1106 S Scott Ave - BR18-004346 - REROOFCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: I - - '13
Documented Construction Value: $ Z6 "$D'°
Job Address: 1106 S SCOTT AVE SANFORD, FL 3277 f Historic District: Yes No Rf
Parcel ID: 30-19-31-527-0000-0210 Residential Rr Commercial
Type of Work: New Addition Alteration Repair W Demo Change of Use Move
Description of Work:
Plan Review Contact Person: LINA Title: PERMIT MANAGER
Phone: 954-7924415x243 Fax:* 407-4728380 Email:_per fhaproducts.com
Property Owner Information
Name PRYOR, FARAH A Phone:
Street: 1106 S SCOTT AVE Resident of property? : OWNER
City, State Zip: SANFORD, FL 32771
Contractor Information
Name FLORIDA HOME -IMPROVEMENT ASSOC. Phone: 954-7924415
Street: 3044 SW 42 ST_ Fax: 407-4728380
City, State Zip: HOLLYWOOD, FL. 33312 State License No.: C—®f,%%%—
Architect/Engineer Information
Name: N/A Phone: N/A
Street: N/A Fax: N/A
City, St, Zip: N/A E-mail: N/A
Bonding Company: N/A Mortgage Lender: N/A
Address: N/A Address: N/A
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 pernlit, 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 of the 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 that all work will
be done in compliance with all applicable laws regulating construction and zoning.
V 4"t - / 0 IQD- d
Signature of Owner/Agent Date Signature of Contractor/Agent Date
Owner/Agent is Personally Known to MelProducedIDTypeofC}O fiv
Contractor/Agent is P1
Produced ID Type
ski%o*
t
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
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
of Heads Fire Alarm Permit: Yes No
UTILITIES:
FIRE:
WASTE WATER:
BUILDING:
Revised: June 30, 2015 permit Application
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
hereby name and appoint: LUIS COLLAZO AND MERCEDES COLLAZO
an agent of: FLORIDA HOME IMPROVEMENT ASSOC.
Name of Company)
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:
1106 SCOTT AVE SANFORD, FL 32771
Street Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name
State License Number
RKE HAMMOND
CCC1330461
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF..at
The foregoing instrument was acknowledged before me this
200_1f, by BURKE HAMMOND
to me or o who has produced
identification and who did (did not) take OK oath.
z` day of _ty-4-,
who is,-N(p-ersonally known
as
ure
cL0
Notary Seal) '-R4 1I/)l/L &n p'e'tzj a` ,
4;P
Print or type name qo
e `
g&
Notary Public - State of a2 O IPI * Commission No.
My Commission Expires:
Rev. 08.12)
Sp 41
s
S7AT£ OF
City of Sanford
Building 1 Fire Prevention
Product Approval Specification Form
Permit #
Project Location Address 1106 S Scott Ave SANFORD, FL 32771 _
As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the
information and product approval number(s) on the building components listed below if they are to be
utilized on the construction project for which you are applying for a building permit. We recommend that
you contact your local product supplier should you not know the product approval number for any of the
applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in
accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product
Approval can be obtained at www.floridabuilding.oW.
The following information must be available on the jobsite for inspections:
1. This entire product approval form
2. A copy of the manufacturer's installation details and requirements for each product.
Category / Subcategory Manufacturer Product
Description
Florida Approval #
include decimal)
1. Exterior Doors
Swinging
Sliding
Sectional
Roll U
Automatic
Other
2. Windows
Single Hun
Horizontal Slider
Casement
Double Hun
Fixed
Awning
Pass Through
Projected
Mullions
Wind Breaker
Dual Action
Other
June 2014
l
Category / Subcategory Manufacturer Product
Description
Florida Approval #
including decimal)
3. Panel Walls
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles Certainteed Landmark Pro FL5444.1
Underla ments Certainteed Diamond Deck FL15692.1
Roofing Fasteners
Nonstructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Built up roofing
System
Modified Bitumen
Single Ply Roof
Systems
Roofing slate
Cements/
Adhesives /
Coating
Liquid Applied
Roofing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels
Roof Vents
Other
June 2014
Category / Subcategory Manufacturer Product
Description
Florida Approval #
include decimal)
5. Shutters
Accordion
Bahama
Colonial
Roll up
Equipment
Other
6. Skylights
Skylights
Other
7. Structural
Components
Wood Connectors /
Anchors
Truss Plates
Engineered Lumber
Railing
Coolers/Freezers
Concrete Admixtures
Precast Lintels
Insulation Forms
Plastics
Deck / Roof
Wall
Prefab Sheds
Other
8. New Exterior
Envelope Products
Applicant's Signature
Applicant's Name i W "o\d
Please Print)
June 2014
SCPA Parcel View: 30-19-31-527-0000-0210 Page 1 of 2
P,g P ,CNt
s>=r.+++o' counrrv.ritxno+
Property Record Card
Parcel: 30-19-31-527-0000-0210
Property Address: 1106 SCOTT AVE SANFORD, FL 32771
Parcel Information
Parcel 30-19-31-527-0000-0210
Owner(s) PRYOR, FARAH A
Property Address 1106 SCOTT AVE SANFORD, FL 32771
Mailing 1106 S SCOTT AVE SANFORD, FL 3277
Subdivision Name MAYFAIR SEC 1 ST ADD
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions 00-HOMESTEAD(2010)
139.26
T, 00 LO
4}.
Y.
f
t(
Legal Description
LOT 21
MAYFAIR SEC 1ST ADD
PB 13 PG 69
Taxes
Value Summary
2019 Working
Values
2018 Certified
Values
Valuation Method - Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value ~ tI $106,836 103,388
Depreciated EXFT Value
Land Value (Market)
9,932-
18,001)
9,961
18,000 _
Land Value Ag
Just/Market Value "' 134,768 131,349
Portability Adj -
Save Our Homes Adj 31,734 30,434
Amendment 1 Adj 0 0
P&G Adj _ - 0 0 -
Assessed Value 103,034 100,915
Tax Amount without SOH: $1,684.68
2018 Tax Bill Amount $1,113.46
Tax Estimator
Save Our Homes Savings: $571.22
Does NOT INCLUDE Non Ad Valorem Assessments
Taxing Authority I Assessment Value I Exempt Values I Taxable Value
County General Fund 103,034 50,000 1 53,034
Schools 103,034 (
u_. .-_..
25,000 78,034
City Sanford 103,034 50,000 53,034
SJWM(Saint Johns Water Management) 103,034 50,000 53,034
County Bonds 103,034 50,000 i 53,034
ales
Description Date Book Page Amount Qualified Vac/Imp
WARRANTY DEED i 5/1/2009 07193 0845 132,000 Yes Improved
SPECIAL WARRANTY DEED
CERTIFICATE OF TITLE
WARRANTY DEED
11/1/2008
3/1/2008
2/1/2006
07095m
06952
06151
1387
1321
1762
79,900
C $100
210,000
No
I No
Yes
Improved
Improved
Improved
11 Find Comparable SalesI
Land
Method Frontage Depth Units Units Price Land Value
LOT 0.00 ! 0.00 1 1 $18,000.00 $18,000
Building Information
Is Bed/Bath count incorrect? Click Here.
Description Year Built Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Repl Value AppendagesActual/Effective
1 1971 i 6 { 3 ' 2.0 j 1,000' 2,946 2,332 1 $106,836 $146,350 jI Description Area
http://parceldetail. sepafl.org/ParcelDetaillnfo.aspx?PID=30193152700000210 10/ 16/2018
ilarkia Honteamprownbnt Associates Floridaroward Phone 954 792 4415
alkilmeNwCCtl3104g1 / QBr81B Miami Dada Phone: 305 S45.M69
40?OS%V J0"Aw., Holtywood, FL.31312 kome•improvement Fax, 954.792.2170
pSs®C aa Webslte:FHAPRODUCrs.eOM
Associates EmaB: Info@lhaproducts.tom
Jobp Replacement Roofing Contract
e1 (zpHomeName: -P-Cr GJ +n- Cell:
Address City State Zip
This Contract is made and entered into this _L day of 0(—C1C-Py' 201 by and between Florida Home -Improvement Associates, Inc,
a Florida corporation I'Contractor' or'FHA'),.and owners) named above of the residence located at the address listed above ('Owner').
The Work: Contractor agreesto perform described below
1) Remove existing roof covering and accessories
2) Prepare roof as necessary to receive Installation of new roofing materials
3) Roof Type: Shingles Tile Roof Metal Roof Flat Roof
4) Remove: Shingles 5 Sq. Tile Root Sq. Metal Roo} Sq. Flat Roof Sq.
S) Remove: Gutters Lineal Feet, Remove and Re -hang
6) Install: Shingles 35 Sq, Tile Root Sq. Metal Roof Sq. Flat Roof 5q.
7) Install: Gutters Lineal Feet
8) Install: Shingle Type: 3 Tab Archit
j[
ural
9) Install: Color: I tN N I r l? I C" Ck
10) Install: Vent Type: Ridge Roil Vent Box Vent
11) Install: Underlayment: X Felt Diamond Deck
Warranty: Check all that apply to this contract: (
Lifetime shingle coverage from manufacturer ` Tear -off50 years from manufacturer
Non -prorated coverage 50 years from manufacturer Disposal 50 years from manufacturer
XMaterials and labor 50 years from manufacturer Workmanship 25 years from manufacturer
Work Not to be done:
Schedule: Contractor shall commence the work within days after the esecvtion of the Contact (the "Commencement Date') and shall endeavor
to complete all work hereunder within days after the Commencement Date. at,1
The TOTAL PRICE for all Labor and Materials (Including any applicable discount) is $
0
DO
Down Payment Is $ 00
Balance Payable is $
Contractor will Provide to Owner a Final Waiver and Release oflien and Contractors Final Affidavit to Owner, substantially similar to the forms
included in ch>J ' 713. Florida Statues:(20OS).
Circle o (YES NO) Owner elects to apply for financing of the above -statue lump sum amount. If yes is circled, see financing agreement
and related ocuments.
Notice to the Owner, if financing is being obtained by Owner:
a) Do not sign this Home Improvement Contract (Including financing documents) In blank. b) You are entitled to a copy of the contract at the time you sign. Keep It to protect your legal rights.
c) The financial documents attached to this Home Improvement Contract may contain a mortgageorotherwise createailen on your propertythatcouldbeforeclosedonIfyoudonotpay. Be sure you understand all provisions of the contract and it documents balore you sign.
Nicellaneous: This contact contains the entire contract oftheparties. It may notbe changed orallybut only bya signed change orderar otherwrittenamendment. The waiver by any party of a breach ofany provision of this contract shall not operate or be construed as a waiver of any
subsequent breach by any party.
IN WITNESS WHEREOF, the Panics hereto have executed this contract, under seal, as of the day and year firstabove written.
You the buyer may cancel this transaction at any time prior to midnight on the third business day after the date of this transaction,
See Attached notice of cancellation form for any explanation ofthis right.
t • s
owner: Contractor:
signature of Owner)
ISlgnalure ofowner)
Date
Home Owners Asutlyq Name: Phones: uy
YES (' ) NDDIl\
v
Community Name:
r
Scanned by CamScanner
Grant Maloy, Clerk.Of The Circuit Court & Comptroller Seminole County, FL
Inst #2018122926 Book:9238 Page:1466; (1 PAGES) RCD: 10/25/2018 10:53:58 AM
REC FEE $10.00
THIS INSTRUMENT PREPARED BY:
Name: BARBARA ESPARZA
Address: FLORIDAHOME IMPROVEMENT ASSOC.
8034 SUNPORT DR. #401. ORLANDO. FL. 328
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
Permit Number: Parcel ID Number: 30-19-31-527-0000-0210
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
LOT 21 MAYFAIR SEC 1ST ADD PB 13 PG 69 • 1106 SCOTT AVE SAN FORD. FL
32771
GENERAL DESCRIPTION OF IMPROVEMENT:
ROOF
OWNER INFORMATION:
Name: PRYOR, FARAH A
Address: 2036 JEFFERSON AVE SANFORD FL 32771
Fee Simple Title Holder Of other than owner) Name: N/A
Address. N/A
CONTRACTOR:
rv.mo• FLORIDA HOME IMPROVEMENT ASSOC.
Address: 3044 SW 42 ST. HOLLYWOOD, FL. 33312
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served
as provided by Section 713.13(1)(b), Florida Statutes.
Name: N/A
a,w. . N/A
In addition to himself, Owner Designates N/A
To receive a copy of the Lienor s Notice as Provided In
Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a
different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A
NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true
to the bes f my owied and belief.
d r
Owner's Sign Owners Printed Nam
Florida Statute 713.13(1)(g):' The owner must sign the notice ofcommencement and no one also may be permitted to in his or her stead. -
State of County of a
The foregoing Instrument was acknowledged before me this day of _2L-
by 4 0 Who is personally known to MIM
Name of1person making statement
OR who has produced Identification Eltype of Identification produced: o<
CITY of
Building & Fire Prevention DivisionSkN'FORD RESIDENTL4L RE-ROOFPOLICY & PROCEDURES
FIRE DEPARTMENT
PERMITTING REQUIREMENTS — NO PLAN REVIEW REQUIRED
THIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE
REQUIRED TO BE SUBMITTED AS PART OF YOUR PERMIT APPLICATION.
THE SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF
COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT.
A PERMIT WILL NOT BE ISSUED WITHOUT THESE DOCUMENTS. COPIES WILL BE MADE TO POST ON THE JOB SITE.
PROJECTS LOCATED IN THE SANFORD HISTORIC DISTRICT WILL REQUIRE PLAN REVIEW AND APPROVAL BY THE
SANFORD HISTORIC PRESERVATION BOARD
INSPECTION POLICY & PROCEDURES
A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMILY, TOWNHOUSE,
MOBILE HOME, APARTMENT AND/OR CONDOMINIUM) RE -ROOF PERMITS.
THE FOLLOWING IS REQUIRED TO BE PROVIDE ON THE JOB SITE:
PERMIT CARD, POSTED IN A CONSPICUOUS AND WEATHERPROOF LOCATION
COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK
COMPLETED AND NOTARIZED INSPECTION AFFIDAVIT
ALL FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS
PRODUCT APPROVAL SHALL MATCH WHAT IS ON THE SCOPE OF WORK)
DIGITAL PHOTOGRAPHS (MUST INCLUDE THE PERMIT NUMBER OR ADDRESS IN EACH PICTURE)
o EACH PLANE OF THE ROOF, SHOWING THE UNDERLAYMENT INSTALLED
o ROOF DECK NAILING PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
o ROOF DECK NAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHOWING SIZE OF NAILS)
o UNDERLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
o DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE OR RULER)
o SHINGLES INSTALLED, NAIL PATTERN AND LOCATION OF NAILS
SKYLIGHTS (IF APPLICABLE)
o DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL
o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT APPROVAL
FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNERBUILDER) SIGNATURE: DATE:
i//"il//(1
e
PERMIT #
City of Sanford Building Division
Residential Re -Roof Scope of Work
JOB ADDRESS: flO S SCo l/ 4'/, Sg 1, 4 rJ ', -32-%7 /
STRUCTURE TYPE: SINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE: V) REPLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF)
DECK TYPE (PLEASE SPECIFY):
PLEASE NOTE: ONLY 100 SQUARE FEET OF THE EXISTING DECK IS PERMITTED TO BE REPLACED"
ROOF VENTILATION: O OFF -RIDGE O RIDGE OSOFFIT OPOWERED VENT
SKYLIGHTS: O YES R 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
O TURBINES
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
SHINGLE C'Ws FL#
O METAL FL#
O MODIFIED BITUMEN FL#
O TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
ROOF EXTENSIONS (PORCHES, PATIOS, ETC.) "YAPPLICABLE"
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 Tokm DOWN FL# -
OINSULATED FL#
O TILE FL#
0 OTHER: FL#
City of Sanford
Building and Fire Prevention
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: J ! ADDRESS: U ._qC2'! 'ALP
I I ` C e_- 1`12 Tl-/y ,4 oq-N ok 'AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTO NGINEER, 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 C
COMPANY / CONTRACTOR: F//1 `f j/{_
CONTRACTOR SIGNATURE: -
MUST BE SIGNED BY LICENSE HOLDER OR
A FINAL ROOF INSPECTION IS REQUIRED:
11 !/l a:r ,. : i
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 5E1-11 N01,Z Sworn
to and Subscribed before me this 2Q day of NNE IM-TL20 18 by: 150CLiE
NA-n r IO"o . Who is N-Pe'r'sonallyKnown to me or has Produced (type of identification)
as identification. Signature
ofNotaFPublic BARBARA ESPARZA pxxrrp State
of Florida = ` "G Comm' F 0'' '" Comm;. DPQMNEA
O'pAE_Z.A Print/Type/
Stamp Name of Notary
Public GG 28143
My Commission
Expires August 30,
2020