HomeMy WebLinkAbout20-22365 CITY OF ZEPHYRHILLS
5335=,STH STREET
(813)780-0020 223 5
BUILDING PERMIT
PERMIT FINKOKMAITWONZt`� 00311MMMONW.1-1-07N INN
Permit Number: 22365 Address: 39602 AMETHYST WAY
Permit Type: ACCESSORY BLDG. ZEPHYRHILLS, FL.
Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book:
Proposed Use: MOBILE HOME PARK Lot(s): Block: Section:
Square Feet: Subdivision: EMERALD POINTE
Est.Value: Parcel Number: 24-26-21-0020-00000-OOCO
Improv. Cost., 1,499.00 NrlW,. R--NrA-—100'Nmfflfflgw��
Date Issued: 1/24/2020 Name: EMERALD POINTE PROPERTY HOA
Total Fees: 75.00 Address: 39602 AMETHYST WAY
Amount Paid: 75.00 ZEPHYRHILLS, FL. 33540
Date Paid: 1/24/2020 Phone: 914-475-1706
Work Dese: INSTALLATION 10 X 12 GAZEBO W/SLAB
— - -- I a -, , 'W'n , W-C -'IF-MMU I"�,,I I V w-�2�r- 772 9 a N I FEW0,P� I I JA-—TT 10 N 'I-
�2- ZVVR C-7-ONTRA, ORLS TW7�W�7,ot
OWNER BUILDING FEE 75.00
7
ohR*40W-Ins pe
FRAMF;
SHEATHING
FINAL
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.
COT TOR SIGNATURE PERMIT OFFIVR
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyr-hills Permit Application Fax-413-780-0021
' Building Department-
Date Received .Phone-Contactfor Permitting:
j 7 —/7D
'Owner's.Name ' 1—r er, f tlr Lbw -so c . '•Owner-Phone Number. .91. la
.owner's Address �3`l o wf=. ,. Owner,Phone:Number; s�J''7/J'-72Z2�
Owner Phone,Number.
r
sas ADDRess 3-5 .02 (•v�< �,/ 'rL 33�" LOT#
SU$DIVISION' )ev PARCEL ID#.
(OBTAINE[1 FROM'PROPERTY TAX NOTICE)._..
WORK PROPOSED NEW CONSTR ADD/ALT ��. SIGN [�. [ DEMOLISH
® INSTALL• 8 REPAIR
PROPOSED USE' 0` •SFR Q COMM OTHER
TYPE OF CONSTRUCTION 0 BLOCK ® FRAM STEEL 0.
DESCRIPTION.OF WORK !"+air W r r e G
I ,
BUILDING SIZE .._./f� x 1-7 SOFOOTAGE "� 2D HEIGNT.` lU 3 •
=BUILDING' . $ VALUATION"OFTOTALCONSTRUCTiON �,.�
l .00 •
=ELECTRICAL rr$ AMP'SERVICE N 4 Q DUKE ENERGY " [� W.R.E:C.
=PL'UMBING $
.. MECHANICAL $ VALUATION-OF MECHANICAL]NSTALLATION
=GAS Q ROOFING `SPECIALTY u OTHER
FINISHED FLOOR ELEVATIONS" FLOOD-ZONE AREA =YES NO
$C @ kC rr f7 rcJaos V
BUILDER ® COMPANY T S a ��t c to �, s r
SIGNATURE REGISTERED• Y 1 N J FEE CURREh Y/
is � 3 e 0
Address to/ 7 �c Y' 3 s' ,Z License'#" Oa4i3Z 009,3449
ELECTRICIAN. COMPANY
SIGNATURE f A REGISTERED "Y/'N';' FEE GU(R`REN�Y 7 N
Address License# l
PLUMBER COMPANY
SIGNATURE.".. N REGISTERED Y/i•N,J `FEE' U(RREEK
Address License:#'
t
MECHANICAL COMPANY
A � .NSIGNATURE _ FEE.CURREn Y/"N^:
Address License#;F
OTHER' COMPANY oYcr P ti%y S SOGi �7
SIGNATURE f ,P REGISTERED I 'YIN "I FEE CURREN LY/N
Address
RESIDENTIAL Attacti(2)..Plot Plaris;,;(2)Esets„of B.ullifih- Plans;(1),,set{ofih0gy.Forrns;•ft=O=W F�ermit�for new'construction;
Minimum"ten(10)`worki'ng"days of e'r-subarilttal date: Required onsite,Construction Plans,Stormwater Plans w/Slit Fence installed,
Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsfiarge projects
_ COMMERCIAL__ Attach(2)complete.sets of Building Plans•ptus a Life�Safety Page;(1)serof Energy:Fonns.R=CkW'Pertnit'ioc:new constructon:
Minimum1en(10),'w-oikiitg,tlays,of(er.submittal:date.'-Required onsite,Construction Plans,Storni"ierinans w/Siit Fence installed,
Sanitary-Facilities&1 dumpster.Site Work-Pernitt forall new-projects.All commercial.requirements'must-meet.compliance
SiGN PERMIT Attach(2),sets,6f Eholneered Plans.
•""'PROPERTY'SURVEY required-for all NEW construction..
Directions:
Fill out appiication.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 owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING ` (copy ofcontract required)
Reroofs If shingles Sewers Service Upgrades'`:A/C 'Fences(Plot/Survey/Footage)
Driveways-Not over Counter if on public roaOwe ..needs;ROW }
,.Ou:: .
NOTICE OF DEED RESTRICTIONS: The undersigned understands that.this permit maybe subject to"deed"restrictions"
which may be more restrictive than County regulations. The undersigned.assumes responsibility-for-compliance with any
applicable-deed restrictions.
UNLICENSED CONTRACTORS AND.CONTR:ACTOR.RESPONSIBILITIES..,-lf:the owner-'has,-hired4a .contractor or
cor`itractorsto undertakis4work;tF' ey:may ba required to be`licensed-,1 accordance.with state and local regulations: If.-the
contractor.is.not..licensed as required%by law;both the.owner.and:coritractor may be,-cited.for a-misdemeanor violation
under'state.1aw. If the owner or intended.contractor are uncertain-as. what licensing-requirements.may„°apply:for the
intended.:work, they,are advised4o conttictthe Pasco County;Bull~ding.inspection-,'Division--,Licensing",Section at 727-847-
80t)9:: Furthermore,. if tfie`owner has hired a contractor or contractors; he is advised to 'have.the--contractors) 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 maybe an indication that he•is not properlylicensed,and is not-entitledto permitting privileges in Pasco
County.
--TRANS,PORTATION-iMP..ACT/UTILITIES IMPACT;°AND:.RESOURCE,RECOVERY FEES: 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 df existing`buildingsF as specifieFdl1i Pasco Co-nty.Oediriance:number 89-07•and
90-07,-as amended. The.undersigned also understands,.,:that--such fees, as may be due, will.be ideritified.atahe time of
permitting, .itis::further-understood,that..Transportatiori Impact-Fees and Resource.Recovery Fees must-be paid prior to
receiving'a "certificate:;of,occupancy" or Wrial-power releaser f,the:projeet:.,does:•not-involve-at certificate of.,occupancyor
final..power:refease, the.fees must-be paid prior to-permit issuari'ce.. Furthermore;'if'Pasco County Water/Sewer Impact
fees.-.are due;they m;ustbe paid;,prior.-:to permit.issuance.:in accordance with applicable:Pasco.County ordinances:
CONSTRUCTION-LIEN LAW hap 713; Fiorida'Statutes; is:'amen`ded): If valuationof work :$2;5,00:00 or more,,l
certify that !; the applicant, have'been provided with°a copy~of the="Florida,.Construe#ion. Lien Lav—Homeowhir's
Protection Guide" prepared-by the'Florida Department'of-Agriculture and'Consumer-Affairs. If the applicant.is�someone
other than.the"owner", 1-ceirtify that.1.have obtained a copy of the above describedAocumentand promise in good faith to
deliver.it to the"owner"'prior:to commencement. '
CONTRACTOR'S/O.WNER'S-AFFiDAVIT:-a I1 certifyL that.all..the„informatibri1h.this.application.is,accurate-,and.,that:all.work
will bar;done.in:.cornpliAn66�.with'4all:<:applicable':lawss:regulating=construction;-zoning.and•land-.development. Application is
hereby made to.obtain:a permit to do=work and..installatiom:as:windicated: 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,Cty. odes,,.zoning regulations, andoland=:development regulations:•in the jurisdiction:• I also
certi ..hat 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 i must.take to.be in compliance. Such agencies1riclude but are not'limited,to:
Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally. Sensitive
Lands,W'aterMastewater Treatment.;
Southwest Florida Water.,. Management- District=W611% 'Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Engineers-Seawalls;:Docks,-Navigable:Waterways.
-Department of'Health & Rehabilitative Services/Envir,.onmentalHealth Unit-Wells,..Wastewater Treatment;
Septic Tanks.
- Ferleral'Ar?iatior",Ali
thacit tion,A eye Asbestos abatement:.. ,US Environmental Protec g y
e .:. y-Run'wa's:
I understand fFiatahe foibwing restrictions apply to the use,of fill
-.:Use-of:fill is:not�allowed in Flood:Zone'tW unless.expressly permitted.
If--.the':#ilf::materio 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
Iicensed:by:the State of Florida.
If the fill.material is to be used in Flood Zone.:"X',in,-•connectionwith a permitted building using stem:wall
construction; i certify-that fill�will be.used only twlt th'warea within the stem.wall.
If fill material-.is to, be used in any,-area, I certify that-use•-of such-fill .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, perrnitissued-under the attached permit'application'for lots less than one (4)
acre which are elevated`by fill,.an engineered.drainage plan is required.
If I-am the AGENT-FOR-,THE-OWNER;I promise..:in good.faith to.inform Ithe owner.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 woek.aiid not as authority to violate;.cancel, alter,.or
set aside any.provisions of the tec•hnical;codes; nor:shall issuance.of-a.permit prevent the Building.Offidial from thereafter"
-requiring a correction.of errorsin plans,=construction or violationsof any cedes: •EVery-permit issued:shall--become:invalid
unless the work autharized'by such•,permit is commenced within six months of permit issuance, or if.work'authorized by
the permit:is.suspendedFor;abanddned-fora period=of.six(6)months after-the,,-time the.work is commenced. 'An extension
maybe requested, in writing; from#Fie Building Official for ai,period not Ito exceed ninety(90) days and wili'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.CO.MMENCE MEN?•MAY RESULT,,IN,YOUR•
PAYING;TWICE:FOR iMPROVEMENTS TO YOUR:PROPERTY. IF:YO.U:INTEND:TO":OBTAIK`FllNAN;GING CONSULT,
WITKYOUR'-I ENOIER 0,R=Afi1+dlT't'ORNEY.'BEFORE RECORDING:YOUR`Nt)TtCE OF COmmkNCEt4l1ENT
FLORIDA JURAT(F.S..Y . . )
OWNER OFF AGENT coOTR,Av^^TOR • `� f
Subscribed and swo .to( affirmed) efor me'this Subsc=i .and sworn to or affirmed:be ore a this
1�c,3o�yt9 by
Who'i6{aje p p�,aIly known to me or has ave produced• !s/are
e rponally known to me.or hasthdve produced
as identification. as identification:
Notary Public Notary Public
Commiss on N . _ Commission No.
Name of Notary typed,printed orstamp d Name of Notary typed,printed or stamped
CARLOS MALDONADO *�'44i•. CARLOS MALDONADO
,.....,�
Commission#GG$46275 Commission#GG 346275
Expires June 16,2023 =;,. a`=Expires June 18,2023
'•.;;oa•P •''•fg?,R�� Bonded Thru Troy Fain Insurance 800.385-7019
t1t.• Bonded Thru Troy Fain insurance 800•385.7o19
i
• • •• • •
A
Lai
B t t
0 1 S C 0 V E R Y • rrr r r • r. rrr S •� •
�r
a � � 1 4"'fj(� � • �—^+�— r , }� 3'rye. ,8
7
Api Io
Avg
1'
� •.J;t .,. `e.ems ..� t� .� s � �»' i
+ .f �} . •� t Via.� �.� +.�"_: r _. - ?�'�a+'>�.?+:.+r.�_ ._......".7,,'.=_• , `
scse, „
17
s -
Ah
Search our products Nftd P.1W 0
Order Here
Q'It Gor V ay Horne&Garden Company Support Blog Create account
E3[d,profess
20%Off Site Wide Use Code:BLACKFRIDAY20
Add to cart
Details
Item#1806528com
Enhance your home and define your outdoor living space with the new Brookdale Gazebo.Our newest outdoor structure is like a room without wafl�,rand
4
the roof makes all the difference by protecting you from natures elements.Worried about lack of light,no worries.Thellrookdale is equipped with outlets
to bring electric capabilities to your newest outdoor addition.
Features
• Assembly instructions available through GILT app
• Snow load tested and certified for up to 50lbs per square foot(equivalent to 30 inches of snow)
• Durable and dent resistant steel roof
• Strengthening sleek gusset brackets
• Elegant corbel design
• Sturtly,,contemporary cedar construction
o Lumber pre-cut,pre-drilled,pre-stained
• Easy to assemble with complete do-it-yourself kit
• Durable Steel Foot to prevent decay from ground moisture
• Concrete Anchors that prevent movement
hd `e
Total Qualify Assured.
Test Report Number: SZHH01291781
Applicant: LEISURE TIME PRODUCTS Date: Sep 27,2018
LEISURE TIME PRODUCTS 3305 AIRPORT
DRIVE PITTSBURG,KS 66762
Attn: DAN WHYMAN
Sample Description:
Evalual3on of Test Result
Lab Report No. SZHH01291781,
Issue Date Sep 27,2018.
Receive Date Sep 11,2018.
Itern Description 12 x 10 Brookdale Pavilion.
Overall Rating Pass.
Rating(Ctimpliance) Pass.
Rating(Performance) Pass.
Client : Sam"s USA. Country of Origin China.
Buyer Jon Odell. Supplier Name Leisure Time
Products.
Department 12. Host Vendor Number 467258.
Brand Backyard Private Label: Y. Supplier lD 467.258620.
Discovery.
Order Type Domestic. GCC/CPC: N. Factory Name Leisure Time
Products.
Sourcing Office NA. Factory Number 00000000.
Vendor'Stock Number 1806528. Children's Product No.
Test Type Production. Supplier.Age+Grade Not Specified.
Laboratory Age Grade Adult
Class Type NA. Date Code NA
***Please see the following pages for additional Item information*"*
To be continued
ALL WORK SHALL COMPLY WITH PREVAILING
CODES FLORIDA BUILDING CODE,
NATIONAL ELi CTRIC CODE, �-
Authorized by: AND THE CITY OF ZEPHYRHILLS
For Intertek Testing Services ORDINANCES* VIE'F Z5,P
Shenzhen Ltd. a M1N1yR
sus p�N
Ben N.L. Lin
General Manager
Page 1 of 25
Intertek Testing Services Shenzhen Ltd. West Side of 11F and 3,4,61E of B,idg.1,1-5/F of Bldg. Tel:+86755 26020111 y;
3,Yuanzheng Science and Technology industrial Fax+86755 35377118%9 r
,)
Park,No.4012,Wuhe Ave.North,Bentian Street, wwwAntertek.66mm
Longgang District,Shenzhen www.intertek.com
-tfffl 1-ao 3.4•5 r.A 100 t4t-Efa 3-!jjWMft
1.5 P=
n t �L -e rt. --,ek
Total Quift.Assured.
Test Report Number: SZHH01291781
Additional Sample Information
Testing History: None.
Supplier Contact Information
Name Leisure Time Products.
DanWhyman.
Address Leisure Time Products 3305 Airport Drive Pittsburg,KS 66762.
City,State.Z71P NA. Kansas State. NA.
Postcode NA.
Country Us.
E-Mail dwhyman@backyarddiscovery.com.
Phone 620-232-2400.
Size(s): PO Number(s):
NA NA.
P,olor(s):
NA
UPC Code(s):
0075211380652.
Item Number(s):
NA.
To be continued
Authorized by:
For Intertek Testing Services
Shenzhen Ltd.
Ben N.L. Lin
General Manager
Page 2 of 25
Interte.k Testing Services Shenzhen Ltd. West Side of 1 IF and 3,4,5/F of Bldg.1,1-5/F of Bldg. Tel:+86756 26020111
3,Yuanzh+eng Science and Technology Industrial Fax:+86755 3537111819 .0
Park No.4012,Wuhe Ave.+North,Bantian Street, jbMwintertek.comcri
Longgang District,Shenzhen wwAr.intertek.dom
WiMA 4012 lafLtE L
jNkEE 1 43-M 3.4•5 R-A 1 f&ffia9t-P=fQ 3 45;RMJT
1-5)-=
n- te rt�l
TOW Qui*Aswred.
Test Report Number: SZHH01291781
Additional Information:
Sealed PO Sealed Stock Supplier claimed Observed Produced Sealing label Sealing label
Number No. PO quantity Quantity for seat serial No.on serial No.on
(pcs) sample(pcs) carton product
NA. NA. NA. NA, NA. NA:
CPC(Children's Product Certication) Yes X No
GCC(General.Certificate of Conformity)RequiredM
Yes X No
Material Change(For Production Only) Yes X No
Meet buyer Testing Requirement Yes No
Import of Record Leisure rime Products.
Individual Vendor Stock 1806628.
Number
Item Type New,ltem.
Factory Address Leisure Time Products Sample Quantity 1 Set.
3366 Airport Drive
Pittsburg,KS 66762.
Icix Request ID Previous Report NA.
No(For Retest)
Test Required A I Product-US,Gazebo,Pavilion-US,CA Prop 65.
Tests Conducted:
As requested by the applicant,for details refer to attached page(s)
To be continued
Authorized by:
For intertek Testing Services
Shenzhen Ltd.
Ben N.L. Lin
Generat Manager
f!�®1100�I��Im®�181
Page 3 of 25
Intertek Testing Services Shenzhen Ltd. West Side of 1/F and 3,4,5/F of Bldg.1,1-5/F of Bldg. Tel:+86755 26020111
f(I #t 1I7Rt6t3t � 3,Yuanzheng Science and Technology Industrial Fax:+86755 3537711819
Park,No.4012,Wuhe Ave.North,Bantian Street, m ww intertek.com.cn
Longgang District;Shenzhen www intertek.com
ilr�i7J;f �t�l�f]i Vtalt4012-!jk7E& i k
J%kfffl { q1 p=fn3 f
1-5 P=
on ertek
Tofal Qualityy Assured.
Test Report Number: SZHH01291181
Remark:
1 Following document was submitted for verification.Actual test was not conducted.
- Lead Content: Document No.SZHH01265936 issued by Intertek dated Jul 10,2018
- CA Prop65:Document No.SZHH01265936 issued by Intertek dated Jul 10,2018
- C,O.C.of toxic in packaging dated Jul 04,2018.
2 According to,the supplier daim the ppower is same as self-report and buyer approve it don't need repeat the
test,please find the result in SZHH01265936.
3 The samples were received at the laboratory with no label, or number. The samples were shipped to the
lab by the supplier.
Authorized by:
For Intertek Testing,Services
Shenzhen Ltd.
f :
Ben N.L. Lin
General Manager
' ima�Anmm®mm�®®
Page 4 of 25
Intertek Testing Services Shenzhen Ltd. West Side of 11F and 3,4,51E of Bldg.1,1-61F of Bldg. Tel:+86755 26020111 Q&T4jtwoo
3,Yuanzheng Science acid Technology Industrial Fax:+86755 3537711819
Park,No.4012,WuheAw North,Bantian Street, www.intertek.coLonggang District,Shenzheh wwwintertek.coth
]11MAW0R1flOMH j1;4012-'7GS
!Ike 1�6ma 3•4.5 IZA I V2*ifitMfQ 3
1-5 R-
Ln'tertOk
Tote)Quali{y,Assured.
Test Report Number: SZHH01291781
Tests Conducted
Walmart Test Protocol for All Products-US dated Aug.07,2018
MEVaIIWtI6n I�C�itatja Criteria iiiiiiiiiiiR_es__!tom
Soo 0 1 Applies.to all products
S.tandards
Wot-Al5plipable
Re uiatons
N6tA Wicable
*California CA Prop 65 The sample should be reviewed againsfthe See protocol
Proposition 65,as requirements of California Proposition-65 to CA prop 65
applicable determine If additional testing or labeling is required.
For protocols(WM-XXXX(US))not posted on Retail
This is.an added link ONLY;note the latest version of SU001 has to
ITS clause be used in which only Walmart requirements are
found. For RL protocols,specific CA Prop 65
requirements have already been included.
In lieu of testing,a passing test report may be
submitted.See Document Acceptance list for
document parameters.
Physical and Mechanical Requirements
Age Grading Walmart USA All products shall be tested according to either the Labelled age
Product Safety appropriate age grade or the labeled age grade if it grade:
and Compliance is more strin9ent.In the event the sample is not age Not specified
Standard based labeled,the test lab shall determine the appropriate Appropriate age
on CPSC Age age grade and test accordingly. grade:
Determination Adult
Guidelines and
ASTM F963 This is a
Annex Al Age general purpose
Grading item.
Guidelines
iumrn�anmm�®mmm®
Page 5 of 25
Intertek Testing Services.Shenzhen Ltd. West Side of 1/F and 3,4,5/F of Bldg.1,1-5/F of Bldg. Tel:+86755.26020111 0 =_
3,Yuanzheng Science and Technology Industrial Fax+86755 3537711819
Park,No.4012,Wuhe Ave.North,Bantian Street, %ryww.intertek.com.cn
w
Longgang District,Shenzhen ww.intertek.coni "
WWI-$AfNd 4012-5�7Gtff T-
OfM1�,L 3-4•5RPt1JjFffM*)H3M3� f
1-5�
Lntertok
Total Quality Assured.
Test Report Number. SZHH01291781
Tests Conducted
illillilllIETluia on'111111MGltataoSi>♦l� Carta �i2ft�
Packaging.and.l ab lip
'Claim Verification Federal Trade Product shall"meet all label claims,both factual and P
Commission objective.Any claim hot addressed by the.Product (See appendix)
(FTC)and Various Safety and Compliance Team should be managed
State Laws by the Walmart Technical and Quality teams.Testing
Shall be performed to substantiate'label claims.
In lieu of testing,a passing test report may be
submitted.See Document Acceptance list for
document parameters.
Walmart's Comments:
For 6PA free claims,the maximum allowed limit is 2
m.
Country of Origin 19 USC 1304 Every article imported into,the United States'shall be P
Marking marked in a way to indicate to the ultimate purchaser
in the United States the English name of'the country
of origin of the article.The article shall be marked in
a.conspicuous place as legibly,indelibly,and
permanently as the nature of the article(or
container)will permit.
..4*..�w..,F...*..,..,HYk.1,t«.*..,F*,...**.,t.*#M��**#F.*..,k...,MMk*.,t*MA,.*..;N,.*.....,..«,►*...,MM..f..,k.�...*,.,.*#r/r�...,Ht*11.,t..«k«...****,k1F«
i��aunmm�m�m�®
Page 6 of 25
Intertek Testing Services.Shenzhen Ltd. West Side of OF and 3,4,51E of Bldg.1,1-51F of Bldg. Tel:+86755 26020111
3,Yuanzheng Science and Technology industrial Fax+86755 3637711819 00
Park,No.4012,Wuhe Ave.North,Bantian Street, wwwintertek.eorg,cn
Longgang District,Shenzhen =111ntertek.com
IMI 40124 7rcjj RM
01M14'W 3-4-5 F=P 1 W{W-*Pf[13 Ps7 f
1-5)-=
terter-ok
Total Quaiity Assured.
Test Report Number: SZHH01291781
Tests Conducted
�Evallt�a_'#ton �Citation� C�_tea I�R�sulY�
Declaration of Walmart USA Packaging'and Labeling content must meet the P
Identity, Product Safety requirements outlined below. Dedaration of Identity
Responsibility,and and Compliance —The identity of the product shall appear on the
Quantity#or Standard based package label and shall not be misleading or
Packaged Products on Various State deceptive.
{Not Regulated by Laws The identity shall be:
FPL:A) ttY
EXCEPT Size, •the name specified in, or required by,any federal
Placement and or state regulation,or
Readability of -the common or usual name,or
Labeling •the generic name or other appropriate description,
induding a statement of function.
NOTE:if a product is clearly recognizable, a
declaration of ldentity is not required(i.e.open stock
dinnerware}.
NOTE:Brand names/logos may appear on product
as part of the identity.
Declaration of Responsibility-The name and
location(street address,city,state and zip code)of
the manufacturer, packer,or distributor shall appear
on the package if that package is sold,kept,offered,
or exposed for sale at a location other than the
premises where it was,packed.
•.The street address and zip code may be omitted if
the company is located in a readily accessible,
widely,published,.and publicly available resource
including but h6t.l'imited to a printed directory,
electronic database or website.
Declaration of Quantity-A declaration of net quantity
shall be accurate and shall appear on the,package
unless the item.is measured by count and contains
six or fewer pieces that are,clearly visible.
•Quantity:statements should include US customary
units and Sl metric units when applicable
NOTE: Where there is a firmly established general
usage and trade custom with respect to the terms
used'in expressing a declaration of quantity such
declaration of quantity may be expressed in
traditional terms,example 15 in steering wheel
cover.
NOTE: Dimensions are not required for irregularly
shaped products unless dimensions are commonly
used for the item to make a buying decision,
Page 7 of 25
Intertek Testing Services Shenzhen Ltd. West Side of 1/F and 3,4,5/F of Bldg.1,1-5/F of Bldg. Tel:+86755 26020111
3,Yuanzheng Science and Technology Industrial Fax:+86755 35377118%9
Park,No.4012,Wuhe Ave.North,Bantian Street, wwwIntertek.com.cn an -
4012 Longgang District,Shenzhen wwrW.lntertekxom a7GK Z
i�1 fit&3.4`5 R'&1 QMM*G-fu 3 lif
1-5 RZ
LntertOk
Total Quality Assumed.
t
Test Report Number: SZHH01291781
Tests Conducted
1tE1Eti��1�Ctatio,nAMG"t$Ira �Result�
Declaration of Walmart USA Packaging and.Labeling siie;placement and P
Identity, Product Safety readability must meet the requirements outlined
Responsibility,and and Compliance below related to the Declaration of Identity,
Quantity for Standard based Declaration of Responsibility and Declaration of
Packaged
ed Products on Various State Quantity. All
PLRegulated by Laws infemiation is required to appear on a consumer
PLA)
Size;Placement package and shall be prominently displayed in the
and Readability of English language. Prominently displayed shall be
Labeling ONLY defined as follows:
-Type size large enough to be read;
..Good contrast in color between font and
background;
-Conspicuous and legible type without obscuring
design or vignettes.
Walmart:s Comments:
Size=Stated font size requirements. Placement=
Stated placement of information(.e."proMinent"or
"Principal Display Panel')Readability=Spelling and
grammar,,abbreviations i.e."in"versus"inches"
Instruction Walmart USA Use and care instructions should be clear and P
Language Product Safety understandable,without errors or spelling mistakes,
and Compliance and provided in English.
Standard
i��mnn�m�m®mm®
Page 8 of 25
Intertek Testing Services Shenzhen Ltd. West Side of 11F and 3,4,51F of Bldg.1,1-51F of Bldg. Tel:+86755 26020111
IMMta*)l j�Al 3,Yuanzheng Science and Technology industrial Fax:+86755 3537711819
Park,No.4012,Wuhe Ave.North;Bantian Street, wwwintertek.eom.en
Longgang District,Shenzhen www.intertek.com a
WI rrr i,tfdU&EJ3MM Tj�A jG 4012-UYCff Z
O[M 1-51§3-4-5 MR 1 JjNf(!#)Rjt 3 gVMV,
1-5�
t
ertok
Total Quality►.Assured.
Test Report Number: SZHH01291781
Tests Conducted
�Ey�al, �tio t��ifatib� Cnferia �Resultt♦
Plastic Bag Walmart USA Plastic bags with a thickness less than one mil M
Waming Statement Product Safety (1H000 inch)having an opening size_of five inches (Thickness of
(if applicable) and Compliance in diameter or more must have the following warning plastic bag> 1
Standard based or.an equivalent warning Visible.from at least one mil)
on Various State side of the bag. If the.total length and.width is more
Laws: California, than 40 inches,this wamirig or an equivalent
New York, waming must repeat at 20 inch intervals and be
Chicago, visible from one side of the bag:
Massachusetts,
and Rhode Island Warning:To avoid danger of suffocation, keep this
State and City plastic bag away from babies and children. Do not
Laws modified use this bag in cribs, beds, carriages or playpens.
This bag is not a toy.
California,Massachusetts, New York,and Rhode
Island Provide minimum type size for the warning.
The following table sets forth type sizes that will
satisfy all four state requirements.
Total Length and Width of Bag Size of Print
60 inches or more at least 24 point
40.to 59 inches at least 18 point
25 to 39 inches at least 14 point
Less than 25 inches at least 10 point
*Virginia's law is intended for dry cleaning bags only
and requires at least 36 oint: e.
*Toxics in Toxics in Intentional introduction of any amount of lead, P
Packaging Packaging Act mercury,cadmium or hexavalent chromium in any (See remark 1)
packaging is prohibited. Incidental presence of these
metals is limited to 106.ppm total concentration of
lead;mercury,cadmium and hexavalent chromium in
any packaging.
In lieu of testing,a passing test report may be
Submitted.See Document Acceptance list for
document parameters.
Walmart's Comments:
For additional information:
www.toxiesin acka in .org
Page 9 of 25
Intertek Testing Services Shenzhen Ltd. West Side of 1/F and 3,4,5/F of Bldg.1,1-5/F of Bldg. Tel:+86755 26020111 OMU?
3,Yuanzheng Science and Technology Industrial Fax:+86755 35377118\9ww.Park,No.4012,Wuhe Ave.North,Bantian Street, wintertek.comcnLonggang District,Shenzhen www.intertek.com
$ 111rifLfF9iz �il �t4012;'7UUEZ
AkIM 1-53'fj 3•4•5 OR 1 Vfflq*M-V 3 s,MM iV,
1-5�
L tertOk
Total Quality Assured.
Test Report Number: SZHH01291781
Tests Conducted
�Ealetia.�=_Citation Cfea �12i3sui#�
.Other Requirements
UPC Codes Actual Use Using-a commercal available bar code reader to C:
Walmart read-the UPC code.pirited on the package/artwork. 752113606528;
Requirement The.code readout shall match with the number R:
underneath.Record the reading displayed on the 752113806528
reader.
Partt'Inveritbry Visual Check Shall meet label.claims. P
j—1Other test re uirement according to test rotocol NA
Sam's Club'Protocol SMC=HD134 for Gazebo/Pavilion
(Version 6 dated Jul 16,2018)
iTiestilt_ms �Citi tion Re ui:eim fflffi-t
Labelin -&:Packa in
Hardware Visual Check Packaging shall include all hardware required for P
roper assembly,which shall be listed:
Tool Visual.Check Package shall list tools required for.proper P
(if,unassembled) . assembly.
Assembly Visual Check Instructions shall be dear&concise and include P
Instructions diagrams or illustrations.
if'unassembled
Physical Characteristic
Overall Dimensions Standard Report overall dimensions(length,width, height). P
Measurement (C:
12'1"x 10'0"x
10'3"/3.7mx
3.0mx3.12m;
R:
146-1/4"D X
120-1/2"Wx
124-1/2".H
Overall Weight Standard Report weight. R:671.4 tbs
Measurement
Construction&Workmanship
Defects Visual Check Components shall not be misaligned,missing, - P
malformed, and/or fractured.Shall not have any
discernible surface degradation including crazing,
Shivering,_denting,bubbles,-blisters;cracks,stains/
dirt,discoloration,chips,heavy tines,waves,shear
marks,scratches, scuff marks,.or,indentations. .
i��®aa�m®mu�mmu�
Page 10 of 25
Intertek Testing Services.Shenzhen Ltd. West Side of 1/F and 3,4,5/F of Bldg.1,1-5/F of Bldg. Tel;+86755 26020111
tl �r � 3,Yuanzheng Science and Technology Industrial Fax:+86755 3537711819
Park,No.4012,Wuhe Ave.North,Bantian Street, www.intartalk.corn.ch
Longgang District,Shenzhen www.intertek.corn e
i1���L���i�I �ttjci�l[f 4012- 7L'1t� S
AEA 1�4 3-4,5 R-A 1 tiff*);� 13 sgj�,f.
1-5 E
Y tert k
Total.Quatity Assured.
Test Report Number: SZ-HH01291781
Tests Conducted
est i'�,�»s"���Ct�"�ian' R i a t 1 tttml't Reis 1t
Metal Surfaces Visual Check All metal'surtaces are plated coated,or equivalent P
to.inhiibit corrosion. .
Head and Neck ASTM F1148-17, Shall..be designed and constructed so:that when P
Entrapment Section 6.1 assembled any accessible opening shall mrneet"the
(Modified) requirements specked in this section to reduce the
risk of accidental head or neck entrapment by either
a head first or feet first entry into the opening.
C?penings between the ground and the bottom edge
of the equipment are exempted from this
ce uieement.
Performance
Functionality Client's Shall function as intended as receiVed.Report P
Requirement details of evaluation(features tested 1 methods used
1 materials tested etc.)if not alrea d dy covered by
other tests.,Additional charge and samples may be
re Lired"fors ecial.features.
*Ease of Assembly Actual Use Follow the instructiiins"to'"assernble;comment on the P
method of the'installation.Parts shall not easy to
break ddrinq normal assetnb{ .
Assembled Product Visual Check Products requiring assembly have to be inspected P
after proper assembly for any aesthetic deficiencies
including but not limited to pieces that do not align,
are not level or straight.All non-conformance shall
result in clause failure with photo(s)attached in the
report.
Page 11 of 25
Intertek Testing Services Shenzhen Ltd. West Side of 1/F and 3,4,51E of Bldg.1,1-5/E of Bldg. Tel:+86755 26020111
3,Yuiniheng Science and Technology industrial Fax:+86755 3537711819
Park,No.4012,Wuhe Ave.North,Bantian Street, WMIntertek.coil.cn
Longgario District,Shenzhen www.intertek.com
!!Yjffl1`ig-#f3-4-5r=-)A1*NMI*Ufa343.91 �f.
1-5 G-
htO k
Tatal Quatiiy Assured.
Test Report Number: SZHH01291781
Tests Conducted
es Ite�i3s�tition a nt 1 �' l � es
Stability As per Criteria Set up the gazebo as per ins#ructions; P
-Measure the area of the projected
.tide S(fe),refer
#o cFiart below'using the.clairned wind speed the
product can withstand(50 mph if no'daim)and load
a pustiing:force F S x Lin the frame center and
hold for 5 minutes;
-The gazebo shell remain stable,no swaying or
moving.
end
Speed
m h . 40 45 50 55 60 65
Static
Pressure 3.9 5.0 6.2 7.6 8.9
Iba::it . 93 .54 40 50 85 10.545
wrid
Speed
lir h . 70 75 80 85 1 90 .95
Static
Presstjire' 12._ 14. 15. 18. 20.
Ib/•ft` 230 040 974 033 217. 22.526
Wind
Speed
m h . 100 1 105 110 115 1 120, 125
Static
Pressure 24 27 30. 33. 35.
lb-!ft` 966 516 201 009 942 39.000
S:Area of the.side(fe)
L:Static Pressure(lb/fe)
F S x L Force.pulling onto the,side of thegazebo)
Roof Snow Load As per Criteria Place a distributed load of the claimed snow loading P
(use 10 lb/fte-,if no daims)on,this roof for 8 h.There
shall be no damage to the roof top or permanent
deformation of the frame.
NOTE:does not apply to products that provide dear
instructions of not leaving the structure erected
during winter when snow is expected.If exempted
from Roof.Sno*Load assessment,record the
instructions on the re ort.
I�IItl�l1��61®�1��1��9
Page 12 of 25
Intertek Testing Services Shenzhen Ltd. West Side of 1/F and 3,4,5/F of Bldg.1,1-5/F of Bldg. Tel:+86755 26020111 on
#lfflfitlin� 3,Yuanzheng Science arid Technology industrial Fax:+86755 3537711819
Park;No.4012,Wuhe Ave.North,Bantian Street, www.intertek.com,cn
Longgang District,Shenzhen wwwAntedeLcom
IM7.A 4012-9-jcbT
J&IM 1 3.4,5 MR&1 MMiI *R-*[I 3 1ajMV-jW,
1-5)-=
Total Qtlaiity.Assured.
Test Report Number: SZHH01291781
Tests Conducted
Test Gita".trots'' R t Ltti t Res e_It
Cycle Testing of Actual Use Components interided to be moveable shall P
Moveable withstand 1,00 cyeles.with no failure.All components
Components must'maintainYa smpoth and uniform movement
throu houteach cVd6.
Effect of Extreme As per Criteria Th;ere shal[be na'evidence or discoloration of loss of P
Temperatures sere ceability:after-the product'is exposed to 140 OF
for 4 hours and..0°.F'for,4 hours.-.
'"Wood Moisture Standard Shall not exceed 12%but no lower than 6%. P
(solid wood) Measurement (Solid wood:
10.4%
"Corrosion' ASTM B117 Shall withstand 24-h of 5%salt fogspray without P
Resistance any signs of corrosion.Grade 9 rating or better
(accessible metal referencing ASTM 15610 or ASTM 13537.
component)
WM4-U001(U.9)CA PROP 65 Version 12
�Pspdiots� Case � txiienTerf�>lllilip��I�Res lt�!
Cords:All items with SF-312962 Lead: No warning label"is P
electrical cords— s 300 porn provided. (See remark 1)
Accessible(surface Method:By EPA 30SOB13051
contact layer)Cord
Jacket and Plug By EPA 30508/3051
Casing Except the following:
01 Infrequently Handled
Products:Exh➢bit F contains
the fist of infrequently handled
products which are exempted
from:the covered product.
Please also refer to;Non-
Exempt Products.List
(Infrequently Handled Products
sets which are not exempt)
b)Cords only used as intemal
cbm onents•
For information only
P_ Pass
NA . Not a�- pplicabie
C Claimed'.
R Recorded
i��uamo�mmmm�
Page 13,of 25
Intertek Testing Services Shenzhen Ltd. West Side of 11F and 3,4,51F of Bldg.1.1-51F of Bldg. Tel:+86755 26020111 ,
3,Yuanzheng Science and Technology Industrial Fax+86755 3537711W
Park;No.4012,WuheAve..North,Bantian Street, www.intertek.com.cn „
Longgang District,Shenzhen wwwiritertak.coni -
J%kfffl 1 F'l§3-4•5 P=)A1 N%1jtWV 3-EJN U:
1-5 E
0.- ".
I,el mor m-
toul Quality Assured.
Test Report Number SZHH01291781
Tests Conducted
Appendix I
Claim Verification
Claim -ClassifleAtion Result
12 x 16 all-cedar,brookdale pavilion with Actual test Visual,Measurement& As Claimed
Olectric;' Nonnal-use
3 electrical outlets provide power;
s6lid.bOd-Of construction;
lni4dt&deciy resistant;
OWbistkquird power be
f6h6ti6hai Not included;
— Efoxlcontents;Metal accessories&
premium;lumbir
— Bok 2 contents:Plastic accessories,
assembly instructions,etectocil
corT I tpo,p ants,m" etal'accessories&premium
lumber,
tiok 3 contents:Premium lumber,
Box*4 contents; Premium lumber;
Box 5contents:Metal roof 'components
Material,Chinese cedar
I Cedar I Letter of.guarantee was provided I As claimed
Photos for reference
f
------------- -----------
Pag6 14 of 25
Intertak Testing Services Shenzhen Ltd. West Side of 1/17 and 3,4,61E of Bldg.1,1-5117 of Bldg. Tet:+86766 26020111
3,Yuanzheng Science and Technology Industrial Fax+86766 353771 18W
Park,No.4012,WuheAw North,gentian Street, yw.intertek.comc_n
Longgang District,Shenzhen wwwInteitekdorn
4012 43`TctEf-4�
jfilffl 1-Ljmy 3.4,5 JER I fj#ffgU*R-fQ 3 t&Mn,
1-5)-=