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HomeMy WebLinkAbout09-9533 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9533 BUILDING PERMIT Permit Number: 9533 Address: 6730 NORTH LAKE 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 - 0150 - 00000 - 0150 Improv. Cost: 10 870.00 - „ Date Issued: 9/10/2009 Name: HOLM, MICHAEL & GINA Total Fees: 85.00 Address: 6730 NORTHLAKE DR Amount Paid: 85.00 ZEPHYRHILLS, FL. 33542 Date Paid: 9/10/2009 Phone: Work Desc: REROOF 30YR SHINGLE a RYMA 10 IN INC R ROOF RE ID N IAL 85.00 ►'l . a' ' . ° a • a s' z a DRY INR••FIN P TAPE JOINT OOF INSP FINAL -I' 1-09 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." CONT OR SCAN RE PERMIT OFFI FR PERMIT 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 - I,�2 • Date Received Phone Contact for Permitting i -- • CCI Owner's Name ftlifilaLLA ,V-6 t nOl_ III Owner Phone Number ♦ f AP S 1 k h Owner's Address G l 30 Noirl i L '33 ST-[ Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS SOO Yi4./ LOT # 1 5 SUBDIVISION 911(14r OOt a PARCEL ID# O — — �I — .d [ 5© C ....-0 50 piR (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT n SI_ GN In MOVE I I DEMOLISH INSTALL REPAIR V-b '" PROPOSED USE gO SFR I I COMM p OTHER I I TYPE OF CONSTRUCTION I 1 BLOCK t I I FRAME n STEEL I I OTHER I I DESCRIPTION OF WORK R '2 -- o � h o u_s u)/ i l t1-t BUILDING SIZE SQ FOOTAGE 5 HEIGHT I I BUILDING $ /0 g r7 o • pD VALUATION OF TOTAL CONSTRUCTION l I I ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY pi W.R.E.C. I I PLUMBING $ I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I I GAS IA ROOFING I I SPECIALTY I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES F INO BUILDER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address 1 License # I PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # (— MECHANICAL COMPANY SIGNATURE REGISTERED L Y/ N . I FEE CURRENT I Y / N I Address I 1 License # '' 4? COMPANY 1 � ma_ n `�'-od \ "E 4 ! ' I Y/ N 1 FEE CURRENT Y/ N I Address I 36 [(3 5 �_ , :_ .L. 33 License# CCC I Z —S LS Nom 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 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" 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 OR IMPROVEMENTS TO YOUR PROPERTY. IF Ye • INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LE I ER OR AN ATT • ' NEY BEFORE RECORDING Y s U " NOTICE OF • ENCEMENT. FLORIDA JUR T (F •. 117.03) f r • ER OR Ad ' • � .� A Subsc •e. ans sworn to (o affirme ,efore m9 Subscribed and sworn to (or affi ”1 •efore m :tli by by Who is /are personally known to me or has /have produced Who is /are personally known to me or has/have de tiff u e as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped 3C09 5 1 f Mash '1i ISA ■ " , R44,01,Tite, 3h ny S A Division of Ryman Construction, Inc. Proposal # 0138 ■ INC. 36413 SR 54 • Zephyrhills, Florida 33541 Phone: 813 - 782 -6094 • Fax: 813 - 788 -6773 Estimate # 0 � License # CCC 1325505 Job # ' b 14s" 1 - 800 - 800 - ROOF Also, Serving the Central and East Coast of Florida //A; (7663) Customer: e— 1A -5 c q /CJq Date: Address: 67 3C2 /1 LcA\ e t. City: Zpl,...t k 1 , 6 Zip: Horne #: u 'fS' 51 i 49 Cell #: 3 9 I - 2LO"t Business #: E -mail Address: W 1 ' omplete tear off of existing �5 e'j (, j Additional Items: .) kk 6j LF c- � J tx iJ Secure all loose roof decking as needed according a %1Jvvi, :R!Aw". R ■ (he_ Ve- - Color - 15 s 441 to Florida Building Codes 11 R • oof dried in with Pte_k - SA- tc k �.nCAl.� W -k' (a) shQ t k3 OF & nstall new valley metal with galvanized metal PH !.Jo 4. tall all new 6 " drip edge color: wks . Ipstall all new lead boots Lejristall all new 30 year fungus - resistant shingles � SShingle brand/color:O. C C. a g 5 1& f , \ (,� j j L r Warranty Package. LYAll roof related debris removed from job site G(A 1 materials, labor and permits furnished Total bid price $ �('�. �O, Extra - UBad plywood replaced at a cost of $ 1.40 per sq. ft. in the roof field. All tlJ wood work/additional labor, such as, but not limited to, valley rebuilding, rafter replacement, etc. will be a rate of $ 6 per man hour plus the cost of materials. 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. Workman's compensation and public liability insurance on above work to be taken out by RYMAN ROOFING, INC., a Division of Ryman Construction, Inc., or its subcontractors. 5. RYMAN ROOFING, INC., a Division of Ryman Construction, Inc. is not responsible to provide any materials or to perform any work other than what is described above. Replacement of deteriorated decking or fascia boards, 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., a Division of Ryman Construction, Inc. and is the entire agreement of the parties and no other written or other forms will 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. 8. A 496 processing fee will be added to all credit card orders. Ryman Rooting, Inc., a Division of Ryman Construction, Inc. will not be responsible for any damage to septic tanks, sod, shrubbery, paint, satellite signal loss, sprinklers, concrete drives or any underground piping. Payment Schedule: aS.5 ( 9 �fa•1hk r 6S,6.„Cc, q. (> ie. jON Payment Method: Acceptance of Proposal as 1 t ■ I ■ :: 1 ► II ■ ■ 1 ■ ■ • ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAW (SECTIONS 713.001 - 71337, FLORIDA STATUTES), THOSE WHO WORK ON YOUR PROPERTY OR PROVIDE MATERIALS AND SERVICES AND ARE NOT PAID IN FULL HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. THIS CLAIM IS KNOWN AS A CONSTRUCTION LIEN. IF YOUR CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SUBCONTRACTORS, SUB - SUBCONTRACTORS, OR MATERIAL SUPPLIERS, THOSE PEOPLE WHO ARE OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE ALREADY 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 YOURSELF, 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 ACCEPT THIS PROPSAL AND HEREBY CERTIFY THAT I HAVE READ AND FULLY UNDERSTAND THE PROVISIONS OF THIS CONTRACT. Purchaser: _Ili A L�. iSMy Date: IAhi Purchaser: Estimato . • 1111011111111111i111111111iiiiiiu1111111111111111 2009127083 • Rept:1262059 Rec: 10.00 DS: 0.00 IT 09/09/09 Dpty Clerk 09/09/09 O'NEIL, PASCO CLERK R COMPTROLLER gal 1 OR BK PGo NOTICE OF COMMENCEMENT Permit No. / Property Identification No. dJ - ZtD - 2-1 - 01 s0 - Ooo:O - 01 so 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 follo information is provided in this NOTICE OF COMMENCEMENT. S� - 61454 oLt Sj kWh,- OC !� 1.Description of property ( legal scription :) Ph.Q.3 Ong P ' s PGs - • a) Street Address: 6 r 7 0 Nnrwl / 1 Z.v • 1 i 11 t > Z, 2.General dAscription of rovements: 3.Owner Information M . t Ap Pot / t, N' or //ll �, a) Name and address: T tf�laa.1 - •4-G.ii�M fooll� 6 ??c, i,kt 4.0. -� 3 ° S L�: r '; f� � 1�/ b) Name and address of fee simple titleholder (if other than owner) L � c) Interest in property tractor Information t� 2 p �• , a) Name and address: fr oy ��-ClIR C 7 " , ‘qt S / 1. St/ 42 'r-4 off5 b) Telephone No.: ! - Fax • Fax No. (Opt.) �3 5.Surety Information a) Name and address: b) Amount of Bond: c) Telephone No.: Fax No. (Opt.) 6.Lender a) Name and address: 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 < 1— W 713.13(1)(b), Florida Statutes: Z U !Y W — e) Name and address: O W W — J _l U b) Telephone No.: Fax No. (Opt.) U O I-- J 9.Expixation datc of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is < Q 0 = Q N o specified): LL w t— W eL ® N Q CO O a. WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF 1— W u. Ce U V COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, Z S O O tT �' 1 FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. ~ > - W u A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST V < 0 CC INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE = U V 2 W COMMENCING- WA[{ QR RECORDING YOUR NOTICE OF COMMENCEMENT. Q ~ o -� Q J STATE OF FLORA '• • ' COUNTY OF . _ • O cr cc L.L. = Q W ' i R Ct[rtsUSnua1eman State at Florida Signature of Owner pr 's Auth zed O cer/Directos/Partner/Muuger Ll. U ° u- 0 � .• • n ' '.►1y:Com:misabnDD75mam0 ^.� ; •" •• (' Explres0m12M2om Print Name Qe O 1— z Q The foregoing t ireniwandclTowledged before me this 4 day of gyp. 1,., , 20a, by . /1V <<�` Q U) D D IMF i • x . � r., r ,, , as (type of authority, e.g. officer, trustee, attorney t j O s 0- p in fact) for (name of party on behalf of whom ins nt was executed). Personally Known i / OR Produced Identification _ Notary Signature Type of Identification Produced Name (print) \ir•N-;..1" p 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. • • • • • Signature of Natural Person Signing Above FORMSINOC,rvsd2007 • • 1 • ASPHALT SHINGLES 2007 FBC PRODUCT APPROVALS MANUFACTURER PRODUCT TESTS PASSED MIAMI -DADE FL # LESS THAN 110 MPH 110 MPH AND HIGHER _ ASTM ASTM TAS ASTM ASTM TAS 03161 07158 107 03161 07158 107 CLASS D CLASS G CLASS .F CLASS G CERTAINTEED CLASSIC HORIZEN X 5444.1 CARRIAGE HOUSE X 5444.1 CENTENNIAL SLATE X 5444.1 GRAND MANOR X 5444.1 LANDMARK X 5444.1 LANDMARK PLUS X 5444.1 LANDMARK PREMIUM X 5444.1 LANDMARK TL X 5444.1 PRESIDENTIAL SHAKE X 5444.1 PRESIDENTIAL SHAKE TL X 5444.1 HATTERAS X 5444.1 PATRIOT X 5444.1 GAF -ELK ROYAL SOVEREIGN X • - 10124.1 CAMELOT ` X 10124.1 CAPSTONE X 10124.1 COUNTRY MANSION X 10124.1 GRAND CANYON X • 10124.1 GRAND SEQUOIA X 10124.1 GRAND SLATE X 10124.1 GRAND TIMBERLINE X 10124.1 TIMBERLINE ARMORSHIELD II X 10124.1 TIMBERLINE PRESTIQUE GRANDE X 10124.1 TIMBERLINE PRESTIQUE 30 X 10124.1 TIMBERLINE 30 X 10124.1 TIMBERLINE PRESTIQUE 40 X 10124.1 TIMBERLINE 40 X 10124.1 TIMBERLINE PRESTIQUE LIFETIME X 10124,1 TIMBERLINE ULTRA X 10124.1 SLATELINE X 10124.1 OWENS CORNING OAKRIDGE PRO 30 X 10674.1 OAKRIDGE PRO 30 AR X 10674,1 OAKRIDGE PRO 40 X 10674.1 OAKRIDGE PRO 40 AR X 10674.1 OAKRIDE PRO 50 X 10674.1 OAKRIDGE PRO 50 AR X 10674.1 DURATION X 10674.1 DURATION PREMIUM X 106741 CLASSIC X 10674,1 CLASSIC AR X 10674.1 SUPREME X 10674.1 SUPREME AR X 10674.1 PROMINENCE X 10674.1 PROMINENCE AR X 10674.1 BERKSHIRE X 10674.1 WEATHER GUARD HP X 10674.1 TAMKO GLASS SEAL AR X 1956.2 ELITE GLASS SEAL AR X 1956.1 HERITAGE 30 X 1956.3 HERITAGE XL X 1956.5 HERITAGE 50 X 1956.4 HERITAGE VINTAGE AR X 7154.1 '1AR /23/2008/SJN 01:51 FIµ7 ZEPHYBHILLS BUILDING FAX No, 813 - 780 - 0021 P, 001/001/ Cr • of �Z • 4i , . .. i - s • - 33t ; t 1.INGDET .tT" _ + NL` • Rt: Permit #1, / . • • 9/17/07. JInspectiou i a t • — . • I ,Ke_iod • 4m,--A,/, •''licensed as a(n):Contractor* /Engineer /.Architect, • ' • - • • ' . (please print name and circle Lie. T ipej - FS 46 8 Building Inspector*. • • License #; e ce / 3 2 Ss U , • ( //',0 • . * •X did' inspect the , • • On or about • &time) • • • *deck nailing and/or seco water bar work at (Job Site Address) • (circle one) ' - 673O /v 44,ce L _ ,A, // s • Based upon that . examination Z• have determined the installation was done according to the urricane Mitigation 1 etrofxt Manual (Based on 553.844 F. S.) Vi i — • -• . ' . - • STATE OF FLORIDA . . • •• COUNTY. OF ' . . • . , • • 5, . • • - ® • . Sworn to and subscribed before tae this• • 0S day' of /� • t bei ` • . 2001 • • • - . • • : Notary Public;: State of Florida - ... .1.4‹.,______•••-•:7-te,„,_•> : . 2 : .(print, type or stamp name) • • Personally known ,or , ' ',T,. ', • r A NN A . paew R e-- stMe a Florida ' Produced Identification i "‘r MCo r E 44, � • Type of identifcation,produced.' ,- • - .: 1401e9 ... '' �,.►�` ' : Np�ilhroY�NallorrrNallrpMl� � ' " General, Handing, Residential; or ltnafmS Caltrectar: or : •., - 5 ikon- Include photographs of each plane of the roof with the pormit # or .Odra; # clearly shown on the . 1.. , —.0. ve:;...i1N.01.. t...Bx f ;. 3... br {.. , f ,D'S ^ti 4..