HomeMy WebLinkAbout06-5545
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
MOBILE HOME SET-UP
5545
Permit Number: 5545
Permit Type: MOBILE HOME
Class of Work: MOBILE HOME SET-UP
Proposed Use: MOBILE HOME SUBDIVISION
Square Feet:
Est. Value:
Improv. Cost: 35,000.00
Date Issued: 3/09/2006
Total Fees: 4,442.58
Amount Paid: 4,442.58
Date Paid: 3/09/2006
Work Desc: MOBILE HOME SETUP
Address: 37319 NEUKOM AV LO
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: GRAND HORIZONS
Parcel Number: 34-25-21-0170-00000-2470
Name: GRAND HORIZON
Address: 37319 NEUKOM AVE LOT 247
ZEPHYRHILLS, FL. 33542
Phone: 813788-5440
H
ACE AIR CONDITIONING & ELEC.
MOBILE HOME PLUMBING
SEWER CONNECTION MOBILE
WATER METER RES 3/4"
IRRIGATION CONNECTION
TRAFFIC IMPACT FEE 1%
FIRE IMPACT FEE
PUBLIC SAFETY 5%
0.0
40.00
808.00
180.00
175.00
15.88
273.00
26.35
AL
MOBILE HOME MECHANICAL
WATER CONNECTION MOBILE He
IRRIGATION METER
TRAFFIC IMPACT FEES 99% COM
PARK FEES MH
POLICE IMPACT FEE
35.00
209.50
180.00
1,572.12
573.73
254.00
.J) cY
/ J1:0/
y\{\y\/\ \~
FINAL
REINSPEcnON FEES: Reinspection fees will comply with Florida statute 553.80 (2)(c) when extra inspection
trips are necessary due to anyone of the following reasons: 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
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 permits required from other governmental
entities such as water management, state agencies or federal agencies
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
~~ ~~
CONTRACT S SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
~-1-0 (p
PHONE GONTACT FOR PERMITTING --rer,. 7 ,,)I-fijl-Jt)
OWNER'S NAME G~lId 11ov"Zd1
JOB ADDRESS . :J1$/9I'VtlAfo!Y7 A vfL LlJj '2-'-11
PHONE 311. 7J3-Sil'lo
LEGAL DESCRIPTION: LOT(S) BLOCK
PARCEL 10 # ']'-1- ZS. 21 - 0 176-00 000- '2-'-170
SUBDIVISION
(OBTAIN FROM PROPERTY TAX NOTICE)
\VORK PROPSED; DNEW CONSTRUCTION o ADDITION DALTERATION o REPAIR ~STALL
DSIGN o MOVE 0 DEMOLISH
PROPOSED USE: DSGL FAMILY DWELLING DMlJLTI-F'AMILY 0# OF lJNITS ~OBILE HOME
o COMMERCIAL o INDlJSTRIAL o SWIMMING POOL o OTHER
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WQRK mob) Je. horn c Sf f -lAJ:>
I
'j)j..5""1
BUILDING SIZE
SQIJARE FOOTAGE
15?? I
HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
& (1) SET ENERGY FORMS.
FORt1S .
r-JOC J
6 BUILDING
35000, ~()
$ ,
PERMITS REQUESTED
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o Progress Energy 0
W.R.E.C.
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLA.TION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES
o NO
COMPANY
STATE CERT OR REGIST #
********************************************************~*********
E~ECTRICIAN
SIGNATURE ~~--r-- -> STATE CERT OR REGIST I
********************************************************,,*********
COMPANy!lce
PLUMBER
COMPANY 8t, -1ft / h dC! IV];l5
SIGNATUREZ:::=;~~~ _ STATE CERT OR REGIST I
******************************************************************
MECHANICAL COMPANY /J c e.
SIGNATURE~~
STATE CERT OR REGIST #
*****************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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BUILDING SHALL COMPLY WITH
ALL APPLICABLE BUILDING,
ELECTRICAL, PLUMBING AND
MECHANICAL CODES. J' I
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1111I11111111111I11I1111111111111111I11111111111111I11111111
2006045313
NOnce OF COMMeNCSMe'NT
County of /115 ( 0
T.HE UNDERSIGNED hereby gilf&$ noriee lhat it, rO\leffle . .
Chal'tPJ 713. "'1<>rK1a $taMes, llle following Inforn~tion is p~~~~~~' ~~.~ ~aln f'&a1 prOP\1r1y, aM in aceordance with
."'- '" \nlS '.OllCl;! of CommenC\!lrT1em;
1. DesenplionofProperty: ParoelNo. ?il- 25 -'21- () ~7tJ-() 0060.- 2q 70
statuf r !OVI J tl
Rcpt:976151
DS: 0. 00
03/07/06
Rec: 10.00
IT: 0. 00
Dpty Clerk
2.
(L~I1i1I~1ion of... I>~)' and w_ ~ If ll.,.,llaDIel
G~a/ Description of Im~vetnenrl17obl i ( hoth.t. <;; e f -l~
JED PITTMAN, PASCO COUNTY CLERK
03/07/06 01:06~ 1 f \.
Crcrr7c! flvVl ZUVJ OR BK 687 ~ PG 43'1
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Owner InfOnnation: NaOlli
7 ~Ljc; C/(lth1!o[:x'::
Adllreu' - ~
imerest In Property:
Name of Ftle Simple Tirlt"!llOlder:
(11<Jll..tI1&n owner)
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5. Surety: Name
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Sraea -
Amount of Bond; S
6. Lender: NSm!l
Ac!aI"",,,
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7. Persons wflhin the StarE! of Florida rJesignated by (.>woer upon whom notices O( olher documen~ msy be se"'ed
as provided b)' Section 713. 13(1)(a)(7), Florida Sratllles:
Name
Ad"''''5~
s~.-
City
B.
In addition 10 hilTl6elf. Owner rJ~ignafe$
of
NoIica <15 provided III Sec..'flon 713. 13("1)(b), Florida S'all.Jt",!'l.
to r&a!ive 8 ropy or the Uenor'.
9.
Expkalion cJate of No1lce of Commencemenr is .one yeat from .he dale of feco(dln9 unleG$ a difl'etem dare i:s
specified.
(~~L- ~~f",~aSH
S~nlllur.. 01
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STATE OF Fl. ~IDA
COUNTY O'::(y 0
~r<;!90ing instr.llO[l[ r:..~edg~O~ me the
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<"::::kOOwnlo..me.OL.wflo has prodUced
$eal:
~~~v ~~ ROBERTA BUTTERFIELD
:Q.t-." MY COMMISSION' DO 071. 797
.~ EXPIRES: March 10. 2006
. "'''w...Ut-~ ~~..~,~~Seniites
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
5547
Permit Number: 5547
Permit Type: ADDITION/ALTERATION
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 7233 HIGHLAND LOO
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block:
Subdivision: OAK RUN
Parcel Number:
Book:
Section:
1,065.20
3/09/2006 Name: THOMPSON, TELAH
40.00 Address: 7233 HIGHLAND LOOP
40.00 ZEPHYRHILLS, FL. 33541
3/10/2006 Phone: 813918-4798
INSTALL FRENCH DOOR REPLACING SLIDERS.
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y \ '-' ' ,19'
REINSPECTION FEES: Reinspection fees will comply with Florida statute 553.80 (2)(c) when extra inspection
trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections 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.
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 permits required from other governmental
entities such as water management, state agencies or federal agencies.
The payment of inspection fees shalf be made before any further permits will be issued to the person owning same
"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."
NO OCCUPANCY BEFORE C.O.
jM-9-~:r' - ~ ~
CONTRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhi11s, FL 33542
813-780-0020 FAX:813-780-0021
DATE RECEIVED
31r'[ID~
PHONE CONTACT FOR PERMITTING
OWNER'S NAME Te.\% ""1hom\>son
JOB ADDRESS f)ot33 b\\~"\tl.f\d laJp
LEGAL DESCRIPTION: LOT(S)
BLOCK
PHONE ~\3-C\\~-4Iq8
Zef'h,y'h', \ \.S I FL ,~3SL\ \
SUBDIVISION ()c.U( '\=<'Uf\
PARCEL 10 #
(ORTA TN FROM PROPERTY TAX NOTH-:El
WORK PROPSED: 0 NEW CONSTRUCTION
o ADDITION
DALTERATION
o REPAIR
1$l. INSTALL
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te.(MI'1
5S~l
o SIGN
PROPOSED USE:~GL FAMILY DWELLING
o COMMERCIAL
o MOVE
o DEMOLISH
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
\f\.<:r\-o..\ \ O.r Ffe~m Doo( (rep\l1C i I'\lj o\\clecS)
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
o BUILDING
PERMITS REQUESTED
$ to~~. 20 VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o Progress Energy 0
W.R..E.C-
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES
o NO
_::!I!I_.....
BUILDER ,w.,u . .. COMPANY ~ 0 10.,., a"'\~ r
SIGNATURE.Je.O~ ~
~.
~)"f~
STATE CERT OR REGIST #
******************************************************************
ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
***************************************************************,r*
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. 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
City of Zephyrhills Building Department, 813-780-0020.
Furthermore, if the owner has hired a contractor or 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 signs 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 may 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. CONSTRUCTUION 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 Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to conunencement.
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 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 construc-cion, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental 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 Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater 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-W"lls,
Wastewater Treatment, S"ptic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone "A" or \'A,etc.", it is
understood that a drainage plan addressing a "compensating volume" will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance.
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 code. Every permit
issued shall become invalid unless the work authorized by such permit is COffinlenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of six months after the time the work is commenced. One 90 day extension of time
may 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
month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINJ.NCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
, 20-
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this _day of----------, 20
by
(name of person acknowledged)
C1ho is personally known to me, or
(name of person acknowledged)
Dwho is personally known to me, or
o who has produced
(type
and whoD did 0 did not
of identification)
take an oath.
o who has produced
(type of identification)
and who 0 did D:iid not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
D:ISCLOS1J1Ul: STA'l'EMBHT FOR OWNER
C:ITY OF ZEP:EYIUC:LLS Bt7J:LD:ING DEPARTMENT
:I, --\.~1o... h \~~~ . have read and fully understand and
agree to the provisions of this instrument.
The undersigned states and affixms that he or she is desirous of constructing,
renovating, adding to or reroofing his or her own domicile~, that he or she
actu~~y occupies, or ~~~ occupy by said domici~e, and same is not for
rent, lease or sa~e. That he or she sha~~ comp~y ~th the following conditions.:
~.
That the owner and he or she ~one shall act as the builder for all phases of
construction.
That the owner wil~ comply with all provisions of the City of Zephyrhi~~s
ordinances and codes pertinent to 'the building.
That in the event various phases of construction are subcontracted, he ~ll
engage on~y properly licensed subcontractors and ~ll personally supervise
such work..
That in the event the Building :Inspector shall require corrections to be made,
the owner will_ assume ful~ responsibility to insure they are made, and upon
completion wi~~ c~~ for a reinspection before proceeding ~th the 'bui~ding.
That the oWer shal~ assume full. responsibi~ity for the construction and wil~
not expect supervision of his work from the City of Zephyrhil~s Bui~ding
Department.
That prior to final inspection any additional fees, inCluding reinspection
fees, must be paid in full. A written request from this office shall
. constitute' an officia~ notice,to pay addition~ fees.
That the owner sha~~ comply ~th all City, State and Federa~ laws' in regard to
social security, workman's compensation, lien ~aws, etc., where applicab~e.
That the owner shal~ comply ~th all the safety codes issued by the Florida
:Industrial Commission.
State ~aw requires construction to be done by licensed contractors. You have
applied for a permit under an exemption to that law. The exemption a~lows
you, as the owner of your property, to act as your own contractor with certain.
restrictions even though you do not have a license. You must provide direct
onsite supervision of the construction yourse~f. You may bui~d or improve a
one-fami~y or two-fami~y residence or a far.m outbui~ding. You may a~so'build
or improve a commercial building, provided your costs do not exceed $25,000.
The bui~ding or residence must be for your own use or occupancy. :It may not
be built or. sUbstantial~y improved for sa~e or lease. :If you seJ.l;or' lease a
building you. have built or substantially improved yourself. ~thin 1 year after
the construction is complete, the law will presume .tha:t you built or
substantia~~y improved if for sa~e or lease, which is a violation of this
exemption. You may not hire an unlicensed person to act as your contractor or
to supervise people working on your bui~ding. :It is your responsibi~i ty to
make sure that people employed by you have licenses required by state law and
by county or municipal licensing ordinances. You may not delegate the
responsibility for supervising work to a licensed contractor who is not
licensed to perform the work being done. Any person working on your building
who is not ~icensed must work under your direct supervision and must be
employed by you, which means that you must deduct J.P.:I.C.A. and rithholding tax
and provide workers' compensation for that employee, all as prescribed by iaw.
Your construction must comp~y ~ th al~ applicable laws, ordinances, bui~ding
codes, and zoning regulat1ons.
JJ~ ~~
2.
3.
4.
5.
6.
7.
8.
9.
OWNER'S S:IGNATURE
ADDRESS
PHONE
3/)-o~
r
DATE
W:ITNESS
PBllKIT #
.
BUILDING CODE COi\lPLIANCEOFFICE(BCCO)
..RODUCT CONTROL DIVISION
i\lI1'MI-DADE COUNTY. FLORIDA
M~O-D^oeFLAGLt:R'8UltDtNG
(40 WEST FJ,.AGLER STRl-:ET. su.n: 1603
I MIAMI. FLORIDA 33 130-IS63
(3050 375-2i)()I FAX (305) 37S-2t)()S
!
NOTICE OF ACCEPTANCE (NOA)
Jeld-Wcn, Inc.
3250 Lakeport Drive
Klamath' Fallli, OR 97601
SCOPE:. . . . i,
This NOAisbeingiss~ed under the applicable rules and regulations governing the usd of construe.tion materials.
The'documentation submitted has bec:n reviewed by Miami-Dade County Product Codtrol Division and accepted
by the Board of Rules and Appea1s (BORA) to be used in Miami Dade County and ot~er areas where allowed by
the Authority Having Jurisdiction (AHJ). '
This NOA shall not be valid after the expiration date stated' below. The Miami-D4de County Prod~t Control
Division (In Miami Dade County) andlor the AHi (in areas other than Miami Dade ~ounty) reserve the right.to .
have this prod~t or material. tested for q~li~ assurance .purposes. If this p~uctorj material. fails t~~f~ in
the accepted manner, the manufacturer wlll mcur the expense of- such testmg andl the AHI may ImmedIately
revoke, modify, or suspend the use of such product or material within their jurisdicticJt: BORA reserves the right
to revoke. thisaccepfimce, ifit is determln~d by Mianu...Oade CQunty Product Gootro! pi vision that this product or
material fails to mee.tthe requireinents of the applicable building cixk . .!
I.
This .Product is a'ppro~ ~ descrii>ed.herein, :md has been'"dcSigried to.complrwith tht High VelOCity Hurricane.... .
Zone.oftheF.londa Bulldll~gCode. ". .' . .... . .>+ '.. .'. '. ....
;r.~.;:l.~.li;t.;;.,..:i.i.~. .~~t~..:~~.&..:\:r.:~.:~~~.l.!~..~.~.'~'<.
BI111dl1'~~..cQnSt11~t$;'i~.~~:~g.the:.M~m~",pa.~n(y J'!r~iJct'.C()rit~I:APfirO~li~~m.p,wli}i;,the'.N~tlcc.o.(;;.",,; .
Accqltancc: 'nuplbC:r and approwJ date by.thc.:Miami..Qad!: Cotinty;Product Conlr()J'Di~~5i()n~' . . . . ..' .. '. ,...
MIsSILE IMPAcrRATING: None. . .' . .'. '.. .;
. ~~E~l'!G:l!aohuni!S~U~'~""~l with .th......f~tutcr'Sn.m< or ~. .;tY"lalc .n{
. .ro.no~~$. s~~~t:'~~ja:m.i;~t>aqe ~9,~P~i~rQ(llJ~.t.qqAttq! J,\~~;, .~I~ q,tpcljVi .~jt9t~4.~:fu:in.?::.;:.. .
. " ':;liNE.'~VAL'~f.thi~;,~OA.. '~l~'cri~Si~~~.i~~ ~:~;'~I'~p~lib;,iio~ J.i~.;~~' fir . ~"'. Jh~r~:h~ ~~:~O'
:'.~h;mg~.~~ ~-='~pp.l~~l~'~~u~~trig'~~~!NelY."~~tl.~i~e,~,tfe~c'.oftm~:.pt:: .'~". ...: ..... .... >.-;, ,':>
.,~:-~~~~~ft~:~~~..~~~t"1r%i~~~;~:ili!h~:^
. produc~ for Sales, advertising or any other purposes. shall automatically terminate this~OA. Failure. to comply
with any StXtion of this NOA shall because for termination and removal of NOA. . .
. . I .
ADVERTISEMENT: The NOA number preceded by the words Miami..nade County. Florida. and followed by
the expiration datc maybe displayed in advertising literature. Ifany portion of the NQA is displayed. then it shnll
be done it~its entirety. !
INSPECTION: A copy of this entire NOA shall be provided to the user by the manufaburer or its distributors
and shall be available for inspection at tbejob sit~at the request of the Building omcinj. .'
This NOA consists of this page. I as welt as approval document mentioned above: .
The submitted documentation was reviewed by Manuel PCrC7., P.E. !
''\. j
8
NOA No 02-0109.01
EXPirt.' ion Date: Jul)' 3. 2007
Appr vul Date: Jut)' 3.2002
I, . rage I
i
~~GOI
.-
BUILDING CODE COMPLIANCE OFFICE (BCCO)
pRODUCT CONTROL DIVISION .
MIAMI-DADE COUNTY. FLORID,\
METRO-DADE FLAGLER-BUILDING
1.$0 WEST FLAGLER STRt:ET. sUln: 1603
MI/\MI, FLORIDA 33 i3U-IS63
(305) 375-21)01 FAX (305) 375-2908
NOTICE OF ACCEPTANCE (NOA)
Jeld-Wcn, Inc.
3250 Lakeport Drive
Klalllath Falls, OR 9760 I
SCOPE:,
This NOA is being iss~ under the applicable rules and regulations governing the use of construction materials.
The documentation submitted has been reviewed by Miami-Dade County Product Control Division and accepted
by the Board of Rules and Appea1s (BORA) to be used in Miami Dade County and other arens where at lowed by
the Authority Having Jurisdiction (AHJ).
This NOA shall not be valid after the expiration date stated below. The Miami-Dade County Product Control
Division (In Miami Dade County) andlor the AHJ (in areas other than Miami Dade County) reserve the right to .
have this product or material tested for quality assurance purposes. If this product or material fails to perform in
the accepted manner, the manufactUrer will incur the expense of such testing and the AHJ may immediately
revoke, modify, or suspend the use of such product or material within their jurisdiction: BORA reserves the right
to revoke this acceptance, if it is determined by Miami-Dade County Product C.oritrol Division that this product or
material fails to meet the requirements of the aPplicable buildingcode~ .
This product is approved as described.herein, and has been designed tocoinply with the High Velocity Hurricane.. ..'
Zone:9ftheFloridaBuildingCode. '" .'. . . ." ..' ....
DES(;:Rln.IQN: S~ri~ "DOorC~rt@~~'8" S/~ Oilt~lViJ.ii.Glazed .lnstil~te~LSt~1 Door w/~v~Si<l~I~t~ ,.':,
.=~f.~~t~i~~l~S~a~S!~~;;.'
Acceptance'nu~bCr and approval datc bythc;M.iami"Dade County: Product Control' Dlvisi-on~ '. '. . '" ..... ......, 'i.
MISSILE IMPAct RATING: None
LABELING: ,Each unit shaH bear a permanent lal>clwjlh thc manufactutcr's namcor logo.city,'statc i!-nd'
.....';.I.lIK.14i~I-I~llmz?~~,,;..
. ma~crials.'use:and/orriiamifatture ofthcptoduct or process; Misuse ofthisN'bA as.an endorsement of ally .
. product. for Sales, advertising or any other purposes shall automatically terminatc this NOA. Failure.to comply
with any section of this NOA shall because for termination and removal of NOA.
ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County. Florida, and followed by
the expiration date maybe displayed in advertising literature. If any portion of the NOA is displ:1yed. then it shall
be done i~ its entirety.
INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors
and shall be available for inspection at the job site at the request or the Building Ollicial.
This NOA consists of this page. I as weU as approval document mentioned above
The submitted documentation was reviewed by Manuel PerC7., P.E.
, '..'~. '.','
9
NOA No 02.0109.01
Expiration Dllte: July 3, 2007
Approval Date: Jul)' 3,2002
. Page 1
I
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JE~WEN, INC.
31725 HIGHWAY 97 NORTH
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This is a contract between Lowe's (as defined in the Terms and Conditions) ("Lowe's.), and the above-named Customer for the installation of goods at the
Customer's residential premises (the "Premises.) at the following installation address:
I~~~ S~~~~.~
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Lowe's to arrange normal installation of the following door(s):
Exterior ~ Interior Prehung Unit ~
Item Number /5" 5"' ~2 RHO LH~
# I Door(s) Size 036 x 80 o 32x80
STATE
ZIP
Slab
p{Other Size 72. )( 8'"0
For warranty to be valid -
customer must finish frame
and all six (6) sides of door
immediately (within 5 days)
after installation.
Customer InRla7<J &
Item Number RH 0 LH 0
# Door(s) Size 036 x 80 o 32x80 0 Other Size
Delivery of Door Yes ~ No 0 (check one)
Haul away of any debris related to installation: Yes 9< No 0 (check one)
Basic Installation includes the following: .
-Normal Installation of door in same size square opening in good condition
-Installation of hardware with pre-bored door
-Reinstallation of present casing or customer provided new casing
-Clean-up of job-site
Basic Installation does not include the following:
-Reframing or alterations to existing structure or carpentry work resulting from old or damaged structure
-Any reinstallation of Burglar Alarms
-Any painting or staining or finishing of new door unit
-Reinstallation of Screen or Storm or Security Door
-Reinstallation of vinyl or aluminum covering on exterior molding
With the exception of Burglar Alarms and finishing, any of the above labor items can be contracted at an additional cost and must be
specifically listed in the additional specifications block on this contract.
I
Additional Specifications: The Environmental Protection Agency (EPA) has requested that
Lowe's notify installation customers that a lead based paint hazard may exist in dwellings built
prior t01978. See pamphlet EPA 747-K-99-001 for details.
'Tax
Labor Lf /6. ()O
'Tax
Work is to commence upon reasonable avail
Estimated completion date is
Total 1060.20
, Where applicable labor Is taxable;
check local tax restrictions.
lity of Contractor which Is anticipated to be
[fill in date].
[fill In date].
NOTICE TO CUSTOMER
All items listed in this contract and specification sheet(s) are to be installed under conditions agreed upon at time of purchase and at the price appearing on this
contract form. This assumes sound existing substructures, superstructure and points of attachments. Extra labor or material incident to installation necessitated
by defective substructures, superstructure, points of attachment, or the moving of fixtures or appliances to be billed at extra cost to customer.
DO NOT SIGN THIS CONTRACT UNTIL COMPLETE AND YOU HAVE READ THE TERMS AND CONDITIONS CONTAINED ON THE
REVERSE SIDE OF THIS CONTRACT. BY SIGNING BELOW, YOU ARE ACKNOWLEQGING THAT YOU HAVE READ, UNDER-
STAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE OF THIS CONTRACT. YOU ARE
ENTITLED TO A COpy OF THIS CONTRACT AT THE TIME OF SIGNATURE.
WITNESSOURHAND(S)ANDSEAL(S)BELOWTHIS~./l DAY OF MA-t<cl-I. .' 200b.
WITN~~~~ 2Serj~~~pA-o---
~ (Seal)
Specialist or Above Spouse
(Seal)
(Seal)
@ 2004 by Lowe's.@ Lowe's and the gable design are registered trademarks of LF Corporation.