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09-9491
CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9491 • BUILDING PERMIT Permit Number: 9491 Address: 37541 LANDIS AVE LO 77 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: GRAND HORIZONS Est. Value: Parcel Number: 34- 25 -21- 0090 - 00000 -0771 Improv. Cost: 27,800.00 � ,,, �= Date Issued: 9/02/2009 Name: BACHELLE, KERRY Total Fees: 255.00 Address: 573 E 83RD ST Amount Paid: %SO BROOKLYN NY 11236 -3114 Date Paid: Phone: (718)251 -3395 Work Desc: CARPORT 30 X 42/ SCRN RM 8 X12/ SHED 6 X 13 # , a. � ..;f a: -,,:70 mom: �; � _ t °1 < , : .4 s pa te , ,41;4 A E ALUMIN M : • • R ••N LL UIL•IN 255.00 p o e- i� A , 37 - i . /L9 a,j--._._- td �i � i Oe- f ,1-1, • • - 2 D - ••U H - LUMB MI C INSULA •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." , 7 .. lie.g._ , 4 4 l ', COI dTRACTOR SIGNATURE PERMIT OFFI r PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER • City of Zephyrhills BUILDING PLAN REVIEW COMMENTS C� ontractor omeowner: /9a, iZ t: /14 A)g r Ale Date Received: - 0 9 Site: tg 7p// Xvi7045 a)-(-- • Permit Type: „a 7 _ Approved w /no comments: ❑ Approved w /the below comments: ❑ Denied w /the below comments: ❑ 1) 11 orn r mG/ Its 6 fos of CP ono ir 1 o T %ns0PC 91/ se-t -dam cI .s -a me(-- This comment sheet shall be kept with the permit and/or plans. I ‘ Kalvin Switzer Plans Examiner Date ,C'ontract d/or Homeowner (Required when comments are present) 813- 780 -0020 City of Zephyrhills Permit Application ra b ls- ,ou -uuLI Aqq-9N1 Building Department Date Received 0 — 0'24-. 0 Phone Contact for Permitting 113 711 -- 531 V Owner's Name ke/YY 6a- ei5 eik Owner Phone Number Owner's Address 3 73 l C OJ O 1s ,✓ ° Ue Owner Phone Number Fee Simple Titleholder Name Owner Phone Number I Fee Simple Titleholder Address I JOB ADDRESS 1 3 734 LcuLti it ,44e n LOT # I 77 SUBDIVISION " "g el /14/Y PARCEL ID#1 3'_0U -- -dd9d -z - 0 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR I ADD /ALT n SIGN I 1 MO \'E I 1 DEMOLISH INSTALL REPAIR PROPOSED USE I I SFR I I COMM 1 I OTHER 1 TYPE OF CONSTRUCTION I I BLOCK I ( FRAME I I STEEL n OTI-ER I DESCRIPTION OF WORK Ca-oav f rte /' /) roam 7 14,604 /o- ` ell . t' A/3 7S BUILDING SIZE i / " 3 ' Y /OL SQ FOOTAGE /04 d- ` i t , HEIGHT I LP BUILDING $ 627 MO 0o VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE I I PROGRESS IENERGY n W.R.E.C. I I PLUMBING $ 1/ M16-6314 I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I I GAS 1 1 ROOFING l I SPECIALTY I I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 'YES rTNO W BUILDER 4(y ...44.01. CoAri- LLB RE GISTE RE D SIGNATURE �Cu COMPANY / I Y/ N I FEE CURRENT I Y/ N I I y 9 o Zb .401 1`71 Ad Z P1- 1 License# Address ��//�J// ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURF ENT I Y/ N I Address License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURF.ENT I Y/ N I Address 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 I • 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, Stormwatar 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, Stormwatsr Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements rust 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 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 1 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 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 TWICE PAYING FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117.03) �� C —Ljt eC !y �c if OWNER OR AGENT CI � � i Y� /5 CONTRACTOR sworn �,,t4_ Su a sworn to (or affirm re me this /51) scribed nd sworn to;(or affirmed) for� this l " /flL • dy by Sk4 (� 1 � � by k C!{ �ll fi� /(4).1 Who'fs /are personally known to me or has/riaie produced W i s /are personally known tome or has /have produced as identification. /Z /X% Notary Public , Notary Public Commission o. Commission o. Name of Notary typed; printed or stamped Name of Notary typed, printed or stamped NOTICE' OF COMMENCEMENT _ Permit No. 111111111111IIIII11111IIIII111111111111111111111111111111111 Tax Folio No. 2009122668 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. Lot 1.Description of property (legal description:) 34- off 6 - A I - 00Q0 - 00000 ? 1 , G rav,d 14e jr-or, 5 , PI'ta se Dry ,77 a) Street Address: 3794 1 G.Qnc) i.s Ave., Zepky rki 11 P. 33s5(l 2.General description of improvements: Car Fort ,Shea, ;SGrC'�` 1'"', Ccift cretr_ 3.Owner Information a) Name and address: {CPrr9 8ache Ile_ , .tee cbD b) Name and address of fee sinfple titleholder (if other than owner) c) Interest in property 4.Contractor Information a) Name and address: Are. A(u v. t navy. 4 (t on.str'vtcfior U.c. ,'f q z, A t,:port ' . , Zepkyrki lIs, Fl. 33512 ® ■ b) Telephone No.: /$I3) 7`32 - Ilo Fax No. (Opt.) 5. `I Information Rept :1261407 Rec : 10.00 a) Name and address: DS : 0.00 IT: 0.00 b) Amount of Bond: 09/01/09 Dpty Clerk c) Telephone No.: Fax No. (Opt.) PAULA S. O'NEIL, PASCO CLERK & COMPTROLLER 6.Lender 09/01/09 0 1 of a) Name and address: OR :BK 8 PG 1763 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 YO ' LENDER OR AN ATTORNEY BEFORE COMMENCEING WORK OR RECORDING YOUR NOTICE OF CO t ' CE 1 ■ . STATE OF FLORIDA COUNTY OF PINELLAS ) � /�� �/ ' � ,. 'jar Ina. - / / /�� • o • wner's Autho - a fficer/Director/Partner/Manager • t a The foregoing instrument was acknowledged before me this 3 /stday of 1 a.5 f , 20 PI', by KaY'ra( (30.c_hell e as h1 p is . /ot•w ner (type of authority, e.g. officer, tildtee, attorney in fact) for (name of party on behalf of wh`,r instrument was executed). Personally Known OR Produced Identification V . Notary Signature '_____ N OT nY JB' IF r: r t IllA Type of Identification Produced Dr, j e r s L e* '€. Name (print) S 1' De, ''at�r '- ,� DF' 0111U :. �. , r � CA L. Verification pursuant to. Section 92.525, Florida Statutes. Under penalties o e :. dtcl that I have read the f. going and that the facts stated in it are true to the best of my knowledge and beli - f. / _ / ir" - 7. -. re of 1 , Person Signing Above FORMS/NOC,rvsd2007 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 ESS MY HAND ' . OFFI IAL ALT S DAY OF __H b 1I 0 0 PAU 'RK COMPTROLLER B ah__ '' 0 ti •J . IP - UTY CLERK Sep 04 09 10:08a SUZANNE BAHR 8137885314 p.1 Citrus Homes of Florida, Inc. DATE OF B'RT 35162 SR 54 West DRIVER'S L;,ENSE BUYER: � Pi/ ZEPHYRHILLS, FLORIDA 33541 B:)YER :53 q92- fwd CO- BUYER: • (813) 788 -3300 Fax: (813) 788 - 3360 CD BUYER: BL rt:ri(SJ I // /Q�y /J�A�� /�Cj �/� r! (f / ��% (,�l� (/y� /� /• F.DORE.'a ,t c G II'!'� /! /�.�v�f� -/ � z /�sTV 6 ' SA A U V r Iklt� /b/ J DELIVERY ACDRESS `� 17 >* � , MAKE a MODEL ��� l ' A YEAR 9EL)Rr c3fS F OC.^, SIl . PII H Sup. i STOCK NUMBER t- %7 2 S*�t) €uSF 1 e,• r ot L (° , 4 1 w SERIAL NUMBER COLOR F•SOPCSFDa ' - AYCATE i KEV NUMBERS _ EW 0 USED _ LOCATION _ R -VALUE THICKNESS YPE OF INSULATION BASE PRICE OF UNIT ,�j/ p 'CJ CEILING • ��' r_.. ., OPTIONAL EQUIPMENT • • EXTERIOR Er r r — SUB -TOTAL $ FLOORS _ i % � r .► T IS INSULATION INFORMATION WAS FURNISHED BY THE MANUFACTURER AI•ID S DISCLOSED IN � COMPLIANCE WITH THE FEDERAL TRADE COMMISSION RULE 1 ECRF, SECTION 460.16. ;SALES TAX 61°124"). 8 CC- � IIIIIIIIW l 01 H11111A• P11 :10;14NN11/11100/.4►1a71411914 t:1•1•Ifl4111111.111111 ; �� c 9,„ : Fri • Delivered _.$__ ; NON- TAXA.BLE;TEMS Tied Dowr VA _ IOUS FEES AND INSURANCE Furnished �� ' Unfurnished _ $ 1. CASH PURCHASE PRICE Fric7v-a: oo Customer responsible for any wrecker fees incurred on lot. 1RCEINIOM&'E $ Wheels & axles deleted from sale price of home. Will tend _ fas at Oe CIV/WE $ for a local move. _ _ NET ALLOWANCE $ _ Customer responsible for releveling of home after initial _ CASH 00W?' PAYMENT $ LC l setup. Can not be responsible for settling of land. We will CSHASICREEDSIMPAlrt $ do again, bul there will be a charge. e de 2. LESS TOTAL CREDITS / — Options include extra: (List) SUB TOTAL $ / SPl /� _ SALES TAX (If Not Included Above) fr T . ' ! '— 3. Unpaid Balance of Cash Sale Price / *y ,Cr.. c!— REMARKS: 92 / '/ 0 >`r .�' / �_ � � NO V ; - A yi = ENTS WILL BE HONORED. I nit• - V .>l.IIt� 41 — ---- 7ga 16 . 116i " BALANCE CARRIED TO OPTIONAL EQUIPMENT $ NOTE: WARRANTY, EXCLUSIONS AND LIMITATIONS OF DAMAGES ON 11-IE REVERSE SIDE. . °m4/Pr/ay OF TRADE-,N YE AD SUE x A(il: NA S'0'RIAI- NO. COLCR AMOUNT OWrlrT ilCAt _ Liquidated Damages are agreed to be $ c r — — 10% of the cash price, whichever is greater. ANY DEBT BUYER OWES ON THE TRADE -IN IS TO BE PAID BY ❑ DEALER 0 BUYER REFER TO PARAGRAPH *6 ON THE REVERSE SIDE OF THIS CONTRACT. THIS AGRE MENTCONTAWS THE ENrrRE UA■iDERST AN &NG BETWEEN DE;LER 4NOBUVERATh) NO Or ER REPRESENTATKM OR INDUCEMENT, VERBAL OR WRITTEN, HAS BEEN RAGE N?40h iS NOT 3ONTANED P! T Hl3 CONTRACT. DealersdBuyermarti[ ythath Ie addtioaltormsandconditionsprintedontheotheraidaof this contra ctses agreedtoasapartof thisagreement, - - .•asil minted above the sign eau es. Buyer is purchasing the abo e • described haler. manufactured tame or vehicle; the optional equipment end accesaorios, ha insurance as described has been voluntary' tha: _ - rs trade-in • tree WWI all claims whatsoever, except as noted 4 I • A/ .a _ 4 • J • - • - • • .T , - .p.. a ► -r:6' 'IS THTH j . Wt. .1 REEMENT, • S,GNc �I / !/ r /� / / / �� Ri1YER Citrus Homes of Florida. Inc. DEALER / /a r3Z. / 6 O6 Not %nt �d (Moss 5 :good Am/ Accap'rd nY en Mau crags conso oy o sn AAf� +'Agent SO IAL SECURITY O. - �S STGNEDX 1 ^_ —_ __ BUYER I B I/ r /- y I Apvr� OC /AL SECUR17YN0. j - ORM 500.3 YJF1vMl Coi 0 1983. 1991 JENK INS BUSINESS FO S • NASCOU A -I. IL • Rev C1.t ) . , e//7L E ././_ (:)7 A'V' /(.10../ 7 Off 3 V - r -- 009d- CO9C0 9 0 , 00 1 ! F-Rwit2sEL, , rz, 1 SCR , /2.00/ I OIERF III N i /Y. 00 ' 13.00 i — - 1 g; \ - I • 1 ' ■ I --(:: 1 T EXIST, c>., Aid/52Z E 2 1 I , I . , i (----> 0 co _.._ _., _ ,,._ , ' -,-----, /S. 60 I ( A \ Pos ED I 30 00 1 ! I t p le_OP-.).5 1 i 37 - Y / t4/01 / 4 Z-7 , ALL WORK SHALL COMPLY WITH ALL PREVAILING CODES, FLORIDA BUILDING CODE, NATIONAL ELECTRIC CODE AND CITY OF ZEPHYRHILLS ORDINANCES Florida Building Code Online Page 1 of 2 , :',"i r , '-' * 1-041v7; ..,,,, ,! „1: . ! j .'- .-, --, , .. < '.. ; : Dr.A }ONE ASCOT bL7l =A PROGRAMS eormset OCCYI ttie _ . b BCIS Home Log In User Registration Hot Topics Submit Surcharge Stets & Facts Publications FBC Staff BCIS Site Map Links Search r ' li tProductAPProvaI ' ° � � ...„ Community Affairs f Product Approval Menu > Product or Application Search > Application List > Application Detail 7 F",?-, gr1 . t FL # FL161 -R3 ' Application Type Revision 3 ' Code Version 2007 7 '4 , 4 4 - Application Status Approved , 1,,....,,„„ , ., r_ Co mments 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 Roberto Lomas developed 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).pdf Referenced Standard and Year (of Standard) Standard Year ANSI /AAMA /WDMA 101/IS2 -97 1997 Equivalence of Product Standards http:// floridabuilding .org /pr /pr_app_dtl. aspx ?param= wGEVXQwtDgvyf4ngAXh 1045csM... 6/11/2009 Florida Building Code Online Page 2 of 2 Certified By Sections from the Code Product Approval Method Method 1 Option D Date Submitted 03/04/2009 Date Validated 05/05/2009 Date Pending FBC Approval 05/11/2009 Date Approved 06/09/2009 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-176B (Guardian Door).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 511038A (Eval Reo 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 -242A CGuardian 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 511050A (Eval Rep Guardian Door no Rooms. olass).pdf Created by Independent Third Party: Yes 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. Coovrioht and Disclaimer Product Approval Accepts: 8oby http: / /floridabuilding.org /pr /pr_ app_ dtl. aspx? param= wGEVXQwtDgvyf4ngAXh1045csM... 6/1 1 /2009 Z m01.0 w m m > cd=T11 TO m a O � � mO 20•77 DF: Yk ms G�S2m r o- -, 2M � 5 y 00 0N o - rn m s 1... 1i a m 6, • T O r • . D m I1 I 1 i -r 1.I 1 ( Z 1 Z ' 5. m • 6N, i�. D m — ti s log xg -; i rtoi *al "C p8 � y O y C 2 �$ ° f b n ' a a 3 v : g g)Z 9 0 x -N z zb ' e_ z of is Z i 33 O m m. 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C'om'munity Affairs roc* Now ABOUT DCA fl PRCeca es CO![TACT D "'"" 1 BCIS Home Log In User Registration Hot Topics Submit Surcharge Stets & Facts Publications FBC Staff BCIS Site Map 1 Links Search c , Product Approval Lal USER: Public User Community ) Affairs Product Aooroval Menu > Product or Application Search > Application List > Application Detail D COMMumlY p FL # FL163 -R2 tt113sr Application Type Revision DEEELOPrerr Code Version 2007 � Application Status Approved ►o OF TIC 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- 3500).odf Referenced Standard and Year (of Standard) Standard Yea 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 (SH- 3500).odf 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 Rep SH- 3500).odf Single Hung Oriel H -C45 55x91 Created by Independent Third Party: Yes Ieack Next DCA Administration Department of Community Affairs Florida Building Code On line Codes and Standards 2555 Shumard Oak Boulevard Tallahassee, Florida 32399 -2100 (850) 487 -1824, Fax (850) 414 -8436 © 2000 -2005 The State of Florida. 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