105 W 18 St; 18-3507; RE-ROOFSANFO
CITY OF
F IR;E DEPARTMENT
AUG 15 2018 Building & Fire Prevention Division
PERMIT APPLICATION
Application No: 15-350`]
Documented Construction Value: $# I (. (.0 Z 0
JobAddress: d '' n ra 32 1(Historic District: Yes No Parcel
ID: e — Q " 3D - SD(e ` jf)C300— 071 D Residential[] Commercial[] Type
of Work: New Addition Alteration[] Repair Demo Change of Use Move Description
of Work: Re — ROo+ Plan
Review Contact Person: 990 Title: Phone:
Fax: Email: Property
Owner Information Name ,
S-tcf afl C l Qsscn Streetl
0 S W. 100 St City,
State Zip: 5 01 n'Ir(i Phone:
Resident
of property? ; G _ Contractor
Information p
r ' 401- lob s- 91 Z 1 Name
n ROOT' 1 n IriG. Phone: Street:
Fair r
1A
1. 1. Fax: l
City,
State Zip: VI I & Ir1(i Og 32-tQ l State License No.: Ccc 12.)51 Lf, 41 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: 6th Edition (2017) Florida Building Code Revised:
January 1, 2018 Permit Application '9 y 0-?8 v1
C
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 requiredinordertocalculateaplanreviewchargeandwillbeconsideredtheestimatedconstructionvalueofthejobatthetimeofsubmittal. The actual constriction 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 g.
Signature Owner/Agent Date Signature of Contractor/Agent Date
Print Owner/Agent's Name
Date
IONNry ruby SIata of Florida
Adis Prebyi
My Commission GG 244916
qa, Expires 08/0112072
Owned-figenil is Personally Known to Me or
Produced ID _o- Type of ID fL 0. "ka%S[,
i7Yigh F4rr
Print Contractor/Agent's Name
reter of tary-State of dda Date
VM+V`
Mt Notary Public State of Florida
ip Adis Prebyl
t My Commission GG 244918
a p` Expires08101/2022
Co own to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building
Construction Type:
Total Sq Ft of Bldg:
Electrical Mechanical Plumbing Gas Roof
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
of Heads
UTILITIES:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: January 1, 2018
Permit Application
Grant Maloy, Clerk Of The Circuit Court & Comptroller Seminole Court FL
Inst #2018093363 Book:9190.Page:1574; (1 PAGES) RCD: 08/15/2018 01:12:54 PM REC FEE $
10.00 THIS INSTRUMENT.
PREPAR D BY: Name: Address:
Q
Ln. Mando 3V-
1 NOTICE OF
COMMENCEMENT Permit Number.
Parcel ID
Number. au— tq-30—Sofa-0000-0.1i0 CER71FIEJD COPY
GRANT MALOY CLERK OF
THE CIRCUIT COURT`' AND COMItiTR +
LE:2 } , ser Ii
LE Cat;;{- E i: aT
GIPUIYCLERK Huv 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) LOTS 1'
1 arid -19 SANFoti 0 HEletHIS PS 2 P& tea 2. GENERAL
DESCRIPTION OF IMPROVEMENT: 9'r -
EZoo 3. OWNER
INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT: Name and
address: JS'+'C r—g2T-1G 1 aS z fr% Interest in
property: 10 S W 10 'r'4' SfiSat n'Tao i:d SZ 1 1 1 Fee Simple
Title Holder (if other than owner listed above) Name: 4. CONTRACTOR:
Name: ~111 V QIr"-17 Qt. KOtp} I Address: to
05 Ln, CI 5. SURETY (
If applicable, a copy of the payment bond is attached): Phone Number:
40, — (O`t S— 9"iZ 1 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. Phone Number:
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 1, 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. 11K Sign
of
Owne r'a orLessee's Au 'zed
Officer/Director/Partner/Manager) 01 iA,
t,. aMA,., Print Name
and Provide Signatory's Tide/Office) State of
ir61 l d VI CountyofThe foregoing Instrument
was acknowledged before me this ' day of 20 E by 711 1
l 'Q.Q, Who Is personally known to me OR Namo of person
making statement who has produced
identificationrtype of identification produced: DrNe s Li cw s-- s}f'f •
Natery;P,ublie State ofFlorida vv Adis Preb i
Notary signature My Commisssion GG
244916 orr p Expires0=
11=22
Advantage Roofing Inc
6903 Partridge Lane
Orlando, FL 32807
407-678-9721
advantageroofinginc@yahoo.com
www.roofingadvantage.com
State Lic# CCC052477
Clienf.. ..
Stefan Clasen
105 W 18th St
Sanford, FL 32771
407-412-2507
Shingle Roof Replacement
Estimate ID: M5NTZM
Date: Nov 30, 2017
Advantage Roofing Inc is dedicated in combining its resources to ensure the highest quality of workmanship and commitment.
We have familiarized all personnel with project conditions and are familiar with all local building codes. Thank you for the
opportunity, time and attention in your process of choosing a qualified contractor.
RE-ROOFPREPARATION
Coverall plants and shrubbery with tarps to eliminate damage and catchall loose trash and nails.
Obtain and post all necessary permits in accordance with all local codes.
Remove existing roof: Shingle roof to wood decking (Roof type).
Removal of extra roof lavers will be charged at an additional cost of $25.00 Per SQ.
ROOFINGSYSTEM
Re -nail decking per FL Hurricane Litigation Reguirements.(8D RING SHANK NAILS PER FL BUILDING CODES)
Install new: GAFArchitectural Timberline HD Shingles in accordance with manufacturers specifications and all
local codes. (Lifetime 50 Yrs / 130 MPH Wind Rating)
WOOD WORK
Replace defected/rotten wood at an Additional cost: $60.00 per sheet plywood.
Replace defected/rotten wall, chimney.flashing, plank and fascia boards at an Additional cost: $5.50 per Lin. Ft.
150.00 Wood Credit)
UNDERLAYMEMT DRY -IN
Install Synthetic (Shingle Underlayment) throughout entire roof deck.
Install Peel & Stick Leak Barrier in the following vulnerable areas that apply( valleys, Penetrations, skylights, and
Chimneys).
EAVEDRIP, FLASHING & SKYLIGHTS
New eave drip 41 #pieces. Color:
Install new lead plumbing boots: 3 inch. 2 2 inch. 3 1.5 inch. _ Elec. Boot 1
Furnish and install new valley metal over peel and stick membrane: 35 Lin. Ft.
Remove and install new glass curb mount skylights. (2x4) (2x2)
Advantage Roofing Inc page 1 of 5
iffWILATION CAP&STARTER SHINGLES Furnish
and install new shingle over ridge vents: 80 Lin. Ft. Remove
and instal I new 4 ft. off ridge vents: Qty. Install
new goose neck vents: 10 inch. 4 inch. Install
hip and ridge cap shingles. 210 Lin. Ft. Install
required starter shingles at eave. 320 Lin. Ft. JOB
COMPLETION Clean
job site thoroughly each day and remove all job related debris from premises. Magnetically drag job site for any loose
nails. Request
all necessary permit inspections(Please do not remove any county permits until final inspections have been completed).
WORKMANSHIP
WARRANTY Workmanship
warranted against ALL LEAKS AND DEFECTS for Five (5) Years from date of completion. Manufacturers
warranty applies to materials only. Warranties are transferable onetime. ADVANTAGE
ROOFING INC, hereby propose to furnish labor, materials, insurance, permit fees, dump fees, supervision,
equipment, qualified installers, and taxes: complete in accordance with the above specifications. NOTES/
COMMENTS Optional
Upgrade: Arch. GAF Timberline American Harvest Shingles (Additional $800.00) Advantage
Roofing Inc page 2 of 5
Items
Customer states multiple leaks. Found lift in shingles in several areas throughout roof. Due to the hurricane force winds the roof
shingles are structurely compromised. Susceptible to further leaks due to driving rain/wind. New roof replacement is
recommende.
Summary
Subtotal $16,620.00
Tax $0•00
Total $16,620.00
Advantage Roofing Inc page 3 of 5
Terms and Conditions
This contract and any agreement pursuant thereto is between Advantage Roofing Inc. hereinafter referred to as the "Co" or
Company"and the customers) named herein on the will be subject to allappropriate laws, regulations and ordinances ofthe
state ofFlorida and the terms andconditions. The above proposal, specifications and conditions are satisfactory. and
Advantage Roofing is hereby authorized to do the work as specified. This proposal is subject to acceptance within 30 days and is
void thereafter at the option of the Licensed Contractor. Should default be made in payment of this contract, charges should be
added from the date their ofcompletion at a rate of (1 %) percent per month,18%per year with a minimum charge of $ 2.00per
month, and ifplaced in the hands ofan attorney for collection, all attorney fees, legal, and filing fees shall be paid bycustomer
acceptingsaid contract.
1. According to Florida's Constitution Lien Law (sections 713.001-713.37 Florida Statues), those who work on your property
orprovide materials and are notpaid in full have the right to enforce their claim forpayment against yourproperty. This claim is
known as a constriction lien. Ifyour contractor orsubcontractor fails topay subcontractors, sub -subcontractors, ormaterials
supply or neglect to make other legally required payments, the people who are owed money may look to your property for
payment, even ifyou have paid your contractor in full. Ifyou fail to pay your contractor, your contractor may also have a lien on
your property. This means ifalien is filed on your property it could be sold against your will to pay for labor, materials, or other
services that your contractor orsubcontractor may have failed to pay. Florida construction lien law is complex and is
recommended that whenever a specific problem arises, you should consult an attorney.
2. All Contracts are subject to approval of our credit department and office without exception. The person executing this
contract must obtain the approval of the officer of the company for this contract to be effective under any conditions.
3. The companyshall have no responsibility from damages from fire, tornado, windstorm, or other perils, as is normally
contemplated to be covered by homeowner's insurance or unless,) specified written agreement be made therefore prior to
commencement of the work. Companyshall not be reliable forfailure ofperformances due to labor controversies, strikes, fires,
whether, in ability to obtain materials from usual sources, ofanyother circumstances beyond the control of the company,
weather of similar ordissimilar nature. Acts of extreme nature voids all warranties. `Co. "cannot be heldresponsible forany
form of mold damage. Manufacturer's warranty applies to materials. Advantage will not be responsible for previous
structural issues, plumbing line damage due to improper installation, driveway damage, gutters, soffits, norsolar panels.
4. Ifmaterial has to be reordered orrestocked because ofcancellation by the customer there will be a restocking fee equal to
twenty five percent (25%) of the contract price. If this contract is cancelled later than three days from execution, the customer
shall pay to the Company twenty five percent (25%) of the contract price as liquidated damages, not as a penalty, and the
company agrees to accept such as reasonable and just compensation for said cancellation.
5. THIS CONTRACT CAN NOTBE CANCELLED ONCE WORK 15 COMMENCEDA CCEPTB YMUTUAL WRITTEN
AGREEMENT OF THE PARTIES.
6. Any representations, statements or other communication not written on this contract oragree to be in material, and not
relied on byeitherparty, anddo not survive the execution ofthis contract. The company is not responsible for construction
problems ofyour home.
7. FLORIDAHOMEOWNERS'CONSTRUCTIONRECOVERYFUND: PAYMENT, UPTOA LIMiTEDAMOUNT, MAYBE
A VA ILA BL E FROM THE FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERYFUND IF YOU LOSE MONEY ONA
PROJECT PERFORMED UNDER CONTRACT, WHERE THE L OSS RESUL TS FROM SPECIFIED VIOLA TIONS OF FL ORIDA
LAWBYA LICENSED CONTRACTOR. FOR iNFORMATIONABOUT THE RECO VER YFUND AND FILINGA CLAIM,
CONTACT THE FLORIDA CONSTRUCTION INDUS TR YL ICENSING BOA RDAT THE FOLLOWING TELEPHONE NUMBER
ANDADDRE55:1940 North Monroe Street. Tallahassee, FL 32399-0783 Tele:850-487-1395
Website: www.myfloridalicense.com
Advantage Roofing Inc page 4 of 5
Stefan Clasen Feb 14, 2018
Advantage Roofing Inc page 5 of 5
2/21 /2018 SCPA Parcel View: 36-19-30-506-0000-0770
f-
LOTS 77 78 & 79
SANFORD HEIGHTS
PB2PG63
Property Record Card
Parcel: 36-19-30-506-0000-0770
Property Address: 105 W 18TH ST SANFORD, FL. 32771
Valuation Method Cost/Market Cost/Market..
Number of Buildings 1 1
Depreciated Bldg Value 202,897 191,023
a
Depreciated EXFT Value 2,350 2,400
Land Value (Market) 46,530 46,530
Land Value Ag
Just Market Value 251 777 239 953
Portability Adj
Save Our Homes Adj 67,231 __........ 59,203
Amendment 1 Adj 0
P&G Adj 0 j.. 0
Assessed Value 184,546 180,750
Tax Amount without SOH: $3,781.22
2017 Tax hill Amount $2,653.90
Tax EsNnator
Save Our Homes Savings: $1,127.32
Does NOT INCLUDE Non Ad Valorem Assessments
County General Fund 184,546 50,000 134,546
Schools 184,546 25,000 ', 159,546
City Sanford 184,546 ! 50,000 134,546
SJWM(Saint Johns Water Management) 184,546 ;: 50,000 134,546
County Bonds 184,546 i 50,000 134,546
FRONT FOOT & DEPTH 180.00 127.00 - 0 !, $275.00 $46,530
Is BE d'B ath Count incorrect'? Click Here,
Descnp igra.' , Year Built Fixtures , , Bed Bath ,;Base Area I Total SF , Livtng SF ; `Ext Wall, Ad1 Value Rep( Value -' Appendages €
http://parceldetaii.scpafl.org/ParcelDetail info.aspx?PID=36193050600000770 1 /2
CITY OF
Building &Fire Prevention DivisionSFORDRESIDENTIALRE -ROOF POLICY & PROCEDURES
FIRE DEPARTINAI NT
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 C COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE: 5
SANFORD
FIRE DEPARTMENT
PERMIT #
Building & Fire. Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
IOB ADDRESS: 105 W • ' S , I , St. S a n fd rd L Z 1
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): Y u/LJIJa
PLEASE NOTE: ONLY 100 SQUARE FEET OP THE EXISTING DECK IS PERMITTED TO BE REPLACED * *
ROOF VENTILATION: DOFF -RIDGE ®RIDGE 0SOFFIT OPOWERED VENT OTURBINES
SKYLIGHTS: O YES 40NO 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 FLORIDA PRODUCT APPROVAL
J SHINGLE
MANUFACTURER
7 i"C FL# 1 O 1 L L4 - ,` 2_O
O METAL FL#
O MODIFIED BITUMEN FL#
OTORCH 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#
OMETAL FL#
O MODIFIED BITUMEN FL#
OTORCH DOWN FL#
O INSULATED FL#
O TILE FL#
OOTHER: FL#
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
I hereby name and appoint: M 1 s Pir cb
an agent o£ tyy Q n Name
of Company) Ir
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 a placation for work located at: 1
dS W . 12)1-" %t. Sa n Pnrcl 92- 1-1 Street Address)
Expiration Date
for This Limited Power of Attorney: e , I S I 1 I License Holder
Name: B Y 1 to Y, FGt Y 1r State License
Number: Signature of
License H STATE OF
FLORIDA COUNTY OF
The foregoing
instrument was acknowledged before me this ) S day of Aft 2009 by
j3r Q n F&,r r who ismpersonally known to me or
o who has produced identification and who
did (did not) take an oath. r. Signatur Notary
Seal)
Notary
Public State
of Florida Adis Prebyl My
Commission GG
244916 IQ Expires 08/0112022 Rev.08.12)
Print or type
name Notary Public - State
of Commission No. My
Commission Expires:
as
IL
CiiY Of
Building & Fire Prevention Division
RESIDENTIAL .RE -ROOF AFFIDA VIT
FII1r, 1.)CPAkTN1EN7
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY IN, FLASHING, AND ALL FINAL ROOF COVERING
PERMIT #: ' .O — 3 J ,[0 ? ADDRESS: 1"05,- 5t..
Soinfird .32-1 -,1 1 I
16 Y'l Q n 1-cl r, 1 'AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR ROOFING
CONTRACTOR, ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE FOREGOING
INFORMATION IS TRUE AND ACCURATE AND'THAT ALL ROOFING COMPONENTS LISTED ON THE SCOPE OF WORK AT THE ABOVE
REFERENCED ADDRESS HAVE BEEN INSTALLED IN ACCORDANCE WITH THEIR PRODUCT APPROVALS AND ALL APPLICABLE CODE REQUIREMENTS —
SPECIFICALLY FLORIDA BUILDING CODE, EXISTING BUILDING. IN ADDITION I CERTIFY THE INSTALLATION MEETS ALL REQUIREMENTS
FOR SECONDARY WATER BARRIER AND NAILING OF THE ROOF DECK, IN ACCORDANCE WITH THE HURRICANE RETROFIT MANUAL
REQUIREMENTS (BASED ON F.S. CHAPTER 553.844). LICENSE #:
C/ `/' e ' Q Lj \ COMPANY /
CONTRACTOR: .A \Y CONTRACTOR
SIGNATURE: DATE: MUST
BE SIGNED BY LICENSE HONiFNR 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 .,. • , Sworn
to and Subscribed before me this day of iL( L J _ 204 by: i%
1 +cL h FGZ:rY Who is Personally Known to me or has Produced (type of identif
ation) as,identiScation. g
a u e of Notary ublic State
of Florida Print/
Type/Stamp Name of
Notary Public Notery
Public State of Florida' ft
Prebyl My
Commission 66 244916 a `
Expires 0a/01/2622