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HomeMy WebLinkAbout09-9670 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9670 BUILDING PERMIT €,'' ` ° .:°" g ry € i d .'s d Ge,� .� � a B ,� t° f . ' : ! Permit Number: 9670 Address: 37425 TEABERRY LP Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL. Class of Work: 434 -ADD /ALT RESIDENTIAL Township: Range: Book: Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section: Square Feet: Subdivision: WEDGEWOOD MANOR Est. Value: Parcel Number: 10- 26 -21- 0120 - 00000 -0220 Improv. Cost: 2,086.50 . 1.7 *! Date Issued: 10/20/2009 Name: DAVIDSON, RICHARD Total Fees: 67.50 Address: 37425 TEABERRY LP Amount Paid: 67.50 ZEPHYRHILLS, FL. 33542 Date Paid: 10/20/2009 Phone: (813)780 -2047 Work Desc: REPLACEMENT WINDOWS SIZE /SIZE (5) s 3 NI 1 W i N : • RU • :UIL•IN 67.50 (T� 1 /. O SiMit: Y,.. = ' "'€ F• • - 4 2ND R• H PLUM: MI C N ULATI•N EILIN 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. REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one 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 befr recording your notice of commencement." (-c) Par • 1 /t , CO RACTOR IGNATU PERMIT OFFI .1 PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9670 BUILDING PERMIT 7.717171=7:71111L:wr :; Permit Number: 9670 Address: 37425 TEABERRY LP Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL. Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range: Book: Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section: Square Feet: Subdivision: WEDGEWOOD MANOR Est. Value: Parcel Number: 10- 26 -21- 0120 - 00000 -0220 Improv. Cost: 2,086.50 `� �� °� Date Issued: Name: DAVIDSON, RICHARD Total Fees: 67.50 Address: 37425 TEABERRY LP Amount Paid: ZEPHYRHILLS, FL. 33542 Date Paid: Phone: Work Desc: REPLACEMENT WINDOWS SIZE /SIZE (5) NI V • N : •N RU TIO = UIL•IN FEE 67.50 iY\ 6,3 4 a''36 Ann re )‘ '44.7441W . . 74'4,f .:. �' `^ r �. _ r ��i £^�,�, s. z �, • •• R •R•UGHPLU - M IN LA I•N EILI 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. REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one 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." CONTRACTOR SIGNATURE PERMIT OFFI FR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER Florida Building Code Online Page 1 of 2 �rA t� �+�a , �� r s Cr ommunsty , a rs . 0 r o tA so ou+ra F DCA PHOGALr RS CCAt MCY LL'A , ,, BCIS Home Log In User Registration Hot Topics ■ Submit Surcharge Stets & Facts Publications I, FBC Staff BCIS Site Map Links Search ' lek 4 " ; Product Approval F USER' Public User Community Affairs Product Approval Menu > Product or Application Search > Application List > Application Detail NIIIIIIIIMINIMMIllen FL # FL10288 -R3 t` Application Type Revision ►SI COMMUNITY Code Version 2007 OMLOPMENT Approved Application Status aimoic<eme r Comments 1OFFICEOF , + , E Archived r fr.'EcRETAR Product Manufacturer PGT Industries Address /Phone /Email 1070 Technology Drive Nokomis, FL 34275 (941) 480-1600 Ext 21106 bclark @pgtindustries.com Authorized Signature Robert Clark bclark @pgtlndustries.com Technical Representative Robert Clark Address /Phone /Email 1070 Technology Dr. Venice, FL 34275 (941) 480-1600 Ext 21106 bclark @pgtindustries.com Quality Assurance Representative Address /Phone /Email Category Windows Subcategory Double Hung I • Mark or Listing "ili L-� Compliance Method Certification g G Certification Agency Keystone Certifications, Inc. Validated By Keystone Certifications, Inc. Referenced Standard and Year (of Standard) Standard Year AAMA /WDMA /CSA 101/I.S.2/A440 2005 Equivalence of Product Standards Certified By • ALL WORK SHALL COMPLY WITH ALL PREVAILING CODES. FLORIDA BUILDING CODE, NATIONAL ELECTRIC CODE AND Product Approval Method Method 1 Option A CITY OF ZEPHYRHILLS ORDINANCES Date Submitted 05/08/2009 Date Validated 05/08/2009 http:// www. floridabuilding .org /pr /pr_app_dtl.aspx ?param= wGEVXQwtDquGotOl ZZ... 10/14/2009 Florida Building Code Online Page 2 of 2 Date Pending FBC Approval 05/15/2009 Date Approved 06/09/2009 Summary of Products IFL # Model, Number or Name IIDescription 10288.1 IIDH -2160 Vinyl Double Hung Window Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL10288_R3_C_CAC_190 449 CAR.pdf Approved for use outside HVHZ: Yes FL10288 R3 C CAC_190- 450- CAR_pdf Impact Resistant: No FL10288 R3 C CAC 190- 451- CAR.pdf Design Pressure: N/A FL10288 R3 C CAC 190- 452- CAR.pdf • Other: Equal Lite, Cottage, or Oriel format 47.5 "x73.5" FL10288 R3 C CAC 190- 453 - CAR.pdf I size achieves a rating of H -R35, and 35.5 "x73.5" size FL10288 R3 C CAC_190- 454_CAR.pdf achieves a rating of H -R50. Double units up to FL10288_R3_C_ CAC _190- 455- CAR.pdf • 95.5 "x73.5" or Triple units up to 131.5 "x73.5' with FL10288_R3_C CAC_190- 459- CAR.pdf • Continuous Head and Sill in Equal Lite, Cottage, or Oriel FL10288 R3 _C CAC 190- 460- CAR.pdf format (max. component window width 47.5 ") achieve H- Quality Assurance Contract Expiration Date R35. E1300 glass requirements may limit product size or 12/31/2011 • require glass upgrades to achieve full design pressures. Installation Instructions Please see test report ATI- 79780.02- 401 -44 for FL10288 R3 II_79780.02- 401- 44.pdf additional information. Verified By: Keystone Certifications, Inc. Created by Independent Third Party: Evaluation Reports • Created by Independent Third Party: 10288.2 DH -2360 PGT Double Hung Vinyl Window Series DH 2360 • Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL10288 R3.__C CAC .,._199- 495CAR.pdf • Approved for use outside HVHZ: Yes FL10288 _R3_C_ CAC _199- 496_C_AR.pdf • Impact Resistant: No FL10288 R3 C_ CAC _199- 497CAR.pdf . • Design Pressure: N/A FL10288_R3_C CAC 199- 498CAR.pdf • • • Other: 54"x91" size achieves a rating of H -LC35, and FL10288 R3_C_CAC_DH 2360 - Car - 486.pdf • 48 "x86" size achieves a rating of H -LC50. Unit Reinforced FL10288 R3 CCAC DH2360 -Car - 487df • in Sash Keeper Rail only at 32 "x56" achieves H- LC50 *. Quality Assurance Contract Expiration Date • E1300 glass requirements may limit product size or 02/25/2013 require glass upgrades to achieve full design pressures. Installation Instructions Please see test report ATI -88626 for additional FL10288 R3 II 88626 02- 4.0.1 -47 -r1 Fax.pdf • • • information. FL10288_R3_II_90764 01- 401 -47 -r0 Fax.pdf • • FL10288_R3_II_DH 2360 - Anchorage.pdf Verified By: Robert Clark 39712 Created by Independent Third Party: No • Evaluation Reports Created by Independent Third Party: Back ( Next DCA Administration Department of Community Affairs Florida Building Code Online Codes and Standards 2555 Shumard Oak Boulevard Tallahassee, Florida 32399 -2100 (850) 487 -1824, Fax (850) 414 -8436 © 2000 -2005 The State of Florida. All rights reserved. Copyright and Disclaimer Product Approval Accepts: (il http://www.floridabuilding.org/pr/pr app_dtl. aspx ?param =wGE V XQwtDquGotOkaJvZZ... 10/14/2009 • f T1-�Cm M2 O PIOD� /102 fA y ()a O O WO rra >N r_m ' g y cn Z � ' I � (A ` 0 O V Z¢ty1 O E nri? � y N (18A 7Z 5 g g53mng � tnO m ftl O O m PRE P mo A A_��-%2om2 �_ = . p A >ter m g C ry m Ny *Mg° Zyo�Q^�'rcS 6 20y ."0 1 m =C y > no-0 p on m =AD0[7 0 > 2y c T v ntnm z r U m r 0 Z z 10 mo- 7C , -1 m g m S m D N c = 1 Z > U ArnD N Z = ZG) NDTp rI7 yDz cum T o 2 - 1 . D T o 0) . -mC zar $ ; it vci m $'o 0, spy -, rm z 8 > D-1^rlrm, - IW 1OOZ ;, r<T4 9,AOS O ijfl 0 r r T � r D c m � m " o r�o8 m 0 m zeo °t * N 0, <M mgom �� y, No o z ;� " m AT 8y s �y m A \\\\\\ AO ' t1> il a i V4 1., ' 1 m w $ co A I Z _ c a \N k.,.,. t z N$: N - P . 1 Q � r C 2133 PIMP g z ltiAsm 0 \ i -- i'° Mir 1: ii t...6 54 IP r5 z, Q m 1 � 1 z' 1 I$w Q x 0 , mi g nt co 0 0 — 11 Ai .... r ,--- i .51--- ra cn _ ram , o 0 7 - r- alb. 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CD z N lili — : I I R 3 r" f I ' N z .- i ? . , //: A N b 1 , : 4 1 tol in i Architectural Testing AAMA/WDMA /CSA 101/I.S.2/A440 -05 TEST REPORT Rendered to: PGT INDUSTRIES SERIES/MODEL: DH -2360 PRODUCT TYPE: PVC Double Hung Window (Head Extender) (Reinforced Exterior Meeting Rail) Report No.: 90764.01- 401 -47 Test Dates: 12/30/08 Through: 04/03/09 Report Date: 04/07/09 Expiration Date: 12/30/12 2250 Massaro Blvd Tampa, FL 33619 phone: 813 - 628 -4300 fax: 813 - 628 -4433 www.archtest.com A • Architectural Testing Summary of Results Summary of Results Title Test Specimen #1 Test Specimen #2 Primary Product Designator H -LC30 1118 x 1905 (44 x 75) H -LC50 813 x 1422* (32 x 56 *) Design Pressure +1440/ -1920 Pa ( +30.09/ -40.13 psf) 2400 Pa (50.16 psf) Operating Force (in motion) 40 N (9 lbf) N/A Air Infiltration 0.25 L /s /m (0.05 cfm /ft2) N/A Water Penetration Resistance 360 Pa (7.52 psf) N/A Test Pressure _ Uniform Load Structural Test +2160/ -2880 Pa ( +45.14/ -60.19 psf) ±3600 Pa (+75.24 psf) Pressure Forced Entry Resistance Grade 10 N/A _ Summary of Results Title Test S • ecimen #3 Test S • ecimen #4 Test S . ecimen #5 Primary Product Designator H -LC50 1118 x 1575* H -LC40 914 x 1905* H -LC45 1219 x 1727 (44 x 62 *) (36 x 75 *) (48 x 68) Design Pressure 2400 Pa (50.16 psf) +1920/ -2400 Pa +2400/ -2160 Pa ( +40.13/ -50.16 psf) ( +50.16/ -45.14 psf) Operating Force (in motion) N/A N/A N/A Air Infiltration N/A N/A N/A Water Penetration Resistance N/A N/A N/A Test Pressure Uniform Load Structural Test ±3600 Pa ( ±75.24 psf) +2880/ -3600 Pa +3600/ -3240 Pa Pressure ( +60.19/ -75.24 psf) ( +75.24/ -67.71 psf) Forced Entry Resistance N/A N/A N/A Test Completion Date: 03/19/09 Reference must be made to Report No. 90764.01- 401 -47, dated 04/07/09 for complete test specimen description and data. Reference Architectural Testing, Inc. Revised Report No. 88626.01 - 401 -47, dated 03/18/09 for complete test specimen description and test results. 2250 Massaro Blvd Tampa, FL 33619 phone: 813 - 628 -4300 fax: 813- 628 -4433 www.archtest.com • Architectural Testing AAMA/WDMA /CSA 101/I.S.2/A440 -05 TEST REPORT Rendered to: PGT INDUSTRIES 1070 Technology Drive, P.O. Box 1529 North Venice, Florida 34275 Report No.: 90764.01- 401 -47 Test Dates: 12/30/08 Through: 04/03/09 Report Date: 04/07/09 Expiration Date: 12/30/12 Project Summary: Architectural Testing, Inc. was contracted by PGT Industries to witness testing on five Series/Model DH -2360, PVC double hung windows at the PGT Industries test facility in North Venice, Florida. The samples tested successfully met the performance requirements for the following ratings: Test Specimen #1: H -LC30 1118 x 1905 (44 x 75); Test Specimen #2: H -LC50 813 x 1422* (32 x 56 *); Test Specimen #3: H -LC50 1118 x 1575* (44 x 62 *); Test Specimen #4: H -LC40 914 x 1905* (36 x 75 *) and Test Specimen #5: H -LC45 1219 x 1727 (48 x 68). Test specimen description and results are reported herein. Reference Architectural Testing, Inc. Revised Report No. 88626.01- 401 -47, dated 03/18/09 for complete test specimen description and test results. The samples were provided by the client. General Note: An asterisk ( *) next to the size designation indicates that the size tested for optional performance was smaller than the Gateway test size for the product type and class. Test Specification: The test specimens were evaluated in accordance with AAMAJWDMA/C SA 101/I.S.2/A440 -05, Standard /Specification for Windows, Doors, and Unit Skylights. Test Specimen Description: Series/Model: DH -2360 Product Type: PVC Double Hung Window (with head extender) 90764.01 - 401 -47 Architectural Testing Page 2 of 10 Test Specimen Description: (Continued) Test Specimen #1: H -LC30 1118 x 1905 (44 x 75) Overall Size: 1118 mm (44 ") wide by 1905 mm (75 ") high Top Sash Size: 997 mm (39 -1/4 ") wide by 930 mm (36 -5/8 ") high Bottom Sash Size: 1022 mm (40 -1/4 ") wide by 956 mm (37 -5/8 ") high Screen Size: 997 mm (39 -1/4 ") wide by 1829 mm (72 ") high Overall Area: 2.1 m (22.9 ft Test Specimen #2: H -LC50 813 x 1422* (32 x 56 *) Overall Size: 813 mm (32 ") wide by 1422 mm (56 ") high Top Sash Size: 695 mm (27 -3/8 ") wide by 676 mm (26 -5/8 ") high Bottom Sash Size: 721 mm (28 -3/8 ") wide by 702 mm (27 -5/8 ") high Screen Size: 697 mm (27- 7/16 ") wide by 1346 mm (53 ") high Overall Area: 1.2 m ft Test Specimen #3: H -LC50 1118 x 1575* (44 x 62 *) Overall Size: 1118 mm (44 ") wide by 1575 mm (62 ") high Top Sash Size: 997 mm (39 -1/4 ") wide by 756 mm (29 -3/4 ") high Bottom Sash Size: 1127 mm (44 -3/8 ") wide by 778 mm (30 -5/8 ") high Overall Area: 1.8 m (18.9 ft Test Specimen #4: H -LC40 914 x 1905* (36 x 75 *) Overall Size: 914 mm (36 ") wide by 1905 mm (75 ") high Top Sash Size: 794 mm (31 -1/4 ") wide by 930 mm (36 -5/8 ") high Bottom Sash Size: 822 mm (32 -3/8 ") wide by 956 mm (37 -5/8 ") high Overall Area: 1.8 m (18.8 ft2) ,4 1k. 90764.01- 401 -47 Architectural Testing Page 3 of 10 Test Specimen Description: (Continued) Test Specimen #5: H -LC45 1219 x 1727 (48 x 68) Overall Size: 1219 mm (48 ") wide by 1727 mm (68 ") high Top Sash Size: 1099 mm (43 -i /4 ") wide by 829 mm (32 -5/8 ") high Bottom Sash Size: 1124 mm (44 -1/4 ") wide by 854 mm (33 -5/8 ") high Overall Area: 2.1 m (22.7 ft The following descriptions apply to all specimens. Finish: All vinyl was white. Frame Construction: The frame was constructed of extruded vinyl. The corners were miter cut and welded. The head utilized a PVC snap -on head extender. Sash Construction: The sashes were constructed of extruded vinyl. The corners were miter cut and welded. Weatherstripping: Description Quantity Location 0.340" high by 0.187" backed 1 Row Head polypile with center fin 0.270" high by 0.187" backed 1 Row Head, interior sill leg, both meeting polypile with center fin rails and top rail 0.270" high by 0.187" backed 2 Row All stiles polypile with center fin 1/2" round foam - filled vinyl 1 Row Bottom rail bulb seal Glazing Details: The sashes utilized a 3/4" thick clear insulated glass fabricated from two sheets of 1/8" thick clear annealed glass separated by a butyl spacer system. The sash were exterior glazed onto a single part hot melt back bedding and secured with vinyl snap -in glazing beads. ak 90764.0140147 Architectural Testing Page 4 of 10 Test Specimen Description: (Continued) Drainage: Description Quantity Location 1/8" diameter weepholes 4 Center of meeting and bottom rail Hardware: Description Quantity Location Vinyl tilt latch 4 Ends of top and interior meeting rails Metal tilt pin 4 Bottom and exterior meeting rail end Metal sweep lock with keepers 2 9" from meeting rail ends Metal sweep lock with keeper 1 Midspan of meeting rail only (32 x 56 and 36 x 75) Reinforcement: The exterior meeting rail utilized an aluminum reinforcement (drawing #2144). Screen Construction: The screen was constructed of roll- formed aluminum. The corners were straight cut and vinyl keyed. The fiberglass mesh screen was secured with a wraparound vinyl spline. Installation: The windows were installed into a #2 Southern Yellow Pine wood buck. The windows were secured with #8 x 2" pan head screws through the jambs 12" from head and sill. Test Specimens #1, #3, #4 and #5 utilized one additional #8 x 2" pan head screw at midspan. No screws in the head or sill. All windows also utilized 3/4" x 3/4" interior and exterior wood blind stops secured with #6 x 2" pan head screws located 3" from corners and 16" on center. Silicone was utilized around the exterior perimeter. 90764.01- 401 -47 Architectural Testing Page 5 of 10 Test Results: The temperature during testing was 27 °C (80.6 °F). The results are tabulated as follows: Paragraph Title of Test - Test Method Results Allowed Test Specimen #1: H -LC30 1118 x 1905 (44 x 75) 5.3.1 Operating Force per ASTM E 2068 Initiate motion 40 N (9 lbf) Report Only Maintain motion 36 N (8 lbf) 155 N (35 lbf) Locks 9 N (2 lbf) 100 N (22.5 lbf) 5.3.2.1 Air Leakage Resistance per ASTM E 283 75 Pa (1.6 psf) 0.25 L /s /m 1.5 L /s /m (0.05 cfm /ft (0.3 cfm /ft max. Note #1: The tested specimen meets (or exceeds) the performance levels specified in AALIA/WDMA /CSA 101 /I.S.2/A440- -05 for air leakage resistance. 5.3.3.2 Water Penetration Resistance per ASTM E 547 See Note #2 5.3.4.2 Uniform Load Deflection per ASTM E 330 See Note #2 5.3.4.3 Uniform Load Structural per ASTM E 330 See Note #2 Note #2: The client opted to start at a pressure higher than the minimum required Those results are listed under "Optional Performance". 5.3.5 Forced Entry Resistance per ASTM F 588 Type: A Grade: 10 Disassembly Test No entry No entry Test Al through A7 No entry No entry Sash Manipulation Test No entry No entry Lock Hardware Manipulation Test No entry No entry 5.3.6.2 Thermoplastic Corner Weld Test Meets as stated Meets as stated 90764.01- 401 -47 Architectural Testing Page 6of10 Test Results: (Continued) Paragraph Title of Test - Test Method Results Allowed Test Specimen #1: H -LC30 1118 x 1905 (44 x 75) (Continued) 5.3.6.3 Deglazing Test In operating direction - 320 N (70 lbf) Top sash, top rail 3.3 mm (0.13 ") 11.4 mm (0.45 ") Top sash, meeting rail 3.3 mm (0.13 ") 11.4 mm (0.45 ") Bottom sash, bottom rail 3.3 mm (0.13") 11.4 mm (0.45 ") Bottom sash, meeting rail 3.3 mm (0.13") 11.4 mm (0.45 ") In remaining direction - 230 N (50 lbf) Top sash, right stile 0.8 min (0.03") 11.4 mm (0.45 ") Top sash, left stile 0.8 mm (0.03 ") 11.4 mm (0.45 ") Bottom sash, right stile 1.5 mm (0.06 ") 11.4 mm (0.45 ") Bottom sash, left stile 1.5 mm (0.06 ") 11.4 mm (0.45 ") Optional Performance 4.4.2.6 Water Penetration Resistance per ASTM E 547 (with and without insect screen) 360 Pa (7.52 psf) No leakage No leakage 4.4.2.6 Uniform Load Deflection per ASTM E 330 (Deflections were taken on the meeting rail) (Loads were held for 10 seconds) 1440 Pa (30.09 psf) (positive) 10.7 mm (0.42 ") See Note #3 1920 Pa (40.13 psf) (negative) 14.5 mm (0.57 ") See Note #3 4.4.2.6 Uniform Load Structural per ASTM E 330 (Permanent sets were taken on the meeting rail) (Loads were held for 10 seconds) 2160 Pa (45.14 psf) (positive) 1.3 mm (0.05 ") 3.6 mm (0.14 ") max. 2880 Pa (60.19 psf) (negative) 2.3 mm (0.09 ") 3.6 mm (0.14 ") max. Note #3: The deflections reported are not limited by AAMA /WDMA!CSA 101 /I.S.2/A440 -05 and ANSI /AAMA /NWWDA 1014.S.2-97 for this product designation. The deflection data is recorded in this report for special code compliance and information only. 1° T1L 90764.01- 401 -47 Architectural Testing Page 7 of 10 Test Results: (Continued) Paragraph Title of Test - Test Method Results Allowed Test Specimen #2: H -LC50 813 x 1422* (32 x 56 *) Optional Performance 4.4.2.6 Uniform Load Deflection per ASTM E 330 (Deflections were taken on the meeting rail) (Loads were held for 10 seconds) 2400 Pa (50.16 psf) (positive) 1.5 mm (0.06 ") See Note #3 2400 Pa (50.16 psf) (negative) 1.8 mm (0.07 ") See Note #3 4.4.2.6 Uniform Load Structural per ASTM E 330 (Permanent sets were taken on the meeting rail) (Loads were held for 10 seconds) 3600 Pa (75.24 psf) (positive) 1.3 mm (0.05 ") 2.5 mm (0.10 ") max. 3600 Pa (75.24 psf) (negative) 0.5 mm (0.02 ") 2.5 mm (0.10 ") max. Test Specimen #3: H -LC50 1118 x 1575* (44 x 62 *) Optional Performance 4.4.2.6 Uniform Load Deflection per ASTM E 330 (Deflections were taken on the meeting rail) (Loads were held for 10 seconds) 2400 Pa (50.16 psf) (positive) 8.4 mm (0.33") See Note #3 2400 Pa (50.16 psf) (negative) 8.4 mm (0.33") See Note #3 4.4.2.6 Uniform Load Structural per ASTM E 330 (Permanent sets were taken on the meeting rail) (Loads were held for 10 seconds) 3600 Pa (75.24 psf) (positive) 2.5 mm (0.10 ") 3.8 mm (0.15 ") max. 3600 Pa (75.24 psf) (negative) 2.8 mm (0.11") 3.8 mm (0.15 ") max. 90764.01- 401 -47 Architectural Testing Page 8 of 10 Test Results: (Continued) Paragraph Title of Test - Test Method Results Allowed Test Specimen #4: H -LC40 914 x 1905* (36 x 75 *) Optional Performance 4.4.2.6 Uniform Load Deflection per ASTM E 330 (Deflections were taken on the meeting rail) (Loads were held for 10 seconds) 1920 Pa (40.13 psf) (positive) 5.3 mm (0.21") See Note #3 2400 Pa (50.16 psf) (negative) 6.9 mm (0.27 ") See Note #3 4.4.2.6 Uniform Load Structural per ASTM E 330 (Permanent sets were taken on the meeting rail) (Loads were held for 10 seconds) 2880 Pa (60.19 psf) (positive) 0.8 mm (0.03") 3.0 mm (0.12 ") max. 3600 Pa (75.24 psf) (negative) 1.0 mm (0.04 ") 3.0 mm (0.12 ") max. Test Specimen #5: H -LC45 1219 x 1727 (48 x 68) Optional Performance 4.4.2.6 Uniform Load Deflection per ASTM E 330 (Deflections were taken on the meeting rail) (Loads were held for 10 seconds) 2400 Pa (50.16 psf) (positive) 15.5 mm (0.61") See Note #3 2160 Pa (45.14 psf) (negative) 18.5 mm (0.73") See Note #3 4.4.2.6 Uniform Load Structural per ASTM E 330 (Permanent sets were taken on the meeting rail) (Loads were held for 10 seconds) 3600 Pa (75.24 psf) (positive) 1.0 mm (0.04 ") 4.3 mm (0.17 ") max. 3240 Pa (67.71 psf) (negative) 1.3 mm (0.05 ") 4.3 mm (0.17 ") max. Tape and film were used to seal against air leakage during structural testing. In our opinion, the tape and film did not influence the results of the test. Drawing Reference: The test specimen drawings have been reviewed by Architectural Testing and are representative of the test specimen reported herein. 90764.01- 401 -47 Architectural Testing Page 9of List of Official Observers: Name Company Mike Erickson PGT Industries Charlie McCaffery PGT Industries Rocky Gulbertson PGT Industries Joseph Johnson PGT Industries Mark A. Hess Architectural Testing, Inc. Detailed drawings, data sheets, representative samples of test specimens, a copy of this report, or other pertinent project documentation will be retained by Architectural Testing, Inc. for a period of four years from the original test date. At the end of this retention period, such materials shall be discarded without notice and the service life of this report will expire. Results obtained are tested values and were secured by using the designated test methods. If test specimen contains glazing, no conclusions of any kind regarding the adequacy or inadequacy of the glass in the test specimen can be made. This report does not constitute certification of this product nor an opinion or endorsement by this laboratory. It is the exclusive property of the client so named herein and relates only to the specimens tested. This report may not be reproduced, except in full, without the written approval of Architectural Testing, Inc. For ARCHITECTURAL TESTING, INC. dr4rAiL . P tL- DON SiMd by. Mack A Haw Dgitally Signed by Daniel P. Braun Mark A. Hess Dan Braun Technician Vice President - Regional Operations MAH:ck Attachments (pages): This report is complete only when all attachments listed are included. Appendix -A: Alteration Addendum (1) Appendix -B: Test Equipment (1) Appendix -C: Drawings (25) 90764,01-401-47 Architectural Testing Page l0 of 10 Revision Log Rev. # Date Page(s) Revision(s) 0 04/07/09 N/A Original report issue This report produced from controlled document template ATI 00156, revised 03/05/09. 813 - 780 -0020 City of Zephyrhills Permit Application4 ( Fax -813- 780 -0021 Building Department Date Received Phone Contact for Permitting J ) 396) -- Z -� o,. Owner's Name �v { CSC Y> V t UV) a rd Owner Phone Number 3 `T ��' L_U L{ ✓-,— Owner's Address F-,q � (eAbZ( � Loo Q Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address + 1 \ JOB ADDRESS 3 �i 4 c� TAG 1D; C ( '322 ,P �y� LOT # SUBDIVISION PARCEL ID# it.) - 7 2 -c) t 2c - coctO ` ZZo (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT I I SIGN l I MOVE 1 I DEMOLISH ?Q INSTALL REPAIR PROPOSED USE n SFR 1 1 COMM I I OTHER I TYPE OF CONSTRUCTION I 1 BLOCK I I FRAME I I STEEL I 1 OTHER I DESCRIPTION OF WORK ) Q ci CR - Vim , iYA.0 c 7 S S •Z-e - o ? BUILDING SIZE SQ FOOTAGE HEIGHT l BUILDING $ •2 0 �� VALUATION OF TOTAL CONSTRUCTION ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY I I W.R.E.C. l PLUMBING $ C\ ke ✓ 61 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION O l GAS I I ROOFING I 1 SPECIALTY I I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES I 1NO f BUILDER 1 • � COMPANY �' tVl i v� �'Sr �� nSt Ap SIGNATURE k � � � 1 ( �� - REGISTERED I Y/ N I FEE CURRENT 1 " Y / N Address License # l ` I 9 %L] ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y / N I Address License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y / N I Address 1 License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N I Address License # OTHER COMPANY SIGNATURE REGISTERED 1 Y / N I FEE CURRENT 1 Y/ N I Address License # P RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. * ** *PROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A/C 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 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. 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 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 /UTILITIES 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 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 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 1 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, 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 - 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 permitted. - 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 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 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 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 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 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 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 JURAT (F.S./117.03) OWNER OR AGENT' / , r A G Rd �� 1-.6A-till ' CONTRACTO �- /O,` - /4 -k + ti.ri � ) t Subscribed and sworn o (or a � before me th(s Subscribed and sworn to (off rmed) before me this CD (Spcl by A -0c lei w ter. `> f 0 5 Cx/ by P .je, tslw�� _-r 0■��) Who is /are personally knowr. me or has /have produced � Who is /are personally know me or has /have produced L(.4,0,t.s.k. as identification. L. t _rt .-- as identification. i Name of /� f�V k $ Notary Public ' :�i -ALA.-4 ., nk . � . Notary Public Y .y x Cornmissi. Co i s o ` = JAC QUELINE BOG � t- C omnd ss on DD 621833 . ; NE BO(3 ` o p e es December 1� 010 ,•, _ mmiselon 17fl A21 ra Name of Notary typed, pnrirea a " tan 7 , p e L ,, ";.: � e�. 1i�@cT2"010 , ' II Thro N C FnGi IM!wnawn eFl0.Pf44gPi4 y b ra ! y City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: 5Ge/lt C V t -t) -2 S 1 5'1 (- (04 Date Received: /0 (�- 0 9 J _ r---1 Site: 3 7 T 2-5 i e& berr y lovp Permit Type: Q A s w / S /s ,� c&_ Approved w /no comments: 1 Approved w /the below comments: ❑ Denied w /the below comments: ❑ This comment sheet shall be kept with the permit and /or plans. /0 — d 0 — 0/ Kal in S tzer Tans Examiner Date Contractor and/or Homeowner (Required when comments are present) Scenic View Design & Construction, LLC 932 Scenic Vie‘k Cir Alinneola Fl 3471> 3C2-536-1132 October 14, 2009 City of Zephyrhills Attn: Bldg Department 5335 8 Street Zephyrhills, FL 33542 To Whom It May Concern; The following individuals are permitted to pick -up permits and related items for Scenic View Design & Construction, LLC and Shawn T. Oldham (General Contractor). 1. Angelo Santiago 2. Angela Santiago Thank you in advance for your assistance. Sincerely, Shawn T. Oldham :`Yw'• KATHRYN A HOUGH On this 14 day 0 I ber 2009 Shawn T. Oldham has personally appeared MY COMMISSION # DD and is person- ly . own to me. . -t,, EXPIRES May 17, 2013 013 f / (407) 398 -0153 FlorideNotaryService.com d A Kathryn A Hou: j, Notary Public 4 AC# 3 8 5 31 1 .' S'AAJ . OF FLORIDA .. r 4, * % [f /t . TX o ` .:.: r )f.: is r - ; t r _ _ , D iR - w r Otp ESS • L; , Et U S -••• $. ' N N = r- cE I = B ARDj t - 1 J I ,t, r i ,f 4 4 -rl , f a f :IC r . ```' T f c 2 ;14 ' S Q # L0$'7�30 0940 t, DATE BATCH NUMBER . t r� y 0 7/]1"5Z94 6 k J CG 5 `sY 7. � - r , y> > � � /22008 A�h5 . - . : ._ � 070 ... ti l ,i 2 Z , � � i Y� re " � � . y Az , C�i ' 'v -The: c ENE ONT TO ;} f Y N _ "�� _ t f >;j , ��', six Nained below�r ]S CERTIF `D' 4 _ 9, • Under tie gro�tssons o C :, 20.1 (7&44,!,:.„,-,-.:!' -�.vi iv ' Expiration date AUG 8�., ;�r� w i - K^• n l s r '''.6::::7'.::.:1:1"-sr-3 f � . ...� r.. , l r t r FrJ ' '''t": A i J rf LDHA ScWA] J ti' � ��F r S EN C M,A CI taz Gr i & C aN L Y C: a • c �. 93.2,E CENIC3 - S: • +cx ( { , ,/ , MINNEOLA `' FL 3 'l 8 - • r , ,. CHA : C RX S T CHUCK O GOVERNOR ' ' r,r p T l . i' uIREb:B LA W I NTE R IM SECRET - ( •r. : 1 . , AC# 4 4 9 7 9 0 3 STATE OF FLORIDA " .. DEPARTMENT OF BU`SIS P RLFCE IN2� LATION CONSTRUCTION UPS " "jj B S EQ# L o9 . 080.6a i7t DATE BATCH NUMBER LICENSE NBR " r . 08/06/2009 090065466 ,: QB62092•- The BUSINESS' ORGANIZATION ` Named below I3 QUALIFIED Under the provis cif- 9 .FS ' Expiration date:' AUG 31, 2011 COMPANY `TO DO. BUSINESS. ONLY IF . IT - HAS A . :QUALYFIR E. j f ' :' SCENIC: VIEW. DESIGN & CONSTRUCTION LLC . ` A 932 _ SCENIC VIEW CR.::: _ ` ' MINNEOLA FL 34715 y '. CHARLIE: CRIST - CHARLES W, DRAGO ' .GOVERNOR:; SECRETARY DISPLaY-Flt LAW BOB MsKEE 2009/2010 ACCT NO. 87280 LAKE COUNTY TAX COLLECTOR LAKE COUNTY BUSINESS TAX RECEIPT RECEIPT NO. 8760016732 FACILITIES/ STATE OF FLORIDA EXPIRES SEPTEMBER 30, 2010 MACHINES ROOMS SEATS EMPLOYEES RENEWAL $30.00 TYPE OF CONTRACTING BUSINESS BUSINESS SCENIC VIEW DESIGN & ORIGINAL TAX $30 :00 CONSTRUCTION 932 SCENIC VIEW CIR AMOUNT $30.00 MINNEOLA, FL 34715 _. . OLDHAM SHAWN - QUALIFIER TOTAL $30:00 932 SCENIC VIEW CIR _ MINNEOLA, FL 34715 • PAID - 6004505 08/10/2009 30.00 . PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA IMPORTANT DEPARTMENT OF FINANCIAL SERVICES DNISION OF WORKERS' COMPENSATION n ; : F to Chapter 440.05(14 ), F.S., an officer of a corporation who CONSTRUCTION INDUSTRY O elects exemption from this chapter by filing a certificate of election CE TE OF ELECT T LAw EXEMPT FLORIDA 0 ` 4 L under this section may not recover benefits or compensation under this D chapter. EFFECTIVE: 02/13/2009 EXPIRATION DATE: 02/13/2011 Pursuant to Chapter 440.05(12), F.S., Certificates of election to be PERSON: SHAWN OLDHAM H exempt.. apply only within the scope of the business or trade listed on FEIN: 208250145 E the notice of election to be exempt BUSINESS NAME AND ADDRESS: E Pursuant to Chapter 440.05(13), F.S., Notices of election to be-exempt SCENIC VIEW DESIGN AND CONSTRUCTION LLC 932 SCENIC VIEW CIRCLE and certificates of election to be exempt shall be subject 10 revocation if, at any time after the filing of the notice or the issuance of the CLERMONT, FL 34715 certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shell revoke a certificate at any time for failure of the SCOPE OF BUSINESS OR TRADE person named on the certificate to meet the requirements of this 1- CERTFIED GENERAL CONTRACTOR section. QUESTIONS? (850) 413 -1609 CUT HERE e Carry bottom portion on the job, keep upper portion for your records. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 A COR / DATE (MIAIODIYYYY) CERTIFICATE OF LIABILITY INSURANCE 1 10114/2609 PRODUCER (352) 357 -4104 FAX: {352) 4830853 ONLYCAND CONFERS ISSUED NO RIGHTS MATTER ON THE INFORMATION 2 , S. PTB 6 t, Co. , Inc. ALTER THE THIS ORDED BY - HE POLICIES OR S BELOW. 2755 S Bay Street, Suite B Eustis FL 32726 INSURERS AFFORDING COVERAGE NAIC # DJSURED INSURER,A: Auto °rollers Insurance Scenic View Design & Construction INSURER Attn: Shawn O].dhai INSURER C: -- 932 Scenic View Cir INSURER D: -- )4inneola FL 34715 INSURER E: ,FRAGEs 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. 1 1 •tkM PO LICY EffECTiVE POLICY PXPIRATION Laws OF INSURANCE POLICY NU MBER DATE IMMNDDIYY) OATS (MMR7WYY) 5OO r QOO EACH ocCURRENCE >r GENERAL LIABILITY E X COMMERCIAL GENERAL LIABILITY glirkT, 1 s 300,000 00, 000 A 1 CLAMS MADE 1� = OCCUR 72692891 2/1/2009 2/1/2010 MED E>PJMY one person) ,s ue . PERSONAL & ADV INJURY 1 500,000 GENERAL AG GREGATE f 500,000 PRODUCTS- COMPAr�3A > i 500 OEN% AGGREGATE LIMIT APPLIES PER: 1E1 PO,ICY f JE& I 1 LOC _ ,.._- AUTOMOBILE LIABILITY COMBINED SINGLE LIMB S (Ea acclaim ANY AUTO BODILY INJURY = ALL OW'IEO AUTOS (Per BODILY IN SCHEDULED AUTOS BODILY INJURY $ HIRED AUTOS (Pa a cideeq NON. OWNED AUTOS PROPERTY DAMAGE s (Per aCGdent) -•• A UTO ONLY - E A ACCIDENT $ GARAGE LU161LITY _ OTHER THAN EA non s ANY AUTO - AUTO ONLY. AGG s FACH OCCURREN(* $ EXCESS/UMBRELLA LIABILITY AGGREGATE 1 OCCUR E CLAIMS MADE s S ------m DEDUCTIBLE $ RETENTION 1 Tp L1MITS ( NU WORKERS CONPENEATION AND E.L. EACH ACCIDENT a EMPLOYERS' LIABILITY ANY PROPRIETOR/PAR ECUTIVE E.L. DISEASE- EA EMP7.OYEE 1 OFFl � CEREMB� EXCLUDED LU0ED � It yes, AI PR ! wider OVISIONS E.L. 015FASE -POLICY LIMIT ^PECIAI PR Wow - .... �. OTHER DESCRIPTION OF OPERATIONS )LOCATION$NEHICLES+EXCLUSIONS ADOED BY OIOORSEMENTIBPECIAL PROVISIONS CANCELLATION CE 16) 780 - HOLDER _. SHOULD A OF THE AB DESCRIBED POLICIES BE CANCELLED BEFORE THE ( is s) City of ZepYGyrhi.11s DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Attn Building Dept 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT 5335 8th Street FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE Zephyrhills, FL 33542 'I\ NSURAR ITS AGENTS ORREPREEENTATIVSS r ®AcoRU coRPORATyoi ,,,....•-•- 988 ACORD za (2001/08) WOWS! ....AA. 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