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Home My WebLink About15-16861 CITY OF ZEPHYRHILLS � ' S335-8TH STREET - (813)780-0020 168 1 BUILDING PERMIT � PERMIT INFORMATION � � LOCATION INFORMATION Permit Number: 16861 Address: 37422 CORNWALL 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: WEDGEWOOD MANOR Est. Value: Parcel Number: 10-26-21-0120-00000-0430 Improv. Cost: 7,500.00 OWNER INFORMATION Date Issued: 12/29/2015 Name: LETO, JOHN & ROSE Total Fees: 75.00 Address: 37422 CORNWALL DR Amount Paid: 75.00 ZEPHYRHILLS, FL. 33542 Date Paid: 12/29/2015 Phone: (813)782-1300 Work Desc: REROOF SHINGLE CONTRACTOR S - - - APPLICATION FEES FOSTER ROOFING INC REROOF RESIDENTIAL 75.00 l�— � �- �� -� � �� ' � ' Ins ections Re uired - - i DR N ROOF I SP TAPE JOINTS RO F NSP /" FINAL � ' �� t 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 performed in accordance with Ci Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. 1 � CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION , CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER " i 813-780-0020 � City of Zephyrhills Permit Application Fax-813-780-0021 . Building Department Date Received Phone Contact for Permittin — 9 ` g� 3 � �� Z - 13oo Owner's Name �oh� �Q�(� Owner Phone Number Owner's Address ��y�—Z- l.�rn �al 1 � r Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS �� -1 ZZ CO�'n UL�CLI� � Y LOT# � SUBDIVISION ��C�' e- �.X�C�C..�' . PARCEL ID# , (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED � NEW CONSTR e ADD/ALT � SIGN Q Q DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR Q COMM � OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q DESCRIPTION OF WORK oL CR� I � r PQ Q.` �1 J C� I BUILDING SIZE SQ FOOTAGE C] HEIGHT � \�i � OBUILDING $� C"�' VALUATION OF TOTAL CONSTRUCTION LJ QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. �PLUMBING $ QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION QGAS � ROOFING Q SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� 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# i MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# OTHER COMPANY � SIGNATURE REGISTERED Y/ N FEE CURREA Y/ Address �� License# � RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,_Stormwater.Plans w/Silt Fence installed, - • - Sanitary Facilities&1 dumpster;Site Work Fermit for subdivisions/large projects COiVIMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. Required onsite,ConstrucGon Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster.Site Work Permit for all:new projects.All�commercial requirements must meet compiiance SIGN PERMIT Attach(2)sets of Engineered Plans. ""*PROPERTY SURVEY required for all NEW constn�ction. Directions: Fill out application completely. Owner 8 Contractor sign back of application,notarized If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) "* Agent(for the contractor)or Power:of„P+ttomey.(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING • .(Eront-of Application Only) Reroofs if shingles Sewers SerGice Upgrades A/C Fences(Plot/Survey/Footage) Driveways-Not over Counter-if on public,-Yoadways..needs ROW ;, r NOTICE 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 appiy 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 specifed 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 Water/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 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—Homeowner'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'SlOWNER'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 pertormed 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 government 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, Water/Wastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. - Department of Health 8� Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, 'c Tanks. Septi - 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 will 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 speciflcally included in the application. A 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 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 permif 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 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT I�IAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUF�CEND�R OR N�e�TTORN�Y BEF�RE RL��ORf�I1VG XO_ FZ_NOTICE OF OMMENCEMENT. FLORIDA JURAT(F.S. 17.03) ` — - `" — - —-__- — OWNER OR AGENT CONTRACTOR� Subscribed and swo t (or affi ed b ore me th' Subscribed and s m t (or affi med fore m ��-Z$ -15 by � �2'Z�-1S b � Who is/are personally known to me or has/have produced Who is/are personally known o me or as/have pro ce as idendficatlon. as identification. i \ � _ Notary Publlc otary Public Commissfon No. ommission No. ,��, �,�� HEATHER D.HOSFELD' ::��pYPVB�� HEATHER D.HQSFELD '��.• ;�°= Notar Public-State o( r• .�s t Fi��ir�- - - ' Name of Notary typed,pri �o pe Name of Notary typed,printe E 'My Comm.Expires Mar 21,201 E� :N„• .Q. y Comm.Expires Mar 2t,2� '•'''F o?; Commission#FF 72365 � ��'%'FOFF��'P�� Commission # FF 72365 ir. ��""��"' '��„��,,,,•. p�cc� � � lIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIiII I IIIIII IIIII IIIII III 2015183846 _ _ _______ _ __ Rcpt:1727892 ITeO0.00'00 D5: 0.00 11/16/2015 K. M. , Dptv Clerk PRULR 5 0'NEIL,Ph D PRSCO CLERK & COMPTROLLER Keyr�o. i PermitNo. 110R66K 1�2��m PG 3133 �N077CE OF COM1ilENCEMENT _ _ THE UNDERSIGNED� �y gives notice that imp rovement will be made � to oerfain real �aridin axordance with Chaoter 713,Florida State E S'taMes,the fp ng rdprtnation es provided in this7Jotioe of ; Ci0R1�IlERC67i1Cili: I � tbis sp.aoe reserved ror re:,wder . ..............................._---'---'---�-�•__--��_--__�_..._.--,�.—_-. t. Descri on�Pro Pa�el No. D ��LL`� c� ��',%� ��"' •/f'�,��;��5 � �: 1a-2�-21-D/� - �.�� ° � � � .� ��z� �C�/i� (Legal description of the properly and streflt 3ddress if available 2 General De�aiption of Irt�ravement RPrc�f / G'� y5 :7/�� ;�G/��J 3. Owner Iniort�a6on: Name c�6 n !�7'0 � � r � _ _-.� AddIeSS' � �7 n..' • / ily ' o . . - /i e p S S. `7 7-�'� Interestin operty: . ` ' -`` r-• . "`"�� ., ,� � � _ , Name oi Fe�S�mple i r r owner: ' - Address i dy e p ' Foster's Roofin 4. Contractor: Name Address: �y e FL p Phone No. � 3��aac�p� ax o. - • 5. Surety. Na�e Address Amnunt o � nd: ne � ax o. e P s. �ersder. Nar'ee wA Address � ty e P Phone No. � ax o. 7. Persons witE�in the State of Rorida designated by Owner upon whom notioes or other documents may be served as provided by Section 713.13(1)(a)(7� RoridaStatutes: Name i�A1jA Address Ciry �y�e Phone o. � Fax No. 8. In addition tp himself or herself.Owner designates �A of to receive a py of the Lienors Notice as pr ' m on � .1 i , onda utes. Phone Nn. f�person or eMity designated by owner: 9. E�iration d�dte oF Notioe of Commencement([he e�iration date is 1 year fram the date of recordng urdess a different date is specified_) WARt�NG TO OWN�R:ANY PAYMEtJTS MADE BY THE OWNER AFTER THE EXPIRATION OF'THE NOTICE OF CO�M�ICEMENT qRE CONg�DERED IMPROPER PAYMENiS UNDF�i C 713.PART 1,SEC 713.73,FLORIDA STAMES,AND CAPI RESIILT IN YOUR PAYING 7WiCE fOR IMPROVEMENTS TO YOUR PROPEHTY. A Npi10E OF EMENT NUST BE RECORDED AND PO$TED ON THE JOB SITE BEFORE 7HE FlRST INSPECTION. IF YOU tt�ITENQ TO OBTAIN FINANCMG, T WfTH YOUR OR AN ATTORNEY BEFORE COMMENGNG WORK OR RECORDING YOUR NOTICE OF COMMENCEMEM. � r� or Oamers ed �cer rector ager � natory s rtl ice »• �Dtqeqtdr�edbysame6elowbyX'mark«• STATE OF ��'"�U' � COUNiY OF I�.s�a ,,/ .1/ . The foregoing insWmjer►t was acknowledged before me this�day ot /v0✓ � 201�by ��/�11� �� , as Ownef for me o erson� (Type o/i aytlur'"ti y g.g.,otllce,uustee,attor fn tace) (Name ot party on behalf ot who ingnunent was exewte� ` ,��,RY P�/ ` y ,to�,.,,�,� DOUG CLOWES ignature o � Print,Type or o I O N N F F 1 2 2 4 5 7 Persortaly Knovm OR Produced Identific�ti�n ,� `oe PIRES:May 20,2018 Type of Identificatinn r uced: �Y/_ /�/_ 9�OFF�� B��dThruBudgetNolaryServices Verification pursuant Section 92.525,Florida Statutes:under penal6es of perjury,I dedare that I have r�ad the foregang and that the facts stated in ii are, we to the best of my novdedg and be�iet. �o�PR•:;'�� DOUG CLOWE3 � ,� � � * MY COMMISSION b FF 122457 n� re o , erson rnng e �,r aP EXPIRES:May 20,2018 I 9�FpF�Oe'� BandedThruBudgetNotaryServices � � I I � ' Noc-�s.wpnnvro�i� 9na�m�g I i ��a�� ' -� � �'�� STf��°�� Fl�Ct�tlD�,CQ4J�JT1(OF PASCO � a� .e.Y�`�` . • �, o � THIS IS TO CERTjFY TFiAT THE FOREGOING IS A .,, In rudZyP r�.r , �S TRUEAND CORRECT COPY OF THE DOCUMENT ,�,E.�4� o ON FILE OR OF Pl'BLIC RECORD IN THIS OFFICE `�.� �� ; . � WITNESS MY HANO AND OFFICIAL SEA�THIS �-`c'�' ��u' �� ,`��° �� J� tr3�s7 �� G o !�' �:�-. ; �DAY G, •�� PAULA S O'NEI , CL K&COMPTROLLER '�"��° � � `O�' ��Fi�d� BY l/ DEPUTY CLERK i 10119l2015 Florida Buiiding Code Onlir�e . � _ ;, _ � �'�Y��' aK s �• � • • � , • • 0 • O ' _ �': '.r,;, r..'��"2�YuA�.;�._,::;^. � � 8Q5 Ho e � Log In � User Regisdation � Hot Topi6 � Submft Surcharge � S[ats&Facts � Publlotlo�tt I FBC Staff 1 BCIS Site.Map • Llrtks ; Search � � ��!I�d Cs'F'3t?i?i2flt: i uUJ�l1�J ��r a�` etA roval � �r Produ PP ��I g�n USER:Public User f si� Pro es �egu�ation p u A roval M nu>Product or Aoolication Search>Aool(cdtion Lis[>Appl'iration DetaH a e . �# FL2569-R10 ° ��B Appli ation Type Revision � Code Version 2014 Applf ation Status Approved Com�nents Arch ved Prod ct Manufacturer Soprema,Inc. (Ca�ada) Address/Phone/Email 1640 rue Haggarty Drummondville, NON-US 00000 (819)478-2400 Ext 3327 imemathieu@soprema.ca , Auth�rized Signature Marc-Etienne Mathieu memathi eu@soprem a.ca � Techhical Representative Marc-Etienne Mathieu Address/Phone/Email 1688 Jean-Berchmans-Michaud � Drummondville, NON-US 00000 � (819)478-2400 Ext 3327 --- i memathieu@soprema.ca Qualty Assurance Representative Jean-Francois Cote, Ph.D, Add ess/Phone/Email 1640 rue Haggarty Drummondville � (888)811-3145 ; jfcote@soprema.ca Catqgory Rooflng ' Subcategory Underlayments i Comlpliance Method Evaluation Report from a Florida Registered Architect or a Licensed ; Florida Professional Engineer '� d Evaluation Report- Hardcopy Received Florida Engineer or Architect Name who developed Robert J. M. Nieminen the valuation Report Flor da License PE-59166 Qua ity Assurence Entity UL LLC � Qua ity Assurance Contract Expiration Date 10/16/2017 Vali ated By John W. Knezevich, PE ! � Validation Checklist-Hardcopy Received I Ce lificate of Independence FL2569 R10 COI 2015 01 COI Nieminen.odf RefArenced Standard and Year(of Standard) StandaM ; Year I ASTM D1970 2009 • � i ASTM D6163 , 2000 ! ASTM D6164 2005 � ��74 2004 FRSA/TRI April 2012(04-12) 2012 TAS 103 � 1995 I TAS 110 2000 httpJ/www.floridabuilding.or�pr/Pr app dtl.aspx?param=wGEVX(�wt�qsKQFEnck6108Erx1Ud3xYluUOxloQcflCknpt8XHMMRWA%3d%3d , ��2 10/19/2015 Florida Building Code Online . • ' • Equivalence of Product Standards Certified By i I Sections from the Code i � I i � Product Approval Method Method 1 Option D � �� I Date Submitted 06/29/2015 , Date Validated 07/02/2015 ; Date Pending FBC Approval 07/09/2015 � Date Approved 08/18/2015 Date Revised 10/15/2015 � i Summa of Products ; FL# Model,Number or Name Description � 2569.1 Soprema Roof Self adhering raof underlayments � � Underiayments � i Limits of Use Installation Instructions ; Approved for use in HVHZ: No Fi�569 R10 II 2015 06 FiNAL ER SOPREMA CA UNDERLAYMENTS FL2569- Approved for use outside HVHZ:Yes Rl . f � Impact Resistant: N/A Verified By: Robert Nieminen, P.E. PE-59166 Design Pressure: +N/A/-90 Created by Independent Third Party: Yes � Other: 1.) Refer to ER Section 5 for Limits Evaluation Reports I of Use. 2.)The design pressure noted herein FL2569 R30 AE 2015 06 FINAL ER SOPREMA CA UNDERLAYMENTS FL2569- pertains to underlayment systems used R10•�df I beneath adhesive-set tile systems. Refer to Created by Independent Third Party: Yes I ER Section 5.6.4 for details. ; � ' i nack Nezt i Contad Us : 1940 NORh Monroe Street,Tallahassee Fl 32399 Phone:550-487-1824 I 'The State of Florida ts an AA/EEO employer.Coovriaht 2007-2013 State of Florida.:: Privacv Statement::Amessibilitv Statement::Refund Statement Under Florida law,email addresses are publtc records.If you do not want your e-mafl addrns released tn respanse to a public-reco�d5 request,do not send ele�tronic mail to this entity.Irsstead,oonta�the office by phone ar by traditional mall.If you have arry ques[lons,please corrtact 850.487�1395.*Pursuant to Section 455.Z75(1),Florida Sta[u[es,effedive Odober 1,2012,Iicensees lioensed under Chapter 455,F.S.must provide the Departmerrt wi an emall address if they have one.The emails provided may be used for offidal cammunicatlon with the licensee.However email addresses are public reaord.I�i you do not wish to supply a persanal address,please pmvide the Department with an email addrnss which on be made available tn the public To detertnine if ybu are a licensee under Chapter 455,F.S.,please didc h�_. Product Approral Accepts: �� i ; srcuriivua:rr.�cr ! '� i , I I � � � I i I i i ii i � MtpJ/www.floridabiril�ing.org/pdpr app dtl.aspx?param=wGEVXQ�rtDqsKQFEnckB108Erx1Ud3�cYluUOxloQdXlcnpt8Xl-IMMRWA%3d°(o3d ?J2 � I, 10119l20s5 ^ Florida Building Code Online , � :if.,. .,� . � �� .�'.,,.._ a � � � � � • � • • ♦ � � �" O � � ,� 1 � t��_,. ' � �!ica L�pas;rrents Ba5 H e � Log In � User Registration � Hot Topics � Submit Surcharge � Stats&FacLs � Publicatloru � FBC Staff � BCIS Sfte Map t Links i Searrh �usines �,�� :�s p�uetApproval fessi��l USER:Public User Pro �egulation Pro u A val Menu>Product or Aooiication Search>Aoplip[ion Lis[>Appi7eation Detaa � � e �L# Fl2569-R10 � ' `� Appli ation Type Revision Code Version 2014 Appli ation Status Approved I Com ents Arch;ved Prod ct Manufacturer Soprema,Inc. (Canada) Addr ss/Phone/Email 1640 rue Haggarty Drummondville, NON-US 00000 i (819)478-2400 Ext 3327 Imemathieu@soprema.ca Auth�rized Signature Marc-Etlenne Mathieu memathieu@soprema.ca Tech ical Representative Marc-Etienne Mathieu Addr�ess/Phone/Email 1688 Jean-Berchmans-Michaud , Drummondville, NON-US 00000 ' � (819)478-2400 Ext3327 Imemathieu@soprema.ca , Qua�ty Assurance Representative lean-Francois Cote, Ph.D. Add�ess/Phone/Email 1640 rue Haggarty Drummondville (888)811-3145 � jfcote@soprema.ca I ' Category Roofing I Subiategory Underlayments , Corr�pliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer ; d Evaluation Report- Hardcopy Received i Flor�da Engineer or Architect Name who developed Robert J. M. Nieminen the valuation Report Flor da License PE59166 Qua ity Assurance En4ty UL LLC Qua ity Assurance Contrad Expiration Date 10/16/2017 Vali ated By John W. Knezevich, PE � � Validation Checklist- Hardcopy Received Ce Iificate of Independence FL2569 R10 COI 2015 OS COI Nieminen.odf i Ref�renced Standard and Year(of Sqndard) Standard Year ASTM D1970 2009 '— � ASTM D6163 2000 I ASTM D6164 ` '2005 �q,}74 2004 , FasA/r�u aP�i2oiz(oa-iz� zoi2 i TAS 103 � 1995 TAS 110 2000 httpJlwww.floridabuil�ng.org�pdpr app dtl.aspx?param=wGEVXQwtDqsKQFEnckB108Erx1Ud3�cYluUOxloQcDClcnpt8XHMMRWA%3d%3d , 1/2 10/19l2015 � Florida Building Code Online � " • I . � Equivalence of Product Standards � I Certified By i ' Sectionsfrom the Code I I Product Approval Method Method 1 Option D �� ( I Date Submitted 06/29/2015 i Date Validated 07/02/2015 Date Pending FBC Approval 07/09/2015 I Date Approved 08/18/2015 Date Revised 10/15/2015 � �, I � Summa of Products ; � FL# Model,Number or Name Description I 2569.1 Soprema Roof Self adhering roof underlayments I Underlayments , Limits of Use Installation Instructions � Approved for use in HVHZ: No F��564 R10 II 2015 06 FINAL ER SOPREMA CA UNDERLAYMENTS FL2569- Approved for use outside HVH2:Yes R10.odf I Impact Resistant:N/A Verified By: Robert Nieminen, P.E. PE-59166 Design Pressure: +N/A/-90 Created by Independent Third Party: Yes � Other: 1.) Refer to ER Section 5 for Limits Evaluation Reports I , of Use. 2.)The design pressure noted herein FL2569 R10 AE 2015 06 FINAL ER SOPREMA CA UfUDERLAYMENTS FLZS64- pertains to underlayment systems used R10.odf beneath adhesive-set tile systems. Refer to Created by Independent Third Party: Yes ER Section 5.6.4 for details. I 3ack Next , I ' Cantad Us::1940 North Monroe Street.Tallahassee FL 32399 Phone:850-487-1824 i lhe Sta[e of Florida Is an AA/EEO employer.Coovriaht 2007-2013 State of Florida.::Privaw Statement::Aa�sibilitv Statement::Refund Statement � Under Florida law,email addresses are public records.If you do not want your e-mail address 2leased In response to a publto-r�ecord5 request,do not send electronic mail to this entity.Ir�s[ead,contact the ofFlce by phone or by traditional mail.If you have arry questions,piease corrtact 850.48741395.'Pursuant to Section 455.275(1),Florida Statutes,effedive Odober 1,2012,Iicensees Ifaensed under Chapter 455,F.S.must provide Uie Department wi�an emall address if they have ' one.The emails provided may be used for offidal communicatlon with the Iicensee.However email addresses are public recard.I yau do not wish to supply a personal addmss,please provide the Department with an email address wtilch tan be made availabie[o the public To detertnine if y are a licensee under Chapter 455,F.S.,please didc here. Product Approral Accepts: �� -�-�—" � SCCU�i�Y}:1:1'li I l'ti .� . I � I � I I t I � � i � � _ I I � i I httpJ/www.flori�build�ng.orglpr/pr app dtl.aspx?param=wGEVXQwtDqsKQFEnck6108Enc1Ud3�cYluUOxloQdXlcnptSXl-IMMRWA°/a3d"/o3d 212 � !�.,�.. s � E A ' ' 6 ! °a �: — Florida Department� BCLS Hame i Log In �.User RegistraBon � Hot Topics ' Submit Surcharge ; Stats&Facts } pubticatlons � FBC Staff � BCIS S([e Map � Links � Search i Business� Professibnal V�. `� usea:PunicAo Proval Regulation , �, Produt[Aoproval Menu>Product or Aoplica[ion Search>Aoolication List>Appliwtion Detail • FL# FL10124-R16 � ,.. Application Type Revision Code Version 2014 Application Status Approved Comments Archived ❑ Product Manufacturer GAF Address/Phone/Email 1 Campus Drive Parisppany,NJ 07054 (973)872-4421 lindareith@trinityerd.com Authorized Signature Beth McSorley lindareith@trinftyerd.com Technical Representative Beth McSorley(current) Address/Phone/Email 1 Campus Drive Parsippany,NJ 07054 (973)872-4421 bmcsorley@gaf.com Quality Assurance Representative Address/Phone/Email Category Roofing Subcategory Asphalt Shingles Compliance Method Evaivation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer O Evaluation Report-Hardcopy Received Florida Engineer or Architect Name who developed Robert Nieminen the Evaluation Report Florida License PE-59166 Quality Assurance Entity UL LLC Quality Assurance Contract Expiration Date OS/14/z016 Validated By John W.Knezevich,PE O Validation Checklist-Hardcopy Received Certificate of Independence FL10124 R16 COI 2015 O1 COI Nieminen odf Referenced Standard and Year(ofStandard) Standard ear ASTM D3161 2009 ASTM D3462 2009 ASTM D7158 2008 TAS 107 1995 Equivaience of Product Standards Certified By Sections from the Code Product Approval Method Method 1 Option D Date Submitted 08/25/2015 Date Validated 08/27/2015 Date Pending FBC Approval 09/09/2015 Date Approved 10/16/2015 Date Revised 12/16/2015 Summa of Products � FL# Model,Number or Name Description 10124.1 GAF Asphalt Roof Shingles Fiberglass reinforced 3-tab,laminated,5-tab and hip/ridge asphalt shingles Limits of Use Installation Instructions Approved for use in HVH2:No FL10124 R16 II 2015 08 FINAL ER GAF Asphalt Approved for use outside HVHZ:Yes Shingles FL10124-R16.odf Impact Resistant:N/A Verified By: Robert Nieminen PE-59166 Design Pressure:N/A Created by Independent Third Party:Yes Other:Refer to ER,Section 5. Evaluation Reports FL10124 R16 AE 2015 08 FINAL ER GAF Asphalt Shinales FL10124-R16.odf Created by Independent Third Par[y:Yes Back Nex Contac[Us:.1940 North Monroe Street.Tallahassee FL 32399 Phone:850-467-1824 The State of Florida is an AA/EEO emptoyer.Coovriaht 2007-2013 State of Florida.::Privacv Statement::AccessibiliN Statement::Re(und Statement Under Florida law,email addresses are public records.If you do not want your e-mail address released in response to a public-records request,do not send elec[mnic mail to thfs entity.Instead,contact the office by phone or by traditional mail.If you have any quesdans,ptease mntact 850.487.1395.•Pursuant to Section 455.275 (1),Fiorida Statutes,effective Oc[ober 1,2012,Iicensees licensed under Chapter 455,F.S.must provide the Department with an email address if they have one.The emails provided may be used for offlcial communication with the licensee.However email addresses are public record.If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public.To determfne if you are a licensee under Chapter 455,F.S.,please dick here Product Approval Accepts: � � �cr«� � xcuriri�,+imuc� - i�� .,. � s e � / B e ' S e � g , t ��f�r� "" ' , • iiNiia�eiiiGd3id I F��Tlaa lxnart(pe�tUf BQS Home � Log In � User Registration � Hot Topks t Submit Surcharge ; Stats&FacGs � Publicatfons � FBC Staff� BCIS Site Map � Linla � Search � r^• Busines�� _ Professi �n�al �� s, USER:v��Approval Regulation Produc[Aoproval Menu>Product or Aoolication Search>Aoplication List>Applieation DeWil •�'�j•_•� p FL# FL10124-R16 •'' '_ Application Type Revision Code Version 2014 Application Status Approved Comments Archived ❑ Product Manufacturer GAF Address/Phone/Email 1 Campus Drive Parisppany,N]07054 (973)872-4421 lindareith@trinityerd.com Authorized Signature Beth McSorley lindareith@trinityerd.com Technical Representative Beth McSorley(current) Address/Phone/Email 1 Campus Drive Parsippany,NJ 07054 (973)872-4421 bmcsorley@gaf.com Quality Assurance Representative Address/Phone/Email Category Roofing Subcategory Asphalt Shingles Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer C�I Evaluation Report-Hardcopy Received Fiorida Engineer or Architect Name who developed Robert Nieminen the Evaluation Report Florida License PE-59166 Quality Assurance Entity UL LLC Quality Assurance Contract Expiration Date OS/14/2016 Validated By ]ohn W.Knezevich,PE 0 Validation Checklist-Hardcopy Received Certificate of Independence FL10124 R16 COI 2015 O1 COI Nieminen.odf Referenced Standard and Year(of Standard) Standard Year ASTM D3161 2009 ASTM D3462 2009 ASTM D7158 2008 TAS 107 1995 Equivalence of Product Standards Certified By Sections from the Code Product Approval Method Method 1 Option D Date Submitted 08/25/2015 Date Validated OS/27/2015 Date Pending FBC Approval 09/09/2015 Date Approved 10/16/2015 Date Revised 12/16/2015 Summary of Products FL# Model,Number or Mame Description 10124.1 GAF Asphalt Roof Shingles Fiberglass reinforced 3-tab,laminated,S-tab and hip/ridge asphalt shingles Limits of Use Installation Instructions Approved for use in HVHZ:No FC10124 R16 II 2015 08 FINAL ER GAF Asohalt Approved for use outside HVHZ:Yes Shinales FL10124-R16.odf Impact Resistant:N/A Verified By: Robert Nieminen PE-59166 Design Pressure:N/A Created by Independent Third Party:Yes Other:Refer to ER,Section 5. Evaluation Reports FL10124 R16 AE 2015 08 FINAL ER GAF Asphalt Shinales FL10124-R16.�df � Created by Independent Third Party:Yes Back Nex Contac[Us:.1940 North Monrce Street.Tallahassee FL 32399 Phone:850-487-1824 The State of Florida Ls an AA/EEO employer.Coovrioh[2007-2013 State of Florida.::Privaw Statement::AccessibiliN Statement::Refund Statemen[ Under Florida law,email addresses are public records.If you do not want your e-mail address released in rnsponse to a public-records request,do not send elec[ronlc mail to this entity.Instead,contac[[he offlce by phone or by traditional mail.If you have any quastions,please contact 850.487.1395.sPursuant to Sec[ion 455.275 (1),Florida Statutes,effec[ive ORober 1,2012,licensees licensed under Chapter 455,F.S.mus[pmvide the Department with an email address if they have one.The emails provfded may be used for official communitation with the licensee.However email addresses are public record.If you do not wish to suppiy a personal address, please provide the Department with an email address which can be made available to the publ(c.To detertnine if you are a Iicensee under Chapter 455,F.S.,please dick here. Product Approval Auxpis: � � eCh:aV. � securitva+��succr I r � �-�- ., � ��is �� .� �-� �� .� ��y��g� __ Y � __.� � , � --r ,�4 Foster's Ra+�f�n�" - ; _ _{��: �w�� V � � ��Rica,rv P.Q.BOX 1 Q553 . _�Yy, .. _ Y� ' i.,".'�r,".»'. '}'" .e'di . l.�.i:i':i.t4�,f^ D�RESS BROOK�V1L�E, FL.34603 ��v�� ISA �� 727-s4s-ssoo 5 � �Ta . _ 352 799 t�a45 MEMBER CCC1327265 � � Date: �!. _._-. ;_, Name � b' Job Name ;: Address � 7 �v/� /: Job Address � City, State, Zip � ' � City, State, Zip ' Phone 3 - �.2. - �3�"� } Phone Special Order -�—= Galvanized Valley :/ Life Time Ultra Angle Flashing `— ° ' Life Time r.� � l� / -� � Aluminum Drip ,/ �f.,� '� 3 Tab Shingle Galvanized Drip �.--- � Synthetic Plumbing Boots: 4" -~� 3" �/' eel'N'St'r � � � a� � �f� 2„ � 1 1/2" � 90 Lb. Ro(I Roofing -- GRV Vent ✓ ' TPO � Range Vent � SBS -- Ridge Vent��Ga�,6�ce : � , ; CementlAdhesive ,/ End Plugs ,, � Piywoad: �P r Sheet.�, 2x6 fascia,S �`l per n. Truss tails 2x4�'per f�.�"�Re-na Plyw J ✓ .ls?G(li�r S .2„ � f� T"t" .�� If � :?1 '� � : - -' .� � llJS i� 'f � � �� a��; Alf woad repair is xtra. By signing this prQposa! you are giving me permission to ch�nge and cha�ge far any bad waod that is reguired by law. Workmanship is guaranteed far a period of 5 years. Pric� includes all taxes nd permit fees. Prices are subject to change without notice.Any legal fees perfi; mmg to this contract or for the callection thereof shafl be paid in fuli by contractee. Homeawner must pravi�e access thru drive ay or yard to the roof. '; We propose he,r�b to furnish materia! and labor-complete in accordance with above specification�„ for the sum of$_ .5� '"� _. Payment to be made as follows: In full upon job completion. A 3% charge will be applied for proc ssing credit cards. g All material to be �pecified.Any alteratian or deviation�rom the above speci#ications invalving extra cos#s wil! be executed o iy tapon written arders, and wil! become an extra charge over and above the e�'timate. All arrangements ontmgent upan s#rikes, accidents or delays beyond our control. Our workers ar�fully covered by worke compe ia insurance " ! S: / t'�� Authorized Sign�ture Nofe:Thisproposalmaybewithdrawrrbyusifnofaccepfetlwit�iri�days. �:: Aceeptance of Pr posal -Th bove prices, speci#ications and conditions are satisfactory and ar�'hereby accepted. You are�authorizing to do the work �s specified. Payment will be made as outlined above. ' � Signature: I �'�-�"� Date a€Acceptance: 11� f � � %v � �