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HomeMy WebLinkAbout09-9538 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9538 BUILDING PERMIT a 7 .:.`£ 7: `' at 7777 : . Tr7 z t 4 Viz Permit Number: 9538 Address: 3533 AQUAMARINE AVE Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL. Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: EMERALD POINTE RV RESORT Est. Value: Parcel Number: 24- 26 -21- 0020 - 00000 -0930 Improv. Cost: 16,000.00 Date Issued: 9/14/2009 Name: HALL, WILLIAM & ELEANOR Total Fees: 235.00 Address: 4912 SOUTH DUPONT HWY Amount Paid: 235.00 DOVER DE 19901 -6418 Date Paid: 9/14/2009 Phone: (302)697 -8814 Work Desc: CONSTRUCT LANAI 22 X 12 -774111 7,441, H•M • - UILDIN 65.00 t AL 35.00 HOMEOWNER PLUMBING FEE 35.00 HOMEOWNER NoC (A -2 ,( 0 • • R 2ND ' H PLUM= /11.1111 ULA • 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 before recording your notice of commencement." Vei CONTRACTOR SIGN TURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 1 1, ■ , �_+._". City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: /1 1/(1 7/ 4 ill Date Received: q- B - q Site: 3533 4-gbi Qma r7 e a2 Permit Type: 21 ' / Z 4, Approved w /no comments: ❑ Approved w /the below comments: Denied w /the below comments: ❑ 1:._ M( f° '� , L/' 6e mt ,6ti ( 41,2_, ,1144/2ediem a) «f 54-kith k „Kid. This comment s et s be ept with the permit and/or plans. 7 77 r �� �- �5 Kal m Switzer — P s Examiner Date Contractor and/or Homeowner (Required when comments are present) C 4 O(Z -ld/f 1111111 IIIII 1011 IIIII IIIII IIIII IIIII IIIII IIIII IIIII 1111 IIII 2009127722 Rcpt:1262659 Rec: 10.00 DS: 0.00 IT: 0.00 09/09/09 -- -_ Dpty Clerk PAULA S. O'NEIL, PASCO C LERK O COMPT ‘ ROLLER NOTICE OF COMMENCEMENT 090R96K9 8igi PG 7 Permit No. Property Identification No. 2 ff our 00 _ 0 -09X THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1. Description of property (legal description :) 74 Ei, Jd .49i ice ta(d. Pa gy ■041 4P7 -9,0 Cs-,Lij a) Street Address: 3533 ix id. It T al, aid • Lbw 2. General description of improvelnen / �� /62._ oLo2-- 3. Owner Information & / a) Name and address: 44/1/0:14 7 15 05733 3 ai¢/Xahit D 4/x /f b) Name and address of fee simple titleholder (if other than owner) v c) Interest in property 4. Contractor Information a) Name and address: D 6Ww" Rt Cie It a (or" b) Telephone No.: Fax No. (Opt.) 5. Surety Information a) Name and address: b) Amount of Bond: c) Telephone No.: Fax No. (Opt.) 6. Lender a) Name and address: Phone No. 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: a) Name and address: b) Telephone No.: Fax No. (Opt.) 8. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(1) (b), Florida Statutes: a) Name and address: b) Telephone No.: Fax No. (Opt.) 9. Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is Specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA 7 r y A COUNTY OF PASCO C Signature (If Owner or Owner's Authorized Officer/Director/Partner/Manager Wt / /ti G Iv l Print Name PA The fore$ ing instru��yi4 was acknowledged before me this o day of , 20 a , by Walt E. /WI . as Q tuk/' (type of authority, e.g. officer, trustee, attorney in fact) for /E-t-Nt nelf (name of party on behalf of whom instrument was exe / cuteed). Personally Known OR Produced Identification // Notary Signature —� (P�� L � / ��' "�d Type of Identification Produced.– Name (print) efe- A/ Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. STATE OF FLORIDA, COUNTY OF PASCO flree,e-C.; Zge( Signature of Natural Person Signing Above TtTIFY THAT THE FOREGOING IS A TRUE AND CORRECT COPY OF THE DOCUMENT p , ;,, y _ n r CF FLOP: [DA ON FILE OR OF PUBLIC RECORD IN THIS OFFICE WITNESS MY HAND AND OFFICIAL SEAL THIS ° r ; 9 DAY OF 2 09 PAULA S. O'NEIL, CLERK & COMPTROLLER aOrv4.6 ' Li uu , ,c w.. a , c. INC. BY dej/A i 101.1t, DEPUTY CLERK 813 -780 -0020 City of Zephyrhills Permit Application Fax- 813- 780 -0021 Bu ilding Deparfor tmePermitt nt j Date Received q- 8 9 -0 Phone C ontact Owner's Name CU/ / /10m ?61 Owner Phone Number Owner's Address 3s'33 , a-t-Lmu-me tOly Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address /, ) g ,(� ��(J p JOB ADDRESS 35 •4�((.,(�- MJL/`, a t �D �-y r/`dh f/. LOT # 93 Ah-/ SUBDIVISION VA- EAtrt.611 &kit, Ric 4 PARCEL ID# 02 04 DV ddDi - dvt0 — 0930 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED ptl NEW CONSTR ADD /ALT I 1 SIGN n MOVE 1 ( DEMOLISH INSTALL REPAIR PROPOSED USE I I SFR 1 1 COMM 1 1 OTHER 1 I TYPE OF CONSTRUCTION I 1 B LOCK 1 1 FRAME n STEEL 1 1 OTHER 1 1 / DESCRIPTION OF WORK C c - _ b2-4- r X let, BUILDING SIZE /6 X e 4-- SQ FOOTAGE r QV HEIGHT BUILDING $ !& OM , Qo VALUATION OF TOTAL CONSTRUCTION r ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY W.R.E.C. E PLUMBING $ 1 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION 1 1 GAS 1 1 ROOFING 1 1 SPECIALTY 1 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES [ NO BUILDER oit 1 ( COMPANY 011-411 a / / / /tt 11 44 SIGNATURE 9 REGISTERED I Y/ N I FEE CURRENT I Y/ N Address 33-33 , (L / ecrat &"PLC/ 4/ 4. -- • License # I ELECTRICIAN ,/,,. ,/�� , , /,� , l je', r O° C OMPANY I d�it r fit/ / i/ / a./h A1/41/ SIGNATURE A . a - t - t�/ . J REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address 1 3533 411_a -` lttejt. 2Qy 01/af*) U.fe F-(-&3 License # PLUMBER •/( -r COMPANY Oa w i I ieff _ A` e / SIGNATURE �s,J REGISTERED 1 Y/ N 1 FEE CURRENT I Y/ N I Address 1 License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # OTHER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 Address License # 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) 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 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 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, 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. 1 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 AN ATTORNEY OBEFORE FINANCING, CONSULT WITH YOUR LENDER OR RECORDING YOUR NOTICE OF OMMENCEMENT. FLORIDA JURAT (F.S. 117.03) !/(/��G � CONTRACTOR c A sac OWNER OR AGENT S scribed an l sworn to or rm,�j ore me this Subscribed and sworn to (or a y ed) before this � dq by ff /�'�' y Wh is /are persona or has/have produced personally known to me Who is /are • ovally known o e or h -s /have produced as identificafion. as identification. _ _��4 Notary Public t . 6t / -- Notary Public - —.I �� ,_ Commission No. �7 , C Name of Notary Commissio o. NikiZN( typed, r ed, printed or st mped ed Name of Notary typed, printed or stamped ary typ Pasco County Parcel: 24- 26 -21- 0020 - 00000 -0930 001 Page 1 of 1 Search Again Show Map Building Schematic Unavailable Frequently Asked Questions Estimate Taxes Other Agency Data: Tax Collector School Board Supervisor of Elections Data Current as Of: I Weekly Archive - Saturday, September 05, 2009 Parcel ID 1 24- 26 -21- 0020 - 00000 -0930 (Card: 001 of 001) Classification 00 - Vacant Residential Mailing Address Property Value HALL WILLIAM E & ELEANOR K Ag Land $0 4912 SOUTH DUPONT HWY Land $25,826 DOVER, DE 199016418 Building $0 Physical Address Extra Features $2,106 3533 AQUAMARINE WAY ZEPHYRHILLS, FL 33540 -7413 Market Value $27,932 Legal Description (First 4 Lines) Assessed (Save Our Homes) $0 See Plat for this Subdivision .2,- Taxable Value $27,932 THE EMERALD POINTE RV RESORT PHASE ONE PB 34 PGS 87 -90 LOT 93 Land Detail (Card: 001 of 001) I Line II Use IlDescriptionll Zoning II Units II Type II Price II Condition II Value 1 0200 MSUBM 00C2 2,448.00 SF $10.55 1.00 $25,826 I Additional Land Information I I Acres II 0.06 11 Tax Area II 30ZH II FEMA Code II X IlResidential Codell EMPTLP1 I Building Information (Card: 001 of 001) I Unimproved Parcel 00 - Unimproved Extra Features (Card: 001 of 001) Line II Description II Year 0 Units 0 Value 1 11 DWC I 1998 11 960 II ,524 2 II UDU -M I I 2007 II 1 $582 Sales History Previous Owner II BARB RICHARD 0 & MARY ANN Year II Month Q Book /Page II Type ll Amount 2007 Il 09 1 7638 / 0083_ II WD II $50,000 2005 II 03 Il 6702 / 1554 I) QC II $ 2003 11 11 11 5612 / 1085 11 WD II $18,000 Search Again Show Map Building Schematic Unavailable Frequently Asked Questions Estimate Taxes Other Agency Data: Tax Collector School Board Supervisor of Elections http: / /appraiser.pascogov. com/search/parcel.aspx ?sec= 24 &twn= 26 &rng=21 &sbb= 0020 &b... 9/11/2009 Gil/ /749 L Name y ?/a 6,) Hu,/ Addr /Pc - /rya/ — To Whom It May Concern, Please be advised that: Stacie Hartwig and Deborah Dokendor_f of Pasco Permit Service have my permission until further written notice to act as my agent to sign and pick up permits. Sincerely, Signature / 2- -lad? Date NOTARY STATE OF FLORIDA, COUNTY OF PASCO The ictregoing instrument was sworn to and subscribed before me this 1 3 day of Iti.Qfi , ZOO4 . Personally known_ /or Produced identification jo Commissioned Stamp Notary Signature /' j� /J and Expiration Date o .1� a taL' L 4,-)))0 • DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPEYRBILLS BUILDING DEPARTMENT I, 1 )//(/r9 , 97. A /7 LL have read and filly understand and agree to the provisions of this instrument. • The undersigned states and affirms that he or•she is desirous of constructing, renovating, adding to or reroofing his or her own domicile;, that he or she actually occupies, or will occupy by :said domicile, and same.is not for rent, lease or sale. That he or she shall comply with the following conditions.: • 1. That the owner and he or she alone shall act as the builder for all phases of.. construction. 2. That. the owner will comply with all provisions of the City of Zephyrhills ordinances and codes pertinent to building. . 3.. That in the event various phases of construction are subcontracted, he will engage only properly licensed subcontractors and will personally supervise such work.. 4. That in the event the Building Inspector shall require corrections to be made, the owner will assume full responsibility to insure they are made, and upon completion' will call for a reinspection before proceeding with the building. .5• That the owner shall assume full responsibility for the construction and will not expect supervision of his work from the City of Zephyrhills Building Department. 6. That prior. to final inspection any additional fees, including reinspection fees, must be paid in full. A written request from this office shall .constitute an official notice-to pay additional fees. 7. That the owner shall comply with all City, State. and Federal laws• in regard to social security, workman's compensation, lien laws, eta., where applicable. 8. That the owner shall comply with all the safety codes issued by the Florida Industrial Commission. 9. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor with certain restrictions even though you do not have a license. You must provide direct onsite supervision of the construction yourself. You may build or'improve a one- family or two - family . residence or a farm outbuilding. You may also build or improve a commercial building provided your costs do not exceed $25,000. The building or residence must be for your own use or occupancy. It may not be built or :substantially improved for sale: or lease. If you sell;or'lease a building you have built or substantially improved yourself. within. 1 year after the construction is complete, the law will presume that you built or substantially improved if for sale or lease, which is a. violation of this exemption. You may not hire an unlicensed parson to act as your contractor or to supervise people working on your building. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not . licensed to perform the work being done. Any person working on your building who is not licensed must work under your direct supervision and must be employed by you, which mesas that you must deduct F.I.C.A. and withholding tax' and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building , codes, and zoning re ati o�ns. • OWNER'S SIGNATURE G�V�%G�L"Y/ r " DATE 0- / 7 0 ADDRESS % �/ &. i r - � Do PRONE t3 o . - G 4'7 - 114 / 4110I2 •oa 4 /.1.3 -° . • WITNESS PERMIT # • • • • . 36 . CYO u s . 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" MOIL ABOUT G RCA PROGRAMS , . 4 COI1TLCS aCA il i BCIS Home ' Log In User Registration Hot Topics Submit Surcharge I Stets & Facts Publications L FBC Staff 1 BCIS Site Map i Links Search t T 4 O I ,r ` Product Approval r, r� . --/ USER: Public User Community Affairs Product Approval Menu > Product or Aoolication Search > Application List > Application Detail o comuuNrrr rouvoim FL # FL163 -R2 II MOUSING aCOMMUNI1Y Application Type Revision oELEUIPIEENT Code Version 2007 k� Application Status Approved 6 omiceir TNE Comments • ' ` "'-' ' Archived Product Manufacturer Custom Window Systems, Inc. Address /Phone /Email 1900 SW 44th Avenue Ocala, FL 34474 (352) 368-6922 Ext 207 mlafevre @cws.cc Authorized Signature Michael LaFevre mlafevre @cws.cc - Technical Representative Michael LaFevre ## Address /Phone /Email 1900 SW 44th Avenue Ocala, FL 34474 (352) 368-6922 Ext 207 MLaFevre@cws.cc Quality Assurance Representative Ralph Emminger ## Address /Phone /Email 1900 SW 44th Avenue Custom Window Systems, Inc. Ocala, FL 34474 (352) 368-6922 Ext 208 Ralph @cws.cc Category Windows Subcategory Single Hung Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report - Hardcopy Received Florida Engineer or Architect Name who developed Roberto Lomas the Evaluation Report Florida License PE -62514 Quality Assurance Entity Keystone Certifications, Inc. Quality Assurance Contract Expiration Date 12/31/2010 Validated By Steven M. Urich, PE Validation Checklist - Hardcopy Received Certificate of Independence FL163 R2 COI 510510A (Eng Eval Rep SH- 35001.odf Referenced Standard and Year (of Standard) Standard Year ANSI /AAMA /WDMA 101/I52 -97 1997 Equivalence of Product Standards Certified By Sections from the Code 1 of 2 3/4/2009 9:53 AM Florida Building Code Online http: / /floridabuilding .org/pr /pr_app_dtl.aspx ?param= wGEVXQwtD... Product Approval Method Method 1 Option D Date Submitted 11/10/2008 Date Validated 11/10/2008 Date Pending FBC Approval 11/14/2008 Date Approved 12/10/2008 Summary of Products FL # Model, Number or Name Description 163.1 3500 Single Hung 3500 Single Hung Limits of Use Installation Instructions Approved for use in HVHZ: No FL163 R2 II CWS -268A (5H- 3500).gdf Approved for use outside HVHZ: Yes Verified By: Roberto Lomas 62514 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: N/A Evaluation Reports Other: 3500 Single Hung Equal Lite H -050 55x91; 3500 FL163 R2 AE 510510A (Eng Eval Reg SH- 3500).edf Single Hung Oriel H -C45 55x91 Created by Independent Third Party: Yes Back Fie 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. 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I com uma.Awra1 nr FL # FL5262 -R1 t MOUSING SCobHRAilTrf Application Type Revision DEVELOPMENT Code Version 2007 rdeEROENGT Application Status Approved A OFFICE OFTME Comments "' ` ' '°" Archived Product Manufacturer Therma -Tru Corporation Address /Phone /Email 118 Industrial Drive Edgerton, OH 43517 (419) 298-1740 sjasperson @tttechnologies.us Authorized Signature Steve Jasperson sjasperson@tttechnologies.us Technical Representative Address /Phone /Email Quality Assurance Representative Address /Phone /Email Category Exterior Doors Subcategory Swinging Exterior Door Assemblies Compliance Method Certification Mark or Listing Certification Agency National Accreditation & Management Institute, Validated By Ryan J. King, P.E. Validation Checklist - Hardcopy Received Referenced Standard and Year (of Standard) Standard Year ASTM E330 2002 TAS 201, 202, 203 1994 Equivalence of Product Standards Certified By Product Approval Method Method 1 Option A Date Submitted 06/28/2008 Date Validated 10/24/2008 Date Pending FBC Approval 11/11/2008 Date Approved 12/10/2008 1 of 3 3/4/2009 10:12 AM _.■ si, ,,to,r, e cr ecnz = fiCi 'oN 3'd 1PIwV =3 'd ua Ni4l _ IA323 { I { s374 1;2 /1 3 ; s3 17Zad I SN41S pc•n,0l -----71-4-7 l8 31v0 `ON q I .N fS30 ` NCLNn373 ?N Ild.Al v? 2 0 3 • 1 1 , I1 • £IS8 ON uo•7oaoHim/ i0 .70.3 :1 uaulCu3 louopwlom to Woos opuou . I�.�en3ssV ao RNd 1 b7 2 d t { sas : ^ ¢ L v 6 own c¢z a � �/ ^ oC CO SSV 9a361j 1 o g g a ? + ' °w 'SINYYInsNO3 orlon a " "n !! Cal- 7Wa3H1 I 0 l Q - l _ W :ea po�odud •7ocmnoo ..L.�.__—.. ... :JJroaoad 1 1 . 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