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HomeMy WebLinkAbout09-9699 CITY OF ZEPHYRHILLS 5335 — 8TH STREET • (813)780 -0020 9699 • BUILDING PERMIT Permit Number: 9699 Address: 4938 17TH ST 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: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 14- 26 -21- 0010 - 00300 -0140 Improv. Cost: 1,883.00 - ,� �� t Date Issued: 10/30/2009 Name: MART JOSEPH Total Fees: 40.00 Address: 4938 17TH ST Amount Paid: 40.00 ZEPHYRHILLS FL 33542 Date Paid: 10/30/2009 Phone: (813)782 -5461 Work Desc: PARTIAL REROOF SHINGLE 3a a .�.e3.+.. AME AN --. IONALR.OFIN "IN A' RERO•F - SIDE TIAL 40.00 Pac 3- l Y.s3 4y',. . €7 M nW.. . DRY IN - • • F 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." 6 402__ CONTRACTOR SIGNATURE PERMIT OFFI PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813 -780 -0020 City of Zephyrhills Permit Application Fax- 813-780 -0021 Building Department Date Received Phone Contact for Permitting -- .... ‘12152Lictu7 Owner's Name Owner Phone Number Owner's Address Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS LOT # SUBDIVISION PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT n SIGN [] MOVE I I DEMOLISH INSTALL REPAIR PROPOSED USE 11 SFR 1 I COMM I I OTHER I I TYPE OF CONSTRUCTION 11 BLOCK I 1 FRAME I I STEEL I] OTHER I I DESCRIPTION OF WORK BUILDING SIZE SQ FOOTAGE HEIGHT zr I.- . I I BUILDING $ VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY 11 W.R.E.C. I I PLUMBING $ I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I I GAS I I ROOFING 1 1 SPECIALTY I I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES I 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 License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N I Address License # OTHER COMPANY SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N 1 Address 1 License # F 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 (PIot/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 - WeIIs, 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF C MENCEMENT. FLORIDA JURAT (F.S. 117.03) / OWNER OR AGENT CONTRACTOR Subscribed and swom to r aff d) fo m 's bed and sworn to (or affirmed) before me this i 30.07 by A 5 y 2, Uy / ryc by " Who Is /are personally known to me or has/have produced Who i$ /arrepersoally known to me or ha / /have produced as Identification. C �Q Notary Public Notary Public / : CQU ELINE Erz�issipii N•' Commissi DD OG F>?1S 33 Com Commission No ;,, s txpires December 12, 2010 , P; h` Boded Thru Troy Fain Insurance 800.384701a Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped 813 - 780-)020 City of Zephyrhills Permit Application - 4 . "(�1 r 1 (`� Fax - 813- 780-0021 Building Department Cr ` I (� Date Received Phone Contact for Permitting .1,--_ Owner's Name 0 � h ! Y) Q-t ? x 1 , /1 j 1 Owner Phone Number I Owner's Ad ) Q y 7 + b 1 S / 1`x 2pjt,y rhr)15 er Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address t,►.� y ,, ,� + k F L �,,} JOB ADDRESS -1 ri ) )4!b . 1 • -p 2 / YI kt-H r h r / I) s , L ` 3 5 1 LOT # SUBDIVISION /Y1 do r .eS PARCEL ID# fr " t � ( f o 'pct - MM ID - 003O - G IVO (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED yi . NEW C ONSTR ADD /ALT n SIGN I MOVE I DEMOLISH INSTALL REPAIR PROPOSED USE SFR r COMM n OTHER I I TYPE OF CONSTRUCTION I BLOCK r-7 l] !� FRAME II—I STEEL r7 OTHER I (� I DESCRIPTION OF WORK Re r()t% /a ` a Q' )-k p LS t( ( L1- R BUILDING SIZE SQ FOOTAGE 1 4 HEIGHT n BUILDING $ VALUATION OF TOTAL CONSTRUCTION F ELECTRICAL $ AMP SERVICE I PROGRESS ENERGY ni W.R.E.C. rT PLUMBING $ I f"c� �{I��' 1 I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION 1 w- Z ^' �! VV F GAS 1 ROOFING r SPECIALTY r i OTHER i . I t • FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES EINO F�1 bi /iri��(� BUILDER COMPANY I f �/ � )('G C SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I t Address 1 License # I ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address I i License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 Address I License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT 1 Y/ N I Address I 74/ 1 License # I n / OTHER COMPANY AIY en i .yl Croks51 Q f y Pn {" SIGNATURE REGISTERED I Y/ N I . FEE CURRENT I Y/ N �� Address i 1 )W fl J Y T illJ (L4 J License # 1(14( ./ 3 a 3 3 I 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, Stornwater 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, Stor mweter 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 W on public roadways..needs ROW 'a2 IYYY ® CERTIFICATE OF LIABILITY INSURANCE DATEWM/DOY) [[!! 10/30/2009 PRODUCER (727)530 -0684 FAX: (727) 532 -9602 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Jack Rice Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 13080 S Belcher Rd ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. Largo FL 33773 _ - INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Hermitage Insurance Co . 000053 American Professional Roofing, Inc., DHA: INSURER 13: -- ......... ._._... -- -- •-- - -.... .. ...-...__...--- - 17018 Ongar Ct INSURER C: INSURER 0: Land 0' ( Lakes FL 34638 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, IN8R Fat - — POLIOY EFFECTIVE POLICY EXPIRATION ------ . LTR WATYPO QN�U RD TF-lpANCE POLICY NUMBER DATF IMM/OOIYYYYI DATF IMWDDIYYYY) -• -- LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED _PREMISES pREMISES (Ea =make) $ _ 50,000 A __ CLAIMS MAOE X OCCUR HGL56242209 8/13/2009 8/13/2010 MED EXP (Any one person) 3 5,000 _ - -_ -.. --- -_ .. ... ... PERSONAL & ADV INJURY 3 _ Z r- QQQ 000 — ._... - -_ _,,,,, .. GENERAL AGGREGATE 3 -.__ 2 1. 000 • , 000 GEN9. AGGREGATE LIMIT APPLIES PER: PRODUCTS • COMP /OP AGO $ 1, 000 , 000 X 1 POLICY n JFCT n LOC _AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - .. ANY AUTO (Et accident) 3 - - ALL OWNED AUTOS BODILY INJURY 3 _ ........_._...____ SCHEDULED AUTOS (Per pnrson) MIRED AUTOS BODILY INJURY NON -OYNED AUTOS (Per e0ddenl) 3 — - PROPERTY DAMAGE 3 (Per accident) GARAGE UABILITY AUTO ONLY - EA ACCIDENT 3 ANY AUTO OTHER THAN EA ACC S - -_ - AUTO ONLY: AGO 3 EXCESS /UMBRELLA UABILITY EACH OCCURRENCE 3 OCCUR CLAIMS MADE AGGREGATE — __ DEDUCTIBLE - RETENTION $ - - -` _ WORKERS COMPENSATION I TORY.J IMIIS.i_ I E[L ..... _ __._._ ___ •_ AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L, EACH ACCIDENT 3 OFFICER/MEMBER EXCLUOED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE 3 N y ee, deecrtb under _— - -- S PROVISIONS Wow E.L. DISEASE • POLICY LIMIT 3 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED HY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City Of Zephyrhills DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN ATTid : Building Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 5335 8th Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 2ephyrhills, k'X, 33542 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Cynthia. Web,ater. /AMC . 7 .-"o C.-€. rn ACORD 25 (2009/01) ©1988 -2009 ACORD CORPORATION. AN rights reserved. INS025 (20 101) The ACORD name and Togo are registered marks of ACORD 10/30/2009 00:32 352 -200 -6346 PAGE 01 Pinellas/W. Pasco: 727 - 364 - 4485 YOUR FULL SERVICE ROOFING CONTRACTOR Hills./Central Pasco: 813-391-7023 State Certified Roofing Contractor Hemando/E. Pasco: 352 - 263-0873 Lic.8CCC1328373 Fax: 727 - 236 -8528 ~dean FULLY LICENSED Email: professionalroofing @live.com B ONDED 6INSURED �u aleoo[onat FREE ESTIMATES R dating, .Inc. ■ * * * * * * * DTP * - ,r } . �C * * * yE 7.'S) * * ** * * * * * * PROPOSAL SUBMITTED TO .$ e l_ / / ' r OI ) Y1 T B Z.' SN‘/ l DATE f 0/7/09 J - STREET 1/ 93 a 1 - Si-. LOCATION CITY. STATE. ZIP a e l'y1It 1 /11 FL- 3.d4/2 OTHER C1 n SHINGLE GOOD BETTER BEST SME - ^ ! o • SME 1, I'm tn. na l sna // W%n COLOR E - 11Mr ' tea+ n COLOR wn4NUPACneieR'S W' ,• - µgMANUFACTURER'S / `� wAl 1 l � b �•v �7 MANUFACTURERS w �R� tre- ICE_ PRICE PRICE- SI IC.1 ' _ WE HEREBY SUBMIT SPECIFICATIONS AND ESTIMATES FOR: .... Teo K.. Cla?aCALL THAT APPLY 00015 ""e IMO ID ❑ Obtain and post local rod permits On accordance with local Low) i ❑ ❑ ❑ ❑ Completely remove cresting rod to bare whoa ❑ ❑Install new lashings fa d plumbing stoats and GfN vents, soled O ❑ ThorougNy inspect rod decking and ceded want asphalt roofing cement 1:1 ❑ Replace rotten decking at $ _per sheet plywood and/or 4 ❑ ❑ Install a Class A fungus resistant shingle $ S^ LF. of decking ❑ ❑ X ❑ ❑ Re -nit entire roof decking per Florida bulking iing code w/ proper ❑ ❑ fasteners MlPllksliao h P ❑ ❑ Instil a self- adhering peel & stick over entire roof deck per Florida ❑ ❑ Clean and haul away as lob related debts to on approved ❑ ❑ CI b"I COCA - _ - - • . _ . .. - ❑ ❑ Honci aeon and magnetically sweep lab see for fees - = .. - - - -- -- - _ - . ❑ ❑ Cati in al Rod Inspections with local perMllhg ❑ ❑ Instal New Drip Edge - Natural - MI Brawn - Gray - Black - Beige for added water tightness, riled to code and sealed wilt) asphalt roof cement Final inspection with fame owner(s) to ensue complete sasroctbn FLAT 6000 BETTER SME STYLE COLOR COLOR — -- - -- • - -- - -.- ��c�� wAriisrwri - " MANUFACTURERS WARRANTY MANUPACRIRER wAeaAMIv PRICE PRICE PRICE ..w .we we CHECK ALL THAT APPLY ❑ ❑ ❑ Obtain and past local roof perrnes lin accadance ) ❑ ❑ ❑ Install a modeled roof system Smooth / GronuIated ❑ ❑ ❑ Corr pletelw remove ;Wang roof to bare wood ❑ ❑ ❑ install Drys of fiberglass felt Install with not tar ❑ ❑ ❑ morougrvy inspect rod decking • ❑ ❑ install an aluminum coat Hass ❑ ❑ ❑ Redoce rotten decking at $ plywood and/or ❑ i= instil a maintenance free cap sheet. Installed with hot tar $ per L.F. of decking ) Granulated finish ❑ ❑ ❑ Re -nail entire roof Florida bulking code w/ proper ❑ ❑ ❑ Make tie In to sloped roof fastener ❑ ❑ ❑ Clean away au job related debris to on approved ❑ ❑ ❑ Instil a - ng peel & slick over enlfe root deck per disposal facility F • tang code ❑ ❑ ❑ Hand clean and IN sweep lop site for rtdls ❑ ❑ ❑ ci 75 b. base sheet secured with fasteners ❑ ❑ ❑ Call In al Roof Inspections peimltting ❑ ❑ Install new Dip Edge - Natural - White - Brown - Gray - Block - Beige ❑ ❑ ❑ We recommend a tapered roof for the elevation Or ponding wooer. Add fl ❑Refused F4hot tspectbn with home owner(s)to ensure saflsfoolion We Propose hereby to furrth maleflal � and tabor - complete In occadance with above spedficallcns, fo the j- to be paid xca tQ the went pent O nQ ...,4 o waiid ! 1 ht �U1� E, i • CY) Payment to be made as follows; 7A `t / Uri t ) . Down Rerw> Vanr Balance -I 1 a Ace. 111 t_ on own 0 ' A Down // G!•' Signature X Ir % i ce / '" Al unpaid and outstanding °minces hereunder shall be sugect Note: This proposal may be to a service charge of 1.5% per month beginning from the due dote. withdrawn by us it non accepted within does Acceptance of Proposal - The above prices. specifications and TERMS AND CONDITIONS ON REVERSE SIDE conditions are sofisf • • • ry and are hereby • • Wed. You are authorized to do the work os Signature X / _ j// • • . made as outlined atwve. I ,,/ s i /A. Ale Date of Aeaptmwce_X / s^ \ / r { 6 ( rv. 4, gJ3- 78'0 - (,o ).a 0, q13--?sr.-r%&I City of Zephyrhills B: 0 DING DEPARTMENT RE: Permit # t ( 36'19 9/17/07 Inspection Affidavit • I C - s A• /7 �. io s r ,licensed as a(n) ontractor* ngineer/Architect, (please print name and circle Lic. Type) uilding Inspector* License #; cc C / 3 .20 3 7 3 On or about 1 , (ka2tie I.01 . la : s 6 I did personally inspect the roof & time) deck =Eli %; , or seconda water barrier work at G 11. G (circle one) (Job Site Address) a X938 /7 s1- Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) r �, i 2 Signature STATE OF FLORIDA COUNTY OF Sworn to and subscribed before me this . - day of _/V c.iV 4 l .. . 200 Q By 06Atif ` Notary Public, State of Florida \ r type or stamp �¢2r to � t, typmp na wh anon. 0011•5 2e, 20 name) Commission No.: Personally known or Produced Identification Type of identification produced. 1 LC;)-- i q N f., LA42-1^ s " General, Building, Residential, or Roofing Contractor or any individual certified under 468 F.S, to make such an inspection. Include photographs of each plane of the roof with the permit # or address # clearly shown marked on the . deck for each inspection.