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HomeMy WebLinkAboutSUBMITTED PAPERSDATE: FEES DUE: • <-Q• I RECEIPT #: Permit #: Q g - --- ---- Planning & Development Services Department Building & Code Regulation Division SCANNED •.. 2300 Virginia Avenue g c Q 1 nyL Ft. Pierce, FL 34982-5652 BY Tel.772-462-1553 St. Lucie County APPLICATION FOR ROOF PERMIT SEE REVERSE SIDE FOR INSTRUCTIONS 1. Location/Site Address: � 2. 7 11 wfa\ 2. Parcel ID Number: .2 3d&Q t M 1• (7(X -3 Office Use Only Section Township Range Map Page Zoning Land Use I Ini ' is 3. Description of Projector Work Activity�� P.p ✓' r� S�i /lq%� /��� 4. Total Roof Area (square feet): .2 5. Roof Pitch: ,�Z• r 6. Type of Roof: [ ] Fiberglass Shingle [ ] Concrete Roof Tile [ ] Wood Shake / Shingle [ ] Tar & Gravel [ ] Modified Bitumen [ Jf" Other 19 [ vfep/"roduct Approval required for all types of Roofing Material (2 Sets) kh el S [ ] All Commercial Roofing requires design by an Engineer or Architect (2 Sets) with Product Approval attached ** Roof Mitigation per F.S. 553.844 will be required. 7. Owner Information 8. Contractor Information Name: \ Vq Mer i RZFELK1 _25845 FL Reg/Cert #: � L� Address: kl[Pen k fiV Y [1 • County Cert #: a City: •eY State: k: Business Name: . Zip: Phone: Phone• - 1 9. Value of Construction: $ (a(n w "Note Dry -in and Final Inspection Required. Additional inspection may be required per Product Approval. CONTRACTOR/OWNER'S AFFIDAVIT: I certify that alVceall rmation contained in this application is correct and that all work will be done in compli applicable laws regulating construction and zoning. PRI1�iT Q AItS/ �RS NAM SIGNAUALIFIER/OWNER STATE OF FLORIDA, COUNTY OF j t ACKNOWLEDGED BEFORE ME THIS DAY OF 20, BY AJ �SIA NALL KN WN T�R HAS PRODUCED AS IDENTIFICATION NOTARY PUBLIC -STATE OF FLORIDA Karen S. Nielsen OF NOTARY TYPE OR PRINT NAME OF NOTARY (seal) ,=Commission #DD1000358 �QI Expires: JUNE 12, 2014 COMMISSION NUMBER 1 I 15 BONDED THRUAnANTiCBONDINGCO.,INC. NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Revised 4/26/2010 Property Appraiser - St.Lucie ro»nty, FL Page 1 of 1 PROPERTY RECORD CARD James Trefelner Record: 1 of 1 <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification ,��,UCIE CO Site Address: 422 Dusk Way Sec/Town/Range: 08 :35S :39E ParcellD: Account #: 2308-601-0131-000-3 13189 QG� y Map ID: 23/08N Use Type: SF Res -. Zoning: AG-2.5 City/Cnty: Saint Lucie County Ownership and Mailing Legal Description Owner: James Trefelner TROPICAL ACRES BLK B LOTS 72 AND 73 (0.70 AC) (OR 3547-2805) Address: 1760 Copenhaver Rd Fort Pierce FL 34945 Sales Information Assessment 2013 Total Land and Building Date Price Code Deed Book/Page 2013 TRIM: 90200 Land Value: 17600 Acres: 0.7 7/30/2013 60500 0112 SP 3547 / 2805 Assessed: 90200 Building Value: 72600 4/24/2013 71000 0112 CT 3511 / 0266 Ag.Credit: 0 Finished Area: 1289 SgFt 6/9/2006 290000 00 WD 2590 / 0876 Exempt: 50000 8/10/1998 84000 00 WD 1164 / 2584 Taxable: 40200 6/5/1998 53000 01 CT 1154 / 1288 Taxes: 995.58 6/7/1996 100 04 QC 1026 / 0170 12/1/1987 9200 00 CV 0568 / 1105 BUILDING INFORMATION Exterior Features View: - RoofCover: SA - Asph Shingle RoofStruct: HP - Hip ExtType: HD+ - HD+ YearBlt: 1989 Frame: - Grade: D+ - D+ EffYrBlt: 1989 PrimeWall: BS - CB Stucco StoryHght: 0010 - 1 Story No.Units: 1 SecWall: - Interior Features BedRooms: 3 Electric: MX - MAXIMUM PrmintWall: DW - Drywall FullBath: 2 HeatType: FHA - FrcdHotAir AvgHt/FI: STD 1/2Bath: 0 HeatFuel: ELEC - Electric Prm.Flors: CU - Carpet %A/C: 100 %Heated: 100 %Sprinkled: 0 Special Features and Yard Items Land Information Type Y/S Qty. Units Qual. Cond, YrBlt. No. Use Type Type Measure Depth SWAV - RES POOL AVG Y 1 450 AV AV 1993 1 0100-SF Res 200 -Front Ft 100 302.5 PA01 - POOL DK-AVG Y 1 723 AV AV 1993 ENC2 - POOL ENC-AVG Y 1 1173 AV AV 1993 SDSF - SITE DEV S-F Y 1 1 AV AV 2001 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED http://www.paslc.org/pasle/prc.asp?prclid=230860101310003 1 8/20/2013 JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY FILE # 3873334 OR BC,'-1556 PAGE 935, Recorded 09/06/2013 - `-1:26 PM NOTICE OF COMMENCEMENT TO BE COMPLETED WHEN CONSTRUCTION VALUE EXCEEDS $2,500.00 OR WHEN HEATING OR AIR CONDITIONING REPAIR OR REPLACEMENT EXCEEDS $7,500.00 PERMIT III: TAX FOLIO #: 2308-601-0131-000-3 State of Florida, County of SAINT LUCIE , 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. LEGAL DESCRIPTION OF PROPERTY (AND STREET ADDRESS IF AVAILABLE): 422 DUSK WAY TROPICAL ACRES BLK B LOTS 72 & 73 2. GENERAL DESCRIPTION OF IMPROVEMENT: REROOF 3. ❑OWNER INFORMATION or ❑LESSEE INFORMATION (If Lessee contracted for the Improvement) a. Name: JAMES TREFELNER Address: 1760 COPENHAVER ROAD, FORT PIERCE, FL. 34945 b. Interest in property: OWNER c. Name and address of fee simple title holder (if other than owner): N/A 4. CONTRACTOR: a. Name: J. A. TAYLOR ROOFING, INC. Address: 302 MELTON DRIVE, FORT. PIERCE, FL. 34982 b. Phone number: 772-466-4040 5. SURETY COMPANY (IF Applicable, a copy of the payment bond Is attached): a. Name & Address: _N/A b. Phone number: Bond amount: 6. LENDER/MORTGAGE COMPANY: a. Name & Address: _N/A b. Phone number: 7. PERSONS WITHIN THE STATE OF FLORIDA DESIGNATED BY OWNER UPON WHOM NOTICES OR OTHER DOCUMENTS MAY BE SERVED AS PROVIDED BY SECTION 713.13 (1) (a) 7., FLORIDA STATUTES: a. Name & Address: _N/A b. Phone number: fax number: B. IN ADDITION TO HIMSELF OR HERSELF, a. Owner designates _N/A of to receive a copy of the Ilenor's notice as provided in section 713.13(1) (b), Florida statues. b. Phone number: 9. EXPIRATION DATE OF NOTICE OF COMMENCEMENT: (THE EXPIRATION DATE IS ONE (1) YEAR FROM THE DATE OF RECORDING UNLESS A DIFFERENT DATE IS SPECIFIED). WARNING TO OWNER: ANY PAYM TS MADE BY THE OWNER A E EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, S ON 713.13, FLORIDA ST ES AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MFPNALTIESOFPERJ/URY,Il ORDED AND POS ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTOR BEFORE COM LING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. UNDLAR AT E READ THE FOREGOING AND THAT THE FACTS IN IT ARE TRUE TO THE BEST OF MY KNOAND BELIEF 2.5 , Fl. A STATUTES AtAlLn IG) AARE OF OWNER or LESSEE or OWNER'S AUTHORIZED DIRECTOR/PARTNER/MANAGER - aSIGNAO TITLE / FFICE E FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFORE ME THIS.,Z-DAY 20LT, BY: E�NE(Z- NAME-OF PERSON TYPE OF AUTHORITY NAME OF PARTY ON BEHALF OF WHOM INSTRUMENT WAS EXECUTED CJPERSON- N OR' ❑PRODUCED IDENTIFICATION TYPE OF IDENTIFICATION PRODUCED I NOTARY SIGNATURE / NOTARY PRINTED NAME / NOTARY SEAL NOTARY PUBLIC-STATF, OF FLORMA Karen S. Nielsen VCommisson#DD1000356 VExpires: JUKE 12, 2014 BONDED T'HRU ATLANTIC BONDING Ca, MC, STATE Of FLORIDA ST. LUCIE COUNT-y � THIS IS TO CERTIFY THAT THIS Is A T nut Ayp fPIRECTCOPYOFTI, ORIGINAteC ►1 JOSfP/(/j.i Aj11TH, VRK Date: T reasure Harvey E — v;inen 7205 Elyse Circle C oast A Professici,_ _=ngineer #92831 P S L Florida 3495%-_ , ,2 B uilding Architect #AR0009471 PHONE(772) 466-5509 E ngineers, Certified General Contractor #CGCO24776 FAX(772) 489-3035 Inc. E-MAIL Contractor J.A. TAX LC)V,� Imc . Owner :Tgaya"g?, Job Address 42-2 VQ9j,- U1 ft FVz ?i O2GE . METAL ROOFING _1._1�,-['��ELoiZ 9,tol=t1J4 5V A NEW ROOF RE —ROOF X REPAIR AREA 1860S�F, MET AL ROOF PLAN Date eg 2 FILE COPY igo9, or o? vvFINEvn�� on n�n�nn�n SEEM �n ME ME= SEEM ENE nSEMEN n� -ASCE 7-10 & FBC 2010 ENCLOSED BLDG _SEMI ENCLOSED BLDG OPEN `PAR.,T 2 lOW RISE C&C SIMPLIFIED -- RISK CAT2/V = _LkO JEXPOSURE__f5LjX = (. 4 f Kzt =1.0/h t3 / 1 /12 PITCH %, ROOF S`7STEM.;EML.� �Ja• I Idefc�._�¢hZA-tL.l ` 1 �,, >tiL Y 'zON E 1 P' @ @ h=30 = X = PSF x 0.6 = - \` 20,NE 2 P @ @ h=30 = X = PSF.,x 0.6 = - 4 ( a = �► _ - ZONE 3 P @ @ h=30 = X - PSF x 0.6 =—4,ep4• J a = Ph - MAX DESIGN PRESSURE PER NOA ^�o14ir . L—. Sz N,1p DECK TYPE i?Lq W,009 THICKNESS q5 z- t-g%LDJ- BASE SHEETiYPePz= NO. PLIES FASTl�ER7Y'�sSPACiNG k�Usc? 2tpM15@l2•" —�._ , . 1'rLe►D PLY SHEET —. NO. OF PLIES FASTENER TYPE ^ SPACING -- TOP PLY NO. OF PLIES FASTENER TYPE — SPACING INSULATION BASE LAYER TYPE -• SIZE TYPE OF FASTENERS: SPACING FIELD PERIMETER — CORNERS INSULATION TOP LAYER TYPE SIZE TYPE OF FASTENERS/ L 41-16 FA9t5k1X" t- 6kz_^L iu4 Whs i4,msz5 DRIP EDGE SIZE 0" DRIP MATERIAL'2-64A-4'1 FLASHING MATERIAL 1-4 46e 4' 1 - FASTENER SPACING FOR METAL ROOF PANELS: FIELD W PERIMETER V' CORNER Ilo" AT .MV * at0'frF—P- OF`' 0 Tp,.N TRf. FAb NRE T reasure Harvey E. Koehnen C oast Professional Engineer #32831 B u i Id i ng Architect #AR0009471 a E ngineers, Certified General Contractor #CGCO24776 Inc. --....----- ............. --.......--...__.-- __.._.. _... These Tables Are For Roof Coverings Roof coverings Installed on Buildings with a Mean Roof Height of 30' or Less Located in Exposures B, C or D 'Table R301.2 [2]_QFz F= turn. �54.45cE 7- is COMPONENTS AND CLADDING WORST CASE DESIGN PRESSURE JPSF]. 160 Exp B Roof > 0 to 7 degrees Zone 1 -27.6 7degrees = 11/2 /12 pitch Zone 2 -46.4 Zone 3 -69.8 > 7 to 27 degrees Zone 1 -25.3 (oof 27 degrees = 6/12 itch Zone 2 - a•>-� 1P S �- one 3 r - +1 '44. I Roof > 27 to 45 degrees Zone 1 - 27.8 45 degrees = 12/12 pitch Zone 2 - 32.4 Zone 3 - 32.4 160 Exp C 160 Exp C 160 Exp D 160 Exp D (One story (Two story*) (One story*) (Two story -33.4 -38.7 -40.6 -45.9 -56.2 -65.0 -68.3 -77.1 -84.5 -97.7 -102.7 -115.9 - 30,7 - 35.5 -37.2 - 42 - 63.4 - 61.8 -64.9 - 73.3 -78.8 - 91.2 - 95.7 - 108:;1 -33.7 -40.0 -39.3 -45.4 -39.3 -45A -40.1 -462 -47.7 -53.8 - 47,7 -53.8 150 Exp B 150 Exp C 150 Exp C 150 Exp D 150 Ezp D (one story*) (tvdo story*) (one story*) ( two story) Roof > 0 to 7 degrees Zone 1 -24.3 -29.6 -34.1 -35.8 -40.4 7degrees = 1112 /12 pitch Zone 2 -40.8 -49.4 -57.2 -60.0 -67.8 Zone 3 -61.4 -74.3 -86.0 -90.3 -102.0 Roof 7 to 27 degrees __ 27 degrees = 6/12 pitch Roof >,.27 to 45 degrees 45 degrees = 12/12 pitch Zone 1 -22,2 Zone 2 -38.7 Zone 3 -57,3 Zone 1 - 24,3 Zone 2 - 28.4 Zone 3 - 28.4 - 26.9 - 31.1 - 46.9 - 54.2 - 69.44 - 80.3 ' 29.5 -34.1 -34.4 -39.8 -34.4 -39.8 One story* = one story building with a maximum mean roof height of 15 feet Two story* = two story building with a maximum mean roof height of 30 feet -32.7 -56.9 -84.3 -35.8 -41.8 -41.8 - 36.9�P�' - 64.3 -40.4 . 0 -47.2 -47.2 If allowed by the Miami Dade N.O,A or Florida Product Approval ., any -system -that does -not meet the minimum components and cladding pressures for the area that the building is located per this form may require a Florida licensed engineer to revise the fastener spacing T C B E, Inc. 7205 Elyse Circle PHONE (772) 466-5509 Port Saint Lucie FAX (772) 489-3035 Florida 34952-8212 E-MAIL hkoehnen@tcbeweb.com WEB SITE http://www.tcbeweb.corr P* taeiseet5peny 5egubtelutrk .r�xT+rt 3�iij.•ai r4 d J� l.m• Product Approval i- USER: Public User Page 1 of 2 r ' n opru a 'Awedan 1aprtgtiri uias. _ €tom Prodt,ct Approval Menu > vrod,j�, pr ApcLcat.Cn Sear-r > AprehCE.t- -.st > Application Detail FL # Application Type Code Version Application Status Comments Archived Product Manufacturer Address/Phone/Email Authorized Signature Technical Representative Address/Phone/Email Quality Assurance Representative Address/Phone/Email Category Subcategory Compliance Method Florida Engineer or Architect Name who developed the Evaluation Report Florida License Quality Assurance Entity Quality Assurance Contract Expiration Date Validated By Certificate of Independence FL14520-R1 on 2010 roved I A TAYLOR ROOFING 302 Melton Drive FT PIERCE, FL 34982 (772)466-4040 Rvalidation@yahoo.com Kyle Taylor flvalidation@yahoo.com Roofing Metal Roofing Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report - Hardcopy Received Charles L THOMAS PE-29439 Keystone Certifications, Inc. lti� 04/11/2021 OI Locke Bowden Validation Checklist - Hardcopy Received FL14520 R1 COI Certificate of Independence FPA odf Referenced Standard and Year (of Standard) Standard Year TAS 125 2003 Equivalence of Product Standards Certified By http: "floridabuilding.ora/pr/pr_app_dtl.aspx?param=w•GEVXQNL-tDquxTVBjriRcYsCCTD3D3z4Qf6pO9... 1/16/201 t Lvttua liu11u111�` k-uue vnnne Page 2 of 2 Sections from the Code Product Approval Method Date Submitted Date Validated Date Pending FBC Approval / Date Approved Summary of Prndur+a Method 1 Option D 11/07/2011 11/07/2011 11/10/2011 12/06/2011 FL # Model, Number or Name Description 14520.1 115 V CRIMP 26GA METAL ROOFING PANEL Limits of Use Approved for use in HVHZ: No Installation Instructions Approved for use outside HVHZ: Yes FL14520 R1 II 5V Crimp Evaluation 'Report Details Rev.Ddf Impact Resistant: N/A Design Pressure: +N/A/-129.25 Verified By: PRI Construction Materials Technologies, Other: The required design wind loads shall be LLC Created by Independent Third Party: Yes determined for each project per the Florida Building Evaluation Reports Code. The maximum fastener/clip spacing listed herein shall not be exceeded. This product Is not evaluated for FL14520 R1 AE 5V Crimp Evaluation Report Rev Ddf Created by Independent Third Party: Yes use In the High Velocity Hurricane Zone. Back Next Contact us :: 1940 North Monroe Street Tallahassee FL 32399 The State of Florida is an AA/EEO employer. Cooynoht 2007-2010 State of Florda .: Privacy Statement :: Accessibility Statement Refund statement Under Florida law, e-mail addresses are public records If you do not want your e-mail address released in response to a public -records request, do not send electronic mail to this entity Instead. contact the office by phone or by traditional mail. If you have any questions regarding DBPR's ADA web accessibility. please contact our Web Master at webmasterrddbor state flus. Product Approval Accepts: ® R K' "Curlt\ %i. : k wim ttp:"floridabuilding.or`,lprlpr_app_dtl.aspx?param=w-GEVXQ%kiDquxTVBjriRcYsCCTD )D3z4Qf6pO9... 1 /16/201? J.A. Taylor Roofing Inc. Evaluation Report for 26 ga. 5V Crimp Metal Roof Assembly FL# 14520-R1 Evaluation Report - 7 Report for: J.A. Taylor Roofing Inc. Date: November 3, 2011 302 Melton Drive Fort Pierce, FL 34982 Building Code:2010 Florida Building Code ! Compliance Method: Rule 9N-3.005(1)(d) Section(s): 1504.3.2 Category: Roofing j Project No.: FAE-001-01-01 Sub -Category: Metal Roofing Scope: Product Category: Roofing Sub -Category. etal Roofing Compliance: v The 26 ga. 5V Crimp Metal Roof Assembly described herein has demonstrated compliance with Section 1504.3.2 of the 2010 Florida Building Code References: Test Application' Standard (TAS) 125-03 Standard Requirements for Metal Roofing Systems, Section 8 testing pursuant to Hurricane Test Laboratory, LLC (FBC Organization ID No. TST1527) report no. 0224-0501-06, dated October 31, 2006. Report addendum for report no. 0224-0501-06 (Specimen #1, 2, &4) issued by Hurricane Test Laboratory, LLC (FBC Organization ID No. TST1527), dated September 28, 2011 Drawings # '26" 5V 24' Coverage' issued by Hurricane Test Laboratory, LLC (FBC Organization ID No. TST1527), dated September 20, 2011. Engineering Analysis by PRI Construction Materials Technologies (FBC Organization No.TST5878), dated April 19, 2011. Product Description: 5V Crimp panel, minimum 26 ga. corrosion resistant steel (Grade 80), 26" panel (24" maximum coverage), '/2" ribs; material shall comply with 2010 Florida Building Code. Section 1507.4.3. IMinimum #9-15 HWH corrosion resistant fasteners with sealing washers designed for metal to wood connections of sufficient length to penetrate 5/16" through the sheathing. Material shall comply with 2010 Florida Building Code, Section 1507.4.4. Limitations: I Limitations and Conditions of Use include the following. J • This evaluation does not include use of the product within the High -Velocity Hurricane Zone (HVHZ). • Fire Classification is not within scope of this Evaluation Report; refer to a current Approved Roofing Materials Directory for fire ratings of this product. Page 1 of 3 JA. Taylor Roofing Inc. Evaluation Report for 26 ga. 5V Crimp Wtai Roof Assembly FL# 14520-R1 Roof Assemblies: • The product shall be installed in accordance with the Manufacturer's instructions and the Roof Assemblies section herein. • Modifications of the products as evaluated herein are beyond the scope of this evaluation. • All products listed herein shall have a quality assurance audit in accordance with F.A.C. Rule 913-72 Assembly No. 1 AAax / Design Pressure: -69.25 `r Slope: 2:12 or greater Deck: ✓Minimum 15/32" plywood or wood plank Deck Attachment: In accordance with the applicable Code. In no case less than minimum 8d x 2" annular ring shank nails spaced 6" o c. In reroofing, where the deck is less than 19/32" thick (minimum 15132") the above attachment method must be in addition to existing attachment. Deck attachment to be designed by others Underlayment: JMinimum ASTM D 226, Type II (No. 30) in accordance with Section 1507.2.8 of the 2010 Florida Building Code or any Approved undedayment having current Florida Statewide or Local Product Approval. 5V Crimp Panels: Installed in accordance with Manufacturer's installation instructions. ++ Minimum #9-15 corrosion resistant fasteners with sealing washers designed for metal to wood connections of sufficient length to- penetrate 5/16' through the sheathing installed 16" o.c. along the crown of the rib in the center of panel and along the lap (See Drawings). Ma Design Pressure. -1 .25\ Slope. :12 or grey r Deck: Minimum 15132' lywood or ood plank Deck Attachm nt: In accordance with a plicable Code.?na se i s than minimum 8d x 2" nnular nng shana ed " o.c. In reroofing, w re a deck is less "thick (minimum 15132") a above attachmentmust be in addition to e isting atta� ment. Decment tobe designed others. Unde ayment.� nlmum STM D 226,Type II No. 30ordancewit Sec' n 1507.2.8 of the 2010 loridg Codeor a y pproved underlayment h ing Florida Page 2 of 3 J A. Taylor Roofing Inc. Evaluation Report for 26 ga. 5V Crimp Metal Roof Assembly FL# 14520-RI Drawings: 5V G imp Panels: / InstallWin through the 4 the rib in the Drawings). I Product Approval nce with anufa urars in Ilation line um -15 cor sion resistant aling hers designe r metal to of su cient length to netFte 5/16' ling ' s led 8' o.c. ng the can pf ite of pa I and ong the lap (See 5-V PANEL PROFILE 24" Coverage _—' FASTGtiLk D__;y,_ Quality Assurance: Keystone Certifications. (FBC Organization No. QUA1824) Evaluator:. Charles L. Thomas, P.E. Florida Registered Profession) Engineer PE No.: 29439 FBC Organization No.: ANE9008 14609 Dixie Hwy, Hudson, FL.34567 Date: �� /� /,-Zep f Page 3 of 3 09/11/2013 16:10 772468g?Q7 r �f JA TAYLOR ROOFINr. PAGE 01/01 Planning & Development Services Building & Code Regulation Division 2300 Virginia Avenue Fort Pierce, FL 34932 772-462-2165 or 772-462-2172 Fax: 772-462-6443 ROOF INSPECTION AFFIDAVIT Re: Permit# �E'J�{s,110o licensed as a ontractor- /Engineer/Architect (Please print name & circle license type) *FS4 nspector *General, Building, Residential or Roofing'Cantractor or any individual certified under 468 F.S. to make such on inspection. On or about I did personally inspect the roof deck nailing (Da e) (, work at: (JOb site address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) - Li signature and Seal (2 (3 � / 2 �? J� License # STATE OF FLORID COUNTY OF 1 sworn to Subscr eel before me this �_ da f 20J by _ White _. Who is pem ally known o me or who has produced �� as identtflcatic i. Notary pu�F oriel Signature of Notary: Commission Number: (Seal) NOTARY M3LIC-STATE OFFLORIDA En 01/19/2011"•• Karen S. Nielsen =Commission#11131000358 yti Expires: JUKE 12, 2014 BONDED MU ATU ricsarrnarG M, INC, RECEIVED SEP 1.17013