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106 Gleason Cv - BR17-003104 - REROOF428788 10 h no CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: 1 -7" 310 H Documented Construction Value: $ 8 loo Job Address: 106 Gleason Cove Sanford FL 32773 Historic District: Yes No 0 Parcel ID: 02-20-30-523-0000-1250 Residential Q Commercial Type of Work: New Addition Alteration El Repair Demo Change of Use Move Description of Work: reroof Owens Coming FL 10674-R12 Techwrap FL 17194-Rl 22 squares 7112 pitch Supreme Antique Silvei 25 year warranty Plan Review Contact Person: Rachel Holcomb Phone: 407-278-7788 Fax: 800-337-3361 Title: admin manager Email: permit@jasperinc.com Property Owner Information Name James O'steen and Cynthia O'steen Phone: Street: 106 Gleason Cove City, State Zip: Sanford, FL 32773 Resident ofproperty?: Yes Contractor Information Name Jasper Contractors Phone: 407-278-7788 Street: 3203 S Conway Rd Fax- 800-337-3361 City, State Zip.. Orlando FL 32812 State License No.: CCC1331153 Name: Street: City, St, Zip: Bonding Company: Address: Architect/Engineer Information 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 ofapplication and the code in effect as of that date: 51 Edition (2014) Florida Building Code kcvised: June 30, 2015 Permit Application 613b,38 Scanned by CamScanner 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 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 of the executed contract is requiredinordertocalculateaplanreviewchargeandwillbeconsideredtheestimatedconstrictionvalueofthejobatthetimeofsubmittal. The actual construction value wilI be figured based on the current iCC Valuation Table- in effect at the: time (lie 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 of Owner/Agcrit Print Owner/Agent's Name Date Signature of Notary -State of Florida Date V, W_ ,{j,, 10/23/2017 Signature of Contractor/Agent Date li ft t , r r. iI," ,--t fn V-1 V/ Name % - 10/23/2017 of Florida Date SKYLAR 8 AMKRAUT ormnigsion it FF 127890 My Commission Expires Owner/Agent is Personally Known to Me or ContractAAA i i oY od Me or Produced ID Type of ID Produced iT_ Type of TD 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 Plumbing - # of Fixtures Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No APPROVALS: ZONING: UTILITIES: WASTE WATER: ENGINEERING: FIRE: BUILDING:_ COMMENTS: Rev crtl• Dine ;0. 7015 Permit. Application LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 10/23/2017 Karla Almodovar, Skylar Amkraut, Rachel Holcomb I hereby name and appoint: Ana Chavez and/or Michelle Monsalve an anent of Jaswcooeaaors lama orCompany) to be my lawH 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): The specific permit and application for work located at: 106 GLEASON COVE.SANFORD FL 32773 Swan Address) Expiration Date for This Limited Power of Attorney: 1 /1 /2019 License Holder Name: Donald Bouchard State License Number. OCC1331153 Signature of License Holder. STATE OF FLORIDA COUNTY OF s The foregoing instrument was acknowledged before me this 23 day of OCTOBER 200 17 , by w-ad who is o personally known to me or ® who has produced a as identification and who did (did not) take an oath. Signature Notary Seal) Ski ar Amkraut Print or type name rs F sKYLAR B AMKRAUTar .. ne.. Commission N FF 127890 dc aS My Commission Expires o 00` June 01, 2018 Rev. 08.12) Notary Public State of FL Commission No. 127890 My Commission Expires: 6/1/2018 SrannPd by CamScanner 10/23/2017 SCPA Parcel View: 02-20-30-523-0000-1250 Property Record Card 08MM= ,Crn Parcel: 02-20-30-523-0000-1250PVR% R Owner: O' STEEN JAMES P & CYNTHIA E ew, Property Address: 106 GLEASON CV SANFORD, FL 32773 i Value Summary 2018 Working 2017 Certified Values Values Valuation Method Cost/Market Cost/Market Number of Buildings 1 1 Depreciated Bldg Value 3 $100,488 94,818 Depreciated EXFT Value Land Value (Market) $25,000 25,000 Land Value Ag Just/MarketValue" $125,488 119,818 Portability Adj Save Our Homes Adj $0 i- Om Amendment 1 Adj $6,412 11,567 P&G Adj $0 0 Assessed Value $119,076 $108 251 Tax Amount without SOH: $2,137.24 2017 Tax Bill Amount $2,137.24 Tax Estimator Save Our Homes Savings: $0.00 Does NOT INCLUDE Non Ad Valorem Assessments Legal Description LOT 125' PLACID WOODS PH 2 PB 58 PGS 4-6 Taxes Taxing Authority Assessment Value 1 Exempt Values Taxable Value County General Fund 119,076 0 119,076 Schools --- 125,488 0 , 125,488 City Sanford 119,076 0 j 119,076 SJWM(Saint Johns Water Management) 119,076 0 119,076 County Bonds 119,076 0 3 119,076 Sales Description Date Book Page Amount Qualified Vactimp WARRANTY DEED 8/1/2014 08309 1946 94,000 ;Yes Improved SPECIAL WARRANTY DEED 10/1/2001 04200 1690$86,600 s Improved Find Comparable Sales Land Method Frontage Depth Units Units Price Land Value 1 LOT 25 000.00 25,000 Building Information Is Bed/Bath count incorrect? Click Here. Description Year Built Fixtures Bed Bath Base Area 'i Total SF Living SF Ext Wall Adj Value Rep[ Value AppendagesActual/Effective 1 SINGLE 2001 6 I 2 2.0 k 1,158 1,554 ! 1,158 CB/STUCCO $100,488 $106,337 Description Area FAMILY i FINISH .... p,._...,_. http://parceidetail.scpafl.org/ParceiDetaillnfo.aspx?PID=02203052300001250 1/2 r'' S (a' f ililll Iltll I1111 Ilill illil IIIII fill till THIS INSTRUMENT PREPARED BY: Ca"C(Ik' Name: Jasper Contrar tors ' Address: 53Rn F ('.fii, ^liaLDrivP 1-4t &-i &*- NOTICE OF COMMENCEMENT Permit Number. 100 Parcel ID Number. [) - 2 i5—a--s 23-Qy(l- i GRANT MALOYr SEMINOLE COUNTY CLERK OF CIRCUIT COURT 6 COMPTROLLER BY. 9011 P9 1414 (1Pes) CLERK'S ' 2017107010 RECORDED 10/23/2017 12:23:31 PM RECORDING FEES $10.00 RECORDED BY hdevore The-undersigned-hereby-gives-notice-that-fmprovemenCwiil-be-made-to•certain-real-property,-and•in-accordance-Wth-Chapter-713, Floddo-Statutes-the following information is provided in this Notice of Commencement. 1. DESCRIPTION OF P ERN: egal description of the roperty and street address if avallableLCT ( 25 t rct r d Wl?o s e 2 TB S9 -r q--6 2. GENERAL DESCRIPTION OF 3. OWNER INFORMATION OR LESSEE INFORMATION IFTHE LESSEE jCONTRACTED FOR TTHENameandaddress: t?)5fiP e r7 c- a men- 1Q6 C/Pasna Interest in property. Clwnpr Fee Simple Title Holder (ifother than owner listed above) Name: Address: 4. CONTRACTOR: Name: Jasper Contractors Phone Number. 407-278-7788 Address: 5380 E Colonial Drive Orlando, FL 32807 5. SURETY (if applicable, a copy of the payment bond is attached): Name: Address: Amount of Bond: 6. LENDER: Name: 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: S. In addition, Owner designates to receive a copy of the Uenor'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 ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. SrgnaWre of Owner or Lessee, or Owners or Lessee's (Print Name and Provide Signatorya Tift/O 6ce) AuDwrizedOfterf/DkedorWartnerManager) D, State of . 0 1 lJU9`-- County of 0'' r _ nTheforegoingInstrumentwasacknowledgedbeforemethist `-Y day of 3t" by c, t `r 1y Y Who Is personally known to me OR Nam of personmaWng stateeront who has produced identificatlo Pype of identification produced: 1-- SKYLAR 8 AMKRAUT Commission N F zMrCommissionExpires e° P• June 01. 201 Scanned by CamScanner 5.180 F. Colonial Dr. Orlando, FL 32807 3203 Con%ay Rd.. Ste. 201 Orlando, FL 32812 407) 278-7788 800) 337-3361 Fax mftr a-iasycrutc.orr ViSA a JASPER J 1pa/rt14WV COM 171, Contractor's License: CCC 1329651 & CCC 1331153 R( InF RIM-ACF.MF.NT CONTRACT Account Manager: 'T !X' Contact : i: IIG i 3 3 5- Compan}': Policy #: 0 Claim #: G v I t or tali r Company- 4-4 Loan Number: / b 60 Y /G v— Owner( j-- Phone G. . c, b.0, I P Address: Alt Phone: G 6 lee, 5C Citv: q /) State: ice( Lip Code: 3 7 Shin le Color: z I r . Email: Roof RCV Amount' Contract Price: Drip Edge Color: L'. - i rl fC i r 1 C G '' 8100 14- . , — If Owner's Itndra nee Camnany dp&s not agree to nav for a full roof reillacement- this contract shall be v Assignment of insurance Benefits for the Full Roof Replacement Only: i hereby assign any and all insurance rights, benefits and proceeds under any applicable insurance policies to Jasper Contractors, Inc. ("Jasper"). die scope of which shall be linuted to a Full Roof Replacement. i make this assignment and authorization in consideration of Jasper's agreement to perform services, supply materials and otherwise perfcxm its obligations under this Contract. including not requiring full payment at the time of service. 1 also hereby direct my insurer(s) to release any and all information requested by Jasper, or its representative( s), for the direct purpose of obtaining actual benefits to be paid by my insurer(s) for services rendered. in this regard, 1 waive my pnvacy rights. if payment is made directly to the Owner/Agent/Insured(s), it shall be endorsed over to Jasper immediately upon receipt. 1 agree that any portion of work, deductibles, betterment or additional work requested by the undersigned, not covered by insurance, must be paid by the undersigned on the day of installation. Deductible: it is the Owner's resoomibility to Day all insurance deductibles. Owner's out-of-pocket expense will not exceed the deductible amount, as stated on insurer's loss sheet (the "Loss Sheet'), UNLESS replacemenurepair of deteriorated decking is required by code and/or Owner requests optional upgrades. Jasper CANNOT pay, waive, rebate, or promise to pay, waive or rebate any or all of the insurance deductible applicable to the insurance claim for payment of work. In the event of a disaepancy, the deductible amount stated on the insurer's Loss Sh C steal verrule deductible amount disclosed. Deductible: S .`ni Ko • G % MUST BE PAID iN FULL. PLUS APPLICABLE SALES TAX (initial) MORTGAGE AUTHORIZATION: 1, Owner[Mortgagtx, grant authorizatim for : ortgage Co. to speak with Jasper on matters including but not limited to, the claim and draw status. (initial) PAYMENT SCHEDULE: Owner agree- to pay Jasper based on the following schedule: (i) Deposit in the amount of , - .7 L' due upon signing this contract: (it) the Contract Price. less the Deposit and any applicable depreciation retatned by Owner's insurer(s), plus upgrade costs, due and payable to Jasper upon completion of work being performed-. and, (in) the retraining. Contract Price (equal to any applicable depreciation and/or change orders) due and payable to Jasper upon completion of work performed. In the event of a pending inspection, no more than 2% of Contract Price may be withheld until inspection has passed. Optional: UPGRADE ITEM: Q'iY: PRICE: TOTAL: S Replacement Work and Price: Upon insurer's approval and subject to the I crtns and Conditions herein, Jasper agrees to furnish all materials and provide the labor necessary to perform the full roof replacement which shall take place following Owner's insurance company's approval, approximately within30days, conditions permitting. Owner's Declaration of Intent: Owner acknowledges and agrees that, upon approval by insurance company for a full roof replacement, Jasper shall perform the roof replacement upon receipt of funds from Owner's insurance company. FLORIDA HONEOWNERS' CONSTUCTiON RECOVERY FUND PAYMENT, UP T'O A LIMITED AMOUNT, MAY BE AVAILABLE FROl11 THE FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND IF YOU LOSE MONEY ON A PROJECTPERFORMED 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 ATTHE FOLLOWING TELEPHON 11 NUMBER AND ADDRESS: Construction industry Licensing Board: 2601 Blairstone Road, Tallahassee, FL 32399-1039, (850) 487-1395 CANCELLATION: If Owner elects to terminate the services of Jasper, Owner may do so before midnight on the third business day after Contract is executed. Owner shall receive a full refund of all deposits. Owner may also rescind Contract before midnight on the third businessdayafterthecontractisexecutedafternotificationfrontinsurer(s) that the claim for payment on roof contract has been denied, in whole or in part. All written notices of cancellation, regardless of reason, shall be postmarked or delivered to Jasper's corporate office: 1690 Roberts Boulevard, Suite 112, Kennesaw, GA 30144. CANCELLATiON EXCEPTIONS: The three (3) day right of cancellation DOES NOT APPLY to contracts for emergency hone repairs as time is of the essence. 1, Owner, have read and understand all statements, Terms and Conditions of the "Roof Replacement Contract" and agree that all details are acceptable and satisfactory. I further understand that this Contract constitutes the entire agreement between the parties and that any further changes or alterations to this Contract must be made in writing and agreed upon by both parties. Each party representsandwarrantstotheotherthatithasthefullpowerandauthoritytoenterintothecontractandthatitisbindingandenforceable in accordance with its terms. " IL t(uthorize riperRepresentativeDateOwADaicScannedbyCamScanner C City of Sanford FD OI Building & Fire Prevention Division Re -Roof Permit Card PERMIT NO. 3I 0!J ISSUE DATE: /O,a;4f ° / 7 CONTRACTOR:g JOB ADDRESS: 106 G' TYPE OF WORK: LAW 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 THE 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 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. FBC 105.3.3 REVISED: 4-17 Inspection Line 407.792.6069 or 855.541.2112 1-1-3104 City of Sanford Building Division Residential Re -Roof Inspection Policy & Procedures 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 ofthe 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 Patter & 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: 10/23/2017 PERMIT # `l 310 LJ City of Sanford Building Division Residential Re -Roof Scope of Work JOB ADDRESS: 106 gleason cove sanford fl 32773 STRUCTURE TYPE: © 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: PLEASE NOTE: ONLYI00 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED * ` ROOF VENTILATION: O OFF -RIDGE © RIDGE O SOFFIT OPOWERED VENT OTURBINES SKYLIGHTS: O YES XO NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: MAIN ROOF AREA ROOF SLOPE: O LESS THAN 2:12 O 2:12 —4:12 © 4:12 OR GREATER TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL Q SHINGLE OWENS CORNING FL# 10674-R12 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# 0 OTHER: FL# FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING &'FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 Application Number . . . . . 17-00003104 Date 10/24/17 Application pin number . . . 694080 Property Address . . . . . . 106 GLEASON COVE Parcel Number . . 02.20.30.523-0000-1250 Application type description ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . MULTIPLE FAMILY Application valuation . . . . 6100 Application desc reroof/shingles NOC ON FILE Owner Contractor O'STEEN, JAMES & CYNTHIA OWNER 106 GLEASON COVE SANFORD FL 32773 407) 278-7788 Structure Information 000 000 REROOF/SHINGLES Roof Type . . . . . . . . . FIBERGLASS SHINGLES Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 1008507 Permit pin number 1008507 Permit Fee . . . . 89.00 Issue Date . . . . 10/24/17 Valuation . . 6100 Expiration Date . . 4/22/18 Qty Unit Charge Per Extension BASE FEE 40.00 7.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 49.00 Special Notes and Comments All projects within the City shall use WastePro for debris removal. Please contact WastePro at 407.774.0800. Normal hours for inspections are from 7:30 through 4:30 Monday through Thursday. Please be aware you must contact the Building Official to schedule a Friday or after hours inspection. This is required since not every inspector is licensed to do every type inspection. Communication is the key, so please contact the Building Official if you have any questions at 407.688.5058 or at dave.aldrich@sanfordfl.gov Other Fees . . . . . . . . . 01-APPLCTN FEE -BUILDING 25.00 O1-BLDG PLAN REVIEW 21.00 O1-BLDG DCA SURCHARGE, 1.35 O1-BLDG DBPR SURCHARGE 2.03 Fee summary Charged Paid Credited Due Permit Fee Total 89.00 .00 .00 89.00 Other Fee Total 49.38 .00 .00 49.38 Grand Total 138.38 .00 .00 138.38 FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS. NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED. NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED. FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 Page 2 Application Number . . . . . 17-00003104 Date 10/24/17 Property Address . . . . . . 106 GLEASON COVE Parcel Number . . 02.20.30.523-0000-1250 Application description . . . ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . MULTIPLE FAMILY Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . Phone Access Code 1008507 Permit pin number 1008507 Required Inspections Phone Insp Seq Insp# Code Description Initials Date 1000 111 BL03 FINAL ROOF / / CITY OF SANFORD REPRINT ' CUSTOMER RECEIPT Oper: ANTONINIL Type: OC Drawer. 1 Date: 10/24/17 01 Receipt no: 12120 Year Number Amount 2017 3104 106 GLEASON COVE SANFORD, FL 32771 BP BUILDING PERMIT RECEIPTS 138.38 2017 3106 108 BOULDER CT SANFORD, FL 32771 BP BUILDING PERMIT RECEIPTS 148.63 2017 3107 176 ROSE HILL TRL SANFORD, FL 32773 BP BUILDING PERMIT RECEIPTS 169.13 2017 3109 142 PINEFIELD DR SANFORD, FL 32771 BP BUILDING PERMIT RECEIPTS 189. 63 2017 3110 352 CONCH KEYWAY SANFORD,.FL 32771 BP BUILDING PERMIT RECEIPTS 220.38 2817 3113 127 CROWN COLONY WAY SANFORD, FL 32771 BP BUILDING PERMIT RECEIPTS f 179.38 2017 152 BRUSHCREEK DR14 SANFORD, FL 32771 BP BUILDING PERMIT RECEIPTS 179.38 Tender detail CC CREDIT CARD 1224.91 Total tendered 1224.91 Total payment 1224.91 i Trans date: 10/24/17 Time: 12:15:54 •. F FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 Application Number . . . . . 17-00003104 Date 10/24/17 Application pin number . . . 694080 Property Address . . . . . . 106 GLEASON COVE Parcel Number . . 02.20.30.523-0000-1250 Application type description ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . MULTIPLE FAMILY Application valuation . . . . 6100 Application desc reroof/shingles NOC ON FILE Owner Contractor O'STEEN, JAMES & CYNTHIA OWNER 106 GLEASON COVE SANFORD FL 32773 407) 278-7788 Structure Information 000 000 REROOF/SHINGLES Roof Type . . . . . . . . . FIBERGLASS SHINGLES Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 1008507 Permit pin number 1008507 Permit Fee . . . . 89.00 Issue Date . . . . 10/24/17 Valuation . . . . 6100 Expiration Date . . 4/22/18 Qty Unit Charge Per Extension BASE FEE 40.00 7.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 49.00 Special Notes and Comments All projects within the City shall use WastePro for debris removal. Please contact WastePro at 407.774.0800. Normal hours for inspections are from 7:30 through 4:30 Monday through Thursday. Please be aware you must contact the Building Official to schedule a Friday or after hours inspection. This is required since not every inspector is licensed to do every type inspection. Communication is the key, so please contact the Building Official if you have any questions at 407.688.5058 or at dave.aldrich@sanfordfl.gov Other Fees . . . . . . . . . 01-APPLCTN FEE -BUILDING 25.00 01-BLDG PLAN REVIEW 21.00 01-BLDG DCA SURCHARGE 1.35 01-BLDG DBPR SURCHARGE 2.03 Fee summary Charged Paid Credited Due Permit Fee Total 89.00 .00 .00 Other Fee Total 49.38 .00 .00 49.38, Grand Total 138.38 .00 .00 138.38 er: ANTONINIL Type: OC Drawer: 1 Date: 10/24/17 01 Receipt no: 12120 2017 3104 BP BUILDING PERMIT RECEIPTS 1.00 $138.38 2017 3106 BP BUILDING PERMIT RECEIPTS 1.00 $148.63 2017 3107 BP BUILDING PERMIT RECEIPTS FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE 1.00 $169.13 PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS. 2017 3109 NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED. BP BUILDING PERMIT RECEIPTS NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED. IN9 9i63 FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 Application Number . . . . . 17-00003106 Date 10/24/17 Application pin number . . . 687240 Property Address . . . . . . 108 BOULDER CT Parcel Number . . 33.19.30.518-0000-1800 Application type description ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . PUD Application valuation . . . . 8000 Application desc REROOF/SHINGLES NOC ON FILE Owner Contractor HESMAN, JAY & GRACE JASPER CONTRACTORS INC 108 BOULDER CT 1690 ROBERTS BLVD SANFORD FL 32771 STE 112 407) 688-7391 KENNESAW, GA 30144 770) 615-4269 Structure Information 000 000 REROOF/SHINGLES Roof Type . . . . . . . . . FIBERGLASS SHINGLES Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 1008523 Permit pin number 1008523 Permit Fee . . . . 96.00 Issue Date . . . . 10/24/17 Valuation . . . 8000 Expiration Date . . 4/22/18 Qty Unit Charge Per Extension BASE FEE 40.00 8.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 56.00 Special Notes and Comments All projects within the City shall use WastePro for debris removal. Please contact WastePro at 407.774.0800. Normal hours for inspections are from 7:30 through 4:30 Monday through Thursday. Please be aware you must contact the Building Official to schedule a Friday or after hours inspection. This is required since not every inspector is licensed to do every type inspection. Communication is the key, so please contact the Building Official if you have any questions at 407.688.5058 or at dave.aldrich@sanfordfl.gov Other Fees . . . . . . . 01-APPLCTN FEE -BUILDING 25.00 01-BLDG PLAN REVIEW 24.00 01-BLDG DCA SURCHARGE 1.45 01-BLDG DBPR SURCHARGE 2.18 Fee summary Charged Paid Credited Due Permit Fee Total 96.00 .00 .00 96.00 Other Fee Total 52.63 .00 .00 52.63 Grand Total 148.63 .00 .00 148.63 Oper: ANTONINIL Type: OC Drawer: 1 Date: 10/24/17 01 Receipt no: 12120 2017 3110 BP BUILDING PERMIT RECEIPTS 220.38 2017 31131.00 BP BUILDING PERMIT RECEIPTS 179.38 2017 31141.00 BP BUILDING PERMIT RECEIPTS FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE 1.00 $179.38 PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS. CC CREDIT CARD $1224.91 NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED. NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED. FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 Application Number . . . . . 17-00003107 Date 10/24/17 Application pin number . . . 270042 Property Address . . . . . . 176 ROSE HILL TRL Parcel Number . . 18.20.31.503-0000-0390 Application type description ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . SINGLE FAMILY Application valuation . . . . 10000 Application desc REROOF/SHINGLES NOC ON FILE Owner Contractor PAYNE, MICHAEL JASPER CONTRACTORS INC 176 ROSE HILL TRL 1690 ROBERTS BLVD SANFORD FL 32773 STE 112 KENNESAW, GA 30144 770) 615-4269 Structure Information 000 000 REROOF/SHINGLES NOC ON FILE Roof Type . . . . . . . . . FIBERGLASS SHINGLES Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 1008549 Permit pin number 1008549 Permit Fee . . . . 110.00 Issue Date . . . . 10/24/17 Valuation . . . . 10000 Expiration Date 4/22/18 Qty Unit Charge Per Extension BASE FEE 40.00 10.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 70.00 Special Notes and Comments All projects within the City shall use WastePro for debris removal. Please contact WastePro at 407.774.0800. Normal hours for inspections are from 7:30 through 4:30 Monday through Thursday. Please be aware you must contact the Building Official to schedule a Friday or after hours inspection. This is required since not every inspector is licensed to do every type inspection. Communication is the key, so please contact the Building Official if you have any questions at 407.688.5058 or at dave.aldrich@sanfordfl.gov Other Fees . . . . . . . . . 01-APPLCTN FEE -BUILDING 25.00 01-BLDG PLAN REVIEW 30.00 01-BLDG DCA SURCHARGE 1.65 01-BLDG DBPR SURCHARGE 2.48 Fee summary Charged Paid Credited Due Permit Fee Total 110.00 .00 .00 00 Other Fee Total 59.13 .00 .00 59.13 Grand Total 169.13 .00 .00 169.13 Oper: RNTONINIL Date: 10/24/17 01 Total tendered Total payment Type: OC Drawer: I Receipt no: 12120 1224.91 1224. 91 Trans date: 10/24/17 Time: 12:15:54 FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS. NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED. NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED. FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 Application Number . . . . . 17-00003109 Date 10/24/17 Application pin number . . . 387731 Property Address . . . . 142 PINEFIELD DR Parcel Number . . 32.19.31.515-0000-0210 Application type description ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . PUD Application valuation . . . . 11400 Application desc REROOF/SHINGLES NOC ON FILE Owner Contractor NICKSON, JESSICA JASPER CONTRACTORS INC 1690 ROBERTS BLVD SANFORD FL 32771 STE 112 KENNESAW, GA 30144 770) 615-4269 Structure Information 000 000 ---------------------- Roof Type . . . . . . . . . FIBERGLASS SHINGLES Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc _ Phone Access Code 1008564 Permit pin number 1008564 Permit Fee . . . . 124.00 Issue Date . . . . 10/24/17 Valuation . . . . 11400 Expiration Date . . 4/22/18 Qty Unit Charge Per Extension BASE FEE 40.00 12.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 84.00 Special Notes and Comments All projects within the City shall use WastePro for debris removal. Please contact WastePro at 407.774.0800. Normal hours for inspections are from 7:30 through 4:30 Monday through Thursday. Please be aware you must contact the Building Official to schedule a Friday or after hours inspection. This is required since not every inspector is licensed to do every type inspection. Communication is the key, so please contact the Building Official if you have any questions at 407.688.5058 or at dave.aldrich@sanfordfl.gov Other Fees . . . . . . . . . 01-APPLCTN FEE -BUILDING 25.00 O1-BLDG PLAN REVIEW 36.00 O1-BLDG DCA SURCHARGE 1.85 O1-BLDG DBPR SURCHARGE 2.78 Fee summary Charged Paid Credited Due Permit Fee Total 124.00 .00 .00 00 Other Fee Total 65.63 .00 .00 65. Grand Total 189.63 .00 .00 189.63 FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS. NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED. NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED. FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 Application Number . . . . . 17-00003110 Date 10/24/17 Application pin number . . . 585960 Property Address . . . . . . 352 CONCH KEY WAY Parcel Number . . 29.19.31.501-0000-1160 Application type description ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . SINGLE FAMILY Application valuation . . . . 14900 Application desc REROOF/SHINGLES NOC ON FILE Owner LILLIAN RAMOS & JESUS RIVERA SANFORD FL 32771 Contractor JASPER CONTRACTORS INC 1690 ROBERTS BLVD STE 112 KENNESAW, GA 30144 770) 615-4269 Structure Information 000 000 REROOF Roof Type . . . . . . . . . FIBERGLASS SHINGLES Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 1008580 Permit pin number 1008580 Permit Fee . . . . 145.00 Issue Date . . . . 10/24/17 Valuation . . . . 14900 Expiration Date . . 4/22/18 Qty Unit Charge Per Extension BASE FEE 40.00 15.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 105.00 Special Notes and Comments All projects within the City shall use WastePro for debris removal. Please contact WastePro at 407.774.0800. Normal hours for inspections are from 7:30 through 4:30 Monday through Thursday. Please be aware you must contact the Building Official to schedule a Friday or after hours inspection. This is required since not every inspector is licensed to do every type inspection. Communication is the key, so please contact the Building Official if you have any questions at 407.688.5058 or at dave.aldrich@sanfordfl.gov Other Fees . . . . . . . . . 01-APPLCTN FEE -BUILDING 25.00 O1-BLDG PLAN REVIEW 45.00 O1-BLDG DCA SURCHARGE 2.15 O1-BLDG DBPR SURCHARGE 3.23 Fee summary Charged Paid Credited Due Permit Fee Total 145.00 .00 .00 Other Fee Total 75.38 .00 .00 75.3 Grand Total 220.38 .00 .00 220.38 FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS. NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED. NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED. FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 Application Number . . . . . 17-00003113 Date 10/24/17 Application pin number . . . 445994 Property Address . . . . . . 127 CROWN COLONY WAY Parcel Number . . . . . . . . 33.19.30.5QS-0000-0520 Application type description ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . SINGLE FAMILY Application valuation . . . . 10900 Application desc reroof/shingles noc on file Owner Contractor krausman, todd & rebeka JASPER CONTRACTORS INC 127 crown colony way 1690 ROBERTS BLVD SANFORD FL 32771 STE 112 KENNESAW, GA 30144 770) 615-4269 Structure Information 000 000 REROOF/SHINGLES NOC ON FILR --- Roof Type . . . . . . . . . FIBERGLASS SHINGLES Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 1008630 Permit pin number 1008630 Permit Fee . . . . 117.00 Issue Date . . . . 10/24/17 Valuation . . . . 10900 Expiration Date . . 4/22/18 Qty Unit Charge Per Extension BASE FEE 40.00 11.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 77.00 Special Notes and Comments All projects within the City shall use WastePro for debris removal. Please contact WastePro at 407.774.0800. Normal hours for inspections are from 7:30 through 4:30 Monday through Thursday. Please be aware you must contact the Building Official to schedule a Friday or after hours inspection. This is required since not every inspector is licensed to do every type inspection. Communication is the key, so please contact the Building Official if you have any questions at 407.688.5058 or at dave.aldrich@sanfordfl.gov Other Fees . . . . . . . . . 01-APPLCTN FEE -BUILDING 25.00 O1-BLDG PLAN REVIEW 33.00 O1-BLDG DCA SURCHARGE 1.75 O1-BLDG DBPR SURCHARGE 2.63 Fee summary Charged Paid Credited Due Permit Fee Total 117.00 .00 .00 117.00 Other Fee Total 62.38 .00 .00 . 8" Grand Total 179.38 .00 .00 179.38 FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS. NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED. NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED. FIRE INSPECTIONS CITY OF SANFORD 407.562.2786 BUILDING & FIRE PREVENTION - BUILDING INSPECTIONS 300 N PARK AVE 855.541.2112 SANFORD FL 32771 DRIVEWAYS -SIDEWALK 407.688.5080 Application Number . . . . . 17-00003114 Date 10/24/17 Application pin number . . . 185272 Property Address . . . . . . 152 BRUSHCREEK DR Parcel Number . . . . . . . . 33.19.30.516-0000-1090 Application type description ROOFING APPLICATION Subdivision Name . . . . . . Property Zoning . . . . . . . PUD Application valuation . . . . 10500 Application desc reroof/shingles NOC ON FILE Owner Contractor justin thielman JASPER CONTRACTORS INC 152 BRUSHCREEK DR 1690 ROBERTS BLVD SANFORD FL 32771 STE 112 407) 322-7069 KENNESAW, GA 30144 770) 615-4269 Structure Information 000 000 REROOF/SHINGLES --- Roof Type . . . . . . . . . FIBERGLASS SHINGLES Permit . . . . . . RESIDENTIAL ROOFING PERMIT Additional desc . . Phone Access Code 1008648 Permit pin number 1008648 Permit Fee . . . . 117.00 Issue Date . . . . 10/24/17 Valuation . . . . 10500 Expiration Date . . 4/22/18 Qty Unit Charge Per Extension BASE FEE 40.00 11.00 7.0000 THOU BLDG PERMIT -CC APPRVD 9.27.10 77.00 Special Notes and Comments All projects within the City shall use WastePro for debris removal. Please contact WastePro at 407.774.0800. Normal hours for inspections are from 7:30 through 4:30 Monday through Thursday. Please be aware you must contact the Building Official to schedule a Friday or after hours inspection. This is required since not every inspector is licensed to do every type inspection. Communication is the key, so please contact the Building Official if you have any questions at 407.688.5058 or at dave.aldrich@sanfordfl.gov Other Fees . . . . . . . . . 01-APPLCTN FEE -BUILDING 25.00 O1-BLDG PLAN REVIEW 33.00 O1-BLDG DCA SURCHARGE 1.75 O1-BLDG DBPR SURCHARGE 2.63 Fee summary Charged Paid Credited Due Permit Fee Total 117.00 .00 .00 11 .0 Other Fee Total 62.38 .00 .00 62.38 Grand Total 179.38 .00 .00 179.38 FAILURE TO COMPLY WITH MECHANIC'S LEIN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS. NOTE: ALL FEES MUST BE PAID PRIOR TO C.O. BEING ISSUED. NOTE: PLEASE BE ADVISED ALL PERMITS MUST BE INSPECTED. 1 1 '$ ® • iiii I ®® Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date:-y~1 I hereby name and, appoint. Scott Meixsell, James Allen, Michael Watts, Jacob Horst, Ricardo Prito, Paul Padgett anagent of -kv;w Contractors Name of Compaay) 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): The specific permit and application for work located at eaan Cbgt SCEVI1 sue Aaarm) Expiration Date for This. Limited Power of Attorney:. I -- ' — 9 License Holder Name: 1Xn (A & b mc, k-0 4 , State License Number. CCC133153 Signature of LicenseHolder. STATE OF FLORMA COUNTY OF S-i—loleThe foregoing instnunient was acknowledged before me this Uday of Q0V, 200W, by °or4d eouchwd who is o personally known to me or o who has produced a- as identification and who did (did not) tak4 an oyatfi Notary Sea]) SKYLAR B AWRAUT o> • s *_ Commission # FF 127890 , oc My Commission Expires June 01 , 2018 Rev. 08.12) Print dr lymname Notary Public - State of Commission No. My Commission Expires: Scanned by CamScanner City of Sanford Building and Fire Prevention RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT NAILING9 SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS PERMIT #: 1 1 ADDRESS: W C U AS A(N) GF.NFRAT._ RTTTT nwc.- RRCTT)FNTTAT. nR 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 #: COMPANY / CONTRACTOR: CONTRACTOR SIGNATURE: v DATE: MUST BE SIGNED BY LICENSE HO R O ILD A FINAL ROOF INSPECTIO 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 FURTHEREXPLANATION 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 '11L day of M C V 20 Aby: cow i Who is Personally Known to me or ha Produced (type ofly idg titic$tion) - as identification. SKYLA B AMKRAUT FF 127890 Commission # M Commission Expires YJune01 , 201 8 9r% 01,10`"1