HomeMy WebLinkAbout19-21658 i CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 21658
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 21658 Address: 4739 SILVER CIRCLE
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: CHALFONT VILLAS
Est. Value: Parcel Number: 15-26-21-0190-00000-0140
Improv. Cost: 3,628.58 OWNER INFORMATION
Date Issued: 8/27/2019 Name: KAISER, TIFFANY
Total Fees: 90.00 Address: 4739 SILVER CIR
Amount Paid: 90.00 ZEPHYRHILLS, FL 33541
Date Paid: 8/27/2019 Phone: 813-764-1465
Work Desc: REPLACE 5 WINDOWS S/S
CONTRACTORS APPLICATION FEES
LOWE'S HOME CENTERS INC BUILDING FEE 90.00 .
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Ins ections Required
FOOTER 2 D ROUGH PLUMB MISC INSULATION CEILING
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans, Specifications Must Accompany Application.All work shall be performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CO RA R SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
. t.
813-780-0020 City of.Zephyrhills Permit Applicatibn Fax,813=780-0021
Building Department
f� O iaW
Date Received Phone Contact for Permitting
r
Owner's Name I Owner Phone Numbe
r'
Owner's Address 'f 73 .i Gl R. Owner Phone Number Q3-7(oN' l y(,S
Fee Simple.Titleholder Name ^� Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS E,q 73 S �U G• H2 1•I I LOT#
SUBDIVISION F PARCEL 10#. 2 s
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR. ADD/ALT 0 SIGN Q Q DEMOLISH
e INSTALL 8 REPAIR
PROPOSED USE Q SFR CJ COMM OTHER
TYPE OF CONSTRUCTION Q BLOCK tQ FRAME 0 STEEL Q7777--
DESCRIPTION OF WORK Re- .! rNl N-.-r5 5`I Si r z 6 6 in 3
BUILDING SIZE I .i SO FOOTAGE HEIGHT �_ I
�UILDING $ �b 2$■ 5$ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL I AMP SERVICE Q PROGRESyS ENERGY Q W.R.E.C.
ev
=PLUMBING $ L P��
12,
=MECHANICAL r— VALUATION OF MECHANICAL INSTALLATION / �✓
0
GAS ROOFING SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA =YES NO
1 �
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BUILDERI`T_iTIT}TT � O9NY •.L■. •w e 5• �-
5; A-A
SIGNATURE REGISTERED __ FEE CURREP I Y/N EJA
Address c9 t C3 ni'lbgt4 ;r'Z License# cf6'e— I'SC.c3 Lf i 7
2`0'79
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y! N FEE CURREN Y!N
Address license#
PLUMBER COMPANY
SIGNATURE REGISTERED YIN FEECURREK Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE l REGISTERED Y/ N FEE CURRD Y/N
Address -License# r�
OTHER COMPANY
SIGNATURE L REGISTERED Y/ N FEE CURREA Y/N
Address License#.
Iltillliililt11111I1.111111111tt111I11111111111tt1111111. 111111111111
RESIDENTIAL Attach(2)Plot.Plans;(2)sets of Building Plans:(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal date. Required onsile;Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities& 1 dumpster:Site Work Permit for subdivisionsAarge projects
COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W'Permit for new construction.
Minimum ten.(10)working"days after submittal date. Required onsile,Construction Plans,Stormwater Plans wl Silt Fence installed,
-- Sanitary Facilities&.1 dumpster.Site Wod,Porm,*t for n1l new projects.All commercial-requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
'"'PROPERTY SURVEY required for all NEW construction.
Directions:f
Fi11 out application completely.
Owner&Contractor sign back,of application,notarized
If-over$2500,a Notice of Commencement is required. (A/C.upgrades over$7500)
'• Agent(for the contractor)or Power of Attorney(for the avmer)would be someone with notarized fetter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A(C Fences(Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways-needs ROW
t ,
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
which maybe more restrictive than County regulations. The undersigned assurnes responsibility for-compliance with any
applicable deed restrictions. '
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the>owner has hired .a contractor or
contractors to undertake work, they may be required to be licensed in accordande with state and local regulations. If the
contractor is not licensed.as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licer)sirI fequirements may apply for the
intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired .a contractor or contractors,.he.is advised to have the contractor(s) sign
portions of the "contractor Block`of this,application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an.indicatiori`that he.is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/,UTILITIES-IMPACT,AND:RESOURCE RECOVERY•F,EES: The undersigned understands
that Transportation Impact Fees and Recourse.Recovery Fees.may apply to the construction of new buildings, change of
use in existing buildings, or expansion-of existing:buildings, as specified in Pasco County Ordinance.number 89-07 and
90-07, as amended. The undersigned also understands,.that such fees, as may be;due, will be identified at the'time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final power release. If the project does not involve a:certificate of occupancy or
final power release, the fees must be paid,prior to permit issuance, Furthermore, if Pasco County Water/Sewer Impact
fees are-due,they must be paid prior to permit issuance in accordance with=applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended):., if valuation of work is.$2,500.00 or more, I
certify that 1, the applicant, Have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Florida Department of.Agrieuiture and Consumer Affairs, If the applicant is someone
other than the"owner". I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"PWner"prior to cornmencernent,
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and'that all work
will be done in compliance with:all applicable laws regulating construction, zonirig ,and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be.performed to meet standards of all laws,regulating
construction, County and Clty code5,' .zoning regulations, and land development regulations in the jurisdiction.. ! also.
certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions] must.take to be in compliance. Such agencies include but are not°limited to:
- Department of Environrttental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
- Southwest Florida Water Management. District�Wells, Cypress Bayheads, Wetlarid' Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways,
- Department of Health & Rehabilitative Services/Environmental Health Unit-Welisi Wastewater Treatment,
Septic Tanks.
US Environmental Protection Agency-Asbestos abatement,.
Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
Use of fill is not allowed in Flood Zone"V":unless.expressly permitted,
If the fill material Is 'to be used In Flood Zone "A" it is understood that a. drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
- If the fill material is to be used in Flood Zone "A" In connection with a permitted building using stem wall
construction, I certify that fill will be used only to.fill the area within the stem wall.
If fill material is to be used in any area, I certify that use of such, till.will .not adversely.affect adjacent
properties,. If use of fill is found to adversely affect.,adjacent properties, the owner may be cited for violating
the'conditions of the building permit.lssued under the attached permit application,for lots less than one (1)
acre which are.elevated byfll,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in.good faith to inform the.yawner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air .conditioning, gas, or other installations.not specifically included in the application, A
permit issued shall be.construed to be a license to proceed with the work and.not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance.of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is.commenced within six months:of permit issuance, or,if work-authorized by
the permit is suspended or abandoned for a period of six(6)months after the time the work is-commenced. An extension
may be requested, in writing,,from the Building Official for a period not to exceed ninety (90) days.and will demonstrate
justifiable cause for the extension. If work ceases for ninety:(90).consecutive days,the job is considered abandoned.
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.
FLORIDA JURAT(F:$.117,03) ----- -- ___ - —_—_------- _ _-- _ _ _-- --
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to for affirmed)before me this S, b red and sworr { r affimm are me his _y
by 1 tv
Who islare personally known to,me or hasrhdVe produced INho is7are p r onally k n6lmblcr,hkslhave produced
as identification; s identification. "/I,p�
t
Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or slam a ,_,�----
MONICAV'JATSOtd
2° c* MY COMMISSION ff GC 35"67
EXPIRES:September t'1,2021
'+.FGf f��P' Bonded Thnt Notary Public Underwriters
INSTR#201 91 31 647'oR BK 9950 PG 3282 Page 1 of 1
08/05/2019 02:53 PM Rcpt:2078342 Rec:10.00 DS:0.00 IT:0.00
Nikki Alvarez-Sowles,Est;.,Pasco County Clerk&Comptroller,ad Interim
THIS EMT EP $Y•
Name:
Adldlrt>;� _.
NOTICE OF COMMENCEMENT
RNMK Number.
wcd y Rn—tea-- e JAC
The w4etatgtted hereby SIM notice hoot Impow am t aA be wade to daettiFm tees property,sad in scowliance Leith Chapter 713,Fields Sta itm the
WkAWng Infatuation is p-avlded in this Notce of Caren wwwnent.
1. C QF :(t. description of the poWely*W sbsM address If aeaitahte)
2. GENERAL 0"�='n L.-1�-
3 ow-mmATtON QR BE Vm IF Ti4E LEssm CONTRfwTw FMTM ovRRVEnofT:
ruame orris addrrass
Intewestin property.
Fee simple TWe Heider(if adw than ownerlisted abon)Nw>de•L—� t
A '
4. Of; Naha C Fhane FNenbrx —
�AOadrass RMS
S StiRE IY(If"pp
.a m"ttte psryrmrft bend is a"}.Nsros -
Ammett of Ronk
Ei. LHfOE L Name Fhoea Number.
Addrimw
7. Pat= oddd. the Sib•of Fiends O.elgwaiod by Osrmor apmm u3rerm m,oNee ar*liar decdow re any I*surer!as pratrhfed by;;ec9
793.13(IXS)� do stabrtas..
tYmne��.• Fhaeee Number
Addrect
8. In adMiam Q+arer deaiWwiee of
to reeeivo a copy:of rite Bettor's Nottpe as prtsrided>n S'ecftan 7'I3�13('i;@}Fkair#i vxfluiea.Pltane rsrmber.
9. Expir om Data of Notice of Cmm imu mmutt(lire seeptratir Is i year Anm daft efrxai i,g udess a Ofua:d dater Is specl5wo
WAt3AM 7D Or-eWR1 ANY PAYMENTS WADE BY THE 01AI aR AFTER THE EWWATION OF TK NOTM OF caMwEMCEmW AFC
CONSIDEREDIMpf20F'ER FAIiSIENTS tRVEit CHAPTER 7113,PARF t:SECTION 713.134 FLORIDA STATtfTfB,AND CAN RESULT Bi Yom
PAYING TWICE FOR MVW40VEMENTS TO YOUR PROPERTY.A NanCE OF COUNIENCEMENT I* T Be RECORDED AND POSTED ON TM
JOB SITE BEFORE THE FIRST WSPEgi IF YOU 9(fEND T0-OWAIN FWJOCNG.CONSIXT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RE 40MNG YOUR NOTICE OF COMAENCE16031t.
. f} aria' ergotayslarroeyt
st"of )r1ae �4 s;auyat �"4St a
The fonegakV ins&t msmt was aeknowrtadged IN in ma tits / dhgr d J k(h .2p
by + tir o a w•dpraon etsm ft VNIM Is p kmmunm oa me Q OR
atMaa�t _who has produced IdettMcaffm IV type of,lderMfiFrr tdiorr prmducad: bL
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s•`� 3=53284 rwsrsonw�
2023 insur4m
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STATE OF FLORIDA,COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COPY OF THE DOCUMENT
ON FILE OR OF PUBLIC RECORD IN THIS OFFICE F . �.
WITNESS MY HAND AND OFFICIAL EALTHIS � tia rn�t
DAY OF h
LE PTROLL R .- ,? a
B DEPUTY CLERK ,,
•4,i g SYe . R �■ `�' •:Vp i iVt4T- •..7V 13 40
i
i'
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LOwE'5 AUTHOR! tS;REPRESEbiT THE :NU,M9ER: CUS'raMEFt
sTORE NO. STIARET ADDRESS STREET ADDRESS
vc�'.: 14-7 S,1ucr Lry
I` cfry: STATE' . :2tP CI. STATE ZIP
. : rh11S k,:11:5 � 33� r.
TELEPHONE' :< Q
1.13
f TELEPHONE D
DATE' LOwe.s CONTRACTOR.L.ICENSE_NUMBER CASH aAHK` ICC; REo
ct3C9508417 C�FtD ctiiHoc
t 'INSTALLATION STREEr_ADORRSS'• rn1': STA VP
�ti'.t�rc4. t,r,l!`?i»:S tall:::'_ . :° r✓►t�rs. r �L G.11 `. <:x1%:%>i . �!^ ..I r . : -�H>^ fti ar:r5 11 will
=:' wit All ' .
J
NOTICE T. .CUSTOMER=PRICE GALCUI:ATIGIN3:In arrier.to';properly:paitotm.the:installation of.certain.Goods,the Cor tract Price may Include more
Goods thap actualty'tvilt;be•.Installets"Hast#d ora.sihe trieasiiiad square 0a6tage'of the Proja�t tires::tls;a.r utt #tte parties.:a'ree`that>ttts lt4nip sun}Brice
Mated to th(s:Gacitraed is:.eatcutafttd upon'tioth the v..sii(s of dstimated Goods:required io:fulhq the•Contract:(inciudtng waste.); hiofi may exceed-the actual
square footage of the Project'ArQa,and tha labor Which.may be es,Nmated;tiesed on tfie amount;of:Goods fequ}red to fuinilrt a Contract:(including..vtaste),..
QY:signing this_contras lialow .G#tstomer scknowtedges rai eiptof.ttils notice:and.agiees..And understands that th Rdce3iigiud�s.thsse:costs Which may '
not-be refunded Dries the in'statlatton.Services.are`peifartnad.
NOTICE TO CUSTOMER,,:Federal,law,requlres1owe's'to pr&I :you:wttti'tha. '
patnphtet Renovate Rlght.'By signIng this;Contract,-Cusitcmer acknowla`dgas
having received woopy of this am htet tiefore vY46rk'be`an'informin Customer Ct7litract Total
p . R. 8 9.: ��Zg.,
of the potential-risk of the load hazard exposure from renovation activity to be applicable'taxes included
performed In Customer's:dwelling unit.
NOTE,. If`rotted wood.1s.discovered.during1ristallation additionat'char$es.will apply.You will ,e givenla quote-and a:cha:lge order "
must:be.compir3ted'and si tuBd;by.the'zustanier:for any,additional ttharges: customer•mustfinitlal.
'Any work or tfis edal'.noi specifi is nof:tnduded in:thls contract,Any ahanges.or additlons will be at'an additional charge for:tha ni aerial An isbor.
NOTICE"TO:OM :- ACCORDING`TI};.FL. RIDAIS-:CQNSTRUCTION',;LIEN:;,LAW`{{SECTION T'OO-1413.37,: :LORID;1_
STATUTES,THOSE:WHO WORR'bN YOUR P OPERTY -R;PROVIDE:MATERIALS AIVD SERVi ES AND ARE.NO. PAID IN
FULL HAV A'RiGHT TO:ENFORCS TH15 R:C IM_.FOR.I'NYMENT;AGAINST:YOU =PRQPERT:Y."7:,tS.GLAIM;IS�(N: . N AS.A-
Ct}NSTRUCTION C.IEN.. IF` tQllR CONTRACTOR QR :>>A.:°SUBCONTRACTOR f.A1LS.'":TO AY. S.UBGONT ,TORS . -
SUB-SUBCQNTRACi`ORS; .OR MATERIAL SUPPLIERS; THOSE PEOPLE WH0 ARE.4WED MO EY MAY LOOK' O YOUR:.
PROPERTY FOR:PAYMENT,;EVEN IF YOII HAVE Ai:READY PAID YOUR:CONTRACTOR IN FULL.. F YOU FAIL TO-P Y YOUR :
CCINTRADTOR;YOUR CONTRACTOR MAY ALSO.HAVE ALIEN ON YOUR PROPERTY:THIS M IF ALIEN iS FIL D YOUR .
PROPERTY.000LD BE SOLD AGAINST YOUk WILL TO PAY FOR.LABOR,.MATERIALS,OR'OTI IER:SERV.ICES�TH T YOUR
CONTRACTOR OR:A SUBCaNTRACT{3R.N[AYiHAVE FAILED TO PA1....TO PROTECT YOURSELFI.YO.0 SHOULD$• PULATE -
!N THIS'CONTRACT:'PHAT;BEFOREANY;PAYMENT;IS iNADE, T UR:CONTRACTOR IS REQUIRE 11TO PROVIDE Y WITH A.
WRITTEN RELEASE.OF.liEN FROM ANY:PER54N OR;COMPANY:THAT':.H AS:_PROVIDE D fiO .'; N{}TIGE TO WISER.11
FLORiDA'.SCONSTRUCTIt7NLIEH LAW IS COhPLEX AND iT iS RECOMMENDED THATYOU.GONSULTAN ATTd)RNEY,
PHOTO RECIAS t CtistQm�r,giants.:to;Lctyre'$`and;;l�ive'sistnployees'slid itidependarit 000tractots the,dobt to tak$'photp�taptis of'#lie-Prerr�ises wfiei s'
Instaliahon Services Wllt#ia.performad brill all workpecfontted at the Prerelsas retated`tu this:Contraat,and irrevocably grants-to tawe's airtight,title and
interest in and to the photographs'for use in all malt is andimtslia,worldwide,to perpetuity:Customei abih6dzes't owa's to opyiright,use and publish the
photographs in"pdnt.ar%d/or electro*aily,and agieei,that Lowlt's may use such photographs for.'any lawful purpose';Including!but.hot:limited to;rnatketing,
advertising;publicity;Illustiatlon,training'and Wets content.sy initlaling here,_Customer agrees.to the foregoing. it ustotmerto initial.to thb'1001.
Work i$$''to'commence upon reasonable availaLillity of,Gontracton and/or any special or r or customer made Gaad s}which is anticipated to be
i,i r.th rri Q.. c+@ t1H itt'date Estimated..com tenon-date is_W !911+ w►vA*lw,i
[ 1 P [fll In datel. ,
Said estimated substantial mpietion date is-noi of the'essence::A statement of any contingencies that Would materially c�ange.seld estimated substantial
completion4ate I&aS:foIIOWs:
�{if a` inset#yF s��tem6nt*ttti i t
•n
This Contr;ct; rovi�lea lhaNatl ctatm&'li�rl ltstorMe[ot'[c�WB's:Y1l1I;tSe resQlYed.by BINDIN' ARSITRATipIi.:t3.ustome aiiil Ltiwe's•GIVG UPiTHE.RiGiiT
TO 0-0 TO COURT to st►fores title Copt act(EXCEPT foo matters:thi t fnay,be taken to SM'AL diA1MS COURT);Lo 'e and tustomoe rights Wlil.be
dgterminedi by a NEUTRAL» ARBI'FRATQFt 4rid-NOT'a•:judge or Jury, l~pwe's'and Cur3(omei $re entitled.-to a F R FIEARING. Hut tha arbitration
prbcedures,are Stii.PhEWAND MGIRE UUffEQ THAN i L.EB APPL.Id.kt k COURT.,., tiattir tiecisions'are.as a orceahle.as.a»y catilt order:and
Pale l of 3 :..: ,
,f Pella
Reliabiit O
Other
PSIE Pricing Worksheet - Windows.
{CompieCe an".0 to installer)
Customer: ; a .A`�fie' �1Ry1 i, r1 stares IgS�I
Phone(hom6..�01t-).y- l Phone(cell)': .. Pliarre(other):
Install Address:. .4 7 3 9 S)%-_Me- i.i wr T p4�yhy t15, F:L 3 3 S-Y/-
Directions:
1.. Draw.the wa(Is.wl ere windows.are beingsepla.ced and label them front, back, L side or R side
(as seen:from`�thestre�t) ;:.: ,;_
2.. -Drawth.e windows:that:are:b�iig'replaced:on each wall drawing.
3. Place°a'ca"pitpI:detter b:eside.`oach,window in,,the'drawing., Windows with the same dimensions
will.have-the same;:Ietter; Complete.=the;ihformation=can the next page.using'-the corresponding
Letter.
Front .
Left
LA
Right Tone : �815Ll
L / a3,7
Page 1 of 3
Product Approval Menu>Product or Application Search>Application List>Application Detail
/
FL# FL16603-113
Application Type Affirmation
Code Version 2017
Application Status Approved
Comments
Archived ,r-� •
ALL
Product Manufacturer Pella Corporation NA77o O�nes �b' 07fI/fF�y�/�V
Address/Phone/Email l76
102 Main
/��� P0. N® NeCy01R/C ��c
Pella,IIA Oft D A/LlyG
(641)621-6096 AjAA1G, PZEpLSpellaproductapproval@pella.com Authorized Signature Beth Phelps
phelpsba@pella.com
Technical Representative TROY FARR
Address/Phone/Email 18600 NE WILKES ROAD
PORTLAND,OR 97230
(503)405-9176 RF��
tbfarr@pella.com
p/N®FzATE�UG q �+ ,
Quality Assurance Representative Pat Bortscheller w ep / q�
Address/Phone/Email 102 Main Street "W��A17Y���� ' 1
Pella,IA 50219
(641)621-1000
PJBortscheller@pella.com
Category Windows
Subcategory Single Hung
Compliance Method Certification Mark or Listing
Certification Agency Window and Door Manufacturer Association
Validated By Terrence E.Lunn,PE
El Validation Checklist-Hardcopy Received
Referenced Standard and Year(of Standard) Standard Year
AAMA/WDMA/CSA 101/I.S.2/A440-08 2008
AAMA/WDMA/CSA 101/I.S.2/A440-11 2011
Equivalence of Product Standards
Certified By
-I affirm that there are no changes in the new Florida Building Code which affect my
product(s)and my product(s)are in compliance with the new Florida Building Code.
Documentation from approved Evaluation or Validation Entity OYes ONo UN/A
Product Approval Method Method 1 Option A
Date Submitted 12/06/2017
Date Validated 12/06/2017
Date Pending FBC Approval
Date Approved 12/07/2017
http://www.floridabuilding.org/pr/pi_app_dtl.aspx?param=wGEVXQwtDgsHepng4%2fS6... 7/29/2019
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�. 4anIu�n
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner:
Date Received:
Site: 73 9 ��-
Permit Type: 6-
Approved w/no comments:❑ Approved w/the below comments: Denied w/the below comments: ❑
This comment sheet shall be kept with the permit and/or plans.
AUGlle�p� 62,019 27119
Kalv' �vit —Plans Examiner Date Contrac and/or Homeowner
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