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906 Holly Ave 17-1046; roofApr.17. 2017 1:04PM SENEZ ROOFING No,8921 P. 2 13010.1 CITY OF SANFORD NQ &'PKE MtV8- NTlON PERMIT APPQ CATION Pplkoflm No: 7 700 Job Address,.,, K10940 District; Ys ParcelID;:— /f) 0mo []'No Commercial TYPOQfWork; New[TAd14j(ioq" -AlOrA00tZ Repoirl] Demo: n 'Change of V.4U veE1 DieseriPt"Ohd Work,. -or r)49? PIaP' ReV.WW Title! Phone:,. FRx., Name City; state. . Z'jg; x2me t r e e t, cifn StAte. zip: Name - City; . 84 Zip, zip. Bonding Company: Adldretsi- rtO. PlDrty' QWnqr InfqrMotiop Ikesident- otpropertyl.: r'S,(3 P^;) 6 0Lj% dior- Wotmatflon 17 Wn, 7- 40State License No.; a- W9 il info - M r . q(Ion, 1V% ortgage'Lender: Address: WARNING ToOVYNER'Y.OTJR'FA TLOkF,:TO PAYIN. 9 TWTi 11ECOX0 A-.'NOT,1Ct (WCOMMENCEMENT NAY, yQ RESULTINFOURA$OTICEO-r!:CONlMtNCEMEr4l'MtjST-BE RECORDEDAND 'POSTED . 0N.THXjoB,'SITlZ BEFORE: THZjFIRST INSPECTION.. IF YOU INTEND TO OBTAIN MNANCINC,j, CONSUL-` WITH, YOM LENDER. OR' AN ATTORNEY BEFORE: RECO" ING YOUR. NOTICE Or. Applicatloriu htTeby:rnade, to obt4w4peritlit to :do the work slid 'In, tkllal"tg':es, iti4ic9ted' I c0rtifYihztno- work. or installation 1129 rld': that, alt work. Will .h. pafbrmed tamvel, standards of.4-jaws,rqgulating r in thisjiurlsdiction.. I und,orstsix;d pgporqtp M .. 'Ons trntioyj permit mk1st:, hP 5;;"r0,fqr efeo- licawp funinces, boilersi.b caters, tar14'. Arid a, coliditiftet§,ze. f PPb1SFj;C 10i..3 Shall be inscrioed yvifh.the,0Q!P of application .2!14 the ppoq jr Qf4ct as. ofchat date: S!" Edi(ion (2014) Florida .Building, Code RJvisP0: June 30. 2015 Mmit Appkalioh Apr,17. 2017 1:05pm SENEZ ROOFING, No-8921 P. 3 NOTICE', -In addition to the reqdifernontp.of thi§ pqrnit) t*6 MAY .e: 64014164tii PT P I atfbund'in the public records oftfthis cou' ty, bp , and, them may be 2dd tj 6rL MAna tional.p, "* ' .Y 11 0Wrftenlditricts,. statt.:8gencil.as 6rinift req9i red from otheroffeder0agallojer9overrimeotalentities' 91jahaswatv Acceptance.pfiiefmitisVeeitre at.41h4r1w'11116 fYthemproftheprp requirernqlas of Florida. LienPPrty.ofthe The City of SAnf6rd requires payment of kplan,reviow_ fee at, Lw, F$ 733. in. or . the.q*rft(1 6r.Per0f Nubrblittal. A copy, 01haftietuted contract, i Oar to oa qojatQ a pla(i reviplv.charp and will'be..copsidpred; fit .. . cqu4edTheactualpogorqptiopvwill6estimatedzonsituolon. value, Off IjQjob at the: time ofsjbr jtfj. Aiuq W d based op: 4he curre jaqcctO0: Wlth.,Iopai ordiharic . ... 0 wa. bas I Vh1uptlon.Tablo.in gffeqt"atthe :timrjfip permit Is is;Sued, increditwill e apl)liedtl) Yftr perhij . t fee. Off ihq- Oxecu,ted Pontr4q, exci;ed the actual comtruption valueWhentheOF411.00 jl s46d, aj Y0 doli1rR'SArlI DA'VqT- D . , ' Ibet ' 111OffI16for.b.going int6rimation-As e1ACompliancelvith-911*4P. accurate.and,.that 211 work will' pjj'dbf '' a ing,, el.lftw jr0gal' 4 cOliStruction and zoning. Qr' v"er/4 , tent: Pript k)%VjjeT/A$Lnt's Name 'SoL e- Fein[ enl tb 1A87l's-%nfP L4 ti. IsnalKe qrJYQ10rY-ftt6 OfFloridt --Date 0 tarY4 MY COMMISSION 4 EXPIRES 000bef 22. 2019 P0a0' tl41IYKhd njom Produced ID: 0 n t M 0 0 r/A. ge 4t.- is TYpeofProducedIDPersonlally.KnQwn to Me:or T. Pe of 111) DELOA. N AIR-01Fffics ug.0NLY Permits Reuired: B14ildbn Perniq1gMechanical Go[] Rqqf Construction Type, 0OUp9nq Use;. VIOW Zone: Total Sq Ft.of Bjdgt milr. occupanq' o4d: 40fStories;- Now 'Construction,- - ] Cilectric #:,Df AMp s KuMbittg. rite Spr. in'41or Permit: y-es N'O",E] # of Heads 'Peemit; Y0 F NoO Fire AhtemAPPROVALS..,- ZONING. —', U . TILITIE8:: ENQiN8v_RrNGA CQMMJ+ NTS : Fin,'! WASTE: WATT- R: 13U1LDfN0:., Raviitd:, Juno 30,20:11 Permit Application Apr, 17. 2017 1:06PM SENEZ ROOFING No, 8921 P. 6 1ptWaj PcourW-Svso i QwA I Parcel: ZS-19-30-51a-1'111.00306: Owner: ORLAN00 43 MGMT LLC W & rwa vem j Property Address; 900 HOLLY AVM SANFORD, FL S2771 Percellnformation i Value Summary Parcel •25-19.30•S12-1111.0030 ` Owner! ORLANDO 43 MGMT LLC Val 7 working 2016 C.Wfi d 4es Values CosUMer e...,,........' valuation Memoq k t Coet/Marketp. Pro pery Address 906 H01 LY AVE SANFORD, FL, 32771L...,_.,...__...._,...._.,_.__.. Melling '1880 OFFICE CLUB PARK COLORADO SPRINGS CO 80920- Buil........._.._............1.... INumbero7Buildings1 1 3uotllVision Name I I 1i71NS,QAC Depreciated Bltlg Vstue 1 $95,698 1 $92.163 Tax Dletnct ;'S1-SANFORD Depreciated EXFT Value i7.743an....._ e ua ( market) ................................ Land Value Ag ) '............. 43 $7,>a3 i DOR Use Code 01-SwGLE FAMII1 Exemptions dll4J(Ma+..f.>a0!...V..dl.4.f,..`. 103,441:...............$99,906 Portaollily Adj I Save Our Homes Adj 1 $0 0 Amendment 1 Adj; 0 j......., ...,.,..,.,.. . 0 P&G AdJ 0..... ...... .... ........ .... 0 Assessed value 103,441 99,908 x.... t ...,...,. .... i ex Amount without SOH: $2,002.67 2,41fyX@x-R![1 m41I11! $2,002.67 r0.!(F.Slirnptor Save Our Homes Savings; $0.00 Does NOT INCLUDE Non Ad Valorem Assessments Book Page Amount Qualified Vacflmp 015 570,600, i No i Improved 011 Q7(01„ Q 16 j $315 000 1 No Improved zo10 07509 07 4 , $75,000 1„..,.,„...,„,.-------.,,. I No I Improved 998 Q3,,S7., 1.97& $t00 No. Improved ^ 978 10165h3L1I $25,100 Yes 'Improve d 977 ; 01149 I ...................._...... _.....- ...... ... .........:..... 1 00043j $ , No ' Vacant ! Apr, 17. 2017 1:06PM SENEZ ROOFING No. 8921 P. 7 Flsc!.n.Dzu,,rlm.snt.a(.I p1c r'"'' ith a n:nrll ;vt:}!• .( ?.,if!-r'h; y, !I ;r. 4?.S.R.LIIfS f,?19L.`,%lc1.1.9. ?IYI I4p.Qf.L..4.!G.4xflJi4A.. / e,irh..RecQr.Q.3 R.stalt,Y..4Q uui.pt.Nu nhsc I Detail by Entity Name Foreign Limited Liability Company ORLANDO43 MANAGEMENT, LLC. Filing Information Document Number M15000004681 FEI/E1N Number 47-3452423 Date Filed 06/16/2015 State CO Status ACTIVE Principal Address 1880 OFFICE CLUB POINTE COLORADO SPRINGS, CO 80920 MAiling Address 1880 OFFICE CLUB POINTE COLORADO SPRINGS, CO 80920 MCCRANIE, DAVID B 125 EAST INDIANA AVE SUITE C DELAND, FL 32724 Address Changed; 02/02/2017 Atatborized Parson(s) Detail Name & Address Title MGR SHERMAN, JAMES E 1880 OFFICE CLUB POINTE COLORADO SPRINGS, CO 80920 Title MGR CULLEN, TIMOTHY M 1880 OFFICE CLUB POINTE COLORADO SPRINGS, CO 80920 Title MGR Apr,17. 2017 1:06PM SENEZ ROOFING N o . 8 9 2 1 P. 9 M Est, 1973 SENEZ ROOFING, LLC Painting & Insulation TRUST • VALUE - INTEGRITY Toll Free: 1-866-350-4050 ' Office: (386) 774-4950 , Fax (386) 775-3338 1060 E. INDUSTRIAL DID. • Suite K ORANGE CITY, FLORIDA 32763 FULLY LICENSED & INSURED i STATE CERTIFIED #CCC7327898 PROPOSAL // INVOICE SUBMITTEDATE: 3 TO: Dza NAME e , f- IJ STREET t1ol, eCITY:oas PHONE: / EMAIL: r'/ 12 COLORS: Shingles ;El' Rubber www.senezroofing. com Cust. Int. Drip Edge_ Vents WE HEREBY SUBMIT SPECIFICATIONS AND ESTIMATES FOR- 1 . Tear off existing roof and haul all debris off bite. Clean job site thoroughly, and Magnet ground for nails. 2. Replace any rotted wood decking, Tr 'and fascia wood work may be extra. Aluminum work not included. 3. tx Install new felt paper dry -in, x Install peel and stick. cL 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 lining. — California Closed Cut Valley. 6. Replace lead boots and, goose necks on al0existing 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 AmWtect'shinaleess - AR (algae/fungi resistant) - lifetime manufacturer's warranty. 9. Each shingle is nailed with six 11/4" roofing nails. 10. Replace (. 1e) lengths of ridge vent, Replace ( y) off -ridge vents. 11. LOW [ etch Roof: Install Peel-n-Stick dry -in, and Single -Ply Modified -Roll -Rubber -Membrane —12 Year Manufacturer's warranty, Replace drip edge, with all new painted galvanized drip edge. 12. All materials used and work installed is properly applied In accordance with current Manufactures, State, and County Codes and Specifications. Senez gets the robfing permit and schedules appropriate roof inspections. All specified work completed is fully guaranteed for five ($) years. Roof material carries standard manufacturer's warranty. ALL MONEY IS DUE UPON COMPLETION OF WORK: Please make check payable to: SENEZ ROOFING A 60 Total Cost of all Work: $ 110r Deposit $ all taxes and fees are included) price reflects cash or check payment) A 4% convenience fee will apply to all Credit Card transactions. WE HEREBY PROPOSE TO FURNISH LABOR AND MATERIALS -COMPLETE IN ACCORDANCE WITH THE ABOVE SPECIFICATIONS, FOR THE SUM OF $ MANY EXTRA WORK, MATERIALS, OR SPECIFICATIONS THAT ARE HAND WRITTEN ON THIS CONTRACT ARE INVALID UNLESS INITIALED BY CUSTOMER AND BY THE OWNER/PFiESIDENT OF SENEZ ROOFING, LLC, 1) Please remove vehicles from driveway and garage/carport by 12 ri Tan 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 vlbra(ion while roofing, we are not responsible. Please have yard mowed prior to job start to help with magnet pickup ofnails, 2) Customer is responsible for: removal of anything around the house a s breakable (i.e.: ornaments, bird baths, hanging plants, etc.), removal of anything attached to the roof/deckinginsidetheatticandoutsidepriortojobstartandreinstal )i or adjustments after job completion (i.e.: solar; satellites, air conditioning components, alarms, pipes, etc.), coveringfurnitureorflooringbelowskylightopeningsandtallatlonofanythingthatmustberemovedtoproperlyrepairanyrottedwoodareas (i.e.: fascia, soffit, siding, gutters, etc,) AUTHORIZED AGENT ( PRINT & SIGN): NOTE: THIS PROPOSAL MAY BE WITF rffa•r, IN THIRTY ( 30) DAYS. DATE: Lv r1 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 VRMS AND CONDITIONS SECTION ON THE REVIsRSE SIDE OF THIS FORM, COMPLETION OF FINAL INSPECTION BY THE MUNICIPALITY FROM WHERE THE PERMIT IS'ISSUED IS NOT CAUSE TO DELAY PAYMENT TO SENEZ ROOFING. PAYMENT IN FULL IS DUE IMMEDIATELY UPON COMPLETION OF SPECIFIED WORK. rTHESE PRICES ARE SUBJECT TO CHANGE IN THE EVENT OF ADDITIONAL ROOFING IS FOUND BENEATH FIRST LAYER OR IF OTHER DAMAUE IS ENCOL14TERED THAT WAS NOT EVIDENT OR DISCLOSED BY HOMEOWNER AT THE TIME THIS ESTIMATE WASPRODUCED. _ ACCEPTED: PRINT & SIGNATURE - --- `3 -`'r OATS: PRINT & SIGNATURE DATE' DRIVERS LICENSE 9 - Apr. 17. 2017-N 1:06PMPREPaSENEZ ROOFING Name: i'1 L Y'CCt YI . Y .C Addr'esa• NOTICE OF MMENEMENT State of Florida County of Seminole Permit Number: A. N,°,. 8921 GFFlNT I1Al._oY, 5f_111NOLL COUNTY CLERK air c:]'ftI uy-f COUIi r & C017I1"Tr(Q1.1l L' K 9895 P. 617 (1Fss) CLERK' S t 201.7037383 RECORDED il4/17/,Wi,7 i.'2:27!'39 Pi`i RECORDING FEED SiU.iti1 RECORDNND NY F 5m i cll Parcel ID Number: 25-19-30-512-1111-0030 The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter713, Florida Statutes, the Following Infoimation Is provided in this Notice of Commencement. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available) eERAL K00TVl?h IPRON ingP@S IMPROVEMENT: OWNER INFORMATION: Name: r7 Address: ' l S nP-C I e Fee Simple Title Holder (if other then owner) Address: CONTRACTOR: Name: Senez Rooflng LLC Address: 1060 E. Industrial Dr. Suite K I Florida 32763 Persons within the State of Florida Designatd by Owner upon whom notice or other documents may be sarved asprovidedbySection713.13(1)(b), Florida Statutes, Name: In addition to himself, Owner Designates To receive a copy of the Lienor's Notice as Provided In Section 713.13(1)(b), Florida Statutes. Expiration Data of Notice of Commencement (The expiration date is 1 year from date of recording unless a differentdateisspecified) W, 4RNfN!5 TO OWNS ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, 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. Under penalties of perjury, I declare that'l have read the foregoing and that the facts stated in It are true t best of my knowledge and belief. Owner' s Signature 0wner's Printed Name ' Florida Statute rt3. t 3(7 i(g); The owner must sign tt notice Of Commencement and no one else May be permitted to sign In his or her stead.' I State of County of i The foregoing instrument was acknowledged before me this day of ( , 20 illin by 3. mtl Ali Who is personally known to meo Name of person making slaternent OR who has produced Identification type of Identification produced: JUUE ! HICKOX 4ZZ vCOMMISSION # FF92 I" XPrFtE3 Oclob r 21, ZtDt9 i ry Signature F Apr,17. 2017' 1:04PM SENEZ ROOFIN No, 8921_P. 1_ S enez Roofing 1.060 K Industrial Der. Orange City, Fl. 32763 www.senezroofing.com E-mail: info senez roofin .com Office: (386) 774-4950 Fax: (386) 775-3338 Fax Cover Sheet Attention;`rm-1-r From: Company to; Scr," Date; ' Fax number: ,- o-)—co W—Si S a- Pages; NOTICE. This is privileged and confidential and intended only for the person named above. If You are not that person, then any use, dissemination, distribution or copying of this is strictly prohibited, and you are required to notify me immediately by calling or faxing me (collect if needbe) at the numbers above. City of Sanford F , D wilding & Fire Prevention Division Re -Roof Permit Card iri® ®® PERMIT NO. ISSUE DATE: CONTRACTOR: JOB ADDRESS410 0. o A TYPE OF WORK: PROTECT F5 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 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: February 2017 Inspection Line 855.541.2112 TO SCHEDULE AN INSPECTION: Dial855.541.2112 Provide the items requested during the message The type of inspection requested must be scheduled under the appropriate permit type Follow the prompts 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 ROOF Final Roof ll 1 Miscellaneous Notes: REVISED: FEBRUARY 2017 Inspection Line: 855.541.2112 SENEZ ROOFING No.8921 P. 4 City of Sanford Residential Re -Roof Inspection Po t i PERMITTING REQUTAEMENTS — No PLAN REVIEW REQUIRED This document. (signed) along with an accurate and completed Residential Re -Roof Sco etobesubmittedas':: art of your permit applicat2on• P of The Scope of Wd k must include all applicable Florida Product Approval numbers for awillbe, installed ph. the project, 11 roof i A permit will no;,6c issued without these documents, Copies will be made to post on the job si Projects locate in the Sanford Historic District will require lan review aHistoricPreser Jtion Board p nd approval ti I INSPECTION POLICY & PROCEDURES A Final Roof Ins Pction is the only inspection required for Residential (Single Family, TownhoHome, Apartment and/or Condominium) Re -Roof Permits, Building Division l4cy & Procedures i; 3 l. W rk are required f components that 1. te. y the Sanford Ilse, Mobile The Following is required to be provide on the job site: I. ii.I . i. Permit Cayl, posted in -a conspicuous and weatherproof location Completf4 Residential Re -Roof Scopelof Work Complete :and Notarized Inspection Affidavit I' s ' All Florid Product Approval and Corresponding Installation Instructions Product Approval shall match what is'on the scope of work) Digital Phltographs (must include the permit number or address in each picture) i o Each plane of the roof, showing the underlaymetit installed o Roof Deck Nailing Pattern & Spacing (including a measuring device or ruler) IoRoofDeckNailsusedi i (including a measuring device or ruler showing size of nails) ;' o Underliayment Pattern & Spacing (including a measuring device or ruler) o Drip Age & Valley Attachment (including a measuring device or ruler) o Shingles installed, nail pattern and location of nailsii Skylig 'ts (if applicable) o Digit a) hotographs showing all installation components, per FL Product Approval o Digitali hotographs showing all re uired flashing, g, per. FL Product Approval i. Failure to follow;rfhese specific guidelines will result in an affidavit provided by a Florida DesignProfessional (arc iitect or engineer), certifying FBC code compliance by personal inspection. CONTRACTOR (OR 0 IIER/BUILDER) SIGNATURE- I' IDATE: SENEZ ROOFING JOB ALRLSS: No.8921 P. 5 I PERMIT # i City of Sanford Building Division Residential Re -Rolf Scope of Work STRUCTURE TYPE: J SINGLE FAMILY RESIDENCbITOWNHil3» O MOBILE HOME APARTMBI VCONDOMINIUM RE -ROOF TYPE: PLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE W.ITH NEW COMpoNENTS) RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF) DECK TYPE (PLEASEj'SPECIFY): PLEASE NOTE: ONLY 100 SQUAB FE T THE EXISTING DECK IS PERMITTED TO BE REPLACED *" ROOF VENTILATION `12 OFF -RIDGEI 0 RIDGE OSOFFCf OpOWERbD VENT OTURgrNES SKYLIGHTS: Q Yi : (*NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #; I f NIATN ROOF AREA ...................................... ROOF SLOPE: O L 5S THAN 2:12 Q 2:12 - 4:12 ®4;12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL 4&SHTNGL13 M rQ L# I ©I"l • .ice O METAL FL# OMODIFIEDBITU EN FL# O TORCH DOWN PL# OINSULATED FL# OTTLE FLY O OTHER: FL# R0OFExTENsxJQNS P101WHES. PATIOS,ETC.) **I.F APPLICABLE" ROOF SLOPE: O i S THAN 2:12 O 2:12 — 4:12 O 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL O SHINGLE FL# I O METAL I FL# O MODIFIED B 1TU N FL# OTORCH DOWN I FL# O INSULATED FL# a 3 OT1LE . i FL# O OTHER: { FL# City of Sanford BUILDING DIVISION RE: Permit # Inspection Affidavit C.lc. Sc-veZ please print name and circle Lic. Type) licensed as a(n) Contract * /Engineer/Architect, 68 Building Inspector* License #;— Q2— On or about —' Cj ' ,DaH, I did personally inspect the roof Date & time deck nailiniz and/or secondary water barrier work at 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.) Signature` STATE OF FLO A COUNTY OF%tLQ--- Sworn to and subscribed before me t4(day of rl . 200 / By I @n — U Notary Public, State of Florida o' LISA A JAY MY COMMISSION # FF930314 EXPIRES October 2Z 2019 007)3 6-0 0 kwiiioNowySwvwe.W" Personally known or Produced Identi ation Type of identification produced. Print, type or stamp name) T Commission No.: L4 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.