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HomeMy WebLinkAbout09-8982 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 8982 BUILDING PERMIT ®.a . ' ?� .:v�d���°"`�`��` �`'".,ws�' j z:7 7 .8 ? . a: �."�. - - a x� � a � �. 'z # � y e S # ""3 ° S .� � �` ` 7 rt:; Permit Number: 8982 Address: 5247 6TH 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: 11- 26 -21- 0010 - 13200 -0080 Improv. Cost: 10,500.00 x ,% 7 1 == w = V I .. 1, Date Issued: 4/03/2009 Name: STANLEY, MARTHA Total Fees: 127.50 Address: 5247 6TH ST Amount Paid: 127.50 ZEPHYRHILLS, FL. 33542 Date Paid: 4/03/2009 (� Phone: (813)469 -8934 Work Desc: REROOF 30 YR �.8.1�( € WA NEUMANN CONSTRUCTION INC REROOF RESIDENTIAL 127.50 0' 6 DRY IN ROOF INSP TAPE JOINTS INT 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 otice of commencement" „Air 4 4 /t CONT CTOR SIGNATURE PERMIT OFFI FR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER Honda Building Uocle Online rage 1 of z Ii y rr1.0A DI PAPTMESIAiT OF . e F OCA HOME -ABOUT DCA DCA PROGRAMS CONTACT OCA Home Log In '. User Registration , Hot Topics Submit Surcharge ' Stets & Facts !, Publications ! FBC Staff BCIS Site Map Links Search AIM d 0 7- 1_ j Product Approval val c y l r, ' is USER: Public User J` C Ertl m u111 ty C..•W - y' Affairs Product Aoorovel M en u > Product or Application Search > Application List > Application Detail FL # FL6895 -R1 1 COMMUNITY PLANNING Application Type Revision "It) JSIr4 4 MMRAI TY„ Code Version 2007 oEVE4GPtAENT ►tiiar;ENCY Application Status Approved MANAGEMENT Comments r OFFICE OF THE Archived &ECRETN Y Product Manufacturer UNION CORRUGATING COMPANY Address /Phone /Email 701 S. KING ST. FAYETTEVILLE, NC 28301 (910) 483-0479 Ext 248 jthomton @unioncorrugating.com Authorized Signature Jason Thornton jthomton @unioncorrugating.com Technical Representative Address /Phone / Email Quality Assurance Representative Address /Phone /Email Category Roofing Subcategory Metal Roofing Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report - Hardcopy Received Florida Engineer or Architect Name who Bala Sockalingam developed the Evaluation Report Florida License PE -62240 Quality Assurance Entity Keystone Certifications, Inc. Quality Assurance Contract Expiration Date 12/31/2011 Validated By Yoosef Lavi, P.E. Validation Checklist - Hardcopy Received Certificate of Independence FL6895 R1 COI Certificatelndependence.pdf Referenced Standard and Year (of Standard) Standard Year UL 1897 1998 UL 580 1994 Equivalence of Product Standards Certified By Sections from the Code http : / /www.floridabuilding.org/pr /pr_ app_ dtl. aspx? param= wGEVXQwtDqu4Bg7NfwG9nc... 4/2/2009 rionaa Dunamg l,oue un1me r GIgc G 01 L. Product Approval Method Method 1 Option D Date Submitted 08/18/2008 Date Validated 08/26/2008 Date Pending FBC Approval 09/15/2008 Date Approved 10/14/2008 Summary of Products FL # Model, Number or Name Description 6895.1 2 -1/2 Corrugated Panel Min 26 ga., 21" wide through fastened panel Limits of Use Installation Instructions . Approved for use in HVHZ: No FL6895 R1 II C1605 1.pdf Approved for use outside HVHZ: Yes Verified By: Bala Sockalingam, P.E. PE 62240 Impact Resistant: N/A Created by Independent Third Party: Yes 1 Design Pressure: + /A/ 129.25 Evaluation Reports Other: 129.25 psf @ fastener spacing of 24" oc FL6895 R1 AE EvaluationReportC1605 1.pdf Created by Independent Third Party: Yes 1 6895.2 15V Min 26 ga., 24" wide through fastened panel Limits of Use Installation Instructions Approved for use In HVHZ: No FL6895 R1 II C1605 2.pdf Approved for use outside HVHZ: Yes Verified By: Baia Sockalingam PE 62240 Impact Resistant: N/A Created by Independent Third Party: Yes Design Pressure: +N /A/ -66.3 i Evaluation Reports Other: 66.3 psf @ fastener spacing of 12" oc FL6895 R1 AE EvaluationReportC1605 2.pdf Created by Independent Third Party: Yes • I Back 1 1 Next DCA Administration Department of Community Affairs Florida Building Cods 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. Coovrioht and Disclaimer Product Approval Accepts: e r seeerW _ y .0111.7. ' �__— http: / /www.floridabuilding.org/pr /pr_ app_ dtl. aspx? param= wGEVXQwtDqu4Bg7NfwG9nc... 4/2/2009 *MAW/ 1101-NO OW OM llib sir ..• O Imo LO[% 913IML13AYJ $ !, Z V002-S I-a me6uxmrxs WS 4..0 T14 I KIflOS l LL MVO 31A71 31A71 3NON e3 r /�y � Y dll� O ✓ d �ro j i a u a ma ^ �. 9MLY DI03 MOM e L N W IN D Cn w W D ■ CC CL w `° c - I_ °- Al f U _ 1 i 0 . 0 W N \ z= D .._ cp LLI z �\ z z \ Q \ O Q if cr) a� 0 �� J Y o Q o Lu Li w '� E E E ..-4 ¢ cra 0 i r @j \ ; `� > CN Z z p w LU -' q a Nw 3QZo cL Ld z z Q meo� Ld _, \ • z �\ z 1 1 w ui z 2 z 0 W 0 CC Lij in Z z I J Z I J LL W a N N W ecUa • A ter f. 11/ rte •• ••..••-• , . - . City of Zephyrliills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: 40 id 2 C._n CA'"S c'` (C.0.,-, Date Received: *- 2 1b c Site: 52.4 7 (off 6 -- rem Permit Type: VA:LW r Ob T' Approved w /no comments: Approved w /the below comments: ❑ Denied w /the below comments: ❑ This co j -n s - shall be kept with the permit and/or plans. at / —3 -- /1 lir Kalvi wi er — ' • s Examiner Date Contractor and/or Homeowner (Required when comments are present) 813-780 -0020 City of Zephyrhills Permit Application weq lax- 813 - 780 -0021 Building Department Date Received Phone Contact for Permitting -- Owner's Name ffi9' / GE Owner Phone Number 6l3 - ' / 9 - g -?/ Owner's Address 52 Y7 0 51 Owner Phone Number 0? -1/ Y - 6 0-7 6 Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS Z V7 t� S� LOT # SUBDIVISION PARCEL ID# t( 6- 21/ —Ol D 1320 0 — 0o9a (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR Fl ADD /ALT I I SIGN 1 I MOVE n DEMOLISH INSTALL REPAIR PROPOSED USE I SFR 1 1 COMM 1 1 OTHER TYPE OF CONSTRUCTION I I BLOCK I I FRAME I I STEEL I I OTHER I DESCRIPTION OF WORK g"° BUILDING SIZE SP SQ FOOTAGE ?3 HEIGHT 2 — Srbl e y BUILDING $ /Di mad VALUATION OF TOTAL CONSTRUCTION 1 ELECTRICAL $ AMP SERVICE [] PROGRESS ENERGY I I W.R.E.C. I I PLUMBING $ F MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION 1 GAS rd ROOFING 1 1 SPECIALTY 1 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA ( IYES ( INO 1 BUILDER // \" COMPANY ti/ 4 /�'�!/�1� l`�Cd''if�'��`�i�i✓ SIGNATURE / REGISTERED 1 Y/ N I FEE CURRENT 1 Y/ N 1 Address /ZG?' c d/C EY, ';. frt /o�s,,�.✓ifNrltAfi% F 3.32.r7,5 License # < (3 Z C / b fi ELECTRICIAN COMPANY SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y/ N 1 Address I License # PLUMBER COMPANY SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y/ N 1 Address License # MECHANICAL COMPANY SIGNATURE REGISTERED 1 Y / N 1 FEE CURRENT I Y/ N Address 1 License # OTHER COMPANY SIGNATURE REGISTERED 1 Y/ N ] FEE CURRENT I Y/ N I Address I 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) 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 1 have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. CONTRACTOR'S /OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: - Department of Environmental Protection- Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. Southwest Florida Water Management District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers - Seawalls, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services /Environmental Health Unit - Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency- Asbestos abatement. Federal Aviation Authority- Runways. I understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone "V" unless expressly permitted. If the fill material is to be used in Flood Zone "A ", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117.03) OWNER OR AGENT CONTRACTOR Subscribed and sworn to (or affirmed) before me this Subscribed and sworn to (or affirmed) before me this by by Who is /are personally known to me or has/have produced Who is /are personally known to me or has /have produced as identification. as identification. Notary Public otary Public Commission No. Commission No. — Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped • Koc , Inc. RESIDENTIAL • MOBILE HOME • COMMERCIAL 12630 Curley Street, Suite 104 • San Antonio, FL 33576 Phone: 352 -588 -0910 • Fax: 352 -588 -0911 LIC# CBCO58155 - LIC# CCC1326166 www.neumannroofs.com March 13, 2009 Re: Re -Roof Proposal (METAL) Jim Rife 5247 6 Street Zephyrhills, FL 33542 813- 714 -6076 /gi - ( 16f -8g31 mrife2@tampabay.rr.com Neumann Roofing, Inc. proposes to furnish all the labor, material, supervision, equipment, fees and other costs to complete the project located at the subject property according to specifications listed below: 1. Record NOC and pull all permitting required. 2. Tear -off existing METAL roof systems down to deck substrate and re -nail roof deck to meet State Of Florida Building Code. 3. Install a 30# felt underlayment system over existing shingle roof system to serve as a barrier between existing and new proposed metal roof system. 4. Install new metal drip edge to match color of new installed roof system. 5. Remove existing furnaces /chimneys below finish roof elevation. 6. Install a new complete Union Master Rib 29 -guage roofing system on main roof. Color: GALVALUME 7. Roof system includes: Union 5V crimp roof panels cut to length, ridge cap, rake trim, transition flashing metal, 6" T -style eave drip, and valley metal; all of matching material finish and color. 8. Haul away all roof - related debris. 9. Our liability insurance coverage is based on completed operations. 10. Provide a 5 -year workmanship warranty. 11. Provide a 30 -year manufacturer's warranty against rust /corrosion of metal. 12. Payment schedule: Full amount at job completion FL. Contractor #: CCC1326166 GAF -ELK License #: ME12709 IIIasEllte mrnmela 12630 Curley Street. Suite 104• San Antonio • Florida • 33576• Ph: (352) 588 -0910 • Fax: (352) 588 -0911 U N Rpofiu Inc RESIDENTIAL • MOBILE HOME • COMMERCIAL 12630 Curley Street, Suite 104 • San Antonio, FL 33576 Phone: 352 -588 -0910 • Fax: 352 -588 -0911 LIC# CBCO58155 - LIC# CCC1326166 www.neumannroofs.com It is understood and agreed the Neumann Roofing, Inc. will be held harmless for alleged or actual damages /claims as a result of algae, fungus, or mold. It is understood the roofing contractor and the roofing contractor's insurance will exclude all coverage, including defense, damages, related to bodily injury, property damage and clean up directly or indirectly in whole or in part for any action brought by mold, including fungus and mildew regardless of the cost, event, product or workmanship that my have contributed concurrently or in any sequence to the injury or damage occurs. Neumann Roofing's Commitment to Quality: • All work will be supervised by project managers to ensure quality work is preformed according to our proposed contract. • All carpentry work will be performed in conjunction with roofing work, in a timely manner. • All work will be completed by skilled and knowledgeable craftsman to ensure production of high quality of work. • The job -site will be kept free of debris throughout the duration of the project. • The perimeter of the project area will be swept with magnets to pick up any loose nails, staples, or other various scrap sheet metal components. • Neumann Roofing, Inc. is fully insured with workman compensation and general liability insurance. GAF;I : h j FL. Contractor #: CCC1326166 GAF -ELK License #: ME12709 Me�Elite 12630 Curley Street• Suite 104• San Antonio • Florida • 33576- Ph: (352) 588 -0910 • Fax: (352) 588 -0911 e • N Ana 7 ,I c RESIDENTIAL • MOBILE HOME • COMMERCIAL 12630 Curley Street, Suite 104 • San Antonio, FL 33576 Phone: 352 -588 -0910 • Fax: 352 - 588 -0911 LIC# CBCO58155 - LIC# CCC1326166 www.neumannroofs.com Options: 1. Include front porch in re -roof process of tearing off the existing and installing a matching roof system as previously proposed. $900.00 P7 6S'/C 2. Upgrade from 29 -Ga e Painted MasterRib to a 26 -Gage Painted MasterRib. $350.00 Im7 g S 3. Cut back existing rafter tails on shingled roof a proximately 6" to remove rot and install new 1 "x6" wood fascia. $350.00 fh 6S / *this option is necessary (broken out per Mr. Rife's request). Unit Pricing Schedule for unforeseen conditions: 1. Replace any rotted or damaged decking $75.00 per sheet. (Neumann Roofing provides 1 -sheet of 4'x8' plywood; included in contract price). 2. Replace any rotted fascia or perlins $4.50 per lineal ft. Total: $(8,900.00) Upgrades: $ .00 �� %) ^ ��2�0 Final Total: $ 10 5 00 .00 • 100% payment due upon job completion. • Our proposed price is valid until March 25, 2009; after which prices are subject to change. Accepted By: Neumann Roofing, Inc. 117 avuk Arta-,4 -- f--4,' Date: 3 —) 6 - `0 1 Date: P +�t:tt: FL. Contractor #: CCC1326166 GAF - ELK License #: ME12709 MasiKElite 12630 Curley Street- Suite 104- San Antonio • Florida • 33576- Ph: (352) 588 -0910 • Fax: (352) 588 -0911 STATE OF FLORIDA, � : ,CO 11111111111! 1111111111111111111111111111111111111111 THIS IS TO CERTIFY TN " 1w tS A 2009039256 TRUE AND CORRECT ' CO 11 i " ON FILE OR OF PURR" E W TNESS MY HAND D s CIAL SEAL H1. .3% • Rcpt : 1233448 Rec: 10.00 DS: 0. 00 IT: 0.00 Ord DAY 05 'el f ` , • 2 r4rly�'' 03/23/09 Dpty Clerk PAULA S. O'NEIL, L RK.: 'COMPTROLLE- . BY ,, e_, . , �, :�� �../ DEPUTY C'L RK NOTICE OF COMMENCEMENT PAULA 5. O'NEIL, PASCO CLERK & COMPTROLLER Permit No. 03/23/09 8 1218 1 o PG 85 Property Identification No. 11- 26 -21- 0010- 13200 -0080 THE UNDERSIGNED hereby give informs you that the improvement will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. CITY OF ZEPHYRHILLS PB 1 PG 54 LOTS 8 & 9 & N1/2 LOT 10 BLOCK 132 1 _Description of property (legal description) a) Street Address: 5247 ATH STRFFT 7FPHYRHII I F Fl 33542 2.General delscription of improvements: TFAR -OFF FXISTINC3 MFTAI ROOF ANTI INSTAI I NFW 5V MFTAL CRIMP•MFTAI ROOF SYSTFM 3.Owner Information a) Name and address: STANLEY, MARTHA B; 5247 6TH STREET, ZEPHYRHILLS, FL 33542 b) Name and address of fee simple titleholder (if other than owner) Fee Simple Titleholder c) Interest in property Fee Simple Titleholder 4.Contractor Information � a)Name and address: W.A. Neumann Construction, Inc. —12630 Curley St., Ste. 104; San Antonio, FL 33576 CC b) Telephone No.: 352 - 588 -0910 Fax No. (Opt) 352 - 588 -0911 .Surety Information a) Name and address: N/A b) Amount of Bond: c) Telephone No.: Fax No. (Opt) 6.Lender a) Name and address: N/A 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 713.13(1)(b), Florida Statutes: a) Name and address: b) Telephone No.: Fax No. (Opt.) 9.Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is specified): WARNING TO OWNER: ANY PAYMENTS MADE BY 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 LNSPECTION. 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 a_ i/ • i Signature of Owner or Owner's Authorized ger • Prim Name The foregoing instrument was acknowledged before me this 16 day of 0 , 20 67' , by as ( • f .g. officer, trustee, attorney in fact) for (name of party on behalf of w as executed). Personally Known OR Produced Identification Notary Si " terry gnatur , Type of Identification Produced FLORIDA} AgWWERS ItC6IS[ Name (print) U.� /eL .0i,e of Oi - 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. DANIEL RAY BONEBRAKE, JR. Notary Public, State of Florida X 1290,vtlex, Fd7RM511pC ,vsd1O07 ` Commission No. DD798045 $ 21 %ignatere of Natural Person 5igmng Above • . . . i O CO, ID * '` i�ii�+ '`. PASCO COUNTY FLORA 18 a :r Building Inspection Division 4 oRto RE: Permit# 89 Fi Form: 10/01/07 '/ Inspection Affidavit 1 , "1 kill/04d , licensed as a(n) Contractor */Engineer /Architect/FS 468 Building Inspector* License #: LCe/3Zti‘j On or about X'7 , did personally inspect the Roof Deck Nailing r Secondary Water Barrier (C ire e one and/or both) At the following address: ..1 61e 5r z646 FL 3 3f3fz (Job Site Address) *********************************************** * * * * * * ** * ** ** * * * * * * * * * * * * ** * * ** Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) I have included photographs of each plane f the roof for each inspection, with the permit # clearly shown marked on the deck. 4 2 2 ' �C� t G - 4 -Zw t a —om Signatu STATE OF FLORIDA COUNTY OF P , lSi o Sworn to and subscri before me this fi t ( day XI / , 20t " f By ,/ C /.N.1,/ , Notary Public Sate of Florida DANIEL RAY BONEBRAKE, JR. 1� Notary Public, State of Rorida (Print, type or stam . •,' ' ' ' ; My won Expires AIM 15, 2012 Commission No. DD798045 Commission No: Personally know or Produced Identification Type of identification produced: *General Building, Residential, or Roofing Contractor or any individual certified under 468. F.S. to make such inspection.