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Home My WebLink About17-18386 ` j CITY OF ZEPHYRHILLS _ 5335-8TH STREET (813)780-0020 18386 ' BUILDING PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 18386 Address: 37632 AARALYN RD BLDG 4#36 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: EILAND PARK TOWNHOMES Est. Value: Parcel Number: 03-26-21-0230-00000-0360 Improv. Cost: 1,540.00 OWNER INFORMATION Date Issued: 4/27/2017 Name: WOOLDRIDGE KRISTINA L Total Fees: 45.00 Address: 37632 AARALYN RD Amount Paid: 45.00 ZEPHYRHILLS, FL. 33542-3211 Date Paid: 4/27/2017 Phone: Work Desc: REROOF LEFT SHINGLE VALLEY OF MIDDLE DORMER CONTRACTOR S APPLICATION FEES BAY AREA ROOFING INC REROOF RESIDENTIAL 45.00 � � � Z_ 7iV�� 1 � ��P�' 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 pertormed in accordance with City Codes and Ordinances. NO OCCUPAIVCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. � CO RACTOR SIG TURE PERMIT OFFI R PERMIT PIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER , ____., 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received Phone Contact for PermltNng Owner's Name ,,J `la (� r Owner Phone Number � ""—� �,�', � � Owner's Address „ Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS � - �� 'S�oT# SUBDIVISION �, V� PARCEL ID# �� a/'�� ^�'U�E'� � .�j� (OBTAINED FROM PROPER7Y TAX NOTICE) WORK PROPOSED e NEW CONSTR e IADD/ALT � SIGN Q Q DEMOLISH^ INSTALL REPAIR PROPOSED USE 0 SFR Q COMM � OTHER �2 � i TYPE OF CONSTRUCTION � BLOCK � FRAME � STEE Q DESCRIPTION OF WORK � � � Y � BUILDING SIZE SQ FOOTAGE� HEIGHT �BUILDING $ VALUATION OF TOTAL CONSTRUCTION DELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W�tR.E OPLUMBING $ {� "� �� OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �GAS � ROOFING 0 SPECIALTY � OTHER �`�' FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREA Y I N Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE GURRE� Y/N Address License# PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# OTHER COMPANY � �C-Q O I SIGNATURE REGISTERED N FEE CURRE� Y/N � /�� ^ �t Address License# � � v IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII111111111111111111 RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;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 Permit for subdivisionsllarge projects COMMERCIAL Attach(2)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,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster Site Work Permit for all new projects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. ""PROPERTY SURVEY required for all NEW construction. Di�ections:• Fill out application completely Owner&Contractor sign back of application,notarized If over$2500,a Notice of Commeneement is required. (A/C upgredes over$7500) " Agent(for the contractor)or Power of Atlomey(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (copy of contract required) Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW � ----- �. . -.�. - ----�-5 , -- ._�-��-.�.=� IVQTlCE OF DEED RESTRlGTIOMS: The nndersigned undersfands,that tfitis,permit may;be subject.#o"deed"restrictions""" : which,maybe.more.restrictive.than�Countyregulations; The;unde"rsigned�as'sumes`re`sponsibili.t�i.fo��compliance-with"any` � applicabls deed restrictions. ,. F �;-:-.a�., , UNI..ICENSEQ GOt�TRACTORS AND CO�ITRACTOR RESP.ONSiBILii'(ES. tf�ffie.owner�=has hired-a';contractor or contractors�to undertake work,#hey„may.be reguired ta be.iicensed in accordance with state and;local regulations:-lf,.tFie}��;.„ contractor is naC licensed as requiied tiy.'law;tiath tha owner arid'contractor=may=-tie cited�fo�;a�misdemeanor violation � under state law. If the owner or intended co_ntractor are uncer#ain as to whaf licensing requirements�may:appty'for;#fi:e:°��;; intended work,they are.advised to coniacf`tiie Pasco Gaunty'Bu[iding lnspecfion-Division-Licensing Section at 727=847- 8009. Furthermore, if the owner-has hiied'"a cdntractor ar conuacta�s, he is advised to?have the contractor.(s},:sign;�„, :; portions of the"contractor Block"of this application.for which they will be responsibte.�if you, as ftie=owner sigri`:as.:tfie "=�° contractor,that may be an indication thak he is not properly licensed'anii i's not entitled�to permitting priviteges_in Pasca. ; County. � .=}r_�•,,-;i T�NSPORTATIO(d IRHPA.C7lUTILlT1ES IMPACT AMD RESOURCE REGOVERY FEES: The uniiersigned undecstands :�„ -.,. that Transportation Impact Fees and Recourse Recovery Fees may.apply to the construction.of new,bu3ldings,ctiange af�-��?�;; use in existing buildings,:or.expansion of.ezisting buildings,as specified in Pasco County Ordinance number'89-07 and .=r? 90-d7,as amended. The undersigned also undgrstands,'that such fees,as�may.be.due,wili.�be�identified°atrtt�e�time:of`��`' permitting. �It is further understood that Transportatian ttnpact Fees and Resource=Recovery:Fees must be paid priar_ta receiving a°certificate of occupancy"or final,power release. If the.project does not•lnvolve a certiflcate of oixupancy.ot��* 'f final power release,the.fees.must be paid prior to permit lssuance. :Furthermafe, i�Pasco County W,aterlSewer.-Empacfi-= fees are due,tfiey mu'st_be paid prior to permit issuance in accordance with�app!lcable'Pasco.Gounty ordfnances. , CONSTRUCTtOt�LIEN LAFId(Chapter T13;Florida Statutes,a�amended): !f valuation of wark is$2,500.00.or.more„i;,,.r certify that t, fhe appticant, have been provided with a copy af the "Florida.Gonstruetion�Lien.lav�=Horrieowrier's�� Pratectian Guide"prepared by the Florida Department of Agriculture and Consumer Aifairs. If the applicant is some.one. ofher than the°awner",I eertify that I,have o6tained a copy of the above d"escribed ilocument and promise in good fa'itli to� _ deliver_ik to.the"owner�'pFloc:to commencement. COtd7R�4CTOR'S/OWNER'S AFFIDAIIIT: I.certify that afl the information in this application!s accurate and that a11 work wilt be done in compliance with al�applicable laws regulating canstructlon,zaning and land development. Appilcation is hereby made to obtain_a,permit to do,work and installation as indicated. I certify that no work or insfallation�has commenced prior to issuance of a perm'it and-that all work will be performed to meet standards of ali laws regulating construction, Counfy and City codes, zoning regulations, and land development regulations In.tha jurisdiction. L�a(so certify that t understand that the regulatians of other government agencies may apply to the tntended work,ar�d that it is my responsibility to identify what acfions I must take to be in compliance. Such agencies include but are not limited ta: � - ,Department of Environme�tat Rrotectian-Cypress Bayheads,Wetland Areas and Environmentally Sensitive Lands,WateNWastewater Treafinent, - Southwest Fiorida Water Management District-Welis, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls,Docks,Navigabte Wa#erways. - Department of Health � Rehabititafive ServiceslEnvironmental.H.ealth Unit-Wells, Wastewater Treatment, Septic Tanks: - US Environmental Protecfion Agency-Asbesfos abatement. - Federaf Aviatian A�thor'tty-Runways. !understand that,the.foitowing restrictions appiy fo the use of fi1i: - Use of fiii is not allowed in Flood Zone°V°unless expressly permitted. - If the fi!! materiai is to be used in Flood Zone "A", it is understaod that a drainage plan addressing a "corr3pensating volume"wiii be submifted at time of permitting which is prepared by a professional engineer {icensed by the State af Fiorida. - lt.the fi!( material is to be used in fioad Zone"A" in connection with a permitted building usmg stem wall consUuctian,t certify that fiit wifi be used only to fiN the area within the stem wall. - !f fifl material is to be used in any area, t certify that use of such-fiii will no# adverseiy a�fect adjacent propertles. If use af fii!is found ta adversety affect adjecent properties,fhe owner may be cited for violating the conditions of the building permit issued under fhe attaahed permit application,for tots iess than one(1) acre wfilch are elevated by frN,an engineered drainage plan is required. If 1 am the AGENT FOR'PHE OWEl�R;I�promise in good faith to infarm the awner of the permitting eonditions set forth in � , this affidavit prior to commencing con3truotion.� i undersfand that a separate permi#may be required for electrical work, I plumbing, signs,wells, pools, air condifioning, gas, or othe�installatioris nof specfif+catly included in fhe appiication. A. permit issued sha!!be construed to`be a license'.to praceecJ with tfie work and not as authority.to viotate,cancei,alter,or set aside any provislons of the technic�l codes,nor sha!!issuance af a permit prevenf the Building Officiai from thereafter requiring a correction of errors In plans,consVuctian or violations of any cades. Every permit issued shalt became invaiid unless the work authorized hy such permit is commenced within six months of permit issuance,or if work authorized by the permit is suspended or abandoned for.a period;of six{S)rsionths after the time the work is c�ommenced. An extension may be requested,in writing,from tlie Building Officia}for a period not to exceed ninety(90}days and witi demonsfrate , justifiable cause for the extension. lf work ceases for ninety{90)consecutive days,the)ob is considered abandaned. - WARtdtNG TO OWNER: YOIIR FAILURE,TO RECQRD A NOTlCE OE.GO�MEPICENlENT MAY'RESUL7(id YOUR PkYING 7WICE FOR IMPi�OVEMEPl1'S 70 YOUR.PROPERTY.,.lF YOU;! • OBTAlN�FINANGINCs,CORlStJlT YUITH 1f8i1R 1:END'ER OF2�AN A7Tt7RN�Y BEFORE RECORDING YO Id� QF�COMMENCEMEtVT. � F�ORtDA JURAT(F.S.'117.03} ' r� � OWNERORAGENT COidTRACTOR � r�f�a`'"� �� Subscribed and swom to(ar affirtned�before me this Subscribed and s t o�^ � dy bet cr tfii by 2T— by �U . ,(fi �,�,{ �r�r Wha istare personatty known to me or hasJhave produced � oy�/a�re Rersonally kn�4vn to me or h /Fiave produced as IdenUficaBon. 1�L• d�GPtS L+tP.ocp� `as Identifica8on. Notary Pubiic / �e'� / Notary Publlc - Commfssion No. C mi lon :�� :"_. Commission#FF 150A22 Name of Notary typed,pdnted or stamped Name of M1tota �, n � ��pB��Q19, ; � 1 , . SEN,oR - ��o�o�ar. � � r h � I�� r�' oiscourvr B�4.Y AR�A;RDOFING � 4261 112'"TERRACE NORTf-1•Clearwater,FL 33762 V�NICE PCNELLAS HIL�SBOROUGN BRADENTON SARASOTA ��198 578-1138 930-9339 74fi-3438 954-8777 ' - ORLANDO � �'� r� � �"i 254-553't STATE CERTIFIED ROOFING CONTRACTOR #CCC057644 FULLY INSURED . STATE CERT(FIED RESIDENl'IAL CONTRACTOP, �CRfiC26297 FREE ESTIMATES , ' , PnCPQSALSU861ITTE070 '> PHON . ��/-Y�l� R/z1� ,,J�.t 'S ' ��3- o:,Te —1 STRE� CELI PliO�(E _� c.�3 Z /-�- a�., r.l � . ' � `. �_ CtTY,57ATE AND ZIP CODE ^ n F 3�y2 � � Da�z..� � Br -l�c� Weherebysuhmilspecificaiionsandestimelesfor SHINGLEREPAIFIORDERFORM .7. Remove existing{SE-}��UL-r� )down 3. Supply all labar and matarials ,- to 6are wood. �1�j l.l.�,��( 4. Clean and haul away de6ris . �; 2112 to 4/12 pitch 2 ply's of 151b.telt paper. 5. ( ,�)yoar la6or guarantee b. 1 layer of 30 Ib.fe{t paper I(above 4/12 pitch 6.Contractor lo pay and pull psrmits arxJ make necessary calls for c. New metal eaves drip-if needed Inspections. e. Instali new(iberglass shingles to match existing Price: shingles as ciose as possihie We hereby suomit s�+ciGcalicn,anU esdmates lor MOB(LE HOME,SHINGLE ROOF 1 Remove existi ( )down 3.Suppl I lahor n�materiafs to bare wood. � 4. Clean an hau away debris 2.a. 2�12 to 4/12 itc 2 ply's of 151b_felt paper. 5, ( � }y r I or guarantee h. 1 layer of 30 I .t t paper if a6ove 41i2 pitch ( )y r anufacturing Warranty on shingles only c. New metal e�v drip-if rieeded 6. Contraelor t pay ar}d puli pemtits and make necessary cails d. New lead 6co[s var all venl pipes tor inspecti e. Install 18'min a aper starter strips at atl eaves Price: before instalfin shi les f. Instail new fi6 glass shi�gles( 1 color TNIS CON7RACT DDES N INCLUOE T}{E COST OF ROTTE�,OAMv1GED OR DE7EFIOqATED WOOp,UryLE55 SFECIFlCALLY 5TqTE01N EXTq,q WORK SECTION OF 7}i15 CGNTAACT IF ROTTED,�,sl;,IqGcD OR DEiERtOpATED yYppp IS DISCOVEqED OR WALL Fl.ASHWG NEEDS TO BE FEPLACED,TyE FE°LACEMFM COST WILL BE PR:CEO 8'f 7HE SUP[AYISOR ON SITE AND A CHANGE OfiDEA WILL H,4VE TO BE SIGNED 6Y THE 06VNER CQNTFUCTpq BY L'nW IS NOT TLLGWED TO IGNOpE OR CrSVER UP FOi i ED.OAfdAGED OR OETERfO�iTE�WOQO.THE REPAIR rtREA DESCFIBcD IS THE EIY(7flEfY QF TriE ROOF FEPAIA.THE 6VARRNfTY EXPqcSSED IS FOa IY.AT REPA{P.CYVLy EXTRA WORK: ��P�� LEFT v��,�y ofi M;1l�� aa�v1�� Pq►(� �Ft�-�- F�,As N��J c� g��w ��a�..�v �.,-:�a�,r�. `CL� �' ��S r /�-� �r-Lt_. E V�.,r t-}i N C� ` i - 'r , . � , , � � . � � � � �'Vt PCO�OSC heteby!o lumish material and 4a6or•tamplete in aaarAance witn above specifications,kr ttw sum ol ro be paitl actarCing W tt;e Faymer,t sdxc'ule set(orifi bel w. `r� � � � / ��F_n./ l,_!+ /� Paymertt�adeas �� nt�� /t�0 tlolWrs(S ��[1 � � — �� Down Payment ��9^ P —� Ba�ance �� Authorized �'�. t` Sipnature � Aq unpaia and cuLstarxlinp Dalances tlue hereunCer eheil te subject to a szrrice!Charge ol 1.5"6 per morttry L�cjirminp Note.This pr�pasal may be 1rom date due. wilhdrawn hy us il not ecccpled wil�tn days Acceptance of Pr S e price, i}icatlans TERMS ANO CON�ITIQNS ON REVERSE SIOE ar�mnddions arz sat(sfaclo a a reby led.Y e a 'ed to au Ihz wcrk an spe=ified r. as � Sir�ature x �ale oF Acceplance }� Signalure X THEUNOEF IVEOACKNOVJLEOGESTERMSANOCONDlitQNSONREVEAS£SIOE Ot�75 e ' Florida Building Code Online Page 1 of 1 , . - +��r.,�.,. "'-_ r. �"�`�� '� � ��e'-�- . i R s e � � � , g �•. ` +�� %,... .r r:,. �,:.�' , .� BCIS Home i Log In � User Regis[2tion � Hot Topics ! Submi[Surcharge i Stats&Fac[s i Pu6lications i FBC S[aff i BQS Site Map � Links i Search � ��0('Idd � � Z,"'; ProductApproval ��-, '-- USER.Public User nrr7:: . .�.'I�-_v'!� , Product Aoproval Menu>Product or Aoolication Search>Application List •.i .�. •��>.�.< ..�:._..`'T'r''�,.�a::J'.� . Search Criteria Refine Search Code Versian 2014 FL# 10124 Application Type ALL Product Manufacturer ALL Category ALL Subcategory ALL Application Status ALL Compliance Method ALL Quality Assurance Entity ALL Quality Assurance Entity Contract Expired ALL Product Model, Number or Name ALL Product Description ALL Approved for use in HVHZ ALL Approved for use outside HVHZ ALL Impact Resistant ALL Design Pressure ALL Other ALL Search Results-A lications FL# Tvqe Manufacturer Validated Bv Status FL10124-R19 Revision GAF John W. Knezevich, PE Approved HistorV Category: Roofing (954) 772-6224 - Subcategory:Asphalt Shingles *Approved by DBPR.Approvals by DBPR shall be reviewed and ratified by the POC and/or the Commission if necessary Contact Us 2601 Blair Stone Road.Tallahassee FL 32399 Phone:850-487-1824 The S[ate of Florida is an AA/EEO employer,Coovriqh[2007-2013 S[ate of Florida. Privacv Statement Accessibiliri Statement Refund 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 elettronic mail to this entity Instead,contact the office by phone or by[raditional mail.If you have any questlons,please contact 850.487.1395.`Pursuan[to Sec[ion 455.275(1),Florida Statutes,effective Oc[ober 1,2012,Iicensees Iicensed under Chapter 455,F.S.mus[provide the Department with an email address if [hey have one.The emails provided may be used for official communication wi[h 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 determine if you are a licensee under Chapter 455,F.S.,please click here Product Approval Accepts: ��_' � e_Chxcf. � Credii Card Safe http://www.floridabuilding.org/pr/pr_app_lst.aspx 3/2/2017 ; � . Florida Building Code Online Page 1 of 2 �� -- � T . + �rt�� i�.�. m 0 o b � o ^ _.0 a 0 � �e.•� U;� �:o� ._.�."�� u .:r.., BCIS Home � Log In : User Registration : Hot Topics ; Submi[Surcharge i S[ats&Facts : Publications ; FBC S[aff i BCIS Slte Map � Links : Search i r�Qf1G�� ;�°,�°,}Product Approval � �j�� USER.Public User +NIi.I:.'F h ,.:r�i;�L'', Product Aoproval Menu>Product or Aoohcation Search>ApohcaGon List>Application Detail • " ° s e FL# FL10124-R19 _ �"�' � Application Type Revision Code Version 2014 Application Status Approved Comments Archived �__i Product Manufacturer GAF Address/Phone/Email 1 Campus Drive Parisppany, N]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 :I 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 Expiretion Date 03/03/2018 Validated By John W. Knezevich, PE ±!� 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 http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEV XQwtDquracB eV CbdMQNZD 6... 3/2/2017 , Florida Building Code Online Page 2 of 2 Equivalence of Product Standards Certified By Sections from the Code Product A roval Method Method 1 I'� PP Option D � Date Submitted OS/26/2016 I Date Validated 08/26/2016 i Date Pending FBC Approval 08/30/2016 Date Approved 10/13/2016 Summar of Products FL# Model, Number or Name Description I� 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 HVHZ: No FL10]24 R19 II Z016 08 FINAL ER GAF Asohalt Approved for use outside HVHZ:Yes Shinqles FL10124-R19.odf Impact Resistant: N/A Verified By Robert Nieminen PE-59166 I, Design Pressure: N/A Created by Independent Third Party Yes i Other: Refer to ER, Section 5. Evaluation Reports �i FL10124 R19 AE 2016 08 FINAL ER GAF Asohalt Shingles FL10124-R19.pdf I Created by Independent Third Party. Yes � Back Next Contact Us 2601 61air Stone Road.Tallahassee FL 32398�hone:850-487-1824 I The State of Florida is an AA/EEO employer Coovriah[2007-2013 5[a[e of Florida Privacv Statement Accessi6iliN Statement Refund S[atement �I Under Florida law,email addresses are public records.If you do not want your e-mail address released in response to a public-rxords request,do not send � electronic mail to this entity Instead,conta�t the office by phone or by tradi[ional mail.If you have any questions,please contact 650.487.1395.'Pursuant to � Section 455.275(1),Florida Statutes,effective October 1,2012,licensees 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 official communication with the licensee.However email addresses are public record.If you do not wish to I supply a personal address,please provide the Department with an email address which can be made available to the public.To determine if you are a licensee under � Chapter 455,F.S.,please cli�k here � Product Approval Accepts: �'r', � ?ChecV 'Y.�c -----�----------- -- - Credi; Card Safe http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDquracBeV CbdMQNZD 6... 3/2/2017 f `Y:;"` � EXTERIOR RESEARCH&DESIGN, LLC. �jz 1 �.�- Cer[ificate of Authorization/t9503 `��:' -rR�i�IO�I E�� 353 CHRISTIAN STREET,UNIT#13 OXFORD,CT 06478 ' PHONE:(203)262-9245 FAX:(203)262-9243 EVALUATION REPORT GAF Evaluation Report 01506.01.08-R21 1 Campus Drive FL10124-R19 Parsippany, NJ 07054 Date of Issuance:01/03/2008 Revision 21:08/26/2016 SCOPE: This Evaluation Report is issued under Rule 61G20-3 and the applicable rules and regulations governing the use of construction materials in the State of Florida. The documentation submitted has been reviewed by Robert Nieminen, P.E. for use of the product under the Florida Building Code and Florida Building Code, Residential Volume. The products described herein have been evaluated for compliance with the 5`h Edition (2014) Florida Building Code � sections noted herein. DESCRIPTION: GAF Asphalt Roof Shingles LABELING: Labeling shall be in accordance with the requirements the Accredited Quality Assurance Agency noted herein. CONTINUED COMPLIANCE: This Evaluation Report is valid until such time as the named product(s) changes, the referenced Quality Assurance documentation changes, or provisions of the Code that relate to the product change. Acceptance of this Evaluation Report by the named client constitutes agreement to notify Robert Nieminen, P.E. if the product changes or the referenced Quality Assurance documentation changes. Trinity�ERD requires a complete review of this Evaluation Report relative to updated Code requirements with each Code Cycle. AovertT�semerur: The Evaluation Report number preceded by the words "Trinity�ERD Evaluated" may be displayed in advertising literature. If any portion of the Evaluation Report is displayed,then it shall be done in its entirety. INSPEc71oN: Upon request, a copy of this entire Evaluation Report shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This Evaluation Report consists of pages 1 through 6. Prepared by: �„��,«,,,,,��- � '��...� �� ^tiJy�`.�7'�`•.��% � j�? �J71'PIS_ �•". `_^� � •y.� i��r�.f'I ' �:n\�: �j� MnIC`�;''� RobertJ.M.Nieminen P.E. � ��"'��:•'•' 7hefa-slmllesealappeanngwasauMorized6yRobertNteminen, � 'I��,�1Jj��Lp``��, P.E.on08/26/201G.Thisdcesnotseneasanelectronlr�llyvgned Florida Registration No.59166,Florida DCA ANE2983 d«ument.Signed,scaled hardcoples h�vc been tran:mitted to�he Product Approval Administrator and to the named dien[ CERTIFICATION OF INDEPENDENCE: 1. Trinity�ERD does not have, nor does it intend to acquire or will it acquire, a financial interest in any company manufacturing or distributing products it evaluates. 2. Trinity�ERD is not owned,operated or controlled by any company manufacturing or distributing products it evaluates. 3. Robert Nieminen,P.E.does not have nor will acquire,a financial interest in any company manufacturing or distributing products for which the evaluation reports are being issued. 4 Robert Nieminen, P.E.does not have, nor will acquire,a financial interest in any other entity involved in the approval process of the product. 5. This is a building code evaluation. Neither Trinity�ERD nor Robert Nieminen, P.E. are, in any way,the Designer of Record for any project on which this Evaluation Report,or previous versions thereof,is/was used for perrnitting or design guidance unless retained specifically for that purpose. � i` _ �_'� � •�t' J ->>' 1�R,I�II�;E�D ROOFING SYSTEMS EVALUATION: 1. SCOPE: Product Category: Roofing Sub-Category: Asphalt 5hingles Compliance Statement: GAF Asphalt Roof Shingles, as produced by GAF, have demonstrated compliance with the following sections of the Florida Building Code and Florida Building Code, Residential Volume through testing in accordance with the following Standards. Complian�e is subject to the Installation Requirements and Limitations/ Conditions of Use set forth herein 2. STANDARDS: , Section Property Standard Year 15o7.2.4,R905.2.3 Physical Properties ASTM D1970 2009 1507.2.5,R905.2.4 Physical Properties ASTM D3462 2009 1507.2.7.1,R905.2.6.1 Wind Resistance ASTM D3161 2009 1507.2.7.1,R905.2.6.1 Wind Resistance ASTM D7158 2008 1507.2.7.1,R905.2.6.1 Wind Resistance TAS 107 1995 3. REFERENCES: Enti Examination Reference Date GAF(PDM 1915) Letter of Equivalency SeaI-A-Ridge Impact Resistant IR O1/13/2012 PRI(TST 5878) Physical Properties GAF-025-02-01 03/27/2002 PRI(T5T5878) ASTM D3462 GAF-059-02-01 09/02/2004 PR1�T5T 5878) ASTM D3462 GAF-080-02-01 OS/25/2005 PRI(TST 5878) Physical Properties GAF-324-02-01 12/Ol/2011 PRI(TST5878) Wind Driven Rain GAF-407-02-01 01/21/2013 UL(TST 1740) ASTM D3462 93NK6295 11/29/1993 UL(TST1740} ASTM D3462 99NK43835 01/12/2000 UL(TST 1740) TAS 107 94NK9632 03/29/2000 UL(TST1740) ASTM D3462 O1NK06632 D2/02/2001 UL(TST1740) ASTM D3161,TAS107 01NK9226 05/21/2001 UL(TST1740) ASTM D3161 O1NK37122 12/18/2001 UL(T5T 1740) ASTM D3462 O1NK37122 12/19/2001 UL(T5T 1740) ASTM D3161,TAS 107 02NK12980 04/10/2002 UL(TST 1740) ASTM D3161,TA5107 02NK30871 09/09/2002 UL(TST1740) ASTM D3161 03CA5367 03/11/2003 UL(TST1740) ASTM D3462 03NK26444 10/17/2003 UL(T5T 1740) ASTM D3462 04NK13850 06/07/2004 UL(TST1740) ASTM D3161 04NK13850 D6/23/2004 UL(TST1740) ASTM D3161 04NK30546 03/10/2005 UL(TST 1740) ASTM D3462 04NK220D9 05/06/2005 UL(TST1740) ASTM D3161 04NK22009 OS/09/2005 UL(T5T 1740) ASTM D3462 05NK27924 02/10/2006 UL(TST 1740) ASTM D3161 05NK27924 OZ/11/2006 UL(TST 1740) ASTM D3161,D3462 06CA18077 06/05/2006 UL(TST 1740) ASTM D3161,D3462 06CA18074 06/16/2006 UL(TST 1740) ASTM D3161,D3462 06CA35251 10/18/20D6 UL(TST 1740) ASTM D3462 06CA31603 12/01/2006 UL(TST 1740) ASTM D3161,D3462 06CA41095 12/27/2006 ,UL(TST 1740) ASTM D3161 07NK05228 03/13/2007 UL(TST1740) ASTM D3161 06CA31611 04/04/2007 UL(TST 1740) ASTM D3161 06CA61148 04/09/2007 UL(TST1740J ASTM D3161,D3462 07CA31742 11/08/2007 UL(TST 1740) ASTM D3161,D7158,D3462 08CA06100 03/13/2008 UL(TST 1740) ASTM D3161,D3462 07CA55908 04/Ol/20D8 Exterior Research and Design,LLC. Evaluation Report 01506.01.08-R21 Certificate of Authorization f19503 FL10124-R19 Revision 21:OS/26/2016 Page 2 of 6 - r��_��`l ; �`-. R 1 .'��y �Ral1\I!�j ERD Entity Examination Reference Date UL(TST1740) ASTM D3161,D3462 09CA10592 03/26/2009 UL(TST 1740) ASTM D3161,D3462 09CA06856 05/15/2009 UL(TST 1740) ASTM D3161,D7158,D3462 09NK06647 OS/Ol/2009 UL(TST1740) ASTM D3161,D7158,D3462 09CA27281 08/27/2009 UL(TST1740) ASTM D3161,D7158,D3462 lOCA35554 03/05/2010 UL(TST 1740) ASTM D3161,D7158,D3462 lOCA13686 05/15/2010 Ul(T5T 1740) ASTM D3462 lOCA07264 05/27/2010 UL(TST 1740) ASTM D3462 lOCA11953 10/29/2010 UL(TST 1740) ASTM D3161,D7158,D3462 lONK11951 10/30/2010 UL(TST 1740) ASTM D3161,D7158,D3462 lONK12070 11/04/2010 UL(TST 1740) ASTM D3161,D7158,D3462 08CA06100 Ol/30/2010 UL(TST 1740) ASTM D3161,D7158,D3462 10CA53934 03/31/2011 UL(TST 1740) ASTM D3161,D7158,D3462 11CA48924 10/22/2011 U L(TST 1740) ASTM D3161,D7158,D3462 11CA47919 12/03/2011 � UL(T5T 1740) ASTM D3161,D7158,D3462 11CA48408 12/08/2011 UL(TST 1740) ASTM D3161,D7158,D3462 11CA48725 12/09/2011 UL,LLC.{TST9628) ASTM D3462 12CA34891 10/12/2012 UL,LLC.(TST 9628) ASTM D3161,D7158,D3462 12CA58151 �2/15/2013 UL,LLC.{TST9628) ASTM D3161 12CA38083 02/26/2013 UL,LLC.(TST 9628j ASTM D3161 13CA32332 06/18/2013 UL,LLC.(TST9628) ASTM D3161 13CA37934 OS/02/2013 UL,LLC.(TST 9628) ASTM D3161,D7158,D3462 4786875675 07/17/2015 UL,LLC.(TST9628) ASTM D3161,D7158,D3462 4787434542 05/17/2016 UL,LLC.(QUA 9625) Quality Control Inspection Report,R21,Mobile,AL 12/28/2015 UL,LLC.(QUA9625) Quality Control Inspection Report,R21,Myerstown,PA 02/23/2016 UL,LLC.(QUA 9625) Quality Control Inspection Report,R21,Tuscaloosa,AL 02/26/2016 UL,LLC.(QUA 9625) Quality Control Inspection Report,R21,Michigan Cty,IN 03/02/2016 UL,LLC.(QUA 9625) Quality Control Inspection Report,R21,Shafter,CA 02/18/2016 UL,LLC.(QUA 9625) Quality Control Inspection Report,R21,Savannah,GA 02/24/2016 UL,LLC.(QUA 9625) Quality Control Inspection Report,R21,Minneapolis,MN 02/09/2016 UL,LLC.{QUA9625} Quality Control Inspection Report,R21,Mt.Vernon,IN 02/09/2016 UL,LLC.(QUA9625) Quality Control Inspection Report,R21,Baltimore,MD 03/01/2016 UL,LLC.(QUA 9625) Quality Controi Inspection Report,R21,Tampa,FL 02/29/2016 UL,LLC.(QUA 9625) quality Control Inspection Report,R21,Dallas,TX 02/17/2016 UL,LLC.(QUA9625) Quality Control Inspection Report,R21,Ennis,TX 02/03/2016 UL,LLC.(QUA 9625) Quality Control Inspection Report,R21,Fontana,CA 03/03/2016 4. PRODUCTDESCRIPTION: 4.1 Asphalt Shinsles: 4.1.1 Marquis� WeatherMax�', Royal Sovereign"' and Sentinel� are a fiberglass reinforced 3-tab asphalt roof shingles. 4.1.2 Camelot°, Camelot� II, Fortitude'"", Glenwood'"', Grand Canyon°, Grand Sequoia�, Grand Sequoia° IR, Grand Sequoia� ArmorShield`"', Monaco�0, Sienna�, Timberline� American Harvest�, Timberline° ArmorShield'"' II,Timberline� Natural Shadow�,Timberline HD�,Timberline� Cool Series�,Timberline Ultra HD�'and Woodlandm are fiberglass reinforced,laminated asphalt roof shingles. 4.13 Slateline�is a fiberglass reinforced 5-tab asphalt roof shingle. 4.2 Hip&Rid�e Shinsles: 4.2.1 5eal-A-Ridge° Ridge Cap Shingles, SeaI-A-Ridge° IR Impact-Resistant Ridge Cap Shingles, SeaI-A-Ridgem ArmorShield'"' Ridge Cap 5hingles and Timbertex° Premium Ridge Cap 5hingles are fibergiass reinforced,hip and ridge asphalt roof shingles. Exterior Research and Design,LLC. Evaluation Report 01506.01.08-R21 Certificate of Authorization tl9503 FL10124-R19 Re�ision 21:08/26/2016 Page 3 of 6 r( % � i t`�-� ` __ � s'�—f�li�fl�'�E�D 4.3 Accessorv Starter Striqs: 4.3.1 Pro-Start� Eave/Rake Starter Strip Shingles and WeatherBlocker`"" Premium Eave/Rake 5tarter 5trip Shingles are starter strips for asphalt roof shingles. � 4.3.2 QuickStartm Peel & Stick Starter Roll is a is a mineral-surfaced, fiberglass-reinforced, self-adhering SBS modified bitumen starter strip, nominal 9-inch x 33 ft roll,for use with asphalt shingles with exposure of 6- inch or less. 4.3.3 StarterMatchT"" Sharter Strip Shingles are color-coordinated starter strips for use with Grand Canyon`� and Grand Sequoiaa' series asphalt shingles. StarterMatchiM are installed as the second starter for Grand Canyon°and Grand Sequoia°series installations. 5. LIMITATIONS: 5.1 This is a building code evaluation. Neither Trinity�ERD nor Robert Nieminen, P.E. are, in any way, the � Designer of Record for any project on which this Evaluation Report, or previous versions thereof, is/was used for permitting or design guidance unless retained specifically for that purpose. 5.2 This Evaluation Report is not for use in the HVHZ. 5.3 Fire Classification is not part of this Evaluation Report; refer to current Approved Roofing Materials Directory for fire ratings of this product. 5.4 Wind Classification: 5.4.1 The GAF asphalt shingles noted in Section 4.1 are Classified in accordance with FBC Tables 1507.2.7.1 and R905.2.6.1 to ASTM D3161, Class F and/or ASTM D7158, Class H, indicating the shingles are acceptable for use in all wind zones up to V,�=150 mph (V��=194 mph). Refer to Section 6 for installation requirements to meet this wind rating. 5.4.2 The GAF hip &ridge shingles noted in Section 4.2 are Classified in accordance with FBC Tables 1507.2.7.1 and R905.2.6.1 to ASTM D3161,Class F,indicating the shingles are acceptable for use in all wind zones up to Va,d=150 mph(V�it=194 mph). Refer to Section 6 for installation requirements to meet this wind rating. 5.4.3 Classification by ASTM D7158 applies only to exposure category B or C, as deFined in FBC 1609.4.3, and a mean roof height of 60 feet or less. Calculations by a qualified design professional are required for conditions outside these limitations. Contact the shingle manufacturer for data specific to each shingle. 5.5 All products in the roof assembly shall have quality assurance audit in accordance with the Florida Building Code and F.A.C.Rule 61G20-3. 6. INSTALLATION: 6.1 Underlayment: 6.1.1 Underlayment shall be acceptable to GAF and shall hold current Florida Statewide Product Approval, or be Locally Approved per Rule 61G20-3, per FBC Sections 1507.2.3,1507.2.4 or R905.2.3. 6.2 Starter Shingles or Starter Strip: 6.2.1 Installation of Pro-Start Eave/Rake Starter Strip Shingles, WeatherBlocker Premium Eave/Rake Starter Strip Shingles and QuickStart Peel&Stick Starter Roll shall comply with the GAF current published instructions. 6.3 Asphalt Shingles: 6.3.1 Installation of asphalt shingles shall comply with the manufacturer's current published instructions, using minimum four (4) nails per shingle in accordance with FBC Sections 1507.2 or R905,2, with the following exceptions: i Camelot, Camelot II, Grand Canyon,Grand Sequoia,Grand Sequoia lR, Grand Sequoia ArmorShield,and Woodland require minimum five(5)nails per shingle. ➢ Slateline requires minimum six(6)nails per shingle. Exterior Research and Design,LLC. Evaluation Report 01506.01.08-R21 Certi�cote of Authorization 1t9503 FL10124-R19 Revision 21:08/26/2016 Page 4 of 6 , t -- a i��---�•.w1 � �l�`ti.�f J 1 t` �f�O�jI�Y �ERD 6.3.2 Fasteners shall be in accordance with manufacturer's published requirements, but not less than FBC 1507.2.6 or R905.2.5. Staples are not permitted. � 6.3.3 Where the roof slope exceeds 21 units vertical in 12 units horizontal, special methods of fastening are required. Contact the shingle manufacturer for details. 6.4 Hip&Ridge Shingles: 6.4.1 Installation of SeaI-A-Ridge Ridge Cap Shingles,SeaI-A-Ridge IR Impact-Resistant Ridge Cap Shingles and Seal- A-Ridge ArmorShield Ridge Cap 5hingles shall comply with the manufacturer's current published instructions with a minimum two(2)nails, minimum 3/S-inch head diameter, per shingle and nominal 0.25-inch diameter beads of Henkel"Loctite PL 530 Roof& Flashing Sealant". ��•5 Saalant �^ (292 mm) 1" Sellanta (25 mm) (25 mm) Enduit d'etancheite ' �. 1 � � 12� � (305 mm) Nail Clavo 6 5/8°-7 518" Clouer (168-194 mm) I 12° (305 mm) 6.4.2 Installation of Timbertex Premium Ridge Cap Shingles shall comply with the manufacturer's current published instructions with a minimum two (2) nails, minirnum 3/8-inch head diameter, per shingle and beads of Sonneborn NP1 Gun Grade Polyurethane Sealant or Henkel PL Roofing and Flashing Sealant. 1`�" �B l!.7151 �^ �2u2 ntt'1, '--.._-'-.'.1�' �'�., f�Jruri} ;�,JTr�r/ . nlla�lp �rcluit ci'et.�rr.i�C ta qi� � --- --. .__. .._ --�- "Isi� ��u�� r).- :�'o�er �7�5�-r-ti i G., I�?_J rnr•i; y s- {:9�5 rrt`�'1 6.4.3 Fasteners shall be in accordance with the manufacturer's published requirernents, but not less than FBC 1507.2.6 or R905.2.5. Staples are not permitted. Exterior Research and Design,LLC. Evaluation Report 01506.01.08-R21 I Certijicote of Authorization N9503 FL10124-R19 , Revision 21:OS/26/2016 Page 5 of 6 _ �,,._ j� ;:, �ri �� i `- � _-�� TRIh11l�'!ERD 7. LABELING: 7.1 Labeling shall be in accordance with the requirements the Accredited 4uality Assurance Agency noted herein. 7.2 Asphalt shingle wrappers shall indicate compliance with one of the required classifications detailed in FBC Table 1507.2.7.1/R905.2.6.1. 8. BUILDING PERMIT REQUIREMENTS: As required by the Building Official or Authority Having Jurisdiction in order to properiy evaluate the installation of this product. � 9. MANUFACTURING PLANTS: Contact the named QA entity for information on which plants produce products covered by Florida Rule 61G20-3 QA , requirements. 10. QUALITY ASSURANCE ENTITY: UL LLC—QUA9625;(847)664-3281 - END OF EVALUATION REPORT- Exterior Research and Design,LLC. 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Ifa:s An�cnnsr or ccatnbut�tv c�nab��ion of atlr�r�',�frnal b� Vl/`�L�Il�V'Cl(;lla:j + [�s��li�tior� P�°e��utions: ' t'�o nppruvca r,n�cr .'rx eac°tty gL�scaw �,Ifh tllc,yan�rr.�: ��IH�2'�� 'Y�ti��4: � :not�2��t�rry ublla in mo��th �� no �t l�ve br.c2 nai;,g on thC t7oor,,;y�•watkin�e�,u'�a�c La�ot��..�;.tt fia�cle+xnkal��is� ��9 t , ��---- - -- ,, � �{� �.�� :�� 4 !! ,�- -+-- -�- — - �- ' - f' a i � � � - y � ��—a� , : b � �- �-- - # � � ;1C.aA-:.� �--=------��--- ---- � ��'' (�a-� _�j .._�,.. '�_ � � � S�'f?Pt_F i �a�iPL:_ 5.�4[PLF. � ��'vfP'��_ � ^'--„ '�:�� -* ,.-.�- -- �' - ; Sl� , I I , � 4 � �,.; .� P I �`-� f ' � __` � • - 1 � _ � ,/4Q'1 — —� —� ; — � �L �.."1_�.', f r.�. � �4i fi 1�-�..�' i � r— ! �" '� i .�— �l � � �.�� •` � � -)�.t�1..�.. ��`�i_ �`�.. R"��. i • ` � ��_' {.�� 7D� C` _ f { �---��i�H ' HE��D � �iF�ID � E'QIN� � QL�' �.. J� � � �ir ' :3�C�'�IESS � Z�ndGTi: � I7�! �y / �. � C ; D 1 E �� t ` � ` - T;� i r'� '-�.�'° i �Z8 j t,�� ; . i, a� '; ZbA i �iD? � r=--__.,� 1 - � -�-- - - - --�--- -t � ,�—i+ � � � 7 ! � ' ; 1 �� i/ ` � � ——�' — -----� Florida Builcling Code Online Page 1 of 1 : .d,.�..,.... . .��-,� 1 � ti� � , � ` � a ° e C ; " ' o a ' �%� -P ,,.i :a: y��:r ,�'�" ~•,. � BCIS Home '. Log In i User Registretion i Hot Topics ! Submi[Surcharge ! Stats&Facts ; Publications � FBC Staff BCIS Site Map Links i Search � ��OI70c7 " t �` �; ;�; Product Approval � ; ��USER.Public User , ��t`:, Product Aooroval Menu>Product or Aoohcation Search>Application List ��``�o-"� '- _T' Search Criteria Refine Search Code Version 2014 FL# 12328 Application Type ALL Product Manufacturer ALL Category ALL Subcategory ALL Application Status ALL Compliance Method ALL Quality Assurance Entity ALL Quality Assurance Entity Contract Expired ALL Product Model, Number or Name ALL Product Description ALL Approved for.use in HVHZ ALL Approved for use outside HVHZ ALL Impact Resistant ALL Design Pressure ALL Other ALL Search Results-A lications FL# ��g Nianufacturer Validated Bv Status FL12328-R7 Revision TAMKO Building Products, Inc. Locke Bowden Approved Historv Category: Roofing (334) 300-1800 Subcategory: Underlayments *Approved by DBPti.Approvals by DBPR shall be reviewed and ratified by the POC and/or the Commission if necessary. Contact Us 2601 Blair Stone Road.Tallahassee FL 32399 Phone:850-487-1824 The S[a[e of Florida Is an AA/EEO employer Coovrioht 2007-2013 Sta[e of Florida. Privacv Statement Accessibilitv Sta[ement Refund 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 electronic mail to[his entity Instead,con[act the office by phone or by tradi[ional mail.If you have any questions,please contact 850.487.1395.xPursuant to Section 455.275(1),Florida Statutes,effective October 1,2012,licensees Iicensed under Chapter 455,F.S.must provide the Department wi[h an email address if they have one.The emalls provided may be used for officfal communica[ion with[he Iicensee.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 determine if you are a licensee under Chapter 455,F.S.,please click here Product ApprovalAccepts: � � �h�V -�aa Credit Card Safe . http://www.floridabuilding.org/pr/pr_app_lst.aspx 3/2/2017 I� Florid'a Builcling Code Online Page 1 of 4 . �, -� - � � ~ • �� r , :r~� I ° ♦ � N G r � � � a 0 ; �i ' -_ 'r�?"w.-'�9!'� �=„ :.r,:,� .:s' ,..w . BQS Home i Log In User Registration � Hot Topics ! Submit Surcharge ; Sta[s&Fac[s i Publications � FBC Staff i BCIS Site Map � Links ' Search � r�OIlG�� _..�•.. � �; Product Approval sr�: �2 f • USER:Public User ::i�i ,. .,., ,_i�.,:�. Product Aooroval Menu>Product or AoolicaUon Search>Aoolication List>Application Detail �""' '� s ' FL# FL12328-R7 ',.?�;�.��k� Application Type Revision Code Version 2014 Application Status Approved Comments Archived � i Product Manufacturer TAMKO Building Products, Inc. Address/Phone/Email PO Box 1404 Joplin, MO 64802 (417) 624-6644 Ext2305 kerri_eden@tamko.com Authorized Signature Carter Lea carter_lea@tamko.com Technical Representative Kerri Eden Address/Phone/Email PO Box 1404 Joplin, MO 64802 (417) 624-6644 Ext 2305 kerri_eden@tamko.com Quality Assurance Representative Address/Phone/Email Category Roofing Subcategory Underlayments Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer ! .I Evaluation Report- Hardcopy Received Florida Engineer or Architect Name who developed Zachary R. Priest the Evaluation Report Florida License PE-74021 Quality Assurance Entity UL LLC Quality Assurence Contract Expiration Date O1/07/2019 Validated By Locke Bowden `� Validation Checklist- Hardcopy Received Certificate of Independence FL12328 R7 COI TBP14001.3 2014 FPA TAMKO Underlavrnents- FINAL.odf Referenced Standard and Year(of Standard) Standard Year ASTM D1970 2009 � ASTM D226 2006 ASTM D4869 2005 ASTM D6380 2003 http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqtF2Aezuarj gOlAramDG... 3/2/2017 Floric�a Builciing Code Online Page 2 of 4 Equivalence of Product Standards Certified By Sections from the Code Product Approval Method Method i Option D Date Submitted 08/23/2016 Date Validated 08/23/2016 Date Pending FBC Approval 08/25/2016 Date Approved 10/13/2016 Summar of Products ' FL# Model,Number or Name Descriptian 12328.1 ASTM Slate Surfaced Roll Roofing Roll roofing surfaced with mineral granules Limits of Use Installation Instructions Approved for use in HVHZ: No FL12328 R7 II TBP14001.3 2014 FPA TAMKO Approved for use outside HVHZ:Yes Underlavments-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 FL12328 R7 AE TBP14001.3 2014 FPA TAMKO Underlayments-FINAL.odf Created by Independent Third Party: Yes 12328 2 ASTM Tile Underlayment Coated organic underlayment Limits of Use Installation Instructions Approved for use in HVHZ: No FL123Z8 R7 II TBP14001.3 2014 FPA TAMKO Approved for use outside HVHZ:Yes Underlavments-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 FL12328 R7 AE TBP14001.3 2014 FPA TAMKO Underlayments-FINAL.pdf Created by Independent Third Party: Yes 12328.3 Master Smooth Asphalt saturated organic underlayment. Limits of Use installation Instructions Approved for use in HVHZ: No FL12328 R7 II TBP14001.3 2014 FPA TAMKO Approved for use outside HVHZ:Yes Underlavments-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 FL12328 R7 AE TBP14001.3 2014 FPA TAMKO Underlavments-FINAL.�df Created by Independent Third Party: Yes 12328.4 Moisture Guard Plus A self-adhering modified bitumen underlayment. Limits of Use Installation Instructions Approved for use in HVHZ: No FL12328 R7 II TBP14001,3 2014 FPA TAMKO Approved for use outside HVHZ:Yes Underlavments-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 FL12328 R7 AE TBP14001.3 2014 FPA TAMKO Underlavments-FINAL.odf Created by Independent Third Party: Yes 12328.5 No. 15 ASTM Asphalt saturated organic felt Limits of Use Installation Instructions Approved for use in HVHZ: No FL12328 R7 II TBP14001.3 2014 FPA TAMKO Approved for use outside HVHZ:Yes Underlavments-FINAL�df Impact Resistant: N/A Verified By• Zachary R. Priest 74021 Created by Independent Third Party• Yes http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqtF2Aezuarj gOlAramDG... 3/2/2017 Florid'a Builcling Code Online Page 3 of 4 Design Pressure: N/A Evaluation Reports Other: See evaluation report for limits of use. FL12323 R7 AE TBP14001.3 2014 FPA TAMKO Underlavm ents-FINAL.�df Created by Independent Third Party: Yes 12328.6 No. 15 UL Asphalt saturated organic felt Limits of Use Installation Instructions Approved for use in HVHZ: No FL12328 R7 II TBP14001.3 2014 FPA TAMKO Approved for use outside HVHZ:Yes Underlavments-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 FL12328 R7 AE TBP14001.3 2014 FPA TAMKO Underlavments-FINAL.odf Created by Independent Third Party: Yes 12328.7 No. 30 ASTM Asphalt saturated organic felt Limits of Use Installation Instructions Approved for use in HVHZ: No FL12328 R7 II TBP14001.3 2014 FPA TAMKO Approved for use outside HVHZ:Yes Underlavments-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 FL12328 R7 AE TBP14001.3 2014 FPA TAMKO Underlavments-FINAL.pdf Created by Independent Third Party: Yes 12328.8 No. 30 UL Asphalt satureted organic felt Limits of Use Installation Instructions Approved for use in HVHZ: Na FL12328 R7 II TBP14001.3 2014 FPA TAMKO Approved for use outside HVHZ:Yes Underlavments-FINAL.ndf 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 FL12328 R7 AE TBP14001.3 2014 FPA TAMKO Underlavments-FINAL.pdf Created by Independent Third Party: Yes 12328.9 TAM-FELT Alternate to ASTM D Z26,Type II underlayment Limits of Use Installation Instructions Approved for use in HVHZ: No FL12328 R7 II TBP14001.3 2014 FPA TAMKO Approved for use outside HVHZ:Yes Underlavments-FINAL.pdf Impact Resistant: N/A Verified By: Zachary R. Priest PE-740Z1 Design Pressure: N/A Created by Independent Third Party: Yes Other:See evaluation report for limits of use. Evaluation Reports FL12328 R7 AE TBP14001.3 2014 FPA TAMKO Underlavments-FINAL.odf Created by Independent Third Party: Yes 12328.10 TW Metal and Tile Underiayment self-adhering modified bitumen underiayment Limits of Use Installation Instructions Approved for use in HVHZ: No FL12328 R7 II TBP14001.3 2014 FPA TAMKO Approved for use outside HVHZ;Yes Underlavments-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 FL12328 R7 AE TBP14001.3 2014 FPA TAMKO Underlavments-FINAL.odf Created by Independent Third Party: Yes 12328.11 TW Underlayment self-adhering modified bitumen underlayment Limits of Use Installation Instructions Approved for use in HVHZ: No FL12328 R7 II TBP14001.3 2014 FPA TAMKO Approved for use outside HVHZ:Yes Underlavments-FINAL.edf 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 FL12328 R7 AE TBP14001.3 2014 FPA TAMKO Underlayments-FINAL.odf Created by Independent Third Party: Yes Back Next http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqtF2Aezuarj gOlAramDG... 3/2/2017 Florid'a Builcling Code Online Page 4 of 4 Contact Us 2601 Blair Stone Road.Tallahassee FL 32399 Phone:850-487-1824 The S[ate of Florida Is an AA/EEO employer Copvriqht 2007-2013 State of Florida. Privacv Statement :Accessibilitv Statemen[ Refund 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 electronic mail[o this entity Instead,contact[he office by phone or by traditional mail.If you have any questions,please contac[850.487.1395.'Pursuant to Section 455.275(1),Florida Statutes,effective October 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 official 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[o the public.To de[ermine if you are a Iicensee under Chap[er 455,F.S.,please click here Product Approval Accepts: L�'J � EChe_V, �•� . �fpC11t C2.1'CI - Safe http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqtF2Aezuarj gOlAramDG... 3/2/2017 ��` Ce►tificate of Authorization No. 29824 �� 17520 Edinburgh Drive Tampa, FL 33647 TECF-IY�IICI�L 3EF2VICE5, I...L.C: (813)480-3421 EVALUATION REPORT FLORIDA BUILDING CODE,5T"E�iTionl(2014) Manufacturer: TAMKO BUILDING PRODUCTS, INC. Issued August 22, 2016 P.O. Box 1404 Joplin, MO 64802 (417)624-6644 http:Nwww.tamko.com Quality Assurance: UL LLC(QUA9625) SCOPE Category: Roofing , Subcategory: Underlayments , Code Sections: 1507.2.3, 1507.2.4, 1507.2.8, 1507.2.9.2, 1507.3.3, 1507.4.5.1, 1507.4.5.2, 15074.5.3, 1507.5.3, 1507.5.3.2, 1507.6.3, 1507.6.3.2, 1507.6.5, 1507.7.3, 1507.7.3.2, 1507.8.3, 1507.8.3.2, 1507.8.8,T1507.8, 1507.9.3, 1507.9.3.2, 1507.9.5, 1507.9.9 Properties: Physical properties REFERENCES Entit Re ort No _� p Standard Year PRI Construction Materials Technologies(TST6049) TAP-191-02-01REV ASTM D 1970 2009 PRI Construction hlaterials Technologies(TST6049) TAP-192-02-01 ASTtii D 1970 2009 PRI Construction Materials Technologies(TST6049) TAP-193-02-01 ASTb1 D 1970 2009 PRI Construction Materials Technologies(TST6049) TAP-214-02-01 ASTM D 4869 2005e01 PRI Construction Materials Technologies(TST6049) TAP-215-02-01 ASTti1 D 226 2006 PRI Construction Materials Technologies(TST6049) TAP-216-02-03 ASTM D 6380 2003(2009) PRI Construction Materials Technologies{TST6049) TAP-217-02-01 REV ASTti1 D 6380 2003(2009) I PRI Conslruction Malerials Technologies(TST6049) TAP-218-02-01 ASTti1 D 226 2006 PRI Construction Materials Technologies(TST6049) TAP-219-02-01 ASTA,1 D 226 2006 PRI Construction Materials Technologies(TST6049) TAP-220-02-01 ASTNt D 6380 2003(2009) PRI Constructlon Materials Technologies(TST6049) TAP-222-02-01 ASTtit D 4869 2005e01 PRI Construction Materials Technologies(TST6049) TAP-319-02-01.1 ACC 188 2012 UL LLC(TST9628) 13CA12269 ASTM D 226 2006 PRODUCT DESCRIPTION AND APPLICATION TAMKOO ASTM Slate ASTM D 6380, Class M,Type II underlayment constructed from organic felt saturated Surfaced Roll Roofing with asphait and coated on both sides with asphalt and surfaced with granules. Min.slope. 2:12 Application: The underiayment shall be installed with minimum 2° side la s and minimum 4"sta ered end la s and in P 99 p accordance with FRSAITRI 07230 for tile ' applications. Allowable roof coverings: Attachment of asphalt shingle valleys and ciay and concrete tile shall be permitted in accordance with the FBC. TBP14001.3 FL12328-R7 Page 1 of 4 This evaluation report is provided for State of Florida product approval under Rule 61G20-3. The manufacturer shall notify CREEK Technical Services,LLC of any product changes or quality assurance changes throughout the duration for which this report is valid. This evaluation report does not express nor imply warranty, installation, recommended use, or other product attributes that are not specifically addressed herein. i ' ��"�� TAMKO BUILDING PRODCUTS, INC. �a TAMKO Underlayments TECHNICAL SERVICES, LLC TAMKOO ASTM Tile ASTM D 63B0, Class M,Type II underlayment constructed from an organic felt saturated Underlayment with asphalt then coated on both sides with asphalt and surfaced with granules. Application. The underlayment shall be installed with minimum 2" side laps and minimum 4"staggered end laps and in accordance with FRSAITRI 07230 for tile applications. Allowable roof coverings: Attachment of clay and concrete tile shall be II permitted in accordance with the FBC. TAMKOO Master ASTM D 6380, Class S,Type IV underlayment constructed from an organic felt saturated ', Smooth with asphalt then coated on both sides with asphalt and surfaced with a fine mineral. I Application: The underlayment shall be installed along the valley ', in accordance with FBC requirements. � Allowable roof coverings: Attachment of asphalt shingle valleys shall be I permitted in accordance with the FBC. � TAMKOO Moisture Self-adhered, ASTM D 1970, fiberglass reinforced, modified bitumen sheet membrane Guard PIusO with a mineral surfacing and a removable release film on the adhesive side. Application: The underlayment shall be attached by adhering � directly to the roof deck with minimum 3-1/2" side , laps and minimum 6"staggered end laps. Min.application temperature: 40�F. Allowable roof coverings: Attachment of asphalt shingles and mechanically fastened concrete and clay tile roofing shall be permitted in accordance with the FBC_ TAMKOO No.15 ASTM ASTM D 226,Type I underlayment constructed from a non-perforated organic feit that is Asphalt Saturated saturated with asphalt. Organic Felt Application: The underlayment shall be installed with minimum 2" side laps and minimum 4"end laps. , Allowable roof coverings: Attachment of asphalt shingles, metal roofing, wood shingles, wood shakes, and roll roofing shall be permitted in accordance with the FBC. TAMK00 No.15 UL ASTM D 226,Type I underlayment constructed from a non-perforated organic felt that is Asphalt Saturated saturated with asphalt. Organic Felt Application: The underlayment shall be installed with minimum 2" side laps and minimum 4"end laps. Allowable roof coverings� Attachment of asphalt shingles, metal roofing, wood shingles, wood shakes, and roll roofing shall be permitted in accordance with the FBC. TBP14001.3 FL12328-R7 Page 2 of 4 This evaluation report is provided for State of Florida product approval under Rule 61G20-3. The manufacturer shall notify CREEK Technical Services,LLC of any product changes or quality assurance changes throughout the duration for which this report is valid. This evaluation report does not express nor imply warranty, installation, recommended use, or other product attributes that are not specifically addressed herein. �� TAMKO BUILDING PRODCUTS,INC. TAMKO Underlayments TECHNICAL SERVECES, LLC TAMKOO No.30 ASTM ASTM D 226,Type II underlayment constructed from a non-perforated organic felt that is Asphalt Saturated saturated with asphalt. Organic Felt Application: The underlayment shall be installed with minimum 2" side laps and minimum 4"end laps. Allowable roof coverings: Attachment of asphalt shingles, metal roofing, clay and concrete iile, slate shingles, wood shingles, wood shakes, and roll roofing shall be permitted in accordance with the FBC. TAMKOO No.30 UL ASTM D 226,Type II underlayment constructed from a non-perforated organic felt that is Asphalt Saturated saturated with asphalt. Organic Felt Application: The underiayment shall be installed with minimum 2" side laps and minimum 4"end laps. Allowable roof coverings: Attachment of aspha�t shfngles, metal rooflng, clay and concrete tile, slate shingles, wood shingles, wood shakes, and roll roofing shall be permitted in accordance with the FBC. TAMKO�TW Metal and Self-adhered, flexible, ASTM D 1970, rubberized asphalt sheet membrane with a Tile lJnderlayment polymer film on the surface and a removable release film on the adhesive side Application: The underlayment shall be attached by adhering directly to the roof deck with minimum 4" side laps and minimum 6"staggered end laps Min.application temperature: 40"F Allowable roof coverings: Attachment of asphalt shingles, metal roofing, and mechanically fastened clay and concrete tiles shall be permitted in accordance with the FBC TAMKOO TW Self-adhered, flexible, ASTM D 1970, rubberized asphalt sheet membrane with a Underlayment polymer film on the surface and a removable release film on the adhesive side Application: The underlayment shall be attached by adhering directly to the roof deck with minimum 4" side laps and minimum 6"staggered end laps. Min.application temperature. 40°F Allowable roof coverings: Attachment of asphalt shingles and metal roofing shall be permitted in accordance with the FBC. TAMKOO TAM-FELT Altemate to ASTM D 226,Type I and Type II underlayment constructed from a non- perforated organic felt that is saturated with asphalt. Application: The underlayment shall be installed with minimum 2° side laps and minimum 4"end laps. Allowable roof coverings: Attachment of asphalt shingles shall be permitted in accordance with the FBC. TBP14001.3 FL12328-R7 Page 3 of 4 This evaluation report is provided for State of Florida product approval under Rule 61G20-3. The manufacturer shall notify CREEK Technical Services,LLC of any product changes or quality assurance changes throughout the duration for which this report is valid. This evaluation repoR does not express nor imply warranty, installation, recommended use,or other product attributes that are not specifically addressed herein. �� TAMKO BUILDING PRODCUTS,INC. TAMKO Underlayments TECHNICAL SERVICES, LLC LIMITATIONS 1) This evaluaiion report is not for use in the HVHZ. 2) Fire Classification is not within the scope of this evaluation. 3) Wind uplift resistance in not within scope of this evaluation. 4) Installation of the evaluated product shall comply with this report,the FBC,and the manufacturers published application instructions. Where discrepancies exist between these sources, the more restrictive and FBC compliant installation detail shall prevail. 5) Minimum application temperature shall be 50°F unless otherwise noted. Contact the manufacturer when ', installing at temperatures below the minimum application temperature. 6) Deck substrates shall be clean, dry, and free from any irregularities and debris All fasteners in the deck shall be checked for protrusion and corrected prior to underlayment application. � 7) The roof deck shall be constructed of closely fitted sheathing for new or existing construction. Roof deck shall be installed in accordance with FBC requirements. 8) Unless otherwise stated,the minimum roof slope shall be in accordance with FBC requirements. 9) All underlayments shall be installed with the roli length parallel to the eave, starting at the eave, and lapped in successive courses installed up the deck in a manner that effectively sheds water from the deck. End laps shall be staggered between courses in accordance with the manufacturer's application instructions. 10) The underlayment may be used as described in other current FBC product approval documents. 11) The underlayment shall not be installed over existing roof coverings. � 12) Contact the manufacturer regarding specific exposure limits for each underlayment. 13) All products listed in this report shall be manufactured under a quality assurance program in compliance with , Rule 61G20-3 , ' COMPLIANCE STATEMENT The products evaluated herein 6y Zachary R. Priest, P E. have demonstrated compliance with the Florida Building Code, 5�'Edition(2014)as evidenced in the referenced documents submitted by the named manufacturer. ```��►i�i►�� .��1G?P�Y E N�PR�F��i �O 1 U.O O.� : P:��.�C' SF • �' �'. '1�. �, . � - . . � No 74021 ' � - �- 2 09.35.39 *: :* ' �.,�wry��...w.� _-�� * ��= -04'00' � :��• STATE OF :�/: :O'•. �<v: ��•:c� � R �p P•'� ,� Zachary R. Priest, P.E. � Florida Registration No.74021 ��'��,S�ONq�� Organization No ANE9641 CERTIFICATION OF INDEPENDENCE CREEK Technical Services,LLC dces not have,nor will it acquire,a financial interest in any company manufacturing or dis[ributinc�produc[s under this evaluation. CREEK Technical Services,LLC is not owned,operated,or controlled by any company manufacturing or distributing products under this evaluation. Zachary R.Priest,P.E.does not have,nor will acqulre,a financial Interest in any company manufacturing or dlstributing products under this evaluation. Zachary R.Priest,P.E.does nol have,nor will acquire,a financial inlerest in any other entity involved in Ilie approval process of the producl. END OF REPORT TBP14001.3 FL12328-R7 Page 4 of 4 This evaluation report is provided for State of Florida product approval under Rule 61 G20-3. The manufacturer shall notify CREEK Technical Services,LLC of any product changes or quality assurance changes throughout the duration for which this report is valid. Thfs evaluation report does not express nor imply warranty, installation, recommended use, or other product attributes that are not specifically addressed herein. ,Jul, ll; 2009 10. 13AM Su��oa�t Clearwafer No, 1662 P. 1 - - �� .__ ° � � � �� SUIL�ZKG PRODUCTS OF�AMERICA CORP. 430 W, MERRICK ROAD,VALLEY STREAM, NEW YORK 11590 • (516)568-0222 • 1(800)BLDG PpT • FAX; (516)Se8-0709 12900 INDIAN ROCKS ROAD,#2, LARGO, FLORIDA 33774 - (727)b96-0259 • FAX: (727)596-OOb2 575B NORTH LAS VIRGENES ROAD,#2B1, CALBA5A5, CALIFORNIA 91302 • PHON�/FAX;(818)880-4292 � d � ' r � I ' � M � u � _ .. . k �: • �.... ■ _ . .. n 'L � . . .. �e� ��'C�'Si. � I � ... Product l�lame: Physi�sl Data: R,out�G He�Meti!Cep Nai1a goili�g PoitII: Not AppliCebla Fedexal S eeificatioo Number: �°°�P°� Not Applicohle p Mcirin�Point Ba9o: a,75o F F�'N-IOSU Tyye II,Sryle 20 Mal�agpCu��oadng; NoC ApDlicebk 6peaSc Cirsvity: T.ES Vepac Ptesautt-at 20°C: Not ApDiiceble �Ie�lth Haza�d Deta: `�°`�.c��: Not A��,� SQtubilia in Wetor. Not BoluDle 9xei.�W p�Qu�u undert�n�,onal eecdtdons eo ant p�eaeat aa 9b of Wh�4: Not AppIicable sab�tletlaa.ingestiost coi�ct8mlthpreavitanmc�tsl�nl. Evapos�laaRatt; Not Appficoblc ^ Ph: Not AP9lic2ble Oi]/Weker Diouib�dieoi Cor�cleai: Not��ppliCable ��ire and Erptosion �a�ards: QdorT'ha�heid Coaceffimeion: Not AppUttcble No��nable ar oomb�c�able. fitenl p:oducte�tho sottd eteme pre- Aypea:aaee(P1�sical6t�s nnd Color): Metalbe G�y 9olid Stnt uD IIrC or exgl.a4leri�ead do apt Coaadbute W LSe co�ibos• �Or No QQoz tion of cil�at�aocrieL9, • �ire and Egplo9ion Dets: B�iag�ti�dng�fefli9: Not AppBc�le SDCCial Fite Fight�In�uctions: Nome ,�;,; fiaatdaus Cbmb�'don Ptodncts: Sla616 under t�tma]coadttinne of ,�"' •'•� ;-r�;.,- wae ��,Bnd uanapoR Wll1 w e �'• ;,s,�,�:;;..- � ti, �;�°;:,x;:.;�,,, rCe�Ct w�it�euODs(nCld 901�boCaie ' "•. 1� • .,'• '� �5;� hyQm�CABi t2mperahaes abov� . �''� : M1��"1 the md�PaLt�.�ay 15�4et0 ��Y ' .�;W;• . �},�i: f�nes oo�faing o�ddes of imn •�'�.. ,,,�'j�-,,'^.. r ° �"_�`�,�7 h � �. B�9�ICyI[lg B�SIL. !'„ Oxid3�g Mat�a�al: Doe�nDt oaase nr ca��bux to _. oombuetion of od�r a�edAl by yieIdiAE o�izcr ��stali�tion �recautions: CTen a�psrved]�aexume: • Uss esdtry g]pasa��ltb t!u�mmer �Cenerei Wernings: � ,not bold or esayr aalls�n mc�uth Do cat 108ve}oeee aal1�on the�loor�r as�y w�aag rn�'ace Do eot uae to f�a�n oteet�Cal wsN � � � �, � rr.nn r_nn� i f �nn � � c r r �� 1"')�� l�l1"�.il.��.7 c c � c < c �,- - � T -f�' � � � I n � � �AP-� 0 T ,� �)CaP:sQ �� :�) '.� : t� � �� sA.�t� saMl� � S1� � �� . a � $� I ; 3 � ��.--� � ; n �.a 24 a za.o �s.a � : � � � � - , , � 6 --� � i Z)�IL:ST�'G1'llZ'E (��-) t�',gl �io�) - LFAGI7� H�1D i�D PQINf - OC►7' �� - �, � � p� Ti�CK�SS i�T�i � ZYFE ,�, ' ,� B C 3 � � - �� ]-L�," 5�.8 6;g 1_Q 43 Zb� ADP � ' -._. �_�_. - --� � , , , AUTHORIZED AGENT AFFIDAVIT . , � fy(� I��/s'��CfyUl�hereby grant authorization to�/�� (Contractor) (Authonzed Agent) to act in my behalf with the Hernando County Building Division while conducting activities related to obtaining permits. These activities specifically include signing all documents requiring signature of"contractor". .�_ , � is to be considered an agent of my business and (Authorized A ent) 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 contracting business. I ��L '�jSGdiWQ�/'U�elieve the Hernando County Building of, (Contractor) and agree to hold the Hernando County Building Division harmless from, any and all responsibility, claims or other actions arising from or related to the Division's acceptance of the above agenYs signature for permit-related activities. I further understand that it is my sole responsibility to grant and terminate any such authorization and to ensure that the Division eive timely notice of any such gr t or termination. ' Signature of Contractor / ignature �Agent �e �Q.�-� � ��/ State Certification or Registration Number , County Certification Number (if applicable) *'PLEASE NOTE: BOTH SIGNATURES MUST BE NOTARIZED** Notary for Contractor's Signature: Notary for AgenYs Signature: State of � County of 1 /G�TiY j�� State of � County of ��1�.(�l�-G ) The foregoing was acknowledged before me this � The foregoing was acknowledged before me this ' � d of � ✓" / ! b da of`�l�P�:/�iiL11.✓t�� by�OJ7�/ � ,who is personally known o i ersona nown o me r o me, r who produced as who produ d / as en ificatio . � I n tfic on / � ��,-.� � Notary Public Sign t e =eR'1 '= ' Notary Public Sig ,��:"•• •-,, • :�. �';;: MY CONfMISSION A FF 238396 ;�. ,� MY COA�h�ISSION�FF 238396 =��. �a: EXPIRES:June 8,2019 :y:, ;° EXpIRES:June e,2019 7�Rf��' Bonded Thru Motary Public Undervrtiters �1,'""'Q.p`�� Banded ihru Notary Public Undervrriters Print,Type,or Stamp N "�'�°"' Print,Type,or Stamp 'The original of this affidavit should be kept in the possession of the above designated"Authorized AgenY'. This affidavit need only be produced to Hernando County when signing documents in the presence of a permit representative. When you sign a permit application be prepared to produce this affidavit, it will be copied and placed in the appropriate permit application* *''�Tlre Drvisioir,at its discretion,ueay require a contrnctor or lice�rse-ho(der to personally apply for or obtain a buildrng periuit i irorivitl�sta�tdiirg afey audeorization aUorvr�:g another person to apply fo�•or obtain any peru:it at behalf of a contractor,qualifter,or license-ho/der. ' Revised 10/2015 contauth.sop / � /