Loading...
HomeMy WebLinkAbout09-9359 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9359 BUILDING PERMIT e tc „:.. := r 1 „ .. ,. .t x , ..,.. ` a it!! 1 . =:. ,' , .,;. J EE Permit Number: 9359 Address: 6049 18TH ST 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: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 02-26-21-0180-00000-0410 Improv.Cost: 6,350.00; €.,°, a ..` §,N` .,.E• i Date Issued: 7/20/2009 Name: REBENSKY, FRAN Total Fees: 125.00 Address: 6049 18TH ST Amount Paid: 125.00 ZEPHYRHILLS, FL. 33542 Date Paid: 7/20/2009 Phone: (813)782 -1003 Work Desc: CONSTRUCT 10 X 14 SUNROOM W/ ELECTRIC 3' - ` 5 �;' ��d N:e - i . 3° Pd Q om � . 1. . ' : 1�' ' I EOM... ° R.J.'S ALUMINUM BUILDING FEE 90.00 ELECTRICAL FEE 35.00 MARTIN ELECTRIC 0 V k ''' A q FOOTER 2ND ROUGH PLUMB MISC INS CEILING 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." c\c4c''.-v_zek4/ isee___ AI CONTRACTOR SIGNATURE PERMIT OFFI 'R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER U I U UU - U V . V . .� �/f ...� r B � iding - - Department q 3S r Building j Date Received D - 17 Phone Contact for Permitting 0 J3 77G - 531 Owner's Name Ft2/I_ e Pf 164a/k& Owner Phone Number 7 ht. —! 0 Owner's Address 4 dV9 1I '4( ,,,JfJJJ // Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address (/ /; /� ( // JOB ADDRESS CL D7 7 l a " fJ F LOT # 7 ! SUBDIVISION V Aria / PARCEL ID# OoL 0. -- o1 a /Gh - 0d (W 09 /d (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED FA NEW CONSTR I J ADD /ALT I 1 SIGN n MOVE I 1 DEMOLISH MI INSTALL I REPAIR // PROPOSED USE 1 I SFR I I COMM OTHER 1 Q 64—Au /f 0/Y) I TYPE OF CONSTRUCTION I I BLOCK ��, I FRAME 1 1 STEEL I I OTHER I I u DESCRIPTION OF WORK cr\ 1 T U BUILDING SIZE /I/ / X 7 / FOOT E `V' L i t HEIGHT BUILDING p VALUATION OF TOTAL CONSTRUCTION ELECTRICAL $ - U AMP SERVICE PROGRESS ENERGY n W.R.E.C. I I PLUMBING $ ,;w e4 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION "' I GAS 1 1 ROOFING I I SPECIALTY 1 1 OTHER / FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IVES I IAC IJ BUILDER T f �'� �" tnU� CI O Lt SIGNATURE �, elf - �✓ �"� COMPANY REGISTERED I Y / N I FEE CURRENT I Y / N I Address 3 75 a 7 4 A .' 1' u &Zense 6110 I/ ■ ELECTRICIAN PW �� % / ! `�� COMPANY 7L ')( SIGNATURE / ire%"" Jot.- REGISTERED I Y / N I FEE CURRENT I Y / N Address f G ( j' 7 l ' / 4 `r• 7 $'4 F/ ' License # PLUMBER COMPANY SIGNATURE REGISTERED I Y / N I FEE CURRENT I Y / N I Address License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address I 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 A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways..needs ROW which NOTICE may DEED RESTRICTIONS: be more restrictive than County regulations. The undersigned this ssumes responsibility for compliance t with any which my 9 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: construction o f new de sig d buildings, of that Transportation Impact Fees and Recourse Recovery Fees may apply 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. 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 ic any a cor rect of errors rors In plans, the technical codes, st uct shall issuance of a permit prevent of any codes. the Building Official from t issued shall become invalid requiring recton of r unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by m a pb thrmit eques is suspended owritf g, from the Building l Off Official for O a period not the time ninety days and will demonstrate may be rted, in ing, justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. MAY RESULT WARNING OWNER: YOUR FAILURE TO RECORD A YOU INT END TO OBTAIN FINANCING NG CONSULT PAY TWICE FOR IMPROVEMENT S TO YOUR PROPERTY. WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR \ NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 1 ,) t / / CONTRACTOR / ? .0 V OWNER OR AGENT to i. Subs ribed nd sworn t �(or affirmed be �, / Su sc ' ed and by sworn to ;r7affi� /G rmed) before m this / by pf o Whho o I - A re aerso nally known to me or h have produced VVhois /are personally known to me or has ave produced as identification. as identification. ,►� �'4y�� Notary Public = G` ' MA-14, (� Notary Public J NOTAFi`i I'fiLi(; - 61 AIE OF FLORIDA Commission No. ,r , "`, Commission No. L1P Hartwig ^TARP PURL ? -'' -ATE O:. s ai , +_i sign #DD652189 t t " �la�nt4. Name of Notary typed, printed or .f - d F, s' OCT. 16, 2 .59 CCommis Name of Notary typed, ►d . t'� , � In , , D BONDI.611 '<' I',tiND1NG C . , • ,;�.. ''Cplres: ' ,: ,5, 209 8.., , [ANTIC b...,........CI.IN5 CITY OF ZEPHYRHILLS 5335 — 8TH STREET (813)780 -0020 9359 BUILDING PERMIT h t*; s a .E n r,,,. .er � i t i .E,,,:':;,;',Iv---,,,,iii,,' ! x A 1 E t 40 '' ,p, '' , Permit Number: 9359 Address: 6049 18TH ST 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: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 02- 26 -21- 0180 - 00000 -0410 Improv. Cost: 6,350.00 - T° Date Issued: Name: REBENSKY, F R A N Total Fees: 125.00 Address: 6049 18TH ST Amount Paid: ZEPHYRHILLS, FL. 33542 Date Paid: Phone: (813)782 -1003 Work Desc: CONSTRUCT 10 X 14 SUNROOM W/ ELECTRIC -, yi, z::: - f" e. 9 ��' �'�' :., _ .. , N p �'. .s a . 4 — ' js e, , :,':I r -- y� : R.J. S ALUMINUM BUILDING FEE 90.00 ELECTRICAL FEE 35.00 MARTIN ELECTRIC t`JD • L 'L?€14"-( t ' : "y. •,ta . : : 0 - < '.say +..,+ 0 .�a .. ; ': ,. ' ;°°;: ' l i i, , ;: E 3 8 � : FOOTER 2ND ROUGH PLUMB MISC INSULATION CEILING 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. "Warning 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 CONTRACTOR SIGNATURE PERMIT OFFI FR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE NEW AEQUICAP INSURANCE COMPANY Renewal of Number 3000 WEST CYPRESS CREEK ROAD FORT LAUDERDALE, FL 33309 Carrier Code: 25477 FEIN: 59- 2581466 Policy No. WC07075488 RISK ID # NONE 1. The Insured/Mailing address: ® Individual 0 Partnership RONALD J. VICKERY 37912 7TH AVENUE ❑ Corporation or ZEPHYRHILLS, FL 33542 FEIN # 593008355 Insured's Identification No. Ao Other workplaces not shown above: 37912 7TH AVENUE ZEPHYRHILLS FL 2. Policy Period: The policy period is from 01/15(2009 to 01/15/2010 12:01 A.M. Standard Time, at the insured's mailing address. 3. Coverage: A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: FL B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: D. This policy includes these endorsements and schedules: SEE ATTACHED ENDORSEMENT WC 99 00 06 A 05 05 4. Premium: The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Code Premium Basis Rate Per Estimated Annual No. Total Estimated $100 of Premium Annual Remuneration Remuneration ` SEE ATTACHED ENDORSEMENT WC 99 00 06 A 05 05 Experience Rating Premium Expense Modification Discount Constant Factor 1.000 0.00000 % $ 200.00 Total Estimated Annual Premium $ 2,586.00 Deposit Premium $ ❑ This is a Three Year Fixed Rate Policy Minimum Premiui'n $ 237.00 Premium Adjustment Period: ® Annual; ❑ Semiannual; ❑ Quarterly; ❑ Monthly AGENT: CENNAIRUS, LLC i { ' 'f / SARASOTA, FL 34277 - Countersigned By — % P.O. BOX 25897 / / ` /Authorized Repree THIS INFORMATION PAGE WITH THE WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY t .:,. , :� " 4 "�" 1 ENDORSEMENTS IF ANY ISSUED TO FORM A PART THEREOF CO MPLETES THE ABOVE NUMBERED POLICY. • , a 7 _ t W C DD 00 01A ' r - s ' w . s .... :: .r- 4,. '�# se • v r'---- . '1 f t a * �. <a.o z .�. .", r 4 - c ` ' i ' '. JDL 6300 01 E d 5- 881 , " ' - ;5„ . .- ra'r ., ,-" ,.� , m0 n • r ;xw n ;, a .i� a3 «. ... x -� � Coopnght 1987 ational Counal an Comoensahon Insurance '' S 4 p e . ' r --�+ S ". ' v * ... , ."$' ` '` ,, t 4 . +'h kl la 'X?.10 `r�As�4, 8,2,, . 2 .t , ' t;`• , , 'Page of 1 '"� s._ ' . * i - iAt '•. .* , ei l= w . f. f T1'ri w -e- 1 _ 1-F 4 , w ' 1 . ,.. *, :. xG.,a s *-- - � ,. 4. .- � ,# 'w ... •�S fS ? " - y [ 1 _ vcB" g ' A °" may... . .� � �' �'�.� ".+.- DATE ISSUED CONTRACT NO. April 6, 2009 I 3305032008 PREVIOUS NO. TPATE005022 THIS DECLARATION PAGE IS ATTACHED TO AND FORMS PART OF CERTIFICATE /COVER NOTE PROVISIONS ITEM /� CERTIFICATE 1 POLICY NUMBER : TCNR011740 Name m e of Assured s ur e d R J ALUMINUM & MASONRY ::: t Ov E E[ S; :.''.;t; P ',x.'i 'i .MO RRI 37912 7TH AVENUE E UDA ZEPHYRHILLS, FL 33541 > .«I 11RAN . MBAN '1 :J .:" I j�<'# ? :.-:; ::::`. >...:; <: : : A .,_.. . !;3:::: REF A; T;<::> �:::::::::: >�<. >::::�:: > >::::: O8 . l r OPANY 1€ SOLV NT:::: > .> .. : SK UR .::: 1 ASSURANCE RI 4 0 5N REO E O ST #160 <'1R1 ....:..::.::. :.;;:.;::...:;;:.. •:.•::.::;.;; :.;:: >::.::.;:.:.;:.:;;:;:: »::; .;;;;;:.: TAMPA, MP A FL 33609 6 0 9 Effective ... e Fr ... m 1 .... 2 2 :01 ,...... m .... Both ........ Days .... at Standard ... d a r Y d ... Time � ... ...... .....::::: ::: :..::.::.;::.;:::. .... . ........ TO ...... - g, - 201 p;::>:;:::>:;:::::.::::.;>::;>::::;:::::::>:::::;;::;:;:;:-:.::-;>:.;> ::; >:: >:.:. >:.;:.:::: :�;:.;:.:: April 6, 2009 NAME OF INSURERS AMOUNT OR PERCENT Acting upon your instruction, 3 we have effected the insurance with: >1111‹ UNDERWRITERS AT LLOYD'S, LONDON 100% ' LIMIT COVERAGE RATE PREMIUM $300,000 COMMERCIAL GENERAL LIABILITY SEE CL150 $525.00 4 TOTAL BASE $525.00 SPECIAL CONDITIONS TERRORISM PREMIUM See SFE -01 (02/03) Schedule of Forms and Endorsements NO $65.00 SPECTI N 5 $65.00 TAX $31.25 FSLSO SERVICE FEE $.62 FHCF FEE $6.25 TOTAL $663.12 6 Countersigned: TAPCO UNDERWRITERS, INC. CLEARWATER, FL In witness whereof this covernote has been signed at BURLINGTON, NC this 6 day of April 2009 NANCY25 FL SURPLUS LINES AGENT 13577 FEATHERSOUND DRIVE TAPCO UNDERWRITERS, INC VIRGINIA C. PHILLIPS PO BOX 17069 LICENSE# A206695 CLEARWATER, FLORIDA 33762 • Original by c,_4 ne 44,-,,64 1111111 11111 11111 11111 11111 11111 1111111111 11111 11111 11111111 2009098333 Rcpt:1253744 Rec: 10.00 DS: 0.00 IT: 0.00 07/16/09 Dpty Clerk PRULR 5. O'NEIL, PR5CO CLERK R COMPTROLLER NOTICE OF COMMENCEMENT 07/16BK9 1 1 126 Permit No. Property Identification No. 0 a1 ---614 --al/ Glad— — cWQ THE UNDERSIGNED hereby give informs you that the improvement 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:) Ld f V/ At f /5U `[t.....6 J/_/ Or3 /1 /'I 7d DIZ 3‘ oho a) Street Address: (p of 9 /elk f/. 2e y -h/, I7, .33,170- P G JAL 2.General description of improvements: '.S t& /VOA — -e10dY cl GUM 1W/4 3.0wner Information a) Name and address: rh5Leear zw4 o dig /0 11-- f)< /'. H, 3 b) Name and address of fee simple titleholder (if other than owner) c) Interest in property , ntractor Information a) Name and address: 47 - 'JA .&. 3 7 9/ 7 4e Z i ,.LY / 4 H 31J- b) Telephone No.: Fax No. ( 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 NOT CE OF COMMENCEMENT. STATE OF FLORIDA COUNTY OF PASCO z Si a of a or Owner's Au horized • i cer/Dir tor/Partner/Manager l9/r�s - . - s'�y not Name / / The foregoing instrtjme was acknowledged before me this /� day of J ' (.N� 20 b F/itAta XJ 4iAhr as OcuAQ/ ✓ ✓✓ (/ 9 , Y in fact) for (type of authority, e.g. officer, trustee, attorney ( name of party on behalf of who instrument was executed). Personally Known OR Produced Identification / Notary Signa ) _5 /J Type of Identification Produced LL Name (print) V l / 0/' `( 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. FORMS /NOC;rvsd200r Signature of Natural Person Signing Above NOTARY PUBLIC • STATE OF FLORIDA ° � , j Stacie Hartwig liir Commission #DD652189 , Expires: OCT. 16, 2009 BONDED THRU ATLANTIC BONDING CO., INC. STATE OF FLORIDA, COUNTY OF PASCO THIS IS TO CERTIFY THAT THE FOREGOING IS A TRUE AND CORRECT COPY OF THE DOCUMENT ON FILE OR OF PUBLIC RECORD IN THIS OFFICE WIT E S MY HAND A • 0 FICIAL SEAL M_ DAY OF PAULA O'NEIL, CL` �� 'OLLER BY � � ' ' UTY CLERK -- i r . , , 90 '6 , 4. i 1 I c ) • N I 1 I 61 Ct.ST • cc ekEE 4/ Jr - k.6014 - Alaa TUN ROOM N r ':-'--- o , s -4- • s- \_.. '7. s 'S fN. C c, P7 /1 , 77/0.4)7: `'_, r ' ■.... es'is ''■ / d , 1 9S 1 1 ......._ ........__ i-.5 i zy a/ / P V (") c 4,.... " 1 1_ ItEVITNI4 DATE: ( Y:: ? c--) N o CITY OF ZEPHYR ILL ■::-. /11/ I I.., DI NG OFFICIAL ji6i,t( _ 11 ' 2-7 C.: DISCLOSURE STATEMENT FOR OWNER �� CITY OF ZEPHYRBILLS BUILDING DEPARTMENT / I, / 11 /�lG 241 - j,i have read and fully understand and agree to the provisions of thia _ 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 the 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, etc., where applicable. S. 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 person 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 means 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 - ...- tions. 4 OWNER'S SIt�i+iATIIRE t I DATE / , k 4 / ADDRESS le d¢' / "' PHONE t/J - 7115).- - /C� Q ' �� of-J wITNBSS XI5 PERMIT # City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: r Atturi,,, urn Date Received: g 7 7 0 9 Site: 00/9 / 6 (6 5 Permit Type: Approved w /no comments: Approved w /the below comments: ❑ Denied w /the below comments: ❑ This comment sheet shall be kept with the permit and/or plans. Bill urgess — uil ' g Official Date Contractor and/or Homeowner (Required when comments are present) .- W-0 00 WC. 0 O D o WKOm> Z j, -<m zc 0=1 3 - -< )zr m 033 01- r. ma;-1 m K _r W mm - 3 * D r m �� m M 0, n05 m 00 0 Nir mtn m 9)3:, D 3fn 00 -I �> Z O T.Wmm �� xxz m C v z n m 3 m 02 m= � m x 0 0) 25 ju y e• r I I • _ 4 it Or ..."‘"-- , �' � F Y Y i �I_ r-0 i I -_ _ -- �� 4 M - n —� I Z -- - - - -- , r 1 • D e• m • — v a .4 1 • . 4 xv 44 4a 0 m °x il x co 0 JD - <0 m On xn w Dm mm -1 DaIA z 1p °z ( 0 h i a m 41 r N ye . x L —� ig z m ti.' . {y,, z 1 oox 1—m- 14� �� o� � II -- . F O ZE g 2 / — W izz� C z ` j { ��ZD mnv�z �° I It z 0 - w r - K z $mm _ v , vD mEm�C ` O ny o m m I I O p) D �xCrK yFa rrn I a0 co cn co K_i nWK, �o °v —I j WO -( 00C 00 Z • m m m D x �m�r z - W C _ D o f d CO r i 7 x m � � nZ c iQ m ` :7 a mz W 2C) q O — " comam Ox _ ' m cnzz io , _.�_ 0 DO mm 70 / ��� I UN IAA -- m =D•zi -1, m. - m m >m cn / �.!.� I -r .a a , 2•r` 00* cnzz K a °i --_'� L ----co y 0 p O ucn � - .�_�rte: % / ? a te \\ 0 Z� x� ���z� < v `� �� • •/1/4 1 /11111 . 0 "\\ /III11�\ m m ,- no O H x x �mmm ij 3)m ' O - z cn m z K m x 031 m D o t � * cnmmz 0 31 � D a v D W m Z a t' OD v Z mm b j _ > DJ m a Iw m v, o D � . - - - -� m m CO c 3 �I a) D v z M JI D m c rm 1 c -I D •hem' W� y P m m O • 0 m O * W T cn p V u O v W W Florida Building Code Online Page 1 of .3 g}, Roma a"„"rA"r BCIS Home Log In Hot Topics Submit Surcharge Stats & Facts Publications FBC Staff B II' ai Product Approval USER: Public User COmmur ity Affairs vrn Approval Menu > Produce OF Appii nn S .r > Appiicatinn List > Application Detail = : >= FL # FL153 -R1 n a Application Type Revision Code Version 2004 su! L�ir� Lo es - Application Status Approved • FLORicfrcddBatiitZriEs'' Comments TRIJST 5 ' ■T cMVY PORCH Archived FLOR Product Manufacturer Custom Window Systems, Inc. Address /Phone /Email 1900 SW 44th Avenue Ocala, FL 34474 N ..t (352) 368 -6922 ext 206 i.:.. F EN TL �u Nancy @cws.cc :43061O11asecREYieav Authorized Signature Nancy Haldin •E- MAtt THE SECRETARY ' Nancy @cws.cc • msPECTOR GENERAL -_ Technical Representative Michael LaFevre Address /Phone /Email 981 NE 16th Street • ONTACT US Ocala, FL 34470 :9UR LOGO =-, Michael @cws.cc SERVICES Quality Assurance Representative Ralph Emminger Address /Phone /Email 981 NE 16th Street Custom Window Systems, Inc. Ocala, FL 34470 (352) 368 -6922 ralph @cws.cc Category Windows Subcategory Horizontal Slider Compliance Method Certification Mark or Listing htt : / /florida building.org /pr /pr_ app_ dtl. aspx? param�vGEVXQwtDgtH8572gvdWIQAbV ... 9/11/2006 ---- m 9 0 - - — - -- - - - - -- _ <m e Z }D r a" x N z m m9o*0 O� O �z mZ 0mt7m zy -D -, m mOm `"mom 8 g fim ilmm 00zc 2 mzm S F ymOrT. m mm C/3 m c > 1 cz�m -Cm Om =0 m O mz m m zi m oZ �m \, ------ I m m 04) LIP.'1 O - _ - 111 Z ,. ____L x `-" z _° ��. 0)-20,4t -1 p i* m _ my x m c 4- ern D mm 00 M 02 1.--G)C�Tr2pry��" y -�� A _imr -- ).yemm?DDcy 5 (A X M Z-M myZ�myDnmp7CZD�', mmZ y °1 1m°r tn .ZI 0M m- iynxc �t � �mrm Z1��ff OOOmxmOxy...�M O mZma m0.*0 xmOm O D'C--{{zMmm- - * OMZC C)y()m Zm m2CZ 1NC)y Z <p OOt Tm 21-173w 00 m S x m !!m00ym' Oy mOr mm °<1 `{ gym 0 O Om *OMM Zm g-- - A M cm*c° O Z m y 3 y Z M 0 E GI Dy C0D mDy m y m -i° 0 3 m Z C 03mZ00 . m xM m ( 11y OZ a m } mm� za - Ch Zm* ZOOMymz p r mZ Z�3 °m Z mo p „a. ez2SrD° %� SZy1-mv 01 m m m c c o r 1 000 r _ps ODmm20 cr > m mOx S g -+ 0 2 0 m �p1 zOgz z F > 1xymV - r c 1p0 m t = z m 0 C m s 1 * I - c 0 D D 1 $t 0 0 il0 mmm0 w00 0 1 r r - m Fy1mzU- -1 1 �. Oz > 8F y O x m n n °mm�g�m I � :A111111111111 $x w j m Di mamW=Eo m Denx = m n z (mo 1 cn �C�� D c 0 0 � �Z1C3r m9 0X � Zaiz z m m m xi *Z o `? , _ ,I_�,'I "' 2M0 ° 0) -i 3 .I 3 ymm5 2 m m X 9 rn m m ym - . m m- z m 0 -fl m > c n z i I m y p l ` p m x Z c mm g �_ 9 o =mgz m u x t 3 n , im O z z z Dy r y C = Oe� 0 y .. x m O / ,, ° m D .Z7 r � 0 • y m O CCDF y T 5 0 z 3 > 4 0 1 $ mPx G) g m xi m ,ill m w & o D * m * k _, .> m 0 r y Z G7 m m ,-,03,- ° O 0 A O rD f e n m All Z z M >*(,) > ( Z z Z D y z _ - _o �o D Z O x z x 1 m ° m 0 2 R < 2O� Pn M x m c� ;� r , ii 016 __ r -I OA 7 3 Z �' r ....71 '- Cn 1 E x z m 0 =M Dip a j m Ozx Em rn w m I I p - to -I 73 r ,I c- o -I O nzemia N y r W Mr m M m mD r Cm m r m m ma. 0 - ° � �+ �� � < t t y � CO _ D� zcim D z t Z m Oz -1 �o Z o e A m O Z 'n O z 1 ym�m cn N p g o Z z p m m y �' z n Z ><-- m m o Zm 0 mz • t p O N CO ~ W = Z W W z ° co LL m O a 0 Q W W HY WLOa v ) O o o ° q s V W Z = F ¢U S Z u w Z u) O Z U ¢ 0 c t 0 ~0 0 < _ 0 H 0 � O ff ' w O=w O W W ❑ ❑ m • H 0.e J O gUl- JWD Z V— Q J OU --I CO Oe X MO (n om ¢ 0¢z ¢ C Z llz v ° J LL ip m ea Q*5 a' r (A Z C- F ZW O 2 z w c� _ Q CI) Q WN O o. O O. 0 2 [OOzc > O Et W D 00 z L w a W >0" .< ¢(n ZF- OjUZWoOO --I _l ZZ � ¢ a w 2No UJ(n O (Q ¢ ZQ� u. =W zQ0 Q' O LL' a 'J (n ❑ w . o�a3 z � u �Qool -M � v ° Q _Jul_ ~ ¢ zz u)U?o2¢OOo¢ O0 OF wiaO� rt Z ¢ Z (nz Z } HNOwZW W J Ow° o 2 u _4~ F W��'oQQZ �- �j < C U` F- - _ LU 1 O ZI- ~ D¢W > ZOtn¢=W W U � J 2 '2 z� �a °wZ� ~�? ~�� o ° w� L Wo t ¢ - 2 " Z O Z¢ 0- 0 =0 - Wm- 1-'-' 1 WZ 1 W-U 5 w o /n (p� J=U¢O¢QW<rri ZUJWI - WZOQm o CO - u ¢ W ^ -m= zMg==;JU� o w u Z ec r- O H ~ Ez�0a�wt - WQWOC -M >O 9 oo D u; u zt)�I- cs".° c•I Uu.75_t:UaS(A�?a =CO?O w 0 r w o I e e o o e o o e o o e 0 o e 0 e o 0 o e 0 0 0 0 0 o e o 0 0 0000‘000,-,0000000t.-o0 w _ ooeeo 0 0 0 0 01 0 0 0 0 0 0 0 0 0 0 0 e e 0 0 0 0 0 0 Gn e e 0 0 oq o e In o q o VI t": 'A IV U „ 6 , �I V) V) V I VI h V) VI VI VI V) N VI VI V) N h VI N N V VI VI VI VI VI V) VI N N R VI VI et V) M VI M 01 VI ON VI 0 N Os V) K 0) 0) p.d Vl In N V1 VI In N VI Vi h V) N VI VI VI V) V1 V) V) N VI V) VI VI VI V) VI N VI N W) N N VI VI V) VI . 0 V) 7 Vi 7 7 7 et w + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + fn (7 z n J V) GO d m C • - N n o v h . h h 00 M N 7 •: CO . OD W) O O VI CO b CO O a ON 01 O O n 00 O n ao h 0 0 0 01 O N b V; 00 R V. O: W !`] el R fn °I b n N O O V; Vi O 00 N P] n O V) V O H 00 A l; VI ‘ e. n h b N 0 (n : O C b M as ON h `O V. O M M M T b N VI ti VO co R v ON v It-.. o r■ b N Y n 00 o. o en . M OI 0'-- e NO ON • N O` .n 0 m a2 ,,,� O1 OI h O. CO 00 00 h 01 Go h h h W h b b b 00 b VI b V7 h b h b N h V) V) b V) h N a V) 7 b v e v v z I I I I 1 I I I I • I I I I, I I I, ■ I I I i, I i I I I I I I I I, I I I I I, I 1 0 co z z v z r 0 12 V i M v v VI h M v v VI h M v v V) r M 7 v N h M e et V) r M T T 01 h M R S Vl I` M 7 v V) h M v< V) N Q e < °w co 0. O - L g E0 a Q y M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M ? v v v a v v v v O -+ <W J e. W '' e o 0 0 0 0 0 0 0 0 O O O o 0 0 0 0 e e 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Q .� ° 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o o e e o = 0 0 0 0 0 0 0 0 0 W p e 0 0 0 0 0 0 0 o e e o 0 o e e e e e o 0 o e 0 0 0 0 0 o ea e e 0 0 e o 0 o e e e e 0 W . e V bN Me110 b P I l e V membr me V N00 )00Nme I br t I -e I N N 0 Q e e e o 0 a e e e o o e e O O o e e e e e O 0 e e e e O e e o e e e e e e e O o e e e e e e . e 0 e e e e O e e e e e e e 0 O e e e e e o e e e e e e o o e e e e e e© 0 0 0 e o O e O 01010101© gvovoaoavoo ooev000ev000000.0000eooa00000 N 3 a v a v v X0 000 00 00 O O O O O b b b b b O O o 0 O N N N N N e v v v v G0 XI Xo 0 0e N N N N N N N N N N N N N N N M M M M M M M M M M v v v v v v v v v v v v v Q v v v v v v M VI N Vl Vl r r N IL - - - - 0 (y O L 0000000000000000000000000000000000000M0000.00 Z O O 4101R=.' O O O O O O O O O o 0 0 0 0 0 o e 0 0 0 0 0 0 0 0 o e 0 0 O1 O O O; O; v 0 0 0 O GD - V v) va v) ) V) VI V) V) In V) In V) Vi V) VI V V) VI in Vi Vi v) 1/1 v) V) V) V) v) in In v, Vi .o b VI N o v 00 Vi Vi No o 0 y 0.. V) VI VI In V) V) In V) N un V) .n V) V) in V) Vi V) VI In VI V) 11) V) to V) V) V) V) Vi In VI ton V) v In V! V) V) v VI V) v v v Q 0. + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + a re °vhg l;e eo lne)N v o Inh o�vnaOOOIb00 aoOMeo 00 e 00 x . 0� o y R 0 eQ r 4 0 e ei 0 O M M Q o In n i V1 0 0 In g v , l t o ry In <n a e e 4 e o n 0 0 P1 Z Z m O1 O .. M M v v 0 °I h0 .i 0 00 N T .hor 00 b N M 'O V) O h m N I` < M V) 00 b I0 O v 00 00 0 b b N y d . � � m N.I .ey O\ 00 h a 0101 ao b m h [� b GO b b b D• h b b V) T h VI Vl v O\ b VI V) v ao b a v v Q Q I I I I I I, I I I, I I I,, I I I 1, I, I I I I I I 1 � I „ I O V M M !T Vl GG M M Rf VI XX M M e In GX M M if In 0 M M !f V1 0 M M R Vl XX M M T V) GO M M V' Vl GO M M R In 0 u. q iii"' W d' Q e co vy m a 0 y N N N N N M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M v 7' C' 'e et e v v v x . .trri v W N W I- .8 s O n N O O O h N O O O r N O O O h N © O O h N © O O h N O © O n N O 0 O h N O O O N N O 0 F' a oenwoe ee. nleoo eenl?oo = oe�,0eo o oM�000 4/ b 00 O M 0O b 00 O 2 b b 00 O M IO IO 00 0 M b b 00 0 M b )O 00 a- ' 00 00 O 2 b `0 00 O- b b 00 O M b 3 r+ N M 1A b h N M V b h N M V b h N M V b h N M V b N M V b h N M V b h N M V b h N M V b i Vl Vl Vl VI V) O o e O O O O O o O O 0 O O O O O O O O O O O O O O O O e O O O O O V) VI V) In V) P4 N P4 N P4 O e O O O O O O O e O O o O O O o O O O O O O O O O O O O e O O O e V N N N V n H O O O O O V In V Vl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 d 01 T 09 0 a v 'IN Q R b 'O b 4N4: N N N N N ls h l [.- le) 0 C 0 0 0 R 7 V v •! 00 00 00 00 G0 M M M 'ion M I .+ n n n N N N N N N N tel M M M M M M M M M v v v v v v v C v v v 7 v v v I In N Vl Florida Building Code Online http:// floridabuilding. org/ pr/ pr_ app_dtl.aspx ?paramwGEVXQwtDq... Community Affairs rOCA HOME AD t7TDCA DCAPROOltePo] CONTACT ODA '''' °'` BCIS Home Log In User Registration Hot Topics Submit Surcharge Stets & Facts Publications FBC Staff ' BCIS Site Map Links Search jib /�► I' lI Product Approval (A] I `.. USER: Public User !Community Affairs Product Aoproval Menu > Product or Application Search > Application List > Application Detail °.. .ea 00AOALMR'rv - FL # FL161 -R3 ∎HOLISMCOMMU IIY Application Type Revision DatELOP MOO Code Version 2007 IiIMAGSEivr Application Status Validated qM�, Comments Reviewed 3/8/09 ' 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 Exterior Doors Subcategory Swinging Exterior Door Assemblies 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 FL161 R3 COI 511038 (Eval Rep Guardian Door).odf Referenced Standard and Year (of Standard) Standard Year ANSI /AAMA /WDMA 101/IS2 -97 1997 Equivalence of Product Standards Certified By Sections from the Code 1 of 2 3/9/2009 2:01 PM Florida Building Code Online http : / /floridabuilding.org/pr /pr_ app _dtl.aspx ?param= wGEVXQwtDq... Product Approval Method Method 1 Option D Date Submitted 03/04/2009 Date Validated 03/04/2009 Summary of Products FL # Model, Number or Name Description 161.1 Guardian Hinged Door Guardian Hinged Door w/ Glazed Insert (Operable or Fixed). Limits of Use Installation Instructions Approved for use in HVHZ: No FL161 R3 II CWS -176A (Guardian Doorl.odf Approved for use outside HVHZ: Yes Verified By: Roberto Lomas 62514 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: +40/ -40 Evaluation Reports Other: Not for use in HVHZ. Primarily used with Screen FL161 R3 AE 511038 (Eval Rep Guardian Door).odf Rooms. Created by Independent Third Party: Yes 161.2 Guardian Hinged Door Guardian Hinged Door w/ Solid Core. Limits of Use Installation Instructions Approved for use in HVHZ: No FL161 R3 II CWS -242 (Guardian Door no glass).pdf Approved for use outside HVHZ: Yes Verified By: Roberto Lomas 62514 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: +40/ -40 Evaluation Reports Other: Not for use in HVHZ. Primarily used with Screen FL161 R3 AE 511050 (Eval Rep Guardian Door no Rooms. glass).pdf Created by Independent Third Party: Yes !Back' INextl 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. Coovrioht and Disclaimer Product Approval Accepts: L.ry IECheckl ei9 Bobly1 3/9/2009 2:01 PM 2 of2 (0 k 0N \ / \ 0 03 > ) » £ a 2/ 7 \ \ 0 ; <0 } < §(§ \ o 0 2 \) - £ § G < : ) 0,,- u ( • < ���U ' . 2 j. z »' % 0' • - A/ / \/• / C4.<= _ § » 5 ` ' ■ 3 5. § § %, " ./2 » ) �� m nit ) % m u) / z } _ Ts 3 o ° j/» \ § / } § 2 0 § o \ 03 0 ) }£ CO \ \ \ } \ \ }) } 2 � . \ ~ z 1- ( G - ) 9® ( ( o / | !( / 0 m z e \ W =g I- ILI CI \ b & » &( e. , \ >- \ CC ) / ) �/ ! - (3 b ) • �) m - ; z \ / . / ( -� ( § \ W ) ) § /\ > — _ _ - -= _ . < < % % @ e cc 2G a / ) ) « 0 ' ® \ < o }j j\ \ ( \ x. -.- 7 _#� / __ § m z!■ <W Q 2 < \ 0 ' 3 - ) () z \ % § • ® E ( < z 0 _ CO 9 ) // 3 ( , § ] CL \ - \\ - \ ) =2 ± - Z. § § § Z < < )0 • § \ �3 Z § ) �; § e k - m o 2 e ) [ ( 3 @ ) 0 0 ( , 0 \ z < z w G - m- E e < 5 5 j ) = k ) ), 2 b ) 0 OH @n§ 5 § e 0 @ ). , § < 0)-z / z z <\ § § 5/; - 3 o o / \ & / 3 » ` § 3 p 0 0< o 5 « <0 (/ .„ 0) < �o = �( ( ) 2 < ) *° o0 H § r \ §= 0 `$ = z /§ = __ yR2m 0 <] $ - k Z wif I- 0 Z <)f} \ §/ < 0 00 cc • 0 m z ) § S ° < .. < ) ) ; /- j 0 \ I_ 0< »� 03 (2 § - %ƒ ( y ± ] § z ¥sd z; :w m ,w o ,= w o Oz § N- O 0 0 0 T " p 2 0 N (n W 2 LLI Z 0 c2.`-.' U O z Ow 2 2 m 6 w p ui II 1 1 o Q w Z 2 < w 0 Q w W ` O U n n n W J (n Z ui- w w ¢ w ¢ 2 2 W H = U N W O Q 0 w w u) N co 0 Q Z w 0 2 J W 0 oi W ❑ ut U m 0 S OZ 0 co W Q J m > 0 p Z U 2 ¢ o w Q O Q z p J P � T ❑ 0 co 2 0 O 4 V (n 2 ❑ 00 0 2 z (n 6 '� W O w J HV ooW o 3 z 0 p 0 M 2 = Z O W Z 0 4 � a H , Z a W > Z D 1- H m H . L l) H W O W 2 20 0 w 2, ¢ H w z } q 0 0 ¢ 2 0 o z v� w ° Z } O o o p () W J W o z w F J H W O W w Q a W Q W ¢ a W T;;r:51-i: ❑ 0 ¢ Z 2 N 2O m Q w H ¢ O F O ¢ >w w O O H3 4 2 2 Q a O U Z Q O z Hi U z z2 H� w ❑ O ¢ a i ao 0 Q ❑ 2E Z I- W H6 v_ i wp 0 co 0 0❑ J z ❑ N z ❑ W o w , L , (i z o Q , \ / W ❑ z ow 2 w H 2p ¢ O z F o � F \ \t * .t( // 2 w M Z o ff Z > ¢ 0 2 CC 3 z a z 3 r ? w • � \\ Q ' • • / J / �i • U z 2 w Z Z 2 J Uw 3 a z w w w w� �! (L I- 2 ma w W 2 w zp w¢ w¢ a og O.5 O -• V1- n H z 0>3 2Q m 0 0 O 3¢ (n w 7 O w o Ogg -J.Z c U) c .J= Z C7 O rs D P H 2 < Zw (7 y 0 3 m o ii ° a m o ¢ — .w ~ a'.6= CC Z O .Z` 2 w Q.o WW H w ❑ 3 Q ° v z it ° v + 3a �•, o F - , ❑ 0 a 2 a 2 ¢ ¢ Z zW j Z +1 y z +� w woa j • i � � 2 00 wO W § 0- 7 ,2 0 N =O w O >Qi � � � /2i. � c,i \ o J o W W O w01- W 0 a%❑ o ❑ =LLB /� / /l lt l pR 0 Z❑ C.) U- 0 2 Z o W HzW 1- w 3 (0 z0 w 0Z z t 4 - . 0 = of z ❑ (n W � F- m O (� m Q H �-- 0 ui r r a (n F Z H cc2 0(0 /)2 2 W Q H Z z a ° o ("O W z W O 0 H Z ( Q 0 U) 5 E 0 O O W (n w lo c°(0 z ow ❑o - HH O w, M2 d -A w w 2 w H 3w O < 4 q - ❑ a ❑- v� o o' o xo I Z (n O w 01❑ 2J_( M 2 w 2 H m J oN� Q O °¢°- H~ ? wz 0 0 W H con ' ' a o �y CI. 2 Z Z Y w W O 2 3 ¢ z U C7 = 2 W 2 0 �� N O a �¢z Dc H ❑ U H Oa a'goco z wo - Z U O O 0 w¢ w WW w > w w UW , _ _6 ¢��w O z a Q Z 0, 2w❑ 0 p w U Z2 ai rica z 0 3� 20 a F? 2 a a ¢ to 7-111111," o?zy D ¢ z - Z W 0 O q H O ¢ 2 W O a <o az LL 2 2 Co 2J w w oz ON ¢F- _ N Z w- U O (n w o U H J W ❑ J J❑ Y N U o g 2O J O Q Z W Z O J 2 . d �z J I- O U H Q ❑ Q w Z Q o r2 0 Q .= W cJ ri a 2 v i Q ro r� ❑ co of z z a o 6 W ¢N J a ZZU 64u O OHO U Wy U w w w �3w Co (7 Co (� N �o Q - -� Z NI Z NI O z z __- W Z CL r = _ = 1 r 2 r - 2 z _` / p Z 0 9 z ` 1 H o f w O d U > > a 0 J 0 cc L1J 1 4 CE i O 1-NM V .r 0 _ r 2 W w Zo m ki 00 U H FFF- -- O ❑ U w Z !Z w ZH H 2= ( 2 Z W 4 0 0 n J m O ,,.�.J J H ■ - .I 651001 0F 3 'eZ o4 JO(n❑ >O o• >w �QpZ0m-J 2 W S N H 2 4 '0;0= ZUQUI -y W Z J W X Z 0<000- ~ I- CZ Z (f) 0 0 • W S Z W W U o 0 O e, U O �_ U z • u V W o S w W F- Y W In Q. F.:-. v .- 4 Z 1- U F- a' Q V S (n CO ° Z ea w O Oct Z LL � ° J ~O° w w CO Q ° .-. = o o m CO b °wg w° ��~ � z W W ok m t°2°5 t ° ate � �C�� < o °z a v c W=" � ww_, w ozv) < mO Q 0 N - o cn U cn 0 • m oz ' Cc, � < (r) 0 U1-H z Z w Zr- LLI >ok > � ° - - Z U O r Cn afn Z F , O J w Zln QfAQ �.1 7 O c Z = 3 �' m �I -4J Z � ° >- LL ¢ ��u Z w \ [--' C c � n y m w J Q QHLLSW -Q \\ O �L I- U)O 0?¢c�¢ } a O � w� a o U Q O ��Z LL �VjO F- QF- W�H( W z J QZZ ~ c O w ° a p -� IQW f- I - QQ'�Q ~ ¢ ol= o o W > > z ° cn :: w U c'n, ¢ o ~ 1-- ° 00SO .1- ov1 °wa L 0 0 Wo_ a > Z cn¢ =¢ M 1-'-. �-- 0 ❑� g cam � �w0 -l Z =g ==cam -J 0 E"' W Z Z W ,-1 Z o 1-..., Z�Qd�WF- WaW -Sp o o CA� w j O¢ ^w Q' oa' D F-� Ii�tL N °o z g O z0,- Uu �Ua��,�?wS�o?o N U - w o LL e e o 0 0 0 o e o 0 o e o o e o 0 o e o 0 o e o 0 2 0 0 0 0 0 o a O e e oo e o e ao o o W e2oO4. eo428.Oe02 200002844.4 goeoa 4.e v,s4:24n V 1 L N N N 2 2:22222,22:22:2:22. h Vii N Vii Vii Vii V�'1 22,222 .1 '222:2222; e l Vh 7 Vii R e 7 R� A.+ + + + + + + . 17 z ti VI y b e N b ° 2 7 R a 2 N 2 00 PI 7, .7 . r N O O? 2 O a N 4 V 4 a y 2 o 4 00 5[ h G q r1 2 I b O m Q A O b M T Q\ t 0 R O M M M T 0 N h b 00 7 e QI a N OI IV I e N 00 7 O M ti or., 00��JJ - T o\ at) t` a, 00 00 00 L- Of 00 C- N N 00 t- 0 0 00 ea 0 .n 0 N n b N V h N In 47 MA V) n I M n < in R 0 O v tt 7 z Q , I I I I I I I I I I ■ I f I ■ 1 1 1 ■ ■ I I I I I I I I I I I I I I I I • I 1 1 I I 1 1 0 . 0 w I- v w 0 0I V M e V v1 I M e e M N M e V .n r M 7 e In [■ M e e In to M e e h N M e e V) N M e e VI n M e e V t - z co .it ` 4 LL Co w 0 1- - 0' Z ; .c.4- w K .1 V 9 m m M m m M m M M m m m M l) M m M m m M m m tom) M m m en m m m m m m In tom) 7 7 7 7 7 e e e e e d ex z H 03 0 3 ¢ a 0 0 0 4. o o4. 0 0 0 2 2 o4. O 2 4 4. e 0 o e e o e o 0 0 2 2 o 4. o 4. o 0 o 0 0 2 0 4. e 4. e a 4. e e ............ 204.2 4 4.4 8 W '� .. e o 0 0 0 0 0 0 o e e o e o 0 0 0 o e 2 o e o 0 0 0 0 0 o e o 0 0 4. o O 4 8 o e e 2 e e 4 2 b o0 N O N IC 00 N O N 10 00 N O N 'D o N O N \0 00 N O N \0 00 N O N '0 W N o N IC 00 N O N V1 00 N O N CO M c N b I` M e Vl `O c- M e )n b n M e V) 0 n M e V1 b N M e N b !` M e h b n M e V) b l M e V) o )` 0 CC a $ e ° o ° o o ° o 00 0 0 0 0 0 o O o ° o o o °o e o ° o ° o ° o ° o ° o o o = o ° o ° o ° o ° o ee oe ° °° ° o o ° 0 0 0 0 o ee e ° ° ° o e e o e e e o e 2 0 2 2 0 0 4 2 2 e e 4 e e o e 0 0 0 e o O 0 O o 0 o O 0 2 O o 0 2 2 0 N 3 et ~ e e e e e 00 00 00 00 00 O O O 0 0 '0 10 'O '0 .p 0 0 0 0 0 N N N N N e e• e ? 00 0o 0 0 od 00 N N N N N N N N N N N N N N N M M M M M M M M M M e e e e e e e e e e e e e e e e e e e e h Vl n 1n h N W 0 O O O o 0 0 0 2 e 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 Z 2 0 o e e 9 1 9 1 9 : e O e e 2 e o 0 4 4 e O e 4 0 o e O o e o 0 4 e e e 9 R e 019 M 0 0 0 0 .o O O F • 0, a VI V') V7 h V) . n In in In V7 w )n i n 07 i I n V7 h In V) V) V) In V) to V) V) in V) V7 in V) V7 V) b V7 )n O 4.F o 1 4)) b b N a °' P' ++++++ + + +++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +e ++ co rt O a o r F m p. _ 1 ; 0 O O V) O N, © .� s g e O. o n 00 O in h o co O) 0 Oi a e Z e (7.1.;.' I X .n o) O o t7 min e e e en V v) O 0 0 0 77 .i a O O 0, b 0 0 0 '19979. 0 M O co O 0 O 00 0 0 0 Z . y m, 0 M N 7 00 F1 00 00 N o.. 00 b N M O n N O N Vl t'1 s o O o ¢ a , I 00 r 1 00 oo r- .- O, 00 o4. y0 ° 00 - . b ° ao b b b 00� V b h 00 N N h e O b v 4. 1) Q C O D b v Q a 2 re e i u. 0 M M e VI 00 M M 7 In o M M e un o M M 7 Vi o M M e Vi o M M 7 V) 0o M M e ,n o M M 7 In oo M M 7 )n 00 uJ C < o IX • i g eV N N N N R1 , M M M M en M M M M M M M M M M M MI P) PI PI M M M M a y M M M M e e e e e e e e e e 0 w • w • 9 F '8 y O r N 0 0 0 N N O 0 0 r N 0 0 0- N 0 0 0- N 0 0 0 N N 0 0 0 N N 0 0 0 N N 0 0 0 n N 0 0 e o,M1oeo RnARR'Rn R'RC:nAee een)oe0'RnAC:c!RMweOt'Rel ;eo4.enloee 3^ r4 0 00 0 M b 0 00 O P1 IG (0 00 0 N) )0 '0 00 4 M '0 b 00 O M 0 0 00 0 N) \0 ) C 00 O M 0 0 00 0 P b b 00 O M '0 N M In 'o N N M M (O p- N M In 'o N N M VI 'o 1- N M In 0 l� N M In O N N M Vl '0 n N M VI (o l- N M M 1 O l� 1 V7 h M M M O o 0 2 0 2 0 0 0 0 0 0 0 0 8 2 0 2 4. 0 0 2 0 0 0 0 0 0 0 e 0 0 4. O 0 In M 'OO . N.. N O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O 4 O N N N 4. t -. 0 0202 In v nln 22444 4 4244 4 22 00 0 0 2 42222.. ., 3, t 01 t 7 R 7 R 7 'D g IO 4 A N N N N r n r r O O G O O 7 7 e e 7 a0 4.0 0o 4.o a0 M M M M "' ^ I" I� N N N N N N N N N N e M M M M M M rr 'r M 7 e 7 7 �! 7 7 7 7 7 7 7 7 7 7 In V7 V7 V i M N • r m0m g MS0 y 0 {mZO • m 5 Z O m m �Z -�.I m m �l�i1Z l m m a1 m N L 11 IS M iiiiiel i=;!! 0 Is 4 1 CO ',- __ _ CO // 1 x * I 0 o _ — �Z - I - o jj 0 c n 0 I� V X LL-- Z-1Xcn a m D 2 TN . , r m x a� 1 p ���Z(pa 00 -471mar2- 11�A�fJNa z a 00 CN _ ON �.z".D... - 5 ....v._ - �* _+mm >y,yO D Dr <miCA m x y m 0 _,00 m -4m m Omr--m y t C x 0 n 2 C(n)m c mQ 0 MM ,z z " -71.GM- . m=0 C 77-!710 00Z x -4^' >nmZ- C0000i)OrmTm m m� �mx rOmOx m mo0zacmi, .. MFZM .,m -1Zy s � 9 Az „” c m ? � m O 0 � m m m a� m =z J m mmZmO, m � Mmk m nopa2z ei z ? mz mf [n zm Gj ZO0 m mrZ DX 001- z mz=a• Oz mi- mn m ZDx D m x -n- 0 pox pm D -- - r (n r D Tfx * �O -4 Xzcro to y MODOmm0 �r - c) cr O m m m DTmo D mi xmr-c m nr E iO zp x z m � �� :../ 73 m Z cn � p3 v�8* � c m i� p m ° 0 ra- > F -4mZ : M p r m ■ L v OZT2 x m r - ( I • p - 11 0 m 2 - - 0 > x7 " �K T am° N >NZO = m zz y o °mNcS I�(��, cn . m gP m �myc, Z , m -n -� en z ,21, 1 1� - �•' = z f z n mz� m z m g � D to = � 1I . �. s m wm> p m m o , -0 1 m T mrn 0 CAA g 'mom ` m z > � m g o -i it °zl 210>t5 Z, m w r x �T 0 o 1.1,- 0 o zzn o m - n l -4 m - C7 0mZ 0 Z C p t � � D r m m x 0 Zp p D 1 I ,* ✓ A -4 -1 cn A -4 m 7 m l b m p ° x z x ! r x m 0>F 1 x x - z m m • o ! 0 g m -< p ZDD r u) 0 . O V. Z m `e y X • ?°. O m _i 0 * m 0 > m . - -o m -- — = - - 0 - (O C7 zz m m 0 m x p x t- Ci m O p 0 D 0 m ` a C z c m D (n (I1 > z 0 Z 2 - !- rn m o m p C Z xi r Z-1 2 x -f m o m I``�JJI 0 � °m D m 0 ° ° 0 o • g < Z 2 cn -n 1P m 1- C W , O > Z =Z ' = D ,1 x J>r —cn 0 D � i'� o D 73* m __ . % 1 tr S g * Z71 Z m 1 r z 0 1 _ , m O3 m w 1 \ �, � (1) 0 A Z o o o Z N 7 3 u v mC)m w �' Can O -I m > T x 1 a s ET 33 33 m r m � 5 m Zw D oD - to o o C]= K m t z zz m �no� O -1 z m OZ -I ° cz-n o c; Z0 m Ni O c Z Z 2 D � m m °° a 0 m z < 3 Nv H L x LTJ x t Zo u) LH o u) cn - 3'- 4 "- 3'- 4 "-- 3' -4'1--- - H' C11 U) C7 '-d H • L-' Z Z1-ri > tI 7d O > t i i Z - - -- Cr CI -� X W H W - i _H 0 I rn H O -Z 0 n -'� — WLTJ w LTJ '� -] H Z 0 _ y rn N _ z. - - -�� H H - Cli Z W -tl] 1 1 0 1 , LI ; 7' 3' 10' ' f- -7' I f o ° H H t x LII d ! �' i y y ,d n H J < 1 �" H ib Z H H Z rii O 1 C7 0 ----7 ' - 6 " Z Z 1 Ll x 0:i H rii 01 al t. U� 60 1 H ;� tr i. r Li cn a y o c - rr' 112 01! _ 0Zxx0- V)x D ( - (r)Z z D oo A m H°� " z � HOD Em-nD �Nd H d � £D p n n -, A CA - 9 G 1 X X<-473n) 'I I I ro1 - C S � � I-I -.4 '1 0-1 i�l fl re -41- � O � = CC' ) (- ) - 1 WV) A Z n n ( a � 70_ rp� �w H� �.. r Z Z m 3 r • 1 = 1 C 3Nr SAC XDD C pD , Cn • � Z 3 >-< Tl ( -, t y, t7 n mtiD z y �o�� = ° D D N - I • , MMZIn 1 N y Z l ,�1� ZS O (( 4 D � OZ n Z � Z) °. ° Z =m3 =m o r x ,� DD ' (n0 X � D - 9 C rMAjj ° dm � RD I �C� M c-) V) n • � PW � d 1 Za D + N13ir=*tN < m X I:3 dr f'lt) `c cn _4 C D �: to m ZZ =W(*1 v' m A y C N q tz XM OZ HX 1.4. --I N CM A r r r ., n o iZ7 D-- -Z 9 - AX rod r mm � z3ro.� Dr"Drl7 r ❑W Si $ � t7 CAm � ° °; °W "" . � rii(- °,, -IDwm 03 0Z(n Df -9m r* 70 M CI \r'l\) (.71"i- - ""' � Z = m C) n ° Cy C H C H p�c < � T °; m _,3,.. mx£ pro 3> U i..)-0 i'lH r ,..,7C/ _ _ _ • v7 W Z �)pv7 Z 11 Arc v' '1 r T �� _ nw opZa£ xi N O O D (i n ., C 1 ■ z X � r9-.Z.:,..,131 m ( (4 D 3 1 1 3> Nry 9 v) 3> \ 01 N 1 I IN _ AA � 3Np I 3> • -' D�Z ('1) C 1 y OH 3 D� < F I ^ -iv fnT1 .-Dp �(4 Q i Z � m S H 1 r� c-1 n --1 � - 9 o m � O S Zl Duerr -1 ro r1 �D N N c°ti 3 Z R m �� cy �� v).--, f'1Dr Or-1� �D�D la td m m i 0 r - - 0 (n V1 v) ri v) — � i -I V7 1'1 W T r ; s �o re m a { I 1 1 D u�y o h e (413 I -o Z •�9 m r . 1 - - D r- d �� n . CI G1A I 1 0 Z D T Zr ° o O 3' m 0 m 1 p .--i , m x I A 1 O f or4 aar cC "V V) '1 c'-1H Kr ' Q Z E r I H ( •AN D mEj A mi 7 I II Dozo D Ox "Vila' rl ti 1 r W A nX p s v A �(n ro om Z 3 .4 14 1 I .Z N C1 r(�iG n mr3 o Z r Y y m ( no c i y r Z t-,-; -i I Cl 1l x H -1 n m . D y 1 ii n c xi E lc ' . i , r � i r NOS 0" r -, r Z ;-, Iv y O ••••••• k .• r- m 7) - Z£ P -' vo z i �� Dfm''I 3 y tZ' � ` Amy �4� ;. Z m ❑.{ N E ��'''' '.:: p Rz 0 =Kr D 7 Wit•: v N LLL. ii(�rt X '0 I n ) \� HOST STRUCTURE Z rn c° w o v° No �'�; c r1�' z X 1.••••• z r'll W co∎ I 1 -1 pO n O `'� W fl o !Liu (7 m y r / O y A y a N -1 r-' riw -1 \ ' x p. O r O vni - .. -/' N x r r NN 1X O z - 'I + N W N ;X 7 (7 -I 1 > - j ] W 1 0 � N \ \ (wii( ti r' o o 3 l D a 2£D D �m =1 ' ffi Z 4 3 • 0 ^VAE fT1 d u y ` _ l p J 7,11'; T. r m aA 9 D� . rz 1 ."+ W f - C O D 7,4 €` �ri1'1 n r s H m D ■ �£ 1.--1 H "0 E s� ,, i _,,,_. v ti o r � _� ~ WD I w O E - ' 3 Z i mD N f £ '1 m n A p er = y � �� 1 - M A nN A V) Z� y �h ' c� i K 2 -1a - V) C r OX -I . x cl ( - ) ID nE D£Dr _ _- CW C)1 1-- v c ) _� c.. ,,, 0 m 3 X Z o y E d - 9 E Marl r1 � � m Z o D£ yz r D - 9 - m r m< 7 A O �+ ^ = = m D ap ms oa �� s Z7 -- DA N OD l 1 NC z''' N 0 , m ': i -� p '1 30 � V7�D Z Z C X3 W A m "AAZ3 PA -g.",., �� , ,( o ••,M" m3 N v r W nro H xm N A N -1, SA N -131 �Crmm N -nr V) 1--- f . > ' R � •'... -mss N = C7v Do m _{7) - 0 7)e D�NDA� xg �y , =z y . A 3 cln D w v °o z t i Xro m rt m7oc- 1cicA -1G1 --1002 E s c VII x rn r xi n r£ ° y - 9 °N8n 1n 9 Pro Nr5''x N OZ 3 \ -1 ADS M g .") W'AAO O N ( Z - I 3>r y 03 O < m , M COx„ V m" 3).3>73-13,--.0 1 - 1C3 I 11 P53 7 ; p . - W r0 A V) A + CV7Zm - 1 P T. � r1-I Dm{'m A m z3 M rDA z D A m DASD i on OAD e rr, =X 4'x cn w< A � Z M M r70 i ,Z) c. y a m -.mm L f O 3,0\ - 1 m AOA O C -, � � � 9' MAX D V) n _I m v, A d �i \ 3> r II (G R) 0* N CI mo R) A > z = n 7i3 X I N p t7 -UI ( m o m �, :rrvn - a t I 7_ O E s -1 - - DfU 30-3 1 zoo \ '' :' Ea r7 �Z -- I3 \ A V) Z y � g 'r' � r r Y �ro „,m n C V) V) ^ te a 1 GI mN C” r '° V OR5 , ' Pp.O -- I -I V) -- I V .__. t' � r1 - N q9 1 � x t1 1 Z £ H d e .'41g P E a � Z1 . E � -1D - 1 II . o 0 0. 03