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100 Laguna Ct; 17-2662; RE-ROOFCITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: 1d(o&)-, Documented Construction Value: $ 1 a I 1 Job Address: I00 LaWmb-N50 1 , Historic District: Yes No Parcel ED: "Z ' Residential R1 Commercial Type of Work: New Addition Alteration Repair Demo Change of Use Move Description of Work: 31 i a , Re G, O F -F 4 Q.ee-a, f US f n f ', 5,) l (Q- R a i Cori,s wid-4JCC r-re(a/ uQ lltAi ff=1 6 -7 Q 1) d 64F_-f- bRf YI S' htrG11C Plan Review Contact Pcrson: O 0 0 n 2 f y reyen Title: Pro e i- lad Phone: --) __7_ cdA CFI Fax: Email: "5n-ee- -7 a 2 Property Owner Information C O `' tl coK• C©m Name CS^H ? n6) — 2rfouiff-- - - Phone: Street: ',Won E . HarfNJ 1. r. 2 Resident of property? : n City, State Zip: 5 Rz- Contractor Information Name Street: rA City, State Zip: Ul C, t L-i Name: Street: City, St, Zip: Bonding Company: Address: Phone: " 15y _''1- 1` 1 - 2-2!8 Fax: State License No.: CCC ) " I Architect/Engineer Information Phone: Fax: E-mail: 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. 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: 5th Edition (2014) Florida Building Code f Revised: June 30, 2015 Permit Application \ 1 60 NOTICE`. In addition to the requirements of this permit, there maybe additional restrictions applicable to this, property that may befoundinthepublicrecordsofthiscounty, 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 requiredinoldertocalculateaplanreviewchargeandwillbeconsideredtheestimatedconstructionvalueofthejobatthetimeofsubmittal. 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. Sigmature of Owner/Agent Date: Paint owner/Agent's-Name Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID Signature of Contractor/Agent ate Contractor/Agent is Azlpersoifd Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building Construction Type: Electrical Mechanical Plumbing[] Gas Roof E] Occupancy Use: Total Sq Ft of Bldg: Min. Occupancy Load: Flood Zone:: of Stories: New Construction: Electric - # of Amps Plumbing - # of Fixtures. Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes Q No APPROVALS: ZONING: ENGINEERING: COMMENTS UTILITIES: FIRE: WASTE WATER: BUILDING: Permit Application Revised: June 30, 2015 8114/2017 ' SCPA Parcel View: 10-20-30-503-0400-0450 CFA Parcel Information Property Record Card Parcel: 10-20-30-503-0400-0450 Owner: CSH 2016-2 BORROWER LLC Property Address: 100, LAGUNA CT SANFORD, FL 32771 Parcel 1 10-20-30-503-0400-0450 Owner I CSH 2016-2 BORROWER LLC Property Address 100 LAGUNA CT SANFORD, FL 32771 Mailing! 8665 E HARTFORD DR STE 200 SCOTTSDALE, AZ 85255 subdivision Name HIDDEN LAKE PH.2 UNIT 1 Tax District SI-SANFORD DOR Use Code 1, 01 -SINGLE FAMILY Exemptions I Value Summary 2017 Working, 2016 Certified i Values i Values Val Iuation Method Cost/Market Cost/Market Number of Buildings Depreciated Bldg Value 93,253 81,651 Depreciated EXFT Value Land Value (Market) 25,000 21,000 Land Value Ag JustlMarket Value, 118,253 102,611 Assessment Value Exempt Values Taxable Value, 118,253 0 118,2153 County General Fund 118.2531118,253 0 Schools 118,253 0 118,253 City Sanford 118,253 0 1,18,253 SJWM(Saint Johns Water Management) 118,253 0, 118,253 County Bonds Sales I Date Book Page Qualified vac/Imp Descrption SPECIAL WARRANTY DEED 11/1/2016 Amount 0023 100 No Improved SPECIAL WARRANTY DEED 6/112014 0 . 8283 g560 92 600 No improved WARRANTY DEED 08187 158,800 No improved WARRANTY DEED 611/2008 1080 162,000 Yes Improved WARRANTY DEED 7/1/2005 05824 1963 11 180,000 Yes Improved QUIT CLAIM DEED 1011/2 145t8 1468 100 N o Improved WARRANTY DEED 8/111987 01877 1329 66,500 Yes Improved WARRANTY DEED 11111198 2 1424 0825 58,500 Yes Improved WARRANTY DEED 12/1/1980 01311 0792 49,300 Yes improved ry Land http:/Iparceldetail.scpafl.org/ParcelDetailinfo.aspx?PID=10203050304000450 1/2 8/312017 Reacbve WO - SMS ONE for Affiliate Proposal #: P- B1408672Al Date: 07/261/2017 Status: Approved Repair or Replace WO:Replace COMPARE Description of Proposal: Roof has multiple leaks, old 3-Tab no fib er left. Shingles - 'Remove 35.7 squares; replace with 41 squares of HD shingles (approved by HOA), Includes new boots, ridge c aps, drip edge, removal and disposal of all related materials, an d re -nailing plywood to code. Chimney- -install new t-1 1 siding on back of side chimney box with new corner boards Material: - Shingles - 30# Felt - 1 114 'Nails - Plywood - 4" membrane - Box es, tin tags - Drip edge (10' per piece) - Pipe boots Total job cos t - $12,125 (includes first, 3 sheets of plywood) Shingles - $11,4 80 (41 squares @ $280 per square) Permit/ Dump fee - $500 Ch imney- $145 Property has 2 skylights witch are not included in this bid to replace ($350 each) """""Any additional wood w ill be billed at - Plywood - $50 per sheet Fascia - $3.5 per lineal foot, plus cost.of wood (all I *x,2', Vx 4' .... ...to 1' x 1 W) Truss w ood work- $ 2.0 per lineal foot plus cost of wood on all. Does n of include - A/C, skylights, solar panel, gutters- work unless me rationed in the scope of work 10 yr, labor warranty included Aut horized Signer: Michael Devaney https:llaffiliate-one.smsassist.com/reactiveWo/1408672tdetaiis#/proposal ill tT- fft xEVOR13 ic_-,-MSTO ballRAc i Ft- f -7 -7 -7 ball145 ' d Aa,c ca,1e , Fr 15-Ob3 r"ERhtrl' W.LMi3R:. Tho undt6gttuibacby gives ntsin; that improve,Ttent Ql be madcto Certain real nrtlpertp, and in accordance Mth Chapm 713, Florida Swutes, ibe foll%iing information is provided in this NoticcofCommencemcuL t. uwC'aunoj 0F ?jkojEFtTy (jvgW dm0jpq. oftke prWoty &stow addmsi,ifaveibile)TAX FotAG O.: 10-20-30-5010400.-0450 souutvlslo% Hidden lake phase 2 ecoci 4 Auer. loT45 100 Laguna CT Sanford, R 32771 a t;mmR tcnLsctrm+ox oguKeaovEmevr. Re - — — 3.o9i-xmiriFOR31ATtox ott.LES=F.-NFORM1L TFtNV TBF. LTMEE OO:i7RYC[FII FoR.ntt9 k, ROY.ChtE-T- me.nemarr r G H 2016-2 Bprrobver LLC.8665E.Hartford Dr#200 Scottsdale, AZ 85255 c: zmeandaddress uf'se afmpit RCdlddbritCdlt6cT from parer 135:cdabv!'b7.. -,: _ --_... -._ ..:,... .. .___ a a: ooxtR.+croR•s1v.tts: Bentley, Roofn_._:—^.., ___ ..-- - _ 1777 Banks Road, Margate, FL 33W3 :w«araba 954-979-2238 5.. SGtt'ET,y (tf tzbrc, a WPy of ihepaymea tgcd is Wi..dadY. 7. Pemms within the State of Florida designated by Qvvuer upon `urbom notices or other documents may be served as providA by Section 113,13 S r) (a) 7., Fw.n . siatmes. S. a to addition to himself or herself; Owner designates to receive a copy of the Lienor's ldctice as provided in Section 713.1. (1) (b), Florida Star-Acs. b- ph-numhei dpa m ati.7 defiyrsaKd by O Iw.. _ 9. Fapirauw diuc ofrlotioe ofcotmncooicMatt (die expiration dew will bel wer from the dare orrecixding unless a di*ren date is specifie():` 6G, Lc Wes tPOrtt Namk and ProvideSipatory'sTitle/0MCe) State of CL-- — County The foregoing .im=urncolwasadwowledgedbeoremethis_;_da: or K us 20 by/ O'> ssC b tl-C t S oP n) ( (rf , atd W ity,. _ c g. offiaa, trusme, zu«noy to fact) for `_. r--F' name ofpa obeh afv&ouu9umentwsaauted) toduedtdertihcatiat T} dof Identfiiaon Protzuccdpersonal!}Kri, x70FRIMAL of ublit7ILLIA101,S mt, Type, or Stamp Conuvissioued Name ofNo ary Public) ESS oanxay. ,o e-nzBLIC. STATE . =FresMGRANTMAL'OY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK'S # 2017089646 BK 8983 Pg 1103; (1 pg) E-RECORDED 09/01/2017 03:18:27 PM 00 ColonyStarwood, E LETTER OF AUTHORIZATION The following SMS Assist employees are fully authorized to act on behalf Adalwin LLC; Beauty LLC; CAH 2O14-1 Borrower LLC; CAH 2O14-2 Borrower LLC; CAH 2O15-1 Borrower LLC; ColFin AH- Florida 5 LLC; ColFin AH-Texas 3 LLC; ColFin AI -AZ 1 LLC; ColFin AI -CA 4 LLC; ColFin AI -CA S LLC; ColFin Al -DE 1 LLC; ColFin AI -FL 2 LLC; ColFin AI -FL 4 LLC; ColFinAll-GA1 LLC; CoIFinAI-GA 2 LLC; ColFin AI -NV 2 LLC; ColFin Al -PA 1 LLC; ColFin Ai -TX 1 LLC; CSH 2O16-1 Borrower LLC; CSH 2O16-2 Borrower LLC; CSH Property One LLC; CSHP One LP; Dallin LLC; Dunley LLC; Fetlar LLC; Inverclyde LLC; Louden LLC; Morven LLC; SFR 2012-1 US West LLC; SRP Sub LLC a Delaware LLC; SRP TRS Sub LLC; SRPS LP; Starwood Waypoint TRS LLC; SWAY 2014-1 Borrower LLC; Tarbert LLC and Tiireli LLC (together the "Entities") solely for the purpose of signingPermits; Affidavits, and Notice of Commencements for the provision of homes owned by the Entities until this Letter of Authorization is changed or withdrawn by written notification. Alex Cotto Director of Operations (312) 878-6159 Claire Caldwell Associate Director of Residential Services (312) 690-7501 Neil Harrington Associate Director of Residential Operations (312) 267-0589 Gary Edwards Associate Director of Residential Operations (312) 548-6673 Aaron Messner Associate director of Residential Operations (312) 273-6537 Address for Correspondence: Colony Starwood Homes. 8665 East Hartford Drive, Suite 200 Scottsdale, AZ 85255 Sig tore of Company Officer Date Justin lannacone Printed Naive of Company Officer Executive Vice President Construction Title Colony Siorwood Mimes - 8665'East Farfllo co Doi e Su;4e 200 - Scot'sdal , A? 85255 - T, -480.800,3300 STATE OF ss. COUNTYOF A,VkW?k I On this day of 2017, before me personally appeared Justin lannacone, to me known to be the person described in and who executed the foregoing instrument, and, acknowledged that he/she executed the same as their free act and deed. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official sea] the day and year last above written. My commission expires: Notary Public' Printed Narhe 4 NANCY REHORST Notary Public- Arizona Maricopa County MyCommission Expires October 6. 2019 lie, AZ 852,55 , T- 480,800,3300, Colony Storwood Homes - 86165 Erist ir;Ofoid Drivc, St-,Ite 100 oitcio N CITY OF III IIII SAIJ!4FORDFIRE DEPARTMENT IIIIIIII Building & Fire Prevention Division Re -Roof Permit Card PERMIT NO. / 7 <2 (P to ol., ISSUE DATE: 047, ®--T / 77 CONTRACTOR: /. s n 01 O /), JOB ADDRESS: /ov Ca , /' a.(10/" 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 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 5:00 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 111 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 Building & Fire Prevention Division Sik ___ r0pj3 RESIDENTL4L RE -ROOF POLICY & PROCEDURES FATE DEPARTMENT 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 DEV ICE 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 SPECIFICGUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY'A FLORIDA DESIGN PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING,FBC CODE COMPLIANCE BY PERSONAL INSPECTION., DATE: CONTRACTOR (OR OWNER/BUILDER) SIGNATURE:f JOB ADDRESS: 100 una Ct PERMIT City of Sanford Building Division Residential Re -Roof Scope of Work STRUCTURE TYPE: 0 SINGLE FAMILY RESIDENCE/TOWNHOUSE Q MOBILE HOME O APARTMENT/CONDOMIMUM RE -ROOF TYPE: (5 REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF) DECK TYPE (PLEASE SPECIFY): Wood PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK !S PERMITTED PO BE REPLACED ROOF VENTILATION: OOFF-RIDGE O RIDGE OSOFFIT O,POWERFD VENT OTURBINES SKYLIGHTS: OYES ($j) NO 1F YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL. #: MAIN ROOF AREA ROOF SLOPE: O LESS THAN 2: 2 TYPE OF ROOF SHINGLE O METAL O MODIFIED BITUMEN O TORCH DOWN O INSULATED O TILE OTHER: underlayment 0 2:12 —4:12 O 4:12'OR GREATER MANUFACTURER GAF Interwrap Rhino roof & Carlise on va ROOF EXTENSIONS (PORCIIFS PATIOS ETC) ` *1FAPPLICABLE** ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 O 4:12 OR GREATER FL# I DA PRODUCT FL10124-RI FL15216-R2-FL16785-R6 TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL O SHINGLE' FL# O METAL FL# O MODIFIED BITUMEN FL# O TORCH DOWN FL# 0INSULATED FL# O TILE FL# O 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 . . . . . 17-00002662 Date 9/05/17 Property Address . . . . . . 100 LAGUNA CT Parcel Number . . 10.20.30.503-0400-0450 Application description . . . ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . SINGLE FAMILY Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 1001478 Permit pin number 1001478 Required Inspections Phone Insp Seq Insp# Code Description Initials Date 1000 111 BL03 FINAL ROOF _/_/ CITY OF S --------- ORD Building & Fire Prevention Division RESIDENTIAL RE -ROOF AFFIDAVIT FIRE DEPARTMENT RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING', SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #: " 2 ADDRESS: 0 D cc I (f il^Ll V)t,y CA-n I j , 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 #: LL L 1-Z 2 71 N 6 COMPANY / CONTRACTOR: , can - I e-,-{ -Z Oy f-o' n C CONTRACTOR SIGNATURE: DATE: MUST BE SIGNED BY LICENSE HOLD OR WNER/ IL ) 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 Y_ 0 UJ Ct - T SP Sworn to and Subscribed before me this d fl a of d 20 ' by: t C- NCLe- pQ 11 x e-'ho is ersonatly Known to me or has Produced (type of identification) Jgn n '6' 0_ Si na ure otary Public St lorida Print/ Type/Stamp Name of Notary Public as i en on. 11H1Ito 1 olill / O,M0ER23, . o 00028517 9 09, IjANdadSC:O•'O O otary