Loading...
HomeMy WebLinkAboutSUBMITTED PAPERSDATE: _ FEES ITS -a t RECEIPT #: Permit #: -- Planning & Development Services Department76l��-�� Building & Code Regulation Division COUNTY e 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 Tel. 772462-1553 tl y APPLICATION FORT ROOF PERAHT�EE REVERSE SIDE FOR NSTRUCTIONS 1. Location/Site Address: , 7 29 P� X t i l to Ci /' K L IF(...2 LJ 95 Z ty 2. Parcel ID Number: 3 4 2.S- '7 D 1p - 0 2SS - 00 a Office Use Only Section Townshi Range Map Pa a Zoning Land Use Initials 3. Description of Project or Work Activity: 4. Total Roof Area (square feet): i 7(1)o 5. Roof Pitch: 6. Type of Roof: I" Fiberglass Shingle [ ] Concrete Roof Tile In l2 [ ] Wood Shake / Shingle [ ] Tar & Gravel [ ] Modified Bitumen [ ] Other ] Product Approval required for all types of Roofing Material (2 Sets) ] All Commercial Roofing requires design by an Engineer or Architect (2 Sets) with Product Approval attached ** Roof Mitigation per F.S. 553.844 will be required. 7. Owner Information 8. Contractor Information Name: Address: 322 City: Two 1-1^r State: �VV\ Zip: iSU uo Phone: '-I M3 D -- `184S eO 9. Value of Construction: FL Reg/Cert #: CC-C / 3 3 0 3 L Z County Cert #: A 9 "7-7 1 Business Name: I 2_ewS t t rc C_o A-s-- Concgots Cell Phone: 7 7 2— "Note Dry -in and Final Inspection Required. Additional inspection may be required per Product Approval. CONTRACTOR/OWNER'S AFFIDAVIT: I certify that all done in comp ° PRINT QUALIFIERS/OWNERS NAME t IG A7 STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS DAY OF WS P WHO I ERSONALLY KNOWN TO ME OR HA ained in this application is correct and that all work will be laws regulating construction and zoning. BY L AS IDENTIFICATION L -STGNA RE OF NOTAR TYPE OR PRINT NAME OF NOTAIR�1seal1tary Pui ii of FloridaMy Comm c,o;r ar 22, 2017COMMISSION NUMBER `C877571NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCffi-RE L�-IN.YO ,owryTWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDE OR ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 1-..­ Notary JOSEPH E. SMITH, CLEP-Tr-nT THE CIRCUIT COURT - SAINT LUCIE COUNTY FILE # 3918572 OR BC$ `3598 PAGE 1166, Recorded 01/27/2014 - 08:5.3 AM iTS1TICE OFOdHMENL7dMENT To bemrsdrba membastkn robe eateeeotrStrsdRoO M MUS.. _ TAXFOUO# STATE OF RMDA COUNTY OF MARM The hereby ghros notice that ImproemertwB be made toouoin real property. end :+ acoordmce with Chapter 7A Florida Statute:, the Himir a information Is proaided In this Notice of Cnmmersarment, IEOALOFSOOPF10N OF PROPERTY (AND STREET ADOMS. IFAWAUAKEO The Preserve at Sevens Club BL.N51 LOT 17 (3729 Panduls Or Port Bt Luds FL 349W) GummDESdtipTWN OF IMPRMEMENT: Tsar OR e46" ehingle rOOf 6 replace with 30 yr architectural shingles OWNIM MFOWAATNIN OR IE6EE W FOMIATPWL, If TIE LESSEE OWMACFED FOR THE A WKINJOEMf: Name; Wa'wm a my- SOW Addr. 325 401 Avenue, Two Harbors, WrM�61� IrrOcreat(n propen- Owner Name ardaddrew dfeesimple title holder (N different from Owner ilsted abwe); CONTMCFOWS NANEt Ron Left (Treasure Coast Conoopb, INC.I Phone No.i 772-777-8130 AddpE 3458 SW PluW UL P-err SL Lrsds, 101.341153 StW&TIY CGWANY INapplical . a copy dthe payment bad is attedredy. Nam edaddresc Phone No.: gad amand LENDERS NAME: Phone No.: Address: POW 114drMthsSUMOfF101 deslpsaI byowneruponwi m nodmorecirvdaaraneetsaaaybesoasprouldedbySatlon715.13 p) (a) 71 NafMasubaes Marne: P1ron! No.: Address: In addition to himself Or berself, mesa des'gnaw Of to reorhre a copy of the Ue ces Notice as prealded in Section 71313(1)(b), Horida Stouts Phone number of person at entity desWurted by Owns: EtPkatbndase d Ilotics dCaarrarwrsrerrt (tire essPYsOsredate say not bebeferetbe oo.pletfatdmetrualon ssd 6rol payrtraRm tlresextratter, dial art belymrharr tbe dated remdrS uelsss a dfResrd datels specified): Usrdet dpeytuy,l rwdlhetaeeohrEad that fasts in R ar■trw the beat dory bwwkdp and beget. SWA*m dower or Lesaegw Owneft oreaseals Jparprw/MwrSer/A Wry Y9 31101 ayanwof0ca '. The fwaSdrgInsWnerrtwas befommetldt ✓ dayd vTty r��' .20,E /11✓YUI. a e 0Y• Vr as Own�rS0 TYPe deutls IVle•L officer, trustee))( Party an behaHofwham lnowent was executed inosvrra_a`etprodumd identrgcatlon 0 ratuType of Identification produced (Pd4Type, or5tamp Cambsiorwd Name of MaWV) T,.%LDt8Id6 FosmsW=AppHcmk=lFa %Nodw fCommeacmmtD ear Rar.9/15/Il j STATE '.OF FLORIDA, ST'1UCIE COUNTY THIS IS TO CERTIFY THATTHISISA TRUE AND CO-R CT COPY OF THE ORIGINAL. �,p,SF�hhE. SMIA,�LEI (_ 2014 1/20/14 Florida Building Code Online i t l!6 Business sProfessional Regulation Ira'.._� FloddaDepaameV BCIsHome I Log In User Registration I Hot Topics Submit Surcharge Stats&Facts I Publications I FBC Staff I BCISSite Map I Links I Search Busines Professi r-ral �roR PutblApper Regulation Product ADDroval Menu > Product or Aoolio tion Search > Application List > Application Detail FL # FL10674-R8 Application Type Revision Code Version 2010 Application Status Approved Comments Archived ❑ Product Manufacturer Owens Coming Address/Phone/Errail One Owens Coming Parkway Toledo, OH 43659 (740) 404-7829 greg.keeler@owenscoming.com Authorized Signature Greg Keeler gr-eg.keeler@owenscoming.com Technical Representative Mel Sancrant Address/Phone/Email 1 Owens Coming PKWY Toledo, OH 43659 (419) 376-8360 mel.sancrant@owenscomig.com Quality Assurance Representative Address/Phone/Email Category' Roofing Subcategory Asphalt Shingles Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer 0 Evaluation Report - Hardcopy Received Florida Engineer or Architect Name who developed the Robert J.M. Nieminen Evaluation Report Florida License PE-59166 Quality Assurance Entity UL LLC Quality Assurance Contract Expiration Date 09/26/2014 Validated By John W. Knezevich, PE L-T Validation Checklist - Hardcopy Received Certificate of Independence FL10674 R8 COI Trinity ERD CI - Nieminen.odf Referenced Standard and Year (of Standard) Standard Year ASTM D3161, Class F 2006 ASTM D3462 2007 ASTM D7158, Class H 2O07 Equivalence of Product Standards Certified By Sections from the Code Product Approval Method Method 1 Option D Date Subrrdtted 12/19/2012 www.floridabuilding.org/pr/pr_app o.aspxC?pararrFwGEVXQwtDgtBNbEY5Vp/o2boQTp/o2b6w7ahReglp/o2b7VrDeeDcPKKrC2fcAozJgp/o3dp/o3d 1/2 1/20114 Florida Building Code Online Date Validated 12/20/2012 Date Pending FBC Approval 12/25/2012 l Date Approved 02/04/2013 Summary of Products FL * Model, Number or Name Description 10674.1 Owens Coming Asphalt Roofing 3-tab, laminated, starter, and hip & ridge Shingles and Starters Limits of Use Installation Instructions Approved for use in HVHZ: No FL10674 R8 II er121912FINAL OC Asphalt Shingles FL10674- R8.odf Approved for use outside HVHZ: Yes Impact Resistant: N/A Verified By: Robert 3. M. Nierrinen PE - 59166 Design Pressure: N/A Created by Independent Third Party: Yes Other: Refer to ER, Section S. Evaluation Reports FL10674 R8 AE er121912FINAL OC Asphalt Shingles FL10674- R8.Ddf Created by Independent Third Party: Yes Bade Nett Contact Us :: 1940 North Monroe Street. Tallahassee FL 32399 Phone: 850-487-1824 The State of Florida is an WEED employer. Copyright 2007-2013 State of Florida.:: Privacy Statement :: Accessibility Statement :: Refund Statement Under Florida law, email addresses are public records. If you do not want your e-mail address released in response to a public -records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. *Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. To determine if you are a licensee under Chapter 455, F.S., please dick Mere . Product Approval Accepts: ® © ECtect M Credit�ArFriE www.floridabulidng.org/car/pr_app dtl.asp)Ciparan-F=%GEVXQwtDgtBNbEY5Vg/o2boQTg/p2b6w7ahRegfp/o2b7VrDeeDcPKXrC2fcAozJg°/p3dp/gad 212 EXTERIOR RESEARCH &DESIGN, LLC. Certificate of Authorization #9503 353 CHRISTIAN STREET, UNIT #13 ,I TRINITY 11 � ERD OXFORD, CT 06478 PHONE. (203) 262-9245 FAX: (203) 262-9243 EVALUATION REPORT Owens Corning Evaluation Report 037940.02.12-R2' One Owens Corning Parkway FL10674-RS Toledo, OH 43659 Date of Issuance: 02/06/2012 Revision 2: 12/19/2012 SCOPE: This Evaluation Report is issued under Rule 9N-3 and the applicable rules and regulations governing the use of construction materials in the State of Florida. The documentation submitted has been reviewed by Robert Nieminen, P.E. for use of the product under the Florida Building Code and Florida Building Code, Residential Volume. The products described herein have been designed to comply with the 2010 FBC and 2010 FBC Residential Volume sections noted herein. DESCRIPTION: Owens Corning Asphalt Roof Shingles LABELING: Each unit shall bear labeling in accordance with the requirements the Accredited Quality Assurance Agency noted herein. CONTINUED COMPLIANCE: This Evaluation Report is valid until such time as the named product(s) changes, the referenced Quality Assurance documentation changes, or provisions of the Code that relate to the product change. Acceptance of this Evaluation Report by the named client constitutes agreement to notify Robert Nieminen, P.E. if the product changes or the referenced Quality Assurance documentation changes. TrinitylERD requires a complete review of this Evaluation Report relative to updated Code requirements with each Code Cycle. ADVERTISEMENT: The Evaluation Report number preceded by the words "TrinitylERD Evaluated" may be displayed in advertising literature. If any portion of the Evaluation Report is displayed, then it shall be done in its entirety. INSPECTION: Upon request, a copy of this entire Evaluation Report shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This Evaluation Report consists of pages 1 through 6. Prepared by: Robert I.M. Nieminen, P.E. Florida Registration No. 59166, Florida DG4 ANE1983 The facsimile seal appearing was authorized by Robert Nieminen, P.E. on 12/19/2012 This does not serve as an electronically signed document. Signed, sealed hardcopies have been transmitted to the Product Approval Administrator and to the named client CERTIFICATION OF INDEPENDENCE: 1. TrinitylERD does not have, nor does it intend to acquire or will it acquire, a financial interest In any company manufacturing or distributing products it evaluates. 2. TrinitylERD Is not owned, operated or controlled by any company manufacturing or distributing products it evaluates. 3. Robert Nieminen, P.E. does not have nor will acquire, a financial Interest in any company manufacturing or distributing products for which the evaluation reports are being issued. 4. Robert Nieminen, P.E. does not have, nor will acquire, a financial Interest In any other entity involved in the approval process of the product. �INITYJERD ROOFING SYSTEMS EVALUATION: 1. SCOPE: Product Category: Roofing Sub -Category: Asphalt Shingles Compliance Statement: Owens Corning Asphalt Roof Shingles, as produced by Owens Corning, have demonstrated compliance with the following sections of the Florida Building Code and Florida Building Code, Residential Volume through testing in accordance with the following Standards. Compliance is subject to the Installation Requirements and Limitations / Conditions of Use set forth herein. 2. STANDARDS: SeGtion ProRertv Standard Year 1507.2.5, R905.2.4 Physical Properties ASTM D3462 2007 1507.2.7.1, R905.2.6.1 Wind Resistance ASTM D3161, Class F 2006 1507.2.7.1, R905.2.6.1 Wind Resistance ASTM D7158, Class H 2O07 3. REFERENCES: Enti Examination Reference Date UL LLC (CER9626) Physicals & Wind Resistance File R2453, Vol. 3 02/15/2007 UL LLC (CER9626) Physicals & Wind Resistance 20120516-R2453 05/16/2012 UL LLC (TST9628) Physical Properties 06CA20263 04/18/2006 UL LLC (TST9628) Wind Resistance 11CA34308 02/18/2012 Miami -Dade (CER1592) FBC HVHZ Compliance 07-1116.12 02/14/2008 Miami -Dade (CER1592) FBC HVHZ Compliance 09-0915.12 12/16/2009 Miami -Dade (CER1592) FBC HVHZ Compliance 10-0817.09 10/27/2010 Miami -Dade (CER1592) FBC HVHZ Compliance 10-0817.10 10/27/2010 Miami -Dade (CER1592) FBC HVHZ Compliance 10-0817.08 10/27/2010 Miami -Dade (CER1592) FBC HVHZ Compliance 10-0817.07 10/27/2010 Miami -Dade (CER1592) FBC HVHZ Compliance 11-0411.03 06/16/2011 Miami -Dade (CER1592) FBC HVHZ Compliance 12-0309.01 07/19/2012 UL LLC (QUA9625) Quality Control Service Confirmation R2453 Exp. 09/26/2014 4. PRODUCT DESCRIPTION: 4.1 Asphalt Shingles: 4.1.1 Classic® and Supreme® are fiberglass reinforced, 3-tab asphalt roof shingles. 4.1.2 Berkshire® are fiberglass reinforced, 4-tab asphalt roof shingles. 4.1.3 Duration®, TruDefinition° Duration®, Duration® Premium Cool, TruDefinition® Duration® Designer Color Collection, TruDefinition® Oakridge®, Oakridge® and WeatherGuard® HP are fiberglass reinforced, laminated asphalt roof shingles. 4.2 Berkshire® Hip & Ridge Shingles, High Ridge, Hip & Ridge with Sealant, WeatherGuard° HP Hip & Ridge Shingles and ProEdge Hip & Ridge Shingles are fiberglass reinforced, hip and ridge asphalt roof shingles. 4.3 Starter Strip Plus and Starter Shingle Roll are starter strips for asphalt roof shingles. S. LIMITATIONS: 5.1 This Evaluation Report is not for use in the HVHZ. 5.2 Fire Classification is not part of this Evaluation Report; refer to current Approved Roofing Materials Directory for fire ratings of this product. 5.3 Wind Classification: Exterior Research and Design, LLC. Evaluation Report 037940.02.12-R2 Cerdricate ofAuthorization #9503 ' FL10674-RS Revision 2: 12/19/2012 Page 2 of 6 F)o '�J TRINITY I ERD 5.3.1 All Owens Corning shingles noted herein are Classified in accordance with FBC Tables 1507.2.7.1 and R905.2.6.1 to ASTM D3161, Class F and/or ASTM D7158, Class H, indicating the shingles are acceptable for us in all wind zones up to Vasd = 150 mph (V�it = 194 mph). Refer to Section 6 for installation requirements to meet this wind rating. 5.3.2 All Owens Corning hip & ridge shingles and Starter Strip Plus noted herein are Classified in accordance with FBC Tables 1507.2.7.1 and R905.2.6.1 to ASTM D3161, Class F, indicating the shingles are acceptable for us in all wind zones up to Vasd = 150 mph (V,it = 194 mph). Refer to Section 6 for installation requirements to meet this wind rating. 5.3.3 Classification by ASTM D7158 applies to exposure category B or C and a building height of 60 feet or less. Calculations by a qualified design professional are required for conditions outside these limitations. Contact the shingle manufacturer for data specific to each shingle. 5.3.4 Refer to Owens Corning published information on wind resistance and installation limitations. 5.4 All products in the roof assembly shall have quality assurance audit in accordance with the Florida Building Code and F.A.C. Rule 9N-3. 6. INSTALLATION: 6.1 Underlayment: 6.1.1 Underlayment shall be acceptable to Owens Corning and shall hold current Florida Statewide Product Approval, or be Locally Approved per Rule 9N-3, per FBC Sections 1507.2.3, 1507.2.4 or R905.2.3. 6.2 Asphalt Shingles: 6.2.1 Installation of asphalt shingles shall comply with the manufacturer's current published instructions, using minimum four (4) nails per shingle in accordance with FBC Sections 1507.2 or R905.2, with the following exceptions: ➢ Berkshire° shingles require minimum five (5) nails per shingle. ➢ WeatherGuard® HP shingles require minimum six (6) nails per shingle. ➢ Starter Strip Plus requires minimum five (5) nails per strip. Refer to Owens Corning published information on wind resistance and installation -limitations. 6.2.2 Fasteners shall be in accordance with the manufacturer's published requirements, but not less than FBC 1507.2.6 or R905.2.5. Staples are not permitted. 6.2.4 Where the roof slope exceeds 21 units vertical in 12 units horizontal, special methods of fastening are required. Contact the shingle manufacturer for details. 6.2.5 Minimum Nailing — Classic@ & Supreme: Normal Mansard or Area pan Wind Areas Higl+ Wind dssvanes y Ana pan vientos ...Me Amax r .m. fuartes �• IA1 +" r r B Z. . 1 � �r r &'Exposure Exposicido Exterior Research and Design, LLC. Certificate of Authorization #9503 Normal Mansard or Area pan Wlnd Area Nigh Wind desranai y Ann para vienios normafa Area rionlos faertaa '• r,. Z. IB �. i & Wi8 Exposure Exposieidn Evaluation Report 037940.02.12-R2 FL10674-R8 Revision 2: 12/19/2012 Page 3 of 6 6.2.6 Minimum Nailing - Berkshire®: SMkkIi S* La th da udada t— • e—s • a—� •r—►a BW 9Yf 9SY BYt (-, "Q 4 TRINITY I ERD SeahMstdQ Lat4adesabdN P 8 Yf 8 Yf 81Y 8 Vf 1' 1 1 � r 1 Asplwk roofing eorrx nt Ow nito de UOodo wtab 6.2.7 Minimum Nailing - Duration0, TruDefinition@ Duration, Duration® Premium Cool & TruDefinition® Duration® Designer Color Collection: 6 Nai Wramdard Ship 8bp� labnkm SURNai° Pa aftern w rldtoparoata-t. dW.6 aptlas Nmftel • • • trtaBUWrawbp•fe aVeriadalreaN. SURN310 \ StROWIP tasterif�p tasfine�g Awde arotddN ` arravAdlt SOMINO P _ 17' ` tt, ' 8iYneouds'as I 'TT-'-7II I 5V Exposu. Na1s SW EVeslxe 6%pdg•do eaposkaft tiaras 5%pulg. de ejoslddn 6.2.8 Minimum Nailing - TruDefinition® Oakridgep, Oakridge0: 4 Neil Pattem Esporm con daws 1' 1• IE— tr --►I li— tr 6 6t8" Exposure Nags 6 Sw Exposure EI016u666apdg Carps £eposfd6ado6618prig. Exterior Research and Design, I.I.C. Certificate of Authorization #9503 6 Nail Mom Esp macen6dauos r r 66l8"Expasule f�� 66/8"Exposute aPasfadpde66/BPdg &wVdwft& S6/BPdg. Evaluation Report 037940.02.12-112 FL10674-R8 Revision 2: 12/19/2012 Page 4 of 6 6.2.9 Minimum Nailing - WeatherGuard® HP: shwe oft V1111111V Vie.lti.rr R�1�7b� Ylli lb 6.3 Hip & Ridge Shingles: TRINITY 1 ERD 6.3.1 Installation of Berkshire® Hip and Ridge Shingles, High Ridge, Hip & Ridge with Sealant, WeatherGuard® HP Hip and Ridge Shingles and ProEdge Hip & Ridge Shingles shall comply with the manufacturer's current published instructions, using four (4) nails per shingle. Refer to Owens Corning published information on wind resistance and installation limitations, including the use of hand -sealing for wind warranties. 6.3.2 6.3.3 6.3.4 Fasteners shall be in accordance with the manufacturer's published requirements, but not less than FBC 1507.2.6 or R905.2.5. Staples are not permitted. Minimum Nailing - Berkshire® Hip & Ridge and High Ridge: Fig.1 4 t— PmvSWWVdnd Dirccwn A NailsfN A 4 I I A I t I I A I I 4 i I I I I I A I I ZNL!S —� Minimum Nailing - Hip & Ridge with Sealant: em Fig_ 2 - High Wind Fastening Pattern K Nails) riin Shingle nd Discard �„ 2„ Excess 1" 1" Sealant • -Strip T 12" ' Fastening 551a" 5"Exposure Distance 12" Fig. 2 Topl iew SidaMew Nails Nails 9" Y Tap Lamirraled Y PleCe 7" I I I I m� 51 �I I I I I I I Exterior Research and Design, LLC. Evaluation Report 037940.02.12-112 Certificate of Authorization #9503 FL10674-RB Revision 2: 12/19/2012 Page 5 of 6 6.3.5 Minimum Nailing — WeatherGuard@ HP Hip and Ridge: Fig. A 4 Prevaalag WIDE!�— Dlnxtbn p A Naps 4 4 I I p I I 4 I 1 I 1 A I I Exposure �jTRINITYJERD Fig. C Hip & Ridge Shingle Fastening Top Vbw Nails Na1Ls 7° za^ V t° s' Exinsare 6.3.6 Minimum Nailing - ProEdge Hip & Ridge Shingles: Prevailing Wind Direction S,,dmt Ship 6- Exposure Fasten 71". Cover Exposed Fasteners with Roof Cement 7. LABELING: Standard Fastening Pattern t2' Sealant 7��'I ° 1 6" Exposure 7.1 Each unit shall bear a permanent label with the manufacturer's name, logo, city, state and logo of the Accredited Quality Assurance Agency noted herein. 7.2 Asphalt shingle wrappers shall indicate compliance with one of the required classifications detailed in FBC Table 1507.2.7.1 / R905.2.6.1. S. BUILDING PERMIT REQUIREMENTS: As required by the Building Official or Authority Having Jurisdiction in order to properly evaluate the installation of this product. 9. MANUFACTURING PLANTS: Contact the named QA entity for information on which plants produce products covered by Florida Rule 9N-3 QA requirements. 10. QUALITY ASSURANCE ENTITY: UL LLC— QUA9625 ; (414) 248-6409; karen.buchmann@ui.com END OF EVALUATION REPORT - Exterior Research and Design, LLC. Evaluation Report 037940.02.12-112 certificate of Authorization #9503 FL10674-118 Revision 2: 12/19/2012 Page 6 of 6 02/06/14 08:32AM EST -> St. Lucie County 7724626443 Pg 1/1 Planning:& Development- Seriltes Building & Code Regulation Division 2300VIrgInIg Avenue Met Pieroto fl. 34982 7724fx4165 or. Faxid 772-462-6"3 I 11,1616121,-M� 401 111fliMill =0 ft�il PL-rr6ft #,,;a LC' I � bi-, Q� 4 2, 111-11sed as a( czntra. dftorlp . Engineer/An-hitedt (Ploaso print name:& elide lictose type) :ft8:rnPSpeMr *General, Buddke ResNefti or Roofing CqnMx1ffqrq0Y.1ndMdU on or. about 1<1 A/ .1 did perso.nolly Inspect the. roof deck -Palling. work:ati elli � bu- a, I:q Iza- (job site address) Based upon that examination I have: determloed theinsta Itation: was done according,to the Hurricane MItigation. fletroMMMOM01 (ftsed on- 553-844 F,54 133 C),S: 'License # STATE OF FLQRI�A to ond SuAscri b. I . . . . . . has produced Who IspersonaWnown to me or *ho !16= W as Identiftcatfan' 40. mL A Lk Y-i) ax A NotaryPublic, Rat 51400A. MO f�ta*� com.misslon NuM6L--r`- :(Seal) Lf, MY-00 W*910M i $62074.1 RECEIVED FEB 06 2014 '