HomeMy WebLinkAbout16-17362 . CITY OF ZEPHYRHILLS �
• � �- 5335-8TH STREET - !�
(813)780-0020 17362
BUILDING PERMIT
� PERMIT INFORMATION _� LOCATION INFORMATION �
Permit Number: 17362 Address: 39426 KENNEDY AVE
Permit Type: ACCESSORY BLDG. ZEPHYRHILLS, FL.
Class of Work: CARPORT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:•
Square Feet: Subdivision: LINCOLN HEIGHTS
Est. Value: Parcel Number: 12-26-21-0280-00000-0460
Improv. Cost: 200.00 • OWNER INFORMATION
Date Issued: 5/17/2016 Name: HERRERA ARNULFO-wife ok sign
Total Fees: 60.00 Address: 39426 KENNEDY AVE
Amount Paid: 60.00 ZEPHYRHILLS FL 33542-4631
Date Paid: 5/17/2016 Phone: 813-312-3912
Work Desc: CONSTRUCT CARPORT 12 X 50 ON EXISTING SLAB
CONTRACTOR S . APPLICATION FEES -
HOMEOWNER BUILDING FEE 60.00
<
� - = � Ins ections Re uire,d -, �
FRAME
SHEATHIN
FINAL
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe 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 property. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans,Specifications Must Accompany Application.All work shall be performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
�" b
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
� �b �
�
, 5'�G u k� t,c�irTf t%y��5'�y� �io'
� a�/H� f�o2ci`ll j �.�- �T � I�DST
I-��9d t�
:
� %�s .S'�C�2� '�-a .
�\
�� '••� ����.� � �{{�'T �
�`. `. 4� I�f 3 x ��o X�y 5 r?5 �,�G
\
�. .
.
� 3 �� �5��2.P/t�!
�� ° 03� �1� s��.i r�.l
' •��3 PoS7"
5'ec d� 70 ��9�`t Q� �R-s�
.� � _ `.
3 '3����`3��� P�o�
.
.� <<r
i
� �� �
� S' <7� `
��— �(O / �< <r
���� ��.��o�3
Pos�
n 3 0 ,,
� � .
�^ `° ��. `'
. '"'' � �� �
5�C�2� TO �'dX/C�Tl
. � x 'l��c�Y� �`���o�v�
- �
r� pI
� � CITY OF ZEPHYRHILLS BUILDING DEPART�N ��� � � �m f��
_ StiaZ�� ct,71,��C�e��'���
Owner: �.J 'f P� �-a.��_- -��� �' .�.P la,n
Job Location/Address: ,-P. � �� � S� � = �� '�t
Parcel I.D. #: Sic� c�( la���"��'
SHOW ALL EXISTIl�TG&PROPOSED STRUCTURES GIVING DIlvIENSIONS&SETBACKS � ����
UTILITY BIJII.DINGS MUST SHOW SIZE&FOUNDATION INFORMATION
I
� po s�' Lo caA�li-o�s Fo v l�1 um�ti,u�w, �ocre•�c1�Q�,�b �av�.��s St�S{e.�.�.,
�� �
� _ ,���, .i
2�c9 � �
0 � � !�'`g" � �141om�Hu�..,� � �
� 1 pQ� � .'' -�� Po�ecQ ���c-�-e..�{ � '
^ �� ���
� . 5� i
.S''a° ,
�� �'ki s'�'y�� ? �� �.�- .
� �
FR4NT PROPERT3C LINE
— — — STREET — — — — — — — — — — —
(NOTE EXAMPY,ES 1&2)..
Example 1. Setbacks for Rl &RZ Zoning Example 2. Setbacks for R3 Zoning
�'
�a
ia
� io�
p E �
R X .
' � I IU ��� lU
' ld � T 1� 141'
, S I 1�'
� E N
D d
PROP05ID
xp ZU•SINQEFMI�.Y/ �'DUPIFX
FRONT PROPERTY LINE fltOHT PROPDqY LQ1L
- - - S7REET -- - - - - - - - - - - -- S�1' -- - - - - - - - - - I
813-780-0020 City af Zephyrhills Permit Application Fax-B13-780-0021
- a Buitding Departrneni
Data Received, ��tr"'��� Phone Gc�ntact`for:Penitltttn `' '.. ,._ ..._. .�-- ..� . ... , _ ,
Owner's Hame _ (�I . , - Owrner Phone Numtier .n � --�J ��`'�
Owne�'s Address � Yl(�• lOwner-Phone Number �.�J ,- �`�O c�C—J1�
Fee Simple Tltleholder Name � � Owner Phone Number �" �_ I
I - ..�t'_ . _. ,a. _ .,_ ..
. . � ., . ...h ,....,.. . .— :.n. ....-. .—. ——,..�. ...... — ....
Fee Simple-71tleholdar Addresa - - _ -
JOBADDRE3S / Y��(l� U�.,,,. r'l,� LOT# ���
SUBDIVISION , �I '• ' � � ,.PARCELID# " , '.' ". ',. . , � ,.. s'� -
. , _ _ „ , � .�-_. • - (QBTAINEDFROM�PROPER7YTAXNOTtCE}. :: � :
. WORK.PROPOSED ';r•NEW CONSTR �"-ADD/ALT ��� � 'SIGN�� -Q' '� " �Q � �'DEMOI.ISH -
, � INSTAtL � �' REPAIR
PROPOSER U8E ` �� �SFR ' '�' `COMM` "[,� ` '-OTHEF2 . � • -
, .. . .
TYPE OF CONSTRUCTION 'Q' :6LOCK'`•. ;Q,� �FRAME Q.� $TEEL ,.-��, _.,.. - �:"
', ._ [� ( �-; �nA
DESCRIPTION OF WORK -• � x �O . p�.I'"�'Y CS'�'; ,�1� 1. �.��'�•...�•. �4�' 1�'IC3-
BUIGDING�SIZE- �' ' �� SQ.FOOTAGE���.,, - - �HEIGHT ���;�'�,��`,�����`'�1/G��
�a ,r-
UIL"DING ��'�:u"�"
'�" . � $: "' Q�� •VALUATION`�F TOTAL`CONS�'RUGTION'; �� �,,p
�, ' C�=� L.���f��d"��
QEt,ECTRICAC $ AMP'SERVICE ,Q, PRQGRESS ENERGY : W.R:�:C. �
. . :/Z�
[�Pi:UMBlNG �� ` , , . ,. �.�'�/��C'L!.-7"'�1�� dt,l., a
� �
�NiECHANIGAL ' � _ � VALUATIOt+I pP MECF{ANfGALliti1STALLATlON.��f,1 '�;%�'�`-�- r�f�('/���
✓ / -�"�..
Q�s 0.. Rao��N� _�. s�Ec��t.�nr 0- _ o-r�t��z �� jc�Y`i�t'��"'�G�t�i�=
FINISHED FLOOR ELEVATIQNS FLOOD ZONE AREA QYES NO �~ � `?�,
'e� � � ������
S � � ��,� �vL.u� - i�iie r
BUILDER � �� COMPANY ,
SIGNATURE � � � ' r REC.,ISTEREQ Y/ FEE CURRE� :.Y/N�.:.� -
/�ddrea� � ' Lic�nse# � �
ELEGTitICIAN , COMPANY' `
SIGNATURE � REGISTERED Y/ N �cuRi��- � Y/N ...-
Addre�� ' � r '"L=lcense# � - �
PLUMBER y ' COMP.ANYa• -•`. ' . .. � � ._� .
SIGNATURE' „ �GISTERED - � ,•�>Y/�N � -. �FEE CURREA `Y/`N;
Address ,, :License# �� �
„-_._; -� _ .i� � , , , , , ..
MECHANICAL' ` :COMPJ4NY�
SIGNATURE ' � � � ' � , --REGIS7ERED ;,Y�/�`:.N:" ;�FEE�CURRED ••�Y�/�IV` •
Addres's � ` `i _ , . , -- .. Lfcense.#�.�� - I
_ . ,. ,_„., - ,�, -_. . ,._ .
._�
O'fHER � � ..COMPANX, . ��.;......;w. ,
SIGNATURE- � - `x "" - � REGIS'rERED �Y/.N:.. ,FEE:GURReK Y�%Nr:. .
, ��r'
Address ry,<°i^;:. �:� - ` - . � ; ' 'License'# ( _ �
.� :.::,� :�;�• �» .�;-1- ; ,__ .,.�,.„�.. n,.:r,=���; :..t,�=;�_'~..;�,:,< ,.�-_ u_ . � , . - -
RESlDENi'iAt;. =Att$cti:,�2)<Plcti?lans;(2}ysets.ofBiiildi"ng'-Pians,�,(1}set'of Energy�Formis;R=O=W.��Pemi'it,for neuv;constniction, -
-.-�.�.���.« .,,;..
- v;Minimum�tena(14),workingjd�ys=after;subinittal£date:.Requiced o'nsfte;f;opstrucdori=Plans;$3formwaterPlans w%.Stlt.Fence tnstiilled,
_ . „Sanitery:FadUtle,s,g���.,du�pst�r�Slte*Wortc's.P.,er�itE°tor:=sutidiirlsEoii��llazge-:proJects.:`;:=a:�:;',:`:`'''< ' , - . . ..
.. �,:�,�.�;o�..f.r�l», ..3;..J.o-:-. �
COMMERCiAL Attach(3)''coinpte#e;sets ofBuitdin�',Pians.ptus�a,l:ife;Sefefy Page;(1}:setof Energy:Forms:R-Q-W Permltfor naw constnictlon:
Minimum ten(t`b)working days after submlttaF date. Required onsite,Ganstruckion Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Fadlitles�1_dumps#er.Site Wo�rk PermJt.far ali'new.prriJecfsrRll commerciai.reqult�ments must.meetcampitance �
SIGN PERMiY Attai�(2�'set's of'Engin",eered�Pla'n9:�;,:�;.�:-' ... ... • . -� -
. . ,
� •"'"PROPERTY SURVEYrequired for;all NEW�cons.huction.,. _ . -
- a � -
Direi:tlons: - ;�:.x:.. - . ..-. .... . . i:r • . .,,
FflLout applicaUan completely.-. F
Owner,;&Contractor stgn badc-of.appltcatton,notarized �
If over$�500,a Notice•af_Commencement,ia requlred. .(AlG,upgradea over 57500) ,
�R �F:i.''Z;"`Yl^Ctl.�:!`Kk}_`
Agent.(for ttie contractoz)o�'Power';of:Attoaiey�(far ttie owner)wouid be someone with natarized tetter.finm owner authotizirtg same
'DVER THE'COUNTER�•PERMITTING-- - , (Front•af Applicatton Oniy)
Reroots.if shingles Sewers Service Upgrades A/G Fences(Plot/Survey/Foo#age)
Drivewsys-Not over Counter if an public roadways.:needs�ROW
�
tdOT1C@ OF D�ED RESTf81CT'IONS: The undersigned.unde�tarrds�;tli�t�tt�l�;;p��mlt.rmay.be.subJ�ct;to,"deedp,resWctlons"
which may.be��more�r.est�ictive��th�Fl-Gounty���regulat(o�tis:'�TFie�un'der�lgn�'d'`a's'sume��re§ponslbil(�y for�compliance witti any
appllcable deed:r�sMctlons. � . _ •
UNLIC@NSED�,CQNT�C�ORS�.AND -CONYRAC7'OR RESPONSIBILITIES: -I€�the owner-has°�hired�a contr�ctor or
contractors to undertake work, they may:be.:required<.tv��be:ilcensed In..�ccor¢lanc�.wi�h��t�te.and•oocal regulations. Ifthe
coMractor�ts, not::licensed as-requleed'�tiy law; botFi the owner and-contiracto�inay�be•�clted-•for�a�misdemeanor violatlon
under state law. If..tFre owe�er or Intend�d.7 conQcactorz are.,�uncert�ln a� to what Ilcensing.require�nent�mays:apply��fior•the
tntended work, they are advlsed to contact ttie';Pasco.County Building.°Inepectlon:Dlvislon—L•Icen�ing Sectlon at 727-847-
8009. Furthermore,-If the ov+rner�has til�ed a coritr�cto� or contractors, he Is advised to have the contractor(s). sign
port6ons oi the "con4ractor �lock" of this appl8c�tiora for�.+hich they ty!!!`.��r��F��aslbl�. if.yau, as...the owne��s(gw as the
co�tractor, that inay be��n Indication�tliat�;he ts:not.proper�y licensed and�is nbti entltl�d to perinitting p�lvileges In Pasco
County. �
TRAN�PORT�TION,-lAAPieCC'flU,Y1L1'fiI�S{IMF�AC7�A(�D•�RESOURCE RECOVERY•FEES: The und�rsigned�understands
that Transportation Impact Pees•:and.R�co.urge Recovery:Fees m�y4epply..to;tF►e construction of.n�w.buildings�.�.change�of
use in existing�buildings;Tor-:expansl�i�ii�{;of.-��ei;xisti�i,g:'buildings,"�s speclfled:(n Pasco�County Ordin�nc� number �9-07 and
90-07,.as �mended._;The undersigned also.,understands, thait:�suoh fees;-.as:treay���e�::due;,wiU�,be Identlfied at the time�.of �
permitting. It I"s�furtFie�under�taod that Transportation Impact Fees and`�Resource,Recovery�Fees_must be paid prlor Qo
� recetving a "c�r.fl�cate.-of�occupancy" or flna4�.power.=�elease. :I��:the proj�ct.;.does:not Involve:a::certiflcafe of oacupancy�or
' final powe� releas�;.the�.;f.e�s:mu$t_be p�ld•prlor to:p�rmit Issuance. -.Ft��thermor',e;:•ff:-:PascoJCounty 1Nater/Sewer��impact
' fees are,du�,tFiey.mu�t:be:.�paid.:pMor to:permlt��lssyance-.in.accordance vri+Itfi:appllcabte.Pasco�County ordinances.
COIVSTRUCTIOM`LIEN'I.AVII'(Ciiapter 713� Flot�ela Statutea��s a�rtende�): ff valuation of work is_$2�500.00:or more, I
; certiPy that I, the:�applicant,_�.have-been-provi.ded with. a �copy� of th� 'Florida•�Construction-Llen: Law=Homeowner's
� Protection Guide" prep�red by the Florida Departmenf of Agric.ultur� and ConsumerAffa(rs. If the applicant Is someo�e
other 9han th�"owner"; I ceettFy.,that.I.�have.obta�ined���copy;of.the:abQve..rles,crlaed'�docu�ent�and:p..r.omis�in,good faith to
� deliver tt to�the,mownec"�prio�:to�cotnmencemerit: . � ' : " ` � ,
, CONTRAC�'OR'�IOt�EIt'8 AFFIDAVIT: I.certify;tki�t.alt�;the`:Info�m�tlor:iai�i;:thls�ppl0catlon is accurate.and that all work
will'be done in compilance with all:applicable laws regulating construction� zonfng and�land developrn�nt. Application (s
hereb� mad� to, obtain .a p�ronit.to :d�;wQfk,:.and installatlon as indiceted:.� ;I certify�that no work:or Installatlon �has
commenc�d p�(or to�issuaroce of a pemait'and that:all work will be pertormed�to m�et standatds of all laws e�gul�ting-
construction, County and City codes, zoning regulati�ns,,and land development eegulations�in the�jurisdlctton: I :�Iso
certify Qh�t I u�dePst�nd that the eegulatlons of o�hee goveenment ag�neles may�apply�Qo the.int�nded:work, and that it is
my responsibility to identffy�cwha4.actions f must•take:to b��i�:.corr�pllance:.Such ag�rricies include but-are.not Ilmtted to:
- Depa�tment of �rlvlronment�I��Protection=Cjrpress'��ayhead�;'WetO�nd.�re�s and Envlronmentally �ensittve
Lands, INatedlMastewater Treatment.
- Southwest FloPida Wat�r Management :.I�tstrict-We113� ;�/��eSS.`���y6108d3�� W�tland Area�, Altering
Watercouesas.
- Army Corps of Engineers-Seawalls, Docks, �lavigabte VVaterw�ys.
- Department of liealth� b.,Ret�abllitattv.��.Services/Environm�ntal �Flealth Unit=Well.s� Waste.water�TreaYment,
Septtc Tank§: � � .
- U3 EnvironmenQal Protectton Agency-Asbestos abatertr�ent.
- Federal Avl�tl�n•Auihorit�c-Runuvays. _
I understand that:the.following,�cestricflons apply'to the t�se of flIL•�
- Use of flll is not�Ilowred�in Flood:Zone"V"unless expressly peernitted.
- If the�:flll�m�ter6al is to.be used;�in flood Zone. "A°, (t is understoodpthat a`dr�inag� pl�n addre�sing a
"compensating volume"wlll b� subm(tted at.tlme of p�rmiftJng wFiich Is prepared by a profes�(onal �ngineer
� Ilcensed by��he�atate�of�Florida. ' ' � �
- If ih� flll maferl�l:is to be used fn Flood Zone 'A� in�connecdion�with.�a"�ermltt�d building using stem wall
conatructlon., l c�rt(ty_that fili�:wJll�b.e used oniy.to.fill fhe arQa.uvlthin�the�s#e�-vu�il.
- If flll matecial I��to�be used-�ln any area, i �certify lhat .use. of such''flll Yvvill rjot �dv��sely affect adJacent
prope�les. If u�e.of flll is found�to adversely.��ffect�ad)aEent��propertl�s,.the owner may be'cited for violating
the condltigns-of�fhe"�b�liding:permit is�u�d under the�atEached,permlt;,applicatlon, for�lots less than.one (1)
._ acre which are elevated�tiy flll;��t engtne�red dralnage plan ls required. •
If I arn the:AG@NT,FOR_YH�_OIMRIER; I;promi'se In good f�Rh to inform th�-owne,r,�of�the.p�rmitting'condftlons set forth In
this affidav(t prtor to commencing const�ctlon. �1 understand that ��separate permlt m�y be required for elect�ic�l �ruork,
plumbing, signs,,well��_pools;,,aie:_condtdontng,.gas,�..or. othec InstalPa`�lons nol:spec�fically included�ira.the�applicatlon. .A
pecmit�issued''�hall be..constru�d to<�be•��'Iicense.�-to:,pr.`oceed with'the wborV�an.'d not�•as;�utho�ity to:.vtoi�te;��cancel, �Iter, or
set asid�any provtstons of t�e"teclinical.c�de�;•nor sh�ll issuance�of a:permit.pcevent.the Bulldtrig.Official from thereafter �
requtring a cocc�ction:.nf..�ROPs-in:;{�lans;:construction or-violatlons-of�any codes.:�E�e-ry.-pi�rriilt�issued�shall become invalid
unless the_work authortzed.by such permit:�s-a�mmenc�d withln_�Uc months�of�permlt I�suance. or If work authorized by
the.permft..is suspended:_or.abandoned for a�.:period;of��lsc�(�)montFasyafter the:time the�wo�k��s comme��esi. An extension
may_be requested, ln;wcitirrg;..fr�m`th���Bulldi�g,.Offlclal~fo�a period�not,to.exc�ed`lilr�ty�(90)�days��nd�wlli`demonstrate
justifiable cause for�the exfer�sion. If wioeR ceas�s:far�i���y.-(90)cons.ec�±6rre:day.s...the job�ts�consider�d a4a�don�d.
.. _ _ ,,x r.; •
WAItNING'1'O�OWNER:``YOUR.FAlILURE=TC1.,;R�E.C.Ot2Q.:A,-M.O.TIG.E•:A�:;COMMENEEIV�EPt'T:MAY�RESULT IN��YOUR
P/AY�NG TWICE:FOR;IMPROVEMEW�3;T-0.YOUR::PRDRERTY.:�;1��YO.U�It�F�EKID"TO�:�OB?fA1N=FINAi�EM1G;'C.ONSULT
- �IE�y Y�l9R-L:�R���:���`.L"��" � �OE�.Rl�Y j��lFOF���E��CO�DIPt�w<�d�'R�'�'C':'�-' ����f-�ti'!'��L',�€:,�°: ":'�:
FLOFtIDA JURA�.,(F:S:;,1:17.03} - - • , .. . . ' .
� OInIN�R,OR AOEPdT.�. ��� -- Y � ` - COPITRAGTOR� �. .
Su.bscrlbed and�wom to(o�a�irmed)bePore me fhls Subsalbed end'suwm=fio.(or.afflrtned)`befor�°me�ffil� ,
by -- � ::by: - - '
Vlfio is/are personelly known to.me or.:ha�/heve.produced INho:le/are:Rerson�llyknown'tito;m�_or hasThave-prnduced-
- - - '-� as IdentlBcatlon:" � ' a�(denBBcadon.
i
--�� Note.ry Public . ' � � Nofary Publlc
Commisslon tJo:' � Commleslon.No.
II Name of Notary typed;.printed or�atamped Name of Notary lyped,printed or.st�mped
DISGLOSURB STATSi�NT FOR OY�NRR
CITY QF ZI3PHYRHILLS BUILDING DZ*IPARTt�1�T
I, have read aad fully understand aad
' agree to the provisians of this iastrum+eat.
The undersigued states aad aftirms that he ar she is desiraus of canstructiag,
reaovatiag, addiaag to or xeroo�iag his ar her owa dom3cile, that he or she = " � •�
ac�ually ocaupies, or W�iz occupy by said domicile, aad same i� nat for
reat, lease or sale. That he or she shall camply with the followiag couditiaas: ' ' • �
1. Tha� the owxier and he or she alane shall act as the builder fas all pha�es af
construction. �
2. That the owa.er wi11 camgly with a1Z provisioas of the City af Zephyrhil2s
ordiaaaces and codes pertinent to the buildiag.� � ' � '
3. That ia �he eveat various phases of coastruc�ioa are subcoa�racted,• he wi11
engage ayaly proper2y licensed subcontrae�ors and vrill persax�ally sup�rvise ,
such work. � •
4. That ia the eveat th� Builc�ing Iaspector sha11 require correetioas �o be made,
the owaes will as�ume full. respaasib�ility to insure they are made, aad' upoa
completiaa wa.11 call fox a reia�peet�3on before proceediag with the build3ag.
5. Tha� the oianer ahall aasume full respons3bility far the coYsstruatioa and will
' aot expect supervision of h3.s work fxom �he City of Zephyrha.11s 8uildiag
Department.
6. That prior ta fiaal ia�pec�fon aay additioaal feea, iacludizag reiaspectioa
fees, must be paid in full. A writ�ea sequest from this office shall
coastitute aa official aotice to pay additioaal fees.
7. That the owner shall camply with all City, State aad Federal laws ia regard to
� social seeurity, workman's compensa,tion, Zien laws, ete. , where appla.cable.
8. Tha� the owaer shall camply with all the safe�y cades issued by the Florida
Iadustrial Commissian.
9. Stat�e law requiree coastruction to b� doae by liceased coatractors. You have
applied for a permit under an eacemptioa ta th�t law. The exemp�ioa allows
you, as �he cv,riner of your praperty, to act as yaur owa contractar with certain'
restrictioas even though you do not have a licease. You must pravide direct
onsite supervisi.on af the construati.ou gourself. Yau may build ar improve a
�I oae-�am�].y or two-famiZy re�sideace or a £arm autbuildiag. You atay.also build '
or improve a commercial buildiag, provid�d your coets da aa� exaeed $75,OOQ.
The building or resideace must be for your ov�a use or occupaacy. It may aot
be built or substantially improved far sale ar lea�se. If you se7.1 or lease a`
� buildiag yau hav� built ar subs�aatially imgrovec3 yourself cvithi�n 2 year after
(�, the aoastruction is complete, the law wil]. preaume tha� you built or
substaat3ally impxoved if far sale or lease, which is a violatioa o€ this
exemptiou. You may not hire au unliceased persoa �o act as your contractor or
to supervise people wor}cing oa yaur buildiag. It is yaur respoasibi7.ity �o
inake sure that p�aple employed bg you hav� liceases sequired by state law and
by aounty or muaicipal liceasiag ordiaaaces. You tnay aot delegate the
respoasib3].ity for supervisiag work �a a liceaaed caatractor who is aat
liceased to perform the work beiag doae. Any persaa warking oa your building
who is aot liceased must work uader your direct snpervision aad must be
employed by you, which m�aas tha� you. must deduet F.I.C.A. and wf.thholding ta�c
and provide workers' compensatian for tha� employee, all as prescribed by law.
Xour coastruc�ioa must comply wi�h all applicable Zaws, ordiaaaces, build3ag ,
cades, and zoniag regulatioas.
OWNER'S Urr�n/U�RE C/ Y...� , Y' i''��i�„�, DATE
ADDRESS �"atc�
PHONE
WITNESS PERMZT #
Florida Building Code Online Page 1 of 2
�• ':,� --��''-r,�'�J�� � ��a sx.. 'w�'-=,"y`•�:"�sa*.��''riiR�;"-' �„+.: --r� -��' -
s ��,�; �,:.� ��- ����:���.�: ;� Y��m%�f�/f� � ��� _ u�
o ;S' D �. e ` - � h` � i s�'� :.�.
?° ayY r�J�����`,'{.� � �°tl � - ,'=�,"'�� ��,'• _-
e{ _ x�����: ' � -x�tt []� - -
" '" ___-___ ,'�'4;;.Bt:' "C Y�. ���
Florida Department� B�IS Home i Log In ; User Regfstration i Hot Topirs ; Submit Surcharge � StaLs&Facts � Publications ! FBC Staff•{1 BC15 Site Map ; Links �',Search :
Busines � - .
Professi��l �� ll� Product Approval
�USER:Public User
Regulation
Product Aooroval Menu>Product or Aoolication Search>Aoolitation List>Appllotlon Detall �,
� �
' ' c �.^ '-'� FL# FL17010-R1
- ' �`��:,�
Application Type A�rmation i
Code Version 2014 �
Application Status Approved I
Comments
Archived 1�
Product Manufacturer ASI Building Products/Lansing Building Products Company
Address/Phone/Email 4501 Trensport Drive-Bldg#5
Tampa Distribution Center(SOth St)
Tampa,FL 33605
(813)769-0361
f.patferno@lansingbp.com
Authorized Signature Frank Patierno
ALL WORK SHALL COMPL�'����$��ingbp.com
Technical Representative PREVAILING CODES,FLORIDABUILDING
Address/Phone/Email CODE,NATIONAL ELECTRIC CODE AI��
C?TY OF ZEPuYn?-TT{?��g��`IANCES
Quality Assurence Representative
Address/Phone/Email
Category Roofing
Subcategory Metal Roofing
- ��VSEW DATE � �`
Compliance Method C�"�-�/O�Z v e or I rida Registered Architect or a
�f�l i��rofessional Engineer
ptq�� E�����tion Report ,N rdcopy Received
, �
Florida Engineer or Architect Name who developed the Robert J.Amoruso,P.E.
Evaluation Report
Florida License PE-49752
Quality Assurence Entity Keystone Certifications,Inc.
Quality Assurence Contract Expiration Date 09/12/2017
Validated By Charles A.Pagen P. E.,Ph. D.Fenestration Technology
[� Validation Checklist-Hardcopy Received
Certiflcate ofIndependence FL17010 R1 COI PER2292 RevO ss odf
Referenced Standard and Year(of Standard)
Equivalence of Product Standards
Certified By
Sections from the Code
1504.3.2
1507.4
2002.1
`��I afFirm that there are no changes in the new Florida
Building Code which affect my product(s)and my product(s)
are in compliance with the new Florida Build(ng Code.
� http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqv2aBQpHpQQ... 5/17/2016
�
Florida Building Code Online Page 2 of 2
;{,�
�
. .`
Documentation from approved Evaluation or Validation Entity �;Yes C)No �t N/A
FL17010 Rl COC A�rmation FL17010 415-0605 ss.odf
Product Approval Method Method 2 Option B
Date Submitted 06/24/2015
Date Vaiidated 06/24/2015
Date Pending FBC Approval
Date Approved 07/01/2015
Summary of Products
FL# Model,Number or Name Description
17010.1 Aluminum Roof Riser Panels Aluminum Roof Riser Panels
Limits of Use Installation Instructions
Approved for use in HVH2:No FL17010 Rl II LBP0001 RevOb RiserRoofPanels ss.odf
Approved for use outside HVHZ:Yes Verified By: Robert J.Amoruso,P.E.FL PE No.49752
Impact Resistant:No Created by Independent Third Party:Yes
Design Pressure:N/A Evaluation Reports
Other:See Installation Drawing for Load/Span Design FL17010 R1 AE PER2292 RevO ss.odf
Pressure Tables Created by Independent Third Party:Yes
i 6ack Next
Contact Us::1940 North Monroe Street,Tallahassee FL 32399 Phone:850-487-1824
The State of Florida Is an AA/EEO emD�oyer.Convriaht 2007-2013 State of Florida.::Privaw Statemen[::Accessibilitv Statement::Refund Statement
Under Florida law,email addresses are puhlic remrds.If you do not want your e-matl address released in response to a public-remrds request,do not send
electronic mail to thfs entity.Ins[ead,mntac[[he office by phone or by tradidonal mail.If you have any questions,please wntaR 850.487.1395.*Pursuant to
Sec[Ion 455.275(1),Florida Statutes,effective October 1,2012,licensees Iicensed under ChaD�r 455,F.S.mus[provide the Department with an email address if
they have one.The emafls provided may be used for o�clai communiption with the Iicensee.However email addresses are pubtic record.If you do not wish to
supply a personal address,please provide the Departrnent with an email address which can be made available to the pu6ifc.To determine if yau are a Iicensee under
Chapter 455,F.S.,please clidc here
Product Approval Accepts:
� � iv^�ec{. �
SLY'UI']tY\1171iIC5'
http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqv2aBQpHpQQ... 5/17/2016
�
• " �o.
:•j r
_y�:f4�
��_ �
.:�3. .
•;:•.c�� ;d.>
5 tS`"�'
City of Zephyrhills
, BUII,I�ING PLAIV I�EVIEW COMiVIENTS
Contractor/Homeowner: � �� ����
c
�� �_
Date Received: SJ L �—`-��
Site: � q �'
Permit Type: �.�Y�'� 2 � �`
,i
i t�pproved w/no comments: Approved w/the below comments: ❑ I�enied w/the below comments: ❑
�;'
J
This comment heet �all be kept with the pernut and/or plans. �
�' 17-1�
Kalvin S tzer- 's Examiner Date Contractor and/or Homeowner
(Required when coanments aze present)
l