163 Walnut Crest Run - BR17-003226 - FENCEI
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
1110V 0 2 2017 Application No: q
Documented Construction Value:
Job Address:r'T 2c NcP, L Historic District: Yes No.
Parcel ID: 3;?-7
Residential ® Commercial
Type of Work: New Addition Alteration Repair ® Demo Change of Use. MoveEl
Description of Work:
Plan Review Contact Person: Lv ! S C C—uju-Do Title:_ Pm- 1
Phone: Fax: Email:av cala'c)0 g"'e-ui /G/or, Cdo J
Property Owner Information
Name L13- 'C)T'c Phone:
Street: 6,3 a Lae F
A
p '' City, State Zip: wfil ,NTE2- S i it JCS ',?
j Coot actor
Name Cow-?Lei-eeA,5&L'_ Tx, IZya i 6,Co
Street: -2 g 7 5 S . c30A-N %f=
City, State Zip:
Resident of property? :
Information
Phone:1-33-`3` .
Fax: L/ 30
State License No.: CCU 1 'S a8 36 S
Architect/Engineer Information
Name: Ni LA Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company: OJ / A
Address:
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 of application and the code in effect as of that date: 511 Edition (2014) Florida Building Code
Revised: June 30, 2015 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 ofthis county, 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 ofthe requirements ofFlorida 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 ofthe 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 Date
Print Owner/Agent's Name.
Signature ofNotary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Signature ofContractor/Agent Date
Lut5 OuFUC'9v
j4i"rQm.o+ II 2- l'1
Signature a ofFlorida?,-. .f to
E BLAND
Nr le -State of Florida
GG 060623
o.......r' My hires Jan 16, 2018
Contractor/Agen i Per to Me
Produced ID Type of ID
BELOW IS FOR. OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas[] Roof `IN
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
Flood Zone:
of Stories:
New Construction: Electric - # of Amps - Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING: UTILITIES: _
ENGINEERING: FIRE:
COMMENTS:
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING -
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Revised: June 30, 2015 Permit Application
THIS INSTRUMENT PREPARED BY:
Name: Luis Quevedo
Address: 2875 S. Orange ave #500-1515 Orlando, FL 32806
Permit Number:
GR(ilgT Iiril..t7'i`, ;!`Il:th}CILE C:Ijt)p.('C'tCLERKCIFC:):RCUTT COURT 2. CC31'I'Tf:rjLL.E f; BY.9'017 F's 1291 (iP:4>}
CLERK'S Y 21117111at11RECORDED1-1/1.32/2017R`:COR[t):ING FEEa d:.l.t =itttRECORDEDBY .1't:1---.P 1ta
Parcel ID Number: 22-19-30-502-0000-1150
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. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
LOT 115
PRESERVE AT LAKE MONROE
PB62PGS12-15
2. GENERAL DESCRIPTION OF IMPROVEMENT:
RE -ROOF
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: ALBERTO SOTO
Interest in property: 632 BLENHEIN LOOP WINTER SPRINGS, FL 32708
Fee Simple Title Holder (if other than owner listed above) Name: N/A
4. CONTRACTOR: Name: COMPLETE QUALITY ROOFING, CO. Phone Number: 321-332-3392
Address: 2875 S. ORANGE AVE #500-1515 ORLANDO, FL 32806
5. SURETY (If applicable, a copy of the payment bond is attached): Name: N/A
Amount of Bond:
6. LENDER: Name: N/A Phone Number:
Address:
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents maybe served as provided by Section
713.13(1)(a)7., Florida Statutes.
Name: Phone Number:
Address: N/A
8. In addition, Owner designates
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 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 A .-TZ
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. n A 3
i__
OWNERK
Signature of (honer or Lessee, or Owners or Lessee's (Print Name and ProvideSignatory'sTitle/Office) !z o
Authorized Officer/Director/Partner/Manager) r r i
State of &_-Or, de, County of
The foregoing instryment was a9knowledged before me this -----2tI.e
day of + n ;.,20~
by Q Who is personally known to me 0 OR ,y a
po%VA gpJq statement
who has produced idea io Ientification produced:
My Comm. Exoms
May '15, 2o+e
Comlrl.OFF 1 Notary Signature
CD
e
Revildors.I
Quality Roofing & Inspections
2875 S. Orange Ave Ste., 500-1515 • Orlando, FL 32806
Telephone: (321)332-3392 • Fax: (407)985-2823
License # CCC1328368 • H18695
Proposal
Prepared for: DATE September 22, 2017
Quotation # 2017-2020
Quotation valid until: October 22, 2017
Alberto Soto Prepared by: Luis Quevedo
163 Walnut Crest Run
Sanford, 32771
Revildor Agrees to furnish the material and labor and material for the above referenced
improvement as follows:
X) Remove existing roofing material down bare decking or workable surface.
X) Re -nailing of roof sheathing - complete re -nail to meet code specifications.
Note: Damaged decking to be removed and replaced at a rate of $75.00 per sheet of
plywood, or $5.00 per linear board foot). This amount is NOT included in final total.
X) Install new underlayment according to code specifications. (Add $700 for SWR optional)
X) Install all necessary new drip edge and flashing to meet code specifications.
X) Install new lead boots and vents to meet code specifications.
X) Install new building code approved shingles according to specifications:
Shingle Type: Certainteed LandMark Designer (if available) Color: TBD
X) Remove, haul away all roofing debris and leave premises clean.
X) 5 years labor warranty
Notes: Hurricane Irma related inspection and estimate.
TOTAL 1 $ 8,500.00
Price is valid for 30 days from the date of this estimate
With payment to be made as follows: 50% Upon signing and approving the binding terms
and condition of this proposal
50% Upon completion of work.
Costumer Initials
Contractor Initials
THANK YOU FOR YOUR BUSINESS!
BINDING TERMS AND CONDITIONS
Revildor (hereinafter, "Contractor") assumes no responsibility for structural integrity of the deck, roof, or the building in which the
roofing is to be installed. Contractor relies on customer assurances that all structural integrity of the deck, roof, or building is to be in
sound condition capable of withstanding the anticipated roofing construction and operation. Customer assures further that customer
has had the deck, roof, or building inspected by an engineer or other licensed professional capable of certifying the structural integrity
thereof. Customer acknowledges and agrees that Contractor does not provide engineering, consulting, architectural or design services.
It is the owner's responsibility to retain a licensed architect or engineer to determine proper design or code compliance. Contractor is
not responsible for design of the work to be performed and any change in specifications or construction necessary to conform to
existing or future building codes, zoning laws, or regulations shall be considered additional work to be billed to Customer for
additional compensation for the additional work and materials.
2. Customer is solely responsible for providing Contractor with such water, electricity, or any other utility as may be required by the
Contractor to effect the work covered by this Agreement during the performance ofthe work contemplated therein.
3. In the event customer requires the matching of colors, Contractor shall make reasonable efforts to contain a color match, however using
standard color and materials. Customer acknowledges and accepts that Contractor does not guarantee a perfect color match.
4. This Agreement does not contemplate work involving asbestos -containing or toxic materials. CUSTOMER ASSURES
CONTRACTOR THAT CONTRACTOR SHALL NOT BE EXPOSED TO ASBESTOS -CONTAINING OR TOXIC MATERIALS
DURING THE PERFORMANCE OF THE WORK CONTEMPLATED IN THIS AGREEMENT AND THAT ASBESTOS -
CONTAINING OR TOXIC ARE NOT PRESENT. IN THE EVENT THAT CONTRACTOR DISCOVER ANY ASBESTOS -
CONTAINING OR TOXIC MATERIALS, CONTRACTOR SHALL BE ENTITLED TO ADDITIONAL COMPENSATION FOR
EXPENSES INCURRED AS A RESULT OF THE HANDLING OF ASBESTOS -CONTAINING OR TOXIC MATERIALS.
5. CUSTOMER SHALL BE ENTITLED TO ORDER CHANGES AND THE AGREEMENT PRICE SHALL BE ADJUSTED
ACCORDINGLY UPON REMOVAL OF THE EXISTING ROOFING AND THE DISCOVERY OF CONDITIONS WHICH
REQUIRE ADDITIONAL WORK, INCLUDING BUT NOT LIMITED TO ROTTEN OR DETERIORATED WOOD. If the scope of
work outlined on the face of this Agreement does not contemplate subsequently discovered conditions, Contractor will promptly report
the condition to Customer and take such steps as are reasonably necessary and prudent to protect the affected structure. Unless
otherwise noted in this agreement, the price quoted does not include removing or replacing fascia, trim, sheathing, rafters, structural
members, siding, masonry, or roofing of any type. If, during the course of work, it should become apparent that any such portions of
the structure should be repaired or replaced, Customer may authorize Contractor to do such additional work for additional
compensation. Customer will be responsible for compensating Contractor for any alteration to or deviation from the specifications
described in this Agreement.
6. Contractor agrees to complete the work within a reasonable time, subject to such delays as is permissible under this Agreement. All
material is warranted as specified. All work will be completed according to standard roofing practices. Contractor shall not be
responsible for loss, damage or delay caused by circumstances beyond its reasonable control, including but not limited to acts of God,
weather, accidents, fire, vandalism, regulation, strikes, failure or delay of transportation, shortage of or inability to obtain materials,
acts of Customer and/or Owner and/or agents of Customer and/or Owner. CONTRACTOR IS NOT .REQUIRED TO REMOVE
WATER FROM THE ROOF. If the roof(s) need to be unloaded due to high winds or storm, customer agrees to compensate
Contractor for labor and equipment for unloading and reloading the roof(s). If gutter and/or downspouts are to be removed to facilitate
a re -roof, Contractor shall not be held responsible for any damage caused by removal and/or re -installation of gutter and -or
downspouts. Contractor is not responsible for adequacy of drainage or ponding on the roof. Customers acknowledge that re -roofing
may cause vibration, disturbance, dust or debris, to fall in the interior. Customer agrees to remove or protect property under the roof or
in the vicinity of the work area in order to minimize potential interior damage. CONTRACTOR SHALL NOT BE RESPONSIBLE
FOR DISTURBANCE, DAMAGE, CLEAN-UP OR LOSS TO INTERIOR PROPERTY THAT CUSTOMER DID NOT REMOVE
OR PROTECT PRIOR TO COMMENCEMENT OF THE WORK. Customer shall notify tenants, if any, of re -roofing and the need to
provide protection underneath the work area. CUSTOMER AGREES TO INDEMNIFY AND HOLD CONTRACTOR HARMLESS
FROM ANY AND ALL CLAIMS BY TENANTS, IF ANY. Customer is committed to acting promptly so that roof leaks are not a
source of potential interior mold growth. Customer will make periodic inspection for signs of water intrusion and act promptly,
including notifying Contractor if customer believes there are roof leaks, to correct the condition. UPON RECEIVING NOTICE,
CONTRACTOR WILL MAKE REPAIRS PROMPTLY; HOWEVER CONTRACTOR IS NOT RESPONSIBLE FOR INDOOR AIR
QUALITY. CUSTOMER SHALL HOLD HARMLESS AND INDEMNIFY CONTRACTOR FROM ANY AND ALL CLAIMS
ARISING OUT OF OR RELATING TO PROPERTY DAMAGE, PERSONAL INJURY, ILLNESS, ALLERGIC REACTIONS,
DISEASE, AND/OR DEATH RESULTING FROM THE OCCURRENCE OR EXPOSURE TO MOLD, MILDEW, FUNGI,
SPORES, AND/OR ANY OTHER HAZARDOUS CHEMICAL OR BIOLOGICAL AGENTS.
7. Contractor workers are fully covered by workmen's compensation insurance. Customer is to carry property and casualty insurance,
including coverage of fire, wind, damage and vandalism.
8. THE WORK PERFORMED BY CONTRACTOR WILL BE WARRANTED BY CONTRACTOR. ACCORDING TO ITS STANDARD
WARRANTY. A COPY OF CONTRACTOR STANDARD WARRANTY IS ATTACHED. CONTRACTOR SHALL NOT BE LIABLE
FOR SPECIAL, PUNITIVE, INCIDENTAL, OR CONSEQUENTIAL DAMAGES OF ANY KIND, INCLUDING BUT NOT LIMITED TO
CRACKED DRIVEWAYS, DAMAGES FROM RAIN, HAIL, OR ANY ACT OF GOD. CUSTOMER ACKNOWLEDGES AND AGREES
THAT, AS MATERIAL TERM TO THIS AGREEMENT, CONTRACTOR STANDARD WARRANTY IS CUSTOMER'S SOLE AND
EXCLUSIVE REMEDY AGAINST CONTRACTOR PERTAINING TO THE ROOF INSTALLATION.
9. Customer acknowledges and understands that while the contractor is actively completing the work under the Agreement, the work
environment, including all roof areas, is a dangerous environment. Customer agrees no to interfere with Contractor from performing the duties
under this Agreement. Customer agrees not to enter the work environment while work is being performed under this Agreement.
10. NOTICE: THIS AGREEMENT CONTAINS PROVISIONS REQUIRING ARBITRATION OF FEE DISPUTES. BEFORE YOU
SIGN THIS AGREEMENT YOU SHOULD CONSIDER CONSULTING WITH A LAWYER ABOUT THE ADVISABILITY OF
MAKING AN AGREEMENT WITH MANDATORY ARBITRATION REQUIREMENTS. ARBITRATION PROCEEDINGS ARE
WAYS TO RESOLVE DISPUTES WITHOUT USE OF THE COURT SYSTEM. BY ENTERING INTO AGREEMENTS THAT
REQUIRE ARBITRATION AS THE WAY TO RESOLVE FEE DISPUTES, YOU GIVE UP (WAIVE) YOUR RIGHT TO GO TO
COURT TO RESOLVE THOSE DISPUTES BY A JUDGE OR JURY. THESE ARE IMPORTANT RIGHTS THAT SHOULD NOT
BE GIVEN UP WITHOUT CAREFUL CONSIDERATION. IF ANY DISPUTE ARISES OUT OF OR RELATES TO THIS
AGREEMENT, OR THE BREACH THEREOF, THE PARTIES WILL USE THEIR RESPECTIVE BEST EFFORTS TO SETTLE
THE MATTER BY CONSULTING AND NEGOTIATING WITH EACH OTHER IN GOOD FAITH AND, RECOGNIZING OUR
MUTUAL INTERESTS, ATTEMPT TO REACH A JUST AND EQUITABLE SOLUTION SATISFACTORY TO BOTH SIDES. AS
A MATERIAL TERM OF THIS AGREEMENT, CUSTOMER AGREES THAT IF THE DISPUTE CANNOT BE SETTLED
THROUGH NEGOTIATION WITH RESPECT TO ANY MATTERS OR QUESTIONS ARISING OUT OF OR RELATING TO
THIS AGREEMENT OR THE BREACH THEREOF, SUCH DISPUTE SHALL BE INITIATED WITHIN THE APPLICABLE
STATUTE OF LIMITATIONS AND DECIDED BY ARBITRATION ADMINISTERED BY AND IN ACCORDANCE WITH THE
CONSTRUCTION INDUSTRY ARBITRATION RULES OF THE AMERICAN ARBITRATION ASSOCIATION AND WILL BE
CONDUCTED IN THE ENGLISH LANGUAGE IN THE CITY OF ORLANDO, FLORIDA. THIS AGREEMENT TO ARBITRATE
SHALL BE SPECIFICALLY ENFORCEABLE UNDER THE PREVAILING ARBITRATION LAW. THE AWARD RENDERED
BY THE ARBITRATORS SHALL BE FINAL, AND JUDGMENT MAY BE ENTERED UPON IT IN ANY COURT HAVING
JURISDICTION THEREOF. ANY AWARD SHALL INCLUDE COURT COSTS AND ATTORNEY'S FEES TO THE
PREVAILING PARTY PLUS INTERESTS AT THE LEGAL RATE. IN CASE OF LATE PAYMENT OR DEFAULT, A CHARGE
OF 1.5% PER MONTH WILL APPLY ON ALL BALANCES DUE OVER THIRTY (30) DAYS. CUSTOMER ACKNOWLEDGES
AND AGREES THAT ZF CONTRACTOR IS REQUIRED TO TAKE ANY ACTION TO ENFORCE THIS AGREEMENT,
CUSTOMER SHALL PAY ALL ATTORNEY FEES AND COSTS, WHETHER OR NOT A SUIT IS FILED. FLORIDA LAW
GOVERNS THIS AGREEMENT IRRESPECTIVE OF ANY APPLICABLE CHOICE OF LAW PRINCIPLES. THE PARTIES
AGREE THAT ANY DISPUTES ARISING OUT OF OR RELATED TO THIS AGREEMENT WILL HAVE EXCLUSIVE VENUE
IN ORANGE COUNTY, FLORIDA.
it, In the event that any conflict exists between any estimate of costs of the work and the terms of this Agreement, this Agreement shall be
controlling. Upon notice to the owner, Contractor may substitute materials that are equal in quality to those specified if the Contractor deems it
advisable to do so in Contractor's sole discretion. This Agreement constitutes the entire Agreement by and between Contractor and Customer
and the parties are not bound by prior oral expression or representation by any party or agent of either party. If any provision of this
Agreement is held in whole or in part to be unenforceable for any reason, the remainder of that provision and of the entire Agreement will be
severable and remain in effect, as long as the remainder continues to reflect the original intent ofthe parties.
12. The full and complete balance of compensation due to Contractor is due in full upon completion. The price quoted for this Agreement shall be
good for thirty (30) days or for such longer period at the sole discretion of Contractor. Contractor will provide a written release of lien upon
request, following receipt of final payment on the Agreement.
13. Please see attached CHAPTER 558 NOTICE OF CLAIM.
14. FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND PAYMENT, UP TO A LIMITED AMOUNT, MAY BE
AVAILABLE FROM THE FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND IF YOU LOSE MONEY ON
A PROJECT PERFORMED UNDER CONTRACT, WHERE THE LOSS RESULTS FROM SPECIFIED VIOLATIONS OF
FLORIDA LAW BY A LICENSED CONTRACTOR. FOR INFORMATION ABOUT THE RECOVERY FUND AND FILING
A CLAIM, CONTACT THE FLORIDA CONSTRUCTION INDUSTRY LICENSING BOARD AT THE FOLLOWING
TELEPHONE NUMBER AND ADDRESS: 1940 North Monroe St. Tallahassee, FL 32399- 0783. Telephone: 850-487-1395.
Website: www.myfloridalicense.com
By signing below, Customer has read the foregoing and acknowledges and agrees to these Binding Terms and Conditions, which are hereby
incorporated by reference to Contractor's proposal set forth in the accompanying estimate.
CUSTOMER
OR AUTHORIZED AGENT: DATE:
CONTRACTOR: DATE:
CITY OF
Building & Fire Prevention DivisionORDRESIDENTIALRE -ROOF 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:
h PERMIT CARD, POSTED IN A CONSPICUOUS AND WEATHERPROOF LOCATION
11 COMPLETED. RESIDENTIAL RE -ROOF SCOPE OF WORK
001 COMPLETED AND NOTARIZED INSPECTION AFFIDAVIT
191 ALL FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS
PRODUCT APPROVAL SHALL MATCH WHAT IS ON THE SCOPE OF WORK)
g, 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
MI 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: a,51 10 DATE: it /0l l
CITY OF
PERMIT # S ORD
1 E Building & Fire Prevention Division
ftTMENT RESIDENTIAL RE -ROOF SCOPE OF WORK
JOB ADDRESS: 16 3 t Aty IJ u"r C-1ZEST V-UrJ jAIJT D, FL 39ZT? r
STRUCTURE TYPE: 0 SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
O RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF
DECK TYPE (PLEASE SPECIFY): LOCOD
PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED"
ROOF VENTILATION: 0 OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT
SKYLIGHTS: O YES ® NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #:
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 2:12 -4:12 O 4: 4 2 OR GREATER
OTURBINES
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE Cc- Q:T R 101E C7FL# s '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.) **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
ORD Building & Fire Prevention Division
i. RESIDENTLAL RE-R OOF A FFIDA VIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT ADDRESS: ( -) WA -(—Out cyF-S Q U
Sla -(F Qk C) j 5F(_ 321-1 I
I 11.V l S l U4_-- L) 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 #: < —_ DC ( 3 , ; 3 (6c.,
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE: DATE: db'1111)
MUST BE SIGNED BY LICENSE HOLDER'OR OWNER/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 onvk_
Sworn to and Subscribed before me this (3 44-
day of 20 l-"11:- by:
L 4'5 F-4-- Q,, a vAoLy . Who is MPersonally Known to me or hasrroduced (type of
identification) FL C)L as identification.
Signature of o rERO)MONG
State of NOTARY PUBLIC
STATE OF FLORIDA
Comm# FF933833
Print/Typ N 881 .
of Notary Public