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Home My WebLink About92-2206 - - -------------.--- ---- ---=...~---:-'--- ~..,-_.._-- -.,----.--..-- BUILDING PERMIT /s?~-o ~-'?..!.>- ~~0ECTAI~ ::::::,~,:~" &~~~ ~ #-'% ~ Parcell.D. # .;;. -d-h - ~/ , CITY OF ZEPHYRHILLS (813) 788-6611 J~L~?J e20- ro ~~~ ~HAN~ Permit N<! 22068 Date <: < - / ft - 9 .:l- Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: ~nergy Code: Description of Work C. _~"':r?1 iRa.don Gas: ,{: tJ b L -~~ ~ ~ 4'"YL NO OCCUPANCY BEFORE C.O. FINAL ,92- DATE Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Inspector Permit Fee Signature Company Address Telephone# :;23S 7-.3 ~ ~'v}, . Valuation or Contract Price ) X; n-tJ. rv City License Registration # / f1 State Certified License# Ftr. ~ - Pre SLB ~ ~;;J '7- ~ L-- Lintel ~- ct L- FRM. V 4 ~ Z}i -q'\...- $AJJ Insul. CL WL -+- Tp.Serv. SLB '-1'-2. 2 . Rough In J/4 ...~~-q LU-Tub Sett./4-U';1LffJ/ Meter Can Water Const. Pole Sewer Pool Final Pre-Meter Final Breakers Ducts Insl. 4 -lb ",4 ~u.. Compressor Final Driveway REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. ~l.gll<1I...ULC -' ~ *********************~~~..""""--_.. Signature Company State Cert. or Regist. 0 . " City License Registratlon " PTHER APPLICATION APPROVED BY -' . J.J . J '_,t~J~*.J(.h *... * '* * *~ * * * * * * * * *;, 'I: ,:" .: .r " ., l. . ,. ... **)1****** ~ . .<AA "";;[ ".... .<rv..Y . . PER~lIT OFFICER. SMOKE DETECTORS SHALL BE ELECTRIC POWERED (PtC) !i'.j PiLL r~;~\rJ CONSTRUCTION NFPA-l01 & NFPA-74 liFE SAFETY CODE. 1 ___31'....0" @J 1l ~ @ fl ~ [ -FLA. F<-M" -BED RM, z /' - /-", =15-8" ( \ -@ rn ~ 0 ) I ~J '-......... ./ '- / 1.5 5:'4" ~-.JO~6 II 8~ro" 12.'. 4" . .9:-,0" --'5"2" s ~ dj. TGRE.ENE ~l'\5 (Orn S1": f C ^ ~-r- 'fJ.. ! c PLt\rJS REVIEWED 3--- /0 - c(1-. --- BUILDING DEPT. APPROVED t~4 6u-~ f 3~O" 1 @ 16~4" ~ 94.5' I ~Z~41' - - - 46'- ~ II 34' 12.' \I 1/ , r f ; I NEW ~DO - 2.0' \ EXISTING / f--- 2~' NOR.T H to T H s'r. ]00' \ \ i _~I'Ll PLY /EN0TRUS5, '5HINGLE~ AND TRI M "10 - f'J\ATCH. APPRO\JED ~TRAP? fi~~~ stl (c1lc.t.i\E-- 1001/}fpf..cJtiD fi>( H EIG HT _TO .MATCH 3- f\tis\~~n"L- f~cfL SLAB i-} (,vl \i\\IU Cl-nJ -:v.. flO 0 E ' '"1'1 "v ~ ~A" TVFF-R 4" -3000 lB ~ -YAPoR. eAr-<. \ ,- ( [:,0 V E D P R I ~~ T R E QUI RED ON JOB SITE MATC.H EXT. FI NISH !3x/e;' FOOTER -5TEM WALL #5" ROD.S-FooTE~, CO~NE~l lE:NTI L CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Th,.und,rsi9ned understands that this perllt lay be sub',ct to "deed restricti~ns' which ~ay be oor~ restr.ietive than City regulations. The undersigned assules responslblllty~fDr. cDlpllance with Bny applicable deed restrictions, B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITI~S If the own~r has hired a c~ntractor ,~r contractors to undertake work, they may be rcquired to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, b~th the ~\1ner and contractor nay be cited for a misdemeanor violation under state laK, If the owner or intended contract~r are unc~rtain as to what licensing require.ents Day apply for the intended work, they are advised tn contact the City of Zephyrhills Bui Iding Departlent, (BI3) 7BB-6611. Furthermore, if the OKner has hired a contractor or contractors, he is advised to have the ce,ntractor(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, Jf the contractor wishes you to sign as contractor that aay be an indication that he is not properly licensed ~nd is not entitled to per~itting privileg~s 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 - Ho~eowner's Protection Guide' prepared by the Florida D~partlent of Agriculture and Consumer Affairs, If the applicant is sO~~Dne other than the 'owner', I certify that I have .obtained l c~py of the above described document and promisc in good faith to deliver it to the 'own~r' prior to cOIDenceDent. : 1. ': I_':~ '. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all work Mill be done in coapliance with all applicable laws regulating construction, zoning, and land developDent. Application is hereby lade to obtain a perait to'do work and install~tion as indicated. I certify that no work or installation has coemenced prior to issuance of a perlit and that all work will be performed to roeet 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 governmental agencies ~ay 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 bill ~I e liC,t li~ited to: . J r -> I Department cf Environ~pntal ReQulatio.~ - Cypress Bayheads, Iletland ~reas and Environmentally Sensi live Ljnds, Hater/WastEwater Treatment I Southwest Florida llater.ManaQEftent District - Wells; Cypress Bayheads, Hetland tlreas, Altering Hatercvufses I Arty Corps ~f Enqineers - SeaMalls, Docks, Navigable Waterways I DepartlEnt of Health L R~habilitative Services. Environmental HEalth Unit - Wells, Wastewater Treat~en:, Septic Tanks I US Environaental Protection Aq~ncy - Asbestos abatement I also certify that, if fill latHial is to be used in FIMd Ze,ne "A" e,r "I\,etc,', it is underste,e,d \1,,1 a drainage plan addressing a 'colpensating volute" will be subtitted which is prepared by a professie,nal engineer regist~led in the state of Florida prior to perlit issuanCE. A perlit issued shall b~ construed to be a liCEnse to proceed with the work and not as authority to viol~te, cancel alter, or set aside any provisions of the technical codesr nor shall issuance of a permit prevent the Building Officil1 fro~ thereafter requiring a correction ~f errors in plans; construction, or violations of any code. Every per~it issu0d ~hall beCDle invalid unless the wClrk authe,ri1ed by such permit is ce'lIIlenced within six roonths elf issuance, e,r if liC<lt; al,t},c" )zed bi the perlit is suspended or abandoned for a period of six lonths after the ti)e the Mork is co~menced. One 90 day e:I~~5ioll of tiae, say be allowed for the per~it with fee charge of ~15.00, The extension shall be reqursted in Hriting to thr Building Official. An approved inspectie,n r..ust be logged during each six month period, or the project Hi 11 be cc,nsidered db"I,Ge,c,ed. WARNING TO.OWNER: YOUR FAILURE TO REGORD, A I\IOT,ICE OF COMMENL:EMENT 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. JOBS' UNDER $2,500 IN VALUE DO NOT E .10 RECioD NiP T A "NOTICE OF COMMENCEMEN f". Before t is ."lay kno p rs~ Y to me "Before me tb.is day known ~~za:An;o me J~led'N:TU~ e di:_ ~~~e _~~%r,A1fun~~~~-----~W~' R OR A{3f::NT CONTRAC~ >J~- DATE ~ - 18 - 9.:2..' DATE______~r_G..l1._tO--'-J.9.9-2---------------- ~~~~:yo~ ~~~~~_~~~~~~~~ ~~~~:~c~~n~~~~------- CC#070092 Dawn E. Woodward CC1tOO70092 MY COMMISSION EXPIRES~~~~~i~~~~~~95.~y COMMISSION EXPIRES__________________ BONDED THRU NOTAllY PUBLIC UNDEll TEB& NO'fA~.~'Yl.unx:, ~;TATE OF FLORiDA MY cprU,1.'iIt:5WN EXPIRES: Jan. 2S 1995 BONDED IHRU NOl'ARY PUBLIC UNDERWRITERs. \[(1 bJ. 8Lub, PL l"\ ,. . f:'L,.iC \ '. " \C '-... \..:: ',- . [;..- ~ \ 4~; 1 l~ ~<r- .1) I~/OD 0 / .~ . C-:' ;..; 7,;;.>0 3Z,5o 2~, 7 :; ~\'\ -: r t\ 2,...0 ~ () 0 Ii' [ .. rl s'" ~ 'T, "r~ Cf1\. t)\1 --r::::: ....... j ." l...... ",- L ~Jf; ) Z3~. 7 ~ / "... .. ( ,,~ ) ,; t,,^-,>"" - h,^ ; ) i ~-.( fd II~ ~, il . " ..'~, ~___,-. l' ~ .fl._t\., \ /'".. "P "1'1 to fJ btl .) 50&' 5q f~, ~. D ftv /' Ii rc. (N)-n ) -c;; -rl) L $'~ 24D,~) .' J., y G. L s-rf. v t. ( ,',.. \ '::.)-1 '2 ' I ->5)<' 5"0<0 55 f.. L,y. ~ Jrr-:1!71utl Page No. of Pages G. L. STEVE (,;CNSTRUCTION 37746 Glades Lane ZEPHYRHILLS. FLORIDA 33541 (813) '7,182.9442 PROPOSAL SUBMITTED TO PHONE DATE MR JIM GREEN ~ STREET 788-5102 JOB NAME MARCH 12, 1992 6145 10th St. CITY. STATE AND ZIP CODE ADDITION AND REMODEL JOB LOCATION 33540 DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: Add 16'4" X ..22'4" u block room ..addition..withp3'u.walkaround north end . . plusa9'X 8' Florida Room. Tie in roof with shingles to match existing. Addition to have bedroom, walk-in closet, bathroom with standard tub, seperate shower, (n Ie) ,doublevafiitY'withuchifiala:vat'ory~"pelongatedtoilet;new . central... air (heat Pump); Tuff-R board wall insulation (3/4"), R-26-30 S.A.B. ceiling. Add cabinets to existing kitchen, drop ceiling with recessed florescent lights. Add 2 recessed can lights, close in door, and add 4/0 wrap o~ening. Add door to bedroom. Add door to Florida Room. Total $17 000.00 Dr Jroposr hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: Payment to be made as follows: . dollars ($ ). All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practkes. Any alteration or deviation from above specifica- tions involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes. accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. Authorized Signature Attrptuutr nf Jrnpnsul - The above prices. specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified, Payment will be made as outlined above, Signature. ( Date of Acceptance: Signature PROOUCT 118.3 (i\ri:-jjs7.I~., Groton, Mass. 01471. ToCIJdef f'ttJNE T(ll FREE I + 8O(}.215.638O I. 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~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 SQUARE FEET OR LESS. AND RENOVATIONS TO SINGLE AND MULTIFAMILY RESIDENCES. ALTERNATIVE METHODS ARE PROVIDED FOR ADDITIONS BY USE OF FORM1000A-91 or900A-91 PROJECT NAME AND ADDRESS: RENOVATION ADDITION IF MULTIFAMILY. NUMBER OF UNITS COVERED BY THIS SUBMITTAL. IT]] CONDITIONED ~8 (;, SO FLOOR AREA ~ FT PREDOMINANT rn [Q EAVE OVERHANG '-' FT LENGTH . PORCH OVERHANG m 0 LENGTH . FT SINGLE- PANE DDUBLE- PANE CLIMATE E: JURISDICTION NO,: NEW GLASS AREA AND TYPE CLEAR TlNTFILM,SOLAR SCREEN DID SO SINGLE- ~ SO FT PANE ~ FT DID SO DOUBLE- DID so FT PANE FT MULTIFAMILY ATTACHED SINGLE-FAMILY DETACHED 0 WALL TYPE AND INSULATION CEILING TYPE AND INSULATION FLOOR TYPE AND INSULATION FOR ADDITIONS ONLY: WOOD FRAME MASONRY UNDER ATTIC: ~.~ WOOD MASONRY PERCENTAGE EXTER~O~ OJ. D EXTE~O~ rn.~ Rc RAISE~ = [[1 D RAISED _ rn 0 OF GLASS R - . TO FLOOR ADJAC~~ OJ. D ADJA~E~T ITJ.O SINGLE ASSEMBLY m.o COM~O~ [[I 0 COMMRO~ ffiO R = [lIJ% COMMRO~ OJ. D COM~O~: m.o COMMON: m.D SLAB-ON- ~ [g Ro GRADE: R = . DUCTS COOLING SYSTEM HEATING SYSTEM HOT WATER SYSTEM -~---- IN ~ CENTRAL 0 NONE D ELECTRIC STRIP gj HEAT PUMP g] ELECTRIC D SOLAR UNCONDITIONED SPACE: R 0 D ROOM D NATURAL GAS D ROOM/PTHP D NATURAL GAS D HEAT RECOVERY m.D D PTAC D OTHER FUELS D NONE D OTHER FUELS D OED. HEAT PUMP IN CONDITIONED D NO NEW SYSTEM o NO NEW SYSTEM D NO NEW . IT] SF/EF 0 o.rn SPACE: R 0 rn.~ COPIHSPFIAFUE = OJ TJ SYSTEM EF c ITJ.O SEER/EER 0 rn NUMBER OF BEDROOMS = I hereby certify that the plans and specifications covered by the calculation are in compliance With the ReView of plans and speCifications covered by this calculation indicates compliance With Florida Energy COde~ <!:' _ the Flonda Energy cOd~~nstruction IS completed this building will be Inspected PREPARED BY '( ~ -,,::\Ie DATE for comphance In accordanc h sectl~;'8. F.S ^ L I hereby certify that ~~s In ~ the Florida Energy Code BUILDING OFFICIAL, '../ /1/1_A ..< 4..~ ~_ OWNER AGENT: / '" -L. 0 DATE DATE .3.. /0 ~ 9 2.-- I TABLE 10AI MINIMUM AEQUIREMENTS 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 pene1rations 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, excep1 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 cutoff (gas) must be provided, External or built-in heat trap 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 7B%. HOT WATER 904-4 Insulation is required only for recirculating systems, including heat recovery units. In 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 mus1 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 insulated to a minimum R-4.2 (R-Ei after 1/1/92), INST ALLA TION HVAC CONTROLS 904_7 Separate readily accessible manual or automatic thermostat for each system. RENOVATIONS 1003.0 Meets the requirements of see, 1003,0. See step 3 of page 2 of this form. ONLY GLASS -1 - CLIMATE ZONES 4 5 6 TABLE 10B. Prescriptive Requirements for Small Additions (600 Sq.Ft. and Less) and for Renovations to Existing Buildings. COMPONENT MINIMUM INSULATION INSULATION INSTALLED Concrete R-S en Wood frame. 2' x 4' R-ll ..... ..... Wood frame. 2' x 6' R-19 ~ Common. Wood frame' R-ll Common. Masonry' R-3 en Under attic R-30 CI Z Single assembly R-19 ::; w Common. Wood frame' R-ll (,) en Slab-on-grade No Minimum a: Raised wood R-ll 0 9 Raised concrete R-S LL Common. Wood frame' R-ll 0 In unconditioned space 1991 1992 :::> R-4,2 R-6 Q In conditioned soace No Minimum EQUIPMENT MINIMUM INSTALLED EFFICIENCY EFFICIENCY 1991 1992 -I 0 Central NC SEER = 9,0 10.0 SEER = 0 - <..) Room unit or PTAC EER = 8,5 8,5 EER = " Electric Resistance ANY z i= Heat Pump HSPF = 6,4 6,8 HSPF <( = - W J: Room unit or PTHP COP = 2,6 2,7 HSPFI = w HSPF = 6,1 6,1 COP - <..) <( Gas, natural or propane a.. AFUE = ,70 ,78 AFUE = C/) - Fuel Oil AFUE = ,76 ,78 AFUE = a: w Electric Resistance EF = ,88 EF = I- - <( 3: Gas, natural or propane EF = ,54 EF = I- - 0 J: 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 OH - SC OH - SC OH - 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' - AO 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 DB and 10C 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 oITable 1 DB in the column titled "INSULATION INSTAllED", indicate the R-value of the insulation being added to each component. On the right side of Table 10B 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 '/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 100to get the percent. Find the largest glass percentage under which your calculated percentage falls on Table 1 DC. 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 10C. 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. 2