129 Gleason Cv - BR18-003631 - REROOFCITY OF
SFORD FIRE
DEPARTMENT AUG
17 2018 Building & Fire Prevention Division PERMIT
APPLICATION Application
No: I F- 3)6 31 Documented
Construction Value: S l k C6-,O -SLR Job
Address: 129 Gleason Cv. Sanford, FI.32771 Historic District: Yes[ —]No Q Parcel
ID: 02-20-30-523-0000-1490 Residential JD Commercial Type
of Work: NewE]Addition Alteration Repair o Demo Change of Use Move[] Description
of Work: REMOVE EXISTING ROOF DOWN TO DECK. INSTALL NEW UNDERLAYMENT
AND SHINGLES TO LOCAL CODE. Plan
Review Contact Person: Cheryl Joshua Title: Office Assistante Phone:
407-284-1738 Fax: Name
Daniel Tucker Email:
ocorpermitting@roofally.com Property
Owner Information Street:
Gleason Cv City,
State Zip: SANFORD, FL 32771 Phone:
407-860-2441 Resident
of property? : Yes -Owner Contractor
Information Name
OAK CREST CONTRACTING Street:
115 TIMBERLACHEN CIR, STE 1013 City,
State Zip: LAKE MARY, FL 32746 ' Name:
Phone:
407-284=1738 . Fax:
State
License No.: CCC1330407 Architect/
Engineer Information Phone:
Street:
Fax: City,
St, Zip: Bonding
Company: E-
mail: 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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Application
is hereby made to obtain a pcnnit to do the work and installations as indicated. I certify that no work or installation has commenced
prior to the issuance of apermit 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 sectored for electrical work, plumbing, signs, wells, pools, furnaces,
boilers, heaters, tanks, and air conditioners, etc. FAC
105-3 Shall he inscribed with the date of applicationand the'code in effect as of thatdate: 614 Edition (2017) Florida Building Code Revised:
humary 1. 2019 hennit Applicauon
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 fcdcral 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 AFFTDAVIT: 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.
E Og-py- If
e ofOtvne'r/Agent /I Date Si re ofControc /Agent Date
C/ -C,141-IK
rt c'ol h116dro Lout.
COMMISSION #QG24 -
AS EXPIRES: July 29, 2022
Bonded 7hm Aaron Notry
Owner/Agent is Personally Known to Me or
Produced ID C Type of ID DL 'TAD •140 -qN
1 a l -1V
Print Cunimctor/Agenr's Nark
as C -i 16
Signature of state o Flo ' u r)a
Ashley GA -- AN•
COM MISSION;029'159
6 r EXPIRES: June 19, 2022
80" Thro Aaron Notary
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:
Total Sq Ft of Bldg:
Occupancy Use: Flood Zone:
Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: January 1, 2019 Permit Application
AGREEMENT
OAK CREST CONTRACTING, INC. 'No Risk' Guarantee!
115 Timberlachen Cir #1013
Lake Mary, FL 32746 oakerest.com REP: 2-
Contractor Registration: CCC133040T
PHONE: 407-284.1738 FAX:866-648-8193
SOLICITOR'S LIC:----- ---------- -------------------
PHONE:-- -----------
OWNER DATE EMAIL ADDRESS
Po,-^E,-i 'sc,00. o
STREET CELL PHONE
v
WORK PHONE .
CITYSPATE ,,- ZIP
3
HOME PHONE
hereby submit scope of work for. W submit FLORIDA CONSTRUCTION LIEN. ACCORDING TO FIARIDA's Wrr IKV I svrt
LIEN LAW (SECTIONS 7131101-71337, FLORIDA STATUTES).' THOSE WHO WORKTearoff_ Ice LAY a TV 1 t K ON YOUR PROPERTY OR PROVIDE MATERIALS AND ARE NOT PAID -IN -FULL
IY# of squares off 2.eC At6t.P AIZ-rc- HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR
O"Recover roof with TZG S ^;a Lf, PROPERTY. THIS CLAIM IS M40WN AS A CONSTRUCTION LIEN, IF YOUR
1314 of squares on N CONTRACTOR OR A SUBCONTRACTOR FATLB TO PAY SUBCONTRACTORS, SUB -
OTHERSUBCONTRACTORSORMATERIALSUPPLIERSORNEGLECTSTOMAKE
g r LEGALLY REQUIRED PAYMIZIIS, THE PEOPLE WHO ARE OWED THE MONEY
property as needed daily 3 Pw 5 /Ptzee
MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN ff YOU HAVE PAID
YOUR CONTRACTOR IN FULL IFYOU FAILTO PAY YOUR CONTRACTOR YOURC
rotect
ecking O OSB O CDX O other •
WUnderlayment O 15 lb. CnO lb. CIL Other 5 Yt4-' } CONTRACTOR MAY ALSO HAVE A LIEN ON YOUR PROPERTY. THIS MEANS IF A
PAY
CYMeta I edge c IOf r'1 I G LIEN IS FILED, YOUR PROPERTY COULD BESOLD AGAINST YOUR WILL TO
SERVICES THAT YOUR CONTRACTOR OR Ag
YValley •1 Gf-w4168 51'F'144.73 O closed O open
FOR LABOR MATERIALS OR OTHER
SuaCONTmcroR MAY HAVE FAILED TO PAY. TO PROTECT YOURSELF. YOU
l7 Hip and 4idge -Ndw Urstandard O enhanced SHOULD STIPULATE IN THIS CONTRACT THAT BEFORE ANY PAYMENT Is'
e aiIs •1 1114 GA Ah/ f J O open eaves MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTENRELEASEOFLIENFROMANYPERSONORCOMPANYTHATHASPROVIDEDTO
e fshin /V E6[ 1 3/1 ea9Riepntilatlon YOU A 'NOTICE TO OWNER.' FLORIDAS CONSTRUCTION IgN LAW IS
O box O ridge O other GaW MrAd-W-"ri3 COMPLEX, AND 1TISRECOMMENDED THAT YOU CONSULT ANATPORNY. around
all vents, pipes and flashings C,, FLORIDA HOMEOWNERS CONSTRUCTION RECOVERY FUND. PAYMENT MAY SealV7
ICe and water shield to local code BE AVAILABLE FROM THE FLORIDA HOMEOWNERS CONSTRUCTION l
urnish all materials, labor and necessary perm! RECOVERY FUND IF YOU LASE MONEY ON A PROJECT PERFORMED UNDER CONTRACT,
WHERE THE LOSS RESULTS FROM SPECIFIED VIOLATIONS OF pelivery
instructions O left O right O other K FLORIDA LAW BY A LICENSED CONTRACTOR FOR INFORMATION ABOUT THE off
construction debris RECOVERY FUND AND FELING A CLAIM, CONTACT THE FLORIDA aul2
year limited warranty CONSTRUCTION INDUSTRY LICENSING BOARD AT THE FOLLOWING JC/
magnet through TELEPHONE
NUMBER AND ADDRESS: CIL.B,1940 North Monroe SL. #42, Tallahassee, FL32399.
ollyardCil
Lien waivers provide upon final payment ANY CLAIMS FOR CONSTRUCTION DEFECTS ARE SUBJECT TOTHE NOTICE AND CURE PROVISIONS
OF CHAPTER 558, FLORIDA STATUTES. BUYER'S
RIGHT TO CANCEL- This is a home solicitation sale. and if you donot want the goods or services, you may cancd this Agreement by providing wriven notice to the seller In person, by
telegram. or by mall. This notice must indicate that you do not want the goods or services and must be delivered or postmarked before mldnot on the third business day aRcr you signthisAgreementIfyoucancelthisAgreement, the seller may not keep all or pan of any cash down payment. By signing this Agreement. you agree that you have also been provided notice
of this rightto cancel orally in addition to the writing contained herelm Customers signaturebelowsignifiesacceptanceofalltankandconditionsofthisAgrument. indudingall temon therevmaesidehereuETerms: l
NS Agreement Is tonlinoent upon irL5lUrice eomipany P!J9and @PP—=81 is Agreement d n mar nr m in nny way unless It Is t rovet bv
rLstomer's insurance OOn1 8na acceEtry bornpanY. t.omparty proposes to 1 Sh all permits, labor and materials to oompleao above replacement or repay— it r
tlis ma stunof total cost wowor1ie'-otherwise agreed upon with Customer's insurance company (Cre "Agreed PrIce'). Customer tluthodzes Company to obtain labor
and materials In accordance with the Agreed Price and the speacallons set lorth herein to accomplish the above replacement or repair. Customer understands that CompanydoesnotworkforCustomer's insurance company and/or the insurer for the property, and that Customer alone has the authority to etlthwize Company to
perform the above repieceme>t or repair. Customere signature on this Agreement also signifies acceptance of an terms and conditions of this Agreement, includingalltermsonthereversesidehereof. In silualions where stloolemerns for elidilwnal work are necessary outside of the original non -Insurance Emergency Tarps insurance
Proceeds Cash/
Financing Total
cost (tax
included) Acceptance
by Owner of property
By: Z Representative Signature By: order made
oavable to Oak
Crest. Cash will not be an acceptable form of pavmenL Estimated Project Start Date: Date
of Completion: Date: 7 `/
0 ",/P . Date:
09 -40 —4V FL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 8/22/2018
1 hereby name and appoint: Cheryl Joshua
an agent of: Oak Crest Contracting
Name ofCompany)
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):
X The specific permit and application for work located at:
129 Gleason Cove Sanford, FL 32773
Street Address)
Expiration Date for This Limited Power of Attorney:,
License Holder Name: Dustin Doll
State License Number:
Signature of License H
STATE OF FLORIDA
COUNTY OF no 1e,
The foregoing instrument was acknowledged before me this ?2 day of
200J_, by Doll who is`Jtiperson Ily known
to me or o who has produced as
identification and who did (did not) take an oath.
llu: - CS^
y , Ashley Geis
Signature
i$SION# GGMM Ao-' 6
1a 2022EXpIRES: JUDB Print or typb name
BondedTmv Aam NOWY
Notary Public - State of FL
Commission No. G 2.2--i-JSg
My Commission Expires: U
Rev. 08.12)
THIS INSTRUMENT PREPARED BY:
Name: Pedro Leop _ _ _ _
Address: Ste. -4949
NOTICE OF COMMENCEMENT
Permit Number,
Parcel ID Number, 02-20-30-523-000D-1490
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
1 T6t 199 18GU W06CS PFi Z Y ft $tn of the property and street address it available)
m0i We-uson v c,c-n r. _ F( 32T7 I
2. GENERAL DESCRIPTION OF IMPROVEMENT:
REMOVE EXISTING ROOF TO DECK INSTALL NEW LINDERLAYMENT AND ROOF TO CODE.
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: Daniel Tucker. 129 Gleason Cv. Sanford,. Fl, 32771
Interest in property. Owner
Fee Simple Title Holder (it other than owner listed above) Name:
Address:
4, CONTRACTOR: Name: OAK CREST CONTRACTING Phone Number. 407-284-1738
Address: 1145 TIMBERLACHEN CIR, STE 1013 LAKE MARY, FL 32746
6. SURETY (N applicable, a copy of the payment bond is attached): Name:
Address: Amount of Bond:
S. LENDER: Name, Phone Number.
Address:
T. Persons within the State of Florida Designated by Owner upon whom notice orother documents maybe served as provided by Section
713A3(1)(a)7., Florida Statutes.
Name Phone Number.
Address:
8. In addition, Owner designates of
to receive a copy of the Lienoes Notice as provided In Section 713.13(1)(b), Florida Statutes. Phone number:
9. Expiration Date of Notice of Commencement (The expiration is 1 year from date of recording unless adifferent 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 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.
Slpr spe ofOMnw wLosseq wOwurcwlsssas's
ANiWrted 0MZV 1(ecmfflWVWM nagen
Sweat *FL,0TZ, n4 County of 5e-A f ) ,-4Q e,,
4% a-n f
PMt NO= Ord Provi00 signmrysTivelOnoer
The foregoing instrument was acknowledged before me this O y day of
SIRES: III. • i, 2022
uodMlVNA2M t dKy
NUG
CITY OF
SX14FORD' Building & Fire Prevention Division
FIRE DEPARTMENT Re -Roof Permit Card
PERMIT NO. '& 3&31 ISSUE DATE: am vjw Is
CONTRACTOR: Ock Co &0X*r.'t1W
JOB ADDRESS: 119 r2leasoa Ly
TYPE OF WORK:
0"ke•
PROTECT FROMnHER
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 I I E
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: INADDITION TO THE REQUIREMENTS OF THIS PERMIT, THERE MAYBE ADDITIONAL RESTRICTIONS APPLICABLE TO THIS PROPERTY THAT MAYBE FOUND IN THEPUBLICRECORDSOFTHISCOUNTY, AND THERE MAYBE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH'ASWATER MANAGEMENT DISTRICTS,
STATE AGENCIES, OR FEDERALAGENCIES. FBC 105.3.3
EVISED: 4-17 Inspection line 407.792.6069 or 855.541.2112
AddMELL CITY OF i
SANFORD Building &Fire Prevention Division
RESIDENTM RE -ROOF POLICY & PROCEDURES
FIRE DEPARTMENT I
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 TVAT 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 1S 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 TIME UNDERLAYML•NT 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: - W DATE: 8/22/2018
CITY OF
Siki4FORD
RPERMIT #
FIE
DEPARRTMEiNrT Building & Fire Prevention Division RESLDENTL4L
RE -ROOF SCOPE OF WORK JOB
ADDRESS: 129 Gleason Cv. Sanford, FL 32773 STRUCTURE
TYPE: (8) SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM RE -
ROOF TYPE: ® REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) ORE -
COVER (NEW ROOF INSTALLED OVER EXISTING ROOF) DECK
TYPE (PLEASE SPECIFY): PLEASE
NOTE: ONLY 100 SQUARE FEET OF THE EVS77NG DECK IS PERMITTED TO BE REPLACED;+ ROOF
VENTILATION: OOFF-RIDGE (S) RIDGE OSOFFIT OPOWERED VENT OTURBINES SKYLIGHTS:
OYES (DNO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: MAIN
ROOF AREA ROOF
SLOPE: O LESS THAN 2:12 O 2:12 — 4:12 0 4:12 OR GREATER TYPE
OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL SHINGLE
IKO FL# FL7006.1 O
METAL FL# O
MODIFIED BITUMEN FL# O
TORCH DOWN FL# OINSULATED
FL# O
TILE FL# O
OTHER: FL# ROOF
ExTENSIONS (PORCHES. PATIOS. ETC.) ••1FAPPk1CA8LE*• 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# O
TORCH DOWN FL# OINSULATED
FL# O
TILE FL# O
OTHER: FL#
CITY OF
S ORD Building & Fire Prevention Division
RESIDENTM RE -ROOF AFFIDA VIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ) D 2-Ip > I ADDRESS: 129 Gleason Cv.
Sanford, FL 32773
I Dustin Doll . 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#: CCC1330407
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE: W DATE: 8/23/2018
MUST BE SIGNED BY LICENSE H R OR O R/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 TCinr)V,
Sworn to and Subscribed before me this 2___ day of A%) - - 20 19 by:
Duab l Do 1 Who isXPersonally Known to me or hast[ Produced (type of
identification) as identification.
4' , jv— c9l
Signature of 10tary Public `tiv 7/'% Ashley Geis
State of Florida MUMINON # GUM
Print/Type/Sta np Name
of Notary Public
14 *
t1ii EXPIRES: June 19, 2022
6=W Ibm Aron"