Loading...
HomeMy WebLinkAbout17-19102 I CITY OF ZEPHYRHILLS 5335-8TH STREET , � (813)780-0020 , 19102 BUILDING PERMIT `� PERMIT INFORMATION � - - : LOCATION INFORMATION - Permit Number: 19102 Address: 6015 9TH 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: 02-26-21-0160-00100-0110 Improv. Cost: 9,384.00 OWNER INFORMATION Date Issued: 12/07/2017 Name: GRAY AARON L & SANDRA Total Fees: 127.50 Address: 6015 9TH ST Amount Paid: 127.50 ZEPHYRHILLS, FL. 33542-3515 Date Paid: 12/07/2017 Phone: (813)312-1961 Work Desc: REROOF SHING 24 SQ 3 SQ MODIFIED CONTRACTOR S APPLICATION FEES RYMAN ROOFING INC REROOF RESIDENTIAL 127.50 �� Ins ections Re uired � � DRY IN ROOF INSP TAPE JOINT 00 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 properly that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing,consult with your lender or an attorney before recording your notice of commencement." Complete Plans,Specifications Must Accompany Application.All work shall be pertormed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. � (j0� CON RACTOR SIG ATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER s�s-780-0020 � Cify af Z�phyrhilis Permit Application Fax-813-780-0021 - � Building Repartment D�t�Rec�ived ¢ Ut � �(,�t� ' @�hone`ConQ�c�fcir P�emiQtin C.}t� � �� �{.F��. U � , Owner's tVaenm ��� �a ' � Own�er H�hone Plucvtber �� -3�a —��W I Owne�'s:Addr�ss. I Owner Phone�9�amb�r �� � F�e Simple Titleholtler�i�am� �� � �wner PY�a�a�e�9urmfoeP �— � Fee Siunple Yitleholder�,dd¢e�ss �o��;�n�a�ss �?���J � �� �1 (�1 i� S � � � � ��o� Lor� � �� � S4l�Dt1tiS10Rt �1��b(� � �,��a���.�o� d.a-��-�1 - (�I�D " �Ot Ot3 --b 11{3 —� (pBTAIPJED FROIIfl PROPERN TAX PdOTICE) �I�RK�?�OP�O��� � N�w coN5zR ADDlACT � SIGN C] 0 DEMOLisH � � INSTALL 8 •REPAIR ��OP,,O�ED USE � Q 5FR Q COMIVI � QTHEFt —v YYP�CiF COP�STI3UG'TIOPJ j Q BLOCK • Q FRAME � STEEL. Q � ; �Esc�ai��na�oF.wa�xa� � �:`o�F ,�P ..�c3tr� p��{ � �t�� 1 +�I e,S c.�Ji�-�'1 G S� t'�I�.rr- �C U�} C�¢.�l'i� � � �� 5 (1'!a� i�i�'� �v��:�t����z� � � ,. � sQ�oo��;�� .c���b ¢a�i�w� ��_� � i�ve'Y1CLt'� �BUl�DlN �' $ (����J t�!? � VALURi'I��OF TOTAL CONSTRUCTiOht . � � ' /z� , � [�ELECTRICA� � $ AMP SERVlCE 0 PRC}GF2ESS El�EF2GY Q W.R.E.C. ; QPLUMBING � � � [�MECHANtQAL ' �; � VALUAT[QiV OF IUIECliAV�ECAL INSTALLATE01� �,� [�GAS Q ROQFIRtG Q SPECIALTY � Oi'HER � �� FIfVISHED FLQOR ELEVATIdiVS r�� FLOOD ZOiUE AREA �YEB fV0 L �uiL�E� c����av �����+���� REGISTERED Y/ (V FEE CURRE� Y/IV ' ,�cPc9r�ss -License# �— � �I.�CY@�I.C1RR1 C�fl!➢O�FrIUY SIGf��,TURE REGISTERED Y/ RI FEE CURRE� Y/N' dlcPc�ress ticense# �- � � �i.u����. �o�t�,�v- 'SIGWAATURE REGISTERED Y�/�N- � FEE CURRE� Y/N +QddP�ss License# � � �il��F�i4�tCAi: � C��11@��Y ' . SBGV�A4TlDPdE• � REGISTERED Y/ fV FEE CURRE� Y/•IV' ,4t9�r�"ss Lic.ense.# �— � c�����a- .. , �� co�p�v tt}`�C� (�t;�t� �G'�C- , SIGMA'B�URE:� �; ,REGISTERED Y/ N FEE CURR ' /N At�c9P�ss. �,! `[� r !�.. 't �� I�S �� License# CCr��..l���S�� � Q2E�ILlEt�TtAR.;�. Attach�.(Z)sP2df'Pians;'�`(2)=sefs�ofButlii9rig�`Plan§,.{9)'se�'of'Energy`'Fafi7is;'R-O,UV:Permit.fornew.consfructipn,. � :, • , �.MinimUm:,:ten?(,1'Q)wprklhy;tlay",s�after-submittal�d�te. 'Required�on�ite�'CanstrocGon Plans,.S�tormwater Plans w/5ilt Fence.installed, �3 Sanitary;Facilities�,&};�1�.:dumpster S,.,ite: ,W.or;k�Rermitfor;'sutidi"vis'ions/large.projects �OiU3M�gtG0,4B. Attaoti(2}ebriYple#e"sets of Buitd�rig P1ans plus a Llfe Safety Page;{1}set af Energy Forrrss.R O-W Permit far new construction. , Minimum ten(10)warlcing days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/8ilt Fence�installed, Sanitary Facilities&1 dumpster.Site Work Permit fo�all,new proJeats.All commercial requirementsmust meet oampliance �SlG�i P'E�1�li' A#fach{2}sets ofFErigineererl Plans:��� *""*PROFEF2TY Sl:1RVEY required for.all.NEW.construction. Dti�cY9ons: _ _ ,_ - Ffll out appiieation aompletely. Owner�Cantractor sign.back of application,nota�ized if over$aS00,��IO$�C�O��GOlYIIYl�PfC�(i'l�91Q IS P¢.'t�II1iP�t0. (,�1G u�gr��+es ov�p$7�Od) i ... - '" Agent(for'4he cont�actor)•or Power of'At4oFney(f6r'the ovirner)would tie�someone with notarized letter fram owner authorizing same .E?UER.Ti��'GC1i3,�tI3ER;�?ER�U(}�"�'I�G {copy of confracf�required} � Reroofs if shingles Sewers� 8ervice Upgrades A/C Fenaes(PIoUSurvey/Footage) , _ • _._._,,............,, .,._ , �r�vevuays»tltcttaves-Gauntec:iF_ort pu6lia�roadvuays:xneeds R4W : _..__. _ .�. ._ - µ._1-� .. `v, -.-____ ,, ,.� r�; ;.. .. .., ;e '� i�;! 5��'{ ' .L� ,.?.,.. 'a?,-- F� � , i ' ' � ��5 � . ., .. � ' ' '!;;� �i r i i�. i '• � •..y���v:�-,`" 'ti '�5,: ._. tt�' ., . . � r: .� :��.." ,fi . , ' . < . �. _. i£ ..7 t. � , i . . .. ' ...T....a...,. ...�.._ .... .T .,,. ..�:m-<-z...r.,. .�......�. �.._� .�...m.�...,�•.m.�..<=�_�ano�.aeFu�:c:suz:-.r•a•unsti.�z°�iac�'.LSt:�4;1!°�9:'t`S3tCiuz�.fd',..�:1:Gb'y� ' 'f t, ,.y;....-.,; ���'@c�lE�9����� I����'l����'��l��: The undersigned unclerstands.that,fihis,per.mif.may�be subjec�to"deed;' �estr'sctions. ...,r:;.....,.,.,�. .,>;,,:.,.. which..may.:b�:,mor�.r,esfi�icti���than:County regwlations:- Thea�wnder�ign�tl�=assume`st�respoiasiliility'fa�^cQrz�plEance�`viritia.=aiiy`"m" I applicabie deed res#rictions. � �:.,. : �� -� � �H��.8��6����:C�I���B���`�DB�� r,��8�� ���I'111°-�s���'�6� �����2.�R���9�.8"��i��: if�tiie owner has°hired..a�contractor or contractors ta underta�e work, �h�y may be cequir�d,#a b��ticensed.in accordance vvith sfia#e and loea) regwlafiions:::��if-.the:- � contractor is.not licens�d as�r�;quired bjr'law, bofh the owner and:con#ractcir�rrtay�6e�cj�ecf��#or-a'miselemeanor viofa#ion under state law. If fhe owner or intended cantracfior are uncertain as to what lic�nsing requir�r�er�ts=�amay:apply for..tf�e�a �� intended wor.lc, fihey.are advis�d to�contact�tti�`Pasco County Building Inspection"Division�Licensing Section at 727-847- ; 8009. Furthermore, if the own�r has hir'ed�a contractor or cantractors, h��is advised to ;havel fh� contracto[(s).:sigp,= ; I parfions o#fihe "con�ractor �1ock" o�ti�is applica#ion for which fhey wili be r�sponsible.. If yau, as�itiie�oviirie`r`'sign as'fFi'e contractor, thafi may be'an indication that he is not prop�rly iicensed arid is not erititEed"to permifiting pri�ileges in t�asco County. ' `�'� ' - "������D��°�11f'@�I� 9V���AC�'/.��°@���'9���8����1�t�6�1� f�����R�C� V�f���@9����[���; 'Che undersign�d understands thafi Transporkafion impact Fe�s and Recaurs� Recav��r Fees may.;apply fio the construction of new buildings, change:of`�'-' use in existing bui[dings, or expansion.of;�xisfiing E�uiidings, as specified in 6�asco County fJrdinance number 89-07 and 90-07, as amencled. 7he undersigned-also unde�stands, that suct�,fees, as may..b.e.dtte, wilt tiei I�Gi iLI'{�� G1L:kfih��fiim°e>of� . p�rmitfiing. It is further understood that Transpa�ation lmpact Fees and Resout'ce'.Recov�ry Fees must be p�id pr�iar to r�ceiving a "ce�fificate of accupancy" or fiinal,power release. lf fhe�project does not inuolve a certificate of occupancy.or� final power r�lease,.the fe�s�.must be-paid pr.ior to permit issuanc�. Furkhermore, if Pasco Co�nty W.,atee/Sewer:lmpaet. �ees ara due,they musf be paid prior to permit issiaance in accordance with applicabie I'asco Caunty orc�inances. ���5�'����'���9 �:9l��4 ��a@�9��������7��, U���g6�P��4�aa����,�����ov����: if valuation of work is$2,50Q.00 or more,..l certify tha� {, the applicant, have b�en peovid�d WftP'} � G0�3� a� �he "Flarida Constructiort Lien Law Fiameawner`s Protection Guid�" prepared by 4he Florida Department Qf Agriculture ahd Gonsumer:Rffairs. If the�applican#�is sorrteane other than the"owner", I:cerfify that I have obtained a copy of the above described tlocum�nt and promise in goad faifh�to d�liver,ifi fio fihe."owner" prior ta commencemenf. � ���3'��"���'�1�����'���I���1���': I.certif�.that.all the informa#ion in this application is accurafie and"that all"work uvil! b� dane in compliance wi�h af! appl9cable laws regulating canstrucfiian, zaning and-lanci�deveiapment. Application is hereby made fo obtain a perrnit.fia .do worle-and instaElafian as indicated. I cer�ify that no work ar ins#a(Ea�ion�has commenced prior to issuanc� of a permif anci that al! work will be performed 4o meet startdards o�' al! laws r�gulating constructian, Counfiy and Cify cad�s, zoning regulations, and land developm�nt regutations in;�the jurisdiction. ! afso c�rtify that t understand that fhe reguiations of ofher government agencies may apply fo the int�ended wark, and that ifi is my responsibilifiy fio identify what acfiians I mus#take to be in campliance. Such..agencies inc(ude but.ar�not fimi#ed.fo: � - Department_of Er�vironmental.'Fratecfiian-Cypress��aylieads; Wetland Ar�as and �nviranmenfiaily Sensitive Lands,WaterlUllastewat�r Treafimenfi. - Southwest Florida Wafsr Managem�nfi Distric#-Wells, Cypress �ayheads, W�tland Areas, Altering ' Watercourses. - Army Corps ofi Engineers-Seawalls, Docks��Navigable Wat�rways. � - Department of €�eal�h $� Rehabiiifa�ive Services/Environmentai .Healfh Unit Welis, W.astewater Treafiment, � Sep�ic��'araks. , - US �nvironmenta!Protection Agency-Asbestos abatement. - F�deral Aviatian Authority-Runways. i understand fihat:.the following:re"sfric#ions apply#o the use of fill: - Use of fiii is not a1lorNed in Flood�one"V"un(ess expressly permifified. - !f �he fill ma#eria! is to be used in Flood Zone �A", it is u�derstood that a drainage p(an addr.essing a °compensa�ing volume" vuil! be submitted at time of permitfiing which is prepared by a professionaf engin�eer licensed.by th�State of Florida. - lf fihe fiill material is to be used in Fload �one °A" in connecfiion .wifih a permifted builtling using stem wall cons#ruction, 1 certify that fil(wiil b�used only fo fiill the area wifhin the st�m wall. - if fi(I �material is to :be used in any area, 1 certify that use� of such�fili will nafi adve�s�ly affec# adjacent p�op�rtiss. !�use of fill is fpund to adversely affect:aefj�cent proper�ies, �h� awner may�be cited fior vialating the eonditions of the�buildirtg permit,issu�d under�the°aftached permit applicatian, far iots.less than one (1) acre wliich are�I�vated by fill, an�ngin�ered drainage�plan is required, ' (f I am the��I��➢�'�'��"�f�� ��4�I�R, I promis� in good faith to inform.th�owner of the permitting conditions set forth in this affidavit prior#o commencing canstruction. I und�rstand that a separate permit�may be require'd for el�cfirical wark, pfumbing, signs, we1ls, paals, air conditioning, gas, or other�iristailafians na# specifically included in fihe application. A permit issued shal! be construed �o be a lic�ns�ta proceed r�r'sth the vvoric and no�as authori�y fo vioiat�, cancei, ait�r, or. �. set aside any provisians of th�technical cades, nor shall issuance of a permit prev�nt the Su�ld9ng Official from thereafter requiring a correcfiion of errors in plans,�construction or violatians of any codes. Every permit issued'shaq becom�invalid unless th� work authorized by such permit is commenced within six mon�hs of permit issuance, or if work authorized by fih�p�rmit is suspended or abandoned-far a pesiod.cf six(6)eronfhs-afi#er�he fime�h�work is'commenced. fi+n�xtension may be requested, in vur.iting, fcom tlie �uild9ng �f€icial for a period.not to exceed=riinety{90} days and..�witi demonstrate ' jusfiifiable caus�for the ext�nsion, !f worlc c�ases for nin�ty{90)consecutive days,th�`job is consider�d abandoned. ��a��6�dG �"� ��R���: ��6��2 �e��1L�9�� 'P�,��2���� � �9�.�'9�� �� ��.h�16l4���1��6l69��1�' 6lfdi�lf��$��@.�8�� 0�9 �f�U6� (P�1f9P��'9�t9��� I"r��6iVd��0�9���9���.�'; �,f��l.�;��i�i��93'fi'Y:. 9���&.01�.�.�fi�'P������'�-���' V6�,iF9��6i��6i��; ���9�Q.Dfl�'P �H�'�4 YQ�9���:��9���2��'� �`�"�'�ti ��6��:��.�IE����GB�G Y�D�DR'��'B' =t� ��'- diii�6��E4t�Ei��`. FLORIDA JURAT"(F:S.- '17.03 i � - � � .r- • Q���������'9��� �.'��'���{'..��� � ..�. Su s,grib d and sw4r�to o � ` d e e}�s Sub ccibe and s ry {o � �q ef re me th�i f i rl� i7 by J�J1 � G�cs'" 1( �i –1 by Yl �I`iG l,l)(k)�" I Who islare gersonaity knawn to me ar h ave produced Wha 9slare persanat own me-.�r ha have produced '"'"�`� as identification. � as identiflcatian. / �_��'�" —Notary Public Notary.Public Commission Na. Commission No. � I Name of o t ed ri ted a�r stam ed Name af Notary typed,printed or stamped �� .`��- ,.•`m,:�:'�'- KELLI B. RYMAN .�``*°o""�� KEL! B. RYMAN � =�°f ,�,�"`�? Commission N ffi�J05017 `�'�* 4¢�""'- Commis ian# FF 9050i7 `W�'�� �Y Co�nmission Expires ;. •? ;..,�4'; My Com is5ian E�pires ��''�%°,;,,;;`''� July 34, 2019 �'%:;p��•°:•` Jul � 30, 2dt9 t r+ts+` I J � � �^j ERICAN ="��� y�• � ' D�RES ,�r:�, - Ry�m a n Roof i n g� I 1 e�. 5%fee for credit card processing. , _ A Division ofRyman Construction,Inc. i�}:r,' _ � ,:``''` Pro osal# '- `� (� 36413 SR 54 • Ze h rhills Florida 33541 P �� - P Y , �� Phone (813) 782-6094 • Fax(813) 788-6773 N�• 00240.5� �� ��I��t�`���� 1-855-Go-Ryman (1-855-467-9626) • Lic.#CCC 1325505 Estimate# � www.RymanRoofing.com � @�� Serving all of Central Florida Job# oWne�rnu��naser Sandra Gray Date: 11/16/17 Claim#: InsuranceCompany: I Policy# �ob Address: 6015 9th St �;ty. Zephyrhills Z;P: 33542 Mail to Address: E-Mail Address: Home #: $13-312-1961 Cell #: Business #: ❑✓ Complete tear off of existing SIlI1lCJ12S Additional Notes/Special Concerns: I IICIUd@S Install new GAF Timberline limited lifetime dimensional �✓ Secure all loose roof decking as needed according ShIC1gIeS to Florida Building Codes ❑✓ Roof dried in with SVnthetlC Four sheets of plywood ✓❑ Install new valley metal with galvanized metal Q✓ Install new 6 "drip edge color: Whlt2 0 Install new lead boots Seam sealing along TPO-shingle transition ' Q Install all new.general roof vents �✓ Install new ❑✓ hingle �Metal �Tile Reflash along roof where pan roof joins shingles .�� �Modified Butimen ❑TPO ' Q✓ Manufacturer (sn�n9ie, meta� or ti�e) C�AF Permit and scheduling of inspections MBflUfciCtUfe� (TPO or Mod. Bitumen) �✓ Color:(Shingle,MetalorTile) Birchwood Color.(TPOorMOD.Bitumen)�I�hi.1�.P � All roof related debris removed from job site, pick-up loose nails using commercial grade magnet Q All materials,labor and permits furnished Base Price"$ ��384.�� � Provide a Five vear labor warranty Additional Items: 1-3" boot Pa ment Method: Check# 1 1 1 1 Cash Financin Insurance Claim Y � ❑ � 9 � ❑ Credit Card# Exp. Date CC ID# Down Payment:$ 3,00� Amount Financed:$ Approx. Monthly Payment: $ PaymentTerms: balance due upon completion Extras: ���4 �R� *Base Price does NOT include any unforeseen costs as described below unless indicated in"Additional Items"abOVe. customer�nitia� �Deficient 1/2"plywood replaced at a cost of$ 65 per sheet in the roof field,which includes labor&materials.All other wood work/ad- i ional labor,such as, but not limited to,valley rebuilding, rafter replacement, 1x decking, etc.will be a rate of$5 per lineal foot plus the cost of materials. THIS BECOMES A BINDING CONTRACT UPON ACCEPTANCE OF PROPOSAL.PURCHASER ACKNOWLEDGES RECEIPT OF A COPY OF THIS CONTRACT. I ACCEPT THIS PR POSA AND HER CERTIFY THAT I HAVE READ AND FULLY UNDERSTAND THE PROVISIONS OF THIS CONTRACT. Purchaser: wY'W�� n Date: 11/21/17 C.J - . . - o��' ^ ' �� ��V -��`-��`-��t, ,� �.�_e .��� - - _ ��!or - l�, ' ,�. .✓ ' `� _w�;."--�. Cl�Of Z�IlyI'11111S BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: � s Date Received: l/ /���/� - Site: [o Q /� 9�- � Permit Type: � (� Approved w/no comments� Approved w/the below comments: ❑ Denied w/the below comments: ❑ i - This comment sheet shall be kept with the permit and/or plans. Kalvin Switzer—Plans Examiner Date Contractor andlor Homeowner (Required when comments are present) PermR Na. ' , � Parael tD No ���{x." �O{ � 'tJ�tt7�—C1tJ�u� [ V . . � j �� �{, �to�rtc�a�coa����tt�rr y(���� • ' J� StateoP ��` �f��` I^ � �� � THE t3ND�RStGtttED hes�hy gives nof�a tltat impmuer¢�st w�tt ire ntade 2a cet#ain r�3 P�tre�Y,and in accardance wRh G1r�P�F718,ftasida StaGstes, �� ihe faltawirtg�FartnaGan is provtded in ihts Natice a4Cammenceme� /�'1-�) _'"'a J _�J l0(.J �CJt✓� v�` `--'�� V �. Descdptlan at ProP . Parce!Idertivi 11o_q F�e. CJO� l0 CX l = y , a S a,.f�, �r ;t s 3 =� Stfee3Addtess: ���� � ���a 2, General DescripUan of Impmvemerd � �e �e ov � 3. Owner k�atmatia r�ee infort[�atioa�the Lessee mniracted foathe unpravemeni: _ {j�,�irQ. �Q . Name h I �'{" . ("�I I 5 �✓� _ V � Stzte , � Address ��_ / �Y � lttte2st tn Frope�iy:, t lp.[ . NGme af Fee Simple 7"�3leftalder: • � � {ff d"BtsL�fratn Owner Qsied a6aSre) _ • . Gi Sfate a. Coc�itra�ctor. Y�� 'n �G � - � ���� 3 S� �! . � �Jth{l S t 335�4 . , P,ild2ss p '�'�Y �! S� ' Catstraciar's Telephone Ne� I� ��S�� �O !�`� • � �. s��: ,,M, . _ �. �z � �- � � �e �W I.L. \. � W i Address � '�'ephane No.: �� � �� O = —� � AmaimteFBon�$ — t!) �U � E—� � 6. t.estdes: �� � Q(,Q� �� Q !Y � � Natne . • ' � ���� a � i Address . . , Clty . �Q O = —' � � Lendets Tetephone Na.: %- I.� �" C! Q Q t-� � t� tC C3 C3 7, Persons witfiin fhe Sfate oi Flodda designa�xl qy e owner upan wham noflces qP other docume�ts tttay 6e served as pmvlded by ���Q� � j Sectinti 793.13(9}{a){7a,Fiotida StaWt�s: � ,/1,. , ' O � [L u.! Q x a�r t3Kt0 �� - � W � Name • ��(~Uj W ``�L- ("�j Adc3ress G�'iY. Shte �w u- Ltf � z � - Telephone Ntun6ar oT Designaked Person: � Lt= CC ty, Z Q W e � O 8. in edddion ta himsaSF,the o+�mec desigt�atss `_ � �� ts. � U t� � a .C�J ; ' to�eiva a capy o�the tiertot's i�(ot3�as provided Tn Secthm 7i3,-i3(1jj6}.Ftemla 3�tute�. � � p � Telephone Niunher af Petsan or EnEiiy�esigrtated by OUVner. LU u) Q J „�� , , . - J . s. E x p i r t I o n d a t e a f l V o U e s o P C o m s n e n c e i n e n t{f h e e x P i i a#i a n d a te�i t a y aat 6e be�ore fhe cam t can �.=��an fi[ra� ayc�ie to the U3� ti � � contractor,6utwill 6e one yearfram{he dzte aFceeordm9 unless a di�ierent date[s spea�teclj:g �t.r l+ 1 �� ����� � � � � �� 0}0 � ' W A R N 1 N t 3 3 0 4 1 t V i�R: A N Y P A Y 1 4 1�N F 5�N L 4 D E 8 Y T H E Q W N E R A F S E R`C H H IX P lRA'i70N C1F THE NOTICE C]P COMMENCEMEN7' � P.RE COP1SiDEF�ED IMPROPER PAYl�fENTS°UNDSFi CFIAPiER7'13. PART`f.SE'{+`TIOfiI74&23, FLOEt[}A 9TA71}TES,A D ID G A i d i RESUI.T IN YOUR PAYING TWSCE FOR I�llPROVEN1EATi'S"t'O YOUR PFROPEF�SY. A•i�IOTIGE O�COMMEt3CEi47ENT M13S3'HE RECOF�ED ANL7 POSTBD ON THE J08 SITE BEFaRE'!7�FiRBT�NSPEC'YfON. IF YOU MTEND TO OBfAIN FINAAICIDIO,CONSUL'i' ''`�� � VUlTH YC1UR LENDER OR AN A'fTQRNEY HEFORB CDMMENCING WORK OR RECORDING YOUR NOTIC�OF CCIMMENCF,�AENT._ ��"'� . .p "AC �' ' ^ �, Under penalfY o�P�ri�Y�I dectare fftat t have teafl�he faCegaiag naEias aF ccmmencemettt andihatifte€2ds:hded fhetehi aa frue tfl ifte besi ��F , oYmyEvtawledgeandhel"�aP. • '"`- ,� �'�, 4 � STA'i�OFFL'OF2SDA � '_- -- ----...--� - �--. ,_ .. _ I�'��w{ — -- --cf.�2 , �°� � '��_�} � COt3NlYOFPASGO �� .�'��'���» •.. �¢' .t^� ,. SlgrratuceoPOwnerarLessee,arO+ametsarLes.re�`sAulhor�d b � .�'�`��'� , O�i�cetfDirectadP=fktedMattager •1���.�'.+�br� � � a" 11 .'wi��+�.,�,d`rt �q ^S..x + t�,."�` �� *+'��ZA7�' 6����!�t�'��, +��, . C,y Stgna#oty's'Ftte106ica C� ��� �:''��-�`•o-.`wj e �'� ��: tJ" I—'6 \ �J �� r 'a 'fhgt�r+:_9P'iqgttt51tyme�wasacknrnMedgedbefacametEds��daycF U� 2CV� y l.J�(,1�'� ��J�Q� �.�'�a �, yi f)W t l,R.,.Y � •t�vpe��t�or�v,�.s.,o�,�us���.atm�rey i��sor � � a ��' {ne P parry a eh2ff am inshurn�rrt s e�cuted). �� �� Re�sffaa2Sy Knavm��Fradueed der�fi 'o'�" ��Y S.L9T�� a- ��` `" Type af Iderttiflo�kion Pmduced .F � �� �����---� � Q� �� • . -..�",��`":`"-`' .='� � Ropt:19122�t$ R+�e: 10.0@ ,,•,,�����• D5: 0.00 IT: 0.00 . �.�a:r a�a., AWGELA HAYWOOD �°w .`�, Notary Public-State at F4orlda �,1/Zg/2@17 J. R. , Dpty Clerk '•tr ;•_ Gammisslon#FF 9i255i � '.�+, °�� My Comm.Explres Aug 24,2019 . _ � �"'�u�u`�'��,, Bondedthrou N2tlpIly ppULR S 0'NEIL.,ph D PRSCO CLERK & GOt�PTRO�iER � 9� t+totary Assn. 211281201���q � = of 1 � ;' OR BK . p� �?G� v lu/IG/LV I/ nvnua uuuuu�y�.v�o viunro _ - _ �� B - .o' o. .0 � . o ° ' A d � - _ _ . __ - ` � - - �'-'��� 'yi' "- BCIS Home � Log In � User RegistraUan I Hot Topics I Submit Surcharge � Stats&Facts� Publications I FBC Slaff � BCIS Site Map I L)nks � Search � Florida . � i ,, ;�_� ProductApproval �IF � '� USER:Pub11c User D.�UV7u�.ClC:.YS � ' &�cn-IRZ�kC.n Product Aooroval Menu>Produd or Aool(cation Search>Apolicallon List>Application Detail ' o" ` a e� " FL# FL5680-R18 1 � -� - — Application Type Revision Code Version 2014 Application Status Approved Comments Archived =� Product Manufacturer GAF, . Address/Phone/Email 1 Campus Drive . Parisppany,N]07054 (800)766-3411 mstieh@gaf.com ' Authorized Signature Robert Nieminen lin da reith @trinityerd,com � Technical Representative William Broussard � Address/Phone/Email 1 Campus Drive Parsippany,N]07054 (800)766-3411 TechnicalQuestionsGAF@gaf.com Quality Assurance Representative Address/Phone/Email Category Rooflng �� Subcategory Modified-Bitumen RoofSystem_ Comp(iance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professionai Engineer i� Evaluation Report-Hardcopy Received � Florida Engineer or Architect Name who developed Robert J.M.Nieminen the Evaluation Report � Florida License PE-59166 Quality Assurance Entity UL LLC Quality Assutance Contract Expiration Date 04/22/2018 Validated By ]ohn W.Knezevlch,PE I � Validation Checkiist-Hardcopy Received I � Certificate of Independence FL5680 R18 COI 2017 OS COI Nieminenpdf .Referenced Standard and Year(of Standard) Standard Year � ASTM D6162 2000 ASTM D6163 2000 ASTM D6164 2005 ASTM D6222 2008 � FM 4470 lg9Z FM 4474 2004 TAS 114 2011 Equivalence of Product Standards , https://www.floridabuilding.org/pdpr app_dtl.aspx?param=wGEVXQwtDqt45H1a2AP31y7JwDnCBwq706yN6tnydQVcGyUnbs3Giw%3d%3d 1/2