HomeMy WebLinkAboutROOF INSPECTION AFFIDAVITJ
10
Permit
SCANNED
BY
ilt. ILude Caafflv
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
I,.s"" TP.lQ/`licensed as a(n)Contractor*/Engineer/Architect
(lease print name & circle license type) *FS468 Building Inspector
RECEIVED
SEP 0 6 2018
Permitting Department
St. Lucie County
Building, Residential or Roofing Contractor or any individual certified under 468 F.S. to make such an inspection.
,ll
Onr about �g/��/l,�I did personally inspect the roof deck nailing
11 (Date)
word' at:��!'
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 708 or the product approval submitted (whichever
is most stt;igent).
Signature and Seal
('CC13266-6-a
License #
STATE 'OF FL
COUNTYOFO <Uat e;�U—My
I
Sworn 'tP a d}u ribed fore me this day of 20
by w�; Nvho is personally known to me�or who has produced
as identification.
Notary'(?ublic, State of Florid
Signatu ,e of Notary: '49 RGE L. FlGUEROA
F2! $ Commis' ion Number: * �$ OMMISSION#FF21W2
EXPEn IIII NrgTFOFFLO�\�P Band dlTRhru9udgetNotarySe0195
IVV CASH BLANCA
N�'1;CONSTRUCTION INC.
LICENSE #CCC1326556
467 S F gler Ave #84
Pompan Beach FL 33060
Phone: ( � 54) 422-2504
SLO
ESTIMATE #_
PERMIT #.
t1
WE ARE PLEASED TO PRESENT THE FOLLOWING CONTRACT
Owner/Agent: Lonnie D PRY/ -S4Date: qllg
Phone: Email!
Owner Address: / 6 6-P T 0Y6wcae— A V
city: Fr f, eYLe V L zip: 314 9 y S,
Job Address: �SGiPM1E
City: Zip:
TYPE: ❑ RESIDENTIAL ❑ COMMERCIAL EXISTING ROOF(S) TYPE:
_ /I2 HIEGHT: I0' JOB TYPE: �RE-ROOF ❑ REPAIR ❑ MAINTENANCE ❑ OTHER:
RE -ROOF TYPE: ❑ N/A ❑ CONCRETE OR CLAY TILE ❑ ASPHALTIC SHINGLESAFLAT / LOW
SLOPE 11 METAL ❑ WOOD SHINGLES AND SHAKES ❑ RE-COVERING ❑ OTHER:
PE OFWORK_kie)' &e e&is4-t xg tnooF 7o f l-ie woo
ATTACIIMENTS: ❑ N/A ❑ Drawing(s) ❑ Specifications ❑ Pictures ❑ Written Requests ❑ Other:
ADDITIONAL COSTS (WOOD): /A ElThis contract includes either _ sheets of plywood OR _ lineal feet of fascia
board free of charge. Damaged deck wood is to be replaced at $ per sheet of plywood, and charged at $ per lineal
foot of fas I'a replacement and truss re -enforcement. ❑ Other:
PERMIT l
NG: ElN/A tloof permit fees are included. Special inspections, engineering tests, existing violations and all non -
roof relate fees/fines are the responsibility of the owner. ❑ Other:
WARRANTY: The work done has warranty from workmanship defects for a period oi� (� YEARS. This warranty
is transfer0le once and must be fully paid to be effective.
PAYMEN I The owner or designee agrees to pay CASA BLANCA CONTT. INC. the sum of 2.0
{ I� ($ .00)
Dollars & O CENTS (tax included in price) in cash, checks, or credit (processing fees apply) in the following installments:
DOWN PAYMENT: / O % OF TOTAL COST ($1.01 SO t .00)
UPON JOB COMMENCEMENT: NO % OF TOTAL COST ($ZD y SD .00)
ADDITONAL WORK & WOOD REPLACEMENT: 100% Additional Charges Billed Separately
UPON LOADING MATERIALS:..., % OF TOTAL COST ($_ .00)
UPON JOB COMPLETION: _" % OF TOTAL COST ($ 20 y$'O .00)
BY SIGNING BELOW YOU AGREE TO HAVING RECEIVED, READ, AND ACCEPTED THE ABOVE TERMS AND CONDITIONS OF
THIS CONTRACT AND AGREE TO PROCEED WITH THE PROPOSED CONTRACT. CANCELLATION FEE OF $300.00 PLUS
PERMIT FEE IF PAID ALREADYWILL APPLY AFTER 24 HRS OF SIGNING. NO CANCELLATION AFTER COMMENCEMENT OF
THE WORK. 4
Ca nca l' onstruction Inc. (Rep.) Signature Date Owner/Agent S Ignalture Date