HomeMy WebLinkAbout16-17699 CITY OF ZEPHYRHILL�
� 5335 -8TH STREET
� ; � (813)780-0020 17699
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit�lumber: 17699 Address: 6550 TEAK CT
Perri�it Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Classlof Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book:
Propo�ed Use: NOT APPLICABLE Lot(s): Block: Section:
S u�ire Feet: . Subdivision: DRIFTWOOD
pEst. Value: Parcel Number: 02-26-21-021A-00100-0030
Improv. Cost: 2,247.00 OWNER INFORMATION
Date Issued: 9/01/2016 Name: WALLIN CARL & CAROL
Total Fees: 75.00 Address: 6550 TEAK CT
Amount Paid: 75.00 ZEPHYRHILLS FL 33542-6603
D�ate Paid: 9/01/2016 Phone: 813-395-6170
Work Desc: 4 WINDOWS 1 DOOR INSTALLATION j
�� CONTRACTOR S APPLICATION FEES
HOMEOWNER BUILDING FEE 75.00
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i Ins ections� e uired
FOOTERII 2ND ROUGH PLUMB MIS INSULATION CEILING
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
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1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
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PRE-SLAB SHEATHING MISC. MISC.
CONSTR��ICTION POLE FRAME MISC. MISC.
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local jovernment shall impose a fee of four times the amount of the fee imposed for the initial inspection or
I� 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 b�e found in the public records of this county, and there may be additional permits required from other governmental
u 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
I; before recording your notice of commencement."
Comp ete 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. �
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�,CONTRACTOR 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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813-780-0020 City af Zephyrhills Permit Application,,.:,.�.. ..�.. �- � FeX e�s-7eaoo2�
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` Bu1�a�ng Depart'rrient"�"` - ;
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� ''�G-�L � Phane-Contact'for Pernittt[n' ' . . . �
� L a- 2t�R� �-ft� �. ,; 8����9�=� t� i
Owner's Nar»e � Owner Phone tdumb r . �
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Owner's Adciress �.��7�-' ��� ���� 'Ow�er Phone Number�- �
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Fee Slmple Tltleholder Name � � Owner Phane Number �� � �
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Fee SImpV��tlehold�r Addresa � • " ;
JOB ADDRESS ' LOT# ���
' SUBDIViStO I�����G��C�,�� PARCEL ID# ' i
I � (OBTAINED FR4M PROPERTY TAX NOTICE)
WORIt PRO�OSED , �NEW CONSTR ADD/A�T � SIGM1i [� Q DEMOI.ISH
INSTALI. REPAIR
PROP05ED USE SFR [� COMM ['� aTHER
TYPE OF CO�WSTRUCTION � Q 6LOCK " [� FRAME [� STEEL Q �
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DESCRIPTIdAI OF WORK ��J��/�LGf/IIG � Gf�/Nj}�IGf�JS "'� � ,QQO/Q.. �
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Stlt1.QIFIG'S�ZE �� �` S4 FOD'TAGE C�, .. HEiGHT�.��� �
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8��11.D1iVG � ,,,, ,,,�,,,, , ,
� �,�G�� � VALUATION OF TOTAL CONSTRUCTION ' �
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QE� CTRIGAL $ " AMP SERVICE Q PR{O�RESS ENEFiGY Q W.R.E.C. �
QPL�MBIN{3 � � -_
[�MECHANICAL $ VALUATION UF'MEChfANICAI.tNS'TAL6ATION
Q „ � Q FtOOFfNG Q SPECIAI.TY � OTHER
FINISHED F �OR ELEVATI4NS r�� FI.00D ZONE AREA QYES NO (
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��a�����a ����<u'• G-l/��,'�.,�C� � � c���a�nr' ,��- ;
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SIGNATURE �� REGISTERED Y/ N FEE CURREP ' Y"/N !
Addres L`Icense•#'� �
ELEC7RlCIAN .'C�MPA41X
SIGNATURE I � REGIS7ERED Y/ N FEE CORRE�` 'Y/N
At1dT8s8 " LiCQ11Se# � � � �
��i�MBER COMPANY
SIGNATURE' REGI3TERED Y./,-N� FEE CURRE� ' Y/N.
Address .License# �� � - i �
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�VIECH,AAIICAt.' ` v CQMP_ANY ,
SIGNATURE� " ` � QEG�ISTERED YJ N . _ FEE CURREA= Y/�N �'
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� Address - - � ' + � :' , < � ' . ' License# �. .� - � �
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a�t��rt ,� , � � .. - : t'coM�i�r � - .
SIGNATURE. '-- = '�' - ' " ' REGI$TERED Y/ N;.-. � =FEE CURRE�` Y/N
Addre�s- ' � '. ` - Cicense# 1 � t
RESIDENTIA�t' > �Aitacfi'{2},Ptot�Plan&;.;(2)sets•-cf=B'ulliling�Pians;•(.1}seEofEnercjyFoiins;�R-0=VfFPermitfarnewcons#�uatEan, ' � �
Miniroumeten~(:1:0)yworking*days after„subiiilttal'`d'ate.'Requl�ed onsite;ConstrucUon:Plans;Stormwate�'Plans w/Sllt'Fence installed, i
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� �� Sanitary FacdllU.e.s;&,1,dumpsterkSite_Wa�ic_��Permit fo[:su6divisionsQarge p„roJegts.,_, °:.. ,,. ; � `
COMMERCIAL Attach{3}°complete sets of'Bulldfng Plans plas a I.tfe SaFety Page;{1�s�t of Ectergy Fcrms.R-O-W Pei�iit for new canstruct�on. �
Minimum ten(10)woricing days after submittal date. Required onsite,Constructlan Plana,Stormwater Plans w!Silt Fence installed, ,
� Sanitary Facilities&,1 dumpster.Site Work Pertnit for all new proJects:.All commerctal ret�utrements.must meet complianca " ' '
SIGN PERN4f� Attacfi(2)se�sb`�`Englneer.ed=Plajns.,4.. F;�^=�.- ., �.. ,. _
•"•"PROPERTY SURVEY required,afor ap,iVEW construction.
Dlresttans: . ,
� FIIFout applicadon completely. �
'� Owner&�Contraator stgn back of applicatton,notarized �
if ov�r 52a00,a Nottce e►f Car►�mencament is cequired. {NG upgrade�aver ST500j �
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Agent(fa�the�contractor)ar PoVuer of Atkomey(fa�tFie owner)would be someane with ncatarized letter from owner authorizing same
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DVER THE CQUN'fER PE�MI'fTiNG.-. .._..tFront of Applic�tion flnly}_,.
Reroofs if shinigles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) � ,
Drivswaya-Not avgr COunter tf on public�aadways..needs ROW �
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, , NOTiCE tiF DEED RESTRICTtONS: The tsnderslgned;under�tar�ds°<ttt�#:this.���rmif may be,subject to,"deed"Arestrictions"
which may°tie=more-restftct(v�-tha�Cour�tjr�+egulat(ons: �The�tindersigned�assumes'�espon�itiility for'caimpliance witli`a�y
� �PPlicable deed t�estrlctEons. ..; .. . • �
UN1.tCENSED• CONTI'�ACTORS AND CONTRACTI�R RESPONSIBILITIES�: •If the owner has �hired�a conhactor or
contraGtors to undertake work, they may:be,:r.gqu_tre.d,;to-;be,ltcensed In accordance.wtth state.and�local.regulatlons. °if�the� �
. cont�actar is nof ticen�ed as requined�by iaw, batti the awner and�contiactoT�in�iy be°cited�for�a�misdemeanor violation
under state law. If the owne�or tntended:;contractor;�ace,.uncertaln as ta what Ilcensing.require�nents'mayw�appfy.-for.�the �
intended i+vork, they are acfvlsed to co�itac#tFie�Pasco C�onty Bult�ting'inspeattaii_,Dhiiston--�ILfcensing Sectlon a#72T-847- ;
�� 8oq9. Furthermore� If the awner fias�hl��d`a con#ractor o� contractors. he Is advlsed ta have the contractor(s),;:sign ',
pottions af the "contraotor Block° of thtsMapp!lcation.for_.which they wlll be r.esponslble.. !f you,.as fhe owner°'sfgii'as th� I
contractar� that�may�be an indication tha#�he is nat prope�y licensed and��is nir�t en#iNed ta pemiitting prhriteges in Pasca
County. � '
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TRANSPORFAT'IOM.:tMPAGTIUTIE.1'T'IES CMPAC�'•�ANI}RESQI�RC�REC�VEF�X��E�: ��,t�nd��lgaa��_��td��!�€�s�s.-.- -
�v.� "�iha�"i`�ansportatio�fmpac�Fees ani9.I�eco.urse F2ecove.ry.Fees m'ay�:apply;to�the,constructlorr of new buildings��chan�e��of= "
use in exisltng buildingst o��eacpansitin.of�=sxlsli�i�:��ulldings, as specfffed.in P�sco Cvunty Q�dlnance number 89-p7 and
80-07. as amended..Yy'Fh�undersigned aiso=understands� that:�su�h fees;�:as�may�tie�adt�e;;;wili:sbe iden#ified at fhe�time��of�� �
;� permitting. It Is iurtFie�understood that Tra�sportation Impact Fees and�Resourc�_Reco�ery�Fees,must be pald prlor ta
� receiv�ng a"certi�cate.of occupancy"or�ftna�-�powerxelease: :If�th�.proj�ct:.does.not Involve.a::cett�icate af occupancy.-�or K
flnal power. rel�ase,�the.fees mu�t"be pat�.pcfior to permit issuanc�. F�tthermore;If.Pasco,:Couniy�llVater/Sewer-Impact �
' fees are due,_they,must be-petd..prior to permlt�.lssyance-ln.accordance wltt�_appltcabl�e Pasco�County ordinances. •
CONSTRUCTtON'LiEN`LAW�(Ciiepter 713� FioHtla Statule���a�amendad}: if valuadon af work is$2,500.QQ•or more, I
certify that I, the applicant;_-have•been .proyided wlth-� copy of the�°Florida Construction. Lien L.av�Hameowner's
Protectlon Guide° prepared by,the Floi�da Department of Agr�cuEture and Cansumer;Affialrs. if#he applicant is sameone
o4her than the°awner", I certtfy.�that I h�v�a.ob.tained�at�copy;of.the".a�bove:descrl�ed`dccur�ent°,and:promise�:in,good#aith.ta
deliver it ta;ti�e�`:.owne�"'.piior�to=comri�enceinent.. . , _ • � .
CONTRACTOR'SIOWNER'S AfFIDAVIT: 1.certiiy,,tlaat-ail::#he:tilnfarmatl�dn:l�-#hl�appllcation is accurate �nd that a0 wrork
will'be done in compliance with all.appUcable laws regulating constructlon. zontng and�land�develapment, Applfcation #s
hereby made to obtaln .a.permit :#o do.wark._.and ihstallatlon �s Indt�eted:�� '1� certify that no work�or tnstaitation tias
commenced prtor to Issuance of�a permlt antl#hat�.all work will be performed to meet standards of all laws regulating�
construc#lan, Caunty and C�ty codes� zoning regulatinns, �nd land development r.egatattons`fn the�urisdictlon. 1 a0'so�
cer#ify that I unde�stand'that the regulations of other government agencles may�apply�to_the intended work, and that it is
my cesponsibllity to tdentfy.what.actions!must•take:M be,ln:.co�p!lance S.uch.agencies-include but•are,nat limi#ed to:
- Department of E�vironmentai><Pro#ection'-Cy+press.�Baytiead�, 1Neffand Areas and Environrr�entally Se�sttive i
Lands, WatedWastewater Treatment. I
- Southwest Flar�da Water Management :t�istrie#-Weils; CYPress.`.Bay�eatfs;- Wetland Ateas� Aitering �,
Watercourses. , ��
• Army Corps of EngUeers-Seawails�Qocks,hlavtgable Waterways,
- Department of Health� 8 Relaabili#ative ServicesJErrvironmen#ai hlealth �Unit Welis; Wastewater<Treatment,
Sep#Ia Tanks: � . .
_ - - _ --�9S,�(31►��OC4R18Cif�ll FfOt@C�OtI A�8t1Cyt-ASb@S�OS`8�}S�@!Tt@At. '- - - - . . __ ._
- Fede�al-Avletton.AutMoclty.-Runways.
!understand,that the.to!lauving:arestrlctions appiy to the use of flil:•
- Use offiti Is not aliowed in Flaad.Zone"V"uniess expressly permiftr�d.
- If the•fill material Is to be used::in flood Zone. "A", Ik. is understaod #hat a drainage plan addresstng a �
"compe�sating volume"wiit be subr�it#ed a##ime of permitting wfiich is prepared by a professionat engineer
Bcensed by the Stat�of`Florida: - � �
- If the f�il material-is to be�us�d In Ftood �one "A" ttr connec�ion�vv�#h�a �ermltted-buitdlrtg �s�ng stem walt
� constructton, i certify that fllL:vuJll.be used only.to.flll the area-wlthln the�stefn��wall.
• !f till materia! is to be used in any are�z� 1 �ct�rtity that use of suah fll!�wl11 r�ot adversely affe�t ad}acent
pfoperties. if use af fil) is,found�to advers��y:��'eot adJaeerit`�prc�perties,.ths owner may be cited far viorating
the c�ndltions_of,the bi�llding=.permiteissued under the°attached�ermit�epplication� far.�lots�.less°#han.one (1)
acre wF�1c�t are elevated`=by fltl;an ertglneered drainage plan is required. �
If I am ttre.AGENT.FOR.THE OWNER;I;promise In good,falth to InformFthe o.wner.of°the permttttng conditlons set farth in
thls affidavtt�prlor to camrife�ctrig construction. 1 understand that,a�sepa�ate�permlt may be required for electrlcal work,
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piumbing,_signs, wetts,.,p.00fs,. alr conditioning,..gas,• or. otMer instell�ttons nol.spec�fcalfy inclu�led-in.the�applicatian. �A
permft Issued shall be conetrued to`be�a'Itcense�to=prciceed with'`ttie work.and;;not�as.-authority�:to,violate,Ncancel� alter. or
set aside.aiiiy provisions of tfie:technical c;od��;•nar sha8lssue�tce�of a.pecmtt.pr.�vent the Bulldlrig fl#i�cial from thereaf�er
requi�l�g a corregtion af er�ors,.in:plans;canstiuction or.violations of�any cades.::Every'p'ermit�issued=sliail�became invalld
uriless the v+rork authorized.by suah permit:�is-commenced�withln�i�c.mor:nths of perml# lssua�nce, or If wark autho�ized by
4he permit.is suspended or,..abacadoned�for�a=pertad of�six���)montFis,:afte`r..the:time the�wowk ts commen�ed. An extension
er►ayrbe requested, In wrtting,,from.'ttie Building,Offlclal for a period«not:.ta.exceed`=nlnety°(90j�day� a�d w1!!'demonstrate
�us#�iable'cause far.�the extensior�. If work.ceas+�s.for ntnetyr.(90}cons.ecutive:days,..the job;is.cansfdered aba�doned.
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9NARMING'TQ QINNER; Yt�Ui�.�A11,.1JRE�Tty►.�:R��Ca�tD.Aa�lal0'�IGE��:C1F.=CflMME�10EMENT:IM�AY-RESi�LT IN-YOUR
PAYING TWiCE;�OR;IMPRQVEMEN;TS�T;O�Y�C1Uf�..Pl�OPERTY:°�IF�.YO.EIrI�'�EM�ID��TCI��OBT'4►1N�'FIPtAf��fNG;'C.ONSULT �
VYIT ' ' . D �fJ. A C? O. �, O �? C� O �G �E � I
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F{.ORtDA JURA'3:(F:S:117:03}.. . . _-. . -_ �,, : : _ -`•..
�WN�R�ORAi4ENT. - � CONI'RAGt'QR��C�i�%u'�'�•G�i/G���� . .
Sub"salbed and swom ba{or af�rmedy b�ore m�tttts 9ub bed arad'swa ta c rm befiri� e` ���,'+
by R�2—1 dr•by.���. .�...•�t���✓y .
YYho is/are personaUy kt►ovsm.M.me_or:has/have.praduced Who. re�p.e onallyacnowr!• .me= rhas/have.produced.
,I . • __ - as td`endBcaN4�:" . _ �. �itZ�•ts�tr�� as[denUflca#�on. �
II -
� Nolery Publia . � � � Notary Publlc ,
i Commtsslon No: Coint� s Plo. '
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I�Pame al Notary typed,Pr�r�ted ar stamped Name of Nota . ;�CJn ES
. , , :•� :.= ammission#FF 150422
_`�' �'a: Expires December 12,2018
� + � '�'`'pnt;;�Q`'``�, 8ondeE7tauTroyFeinlnsuranoe800395-1018
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DISCLOSIIRE STATEMENT FOR OWNER �
CITY OF ZSPHYRHILL3 BIIILDZN� DFPARTMFSRZ'P ;
I, ��'�� ,C/� (/V!'fG�-��" have read and fuZly v,aderstaad and I
ag�e� �o the,_provisions of this instrumeat. 1 �
The undersigaed atates and affirms that he or she is desiraus of ccastructiag, I
re�ovatiag, addiag ta or reroofiag his or h�x ow,n ciomicile, that he or she ,
ac�ualZy occupies, or will aacupy bg said damicile, aa� same is not for '
reat, lease or "sale. That he or she shall comply wit]� the following couditioas: �
�
I. Tha� the owaer aad he or she alone �hall aat as the builder for alI phases af
constructioa. ,
2. �hat the awner will comply with �11 prcvisioas af the City of Zephyrhills '
ordiaances aad cades pertiaent �o the buildiag. '
3. That in the eveat variaus phasea of aonstzuc�3on are svbcoatracted, he w3ll
engage oaly praperly Siceased subcot�,traators aad will personally sup�rvi�e
' � such work. �
4. That in the eveat the Sui2ding Snspector sha12 require corsections �o be made, � �
the owaer will �assume �ull respoasibility to insure they are made, and upon ;
completian wi13 call faz a reiaspection before praceediag with �he buildiag, ;
5. That the owaer shall assume full responaibility far the conatructioa and will
not expect supervisioa of his work £rom �he City of Zephyrhills Building i
D�partmeat. ;
6. ', Tha� priar ta fiaal iaspectioa aay addit3.ona1 fees, iacludiag reinspectiaa
�' €ees, must be paid in �ull. A writtea reques� fram this otfiee sha21 i
� - � coastitut�e an offa.cial aotice ta pay add3.tional feea. !
7. Tha� the owaer sha11 comply with all City, State and F�deral laws in xegard to �
sacial security, workman's comp�nsation, 3ien laws, etc. , where applicable.
8. That the owaex shall camply with all the safety cades atssued by the Florida
, Iadustrial Commission.
9. State law requires construction to b� doae by liceased contractars. You ha.ve
, applied for a permit uader aa e�cempta,oa to that law. The,exemptioa allows
you, as the owuer of your property, �o act as your os,ra coatractaz with certaia
restrictioas even though yau do aot have a lic�nse. Yau muet provide direct
onsitie supervisioa af the aonstruct3.on yaurself. You may build or imprave a
one-�amily os two-family residence or a farm autbuildiag. You may also build
or a.mprov� a commercial buildiag, pravided your costs do not exaeed $75,000. '
The buildiag or resideace must be fox, you= owa use or accupancy. It may aot �
be built or substa�ntially improved far sale or lease. Zf yau sell or leaee a
build�.ag you have bui2� or substaatially impsoved yours�lf t,rithix�, 1 year afte= ;
the conatructioa ie complete, the lata will preaume that you built or �
substaatially impxaved if for sale or lease, which is a violatiaa of this
exemptioa. Yau may no� hire an unliceased peraoa to act as your coa�ractar or
�to superv3se people workiag oa your buildiag. It is your respoasibility �o
m�ke sure tha� people employed by �rou have licenses rec;w.ired by state Iaw aad
by cavaty or municipal liceasiag ordiaanc�s. Xou may aat delega�e the
x�spansibility for supervisiag work to a licensed contraetor who is aot
Iiaex�,sed �o perform the work beiag daae. Any persoa workiag on your building
who is aat liceused muet work under gour direct supervision and must be
I emplayed by you, which meaas that you mus� deduct F.I.C.A. �nd withhol.ding ta�c
, �and provide warkers' campensation for tha�G employee, a17. as presaribed by law. I
Your aoastruc�ion must comply with all applicabZe laws, ordiaaaees, buildi�ng
,�codes, and zoaing regulatioas.
OWNER'S SIGNAfiURE L�'i%L[' - L{/�-aiG�f� DATE ��c� "'l`� }
i�,nnxz�ss �'SO 7'ERK �T,. - �l�/�t'S. �c. �3SY� !
�xorr�
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;=xxsss ���� .#
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Product Manufacturer Custom Window Systems Inc. ,
` Address/PhoneJEmail 190d SW 44th Avenue {
� Oca1a, FL 34474 ; - �
� i° � {352)368-6922 Ext 255 ; _ �
� � sbrooks@cws.cc � �!
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Authorized Signature Stephen Brooks a
ti sBrooks@cws.cc '
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� � Technical Representative Erin Koss pf���ORJ{�n� �, �'� ��
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�� AddressJPhonejEmail 190U SW 44th Ave. F�Oj,�� ���VG 'qLC C � i
� �, (52j 36836922 Ext 2�r�ri��°�scri��,°,��s°�'pcyv�,rH; j ;
� ekoss cws.cc �Q+�' ��'E�: C'CpC? � j
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Quaiity Assurance Representative Jay Lathrop �1�{/,� � �
� i AddressjPhoneJEmail 1900 SW 44th Ave. ��.� '�
; � Ocala, FL 34474 �
r {352)368-6922 Ext291 �
� jtathrop@cws.cc ��V,�
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Category Windows �j��` r Q���T�' � ._
Subcategary Single Hung '°"�►Y�' A����}f���,6��
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Cornpliance Method Evatuation Report from a Florida Registered Arc����%�Licensed Flonda
I Professiona!Engineer � , � �
f Evaluation Report-Hardcapy Received � �
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Florida Engineer or Architect Name who developed the Lucas A.Turner
i Evaluation Report �
Fiorida Ucense PE-582Q1 �I
Quatity Assurance Entity Keystone Certiflcations,Inc. �
Quality Assurance Contract Expiration Date 02/23j2025
Vaifidated By Steven M.Urich, PE '-
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� Validation Checkiist- Nardcopy Received =
Certificate of Independence FLi63 R6 COI EvalRen CWS-4b6D{SH-350Q)adf
� Referenced S#andard and Year(of Standard) Standard Year
�i ANSI/AAMAJIOIJIS2JA440-05 2Q05
ASTM E 1300-04 2004
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Equivalence of Product Standards �
Certified 8y
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Code Versian 2�24 '
� Applic8tion Status Approved � �
*Approved by DBPR.Approvais by OBPR shall be revtewed and ratified by
� the pOC and/or the Commis5ion If qeCessary. j
Camments ���j��A� �
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Produtt Manufacturcr PGT Indus�trtes ��'1� ������� �i��� �
AddressJPhaneJEmatl 1070 Technolagy Dr{ve -�
Nakflmis,F�3d275
(�ai)ase-oroo Ext22318 .
druark@pgtindustries.com ,
Au#ho�lzed Sfgnature lens Rpsowski I
,}rosowskt@pgtindustries.com '
� Technical Representative .Iens Rosowsk! �
Address/Phane(EmaU it}70 Technaiagy Drive �
Nokomis,Ft_34275 � .
{941}486-OSUO Ext2114U �
jrosowski@pgtindustries.com I �
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Qoality ASSvrance Representative
Address/phonelEmall i ,
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CategorY Exiarior DaorS �
Subtategory Sw(nging Exterior Daor Assembties �
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� Campli8nce Method Cert(Eication h5arlc ar Usting � I
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CerUficatton Agency Keystone CecYlfications,inc.
Va4idaked 8y Sfeven M.U�Ch,PE ;
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� VaiidaCion Checkii5t-Hardcopy ReCeived
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Referenced St$ndard and Year{oF Standard} Standard y�z !i
AAMA ASq 2U10 � !i
AAMAJWDMRJCSA 201Ji.5.2/A��U 2dd$ � i
, ASTM E-18$6 2005 �'
ASTM 8-1996 2009 '� ;.(�
ASTM E-1946 . 2Q32 � �
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Equtvalence af Praduct Standards �
Certi€!ed 8y �
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Product Approval Methad A72thad 1 Option A '
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DateSubmitted 06!l112pf5 � " �{
Date Valldated O6)15/z015 ;��!
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Date Pending FB,C Appraval
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City of Zephyrhills i
BUILDING PLAN REVIEW CONIMENTS �
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ContractorlHomeowner: G!/�l <`� �
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•Date Received: " Z��
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� Permit Type: � ����?Gl ol�l / �f— /'�` Q��-�'1� ,
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Appro�i d w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑ �
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This comment sheet s 11 be kept with the permit and/or plans. �
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Kalvin�Switzer P Examiner Date Contractor and/or Homeowner
(Required when comments are present) �
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