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304 McKay Blvd - BR18-003028 - REREOOFCITY OF Ski4FORD • , ' Building &Fire Prevention Division PERMIT APPLICATION FIRE DEPARTMENT JUL 10 1018 13 ©CAXpicationNo: l Documented Construction Value: S \8 Job Addre; Parcel ID: Type of Work: New Description of Work: Historic District: Yes Nol@ Residential® Commercial Alteration Repair Demo Change of Use Move rYl Plan Review C'ContactPerson:5Qk 4 n Title: Phone: 4611Cnn(6D- SC 3 Fax: Email: Property Owner Information Name Phone: Street:' S 0 Vk-_ q - 1 Resident of property? City, State Zips: a_•'1- 2:1a-7 1 Contractor Information Name X LLC Phone: Street: Fax: pp ,,, ^^ /I City, State Zip: (y[,a =-L 317-7 ( State License No.: l W 13 aci - b 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. 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: 611 Edition (2017) Florida Building Code Revised- January I, 2018 Permit Application NOTICE: In addition to the requirements of this permit, there may bg 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 ofthe 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. Signature ofOwner/Agent Print Owner/Agent's Name Date Signature ofNotary -State of Florida Date Signature of Contractor/Agent Date Print Contractor/Agent's Name JOANNt+DJOHNSON MY COMMISSION r FF WV EXPIRES: March 23, 2M$ Bonded Thru Notary NbBc Underwriters Owner/Agent is Personally Known to Me or Contractor/Agent is Personally j own Me or Produced ID Type of ID Produced ID !,Type of 1D 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: # 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, 2018 Permit Application 44/2018 SCPA Parcel View: 31-19-31-527-0000-1000 c Plopert`y Record Card Parcel: 31-19-31-527-0000-1000 Property Address: 304 MCKAY BLVD SANFORD, FL 32771 Parcel Information Parcel 31-19-31-527-0000-1000 Owner(s) SEDA, SHIRLEY - Tenants in Common SEDA, RUBEN - Tenants in Common Property Address 304 MCKAY BLVD SANFORD, FL 32771 Mailing 304 MCKAY BLVD SANFORD, FL 32771- Subdivision Name CEDAR HILL REPLAT Tax District S1-SANFORD DOR Use Code 01-SINGLE FAMILY Exemptions 00-HOMESTEAD(2017) Seminole County GIS Value Summary 2018 Working Values 2017 Certified Values Valuation Method CostlMarket Cosl/Market Number of Buildings 1 1 Depredated Bldg Value 148,907 132,722 Depredated EXFT Value 1,300 1,350 Land Value (Market) 32,000 30,000 Land Value Ag Just/Market Value " 182,207 164,072 Portability Adj Save Our Homes Adj 14,689 0 Amendment 1 Adj 0 P&G Adj 0 0 Assessed Value 167,518 1$164,072 Tax Amount without SOH: $2,336.32 2017 Tax Bill Amount $2,336.32 Tax Estimator Save Our Homes Savings: $0.00 Does NOT INCLUDE Non Ad Valorem Assessments Legal Description LOT 100 CEDAR HILL REPLAT PB 63 PGS 96 97 8 98 Taxes Taxing Authori Sales Find compamb* SaM Land ty Assessment Value Exempt Values Taxable Value County General Fund 167,518 550,000 117,518 Schools 167,518 25,000 142,518 City Sanford 167,518 50,000 117,518 SJWM(Saint Johns Water Management) 167,518 50,000 117,518 County Bonds 167,518 50,000 117,518 Description Date Book Page Amount Qualified VarJlmp SPECIAL WARRANTY DEED 7/1/2011 07612 1070 120,000 No Improved CERTIFICATE OF TITLE 8/1/2010 07439 1124 100 No Improved SPECIAL WARRANTY DEED 7/1/2004 05401 1554 143,100 Yes Improved CORRECTIVE DEED 7/1/2004 05395 1 100 No Vacant WARRANTY DEED 10/1/2003 53814 405,000 No Vacant Method Frontage Depth Units Units Price Land Value LOT 0.001 0.00 1 32,000.00 32,000 http://parceldetail.scpafl.org/ParcelDetaillnfo.aspx?PID=31193152700001000 1 /2 r14/2018 SCPA Parcel View: 31-19-31-527-0000-1000 t is neonsam count mcorreci r Lmm mere. Description Year Built Fixtures Bed Bath Base Area Total SF Wvin SF Ext Wall Ad Value Rapt ValuepActual/Effective 9 1 P Appendages 1 I FSINGLEAMILY 12004 I 91 a I 25 I 1,120 I .2,659 2.215 I FNSHCB/ STUCCO I $148,907 I $156,333 Permits Description Area GARAGE 420.00 FINISHEDOPEN PORCH 24.00 FINISHED UPPER STORY 1095.00 FINISHED Permit # Description Agency Amount CO Date Permit Date 00343 15V X 6' PVC FENCE SANFORD 4,305 11/2/2005 01193 NEW -RESIDENTIAL ISANFORD 97,752 1 7/20/2004 2/16/2004 pamkH Aobdonnot oHgbiobhem Um SaMnoloCounty Prpeny Appnbo•o ofttw por dobtbor questions COnnmbq opmnIL pbteo coebdthebulking dpartnimtor thetocbbtd to nnitfba* so"" my Is low*& Extra Features Description Year Built Units Value New Cost PATIO 2 15/1/2004 1 1,300 I $2,000 http:// pareeldetaii.scpafl.org/ParcelDetailinfo.aspx?PID=31193152700001000 2/2 THIS INSTRUMENT PREPARED BY: Name: SHIRLEY SEDA Address - NOTICE OF COMMENCEMENT Permit Number. Parcel ID Number. 31-19-31-527-0000-1000 GRANT MALOYr SEMINOLE COUNTY CLERK OF CIRCUIT COURT & COMPTROLLER BK 916E P9 1078 (1P9s) CLERK'S : 2018078281 RECORDED 07/09/2018 11:45:17 All RECORDING FEES $10.00 RECORDED BY rdtemp 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. ate9!8rip j T g l t ; %$5 V V1ft?SANFORD, FLORIDA 32771 2. GENERAL DESCRIPTION OF IMPROVEMENT: RE -ROOF 3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and address: SHIRLEY SEDA 304 MCKAY BLVD SANFORD FLORIDA 32771 Interest in property: Fee Simple Title Holder (if other than owner listed above) Name: Address: 4. CONTRACTOR: Name: XRC, LLC Phone Number. 407-960-5933 Address: 4019 W 1St STREET, SANFORD, FLORIDA 32771 5. SURETY (Ifapplicable, a copy of the payment bond Is attached): Name: Address: Amount of Bond: 8. LENDER: Name: Phone Number. Address: T. Persons within the State of Florida Designated by Owner upon whom notice or other do, 713.13(1)(a)7., Florida Statutes. Name: Phone 8. In addition, Owner designates of to receive a copy of the Lienors Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number. 9. Expiration Date of Notice of Commencement (The expiration Is 1 year from date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARECONSIDEREDIMPROPERPAYMENTSUNDERCHAPTER713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. SHIRLEY SEDA SlgnsAue Owner or Lessee. or Ownels or Lessee's (PAnI Name and ProNde Blgnatorys litle/016oe) AuftdzM OMo9dD1MdWfi r nWManegerj Vi State of akda- County of The foregoing Instrument was acknowledged before me this G ' day of by Who is personally known to me 0 OR r 1 • - who has produced identification$jype of Identification produced: RUTH-ANN RUBIN NOTARY PUBLIC ESTATE OF FLORIDA Comm# GG159793 N 0 Expires 11/13/2021 LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs ER. Date: ao I hereby name and appoint: an agent of U-P, 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): O The specific permit and application for work located at: Street Address) Expiration Date for This Limited Power of Attorney: License Holder Name: State License Number: C.cc, Signature of License Holder: STATE OF FL RIDA COUNTY OF The foregoing instrument was acknowledged before me this day of , 20#B by jMQa0,W k.0ojL who isyperson ly known to me or o who has produced as identification and who did (did not) take an oath. Notary Sea]) RUTH-ANN RUBIN NOTARY PUBLICoSSTATEOFFLORIDA Comm# GG159793 A Expires 11/13/2021 Rev. 08.12) i d .. -ui L__ a. Notary Public - State of Commission No. GG 1591A 3 My Commission Expires: CITY OF SI O Building &Fire Prevention Division RESIDENTIAL REROOF 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 WELL 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) SIGNATURE: _, DATE: 101,2018 CITY OF SWORD FIRE DEPARTMENT JOB ADDRESS: PERMIT # 10 -300-8 Building & Fire Prevention Division RESIDENTIAL RE -ROOF SCOPE OF WORK STRUCTURE TYPE: 10 SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM RE -ROOF TYPE: 01 REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS) O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF) DECK TYPE (PLEASE SPECIFY): PLEASE NOTE: ONLY 100 SQUARE FELT OF THE EXISTING DECK IS PERMITTED TO BE REPLACED** ROOF VENTILATION: TOFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT SKYLIGHTS: O YES %kNO 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 OTURBINES TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL SHINGLE FL# O METAL FL# O MODIFIED BITUMEN FL# O TORCH DOWN FL# O INSULATED FL# OTILE FL# O OTHER: FL# ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) **1FAPPLICABLE** 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# 0MODIFIED BITUMEN FL# OTORCH DOWN FL# 0INSULATED FL# OTILE FL# O OTHER: FL# City of Sanford Building and Fire Prevention Product Approval Specification Form Permit # Project Location II I As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the information and product approval number(s) on the building components listed below if they are to be 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 Approval can be obtained at www.floddabuilding.ora. 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. Category / Subcategory Manufacturer Product Description Florida Approval # include decimal 1. Exterior Doors Swinging Sliding 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 104n'Ii4- R 1 Underla ments bwolyq cdmin&F 0 - Roofing Fasteners Nonstructural Metal Roofing Wood Shakes and Shingles Roofing tiles Roofing Insulation Waterproofing Built up roofing System Modified Bitumen Single Ply Roof Systems Roofing slate Cements/ Adhesives ! Coatinci Liquid Applied Roofing Systems Roof Tile adhesive Spray Applied Polyurethane Roofing E.P.S. Roof Panels Roof Vents Other June 2014 Category / Subcategory Manufacturer. Product Description Florida Approval # include decimal 5. Shutters Accordion Bahama Colonial Roll u Equipment Other 6. Skylights Skylights Other T. Structural Components Wood Connectors / Anchors Truss Plates En ineered Lumber Railing Coolers/Freezers Concrete Admixtures Precast Lintels Insulation Forms Plastics Deck / Roof Wall Prefab Sheds Other 8. New Exterior Envelope Products Applicant's Signature Applicant's Name Please Print) June 2014 Cel tb Xtreme Roofing & Construction ft 4019 West 1st Street 0-*N Sanford, Florida 32771 Recap by Category O&P Items CLEANING CONTENT MANIPULATION GENERAL DEMOLITION DOORS DRYWALL ELECTRICAL FENCING INSULATION LAB LIGHT FIXTURES PAINTING ROOFING Total 320.69 47.83 4,144.99 250.01 345.60 92.05 137.40 103.56 4.82 132.96 576.48 11,118.25 17,274.64O&P Items Subtotal 375.00 Permits and Fees 247.18 Material Sales Tax 1,789.73 Overhead 1,789.73 Profit n 21,476.28 Total 1.49% 0.22% 19.30% 1.16% 1.61 % 0.43% 0.64% 0.48% 0.02% 0.62% 2.68% 51.77% 80.44% 1.75% 1.15% 8.33% 8.33% 100.00% The attached estimate reflects the scope ofdamage based on what could visually be seen during our assessment of the subject property. Any unforeseen damage will result in a change order and possible additional charges. SEDA 52671 4/16/2018 Page:9 1i/9/26* Florida Building Code Online SOS Home I Lop In User Registration I Hot Topics I Submit Surcharge I Stats Q Fads Publications Contact Us SCIS Site Map Unks Search rich Product Approval p USER: Public User d pater Product Aoproyal Menu > Product or Annliratlon 5earoh > Application Ust > Application Detail 0 OFFICE OF FL # FL10674-1113 SECRETARY Application Type Revision Code Version 2017 Application Status Approved Comments Archived Product Manufacturer Owens Coming Address/Phone/Email One Owens Corning Parkway Toledo, OH 43659 740)404-7829 greg.keeler@owenscoming.com Authorized Signature Greg Keeler greg.keeler@owenscoming.com Technical Representative Mel Sancrant Address/Phone/Email 1 Owens Corning PKWY Toledo, OH 43659 419)376-8360 mel.sancrant@owenscomig.com Quality Assurance Representative Address/Phone/Email Category Roofing Subcategory Asphalt Shingles Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report - Hardcopy Received Florida Engineer or Architect Name who developed the Robert J.M. Nieminen Evaluation Report Florida License PE-59166 Quality Assurance Entity UL LLC Quality Assurance Contract Expiration Date 05/16/2020 Validated By John W. Knezevich, PE Validation Checklist - Hardcopy Received Certificate of Independence Referenced Standard and Year (of Standard) Equivalence of Product Standards Certified By Standard Year ASTM D3161 2016 ASTM D3462 2010 ASTM D7158 2011 Sections from the Code https:/Mrww.floridabuilding.org/pr/pr_app dtl.aspx?param=wGEVXQwtDgtBNbEY5V%2boQT%2b6w7ahReglCQ8ucR6ixEBFhs7tvJgZewolo3d%3d 1/2 0/9/2018 Florida Building Code Online Product Approval Method Date Submitted Date Validated Date Pending FBC Approval Date Approved Summary of Products Method 1 Option D 10/10/2017 10/11/2017 10/15/2017 12/12/2017 FL * Model, Number or Name Description 10674.1 Owens Corning Asphalt Roofing 3-tab, 4-tab, 5-tab, laminated, starter and hip & ridge shingles Shingles and Starters Limits of Use Installation Instructions Approved for use in HVHZ: No FL10674 R13 II 2017 10 FINAL ER OC ASPHALT Approved for use outside HVHZ: Yes SHINGLES FL10674-R13.odf Impact Resistant: N/A Verified By: Robert 3. M. Nieminen PE - 59166 Design Pressure: N/A Created by Independent Third Party: Yes Other: Refer to ER, Section 5. Evaluation Reports FL10674 R13 AE 2017 10 FINAL ER OC ASPHALT SHINGLES FL10674-R13.Ddf Created by Independent Third Party: Yes Bock Ne:t Contact Us :: 2601 Blair Stone Road, Tallahassee FL 32399 Phone: 850-487-1824 The State of Florida Is an AA/EEO employer. Q2i)ybght 2007-2013 State of Florida.:: Privacy Statement :: AccesslbilitX Statement :: Refund Statement Under Florida law, email addresses are public records. If you do not want your e-mail address released In response to a public -records request, do not send electronic mall to this entity. Instead, contact the office by phone or by traditional mall. If you have any questions, please contact 850.487.1395. -Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address If they have one. The emalls provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. To determine It you are a licensee under Chapter 455, F.S., please dick here . Product Approval Accepts: Credit Card Sate https://www.floridabuilding.org/pr/pr appd0.aspx?param=wGEVXQwtDgtBNbEY5V%2boQT%2b6w7ahRegIC08ucR6ixEBFhs7tvJgZew*lo3d%3d 2/2 7/0/2718 Florida Building Code Online Business r onal r 005 Home I Log In I use, Registration I Hot Topic Submit Surcharge slats p Facts Publications I Contact Us SCIS site Map links Search rida r ®Product Approval USER: Public user t Product ARoroval Menu > Product or Aoolicatlon Search > BQollcatlon List > Application Detall OFFiCE OF THE FL # FL11602-R5 SECROARY Application Type Revision Code Version 2017 Application Status Approved Comments Archived Product Manufacturer Owens Corning Roofing and Asphalt, LLC Address/Phone/Email One Owens Corning Parkway Toledo, OH 43645 740)321-6345 Greg. Keeler@owenscorning.com Authorized Signature Keeler Greg Greg. Keeler@owenscorning.com Technical Representative Greg Keeler Address/Phone/Email 2790 Columbus Road Granville, OH 43023 740) 321-6345 greg.keeler@owenscoming.com Quality Assurance Representative Address/Phone/Email Category Roofing Subcategory Underlayments Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report - Hardcopy Received Florida Engineer or Architect Name who developed the Robert Nieminen Evaluation Report Florida License PE-59166 Quality Assurance Entity Intertek Testing Services NA, Inc. - QA Entity Quality Assurance Contract Expiration Date 12/31/2020 Validated By John W. Knezevich, PE Validation Checklist - Hardcopy Received Certificate of Independence Referenced Standard and Year (of Standard) Equivalence of Product Standards Certified By Standard ASTM D1970 ASTM D226 (physicals) FRSA/TRI April 2012 TAS 110 (weathering) TAS 117(B) Year 2015 2009 2012 2000 1995 https://www.floridabuilding.org/pr/pr app_dd.aspx?param=wGEVXQwtDgsQFc5K%2fTrZeHYB7UCe5KMrBMylhtfVyxkRllwQitWhiw%3d%3d 1/2 e 719/2U18 Sections from the Code Product Approval Method Date Submitted Date Validated Date Pending FBC Approval Date Approved Date Revised Summary of Products Florida Building Code Online Method 1 Option D 04/20/2018 04/20/2018 04/22/2018 06/12/2018 06/20/2018 FL it Model, Number or Name Description 11602.1 Titanium Roof Underlayments Synthetic sheet -type roof underlayments Limits of Use Installation Instructions Approved for use in NVNZ: No FL11602 RS II 2018 04 FINAL ER OWENS Approved for use outside NVNZ: Yes CORNING FL11602-RS.pdf Impact Resistant: N/A Verified By: Robert Nleminen PE-59166 Design Pressure: +N/A/-45 Created by Independent Third Party: Yes Other: 1.) The design pressure noted herein pertains to use of Evaluation Reports a specific underiayment system beneath foam -on the sytsems. FL11602 R5 AE 2018 04 FINAL ER OWENS Refer to ER Section 5.6.3 for details. 2.) Refer to ER Sections 5 CORNING FL11602-R5.Rd and 6 for other Limits of Use. Created by Independent Third Party: Yes Back FEE Contact Us :: 2601 Blair Stone Road. Tallahassee FL 32399 Phone: 850-487-1824 The State of Flonda is an AA/EEO employer. Qnyjjght 2007-2013 State of Flonda.:: Privacy Statement :: Accessibility Statement :: Refund Statement Under Florida law, email addresses are public records. If you do not want your e-mail address released In response to a public -records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mall. If you have any questions, please contact 850.487.1395. *Pursuant to Section 45S.275(1), Florida Statutes, effective October 1, 2012, licensees licensed underChapter 455, F.S. must provide the Department with an email address If they have one. The emalls provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. To determine If you are a licensee under Chapter 45S, F.S., please dick h . Product Approval Accepts: Credit Card Safe https:llwww.floridabuilding.org/prlpr app dti.aspx?param=wGEVXQMDgsQFc5Ka/o2tTrZeHYB7UCe5KMrBMylhtfVyxkRllwOitWhW/o3da/o3d 2/2 CITY OF S.ORD Building & Fire Prevention Division RESIDENTIAL REROOF AFFIDA VIT FIRE DEPARTMENT RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAI[LING, SHEATHING, DRY -IN, FLASHING, AND ALL FFINA)L ROOF COVERINGS PERMIT #: V — "`C) ADDRESS: 30%A 1 ` `C 1Kl A l`ma . I N VJ h , AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR ROOFING CONTRACTOR, ENGINEEA, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, 1 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 #: C-U, COMPANY / CONTRACTOR: LLC 1 Q CONTRACTOR SIGNATURE: DATE: -71 1O 1 o 1V MUST BE SIGNED BY LICENSE HOLDE R/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 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 Sworn to and Subscribed before me this day of kViLA 20 .L by: MrAN) t-ti1llW.l . Who isyfersonally Known to me or has O Produced (type of Identification) as identification. LAU Signature of Notary Public RUTH-ANN RUBIN State of Florida NOTARY PUBLIC,;. Print/Type/Stamp Name of Notary Public STATE OF FLORIDA CQW dl GG159793 Fvims 11/1xmi