HomeMy WebLinkAbout21-2684City of ZephyrhiliT
5335 Eighth Street
Zephyrhills, FIL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021 1
BAR-002684-2021
Issue Date: 09/15/2021
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 subsequent reinspection.
Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permit required from other governmental
entities such as water management, state agencies or federal agencies.
Complete Plans, Specifications add fee Must Accompany Application. All work shall be performed
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE
CONTRACTOR SIGNATURE PE 7MIT OFFICIEV
-�/PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
T . =w 1 2
813-780-0020 City of Zephyrhills Permit Application Fax -813-780-0021
L Building Department
Date Received fi
"� r 1 Phone Contact for Permitting (& 13 908 0131
Owner's Name Johnson Kyle G & Erin L Owner Phone Number or
6140 Silver Oaks Dr ZephyrhiltS, FL 33542 267-214-9254
Owner's Address Owner Phone Number
Fee Simple Titleholder Nam® I N/A Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS 6140 Silver Oaks Drive Zephyrhills, FL 33542 LOT#
SUBDIVISION Silver Oaks PARCEL ID# 03-26-21-0120-00000-0060
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADDIALT SIGN DEMOLISH
11 INSTALL REPAIR
PROPOSED USE SFR 0 COMM OTHER
TYPE OF CONSTRUCTION BLOCK FRAME STEEL
Replace Same Size Non -Impact Resistant 10 window= and 4 sliding glass doors
DESCRIPTION OF WORK EPA 239 1 261 1 243 1 8
BUILDING SIZE SQ FOOTAGE= HEIGHT
BUILDING S 20 617.00 VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL AMP SERVICE PROGRESS ENERGY W.R.EG.
PLUMBING r>
4
=MECHANICAL S VALUATION OF MECHANICAL INSTALLATION
=GAS ROOFING a SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER
° Weather Tite Windows
SIGNATURE RFG sTEREC Y N FEE CURREN Y i N
Address !� J �— t License# k IS,
ELECTRICIAN NIA COMPANY �
SIGNATURE R;
EG�sTEREC Yl'" ' FFF CURREN
Address i License #—�
PLUMBER N/A COMPANY
SIGNATURE REG13rEREr Y ! IN Fee CURREN Y ! N
Address License # �_
MECHANICAL N/A COMPANY
SIGNATURE REGisTEREC LY i N FEE U URREN Y t N
Address License #
OTHER N/A COMPANY
SIGNATURE REGisTERer Y I N FNF_ GURREIh Y I N
Address License #
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 onsite, Construction Plans; Stormwater Plans w,' Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large 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 onsite, Construction Plans. Stormwater Plans w( Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
****PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (AIC 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 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
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be 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 CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they
may be required to be licensed in accordance 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 licensing requirements
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 indication that he is not properly licensed and is
not entitled to permitting privileges in Pasco County_
TRANSPORTATION IMPACT/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 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 I mpact 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 I, the applicant,
have been provided with a copy of the "Florida Construction Lien Law --Homeowner's Protection Guide" prepared by the Florida Department of
Agriculture 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 "ownerprior to commencement.
CONTRACTOR'SIOWNER'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, zoning 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 City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I
understand that the regulations of other govemment 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 agencies include but are not limited to:
Department of Environmental Protection -Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, WaterMastewater Treatment.
Southwest Florida Water Management District -Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Engineers -Seawalls, Docks, Navigable Waterways.
Department of Health & Rehabilitative Services/Environmental Health Unit -Wells, 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 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 building permit issued under the attached permit application, for lots less than one (1)
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 the 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 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,
TTi �i T N •TT\* �.. '� t w. _ fie.:. � � � �.: � w.. «.
FLORIDA JURAT (F.S. 117 03)
OWNER OR AGENT c t Cam'
+he
s ribed and sworn t m )before me this
by 4 - 3
isfare. personally known to me or has/have produced
as identification-
Public
Commission No.
Name of Notary typed, printed or stamped
11 La
SPENCERKASS
COMMISSION # G-121021 I REs: November 1, 2021ed Thru Notary
Public Unden�rlters
S b on d and sworn t6 or ffirmed) before this
t a,-
Isla so ersonally known to me or has/have produced
as identification_
Notary Public
V
Commission No.
Name of Notary typed, printed or stamped
eanoa:r ap
SPENCER KASS
<�=��.Y
a� .
MY COMMISSION # OC 1:22,1]
EMPIRES: November 1;
ram=
Banded Thru tdn cry fublio Unit
1) Need manufactuiring installation specifications,
2) Must meet sections R308 and R612 of the 2017 F,B,C.
3) If windows are to be installed inside the historical district, they will need to be approved
by the historical committee.
4) No other work shall be permitted (framing, plumbing, and mechanical) unless otherwise
specified.
5) This is for replacement (glass for glass) only, if you wish to change from screen or vinyl
windows to glass, then additional information is required.
6) All windows to wall connections shall be left visible for inspection,
7) All labeling and sticker's shall remain on windows until final inspection,
8) No work shall start without permit first,
1119 W. Columbus D,I,, - Tampa, Floirldn 33607
(941) $70-0619 (813) 908-0131
(727) 280-6029 (800) 640-3161
WEATHER T irr PURCHASE AGREEMENT
MHD@M �1 16 � CGCft 1515541
TRIS CONTRACT Tnade this _A3�_ Day of 207P__ by and between Weadieffite, (hereinafter referred to as "Seller")
and Name: ------ Address: kS 1-10 � ; �IWI QA
City: State: J� Zip: Email:
Primary Phone: —2,0_!1=21��— 151�70 Secondary ypp referred tons "Buyer")
Seller agrees to sell, and buyer agrees to buy, all those materials and labor necessary to install the same as set forth in the following Specifications and in
accordance wuh the Tdrins and Conditions below and with approximate inctersuremems and specifications listed on Exhibit A and/or Exhibil, B.
, _,5S_tH0_
I 'S -E ---- —3,
I
Installation does not include painting anchor staining, This price reflects all trade-ins, specials, and discounts.
TOTAL CASH PRICE lr, DOWN PAYMENT AMOUNT S (01 i�a`6 UNPAID BALANCF,$
AMOUNT FINANCED" S (�_ * S21blecj to elvdii appioovals and e-Usting intatiest twes ivith qpj)it)j,jjjg institution,
IF CREDIT, NO. OF MONTHS CREDIT CARD #
CREDIT CARD TYPE EXP, DATE BILLING ZIP, CV2
1, Arty Wide, or flu., v su re, =dh -In'tiat N,.bj,el to all tisons slid drjd.,0wInCfi the ubbus eland assets litailm therall ... d'good., ri,servirciobtain'd inarstlint hernia or "ith tire pol,"ed., nonnir,
Rco.,alT hereunder by ilia dvbwshall not exceed ianounts paid by use data,,, haeundr, VIllne -filly-ent discrepanoics to be dmieflotll by Wiink, rite Windows Daly.
2, a r ,;lys'qr_.nI sceept delivery or amerfills alder police from Seller run, installation date. Ater S days past its! data irbaea, iralbs. Ill remin d0tvai-y g 1, 11 be
nine T2 5% -she
1 'This anoso, runt is lot -the Irsiver, I of, and shall to binding upon, I fia parties a all ille! r Nslasailo, heirs, successors still nsligjla.
,I, Bluveranthrorizes Sellqrtc make Inquiries prinfiers coneeming credit nubmultho% including, but not Nutted to pmentint; eunsuniumpoll, fleet consumer mporiing ripmam
4t. Any ne,411 thistrequirsa servict, or sarlIces during the time ofinstalticion that diienotaftat the lamolme I Domains, .1'products is, ard vi It bar =stdrirod a elanplatir metal; and Imme agrees act
pay ill (bit atime of intan) I. A It services Wilt be reported to Afree,.sibodollsd end tompharni. ruin bay,,, andsorlanding that all Paris am custom and tin, D is needed foram nununsrhipi. nonnownerraw
withhold loan r I, aquall 1. .1inurtld etlu .4"rur.6in, firoto fall plyment ly,Peyonaw rcvoi,sd shall be applied first to intionso tal all urasurading, in,mr. Did Lino, to th. minsmal al,onot r,flhv
mflsloodnq, i .. i-la), Cuslonal-listar, to Day doulem of 11/2 %. per nmmh (ANNUAL PhRCENiAur, Rvir,, OF I if%),n,h,s, ono,rke terinited by Ia% all the ballore rely tamid'ia,.om, if
cusnow, do's our mrfo plymena Contract., slont be entitled to reto'e, Item Cu'lonvor all costs ofeullaltion, i,,r.—d by Comotoo.; ic,ludmg zortionsy's fits, costs, arldextsoses. collaxtiml msucts
only be procisistal through litigation orsubdralkli at the sale distrinion pf CpR7Caelaf. The filter. ofC.,asiaw to miltoi jimper payliann, to crintrael., Nytim du'hall vittalt, Cornmelor, aI it, 41sinrenal, (a
suspend all mark, stimulants amil., wrinninflos until full pays ono is made or rl,mumuz this ilonnact.
6, All Data Restricted Comannatiol, eandes and hitamrivolne aasmirlreu inotobs,s roust assist is spprovll of products -Any nupriool lypuo,ahs Are the sale. responsibility of the humuono,
7. Buy" is solely ragnitalble for D,.,iDg Ibruilero. mloo,ing and replamg blind$ and arty .)rion systems near or almould to �,V otaning tbat v,r, it isbeing psounme, Weari Tail Whid,ols will not be
ffirlocimly responsible for darnalto ors'sh items, flamitum, and!rir flours or any other damiltdr ile0rund by Susan Buyer',' hoine, orProprody whwilavcT,
8, 1 Bull, ptrti., agree Ghat any dispute arising from mi'agucamerd shalt be kept private and onfictinind and .I filed or mc,asled I,, any public record, The Illercrogns, 1. keep the transaction land a,
;111.e lusling lu, thin minsaiditu, ini,elp, end cut to di,saaa, publish or doestunao ray alournetion 'ithout o.sall Di Woffil,, TH. Wind.,- A dispute arising Ji o this contract shell b,
l-ld ba as -sbiloo-, atovd to by balli partian and paid for solely by the Buye, Should Cunt la employ as attorney to in'liwo, Iiotio. ,bhoohra to rurnme any Drift, I"ovkhars hf, in roe et its nast in say Diane, inisirrit not or., minted to flits Agar. ,niell, Cnlinaou,
sh.11 he entitled to ', Imas the cearmas, .11 urns ruwooy's r., and cart
ed bervir, iD,t luily au"rarry's fees, and l,res/epruses ireaq,,d at m.auj.,, ajouns,o-sto , splisrilara
u, Wilton B"y procproceedings.edfing
I Mau solo as-pnon to bindings,bitraliers stell for Ia,n.',p.yrnsa,, Bntvideh aase.Wmlhe,Trteat III -to dj111i.o may 111,forst uldvanorl or any offirrosems inlo—al by lan,
I I .Atnr and pit bousn','d Iblka will be slurrited I in amid elasrk me ors3o or lha maximum amount showed by, Ill,, should . con", vi nave to aa to tol[ertions, buyer shall pay tvo times the voll"hon ill,
Incurred Clod
eery
),got re ollw, Ives in --ad by wealk, File,
I 2,Waade, lae n, not responsible for rebates. les anal anwor any o0m, 3,0 party P.golonsanc,il"es,
13'5kauld is, "dle, I it. Wh ol—inut .6,e Colt ply.rnt rth. .1no.uMmel amount far say reHban, willing aiar.d upon reductions in the comsat amount, gna "arninty Firm') Werth. Tit, Wind.sN,
shall r0
shall -de minimum I year as bon .mainly ramdrud by]4%v cla applicable, hull
"it v.id'yo.' only '" 14.C.nd.j., dilchnno, it][ liability ril dru'le, nAdcr this eraulert and/or varvolly, disinans, diu,,, losses, dr,,rqn,.,, enusps of4e4l,is or Piohas Io killd, inumb or"'.41,
IW[dckk,, linnin bacteria, at any orgarmsda Is Deny surfatsrthelvindrov, door, orlmiletare (,Ihisinar on the expostri fir utlespaiind surfaces), hiclualub; Chinsirs arising out oforrel"Ifinst it, Our dcactern
men-st, disposal, ,, D, edban,is ofady arms, above, whether those Claims a,na I. le," equity, e.ineirn warranty, In", ,, Well ., oinclultntroy Ora 6, slid whrlix, those Claims are based antic
srus erard'sim, rconturem, or oldivitheill, or omilies none, C.samilors neol, 'the Coiner— is sololy uaidod radaible for all dauslies, ,hailicrtunual orcoascguaatiai, canlad by any orlho
abia" sad inclined by Custonitt, Cmunicloror Must parties.
15'Com"Di (aShall not be responsible for addituatifl costs required alle tolleeesimenee of utilities, "It insulation, &mridwed structure or other subsurface or latent conditions marine not disclosed III
"Ding, �o Comi-aam Should tolianated rar.ollanvu condo ions m air axi,liartsir ofir n be at -flaare "ki, undifirms indicated in thn dis-l-Pths, of the k In he Part ad Done those noli Illy
alimumnadUnit gracrally railogni.tIss 44ourtad Jark of chars al ,p,dvdj,d Far is fins Agrassocut, th./iiare.ruent mili, fihill bl'iquitably.i1m,ted nPon Dart. Onlooffiren, the Contrarlor in the
C at.."
16,Clanma .list nuIfeal-LrIpm,in,dby eliketituthe dollin ,tome,, orthe
Atimlim,ni, ful-say, air,[ all injuries, daurrogrri. olohns, D.Pana. ., annul usPen.'s including any,i, jins, "'yos and isFal.l arising, out -of., mating to this Atillam,at unisilducss of-Illher it is based
at -1—'ay, "I " 'o c', shier liability, negfignee, errors, omissions, or from any other cause or causes.
11-11 all, 11 11111"usnor the Atimenrulit sball be conaroad as Whom primes ougually drafted tio, Atean,am. If . povirwo ofuds Agreement for the piphlabill of to is held by It eona m vitotqion In re
im,elid re unenforceable, line provision will be eilmnal uparrible, from the loonsilling prolisms, of km, Ago emit, evill be refuraltd/omforeed to tire gamut that it is valid ,aid isaarcildshr, slid Nvin list
Weet the slidity or odorpratiolon or the the, Provisions or the lophairtion of that provision to a perms or eireturnrinae to which it I, .hd and aaryrelldhlc. Headings are' for com,alulica only old do
"at itfild"i oa,qoendior. The, Artar-m-1 Dd, flu, entire ameam.t of onParties and saper sv&, any previous or Deraperamous allrectinau, understanding, (it utpoiatelodiDl, oral or by the
partim All docamansfalvdits; rVisored to in ibis Agreement up an Integral pan of the Agransinnu and are intlamonered by Manallot,
BUYER ACKNOWIEDOES R ECIFIFT OF AN EXLCUTED COPY OF THIS AGRE EMEN E BLI YCR HERE AGR EFS TO TH E TERMS AND CONDITIONS OF THIS ORDER.
BUYER ACKNOWLEDOT.IS THE RECEIPT OF A TRUE COPY OF THIS CONTRACT, DISCLOSURE STATEMENT, WARRANTIES, GUARANTEES, NOTICE OF RECISION Olt
NOTICE OF C',1rNCLLLAT1QN
ALL CONTRACTS SUBJECT TO OFrJCE APPROVAL, WEATHERI�T _C WINDOWS,A DrVISION OF HOLLANDER EXTERIORS, INC,
BUYER
BY: BUYER, sst,
A VYYI _WS
YOU, TI I r BUYER, MAY CANCEL TRIS TRANSACTION AT ANYTIME PRIOR TO NUDN I GHT 0 r TlI ET'111 RDBUSINESS DAY AFTER THE 1) ATE, Or 1-1 HS
TRANSACTION: CANCELLATION BY THE BUYER A FTF R THE RIGHT TO RESCIND HAS PASSED, SHALL BE DEEIVIEDA MATERIAL BIREACH 0 F TH is
AGREE M ENTAND ENTITLES THE CONTRACTORS TO DANIA GES EQUAL TO (50%) FIFTY PFRcrNT Oil THE AGREED CONTRACT AMOUNT.
Dillrill"Inal; Nvial,: Oflr Who, ibuvr rI,k; nuocr V[ToMOA 04114
INSTR#2021158754OR 8KI0403 PG212. Page 1 .1
07128/2021 11:39 AM Rcpt: 2332020 Rec: 10.00 DS: 0.00 IT: 0 00
Nikki Alvarez-Sowles, Esq., Pasco County Clerk & Comptroller
POrMli Number
Parcel ID Number
UQ--::-Q0U0
NOTICE OF COMMENCEMENT State of f:11 - a
county of - m5a:�
otice that improvements will be made
THE UNDERS16iED hereby as nto certain real Property, and in accordance with
Florida Statutes, the following information is Provided in this NOTICE OF COMMENCEMENT,
1-Description 0fproperty (/e981descrjpt1GP): Section 713,13 of [he
a) Street Vbb) Address: W,10 P,
Of improvements, R,pl a 179 for �d Ic
size in Ej
2,13eneral description 1��
8) Name and ed for the improvement: . ........
10wrier Information or Lessee Information if the Lessee co
b) Name and address., �address of fj 1--t - (---I ,
fee ample titleholder (it different than Owner listed -0-a k Dy 7:�2ALj�- I
c) interest In Properly: Owner
above)
4.COntractor Information
a) Name and address: Weather The Windows 2
s Or, Tampa, FL 33607
b) Telephone No,: 119 W, Columbu
5.Surqty (if applicable, a copy —of thW-ayma-nt,b�r@ —jr Fax No,;(oPt1onaI e-0
P813-9( 0134
3) Name and address; NIA
b) Telephone No,,
c) Amount of Bond: $
6-Londer - ------
a) Name and address: N/A
b) Telephone No,�
7. Persons within the State of —F1ori-didijj'jnjae-d 6
Y Wrier upon
713,13 (1) (a) 7., Florida Statutes; or other dooumg
a) Name and address: NIA
b) Telephone No.:
&aJn addition to himself or
r designate_ ---------- Fax No,: (optional)
to receive a cOPyof the Lienar's Notice as Provided' s
In eGfion 713,13 (1) (b), Florida Statutes.
b)Phone Gmberof Person orentIfy designated by Owner;
9. expiration state of notice of commencement (the expiration . n
contractor b date may not be before the completion 0
'8r from the date of race f consiruction and final payment .9 ( �rdln to the
WNER; ANY --PAyMj�6j- -� _ unless a different date lj.�pacffiedL
MADE By f
CONSIDERED IMPROPER PAYMENTS UNDER CHAP
THE EW1i�4T1-0N'-0-F -Tj 20
HE-N—Orld-E-OF --
G OMMENC§fENT ARC TER 713, PART 1, SECTION 713.13 FLORIDA STATUTES, AND CAN RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS To YOUR PROPERTY, A NOTICE OF CC)MmE '
NCEMENT MUST 13E RECORDED AND POSTED ON
THE JOB SITE BEFORE THE FIRST INSPECTION, IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE COMMEN C-I
Under NG WORK OR REC
ar Penalty of perj ORDING YOUR. -NOTICE OF COMMENCEMENT, knowledg dF, -- -
I d belief, foregoing jDtice commencement -an that the facts stated I
er"In are true to thi-ei-it-of—'
8 0 my
{Signalvsm 0
�(w Owners orLe6sewi
ri .- X-A
The foregoing Instrument was ackn W�e
Owled jj (P i ;v
-- ged before me this rh Pm andProvideS' ---- — ------ -
by
J�
C day of as
for We her Tjt6 Windows ...
officI
er, haste p�ffaC(Namecfpa. asCantractorfor
(type )fflcel' ,�
mO Of PadYcn behalf of whom Instrum was
Produced ID
V
PersO,nall� �novvn (na
Type of ID DL
Notary signature
Print name
77-
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If -
Customer Name/Number'1 smart 11 / FL Product Approve( . �, r� LD w 4 ndcgitJ S
Exposure % ( t t
Size for Size Replacement: Yes No
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Customer Name/Number
Mr..=
(�A) /('o, -,
PGT
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PANELS
RISERS�
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NOTES�—
-bcors 60 1�
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Size for Size Replacement: (YesNo
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FL #
rL243-R24
Application Type
Affirmation
Code Version
2020
Application Status
Approved
Comments
Archived
Product Manufacturer
PGT Industries
Address/Phone/Email
1070 Technology Drive
North Venice, FL 34275
(941) 486-0100 EZU1140
.
jrosowski@- , WORK SHALL COMPLY WITH PREVAILUN�
CODES FLORIDA SULDING C('%0E'
Authorized Signature
Jens Rosowski NATIONAL ELECTRIC CODE,
W0,T jrosowski@pgtindA +jE CITY OF ZEPHYRHILLS
ORDINANCES
Technical Representative
Lynn Miller, RE,
Address/Phone/Email
1070 Technology Dr
N Venice, FL 34275
(941) 486-0100 Ext 21142
Imiller@pgtindustries,com
Quality Assurance Representative
Address/Phone/Email
Compliance Method
Certification Agency
Validated By
Referenced Standard and Year (of Standard)
Equivalence of Product Standards
Certified By
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Documentation from approved Evaluation or Validation Entity
Miami -Dade BCCO - CER
Miami -Dade BCCO - VAL
Year
1994
I 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,
Yes No N/A
Product Approval Method Method 1 Option A
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FL #
FL242-R28
Application Type
Affirmation
Code Version
2020
Application Status
Approved
Comments
Archived
Product Manufacturer PGT Industries
Address/Phone/Email 1070 Technology Drive
North Venice, FL. 34275
(941) 486-0100 Ext 21140
jrosowski@pgtindustries.com
Authorized Signature .lens Rosowsk!
irosowski@pgtindustries.com
Technical Representative Lynn Miller, P.E.
Address/Phone/Email 1070 Technology Dr
N Venice, FL 34275
DE
(941) 486-01il � Ya42
lmiller@pgtir SHALL CoMpL ,S FLO A
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Compliance Method Certification Mark or Listing
Certification Agency Miami -Dade Ei R�V"FW DAZE S,�� 0
Validated By OF zep�/
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Referenced Standard and Year (of Standard) gtan$Lard
Year
TAS 201, 202, 203 1994
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 Yes No N/A
Product Approval Method Method 1 Option A
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Appjju== > Application Detail
FL #
FL261-R13
Application Type
Affirmation
Code Version
2020
Application Status
Approved
Comments
Archived
Product Manufacturer PGT Industries
Address/Phone/Email 1070 Technology Drive
North Venice, FL 34275
(941) 486-0100 Ext 21140
jrosowski@pgtindustries,com
Authorized Signature Jens Rosowski
jrosowski@pgtindustries.com
Technical Representative Lynn Miller, P.E.
Address/Phone/Email 1070 Technology Dr
N Venice, FL 34275 -
(941) 486-0100 E&YWRKS8ALL COMPLY WITH PRE
Imiller@pgtindustri WES FIORIDA BUILDIVAUNG
NG CODE ,
NATIONAL ELECTRIC CODE Quality Assurance Representative AND THE CITY OF ZEPHYRH'ILLS
Address/Phone/Email ORDINANCES
Category Windows
Mullions Subcategory '� 'E W DA TE SI'57) 0 6
Compliance Method Certification Mark or 7E
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Certification Agency Miami -Dade BCCO - CER E
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Validated By Miami -Dade BCCO - VAL
Referenced Standard and Year (of Standard)
Equivalence of Product Standards
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Documentation from approved Evaluation or Validation Entity
§la_n_o and
TAS 201, 202, 203
Year
1994
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.
Yes No N/A
Product Approval Method Method 1 Option A
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> > 6QPIioS1Q.2LISS > Application Detail
FL #
FL251-R34
Application Type
Revision
Code Version
2020
Application Status
Validated
Comments
Archived
Product Manufacturer PGT Industries
Address/Phone/Email 1070 Technology Drive
North Venice, FL 34275
(941) 486-0100 Ext 21140
jrosowski@pgtindustries.com
Authorized Signature Jens Rbsowsk!
jrosowski@pgtindustries.com
Technical Representative Lynn Miller, P.E.
Address/Phone/Email 1070 Technology Or
N Venice, FL 34275
(941) 486-0100 Ext 21142
Imiller@pgtindustries-com
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Category Exterior Doors RSA
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Subcategory Sliding Exterior Door Assemblies
Compliance Method Certification Mark or Listi
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Certification Agency Miami -Dade BCCO - CE � 06
Validated By Miami -Dade BCCO - VAL /Ii/v A
Referenced Standard and Year (of Standard) Standar
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TAS 201, 202, 203 1994
Equivalence of Product Standards
Certified By
Product Approval Method Method I Option A
Date Submitted 04/19/2021
Date Validated 04/19/2021
Summary of Products
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pro Approval
jI.
o UiSIERlV Public User
I 1,SPQka=_LL9 > Application Detail
FL #
Application Type
Code Version
Application Status
Comments
Archived
Product Manufacturer
Address/Phone/Email
Authorized Signature
Technical Representative
Address/Phone/Email
Quality Assurance Representative
Address/Phone/Email
Category
Subcategory
Compliance Method
Certification Agency
Validated By
Referenced Standard and Year (of Standard)
Equivalence of Product Standards
Certified By
Documentation from approved Evaluation or Validation Entity
Product Approval Method
FL239-R28
Affirmation
2020
Approved
PGT Industries
1070 Technology Drive
North Venice, FL 34275
(941) 486-0100 Ext 21140
irosowski@pgtindustries,com
Jens Posowski
jrosowski@pgtindustries.com
Lynn Miller, P.E.
1070 Technology Or
N Venice, FL 34275
(941) 486-0100 Ext 21142
Imiller@pgtindustries.com
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TAS 201, 202, 203 199
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.
Yes No N/A
Method 1 Option A