HomeMy WebLinkAbout16-17391 CITY OF ZEPHYRHILLS
5335-8TH STREET
f - ' (813)780-0020 17391
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 17391 Address: 5907 GREENBERRY CT
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: WEDGEWOOD MANOR
Est. Value: Parcel Number:
Improv. Cost: 8,800.00 OWNER INFORMATION
Date Issued: 5/31/2016 Name: NARUM TERRY L &JEANNE
Total Fees: 80.00 � Address: 5907 GREENBERRY CT
Amount Paid: � 80.00 ZEPHYRHILLS, FL 33542
Date Paid: 5/31/2016 Phone:
Work Desc: REROOF SHINGLE '
CONTRACTOR S APPLICATION FEES
SCOTT BLACKMAN ROOFING INC REROOF RESIDENTIAL 80.00
�
�/��
Ins ections Re uired
DRY IN ROOF I P �
TAPE JOINTS R OF IN P �
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 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 atto'rney
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.
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
s�a-780-0020 City of Zephyrhilis Permit Application Fax-813-78G-0021
Buttding Departrnent
, •• .
Date Recstv�d , � -, �, ,
�: Phoa�,Coritac#'fdr`Parmiftln"`::` -
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Owner•s Name / rv �t�vt w1 Uwner Phoa�Number '
/ . : . . : ,���,�
Ownar's Address ..7 � �- Ca Y Q C h ��.h r Cf • Ownerphone�Nii�nbet ff � .
Fee Slmple�TlBehalder,Name ��_, � . �� Owner Phone Number I ,�� � .
� �3'!` _ . ,
Fee Slmple Titl�holder Address " �-;`s � ' -
JOB ADDRESS � � D � C��� �h 1�.r� G� � � ��,, %�,r fi! 3 3-5 Lf� �o�r� �,�,�
SUBDNISION �: , �� ' 'PARCEL'ID#"�, � r' z�' '�2I'�U I � d ^00(?'Ob ^O� ��.
_ ' ' - ' - • � :_�(OBTAINED FROM PROPERTY TAX NOTICE). �
wORK PROP..OSED �- NENv caNSTit ' ADD/A�.T � SIGN (� -Q�"` .DEMOLISH •
_: � � . INSTAI:L = �.� REPAIR� ' � - '
PRpROSED USE - . _ [�; SFR �' � "COMttii!�. � OTfiER� ";
TYPE OF CONSTRUCTION,;'� �Q BL'OCK�' ;�Q� ,F�AME �,� STEEC, � ��
,�. .....
DESCRIPTION OF�WORK U�--L r v� �� G�I��_ T(.�,�i•-�r�V e 3 U S : � ���.
: � -� � - -
BUlLDING SiZE�� � $Q.FOOTAGE��. . , ;;HEIGHT�.�. �_:
. QBt1}IDING , $ �=-�;s,;,.;��. �,�r,n,..r,,._ ..
. , , ��C'"(}Q!�► t�' VAI:UATION OF 7'O'i'AL=CONS1`RClCTION
[�Ei.ECTRICA� �� AMP SERVlCE 'Q PROGRESS ENERGY [� W.R.E.C.
QPi:UMB1NG ::$ .
:. . �. � .,4"C, , ,.' , .; ' .
. , .';,r_ ,
QMECHi4NIGAl $ .—��. : y V11t.tlRTION OE M�GHANICP�I.INSTAt.LAT10(+� . -, �
QGAS . [�] �,R�OFING:�r,0 SP.ECIALTY ",��' OTHER �
FINISHED F1,00R ELEVATIONS FLOOD ZONE AREA QYES. NO . ,
� �,_� . - - ' ' ' .. , . _ � •
BUtL.DER COMPANY� ` ' --
SIGNATURE REGISTERED Y/ N. �e Cuw�E�" Y/.N •,
Addreas - . , �, _ ' License#i�t .. �
, ,. . .,. �� '' �
El.BCTR1CfAitt� , , - - � , GOMPANY � .,, , . , _ � ' -
SIGNATURE + �"' �G�srER�a Y/ N �cut�n, `Y/N .
- , , .
Addeess . - - �L•icen"se.#�� � ��
PLUMBER ` . � � � CQMP,ANIf. ,- ,, ::;; " ; „ ; ,
31GNATURE� - `'� 4 . , �
��.- . . :�Q�s.r��a: ,�. .;.Y/�4N• ,, �e:cuw�en �Y�;N:.
Address . -. �. y - , . , ..Llcense# � �
MECH11N1C1�[:. , - - . � . - .. ;GOMPqNY ' . " •� _ - •�
SIGNATURE ` . . `": . . � - . „ - , REGI�STERED:; , , ..Y./:;N.., ,::FEECURRE�'; . "'Y'/rN.;,�. , ' , .
�ddress;` „ ,- , . , .�., - � . ,_, .,. -- , _ . �'°- , �..Llcense# j. .;�- ` :�� . �� _
OTHER ` ' _ _ u .'�=.; . . y/� �-7-
.., - .. ' - : _ - _. , - . . .- _ ..
:CiC11111PAN1! �:U� ,f�!LGIt HL'.;st� ,: G.U:r,.°;''` ,..i.-:0� f
SIGNATURE. . . ` `
�REGI97ERED. Y/-N�.<' FE�iGURRE�' t� f:Y�/;N_;: .
., : ;�, :°a-��,�:, ;;� . ;;--� � .+,.,:. ... .v z. j.',.. .a S�y'_ ��.��r . - ,,,,, ,_.-.� .��c:��~ �9'� 7 �
�dreas 3 .j': _� �`� .�;�y�' j ;�-�-" `iJcense"#� �
3 �
.r�A"..�:.. � r..�/�� 'j��y r�£�a:(,�p"..r'. ' . `
: ' � { .+ _. _ ,'-t, ' .a-. ;, y�__ " .' y:'I..'r � �.�`§r �WIFSVMY$Gn ._ .. e r
� RESIfi}E�ITiAI:,_.;=Pitkacti�{2)..P1ot:F',tans;s(2):sets=of:Bu�l�lrigrF?lans;.(4}'sef,af.=Erier�yr°�Faiisis��R-0=tlttxPerrii'it:fo7.r��ir;;,, . - . - ,
� �. �_�- ..
_::..,nMlnirtiunn�,ten(F1Aj,fworlting;day,s=atter�sutimittal�'tlate:;Requlred anslte;Con"sfruction•Plans Stor►nwater```Plansw%Sllt Fence�installed, � .
", SanllacyFad4{tl@s8��,l�dum�sterStteWark�Pe�nftfor.�ubdlvisfonsllarge•'pcaJect's'..,:�,;ri��=._:-',• ;:,- '� : � :� . �� .�- . -
COMMERCIAI. Atkach(3}coinplete=sets'of Butt�l'ng Plans plus a'llfe Safety Page,(1j set of Et�ergy+Farrns.R-O W Petmit far neW canstreic�ton. _
MlNmum ten(14)working days'aRer submittal date. Repuired onsite,.CansWcUon Plans,Stormwater Plans w/Slit F,ence Insfalled,
San!ffiry_Fadtitles.t�,i dumpster..,Stte:Work_Petmttifor�il:new`prqjacts:Ail.cammerciai,caqutrements_ritust meet campltance _
StGN.PERMlT A#tactf'(2)sets o"fi�ngiiieered=Plar�a:�;;;.i��r �,;.` , . - , •.. . ` . �_ -
•"""PROPERN�SURVEY:.regulredlqr.all NEW,consUucflon.;_ - �� . : ' , -, • � .
D�f6C�0i18: _:�,.�:�;i....t.,�_�:4' - _ -_ _'_ _" . _" _ _ - -,.
FIII:out appllcaUan completely.
E�wner 8�Cantracfoc sign bacic af.applicatlan.notarized
If over 52500,a Notice,of CommencemeNtla requlred. (AIC upgrades over_5T500),_... . ;, . .
__. ..__.._:_._... .:_._,,._.._._, � _ _ -
.. • i�<z„�Y�'j�,<''•t'i<�:a�,;.`.. ,.. . . .
Agenk(far the cbntractar)'or:Powe�of-Attomey'(for ttie'owner.).would be someone with notarized letter from owner authodzfng same
d,VER'THE=COUNTER:PERMITTING,_:.-,:.�.(Froa9t-of=J4ppltcation Only)__"� < � . � �. �. _ _ �
Reroafs if"shingles Sewers Servtce Upgrades �NC •� Fences(Plot/Survey/Footage) -- - ,,
...s�t.. ; , .3 _ ..,
Driveways-Not aver Gounter if on•pubiic roadways.:needs RQiN� _.--_- � �
�
� .�;,;�
, ,_ ; . , t._ :- „ . '. . ` - _ . .
. � � ' � � ..
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, �
IOTICE OF DEED�RESTRICTIONS:� The:undersigned�undergtan�ds��#I�t;ihl�.p�rmit;may.be.�sub)ect�.to;"deed":resUi;ctions"�;;�;.�;�,;��;`,_.., ,
rhich may�:be��more�"r.esfrlctive�th�I�GounEy,ar�g�latforis:���TFie?i�nder's1gnedias�ume's�responsibiltty�'fo�compiiance w(th�any � - - � ,
�pplicable deed'�resMctions. - _ �;;`> :.,-..}�� , � r_ ' _ -- - - _ _ ' _ _ - _ .,., . � �
INLICENSED:".CONTR�IC�OR���AND'�CONTRACTOR RESPOwS1�iLITi�S:����If-�hetowiiei��has�Jhired�:a'coititractor or
Antractors to:undertake work,.:the may::be;rgqt�ired�to�;�.e.l�enseii:�in�.acco�dance:witli�sta#e��and:�local�.regulafions:���if�tlie���: �� . ,
. Y aw�..�::.,,., :.. . �.
ont�acto�'Js�noE•Ilcensed=a�"requlre�:=tiy law; both�the�own�r and�contracto�-•may�tie•cited-�foc~� misdetneenor ylolation
�nder �tate�law. If tfie owner or Intendeid�.contra�ttor�ai;e�,:uncertaln.,a�.to-what'licensin r uGements:,ma. r`s �fo�:-.tli'e.<���,=�_'����
�.. ,.;.,t,�.,,...,..,...,,., �� •. . ,
..x--••:�. 8: e4......,, . .. . Y.� PR�Y"
. _.....
�tended'wo►k,•they are�advised=to:clontact:the.Pasco?.�ounty.Buildi�g::Irispectlori;PDIvIsIon=Licens(ng�Section=at 727=847- �
. ,....,.
008. F,urthemio�e;�'(f=the��oin�ner��has-`Fil�etl�a'�conha6to� o��conCractors; he ls advised`to have;the conhactor(s).,slgn,. ;_ ,._. ,;,._
ortions of`the"contractor Block°,_of.�.thls^eppilcatlon�for..which�they..will...be�r.esp.onsit�le._:..I�you;�;as`:the:oininerisign�'as'tFie� ��� . ,
:, . -,,,, ..� _. ... .., �
ontractor,.that-�rriay be=an'indication�(h�t he=ls�notr'prope�ly 1laensed and is not'"eriqtled°`to-pennittingprivll'eges in Pascor ��
�ounty. . . . ^ " ` . ' , . : .... .. .,... --:_�.. `''�'-� " ' � ' ,
:,_ .:
, . . . - =_ � ._ ..��: -
'ItANSPORTATION��.IMPACTIUTILITIES'=IMPAC�'�AN�=i�ES0�1�CE REC0IIERY•FEE3:�The°nndersigned�understands �; '�
�at Tran'sportation Impact Fess:and.Recourse.RecoVery.�ees;may„�epply��#a-tF�e.constructlon;of:.new�buildtngs;:�change�of�':e'����=��'�'-"�'- ;�,.
se in exisHng•buildings;:a�[,�ezpanskin��:of=��zi.sN�ig�briiitlings;as spectfled.in Pasco County�Ordinance-number 89-0.T and _ �
0-07. as amende.d,.,��h�.undetsigned also_,urtderstands� thalt:`suchfees;-;as�may�be:-due;:.will�be Identi�ed at the�ttme�of'�=� `'��-�''` �
ermi�ting. it is iiirtfier understood th�t Tra�ispbrtation.Impect"Fees and��Ftesource Reco�ery��Fees,_;mu�t be paid prior to . .
�ce�ving a "certfflcate,of.occupancy"-�or flnat�.power�,release:��:lf�the.proJe�t-;does`:no�involve�:ar.certiflcate of occupancy.o���==�-.=`'�r�" :
nal powen„celease;�_the�;fees:�.mu�,t��be�paid�prfor,to;,permit Issuance. -Ft�iGtk�ermore;l�ffPascd,�County:°Water/Sewer"�Impackt�� ::;�-�..�< ,
jes are due, they�must be,.pald:p�lor to�perrr�lt�•I§syenc.e;�n�accordance,with;applloabte:Pascc'.County�ortlinances.
;ONSTRUCTI�N`LIENwLAVII�(Chapter 713� Flor�da�Statute��a�.amerrded): If valuaHon of work is$2,500:O.O�or;more;�I�� - , �:: �
ertify that, I,,_the_.applicent,._haxe:,�been=::pnovidetl�.wlth-a cvpy._of.-�the_"Florida��Constructton��Llen��:Law:-Homeowner's
�rotectlon Guide" prepared by;tF�e''Flo�ida Dep�rtment�of Agriculture and Consum�er,.�/kffairs: If the appl(cant Is someone�. ....r� :�.-
r... �.,.
ther than the"owner", I cert(fy;:th�t�.l.have,obf�ined�a�copy,of the;abQve..des,critie�d��cu�ent;an,d:;p.romi.se��in;goodc;faith�to: -.
eliver It to the.'owne�'°prto��to.rcommen'cemeriE:'-�'� �``"�� , � :� ,,. . .` . . �. . ...- - - .:-- � --- -
�ONTRACTOR'�IOVYNER'S-AFFID`AVIT: I.ce'r:tlfjr;st�i�t�:al�:�the-.Inf.ormetiom�.a��thl��applfcatlon is accurat�:and that all'work
rill'be done in compilance wfth all.applicable laws regulating construc8on� zoning and:�land�:development. Application is
ereby made to, obtain�:a=.permit;to.�..do:;wotk;�,and;�'In�tallation as ind[cafed:�:��`I: certify tFiat no work��o� Installatlon fia`s� -
ommenced'p�lor to'issuance of�a perriiit�and+thaf.alf work will be pertormed�to meet-standards<of ail laws regulating-
onstn�ction, County and City codes, zoning.regulattans, and land development regulattons'�intthe;-Ju�isdiction.>•I-�al'so
ertlfy that I u�derstend that the regulattons of other government agencies may�apply��;to the_.Intended work, and that it is
�y responsibility to Identify•what.actto.ns l must•take;to be,tln:.conlpllance;.;,Such agencie's�include but�are:not Itmited:.to: � _ '
- Department of Er�vironmental���Prote`cH�ii`�Cypress:`Bayhead�;`VIIeUand�Areas and Ernlronmentally Sensitive ��
Landa,WaterNtlastewater Treatment. 4. ,�� ' �, �
- �outhwest Florida Water Management�::I�tstrict Wells, ��Cypress• .Baylieads;�` Wetland Areas, Altering
Watercourses. - . .. .. `- ' �
- Army Corps of Englneers�3eawall§;Docks� Navig�tile Waterways. �
- 13epartment,of ,Health,:B;�.ReMatiilitatiVe;ServtceslEnvfronmen#'at<:Health��:Unit:Wells; W�ste.water��Treatment; ' .
Septicfianks: =. .., , _ �:� - - _ , � ' . . - --
- US Environmental Protection Agency-Asbestos abatement.:.
Federal Avletlon;AutMority=Runways: � � . .� =
understand that.the.folloiiving�restNctlons apply'fo�the�t�se offlll: --
- Use of fill is not allowed in Flood:Zone"V"unless expresslypermttted.
- If-the.flll�:materlal.�_i"s'�to�;bs':used:_Irt:.�F.lood�-Zone. "A", I�: is underetood-that a drainage��plan �ddresstng a
"compe�sating'volume"will be subm(tted at�ime of permitting wf�lch is prepared by a professtonal engineer �
Iicensed by��he;�tate��of;Flotlda; - ' . �� , ..
- If ih� flll.materiat`,i��to-be�-used in �lood �one 'A" in+connectton�with�:a��permitted building usln�g stem wall
� conatrvction,,l,certify that,fill,;vulll:ti.e:used only..to..iill the_are.a within�the s#em wall.
- �� If�fllf"mafecial�4ts��=to��be��used °in any�areei;`t`��certify that .use. of such'flll-will'not"adversely affect ad)acent
properties, If use of.fill.is found to advereely..�ffFecf�adJ�cent��pra�pertles,.the owner may be clted for violating ;
the cond�lo�is;of�the:tii�iiding�;permit issuedF..u�der the'�it��cfied_pecmit�applicatio��.foe:lots_less_�than�one (1)
acre which ar"e"�elevated�tty,f111;��t engineered dralnage pl�n�ls requlred. . r ,:
!am the AGENT.FOR.THE�O.WNER;'I>�proml'se�in.good,falth to�inform the��owner�of�#he:;permftting conditlons_set forth in :
iis affidavit priorto�-commencing'�con�huctlon: "1`understand'that a�aeparate pettnit may be requlred for electrical work,. , , . ,:`
y..�--, _..,.,,, ,.. _ _
lumbing, signs� wells,.,:po,ols;,,air..cond(tloning,.:gas..or�.otMec_.insfa��Ign"s nok speclflcal�y lncluded�in.the�applicatlon, .A „_ , ��
ermit Issued-sFiall be.consitrued to`be�a`Iicense>to��proceed with"tFle;work�and n.o,t,as~authoN �to violate��cancel;.alter, o� ^��
h!,..
9t aslde any�provistons�of•tfie tectinfcal..codes;:nor shall issuance�of�a.pe'rmlt�.prevent the 8ulldirig O#ficlal from thereafter ,,
:qulring a correctton.,nf errors..ln_plans�;,;consi`ruction.or irlolatlons��'any codes:.=Evsry p'ermit_issued:shalb.become invalid � '
nless the work auifioNzed-:by such perinit:�ts-coinmenced�witFitn,sfx;months of:permlt Issuance, or If work authorized by ' r
ie permit is suspended:or,abaqdoned,•for�a::per(od,af�eix�f6)�montFis,�after the.Nrne the�work��s commen�ced. �An extenston . '.�
iay be requested, in,writing� from the"�Building,�Offtclal°�,for��a perlod;not to.-exceed'ntnety{90)�,�ays:and�wilf`�demonstrate +��
stifiable cause for.�the extension�� If work:ceas.es,for ninety(90)cons.ecutive:day.�...the�ob�ts�considered aba�doned.� _ �.:�
- --.. �, . - _�.; --
IARNING TO OWNER: YOUR:FAILWRE.TC1.;;R�EC�ORQ�:A;;N.OTIGE<OF�-COMMEMEEMERtT:,MAY;RE$ULT�IN�:YOUR . a� - <<;
AYIMG TWI.CE;FOR IMPROVEMENT�;TO:YO,U,,R�::PROPERTY��.:1�°YO.U�I��EKID"TQ;�.�B�T�AIN�FIN�NE1�ICa;:�0�13ULT � �
►ITH YAUR LENDER:OR AN-ATTORwEY��FEIR�;R�COR0ING'1rOUR'NO ,'[C�::OF°���11AIf11ENC�E'AI�IT:' �
ORIDAJURA�•(F.S:-t17 j .� .... . . .,, � ,- _ .. , -
---- - _,—.-___.— : -_----- - _ - ---— —= - -^_ — -
NNER OR/qdENT i. . CONTRACTOIt� ,����� '
ibsatbed and s M(or a(flnned)before me'thl�" - " Sutisctlb'ed'and'—sV�iom=b(or'aftinned)�before;me�thi9 ..,
ny S— / �
ho Islare personally known to.me or�haalhave produced Who:(s/ere. rsona kiwwir�u nte;,or haslhave,produced. •
as:IdentlflcaHon:� - ` " .' as"Id`entl8cation.
t _ .'; .
. �
NoUary Public , t . 1 ;(�i � '�l/ Notary Public
�mmisslon No: Co Ion.No "J'��-.,
�::_ Commission#FF 150422
ime o1 Notary typed,printed or atamped Name of tJoteny. '„ R, n 8 nN roy 'n Ins ance Bpp�gS.$j019
�
s��� Proposal/Contract
� .�cdtt �Qa.cl¢��rz �a�•�, �rzc.
P.O. Box 1188 • 33010 SR 52
�
San Antonio, FL 33576 -�'��•
� (352) 588-ROOF (7663) • (813) 782-1330 �a�& ,
1-866-407-0559 • Fax (352) 588-9763 �I�a,�vred '
www.scottblackmanroofing.com
����� email: blackmanroofing@aol.com Date ,�j Z � .- f 10
L•'eG 057957
PROPOSAL SUBMITTED TO WORKED TO BE PERFORMED AT
�
Name / r /�R_���t Street
' Street � �D 7 (� vG GitJ ��/r h City
City � �,r Ill State Zip
State I"'� Zip Ovirner of Property
Phon�Number Fax Phone Number Fax
We hereby propose to furnish all the materials and perform all he labor necessary for the completion of: ,
�Remove existing shingle roof [�'Replace bad fascia boards at$�� �'v per foot
9'6ry-in with ❑ 30 Ib. U.L. �etic underlayment ❑ Replace 1x decking at$ . per foot �
❑Dry-in with a fully adhered underlayment$ �Install �� feet of ridge vents
additional
❑Install new galvanized valley metal ❑ Install 25 yr. fungus resistant 3-tab shingles
I�nstall new lead boots ❑ Install G�,Yc�i�.c- fungus resistant dimensional shingles ,
1a'(nstall new roof vents ❑Shingle manufacturer color '
�'fnstall new drip edge, �h i � color ❑ Install TPO, white rubberized roofing membrane
❑Install newflashing as needed ❑Other: Z d �-y �,,,�� eC i k. G lr�-�
epl e plywood at$ �S s vJ per sheet
C�"Repair rotten trusses at$ 3r°`J per foot � ' '
*Woodwork is an additional charge,see pricing above
All material is guaranteed to be as specified, and the above work is to be performed is accordance with the drawings and specifi-
' cations submitted for above work and completed in a substantial workmanlike manner for the sum of$ D D (�os U �
with payments to be made as fo��ows: Payment due in full on completion, unless otherwise noted. Thank You.
Credit cards.accepted, additional�3% charge.
*Not responsible for satellite signal when satellite is reinstalled *Not responsible r C&electrical.line too close to roof decking
II Any alteration or deviation from above specifications involving extra costs will be !
executed only upon written orders, and will become an extra charge over and
� above the estimate.All agreements contingent upon strikes,accidents or delays Officer/Agent Scott Blackman Roofing
beyond our control. owner to carry fire,tornado and other necessary insurance Note: ThiS P�O�OSaI may be withdrawn by us if not aeeepted
� upon above work.Workers'Compensation and Public Liability insurance an above i
work to be taken out by Roofing Contractoc Extreme caution should be used within � dByS.
during and after construction for debris and nails missed during cleanup.
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do
the work as specified. I have read the back of this Proposal/Contract, which contains Florida Statues 713.001-713.37.
Payment will be made as outlined above. Client gives permission to drive on riveway to deliver materials.
Accepted Signature � �'�.✓
Date Signature