HomeMy WebLinkAbout15-15893 CI OF Z�PHYRHILLS
5335 i$TH STREET
(si3)�so.-nozo 15 93
_ �.� UILDI�NG PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 15893 Address: 39023 CANARY AVE
Permit Type: RE-ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: EASY ACRES
Est. Value: � Parcel Number: 13-26-21-0120-00000-0370
Improv. Cost: 7,400.00 I OWNER INFORMATION
Date Issued: 1/07/2015 Name: SMALL, SEAN & SABOTA , HELEN
Total Fees: 112.50 Address: 39023 CANARY AVE
Amount Paid: 112.50 ZEPHYRHILLS, FL. 33542
Date Paid: 1/07/2015 Phone: (813)862-3460
Work Desc: REROOF RUBBER ROOF �
CONTRACTOR S APPLICATION FEES
RYMA ROOFING INC REROOF RE ID NTIAL 112.50
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Ins ections Re uired �
DR N ROOF INSP
TAPE JOINTS ROOF INSP
FINAL � - l 3 -- i j�
REINSPEC�ION FEES: Reinspection fees will c mply with Florida Statute 553.80 (2)(c)when extra inspection
trips are necessary due to any one of the follo ing reasons: a)wrong address b) condemned work resulting
from faulty construction c) repairs or corre ions no�made when inspections called d)work not ready for
inspection when called e) permit not post d on jo�site� plans not at job site g)work not accessible.
NOTICE: In addition to the requirements of this per it, there may be additional restrictions applicable to this property that
may be found in the public records of this county, a d therelmay be additional permits required from other governmental
entities such as water ma agemen�, state agencies or federal agencies.
"Warning to owner: Your failure to record a otice of commencement may result in your paying twice for
improvements to your property. If you inten to obt�ain financing,consult with your lender or an attorney
before recording your notice of commencement." �,
Complete Plans, Specifications Must Accompa y Appli'cation.All work shall be pertormed in accordance with
City Codes and Ordi ances. NO OCCUPANCY BEFO C.O. �
CONT TOR S E PERMIT OFFI R
P MIT EXPIRES IN 6 MO THS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTI N - 8� HOUR NOTICE REQUIRED
PROTECT ARD FROM WEATHER
�
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813-/tlU-UU'GU l�ll,�/ VI C���y���m�u � a.�nu�,•rr�,•••,•,.,.•'-
Buitd(ng Department �
Date Received � �( ? c�
hane Carttaet far Ferinitting �3 7�? � �� !_� ;;
owiser's�Ha�ine _. fi��l t5�0�(� � ��c�� "�- �(�C�� ��
. ._......._..: Clwner Phoae Nuriiber !s> _ 't t� !
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Owner's�Addiess ��Z� C_F/�v`C� / �`+�— Owne�Phane Number
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Fee Simple Titleholder�Name I Owner Phone Number�- �!;
. � ,�
Fee Simple TitlehalderAddress � •
JOB.ADDRESS: ���''� C.Gc^r'Gtfi" �¢' �'t �'h(i��S� T�-- �3�'J�2^ L.OT#
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_ _su��i�v_isrorr' �tt.s �'�5 . ;,;PARCEL=;lD� :'I3:°'2.�—2i-- D I.zb--���--.d�7t� . .
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WOFtMC PitOPOSEp� e iVEW Ct7NSTR ADDlAL'i' StGN MOVE Q DEIVtOL(SFi
� � � ' ��� ` `"'�' � � INSTALL REPA�Ft � _
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PRt)POSED U5E . Q SFR'� GQMM `���OTHEff �' . ` " • • '
TYPE OF CONSTRUCTION ,�✓�. BLOCK _,, FRAM6 Q STEEL � Q OTHER ' - � � �
DESGRIPTIONtOF;INORK},' It,a,ii�'i3��i'fC"'f�' `�� '���� ) �f d fdb� j�UG( �5c$•;,.�tm'�' t�{�'.C,�G. .C`--��I.C� ,
I BUlLDING,SfZE �� ., :_SQ FOOTA �E.1_. � _� NEI�,FtF��_� � �
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, � BLlIi.DING . � .. � 1 t, � VAE.Cl�TiU{V OF TC)TAL Gt�NSTi2U.CTItiN � . ' ' . ,. '
� ��`{;�`:��. .'.•`� . . -
Q �LECTRICAC � � AMP SERVIGE Q PF20GRESS E1�iERGY Q W.R.E.G.
Q P�EJMBING � � . � ..
. �
Q �MEGHANlCAL $ z , _ VAl.UATION OF MECtiANtCAL INSTALIAT[Ot1 • ���� �
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� o,as �:� t�oo���� s��c�aLrr j� ort��R � " �
FINISWED F1.00R ELEVA710NS FLOOD ZONE AREA QYES [�NO , .
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SIGNATURE . . ,RE��s7ert�o Y/.N . FEE CURREN'f �� `Y/IV ' - ° " I
Address � ' ,Lficense# '� .` ' ' � ' ( (
. �
ELECTRICtAN CUMPANY � � ' - `
SIGNATURE REGISTERED Y/ N �FEE CURRENT' ''Y/N
Address � License#�"�� ' �
PLUMBER CCIMPANY
SIGNATURE � R��ISrER�D Y/ N �e cU�Nr Y!N
Address I Ltcense#� � - -- �
M6CHANICA� COMPANY' � � • '
SIGNATURE �R��is�REa � � Y! N �e cuRR�Nr Y!N
Address ` ' - ' �I Llcense# - � ' 1
OTHER:° ��.� =.Ct}MPANY..::� �"� ��b-F�h ' ��Xt4 , . ` .
SIGNATURE�� RE�.,ISTER�O Y IV FEE CURRENT' Y 'R)
;Attilress=.; ,�tv�t3 �' � t r'�?r��5 F� 35�� � . �`License� 1��%�./�`ZS���
RESlpENTlAE. Attach{2}Pta#Pians;{2}sets af Buiiding PIa s;{1j set�of Energy Forms;R-0=W Perm(t for nevu construcUon,
� Minimum fen(10)..working:days after submitt i date. Required onsife,ConstrucNon Piaas,Stormwater Plans w!Si1f Fence iristalled;
� Sanitai.ry Feciltties 8�1 dumps#er;,Site Work �ermit fbr subdivisionsllarge proJects " �
GOMMERCIAL Attach(3}_sets af�Building Pians;(1)set af E ergy Forrris:12=0-W..Permif farnew construcNnn. ; : . ' .
Minimum ten�(10j wotking days affer submi## I date. �Requtred onsite,Constructian Pfans,Sformwafer Plans.w!Silf Fence instaJisd,
Sanitary Facllitles&1'dumpster.Site VVork ermlf for all new proJeots.Al)�ommercial requirements must meet compliance` � - ,
SIGN PERMIT Athach(2}sets of Engineered Plans. ` . , '
"*"PROPERIY SURVEY requtred.for all N6 construcUan. . .
Directlons: .
Fill out application compiefety. � ' , � ,_ �
Owner&Contractor sign back of applicaUon,notarized
If over$2500,a Notice af Gommencement is requlred. ( C upgrades over$5000} •
•' Agent(for the aantractoc)or.Powec of Attomey.(for the.owner would be someone wikh notarized lette��from'owne�;authorizing'sam'e°';" '
'QYERTHEGOt}t�iTERPERMlTfING (Ftnnt�of�App�icaUon�Otil j'; „ ;,r:� ` _., .. " . . �
Reroofs Sewers �Serviae;Upgrades ,AJ '� Fences(P1otJSurveyJFootage) ,t" ,:;; � . � ' - --.
I' � f, �y' - � � ,
. .., . . ,- � - . _ :1'. .. r�... .� . .� . .� . ' .
priveways-Not over Cciuriter,if,on.puii.lic roaii,ways..ne_e:ils R� Vii _ , .. ...u._..�.......,._ F..,,...,�.,,..,,,,.
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• NOTICE OF DEED RESTRICTIONS: The,undersigned understands that this permit may be subject to"deed"restrictions°
which may be moce restrictive than County.regulations. The undersigned assumes responsibility for corppliance with any
applicable deed restrictions. '
UNLICENSED CQNTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contracto� 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 h(red a contractor or�contractors, he is advised to have the contractor(s) sign
� portions of the "contractor Block° of this application for which thgy 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 IMPACTIUTiLIT1ES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that T.ransportation Impact Fees and Recourse Recovery Fees may apply to tHe construction of new buildings, change of ,
use in existing 6uiidings, 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 idenfified_at the time of
permitting. It is further understood that�Transportation Impact Fees and Resource Recovery�Fees must be paid prior to.
receivtng 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 permif issuance. Furthermore, if'Pasco County`WateF/Sewer Impact
�fees are due,they must be paid prior to.permit.issuance ir�accordance with applicable Pasco County ordinances.
CON$TRUCTION,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—Flomeowner's
Protection Guide" prepared by the Flo�ida Departmet�t 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"owne�'prior to commencement. �
CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be doRe�in compliance with all applicable laws regulating construction, zoning and land development: .Application is
hereby made,to olitain 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. ( also
. certify that I understand that.the•regulations of.o#fier government agencies may�apply.to the intended work, and that it is
my responsibility to identifj►what actioris I must�take fo be in compliance. Such agencies include but are not li'mited to:
- Departmenf�of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
.Lands,Water/Wastewater Treatment.
- $outhwest Florida Wate� Management District-Wells, Cypress Bayheads; Wetland Areas,. Altering
Watercou�ses: �
- Army Corps of Engineers-Seawalls, Docks;Navigable Watetways. -
� . � Department of Health .8 Rehabilit�tive Servlces/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental_Protection Agency-Asbestos abatement.
- Federai Aviation Authority-Runways. -
I undersfand that the following`restrictions apply to the use of fill:�
- �Use of.fill is not_allowed in Flood Zone"V"unless expressiy 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 engineec:
li�ensed by the State of Florida. �
- � If the fill material is. ta 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 violatirig
the.conditions of the building permit issued under the attached permit application, for lots less than one (1)
. acre wh[ch are elevated by fill, an engineered drainage plan is required. .
If I atn 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 undecstand that a separate permit may be required for electrical work,
plumbing, s.'igns, wells, pools, air conditioning, gas, or other-instailations not specifically inciuded in��the application. �4
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 p�ovisions of the technical codes, nor shall issuance of a permit�prevent the Building Official from thereafter
requiring a correction of�rrors in plans, construction�or violations of any codes. Every permit issued shall become.invalid
unless the work authorized by such permit,is commenced�withirr six_months of permit issuance, or if work authorized by -
the permit is suspended or abandaned for a period of six(6)months after the time the work is commenced. An extension
may be �equested,-in writing, from the.Building Offlcial for a period not to exceed ninety (90) days and wiil demonstrate
justifiable cause f,o�.the extension. If�work ceases for ninety(90)consecutive days,th�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 YO.0 INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. �
FLORIDA JURAT(F:S.11�7.. •
—.;�+rw ;T��:y 'v.Tiie, n3i,."- ,'v';�,i<�zF.�i�j`�,3`���.°�.���T{i;f?;i`;1;�:F::s;•::':ir„=' - ' — ;'i:�,�.. -
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OWNER,QR�AGENT:.... - . ��:.Y-�-`�:='si`GONTRACTOR:`•�. �
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• Suti'scribed and swom toPor et me thts Subscribed and swom. r a �rtned �fore me.thts
by `T�mir � by ( �'1 ���� -
Who.is/are personally known me or has ave produced Who is/are Personally known to or has/have produced
' as idendficaBon. as idendflcation.
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� tary Public Notary Public
'� '1�'�: L E.B CON � � ' I
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, _; a: Expires June 29,2018 �: ':.= Commission#FF 137073
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' A Division of Ryman Constructi n,Inc. "' Proposal#
36413 SR 54 •Zephyrhills, FI rida 33541 0 6 �,5
INC. p h o n e(8.1 3)7 8 2-6 0 9 4 • F a x(8 1 3)7 8 8-6 7 7 3 S 1z,c.—7 Es tima te# ��
1-855-Go-Ryman (1-855-467-9626) • ic.#CCC 1325505
Serving all of Centr I Florida Job# ,
OwnedPurc r. ��� �� Date: U� (� I�,
Claim#: Insu anceCompany:
Policy#
Address: (� � (,�t��'f � City: ��y'� ��1 t(-� Zip: �3�
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Home#: Cell #: � �`' � Business#:
E=Mail Ad ress: 7/�� � � �
Complete tear off of existing Additional Notes/Special Concerns: '
I
Secure all loose roof decking as needed according I
to orida Building Codes I
oof dried in with
I
� In all new valley metal with galvanized metal I
ns I new "drip edge color: U� I
tall new lead boots I
Install all new general roof vents
Install new �J l�� � � �� I
❑ anufacturer: , � -
Col : '? e I
I roof related`debris removed from job site, pick-up lo se I
s using commercial grade magnet
All materials; labor and permit�.f rn�s�ied
❑ Provide a�� /� �✓ � `�C labor warra ty Total Investment$ cv `� ���
Additional Items:
�J�Yr� �'i,�'i'/:r'�I ���zi�— �d�2/d�'.�t%� ��.
a '�. o{-F' �Jl�Y� tisJ -r-� !PL��?✓'✓"`�1�, _
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Payment Method: ❑ Check# �Cash ❑ IFinancing ❑ Insurance Claim
❑ Credit Card# Exp.i ate CC ID#
Down Payment:$ Amount Financed: '�� Approx.Monthly Payment:$ �
PaymentTerms: � `� ,/ v" " �� .(� c/' �M � ��� ����"�
Extra . ' t�
eficient 1/2"plywood replaced at a cost of$ ��! p r sq.ft. in the roof field,which includes labor&materials.All other wood work/ad-
ditional labor, such as,but not limited to,valley rebuilding,raft r replace�ment, 1x decking,etc.will be a rate of$ per man,hour plus the
cost of materials. � •
THIS BECOMES A BINDING CONTRACT UPON ACCEPTANCE OF P OPOSAL.PURCHASER ACKNOWLEDGES RECEIPT OF A COPY OF THIS CONTRACT.
I ACCEPT THIS PROPOS L D H REB CER IFY THAT I HAVE R AD AND FULLY UNDERSTAND THE PROVISIONS OF THIS CONTRACT.
Purchaser: �'� Date:��Q� /� _
Purchaser: Estimator: ,��►"�� ' � ,���
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Busines����� �-�
Professibn�al �`'"���P e°a b�tuAPproval
Regulation
Produc[Aooroval Menu>Produd or A Ilcati n Search>A IlcaHon >A ieation Oetail ���f���v 1'��f.�,�� �v
:s:�"G"��`�.7'�..��i� FL# F 6943-Ft3 pL Y UFt_��%yY �_
�;�y����a� y:��:3 evislon q�VS E R�l
���,r_�r�5'3;���:,��-.� APPlicatlon Type �'/.���� ��
��::'�=x��s_ .2010 �R
;��3,`��;�-`=-�:.'".--�a-�'-,,;� Code Verslon `
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� 2�11
' � TAS 114 2004
UL 1897
___ Equlualence of Froduct Standards
—�---- --- -
- - - -- -- --. Certlfled By -------
Sections from the Code
Product Approval Method Nlethod 1 Optlon D
Date Submitted 12/12/2011
Date Valldated 12/14/2011
Date Pending FBC Approval 12/20/2011
Date Approved OS/31/2012
Summary of Products �
FL# Model, lumber or Name Deseription
6943.1 GenFlex PO Single Ply Roof THe�rrioplastic polyollfin,single-ply roof systems
Systems �
Limits of Use Installation Instructions
ppproved for use in HVHZ: o FL6943 R3 II A1 eriZ0911FINAL GENFLEX
TPO FL6943-R3.odf
Approved for use outside H HZ:Yes Verifled By: Robert Nleminen PE-59166
Impact Resistant:N/A Created by Independent Third Party:Yes
Design Pressure:+N/A/-292 5
Other: 1.)The DP In this appli atlon rendixtfo�all FL6943'R3 AE er120911FINAL GENFLEX TPO FL6943-I
specific roof assembly. Refer to ER App —�
assemblles and max design pre sures. 2,)Refer to ER ��e�d by Independent Third Party:Yes
Sectlon 5 for Limlts of Use. ` --
-----
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The State af Florida is an AA/EEO emplo ec Co rl htI2007-2010 State of Plorida.::Pdva�v Statement::Accesslblli�5teteme^�::Refund Statement
U sendFelect o'nlc�malrl to this en[ity.Ins eadl,can[act thefofflce by ph ne or by tradltlonal mall.If yau havef any questions regarding DBPR'suADA web t
ac esslbllity,please contact aur Web Master at wehmas[er@dhorstare.fl.us.
, Praduet Approval Accepts:
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- - --Flari�a C:partment,f'— _ . -----
Business(L1I :;y`y product Approval
Professib�a �`�^���USER:Public User
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ProduR Ao��o�a�Me���P�oduc[ar A Iicat n Search> Ilca n LI5 Applicatian 0[aiI f"�E��lC�� �,�-
:`s�^k^�,�s'�"'-'�.-+:�a;;,-�;��a FL6943-Ft3 ��TY OF�,w�HYRH�LLS
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�:�;�;�i'"��''y}.' ro rtev�s�on l�NS EXA
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Comments
Archived r
Product Manufacturer Gen. ex Rooflng Systems,LLC
Address/Phone/Email 250 West 96th Street r�-;Jy�„�j(i�li: ,�:'t�.'_`- '.'��NiPL�'��'JI'I`F�
suite 150 ,�,L f�''FIJ�.,�,:x i;;c, �UILDI�I�TG
Indianapolts,IN 46260 �
(317)816-3806 ELEC�'RICA�,,?'LiJN�.BING�
mcquillentim@flrestonebp.�,aFl7��,�r�_r'�A,?,�:���$,
Authorized Signature tim mcqulllen
mcqui Ilentl m@flrestonebp.com
Technical Representative Tim McQuillen
Address/Phone/Email 250 West 96th Street
Indianapolis,IN 46240
(B00)443-4272 Ext53806
mcquillentim@Flrestonebp.com
Davld Wally
Quality Assurance Representativ 393 Denton Circle
Address/Phone/Email Tuscumbia,AL 35674
(256)386-8383
d avi d.wal I ey @ o m nova.co m
Category
Roofing
Subcategory Single Ply Roof Systems
Compliance Method Evaluation Report from a Florida Registered Architect or a Llcensed
Florlda Professional Engineer
r' Evaluation Report- Hardcopy Recelved
Florlda Engineer or Architect Na e who
Robert Nieml�en
developed the Evaluation Repo pE-59166
� Florida Llcense
quality Assurance Entity Underwriters Laboratories Inc.
03/30/2013
Quality Assurance Contract Exp ration Date �ohn W.Knezevich,PE '
Valldated By � Received
r Valldation Checklist-Hardcopy
Certificate of Independence FL6943 R3 COI Trinitv ERD CI-Nieminen.pdf
) Standard Year '
Referenced Standard and Year of 5tandard Z006
ASTM D6878
FM 4470 i99Z
FM 4474 2004
�, i
http://www.floridabuilding.org/pr/pr_a�p_dtl.aspx?param=wGEVXQwtDqu%2foRM43U... 3/14/2012 .
.
" �I'1Vlll:�t 17uttuut�j�..vu.. viuucv
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+ TAS 114 2d11
, � Uk,1897 2044
------ --. -- . _ ._Equtvalence of.Product Standards
- - - - - --- -- - ._-._ _Cer.tifled ey ._ __�.
Sections from the Cade
Product Approvai Method Niethod 1 Optton R
Date Submltted 12J12J2011
Date Valldated 12/14i2011
Date Pending FBC Approva! 12J20J201S
Date Approved dii31J2412
�
Snmmary of Products �
FL# +��}Model, umber or Name Description ,
6943.1 GenFtex PO Single�Piy Roof TFierrriop{astic,poiyaliPtn,singie-p{y roof systems
�_—�Systems . ,
Limits of Use Znstallation Instructions
Approved for use in HVHZ: o �L6943 R3 II AS er120911FINAL GENELEX
Appraved for use outside H HZ:Yes TPO PL6943-R3.pdf
Impac#Resistant:N/A Verified By: Robert Nteminen PE-59166
Design Pressure:+NjAJ-292. Created by Independent Thlyd Party;Yes
Qther: 1.)7'he DP in thls appll afiion refers to one Evalua#4on Reparts
specific raof assembly.Refer to ER Appendtx for a(1 FL6943 R3 AE er120911FINAL GENFLEX TPO PL6443-�
assembiies and max des{gn pre sures.2.)Refer to ER R3.odf —�—�
Sect(on 5 for L(mtts of Use. Created by Inde endentThird Party:Yes
6ack Ne�ck
Conta Us::1440 Hqrth Monroe Street Tallahassee FL32399 Phane:850-487-1824
The State oP Flortda(s an AAjE£O emplo er.Convriahtl2007-2USQ Skate of Florida.::Pdvacv St�tement::Acressl6il(tv Statemen�::Refund Statement
Under Florida law,e-matt addresses are ub!!c recordsi Sf yau do not want your e-mall address released In response ta a pubiirrecords request,da not
send etedronic metl ta this eattty.Ins ead,r.�ntack khe ofFlce by phone or by tradlttonal mall.If you fiave any questfons regardtng D9PR's ADA web
ac esslblllty,please rontact our We6 Master at we6maste dhpr.sta[e,fl.us.
Product Approval Accepts:
� � c�ticek —�>,c
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securitsau:ruic,
Ven5lgn� �j!�1 '�+'
rru9cea 1 ;
VEIIIFY�
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http://www.floridabuilding.orglprlpr_a p_d�l.aspx?param=wGEVXQwtDqu°la2foRM43U... 311412012 ,
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City.o�f Zephyrhilis
BUILDIN PLAN REVIEW CO1�rQvIENTS
ContractartHomeowner: � ���� r � �
I
` Date Received: 1 Z. - I � t — �
l �
s�t�: 3Ya 3 CAN ARY Av�
, Pezmit Type: `� a �R oo► �j V�.�
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, t � enied w/the below comments: ❑
aved w e belaw commen s. ❑ D
Approved w/na camments. Appr ,
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This comment sheet shall be kept with the permit dlor p'1ans.
s � 7 �t���l�.
Kalvin Switzer—PI Examiner Date I Cantractor andlor Homeowner
� {Required when camments are present}
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I IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII
,
, , 2015001311
Permit No. Parcel ID No ��''�lr�� ��- �l�6 -���Q �d 3�O
NOTIC OF COMMENCEMENT
State of ,County of g�`,�v
THE UNDERSIGNED hereby gives notice that improvement will e made.to certain real property,and in accordance with Chapter 713,Florida Statutes,
� the following information is provided in this Notice of Commence ent: � '
1. Description of Property� Parcel Identification No. � "�o J z(-�lZ(7-' bC7c�C0� d3"T d
Street Address. .t. �
_ 2. General Description of Improvement � !�
- -- i
3. Owner Information or Lessee information if the Lessee contracted�for the improvement:
� � . �
ame �..� � � � , �f D��I Q��i I�S � `.�JJ' C�Z
Address � Cit�— state i
� Interest in Property� ��n� ' �Rcpt:1651844 Rec: 10.00 _
� D5: 0.00 IT: 0.00
Name of Fee Simple Titleholder• _ __ _ _ 01/06/2015 S. P. , Dpty C 1 erk _
f different from Ow er listed above) '
I
Address ' City State
Contractor \. �
� C Na . ���� e d IS � �J 35�/
� Address � City State
� ��� _� r �
Contractor's Telephone No.. PRULA S 0�NEIL,Ph D PRSCO CLERK & COMPTROLLER
0�oR6BK 1�13�m PG 31�4
5. Surety i _
Name
Address City State
Amount of Bond: $ Telephone No.
6. Lender:
Name I
Address � City State
Lender's Telephone No.. �
i �
7 Persons within the State of Florida designated by t e owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)(7),Florida Statutes:
Name ,
Address � City State
, Telephone Number of Designated Person: �
8. In addition to himself,the owner designates of
to rec ive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes.
Telephone Number of Person or Entity Designated by wner
9. Expiration date of Notice of Commencement(the expi tion date'may not be before the completion of construction and final payment to the
contractor,but will be one year from the date of recordi g unless al,ldifferent date is specified):
WARNING TO OWNER: ANY PAYMENTS MADE B THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UND R CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROV MENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFO�2E THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT
Under penalty of perjury,I declare that I have read the f regoing notice of commencement an that the facts stated therein are true to the best
I of my knowledge and belief.
STATE OF FLORIDA
i- - CGuiV I Y"vr PH�GG -- - —- - - - - �-�-- - °�..�-'-- -- - — - -
Si nature-of�0 rorLessee,-o�Owne�'s o�Lessee's Authorized -----,
OfficeNDirector/PartnedManager -J�-°°�-----
(�C[//.�1,G�iL
Signatory's Title/Office
The foregoing instrument was acknowledged before me this 'day of �� ,20((�,by r"1 y��� "� ���"`Q �n��`�
as ' (type of authority,e.g.,officer,trustee,attorney in fact)for
'7 V ��/`� � 4''� �1' (name of party on behalf o o instrument was executed).
Personally Known❑OR Produced Identification� Notary' Signature� JC �l.�i!�d i`
Type of Identification Producedc���l-- �r.7���Z���'� Name!(Print)_ .x�V 1?� i�" �`JG � �r�i�� �
� L -L t .
,
I `,��\Y�1���' XAVIER ST BELLINI
� ;io�p ;`�:'s Notary Public-State ot Florida
I ;•? My Comm.Expires Jun-9,201e.
%�"•�s;: Cammission� M ff�130910
i4,h�b piN�,, � IM�MS�7�'
wpdata/bcs/noticecommencement�c053048