HomeMy WebLinkAbout10-10149 CITY OF ZEPHYRHILLS V
5335 - 8TH STREET
(813)780 -0020 10149
BUILDING PERMIT
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Permit Number: 10149 Address: 5516 16TH 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 - 14000 -0160
Improv. Cost: 1,795 . 00 4* - , , t!ik7: — a 777 . 7 , >3 A
Date Issued: 2/22/2010 Name: BART RALPH & BETTY -JEAN
Total Fees: 60.00 Address: 6576 STEEPLE RIDGE
Amount Paid: 60.00 CLARKSTON MI 48346
Date Paid: 2/22/2010 Phone: (813)782 -6588
Work Desc: REROOF FLAT ROOF
R
F.
PAUL * HA _ = R• • IN I ' E R• • F RE IDE IAL 60.00
Illk
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INSP s .
TAPE JOINTS ROOF INS?
FINAL 1-7 S --' l/
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 recordin our notice of commencement."
AN. ! .
•III �T"'•R SIGNATURE PERMIT OFFI R
• ERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 10149
BUILDING PERMIT
Permit Number: 10149 Address: 5516 16TH 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 - 14000 -0160
Improv. Cost: 1,795.00 .y 1 :e ysg4.,.,
Date Issued: Name: BARTHEL, RALP & BETTY -JEAN
Total Fees: "( IX . Address: 6576 STEEPLE RIDGE
Amount Paid: CLARKSTON MI 48346
Date Paid: Phone: (813)782 -6588
Work Desc: REROOF FLAT ROOF
'AUL D HA - R• • N 1 - RO• REST' IAL 40.0
G,LI *
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DRYI - 05 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."
CONTRACTOR 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 � o Fax-813-780-0021
Building Department - T (v � .
Date Received 4 —/, (� Phone Contact for Permitting ' H '?. ZO
Owner's Name RA L PO. E ' A F. n / iIa T H t-- Owner Phone Number (`- 1 8e ( 8 8
Owner's Address tc).S 1(o P L (c �ti�. rY Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS 5c-J I (v j� _ LOT # I
SUBDIVISION PARCEL ID# 1 1 - 2A„, 1 O I Lt C)OC) a I (o
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD /ALT 1 1 SIGN 1 1 MOVE n DEMOLISH
INSTALL REPAIR
PROPOSED USE n SFR 1 1 COMM 1 1 OTHER 1 ■12 1 Nk
TYPE OF CONSTRUCTION I 1 BLOCK 1 1 FRAME n STEEL 1 I OTHER 1
DESCRIPTION OF WORK
BUILDING SIZE SQ FOOTAGE HEIGHT
BUILDING $ ( I „1 6 VALUATION OF TOTAL CONSTRUCTION
1 i c , Vl
1 1 ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY ( I W.R.E.C.
PLUMBING $ - v
MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION /(�I
n GAS n ! ROOFING_ ' I mo, 1 SPECIALTY 1 1 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 'YES FIN()
BUILDER COMPANY
SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT I Y/ N I
Address License #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y / N 1 FEE CURRENT I Y/ N 1
Address I License #
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
Address License #
MECHANICAL COMPANY
SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y/ N 1
Address License #
OTHER (? LL `, COMPANY I c>..�.ti 1 'r.3 �- vG� �� c Tr L
SIGNATURE � " REGISTERED I Y/ N 1 FEE CURRENT 1 Y/ N
Address bc- ' i cy, (\\ ("3\ , 11S License # CC C_ U `SD ? ) `q
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 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 I have obtained a copy of the above described document and promise in good faith to
deliver it to the "owner" prior to commencement.
CONTRACTOR'S /OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
Department of Environmental Protection - Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
- Southwest Florida Water Management District - Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Engineers - Seawalls, Docks, Navigable Waterways.
- Department of Health & Rehabilitative Services /Environmental Health Unit - Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency- Asbestos abatement.
Federal Aviation Authority- Runways.
I understand that the following restrictions apply to the use of fill:
Use of fill is not allowed in Flood Zone "V" unless expressly permitted.
- If the fill material is to be used in Flood Zone "A ", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. MAY RESULT
IN YOUR
WARNING TO OWNER: YOUR FAILURE TO RR PROP PROPERTY. YOU INTEND TO CMMENCEMENT
N FINANCING CONSULT
PAYING TWICE FOR IMPROVEMENTS TO YOUR
YOUR LENDER OR AN A TORNEY BEFORE RECORDING YOUR NOTICE OF C MENCEMENT.
FLORIDA JURAT (F!§.-11K.03) l �.. �' r / �...
OWNER OR AGENT _. CONTRACTOR ~ C, T rt
Sub cry ed and sworn to (oi' ffirm re is Sub cri d and sworn S ',or affi efor
q b 1.t.(� c '14 ' _k t) by iv' 0 ( S
i me this
cY
Who / Who is /are personally known to me or h s /have prd '•'uced
Who is are personally kn to me � r has/haveirouced as identification.
as identification.
�,� ___ Notary Public
Notary Public
N o sut 11NNE uOUGLAS - ALLEN Cbmmission KfC
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/ Commissi q o PsY pro SU ZANNE DO LA5 -A LL N�
o tPaY Pu6`o ; Notary Public -Stat of Fl �� Nota • .
a My Commiss Exvlres e oct 25, 2011 a o lorida
i Na me o f , P n1Ib1P�'
Name of Not t„ -,: ird d or 4R� n # DD714319 IPA Commission #
'1' Through National Notary Assn of F
of F , :.° Bonded ,„, Bonded Through �, - ." —w .. 9fi National NotaryAssn.
Pasco County Parcel: 11- 26 -21- 0010 -14000 -0160 001 Page 1 of 1
Data Current as Of: Weekly Archive - Saturday, February 20, 2010
Parcel ID 11- 26 -21- 0010 - 14000 -0160 (Card: 001 of 001)
Classification 01 - Single Family
Mailing Address Final 2009 Value
BARTHEL RALPH E & BETTY -JEAN Ag Land $0
TRUST Land $27,300
BARTHEL R E & B J TRUSTEES Building
6576 STEEPLE RIDGE $23,964
CLARKSTON MI 48346 -1589 Extra Features $0
Physical Address Market Value $51,264
5516 16TH ST Assessed (Non - School Amendment 1) $51,264
ZEPHYRHILLS FL 33542 -4322
Legal Description (First 4 Lines) Taxable Value $51,264
See Plat for this Subdivision ,''
CITY OF ZEPHYRHILLS
PB 1 PG 54 LOTS 16 -18 INCL
BLOCK 140
OR 5770 PG 1254
Land Detail (Card: 001 of 001)
Line II Use IlDescriptionll Zoning it Units II Type II Price II Condition 1 Value
1 I 0100 II SFR II 00R2 Il 8,400.00 II SF I $3.06 II 1.00 lI $25,704
2 lI 0100 II SFR II 00R2 II 4,200.00 II SF (I $0.38 II 1.00 0 $1,596
Additional Land Information
Acres II 0.29 II Tax Area I 30ZH II FEMA Code (i X IjResidential Codell ZHLHLP2
Building Information - Use 01 - Single Family Residential (Card: 001 of 001)
Year Built 1955 Stories 1.0
Exterior Wall 1 Asbestos Shingle Exterior Wall 2 None
Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle
Interior Wall 1 Drywall Interior Wall 2 None
Flooring 1 Pine or Soft Wood Flooring 2 Carpet
Fuel Gas Heat Convection
A/C Window Unit Baths 1.0
Line II Description II Sq. Feet II Repl. Cost New
1 II 2 II F 1,074 I) $37,053
FOP I (
II I) $1,139
3 II UDG I 336 Il $3,485
Extra Features (Card: 001 of 001)
Line II Description 11 Year II Units II Value
No Extra Features
Sales History
Previous Owner 11 RUMOHR RUSSELL &
Year II Month ( Book /Page II Type II Amount I
2004 II 02 I I 5770 / 1254 11 2 11 $0 I
1993 07 3188 / 0938 II QC (I $0 I
1988 II 12 II 1777 / 0122 II PR II $ I
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' City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
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CQntragtarliomeowner: � ic.E� .
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Date Received: -16 - / c)
Site: -5-516 - /6 .
Permit Type: "\j.-eat' 1 --
Approved w /no comments: Approved w /the below comments: ❑ Denied w /the below comments: ❑
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This comment sh= :r ► - kept with the permit and/or plans.
Al / /,,,p i d .
B : urg - s - :'ceding Official Date Contractor and/or Homeowner
(Required when comments are present)
Florida Building Code Online Page 1 of 2
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Application Type Revision 3R4
►Hcl. ,n;r 1 :(744.a"Nrr, Code Version 2007
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Application Status Approved
■ amE- F -„ l `1 1p
A G < �I Comments REVIEW DATE :2�
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Product Manufacturer IB Roof Systems CITY PLAN OF EXA EPHYRHIL MINER CS
Address /Phone /Email 2877 Chad Dr
Eugene, OR 97408
(972) 574 -3551
joelstanley@lbroof.com
Authorized Signature Joel Stanley
joeistanley @Ibroof.com
ALLWO SHALL COMPLYWITHALL
Technical Representative Trace Stanley a ( CODES, FLORIDABtIILD= 'I
Address /Phone /Email 2877 Chad Dr rRE�AIL IONALELECTR C ODE W
Eugene, OR 974 �VDE , NA
(541) 242-2871 CITY OF ZIEPHYRHILLS OItDIN CE
tstaniey @lbroof.com
Quality Assurance Representative
Address /Phone /Email
Category Roofing
Subcategory Single Ply Roof Systems
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 Robert Nieminen
developed the Evaluation Report
Florida License PE -59166
Quality Assurance Entity FM Approvals - QA
Quality Assurance Contract Expiration Date 03/01/2012
Validated By John W. Knezevich, PE
Validation Checklist - Hardcopy Received
Certificate of Independence FL2534 R4 COI Trinity ERD Certificaiton of Indeoendence.odf
Referenced Standard and Year (of Standard) Standard Year
ASTM D4434 2004
CAN /CGSB 37.54 -95 1995
FM 4470 1992
Equivalence of Product Standards
Certified By
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Va
Ca
Jw ophyrhins, Fl 33541
„. ) & (3 21' 567-8580 FOX: (8131 '15-48
DING AND ROOFING C,ONTRA.CTOR #CB-C;(6.1431' and -4
(41 ; omEs g BUSINESSES S' 976 www.schopercorishuction.corn
Name J 2 ;
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SID te
Address
CitytC lint
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We hereby prr to funiit-1 ['lab-vial:4 and labor necessary for the completion
pyc-CPA Roofing System Proposal
I Barricade off work area as nee..ded.
2. ReMOVC loose debris from flat roof.
3. Rem ove existing ilaslungs and boot as required.
4. Check substt decking for water damage. Replacement of decking will be done on a time and
matetial basis at the rate of _ 0 dollars per man -hour plus materials marked
up a contractor's fee.
installinsulation, mechanically attached per manufacturers specification.
6. install PVC CPA membrane.
7 . install new boots. CUStOtla curb mid corners as required.
install two-way vents as required.
9. Install term bar as required.
Schaper Roofing, COMITli tm t to Qualtitv
*All work shall be 'carefully supervised cox! conipleted by workmen -.lilted and knowledgeable in methods needed to
produce high quality work.
$The job site shall be kept dean daily for the duration of the job and the grounds shall be left dean of Al roof related
debris a ffet completion.
The yard shall be swept with a magnet
'The contractt r shall provide permit, workman compensation, and general liability insurance.
°Carpentry, authorized change orders and work, which are not covered under the scope of work outlined herein, shall be
perfornied CM a time and material basis unless otherwise agreed upon.
•
Page l of 2
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CONTRACTOR WARRANTY (IS)
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et of all monies owed. Contractor shall issue:
warranty for workmanship limited to leaks c.aus by any component install by the contractor_
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, _' l' ,• ,, ,:,. ri.ifar..u.ter shall
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Price valid for thirty (30) El;ays_
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d i tiy, together with interest shall be added to the contract piice if payment default oc:curs. Cancellation ■
of the cont , M : : . the . 72-hour grace period shall incur a nominal fee.
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Florida Building Code Online Page 1 of 2
ENEVARIIRNI of
The Florida Depart `af Community : Aff ` n a i i rs ' , ' 4 c to Y t.
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O+;t Subcategory: Single PIy Roof Systems
-T-T-- -- Application/Seq #:
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App/Seq Manufacture Category Subcategory Validation Status
Mailing Entity/Validator
Wilt Approved
FL2534 Vladimir John
IB Roof Single Ply Roof Knezevich Evaluatio
R1 Roofing
Fltrda lfistory Systems Systems Report -
FBC ouftd;ng (954) 522 -3690 Hardcopy
wtr)tYti :d in Received
Page: Go
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Copyright and Disclaimer ; 02000 The State of Florida. All rights reserved. one -
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http : / /www.floridabuilding.org /pr /pr srch.asp 6/20/2005
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• IB Roof Systems Specification Manual
5"
4 f
ic OUTSIDE EDGE OF
Z'
MEMBRANE
FASTENER LINE PREPRINTED ON
MEMBRANE
5" LAP LINE PREPRINTED ON
MEMBRANE
PLAN VIEW
IB FASTENERAND PLATE
1 1/2" HOT AIR WELD
INSULATION*
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'<;,<Jei Utz• SUBSTRATE 7RZ rY ernco
STANDARD SCREWS FASTENING PATTERN
HALF SHEETS 12" O.C. SCREWS & PLATES
FIELD SHEETS 12" O.C.
ISULATION IS OPTIONALAND MAY NOT BE REQUIRED ON EVERY PROJECT. IF INSULATION IS NOT REQUIRED
I IT DOES NOT HAVE A GLASS OR FOIL FACER , AN IB APPROVED SEPARATION SHEET MUST BE USED.
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,. ..,... ,
OOF SYSTEMS .w REVISION
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02/24/2010 09:00 FAX 51001/002
--1, , . •
.1
. . • JURIiSDICTJONlOF YOUR. CHOICE .
...BUILDING DEPART IENT -'
Permit# i. 0
C. 9117/07
¶[n pection Affidavi . .
... /Engineer/Architect;
I +" `; '.--C . ;, • )C, `r 1 c . + �> 'Z' ", -, ,licensed as a(n) C /Engm Inspector*
(please print name and circle Lie_ 'Type) `FS 468 Building p ,
License #; .
C c " ! , I did personally inspect re roof
d ' k nailinz.and/or secondary water barrier work at (Job site Address)
. I _.}. . 7 11 C
Based . A n • - t examination I have determined the installation was done according to the
Hi. ; u. gation Retrofit Manual (Based on 553.844 F.S.)
. Signa k' \
. .
. .
•
STATE OF FLORIDA •
`; ; 0 COUNTY OF ' -_.
• S worn •
to and subscribed before me t � '2 da of b - c 4 r L-L(..., i . 260
1
By i l )c. y.: )(2 i l .,
. ' Notary Public, State of Florida
I i i ,
• �.. V
� SUZANNE DOUGLAS•ALLEN
(hint,
e; stamp name)
4 s Nolary Public - State o 1 Florida y" "�'
• (M ... m Commiss E
"i xpires Oct 2 2011 1
%r, '' 0 mma \
c , .. Co bn - # 00714319 Commission - N° -:
'' %�; '�' Bord
' � � rough N ational !
Per mown ..;.,,,� , , . . Nofary Assn.
Produced Identification i
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 # clearty shown marked on the
deck for each inspection. .