122 Lindsey Way; 18-3772; RE-ROOFj CITY OF SANFORD
2018 BUILDING & FIRE PREVENTION
e _ PERMIT APPLICATION
R -
A
Application No: 3
Documented Construction Value: S
Historic District* YesJobAddress: No
voT Parcel
ID:-- iq --?-o' t Residential Commercial Type
of Work: New Addition Alteration Repair Demo Change of Use Move Description
of Work:. 1 60 Plan
Review Contact Person:2 Title:-YiC Phone:
Email: 'A Property
Owner Information'' NameRY!
A1Aq-C-rX,Phone: 0-7 -(_pS-__ -77R-7CKC0_ Street:
Lin Resident of property? mpuq City,
State Zip: 1D Contractor
Information Name
Phone: Street:
I 12f • Fax: City,
State Zip• I h State License No.: Architect/
Engineer Information Name:
Street:
City,
St, Zip: Bonding
Company: Address:
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: 5` Edition (2014) Florida Building Code Revised:
June 30, 2015 Permit Application
r
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 com liance with all a plicable laws regulating construction and zoning.
0(4 - IB
gnatu o wnedAgenY Date Sig tore of actodAgent Date
Print OxvuerfAcent's Name Print
t Z 0 (Q`
gAF1)(jEL MOv 17 u
MY COMMISSION # FF953572
EXPIRES January 25. 2020
is Name
State
zo v1
SAIMUEL MOOTY
MY COMMISSION # FF953572
EXPIRES January 25. 2020
14C /13YtlV'° 14C/19Y6-0':13 PIOiMnNotaNSMylc°.L0n'
Owner/Agent is Personally Knolyri to Me or Contractor/Agent is k Personally Known to Me or
Produced ID Type of ID Produced ID Type of ID
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:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
Grant Maloy, Clerk Of The Circuit Court & Comptroller Seminole County, FL
Inst #2018101433 Book:9204 Page:812; (1 PAGES) RCD: 9/5/2018 12:19:45 PM
REC FEE $10.00
INsTFi ME __PARED 13YI
Nome;
AdEIrQsB. -
1.- - - — —
NOTICE OF COMMENCEMENT
Permit Numben
Parcel IB Numh@n
CERTIFIED COPY
CLERK OF THE CI
SEI)OINOLE
8Y
GRANT MALOY
2UIT COURT
Y FLORIDA
AFWY CLERK
The undersigned hereby give§ WIG@ that impr9v@ment will be made to certain real property, and in accordance with Chapter 713, Florida Statute§, the
following information I§ provided in thia N94ce of Commencement.
1. 9ESCRIPTIQN OF PRQPERTY; (Legal de§cription of th@ pmporty and oyeet addre§§ if availablA,
2, 4i€QE,AQP€fR IP-TIoN 4F IMPROVEMENT,
3, OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTEB FOR THE IMPROVEMENT;
Name and @ddr@@e Mike Arm.gA RO, Box 950424, fake Mary 02725=0424
Interest in property:
Fee Blmpl@ Titl@ H914er (if other than owner IWO @b9v@) Name:
4, Phone Number.
Addre§§. 16100 W, 9-gl4nial Dr:, Winler Garden 34707
b, SuRETY (If @ppllc@ble, @ copy 9f the p@yment pond 1@ ntt@ched); Name: ----
Address: Amount of Bond!.
s, LENeER; Name: Phone Numb@r
7, P@rs9nc within the St@t@ 9f Floridn 4egign@tad by Qwn@r upon whom notice or oth@r documenlo may b@ @@rve<! n@ provlded by Sectl9n
713,13(1)(a)7., Florida St@tut@@,
N@m@: Phone Number
A49mm;
e, In @ddiIIQn, Own@r design@Ie§
19 r@9@Iva a copy of the LI@nor'@ N9ti9@ @§ provided In Swtign 713.130)(0), Florida Statut@§. Phone number;
@, €xpir@tlon Date of Notice of Commenc-@m@nt (Th@ eI(pir@ti9n 1§ 1 year tr9m date of recording unl@§§ a different date i§ spNhl@d)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EKPIRATION OF THE NOTICE OF CCMMENC€MI NT ARE
GON51DER€B IMPRQPFR PAYMENTS UNDER CHAPTER 713, PART I, SECTION 71313, FLORIDA 5TATUTE5. AND CAN RESULT IN YOUR
PAYING TWIG€ FOR IMPROVEMENTS To YOUR PROPERTY, A NOTICE OF COMMENCEMENT MUST B€ R€CORDED AND POSTED ON THE
JOB SIT€ BEFORE THE FIRST INSP€OTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT,
Sigpal - Brc-v-mQ, Ce ,e o 9yyrfe's o esaee•g
AulhehW Office(/§ e,_ ., !p@ftrtepltenaper)
Print Name =n9 Preri98 sign.4mrys rtrarorfi
State of County of
G jz_1 ,
L _
Th@ 19reg91ng In§trument was ackn9wl@dged pefor@ m@ thl>e T day of -
by mr t- R r S U a °) - Who I8 p@rnon@lly known to me o OR
ar" P2rso_n rytakiflg s(ateTent
who heo pr9duce9 id@ntlfication I?'Eyp@ of 19enfifica419n produeod;
E
AMUEL MOOTY
OMMISSION p FF953572
IRES January 25. 2020ZFbrrMWoay +ro c
CITY OF
ORDBuilding & Fire Prevention Division
RESIDENTIAL RE-ROOFAFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ADDRESS:
PD3 k--p— 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 'FHE ROOF DECK, IN ACCORDANCE WITH THE HURRICANE RETROFIT
MANUAL REQUIREMENTS (BASED ON F.S. CHAPTER 553.844).
LICENSE 9: TDC l
COMPANY / CONTRAC-
CONTRACTOR SIGNAT
MUST BE SIGNED BY L
rOR: '-A
qq
URE: DATE 7/1y
ICE & ER OR OWN R/B ER
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 ov"5;;
Sworn to and Subscribed before me this. day of SL°2!4!nji . 20 (f by:
f 4 J. Who is-+: ersonally Known to me or has Produced (type of
identifica ' n) as identification.
Signat@re of Notary Public
tate of Florida
SAMUEL MOOTY
Print/Type/S amp Va e 'AofNotaryPublic
MY COMMISSION # F5953572
EXPIRES January 25. 2020MN,.
44C 0 j9"'FIorK1alloca'vS0rV1c0- Orr
CITY OF 1
PERMIT 31 '1 6SA&FORD
Building & Fire Prevention Division
FIRE DEPARTMENT RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS:
STRUCTURE TYPE: SINGLE 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): LA 2- i l
PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED"" >F7 A
ROOF VENTILATION: OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES I No IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 212 - 4:12 O 4:12 OR GREATER
OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
7TYPSHINGLE 1'l FL#
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
O INSULATED FL#
OTILE FL#
OTHER: i_L I..FL# l
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#
OTORCH DOWN FL#
O INSULATED
OTILE
FL#
FL#
O OTHER: FL#
i7NP -,J C-s NN ter(_ - /ZI -d.1y - vle l-r
y
prapa$a1 RC 29027533
IZ NtP
Magnolia Avenue15100WestColonialDrive920Ma9
Winter Garden, Florida 34787 Auburndale, Florida 33823WESI' ORANG407-656-8920 863-965-8920
ROOFING
Serving Central Florida Since 1978
PROPOSAL SUBMITTED TO: PHONEa,0.?_ 687-5'7$ II
DATE Q /1 /f gv
NAME j, r A ASU Jh
JOB NAME
STREET ^
ri'fhK-
STREET
V
CITY
STATE :;7 -L' -7 STATE
e*44,i L : M k ke, - coves%
We hereby submit specifications and estimates, subject to all terms and conditions as set forth hereof, as follows:
ITEMS CHECKED
Remove old roofing_ Install new gravel -stop - galy_ alum_ copper!
Install new felt - 1 "fb._ 344). C*MIx)i'EV-p (ZI00V-' RU1314 i2 ElInstall new metal roof- color_ gauge_
TI Install new eve -drip - galy_ alum_ color copped} LYJ Install new shingle - fiberglass_ other 694tVWT
J VrStInstallnewvalley -metal_ gale %/ alum_ er4 L +S Yl Haul away old roofing and materials
S1 tG6GVInstatlnewleadbootsk —7; "
I 1 0-2 l' Q/ Clean up grounds
Install new range vent cap _ R.eroof over old roofing
NI Install 4 ft. off ridge vent 2 number of vents_ ow-4-perorr t S_ Install insulation board - type size
Install ridge vents_ number of vents_ color_ cost per vent S_ Install new skylight - number type size
Install new flashing - wall_ chimney_ Other (ZV NOAI L- RbOqr- DSMI NC1 TO HE€r
Rework flashing - wall_ chimney_ LU 04t-i'74 T G D Dom,
Reinstall existing ventsMt1JE a w Qt •i NT',orN R- vQiK
Install roll roofing - color_ MFG warranty - number of years '*O
Install build-up roof - number of plys_ fiberglass_ organic_ S/ Workmanship warranty - number of years "07 '44ZS.
Install rock - river rock_ color_ slag_ other_ El Extra cost, wood repairs - labor per man hour $ plus
Install bald -top roof with fiberglass felt - plys_ coating_ materialsLam^ Approximate cost for wood repairs $S SHT / lVVIL^ AWM Install
one ply system - coating color 2
X 4 3 A-99 Or- PL4w001VtM;C K1*I ntGLLAQ 0V 11 f-iUCV, fb4t \A100V t & Arm'
L- 2 -C Act 'f7Er.>. 60Ja14 JJrapiise
herebytfitisItmaerialandlabor -complete in accordance with above specifications, for the sum of:+14e 1 tf0U5At4Q T (tp
Q
j 1 jJ Ef dollars (S 151'14q2. — Note: This proposal in be withdrawn by us if not accepted within days. Authorized Signature
a C1rUpt$:
Theabove prices, specifications and conditions are Date: satisfactory and
are hereby accepted. You are authorized to do the work as specified. Payment
will be made when repairs are completed. Signature: West Orange
Roofing is not responsible for damaged or cracked driveways. Signature: _ CONDITIONS All
material
is guaranteed to be as specified. All work is to be completed in a workmanlike manner according to standard practices. Any alteration or
deviation from specifications involving extra costs will be executed only upon written orders, and will become an extra charge over and
above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado, and other
necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance.
CITY OF
Building & Fire Prevention DivisionSANFORDRESIDENTIALRE -ROOF POLICY & PROCEDURES
FIRE 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 UNDERLAYM ENT 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) SIGNATUR DATE: \
I
Ly I
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: Ck
I hereby nal
an agent of:
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 wor located at:
12- t 1 kLl_
Street
Expiration Date for This Limited Power of Attorney:
License Holder Name:
State License Number:
Signature of License H
S I A I L M rLUKIUA
COUNTY OF Q
The foregoing instrument wa1=hd
owledged before me this Yday of ,
200 9 , by o who is personally known
to me or who has produ d
identification and who did (did not) to an oath.
1 re
17 rytARUEL MOOTY
c MY COMMISSION tt FF953572
EXPIRES January 25. 2020
y3 FWKWNM'VSawka.:pn•
Rev. 08.12)
Print or type name /
Notary Public -State of 61 6 4 4 C
Commission No.
My Commission Expires: q Z Cl Zs-Lo
2E
CITY OF
fZoANFORD 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 #: ( ADDRESS: 1 -?
I1 '"- AS
A(N) GENERAL, BUILDING, RESIDENTIAL, OR ROOFING
CONTRACTOR, ENGINkER, .ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF I -HE 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 FLORLDA 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
4: _)2L COMPANY" /
CONTRACTO CONTRACTOR
SIGNATUR MUST
BE SIGNED BY LIC R: -
e5z ov 1 E: - - -
i" - DATE: ! Z- I EN
OLDER O OWN . ' U _ R 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
NVITH DIGITAL PHOTOGRAPHS OF EACH PLANE OF THE ROOF SHOWING IN DETAIL ALL COMPONENTS (DECKING, UNDERLAYM.
ENT, FLASHING, DRIP EDGE ATTACHMENT) WITH THE PERMIT NUMBER OR ADDRESS CLEARLY NLARKED 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 r': Sworn
to and Subscribed before me this ay of 20 by: Who
is Personally Known to me or has Produced (type of identifi
v as identification. VSig
natureof5NIublic Flo
Moo' ::
v.'"JL t;<: SAtyIUEL M001'Y Print/
Type/Stamp Name MY COMMISSION # FF953572 of
Notary Public !n.w,, EXPIRES January 25. 2020 14Cto
348-0153 FbrKUNmayScrv'ce. con-