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10-11011
CITY OF ZEPHYRHILLS .f 5335 - 8TH STREET (813)780 -0020 11011 BUILDING PERMIT Permit Number: 11011 Address: 38048 1 AVE 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: 11- 26 -21- 0010 - 05900 -0205 Improv. Cost: 9,900.00 , f .'., :; : Date Issued: 10/11 /2010 Name: CARVER, EA J& DAVIS, DOROTHY Total Fees: 127.50 Address: 39439 DUNDEE RD Amount Paid: 127.50 ZEPHYRHILLS, FL. 33542 Date Paid: 10/11/2010 Phone: (813)780 -6867 Work Desc: MEMBRANE SINGLE PLY REROOF A L • - • A - •'• & • - - •• - • IAL 127.50 s qfr 1:i1,,,, N .:4:::, TAPE JOINTS ROOF INSP FINAL /l — g.( ( 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 befo recording your tice of commencement." iSejg, 1 NT CTOR 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 # / /di/ Date Received — -2.27 - t D �l Phone Contact for Permitting 27 z - /o/ ` 7 Owner's Name -- E/Pe- 4 - C ,4 /�(I ^ , Owner Phone Number 6 r 3) 74 — Owner's Address 89' ' ck E- Owner Phone Number • Fee Simple Titleholder Name Owner Phone Number I Fee Simple Titleholder Address 4 / � JOB ADDRESS ' 3 N 4 6 (z 7C / .- Y r f z (T V t' 4.4 LOT # SUBDIVISION UT"( ?"Y 'Ot row cekt rL l PARCEL ID# 4 C - 2- 1 O a D9 O Q - (30z 4) 'c (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT 1 1 SIGN 1 I I I DEMOLISH INSTALL REPAIR PROPOSED USE Ep SFR n COMM I 1 OTHER I Kk F TYPE OF CONSTRUCTION 1 I BLOCK nI n FRAME �^ I STEEL I DESCRIPTION OF WORK k-c �. L OF: l�(�PC/4 C (w (., / Tr//V0 A.1646 y' /1-( C/t4 & AIO BUILDING SIZE SQ FOOTAGE 1 5' HEIGHT (BUILDING $ 1 l {v (� f VALUATION OF TOTAL CONSTRUCTION l hl (ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY I I W.R.E.C. (PLUMBING $ (MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION (GAS ROOFING I SPECIALTY I I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I (YES NO //� C�' n BUILDER , ,��� ` COMPANY ALL 1 Y� "f V l T CP �' V � 'i" //art . SIGNATURE U °\ REGISTERED a N FEECURREF ( Y7 Address 13 3 - t;LTt &fir' if+10, 4 License# I CJ C C t 'Z7 4 ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREt` I Y/ N 1 Address License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREI 1 Y/ N I Address License # I MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N J FEE CURREP I Y/ N I Address License # I OTHER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREh I Y/ N 1 Address License # RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects COMMERCIAL Attach (3) 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 $7500) ** Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized Ietter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs if shingles 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 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 IMPROVE NTS TO YOUR PROPERTY. IF Y a U INTEND TO OBTA FINANCING, CONSULT WITH YOUR LEN E - OR AN AT RNEY BEFORE RECORDING YO ‘ - ■ O ICE OF CO ENCEMENT. FLORIDA JURAT (F.S.\ 1 I ) �. OWNER OR AGENT / CONTRACTO \ " Subscribed and sworn b. ui '� • e . ; ; Subscribed and sworn to) (..a. / ' by 0C � �� by" Who Is /are personally known to me or has/have produced Who is /are personally known to me or has/have she pr o u oed as Identification. i F ,FSNotary Public Notary Public n. : qY ei `: Commi DD 6262 "" : JACQUELINE BOGES Commission No , _ " Expires nacamhrar 12, 2010 Commission Ni3 : i"? Commission OD G21833 °.;�' 0 0onded ThN Troy rein Insurance 800-385 ��P Expires December 12 2010 Bonded ThN Trrry Fain b`y'eM., OOP9orN le Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped Pasco County Parcel: 11- 26 -21- 0010- 05900 -0205 001 Page 1 of 1 Data Current as Of: II Weekly Archive - Saturday, September 18, 2010 Parcel ID II 11- 26 -21- 0010 - 05900 -0205 (Card: 001 of 001) I Classification 1 01 - Single Family Mailing Address Property Value CARVER EARL JAMES & Ag Land $0 DAVIS DOROTHY H Land $23,979 39439 DUNDEE RD Building $37,262 ZEPHYRHILLS FL 33542 -4771 Physical Address Extra Features $1,371 38048 12TH AVE Market Value $62,612 ZEPHYRHILLS FL 33542 -3429 Assessed (Non - School Amendment 1) $62,612 Legal Description (First 4 Lines) Taxable Value $62,612 See Plat for this Subdivision .1'" CITY OF ZEPHYRHILLS PB 1 PG 54 E1/2 OF LOTS 20 21 22 23 & 24 BLOCK 59 OR 5610 PG 515 E Land Detail (Card: 001 of 001) I Line II Use IlDescriptionll Zoning II Units II Type II Price II Condition II Value I 1 II 0100 II SFR II 00R3 p 8,400.00 II SF II $2.84 II 1.00 II $23,856 I 2 II 0100 II SFR II 00R3 Q 350.00 II SE 1 $0.35 II 1.00 II $123 Additional Land Information Acres 0.20 Tax Area I 30ZH I FEMA Code X Residential Code ZHLHLP2 I Building Information - Use 01 - Single Family Residential (Card: 001 of 001) Year Built 1968 Stories 1.0 Exterior Wall 1 Concrete or Cinder Block 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 Terrazzo Monolithic Flooring 2 None Fuel Electric Heat Forced Air - Ducted A/C Central Baths 1.5 I Line Description ( Sq. Feet II Repl. Cost New I 1 BAS I 977 1 $43,262 I 2 198 I $2,214 3 FQ FSA i 30 II $23 90 I 5 I Ma 60 II $1,063 I Extra Features (Card: 001 of 001) Line Description Year I Units II Value 1 DWC 1968 1 2 2 UDU -M 2002 1 1 II $ 792 3 CLFENCE 2003 320 $429 Sales History Previous Owner WILLIAMS TONY Year Month Book /Page Type Amount 2003 11 5610 / 0515 WD $0 I 2001 I 01 II 4529 / 0977 II WD II $59,000 I 1999 11 4270 /1101 WD $54,900 http: // appraiser. pascogov .com /search/parcel.aspx ?sec =11 &twn= 26 &rng=21 &sbb= 0010 &b... 10/5/2010 NOTICE OF COMMENCEMENT II�1II�IIIIII i� III � I �� IIItIIIII � IfIIIII Permit No: 20101 3788 1 1 I�IOIII EIRE Tax Folio No: Re pt:132783 6 DS: 0.00 Ree: . 10 ty 00 09/27/10 jT: 000 S Shultz, Dp Clerk To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is stated in the NOTICE OF COMMENCEMENT. 1. Description of property: Street Address: - l i 01'4 f 2-- T tct rq c i Z iZ i �ZZ 3 ,3:S Parcel ID: 1 / — .2._.( r— u (.) — CS Ii — 4Z. .Q 4" 2. General description of improvements: r L.) t 3. Owner's Information: Name & Address: �7`} PL - e ?9 , (, t` , 3 G l2 (n` / t , Interest in Property: 0 tN (C)� , CcY'r`o / Kr /�C S f ; ,G . j 3, z Name and Address of fee simple titleholder (if other than owner) ' / T ^ r�r ��`� -13 � 4. Contractor Information: All Florida Weatherproofing & Construction, Inc. v? 13555 Automobile Blvd., Suite 410 • Clearwater, FL 33762 ING:,k( t/751 (/ Phone: (877) 572 -1019 Fax: (727) 573 -1205 5. Surety Information: Name & Address: PAULA s . o' NE IL , Ph . D PnSCO CLERK B COMPTROLLE Amount of Bond: 09/27/10 11: 44am 1 of 1 6. Lender Information: Name & Address:a OR BK PG 1316 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: Name & Address: 8. In addition to himself, owner designates the following person to receive a copy n th * ier:or's Notice as Provided in Section 713.13 (1) (b), Florida Statutes: Name & Address: 9. Expiration date of Notice of Commencement (the expiration date is 1 year from he date of recording unless 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 YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTEQ 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 gnature of O ner or Owner's Authorized OfficefDirector/Partner/Manager ector /Partner/Manager 0,141 GAILZUPKO R 4 e V c P. ( N :••. = MY COMMISSION # DD 979360 N�� , EXPIRES: July 4, 2014 Print Name .ZP ,1" Bonded Thru Notary Public Underwriters The foregoing instrument was acknowledged before me this Z day of `-- — 20 /" by .4 r./ , Y, ,f V as -, A7 /, , k (type of authorit fficer •. ! , trustee ; . • in fact) for I.- r' (name of party on behalf of wh ,, m instr ent wa • xecuted). _ 4 Personally Known OR Produced Identification 4� Notary Signatur= , i, •'. ■� ,/L� Type of Identification P'ro"ducet t G� j6 ' 7 1 ° -3 Z- i 7 ? Na m e (print) T a ,( I "t (c.....0 MI ,0,4,,,,a Verification pursuant to Section 92.525, Florida Statutes. Under penalties of pel jury. 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. -- Sign. re of Nat .: Person Signing (in line #10) Above STATE, OF FLORIDA, COUNTY OF PASCO THIS IS FO CERTIFY THAT THE FOREGOING I:, TRUE AND CORRECT COPY OF THE DOCUMENT ON FILE OR OF PUBLIC RECORD IN THIS OFFICE WITNESS MY HAND AND FFICIAL SEAL THIS DAY OF 2 Oi C _ PA LAS O'N' , C .ERK & COMPTROLLF BY i /. . . �� _ r • PLEASE CUT OU7 CARD :BELOW AND RETAIN FOR FUTURE REFERENCE 4 IMPORTANT _M „*1 _\; 4 „e, F Pursuant to Chapter 440.05(14). F.S., an of liter of s ,e4rmorotion who "'nN \ f "`�°'•� O elects exemption from this chapter by filing a certificate of election limurner ; Rxt9w1 T PTPROMPLORIDA _ o a L under this section may not recover benefits or compensation wider this . 01/211/200e EXP. XRAT:ION DATE: 01/20/2011 Pursuont to Chapter 440.06112). F.S., Certificates of *Nation to be 11RVIS ,PULVORD H exempt.. apply only within the scope of e business err trade listed on E t the notice of election to be exempt. so1272 R dot AND ADDRESS: E Pursuant to Chs too 440.05(13), F.S. Notices of election to be exefapt let R •" TWno0FUN a eol$TRUCTwri etc and certificates of election to be exempt shall be subject to revocation fast t>� yp► most*. 4 i if, at any time after the filing of the notice or the issuance of t certificate, the person named on the notice sr certificate no 4enger meet aTrR - the renuivenlents of, this section for immense of a certificate. The department shell revoke • certNlcae at any time fur failure of the 1�,,_ e SS OR person named on the certificate to meet the ragndrancMs of. WMs �'`wF t 2- CERTIFIED ROOFING CONTRACTOR section. QUESTIONS? SSOi 413 - ?$0S `......•/'.- ....' ` CUT HERE *Carry bottom portion on the job, keep upper po for your records. EIWt ATE OF ELECTION TO DE EXEMPT REVISED 09 -06 s ' :' e,- r' y ` ; 'r + t J • 01-30-2009 'Q. 5°K STATE OF FLORIDA � dtcui,o DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION fl it CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CC CTION INDUSTRY EXEMPTION J* sties that the individual listed below has elected to be exempt troom Florida Workers' Compensation law. ' Nils IIVE DATE 01129/2009 EXPIRATION DATE: 01/29/2011 PbtgFgOt FULFORD TRAVIS 1 753201272 S oSS NAME AND ADDRESS: � WATERPROOFING a cONSTRUCTION INC AO- pOTONDEILE OM STE. 410 1 dIATIi! FL 33702 • OF BUSINESS OR TRADE: VI' dint PROOFING 2- CERTIFIED ROOFING CONTRACTOR 1�� Pettassl Is Pow 440 . 00(14), f.S.. es officer el • corperatla who elects exemption, front this chapter by 1111. • .ts a wane* of &dile Wet els x.: 11 ea recover 0•wlRs or c pasetioe a4er tills chapter. Purseael to Chapter 440.00(02). F.S., Certificates of ebetlN to N •seal... apply only MOM IN 05 baleen sr tree 11.1.1 oe the notice of election to be exempt. Fermat ie Chapter 440.06(03). F.S., NMlees el Medley to N exempt eel certified 's of s ale 11 he exempt Melt he *Niece to r•vocelia It of say time offer the lilies of the emits se the isonao• of the certificate. the penes aeon se the sales or w ind N lager meets the requirements el this adios for assumes of • certtilts h ts. The pertmest shall revoke • certificate es any Ile ler Whys el the person c •Ag 1v i r de calEkos N meet IM requirements of this section. (11 STIONS? (850) 413 _ Orman OF ELECTION TO SE EXEMPT REVISED 09 -06 ` ,, ',' -ri - :. STATE OF FLORIDA iw DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION -1-. CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 FULFORD, TRAVIS ALLEN 1 ER OFI0G & CONSTRUCTION INCORPORATED CLEARWATER FL 33762 Congratulations! With this license you become one of the nearly one million � • ' �' " � t` � " Floridians licensed by the Department of Business and Professional Regulation. , .,. 1, ,1 i`,,, r r..� " .. . Our professionals and businesses range from architects to yacht brokers, from �`�rt ,�y <k, : a „ -, F �t2►E �' kJ . �„ -c, c boxers to barbeque restaurants, and they keep Florida's economy strong. ; a . — ...'1014; r ��r , ,� ' Every day we work to Improve the way we do business in order to serve you better r ...e �••� j: !, , 1, '' ' 4 ' , i}h For information about our services, please log onto www.myfloridalicense.com. e ‘..4.:'''';;I.‘. ' 't There you can find more information about our divisions and the regulations that „ .4+< rjL „....,,-4 t impact you, subscribe to department newsletters and learn more about the f + }t �!' +' . ,, , , ; , , ` § s + Department's initiatives. ” , t � n ,� r • ,, r tti •'li' i 1 Our mission at the Department is License Efficiently, Regulate Fairly. We '" " • ' r J ,'4 . �" ''' • \ , ,?t,., v �r '" ;`) co ns t antly strive to serve you better so that you can serve your customers. r.,;,..,, „0,8 UtJ Wi i Thank you for doing business in Florida, and congratulations on your new license I n ,f Ar ' �Jk . r ,. 49 M„ .. }�• Jh r+ r . i,C'..^ ,A l ^i. Fe+.. DETACH HERE y• t , ;,; \'� :,. e , } 7 ' ! -. et' rr„ •,r, '4.-,,,,,,,,,..,,, > - � ^ � } ;' r 'F.:, l +• ., • -1 . • . .,,,_ ,r' i � +k .) < ,`" . 't om n '�. � . 1 . 1 st }t % , 7Y` c �11�(^ i tir`/ t r ., 3, } ` { Y, ' r : ,'kl ; ;'' f. r .,' t �Yt ` � r - l�'l 4 „.- .. 7;;;;;.$:,...., m ° .� I , : , tist� T � iti i .....,, >.;+ 4.'410. .. l ' .y r' 3 i { `,� ,. K . '''''?/%',";” �' - �\ .�.++." .� y .,�; +-- _" ...,. .'.ye 1 �. t , �";,': �'=. C .- �vyA: :t lit e"''''''' Y p •r /N � ,�^ `. • , f —1 .1,..7;04.v....1., a . 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O. c Z U ,•-i' Q W U- w H CO 'a / k . U 4 -4 - N 1 J Q 1 .9 0 O 0 (r) w r-r 7 W . � •.� ! a o E �0 = JOF -Q UZ ►.:'••) c •a ° O -0 0 J 5 f 11 Z eL v) Z a V O � c v c 7 O c 1 c t . • -_ �, . . fa 5 OW j ' o '- o � to ri ` zwiaw�vovao oo a = a � i rn Ci. t- 13 b a) a, Q 1- tn -Oaa ZU cn.r�c ei — s c cn co U o N u ,. y •°' fl) a). i, J • )0 w 3 � a 1 u): al Ot O m a) of U j m ; cv 2' m of . > o. (pi 03 g at rn 2i o of a) L; a c ca; = c c zi a) a E. o, w: 75 Q Y• ••c t: ° : o Y o a LJ ca 1 = m = , o. 3 a cf. 3 � a a a a) N c •o! v' w' c c a) O7 t a) ° N E c. Q• o c a) C O o O ca U a > in J Z w ii u) U co it us U. 0 c c 1 o 0 3 s 3 3 0 0 Q • • CERTIFICATE OF LIABILITY INSURANCE OP ID Ss DATE(MM/DD/YYYY) ALLFL -1 , 10/13/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Scarr Insurance Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 8200 113th Street N Ste 202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. inole FL 33772 .Ine:727- 393 -5055 Fax: 727- 392 -0497 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: AMERICAN SAFETY INDEMINTY co INSURER 8: ALL FLORIDA WEATHERPROOFING & CONSTRUCTION INC. INSURER C: 13555 AUTOMOBILE BLVD STE 4 1 1Z--- INSURER D: CLEARWATER FL 33772 I 3 3`7(02 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSRC TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIYYYY) DATE (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY lOTSR- GL2587 -00 10/11/09 10/11/10 P $50,000 _ CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1 , 000 , 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 PRO- POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ • ALL OWNED AUTOS c7 7 2- M/9 BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS 7 i -/S---60 BODILY INJURY NON -OWNED AUTOS $ / Z S (Per accident) O RTY AMAGE D $ (Per PR acc GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ — ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE RETENTION $ — WORKERS COMPENSATION WC 5I A I U- 0I H- AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIV1 I OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $ (Mandatory In NH) If yes, describe under E.L. DISEASE - EA EMPLOYEE $ SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER - DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RESIDENTIAL ROOFER DOING ONLY FOAM AND RUBBER MEMBRANE ROOFING (NO TAR, FLAME, ETC) ON ONE STORY RESIDENCES AND MOBILE HOMES * ** *SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS * * ** CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL. ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR City of Zephyrhills REPRESENTATIVES. 5335 Eighth St AUTHORIZED REPRESENTATIVE Zephyrhills, FL 33542- Paul Flaig ACORD 25 (2009/01) ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD All Florida Weatherproofing & Construction, Inc. 13555 Automobile Blvd. Suite 410 Clearwater, FL 33762 (877) 572 -1019 FAX (727) 572 -5670 State Certified License CCC1327406 Contractor's Letter of Authorization I hereby authorize the below named individual to act as my agent to obtain all necessary permits for residential roofing work for: Owner: ?9 d `r At this location: 0 (f Y O Z - f P `f `11j' 1 This person is also empowered to obtain, complete, and sign all forms, applications, registrations, and documentations, with this limited power of attorney, on behalf of me that may be required to accomplish this issuance of any permits that may be required in any jurisdiction throughout the State of Florida. Authorized FL Driver's License # Signature George C. Vaczi V200- 303 -60 -054 -0 1 Contractor's Signature: _____Fa,r�° e `s , f ‘ Travis A. Fulford — Contractor / Director State License # CCC1327406 Notary (as to Contractor) Sworn to and subscribed before me this 3 day of Se /' , 20 r 0 , Personally known to me — ri f t") Cif c• -f—C-6 - *(Print Name), or has produced as identification and who did (did not) take an oath. My Commission E . ��..“ c�nPco Notary Signatur / t _ ;;. MY IR SSpu # 014 :*- 1 •� ' i B Thru Notary - - * ` MIRES: July N UUndeliw hers • . PRODUCT APlOVAL SPECIFICATION SHEET As required by Florida Statute 553.842 and Florida Administrative Code 913 -72; Wombats on the bugling components listed below Ahoy please provide the information and approval for a 9 tom. We recommend you contact they will be utilized on the construction project for which you are epplytrig your local product supplier should you not know the product app -..u_ Hst • ed for of , ::.. � . _ 8 , • - • ' �. = a • rod • roducta are listed online Cr www.ftoridabu • 1. 1•T' 1•� - - /bd A. SWINGING B. SLIDING C. - CTIONILLIROLL UP • D. OTHER _ Z WINDOWS A. SI • • HUNG 8. HORIZONTAL SLIDER C. •' MENT D. FIXED E. WON inemminur_ F. SKYLIGHTS G. OTHER • 3. PANE. WALL —� A. SIDING MIll11111111111111.0.1 C. STOREFRONTS MINI11111111111111....1 D. • • BLOCK E. OTHER - -= �!A. i1• 1 , A. ASPHAL I N S II a B. NON-STRUCT METAL C. ROOFING TILES _ D. SINGLE PLY ROOF _ ' E. OTHER maim �t'I� 5. STRUCT compoNpwf'S - -� A. W000 CONNECTORS - B. W • • • • HORS C. TRUSS PLATES D. INSULATION FORMS _ 111 1112:1111.11111111111111111111111.....m.m. E. LI S 11111111111111111111- F. OTHERS O. NEW EXTERIOR ENVELOPE PRODUCTS A. The products listed below did not demonstrate product approval at plan review. I understand that at the time of inspection of these products, the following Information must be available to the inspector on the jobsite; 1) copy of the product approval, 2) characteristics performance which the product was tested and certified to comply with, 3) copy of the applicable manufacturers installation requirements. Further, I understand these products ■ may have to be removed if approval cannot be demonstrated during inspection. • • • APPLICANT SIGN RE V3 / • DATE • R•1305 01.04 Florida Building Code Online Page 1 of 3 • FL # FL11300 Application Type New Code Version 2007 Application Status Approved Comments Archived Product Manufacturer Firestone Building Products Company, LLC. Address/Phone/Email 250 West 96th Street Indianapolis, IN 46260 (317) 816-3806 Ext 53806 McQulllenTim0flrestonebp.com Authorized Signature James L. Buckner, P.E. 0 CBUCK, Inc. jimmy @cbucklnc.net Technical Representative Gregory A. Brandt Addness /Phone/Emall 250 W. 96th Street Indianapolis, IN 46260 (317) 575 -7199 brandtgreg @flrestonebp. com Quality Assurance Representative Tim McQuilien Address /Phone/Email 250 W. 96th Street Indianapolis, IN 46260 (U (317) 575-7199 -0 mcqulllentim@flerstonebp.com Category Rooflng Subcategory Single Ply Roof Systems Compliance Method Certification Mark or Listing Certification Agency Miami -Dade BCCO - CER Validated By Warren W. Schaefer, P.E. Validation Checklist - Hardcopy Received Referenced Standard and Year (of Standard) Standard Year TAS 114 1995 Equivalence of Product Standards Certified By Product Approval Method Method 1 Option A Date Submitted 09/05/2008 Date Validated 09/10/2008 Date Pending FBC Approval 09/15/2008 Date Approved 10/14/2008 'Summary of Products FL * Model, Number or Name Description 11300.1 Firestone single Ply Roof Systems TPO Single Ply Roof System Attached to Cementitlous Wood Fiber Deck per NOA #07- 0723.03 Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL11300_RO_C_ CAC _07- 0723.03_TPO_on_CWFDecks.pdf http: / /floridabuilding.org/pr /pr app dtl.aspx? param= wGEVXQwtDgvIL5K15SW1d2Xzh8... 3/10/2009 Florida Building Code Online Page 2 of 3 • Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: No 07/05/2012 Design Pressure: +N /A/ -45 Installation Instructions Other: Installation shall comply with NOA #07- 0723.03 Including FL11 300_ RQ_ II _07- 0723.o3_TPO_on_CWFDecks•pdf System Limitations Verified By: Miami -Dade BCCO - CER Created by Independent Third Party: Evaluation Reports Created by Independent Third Party: 11300.2 'Firestone single Ply Roof Systems •0 Single Ply Roof System Attached to Concrete Deck per NOA #05- 0803.03 Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL11300_RQ_C_CAC_05- 0803 .03_TPO_on_ConcreteDeckS.pdf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: No 05/18/2011 Design Pressure: +N/A/ -195 Installation Instructions Other: Installation shall comply with NOA #05- 0803.03 including F1. 0803 .03_TPO_on_ConcreteDe.GkS•pdf System Limitations Verified By: Miami -Dade BCCO - CER Created by Independent Third Party: Evaluation Reports Created b Inde•endentThird Pa 11300.3 'Firestone single Ply Roof Systems TPO Single PIy Roof System Attached to Concrete Deck per NOA #07- 0723.06 Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL11300 _R.0_C_CAC_07- 0723.06_TPp on ConcreteOecks•pdf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: No 07/17/2012 Design Pressure: +N /A/ -202.5 Installation Instructions Other: Installation shall comply with NOA #07- 0723.06 including FL11300_RO II_07- 0723.06 TPO_on_ConcreteDecks.pdf System Umitations Verified By: Miami -Dade BCCO - CER Created by Independent Third Party: Evaluation Reports Created by Independent Third Party: 11300.4 'Firestone single Ply Roof Systems •0 Single PIy Roof System Attached to Gypsum Deck per NOA #07- 0723.04 Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL11300_RO_C_ CAC_ 07- 0723.04_TPO_on_GypsumDecks.pdf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: No 07/05/2012 Design Pressure: +N /A/ -135 Installation Instructions Other: Installation shall comply with NOA #07- 0723.04 including FL11300_ R0_ I1_ 07- 0723.04_ TPO _on_GypsumDecks.pdf System Limitations Verified By: Miami -Dade BCCO - CER Created by Independent Third Party: Evaluation Reports Created b Inde • endent Third Pa 11300.5 'Firestone single Ply Roof Systems TPO Single Ply Roof System Attached to LWC Deck per NOA #05- 0803.04 Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FLI1300_R0_C_ CAC _05- 0803.04_TPO_on_LWCDecks.pdf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: No 05/18/2011 Design Pressure: +N/A/ -135 Installation Instructions , Other: Installation shall comply with NOA #05- 0803.04 including FL11300_ RO_ II _05- 0803.04_TPO_on_LWCDecks.pdf I System Limitations Verified By: Miami -Dade BCCO - CER Created by Independent Third Party: Evaluation Reports Created by Independent Third Party: 11300.6 Firestone single Ply Roof Systems • • Single PIy Roof System Attached to LWC Deck per NOA #07- 0723.05 Limits of Use Certification Agency Certificate Approved for use In HVHZ: Yes FL11300_RO_C_ CAC _07- 0723.05_TPO_on_LWCDecks.pdf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: No 07/05/2012 Design Pressure: +N /A/ -235 Installation Instructions Other. Installation shall comply with NOA #07- 0723.05 including FL11300_R0_II_07- 0723.05 TPO_on_LWCDecks.pdf System Limitations Verified By: Miami -Dade BCCO - CER Created by Independent Third Party: Evaluation Reports Created by Independent Third Party: 11300.7 'Firestone single Ply Roof Systems O Single PIy Roof System Attached to Recover Deck per NOA #07- 0723.07 Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL11300_12Q_C_ CAC_ 07- 0723.07_TPO_on_Retoverpecks.pdf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date http: / /floridabuilding.org /pr /pr app dtl. aspx? param= wGEVXQwtDgvIL5K15SW1d2Xzh8... 3/10/2009 Florida Building Code Online Page 3 of 3 • Impact Resistant: No 07/17/2012 Design Pressure: +N /A/ -202.5 Installation Instructions Other: Installation shall comply with NOA #07- 0723.07 Including FL11300_ RO_ II_ 07- 0723.07_TPO_on_RecoverDecks.pdf System Limitations. See specific deck type for design pressure. Verified By: Miami -Dade BCCO - CER Created by Independent Third Party: Evaluation Reports Created by Independent Third Party: 11300.8 Firestone single Ply Roof Systems TPO Single Ply Roof System Attached to Steel Deck per NOA #07- 0723.02 Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL11300_RO_C_ CAC_ 07- 0723.02_TPO_on_SteelDecks.pdf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: No 07/17/2012 Design Pressure: +N /A/ -105 Installation Instructions Other: Installation shall comply with NOA #07- 0723.02 including FL11300_ R0_ II_ 07- 0723.02_TPO_on_SteelDecks.pdf System Limitations Verified By: Miami -Dade BCCO - CER Created by Independent Third Party: Evaluation Reports Created by Independent Third Party: 11,300.9 'Firestone single Ply Roof Systems •O Single Ply Roof System Attached to Steel Deck per NOA #07- 0813.07 mats of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL11300_R0_C_ CAC_ 07- 0813.07_TPO_on_SteelDecks.pdf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: No 11/27/2012 Design Pressure: +N /A/ -97.5 Installation Instructions Other: Installation shall comply with NOA #07- 0813.07 including FL RO_ II_ 07- 0813.07_TPO_on_SteelDecks.pdf System Limitations Verified By: Miami -Dade BCCO - CER Created by Independent Third Party: Evaluation Reports Created b Inde• - ndent Third Pa . 11300.10 Firestone single Ply Roof Systems •O Single Ply Roof System Attached to Wood Deck per NOA #07- 0130.04 Omits of Use Certification Agency Certificate Approved for use In HVHZ: Yes FL11300 RO_C_CAC 07- 0130.04 TP024n_WOOdDecks •pdf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: No 04/19/2012 Design Pressure: +N /A/ -60 Installation Instructions Other: Installation shall comply with NOA #07- 0130.04 Including FL11300_RO_II 07- 0130.04_TPO_on_WoodDecks.pdf System Limitations Verified By: Mlaml -Dade BCCO - CER Created by Independent Third Party: Evaluation Reports Created b Independent Third Part : http : / /floridabuilding.org/pr /pr__ app _dtl.aspx ?param =wGEV XQwtDgvIL5 K 15 S W1d2Xzh8... 3/10/2009 . ..'I. . ..1.5 L 1/OiLr.SEW0LI/.II/AMf. Y.I.M 2 y��£ UOIPRQSU DU 300 svl 3 5 C=r/ J e4aeeM EIPP IM rarstn3a ,._. $ 4104 ;ooy ued wnwwnro $ is ItlaN1 'u•d'w o£ 1 lig i Pi IN 1 o� _ ill li iiiii f, g ti! x■11 RI El i 1_, ii t tci I� E--. a g b i .. = 3 0 II ' 11 4' 'i x l' = pft lV ffl vi f A d Of 11 iel g 1 11 • g lig 1 ! PE i r 1 \ ' Vi � �� ig tit g' gig 8 1 , ....: , ',---. I EPi ' 1 hi i �; 91 o " B i g __ 11 lib ii 11/41 lo 11 . 1 , , it il. A 1 1 11 - pet i A -_-.. N,,al . - i iv 1t?l- A 1-cti m lot L g j—' ii :i.Agi 1 i I is, : Ili ,:ilE ggi g illit.b§ P. E ij a ij j 1hi 1, =iiw ad r- rOraw 5 • iTiiirER r -M -70. n;,,,,- L-Z„.... 1 Cs 1111 • VM�MM/• � MCC 14 • JeleMing - I, CADOUJO SSE .� 1 O )4 c r/ 1 ! •^1`� ig DUII nKSY�PI 3/Y0 �1 N uo e� MepPoi�ro a 1v0151i13M ..�. 4 4 :ao J oa n ued u ntutun y $ lnQ IOW ' N "d"W 0£ 1 Ei Eil l . i 0 0 G 7 g g =NA RIM l y 11 • ••1 o smWA ►,,, • • • • • :4'4 k:!_____:.----' • • II a:: Sie 1 .44-J • • • • . ■Inith■ .,Mil 510 711, 1 ii r;0., gi • !i )-E % t ; E x li k t t 5 1 - i - , -- as m as i 10's i i t I I Q 1 1 I 0 `, 4 1 s 1 OM 11.11.11 -1p � L h . i i li w it de . - Li b n 1•$g s 1 1 1 v N ` III f * h e- tiA - ALL FLORIDA WEATHERPROOFING • ..,...4., A ND CONSTRUCTION, INC. , 13555 Automobile Blvd., Suite 410 • Clearwater, R 33762 Cad* I l lusion5- 4 (877) 572- 1019• Fax (727) 572 -5670 'Firestone • T.,o .. www.allfloridaroofs.com ag�t Ras •„ 1 Certified License # CCC1327406 • : BC1255525 Own er(s�Purchaser(s) a r � GB` r c r phone: $i 3 7 • 9:°-6947 (C) Mailing Address: 1O ? �Z... f?i City:Z ' / iounly 4 W , ''' State: Zip:1337Z_ Ar art (Circleh SB 9 MHP ] Community Name: j� j if S �? t �/�. � Address: ! 3 7 D J rl [i++tL �-K(� �IY�lState:_ : •7A5 Rfi6rr� _ ma 1(}/# 1 L We, the Owner(syPurchaser(s) of the premises described below, herd referred to as Purchaser' offer to =tract will ALL FLORIDA WEATHERPROOFING AND • CONSTRUCTION, INC., h e r e i n a f t e r mimed b as Tor ad o 1ra h, b delver and arrange for istalstim of al :: - mpove the premises located at 7 JobsiteAddress: :�� Y v O i Z'-- /` V a Z.-et e : J 3 G— according to the timing written sftedtiwtiarms: CHECK MEMBRANE TYPE: X SOUD WHITE MEMBRANE: BRAND FO'n s T' ,• •,.. • • K MEMBRANE: BRAND A COLOR 0 OTHER: 1. PROVIDE ENERGY-SAVING INSULATED WATERPROOFING SYSTEM FOR E ) OWING AREA(S): 1 44412 14,01"...„4.-/--F6 Kordy-,.t 2. INCLUDE ENERGY-SAVING DOUBLE -FOIL FACED INSULATION AS IN ATED: 9 BRONZE: 45 MIL NO INSULATION LATION OGOLL 45 MI :" INSU • ION 3. ALL CUSTOM ROUNDED PRESSURE TREND FRAMING INCL,UDED. TOMER 4. INCLUDE NEW SPUN ALUMINUM VENTS: SMALL LARGE INITIALS FO • 5. INCLUDE UP TO 100 SQ. FT. OF NECESSARY DECK REPLACEMENT. ADDITIONAL DECK S r REPLACEMENT TO BE INVOICED SEPARATELY AT $3.00 PER SQUARE FOOT. 6. INCLUDE ALL REQUIRED PERMITS. 7. CLEAN UP AND REMOVE ALL JOB: RELATED DEBRIS FROM JOB SITE. 8. MAIL OUT [ LIMITED LIFETIMEI NO -LEAK, TRANSFERABLE WARRANTY FULLY COVERING ALL LABOR AND MATERIAL. ($50 TRIP FEE MAY APPLY) 9. ADDITIONAL INFOR ION: 10. IT IS UNDERSTOOD THAT THE FO ING AREAS WILL NOT sisuwAI& AREAS or msg. tihlorrrasas AS BE INCLUDED IN THE COVERAGE PROVIDED BY TH awczirtan Y. citrate .3 ,10. DIANDIS 20 HS aovIERZD. ' AGREEMENT Also = = • rawing at Right): �'as f MCN SMARMS MT an BB COVERED. i _ ',r i�G1/ mil ... § OTHER OTES: 3-10 ' j O CIfJ r� l / �� N S' NOTE: RETAIL SALES TAX MUST CHARGED UNLESS TNJr ocouru GNS THE FOLLOWING: I certify that 1 own the land on which the structure I am improving is permanently affixed. Furthermore, I have filed a declaration with the Property Appraiser requesti g tlsstructure be assessed as realty and it bears an - RP - decal. SIGNATURE: C ! S,.-�. '•. . The CASH CONTRACT PRICE for all Labor & Materials (including any applicable discounts) is $ t [ Q 2 Terms10 Cash 0 Credit (Subject to the approval of the Credit Sales Department) — Sales Tax $ — If this is a cash transaction, the purchase prigc$$ d as follows: _ G � Q QQ �' Cash down Payment (Minimum 33 %) $ ( ' Balance Payable $ Q Total Price $ / < If this is a credit transaction, the agreement for credit is contained in a separate document which is incorporated herin by reference and Made a part thereof. IIWe undersigned are hereby authorizing ALL FLORIDA WEATHERPROOFING AND CONSTRUCTION, INC. to verity and review my /our credit record with an independ- ent credit reporting agency and release them from all lability incurring from inadvertent omissions or errors. Verbal understandings and agreements with representatives shall not be binding. All understandngs and agreements must be set forth in writing in this Contract. ADDITIONAL PROVISIONS ARE STATED ON REVERSE SIDE AND ARE PART OF THIS CONTRACT. UNLESS OTHERWISE SPECIFIED, IT IS UNDERSTOOD THAT THE OWNER(S) IS/ARE READY FOR THIS WORK TO BEGIN. THE PURCHASE PRICE QUOTED ABOVE WILL BE HONORED ONLY UNTIL . Purchaser(s) understands and agrees that 11 this agreement is cancelled after the rescission period , the Purchaser is liable for twenty five percent of the total sales price as damages to the Contractor. In the event this offer to contract is not accepted by Contractor, any payment made hereunder shall be refunded to the Purchaser(s) and this proposal shat be null and void and of no effect. Contractor is not responsible for existing structural defects, dry rot or other factors beyond our control. ol. No repairing, plastering, painting, carpentry, or decorat- ing is included unless specifically charged for and specified in writing herein. Purchaser agrees to the Total Price in tuft upon in lation unless otherwise agreed to in writing. If installation is started but not completed the same day and the parties ag at the instalation is completed rchaser may withhold 10% of the Total Price until installation is completed. �T r IN WITNESS J CP NESS W HERE OF Purchaser(s) have hereunto signed their name(s) this PI0 4-�-� y of and acknowle. : e� receipt of a true co of th is Contract. „ I ` g - z7 -/a x ff , c - r , 9 -z3 -ice SU:, s BY: Re $emotive Date ACCEPTEs : sea n er Date I ` 91. -JCL I'LY Z 3 -,(0 L 1 C: - L BY Authorized Signature for Contractor Date ACC - s BY: • u - '. r /Owner Date J City of.Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: " 1 ( `1' 6 ' c & Vt ' pr Date Received: 9 -27 --/0 Site: 3 ?yo( t 2- — �, Permit Type: L �•C Approved w /no comments: 4) Approved w /the below comments: ❑ Denied w /the below comments: ❑ This comment sheet s all be kept with the permit and/or plans. /Z)-4 . • Kalvin witze lans Examiner Date Contractor and/or Homeowner (Required when comments are present)