HomeMy WebLinkAbout18-19553 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 19553
BUILDING PERMIT
PERMIT INFORMATION a LOCATION INFORMATION =
Permit Number: 19553 Address: 4748 9TH ST
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: MOORES FIRST ADDITION
Est. Value: Parcel Number: 14-26-21-0010-02900-0130
Improv. Cost: 3,500.00 OWNER INFORMATION
Date Issued: 4/18/2018 Name: FREDERICK FINANCIAL HOLDINGS LLC
Total Fees: 60.00 Address: 27318 SORA BLVD
Amount Paid: 60.00 WESLEY CHAPEL FL 33544-3467
Date-Pai 4/18/2018 Phone:
ork Desc: - O'OF SHINGLE
jDaNTRACTOR(S) APPLICATION FEES
IA 7OBSPROPERTY MGMT I C REROOF RESIDENTIAL 60.00.
r
rl
C �
Inspect uired C -
DRY IN ROOF INSP O�I
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.
NO OCCUPANCY BEFORE C.O.
r -
T CTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS
5335-8TH.STREET.
(813)780-0020 719462
_EUILDING PEKMIT
PERMIT'°INFORIV6ATIC�iV _,: - ' ;:r :': Ci�TION'1NFOR
Permit Number: 19462 Address: 37408 CASTLEBERRY DR
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of-Work: A/C CHANGEOUT Township:,, Range: Book:
Proposed Use:' NOT.-APPLICABLE Lot(s): Block: Section:
i Square Feet: Subdivision: WEDGEWOOD MANOR
Est. Value: Parcel Number: 10-26-21-0120-000b0-0660.
Improv. Cost: 6,702.00 .,""::OWNER INFORMATION - ° :<< ' -;""` --
4 Date Issued: 4/16/2018 Name.: RENNER WILLIAM & MARY ANN-TRST
Total Fees: 75.00 Address:. 37408-CASTLEBERRY-DR
Amount Paid: 75.00 ZEPHYRHILLS, FL. 33542
D " 2018 Phone: (813)783-3593
r ork Des C CHAN OUT 2.5 TON
I CONTRACTOR APPLICATION,FEES
ACS NONCE SERVICES A/C CHANGEOUT 75.00
f
I
i -
Ina ectiae s..11 aired:. -
DUCT.!TiNSTALLED
DUCTS INSULATED '
j FINAL'
i
REINSPECTION FEES: (c)Wlth 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,far each such subsequent reinspection.
NOTICE: In addition to.the requirements of this permit, there-maybe additional restrictions applicable to this property that
may be found in.the public records of this county, and there may be additional permits required from other:governmental
i entities such as water,management, state agencies or federal agencies.
"Warning to owner: Your failure to-record a notice of commencement may result in your paying twice for -
improvements to-your property. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."-
Complete Plans, Specifications Must Accompany.Application. All work shall be performed.in accordance with"
Ci Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
I NO OCCUPANCY-BEFORE C.O.
YCON R SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN S_MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - B HOUR NOTICE REQUIRED
PROTECT CARD FROM {HEATHER
IIIIIIIIIIIIIIIIIIIIIillllllllllllllllllllllllllllllllllllll .
2018058604
Permit No. Parcel ID No k r ^.2 6--2/- 001V' 0 200-0,l 0
NOTICE OF COMMENCEMENT
State of 0 ri a/c- County of ' Pal C_o ® r`
(D m-.
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,Florida Statutes, N
the following information is provided in this Notice of Commencement m m.A
1. Description of Property: Parcel Identification No. � ' .Z 'Or' 0- V s 900 0 m 1 w
Street Address: 4? �1�
2. General Description of Improvement
3, O
3. Owner Information or Lessee information if the Lessee contracted for the improvement
(`e�lartrk Sf agei4d/
Nae C9
27,3/9 5m rs ✓off / CA q.L/ State K t9
Address City
Interest in Property:
N,
Name of Fee Simple Titleholder. '1
/� �-/^� (If differeent/from
�Owner listed above) F
Can tractor. �Ff"T City State
4. ��
Address Crry 3 tt3e
Contractors Telephone No_:
5. Surety:
' Name
Address City State
Amount of Bond:$ Telephone No.: I vro
la
6. Lender. a
Name
(0,
Address City State �f j o
Lender's Telephone No.: OD
/ z
7. Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by '�D r-
gm
S
Section 713.13(1)(a)(7),Florida��Statutes:Name
/� az7 rs s-- t5/r k i ue1 KCtia� a,
Address o city State 3 0
Telephone Number of Designated Person: O Y-3t1 7- o 22 S 0
m
8. In addition to himself,the owner designates of_ 1` -O
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. w
Telephone Number of Person or Entity Designated by Owner. o
9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction and final payment to the y
contractor,but will be one year from the date of recording unless a different date is specified): Agri 1 3 / 2.0 L? o
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT m
ARE RESULTOINIDYOURD IMPROPER PAYING TWICE FORTS UNDER IMPROVEMENTS TOR 713 YOURPART ROP,RTY.nANNOTIC� OFORIDA COMMENCEMENT AND CAN
MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the fads stated therein are true to the best
of my knowledge and belief.
STATE OF FLORIDA ��(Z -ON UOt99A11W0� i ao�`
COUNTY OF PASC Selid UOIS61WW0 a�(1
�IOZ/SZjV0 X3 z)AVJ \�;�t� ignature of Owner or Lessee,o e's Authorized
8pI10U{0 WIS o cer/Dir ector/Partner/Manager
LmidOU•P dilgid '�eQd Atl+yC
)v, Signalor/s Title/Office
The foregoing instrument was acknowledged before me thisday of Pn L ,20(�?by `�
as XL (type of authordy,e.g.,aft cer,tnistee,attorney in fact)for
(name of party on b a of whom instrument was executed). i
Personally Known❑0$Produced,identification Notary Signature
Type of Identification Produced �"�'�� �� Name(Print)
4hp1 cape` PhMm d,KOptafl .. -
r° State of Florida
t _*My
Nty Commission Expires 04I25I2019 . . _... '
wpdatalbrslno6cecommencementyco5304eji, �oO COmmis61on No.FF 2186W
STATE OF FLORIDA,COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
'TRUE AND CORRECT COPY OF THE DOCUMENT
ON FILE OR OF PUBLIC RECORD IN THIS OFFICE
MY HAND AN OFFIC_ IAL SEAL THIS
rs>
_m�C�----DAY OF .' rn�ao
PAULA S.0YNE1 CL K&COMPTROLLE gi,
DEPUTYY CLERK
BY ,
ED
a
. . City of:Zephyrhills . .. ;
533$8t''St :
.
Zephyrhills FL 33542
•
ROO
FING INSPECTION AFFIDAVIT
Permit No.:
licensed under Chapter 468; Florida Statutes as.a(n):.
-Contractor KEngineer_Architect Building-.In
spector_: .
License No.:
On or.about ram . /7—' •did personally,inspectthe: : :
(/ ry' F g p g
�
. Check; Roof Deck Nailing' - D, in - �/, - lashin and'Dri .ed e- '
Check which was used 30#felt :-Peel and Stick.- : Other(List) Z�.W..TJ7L�1
At the followin
g .
address:.�'7.�`O
Based upon-that.examination, l have determined the.in'stallatio.n was done:according:to the Hurricane
Mitigation Retrofit Manual.(Based on Section.553.844;Florida Statutes):.
Signature: -
-STATE OF FLORIDA
COUNTY OF PASCO-.
Sworn.to and subscribedbeforethls day
Notary Public State of'
Florida
ors r P���ti. :JACQUELINE BOGES
Commission#FF.150422
.:
Expires December 12 2018:
Bonded Thru Troy Fain lnsurance9W3B5.7019
813-780-0020 -City of Zephyrhills Permit Application Fax 813-7a0-0021
• - Building Department
Date Received
• Phone'Contact•�for Permlttln �:,
Owner's Name � � l/(f /�' 6,Qwner Phone Number ,
Owiner's �/ '�f � � Owner Phone Number
-
Fee . �
Fee Slmpla Titleholder Nari+e-•-�a- Quirner•Phone Number
I "
Fee Simple Titleholder Address
JOB ADDRESS 7`7' �1"� >��- FL 3 35ZI LOT#
SUBDIV1810N:_ „ �: PARCEL 111* i
r+
(OBTAINED FROM PROPERTYMAXNOTICE)
WORK PROPOSED NEW CONSTR ADD/ALT- 'Q SIGN Q Q DEMOLISH
} INSTALL 8.. ':REPAIR
.I; i
PRQPQSED;:USE•. SFR Q :,"COMM, OTHER
if
TYPE°OF CONSTRUCTION. BLOCK •. ,Q FRAME. Q, STEEL [ ;
DESCRiPTION-of WORK
BUILDING SIZE � ''SR'FOOTAGE,=•. .-HEIGHT
ILDING $ VALUATION'OF TOTAL CONSTRUCTION
ELECTRICAL $ . AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C: . ,
4r
QPLUMBING
MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ��v
C]GAS ROOFING Q SPECIALTY.. OTHER ��"
FIN SHE FLOOR ELEVATIONS FLOOD ZONE AREA =Y.ES NO
:BUILDER COMPANY /`}' F12�—�v 67
SIGNATURE a REGISTERED I Y'/ N FEE CUR
rREE� Y'/'
Add cs lfl/f M11, 4C, IPA40� 0, r /77v 't eense:# t; 'I 2 7 a��
``'-ELECTRIGtAN:- -COMPANY
?5,:SIGNATURE REGISTERED Y/ N . FEE CURREt` Y/Ni
Address
f•.. 'License:#." I .. ...
` =P.LU COMPANY.
K.,.•,SIGNATURE" :REGISTERED. . Y/ N .FEE-CURREt`
f,t Address '.License•#.)
MECHAN1GAl` = CQMPAIVY
:SIGNATURE ?.' REGISTERED I Y/•N FEEICURREP. .
Aitdr-
0S x>. .l tense.#
SIGNATURE r;rax3: REGISTERED 1(/.N. FEE-CURREn" Y/N
Address::. License'!it Hi Hee H.14-ti-ifliff,ki
'REST°EN 61' i0.tta n 2, PC"t Pi` `s=" •n e` '+s ii i ? ?ia's�'1r s` f!= >= R O Pe i `Tr riew::: stiuctton
rtn t:fo c;on ;N,t ,
�. ... �,•. ... ;:.:_ ui felled is : w . Minimu . tens>1'0;;intojitlii"''"a` afte�xsi�t rriittalai ate:`:Re aired°ahsite Gon§tructlon Plans,`Staonwater'Plans w/:SiltFenca i s
O
�.
agl•:.-.y.. q
Santta: Faciilties' =t clam sie ;;3[_ ;W;.c}rte i?esmitfor.saiidivisioristta e' ro acts
GOMMERGIAL Attach%(2)=complete-sets of Building'Plans pars"a`Life Safetji'Page;(1)set of Energy Forms.R-O W Permit fcir new construction.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt FenceAnstalled,,.
4s` Sanitary:Facilitles&1 dumpster.Site Work Permit W-ll;neiar pTofects:All commercial requirements must meet-compliance
MiPERMIT
i`•''a`' ""PROPERTYrtSURVFY,requiredfor,.aII,NEW,cons ttuctlon......
fl6.Vul"application completely.
f t flvwner&Contractor,sigh;back of applicat on,notarized
'"'lf:over'$2500;-a°N.otice,ofCommencement Is required. (AIC upgrades over$7500)'
Rgent(far`ttia coniiactor).or°PowerioYAttomey`{ftir'ttie'ouvnet)viro''bid-tie i6meone with notarized letter from owner authorizing same
?'fiOVEftwTHE CQUNEt2 P,ERfY41TTING,,.., (copyof�contract requited)
;Reigbfs':i8sfiingles S®viers. `Service Upgrades A/C Fences(Plot/Survey/Footage)
:Dirlveways-Not over Counter ifon pa6lic`�oad`w'ays::rieeds ROVU
iY
NOTICE:OF:DEED RESTRICTIONS:. The undersi ned.undeFs#ands:,tha t+u�:,is Decmi#;•rttav'=be:stib1ec#<to"deed'res#.'chons"`�-`:..
t :;FS g�. y,,,�,r .�:;I:VrY�• ` ';h'A%��.: ,,t k,, .;r}I` .t�r!.d. •l � •y."^$., y,,,
.. ..,.......r... -... .._ti :.N :. . r...,.z.w.s;';" ..,u.„riz3' :,_i.,:;,wT'...} t';i�,;_.f gi,'.a;-ci ��`=tii�,:,,-.., .,;;t., ,3;y";.'`.�g,; .,
which1mayAbe;:mores-restrletives=than�r,Couraty<reig lattans -The riridersrgr+ed "s�sumes spot s+ttiCty or.taampiian, v+rith any;:
applicable-,deed`restrictions: u�?tictrc„[��,'•`'i'
UN LtCENSEI3'yCt1NTRACTORS�;AND'COli1TiZACTOR RESpaNSiB'ILiTl1=S if tii'e ofnmer'=f as :F rQtF:°`ajcai tractor'.or
:> .
contractors to.undertake work;they:may be;;requir,ed.to be'.licensed:in accordance�v+ritki.state°and io�iairfegulations:i
.w�` .y. e-'F:: - .,,1 - - _s£jrfi,:""a.,•ifiy,£;;..�"4,._..'.;:>>.:; •,.•e:f'"v�...».
contractor.is=not;licensed-as:regiired°'lay.law;'both'-the oininer a nd``coitactor mayNbecited�fiir :>misd�ein+ anor•violatiin;.
under state law: if the owner.or Wended--co
are;uncertain as..to.what..(icensin re uiieinerits� a, <<a^" it for=tt e
intended-worki.-they.are advised`to coit'aEf-Ihe P'asca County
`tagildir``+I is .action Di siori T CcensJn Section'at 727=84fi�'
_. ..,._ .. ty 9_.._,.p. .. F..... .. g 80.09: �Furthermore;..if the owner'lias`fiired`a chi tractor or contractots, he 1s advised to'have.thex,;co itractor(s)szgnz Y,a Y
portions of.the "contractor:Block°,,of this.application-,for-•which,.they-.wiiF:be responsitile::if.;.you,;askfh ovr+ne3r sfign-astthe '': ;
contractor.; that may be an indication that tie is not propetly`llcensect and is not eritified`to permitting Rtiriieges
County, "
TRANSPORTATION:•IMPACT/UTILITIES-IMPACT AND RESOURCE RECOVERY-FEES:''-The undersigned understands ,
that Transportation_lmpact Fees-and-Recourse Recovery-Fees" ay;apply to{:therconstr�ction:,og:new:tiuiid+ngs;.char' a of` `
use in ixisting�buildirigs;<.or expairision-o#<e i'sti 'g buildings, as specified in Pasco County Ordinance nurnber:6m.7,_and
90-07,;as amended: 'The undersi ne iso yi g d;a .under:stands, that:'such<fees;as may tie;due; will"beyidentified at'th"etie`of.
,
permitting. It is further understood that7ransportatian impact Fee's�and`Resource�i ecovery:F:ees_must be paid:piior,
receiving..a. certificate•of occupancy or final._power_release.;if#he,projegt does riot invsilve=;a celtificate of:occupancy,oi
final-powerreleaser:the::fees must be,paid::prior.to-per friit`issuance,.,:Furtiermore,.if>.Pas;co CourityWaterJiewertrttpact: tY'
fees are.due;:th.e.y.m66t be,paid-prior to-permit'issuance:in"accordbnce with-appli6d'bile Pasco'County ordinances.
CONS?RUCTION;LIEN"LAW.(Chapter?1.3;''Fiorida'Statutes,as amended): if valuation of work is$2,.50,0:0;O,:O T-.more.41;' :•.
certify..that •i, "'the_applicant„-have.been. provided with-a-:copy_:of the�"Florida'Coias#n coon:'lien:Lauu i omeowner's
Protection Guide"'prepared-by-:the Florida Department of Aghcuiture and•Consumer Affairs. if the appiicant�is.someone,{-... .
other than the"owner", l.:�ertify.that:l have:abtained,"' copy of'the above"descr" .`if,cumerit oh—tomise-rt,good:fa�th=:to
" ; .
deliver•1#;:6111e:fouvner"i•`pdbri'o",commencement
CONTRACTOR'SIOWNER'S AFFiDAVIT:,:'a�ectifythat'alE°the infor:.matibn h this application is accurate and'that alf Work
will be done in compliance with all appiica6le'iaws.reguiating construction, zonihi-;i id:land-�development. Application,is
hereby.°made to obtain;,a:::permit:to=do;work-and..installation.as`-indicat'ed: 'I certify that no...work or-.Installat'r'&has
commenced pnor'#o issuance of'a permit and that all work will be performed to::meet-standards of all taws regulating..
construction, County and City codes, zoning regulations, and land development.-regulations in the jurisdiction:',-I:,,also
certify that ( understand that the regulations of other government agencies may app14o the-intended work, and that it is
my responsibility to identify what actions I must-.take to be in'.compliance.,:Such.ageric!es include:but=are not:llmited tm:'
Department of Environrieiital Wofectiori=cypress Baylieads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
Southwest Florida Water Mana9ement District Wells;- Cypress� .Bayheads, Welland Areas, 'Altering
Watercourses, i
Army Carps of Engineers=Seawilis, Docks, Navigable Waterways.
Department,,of Healthy A Rehabilitatiye;$ervices/Environmental Hearth^-:Unit Wells,:Wastewater:Treatment;
..Septic Tanks.
US Environmental Protection Agency-Asbestos.abatement.
{ Federal. -Runways, .
I understand that464h'.following=restrictions applyto'the use of.fill:
- } Use of fill is not'allowed in Flood Zone"V"unless expressly permitted.
lf.the'fill:material .Is to be- used'in Flood Zone "A", it is understood that a drainage plan addressing a;
"compensating volume" will be submitted,.at time of permitting which is prepared by a professional engineer
licensed by.the'State of Florida. .
If the'fill 'material s' to-be. used in Flood Zone "A" in connection with a' permitted building using stem wall!
construction, i cerfifyahat:fill`will°be used only to fill the,area'within the stem wall.
. If fill';matenal`is'-to--be used in -any area, I certify that use of such-fill will not adversely affect adjacent; tr;
properties.'If use of fli is found to adyersely:affect adjacent:properties, the owner may be cited for violatingi. n
f.,. ;.
the conditions:of:tile:bra iidrng':permit.:issued Under`th6'aftached-perm.it:.appiication,.for.lots'''less than one (1-)l
acre which ire,-elevated by..fill,an engineered drainage plan is required.
if i am.the'AGENT,FOR;:THE.OWNER�>I,promise in_good faith to Inform the owner of-thepermitting•conditions set forth in! i
this affidauit:prlor to commencing'cons frubtlan: :`I-understand that,a.separate permit may be required for electrical.work,!.
plumbing; signs, weds,-:.•penis,-air,. r�ditioning;,gas :.or otfi`er`installations.not specifically included In the application: A.1;
a,
permit issued shall'be construed to be a 1+cerise`to:proceetl with the work.and,riot.,as:authbrity=to violate,.cancel, alter, or; `
set aside.44 provisions of`the technical,codes, nor shall Issuance of a permit prevent the Building Official from thereafter p w:
requiring..a correction:of;er,r.ors iri.°plans;~coristructlon•.or violet'cans of any:cod'es:�Every permit isstrecl'shall become invalid'
unless thd'.Wbrk authorized by such permit Is commenced.within,six.:months of permit issuance, or if work authorized by:
the permit is;suspended:.or-abandoned for:,a::per!od:of::six(6j riiont4 after the time the work is commenced.•,An.extension i .)
may be requested, in writing,,from the„Buildih'M.6 t116 a! for a period:not:to.exceed�h' .-dty-(96)days and'-will demonstrate i
justifiable cause fbr.tlieiii extension.,.If W. QTk.,cpases for ninety(90)consecutive•days,the job.is.considered abandoned.' i
:WARNING'?i'4 OWNER: =:Y 'RD=.A;NOTICE,OF:CO 1ll9flENCEMENT•MAY:'RESULJ•IN' OUR
PAYING::TUVICE'FO.R=lMI?i01EMENTS = YQU: RIPERTY;,:!. a i
,,:,' :.:r,, ::.. R= '._.,:... .._ F Yf?.t t iN EN. .TQ;O N FINANG111 G 1 CONSULT '
WITH"'YOUK LENDER OR AN ATTORNEY BEFOREMF_CORDiNG'YOUR -'E,O0= VfM- t3►1ENCEMENT `
FLORiDAJURAT,(F.Ss,! ;
OWNER.OR'AGENT• AC
' CONTRT.O '
;Subscribed avid'swom to'(or affirmed)before iris this Sub a d s (o affirmed)befbrki e'l
by
Who.islare•peisonally known to me or has/have produced o:is are personal) .,nown.:to:me;o[:has/have:produced.
'.
as ldenaftcatlbn.l' as identification.
Notary' Public ft SZ Notary Public
:ommtsston-No. Comma si No.
Jame of Notary typed,printed or stamped Name of N tekl p , �Q :' R_ 50422
Expires Ve, 12:20t8
i,Qi'N P Bopd^.i Tiv;;ka,Fa:f Msu:xe:e A4':•s95d019
i
City of Zephyrhills
F:4UH111;fl p, 5335 8"St
Zephyrhills FL 33542
(813) 780-0020
ROOFING INSPECTION AFFIDAVIT
Permit No.y/!�'v-5nq
licensed under Chapter 468, Florida Statutes as a(n):
i
Contractor_Engineer_Architect_Building Inspector_
License No. GCS /� 7 5oZoZ•
On or about /l�f _ ��^ /9 did personally inspect the: n�
Check: Roof Deck Nailing / Dry in Flashing and Drip edge
Check which was used: 30#felt_Peel and Stick_Other(List) z/tT
At the following
address: Z/Fz19 �7`f/ T 77
Based upon that examination, I have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual (Ba§BAon Section 553.844, Florida Statutes).
Signature:
STATE OF FLORID 'L
CO U N 0 PrASCOF
.worn o and subs rib befi.ar-e-this day
Y: 4 X3
Notary Public State of Florida
o� JENELL SMITH
NOTARY PUBLIC
_STATE OF FLORIDA
Comm#FF149272
° Expires 8/10/2018