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HomeMy WebLinkAbout10-11087 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 11087 'BUILDING :,PERMIT SINGLE?FAMILY RESIDENTIAL :I.L�,.€,:.; �..,. i z 's# , "�,�` - �;.£ E a „ - , ...a ....x,.: .� Permit # :11087 Issued: 10/26/2010 .Address: 3803 PRAIRE DUNE ST LOT. 20 Permit Type: ALUMINUM ZEPHYRHILLS, FL. Class of Work: ALUMINUM PACKAGE Township: Range: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Sq. Feet: Est. Value: Book: Page: Cost: 9,200.00 Total Fees: 127.50 Subdivision: MAJESTIC OAKS Amount Paid: 127.50 Date Paid: 10/26/201 . Parcel Number: 2 4- 26 -21- 0000 - 00100 -0090 Name: SUN S INC Name: NHC -FL115 LLC Addr: 6148 FT KING RD Address: 6991 E CAMELBACK RD STE B -310 ZEPHYRHILLS,FL. 33542 SCOTTSDALE AZ 852512 Phone: (813)788 -7308 Lic: Phone: (813)783 -3477 Work Desc: CARPORT, SHED & CONCRETE 14 X 39 f s , a s f }S�.sv§ F � .�: :°'�- '�'�"�}s ;m tia� wa�4' �'`� "`�"' �..�tm. :l • 1 1 7.50; 4( 2.61[\ SLAB SHEATHING RAISED SLAB DRIVEWAY FRAME I ELECTRICAL ROUGH 1ST ROUGH PLUMB 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." (Cc SIGNATURE PERMIT OFFI - PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER JJ ruprnia1 Page No. of Pages SUN STATE ALUMINUM,' INC. 6154 Fort King Rd. ZEPHYRHILLS, FL 33542 (813) 788 -7308 L SUBMITTED TO PHONE --P-1 7- . 77E1 ---- . ( \ - ^t -- % C.,_„\---. DATE STREET ( , �} \ 4 "` ( � (`� "a JOB NAME• \ CITY, STATE 9,KI ZIP C9 DE , , JOB LOCATION ARCHITECT \ �� `� C'1C' s---) l DATE OF PLANS 1 w JOB PHONE We hereby submit specifications and estimates for: i % -�' ` r f � { \ ` >`� - T "---", t C :3,_. - \ 4 X 1 _ rte .; 1 l { * ( P (} f ,., V •- 1 -r_ ` S" _l L-'\_ Ili Q Propose Vie., to furnish matariai.and IA r 1 complete in accordance with above specifications, for the sum of: '� - �' ---- --_ C� Payment �_' dollars ($ � L \ )• ayment to be made as follow All material is guaranteed to be as specified. Al work to be completed in a workmanlike ! __ manner according to standard practices. Any alteration or deviation from above specifications Authorized �,�� /���.�A"f - __ - 7---,_ - - - �. =1 involving extra costs will be executed only upon written orders, and will become an extra Signature / charge over and above the estimate. All agreements contingent upon strikes, accidents ` - or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Note: This proposal may be \\ Our workers are fully covered by Workman's Compensation Insurance. / \j withdrawn by us if not accepted within pp days. 'Acceptance of Proposal — The above prices, specifications _ \\ ' and conditions are satisfactory and are hereby accepted. You are authorized Signature 1 , ' �' _; --N � \ to do the work as specified. Payment will be made as outlined above. 1 r � / —'� Date of Acceptance: \A Signature j 813 -780 -0020 City of Lepnyrnllls rut lint frAppliucului i Building Department Z //1 V Date Received T1 /D o2 f - / c Phone Contact for Permitting 4F ` v 70 -- c /Jt IIIIIIIIIII,ItI , t Owner's Name /94.11le 10Crnle Owner Phone Number Owner's Address JIB pial( dr. Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address p�,� JOB ADDRESS 31c 3 P'i- t i. Dr' Z��L4 Jr/ £T+ / 5- LOT # 6 2 0 SUBDIVISION //l SjtJl _ Q PARCEL ID# o .z/— dada - 'died- ®d (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED pR NEW CONSTR ADD /ALT I I SIGN I I MOVE I I DEMOLISH INSTALL REPAIR PROPOSED USE 1 I SFR 1 I COMM I I OTHER I I TYPE OF CONSTRUCTION 1 I BLOCK I I FRAM ` E ,J.,-,'-� 1 1 STEEL I I OTHER I I DESCRIPTION OF WORK C4,t, #' tl Led 7 Co•caAut BUILDING SIZE L9 x39 SQ FOOTAGE Nit t HEIGHT BUILDING $ 9/ 247 00 VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY 1 1 W.R.E.C. 7 .€,—.1 kez - I I PLUMBING $ I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION GAS 1 1 ROOFING 1 1 SPECIALTY I I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES I INO BUILDER 4' �-C 14A40. k' . COMPANY f J 4 C die.h *► .. SIGNATURE /,- _ �� / IS REGISTERED I Y / N 1 FEE CURRENT 1 Y /N I Address (e sl y Fe k nt 6(J k 2' 4 l7 License # ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # PLUMBER COMPANY SIGNATURE REGISTERED l Y/ N I FEE CURRENT 1 Y/ N I Address License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 Address License # OTHER COMPANY SIGNATURE REGISTERED 1 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, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. * ** *PROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000) ** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways..needs ROW which NOTICE may be more restrictive DEED RESTRICTIONS: County regulations. The undersigned this ssumes responsibility for compliance restrictions" with any which my , 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 commis air conditioning, gas, orr installations not specifically b included en the application. electrical A plumbing, signs, wells, pool , set aside a ny p i s io ns of the construe technical codes, nor shall proceed the work and not as a permit prevent the Building Official from thereafter set asde any provisions unless t a correcti he work au th ho ri z ed errors by in plans, uch permit violations of within six a months of permit Pssuance,uordif shall become invalid work authorized by unless ttried by s the permit is suspended or , from the Building Official for a period not to exceed the ninety (90) days and will demonstrate m strate may be requested, in writing, justifiable r le cause for the e extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned. WARNING OWNER: YOUR FAILURE YOUR NOTICE OF COMMENCEMENT MAY RESULT IN YOU INTEND TO OBTAIN FINANCING, CONSULT PA TWICE E FOR IMPROVEMENTS WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117.03 , / CONTRACTOR , � (� ub c r bed and sworn to r affirmed efor ,one this OWNER d AGENT " d I "" ' p� Sub ri ed and sworn to (or afFirme�) befog me this r , y t � �j e 2 Y ,...;...e 1- is /are nwn t2 me or has /have produced Who is /are perso ^ "' k ^ ^� "m to m i has/ .v produced ersonally k P o as identification. as identification. `� �_ Lj��i2 Notary Public �� �` i Notary Public '' Commission No. y ppsLiC STATE OF FLORIDA ommission • • , - - STATE OF FLORIDA Suzannc �3a11T „ � Name of Notary typed precr. mpadsion #DD601110 Name of Notary typed Pfi sioi L`D6C i :. ?'; a iris: NOV. 15, 2010 � ''„,, „o• - • Expires: NOV. L, 201 �TIlL�T.0 BONDING CO., INC BONDED 'RI :i[ it YI1C BONDING Co., ;A THAT PART OF EAST 80.00 FT OF NW1 /4 & THAT PART OF WEST 1/2 OF y NE1 /4 OF SEC 24 LYING NORTH OF ZEPHYRHILLS BYPASS EAST AND n). h Sic,/ LYING WEST OF MAJESTIC OAKS COMMUNITY -PHASE ON,EAS PER. PE _ 35 p1: PGS 107 -112 EXC NORTH 20 FT THEREOF FOR RD RAN & MAJESTIC OAKS I COMMUNITY C . MUNITY PHASE ONE PB 35 PG 107 -112 LOT 1 THRU 16 INCL & LOTS 19 Pa d �� S3' THRU 24 & LOTS 26 THRU 31 & LOTS 33 THRU 74 OR 6825 PG 87 vir 1111101111111111111101131111111111111 NOTICE OF COMMENCEMENT 2010151867 Rcpt :1331969 Rec: 10.00 DS: 0.00 IT: 0.00 Permit No. 10/21/10 A. Giard, Dpty Clerk PAULA S.O'NEIL,Ph.D.PRSCO CLERK & COMPTROLLER Property Identification No. ,Z.y_ 6Q/00 10/21/10 :17a 0 1 OR BK 8 of 1 PG 957 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 (iesW des e) (.W- 42-0 /if ; edge Oak a) Street Address: J/* ibe//Kc. //ya 11; ,, fir ,. see c �� . , 2. General description of improvements: , f� 3,Owner Information CA L ���"` a) Name and address: peiet. Qtri vJ (S43 ' Or • b) Name and address of fee'simple titleholder (if other than owner) 4A f/ ` c) Interest in property «•''tractor Information a) Name and address: �lyt f ■-l�( & b) Telephone No,: ' Ze p/+ fi t/ , 5.Surety Information Fax No. (Opt.) 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.: 9. Expiration date of Notice of Commencement Fax No. (Opt.) specified): {the expiration date is one year from the date ;r' rdin unless a different date is WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER ATTER THE COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS E 713, PAR RT OF THE SECTION 713.13, TICE OF UNDER CHAPTER 713, P FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR i A. NOTICE OF COMMENCEMENT MUST BE RECORDED AND PQ INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE PROPERTY. COMMENCING WORK OR .RECORDING YOUR NOTICE OF COMMENCEMENT. POSTED ON THE JOB SITE BEFORE THE FIRST NR STATE OF FLORIDA e • COUNTY OF PASCO Sign o • 4. Owner's Authorized Of icer/Director/Pumer/Manager Print Name Th f' - going, insissunent was acknowledged - .434Ri Vd, as in fact) for i � / before me this day of �c:�eg 20/0 e' by (name of party on behalf ofwh me au ment y was' e.g. officer, ecu#ed) tntstee atto Y Personally instrument ex. Y Kn own OR Produced Identification Notary Signature *h. .1 T! s Type of Identification Produced DZ. Name (print) e A41 Verification pursuant to Section 92.525, Florida Sta the facts stated in it are true to 9 2 • Under penalties of �' knowledge and belief peritny, I declare that I have read the foregoing and that ORM ` r� .. ..1111t. Signature of Natu • on igning Above NOTARY PUBLIC -STATE OF FLORIDA Stacie Hartwig I Commission #DD926164 Exp1es: OCT. 16, 2013 BONDED THRU ATLAYTIC 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 WITNESS MY HAND AND Q FIC L SEAL THIS DAY OF �MPT R PAULA S �► NEIL, CLERK 8 BY ._� �. 'M LERK { A City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contra meowner: / Atel Date Received: /0 /0 Site: Permit Type: /� L9--"I ( , , Approved w /no comments: ❑ Approved w /the below comments: Denied w /the below comments: ❑ S(QUt T h i s comment e s ' .i be k - -t with the permit and/or plans. Kalvin Switz P .0 Examiner Date ontractor nd/or Homeowner (Required when comments are present) Plan Review Modular Home Set -ups and Aluminum Packages 1) All property markers shall be exposed and clearly marked at time of first inspection. 2) All set -backs shall be met. 3) All garages shall comply with section 309.2 ( Fire separation ). 4) Access shall be made available at time of inspection. 5)Manufacture specification manual, approved plans and permit shall be available at time of inspection. 6)No electric, plumbing, mechanical or framing is to be covered without inspection and approval first. 7)R.O.W. Use permit required for driveways on public streets. 8) At least 10' separation between other units. 9) All work shall comply with the 2007 F.B.0 and the 2008 N.E.C. R.O.W. - Right Of Way F.B.C. - Florida Building Code N.E.C. - National Electric Code I 1 1 1 , - � -,-- • _ I NE14, C ifjE j 1 l I : ,' ----1) . i I I 1 � fl � I - _ ma y �� ��, � °, : -', N 11 g, 1 m11 r--- „, ;... , , i ; kit., . ,s,.... , , ,f_. . , n1 ^ , j 1 11 1 1 4 02, co � 1 R a• • _i 1 • • Li I - • ■ y 3903 ,P2¢„rE W. L - - - - -- -..9 1 ” S,- � -+ - - - � � 1 NN\:<- Florida Building Code Online http:// floridabuilding. org/ pr/ pr_ app_dtl.aspx ?param= wGEVXQwtD... C omit Affair �� i --_ ` - BCiS Home I Log In I User Registration I Hot Topics I Submit Surcharge 1 Stets & facts 1 Publications 1 PBC Staff I BCS Ste Map I Links I Search I i;� i , , 44I Product Approval Cy j l USER: Public User �.. ( Community Affairs - Product Anoroval Menu > product or Application Search > Aoori atipn Ust > Application Detail 4c Jr,arluvr r r atinn FL # FL163 -R2 yk y , iN - S. O .1U Application Type Revision ' " x )PMe,, Code Version 2007 '' aret:cr Application Status Approved ara,cavEN PP n> ri nr Ttt Comments Oar< Tet Archived t' 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 V' 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 I'' Validation Checklist - Hardcopy Received Certificate of Independence FL163 R2 COI 510510A (Eno Eval Rep SH- 3500).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 E; mm "a v p♦ yr m,+. w *p C Y ' > m . a ro b �' 6 m2 z -! °P ?.% m r > o is > w- m za 'z ' � o � m v m> > Of 8 ' Op 1 0 . § g S> m -o r" Z w1 r z $G =§ a min z • -cm ;O ma S n z 9 b C 0 015 > Z3' ; tog C) v) 2 0 0 En 71 9 X 1gm m O > O' O 0 03. > =m __ - § 9 ' = N r m y m v 8 � r Z Y .--- I ` y °M0 am 3. ng O C m m C X z mO = 0 K am gra 1 - -a --1 z { 0 —F, On wM>m m w m m w p z m1 > y - .- -T - _ 7�� � crn <m *z m A m m -a> d cc nmp o m m ,853 ,1-1 z 5 020 mo Om > 71 ? 0 m o .z pO i -1 - =n O Z MI rn -1 Zm C x = 1 S X 0 L m m , r 1 ____m 0 0 $i I O c O m m1 0 z z C-n 0 C $ . c) 0o m cox 0 x 0 Mc m - ' Q F Q pm > a= m 0 0 L -4 r- ,go mr- a z 0 w > > m5 - 0 4 Z m 171 f n o 0 cr1 c O - ..- - - - -.- _ _. _ -. > m a m 1m m w m az -1 M m m zz 0 m m a z m > m m0 0 Z m , co _ 17 > O L7 * O w c-4 0 z z m0 w N -a- oo gox w 1= r- K m "— > m M m = - a N 2 m in mS O m m ^° 9 V, O X> m " -1 I PI K > 1 mm O m z = 0 � � a 0 al M d r- m ° <m w > m P r 1 x r. 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Search P e 1 ' Product Approval +++'7��iII� 0 p { f USER: Public User Community Affairs Product Approval Menu > Product or AonlicatIon Search > Anolication List > Application Detail s ctlmmutgrfKANMN, FL # FL161 - R3 Application Type Revision r44ousirGac°Pmu ITY. Code Version Dm Ni 2007 wen Application Status Approved marowaievr Comments * +CE OFTHE : Archived eEcREAARY 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 httn• / /fl nridahnil din a nra /nr /nr Ann dt1 acnx lxrC'. 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