134 Gleason Cv - BR18-003628 - REROOF6- 2_14 — (IF
CITY OF
SXNFORD
FIRE DEPARTMENT
AUG 1 7 1018 Building & Fire Prevention Division
PERMIT APPLICATION
Application No: t 8 3 cPa8
Documented Construction Value: $ q $201 .19
Job Address: 134 Gleason Cv Sanford, FL 32773 Historic District: Yes NoD
Parcel ID: 02-20-30-523-0000-1110 Residentia1z Commercial
Type of Work: New[] Addition Alteration Repair Demo[] Cbange of Use Move
Description of Work: REMOVE EXISTING ROOF DOWN TO DECK. INSTALL NEW
UNDERLAYMENT AND SHINGLES TO LOCAL CODE.
Plan Review Contact Person: Title:
Phone:407-284-1738 Fax: Email•ocorpermitting@roofally.com
Property Owner Information
Name Oviedo, Marco & Oviedo, Amaro
Street: 134 Gleason Cv
City, State Zip. SANFORD, FL 32773
Phone: 407-607-0190
Resident of property?: Yes - Owner
Contractor Information
Name OAK CREST CONTRACTING
Street: 115 TIMBERLACHEN CIR, STE 1013
City, State Zip: LAKE MARY, FL 32746
Phone: 407-284-1738
Fax:
State License No.: CCC1330407
Architect/Engineer Information
Name: Phone:
Street:
City, St, Zip:
Bonding Company:
Address:
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 ofapplication and the code in effect as of that date: 611 Edition (2017) Florida Building Code
Revised: January 1, 2018 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.
giignature,91ownedApff Date
A 1 6?pl bo
Print Owne Aeen s Name
3 * ii01m1Mm B*w 04124M
CM1dWMNaGOW5N
Owner/Agent is Personally Known to Me or
Produced ID _, Type of ID f1- 91,
AT >rr 9)_1
Si re of Con /Agent Date
0_k n moll
Print Contractor/Agent's Name
11 51. Ul .At I al_ ) n( -1 -to
Signature of No SwTe ofFlorida e
F-Uphley GeisWMIRCOMMlSS10N# Gi> 759
EXPIRES: June 19, 2022
QwW In Aaron Notary
Contractor/Agent is Personally Known to Me or
Produced ID Type of I
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
APPROVALS: ZONING:
COMMENTS:
of Heads
UTILITIES:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
ENGINEERING: FIRE: BUILDING:
Revised: January 1.2018 Permit Application
OAK CREST CONTRACTING, INC.
115 Timberlachen Cir # 1013
Lake Mary, FL 327d6 ookcrest.com
Contractor Registration: CCC1330407
PHONE: 407-28A-1738 FAX:866-648-8193
No Risk' Guarrante`e!,
G
REP: _ 1Q o _L>,,t `5
SOLICITOR'S LIC: _______________--
PHONE:__ i4AO _ _ -5_1-1 L-- --
OWNER DATE EMAIL ADDRESS
STREET CELL PHON16 WORK PHONE
leaso Coverff STATE ZIP HOME PHONE
t2n o L 3 773-Skis! 07 60 _o/9a
We hereby submit scope of work for: FI.ORIDA CONSTRUCTON LIEN. ACCORDING TO FLORIDA'S CONSiRUcnON
Tear off 5 (
LIEN LAW (SECTIONS 713.001.713.37, FLORIDA STATUTES). THOSE WHO WORK
c— T.lZ ON YOUR PROPERTY OR PROVIDE MATERIALS AND ARE NOT PAID-IN-FUU.
of squares off - HAVE A RIGHT TO ENFORCE THEIR CWM FOR PAYINLKT AGAINST YOUR
t7 Recover roof with 5 PROPERTY. T1i15 CLAIM 1S KNOWN A5 A CONSTRUCTION LIEN. IF YOUR
ti of squares on CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SUBCONTRACTORS. SUB -
hip le/COIOr C g
SUBCO: TIRACTORS OR MATERIAL SUPPLIERS OR NEGLECTS TO MAKE OTHERSUBCONTRACTORS
15 Protect daily AA
LEGALLY REQUIRED PAYMENTS. THE PEOPLE WHO ARE OWED THE MONEY
property as needed MAY LOOK TO YOUR PROPERTY FOR PAYMENT. EVEN IF YOU HAVE PAID
ecking O OSB O CDX O other 3 - YOUR CONTRACTOR IN FULL IF YOU FAILTOPAY YOUR CONTRACTOR YOUR
q Vnderlayment O 15 lb. t 0 lb. O Other 5 W47v+ CONTRACTOR MAY ALSO HAVE A UFNON YOUR PROPERTY. THIS MEANS IFA
LIEN IS FILED. YOUR PROPERTY COUID BE SOLD AGAINST YOUR WILL TO PAYMetaledgecolor g
Valley I'-e-E U-MI M 5 1 O closed O open
FOR LABOR MATERIALS OR OTHER SERVICESTHAT YOUR CONTRACTOR OR A
SUBCONNTRACTOR MAY HAVE FAILED TO PAY. TO PROTECT YOURSELF. YOU
CkHip and Ri ge ice Gl.C O standard O enhanced SHOULD STIPULATE IN THIS CONTRACT THAT BEFORE ANY PAYMENT IS
r ails 1 b py GRL-AJ AN/ 20-Z O open. eav MADE. YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU Wmi A WRTrTEN
Crf Pipe flashing 1.C 0 11 RF SE OF LIEN FROM ANY PERSON OR COMPANY THAT HAS PROVIDED TO
NOTICE
C1 V ntilation O box ridge O other_ L 7TiC t 7- YOU A TO OWNER' FLORIDA'S CONSTRUCTION -UEN LAW IS
COMPLEX AND IT ISRECOM.IIENDEDTHAT You coNs rANATTORNY. Veal
around all vents, pipes and flashings FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND. PAYMENT MAY 1
JLe and water shield to local code BE AVAILABLE FROM THE FLORIDA HOMEOWNERS CONSTRUCTION Furnish
all materials, labor and necessary permits RECOVERY FUND IF YOU LOSE MONEY ON A PROJECT PERFORMED UNDER O
elivery instructions O left O right O Other' CONTRACT.
WHERE THE LOSS RESULTS FROM SPECIFIED VIOLATIONS OF FLORIDA
LAW BY A UCENSED CONTRACTOR. FOR INFOMMATION ABOUT THE PPaul
off construction debris RECOVERY FUND AND FILMIC A CLAIM. CONTACT 'THE FLORIDA LJ
L year limited warranty CO/r'srRUCTTONINDUSTRY LICENSING BOARD AT THE FOLLOWING TELEPHONE
NUMBER AND ADDRESS: CILB, IWO North Monroe St., sot. Tallahassee. CYRoll
magnet through yard Fl.3D99. eLien
waivers provide upon final payment ANY Cl.AlhlSFOR CONSTRUCTION DEFECTS ARE SUB)ECI'TOTi-IENOTICE AND CURE PROVISIONS OF
CHAPTER 558, FLORIDA STATL"IT'S. BUYER'SRIGHT
TO CANCEL, This is a home solicitation sale, and if you do not N5n1 the goods or services. you may cancel this Agreement by Providing written 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 midnight on the third business day after you sign this
Agreement If you cancel this Agreement. 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 right to anal orally in addition to the writing contained herein. Customers signature below
signifies acceptance ofall terms and conditionsof this Agreement, including all terms on the reverse side hcred Terms: This Agreement is
contingent upon insurance company price and approval. This Agreement does not obligate the Customer or Company in any way unless it is approved by Customers insurance
company and aompted by Company. Company proposes to furnish all permits, labor and materials to complete the above replacement or repair for
the estimated sum of total cost below or the price otherwise agreed upon with Customer's insurance company (the "Agreed Price"). Customer authorizes Company to obtain
labor and materials In accordance with the Agreed Price and the specifications set forth herein to accomplish the above replacement or repair. Customer understands that
Company does not work for Customer's insurance company and/or the insurer for the property, and that Customer alone has the authority to authorize Company
to perform the above replacement or repair. Customer's signature on this Agreement also signifies aoceplance of all temps and conditions of this Agreement,
including all terms on the reverse side hereof. In situations where supplements for additional work are necessary outside of the original scope of work (ex,
additional layers or measurements), Company will seek approval from insurance company. Customer's out of pocket expense not to exceed deductible puss upgrades for
awn -insurance related claim items. Payment Method: Payment Upon
completion of Each Trade. Check or money Emergency Tarps Insurance Proceeds $
Cash/ Financing $
Total cost (
tax included] $
Acceptance by Owner of
property By: Representative Signature By: payment.
Estimated Project Start
Date:
ated Date of Completion:
Date: Date. FL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:-9- 1- 18
hereby name and appoint: kNnke,j Ce t S
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):
S( The specific permit and application for work located at:
Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name: Dustin Doll
State License Number
Signature of License t
STATE OF FLORIDA
COUNTY OF knp I e
The foregoing instrument was acknowledged before me this 1 day of
I- , by STtVJ who is personal y known
to me or o who has produced
identification and who did (did not) takejqn oath.
Signat
JdsHOP,
Print or type name
Notary Public - State ofx
Commission No. V 1
My Commission Expires: ko- 2
Rev. 08.12)
as
THIS INSTRUMENT PREPARED BY:
Name: Ashley Geis .
Address: 115 Trmberlachen Cir. Ste 1013
Lake Mary, FL 32746
NOTICE OF COMMENCEMENT
Permit Number.
Parcel to Number. 02-20-30-523-000D-1110
The undersigned hereby gives notice that Improvement win be made to certain real property, and in accordance with Chapter 713, Florida Statutes, thefollowinginformationIsprovidedinthisNoticeofCommencement.
1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address 9 available)
LOT 111 134 Gleason Cv Sanford_ FL 32773
2. GENERAL DESCRIPTION OF IMPROVEMENT:
REMOVE EXISTING ROOF TO DECK INSTALL NEW UNDERLAYMENT AND ROOF TO CODE.
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: Oviedo. Marco & Oviedo, Amato 134 Gleason Cv Sanford FL 32773
Interest in property: Owner
Fee Simple Title Holder (d other than owner listed above) Name:
Address:
4. CONTRACTOR: Name: OAK CREST CONTRACTING Phone Number. 407-284-1738
Address: 115 TIMBERLACHEN CIR STE 1013 LAKE MARY FL 32746
S. SURETY IN applicable, a copy of the payment bond Is attached): Name:
Address: Amount of Bond:
6. LENDER: Name: Phone Number.
Address:
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents maybe served as provided by Section713.13(1)(a)7., Florida statutes.
Name: Phone Number.
Address:
8. In addition, Owner designates of
to receive a copy of the Lienor's 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 a different date is specified)
WARNING TO OWNER ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARECONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEYBEFORECOMMENCINGWORKORRECORDINGYOURNOTICEOFCOMMENCEMENT.
GLIf y/zC irc:
sonae,R . d w.w. a......r.
nw,ulm eoaeendnaorrvannwori Inca mum am rmoft • now5wi of
State of 1Cj County of
The foregoing Instrument was acknowledged before me this ., day of fotui i
by ii iii%I(f \ !I erj . Who is personally known to me O OR
who has produced Identificatiori type of identification produced:
QiingDetbee
fe.IN52C4111111bdIllifteou"M
Myooan>fonl beetrTi'24M
V '"MMIED COPY GRANT MALOY
Cl iK r'yE CIRCUIT COURT .
At L " ^
IOU, rY,
GRANT MALOY, CLERK OF CIRCUIT COURT SEMINOLE COUNTY FL =-
CLERK'S # 2018062931 BK 9145 Pg 0458; (1pg) E-RECORDED 06/04/2018 01:51:13)Q -- OLPI1 i ' CLERK(
10.00
CITY OF
J SA.TFORD' Buiiding & Fire Prevention Division
FIRE DEPARTMENT Re -Roof Permit Card
PERMIT NO. I 3 98 ISSUE DATE: 8 -11 Is
CONTRACTOR: OQ it cftst raA&T-acti K4
JOB ADDRESS: 13% Golftmm Cv
TYPE OF WORK: e • 1
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 REMECTED 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 THISPERMIT. THERE MAY BE ADDITIONAL RESTRICTIONS APPLICABLE TOTHIS PROPERTY THATMAY BE FOUND INTHE
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 105.3A
EVISED: 4-17 Inspection Line 407.792.6069 or 855.541.2112
CITY OF I
SANFORD ' Building &Fire Prevention Division
RESIDENTIAL RE -ROOF POLICY & PROCEDURES
FIRE DEPARTmEN'T
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 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 OWNERIBUILDER) SIGNATURE: - ` DATE: a - I - b
CITY OF
Ski4FORD
1
FIRE DEPARTWNT I
PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: A3yC,eaSO C C04e SGr4c)(- rL, -S2 T STRUCTURE
TYPE: (D SINGLE FAMILY RESIDENCEITOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM RE -
ROOF TYPE: 0 REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) O
RE-COVER (NEW ROOFINSTALLED nVF,REXISTING ROOF) DECK
TYPE (PLEASE SPECIFY): PLEASE
NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED** ROOF
VENTILATION: D OFF -RIDGE G RIDGE OSOFFIT OPOWERED VENT OTURBINES SKYLIGHTS:
O YES (3) NO 1F YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: MAIN
ROOF AREA ROOF
SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 I) 4:12 OR GREATER TYPE
OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL SHINGLE
KO FL# lOOly , O
METAL FL# O
MODIFIED BITUMEN FL# O
TORCH DOWN FL# OINSULATED
FL# O
TILE FL# OTHER:
1 1iICAN C-Ol CAL . 2 FL#
v 5 2. ) LD - 9-3 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# OMETAL
FL# O
MODIFIED BITUMEN FL# O
TORCH DOWN FL# OINSULATED
FL# O
TILE FL# O
OTHER: FL#
CITY OF
SAORD
FIRF IIFPARTMFNT
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#: — 31Q2.6 ADDRESS: 134 Clk,&SOn CDJI
32-773
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 M CCC 1330407
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE: W DATE:
MUST BE SIGNED BY LICENSE AROR O RBUILDER)
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 SeM1(\O`e—
Sworrn to and Subscribed before me this 1-1 day of 20 _L_ by:
Who is?§ Personally Known to me or has D Produced (type of
identification)
Signature of Note Public
State of Florida
SK(LI Lo S
Printfrype/Stdmp Name
of Notary Public
as identification.
Ashley Geis
3ie OOMMISSION S OGZ28TS9
n
EXPIRES: June It 2022
Bated TNu As= Ndwy