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HomeMy WebLinkAbout09-9818 CITY OF ZEPHYRHILLS 1/ 5335 - 8TH STREET (813)780 -0020 9818 BUILDING PERMIT Permit Number: 9818 Address: 4640 CHARTER 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: WINTERS Est. Value: Parcel Number: Improv. Cost: 3,050.00 ¥ �: r _ a gig Date Issued: 11/25/2009 Name: BOLTON, WILSON Total Fees: 50.00 Address: 4640 CHARTER ST Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 11/25/2009 Phone: Work Desc: RE -ROOF MOBILE HOME WITH SINGLE PLY MEMBRANE 444 SQ FT ag., a` '° • • ` • ` Y EMS NC R E S I R • IAL 50.00 ?t - ": ..a. .... ° per r c ' . _., s fie' "�` • -Y N -•• IN P TAPE JOINTS ROOF IN$P 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 - • • ing your notice of commencement." ar 4 4 ft. , A C ONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER O 1J VV - vvry - - ' Building Department Date Received I t a - 1 (f° 2"/ b) -- 0? 4-0 Phone Contact for Permittin, 1 �1 Owner's Name 63 ' 1 ` o 1 h Owner Phone Number B I z - i i s — Q l ed q Owner's Address 4 'C , 40 C \ -r ' A- Owner Phone Number Fee Simple Titleholder Name Owner Phone Number I I Fee Simple Titleholder Address 11 JOB ADDRESS 4(s�t0 Ch.ar 54-- LOT# 1 I SUBDIVISION hr ` ^ ,-4 N P PARCEL ID #) ( `E- 't(° -1.1" 0 a:7 0 - 0voo0 - 035 -- 00 j (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED I NEW CONSTR I I ADD /ALT n SIGN n MOVE n DEMOLISH I INSTALL REPAIR PROPOSED USE I 1 SFR I 1 COMM 1 1 OTHER I 1 TYPE OF CONSTRUCTION n BLOCK I 1 FRAME I 1 STEEL 1.f.. 1 OTHER 1 Yh 1 H I DESCRIPTION OF WORK ( ` ). -----'`ad and L ; Ve ko wee tnf. 4. 5 i t, PI y YYl e. w.b - ' 1 1i k SI F4 BUILDING SIZE t a 3 SQ FOOTAGE 1 \ 1 HEIGHT I n BUILDING $ VALUATION OF TOTAL CONSTRUCTION 3aso .v0 I 1 ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENER9Y- n W.R.E.C, n PLUMBING $ 9 I. I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I I • GAS ,,,1E;:r ROOFING 1 1 SPECIALTY n OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES nNO BUILDER COMPANY I CO vvv-co r 4 C u c r Sy d ✓V ( C - fi SIGNATURE d ,.. . REGISTERED Y / N I FEE CURRENT Y / fd Address 1 2 t■ I Qt v`_ec S-I-, \eo,rwo.4C' (,- 337S1. License# ' 1 QC co s7O i ELECTRICIAN COMPANY I SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N 1 Address I License # 1 PLUMBER COMPANY I SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N 1 Address License # I MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT , 1 Y/ N I Address License # I OTHER COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N 1 Address License # 1 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 onslte, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects COMMERCIAL Attach (3) 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 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 Cotnmencement 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 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 ", l 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 is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A N TIE F YOU COMMENCEMENT MAY RESULT IN TO OBTAIN FINANCING, CONSULT PAYI TWICE FOR IMPROVEMENTS TO YOUR PROPER WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117.03) CONTRACTOR . _ .re me this OWNER OR AGENT Subscribed and sworn to rAffiryned) Subscribed and sworn to (or affirmed) before me this , i -. _ by Ke b _ c , /A ,. .) by • • • ., : a • pro Who is /are personally known to me or has/have produced as ntification. as identification. Anne M Meade My Commission D0936510 0 , p dw Expires 11/04/2013 . Notary Public Notary . C• mi ion No. Commission No. - lima A awn. Name o otary . 1 • -d or s amped Name of Notary typed, printed or stamped 111111111111111111111111111111111IIU 1111111111 IIUI1111 IUI 2009169508 Rcpt: 1275274 Rec: 10.00 DS: 0.00 IT: 0.00 11/25/09 Dpty Clerk • NOTICE OF COMMENCEMENT PAULA S. O'NEIL, PR5CO CLERK & COMPTROLLER . , . 11/257091J 1 4 1 92 . OR BK PG Permit No. #A ( y 1 Tax Folio /Parcel ID: O1-10 ^ MO 0 - 635 - 0 -,►C) i State: C County: U e x 6c o The undersigned hereby gives notice that improvement will be made to certain real property. In accordance with Chapter 713, Florida Statutes, the following information is provided in the Notice of Commencement: 1. Description of property (legal description, lot, block, and street address if available): VI- 2.c ' -1 -Qi -'10 - (Ta000 "03`' 0 -001 4 Vi 0 Cf, r kr S - I 3 s Gl "„ e.f.5 PIA �« 2 e L - `t s i EL, 3 36 -- 2. General description of improvement • 0 - e -nic.1 t 3a. Owner name /address: W 5or k) 3 t -6 v $cz4O o.f c cS.,-• 2- •erLsi r i,`. c FL 30Si- 3b. Interest in property: O W v-e-f 3c. Name and address of fee simple title holder (if other than owner): ! I 4. Contractor - Qualifier Name and Address: 1`c � 1(Y �o ecce� ' �;N- or LAvec SITSdenMS, V; t - 7 tk T' r,.e r Z4 _ C(eo,cw 4r- I (_ 3.3 7Sb 5. Surety - Name and Address: I' f 4 Amount of bond: $ 6. Lender - Name and Address: ! v 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a) 7, Florida Statutes: N r 4 8. In addition to him /herself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes (Provide Name /Mailing Address): (A 9. NoC expiration date (one full year from the date of recording unless different date is specified): / / :: //0 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 INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFOR COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. 1 /0 Signature of Owner (or Owner's Authorized Officer/ Date Director /Partner /Manager) STATE OF FLORIDA County of rrL:3 (-c7 The foregoing instrument was acknowledged before me this ■ ? of N r V , 202, by i (K) ►lS2h A 1 rkOv\ (print name of person) as (type of authori , e.g. officer, trustee, attorney in fact) for (name of party on beh• o who►• instrument wa= e uted). i j r e0 Rot_ N Puoiic State of Florida l — , ■ /���� Li � onda NOta Pb : Daniel A Wilder ry lc. j My Commission 00789576 "For o- Expires 07K)0/2012 -2 •al) Personally Known -OR- Produced Identification q) t-- Verification pursuant to Section 92.525, Florida Statutes: r, ;Rser,Fiptme that I have read the foregoing and that the facts stated in it THIS o C C • . F 19 • k Mkt g® 1$ elief. TRUE AND CORRECT COPY OF THE DOCUMENT , �� /. 5) ( ` z Z ON FILE OR OF B • . EC ORD EAL OFFICE Signature of Natural Person Signing Above WITNESS H ((�� e )' I, o- , DA ' t'"'fc ' Oe.recJl�oy 'D„-, C � ( w � l l/•� ' . .. O'11Q _ 3 K & CeMPTROLLE` 6` I V i ►1ar S } ( BY ' • ,`• • PUTY CLERK C l ,ea, ,„,,A, Fr 33 7 Si `4 t Pasco County Parcel: 14 -26 -21 -0270- 00000 -0350 001 Page 1 of 2 Search Again Map Generalized Building Schematic Frequently Asked Questions Estimate Taxes Other Agency Data: Tax Collector School Board Supervisor of Elections Data Current as Of: 1 Weekl Archive - Saturda , November 14, 2009 Parcel ID 1 1 14-26-21-0270-00000-0350 (Card: 001 of 001) Classification 02 - Mobile Homes Mailing Address ! Property Value - BOLTON WILSON A Ag Land $0 CIO EDWIN V BOLTON Land $14,709 16987 COUNTY ROUTE 59 Building $12,851 DEXTER, NY 136342027 Physical Address Extra Features $433 4640 CHARTER ST Market Value $27,993 ZEPHYRHILLS, FL 33542-7861 Assessed (Save Our Homes) $0 Legal Description (First 4 Lines) EDGEWOOD NO 1 UNRECORDED PLAT Taxable Value $27,993 LOT 35 DESC AS COM SW COR OF NW1 /4 TH NOODEG 49'53 "E 665.36 FT TH N89DEG 52'03 "E Land Detail (Card: 001 of 001) Line Use Description Zoning Units Type Price Condition i Value L 0200 MBL HM SUB 00M2 , 5,310.00 SF $2.77 1.00 i $14,709 Addition - = nd Information Acres F 0.12 1 Tax Area 4 i rk FEMA Code T AE [Residential Code NTERLP1 Buildin • Information - Use 02 - Mobile Home (Card: 001 of 001) Year Built 1967 Stories - - -- - -- 1.0 -- -- - - - - -- - - - - - -- - -! Exterior Wall 1 Pre - Finished Metal Exterior Wall 2 None Root Structure Flat Roof Cover Min Roof(Corr. or Sh M) Interior Wall 1 Plywood Panel Interior Wall 2 None Flooring 1 Cork or Vinyl Tile Flooring 2 Carpet Fuel Gas Heat Convection A/C None Baths 1.0 Line Description — Pt --- Sq Feet Repl. Cost New 1 BAS I __ 432 $21,669 -! L - ___ 2 FOA 160 $2,006 3 FEA 200 $8,527 4 FCA 290 - - -- - - _. - -- - $2,,9909 _ - -- - -- FST - - - - -- ! 70 $1,605 Extra Features Card: 001 of 001) Line I Description Year Units Value 1 1 DWSWC _ 1967 - 1 30 $203 2 I UDU M 1 1989 1 $140 3 _ - A C -3 1999 1 $90 - - Sales History - - — — — - — Previous Owner 1 BOLTON WILSON A & MARY W Month --1- -------- - - -- Year Book /Page ! T T - + - - - 1- Type Amount 2004 05 5858/0957 I 2 I 1996 04 ; 3560 / 0729 1 I WD $16,000 http: // appraiser. pascogov.com /search/parcel.aspx ?sec= 14 &twn= 26 &rng=21 &sbb= 0270 &blk = 00000 &lot =0... 11/20/2009 Pasco County Parcel: 14- 26 -21- 0270 -00000 -0350 001 Page 2 of 2 1989 I 12 ! 1868 0985 WD $16,500 Search Again Map Generalized Building Schematic Frequently Asked Questions Estimate Taxes Other Agency Data: Tax Collector School Board Supervisor of Elections http: // appraiser. pascogov.com / search /parcel.aspx ?sec= 14 &twn= 26 &rng =21 &sbb= 0270 &blk = 00000 &lot =0... 11/20/2009 t�irl 4 0,1, w� ;a. hla'Lt v m&�`� TM � d�rars�x mf aM1>o ffIt J, " �+ ? r Y v v -v t �, 1^° si a a t E X t s ., t . .. . , r�aK n v ; • . ?k� } u, � � H, w `� ,,,n, ��`.xw��i"w+:a4:t`.�«.`ca'. BCIS Home Log In User Registration Hot Topics Submit Surcharge Stets & Facts Publications FBC Staff BCIS Slte Map Links Search E Product Approval , tor. 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FL # FL7699 -R1 '� Application Type Affirmation 4t Code Version 2007 z • xWt4W s Application Status Approved Comments Archived Product Manufacturer Cooley Incorporated Address /Phone /Email 50 Esten Avenue Pawtucket, RI 02860 (702) 525 -3474 ReedL @cooleygroup.com Authorized Signature Stephen McWilliams mcwilliamss @cooleygroup.com Technical Representative Address /Phone /Email Quality Assurance Representative Address /Phone /Email Category Roofing Subcategory Single Ply Roof Systems Compliance Method Certification Mark or Listing Certification Agency Miami -Dade BCCO - CER Validated By Referenced Standard and Year (of Standard) Standard Year ASTM D4434 2004 Equivalence of Product Standards Certified By rtn. iNAna,.aw fInridahllilding- erg /nr /nr ann dtl. asnx? naram= wGEVXQwtDgs4uUmmA52Cf2XE4f %2fR2gBm... 4/15/2009 Product Approval Method Method 1 Option A Date Submitted 03/18/2009 Date Validated 03/18/2009 Date Pending FBC Approval Date Approved 03/25/2009 ,Summary of Products 11 FL # Model, Number or Name jDescription 7699.1 C3 Plus PVC Roof Membrane Limits of Use 1Certification Agency Certificate Approved for use in HVHZ: Yes FL7699R1C CAC __. NOR 06022.703 - Wood.pdf Approved for use outside HVHZ: Yes F1_7699 R.0 CAC _._ NOA 06041801 Steel.pdf Impact Resistant: Yes FL7699 R1_C CAC NOR 060 41802 - Concrete.pdf Design Pressure: N/A FL7699 421 C CRC NOA 060 11803 - Wood Fiber.pdf Other: See System and General Limitations set forth in FL769 81_C CAC NOR 06041804 - GypsLirn.pcif Miami Dade NOA FL7699R1.__2 CAC NOR 06041805 - Reco�er.pc. Quality Assurance Contract Expiration Date Installation Instructions FL7699 R1IINOA 06022703 Wood.pdf FL7699 R]- I1 NOA 06041801- Steel.pdf FL7699_R1__11_NOA 06041802 - Concrete.p:.if FL7699 R1 1i NOA 06041803 - Wood Fiber.pdi FL7699_R1.1 ,NOA 060 180 pdr FL7699_- Rl_II_NOA 06041805 - Recoyer.pdf Verified By: Miami -Dade BCCO - CER Created by Independent Third Party: Evaluation Reports 1 Created by Independent Third Party: Back 1 Next J DCAA Administration Department of Community Affairs Florida Building Code Online Codes and Standards 2555 Shumard Oak Boulevard Tallahassee, Florida 32399 -2100 (850) 487 -1824, Fax (850) 414 -8436 © 2000-2005 The State of Florida. All rights reserved. Copyright and Disclaimer Product Approval Accepts; i (Ei.tECYJ Secured) Bobbj VER fT 1ttn : / /www.floridabuildins.org /pr /pr app dtl. aspx? param= wGEVXQwtDgs4uUmmA52Cf2XE4f %2fR2gBm... 4/15/2009 1 r ri t Fi+ .';,:t r' ¢ ;' n 'M1 ➢ r `E i , f ''rS „, . tS i 1 ��'' e 1S a§' t1 r u � x , ar S N ∎ ' F t f , \^ , , 11 ,, «: r xi t S u y "' R .14p i 9'+ .: 'd'. % -.- "� 5 . r . „, ,r-r, S b ..-- y � 11111,,,„ " " " "" ei c A tai, hti ,.d „0 E , k 5 ',„, u 4 „,,(07,-b, . 1 ,:i ae ' av ' Ns c ' ei t t e a, a "K - a Ski` i ", y > ' ,f r�' � ,. P �` �' � n p '` ti �� A x e a 4 41 v 5 , ,j} l d. ' y trt"� ,,',J a : i .:! ,T . ° � ,1,11't;,, ' y i iii ' ... �' tq" . � ; R S Y aY ' 3 .. ,�+� • j A '.� * � r r f " X a4f . � �Y;? sY d, r� + �;!. ,s: r><; ,a,,: L J Y .„ +� t `„ ..^a.n r aza."'A�frkv $ r . BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats & Facts Publications FBC Staff BCIS Site Map Links Search 1', t k Product Approval a 1 'I USER: Public User n , Community ,, 1 Affair 5 S y ' Produc*,4pprova! Menu > Product or Application Search > Application List > Application Detail tit F bl f'1N+1'I a r4 , y W r.' t oovt,, FL # FL7699 -R1 o i 4 ' Application Type Affirmation i&V l„ lab4 r V '' r4 Code Version 2007 w vfr, r Application Status Approved r ,v '", ire^ q.,+.14wkut 4 t � ' Comments `g'” ? � ' ', Archived Product Manufacturer Cooley Incorporated Address /Phone /Email 50 Esten Avenue Pawtucket, RI 02860 (702) 525 -3474 ReedL@cooleygroup.com Authorized Signature Stephen McWilliams mcwilliamss @cooleygroup.com Technical Representative Address /Phone /Email Quality Assurance Representative Address /Phone /Email Category Roofing Subcategory Single Ply Roof Systems Compliance Method Certification Mark or Listing Certification Agency Miami -Dade BCCO - CER Validated By Referenced Standard and Year (of Standard) Standard Year ASTM D4434 2004 Equivalence of Product Standards Certified By 'ftn• / /wxnxnxt flnridahnildina.nrp/nr /nr ant) dtl. asnx? param= wGEVXQwtDgs4uUmmA52Cf2XE4f %2fR2gBm... 4/15/2009 - Product Approval Method Method 1 Option A Date Submitted 03/18/2009 Date Validated 03/18/2009 Date Pending FBC Approval Date Approved 03/25/2009 Summary of Products .FL # Model, Number or Name (Description 7699.1 1 C3 Plus PVC Roof Membrane Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL7699R1 C CAC NOA 06022703 - Wood.pdt Approved for use outside HVHZ: Yes F17699 R3 C CAC NOA 06041801 SteeLpdf Impact Resistant: Yes FL7699 R1 C CAC NOA 06041802 - Coricr Design Pressure: N/A FL7699R1 C CAC NOA 06041803 - Wood Fiber 6 df: Other See System and General Limitations set forth in FL7699R1 C _._ CAC __. 06041804 - Gypsum. d Miami Dade NOA FL7699R1 C CAC NOA 06041805 - Recover.poit Quality Assurance Contract Expiration Date Installation Instructions FL7699R1IINOA 060227073 - Wocd.pdf FI.7699 R1IINOA 06041801- SteeJpdf FL.I699 __ -:i II NOA 06041802 - 1Concrete.pci` FL.7699R1 II NOA 06041803 - Wood Fiber.pdi FLT 690 R1IINOA 06041804 Gy ,sum.p8!f FL7699 81 II NOA 06041805 Recover.pdf Verified By: Miami -Dade BCCO - CER Created by Independent Third Party: 'Evaluation Reports 1_ Created by Independent Third Party: Back I Next - - 1 DCA Administration Department of Community Affairs Florida Building Code Online Codes and Standards 2555 Shumard Oak Boulevard Tallahassee, Florida 32399 -2100 (850) 487 -1824, Fax (850) 414 -8436 © 2000-2005 The State of Florida. All rights reserved. Copyright and Disclaimer Product Approval Accepts: ktf ® , _1 see eD ae.- .4 aPAU'.c rEF■FY ittn:/ /www.floridabuildins;.or>; /nr /pr app dtl. aspx? param= wGEVXQwtDgs4uUmmA52Cf2XE4f %2fR2gBm... 4/15/2009 Contract 1 (727) 298-0955 (800) 226 -0955 711 Tumer St. Fax: (727) 298 -0111 COMFORT COVERSYSTEMS Clearwater, FL 33756 FL Lic.# CCCO57091 1114) A P3) • 7/5- 0141 PROPOSAL SUBMITTED TOW / 13 /To /V PHONE CONTRACT DATE it i 7 - CI part /. . STREET& 6 022 Vote* A) I#yvyo CNHRa b 12 Sr, MHP NAME 44/ CITY, STATE, ZIP / ZyPN�i/ZH !/4 �/• 3 3 S^ ya MHP ADDRESS3��lLZ ti..)/4/7 A REPRESENTATIVE: / /J .441 C GCS, g . APPROX. JOB START DATE We hereby submit the following specifications and estimates: Year: 7 ' Make: l hO44i7 d Model: 1. INSTALL COMFORT COVER SYSTEMS PATENTEp ROQFING SYSTEM FOR THE FOLLOWING AREA: /hI�t! floor i Aaw- oNt , epee /v P l'J 1 ' f . itof G9 kreet.r, .... , 2. SYSTEM TO BE INSTALLED: V WHITE GRN. GREY BEIGE 3. INCLUilt DOUBLE - FOIL -FACED INSULATION AS INDICATED: VV 2" nom. 3/4" nom. NONE 4. INCLUDE NEW SPUN ALUMINUM VENTS, EXCLUDING FURNACE VENT; (ELIMINATE DEAD AIR SPACE VENTS) 5. INCLUDE ALL REQUIRED PERMITS. 6. CLEAN UP AND REMOVE ALL JOB - RELATED DEBRIS FROM JOBSITE. 7. # SKYLITES TO BE INSTALLED. NO INSIDE FINISH INCLUDED. 8. PROVIDE TRANSFERABLE LIFETIME CONTRACTOR'S WARRANTY COVERING LABOR AND MANUFACTURER'S BACKED LIFETIME WARRANTY COVERING MATERIALS. SPECIAL INSTRUCTIONS & EXTRA WORK (USE ADDITIONAL PAPER IF NECESSARY) NOTE: RETAIL SALES TAX MUST BE CHARGED UNLESS THE CUSTOMER SIGNS THE FOLLOWING: I certify that I own the land on which the structure I am improving is permanently affixed. Futhermore, I have filed a declaration with the Property Appraiser requestin the structure assessed as realty and it bears an "RP" decal. SIGNATURE:.k �,/1 7 CASH PRICE AND PAYMENT NT SailEDULE Aelere -i i lc a pros* ,:rater-ms imam al rla lL ataawataa as a . soft +r morale tr la catmolleni *sr onast,L , Samaio acmes t pea Sander rat art it Swelr ac faliaa skaaata Marta Qj SI , tatoe oat at anew flea marono ors 111r4�r ae . $ .3 S _ 0 R weed eed P the setter are retort We b any pupate or vel m tanmreurei 1. Price i b until final & complete payment is made. An express mechanc Yen is rtereby 2. Tax $ acknowledged for security of this debt and the total amount will be paid wenn 3. Down Payment $ '.---6 ° ` ' terms shown. 4. Balance $ 2 f ,S -a I, (we) herewith expressly agree to pay not as a penalty but as liquidated �, damages, 25% of the principal amount of this contract to Comfort ON COMPLETION OF ALL WORK CoverSystems in the event of a breach of this agreement by I (we) for any reason whatever. Terms: O Cash 0 Credit (Subject to the approval of the Credit Sales Department.) Authorized Signature NOTICE TO OWNER All material is guaranteed to be as specified. All work to be completed in a workmanlike Do not sign this home improvement contract in clank, or manner according to standard practices. Any alteration or deviation from above specifica- to protect t y before you at the time you it. You are sign. gtled e it a tions involving extra costs will be executed only upon written orders and will become an copy of f y ouur r legal rigghtshts at u yer's right extra charge over and above the estimate. All agreements contingent upon strikes, egal . Buto cancel accidents or delays beyond our control. Owner to carry fire, tornado, and other necessary on reverse side. insurance. Our workers are fully covered by Workers Compensation Insurance. Acceptance of Contract - The above prices, specifi -' 4. cations and conditions are satisfactory and are hereby Signature X` / ✓'_.,rv� , a).-7 accepted. You are authorized to do the work as specified. Signature Payment will be made as outline above.