HomeMy WebLinkAbout21-1353 m
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F' °�►���° City of Zephyrhills PERMIT NUMBER
- „ 5335 Eighth Street
Zephyrhills, FL 33542 BGR-001353-2021
Phone: (813)780-0020
Fax: (813)780-0021 Issue Date: 01/14/2021
Permit Type: Building General (Residential)
Property Number Street Address
02 26 21 021A OOB00 0040 38225 Boxwood Drive
Owner Information Permit Information Contractor Information
Name: ROY&NORMA SMITH Permit Type:Building General(Residential) Contractor:ALL STATE PLUMBING
Class of Work:Plumbing SERVICES INC
Address: 38225 Boxwood Dr Building Valuation:$0.00
ZEPHYRHILLS,FL 33542 Electrical Valuation:$0.00
Phone: (813)715-4308 Mechanical Valuation:$0.00
Plumbing Valuation:$1,700.00
.Total Valuation:$1,700.00
Total Fees:$72.75
Amount Paid:$72.75 /
Date Paid:2/8/2021 12:45:18PM
Project Description
REPLACE TUB W/WALK IN TUB
Application Fees
Plumbing Plan Review Fee $24.25 Plumbing Permit Fee $48.50
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 subsequent reinspection.
Notice: In addition to the requirements_of this permit,there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permit 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 add fee 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.
ValQgL4
CONTRA R IGNAT RE PE IT OFFICE
PERMIT EXPI S IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
a 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received i ✓ Phone Contact for Permitting ( )
# EEEait
Owner's Name Smith, Norma Owner Phone Number 813-715-4308
Owners Address 38225 Boxwood Dr Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS 38225 Boxwood Dr LOT#
SUBDIVISION Driftwood of Zephyrhills PARCEL ID# 02-26-21-021A-OOBOO-0040
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR eX ADD/ALT = SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE = SFR = COMM = OTHER
TYPE OF CONSTRUCTION = BLOCK FRAME = STEEL
DESCRIPTION OF WORK REMOVE EXISTING TUB AND REPLACE WITH WALK-IN TUB IN SAME FOOTPRINT
BUILDING SIZE I SQ FOOTAGE HEIGHT
BUILDING $ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C.
=PLUMBING $ 1700.00 13��
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS = ROOFING = SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER' COMPANY
SIGNATURE REGISTERED I Y/N FEE CURREN I Y/N
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN I Y/N
Address I License#
PLUMBER COMPANY All State Plumbing Services
SIGNATURE REGISTERED Y/N FEE CURREN
Address 540 E Me anna Ave.Clermont FL 34711 License# CFC057323
MECHANICAL COMPANY
SIGNATURE F REGISTERED Y/N FEE CURREN Y/N
Address License# '^
OTHER COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN Y/N
Address I License#
■aaRIIiY:liiislasstailil.i:3 I'll E.S.9allatE1l.Ei.lfEa11E1i swan'eilEg.@1s:11I@lIE:3.�ii.lE9t
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(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 subdivisions/large 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.
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required.(A/C upgrades over$7500)
Agent(for the Contractor)or Power of Attorney(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(Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
813-780-0020 City of Zephyrhills Permit Application Fa"13-780-0021
Building Department
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 1,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"V"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 RECORDIN9 YOtJp NOTICE O�COMMENCEMENT,
FLORIDA JURAT(F.S.117.03)
SOWNER'ORAGENT CONTRACTOR _
'crib and savor[i to(or affirmed)before me this Subsc a and sworn to(or affirmed)before me this
A/ z. by Norma Smith �_byJoel Casimiro
Who' are personally known to me or ha have
produced Who i/are personally known to me or has/have produced
4�.jU as identification. FL—-N5 _ as identification.
((�� 7 Notary Public �7 Notary Public
Commission No.� 9 L 7 0 �3 , Commission No. C,LZ 5 ��L
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
�V C Notary Public State of Flodda
Rebecca E Stephens
aV Notary Public State of Florida -A My Cornmiaaion GG 958848
Joshua A Schulz 41p Expires 02/16/2024
•o.wlf My Commission GG 230131
R Expires 1 0/1 612 022
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{Customer Name: �;,- � `-�,. 38225 BOXWOOD DR Date: —1 Z-
Drawing o,Existing Bathroom (Show tub, vanity, toilet, window and shower)
REMOVE EXISTING TUB
AND REPLACE WITH
I4 WALK-IN JETTED TUB
U`� IN SAME FOOTPRINT
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THE ULTgl��TE BATHING -r '
Once you step inside your Liberation by American StandardT"' walk-in bathtub, you'll be
` surrounded in a soothing, therapeutic bathing experience - in the privacy and comfort
of your own bathroom. The many advanced features work together to bring the ultimate
in safe, soothing relief, customized to your preferences. Choose your desired settings of
hydrotherapy, aromatherapy or chromatherapy for total-body indulgence that can calm
and comfort or refresh and revitalize you.
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- Premium Cast Acrylic Construction - Multi-Settings Shower Wand - 30" wide x 51" long x 37.5"
17" Chair-Height Seat Embossed Backlit Controls - Operating capacity: 60 gallons
i - Textured Bathtub Floor - Chromatherapy - Color: white or linen
a Built-In Safety Grab Bar - Aromatherapy - Left hand or right hand door&
- 16 Directional Water Jets - Neck Pillow drain
a 28 Multi-Speed, Heated Air Jets - In-Line Heater
Legs-Only Massage - Self-Cleaning Sanitary System
." Foot Jets on Tub Floor o Auto Purge System
Hand/Wrist Jets a Extension Kit to Fit into 60" Space
Patented Quick Drain"
W�M
BEST IN-CLASS LIMITED PATENTED QUICK DRAIN" 44 HYDROTHERAPY JETS MORE
LIFETIME WARRANTY ON BATH DRAINS IN UNDER 2 MINUTES THAN MOST OTHER WALK-IN
I --- - --- -- ; BATHS
-Lib ''raft -Wa ,
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Liberation 3051 Soaking Tub
• Premium cast acrylic construction 50-1/2" 2"
• Free standing metal support frame with five adjustable 9-31
-4
•
leveling feet ® "
• Easy access door system
• Contoured,17"high,built-in seat 1a-11z
• Built-in grab bar and textured tub floor
• Premium deck mounted faucet with hand shower 24a�x
• Color matched cable driven drain assembly 3° 2T 15 _-
• Air filled neck pillow
• Extension kit to fit into 60"space
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Liberation 3051 Combination System ,,2 3.1 a
• Premium cast acrylic construction 1T
• Free standing metal support frame with five adjustable
leveling feet rr 16-
• Contoured,17"high,built-in seat
• Built-in grab bar and textured tub floor
• Premium deck mounted faucet with hand shower
• Polished chrome cable driven drain assembly 16j/2
• Air filled neck pillow 29-t12"
• Includes exclusive Quick Drain°fast water removal
technology I -C
• Embossed backlit controls seat17* o 0
• 7 amp whirlpool pump o:U_
• In-fine heater*
• 16 directional water jets
• 28 multi-speed,heated jets
• Legs-only massage
• Automatic purge cycle GENERAL SPECIFICATIONS FOR LIBERATION
• Self-cleaning sanitary system 3051 WALK-IN BATHING TUB
• Extension kit to fit into 60"space INSTALLED SIZE 51 x 30-1/2 x 37-1/2 in.(1295 x 755 x 953mm)
• Chromatherapy WEIGHT 190Lbs.(86Kg.)
• Aromatherapy WEIGHTw/WATER 698Lbs.(313Kg.)
OPERATINGGALLON 60Gal.(227L.)
Nominal Dimensions: FLOORLOADING 64Lbs./Sq.Ft.(312Kgs/Sq.m.)
30"x 51"x 38" (PROJECTED AREA)
(755 x 1295 x 953mm) CUBE(F-P) 33.8
Requires!Electrical Specifications:
The in-line heater and air pump require their own dedicated Notes:
15 amp circuits.Drain and Whirlpool pumps should be run off TUB IS SUPPORTED BY THE FRAME AND FIVE INTEGRATED
of a 20 amp circuit.DO NOT BYPASS CONTROL BOXES FOR ADJUSTABLE FEET,NO ADDITIONAL SUPPORT REQUIRED,
INSTALLATION. REFER TO INSTALLATION INSTRUCTIONS SUPPLIED WITH TUB
Compliance Certifications=
FOR ADDITIONAL INFORMATION.
Meets or Exceeds the Following Specifications: PROVIDE SUITABLE REINFORCEMENT TO SUB FLOOR FOR ALL
• ETL-INTERTEK SEMKO SUPPORTS.
• IAPMO- USPC
• ANSI Z 124.1.2-for Plastic Bathtubs IMPORTANT:Dimensions of fixtures are nominal,may vary and
• are subject to change or cancellation.
ASME Ali2.i9.7-Whirlpool Appliances ALL ROC".1.i�ty-isj, y ed fqr use of superseded or voided
• ASME A112.19.15-for Walk-In Bathtubs C{�p k a € �sll�t VOTH PNEVAC� NG
• CSA B-45.5-Canadian Plumbing Fixtures BUILDING CODE,
NATIONAL ELECTRIC CODE,
To Be Specified -Required: AND THE C!"'y CP ZEPHYRHILLS
❑ Drain Configuration:Left(L)or Right(R) ORDINANCE'S
❑ Color:White(W)or Linen(L)
* mote:The whirlpool heater is designed to maintain water REVIEW ATE LP9
temperature during operation.It will not heat cold water to C1 YOF pZp��EnnfpflHYFC ,
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desired bathing temperature. — O 2 14'k``3��a E141-322
L 8 E R r.T 1 0
ES-P-LFLM495
Product Specification
Job Name Contractor
Job Location
HYDROGUARD® �.
Series LFLM495
Thermostatic Mixing Valves for, era NSF.
Lavatory Installations Advanced Thermal ® "o
Features Activation
• Temperature control to ASSE 1069, 1070 and 1017 down to
0.5 gpm UNION CONNECTIONS
u Advanced thermal actuator improves performance at low flow Female NPT 1/2"(15) LFLM495-1
u Lead Free*cast copper silicon alloy body construction for 3/4" 20 LFLM496-1
durability and to comply with Lead Free*requirements 1" 25 LFLM497-1
Adjustable temperature selection with lock down Sweat 1/2"(15) LFLM495-2
Union connections for easy maintenance 3/4"(20) LFLM496-21" 25) LFLM497-2
Integral checks and screen prevents cross-flow and contamination CPVC 1/2"(15) LFLM495-3
Available in 1/2",3/4", 1"(15,20,25 mm)with NPT,Sweat, PBX, 3/4"(20) LFLM496-3
Quick-Connect,CPVC union connections and w/press 1"(25) LFLM497-3
PEX 1/2"(15) LFLM495-4
Specifications 3/4"(20) LFLM496-4
Temperature Adjustment: 80°-120°F(27°C to 49°C) 1"(25) LFLM497-4
Approach Temperature: 50F(3°C)above set point Quick-Connect 1/2"(15) LFLM495-5
Max.Operating Pressure: 125 psi(861 kPa) 3/4" 20 LFLM496-5
Max.Hot Water Temperature: 200°F(93°C) 1"(25) LFLM497-5
Max.Pressure Differential w/Press 1/2"(15) LFLM495-1 w/press
between 3/4"(20) LFLM496-1 w/press
Hot&Cold Water Supplies: 25% 1" 2 LFLM497-1 w/press
Minimum Flow: 0.5 gpm(1.90 Ipm)when tested in accor- f WARNING
dance with ASSE 1017-2003
Check Valves: Integral i When used in an ASSE 1017 application at the hot water source,the
Construction: Lead Free*Cast copper silicon alloy body Powers Thermostatic Mixing Valve Series LFLM495 cannot be used by itself
Listing: ASSE 1069,ASSE 1070,ASSE 1017,IAPMO to control final temperature at fixtures where ASSE Standard 1016 or ASSE
cUPC,and NSF372 Standard 1070 listed devices are required.Such use may result in severe
bodily injury(i.e.scalding or chilling)and/or death.ASSE Standard 1016,
Viega Pro-PressTM connections are optional factory installed fitting on ASSE 1069 or ASSE Standard 1070 listed devices,such as Powers Series
each end of the approved/certified assembly LFe480 or LFLM495,should be used at point-of-use to prevent possible
injury.Consult all product manuals,and instruction guides before installing
Capacity any referenced product.
Recirculation systems should recirculate water at temperatures over 140oF
Pressure Drop Across The Valve to reduce the risk of bacterial growth in the piping.This valve should not be
(Cv)1 psi 5 psi 10 psi 15 psi 20 psi 30 psi 45 psi 60 psi used at the hot water source in recirculation systems.
i,7 kPa) (34 kPa) (69 kPa) (103 kPa) (138 kPa) (207 kPa) (310 kPa) (414 kPa)
AM
179 4.0 gpm. 5.7 gpm 7.0 gpm 8.0 gpm 9.8 gpm 12.0 gpm 13.9 gpm The information contained herein is not intended to replace the full product
(15.0Ipm) (22.0 Ipm) (26.0 Ipm) (30.01pm) (37.0Ipm) (45.0 Ipm) (53.0Ipm) installation and safety information available or the experience of a trained
product installer.You are required to thoroughly read all installation instructions
'The wetted surface of this product contacted by consumable and product safety information before beginning the installation of this product
water contains less than 0.25%of lead by weight.
Powers product specifications In U.S.customary units and metric are approbmate and are provided for reference only.For precise measurements, POWERS'
please contact Powers Technical Service.Powers reserves the right to change or modify product design,construction,specifications,or materials with-
out prior notice and without incurring any obligation to make such changes and modifications on Powers products previously or subsequently sold. A VVATrS Brand
Dimensions
Ii
1 1
„A„ E147/1 4-7/8 5-5/16 4-13/16 5-5/16 5 13/16 4 3/4 5 1/4 5 11/16 5 1/4 5-1/2 5 7/8
(124mm) (135mm) (123mm) (135mm) (148mm) (121mm) (133mm) (144mm) (133mm) (140mm) (149mm)
11Bn 5-7/16 5-5/8 5-3/8 5-5/8 5-7/8 5-5/16 5-9/16 5-13/16 5-9/16 5-11/16 5-7/8
137mm 143mm) (137mm) (143mm) (149mm) (136mm) (142mm) (147mm) (142mm) 145mm) (150mm
t,c,t 3-3/16 3-3/16 3-3/8 3-1/8 3-3/8 3-5/8 3-1/16 3-5/16 3-9/16- 3-5/16 3-7/16 3-5/8
(80mm) (80mm) (86mm) I (80mm) (86mm), (92mm) (79mm) (85mm) (90mm) (85mm) (88mm) (93mm)
II ,. .., ,. .. .. A
CONNECTIONS
i
1 i t )
1 CONNECTCONNECT
„A„ 6-5/8 6-15/16 7-1/8 Hnzw�tetmt0:
(168mm) (177mm) (181 mm) catdw.....let
6-1/4 6-7/16 6-1/2 Note: - - - pf----�----� — -
"gl� Dimensions are shown:1/4" B
(159mm) (163mm) (165mm) Dimensions in brackets are in mm
4 4-3/16 4-1/4 Consult factory for dimensions
�.. (102mm) (106mm) (108mm) w/press
c •1
Tempered Outlet
Ordering Information
Model LFLM49
(800- 120°F)
!Valve (270-49°C)
1�2. .............................................
,5
3�4.. ................ ........................... ..
�
1"..............................................7
Inlets
Union NPT Female................................1
Union Sweat................................. .. ..2
Union CPVC.....................................3
Union PEX....................... ................4
Quick-Connect.....................................5.
w/press......................... ........1-w/press
Typical Specification
Thermostatic tempering valve shall be constructed using Lead Free*cast valve shall feature a vandal-resistant lockable handle to prevent tamper-
copper silicon alloy material which shall comply with state codes and ing.The valve shall be a Powers' HydroGuard®Model LFLM495(1/2",
standards,where applicable requiring reduced lead content.The valve 15mm), LFLM496 (3/4", 20mm), LFLM497 (1", 25mm). Any alternate
shall feature advanced paraffin-based actuation technology and union must have a written approval prior to bidding,
connections for ease of maintenance.AiI internal components shall'be
corrosion-resistant.Valve shall feature integral checks to prevent cross-
flow and inlet screens to filter out debris.The valve shall be ASSE 1069,
ASSE 1070,ASSE 1017 and IAPMo cUPC listed.Capacity of the valve
shall be 12.0 gpm(45.0 Ipm)at 45psi(310 kPa)differential.Valve shall
perform to a minimum flow of 0.5 gpm (2 Ipm)to ASSE 1070. Control
temperature shall be adjustable between 804F-120OF(27-490C).The
POWER�rm
A WATTS Brand USA:Tel:(800)669-5430 o Fax:(847)229-0526*PowersControis.com
Canada:Tel:(905)332-4090•Fax:(905)332-7068 o PowersControis.ca
Latin America:Tel:(52)81-1001-8600•Fax:(52)81-SODO-7091 •PowersControls.com
ES-P-LFLM495 1905 0 2019 Powers
ALL-STATE PLUMBING 540 E Minnehaha Ave.
- Clermont,FL 34711
Services,Inc. Tel:352-874-4225
E-mail allsiplumbinunvahoo.com
CFC 057323
CONTRACTOR AUTHORIZATION FORM
STATE LICENSE NO..
CFC057323
PRINT QUALIFIER'S NAME: JOEL CASIMIRO
BUSINESS NAME: ALL STATE PLUMBING SERVICES
*THIS AUTHORIZATION SUPERSEDES ALL PREVIOUS SUBMITTED AUTHORIZATIONS*
I authorize the following individuals to sign for and obtain permits: (Please print names clearly.)
Dou-qc'-C-4- 131r cc C e C. t/
: f
Signature of Qualifier: = Date:
State of Florida.
S AP sc rthis day f`�� JtM✓+�ztr 2-G1-� �, ,��.z I ��,3,'nn+ice
. RebM=Eephens
MY Cammi 3km GG 95W8
�i,r Expimso211&W24 NdtgFy Public State of Florida
(Stamp)
My commission expires 2 'C Z`
g/devsvcsdocuments\l-documentspecialists\bcs\bcsforms\ContractorAuthorization Form Revised 4/3/17