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HomeMy WebLinkAbout09-8776 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 8776 • BUILDING PERMIT Permit Number: 8776 Address: 6152 SILVER OAKS DR Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: SILVER OAKS Est. Value: Parcel Number: Improv. Cost: 15,000.00 Date Issued: 1/29/2009 Name: HENDRICKS, MARVIN Total Fees: 105.00 Address: 6152 SILVER OAKS DR Amount Paid: 105.00 ZEPHYRHILLS, FL. 33542 Date Paid: 1/29/2009 Phone: (813)715-4211 Work Desc: REROOF 30yr HOME IMPROVEMENT SERVICES REROOF RESIDENTIAL 105.00 DRY IN ROOF INSP TAPE JOINTS ROOF INSP FINAL REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c)when extra inspection trips are necessary due to any one 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." CONTRACTOR SIGNAT PERMIT OFFI R LP.F.RMIT EXp.E IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received Phone Contact for Permitting I -- ^ Owner's Name /'/ I-VI J /�L // 14tS Owner Phone Number 8i /J t/2_1/ Owner's Address J l O4 <S Owner Phone Number Fee Simple Titleholder Name I Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS .c V'4.i/� ` LOT# II SUBDIVISION 5hd2 o S PARCEL ID# L4 ' l/-a(o2 0070 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED e NEW CONSTR B ADD/ALT Q SIGN Q MOVE DEMOLISH INSTALL REPAIR PROPOSED USE SFR 0 COMM Q OTHER TYPE OF CONSTRUCTION L BLOCK 0 FRAME Q STEEL L OTHER DESCRIPTION OF WORK I BUILDING SIZE ____ SQ FOOTAGE HEIGHT EII BUILDING $ VALUATION OF TOTAL CONSTRUCTION /,S�D'O .. C) a LII ELECTRICAL Is AMP SERVICE PROGRESS ENERGY Q W.R.E.C. 0 PLUMBING $ 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION GAS ROOFING SPECIALTY Q OTHER FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA =YES QNO BUILDER ow / COMPANY I;f - E�✓ l r SIGNATURE �"I C/ REGISTERED Y/ N EE CURRENT Y/N AddressI ( ) License# (— ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N Address I License# PLUMBER COMPANY SIGNATURE REGISTERED Y/ N I FEE CURRENT I Y/N Address I License# I I MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N Address I License# OTHER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N Address I License# 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. 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$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 A/C 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" 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 IMPACTIUTILITIES 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'SIOWNER'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,tions not on. A plumbing, ed wells, onstr edrto be a l license to proceed with th gas, or other e work and not as authority to cally included violate violate, alter, or permit issued shall be construed set aside any provisions of the technical constructionl issuance of a permit prevent of any codes. Every t requiring a correction of errors in plans, permit issued shall become invalid commenced in six months of nce, or if work by unless the work authorized by such permit lals period of six(6) months after the time the workais commenced. Anexte authorized ion the permit is suspended or abandoned P may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate the job is considered abandoned. justifiable cause for the extension. If work ceases for ninety(90)consecutive days, , WARNING TOOWNER: YOUR FAILURE RDA NOTICE YOU INTEND TO OBTAIN FINANCING CONSULT MMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S. 117.03) CONTRACTOR OWNER OR AGENT Subscribed and sworn t or affirmed)before m his Subscribed and sworn to(or med) efore me is by __by Who is%are personally k o n to me or has... ced Who is/are personally kno to me or has/h a prod ed as identification. as identifi tion. Notary Public Notary Public Commission No. commission No. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped _________ ___________1 Permit I11111111111VIIIVIIIVIII1111!11111V1111111111111111IIII Tax Folio No. 7� 2009012769 THE UNDERSIGNED hereby gives notice that improvements 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. I.Description of property(legal description). O s� ///� DoT a)Street(job)Address: 2.General description of improvements: - T 3.Owner Information a)Name and address: �1�4'R✓//Y DdU6,1 S (P/.�a 1;4 y � Q S b)Name and address of fee simple titleholder(if other than owner) LAS c)Interest in property 4.Contractor Information O VI. SL a)Name and address: 14377 US 19 NORTH, CLEARWATER F,� 3 3 7 6 4 b)Telephone No.: 7 -530-0412 FaxNo.(Opt.) 727-539-6912 5_Surety Information a)Name and address: Rcpt.: 1223969 Rec: 10.00 b)Amount of Bond: DS: 0.00 I T: 0.00 c)Telephone No.: 01/29/09 Dpty Clerk Fax No.(Opt) 6.Lender pRULR S. O'NEIL, PRSGO CLERK & COMPTROLLER 01/29/09 1 1 a)Name and address: OR BK PG 0 IC J 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 +a INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT YOUR LENDER OR AN ATTORNEX BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA NOTARY PUBLIC-STATE OF FLORIDA COUNTY OF PINELLAS Peter E. 1 0%niak lO. '-Commission#DDb52181 Signature of owner or Owner's Au orized cer/Director/Partner/Manager Expires: MAI 04,2011 � ,// BONDED THRU AILAN11C BONDING CQ,INC. • /'"'� )�/, // QI''Zj ,_Jr Print Name The foregoing instrument was acknowledged before me this !! day of ,20 ,by L1J. /Cl<cas 'dc2 of authority,e.g.officer,trustee, attorney in fact)for • (name of party on was executed). Personally Known-_OR Produced Identification Notary Signature alf of whom instrument Typ e of Identification Produced / Name(print) Verification pursuant to ectidn 92.525,FloridStatutes.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 knowledge and belief. FORMS/NOC.rvsd2007 .6ignature of Natural Person Signing in line#10.)Above STATE OF FLORIDA COUNTY OF PASCO THIS IS TO CERTIFY THAT THE FOREGOING IS A TRUE AND CORRECT COPY OF T,HE DOCUMENT ON FILE OR OF PUBLIC RECORD.IN THIS OFFICE WITNESS MY HAND AND OFFICIAL SEAL THIS r DAY OF 6W 2� PAULA S. O'NEIL, CLERK&COMPTROLLER BY DEPUTY CLERK Pasco County Parcel: 03-26-21-012A-00000-0070 001 Page 1 of2 earch A ap �(�ien�eralizeuildinciSchematic Estimate Taxes Frequently Asked Questions Other Agen aF Collector School Board Supervisor of Elections Data Current as Of: Weekly Archive - Saturday, January 24, 2009 Parcel ID 03-26-21-012A-00000-0070 (Card: 001 of 001) Classification 01 - Single Family Mailing Address Property Value HENDRICKS MARVIN A REV LIV TST Ag Land $0 HENDRICKS MARVIN A TRUSTEE Land $57,842 6152 SILVER OAKS DRIVE Building $124,557 ZEPHYRHILLS, FL 335424800 Physical Address Extra Features $7,165 6152 SILVER OAKS DR Market Value $189,564 ZEPHYRHILLS, FL 33542-4800 Assessed (Save Our Homes) $142,212 Homestead 196.031 - $25,000 Legal Description (First 4 Lines) Non-School Additional Homestead Exemption - $25,000 SILVER OAKS PHASE 1A Non-School Taxable Value $92,212 PB 30 PGS 51-52 School District Taxable Value $117,212 LOT 7 Warning: A significant taxable value increase OR 4808 PG 350 may occur when sold. Click here for details and info, regarding the posting of exemptions. Land Detail (Card: 001 of 001) Line II Use IlDescriptionli Zoning Units Type Price Condition II Value* HH1 0140 SFR GOLF OPUD 6,000.00 SF $8.36 1.00 $50160 0140 II SFR GOLF II OPUD II 5,121.35 SF $1.50 1.00 H $7,682 Additional Land Information Show Mineral Rights - 5 Acres 0.26 II Tax Area 3OZH FEMA Code X PResidential Codefl SIVLGPI Building Information - Use 01 - Single Family Residential (Card: 001 of 001) Year Built 1995 Stories 1.0 Exterior Wall 1 Concrete Block Stucco Exterior Wall 2 None Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle Interior Wall 1 Drywall Interior Wall 2 None Flooring 1 Cork or Vinyl Tile Flooring 2 Carpet Fuel Electric Heat Forced Air- Ducted A/C Central Baths 2.0 Line IJ Description Sq. Feet Repl.Cost New 1 BAS 1,744 2 FOP 285 $5,226 3 II FR 440 $12,954 Extra Features (Card: 001 of 001) Line Description Year Units Value 1 DWSWC 1995 800 $1,180 2 JACUZZI 1995 1 $600 3 SCRN-AF 1995 1,058 $952 4 POOL-6 1995 J 274 $4,055 5 COOL DK 1995 126 $378 Sales History Previous Owner WEAVER PAUL W JR&PATSY L II II II II http://appraiser.pascogov.com/search/parcel.aspx?sec=03&twn=26&rng=21&sbb=012A&... 1/29/2009 HOME IMPROVEMENT SERVICES 14377 U.S.Hwy. 19N•Clearwater,FL 33764 1951 Porter Lake Road,Suite A•Sarasota,Florida 34240 Phone:727-530-0412•Toll Free 1-877-845-6660 Phone:941-377-6100•Toll Free 1-877-374-6778 Fax:727-539-6912 Fax:941-377-6133 Lic. No. CCC058227 SALES CONTRACT Home Improvement Services agrees t furnish all materials and labor necessary to do the modernization work at the following address: >Name L�/��� f'1e vi c l'y G kc Phone 7'' 7/ç '12-//Phone(w) ,Address `S 2 _ 5i�riz/L ( 2 ACS Date________ City 2- 7I b' I'I State zip 3>J % Z-- In accordance with the specifications given below: REROOF: A.SHINGLE ROOF 1. REMOVE OLD ROOF TO WORKABLE SURFACE. 2. RENAIL ROOF DECK WITH RING SHANK NAILS. 3. REPLACE ANY ROTTED WOOD WITH STANDARD SHEATHING @ $7.00 PER FOOT AND$90.00 PER SHEET OF PLYWOOD,IF ANY. (Initial) 4. INSTALL S.A.WATERPROOFING UNDERLAYMENT OV R ENTIRE ROOF. 5. INSTALL FHAIVA EAVES DRIP. COLOR 6. INSTALL NEW VALLEY METAL AND FLASHINGS AS NECESSARY. 7. INSTALL NEW LEAD BOOTS OVER VENT PIPES AND RESEAL VENTS. 8. INSTALL _YEAR FIBERGLASS SHINGLES. COLOR i-'r'f c*C- 9. INSTALL _44 ( FEET OF RIDGE VENT AT$6.00 PER FOOT. COLOR 7 10.CLEAN-UP,IUrSITE OF ALL WORK DEBRIS AND HAUL AWAY ALL RELATED DEBRIS AND LEAVE JOB SITE CLEAN. 11. CONTRACTOR WILL COORDINATE REMOVAL AND REINSTALLATION OF ROOF RELATED PERIPHERALS SUCH AS(BUT NOT LIMITED TO)SOLAR UNITS,SKYLIGHTS,T.V.DISH AND AIR CONDITIONERS,ETC. REMOVE AND REINSTALL EXISTING SOFFIT AND FACIA @$4.25 PER FOOT IN ADDITION TO CONTRACT PRICE,IF REQUIRED. THE COST FOR SUCH WORK WILL BE IN ADDITION TO CONTRACT PRICE AND HEREIN APPROVED BY HOMEOWNER. B.1 PLY R OF SYSTEM 1. REMOVE OL O WORKABLE SURFACE. 2. RENAIL ROOF DECK W SHANK NAILS. 3. P.EPLACE ANY ROTTED WOOD DARD SHEATHING @ $7.00 P ND$90.00 PER SHEET OF PLYWOOD,IF ANY (Initial) 4. INSTALL S.A.WATERPROOFING UNDERLAY F. 5. INSTALL NEW LEAD BOOTS. 6. INSTALL FHA/VA EAVES DRIP. COLD 7. INSTALL 1 PLY ROOF SYST . OR 8. CLEAN-UP JOB SITE OF ',WORK DEBRIS AND HAUL AWAY ALL RELATED DEBRIS AND LEAVE JOB SITE CLEAN. 1. Contract Documents.This contract consists of this document,extra work/wood authorizations,if any,and,if payments hereunder are to be financed,all financing documents.No promises other than those specifically set forth in the contract Contract Price -1 � documents shall be recognized by either party.The entire understanding and agreement of the parties is contained in the -- -r------ -- contract documents 2. It is understood and agreed that this contract shall not become binding upon Home Improvement Services until it is duly approved,accepted,signed and witnessed by an officer or officers of the Seller. 200.00 3. Work on the job des bed in the tract documents will commence on approximately and be completed Permit $_ on approximately .The recited dates are approximations and are subject to scheduling difficulties of Seller,labor and/or rrthtenal sirorlages,acts of God and other events not foreseen by Seller. Seller reserves the right to employ any sub-contractor for the completion of the work described in the contract documents. 4. Home Improvement Services reserves the right to substitute materials of equal or greater value and kind.Any required U E?Q material such as fire retardant plywood,tongue and groove board,etc.will be billed on a time and material basis.All other Total /� c+ changes required by New Jurisdictional Code Enforcement Laws may result in additional charges. —r ---- 5. Interest at the rate of eighteen(18%)per cent per annum will be charged on all balances not paid as per the terms specified above.Reasonable attorney's fees will be charged to the Purchaser it it is necessary to place this contract in the hands of an attorney for collection,and this charge becomes a part of this contract and obligation of the Purchaser to pay. 6. Parties agree that this agreement shall be construed according to the laws of the State of Florida and any action brought 1/3 Deposit $ Ihereon may be brought in the State of Florida.Venue is hereby agreed to be in Pinellas County,Florida. '. BUYERS RIGHT TO CANCEL-If you do not want the goods or services,you may cancel this agreement by providing written notice to the seller in person,by telegram,or by mail.This notice must Indicate that you do not want the goods or services and must be delivered or postmarked before midnight of the third business day after you sign this agreement. 8. Both worker's compensation and public liability insurance are carried by the Seller and they are applicable to the work lobe Subtotal performed. $ ----9. It is understood and agreed that the buyer hold harmless,Home Improvement Services,for any damages that may occur to the buyer's driveway(s)during the delivery of materials and/or the removal of work related debris that may be required to tS J G,,0') perform this home improvement contract.Furthermore,the buyer herein gives permission for typical delivery vehicles and BALANCE DUE $---_— /-- '_ typical waste removal vehicles to enter said driveway(s)for the purpose of expediting this sales contract, (Plus Tl f It N 3 ) 10.Contractor will coordinate removal and reinstallation of roof related peripherals such as(but not limited to)solar units,skylights o rom em O. BbOve TV.dishes,and air conditioners,etc.The cost for such work will be in addition to contract price and approved by homeowner. UPON COMPLETION 11 Home Improvement Services shall not be held responsible for damage to electrical lines,water lines,refrigerant lines or other mechanical components that have been improperly installed near roof decking and may be damaged while performing installation of roofing materials.Home Improvement Services shall not be responsible for any additional costs due to roof decking that may have old materials adhered in such a way that requires redecking of the structure. 12.Construction Industries Recovery Fund payment may be available from the CIRF if you lose money on a project performed under contract,where the loss results from specified violations of Florida law by a state-licensed contractor. For information about the recovery fund and filing a claim,contact the Florida Construction Industry Licensing Board at the following telephone number and address:7960 Arlington Expressway,Suite 300,Jacksonville,FL 32211.7467 or call(904) 727-6530. 13. Chapter 558,Florida Statutes contains important requirements you must follow before you may bring any legal action for an alleged construction defect in your home.Sixty days before you bring any legal action,you must deliver to the other party to this contract a written notice referring to chapter 558 of any alleged construction defects and to consider making an offer to repair or pay for the alleged construction defects. You are not obligated to accept any offer which may be made.There are strict deadlines under this Florida Law which must be met and followed to protect your interests. Executed in triplicate, one copy of which was delivered to, and receipt is hereby acknowledged by Buyer, this day of ,20 ' Approved and Accepted: NOTICE TO OWNER a. Do not sign this home improvement contract in blank. b.You are entitled to a copy of the contract at the time you sign. Keep it to protect your rights. cam_ (Seal) (X) / j' ,_. _ Seal) (Dealer-Seller) (Purcha erSign ere BY (X) (Seal) / (Title) (Purchaser Sign Here) I77/ L SALESMAN HI 0700053 HIS 3-4/24/08 RS 0701566 GO CO PASCO COUNTY FLORIDA a e Building Inspection Division a RE: Permit#? 7 (, Form: 10/01/07 Inspection Affidavit I, TS G L , licensed as a(n) Contractor*{Engineer/Architect/FS 468 Building Inspector* License 1 On or about _ O' , did personally inspect the Roo Deck Nailin r Sec nda Water Barrier Circle o At the following address: f S _ _V — O S D1 33L (Job Site Address) Based upon that examination I have determined the installation was done according to the Hurricane Mitig Lion Re ofit Manual (Based on 553.844 F.S.) I have included photographs of each plane of thtr each inspection, with the permit# clearly shown marked on the deck. Signature ' STATE OF FTC DA COUNTY (5F ____________SC'. Sworn to and subscribed before me this#day ,2000 7 By S e L , Notary P is Sate of Florid (Print, ' e or stamp ) �gIDA Commision LTV Lie-STAB peter Cc missicn#Y a4,2011 Personally know or 1 "s gXpires: Co. Produced Identification $ Type of identification produced: *General Building, Residential, Roofing Contractor or any individual certified ujider 468. F.S. to make such inspection.