102 Hazel Blvd 17-1450; ROOFMAY 17 2017
CITY OF SANFORD
BUILDING & FIRE PREVENTION
Application No:
PERMIT APPLICATION
Documented Construction Value: $ 7
Job Address: )Oa XlZe-) G)tk'), Historic District: Yes No Er
Parcel ID: JO->AO -34- 5709- 0®QC — 00AC9 Residential Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: ge_-(bo-F W 14A .3Z 59, K0 G—_P, DC'%U_.)4yC S
pp i 4 c.1, ) 5+0 y
Plan Review Contact Person: QOberi' 9vem"Y. f Title: -c + Cq:,*,do r
Phone: 07 330 S>Ss y Fax: ya7 682- 875-" Email: froa f s (S Go s, cayn
Property Owner Information
Name in c r }5 G'"' a r, .s )Cy Phone:
Street: )0 ; Resident of property?
City, State Zip: 3 z 77 3
Contractor Information
Name 17W j-io r; t Phone: 9 o7 '9 30 $ SS y
Street: R O , &Y, Fax: !Va7 G 52- 95_Sc/
City, State Zip: L0!25CaaJ, FL 3Z75Z_ State License No.: CCCC US 7 g S(4
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
M
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: 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 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 information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning.
igynatureofOwner/Ageht Date_ A
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Print Owner/ nt's Name
IVavsailSignature
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Agent is Personally Known to Me or Produced
ID _ Type of ID BELOW
IS FOR OFFICE USE ONLY g
IAS WONDER NOTARY
PUBLIC STATE
OF FLORIDA Comm#
FF104514 Expires
3/2012018 Contractor/
Agent is Personally Known to Me or NOTARY
PUBLIC Sig
r of Notary -State of Florida Date JOEL
HANGOCK IY
nSTATE
OF FLORIDA r =
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Expires 4/27/2019 li
Produced
ID Type of ID Permits
Required: Building Electrical Mechanical Plumbing[]GasGas[-]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:
FIRE:
WASTE
WATER: BUILDING:
Revised:
June 30, 2015 Permit Application
SCPA Parcel View: 10-20-30-509-0000-0020 Page 1 of 2
Property Record Card
CrA Parcel: 10-20-30-509-0000-0020
Owner: ROMANSKY MARTA
e+o4coouNry noaon
Property Address: 102 HAZEL BLVD SANFORD, FL 32773-7407
Value Summary
2017 Working2016 Certified I
Values Values
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 116,496 $121,939 [
Depreciated EXFT Value 9 600 $9 600
Land Value (Market) 25,000 $20,000
Land Value Ag
Just?Market Value *' 151,096 $151,539
Portability Adj
Save Our Homes Adj
f
48,356 $50,912 E
Amendment 1 Adj
P&G Adj
t
0 $0
Assessed Value 102,740 $100,627
Tax Amount without SOH: $2,224.00
2016 Tax Bill Amount $1,204.00
Tax Estimator
Save Our Homes Savings: $1,020.00
Does NOT INCLUDE Non Ad Valorem Assessments
Legal Description
LOT 2
HAZEL GLEN
PB 33 PG 63
Taxes
Taxing Authority I Assessment Value Exempt Values Taxable Value
County General Fund 102,740 50,000 52,70
Schools 102,740 ! 25,000 , 77,740
City Sanford 102,740 50,000 . 52,740 [
SJWM(Saint Johns Water Management) 102,740 50,000 52,740 €
County Bonds 50,000 52,740 E102,740 ^
Sales
Description Date I Book
mm^
Page Amount Qualified Vac/Imp
QUIT CLAIM DEED 9/1/2004 05473 0826 100 No Improved
WARRANTY DEED 12/111987 G1916 0144 83,700 = Yes Improved E Find Comparable 5m1e ;
t
Land Method iFrontage
Depth
Unds
Ur its Price and Value LOT 0.00 0.
00 1 25,000 0? i 25 000 € Building Information Year Built# :
Description Actual/
Effective Fixtures
Bed Bath Base Area I Total SF [Living SF Ext Wall Adj Value Repl Value ;Appendages 1 s SINGLE 1987
6 3 2 0 1,840 1,882 1,840 CB/STUCCO $116,496 E-$133,138) Description Area i FAMILY
FINISH 42.001
http://parceldetail.
scpafl.org/
ParcelDetailInfo.aspx?PID=10203050900000020 3/24/2017
r
MHD FLORHDA fROOFXNG ESTHMATE/SALES ORDER
768 Ferne Drive STATE LICENSE: CCCO57834
Longwood, FL 32779
Tel: (407) 830-8554
Fax: (407) 682-8554
Date of Estimate: — ` Sales Rep Name:
Customer Name: 0 Ili eh s- Sales Rep Phone #:-0—Z-S6-_ o o s,
Job Address 1 o V Cust. Day Phone #: 361 SI a -.1.2
City, State, Zip: Sm JJ r- av3 ci-1 3 Cust. Eve. Phone #: By
signing below, Customer and Mid Florida Roofing, Inc. hereby agre o the terms a d conditions described in thls contract: emove
existing roof from above address. Total number of squares: Roof Pitch:_ Two
or more layers on roof to be removed at $45 per square. $45/sq. X squares = $ (included in total price below) Remove
and replace the following items with like or equivalent materials: A.
Valley Metal o total linear feet B.
Plumbing vent pipe boots: 1 '/: inch: 2 inch: 3 inch:1- 4 inch: 5 inch: C.
Kitchen & Bathroom vents: 4" goose: 6" goose: 10" goose: Color: D.
Off -set ridge vents (4ft): —L
Color:
E.
Ridge Vents (10ft): Color: ? F.
Replace eave-drip (except behind gutters) with: l pieces. Color: u Replace
all rotten sheeti (if any) t an additional charge of $60 per sheet including installation. Charge is not included in total contract price below. All
replaced wood (including ng, fascia, siding, trusses, tails, etc.) will be documented and billed separately. Replace
underlayment with the following: 151b Felt 301b Felt Titanium PolyGlass TU Plus Install
new roof using: V,ArchitecturalShingles 3 Tab Shingles IConcrete Tile Clay Tile 5V Crimp Standi Seam DECRA Manufacturer/
Style: ! '` /J 'i e Color: (J Je- Install
new 4ft off -set ridge vents ($80 each) Total $ Install new 1Oft ridge vents ($50 each) Total $ Replace
2' x 2' skylight: Qty: Replace 2' x 4' skylight: Qty: Total $ (included in price below) I
Upon completion, Mid Florida Roofing will remove all job -related debris, garbage and excess materials from job site and will use magnet for nails, staples,
simplex, etc. Customer
requests that Mid Florida Roofing remove and discard existing solar heating panels prior to commencement of installation. If this option is not
checked, customer is responsible for removal of solar heating panels prior to commencement of installation. Customer is also responsible for re -
installation of solar heating panels when roof work has been completed, if this option is not checked. SPECIA
j INSTRUCTIONS: L
C d G o I/ c 1(-4JeId L J U, S r c rA
0-i L 6U_ -0 )v 1y If
payment is not made under the terms of this contract, Mid Florida Roofing, Inc. reserves the right to place a lien on the above mentioned property and a
finance charge of 5% per month will be added to the unpaid accounts 30 days from date of agreed payment of this contract. Should collection action be
necessary, the person on this contract shall pay all court costs, attorney fees and appeal costs (if any). This contract is valid for one month from the date
of acceptance and approval by Mid Florida Roofing, Inc. Mid Florida Roofing, Inc. reserves the right to cancel all or part of this contract at any time. The
State of Florida has a construction recovery fund. WARRANTY:
Includes manufacturer's material; warranties and five year workmanship warranty unless otherwise specified in special instructions above. PAYMENT
TERMS: Full payment is due upon completion of the work described on this contract, unless otherwise agreed upon in writing between custom
nd Mid Florida Roofing, Inc. W
Accepted:
Date: 25 --"l Customer
Signature Approval:
Date: TOTAL PRICE _ $ 7 a C0 0Q) V
4-*
Mid Florida Roofing Authorized Signature (Due upon completion)
TERMS AND CONDITIONS
Mid Florida Roofing, Inc. guarantees the labor for the roof work described on the reverse side of this contract for a period
of 5 (five) years from the date of final invoice to customer. Mid Florida Roofing, Inc. will make any repairs necessary to
correct roof leaks resulting from (but not limited to) the following causes, at no additional charge to the customer:
1. Deterioration of roofing felt or base flashing resulting from usual and ordinary effects of wear and weather.
2. Workmanship of Mid Florida Roofing, Inc. in applying roofing and flashing materials.
3. Splits in roofing or flashing felt, except those caused by structural failure.
EXCLUSIONS (This guarantee does not cover):
1. Leaks or other damage caused by natural disasters including (but not limited to) floods, fire, lightning, hurricanes,
tornadoes, hail, windstorms, earthquakes, dry -rot, etc. including such occurrences which take place during a job
or prior to the completion of a job.
2. Structural failures such as cracks in decks, walls, partitions, foundations, windows, blockage of roof drains or
gutters, changes in the original principal usage of the roof (ie. using as a deck), erection or construction of any
additional installation on or through the roofing surface after the date of completion, roof or flashing repairs by
personnel other than Mid Florida Roofing, Inc. personnel, painting or coating without prior written approval from
Mid Florida Roofing, Inc., riots or vandalism, termites or other insects, squirrels, rats or other rodents, penetration
of the roof from beneath by rising nails.
3. Damage to the building or its contents, roof insulation, roof deck or other base over which roofing underlayment is
applied.
4. If at any time during the term of this guarantee the subject property shall be exposed to windstorms or hurricane -
force winds greater than the manufacturer's warranty specifications.
5. Any solar heating panels or plumbing in attic which leaks after roof installation.
6. Any mold or airborne organisms existing, occurring or reoccurring during or after warranty.
ACTION: In the event that leaks in roof occur, customer shall notify Mid Florida Roofing, Inc. promptly in writing. Mid
Florida Roofing, Inc. will inspect the roof, and if cause of leak is within coverage as stated above, Mid Florida Roofing, Inc.
will arrange for repair at no cost to customer. If cause of leak is not covered under the terms of this guarantee, Mid
Florida Roofing, Inc. will not be responsible for cost of any necessary repairs. If Mid Florida Roofing, Inc. determines that
leaks are not covered under the terms of this guarantee, a service charge at Mid Florida Roofing, Inc's then current
billable rate shall be invoiced to customer. This guarantee shall become null and void if payment of said service charge is
not paid within 30 days of billing date.
In the event that damage occurs to customer's property including (but not limited to) gutters, downspouts, sprinklers,
satellite dishes, drywall, etc. it is the customer's responsibility to notify Mid Florida Roofing, Inc. promptly in writing. Mid
Florida Roofing, Inc. will inspect the damage and if cause is determined to be the fault of Mid Florida Roofing, Inc.
personnel, Mid Florida Roofing, Inc. will arrange for repair at no cost to customer. In the event that damage occurs to
customer's property and is the fault of Mid Florida Roofing, Inc. personnel, customer may hold 5% of total contract price
until Mid Florida Roofing, Inc. has completed all repairs and/or corrections to damages or problems caused by Mid Florida
Roofing, Inc. personnel, at which time customer will remit payment of the remaining 5% owed on original contract.
Mid Florida Roofing, Inc. and customer agree to a limited liability in that Mid Florida Roofing, Inc. shall not be liable for
damages to customer's property caused by Mid Florida Roofing, Inc. personnel in excess of the total contract price shown
on the reverse side of this contract.
The State of Florida has a contractor/construction recovery fund. Customer is responsible for exercising manufacturer
warranties directly with manufacturers in the event of a manufacturer defect.
ENTIRE AGREEMENT: By signing and dating the front side of this document, the customer named therein and Mid
Florida Roofing, Inc. agree to be bound by the terms and conditions described in this contract. This document represents
the entire agreement,between the Customer and Mid Florida Roofing, Inc. There have been no verbal changes or
otherwise implied agreements between the Customer and Mid Florida Roofing, Inc.
116111111111lIIIIIIIII IIIIIIIIIBIIIIIII
THIS INSTRUMENT PREPARED BY:
Name: Robert H. Shoemaker
Address: PO Box 522610
Longwood El 37752
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number:
GF;ANT NALOY= SENINOLE COUNTY
C:1...I-' OF CIRCUIT COURT & COrIPTROLLER
BK. ''916 Ps 1431
CLERK'S 4 201704.9672
RECORDED 1"15/17/2017 Q.,,y.'_ ,`err P11
RECORD] VIG FEES b$40.00
RECORDED BY rdi.;otlP.
Parcel ID Number: 10-20-30-509-0000-0020
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 if available)
102 Hazel Blvd. Sanford FL 32773
N7 tv1AL0Y
rztERK PAP T14c asr_LItT COURT
GENERAL DESCRIPTION OF IMPROVEMENT: AND COMPTROLLERen,tn,Tv riADA '°.. --
RPmof
OWNER INFORMATION:
Name: Marta Romansky
Address: 102 Hazel Blvd. Sanford, FL 32773
Fee Simple Title Holder (if other than owner)
CONTRACTOR:
ma, Mid Florida Roofin
Address: PO Box 522610 Longwood, FL 32752
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served
as provided by Section 713.13(1)(b), Florida Statutes.
Name:
Address:
In addition to himself, Owner Designates
Section 713.13(1)(b), Florida Statutes.
of
To receive a copy of the Lienor's Notice as Provided in
Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a
different date is specified) 7/10/2017
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.
State of MI6 - County of
The foregoing instrument was acknowledged before me this / day of , 20 ! 7
by M c +-\ i oy c n S )<,y Who is personally known to me
Name of person making stfqerDent /
OR who has produced identification p( type of identification produced: [
tf—
JONAS WONDER
NOTARY PUBLIC.".
STATE OF FLORIDA
Comm#FF104514
1\cli 11% Expires 3/20/2018
NotaISignature
PL)V CLERK
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: '3- Z5-/ -7
I hereby name and appoint:
an agent of: > j Io/";dC 9 oc-- ;,l
Name of G
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):
2` The specific permit and application for work located at:
16a h zze.l 6W . t FL 3Z'77 3
Street Ad ess)
Expiration Date for This Limited Power of Attorney:
License Holder Name: k erf / • .54oen,— I e r
State License Number: C:C. C: 05 7 8 -3 9
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before me this Aekday of ^VICA ,
2047 , by Q06er+W 51 o,%i e-r who is utersonally known
too me or who has produced as
identification and who did (did not) e an t .
i ,.
Sign re
N*rS OEL HANCOCK
NOTARY PUBLIC
STATE OF FLORIDA
Crxnm# FF224497
isExpires 4/27/2019
Print or type name
Notary Public - State of
Commission No.
My Commission Expires:
Rev. 08.12)
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 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.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE: ZS
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: fV' %S)Ud l
STRUCTURE TYPE: aIINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: 816LACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY): yx,?
i /- /
y waoci
PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED **
ROOF VENTILATION: OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: OYES 491G0 IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
26HINGLE r'ld C,-vnbr', J e 14K FL# 7W6 ` 9 c1
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
O INSULATED 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 0 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O SHINGLE FL#
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
O INSULATED FL#
O TILE FL#
O OTHER: FL#
PERM
City of Sanford
Building and Fire Prevention
ROOF INSPECTION AFFIDAVIT
FLASHING, AND ALL FINAL ROOF COVERINGS
ADDRESS: )OLZ 4czed 15W,
sc"-iCd FL, 32773
I 906, e(4) , S1,otY)r-ge r , 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 #: c cc US 7 [} Jt(
COMPANY / CONTRACTOR: / / / i o-(, U
CONTRACTOR SIGNATURE: _
MUST BE SIGNED BY LICENSE OWNER/BU ILDER) .
A FINAL ROOF INSPECTION IS REQUIRED:
Q DATE:
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 Sew 3p7c),
Sworn to and Subscribed before me this d day of P i 20 )'7 by:
Who is A' rsonally Known to me or has Produced (type of
ide tiff 4tion)
as identification.
V4t,ESW74
JOEL HANCOCK
NOTARY PUBLIC
SI ure of NotaryFublic STATE OF FLORIDA
Sty aof Florida'Ccxnm# FF22 §7
Expires 4/27/2019
Print/Type/Stamp Name
of Notary Public
I