131 Pinefield Dr - BR17-002859 - ROOF01IN CITY OF SANFORD
BUILDING & FIRE PREVENTION
S 2017 PERMIT APPLICATION
o
SY: Application No: / 0S
Documented Construction Value: $ 4
Job Address: 131 Pinefield Dr, Sanford, FL 32771 Historic District: Yes No
Parcel ID: 32-19-31-515-0000-1180 Residential ® Commercial
Type of Work: New Addition Alteration® Repair Demo Change of Use Move
Description of Work: Re -Roof - remove existing roof covering down to the substrate,
inspect deck/re-nail per code as necessary, install asphalt composition shingles
Plan Review Contact Person: Jerry McElroy Title: Project Manager
Phone: 240-520-4675 Fax: Email: jerry@bfarrcontracting.com
Property Owner Information
Name Darren & Tamra Vanderhorst Phone: 864-266-1205
Street: 131 Pinefield Drive Resident of property?: Yes
City, State Zip: Sanford, FL 32771
Contractor Information
Name BFARR Enterprises, LLC. Phone: 407-543-8078
Street: 3500 Aloma Ave, Suite C6 Fax:
City, State Zip: Winter Park, FL 32792 State License No.: CBC# 1261115
Architect/Engineer Information
Name
Street:
City, St, Zip:
Bonding Company:
Address:
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction
in this jurisdiction. I understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools,
furnaces, boilers, heaters, tanks, and air conditioners, etc.
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5t6 Edition (2014) Florida Building Code Q' 1
Revised: June 30, 2015 Permit Application I §
0 I
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records of this county, and there may be additional permits required from other governmental entities such as water
management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy 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
be done i comp • ne with all applicable laws regulating constructio i
8/25/17
Signa re of /Agent Date Signature of Contrac ent Date
Darren Vanderhorst Brian Farr
Print Owner/Aggeentt's Name Print Contractor/Agent's Name
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Agent is 1 e or Contractor/Agent i9 d"e'yeProduced
ID I` "Qo7p ProducedIDBELOW
IS FOR OFFICE USE ONLY work
will Me
or Permits
Required: Building Electrical Mechanical Plumbing Gas Roof Construction
Type: Occupancy Use: Total
Sq Ft of Bldg: Min. Occupancy Load: Flood
Zone: of
Stories: New
Construction: Electric - # of Amps Plumbing - # of Fixtures, Fire
Sprinkler Permit: Yes No APPROVALS:
ZONING: ENGINEERING:
COMMENTS:
of
Heads UTILITIES:
FIRE:
Fire
Alarm Permit: Yes No WASTE
WATER: BUILDING:
Revised:
June 30, 2015 Permit Application
3500 Aloma Ave, Ste# C6-8 E N 1 E R P R 3 S E S
Winter Park, FL 32792-4018
1ldlag Relationships
Office:
State License: CBC# 12611115
NAME-
6 o-,C Vcx,,r\ c Q- r ko M -r
PHONE DATE
STREET CELL PHONE HOMEWORK PHONE
131 'P1
CITY, STATE, ZIP ODE E-MAIL ADDRESS GATE CODE
S F` 3a7.7i eeflyP CLa(.I's . CONTRACT
AND AU We
agree to furnish material & labor Payment
to be made as follows: I IZATION
TO PERFORM for
the sum of: $ - - Q' ry due
u1 n comp etion of w SCOPE
OF WORK: (only those items indicated with a Yin the left column.) Existing
damage/known problems: , (A) V
A. Ground Preparation: Tarps: k,,_ Other: L.,A i APi(AG fJ Cj'.A,,;,M 6,4r i ,t j c i j r
2. Tear Off Existing Roofing System: # of layers: _. Types of layers: 1st TI • y,4J 2nd - 3rd NOTE:
Additional charges will result if additional roof layers are discovered during tear off.) Inspect
decking for dry rot and other damage. Repair any damaged or non-nailable wood at a rate of $75 per sheet of plywood, $5.50 per linear foot for 1xdeckingand $9.50 per linear foot for 2x decking. 'THESE ARE ADDITIONAL COSTS OVER AND ABOVETHE CONTRACT COST' AP
4. Re -nail Roof Decking to meet required current building code requirements. (Not required for repairs or retrofits) 5.
Install: Underlayment: 15# felt = - 30# felt = - Synthetics - Type: 914 1 nlu P.
Install: Metals: Roof -to -Wall = - Step Flashing M - Valley Metal : - Rolled F-; or W-Pan Drip Edge - Color PRO
7. Install: Ice & Water Shield - > Location: Valleys = - Penetrations = - Other -- tit-
8. Install: Roofing Material Manufacturer: 6C Type: A r JN - rrzu D - - Color: J-)/24 F 7kUdGi- _ c
9. Install: 10.
Install: Metal Flashing: Chimney h - Skylight Counter Flash = - Other ti tk.
A 1. Install: Exhaust Vents: Box/Turtle or Off Ridge Vent f~ - Replace # - Ridge Vent m - Total L.F: K.,
12. Install Kitchen/Bath Vents: Size # Size # I Size # Type: w-
13. Install: Lead Plumbing Stack Flashing: 1.5" = 2" = 3" = 4" _ > Split Boot (power mast) r- c
4. Clean Up: Gutters) Walkways Driveways04-.--Yardf*- Magnetic Sweep it Y
15. BFARR Enterprises to provide two (2) years of workmanshipAabor warranty. 16.
BFARR Enterprises is proud to include the Owens Corning Preferred Protection Roofing System Warranty which affords you with a 50 year Non - Prorated
TruPROtection Warranty for material defects as wells as a 10 Year Non -Prorated Warranty for workmanship or installation issues. OPTIONS,
NOTES, SPECIAL INSTRUCTIONS: d !
ZrA,._l( I-,. I. o 0) (_ n4% C_ trri,.- - rlrn . 21714,,lIII! i/ a/.IIC-r-n (!P_A,Vr1- PAYMENTTERMS:
509/6 Deposit, Remaining BALANCE DUE IN FULL UPON COMPLETION Along With
Any Upgrades, Change Orders Or Woodwork. Accounts Must Be Paid In Full Within 10
Days Of Completion Or The Warranty Is Voided. Unpaid Accounts Are Subject To Collection Costs,
Attorney's Fees And The Maximum Interest Allowed By Law. ACKNOWLEDGEMENT: Buyer(
s) Has Read All Terms & Conditions On This Contract Unless Otherwise Stated.
Buyer(s) Acknowledges Receipt Of A Copy Of The Statement Of Policies, Terms
And Conditions & Disclosure Notices On The Reverse Side Or Attached, Which Are
Incorporated As Part Of This Contract. Buyer(s) Acknowledge(s) Understanding Of All
Details Contained Within And By Signing Below, Authorizes BFARR Enterprises To Proceed With
The Scope Of Work Outlined Herein. Any Deviations From The Above Scope ies. zs1
Date
Date
Date
Customer
Initials:
Customer Initials:
INTERNAL OFFICE
USE ONLY Deposit Amount:
Type of
Payment/CkCk#: Funding: Service
Finance}( OR Cash
Is
CITY OF
Building & Fire Prevention DivisionOFMRESIDENTIALRE -ROOF POLICY & PROCEDURES
FIRE DEPARTMENT r
PERMITTING REQUMEMENTS — 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 CONDOmmw) 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 RES AN AFFIDAVIT Dir7WFLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTWYPJP-fKCO CE BY PERSONAL INSPECTION. CONTRACTOR (
OR OWNER/BUILDER) SIGNATURE: DATE: j
Agft6, CITY OF
INS PERMIT # / - - 2 v s
Building & FirePrevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
Jos ADDREss: 131 Pinefield ®rive, Sanford, FL 32771
STRUCTURE TYPE: ® SINGLE FAMILY RESIDENCE(rOWNHOUSE 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): 1/2" Plywood
PLEASE NOTE: ONLY100 SQUARE FEET OFTBE EXISTINGDECKIS PERMITTED TO BE REPLACED**
ROOF VENTILATION: DOFF -RIDGE O RIDGE OSOFFTT ®POWERED 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 (g) 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE Owens Corning FL# 16-0425.01
OMETAL FL#
OMODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
OTHER: Underlayment interwrap/Owens Cornin FL# 14-0603.18
ROOF EXTENSIONS (PORCHES. PATIOS. ETC.) **IFAPPmcABLE**
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#
OMODIFIED BITUMEN FL#
OTORCH DOWN FL#
OINSULATED FL#
O TILE FL#
0 OTHER: FL#
CITY OF
0 S. ORD Building & Fire Prevention Division
RESIDENTIAL RE -ROOF AFFIDA VIT
FIRE DEPARTMENT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERNIIT #: ADDREss: 131 Pinefield Drive
Sanford, FL 32771
t
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 #: CBC# 1261115
COMPANY / CONTRACTOR: B FA R R
CONTRACTOR SIGNATURE:
MUST BE SIGNED BY LICENQej1QrffER OR
A FINAL ROOF INSPECTION IS REQUIRED:
DATE: Z r I7
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 V PAAG
Sworn to and Subscribed before me this A-f * day of 5CI7741sag 20 17 by: 317 (
4J Fm4L Who is 0 Personally Known to me or hasKProduced (type of Print/
TypelStamp Name of
Notary Public MCF
9o`, 01,
CjGG118571
EXPIRES
m: y
h u Ash° •` I" /
ic. State
1111111111111111111111111111111111111111
iNST UMF NT PREP LIED' BY:
ame: Gt rJ G r
Address:
NOTICE OF C
Permit Number:
Parcel ID Number:
i
The undersigned hereby gives noti
following information is provided in
1. DESCRIPTION OF PROPERT
2. GENERAL DESCRIPTION OF
3. OWNERINFORMATION OR LN _ORRLName
and address:--234A Interest
in property: _/12 Fee
Simple Tide Holder (if ott 4.
CONTRACTOR: Name:_( Address: ;<
o Ai 5.
SURETY (If applicable, a 6.
LENDER: N Address: _
7.
Persons within the State of 713.
13(1)(a)7., Florida Statu Address:
8.
In addition, Owner designates to
receive a copy of the Lieno 9.
Expiration Date of Notice of C MMENCEMENT
GRANT
MALOYr SEMINOLE COUNTY CLERK
OF CIRCUIT COURT & COMPTROLLER BK
8931 F's 1019 (1F'3s) CLERK'
S T 2017088568 RECORDED
08/30/ 2017 03.' 08: ib F'M RECORDING
FEES $10.00 RECORDED
BY hdevare 3i •-
ri1—Goon:: i y that
improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the s
Notice of Commencement. Legal
description of the property and street address if available) 5 ,d/L ( 3 2 7 I i3 ( ).JGFt 7 'Da r INFORMATION
IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: 4,
1 -rA.-(,4?A Vmfl than
owner listed above) Name: of
the payment bond is attached): Phone
Number: 17D qX,? hoc) 1 Phone
Number: Amount
of Bond: Designated
by Owner upon whom notice or other documents may be served as provided by Section Phone
Number: of
Notice
as provided in Section 713.130)(b), Florida Statutes. Phone number: imencement (
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 HAPTER713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR CONSIDEREDIMPROPERPAYMENTSUNDERCPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORECOMMENCINGWORKORRECORDINGYOURNOTICEOFCOMMENCEMENT. Print
Name and Provide Signatory s Title/Office) Signature
of Owner o Lessee, or owner's or Lessee's Authorized
Office hector/Partner/Manager) State
of The
foregoing instrument t1was Name
who
has produced identificati 0
BY
County
of U+-L fledged
before me this day of 1/1 • 20 17 I
Vtype of ide N!
NMl . sow .'
t
GG115511 W ; E)p%rrs It 22, 20210: p OC•'( i
ruo& A,
r., came_..•° Who is
personally known to me OR
9/26/2017 SCPA Parcel View: 32-19-31-515-0000-1180
i
Property Record Card
CIAffp*M
Parcel:
VAND
31-51
RST T-
1180
MROwner: VANDERHORST TAMRA L &DARREN L
j se m+o co.rrv.aczanw
Property Address: 131 PINEFIELD DR SANFORD, FL 32771
Parcel Information
Parcel 32-19-31-515-0000-1180
Owner VANDERHORST TAMRA L & DARREN L
Property Address 131 PINEFIELD DR SANFORD, FL 32771
Mailing 131 PINEFIELD DR SANFORD, FL 32771
Subdivision Name CELERY LAKES PHASE 1
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions 00-HOMESTEAD(2005)
01
Seminole County GIS
I
Legal Description
LOT 118
CELERY LAKES PHASE 1
PB62PGS75&76
Taxes
Value Summary
2017 Working 2016 Certified
Values Values
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 145,294 125,490
Depreciated EXFT Value
Land Value (Market) $32,500 23,100
Land Value Ag
Just/Market Value " 177,794- 148,590
Portability Adj
Save Our Homes Adj 63,604 36,749
Amendment 1 Adj
P&G Adj 0 0
Assessed Value-$114,190 111,841
Tax Amount without SOH: $2,165.00
2016 Tax Bill Amount $1,428.00
Tax Estimator
Save Our Homes Savings: $737.00
TRIM Notice Help
Does NOT INCLUDE Non Ad Valorem Assessments
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund 114,190 1 $50,000 64,190
Schools 114,190 25,000 89,190
City Sanford 114,190 50,000 64,190
SJWM(Saint Johns Water Management) 114,190 50,000 64,190
County Bonds f $114,190 50,000 64,190
Sales
t
Description Date Book Page Amount Qualified Vac/Imp
SPECIAL WARRANTY DEED 12/1/2004 05202 ! 1288 $153,200 I Yes f Improved
Find Comparable Sales
Land
Method Frontage Depth Units Units Price Land Value
LOT 1 ! $32,500.00 32,500
Building Information
Description Year Built
Actual/Effective Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value Appendages
1 1 SINGLE 2004 13 4 ( 30 I 1,364 I 3,424 i 3,012 CB/STUCCO $145,294 j $152,540 " Description AreaFAMILYFINISH ! p
OPEN 16.00
11 PORCH
http://parceidetaii.scpafl.org/Parcel Detail lnfo.aspx?PID=32193151500001180 1/2
JIM ,q
9/26/2017 SCPA Parcel View: 32-19-31-515-0000-1180
Permits
FINISHED
GARAGE 396.00FINISHED
UPPER
STORY 1648.00
FINISHED
Permit # Description Agency Amount CO Date Permit Date
02751 NEW - RESIDENTIAL SANFORD 128,488 1 1/28/2004 8/27/2003
Extra Features
Description Year Built Units Value New Cost
No Extra Features
http://parceidetail.scpafl.org/ParcelDetaillnfo.aspx?PiD=32193151500001180 2/2
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: 1 1 ADDRESS: (b , N)w'-mobe)IA 0"--
I 1 L'r- 7cr ! r , 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 NAILINGOF THE ROOF DECK, IN ACCORDANCE WITH THE HURRICANE RETROFIT
MANUAL REQUIREMENTS (BASED ON F.S. CHAPTER 553.844).
LICENSE ##:UC [-7
V
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE: DATE: J
MUST BE SIGNED BY LICENSE HOLDER OR OWNER/B
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 Z19 -1A day of Cc +t 20 -1 '7 by:
13r; an FA I /` Who is Personally Known to me or has a froduced (type of
identification) L % as identification.
Si ota Public
St i a A MODES PARRA
MY COMMISSION to GG 0971 o 1
Pr t t Pw* Und.s wro,
of o ary