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HomeMy WebLinkAbout18-20021 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 20021 BUILDING PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 20021 Address: 6045 12TH ST Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL. Class of Work:. 434-ADD/ALT RESIDENTIAL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s):5 Block: 1 Section: Square Feet: Subdivision: TYSON Est. Value: Parcel Number: 02-26-21-0080-00100-0056 Improv. Cost: 1,584.00 OWNER INFORMATION Date Issued: 7/26/2018 Name: CHAMBERLAIN STARR Total Fees: 75.00 Address: 6045 12TH ST Amount Paid: 75.00 ZEPHYRHILLS, FL. 33542 Date Paid: 7/26/2018 Phone: (813)377-5858 Work Desc: GARAGE DOOR REPLACEMENT 9 X 6.9 CONTRACTORS APPLICATION FEES PRECISION DOOR SERVICE BUILDING FEE 75.00 Ins ections Required FOOTER 2ND ROUGH PLUMB MISC INSULATION CEILING FOOTER BOND DUCTS INSULATED SEWER MISC. ROUGH ELECTRIC LINTEL MISC MISC. 1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC. DUCTS INSTALLED WATER MISC DRIVEWAY PRE-SLAB SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. 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. O , SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER Jul. 23, 2018 9;30AM No. 0058 P. 1 si3 78 20 City of Ze Perintt A,psliedon Fax 979.Teap>fzt . BuDdsg DePasTfe+an!' +� �r ,Date Recalvad Fhona Con Pot atmlht �J `+� Owner's Name Gm 1`4ti��1 OwnarphIno Nwnber rlvmoFsAdaress ���15 t�'�' �}N,, �I dwnorPhoneNwnber {---� � FttsSmplaTldahatderName 1 OwoerPhangMamher I Fsa&knPla 17NeeEtolder Address JOHADDRMS ipSlr1 rintl� 33a41 Lord SvealuislON ' '� PARMLW Cn . - -0 0-`QQ 10Al C^--S4 (�TAha�f FRpN PROPTNt�tseXt3aY10Et WORKPRCWOSM a NEWCODESIti� ADDIALT [ SIGN (� t Q DEMOUSH INSTALL REPAIR PROPOSEDUSS SFR 0 COMM OTHER m 011COaSrauCIrloN BLOCX p FRAME S,EI. DESCRIPTIDNDF WORK SUILDIN SIZE _ ..1 SQVOOTAG* HEIe14T ^rr-irr�-�rrCr�^m'M-t�-t�rrs' [�9UIIfiINa $ VALUATION OF TOTAL CONSTRUCTION MELECTRIM C�`- APP 300E p PROGRFSSME SY WFLEa MP(JU6AeIMG F- Q�ANICAI VALUATION OF LIECKAtnC&INSTALLA M d Q ROOFING [] SPECIALTY[= OTHER FIMSEIED FLOOR ELEUATIONS FI.00DZDNEAREA mYEs NO . r♦ rr r Yr�,.Jur��. +r r �r� rr . i�..w r r rr• .r�� C ��w DUILDER BIGNMRE C TEGISTERr9 Y/14 1 I'MU su I YIN I Addraea �p'AM14 �• `• �. 1taYM18e# 7�.,� � 1 ELECTRECIAH '" COMPANY SfGNATUFI! ,,,jjj fEYIN If txtt Y!N Addm-A LI'm A PL.UWMER COMPANY SIGNATURE pjaeUm I Y/N FIX"m Y/N Addrew Llo3nsolf MLIGHANIM COMPANY Addy x ( Llwsed OTHER L -� COMPANY 1 SIGNATU I YIN fumf Cn U Aaaxa9 Lkenea� rr,r „rirrr,,,irrr, r ,r,r,r, r,rrrrrrirrrrr„rrl„rrrrtrr„ rrrr„r„r WIDENTIAC Allsoht2)F�tPtecisr.(�ee�orBulk£ngPlens;(i}sctoFk�e�gYForms;RO�V+'Fa,mltorttewc�nstructon, lAinb7iunttatl:Ii}}wutkGNdsyasSi63`StiFntiilsSdate.RequttulaliaUa+Cansh�tibtiPtBtts,Slonnti�C6r•PlSfiisYQSdtFBncelnsta0ea, &anXatyt er111res It i dranpslcr,u6Ea Wot�Pemu'[taraubdtdslonsrtarge Prof COMMRRCIAL AI (2)awyVaSosetaotBadingPAP&PiueaUfoSzi"Paee:(t}SPA cFEaerpyFalna,RO-WPomittornswconawdlen. ItdAlrutm{eA(t0}V�arkingdsYeatter'sUbjrl9aldat4 Regoltedopsl4F.'rGottaflus6otlPlane,&hmalt�te!`PlanswlS9lletloah�slA�ed, Sani(aryFredr6esaidumpster.Vita WorkParmA%rainawpw*4,.AtIc anePGksllLvNlrarasstlsmretrgeNmm kSa SIGNPEW A c (3}selsSnlhWadPlarua ""PhROPERTYo(sURVEYregWradg Mftall NEW corowdon. ahem flu oul appl(�lion oamPfeloly. o„per&cont,�cmrs�n�adcotapa�I�do�, a lravar�15G4.�Na>icaofCoinaiancenseatlaraqutred, WCvPgradeaover$75saD} Ageni(for the oanl arPmwo4A9bnWfor%eowner)wouldbesomecnEiWthnoWt*d1sft MaMmersuUwwfloeeme oveRTHECOUNrEI:t�ERnitTrfNa (ooPyorcatdntclrequlrad) Rtmolstr4boea Sewora Sft*oUpgmdds PM F=*4(P)W&mvayJFoal6B8} pnYtwsyaNtAauerComlerlran pupUaToadways,.needa ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-, 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the"contractor Block"of this application for which they will be responsible. If you, as the owner sign as the contractor,that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of use in existing buildings, or expansion of existing buildings,as specified in Pasco County Ordinance number 89-07 and 90-07,as amended. The undersigned also understands,that such fees,as may be due,will be identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a"certificate of occupancy"or final power release. If the project does not involve a certificate of occupancy or final power release,the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of work is$2,500.00 or more,I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the"owner",I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the"owner"prior to commencement. CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction,zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work,and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,Water/Wastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls,Docks,Navigable Waterways. - Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. - Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of fill: - Use of fill is not allowed in Flood Zone"W unless expressly permitted. - If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume"will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. - If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction,I certify that fill will be used only to fill the area within the stem wall. - If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one(1) acre which are elevated by fill,an engineered drainage plan is required. If I am the AGENT FOR THE OWNER,I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate,cancel,alter,or set aside any provisions of the technical codes,nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid unless the work 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 period of six(6)months after the time the work is commenced. An extension may be requested, in writing,from the Building Official for a period not to exceed ninety(90)days and will demonstrate justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S.117.03) OWNER OR AGENT CONTRACTOR Subscribed and sworn to(or affirmed)before me this Subscribed n s i ed) r e by l�+J Who is/are personally known to me or has/have produced W o i§fir•personally own to r h s/have produced as identification. �/ 1//per •C./� as identification. Notary Public 0_6! & Notary Public Commission No. Commission No. ©' d6l,2 Name of Notary typed,printed or stamped Name of No s DEBRA ELAINE RUFFELL • 'Commission#GG 045343 Expires November 7,2020 -'•FO ;;°p'� Bonded Thru Troy Fein Insurance a00.365.7019 Ju1. 23. 2018 9:30AM No. 0058 P. 3 ` 6/27/2018 FloHda Sulldlrlq Code Online r• - Poines5 o ' e - a R qplafiNO- aces Home l09 ra I user kw1bafta ( HotTooke I SAMMrdaree 1 Mace a ft& I i blMons I Conbxtb; I eels st Map I unw ( smart Product Approval USER:PubSt thw �Sti�rr yroauct Awmwl reenu:1 Prxdugg. Mi> eaUs o Search y AjWleatlanList.ApplicaUon Dull �I Fl. FL13521-R5 Application Type Revision Code Version 2017 Application Status Approved Comments Archived Product Manufacturer Amarr Garage Doors/F_ntrematic Address/Phone/ftP0 165 Carriage Court Winston-Salem,NC 27105 (a36)231-1307 robart.richardson@entmmatic com Authorized Signature Robert Richardson robertrlchardson0entremadc.wm Technical Representative Robert Richardson Address/Phone/Emad 165 Carriage Court Winston-Salern,NC 27105 (336)252-1307 robert.tichardsoncentramadc.com L COMPLY WITH PR PAIL' ALL WORK SHAL Quallty Assurance Representative Danny Joyner CODES FLORIDA �DING CODE, Address/Phone/Emali Amarr Garage Doors NATIONAL ELECTRIC 16S Carriage Court AND THE CITY OF ZEPHYRHILLS Winston-Salem,WC 27105 ORDINANCES djoyner0amarroom p Category Exterior Doors VjEVIEVW DATE�— S Subcategory Sectional Exterior Door Assemblies ITY OF ZEpHYPOLL � � E)(pddII1NE�� Compliance Method Evaluation Repore IMM a Morlda Reg Ardrltect or a Ucensed Florida Professional Engineer Evaluation Report-Hardcopy Received Florida Engineer or Archited Name who developed the'Thomas L Sheimerdlne Evaluation Report Florida license PE-0048579 Qlrality Assurance Entity Intertek Testing Services NA,Inc.-QA Entity Quality Assurance Contract Expiration Date Ol/OlAO27 Validated By Steven M.Urlch,PE Validation Checkllst-Hardcopy Received Certificate of Independence FL13521 R5 COi Statement of Independence 2017.nd Reerenced standard and Year(of Standard) >` UdDld Year ASTM E1996 2009 . ASTM E330 2002 DASMA 108 2012 DASMA 11S 2012 Equivalence of Product Standards Certified By Florida Licensed Professional Engineer or Architect h�a....1R......a...wnr,.dlAln.vnrNln.Jn� ann eIH��..,.�..e.a...a,,.f:C�Nl1��.ttl�ri�unrH:lGrflr-Ine�rAfYY4rRllldhrnrfaiil�9n�nu3flfn117aQWur�La►ie/ari 1lA Jul. 23, 2018 9:31AM No. 0058 P. 4 s/27P1U18 Florida 00ilding Cods Online FS 1 3591 RF EQUIV DASMA 108 and g 15 7Q95 V,5.243-,4df Sections from the Code Product Approval Method Method i Option D Date Submitted 10/16/2017 Date Validated 10/17/2017 Date Pending F8C Approval 10122/2017 Pate Approved 12/12/2017 Summary of Products F4 Model,,Number or Name Description 13521.1 Stratford,Heritage and Oak Summit Dwg,IRCr6016-155-26-I,Thru 16'Wide. Models 600,650 and 950 Limits of Use Installation Instructions Approved for use in HVHZ;No FL13521 R5 II IRC-6016-155-26-I Drawing 7-10 FL.odf Approved for use outside HVHZ:Yes FL13521 R5 II Retail Product Croca Reference Chart.pf Impact Resistant:Yes Verified By:Thomas I.,Shelmerdine K PE#0048579 Design Pressure:+37A/-41.0 Created by Independent Third Party:Yes other: Evaluation Reports F1,13521, R5 AE IRC-6016-155-26-1 Evahration Report 7-10 sealed.ndf Created by Independent Third Party:Yes 13521.7 Stratford,Heritage acid Oak Summit Dwg,IRC-6009.150-i5-I,Thru T wide, Models 600,650 and 950 Limits of Use Installatiop Instructions Approved for use in HVHZ:No FL13521r RS 11 IR 6009-150-157 Drawing -10 d! Approved for use outside HVHZ:Yes FLISS21 R5 II Retail Product Cross Reference Chart,g Impact Resistant.Yes Verified By:Thomas L.Shelmerdine FL PG#0048579 Design Pressure:+35.6/-411 Created by Independent Third Party:Yes Other: Evaluation Reports FL 3521 RS AE IRC-5009�150-15-I Evaluation Repart7-14 sea Created by Independent Third Pdrty:Yes 13921.3 Stratford,Heritage and Oak Summit Dwg.IRC-6009-169-15-I,Thru 9'wide. Models 600,650 and 950 Limifg of Use Installation Instructions Approved for use in HVHZ:No FL13521 R5 II IRC-6009-169-i5-i Dr2iwfna_7-10)L.pdf Approved for use outside HVHZ:Yes FLi352i R5 Ii Retail Product Crass Referance Cbert.adf impact Resistant:Yes Verified By:Thomas L,Shelmerdine FL PE*(I048579 Design Pressure:+45.3/-51.2 Created by independent Third Party:Yes Other; Evaluation Reports FL13571 RS AE IIIQ6009-169.15-I Evaluation Report 7-10 ow-e,p-of Created by Independent Thi rd Party:Yes 13521.4 Stratrord,Heritage and Oak Summit Dwg.IRC-6016-140-24-6,Thru 16'wide. Models 600,650 and 950 Limits of Use Installation Instructions Approved for use In HVHZ:No F1,12521 RS 11 zaG6016-140-24-G Drawing 7 10 rL p-dF Approved for use outside Wfli-Yes FL13521 R5 11 Retail Product Cross Reference Chart.cdF Impact Resistant:Yes Verified By:Thomas L.Shelmerdine FL PF#0048579 )Design Pressure:+29.7/-33.8 Created by Independent Third Party:Yes other: Evaluation Reports FL13521 R5 AE IRC-6016-140-24-G Evaluation Report 7-10 . sealed.edF Created by Independent Third Party:Yes 13521.5 StratFord,Heritage and Oak Summit Dwg.IRC-6016-i30-154,Thus 16'wide, Models 600,650 and 950 Limits of Use Xnst4liatlon insrtructionss Approved for use in HVHZ:No FU3521. R5 it IRC-E016.130-IS-i Drawincq 7-10 FLpdf Approved for use Outside HVHX;Yes FL13521 R5 ii Retoll Product Cross Reference Chart.pdF Impact Resistant:Yes VerMed By:Thomas L.Shelmendlne FL PF#0048579 Design Pressures+25.6/-29.1 Created by Independent Third Party:Yes Others Evaluation Reports FL13521 R5 AE IRC-6016-130-15-1 Evaluation Report 7-10 Mips:/Amw,floddabullding.org/pr/pr app.dil.aspx?param=wGEVXCMWquynOPErOFieedQlXYkl6Di4hmofaiDa3puMMU7-e96w%3d%3d 2/3 Jul. 23. 2018 9:31AM No. 0058 P. 5 6/27/2018 Florida Building Code Cnllne Created by Independent Third Party:Yes 43521.E Stra ard,Heritage•and Oak Summit Dwg.IRC-6009-130-15-1 M els 600,650 and 95Q Limits of Use Inotellation Tnatruetions A r use In HIfHZ:No FU3521 R5 II IRG6009-430-15-I Drawin9.7-IQ fj W Approved for use outside HyHX:Yes FL13521 R5 II Retaalt Product Cross RefereQ9t~-Ch7a&jf rinptt Resistant:Yes Verified By.Thorns L Sheimerdlne FL PE*0048579 Deslgh Pressuret+26.71-31.6 Created by IndependentThi d Party:Yes Other.- Evaluelon Repotte FL13521 RS AS IRC-6009-130-15-I Evaluation Reoort 7-jA Created by Independent Third Party:Yes Back N—. ContactUc::2601 Blair Stone_Pead,Tallt<ha+se6 FL31399 Phone:650 467r1924 The state or Fionoa is an AA/E�60 employer Copyrtahk 20d7-2019 state of Aartda.::privacy Statement c:deCeSsibAitY tdtpm n ;0 RNnd Statemwtt Under ftorlda law,email addressor ve public records.If you do one want your e-mall address released In response to a pubik-records request,do not send etectron1c mail to this entltr.Instead,contact the office by phone or by tradidaml map.IFyou have any questions,please contact 650AS7.1335. Pursuant to se"455.275I13, Florida 5mtutes,etrectlye October 1,2012,1(censee:licensed under chapter 455,6,S,must prav)de the Department with an email address 7 they have one.The emaltE p Mad entry be used forolndal comrnunieation oath the Kcertcee.Howewr ama0 addresses are public record.If you do newish to supply a personal eddres3,plem pmylde the 0epamment with an ema6 address which an be mDdo avoQ,%ble to the public.'fu d&Artrdne if you are,a kih=e:e underChaptrx 455,FS please 0&hUL. product Approval ncoopbs: � ®®E Gredit I✓ard Siff; i hffnedhuunuirewiAnhio4Ainn nrnlnrinr anrt rld acnw?mmm--wrFW(Our}nmrvnnPFrOHePdO XYklrir')i4hmrfAidAinuwif<nU7A96wo/n3d%Sd 3/3 • I.a 144A.18NJFN*OR ATTAWED ID VA C&MIEWN. 1�? D P.l a/J.Y.CCIaSNT2!'L ► xJ 0)V/"__�Is��WA. 1(10,n"DIS ATTA0fm w �, j fiCX}A/L iia[VS dAA1L1ATL[ From tlriTAGiEL AT AINi7r Y b V x ► vlQk 0f16•X?J+1'ZQT wW rHIMAn 'Co aJY![X " 3' 3�T�fTsATrACIED 1eXrltAC�Erf[xt _ �� CMIAM arrn wr PW[1R TYP]CJ1 TLIP FYK71 PAAt a Ff7R aPTTRNi. 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N Q3Sti8} IYSI{d31(TdiS �_ Z 3'CE�I L 3�eHl 0 cv � cY i ry Jul. 25, 2018 1 ;29PM No. 0064 P. 2 6/27/2018 Florida Building Code Online & 'Professional Regulation Basmofne I LO97n I UserROSaW-aon I Not Topic I SA &Surdmege 1 SixIs&Facts P.M.50.9 1 ContectU9 BCISSMMep i Uffio I Seardi Product Approval �+ 4PUSEW PUbIIC Use O vLL>PMIMc;toEAgellotionSwch>Apphcatlon Us!>APPliratron Dawl FL V FL13521-RS APPllcatiop TYPO Revision Code verslon 2017 Application StatuS Approved Comments Archived Product Manufacturer Amarr Garage Doors/Entrematic Address/Phone/Email 165 Carriage Court Winston-Salem,NC 27105 (336)251-1307 robert.richarcrson@entrematic.com Authortzed signature Robert Richardson roberk richardsone ehtmmatic.com Technical Representative Robert Richardson Address/Phone/EMai► 165 Carriage Court Winston-Salem,NC 27105 (336)2SI-1307 robert.richardson@entrerraftcom Quality Assurance Representative Danny 3oyner Address/phbne/l mall Amarr Garage Dwm 165 Carriage Court Winston-Salem,NC 27105 djoynereamarr com Category Exterior Doors Subcategory Sectional Exterior Door Assemblies Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer 0,Evaluation Report-Hardcopy Received Florida Engineer or Architect Name who developed the Thomas L,Shelmerdine Evaluation Report Florida Ucense PE•0048579 Quallty Assurance Entity Tntertek Testing Services NA,Inc.-QA Entity Quallty Assurance Contract Expiration Date 01/01/2027 Validated 9y Steven M.Urich,PE 21 Validation Checklist-Hardcopy Received Certificate of Independence FL13521 R5 COI Statement of Indenn_gg 211iZ, Referenced Standard and Year(of Standard) dBr yeat ASTM E1996 2009 ASTM E334 2002 DASMA 108 2012 DASNIA 11S 20i2 Equivalence of Product Standards Certified By Florida Licensed Professional Engineer or Architect httnsx/Auww.fioridabuildino.om/or/or a w dtl.asw0i)aram=wGEVXQwtDauvnCPErOMeedQfXYkC5Di4hmcWt)a3auwifl(nU7e96w%3d%Sd 113 Q� o I'Lo In e City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: Si Qh Date Received: J-- Site: Z �� Permit Type: ?)4 9 Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑ This comment sheet shall be kept with the permit and/or plans. / / C/- �-- )- �,,/ Kalvin Switzer `ans Examiner Date Contractor and/or Homeowner (Required when comments are present)