HomeMy WebLinkAbout08-7797
.\
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
7797
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
7797
RE-ROOF
ROOF REPLACEMENT
NOT APPLICABLE
Address: 6211 16 T
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 02-26-21-0180-00000-0130
4,550.00
4/24/2008
55.00
55.00
4/24/2008
REROOF GAF 30 YR
Phone:
Fir; b /O€3
TAPE JOINTS ROOF INSP
FINAL
REINSPEcnON FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d) work not ready for
inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible.
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 permits required from other governmental
entities such as water management, state agencies or federal agencies.
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"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. II
/~ ..
/' CONTRACTOR SIGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020
Date Received
City of Zephyrhills Permit Application 1-1:17 /']
Building Department rr r {
Fax-813-780-0021
Owner's Name vJi.'\f\ { joh"l~Ov1
Owner's Address I G 2./1 . (/, -i-t.-. .5 r
Fee Simple Titleholder Namel
~ (\.J)--
Fee Simple Titleholder Address I
o 2.l /
JOB ADDRESS
{ ~ t-~ ..s t
WORK PROPOSED
B
D
D
I
NEW CONSTR
INSTALL
SFR
BLOCK
2ep,^)v~,\\s Fl 3>3i)LfL LOT #
I PARCEL ID#I oL -2...lo - 2..1-Olg-O-ooC."'O-(){~O
(OBTAINED FROM PROPERTY TAX NOTICE)
c=J ADD/AL T D. SIGN D MOVE D
D REPAIR
D COMM D
D FRAME D
SUBDIVISION
DEMOLISH
PROPOSED USE
TYPE OF CONSTRUCTION
OTHER
STEEL
I
D
OTHER I
DESCRIPTION OF WORK
BUILDING SIZE I SQ FOOTAGE I 2--- ~ 52-HEIGHT I
, . . I . . . . I I I I . . I I I I . . . I I . . . I . . . I . . . . . I I I . . . . . I I . . . . I . I . . . I I . . I . I . . I I , I . . . . I I . . . . . I I I I . . I I I . . . I I I I . . . II I I I I . . . . . . . . I . I I I I . . . . . . I I I . I I I I I I I I I I . . . I . I I
1$ tj)~O, 00
1$
1$
1$
c=J GAS ~
FINISHED FLOOR ELEVATIONS I
c=J
ROOFING
I
I
I
I
D
I
AMP SERVICE
D
PROGRESS ENERGY
D
W,R.E.C
BUILDING
VALUATION OF TOTAL CONSTRUCTION
c=J
c=J
c=J
ELECTRICAL
PLUMBING
MECHANICAL
VALUATION OF MECHANICAL INSTALLATION
SPECIALTY D
FLOOD ZONE AREA
OTHER
DYES
DNO
I I I I . , . , , I I I , , I I I I . . I . I . . . . I . . I , , I I I , , , . . . I . I I , . . , , I I I . I I . I . . I I I . . . . . . . , . . . t I I I I r , I , , I I , , , I I I , , I I I I I I . . . I . , I I , ~ I . . . , , . I I . , . , , , . I , P r I . . . . . . . . . . . . . .
BUILDER
SIGNATURE
COMPANY
REGISTERED
Y/ N FEE CURRENT
License #
Y/N FEE CURRENT
License #
Y/N FEE CURRENT
License #
Y/N FEE CURRENT
Y/N
COMPANY
REGISTERED
Y/N
COMPANY
REGISTERED
Y/N
Address
MECHANICAL I
SIGNATURE
Address I
OTHER ~. I
SIGNATURE
Address .1 P Ii 6 () ^ II rr ~ h t/ln ~ P / .7.3S-? ~
COMPANY
REGISTERED
Y/N
COMPANY
REGISTERED
License # I
LS{o If @/ ",-d~e;, ~ ~ h ~/ Ii, ('
I Y / N I FEE CURRENT I Y1 N I
License # I Cc Co F 7 7 .5~ 7
111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111
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 subdivisionsllarge projects
COMMERCIAL Attach (3) 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.
1II11111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111I11111I
Directions:
Fill out application completely,
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000)
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 (Front of Application Only)
Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrict!ens"
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 "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 th~ work is commenced.. An extension
may be requested, in writing, from the Building Offici a! for a period not t~ exceed nln~ty (.90) da~s and Will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the)ob 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 (1=,5, 117!l~.}~_-:-. _ __._ ('~::>? ...L...J-- ~
OWNERORAGENT/.~ CONTRACTOR ---~ ~
Subscribed and swom to (or affirmed) before me this Subscribed and sworn to (or affirmed) before me this
~ ~
Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced
as Identification, as identification,
Notary Public
Notary Public
Commission No.
Commission No,
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped
STATE OF FLORIDA
. COUN-TY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORREGT COpy OF THE DOCUMENT ON FILE
OR OF PuBLIC RECORD I. THIS OFFI~lt.ESS MY
HAN AND OFFICIAL SEAL THIS,""" . DAY OF
Y 2ID
rf ~'~~CUIT:CLERK
1111111111111111111111111111111111111111111111111111111II11I
2008061160
Rcpl : 1176259 Rec: 10. 00
OS: 0.00 IT: 0.00
04/24/08 _ Dpty Clerk
~~'2:~~~MAIN1~5P0ASCO COUNTY CLERK
. am 1 of 1
OR BK 7819 PG 1440
NOTICE OF COMMENCEMENT
Pennit No.
Property Identification No.OL- "1.(P- 21 - 0 I '8'Q-OOoOd ~0/3 0
THE UNDERSIGNED hereby give informs you that the improvement will be made to certain real property, and in accordance with
Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
p~~k /-hil Sut9 UNI T / ,a.(j /'1 ,.06 70 LoT /31<..(3
I.Description of property (Ie al descri tion:) { 0 '7 I :.... G ~ ~ ?
a) Street Address: 2/1 '6 rlt _ f- Ze .t:1 Jr...v r 1" . I... .,c I :3 '3 C l./ Z
2.General description of improvements: I< (J v"O" - t-.Jl c.. .., . 30 y<.:t v. G ~F nM bey" ht,.
,
3. Owner Information ,: I I I J ' ,II f4..' J
a)Nameandaddress: W~I1.(Xelf .John-JOI1 2 I' .jf- Zefh..tv l-" h
b) Name and address offee simple titleholder (if other than owner)
'\C'- c) Interest in property 0 LA...> n ~ V
'~. 4.Contractor Information
a) Name and address: S (0 If 13/4. C. /u.;.. ~ '"
b) Telephone No,:
5.Surety Information
a) Name and address:
b) Amount of Bond:
c) Telephone No.:
6.Lender
a) Name and address:
t:1 ~ 3S-Y2
120" h:J' IJ,( ])01 () 5tC- S-"Z.. j?() 6"Allfy~1'1 An,f /'/33s7(a
Fax No. (Opt.)
Fax No. (Opt.)
Phone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
8.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13 ( 1 )(b), Florida Statutes:
a) Name and address:.
b) Telephone No.: Fax No. (Opt.)
9.Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is
specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA
COUNTY OF PASCO ~~/ ___
Signature of Owner or Owner's Authorized OfficerlDirector/PartnerlManager
Sro(f n(4LkMc.V1
Print Name - ,
The foregoing instrument was aclmowle~d bef?re me ~s ~day of -1tn ' ( , 20flL, by (') CtJ ff 8k.GkJl.t~V7
. , as ~"\. <- to v (type of authority, e.g. officer, trustee, attorney
10 fact) for W f h ci.eJ' <.. h:.:>h ' (name of party on behalf of whom instrument was executed).
Pc"onally Known ..J.. OR Produced Identification _ Notary Signature Cu-v. CL..- ~ ~ ;9---<;~_
Type ofIdentification Produced Name (print) Co r t Q Vl Y\ {:J C. (ll~
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that
the facts stated in it are true to the best of my lmowledge and belief.
./'/J?// .
~~ -
," Signature of Natural Perso Si in Above
FORMSlNOC,rvsd2007
m';I'" CORI ANN KEOUGH
i ~ NolIIy PuIlIc ~ StIlI of Fbtda
i. . ~ ConniIelan Exp/raAug t7. 2OtO
,!ao...... . CcIfrInJaIb.' DO 581503
"'10".. Bonded By Nalioftll AIIft.
OJ 11 OH 17:38 FAX S137799~~~
__ _~___~:~:.~~1.~\~~~~Y.:_ _:;'r?:]:~[[; _J!hALTE
[4:00;::
Proposal/Contract
S~ ~t4d4W(ue iE!~#Vf" 1~.
P.O. Box 11 as
3~~;O 1 0 SR 52
San Antonio, FL 33576
(352) SS8-RooF (71563) · {B13} 782-1330
Fax (352) 588-9763 .. ~ /9 {,:,f
(!(!.80S?'$7 email: blackmanroo1ing@aol.com Oate __~:+f__!::-__
.. - --.------.---r-.----------------- -----.-.--.-
PROPOSAL SUBMITTED TO WORKED TO BE PERFOFlMED AT
-......---..- - ...------+--.---.------------.- .~ ..--.---.--.------..
Name t-..!t;.-vb-LL. :)01-"1 A.J 'SO'....1 _____., SlTeet;.__~-..e-"~~~.."'t.~(~ ~ ._._____..________
StrE'et___(!.?~J J J C" '" ~_.____ I City _.___t~ ~n ._-------,____~--._______
I ./ '0
City ___ ._~ 4 J... : It ~__... _______-_-_..___. StatEl_____~--_______ Zip ____.__ _______
S1at<.~___......._t_L._...__.__ Zip________..__.__ ONner 01 Property _._ _.__ ..__ _.~___ __~_____._..
P'10PP Numb!!':r__J:iJ/ -_2.~_Jj_Fax.___.___,____~._.__ Phone Number _.__~_____.___Far. _.m.
~ e~_IU.,.ttt~
fI....ert "
"'....~ctt
We ht'traby propose to fumlsh all the materials a.nd perform all the labeH' ne<::essary for the completion C'f
l(Remove t',;xl$ting r.hlngle roof tCReplaoe bad fascia boards at $~. _ z.... p ~~__. _ __ perfoot
:! Remove existing built-up roof 8.1'nstaH --S.t2.-.. feet of ridge vents
~ry-In with :::J 151b. 030 ltil/rvl1o/ Il-J~rtJ __ CJ ln~tall modified bitlmen (granulated) tcrct-l down roofirlg
)('nstF.\11 n~w galvanlzf.ld valley metal UNJ-t:r' rAi I'f,W I black. wtlite or oth.u colGr ~______
~ln$1a11 mow !Qad-boot$ 0 Insta1l2S yr_ fungus reslstam 3 tab shin~Jlas
o Install new exhaust vents ~stall 30 y[ fungus resistant dimenl;iio<"laJ shin
;f1 nstall new drip edge. --tJl.\.: :~.___. color ~hingle manufacturer .11~::f:'___h__ eN
.....lnstall new flashing as needed O/f,ld'.Mtn5talJ TPO, white rubberized rooting rnernora'IU (),/~ r f-Irl-YR.LJ
~(:m!aca j;IY'lVood at $------__.3..~_ per sheet ~er: _R....AlA~ 1 r it vJQ~! lb ~z.L_ .c~-r----.-
~epa;rrott8ntrussesat$ 7.~~__P(Hfoot d_?k>Y.~~'r ~"-,,"AL.;.'r')-4 1 f<t:'C5_fY$.IL'~1 e~<
.Woocwurki::oan acJdltlonalcharge, , J..c:' ~.rl5.u~~~ :1~
.. ",:~$SZ) -c:-.. ~~__._._________' it::~_(
.A.II malsr\a IS guaranteed to bl;! as.
lIons Si..bmltled br above work and compieted in a substantial workmanltkf1 marmerfor the sum of $..____._--____
wl'tr-'. paym6nts to be made as foilows. P.JlY-m1)l1t due in ful_f..2nJLQmpletiQn, unless otherwise noted. Thank You.
----.-.- ---.- -------. .~_._.-..-__._ -_.-,-Z~-cr---<<edt-A2_~~ca~~~ac:cePted~ a.d.__dil_lo~n_~~1_2_'S~/_~_t_~tlC\_rge_.
Any &1\tll~lk)n QI d".1.1Icn from ,.tlD~e ~pecllk:sJio'l$ irrJ"tvin] aldl1l 00'>!ll wi/l _
pe e~61-Ute<l OOIY Jpcr "'rl'~en Ofd_. an.j will t>f,tcCltnlll iln e:t\r" chaftl9 "...e~ and
~Ucd'" th. Y'3Ii''l1ala. ^fl ito""em(.l~ CQr'tirlg."1 upor ~t,,1t9:> accll;lttntll or rll\!aY5
,,~y~,d "V, cOn',>;)1 OW"KlT 1(.1 ClI''Y fll'l;. lomad'J afl4 otnttt Ml:e~$Clry InlW/B'U>il OffiG€rfAgent Seatt Blackman Hoofing
'~"'t1atlo'''"Jcrk Wo..ker~'Co~nsallQnllndP~MaUal;looyinw'..~nc"el'l""''''''tl Note. This proposal may i;>e withdrawn by U~~ if pat aCGl::lptEH
w~," hI l)~ 11I'SO "'"' ~y RD<)ling O'lrtraClOr. I 'I'?
"" wlthin./ v____ days
Ch;mt glV€S permission to dt'lve Oil driveway to deliver rnute(ials.
------.----... --.----.----.-. . ACCEPTANCE OF Pr40POSAL-----------~._-------------'--.--.
Ttl': above prices, specifIcations and conditiol"ls are satisfactory a.nd are hereby accepted, YOIJ ra au ,Orlz(!'d to Of) the wo~k ib
~;pSJjcilted I hav€t rQQd the bRCk of this f'roposaf/Contraet which contains FloriQa Statues 713.001 . 3,37. pa: ,Qitt will be made <1-;
o~Jtllnl!ld above I M _ / ./ /.
A''''"''''' ~~.r d ~..b",.r"~_.. s,gn.",,~A.~_._
I Ddte#V.EO _. ---- .- ------- Signatur~_____.~____ n_._____________-
*M.-.~:::,Vh~---jt,/7fo/ 3-:-;Z 7~ ~ ..- .------~--------
. .
City of ZeJmyrhiIls
BUILDING DEPARTMENT
RE: Permit # 77ql
9/17/07
Inspection Affidavit
I &ott-R/~cfMCUj
(pleaslC print name and circle Lie. Type)
License #('C C OS- 7 9-57
On or about '-//25/05" 3 ,100 ,:JfI\. , I did personally inspect the roof
tDate & time)
ork at G:A /) / (,+1,3+
(Job Site Address)
,licemed as . '~)lEngin_/kchitect,
~~lding Inspector*
Based upon that examination I have detenniJed the installation was done according to the
Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.)
/~~
," Signature
STATE OF FLORIDA
COUNTY OF 11 ~ ~' I
Sworn to and subscribed before me this~day of
By cy(!:)t{- 43JQ c.J:'JIV\CtJ;\ .
. Notary Public, State of Florida
CM/.~ ~
(Print, type or stamp name)
.200-2'
Personally knO~ or
Produced Identificatlon~
Type of identification produced.
Commission No.:
. Genenll, Building, Residential, or Roofing ContractoJ" or any individual certified under,468 F.S. to makt: sucb 821
inspection. Include pbotogrsphs of each pl_e of the .-oofwith the pc:nnit 1/ or addres!l # clclIdy shown marked on the
dcck for each in:JpCCtlon.
. CORf ANN ICEOUGH
--,.. ...".....
· . C.Il' r '~AIlg17.2DtO
CnI' . ,'DD_
....... .. --.. AIM.