HomeMy WebLinkAbout09-9880 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 9880
BUILDING PERMIT
I m >. i r E 3 ._ „ ?.& 'ka" ,>,; -_
Permit Number: 9 Address: 38415 EVERGREEN VILL 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: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 02- 26 -21- 0010 - 05300 -0020
Improv. Cost: 19,400.00
Date Issued: 12/10/2009 Name: Z -HILLS LTD.
Total Fees: 130.00 Address: 38415 EVERGREEN VILLAGE DR
Amount Paid: 130.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/10/2009 Phone:
Work Desc: RE ROOF WITH SHINGLES ON MULTI FAMILY UNITS (1 BUILDING)
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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 y r notice of commencement."
♦_ r 4 1 '1"
CO 1 OR SIGNATURE PERMIT OFFI R
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 813 782 -- 0 q 20
•
Owner's Name e a • gi t Owner Phone Number . 82 214 •
Owner's Address L R 0• Bo)c 5252 L. A [ LAN 1 I Owner Phone Number
Fee Simple Titleholder Name 1 Owner Phone Number
Fee Simple Titleholder Address Eve JOB ADDRESS 1 15 Eve 2 G a ee•J L• G S D Q LOT #
SUBDIVISION PARCEL ID# O Z Z(Z1 0010 O 5300 OO 20
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD /ALT n SIGN n MOVE 1 1 DEMOLISH
INSTALL REPAIR
PROPOSED USE ( 1 SFR 1 1 COMM 1 1 OTHER 1 1
TYPE OF CONSTRUCTION 1 1 BLOCK 1 1 FRAME 1 1 STEEL 1 1 OTHER I 1
DESCRIPTION OF WORK RE- ROOF'"{ //)ils N1tti.Ti —'r�cY,�l�f
BUILDING SIZE SQ FOOTAGE lt® '--)G� f e.S HEIGHT
■ ` 1 BUILDING $ VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY n W.R.E.C.
PLUMBING $ qv
MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
1 GAS 1 1 ROOFING 1 1 SPECIALTY 1 1 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 YES nNO
BUILD COMPANY (�u- SG hap !C Co,ns+�wct
SIGNATURE • REGISTERED dNIP N FEE CURRENT I Y / N
Address License # C C C o 5813q
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N 1
Address License #
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y / N 1
Address License #
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N 1
Address License #
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT � Y/ N
Address License #
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects
COMMERCIAL Attach (3) 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 Commencement is required. (A/C upgrades over $5000)
** Agent (for the contractor) or•Power of Attorney (for the owner) would be lomeone 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 O SEtpt1AtESTIONS: jndersigned 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
ap eale ,� { 4 ii t �_
UNLICENSED CONTRACTORS AND CONTRACTOR REt1��� 6thgbwgr diked rMntractor or
contractors to undertake work, they may be required to be..thlensgikki accordance with state and local regulations. If the
contractor is not licensed as required by law, both the'.bAMIErand 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. V S .•1 A .%.J I,' !4:. ., g a) 31 .'s *v.:4 - :.�+ +•
TRANSPORTATION IMPACT /UTILITIES IMPACT AND RESOURCE RECOVERY FEES: T undersigned understands
that TransfloNtgtOrAllitaotKbe0 Aidideftbb oYe 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 wpjk is $2,500.00 or more, I
certify that I, the applicant, have been provided with a copy of the "Florida teliAflcti :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,
'met `(y u1 j C Septic Tanks., . i t"
tl rfvfrbifteritbl Prv,+clforj.Agency- Asbestos abatement.
- Federal Aviation Authority- Rlugways.
I t ? irlpaa �afollowing restrictions apply to the use of fill: a ,441
use o M 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 Y • INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LEND .- OR AN ATTORNEY BEFORE RECORDING YO ) 1. NOTICE • F COMMENCEMENT.
EMENT.
FLORIDA JURAT (F.S. 03) 7
.• - _ _ ' , --
OWNER OR AGENT _ - �, ` CONTRACT° - Subscribed and sw "". (or affi ' d) before me this
Subscribed and swor ' r lane, •e .re e this b
by by
Who is /are pers known to me or has/have produced Who is /are personally known to me or has /have produced
/ as identification.
i as identification.
'lin
A N otary Public / _ Notary Public
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ommissi• ..,. ._ ;r �' •
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PRA p� SUZANNE DOUGLAS - 1 My Commission Expires Oct 25, 2011
os 'e.,.... Nota P� n� i� Commission a uu
Alort
Notary c Expires of Florida Name o f N t .,�4 ped
Name of Notary typed, • . • • - , e .- _I Wk ommission Expires Oct 25, 2011 , oF F` Bonded 'Noun Nation 3 N� ar ss
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'N �� � � ` B onded Commission #
National Notary Assn.
n„n� Through ry
1111111 11111 a 1111111111111111111111111111
2009176201
Rcpt:1277325 Rec: 10.00
DS: 0.00 IT: 0.00
12/09/09 Dpty Clerk
NOTICE OF COMMENCEMENT
State of FLORIDA County of PASCO
Property Identification Number: 0 2 Z.C. Z 1 00 t 0 0.5300 00 2 0
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance
with Section 713.13 Florida State Statutes, ;nf1rmation is provided in this Notice of Commencement:
1.. Description of Property .(legal descripti ZEPHYRIIILLS COLONY CO LANDS PB
1 PG 55 N 273.81 FT OF TR 53 PAULA S. O'NEIL, PASCO CLERK & COMPTROLLER
•• EXC E 15.00 FT FOR RD R/W 12 pR 9 BK 9 132 1 § I 1 PO °i9 9
OR 2028 PG 1394
Street Address: 5 gq t E y� r � r E- �. v l lc( c c. C' G / c 1 LS
2. General Description of Improvement:,
3. Owner Information: -" 2 h, tea L ( M 'Pave r-rt �s
a) Name and address: PO BOX 5 2 La_ ktr land 4 1 3 . 3 �: l
b) Name and addressmf fee simple titleholder (if other than owner): N/A
c) Interest in property: Owner
4. Contractor: Paul Schaper, 8949 Gall Blvd., Zephyrhills, Fl 33541 8/3- - 09a L'
5. Surety: Bauer & Associates, 12210 HWY 301, Dade Ci ty, Fl 33525
6. Lender :. Name/Address: N/A
7. Identity of persons within the State of Florida designated by Owner upon who notices or other
documents may be. served as provided by Section 713.13(1)(a)(7), Florida Statutes.
a) Name and address: N/A
b) Telephone No.: Fax No. (Opt)
8. In addition to himself, Owner designates the following person to receive a copy of the
Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes:
Paul Schaper, 8949 Gall Blvd, Zephyrhills, FL 33541
Ph: (813) 782 -0920 Fax: (813) 715 -4875
9. Expiration date of Notice of Commencement (the expiration date is 1 year from the
date of recording unless a different date is specified.)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,
PART 1, 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 YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA
COUNTY OF PASCO ,t—
gn of Owner or Owner's Authortz4Offcer /Director/Partner/Manager
felegner.5 _vie/
•
Print Name
2 C 1
The foregoingJmstrument was acknowledged before me this fl day of d ec r l- , . ;2008, b
i +i t 1leti as <arvt,t (type of authority, e.g. officer,
name of party &o fficer trustee, attorney in fact) for
(� p rty on b ehalf o f whom instrument was executed).
Personally Known OR Produced Identification Notary Signature 0 \
Type of Identification Produced /,{rio se.s y G z3 0
Verification pursuant to Section 92.525, Florida Statutes, Under
and that the facts stated in it are true to the best of my knowledg penalties
nd belief.
perjury, I declare that I have read the foregoing
SUZANNE DOUGLAS -ALLEN
ar g Above
Not Public - State of Florid ignature of Natural Person Si
Notary, .nc oct 25.2011
e 'elatiaiWovi mp Aloe Notary)
n o Bonded Through National Notary Assn.
„nun '��
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, t EC O R D L IN EA IS OFFICE
_� DAY 0
PAULA • N RK & COMPTROLL R
•
, _
DEPUTY CLERK
v , ( C.) C. •
/ itlerCta'41 t rt- 1
§ 4,6 n „p 1Ltv
bcte ord. Zerh 33.541
PH 782-092D & (35Zi 56
T.ATE CERTIFIED BUILDING D ROOF NC- CO N1 B-00.5'= 6 7 ar
SERVNG FLORIDA'S FrNTEST HiusAIrs & BUMTESSE23 SEICH t) 16 ww h perczruction _ corn
Daret ”
Nme: ,„. - Utmtaeit
CIty Address: '5-
r 1 State ZIP
Parcel #
We hereby propose to furnish riWerials and labor necessary for the completion oft
Shingle Re-roof
1_ For the shingled portions of the home, remove old rOoting m teri1 f.4 t 0 dry-4i, taking precaution E; to
protect the building aid the land,scaping. Groom the deck and reset the existing decking nails.
2. Replace bacl wood other than herein agreed to at /41-/, CC dollar:, per m our plus
materials markedup at a ' ./cL-TY • percent contractor's fee.
3. Install (IA_ , eaves drip with:alt e sealed with ple6tie fnent
4. Install Lt\ layer(s) of ASTM15-lb asphalt shingle uiid&ayment.
. Initall galvanized valley metal for the length of all valleys_ Valleys will be dosed.
6. Install new lead boots over vent pipes and replace n etal vents with new
7. Chalk lines shall be struck to assure proper shingle: exposure .
8_ Install Vent , Class. a self-sealing fungUS _resistant fiberglw;E=
Manufacturer: Cokt. a
9 Six 1-1 cor resistant nails shall be Mstalleel per Manufacturers instructions.
Options
Hurricane-nail the deck to the railers to meet current SI3CCI code. 4 '
Install / -; feet of aluminum ridffe vent_
*See Pricing Section
f3t. IC, RE-ROC* Cri
A ' ---- - I ''i
a_ i - 1.
Sr 1 I" t C K Roofing. Inc
:,.
Shingle Re-roof continued :. .
4
Schap er Roofing Conan en t to Qvali6
*All work shall be carefully supervised and completed by workmen skilled and 14nowledgeable. in methods,neecled to
produce high quality work.
*The job it shall be kept dean daily for the duration of the job and the grounds shall be left clean of all roof related
debris after completion.
6 The yard shall be swept with a magnet
•The contractor shall provide permit, workman compensation, and general habilih”insurance.
*Carpentry, authorized change orders and work, which are not covered under the scope of work outlined het ern, shall be
performed on a time and material basis unless otherwise agreed upon.
MANUFACTURER & CONTRACTOR WARRANTY (5) .
Upon completion of the work and payment of all monies owed, Contractor shall issue:
1. A L: _ year warranty for workmanship limited to leaks caused by any component installed by the contractor.
2. Shingle manufacturer shall provide a vest limited 14
n - -------
CONTRACT PRICING
Pr
I 'Visible T & 1M All owance------- ---- ---:-:--------- -- - :IL:- -- ----- - - - - ------- -- SI .: ,- - 7 • --- 1
1 Shingle Re-roof as degcribed herein S
1 rviodificatiOnS $ 1 ."
------
$ --7—
1
' I -
1 TOTAL AGT<EIT1- 'UPON Comp...ACT PRICE, LidiOR AND MATERUI,- ._
--___L.________i
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, , .. . _..,
,
:
._____ ___
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1 - - , . : Price Valid al" Thirty (13(') Dzy 7-
Collection costs ifany. together with intereRt thall be added to the contract pric e if payment default ),-.Cur
Cancellation of the contract after the 72-hour grate period shall incur a nominal fee.
, . ..
1 /
Schvei Roc. Jr v:. Repffsentafive
1
I accept the above rice and terin5. yogI tirk 3 f.t.riZed tr../ beffii A . q 11 " 1. !
Sigtied . „,.. , '11 /2----7, Dal P
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Pa'ee :: :'.!:•.,-:
,..,
' •••^ (4 28 2000 1 5:02 /ST . 1 5 : 01 /N.. 751 8748788 P 2
ASPHALT SHINGLES 2007 FBC PRODUCT APPROVALS
MANUFACTURER ' PRODUCT TESTS PASSED MIAMI -DADE FL it
LESS THAN 110 MPH 110 MPH AND HIGHER
ASTM ASTM TAS ASTM ASTM TAS
D 3161 07158 107 03161 07158 107
CLASS O CLASS G 4 CLASS•F CLASS G
CERTAINTEED CLASSIC HORIZEN X 5444.1
CARRIAC E HOUSE X 5444.1
C£NTEN 4IAL SLATE X 5444.1
GRAND MANOR X 5444.1
LANDMARK X 4 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
CAMEL& ' X 10124:1
CAPSTONE • X 10124.1
COUNTFY MANSION X 10124.1
GRAND CANYON X 10124.1
GRANO SEQUOIA X 10124.1
GRAND .o LATE X 10124.1
GRAND - IMBERLINE X 10124.1
TIMBER/ INE ARMORSHIELD II X 10124.1
TIMBER/ INE PRESTIQUE GRANDE X 10124.1
TIMBERLINE PRESTIQUE 30 X 10124.1
TIMBER/ INE 30 X 10124.1
TIMBER/ INE PRESTIQUE 40 X 10124.1
TIMBER/ INE 40 X • 10124.1
TIMBER/ INE PRESTIQUE LIFETIME X 10124.1
TIMBER/ INE ULTRA X 10124.1
SLATELI V E X 10124.1
•
OWENS CORNING OAKRID E PRO 30 X 10674.1
OAKRID t' E PRO 30 AR X 10674.1
OAKRID E PRO 40 . • ' X 10674.1
OAKRID E PRO 40 AR X 10674.1
OAKRID PRO 50 X 10674.1
OAKRID E PRO 50 AR X 10674.1
DURATI o N X 10674.1
DURATI PREMIUM X 10874.1
CLASS I ( X 10874.1
CLASSII AR X 10674.1
SUPRE E X 10674.1
SUPRE EAR X 10674.1
PROMI NCE X 10674.1
PROM/ NCE AR X 10674.1
BERKS IRE X 10674.1
WEATH. R GUARD HP X 10674.1
J GLASS ' EAL AR X % 1956.2
ELITE G • SS SEAL AR X 1956.1
1966.3
HERITA. E XL X 1956.5
HERITA E 50 X • 1956.4
HERITA. -E VINTAGE AR X 7154.1
• - ^"•^ 4.4 29 2009 15:02 /ST. 15:01 /No. 7518749788 p
•
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
D 3161 0 7158 107 0 3161 0 7158 107
CLASS O CLASS G 44 CLASS CLASS G
CERTAINTEED CLASSIC HORIZEN X 5444.1
CARRIAC E HOUSE X 5444.1
CENTEN DIAL SLATE X 5444.1
GRAND MANOR X 5444.1
LANDMARK X _ 5444.1
4. 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
COUNTFY MANSION X 10124.1
GRAND CANYON X 10124.1
_GRAND SEQUOIA X 10124.1
GRANO SLATE X 10124.1
GRAND `IMBERLINE X 10124.1
TIMBERI INE ARMORSHIELD II X 10124.1
TIMBERI INE PRESTIQUE GRANDE X 10124.1
TIMBERI INE PRESTIQUE 30 X 10124.1
TIMBERI INE 30 X 10124.1
TIMBERI INE PRESTIQUE 40 X 10124.1
TIMBER! INE 40 X 10124.1
•
TIMBERLINE PRESTIQUE LIFETIME X 10124.1
TIMBER' INE ULTRA X 10124.1
SLATELI VE 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 10674.1
CLASSIC X 10674.1
CLASSIC AR X 10674.1
SUPREh E X 10674.1
SUPREh E AR X 10674.1
PROMINENCE X 10674.1
PROMINENCE AR X 10674.1
BERKSh IRE X 10674.1
WEATHER GUARD HP X 10674.1
GLASS SEAL AR X 1956.2
ELITE GLASS SEAL AR X 1956.1
HERITAGE XL X 1956.5
HERITAGE 50 X 1956.4
HERITAGE VINTAGE AR X 7154.1
01/11/2010 12:36 FAX al001/001
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• -JURISDICTION : OF YOUlt.CHOICE. •
• . : 'BUILDING 13EPAR.TMENT . ••
• . .
.. . .
RE: Permit # cr 8 S 0 • . . 9/17/07
• .
. • . •
• Inspection AffidaVit • • . •
. ,
. . •
• •
. . . -
.1 Pam. I '3c..bait', e. Y ' ,licensed as a(n) Contractor* /Engineer/Architect,
. (please print name and circle Lic. Type) . TS 468 Building Inspector* •
•
. -
License 4i; • C.Cco58 , i Si4 • . . .
- .
- - On or .-101. kJ i 1 20 t 0 ' , I did personally inspectthe roof'
(Date & time) . .
-------,--___. .
cnailink and/or secondary water barrzerwt •
,
(circle one) - (Job Site Address). .
r*
. 3.8 4 t t..,/e. eG 2, ee kJ NA L.I. A G.E. D r -
•
•
Based upon that examination I have determin ed the installation was done according to the
• Hurrican , 6 I ti: : on Retrofit Manual (Based on. 553.844 F.S.)
NA% 11 - • .
Sigiaatur li ' . .
. ,
•--,... •
• STATE OF FLORIDA
COUNTY OF
1
• Sworn to and subsribtd 1 me this 1 I: day, of Zgakote.q . 209. E010
It By .
. • : Notary Public, State of FloriAa
. ' ' v ' — ' S117.kliNEDOUGLAS-ALLEN
' - '''''''''''''''';'', Holary Public • State ot Florida
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Perscmally kuown or :;, sor,dcerrtmrousgt;';'Y 1-1Nstional4171.41o4tary19Assn - •
Produced Identification I
Type of identification produced. • - •
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* General, Ehdlding, Residential, or Roofing Contractor i:n any individual certified under 468 F.S. to mak* such an
inspection. Include photographs of each plane of the roof with the permit # or address # clearly shown romrir*d on the
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