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HomeMy WebLinkAbout92-2658 BUILDING PERMIT ~ ". ro ~ ~ ::~:;:::~e3 ~3 ~t2:zi" ~ Parcell.D,# //-86,-,2/- 00/0 - /~Oi) -o/3~- Zoning: Energy Code: Radon Gas: ~<~ 7 ~ Description of wo~~ ~ a-J ~:1z;~ CITY OF ZEPHYRHILLS (813) 788-6611 Permit N~ 2658& 9-d3 - 7':1. DatE! MEC~ Sewer Conn Water Conn: Water Meter: T.I.F.'s: NO OCCUPANCY BEFORE C.O. FINAL 'L DATE Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances, Inspector P~'m;t Fee~~ Signature _~-.A.. Company Address Telephone# ?7 Valuation or Contract Price I;f tTZJ?> ' cr-o , City License Registration # 3-5- r State Certified License# -- ME~ICAL ------ Breakers Ducts Insl. Compressor Final REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade: a, b. c. d. e. f. g. Wrong Address Condemned work resulting from faulty construction. Repairs or corrections not made when inspection called. Work not ready for inspection when called. Permit not posted on job site. Plans not at job site. Work not accessible. /3 2-1 1rt/7' The payment of inspection fees shall be made before any further permits will be issued to the person owning same. FORM 1000-C-91 SMALL ADDITIONS AND RENOVATIONS FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Section 10 - Residential Prescriptive Compliance Method Department of Community Affairs Climate Z9Q,es CENTRAL(Y5 6 COMPLIANCE WITH SECTION 10 OF THE FLORIDA ENERGY EFFICIENCY CODE MAY BE DEMONSTRATED BY USE OF FORM 100QC,91 FOR ADDITIONS OF 600 SOUARE FEET OR LESS. AND RENOVATIONS TO SINGLE AND MULTIFAMILY RESIDENCES ALTERNATIVE METHODS ARE PROVIDED FOR ADDITIONS BY USE OF FORM 1000A-91 or 9OOA-91 BUILDER: PERMITTING ,-. OFFICE: PERMIT NO.: PROJECT NAME AND ADDRESS: ~ 5060 ~ OWNER: RENOVATION ADDITION N o o CONDITIONED ~I SO NEW GLASS AREA AND TYPE FLOOR AREA ~ FT CLEAR TINUILM.SOLAR SCREEN PREDOMINANT rn ~ SINGLE, mIJ- SO SINGLE, ITJJ] SO EAVE OVERHANG . () FT PANE FT PANE FT LENGTH . PORCH OVERHANG m 0 DOUBLE'ITJJ]SO DOUBLE. ITJJ] sa LENGTH . FT PANE FT PANE FT WALL TYPE AND INSULATION CEILING TYPE AND INSULATION FLOOR TYPE AND INSULATION WOOD FRAME MASONRY UNDER ATTIC: flFl.O WOOD MASONRY EXTER~O~ WIJ. ~ EXTE~O~ rn. 0 R 0 lLILJ RAISE~ = [II D RAISE~ = DJ.D D SINGLE ASSEMBLY morn 0 COMMON rn ADJAC:N~ rn . 0 ADJA~E~T rn. R = . COM~O~ . R = COMMRO~ rn. 0 COM~O~: .0 COMMON: R 0 m.o ~~~~t R = rn. 0 UNITS COVERED BY THIS SUBMITTAL OJ] IF MULTIFAMILY. NUMBER OF MULTIFAMILY ATTACHED SINGLE-FAMILY DETACHED FOR ADDITIONS ONLY: PERCENTAGE OF GLASS TO FLOOR [}1]% DUCTS COOLING SYSTEM HEATING SYSTEM HOT WATER SYSTEM IN 0 CENTRAL o NONE 0 ELECTRIC STRIP D HEAT PUMP D ELECTRIC D SOLAR UNCONDITIONED D D D D NATURAL GAS D SPACE: R = ROOM NATURAL GAS ROOM/PTHP HEAT RECOVERY m.o D PTAC D OTHER FUELS D NONE D OTHER FUELS D DED HEAT PUMP ~ NO NEW SYSTEM ~ NO NEW SYSTEM ....,.---, ~ NO NEW ,IT] SF/EF = o.rn IN CONDITIONED SYSTEM EF c SPACE: R = SEER/EER = IT].O cOP I HSPF I AFUE = D ,[1_J rn m.o NUMBER OF BEDROOMS = ReVIew of plans and specifications covered by this calculation Indicates compliance with the FlOrida Energy Code. Before construction is completed. thi uilding will be Inspected for compliance In accordanc th Secti 53.90B, F.S-' ~~;;~=YE~:::~: and spe7atlons :overe~ by ~h,e calculation are In compliance With; . PREPARED BY' ",." . DATE 7 -~ 1 2- / '\ I hereby certify that'this building is in compliance with the Florida Energy Code OWNER AGENT: DATE DATE BUILDING OFFICIAL TABLE 10AI MINIMUM REQUIREMENTS FOR ALL PACKAGES COMPONENTS SECTION REQUIREMENTS CHECK WINDOWS 904.1 Minimum of 0.34 CFM per linear foot of operable sash crack (includes sliding glass doors). }' EXTERIOR & 904.1 Maximum of 0.5 CFM per sq. ft. of door area: solid core, wood panel, insulated or glass doors only. -/, ADJACENT DOORS EXTERIOR 904.1 To be caulked, gasketed, weatherstripped or otherwise sealed. 'I JOINTS & CRACKS SOLE & TOP 903.2 Sole plates and penetrations through top plates of exterior walls must be sealed. '/.- PLATES INFILTRATION 903.2 Infiltration barrier must be installed in exterior walls & raised wood floors. 'f BARRIER INTERIOR 903.2 All openings in interior surfaces of ceilings and exterior walls must be sealed. '1 JOINTS/CRACKS FIREPLACES 903.2 Fireplaces must have flue dampers, glass doors and outside combustion air intakes. IV II EXHAUST FANS 903.2 Exhaust fans vented to unconditioned space shall have dampers. except for combustion J}.f: devices with integral exhaust ductwork. WATER HEATERS 904.2 Comply with efficiency requirements in Table 9-7A. Switch or clearly marked circuit breaker (electric) I or cutoff (gas) must be provided. External or built-in heat trap required. ~7i SWIMMING 904.3 Spas & heated pools must have covers (except solar heated). Non-commercial pools must have a '-r! POOLS & SPAS pump timer. Gas spa & pool heaters must have minimum thermal efficiency of 78%. 1-' ,I HOT WATER 904.4 Insulation is required only for recirculating systems, including heat recovery units. In such cases. /1 PIPES piping heat loss shall be limited to a maximum of 17.5 BTUH per linear foot of pipe. /1/'1/ SHOWER HEADS 904.5 Water flow must be restricted to no more than 3 gallons per minute at BO PSIG. L i~ HVAC DUCT 904.6 All ducts, fittings, mechanical equipment and plenum chambers shall be mechanically attached. CONSTRUCTION. sealed. insulated and installed in accordance with the criteria of Section 904.6. Ducts in unconditioned ,I INSULATION & space and air handlers located in attics must be insulated to a minimum R-4.2 (R-6 after 1/1/92). t... 1: INST ALLA TION HVAC CONTROLS 904.7 Separate readily accessible manual or automatic thermostat for each system. /.,_J .' RENOVATIONS 1003.0 Meets the requirements of sec. 1003.0. See step 3 of page 2 of this form. ) ONLY GLASS 1. /1 -1 - CLIMATE ZONES 4 56 TABLE 10B. Prescriptive Requirements for Small Additions (600 Sq.Ft. and Less) and for Renovations to Existing Buildings. COMPONENT MINIMUM INSULATION INSULATION INSTALLED Concrete R,S ~ Wood frame. 2' x 4' R,11 ~ f\ ..... Wood frame. 2' x 6' R'19 ~ Common. Wood frame' R,11 Common. Masonry' R,3 en Under attic R,30 CI Z Single assembly R,19 ~'1 ::; iii Common. Wood frame' R-l1 C,,) en Slab'on.grade No Minimum a: Raised wood R,11 0 9 Raised concrete R,S .... Common. Wood frame' R,11 ti In unconditioned space 1991 1992 * :::> R-4,2 R-6 0 In conditioned space No Minimum 'Common components are those which separate two conditioned living units in a multifamily build TABLE 10C. Prescriptive Requirements lor Glass Areas in ADDITIONS ONLY (Renovations see 3 below) EQUIPMENT MINIMUM INSTALLED EFFICIENCY EFFICIENCY 1991 1992 ...J =~ 0 Central NC SEER = 9.0 10.0 SEER 0 () Room unit or PT AC EER = 8.5 8,5 EER = C) Electric Resistance ANY z i= Heat Pump HSPF = 6.4 6.8 HSPF =~ <( W I Room unit or PTHP COP = 2.6 2.7 HSPFI = w HSPF = 6.1 COP - () 6.1 <( Gas, natural or propane a.. AFUE = .70 .78 AFUE = (/) - Fuel Oil AFUE = .76 .78 AFUE = II: = -=k- w Electric Resistance EF = .88 EF I- <( :: Gas, natural or propane EF = .54 EF = I- - 0 I Fuel Oil EF = .54 EF = ing. '1' AVD 1./ (!.~ ':;'l:rle.r,,, Maximum percentage glass to floor area allowed is selected by type, overhang length, and shading coefficient. See below. Maxim~ % ~stalle~ % = " GLASS TYPE, OVERHANG, AND SHADING COEFFICIENT (TINTING) REQUIRED FOR GLASS PERCENTAGE ALLOWED UP TO 20% UP TO 30% UP TO 40% UP TO 50% Single Double Single Double Single Double Single Double OH - SC OH - SC OH - SC OH - SC OH - se OH - se OH - se OH - se l' - 1.0 0' - .90 2' - 1.0 l' - .90 3' - 1.0 2' - .90 4' - 1.0 3' - .90 0' - .86 l' - .86 0' - .70 2' - .86 l' - .70 3' - .86 2' - .70 2' - .65 0' - .65 l' - .65 0' - .50 l' - .45 l' - .50 0' - .45 0' - .35 0' - .40 Shading coefficients (Se) may be obtained from the manufacturer of the glass. Typical shading coefficients are: single-paned clear se = 1.0, double-paned clear se = .90, and single-paned tint se = .86. Form 1000C may be used to comply the following types of construction: SMALL ADDITIONS TO EXISTI NG RESIDENCES. Additions which have 600 square feet or less of conditioned area may comply with the Energy Code using this form. The prescriptive requirements in Tables 10A, 1 OB and 10C apply only to the components of the addition, not to the existing building. Space heating, cooling, and water heating equipment effiCiency levels must be met only when equipment is installed specifically to serve the addition or is being installed in conjunction with the addition construction. Components separating unconditioned spaces from conditioned spaces must meet the prescribed minimum insulation levels. RENOVATIONS. Residential buildings undergoing renovations costing more than 30% of the assessed value of the building must comply with the Energy Code using this form. The prescriptive requirements in Tables 10A and 10B apply only to the components and equipment being renovated or replaced. GENERAL DIRECTIONS: 1. On the left side of Table 10B in the column titled "INSULATION INSTAllED", indicate the R-value of the insulation being added to each component. On the right Side of Table 10B indicate the efficiency levels of the equipment being installed in the column titled "EFFICIENCY INSTAllED". All R-values and efficiencies installed must meet or exceed the minimum values prescribed in the preceding column for that component. Components and equipment neither being added nor renovated may be left blank. 2. ADDITIONS ONLY. Determine the percentage of new glass to conditioned floor area in the addition as follows. Total the areas of all glass windows, sliding glass doors and glass panels in doors which are more than '/3 of the area of the door. Double the area of all non-vertical roof glass and add it to the previous total. When glass in existing exterior walls is being removed or enclosed by the addition, an amount equal to the total area of this glass may be subtracted from the total glass area. Divide the adjusted glass area total by the conditioned floor area of the addition. Multiply by 1 00 to get the percent. Find the largest glass percentage under which your calculated percentage falls on Table 1 OC. For example, 29% glass would qualify for the "Up to 30%" column. Prescriptives are given by the type of glass (Single or Double pane) and the overhang (OH) paired with a shading coefficient (SC). Any pair within the selected "Up To " category is acceptable. For a given glass type and overhang, the maximum shading coefficient allowed is specified. Indicate the category into which the percentage falls in the box at the top titled "Maximum % = ". In the next column titled "Installed", indicate the calculated percentage of glass in the addition. Actual glass windows and doors previously in the exterior walls of the house and being reinstalled in the addition, do not have to comply with the overhang and shading coefficient requirements on Table 10C. All new glass in the addition must meet the requirements for one of the options in the glass percentage category you indicated. The overhang (OH) distance is measured perpendicularly from the face of the glass to a point directly under the outermost edge of the overhang. 3. RENOVATIONS ONLY. Only glass areas which are being replaced as part of the renovations need to meet the following requirements. Any glass type and shading coefficient may be used for glass areas which are under at least a two foot overhang and whose lowest edge does not extend further than 8 feet from the overhang. Glass areas being renovated that do not meet this criteria must be either single-pane tinted, double-pane clear, or double-pane tinted. 4. Complete the information requested on the top half of page 1. 5. Read "Minimum Requirements for Small Additions and Renovations", Table 10A on page 1, and check to indicate your intention to comply with all applicable items. 6. Read, sign and date the "Owner/Agent" certification statement on page 1. . f)Uv.. o. ~~j' ~ #Sru . 1'1- file, J. ,-L _, _ _ _ ~_ _ _ _ tI~ ~~ Id ' # /0 uJ~ ~f;~ ~ ~ ~ "&(r~ . ~ S \ __" c:.----- <- &) 7 ~ \ * v ~~\ ..,..... " !-I ( 1 ~-' ~ 1:, --Jr 'Vl I- ~ . 1'7 ~ - ~.. \ <, ~%~~ 6~1" <9<\ ~,. ~~ '-... --S i ~ J li\ L ____~ 7.. ~.._"_ -- SITE PLAN (RESIDENTIAL USE ONLY) PARCEL J.D. II "- ~ :2.1 /1 SEC ::l-~ TWP PROPEHTY MEASUREMENT 00 If/.) I J.. 3 (] 0 1-/ RNG o I .J~ .s- rrB ., rs~ ? (7;') SUBD BLOCK LOT CURRE.NT OWNERS ,~jVYJ't.-^.-<4- All drawings sbal1 be drawn to scale for all p N @Jl;t {1~ ~1 l~- - fL!A JJt 7- ~.Ltl ~~ /tJCj ~ vi 1\ (]'zj-{.' e IwrE o "')"? 0' ""7 ( --- ",,_ ..>- I .--. ~ or lots five acres or less. .. -.Q. 1 ij \ ' 3' \ <iJ ~ 0/ I \ \)'.\ 'J\, -' , DATE BUILDING DEPT APPROV ~ v-~ ~ \ ht<M4 ~, l'l;< 1(.;, 2 # 5 (2cIt ;~w~~I::I<-,"~---~ ~~p~ 300tJ $ \ ~ c:._____-.. . <:1/ )' -A -1 ~ \'~~ ! \, r ---...L ; U"., '1-_. 'J t, . \ ..,J . - '.-1'" <-. 1--1 . I l~- ~.... ~ ~ \ ---If Y7 I- ~ Tn ........... ......r ~ ~ '~-yr~/ ~l \ . 17 - i ~ J - {? ~.. · \<"\ \t 6$~ ~~ 61~ %< ,t .r .J. < ,.-a ~ ~ 7V\Ai r K./ ,/'/ I J i \ ~"\" ~ ~'- i ""'-.. I~ !r\.l ~. Ie-.. \ i\ JOB SPBCIFICATIONS 1. INSULATION WILL BE 3.5 INCHES.THICK IN WALLS 6 INCHES IN CEILING 2. SHINGLE ROOF 4 TO 1 PITCH 3. ALL EXTERIOR DOORS 310tl 4. 8' CEILINGS 5. 2 CEILING FANS WITH LIGHTS 6. INSIDE WALL COVERING IS 1/2tl SHEETROCK 7. EXTERIOR WALL COVERING IS VINYL SIDING 8. MONOLIFIC SLAB BELL FOOTER WITH 2 #5 ROD 9. ANCHOR BOLTS 8' OIC 10. 2X4 FRAME WALLS STUDS 1611 OIC 11. ALL WORK TO BE DONE TO CITY AND COUNTY REQUIREMENTS COND I T IONS OF PE -'t, I T lCiFF I Dr'l') I T. A. NOTICE OF DEED RESTRICTIONS The undersigned under~tands that this perait .ay be subject to "deed restrictions' which lay be lore restrictive than City regulations. The undersigned assuaes responsibility for cOlpliance wit" any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RE~PONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they say be required to be licensed in accordance with state and local regulations. If the'~onttactDr is not licensed as required by law, both the owner and contractor aay be cited for a aisdeaeanor violation under state iaw. If the owner or intended contractor are uncertain as to what licensing requireaents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-6611. Furtheraore, if the owner has hired a contractor or contractor~! hp. is advised to have the contractor!s) sign portions of the "Contractor Sections" of this application for which they wili be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are re~ponsible for the work. ,If the contractor wishes you t) sign as contractor that aay be an indication that he is not properly licensed and is not entitled to peraitting privileges in "the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~ D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES~ AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - Hoaeowner's Protection Guide" prepared by the Florida Depart.ent of Agriculture and Consuaer Affairs. if the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the "owner" prior to cOllenceaent. E. CONTRACTOR'S/DWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is h~reby lade to obtain a per.it to do w~rk and installation as indicated. r certify that no wor~ or installation has cOlaenced prior to issuance of a per.it and that all work will be perforled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also certify that I understand that the regulations of other governmental agencies lay apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in coepliance. Such agencies include but are not liaited to: I Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment I Southwest Florida Water "anaQelent District - Wells, Cypress Blyheads, Wetland Areas, Altering Watercourses I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Departlent of Health ~ Rehabilitative Services. Enviro~lental Health Unit - Wells: Wastewater Treatlent, Septic Tanks f US Environlental Protection AQency - Asbestos abatele. t I also certify tnat, if fill laterial is to be used in Flood Zone "A" or "A,etc.., it is' understood that a drainage plan addressing a "colpensating volule" Mill be sublitted whic~ is prepared by a professional engineer registered in the State of Florida prior to perait issuance. A perlit issued shall be construed to be a license to proce~d 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 frot thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issued shall becole invalid unless the work authorized by such perlit is coalenced within six aonths of issuance, or if work authorized by the permit is suspended or abandoned for a period of six aonths after the tiDe the work is cOlienced. One 90 day extension of tile, lay be allowed for the perlit with fee charge of $15.00. The extensi~fi shall be requested in writing to the Building Official. An approved inspection lust be logged during Poach ~ix lonth perioo, Dr the project Mill be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A MOiILE OF COHMENCt~ENT MAV RESULT IN YOUR PAVING THICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YGUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF ~CO""El""ENT' ,.M U":' ;',500 IN VAlUE Dll NO: '!EE' TD 'ErO,," ,,~p~. . 'NOTICE OF;"E~"ENT"(:).., -", / I a. ~ v~ ~~df::::i.i:::;;:~ G TURE: OWNER OR AGENT SIGNATURE: CONTRACTOR ~ STATE OF FLORID~LJ-r- . COUNTY OF r I{ 0 C cJ The foregoing in~trument was acknowledged befol-e me this 7 -.;l Z- , 191~ by STATE OF FLORIDA ;;:In...-C' A COUNTY OF / 'T~ v The foregoing instrument before me th i s 7-~-0 vJas ac knovJ I edged , 19 <J~ by who is personally known to me or who has produced as identification and who did/did not ta~~1 oath. W. ~'~ (")Jnat~ ' 1=t/<.t;'4RcTh J.v GRIFF//V (Name Typed, Printed or Stamped) NOTARY PUBLIC who is personally known to me or who has procuced ?s identification and who did/did not ta~':e an oath. . - q' .PJ~ . f1 (;l/l1Cl~ W. f7- ~ LC'Vl./ (Sigpature) . · /71T/:Zt::R-/2&T~ v.v. G;2/r'F//)./' (Name Typed, Printed or Stamped) NOTARY PUBLIC /tJ.-3o'-~3 Ex {:J. OWNER'S.lWtE Er rJ r ff ~ /l1 /:5 OWNER' S ADDRESS :3 8;Z ) :3 7 :a.. /} v ~ 5if~~ LEGAL DESCRIPl'ImI: urr(S) /:3 - ( C J J ,.<~ ,.< / JOB ADDRESS PARCEL 1. D.' APPLICA'I'ION FOR PERKIT CIn: OF ZEPllYRHILLS BIJJIlJ)TIliG DEPAR1'lIfENT . , . . PHONE '7g~-- ~3,-{ J --rS - -if. BLOCI{ /%l'_SUBDIVISIOlil 00 /0 :58 71~ ~G 177 CJJ3~ /...<. :? ocr WORK PROPOSED:_!I1ew Construction ~ition K.Alteration _Repair _Install _Sign _Move _Deaolish PROPOSED USE: X Single Faaily _KIF _, of llfnits _M/H _ec-ercial __Indust. _S.n.. Pool. Other _Rest:aurant &: Healt:h Depart:aent Approva1 )~/ ~ BUILDING SIZE: / X /7. X 8')' Square Feet. 4BUILDING 4ELRCTRICAL .~CAL tf/t PLUKBING TYPE OF CONSTRUCTION: _Block ~Fraae __.Steel FHiISHED FLOOR ELEVATIONS: 8# w.. IS PRt 'JECT IN FLOOD ZONE AREA? COm'RACIOR SECTION COfPMIV_.. r A, G./f/R-7~ c~~~ :r.:.a~e Cc~". or Regist. " <<.;~: Ly 'i:.:~t:.."lse Registration , ]~~ ........................................"'.........i':...'i::'l:* .'. :IlI*..,.....................*........................ =CIAR~ ~ ampA1:~ rrd ~ / . . S1:ate C~rt. or Regist. , E:.IICC Si ture." .1 V A ~ . City I.lr..nse Registration t r.jl / "'......... ..............................................-il:...,i':*.....................*........."'......' RESIDENTIAL : COttMERCIAL : BUILDER Signature PLDKBER Signature KECHARICAL Signature 0T1IF.R Signature ~~- ~_ /0" Height ATTACH (2) PLOI' PI.AICIS &: (2) SEiS OF BUILIlING PLMS 5: (1) SE'f ENERGY FORMS. *'* ATTACI (3) SETS OF BUILDIBG PLUlS &: (1) SET ENERGY FORKS....... "''''COPT OF COn'RAGT REQm:KIlD. PERKITS REQUESTED ~ ~ $ . / j' c:f) O'?:)... < Valuation of Total Construction ~C5 AKP Se:C"?ice Lplorida Power Corp. W.R.E.C. $ Va1uation o~ Kechanical Installation GAS V' ROOFING . #/r / SPECIALTY Other ~ YES NO ...............*...............:k i:&-..........................."......*...........................*.................. 4~- .::. .~:~." .~: ",-.#1...1' -A.n..F.,_ft...,~. ...,..IIl............a....~.... .JI-.....,...4....a............~,.I'\.......$.....ll!o_,A.~."='+-!' COlIPMY State Cert. or Regist. , City License Registration I ~ COlIPAJMY State Cert. or Regist. I . C'~ ~- City I.icense Registration I ......"'......"'''''4'.........'''...'''.........-:2:...'''...**''',;,'''............'''.........'''..................... CO!IPdY L1::/ ~ State ~rt. or Regist. " ~ ~ City License Registration . , ......*...............~*......*..."'..................*......*.........*....................................... . APPLICAnOR APl'IlOVW BY ?1 tl,AI G- ,0 '^-<"-' r PERKIT OFFICER.