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Home My WebLink About11-12321 CITY OF ZEPHYRHILLS , 5335 - 8TH STREET . , (si3)�so-oo20 12321 BUILDING PERMIT Permit Number: 12321 Address: 5542 GALL BLVD Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-08900-0250 Improv. Cost: 8,100.00 Date Issued: 9/06/2011 Name: CCA INDUSTRIES INC Total Fees: 120.00 Address: 13010 US HWY 301 Amount Paid: 120.00 DADE CITY FL 33525 Date Paid: 9/06/2011 Phone: (813)997-0472 Work Desc: REROOF 21 SQ GENFLEX TPO 1 . � C�.� �, r�,l _ ; � TAPE JOINTS ROOf FINAL � `t ( 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 � 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. "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." Complete Plans, Specifications Must Accompany Application. All work shall be pertormed in accordance with Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O. CON CTO GNA RE PERMIT OFFI R ERMIT 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 Date Received � __ phone Contact for Permittln — Owner's Name �5,:.,�1 �-i 1 J (n � U Owner Phone Number � "1 _I � � � � Owner's Address ��1 � � � Owner Phone Number Fee Simple Titleholder Name Owner Phone Number � Fee Simple Titleholder Address JOB ADDRESS c LI �(�6.t� �(�1 l� �- J�cy LOT #�� SUBDIVISION . PARCEL ID� I+• • o� G � V' 0� �• (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH B INSTALL B REPAIR � � _(�,� PROPOSED USE Q SFR COMM Q OTHER TYPE OF CONSTRUCTION � BLOCK FRAME Q STEEL Q DESCRIPTION OF WORK �' 1� C.�. �°l� � I '1' 1'Y BUILDING SIZE �— � SQ FOOTAGE '-( HEIGHT QBUILDING $ 1 _.�- VALUATION OF TOTAL CONSTRUCTION DELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. QPLUMBING �� .. �� 2 �� J QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION QGAS � ROOFING Q SPECIALTY � OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y! N Address ' License # �_ ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address Llcense # �— —� PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address Llcense # � � MECHANICAL COMPANY SIGNATURE REGISTERED Y! N FEE CURRE� Y/ N Address � License # OTHER � ��' COMPANY IL-U� �C I SIGNATURE REGISTERED Y/ N FEE CURR Y/ N Address � ��J� � 33 � License# �� _��1 )�`, j RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set af Energy Forms; R-O-W Permit for new construction, Minimum ten (10) woricing days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities 8 1 dumpster; Site Worlc 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 ail new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. '"*"PROPERTY SURVEY required for all NEW construcUon. Directlons: Fill out application completely. Owner 8 Contractor sign back of application, notarized If over;2500, a Notice of Comr�epcament is.sequl[ed, (A/C upgrades over 57500) " Agent (for the conVactor) or Power of Attomey (for tFie owner) would be someone wlth notarized letter�from owner authorizing same ,. , OVER THE COUNTER PERMITTING (Front of Application Only) ' �y�� Reroofs if shingles Sewers Service Upgrades A/C Fences (PlobSurvey/Footage) r'4� �� 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 compllance 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 Counry. TRANSPORTATION IMPACTIUTILITIES 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, vr 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 cert�cate 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 wo'rk, 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, Wetfand 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 8� Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. - Federal Aviation Authority-Runways. 1 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, 1 certify that use of such fill will not adversely affect adjacent properties. If use of �II 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 fitl, 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 ninery (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU NOTICE OF COMMENCEMENT. FLORIDA JURAT (F. . 117.03) f , OWNER OR AGENT � CONTRACTOR ' �� Subscribed and swom to (or a rm befo e hls Subscribed and swom to (or �d) befor e is by bY Who islare personal known to me or has/have produced Who Is/are pers�nallv known to me or has/have produced as IdenBflcaHon. as identification. ,� �.-- � � �' � Notary Public Notary Public " "", NE BOG��. - t ,...�.�....�,�,� �-��°a"�^'" Cor�mi�sion 2'omm — ` _.: :+: �,• .- . �:,.�.:,..,:_ . • •: ,: � Expir� Decernb: �, ,;,��:� F;:��. :.: {��iri,ri�s.i,C�C1#�� ..,. ... I Name ' �� Name of Notary ty �,.,,�;,.�,�....�'t - FbrdedlMuTroyFanl -. -, _. • • • � • � � ,�•• •• "• �•,� �� JL invcoimcirio,tir� I�UUI/UU1 _ �'o� �a�,o �� o��, �I•�. ��a ��,-� 3 � � A Division of Ry nr�rt Coratrtc�tiou, lnc. ��,� � �,,, �� 15 ,�'-(,, ,'� �� a I rccncr= CCC !3'SqA� Customcr: Tim Linville Date: 8-16-I 1 Codet�: 021 Address_ Zephyrhills Car Wesh ContR�t Numbers: S 13-997-0472 Job Description: I. Perform complete tear af� ofexisting modified torcli material down to plywood deck 2. R�place up to 4 sheets of'/," plywood 3. [nstall Y�" fan fald over ply�vood dcck 4. Install 0.60 white Gen-tic� l'PO roof system over fan fold 5_ �asten ou�sid� cdges with visible aluminum ccrminatior� ba� over existing drip edge 6. lnslall(2) ne�v pitcl+ pans with pout�ble sealer 7. RN��se (4) e�isting roofd�ains 8_ All materials, labor. & permits fumished 9. All roof relatecl debris removed from job site 10. Provide a S year transferable labor �varrflnty on all work and A 20 year manu facturers warranty Addilion�l iums: Bad `/," plywood is replaced At a rnsc of S I.90 sq_ ft. in the roof tield_ All other ��uad wark such as but not limited too, rafler repfacement, Eascie board replaceme�tit. etc. �vill be charged at an Itourty rate of SS5.00 prx ntan hour plus the cos� of matcrials. Additional Nutes: l�aym�nr to be mado as fopcnvs: To be determinvd F'aymenc Mc+had_ rn Totsl Bid Price $8,100,00 {x� (x � V ) 'I'his bccamcs 1 binding contnlCt apl�n acccplaete oPpmpo.vl. Purcha3tr eCkoowie�a a cepy of Ihi c Itac�. �� - 1 All mulerial is guaranlccd l0 b� As spccifiN nnd complctcd in n wbSroedR1 nlxklmnlikc nwnn�r 2. AN n�,ruemCn�s cortlin�eeht upon strikrs. aceidems qr delay bcyon�t our ranrol. ONec+ �o c.m firc. hurriw�t anJ dher htC�f) insa�nC� upon aba� C ��'nrl:. 3. Lnbw �� arman• dors n�e co�•cr doma�,e io roai's causal by IiFhtin�. h��rrirenr. �anada h�ilsram, lm�mct of t'acign q6jecls or ulhcr ridCne atMm ar cawahy JamaEc 10 rool"s Juc lo altlmt�mi. distallon, failure or aveking of�oofdcd: .�aus a r«��;o■ orv building. .I, WnrL•mcil'� eqnp�nsolion s��d publlc liability instlf�ncc pn sbo�•e ��wk ta bt u1kCn q�t by RYMAN ROOfI\G Or ils sub• �vnlfAClixc 5. RYMntv tt(�OF1NG. IroC, is nol rcsponsibl� to prm�idc am mrtwri�ls or lo perform om• a�orl• oth�Y dwn H•hat is dcs�ribed �bove. Rcplaa�ncm uf Jacriorarcd �kckinp. fascis bonrd or a� o�ha mddi�ional ina�ai�IsrMfxx Ilml mq•bc na.�.r! rnd is ��oi dv�cribnl alnwc a�ll hc cl�rge us an c�in unless oU�en+isc s�mcd lw�ein. 6. This conl►+ci is subjeCl lo I+�wl apixo� b�� RYMAN R001� INC,. INC, snd is ihc rn�in agrecinrn� ol ihc {ztnics and na olbcr ��Tiurn or pthcr fonns rill bc ►ccosnizcd. 7. A Cl�egc oC 1.S�ib aaill lie i�dc on ail mlpald I+alaxe� alla 30 da� s D4�s attornn•'s f�. K A a"e rra«�.�in� li�. a�ll M� �dJ�d lu oll cr¢dii a.Krcl �xdero. 7his propowl nw�• bv ��iihdra��n M• Rym�1n RPOfina ifnw �Cep�Cd in � 10) i�n•s � Pricec sobj��ct �v el�an� .+i�ba�� na�ec u�d�xs proposel has txen o��ptcJ by bali Mrtics Thc �.•c pri�,.K. specificaiions and condi�ions e satisfanon• a rcby accrn�od• Yuu uc - �` `' n��no��na �o ao �� r Date• � � Purehase�: Datc$/�,��'�\ �stiia�ator: -- --- R>•man R�lin�. Ine. �+ill nol bc I�eld respmsiblc for am• se�elli�e si�l lors. scp�ic rank. sod. yhrubber.•. pain�. aw�crcir ri1�YnlCni sidC�valk. gultera doH1t Sp/Ntts, scrcenin� vfqm I,��pe aadior am• ahcr typc ofpiping da�Ec �hn1 m�.• aCUt Urnn d1e Abore rCfarod job, 3G41 i SR S4 •%epht�rhills, Fl�rid:i 335�11 • Tcicphon�: 813-,'8?-G(194 • rax: 81.i-�RR-C� -� -� \ �� i �.L' �S �1�.1,1�11:J�� r •��r1 � 1 \ r � �'1'A`1'k: OF liLOltillA IIIIIII IIIII IIIII IIIIIIIIII IIIII IIIIIIIIIIIIIIIIIIIIIIIII�II COUNTY UF 2011136028 TtiL tTNllLRSIGNLD lii;rvby �ives notice t11at un��rovclu�nt will be xnade io c�rlain real property, and 'ui accordance with Cl�aptzr 71�, Florida Sttttues, the 1o11owing uifoiination is provided i�i tlxis Notic� oi'Coiiun�ncemeiil:: L. Dtscription of Propzrty: Ytu•cel No. I 1� o�.LQ •c� I.C�jl Q,' S`� Z-1 � A-�� (J�� . ,. � � � �2-e.��-t-rh� l.e � � G 5� �--��,�- pdr-F-� a-� l�c�c.�- �� i�lc.v ,,� �e d �� -�, � �.., � �z:-� • � � Sc� 3 c� 2. General D�scriptioci of lmprovemeiit: �� - ��,;� 3 • Owii�r l�ifoiznation: Naine: , . A�ldr�ss: � - � � � � 1 ��-� City O ---_ State � Zip code _��;�a � � l�it�:r�st in Prop�rty: Na�iiz of l�ee Sunple Tittleholdei•: 11 �tlier than owner: Addr�ss: � � lty State Lip Code ��. Coniractoi': YYl`��(`l _ ��'1�-�i <l.� e�„�1 I,.' Addr�ss: 36�13 5.1�. 5�}. Zaphvrhills 1�L"33541� .' G �. Sur�ty: Naure N/A � Addr�ss Phoile # City � �tale AIIlOUi1C OP$OIIC�: � Zip Code Rept:1386319 Rec: 10.00 �. Lcnder: N aine N/A Phone # DS : 0. 00 I T: 0. 00 Aclilr�ss 09/01/11 K. Garcia, Dpty Clerk �� State Zip Code �7• 1'Crsons withui tha Stata of Florida designat�d by owucr up�ii whum notices or other c(ocun�ents may be s�rved as pi•uvid�d by Sectioii 713.13 (1) (a) (7), rlorida Statutes: PqULq 5 0 'NEIL,Ph D PqSCO CLERK & COMPTROLLER Nam� N�/A Phone # 09/01/11 09_51am 1 t1ddress OR BK � �r•�� P �' �� Stale ' _ Zip Code 1�. lii additioi� to himselt; Orvn�r designates: N/A °t Phone # to receive a copy oPthe Lienor's Notice as pz�ovid�d in s�ction 713.13(1) (b), Florida Staiutes. 9. E�piratron dat� of Notica of Conuiienc�ment (tl�e expu•ation date is oiie (1} yo�u• tcom 1,1�e clal� of record'uig unless a ditfereni date is speciiled.) � \�Vi�1�.N1NG TO OWNElh: ANY pA�1VIEN 1 S 1VlADE T3y T�-I� OWNLR AFTLh TH� LXl'i1tAT101V OF THE 1vOT10E OF C�.1VIIvrLNCENIENT ARL CUNSIDEI..ED TNil'ROPLR PAYMENTS UNDLR CI�A.PTER 713, NARI l, SECTION 713.13, FLOP.IDA STATUTES, ANp CAN R.�SULT IN YOUR PAYING TWICE FOR X1V11'ROVEIVlEN`1 S TO YOUR PROPERTY. A NOTICE OF CONIMENC�MLNT NIUST BL ItECORD�ll ANll 1'OSTED vN T�E JOB SITE BEFORE THE FIRST TNSP�CTION: IF YOU 1NTEND TO �BTA1N I�iNANCi1VG, CONSULT WITH YOUR LENDER OR AN ATTOIZNEY BEFORI: C4M.IvIENCING WOP.I� OR 1�k;CORDING YOUR N TICE OF CO IENCEMENT. _ ^ tiigii�uurC uF Ownei° ---- Printecl Name_ ` � � _ � } �, �. `l,� s�r�a i r, or r L:ua�. coti�v� Y or '1'�� torCgoing uistrumant was acl:nowledgzd b�fore m� this � da of _�____ Y ��Ic �'� , 20 ,`'";_p�rsoiiaT iciiown to in� or who produced ideutitic• ion, and �vho did/did nut t�lcc oath (piease cu•cle whicli) TI i`�l �',�v � l� ,�,Rr. � � � r o � Notary p'ublic Std�of F.lorid� ---____ Chrisiian Rymafil ^�. NUttll'y Y �! �� Nl� COITll'll1SS1011 LX�11I'BS: �` � MY, CbmmigSj0�p7� ' • �' .. Uizd�r peualti�� of peijuiy, I declare that I have r�ad tli� for��;ouig Notice oi:Coinmenc�niznt and ihafi.the facts•stale it are tru� lo lia b�st of l:n��vledg� and beli�f � , w:, � • �;; �'- (Siguatur� uf O ier Si�nin� Above) STATE OF FLORIDA, COUNTY 0� PA5C0 THIS IS 70 CERTIFY THAT THE FOREGQING IS A TRUE ANp �QRRECT COPY OF THE p�CUf�ENT ON FILE QR QF PUBLIC RE�QRD IN TH1S OFFICE WITNE,SS MY HAND AN FI I�XL �EA� THIS � DAY OF, ` � ' PAULA S O' EIL, C�E & COMPTF�Oi� ER � DEPUTY CLERk O � !f� � � City of Zephyrhills BUILDING PLAN REVIEW COMMENTS •—� Contractor/Homeowner: � ' �� C Date Received: – / – ( I " site: ,�,-�j � Z �D �4 f 1 J� � V(� Permit Type: � � Q Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑ This co e t s eet all kept with the permit and/or plans. � Z`��/ Kal n Switzer ans Examiner Date Contractor and/or Homeowner (Required when comments are present) _ �i__ .____. ..--'- - � Florida Building Code pnline �� l �'� � of 2 � . __..-----�� ..� ,, � � — . t'" lCIS Name Lsy tn , U�r Raphtratlen ' Hot To� 8�nk Swduroe Sats a fsas PuhNntloro ; FeC RkF . stf5 Sk� M�v . UnNS � SNreh Produet Approvai �i usu: a,eNe vw. / � '� anau�la�nva�!l�uu � Proarcc w.�vvuwe�ao.se�� > �ord wc >�rrawa.e o.tat� -- + ALL WOF(K SHALL COI�fpLy WITH ALL � ApplteaHon Type i�� n PREVAILING CODES, F'LOWDA BUILDING coa� v�o� �, zoo� CODE, NATIONAL ELECTRIC CODE AND nppuc�don status '� �vv►�� CITY OF ZEPHYRHILI.S ORI�INANCF,S Comments ` � ArchNed ' I� Product Manufadurer Genflex RooAnp Sysbems, LLC Addrcss/Phone/Emall ?SO Wast 96th Sb^eet Sulte 150 ( Indlanapoll�� IN 46260 � ".�. V� L)H�`� "� J f rt �equue�pm�nrestoneDp.com : � 1 �' �� OF z'EpHYF; ILLS -_ Autl�o►Ized �gnature tlm mequlllen ��' �XqIV►J►�� _ �tl mcqudlenpmlflrcstonebp.com � Teehnlcal Representative Tim McQulNen � Address/PhoneJEmall 250 West 961fi Street indlanapalls, IN 46240 (800) 443-+1272 ExC 53606 mcquUkntim�flrestnnebp.com Quallty Assurance Representative David Wally Address/Phone/EmaU 393 DenWn drele Tuscumbla, AL 35674 (256)�86-8383 davld.waileyaomnovs.corr� ^ Cstegory Rooflny Subcategory Single Ply Raof Systems Compllance Method Evalustlon Report from a FloMda Registered Arehttect or a Uce�sed Florlda Profasslonal Fnqineer fY: Evaluatlon Report - Itardcopy Recelved FloAda Englneer or Archltect Name who Robert Nleminen — developed the EYaluatlo� Report FloNda Llcense PE-59166 — Quallty Aseurance EnNty UnderwHters Wboratorles Ine. Quellty Assurance Contract Expirotlon Date 03/3D/2013 Valldated ey )ohn W. Kneuvich� PE Ig Validadon Checkllst - Hardwpy Recdved Certifltate of Independence FL69d3 R2 COI Trinitv ERD C[ - Nieminen.edf Referenced Standard and Year(o� Standard) Standare Y�ar ASTM D6878 2003 FlM 4470 1992 � ,ttp://www.floridabuilding.org/pr/pr app_dtl.aspx?pazam=wGEVXQwtDqu%2foRM43... 11/22/2010 f ; , � v Page 2 of 2 Florida Building Codc Online Equlvalence of Product Standards _ Certlfled By Sectlons from the Code Product Approval Method Method 1 Optlon D Date Submltted 06/28/2010 pate Valldated 06/28/2010 pate Pending FBC Approval 07/12/2010 pate Approved 08J10/2010 YA1111i O� PfOdYdf ^-_�...-.•^.......•......•..•-.� ...___._.._..__».. ._... � p Numba� er Name ri n 6943.1 TPO S�n�le �Y � � rmoplastic polyoqfln� stn9le-Ply rnof sYs�� Wnits �t usa tatlon Imtrudtsn� Ilop'oved for use in FIVHZ: No EL�l4�$�tLAL�.fIlEZSi Q�IN,..,GE�,IFt,EX Approwd fo� use outside HVN2: Yes ..�164�.B2.RS�[ =enpact ReslstaMt WA Verlfled By: Robert Ntemtnen PE-59166 peNge Prasuh: +N/N-292.5 Created by Independe� Thlyd Ps�'tY: Yes OtMr. 1.) The DP tf1 thls ippllcatlo►1 f'e�ers to o11e [valu�Non R�perts c root assem6ly. Refa to ER Appendlx for alt � 6�43 R2 AF er032si0FINA� Gd�tFL TPO FL6943 seembNes and max desiyn preswras. 2.) itefer to ER on 5 for Umits of Use. Created Ind ent Thlyd Pa : Yes -- � a�xe pyr� t��ln C1MIu Md�vMr tS?Sirianird Ork Onalsrad r�ei�w r�r, u�s-u� �eso1 rsrao�. ax n+ol.t«ass e x000-mia me stio. �r �. �a �s �awd. � I �e�wrLht ShtenSe� � I p�yp'In SeRware � nM -, e � I� �11C� � � "_ � � � � •xWk lthtwua r wi:s . v...v � http://www.floridabuilding.org/pr/pr app dtl.aspx?param=wGEVXQwtDqu%2foRM43,.. ll/22/2010