HomeMy WebLinkAbout08-8263
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CITY OF ,ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
8263
Permit Number: 8263
Permit Type: ADDITION/AL TERATION
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: SINGLE FAMILY RESIDENTIAL
Square Feet:
Est. Value:
Improv. Cost: 1,157.21
Date Issued: 9/04/2008
Total Fees: 60.00
Amount Paid: 60.00
Date Paid: 9/04/2008
Work Desc: REPLACE 2 EXTERIOR DOORS
Address: 5 10 17TH ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-04800-0200
Name: DYER, RICHARD
Address: 5910 17TH ST
ZEPHYRHILLS, FL. 33542
Phone: 813469-4486
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TER
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC,
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."
~(I-c7Y
CTOR SIGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020
City of Zephyrhills Permit Application
Building Department
Fax-813-780-0021
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Date Received
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PARCELID#IJJ~-81::Q2lo-o-froa-c..D~ I
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN D MOVE D
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OWner's Name
OWner's Address
Fee Simple Titleholder Namel
Fee Simple Titleholder Address I
JOB ADDRESS
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o NEWCONSTR D ADD/ALT. tvr
D INSTALL D REPAIR ~
PROPOSED USE 0 SFR 0 COMM 0 OTHER
TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0 STEEL D
DESCRlPT1ONDFWORK I ~hC\G:1 &k.rt~~~Jdf-<;'h:, ~
BUILDING SIZE . I SQ FOOTAGE I I HEIGHT I I
74 BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION \ \S1.c9. \
D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D
D PLUMBING 1$ I
D MECHANICAL 1$ I
D GAS 0 ROOFING D
FINISHED FLOOR ELEVATIONS I I
SUBDIVISION
WORK PROPOSED
DEMOLISH
OTHER I
W.R.E.C.
VALUATION OF MECHANICAL INSTALLATION
SPECIALTY D
FLOOD ZONE AREA
OTHER
DYES
DNO
BUILDER
SIGNATURE
COMPANY
REGISTERED
f:~ Nb rc.:t.:.t;y I
License # I
Y/N
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Address
ELECTRICIAN I
SIGNATURE .
Address I
PLUMBER I
SIGNATURE
I
COMPANY
REGISTERED
Y/N FEE CURRENT
License #
Y/ N FEE CURRENT
License #
Y/ N FEE CURRENT
License #
Y/ N FEE CURRENT
Y/N
COMPANY
REGISTERED
Y/N
COMMERCIAL
Address
MECHA~ICAL I
SIGNATURE .
Address I
OTHER I
SIGNATURE
~~! ~~#
I111111I " 1I11I111II1I111I1111 " 111111I " 111111I1I11111 " 1111II11111 " 1I1I11 " 1111111111111 " 111111I11II11 " III i III i I j j I ; 111111111111111 ! II1III ! ! I
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns; R-Q-W Pennit for new construction,
Minimum ten (10) working days after submittal date. Rerrulred onslte, Construction Plans, StonnWater Plans w/ Slit Fence Installed,
Sanitary Facilities & 'I dumpster; Site Work f'ennit for subdivlslonsnarge projects
Attach (3) sets of Building Plans; (1) set of Energy Fonns. R-O-W Penn It for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stonnwater Plans wI Silt Fence Installed,
Sanitary Facilities & 1 dumpster. Site Work Penn it for all new projects. All commercial requirements must meet compliance
Attach (2) sets of Engineered Plans.
....PROPERTY SURVEY required for all NEW construction.
COMPANY
REGISTERED
Y/N
COMPANY
REGISTERED
Y/N
SIGN PERMIT
DI~~ti~~~~ ' . . , , . . , , . , . . , . . . . , . . , , . . , . . . , . . . . . . , . . . . . . . . . , , . . , . , . . . . . . , , . . . . . , . . . . . . . . , , , . . . . '. . . . . , . . . , . . . . . , . . . . , . .. , , . . . . . . . . . , . , . . , . . , . . . . , , . . .
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000)
Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRI(j:TIONS: 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 compliaflce with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed a~ 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 advi~ed 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 IMPAC,T/UTILlTIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact F~es 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 urjdersignec:i also understands, that such fees, as may be due, will be identified at the time of
permitting. It is further und~rstood 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 p~id prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that I, the applicant,' have been provided with a copy of the "Florida Construction Lien Law-Homeowner's
Protection Guide" prepared ~y the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the "owner" priorto commencement.
CONTRACTOR'S/OWNER'$ AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance ~th all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a p;ermit 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 thatithe 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, WaterlW~stewater Treatment.
Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
US Environmental Protection Agency-Asbestos abatement.
Federal Aviation :Authority-Runways.
I understand that the followin:g restrictions apply to the use of fill:
Use offill is not allowed In Flood Zone "V" unless expressly permitted.
If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating v,olume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
If the fill materi~1 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 u~e of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are ~levated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to. violate, cancel, alter, or
set aside any provisions of t~e technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authoriz~d 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, th~ob is 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 FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURA.T (F.S. 117.03) . r\ \
OWNER OR AGENT CONTRACTOR ~
Subscribed and sworn to (or affinned) before me this Sub~d and swo
~ IS - ~
Who is/are personally known to me ,or haslhave produced WI)o.I6Iare p me or haslhave produced
as Identification. ..J Q J:? as Identlftcatlon.
Notary Public
Notary Public
Commission No.
Name of Notary typed, printed or stamped
Notary Public State of Florida
Shelly BesWick
My Commislion 00745038
Expires 03/03/2012
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City of Zephyrhi1ls
BUILDING PLAN REVIEW COMMENTS
Site:
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Contractor/Homeowner:
Date Received:
Pennit Type:
Approved wino comment''f
Approved withe below comments: 0
Denied withe below comments: 0
be kept with the permit and/or plans.
ti1.-tJj
Date Contractor and/or Homeowner
(Required when comments are present)
ACORDTM . CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY)
05/02/2008
PRODUCER (561) 338-3030 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Stirling Insurance Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1700 North Dixie Hwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 109
Boca Raton FL 33432- INSURERS AFFORDING COVERAGE NArc #
INSURED INSURER A: Na tionwide Mutual Ins. Co 23779
J&G Carpentry, Inc. INSURER B:
13461 79th Court North INSURER C:
INSURER D:
West Palm Beach FL 33412- INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY
REQUIREMENT, TERM OR CONDITiON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,
THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN is SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MMlDDIYY) DATE (MM/DDIYY) LIMITS
A GENERAL LIABILITY 77PR769812-3001 05/02/2008 05/02/2009 EACH OCCURRENCE $ 1,000,000
f--- ~~~~H?E~~J~~ncel
X COMMERCIAL GENERAL LIABILITY $ 50,000
I CLAIMS MADE ~ OCCUR / / / / MED EXP (Anyone person) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
/ / / / GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREAE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $ 2,000,000
:xl PRO. ~- / / / /
POLICY JECT LOC
A AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT 500,000
- (Ea accident) $
- ANY AUTO
ALL OWNED AUTOS / / / / BODILY INJURY
- (Per person) $
- SCHEDULED AUTOS
- HIRED AUTOS / / / / BODILY INJURY
$
NON.OWNED AUTOS (Per accident)
r--
~ OWNED 77BA769812-3002 05/02/2008 05/02/2009 PROPERTY DAMAGE
(Per accident) $
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
R ANY AUTO / / / / OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY / / / / EACH OCCURRENCE $
tJ OCCUR D CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE / / / / $
RETENTION $ $
WORKERS COMPENSATION AND / / / / I WC STATU- I 10TH.
EMPLOYERS' LIABILITY TORY LIMITS ER
ANY PROPRIETORlPARTNER/EXECUTIVE EL EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? / / / / E.L. DISEASE - EA EMPLOYEE $
If yes. describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
OTHER / / / /
/ / / /
/ / / /
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
( ) - (813) 780-0021 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
City of Zephyrhills FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
Permitting / Licensing INSURER. ITS AGENTS OR REPRESENTATIVES.
5335 8th Street AUTHORIZED REPRESENTATIVE ~~~ -'
Zephvrhills FL 33542- f'Or 'T"erry ~ !:J,na7n"n'u.t:o
ACORD 25 (2001/08)
f'tTM" INS025 (0108).05
ELECTRONIC LASER FORMS, INC. - (800)327.0545
@)ACORD CORPORATION 1988
Page 1 of2
1J~/Zll/ZOOll FRI ll: 00 FAX 561 :n3 1747 ......... CHRIS TAMPA IlQ01orOl
A.CDRQ. CERTIFICATE OF LIABILITY INSURANCE I CIRTlI'lc:ATE NO./DATE
ACOQ. '2G04G2. ~0?U6
OJ/25(20n 01:31 PI
,"~DUCER THIS CI!JmFICATE IS ISSUED AS A MATTEA OF INFORM4T1ON
Highpoint lli~k Service~ L~C ONLY AND CONP.R. NO RIGHTS UPON THE CER11FICATB
14160 DallaD Parkway 1t500 HOLDIR. THIS CBmFICATI! DOI!S NOT AMI!ND, I!XTI!ND E.!!
D_11iLli, 'rx 75254
(800) 632-5096 INSURERS AFFORDING COVERAGE
IIN!IllIiI!D!"II ';(Ms" "'ti aN r IN!URER ^' Can"an1on PronQrtv and CaliuiL1tv InliuranClI;I C
J " C CARPENTRY, INC. INSURER B;
13461 79 CT, NOR~R INSURER 0;
WEST PALM BEACH, FL 33412 INSURiR D;
(5&1) 333 -7-'04 Fax: ( Stil) 333-7747 INSURO'II::
THli POLICIES OF INSURANCE USTED BELOW HAVE ElEeN ISSUED TO THi INlURiD NAMiD AiOVE FOR THE ..OLlCY PERIOD INDICATeD.
NOTWITHSTANDING
A~~.~~~~RI!MENT, TllRr.1 OR CONOmON OF ANY CONTRACT OR O'I'HER DOCUMENT WITtl RESPECT TO WHIc:t1 THIS CERllFICATE MAY E1E
~ lYpeOl'INSUMNCf POLICYNUMll!ft ~~ UMITS
~I!NI!:AAL UAI!1LllY I!"'CH OCCUAA!NCI! S
10- O""MERCIAL CENI!/W. L'A!lIUTY I'IRI: DAM!\GI: (My 011' "re, ,
I- CLAIMS M!\DE 0 OCCUM MI:D I:lCP 1M, 0", 1II1I0n) S
10- PI&ASONAl. , AlN INJURY S
- GeN~ML AGGrteGAu S
~N1. AQQ~En ~rMIT "nS peR: I'I'IO~. OOMP'lO"!\GO $
I'QUCV F,.fl~ LOO
~UTOM081~; UA8ILITY OOMIIINIOD $INGLIO LIMIT ,
AN'( AIITO (fa acddenU
-
AlL OWNED AVTOS IiOPI!,V IN,jUl'l'f
f- a
SCHI:OULl!:D AUTOS (Ptr pelton)
-
WI"'O AUTOS BODlLT INUI'IV
- $
- NON.()WI';EO AUTOS (PW .Cl:id.n1)
- PROPERTY DAMAGE S
(Per accicIonl)
~RAG' l.I,lIlI~ITY AUTO ONLY .I!'" ACCIDENT $
!\N'f AUTO OTHliR THo\N I:...ACC S
AUTO ONLY: AGG i
~I!CS UABlLITY eACH OOOVIIIII!NOI! s
'"- OCCUR 0 CLAIMS hti\Dl: AGOIII!CilTI! .
S
I- OEPUCTIIlLE
$
~
1Il!T!r-mON S S
WOAKllRI <:OMPIiNSATlON ANll x f'''''!OTATU.. I 10J:lt
I!M'LOVeAS' LlA~LITY WC77779990601 04/01/2008 04/01/2009 s 1000000
l!.L I!ACH ACCIDI!,,"
A E.L D18I:A8l! - EA EMPLOYEE S 1000000
".1- 0l8I!AS~. "OUCY LiMIT , 1000000
:rIA LIWITS S
UWITS S
olSCAlPTlON 0,. OP1!IIATlDNSlLOCATIONSlVIIMlCl.QIEXc;I.U510NI IIPPIP .., PfElOMEMENTlSPECIAL PAOVICICltfS
1. Insured is afforded Occupational Accident Coverage as . co-employer under the policy for employeell
lea~ed from ANS Staff Lca.ing. Inc. 2. 'mi. c.r~ifica~e remains in cffoct, providod tho cliont's
account ili in good stiLnding with AMS. COver~go i. not provided for any employee for which the c1i~t
~.s not repor~ing wagee to AHS. Applies to lOot of the employees o( AMS lea~ed to J & C CARPENTRY,
INC., effective 04/01/2008
"''''8 I I ADIlITIONAL INSUAI!D: INSUAIIA L;TTCJl: .... ...."'. .........,
SHOULD ANY OF TMIi AIIQVIji DACIIIRiD POLlCIIilIiIi CoIi/t4C;SI.LliD R"FOR" na;: IiXPlllAllOii
DoIiT1: 'Tlfl:llrol'. TH!! ISSUING INSUReR WILL eNDeAVOR TO MAIL 30 DAYS WAITTIN
CITY 01-' ZIOPHYRJfILLS NOnCE TO 'Tlfa e'RTII'lCAft HOLDIUI _ID 'to 'tHI lU't. ell'l' ,&11.1I... TO DO 10 'HALL
fiJJ5 8 TII STREET IMPOS. NO ORLIlIA110NOII UARIUTT OPANT KIND UPON TltIINl..-, I7WA_O~
b~: 813-760-0021 AGPIICJ:IWTATlVIiI-
ZEPRYRRrL~S. FL 33542 AUlJ10rua:o AI:P11IlSINTAl1VJ: l -. ",
ACORD 25.S \TI9TJ o ACORD CORPORATION 19 I
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MIAMI-DADEII.
BID
BUILDING CODE COMPLIANCE OFFICE (BCCO)
PRODUCT CONTROL DIVISION
NOTICE OF ACCEPTANCE (NOA)
MIAMI-DADE COUNTY, FLO~IDA
METRO-DADE FLAGLER BUII.QING
140 WEST FLAGLER STREET, SUITE ~603
MIAMI, FLORIDA 33130-~563
(305) 37S-2901 FAX (30S) 37S-~908
WWW.buildingCodeOnIine.~
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Jeld Wen Inc.
3737 Lakeport Blvd.
Kalamath Falls, OR 97601
SCOPE: I
This NOA is being issued under the applicable rules and regulations governing the use of construction :t:
materials. The documentation submitted has been reviewed by Miami-Dade County Product Control Divi ion
and accepted by the Board of Rules and Appeals (BORA) to be used in Miami Dade County and other s
where allowed by the Authority Having Jurisdiction (AID). r
This NOA shall not be valid after the expiration date stated below. The Miami-Dade County Product Co~i 01
Division (In Miami Dade County) andlor the AID (in areas other than Miami Dade County) reserve the ght
to have this product or material tested for quality assurance pwposes. If this product or material fail to
perform in the accepted manner, the manufacturer will incur the expense of such testing and the AID IPaY
immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. B~
reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product CO$ol
Division that this product or material fails to meet the requirements of the applicable building code.
This product is approved as described herein, and has been designed to comply with the Florida Building I
Code, including High Velocity Hurricane Zone of the Florida Building Code.
DESCRIPTION: Series WIE Outswing Opaque Insulated Steel Doors & wlwo Sidelites
ApPROVAL DOCUMENT: Drawing No. S-2108-01, titled ''Wood Edge Opaque Steel Outswing", shee~
1 through 8 of 8, prepared by PTC, LLC, dated 12-15-01 Last revised on 101251W, signed and sealed by $c
S. Nielsen, P.E., bearing the Miami-Dade County Product Control Renewal stamp with the Notice of
Acceptance number and expiration date by the Miami-Dade County Product Control Division.
MISSILE IMPACT RATING: i
1. Doors: Large and Small Missile Impact n:l;l
2. Sidelites: None. Approved Hurricane Protection Devices, complying wI FBC, as applicable are requiIr.
RENEWAL of this NOA shall be considered after a renewal application has been med and there has beeIlj
no change in the applicable building code negatively affectiJ?g the perfonnance of this product. r
TERMINATION of this NOA will occur after the expiration date or if there has been a revision or Changt
in the materials, use, andlor manufacture of the product or process. Misuse of this NOA as an endorsement of
any product, for sales, advertising or any other purposes shall automatically terminate this NOA Failure to
comply with any section of this NOA shall be cause for tennination and removal of NOA. I
ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County, Florida, and follOWed
by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, ~en
it shall be done in its entirety. !
INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its I
distributors and shall be available for inspection at the job site at the request of the Building Official. I
This NOA renews NOA #02-1216.10 and consists of this page 1 and evidence pages B-1 and E-2. as well ~
approval document mentioned above. I
The submitted documentation was reviewed by Ishaq I. Chanda, P.E. I
I
I
NOA No 07-07 .07
Expiration Date: August 01, 2 12
Approval Date: November 15, 2
Pa el
D.
E.
JeW Wen Inc.
NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED
A.
DRAWINGS (Transferred from file # 02-1216.10)
1. Manufacturer's die drawings and sections. i
2. Drawing No. S-2108-01, titled "Wood Edge Opaque Steel Outswing", sheets 1 thro*gh
8 of 8, prepared by PTC, LLC, dated 12-15-01 Last revised on 10/25/07, signed an4
sealed by Eric S. Nielsen, P.E. i
I
I
TESTS (Transferred from file # 02-1216.10) Original test conducted per SFBC, P A 202-94,1
now known as FBC, T AS 202-94 I
1. Test reports on 1) Air Infiltration Test, per FBC, TAS 202-94 I
2) Unifonn Static Air Pressure Test, Loading per FBC, T AS 202-94 I
3) Water Resistance Test, per FBC, TAS 202-94 I
4) Large Missile Impact Test, FBC TAS 201-94 I
5) Cyclic Loading Test, per FBC T AS 203-94 i
6) Forced Entry Test, perFBC 24113.2.1 and TAS 202-94 I
along with marked-up drawings and installation diagram of outswing Glazed steel d~or,
prepared by Certified Testing Laboratories, Inc., Test Report No. CTLA 697W A, dtted
11/12/01, signed and sealed by Rame.sh Patel, P.E. t
2. Additional test report I
I
Test reports on 1) Air Infiltration Test, per FBC, TAS 202-94 i
2} Unifonn Static Air Pressure Test, Loading per FBC T AS 202-94 I
3) Water Resistance Test, per FBC, TAS 202-94 I
4) Forced Entry Test, per FBC 3603.2 (b) and TAS 202-94 r'
along with marked-up drawings and installation diagram of wood edge outswing gl
steel door, prepared by Certified Testing Laboratories, Test Report No. CTLA- 961 ,
dated 10/23/01, signed and sealed by Ramesh C. Patel, P .E. I
I
CALCULATIONS 11
1. Anchor Verification Calculations, prepared'by PTC, LLC, dated 06/20/07, signed d
sealed by Eric S. Nielsen, P.E. .
2. Glazing complies w/ ASTME-1300-02 .
I
B.
C.
QUALITY ASSURANCE
1. Miami Dade Building Code Compliance Office (BCCO).
MATERIAL CERTIFICATIONS .
1. Notice of Acceptance No. 05-0921.09 issued to ODL, Inc. for "HP Propropylene
Doorlight Assembly", expiring on 1/17/11.
2. Notice of Acceptance No. 07-0828.01, issued to Trinity Glass International, Inc. for
''Trinity Lite Frame" expiring on 7/3/12. I
3. Tensile Test prepared by Internek Testing Services Inc., Project No. J99OO6660-001
dated 3/30/99, tested per ASTM E84-97a and ASTM D 1929-91.
E-l
Jeld Wen Inc.
E.
F.
G.
NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED
MATERIAL CERTIFICATIONS (Continue)
4.
Photocopy of test report 114884-1 dated 11/24/98 for "Standard test Method for Ra~e of
Burning of Self-Supporting Plastics in Horizontal position per ASTM D 635-97; ~
test report No. 114884-2 dated 11/24/98 for "Measuring the Density of Smoke or !
Decomposition of Plastics" per ASTM D 1929-96; and test report No. 114884-2 dat
11/24/98 for "Measuring the Density Smoke from the Burning or Decomposition 0
Plastics" per ASTM D 2843-93; all the above tests reports are for DC-I643-05 Fill
Polypropylene Fiberglass & Mica, issued by SGS U.S. Testing Co. Ine. r
Photocopy 4500 Hours Xenon Arch completed tensile report No. PRI00034 dated I
December 12, 2000, issued by PRI Asphalt Technologies to ODL for Spartech :
Polycom PP5530-CI3, 4500 Hours Xenon Arch exposed samples, Tested per AS*
D 638900, signed and sealed by Charles L. Thomas, P.E. !
Notice. of Acceptance No. 02-0429.11, issued to Trinity Glass International, Inc. fori
''Trinity Lite Frame" dated 7/3/02, expiring on 7/3/07. !
I
I
STATENUENTS i
1. Statement letter of conformance and ''No financial interest, dated 06/21/07, signed ~d
sealed by Eric S. Nielsen, P.E. I
Laboratory compliance letter, as part of above referenced test report.
s.
6.
2.
OTHER
1. This NOA renews NOA # 02-1216.10, expired on August 01, 'lOO7.
E-2
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