2445 Mellonville Ave 17-1431; ROOFw
CITY OF SANFORD
1 BUILDING & FIRE PREVENTION
Y PERMIT APPLICATION
Application No: / I- / ,s I
Documented Construction Value: $ 5'3 0D- tV
Job Address: 'o S,yS• i' E1-LOiVt LI #J * b Historic District: Yes No
Parcel ID: Residential Commercial
Type of Work.: New Addition Alteration Repair M Demo Change of Use Move
Description of Work•'l.
Plan Review Review Contact Person: V-'Q!A C."SC-0 -'b A-'Vr1_add Title:pwvi&-&-) YYI
Phone:Uz-1Fax: +1..t0 -1 18 Email: Property
Owner Information Name'
s-r P E V4 w Phone: LMI " `• O-•a # `a Street:
q W%k S 0G "-QyAQJ L L-S (-We- Resident of property?: 0 U:)*.LE(L City,
State Zip:" ,54,, =010,0 FL • •3-1 `111 Contractor
Information Name
Z-Mcs 'Rwc i3c4D Phone: Street:
l 25 U +r.1 111 TV 0& • ?c \ % % w1Av
Fax:
yQZ -- $' t' 3 City,
State Zip: L-Qy tGu--o fl .. 3 1;k1)5 D State License No.: CCc,135 06 09 Name:
Street:
Architect/
Engineer Information Phone:
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 matte 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, wens, pools, furnaces,
boilers, heaters, tanks, and air conditioners, etc. FBC
105.3 Shalt be Inscribed with the date of application and the code in effect as of that date: P 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.
signature OfO%MefAgent Date
Print 0wnedAxwe0a Signature
of1?6ftry-9tffc-of OSCAR
DAVID MUNOZ r
NOTARY pU8L1C - STATE OF FL4RIDF 1`
COMM, ISSIONiFl%44501 OT
My Commissbn Esprres3anuary 11, 202' Owner/
Agent is Personally Known to Me; or Produced
ID Type of ID Signanlre
of Contractor(, Date Print
Contractor/:AContrwtor/Agsat:A Fume Signature -State
ofFlorida Date L"emso-
lmlyOSCARDAVID
MUNOZ NOTARY PORIUSUC •
STATE OF FLOACOMMISSIONiFFp.Qsol Cmr^
rssfa^ ExR+
reslanuai2020 Contractor/Agent is Produced ID
Type of ID
BELOW IS FOR OFFICE USE
ONLY Permits Required: Building n Electrical[]
Mechanical Plumbing[] Gas Roof Q 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: ENGINEERING: COM31ENTS: UTILITIES:
WASTE WATER:
FIRE:
BUILDING:
Revised: June 30,
2015 Permit
Application
I
Cen'tra 1
Homes
1445 D Io sner P . Sanford, FL 32771 office: 407,732.7262 centralhomesoffice@gmail.com
Customer Info: Rape Res.. Date: 4/24/2017
Job Address: 2445 Mellonville Ave., Sanford, FL 32771
PROPOSAL - CONTRACT
WE PROPOSE THE FOLLOWING AT THE ABOVE LOCATION:
A. Tear off and haul away the existing: shingle roof system (one layer). An additional Sao/sq, for removal of eachunforeseenadditionalrooflayerwillbeadded.
B. Inspect the roof sheathing fastening system and supplement (re -nail).
C. Inspect the roof decking and repair as necessary on a per lineal or per piece basis as described below. D. Supply'and install one layer of Rhino Synthetic felt underlayment.
E. Supply and install new aluminum ridge vents for proper ventilation. F. Supply and install new 2 '/s" eave drip.
G. Supply and install Bullet Rubber boot flashing for plumbing stacks.
H. Supply and install Certain teed Landmark Architectural Shingle.
I. We will obtain and pay for a permit and obtain all required inspections.
J. Upon completion, all roofing debris will be picked up and taken away.
PRICE: $5,800,00 Payment Terms: Balance due upon completion of iob
A surcharge of 3.5% will be added to above price if paying with a credit card.
Any unforeseen decking repairs and/or wood rot repair will be done at a cost of $65.00 per sheet of plywoodand/or $6.00 per lineal foot of fascia.
WARRANTY: Central Homes LLC, 7-year workmanship warranty
This proposal is null and void if not accepted within 10 days of the date referenced in this proposal due to price volatility inasphalt -related products.
I have read and accept t dditional Terms editions printed on the back of this page. The prices, specifications and conditions of this proposalaresatisfactoryandeyaccepteddCralHomesLLCisauthorizedtodotheworkasspecified: in thisproposal. } /,
U
ACCEPTED: /--( (N C, DATEPayment
will b - made as outlined
ACCEPTED:
DATE
Central Homes Representative Date
Central Homes Roofing & Flooring State of Florida License CCC1330609
TiiiS iNSTRt}IVIEi t:f'E'RE'PARED BY:
Vie;• "MatiaT:.i3itcher.
Address: 1225Beilse»Dr. #1.11
LohOood; -FL', 32750
N InI E CIF C`t E# 1 T
GRANT t1ALOYr SEMINOLE COUNTY
CLERI'' OF CIRCUIT COURT & COMPTROLLER
8K 5919 Ps 1223 (iPaa)
CLERK'S 4 2017051513
RECORDED 05/23/2417 01:12:05 PI1
RECQIIDII4G FEES $10.00
RECORDED BY .ieckenro
Permit Number.
Parcei' ID Nu r ber.'a l - 1Q - 3 i - 5;R q-
The undersigned Hereby gives=nbtloe that.improvementwill be made to certain real property, and In accordance with .Chapter 713, Florida Statutes, the
folloWrig Information Is provided in this Notice of Commencement.
1. DESCPIPTION OF PROPERTY: (Legal description of the property and street address if available)
Au°-rT rSS-`1d- 0Ickr OFWTs 13h ! +t++ L.Ot'S 15--18 3
P e, %A 'Pe--,- Gl --x At-t.o r s I t- n a- t t- i S V/.I-+LK.. O (3 S P G I 4-
Z GEOERAILOESCRIPTiON OF
3. OWNE*'IRFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: { 1wci i 1Z Q Lc -' a 11 5 CA (SLLQv,1.y LL LE 4-.y15 -5/1WC--CA?-,
interest .In property:
Fee Simple T ltiti=Holder (if other than owner listed above) Name:
Addres§:
a. CONTRACTOR: flame: Central Homes LLC Phone Number, 407.732.7262
Address: 1225-'-Bennett'Dr. #111" Longwood, FL 32760
S: SURETY (if4pplicable, a copy of. the payment bond is attached): Name:
Address: Amount of Bond:
6. LENDER: Name: Phone Number.
E
Address:
7. Persormwlthhi ttw.State offlorida,Designated by Owner upon whom notice or other documents may be served as provided by Section
713.13(1)(a)7:; Florida Statutes.
Name: Phone Number.
8. In addition, Owner designates of
to receive a,copyof the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number:
9. Expiration Date of Notice of Commencement (The expiration is 1 year from date of recording unless a different date is specified)
WARNING,TO.'bWNER:•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'TWfCE 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 RECORPMG YQUR NOTICE OF COMMENCEMENT.
t /
r gnaaire or or (Print N and Provide Sf tys Tide/Ofte)
AuthorUed Ohio_ Oreaor ertManager7
State of F-00-.0 County of `^L
y .
4
e
Cq
The foregoing Instniment was acknowledged before me this ac day.of Y • ` `4
byLUwC,- ,(Q is Who is personally known to me r(OR
NamNaof person m0dnement 1g stat whohas'
produced"ldentiflcation type of Identification produced: v OSCAR
DAVID
MUNOZ ATE OFRDPuOA [a tW.s C40 NOTARY PUBLIC - ST, p X t.,
fCOMMiSS[
ONsFF449`'Q41 2420 J Noa _
10,
f
My Commission Ezptres)anw?rY gna rre u' he
4.J sw cad 1..
T
i.J Q vt Cti
City of Sanford
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. / '{ ® f ISSUE DATE:
n oc 49 Ile
CONTRACTOR: HVM6
JOB ADDRESS: q &//04 V I'/I do
TYPE OF WORK:
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
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 itemsrequested 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.
Now
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
City of Sanford Building Division
Residential Re -Roof Scope of Work
Jos ADDRESS: ayvAs tLt7raVi i !. 1- V.0 . Sonoma, - o1R b . C L
STRUCTURE TYPE: OSINGLE FAMILY RESIDENcE/TOWNHOUSE Q MOBILE HOME Q APARTMENT/CONDOMINIUM
RE -ROOF TYPE: REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
Q RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DEcx TYPE (PLEASE SPECIFY):
PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DEC%IS PERMITTED TO BE REPLACED'`*
ROOF VENTILATION: QOFF-RIDGE Q RIDGE QSOFFTT QPOWERED VENT QTURBINES
SKYLIGHTS: Q YES QWNO IF YES, PLEASE PROVIDE FI.ORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: Q LESS THAN 2:12 Q 2:12 - 4:12 (V 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL.
SHINGLE E (Z i ILxt t+'.x'tF FL# SJ U %A 4 ---
Q METAL FL#
Q MODIFIED BITUMEN FL#
Q TORCH DOWN FL#
INSULATED FL#
Q TILE FL#
Q OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **1FAPPLICABLE**
ROOF SLOPE: Q LESS THAN 2: 12 Q 2:12 -4:12 Q 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
Q SHINGLE FL#
Q METAL FL#
Q MODIFIED BITUMEN FL#
Q TORCH DOWN FL#
Q 1NSULAiED i
FL#
Q TILE FL#
Q OTHER: FL#
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)
a 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/$UILDER) SIGNATURE: """ DATE: , '
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
855.541.2112 SANFORD FL 327?1
DRIVEWAYS -SIDEWALK 407.688.5080
Page 2
Application Number . . . . . 17-00001431 Date 5/23/17
Property Address . . . . . . 2445 MELLONVILLE AVE
Parcel Number . . . . . . . . 31.19.31.524-0100-0050
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . . WYNNEWOOD
Property Zoning . . . . . . . SINGLE FAMILY
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 984989
Permit pin number 984989
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 BL03 FINAL ROOF / /
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: 1 l -- t 4 3 Z
I'—''`C s '
t hereby acknowledge that I personally inspected
Roof deck nailing and/or 0 Secondary water barrier work
at 'a --A 4 S f '1 C3
anA have determined that the workJobSiteAddress) 3 ..- '
was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.)
I certify that my statements herein are true and accurate to the best of my belief and that I fullyunderstandthatmakinganyfalsestatementsinwritingwiththeintenttomisleadapublicservantinthe
performance of his or her afffcial duty shall constitute a misdemeanor of the second degree pursuant toSection837.46 F.S.
AA—
Signatur of Contractor Date
Ti cis c r,n!A C-Cc \,3 304 b 9PrintedNameofContractorLicense #
License Type: C General Building L7 Residential Roofing Contractor
p or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF SE'm % v-4 0 _r
Sworn to (or affirmed) and subscribed before me this Qr day of . Zp k7l b Ywhois- Personally Known tome or has CJ Produced (type. ofidentification} as identification.
Signature of Notary Public (
SEAL)
Stpte of Florid
Print/Type/Stamp Name MARIA T. BUTCHER
of Notary Public * MY COMMISSION # GGIG1540
EXPIRES May 04. 2021
D
3
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: r'l - t U a ADDRESS: a %'A' -Vs TnecL aV \ Q.L.F. f'aJE
I , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFINGCONi'RACTOR, 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 #: GCC. V3 3 O b 09
COMPANY/CONTRACTOR:
CONTRACTOR SIGNATURE:
MUST BE SIGNED BY LICED
A FINAL ROOF INSPECTION IS REQUIRED:
au
DATE: S SL
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 REQUIREMENT S.
FAILURE'T'O 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 SE rn
Sworn to and Subscribed before me this 30 day of 20 11 by:
rZ C Sc 1w11V1 Who is?(, Personally Known to me or has n Produced (type of
identification)
L I =-)?:>
L'__
Signature of Notary Public
State of Florida
Print/Type/Stamp Name
of Notary Public
as identification.
y MARIA T. BUTCHER
MY COMMISSION # GG101540
Y,. EXPIRES May 04, 2021
CITY OF SANFORD BUILDING SERVICES
Residential Re -Roof
Hurricane Mitigation Inspection Affidavit
Permit #: i— k q -6 1
I' QO'"r'k hereby acknowledge that I personally inspected
Roof deck nailing and/orX Secondary water barrier work
at 'a %A`k S fnGLw&\v 1\.1JE- rL and have determined that the workJobSiteAddress)
was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.)
I certify that my statements herein are true and accurate to the best of my belief and that I fullyunderstandthatmakinganyfalsestatementsinwritingwiththeintenttomisleadapublicservantintheperformanceofhisorherofficialdutyshallconstituteamisdemeanorofthe, second. degree pursuant toSection837.06 F.S.
Signature. Contractor Date
Z Lis -1 k'3t(oPrintedNameofContractorC 09License
License Type: General Building Residential Roofing Contractor
or any individual certified in accordance with F.S. 468 to make such an inspection.
STATE OF FLORIDA COUNTY OF S Eyn t w,z L s
Sworn to (or affirmed) and subscribed before me this _ day of 'i(J 20c`5 +^' , who is X Personally Known to, me or h s Produced (( pe ofentifieation as identification.
SEAL)
Signature of Notary Public
State of Florida
MARIA T. BUTCHER
Print/Type/Stamp Name ; Mr coMMlssloN # GG101540
Of N ?y M1 EXPIRES May 04, 2021NotaryPublic ..
3
t1
J ,iT
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: al S LLc VI CLLs 1 Q e . Soa% A C_—QA
STRUCTURE TYPE: WSINGLE 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: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED **
ROOF VENTILATION: DOFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES XIO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
AAROOFSLOPE: O LESS THAN 2:12 O 2:12 — 4:12 `aV 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE 1 wWTG- FL# J Li
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
O INSULATED FL#
O TILE FL#
O OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IF APPLICABLE**
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#
0 OTHER: FL#