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HomeMy WebLinkAbout09-9181 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9181 BUILDING PERMIT Permit Number: 9181 Address: 38026 14TH AVE 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 - 02800 -0010 Improv. Cost: 2,572.18 :FM g z; ; .7. 7.7 e: `;. -.`., `. Date Issued: 6/01/2009 Name: WATSON, SALLY Total Fees: 45.00 Address: 38026 14TH AVE Amount Paid: 45.00 ZEPHYRHILLS, FL. 33542 Date Paid: 6/01/2009 Phone: Work Desc: RE -ROOF SHINGLE - 13 SQS 0 : ; s . "7:7 . t. .. MILBAR CONSTRUCTION REROOF COMMERCIAL 45.00 V 'C DRY IN ROOF 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." ar 4 1 /I Ar CO RACTOR S GNATURE PERMIT OFFI Fr R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 06/01/ 13:49 3525674454 MILBAR PAGE 01/01 813 -780 -0020 City of Zephyrhills Permit Application Fax -813- 780.0021 - Building Department Date Received I J Phone Contact for Permitting 1 n1 - I. tees Name 21 I Owner Phone Number S .-1 . • - .. Owner's Addre s Owner Phone Number Fee Simple Titleholder Hamel If 1 I Owner Phone Number ( Foe Simple Titleholder Address 1 N (A • 1I JOB ADDRESS I AR 07_42_ 14 /G/rntnt ;1< 7rirt yr1 \ 3g44z 1 LOT* 11, /J l t' 11, Z, 3 1 SUBDIVISION 1 1 PARCEL ID# I /! 0 G a2 /' TiD/G � -- �� (OBTAINED FROM PROPERTY TAX � t E1 WORK PROPOSED NEW CONSTR s ADD /ALT Q SIGN Q MOVE f• DEMOLISH B INSTALL REAI r PROPOS USE ED SFR Q COMM d OTHER 1 Re. I . TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL r OTHER r I � —\ !� ' i c sh:o.4t, F 4 t 544 , �- � \ I DESCRIPTION OF WORK 1 Shwlgt< t:e,Q<a "Sr 1 artl X' t< 2.'S `) 1 , . � BUILDING SIZE I SQ FOOTAGE I HEIGHT 1 ; I qi � Ir BUILDING S VALUATION OF TOTAL CONSTRUCTION I ?S 7Z.10 Q ELECTRICAL IS AMP SERVICE Q PROGRESS ENERGY 0 W.R.E.C. r n , l �i 0� � . 1 1 PLUMBING IS ` �-► ED MECHANICAL S ' VALUATION OF MECHANICAL INSTALLATION 13 , ✓n / Q GAS ©-- ROOFING SPECIALTY Q OTHER I 1412 FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA r]YES NO l g"O ( / / //� /� COMPANY I MI I' • r eonsIruG'�1 Zre SIGNATURE / l ,a-<-4 YIJ/�`�(- / REGISTERED a N FEE CURRENT N l Address 1 15q►I UP So) 'Dade C.145 33 33 1 License# I erc051 V - ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I I FEE CURRENT ' Y / N I Address I U License* PLUMBER COMPANY 1 SIGNATURE _ REGISTERED I Y/ N l l FEE CURRENT I Y/N I Address I l LiCenae It I MECHANICAL COMPANY 1 rr,NATURE REGISTERED I Y / N _1 FEE CURRENT I Y / N I Address 1 License # 1 OTHER SIGNATURE REGISTERED I I Y1 N _I FEE CURP.SNT I Y l N 1 Address I ,I License# I .A RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy f=orms Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms, Minimum ten (10) working days after submittal date. Required white, Construction Plans, Sanitary Facilities 8 1 dumpster All commercial requirements must meet compliance, SIGN PERMIT Attach (2) sets of Engineered Plans. *PROPERTY SURVEY required for all NEW construction. ructions: FIJI out application completely. Owner & Contractor sign back of application, notarized If over $2500,a•Notice of Commencement Is required. (A/C upgrades over $5000) '< Agent (for the contractor) orPdwer Attorney (fdrthitaNner) would be someone with notarized ietterfromowner authodzing same ' OVER THE COUNTER�isERNITTING • ,( of Appiltaliofl Only) Reroofs Sewef8 'Service Upgrades : A/C Fences (Plot /Survey/FOotage) • i F Driveway's -Not over Counter If on public rosdways skids ROW 81$ -180 -0020 City of Zephyrhills Permit Application Fax- 813 - 780 -0021 Building Department Date Received Phone Contact for Permitting ier's Name Owner Phone Number Owner's Address ME ,11111.11/N Owner Phone Number Fee Simple Titleholder Name 1 )1% Owner Phone Number Fee Simple Titleholder Address }J IP JOB ADDRESS Url j -Y- AveintoX . 7(h\ t.„ LOT# !, Z, 3 SUBDIVISION PARCEL ID# I i..h (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT n SIGN n MOVE n DEMOLISH INSTALL RE PAI PROPOSED USE Q SFR n COMM I✓r OTHER I ' . TYPE OF CONSTRUCTION n BLOCK 1 1 FRAME n STEEL n OTHER DESCRIPTION OF WORK hwtl� �0 1� ASS+ (the .� n�t� �1 X� 25 ZJ < ��l �vv� fl.-* 54 -1 BUILDING SIZE SQ FOOTAGE HEIGHT I BUILDING $ VALUATION OF TOTAL CONSTRUCTION I ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY 1 ( W.R.E.C. r PLUMBING $ MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION GAS ROOFING 1 1 SPECIALTY n OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA FIVES [ NO g,H{tp� SIGNATURE �/ /'�/ COMPANY f r t � � r.S�l� l�l�'1a71' I,tCTI D �r (�/( REGISTERED N FEE CURRENT KA N Address I 1 5 0 0 1 (4 & 1 Q C G i l l 3 3 3 License # I l OEW5 g, ELECTRICIAN COMPANY SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N Address I License # • PLUMBER COMPANY SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT I Y/ N 1 Address I License # MECHANICAL COMPANY r EiNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N Address I 1 License # I OTHER COMPANY 1 SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y / N 1 Address I License # RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. SIGN PERMIT Attach (2) sets of Engineered Plans. * ** *PROPERTY SURVEY required for all NEW construction. rections: 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 (Plot/Survey /Fbotage) 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 - i 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 a 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, certify that 1, 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 I hereby made to obtain a permit to do work and installation as indicated. 1 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. t 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 t 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 I 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, OWNER OR AGENT /_-/f /. CONTRACTOR L /�/, / 1 \ CA '� Subscribed ands n to (or affirmed) afore affirmed) before me this G��110`) by J1t iz H me this Subscribed and swo n to (or a bta 1 ... O. �e Who is /arersonally known to or has /have produced Who is /ar- personally known folyle or has /have produced as identification. as identification. • i 61 /i 9 k Notary Public Q ° .(/ f� " Notary Public Commission No. ., " "' "� r � Commission No. • �. �.' • lE . 4 •�i ao o, • • co.ma�e :1 ` ,,.009 • Name of Notary typ .. . • L ; - � , • . *a se , ► " -tamp , :miaK1M Name of Notary typed, printed . • 14- 110011DI ROUON ► PI t4Nr*M CII C04064 ► t;? W MIIIUNCS COMr Nif L• • .u.uA.A. yam.... ► r ............ Page No. of 2 rages ______ _ Proposal lit • Msint" er of the Florida State Certified – Roofing and Sheet Metal R oofer #CCCO51562 Association RCI Registered co MilBar Construction, Inc. Roof Consultant #0149 Roofing • Concrete • Commercial • Residential 1 15911 US Hwy. 301 North • Dade City, Florida 33523 l 352/567 -6047 • 800/562 -2393 • FAX: 352/567 -4454 I PROPOSAL SUBMITTED TO PHONE DATE 352/567 -2680 r, o . a STR ' • • JOB NAM CITY, d;? - • . JOB LOOATIOFIQN PRQPERTY :, - - - ARC "" ► DATE OF PLANS JOB PHONE I . • -- ------ 2FPH,YRHTLLS FL __, We hereby submit specifications and estimates for: j SHINGLE RE -ROOF 1. Tear off and haul away existing one -layer shingle roofing system. 1 2. Re- fasten the existing plywood roof deck in accordance with the 2007 Florida Building Code. 1 ' 3. Provide and install two layers of new 15 lb. saturated felt paper,secor'�tary water barrier in accordance with 2007 Florida Building Code. 4. Provide and install new CERTAINTEED 'r XT 25" 25 -year 3 -tab wi streak- fighter - �� ! ( g � g al ae- resistant fiberglass shingles; Miner to select shingle color from CERTAINTEED`s standard colors. Shingles have a 25 -year limited warranty from i i IA/ t_5.6.0i \01 CERTAINTEED. n ve . `rc conditioning v heating, ventilating, air g o I ' 5. Replace all valley flashif� and he g, g. and a t 6. Provide and install new lead boots for the plumbing vents. 7. Provide and install new pre- finished aluminum eavedrip (white or brown). , 8. Repair /Replacement of any rotten or damaged wood (deck, fascia, trim, framing, etc.) will be completed on a cost -plus basis above and beyond the contract price. . 9. MilBar Construction, Inc. to provide a 5 -year workmanship warranty to the original purchaser that covers shingle roof leaks; exclusion s: storm dame g e , work done or damage by others, tree damage, and /or structural damage to roof deck. II j ill e 3, rn n8e hereby to furnish material and labor — complete in accordance with above specifications, for the sum of: - S EE f��16E TIJt dollars ($ ) Payment to a made as oilows: I Invoiced amounts not paid in accordance with tff6 payment terms shall be considered delin- Authorized f�/ 4 quent and bear interest at the rote of one and'one -half percent per month. Owner agrees to Signature ccc/// !!! pay all costs incurred, such as attorney fees, collector fees, court costs, etc., for collection of delinquent invoices including interest. Owner to carry fire, tornado and other necessary Note: This proposal may be 30 insurance. Our workers are fully covered by Workman's Compensation Insurance. withdrawn by us if no pted within days. c Ara taxtce of Proposal � —Th abov prices, specifications and conditions are satisfactory and hereby accepted. You are authorized Signat - ./. .. - -"Alf' Af II to do the work as specified. Payment will be made as outlined above. Date of Acceptance: Signature / '' - Proposa _ P No 2 of 2 Pa — No. .,eer of the Florida State Certified rkrofing and Sheet Metal Roofer #CCCO51562 ll Association RCI Registered CT MilBar Construction, Inc. Roof Consultant #0149 Roofing • Concrete • Commercial • Residential 15911 US Hwy. 301 North • Dade City, Florida 33523 352/567 -6047 • • 800/562 -2393 • • FAX: 352/567 -4454 PROPOSAL SUBMITTED TO PHONE 352/567 -2650 DATE il WATSfN, SAI t Y R13/390—R377 CELL 05/20/09 ,, STREET JOB NAME ' 13SSQ) 11TH STRFFT WATSON PROPERTY II I, ' CITY, STATE and ZIP CODE JOB LOCATION I I ',j DADE CITY. FL 33525 38026 14TH AVENUE 1 ARCHITECT DATE OF PLANS JOB PHONE ZEPHYRHILLS, FL 1 We hereby submit specifications and estimates for: l ' 10. Owner to provide access to roof for delivery truck for loading /unloading for roofing materials. 11. MilBar Construction, Inca to provide General Liability and Worker's Compensation Insurance ($2,000,000 limit) and re— roofing permit. 12. OPTIONS a. SSh nalwiiU0i 63^:e ds. �,/ Provide and install new CERTAINTEED .Landmark" 30 —year laminated dimensional iii 4t P shingles with streak — fighter (algae — resistant) in lieu of CERTAINTEED .XT 25" 1 , 1 25 —year 3 —tab with streak— fighter ( algae — resistant) fiberglass shingles. ADD $4$#;27 to the contract price. b. Rith1e::Vent. Provide labor and materials to install W 1.f. of new pre — finished aluminum ridge vent. ef fif ADD $80 OO to the contract price. I LI I. �/ ill E PrOpOSe hereby to furnish material and labor — complete in accordance with above specifications, for the sum of: 1, TWO THOUSAND FIVE HUNDRED SEVENTY —TWO AND 18/100— dollars($ 2,572.18 Payment to be made as follows: DUE UPON COMPLETION. Invoiced amounts not paid in accordance with the payment terms shall be considered delin- Authorized quent and bear interest at the rate of one and one -half percent per month. Owner agrees to Signature 4 ' „L� , H a all costs incurred, such as attorney fees, I e ees collector t fees, court costs, etc. for collection pay Y � n o of delinquent invoices including interest. Owner to carry fire, tornado and other necessary Note: This proposal may be 30 insurance. Our workers are fully covered by Workman's Compensation Insurance. withdrawn by us if not ac • .ted within days. c iArre�tan —The above prices, specifications re of Proposal ' /` and conditions are satisfactory and hereby accepted. You are authorized Signat y- - _ �• 1 to do the work as specified. Payment will be made as outlined above. r': Date of Acceptance: Signature \- - 07/20/2007 11:25 727 -453 -3358 D.R.S. PERMITTING PAGE 01/01 NOTICE OF COMMENCEMENT 111111111111111111111111111111111111111111111111111 11111111 2009075643 /Vii !t it) Z Permit No. Rept : 1245969 Ree : 10.00 Tax Folio No. 11. 2.to - Z1. Oe>lo- 071..E (,?y+s DS: 0.00 IT: 0.00 06/01/09 Dpty Clerk THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section 71 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1.Description of property (legal description): . . , j4 ,i 4h,, h.fi, i'i3 1 4 5 Lail 4 Z ? 3 beu _ �Zy 73 3 rr i'- Bi.2 2- a) Street (job) Address: Ool ,3) 24, t'6 in � —? �D ►.e 6K, It Al c 7 S 2.General description of improvements: A.-/>fi r, S 33ea. /LW. / it 3.Owner Information m $ a) Name and address: loakro n ,Sa 10 , / 551) J)i1 .�1Ytrt �arJc Cal F( ,x ° b) Name and address of fee simple titleholder (if other than owner) N) A. _ c) Interest in property 1) .L M,.-✓^ CO m N 4. tractor Information tO Z a) N and address: Ma di r 4445ret i r. h i' lilt , 1011 a..t 301, lode.. 6 i=t. 33513 513 gym, e b) Telephone No.: 357/51.1. �, ) 7 Fax No. (Opt) . A. Li Z151.7 f - 2 7 Surety Information a) Name and address: On- OE 2 b) Atnount of Bond: 0 c) Telephone No.: Fax No. (Opt.) c 1 6.Lender 0 A. a) Name and address: /t/16, � ' e P No. 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: 03 o a) Name and address: • 61 F pi . b) Telephone No.: Fax No. (Opt.) A 8.In addition to bzznself 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 Cowwmencelnent (the expiration date is one year from the date of recording unl 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 INSPECTION. IF YOU IN7CEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF CO NCEMENT. STATE OF FLORIDA / COMM' OF F 1rstAS t. 10..*� . � A 1 ,. Si! re o Owner j er's o Zed O ICer ircctor/Partner/Menager Print Name / �ij "1?�f' or The foregoing instrument was acknowledged before the this 22... day of mr. , 2009 , by r)a l ( 41 1 / 11,1-1sTl as UW' t,- (type of authority, e.g. officer, trustee, attorney in fact) for . (ce4Si- (name of party on behalf 0 ' hom instrument was executed). Personally Known L. OR Produced Identification Notary Signature j Ar / %a �. r Type of Identification Produced Name (print) t• /;:■ OUVIA A. LOVETT „ ": EMS JUL 282012 Verification pursuant' to Section 92.525, Florida Statutes. Un penalties of pe ,1 dec , e ,. ave reaa ia and t 1 t the facts stated in it are true to the best of my knowledge and belief. , ... ., x . 11 ro&MSMOC,rv,d200? t 2 '° /` �Signa u re of Natural Pey' Signing On line # 10.) Above 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 RE RD IN T'HJS OFFICE WITNES MY HAN N , O �C1A!. BEAL.THIS '�/- CSAY 0 A ►u::..► " 6 PAULA ' O'NEIL, ' EF K & CTS TROLLER BY �� ` - - EPUTY CLERK . z 06/06/2009 08:57 3525674454 MILBAR PAGE 02/02 ?City iof Zephyrh "ills B 1 DING DEPAR Q NT RE: Permit # 9 is; \ 9/17/07 Inspection Affidavit • I �2�� d l�► ,licensed as a(n) Contractor* /Engineer /Architect, (please print name and circle Lic. Type) FS 468 Building Inspector* License #; C.C.0 ost51.2 On or about O( ohti,Dy , I did personally inspect the roof --� - r (JAM & time) ec_k na r are r secondary water ba work at o 2. .t (circle one) (Job Site Address) Based upon that examination I have detennined the installation was done according to the Hurricane • "gation Retrofit Manual (Based. on 553.844 F.S.) Id" Signature STATE OF FLORIDA COUNTY OF Sworn to and subscribed before me this. 5 day of . 2009 By • Notary Public, State of Florida OUVIA A. a 'r COAMNit1oN IO 4e (Prin �� , atom • carrwV Commission No,: Personally known L.. or Produced Identification Type of identification produced. s' General, Building, Residential; or Roofing Contactor or any individual certified under 468 F.S, to make such an inspection. Include photographs of each plane ofthe roof with the permit # or address # clearly shown marked on the . deck for each inspection. 06/06/2009 08:57 3525674454 MILBAR PAGE 01/02 MILBAR CONSTRUCTION, INC. 15911 U.S. 301 Dade City, FL 33523 jo4fo) / O dc.4ctlt 013 -76o - o z Galt 7 'iV Ytit.w r g l d 1 Cc- A J acki t e po)tse_ ca-ti P eiT 35 2. ` .5 60r1 41) h, 1414,44.,>r . Cad, ;AA- you_ �/L I�L� -L �S (.11:31 1 t v Het.4 Ali e .4 R tae4