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HomeMy WebLinkAbout11-11365 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 11365 BUILDING PERMIT Permit Number: 11365 Address: 5236 BELTRAM DR 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: 12- 26 -21- 0030 - 00500 -0140 Improv. Cost: 13,213.00 Date Issued: 1/04/2011 Name: BARTON, GLADYS Total Fees: 157.50 Address: 5236 BELTRAM DR Amount Paid: 157.50 ZEPHYRHILLS, FL. 33542 Date Paid: 1/04/2011 Phone: (813)779 -4554 Work Desc: 8 WINDOW REPLACEMENT SIZE /SIZE 01 7 •. VT N1•VY : .•O" 7 . :1 . 1 57.51 7:2.1 ti Q/ •• _ .. -. - 17: . . IF • 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 tice of commencement" � _ i 44%4, - C• IT CTOR GNATURE PERMIT OFFI EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER < 3 �r' "�" z_ pio rli PI i 1.\ " City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor omeowner: j / A/',i , . ..i ■ - > Date Received: / a -,79 /U Site: � �.1 ( L5, Permit Type: /2) .5 ,z z_.-- Approved w /no comments: ❑ Approved w /the below comments: Denied w /the below comments: ❑ Cee .( This comment sheet s all 1 kept with the permit and/or plans. /2 Kaivi Switzer - ' Jr. Examiner Date Contractor . d/or Ho - owner (Required when comments are present) 01/04/2011 14:02 FAX 7275338835 DURAMADE 10001 ACORD. C ERTIFICATE OF LIABILITY INSURANCE _ °"�""'""°°"'""' 12J7/2010 PRODUCAt Phone: 727- 96] -6049 Fax: 727 - 442 -7695 Brown & Brown Insurance - Clearwater P.O. Box 2456 Suite 660 Clearwater FL 33757 -2456 INSURED THIS CERTIFICATE IS ISSUE) AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATI DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFF ORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVEF WE NAIL i INSURERA:$OUth Qwn ers 7:ns. Co. 10190 Duramade Windows & Doors Inc & dba Southern I�nergy Systems 5733 Myerlake Circle INSURERS FCCT j IsuranC ;I 10178 IN$URERC :Natiprla T ry ;.rlsuraup- a CO. 20141 Clearwater FL 33760 INSURER D: • INSURER E: _ COVERAGES — TEE POLICIES OF I.r9 URANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR `HE POLICY PERIOD INDICATED. NOTWITHSTANDING AdY REQUIREMENT, TERM OR CONDITION OP ANY CONTRACT OR OTHER DOCUMENT WIII RESPECT TO WHICH THIS CERTIFICATE MAY EC ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES OESCRIIn HEREIN I9 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN NAY HAVE BEEN REDUCED BY PAID CLAIMS. I — ,TR_.IY . rnJ? )FUISHRAN*.F roe= HUMP WP/P/amWossrvi — LAM A GENERAL LIAR 20715155 12/8/2010 12/8/2011 EJ%I'IOCCURRENCE 51.000.000 COMMERC IAL GENERAL LIABILITY PF eAMI E&E�oCC1IMICeJ $ 3Q0 I �Q -, CLAP 15 MADE ©OCCUR MI ) E'XP (Anyone person) $ 10.000 PE tEDNAL&ADV S 7 . 000. 00,0 + , • of 45194 AaoRSoATE 6 2, 0 0 0, 0 0 0 — GENLAGGREG4TE Lan APPLIES PER; PF mum - COMP/OPAGG 5 Q0 0 x Poucv I - 1 n Loc _ C AUTOMOBILE L ABILITY CA0017326 12/8/2010 12/8/2011 CC MINED SINGLE LIMIT ill ANY AUTO (Fr 409900 $1,000,000 AU- OWNS) AUTOS BC KY INJURY $ ■ SCHEDUU.0AUTOS (PI pew) ■ HIRED AU105 GC 7KYINJURV $ ■ NON-OWN :DAUTOS (PI a:cldest) ■ PR IP_RTYDAMAGE $ (1 wxAdent) GARAGE LABS TTY AU 0 ONLY- EA ACCIDENT S ■ ANY AUTO OT iERTHAN $ ,. AU 0 ONLY: AGG $ EXCESS/ MORI LLA UABEJTY EA H OCCURRENCE $ ■ OCCUR CLAIMS MADE AG :REGATE $ $ ■ DEDUCT'S .E _ _ s RETENTIOI J $ S B woRNERS COMPENS/,TIONAND 64934 12/8/2010 12/8/2011 X Arm' MRSI I oa EMPLOYERS' LJAEINJY, ANY PROPRIETORIPAF I'IERJEXECUTIYE E.L EACH ACCIDENT $ .500 . 000 OFFICERJMEMBEREX(LUDED7 EL DISEASE -EA EMPLOYEE S 500.000 nes. Mote MOM SPECIAL PROVISIONS below E.L DISEASE- POLICY LIMIT $ 500.000 OTHER — DESCRIPTION OF OPERATIO 4S/ LOCATIONS I VENICLE5l EXCLUSION:I ADDED BY EEDORSEMEITI SPECIAL PROVISIONS License Holders: John MacLeod CBC010111 (Duramade Windows & Doors, Inc Jeffrey Saitta CVC36780 (Duramade Windows & Doore Inc dba Fafco Solar of Tampa Ian Morrissey CVC55751 (Southern Energy Systems) CERTIFICATE NOLDI ER CANCELLATION _ SHOULD ANY OF 'CBE ABOVE DES RIESE) POLICIES 8E CANCELLED Lit of 2e h rhille BEFORE THE EXPIRATION :ATE ' HEREOF, THE ISSUING INSURER Y P Y WILL ENDEAVOR TO MAIL 30 DA 5 WRITTEN NOTICE TO THE 5335 Sth Street CERTIFICATE HOLDER swim TO Ti(E LEFT, BUT FAILURE TO DO SO Zephyr1.ills FL 33542 SHALL IMPOSE NO OBLIGATION .R LIABILITY OF ANY KIND UPON THE INSURER, xrs AGENTS OR EPRE$ENTATTVE$. AUTNORQED REPRESENTATIVE itg04 0 04444M." . • ACORD 25 (2001108) 03 ACORD CORPORATION 1988 I 01/04/2011 14:02 FAX 7275338835 DURAMADE 4t002 BUSINESS TAX RECEIPT • City of Largo • FILE # 2011004506 2010 — 2011 DE : DUPAMADE WINDOWS & DOORS INC Business Name +, Mailing .Address Physical Address, Owier, Phone DURAMADE WINDOWS & DOORS INC 5733 MYERLAKE ;TR • CLEARWATER, FL 33760 5733 MYE.RLAKE CIR JOHN C MACLEOD CLEARWATER, FL 33760 -2804 727 -239 - 0033 • Bus111eSS De Cr1? . .1QII # BUILDING CONTRACTOR • NAICS No. Amount Classifiestiion X542 150 $150.00 Nonresiden :ial Construction, Nec • PCCLB; REG 9/30/2011 STATE: CBC010111 8/31/2012 Certificate Number; 40629 Engaging in any business occupation is subject to zoning reStrictLofls. The collection of this Business Tax /Administrative Service Charge doe$ not authorize the holder to operate in violation of any City ordinance, law or Regulation. Each holcar is solely responsible for not1fyincr the Community Development Department, in waiting, cE any change in status, location or ownership. Renewal notices will be sentthe last known l anddo of record. I:;suance is in no way intended as an approval F competence o: skill. This Business. Tax Receipt expires 30 September 2011. Penalties are provided by F.5. n2 0 0 5 if not renewed before 1 October 2011. Additional penalites of up to $250 may apply if renewed by 3:. December 2011. THIS IS NOT A BILL NO REFDND ; POST IN A CONSPICUOUS PLACE CDPR3026.RP' 01/04/2011 14:03 FAX 7275338835 DURAMADE 1201M BUSINESS TAX RECEIPT City of Largo 2010 - 2011 FXLE # 2011005028 DBA: SOUTHERN ENERGY SYSTEMS Business Name & Mailing Address Physical. Address, Own■r, Phone SOUTHERN ENERGY SYSTEMS 5733 I4YERLANE C:R CLEARWATER, 3'"L 33 5733 MYEF LAKE CIR CLEARWATE R, FL 33760 -2804 IAN L MORRISEY 727 - 239 - 0033 � usi D $ r4..pt on MEM SOLAR CONTRACTOR Classification NAICS No. Qty.. Amount Plumbing, Hf,ating, Air - conditioning Col 1711 100 $100.00 PCCLB: REG 9/30/2011 STATE: CVC56751 8/31/2012 Certificate Number: 40966 Engaging in any business occupation is subject to zoning restris:tioi:3. The collection of this Business Tax /Administrative Service Charge does not authorize :he holder to operate in violation of any City ordinance, law or regulation. Each holder is solely responsible for notifying the Community Development Department, in writing, of any change in status, location or ownership. Renewal notices will be sent to the last krDwn address and owner of record. Issuance is in no way intended as an approval or disapproval of the holders competence or :skill. This Business "ax Receipt expires 30 September 2011. Penalties are provided by F.S.2 if not renewed be:`ore 1 October 2011. Additional penal1tes of up to $250 may apply if no renewed by 31 December 2011. THIS IS NOT A BILL NO REFUNDS POST IN A CONSPICUOUS PLACE g-'/O-Aiy CDPR3026.RPT 813-780-0020 ' 13 780 0020 City of Zephyrhills Permit Application ), - ; • D Fax - 813 -780 -0021 Building Department � ►' � Date Received 02- 7- ` '0 Phone Contact for Permitting ;y` jri -- > okr 1 L i . Owner's Name (7LA 01 S C W-ICA Owner Phone Number Owner's Address J i ( -t_1Qs+ £ - Owner Phone Number [ Fee Simple Titleholder Name Owner Phone Number { Fee Simple Titleholder Address JOB ADDRESS 5g SC > M Lr O2- LOT # I 1 14 l ( SUBDIVISION C.-C- t't H ! S P ARCEL ID# � OQ O© S! LO a 1- (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT 15 I SIGN I I MOVE 1 1 DEMOLISH INSTALL REPAIR PROPOSED USE I I SFR I I COMM I I OTHER TYPE OF CONSTRUCTION I I BLOCK I I FRAME l 1 STEEL I I OTHER I DESCRIPTION OF WORK 03 N Dl \./.1_ $L- 5 BUILDING SIZE SQ FOOTAGE HEIGHT (I BUILDING $ ' g-A 3 VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY 1 1 W.R.E.C. I I PLUMBING $ g lif& I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION / , ‘ L a d e I I GAS 1 1 ROOFING 1 I SPECIALTY I I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [ IYES I INO ff BUILDER / /7 - � . t� I. COMPANY D £ v� IN '-� SIGNATURE L./. zz (��- / (1„, ' • REGISTERED I cry N I FEE CURRENT Address 3J PA i� x- et a- LL-.) fl T te -, License # L 3QQ I Y / N 1 7 C 0 iv 1 1) ELECTRICIAN COMPANY . SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # PLUMBER COMPANY SIGNATURE REGISTERED I Y / N I FEE CURRENT I Y/ N I Address License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # OTHER COMPANY SIGNATURE REGISTERED I Y/ N l 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. i-H-H IIIIIIIIIH IIIIIIIIIIIIH lilllllin it 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 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 Tots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNE o R, trucfionl s I in good inform at permit may be required conditions ed for electr electrical this affidavit prior to commencing plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. set aside an y p v i s io ns of the construe technical codes, nor shall issuance of a permit prevent the Building Official from thereafter set asde any provisions unl t h e cor wor k aut ho ri z ed error y in plans permit s commenced within six a months of permit issuance, uordif shall become invalid work authorized by unlss the k autried b s the permit is es in d or , from the Building Official for a period not the time ninety may (90) days and will demonstrate may be e requested, writing, the ing from cause for the e e extension. If work ceases for ninety (90) consecutive days, job is considered abandoned. WARNING TO OWNER: YOUR FAILURE YOUR NOTICE OF YOU COMMENCEMENT OBTAIN MAY PAYING TWICE FOR IMPROVEMENTS TO WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR N • I OF CO MENCEM NT. FLORIDA JURAT (F.S. 117.03) CONTRACTOR L. `is OWNER OR AGENT Subsscrribe and sworn to (or affirmed) before meth Subscribed and sworn to (or affirmed) before me this lA iQ MAC i-f-4) by Who is/are personally known to me or has /have produced Who is /are personally known to me or has /have produced as identification. as identification. -401W Notary Public Notary Public \ . - Commission No. • Commission No. typed, tinted or stamped Name . `_pMee SO MISSION # uD913786 • Name of Notary typ P EXPIRES August 25, 2013 (407) 398.0153 FkxidallotaryService.com ...« —••. 4 _ „ «, .. m Plan Review Windows & Doors 1) Need manufacturing installation specifications. 2) Must meet sections R308 and R612 of the 2007 F.B.C. 3) If windows are to be installed inside the historical district, they will need to be approved by the historical committee. 4) No other work shall be permitted (framing, plumbing, and mechanical) unless otherwise specified. 5) This is for replacement (glass for glass) only. If you wish to change from screen or vinyl windows to glass, then additional information is required. 6) All windows to wall connections shall be left visible for inspection. 7) All labeling and stickers shall remain on windows until final inspection. 8) No work shall start without permit first. 1111111 11111 MEIN 111111111111111 nil 11111 1111111111111 2010184547 NOTICE OF COMMENCEMENT Rept:1342916 Rec: 10.00 DS: 0.00 IT: 0.00 Permit No. 12/29/10 S. Shultz, Dpty Clerk Tax Folio No - y l Li() THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1.Description of property (legal description)- • ` V,. • . � +1 a) Street (job) Address: .S 13€1,1 in DE Zl`.Pvik1 aft - 33 2.General description of improvements: iNt.V QC4J5 3.Owner Information � a) Name and address: CiLA D�i S 'J fi QT(ka1 ' S 33' SECT AA" Q R L Otl CH Li.) fb 3313 b) Name and address of fee simple titleholder (if other than owner) /V 14 c) Interest in property ©j,>vn1Jt 4.Contractor Information a) Name and address:. QC (' ji. Qi-lw j .C M` e-i V `E CAL. CLEACI.11 ie1L c(, b) Telephone No.: } 00 33 Fax No. (Opt.) 5.Surety Information a) Name and address: Paula s.o'NEIL,Ph.D.PRSCO CLERK & COMPTROLLER b) Amount of Bond 1 2/29/ 10 09: 50am 1 of 1 c)TelephoneNo.: Fax No. OR BK 8495 PG 1247 S.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(1Xb), 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 IN IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA +E �CIVNSJ r I—% GOL) -t: 13' l COUNTY OF PINELLl1es 1 * MY COMMISSION # DD913786� • I • -.1 Signs a Owner o ner's tho Officer/Director/Farmer/Manager EXPIRES August 25, 2013 -7111D C)AC2-10 Print Name (� The foregoing instrument was acknowledged before me this I 0 day of DE ( E L , 2 0 1 0 , by (11A D (A (L--fp,.0 as Out) c/a_ (type of authority, e.g. officer, trustee, attorney in f a c t ) f o r S € . ( (name of p : • , • • h o m _ , s o ent was executed). Personally Known OR Produced Identification Notary Signature �� ! Type of Identification Produced FLDC Name (print) hOK/S Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and tha the facts stated in it are true to the best of my knowledge and belief. i!/w` FORMS/NOC.rvsd2007 XS ignature f Natural P n Si g (in line # 10.) Above STATE O FLORIDA, COUNTY OF PASCO THS IS TO CER HT F ORGONG IA TRUE AND CORREC COPY or THE DOCUMENT ON FILE OR OF C RECORD IN THIS OFFICE WITNESS MY HA!\ID AND OFFICIAL. SEAL THIS DAY OP 2 L2/ PAULA S.'o'NEIL, LER & COMPTROLLER _ 41 CLERK .� ' WORK ORDER r -- DURAMADE State Certified Specialty Contractor License # CBC010111 INCORPORATED /� p b Customer Name 1n >S / Or t)'" MHP/ Subdivision Job Address • ' ; �,�i�/f� City —* /X / /j( ( ( Zip <y) Phone (€ " 7 7 ' L i f 3y WORKSHEET SUBMITTED BY DATE: 7U Window Window Window WINDOW PLAN: #1 #s r11 Show window locations by CI ` ,� j number on inside of drawing. -3) J 3'g If additional areas are neces- sary, draw ENTIRE PLAN on /i ®11 seperate sheet and check below. < e — "yj < '7 > < > EJSEE DRAWING ON SEPERATE SHEET. 7/174 - ttl L Z:,,,sr ie 3 Window Window Window (03 BACK C�eSt'3, #2 #7 7 r12 r::_i ....■ n 9 15 3 y <)-J3-> < 3 9 > < > c,.,v,r €Z C� 6.0$1 3 Window Window Window #3 #8 #13 ,: < `= �� ' 7 )^ > 1 < ? 7 > < > I. J FRONT W-S/ CIRCLE RESPONSES Window Window Window Large Outside Trim Y N #4 #8 014 Siding on Home Y N l � Awnings covering screws Y N 1 SPECIAL INSTRUCTIONS: D 11 2 y irnvL A l na.v PCV < ,) < > < > CHECK NANCE 0 VISA ❑ MASTERCARD Window Window Window #s Ito its _� 1 t 1 TOTAL / �� S - DEPOSIT 0/ BALANCE /, /3 < 3 61y } > < > < \ DIRECTIONS TO HOME: 5 5?t7 Page 1 of 2 I �� Building Code Online � // /��A on l �Y1 V �/ • i tt 6i i" "'1f..III< itv Affairs ,, .. .t g i 1 BCIS Home Log In i User Registration Hot Topics I Submit Surcharge Stets & Facts Publications FBC Staff ! BCIS Site Map Links S. v' ' � t 1 / ,product Approva Crn _ „i , , USER: Public User oy i r tt i > A licatio Detail f3 Ali.,.. L i - ,; . -- Product Approval Menu > Product or Application Search. > • p. [cation Lis PP liElEREEEMMISEDUM 3 " FL # FL12646 • App l i cation Type New r,s 2007 .` -r ` Code Version f . Approved .,, Application Status 1 , 1 4E F 4. Comments ' ; Archived Product Manufacturer Gorell E• erprises Inc. ALL WORK SHALL COMPLY WITH ALL Address /Phone /Email 1380 , ayne Ave. PREVAILING CODES, FLORIDA BUILDING 1 , ana, PA 15701 ELECTRIC CODE AND rgibs 465-1839 CO, OF ZEPHYRHILLS ORDINANCES rgibson @gorell.com Authorized Signature Richard Gibson rgibson @gorell.com Technical Representative Address /Phone /Email REVIEW DATE 1 ' 0_'(0 Quality Assurance Representative CITY OF ZEPHYRHILL // ( Address /Phone /Email `FLANS EXAMINER Ili) Category Windows Subcategory Double Hung Compliance Method Certification Mark or Listing Certification Agency American Architectural Manufacturers Association Validated By American Architectural Manufacturers Association Referenced Standard and Year (of Standard) Standard Ye AAMA /WDMA /CSA 101/I.5.2/A440 201 Equivalence of Product Standards Certified By Product Approval Method Method 1 Option A Date Submitted 05/15/2009 Date Validated 06/17/2009 Date Pending FBC Approval 06/24/2009 Date Approved 08/11/2009 [Summary of Products http: / /www.floridabuilding. org /pr /pr_app_dtl.aspx ?param= wGEVXQwtDq... 1 1/23/2009 r,; - d4 Building Code Online Page 2 of 2 FL # Model, Number or Name Descri • tion . ; G53o5 � G5305 Double Hun• R50 44 x 63 _. Certification Agen Certificate Limits of Use FL12646 RO C CAC G5305 DP50 AAMA APC 44 x 63.. Approved for use HVHZ: Quality Assurance Contract Expiration Date Approved for use outside HVV HZ: Yes 05/04/2013 Impact Resistant: No Instal /20 on Instructions Design Pressure: +50/ FL12646 RO II •5305 fastener w wood sto•s 5- 11 -09. Other: Verified By: American Architectural Manufacturers I Association I Created by Independent Third Party: ,Evaluation Reports , Created b Inde•endentThird Party: 12646.2 G5305 G5305 Double Hung R35 52 x 72 ( Cert i f i cation Agency Certificate ( Limits of d Use d for use in HVHZ: No i FL12646 RO C CAC G5305 DP35 AAMA APC 52 x 72.. Approve Quality Assurance Contract Expiration Date Approved for use outside HVHZ: Yes � 05/04/2013 Impact Resistant: No Installati Instructions Design Pressure: +35/-35 FL12646 RO II P5305 fastener w wood sto.s 5-11-09. Other: Verified By: American Architectural Manufacturers ,Association I Created by Independent Third Party: Evaluation Reports I Created b Inde•endentThird Party: Back I Next DCA Ad atio Department of Community A ffairs Florida Building Code On Codes and Standards 2555 5humard Oak Boulevard Tallahassee, Florida 32399 -2100 (850) 487 -1824, Fax (850) 414 - 8436 © 2000 -2005 The State of Florida. All rights reserved. Coovu ht and Disclaimer Product Approval Accepts: XI 112 http://www.floridabuilding.org/pepr app_dtl. aspx ?param= wGEVXQwtDq... 11/23/7009 A,. L - i AAMA (Validator / Operations Administrator) CERTIFICATION PROGRAM lrYil AUTHORIZATION FOR PRODUCT CERTIFICATION Gorell Windows & Doors 1380 Wayne Ave. Indiana, PA 15701 Attn: Dan Davis The product described below is hereby approved for listing in the next issue of the AAMA Certified Products Directory. The approval is based on successful completion of tests, and the reporting to the Administrator of the results of tests, accompanied by related drawings, by an AAMA Accredited Laboratory. 1. The listing below will be added to the next published AAMA Certified Products Directory. SPECIFICATION RECORD OF PRODUCT TESTED AAMAIWDMAICSA 101lLS.21A440 -0 H -R35- 1321x1829 (52x72) CODE SERIES MODEL & PRODUCT MAXIMUM SIZE TESTED COMPANY AND PLANT LOCATION NO DESCRIPTION G5305 DH FRAME SASH Gorell Windows & Doors PVC X!X OG 1321 mm x 1829 mm 1226 mm x 902 mm 1380 Wayne Ave. GOR -1 ( )( �( ) x � 4 0" x 3'0 ") (INS GL)(TILT)(ASTM) (4'4" 6 0 ") Indiana, PA 15701 2. This Certification will expire May 4, 2013 and requires validation until then by continued listing in the current AAMA Certified Products Directory. 3. Product Tested and Reported by: Architectural Testing, Inc. Report No.: 91291.01 - 501-44 Date of Report: May 13, 2009 Validated for Certification * .. , A _. .ted Laboratories, Inc. Authorized for Certification Date: May 14, 2009 ` i ii Cc: AAMA JG S i ec America h Ural M aotur an er ssociation JGS ACP -04 (Rev. 8/06) F ."2: --') M i � r O r Q 3 ci- c 1 i to i 6 IMIll 4 1 ? O z 11) a i o II I O 4 w a a ��II _ ' N � � o W IJ!U Z j8 z N a I '�A�1;�' (� z o z o z k"' ` ?�I��J r�� 11� I 0 g m I d a IMIMI■1 la a 3 o m c a lJI♦I� 1 6 —3 w `` ° 01 o z = F=o 3 1�' w \�I 1 N 3w c p 5 m £J W Q Q Q U J a* W O d �� Q m M7 0 H Ir ___ = .... ,._. W O N,_ x i O w ~ to co U Q QUO z cc 0 a ��- H0 =W NI Q U Z Z Y (n Q � �ejj ( 0. N } ,........,.._ ... Z r N r7 t0 Q a P7 cn cc Li — Z o w = Z W w z g w z m co N�o— 1 _ — 0 .- I t) . / !:, - --1. , cn : i j & ,D,o1 II O I ..... _� 111 z L4:31 z o = i x 00 F'_orida Building Code Online a1,(S Page 1 of 2 • � i iu Affairs riangszsumantsue BCIS Home Log In User Registration ! Hot Topics Submit Surcharge Stats & Facts Publications FBC Staff BCIS Site Map Links F. Product Approval USER: Public User Product Anoroval Menu > Product or Application Search > Application List > Application Detail el= FL # FL9654 -R1 Application Type Revision °EVE :■^&a "" Code Version 2007 Application Status Approved r. ac rt Comments Archived Product Manufacturer Vi Win Tech Address /Phone /Email 2400 Irvin Cobb Drive Paducah, KY 42003 (270) 538 -4411 (hall @viwintech.com Authorized Signature Lori Hall lhall @viwintech.com Technical Representative Lori Hall Address /Phone /Email 2400 Irvin Cobb Drive Paducah, KY 42003 (270) 443 -9622 Ext 222 lhall @viwintech.com Quality Assurance Representative Eldon Reel Address /Phone /Email 2400 Irvin Cobb Drive Paducah, FL 42003 (800) 788 -1050 ereel @viwintech.com Category Windows Subcategory Mullions Compliance Method Evaluation Report from a Florida Registered Architect or a License( Florida Professional Engineer ,/ Report - Hardcopy Received Florida Engineer or Architect Name who developed Luis Roberto Lomas the Evaluation Report Florida License PE -62514 Quality Assurance Entity National Accreditation & Management Institute, Quality Assurance Contract Expiration Date 12/31/2011 Validated By Steven M. Urich, PE Validation Checklist - Hardcopy Received Certificate of Independence FL9654 R1 COI 510308B.odf Referenced Standard and Year (of Standard) Standard Year TAS 201 1994 TAS 202 1994 TAS 203 1994 Equivalence of Product Standards Certified By http: / /www. floridabuilding. org/pr /pr_app_dtl. aspx ?param= wGEVXQwtDqtH... 9/1/2010 Florida Building Code Online Page 2 of 2 Sections from the Code Product Approval Method Method 1 Option D Date Submitted 01/27/2009 Date Validated 02/26/2009 Date Pending FBC Approval 03/15/2009 Date Approved 04/07/2009 Summary of Products FL # Model, Number or Name Description 9654.1 ShoreLine 3" Impact Mullion Mull 1.5" x 3" Heavy Aluminum with clips, T- Configuratii Limits of Use Installation Instructions Approved for use in HVHZ: No FL9654 R1 II 08- 00237A.odf Approved for use outside HVHZ: Yes Verified By: Luis Roberto Lomas 62514 Impact Resistant: Yes Created by Independent Third Party: Yes Design Pressure: +80/ -80 Evaluation Reports Other: Covers must be White PVC to match windows. FL9654 R1 AE 510308B.odf Created by Independent Third Party: Yes I Back I I Next 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 CO 2000 -2010 The State of Florida. All rights reserved. Privacy Statement, 1 Convriaht Statement 1 Accessibility Statement 1 PIuo -in Software 1 Customer Service Survey 1 Contact Us Product Approval Accepts: 1111 IN ER 1111 y� t ise c,��,r amtvxrrwcs SAF http: / /www.floridabuilding .org/pr /pr_app_dtl.aspx ?param= wGEVXQwtDgtH... 9/1/2010 L. Roberto Lomas P.E. Engineering Evaluation Report 1432 Woodford Rd. Lewisville, NC 27023 Report No.: 510308B 336 - 945 -9695 Manufacturer: ViWinTech Windows and Doors 2400 Irvin Cobb Dr. Paducah, KY 42003 -0588 Product Line: Shoreline 3" Impact Mullion Compliance: The above mentioned product has been evaluated for compliance with the requirements of the Florida Department of Community Affairs for Statewide Acceptance per Rule 9B- 72.070 method 1(d). The product listed herein complies with requirements of the Florida Building Code. Product description: Mullion: Extruded aluminum 1.375" x 2.8" 6063 -T6. Supporting Technical Documentation: 1. Approval document: drawing number 08 -00237 Revision A, titled Shoreline 3" Impact Mullion, prepared, signed and sealed by Luis Roberto Lomas P.E 2. Test Report No.: FTL 06 -364, signed and sealed by Edmundo Largaespada P.E. Fenestration Testing Lab, Hialeah, FL Shoreline 3" Impact Mullion TAS 201 -94, Large Missile Impact test. Vertical mullion was impacted with #2 Southern Yellow Pine 2x4 at 50.6 ft/sec. Horizontal mullion was impacted with #2 Southem Yellow Pine 2x4 at 50.1 ft/sec. TAS 202 -94, Uniform Static Load Test, ±80 psf design pressure (.661" deflection) TAS 203 -94, Cyclic Load Test, ±80 psf design pressure 3. Anchor calculations report No. 510309A prepared, signed and sealed by Luis Roberto Lomas P.E Limitations and Conditions of use: • Maximum design pressure: ±80.0psf • Maximum window unit size: 36" x 56 %" • Maximum transom height: 12" • Window units and transom attached to mullion must have their own separate approval. • Vertical units may be mulled indefinitely as long as maximum unit size is not exceeded. • Mullion may be used vertically or horizontally • This product is not rated to be used in the HVHZ. • This product is Impact resistant and does not require protection in wind bome debris regions. • Design pressure of mulled units shall be controlled by the lesser design pressure of the assembly components; the mullion or the individual units. Installation: • Mullions must be installed in strict accordance with installation instructions document 08 -00237 Revision A. Certification of Independence: Please note that I don't have nor will acquire a financial interest in any company manufacturing or distributing the product(s) for which this report is being issued. Also, I don't have nor will acquire a financial interest in any other entity involved in the approval process of the listed product(s). ■ \ \I R t J1 f • • I. \ GEN e :T is K e a* Y.. i *w . TAT OF •tr % r r 1 of 1 1 Ii i ii i i 10 FL No.: 62514 02/26/2009 NV Cy m c c Z n - x 0 x • Z O m c.+ Z ni Cn I.I. 2 o1 F ---- ] OD m a x - *x O y W o CA ( m 0 w TT -I T y al 0 x m H I�'� I N 0 ,ti 0 3' 1 �o o X m m < n m a Z m c,+ _ ° 75 A Co -1 D D 0 D K , • - • - J F, a t 2 - - x O ZO r y ,n D \\ D O s - n C O 0 < r z 0 0 D ` Z 0 Z CO - n 0 n m r r < ° 0 0 D O m m O 0 O CI) 1n 0 z A z j 0 y 0 m r y Z 0 Z - 7 0 O N Z C C 9 Z m O A O O Z D D ▪ m 0 u r O < m > 0 . 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