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HomeMy WebLinkAbout17-18327 CITY OF ZEPHYRHILLS 5335-8TH STREET ' (813)780-0020 1�7 S � BUILDING PERMIT / � - PERMIT INFORMATION LOCATION INFORMATION Permit Number: 18327 Address: 5051 5TH ST Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT - Township: Range: Book: Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: - Parcel Number: 11-26-21-0010-18700-0040 Improv. Cost: 3,790.00 OWNER INFORMATION Date Issued: 4/19/2017 Name: STEBBINS, MADELINE Total Fees: 82.50 Address: 5051 5TH ST Amount Paid: 82.50 ZEPHYRHILLS, FL. 33542 Date Paid: 4/19/2017 Phone: 813-782-2417 Work Desc: REROOF METAL CONTRACTOR S APPLICATION FEES A. BARTLETT ROOFING OF CENTRAL F REROOF RESIDENTIAL 82.50 V ��� �� � � �� C � � � � Ins ections Re uired DRY IN ROOF INSP TAPE JOINTS ROOF INSP 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 attorney before recording your notice of commencement." Complete Plans, Specifications Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. �VO OCCUPANCY BEFORE C.O. -� CONTRAC �Sf�1�ATURE PERMIT OFFI R E�MIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER o�S� � i car�iun � ,-=�y;:i=%- r �'� i�i�� . Eq City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: !-t ' ���� T`G�r� � Date Received: ���� � Site: ��(� J�'�� ���/ Permit Type: /�(�%�6(-f' /`e�'' Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑ Tlus co t sheet shall be kept with the permit and/or plans. �%�/> lvin Sw' —Plans Examiner Date Contractor and/or Homeowner (Required when comments are present) s�a-�so-oaZo City of Zephyrhills Permit Application Fax-813-780-0021 = Build'ing Department ��_ �. Date Recelved : +� _ �-'�� Phone Cantact far Permitting � Owner's Name �..�2 Owner Phone Number - T � Owner's Address �� S � Owner Phane Number �— � ' ���L � � Fee Simple Titiehotder Name Owner Phone Number �¢ Fee Siinple Titleholder Address JOB ADDRESS � c � � Q LOT# ��� SUBDIVlSION �� � PARCEL ID# � oZ� �} � (OBTAINED FROM PR PERTY TAX NOTICE) WQRK PRQPOSED NEW CONSTR ADDIAI.T � SIGN Q Q DEMOLISH � INSTALL � �REPAIR PRORQSED USE 'Q SFR Q COMM � QTHER TYPE OF CONSTRUCTION Q BLOCK • Q FRAME � STEEL Q � � DESCRIPTION OF WORK �P�fi BUI�DING SIZE �i � SQ FOOTAGE .�(� HEIGHT [—_____� �����'���� ���� VALUATION OF TOTAL CONSTt2UGT10N f DE�ECTf21CAL $ AMP SERVtCE 0 PROGRESB ENERGY Q W.R.E.G. �,,.._ � QPLUMBING $ C�� � i $3�1 I QMECHANlGAL $ VALUATIQN OF MECNANIGAL ENSTA�IATION ��t e 1 � OGAS f20QFlNG Q SPEClAI.TY � OTHER �� � � � FINISHED FLQOR ELEVATIONS FLOOD ZONE AREA �YES NO ��1 ti BUIlDER � COMPANY SIGNATURE REGI8TERED N FEE CUF2RE� /N , Address � � ��.�-"" ph. License#.�— � � , 'ELECTRICIAN - COMPANY ' SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address' License# � { � PLUMBER. COMPAi�tY SIGNATURE • REGISTERED Y°/ 'N'` ' FEE CURRE� Y/N Address � `"Cicense#'���— � MECNANICAL � C4MP�Wl' � SIGNATURE ' � REGISTerteo . �Y/-N FEE CURRE� Y/N � Add�ess-� , ' , � - I � , -Lic,ens,e#•.:� � �� :<::, , , - . ... ' - fJ?F#ER- "'. _ - COMi?ANY � SIGNATURE.. -� � - ' REGIS7ERED Y/.N.. FEE CURRE�' .,, r Y./N Addr�ss�, � - ' • License# �— � 'RESIDENT[ALt:, Attach�{2}:!'lofF2lans;-(2}:setsofBuilcling?P[ans;'(1)=setof'Energ}i'Forins;'R-0-W;Pe'rmit.for.new.construction,� • Minimum.#em,(a10),working;days'after."submittal`iiate. Required onsite,Cbnstructian Plans,Stormwater Plans w/Silt Fence installed, � .° :E� z,.. �9 P ' � Sanita,ry;;Facitities.&:l�.dumpster.;Site Wock:Permit for subd'ivisions/!a e rojects�:. - .,___ :GOMMERClAL. Attach{2)'complete sets of Builiiing Plans ptus a L.ife Safety Page;{9}set af Energy Farms.R-O-Utt Permit for new construction. " Minimum ten(10)working days after submittal date. Required onsite,Canstruction Plans,Stormwater Plans w/Silt Fence ins#alled, Sanitary Faeflities&1 dumpster.Site Wark,Permit for all new proJects.Ali commercia!requirements must meet compliance ;.�,SiGN PERMiT Attach(2)sets of,Engineered Ptans.�� � � � '"**PROPERTY SURVEY required for.all.NEW,canstructian. Directtons: �;•-:t=-- - . - Fill out application completely. � � Ovirner&Gontraator sign.back of application,notarized - . If over$2500;a Notice af Commencement is required. (A/G upgrades over$750d) "' Agent{for'fhe cont�actor)'or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same ,.;OVER.7HE COUNTER;PERMiTTING. , (copy of cantraet required). �; Reroofs if shingles Sewers ', Service.Upgrades-A/C„ Fences(Plat/Survey/Foatage) _. . . - "(I.. .. ., li Driveways-Not over Counter if on public�roadways.:need's,�ROW;. � ' � ' „ . ,. , ;; , � --_. ! , - - ���-�.�.�-�u��;,�:� n n* » �I N4TtCE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject,to_ deed, restrictions, _� which may_be.more restrictive.tfian Caunty regulations: The,undersignied asseimes:responsibitity forcompiiance witfi-any �` appticable deed.restrictions. � �� ` " UNLICENSED GONTRACTORS ANQ CONTRACTOR RESPONSlBlLITlES:- !f the ovuner has �hired��a=contractor. or � contractors to undertake work, they may be required to be�licensed in accordance with state and:loca! r.egul;ations. "#f-:the:�.: contractor is,not licensed as required dy law, both #he owner and contractor-rnay�-be cited for:.a�misdemeanor vialation 'f under state iaw. If the owner or intended contractor are uncertain as to what iicensing requirements,;rnay apply for�.tfie�- "� intended.wark, #hey are advised ta cantact�the Pasca County Building'Mspectiori�Di"visian=Licen'sing Sec#ion at 727=847- 80Q9. Furkhermare, if the owrner has hired a cantractar or cantractors, he is`advised to 'have the cantractor{s} sign,..., , portions of the "contractor Black" o€this application for which they will be responsible. !f you, as�the owner`s'ign as'the " '� � contractar, that may be an indication that he is not properly licensed and is not entitled�to pe�mitting privileges in Pasco County. � ., ,.,, , TRANSPORTATIGIN IMPACT/UT1LiTtES 1MPACT AND RESCIURCE RECOVERY FEES:The undersigned understands � that Transparta#ion Impact Fees and Recourse Recovery Fees may appty to the canstruction of new buildings, change of� �� , use in existing buiidings, or expansion af existing�buildings, as specifed in Pasco County Ord�nance number 89-07 and i 90-07, as amended. The undersigned also understands, that such.fees, as may�_b.e.dus, wili tie identified at'the tiriie��of � ', permitting. It is further understood that Transportatian 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 af occupancy or �� n � final power release, the fees mus# be paid prior#o permit issuance. Furthermore, if Pasco County WateNSewer•Impact. • ' fees are due, they must be paid prior to pertnit issuance in accardance with applicabie Pasca Coanty ordinances. � , GC?NSTRUCTft?N LIEN RAW{Chapter 713, Flor�da Statates,as amended}: If valuation of wark is$2,500.0�0 ar mare,.f:, �f certify that I, the applicant, have been provided with_ a eopy. af the °Florida Constructian Lien Law—Homeowner's� Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant•is someane other than the"awner", I certify that I have obtained a copy of the abave described'document and pramise in goad�faitfi to deliver.it to the"owner"prior to commencement. CONTRACTOR'S/OV{►NER'S AFFIDAVIT: t certify.that all the irtfarmation in#his appiicatian is accurate and`that all wark wiN be done in campliance with all applicabfe laws regulating construction, zoning and iand-development. Application is hereby rnade to abtain a permit to do work and insta!latian as indicated. t certify that na wark or installatian has commenced prior to issuance of a permit and that all work will be perEormed to meet standards of all laws regulating , ', construction, County and City codes, zaning regulations, and land development regulations in the jurisdiction. ! also certify that i understand tha#the regu(ations of other government agencies may apply to the intended work, and that it is my responsibility ta idenfify what actions I must take to be in compliance. Such agencies include but are nat timited to: , - Department of Environmen#al Pratection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,WaEerN1las#ewater Treatrnent. - Southwest Florida Water Management Distric#-Wells, Cypress Bayheads, We#land Areas, AI#ering Watercourses. - Army Corps of Engineers-Seawalls, Dacks, Navigable Waterways. - Department a# Heaith 8� Rehabilitative ServicesJEnvironmentai Health Unit Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbes#os abatement. � - Federal Aviation Au#harity-Runways. i understand that the fallowing restrictions apply to the use of fill: - Use of fill is not allowed in F1aod Zane"V" untess expressly permitted. - If the filf material is to be used in Fiaod Zone "A", it is understood that a drainage plan addressing a "corr�pensating volume" wil! be submitted a#tirrie af permitting which is prepared by a prafessional engineer " licensed by the State of Florida. � - If the fill material is to be used in Flood Zane "A" in connec#ion with a permitted building using stem waN construction, I certify that fill will be used anly to fill the area within the stem wall. ; - if fill material is to be used in any area, I certify that use af such fill will not adversely affect adjacent � properties. I#use of fill is faund to adversely affect adjacent properties, the owner may be cited for violating. the conditians of the building permit issuec! under the attached perrnit application, for lots less than ane {1} � acre which are elevated by fill,an erigineered dra9nage plan is required. ; If I am the AGENT FOR THE OWNER, I promise in good faith to inform the ownsr of the permitting conditions set forth in � this a�davit priar #a commencing constructian. .I understand that a separate permit may be required for electrical work, ' plumbing, signs, we11s, pools, air conditioning, gas, ar:other installations not specifically included in the applicatian. A permit issued shall be construed to be a license ta proceed with fhe work and no# as autharity to viala#e, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance af a permit prevent the Suitding Qfficial from thereaf#er requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shali become invalid unless the work authorized by such permit is commenced within six manths af permit issuance, or if wark authorized by the permit is suspended or abandoned for a period.of six(6) months after the time the work is commenced. An eac#ension may be requested, in wri#ing, from the Building Officiai for a period not to exceed•ninety (90) days and will demonstrate justifiabte cause far the extension. tf work ceases far ninety(90}consecutive days,the jab is cansidered abandoned. WARNING TO QWNER: YOUR FAILURE TO RECQRD A NQTICE OE COMMENCEMENT MAY RESUI.T IN YOUR PAYING TWICE FOR IMPROVEMEN7S TO YOUR PROPERTY, IF YOU;INTEND-TO CIBTAIN FINANClNG,CONSULT WiTH YOUR LENDER OR AN ATTORNEY BEFORE RECORDIN��YO.I�It=NClTICE-OF C�IMMENCEMi��9'�.- -i- � - `�- ��-" _.__ .- �`vniunJUriini�{F:j�" ' :�3j__ - ._ OWNER OR AGENT � 1 ,����//� GONTRACTOR --� Subscribed and swom to(or affirrned}.b re e this T Subscribed and swom ta(or affirme fore me tliis by y Who islare personally known to me or has/have produced ' Who is/ar ersonally nown to me or has/have produced as identificatian. as identlfication. Notary Public u�"� sy-^ Natary Public Commission No. Commi ton .�.�.Y A`y'��•, ,lACQUELiNE BOGES .��g•• �fi; Name of Notary typed,printed or stamped iVame of o, i� Qf e�L � ,201$ :+ Q; � '���+��`yQ` Da,�deG Thm Tray Fain ie:.urane�a @60aD§•7819 � - -- ----�— - - x ti������������`�������4�����������ii�i«�sR�ti�i��i�����i���i� 2Q17050603 �er,�(tNO, _� `-'* " �� Parcaf{p No l�G��...� �4�� ,���d C`�d�'� �/f A�t3�'#�����6�tt�1C�8�i3'��{� h�ot 1-I(�f'I C C�- �ou�r oi T� 5� r#�UAiD�R�91flR�D t�ay gr�,�4�st tt��auarmm�t wat D�r��t���tn s�f�raper�j,a�d!�egcnr�s�sm�c�ih chap�r 79a,F►as��t�, h��awttr�i�ar�aUen 1e pgevf��2n#ide N�aa a!�er�n mar�: ,. 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'4� � � t. �9�3(4j(a}�j,���a a��s�gnm�ed by fhs own�t�n+�om s�c4tt�or�thor documm�ie 3s�9m osr�d �a prcvJd�6y ��l, a . -e � � w' o ��e (�ti z��� ��� ae� � � g� ;d�\.�% � � T�t����t�na�.���: �. 4n atldiftan to htma�tP,tho avmsr d�nama �.e.. � �6 � c�, �''' A to rr�slva e oopy o4 th�UenaPo fdotlp ae Arouldod In S�fon'P93.49(41(4)�hYeAB��. �`� w � : � Y�la�hstSmAfum6sra9.�e�os�Ct@�Ify0�lgnat�d.bp-�wntar': �'� � g`�� q. �{r�1tOn�te o9 MoU�04 Gommene�ment(tho e�le�tton qf�o meN nCt lxa 6s^iote Iha aetnpisiton aP conetnmifan and Anql R�m t�stie ° - �,eut vata bo anc,ya�v t�svs sAa�ab ot nnoot�i�u�e a1�t aa4�ks e�easa�tl; �� k} �( � tNARNt}VCE T9 OWN�: R�ipdYp pAYpMq�yN� MASd��Y TH��VYt�R FlFT$R 6KPiRAoTtON F'tt3� Gfi F CONr7`�{SqVG�iE. F. u3 ��.R,�D�d�p�P��'eFRPMII�pQ��•8P�O�YHE� T IQNE?�N:.��A��� O�a���A6,"�x �MUfiiT� Q � u1 �u�.. _ W � UV7YF�iYOLWLENDE�`'C4�ANA4TC�F�.88PK11?B.GKtlN�!!:+!�.NIC?Ri4CRlldx�J�SLTthtl�KIYiTCgQFG��h&�t�#�IL�.�i�t���� {„) �� Q � � } u�a��nanv a�odury,�d�fatai th8t 1 hovs r�ed 9ho 4owgC1ltig rtoVo9 om an�uxyt u�a aa�o�d��,ar��u��n � o � � ��� � a7myh��m+h�Igc,anB.baHo9 � -- --- � � a � �4 � w �w � � 'c'r�� n- a � � � C4U�NTY�OFPA61W �,ra�Rl�`}IARDC.HARTLET`f g�BtuiD ot' 6�9,4t' vR� dr � � f-y- C] Q O +��gyyp��py�+ tS�Uaar181 u.. � U U _ �AtV C1�9@3SIQk @ FFb1269$ � � �,} Q�Y ,�y '4'� EY3if�.7C}y3i.X�I7 'Psa:n O- � '4'�t'�s+sgnl�irm��ur�a catsn�t�nladgad isEs;`ota¢nm thW dmy aP .3U,,,,o,�p 4 S � C? Z e� t�c etAv�. � �itcrrKsy tn�}�ar �d � i- .:� Q U (nama o �h 1 m Ine4rum�nt trtc�s Q�. '� u}- W � z C�'7 J �= t- L� t�- Q a- !!S P�amt�6y Ks�avm Q�Pradt�lcSmtst�ica4}w; Nc�ry�lgrt�tu t� EY_ LC LL S d Z 't�rpa aPlde�Pif�tlan�todua�d ` r��a e��q � `;° � � '� o R�pt:1852373 �e�: 10.ea � � � � c� D5: 0.00 IT: 0.00 t�,� cn Q -�-� Q 04105/2017 J. R., DplY Clcrk r'" cn � �+- z . F�- S � � ~ Q � " cs3 i-- r O � a. m ppULR S 0'NEIL�Ph.O PASGO CLERK & COMPTROL4ER t�qSiYdP¢tDt�ltt9ttO:COtttitt�ti43iri�n�pC4694�8 �40R BK 1 5 m g� �'T�L+ �'�2� _ �. ��.�tXP�� �.00fir�� �f �Ce����� ,��.��i��e ��c� � � • �00 R1c�ard �artlett �'"°' 3840� 3�d Ave. � Zephyrhiils, FL 33542 . �'`' (813) 782-55E5 � (352) 523�1944 � (�13) 973-773? Lic. #CCC 1325499 �►�e o��he ��rges�, �Ide�t, l�o�t �ependable Roofing Compar�ie� irr �entral Fl�ric�a Specializing in Mobile Mome White C�mmercia/Rubber, Shinc�les � Co/or Metal Roofing� . RESIDENTIAL e CON1NiERCIAL e MO�{LE H(�ME LICENSED � d6�lSUi�fED � ��t�DE� � �M�iU1��R OF THE CHAlUIBEF� O�COM►ME�CE� �ETTER �U�IiVESS �UF��A(1 � We do everything vuQ can to maintain our A+ rating from the Bett�r F3usiness f3ureau �er�rir�g �ephyrhe9ls, Dade City, Crys�a9 Spr6ng�, Q�aii F9oltow, �lesley �h�pel, ar�d �urround"ang ���a�. We have re-roofed or repaired more roofs(19,000)in the past 44 years, than the four loca�leading roofing companies com6ined. !N�do nat ctaarge extra fe@�fmr cr�df�card purcha��.Mo�e c�mpanf��cl�arg�3 to�°60 Date 3/27/Z7 ������a ra�. �1laP'Ct2 Mad�.�1-�-� Stebbins Address ___50�1 Sth._ Street,__Zephyrhills , F1. Phone 813-782-2�►17 . ,.._ . ._ - ,.. .�.:,,,�,_ ..... ._,. - , _-,;,,.�-.,..;. z _,,.._.._,..<.L,.- - - - _. , _ -:,�.; _ _ - ,�- , �.::<<�:>�,. ,�-<�:.:�.. ,:f� - x' -n<, r= - --- '�'- - � . ,:-, "nr-�'� r-r - - - ,*�.: �:y}s y - " - .^f:k _ _ " �,:��. -i �fi. _ _ .J�'." q �/ - �:ti:. '!+-:. �t� ..i�•'_;.y:�%�. ,,'+µ-. `;%�::. - ;f"� a{■{� `z' - - ,r'3.� :��- ,�� ��g _�p.���:r.�i _ - 't'��.�"`+;-VI�r: �'i`:1� �i_:`�"°N� �t� "��ll� 9�,�V �� � '����� ��� ''�'.in, ���. .t``w Y�=� :;"cti :��3.�z.`'ei'ii:.�."'..�'.n _ _ - _ ����_,af. V�A. ��_ ..,7' �'Y`.' y`E='-' ��`r'.: '}:�� r.C.♦_ - �`r _ "e_ - _ _ " . _ 't+'' ;4' ' - .r}7'.�a:'^•. ' _ _ - _ - 'Yu'^ - - - - '�4n•= - 'z' - - - -" - =- - �:�.::�.� - _ <-�( ot �he losaer res ure wash the lower roof east side. c nn c ed t b r & material e Install a ,029 5 V cr_i.m ed metal roof on all 3 sides . Scre�v down using a 1 1/2" screw, Install new 20" valley metal , Ins�a11 new 14" ridge venL- . No sal.es taxo 5 year leak warranty . ChPck screws on lower eas� side . 379�a�`� A , 9 � b when material ord red ' � Home � Richard C. t?�S, resldent&Owner , arttett Roofing of Cer�rai FC,Inc. � ', . � �15 0 0,fl� � � � THANK YOU Your Business is Apprecfated. UpO n C o m p 1 e t e t i o n o Payment upon completion unless previous arrangement made,Warranties pertain fo original owner. Ali arrangements contingent upon suikes,accidenis or delays beyond our conirai,Owner to.carry tire,tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance.Customer is liab(e for am�charges incurced in collecting this bill. Rotten wood is an extra$35.00 per sheei(4-plyy.Rotten fascia is.$2.00 per linear foot. ����' -- --- - ---- -- -- - - - . - - -- � Florida Building Code Online • Page 1 of 4 �� , , � � .�:;�..m.. ssaY!�-�.'�..}�,EY�;^ >.�;:i;.�;r���.-?r�:,;�su-:�r,,>s.�.y':-rAr�.,Xt✓.i>o���a:+:�;,<{y,s'a<,s�';�, c�r„s�^z*'_.'�3'�r,�,,.z°-X�' ^��y- '�:r:fu;,,4., .::-a, '�� ��:; ri;r,?�,�'w.�'n-- ':��arr:�.s$;,=:«:��;,:;�;£.�,,.;�'°t"a'<„Kt-?.Z�` S,•;�,+`r;:fs....�. ` ':�� �K':'. ,*3�� `�:`'�',�a�°�k-.,,,� _:a ! �"'`"ii�- �r,r:;'�...< n.-a;. �.� �. �S,y�Lwa� at�_: T?� �. t ,s F �... ;��t»:i�:°.r�'it"'ti3:w;�iLu ,„.�a�;::T,;Xy`�<:;f`'p.s3z� :�' +�.��.�z:%"„;;s-„�;�`��i� �'.t.�-�"^'ex^„,-- xr:.^� ..:��� , ;,s��-a zk� �?_<��._ r,,.r�.s'%�sw��;z:,� �� �*::sz;.e�•�.¢� �' � .�, z"" �� ;�..�s,^,ui .�,�!..3•.'"tiiL: r,3.`��.,;4z:a.r'S'? .4-.`az i,:.'�.�„e" ��'•_ ~ Y:•.<�: `f�''>� 'i�£y v.^:�� y.yF � p ,,,::�r�.�}, r.� � '� .'�.'"�' 3�y?' «,��,;:: rt.'��r�y�ld. n.. 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BCIS Site Map ; Links i Search � Busines�;� . -:� �`=�` ""��Product Approval �r���$$!� �� ���USER:PublicUser �e��lati�r� r ,�",� Froduct Aooroval Menu>Product or Aoolitation Search>ADnlicatlon Lis[>Application Detall �i:a>iz:'y Ece3.<:<�w:�-"z V,�_e, ����'�=�'�`;��'•^`(:���"':�. y FL7271-R3 y�4��,r��Ye���'n#.'£�'i:C�yfi�� �YF �i:a���r.�.2�3��x�."N'..�.t.5 Application Type Revision Code Version 2014 Application Status Approved Comments Archived � Product Manufacture� UNION CORRUGATING COMPANY Address/Phone/Email 701 S.KING ST. FAYEITEVILLE,NC 28301 (910)483-0479 Ext256 1�/' • jstieby@unioncorrugating.com ��o�`���'� `���/�_ �� pr �Ep�y��r /� Authorized Signature John Stieby �e� ���1p� ��� jstieby@unioncorrugating.com etl�� , Technical Representative -- Address/Phone/Email Quality Assurance Representative �L,� � Address/Phone/Email �'R��oRK SH �Al���G �LL C6 Nq�R�bABU�pl�ES �pLYWlry Category Roofing Ofl/A� /VG C Subcategory Metal Roofing cl�O�Z �LER�rL�S�k� ,�f.- €o�Hy Cop� .: Com Ifance Method ���' P Evaluation Report from a Florida Registered Architect or a Licefi�s��� Florida Professional Engineer � Evaluation Report-Hardcopy Received Florida Engineer or Architect Name who developed Bala Sockalingam - the Evaluation Report Florida License PE-62240 Quality Assurence Entity Keystone Certifications,Inc. Quality Assurance Contract Expiration Date 12/31/2020 Validated ey Yoosef Lavi,P.E. � Validation Checklist-Hardcopy Received , Certificate of Independence FL7271 R3 COI CertificateIndeoendence odf Referenced Standard and Year(of Standard) Standard Year ASTM E1592 2001 FM 4470 1992 UL1897 1998 UL 1897 2004 UL 580 1994 UL 580 2006 Equivalence of Froduct Standards Certified By Florida Licensed Professional Engineer or Architect � `• FU271 R3 Eauiv TestEauivalent 7271 UL odf i f FL7271 R3 Eouiv TestEau(valent C1990 19 vdf �� 1.4�....,.//11..«:.7..L..:1.7:�.` ..�„L_../�� ..__� �il __"_'rI�__'_"_____rr±�7�T� _ ar� .7-� �� n�ri�crrrr� .�.i. �ii.i.. � �