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HomeMy WebLinkAbout08-7967 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 7967 BUILDING PERMIT Permit Number: 7967 Address: 6423 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: 03-26-21-0120-00000-1051 Improv. Cost: 8,000.00 Date Issued: 6/18/2008 Name: KIRK, MICHAEL & ROBYN Total Fees: 70.00 Address: 6423 SILVER OAKS DR Amount Paid: 70.00 ZEPHYRHILLS, FL. 33542 Date Paid: 6/18/2008 Phone: (813)917-0670 Work Desc: RE-ROOF ON EXISTING SGL FAM DWELLING NOT NEW ADDITION) MILBAR CONSTRUCTION REROOF RESIDENTIAL 70.00 , 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." CONTRACT IGNATURE PERMIT OFFI R PE MIT EXPIRES 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 Owners Name LMt Owner Phone Number � Owners Address I Owner Phone Number Fee Simple Titleholder Name Owner Phone Number I I Fee Simple Titleholder Address JOB ADDRESS LOT# I SUBDIVISION PARCEL ID# . O .J,J (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED B NEW CONSTR ADD/ALT = SIGN = MOVE = DEMOLISH INSTALL REPAIR PROPOSED USE = SFR = COMM OTHER TYPE OF CONSTRUCTION = BLOCK FRAME = STEEL = OTHER DESCRIPTION OF WORK 1biftlt tRA VPqe 3 Z rL I3 BUILDING SIZE I SQ FOOTAGE I OO HEIGHT = BUILDING $ VALUATION OF TOTAL CONSTRUCTION = ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. = PLUMBING $ = MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION = GAS ® ROOFING SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES =NO BUILDER COMPANY SIGNATURE REGISTERED I Y I N FEE CURRENT I Y/N Address I License# ELECTRICIAN COMPANY SIGNATURE REGISTERED I YIN I FEE CURRENT I Y/N Address License# PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N Address License# MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURRENT I YIN Address License# OTHER COMPANY m 12p ( tStrt.hji SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N Address ' U . License# RESIDENTIAL .......Ii(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. ****P5OPERTY SURVEY required for all NEW construction. Directions: Fill Out application completely. Owner&Conn„ t ,irk of application,notarized If over$2500,.......commencement is required. (A/C upgrades over$5000) Agent(for the con,;:,....n;or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER-'t:t,:I TYING (Front of Application Only) Reroofs Service Upgrades A/C Fences(Plot/Survey/Footage) Driveways-Not over L;meter 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 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 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 LENU)i_R O N ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURi1T(f OWNER OR AG ENT CONTRACTOR Su scribed d won migd)b-gfore�a this Subscribedd swum t oraffjrm ) fore me this JhY i_ by Wh is/ onmi y k�i;u_m to i tre�ias/have produced Who st a v o e or has/have produced entification. as identification. Notary Public - 77j •-lgtaryubtic '.� Commission.No yi : _ Commission No. 1 2 f / 1 Name of Notar', ',p J,ltrMfeti or stamped Name of Notary typed printed for I .�;,fgm. o. of 3 Pages rFaI Member of the Florida State Certified Roofing and Sheet Metal Builder#CBC023221 Association State Certified C1 MilBar Construction, Inc. Roofer#CCC051562 U.S.Intec Certified Roofing•Concrete•Commercial•Residential State Certified Platinum Installer Roofer#CCC1326217 #5204 15911 US Hwy.301 North•Dade City, Florida 33523 Oc RCI Registered 352/567-6047 • 800/562-2393 • FAX:352/567-4454 Roof Consultant#0149 -6681 PROPOSAL SUBMITTED TO PHONE 813/917-0670 DATE KIRK, R0RIN 813/983-0347 FAX i 05/01/08 STREET JOB NAME 6423 SILVER OAKS DRIVE KIRK RESIDENCE CITY,STATE and ZIP CODE JOBLOCATION SILVER OAKS SUBDIVISION ZEPHYRHILLS, FL 33542 6423 SILVER OAKS DRIVE ARCHITECT DATE OF PLANS JOB PHONE ZEPH'YRHILLS, FL 33542 We hereby submit specifications and estimates for: SHINGLE RE-ROOF OF EXISTING AND NEW SHINGLE ROOF ON ADDITION SHINGLE RE--ROOF OF EXISTING 1. Tear off and haul away existing one--layer shingle roofing system. 2. Re—fasten the existing plywood roof deck in accordance with the new 10/0 ./07 Building Code. 3. Provide and install the secondary water barrier (4" wide strips of peel & stick) at all joints in the plywood roof deck in accordance with the new 10/01/07 Building Code. 4,. Provide and install new 15 lb. saturated felt paper. 5. Provide and install new TAMKO "Heritage 30 AR" 30—year dimensional algae--resistant laminated fiberglass shingles. Owner to select shingle color from TAMKO's standard colors. Provide TAMKO.s 30—year limited shingle warranty. 6. Replace all valley flashing and heating, ventilating, and air conditioning vents. 7. Provide and install new lead boots for the plumbing vents. S. Provide and install new pre--finished aluminum eavedrip (white or brown) . 9. Replace existing ridge vent with 40 l.f. of new pre--finished aluminum ridge vent. e 3 ropnSe hereby to furnish material and labor—complete in accordance with above specifications, for the sum of: SEE PAGE THREE. dollars($ ). Payment to be made as follows: Invoiced amounts not paid in accordance with the payment terms shall be considered delin- Authorized / tfl quent and bear interest at the rate of one and one-half percent per month.Owner agrees to Signature pay all costs incurred,such as attorney fees,collector fees,court costs,etc.,for collection of delinquent invoices including interest.Owner to carry fire,tornado and other necessary Note:This proposal may be 30 insurance.Our workers are fully covered by Workman's Compensation Insurance. withdrawn by us if not accepted within days. hrc t U rr ofrtipiizal —The above prices,specifications conditions are satisfactory and hereby accepted.You are authorized Signature to do the work as specified.Payment will be made as outlined above. Date of Acceptance: Q s -� Signature' Page No. 2 of 3 Pages Member of the Florida State Certified Roofing and Sheet Metal Builder#CBC023221 Association State Certified C� MilBar Construction, Inc. Roofer#CCC051562 U.S.Intec Certified Roofing•Concrete•Commercial•Residential State Certified Platinum Installer Roofer#CCC1326217 #5204 15911 US Hwy.301 North•Dade City, Florida 33523 O• RCI Registered 352/567-6047 • 800/562-2393 • FAX:352/567-4454 Roof Consultant#0149 813/714--6681 PROPOSAL SUBMITTED TO PHONE 813/917-06 70 DATE KIRK, ROBIN 8131983-0347 FAX 05/01/08 STREET JOB NAME 6423 SILVER OAKS DRIVE KIRK RESIDENCE CITY,STATE and ZIP CODE JOBLOCATION SILVER OAKS SUBDIVISION ZEPHYRHILLS, FL 33542 6423 SILVER OAKS DRIVE ARCHITECT DATE OF PLANS JOB PHONE ZEPHYRHILLS, FL 33542 We hereby submit specifications and estimates for: 10. Repair/Replacement of any rotten or damaged wood (deck, fascia, trial, framing, etc. ) will be completed on-a cost—plus basis above and beyond the contract price. 11. MilBar Construction, Inc. to provide a 5—year workmanship warranty to the original purchaser that covers shingle roof leaks; exclusions: storm damage, work done or damage by others, tree damage, and/or structural damage to roof deck, 12. MilBar Construction, Inc. to provide re—roofing permit. NEW SHINGLE ROOF ON ADDITION (16'X29' ) „ I., Provide and install new TAMKO Heritage 30 AR 30—year dimensional algae_-resistant laminated fiberglass shingles; Owner to select shingle color, from TAMKO's standard colors. Provide TAMKO.s 30--year limited shingle warranty. 2. Provide and install new flashing (valley, or any wall flashing) . 3. Provide and install new pre—finished aluminum eavedrip (white or brown). 4. Provide and cut--in 20 l.f. of new pre—finished aluminum ridge vent. 5. MilBar Construction, Inc. to provide a one—year~ workmanship warranty to the original purchaser that covers shingle roof leaks; exclusions: storm damage, roof traffic work done by other , tree damage, and/or structural damage to roof deck. 6. General Contractor to provide permit and schedule inspections, 15 lb. felt dry--in. E 3, ru IISE hereby to furnish material and labor—complete in accordance with above specifications, for the sum of: SEE PAGE THREE. dollars($ ) Payment to be made as follows: ji Invoiced amounts not paid in accordance with the payment terms shall be considered delin- Authorized quent and bear interest at the rate of one and one-half percent per month.Owner agrees to Signature pay all costs incurred,such as attorney fees,collector fees,court costs,etc.,for collection of delinquent invoices including interest.Owner to carry fire,tornado and other necessary Note:This proposal may be 30 insurance.Our workers are fully covered by Workman's Compensation Insurance, withdrawn by us if not accepted within days. hrte tancr of Irop1T%al —The above prices,specifications conditions are satisfactory and hereby accepted.You are authorized Signature to do the work as specified.Payment will be made as outlined above. Date of Acceptance: Signature 05/20/2008 13:47 3525674454 MILBAR PAGE 02/02 I IIIIII VIII Iilil VIII I 1111111111 VIII II II 2008090666 Rcpt: 1187219 Rec: 18.50 DS: 0.00 IT: 0.00 06/18/08 Dpty Clerk NOTICE OP COMMENCEMENT JED 1PITTM8/08 N 0 : PASCO 1 OUNT f CLERK 2 OR BK 7863 PG 1854 Permit No. �j (���-V� Property Identification No. O - 1 VI iZ) 1 L __tC k 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 OP COMMENCEMENT. I Description of property(legal description: kk h a)Street Address: to4Z3 �i VC r Da 2.Gen eral description of improvements: r'LP i.J rU O{� `' f e ✓l z 3.Owner Information 2t�Ph�r F.t FL a)Name and address: 1GhG& a� RD)oLjn KjrK ter OKs OYiJF , 33s'11 b)Name and address of fee simple titleholder(if outer than owner) c)Interest in property owYl�Y 4.Coniractor Information m t t (Jl r t,x)11S±r U C. • D nc- i 1 1 1 u,__ _30 I cc C:- F f•- aS 2 a)Name and address: b)Telephone No.: t5b 5LZ 23 3 Fax No.(Opt.) �-s to'7 5.Surcty Information a)Name and address: IJ 1 b)Amount of Bond: c)Telephone No.: Fax No.(Opt.) tS.T,ender a)Name and address: /,j\A Phone No. 7.Identity of person within the State of Florida designated by owner upon whom notices or other docua+ents maybe served: a)Name and address: ry l'' b)Telephone No.: Fax No.(Opt.) Sin addition to himself,owner designates the following person to receive a copy of the Lieaor's Notice as provided in Section 713.13(1)(6),Florida Statutes: a)Name and address: ►-� (A 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 TEE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13, FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST RE RECORDED AND POSTED ON TIIIE 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. STA'I'R OF MORMA t-'Irl t� r • COUNTY OF PASCO ^^,, Signatu f Owner or Owner's Authorized Offleer ec "er +aver y V t (K PrintName ti The fare rn instrument was acknowledged before tae this dsy ofm, .20 byfl c ai 1W W r i YIL as ©t >VtP.r type o authority,e. car,tru$€e,atnmcy in fact)for (nanieofpartyonbeha1fofwnoAnsuent seated). Personally Known_OR Produced Identification X Notary Signature Type of Identification Produced G L_ L Name(print) G Verification pursuant to'Section 92.525,Florida Statutes.Under penalties of perjury,I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. POAMAMOe,rvcd2007 ,M''t Netaty P ubli� tate 0 on ignah+re orNaturdt Person Signing At eve �; MYReC ern I Clark Ivly C�mn�wssi��n DD649259 • OF °"P Ex ires 03/13/2011 Legal Description A parcel of land being a portion of Lot 105 106, siLTrple OA"PHASE _ OR BK and Lot 7863 PG I Plot thereof,s recorded in PIatOB0000k � 26,Pages 9 1855 'of the Public$ecords of Pasco � F7or 2 of 2 r parcel being more h', [dq saidP cularlY described as follows.. C'ommen a at an intersection of the Southerly ; _ Lot 104 as shown on said lot o Soirtr s.R .-- i Pt9d.5! fi2.rT p f•F7LM 0A - -�- OJV1 with the Northerl line nf..-. ,..I :_:; - wim inc Wwi line ulsaid Lot 10.'S•thence tilt['Rwesr,qp '+: is the arc of Y r lid' .3 u tine arc of a curvexr 12r2uina' .---v: c Y �� _ ,. a*0jtu@i1Steriv, �:- _•--� ! 00 Oh fill arc�r�.�i.�ta _S rc 5th .silblendeLt by a chard bearing distanrp . , r,tt S JL'!Ztt 'r_43 4?e._s.=rig,, '=rzi isic:;o; i: TaJc iVTrlE'/1 bJ fl 14^�n 7?0 rvsía an t,� ..__.... _. a]7 e/tr I;... ._ 5Dj of r 'ltt--r1T 4'ats nr thc,rs. Su plat of .4Ir"ljf OAK -- '.'s on :iiW- the arc -/ -�-a a t(/,1ri,"s r37 i'4ft rir' it • at c Ciein thte7__rrfed in, a chard hears a?ul�r1.-ate- _South`. _ _ t-" l.,,.,..., s.vue__ £u r�=,__r: ; :tU(SW c2rrve . •'w uuuz 1O S2 j" -Wart ?0 00 t _ '� ic:s`, i"ence West hne t Had lot lilt' fl'ce y t i 0'2 r' .. -::z =r_a:_, ..v're ieadng c�i - �•• _'r 140O0 feet an,rr rlia-r., f-'4 la trL- c i vicrr iii U•i'. 49.f4 f_ 2a :-- _ Y& SFeYLv ) t,=,:{:-�'`+�.._, r--- o asboi a rieSCrtiled r,nr ,i nfL,„f ttt?:,rR23;;2Ld : r fir 0230- nns'f;J�90 ,iv��u i rr1a:Wont;hlI ;r7 0? :_s[rr[C[ tlrl! a.uirKU pr/ %/ .er'isltea o- Est_'!2ue; a k: Inc. I'U (American Title Insurance t_Tomourv. GM.4C Th . ti STATE OF FLORIDA COUNTY OF PASCO THIS IS TO CERTIFY THAT THE FOREGOING IS A TRUE AND CORRECT COPY OF THE DOCUMENT ON FILE OR OF PUBLIC RECORD IN THIS OFFICE.WITNESS MY HAND AND OFFICIAL SEAL THIS /8 , DAY OF yuk1=. 2ej2 S JED PI MAN,CLERK OF CIRCUIT COURT BY . 1 DEPUTY CLERK MILBAR CONSTRUCTION, INC. 15911 U.S. 301, Dade City, FL 33523 Ph: 800/562-2393 Fax: 352/567-4454 Date: 18 June 2008 To: City of Zephyrhills Building Department Ph: 813/780-0020 5335 8th Street Fax: 813/780-0021 Zephyrhills, FL 33540 Re: License # CCC051562 To whom it may concern: Please accept this letter of authorization for the following list of individuals to act on behalf of myself, David R. Abla, and Milbar Construction, Inc. in the procurement of all legal permits and/or licenses as required by the State of Florida and/or the various city and/or county governments located therein; authorization is also granted to sign in my stead as required in the acquisition of the aforementioned permits and/or licenses: Vance Milton, Frank Albritton, Olivia Lovett, Frank Albritton, and James Henagan. Please delete all other names. MilBar Construction, Inc. Davi R. Abla, Vice President MilBar Construction, Inc. State of Florida County of Pasco The foregoing instrument was acknowledged before me this 1PZ day of u ._ by David R. Abla, who is personally known to me and did not take an oath. Notary Public: Comission: 06/24/2008 10:52 3525674454 MILBAR PAGE 01/01 7`fk' o`er • • ,heady- , wQ �TCDIC'1ON 'O YC�► !CHOICE. ; BDIGEPART1VNT 9117107 ?a pczmit#,_...�9�^! ¶necfiiiion Affidavit .1 licensed as a( Cantractoz / `FS 468 BuWing7msp• (Please prime name sod circle Lia Type) ector License#; • On.orabout o „ Y did personally imsFect'thc ro • (Dte&limb) • • work at 4'!�• 1�1��� t si Dr. deck nailznsrd1 ynP secondary water barn " (Job Site A` dlss) (curls one) Based upon that examination I have dammed$.e installation was done according to the • Huzzicane Mitigation Retrofit Mammal(Based on 553.844 F.S.) • Signature I . . • STATE OF FLORIDA • COUNTY OF 0 Swam to and snbacnbed before me this day,of .Z00�, By + Notary Public, State of Florida (print,type or nsme) .� _ cam• , OLIVIA A LOVFTf Cv=ndssion No.: n DIVI R5 t r FY.1PES.I"Ay N t'2O09 tXIC;, Personallykwvm. F or o��oe . PONM O1rCy Produced Identifica>tiozl I rni rrciRn Ncc.� rnNr Type ofid>eutification produced i Cienerxl,a*chide R to icp °rcacb a of t roof with the pcamit# Address# 4Elear*y abaaRi motjeed the • imspe�on.lnttclnde Pboto�P p dealc for each is.7eelion •