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Home My WebLink About17-18150 CITY OF ZEPHYRHILLS 5335-8TH STREEi' ' " (813)780-0020 18'f 50 BUILDING RERM�T �'ERMIT INFORMATION - LOCATION INFORMATION Perrriit Number: 1815Q Address: 39349 9TH AVE Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of W�rk: ROOF REPLACEMENT Township: _ Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: SUNSET ESTATES Est.Value: Parcel Number: 12-26-21-0300-00000-0110 Imprav. Cost: 2,300.00 OWIdER INFORMATIQN Date Issued. 2114/2017 Name: ANDERS�N, JOHN & DONNA Total Fees: 50.Op Address: 299$ COATES RD Amaunt Paid: SQ.OQ ZEPHYRHILLS, FL. 33542 Date Paid: 2/14/2017 Phane: (813 782-6639 Work Desc: RE RC?OF SHINGLES CONTRACTOR S APPLICATION FEES Hf]MEOWNER REROOF RESIDENTIAL 50.QQ � s ections Re uired � DRYINR FI P TAPE JOINTS R�� FINAL REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the loca!government sha!! impose a fee of four times fihe amount of the fee imposed for the initiai inspectian ar first reinspection,whichever is greater,far 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 publie records of this county, and there may be additionai permits required from other governmental entities such as water management, state agencies or federal agencies. "1Narning fia ouvner: Your faiinre to recard a notice af commencement may result in your paying twice for improvements ta 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 wark shall be perFormed in accardance with Ci Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. a��`��'t�LU ��2.��./,�Z� CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN fi MC}NTHS 1NITHOUT APPROVED INSPECTIBN CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PR{)TECT CARD FROM 'WEATHER 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 °- Building Department Date Received ' �Phone Contact for Permitting � — � 3/�- s�3�-- �� <9 �%�, Owner's Name d/1 /1 y1 Owner Phone Number Owner's Address �� Owner Phone Number �1.�� /.5 /� l�`T I ��'/�iL Fee Simple Titleholder Name Oxiner Phone Number Fee Simple Titleholder Address JOB ADDRESS (�S ��JO�� LOT# � SUBDIVISION PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) � WORK PROPOSED ,. NEW CONSTR ADD7ALT Q SIGN Q � Q DEMOLISH e INSTALL e REPAIR - PROP.,OSED USE Q SFR Q COMM Q OTHER . TYPE`OF CONSTRUCTION Q BLOCK •• Q FRAME 0 STEEL Q " � . DESCRIPTION OF WORK • r`�� 4�� BUILDING SI SQ FOOTAGE�� HEIGHT • BUILDING $ �3 DU, VALUAl'ION°OF TOTAL CONSTRUCTION � QELEC7'RICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. QPLUMBING $ QMECHANICAL $ VALUA7'ION OF MECHANICAL INSTALLATION Q_GAS ROOFING Q SPECIALTY � OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO -BUILDER d?�� (.v`Z2��.9�(/"✓(/ COMPANY �/'2�lr7YJ.Q/ G��/�'y[XiV SIGNATURE '�- REGISTERED Y/ N FEE CURRE� Y/N Address � License# -;:r.. ;. • .. ELECTRI,C-,IAN _ COMPANY . SIGNATURE REGISTERED Y/ N FEE'CURRE� �. Y/N. Address License# _ - ", -:�•: . .. , , , , , . P.LUMBER.;:; • -COMPANY' . : . ' . -�SIGNATURE � - �REGISTERED ; Y,•/ N� ' " '" FEE CURRE� � Y/N� Add�ess License#=. •�".MECHANICAL. _� . • . , COMP.ANX, . - �-'`SIGNATURE'"'' ` REGISTERED ,' Y/ N . ; FEE CURRE� Y/N =. Aaa�ess��- � � � . . , � - " License.# - ;ri� •� .... . , _ �.OTHEPt:i�",;:.;� - . ' . ' ' � � 'COMPANY � � ��SIGNATURE:,_. - - " � " . .- REGISTERED Y/ N. FEE CURREK Y/N -- ,. ' -- , � _ , - - - , . , �,_ - . . - Address��,+_ _ - � - � � ,_ - . , Licen§e# � . � ' ;- - - 7,.:,�..>t,;:..;:::.�<.��.;�; n<�,,:. - ,;�;,� -,' ;.�:,.(;,,::;:. . .. . . . :_RESID.ENTIAL��„_•.AttacFi`;(2)>Plot Plans;�(2)�sets�of Building�Flan§;.(1�)`set`of�Energy;Forms;R-0;=V11.:Permit.for new.constniction�"�` -� =. , , . , , `" "-;°:;�•�,t,-�.'-�`-�:Minimum::ten:;1'O..workin�;da�s'after�submittal?date::'Re. uired'onsite;Constni'ction�Flans;Stormwate�.Rlans�w/Silt-Fenoe�installed � - �,:�.;ti,:;�,.o.,_ W,,., .... . �...) - ,.9 . Y_ q .�:�r . , . .. , ,._ . .., .s.,n , . , , _ - • - Sanitary�,Facilitles,&,��1�;dwmpste.,r•,`Sife'.Work_Permit:for'subdivisions/large"projects.';; :- �<;.� ` _.__. _ _ _ ._ : -_ ��.COMMERCIAL Attach.'(2)�cgmplete sets;of;BuiliJi'ng Plans=plus a Life;S.afety Page;.(1)set�of,En,ergy;Forms:�R-O-W�Permif;for.new.construction. - • ' � _ , � � .Minimum ten.(10),,working�tlays�.after subrriittal`date.;Required onsite,.Constiuction Plans;;Stormwater Plans w/SilfFence installed, � - � "� � " �SaMtary-FaciliUes:B'1;:dumpster:.Site;Work;P.errriit"fo��al�'new,projects.All;commerciaCrequirements.must.meet.compliance ' �SiGN�.PERMIT> -AtfacFi{2)sets of,Engineered,Flans:-�.'; � _ : _ , .. - � - - _ -� . . "'"'PROPERTY SURVEY�egui�ed',fo'e:aII:NEW�construction:.:. _. `_ - • � - - • � � '�Dicect'ions: `.r. ` . �:�:;-;ti':. , _ .•.- -. ... . _ _ • , .., . , ._ -; �Fill':ouYap'plication.bompletely;;;", • � � - ,. =. ��' . , . Qwner�8 Contracfor�sign.back of�application;notanzeii� -. . ��- � ' .. . 5�� If over$2500;a.Notice°,of?Commencement ts,required._ '(A/C upgrades.over,$7500);�;-. . , , �""'-'_ A'ent fortFi'e cont�aotor'orPower,ofAttome ;:for�tFie�o.wne�:would tie�someone;with;notarizedletter`from:ownerauthoriiing_same 9 � � )� . Y� ) ,. � ;=OV.ERTHE�COUNTER;PERMI7TING :.�,(copy,of contract:required)::�-""'�:,'`` - • - _ � .. ;��`.Reroofs:.ifshingles. � �.'Sewers --��_'Service.Upgradesj.A/C � Fences{Plof%Survey/Footage) � � � ,�,- _..;�=,-,-; - '- � � � -.. � - , ' : D�iveways-Not oVer Counter if.on'.putilic�roadways;.`neecls`ROW � `, ' " , �:` . .. . - • . , � '_ ,. ' � `c_. — , � ' , , . ' . . . ' ` %a� ,. . _. - ��:-�-*�r�. �:.�'i � l .� :;L�_^..:�,,.y. : NOTICE OF DEED RESTRICTIONS: The undersigned,understands,that this;permit may,be..subject to-".deed"_resfniction;s"�`'� y whieh.ma ;:be.,moce;restrictive.; - ..��._.,:�a;�.,�R:��.�.., _ ....�:�;:.,;_v;,,:;;�.K.;.,...,. ;.,;n;.. - ., ,,...: �. ..:,.. _ �:.;.. „,_�. ,.. :._,..�.:, , y, ,, ,. than�Countyregulations:�rTlie�under�igned��assumes��responsibifity`fo�°�compliance�viiithhariy_"';� applicabie deed restrictions. .,,:,,:;;�� _;;;;��,,.:� UNLICENSED:=CONTRACTORS AND CONTRACTOR RESP:ONSIBILITIES: if:tfie-owner�has°�liired�a��contractor or � contractors�•to uridertake work, they may.be required"to be:licensed.in accordance:with state_and'-1oeaF:regu�I.atioms:y:=lf.the�F�;`�t.�,� contractor is not licensed•.as:required'by�'laVii, botli�the owner and`eont�aet6r�may�6e�cited�=fo�-�a:'misdemeanor. violafion� ;; � under state law. If the owner or intended,contractoc are�uncertain as to what licensing require�ments:�rnay�.apply�_f.or�;the<<;=,r.'f. ,.,,.�u . intended wock,.they:are•advised to confacffFie'Pasco County�Building�Inspection:Division-Cicensing Section at 727-847- ' �U� 8009: -Furthermore, if the owner has�hired`a contractor or cont�acto�s, he is advised to if5ave;the: contractor(s�J::sign �,;,:;';�. portions of the "contractor Block"of this application,for which they will be resp.onsible.-lf;you,_as`:tfie�owner sig'n,asx.ttie:='`:�V�,: contractor., that.may-be an indication#hat he��is not properly licensed and is nof entitled to permitting privileges in:Pasco'..,�:,, `;5;�i..�t.r:�: Y ounty. . ._ _ .._.. ' _°: -, ��: TRANSPORTATION IMPAC7lUTILITIES�IMPACT AND RESOURCE RECOVERY FEES:`�The`undersigned understands;�-., ;°i� that Transportation Impact Fees and Recourse Recovery Fess:may:apply to;.the construction.of,new.buildings,•.eFiange�of�'_=;,�;.�; use in existing bt�ildings,.:or�expansion of:existing`buildings, as specified in Pasco County Ordinance number 89=UZ and ; ;`.;;'� 90-07, as amended. The-undersigned also understands, that suchtfees, as�rnay..,b,e.due, witl be�identified�atkthe�timer.of��'=°�-;:� permitting. 'It is further�understood that Transportation Impact Fees and Resource��Reeovery:.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�o�l;a`��,`:3�� final-power rele.ase, #he-fees=must be,paid prior to permit issuance. :Furthermore,_if Pasco County WaterlSewer.t;lnipast'.t,-; � fees are due, tliey must_be._paid prior to permit issuance in accordance with�applicatile:Pasco_County ordinances. '' CONSTRUCTION LIEN�LAW(Chapter 713, Florida�tatutes, as amended): If valuation of work is$2,500.O.O.or.mor,.g,:,l,,,E. h_ certify that 'I, the applicant, have been provided with a copy-of. the Florida Construetion :Lien Law-;Homeownei'�s � Protection Guide° prepared by the Florida Department of Agriculture and Consumer.Affairs. If the applicant�is s.omeqne,�,, �. other than the"owner�, I,eertify that I.ha�e obtained a copy of the above'descri6ed'document�and,promise�in-goo.d:faith'to.;A.:,, deliver,it.to�the.',owner°'prior:fo-commencement. - � CONTRACTOR'S%OWNER'S AFFIDAVIT: I.certify that all the information in this application is accurate and"that alf 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 comrrienced prior to issuartce 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 iri :the jurisdiction. =�-1 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: �: - <nDepartment of Environmental-'Protection=Cypress Bayheads, Wetland Areas and Environmentally Sensitive ' Lands,llVateNWastewater Treatment. • - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. �; - Army Corps of Engineers-Seavvalls, Docks, Navigable Watervuays. - Department of Health & .Rehabilitative Services/Environmental klealth Unit-Wells, Wastewater 'Treatment, ' Septic:Tanks: - � ' - US Environmental Protection Agency-Asbestos abatement. , _> ' - Federal Aviation Authority-Runways. I understand that�the following:restricfions 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 �II material is to be used in any area,, I certify that use of such�fill wrill 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 requi�ed. 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 fo commencing construction. I understand that a separate perm'it may be required for electrical work,. ,- ; plumbing, signs, wells, pools, air conditioning, gas, or otfier installations not specifically included in the application: A permit issued shall�be construed•to�be a license to proceed with the work and not as authocity to violate, cancel, alter, or � � set aside any provisions of the�technical codes, nor shall issuance of a permit prevent the Building Official from theceafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall 6ecome invalid unless the work authorized by such permit is commenced within six months of permit issuance, or ff work authorized by � the permit is suspended.or abandoned-for a period-.of.six(6) months after the time the work i�'commenced. An extension ; may be requested, in�writing, from the Building Official for a period.rnot 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 MAY�RESULT IN YOUR PAYING TWICE.'FOR IMPRQVEMENTS;TO YQ.UR:PROPERTY.: IF YOU,INTEND•TO�OBTAIN,FINANCING, CONSULT WITH YOUR'LENDER OR AN ATTORNEY_BEFORE REC.ORDING.Y_O_UR NOTICE`OF�COMMENCEMENT- _-- - - FLORIDA JURAT(F.S.117.03) � � � � OWNER OR AGENT�iVI A1 , C'/YL.Q,� �110/In i C.ONTRACTOR "�J(�'t/Yl�1r(, WYI��.E:2,�4-Q/Y�� Subscribed and swo to(or affirme�bef re me thls � Subscribed and swom to(or affirtned)befor,e�me is by �D n n C�--ct11.�� by n D I?/1l ft��(�� Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced as IdenUfication. as IdentificaUon. Notary' Public Notary Public � Commission No. Commission No. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped Florida Building Code Online Page 1 of 3 k,. ' � :�:� �Y .r.,, x � �' va .&., � „y. �x��.� `a- f�' ,>' f �� Y * a $ ` � . 4 � �. o - ,,� ,�;rv:�r� � ":' a. � ��: ,, ,x�ae�:�v�. BCIS Home � Log In f User Registration Hot Topia ; Submit Surcharge Staks&Fac[s I Publi[ations ! FBC Staff � BCIS Site Map � Links j'Search � Florida :� Product Approval 11�!,� � �" USER:Public User � �� :�ctnnr.a G�''�,:ixah'•esi:� pr�fuct ADOrOval Me,r�,y>Product pLppJsation Search>Aoolitation Lis[>Appllwtion Detali �ta:4 ,� , ,:.'�" FL# FL9777-R8 Application Type Revision Code Version 2014 Application Status Re-Apply , Comments set to t-a per applicants request 2/13/17-rb Archived ❑ Product Manufacturer Owens Corning Address/Phone/Email One Owens Corning Parkway Toledo,OH 43659 (740)404-7829 greg,keeler@owenscorning.com Authorized Signature Greg Keeler greg.keeler@owenscorning.com Technical Representative Address/Phone/Email Qualfty Assurance Representative Address/Phone/Email Category Roofing Subcategory Underlayments Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Cl Evaluation Report-Hardcopy Received Florida Engineer or Architect Name who developed Zachary R. Priest the Evaluation Report Florida License PE-74021 Quality Assurence Entity UL LLC Quality Assurence Contrect Expiretion Date 12/31/2020 Validated By Locke Bowden G Validation Checklist-Hardcopy Received Certificate of Independence FL9777 R8 COI OCR14002.5a FBC 2014 Evaluation Report Weatherlock Non-HVHZ-final,odf Referenced Standard and Year(of Standard) Standard Year ASTM D 1970 2009 ASTM G 155 2005 TAS 103 1995 UL1897 2004 Equivalence of Product Standards Certified By Sections from the Code http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqtgkcMGblcW7I... 2/14/2017 Florida Building Code Online Page 2 of 3 Product Approval Method Method 1 Option D Date Submitted 02/12/2017 Date Validated Date Pending FBC Approval Summa of Products FL# Model,Number or Name Description 9777.1 Weatherlock G Weatherproofing Underlayment Limits of Use Installation Instructions Approved for use in HVHZ:No FI_9777 R8 1I OCR14007_.Sa FBC 2014 Evaluation Report Approved for use outside HVHZ:Yes Weatf�rlock Non-HVHZ-final.�df Impact Resistant:N/A Veriffed By: Zachary R. Priest 74021 Design Pressure: N/A Created by Independent Third Party: Yes Other:See evaluation report for Iimits of use. Evaluation Reports FL9777 R8 AE OCR14002.Sa FBC 2014 Evaluation Reoort Weatherlock Non-HVHZ-final.�df Created by Independent Third Party: Yes 9777.2 Weatherlock MAT Waterproofing Underlayment Limits of Use Installation Instructions Approved for use in HVHZ:No FL9777 R$ II OCR14002.Sa FBC 2014 Evaluation Repork Approved for use outside HVHZ:Yes Weatherlock Non-HVHZ-final.odf Impact Resistant:N/A Verified By: Zachary R. Priest 74021 Design Pressure: N/A Created by Independent Third Party; Yes Other:See evaluation report for limits of use. Evaluation Reports FL9777 R8 AE OCR14002.5a FBC 2014 Evaluation Report Weatherlock Non-MVI-17_-final.odf Created by IndependentThfrd Party: Yes 9777.3 WeatherLock Metal Weatherprooflng Underlayment Limits of Use Installation Instructions Approved for use in HVHZ:No FL9777 RS II OCR14002 Sa FBC 2014 Evaluation Report Approved for use outside HVHZ:Yes Weatherlock Non-HVHZ-final.�df Impact Resistant:N/A Verified By: Zachary R. Priest PE-74021 Design Pressure:N/A Created by Independent Third Party: Yes Other:See evaluation report for limits of use. Evaluation Reports F197%7 R8 AE OCR14002.Sa FBC 2014 Evaluatfon Report Weakherlock NQn-HVHZ-final.odf Created by Independent Third Party:Yes 9777.4 WeatherLock Metal Weatherproofing Underlayment Limits of Use Installation Instructions Approved for use in HVHZ:Yes FL9777 RS II OCR14002 Sb FBC 2014 Evaluation Re o�rt Approved for use outside HVH2:No Weatherlock M2tal HVhl7_-finai.odf Impact Resistant:N/A Verified By: Zachary R. Priest PE-74021 Design Pressure:N/A Created by IndependentThfrd Party: Yes Other:See evaluation report for limits of use, Evaluation Reports 1=19777 RS AL OCR14007.Sb FE3C?014 Fvaluation Reoort Weatheriock Metal HVHZ-final.�df Created by IndependentThfrd Party: Yes 9777.5 WeatherLock Specialty Tile&Metal Weatherproofing Underlayment Limits of Use Installation Instructions Approved for use in HVHZ:No FL9777 R8 II OCR14002.Sa FBC 2014 Evaluation Reoort Approved for use outside HVHZ:Yes Weatherlock Non•I-IVFI7-final,odf Impact Resistant:N/A Verified By: Zachary R. Priest 74021 Design Pressure:+0/-105 Created by Independent Third Party: Yes Other:See evaluation report for limits of use, Evaluation Reports FL�777 RS AE QCR140Q2.SQ a FBC 2214 Evaluation Rp,�c�r,t Wealherlock Non-HVHZ-final.pdf Created by Independent Third Party: Yes Back Next Contad Us;:2601 Blair Stone Road.Tallahassee FL 32399 Phone:850-487-1824 The State of Florida is an AA/EEO employer.Coovriaht 2007-2013 S[ate of Florida.::Privacv Statement::A �Ibilir�N�tat_menc::Refund Statement Under Florida Iaw,email addresses are public records.I(you do not want your e-mail address released(n response[o a public-records request,do not send electronic mail to this entity.Instead,conWc[the office by phone or by traditional mail.If you have any questions,please contact 850.487.1395.'Pursuant to Sectian 455.275(1),Florida Statutes,effective Oc[ober 1,2012,licensees Ilcensed under Chapter 455,F.S.must provlde the Department wlth an emall address if they have one.The emails provided may be used for official communica[fon with the Iicensee.However emall addresses are public rewrd.If you do not wlsh to http://www,floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqtgkcMGblcW7I... 2/14/2017 Florida Building Code Online Page 3 of 3 supply a personal address,please provide the Department with an emall address which can be made available to the public.To de[ermine if you are a Iicensee under Chapter 455,F.S.,please click j�g. Product Approval Accepts: � � �� Credit.Card Safe http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEV XQwtDqtgkcMGblc W7I,.. 2/14/2017 Florida Building Code Online Page 1 of 2 .- "�` „��, ; � ��,. " � �s 'a• t�` �� ! 'tl' � � <, � ,`�= o � p; o < �F .a� � _ �.. �'.�: �',: BCIS Home ; Log In � User Registration Hot 7opics j Submit Surcharge Stats&Facts i Publicatians � FBC Staff 4 BCIS Site Map � Links j'Search � � F�Q�'1C�d �I � �� " Product Approval I �a �y USER:Public User � &:;a'r�„�i 2°� . proAuct Aoorqy��Mgay>Product or Aoolicatlon Search>Aoulication List>Applicatlon Detall `:� ' � FL# FL10124-R19 Application Type Revision Code Versfon 2014 Applfcation Status Approved Comments Archived C7 - Product Manufacturer GAF Address/Phone/Email 1 Campus Drive Parisppany,NJ 07054 (800)766-3411 mstieh@gaf.com Authorized Signature Robert Nieminen 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 �J 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 Assurence Contract Expiratfon Date 03/03/2018 Validated By ]ohn W. Knezevich,PE C� Validation Checklist-Hardcopy Received Certificate of Independence FL10124 R19 COI 2016 O1 COI Nieminen,odf Referenced Standard and Year(of Standard) Standard Year ASTM D1970 2009 ASTM D3161 2009 ASTM D3462 2009 ASTM D7158 2008 TAS 107 1995 Equivalence of Product Standards CertiFled By Sections from the Code http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDquracB eV CbdM... 2/14/2017 Florida Building Code Online Page 2 of 2 Product Approval Method Method 1 Option D Date Submitted 08/26/2016 Date Validated 08/26/2016 Date Pending FBC Approval 08/30/2016 Date Approved 10/13/2016 Summary of Products FL# Model,Number or Name Description 10124.1 GAF Asphalt Roof Shfngles Fiberglass reinforced 3-tab, laminated,5-tab and hip/ridge asphalt shingles Limits of Use Installation Instructions Approved for use in HVHZ:No FLt0124 R19 Ii 2016 OS FINAL ER GAF Asohalt Approved for use outside HVHZ:Yes Shinales FL10124-R19.pdf 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 R19 AE 201G 06 FINAL ER GAF Asahalt Shingles FL10124-R14.pdf Created by Independent Third Party:Yes Back Next Contad Us::2601 Blalr Stone Road.Tallahassee FL 32399 Phone:850-487-1824 The State of Florida is an Aq/EEO employer.Coovriqht 2007-2013 State of Florida.::Prlvacv Statement::Accesslbilitv S[atement::Refund S[a[ement Under Florida law,email addresses are public records.tf you do no[want your e-mail address released in response to a public-recards request,do not send electronic mail to this entity.Instead,cantact the office by phone or by tradi[lonal matl.If you have any ques[lons,please con[act 850,487.1395.'Pursuant to Sec[lon 455.275(1),Florida Statu[es,effective October 1,2012,Iicensees licensed under Chapter 455,F.S.must provfde the Department with an email address if they have one.The emails provided may be used for o�cial communication with the Iicensee.However email addresses are public record.If you do not wtsh to supply a personal address,please provide the Department w(th an email address which can be made available to the public.To determine ff you are a Iicensee under Chapter 455,F.S.,please click here. ProductApprovalAccepts: � � e'CFes � Credif Card Safe 1.,1� http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDquracBeVCbdM... 2/14/2017