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PAYING TWICE FOR IMPROVEMENTS; T....Q"YOURR',"PTy NOTICE, OF COM]VI,ENC.EIVIENT"MUST BEOST PRECORDEVAND, EP,A N ,O :UW190-,,SIT.E,E, ,.REFORE THFIRST 'INSPECTION .'IFYOU; INTEND 4610BTAjX- FINANCING, $VL-TWTrYOUR LENDER
DR , BEFORE 9Olk ING YOURNOTICE OF Application is l erc fy d
sta ations,-: 'i a eo' -M, 1',Ill440; work ar nstallatton has d"t b't-ajjq;k' todi 'ih k' A-4-Ad i i jun.-
sdidibfi. I understand
that' a" Sepmust "&,l i -Jelectrical-' I - bit- .Wells Pools q" - I -.` A; STPsi pre, [or, t,Nvor p,umnOr0furnaces, boilers, heaters, Ip
lj;, TRCIOUS6Riinscribedwith
4*6UH ,i)tfifat-dafe 51 Edjtjqn-(20-11 Pea ii p iu Revised: IJune,-3 0 20,0: ?
c,rAAppIcarion
ORINTHIANS DAVIS
5Commission # F 56721
My Commission Expires
SePtOMber 03, 2018
NOTICE: In addition to the reqtiirements,of tffislpcmait, there may be additional 'tostndti6nsa -1k6b]. t Ah"' pp.qq,.,.q,o q Op,,cr1ythat*,,may e
foundin the public.records ofthis -county., and theme maybe aOdjfiOt4k,' governmental entiticg.guhAs water. tnaffagement:
distncisi,.state,agencies,:orl,fe.deral,azencies.,. Acceptance,
qfperTKiitis-v4izrificatioii tharl will notify th6 owner of property rtybfihextquittinents,ofPlotid&t,,ientaw,P87,,-I3zII- The
City of.Salford .itquires paythent of aplah',re-0kw fee ai,.the76me,-ofpermtf,sqbinlfW 'executedI contract requiiecl `b
t.- the-4fibb.-of subnuttaL. Iqonsiderc - c - 9,1. .]R. t , , ill: order, to cilcufge,a plaTureview charge ,and will I . i estimated , construction bedIS '-6d' 'g'p1. u 6ffid,,
4t 6: ev, epek-m i -issued;-In The. ,aptpal,co wi n." " PCq, jj -,,-d - " -,—ffi tjCc--,,Viiwid,f based P A'-
th 4C bjatfUt &XCFedd',.th6z9c I,dfion;v'al'u'e, accordanceqW&4AUAWd pr -,,R, ,i : q executed actual construction; Shcffcredit
q gppp§4to Y ur ,fees ,when ,-,fire ,permi iLsjs, OWNER'18,
A"'AV-J— 0' that A ofhb I 64-otie, int.
6, Abj frec 1-7Signature
f)fOwnci/.-
gmt A0, c A017:
71-1 Print OwnedAgent's -
Name 10111 17 Signature ;
O,fNo
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6,r. Owncr/Agptifi-8ersfrmahoni"s
curate andthat all work'will rnchon )Wzo'ning.
Date Cpntr
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ProducedID- D4 BELOW
IS FOR .
OFFICE I: USE. ONLV ult-d6gT-] O`
iotiltdE] EJiftgEl G-4.0 R,6ofO"' Permits oot8106ib, Construction. Type: OC60-
A-MY U,-Se::,. Flood Zone:,. Total Sq,Ft-
of.Bf4g;.. -Of softeRa Papoy 9k NewConstruction: Electric --#
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WASTEWA TER::,
SEA4INOLE COUNTY MULTI%URISDICTIONAL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs, <Nke c {mac \L.,
Date: n J / t-)
I hereby name and appoint:A_Sri t V ISrYCS'
an agent of:
of
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):
KA
LLJ
Or
0
All permits and applications submitted by this contractor.
The specific permit and application for work located at:
Street Address)
Expiration Date for This Limited Power of Attorney: Ce-Y \1C
License. Holder Name: ` '
State License Number:
Signature of License He
STATE Oi= FLOR q --
YY tCOUNTYOF _
The foregoing instru ent was acknowledged before me this day of
2d 2) by 1f 1(iir r ` ```who ismpersonally known to me or
who has produced as identification
an who idLidt) take an oath.
ignat re of Notary
It
Print or type Notary name
Notary Public - State of J
Commission No. 1"ZtG 3c
My Commission Expires C q
6t0Z'9Z lag=0:S3HldX3 :... .,,•_
6£6LZ6 &I # NOISSMLNOO AW ice; K
W1IHivl WSW
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number.
liilil Ilil! iilii lllli !i!!i lliii !!!! !ii!
GRANT MALOYr SEMINOLE C:OIJNTY
CLERK. OF CIRCUIT COURT & COMPTROLLER
BK 9007 Pq 493 (1Pgs )
CLERK'S 4 2017103923
RECORDED 10/16/2017 11.40.26 AM
RECORDING FEES $10.00
RECORDED BY .ieck nro
Parcel ID
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
DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
GENERAL DESCRIPTION OF IMPROVEMENT
OWNER
r5..z l i!' T1.:'`:r il lTilli it 1A
Address:
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served
as provided by Section 713.13(1)(b), Florida Statutes.
Name:
In addition to himself, Owner Designates Of
To receive a copy of the Uenor's 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
INSPECTIDN. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true
to the b of my knowledge and belief.
Owners signature Owners Printed Name
Florida Statute 713.13(1)(g): 'The owner must sign the notice of commencement and no one else maybe permitted to sign in his or her stead
State of F-1 O E t AC-%- County of ) E M t (1 C) 1,e .
The foregoing instrument was acknowledged before me this ( 1 day of O(' -i Lo bo-,c
by 'fieX1laSS- CoLL,nonWI Name
of person making statement OR
who has produced identification type of identification produced: CORINTHIANS
DAVIS Commission #
FF 156721 My
Commission Expires 1
wnro September 03, 2018 n" Notary
signature F>-
C-
UILDER'S
Sameer Asmar/Ali Asmar
7608 Dunbridge Dr., Odessa, Florida 33556
C/ 813-843-5119 0/813-920-9065 F/813-920-9064
sasmar rhgbuilders com sasmarna gmail.com aliameccabuilders com
September 19, 2017
Venus Facciponti
2533 Iroquois Ave
Sanford 32773
Phone: Email: ifaccip(a,gmailcom thep)anetrnom(a,gmail.com
Mast"e"r Elite
We propose to furnish All Labor, Materials and Permits as needed for the New Roof. Total 24 Squares including flat areaWorkScone
I. Permits
1. Pull and provide all Permits necessary and provide homeowner with inspection results. II. Roof Approximately 24 Squares
1. Remove current shingle roof and undedayment layers -Currently 1 Layers of Shingles. 2. Remove the old vent stacks, goose neck and e-drip edge.
3. Install 2 3/8' ring shank nails around the perimeter and the decking of the roof at 6° intervals. 4. Remove and Replace any rotten plywood on the roof. Include up to 7 full sheets of plywood.
5. Replace the rotten fascia along the home - Will replace all the rotten fascia boards found up to 50 LF. 6. Install GAF Weather Watch Leak Barrier
7. Install GAF Tiger Paw Underiayment with the Life time Roofing System.
8. Install New Vent Stacks and New Goose Neck Stack.
9. Install New 26 Gauge galvanized metal Valley flashing in all valleys and new metal flashing around the chimney.
10. Install New E-Drip around the entire edge of the home color as per owner selection.
11. Install GAF Pro Start Starter with Life time Roofing System.
12. Install GAF Timberline HD Architectural Dimensional shingles as per owner selection of color.
13. Install GAF Cobra 3 Ridge Vents with Life time Roofing System.
14. Install GAF Pro Ridge cap with Life time Roofing System.
15. For the Flat roof Modified Bitumen Base sheet and a Granulated Modified Bitumen Torch Down Cap Sheet.
III. Insurance and Wind Mitigation
1. Provide and fill out the necessary Wind Mitigation forms) and provide pictures for the insurance wind mitigation.
2. Provide a Roof Certification that can be provided to the Insurance Company.
IV. Dispose of Debris
1. Cleanup of job site, removal of all demolition debris as well as removal of all construction debris. Keep the area
broom swept clean.
V. Warranty
1. A 25 year warranty for all labor performed as part of the replacement process provided by GAF.
2. A GAF/50 year lifetime - Golden Pledge Lifetime Warranty will be provided based on the GAF Lifetime Roofing
System.
MATERIAL SCHEDULE
GAF Tigerpaw / 2 3/8" Ring Shank Nails for re nailing the deck as per Florida Code. GAF Timberline HD Architectural
Dimensional, Shingle.
GAF/50-LifeTime Warranty are 130 Mile Per Hour Dimensional Shingle as Per New Code. As per FBC.
Our price for performing this work is $9,600.00 with the GAF Golden Pledge Warranty which is Upgraded Materials to the
GAF Lifetime Warranty Roofing System. All of our roofing, new construction and home ad iti ns come with a warranty for
quality and performance.
PAYMENT SCHEDULE
Total Contract Price
Deposit at Signing
Balance to be paid at project completion
Conditions:
J 0
49; 69.80
1,000.00)
ell
ald 0
1. GAF WILL PROVIDE A 25 YEAR WORKMANSHIP WARRANTY FROM THE COMPLETION DATE FOR THECOMPLETERE -ROOF. GAF PROVIDED GOLDEN PLEDGE LIFETIME WARRANTY — 50 YEAR NON PRORATEDWARRANTYONALLTHEMATERIALS.
2. MATERIALS HAVE A GAF GOLDEN PLEDGE LIFETIME 50/LIFETIME YEAR WARRANTY AS PER THEGOLDENPLEDGELIFETIMEROOFINGSYSTEM. As required by GAF, the contractor, Rainer Builders LLC/RHGBuildersLLC, will register and pay for the GAF Golden Pledge Ltd. Warranty within 45 days after installation. If thecontractorfailstoregisterandpayforthewarrantywithinthe45daysandGAFrefusestoissuesaidwarranty, thecontractorwillreimbursethehomeownerfortheassociatedcostoftheGAFGoldenPledgeLtd. Warranty as determinedbyGAF.
3. At the completion of this project, Contractor shall execute an instrument to Owner warranting the project for (25YearsLaborand50YearsMaterialfortheGAFTimberlineHDDimensionalShinglesthewarrantyisheldandhonoredbytheGAFCompany) against defects in workmanship or materials utilized. No legal action of any kindrelatingtotheproject, project performance or this contract shall be initiated by either party against the other party after thewarrantyhasbeenregisteredandbeyondthecompletionoftheprojectorcessationoftheWork. 4. This warranty is in lieu of any other warranty, express or implied. Any implied warranties, including but not limitedto, the implied warranty of merchantability, fitness for a particular purpose, habitability, and any UCC warranties arewaived.
5. This warranty shall be null and void and Contractor shall not be liable for any damages or expenses, If OwnerdoesnotfirstgrantContractoraccesstothepremisesandtheopportunityofContractortoinspect, correct, or replaceallegeddefectiveitemsbeforeOwnerincursexpensesorhasworkdonebyareplacementcontractor. 6. Contractor hereby assigns (to the extent they are assignable) and conveys to Owner all manufacturers' andsuppliers' warranties, together with operating instructions if available , on all goods, material, equipment and appliancesprovidedtoContractor. Owner's sole remedy for defective products is against such third party vendors and theirwarranties, if any.
7. Any claims for defects in construction, material, or workmanship are subject to the notice and cure
provisions of Chapter 558, Florida Statutes. Such claims must first be presented in writing to Contractor (and notContractor's insurance provider) to allow opportunity for Contractor to inspect and repair.
8. IF THERE IS MORE THAN ONE LAYER OF SHINGLES THEN A $10.00 PER SQUARE ADDITION WILL BEADDEDTOTHEBALANCE.
9. SHOULD YOU HAVE ANY QUESTIONS OR COMMENTS, PLEASE CALL US.
10. PLYWOOD REPLACEMENT AT AN ADDITIONAL CHARGE OF $50.00 PER SHEET.(4)0) (if needed
beyond the 7 sheets in the agreement.) ALL NAILS AND NAIL PATTERNS TO MEET CODES. PLYWOOD
CLIPS SHALL BE USED AS PER CODES. REPLACEMENT OF DAMAGED OR ROTTEN 3-FASCIA WILL BE AT A
RATE OF $3.95 PER LF.6-FASCIA $3.40 PER LF_ (Excluding the 50 If included in the agreement.) SUB FASCIA AND
RAFTERS ARE AN ADDITIONAL $5.25 PER LF.
ESTIMATED TIME OF COMPLETION WILL BE DETERMINED UPON RECEIPT OF PERMIT, EXCLUDING
SUNDAY AND WEATHER DAYS.
A 3.5% CREDIT CARD PROCESSING FEE WILL BE CHARGED ON ALL CREDIT CARD TRANSACTIONS.
This agreement is subject to revision or withdrawal by RAINIER BUILDERS LLC / RHG BUILDERS LLC until signed and
accepted by Client and executed by an Officer of RHG BUILDERS LLC. This is the complete agreement between the two
parties. No prior of contemporaneous oral agreements, and no other written agreements, except as listed above, shall be
binding. The undersigned hereby accepts this Agreement and agrees to be legally bound by all the terms and conditions
set forth on the terms and conditions page. This Agreement shall be governed in accordance with the laws of the state of
Florida. Any action arising under this Agreement shall be brought in the County where RAINIER BUILDERS LLC / RHG
BUILDERS LLC' s principle office is located.
Cli nt Signature Date/
Emmanuel Chipungu
September 19, 2017
Sameer Asmar/Ali Asmar
State Certified Licensed General and Roofing Contractor
GAF Master Elite Roofing Contractor
RHG Builders LLC - Lic#'s CGC-1513313/CCC-1329799/Rainier Builders LLC — Lic# CGC-1521952/CCC-1330366
www.rhgbuilders.com THANK YOU FOR YOUR CONSIDERATION
r, t. City of Sanford
Building and Fire Prevention
Product Approval Specification Form
Permit #
Project Location
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.floridabuilding.org.
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 Up
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
Florida Approval #
including 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 HID cx V-Ch-X
Underla ments
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 /
Coating
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 up
Equipment
Other
6. Skylights
Skylights
Other
7. Structural
Components
Wood Connectors /
Anchors
Truss Plates
Engineered Lumber
Railing
Coolers/Freezers
Concrete Admixtures
Precast Lintels
Insulation Forms
Plastics
Deck / Roof
Wall
Prefab Sheds
Other
8. New Exterior
Envelope Products
Applicant's Sig
Applicant's Name
Please Print)
June 2014
r'
CIA
coe+ac oournx Ftc uon
Parcel Information
Property Record Card
Parcel: 01-20-30-508-0000-0040
Owner: FACCIPONTI JOSEPH JR & ROUSSOS VENUS
Property Address: 2533 IROQUOIS AVE SANFORD, FL 32771
Value Summary
Parcel 01-20-30-508-0000-0040
Owner FACCIPONTI JOSEPH JR & ROUSSOS VENUS
Property Address 2533 IROQUOIS AVE SANFORD, FL 32771
Mailing 2533 IROQUOIS AVE SANFORD, FL 32773-5054
Subdivision Name DREAMWOLD MARIAN SEC
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions 00-HOMESTEAD(1999)
y
i
Pn
Semino County GIS
Legal Description
LOT 4
DREAMWOLD MARIAN SEC
PB9PG101
Taxes
2017 Working 12016 Certified
Values Values
Valuation Method Cost/Market Cost/Market
Numberof Buildings 1 1
Depreciated Bldg Value I $56,296 51,169
Depreciated EXFT Value 8,440 8,440
Land Value (Market)
Y
16,000 - - 16,000
Land Value Ag
Just/Market Value " 80,736 75,609
Portability Adj
Save Our Homes Adj 1 $9,602 5,938
Amendment 1 Adj
P&G Adj l -
0 0
Assessed Value 71,134 69,671 -
Tax Amount without SOH: $702.28
2016 Tax Bill Amount $649.80
Tax Estimator
Save Our Homes Savings: $52.48
TRIM Notice Help
Does NOT INCLUDE Non Ad Valorem Assessments
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund 71,134:: 46,134. 25,000
Schools 71,134 ' 25,000 46,134
City Sanford 71,134 46,134, 25,000
SJWM(Saint Johns Water Management) 71,134 46,134 25,OOOJ
County Bonds 71,134 46,134 25,000
Sales
Description Date Book Page Amount Qualified Vac/Imp
WARRANTY DEED 5/1/1998 03435 0840 72,000 Yes Improved
QUIT CLAIM DEED 9/1/1986 01776 0703 100 , No Improved
WARRANTY DEED 5/1/1979 01224 0371 29,000 Yes 1 Improved
Find Comparable Sales
I Land
Method Frontage Depth Units Units Price Land Value
LOT 0.00 0.00 1 $16,000.00' $16,000
Building Information -
Is Bed/Bath count incorrect? Click Here.
Description Year BuiltActual/Effective Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages
1 SINGLE 1956 6, 3 2.0 ' 1,470 1,845 1,745, CB/STUCCO $56,296 1 $100,081 j Description AreajFAMILYFINISH
275.60jj
I Permits
BASE l
FINISHED
UTILITY I
FINISHED ' 55.00
1__.,—.__.
OPEN j
PORCH } 45.00
FINISHED
I
Permit # Description Agency Amount CO Date Permit Date
04782 ` REROOF COUNTY $1,800 5/1/2003
01708 g REROOF
e.._.......,_..___,e__.._...—,_
SANFORD $1,800 15/1/2003
i Extra Features
Description Year Built Units Value New Cost
ELECTRIC HEATER 12/1/1983 1 ! $440 1 $1,100
POOL 2 12/1/1983 1 $8,000 i $20,000
CITY OF
Ski4FORD 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 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 OwNER/BUILDER) SIGNATURE: DATE: I 1
Ir.CITY OF
JOB
PERMIT # /-7 - —W
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
STRUCTURE TYPE: ® SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: 0 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 FEET OF THE EXISTING DECKIS PERMITTED TO BE REPLACED
ROOF VENTILATION: O OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 O 2:12 - 4:12 O 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE FL# I,4L4
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
OTHER: OL FL# `%
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#
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
CITY OF
S.,kNFORD 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 #: / ADDRESS:
AS A(N) GENERAL, BUILDING, RESIDENTIAL, ORROOFINGCONTRACTOR, ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THEFOREGOINGINFORMATIONISTRUEANDACCURATEANDTHATALLROOFINGCOMPONENTSLISTEDONTHESCOPEOFWORKATTHE
ABOVE REFERENCED ADDRESS HAVE BEEN INSTALLED IN ACCORDANCE WITH THEIR PRODUCT APPROVALS AND ALL APPLICABLE CODEREQUIREMENTS — SPECIFICALLY FLORIDA BUILDING CODE, EXISTING BUILDING. IN ADDITION I CERTIFY THE INSTALLATION MEETS ALLREQUIREMENTSFORSECONDARYWATERBARRIERANDNAILINGOFTHEROOFDECK, IN ACCORDANCE WITH THE HURRICANE RETROFITMANUALREQUIREMENTS (BASED ON F. S. CHAPTER 553.844).
LICENSE #: 0
COMPANY/
CONTRACT
MUST BE S
CONTRACTOR: 1 S
OR SIGNATURE:
DATE: IGNED BY NSE HOL =ER 41—tQ11
A FINAL ROOF INSPECTION IS REQUIRED:
THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE ATTHE 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 PERMTr NUMBER OR ADDRESS CLEARLY MARKED ON THE DECKFOREACHINSPECTION. THE PHOTOGRAPHS MUST INCLUDE A RULER OR MEASURING DEVICE TO CONFIRM ALL NAIL SPACING ANDOVERLAPS, INCLUDING DRIP EDGE AND VALLEY FLASHING. PLEASE REFER TO THE RE -ROOF POLICY AND INSPECTION PROCEDUREPAPERWORKFORFURTHEREXPLANATIONOFALLREQUIREMENTS.
FAILURE TO FOLLOW ALL REQUIREMENTS WELL RESULT IN A FAILED INSPECTION, A RE -INSPECTION FEE AS
WELL AS REQUIRING A DESIGN PROFESSIONAL (ARCHITECT OR ENGINEER) TO CERTIFY, BASED ON PERSONALINSPECTION, THE INSTALLATION OF ALL ROOFING COMPONENTS.
STATE OF FLORIDA COUNTY OF
Sworn to and Subscribed before me this day of 20 _1_qby:
lt'- Who is Personally Known to me or has YC'produced (type of
id tification) as identification.
I atare of Notary b c-
State of Florida
Print/Type/Stamp Name
of Notary Public 4iinN •