HomeMy WebLinkAbout16-17579 CITY OF ZEPHYRHILLS I
5335-8TH STREEf
(8�3)780-0020 17579
' � � BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 17579 Address: 5128 17TH ST
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: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-20200-0180
Improv. Cost: 5,810.00 OWNER INFORMATION
Date Issued: 7/15/2016 Name: GARCIA BILLE & NOTHSTEIN RICK
Total Fees: 65.00 Address: 5128 17TH ST
Amount Paid: 65.00 ZEPHYRHILLS, FL. 33542
Date Paid: 7/15/2016 Phone: (813)469-5816
Work Desc: REROOF SHINGLE
CONTRACTOR S APPLICATION FEES
ALAN'S ROOFING INC REROOF RESIDENTIAL 65.00
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Ins ections Re uired
DRY IN R OF INSP
TAPE JOINTS ROO INaSF�('
FINAL -�l/ �
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 pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
i
C T CT I E PERMIT OFFI R
PER IT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
elsaaaoozo ' City of Zephyrhills Permit Application raX-��a-���-�uz��
Building Department _
i}ate ReGetved � �_ ` � Phone Contact for Permitting
Owner's Name ��\��e. � ` � Owner Phone Num6er
Owner's Address �,�CJ 1 �� Owner Phone Number� �
Fee Simple Titlehoider Name Owner Phane Nom6ar� �
Fee Simpte Titiehotder Address
JOB ADDEtESS ���� 1�� � i 1 ���1 1� �+ �� ��� LOT# ��
suso�vtSEo� [! � PARc���o# c� o� C�C� o� C�d 01 C'SO
{OB7AIHEO FROM PROPERTY TAX NOTiGE�
WORK PROPOSED e NEW CONSTR e ADDIALT Q SIGN C] MOVE Q pEMOLISH
tNSTAI.L REPAIFt
RROP05ED USE 0 SFR � • COMM Q OTHER
TYPE OF G4NSTRUCTtON Q SLOCK 0 FRAME [� STEEL Q OTHEFt
DESGRIPTION OF WORK �c�i ' e-!\WS� � S� `��t � I��,`� � �
BUILDING SIZE � � SQ F007AGE� � HEIGHT
! 0 BUILDING r�/"�E /�� VALUATION OF TOTAL CON5TRUCTION
' � � V v
� ELEC7RICAi, �$ � AMP SERVtCE [+� PROGRESS ENERGY C] W.R.E.C.
�
� PLUM6ING �$ � , ��� G�
� �;{r�' �
0 tv1EGNAi�lICAL � � ALUATION OF MEGFtAFJlGA�IAlSTALLATtON �!
�►�i�.�o
� GAS Q ROt7F1NG SPEGlALTY Q OTHER
FINISHED FLOOR ELEVATIONS � � FLCIOD ZONE AR�A QYES QNO
8U1Li}ER GOMPANY
SIGNATURE REGIS7ERE0 Y/ N FEE CURRENT Y!N
Address License# �� �
! ELEGTRlGlAN COMPANY
SiGNATURE REGISTERED Y J IV FEE CUI2RENT Y J N
� Addres� � �icense# �� ��
�
' PLUMBER COMPANY
S16NA'1'IIEtE REGISTEftEi} Y/ �I �E$CURREiJT Y/N
� Address License# � � �
MECHANICAL COMPANY
SlGNATURE REGISTEREO Y/ N FEE CURRENT Y!N
Address Llcense# r V��_ � �,fJ`1�Ck. �
OTHER COMPANY
SIGNA7UR REGISTEREO Y/ N FEE C RENT Y/N
Addre / �.�.�� b t � -e �"�„()�1 �i�/'�. Lfcense# � �
RESiDENTiAI. Aftach(2}Plot Plans;{2}sefs of Buildiag Pians;{1)set of Energy Forms;E2-O-W Perrnit far new construction,
Minimum ten(10)working days after su6mittal date. Required onsite,Construckion Plans,Stormwater Plans w/Silt Fence installed,
a�'anftary Facilities&1 dumpster;Site Work Permit far subdivisionsllarge projecks
GOMMEFtGiAi. Attach(3}camplete sets of 8utfding Plans plus a Llfe Safefy Page;{i)set oE Energy Forms.R-O-W Permit for new consWctlon.
—�-�-- �- ,- - PJlinimum,•ten(10)�r�orking days-after submittal-date:-Required onsite,-Construction Plans,Stormwater P_lans w/Silt Fence installed,_
8anitary Factlikies 8�1 dumpster.5ite Workc Permit for al!new projects.A!!commercial requirernents must meet compqance �
StGN P.ERM�'i" Attach{2}sets of Ertgineered P1ans.
""'PROPERTY SURVEY required for all NEW constnaat(on. '
Directians: -
Fifl out application completely.
Owner 8 Contractor sign back of application,notarized
i#over$25QQ,a Notice of Cammencement is requlred. (AIG upg�ades over$SUOQ�
"' Agent(for the contractor)or Power of filtarney(for the owner)would be sameone with notarized letter from owner authorizing same
I OVER TFtE GOUNTER PERMITTING {�rant oFApplication Oniy}
Fteraafs Sewers Service t,ipgrades AIC 'Fences(Ptot/Survap/Footagej �
Driveways-Not over Counter if op pubiic roadways.:needs ROW
NOTlCE C!F DEED RESTRICTIONS: 7he undersigned understands that this permit may be subject to"deed"restrictions"
whiah may be mare restrictive than Caunky regulations. The undersigned assumes responsjbilify for compliance witfi any
applicable deed resEricfions. � �
UNLICENSED CONTRACTC?R5 ARiD CONTRAGT�R RESPQNSIB!l.iT1ES: !F the owner has hired a contractor or
confracfors#o undet�Eake work, they may be requlred to be (icensed in accordance wikh state and loca! reg�alativns. If#he
contracEQr is not licensed as required by law, both the vwner and contrackor may be cited for a misdemeanor violation
under state law. if the owner or intended cantractor are uncertain as to what iicensing requirements may apply far fhe
intended work, they are advised to con#act fhe Pasco Counfy Buiiding Inspection Division—Licensing Sectic�n at 727-847-
8009. Furfherrr►ore, if the owner has hired a contracEor or contractors, he is advised to have the cantractor(s) s�gn
porfions af the "contractor Bfock" of tttis app4ication for which Ehey wil! be responsible. If you, as the owner sign as the
conkractor, that may be an indication that he is riat Qroperly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACTIUTI�.iT1E5 1MPACT AND RESCiURCE RECCIVERY FEES: The undersigned understands
that Transportation Impact Fees and RecQurse Recovery Fees may appiy to the construction of new buifdtngs, change of
use Rn existing buifdings, or expanslart 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
permit#ing. It is further understood that Transportatian impaat Fees and i�esaurce Recovery Fees must be paid prfior to
; receiving a "certificate of occupancy" or final pawer release. If the project does not invoive a certificate of occupancy oc
finat power reiease, the fees must be paid prior ta permit issuance. Furthermare, if Pasco County Water/Sewer lmpact
fees are due, they must be pafd prior ta permit issuance in accardance wltl�applacable Pasco County ord3nances.
CONSTRUCTION �.IEN LAW(Chapter 713, Florida StatuEes, as amended): If valuatian of Vvork is $2,500.00 or more, I
certify that I, the applicant, have been provided with a copy af the "Florlda Construction Lien Law—Homeowner's
Protection Guide" prepared by the Fiorida Departmenf of Agricuiture and Consumer Affairs. If fhe appifcant is someane
afher fhan the"owner", 1 certify fhat# have obtained a copy o#the above described document and promise tn good faEth to
cietiver it ta fhe"awner"prior to commencement.
CflNTRACTOR'SlOWNER'S A�FIDAVIT: I certify that all the infarmatian in this appiication is accurate and #hat aN wark,
will be dane in compliance with all applicable laws regulafing construcfian, zoning and tand devetopmenf. Appiication is
hereby made ta obfain a permit to do wvrk and instatlation as indicated. t oertify that no work or installation has •
� commenced prior to issuance of a permit and fhat all warlc w�ii be perFormed to meet standards of a!I laws regulating.
consfruction, Gounfy and City codes, zoning regufations, anc! land developrnent regulations in the jurisdiction. I also
cert�fy that i understand that the cegulatians of other government agencies may apply to the intended work, and fhat it is
my�esponsEbility to identify what actions I must take to be in compliance. Such agencies inctude buf are nof iimifed#o:
- Department af Environmenta( Profecfion-Cypress Bayheads, Wetfand Areas and Environmentafily Sensitive
t..ands,VVater/Was#ewater Treatmenf. '
- Southwest Florida Water Management Distriat-Welis, Cypress Bayheads, Wetland Areas, Altering
Vilatercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable 11Vateruvays.
- �Department of Health & RehabiliEafive ServiceslEnvironmentai F#ealth Unif-We11s, Wastewafer Treattrten#,
Septic Tanks.
- US Environmenfa!Protection Agency-Asbestos abatement.
- FederaE Avlation Authority-Runways.
1 understand that the following restrictions apply to the use of fill:�
- Use of fili is not allawed in Flood Zone"V"untess expressiy permitted.
- ff the fi(( maferiat is Eo be used in FEaod Zone "A°, it is undetstood Ehat a dtainage plan addressing a
"cornpensating volume" wili be submitted at time of permitking which is prepared by a prvfessional engineer
i iicensed by the 5tate of Flor�da.
- - �- If the #il! materfal is #o be used in Flood Zone °A" in aonnec�ion with a permitfed building using s#em wall
� construction, i certify that fiil will be used only to fitl the area within the stem wali.
- If fill material is to be used in any area, 1 certifiy that use of such �{t wiil not adversely a#fect adjacent
properties. If use af�ill is faund to adversely a�fect adjacent properties, the owne� may be cited for violating
the condifions of the building perm9t Issued under the attached permit application, for lofs less than ane (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 faifh to inform fhe awner of fhe permitt9ng conditiot�s set forth in
this affidavit prior to oommenaing canstruc#ion. i understand fhat a separate permit may be required for electrica) work,
plumbing, signs, weiis, poais, air cvndifioning, gas,�or other installations not specifically included in the application. A
permit issued shali be construed ta be a license to proceed with the work and not as authority to,violate, cancel, alter, or
set aside any provlsians of the technical codes, nor shall issuance af a permit prevenf the Suiiding Officiat firam thereafter
requiring a correction of errors in plans, construction or vlolations of any codes. Every permiE issued shail become invalid
unless the work authoriaed by such permit is commenced wifhin six manths of pertnit issuance, or if work aeikhorized by
the permit is suspended or abandaned for a period of six{6)months after the time the wark ts commenced. An extension
rriay be tequesteci, in writing, from the Building C?fficial for a period not to exceed ninety (90) days and w(II demanstrate
)usfifiable cause for the extension. !f work ceases for nfnety(90)consecutive days,ti�e�job is considered abandoned.
WARNING TO oWNER: YOUR FAILURE To R�cciRu A NOTICE oF COMMENCEMENT MAY RESULT !N YOUR
PAYING TWICE FO tMPROVEMENTS TQ YOtJR PRf)PERTY. fP YQU IN7END TO OBTAIN FINANCING, GONSUL.T
f WiTH YOU��Ei�i�E ���'+N�tTT fd "!'BFPOFtE RECORDING YOUR NO ICE OF CONfMENCEMENT.
FLQftiDR JUFtAT{P:S.1 ..03
,
������A�� CONTRACTOR
S bsarlbed and s om t a med re e h Subscribed and swom ta{or attirmed)be#ore me thfs
—._6y _ �Y
o istare,�ersona nown to e or haslhave produced Who Is/are personally known to me ar hasJhave produced _ _ ti
as IdentificaUon. as fden6ficatton.
c �
^Notaty Publtc Nofary Pubiic
Commission No. Commission Plo. ,
Name of Notary typed,prinEed or sfar�ped,_ �,,,�� , Name of Nvtary lyped,printed or stamped
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,; "�� �n� ,,.,, .. �.,M1•�I�_; �',�:8; t�lY COMMISStQN#�F22716g!t
w„�t „�.:: .�.a R;;�Q�,4: �'xF�RFS tv�ay 45.2C119 !
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� p���.. � CONTRACT Hernando: (352)686-3330
��A� � �t,�{��������C� � �—' Cornmercial 8� Residential (352�754-8884
14498 Ponce De Leon Bivd. "Home of the FREE Roof Inspection" CI�1'115: (352)341-1400
Brooksviile, FL 34601 vvww.alansraofinginc.com P�seo�(727)gls'g27$
-, l.{CENSE NOa_cccoas9�2 Toll Free: (800)309-5667
�������. �; �, � ��; � �ax: {352}754-8902 �
��. � i.r��� � e:,s=... s, �:
PEease Print '" �` `�`" �"' i
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� `� PHONE DATE�J�:O������
NAME� �:Ilt c� � �ti.0 6: s ~a,
RDDRESS ���� 6� ��� � q CITY�"�t,,'�'. ' `� ' " '!r ��� ZIP '�-..� .���
�" ..<, M.HOME c�.,{�E�a
SALESMAN�c.``"�'� ' �`�'Vay�"'�- CONTACT PHONE�,�+�*° "'�-�✓ �'r�`� OTHER COMMERCIAL JOB#
BRAND AND DESCRIPTION ,� e q � � GOLOR�j�::���' ��'�� °9�`w-- PITCH 7'�`� '�'
OF PRODUCT � 9� .� d ti�`a�a f.�..'-" �' `�
['� 1. PULL A CITY OR �COUNN PERMIT -%='���-��?¢-SQ.RENAIL WOOD
°� 2. TEAR OFF. SQ.OF OLD SHINGLES SQ.OF FLAT ROOF SQ.0�OI.D T1LE
�� 3. DRY IN:����1NDERLAYMENT �1 LAYER ^ 2 I.AYERS PEEL 8�SEAL
' 4. INSTALI.: �� GALV.VALLEY METAL LF ._.:, SELF ADNERING VALLEY LINER I.F � METAL OVER R1DGE LF
5. INSTALL. y"`ALUM.DRIP EDGE !F�_���STEEL DRIP EDGE�F ��� PAN FtASHING LF `�L.FLASH(NG LF ��COl.OR '
�
'�6. INSTALL REPLACE: LF OF R.V. PLUGS COLOR ���� � FT VENT SURE
i 7. REPLACE:_�1 1121N. °'�' 2 W. �/ _31N. LEAD BOOTS �---" 41N.GRV'S�"10 EN GRVS _� ELEC.R1SER
8. d fG �'' STARTER RO�L STARTER STRlPS CIRCLE ONE
9. LAY SQUARE OF�NEW FIBERGLASS SHINGLES � CAP 3-TAB / QF�R/ HIP&RIDGE
` ,�
❑ 10, iNSTAtt: ��-SM.DEAD VAl.LEY '�LG.DEAD VALLEY ^�' MOD3FIED � �IBERTY
❑ 11. lNSTAt�: � TPO �� LAYER OF lNSULATlON `� TBAR/SFAM TAPE
❑ 12. INSTALUREPLACE: �"X'2 ,-_- 2 X 4 -�•4 X 4 •�- SKYLIGHTS ACRvttc SFn FtxED cuss
DOMES CM CLASSIC
�i3. HAUL OFF ALL TRASH AND RUN tNAGNETAR0UtV0 GROUNDS
(�' 14. ALL WOOD WORK W1LL BE EXTRA PERA7TACHED WOOD BILL � u'� ��_:� °���d�e' �,g"4.1 �'�.������,,�. - " �s' _":
ALAN'S ROOFiNG NAS MY PERMISSION'f0 CQNTRACT W{TN AN ENGINEER�F Il''S CNQiCE TO
5� CONDUCTANY QR ALL INSPECTIONS THAT MAY BE REQUIRED UNDER LOCAL OR STATE LAW
Q� 16. SPECIAI.INSTf2UCT10NS ��'�s����. `,��'&'� �Q �� � �`g;�'-5�-'
T � "`� G ��(�.q17r' �y Y'U'-"T,��„+���Cc.'^ola. 'f' U'i J W t�:.'�
_ TI�TAL, CONTRACT AMOUNT ,� :��� �' "'
Price is gaad for 3Q days DEP4SIT �'�✓ j � �
ACCESS:Customer agrees to allow access to tha property and realizes that heavy equipment is being used. ��
ConVactor shall not be liable for,without limitation,damage to driveways,sidewalks,lawns,sprinkler systems,gardens,sepqc syslems and any gALANCE DUE UPON
other strudures thereaf,as a resuit of rooitop ar job deliveries. �' {_„ `'��"
DAMAGE ETG..Gustomer shali be responsibie tor removai,reinstaitation and recaiibration ot sateiiite dishes.Shontd customer become aware GOMPLETION � �-f �
a(damage to pmperty by Contrector,his agents,ar employees during the course of instaliatlon of the root,said damage shali be 6rought to the
attention of the Contractor pnor to the time of payment for the roo(in question. If Cuslomer f8ils to notify ConVactar of said damage,within 5
working days of occurrence,then shall Waive all t3ghts agains[Conlractor conceming said damage. Alan's Roofing is not responsible for roofing nails penetreting A/C lines in hhe atlic. Customer egrees lo secure and
pratect theit assets inclading Shetves,ceiling tans,faals and other vaSuables to avofd damage from vibration,breakage andJor detachment of parts,etc.
DELAYS,E7C. Hereby acknowiedges tbat Contractor may be subject to delays occasioned by inctement weather,labor disputes,and materia!suppSy shortages or other causes which are beyond the wntrot of the
Contractor and hereby accepts delays Or.Casfoned by one or all of these circumstances in lhe inslallation of lhe roof.
PAYMEN7 OF CONTRACT Customer hereby egrees that all amounts due for this vrork shall be paid upon campletetlon of installation,Any amounts unpaid will bear Interest at a rete ot 1 7!2%per month.Contrector shall
be enfitied to aiS costs ot callecNo�lnGuding attomeys'fees.
RtGHT TO CANCEL:!f this Ia a Home Soticitetio�Sate,and if yau do not wani the goods or services,you may cancel this agreement by providing wntten not'sce to the seller in petson,by telegram,or by mait.This notice
must indicale that you do noC want the goods or service and must ha dei'rvered or postmarked before midnighi ot the third business day after you sign this agreement.if you cancei this agreement,tha seiler may nat keep
all or part o(any cash down payment.
IF THIS IS NOT A HQME SOLICITATION CONTRACT Once it is eigned;you are bound lo it by lhe laws of lhe State of Florida.If in the event you hreach or atlempt to cancel this canUact,the Contraclor shall be
enSNed to att lost profiis fmm the contract.
ACCEPTANCE PRQPOSAL. The above prices,specifications and conditions are satisfaaory and hereby accepted.
All contracts are subject to Alan's Roofing,Inc.management approval.Customer agrees to allow PJan's Roofing,Ine. ��^'
to use photas,tetters of recammendation,satistactions fortns,etc.to be used ta�advertising purposes. "
x �
In case any one or more of the provisiorts cantaiaed herein sha3t ba invaiid,iitegat or unenforegat�te io any resped,the vaSidity, ¢�"� y �'A`s::.+:�c,v---�-"
legality and enforceability o(the remaining provisions and other applicatian thereot shall not in any way be aNected r imparied. SALESMAN SIGNATURE �� *'�`'� �"�="f
%� � �!/
�-^;d.^s ;
CUSTOM£R StGNATURE I����,�.L,�. Y.. .S�'�?/_,-r^.G��.- DATE �4�Q`^� �'�� MRIVAGEMENTAPPROVAI
Construction Industries Recovery Fund: Payment may be available from the construction indusVies recovery fund if yau lose money on a project performed under contract,where the
loss results trom specified violations of Florida Law by a State Licensed Contractor. Far i�fortnation about the Recovery Fund and filing a claim,contact the Florida CILB at the following
teiephone number and address:850-487-i395. Florida ConstrucfiaR Industry Licensirrg Board,I940 N.Monroe Street,Tatlahassee,FL 32399. 'C&01
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' 2016110815
Rcpt:2786520 Rec: 20.00 .- --
DS: 0.00 IT: 0.00
Key No. ' Permittvo 07J15/2016 J. R. , bpty C1erk
NOTiCE dF COMMEf�CEMEF�bT ���� ��� �� ��
THE UNDERSIGNED hsreby gives notice that improvement wiit be { ,(�� +�^� 1 �
Made to certain,antl in accorda�ce with Chapter 713,Florida State �� i��Y\\� I,�) 1 L- v"d� 1�
Statues, the to!lflwing information is provided in this Notice of
Commencement:
1 Description of Property. Parcei Na.: �1 (7l� � ` V V} ti✓ CXI��� LJ�O v
{Lega! desCription of the property and streei address if availabte)
2 Gen ra! escriptian of Improvement:
'2—�
3. C?wner inform�ation. N me. C�
Address '�i1�1� �1�� City -e i State�L Zip�, ►�01,
Interest in Property: Fee Simpte �
Name and Address af Fe� Simp(e Titiehofder(If other than owner) .
� Con4ractor: Name: Rian's Raofinq !nc
Address• 14498 Ponce De Leon Blvd City Brooksviiie S#a#e FL. Zip 34601
� Phone No. 352-68fi-333C! Fax No. 352-754-8902
5. Sure'�,�• "-:_,� Amount of Band. $
.�:�ress: City State�Zip
Phone No. Fax No
6. Lender: Name� �
Address: City State_,__Zip
Phone No Fax No
7 Persons within #he State of Florida designated by Owner upon whpm notices or other documenEs may be
served as provided by Section 7'l3.13{1)(a}{7} Flori:ia Statutes.
t�.l�r!1P..
Address' City �tate �Zip
Phone No, Fax No
8 In addtion to hirr,�=':;;, ;�ers�ir, Owner designa'res t�/A of
�� ;�:caive a copy of the Leinar's Notice as provided in Section 713 13(1){b), Florida Statutes
9. Expiration date af Notice of Cammencement(the exp'sration date is '! year of recording uniess a different
date is specified.)
WARNING TQ OWNER:AfYY PAYMENTS MAl7E BY THE OWNER AFTER THE EXPiRATiQN tJF TtiE PtOTiGE d�COMMENCEMEN7 Af2E
CONStDERED IMiPROPER PAYMENTS UNDER GHAPTER 7I3,PART 1,SEC 773.1J,FLORIDA STATUTES,AtVD CAN RESULT fN YOUR
pAYlAiG�!'JtCE FOR IMPROVEMENTS TO YOUR PRCIPERTY.A HOTICE OF CQMMEflGEMENT MUST 9E RECORDEp AND POSTED ON 7HE
JG18 StTE SEfqRE THE FlRST 3NSPSCTIQN.IF YOU INTEN�TO OBTAtN FtNANCiNG,COfVSUtT Wi7N Y6VR LEJvnER OR AN ATTOFtNEY
BEFORE CUMMENCiNG WOFtK OR i2ECORQiNG Yt3UR tJOTICE QF COMMENCEMENT.
/{�� �//�} e
x /-./.�GJ`.�Q o ,�'�.�
Signawra of pwner ar Owner's•A�thori2eC OKcerlClireGiorlPartnerlManager S�gnatory's Titf@IOKCE
""S}gna�tu{re Reqvired by same betow 6y'X"mark••• ����y�'-'Ji����
stare of ���Y1�AV• ``,, �{ co��cy or
7he forgoing instrument was aCknowtedgetl before me this��{day of,1�U1 24�by ��1��:Q, t ��.i�
a5 � (Pr�nted name a�son ackncwledgi�g)
for
{Type o(aulitiorrt .g�otfiae,irusie , e in fact) (Name of party on behal(UI who insVument was executed)
Signature of olary Print Typa or Stamp Name o(Notary
PerSonaiiy known OR Prod.y ced ideniifi �on ✓�
Type olldenfification Produced: iy��$��S'���-
Veritication purauant to Seetion 92.525,Ftorida Statutes:under f'enalties ot perjury,1 dectare that I have read the foregaing and tAet the tacts '
stated in It are true to the be'st of my knowledge and befiel.
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•PRULA S 0'NEIL,Ph.p.pRSCQ CLERK & COMP7ROLLER
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����: a�,�� S?ATE OF FLORIDA, C�U(�TY�F PASCCJ
�� �o� THIS IS 1'q CERTIFY TMA7 TH�FOREG@IN�IS q
��', e �0 TRUE AND C�RRECT COPY OF TFiE DOCUM�NT
•, � ON FILE Of�QF PUBUC R�C4Rp IN TFIIS QF�I�E
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��"��, �r --_�<�DAY OF ��
� � , '�, ,�� •� PAULA S. O'NEIL, CLERK& OtJIPTROLL�R
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�,� ' • � ����° BY- L�'/�• DEPUTY CLERK
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L��'� "Home of the FREE Roof Inspection"*
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July 14, 2016
To Whom It May Concern:
I, Alan J. Field, hereby grant authorization to Holly Field, to act on my behalf with the City of Zephyrhills
Building Department while conducting activities related to obtaining permits and contractors licensing
' These activities specifically include signing all documents requiring signature of"contractor".
Holly Field is to be considered an agent of my business and therefore the signature of said agent is
binding and causes me to assume all responsibilities connected to or associated with the signature as
they may relate to my roofing business.
If you have any questions regarding this matter, please do not hesitate to contact me.
Sincerely,
�
Alan J. Field I
President
The forgoing instrument was acknowledged before me this 14th day of July 2016, by Alan Field, who is �
personally known to me and did not take an oath.
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Notary Signature& Expiration Date
Commercial&Residential
Hemando:(352)686-3330 • Citrus:(352)341-1400 • Pasco:(72'n 816-9278
Toll Free:(800)309-5667 • Fax:(352)754-8902
vwvw.alansroofinginc.com
'ResVicfions Apply