HomeMy WebLinkAbout120 Sophie Marie Cv1-31-18
CITY OF SANFORD
BUILDING & FIRE PREVENTION
FEB 0 2 2011 PERMIT APPLICATION
Application No: _L-
Documented Construction
Historic District: Yes No
Residential Commercial
ype of Work: New Addition Alteration
n—' ',,
on Re pair Demo Change of Use Move ElDescriptionofWork: KF-I)fTt
Value: $ 11,
Job Address: a( .Sr hicJ
Parcel ID:
T
Plan Review Contact Person:
Phone: Fax: Email:
Property Owner Information
Title:
Name -AT may) n Phone:SJ — _9_1?-OaD0
Street: I —Y )5 i (`i 17\/P' Resident of property?
City, State Zip: F7_
Contractor Information
Name R ?D)1 Phone: L D 7-33, 7h,
Street:
Fax:
City, State Zips
State License No.:
Arch itect/Eng!nee r Information
Name:
Phone:
Street:
Fax: _
City, St, Zip:
E-mail:
Bonding Company: Mortgage Lender:
Address:
Address:
WARNING TO OWNER: YOUR FAIIL,URE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BERECORDEDANDPOSTEDONTHEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAINFINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OFCOMMENCEMENT.
Application is hereby made to obtain a permit to do the. work and installations as indicated. I certify that no work or installation hascommencedpriortotheissuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. 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 Code
Revised: June 30, 2015
Permit Application
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may befoundinthepublicrecordsofthiscounty, and there may be additional permits required from other governmental entities such as watermanagementdistricts, 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 requiredinordertocalculateaplanreviewchargeandwillbeconsideredtheestimatedconstructionvalueofthejobatthetimeofsubmittal. The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, inaccordancewithlocalordinance. 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 willbedoneincompliancewithallapplicablelawsregulatingconstructionandzoning.
Signature of Owner/Agent Date
Print Owner/Agent's Name
ignature of ty-State of Florida Date
5ersonWyowntate of Florida
kenbush:
n GG
156878021Owner/Agent is to 1VIe or
Produced ID Type of ID -
Signature ofJCContractor/Agent Date
i / Ce' rim
Punt Contractor/Agent's Name
Produced ID
31. )Sl-
og h4k, Notary Public State of Florida
Jennifer Quakenbush
v, ` , p< My Commission GG 156878
dfhd' Expires 10/31/2021
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building n Electrical Mechanical Plumbing[]
Construction Type: Occupancy Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
N
COMMENTS:
y Known to Me or
of ID
Gas [] Roof []
Flood Zone:
of Stories:
Plumbing - # of Fixtures
of Heads Fire Alarm Permit: Yes No
UTILITIES:
FIRE:
WASTE WATER:
BUILDING:
Revised: June 30, 2015
Permit Application
PROGUARD REsTORATION
Where (2yartry comes _TftT,r
641 Monroe Road, Sanford, FL. 32771
Ph: 407-330-76
1
63 ® Fax: 4.077330-7661
PROPOSAL] CONTRACT
State Certified# CCC1330234
www-proguardrelstoration.com 2w.
Date
Submitted To Cg)ken
ddresOtIa &y n Qo nci State S4"Al'-1 ZP3L7PhItC0M
Q. M's cc) Email —A -H oc, CO/9. Job Address
We Hereby'
Submit Specifications Estiffiates For: Oemove existing
roof to deck place -Replace
roof valley liner. 1 wallrottenordamagedwoodroofdeck 'Replace roof soil stacks : x perLr: $ Co .00 plywood pershe Pit: $ G().'06 Replace roof vents: FRecod droofRe
t
Sly Replace underlam(b.., Replace dn" edge,!of r: l Replace,-roof:' 6 rI X A - Color ADDITIONALWORK
SCOPE INFORMATION 1 A
01 i'
con r- reS- INSURANCE CLAIMS
ONLY X Cont ivkcjA ound/ I 00 All
workscopeand/or costs specified in this contract agreement is subject
to or contingent upon the approval,of the customer's insurance company.
The undersigned further appoints PROGUARD RES- TORATION (hereinafter
referred to as "PROGUARW) as its representative U S. DQllars ($ and permits
PROGUARD to negotiate with the insurance company for set-. tlement of
the insurance claim. If there is a difference of Work scope and/or Paympf1t.to bema0j!pgn 2o g tLip -oras follows: costs, PROGUARD,
may negotiate a reasonable replacement, and/or, replace- meet cost
mutually agreed between PROGUARD and the insurance compa- ny. PROGUARD
will not start until work is approved by the insurance company. INSURANCE
COMPANY
L, All payments
to be ma de payable to PROGUARD RESTORATION only ACCEPTANCE OF
PROPOSAL The above
prices, specifications and conditions of this contract are,satisfactbry:and-are hereby accepted. I / We have read and understand the terms
and conditions located on the back of this document / contract agreement. PROGUARD RESTORATION hereafter referred
to as "PROGUARD") is authorized to do the work as specified and in,accordance with the terms and conditions and stipulations'of
this,contract agre6ment will be made as stated above. Authorized Si* nature
a u rPrintName, ao
Title Sales
T-H-18 INSTRUMENT RMPARED.SY:
Nme-- Pro card Restoration
Addres"Is: Onro-
a or11
Parcd ID Number- Md in =y=bda"Cheiftr 713. Rodda Stab, the
The undersigned hereby gives notice tile; improvement vM be made to Wtain red Prop".
f0flawing wormagort is provided In This Notice of COnmencernwt
1. OESCRVnON OF PROPERTY: (Leo, desedpoon oyth, property and street address if available)
n- . owNER INFORNIA-nom OR LESSEE MFOPMATM IF THE LESSM -COWRACTED r
Name and addrsss
Interest in proparty.
Yee simple Ift Holder (if other than oner listed above) Name*
4-
SURETY11f applicablet'a copyof the Patent bond isaftachad): Nam Arnount of Bond.
Address:Phone Number,
LENDER. Macrae:
Address:
7. pwwrs wwft*A st-&*
Florida
Ph ' one Number
Name
Addrnss
of
e. in addition, owner designates
Flodda Statutes. Phone numbantoreceiveacopyoftheLienoesNoticeasprovid6dinSection713.13(9)(b),
confing unless a different date is specified) J. E)Vr.-ton Date of Notice of Commencement (Me 0*TatiOn is 1 year ftm date of re
CEMENT ARETKF- OMER AFTER THE EXPIR&TION OF TKE NOTICE OF COMMENRESULT IN YOUR
CRAPTEWARNINGTooWWMANYPAYMDEBy =R 713. PART 1. SECTION T13.13. FLORIDA STATUTES, AND CANTICEOFCOMMENCEMENTMUSTBERECORDEDAND POSTED ON THEPAYINGTWICEFORIMPROVEMENTSToYOURPROPERTY. A NO EYJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TOOSTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEYBEFORECOMMENCINGWORKORRECORDINGYOURNOTICEOFCOMMENCEMENT•
State of County of
dayof 20 Ttle
foMolng kjsWument vjm acknowtedged bare rite this ---------- Who
is pmanally krwwn to Om0 OR wire €
has proftce&;&.O- toe RYAIN
S. QUAKEMBUSIM My
COMMISSION FF90TrW EXPIRES
August 06.2019
THIS uasrRuMENr PREPARED gY: - .._
s Prooutard Restoration n •en t l
onroe
Sanford,
NOTICE OF ENCEMENT
arM Parcel
ID Nmbe, -3-MM-50-0000-01 The
undersigned hereby gkw notice that impovementwIl be made to omtdn real property. and In accadanoe with Chspter 713, Florida SWWte% the following
Informs Is provided in ftds Ncdoe cf Cormnencernent OF
n of thff=6T Vw SIDE - --
2. a('F-IEVE. 02 Re -
goof 3.
O TNFORMA OR LEA RIFORMAYM W THE LESMVON RACM FOR THE TII iT- Name
and address h , re) F.2 Y272 Interest
in property: rmIrye Fee
Slmpte Titfa Holder (t otherthan owner fisted above) Name: Address:
4.
CqM t R 407-33Q-7%& Addis=
641 MonrOe•Rd•Sanford,FL32771 Phone
Number: tw.>
sp-oeast er•_ _ neagti>ei se,s1 3ac•.>goa Phone
Number: to
receive a copy of the Lienot's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone rtumbar: 9.
Expiration Date of Notice of Commencement (The w plfation is 1 year from date of recordmg unten a dUment date Is spewed) WAFWIAFG
TO OMM ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER -PAYMENTS UNDER CHAPTER 713. PART L SECTION 713-13. FLORIDA STATUTES. AND CAN RESULT IN YOUR PAYING
TWICE FOR IMPROVEt1t NM TO YOUR PROPERTY. A NOTICE OF OOMMENCEIMENr MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST iNISPECTTON. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. State
of i--- IQ County of _f? Jj flQ t f The
foreeotosg Insintmerttvvm adotowbedg/cdFb efore rose Shia V day of:,%1Lt 6J • by _
Al Ir bird (-/ hei) . dYho is p fry ksta+ans to roe &YOi$ Nwm
of pm=n g obbowd who
bw produced EF "0 011 to S f4m—ORM RYAN
S. QUAKENIUS" MY
COMMISSM 0 FFSD"36 EXPIRES
Nigust e6, 2010 t10T
398dti7 GRANT
MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK'
S # 2018011009 BK 9066 Pg 0484: (1pg) E-RECORDED 01/30/2018 02:20:52 PM 10.
00
CITYOF Building &
Fire Prevention Division RESIDENTIAL
RE ROOF POLICY &PROCEDURES I
IR I7F t o a3'kSF;iV1` PERMITTING
REQUIREMENTS - NO PLAN REVIEW REQUIRED THIS
DOCUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE REQUIREDTOBESUBMITTEDASPARTOFYOURPERMITAPPLICATION. THE,
SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF COMPONENTSTHATWILLBEINSTALLEDONTHEPROJECT. 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 SANFORDHISTORICPRESERVATIONBOARDINSPECTION
POLICY & PROCEDURES A
FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMILY, TOVi'NIiOUSE, MOBILEHOME, 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 is
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) DIGITAL
PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL 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 (ARCHTTECT OR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION. CONTRACTOR (
OR OWNER/BUILDER) SIGNATURES ' _,Cf i _} DATE:
44'
CITY Of.
SXNFORD
JOB ADDRESS: _wo '5 DhI
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
STRUCTURE TYPE: Q <SINGL&FAMILY RESIDENCE/TOWNHOUSE 0 MOBILE.HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE:
I Q;REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTSORE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF) )
DECK TYPE (PLEASE SPECIFY):
PLEASE NOTE: ONLY 100 SQL RR(E' FEET OF THE EXISTINCDECKIS PERMITTED TO BE REPLACED *x
ROOF VENTILATION: ( OFF -RIDGE O RIDGE QSOFFIT QPOWERED VENT QTUR INES
SKYLIGHTS: O YES &<O IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
iVIA11N ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 Q 2:12 — 4:12 V140el2 oR GREATER
ROOF EXTENSIONS (PORCHES PATIOS ETC) "IFAPPLICABLE"
ROOF SLOPE: Q LESS THAN 2:12 Q 2:12 — 4:12 O 4:12 OR GREATER
TYPE OF ROOF
0SHINGLE
Q METAL
0 MODIFIED BITUMEN
O TORCH DOWN
QINSULATED
Q TILE
O OTHER:
MANUFACTURER FLORIDA PRODUCT APPROVAL
FL#
FL#
FL#
FL#
FL#
FL#
FL#
CITY OF
t' SkNFORD Building & Fire Prevention Division
FIRE DEPARTMENT Re -Roof Permit Card
PERMIT NO. 18--&LIA ISSUE DATE: '
a
CONTRACTOR:
JOB ADDRESS: , •
TYPE OF WORK: ,"' roo
PROTECT FROM WEATHER
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
It
ROOF
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
TO SCHEDULE AN INSPECTION:
Dial 407.792.6069 or 855.541.2112:
Provide the items requested during the message '
The type of inspection requested must be scheduled under the appropriate permit type
Follow the prompts M "
PLEASE NOTE: Inspections scheduled by 3:30 p.m. will be conducted the
next business day.. If you. experience difficulty, please call 407.688.5150
Monday - Thursday 7:30 am - 5:30 pm for assistance.
AUTOMATED INSPECTION SYSTEM CODES
Final Roof Inspection Code III
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), certifying FBC code compliance by personal inspection
REVISED: 04-17 Inspection Line: 407.792.6069 or 855.541.2112
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407,688.5080
Application Number . . . . . 18-00000642 Date 2/01/18
Application pin number . . . 064754
Property Address . . . . . . 120 SOPHIA MARIE COVE
Parcel Number . . . . . . . . 33.19.30.510-0000-0140
Application type description ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Application valuation . . . . 11400
Application desc
reoof/noc on file
Owner Contractor
ARMAND COHEN PROGUARD RESTORATION INC
120 SOPHIA MARIE COVE 641 MONROE RD
SANFORD FL 32771 SANFORD FL 32771
407) 330-7663
Structure Information 000 000 REROOF/SHINGLES
Roof Type . . . . . . . . . FIBERGLASS SHINGLES
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1029008
Permit pin number 1029008
Permit Fee . . . . 124.00
Issue Date . . . . 2/01/18 Valuation . . . . 11400
Expiration Date . . 7/31/18
Qty Unit Charge Per Extension
BASE FEE 40.00
12.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 84.00
Special Notes and Comments
All projects within the City shall use
WastePro for debris removal. Please
contact WastePro at 407.774.0800.
Normal hours for inspections are from
7:30 through 4:30 Monday through
Thursday. Please be aware you must
contact the Building Official to
schedule a Friday or after hours
inspection. This is required since not
every inspector is licensed to do every
type inspection. Communication is the
key, so please contact the Building
Official if you have any questions at
407.688.5058 or at
dave.aldrich@sanfordfl.gov
Other Fees . . . . . . . . . 01-APPLCTN FEE -BUILDING 25.00
01-BLDG PLAN REVIEW 36.00
01-BLDG DCA SURCHARGE 2.00
01-BLDG DBPR SURCHARGE 2.76
Fee summary Charged Paid Credited Due
Permit Fee Total 124.00 .00 .00 124.00
Other Fee Total 65.76 .00 .00 65.76
Grand Total 189.76 .00 .00 189.76
CITY OF SANFORD
CUSTOMER RECEIPT *
Oper: BLANDA Type: OC Drawer: 1Date: 2101118 01 Receipt no: 65473
Year Number Amount
21018 642
120 SOPHIA NARIE COVE
SANFORD, FL 32771
BP BUILDING PERMIT RECEIPTS
189.76
AC 053116
Tender detail
CC CREDIT CARD $189.76
Total tendered $189.76
Total payment $189.76
Trans date: 2101118 Time: 16:30:46
FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE
PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS.
NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED.
NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED.
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
Page 2
Application Number . . . . . 18-00000642 Date 2/01/18
Property Address . . . . . . 120 SOPHIA MARIE COVE
Parcel Number . . . . . . . . 33.19.30.510-0000-0140
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1029008
Permit pin number 1029008
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 BL03 FINAL ROOF _/_/
Print/Type/Stamp Name
of Notary Public
CITY OF
SkNFORD Building & Fire Prevention Division
RESIDENTIAL RE -ROOF AFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ) '
e7-{
o I ADDRESS: 130 Sop h ICG /rl < s.
IxEocd , fL ` ?727 I
Delft A Dean 'AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR 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 #:
COMPANY /
CONTRACTOR: P I ba unrs 'F\)e4*-qra on CONTRACTOR
SIGNATURE' DATE: 1 MUST
BE SIGNED BY LICENSE HOLDER OR OWNER/BUILDER) 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 IseJ Sworn
to and Subscribed before me this day of 201.E by: fin
Who is V, rersonally Known to me or has Produced (type of identification)
as identification. ignature
votary ublic State
of Florida,, o•
NY W^ Notary Public State of Florida Jennifer
Ouakenbush e`
MY Commission GG 156878 Expires
10/31/2021