HomeMy WebLinkAbout09-9345 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 9345
BUILDING PERMIT
Permit Number: 9345 Address: 4803 20TH ST
Permit Type: RE -ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 14- 26 -21- 0010 - 02500 -0020
Improv. Cost: 7,240.00
Date Issued: 7/14/2009 Name: JENSEN, RAY
Total Fees: 70.00 Address: 4803 20TH ST
Amount Paid: 70.00 ZEPHYRHILLS, FL 33542
Date Paid: 7/14/2009 Phone: (813)748 -5952
Work Desc: REROOF SHINGLE 34 SQ
PAUL D SCRAPER ROOFIN INC REROOF RESIDENTIAL 70.00
r 7 -- _
ZZ °
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 o your property. If you intend to obtain financing, consult with your lender or an attorney
be • re recordi • your notice of commencement."
1. r
of • - 1 - 41R 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
0 e'' 2)
Date Received Phone Contact for Permitting Fit C – ORM
-- -- - - - - --
iIIIIIIIIIIIIItW_I9_
Owner's Name
` T1 t' A?A1SeA\ Owner Phone Number 813 - -Y3 `J %�,.)
Owner's Address I t S 0 3 r), V ' Si Owner Phone Number
Fee Simple Titleholder Name psi 1/1 Owner Phone Number
Fee Simple Titleholder Address j /
JOB ADDRESS 'Igo L.+ � 3 c L (& .S �th € r �1 LOT #
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED I I NEW CONSTR ADD /ALT n SIGN n MOVE n DEMOLISH
INSTALL REPAIR
PROPOSED USE I I SFR I I COMM n OTHER I
TYPE OF CONSTRUCTION n BLOCK I I FRAME I I STEEL I I OTHER I
DESCRIPTION OF WORK 3q a kli'4( V 'n Q - &o f)
BUILDING SIZE SQ FOOTAGE HEIGHT
BUILDING $ ;6 ' ' 1 . 7-.? / /D o a VALUATION OF TOTAL CONSTRUCTION
•
I I ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY I W.R.E.C
I I PLUMBING $
I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
n GAS n ROOFING 1 1 SPECIALTY n OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES =NO
BUILDER
�, ,� - " "°._._ . COMPANY 5, UR c!(.. •
SIGNATURE 1 ,t REGISTERED Y/ N I FEE RENT Y/ N 1
Address 1 •‘ti Z
- µ 335 License # leccosei a
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
Address License #
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
Address 1 License # I I
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
Address License #
OTHER COMPANY
SIGNATURE REGISTERED I Y / N 1 FEE CURRENT 1 Y/ N I
Address License # I I
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
* ** *PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000)
** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades A/C Fences (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 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 1 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 expre"ssly'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 Tots 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 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
s
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.
lae/ 14✓( Notary Public t / Et'r_. - Notary Public
Commissio- ' I b O od I �• a ,'*io T!a+T�� � !/ C/
?.•
• , , MY COMMISSION ADD _
14, 2052
7,7;, Y D. SUT1 .N'i IRES:
Name • it t' •_,' ; h .0. �
_Ot rc ; .Lieu- ,�jjli
= EXPIRES: : ,July 14, �.1 -•-- - -- �---_" v
� " � 4
Bonded film Nota tv Puww undo rs
1 ii iiiii iiiii iiiii iiiii iiiii rill rill
Rcpt. 1253390 Rec:10.00
DS: 0.00 IT: 0.00 Clerk
07/14/0 -- - - DptY
PRULR S. .'NEIL, PRSGO G LERK & G O�IPTR.LLER
-- 07/14/09 Z 1 PG 01 8 55
OR BK
NOTICE OF COMMENCEMENT
State of FLORIDA County of PASCO
Property Identification Number: 14 - 2. Co - Z t - 001 Q - o z-�� - c a 2 c)
•
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance
with Section 713.13 Florida State Statutes, the following information is provided in this Notice of Commencement:
1. Description of Property (legal description:)
votes A] M i3 t PG 5 - 1 L2
•• 131-00 Z S OR 8081 PG - 12
Street Address: 4So3 2o-On 5-b-'ga+ ZEpN-i21411__LS V1 :3.9)545
2. General Description of Improvement :, R, ,rcx, .c'
3. Owner Information: -
a) Name and address: RAy Jenutsc.r.•I 48o3 2c.)411 5A-• 2E01-1 - 'IZ1-1 ILLS f 1- 33545
b) Name and address of fee simple titleholder (if other than owner): N/A
c) Interest in property: Owner
Contractor: Paul Schaper, 8949 Gall Blvd., Zephyrhills, F133541 si 3 -'18 -09x0
5. Surety: Bauer & Associates, 12210 HWY 301, Dade City, 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 it 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
Si r , Owner's Authorized Officer/Director/Partner/Manager
/ '
Name
foregoing instrument was acknowledged before me this day of 200, by
SQ.y1 as 6743h -?• (type of authorit , e.g. officer, trustee, attorney in fact) for
(name of party on behalf of whom in iment was executed).
Personally Known OR Productgde,ntification Notary Signature i geif / Z SZ 1 ' 6P
Type of Identification Produced '3 4 , e9_5 ' '. S ? (-c7 C> O
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 M . r...�+
t my knowledge d b '
° ,"„ MEW OERLY D. SUTHERLAND /
• MY COMMISSION # DD 805627 • s i s) = EXPIRES: July 14, 2012 � ° - �
aw, d.aThm raw, Public uneunMlers Signature Na " al PersonSigning Above •
Notary Public: � �xr,,1 ~;• .,.,,�,,,_
• (Type, Print, or Stamp Name of Notary)
STATE OF FLORIDA, COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING 1$tiA r.
TRUE AND CORRECT COPY OF THE DOCUM T r.: . , "
ON FILE OR OF PUBLIC RECORD IN THIS C# -'� �4`t‘ , f R
WITH ` MY HAND AND •FFI IAL SEAL THI 1,
DAY OF i / / `� , �1;' i a .4} �
PAU • ''. O NEIL, CLEAT; 'Y
CO U i ,(��/ ,
GCI�
t
BY ��� r ' i . 1 Y CLERK > 1T 0$7, -, "
e
__
Pasco County Parcel: 14 -26 -21 -0010- 02500 -0020 001 Page 1 of 1
Search Again Show Map Generalized Building Schematic Frequently Asked Questions Estimate Taxes
Other Agency Data: Tax Collector School Board Supervisor of Elections
Data Current as Of: I Weekly Archive - Saturday, July 11, 2009
Parcel ID ( 14- 26 -21- 0010 - 02500 -0020 (Card: 001 of 001)
Classification 1 01 - Single Family
Mailing Address Property Value
JENSEN RAY Ag Land $0
4803 20TH ST Land $18,612
ZEPHYRHILLS, FL 335425223
Building $64,565
Physical Address
Extra Features $609
4803 20TH ST
ZEPHYRHILLS, FL 33542 Market Value $83,786
Legal Description (First 4 Lines) Assessed (Save Our Homes) $0
MOORES AD MB 1 PG 57 L2 Taxable Value $83,786
BLK 25
OR 8087 PG 72
Land Detail (Card: 001 of 001)
Line II Use °Description° Zoning II Units II Type II Price II Condition II Value
I 1 II 0100 II SFR II 00R3 II 6,600.00 II SF II $2.82 II 1.00 II $18,612 I
I Additional Land Information
I Acres 11 0.15 II Tax Area II 30ZH II FEMA Code ° X °Residential Code° ZHLGLP7
I Building Information - Use 01 - Single Family Residential (Card: 001 of 001)
Year Built 2007 Stories 1.0
Exterior Wall 1 Eifs Exterior Wall 2 None
Roof Structure Gable or Hip Roof Cover Metal
Interior Wall 1 Drywall Interior Wall 2 None
Flooring 1 Ceramic Clay Tile Flooring 2 Carpet
Fuel Electric Heat Forced Air - Ducted
A/C Central Baths 1.0
Line 11 Description (I Sq. Feet 0 Repl. Cost New
1 II BAS
II 066 II $64,365 2 FOA 25 (I $362 I
Extra Features (Card: 001 of 001)
Line II Description I Year II Units
II Value
1 II DWC II 2007 280 II $609
Sales History
Previous Owner II GOWER GEORGE 0
Year II Month B /Page II Type (I Amount
2009 II 05 I 8104 / 0071 II WD II $0
2009 I I 05 II 8087 / 0072 II WD II $90,000
2008 II 06 II 7869 / 0682 II GD II $14,300
Search Again Show 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= 0010 &b... 7/14/2009
PAVE SCii Roofing, Inc.
8949 Gall boulevord Zehhi1Es 9 33541
PH: (813) 782-0920 8: (3521 567-8580 Fax: (813) 715-4875
STATE CERTIFIED BUILDING AN D ROOFING CONTRAC.',TOR #C6-CX159817 and #CC-0O56134
SERVING Ps-ORD .FThi&T HCMES &MINES:ES sr 1976 www.schaperconttniction.com
1 (4 S
,
Data Z/V69 Phone
Name: v v.‘ Cuntath
Address: ge,9- 3/
City Ze- I-9C, it VT «/ 5 State / Zip
Parcel #
We hereby propose to furnish materials and labor necessary for the completion of
Shingle Re-roof
1. For the shingled portions of the home, remove old roofing materials to dry-in, taking precautions to
protect the building and the landscaping. Groom the deck and reset the existing decking nails.
2. Replace bad wood other than herein agreed to a H 4100 dollars per m an-hour plus
materials marked up at a percent contractor's fee.
3. Install /, r / rot. .. 4 p L eaves drip with all edges sealed with plastic cement.
4. Install layer(s) of ASTM 15-lb asphalt shingle underlayin era
5. Install galvanized valley metal for the length of ail valleys. Valleys will be closed.
6. Install new lead boats ver vent pipes and replace in etal vents with new
7. Chalk lines shall be , struck tt) aSSUre-properlthingle exposure. ---
8. Install 2 C-) Year Class, a self-sealing fungus resistant fibergkes shingle.
Manufacturer: d-, Color:
9. Six 1-114" corrosion'tegistatit nails shall be installed per manufacturers instructions .
r V c2 t *^ A `" k. - 3
Options
Hurricane-nail the deck to the rafters to meet current SBCCI code. *
Install feet of aluminum ridge vent. * . -
*See Pricing Section
[ 3p art) BLANK SHINGLE RE-Pi:X
Page 1 of
i (PAUL Se Roofing
Shingle Re-roof continued . .
Schap Roofing, Commi tm ea t to Qua' ty
*All work shall be carefully super used omple #ed b
and c -
produce high quality work. y vv q nkrsovvledgeable in methods needed to
*The job site shall be kept clean daily for the duration of the job and the grounds
shall be left clean of all roof related
debris after completion.
The yard shall be swept with a magnet.
The Carttractor ovde mint w orkman compensation,
I.
*Carpentry, and general liabil*Carpentry, authorized change orders and work, � g � insurance.
which are not covered under the ,cope of work outlined herein, shall be
4 performed ass time and material basis unless otherwise agreed upas.
I
MANUFACTURER & CONTRACTOR WARRANTY (S)
Upon completion of the work and payment of all monies owed, Contractor shall issue:
1. A ,_ year warranty for workmanship limited to leaks caused by any component installed by the contractor.
2. Shingle manufacturer shall provide a
year limited warranty.
CO . ' CT PRIC 7 . G — - i
V isible T & Ai Allowance
1 1
Shingle Re-roof described herein-------- ---- - -- ___ - - -- – –
Modiftcat ons tV - ! u $ ' t `
-fi --,�,, , w r,
I w w f
TOTAL A.attirD tirorT CONTRACT PRICE, LABOR AND MAC.----------- - --
TERMS
r 4,...6_,, f—
Collection costs if any, together with interest shall be added to the contract price if payment default occur&.
- Cancelkftkon of the contract after ;he 72-hour grace period shall incur a nominal fee.
--- - -- ) .r ' z x.- ..A•..t t :... h4 -N--+ ..,' Date d
chage Inc Repres ti ! 6 cp i
r
I accept the abo7Ii and terms; you are authorized to begin work.
Signed - / i
-_ _ Date
Signetl
[3p attj 2LANK' SHINGLE RE-ROOF `
F
i
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BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats & Facts Publicatit
.rr !J %rI
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% } ' f `r i t / }!• USER: Public User
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Affairs ''' {••: Product Approval Menu > Product or Application Search > Application List > Application History > App
FL1956 -R1
v{ :... { {r_`,.:: r ?: �.! { : . ?':i F.
Application Type Revision
;.;;F {rt5r r f r Ff:.:: ? MA:tr.` O : •g
Code Version 2004
y: �s,• ::. =F;
rf r. °E, r
'' f Application Status Approved
:•y #:4 . ..:,.;:::,..:,,:.;.:::.: {:rr,; Comments
�:,...5 . i y n;: fi fir.- i.•.•.- •! %.•:,l'
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Product Manufacturer TAMKO Building Products, I
Address /Phone /Email PO Box 1404
Joplin, MO 64802
(417) 624 -6644 Ext 2305
kerri_eden@tamko.com
Authorized Signature Frederick O'Connor
fred_oconnor@tamko.com
Technical Representative Frederick J. O'Connor
Address /Phone /Email PO Box 1404
Joplin, MO 64802
(800) 641 -4691
fred_oconnor@tamko.com
Quality Assurance Representative
Address /Phone /Email
Category Roofing
Subcategory Asphalt Shingles
Compliance Method Certification Mark or Listing
Certification Agency Underwriters Laboratories I
Validated By
http://www.floridabuilding.org/pr/pr_app dtl. aspx ?param= wGEVXQwtDgs %2fmGFoyT 5/29/2009
Florida Building Code Online rage h o�
Referenced Standard and Year (of Standard) Standard
ASTM D 3462
Equivalence of Product Standards
Certified By
Product Approval Method Method 1 Option A
Date Submitted 06/09/2005
Date Validated 06/20/2005
Date Pending FBC Approval 06/25/2005
Date Approved 06 /29/2005
Date Revised 08/07/2008
Summary of Products ��- �._.._...
FL # Model, Number or Name ! Description
1956.1 Elite Glass -Seal AR heavy weight 3
Limits of Use (See Other) (Certification Age
Approved for use in HVHZ: Quality Assurani
Approved for use outside HVHZ:
Impact Resistant: Installation Inst
Design Pressure: +/- i PTID 1956 R1 I
Other: Asphalt shingles shall be used only on roof Verified By:
slopes of 2:12 or greater. Not approved for use in HVHZ. ; Created by Indep
Evaluation Repo
Created by Indep
:11956.2 Glass -Seal AR A 3 tab asphalt sh
Limits of Use (See Other) Certification Age
Approved for use in HVHZ: Quality Assurani
Approved for use outside HVHZ:
Impact Resistant: (Installation Inst
Design Pressure: +/- ! Verified By:
• Other: Asphalt shingles shall be used only on roof Created by Indep
slopes of 2:12 or greater. Not approved for use in HVHZ. Evaluation Repo
Created by Indep
11956.3 'Heritage 30 AR _ A heavy weight di
lLimits of Use (See Other) Certification Age
Approved for use in HVHZ: Quality Assurant
Approved for use outside HVHZ:
Impact Resistant: Installation Inst
Design Pressure: +/- Verified By:
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umievorters:
Laboratories Inc.
.A.trte 17;2005
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404
220 W. 4 Sztwt:
.1001ifi. MO 648024404H
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Florida Building Code Online
BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats & Facts pumicam
Product Approval
USER. Public User
Commuriity
Affair's Product Product
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FL1956-R1
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Application Ty pe Revision
Code Version 2004
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Application Status Approved
Comments
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Product Manufacturer TAMKO Building Products, I
Address/Phone/Email PO Box 1404
Joplin, MO 64802
(417) 624-6644 Ext 2305
kerri_eden@tamko.com
Authorized Signature Frederick O'Connor
fred_ocomoor@tamko.com
Technical Representative Frederick]. O'Connor
Address/Phone/Email PO Box 14O4
Joplin, MO 64802
(800) 641-4691
fred_oconnor@tamko.com
Quality Assurance Representative
Address/Phone/Email
Category Roofing
Subcategory Asphalt Shingles
Compliance Method Certification Mark or Listing
Certification Agency Underwriters Laboratories 1
Validated By
Florida Building Code Online rage L oi ,+
Referenced Standard and Year (of Standard) Standard
ASTM D 3462
Equivalence of Product Standards
Certified By
Product Approval Method Method 1 Option A
Date Submitted 06/09/2005
Date Validated 06/20/2005
Date Pending FBC Approval 06/25/2005
Date Approved 06/29/2005
Date Revised 08/07/2008
:Summary of Products
FL # Model, Number or Name Description
11956.1 Elite Glass -Seal AR A heavy weight 3
Limits of Use (See Other) 'Certification AgE
Approved for use in HVHZ: Quality Assurani
Approved for use outside HVHZ: 1
Impact Resistant: I ' Installation Inst
Design Pressure: +/- PTID 1956 R1 I
Other: Asphalt shingles shall be used only on roof Verified By:
slopes of 2:12 or greater. Not approved for use in HVHZ. I Created by Indep
, valuation Repo
Created by Indep
11956.2 Glass -Seal AR A 3 tab asphalt sh
Limits of Use (See Other) Certification AgE
Approved for use in HVHZ: ; Quality Assurani
Approved for use outside HVHZ:
Impact Resistant: Installation Inst
Design Pressure: +1- I Verified By:
Other: Asphalt shingles shall be used only on roof Created by Indep
slopes of 2:12 or greater. Not approved for use in HVHZ. Evaluation Repo
Created by Indep
1956.3 iLH 30 ARA heavy weight di
Limits of Use (See Other eritage ) Certification AgE
Approved for use in HVHZ: Quality Assurant
Approved for use outside HVHZ:
Impact Resistant: Installation Inst
Design Pressure: +/- , Verified By:
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P.(),.1-31404
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1 ;w611 :4.r 0 .\R ' i10xtd e \L i a .tip€ `fetibg st gy . Tratiatt.telure i i DO . s
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07/21/2009 08:28 FAX ZI002/002
Ci Hof 2 eu
'BUILDING DEPARTMENT
9/17/07
RE: Permit #s`� — -
Ins �ection affidavit
I
PcL(,L( �1� f ,licensed as a(n) Contractor* /Engineer /Architect,
�
lease ht name and l e � Lie. Type)
FS 468 Building Inspector*
(P pr
in
#; .e ) 05 3I 3`f
•
On or about ' (9-O Oci , I did personally inspect the roof
(Date Sr. time)
__ .. c�s4" e)3 `),Irp
deck nailing and /or secondary water barrier „Work a (Job Site Address)
( circle one ._, - -•�'�
Based po . at examination I have determined the 5 8 F io was done according to the
Hurri. i. e ,� ' •gation Retrofit Manual (Based on
STATE OF FLORIDA
COUNTY OF
Sworn to and subscribed before me thin o day of
Y 0.1/1/0- 3.4/Kigja •
EXPIRES: July 14, 2012
Bonded Tlw Notary Public UndsVnders
(Print, type or stamp name)
Commission No.: bbRacO%1
Personally known ✓ or
Produced Identification
Type of identification produced.
* General, Building, Residential, or Roofing Contractor or any individual certified under 468 F.S. to make such an
inspection. Include photographs of each plane of the roof with the permit # or address # clearly shown marked on the ,
deck for each inspection.