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210 Sir Lawrence Dr 10-1296 (roof)1 ME APR 2 2 RECEIVED CITY OF SANFORD 20'61-DING & FIRE PREVENTION PERMIT APPLICATION Application No: o� 1 �P Documented Construction Valise: $ S l010 Job Address: c':�1�5 `c r -e nC p � ` _ Historic D43trict: Yes ❑ No ❑ Parcel ID• 10 'S —cx-sto -- 053 b Description of WorkX''S47�-N r0 Plan Review Contact Person: Phone: Fax: Zoning: E-mail: Property Owner Information NameC'9 Y1� Phone: Street: a 10�- City, State Zip: / AR.A Title: Resident of property? : Contractor Information NameZ Phone: Street: 1 �. i \ Fax: JQ 1_D-' City, State Zip: �G L 3 ��(o3 State License No.: Ar itect/Engineer Information, Name: Street: City, St, Zip: VA Bonding Company: Phone: Fax: E-mail: — Mortgage Lender: Address: �8Address: PERMIT INFORMATION Building Permit Square Footage: oZ -i d Construction Type: No. of Stories: No. of Dwelling Units: Electrical ❑ New Service — No. of AMPS: Flood Zone: Mechanical 13 (Duct layout required for new systems) Plumbing ❑ New Construction'- No. of Fixtures: Fire Sprinkler/Alarm ❑ No. of heads: 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. ` 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 zohing. 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 OBTAIN N SFINANCINGE JOB SITE BEFORE THE CONSULT WITH YOUR FIRST INSPECTION. IF YOU INTEND T 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. 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. A copy of the executed contract is required in order to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate .the plan review fee based on past permit activity levels. Should calculated charges exceed the documented construction value when the executed contract is submitted, credit will be applied to your permit fees when the permit is released. ' 0,—tur,,rk,61Age,t Date Print Owner/Agent's Name Notary -State of Florida ERMSENEZ ( MY COMMISSION # I)D 966002— EXPIRES: February 28, 2014 Bonded Thru Notary Public Undewiters Owner/Agent is Personally Known to Me or Produced ID — Type of ID APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: q Signature of Contractor/Agent Date CIL- Print ctor/Ag�enCssNNa�me�% y� NEIDY S. ESPINOSA Notary Public - State of Florida * . ° My Commission Expires Jun 2, 201 Commission # DD 794084 �5 Battled Through National Notary Ass Contractor/Agent is Personally Known to Me or Produced ID Type of ID WASTE WATER: :BUILDING: Rev 11.08 Seminole County Property Appraiser Get Information by Parcel Number Page 1 of 1 PARCEL. DETAIL DAVID JOHNSON. CTA, ASA r' PROPERTY A PPRAi5ER SEMINOLE COUN", Fl. x ", w _ 1101 E. FIRST ST SANFORD.FL3277t-1468 407-665-7506 VALUE SUMMARY VALUES 2010 2009 Working Certified GENERAL Value Method Cost/Market Cost/Market Parcel Id: 10-20-30-501-0000-0930 Number of Buildings 1 1 Owner: BENGE JEAN LIFE EST (BENGE Depreciated Bldg Value $70,465 $77,040 Own/Addr: DARRELL D t£ HICKS BRENDA B) Depreciated EXFT Value $680 $680 Mailing Address: 210 SIR LAWRENCE DR Land Value (Market) $15,000 $26,000 City,State,ZipCode: SANFORD FL 32773 Land Value Ag $0 $0 Property Address: 210 SIR LAWRENCE DR SANFORD 32773 Just/Market Value $86,145 $103,720 Subdivision Name: GROVEVIEW VILLAGE Portablity Adj $0 $0 Tax District: S1-SANFORD Save Our Homes Adj $14,241 $33,706 Exemptions: 00-HOMESTEAD (1994) Assessed Value (SOH) $71,904 $70.014 Don 01-SINGLE FAMILY Tax Estimator Portability, Calculator 2010 TAXABLE VALUE WORKING ESTIMATE Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund $71,904 $47,404 $24,500 Schools $71,904 $25,500 $46,404 City Sanford $71,904 $47,404 $24,500 SJWM(Saint Johns Water Management) $71,904 $47,404 $24,500 County Bonds 1 $71,9041 $47,4041 $24,500 Potential Portability Amount is $14 241 The taxable values and taxes are calculated using the current years working values and the prior years approved millage rates. 2009 VALUE SUMMARY SALES Tax Amount (without SOH): $2,023 Deed Date Book Page Amount Vacllmp Qualified 2009 Tax Biil Amount: $63 QUITCLAIM DEED 07/1984 01616 0051 $100 Improved No 390 Save Our Homes (SOH) Savings: $1390 , WARRANTY DEED 02/1980 91264 0630 $38,000 Improved Yes 2009 Certified Taxable Value and Taxes Find Comparable Sales within this Subdivision DOES NOT INCLUDE NON -AD VALOREM ASSESSMENTS LAND LEGAL DESCRIPTION Land Assess Method Frontage Depth Land Units Unit Price Land Value PLATS: Pick... f. LOT 0 0 1.000 15,000.00 $15,000 LEG LOT 93 GROVEVIEW VILLAGE PB 19 PGS 4 TO 6 BUILDING INFORMATION Bid Num Bid Type Year Bit Fixtures Base SF Gross SF Living SF Ext Wail Bid Value Est. Cost New 1 SINGLE FAMILY 1974 6 1,222 1,718 1,222 CONC BLOCK $70,465 $84,898 Appendage / Sgft GARAGE FINISHED / 460 Appendage I Sqft OPEN PORCH FINISHED / 36 NOTE: Appendage Codes included in Living Area: Base, Upper Story Base, Upper Story Finished, Apartment, Enclosed Porch Finished,Base Semi Finshed EXTRA FEATURE Description Year Bit Units EXFT Value Est. Cost New ALUM SCREEN PORCH W/CONC FL 1990 200 $680 $1,700 NOTE: Assessed values shown are NOT certified values and therefore are subject to change before being finalized for ad valorem tax purposes. '** If you recently purchased a homesteaded property your next ear's property tax will be based on Just/Market value. http://www.scpafl.org/web/re-web.seminole-county_title?parcel=l 0203050100000930&c... 4/20/2010 "SENEZ �0 FING, LLC�' TRUST • . LU . • INTEGRITY Toll Fre' 1-8 6-350-4050 Office: (386) 774- `� 6 Fax: (386) 775-3338 1060 E. INDUSTRIAL DR. • SUITE K ORANGE CITY, FLORIDA 32763 FULLY LICENSED & INSURED STATE CERTIFIED #CCC1327898 www.senezroofing.com PROPOSAL / INVOICE SUB NAME: ,! P14 STREET: A /0 l TO: DATE: CITY:"/�✓i�% PHONE: X M S-,OLORS: Shingles ` v Drip Edge _ Vents a WE HEREBY SUBMIT SPECIFIdATIONS AND. ESTIMATES FOR: 1. Tear off existing shingles. Haul debris off site. Clean job site thoroughly, and Magnet ground for nails. 2. Repla9� aII fully rotted wood decking. Major fascia wood work may be extra. luminum Work not included. 3. x' !!..•� Install new felt paper dry -in. x Install secondary water barrier. x Re -fasten decking. 4. Replace drip edge with all new painted drip edge. Cement in all eaves and rakes with quality roof cement. 5. Install valley lining in all valleys - Cement in shingles over metal/lining. - California Closed Cut Valley. 6. Replace lead boots and goose necks on all existing vents and pipes. Paint to match venting or drip edge. 7. Replace ("..-,,) existing skylight(s) with new skylights(s).-(�Flash Chimney. (_).Cricket Chimney. 8. Install new asphalt Architect shingles - AR (algae/fungi resistant) - 30 year manufactures warranty. 9. Nail all shingles with 1 t/4" roofing nails. 10. Replace (-­� lengths of -ridge vent. Replace-(---T-),off-ridge vents. Install (3 ) new off -ridge vents. Install (--4-new solar powered attic fan vents. 11. All materials used and work installed is properly applied in accordance with current Manufactures, State, and County Codes and Specifications. Senez gets the roofing permit and schedules appropriate roof inspections. All specified work completed is fully guaranteed for five (5) years. Roof material carries standard manufacturer's warranty. ALL MONEY IS DUE UPON COMPLETION OF WORK: Please make check payable to: SENEZ ROOFING Total Cost of all Work: $ , � (� (all taxes and fees are included) WE HEREBY PROPOSE TO FURNISH LABOR AND MATERIALS -COMPLETE IN ACCORDANCE WITH THE ABOVE SPECIFICATIONS, FOR THE SUM OF $ ANY EXTRA WORK, MATERIALS, OR SPECIFICATIONS THAT ARE HAND WRITTEN ON THIS CONTRACT ARE INVALID UNLESS INITIALED BY CUSTOMER AND BY THE OWNER/PRESIDENT OF SENEZ ROOFING, LLC. 1) Pleaseremove vehicles from driveway and garage/carport by 12 noon the day before the job. Remove any items on walls and furniture and check that all fixtures in house or porches are secure that may fall or bounce off due to banging vibration while roofing, we are hot responsible. Please have yard mowed prior to job start to help with magnet pickup odnails. 2) Custorber is responsible for. removal of anything around the house that is breakable (.e.: ornaments, bird baths, hanging plants, etc.), removal of anything attached to the roof/decking inside the attic and outside prior to job start and rein tallation r adjustments after job completion (.e.: solar, satellites, air conditioning components, alarms, pipes, etc.), covering furniture or flooring below skylight s an re-i a tion of anytj i that must be removed to properly repair any rotted wood areas (;e.: fascia, soffit, siding, gutters, etc.) AUTHORIZED AGENT (PRINT & SIGN):opening DATE: i'' NOTE: THIS PROPOSAL MAY BE WITHDRAWN BY US IN THIRTY (30) DAYS. t, ACCEPTANCE OF PROPOSAL: THE ABOVE PRICES, SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED. I HAVE READ, UNDERSTAND, AND AGREE TO THE TERMS AND CONDITIONS SECTION ON THE REVERSE SIDE OF THIS FORM. COMPLETION OF FINAL INSPECTION BYTHE MUNICIPALITY FROM WHERE THE PERMIT IS ISSUED IS NOT CAUSETO DELAY PAYMENTTO SENEZ ROOFING. PAYMENT IN FULL IS DUE IMMEDIATELY UPON COMPLETION OF SPECIFIED WORK. ACCEPTED: PRINT & SIGNATURE PRINT & SIGNATURE MAIN Rev. 12/09 N. ---- I I I I 52032A IJ .. .. ...... .... ...... } _ ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDOIWYY) 05/08/2007 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER Affiliated Agency Ops ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 16 South River Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTERE COVERAGE AFFORDED B HE LIC ES BE O INSURERS AFFORDING COVERAGE NAIC # Wilkes-Barre, PA 18702 Tel: (800) 673-2465 Fax: (570) 820-7968 INSURED Employee Leasing Solutions, Inc. INS[ IRFR A, EnsIQUARD Insurance Company 14702 INSURER : Phone: (941) 746-6567 INSURER C: � INSURER D: 1401 Manatee Ave W. Suite 600 - INSURER E: Bradento , FL 34205 COVERAGES BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING THE POLICIES OF INSURANCE LISTED BELOW HAVE OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY REQUIREMENT, TERM OR CONDITION POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY POLICYRATIMXPIRATI) LIMITS INSR ADD'L (MMfECTNE LTR INSR TYPE OF INSURANCE POLICY UMBER DATE MMIDD DATE MMIDD , EACH OCCURRENCE S GENERAL LIABILITY DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY - PREMISES MFD EXP (Any one e CLAIMS MADE OCCUR PERSONAL B ADV INJURY r GENERAL AGGREGATE S GENt AGGREGATE LIMIT APPLIES PER: PRO - POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ _ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per Person) $ • SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per ecc1denl) $ NON -OWNED AUTOS - - - -- —- PROPERTY DAMAGE S (Per accident) ' AUTO ONLY -EA ACCIDENT $ GARAGELIABILITY ' _ ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG S ' EACH OCCURRENCE $ EXCESSIUMBRELLA LIABILITY F_jCLAIMS AGGREGATE $ OCCUR MADE S E DEDUCTIBLE S RETENTION $ WORKERS COMPENSATION AND , y WC STATU- OTH- X LIMITS ER - TORY EMPLOYERS' LIABILITY E L. EACH ACCIDENT $1 000,000 E.L. DISEASE -EA EMPLOYEE $1.000.000 A �XRTNEWE ECUTIVE EMWC109947 01/01/2010 01/01/2011 OFFICEOPRIET E.L. DISEASE -POLICY LIMIT 51,000m It es, des crib, under SP CIA P VIS SIGbelow OTHER * Valid in the State of Florida Client ID: #5902007 ADDED SPECIAL PROVISIONS EastGUARD'Ins urance Company LOCATIONS OT ONTRACTORSOFNTI TED EXCLUSIONS DESCRIPTION IEMPLOYEES VEHICLES RAGEAPPLIES ONLY OTHOSE carries an A.M. Best Senez Roofing LLC Rating of A- (Excellent) Qualifiers Name: Isaac Senez , Finotholi i stM"Oih and a financial sip �,,a� Aprox active employee count: 23 Category of Vill A axe laht ! i CERTIFICATE HOLDER' ! City of Sanford ! Building Department —! I ! P. O. Box 1785 I• Sanford, FL 32771 ACORD 25 (2001/08) I� II IJ F- II IJ CANCELLATION i I_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3_, DAYS WRITTEN , NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL s IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTA © ACORD CORPORATION 1988 f 4 .-----._...------....___ -------_--- .•., - r -JUI. IU. LVV7 Yy a it i it a u I a u c I J U L V J J ' `� -ATE (MM/DDM YY) . _. , . _ .���.ITY INSURANCE OP 1 07 16 09 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Ryan Insurance 6r Financial Svc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 302 W New York Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Deland FL 32720 Phone:386-738-2000 Fax:386-738-2053 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Western Heritage Ins- Co. 37150 INSURERB: LVm Mbtual 174xo Zn•vranc Co. 23779 Senez Roofing LLC INSURER C: 1060 E. Industrial Drive Ste K INsuRERo; Orange City FL 32763 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN 18SUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS. EXCLUSIONS ANC POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSIRE TYPE OF INSURANCE POLICY NUMBER DATE MM/DDIYYYY DATE MM/DD✓YYYY GENERAL LIABILITY A !17CLAIMS MERCIALGENERALLIABILITY SCP06860BS 05/03/09 05/03/10 MADE FXI OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: 711 POLICY n PRO- JECTF7 LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS X SCHEDULED AUTOS $ X HIREDAUTOS NON -OWNED AUTOS GARAGE LIABILITY 7 ANY AUTO EXCESS I UMBRELLA LIABILITY OCCUR a CLAIMS MADE DEDUCTIBLE RETENTION 8 RK WOERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOPIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandylory In NH) If yes, descriDe under SPECIAL PROVISIONS below OF CERTIFICATE HOLDER I City of Sanford PO Box 1785 ACORD 25 (2009/01) 77BA8312783001 I EXCLUSIONS ADDED BY CYSANF'0 04/19/091 04/19/10 CANCELLATION SHOULD ANY OF THe ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, >/ (Sean D Ryan 01988-2009 ACORD The ACORD name and logo are registered marks of ACORD rED. NOTWITHSTANDING NAY BE ISSUED OR CONDITIONS OF SUCH LIMITS EACH OCCURRENCE $ 1000000 PREMISES (Ea occurcrice)$ 50000 MEO EXP (Any one parson) S 1000 PERSONALS ADV INJURY $ 1000000 GENERAL AGGREGATE $1000000 PRODUCTS, COMP/OPAGG $ 1000000 COMBINED SINGLE LIMIT $ 300000 (Ea accldenl) BODILY INJURY 8 (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) AUTO ONLY -EA ACCIDENT 8 OTHER THAN EA ACC $ AUTO ONLY. AGO 8 EACH OCCURRENCE 9 AGGREGATE S $ S $ TORY LIMITS 1 ER E.L. EACH ACCIDENT $ E.L DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ TION. All rights reserved. lu1l111►1101111111111111111111111111111it1110"1ifIII 11111 THIS INSTRUMENT PREPARED BY: Name:`,E_r'• C-qIN Address 1 r� 1 uS �t�r' rG\(�C L` +1= L �lv� S of VAAOivEuCOUN TY State ' f orida MANYtiNNt_ lv9jNW:y 1101K ill- i lNiMIT t OAMT StAINi)LE Wt)NTY BK VIAB pg 1882, tlpg) CLERK'S # 2010045702 REQN111L-•I) 04/L1P_/i?010 01:08:18 PN Rl LWIUIN13 FEi_`; 10.0 REI`11101) HY J 1:c,kenra•th(all) NOTICE OF COMMENCEMENT Permit Number Parcel ID Number (PID) 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. D SCRIPTION OF PROPERTY (Legal description the property and street address if available)CV GENERAL DESCRIPTION OF IMPROVEMENT R� OWNER INFORMA: Name and address V_ L-• �- CONTRACTOR Name and address' C— Q ��"Z 00" 1MI U Persons within the StbateFifo ida Statutes . by Section 713.13(1)( ), Name and address: In addition to himself, Owner Designates, Section 713.13(1)(b), Florida Statutes. by Owner upon whom notice or other To receive a copy of the may be served as provided of �r's Notice as Provided in Expiration Date Of Notice of Commencement: EXPIRATION OF THE NOTICE OF The ex iration date Is 1 ear from date of rep di . unless a different date is s ec 3.13 OVMENTS TO YOUR PROPERTY• A PER PAYMENTS UNDER CHARTER 713, PART 1, SECTION 7FIR A WARNIN G TO OWNER: ANY PAYMENTS_ NI pE BY THE OWNER AFTER P E COMMENCEMENT ARE CONSIDERED IMPROPER H YOUR LENDER OR AN ATTORNEY STATUTES,' CAN RE�SUL1'• IN YOUR PAYING TWICE FOR A BE RECORDED AND POSTED ON THE JOB SITE BEFORE T FLORID CONSULT NOTICE OF COMMENCEMENT MU' OBTAIN FINANCING, INSPECTION. IF YOU INTEND TOOUNTY OF SEMINOLE BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COCOMMENCEMEN . STATE OF FLORIDA C= OWNERS PRINTED NAME e ermitted to sign in his or.her stead." JE R SIGNATUR�,,�3� owner must sign...... and no one else may p , l 2010 ,,(NOTE: Per Floridat�m day Of Y1 instrument was acknowledged before me this {mown to me _ --- Who is personally The foregoing produced r _type of identification p by ur. u IJame, p erson making statement 1 OR who iias produced identifica o -- URSUANT TO SECTION 92.525, FLORIDA STATUTES P D THE FOREGOING AND:THAT THE FACTS STATED IN IT VERIFICATION LARE THAT I HAVE READ THE BEST OF MY'KNOW}-EDGE AND 6ELIEF' UNDER UE TO.A�TIES OF PERJURY, I DES ARE TR • ERSnN SIGNING ABOV 'SIG TURE OF NATURAL P �a�Y et • ERICKA SENEZ � = MY COMMISSION # DD 92014 S: February 28, EXPI�h u Notary Public Undenvdleta .....a, Bonded „ CUPI Notary SignS WIARY AANNE CLERK OF CIRCUI T CSIONOLE COUNTY, FLORIDA a 0 /6 0 S) n� 8 U Y CLERK APR 2 2 2010 t'ri - , City of Sanford BUILDING DIVISION RE: Permit # /0 -I g9� Inspection Affidavit ,licensed as a(n) Contractor* /Engineer/Architect, (please print name and ddyycircle Lic. Type) �7 g FS 468 Building Inspector* License #; On or about 7` �U f v I did personally inspect the roo (D to &time) deck nailing and/or secondary water barrier work af-2����reYz� (circle one) (Job Site Address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) <�:i� Signature STATE OF FLO A . COUNTY OF V o LLcSAZ&-, �,�, Sworn to and subscribed before me this &9day of . 201& By U—C- -C- Sk'n 6L--- E- NEIDY S. ESPINOSA Notary Public - State of Floridasty Commission Expires Jun 2, 2012Commission # DD 794084 BondedTtmo National Notary Assn. Personally known ? or Produced Identification Type of identification produced. Nota Public, State of Florida n e o st am Commission No.: * General, Building, Residential, or Roofing Contractor or any individual certified under 468 F.S. to make such an inspection. Include photographs of each plane of the roof with the permit # or address # clearly shown marked on the deck for each inspection.