HomeMy WebLinkAbout15-16105- � CITY OF ZEPHYRHILLS
a� 5335-8TH STREET
(sis)�so-oo20 161
BUILDING PERMIT
PERMIT INFORMATION " LOCATION INFORMATION
Permit Number: 16105 Address: 38638 9TH AVE
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434-ADD/ALT RESIDENTiAL Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): _ Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-10500-0010
Improv. Cost: 6,250.00 OWNER INFORMATION
Date Issued: 3/25/2015 Name: KOEN TIMOTHY&GIORDANO FRANCIS
Total Fees: 105.00 Address: 22524 CLIFFSIDE WAY
Amount Paid: 105.00 LAND O LAKES FL 34639-6767
Date Paid: 3/25/2015 Phone: 813-719-2082
Work Desc: REPLACE 7 WINDOWS SIZE/SIZE
CONTRACTOR S APPLICATION FEES
FF RDABLE WIN &D ORS OF TI BUILD NG FEE 105.00
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Ins ections Re uired '
FOOTER 2ND ROU H PLUMB MI INSULATI CEILING
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
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 performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFO C.O.
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ONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: � �P" �R D��Lk- � i N(�Q�S
Date Received: � — � � � � �
Site: �� b3$ f Rv�
Permit Type: RE Q L/�C t � W 6 iJpOwS 5i2t./S 12E
Approved w/no comments:❑ Approved w/the below comments: Denied w/the below comments: ❑
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This comment sheet shall be kept with the permit and/or plans.
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Ka vin Sw' z –Plans Exanuner Date tractor and/or Homeowner
(Required when comments are present)
, s�saaaoo2o City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
:
Date Received phone Contact for Pertnitting ��! �7 V-�• _� ` �j �
Owners Name � , Q�Q Ol� Owner Phone Number
Owner's Address .� G . � .p Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number �'�� �
Fee Simple Titleholder Address
JOB ADDRESS � [/�L � , 3 LOT# � �
sueoivisioN i T .'L PARCEL ID# //'o��—o� -OD .CXj/
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW cONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSEDUSE Q SFR Q COMM 0 OTHER jN (�
TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK Ro �[ G e ' ' '
BUILDING SIZE SQ FOOTAGE� HEIGHT �
�BUILDING $ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
�
�PLUMBING $ � ����5
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
QGAS Q ROOFING Q SPECIALTY � OTHER
FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES NO
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BUILDER /1m( � COMPANY ��PO o W:rL�GLti
SIGNATURE �lts REGISTERED Y/ N FEE CURRE� Y/N
Address J d V. i � To� License# 0
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
I 1 1 1 1 1 1 1 I 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 I 1 1 1 1 I 1 1 I I 1 1 1 I 1 1 1 1 1 1 1 1 1 1
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buiiding Plans;(1)set of Energy Forms;R-O-W Pertnit for new construction,
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Pians 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 Fortns.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 R 1 dumpster Site Work Pertnit for all new projecls.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW wnstrudion.
4-FFI-.1—:-.�.-r...r1..FFC..�.—.�.�1-.1—�1--�:....-�...r�4-�•
Directions:•
Fill out application completely
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is requfred. (A/C upgrades over$7500)
" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner autharizing 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
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NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed'restrictians°
wflich may be more restrictive than County regutations. The undersigned assumes responsib!!tty for compliance with any
appticabie deed sestrictians.
UNLIGENSED CONTRACTORS ANp CQNTRACTOR RESPONSIBILITIES: tf the owner has hired a canfractor or
contractors ta undertake work,they may be required to be licensed tn accardance w3th sfate and local regu4aEions. 3f fhe
contractar is not licensed as required by law, bo#h the owner and conUactor 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 tnspecflon Divisian--Licensing SectEon at 727-847-
80Q9. 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 ihis appiication far which they witl be responsible. If you, as the owner sign as fhe
contraator,thaf may be an indlcation that he Is noE properly Ilcensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATiQN IMPACTNTILiTiES IMPACT AND RE50URCE RECOVERY FEES; The unciersigned understands
that Transportation Impact fess and f2ecourse Recavery Fees may apply to the canstruc4ion of new bu�lding5,change of
use in existing buildings,or expansion of existing buildings, as specified in Pasca County Ordinance number 89-07 and
90-07,as amended. The undersigned also understands,that such fees,as may be due,witt be idenf'rFed at the time of
permitting. It Is further understood thak Transportation lmpact Fees and Resaurce Recovery Fees must be paid prior to
receiving a°certficate of occupancy"vr final power release. If the project does not invoive a certificate of occupancy or
final power reiease,the fees musf 5e paid prior to permif issuance. Furthermore, if Pasco County Water/5ewer Impac#
fees are due,they must be paid prlor ta permft fssuance 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 fhat 1, tfie applicant, have been provided w3th a copy o# the "Fiarida Construction Lien �aw—Hameowner's
Protectlon Guide"prepared by the�Iorida beparkment of Agriculture and Consumer Affalrs. If the applicant is someone
other than the"owne�",I cerfify ihat I have obtained a copy of the above described document and promise in good faith to
detiver it to the°owner"prior to commencement.
CONTRACTQR'SlOWNER'S AFFIDAVIT: I certify thet all the information in this applicatian is accurate and that all work
will be done in comptiance with al�appticable laws regulating construction,zoning and land development. App(ieation is
hereby made ta ob#aln a perml# ta do wark and fnsta!!at'son as indicated. f certify that na work or instaltatfon has
commenced prior to issuance of a permlt and that all work will be performed to meet standards of all laws regulating
construction, County and Ciiy codes, zoning regutafions, and land development regutatiorts in the jurisdictian. 1 al"so
certify that 1 understand fhaf the regulat9ons of other govemment agencies may apply to the intended work,and that it is
my responsibilfty to identify what actions I must take to be In compliance. Such agencies include but are not limited to:
- Department of Environmentai Profection-Cypress $ayheads, tNettand Areas and Environmen#ally Sensitive
Lands,WatertWastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Aitering
Watercourses.
- Army Carps of Engineers-Seawalls,Docks,Navigable Waterways.
- Department of Health & Rehabilitative Services/Environmental Healkh Unit-Wetls, Wastewater Treatmenf,
Septic Tanks.
- US Envisonmental Proteckion Agency-Asbestos abatement.
- Federal Aviation Autharity-Runways.
t understand that the foliowing restrictions apply to the use of flli:
- Use of fill is not allowed in Flood Zane"V°uNess expressly permitted.
- If the fill material is to 6e used in Flood Zone "A", if is understood that a drainage plan addressing a
°campensating voiume°wEN be sobmitted aE time of permitting which is prepared by a professional engineer
licensed by the 8tate of Florida.
- If the flll materiat is to be used in Flood Zone"A"in connection witfi a permitted building using sfem wall
construction,i certify thaf fiii wlii be used vniy to fii{the area withfn the stem wall.
- If fl!I rnaterial is to be used in any area, I certify that use of such fill will not adversely affect adjaoenf
properties, if use of fllt is found to adversely affiect adjacent properties,the owner may be oited for violating
the condit�ons of the buPlding permit issued under the attached permit application,far lots less than one{1)
acre which are elevated by fill,an engineered drainage plan is required.
ff I am the AGENT FOR THE OWNER,1 pramise in good faith to inform fhe owner of the permitting conditions set forth in
#his affidavlt prior to commencing construction. !understand that a separate permit may be required for electrical work,
plumbing, signs, welis, pools, air condltioning, gas, ar other Installations not spec�ca(iy included in tfie appticatian. A
permlt issued shait be consfrued to be a license to proceed with the worK and not as autho�lty to.violate,cancel,alter,or
seE aside any provisions af the technical codes,nor shall issuance of a permit prevent the Buildirig Official from thereafter
requiring a correction of errors in plans,constnactian ar violaGons af any codes. Every permft issued shall become invatid
untess the work authorized by sucfi permit is commenced wiFhin six months of permik issuance,or it work authorized by
the petrrtit is susgended or abandoned fo�a period of six(6)months after lhe fime the work is commenced. An exfension
may be requested,in writing,from the Building Offiicial for a period nof to exceed ninety(90}days and will demonsfraEe
jusfifiable cause for the extension. !f work oeases for ninety(90}canseoukive days,the job is considered abandoned.
WARNING TO OWNER: YOUR FAfLURE TO RECOitd A NO710E OF COMMENGEMENT MAY itESULT IN YOUR
FAYtNG TWlCE FOR tMPROVEMENTS TO YOUft PR4PERTY. !F YOU INTEND TO OBTAIN FINANCING,CONSULT
WITN YOUR LENDER O AN A'tTORNEY BEFORE EGO DING Y U NOT(CE QF COMMEN EMEN7.
FLORIDA JURAT(F:S.117.03}
OWNER OR AG�NT CONTRACTOR ' S�,• '��.."'1,,,.
Snbscribed and swom to{or aflirmed)before me this S�hs�b d end swom o o rmed before me this
by �'i. ��.5 f�.� �_L�_ .
Who islare personatty known Ro me or has/have produced Who Is/are rsonally own to me or has�idenSfication.
asidentlftcation. /
Not2ry Pubflc ` `' �� ,� Not ty Public
Commisslon No. Com iss o.`.°"z' �`•L%'.'�-���-E�E B ES
� , �����t�ission FF 150422
Name o(Notary typed,pdnted or stamped �Name of No .ry typed,printed ar s�e�oy Pain I�su�anco8003&57U19
i
�i iiiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiii iiii
2015036179 NOTICE OF COMMENCEMENT CI�/EST 73PFT OF LOTS B 2 &354
Permit No. BLOCK 105 SUB)ECT TO EASEMENT
Tax Folio No.//-�(o��_Q GJ d��0�-a��a OVER SLY 5FT THEREROF FOR
THE iJNDERSIGNED hereby gives notice that improvement will be macle to certai�a real property, and in accordance with
Chapter 7]3,Florida Statutes,the following infortnation is provided in this NOTICE OF COMMENCEMENT.
1. Description of property(legal description of property): ._
a)Street(job)Address;3$�o'3Q� 9 "'Av n ZT�i4/�:t�.s FL . 3 3�'S�y�. ._
2. General description of improvement(s): R�eA ee ? l�;tida�.,��it:7fi' J.t f<.� S%Z,��,g .,
3 wner or Lessee inform�on essee as owner only if co t ctce�d for im,P oxements J /
.Name and address; �3 O �° /�, . /,/ /,
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b.Interest in property: ('�;����� ._
c.Name and address of fee simple titleholder(if other than owner): ,_
4. ContractorInformation qp�oad�6�• W%...dow�y
a.Name and address:��7 ,' / �a .�� F�. 33 7(� � �_
b.Phone number: /_�a7-SI 3 7� d o 7 Fax No, (Opt.)�-)az.. ����3_� _
5. Surety Inforination Rcpt:1666126 Rec: 10.00
a,Name and address; QV�/}� DS: 0.00 IT: 0.00
b. Amom�t of bond$ 03/10/2015 J. G. , Dpty Clerk
c. Phonenwnber: FaxNo. (Opt.)_ PRU�a s o'NEIL,Ph D PASCO CLERK & COMPTROLLER,
6. Lender 03/10/2015 09:30am 1 of 1
a.Name and address. �,/Q�'' '
b,Phone number: OR BK �1�� PG ��Z� �
7. Persons within the State of Florida designated by Owner upon who notices or other documents may be served as provided b;�
Section 713.13.(1)(a)7.,Florida Statutes:
a.Name and address: /V//'�
b.Phonenumber: �
8. In addition to himself, Owner designates the following person(s}to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b),Florida Statutes:
a.Name and address: QV//�
b.Phone nuinber: '
Expfr�tion date of netiee of eommencemsnt(the axpiration date is 1 year irom the date of recordin�iinless a�iffere�t —
iiai.e i�5pecifiiedj
WARNING TO OWNER: ANY PAYMENTS MADE BY TI3E O�JVNER AFTER THE
EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSID�RED IMPROP�R
PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13,FLORIDA STATUES, AND
CAN RESULT IN YOUR PAYING TWICE FOR 1MPROVEMENTS TO YOUR PROPERTY. A
NOTICE OF COMMENCElVIENT MUST BE RECORDED AND POSTED OiV THE JOB SITE
BEFORE 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.
Verification pursnant to Sectiou 92.525, Florida Statutes. �Inder penalties of per.jury, I declare Chat I have-
read the foregoiug and that tbe facts in it are true to the best of my knowledge and belief.
Signatur of wner or Lessee,or Ownei•'s or Lessee's Authorized Officer/Director/Partner/Manager
Signatory's Ti]e/ fficer:
State of Pl ori da
County of�ivf�r�e �q g�Q
The�o�a' g ins�um�r�t was acknowledged before me this�day of �b 20 )� by �
� ��''t- ,who is personally known me or has prodviced
OG� I- (� 'U , and who did/did not au oath.
(Driver's License#)
Signature ofNotary
,�������,, Publ - tate of orida 1
�Lp`RY PVB��i� ALEXANDER R LANGE
'r�• '°' Notary Public-State of Florida �
N;���; My Comm.Expires Apr 3,2017 Print,Type,or Stamp
9iFOFf���� Commission# FF 004382 Commissioned Name ofNota�y Public
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�.� • TNIS IS TO CEFtTfFY TH�1T THE FOREGOI�JG IS A
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� �"� `W¢7r�t $c TRUE AND CORRECT COPY OF THC DOCUP�I!ENT
m �,ro� :a�'',, , � ON FILE OR OF PUBLIC CtFCORD IN THIS OFFICE
� A � � WITNESS MY HAND AN�7 FFICIAL SEAL THIS
` �� ����,aa, ��; �=QfiY OF (�=1,�"(�e� � o�s
� , e ����,°�; PAULA S O' IL, CLERI�&COMPTROLLER •
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' B DEPUTY CLERK
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, , �;�{��'fordable Windows &,�,,oars �
, af Tampa Bay, LLC
�i��r�y �� ������„� 28$70 U.S. Highway 19 N, Suite 3QQ
Giearwater, FL 33761 '
Lic. #CGC1520791 72�_q.37_pp1�
727-725-2933 (Fax) � � � T� ~� i .~ �'� � `�
I{we)hereby cantract with Affordable W rsdows&Doors of Tampa Bay,�,LC the foHowing work and authorize Affordable Windows&Doors of Tampa Bay,LLC to furnish all the necessary
materials,labor and workmanship,to install,construct and place lhe improvemenls according to the following specifications,terms and conditions on the premises below described.
'I�tais eor�tr�3ct, made this ��-' Day af �J�N= �p } �
C7«•ner's Name_��rn ��-��� � Ph# Hoine Work C;el!
r�ddress � �C}3`a 9 ta� .._City `z�y�� State�_.Zip �3��r�--
Jub address. (1f differenC thaza atiov�} �S'�-+��-
tY)iv'i'I:AC'I'C3I2'I'C>t�Ui2Nl5H ctc iNS7'ALt.MfiCk:lttALSAS t�O1,,1.,OW5.
�Affordable Windows & Doors of Tampa Bay will retnave � o1d wrndaws and install the fallowing new
Affordable Windows & Doors of Tampa Bay replacennent windaws ta existing jatnbs, headers and sills as follaw�:
�� Lac�tiort lppe ivi�tJe1!1 S�Tnon cnd Gi�s c�,tnr F�ustoa ivle�suremeat �,�, 1»Measurement U,�, pcscr'sption 1 Note
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TERM$ OF SALE Nt}i'iCE
The Buyer(s)agree(s) to pay a sum as follows ,,,. ANY HOLDER OF THIS CONSUMER CREDIT 1 J•IAVE ItL:AD
(A}Cash Price of Worl� $��J �_ CONTRACT IS SUBJECT TO Al.l.CLAIMS ANDAGI.GE WITH
(B)Downpayment Made by Owner $�?��_ AND DEFENSES WHICH THE DEBTOR THETERMSAND
(C)Unpaid Baiance COULD ASSERT AGAlNS7 THE SEL�ER OF �=�NDITIQNS ON TFIE
{T�paid Upon Completion af Jol�} GC30DS OR SERVICES 08TAiNED PURSU- FkUNt'�:REiV�; "
$'�;`�'�����"�'�'` ANT HERETO OR WITH THE PROCEEDB S1D��S
ash upon delivery U To be Financed ,,,;������. .! �
'"� HEREOF, REGQVERY FfEREt1NC?ER SY TNE ��__�����������__ ���
•'�.;'��.,��,'�a�"�` % "">���� � DEBTOR SHALL NOT EXCEED AMOUNT c�ML•:IN-� rrin�`�
}�i �.'i�c:'�„;.r,,.�.-�-
"=�'�"-�" " � PAID BY THE DE6TOR HEREUNDER.
�k.OR1DA HONiEOWNERS' CONSTAUCTEON F?ECOVERY FUND: A'AYMENT MAY BE AVAIi.ASLE FR{3M THE FLORiDA NCIME4WNER5'C4N-
STRUCTION RECOVERY FUNp IF YOU LOSE MONEY ON A PROJECT PERFORMED UNDER CONTRACT,WHERE THE LOSS RESULTS FROM
SFECIFlED YIOLATIONS OF FLOR}DA�AW EtY A LICENSEQ GONTRACT'OR.FOR iNFORMATiON ABOUT TNE AECQVERY Ft1Np AND FtLlNf A
CC.AlM,CQNTAGT TFtE FLORIDA CONSTRUCTtOtd IlVDUSTAY LiCEMS(NG BOARD AT TNE FOLLOWING TELEPNOTJE NUMBER AND ADDRESS:
Gonstruction lndustry Licensing Board
iS40 North Monroe Street
Tallahassee, F'L 32399-0783
850.487.1395
ACCt�FtDiNG i0 FI.ORiDA'S GONSTRUGTION L3Et1!_AW{SEGTIOhtS 713.QQ1-713.57,FI.taFi1DA STATUTES},7FiOS�WHO W{?RK ON YOUR PROP-
ERTY OR PROV-IC7E 1�AATER(ALS.AND SERVICES ANd ARE.IVOT PA1D 1N FULL.HAVE A�RIGHT TO EN�ORCE THEIR OLAIM_EOR PAXMEN7 AGAINST
� YOUR PROPERTY.THIS CLAIM IS KrlOWN AS A CONSTRUCTION 4.IEN.IF YOUR CONTRACTQR OR A SUBCONTF2ACTOR FAILS TO PAY SUBCON-
TRACTORS,SUB-SUBCC?I�tTt�ACTORS,OR tvIATERtAL 3UPPLIERS,THdSE PEdPl.E WHO ARE OWECt MONEY IvIAY LOOtC TO YOUR PROPERTY
=0R PAYMENT,EVEN IF YOU HAVE ALREADY PAID YOUR CONTRACTOF#IN FULL. IF YOU FAIL TO PAY YOUR COMTRACTOR,YOUR CONTRAC-
1'OR MAY ALSO MAVE A I.IEN QN YOUR PROPERTY.THIS MEANS IF A LI�N IS F'ILED YqUR PROPERTY COULD BE SOI.D AGAINST YaUR WILL TO
°AY FOR zAB�R,MATERIALS,OR OTHER SERVICES THAT YOUR GONTFiACTQR OR A SUBCON7RACTOR MAY HAVE FAILED TO PAY.70 PRO-
iECT YOURSELF,YOU SHOULD STIPULATE IN THI$CONTFiACT THAT BEFORE ANY PAYMENT IS MADE,YQUR CONTRACTOR IS REQUIRED 70
?RQVIDE YOU WITH A WRITTEN RELEASE OF UEN FROM ANY PERSON OR COMPANY THAT HAS PROVlDED TO YOU A"NOTICE TO QWNER."
=LORIDA�S GOi�IS7FtUCT10N LIERI LAW IS GOMALEXr ANt7 1`F IS FtEGOMNfEt�1DED TNAl"YOU CONSUt.T AN.�1T_TOR Y. i
IN WI'1'NESS WHEREOF the undersigncd h�va hereunco subscribed their nante the day and the year first above writte c ubject to office approval.'I'Ire undersigned �
:t�kria�ti� � eccip t o campletv capies nf the Notic� f 12i st to Cancel attaclied below on the date first abov wrilten. (
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FroduR Aooroval Menu>Protluc[or f1oollca0on Search>Aoolicatlon Llst>Appllmtfon Delail
FL!k FL15781-R4
@. • � �� ��� qpplication Type Revision
Code Version 2010
Application Sta[us Approved
Comments ���,�4f1�1J,/ ��`•t•�-+ ( ,-1 �,�� �, `,��
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Archived n ;;�`I"Y �F `�_FHYF�HILLS
Produc[Manufadurer Soft-LIteLLC pLFif�S �Xp,i�n�f�1�R `
Address/Phone/Email 10250 Philipp Parkway I
Streetsbora,OH 44241
(330)528-3400 6ct 1109
j ti n ke r@ s oR-I i te.ca m
Authorized Signature Vivian Wright
rickw@ rwbldgconsultants.com
Technical Representative ��L'D�'�'� �'��'`��`L�"�1�����l T�
Address/Phone/Email ,�i,L,�pP3.ICA.?�L���LDR•TG�
BLEC";'�ICAL,�'Li1T��ING ANF?
QualityASSUranceRepresentative �i��`�-���'`'��'�LS-
Address/Phone/Emaii
Category W indows
Subcategory Horizontal Slider
Compliance Me[hod Evaluation Report from a Florida Registered Archi[ect or a Licensed Fiorida
Professional Engineer
� Evaluation Report-Hardcopy Received
Florida Engineer or Architect Name who developed the Lyndon F.Schmidt,P.E.
Evaluation Report
Florida License PE-43409
Quali[y Assurance Entity Farabaugh Engineering and Testing,Inc
Quality Assurance Contract Exp(ration Date 12/31/2015
Validated By Ryan J.King,P.E.
' ❑d Validation Checklist-Hardcopy Received
Certificate of Independence FL35781 R4 COI CERTIFICATE OF INDEPENDENCE.odf
' Referenced Standard and Year(of Standard) Standard Year
—
AAMA/WDMA/CSA101/I.5.2/A440 2008
AAMA/WDMA/CSA101/I.5.2/A440 2005
ASTM E1886 2005
ASTM E1996 2006
TAS 201,202,203 1994
Equivalence of Product Standards
Certified By
Sections from the Code
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Florida Building Code Online Page 2 of 3
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I 4'
•i
Product Approval Method Method 1 Option D
Date Submitted 12/SO/2014
Date Validated 12/17/2014
Date Pending FBC Approval 12/19/2014
Date Approved 02/23/2015
Summary of Products
FL# Model,Number or Name Description
15781.1 a."Imperial LS DSL12"Double Slider Extruded PVC Double Horizontal Sliding Window-()QC Configuration)
Windaw
Limits of Use Installation Instructions
Approved for use in HVHZ:No FL15781 R4 II INST 15781.S.odf
Approved for use outside HVHZ:Yes Verified By•Lyndon F Schmidt,P.E.43409
Impact Resistant:No Created by Independent Third Party Yes
Design Pressure:N/A Evaluation Reports
Other:See INST 15781.1 for Design Pressure Ratings,any additional FL15781 R4 AE EVAL 15781.1.odf
I use limitations,installation instructions and product particulars. Created by Independent Third Party Yes
15781.2 b."Imperial LS TSL12"Triple Slider Extruded PVC Triple Horizontal Sliding Window-(XOX Configuration)
Window
Limits of Use Installation Instructions
Approved for use in HVHZ:No FL15781 R4 II INST 15781.2.odf
Approved for use outside HVHZ:Yes Verified By•Lyndon F Schmidt,P.E.43409
Impact Resistant:No Created by Independent Third Party Yes
Design Pressure:N/A Evaluation Reports
Other:See INST 15781.2 for Design Pressure Ratings,any additional FL15781 R4 AE Eval 15781.2.odf
use limitations,installation instruc[ions and product particulars. Created by Independent Third Party Yes
15781.3 c."5300 DSL53(G5352)"Double Slider Extruded PVC Double Horizontal Sliding Window-(XX Configuration)
Window
Limits of Use Installation Instructions
Approved for use in HVHZ:No FL15781 R4 II INST 15781.3.odf
i Approved for use outside HVHZ:Yes Verified By•Lyndon F Schmidt,P.E.43409
� Impact Resistant:No Created by Independent Third Party�Yes
Design Pressure:N/A Evaluation Reports
Other:See INST 15781.3 for Design Pressure Ratings,any additional FL15781 R4 AE Eval 15781.3.odf
' use limitations,installation instructions and product particulars. Created by Independent Third Party Yes
15781.4 d."5300 DSL53(G5352)"Double Slider EMruded PVC Double Horizontal Sliding Window-(XX Configuration)
W indow
Limits of Use Installation Instructions
Approved for use in HVH2:No FL15781 R4 II INST 15781.4.odf
Approved for use outside HVHZ:Yes Verified By Lyndon F Schmidt,P.E.43409
Impact Resistant:Yes Created by Independent Third Party•Yes
Design Pressure:N/A Evaluation Reports
Other:See INST 15781.4 for Design Pressure Ratings,any additional FL15781 R4 AE Eval 15781.4.odf
use limitations,installation instructions and produc[particulars. Created by Independent Third Party•Yes
15781.5 e."5400 SSL54(G5402)"Single Siider Extruded PVC Single Horizontal Sliding Window-(OX or XO
Window Configuration)
Limits of Use Installation Instructions
Approved for use in HVHZ:No FL15781 R4 II INST 15781.S.odf
Approved for use outside HVHZ:Yes Verified By Lyndon F Schmidt,P.E.43409
Impaet Resistant:No Created by Independent Third Party Yes
Design Pressure:N/A Evaluation Reports
� Other:See INST 15781.5 for Design Pressure Ratings,any additional FL15781 R4 AE Eval 15781.S.odf
use Iimitations,installation instructions and product particulars. Created by Independent Third Party:Yes
15781.6 f "5400 SSL54(G5402)"Single Slider Extruded PVC Single Horizontal Sliding Window-(OX or XO
� W indow Config uration)
Limits of Use Installation Instructions
Approved for use in HVHZ:Yes FL15781 R4 II INST 15781.6.odf
I Approved for use outside HVHZ:Yes Verified By Lyndon F Schmidt,P.E.43409
� Impac[Resistant:Yes Created by Independent Third Party�Yes
Design Pressure:N/A Evaluation Reports
Other:See INST 15781.6 for Design Pressure Ratings,any additional FL35781 R4 AE Eval 15781.6.odf
use limitations,installation instruc[ions and product particulars. Created by Independent Third Party�Yes
15781.7 g."5400 TSLF54"Triple Slider Window Extruded PVC Triple Horizontal Sliding Window-(XOX Configura[ion)
Limits of Use Installation Instructions
Approved for use in HVHZ:No FL15781 R4 II INST 15731.7.odf
Approved for use outside HVHZ:Yes Verified By•Lyndon F Schmidt,P.E.43409
, Impact Resistant:Yes Created by Independent Third Party Yes
Design Pressure:N/A Evaluation Reports '
Other:See INST 15781.7 for Design Pressure Ratings,any additional FL15781 R4 AE Eval 15781.7.odf
use limitations,installation instructions and product particulars. Created by Independent Third Party Yes
15781.8 h."5400 TSLF54"Triple Slider Window Extruded PVC Triple Horizontal Sliding Window-(XOX Configuration) ,
I Limits of Use Installation Instructions �
Approved for use in HVHZ:Yes FL15781 R4 II INST 15781.8.odf
Approved for use outside HVHZ:Yes Verified By•Lyndon F Schmidt,P.E.43409
Impact Resistant:Yes Created by Independent Third Party Yes
Design Pressure:N/A Evaluation Reports
Other:See INST 15781.8 for Design Pressure Ratings,any additional FL15781 R4 AE Eval 15781.S.odf
use limitations,installation Instructions and product particulars. Created by Independent Third Party•Yes
as �
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Florida Building Code Online Page 3 of 3
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Contat[Us 1940 NoKh Manroe SFreet.Tallahassee R 32399 Phone�850-487-1824
The State oP FlonEa is an AA/EEO employer.Coovrlaht 200]-2013 State at FIOrIOa. Pmacv Statemen[ AccessibiliN Statement ftefvntl 5[atemenf
llnder Flaritla law,email addresses are Oublic remrds.It you do nat want your e-mail address releaseE in respanse to a puhlio-remrds request,do no[send eleetranic mad ro this entity.Instead,
contaR Me ofFlce by phone ar by tratlltlonal mall.if you have any quest�ans,please cantact 850.487.1395.'PUrsuan[Io Secbon 455.275(I),Flantla StaNtes,etfettive Ottaber 1,2012�
Ilcensees IlcenseG untler Chap[er 455�F.S.must proviEe[ha Departmen[wlth an email atltlress rf[hey have ane.The emails prowdeG may be usetl far offcial communication wlth the Iicensee.
However email atlEresses are pu611c remrE.If yau Eo not wish to supply a persanal atltlress,DleaSe provitle Ihe Departmenf with an emall aEGress w�l[h can be maEe available Io the public.To
determine If you are a Ilcensee under Chapter 455,F.S.,please click here
Protluc!Approval AccePts:
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SC cu t i tY st�:'r[��c:s
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GENERAL NOTES � � � ¢�
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� 1. This product has been evaivated and is in compliance with the 2010 Florida Building = ol � �W
� Code(FBC)structural requirements excluding ihe"High Velocity Hurricane Zone" v a a a
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2. Producf anchors shall be as listed and spaced as shown on details.Anchor � �
embedment to base material shall be beyond wall dressing or stucco.
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� 3. When used in areas requiring wind bome debrB protection,this product complies
� with 3ection 1609.1.2 of the FBC and does not require an impact resistant covering. o Z
� This product meets missile level"C"and excludes Wind Zones 3&4 as defined in � o
� ASTM E1996 and Section 1609.1.2.A of the FBC. 3 �
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4. For 2u stud framing construcfion,anchoring of these units shali be the same as that
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� shown for Dc buck masonry construction. N
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a 5. Site conditions that deviate irom the details of this drawing reqvire fuhher � �
� engineering analysis by a licensed engineer or registered architect. 'F Q
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Application Status Approved
Comments
Arthived ���
Product Manufacturer Soft-Lite LLC
Address/Phone/Email 10250 Philipp Parkway
Streetsboro,OH 44241
(330)528-3400 Ext1109
jtinker@soft-I i[e.com
Au[horized Signature Vivian Wright�
rickw@rwbldgconsultants.com
Technical Representative
Address/Phone/Email
Quality Assurance Representative
Address/Phone/Email
Ca tegory W indows
Subcategory Double Hung
Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida
Professional Engineer
i
�� Evaluation Report-Hardcopy Received
' Florida Engineer or Architect Name who developed the Lyndon F Schmidt,P.E.
Evaluation Report
� Florida License PE-43409
Quality Assurance Entity Farabaugh Engineering and Testing,[nc
Quali[y Assurance Contrac[Expiration Da[e 12/31/2014
Validated 6y Ryan J.King,P.E.
IJ� Validation Checklist-Hardcopy Received
Certificate of Independence FL15730 R3 COI Cerfificate OF Indenendence.udf
Referenced Standard and vear(of Standard) Standard Year
AAMA/W DMA/CSA101/I.5.2/A440 2008
ASTM E1886 2005
ASTM E1996 2006
ASTM E1996 2009
TAS 201,202,203 1994
Equivalence of Product Standards
Certified By
Sec[ions from the Code
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, 1'lorida}3uilding(;ode Unlute t'age�or�
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Product Approval Method Method 1 Option D
Da[e Submitted 10/10/2013
Date Validated SO/30/2013
Da[e Pending FBC Approval 11/04/2013
Date Approved 12/13/2013
Summary of Products '
FL# Model,Number or Name Description
15780.1 a."Imperial LS DH12"Double Hung Extruded PVC Double Hung Window-(X/X Configura[ion)
Window
Limits of Use Installation Instruc[ions
Approved for use in HVHZ:No FL157S0 R3 11 INST 15780.1.odf
Approved for use outside HVHZ:Yes Verified By•Lyndon F Schmidt,P.E.43409
Impact Resistant:No Crea[ed by Independent Third Party�Yes
Design Pressure:N/A Evaluation Reports
Other:See INST 15780.1 for Design Pressure Ratings,any additional FL15780 R3 AE EVAL 1578D.l.odf
use Iimita[ions,installation instruc[ions and product particulars. Created by Independent Third Party•Yes
15780.2 b."5400 DH54(G5405)"Double Hung Extruded PVC Double Hung Window-(X/X Configuration)
Window
Limits of Use Installation Instructions
Approved for use in HVHZ:No FL15780 R3 ][ INST 1578D.2.pdf
Approved for use outside HVHZ:Yes Verified By•Lyndon F Schmid[,P.E.43409
Impact Resistant:No Created by Independent Third Par[y•Yes
Design Pressure:N/A Evaluation Reports
Other:See INST 15780.2 for Design Pressure Ratings,any additional FL157fl0 R3 AE EVAL 15780.2.od(
use limita[lons,installation instructions and product particulars. Crea[ed by Independent Third Party•Yes
15780.3 c."5400 DH54(G5405)"Double Hung Extruded PVC Double Hung Window-(X/X Configura[ion)
I Window
Limits of Use Instaliation Instructions
Approved for use in HVHZ:Yes FL15780 R3 II INST 15750.3.udf
Approved for use outside HVHZ:Yes VeriFed By•Lyndon F Schmidt,P.E.43409
Impact Resistant:Yes Created by Independen[Third Par[y•Yes
Design Pressure:N/A Evaluation Repor[s
i Other:See INST 15780.3 for Design Pressure Ratings,any additional F�15780 R3 AE EVAL 15780.3.pd(
use Iimi[ations,ins[allation instructions and product particulars. Created by Independen[Third Party Yes
15780.4� d.,"5300 DH53(G5305)"Double Hung � Extruded PVC Double Hung Window-(X/X Configuration)
_Window "
Limi[s of Use Installa[ion Instructions
Approved for use in HVHZ:No FL15780 R3 II Inst 15780.4.odf
Approved for use outside HVHZ:Yes Verified By�Lyndon F Schmidt,P.E.43409
Impact Resistant:No Created by Independent Third Party•Yes
Design Pressure:N/A Evaluation Reports
Other:See INST 15780.4 For Design Pressure Ratings,any additional FL15730 R3 AE EVAL 157II0.4.udf
use Ilmitatlons,installation instructlons and product particulars. Created by Independent Third Party•Yes
15780.5 e."5300 DH53(G5305)"Double Hung Extruded PVC Double Hung Window-(X/X Configuration)
Window
Limits of Use Installation Instructions
Approved for use in HVHZ:No FL15780 R3 II Inst 15780.S.odf
Approved for use outside HVHZ:Yes Verified By•Lyndon F Schmidt,P.E.43409
Impact Resistant:Yes Created by Independent Third Party•Yes
Design Pressure:N/A Evaluation Reports
Other•See INST 15780.5 for Design Pressure Ratings,any additional FL15780 R3 AE EVA�15730.S.odf
i use Ilmitations,installation instruc[ions and product particulars. Created by Independent Third Party•Yes
� �
Contact Us 1940 North Monrae Street.Tallahassee FL 33399 Phane:850-58]-1824
The S[ate of Fbritla Is an M/EEO employer.Coovrluht 2007-2013 State of FIarIEa. 7nva[v 5[atement B cesslblll[v Stalement ReFUntl Statement
UnGer Florltla law,emall atlEresses are publlc records.I(you Eo no[want your e-mall address releasea in response[o a pubho-rerords request,Eo no[sena elechanic mall ro[his enUty.Insteatl,
on[act Me oHice by pM1On¢or by traCRianal mail.If you have any questlons,Dtease contact 850.48].1395.'PUrsuant to Sectlon 455.275(1),Flonda 5[atutes,effectrve October 1�2012,
Ilcensees 6censetl untler Chapter 455,F.S.mu5t provide Ihe Departmen[with an email atltlres5 A[hey have one.The emails provitled may be used far o(fGal communication wl[h[he Ilcensee.
However emall a00resse5 are publlt retorA.I!you Eo not wlsh[o supply a persanal adtlre55,plea5e proviEe Ne Departmen[wich an email aUGress whith tan Ge maEe available[o[he publlc.To
determine If you are a iicensee unGer Chapter a55,F.S.,please tlick here
ProEUR Approval Accepts:
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� required fo be protected with an impact resisiant covering that complies with i
� Section 1609.1.2 of the FBC.
4. For 2x stud framing construction,anchoring of these units sholl be the same as �,
that shown for Dc bvck masonry construction. o
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REVISIONS l.yndon F Schmfdt. P.E. No. 43409
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NOTE:
- I Item#30,Sill Block.musf be installed Oush against
E '. " • • fhe inside edge of the exterior frame leg.
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BlLL OFMATERIALS 1•37' 1/7'GLASS BITE ;�- 7/e"THICK
PAR�6 MATERIAI �I � �
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B 2X BUCK SG>=0.42 - WOOD �� AIR SPACE ?�m�� o-°°
C 1/4"MAX.SHIM SPACE - - � ° ��m a���
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E MASONRY-3,192 PSI MIN.CONCREfE CONFORMING TO ACI �o m o.� '
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F #10 X 2-1/2"PPH SMS - STEEL 1/7'GLAZING TAPE m Z �� °J '^
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H 1/4"X 2-1/4"PFH ELCO OR fTW CONCREfE SCREW - STEEL �
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K 1/4"X 33/4"PFH ELCO OR ITW CONCRETE SCREW - STEEL �
L #10 X 1-1/7'PFH SMS - STEEL � 0.0�' � I �❑ n � ° �
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8 PLAINSTILE' 11�7 PVC 4.24" � � N O O
9 GLAZING BEAD` 12126 PVC T � I 6 ^ a� o l
10 REINFORCEMENT 6065-TS ALUM � ^ � � � °� Q }
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` 20 LOCK 46013 - � I �� ]� O�❑ 1 OOOO I m
9 21 LOCK KEEPER 46014 N m �a � f �--1.51"--� �-1.76"-�—
23 #7 X 3/B"PFH MS(KEEPER SCREWS) 48016 STEEL
25 TILT LATCH 47004/47010 - J� KEEPER HANDLE RAfC
� 26 #6 X 1"PFH TEK(LOCK SCREWS) 48000 STEEL I 5 � ��CK RAIL
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�, 27 WEATHERSTRIP(0.250"SINGLE FIN PILE) 140020p _ o
q 28 WEATHERSTRIP(0.350"SINGLE FIN PILEJ �40050p _ � HFAD AND IAMa �
� 29 BULBSEAL 14001XX - �
� 30 1/4"X 7'X 6"LONG PLASTIC SILL BLOCK . qgg �
0 31 PIVOT BAR 5004200 STEEL 1.86"
� 32 #6 X 1/7'PFH TEK(PIVOT BAR) - STEEL �0.83" ri
33 BALANCER BRACKET 7006XX - � Z
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`THE APPROVED WHITE RIGID PVC IXTERIOR IXTRUSIONS FOR WINDOWS ARE TO BE PRODUCED BY � - w i
IXTRUDERS LICENSEES IN"AAMA CERTIFICATIONS PROGRAMS FOR RIGID PVC IXTRUSIONS" � I l � � � 0—j- ¢ ;
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