HomeMy WebLinkAbout16-17199 CITY OF ZEPHYRHILLS
� t 5335-8TH STREET `��~
�` '! (813)780-0020 17,1�99
BUILDING PERMIT
, PERMIT INFORMATION _ - LOCAT.ION INFORMATION `
Permit Number: 17199 Address: 38802 HENRY DR
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: PARK HILL TERRACE
Est. Value: Parcel Number: 02-26-21-0180-00000-0160
Improv. Cost: 1,396.28 , � • OWNER INFORMATION
Date Issued: 3/24/2016 Name: HELMS ELIZABETH A
Total Fees: 67.50 ' Address: 38802 HENRY DR
Amount Paid: 67.50 ZEPHYRHILLS FL 33542-2656
Date Paid: 3/24/2016 Phone: 813-783-2139
Work Desc: REPLACE DOUBLE DOOR S/S
CONTRACTOR S � ' - APPLICATION`FEES
LOWE'S HOME CENTERS INC BUILDING FEE 67.50
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- ' � � Ins ections Re uired , `- ' - � � � -
FOOTER 2 D ROUGH PLUMB MIS INSULATION EILIN
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 obtain financing,consult with your lender or an attorney
before recording your notice of commencement." I
Complete Plans, Specifications Must Accompany Application.All work shall be pertormed in accordance with I
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
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CONTRACTOR SIGNA URE 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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� Building Department
, TpfV iGA
Date Received Phone.¢ontac�f,or Pe Ittin �3 '� — -�9 65
Owner's Name � ���M � Owner Phone Numba `��3-�g3- Z�39
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Owner's Addr�ss 3 SSa z �e n/R �R Owner Phone Numbe
Fee Simple Titl eholder Name Owner Phone Numbe
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Fee Slmple Tltlehoider Address
JOBADDRE33 �gg�� �� `( PQ �P�'�Y��115 FL 33S�1z LOT# � 6
SUBDIVISION; V R2K �'�'1�� PARCEL ID# ��'�'.Z�'dl$0 -Q OOO � lJ/6�
(OBTAIHED FROM PR PERTY TAX NOTICE)
WORK.PROPOSED B NEW ONSTR B ADD/RLT � SION Q Q DEMOLISH
� INST LL REPAIR
PROP03ED USE Q SFR Q COMM � OTHER
TYPE OF CON8TRUCTION Q BLO K Q FRAME [� STEEL Q
DESCRIPTIONI OF WORK AL2 K/�L 'Y' Sr
'�Sr'ie, FL .Z 6 q. 3
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BUILDIN(i SIZE SQ FOOTAOE� HEIOHT
OBUILpINO $ VALUATION OF TOTAL CONSTRUCTION
� � 6 $
QELEC7RICAL $ AMP S�RVICE Q PROO ESS ENERC3Y Q W.R.E.C,
OPLUMBINO $
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C]MECHANICAL $ VALUATION-OF MECHANICAL INSTALLATION � �?� [ �
�]OASi Q ROO ING Q SPECIALTY � OTHER Z ���
=1NISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �
G C�F�.�l �--.'Z"
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3UILDER q-�� �� � / �� COMPANY L ow•eS NoMe, CeN'T�2s � L�
51GNATURE v���.�• REGISTERED �Y7, N FE CURRE� Y/N
Address � �O 1� � O ��J 2�A��'" 3�"��� Licens # ��o .S(� 1
=L.ECTRICIAN, COMPANY
31GNATURE RE013TERED Y/ N FE CURRE� Y/N
Address Llcens #
�LUMBER � COMPANY
31GNATURE � REOISTERED Y/ N FE CURRE� Y/N
Address Licens # �
MECHANICAL; COMPANY
31GNATURE REGISTERED Y/ N FE CURRE� Y!N
Addres� , Licens #
7THER COMPANY
31t3NATURE ' REOISTERED Y/ N FE CURRE� Y/N
Addreas I Ltcens #
2ESIDENTIAL Attach(2)Piot Plans;(2)sets f Bu.ilding Plans;(1)set of Energy Forms;R-O-W Pennit for ew construction,
MlnlmuM ten(10)worfcing day after submittal date. Requlred onsite,Constructlon Plans, tormwater Plans w/Sllt Fence Installed,
---— - - � Sanitary,FaclllUes 8 1_dumpst r,Site Worfc Permlt;for subdlvlsionsflarge proJects _
:OMMERCIAI Attach(3)complete.sets of Bu Iding Plans pius a Llfe Safety Page;(1)set oi'ene�gy Forma:R=0=1h'PeRnit-ioc�nev�-constructl�n.� ----
Minlmum ten(10)working day after submlttal date. Requlred onsite,Constructlon Plans, toRnwater Plans uv/Sllt Fence installed,
Sanitary Facllltles�1 dumpst r.Site Work Permit�for all new proJects.All commerclal requi ements must meet compllance
31GN PERMIT , Attach(2)sets of Engineered lans.
'""PROPERTY SURVEY req Ired for all NEW construction.
)irections:
Ffll out appllcatlon completely.
Owner&Contractor sign back of appllcation, otarized
If over 52500,a Notice of Commencement s required. (AIC upgrades over 57500)
' Agent(for the contractor)or Power of Attome (for the ovmer)would be someone wlth noterized letter fro owner euthorizing same
)VER THE COUNTER PERMITTIN(3 (Front of ApplicaUon Only}
Zeroofs If shingl;es Sewers Service Up rades A!C Fences(PIoUSurvey/Footage)
Drlveways�Not over Counter If on public roa ys..needs ROW
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NOTICE 0�DEED RESTRiCTIONS:��The undersigrted understands that this permlt m y be subjecf fo"deed°restrictlans"
which may be more restrietive than C unty reguiations. The andersfgned assumes ces onsibl4lty for compllance w�kh any ,
appllcable deed�restrictions. �'
UNLiCENS�D CK?NTRACTQRS AN CONTRACTQR RESPONSIBILITtES; If the� owner has hired a confractor ar
contractors to undertake work, they y be requlred ta be Ilcensed In accordance wlth state and local.regulatlons.. if the
contractor fs not ticensed as require �by faw, both the owner and contractar may be clted for a mfsdemeanar violaklon
under stake law. If kh� owner or In#e ded contractor are uncertain as to what iicensi g requirements may app{y far the
infended work, they are advised ta aa tact the Pasco County Bulid(ng lnspection Divlsi n—Llcensing Seefion at 727-847-
8009. Furthermore, if the owner ha hired a contrackor ar cantractors, he is advls d to have the contractor{s) slgn
portfons of the °contractor Block" of t Is application for which they wiil be responsibie if you, as the owner sEgn;as the
contraetor, that may be an indicatian hat he !s nat properly Ilcensed and Is not entitle to permitting priviieges in iPasco
County,
TRANSPORTATION IMPACTIUTiLI ES iMPACT AND RES4URCE R�CQVERY fE S; The�tindetslgned under's#ands
i that Transpartation lmpact Fees and ecourse Recovery Fees may apply to the const uction of new buiidings, change of
use in existing buiidings; or expanslo of exlsting bu1ldings, as speclfled in Pasco Co nty Ordinance number 89-07 and
90-07, as amended, The undersigne aiso understands, that such fees, as may be ue, wi!! be Edentified at the fime of
permltting. It ls furkher understood f at Transportatlon lmpact Fees and Resource R aovery Fess must be paid p�fbr to
recelving a "certificate of occupancy" or flnal power release. If the proJecf does not in olve a certificafe of occupancy or
final power reiease, the fees must b pafd prlor to permit issuance. Furthermore, if asco Gounty WaterlSewer �lmpact
fees are due, they must be pald prior o permit issuance in accardance with appl#aabie asaa Caunty ordinances.
CdNSTRUCTION LlEN LAW(Chapt r 713, Florlda Statutes, as amended): 1f v�lua ion of work is $2,500.00 or mvre, i
eertify that i, the applicant, have�b e�i provlded� with a copy �of the "Florlda Con tructlon :Lien Law--Horneowner`s
Protectlon Guide" preparad by the FI rida Department of Agrlcuiture and Consumer ffairs. If the appflcant Is someone
other than fhe"awner", !certlfy that I ave obfalned a copy of tha above describad doc ment and promise in good;fafth_to
deRlver It ta the uowner°prior to comm ncement. ' I
CONTRACTOR'SIOWNER'S AFFiD VIT: i certlfy that a4! the lnfarma�lon !n this appli ation is accurate and that al! work
wili be dane (n campliance with all a piicable laws regulating constructian, zoning an �land�°deve}opment. Applicatian Is
hereby made to obtaln a permft ta do wurk and Insfallatlon as indlcated. ( certi that no work or Insfaila#ion has
corrimenced prlor to lssuance of a ermit and that a!# work w!i! be perFormed to me # standards of aU laws regulating
construction, County and Cify code , zoning regulations, and fand development re ulatlans In the jurlsdlation. � ! a{so
certlfy that i understand thaf the reg lations of aflier government agencies may apply to fhe infended wark, and'thaf (t is
rny responsibllfty ta Identi#y what act) ns ! must t'ake ta be In camplianoe. Such agenc! s Include buf are not lim(ted to:
- Department af Enviromm �tal Protectian-Cypress Bayheads, V1letland Ar as and Envlronmentally Sensitive
Lands, Water/Wastewa#e Treatment.
- Southwest Florida Wa er Management Dlstrlct-WeDs, Cypress Ba heads, Wetland Areas, Altering
Watercourses. '
- Army Corps of Engineers Seawaiis, Docks, Navigabie Waterways.
- Department �of Health Rehabillt�afive Servlces/Environmental Health nit-Weils, Wastewater Treatment,
Septic 7'anks. . •
- US Enviranmentai Pro#e tlon Agency-Asbestos abatement.
- Federal Avtation Authori -Runways, �
! understand khat the following restrlc lons apply to the use of fill:�
- Usa af fili Is not allawed # Flood Zone°V"unless expressly permltted.
- lf the flll material is to e used in Fiood Zone "A", ft is understaod t at a drafnage plan addressing a
"compensa#ing volume" iil be submltted at time of permitting which is p epared by a prafessionai engineer
Ilaensed by#he Skake of Iorlda.
- if th� fi(f materiai is to used in Flood Zone "A" fn connec#fon wl#h a permltted bullding using sfem wal!
� construction, 1 certify fha flil wili be used oniy fo fl(I the area witMn the ste wali.
- !f fl!I materia! is to be sed In any area, I certlfy that use of suah fili wili not adverseiy affect adjacent
prapertles. If use of flll i faund to adversely affecfi�adJacent properkles, t e owner may be c(ted for Wolating.
the conditfons of the bui dfng permit issued under the attached perml,t a pllcat(on, for lots less khan;`one (1)
acre which are efevated y fill, an englneered drainage pian�is required. �
If I am the AGENT 1=QR THE OWN , ! promise in gaod fa(fh fo Inform�the owner of he perm(tting condifians seE�forth In
this affidavit prfar to commencing co struc#lon. ! understand that a separate permlt ay be requ(red for eleckrical work,
plumbing, signs, welis, paols, air co ditioning, gas, or other installations not specifl ally fncluded in the applica'tlan. A
permlt issued shall ba construed fo e a ilcense fo proceed wlth the work and not as authority fa,violate, cancal, aft�r, or
set aside any ptovlsions of the techn ca! codes, nor shall lssuance of a permlt preven the Bulld(rig Offic(a(from Ehereafter
requiring a correction of errors in pia s, construction or vio{atfons af any aodes. Eve perm(t Issued shall become lnvaNd
unless the work author(zed by such ermit is commenced wifhfn six months of permi issuance, or ff work authorized by
� the permik!s suspended or abandon d for a period of six (6) months after fhe time th work(s commenced. An extension
may ba requested, In w�itfng, from t e Bullding,Offlcla! for a period not to exceed n! ety (90) days and wUl demonstrate
Justifiable cause far the extension. tf ork ceases for ninety(90}cansecutive days, th Jab fs cansidered abandoned.
WARNlNG TO �WNER: YOUR F ILURE TO RECORD A NOTICE QF COMMEN EMENT MAY RESULT IN YOUR
_ PAYiNG TWtCE FOR IMPROVEME 73 TQ YOUR PRClPERTY. !F YQU INTEND 7" OBTAlN FINAN�lNG, CONSULT
-- WI YO �k D . � TT 62Pi� FO �CORDI - CE �
F4.ORIDA JURi4T(F.S: 117:03) �
OWNER OR ADENT CONTRACTO r' . �
Subscr(bed a�d swom to(or afflrmed)before e thls Subscribed and s o(or a�irme )�before me this
a�' bY ' ...�1,��` . '
Who Is/are personally known to me or haslha e produced Who lslare-person y nowrrta me r hasliieve pradueed
es Idendflca on. as identtflcafton.
Notary Public � Notary Publtc
Gommisslon No. Commissian No.
Name of Notary tyrped,printed or stamped Name of Nokary typed,printed'or s mped
STORE C4PY
\ � iNS3ALLATION SERVICES CUSTOMER CONTRACT-MWORK-INTIEXTIPATIO DOOR
M � LOWE'S OF ZEPHYRHILLS,FL,STORE#1854 STORE PHONE:{813)838-9000
LL � , � 7yL I t�HLL allliLtl%H1=1U SHLtJPtI'fSOl�l:CI"IFSIj 1 C�Jt'1"ICI'f NIH11j!'IF1LL
EPHYRHILLS, _FL. 33541 ___ _ SALESPERSON I_ 703_ � .___
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Document Print t Ot6 �� j ��
This is only a Quote for the merchandise and services printed below.This becomes an agreement upon pay� t � nce of a Low ' �pt, u n which the entire agree-
rnent, including the specifically completeti pages of this document, the Terms and Conditions included with t��cu�n t, the applicabfe,p rtidn(s) of Lowe's receipt, and any
ot�er addenda or attachmenis hereto,shall be referred to herein as this"Contract." � � o � p�
PlEASE READ THIS ENTIRE DOCUMENT.1NCLUDING T E"TERMS AND CONDITION " BEFORE SIG 6`? U �, � W
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Lowe's Registration or Contractor License fVumber/Lowe's Contractor Name W fl-
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Flor�da Contractar L�cense Number CGC1508417 � � o � 7 �.� � .
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� Customer Name 3 7 W y,, �Hbr�e hone I
00 �. �connn� uc� e�� a � Q H .Q;.�-?�,?-2i39
\ Vvl IVIY/L��LI�I� O f"� V�V l
� ~ Customer Address Other Phone
oMo � 38802 HENRY DR
� �- City State 1 Province Zip I r ostal Code
� + p ZEPHYRHELLS FL 33542
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ti lnstallation Address
'"' • -r �t3t3U1 I-I�IVFiY DR
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p Installation City Installation State/Province Installation Zip/Postal Code
`� 0 ZEPNYRHIL�S FL 335�2
MERCHANDISE AND INSTALLATION SUMMARY
�►7ERCiiANDI�� �lli�iilllARlf - .
4874: 366-PFJ7:STK: PFJCASE366 2-f/4-INX11/16-IfVX7-FT: PFJCASE366 2-1l4-INX11/16-INX7-FT: METRIE INDUSTRIES INC-QTY 6
394006:60SBBGSGOPRHOSNgM : STK : RB 6'STL FR BBG SGLOP RHOS NBM: RB 6'STL FR BBG SGLOP RHOS NBM :JELD-WEN,MILLWORK MAS-
TERS-KNOX-Q7Y 1
Materials Price $ 693.28
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� INSTALLATION DESCRIPTION I
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� St�''re 1854 Project No. 467827025 for JEROME HELMS Page 1 of 7
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STORE COPY
� Stock or SOS: Stock Door Type: Patio I
� ��' �elect Location : �ack Door Select EVew Door: Hinged/French
� �vi�^c �iy^�iS^vi Tiai�Si'iii�S; �i� riidden�amage uescripiion : ivone �
Number of additional holes bored for accessories : None install Specialized.Mortise Hardware:_No
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Total Linear Feet of Custom Trim to be Insta![ed:0 Deliver poor: No
Customer Understands Scope of the Project:Yes Permit Required:Yes
Who Will Obtain Perrnit:Lowe's Permit Fee :Yes
Additional Miles Traveled over 20:0 Bring Up To Code Description : None
Local Disposal Fee :Yes Describe Other Work Needed: None
Comments : 72"x80" outswing fench style steel door item#394006 Lead Safe Practices: No
!abor�harges $ 6�9.0
n Detail Deduction -$ 35.00
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� Additional Specifications:
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�a Notation: Lowe's will not malce structuraf r�odifications, paint or stain or remove/reinstall security system equipment. Customer is responsible to advise if�rop-
� erty is governed by Historic District Regulations.
~ Additional Specifications: Federal law requires Lowe's to provide you with the pamphlet Renovate Right: Important Lead Haz�,•d Informafion for Familes,
� . �;�� Care �ro✓iue�� a,-,u�c�ruuis. By sigr�ing fnis �oniraci, Customer acicnowiedges having receivea a copy oi inis pampniet before wor�c negan inrorming
o Customer of the potential risk of the lead hazarci exposure from renovation activity to be performed in Customer's dwelling unit.
`� PNOTO RELEASE: Customer grants to Lowe`s and Lowe's employees and independent contractors the right to take photQgraghs of the Prem�ses where In-
stallation Services wilf be performed and all work performed at the Prer�ises related to this Contract, ancf irrevocably grants to Lowe's aIl right, titfe, interest in
and to the photographs for use in all markets and media, worldwide. in perpetuity. Cus#orrter authorizes Lowe's to copyright, use ancf publish the photographs in
print and,'or electronically, and agrees that Lowe's may use such photographs for any lawful purpose, including, b�t not IEmited to, marketing, advertising, publi-
city. iflustration, training and Web content. By initialing here,Customer agrees to the foregoing. (Customer to initial to the left].
' !�lO7��E TQ G�ST�!!�lEF3 - P!?!CE �E���;::.A?':�EvS: In order ta p;operly perfarm the installation cf certail Gao�s, the �ontract Price may include mare
Goods than actually will be installed based on the measured sguare footage of the Project Area.As a result,the parties agree that the lump-sum Price stated in
this Contract is calculated upon both the value of the estimated Goods reyuired to fulfill the Contract (incfuding waste), which rnay exceed the actual square
footage of the Project Area, and the labor which may be estimated based on the amount of Goods required to fulfill the contract (including waste). By signing
this Contract below, Customer acknowledges receipt of this notice and agrees and understands tha#the Price includes these costs�vhich may not be refunded
once ihe Installation Services are performed..
NOTICE OF ARBITRATION AGREEMENT
� This Conh act provides that all claims by Customer or Lowe's will be resolved by B[NDING ARBITRATlON. Customer and Lowe's GIVE UP THE RIGHT TO GO
o TO COUF�T to enforce this Contract (EXCEPT for matters that may be taken to SMALL CLAIMS COURl�. Lowe's and Customer's rights will be determined by
o a NEl1TF;AL ARBITRATOR and NOT a judge or jury.Lowe`s and Customer are entitled to a FAIR HEARING. 8ut the arbitration procedures are SlMPLER AND
r' MORE LI�✓11TED THAN RULES APPLICABLE IN CQIJRT. Arbitra.tor dee:iSiC��S �.re 3s e!�fOrCe?ble ?s anv �.r�irrf pr�l�r a�ri are s�!b�eCt tn VFRY 1 111l�ITFf,� RF-
r- VIEW BY A COURT. FOR MORE DETA{LS: Review the section titled ARBITRATION AGREEMENT, WAIVER OF JURY TRIAL AND WAIVER OF CLASS AC-
N �• T10N ADJUDICATION found in the Terms and Conditions of this Contract.
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� Sta:e 1854 P��oject No. 467827025 for JEROME HELMS Page 2 of 7
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STORE COPY
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. TOTAL CHARGES OF ALL MERCHANDISE AND SERVICES :wne�_eappr�b�e _
SUB-TOTAL $1317.2
*TAX $ 0.0
DELIVERY $ 79.0
ORDER TOTAL $1396.2
BALANCE DUE
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� Worlc is to commence upon reasonable availablity of Contractor which is anticipated to be ���� _�fill in clate].
� Fgtimatgrl Emm�lPti�n Vl�fc;g l�. J�fl/��1n@ f4;ll�^4��c1
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tO• All items [isted in this contract and specification sheet(s)are to be installed under conditions agreed upon at time af purchase and at ihe price appearing
� on this contract form.This assumes sour.c sx�sting s�!bstr!�ctures, s�!perstructure and paints of attachments. Extra labor vr material incident to installation
necessitated by defective substruc#ures. superstructure, points of attachment, or the moving of fixtures or app(iances to be billed at extra cost to.custom-
�' 2�. ^O ��^vT���^,z,v i r'i�� ^.^viv i^ni►C i�iv i i� CviviPLc i c ilivv t vu nilv E n�iru i ri�T�n^ivi8 iv"v^u i viJ^viTiv v�^vF i rii�Cv"+T i�+C�. gY S�.^.���{P�u
o BELOW, YOU ARE ACKNOWLEDGING THAT YOU HAVE READ, UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTN ON
cn THIS CONTRACT. YOU ARE ENTITLED TO A COPY OF THIS CONTRACT AT THE TIME OF SIGNATURE.
^ N�TiCE TO OWfVER:-ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAW (SECTIONS 713.001- 713.37, FLORIDA
STATU7ES), THOSE WHO WORK ON YOUR PROPERTY OR PROVlDE MATERIALS AND SERVICES AND ARE NOT
PAID IN FULL HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGA[NST YOUR PROPERTY. THIS CLAIM IS
KNOWN AS A CONSTRUCTt4N LIEN. (F YOUR CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SUBCON-
�'Fi�►C�C'iR�, ��Da-SrJ�COioi�i'R�►�i^vRS, �iR iv'iP�i ERi�►L S�PPLiERS, �'H��c �cE3r�� ir"�Hfi �R� E`i�'JE.0'i �iii0i'�iEY i�iAl(
� LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN iF YOU HAVE ALREADY PAID YOUR CONTRACTOR IN FULL. IF
YOU FAIL TO PAY YOUR CONTRACTOR, YOUR CONTRACTOR MAY ALSO HAVE A L1EN ON YOUR PROPERTY. TH1S
MEANS IF A L(EN IS FILED YOUR PROPERTY COULD BE SOLD AGAfNST YQUR WfLL TO PAY FOR LABOR, MATERI-
ALS, OR OTHER SERVICES THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FAILED TO PAY. TO �
PROTECT YOURSELF, YOU SHDULD STIPULATE IN THtS CONTRACT THAT BEFORE ANY PAYMENT IS MADE, YOUR
o CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN RELEASE OF LlEN FROM ANY PERSON OR COM-
� PANY THAT HAS PR4VIDED TO YOU A "NOTICE TO OWNER." FI.ORIDA`S CONSTRUCTION LIEN LAW IS COMPLEX,
� AND IT IS RECOMMENDED THAT YOU CONSULT AN ATTORNEY.
N � WITNESS OUR HAND{S)AND SEAL(S) BELOW THIS �� DAY OF I��c�. , �Ul� __,
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� Store 1854 Project No. 467827025 for JEROME HELMS Page 3 of 7
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'-'�• +. ilr,�nr(lplait$o@�i�ECatiQilS Holley Dev Corp�I54584 �
r� � � �''-�._�� please�rovlde drawiag frars�onsite using swing tnfo on right �
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�.,�:: ?.,''� . '�?'::1 08�e: - - Note Inte�tiiP/Fzteriov vicw - - - -- - - . - - - --. - --. -LCft k#and Right Hand - -- �. _ _,
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Store#: �., a
Customer: � �
Patio Sw1pg:A=Active,i=lnactive
Custome�Phons: Stiders:X=Activ�,p={nactive
Customer must�e hame fivr instaltation .
�usiomerto app(y#inish{paintJstain} �'—''��-^��
, r�; ��:�
fxtertor-Note fiilish of harrte:�W G K- W� ..S'WGGO � ""'
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Door units to measure-one daor per row-aii measurements must 6e m inc�es. +'*
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Product Apurovll Menu>Product or A�plicTtion Search>Application List>Applic�tion Delail
FL# FL12769-RG
Application Type Revision
Code Version 2p14
Application Status Approved
*Approved by DBPEL.Approvals by DBPR shall be reviewed Tnd ratified bylthe POC
andlor the Commission if necessaq�
Comments
Arcliived
Product Manufacturer )ELD-WEN
Address,�Plione/Email 3737 L�keport Blvd
Klamatli Falls,OR 97601
(800)535-393G �
fbc I(�jeld-wen.com
Authorired Signature Kaede McL�ughlin
fbcl(r�jeld-wen.com
"feclinic;�l Representative ,IELD-WEN Corpor�te Customer Service
Address•,'Phone/Em1il 3737 Lakeport Blvd.
Klamatli Falls,OR 97601
(800)535-3936
customerserviceagents ajeltl-�ven.com
Qualiry.4ssurance Representative
AddresslPhone/Email
C�tegon� Exterior poors
Subcate�;ory Swin;ing Exterior poor Assemblies �
Compliance Method Certification Mark or Listing
Certification Agency National Accreditation&Management Institute
Validated By National Accreditation&Management Institute
Referenced Standard and Year(of Standard) St�ndard Year
ASTM E330 2002
ASTM E331 2000
TAS 202 1994
Equivalence of Product Standards
Certified By
Product Approval Metliod Mediod 1 Option A
Date Suhmitted l l/I 1/2015
Date Validated 11/13/2015
Date Pending FBC Approval
Date Approved I I/20/2015
Summary of Products
�
http://www.floridabuildin�.or�/pr/nr ann dtl.asnx?naram=wC'TEVX(�wtT)asmFRc(11�h9X 1 1/��l�f115 �
Page 2 of 3
' P'L 1i Modcl,Number or N�me Description ;
12769 I Contours Steel,Wood Edge Full Lite,Ins�ving Door�v/or w/out Sidelites, 12'-0"�6'-8" � ^
Limits of Use Certification Agency Ccrtiticate
App�roved for use in HVHZ:Yes FL1_?.7f,9_R6 C CAC_N1009887-R�1 Ceriificate;pdf
Approved fm•use outside HVHZ:Yes Quality Assurance Contract Gxpiration D�tc
[mpact Resistant;No 03/31/2020
Dcsign Pressure:+55/-55 Installation Instructions
Other:Product Can Be Inst�lled In Tlie X,OX/XO,OXO,XX, FLl?7f9_R6_[I,,.,A008730 SS 2013-09-08;pdf
OXX/XXO,and OXXO Configurations Per lnstallation Instnictions.Since Verified By•Hennes�.Norero Florida PE No.73778
product does not meet water intiltretion requirement for HVHZ,it must be Cre�ted by Independent Third Party•Yes
installed per overhead requirements as identified in Sec.4410.2.3.2 of the Evalu�tion Reports
Florida RBC. FL12769 R6 A[?PER3791.pdf
Created by Independent Third Parry•Yes
12769.2 Contours Steel,VVood Gdge Full Lite,Inswing Door,w/or�v/out Sidelites, 12'-0"x 6'-8"
Limits of Use Certification Agency Certificate
Approved for use in HVHZ:Yes FL12769 R6 C CAC NI009887-R4 Certificate.pdf
Approved for use outside HVIIZ:Yes Quality Assurance Contract Cxpiration D1tc
ImpacC Resistant:No 03/31/2020
Design Pressin•e:+66/-66 Instnllation[nsh•uctions
Other, Product Can Be Installed In The X,OX/X0,OXO,XX, FL12769 R6 fl_A008730.SS_20.13-09-08,pdf
OXX/XXO,end OXXO Configin•�tions Per Installation Instructions;and Veritied By•Hermes F Norero Florida PE No.73778
Must[3e Installed With SurfTce[3olts.Since product does not meet water Created by Independent Third Party:Yes
infiltr�hon requirement for HVHZ,it must be instnlled per overheed Gvaluation Reports
requirernents as identified in Sec.4410.2.3.2 of the Florida RBC. FL12769 R6 AE: PER3791.pdf
Created by Independent Third Parry•Yes
12769.3 ' Contours Steel,Wood Edge Full Lite,Outswing Door,w/or�v/out Sidelites, 12'-0"x 6'-8"
Limits of Use Certitic�tion Agency Certifcate
Approvcd fm•use in HVHZ:Yes FL 12769 R6_C CAC_N1009887�Ra Cenificate.,pdf
Appiroved fm•use outside HVHZ; Yes Quality Assur�nre Contract Gxpiration D�te
Impxcl Resistant:No 03/31/2020
Design Pressure:+55/-55 Installation Instructions
Other:Product Can Be Installed[n The X,OX/XO,OXO,XX, FL 12769 R6 II A008731 SS 2015=10_03_.�df
OXX/XXO,and OXXO Configurations Per lnstallation Instructions.:iince Verified By•Hermes F Norero Florida PH No.73778
product does not meet water infiltration requirement for HVHZ,it must be Created by Independent Third Parry•Yes
inst�lled per overliead requirements as identified in Sec.4410.2.3.2 of'the Gvaluation Reports
Florida RBC. FL12769 R6 AE PER3792.ndf
Created by[ndependent Third Party:Yes i
12769 4 Conrours Steel,Wood Edge Full Lite,Outswing Door,w/or w/out Sidelites, 12'-0"x 6'-8"
Limits af Use Certification Agency Certific:�te
Approvcd for use in HVHZ:Yes FL12769_R6_C_CAC N1009887-R4_Certiticate,,pdf
Approvcd for use outside HVHZ; Yes Quality Assurance Conh•act Gxpir:ttion Date
Imp:ict Resist�nh No 03/31/2�20
Dcsign Pressure:+66/-66 ]nstallation Instructions
Other:Product Can Be[nstalled]n The X,OX/X0,OXO,XX, FL127G9_R6 11._A008731 2015_10-03,.�df
OXX/XXO,�nd OXXO Configurations Per lnstallation Instructions;and Verified By:Hermes F Norero Florida PE No.73778
Must Be Installed Witli Surface Bolts.Since product does not meet water Cre�ted by Independent Third Party•Yes
intiltration requirement f'or HVHZ,it must be installed per overhead Gvaluation Reports
requirenients as identitied in Sea 4410.2.3.2 ofthe Florida RBC. FL12769 R6 AE PER3792.,pdf
Created by Independent Third Party•Yes
12769.5 Contours Steel;Wood Edge Full Lite,Inswing Door,w/Vent Lite,3-0 x 6-8
Limits of Usc Certitication Agency Certificate
rlppro�•cd for use in HVHZ:Yas FL12769 R6 C CAC Nf011489-RI Certificate.odf
Approved fm•use outside HVHZ:Yes Quality Assurance Contract Espiration D�te
[mp�ct Resistant:No O1/31/2U20
Design Pressure:+55/-55 Install�tion Instruetions
Otlier:Product meets water intiltration requiremeuts for HVHZ FL12769 R6 II A009078 SS 2013-02-28.pdf I
Veritied By�Hennes F.Norero Florida PE No.73778
Created by Indepeudent Third Party:Yes
Graluation Reports
FL12769 R6_AE PER3793.pdf
Created by Independent Third Party• Yes
127G9.6 Contours Steel,Wood Edge Full Lite.Outswin�Door,w/or w/out Sidelites,9'-0"x G'-8"
Limits of Use Certification Agenc,y Certiticate
tlpproved for use in HVHZ:Yes FL12769 R6 C CAC N1011352-R1 Certificate.pdf
Approved fm•use outside FIV1iZ:Yes Quality Assurancc Conh'act Cxpiration Date
htt ://www.floridabuilding.org/pr/pr app dtl.asX�x?�aram=wGEVXOwtDasmFBcODh9X... 1 l,/�(1/�(11 S
P J
iPage 3 of 3
� Impact Resistant:No l2/31/2020
Design Pressure:+50l-50 Installation Instructions
Other: FL12.769 R6_II_A008496FL.pdf
Verified By:Hermes P.Norero,P.E.73778
Created by Independent Tl�ird Party:Yes
� Evalu�fion Reports
FL12769_R6_AE PER383.�df
Created by Independent Third Party:Yes
httb://www.floridabuildin�,or�/nr/nr ann dtl.asnx?naram=w(�FVX(�wtnasmFRc�1�h9X 1 1/�fl/�(115
�
JELD-WEN DOOii INSTALLATION DETAILS TABLE 7 I
I �QiVT�JllRS PREMIUM ST�€i WflO�EDGE DESIGNPRESSURERATING.
FULL Lri'E NON-IMPACT OUTSWING SRE QUALIFIES.FULL LITE iJON-IMPACT ACTIVE PANELS WITH OR W/O SIDELITES 6
MAX.PANEL WIDTH=35 314' 6-8 TALI SYS7EMS. (XX)(XXO)(OXXO)(X)(OX)(XO)(OXO)
�'���"�-�"'���-$�� GENERAL NOTES WITHOUT wi�H SURFACc BOLTS
1 ?H1S?ROD'JCT iS DESIGNED?O CONPLY WlT::CURRENT 1NTERNA?lONAL SU1LDlNG CODE(1.9..^..)&1NTERNATIONAL RESIDENTIAL SURFACE SOLTS. SURFACE BOLTS: AND ODL SMART FRAME
CODE(i.R.C.)AND THE CURRENT FLORIDA BUILDING CODES(FBC),INCLUDiNG HVFZ AND HAS BEEN EVALUATED IN ACCORDANCE OU7SwING POSITIVc +55'K +66 +60
TO TAS 202-94,ASTM E330-02.E283-04,E331-00 AND AAMA 1304-02. NOTE:ODL SMART�RAME IS HVHZ EXEMPT AND OIJLY RATED NEGnTivE _�5' -66 -60'e
EOR WINDZONE 3_ . - - . - ------ - -- -- - �------------- --- -- - --- � -
COMPONENT LIST
2.'IX AND 2X WOOD BUCKS BY OTHERS AND MUST BE ANCHORED PROPERLY TO TRANSFER LOADS TO THE STRUCTURE. BUCK ITEM DESCRIPTION MATERIAL QTY.
MATERIAL MUST HAVE A SPECIFIC GRAVITY OF 0.55 OR GREATER. 1 NON-COMPRESSION SHIM(0.25"MAX.THK.) WOOD AS REQ.
3.CONCRETE OR MASONRY MUST BE ANCHORED PROPERLY TO TRANSFER LOADS TO THE STRUCTURE. CONCRETE MATERIAL SHALL 2 2x WOOD SUB BUCK(S G.MUST BE 0.55 OR GREATER) WOOD AS REQ.
HAVE A MINIMUM Fc OF 3000psi OR MASONRYlCMU SHALL CONFORM TO ASTM C90. 3 1x WOOD SUB BUCK(S.G.MUST BE 0.55 OR GREATER) WOOD AS REQ.
4 PRODUCT ANCHOR TYPES AND SPACING ARE SHOWN ON SHEETS 6&7. DIMENSIONS SHOWN FOR ANCHOR SPACING ARE ALWAYS 4 #10 WOOD INSTALLATION SCREW W/'1 1/2"MIN.EMBEDMENT STEEL AS REQ.
FROM EDGE OF UNIT FRAME. ANCHOR EMBEDMENT TO BASE MATERIAL SHALL BE BEYOND WALL DRESSING OR STUCCO 5 3I1S"ITW TAPCON ANCHOR W!1 1/4"MIN.EMBEDMENT STEEL AS REQ.
5.THIS DOCUMENT SUPERCEDES OTHER ANCHOR INSTALLATION 6 #9 X 2'i12"PHILLIPS FLATHEAD WOOD SCREW STEEL 2 OR 4
149'MAX.FRAME
INSTRUCTIONS FOR NON-IMPACT RATED DOORS. FOR OTHER 3���2"MqX 7 #8 X 2"PHILLIPS FLATHEAD WOOD SCREW STEEL S REQ.
IMPORTANT INSiALLATION INSTRUCTIONS,REFER TOJELD-WEtv 1'11'i/2"MAX.FRAME� FRAME TYP � 8 #9 X 3/4"PHILLIPS FLATHEAD WOOD SCREW STEEL 22 OR 44
DOCUMENT#JII106(INSTALLATION INSTRUCTIONS FOR D.L.O. g �"O.A.IG NON-IMPACT FRAME BY ODL Polypropylene 1 OR 4
PRE-HUNG ENTRY DOORS)FOUND ON THE JELD-WEN � SHT#3 10 KWIKSET LOCK SERIES 400 STEEL 1
WEBSI i E:JELD-WEN.COM/LEARN/RESOURCES/ !
INSTALLATION&FINISHING/. � 1 i KWIKSET DEADBOLT SERIES 780 STErL 1
T o � � '� � 12 1"O.A.IG NON-IMP SMART FRAME BY ODL Polypropylene i OR 4
o-LORIDA APPROVED SHUTTEftS ARE NEEDED ��j � / � � 13 3/4"O.A.IG NON-IMPACT VENT UNIT BY ODL Polyoropylene 1
WHEN lMPACT PROTECTION:S REQUIRED. �w �
2
7D. 1NTEGRAL MULL POSTS&DOUBLE-BACK JAMSS �S � �� OVERHANG
ARE INTERCHANGEABLE.SEE SHEET 3 FOR (9 Q � LENGTH I I
MULLING INSTRUCTIONS. Z� '� * NOTE. PRODUCT HAS NOT BEEtJ RATED FOR
�`L � � 10 WATER INFILTRATION. 1F AUTHORITY HAVING p�$,�I
8. ALL FASTENERS IN WOOD SHALL j� � JURISDICTION REQUIRES THAT PRODUCT MEETS �le � � � �
SF CO�JNTFRS�JNK�/?6"DFFP L I HIS(�Cl�.VII�CIVICU 1,�Rvv�C i JI�HL�DC VS�v j > Q o
EXAMPLE: 3/16"--� �a � , � �p� � � WNEN INSTALLED AT LOCATlON PROT�CT�fl SY �_ _ �� � �+ N `D
�
i� � OVERHANG SUCH THAT OVERHANG OH RATIO= � I c� � � � o
lNACTIVE ACTIVE � � � � O m ui
FIXED � FIXED > !i W
OH LENGTH= OH HEIGHT IS='I.0 = n --��
� DOUBLEBACK OVERHANG I� �' � � Y �O � �
r�MULL POST JAM9 MUL: �T�Q '� � ¢ p J � � �
SURFACE BOLTS NOT ;' w =I �I Y I
REQUIRED FOR APPLICATlONS �z_0 X 6-8 ELEVATION � \ �• � � F I� � � �
RE�UIRING OP-55 OR LESS
- NON-IMPACT LITE 'i p ° 6% �" �c a �
37 1/2'MAX.O.A. SEE SHT #3 DOUBLE DOOR W/FULL 3-0 SIDELITES(OXXO) �; o
� � FRAME TYP j 75"MAX.FRAME--+ �-75"MAX.FRAME^-� I-�--1'12'I/2"MAX.FRAME---I ff—'!12 1/2"MAX.FRAME---, �'i I I F
1
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Q ACTIVE ACTIVE ACTNE ACTIVE ACTIVE J '� �
� FIXED FIXED �IXED FIXED FIXED FIXED FIXED, �W � F
� 3-0 X 6-8 ELEVATION 8-0 X 6-8(OX) 6-0 X 6-8(XO) 9-0 X 6-8{OXO) 9-0 X S-8(OOX OR XOO)```��1 I I I 1/��� v~i o � �
SINGLE{X)&(0) I�74"N1AX.FRAME---j ��911 1/2"MAX.FRAME�i `���, �S F O '���� � Q �
♦ � � � � � = O o iz
Digitally signed by Hermes F Norera,P.F. }L � � � s-o x s-s cxx� ` � ,� I� � , •' . ' g Z � �
Reason:1 am a p provin g this document o� i / ' � SURFACEBOLTSNOT j / i� � � � ;��� 1F '': O � ` o �
Date:2015.10A3 18:1339-04���� _ ' I �i RE�UIREDFORAPPLICATIONS � j7�i � nTe: 12�2��2�12
� �, �� RE�UIRI�G DP-SS OR LESS I I �' P
sHe�ir�»c �4 r.� ; � i �,e �71C ` � - 7K :�ONE
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S i-3 E E i# D�5�2:�Ti 0� ��.� T P I I I!e
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•2 cLcVAiiC�S rOR 3'�?ANES A\�1-2 SiD�L?ES >- �
3 I OUTSNI:nu 80X MliL.ING D-AiS I � � ��k �� ` D�WING N0.
s I o�.trswt��ve�-;�,!nuo:�o�?zan:n!s=_rnovs�u woo� i i I o f 39�A� EACH T3LV .�E.��B
; i Ci.TSNi�G V�RT.ANJ^02:Z.Sc�iONS.0�ASCNRYJcotic�_e I f' ��X 6-5 � ����` �♦ A008731
' i�AC?iV'c. .ACT:VE � INACi:VE �8 AC-:V= I I FIY� �
6 ,i A�CF:OR_\G D=.TAi!S - & � (OXX OR XXO? =x=_o', :,; I Q s:<-e a= 7
� , n�crc�_��o_-a:�_s i FBPE �R]' A T �3b.29578 - -
' ��OS"MAX.FRAME� �89 i/2"MAX.FRAME--{
89 1/2,�A4:4X.rRAnn� � �q•anpy c�qry���l �
15 1/2"MAX. I 'I S 112"MAX.
--I- O.L.O. FRAME TYP - --� 1_ FRAME T.'o __
� SHT#3
io 2 O ` ` � � \ \ �
r�U' J � � � �
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7 Q =
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FY � � \ /� � \ /� , ',
�
INACTIVE ACTIVE INACTIVE ACTIVE
i FIXED FIXE FIXED
7�MULL POST �DOUBLE BACK
JAMB MULL
SURFACE BOLTS NOT �
REQUIfiED FOR APPLICAT10N5
RE�U!o!NG DP-55 OR lESS
8-4 X 6-8 ELEVATION 7-2 X 6-8 ELEVATiON
DOUBLE DOOr2 W/ 1-2 SIDELITES(OXXO) DOUBLE DOOR W! i-2 SIDELITES(XXO OR OXX) m
al �
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37 1/2"MAX. 6- Y a u'
SEE SHT #3 53"MAX.FRAME I� � 53"MAX.FRAME � ��68 1!2"MAX.FRAME� �O�{ FRAME � �
+ � I
1 �
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4-2 X 6-8 ELEVATION G-2 X 6-8 ELEVATION 5-4 X 6-8 ELEVATION 3-0 X 6-8 ELEVATION ��� ,�n�s F• O ��i � a
DOUBLE(OX) DOUBLE(XO) TRlPLE(OXO) VENT L1TE(X) �� ��' , � �. t � o
o z �
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� � �• � �7��= � ' A�:Uz/zo/zaiz
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I �i�I-{FF2�I�TCy��Jp..(��\��-� ya,W�1•�` S.SA�`
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APPLY DAP ALcX PLUS SILICONE 'Ig 5/8"MAX.D.L.O
6-#8 X 2" OR EQU1V BE7WEEN
PFH SCREW AT JAMBS BEFORE MULLING j
EACH MULLION TYP
1 6"MAX.D.L.O� � ^ �21"MAX.D.L.O p I I �
� �„���� ��, 1
� - - - - f �_ _� � I _ I
A3 � � � �
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B3 B3 63 63 0
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Ip a i.. � � �
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ODL 1"O.A.NON-IMPACT ODL 9"O.A. NON-IMPACT � � � __ �
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?-2 X 6-R SHO:n�n: 3-Q X S-R SHO:n�n! n c v
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1/8"TEMPERED �
GLASS 3/4'OA. ~
INTERIOR �/g"TEMPERED INTERIOR � �
^ SIDE GLASS SIOE �/2•pIRGAP � 0
\'.Z �z INTERIOR �
�� SIDE ��8"TEMPERED LL �
� � � � 1/8'TEMPERED I- j �
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3/8'MIN.GLASS 3/8"MIN.GLASS � 3 N J
BITE BITE � -� Q
1 3/8" i'I/2" W �
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13 N � n
} DETAIL B3 DETAIL B3 `���D�tb�I�.IP.�3.�` � o W z
� ODL NON-IMPACT GLAZING DETAIL ODL SMART FRAME `���Q�/�i�.1 �AfVlgj� � � �
NON-1MPACT GLAZING DET ���I�lOhl• A �� t � o �
BOX SiDELITE MULL A3 1 ` � •;'�` -.; O � � o a
MAX.4 UNITS �
EXAMPLE.OXXO,OXO,OX ; ���.� + A� iz/za/zeiz
{—^7 I I—� 7C - 7C �e:hOi�?E
� � : T T�E F ' LY �vic er:G.LUB8ECKc
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DETA]L A3 � � K�RD� I�$a (v� CHK.BY' S.SAf�C_�
� {S)FASTENER LOCATIONS AT 39�A���EACHgLV���,.�8 �M������
DOUBLE-BACK JANB AITACHMENT �����LF��QQ�� AOD8731
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i"ViIN.� l"MIN. 4 1"MIN. 1"Ml�l. —� 4 ppTIONAL
� Q � � Q • ,
WOOD OUTSWING DPERATING UNIT
Z Z O?TIOfVAL E!�!DURA SIL!#FOB 45S6k
i vz•v!in. i vz°Miv. so�c�n��(% / _
EMB. � ' EMB. � 1 RAIL I%�_�J/
l�
f 1 /. •� / / . � � 1 / /� / � � �� ��.
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-- 1!4" - - ' 'l/4" � - ' 7"MIN. � 'I'.MIN. 4 1 �� ' �, -
MAX. � MAX. 1
SHIM ��$" SHIM 1�$° � Z \�� �
9 1/2"MIN. INTERIOR � �
SEE NOTE#7 SEE NOTE#7 EXTERIOR EMg 4 �
ON SNEET i ON SHEET'I �NTERIOR , � ` �EXTERIOR
#8 X 3"PFH FOR i 4 � �
STRIKE PLATE OUTSWING OPERATfNG UNIT � / // / •
INTERIOR VERTICAL CROSS SECTION 1/4" �
EXTERIOR HEAD JAMB MAX. � 1!2"MIN. 2
SHIM EMBED.
OUTSWING OPERATING UNIT SEE NOTE#7 INTERIOR 1
W/OPTfONAL SURFACE BOL ON SHEET 1 EXTERIOR f I— 1"MIN --�-- i"NI�I --�
VERTICAL CROSS SECTION
HEAD JAMB OUTSWING FIXED OR
OSITSWIlVG FIXED UNIT OPERATING UNIT
2 VERTICAL CROSS SECTION VERTICAL CROSS SECTfON
,� „�„��^�„� ENDURA ZOBL4566
11l2'MIN. ��4��X�� I I HINGE DETAIL.
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