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Home My WebLink About08-8067 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 8067 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: 8067 RE-ROOF ROOF REPLACEMENT NOT APPLICABLE Address: 5912 NEWBERRY C ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: WEDGEWOOD MANOR Parcel Number: 10-26-21-0120-00000-0280 4,800.00 7/09/2008 55.00 55.00 7/09/2008 REROOF- SHINGLE Phone: I OOF IN;~m_H) 1/19/O~ 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 befo recording your notice of commencement." OR SIGN URE PERMIT OFF I 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 Lb~' o~ 1 Building Department ..".. I) Fax-813-780-0021 Owner's Name hG\.... Owner's Address I ":;, ~ ot ~ Fee Simple Titleholder Namel ~ ~y W D ~ C()..o f1 JC:r:.& Owner Phone Number '"> 'U""f.{ "2..- ~1J. (/l1wn" Phone Numbe, I Owner Phone Number I Fee Simple Titleholder Address B PROPOSED USE D TYPE OF CONSTRUCTION D DESCRIPTION OF WORK I R~-'rn(lf I I I . . I I . . . I I r , , . . 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 I . . , , . . . . I I , , , r I , I r , I , I , . . . . . . . . . . . . . I r . . . , 1$ L-\"<3 cO . 1$ 1$ D MECHANICAL 1$ D GAS t8r FINISHED FLOOR ELEVATIONS I B D D - 21, l~es SQFOOTAGEI. crJ JOB ADDRESS SUBDIVISION WORK PROPOSED NEW CONSTR INSTALL SFR BLOCK BUILDING SIZE D D D BUILDING ELECTRICAL PLUMBING ROOFING LOT # Ic::;(~ ADD/ALT REPAIR COMM FRAME - Oca:xJ- OZ 8C) (OBTAINED FROM PROPERTY TAX NOT/CE) D SIGN D MOVE D (<. oo-fl- D OTHER D STEEL DEMOLISH I D OTHER I HEIGHT I ~I VALUATION OF TOTAL CONSTRUCTION I I I D I D D AMP SERVICE PROGRESS ENERGY W.R.E.C. VALUATION OF MECHANICAL INSTALLATION SPECIALTY D FLOOD ZONE AREA OTHER DYES DNO .11111.....'.,""..11111111...11..11'."'.111'.'.,'"111111"'11111..."11'."""""".."...'11"11"1'......lllflll.....IIIIIII'."'IIIIII.,1 BUILDER COMPANY SIGNATURE REGISTERED Y / N FEE CURRENT Y/N Address License # ELECTRICIAN I COMPANY SIGNATURE REGISTERED Y / N FEE CURRENT Y/N Address I License # PLUMBER I COMPANY SIGNATURE REGISTERED Y / N FEE CURRENT Y/N Address I License # MECHANICAL I COMPANY SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N Address License # I OTHER ~M~ ROJi'~ ~ Y / N FEE CURRE I Y/N I Address >>St.{'V License # ICcc I ~ 5 <;OS 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 (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. 1111111111111/1111111/111111111/11111111111111111111111111111111111111111111111111111I11111111111111111111111/11/11/11/11/1//1111111111/1111111111 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 t1-,e contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing s.:'\me OVER THE COUNTER PERMiTTING (Front of Application Only) Reroofs .,Sewers Service Upgrades AlC Driveways-Not over Counter if on public roadways..needs ROW Fences (Plot/Survey/Footage) 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 "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 ~nstallations not specifically in~luded. in the application. A permit issued shall be construed to be a license to proce?d With the work a~d not as authorlo/ !o vlol~t~, cancel, alter, or set aside any provisions of the technical codes, n?r shall.lss~ance of a permit prevent the B~II.dlng OffiCial from the~eaft?r 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) mon.ths after the time th~ work is commenced: An extension may be requested, in writing, from the Building Officia~ 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\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 YO INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LE ER OR AN ATTORNEY BEFORE RECORDING YO R NOTICE OF COMMENCEMENT. FLORIDA JURAT' F. . 117.03) \ ,. ,r..) .-- (I ~,,,.>-f(_l.. A-f~ Notary Public or has/have produced as identification. Notary Public Pasco County Parcel: 10-26-21-0120-00000-0280 001 Page 1 of 1 Search.Again Sho~1\1Qp G~nerali?:ed Bujldill9 Sch~matic Estimate Taxe~ Erequent!'l)~sked.Qy~stiO.!1~ Other Agency Data: IQx Collector School Soard S1!Q~Ddsor ofElec;.tLQns Data Current as Of: Parcel ID Classification Mailing Address VANATER ANNA B 37423 WEDGEWOOD DR ZEPHYRHILLS, FL 335427950 >Jr Physical Address It 5912 NEWBERRY cr ZEPHYRHILLS, FL 33542-7935 Weekly Archive - Saturday, July 05, 2008 10-26-21-0120-00000-0280 (Card: 001 of 001) 01 - Single Family Property Value Ag Land Land Building Extra Features $0 $18,003 $96,043 $440 Legal D~scription (First 4 Lines) WEDGEWOOD MANOR PHASE I & II PB 27 PG 11-14 LOT 28 OR 7650 PG 652 Market Value Assessed (Save Our Homes) $114,486 $0 Taxable Value $114,486 Line 1 2 Use Price $4.65 $0.45 I Condition I 0.80 0.80 Building Informatiol1 - Year Built 1990 Exterior Wall 1 Above Average Roof Structure Gable or Hip Interior Wall 1 Drywall Flooring 1 Cork or Vinyl Tile Fuel Electric A/C Central d Information I FEMA Code ICTI Re Use 01 - Single Family Residential (Card: 001 of 001) Stories 1.0 Exterior Wall 2 None Roof Cover Asphalt or Composition Shingle Interior Wall 2 None Flooring 2 Carpet Heat Forced Air - Ducted Baths 2.0 Line 1 2 3 Description BAS FGR FOP Sq. Feet 1,434 340 20 Repl. Cost New $104,725 $9,932 $365 Line 1 Extra Features (Card: 001 of 001 Description II Year I Units DWSWC II 1990 I 279 Sales History Value $440 Previous Owner Year 2007 2001 1990 Month 09 12 03 Book/Page 7650 / 0652 4819/0859 1891L 1379 HABERLAND CJ I Type wp Amount $125,000 $0 $18,000 S~arch.Again Show M.aQGenen'llized_ BuiLctinQ..Schematic EstimateJaxe~ Frequen1!y.}\skedQuestioQs Other Agency Data: ICiX Collector Schoo/Board SupervisorQf ElectiQns http://appraiser. pascogov .cOIn/searchlparcel.aspx?sec= 1 0&twn=26&mg=21 &sbb=O 120&bl... 7/912008 :/~~ ~~~ ~'1met~ ~(j(j'i~9 A Division of Ryman Construction, Inc. 37325 SR 54 * Zephyrhills, Florida 33542 Phone: 813-782-6094 Fax 813-783-2645 License #CCC 1325505 -< ~ .5 00 S'b - Ft- ..... Customer: A."\~ V 6.,....o,l... )' Address: S'1 \ d.... N..u..v b-t.. ') rl c. ~ Home Telephone: A?.::J - OlivO Alternate Phone # Date: 7/2/02 City: .zeP~ -j )~ Zip: w::: Complete tear off of existing shingles l:3' Roof dried in with # ~ felt liY' Install new valley metal with galvanized metal ~ Re-secure all loose roof decking as needed [4 Install all new lead boots'ElS RiQIJid Gt' Install all new drip edge..i1 ROoclocl .5'~' L.-h, ~ ~Install all new 3CL year fungus-resistant shingles L:f - Shingle Color t:', 4 'C.-/ ~ \ k S \G\. \..<.. ~ All debris removed from the job site Gl" All materials, labor and permits furnished Business Phone # Additional Items: ~;~\ ~o u:. ~,o... \\ ()~ L. ~ <,.>.:] "_'_ . B_ &4." ~ ~ ~, t;-" ')~ n.)- ~ bo"'" ~:A ~-1'"t~-V Extra's /~ L _ (' 0 U Bad plywood replaced at a cost of $ Is. <J per sheet in the roof field. All other wood work, such as valley rebuilding or rafter replacement, will be at a rate of $ 5~- . 00 per man hour plus the cost of materials. . "00 Total bid price $~OO. THIS BECOMES A BINDING CONTRACT UPON ACCEPTANCE OF PROPOSAL. PURCHASER ACKNOWLEDGES RECEIPT OF A COPY OF THIS CONTRACT. 1. All material is guaranteed to be as specified and completed in a substantial workmanlike manner. 2. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, hurricane and other necessary insurance upon above work. 3. labor warranty does not cover damage to roofs caused by lightning, hurricane, tornado, hailstorm, impact of foreign objects or other violent storm or casualty damage to roofs due to settlement, distortion, failure or cracking of roof deck, walls or foundation of a building. 4. Workmen's compensation and public liability insurance on above work to be taken out by RYMAN ROOFING (a subsidiary of Ryman Construction, Inc.), or it's sub-contractors. 5. RYMAN ROOFING, INC is not responsible to provide any materials or to perform any work other than what is described above. Replacement of deteriorated decking, fascia board, is not included and will be charged as an extra unless otherwise stated herein. 6. This contract is subject to final approval by RYMAN ROOFING, INC. and is the entire agreement of the parties and no other written or other forms will be recognized. 7. A charge of 1.5% will be made on all unpaid balances after 30 days plus charges incurred for non-payment procedures plus attorney's fees. Ryman Roofing, Inc. will not be responsible for any septic tank, sod, shrubbery or paint damage. Payment due upon completion o/job. Acceptance of Proposal The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. P",cOOsei ~~~.. : Dare 7/ ~J 0 ~ Estimat~ '. Date: "7'/~",- c::;d> Pleased note: A charge of 1.5% will be made on all unpaid balances after 30 days, which is an annual percentage rate of 18% applied to past due balances. STATUTORY NOTICE REGARDING CONSTRUCTION LIENS: ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAW (SECTIONS 713.001-713.27, FLORIDA STATUTES), THOSE WHO WORK ON YOUR PROPERTY OR PROVIDE MATERIALS AND ARE NOT PAID IN FULL HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. IF YOUR CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SUBCONTRACTORS, SUB:SUBCONTRACTORS, OR MATERIAL SUPPLIERS, THE PEOPLE WHO ARE OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE PAID YOUR CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR, YOUR CONTRACTOR MAY ALSO HAVE A LIEN ON YOUR PROPERTY. THIS MEANS IF A LIEN IS FILED YOUR PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR, MATERIALS, OR OTHER SERVICES THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FAILED TO PAY. TO PROTECT ~OURSELF, YOU SHOULD STIPULATE IN THIS CONTRACT THAT BEFORE ANY PAYMENT IS MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN RELEASE OF LIEN FROM ANY PERSON OR COMPANY THAT HAS PROVIDED TO YOU A "NOTICE TO OWNER". FLORIDA'S CONSTRUCTION LIEN LAW IS COMPLEX AND IT IS RECOMMENDED THAT YOU CONSULT AN ATTORNEY. I HEREBY CERTIFY THAT I HAVE READ AND FULLY UNDERSTAND THE PROVISIONS OF THIS CONTRACT. Pu<cha", ~ t/~~ By 7/ If /P r Date ~11\I'.e1't-- Title Purchaser: F\..OA\OA S" A iE OF F P "sec ii'll: FOREGOING ~~& COUN';~'~~~h~i5~~~ tRUE ~;~BLlC RECORO ~Ef>.L iH\5 OR OF QFflClf>.L """"~ NO ~NO . ~ _ 2 u;,.u;> OURi ~~ .,J\i. t, R\I. Of CIRCUli C "N CLERK JEO ~\rr~~a~o-o/: -~8TICE OF COlVIMENCEMENT .y~ ~~'0GJ~~;i'~sco,CO~~TI CLERK l'ennitNo. OR OK 787~ PO 1369 Property Idenbficaboli No.. 10 -L.~-21- 6~ir)- Qcc,o:) - 02- i30 11111111111111I1111111111111111111111111111111I1111111111111 2008101139 Rcpt : 1191188 Rec: 10.00 D~ 0 00 IT: 0.00 : . Dpty Clerk o /09/08 3.0wner Informalion /\ 'J N,me 'nd 'dd,e,,, N1\I)o. -' VC\~ S"N:>.?, (j..JQ~~ 2e~~..t,'IIS '5>;'~ b) Name ancl address of fee simple titleholder (if other than owner) , :~ c) Interest in property Rconh'actor Inform<ltion ....f' . a_) ~ame and add''''fu~Cl'' RCCl'-,.\-VlOI 1 . b) lelephoneNo.: -_~'92- ~~~ ;r-. 'urely Infamlation I a) Name and address: , b) Amount of Bond: c) Telephone No.: 6.Lender a) Name and address: ~ - Phone No. 7. Idellti'y lit' per'"n withill the Stale ot' Florida designated hy nwnet. upnn whom nntices or nther document, maybe ","ved: a) Name and address: b) Telephone No.: = Fax No. (Opt.) 8.1n ..dd;tion to hin"e1f, own". d"ign"e, the follow;"g pe>>on to ...ceivo . copy of the Lionor', No'ice as provided Ut Section 713. 13 (1)(b)} Florida Statute~: s7S2-S- '3~ $4 2..~'['-hlllS ~d-. Fax No. (Opt.) Fax No. (Opt.) u) Nanl.t': and address: b) Telephone No.: : Fax No. (Opt.) 9.Exprr"ion d.te of Notice of Comme"cement (the expli', tion dote i, one ye.,. from the dote oheemdlitg unt", . diff"en' dale i, specified): STATE OF FLOlUDA COUNTY OF l' A.~j;:~ '., .~...,.. \\,.rrtf . 11;1;,. \,. l "1 ....'\\ Ob "'.1..- ",I. ....... .r/ ~ ;:-....... ._i1.. ~ ...., "-":'r~ /" "; .-:..., 0'" ~ -'. Print Nallle ;; -..,. ... \;) :..;,. ....-l _' _ . I T~>~.:~~~~!e.ljt5i~ ~clOlowledged before me this ~ day af-:5'"u \~ 1 . . ~_. - as 11 in f~-li:t)J()t..:.~L-. ~. >.~ ,.:' (name of party on behalf df " (0 '..'. . PelsOl~,~n;:id,l~W!l.~~R Produced Identification WARNING TO OWNER: ANY PAYMENTS MADE ny THE OWNER AI~ER THE EXPIIlATION OF THE NOnCE OF COMMENCEMENT,ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECnON 713,13, IILOlUDA STA TtJTES, AND CAN RESULT IN YOUR P A Ylrw TWICIt FOR !MPROVEMltNTS TO YOUR PROPltRTY. A NOTICE 0., COMMENCEMENT MUST BE HECORDED AND POSTED ON THE JOIl SIm B1WORE TlIE F'lRST INSI'ECTION. IF YOU INTEND TO OnTAIN IllNANClNG, CONStJL T YOIJR LENDER OR AN ATTOIlNEY BEFOHE COMMENCING WOlU( OR RECORDING YOUR NOTICE OF COMMENCEMENT. k L~ ~d~ Signature of Owner or Owner's Authorized Ofticer/Director/ParlllerlMallager - ,200Y ,by a.hn~~ (type of authority, e.g. officer, trustee, ilttomey 10m instrun It was executed). rype of Identification Produced Notary Signature Narne(pd"t) L~; ~~i,~ I "'ifi,"io,, p.rr'U"tt '0 Seetion 92.525, Florid. St'lutes. U ndor pen.I,,, of peri",,,,, I decl"e thatllwv"eod the foro going .nd aw' he facts stated in it are hl1e to the best of my knowledge and belief. .~ . Notary Public State of Florida #-.. , Lori Ritchie ~ C .. My CommilllOn 00789562 -v; O"',,'rJf EXplres 0611112012 Signature ofNntural Person Signing Above JRMS/NOC,rvSd2007 City ~of Zephyrhills BUILDING DEPARlfMENT RE; p'ennit'# 80b7' 9/17/07 Inspection Affidavit "'- , I -..k~ V~" ~,~~ . (please print name and circle Lie. Type) ,licensed as a(n) Contractor* !Engineerl Architect, FS 468 Bll~lr1jng Inspector* \ \ License #; e.c:..c.. ~ ~ On or about 7/' t.i/c:9 ' : 30 ~ , I did personally insp~ the roof ~ (Date: " time) ~k nai'7and1or secoruiarv water barrier work at s<1 J ~ .AI e..W baN c..i:.., ~- (ctn:le one) . (Job Sita Adclrc88) ,- ~~~rbiJ\S\ fL. )3~L..\~ Based upon that examination I have determined the installation wu done according to the ~;tigaDon Retrofit Manual ~..ed OIl SS3.844F.S.) Signature STATE OF FLORIDA COUNTY OF . ":7SC;bed--~~~daYof ~I~ Notaty Public, State of Florida . 200S> ;tJ Howry Pubic StIlle Of Flartda 1-... , ann-Itln Rpwl :.. ~ My CommlelllCln OD78'.10 ~"'IIIt;; Ex;lre10112<112012 C\...I"\'S~ R--I~_ (print, type or stamp name) . , Personally known ~ Produced Iden1i1ication_ Type of identification produced. Commission No.: · Cicneral.. Builciiag. RaDclentilll, or llootins Conaacr.or or IIIJy iDdividual CS!ified UDdIr 468 F.S. to IDlIkClsudl Ill. inspection.1Dc:ludc photognspbs of each plane of the roofwitb 1hcpc:nnit # or address # c:lCl1l"ly shown mIrkccl OD the deak far CBCh iDspeclicm. lOO/lOOl2J XVj LG:9l 800G/Pl/LO