HomeMy WebLinkAbout17-18500 CITY OF ZEPHYRHILLS
5335-8TN STREET
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'` BUILDING PERMIT
- PERMIT INFORMATION " �� LOCATION INFORMATION
Permit Number: 18500 Address. 37545 GIL�.AVE �OT282
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Ciass of Work: 434-ADDlALT RESIDENTlAL� Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Btock: Section:
Square Feet: Subdrvision: GRAND HORIZONS
Es#.Value: Parcel Number: 34-25-21-0'170-00000-2820
Imprav. Cost: 10,600.00 OWNER INFORMATION
Date Issued: 6116/2017 Name: C4RBITT ROGER D & MEC.ISSA
Total Fees: 187.50 Address: 9778 SW 99TH AVE
Amoun# Paid: 187.50 OCALA F� 34481-6554
Date Paid: 6/16/2Q17 Phone: 703-300-0331
Wark Desc: INSTALL CQNCRETE, SHED, CARPORT & G�ASS ROC�M $16 SQ FT
CONTRACTOR S APPLICATION FEES
ALL FLORIDA MANUFACTURED HOME S BUILDING FEE 127.50
LIL�EY A1R CONDITIONING 1NC ELECTRICAl. FEE 60.00
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Ins ections Re uired `
F QTER 2 ROU H PLU MISC INS LATlO CEIU
FOOTER BQND DUCTS 1NSULATED SEWER R1i1SC.
RQUGH EL.ECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER lNSULATlON WALL MlSC.
DUCTS IRlSTALLED WATEFt N1ISG DRNEWAY
PRE-SLAB SHEATHING MISC. � MISC.
CONSTRUGTION POLE FRAME MlSC. IUi1SC.
REINSPECTION FEES: (c)With respect ta Reinspection fees will comply with Flarida 5tatute 553.80 (2)(c)the
local government sha11 impose a fee of four times the arnount of the fee imposed for the initial inspection or
first reinspecfiion,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe additiona! restrictions applicable to this property that
may be found in the public recards af fihis county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
"V1►arn�ng fio owner: Your failure to r,ecord a notice of commencement may result in your paying twice far
impravements ta your property. If you intend to abtain financing,consult with your lender or an attorney
befare recarding yaur notice of comrrtencement."
Complete Plans,Specifications Must Accompany Application.All work shall be pertormed in accordance with
Ci Codes and Qrclinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
,
CON TOR SIGNATURE PERMIT OFFI R
ERMiT EXPIRES IN 6 MONTHS WITHOUT APPRf.�VED IN5PECTION
' CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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Czty af Zephyrhills
BLTILDINGr PLAN REVI�W Ct�MMENTS
CantractorlHomeowner: 1��
Date Received: �'�"'� �
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Site: � �J t
Permit Type: �5�� � �� �f�"
Approved w/no comments:❑ Approved wtthe below conunents: � Denied w/the below comments: O
J�� �lr�'`�-�'`�� �l�� 7'����ir t_1�
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'This camrnent sheet shall be ept with the pernut and/or plans. {
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Kalvin �itzer— s Examiner Date Ciantractor dlor Homeowner
(Require when comments are pxesent) ;
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813-780-4Q20 City of Zephyrhiits Pe�mit Application Fax 813-780-0021
Building Depaetrn�nt
Date�tecetved ���"� -° phone•ContaatforrPermtftln� � S"i -
Owner`s Name �`(' t T - ` � /Own�r Phone Number � , � ,
Owner's Address "1� � ��"�' '""�'f`ti..`'b � . �Ow�er Phone Nutnber. .+ ��'�
Fee Sim�9e Tltleholder Alame �— � �� Owmer Phone Number -"�_����
- 3� - � . -
Fee 3fmpls Titlehalder�ddress �
JOB�DDFYESS � 1 � � y,\ �V�-Q_ Z �'lr \L S Lf3T# �_1��
$UBBiVIS10W ,�[ "��� ��1'L�� PARCE4ID# ' � 0�5~ �� "���� a��� � ,, �
., , -(QBTAlNEDFRQAl:PRQPERTY.TNCNOTSCE) -
�� WORKPROPOSED �=.;NEWCONSTR, ADDlAtT `�` S1GN`�" 'Q• �' 'Q` DEMOL`ISH
� e.� .liVSTAi.L � : ,, F2EPAIR �� -
PRBPOSEDEUSE � C] SFR. C] ''COMM " � �]' OTHER " " � - ' '
7YPE QF CONlSTFtUGi'!ON [�� . .BLOCiC •• 'Q. � FRAME �� STEEC �Q �
. • � -
DESCRII'7'IOPI OF WORa' ' Y1 C(�1� (F�'i' (��'1
BUILQlNGSfZE �� V� ��SQ FOOTAGE"('�� � HEIGHT!�r 1 � �
,��,J:
�BUILDING � ����y�, VALUATION'OF�tOTALCONSTRUCTION , -
�ELECTRICAL. • r$'���'O�� AMP SEFtVIGE 'Q :PRt}Gf2ESS�M1IERGY Q " W:R:E.C.
�._.._ U d -.�
QPLUMSihiG ��= ����i 5'� ' Y
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QMECHANtCAL $ ' ° ' VACUATION pF`MECHANICAL INSTALLATlON. � �
OCuq5 [� ROC?FiNG .Q SPECI�4LTY [�_ _ OTHER� , _
FINISHED FLOOR ELEVATIONS � � FLOOD Zt�NE AREA QYES _NO
BUILD�R COMP�fY^ -� �'C" -
SIGNATURE REGISTEREQ Y! N ��cuRt�n - ' Y/N'
Addre�s � �^-� ��Q.. - - : - �License#:! �G-L..�,��5,�.,��
ELECTRICIAAi�l: � .. . ; :,�COiWPANY�' . t � - ' - .
SIGNATURE '�' REGISTEREd Y! N PEE:CURREA'." Y/N' '
--- -�tic�P�ss —-- �Rr- � -..- -- - .... -- _�,.�...-'�__----.,-----,-- -_ - - - -- -- �i p-. - - --
. _ , _.Ucense#��� r�� �a�'b��
PLUifA�ER" _ , . ... � '. C.OA�F�P�VY _ .�_ - . .. . _ . . - �
SIGRIATURE � �-.. - . . ; �REGl3TEREQ Y(-N.> . rFEE�CtJRREt� � �." Y I N `-
Address , � � - . „Liaense,# C �
WiECHAAtiCAL' � ` � . COPAPfaWY . ,
�IGNR'fURE � .. � � . . ��c�sz� Y,! N ;. �CUR�n. Y i�iV� , � ,
Addre�§ � � ' - � , ' � . , ,` _ � . . ` License# r " � ,
OTHEF2 _� . . � . . .. , ,''tCONiPAfVX .,, , .
SIGNATUi3E' `:: -' .. �- ` _� .. . ' „ . :' �REGlSTBRED'' ` " Y!`N, ��E CtiR�Eh Y i N . � .
�ddre$s ,: , .. . � , _ _ .. � -. Ucense#�1"` - . . �- . .
}.. . .. .i. .. , .�y..,�`��.: _• ;} , . �. .. -:»., . .<F� " " .
ESIDEPtT(1,4i;..,;�.,�Attach'(2};PiofPians;;(2)`sefs:.of$Bullding,Pians,�(1)�'sefof�EnergyfFomts;�R-O-1NPermitforaew.construction, � `
5 ;�. Minimum�ten�(1.0),worlcing;"day,s;.after,�sutiiiinittal'date`+Requtreil onsife;:Constiitck(on�Plans,$tormwater'Pians w!Slkt Fence instaited,
"' Sanitary F�c(lities&z1:;dumpster;;Site Work�Permit,for subdiyislonsllarge pmje,cts.:..;�?,;; -� ° '� - � " ' "� - �
OMMERCtAL Attach(3)•comptete sets�of Buildirig Plans plus a�Ctfe Safety Page;�(1)set of Energy Foims.R O-W Permit for new:constnactiorr.= ' ` `
Minimum ten(10)working days'after submltkal date. Required onsite,Constructlon Plans,Stormwa2er Plans wl Silt Fence tnstalted,
Sanitary Faciflt(es&1 dumpster.-Site Work Pertnit_far all pewtproJects.All cammercla!requlrements must meet campi}ance-'
otGW-P1ER�II6'� Attactt={2}sets-of-Engineer.ed�Flans:._:,�°,:=��„,- .. � : � -- - = ' _ _ .
«•••PROPERTY SURVEY reguired for all NEW constructian:., ���` ----_- -- ---- -, _-. _ �-
ireations: � .-, . - � _ ,
FIII out applica8on completely.
Owner&Contractor sign back of app!(cation,notarized
!f over;62500,a Notic�of Commeraaerreen#fs requlred. (AfC opgrade�ov�r$7500) -
.�. - • _
Agent(foc the contraotor)or Pbwer of Attam`ey`(for ttie�owne�}woutd be someane�vith notarized letter from owner authorizing same
r .
VER THE COUPITER�PEttMIT114YG- •••--�(Front of-AppllcaUan-Onlyj;, � ' .
eroafs if shingles Sewers Service Upgrades A!C Fences(PlotlSurveyJFootage)
DNvewa Not oyer Co .. � � -,, --- .� �, .
ys- __unter if on,publfo roadways.:needs ROW" � . . . , j+. '_ . ,.
� ,.. ,`..,, Y '.. ._ , . ; , � �- r.x� ..,= .r r. .,._ w. , .. - . ... �. _
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M�TtCE OF-DE�D RiESTE2GCT80MS:, The undersign�d�under�t�nds:t��#�this;p�rmif�.may:be,lsubJect,to"deed"restrictlons°;�` ` "" _`_
:,.., ._,..�:. . .:•,�-.,. < . _ :., .. . _. �.-_.. ..; .. �...,.,:,,<_....-„<;.- - . _. „ ,o_
.,. .,.�..,:>.r.:.
-�- _. 4�. �..... :.:z..�.„.,,, ,,:. ,,_., ;.;.s ,,., ...:�:. ... .... . . ..
which may�;be:more`,restFlctive>th��=County}�reg�ilatlonss�'"7Fie�undersigned��ssumes�.re�pon��titllty='fo��compli�nce'tn►itFi=any""" '�
appllcabie:�deed:rest�ict(ons. .:-,.,..::�;3,;��:�.;` s..;�,. ,., . ° , ., .:_::. � ., .
�............ . ... ..
lUCd�.eCENSEDJ'CONTRI4CTOR� �AND CONTRA►CT�� �E�PON�IBILITIES:�+���If=tlie�-owner:has��`hir'�d�ya'''contractor or
eontractors to-.undertake:work,;they.may�,be;�requtred:_to::be,licensed.'In-.accordance.with�state,and;locail:regulations:����if=the•� =' �=�r
contractor is=not Ncensed �s�-required;tiy law; both�the owner and��contractor=�rriay�be��cited�for�a"misdemeanor violation
undar state lau�r.. If the own�r or Intendedreontr,a�torv�ar�;,uroc��taln �s to what�llcensing.requirements;mayrapply��for�:tfier�.<<�•� -�=��`_
in�ended'vvorli, they�are_advt§ed to'contact.tlie�_Pasco rCounty,�uildtng�In�p;ection�LDIvislon-Licensing Section at 727-847-
8009. Furtfiermore, fP�the owner'has`htred �a�aonl�aato�'or contra,ctors� he Is advlsed to have'the contractot(s) sign., ,,, _
portions.of the "contractor Block" of.:,thisriapplication�_for�whichrthey_v�eill:.be..responsibieM1,.,,.lf.jyou;_as athe,oviine�"sign�as`tfie'�`"�" "'
cont�ac#or, tliat.�rnay be an Indication tHat`iie"is`nof.prope�ly'lic�ns�d�anil"Es�riot"entiti�d to permitting.privileges In Pasco .
County. - _ ._ . .. , _ � .. . ._ ._ _.. . ..� : _
�'Rd�fd�PARTATION.:I1dIP,ACT/UTs�ITIES�IR�II�AC'1'-A�b��E�OURCE R�ICOVI�RYlFEE�:��The�und�r�(gned"understands
that Transportation`lmpact'Fees and.Reco.urse'Recobery:F�es m�y�,applya to�tF�e constructfon,of new�buildtngs���change•of"F'�� ��� �s'� _
use In existing buildings, or-:expar�sion:•of�existin;g;builtltngs, �s specifled.in Pasco County Ordinanc� numb�r 89-07 and `
90-07� as amended;.:.,The. und,ei�stgned aisocurtderstands, ttiat��such fees;�as�may;�e�:due;�;wlll:}tie IdenQif(ed at the��tiine°�of�=�`�-•����' �'`
permitting. It is furtFier understood that Tra�sp�ortation Impact Fees and'�Resourae�Reco�ery��Fees:must be paid pr(or to
receiving=a.°cerfl�cate�of�occupancy"�or�flnal�power.release: :If`the.project:;does;,not Involve�a%certificaCe of occupancy�o"r-�°�-� `�- �
flnal powerrelease;��,the-.fees�mii�t 6e paid'�;prlor to.;,permit iss�an'ce. Furth�rmore;-if Pasco:County;'Water/�ewe[p:lmpact� �- �H���r�.�
fees are.due;..they�must-:be::paldApN�c.to;,permit:,lssuance=�n.accordance:.viiith'�app116able-Pasco'County�o�ilinances. -
CORl�TRUCTION'L'Il�6�'I.AW(Cli'�ptee 713�.FlorJd�S�t�te�t������r��n��d): If valuation�f work is�2,500.00.,or more,:I� - ., _
certi€y that I;••the.�:applicant;�=hav.e-:been:provided:�with--a� copy��of�:the�'"Florida°�Constnaction���Lien`Law—Homeowner's
Protection Gutde" prepared by,�tlie Floi�ida Departmenf of Agricultur� and_Consum�r,Affairs. !f the applicant ls,someone; ,. >F �= •:>
other than the"owner", I.certify�;that:l�h�ve,.optained�a copy;of.the`4above::desc.ribed,�docuiiaent-and.promise��in;good';faith..to . .. .
deliver it=to�.the;�'owne�"::p�ioc�to�commencement:'-:''. . � �' . . . , ' � . ; ' •
CON4RACTOR°SIOMINER'�AF�IDAVIT: I.ce�tffy<;th:at,:all�.the�.�lnf.ormation�;in'�this �pplication is accur�te and that�II work
will�be done.in compltance wlth ail.appltcable{laws regulating constructlon, zoning antl��landydevelopment. Appltcation,is
hereby made,�to obtatn-.a.per,mit��to��do;,;:work;,�and;ihst�llatlon as indt�afed:���-�:I certini that no work���or Instaliatton tias'
commenced p�to'r to Issuance of a�p�rmit"and that:all�i�ork wlll be pertorm�d�to meet_standards-of�all laws regulating�
construction, County and City codes� zoning r�gulations, and land development regulatlons�tn the;jurlsdtctton.= h=al'so•
cerQlfy that ( und�rstand 4hat the regulatlons af other�gov�rnment agencies may•apply;to the intended.�ork, and that it(s
my responsibility to identlfy•what.actions I must•take:to,be�ln,;compifar�ce,Y;S.uch;agencles Include=but�are.not Itmited to:
- Department of Er�vironmental�'Protectton-Cyp�ess. 8ayfi'ead�; 1l�etland Areas and Environmenta�lly Senslttve
Lands,IMatedWastewater Treatment.
,.•
- Southwest FIo�Pda Wa�ter Managemenk>:District-Wells;`�Cypres.s.� B�yheads; Wetland Area§, Altering
Watercourses. ,,.;,. � - � �
- Army Corps of�ngineers-Seawalls,�Docks, Navigable Wat�nnrabs.
- Department. of;Health:::�.:�Rehabllltative�,:Seniices/Environment�il{,Health Unit-�Ueil.s; Wastewa�ter=Treatment,
Septla Tanks:. � " � • , � .
- US Envlronmental Protectlon Agency-Astiestos abatem�nt: � �
Federal Avlatton:Authority=Runuvays: " . '
I understand.that:the;followtng;�estrlctions apply'to the us�of�IIL•• , ` , � �, , , , __ � „
- Use.ogfili ls-nofallowed in;Flood�Zone"V"unless�xpressly permittsd. �- �
- -If-the`-:fiil r�aterlal�is'to���be:-used:"In.:Flood�Zone. "A", It. is understood'�that a drainage plan addressing a
°compensating volume"will be subm(.lted at�ime of;petmltting which Is prepared by a�professional engineer � �
Iicensed�6y the,�State=of�Florida.. ����� + ���' . �
- If ihe flll mater(al�.ls=to°be;used tn Flood Zone 'A° in�connec�ion•bilth�a�permitted building using�stein wall
� . construction, I�certify.that-fill:wall.be;used only.to.fili the area.withln the�stem�wall:
- �' 'if flll�mate�lal`�is'to be�used In any e�ea; l��c�rtlfy th�t .us�. of,�such fill wlll.not adversely affect adjacent
properties:__If.use;of f10:is,found-.to adversely..�ffect�ad)acent,`properties,.the owner may_be cited for violating,
the condifion's::ofmthe.bi�llding�':permlt�.issue`d,under tlie'attached_:permit �ppllcation;-for:lots�less 4han:one (1)
acre wHfcfi-a"r8=elevatetlzby fill,�n,engin�ered dralnage�plan is required. • •
If I am the AGENT FOR�THE�OYYt�ER; I;promise�In�good_f.alth to inform:the:owner of��tfie permitting cot�dit(ons set.forth tn
this affidavtt'prtor to commencing conshvction. 'I und�rstand that=a3separate�permlt may be required for electrical�work� .. .
plumbing,-signs,..w�lls�..pools;.,aic:condttioning,...gas�.,.,or�oth�c Installa'tlons not.spec�ically included�tn.the�application. •A-.
p�rr�it lssued shall be�construed to'b'e~a`license�to�proce�d with tNe,wo�k and�not-as:�authoHqc�to.violate';"cancel; alter, or
set aslde�ny provisions of the.technical�c�odes;,nor shall Issuanc��of a.permit.pcevent the Bulldlrig Official from thereafter
re�uiring a conection af.enors�in;plans;�constivction.,or vlolattons of•any�codes:-`Everypiermlt=ls"sued�sfia�ll-tiecome�invalid
unless the work authorized.by such.permit:�is.commenced•within,,st�..m.onths of�permit issuance, or t�work authorfzed by
th�perm(t ds suspended�or.abandoned-for�a�;period,yof�six;f8)�montFis;-:after,,the time the�wo�k�ts co►v�menced. An extension
may be requested�:tn:writ(ng;;�f�om tFie�'Building,Offlci�il�for a p�riod`not-.to�exceed=ninet`y(90) d"ays and�•�iiill demonstrate
justifi�ble'cause for�the�xtension: If work�ceases.for ninety.{90)cons.ecutive�days�..th�Job�is.considered aba�doned.
NNARNIP�C TO �VH�IVER: YOU9�:.�AILWRE;,T�.�REC,O�tD.An(�OTICE::OF.��CONIMENC�IVIENT,MAV�REStJL:T 1N�Y0UR
P�4YI�IG TWICE;F,OR-,IMPRO.VEMIENTS-TOhXzOUE�=PQtOPER'�'X:�:�IF�YO.U:tIN'FENID,�Y��`��TAIN�!FIRtAI��TNG;'CONSULY
WtT U D �O AM TTO N �B FORE�,�ECOR� G:� OU � � � E EIIN T' '
FLORIDA JURA�'�(F.S:1.17.03 , ' , . • . - _ ' - .
OIMNER O�AOENT �.: �.. COIdTIdd�GTO <� �
Su s bed and swom or afflrtned)before me this S�ibs rlb �and'swo (or aflirtned)�before me tfii�.
a �� b es �a . ,, . - -
�VNho Islare pers II kno .me or;has/hav ,produced . Who.ls/�re;p onallyknown• me or has/ha •produced •
` as Id`entlBcatlon. ' � es IdendficaUon.
� Motary Publlc . � Notary Publlc
Commisslon No.� \ \ 0��71.�Q� Comml�sion. o. t`� o���u�S .
Name of Notary , or stamp�dENE Name of Motary typed,printed or stamped
.s:•
��' � MY COMMISSION#FF 2'13095 _ L JENE BIA�K
�': • - EXpIRES:October 20 2019 ;�*'eva,'�;, 43085
�;�'�� publieUnderv+ritars ?�' :� MY COMMISSION @ FF 2 2019
.;� F:�' BondedThm No�3n =•-�a, �pIRES:Octobar 20, �
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^ �;•' BondedThruNotazYPubGcU�enm �
' "'�Rf�
Data Current as Of: � Weekly Archive-Saturday,April 29, 2017
Parcei ID � 34-25-21-0170-00040-2820 (Card: 041 of 001}
Classification -00 -Vacant Residential
Maiting Address . ._. Praperty Value
CORBIIT ROGER D & MELISSA A Ag Land $0
9778 SW 99TN AVE Land _ $26,409 �
OCALA FL 344$1-6554 Building $0
Physical Address Extra Features $0
37545 GILL AVE
ZEPHYRNILLS F� 33541-7795 7ust Vatue $25,409
Le�al Descriqtion (First 4 Lines) Assessed (Non-School Amendment 1) $26,409
� See Plat for this Subdivisian
GRAND HORIZONS - PHASE THREE Taxable Value $26,409
PB 53 PG 120
LOT 282 -
OFt 9491 PG 3528
7urisdiction
City af Zephyrhi I ls
M,and Detail (Card: 001 of 001)
e_,.__.____._____
_�ine ------_�Use_.___._=�Description ,Zoning .---�Units . __ TyPe _ __.�F►rice--------- Conditian ,Vatue --
1 � `0200 �MBL HM SUB;��OOM1 �6,000.00 i SF j $4.40 ?� 1 AO __; $26,400
------2-----G� 02Q0 ;M LB HM SUB� � QQMl i 17.00 _#_.--. SF.._.___i �0.55 -----1.00 ; �.-$9 --
Additional Land Information
.._____._---___....,.__.___.�_____-Y--__.___..�.�_..__.__.._.. �_ _�____�_._---.___.�.._______�..--------
I Acres ' 0.14 � Tax Area � 30ZH # FEMA Cade� . _ --- �! Residential CocEe � GDHZ�P1
Building Information - Use 00 -Unimproved (Card: 001 of 001)
Unimgroved Parcei 00 -Unimproved
Eactra Features (Card: 001 of OQ1)
_._.__�.�.._.-----.._v..____.______._____.f__._.__._____.___._____._..____._._ _ __.�._,__--_.__�__._____..A--....__.-_--_._..----____;�__._.�-------.._.._. _._._.
Line Description Year Units Value
��..-----.--.._.�_.__.____v_____—______._�.__._..�.__.._.____. __�____..----.____.__.________.----�.�_._.___._.____.__�__...__._.___
No Extra Features
Sales History -See All 5 sales
Previaus awner: HEIDMAN BRIAN W
__.._____,.__.__.._.�.---__._._�...____.__.�___�,_..`_.__.._.__._.--- ..�.._,__....,..--------_,_.___.____________. __.__.�._�_._--_-�.__..._�--__.
Month/Year Book/Page ,Type DOR Code Condition Amount
_____....�_ _____ __.�__ �_________.____.___�.�.____.___.�__:.._._�__.._._--_--,;_�__---^_.____.___.___ _._.
I 02j2017 � 9491 1 3528 � Warranty Deed � 01 i Vacant ; $30 000
_,._.___. _ , -. _.__�.__.___________...,.._,_�.________.�__.._____._.._
..�_._.________ .__._�_,._..�.._.._ _�_.._ __.._______.—_._
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Apri126,2017
Re.: Attachment Beam(Host Beam�Verification:
Serial Number: #00984
37545 Gill Ave Zephyrhills
To whom it may concern;
The above listed Jacobsen manufactured home has been constructed with a structural attachment
bearn,ar"host beam".The host beam design and the home plans are both approved in accordance with
the requirements of the F deral Manu�'actured Home Construction and Safetv Standards commonly
referred to as the "HUD Code". The design af this host beam allows an attachment �typically sheds,
carports, screens rooms, etc...) to be made directly to the 9ncluded structural member in lieu of the
typicaliy required "fourth wali construction". Please refer to the seriaiized floor plan ta verify the
location of the host beam.
This manufactured home is required to be set-up or installed, on-site,in accordance with the Jacobsen
Homes "Set-Up Manual" and it's "`Addendum". Please specifically refer to page SU-01-0008, which
includes site requirements that must be followed in order to attach a structure to the host beam
provided. This page also has the ma�timum sizes allowed for any attached structure along with the
requirements for peritneter blocking along the entire sidewaii area where the host beam is installed.
A11 site installed structures shali he designed by a Professionai Engineer (PE) registered in the State af
Florida or as allowed by the Local Authority Having Jurisdiction (LAHJ). The design shall carnply with all
applicable sections of the Florida Buildin Code that is in effect during the time af the construction of
the addition. All attachment designs and construction are by others, not Jacobsen Homes. Any site
installed structures shall be subject to permittin�plan review,and inspection(s)by the LAHJ.
If I can be af further assistance,please feel free to call me at 727-726-1138.
Sincerely,
�,.��. �~'`� _
.��a�:j�,.- � -
�r�c� �
�t'•+-.}
Craig Young
Director of Engineering
Jacobsen Homes
File
600 Packard Court,Safety Harbor,FL 34695
Telephone:727-726-1138 Fax:727-726-7019
iVatianaL•800-843-1559 3n Flarida:800-282-5389
www.iachomes.com
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BCIS Home Log In User Registratlon Hot Topiw Submit Surcharge SWts&Facts Publications FBC Staff BCIS Site Map Links Search
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Product Avosoval Menu>Produr[or Anolica[ton Search>Aoolicatbn List>Appfication DeWil
�=-::`.,.....;�,:-;.;_.''::� --=,;. FL# R12231-R2
�':`-'::�'' -
� " � ' � ` Application Type Revision
Code Version 2014
Application Status Approved
Comments
Archived
Product Manufacturer Style Crest Inc.
Address/Phone/Email 600 Hagerty Drive
Fremont, OH 43420
(419) 333-5835
I ewis.pope@styl ecrest.net
Authorized Sfgnafiure Lewis Pope
Iewis.po pe@styi ecrest.net
Technical Representative Lewis Pope
Address/Phone/Email 600 Hagerty Drive
Fremont, OH 43420
(419) 333-5835
lewis.pope@stylecrest.net
Quality Assurance Representative Lewis Pope
Address/Phone/Email 600 Hag�rty Dr
Fremont, OH 43420
lewis.pope@poly-foam.com
Category Panel Walls
Subcategory Siding
Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed
Florida Professional Engineer
�' Evaluation Report- Hardcopy Received
Florida Engineer or Architect Name who developed Eric J.Tompos P.E.
the Evaluation Report
Florida License PE-63511
Quality Assurance Entity Architectural Testing,Inc.
Quality Assurance Contract Expiration Date 12/31/2018
Validated By Wiliiam R. Heiden III, P.E.
� Validation Checklfst- Hardcopy Received
Certificate of Independence Ft i���� R COI E)T COI.�df
Referenced Standard and Year(of Standard) Standard Year
ASTM D3679 2009
Equivalence of Product Standards
Certified By Florida Licensed Professional Engineer or Architect
FL�cc.71 n4 �uu� � I f D rl f Ctanriarrl�cT��y�7 i 1-8 2015-
08-19 Sealed.qdf
Sections from the Code
Product Approval Method Method 1 Option D
Date Submitted 07/22/2015
Date Validated 08/30/2015
Date Pending FBC Approval 09/06/2015
Date Approved 10/16/2015
SuC mmary of Produc, t�
FL# �Model,Number or Mame Description �
I
12231.1 Fairfield, Alpine Ridge and D4, DL4, D5 and DL5 Configurations I
�Ridgeview Vfnyl Siding
Limits of Use Installation Instructions
Approved for use in HVHZ: No FL12231 R2 tI installation tnstructions Attachment D tails
Approved for use outside HVHZ:Yes 2015-08-�i.pdf
Impact Resistant: No F1 1223i R2 �I Vinyl Siding Installation 2011 p�
Design Pressure: +N/A/-59 Verified By: NTA, Inc.
Other:Design pressure varies based on the installation Created by Independent Third Party: Yes
method. Please refer to the evaluation report for the proper Evaluation Reports
design pressure based on the installation. F�12231 R2 AE Evaluation Renort STCS11111-8 2015-08-19
Sealed.pdf
Created by Independent Third Party: Yes
12231.2 Harbour Crest, Spiegel Grove, D4, DL4, DL4.5, D5, DL5 and T3.33 Conffgurations
Addison Heights, and Sawmill Vinyl
Siding
Limits of Use Installation Instructions
Approved for use 6n HVHZ: No Fl�223� R2 1I Installation Instructions Attachment Der�ils
Approved for use outside HVHZ:Yes 2015-08-21.�df
Impact Resistant:No FL12231 R2 II Vinvl Sidinq Installation 2011.odf
Design Pressure: +N/A/-74 Verified By: NTA, Inc.
Other: Design pressure varfes based on the installation Created by Independent Third Party: Yes
method. Please refer to the evaluation report for the proper Evaluation Reports
design pressure based on the installation. R12231 R2 AE Evaluation Re�ort STClillli-8 2015-08-19
Sealed.odf
Created by Independent Third Party: Yes
12231.3 Oak Harbor, Bristoi Bay and Town D4, DL4, DL4.5, D5, DL5 Configurations
Square Vinyi Siding
Limits of Use Installation Instructions
Approved for use in HVHZ: No F�12231 R2 II Installation Instructions Attachment Details
Approved for use outside HVHZ:Yes 20]5-08-21.odf
Impact Resistant: No FL12231 R2 II Vinvi Sidino Installation 2011.odf
Design Pressure: +N/A/-59 Verified By: NTA, Inc.
Other: Design pressure varies based on the installation Created by Independent Third Party: Yes
method. Please refer to the evaluation report for the proper Evaluation Reports
design pressure based on the installation. FI_1�231 R2 AE Evaluation Report STCllllli-8 2015-08-19
Sealed.odf
Created by Independent Third Party: Yes
12231.4 Pro Pride �DL4.5 Configurations
ILimits of Use I Installation Instructions �
Approved for use in HVHZ: No ; FL12231 RZ II Installation Instructions Attachment Details �
i Approved for use outside HVHZ:Yes �2015-08-21.odf `
i Zmpact Resistant: No � FL12231 R2 II Vinvl Sidina Instaliation 2011.odf �
� Design Pressure: +N/A/-76 j Verified By: NTA,Inc. ;
' Other:Design pressure varies based on the installation I Created by Independent Third Party; Yes i
method. Please refer to the evaluation report for the proper Evaluation Reports
design pressure based on the installation. FL12231 R2 AE Evaluation RegQ.rt STCllilli-8 2015-08-19 (
Sealed.odf i
_ Created by Independent Third Party: Yes �
12231.5 Prospan Premium, Dura Span and T4, D5 Configurations
Pioneer Vinyl Siding I
Limits of Use ��nstallation instructions �
Approved for use in HVHZ: No � FL12231 R2 II Installation Instructions Attachment Details I
Approved for use outside HVHZ:Yes I 2o15-a8-21,pdi t
Im pact Resistant: No � FL12231 R2 II Vinvl Siding Installation Z011.odf �
Design Pressure: +N/A/-37 Verified By: NTA, Inc. �
Other: Design pressure varfes based on the installation Created by Independent Third Party: Yes ! �i
J
�method. Please refer to the evaluation report for the proper I Evaluation Reports i
`' - design pressure based on the instaliation. � _F1,)2231 R2 AE Eva(uation Reoort STCilliil-8 2015-08-19 i
Seafed.qdf ,
Created by Independent Third Party: Yes I
__ _ � i
12231.6 Select Series Beaded Siding and �Beaded 6.5 Configuration -�
' Lexington Series Beaded Vinyl � i
Sidfng ��
lLimits of Use ' Installation Instructions j
Approved for use in HVHZ: No FLZ2231 R2 II Installation Instructions Attachment Details �
Approved for use outside fiVHZ:Yes 2Q15-68-21.adf
ImpactResistant: No FI_12231 R2 II Vinvl Sidino Installation 201L�df �
Design Pressure: +N/A/-74 Verified By: NTA, Inc. i
Other: Design pressure varies based on the installation , Created by Independent Third Party: Yes '
method. Please refer to the evaluation report for the proper �Evaluation Reports `
design pressure based on the installation. FL12231 R2 AE Evaluation Report STClllili-8 2015-OS-19 i
Sealed.odf
Created by Independent Third Party: Yes �
12231.7 Select Series Board and Batten and Board and Batten ConPiguration
Lexington Series Board and Balten
Vinyl Siding
Limits of Use Installation Instructions
Approved for use in HVHZ: No ���7�� R2 II Installation Instn!ctions Attachment Details
Approved for use outside HVHZ:Yes 2015-08-21..odf
Impact Resistant: No �� 31 R II Vinyl idi a lnstallation 201�.ndf
Design Pressure: +N/A/-50 Verified By: NTA, Inc.
Other: Design pressure varies based on the installation Created by Independent Third Party: Yes
method. Please refer to the evaluation report for the proper Evaluation Reports
design pressure based on the installation. R12231 R2 AE Evaluation Re�ort STC111�11-8 2015-08-i9
Sealed.odf
Created by Independent Third Party: Yes
12231.8 Timbermiil D4, S7 Configuration
Limits of Use Installation Instructions
Approved for use in HVHZ: No Fl i»31 R2 II Installation Instructions Attachment Detaits
Approved for use outside HVHZ:Yes 20i5-08-21.odf
Impact Resistant: No FL12231 R2 II Vinyl Sidfng Installation 2011.odf
Design Pressure: +N/A/-72 Verified By: NTA, Inc.
Other:Design pressure varfes based on the installation Created by Independent Third Party: Yes
method. Please refer to the evaluation report for the proper Evaluation Reports
design pressure based on the installation. FL12231 R2 AE Evaivation Report STCSilili-8 2015-08-19
Sealed.odf
Created by Independent Third Party: Yes I
12231.9 Timbermili Log Cabin Panel Siding Cabin Board (S6.5) Configuration
Limits of Use Installation Instructions
Approved for use in HVHZ: No FL12231 R2 1I Installation Instructions Attachment Details
Approved for use outside HVHZ:Yes 2015-08-21.odf
Impact Resistant: No FL12231 R2 II Vinyl Siding Installation 2011 �df
Design Pressure: +N/AJ-100 Verified By: NTA, Inc.
Other: Design pressure varies based on the installation Created by Independent Third Party: Yes
method. Please refer to the evaluation report for the proper I Evaluation Reports
design pressure based on the installation. FL12231 R2 AE Evaluation Report STCiillil-8 2015-08-19
!Sealed.qdf
� Created by Independent Third Party: Yes
12231.10 j Timbermill Vertical Siding D5 Configuration
Limits of Use Instaltation Instructions
Approved for use in HVHZ: No Ft t���� R7 II Instaliation Instructions Attachment Details
Approved for use outside HVHZ:Yes 2015-08-21.odf
Impact Resistant: No �L»231 RZ II Vinyl Sidina Installation 2011�df
Design Pressure: +N/A/-57 Verified By: NTA, Inc.
Other: 10" oc into OSB sheathing Created by Independent Third Party: Yes i
Evaluation Reports
FI 177'�1 R7 AE Evaluation Reoort STCilllll-8 2015-08-19
�ealed.�df
� Created by Independent Third Party: Yes J
� �
Gontad Us::2601 Blalr Stone Road Tallahassee FL 32399 Phone:850-487-1624
The State of Florida is an AA/EEO employer.c'nnvrinht 2007-2073 State of Florida. :: Privacv Statement::Accessibilitv Statement::Refund Statement
Under Fiorida law,email addresses are public records.If you do not want your e-mall address released In rnsponse to a public-records request,do not send electronic
mail to this entity.Instead,contact the offlce by phone or by traditional matl.If you have any questlons,please wntact 650.487.1395.'Pursuant to Section
t• � 4 - ' ... •` � �. � _ .,.. __ _ -'' " ` " `� - '- "_- '�1.}�a�t��i'+Vari'7 t4'^I'.i�"--���''��
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BCIS Home Log In User Regist2tfon Hot Topics Submit Surcharge Stats&Fac[s Publications FBC Staff BCIS Site Map Lfnks Search
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Prpdud Ao�roval t+enu>Product or A�otication Search>Ao�liwtlon Ust>Application Detail
;:�:.��:.rH=:,-„;:�., .:':.'-�' FL# R18464
` .". , � -- ""-'`` APPlicationType New
Code Version 2014
Application Status Approved
Comments
Archived
Product Manufacturer Metals Building Products
Address/Phone/Email 7815 American Way
Groveland, FL 34736
(352) 787-7766
bkaufmann@metalsbp.com
Authorized Signature Bill Kaufmann
bkaufmann@metalsbp.com
Technical Representative Bill Kaufmann
Address/Phone/Email 7815 american Way
Groveland, FL 34736
(800) 342-9077
bkaufmann@metalsusa.com
Quality Assurance Representative BILL KAUFMANN
Address/Phone/Email 7815 AMERICAN WAY
GROVELAND, FL 34736
(352) 787-7766 Ext227
bkaufmann@metalsusa.com
Category Roofing
Subcategory Metal Roofing
Complfance Method Evaluatfon Report from a Florida Registered Architect or a Licensed
Florida Professional Engineer
�' Evaluation Report- Hardcopy Received
Florida Engineer or Architect Name who developed Steven Moraga
the Evaluatfon Report
Fiorida License PE-64609
Quality Assurance Entity UL LLC
Quality Assurance Contract Exptration Date 04/29/2018
Validated By ]orge A. Pomerantz, P.E.
� Validation Checklist- Hardcopy Received
Certificate of Independence Fl 18464 RO COI Rhino cert of indeo FBC
701401322320150831130601.odf
Referenced Standard and Year(of Standard)
Equivalence of Product Standards
Certified By
Sections from the Code •
FBC 1504.3
, ,
'� FBC 1507.4
FBC 1607.1
FBC 1609.3.1
FBC 1609.4.3
Product Approval Method Method 2 Option B
Date Submitted 08/31/2015
Date Validated 09/11/2015
Date Pending FBC Approval 09/13/2015
Date Approved 10/16/2015
Summa of Products
FL# Model,Number or Name Description
18464.1 Rhino pan,Twin Vee W pan Steel roof panels for outdoor patio products. residential or
commercial patio covers, carports, screen rooms,awnings,
canopies, walkway covers,sheds
Limits of Use Installation Instructions
Approved for use in HVH2: No Fl 18464 RO II Rhino T�vinVee orod aoorvl
Approved for use outside NVH2:Yes instalQ13704�0150911130952 pdf
Impact Resistant: No Verified By: Steven Morega 64609
Design Pressure: N/A Created by Independent Third Party: Yes
Other:see installation instructions for span tables Evaluation Reports
FL18464 RO AE Rhfno eval Itr
FBC201401322220i5083�130516 pdf
Created by Independent Third Party: Yes
0 +_.<<.
Contad Us::2601 Blair Stone Road.Tallahassee FL 32399 Phone:850-487-1824
The State of Florida is an AA/EEO employer.Convriaht 2007-2013 State of Florida ::Privacv Statement::Q,�c essibilitv Statement::Refund Statement
Under Florida law,emall addresses are public records.If you do not want your e-mafl address released in response to a pubUo-records request,do not send electronlc
mail to this entity.Instead,contact the office by phone or by traditional mail.If you have any questions,please rnntact 850.487.1395.*Pursuant to Section
455.275(1),Florida Statutes,effecdve October 1,2012,licensees licensed under Chapter 455,F.S.must provide the Department with an email address if they have
one.The emails provided may be used for offlcial communiotion wi[h the Iicensee.However email addresses are putlic record.If you do not wish to supply a
personal address,please provide the Department with an email address which can be made available to the public.To detertnine if you are a licensee under Chapter
455,F.S.,please click ere.
Produd ApprovalAccepts:
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BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats&Facts Publlcations FBC Staff BCIS Site Map Links Search
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produR Aocroval�dFnu>Produc[or Aoollcation Search>A�oticatton List>Application Detail
'i_;- .•._- - - -- ---
. _ - -- _: _ :: FL# FL16468-RS
'- " "'`-� - Application Type Revision
Code Version 2014
Application Status Approved
Comments
Archived �
Product Manufacturer ]ELD-WEN
Address/Phone/Email 3737 Lakeport Blvd
Klamath Falls,OR 97601
(800) 535-3936
fbcl@jeld-wen,com
Authorized Sfgnature Kaede McLaughlin
fbcl@jeld-wen.com
Technical Representative JELD-WEN Corporate Customer Senrice
Address/Phone/Email 3737 Lakeport Bivd,
Klamath Falls, OR 97601
(800) 535-3936
customerserviceagents@jeld-wen.com
Quality Assurance Representative
' Address/Phone/Email
Category Exterior poors
Subcategory Swinging Exterior poor Assemblies
Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed
' Florida Professional Engineer
� Evaluation Report- Hardcopy Received
Florida Engineer or Architect Name who developed Hermes F. Norero, P.E.
the Evaluation Report
Florida License PE-73778 '
Quality Assurance Entity National Accreditation&Management Institute �I
, Quality Assurance Contract Expiration Date 01/01/2018 I
Validated By Locke Bowden '
' ° Validation Checklist- Hardcopy Received
, Certificate of Independence R16468 R8 COI COI]W SS 2015-04-27.�df
Referenced Standard and Year(of Standard) Standard Year il
TAS 202 1994
Equivalence of Product 5tandards �,
Certified By
Sections from the Code
� Product Approval Method Method 1 Option D
Date Submitted 04/15/2015
Date Validated 05/01/2015
Date Pending FBC Approval 05/30/2015
Date Approved 06/22/2015
Date Revised 08/26/2016
Summa of Products
�
FL# �Model,Number or Name _�Description �
16468.1 ��Design Pro/Smooth Pro Fberglass `5ingle(X) Opaque Door 3-0 x 6-8 and 3-0 x 8-0 Inswing and
�Outswing
Limits of Use Installation Instructions
Approved foruse in HVH2:Yes FL164fi8 R8 II A010861A.odf
Approved for use outside HVHZ:Yes Verified By: Hermes F. Norero, P.E. 73778 i
Impact Resistant: No Created by Independent Third Party: Yes
Design Pressure: N/A Evaluation Reports f
Other: FL16468 R8 AE PER3472.pdf I
Created by Independent Third Party: Yes
16468.2 Design Pro/ Smooth Pro Flberglass Single(X)Glazed Door 3-0 x 6-8 and 3-0 x 8-0 Inswing and
Outswing
Limits of Use Installation Instructions '
Approved for use in HVHZ:Yes FLifi468 R8 IT A010£362B.�df
Approved for use outside HVHZ:Yes Verified By: Hermes F. Norero, P.E. 73778
Impact Resistant: No Created by Independent Third Party: Yes
Design Pressure: N/A Evaluation Reports
Other: R16468 R8 AE PER3473.odf
Created by Independent Third Party: Yes
16468.3 Design Pro/Smooth Pro Fberglass Doubie(XX) Opaque Door 6-0 x 6-8 and 6-0 x 8-0 Inswing
and Outswing
Limits of Use Installation Instructions
Approved for use in HVHZ:Yes FL16468 R8 II A010863A.odf
Approved for use outside HVHZ:Yes Verifted By: Hermes F. Norero, P.E. 73778
Impact Resistant: No Created by Independent Third Party: Yes
Design Pressure: N/A Evaluation Reports
Other: Rifi468 R8 AE PER3474.pdf
Created by Independent Third Party: Yes
16468.4 Design Pro/Smooth Pro Fberglass Double (XX) Glazed Door 6-0 x 6-8 and 6-0 x 8-0 Inswing and
Outswing
Limits of Use Installation Instructions
Approved for use in HVHZ:Yes R16468 R8 II A0108b4A.�df
Approved for use outside HVF#Z:Yes Verified By: Hermes F. Norero, P.E, 73778
Impact Resistant: No Created by Independent Third Party: Yes
Design Pressure: N/A Evaluation Reports
Other: FL16468 RS AE PER3475.adf
Created by Independent Third Party: Yes
16468.5 Design Pro/5mooth Pro Fberglass Single with sidelite(s) (X,O/O,X/O,X,O) Opaque Door 9-0 x ,
- � 6-8 and 9-0 x 8-0 Inswing and Outswing
Limits of Use Installation Instructions
Approved for use in HVHZ:Yes Fl.16468 R8 JI A010865A.pdf
Approved for use outside HVHZ:Yes Verified By: Hermes F. Norero, P.E. 73778
Impact Resistant: No Created by Independent Third Party: Yes
Design Pressure: N/A Evaluation Reports I
Other: FL16468 R8 AE PER3476.pdf
Created by Independent Third Party: Yes �
16468.6 Design Pro/Smooth Pro Fberglass Single with sidelite(s) (X,O/O,X/O,X,O) Glazed Door 9-0 x I
6-8 and 9-0 x 8-0 Inswing and Outswing � I
Limits of Use Installation Instructions �
Approved for use in HVHZ:Yes FL16468 R8 II A0108666.�df
Approved for use outside HVH2:Yes Verified By: Hermes F. Norero, P.E. 73778
Impact Resistant: No Created by Independent Third Pariy: Yes
Design Pressure: N/A Evaluation Reports
Other: I FL15468 R8 AE PER3477.odf
_'__ _^__�_Created by Independent Third Party: Yes '_�
-- ��--
16468.7 �Design Pro/ Smooth Pro Fberglass Double with sidelite(s) (XX,O/O,XX/O,XX,O) Opaque Door�
� �12-0 x 6-8 and 12-0 x 8-0 Inswing and Outswing �
' ` Limits of Use + Instailation Instructions i
Approved for use in HVHZ:Yes I FL16458 R8 II A01�867A.�df i
Approved for use outside HVH2:Yes Verified By: Hermes F. Norero, P.E. 73778
Impact Resistant: No Created by Independent Third Party: Yes �
Design Pressure: N/A Evaluation Reports
Other: FI.16468 R8 AE PER3478.�df
I Created by Independent Third Party: Yes i
16468.8 �Design Pro/Smooth Pro Fberglass Doubie with sidelfte(s) (XX,O/O,XX/O,XX,O) Glazed Door
� 12-0 x 6-8 and 12-0 x 8-0 Inswing and Outswing �
Limits of Use Installation Instructions �
Approved for use in HVHZ:Yes EI,�,6468 R8 IT AQ10&68A�df
Approved for use outside HVHZ:Yes � Verified By: Hermes F. Norero, P.E. 73778
Impact Resistant: No Created by Independent Third Party: Yes
Design Pressure: N/A Evaluation Reports
Other: FL16468 R8 AE PER3479.odf
Created by Independent Third Party: Yes I
0 0
Contact Us::�601 Blair Stone Road Tallahas=�FL 32399 Phone:850-487-1824
The State of Florida is an AA/EEO employer.Convriaht 2007-2013 State of Florida. ::Privacv Statement::Accessibilitv Statement::Refund Statement
Under Flarida law,email addresses are public records.If you do not want your rmail address released in response to a public-records request,do no[send electronic
mall to this entity.Instead,contact the office hy phone or by t2ditional mail.If you have any questions,please wntact 850.487.1395.*Pursuant to Section
455.275(1),Florida Statutes,effective October 1,2012,Iicensees Ilcensed under Chapter 455,F.S.must provide the Department with an emall address if they have
one.The emails provided may be used for oFficial rnmmunication with the licensee.However emaif addresses are public record.If you do not wish to supply a
personal address,please provide the Department with an email address which pn be made available to the public To detertnine if you are a Iicensee under Chapter
455,F.S.,please dick here.
Product Approval Accepts:
�:� � �� �
Credit Carc1
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BCIS Home Log In User Registratlon Hot Top(cs Submit Surcharge Stats&Facts Publications FBC Staff BCIS}Site Map Links r YSearch' '
� Flor!t�a .�;�.,�.
�'� �,�;. ��-=�.. �;� .�
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product.4�+orovzl Menu>Produd or Anotication Search>Aoolicatlon LtsY>Appiication Detail
_�_ 4�•:�-:. "�: : FL# FL15279-R4
� " "" � "� � Application Type Revision
Code Version 2014
Application Status Approved
*Approved by DBPR. Approvals by DBPR shali be reviewed and ratified
by the POC and/or the Commission if necessary.
Comments
Archived
Product Manufacturer Clopay Building Products Company
Address/Phone/Email 8585 Duke Blvd.
Mason, OH 45040
(513)770-6062
mwestertield@clopay.com
Authorized Signature Scott Hamilton
shamilton@clopay.com
Technical Representative
Address/Phone/Email
Quality Assurance Representative
Address/Phone/Email
Category Exterior poors
Subcategory Sectional Exterior poor Assembltes
Compliance Method Certification Mark or Listing
Certification Agency Intertek Testing Services NA, Inc.
Validated By Gary Pfuehler
{ Validation Checklist- Hardcopy Received
Referenced Standard and Year(of Standard) Standard Year
ANSI/DASMA 108 2005
ANSI/DASMA 115 2005 �
ASTM E1886 2002
ASTM E1996 2002
ASTM E330 2002
Equivalence of Product Standards
Certified By Florida Licensed Professionai Engineer or Architect
FI..15279 R4 Eauiv 20150319- FBC- DASMA 108 eauiv,pdf
FL15Z79 R4 Eauiv 20150319- FBC- DASh7A 115 equiv.odf
Product Approval Method Method 1 Option A
Date Submitted 03/19/2015
Date Validated 06/12/2015
Date Pending FBC Approval
Date Approved 06/21/2015
Summary of Products
Go to Page � i� � Page 1/8� �
FL# ! Model,Number or Name �Description --�
I
15279.1 �001 W3-09 DSIE-1A171: 2050, 1-3/8"Double-skin Insulated EPS (exterior skin 27 ga. min.; i
2051, 2053,4050,4051,4053, 62, interior skin 29 ga. min.) Single-Car(up to 9'0"wide) `
64, 65, 62G, 62LG, 64G, SDP38, WINDCODEp W3 Garage Door �
SFL38, SRP38, 134, 135, 136,6130, �
�6131, 6133
Limits of Use Certification Agency Certificate ,
Approved for use in HVHZ: No FL15274 R4 C CAC Letter�vith oroof of conFract and oroof
Approved for use outside HVHZ:Yes of inspection.odf �
Impact Resistant: N/A FL15279 R4 C CAC W3 Listina Intertek odf
Design Pressure: +20 PSF/-20 PSF Quality Assurence Contract Expiration Date
Other:The OPTIONAL glazing available for this product 05/21J2028 �
meets the wind load requirements of the building code but Instaliation Instructions
DOES NOT meet the impact resistant requirement for FL15279 R4 II 101655-Rev12.�df
windborne debris regions.The product without glazing DOES Verified By: Intertek Testing Services NA, Inc.
comply with the impact resistant requirement for windborne Created by Independent Third Party:
debris regions (ref 1609.1.4 FBC). Evaluation Reports
Created by Independent Third Party:
15279.2 002 W3-09 DSIE-1A471: GD1SP, Gallery/Artistry/Expressions: 1-3/8" Double-skin Insulated
GR1SP, GDSLP, GR1LP,AR1SP, EPS(exterior skin 27 ga. min.; interior skin 27 ga. min.)
AR1LP, EDiSP, ED1LP,4132, 2132, Single-Car(up to 9'0"wide)WINDCODEp W3 Garage Door
6132, SFC38, MFC38
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL15279 R4 C CAC Letter with oroof of contrect and proof
Approved for use outside HVHZ:Yes of ins�ection,�df
Impact Resistant: N/A FL]5279 R4 C CAC W3 Listina I�tertek.Rdf
Design Pressure: +20 PSF/-21 PSF Quality Assurance Contrect Expiration Date
Other:l'he OPTIONAL glazing available for this product 05/21/2028
meets the wind load requirements of the buiiding code but Installation Instructions
DOES NOT meet the impact resistant requirement for FL15279 R4 II 103952-RevOl.odf
windborne debris regions. The product without glazing DOES Verified By: Intertek Testing Services NA, Inc.
comply with the impact resistant requirement for windborne Created by Independent Third Party:
debris regions(ref 1609.1.4 FBC). Evaluation Reports
Created by Independent Third Party:
15279,3 003 W3-09 DSIU-1A171: 9130, Double-skin Insulated PUR(exterior skin 27 ga. min.; interior
9131,9133, HDP13, HDPF13, skin 27 ga. min.) Single-Car(up to 9'0"wide) WINDCODEp
HDPL13, 7130, 7131, 7133, 8130, W3 Garage Door
8131, 8133
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No Fl 15279 R4 C CAC Letter with r�roof of contraer�nd p�
Approved for use outside HVH2:Yes of inspection.�df
Impact Resistant: N/A F1.,15279 R4 C CAC W3 Listina Intertek.�df
Design Pressure: +20 PSF/-20 PSF Quality Assurance Contract Expiration Date
Other:The OPTIONAL glazing available for this product 05/21/2028
meets the wind load requlrements of the build(ng code but Installation Instructions
DOES NOT meet the impact resistant requirement for F1.15279 R4 II 104175-RevOl.odf
windborne debris regions.The product without glazing DOES Verified By: Intertek Testing Services NA, Inc,
comply with the impact resistant requirement for windborne Created by Independent Third Party; I
debris regions (ref 1609.1.4 FBC). Evaluation Reports I
I
Created by Independent Third Party: !
i
�
15279.4 004 W3-16 DSIE-1A171: 2050, I 1-3/8" Double-skin Insulated EPS (exterior skin 27 ga. min.; ;
2051, 2053,4050, 4051,4053, 62, �interior skin 29 ga. min.) Double-Car (9'2"to 16'0"wide) {
64, 65, 62G, 62LG, 64G, SDP38, WINDCODEp W3 Garage Door �
SFL38, SRP38, 134, 135, 136, 6130,
6131, 6133
Limits of Use � Certification Agency Certificate
Approved for use in HVHZ: No FL15279 R4 C CAC Letter with oroof of contract and oroof �
Approvedforuse outside HVHZ:Yes of ins�ection.odf i
Impaet Resistant: N/A FLi5279 R4 C C.AC W3 Liskin4 Intertek.odf �
Design Pressure: +20 PSF/-21 PSF Quality Assurance Contract Expiration Date I
Other:The OPTIONAL glazing avaitable for this product 05/21/2028 �
meets the wind load requirements of the building code but Installation Instructfons i
DOES NOT meet the impact resistant requirement for FL15279 R4 tI 101820-Rev13.�df i
I windborne debris regions. The product without glazing DOES � Verified By: Intertek Testing Services NA, Inc. i
, �comply with the impact resistant requirement for windborne � Created by Independent Third Party: I
� I debris regions(ref 1609.1.4 FBC). �Evaluation Reports i
_ _ _ I Created by Independent Third Party:
15279.5 �r005 W3-16 DSIE-SA471: GDiSP, I Gailery/Artistry/Expressions: 1-3/8" Double-skin Insulated �
�GRiSP, GD1LP, GRiLP, AR1SP, 'EPS (exterior skin 27 ga. min.; interior skin 27 ga. min.) �
�ARiLP, EDiSP, EDiLP, 4132, 2132, �Double-Car(9'2"up to 16'0"wide) WINDCODEp W3 Garage �
_ �6132, SFC38, MFC38 !Door
Limits of Use ;Cettification Agency Certificate
Appeoved for use in H1/HZ: No ` FLI5774 R4 C CAC LPttpr with r�roof of contract and r2oof
Approvedforuse outside HVHZ:Yes of insoection.odf
Impact Resistant: N/A Fl 15279 R4 C CAC IM3 � tinp IntPrtPk n�lf I
Design Pressure: +20 PSF/-21 PSF i Quality Assurance Contract Expiration Date I
Other:The OPTIONAL glazing available for this product 05/21/2028
meets the wind load requirements of the building code but Installation Instructions
DOES NOT meet the impact resistant requirement for �t 15279 R4 II 2040 8-R v0 odf
windborne debris regions. The product without glazing DOES Verified By: Intertek Testing Services NA,Inc.
comply with the impact resistant requirement for windborne Created by Independent Third Party:
debris regions (ref 1609.1.4 FBC). Evaluation Reports
, Created by Independent Third Party:
' 15279.6 006 W3-16 DSIU-1A171: 9130, Double-skin Insulated PUR(exterior skin 27 ga. min.; interior
I9131, 9133, HDP13, HDPF13, �skin 27 ga. min.) Double-Car(9'2"to 16'0"wide)
HDPL13, 7130, 7131, 7133, 8130, WINDCODEp W3 Garage Door
8131, 8133
Limits of Use Certification Agency Certificate I
Approved for use in HVHZ: No FI,.1Sz79 R4 C CAC Letter with proof of contract and �roof
Approved for use.outside HVH2:Yes of insoection.odf
Impact Resistant: N/A FL15279 R4 C CAC W3 Listina Intertek.odf
Design Pressure: +20 PSF/-21 PSF Quality Assurance Contrect Expiration Date
Other:The OPTIONAL glazing avaflabie for this product � 05/21/2028
meets the wind load requirements of the building code but Installation Instructions '
DOES NOT meet the impact resistant requirement for Ri5279 R4 II 104168-Rev0l.odf
windborne debris regions.The product without glazing DOES Verified By: Intertek Testing Services NA, Inc.
comply with the impact resistant requirement for windborne Created by Independent Third Party:
, debris regions (ref 1609.1.4 FBC). Evaluation Reports
Created by Independent Third Party:
15279.7 007 W3-16 PAN-2F153: 73, 1500, Steel Pan(min. 25 ga.) Double-Car(9'2"to 16'0"wide)
75, 190, 84A, 94, 42, 48, 55,426, WINDCODE�W3 Ga�age Door
48B, 55S,4RST,6RST, 4RSF, 6RSF
Limits of Use Certification Agency Certificate
' Approved for use in HVHZ: No FL15279 R4 C CAC Letter with oroof of contract and �roof
Approved for use outside HVHZ:Yes of inspection.odf
Impact Resistant: N/A FI 15 79 R4 A W Listing IntertPk:nrtF
Design Pressure: +20 PSF/-21 PSF Quality Assurance Contract Expiration Date
Other:The OPTIONAL glazing avaflable for this product 05/21/2028
meets the wind load requirements of the building code but Installation Instructions
DOES NOT meet the impact resistant requirement for I Fi,15279 R4 II 101308-Revl2.odf
windborne debris regions.The product without glazing DOES Verified By: Intertek Testing Services NA, Inc.
comply with the impact resistant requirement for windborne Created by Independent Third Party:
debris regions (ref 1609.1.4 FBC). Evaluation Reports
Created by Independent Third Party:
15279.8 �08 W4-09 bSIE-1F171: 4300, 4301, 2" Double-skin Insulated EPS(exterior skin 27 ga. min.;
4310, 4400, 4401, HDG, HDGL, interior skin 27 ga. min.) Single-Car(up to 9'0"wide)
HDGF, 66, 66G, 67, 67G, 68, SP200, WINDCODE� W4 Garage Door
SF200, SE200, 6200, 6201, 6203
Limits of Use Certification Agency Certificate I
Approved for use in HVHZ: No FL15279 R4 C CAC Letter with proof of contract and oroof
�pproved for use outside HVHZ:Yes of inspection.qdf �
� Smpact Resistant: No FL15279 R4 C CAC W4 L�±ina Intertek.�dF �
( Design Pressure: +28 PSF/-29 PSF �Quality Assurance Contract Expiration Date �
i Other:The OPTIONAL glazing available for this product � 05/21/2028 �
meets the wind load requirements of the building code but Installation Instructions
DOES NOT meet the impact resistant requirement for � FL15279 R4 II 10165Z-B-Revll.odf
windborne debris regions.The product without glazing DOES Verified By: Intertek Testing Services NA, Inc.
comply with the impact resistant requirement for windborne � Created by Independent Third Party:
debris regions (ref 1609.1.4 FBC). I Evaluation Reports
� Created by Independent Third Party:
15279.9 009 W4-09 DSIE-1F471: GD25P, Gallery/Artistry/Expressions: 2" Double-skin Insulated EPS
IGR2SP, GD2LP, GR2LP, AR2SP, (exterior skin 27 ga. min.; interior skin 27 ga. min.)Single-
AR2LP, ED2SP, ED2LP, 4302, HDGC, �Car(up to 9'0"wide)WINDCODEQ W4 Garage Door
�6202, SFC68, MFC68
1 Limits of Use 1 Certification dgency Certificate
Approved for use in HVHZ: No ( FL15279 R4 C A tr r wi h Rroof of contrart and�r g[ i
Approved for use outside HVHZ:Yes �of ins�ection,adf �
Impact Resistant: No l FL15279 R4 C CAC W4 Usting Intertek.pdf �
Design Pressure: +28 PSF/-29 PSF i quality Assurance Contract Expiration Date
� Other:The standard glazing available for this product meets I 05/21/2028 �
the wind load requirements of the building code but DOES Installation Instructions �
NOT meet the impact resistant requirement for windborne � F7..15279 R4 II 103q69-B-Rev02� �
debris regions. � Verified By: Intertek Testing Services NA, Inc.
� Created by IndependentThird Party: �
I I Evaluation Reports �
� Created by Independent Third Party: I
15279.10 �010 W4-09 DSIU-iF171: 9200, �Double-skin Insulated PUR(exterior skin 27 ga. min,; interior i
� I 9201, 9203, HDP20, HDPF20, skin 27 ga. min.) Single-Car(up to 9'0"wide)WINDCODEp
�HDPL20, 7200, 7201, 7203, 8200, W4 Garage Door �
'8201, 8203 '
i
Limits of Use Certification Agency Certifcate ��
Approved for use in HVHZ: No ` I Fl]S27g R4 C CAG Letter Fvith proof of contrarr an�l nrn�
Approved for use outside HVH2:Yes �of in�pection.ndf
Impact Resestant: N/A R15279 R4 C CAC W4 Listin4 fitertek.pdf I
Design Pressure: +28 PSF/-29 PSF Quality Assurance Contract Expiration Date �
Other.The OPTIONAL glazing available for this product 05/21/2028 �
meets the wind load requirements of the building code but Installation Instructions
DOES NOT meet the impact resistant requirement for FL15279 R4 II 104183-RevO7..�df
windborne debris regions.The product without glazing DOES Verified By: Intertek Testing Services NA, Inc.
comply with the impact resistant requirement for windborne Created by Independent Third Party:
debris regions(ref 1609.1.4 FBC). Evaluation Reports
Created by Independent Third Party:
15279.11 011 W4-09 DSIUO-iK479: Canyon Doubie Skin Insulated PUR(exterior skin 27 ga. min.; interfor i
Ridge/Brookstone skin 27ga. min.) with Overlay Single-Car(up to 9'0"wide)
WINDCODEO W4 Garage Door
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL15279 R4 C CAC Letter with �roof of contract and oroof �
Approved for use outside HVHZ:Yes of insoection.�df
Impact Resistant: N/A FL1S279 R4 C CAC W4 Listina Intertek.odf
Design Pressure: +28 PSF/-29 PSF Quality Assurance Contract Expiration Date
Other:The OPTIONAL glazing available for this product 05/21/2028
meets the wind load requirements of the building code but Instaliation Instructions
DOES NOT meet the impact resistant requirement for FL.15279 R4 II 104456-Rev0l.�df
windbor�e debris regions.The product without glazing DOES Verified By: Intertek Testing Services NA, Inc.
comply with the impact resistant requirement for windborne Created by Independent Third Party:
debris regions(ref 1609.1.4 FBC). Evaluation Reports
Created by Independent Third Party:
15279.12 012 W4-09 PAN-2F151: 73, 1500, Steel Pan (min. 25 ga.)Single-Car(up to 9'0"wide)
75, 190, 84A,94, 76,42,48, 55, WINDCODEp W4 Garage Door
426, 48B, 55S, 4RST, 6RST,4RSF,
6RSF, 2RST, GDSS, GDSSV, GRSS,
GR5SV,ARSS,AR55V, ED55, EDSSV I �
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FI_15?_79 R4 C CAC Letter with oroof of contract and proof
Approved for use outside HVH2:Yes of insoection.qdf
Impact Resistant:No FLi5279 R4 C CAC W4 Listing Intertek.odf
Design Pressure: +25 PSF/-32 PSF Quality Assurence Contract Expiration Date
Uther:The standard glazing available for this product meets 05/21/2028
the wind load requirements of the building code but DOES Instaliation Instructions
NOT meet the impact resistant requirement for windborne FL15279 R4 II 300159-B-Revl6.odf
debris regions. Verified By: Intertek Testing Services NA, Inc.
Created by Independent Third Party:
Evaluation Reports �
Created by Independent Third Party:
�15279.13 013.W4-09 PAN-2F441: G4S, G54, Gallery/Artistry/Expressions: Steel Pan (min. 24 ga.) Single-
G4L, GL4, GD4S, GD4L, GR4S, I Car(up to 9'0"wide)WINDCODEp W4 Garage Door
;GR4L, G4SV, GS4V, G4LV, GL4V,
I I GD45V, GD4LV, GR4SV, GR4LV, I
E4S, E4L, ED4S, ED4L, E4SV, E4LV, '
j �ED4SV, ED4LV, SS4, SL4, AR4S, I I
AR4L, 554V, SL4V,AR4SV, AR4LV i
Limits of Use Certification Agency Certificate �I
Approved for use in HVH2: No FL15279 R4 C CAC Letter with rzroof of contracr and nroof ,
Approved for use outside HVHZ:Yes of insoection.odf
Impact Resistant: No FI.15279 R4 C CAC W4 Listing Intertek.pdf �
Design Pressure: +25 PSF/-32 PSF Quality Assurence Contrect Expiration Date �
Other:The standard glazing available for this product meets 05/21/2028
the wind load requirements of the building code but DOES Installation Instructions
NOT meet the impact resistant requirement for windborne FL15279 R4 II 103486-B-Rev08.adf �
I debris regions. Verified By: Intertek Testing Services NA,Inc. ;
Created by Independent Third Party: I
! Evaluation Reports `
Created by Independent Third Party:_ ^ �
152?9.14 �414 W4-04 SPO-2F449: Grand `•,Steei Pas�{min. 24 ga.)with 4vertay S1ngle-Car{up to �
� ' i Harbor Stone Manor ;9'0"wide)WINDCODE�1 W4 Garage Door i
_ ...�I__-'_�_.,_-_ � .� _..�___ ._.-�_ __�_..�
Limits of Use �CeetiRcat�on Agency Certificafe �
Appraved far ase in HVHZ;No � F�152�9 R4 C �C Gg ter wjth oroof of nn ract an,� araoF �
Approved for use outside HVHZ:Yes i of ins�e,ction.odf I
Impaet Resistant:N/A � F1.15274-R4 C CAC VdQ L�sting Intertek.�df ,
Design Pressucee +25 PSFJ-32 PSF Qnality Assurance Contract Expiration Da#e
Other:The OPTIONAL glazing available for this product � 05/21/2028
meets the wind load requiremenYs of the building code but Instaltafiion Instructions
DOFS NOT rneet the impact resistant requirement for � F�15279 R4 IT 103549-Rev06.�df
windborne debris regions. The praduct without glazing DOES � Verified By: Intertek Testing Services NA, Inc,
comply with the impact resistant requirement for windbarne Created by Independent Third Party:
debris regions{ref 1644.2.4 FBC}. Evatuatioce Reports
t �reated by Independent Third Party: �
-----� _
15279.15 �015 W4-i6 dSIE-iF17i: 4304,430i, I 2" Double-skEn Insuiated EPS{exteriar skin 2?ga. min.;
4310,4400,4401, HDG, HDGL, �interior skin 27 ga. min.) Double-Car (9'2"to 16'0"wide)
HDGF, 66r 66G, 67, 67G, 68, SP200, WINDCODEQ W4 Garage Door I)
SF200,SE200, 6200, 6201, 6203�
� Limits of Use Certification Agency Certificate
Appmved far ase in tlVFt�:1Vo � FL25279 R4 C CAC �Yter with r�aaf of contract anc!proof �
Approved for use outside HVHZ:Yes pf insoe�tion.pdf
ImpactResistant: No � F�.1527� R4 C CAC VJ4 Listing Intertek.odf
', Design Pressure;+25.5 PSFJ-25.5 PSF Quality Assurance Contract Expiration Date
Other:'The standard glazing availabie for this product meets 05J21J2028
the wind load requirements of the building code but DOES Installation instruckions
NOT meet the impact reststant requirement for windborne E115279 R4 II 1014$l-B-Revl3.odf
debris regians. Verified By: Intertek Testing�ervices NA,Inc.
Created by Independent Third Party:
, Evaluation Reports
� Created by Independent Third Party:
' 15279,16 416 W4-16 DSTE-SF471: 6D2SP, 6alkery/Artistry/ExPressions: 2" Doubie-skin Insufated EPS
GR2SP, Gi72tP,6R21P,AR2SP, (exterioz skin 27 ga. rnin.; interior skin 27 ga. min.} Double-
AR2LP, ED25P, ED2LP, 4302, HDGC, Car(9'2"up to 16'0"wide) WINDCODEQ W4 Garage Door
6202, SFC68, MEC68
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No Fi..15279 R4 C CAC Letter with oroof of conkract and proof
Appraved Faruse outsicie HVHZ;Yes of ins�,P ion.odF
ImpactResistant:No FL15�79 R4 C CAC W4 Listing Intertek.odf
' Design Pressure; +25.5 PSF/-25.5 PSF Quality Assurance ContracC Expiration Date
' Other:The standard glazing available for this product meats 05J21J2428
the wind load requirements of the building code but DOES Installation Instructions
N4T meet the fmpact resistant requirement for windborne �L15274 R4 TI 104029-B-Rev03.odf
debris regians. Verifled By: Irttertek Testing Services fVA,Snc.
' Created by Independent Th'srd Party:
Evaluation Reports
Created by Independent Third Party:
�
15279.17 �417 W4-16 DSIEO-iF479: Double Skin Insulated EPS (exkerior skin 27 ga. min.; interior
( Goachman/Settters(Affinity skin 27ga. min.}with Overtay Double-Car(up to 16'0"wide)
WIt3dCODE@ W4 Garage Door
Limits of Use Cerkification Agency Certificate
Approvad for ase in F[VF#Z:Na FL252?� R4 C CAC L�tter w3th oroQf of cantract and prnaE
Approved for use outside HVHZ:Yes �f insoection.od
Impact Resistant: N/A FL 5�79 R4 C CAC W4 �skin4 InCert�k.odP �
Design Pressure:+25 PSFj-ZS PSF Quatity Assurance Can#ract Expisatian date �
Other:7he OPl'IONAL glazing evailabie for this product 05/2l/2028 �
meets the wind load requirements of the building code but Installation InsEructions
DQES NOT meet tha impact resistartt requirement for F�15279 R4 Ii 20344&-Revfl7.adf
!windborne debris regions.Tfie product without glazing DOES Verified Sy: Intertek Testing Services NA,Inc.
comply with the impact resistant requirement for windborne � Created by Independent Third Party:
�deb�is reg'sons(ref l604,1.4 FBC}. EvaEuatiar►Reposts
� Created by Independent Third Party:
�______`^� ____
� -
�15279.28 018 W4-16 DStll-iFi71: 4244, Do�ble-skin Insutated PUE2(exLerior skin 2?ga. min.; interior
9201, 9203, HC1P20, HDPF20, skin 27 ga. min.} Double-Car(9'2"to 16'0"wide}
HDPL20, 7200, 7201, 7203, 8200, WINDCODEO W4 Garage Door
82Q1, 8243 __�. i
Liroits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL152]9 R4 G CAC Lgtter with oroof of contract and oroof �
Approved for use outside HVHZ:Yes 6f{nSp�Ction.pd�
Impact Resistant: N/A FL15279 R4 C CAC W4 Listi�g Intertek odf
desige Pressure: +25.5 PSF/-25.5 PSF Quality Assurance Contrect Expiration Date �
Other:The OPTTONA�glazing available for this product � 05J21J2028 �
meets the wind load requirements of the building code but Instatlation Iastructions i
�pQES NOT'meet the impact resisCant requirement for FL15279 R4 i[ 104169-RevfZt.odf � '
;windborne debris regions.3he product w'sthaut glazing DOES Verified Sy: Inkertek Testing Services NA,Ir�c. �
i Created by Tndependent Third Party:
�comply with the impact resistant requirement for w(ndborne 'Evaluation Reports �
Ldebris regions (ref 1609._l.r 4 FBC). _� Created by IndependentThird Party: �
-�J
i 15279.19 '019 W4-16 DSIUO-iK479: Cany— on —T Double Skin Insulated PUR(exterior skin 27 ga, min.; interior j
i Ridge/Brookstone J �skin 27ga. min.)with Overlay Double-Car(92"to 16'0„wide) i
�WINDCODEp W4 Garage Door
Limits of Use �Certification Agency Cert�cate
Approved for use in HVHZ: No FL15279 R4 C CAC Letter Lvith aroof of contract and oroof
IApproved for use outside HVHZ:Yes �of insoection.pdf
Impact Resistant: N/A ' FL15Z79 R4 C CAC W4 Listing Intertek.odf
Design Pressure; +25.5 PSF/-25.5 PSF Quality Assurence Contract Expiration Date I
Other:The OPTIONAL glazing availabie for this product 05/21/2028
meets the wind load requirements of the build(ng code but Installation Instructions I
f DOES NOT meet the impact resistant requirement for I FL15279 R4 II 104457-Rev02,_pdf
windborne debris regions.The product without glaz(ng DOES � Verified By: Intertek Testing Services NA,Inc. �
comply with the impact resistant requirement for windborne Created by Independent Third Party:
debris regions(ref 1609.1.4 FBC). Evaluation Reports
Created by Independent Third Party:
15279,20 ! 020 W4-16 PAN-2F153: 73, 1500, Steel Pan(min. 25 ga.) Double-Car(9'2"to 16'0"wide)
75, 190, 84A, 94,42, 48, 55,4RST, WINDCODEp W4 Garage Door
6RST, 4RSF, 6RSF, GDSS, GD5SV,
GRSS, GR5SV,ARSS,ARSSV, EDSS,
EDSSV
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No E1.15279 R4 C CAC Letter with oroof of contract and oroof
Approved for use outside HVHZ:Yes of in�ection.odf
Impact Resistant: No Fl_15279 R4 C CAC W4 Ustinq Jntertek.odf
Design Pressure: +24 PSF/-24.5 PSF Quality Assurance Contrect Expiration Date
Other.The standard glazing available for this product meets 05/21/2028
the wind load requirements of the buiiding code but DOES Installation Instructions
NOT meet the impact resistant requirement for windborne F1.15z79 R4 II 101711-B-ReviS.pdf
debris regions. Verified By: Intertek Testing Services NA, Inc.
Created by Independent Third Party:
Evaluation Reports
Created by Independent Third Party:
Go to Page � � �3 Page 1/8� �
�
`� 0
Contad Us::2601 Blafr Stone Road.Tallahassee FL 32399 Phone:650-487-1824
The State of Florida is an AA/EEO employer.Coovriaht 2007-2013 State of Florida.:;Privacv Statement::Accessibiliri Statement::Refund Statement
Under Florida law,email addresses are public records.If you do not want your e-mail address released in response to a pu611c-records request,do not send electrontc
mail to this entity.Instead,contact the office by phone or by traditional mail.If you have any questions,please mntact 850.487.1395.'Pursuant to Secdon
455.275(1),Florida Statutes,effective October 1,2012,Iicensees Ilcensed under Chapter 455,F.S.must provide the Departrnent with an email address If they have
one.The emails prov(ded may be used for offlcial mmmunication with the Iicensee.However emall addresses are public record.If you do not wish to supply a
personal address,please provide the Department with an email address which nn be made available to the public To detertnine if you are a Itcensee under Chapter
455,F.S.,please dick her�.
Product Approval Accepts:
�: �'�� €CF.a:� �
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BCIS Home Log In User Registration Hot Topics Submi[Surcharge Stats&Facts Publications FBC Staff BCIS Site Map Links Search
Florlda rn
F(� , ��aj Product Approval
�[ ��-A ��= USER: Public User
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4.��- E �L=w;
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Product Approval Mznu>Product or Aoplfcation Search>Aoplicadon List>Appllcation Detail
� 1. �:
�t'�r:�,€;,'��"s;y��,,;;, : �-; FL# FL153-R5
_����.:!;s�.:__-_--:---�
Application Type Revision
Code Version 2014
Application Status Approved
Comments
Archived
Product Manufacturer Custom W(ndow Systems Inc.
Address/Phone/Email 1900 SW 44th Avenue
Ocala, FL 34474
(352) 368-6922 Ext255
sbrooks@cws.cc
Authorized Signature Stephen Brooks
sbrooks@cws.cc
Technical Representative Erin Koss
Address/Phone/Email 1900 SW 44th Ave.
Ocala, FL 34474
(352) 368-6922 Ext 291
ekoss@cws.cc
Quality Assurance Representative Jay Lathrop
Address/Phone/Email 1900 SW 44th Ave.
Ocala, FL 34474
(352) 368-6922 Ext 291
jlathrop@cws.cc
Category Windows
Subcategory Horizontal Slider
Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed
Florida Professional Engineer
•' Evaluatlon Report- Hardcopy Received
Florida Engineer or Architect Name who developed Lucas A.Turner
the Evaluation Report
Florida License PE-58201
Quality Assurance Entity Keystone Certifications, Inc.
Quality Assurance Contract Expiration Date 07/21/Z020
Validated By Steven M. Urich, PE
' Validation Checklist-Hardcopy Received
Certificate of Independence FL153 RS COI EvalReo CVJS-171E(HS-56001.odf il
Referenced Standard and Year(of Standard) Standard Year
AAMA/W DMA/101/ISZ/A440-05 2005
ASTM E1300-04 2004
Equivalence of Product Standards
Certified By
Sections from the Code
Product Approval Method Method 1 Option D
Date Submitted 04/07/2015
Date Validated 04/08/2015
Date Pending FBC Approval 04/12/2015
Date Approved 06/22/2015
Summa of Products
FL# Model,Number or Name Description
153.1 5600 XX Horizontal Sliding Window 5600 XX Horizontal Sliding Window
Limits of Use Installation Instructions
Approved for use in HVHZ: No FL153 RS II CWS-171E(HS-56001 pdf
� Approved for use outside HVHZ:Yes Verifled By: Lucas A.Turner 58201
Impact Resistant: No Created by Independent Third Party: Yes
, Design Pressure: +35/-35 Evaluation Reports
Other: 5600 Horizontal Sliding Window (previously known as FL153 R5 AE EvalReo CWS-171E(HS-5600)odf
, HS-6200) HS-C35 72x72, Glass conforms to ASTM E1300-04. Created by Independent Third Party: Yes
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� Contad Us::2601 Blair Stone Road.Tallahassee FL 3Z399 phone:850-487-1924
The State of Florfda is an AA/EEO employer,Copvriaht 2007-2013 State of Florida :: Privacv Statement::Accessibilttv Statement:: Refund Statement
Under Florida law,email addresses are public records.If you do not want your e-mail address released fn response to a public-records request,do not send electronic
i mail to thls entlty.Instead,contact the office by phone or by t2ditional mail,If you have any quesdons,please contad 850.487,1395.'Pursuant to Sect(on
455,275(1),Florida Statutes,effective October 1,2012,licensees Iicensed under Chapter 455,F.S,must prov(de the Department with an email address if they have
one.The emails provided may be used for offitlal communication with the Iicensee,However email addresses are public remrd,If you do not wish to supply a
personal address,please provide the Department with an email address which�an be made available to the public.To determine if you are a Iicensee under Chapter
455,F.S„please click here,
Product ApprovalAccepts:
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