HomeMy WebLinkAbout15-16068 i
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� CITY OF ZEPHYRHILLS
5335-8TH STREET
:•
; �si3��so-oo20 16068
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16068 Address: 6804 SUNNIDALE DR
Permit Type: RE-ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: VALLEYDALE RO ASSOCIATION
Est. Value: Parcel Number: 03-26-21-0170-00000-1410
Improv. Cost: 6,188.00 OWNER INFORMATION I
Date Issued: 3/06/2015 Name: HARRIS, JERRY & BRENDA, TRST
Total Fees: 105.00 Address: PO BOX 2246
Amount Paid: 105.00 ZEPHYRHILLS FL 33539-2246
Date Paid: 3/06/2015 Phone: 352-875-7399
Work Desc: RUBBER REROOF
CONTRACTOR S APPLICATION FEES
ALL RIDA WEATHERPR FING CO REROOF RESIDENTIAL 105.00
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Ins ections Re uir
DRY IN ROOF INSP
TAPE JOINT�00�IfV�Pr�
FINAL ����
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c)when extra inspection
trips are necessary due to any one of the following reasons: a)wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d)work not ready for
inspection when called e) permit not posted on job site� plans not at job site g)work not accessible.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this properly 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, state agencies or federal agencies.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your properly. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Com te Plans,Specif tions Must Accompany Application.All work shall be pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFO C.O.
C6
O CTOR SI NATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
�, CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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- City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: �I �����' �i'�'
�
Date Received: �' �� �J
Site: � � � � C �
Permit Type: ��
Approved w/no comments:� Approved w/the below comments: ❑ Denied w/the below comments: ❑
This comment sheet shall be kept with the permit and/or plans.
� ,-' � -3 ���
Kalvin Swit er Plans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
s�s-�so-oaaa City of Zephyrhiils Permit Applica#ion �ax-sis-�so-oa2i r
Building Departmen�
'�_ __._.____�_..�
Date€teceived �d -�''� phone Contact for Permitting vZ V �tti, - l o�
`n x y r
Owner's Name � ��I`- <<�+I��C� Owner Phone Number � � ���`� (°-��
Owner's Address �v �� ''��/".�r��'�'� °��" Oterner Phone Number � �
� � � � �
Fee Simple Titleholder Name Qwner phone Numbei'
Fee Simple Titleholder Address
JOB ADDRESS V `.I "L �*' ��7�t�� �r� K. ���I�tf 1+�'�� LOT# l t
SUBDIVISIQN �,11r') �'��l '��I R-- " j r PARGEL ID# "="z-'� �'����"'���7� "� �`�'�/��"� I�� �
� (OpTAINED FROM PROPERTY TAX NOTICE) ,i�
WoRK PROPOSED e r�ew caNSr�8 A�DIAL.T � S3GN 0 0 DEMOLis!-i
INSTALL REPAIR
PROPOSED USE Q SFR Q CO(ViM 0 TNER
TYPE OF COIVSTRUCTION [�] BLOCK RAME � STEEL C]
DESCRIPTION OF WORK �-� /`L
BUILdiNG SI2E � � SQ FC}C}TAGE !� � HEiG}iT __,I� �
�BU�ZDiNG � �`/C�� VAE.UATiON OF TC3TAL CONSTRUCTION
p f
�E�EGTRI�AL ��� AMP SERVICE � PROGRESS ENERGY � W.R.EG.
�P�.U�rSBIN� $ , � � f
� � �Gti�
�MEGHANICAL $ VAI.UATION OF MEGHANlGAL INSl'ALlAilON �
��,/1
�GAS � ROOFING Q SPEC3AE.TY � O7HER ���"�F"��
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO �� f���J V
' . � .
_,,,.� � �A (� �/
BU!l�DER ����' n� ����'t� ��4✓ � �CCiMFANY .�aL� �.C�t1 f�t�.� ��j�1t7�/��lt��✓��1
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
_ _ _ _ _ _ _ _ _.. _
Address ��f I I� �� ����. ����� l�� h�����T�'"License# �1.,i��l�+Z_�"t' +U f� � ^
ELEC3'RICtAi3 COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREP Y/N
Address License# �� �
PLUiVfBER CtJNii'ANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �- ^��
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �� �
4THEi2 COMPAI�Y
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address L.icense# T�
RESIDENTtAL A#tach{2}Plat Plans;{2}sets of Bu3ldtng Plans;{1}set af Energy Forms;R-C7-W Fermit for new construction,
Minimum ten(10)working days after submittal date. Required onsite,Conskruction Pians,Stormwater Plans w!Silk Fence installed,
Sanitary Facili#ies&1 dumpster;Site Work Permit for subdivisions/large projects
GCIMMERCIAL Attach{3}complete sets af Building Plans pius a Li#e Safety Pags;(9}se#of Energy Forms.R-O-W 3'ermi#far new constructian.
Minimum ten(10)working days after submitta�date. F2equired onsite,Construction Plans,Stormwater Plans w!Silt Fence installed,
8anitary Facilitfes&1 dumpster.Sike Work Permit for all new projects.All cammercial requirements must meet compliance
SEGN PERMIT Atfach{2�sets of Engineered Plans.
`"*"PROPERTY SURVEY required far all NEW construction.
Directions:
Fill out application completely.
Owne�&Contractor sign back of application>notarized •
tf over$250U,a Ftofice aE Gommencement is required. (AJC upgrades over$7504}
"" Agent(for the contractor)or Power oP Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER 3HE COUNTER PERMtTTING � {Frant of Appiicat4on Oniy} � � - � � - `
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Foofage)` , - � -�
Driveways-Ndt aver Counter if on public roadways..needs ROW � `
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" 'rest�icfions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance witli any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owne� has hii-ed a contrac�o� o'r
contractors to undertake work, they may be required to be licensed in accordance with stafe and locaf regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeano� violation
under state law. If the owner or intended contractor are tance�tain as to what licensing requiremehts may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847=
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sigri
portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersignecl Understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid 'p�io� to
receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County VVater/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes; as amended): If valuation of rivork is $2,500.00 0� ino�e, I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowne�'s
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"owner" prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installatiori has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws tegufa�ing
construction, County and City codes, zoning regulations, and land development �egulations in the jilrisdiction. I also
certify that I understand that the regulations of other government agencies may apply Io the intended work, and 4hat it is
my responsibility to identify what actions I must�ake to be in compliance. Such agencies include buf a�e hot limited to:
- � Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, WaterNVastewater Treatment.
- Southwest Florida Water Nlanagement District-Wells, Cypress Bayheads; V1letland Areas, Alte�ing
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable VVaterways.
- Department of Health & Rehabilitative ServiceslEnvironmental Nealth lJnit-Wells; ilVaslewater Treatriment;
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone"V" unless expressly permitted.
- If the fill material is to be used in Flood Zone "A", it is understood that .a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
- If the fill material is to be used in Flood Zone "A" in connection vuith a permitted building lising stem, rivall
construction, I certify that fill will be Used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that iase of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited fo� viola4ing
, the conditions of the building permit issued under the attached permit applicatiori; fo'r Iots fess than one (1)
acre which are elevated by fill, an engineered drainage plari is required. '
If I am the AGENT FOR THE OWNER, I promise in good faitfi to inform the owner of the permitting coriditions se��o�th in
this affidavit prior to commencing construction. I understand that a separate permit inay be �eqtiirec� for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. !�
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit p�event the Building Official from thereafteF
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six rrionths of permit issuance, br if work aiatho�ized by
the permit is suspended or abandoned for a period of six (6) months after the tirrie the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed 'ninety (90) days and wili dembnstrate
justifiable cause for the extension. If work ceases for ninety(90) consecutive days, the job is conside�ed abandoriecf.
WARNING TO OWNER: YOUR FA LURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL7' IN YOUR
PAYING TWICE F �IR� IMPROVEME TS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LEN ER N ATT RNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S. '17 ) - - -- - -- - --- �-- -- — - - - -
OWNER OR AGENT ' CONTRACTOR `�` �l�ln-t� -C � I}�
5ub nbe and sworn �� e e forE lhis S bs ibe "and swom to [aff�ir�!ed)be e t is � 1
. 7 C� by �� (� /}` by �?��//rr ����.�L�.�
Who is/are e onall known to me or has/have produced ho is/a epersonally known to me or has/have produced
f entification. s identifi ' n.
c ��
/ iary Public `r"" r' ublic �
Commissio .No. ;•�qt'•"•"'���'•: GAILZUPKO �ommission No. ;''ti!"•"y''••: GAILZUPKO �'
;+: - �:•- N 126167 =+: _ i+': MISSION N FF 126167
:�'� ;e; EXPIRES:July 4,2018 `;;.,, ,.P; EXPIRES:July 4,2018
:+;•.
nae�,�ters ame of Nota ed, nnted or s erwn ers
Name of Notary typed,printed rY�YP P�
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I 111{il i{{f4l�llf i141!�IIII�IIII IIIII III�I NI�I 4{III{��(II�I ;
P�rm�it Number: 2015029137 �
� FofiiolParcefi identiflcation Number: ��'�-„��`�.��,��.-
Prepa�Bd�y:�earge Vacxi
��� G'������ ��F�� Rcpt:1663023 Rec: 10.@0 i
Rettiztl#0_All Florida Weat�erproofing Et Construction,lnc. DS: 0.00 IT: Q-@�
423'1 112th Terrace N 02125/2015 L. -K. , Dpty Clerk
Clearwater F(. 33762 ppULA S 6'NEIL,Ph D PaSGO CLEt2K & GOS�PTR4LlER �
. OTECE C}F CC7MMENCEMENT �2p��K�1�4 ,r.��'m PG ��L� �
State of Florida, County of �;���„� . '�'
The undersigned hereby gives notice that improvement wiq be made ta certain reai pr4perty, and in accordance
with Chapter 713, Florida Statutes,the fallawing information is provided in this t�otice of Gommencement.
�. pasc ' t� n�f�r�ert��`�scr�tion of��th�propert�y, an�s���fI f,�,C avai��) t3,3"�'"�r 2,
2. Gen�slcr,ip,�i�o�of improvement �'� L ;�"(.��,�� �` J�j
' '�"l�[.l
3 awner infior t��C}a-n�/�or essee in/�formatian/aif the Lessee contracted foc tFte icnpr4vement
tY�la��. +1 ""+i�.� / J ���t• J
Address c�' (' /(/�� ,G . � � / f � �1 �
lnterest in Property
Name and address b fee simple tiflehoider(if differenf from Qw�ter listed above}
Narne N�A -
Address
4. Contractar
I�laC112� Trav7s Fu(ford�A!l Florida Weatherproofing�Construction Telephone Number �727-572-1019
AddfBSS 4231 112th Terrace N. Clearwater, Fl 33762
5. Surety(if appiicatii�, a copy at tne payrnent bond is aftached)
Name "J" Teiephone Nt�enber -
Address Amount of Sond $
6. �ender
Name "r" � Telephone Numher
Address
7. Persons withiR the State of Ftarida designated by t3urner u�an wham notices or o#her dacuments may
be served as provided by�793.'!3('f}{a}7, Figrida S�atutes. •
Name "�a Tslephone Nurnber
Address �
8. In �dditian to himself or herself, Ovrner designates the fa(lowing to rec�ive a copy atthe Lienor's
Natice as provided in§713.'i3{'i){b), Ftarida Stafutes.
Name "'A Telephane Number
Address
9. Expira#ian date of not'sce of commencemen#(fhe expiration date may not be before tFae cornpletian of
construction and final payment to the contracfor, but will be 1 year from the date of recording unless a
different date is specified) "�"
WARNiN�TO OtA+NER:AhlY PAYMENTS MADE BY T1iE OINNER AFTER THE EXPlRATtON OF T!-EE NC77lCE OP COMMENCEMEN7
ARE CONSlqERED IMPRaPER PAYMENTS UNDER CNAP'fER 713,PARi'I,SEC."flON 713.i3,F40E21aA STATUTES,AND CAN
RESUL7 iN YOUR FAYtNG 7WiCE FQi21NfFROV6MENTS TO Y4UR PROPER'f'l.A NOT3CE OF COMIVIENCEMENT MUST BE
FtECE}RC}ED AND PC}STED OH TNE J4B SITE SEFORE THE FlRS7 iC+tSFEC7'lQN.IF YOU!lVTE1+lD 3Q OB7AIN FINAt+iClA1G,CONSULT
WITH YOUR LEN�ER OR AN ATTORNfEY BEFDRE COMMENCING W�RK OR RECORDING YQUR h10T�CE OF COMMENCEM�N7.
Under penat#y of�erjur�, ! ciare that J have read the foregoing notice o#comrrtencement and that the
facfis st ted in it are true t #he E�est o€my knawledge and b�Eief,
Sig of Owner r ssee,or wner's ar Lessee's Autfiorized Officer/DirectorlPartnerlManager ��eC {
t 5ignatory TitteJ Office
T e toragoi g instrument was acknowledged before me this�day of��'�!zou by�-,�/�. i" �����N
as ^Owner ��r NonN name of person
5elf •
- Type af au arity,e.g.,o�cer,trustee, tfo ey i Name af party on behelf of whorn insuvment was executed
Signattl're o R! tary�blic—S�at�af Flarida Print,type,or stamp comrriissioned name af�lotary Public
Personally Known OR Produced ID � ;=a�'"""°a��; REGHA€�D A FULFORD _
Driver's liccnca Number :' " MY CQMMlSSlQN#FF459564
=N. F;
' Type of ID Pt'oduced � �`'����- �o°° EXP►RES october 2,201,
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�"_ oQ,r,e?rust • W1Ti'��5.^Pv1Y W�itJ�,t'�C 0�'�ICIAL;'EAL THIS
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O � � � PAUI..��.C)'N�IL, GL�R�'.e�CO ROLLER
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/�c�'�� C��`'� r2�.S � � o�� �
A;LL FLORIDA WEATHERPROOFING �
� AND CONSTRUCTION, INC.
. ' _ , 4231 112th Terrace N.•Clearwater,FL 33762 ��
_ � ; i I (87�572-1019•Fax(72�572-5670
www.AllFloridaRoofs.com 'Ftreston¢
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State ertifi d License#CCC132/7/406 • #CBC1259006 �
Owner(s)/Purchaser(s): J' ��� � �Phone:�H)�S �j�(�— �7�(C) ����
Mailing Address:�����/ SU/V1�(/o °i�L� Ci : z r �� ounty,� 's�(J State:/�` Zip:,�3S�.�.
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[Circle:SB• P Community Name:' U � Lot#:
AlternateAddPS�hL,�yo { • P�I�J� City:2 � State:_Zip: Phone:
E-mail: � 3�q
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UWe,the Owner(s)lPurchaser(s)of the premises�escribed below,hereinafter referred to as"Purchaset'offer to comract with ALL FLORIDA WEATHERPROOFING AND
CONSTRUCTION,INC.,hereinafter referred to tracto�'to fu is/h,to deliver and arrange for insfaliation of all m eriaGs ece�s o improve the premises bcated at
JobsfteAddress:�,()�O�/ SC/fZ.I/V��LY'�Q�/ City:� � �Lc tate;�Zp:���
accorcling to ihe following written spec�ptions: �
/�f�/e " - . -
�LID WHfTE MEMBRANE:BRAN���❑ SHINGLE•LOOK MEMBRANE:BRAND 8 COLOR
❑ OTHER: �
I
1.PROVIDE ENERGY-SAVING INSULATED W TERPROOFING SYSTEM FOR THE FOLLOWING AREA(S):
` I
� . i �
2.INCLUDE ENERGY-SAVING DOUBLE-FOIL FACED INSULATION AS INDICATED:
O BRONZE:45 MIL NO INSULATION O SILVER 45 MIL 1-1/4"INSULATION �(',,OLD.45 MIL 1-5/8"INSULATIO
3.ALL CUSTOM ROUNDED PRES�URE TREATED FRAMING INCLUDED.
4.INCLUDE NEW SPUN ALUMINUN�VENTS:�SMALL _�LARGE INITIALS FOR
5.INCLUDE UP TO 100 SQ.FT.OF NECESSARY DECK REPLACEMENT.ADDITIONAL DECK SYSTE
REPLACEMENT TO BE INVOICE�SEPARATELY AT$3.00 PER SQUARE FOOT.
6.INCLUDE ALL REQUIRED PERMI S.
7.CLEAN UP AND REMOVE ALLJOB-RELATED DEBRIS FROM JOB SITE.
8.MAIL OUT[LIMITED LIFETIME�NO-LEAK,TRANSFERABLE WARRANTY FULLY COVERING ALL LABOR AND
MATERIAL.($50TRIP FEE MAY APiPLI� � r ��_
9.ADDITIONAL INFORMATION: � ���1�(�,P � l�� e G6�
_ 5�-� ��e�G��`� g ���,��. ���,�.����� .�-�,�.�
10.IT IS UNDE STOOD THAT THE F�G AREAS WILL j�,�T y�npr nr.r.�pp�g�,�p,affi��Ag/(ifjJ'
BE INCLUDED IN THE COVERAGE PROVIDED BYTHIS ��.n�x��^nVU�ssv��. �`�
AGREEMENT(Also See Drawing at Rlght): ��"���'���• � G�
Car�arT a�' s l wca,w��
,
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OTHER NOTES:
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NOTE:RETAlL SALES TAX MUST 8E CH,4RGED UNLESS THE CUSTOMER SlGNS 7HE FOLLOWING:
I certify that I own the land on vrhich the structure I am im roving is permane y aHixed.Furthermore,I have filed a declaration
with the Property Appraiser requesting the cture be ass as realty and it bears an°RP°decal.
SIGNATURE:
i
The CASH CONTRACT PRICE f�r all Labor& erials(including any applicable discounts)is$ Y�l�1�� �
( Terms:�Cash O Credit(Subject to the approval of the Credit Sales Departrnent) Sales Tax S ��P��
If this is a cash iransacGon,fhe purchase pn'Ce sha b paid as follows: /
Cash doxm Paymeat(Minimum 33%)S � Balance Payable$ � Total Price; / �t
If this is a aedit Vansaction,ihe agreement for credit is contained in a separate document ich is incorporated herin by reference and made a part thereof.
IRNe undersigned are hereby authorizing ALL FLORIDA WEATHERPROOFING AND CONSTRUCTION,INC.to verify and review my/our credit record with an inde-
pendent cred'R reporting agency and release th�m from all liabiliry incurring from inadvertent omissions or errors.
Verbal understandings and agreements with representatives shall not be binding.All understandings and agreements must be set forth in writing m ihis
Contract.ADDITIONAL PROVISIONS ARE STATED ON REVERSE SIDE AND ARE PART OF THIS C�NTRACT.
UNLESS OTHERWISE SPECIFIED,IT IS UNDERSTOOD THAT THE OWNER(S)ISlARE READY FOR THIS WORK TO BEGIN.THE PURCHASE PRICE
�UOTED A80VE WILL BE HONORED ON�.Y UNTIL .Purchaser(s)undersfands and agrees that iF this agreement is canceiled after the
rescission period, the Purchaser is Gable for twenty five percent of the�total sales price as damages to the Conhactor.In the event this oRerto contract is
not accepted by ConVactar,any payment r�ade hereunder shall he refunded to ihe Purchaser(s)and this proposai sha�be nu0 and void and of no efteG.
ConVactor is not responsible for exis6ng stnictural defeds,dry rot or other factors beyond our control,No repairing,plasterirtg,painting carpentry,or decorat-
ing is included unless specifiralty charged fdr and spedfied in writing herein.Purchaser agrees W pay the Totai Price in full upon installation unless ofhenvise
agreed to in writing.If installatian�s started bLt not completed fhe same day and the parties agree that the installation is not completed.Purchaser may withhold
10°,6 of the Total Price un61 installation is completed. /� �—
INWITNESSWHEREOFPurchaser(s)havejhereuntosignedthefrname(s)this�dayof ��f� 20%
and ack wled�c e�recei�t of a e of this Contract
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�SU MITTED BY: epres tive i Date A BY• . rc edOvmer Date �
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LACCEPTED BYAuthor¢ed Signature for Contractor _ Date____ A E_ BY_urchased ner ____ Date __J
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PR�DUCT APPROVAL �PECIFICATI�3N SHEET
As required by Florida Statute 553.842 artd Florida Adrrtinistrative Code 98-72,please provide the information and appTOVaf
numbers an the building companents listed below if they will be utilized an the construction projec# for which you are applying
for a buiEding permit. We recomcnend yau contact yaur tocal produ�t supplEer shcutd you not know the product approvat
number far an af the a licabie listed roducts. Statewide a raved roducks are listed ot�line www.floridabuildin .or
Cate a Subca� c lUlar►ufacturer Prodac#Descri tion A ravat Number s
1. EXTERIOR DOORS
A. BWINGING ' '
. B. SLIQiR1G
C. SEC710NAUROLL UP '
D. OTHER
2. WINDOWS '
A. SINGLFJDOUBLE HUR1G
B. HORIZONTAL SLIDER '
C. CASEMENT
D. FIXED •
E. MULLlQN
F. SKYLIGHTS
G. OTHER
3. PANE�WALL
A. SIQING
B. SOFFITS
C. STOREFRONTS
D. GtASS BLOCi{
E. OTH ER
4. ROOFING PRODUCYS
A. ASPHALT SMINGLES
B. NON-STRt1CT METAL
C. ROOFING TII.ES
D. SENGLE PLY F200F �tute-Hlde ProducLs Ca„IaC. Tttermaptastic patyote#in.singEe pty raaf systems Fti2772.1
E. OTHER
5. STRUCT COMPONENTS
A. WOOD CONNECTORS
8. WOOL}ANCHORS
C. 1'RUSS PLATES
fl. lNSUlATIQN FQRMS
E. LINTELS
F. OTHERS
6. NEW EXTERIOR '
ENVELOPE PRQDUCTS
A. •
I ihe products listed betow did not demonstrate produd approvat at pian review. i understand that at the time of inspection of these �'
products,the follawing informatian must be available to the inspector on the jobsite; 1)copy of the product approval,2)perFormance
characteristics which the product was tested and certfied to compiy with,3}copy of tize applicable manufacturers insfattation .
requirements. Further, I understand these products may have to be removed if approval cannot be demonstrated during inspection.
. � r ��,�,-.
AP L AtVT SlGNRTURE = dATE
R-1305 01-04
�,
riuriva�suiiamg�oae Unune http://www.floridabuilding.org/pr/pr app_dtl.aspx?param=wGEV...
�
• •�� '� Product Approval
� - USER:Publk User
Product Aopmval Menp>pmdu[t or A�pli ation ar h>gRnli ation Kt>qppllption DCtail
FL# FL12772-R2
Application Type Revision
Code Version 2010
Application Status Approved
Comments
Archived
Product Manufacturer Mule-Hide Products Co.,Inc.
Address/Phone/Email 1195 Prince Hall Dr
Beloit,WI 53511-5481
(608)365-3111 Ext809
- lindareith@trinityerd.com
Authorized Signature Timothy McFarland �"{C,j��h`T�
lindareith@trinityerd:at-gr�,��yLj�'I�p���
AE,�LE�,�c CqgZ�� �r'�l�Z g�.�
Technical Representative Tim McFarland 1Y�C `�,p �ILD I�'�
Address/Phone/Email 1195 Prince Hall Dr ���``�t.�,'��`��('j G'
Suite A �S, �
Beloit,WI 535115481
(608)365-3111
tim.mcfarland@mulehide.com
Quality Assurence Representative
���°��� s�
Address/Phone/Email T ''y'"�
�fY�'����L�' L'�`
Category Roofing vs����'7 Y'i���/��.`QQQ/�
Subcategory Single Ply Roof Systems ���R �``3'
Com liance Method �/�
P Evaluation Report from a Florida Registered Architect or a�y�ensed
Florida Professional Engineer
Evaluatlon Report-Hardcopy Received
Florida Engineer or Architect Name who developed Robert Nieminen
the Evaluat�on Report
Florida License PE-59166
Quality Assurance Entity FM Approvals-QA
Quality Assurance Contract Expiration Date 06/14/2015
Validated By ]ohn W.Knezevich,PE
� Validation Checklist-Hardcopy Received
Certificate of Independence FL3_2772 R2 COI Trini ERD CI-Nieminen 2013 odf
Referenced Standard and Year(of Standard) ta da�
Year
ASTM D6878 2006
FM 4470 1992
FM 4474 2004
TAS 114 2011
Equivalence of Produd Standards
Certified By
Sections from the Code
Product Approval Method Method 1 Option D
Date Submitted 10/10/2013
Date Validated 10/14/2013
Of�� Date Pend(ng FBC Approval 10/20/2013
6/26/2014 2:35 PM
rionc�a tiinitlmg l;ode Unlme http:Uwww.floridabuilding.org/pr/pr app_dtl.aspx?param=wGEV...
, • Date Submitted 10/10/2013
y Date Validated 10/14/2013
Date Pending FBC Approval 10/20/2013 I
Date Approved 12/13/2013 ,
Summa of Products
����F��L#_______ I Model,Number or Name Description
;127� 72.1 � I Mule-Hide TPO-c Single Ply Roof Thermoplastic polyolefin single ply roof systems �
i _^ �Systems �
�
� -- �
(Limits of Use Installation Instructions i
� Approved for use in HVHZ:No FL12772 R2 II A1 er092713FINAL MULE-HIDE TPO- I
Approved for use outside HVHZ:Yes c FL12772-R2�df �
Impact Resistant:N/A Verified By: Robert Nieminen PE-59166
Design Pressure:+N/A/-525 Created by Independent Third Party:Yes I
Other: i.)The DP noted in this application pertains to one Evaluation Reports E
particular assembly.Refer to the ER appendix for all FL32772 R2 AE er092713FINAL MULE-HIDE TPO- !
assemblies and DP's.2.)Refer to ER section 5 for Limits of c FL12772-R2.odf �
Use. Created b Inde endent Third Party:Yes !
L__.,__....__ __ Y P Y �
?of�
6/26/2014 2:35 PM
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1VIobile/Manufactured Home Roof Coverin�Details �
General Notes --�$�6� a �' �
i. SUBSIRAIES TO BE A MlN1MUM 15/32" ���RY B&C 15'AS.D. � WIDTH VARIES �
PLYWOOc?QR MEfAL LTECX�Zffqo. C1R 0.024" ROOF(CAIEC08Y 8}PRESSURES ARE 1N ASf! �
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�o ff +16,0-27.6 +16.0-46.4 +16.0-69.8 � q 3'ROUND MEfAL RqWL G4GYqLUM£w
2. p0 NOT OVER TORqUE FASTENERS lF '
FAST£NER SR2IPS OUT TNROUCH SUBSIRAIE ��' +16.0-26.0 +f6.0-34.8 +16,0-41.9 ...::........,........ � �12 SA4EWS w/M/AC 1 1/2°
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RE fASTEN{S77N ANOTNER FASTfNER if`jlrY t" tar sF tts.0-153 ti&0-3Q0 tJ6.0-30.0 ' � _ f Q � fMBEt7AlENT�6'OC. QR t£SS AS
HOOF(l'AIECORY CJ PRESSUR£S ARE lN ASD .. '• "'�fR MiWUFACTURfRS SPECS FOR
: ::. .. .. .. �:..
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At[ WQRK iS TO BE tN ACCPRi�WCE Wj 7XE !o g t16.0-3.�5 t(60-56.2 tt6.0-84.6 ..
FZORtOrt 8UlL1NNB CODE'2Q10 AND 7NE 2t1t0 F8C ��` ti&P-dt.b +160-42.3 tt6. - .8
IXISIINC BUI[DING -LEI�Z 1 ALIER9AON i�s� +16.0-3o.s +lso-76.J +�6,0-a6.J • '
ASCE 7-10 CHAPIER 26-3i fOR ALL WIND LOAGS, ' '•
AND LOGAt COOES BY IAWS AN11 REGULA7tONS 3 2 3 .. •• uP,urx. s"ejW&XOr
i'1NfRE tNESE TAKE PRECEQENCE 8Y ASLF 7-10 A/R WFtD(M?j
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• tso�rPx. �rxo cc�aos oR cESS � : �� " -- lm'•J
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RISK CAIEGORY- IYPE lI 2 a 2 Z
STRUCIURE NO MORE TNAN 15'HIGH � `• _.„ 3'ROUNO MEtAL RAWL G9tYALUMf w
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Skylight I nstallation � ... . ���� �2•o.� dR`�S�
PER MANUfAC1UR£RS SPECS ii
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INSULATiON 80ARD.
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