410 S Elliott Ave - BR18-002890 - ReRoofCRY OF SANFORD
q, BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application. No: CAR 90
Documented Construction Value: $ . 119, 00
Job Address: q/0 S Eu XOT7 AVE SANFveP, fl 3071 Historic District: Yes No
Parcel ID: 30 Iq -3 ! - 5t5 ` OQGD • OZ 30 Residential® Commercial
Type of Work: New Addition Alteration Repair ' Deino Change of Use Move
Description of Work: IEE - 4yF , QW&N5 Cv4XZyd Jf/X4*110 'Z t: $Q ;
Fl ZA/TASTZL 2 $Q , G //Z - iiTG f/ Z r 56 Twr4l
Plan Review Contact Person:
Phone: Fax: Email:
Title:
Property Owner Information
Name _AIAak U&S, GAkOVE ST/tAVS Phone: 41731
Street: q1y J OuTol AVL Resident of property?
City, State Zip: 34ofoRD F1 32771
Contractor Information
Name To7At h/hE QoyFZAIG : i2ogUT J-VMV0 Phone: -4/07 %0 3910
street: Z01 t1/ 37 to N3 oI for Fax: 407 In of I
City, State Zip: W I,v76R $PA W65 F1 3 Z?Bg State License No.: «c- 133 mti8 9
Name:
Street:
City, St, Zip:
ArchitecVEngineer Information
Phone:
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 NOTICEOF 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 apermit 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: 51 Edition (2014) Florida Building Code Revised:
June 30, 2015 Petmh Applieadon
NOTICE: In addition to the requirements ofthis permit, there may be additional restrictions applicable to this property that maybe
found in the public records of this c6ur6, and there may be additional permits required from other governmental entities such as, water
management districts, state agencies, or federal agencies.
Acceptance ofpermit is 'verification that I will notify the owner ofthe property of the requirements ofFlorida Gen 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.
Date siprature cutractor/Arat Date
C r Qhher t DnlnwanPsiot4wnv/kgcm's Imime Pant Contrector/AaeWs Name
Signature
r/-/ le?
Ir:MES ANDERSON
My COMMISSION! is FF959102
EXPIRES February 10, 2020
Owner/Agent is Personally Known L&- Produced ID Type of ID
N
sigeahue of hoary-s Date
YP a OY
Commisaloni00 5D
Expires May 24, 20nrFnoe 8ond°dil°aBudpr4N rN8a^Aoa
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: Occupancy Use: Flood Zone:
Total Sq Ft of Bldg: Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No
of Stories:
Plumbing - # of Fixtures
of Heads Fire Alarm Permit: Yes[] No
APPROVALS: ZONING: UTILITIES:
ENGINEERING:
COMMENTS:
WASTE WATER: .
FIRE: BUILDING:
Revised: June 30, 2015 permit Applicatloo
r e, BREVARD COUNTY OFFICE
321-452-9223
HOMETOTALOME
ORANGE St COUNTY OFFICE
407-960-3810
VOLUSIA COUNTY OFFICE f
386-233-3244
NAME: Il DATE
STREET: CCC1330489
CITY/STATE/ZIP:
HOME PHONE: /
r
CELL PHONE: J 17
EMAIL:
I
ROOF Due Care taken to protect home exterior, shrubs and landscaping.
Includes labor to remove existing roof and haul off.
Includes Oumpster. Roll off dumpster for paver driveways.
Includes Inspecting deck for damage and renaalling to code with 80 ring shank nalls.
Includes saving gutters, soffit fascia d t g home (so adamage m;ty occur In constructlon).
rIndudesreplacingridgevents. (aJ /.SL OkIndudesreplacingexistingdripedgeinWeoColor. DRIP EDGE COLOR IfyT
Includes 11/4' roofing collated nails. rf
Includes Installing new shingles In choice of color. j SHINGLE COLOR '/ INT
I"dudes replacing all lead boots and goose vents (does not Include gas related vents). /7
Indudes new galvanized metal inall valleys.
includes Starter Shingle and Ridge CaO per Code.
includes obtaining and postingpermR with local jurisdiction.
Includes magnetically sweeping job she, cleaning out gutters and hauling away debris.
MATERIAL ARCHITECTURAL ASPHALT LIFE TIME SHINGLES
9
130MPH
UNDERIAYMENT PEEL 8 STICK 3018 FELT 151B FELT
MIX
O! 00
INCLUDES LABOR AND DUMPSTER TO REMOVE C LAYER(S) OF SHINGLES.
ADDITIONAL LAYERS WILL COST S PER LAYER ADDITIONAL LAYERS INT
Deteriorated existing decking replaced at SQLL_ per sheet of plywood(/ / L
Deteriorated existing decking replaced at S per linear R.—M/00/D ACKNOWLEDGMENT INT
Does not Include painting to match
Does not Include any stucco repro where deteriorated gashing had to bereplaced.
WARRANTIES Worry -Free Gold 7yrno"mrotedWORKMANSHIP INCLUDED
or Frree latlnu IS yr oft tndustve
rrorrooJrCorryo7yearwork - WPcoo ty
Eli UV VErflMRRXrUA1aA6 CiION - Customer In a s
Any interior damage which occurs during constructlon will not
INCLUDES NEW WIND mrnGATION--INSPE ON TOTAL Ji'(>
Y FINANCING OPTIONS
Monthly Payment
9.90% APR Is
12 months NO INTEREST Is T
Throupb We/4 farpoaon& withapprovedaedrt.
rAmndngmust becompletopriorto stmlofprefect
CUSTOMER DATE TOTCROME ROOFING DtTE
IHAVE READ AND UNDERSTANDTHIS PROPOSAL, THE TERMS AND CONDIMONS, AND ALL DOCUMENTS REFERENCED THEREIN AND AGREE TO BE BOUND BY THEIR
TERMS.
ACCEPTANCE OF PROPOSAL: The above prices, their specifications and conditions are satisfactory and are hearby accepted. Contractor Is authorized to do the work as
specified. By signing Customer acknowledges that Customer Is owner of the property where work Is to be performed.
ALL PAYMENTS ARE DUE UPON COMPLETION OF 7HE PROJECT.
ArrydelayIn payments may result In1.5% Interestper 30days.
Wind Mitigationsare not considered partofthe project but offered asa service to our customers throughathirdparty certifiedlicensed Inspection company andshall
notbe usedasreason for any delay of Rnelpayment.
This agreement constitutesthe entire contract by and between contractor and owner and parties arenot bound byoral expressions orrepruentationby any partyor
agent of either party.
ENSTRUM70TAas:, Oil D434 W Dnnos. FL 32708
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number.
11 lII I ifl « IIII Il1l I III Ifll fl!!
GRANT MALOYr SEMINOLE COUNTY
CLERK OF CIRCUIT COURT & COMPTROLLER
8K 9156 Ps 1257 (1P3s)
CLERK'S T 2018070678
RECORDED 06/20/2018 01:04:09 PM
RECORDING FEES $10.00
RECORDED BY jeckenro
Parcel ID Number: 39- I ` -3/ .5l - _ 6040 -OZ 3O
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.
DE CRIPTION 022ROPERTY: (Legal descoi tion of the property end street address if evaitable) V'T 13 sal .. • s1. S' FT P7 BEG
FEAT M ELL4#
Ps 3 /6 ! f
GENERAL DESCRIPTION OF IMPROVEMENT:
re -roof ONLY
OWNER INFORMATION:
Address:
Fee Simple Title Holder (if other than owner) Name:
Address
CONTRACTOR:
Name: Total Home Properties DBA Total Home Roofing
Address: -dl W ST RD 434 Winter Springs, FL 32708
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served
as provided by Section T13.13(1)(b), Florida Statutes.
Name:
Address:
In addition to himself, Owner Designates
To receive a copy of the Llenors 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
different 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.
Under penalties e a ave rea the foregoing and that the facts stated In It are true
to the bes n dge d bet.
m Owners PMtedName
Flaws Itt uft 713.13(11(gy' Tho ownm mat sign dro notke ofcwwnwcanent end no onoofso may be pem0W tosign In hisor herstew.'
State of FLORIDA County of SEMINOLE
The foregoing instruu nt was acknowledged before me this / / day of Zy i e
by Who is personally known to me
Nameof person making voWnft / '; J
OR who has produced Identification "a of Identification produced: tfi (
9AMES ANDERSO11(
MY 4g0M AISS10N # FF95940
EXPIRES February 10, 2020
a2 •
t .1
2 2
d w
U o:
w w poFI.-U
O 0 oNz
V V 4 N
cc
O
C
SEMINOLE COUNTY MOLT/ )URISOICTIONAL
LIMITED POWER OF ATTORNE*
Altamonte Springs, Casselbery, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 6/20/18
I hereby name'and appoint: Cara Laracuente
an agent of. Total Dome Roofing
Name of Company)
to be my lawful attorney -in -fact to act for Te to apply for, receipt for, sign for and do all things necessary to this
appointment for (check only one option)t
Z All permits and! applications submitted by this contractor.
Or
The speck permit and application for work located at:
201 W State Road 434 Winter Springs FL 32708
Expiration Date for This Limited Power of Attorney: 6/20/19 i
License Holder Name: Robert Donovan
State License Number: CCC1330489
Signature of License Holder:
STATE OF FLORIDA ,
COUNTY OF StinrybGF i
s
The foregoing instrument was acknowledged before me this day of Jun e
20_IX by Qt:dbeX 1 00 n.CJVC n who Is 5(personally known to me or
0 who has prodooed as identification
and who
y : #GG 221750
Gy 90 ; OdodClhN,1f'. +Q'
Notary 5t, p4':
e('
an oath.
f
Pdnt or type Notary name
Notary Public - State of
Commission No.
My Commission Expires:
CITY OF
SkNFORD
BUILDING DIVISION Building c C Fire Prevention Division
Re -Roof Permit Card
PERMIT NO. 1 V wAIR q V ISSUE DATE: ' 1
CONTRACTOR: A004' ii St
JOB ADDRESS: 410 fowitlos*
TYPE OF WORK: kco p
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 TIIE 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 TOTHIS PROPERTY THAT MAY BE FOUND IN THE PUBLIC
RECORDS OF THIS COUNTY, AND THERE MAY BE ADDITIONAL PERMITS REOUIRED 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 855.541.2212
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
CITY
I
Building & Fie Prevention DivisionSjkiq—*F.0.R-DRESIDENTIAL RE -ROOF POLICY & PAOCED URES
FIRE 01PARTMENT
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. i
THE SCOPE OF WORK MUST INCLUDE ALI, APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF
COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT.
I
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 A ID APPROVAL BY THE
SANFORD HISTORIC PRESERVATION BOARD
INSPECTION POLICY & PROCEDURES
A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMIIJY , 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 INSTRUCTIOrIS
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 $c 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 PRODUCTAPPROVAL
o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT APPROVAL
I
FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PRO IDED BY A FLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC OMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNERIBUILDER) SIGNATURE: DATE: & G
CiTY OF
ORD
JOB ADDRESS: 1 Ib S 1:.1 I i v+ awe
PERMT #
Building & Fire Prevention Division
RESIDENTIAL REPROOF SCOPE OF WORK
I
i
STRUCTURE TYPE: k!9 SINGLE FAMILY RE3IDENCEI TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONI NTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY):
i )n C, -D
PLEASE NOTE: ONLY 100 SQUARE FkET OF THE 1aS7I1VG DECK ISPERMITTED TO BE REPLACED**
1
ROOF VENTILATION: O OFF -RIDGE IkkIDGE OSOFFIT OPOWERED VENT QTVRBINEs
SKYLIGHTS: O YES wO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
fROOFSLOPE: O LESS THAN 2:12 O 2:12 — 4:129:12 OR GREATER
r
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE G 5 Chi n) n FL# JO 4
O METAL FL#
0MODIFIED BITUMEN FL#
OTORCH DOWN FL#
OINSULATED FL# i
O TI-E FL#
O OTHER: FL#
i
ROOF EXTENSIONS (PORCHES. PATIOS. ETC.) **IFAPPLICABLE**
ROOF SLOPE: p LESS THAN 2:12 Q 2:12 — 4:12 p 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O SHINGLE FL#
OMETAL FL#
O MODIFIED BITUMEN FL#
I
O TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
FIRE INSPECTIONS CITY OF SANFORD
407.562.2786 BUILDING & FIRE PREVENTION
BUILDING INSPECTIONS 300 N PARK AVE
55.541.2112 SANFORD FL 32771
DRIVEWAYS -SIDEWALK 407.688.5080
Page 2
Application Number . . . . . 18-00002890 Date 6/28/18
Property Address . . . . . . 410 ELLIOTT AVE
Parcel Number . . . . . . . . 30,19.31.525-0000-0230
Application description . . . ROOFING APPLICATION
Subdivision Name . . . . . . FORT MELLON
Property Zoning . . . . . . . SINGLE FAMILY
Permit . . . . . . RESIDENTIAL ROOFING PERMIT
Additional desc . .
Phone Access Code 1061118
Permit pin number 1061118
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
1000 Ill BL03 FINAL ROOF _/_/_
CITY OF
Ski4FORD
FIRES DEPARTMENT
Building & Fire Prevention Division
RESIDENTUL REROOF AFFIDA VIT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHINGS DRY -IN, FLASHING, AND ALL FINAL ROOF COjVERINGS
r,
I I
PERMIT #: V ADDRESS: 40
ooer + xlfw, 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 #: C cc I Is aD H v /1
COMPANY / CONTRACTOR:
pp
CONTRACTOR SIGNATURE: DATE: O I a
MUST BE SIGNED BY LICENSE HOLDER O R/BUILDER) q
A FINAL ROOF INSPECTION IS REQUIRED.
THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINALIROOF 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 134'1"
day of 20 by:
COW- llrlfl l t'1 Who is a onally Known to me or has D Produced (type of
Zgniden '
ca on) as identification.
ature of N Public
Stat of Flor'
Pri ype/Stamp Name
of Notary Public
M!V CARALLWACUEN I i
Commission gGG NMIEONA0Idi
io!AfIFab b omq 8 MM7019