120 Hays Dr - BR18-003063 - REROOF9k, V CITY OF SANFORD
OBUILDING & FIRE PREVENTION 8Y
i2 all PERMIT APPLICATION a'
ApplicationNo:
Documented Construction
Value: S `0 , 9 UO . °" Job Address: /
a'Z.( HMy S' b 2 . •1'G,..,(.o / Historic District: Yes No Parcel ID: 5_ /
9 30 • 5.5 • n.9 0 O . 0 O 3 a Residential Commercial Type of Work:
New Addition Alteration Repair Demo Change of Use Move Description of Work: ',
c.Op Plan Review Contact
Person: Q Title: O
W
Miz:2 f Phone: ' 31Z
Fax: 7' 3LZ' 15 1i Email: (;c>Gcr1' t n ScLtT >, . r'e Itn,, Property Owner
Information
Name /`[ A 12c
i C 1ez O-/N S dtil Phone: 4/0 %• G S; 7. 9 Street: Id- D
11-1.+. k/ Si D /I Resident of property? : S City, State Zip: '
C 3 J-2 -7 / Contractor Information Name
Phone: LA
03 ' 3 Jul - ti !1 Z Street: P 0
L'-, Fax: *,-I L 7 ' 3_)__ 5 012— City, State Zip: <
a1=62ruo . ->!L, State License No.: Ui Architect/Engineer Information
Name: t\J /-
I)t Phone: r'J L\ Street: City, St,
Zip:
Bonding Company: N
A Address: Fax: E-
mail:
Mortgage
Lender: !\i
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 certifv that no work or installation has commenced prior to
the issuance of a permit andthat all work will be performed to meet standards of all laws regulatingconstruction 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: 5iDEdition (2013) Florida Building Code 0 - Revised June 30,
2015 Permit Application 1 'Jn 1
k
NOTICE: In addition w the requirements of this hermit. there m3• be additional restriction, applicable to this prt)pem that ma.- be
round in the public records of this county. and there ma\ be additional permits required from other governmental entities such as -water
m3naucmettt districts, state agencies. or lcderal agencies.
Aeceplance oi'permit is \eritication that I \%ill notii', the r%tner of the propem ofthe requirements ol'Florida Lien Law. FS 713.
The chit% ofSanford requires payment of a plait re\ icw ice :it the time of permit submittal. A copy ofthe executed contract is required
in order to calculate a plan review charue and \%ill be considered the estimated construction \aluc of the job 31 the time of submittal.
The acutal construction value \%ill be Inured hared on the current ICC Valuation Table in ellcct at the time the permit is issued. in
accordance \kith local ordinance. Should calculated char2cs fieureci off the executed contract exceed the actual construction value.
credit %\ill he applied a) %our permit fees \khan the permit is issued.
OW"NER'S AFFIDAVIT: I ce
be bone in comMittnce with all
at all of the foregoing information is accurate and that all work will
able laws regulating construction and sorting.
I _K+ner:Agent . Inc
tg r Mary -Stu, '1710.1 ;t Date
ED— DONAID RASH
Notary Public - State of RondaCommission1. FF221706
OwneriA lmits •?':iiuZ't c9i : or
ProducedI. p o
Signature wl'Co 01 ALOit Date
o nn-eJ
Print'Cont t . :+roc
Sign,., to of No - tutc of Flo. da Date
DONALD RASH
Notary Public - State of Florida
Commisston t FF 2217026
Contras j
MYCctna+er lonaif 6:no to ate or
Produced 1 pe oT I
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type: Occupancy Use:
Total Sq Ft of Bldg: thin. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes[] NO of Heads
4.
APPROVALS: ZONRNG: UI'II..ITIES:
ENGPNEEItING:
COKMENTS:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire alarm Permit: Yes \o
1WASTE WATER:
BUILDING:
Roiwd. Junc 3+!. 2015 Pernal Application
Nk i i It_!" In .1"
und in the r*.*cor,: courw.. an ; 'J'ic-v 'he jj-';iit):i-' r,*qvirt,,; IN-M)" is N%nw-
or
A w rcrnii I;, • c, i*;,-.,,d;-,n I nk)(Wx thic (w. a,f :a%: prt,--.7v;t, tnv r.,,,wrcrevn! oI* F"orid- :c:i I -av- F S 7 1
r*.:%jutrcs pa.% incin -v :i ie\% ;e, as lh,: o, nef.-Iii :ort (,)fthe executed contr-:i ;I.N required
nIan -v-, 1.11 .hztrb-- T lbe tht: :.,tirnawk! 4ivc w' the -d-w tirne w' atibntilttad,
L.c \6H be 1; bt,ci the 1(-'.( ' V.d..."Itivil Tw)le in --he thne !hv pvrini-, k i.s.,uej. IR
wt:i.,rdIncQ ltllh vrdilnzancv. 4 Cl: ):: :'-,: v.\.kvated conirac* %:,wvvd ;he joual consir;:viion \:,iue. L
Clit .,ili h -I)PIi;:J tvur pcirgiti: hvii the pvrmi: i, I V!, -: L I ,
OWNEWSAFFIDAVIT: I. ceriif\' al all of the foreaoin2 information is accurate and that all work will be
done in compliaince %viih inflicable IaN s regulatin.2 construction and iinlg. DONALDRASH
Notary
Public - State of FloridaCommission
I FF 221706 PUZmyComm. Expires Apr 16,2019 Ov.
Tersonif—F. to \+e or Produced
ID T, m, o!" I D DONALD
RASH Notary
Public -State of Florida Commission
I FF221706 9
MyComm. Expires Apr 16, 201 CLNW.
r:i:Ior-Aveni is .-.- Per-S011311y Kno,,,.:i*j to N-Ie or ProduccJID.-
BELOW
IS FOR OFFICE U;SE ONLY Permits
Required: Building F-Jectrical [] \le,:hanical 0 PlumbingyFi Gas1-1 Row-F Construction
Type: Occupancy L se: Flood Zone: Total
Sill Ft of Bldv: Alin. Occupancy Load: = ol'Stories: Nei%
Construction. Electric - = iit'Amps Plumbing - # of Fivures, Fire
Sprinkler Permit: Ycso \,)El :, of Head;, Fire Alarm Permit: c,; 11 \o APPROVALS:
XONING: F'
NG 1',\ c E j i \ (,,: C
ON,] NI E N TS: T
II . IT I E. S: i
I k 1-,: WASIT
WATER: 131.]
LDING:
T141S INSTRUMENT PREPARED BY:
Name: ADCOCK ROGF NG AN-DY ,%r.%K
Address: _°CO S.7J-,7! H H; - _ -- -
FL
NOTICE OF COMMENCEMENT
Permit Number -
Parcel lD Number _ 35-19-30-522-0600-0030
e a^ar:c.; :rd' Cam; 3 ves -1cM_ tha:. rueo. ,, ,er::.•n.:i .•C : 3rg :c coca::; mv• .&-y ar`. Ir. 6,{0:4o-.Cc rn:?' Thal+:c' '13. =:C' :a Jla:. Igo, .,r. Lnu:.;;r IS LrOvCed ir. 11,s N::ICe Cr Cmr.,gnC«n•I;:
1. DESCRIPTION OF PROPERTY: •.Lega; I^C r: ;;er,; at— 51 ! r:: a-X'ass •f ava ate. 120 Hays Dr Sanford. FL 32771: I_3 3 Cot;IVT/lr/ LA Mq-"C;4• V PJ 3
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Re -Roof
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name a:.j ac::ess M3-cie Robirmon• '2C.F_iays D. Sanford. FL 327'?
I.1%.rest'1c:'.pery Owner - —
Fee Simple Title Holder :.f !:;SFr inar -
Aar.' ess "
4. CONTRACTOR: ,*sma Adccck Rccflnr — F —
Aacress 600 S. Frer. IT Ave -
a'e s?-322-9556
c. e . Santoro. FL 327"1 _...
S. SURETY fit applicable. a copy of the payment bond is anachedl::.
Ess
6 LENDER: Name
G Jres$ — -
7. Persons within the Stale of Florida Designated by Owner upon whom notice or other documents may be served so provided by Section713.13(1)(al7.. Florida Statute$•
Acd, ass
8. ..iv ner 1E'31 na1E5
vea_aC: .'CI'm'S '`.C,:;$as
Ci.:aaon Ca:e ' !V.' ' ::Jlr.":e"ta^.'a••.1 . ^.e rtC ., S ^ .. .,., --• .. ._ a: i..a• =oi^ :e^.a :.ny :rSc ri:1• .0 l`•,: aa'a
C ^45_o ANY 'J V•It `.ij isA C e' - _•: :'S AF'CR --,_ XCr:EIDERF0:R1PtmJREP• PAY. .L'47S iN:;tn r ,i.e+TER 7 V.RT
I+:F.T''h i T.: N:ji.vE ,= C7r.1f1.C+E•'.'ETtiT APE
FfYIN, TYV:CE FOR I•,1?,i0vE-P. EN- i , ;Fa , . - _-
SFt'I'ON 13 t) FL OR11,:• STtiTU-ES AND CAN REStj:r :N YO,Jp
03 S TF. 8EFORE = F'RS? IN - on• - =` '' :
L L :°L'S' iF 4"t vP,DF • :•
AN /.
7 C•ti'H_
3Er0Rc C 1 .}trJ^..•-
EC i('iNGIF Ire c't_ -- .r,.:':r 1..•: ,:' !'V 'vCt'_- .. Fri t':'•:R LcPi:1E- OR AN I•? T ,P'.lE:
State of f Y ( N County of, M i vtw,L
The foregoing instrument was acknowledged before me this _ t Y da cf 1
n y . 20 1
by L e ` \0 %.,ay L11 Who is personally known me.-' OR who
has produced identification,_ type Of identificalon produced: 77
y C'•KS:'= :ail ):,'r GRANT
MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK'
S # 2018072992 BK 9160 Pg 0349: (1pg) E-RECORDED 06/25/2018 03:38:05 PM
ADCOCK ROOFING
800 French Ave. Sanford, FL 32771
407) 322-9558 * (407) 330-9333 (Fax)
adcockroofingl@bellsouth.net
www.adcockroofing@bellsouth.net
December 5, 2017 ESTIMATE
Name: Marcie Robinson Phone: (407) 687-9461
Address: 12 Hays Dr. Cell: (407)
City: Sanford, FL 32771 Fax:
Email: marcie32771@yahoo.com
SCOPE OF WORK: COMPLETE ROOF REPLACEMENT
1. Remove old roof on complete building.
2. Re -nail decking as per new building code.
3. Dry in with new layer of synthetic underlayment as per new building code (July 2015).
4. Install new 30 year architectural shingles.
5. Install new drip edge; 26 gauge, painted galvanized.
6. Install new kitchen and bathroom vents.
7. Install new lead flashings on plumbing pipes.
8. Install new ventilation to match existing.
9. Secure all permits.
10. Clean up & haul away debris.
11. Inspections included.
Labor & Materials: $10,800.00
Extra — Bad wood: Time & Materials - $70.00 per sheet plywood; 2 x 4 and fascia - $4.50 ft.
Warranty: 30 Years on Materials from Manufacture
5 Years on Workmanship
Andy Adcock, Owner
Andy Adcock
ADCOCK ROOFING
800 French Ave. Sanford, FL 32771
407) 322-9558 * (407) 330-9333 (Fax)
adcockroofingI@bellsouth.net
www.adcockroofing@bellsouth.net
December 5, 2017
Name: Marcie Robinson
Address: 12 Hays Dr.
City: Sanford, FL 32771
ESTIMATE
Email: marcie32771@yahoo.com
SCOPE OF WORK: COMPLETE ROOF REPLACEMENT
Phone: (407) 687-9461
Cell: (407)
Fax:
1. Remove old roof on complete building.
2. Re -nail decking as per new building code.
3. Dry in with new layer of synthetic underlayment as per new building code (July 2015).
4. Install new 30 year architectural shingles.
5. Install new drip edge; 26 gauge, painted galvanized.
6. Install new kitchen and bathroom vents.
7. Install new lead flashings on plumbing pipes.
8. Install new ventilation to match existing.
9. Secure all permits.
10. Clean up & haul away debris.
11. Inspections included.
Labor & Materials: $10,800.00
Extra — Bad wood: Time & Materials - $70.00 per sheet plywood; 2 x 4 and fascia - $4.50 ft.
Warranty: 30 Years on Materials from Manufacture
5 Years on Workmanship
Andy Adcock, Owner
Andy Adcock
CU'STCfR NAME: MATERIALS DATE: ADDRESS:`
CITY:
ZIP:
HOME PHONE:
WORK PHONE; v
CELL PHONE: <` .
FAX: ` ,
J tilll G G C.
EMAIL ADDRESS
2S YEAR SHINGLE
30 YEAR SHINGLE
SQ:
PITCH:
L
MODIFIED (FLAT)
SQ:
PITCH:
CHIMNEY. YES NO
DRIP EDGE - YES NO
NOTES:
SKYLIGHT (S) . YES NO
TOTAL $
r
EOLEAGLEVIEW
REPORT DETAILS
QuickSquareSTM
October 19, 201.7
Roof #1 Area: 23 Squares •
Predominant Pitch: 5 100% .
This report includes up to two structures on a residential property and one structure on a multi -family property. The pitch °,," .4°
has been factored into the calculation with no waste. Please upgrade to a Premium Report to receive measurements for
additional structures and for any lower roof areas that may be obscured from view in the top -down image, as they are not Satisfaction Guaranteed
Included in the totals on this report. www.eagleview.com/Guarantee
Upgrade Your Report!
QuickSquares is a report used to estimate the overall size of the roof; for material -ordering accuracy, contractors should
upgrade to a Premium Report. The price of your QuickSquares report will be deducted from your upgrade.
A Premium Report includes:
3D Roof Diagram • Length Diagram • Area Diagram
Aerial Images (Top, N, S, E & W) • Notes Diagram • Pitch Diagram
Waste Calculation Table • Report Summary • Customizable Report
Square Footage Pitch Table
ccD 2008-2017 Eagle Yew Technologles, Inc. and Pictometry Intenrat—al Corp. - All Rights Reserved - Covered by one or more of U.S. Patent Nos. 8,078,436; 8,145,578; 8,170,840; 8,209,152; 8,515,125; 9,183,538; 8,818,770; 8,542,880; 9,244,589;
9,329,749. Other Patents Pending.
EAGLEVIEW
0,
REPORT DETAILS
QuickSquares"
October 19, 20417
Roof #1 Area: 23 Squares ."
Ad.
s
Predominant Pitch: 5 1000/o
This report includes up to two structures on a residential property and one structure on a multi -family property. The pitch C44 IAM O
has been factored into the calculation with no waste. Please upgrade to a Premium Report to receive measurements for
additional structures and for any lower roof areas that may be obscured from view in the top -down image, as they are not Satisfaction Guaranteed
included in the totals on this report. www.eagleview.com/Guarantee
Upgrade Your Report!
QuickSquares is a report used to estimate the overall size of the roof; for material -ordering accuracy, contractors should
upgrade to a Premium Report, The price of your QuickSquares report will be deducted from your upgrade.
A Premium Report includes:
3D Roof Diagram a Length Diagram • Area Diagram
Aerial Images (Top, N, S, E & W) • Notes Diagram • Pitch Diagram
Waste Calculation Table • Report Summary • Customizable Report
Square Footage Pitch Table
r 2008-2017 Eagle View Technologies, Inc. and Mdornetry International Corp. — All Rights Reserved — Covered by one or more of U.S. Patent Nos. 8,078,436; 8,145,578; 8,170,040; 8,209,152; 8,515,125; 9,183,538; 8,818,770; 8,542,880; 9,244,589;
9,329,749. Other Patents Pending.
CITY OF
Ski!4FORD Building &Fire Prevention Division10RESIDENTIALRE -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 WEATH EIRPROOF 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 PATI'ERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
o DRIP EDGE & VALLEY A17ACI-IM ENT(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: v DATE: &, a a . -wi g-
CITY OF
SkiI4FORD
FIRE DEPARTMENT
JOB ADDRESS: 0100
PERMIT # /8' 3 06 &
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
STRUCTURE TYPE: SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME
CL 3 17
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): I ` t1 JQ L Sj W b
PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EX TING ECK IS PERMITTED TO BE REPLACED**
ROOF VENTILATION: DOFF -RIDGE O RIDGE OSOFFII' OPOWERED VENT OTURBINES
SKVLIGIITS: O YES O'NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 -4:12 (D-4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
Q'SHINGLE FL#
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
O INSULATED FL#
O TILE FL#
0OTHER: FL#
ROOF EXTENSIONS (PORCIIES, 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 FL#
O TILE FL#
OOTHER: FL#
THIS INSTRUMENT PREPARED BY: •
Name: ADCOCK R0GF: vG'- ANDY MDCO CK
Address: 8v6 S.:RF!,CH H; E. ---. --"-"
M-P0QD. FL 32?,
NOTICE OF COMMENCEMENT
Permit Number -
Parcel ID Number: _ 35-19-30-522-0600-0030
ie-j^dtrs,^,•:ed ,06 ,1cf-e tha: ;•n;P:p;?nlen1 rn:l C-C ; .3Ce :: ;x:;a:a r?.::: Ste$'- a^ tf. a;te:da":e r:Gh. tl :o• '`1' , r
v„'n ^/MTot•Cnis is Croy.ced h, Ih•s Nz C 'r aC d. %:G' .JB Sla:.: es.:!1r,• Ice cr , omrsCzn•ct::
1. DESCRIPTION OF PROPERTY- •._ega; oetawt -a a+ I,c at e-p ar, srFca ,+::U•tas ! avarat e120HaysOrSanford. FL 32771: 1I_'3 3g C-oulyT2'/ M 4L
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Re -Roof
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Narre a:•J aUe:ess M3-Cie Robinson. '20 Hayti Dr. Santoro. FL 327?1
In:::es: , p::pery Owner
Fee Simple Title Holder ,J r;her tnar.:,,nP• s:t aoe.e• :oaTe
Awes&
l... ,_- —_-. Fr.a-•e r.:: a ._=07-322--9558d. CONTRACTOR: •:ante AdCCCk RCafl c
aacress 800 S. French Ave . Sanford. FL 32771
S. SURETY (if applicable. a Copy of the payment bond is attached): N*a-•e
6. LENDER: Sian e' hire 1:1iMper.
Adores$ —
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents may be toned as provided by Section713.1301(a)7.. Florida Statutos. game•
Address
S. '
n ao_:aon. 0%ner dcstgnaie3 tl- a:
c:e,vea:0C)C,!: :acnlr'sN.Ca;eas:1 iL':1:,'-t3 :•'•;o t oa S:a;t.tes crane -v"ber -•-_ _ c
vt • f:; :e:a••:•ny Jn:ess a 9•'12•crr: da:? is 6aett`,e0! i'•''':
r !'r" .`,.'r'i= ANr !•v Tr•E AFTILR --+C i-XI+:R:.-t•.1N i; T,iF W,)i;CE OF COMMENCE•':tN'T ARE 3CNE10ERED !41PROPEP PAY61EN S ;;N:.EFi C• ,APTER 713 PART SFi 1-014 713 13 FLORIDA STATUES AND CAN RESULT :N YOU'* PAYINGTVvlCEFOR 'e-IPRO:rE 1; F.N • S 10 'f'O:Jk PRC rPER7 v r, NC - fr ' ? :!L1E+.1 _L:FK'. : L* 7 IF. 4E _OP•CFC- r•N7 P!; jT CD ON THE 03SITFBEFORETf•,C F:FZST IN$aEC-IC?i IF •Ifs Fft_• r t:?; r,: ¢. 3ErJRc
C011!.fe'rCl!: a :17?t '-+7 R=_Ca.t? \G' CuR \'''' 44E ::R
LcN;:E6 OR AV !• TvR:JEv Co
J L,
State
of C71rj.117 A County of P n t 4A.4 ti The
foregoing instrurnent was acknowledged before me this I_ day of - 20 D by
a rV V Who is personally known me OR who
has produced identification's type of Identifrcal,on produced: ••. ram:
0C%3 :/SH WSte# *
1--tee- =
Ks : e :: 2„ 7M. F
c.:rosa7r'520:9 GRANT
MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL CLERK'
S # 2018072992 BK 9160 Pg 0349; (1pg) E-RECORDED 06/25/2018 03:38:05 PM 10.
00
CITY OF
S ORD Building & Fire Prevention Division
RESIDENTIAL RE-ROOFAFFIDAVIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: D . ADDRESS: /.L O 6 10e- .
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 ALI, APPLICABLE CODE
REQUIREMENTS — SPECIFICALLY FLORIDA BUILDING CODE, EXISTING BUILDING. IN ADDITION I CERTIFY THE INSTALLATION MEET'S 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 #: CC(- U
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE:
MUST BE SIGNED BY LICENSE HOLDER OR OW •R/BUILDER)
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: v Sa- p n
THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF L ROOF INSPECTION
ALONG WITH DIGITAL PHOTOGRAPHS OF EACH PLANE OF THE ROOF SHOWING IN DETAIL ALL COMPONENTS DECK
UNDERLAI'MENT, FLASIIING, DRIP EDGE A-I-I'ACHMENT) WITH THE PERMIT NUMBER OR ADDRESS CL r KED 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 TFIE RE -ROOF POLICY AND INSPECI'ION PROCEDURE
PAPERWORK FOR FURTHER EXPLANATION OF ALI. 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 c ie-mi 'W t,e,
Sworn to and Subscribed before me this day of 20 1 by:
f'I-%(. ADLxD1(Y-- Who is D-ersonally Known to a or has D Produced (type of
enti i ion) as identification.
46
DONALD RASH
Notary Public - Stateot Florida
v Commission IFF 221706StateofFlorida ' My Comm. Expires Apr16,2019
1)6 tin 6,.
Print/Type/Stamp Name
of Notary Public