HomeMy WebLinkAbout91-1927
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13. INLET FmIHG$)...
14. MAIN DMIN I
11. THERAPY JETS
11. SUOI
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11. CHLO"rHATO" I
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22. ENClOSED SPA -
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HOMETOWN POOL. INC.
1 ""CE~. PH. "S.T'N~17 .
ZEPIMUIILLS. n 542"
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CWTOMII"S UGIU 1'\11I
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STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
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Type of Permit
( . ,-BUll ~
....
PermitN~ 1927$
Date /1- /1-$' I
...
BUILDING DEPARTMENT
1-813-788-6611
D
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)0
~CECTRlr~
PLUMBING
~MECHANIC~
Property Owners Name: 1lZ1Y- ~A:~ '
Job Address: 9:;..J.~ c:X{ ~J.
Legal Description: Sub.Div. Lot Blk.
Zoning CI:
Description of Work
Energy Code Readout:
~/13
)/~
Complete Plans, Specifications and Fee Must Accompany Application
. 4 .z :3 ~f) . ~
Estimated Cost:7f " v
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE #
C_. (,/ i<J-yJV>)
BUILDING
~--_..
Ftr.
Pre SLB
Lintel
FRM. /1.. 17-D-l? I
Insul.CL ~
WL /2./2.1"-'11
StB
Tub Set
Water
Sewer
Final
Driveway
gV
Fee: 70 '-- .~
SIGNATUREv' ~ ' -
COMPANY
ADDRESS
TELEPHONE #
(o"~J
ELECTRICAL
.,
Tp.Serv.
Rough 'ntz - Zo -Cjl
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
Breakersi .
Ducts Ins!. / -1- i',-,/
Compressor
Final
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of ten ($10.00)
dollars shall be made for /each trip.
(a) Wrong Addres~./'
(b) Condemned wbrk resulting from faulty construction
(c) Repairs or corrections not made when inspection called for
(d) Work not ready for inspection when called.
The payment of reinspection fees shall be made before any further permits will be issued to the person owning same.
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT jJJ/tLJ:' / e.flJ/ EK..
ADDRESS 39659 /'l!PL7rka/O/")7'---L Lor
OWNER /JJJ9/Cj:' / .e/l//E/C
JOB LOCATION ~~~
PHONE
7f-,2 -?j>L/g
LOT SIZE~X //0 AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
~.
PARCEL I.D.# /3 -;;2~ - ~/ - tJ/~tJ - OOOOC - C) ~y.o
WORK PROPOSED:____New Construction ~dition ____Alteration
____Repair
____Install
____Sign/Temp.
PROPOSED USE: ~Single Family
_Sign
____Move
_Demolish
_M/F
____iF of Units
._M/H
_Commercial
_Indust,
____Swim. Pool
Other
_Restaurant & Health Department Approval
BUILDING SIZE: 1'& X a &,
'd-f(;O
Square Feet,
g / 'III
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,**
**COPY OF CONTRACT REQUIRED.
/
--lL.BUILDING
~LECTRICAL
PERMITS REOUESTED
$ d.. 3 ,-/0. O<.:J Valuation of Total Construction
AMP Service Florida Power Corp.
_W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block
_Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
BUILDER
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CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration #
******************************************
Signature
/
ELECTRICIAN i ./ ,.
\. ,--.
?) // f K..... Company
State Cert. or Regist. #
City License Registration #
******************************************
Signature
PLUMBER
Signature
Company
State Cert, or Regist. #
City License Registration #
******************************************
Signature
Company )(',. A.; s ..(.,. ~ 11-"" Ire-v(
State Cert: or Re{ist. # R !//J--n<;;-070
City License Registration # 7/
*****************************************
,...
OTHER
Signature
IF
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this pertit lay be subject to "deed restrictions. which may be lore restrictive than City
regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor Dr contractors to undertake work, they .ay 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 .isdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, (813)
788-6611.
Furthermore, if the owner has hired a contractor Dr contractors, he is advised to have the contractor(s) sign portions of the
'Contractor Sections' of this application for which they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that .ay be an indication that he is not properly licensed and is not entitled to permitting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D.
CONSTRUCTION LIEN LAW
(CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - Homeowner's Protection
Guide' prepared by the Florida Department of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
'owner', I certify that I have obtained a copy of the above described docu.ent and promise in good faith to deliver it to the
'owner' prior to cOllencelent,
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all work will be done in cOipliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a pertit to do work and installation as indicated. I certify that no work or
installation has cot.enced prior to issuance of a perlit and that all work will be performed to meet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies may apply to the intended work, and that it is
ay responsibility to identify what actions I aust take to be in cCllllpliance. Such agencies include bll! ~i p. liOt littited to:
I Departtent of Environ.ental ReoulatiCln - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Ldnds,
Water/Wastewater Treatlent
* Southwest Florida Water ManaQeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatment. Septic Tanks
I US Environ.ental Protection Aoency - Asbestos abatelent
I also certify that, if fill aaterial is to be used in Flood Zone "A" Dr "A,etc.', it is understood that a drainage plan
addressing a 'co.pensating volule' will be sub.itted which is prepared by a prClfessional engineer registEred in the State of
Florida prior to per.it issuance.
A perlit 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 Offici~1 from thereafter
requiring a correction of errors in plans, construction, or violatiClns of any code. Every perlit isslled ~haJI beco.e invalid
unless the ~ork authorized by such pertit is coamenced within six .Clnths of issuance, or if work authol lzed by the per~it is
suspended or abandoned for a peric1d of six .onths after the ti.e the work is cO'lmenced. One 90 day e;:te"SIOII of time, laay be
allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection must be logged during each six lonth period, or the project will be cClTisidered abaildoned.
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 A1TORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
o
SIGNATURE___~~R~R~GENT--------_=O_-
DATE__)J~!.'i-.Ltt.='-(-------
SIGNATURE
------------------------------
CONTRACTOR
DATE
-----------------------------------
~~~~:YO~SA~~N~-~--- ~g~~:~C~~R~~___________________________
"OTARY PUBLIC; STATE OF FLORIDA AT LARGE
MY COMMISSION EXPI.-@'",COMMISSION EXPIRES MAY 27,1995
~Bar1'HRlt'A"!ttf6IoII"'A'O!!~NC ---
MY COMMISSION EXPIRES
------------------
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SECTION 13, TWP. 26 5.. RGE. 21 E.
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SCALE -
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.., LOT 4$
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LEGENO:
(P)-Denotes measurement IJcr plat.
(F) -Denote; fie 1 d der i ved role a surrfilPnt.
o -Denotes In" iron rod found (except u'; not(~d on Inap).
NOTES:
1. No dppiJrent surfJce encroc1chment~ o,ccpt d:; ~)hov.'l1 hrrcon.
2. Ulld(;r~r(Jund encroc1chments or utilitif::. (if any) not lOCJtf'rj ili
conjunction with thi:, >urvey.
3. Descri IJt i on shown hereon token from \JJrru nty Deed recorded in
OfficLd Record Book 1231, Puye 1611, Public Record:.; of PJ:"co
County, Florida.
4. BearinS3 5hown hereon based on recor~ pl~t.
5. This propf:rty surveyed without the hellefit of a title seilrch fur
(lcl:ic:rtlCnts, ilddition"l Ri<jhts-of-Way-:; or other ('ncllrnbrJncc~ of
record not show~ hereon.
C. The lrllld shoV\n hereon Jppears to lie ill Flood Lone "e" acc(Jrdiny
to F.l.R.M. Conmlunity P'lnel 1~0230 0/160 C, dClteG ~1.:r(h 15, !'):ti,
7. Fe~ces shown hereon not to sCille.
DESCRIPTION:
Lot 411 of MEI\DO\oiOOD ESTATES, as per plat thereof recorded in Plilt [look,
15, Pase lOG of the Public Records of Pasco County, FloridJ.
NOT VALID UNLESS IMPRINTED WITH RAISED SEAL
lJATt Of- SUIWEr, (;!?~(.~~_
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CERTIFIED TO: ATTORNEY'S TITLE INSURANCE FU~U, INC.
FIRST UNION rIATIONJ\L [lANK OF FLORID/I
KATHERINE r~. TRAVER J\:!D/l)i{ ASSIGr;S
I hereby c('rtify thot the Boundury ~nd
Improvement Survey represented hereon meets
the requirements cf Chupter 21 HH-6 Florid.;
Administrative Code,
~ ~
PREPARED BY: 2/LJ .
Mi\lJR I CE lL BEALL
Professional LI1nd Surveyor
Florida PlS Cert. ~G. ~201
BEALL 8 CO. LAND SURVEYING
3/b" f'ttlN:iyn'AN!-4 A~/l iV/k
r. o. (lOX 11.1
SAN AN WNIO, f! ON/vA .1JtJi'6
(~::)4) tJl:Ji) ,. -1/4 ~
;"1:. ~ IS/~JN
./<.'t1 NO. 89085
Slit I: T
ONE OF ONE
--- --_.---- .
PHtf'iJHE.D fUH
KATHERINE Ai TRAVER AND/OR ASSIGNS
...
FORM 1000-C-91
SMALL ADDITIONS
AND RENOVATIONS
FLORIDA ENERGY EFFICIENCY CODE
FOR BUILDING CONSTRUCTION
Section 10 - Residential Prescriptive Compliance Method
Department of Community Affairs
Climate Zones
CENTRAL 4 5 6
COMPLIANCE WITH SECTION 10 OF THE FLORIDA ENERGY EFFICIENCY CODE MAY BE DEMONSTRATED BY USE OF FORM 1 OOOC-91 FOR ADDITIONS OF 600 SOUARE FEET OR LESS. AND RENOVATIONS
TO SINGLE AND MULTIFAMILY RESIDENCES. ALTERNATIVE METHODS ARE PROVIDED FOR ADDITIONS BY USE OF FORM 1000A-91 or900A-91
;, " ,.:.: BUILDER: 1;:- '1
PERMITTING c!. I 7 I( 01
OFFICE: .....-?' r?
PERMIT
NO.:
PROJECT NAME
AND ADDRESS:
RENOVATION ~
ADDITION 0
MULTIFAMILY ATTACHED 0
SINGLE-FAMILY DETACHED E2.I
IF MULTIFAMILY. NUMBER OF
UNITS COVERED BY
THIS SUBMITTAL ITIJ
CONDITIONED ITTT:T:lz / 0 SO
FLOOR AREA ~ FT
PREDOMINANT rn ~
EAVE OVERHANG IJ F T
LENGTH .
PORCH OVERHANG m D
LENGTH . FT
CLIMATE 4 rvl 5 D 6 D
ZONE: ~
JURISDICTION ~I I { !J .1'\
NO.: ~
,"-~ ,,"',
OWNER:
111 \i i< k
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WALL TYPE AND INSULATION CEILING TYPE AND INSULATION FLOOR TYPE AND INSULATION
FOR AODITIONS ONLY: WOOD FRAME MASONRY UNDER ATTIC: DJ.D WOOD MASONRY
PERCENTAGE EXTER~O~ OJ. D EXTERIOR rn [Q] Rc RAISE~ = IT] D RAISED _ OJ 0
OF GLASS R= ".0 DJ.D R - .
TO FLOOR ADJAC:N~ OJ. D ADJA~E~l 02. [Q] SINGLE ASSEMBLY COM~O~ [[J. D COM~O~ DJO
R =
[9]1]% COMMRO~ OJ. D COMMON: w.1OI COMMON: [LIZ]. [QJ SLAB-ON- ~ [g
R = .......: . \...-1 R= GRADE R = rJ () . 0
SINGLE.
PANE
DOUBLE
PANE
NEW GLASS AREA AND TYPE
CLEAR TINT.FILM.SOLAR SCREEN
ITJJJ SO SINGLE ITJJJ SO
FT PANE FT
~SCI DOUBLE. ITJJJ SO
~ FT PANE FT
DUCTS COOLING SYSTEM HEA TlNG SYSTEM HOT WATER SYSTEM
IN 0 CENTRAL o NONE 0 ELECTRIC STRIP 0 HEAT PUMP D ELECTRIC 0 SOLAR
UNCONDITIONED
SPACE: R = 0 ROOM 0 NATURAL GAS D ROOM I PTHP o NATURAL GAS 0 HEAT RECOVERY
DtJ.~ 0 PTAC D OTHER FUELS D NONE o OTHER FUELS D DED. HEAT PUMP
IN CONDITIONED ~ NO NEW SYSTEM ~ NO NEW SYSTEM ~ NO NEW EF c . IT] SF/EF = D.m
SPACE: R = m.D COPIHSPF/AFUE = D.O= SYSTEM
m.D SEER/EER = NUMBER OF BEDROOMS = rn
by the calculation are In compliance With the
PREPARED BY
DATE
/'IA.bv9/
/tfli't,v f /
ReView of plans and specifIcations covered by thiS calculation indicates compliance with
the Florida Energy Code. Befor struchon I ompleted. thiS building will spected
for compliance in accordanc Section 08. F.S ."
J hereby certify that this
BUILDING OFFICIAL
OWNER AGENT.
DATE
DATE
TABLE10A[ MINIMUM REQUIREMENTS FOR ALL PACKAGES
COMPONENTS SECTION REQUIREMENTS CHECK
WINDOWS 904.1 Minimum of 0.34 CFM per linear foot of operable sash crack (includes sliding glass doors).
EXTERIOR & 904.1 Maximum of 0.5 CFM per sq. ft. of door area: solid core, wood panel, insulated or glass doors only.
ADJACENT DOORS
EXTERIOR 904.1 To be caulked, gasketed, weatherstripped or otherwise sealed.
JOINTS & CRACKS
SOLE & TOP 903.2 Sole plates and penetrations through top plates of exterior walls must be sealed.
PLATES
INFILTRATION 903.2 Infiltration barrier must be installed in exterior walls & raised wood floors.
BARRIER
INTERIOR 903.2 All openings in interior surfaces of ceilings and exterior walls must be sealed.
JOINTS/CRACKS
FIREPLACES 903.2 Fireplaces must have flue dampers. glass doors and outside combustion air intakes.
EXHAUST FANS 903.2 Exhaust fans vented to unconditioned space shall have dampers, except for combustion
devices with integral exhaust ductwork.
WATER HEATERS 904.2 Comply with efficiency requirements in Table 9-7A. Switch or clearly marked circuit breaker (electric)
or cu10ff (gas) must be provided. External or built-in heat 1rap required.
SWIMMING 904.3 Spas & heated pools must have covers (except solar heated). Non-commercial pools must have a
POOLS & SPAS pump timer. Gas spa & pool heaters must have minimum thermal efficiency of 78%.
HOT WATER 904.4 Insulation is required only for recirculating systems, including heat recovery units. 111 such cases,
PIPES piping heat loss shall be limited to a maximum of 17.5 BTUH per linear foot of pipe.
SHOWER HEADS 904.5 Water flow must be restricted to no more than 3 gallons per minute at 80 PSIG.
HVAC DUCT 904.6 All ducts, fittings, mechanical equipment and plenum chambers shall be mechanically attached,
CONSTRUCTION. sealed. insulated and installed in accordance with the criteria of Section 904.6. Ducts in unconditioned
INSULATION & space and air handlers located in attics must be insula1ed to a minimum R-4.2 (R-6 after 1/1/92).
INST ALLA TION
HV AC CONTROLS 904.7 Separate readily accessible manual or automatic thermostat for each system.
RENOVATIONS 1003.0 Meets the requirements of sec. 1003.0. See step 3 of page 2 of this form.
ONLY GLASS
-1 -
. .' . CLIMATE ZONES 4 5 6
TABLE 108. Prescriptive Requirements for Small Additions (600 Sq.Ft. and Less) and for Renovations to Existing Buildings.
COMPONENT MINIMUM INSULATION
INSULATION INSTALLED
Concrete R-5
~ Wood frame. 2' x 4' R-11
-' Wood frame. 2' x 6' R-19
J Common. Wood frame' R-ll
Common. Masonry' R-3
en Under aftlc R-3D
CI
z Single assembly R-19
::;
iil Common. Wood frame' R-l1
u
en Slab-on-grade No Minimum
ac: Raised wood R-11
0
9 Raised concrete R-5
u.. Common. Wood frame' R-1l
0 In unconditioned space 1991 1992
=> R-4.2 R-6
Q In conditioned soace No Minimum
EQUIPMENT MINIMUM INSTALLED
EFFICIENCY EFFICIENCY
1991 1992
...J
0 Central AJC SEER = 9.0 10.0 SEER =
0 -
() Room unit or PT AC EER = 8.5 8.5 EER
=
CJ Electric Resistance ANY
z
i= Heat Pump HSPF = 6.4 6.8 HSPF
<( = -
W
I Room unit or PTHP COP = 2.6 2.7 HSPFI =
w HSPF = 6.1 COP -
() 6.1
<(
0.. Gas, natural or propane AFUE = .70 .78 AFUE =
(IJ -
Fuel Oil AFUE = .76 .78 AFUE =
a:
w Electric Resistance EF = .88 EF =
!;j: -
~ Gas. natural or propane EF = .54 EF =
I- -
0
I Fuel Oil EF = .54 EF =
'Common components are those which separate two conditioned living units in a multifamily building.
TABLE 10C. Prescriptive Requirements for Glass Areas in ADDITIONS ONLY (Renovations see 3 below)
Maximum percentage glass to floor area allowed is selected by type, overhang length, and shading coefficient. See below. Maximum Installed
%- %=
GLASS TYPE, OVERHANG, AND SHADING COEFFICIENT (TINTING) REQUIRED FOR GLASS PERCENTAGE ALLOWED
UP TO 20% UP TO 30% UP TO 40% UP TO 50%
Single Double Single Double Single Double Single Double
OH - SC OH - SC DH - SC OH - SC DH - SC OH - SC OH - SC OH - SC
l' - 1.0 0' - .90 2' - 1.0 l' - .90 3' - 1.0 2' , .90 4' - 1.0 3' - .90
3' - .86
0' - .86 l' - .86 0' , .70 2' - .86 l' - .70 2' - .65 2' - .70
0' - .65 l' - .65 0' - .50 l' - .45 l' - .50
0' - .45 0' - .35 0' - .40
Shading coefficients (SC) may be obtained from the manufacturer of the glass. Typical shading coefficients are: single-paned clear
SC = 1.0, double-paned clear SC = .90, and single-paned tint SC = .86.
Form 1000C may be used to comply the fOllowing types of construction:
SMALL ADDITIONS TO EXISTING RESIDENCES. Additions which have 600 square feet or less of conditioned area may comply with the Energy Code using this form The prescriptive
requirements in Tables 10A, 1 OB and 1 OC apply only to the components of the addition, not to the existing building. Space heating, cooling, and water heating equipment efficiency levels must
be met only when equipment is installed specifically to serve the addition or is being installed in conjunction with the addition construction Components separating unconditioned spaces from
conditioned spaces must meet the prescribed minimum insulation levels.
RENOVATIONS. Residential buildings undergoing renovations costing more than 30% of the assessed value of the building must comply with the Energy Code using this form. The
prescriptive requirements in Tables 10A and 10B apply only to the components and equipment being renovated or replaced.
GENERAL DIRECTIONS:
1. On the left side ofT able 1 OB in the column titled "I NSULATION INSTAllED", indicate the R-value of the insulation being added to each component. On the right side ofTable 1 OB indicate the
efficiency levels of the equipment being installed in the column titled "EFFICIENCY INSTAllED". All R-values and efficiencies installed must meet or exceed the minimum values prescribed
in the preceding column for that component. Components and equipment neither being added nor renovated may be left blank.
2. ADDITIONS ONLY. Determine the percentage of new glass to conditioned floor area in the addition as follows Total the areas of all glass windows, sliding glass doors and glass panels in
doors which are more than 1/3 of the area of the door Double the area of all non-vertical roof glass and add it to the previous totaL When glass in existing exterior walls is being removed or
enclosed by the addition, an amount equal to the total area of this glass may be subtracted from the total glass area Divide the adjusted glass area total by the conditioned floor area of the
addition. Multiply by 100 toget the percent. Find the largest glass percentage under which your calculated percentage falls on Table 1 OC. For example, 29% glass would qualify for the "Up to
30%" column. Prescriptives are given by the type of glass (Single or Double pane) and the overhang (OH) paired with a shading coefficient (SC). Any pair within the selected "Up To "
category is acceptable. For a given glass type and overhang, the maximum shading coefficient allowed is specified. Indicate the category into which the percentage falls in the box at the top
titled "Maximum % = " In the next column titled "Installed", indicate the calculated percentage of glass in the addition. Actual glass windows and doors previously in the exterior walls
of the house and being reinstalled in the addition, do not have to comply with the overhang and shading coefficient requirements on Table 1 OC All new glass in the addition must meet the
requirements for one of the options in the glass percentage category you indicated. The overhang (OH) distance is measured perpendicularly from the face of the glass to a point directly
under the outermost edge of the overhang.
3. RENOVATIONS ONLY. Only glass areas which are being replaced as part of the renovations need to meet the following requirements. Any glass type and shading coefficient may be used
for glass areas which are under at least a two foot overhang and whose lowest edge does not extend further than 8 feet from the overhang. Glass areas being renovated that do not meet this
criteria must be either single-pane tinted, double-pane clear, or double-pane tinted.
4. Complete the information requested on the top half of page 1.
5. Read "Minimum Requirements for Small Additions and Renovations", Table 10A on page 1, and check to indicate your intention to comply with all applicable items
6. Read, sign and date the "Owner/Agent" certification statement on page 1.
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