2422 Princeton Ave; 17-2847; REROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
7, PERMIT APPLICATION
Application No:
Documented Construction Value: $ - 4000
Job Address: 2-422- Pri'n(eion Pry,(, Historic District: Yes El No -
ParcelParcellD:3)1_jq_, 1-511 L 6ma - a(0 06 Residenti4oCommercial El Type
of Work: NewP AdditionEl Alteration El Repair EJ Demo El Change,of Use 0 Move El Description
of Work: re -r-oot' 1-7 66-. to I .O or Pv(,h r/q'hi(w Plan
Review Contact Person: Phone:
40 2&52-2-1!5- Fax: Property
Owner Information Name
4-r, ppq Valleu PrvoeAes LLL Phone: Street:
nr A IL jd& , i UOL Resident of property? City,
State Zip: `1 10 P61 Ft ; 75-1 Contractor
Information Name )(
f- , VIDW-S C _V Phone: qO 2,16 )Ulb__' Street:
TcQ )ooci c-4- Fax: City,
State Zip: La kk wo L4 R, -3Z-7,-/(f State License No.: (.1
cc, Wchitect/
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 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,
CON I
SULT
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 commencedprior
to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this
jurisdiction. 1 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. 511 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.
c.. , 0 -- g12S/i -7
Sign^ atu e of Contractor/Agent Date
1- a2f)" Pe.,40" o',
Print Contractor!)
igent'
s Name Signature
of Notary -State of Florida J Date 1rs;
eec ROPF.RtV,MALONEY M,
NaFF917443 u
zttie"ryS tYkLS Contractor/
Agent is Personally Known to Me or Produced
ID Type of ID BELOW
IS FOR OFFICE USE ONLY Permits
Required: Building Electrical Mechanical Plumbing[] Gas Roof Construction
Type: Occupancy Use: Total
Sq Ft of Bldg: Min. Occupancy Load: New
Construction: Electric - # of Amps Fire
Sprinkler Permit: Yes No # of Heads APPROVALS:
ZONING: ENGINEERING:
COMMENTS:
UTILITIES:
Flood
Zone: of
Stories: Plumbing - #
of Fixtures Fire
Alarm Permit: Yes No WASTE
WATER: BUILDING:
Revised:
June 30, 2015 Permit Application
MJP WINDOWS & CONSTRUCTION, INC.
LAKE MARY, FL 32746
LUIS RUIZ SANCHE 407-486-5983
407)265-2215 J PHONE
iiajpwin@cfl.rr.comcfl.rr.com
LICENSE # CRC057525& LICENSE # CCC057886
PROPERTY ADDRESS:
NICOLE LESSARD
HAPPY VALLEY PROPERTIES, LLC
2422 PRINCETON AVENUE
SANFORD, FL 32771
EMAIL ADDRESS:
A PROPOSAL FOR THE FOLLOWING:
TO TEAR OFF EXISTING SHINGLE ROOF
HAUL OFF ALL ROOFING DEBRIS & MATERIAL
INSTALL NEW UNDERLAYMENT
INSTALL NEW PLUMBING STACKS
INSTALL NEW VENTS
INSTALL NEW PEEL & STICK IN VALLEYS
INSTALL 26 GUAGE EVE DRIP
RE -NAIL DECKING TO CODE
SEPTEMBER 19, 2017
LABOR ONLY QUOTE
REPLACE ANY ROTTEN WOOD AT AN ADDITONAL COST OF $50.00 PER SHEET OR $6.00
PER LINEAR FOOT FOR DECKING BOARD AND FASCIA BOARD N '-linitial
INSTALL NEW 30 YEAR GAF ARCHETICTUAL SHINGLES
WILL CEMENT ALL EDGES OF ROOF AND VALLEYS
MJP IS NOT RESPONSIBLE FOR REMOVAL AND RE -INSTALLATION OF SOLAR PANELS
3 YEAR LABOR WARRANTY
PERMIT INCLUDED
WE PROPOSE TO FURNISH THE ABOVE COMPLETE IN ACCORDANCE WITH THE ABOVE
TERMS FOR THE SUM OF:
TOTALING: $4,000.00
PRICES ARE GOOD FOR 30 DAYS FROM ABOVE DATE
TERMS: TOTAL PAYMENT DUE UPON COMPLETION
CONTRACTOR'S ACCEPTANCE
COMPANY REPRESENTATIVE:
OWNER'S ACCEPTANCE
THE FOREGOING TERMS, SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND
ARE HEREBY AGREED TO. YOU ARE AUTHORIZED TO DO THE WORK SPECIFIED.
PAYMENT WILL BE MADE AS OUTLINED ABOVE. THE OWNER UPON SIGNING THIS
AGREEMENT REPRESENTS A ND WARRANTS THAT HE/SHE HAS READ THIS
AGREEMENT.
OWNER: DATE:
m
THIS INSTRUMENT PREPARED BY:
Name: DORENE PENHALIGON
Address:
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number: Parcel ID Number:
sill 11111 I91111111111111 Jill. GRAK MALOY, EMII4OLF COUNTYt:i_ filt tJF { ,R(:U11' t:> tlfiT & COiff'1'F`l7!_LEF: i'I{ ug9T P3 1'.. { 11 `9 } kEfiY. u 2t1171196}, RL
R EGIJ GF'CrAYEn,>=:,l r rrr
31-19-31-518-0000-0600
The undersigned hereby gives notice that improvement will be made to certain real property, and In accordance with
Chapter p713, Florida Statutes, the following information is providre dd in this Notice of Commencement
15 U
O
1 iSc N 1 U b 1L:V TeAffbAn' i9M f` 9VPG 77
IT -WV CRIPTION OF IMPROVEMENT:
OWNER INFORMATION:
Name: HAPPY VALLEY PROPERTIES
Address: 1600 LYNDALE BLVD. MAITLAND, FL 32751
Fee Simple Title Holder (if other than owner) Name:
CONTRACTOR:
Name: MJP WINDOWS & CONSTRUCTION, INC.
Address: 208 TEAKWOOD COURT LAKE MARY, FL 32746
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 Of
To receive a copy of the Lienoes Notice as Provided in
Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement (The expiration date 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 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 qiat I have read the foregoing and that the facts stated In it are true
to the best of my knowledge and be f.
I
Own i nature Owner's Printed Name
Florida Statute 713.13(1 )(g .' a owner must sign the notice of commencement and no one else may be permitted to sign In his or her stead.'
9Stateof1Countyof l i ( iV `x
17TheforegoingInstrumentwasacknowledgedbeforemethis 2 day of t ( I/ !CJ/ I J 20
Name of person making statem
OR who has produced identification type of
O4rpY P(,e Walbert Soto
State of Florida
My Comm. Expires 10/27/2020
koF oP Commission No. GG 42956
Detail 'by Entity Name Page 1 of 2
Florida Department of State
Department of State / Division of Corporations / Search Records / Detail By Document Number /
DIVISION OF CORPORATIONS
http://search. sunbiz.org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 9/26/2017
Detail by Entity Name
Title MGRM
LONGO, BRIAN C
53 Buckthorn PI
Alamo, CA 94507
Title MGRM
LONGO, MINDY Z
53 Buckthorn PI
Alamo, CA 94507
Annual Reports
Report Year Filed Date
2015 04/29/2015
2016 05/08/2016
2017 04/05/2017
Document Images
Page 2 of 2
04/05/2017 -- ANNUAL REPORT View image in PDF format
05/08/2016 ANNUAL REPORT View image in PDF format
04/29/2015 -- ANNUAL REPORT View image in PDF format
04/26/2014 --ANNUAL REPORT View image in PDF format
04/14/2013 --ANNUAL REPORT View image in PDF format
10/19/2012 -- Florida Limited Liability View image in PDF format
Florida Department of State, Division of Corporations
http://search. sunbiz.org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 9/26/2017
CITY OF
m;. SkNFORDBuilding & Fire Prevention Division
FIRE, DEPARTMENT Re -Roof Permit Card
1/7PERMITNO. /07 Q?g ISSUE DATE: ®g I L •
CONTRACTOR: M a P
JOB ADDRESS: 7Va I • Pl 61to%A.-
TYPE OF WOR 400 F
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 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
Y OF
fs.NFORD Building &Fire Prevention Division
RESIDENTIAL RE -ROOF POLICY & PROCEDURES
FIRE DEPARTMENT
PERIMITTING 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 PLAIN REVIEW AND APPROVAL BY THE
SANFORD HISTORIC PRESERVATION BOARD
INSPECTION POLICY cot PROCEDURES
A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMILY, TOWNHOUSE,
MOBILE HOME, APARTMENT AND/OR CONDOMINIUM) RE-ROOFPERMITS. 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: G"vl (21 DATE: 'I 12,5111-)
CITY OF
SANFORD PERMIT #
Building & Fire Prevention Division
OE DEPARTMENT RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: 21122 01,11 ! t a)lj k W &aLIA-
STRUCTURE TYPE: a0SGLE FAMILY RESIDENCE/T OWNiIOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: PLACEMENT (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 DE EXISTING DECK IS PERMITTED TO BE REPLACED * *
ROOF VENTILATION: OOFF-RIDGE O RmGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES i0 IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:1.2 j(?(
4"'12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SIiLNGLE FL# 0 Z
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
O INSULATED FL#
OTI LE FL#
O OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **IF APPLICABLE"
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:1.2 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#
OINSULATED 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 . . . . 17-00002847 Date 9/26/17
Property Address . . . . . 2422 PRINCETON AVE
Parcel Number . . . . . . . 31.19.31.518-0000-0600
Application description . . ROOFING APPLICATION
Subdivision Name . . . . . GARDENIA
Property Zoning . . . . . . SINGLE FAMILY
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1003862
Permit pin number 1003862
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 BL03 FINAL ROOF / /
P-
a CITY OF
SkNFORD
FIRE DEPARTMENT
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF AFFIDA VIT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: l l ' ` V ! ADDRESS: 2 I , , r_
1/
6 c 610rd CC 3-7 I I "(,
ot I M Pelnhallmm , AS AM GENERAL, BUILDING, RESIDENTIAL. OR ROOFING
CONTRACTOR, ENGINEER, ARCHITECT,\C* 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 ONF.S. CHAPTER553.844). LICENSE #: Ucobqk
lo COMPANY / CONTRACTOR:
J CONTRACTOR
SIGNATURE: ..
I /Ll = DATE: / 1,dl —/) MUSTBE
SIGNED BY LICENSE HOLDER OR OWNER/BUILDER) A FINAL
ROOF INSPECTION IS REOUIRED: 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 1,0 (2 1-6 Sworn to
and Subscribed before me this _day of 20 / 7 by: 010 rh
n A/7 All a>f1 Who is ITPersonally Known to me or has Produced (type of identificatio as
identification. 41 - ii
Rj'&J8Signatureof
Notary Public State of
Florida 1 a
efi i V /h LaaESD Print/Type/
Stamp Name of Notary
Public