HomeMy WebLinkAbout16-17390 CITY OF ZEPHYRHILLS
5335-8TH STREET
; .y� (si3)780-0020 17390
BUILDING PERMIT ,
PERMIT INFORMATION LOCATION INFORMATION �
Permit Number: 17390 Address: 5910 11TH ST �
Permit Type: RE-ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-02200-0180
Improv. Cost: 6,020.00 OWNER INFORMATION
Date Issued: 5/27/2016 Name: WELLS FARGO BANK NA
Total Fees: 105.00 Address: 3476 STATEVIEW BLVD
Amount Paid: 105.00 FORT MILL SC 29715-7203
Date Paid: 5/27/2016 Phone: 941-803-9468 I
Work Desc: REROOF SHINGLE & FLAT
CONTRACTOR S APPLICATION FEES
W D HUTCHINSON CONSTRUCTION LLC REROOF RESIDENTIAL 105.00
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Ins ections Re uired
DRY IN ROOF INSP
TAPE JOINTS ROOF INSP
FINAL ,�n—����ii
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 property 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 pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
ON C OR SIGNATURE 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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813-780-0020 City of Zephyrhills Permit Application Fax-813780-0021
Building Department
� /_
Date Received �
, Phone ContactforPermitting 727 723 -8581
Owner's Name Wells Far o Owner Phone Number 6��
Owners Address 3476 Stateview Blvd Owner Phone Number '
Fee Simple TiUeholder Name Owner Phone Number
Fee Simple TiUeholder Address
JOB ADDRESS 5910 11th Street Ze h rhills FL 33542-3619 LOTS# 18-20 incl blac 22
SUBDIVISION 1��� � � �r�' I`�PARCELIQt� 11-26-21-0010-02200-0180
(087AINED FROM PROPERTYTAX NOTICE)
WORK PROPOSED e NEw CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH '
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM 0 OTHER Roof Re lacement
TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK Roof Re lacement ��C\�, � ` (f Q
BUILDING SIZE SQ FOOTAGE ��� HEIGHT �
08UILDING $ �/ �v VALUATION OF TOTAL CONSTRUCTION
V
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $
OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �/��3�v
� �
QGAS Q ROOFING XQ SPECIALTY Q OTHER ���] �
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO �
_ -i �F:�1--0-...r�i-� �.�.�-.�i-:--r..�-.-5�-. .--.
BUILDER COMPANY I
SIGNATURE ' RecisrErt� Y/ N FEE CURREA Y/N
Address License# �
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address � License#
OTHER I� � COMPANY WD 1'�L \�S� ��� '
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address •'t�� `� � . �"f�„�� License# �;.l�4�1 �
IIIIIIIItllltltlllllllllllttllll � lllllllltlllllllllllllllllllllll �ll
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Pertnit for new consVuction,
Minimum ten(10)woricing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8 1 dumpster,Site Work Pertnit for subdivisions/large projects
COMMERCIAL Attach(2)complete sets of Building Plans pius a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construction.
Minimum ten(10)working days after submiltal date. Required onsite,Construction Plans,Stortnwater Ptans w/Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Permit for ail new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW constniction.
Directions:•
Fill out application completely.
Owner 8 Contractor sign back of appiication,notarized
IM If over�2500,a Notice af Commencement is required. (A/C upgredes over$7500)
Agent(for the conVactor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITfING (copy of contract required)
Reroofs'rf shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
1
s ,,jaNOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to°deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements 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) sign
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 undersigned 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 prior 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 WatedSewer 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 work is$2,500.00 or more,I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowners �
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 installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other govemment agencies may apply to the intended work,and that it is ,
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,WateNWastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
' - Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
- Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
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 with a permitted building using stem wall
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 use of such fill wiil not adversely affect adjacent
, properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating
the conditions of the building permit issued under the attached permit application,for lots less than one (1) �
acre which are elevated by fill,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be consVued 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 prevent the Building Official from thereafter
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 months of permit issuance, or if work authorized by ,
' the permit is suspended or abandoned for a period of six(6)months after the time 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 will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
WARNING TO OWN�OUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE F IMP OVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LEN'DER O AN ATTORNEY BEFORE RECORDING YOU NOTICE OF COMMENCEMENT.
• FLORIDAJURAT(F .117.03) � _,__
OWNERORAGENT C NTRACTOR � 1AM�
I Subscribed and swom (o, ffirtned be�fore th' scr�bed aJld swo��.jo(o('a rtned bef,o` m th'
—�_by O�(.'+" LP by LtJ%l(iFFvYi �. 1—k�.l.�«95��
VjQlajs/are personally kno r haslhav odu d o's/are personally known to me or haslhave produced
as identificah n. '` a�.identification.
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, Notary Pubiic �WJ� Notary Public
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�y order of the Building OfFicial: �ViCC�a�A. . �urgess
All �uilding, plurr�bing, electrical and mechanical work I
shall cease at the below mentionecl propert�/.
�- � � � � � r� � ,, � �_;:�
Acldress:
Date: S "' z 7 ' � 6
Code Enforc�rnent Officer: J �� C�/�
Contact the
Zephyrhills �uilding Departr�ent
5335 - 8th Street
�13-780-0020
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P.O.8ox 92196•Laketand,F�338QA-2 S 96•{863)686-334Q•Fa�c(863}68fi-7274
6mail:williamdhutchinson�yahoo.com �
License f�umber:CCC1328714
, Attz�; Travis
PAOPOSAL SUBMITTED 7i7 PHONE DATE
Phillips Con�racting Tne 941-803-9�68 5-10-16
STREET Jp8 NAME
395 Commercial C�. SteA2 Same
CITY.STATE ANp ZIP COpE Jd8 tOCATION
Venice, F1. 34292 5910 1�.th St. Ze h rhills Fl.
FAX N OATE OF PIANS JOS PHONE
W�hereby submit sp�cificat#ons and estimates tar.
To remave al2 af oId shinales, renail raaf d�ckina to cade. Dr�r in
with twa AlyS 15# felt. Instal]. new eave trim, lead boots. vents. 2-4ft
off ridcte vents. Tnstall 25 vear 3-tab shinales. On l.c„�w ,�itched area
of roof, ins�al.1 43# base £elt. Install. sinale gly tarch down. An,y
rotten wood will be extra an a time anc� material basi�, Clean s,a;p and
haul awav roofina debris.
5 vear workmanship auarantee
25 vear znanufacture warrant,,y .
Roof: 56020,�p0
14 saaureG shinales
7 st�c�»r � f 1 at'
PiOTE:Ntacd Fi�lsce��nY,i4 roquirad.ta nct inNuded in thie quote.Woad replacmment mrili�e charg�d on s tlme t�materiars basis,
le0or no9 to excaed $�0•�Q pe►men hour plua coat o4 maGeNele.
f�t�[OpOg�Pwroby to tumish metorial and lobar—complete in accordence with aDove opmcHicatlone,Mr the wm of:
Six �thousand twenty 6020.00
doll�r�(S y.
{�Nl�f1t t0 bQ fY1GtfQ 03�OIIOWS: N0T10E TCt OWNEFI:As reauired by Ihe Flonda Constnxtion Lien Law(FST13.06)(2)(6).
�.}i1� upon completion bu,i�er neraby rtotd�6s ovrner Sh�t p2rsans or eampanec3s tumishirsg t�.0or or matariafS far 4?ro
construtt�on an oamerS IanQ rriay nave 6en ngnts on owners IanA 4u�kfirtgs il not paid.
Those enhlleC to hen nghts.�n add�hons ta Me unders�gried buihfer,are Ihose wPia conhaet
tlnectly vMh Ihe owngr or Ihose who grve the ovmer Ma mt�e aRer they 1ir31 fumish 4sbor a
mate{ia�s for tha ca�struci�on
AIi m�teriai is guarante�+d to De as spetrfied. Ali work to b8 Compteted rn a work-
manlike manner according to standard practices.Any alteration or deviahon Prom ��D.HUTCHINSOH COPISTqUCT10N,uC wltl rrot bp hNd IlatrN fa a»cr.d arwwqrs.
above specifications�rnrolving extra costs w�A be executed only upon written orders. 11d��"��""ar aamyye eo upale unrs du��o e�uM ot our havy�qutprn�rit.fiw�ns
� and wiB bscome an etttra charge over and abave the sshmate. A1I agreements con- {Q'�6nsl4tttry ta pvovld�aeceae fa haavy equtpm�rrt.
tingent upon strihes,accidents or delays qeyond ou�control. Owner lo carry hre, In caea of leea peymem w do9euit,en 1�1te prym�nta,caoi�c2loa�wato ona¢o cttarm��'o
tornada a�d other necessary �nsuranCe. Our workers are fufly covered by fe�e a�n be paid by dsbter, d etu,pa of t 9f,t�X,w711 br�a+pwt moMhq•am atl
Ydorkmen's Gffmpensaiion�nsurance. aceoume mror 3u dsps old. (
i Pf0'TE: This proposal may he wrthdrawn 30 Aumoriaod Jim/Gary �
by us il not accepted within days. Sfgnature
! �[[lptc7tl[¢ 0� �COpO�dl- The above prices, specifications and con-
ditions are satis#actary and are hereby accepted. You are authorized to g�gnatufe
I do the work as specified. Payment will be made as ou4�ined above
Date of Acc�ptance S�gnature
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� -''°' CQNTRACTING, INC
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If t6e utitrities are not ort at the time of yt�zr�rriva],ple�se conta�t your Project Manag�r andlor Repairs Coordinator
Contractor; WD Hutchinson Construction LLC
Contractor Name: Ga�y Hutchinson
Address: 59141 lth St Zephyrhills, FL 33542
Lackbax Combination: Padlack Code/Key Code: A389/6776?
Water On? No-Needs'�a be Tumed On
Eleetrical Qn? Na-1'�aeds to be Turned C7n
Gas Un? N/A
If you are unable to complete a repair,if you discover additional repairs nceded, or if you are
, in need of a special order itern,natify your repairs coordinator andlor your project manager
imrnediately.
Please leave#he power and water on after repairs are compieted,u�tess af course t�ere
is an electrical issue or a leak.
Project Manager: Paul Palazzolo
Repairs Coardinator: Jocelyn Hargreaves
gif�•�e�a�fln°s ��•�n�nc���➢����y Y9an������n�E/��°a�g���a a�sg�����an a��QB� s•e-n��g����Hc�aa f��
�a➢� �r��9e�an�8�� �'a•�e� �9a�aaia�s�n•���a�Q e�nv�o���e
APPROVED REPAIRS
DITE DATE: OS/28I2U16 TOTAI.. : �6,42U.0
�pe Descripiian ,
�
i 1. Remave l layer af shingle roafing mater.ial,re-naii decking to code($500.00},
2, Replace up to 4 sheets of decking($275.00},
� 3. Instalt new underlayment,&install approx. 14 squaras of new Diniensional
materiat.
Raof 4.Install new underlayment, &install approx. �squares ofnew Madified bitumen
Material
Iz7cludes uents,baots, drip edge,perniits,inspections,&cleabup, Subject to HOA
approval.
� WORK PERFOI2MED BY OTHERS
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BUIL]�ING PLAN REVIEW C0�4�VIENTS
�c�ntractor/Harneowner: ��� �-f�'�L ` /I�S,S� .�.�
I3ate Received: ��'�'' ��1° �
sx�e: , �� ! � � ����`��
lPemut T e: ��� ' 1� ��-` �-� ` �
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Approved wlno c�mments: A.pproved wlthe below comments: ❑ I?�nied wlthe be�aw comments: ❑
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� This comrnent sheet s al be kept with the pennit andlar plans.
�f�7-�(
I�.aivin S s Examiner i3ate Contractor andlor Homedwner
� (Required when comments are present)
_ Illlllll(IIIIIIIIIIIillllllllllllllllllllllllllll II
� 2016082626 III I�II IIII
Pertnit No. ' Parcel ID No:11-26-21-0010.02200-0180
NOTICE OF COMMENCEMENT '�0�
State of orida County of Pasrn �N�
FI
i , N `,�
'ves notice Vtat im rovement will be made to certa fn rea l prape ri y,an d In accor dance un t h C hap ter 7 1 3,F i o r i d a S t a t u t e s, ��
T H E U N�E R S I G N E D h e re b y g i p . N
alian Is rovided(n thfs Notice of Commencement �
the foilowing iniortn p N m v
1, Desaiption of Property: Parcel Iden�cation No.PB 1 PG 54 LOTS 1&20 INCL BLOCK 22 or 9216 PO 2915 B m�
SVeet Address: 5910 11th SVeet Zephyrfiiils FL 33542-3619 � w
m w
2, General Desuiption of Improvement Roof Replacement •
3��
3. Ovmer Infartnatlon ar Lessee infartnation if the Lessee conlraGed far the improvemenl: A
vm�•
� •
^9ank �«�►+
Neme �C m B
o�va e���e.,;o...ci„� FaA�Aitl $� '
Address City Slate � � �
Interest in Property:Bzsal �
7
Name of Fee Simple Titleholder. �
(If difterent fram Owner listed ahove)
Address Ciry State
�4. Contradoc WD Hutchinson Construction LLC
Name
PO Box 1308 Dunedin FL
Address City State
Contraclofs Telephone Nn..���7�a-asa+ �
�D
5. Surery: �
c
Name �N a
01
Address Ciry State �\N
0
Amount af Bond: $ Telephane No.. ��z
//��+m •
6, Lender. {y/�r=
Name '
N�
s
Address Ciry State
�o
Lendels Telephone No.: �j,�-o
D
7, Persons within the State of Flarida designated by the ovmer upon whom notices or other documents may he served as provided by 3 0
Sedion 713.13(1)(a)(7),Florida Statutes: -0
�rr
Name m
�
�F.10 "
Address Ciry Stete ��,,,.���
c�
Telephone Number of Designated Persan: �~3
a
of �N �
8, In addition to himseif,the owner designetes —
to receive a copy of the Lienors Notica as provided in Section 713.13(1)(b),Florida Statutes. �
Telephone Number of Person or Entity Designated by Ovmer. r
9. E�iration date af Notice of Commencemenl(the e�ira6on date may nol be 6efore the compleGon of con/5�_ucftio�l d/(�//paymen!lo the
conUadar,hut will be ane year fram the date of recarding unless a difterent date(s specified): O V/ 7�/ (b `
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFfER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
• ARE CONSIDERED IMPROPER PAYMENTS UNOER CHAPTER 713, PART t, SECTION 713.13, FLORIDA STAMES, AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST 0E
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FI SPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATfORNEY BEFORE COMMEN G W RK OR RECORDING YOUR NO710E OF COMMENCEMENT
Under penelly of perjury,I dedare that I have read the foreg g notice o commencement and that the fads stated therein are true ta the hest
af my knovAedge and behet.
STATE OF Ft9RfBA.�6(,��6�- '
' COUNTY OFPh3Cd �r�
Signa f Owner ar Lessee,or ers or Lessee's Autha'z d
ir or/PartnedManage
'Ga.�--� `�.,1� -
Sfgn ys rue�arce /
The faregoing insWment was acknawledged b�rg�ne�is�ay of� ,20/�O,hy f/!/I� �G�G�fZ��
5 �l (type of aulhoriry,e.g.,offieer,tnis e,anomey in fad)for
�• (neme of party on behalf of om InsWment was executed).
Personaliy Knavm �Produced Identlfication❑ Notary Signature
Type of Identification Produced Name(Print)
� � MATTNEW HAC�EN - �
;��`� Commission Number755526 � � �
I�,�^' My Commission Expires
wpdatait ' cemen�c'�SSO�Br�—T.. '
I
STATE OF FLORIDA,COUNTY OF PASCO ,��,������, '
THIS IS TO C�RTIFY THAT THE FOREGOING ISA . �� o `o'� �
TRUE AND CORRECT COPY OF THE DOCUMENT � _ o �
ON FILE OR OF PUBLIC RECORD IN THIS OFFICE � • ' , .� • �
WITNESS MY HAND ApN�D�OFFICIAL SEAL THIS ,�Q,.,�t' :
a���DAY OF �" 1 2�l W` s} � rn G ;..�'''.. � I
PAULA S.O'NEIL,CLERK OMPTROLLER �• •� '
(; a �
gY r ' `Y`Q DEPUTY CLERK � ' ����� �,
e
�`��oF����
�.,.��. 07f07120i6 O$:39 �428 P.001t002
Florida Buiiding Cade Online Page 1 of 2
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Product�tanuracturer k CertainTeed CorporaHon-Root�����i`��''���5�
..Address/Phanel�malt : i8 Maar2s Raad
Malvem,PA 19355
(G�0}65�-5847
mark.d.l�arnec@SalaC-gabaln.rAm
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Address/Phane/Emaii �8 Moores Road �
I ,, Ma1VEm,PA 29355
(610)651-5847 I
�f Mark.D.Harner@saint-gabalc►.com .
���I Qu8lity Assurance Representat#ve
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Cate9ory Rocting
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Subcategory ModlPfed 6}tumen R�of System , .
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Compiianee�7ethod Evaluation Repart from a florlda Registered Archltect or 8 Ucensed
FioNda Profsssianai Engineer :
i ' , �' Evaluation Report-Hardcopy Rece(ved
Fforida Engineer or ArsnitecL Name who Rabert N1eminen I
developed the Evaivation Report
�lorlda litense PE-59186
Quality Assurance Etatity U�.LLC
Quality Assurance Corttract Explranan Date 07/03/2017 �
' ValldatEd 9y 3ohn W.KnezavSch,PE
i� Vaildatian CheCkNst-Hardcopy Rece4ved
�� CeCtiflcate of fndependence �,�� a s Qi 2p1S 01 COI rytem4net�ndP
Referenced 5tendard and Year(af Standard) S ndst'd Year
� ASTM t]6162 2000
4 ASTM Qbi53 2�Qa
� ASTM D6I64 2QU5
ASTM D6z22 2008
A5'fM DbSU9 2009 '
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