105 Edgewater Cir - BR18-002610 - REROOFCITY OF
SkNFORD
FIRE DEPARTMENT
Building & Fire Prevention Division
PERMIT APPLICATION
Application No: it _ _1 /„ 10
Documented Construction Value:
Job Address: A& Historic District: Yes No
Parcel ID: // 020 -,9 /o -DOUa -/CW0 Residential Commercial
Type of Work: Ne-vi• Addition Alteration Repair Demo Change of Use[] Move El
Description of Work:.Q
Plan Review Contact Person: 1 - Title:
Phone: 32%- tf /— a?3D1) Fax: 3 2j _q 1—a?3/3 Email: 1d h '.J+a n '1 111 •r•eoM
Property Owner Information
r
Name—f! K V...4.,Phone: ff_?t- A'y
Street: q0 Resident of property?
City, State Zip:
Contractor Information
Name Phone:
Street: Fax. 3o71—
City, State Zip: l— 7[.1l 3?ice State License No.: y
Architect/Engineer Information
ivame: Phone:
Street:
City, St, Zip:
Fax:
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 Olt 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: 6rt' Edition (2017) Florida Building Code
Revised: January 1. 418 Permit Application
NOTICE: In addition to the requirements of this pennit, there may be additional restrictions applicable to this property that may be
found in the public records ofthis 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 clone in compliance with all applicable laws regulating construction and zoning.
C pYG1Zi fit,
Signature of 0 —r/A&I
n A'
We
T'
Print Omwer/Agent's Name
Signature or Notary-Statclolslo ridn Date
TRISSA S KELLY
MY COMMISSION 8 GG135698
EXPIRES August 17, 2021
Owner/Age
Produced ID Type ^_ _
444/now" Y_ (0Lle
Signamrt of C itracto gent Daft
J ,
Prini Contractor/Age s Name
JyAa kk
Signature of Notary -State okFIorida Date
a
1L*
s
TRISSA S KELLY
MY COMMISSION p GG135698
y EXPIRES August 17, 2021
00,
4t'•'
Contractor/ VFW[1s ersonally Known to Me or
Produced In o. !D
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electri raE] Mechanical Plumbing Gas Roof
Construction Type: Occupancy Use:
Total Sq Ft of Bldg:
Flood Zone:
Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes[] No
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
of Heads Fire Alarin Permit: Yes No
UTILITIES:
FIRE:
WASTE WATER:
BUILDING:
Revised: January I, 2018 Permit Application
COLLIS ROOFING, INC.
P.O. Box 520668
Longwood, FL 32752-0G68
Ph. (321) 441-2300
Fax (321) 441-2313
Lie. N CCCO58022
Jabs 1a1 354 Date: 5/
30/18 Phone: Attention: Douglas
Lanier E-mail: Job Address:
105 Edgewater Circle Sanford FI 32773 SHINGLE RE -
ROOF SCOPE OF WORK A) Remove
old shingles and underlayment to bare deck and dispose of properly. B) Inspect
existing decking for water damage and re -nail according to code with 8d ring shank nails. C) We
will remove and replace rotten or deteriorated wood as indicated on page 2 of this contract. (Note: Wood replacement is
not included in the total below). D) Collis
Roofing, Inc. will provide all applicable permits. I. Supply
and install code approved Rhino U-20 to deck using simplex nails. 2. Supply
and install code approved Mid -States Ice and Water Sand self -adhered underlayment along all valleys per manufacturer specifications.
3. Supply
and install standard galvalume preformed valley metal. 4. Supply
and install code approved 2 %" galvalume painted drip at all eaves, directly to the deck. 5. Supply
and install code approved 2'/2" galvalume painted eave drip at all rakelgable ends. (D`"ri Color•: 6. Secure
the eave metal with mastic and then apply starter shingles at all eaves with the seal strip at the edge of the roof. 7. Supply
and install Bullet Boot flashings for plumbing and HVAC penetrations. 8. Supply
and install code approved paint galvanized 4' off ridge roof vents OR code approved painted aluminum 10' on - ridge vents
as required (Vent color•:1 9. Supply
and install Tamko Heritage diyjens'onal shingles per manufacturer's specifications and all applicable building codes (Slingle
c_olor: _ ;suei//Y' 10. Clean
up all debris and walk perimeter with a roll magnet. II. All
materials to be installed to manufacture recommendations. 12. Collis
Roofing, Inc. will provide all applicable permits. 13. All
workmanship to be warranted for two (2) years from date of completion of building (Sample Attached). PROJECT TOTAL: $
6,500.00 PRICING MAY
EXPIRE THIRTy,(30) DAYS FROM THE DATE GIVEN ABOVE" Payment Terns:
50% down 50% upon completion' Note - Contractor
reserves the right to retain qualified subcontractors to perform any portion of the work contained herein. To the extent
this provision conflicts with any other provision in any Contract Document, this provision takes precedence, controls and governs.
Respectfully Submitted:
J. Doug Lanier, Collis Roofing, Inc. The above
prices and scope of work are satisfactory and Collis Roofing, Inc. is hereby authorized to do the work as set forth above and in
accordance with the terns and conditions attached hereto; payments will be made as outlined. As Owner,
Collis Roofing, Inc. O ,O 44,0", Date: Approved
By (Sign and 'Print):
THIS INSTRUMENT PREPARED BY:
Name: Autumn McAllister
Address: PO Box 520668 Lonawood FL 32752
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
iii t i titll hill IIIII fill IIII
GRANT MALOYr SEMINOLE COUNTY
CLERK OF CIRCUIT COURT In COMPTROLLER8K9148Ps1s9 (1P9s) CLERK'S : 2018064621
RECORDED 06/07/2018 09:23:30 AMRECORDINGFEES
RECORDED BY lidevore
Permit Number: Parcel ID Number: 11-20-30-510-0000-1280
The undersigned hereby gives notice that improvement will be made to certain real property, and In accordance with
Chapter 713. Florida Statutes, the following Information is provided In this Notice of Commencement.
DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
LOT 128 HIDDEN LAKE VILLAS PH 5 PB 28 PGS 81 TO 83
105 EDGEWATER CIR SANFORD, FL 32773
GENERAL DESCRIPTION OF IMPROVEMENT:
Roof Replacement
OWNER INFORMATION:
Name: JOYCE A and J DOUGLAS LANIER
Address: 907 ARABIAN AVE WINTER SPRINGS, FL 32708
Fee Simple Title Holder (If other than owner) Name: N/A
Address:
CONTRACTOR:
Name.. Collis Roofing Inc.
Address: PO Box 520668 Longwood FL 32752
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 Llenor's 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
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 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.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated In it are true
to theetiest of mMknowledtte and belief.
Owner's Printed Name
13(1)(9); • The owner must sign the noticeof commencement and no one else may be permittedto sign in his or her stead'
C—
State of f -I— County of .?
The foregoing Instrument was acknowledged before me this 3 day of % /. 20 Air
by ' Lyu C gas -7 6 f tL Who is personally known to me 0
Nerhe of person making statement
OR who has produced Identification type of Identification produced:
We. EMELY J THOMAS
MY COMMISSION # 0GO73
L EXPIRES April 17, 2021
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 06/06/2018
I hereby name and appoint: Ray Henderson
an agent of: Collis Roofing, Inc.
Name of Company)
to b,: lawful attorney -in -fact to act fc: me to apply for, rczc:p: 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:
1n5 Edepwater C:ir Sanforij 32773
Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name: J. Douglas Lanier
State License Number: CCCO58022
Signature of License Holder:
STATE OF FLORIDA
COUNT OF ecminole
The foregoing instrument was acknowledged before me this 6th day of June ,
20018 , by J. Douglas Lanier who is KFpersonally known
to me or o who has produced
identification and who did (did not) take an oath.
C42"A
Signature
Notary Seal)
TRISSA S KELLY
MY COMMISSION 0 GG135698
EXPIRES August 1?. 2021
Rev. 08.12)
7r.Y!/d S-cc- e-& lL1
Print or type name
Notary Public - State of _
Commission No.
My Commission Expires:
as
TRISSA S KELLY
MY COMMISSION p GG1356?". •
EXPIRES August 17.2021
City of Sanford
Building and Fire Prevention
Product Approval Specification Form
Permit #
Project Location Address 3a?
As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the
formation and product approval .number's; or the building, components listed below if the; are tc he
utilized on the construction project for which you are applying for a building permit. We recommend that
you contact your local product supplier should you not know the product approval number for any of the
applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in
accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product
Approva; can be cbtainad at www.floridabuildinQ.org.
The following information must be available on the jobsite for inspections:
1. This entire product approval form
2. A copy of the manufacturer's installation details and requirements for each product.
Crlegory / Subca!egory M-nufacturer Produc!
Description
Florida Approval #
include decimal
1. Exterior Doors
Swinging
Slidinq
Sectional
Roll U
Automatic
Other
2. Windows
Single Hun
Horizontal Slider
Casement
Double Hun
Fixed
Awning
Pass Through
Projected
Mullions
Wind Breaker
Dual Action
Other
June 2014
Category / Subcategory Manufacturer Product
Description(including
Florida Approval #
decimal
3. Panel Walls
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles 1..
Underla ments R 3
Roofing Fasteners
Non;'rucW alMetalRoofingWood
Shakes and Shingles
Roofing
tiles Roofing
Insulation
Waier
roofin Built
up roofing System
Modified
Bitumen Single
Ply Reef Systems
Roofing
slate Cements/
Adhesives /
Coating
Liquid
Applied Roofing
Systems Roof
Tile adhesive
Spray
Applied Polyurethane
Roofing
E.
P.S. Roof Panels
Roof
Vents o At. ,. Other
June
2014
Category / Subcategory Manufacturer Product
Description
Florida Approval #
include decimal
S. Shutters
Accordion
Bahama
Colonial
Roll u
Equipment
Other
6. Skylights
Skylights
Cher
7. Structural
Components
Wood Connectors /
Anchors
Truss Plates
Engineered Lumber
Bailin
Coolers/Freezers
Concrete Admixtures
Precast Lintels
Insulation Forms
Plastics
Deck / Roof
wall
Prefab Sheds
Other
8. New Exterior
VYVV V VMNV O
Applicant's Signature
Applicant's Name
Please Print)
June 2014
CITY OF
IFSjkNFORD Building & Fire Prevention Division
FIRE DEPARTMENT Re -Roof Permit Card
PERMIT NO. 01 ISSUE DATE:
CONTRACTOR:
JOB ADDRESS: oS ECIqlewatv,
TYPE OF WORK: R e edw
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
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 . . . . . 18-00002610 Date 6/08/18
Property Address . . . . . . 105 EDGEWATER CIR
Parcel Number . . 11.20.30.510-0000-1280
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . .
Property Zoning . . . . . . . PUD
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1056241
Permit pin number 1056241
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 111 BL03 FINAL ROOF _/_/_
RESIDENTIAL RF_ lfSXKF0RD Building &Fire Pr•evenlinn Division
ROOFPOLICY & PROCEDURES
FIRE DEPARTMENT
PERNIET'TE\C REQUIREMENTS -No PLAN RrvnaY REQUIRED
THIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDIiN'I'IAI. RI Roof SCOPIi OF WORK ARE.
REQUIREDTO BE SUBMITTED AS PART OF YOUR PERMIT APPLICATION.
THE SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALI. ROOF
COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT.
A PL•RN11T WILL NOT BE ISSUED WITHOUTTI IL•SEDOCUMENTS. COPIES wiLI. BE, MADE TO POST ONTHE JOB SITE. PIIOJFCI'S
LOCATED INTHE SA\FORD HISTORIC DIS'I'RIC'f WILL REQUIRE PLAN REVIEW ANI) APPROVAL BY TIIE 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
REQUIREDTO BE PROVIDE ON THE JOB SITE: PERMIT CARD, POSTED IN
A CONSPICUOUS AND WEATHERPROOF LOCATION COMPLETED RESIDENTIAL RE -ROOF
SCOPE OF WORK c CC:.:. LZTED AND
NOT.i:.IZED INS, Z0T,0., i.i•FII)AVIT ALL FLORIDAPRODUCT APPROVAL
AND CORRESPONDING INSTALLATION INSTRUCTIONS PRODUCT APPROVAL SHALL MATCH
WHAT IS ON TIIE SCOPE OF WORK) DIGITA! P!!nTC'17-
PAPEIS (MUST' I!,!Cl.i in-r. TI.IF PFa.NA!T Ni IMnl:l .OR ADDpt=cc IN r_ ACH PICTURE) o EACH PLANE OF
TI IE ROOF, SHOWING THr_ 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
ATI'ACI•IMENT (INCLUDING A MEASURING DEVICE OR RULER) o SHINGLES INSTALLED, NAIL
PATTERN AND LOCATION OF NAILS SKYLIGHTS (IF APPLICABLE) o
DIGITAL PHOTOGRAPHS SHOWING
ALI. INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL o DIGITAL PHOTOGRAPHS SHOWING
ALI, REQUIRED FLASHING, PER FI, PRODUCTAPPROVAL FAILURF TO FOLLOW TIIFSE SPI,'
CIFIC CUIDEI,1\ES WILL RESUI;1' IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN PROFESSIONAL (ARCIIE'I'EC'1'
OR ENGINEER), CrRTIFYI NG FBC Com.: CON II'LIANCE BY PERSONAL INSPECTION. CONTRACTOR (OR OWNERIBUII.DER) SIGNATURE: n
1Z4(L DA'I'L•: -='-r vi l8
Y OFSXNFORD
FIRE DEPARTMENT
PERMIT #
Bitilding & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: ZQS— 69 f, 06?77
STRUCTURE TYPE: SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME Q APARTMENT/CONDOMINIUM
RE-RooF TYPE: gRr.-Covr-R
REPLACEMENT' (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW CONIPO\ENTS)
NEW ROOF INSTALLED OVER EXISTING ROOF)
DFcK Tl'PF (PLEASE SPF.CII'V):
P/.F.ASF. NOTF. on), 100 SQUARE; FF.F.T OF THE F. xisvivG DECK IS PF.RdATTF.D TO RF. REPLACED **
ROOF VFNTILATIO\: OOFF-RIDGE RIDGE QSOFFIT OPOWERED VENT 0Tl1RDINr:S
SKYLIGHTS: Q YES (CNO IF YES, LEASL' PROVIDE FLORIDA PRODUCT APPROVAL#:
MAIN ROOF AREA
ROOF SLOPE: Q LESS THAN 2:12 O 2:12 -4:12 12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
HINGLE Q tQ FL# 3
Q METAL FL#
Q MODIFIED BITUMEN FL#
OTORCH DOWN FL#
O INSULATED FL#
QTILE FL#
O'I'l1ER:jp,"/ S 1 FL# 507
ROOF EX'1'F.\SIO\S (PORCHES. PATIOS, E'TC.) **IFAPPLICABLE**
ROOF SLOPE: Q LESS TITAN 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#
QTORCH DOWN FL#
Q INSULATED FL#
Q TILE FL#
00THER: FL#
On
CITY OF
it &ANFORD Building & Fire Prevention Division
RESIDENTIAL RE-ROOFAFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMrr #: 18-2610 ADDRESS: 105 EDGEWATER CIR
I J DOUGLAS LANIER , 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 #: CCCO58022
COMPANY/CONTRACTOR: COLLIS R O jING / J DOUGLAS LANIER
CONTRACTOR SIGNATURE: DATE:
MUST BE SIGNED BY LICENSE HOLDER O OW BUILDER)
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 OFTHE ROOF SHOWING IN DETAIL ALL COMPONENTS (DECKING,
UNDER LAYMENT, 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 SEMINOLE
Sworn to and Subscribed before me this 1O day of `&, Z 20 /R'by:
J DOUGLAS LANIER Who is XPersonally Known to me or has 0 Produced (type of
idetion) as identification.
jAAj
Signature orgota6WbKUTRISSAS KELLY State
of Florida ='• TRISSA
KELLY Print/
Type/Stamp Name of
Notary Public MY
COMMISSION # GG135688 a".'
o EXPIRES August 17, 2021