HomeMy WebLinkAbout07-6959
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
6959
6959
Permit Type: ADDITION/AL TERATION
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:
2,620.00
Address: 4801 AIRPORT
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 13-26-21-0130-00200-2140
1
Name: SMITH, RAY & KATHLEEN
Address: 4801 AIRPORT RD #214
ZEPHYRHILLS, FL. 33542
Phone: 813 783-7532
INSTAL GLASS LOW E BYPASS DR & 2-TRANSOMS IN EXISTING BALCONY
67.50
(irl/J2e)
W/(-iJ 1
REINSPECTlON 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 shall 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."
/ &ibJJ~ ~
I' CONTRACT~~NATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
City of Zephyr hills
BUILDING PLAN REVIEW COMMENTS
.Contractor/Homeowner:
~..l)y\\1L,\~ AtUI'Y\,0um.
Date Received:
.,
,
'6-1\0-01
Site:
. 4X'Dt~"ec-,\+- Qr1 .lJ,. dlLf
G\Cu~ S'('lC.\0SL5L.\Q...C E:n-tc.UYlLf
Permit Type:
Approved wino oomm~ Approved withe below oomments: [] Denied withe below oomments: D
This comment sheet shall be kept with the permit and/or plans.
lito
er
Date
Contractor and/or Homeowner
(Required when comments are present)
._ ..___._...~..__.._._...+-~~.._w~-_._._...._......_.._--_... --..." .:..
._. . .....____--T-"'- .
....------.--.....-
.................
:::::CitY::~fZephy.thills . .
BUILDING pLAN REVIEW COMlvIEmS
. Date Received:
. ~
,
. .
Wj;k I)k{Yll/1umAdodS~
. '9-/8-tJ 7
'111/J1 iJi,.llrT. ~d#2l/ .. .
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.... . ' !JalcP,'/
Approved. withe below comnients: 0 Denied wIthe below c~ents: '.0
. .
. ContractorlHomeowner:
Site:
permit Type:
. ApprDvedw/no =ents!
T
. I .
. '. ~.COTn~~eT1t sh~eeti..~ be kept ~tb. ~e p~t ~dlor~1ans. .
.. ....: ..: Fe /p..tr} .
Ka}:vm tzer ..,.. : Examiner .. ~ate con:t::ractor and! or Homeo"WD.er
(Reqcired when comments are present)
~
REV\EW ~~~~YR\-\\LLZLS
C\'TY OFE)(AM\NER~
pLANS
EXISTING C/B CONDO UNIT
T T
~
'"
1 ....,
iio
1
~
<-
N
-'>IL
k 9' 5" ~
IE- 4' 5 "---71 IE- 4' 6"---71
2nd FLOOR BALCONY
,e{ 1(~i6'\.
A. T 1 WORK SHALL COMPLY WITH ALL '0
P~VAILING CODES, FLORIDA BU1LD~~\J
CODE. NATIONAL ELECTRIC CODE A.~'-'
CiTY OF ZEPHYRHILLS ORDINANCEu
PROPOSED:
INSTALL GLASS (LOW El
WINDOWS;
IN EXISTING BALCONY OPENING
BEHIND EXISTING GUARDRAIL
1) 53.875 X 64 X 0
2) 53.875 X 64 0 X
3) 53.875 X 31.5 X 0
TEMP.
4) 53.875 X 31.5 0 X
REV:
JOB: SMITH. RAY DWO: M ANDRE
PRK: DATE: 08/09/2007
SHEET
ADD: 4801 AIRPORT RD. # 214 SCALE: 1/8"= 1 '.()" 1 OF 1
LOC: ZEPHYRHILLS. FL 33542 CTR#: lliQ2l
APP/ ::seq tt
2004 Building Codes
Florida Department of Community Affairs
2004 Building Code Approvals
Page 1 01 1
\e{i ~\ art
App/Seq Manufacturer Category Subcategory Validation Status
# EntityN alidator
FLl49-RI Custom Window Windows Fixed Approved
--..--------
Systems, Inc. (Series 4000)
(fF"Ll53-RI Custom Window Windows ( HorizontJ'll ~lider ~ Approved
,f;:ystems, Inc. ?Series 6200 &~ries 7000)
Custom Window Exterior Sliding
FLl57-RI Doors Approved
Systems, Inc. - (Series 9000 & 9200)
!custom Window Exterior
FLl61-RI Doors Swinging iApproved
Systems, Inc. - (Guardian Prime Door)
FLl63-RI !custom Window Windows Single Hung iApproved
Systems, Inc. (Series 3500)
FLl241- Custom Window Windows Single Hung Approved
RI Systems, Inc. (Series 3500 & Oriel)
FL4091- Custom Window Windows Single Hung Approved
Rl Systems, Inc. (Series 8100 Vinyl Frame/PVC)
FL4092- Custom Window Windows Horizontal Slider Approved
RI Systems, Inc. (Series 8200 Vinyl Frame/PVC)
FL4093- Custom Window Windows Fixed Approved
RI Systems, Inc. (Series 8300 Vinyl Frame/PVC)
FL4452- Custom Window Windows !Casement Approved
Rl Systems, Inc. (Series 8400 Vinyl Frame/PVC)
2001 Building Codes (The following do not require 2004 Product Approval Codes)
App/Seq Manufacturer Category Subcategory Validation Status
# EntityNalidator
National iApproved
Accreditation &
Custom Window Windows Mullions Management ~! Evaluation
FL917 Systems, Inc. (Horizontal & Vertical) institute, lReport -
lHardcopy
757) 594-8658 lReceived
!custom Window Windows Wind Breaker (Acrylic), iApproved
FLl575 ...-----------.
Systems, Inc. l(Vinyl Film: Vert & Hori:.)
http://www.cws.cc/FLDCA.htm
11/22/2005
.
SECTION 38
PAN ROOF, COMPOSITE
PANEL OR HOST STRUCTURAL
FRAMING
(4) #8 x 1/2" S.M.S. EACH SIDE
OF POST
1 x 2 TOP RAIL FOR SIDE
WALLS ONLY OR MIN. FRONT
WALL 2 x 2 ATTACHED TO
POST W/1" x 1" x 2" ANGLE
CLIPS EACH SIDE OF POST
GIRT OR CHAIR RAIL AND KICK
PLATE 2" x 2" x 0.032" MIN.
HOLLOW RAIL
ANCHOR 1 x 2 PLATE TO
CONCRETE WITH 1/4" x 2-1/2"
CONCRETE ANCHORS WITHIN
6" OF EACH SIDE OF EACH
POST AT 24" O.C. MAX. OR
THROUGH ANGLE AT 24" O.C.
MAX..
MIN. 3-1/2" SLAB 2500 PSI
CONC. 6 x 6 - 10 x 10 WW.M.
OR FIBER MESH
\eV\~\~
GLASS & MODULAR ROOMS
I
1" x 2" TOP RAILS FOR SIDE WALLS
WITH MAX. 3.5' LOAD WIDTH SHALL
HAVE A MAXIMUM UPRIGHT
SPACING AS FOLLOWS
WIND ZONE MAX. UPRIGHT
SPACING
100
110
120
123
130
140-1&2
150
7'-0"
6'-7"
6'-3"
6'-1"
5'-8"
5'-1"
4'-11"
INTERNAL OR EXTERNAL
'L' CLIP OR 'U' CHANNEL CHAIR
RAIL ATTACHED TO POST WI
MIN. (4) #10 S.M.S.
1 x 2 OR 2 x 2 ATTACHED TO
BOTTOM W/1" x 1" x 2" x 1/16"
0.045" ANGLE CLIPS EACH
SIDE AND MIN. (4) #10 X 1/2"
S.M.S.
1" X 2" x 0.032" MIN. OPEN BACK
EXTRUSION
1-1/8" MIN. IN CONCRETE
VAPOR BARRIER UNDER
CONCRETE
· FOR POST TO WOOD DECK (MIN. 2" NOMINAL LUMBER) USE THESE DETAILS WI WOOD
FASTENERS (1-3/8" EMBEDMENT)
(FUisT TO BASE, GI~~A~~~' ~~~T TO BEAM DET AI0
Lawrence E. Bennett, P.E. FL # 16644
CIVIL & STRUCTURAL ENGINEERING
P.o. Box 214368, South Daytona, FI32121
Telephone #: (386) 767-4n4 Fax #: (386) 767-B556
Email: lebpe@bellsouth.net
PAGE
3B-10
@ COPYRIGHT 2006
NOT TO BE REPROOUCED IN WHOLE OR IN PART WITHOUT THE WRmEN PERMISSION OF LAWRENCE E. BENNETT, P.E.
\eY\~
GLASS & MODULAR ROOMS
SECTION 38
Table 38.2.1 Allowable Upright Heights, Chair Rail Spans or Header Spans
For Glass & Modular Rooms
Aluminum Alloy 6063 T -6
For 3 second wind gust at 110 MPH velocity; using design load of 18.1 #/SF
Tributary Load Width W .. Purlln Spacing
Sections 3'-0" I 3'-611 4'-0" I 4'-6" I 5'-0" 5'-6" I 6'.0" I 6'-6" 7'-0" I 7'-6"
Allowable Height 'H' I bending 'b' or deflection 'd'
2"x 2" x 0.044" Hollow 5'_5" b 5'-0" b 4'-8" b 4'-5" b 4'-2" b 4'-0" b 3'-10" b 3'-8" b 3'-7" b 3'-5" b
2" x 2" x 0,055" Hollow 6'-2" b 5'-9" b 5'-5" b .5'-1" b 4'-10" b 4'_7" b 4'-5" b 4'-3" b 4'_1" b 3'-11" b
3" x 2" x 0.045" Hollow 6'-7" b 61_11' b 5'-8" b 514" b 5'_1" b 4'-10" b 4'-8" b 4'_5" b 4'-3" b 4'-2" b
3" x 2" x 0.070" Hollow 7'-11" b 7'-4" b 6'-10" b 6'-5" b 6'-1" b 5'-10' b 5'_7" b 5'-4" b 5'-2" b 4'-11" b
2" x 3" x 0.045" Hollow 7'-0" b 61-611 b 6'_1" b 5'_9" b 5'-5" b 5'-2" b 4'-11" b 4'-9" b 4'-7'1 b 4'-5" b
2" x 4" x 0.050" Hollow 8'-10' b 8'-2" b 7'_7" b 7'-2" b 6'-10" b 6'-6" b 6'-3" b 5'-11" b 5'-9" b 5'-7" b
2" x 5" x 0.062" Hollow 12'-4" b 11 '_5" b 10'-8" b 10'-1" b 9'-7" b 9'_2" b 8'_9" b 8'-5" b 8'-1" b 7'-10" b
2" x 5" x 0.050" S.M.B. 14'-8" b 13'-7" b 12'-8" b 11'-11" b 11 '-4" b 10'-10" b 10'-4" b 9'-11" b 9'-7" b 91_311 b
2" x 6" x 0.050" S,M.B. 17'-2" b 15'-11" b 14'-11" b 14'-0" b 13'-4" b 12'-8" b 12'-2" b 11'-8" b 11'-3" b 10'-10" b
2" x 2" x 0.044" Snap 6'-511 b 5'-11" b 5'-7" b 5'..311 b 4'-11" b 4'_9" b 4'-7" b 4'-5" b 4'..3" b 4'_1" b
2" x 3" x 0.045" Snap 7'-10" b 7'-3" b 6'-9" b 6'-5" b 6'_1" b 51_91l b 5'-6" b 5'-4" b 5'-2" b 4'-11 " b
2" x 4" x 0.045" SnaD --'l:..3 " b 8'-6" b 7'-11" b 71~" b 7'-2" b 6'-10" b 6'-6" b 6'-3" b 6'-0" b 5'-10" b
For 3 second wind gust 8('120 MPI-&teloclty; using design load of 21.5 #/SF
Trlbutarv h W .. Purlln Spacing
Sections 3'-0" 3'..4)" I 4'.011 I 4'-6" f' 5'-0" .0 5'-6" I 6'-0" 6'.6" 7'-0" I 7'-6"
Allowable He ijjI1t 'H' I bending 'b' or deflection 'd'
2" x 2" x 0.044" Hollow 4'-11" b 4'_7" b 4'-4" b 4'_1" b 3'-10" b 3'-8" b 3'-6" b 3'-5" b 3'-3" b 3'-2" b
2" x 2" x 0.055" Hollow 5'-8" b 5'_3" b 4'-11" b 4'-8" b 4'..5" b 4'_2" b 4'-0" b 3'-10" b 3'-9" b 3'-7" b
3" x 2" x 0.045" Hollow 6'..()" b 5'-7" b 5'_2" b 4'-11 " b 4'-8" b 4'-5" b 4'_311 b 4'-1" b 3'-11 " b 3'-10" b
3" x 2" x 0.070" Hollow 7'-3" b 6'-8" b 6'-3" b 5'-11" b 5'-7" b 5'-4" b 5'-1" b 4'-11" b 4'-9" b 4'..7" b
2" x 3" x 0.045" Hollow 6'..5" b 5'-11" b 5'-7" b 5'-3" b 4'-11" b 4'-9" b 41_7" b 4'-5" b 4'-3" b 4'_1" b
2" x 4" x O.OSO" Hollow 8'-1" b 7'-6" b 6'-11" b 6'-7" b 6'-3" b 5'-11" b 5'-9" b 5'-6" b 5'-3" b 5'-1" b
2" x 5" x 0.062" HolloW' 11'-4" b 1 0'-6" b 9'-10" b 9'-3" b $I'_l1" " 8'-5" b 8'-0" b 7'-8" b 7'-5" b 7'-2" b
'Coo x 5" x 0.050" S.M.B. 13'-5' b 12'-5" b 11 '-8" b 10'-11" . 10'-5" b 9'-11" b 9'-6" b 9'_2" b 8'-10" b 8'-6" b
2" x 6" x O.OSO" S.M.E. 15'_9" b 14'-7" b 13'-8" b 12'-10" b 1~b 11 '-8" b 11'-2" b 1 0'-9" b 10'-4" b 9'-11' b
2" x 2" x 0.044" SnaJ 5'-11" b 5'-6" b 5'-1" b 4'-10" b 4'_7" b 4'-4" b 4'-2" b 4'-0" b 3'-10" b 3'_9" b
2" x 3" x 0.045" SnaJ 7'-2" b 6'-8" b 6'_311 b 5'-10" b 5'-7" b 5'-4" b 5'-111 b 4'-11" b 41-811 b 41-7" b
2" x 4" x 0.045" Snap 8'..5" b 7'-10" b 7'-4" b 6'-11" b 6'_7" b 6'_3" b 5'-11" b 5'_9" b 5'-6" b 5'-4" b
Notes:
1. Above spans do not include length of knee brace. Add horizontal distance from upright to center of brace to beam connection to the
above spans for total beam spans.
2. Spans may be interpolated.
Lawrence E. Bennett, P .E. FL # 16644
CIVIL & STRUCTURAL ENGINEERING
P.o. Box 214368, South Daytona. FI32121
Telephone #: (386) 767-4 n 4 Fax #: (386) 767-6556
Emall: lebpe@bellsouth.net
@ COPYRIGHT 2006
NOT TO BE REPRODUCED IN WHOLE OR IN PART WITHOUT THE WRITrEN PERMISSION OF LAWRENCE E. BENNETr, P.E.
PAGE
3B-49
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CITY OFZEPIrIYRHILLS
53j5 - 8TH STREET
(813)780-0020
BUILDING PERMIT
6959
Permit Number: 6959
Permit Type: ADDITION/ALTERATION
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv" Cost: 2,620.00
Date Issued: 8/23/2007 Name: SMITH, RAY & KATHLEEN
Total Fees: 67.50 Address: 4801 AIRPORTRD #214
Amount Paid: 67,50 ZEPHYRHILLS,FL. 33542
Date Paid: 8/23/2007 Phone: 813783-7532
Work Desc: INSTAL GLASS LOW E BYPASS DR & 2-TRANSOMSIN EXISTING BALCONY
Address: 4801 AIRPORT RD #214
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 13-26-21-0130-00200-2140
PLEASE DO NOT REMOVE PERMIT
UNTIL COUNTY/CI1Y INSPECfOR HAS SIGNED OFF
IN IDGHLIGHTED AREA
Any Questions? Please Call
White Aluminum Products at:
(863) 956-3441 or (407) 436-1620
REINSPECTlON 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 1) 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
"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""
/ ~ e&PI
CONTRACTOR SIGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
JOB: SMITH. RAY
PRK:
ADD: 4801 AIRPORT RD. # 214
LOC: ZEPHYRHILLS. FL 33542
~ . ., 0", ..-~~ nn 1 f') i.1.. L \.,'
(..,,-),.'L,; t.L'-- 1\." ,.. '._
,\ J J,L... \ ,_.__,
. .. r. . ELECTRIC Cl)L.t~,
com~, NA[lO,~^~-. (C:. ORDINANlt2)
CJY OF ZEPHYRHIL",
'Y; - t ~,.- 0 -)
REVIEW DATE
CITY OF ZEPHYRHILLSIL~
PLANS EXAMINER .
EXISTING C/B CONDO UNIT
T
..,
Co
1
k
~
~
i PROPOSED:
INSTALL GlASS (LOW E)
~ BYPA..<;S DOOR AND 2 TRANSOMS
'C IN EXISTING BALCONY OPENING
1 BEHIND EXISTING GUARDRAIL
~
-+
-I
9' 5"
2nd FLOOR BALCONY
DWG: M ANDRE
DATE: 08/09/2007
SCALE: 1/8"-1 '.{)"
CTR#: li1Q2l
6005 HWY. 17-92 W. HAINES CITY 863-956-3441
A
REV:
SHEET
1 OF 1
813-780.0020
City of Zephyrhills Permit Application
8uilding Depanment
Fax-813-78o.o021
Dale Received
NOC-Dade City
SS"-j<.:, -07
REC"
Owner's Name Smith,
Owner's Address 14801
Fee Simple Titleholder Name [
Ray & Kathleen Owner Phone Number
Airport Rd" -Z" Hills, FL33.$420wner Phone Number I
I Owner Phone Number I
-=-~ e 0.( fvksS" ~
. Q.Cf'\I-th ncr
SUBDIVISION
Est. East
I LOU I
C~ndfiARCELID#113-26-21-0130-00200-2140
(OBTAINED FROM PROPERTY TAX NOnCE)
I
I
I
214 I
(Card~
001 of 001)
Same
JOB ADDRESS
Fee Simple Titleholder Address
I Same
IZephyr
DESCRIPTION OF WORK
B
o
o
lnstl" Glass
SFR Lanai
BLOCK
OTHER
STEEL
WORK PROPOSED
NEW CONSTR
INSTALL
SIGN
D
MOVE D
DEMOLISH
PROPOSED USE
TYPE OF CONSTRUCTION
dr" &
I
Ii] OTHER I f.lalB
2-transoms in exist" alcony
I 8' 3" opening. behind exist"
, gUardrall.
9' 5"x:
un 1
SQ FOOTAGE I
HEIGHT
BUILDING SIZE
ITI BUILDING IS 2,620"00 I VALUATION OF TOTAL CONSTRUCTION
D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D w.R.E.C.
D PLUMBING IS I
D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION
D GAS D ROOFING D OTHER
DYES DNo
Keith B" Wood-CBC125062
BUILDER
SIGNATURE
Address 16005 W" Hwy" 17-92 Haines Ci t y . I FL 33844 License# ICBC1250625
ELECTRICIAN I COMPANY I
SIGNATURE REGISTERED L!i.!U FEE CURRENT l...r.!!U
Address I License #
PLUMBER I COMPANY
SIGNATURE REGISTERED L!i.!U FEE CURRENT I Y I N I
Address I License #
MECHANICAL I COMPANY
SIGNATURE REGISTERED L!i.!U FEE CURRENT l...r.!!U
Address I License #
OTHER I Dale Hall-POA COMPANY ISame
SIGNATURE REGISTERED L!i.!U FEE CURRENT l...r.!!U
Address I Same License #
RESIDENTIAL
Attach (2) Plot Plans; (2) sats of Building Plans; (1) sel of Energy Forms
Minimum len (10) working days after submlll8l dele. Required ons~e, Construction Plans, San~Bry Facil~ies & 1 dumpster
Attach (3) Sels of Building Plans; (1) set of Energy Forms.
Minimum len (10) working days after submlll8l dele. Required ensile, Construction Plans, Sanitary Facilities & 1 dumpster
All commerciel requirements mUSI meet compliance.
Attach (2) sets of Engineered Plans.
-PROPERTY SURVEY required for all NEW construction.
COMMERCIAL
SIGN PERMIT
Directions:
Fill out application complately.
Owner & Contractor sign back of application, nOl8rizad
If over 52500, a Notice of Commancemenl is required. (AlC upgrades over 55000)
Agent (for Ihe contractor) or Power of Allorney (for the owner) would be someone wnh nol8rized laller from owner authorizing same
OVER THE COUNTER PERMITTING (Front of AppllcaUon Only)
Reroofs SewersServi ce Upgrades AlC
Fences (PloVSurveylFoolege)
DriveWlys-Not over Counter n on public roadwaysuneeds ROW
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.
UNL.ICENSED CONTRACTORS AND CONTRACTOR RESPONSIBIL.ITIES: 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/UTIL.ITIES 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 Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION UEN 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 .owner" prior to commencement.
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
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 government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, WaterMlastewater 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 ServiceslEnvironmental 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 pennltted.
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 affed adjacent properties, the owner may be cited for violating
the conditions of the building pennlt issued under the attached pennit 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 10 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 permll is commenced within six months of pennlt 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.
WARNING TO OWNER: YOUR FAlL.URE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPRO TS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCI G, CONSULT W!
WITH YOUR L.ENDER OR AN TT R Y R CORDING YOUR NOTICE OF COMME EME
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT Dale Hal - "-
Subscribed and sworn to (or lIfIirmed) before me this
~)is9.~ ~e~l~ ~~:; m~~!l.K~Auced
...Mown as i ifation.
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1111111111111111111111111111111I1111111111111111111111111III
2007139328
STATE OF FLORIOA
COUNTY OF ,PASCO
TKlS'iS TO CERTlFvfHAT THE FOREGOING IS A
TROEcANO CORRECT COpy OF ;rH~?OCUMENT ON ALE
OR Of &'Uil.ICRECORO .IN THI~. OFFICE. WITNESS MY
HAND AN OFFICIAl,. SEAL rHI~L6- DAY OF
..;,.. ;. &1.'7
....\~ ,.~
, C~ERK OfCjRCUIT COURT
. J' .:'.' DEPUTY CLERK
Rcpt:1122394 Rec: 10,00
DS: 0.00 IT: 0.00
08/16/07 ___Dpty Clerk
JED PITTMAN, PASCO COUNTY CLERK
08/16/07 11: 19am 1 At-J...
OR BK 7603 PG a fa
NOTICE OF COMMENCEMENT
State of
FLORIDA
County of
PASCO COUNTY
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information is
provided in this Notice of Commencement:
4801 Airport Road #214 Zeppyrhills, FL 33542
1. Description of Property: Parcel No,13-26-21-0130-00200-2140 (Card: 001 of 001)
Zephyr Estates East Condo PB-13 PG-132 Apt 214 Bldg. 2 & Common Elements or 7465 PG 1494
(Legal description of the property and street address if available)
2.General Description of
Improvement Install Glass (Low E) bypass door and 2 transoms in existing
balcony opening behind existing guardrail.
3.0wner Information: Name Smith, Ray & Kathleen
Address 4801 Airport Road #214 CitYZephyrhillsState FL
In terest in Property:
Name of Fee Simple Titleholder:
~. (If other then owner) Keith B. Wood-CBC1250625
rt 4.Contractor: Name White Aluminum Products,LLC 863-956-3441 Fax:
Address 6005;W. Hwy. 17-92 Cit~aines City, State FL
5. Surety: Name ,
Address
Amount of Bond: $
6.Lender: Name
Address City State Zip
7.Persons within the State of Florida designated by Owner upon whom notices or
other documents niay be served as provided by Section 713.13 (1) (a) (7), Florida
Statutes:
Name
Address
8. In addition to himself, Owner designates
of
(0)
Zip 33542
5286
Zip33844
City
State
Zip
City
State
Zip
to receive a copy of the Liener's Notice as provided
in Section 713.13 (1) (b), Florida Statutes.
9.Expiration date af Notice of Commencement (the expiration date is 1 year from
the date of recording unless a different date is specitied.)
SIGNATURE of OWNER: 'f;t/i;h1tu1 k, {)nuH~
DRIVER LICENSE: CE>~() !2.-A-~ [) q ~ - t q J. - 57 / a.
The foregoing instrument was acknowledge before me this
, 8. 20 07 , by Kathleen R. Smith
known to me or produced
identification, who did/did not take
Notary Public:
My Commission
10 day of
who (is)(are) personally
(DmerJLLic.e.n.ae #I w....
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~ '!Il vi I;;;~i;~~;~~~::~ 00579351
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Building Schematic - Pasco Co. Property Appraiser
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http://appraiser. pascogov .comlsearchltraverse/showtrav .asp?traverse= UEP%3 D W 15 S 7E 15... 8/9/2007
Building Permit Application Affidavit of Intent
White Aluminum Products, LLC 6005 W. Hwy. 17-92 Haines City,FL
I, ___K..e_i_"-~_~:._~~~~_::.!'::!!.:.?~!,~o hereby state that this building 86 j ~ g~t 3 441
. Contractor 4801 Airport Rd. #214
Permit application for _~e"'p_hJJ_h_i_~~~!.._~~_~~~~~_________is for a
Location
N Smith, Ray & Kathleen . .
ew clistomer____________________________or IS a Spec urnt.
Customer Name
I also will have the building permit application picked up
Within 30-days of notification that the application is ready,
I can be contacted at .!Jill~-BillJ--J>_0_iL_~~1._=_2.2Q.=2~~1____or Fax: 5286
Phone
------.:..-------------------------------. I further understand
E-Mail
That in order to pick up the application and have the permit
Issued I vvill need, as a minimmn, to bring the following:
(if applicable)
1-
1. Deed shovving ownership of the lot.
2. NOC or affidavit required by Section 713, Florida
Statutes (over $2500.00) ($5000.00 if mechanical)
3. Utility Receipt or where applicable the Septic Permit from
Health Department (if needed).
4. Customer addressed stamped envelope (if NOC is
Required).
Signa ture:-~~.::..&A___________________________
NAME. Dale Hall-POA
-------------------------------------------------------
CONTRACTOR PASCO ill #:______0_1_~~~~_____________________
IllTAI
.IIIIITE
.'.III'.'II.tlllll" Serving Florida since 1955
PRODUCTS, INC.
o
2101 E. Main Street
Leesburg, FL 34748
(352) 787-6783
o
719 Otis Rd.
Lecanto, FL
(352) 795-3325
o
18040 U. S. Hwy. 441
Mount Dora, FL 32757
(352) 383-7135
o
2302 Mercator Dr.
Orlando, FL 32807
(407) 681-8823
o
5059 Ridgewood Ave.
Port Orange, FL 32127
(386) 788-1048
6005 w~. 17-92
Haines City, FL 33844
(863) 956-3441
o
2300 Bruner Lane S.E.
Fort Myers, FL 33912
(239) 481-4900
o
1404 Mercantile Court
Plant City, FL 33567
(813) 717-9177
o
CORPORATE OFFICE
P. O. Box 491292
Leesburg, FL 34749
(352) 787-3622
Date:
8/10/07
City of Zephyrhills
Buildina Division 4801 Airport Rd. #21l~
Zephyrhills, FL 33542
(Job Address)
Dale Hall-POA
(Runner's Name)
SIGNATURE AUTHORITY FORM FOR THE PURPOSE OF OBTAINING
BUILDING PERMITS
I, Keith Wood, of White Aluminum Products, LLC. do hereby designate
the following individuals as having the authority to sign and submit
applications and related documents for the purpose of obtaining building
permits under my State Certified License #CBC1250625. I further
acknowledge and accept as a licensed contractor, my responsibility and
liability for each project permitted under this authority designated on this
form, and that my failure to assume and fulfill said duty may be grounds
for the initiation of disciplinary action against my contractors license.
DESIGNATED SIGNERS:
Tyke Havasy
Keith Wood
'iwJg,L~
(Contractor's Signature)
. . 10 8
Subscnbed and sworn to before me this _ Day of
200~
~dlJ ~l (l~
,
NOTARY PUBLIC
My Commission Expires:
i:'tP
,\ r r r
d.L..., ~VOt'>I'/ S'}
\.\ .f,U'"
PI{EVAILING L L, CO[~iP[j Vi/IF,. .
COD' " COD1:8, Pi o. . ,'dLj
Cl"'}' NAT'lONAL HLCrXVDA BUlLD!!>:;
. . OF ZEPHYRJIILLS . IC CODE AN:.)
ORDINANCES
REV/f;:W
C1iYOF DATE 6-(6'0-
PLANS E~~PH~
""'MINE~
EXISTING C/B CONDO UNIT
T
~
00
1
k
~
-+
-t
~
T PROPOSED:
INSTALL GLASS (LOW E)
00 BYPASS DOOR AND 2 TRANSOMS
1'0 IN EXISTING BALCONY OPENING
BEHIND EXISTING GUARDRAIL
~
2nd FLOOR BALCONY
REV:
JOB: SMITH. RAY DWG: M ANDRE
PRK: DATE: 08/09/2007
SHEET
ADD: 4801 AIRPORT RD. # 214 SCALE: 1/8"= 1 '.{)" 1 OF 1
LOC: ZEPHYRHILLS. FL 33542 CfR#: lli:Q2l
Florida Building Code Online
Page 1 of3
J.~~fl!Y~NI~
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Product Approval
USER: Public User
Product Aooroval.l1m!.! > Product or Aoolication Search> Aoolication list> Appllcmlon DetllII
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
Referenced Standard and Year (of
Standard)
Equivalence of Product Standards
Certified By
FL149-R1
Revision
2004
Approved
Custom Window Systems, Inc.
1900 SW 44th Avenue
Ocala, FL 34474
(352) 368-6922 ext 206
Nancy@cws.cc
Nancy Haldin
Nancy@cws.cc
Michael LaFevre
981 NE 16th Street
Ocala, FL 34470
Michael@cws.cc
Ralph Emminger
981 NE 16th Street
Custom Window Systems, Inc.
Ocala, FL 34470
(352) 368-6922
ralph@cws.cc
Windows
Fixed
Certification Mark or Listing
Keystone Certifications, Inc.
Standard
ANSI/AAMA/WDMA 101/IS2-97
Year
1997
http://www.floridabuilding.org/pr/pr _ app _ dtl.aspx?param=wGEVXQwtDquZRj 59%2fDrx2... 8/9/2007
Florida Building Code Online
Page 2 of3
Product Approval Method
Method 1 Option A
Date Submitted
Date Validated
Date Pending FBC Approval
Date Approved
08/02/2005
08/02/2005
08/04/2005
08/24/2005
Summary of Products
FL# Model, Number or Name Description
157.1 9000 OXX SGD 9000 OXX SGD
Limits of Use (See Other) Certification Agency Certificate
Approved for use In HVHZ: Instllllatlon Instructions
Approved for use outside HVHZ: PTID 157 R1 I CAR 138-115.odf
Impact Reslstllnt: PTID 157 R1 I CAR 138-116.pdf
Design Pressure: +/- PTID 157 R1 I CAR 138-117.pdf
Other: 9000 OXX SGD SGD-C35 146x96 PTID 157 R1 I CAR 138-118.odf
PTID 157 R1 I CWS-011.odf
PTID 157 R1 I CWS-012.odf
PTID 157 R1 I CWS-013.pdf
PTID 157 R1 I CWS-014.pdf
PTID 157 R1 I CWS-018.pdf
PTID 157 R1 I CWS-019.odf
PTID 157 R1 I CWS-020.odf
PTID 157 R1 I CWS-021.odf
PTID 157 R1 I CWS-022.pdf
PTID 157 R1 I CWS-023.odf
PTID 157 R1 I CWS-024.pdf
PTID 157 R1 I CWS-025.odf
PTID 157 R1 I CWS-026.pdf
PTID 157 R1 I CWS-027.pdf
PTID 157 R1 I CWS-028.odf
PTID 157 R1 I CWS-029.odf
Verified By:
7.2 ~9200 OXX SGD o OXX SGD
Limits of Use (See Other) Certification Agency Certificate
Approved for use In HVHZ: Tnstllllatlon Instructions
Approved for use outside HVHZ: Verified By:
Impact Reslstllnt:
Design Pressure: +/-
Other: 9200 OXX SGD w/heavy duty interlock
1IIISGD-C50 146x96
157.3 19200 XX SGD 9200 XX SGD
Limits of Use (See Other) Certification Agency Certificate
Approved for use In HVHZ: Instllllatlon Instructions
Approved for use outside HVHZ: Verified By:
Impact Resistllnt:
Design Pressure: +/-
Other: 9200 XX SGD w/heavy duty interlock
SGD-C35 120x96
157.4 119200 XXX POCKET SGD 9200 XXX Pocket SGD
Limits of Use (See Other) CertlflClltlon Agency Certificate
Approved for use In HVHZ: Instllllatlon Instructions
Approved for use outside HVHZ: Verified By:
Impact Reslstllnt:
Design Pressure: +/- i
Other: 9200 XXX Pocket SGD SGD-C45 146x96
Back Next
http://www.floridabuilding.org/pr/pr_ app _ dt1.aspx?param=wGEVXQwtDqt3e 1 SAlnEOW3... 8/9/2007
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Page I of3
.~MtlNmtPI.ANM~ ,
W<lfT1tleOUHE :
Product Approval
USER: Public User
Product Aopr.~ > Product or Aoollcation Search> Aoolication List > AppllClltlon 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
Referenced Standard and Year (of
Standard)
Equivalence of Product Standards
Certified By
FL157-R1
Revision
2004
Approved
Custom Window Systems, Inc.
1900 SW 44th Avenue
Ocala, FL 34474
(352) 368-6922 ext 206
Nancy@cws.cc
Nancy Haldin
Nancy@cws.cc
Michael LaFevre
981 NE 16th Street
Ocala, FL 34470
Michael@cws.cc
Ralph Emminger
981 NE 16th Street
Custom Window Systems, Inc.
Ocala, FL 34470
(352) 368-6922
ralph@cws.cc
Exterior Doors
Sliding Exterior Door Assemblies
Certification Mark or Listing
Keystone Certifications, Inc.
Standard
ANSI/AAMA/WDMA 101/152-97
Yellr
1997
http://www.floridabuilding.org/pr/pr_app _ dt1.aspx?param=wGEVXQwtDqt3e 1 SAlnEOW3... 8/9/2007
FI<?rida Building Code Online
Page 2 of3
Product Approval Method
Method 1 Option A
Date Submitted
Date Validated
Date Pending FBC Approval
Date Approved
08/02/2005
08/02/2005
08/04/2005
08/24/2005
;umm,m
mmary of Products
FL :# Model, Number or Name Description
149.1 4000 Fixed 4000 PW 1/4" Annealed / 3/8" Annealed
Limits of Use (See Other) Certification Agency Certificate
Approved for use In HVHZ: Installation Instructions
Approved for use outside HVHZ: PTID 149 R1 I CAR 138-112.pdf
Impact Resistant: PTID 149 R1 I CAR 138-113.odf
Design Pressure: +/- PTID 149 R1 I CAR 138-114.pdf
Other: 4000 Picture Window F-LC40 120x60; PTID 149 R1 I CAR 138-132.pdf
PTID 149 R1 I CWS-006.pdf
PTID 149 R1 I CWS-007.pdf
PTID 149 R1 I CWS-008.pdf
PTID 149 R1 I CWS-009.odf
PTID 149 R1 I CWS-0125.pdf
PTID 149 R1 I CWS-0129.pdf
PTID 149 R1 I CWS-0130.odf
Verified By:
149.2 114000 Fixed HUD 4000 Fixed HUD
Limits of Use (See Other) Certification Agency Certificate
Approved for use in HVHZ: Installation Instructions
Approved for use outside HVHZ: Verified By:
Impact Resistant:
Design Pressure: +/-
Other: 4000 Picture Window Wind Zone II and
III @ 58 psf 120x60
149.3 114000 Fixed Tempered 4000 Fixed Tempered
Limits of Use (See Other) Certification Agency Certificate
Approved for use in HVHZ: Installation Instructions
Approved for use outside HVHZ: Verified By:
Impact Resistant:
Design Pressure: +/-
Other: 4000-Tempered Picture Window F-LC80
120x60
149.4 114000 Fixed w/lntegral Mull 4000 PW w/lntegral Mull
Limits of Use (See Other) Certification Agency Certificate
Approved for use In HVHZ: Installation Instructions
Approved for use outside HVHZ: Verified By:
Impact Resistant:
Design Pressure: +/-
Other: 4000 PW w/lntegral Mull F-LC45 120x60
Back
Next
DCA Administration
De/NIrtment of Community A""lrs
Florida Bulldlnll Code Onll_
Codes .nd Stltnd.rds
2555 Shumard Oak Boulevard
Tallahassee, Florida 32399-2100
(850) 487-1824, Suncom 277-1824, Fax (850) 414-8436
@ 2000-2005 The State of Florida. All rights reserved. CODvriaht and Disclaimer
Product Approv.' Accepts:
http://www.floridabuilding.org/pr/pr _ app _ dt1.aspx?param=wGEVXQwtDquZRj 59%2fDrx2... 8/9/2007
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AUG-16-2007 14:52
Message To:
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WHITE ALUM HAINES CITY
863 956 5286
06
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Following This Cover Page
AUG-16-2007 14:52 WHITE ALUM HAINES CITY
....'Ea 8T A TE OF FLORIDA
'.., ~ DEPARTMENT OF BUSINESS AND PROFESSJ:ONAI.
J CONSTRUCTION INDUSTRY LICENSING BOARD
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863 956 5286
P.02/06
REGULATION
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WOOD, KEITH BAXTER
WHITE ALUMINUM PRODUCTS INC
280 HARBORD ST WEST
LAKE ALFRED FL 33850
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STATE OF FLORIOA
DEPARTMENT OF J3lJSnmSS A.ND
#. PROFESSIONAIj REGULATION
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C.BC12S0625
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CERTIFIED BUILDING CONTRACTOR
WOOD. KEITH BAXTER
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CONSTRTJCTION INDUSTRY LICENSING BOARD SE<;.}#r.060(l2201J.79
DATE
: . LICENSE NBR
08 22 2006 060109275 CBC1250625
The BUILDING CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chap~er
Expiration date: AUG 31, 2008
489 FS.
WOOD, KEITH BAXTER
WHITE ALUMINUM PRODUCTS INC
280 HARBORD ST WEST
LAKE ALFRED FL 33050
J.EB BUSH
GOVERNOR
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6:43:21 AA
,Licensee Details
Licensee Information
Name: WOOD, KEITH BAXTER (Primary Name)
WHITE ALUMINUM PRODUCTS INC (DBA N;
Main Address: 280 HARBORD ST WEST
LAKE ALFRED Florida 33850
Certified Building Contractor
Cert Building
CBC1250625
Current,Active
12/05/2002
08/31/2008
Qualification Effective
OZ/20/2004
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AUG-16-2007 14:53
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~~~~~~~:;~~~~~:~z~~~!~~
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WHITE ALUM HAINES CITY
863 956 5286
P.05/06
.I. Wo5'" . VA .
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8.42.03 AA
Licensee Deolils
Licensee Information
Name: COLEMAN, CLELL III (prImary Name)
WHITE ALUMINUM PRODUCTS INC (DBA 1'4;
Main Address: 323 LAKESHORE DR
LEESBURG Florida 34748-6828
County: LAKE
1327 LEE CT
LEESBURG FL 34748
LAKE
Certified Building Contractor
Cert Building
CBC001467
Current,Active
08/31/;Z008
Qualification Effective
02/20/2004
Vi.e.w R.elat5!J). J.j~_e..n$e I nformatipn
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Ucense Number:
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***** FACSIMILE COVER SHEET *****
AUG-16-2007 15:29
Message To:
a18137800021
Message From:
WHITE ALUM HAINES CITY
863 956 5286
05
Page(s)
Following This Cover Page
AUG-16-2007 15:30
WHITE ALUM HAINES CITY
863 956 5286
P.02/05
IMPERIAL POLK COUNTY OCCUPATIONAL LICENSE
E:xPInES
9/30/2007
CLASS
L1CLNSE 1 ACCT II 2010000205
LOCA'ION 5333 W HWY 17.92
9 - HAINES CITY. NOT IN CITY
OWNER: CLELL COLEMAN III - ST ceRT
B
230080 CONTRACTOR BUILDING
WHITE ALUMINUM PRODUCTS INC
RICHARO GERBER - PRES
5~~3 W HWY 17-92
HAINES CITY, FL 33844-0000
LICENSE TYPE:
BASE TAX
RENEWAL
55.00
FEE:
ADDL aces:
DATE P,l.IO;
PENALTIES:
AODI. IIMT;
TOTAL. PAID:
55.00
.1.l:ll".:i']']=';.Ir':l:.tI.~III:fM{'l:""'lCID~B--:";tII'WIIllI.tcJ~~'"(;J-''~'''.~"........fliIltt""""""",,-
THIS OCCUPATIONAL LICENSE MUST BE CONSPICUOUSLV DISPLAYED AT THE BUSINESS LOCATION
PAID-4117000.0DD1-0001 401 09/19/2006 55.00
AUG-16-2007 15:30
WHITE ALUM HAINES CITY
863 956 5286
P.03/05
ACORD. CERTIFICATE OF LIABILITY INSURANCE I DATE (AoWIDOm)
04/01/2008 03/30/2007
~ER LOCKTON COMPANJES.LLC-l KANSAS CITY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
444 W. 47th Street, SUi1e 900 ~pLDE~"~HI~ CERTIFICATE DOES :$I~.~~.I!'iT:~.on~
Kansas City Me 64112-1906
(916) 960-9000 INSURERS AFFORDING COVERAGE
NSUfWl WHITE ALUMINUM PRODUCTS, LLC INSVRERA: INSURANCE COMPANY OF.
1On293 . .ST A TF. n,: . ...
2101 EAST MAIN STREET
LEE'SBURG, FL. 34748
I
COVERAGES WHIAL03 B2 THIS CERnFICATE OF INSURANCE DOES NOT C~smuTE A CONTRACT B~EEN THE IS~Y~
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TtE INSURED NAMED ABOVe I=OR THE POUCY PERIOD NDICAlED, NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH REsp\:cr 10 WHICH 1'I-IIS CERTIFICATE MAY Be ISSUED OR
MAY PERrA/N. THE INSLlRANCE AFtfOROEO 8'1' THE POLICIES DESCRIBED HEREN IS SUBJECT TO ALL THe TERMS, EXCLUSIONS AND CONDmONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLANS.
~ TYPE OF' INSURANce fIOLlCY NUMBER ~ El'f'ECTIVE POUCY EXPIRATION LIMn'S
~EMLl.M8IUTV i"..,.w $
10- nMMEACIAI. GENERAL UASIUTY NOT APPLICABLE ana firg' = XXXXXXX
aJ\IMS MADE 0 OCCUR I w;tlI'WP rsGn' S 2QOOOOO{
~ PI1Al!:nOl" I Jil)V INJURY $ XXXXXXX
- GeNE_A' S XXXXXXy
~:fn;n,~ I'ROOUCTS. COMPIOP AGG S XXXXXXX
~UAIIIUTY COMSINED SINGU: lIMIT , XXXXXXX
- N4Y AUtO NOT APPLICABLE ,~ 3Cl:ilIanl)
- All OWNeD AUTOS 8OD/L. YIlt/JURY
$ XXXXXXX
- SCHmlJlS) AlITOS (Pet "110ft)
10- HillED AUTOS BODILY INJURY XXXXXXX
:;
'-- HONoOWNED AUTOS (P", -=ldenl)
PROPERTY DAMAGE $ XXXXXXX
IPer iICIClGInI)
UIUlIiE LIAIIUTT Al1tO OM. V - EA ACt"..oeNT : XXXXXXX
R /<HI' AlJrO NOT APPLlCABL.E OTH&rt THAN EA ACe $ XXXXXXX
AUTO 0Nl v: AGG S XXXXXXX
Uc:eIlS UAIII\JJ\' e~ OCCUFlRENCli $ XXXXXXX
:J OCCUll 0 CLAIMS MACE NOT APPU(:ABLE AGGAEGA,T!; $ XXXXXXX
=l~UCTeU: O~ s XXXXXXX
~ XXXXXXX
RETENTION fi $ XXXXXXX
A WOllKERS COMPBISA'l'lQtl ANO WC342471J 04/01/2007 04/0112008 X Iwe STATU. .1 IgrH-
~'L./AIIIU!Y E.L EACH ACCIDENT ] 000 000
S
Ii.L DI.'l..Ia~I'. ~. $ J nnn Ann
EM.. DlliliASE -I'OUCY LIMIT . I 000 000
antE/It
DE~ elf 0f'UA1'lOW&ILOCATIOHSI\IIH/Q.I!SIEXCUJ$laNS ADDED BY BDORSEIIENTISPEaAl.I'AOII1S1ONS
Re: C1dJ Coleman License Holder CCC035 167 and CBC 00 '''67 and Kc:ilb Wood License Holder CBC1250625
..".. r fADDmONAL IlSURED- INSURER lETTER: ,. .......,.1:1 1 ... nn..
2821348 SIIOULD ANY OF THE ABOVE D9CIlIIll!II I'OUCll!S Ill! CAIIICl!l.L!D IIeFOAE THE EXPIAATIOIf
City 01 Zephyrtulls DATE TtlEAEOF. THE ISSUlNG IIilSURER Wll.1. ENDEAVOR TO MAIL ~ DAYS WRm'BI
53SS Eighth NOTlCETD THE C:smFlCATE IWLDER NAMED TO THE lEFT.BUT FAILURE TO 00 10 SHALL
Zephyrhils FL 33540 "f'OSE NO oeuGATlON OR UAIIlUTY OF ANY KIMI UI'ClN THE INSURER. rrs AB6HrS OR
IlEPRESEII1'ATlVE$.
AUTHORIZ&D REPReSENTATIVE L'f}- --4 -'~ -"'IlL
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ACORD zs.s (7197) "",--.......-...-.... ..._-~...""""-' ---..-,..........__lIIln. oAeDIm CORPORATION 1988
RUG-16-2007 15:30
WHITE RLUM HRINES CITY
863 956 5286
P,04/05
.A.C...Q~D.. CERTIFICATE OF LIABILITY INSURANCE OP ID lnt DATE (MMIODIVYYYI
WH'ITA'L 03/01/07
PRODuCeR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
J Rolfe Davia In8~ance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 945255 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
~tl&nd FL 32794-5255
Phane:4D7-691-9600 INSURERS AFFORDING COVERAGE NAIC#
IflSUlUiD 'NSURER A; Auto-owners IIl8~ance Co. 18988
INsuRER B: ao~n.-own.e. IAauanC3e Co. 10190
Vbi u AluainUII P~oduot8, LLC 'NSUReR c; lIac.l.cmN ClN.cn 'be 1.... CD. 19445
~~39fl9~4749-1292 INSURER 0:
'NSURER e;
COVERAGES
THE POUClES OF INSURANCE USTED BElOW HAVEBfiEN ISSUED TO THE 'NSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY ReQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCuMEN1 WITH ReSpECT TO WHICH tHIS CERTlFICATE MAY BE ISSUeD OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES OESCRIBED HEREIN IS SUBJECT TO ALL THe TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POUCIeS. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
~ POUtY NUMBER IPDL UMrrs
TYPe OF INSURANCE PATE IMMlDIf/YYl IlATE! IMMIDPIYYT
~HIiRAL.1JA1IlU'TY EilCtt OCCuRfUil'lCE $ 1000000
8 ..!.. 5MeRCIAL GeNIiRA~ I.IASIl.I'rY 7269147506 09/30/06 09/30/07 I ~R~~~';'E~~~~I $ 300000
~ CLAIMS MADE 0 OCCUR Mell E:XP (AflY one ",,,.on) $ 10000
X CoftuactuaJ. per PERSONAL & AOII INJURY S 1000000
COllPaDY f'ora GENaltAL AGGReGATE $ 2000000
h'L AGGAE6€lE LIMIT APnS PER: PRODUCTS-COMP~PAGG S 2000000
POLICY X ~~ LOC
~o..oelLe LIABILITY COMBINED SINGLE UMIT $ 1000000
A ~ ANY AUTO 4269310901 09/30/06 09/30/07 [Ea accidenl)
ALL OWNeD AUTOS BODILY INJURY
- $
SCHEDULeD AUTOS ("'er PCF$Oft)
...-
~ HIRED AUTOS BOOlLY INJURY
S
.!. NON.(lWNED AUTOS (Pet 8CCldenO
PROPERTY DAMAGE 5
(Per .cllidenO
GARACE LWIl~1TY AUTO ONLY. lOA ACCIDENT $
~ ANY AUTO OTHER THAN eAACC $
AUTO ONt. Y: AGG $
EXCESSMIl8A&1.l.A LIABILITY EACH OCCURRENCE $ 1000000
C ~. OCCUR 0 ClAIMS MAOE BE56188B3 09/30/06 09/30/07 AGGREGATE $ 1000000
---
---~_.~-- $
=x=l DEDUCTIBLE $
X Rla'TewrlQN 510000 S
WORKI!RS CClMNNSATlON 4NIl ITORy ~IMI,.s I IOJk'-
EMPLOTER5' UAIlILI'TY E.L EACH ACCIDENT $
ANY PROPRlETORIPARTNERlEXECUTIVE
OFFlCERlMEMBER EXClUDED? E.L DISI1ASE . EA EMPLOYEE 5
g~I~~=NSIleIOW ;;.;
E.L DISEASe - POI.ICY LIMIT S
OTHER
DesCRIPTION OF OPERATIONS I LOCATIONS I VEIlICU!S I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Reference : Cl.ll Col...n License Holder tC8COO1467; 'CCC03S611 and Kei~
Wood licenae tCBC1250625 Liability 18 limited to 1088 O~ daaage ari.ing out
of neqli!Jent acta c4 the i.ft8ured. lItJ:xcept a. required by Florida Statute.
Ci ty of Zepbyrhil.l.
5335 B1gbtb Street
ZepbyE~11. rL 33542
CANCELLATION
CXOFZBP SHOULP ANY OF TtlI1. A!lOV6 DESCRIBED POLICIES BE CANCELLED BEFORE THE I!XI'IRATION
DATE THEREOF, TttE ISSUING INSUReR WlI.L eNlIEAY~ TO MAIL ~ DAYS WRITTEH
IIIOTIC;" TO THe CERTIFICATE HOLDER HAMID TO THE LEfT. BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THe INSUReR, ITS ACiENT5 OR
REPRESENTATMiS.
CERTIFICATE HOLDER
ACORD 25 (2001108)
o ACORD CORPORATION 19U