingdthe svucmre. 12.Cmstur4m hdusbyReca+ayFurd{wyrredraY araia6bhamitnClRFdyoumsemonrymepajedPafomedudermmract.vAeretlre*.dion a fromspea& vroatimdFbtida lawbya smblaensed rmlreda. frorkdormaionatrndihe naxxreryfurdadfilirga dairrq,xsdadlhe FbridaConsbed95. IndustryliansingBoardaltherogowi..... i honenumheraneaddress:1940NoMMyourmytTalganyleaac5on323n9-2215matrudedde7ctsiny 13.1 ter55e, norida $tildes ordains imponad msy,iraredatoorrsWfdmwbefaayoumaYb^ng 9legal amar Uran agepad mnAmded deleds in your home.Sidydays befom you bmganylegalaction,youmusldegwrmfheothwpaMmtNsontmdawdten nogm mmmngtoChaptw558andm onsidm mWdrgwoftamrepasa(syforftallegWcroshudondofeayouamnotodigamdmaooWmyofmrv"chmayMmade.Themaresbiddea®mwWer this Florida Law which =at be met and followed to Protect your interests. ecuted in duplicate, one copy, one copy of which was delivered to, and receipt is hereby acknowledged by Buyer, this —=day of 201aL• Approved and Accepted: NOTICE TO OWNER a. Do not sign this home Improvement contract in blank b. You are entitled to a copy of the contract at the time you sign. Keep it to protect your rights. m SalesmaX Pdrchaser Sign Here Officer's Signature Purchaser Sign Here ypr/01/2212015 LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 1211 S -- I hereby name and appoint: OAJ f Bn&- an agent of: 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): 0 and application for work located at: riw 'CAAFM M. PL 32773 Expiration Date for This Limited Power of Attorney: 115012o to License Holder Name: CIO, 1,4_ ( M • Pa State License Number: 20( 9- Signature of License Holder: r STATE OF FLORIDA COUNTY OF ,Semi'wto— The foregoing instrument was acknowledged before me this lS—day of beLLM , 2001'—, by e%( KU who is Xpersonally known T to me or who has produced as identification and who did (did not) take an oath. 4 Signa re Notary Seal) tee", Print 6r type name YN 9-, Al.iRD0JPX Notary Public - State of FrW dnvcohjfFFs+ct Fr sr aCommission o ' B01,„ ,,,,,t,.u„ n«ers No.7 q My Commission Expires: Rev. 08.12) 12/15/2017 SCPA Parcel View: 10-20-30-501-0000-0` Property Record Card rr%v Parcel: 10-20-30-501-0000-0130 Owner: REYNOLDS NICHOLAS J & REYNOLDS JOHN L sc-mvq i.-o0u ay.A.CIFWA Property Address: 125 ANTHONY DR SANFORD, FL 32773-5938 Parcel Information Value Summary Parcel 10-20-30-501-0000-0130 Owner REYNOLDS NICHOLAS J & REYNOLDS JOHN L Property Address 125 ANTHONY DR SANFORD, FL 32773-5938 Mailing 125 ANTHONY DR SANFORD, FL 32773-5938 Subdivision Name GROVEVIEW VILLAGE Tax District S1-SANFORD DOR Use Code 01-SINGLE FAMILY Exemptions 00-HOMESTEAD(2013) e 75.00 1 75.00 1 75.00 Seminole County GIS Legal Description LOT 13 GROVEVIEW VILLAGE PB 19 PGS 4 TO 6 Taxes 2018 Working Values 2017 Certified Values Valuation Method Cost/Market Cost/Market Number of Buildings 1 1 Depreciated Bldg Value 94,947 89,523 Depreciated EXFT Value 1,418 1,501 Land Value (Market) 25,000 25,000 Land Value Ag Just/Market Value'* vPortability 121,365 116,024 Adj Save Our Homes Adj 41,766 38,062 Amendment 1 Adj 0 P&G Adj 0 0 Assessed Value 79,599 77,962 Tax Amount without SOH: $1,421.42 2017 Tax Bill Amount $696.67 Tax Estimator Save Our Homes Savings: $724.75 Does NOT INCLUDE Non Ad Valorem Assessments Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund 79,599 50,000 29,599 Schools 79,599 25,000 54,599 City Sanford 79,599 50,000 29,599 SJWM(Saint Johns Water Management) County Bonds 79,599 79,599 50,000 50,000 29,599 29,599 Sales Description Date Book Page Amount Qualified Vac/Imp QUIT CLAIM DEED 1/1/2013 07954 0919 100 No Improved QUIT CLAIM DEED ~ 9/1/2006 - 06412 1610 100 No Improved WARRANTY DEED WARRANTY DEED 7/1/1998 065812/1/1989 03474 02133 0065 0658 67,500 57,500 Yes Yes Improved Improved ADMINISTRATIVE DEED 10/1/1989 02118 0542 57,500 No Improved WARRANTY DEED 11/1/1980 T 01306 1136 43,900 Yes Improved WARRANTY DEED 3/1/1980 01269 0090 1,410,500 No Vacant F1n 1 tatrxpa'ra`b'te a'les Land Method Frontage Depth Units Units Price Land Value LOT 0.00 1 0.00 1 25,000.00 25,000 http://parceidetail.scpafl.org/ParcelDetaillnfo.aspx?PID=10203050100000130 1 /2 12/15/2017 I Buildir';Information SCPA Parcel View: 10-20-30-501-0000-0 Description Year Built Fixtures Bed Bath Base Area Total SF Living SF Ext WallActual/Effective 1 SINGLE 1980 6 3 2.0 1,284 1,836 1,284 11CONC FAMILY I I BLOCK Permits Adj Value I Repl Value I Appendages 94,947 $115,437 Description Area OPEN PORCH 12.00 FINISHED GARAGE 540.00 FINISHED Permit # Description Agency Amount CO Date Permit Date 02658 WOOD PRIVACY FENCE SANFORD 300 6/1/1999 00500 REROOF SHINGLES; PERMIT #98-500 SANFORD 2,400 12/1/1997 Extra Features Description Year Built Units Value New Cost COVERED PATIO 1 11/1/2005 1 567 1,000 SCREEN PATIO 1 11/1/2005 1 851 1,500 http://parceldetail.scpafl.org/ParcelDetaillnfo.aspx?PID=10203050100000130 2/2 CITY OF Sk ORD Building &Fire Prevention Division RESIDENTIAL RE -ROOF POLICY & PROCEDURES FIRE DEPARTMENT 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 INSTALLATION 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), CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: CODE COMPLIANCE BY PERSONAL INSPECTION. DATE: L7- 21. T v,>CITY OF Ski!40RD FIRE DEPARTMENT JOB ADDRESS: PERMIT # Building & Fire Prevention Division RESIDENTIAL RE -ROOF SCOPE OF WORK STRUCTURE TYPE: ® SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM RE -ROOF TYPE: © REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF DECK TYPE (PLEASE SPECIFY: PLEASE NOTE: ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED * * ROOF VENTILATION: OOFF-RIDGE & RIDGE OSOFFIT OPOWERED VENT OTURBINES SKYLIGHTS: O YES ONO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: MAIN ROOF AREA ROOF SLOPE: O LESS THAN 2:12 2:12 - 4:12 O 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL SHINGLE F/ FL# O METAL FL# O MODIFIED BITUMEN FL# OTORCH DOWN FL# 0INSULATED FL# O TILE FL# O OTHER: FL# ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IFAPPLICABLE** ROOF SLOPE: O LESS THAN 2:12 O 2:12 -4:12 O 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL O SHINGLE FL# O METAL FL# O MODIFIED BITUMEN FL# O TORCH DOWN FL# O INSULATED FL# O TILE FL# OOTHER: FL# CITY OF SkNFORD FIRE DEPARTMENT but ding & Fire Prevention Division RESIDENTIAL RE-ROOFAFFIDAVIT RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT#: k-4- 3:(o ADDRESS: 125' AI R g on--f or'I V t 6anKrd, F IpYT6a 3Z9:43 I e `) h elr 4 • PO ' I0 AS A(N) GF.NFRAI._ RI)II.DIN(,_ RFSIDFNTIAI. nR ROOFING CONTRACTOR, 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 #: C.CC.'132cl 033 COMPANY / CONTRACTOR: f Koof_4rm 2.1 Ili CONTRACTOR SIGNATURE: 'v MUST BE SIGNED BY LICENSE HOtVER OR A FINAL ROOF INSPECTION 1S REQUIRED: DATE: 12- LS - 1-4- 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 5i?r tii r01e Sworn to and Subscribed before me this 26 day of r%,"10_C.Q,C-'_6G1( 20 R by: QVIl Q,1l Q{IiIU Who is Q'Personally Known to me or has Produced (type of identification) O ' Signa re of Notary Public State of Florida jqj ] p 5a 4P-n Print/ Type/Stamp Name of Notary Public as identification. A A 2 p --1 -