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Roof Affidavit
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Steps
1.
Step One
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2.
Step Two
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3.
Step Three
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Step One
Permit Number
*
Job Site Address
*
Company Name
*
License Holder Name
*
Contractor License Number
*
Job Site Contact Name
*
Phone Number
*
Date Work Performed
*
Date Work Performed
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Step Two
Nail Schedule of Purling and/or Re-nailing of Decking
*
Amount of Framing/Sheathing Repair
*
Specifications & Type of Underlayment Overlap and Roof Pitch
*
Sealed Edges, Objects and Valleys, Valley Material Type with a Minimum Four Inch (4") Flashing Cement
*
Nail Schedule for Eve Drip, Metal, Roof Shingles
*
Roof Vent Types & Quantities:
Gas
Plumbing
Dryer
Range
Bath
Attic Ventilation Type
*
On Ridge
Off Ridge
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Step Three
The Contractor/Owner-Builder named above accepts full responsibility, and indemnifies and holds harmless the City of Temple Terrace for any liability that arises due to having missed the In-Progress Inspection for the above named permit and certifies that all work performed complies with the Florida Building Code Sixth Edition (2017).
The Contractor/Owner-Builder named above accepts full responsibility, and indemnifies and holds harmless the City of Temple Terrace for any liability that arises due to having missed the In-Progress Inspection for the above named permit and certifies that all work performed complies with the Florida Building Code Sixth Edition (2017).
License Holder Signature
Date
Date
State of_____________
State of_____________
County of____________
County of____________
The foregoing instrument was sworn to (or affirmed), subscribed, and acknowledged before me by means of ☐ physical presence or ☐ online notarization, this ____ day of __________, 20__ , by ___________________ (name of person making statement), who is personally known to me or has produced ___________________(type of identification) as identification. Signature of Notary Public
The foregoing instrument was sworn to (or affirmed), subscribed, and acknowledged before me by means of ☐ physical presence or ☐ online notarization, this ____ day of __________, 20__ , by ___________________ (name of person making statement), who is personally known to me or has produced ___________________(type of identification) as identification. Signature of Notary Public
Signature of Notary
____________________________________________
____________________________________________
Name of Notary (Printed)
____________________________________________
____________________________________________
(SEAL)
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