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HomeMy WebLinkAbout15-16629 CITY OF ZEPHYRHILLS 5335-8TH STREET ; ° (si3)�so-oo20 16 9 BUILDING PERMIT PERMIT INFORMATION � ; LOCATION INFORMATION Permit Number: 16629 Address: 38552 PIEDMONT 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: ALPHA VILLAGE Est. Value: i Parcel Number: 35-25-21-0050-00000-0880 Improv. Cost: 1,589.00 OWNER INFORMATION Date Issued: 9/30/2015 Name: PHILLIPS AL Total Fees: 67.50 � Address: 38552 PIEDMONT AVE Amount Paid: 67.50 i ZEPHYRHILLS, FL. 33540 Date Paid: 9/30/2015 � Phone: 813-428-0190 Work Desc: GARAGE DOOR REPLACEMENT 9 X7 CONTRACTOR S APPLICATION FEES BAN O OVE H AD DO R I C .BUILDING FEE 67.50 � - � lf� �- l2 - IS ; ��� � � - Ins ections Re uired F OTER 2ND R UG PLUMB M SC NSULATIO 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: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the local government shall impose a fee of four times the�amount of the fee imposed for the initial inspection or first reinspection,whichever is greater;for each such subsequent reinspection. NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this properly 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 obt'ain 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 City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. � 1� � �— CON CTOR SIGNATURE � PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD' FROM WEATHER CITY OF ZEPHYRHILLS - 5335-8TH STREET i • (sis)�so-oo20 16629 : BUILDING PERMIT PERMIT INFORMATION ` - LOCATION INFORMATION - � Permit Number: 16629 Address: 38552 PIEDMONT 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: ALPHA VILLAGE Est. Value: Parcel Number: 35-25-21-0050-00000-0880 Improv. Cost: 1,589.00 ��f ' OWNER INFORMATION � Date Issued: ' Name: PHILLIPS AL Total Fees: 67.50 Address: 38552 PIEDMONT AVE Amount Paid: ZEPHYRHILLS, FL. 33540 Date Paid: Phone: 813-428-0190 Work Desc: GARAGE DOOR REPLACEMENT 9 X7 � CONTRACTOR S � � : APPLICATION FEES� � BA ER EAD DOOR I C BUILDING FEE 67.50 , 2q�� 1�1� � � ' Ins ections�Re uired - � F TER 2ND ROUGH PLUMB MI C INS TION 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: (c)With respect to Reinspection�fees will comply with Florida Statute 553.80(2)(c)the local government shall impose a fee of four times the'amount of the fee imposed for the initial inspection or first reinspection,whichever is greater;for each such subsequent reinspection. NOTICE: In addition to the requirements of this permit, there maybe 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 BEFORE C.O. NO OCCUPANCY BEFORE C.O. CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER �. � �� �+�'. .. ;,�. City of Zephyrhills BUILDING PLAN REVIEW CQMM�NTS � CantractorlHomeowner: s��.�t1.� � I _ Date Received: �--2-�— �� 2 �C � � �p ,� fc�,����i�� Site: c1�v� fi! l!f �LL( 1 DYE`������' -.�t �� � � � � Permit Type: t�j� .�i �Y �/'��J , ; Approved w/no comments: Appxoved w/the below comments: ❑ Denied w/the below comments: ❑ I � ; � ; i � � �� � � i� , � � � I � � �i � � � � � � This comment sheet shall be kept with the permit and/or plans. °t ; t "� rf G����{v j�a�� Kalvin Switzer– ans Examiner Date !Contractor andlor Homeowner , (R.equired when comments are present) I ' ' �- � ; Build�ng Depattment , ' • • I. i ' pate Receive,d t , ' ' ' �hone Contact for Permitting � •.� *�- •` . / ft . // Owner's Name � � .// . � Ciwner Phone�Ntimber �/.l"`j.Z�` ��/�� • , .� . � . . .. '• ._� Owner's Address . /,�1�2¢i'l/ t�'t.°.! ' Uuirner Phone t+lum�ei� . � _ • � Fee Simple�Titleholder Name I• � ' i ' Owner Ptione Num6er � . . . . . • . Eee SInnpleTiUeholder Addr ss"'' ( ' -. �• . • - , • J08 ApDRESS f� 8~�'S� l'i Pc�i,�?v� l�lvr�. ' LOT�� �� . SUBDIViSIDN.� • � , � ' �� � P'ARCEL @# G of't�it-ai'�� ' , . • ' : . ' • •-I -(OBTAINED FROM PROP 7AX NOTIG� � WdRKPRtaFOSED ' , ';. NEWCON57R 'Al7D/Al.T SIGN MOVE �[� UEMOLISH . . . • ' I INSTALL ' � ..RE IAIR� • • � • PROPOSED USE # S�Ft , �- GaMM Q OTHER ' • � • TYPE t�F C01USTRUCTI�1N � BLOCK Q, FRAME' .C[ � STEEL Q QTHER • � . , . DESCRIPTIOiV OF WORK. • � . I ,)!('� " L-� r✓ri27J.�'D� . BU1LQlNC SIZE. " • � SR FOt?TAGE � i' � � H�IGHT ��� ' [�] 6UILDING $..> i� VALUATION O�TOTAL COIVSTRUCTION . �j�"•r�,�p�` !�� ' .��!� , , �+ ( Q 'ELECTRICAL $ • '_ ' . AMP SER�/ICE � Pi2t3GRESS�ENEt26Y Q W.R,E.C. " ' � - � - � . • i , ' . [� �Ltl(VIBINC � ���. .. � . � � 1'��t,,c1 � � �'�""�, Q MEGNA�IiGAt, $. , � + . . .. VqU1AT10N.DF MEGHAPtlCAL INST�ILlATlQN ��r��� � � . . , _ . _ � fa � � GAS r, [� �, Rf3QF13�lG- ,� . SPEGIP►lTY � `07"HE}�' • , Cf�r��-�/� FINISiiEt7 F�OOF2 ELEVA'f ONS � . - . FLOOD ZONE AREA . �YES` � �QIV�Q,.%` ; � .� . • , BiI1Lt}ER ' . � -' j �,. , �._f COMPANY ' . ... - . : �t�r�f5'. Si6NATURE • Gr�� ' � �q � ; . 1�7 L�P_i'' .. , , RE��sr��a Y! N .. ��cuR�rn': .Y�/N � Address �t 7'a, FL .3'3L3y - " . . Ltcense� �� ,��Q&7g� � , . � , , •, � . . • , ��.��cn:ic�u." . � . �,°'rcaM�A[�Y -� . SlGNATI�lRE ` � �'' • ; �r�s�En . .' .Y/ N '-F�cut�Ertr - Y/N ' � Adiires� - ` , , , , . • License# �� �—� , i ' • • ' - I � . PLUMBER '' _ . � . �� . , CAMPANY .. � • . � SIGNATURE• � i REGISI'EREO Y/ N FEE CURFiENT ' �Y I ht . Address � ' . . �, i • `'' . . 'LlGeASe# �� � � . , ;� , MECWI�NICAL � - ' � � , � '_ ' � COMPANY �� - • SIGNATURE - ' � � REGtsI'�REq Y/ �1 . FEE CURREN3' ' Y J N . . . . Address � ' ' ' ` � ��� �� - • • ' ' . .License# '—' OTHER' ; ._.. ..�..___._._.�.__ - .. . i . . . - . . SI�NA'i't�ttE � '. �.'. � � ! ��ts��o ' Y/ t� �cu�r N � -- . . . , . - � . ;� Address ' j ` • (.iaen'se# .�u �� � � RESiDEHT1AL At#ac}�(2}P1a Plans;(2)sefs of Building Pians;(9)set af�ttergy Fatms;R-0-W�Permi#for neinr coasttucUot�, , . °Minir�um,ten. ,Q}warking,clays after su6mittal date.� Required anslte,Constructinn Plans.Stormwater Plans w%Sil1 Fence installed, �, � Saai' ry:Eacili es 8�1.d' g P. 1 �,a ur�pste'r,Site Work Periiilit fior subclivisicinsflar e ro eafs- COMNiE12C1A! . ,AttacFi.(3)co plete sefs af 8uitdiog Pians plus a Liie SaFe[jr Page;.(1)set•of�nergy For�xis_[3-i0r-W 1'ecm[f for,new constructlon. � . �Mlnii�sum ten +70)working day's aftersUdmiltat dateq RequPred o�isite,ConstrucGon Plans,Stormwater Plans w/"S(It FenCe•insfaUed, SaN ry Facil 'es&1 dumpster.Site Work Permit for all new projects.AU commerciat requirements mUSt meet�ompliance ' Si�N PERMiT Atfa�h(2}set�of Engineered Plans. - __ --. � - - - --- ---- ___ . _. . "","'P�FtOPER`fY SU[�VEY required fpr al1-NEtG46:�onstruction. � - � ' - - Dtrect�dns: ' . � . , . . . 1=i!!out applicaUon cosnpletely. � .. ' • � - . Owner&Co�tractar ign b�ck�of applicaiion,notarized ' � • ' If ave�$2�00,a Not��e of Co�mencemenf is required. (AIC upgrades aver�50dd) � ' ' ** Agent(for fhe conha�tor)o�P�wer of Attorr�ey(for the ovuner)wouid be someone with notarized letter from owner autharizing same - OVER l ME GOUN7'ER PERMi7Ti (3 (Fror�t o�Application�nty) , - .ftesaafs 5ewers Se�,rlce.Upgrades AtC Fences(Pto#/Sesrvey/�ootage} - . DriveWays-Not over�ounter f op pubiic roadways.:needs ROVN � � ' � � � � ��- ;r. � • �: .�� -. .... ' . t '�'ss'• . , . n• , . i } . Nt?TICE OF DEEQ RES RlCTlC�NS: The understgned understands that this p�rmit may be subject#o"deed"testrictions" � whlch maj►be more resfr�ctive th��n Cot�'nty regulatians: Th�undersigi�ed assumes responsibility for compliance witti any applicable deed resEricEions. i UNLtCENSED CUNT �GTURS AND CANTEZACTUR RESPONSiB1LITiES: if fhe awner has hired a contractor or canfractars#a undertak��ork,they may 6e required to be ficensed in accordance with state and Ivcat regulsfions, tf the I contr�cEor is no# licens��� as require@ by taw, 6oth the owrier and cantrac#or may be c�ted it�r a misdemeattot v[oiat[on unde� state law. ff the c�wner o'r intended cantraetor are uncertain as to what licensing requirements may apply for the ; intended work,they are dvised�to contact fhe Pasco Couniy Building (nspeciion Division—Licensing Section at 727-847- 8009. Fur�hermore, if f�e owner has hired a contractor trt confractors, he is advised Eo have fhe confracfar(s) sign parfions of the �contract�r Black" of this application for whieh=fhey wiff be responsibte_, tf yata, as the awner sign as th� contracfor; fhat:rriay be'an indi�atian that he is rlot properly licetised and is not entiEled to permitting privileges in Pasco Goun • TRA SPORTATION IM AGTIUTILITIES IMPACT AND RESOURCE RECUVERY FEES: The undersigned understands fhat Transport�tion tmp cE•Fees and Recourse Recovery Fees may appty�a the constnactivn of new buildings, change of , use in existing buiidings or expansion of existing buildings, as specifiieci in Pasco Gounfy Ord'►nance number 89-07 and 90-07', as amended T e uridersigned atsa understands, that such fees, as may be:due�wit! be identified at fhe fEme af permitting. It is further ndecstooc! that Transpark�tion Impact l�ees and Resource Recovery Fees must be'paid prt�r��o receiving � °certifcate of occupancy° ar final power release, If the project does not involve a certificate af occupancy vr flnal power release, the�fees must be paid prior fo permit issuance. Furfhermore, if Pasco County WaEeNSewer Impact fees are due,#hey must be paid prior fo permit issuance in accordance wi#h appiicabie Pasco Couniy ordinanc�s; � ; CONSTRUCTiON LIEN LAW�Ghapter 713,Flarida Sfatntes,as amettded): If valuation af work#s$2,500.00 ar more, � � cerf#iy that i, the appli anf, have been provided wi#h•a copy t�f the "FEorida Gonstruction L.ien Law Homeowner's Protect�on Gufde" pTep ted by'the Flotida Degartment of Agriculture and.Consumer Affairs. If the �pplicant is someone other�th�n Eti�°owner°, certify�fhat�1.have a�btained a copy of the above described document and pramise in good�faith ta deliver it ta the°owner" rlor#o commencement. � - : - CONTRACTOR'SIOWI�ER'S �1�FIbAVIT. I certifiy fhat ait fhe informafion in this applicatian is accurate and that att work wiil be done in comptiafice withI afi appiicable laws regulating consirctctivn, zoning and iand-deveTopment. ApplEcatian is hereby made to obtair� a pertntt to do wark and instaElation as indicated. ! cer{ify th�t no work or instal4atian has commenced prior ta tssuance�of a pe�rnit and that a0 work vuil! be petfor.med to meet standards of all laws regulating construction, County a(��d City;aodes, zoning regulations, and land development regulafions in the jurisdiation. ( al"so certify that I �inderstand that tNe regulations of ofher govemmen#agencies may appiy#o the infended work� and fhat iE is my responsibilify to ider�tify whak acfions t must#ake�to�be:in compiiance. Sct�h agencies include put are nofi timiked to: - Deparfinent of Environmenfai Proteetian-Cypress Bay�ieads, WetEand Ar�as and Erivironmentaily Sensifive � iL�nds,Wa erlWastewater Treatment: , . - Southwest� Florida Water; Management District Wells, 'Cypress B�yheads, Wetland Areas, Altering Wat�rcour�es. ' - . - � Army Corp of.Engineer�-Seawatts,Docks,�tavigabie VVaferways. - Departme t af Healtfi&"Rehatiiiifative Servic�sJErivironm`+entat Heaith Unit Welts,.ilUastew�fer Treatment, Septic Tan s. � � - US�Enviro mental�Protection Agency-Asbestos aba#ement. - Federal Avjiation AuthQrity-Runways. � � � 1 understand that the fdllawing�restrictions apply to fhe.use af fill: - � - Use of fil(is not allowed in Flaod Zone°V"uniess expressly petmiffed: " - If fhe fiif r�naterial is fo be used in F.lood Zane °A°, i# is understood tha� a drainage plan addressing a �campens Eirig vo�ume°will be submitted at•time of pecmitting which is prep�ted by a professio�ial`eng(rteer iicensed b' the State of Florida. ' - � ' - !f fhe fill t�taterial�is to be used in Flood Zone "A" in conriection with a permitted building Using,sfem walf constructidn,,I certify that fill will be used only ta fitt'fhe area within fhe stem walt. - If.fill mat �rial is fo be used in any aTea; 1 certify fhaf use ofi such fi11 wiii not adversely affect.adjacent � proper#ies if.use af fiti is faund ta adverseiy affect adjacet�t properties,fhe owner may be citeii far. vtolating , fhe condif ans•of�the building permit issued uncler the attached permit applic�tion, for lots less than one (�) acre which are efevated by fill,�an engineered drainage plan is re,quired. (f 1 am the AGENT FOR THE�OWNER, t promise in ga4d�faitH to infarm the owner of fhe permifting condifions set forth in this affidavit prior to c�mmen�cing consfruction. ( undersfand fhat a separate permit tnay be required for electrical work, plumbing, signs, weil , poois; air conditianing, gas, ar afher'ins#alia#ions no� specifically inctuded in the app{icatioci. A permit issued shaii be�cons#ru�d to 6e a license#o proceed with the wark and not as authoriky to_violate, cancel, alter, or seE aside any pravisia�rs of fhe technicai cc�des, nor shail issuance of a permit prevent the Build9ng Officia!from thereaffer �requir:.i»g=.a;.carrection:�of-,e�r:ots��n.,plar�s,-,.cons#r.uctio�.oi'violatians of any codes. Eve�pecmit�issued shall-became-i�t►,alid- �-���. unless the work aukh�rized by such permit is commenced within six monfhs of permit issuance, or if work adthorized by khe permit is suspended or abandaned for a period of six(6)monfhs after flie#ime#he work is commenced. An extension may be•requested, in�wri#ingj from fhe 8uilding C7fficiai for a-period no�to sxceed ninety{90} days and wiiE demans#cate justifabte cause far th�e extensfion. if work ceases for ninety, {9Q�cansecutive�lays,the job is conslder.ed abandoned. , WARNlNG TO.OWN�R` YQUR FAILURE-T(•? RECORD IA NOTICE O� C+OMMENCEMENT 1fAAY RESULT �Tl YOUR �`- P�1YIti��=TW[���4.R;;III��F�OVEMENT�'TO°YOUR•PRt3PEFlTY. �iFYt3ti,ii+ITEf�D,TO.OBTAIN F1i�i4.NGiNG�,CQNSULT WITH'YC1UR ENDEFt OR�•AN�A C1RNElf"BEFt)RE'RE�ORDI`t7�Y{�UR��t�QT�� �CliF'��U4!lt41!lE6ttC�1V1��l�'. - ___ _ 'FLCfR1DA JURAT(F:S.1_� .1 •� ' .������� 1 ., OWNER OR AGENT ' ������R ' ~v-' S sq�ed a d swom to��sr a e eEote me thts ' - Sub cribed an.,,1c suvom to{o�ffirmed�be re r�7e�is� i�.�"/�by !U'.�^ve'��d+�E"..�' �3 /,5 by "?�i^�X� GFi 2.° Who ls/are personally knoVun fo me 5r hasfhave produGed Who istare personatiy known to me or haslhave praduced i as�ldenlification. as identiBcatton. � - ', , �.!� �--> ��� - . . �.�.�f � Notary Public Nofary Publie Commisston hlo. �� �� CO[i1A31sSl0ii IVo. � � � Name af iVotary,,typed,printed orst mped _ - --- Name of hloha etl -Printed orsFamped-----____._ ._A��. - t}'�,, ,• �y,, .A ,r,�...'.-.-, t';i, Y+ �, .,� ,. ;_.r ,�r } •..!e�:�U:l i:..�_J li� ,' � ,r: . ,r .:� �•.�'��tt,»�;::i`4� 1.>•�L'J���'L�'S1!'�,?.'! `t;�`1,J' .. `,:, hF�4;�?!Vls�. ,( ;•'�; , � y';t� ,, .. 't�,�:v�'�_'••°�.b`� ,;:,>,.;�.,,-r� �:" ':�+� ^����`'�; �:'�� ,�°� � S1�a�i'Q,�a_3; f as�,t l_�.:,.-.:.'r.a.� � .,{' .z<� i,4.; :_... o " ' �,' i:P; ,,. . t�� �'� i ::'�., .�_ti .=.�nS'�Sii!:.i�.:E-iil'"S� "`�` ':��1�• � - `ir.� I;:.�.�.�c.-,...(ii:=i.1' z.:...�.. ��t�',r�f".'4.�,��,4<;? I'i;; •Kr,!^ ..r�it7F,'.GOfY7 + c:�.. . . : Gk1.:,-:..,>,�.-,__�; :, r, 1 , . • � �lti���� H ST. TAMPA F�33634 �� � t I� 5329 W. CRENS A1N � , Q 877-90-BANKO (22656) � ;BanKaDoors.com ; Tampa Say Area:813-882-9904�ManateeiSatasota:941-T56-7424 �PineilaslPasco:727-530-44Q1 ' DATE y�r�'�,�"" INSTALL!DATEITIME 1��; �-�1 O T�CKET NO. �ZS0�.3 OYERHEAD DQDRS,INC. �—�- � GARAGE DOO72S&QAEtJERB i blte cannot redict the tifes an of a rehooked o ener Name �, �L�DS � Door and a ener are se arate items Address ��s�2- �.E3'�r1�v{' ��_ ' 1�nr+it be available for a count ins ettor to ins ect work , I We do not caulk or aint CI yf—�i�t?��'►��State Zip—� , ln/�anao redi are not res onsiblefor-stucco --- Subdivision L.oUBLK � Pa ment in full due at time of the install ��� �� e � 1 Gara e must be clear zo'back on instatl da Phone ��3 ; 5 ecia�order doors take a roximatel z weeks to arrive Ema�l �g'��'''�1����/!d �e��. G6V�` !1 hereby authorize Banko to publish the photographs of my �, . garage doar or sne for use in prfrrted publ'scatians and website. Sales Consultant �� �� � `�3 �q�- Olher. � � ..• . . . i . . . . �- ��.�'33 C�ca p. $�r ..�, ? '� ,� ... inl� t�s ts• i � ' B A�� e—F' ��s��c� v,,ss S��s� �aa3 /95'"" ; �y-�-� `�1� �.� ���.� b�� ���� � �.-�-�:..� ��4.- i�rGl.a d+�s ��.. �rn �'�S�w1� � �..P�k � `Z �� ' r-� {-�s��v�.� � f3�k� r's��s` �'�"-�' � �"7`t 5��"a/��,�"��F '�-� �o:� -(�t,—. .- . . .- . . . . . . j�$9,.,, � � Fiomeowner Signature i "�.,x"�� �`°""°'` "- -.�'�':� Framin : Existin Doar ❑None ❑1-piecs � ceit�rr� �r.:� 9 g �.Sectionat in Pinettas _it;+ ���,�,,,�F�?*-� ,,� � Wood �:'�:►"`.t`;,r=- i3'sN;_-,``r�. ❑ ^� Courtty,bucks ���� :-��;.n��'-� ♦�� � Does current trim rotrude over 1/4"? Na Yes '�ctelie�-=; �?��. �s"Fce1� I P 'C�l ❑ must be hr h ��,�. ��_ '�.==T' ���'����3""� � �B�ock Haw Fan 9 � � �� ��- ��t' �.�,-._ �;-'s�.," erraugh fa `'"' `��feiten� Tr �i�-�e�aee=�..s�'' S#am k ,'a�- '�`,�u��`'"'��'==^'�':.<;��: ❑Wali Recess -[�Okay ❑Needs to he C�i allowinstalf af .�..�.�:__ .. _w�s�c��---�_,:•�-�. 1� �i_Y� i bearing pfate ; ,`a' ,- , 1:�=��,';� �� ❑Other 10'Back Workroom ❑Yes �No �T^old to Clear tTangs l8g.lf �reglace= Add Anchors. YES NO � u� bucks are . ,.:�- :` Requirements for tostaller. �'����buckhetgnt � Existing Opener �YQS ❑No short add � t'`' rio�ip ; W4-5,min.�5„intervals °`'��"w� � e�dertsrons to °,°�. : Wb,min t2"intecvals r�i�n�� � Existlng Opener Works? �Y� ❑No ❑Recommend New �?,�,. , �'':$�::�d�s 3 ReGannect? ❑Na ❑Yes esfimale. �:;:� :W�,g-see speciat�nsLructians ,;;s:„� -~�- �"-°�°'�' Brand of Existing Opener C�4N��„f'(CJja/ Apx.Age (4"min clearance on each side of opening) I Prewire? �Yes ❑Na Vinyl tnstructians �c�a2 Al'�"` � Power Onsite? �Yes ❑No W5 Color Y..�I�.�T� � � Ceiling OuUet? �]Yes ❑No Nardwara ❑Keyhand2e ide Locks ❑8arrel Vauit Release � � + (PERMlTTlNG INFO OIVLYJ t� Who is Pulling Perrnit? ❑Customer �',Banko ❑N!A ❑Unknown I Who To Cal1 �d O' �J , h. lnsiall Oate� Opening Sizes 1 ------�'-��• � `� 2 � Phane �.7 '� "v � Ait.Contact# 3 4 i �t �` �� � Email K.IM TtY<<►�'� C1 ! Are flpenings Square? �Ye� , Q No (Measore Boih Sides of Openings} Dnor Approvat# Floor to Ceiling Height � , 15'rad.(8'5"8 higher) � �D_T (7'8"-7'11"} „�i 2°rad{8'-8'4"} �(}.7'.Rear(7'5"-7'7°} � �1` Year Built �+� �Existing Structure ❑New Structure i .��_�(� ��n��.C �r' Special instructions: �J�� �`� � ... �d'�r����' .���/31b�-s � i I R�t sk� �loricia Building Code Online Page 1 of 5 , �� -- ; YF`� 11�.'� , � o c ' a 1 . ' - e , t �_� - .._ --� . - - ___._ .... --- -.. _. .._. . - I �,:-- ., j,:,. ��/'�:-• � - Florida Department�f BCIS Home � Log In ; User Registratlon � Ho[Topics � Submlt Surcharge � Stats&Facts � Publiwtions � FBC Staff ; BCIS Site Map i Links ; Search E Busines !� � Professi���l f'� ���Product Approval I I � USER:Public User Regulation ' �I Produc[Aooroval Menu>Product or Aoolication Search>Aoolicatlon List>Application Detaii ' I i�'t"b� • `�� FL# R15279-R4 I "'"'"'� ' ApplicationType Revision ��� Code Version 2014 I Application Status Approved ' ' i'Approved by DBPR.Approvals by DBPR shall be reviewed and ratified by the POC � and/or the Commfssion if necessary � i i Comments � Archived I❑ Product Manufacturer Clopay Building Products Company Address/Phone/Email 8585 Duke Blvd. �Mason,OH 45040 �(513)770-6062AZ,7_��ORK SHALL COiviPLY V�iTH ALL mweste�eld@cly��pylyo r I PREVAILING CODES,FLORIDA BUILDING Authorized Signature ;shamilton@dop�'.E�E,NATIONAL ELECTRIC CODE AND � ; CITY OF ZEPHYRHILLS ORDINANCES Technical Representative I Address/Phone/Email I Quality Assurance RepresenWtive i Address/Phone/Email � ���'v'��:��I!'�/�TE .��i�'_a . Category I EMerfor poors r..,����,r� ��� Subcategory �Sectional Exterior'd o sArnDiies L1 Jp��� i � rl i 1� LS � � �A.fVS �}(��1�1Ep Compliance Method �l Certification Mark or Listing !� � I CertiFica[ion Agency Intertek Testing Services NA Inc.-ETUWamock Hersey Valfdated By 'Gary Pfuehler I �1 Validation Checklist-Hardcopy Received i Referenced Standard and Year(of Standard) I Standard Year i ANSI/DASMA 108 2005 iANSI/DASMA 115 2005 I ASTM E1886 2002 1 ASTM E1996 2002 ' ASTM E330 2002 i EquWalence of Product Standards I Certified By I Florida Licensed Professional Engineer or Architect � FL15279 R4 Eauiv 20150319-FBC-DASMA 108 equiv.odf � FL15279 R4 Equiv 20150319-FBC-DASMA 115 eauiv.Ddf � � i Product Approval Method 'I Method 1 Option A Date Submitted I 03/19/2015 I htt //www.floridabuildin .or / r/ r_a dtl.as x?� aram=wGEVX wtD v3 WKJZ1 9/23/2015 P� g g P P Pp_ P P Q q Y Q... F"rorida$uilding Code Online , Page 2 of 5 . ; , Date Validated 06/12/2015 I Date Pending FBC Approval ; Date Approved 06/21/2015 I I Summary of Products , Go to Page 4� � , � � Page 4/8� � FL# Model,Number or Name Descrlption 15279.61 O61 WS-16 PANSP-2F156:765P,�76VSP Steel Pan(mfn.25 ga.)Double-Car(9'2'to 16'0"wide)WINDCODEp � � WS Garage Door Llmits of Use Certification Agency Certiflcate Approved for use in HVHZ:No I FL15279 R4 C CAC Letter with oroof of contrect and oroof of Approved for use outside HVHZ:Yes i ectio . df Impact Resistant:Yes FL15279 R4 C CAC WS Ltstina Intertek.odf Design Pressure:+32 PSF/-37 PSF Quality Assurance Contract Expiration Date Other:Solid doors(no glazing)or doors with optional impact�resistant OS/21/2028 glazing are impact-resistant(large missile impact). , Installation Instructions FL15279 R4 II 103723-A-Rev08.odf i Verlfied By:Intertek Testing Services NA Inc.-EI'L/Wamock Hersey Crea[ed by Independent Third Party• � Evaluation Reports � Created b IndependentThird Party: 15279.62 062 WS-16 SPO-2F449:Grand Harbor, Steel Pan(mfn.24 ga.)with Overlay Double-Car(9'2"up to 16'0"wide) Stone Mdnor � WINDCODE�WS GBrBg2 DOO� Limits oP Use i Certlfication Agency CertiFcate Approved for use in HVHZ:No � FL15279 R4 C CAC Letter with oroof of contrect and oroof of Approved for use outside HVH2:Yes � ins ection. df Impact Reslstant:N/A FL15279 R4 C CAC WS Listina Intertek.odf Design Pressure:+30 PSF/-30 PSF ! Quallty Assurance Contract Explration Date Other:The OPTIONAL glazing available for this product meets the wind OS/21/2028 load requirementr of the building code but DOES NOT meet the impact Installation Instructions reslstan[requirement for windborne debris regions.The product without FL15279 R4 II 103553-Rev06.odf giazing DOES comply with the impact resistant requirement for VeriFled By:Intertek Testing Services NA Inc.-ETUWamock Hersey windborne debris regions(ref 1609.1.4 FBC). Created by Independent Thfrd Party i Evaluation Reparts Created byIndependent Third Party: 15279.63 063 WS-16 W-1B699:Reserve Gollection Reserve Wood Double-Car(9'2"To 16'0"wide)WINDCODEp WS Garage RHxx I Door Limitr oP Use , Certl£cation Agency Certificate Approved for use in HVHZ:No FL15279 R4 C CAC Letter with oroof of contract and oroof of Approved for use outside HVHZ:Yes � ins ection. df Impact Resistant:N/A FL15279 R4 C CAC WS Lfstina Intertek.odf Design Pressure:+30 PSF/-33.5 PSF � Quality Assurance Contract Expiration Date Other:The OPTIONAL giazing available for this product meets the wind OS/21/2028 load requirements of the building code but DOES NOT meet tlie impact Installation Instructions resistant requirement for windborne debris regions.The product without FL15279 R4 II 102536-Rev06.�df glazing DOES comply with the impact resistant requirement for Verified By:Intertek Testing Services NA Inc.-ETL/Wamock Hersey wfndborne debris regions(ref 1609.1.4 FBC). ; Created by Independent Thlyd Party• � Evaluation Reports Created by Independent Third Party: 15279.64 064 WS-16-B AL-SF499:Avante'" Full View Aluminum Residential WINDCODEp WS Sectionai Door,12'3" � to 16'2"wide Limits of Use ' Certi£cation Agency Certiflcate Approved for use in HVHZ:No j FL15279 R4 C CAC Letter with oroof of contrect and oroof of Approved for use outside HVHZ:Yes i ins ection. df Impact Resistant:N/A � FL15279 R4 C CAC WS Listina In[ertek.odf Design Pressure:+30 PSF/-30 PSF Quality Assurance Contract Expiration Date Other:The OPTIONAL glazing available for this product meets the wind OS/21/2028 load requlrements of the bullding code but DOES NOT meet the impact Installatlon Instructions resfstant requiremen[for windborne debris regions.The product without FL15279 R4 II 103447-Rev04.odf giazing DOES comply with the impact resistant requirement for Verified By Intertek Testing Services NA Inc.-ETLJWarnock Hersey windbome debris regions(ref 1609.1.4 FBC). i Created by Independent Third Party: , Evaluation Reports Created byIndependentThird Party: 15279.65 065 WS-16-C AL-iF499:AvanteTM Full View Aluminum Residential WINDCODEp WS Sectional Door,12'3" ' to 16'2'wide Llmits of Use ' Certificatlan Agency CertiFicate Approved for use in HVHZ:No ' FL15279 R4 C CAC Letter with�roof of contract and oroof of Approved for use outside HVHZ:Yes � ins ection. df Impact Resistant:N/A . FL15279 R4 C CAC WS Listino Intertek.odf Design Pressure:+32 PSF/-32 PSF Quality Assurance Contract Expiration Date Other:The OPTIONAL glazing available for this product meets the wind OS/21/2028 load requirementr of the bufiding code but DOES NOT mee[the impact Instaltation Instructions resfstant requirement for windborne debris regions.The product without FL35279 R4 II 103446-Rev04.odf glazing DOES comply with the impact resistant requlrement for Verified By:Intertek Testing Services NA Inc.-ETL/Warnock Hersey windborne debris regions(ref 1609.1.4 FBC). Created by Independent Third Party ' Evatuation Reports Created by Independent Third Party: 15279.66 066 WS-16-HY DSIE-1A171:2050,2051, 1-3/8"Double-skin lnsulated EPS(exterior skin 27 ga.min.;Interior skin 2053,4050,4051,4053,62,64,65,62G, 29 ga.min.)Double-Car(9'2"to 16'0"wide)WINDCODEp WS Garage 62LG,64G,SDP38,SFL38,SRP38,134, Door 135,136,6130,6131,6133 �, Llmits of Use Certifcatlon Agency CertiFcate Approved for use in HVHZ:No I FL35279 R4 C CAC Letter with oroof of contract and oroof of Approved for use outside HVHZ:Yes i ins ection. df Impact Resistant:No � FL35279 R4 C CAC WS Listino Intertek.odf Design Pressure:+32 PSF/-32 PSF Quality Assurance Contract Expiration Date Other:The standard glazing available for thts product meets the wind O5/21/2028 Ioad requirements of the building code but DOES NOT meet the impact Installatlon Instructlons resistantrequirementfor windborne debris regions. FL15279 R4 II 102185-B-Revl2.odf ' Verified By Intertek Testing Services NA Inc.-ETL/Warnock Hersey � Created by Independent Third Parry• Evaluation Reports Created byIndependent Thfrd Pa 15279.67 067 WS-16-HY DSIE-1A171 2050,2051, 2053,4050,4051,4053,62,64,65,62G, http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqv3yVVKJZ 1 Q... 9/23/2015 Fiorida�uilding Code Online Page 4 of 5 � Other:Solid doors(no glazing)or doors with optional impact-resistant Installation Instructlons glazing are impact-resistant(large missile impact). , FL15279 R4 II 101526-A-Revl6.odf Verified By Intertek Testing Services NA Inc.-ETL/Wamock Hersey , Created by Independent Thfrd Party: Evaluation Reports ' Created byIndependent Third Party 15279.74 074 W6-09 DSIE-SF171:4300,4301, 2"Double-skin Insulated EPS(exterior skin 27 ga.mfn.;interior skin 27 4310,4400,4401,HDG,HDGL,HDGF,66, ga.min.)Singie-Car(up to 9'0"wide)WINDCODEp W6 Garage Door 66G,67,67G,68,SP200,SF200,SE200, 6200,6201,6203 Llmits of Use � Certlficatian Agency Certlficate Approved for use in HVHZ:No � FL15279 R4 C CAC Letter with oroof of contract and oroof of I Approved for use outside HVHZ:Yes ins ection. df ' Impact Resistant:No FL35279 R4 C CAC W6 Listinq Intertek.odf I Design Pressure:+37 PSF/-40 PSF Quality Assurance Contract Expiration Da[e Other.The standard glazing availabie for[his product meets the wind OS/21/2028 i� load requirements of the building code but DOES NOT meet the Impact Installation Instructions � resistant requirement for windborne debris regions. FL15279 R4 II 101526-B-Revl6.odf '� Verified By:Intertek Testing Services NA Inc.-ETUWamock Hersey �� Created by Independent Third Party: ' Evaluation Reports � Created byIndependentThird Party• ' 15279.75 075 W6-09 DSIE-SF471.GD25P;GR25P, Gallery/Artistry/Expressions:2"Double-skin Insulated EPS(eMerior skin GD2LP,GR2LP,AR25P,AR2LP,ED2SP, 27 ga.min.,interior skin 27 ga.min.)Single-Car(up to 9'0"wide) ED2LP WINDCODEp W6 Garage Door Limits of Use �� Certlfication Agency CertiFcate Approved for use in HVHZ:No , FL15279 R4 C CAC Letter with oroof of contra[t and oroof of Approved for use ou[side HVHZ:Yes ins ection. df Impact Resistant:Yes FL15279 R4 C CAC W6 Listina Intertek.odf Destgn Pressure:+38 PSF/-42 PSF Quality Assurance Cantract Expiration Date Other.Solid doors(no standard glazing)are impact-resistant(large OS/21/2028 missile impact). �� Installation Instructions FL15279 R4 II 103954-A-Rev03.pdf Verified By•Intertek Testing Services NA Inc.-ETL/Warnock Hersey � Created byIndependentThird Party• Evaluation Reports I Created by Independent Third Party: 15279.76 076 W6-09 DSIE-SF471:GD25P,GR25P, Gallery/Artistry/Expressions:2"Doubie-skin Insulated EPS(exterior skin GD2LP,GR2LP,AR25P,AR2LP,ED2SP, 27 ga.min.;interior skin 27 ga.min.)Single-Car(up to 9'0"wide) ED2LP WINDCODEp W6 Garage Door Lfmitr of Use Certiflcation Agency Certificate Approved for use in HVHZ:No ; FL15279 R4 C CAC Letter with oroof of contract and oroof of Approved for use outside HVHZ:Yes ins ection. df Impact Reslstant:No FL15279 R4 C CAC W6 Listinq Intertek.odf Deslgn Pressure:+38 PSF/-42 PSF ' Quality Assurance Contract Expiration Date Other:The standard glazing availabie for th(s product meets'the wind OS/21/2028 load requirements of the building code but DOES NOT meet tlie impact Installation Instructions � resistant requirement for windborne debris regions. � FL15279 R4 II 103954-B-Rev03.odf , Verified By•Intertek Tes[ing Services NA Inc.-ETUWamock Hersey � Created by IndependentThird Party: Evaluation Reports � i Created by Independent Third Party: 15279.77 077 W6-09 DSIEO-1M479: ' Double Skin Insuiated EPS(exterior skin 27 ga.min.,interior skin 27ga. Coachman/Settlers/Affini[y min.)with Overlay Singie-Car(up to 9'0"wide)WINDCODEp W6 Garage Door LImItr of Use i Certification Agency Certiflcate Approved for use in HVHZ:No FL15279 R4 C CAC Letter with oroof of contract and oroof of Approved for use outside HVHZ:Yes ' ins ection. df Impact Resistant:Yes FL15279 R4 C CAC W6 Listina Intertek.odf Design Pressure:+38 PSF/-42 PSF Quality Assurance Contract Expiration Date Other:Solid doors(no standard glazing)are impact-resistant(large O5/21/2028 missile impact). � Installation Instructions FL15279 R4 II 103223-A-Revli.odf Verified By:Intertek Testing Services NA Inc.-ETL/Warnock Hersey Created byIndependent Third Party � Evaluation Reports � Created by Independent Third Party: 15279.78 078 W6-09 DSIEO-SM479: ' Double Skin Insula[ed EPS(eMerior skin 27 ga.min.,Interior skin 27ga. Coachman/Settlers/Affinity � min.)with Overlay Single-Car(up to 9'0"wide)WINDCODEp W6 Garage DoOr Limits of Use � Certi£cation Agency Cerdficate Approved for use in HVHZ:No ' FL15279 R4 C CAC Letter with oroof of contract and oroof of Approved for use outside HVHZ:Yes ins ection. df Impact Resistant:No FL15279 R4 C CAC W6 Listino Intertek.odf Design Pressure:+38 PSF/-42 PSF Quallty Assurance Contract Expiration Date Other:The standard glazing available for this product meets the wind OS/21/2028 Ioad requirements of the building code but DOES NOT meet the(mpact Installation Instructions resistant requiremen[for windborne debris regions. � FL15279 R4 II 103223-B-Revll.odf , Verified By Intertek Testing Services NA Inc.-ETL/Wamock Hersey Created by Independent Third Party , Evaluatlon Reports Created byIndependent Third Par[y• 15279.79 079 W6-09 DSIU-1A171:9130,9131, Double-skin Insulated PUR(exterior skin 27 ga.min.;fnterior skin 27 ga. 9133,HDP33,HDPF13,HDPL13,7130, min.)Single-Car(up to 9'0"wide)WINDCODEp W6 Garage Door 7131,7133,8130,8131,8133 Llmits of Use I CertiFcation Agency Certiflcate Approved for use in HVHZ:No , FL15279 R4 C CAC Letter with oroof of contract and oroof of Approved for use outslde HVHZ:Yes ins ectio�. df Impact Resistant:N/A FL15279 R4 C CAC W6 Listinq intertek.odf Design Pressure:+37 PSF/-37 PSF Quality Assurance Contract Expiration Date Other:The OPTIONAL standard glazing available for this product meets OS/21/2028 the wind load requiremenks of the building code but DOES NOT meet the Installation Instructions impact resistant requirement for windborne debris regfons.The product FL15279 R4 II 104180-Rev0l.odf withou rd glazing DOES comply wi[h the impact resistant Verified By:Intertek Testing Services NA Inc.-ETL/Wamock Hersey rement for ' dbome debris regions(ref 1609.1.4 FeQ). Created by Independent Third Party: , Evaluation Reports i Created by Independent Third Party: 15279.80 � � http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqv3yWKJZ 1 Q... 9/23/2015 Fr'otida�uilding Code Online , Page 5 of 5 < � , 080 W6-09 DSIU-SF171:9200,9201, Double-skin Insulated PUR(exterior skin 27 ga.min.;interior skin 27 ga. 9203,HDP20,HDPF20,HDPL20,7200, min.)Single-Car(up to 9'0"wide)WINDCODEp W6 Garage Door with 7201,7203,8200,8201,6203 Optional Impact-Resistant Lites Limlts of Use ', Certiftcation Agency Certificate Approved Por use In HVHZ:No '� FL15279 R4 C CAC Letter with oroof of contract and oroof of Approved For use outside HVH2:Yes � ins ection. df Impact Resistant:Yes � FL15279 R4 C CAC W6 Listinq Intertek.odf Deslgn Pressure:+37 PSF/-40 PSF i Quality Assurance Contract Expiretion Date Other:Solid doors(no standard glazing)or doors with optional impact- OS/21/2028 resistant standard glazing are impact-resistant(large missile Impact). Installation Instructlons � FL15279 R4 II 104184-A-Rev0l.odf � Verified By:Intertek Testing Services NA Inc.-ETL/Warnock Hersey Created by Independent Third Party• � Evaluation Reports � Created by Independent Third Party: Go to Page � � � � � Page 4/8� � I I � � Contact Us::1940 North Monroe Stree[.Tallahassee FL 32399 Phone:850-487-1824 The State of Florida Is an AA/EEO employer Copvriqht 2007-2013 5[a[e of Florida.:•Privacv Statement Accessihilitv Statement::Refund Sta[ement Under Fiorida law,emall addresses are public records.If you do not want your e-mail address released in response to a public-records request,do no[send electronlc mali to this en[ity Instead,contac[the offlce by phone or by traditional mail.If you have any questions,please con[ac[850.487.1395.•Pursuan[[o Sectlon 455.275 (1),Fiorida Statutes,effective October 1,2012,Iicensees Ilcensed under Chap[er 455,F.S.mus[provide the Department with an emall address If they have one.The emalls provided may be used for offlclal communicatlon wi[h the Iicensee.However email addresses are publlc record.If you do not wlsh[o supply a personai address, please provide[he Department with an email address which can be made available to[he public.To de[ermine If you are a Ilcensee under Chap[er 455,F.S.,piease click e e, Product Approval Accepts: �-�-- � cChe�Y. � I � securitvsu:nz�cs I � I � � � � i � I I il I i I � http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqv3yVVKJZ 1 Q... 9/23/2015 � T 4 3 2 1 • . H�� Et�ss 7YPE e�F REVISIONS ` SHORT LONG FLUSH D���T SECTIDNS , CL�PAY 92U0,F�P20 9203,HDPL20 9201,F�PF20 UP TD 7'0' 4 REV. N0. ZONE: DATE: ECN N0. APPVD: DESCRIPTION 7'3'TO e'9• 5 00 - - - SH INfTW_RELEASE IDEAL 8200 8203 8201 9'0'70 10'6' 6 01 SH UPDATED WINDCODE CHAR� 10'9'TO 12'3' 7 F�MES 7200 7203 7201 12�6'Ti]14'0' 8 14'3'TO 1S'9' 9 D 16•�• 10 �.��,.sm��s D MAX SECTION HEIGHT�21' ��m/cnim,av/�ev.E nc oaon av�n avio�a�aa wr�enunvm an�vmr�ou�r oacs xor krter n�xo tao waNO v ne ooaie u�a�a sa ss�ox e-e rw�4 � R( un Tor auaar �000a w�tut[n f�m em � (�)7�4 R�S]F TAi4fA S17E114 �ppppk���1 odAE Ipf@711QL TUIX r-- --i i r__ i r ___� u a.om� .e a..�n�.re �-j� r � i i � i i i � i 'i ss ew r� t�w atv.ma cuo aa�c�r. i i i i ,i ovu. � � ta ua wv.srta n�o a'�oar. va� ro�aao,wm�nx � � �n e e-.�-e/e'w saaas �e tetita��m�r. �__���—�r�`�=� ���� �ra,ieyB To SUPPORTING �?RUCTURE ATTAGHMEM �°°� ��� �� �_—� i!Y_� �-v! __ °c°'a. 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NO.: 104784 VER: IBC 4 3 2 G�L�OG�ODQ pG?OODNJC�`��pL°PG30OMQ�9��77J i