100 Rose Hill Trl; 17-1966; roofCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $ 9,300
Job. Address: 100 ROSE HILL TRL SANFORD, FL 32773 Historic District: Yes No
Parcel ID: 18-20-31-503-0,000-0010
Residential Commercial
Type of Work: New Addition Alteration Repair 0 Demo Change of Use Move
Description of Work: RE -ROOF OWENS CORNING FL10674 TECHWRAP FL17194 25 SQ'S 7/12 PITCH
OAKRIDGE BEACHWOOD SAND LIFETIME WARRANTY
Plan Review Contact Person: RACHEL HOLCOMB Title: MANAGER
Phone: 407-278-7788 Fax: 800-337-3361 Email: PERMIT@JASPERINC.COM
Property Owner Information
Name VERGARA CARMEN J & RAMOS CARLOS J Phone:.
Street: 100 ROSE HILL, TRL Resident of property? : YES
City, State Zip.• SANFORD, FL 32773-7237
Contractor Information
Name MICHAEL STEPHEN
Street: 3203 S CONWAY RD STE 201
Phone:
407-278-7788
Fax: 800-.337-3361
City, State Zip: ORLANDO FL 32812 State License No.: CCC1329651
Architect/Engineer Information
Name: Phone:
Street: Fax
City, St, Zip: E-mail:
Bonding Company:
Address:
Mortgage Lender:,
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 made to obtain a permit to do the work and installations as indicated. 1 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: 51h Edition (2014) Florida Building Code
Revised: June 30, 20,15 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
inanagement districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of requirements ofFlorida 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
offaccordancewithlocalordinance. Should calculated charges figured othe 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. W
7u'` Signature
of Owner/Agent Date !SigpuatErentractor/Agent Date Skylar
Amleraut Print
Owner/Agent's Name fist Contractor/ gent's ame OL
Signature
of Notary -State of Florida Date Signature FE,
ANA CHAVEZ State
of Florida -Notary Public Commission #
GG 112152 My
Commission Expires june
06, 2021 Owner/
Agent is Personally Known to Me or Contractor gent is Personatly0loTTI o Me or Produced
ID Type of ID Produced ID X Type of ID DL BELOW
IS FOR OFFICE USE ONLY Permits
Required: Building Electrical Mechanical Plumbing Gas[] Roof 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: UTILITIES: ENGINEERING:
COMMENTS:
FIRE:
WASTE
WATER: BUILDING:
Revised:
June30, 2015 Permit Application
Jasper Contractors, Inc.
5380,E Colonial Dr.
Orlanao FL 32807
407) 2M-7788
800) 337-3361 Fax
JasperRoof.com
info@jasperinc.com
Account Manager UM \ C k)Z
a Contact #,96 '1.S -S`' VV
Insurance Companx Information
Company `c,,r Gk Vc. r-. k`f nJASEmPolicy #Ci
e--<= JosporRoot.eom Claim.#
Contractor's License# CCC1329651
ROOF REPLACEMENT CONTRACT
Mortgage Company Information
Compan.... — 'Al- /Cc
Loan NumberWT,
Owner(s):
a
Phon
4Q -6 _6IGO
Address:
LS A fc„ \
Alt Phone:
40-\ V_ 51LklA
City: f,
ta
U A
Zipp code:
3 "1
ingle,Color:
iv $o r,
Email:
Ctnr" C W y,h,-c"N\
Roof RCV amount:
9,300
De'r"-pp,, g'C(oIor:
VV 1-y"
If Owner's Insurance Company does not agree to pay for a full roof replacement, this contracC shall be null and void.
Assignment of Insurance Benefits for the Full Roof Replacement Only: I hereby assign any and all insurance rights, benefits and proceeds
under any applicable insurance policies to Jasper Contractors; Inc. ("Jasper"), the scope of which shall be limited to a Full Roof Replacement. I
make this assignment and authorization in consideration- of Jasper's agreement to perform services, supply materials and otherwise perform its
obligations under this contract, including not requiring full payment at time of service. I also hereby direct my insurer(s) to release any and
all information requested by Jasper, its representative, or its attorney for the direct purpose of obtaining actual benefits to be paid by my
insurer(s) for servicesrendered. In this regard, I waive my privacy rights. If payment is made directly to the Owner/Agent%Insured(s), it shall be endorsed
over to -Jasper immediatelyupon receipt. I agree that any portion of work, deductibles, betterment or additional work requested by the undersigned,
not covered by insurance, must be paid by the undersigned on the day of installation. Deductible:
It is the Owner's responsibility to pay all. Insurance Deductibles. Owner's out-of-pocket expense will not exceed the deductible amount,
as stated on insurer's loss sheet, UNLESS replacement/repair of deteriorated decking is required and/or Owner requests optional upgrades.
Jasper CANNOT pay, waive,.rebate, or promise to pay, waive or rebate all or any part of the insurance deductible applicable to
the insurance claim for payment of work. In the event of a discrepancy, the deductible amount stated on the insurer's Loss Sheet shall overrule
Deductible listed abo e. Deductible:
S S Oo , RF MUST BE PAID IN FULL, PLUS APPLICABVE SALES TAX / (initial) MORTGAGE
AUTHORIZATION: I; Owner/Mortgagor, grant authorization for C/ . 1ldh fc ec• 1Vlortgage o t speak with Jasper
on matters including, but not limited to, the claim and draw status. i initial) PAYMENT
SCHEDULE; Owner agrees to pay Jasper based on the following pay schedule (1) Deposit in the amount of $ due upon --
signing this .contract; .(ii).the . Contract :.Price,._ less -the .Deposit -and. any.applicable, .depreciation_retained. by.Owner.'.s .ins er(s),_plus Upgrade
Costs, due and payable to Jasper upon completion of work being performed; and, (iii) "the remaining Contract Price (equal to any applicable
depreciation and/or change orders) due and payable to Jasper upon completion of work performed. In the event of a pending inspection,
no more than 2% of ContractPrice may be withheld until inspection has passed: Optional:
UPGRADE ITEM: "7
QTY:
PRICE: $ ; TOTAL: S Replacement
Work and Price: Upon insurer's approval and subject to the terms and conditions herein, Jasper agrees to furnish all materials and
provide the labor necessary to perform the full roof replacement which shall take place following Owner's insurance company's approval, approximately
within 30 days, conditions permitting. Owner'
s Declaration of Intent: Owner acknowledges and agrees that,. upon.approval by insurance company for a full roof replacement, Jasper shall
perform the roof replacement upon receipt of funds from Owner's: insurance company. CANCELLATION:
If Owner elects to terminate the services of Jasper; Owner may do so before midnight on the third business day after
Contract is executed. Owner shall receive a full refund of all deposits. Owner may also rescind Contract before midnight on the third
business day after the contract is executed after notification from insurer(s) that the claim for payment.on roof contract has been denied,
in whole or in part. All. written notices of cancellation, regardless of reason, shall be postmarked or delivered to Jasper's corporate
office: 1690 Roberts Blvd Suit 112.Kennesaw, GA 30144. CANCELLATION EXCEPTIONS: The three (3) day right of cancellation
DOES NOT APPLY to contracts for emergency home repairs as time is of the essence. I,
Owner, have read and 'understand all statements, terms and conditions of the "Roof Replacement Contract" and agree that all details
are acceptable and satisfactory. I further understand that this contract constitutes the entire agreement between the parties and that
any further changes or alterations to this contract must be made in writing and agreed upon by both parties. Each party represents
and warrants to the other that it has the full power and authority to enter into the contract and that it is binding and enforceable
in accordance with its terms. Authorized,
Jasper. Representative Date wner, v
Date
TERMS
AND CONDITIONS: Acceptance of Terms: I, Owner, hereby agree to retain Jasper for a full roof replacement on the terms and conditions
stated herein. I further agree tb provide Jasper with the Scope of Loss Report generated by my insurer and authorize and grant full access
to the property for the purpose of staging and completing all agreed upon work. Supplemental Claims: Jasper reserves the right to file a supplemental
claim with Owner's insurance in the event that the estimate is incorrect and/or additional damage is discovered after
THIS,INS, T PRE .AREDt C
Addr'ess:
J, ai'ii"'faOL eft
OLL) ' t LEft;'S Y 20171_IF4254
KCrDRDEDNOTICE ® COMM : NT Ll CAzL,`
h'
FJ,Ul?fi,r
Permit Number. ^
Parcel ID Number. — t — _' C)
The undersigned hereby gives notice that improvement will be made to certain realfollowinginformationisprovidedinthisNoticeofCommencement. property, and in accordance with Chapter 713, Florida Statutes, the
I. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
2. GENERAL DESCRIPTION OF IMPROVEMENT:
3. OWNER INFORMATION OR LESSEE i FORMATION IF THE
Name and address:(ay-my'lr\
Interest in property;
Fee Simple Title Holder (f other than owner listed above) Name:
AAA.---. -
5. SURETY (If applicable, a copy of the payment bond Is attached): Name:
Amount of Bond:
6. LENDER: Name:
Phone Number.
Address:,
7. Persons within the State of Florida Designated b Owner. upon t cn r r c r n ry , tv M sue„• . 9 y whom notice or other documents m YE6l stier iftt?CRpt 9 hYQi713.13(1)(a)7., Florida statutes.
AND CO}r1PTI(Ol1.F.(( Name:
Phone Number rrWhini r rpo jfITY Fl MMA
Address
8. In addition, Owner designates of ._ BY
to receive a copy of the Lienor's Notice as provided. in Section 713.13(1)(b), Florida Statutes. Phone number j Uj
9. Expiration Date of Notice of Commencement (The expiration is 1 year from date,of recording unless a,different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE, BY THE OWNER AFTER THE EXPIRATION OF THE NOTICEOF 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. Signature
or Owno or Losseq Owner's or Lessee's (Print Name and PrWde Signato" 1_ jW01111ce) Authorized
OrBcerlDimctor rtmr/Manager) State
of t' Countyof The'fore/
g'oing instrument was acknowledged before me this day of (u M , .20 by Who
Is personally known to me O OR Name or
parson Mang statomont who has
produced Identification type of:identification produced: D r SKYLAR B
AMKRALT fa 2789U
n FF , Commission rmy
comm"ss,on Exptrt;s I orr June
Ol 2018,`_J
427017
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake :Mary,. Longwood, Sanford,
Seminole County, Winter Springs
Date: 6/26/17
I hereby name and appoint: Karla Almodovar, Ana Chavez, Skylar Amkraut, Rachel Holcomb _
an agent of Jasper Contractors
NamcorCompany)
I
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):
The specific, permit and application for work located at:
100 ROSE HILL TRAIL SANFORD FL 32773
Stmz nddiess)
Expiration Date for This Limited Power of Attorney: 1/11201B
License Holder Name: Michael Stephen
State License Number: CCC1329651
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF SEMINOLE
The foregoing instrument was acknowledged before me this 26 day of JUNE
20017 , by Michael Stephen who is o personally known
to me or who has produced
identification and who did (di
Notary Sea
AR 127 390
e Comn;ission
FF
ExPj(essso+
r Niy Comm 01 201 S
Rcv. os. 12)
Print or type name
Notary Public - State of FL
Commission No. 127890
My Commission Expires: 6/1/18
City of Sanford
Building & Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. I / 9 L ISSUE DATE: 0&,, al 77o 17
CONTRACTOR:
00
JOB ADDRESS: /00 ® • `l
TYPE OF WORK: YQ
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 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
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 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:
e 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: 6I26/17 -
427017
PERMIT#
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: 100 ROSE HILL TRL SANFORD, FL 32773
STRUCTURE TYPE: ® SINGLE FAMILY RESIDENCUTOWNHOUSE 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: ONL Y 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED * *
ROOF VENTILATION: OFF -RIDGE RIDGE OSOFFIT OPOWERED VENT OTURIiINES
SKYLIGHTS: O YES O NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: Q LESS THAN 2:12 O 2:12 -4:12 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE OWENS CORNING FL# 10674
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
0INSULATED 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 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#
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 . . . . . 17-00001966 Date 6/27/17
Property Address . . . . . . 100 ROSE HILL TRL
Parcel Number . . . . . . . . 18.20.31.503-0000-0010
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 991174
Permit pin number 991174
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 BL03 FINAL ROOF / /
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: `— \"1 ADDRESS: _ \OD
S vb)a ,
AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTO , ENGPdER, 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 #: ( A .(_ , J G(v )
COMPANY / CONTRACTOR: J
CONTRACTOR SIGNATURE: DATE: `•
MUST BE SIGNED BY LICENSE HO OR O UILDER)
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
Sworn to and Subscribed before me this day of 14 20 by:
Who is Personally Known to me or has Produced (type of
id tifcation) D- as identification.
Sig ature of Notary Public
State of Florida
ANA CHAVEZUUpi
l Y pVB
4State of Florida -Notary Public
c Commission # GG 112152
Print/Type/Stamp Name %i c My Commission Expires
of Notary Public F%% June 06, 2021