HomeMy WebLinkAbout12-12985 ,r'
CITY OF ZEPHYRHILLS !
5335-8TH STREET
�sis��so-oozo 12985
� BUILDING PERMIT
Permit Number: 12985 Address: 4828 COURT 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: ��.T'-+.�Ty�-'-r'� "�r'-� ���1? C� S4
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Est. Value: Parcel Number: 15-26-21-0200-00000-0060
Improv. Cost: 3,137.00
Date Issued: 4/24/2012 Name: B' �r�ri �v ����"^, �l Q�
Total Fees: 82.50 Address: 4828 COURT ST
Amount Paid: 82.50 ZEPHYRHILLS, FL. 33542
Date Paid: 4/24/2012 Phone: (813)782-7719
Work Desc: REPLACE ONE DOOR UNIT & SIX WINDOWS SIZE/SIZE ��v°� � t
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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) oondemned 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� plans not at job site g)work not acxessible.
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 to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your properly. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans,Specifications Must Acxompany Application. All work shall be pertormed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O.
� �70�
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
..�.� v� �.,r��y���„�� i vi��nar�Nr���.ativii
i O/��V 1 J'/VV'VVG I
Builiiing Department
�1�1 C?N/L/�
Date Reaeived �� J`-( �/ phone Contact for Permittin �13 Z�cI – CI���5
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Owne�'s Name –� RC�C �euJ Owner Phone Number ��3 � �f- �{- �2-�'�
Own�r's Address �Z-� �0(,�2� S / � Owner Phone Number �
Fee:3lmple Titleholder Name� � Owner Phone Number �
Fee:3imple Titleholder Addres:s �
JOBADDRESS ���_ �pLr/�7 S% Z-ePhnyti�/lS �L ?j 3.S �� � LOT# ��
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SUBDIVISION C Y 4� PARCEL ID# I.�j' �ZC� �/- 0200 -bbGoo ' O D�b
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED ['�� NEW CONSTR e ADD/ALT Q SIGN Q MOVE �� DEMOLISH
[ INSTALL REPAIR
PROF�OSED USE �^� SFR Q (:OMM Q OTHER �—
TYPE OF CONSTRUCTION [� BLOCK � F�RAME Q STEEL Q OTHER C �
DESCRIPTIONOFWORK Ci�IACP_ % ✓,JD[+!Z(.r li� � 4v (n,iNCrO�(�nlrfs` S���siZ� '
BUILUING SIZE �_� SQ FOOTAGE C_ HEIGHT �
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0 BUILDING $ VALU,4TION OF TOTAL CONSTRUCTION
���� �
� ELEC7RlCAL $ AMP;iERVICE � PROGRESS ENERGY a W.R.E.C,
�--
� PLUMBING � �
0 MECHANICAL r$ VALUi�TION OF MECHANICAL INSTALLATION ��" � ��
L_
0 GAS [_� ROOFINO O S�ECIAL7Y � OTHER
FINISNED FLOOR ELEVATIONS � FI.00D ZONE AREA QYES QNO
BUILDER �� � � �>
SIGNATURE ��j��,,!I��,� 1 C MPANY {-�;� � � �
` REGISTERED N FEE CURRENT Y/N
a�a�es$ 1� (�cau _7�Sr ��l'� [�2��1 �Z�7S ,
--- C�� �L� License# C����{-��
ELECT�ICIAN COMPANY
SIGNATURE
REGISTERED Y/ N FEE CURRENT Y/N
Addresa �_ � Ucense# �
I'LUMEIER COMPANY
SIGNA�URE —_ REGISTERED Y/ N FEE CURRENT—� Y/N
Address �_ � License# �
MECHANICAL
:;IGNATURE COMPANY
-- REGISTERED Y/ N FEE CURRENT—L Y/N
Address � �
== License#
UTHER
SIGNATURE COMPANY
` REGISTERED Y/ FEE CURRENT Y/N
Address � �
-+tti-fHt � l.icense#
RESIDENTIAL Attach(2)�lot�lans;(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. Requlred onsite,Construcdon Plans, Stormwater Plans w/;iiit Fence tnstalled,
Sanitary FacilirJes 8�1 dumpster;Site Work Permit for subdlvfsions/large projects
COMMERCIAL Attach(3)seks of Butldinq Plans;(1)set of Energy Forms.R-O-W Permit�or new construction.
Mlnimum ten(10)working days after s�brn�ttal date. Required onsite,Construcdon Plans,Stormwater Plans w/Silt Fence Installed,
Sanitary Facflities 8 1 dumpster. Site Work Permit for all new pro)ects.All commerclal requirements must meet cc�mpliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
"'"PROPER'f`f SURVEY required for all NEW constructfon,
Directions: _
Fill out application completely.
Owner 8 Contractor stgn back of appltcatlon,notarized
If over;2500,a Notice of Commencement Is requlred. (A/C upgrades over b5000)
" Agent(for the contractor)or Pawer of Aktorney(for the owner)would be someone with notarized letter from owner authorizing sam�
OVER THE COUNTER PERMITTING (Front of Appllcation Only)
Reroofs Sewers ;�ervice Upgrades A/C Fences(PIoUSurvey/Footage)
D�Iv�ways-Not over Counter if on public roadways..needs ROW
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NOTICE OF DEED RE3TRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
which may be morE3 restrictive than County regulations. The unclersigned assumes responsibility for compliance with any
applicable deed re:�trictions.
UNLICENS�D CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
eontractors to undesrtake work, they may be requfred to be Iicen:sed In accordance with state and local regulations. if ti�e
contractor is not liaensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. i�the owner or intended contractor are uncertain as to what licensing requirements may apply for the
(ntended work, they are advised to cvntact the Pasco County Building Inspection Divfsion—Licen:>ing Section at 727-847-
8009. Furthermore, if the owner has hired a contractvr vr contractors, he is advised to hav�3 the contractor(s) sign
portions of the "coiitractor Block" of this application fvr which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properiy licensed and is not entitied to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOIIRCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees rnay apply to the constructian of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordin�ance number 89-07 and
90-07, as amendeci. The undersigned also understands, that s�.�ch fees, as may be due, will be identified at the time of
perrrtitting. It is further understood that Transportation Impact F'ees and Resource Recovery Fe�s must be paid prior to
receiving a "certificate of occupancy" or final power release. If I;he project does not involve a certificate of occupancy or
finai power releaso, the fees must be pafd prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accor��ance with appiicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, �is amended): If valuation of woric is $2,500.00 or morE;, I
certify that I, the appiicant, have been provided with a copy of the NFlorida Constructfon Lien Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consume� Affairs. If tfis applicank is svm�one
other than the"owner", I certify that I have obtained a copy of th�3 above described document and promise in good faith to
defiver it to the"owner"prior to commencement.
CONTRACTOR'S/OWWER'S AFFIDAVIT: I certify that all the i.nformation in this application is ac;curate and that all work
will be done in compliance with all applicable laws regulating cunstruction, zoning and land deve►lopment. Appiication is
hereby made to obtain a permlt to do work and installation as indicated. I certify that no work or installatfon has
commenced prior to issuance of a permit and that all work will be perF�rmed to meet standarcis of ail laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I aiso
ce�tify that I understand that the regulations of other governmerit agencies may apply to the intended work, and that it is
my responslbitity ta Identify what actions I must take to be In com�pilance. Such agencies include t�ut are not limited to:
- Depa�tment of Environmental Protection-Cypress E�ayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
' Waterc;ourses.
- Army(:orps of Engineers-Se�walis, Docks, Navlgable Waterways.
- Department of Health 8� Rehabflftative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
p - US Environm�ntal Protectfon Agency-Asbestos abatement.
- Feder�l Aviation Authority-Runways.
I understand that the following restrictioFlS appiy to the use of fill:
- Use of flll is not allowed in Flood Zone"V" unless ex��ressly permitted.
- (f the fill mate�lai is to be used in Flood Zone "�4", it is understood that a drainage plan addressing a
"compansating volume" will be submitted at time of permitting which is prepared by a,professional engir�E;er
IicensE:d 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 wail
construction, I certify that fill will be used only to fill ti�e area within the stem walf.
If fiil rnateriai is to be used in any area, I certify that use of such fill wili not adversety affect adJac�nt
properties, If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the buiiding permit issued under 1he attached permit appiication, fpr lots less than one (1)
acre which are elevated by fill, an engineered draina.ge plan is required.
If I am the AGEN1'FOR THE OWNER, I promise in good faith t�� inform the owner of the permitting conditions set fortri in
this affidavit prior ko commencing construction. I understand that a separate permit may be requfred for electrical wark,
plumbing, signs, welis, pools, air conditioning, gas, or other installations not specificaily includ�d in the application. A
permit issued shall be construed to be a iicense to proceed witfi the work and not as authority tc� vioiate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Buflding Officiai from thereatter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shali become invalid
unless the wo�k authorized by such permit is commenced within six months of permit issuance, c�r if work authorized by
the permit is susp�nded or abandoned for a period of slx(6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a pe�riod not to exceed ninety (90) d��ys and wiil demonstrate
}ustifiable cause for the extension. If work ceases for ninety(90;i consecutive days, th�job Is com�idered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT IUTAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSI.ILT
WITH YOUR I ENQFR OR AN ATTORNEY BEFORE RECORC��Nr YOUR NOTICE OF COMME:lVGEMENT.
FLORIDA JURAT(F.S. 117.03)
OWNER OR A(3ENT_ CONTRACTOR
Subscribed and swom to(or afflrmed)before me this Subscrit�ed and swom to(or affirmed)before me thls
� by
Who Is/are pe�sonally known to me or has/have produced Who Is/��re personaily known to me or ha asaden IflcaBo n
as Identlflcatlon.
Notary Public __._.__ Notary Public
Commission No. Commission No. ' __----- —
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: G-(J�-S `�'1'f'lC ��+'"'
Date Received: �— � �J"" � 2
Site: � �'j 2� C�U-r� � �
Permit Type: � Ct.C�., Gt,� ��dZc�-S � � ��r
Approved w/no comments:❑ Approved w/the below comments: Denied w/the below comments: ❑
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This comment sheet shall be kept with the permit andlor plans.
����.�- _, �
�°,� =� ��-�� ��_ � � �-
Kalvin � 'tzer—P s Examiner Date , Contractor and/or Homeowner
(Required when comments are present)
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cdmht�.d,ete is as follows:• .. ...•. :.,,_�_,:... � .
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i USER.Public User
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PrOdVGt ADArOva/MenV>PrOducf 7rAAAliGd_tion..SEd_r�h>APpli�dli0n 4iSt>APP/lcatlon Deta/I
FL # FL11152-RS
Application Type Affi�mation
Code Version 2010
Application Status Approved
Comments
Archived
Product Manufacturer Pella Corporation
Address/Phone/Email 102 Main St.
Pe!la, IA 50219
(64i) 621-6096
pellaproductapprovalC>pella.com
Authorized Signat�ure Joe Hayden Sandi Robrnson
pellaproductapprovalCa�pella,com
T'echnical Representatrve Joseph Hayden
Address/Phone/Email i02 Main St�eet
Pella, IA 50219
(641) 621-6096
jahayden@pel/a.com
Quality Assurance Representative Andrew Nelson
Address/Phone/Email 102 Main St
Pella, !A 50219
(641)621-3804
nelsona@pella com
Category Windows
Subcategory Double Hung
Compliance Method Certlfication Mark or Listing
Certification Agency Window and Door Manufacturers Association
Validated By James L. Buckne� P.E. at CBUCK Enqinee�ing
Valydation Checklist-Hardcopy Received
Referenced Standard and Year(of Standa�d) Standard
Year
AAMA 101/I.S.2-97 1997
AAMA 101/7.5.2/NAFS-02 1002
AAMA/WDMA/CSA 101/1.5.2/A440-05 2005
Equiva/ence ol Product Star�dards
Certlfied By
I a��m that there are no changes Vn the new Florida Building Code whrch
affect my product(s)and my product(s)are in compliance with the new
FloNda Bullding Code.
Documentation from approved Evaluation o�Valydation Entity yes No N A
/
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Product Approval Method Method 1 Optlan A
DaGe�Submitfed i2/09/2�11
Date Validated 12/09/2011
Date Pending FBC Approval
Date Approved 12/14/2011
--------------- --- ----- ------..._- ----------------
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Summary of P�oducls -�------ - - -
_ ,
FL # �Model,Number o�Name Descri tion
;11152.1 �Se�ies 20/25 Doub/e Hun Vin 1 Double Hung Window 48"x 62')
�Llmits of Use Certtfication Agency Ce /�cate �
; Approved for use Jn HVNZ:No FL11152 RS C CAC 411-M-859 32-35 odf �
Approved for use outside HVHZ: Yes FL11152 RS C CAC 411-M-862 36-39 ndf
Impacf Resistant:No Quality Assurance Contr�ct Expiration Date
; Design Pressure: +25/-25 04/18/2015 �
Other:Configu�ations of g/ass sha!l conform to current ASTM Insfallafion Xnstructions
E1300 standard. FL11152 RS II InstallatiorLDrawin�1596.,C...df
_ P_
Verifred 8y: Warren W, Schaefer, P.E. 44135
Created by Independent Third Party: Yes ;
Eva/ualion Reports
_ �. . . �_Drawing.1596 C..pdf �
Series 20/25 Double Hun VIn1/Doub eSHunE IW'ndoworrd Part : Yes �
Created b Inde endent Th
11152.2 — � Y g (36"x 72')
Limits of Use !
CeKificaffon Agency Cert�cate ;
, Approved for use in HVHZ:No FL11.152 RS C CAC 411_I-j-859.24-.27.Adf
` Approved for use outside HVN2: Yes FL11152 RS C CAC 411-H-862 28-31 pdf
; Impact Resistant:No QuaJity Assurance Contracf Expiration Dale !
Design Pressure: +30/-30 04/18/20i5
Other:Configu�ations ol glass shalf conform to cur�ent ASTM InsYallatfon Inst�uctions
'E1300 standa�d. FL11152 RS 11 Installation Drawina i596 C odf
Verlfied By: Warren W Schaefer, P.E, 44135 !
Created by Independent Third Party: Yes �
Evaluation RepoKs �
FL11152 �qE Insta!/atlon Orawlno 1596 C odf �
Created b Independent Thi�d Pa ; Yes
11152.3 Ser/es 20/25 Double Hung Vlnyl Doub/e Hung Wlndow(�6"x 62"
;Limits of Use Certification Agency Certi icate �
' Approved for use in HVHZ:No FL11152 RS C CAC 411-HL859 28-31 Ddf `
Approved for use outside HVHZ: Yes FL11152 RS C CAC 411-H+862_32-.35.pdf
� Impact Resistant:No Quality Assurance Contract ExpTration Date '
Design Pressure: +35/-35 04/18/2015 �
Other: Confrgu�ations of glass shaN conform to current ASTM Installa[ion InsfruCtions
E1300 standard. FL11152 RS II Insta!lation rawing,_I596 C.pdf
Verified By: Warren W. Schaefer, P.E. 44i35
C�eated by Independent Thrrd Party: Ves
fvaluation Reports
FL1.1.1,52 RS AE Insta!latr_on_Drawing 1596 C,p..d.f
- Created b Independent Third Party: Yes �
�11152.4 �Se�ies 20/25 Double Hung Vin l Doub/e Hung Twin Composite(89"x 78)
�mits of llse Certifica!!on Agency Certiffcate �
pproved for use in HVHZ:No FL11152 RS C CAC CCL for Pe!!a 7-14-11 411-H-866_12-.1 S�df �
Approved for use outside HVHZ: Yes FLi1152 RS C CAC CCL for Pella 7-14-11 411-H-867.18_.21.adf
Impact Resislant:No Quality Assu�ance Confract Expirafion Dale
Design Pressure: +20/-.?0 04/18/2015
' Other: ConfrguraFions o(g/ass shall conform to current ASTM Insla//alfon Instructions
E1300 standard. FL11152 RS 11 Installation Orawino 1596 C.Odf
Ve�ifred By: Warren W. Schaefer, P.E. 44135
Created by Independent Third Party: Yes �
Evaluatfon Reports '
FL11152 RS AE Installation Orawina 1596 C odf
- Created by Inde endent Third Party: Yes '
I1152.5 I Serles 20/25 Double Hun Vin 1 Double Hun Twin Com osite 96-]/2"x 72" �
�mils of Use Certification A_qency Cerfifica[e
� pp oved for use in HVIiZ:No FL11152 RS C CAC CCL for Pella 7-I4-11 411-H-866 16- i9 odf ;
! Approved for use outs/de HVNZ: yes FL11152 RS C CAC CCL fo�PeUa 7-i4-11 411-N-867 22-.25.Ddf �
Impact Resisfant:No Quality Assurance Contract Expiration Dale i
Design Pressure: +25/-25 04/18/2015
Other:Configurations of g/ass shal!conform to current ASTM Instal/a[ion Instrucfions
!E1300 standard. fL1i152 RS II_Installation Qrawin�g_1596 C.pdf
� VeriFed By: Warren W. Schaefer, P.E. 44135
Created by Independent Third Party: Yes '
http://www.floridabuilding.org/pr/pr app_dtl.aspx?param=wGEVXQwtDqttaGsIp3Gvu1V... 3/19/2012
_ _�_.__ ��..�...b .,..,, ..�.�.��., Yage .5 oi 4
'� • IEva/u�tion Reports
FL11152 RS_AE Installati4n Drawina 1596 Cgdf
� Created by Independent Third Party: Yes
i 11152.6 Se�/es 20/25 Doub/e Hun Vrny/Doub/e Hun Twin Composite(72-1/2"x 72')
i Limifs of Use Certificatlon Agency Certificate
; Approved fo�use in hIVH7:No FL11152 RS C CAC CCL�or Pe!la 7-14-11 411-H-866.32-.35.odf �
' Approved for use out�side HVHZ: Yes FLI1152 R5_C CAC CCL for Pella 7-14-11 411-H-867.38-.41.ndf ;
Impac!Resistant:No Quality Assuranee Contract Explration Date
i Design Pressu�e: +35,/-35 04/18/2015
; Ofher:Configurations of glass shaH conform to current ASTM Instal/ation Inslructions
�E1300 standard. FL11152 RS II Installatioh Orawina 1596 C odf
Verified By: Warren W. Schaefer, P.E. 44135
Created by Independent Tltird Party: Yes
Evaluation Reports
FL11152 RS AE Installatian Drawino 1596 C�df
_ Created by Independent THird Party: Yes
11152.7 �Series 20/25 Doub/e Hung Viny!Doub/e Hun Tri le Co'mposite(89"x 78)
'Limits of Use Certificatlon Agency Cert�cate
Approved for use in NVHZ:No FL11152 R5 C CAC CCL fb�Pella 7-21-11 411-H-872 12- IS vdf
Approved for use outside HVHZ: Yes FL11152 RS C CAC CCL f0�Pella 7-21-11 4i1-H-873 12- 15 vdf +
Impac!Resisfant:No Quality Assurance Contract Expiration Date �
Design Pressure: +3U/-30 04/18/2015 3
Other:Configurations nf glass shall conform to current ASTM Installafion Inslructions �
E1300 standard. FL11152 RS II Installation Orawinq 1596 C.pdf
Veri�ed 8y: Warren W, Schaefer, P.E. 44135
Created by Independent Third Party: Yes
Eva/uafion Reports
FL11152 R5 AE Installatron Drawin4 1596 C.Qdf
Created b Independent Thtrd Party; Yes �
11152.8 Se�ies 20/25 Double Hung Vlnyl Doub/e Hun Trip/e Composite(108"x 72')
i Limits of Use Certification Agency Cert��ficate '
Approved for use in HI/H2:No FL11151 RS C CAC CCL for Pella 7-21-11 411-H- 72.16_19.vdf i
Approved for use outside HVMZ: Yes FL1.11�2 RS C CAC CCL f_o,r PeNa.7-21__11.,41.1-H_873.16-..19.pdf .
' Impacf Resisfant:No Qua�Tt Assurance Contract Exp/�ation Date
� Design Pressure: +25/•25 04/18/2015 '
Olher:Configurations of glass sha!l conform to current ASTM Installa[!on instruclions
E1300 standard. FL21152 RS II Instal/ation Orawino 1596 C•�df
Verified 8y: Warren W. Schdefer, P.E. 44135
Created by Independent Third Party: Yes '
Eva/uation Reports
FL11152 RS AE Instadatio�l Drawina 1596 C odf
_ Created b Independent Thrtd Party: Yes �
i 1152.9 �Se�ies 20/25 Double Hung Vin I Double Hcrng Tri le Composlte(108"x 62') �
Limits of Use Certif/cation Agency Certi�cate
: Approved fo�use in HVHZ:No FL11152 RS C CAC CCL for Pella 7-21-11 411-H-872 20-2 3�df i
� Approved for use oulside HVHZ: Yes PL11152 RS C CAC CCL for Pella 7-21-11 411-H-873 20-23 odf '
Impact Resisfant:No Quality Assurance ContraCt Expira[ion Dale �
; Design Pressure: +35/-35 04/IS/2015
; Other:Configurations of glass shal!conform to current ASTM Installation Instruclions
E2300 standa�d. FL11151 RS 11 Installation Orawino 1596 C odf i
Verified 8y: Warren W. Schaefer, P.E. 44135 �
Created by Independent Third Party: Yes
Eva/uation Reports
FL11152 RS AE Insta!latlon Drawiny 1596 C�df
Created by Inde endent Third Party: Yes
11 i52.10 _�Series 20/25 Double Hung Vinyl Doub/e Hung Window 48"x 78')
L�imits of Use Certificafion Agency Certif/cate
pproved for use in HVMZ:No FL11152 RS C_CAC 411-H- 59 20-23. df
� Approved for use oufside HVHZ: Yes � --�--
FL111�2 R�C_�A�411-H-$62,2Q-,.23..pdf (
Impacf Resistant:No Quality Assurance Contract Explration Date
Design Pressure: +20/-"1.0 01/i0/2015
� Other:Configuratlons of yfass shall conform to cur�ent ASTM Insta!/atfon Instructions
�E1300 standa�d. FL11152 R5 II Installation Orawino 1596 C odf
Verlfied By: Warren W. Schaefer, P.E. 44135
Created by Independent Third Party: Yes
Evaluafion Reports
FL11152 RS AE Installatlon prawing 1596 C Ddf I
; C�eated b Inde endent Third Pa : Yes !
i 11152.11 Series 20/25 Doub/e Hung Vin !Doub/e Hung Twln Com �sJte(96-1/2"x 53"
'Limits of Use
i Certiflcarfon Agency Certiflcate I
Approved for use in HVHZ:No FL11152 RS C CAC CCL for Pella 7-14-11 411-H-866 24-.27.odf j
! Approved for use outside HVH2: Yes FL11152 RS C CAC CCL for Pella 7-14-11 411-N-867 30-.33.ndf '
Impac!Resislanf:No Qualily Assurance Contracf Expiration Date
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_ ..,..,.w�...._....b ,,..,, V111111V ra�e �+ or 4
� Design Pressure: +35/-35 04/i8/2015 i
� Othe�:Conflgurations of glass shall conform to current ASTM Insta/latlon Instructions �
�E1300 stanobrd. FL21152 RS 17 Installation Drawing 1596 C p_df
' �Verlf/ed By: Warren W. ScNaefer, P.E. 44135 �
Created by Ir�dependent Third PaKy• Yes
Eva/uation Reports
FL11152 RS AE InstallatiQn Drawlna 1596_C•pdf i
Created by Inde endent Third Party: Yes
;11152.12 _�Serres 20/25 Doub/e Nun Vinyl Double Nun Twin Composite 96-1/2"x 62')
Limits of Use Certification Agency Cerfi�cafe �
; Approved for use in HVHZ;No FL11152 RS C CAC CCL fpr Pella 7-14_11 411-H-866.20�23.pdf �
i Approved fo�use outside HVH2: Yes FL11152 RS C CAC CCL._fpr_Pella,J-14-i1 411-H-861.26-,29.pdf ;
' Impact Resistant:No Qua%ity Assu�ance Contraict Expiralion Date �
Design Pressure: +30/-30 04/18/20i5
Other:Conf;gu�ations of glass shal!conform fo current ASTM Installation Xnsfructions i
E1300 standard. FLI1 i 52 RS II Instal/atlon Drawino 1596 C odf
Verified By: Warren W. Schaefer, P.E. 44135
Created by Independent Third Party: Yes
Eva/uation Reports �
FL11152 R5 AE Insta!latlon Drawino 1596 C pdf !
C�eated by Inde endent Third Party: Yes �
11i52.13 �Series 20/25 High Pe�formance Double Viny/High Performance Double Hung Twin Composite(72-1/2"x �
Hung 72^
Limits of Use Cer[ification Agency Certiffcate
j Approved for use Jn NVHZ:No FL11152 RS C CAC CCL fOr Pella 7-14-11 411-H-866 28-31 odf �
� App�oved for use oulside HVHZ: Yes FL11152 RS C CAC CCL for Pella 7-14-11 411-N=867.34_37.Ddf �
' Impact Resistant:No Qua/ity Assurance Contract Expiration Date i
i Design Pressure: +50/-50 04/18/2015 !
Olher:Configu�ations o(g/ass shall conform to current ASTM Insta!lation Instructions
E1300 standard. High performance windows shall have metal tllt FLIi152 R$ 17 Installation Orawfng.1596,C,pdf ,
latches on the bottom sash rnterlock. Verified By: Wa�ren W. Sch2efe� P.E. 44135
Created by Independent Third Party: Yes !
Eva/uation Reports �
FL11.152 R5 AE Installation_Drawing_2596 C.pdf �
_ _ C�eated by Independent Thr'rd Party: Yes
11152.14 Series 20/25 High Performance Double Vinyl Hlgh Performance DouBle Hung Window(48"x 71")
Hung I
�imits of Use Certification Agency Certificate
, Approved for use in HVHZ:No FL11152 RS C CAC 41i-H-859.48- 51 odf
Approved ior use outside HVHZ: Yes FL11152 RS C CAC 411-H-862.24-.27 odf
; Impact Resistant:No Qua/ity Assurance ContraCt Expiralion Date
; Design Pressure: +50/-50 04/25/2015 i
Other:Configuratrons of glass shall conform to current ASTM InsfaNaHon Insfructions
'E1300 standard. High penormance windows shal!have metal tilt FLi1152 RS 11 Installation prawino 1596 C pdf
i/atches on the bottom sash interlock. Verified By: Warren W. Schaefer, P.E. 44135
Created by Independenf Thlyd Party: Yes
Fvaluatfon Reports �
FL11152 RS AE Installationr Drawina 1596 C pdf !
Created b Independent Thi�d Pa : Yes !
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��R',`4 USER.'PUbl�c User
PrOduCf Approva!Men✓>PrOdUCf Or AppliCaf�On Sed�Ch>App6[d(i0n Cist>Appl![atlan Detall
FL # FL11161-R2
AppDcation Type Affi�mation
Code Version J_O10
Application Status Approved
Comments
A�ch�ved
Product M�3nufacturer PeRa Corporatron
Address/Phone/f=mai! 102 Main St.
Pe!la, IA 50219
(641) 621-6096
peHaproductapproval@pella,com
Autho�ized S�gnature Joe Hayden Sandi Robinson
pellaproductapproval@peHa.com
Technical Representvtive Alan Hughes
Address/Phone/Emai! 2000 Proline P/ace
Gettysburg, PA 17325
(717J 338-1165
hughesa�@pel/a.com
Quality Assurance Representat�ve Ali Zarghami
Address/Phone/E�mail 102 Main St
Pella, IA 50219
(641) 621-1000
zarghamia@pella.com
Ca teg nry Wrndows
Subcacegory Horizon[al Slider
Compliance Method Certnc�ation Mark o�Listing
Certification Agency Wrndow and Door Manufacturers Association
Validated By Iames L. Buckner, P E at CBUCK Engrneering
Valydation Checklist- Hardcopy Received
Referenced Stanciard and Year(of Standard) Standard Yea�
AAMA 101/I 5.2-97 1997
AAMA/WDMA/CSA 101/I.5.2/A440-OS 2005
Equivalence of Product Standards
Certified By
1 affirm that there are no changes in the new Florida Building Code which
affect my product(s)and my procluct(s)are!n compliance wlth fhe new
Florida Bui/ding Code.
Documentation from approved Evaluation or Va/idation Entity yes No N/A
FL_11161_R2_COC Compliance Letter FL21161_pdf
http://www.floridabui lding,.org/pr/pr_app_dtl.aspx?param=wGEVXQ��tDqttaGsIp3Gvuna... 2/27/2012
Florida Building Code Online Page 2 of 2
Produr.t Approval Method Method 1 Optron A
Date:>ubmitted 12/21/2011
Date Validafed 12/21/2011
Date Pending FBC Approva!
Date Rpp�oved 01/OS/2012
-- -- -- - --- - - - -
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PrOdu.Ct AOArQydl Meny>PrQdllCt OrAQpliS.dfipn..$GdrGh>ARD/i�li2�../Jif>APPIlwt/on Detell
FL # FL4904-R5
Application Type Revision
Code Versron 2010
Application Status Approved
*Approved by DCA. Appravals by DCA shafl be reviewed and ratrfied by the POC
and/or the Commisslon if necessary.
Comments
A�chived
Product Manufacturer Masonite Inte�natronal
Address/Phone/Email 1955 Powis Road
West Chlcago, IL 60185
(615)441-4258
sschreiber@masonife.com
Authorized Slgnature Steve Schrerber
sschretber@masonite.com
Technica/Representative
Address/Phone/Email
Quality Assurance Representative
Address/Phone/Email
Category Exterior poors
Subcategory Swinging Exterior poor Assemblies
Compliance Method Certification Mark o�Listrng
Certrfication Agenc.y National Accreditation&Management Institute,
Validated By National Accredita[ion&Management Institute,
Referenced Standard and Year(of Standard) Standard Year
TAS 201 jggq
TAS 202 1994
TAS 203 1994
Equivalence of Product Standards
Certifred By
Product Approva!Method Method 1 Optron A
Date Submitted 10/12/2011
Date Validated 03/18/2012
Date Pending FBC Approval
Date Approved 03/26/2012
.._. _.._.._. �..---____._._.�..--___. ....__---_____------_-_-------------...___..__._.____----__.__..
'Summary of Products - _ ._�...__-__..-.----___._.._..__..-.-_- -._.
l�ttp://www,floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqteluIwHNbblSc.,. 3/28/2012
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!FL # Mode/ Number or Name Descr !!on �
�
4904.1 . g Wood-edge Steel Sfde-Hinged Door 6'-8"Opaque I/S and O/S Sing/e Door �
Units
= 1
Llmits of Use CertificatJon Agency Cert flcate
' Approved for use in HVHZ: Yes
f1.4904 RS C CAC N10061�10 Ol Odf �
; Approved for use nutsl'de HVHZ: Yes Quallty Assurance Contra�t Explrat/on Date
; Impact Reslstant: Yes 12/31/2014
' Design Pressure: +76.U/-76.0 Instal/a!!on Instructions
Other:Eva/uated fo�use In locations adhering to the F/orida FL4904 RS II FL0128 vdf
Bu/Iding Code lncluding the High velocity Hurricane Zone, and Verlf/ed By: Natlona/Accredltadon&Management Institute, i
where pressure requlrements as determined by ASCE 7, Mlnimum Created by InJependent Thlyd Party:
'Design Loads for Buildln5is and Other Structures, does not exceed Eva/uatfon Reports
�the deslgn pressures/rsted. 3'-0"x 6'-8"max nominal s/ze. When FL4904 RS AE� 4A. df
;farge missile impact reslstance is required, hurricane protective Created by Independent Third Party: Yes
's stem is NOT required. See OWG-MA-FL0128-OS for details.
4904.1 al Wood-edge Stee/Side-Hinged Door 8'-0"Opaque 1/S and O/S S/ng/e Door �
J Units i
Limits of Use Certiflcat/on Agency Certificate
Approved for use in NVHZ: Yes FL4904 RS C CAC N7006110 02 vdf
Approved fo�use outsi�ie HVHZ: Yes Quality Assurance ContraCt Explrat/on Date
Impact Resistant: Yes 12/31/2014
Design Pressure: +70.0,/-70.0 Insta//at/on Instruclfons
Other:Fvaluated for use In locatJons adhering to the Florlda FL4904 RS II fL0129 vdf
;E3u!lding Code lncluding thc�High Velocity Nu�Ncane Zone, and Verifred By:Nat/ona!Acc�editation&Management Institute,
i where pressure requirements as determined by ASCE 7, M/nlmum Creared by Independent Thlyd Pa�-ty: �
!veslgn Loads for f3u11dings and Othe�Structures, does not exceed Eva/uation Reports
the design pressur•es Ilsted. 3'-0"x 8'-0"max nominal size. When FL4904 RS AE 503A Ddf I
large miss!!e lmpact resis[�nce is required, hurricane p�otective Created by lndependent Thlyd Party: Yes !
system!s NOT requlred. ;se�e OWG-MA-fL0129-OS fo�deta!!s,
49�4•.3 ���I Wood-edge Stee!S/de-Hinged Door 6'-8"Opaque I/5 and O/S Door w/or w/o SideNtes
Units
Limits of Use CertlNcation Agency Certlf cate �
Approved for use in HVIiZ: Yes fL4904 R5�CAC N1006110�OI.pdf
Approved for use outslde HVNZ: Yes Qualfty Assurance Contrac�Exp/rat/on Date
Impac!Resistartt: Yes 12/31/2014
Design Pressure: +SS.Oj-55.0 Insfallation Instructions
Other:Evaluated for use in locations adhe�ing to the florlda FL4904 RS II FL0128.Odf
;Building Code lncluding the Hlgh Veloclty Hurricane Zone, and Verlfied By: Natlona/Accredit�at/on&Management Instltute,
where pressure requlremc�nts as defermined by ASCE 7, Mlnimum Crea[ed by Independent Thlyd Parfy:
Design Loads for Bulldrngs and Other Structures, does not exceed Evaluatfon Reports
'the design p�essurr_s listed. 12'-0"x 6'-8"max nominal size. When FL4904 � AE 902A.Ddf
la�ge misslle Impact reslslance!s required, hurNcane protective Created by Independent Thlyd Party; Yes �
system is NOT requlred ai opaque panels, but/s requlred on glazed
;panels. See DWG-MA-fL01'1.8-OS for detaUs,
!4904.4 Wood-edge Stee/S/de-Hinged Door 8'-0"Opaque 1/S Door w/or w/o Sldelltes
�Units
Limils of Use Certiflcat/on Agency CertiflCate
Approved for use in HVHZ: Yes fL4904 RS C CAC NI00611 02. df
Approved for use outsldr�HVHZ: Yes �y ��-
Quality Assu�ance Conlrac[Expfra[ion Date
! Impact Resistant: Yes 11/31/2014
Design Pressure: +45.U/-50.0 Installation Instructions
� Other:Evaluated fo�use!n locations adhe�ing to the F/orida FL4904 RS II f'L01�9 nr�f
;I Buildrng Code includiny the High Veloclty HurNCane Zone, and Verified By:Natlona!Accreditdtlon&Management Instltute,
;where pressu�e requiremenfs as determined by ASCE 7, MInlmum Created by Independent Thlyd Party: �
Des�gn Loads for Buildings and Other Structures, does not exceed Evaluation Repnrts
�the design pressures 11steU, 12'-0"x 8'-0"max nominal s/ze. When FL4904 RS AE 1 , df �
;large missile impacC reslst3nce Is required, hurrlcane protect/ve Created by Independent Thlyd Party; Yes
;system is NOT required on opaque panels, but!s required on g/azed
�panels. See OWG-MA-FLOI29-OS for detalls.
I4904 5 �lrvood-edge Stee/Slde-Hrnged Door 8'-0"Opaque O/S w/o�w/o Sidelltes �
�Units
Limfis of Use Cert/fica[fon Agency Cert/f/cate '
Approved for use in HVH'T_: Yes FL4904 RS C CAC NI006110 0 odi t
Approved for use outslde HVH2: Yes Qua/!ty Assurance Conlract Explratfon Date �
Impact Resfstant: Yes 12/31/2014
Deslgn Pressure: +50.0/-•75.0 Insfal/at/on Instruct/ons �
Other:Evaluated for use in locatlons adhering to the Florlda F1,4904 R5 II FLOi29�pdf
;t�uilding Code lncluding the hligh Veloclty Hu�rlcane Zone, and Verified By: Nationa!Accred/tat/on&Managemenf Institute,
�where p�essure�equlremenL�as dete�mined by ASCE 7, M/nlmum Creafed by Independent Thlyd Party:
;,�esign Loads for Bu1/dings ar�d Other Structures, does not exceed Eva/uation Reports
"Che design p�essures llsted. �'2'-0"x 8'-0"max nomJna!size. When FL4904 RS AE 5'OIA odf
;�iarge missrle impact�eslstance Is requl�ed, hur�lcane protective Created by Independent Third Party; Yes
;�system Is NOT requJred on opaque panels, but!s requlred on g/azed
�panels, See OWG-MA-FI_0129-OS for detalls. �
http://www.floridabui:lding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqteluIwHNbblSc.., 3/28/2012
� ra�C � �i �
4904.6 Wood-edge Stee/Slde-Hinged Door 6'-8"�G/azed 1/S and O/5 Door w/or w/o S/delltes
, s_ Units
;Limi�s of�l/se ,Certiflcat/on Agency Certlficate �
� AElproved for use in hIVHZ: Yes FL4904 RS C CAC NI006110 03 pdf
; Approved for use outslde HVHZ: Yes Qua/!ty Assurance Contracf Exp/ration Date
; Impact Res/stant:No 12/31/2014 �
' Design Pressure: +50,.5/-50.5 Ins[allaf/on Instructions
Other:Evaluafed for user!n locations adherMg to the Florida FL4904 RS II fL0130 ndf j
;euilding Code including the H/gh Ve/odty Nurrlcane Zone, and Verifled By: Natlona/Accredifation&Management Insfitute,
�whe�e pressure requiremn.nts as dete�m/ned by ASCE 7, M!nlmum Created by lndependent TMi�d Party:
;Design Loads for Buildlnys and Other St�uctures, does not exceed Eva/ua[!on Reports
;the design p�essures Usted. 12'-0"x 6'-8"max nomina/s/ze. When fL4904 RS AF 502A vdf '
i la�ge misslle lmpact resisfance fs requlred, hurricane p�otective Created by Independent Tl�lyd Party: Yes
system is required. See UWG-MA-FL0130-OS for deta!ls.
4904.7 � Wood-edge Stee/S/de-Hinged Door 8'-0"G/azed I/S Door w/or w/o S/delltes
Units
Lfmlts of Use� Certiflcat/on Agency Certif/cate
Approved for use!n HVHl; Yes FL4.�Q4 R�,.CiC�I.�NIQO¢�1.Q Q4..p�f �
� Approved for use outs/de NVHZ: Yes Qua/!ty Assurance Contrac!Exp/ralion Dale
Impact Reslslant:No 12/31/2014 �
Design Pressure: +40.0/-45.0 Insfa/lallon InslrucNons
; Other:Evaluated for use in locations adhering to the Florlda FL4904 RS 17 fL0131.ndf '
8uiiding Code including tfre Hlgh Ve/oGty HurNCane Zone, and Ve�lfled 8y:Natlona!Accred/tatlon&Management Institute, �
;where pressure requl�ements as dete�mined by ASCE 7, M!nlmum Created by Independent Th/rd Party:
�Design Loads for Buildings and Other Structures, does not exceed Eva/uatlon Reports
the design pressures listed. 11'-0"x 8'-0"max nom/na/size. When FL4904 RS AE SOIA�'
�large miss!/e impact resislance is requlred, hurricane protecflve Created by Independent Th��d Party: Yes
;system is requ/�ed. See DWG-MA-FLOl.?1-OS for details.
'4904,8 Wood-edge Stee!Side-Hinged Door 8'-0"G/azed O/S Door w/or w/o Slde/Ites
Units
Lfmfts of Use � Cert/fication Agency Certiffcate ;
Approved for use In HVNZ: Yes FL4904 RS C CA� N1006i10 04 f
Approved for use outside HVHZ: Yes Quality Assurance ContraCt Expl�tlon Date
! Impact Res/stant:No 12/31/2014 i
: Deslgn Pressure: +45,0/-40.0 Insla!/at/on Instructions
Other:EvaJuated for use in locatfons adhering to the Florida FL49 4 RS II FL0131 pdf
,Sui1ding Code lncluding the High Ve/ocity HurNcane Zone, and Verlfied By:Nat/ona/Accreditatlon&Management Institute,
�where pressure requirements as dete�mined by ASCE 7, Min/mum Created by Independent Th/rd Party:
�Deslgn Loads fo�Bu11dings and Other Structures, does no[exceed Eva/uation Reports
�the deslgn pressu�es llsten: 12'-0"x 8'-0"max nom/na!slze. When F,�49�4__RS AE.�Q1A_pdf i
i large misslle impact reslsteince!s required, hu�r/cane protect/ve Created by Independent Thlyd Party: Yes
�system!s re ufred. See DWG-MA-FL0131-OS for deta!ls.
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— --- --- R VISIONS &DETNLS
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2012066410
, Rcpt:1429748 Rec: 10.00
• D5: 0.00 IT: 0.00
04/19/12 S. Pelt, Dpty Clerk
' NO'�'�CE O�+C4M1V,[El'�f C�N�ENT
PC��i,t NO. PRULA S 0'NEIL,Ph D PRSCO CLERK & COMPTROLLE
Tax Fol�No. �
040R BK2 ���� P�o ����
���f�i�1� `by,2,4d ���� _�C`��O
0 hen givGS no o a e improvements will be made tp'rosl proparty,and in accordsace with Saclion 713.13 of
, the k'��arida Sta�es,t�e�ouow ng i��o�ation is provided in this NOTTCE OF CO�C�MEEN'f.
1.Description of tn'oPertY(1e�a�1 description): T � ...�1�+� � P : _3 -� 7'=5 v,2 �'b�� I', !,9 5
a)Street(job)Ad'dress: L1`'g 2�' C' �� rtT s i z�Fn,x.�.�Is F �' �.!/
2, General description of inr�pr��vements: (�n„R ,�-rti+��.r���.,, ,Qp ,a/A cer,-�e�7-
3.�wner Informad0�a— -�� �•
a)Name and address; � ti' z �`� S Z✓77�-`f f
b)Name amd$dd�ess o�sfam inpao titloholder(i�ather d�an owt�er) -- �
c)Interest in properly Ow�ie� '
a. adraatar�nfor,aastion �
' )Name and address:,,�_ c. � ox 7$ 2
b)Telephone No; r�.e 7^S����- d Fax Nn: IV LL..
5, Surety J.nfoxuaat�ian '—
, a)Name and addross:_NA •
b)Amount of Hond; NA �
c)'�elephone No_NA_ �
6.Lende�r
a)Name ead address; Nrw ,
b)Telephone No; NA_ Fax No: NA,
7.Identity of person wichin the 3tata of Florida designated by owner upon whom notices or other dacuments may be sarved
$)Name and address_NA_
b)Telapho�e No: NA Fax No_NA
S.�n addition to himsel�ownar designatas the followtng person to receive a copy of kha Lienor's Notlr.a es providod in Searon 713,13(x)(b),
Florida 3tatutes;
a)Name a�►d addreea;_NA,
b)T�le�baae No. NA Fax Na. NA
9.Bxpieation dete of Notice of i:ommoneomant(the expiratioa date u one yesr from the data of ro�ording ualea a dln'ereqt date�e
�pcei5dd):
WARNING TO OWNER�ANY 1'AY1N�N'1'3 Mr#D�HY'k'H��WNER AF'CER T�EXPIRATION OF T�S NO'1'ICE Og
COM1Vl,ENCF.MENT ARE CO1V�iIDBR�D IMPROPER�AYMEN'�'S tJN1�ER CHAPTER?13�PART 1�SEC'!'XOIY 713.13.FL�RIDA
STATU'Y'�9 CAN RESUL'R'�N Y�DU�t PAYIIVG TWICE FOR III�'ROVEMEN�S'I'Q YOIJR PROFE81'Y.A NOTICE O$�p��pr
11�i73T BE H�C�RDEn AND P[�S'I`�D ON�,JQHSI'�'E�$�O��F�nYSP�CTION.IP'YOU INTEND TO�$'�AIIY�'iNANCIIYG,
CONSULT YUUR LENDER dR AN A'X"I'ORN�'�f!B�F'Q�CO�NCWG�WORK bR RECORDING YOi.l�t NOTICF OF
COMM�NCEM$N'1'.
State of Ftorida
Cowrty Of G � ,
�_
4,xr.� KEITH 8 AHLHEIM �"�"�n °ra""a��
_° ti� MY COMMISSION#EE137457 �
D(PIRES:OCT 12,2015 'n NBrtu
Tha fora 1 ��e9it�w���� ��� Chi9,�=dayof r p�by �
� `('type of authorityr,e.�officcr,trustee�ateomey In fsGU ,
�� (na�nc ot'parry on bd�alf of whom in e oe exeeute�,
Personapy Knowo---OR Produeed denti�icot;on� Nora�y Si�nawwte
Ty�p�of Idontlflcation Produced,�(�q� ���� '
--pIYD—
Verifeetion puisuent m Sedion 92.523,Florida Stacutes.Unda pe�talties of perJury�1 decla�e tf�at[ caed a foregoing end d ������m��of
my lmowlcdgo and bolia£
STO1tL�! ���
—_ � ofN� igni:�g(in line
�T�TE t�F FLOFtI��+, COUNT'�� �� �'�`��CC!
THIS IS TO CERTIFY THAT THF FOREGC}iI�G IS A
TRUE Ar�G GORREC7 CUPY�F THE DOCUI�ENT
ON FILE OR OF PUBLIC REGORD IN THIS OFFICE
WITNE S MY Hi�NC?FOND�7F.�ICIA4 SEALTM�{�
__��__r�av or-_���—_�
pa S O'NEl�, CLERK �CO��IPTROLLER
}�, .
o Yl_r�����FU�r������
813-780-ODZO l.�l[y OT LePflyffllli5 t'Eiflilll/-1NNIIVauvii '"^""' "'� �"`•'
Building Department � '
/n On�/ ��
Date Received �- 2 - 1i Phone Contact for Permittfn �3 2 9 - �'96�
Ownera N�me � - A G � Owner Phone Number ��3 '"`7d "ZZ. t�
Uwner's Addresa Ci���� �� Ownar Phone Number
Fee 3imple Titleholder Name Owner Phone Number� �
Fee 3lmple Titleholder Addreas
JOB ADDRESS T O Z-$ GQU/Z� � Z�'-�'�ti �l�J�S FG �3J� / LOT# ��
SUBDIVISION � �1 �� PARCEL ID# � -Z'6 "�/ ' d Z�O -Q�L�90 - Q�j,Q
(OBTAINED FROM PRQPERTY TAX NOTICE)
WORK PROP03ED e NEW CONSTR B ADD/ALT �] SIGN Q MOVE [� DEMOLISH
INSTALL REPAIR
PROPOSED USE [� SFR �] COMM Q OTHER
TYPE OF CONSTRUCTION �] BLOCK Q FRAME Q STEEL Q OTHER
DE3CRIPTION OF WORK �UlS/O N �O �eit/1�/�� Z g� - �'�d 3 �, O�J uNt�"S �i Sj
BUILDIN(3 SIZE 8Q FOOTA(3E HEIGHT �� �r�b �Oa �
7-�-(( I b 1.
[� BUILDING $ Q p- Q � VALUATION OF TOTAL CONSTRUCTION
6 0
Q ELECTRICAL ($ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
� ,
Q PLUMBINO ��
[� MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
� OAS Q ROOFINO � SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS � � FLOOD ZONE AREA QYES QNO
t ; s� � �. b �
BUILDER � ac COMPANY .
31r'aNATURE REGISTERED N FEE CURRENT Y/N
Address � Q X � 9 3 � p FL 32�f�7$ License# ����"��
ELECTRICIAN COMPANY
81GNATURE REGISTERED Y/ N FEE CURRENT Y/N
Address License# -�
PLUMBER COMPANY
31GNATURE REGISTERED Y/ N FEE CURRENT , Y/N
Address License#
MECMANICAL COMPANY
SI.GNATURE REGISTERED Y/ N FEE CURRENT Y/N
Address Ucense#
OTHER COMPANY
SIGNATURE REGISTERED Y/ FEE CURR6N�' � Y/N
Address License# ��
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new constructlon,
Minimum ten(10)working days after submittal date. Requlred onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed,
Sanitary FactliUes&1 dumpster,Site Work Permit for subdivisionsAarge proJects
COMMERCIAL Attach(3)sets of Building Plans;(1)set of Energy Forms.R-O-W Pe►mit`for new construcdon.
Minlmum ten(10)workfng tlays afte�submittal datu. Required onsR.e,Conshuctlon Fians,Stormwater Plans w/Sill Fence instailed,
Sanitary�adlttles 8 1 dumpster.Sfte Work Permit for all new proJects.All commercial requirements must meet compllance
SICiN PERMIT Attach(2)sets of Engineered Plans.
"""PROPER7Y SURVEY�equfred for aN NEW constructlon.
Directions;
FIII out applicatlon completely.
Owner&Contractor stgn back of applfcatlon,notarized
If over;25q0,a Notice of Commencement la required, (A/C upgrades over a5000)
" Agent(for the contractor)or Power of Attomey(for the owner)would be someone wlth notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Appllcation Onty)
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 restrlctive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENS�D CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner fias hired a contracto� or
eontractors to undertake work, they may be required to be licensed in accordance with state and Iocal regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor vtvlation
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�ounty Building Inspectfon 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 Blo.ck" 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 entitied to permitting p�ivfleges in Pasco
County.
TRAIJSPORTATION 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 expansio� 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, wili be identified at the time af
perrriitting. It is further understood that Transpo�tation Impact Fees and Resource Recovery Fees must be paid p�(or to
receiving a "certiflc�te of occupancy" or flnal power release. If the project does not involve a certfficafe of occupancy oc
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 tIEN LAW(Chapter 713, Florida Statutes, as amended): If valuatfon of work is $2,500.00 or more, 1
certify that i, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Fiorida Department of Agriculture and Consumer Affairs. If the applicant is svm�one
other than the"owner", I certify that I have obtained a copy of the above described document and promise in gopd falth tQ
deliver it to the"owner"prior to commencement.
�ONTRACTOR'S/OWMER'S AFFIDAVIT: I certify that ail the information in this application is accurate and that aA work
will be done in compliahce with all applicable laws regulating construction, zoning and land d�velopment. 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 fssuance of a permit and that all work will be performed to meet standards of all laws regulating
consCruction, 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 agencles may appiy to the intended work, and that it is
my responsibility to Identify what actions t must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmentai Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, WateNtNastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
' Watercourses.
- Army Corps of Engineers-Se�walls, Docks, Navigable Waterways.
- Department of Health � Rehabilitative Services/Environmental Health Unit-Welis, Wastewater Treatment,
Septic Tanks.
. - US�Environmental Protection Agency-Asbestos abatement.
- F�deral Aviation Authority-Runways.
I understand that the following restrictio�s apply to the use of fill:
- Use of flll is not allowed in Flood Zone"V" unless expressly permitted.
- If the fili material is to be used in Flood Zon� "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 engirteer
licensed by the State of Florida.
If the fill material is to be used in Fload Zone "A° in connection with a permitted buildfng using stem wali
construction, I certify that fill will be used only to fill the area within the stem wail. `
- • If fill material is to be used in any area, I certify that use of such fill will not adversely affect adJacent
prbperties. If use vf fill is found to adversely affect adjacent properfies, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lot5 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 fafth to inform the owner of the permitting conditions set forth in
this affidavit prfor to commencing construction. I understand that a separate permit may be required for electrical work,
plum6ing, signs, wells, pools, air conditioning, gas, vr other installations not speciflcaily included in the application. A
permit issued shail be construed to be a Iicense to proceed with the work and not as authority to,violate, cancel, aiter, or
set aside any provfsions'of the technical codes, nor shail issuance of a permit prevent the Building Official from thereafter
requlring�correction of�rrors in plans, construction or violations of any codes. Every permit issued shall become fnvalid
uniess the work �uthorized by such permit is commenced within six months of pe�mit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six(8) months after the time the work is commeneed. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and wiil demonstrate
justiflable cause for the extension. If work ceases for ninery(90)consecutive days, the�Job is considered abandoned.
1MARNING TO OWNER: YOUR FAILURE TO RE�ORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCI T, CONSULT
F�o pAQU�RT(ENDE ROR AN ATTORNEY BEFORE RECORDIlV Y N
�
OWNER OR A(3ENT. CONTRACTO
Subscribed and swom to(or aftirmed)before me this Subscribed and , o( r affirmed)bef re me is
b � b
Who is/are personally known to me or has/have produced Who Is/are personally known to m�or has/ha�ve P�rod�u�ed
as identlflcatlon.
Notary Public Notary Public
Commission No. Commissfon No. '
Name of Notary typed,printed or stamped Name of Notary typed,p�inted or stamped
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner:
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Date Received: ;�-Z�-l z'
Site: 7 � Z� �c72-u'"I`���-
Permit Type: .� ���h�G2�_S ��./>'Vf � �`�'���'
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Approved w/no comments: Approved w/the below comments: � Denied w/the below comments: ❑
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This comment sheet shall be kept with the permit and/or plans.
gf�-�Z
Kalvin witze lans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
�-�� 2012-05-17 07:49 (1854) 813-838-9008 - Ins Sales/CGC1508417 �w�/2 '-�' '
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Florida Building Code Online ra�c � u� �
Prcaduct Approval
IX:fR:PubUC User `
Producl.Anarvral..Men.v>Pmatvcc.ar.AvnLrGa.t(an.5earch>ARQ�(C81L00 A.(Af�Apallvtlon Dstsl/
FL A� FL11206-R6
Appllcatlon Type Revislon
Code Version 2010
Applicatlon Status Approved
*Approved b OCA. Approva/s by OC:A sha/1 be revlewed and re[IAed by the POC
and/or the ommisslon if necessary.
Comments
Archlved ��
Producl Manufacturer Pella Corporatlon
Address/Phone/Emall 102 MaJn St.
Pella, IA 50219
(641)621-6096
pellaproductapproval@pella.com
Authorized Slgnature TROY FARR
tbfarr@pella.com
Technlca/Representative Joseph Hayden REV��V�(,���.,,�� ��
Address/Phone/Emall 102 Maln Str�et �}�]�' =.- �Z
Pella, IA 50219 �F�'������;�f; ,
(641)621-6496 �'Lp►�'S �X��,1�,��.
Jahayden@pella.com �`
/
Quallty Assurance Representative Andrew Nefson
Address/Phone/Emai! 102 Maln St
Pella, IA 50229
(641)621-3804
ne/sona@pella.com
ALL WORK SHALL COMPLY WITHALL
cate9ory wtndoWS PREVAILING CODES,FLORIDA BUILDING
subcate9ory Single Hung CODE,NATIONAL ELECTRIC CODE AND
Ci:'X CF ZrPHYR,'�i1LLS O.RJINANCES
Compllance Method Certlficatlon Mark or Llsting
Certlflcatlon Agency Wlndow and Door Manufacturers Assoclat/on
Validated By lames L. Buakner, P.E. at CBUCK Eng/neering
� Va!ldatlon Checkllst-Nardcopy Rece/ved
Referenced Standard and Year(of Standard) Standard Year
AAMA 101/I.5.2-97 1997
AAMA 101/1.5.2/NAFS-02 2002
AAMA/WDMA/CSA IOi/1.5,2/A440-OS 2005
Equlvalence of Product Standards
Certlfled 8y
Product Approva!Method Method 1 Op'tlon A
Date Submitted 11/03/2011
http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQ�rtDqs6 WGOndIUH... 2/27/2012
Florida Building Code Online rage � or �
Da[e Valldated 11/07/201 i
D�te Pen,dlrsg FAC Approval .
Date Approved 11/10/2011
Summary of Products ��-------�--------__.__�...._._ ---• ---------•------ ---
�PL# Model Number or Name D scrJ tion
i i i206.1 Series 10 F/an ed Sin /e Hung Vl l F/an ed Sln le Hun W/ndow 54"x 90"
�1/mits of Use C rtffieat/on Ageney Certlfieate
IApproved for use Jn NVHZ:No f'L11206 R6 C CAC CCL for Pella 6-30-09 41i-H-1032.01-03.vdf
Approved for use oufslde HVH2: Yes Q}�a!!ty Assurance Confract Exp/ratlon Dafe
; impact Reslstant:IYO 06/10/2013
Deslgn Pressure: +30/-30 Installat/on Instruclfons
; Olher:Configuratlons of g/ass conform to latest ASTM E1300 �11106_R6 11 141�1f
I standard, Verified 8y: Warren W. :ichaefer, P.E. 44135
! Created by Independent Thlyd Party: Yes
; Eva/uallon Reporis
P 11206 R6 AE 1414.Ddf
! reated b Inde endent Th/rd Pa : Yes
�1 i�06.2 Series 10 flan ed S/n /e Hun V !flan ed Sin le Hun Window 52-1/8"x 73"
1lmlts of Use C,rtlf/cat/on Agency Certlflcate
� Approved for use fn HVHZ:No FL21206 R6 C CAC�C'L for Pella 6-3a-09 411-H-1032,05-07.odf
IApproved for use oulslde HVH2: Yes Q'p a!!ty Asaurance Confract L�xpiratlon Date
impact Resislant:No Q4/20/2013
Deslgn Pressure: +50/-50 Ihsla!la!!on Instruc[lons
( Olher:Configuratlons of gfass conform to latest ASTM E1300 FL11206 R6 II 1414,D1if
�standard. Verifled By: Warren W. Schaefer, P.E. 44135
� Greated by Indepe»dent Third Party: Yes
Evalua!!on Reports
� �L1.1.�.Q¢_R.�_��.�4i4•.2.d..(
� reated b Inde endent Thlyd Pa ; Yes
I 11206.3 Ser/es 10 F/an ed Sin /e Hung Vln !F/an ed S/n /e Hun Window 36"x 62"
�Llmits of t/se C rtlf/ca[fon Agency Cert/fJcate
� Approved for use in HVH2:No �12Q¢R¢��A�.�,(:.4„f�r.P,����-3QQ�4�,�!_�32.I�I�.p�lf
� Approved for use outslde HVHZ: Yes Qualfty Assurance ContraCt Explratlon Date
; Impact Reslstant:No 02/11/2013
! Des/gn Pressure: +55/-55 Ihsta!lat/on Inslructlons
; Other:Conflguratlons of glass conform to latest ASTM E2300 PLI�Q_6_R6 II i4l�cif
�standard, Verifled By: Warren W. Schaefer, P.E. 44135
Created by Independeni Thlyd Party, Yes
! Evaluallon Repo�ts
�?�Q.����19.�4,11�
dreated 6 Inde endent Thlyd Pa ; Yes
;11206.4 SerJes 10 P/an ed SJn !e Hun V n /F/an ed S/n /e Hun Wlndow 36"x 90"
�Lim/ts of Use C�rtlftcatfo»Agency Certlflcate
Approved for use fn HVHZ:No �L11206 R6�C��;1 fo�_�Ila 6-30-09 411-H_1032,0 -9 Il.vdf
; Approved for use outside HYHI: Yes Q,ua%/ty AssurBnce Contrac[Exp/ratlon Dete
; impact ResJstant:No 42/09/2013
; DesJgn Pressure: +50/-50 Ihsla/lation InstrucHons
; Other. Conflguratlons of g/ass conform to/atest ASTM Ei300 �L�1�CLl�¢ 11 141�pdf
I standard. Verlf/ed By: Warren W. .Schaefer, P.E. 44135
Created by Independent Thlyd Party: Yes
Eva/uatlon Reports
; �11206 R6 AE 14��51[
I Created b Inde endenf Thlyd Pa : Yes
'11206.5 Serles 10/20 Hlgh Performance Sing/e V)nyl N/gh Performance.'�ing/e Hung Twln Compos/te(72"x 65-
Hun 1/2"
!Llmifs of Use Gert/flcatlon Agency Cartlf/cate
; Approved for use fn HVHI:No �L11206 R6 C CAC�1-H-1093.odf
; Approved for use outsfde HVH2: Yes +�l,t1206 R6 C GAC 4�1-H- S.odf
i impact Res/stant:No Q;uality Assurance Conlract Expiraflon Date
� Deslgn Pressure: +5�/-50 11/17/2013
� Other;Conflguratlons of g/ass conform to latest ASTM E1300 Itista/latlon Instructions
i standard. FL2120¢R6 11 Or�wlnq.,�572.�df
Ve�lfled By: Warren W. .Schaefer, P.E. 44135
Created by Independenf Th/rd Party: Yes
EValuatJon Reports
; , 11206 R6 AE Dr��_q 1572•p�f
i ��eated b Inde endenl•Thlyd Pa ; Yes
i 11206.6 Serles 10/20 H/gh Performance S/ng/e Vfny/Hlgh Performance�31ng/e Hung Wlndow(42"x 72)
Hun
i Lim/ts of Use Certificallon Age»cy Certl�cale
http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqs6 WGOndIUH... 2/27/2012
r lorida �iuilding C:ode Unline rage s oi �
� App�oved for use/n HVHZ:No f • L for Pella 10-20-09 411-H-1o46 01 vdf
- Approved for use outside HVH2: Ves Q afity Assurance Conlract Expiration Date
; Impact Res/slanf:No 08/07/2013
; Deslgn Pressure: +50/-50 I►islal/ation Instruct/ons
� Other:Configuratlons of glass conform to latest ASTM E1300 FL11206 R6 f1 DrawJng 1572.D�
�standard. Verlfled By: Warren W. �;chaefer, P.E. 44135
; Created by Independent Thlyd Party: Yes
Evalualfon Reports
' FL11206 R6_AE Draw/no 1572.ndf
� C�ated b Inde endent Th/rd Pa : Yes
i 11206.7 Ser/es 10/20 S/n /e Hun Vl l S/n /e Hun W/ndow 48"x 72"
�Llmlts of Use C rttf/cation Agency Certiflcate
� Approved for use In HVH2:No F�.11206 R6 C CAC CCL for Pe!la 10-20-09 41i-N-1043 05 ndf
� Approved for use oulslde HVH2: Yes Q�al!!y Assurance Conl�ac[Exp/rallon Dale
; Impact Reslstant:No 08/04/2013
j Design Pressure: +35/-35 I�tstal/at/on Inslruct/ons
I Other:Configuratlons of g/ass conform to lafest ASTM E1300 FGi1206 R6 11 Ora�,ing 1572.Ddf
�standard. Verlfled By; Warren W, 5chaefer, P.E. 44135
C�eated by Independent Thlyd Party: Ves
� Eva/ua[!on Reports
i E��1�11���_A�.�[�1!19_��Z�,.RS_�L
eated b Inde endent Th/rd Pa : Yes
;]1206.8 Serles 10/20 S/n /e Hun VI l 5/n !e Hun W/ndow 48"x 59-1/2"
'L/m/ts oi Use C rtff/catfon Apeney Certlf/cate
Approved for use/n HVHZ:No .�Q¢����4G_���,�p�/a 10-20-09 411-�4�,Q�Q,Qdf
Approved for use outsfde HVHZ: Yes Q�ia/ity Assurance Contrsct Expiration Date
i Impac[Resistant:No 0 /04/20i3
� Design Pressure: +35/-35 I�atallation Instructions
Other:Configurat/ons of g/ass conform to/arest ASTM E1300 �f 1205 R6 I! Draw/na 1572.ndf
�standard. V,erifJed By: Warren W. 5chaefer, P.E, 44135
i O�eaced by Independent Thlyd Party: Yes
fya/uatlon Reports
� FL11206 R6 AF oraw/nq�72.,�df,
� dreated 6 Inde endent Thlyd Pa : Yes
j 11206.9 Serles 10/20 S/n fe Hung VI l Sln /e Hun Wlndow 36"x 59-1/2"
�L/mits of l/se C rt/flcadon AQency Cnrtlflcate
( Approved for use in HVH2:No F�.11206 R6 C Ga[ C L for Pella r0-2�-09 41�-H-1043.17,p�f �
I Approved for use outside HVHZ; Yes Q�ral/ty Assurance Conlract Explrat/on Date
IImpact Reslstant:No OB/03/2013
Deslgn Pressure: +35/-35 Ir�sfallat/on Instruct/ons
�� Olher:Conf/gu�at/ons of g/ass conform fo/atest ASTM Ei300 �11206 R6 1I Drawlna 1572•Ddf
standard. � VeNfled By: Warren. W. Schaefer, P.E. 44135
� Created by Independent Thlyd Party: Yes
� Eva/uat/on Reports
FLi1204 R6 AE Dra�n 1 72,�
Created b Inde endent Thlyd Pa : Yes
�11206.10 SeNes 10/20 Sln le Nun VI I 51n !e Hun W/ndow 48"x 84"
;L!mlts of Use C rt/f/cat/on Agency CorUf/cate
` Approved for use Jn HVH2:No 11 R6_ G_�q��C(,for Pel/a 10-20-09 411-H-104��i ��rf
� Approved fo�use outside HVHt: Yes �L for Pella 10-20-09 a��-u-+ne� �s.,.+s
i Impac!Resistant:No Q alfty Assurance Conlrac!Fxpiration Date
, Des/gn Pressure: +35/-35 08/07/2013
i Other:Conflgu�atJons of g/ass conform to/atest ASTM E1300 i�iafa//allon Inslruetions
standard. F�Q¢ R6 I�,1572.ndf
� VerJf/ed 8y; Warren W. ;,chaefer, P,E, 44135
(7reated by Independen[Thlyd Party: Yes
Eva/uaHon Reports
�206 R6 AE Orawina 2572.odf
� Crea[ed b Inde endent Thlyd Pa : Yes
��11206.11 Ser/es 10/20 Sln !e Hun V! I S!n le Hun W/ndow 36"x 72"
LIm!!s of Use C rNffcaHon Ageney CArtlflcafe
�� Approved for use!n HVHZ:No CAC�L for Pe/la 10-20-09 411-H-104� r���f
Approved for use outs/de HVHZ: Yes Q a/!ty Assurance ConMact Explrat/on Date
i Impact Reslslanl:No 0�/03/2013
� Deslgn Pressure: +35/-35 I stalle!!on InstructJons
! Other:Conf/gurat/ons of g/ass conform to latest ASTM E1300 F�i�1,Q¢ R�II D�w(ny��72,,�,��
�standard, erif/ed By: Wa�ren W. 5chaefer, P.E. 44135
C�eated by Independent Th/rd Party: Yes
Eva/ua!!on Reports
F(,11206 R6 AE Draw/ng 1572 ndf
' Created b Inde endent Thlyd Pa : Yes
!11206.12 Serles 10/20 S/n /e Hun V!' l S/n /e Hun Twln Com osite 72"x 53.5"
:LJm1ls of Use C,rtlficatJon Aqency Cnrtiflcate
http://www.floridabuilding.org/pr/pr_app_dtl.aspx?pa�am=wGEVXQwtDqs6 WGOndIUH... 2/27/2012
Florida Building Code Online Yage 4 or �
; Approved„for use in HVHZ:No fLi1206 R6 C CAC 411-H-1094.vdf
; Approu�ed for use outslde HVHZ: Yes ��a!!ty Assurance Contrsct Expl�atlon Date
; Impact Reslstanl:No 1�f/17/1013
� Deslyn Pressure: +35/-35 Itlsta/lat/o»instrucdons
� Other:Conflguratlons of g/ass conform to latest ASTM E1300 F�.11206 R6 1I Drawlna 1572.ndf
;standard. VeNf/ed By: Warren W. Schaefer, P.E. 44135
! Oreated by Independent Thlyd Party: Ves
EValuatlon Reports
i �11206__R6 AE D�awlna 1572.Ddf
� Created b Inde endent Thlyd Pa : Yes
I 11206.13 Serles 10 20 5/n le Hun VI I S/n le Hun Tw/n Com os/te 96"x 53.5"
L/mlts of Use C rtlfleat/on Ageney CerHf/eale
Approved for use/n HVHZ:No i20 R6 C A 411-H-1099.odf
Approved for use oufs/da HVHZ: Yes Q al/ty Assurance Contrac!Explratlon Date
Impact Reslstant:No 11/19/1013
Deslgn Pressure: +35/-35 Ir�staNatlon InsUuctlons
Other:Conflguratlons of g/ass conform to/atest ASTM E1300 FL11206 R6 11 Orewinu 1572.ndf
�standard. Uerlfled By: Warren W. Schaefer, P.E. 44135
Qreated by Independent Th/rd Party: Yes
Ei�a/ustion Reports
i CreatedbR�nde e�entT�,Pa�f: Yes
�
�11206.14 Ser/es i0/20 Sin le Hun V! 1 Sln le Hun Twln Com os/te 96"x 72"
I LIm/ts of Use CbrNficallon Ayency CorHf/cale
� Approved for use!n HVHI:No F' �1._?,Q6 g¢ C CAC g,��-L�1-1 Q,Q¢,,psl�
; Approved for use outslde NVHZ: Yes ��6 R6 C CAC�1-H-i100.vdf
i impact Reslsta»t:No Q�allty Assurance Contrac!Explratlon Dafe
' Deslyn Pressure: +30/-30 1;1/18/20i3
� Olher:Conflguratlons of g/ass conform to/atest ASTM E1300 Ir}stallat/on Ins[ructlons
�standard. �L21206 R6 II Oraw/nu 1572.vdf
U;erJf/ed By: Wa�ren W. Schaefer, P.E. 44135
Qrea[ed by Independent Thlyd Pa�ty: Yes
Ey�a/uatlon Reports
f' 1206 R6 AE Orawing i572.vdf
�reated b inde endent Thlyd Pa : Yes
'11206.15 Serles 10/20 Sln !e Hun Vln /S/n /e Hun Tw/n Com oslte 72"x 72"
L/mits of Use C rt/flcatlon AQency Cartlffcale
Approved for use!n HVH2:No �1-N-1092.,�f
i Approved for use oulside HVH2: Yes Q ality Assurance Conlract ExpJration Date
:. Impact Reslslanl:No 1�2/17/20i3
� Design Pressure: +35/-35 I stal/at/on instructions
Other:Conftgurat/ons of glass conform to latest ASTM E1300 �111206 R6 73 Orawinq i572.vdf
i standard. l�erified By; Warren W. 5chaefer, P.E. 44135
�ireated by Independent ThJrd Party: Yes
� E�ralustfon Reports
� f�L11206_R6 AF Orawlna i572.�f
': reated b Inde endent Thlyd Pa : Yes
�11206.16 SeNes 10/20 51n le Hun VI I F/xed With S/n /e Hun Flankers 108"x 72"
Lim/ts of Use C rtlt/ca!!on A�ency C�ertlf/ca[e
� Approved for use fn HVHZ:No R 12 CAC�f'L for Pella 411-H-950-02.odf
; Approved for use oulslde HVHZ: Yes q, allty Assurance Conlrac�Explratlon Date
Impact Reslstant:No 1�0/03/2015
� Des/gn Pressure: +30/•30 I�fstallaHon Insl�uctfons
� Olher:Conflgu�atlons of gfass conform to/atest ASTM E1300 PL21206 R6 I! Dra� I S�df
I standard. V:eNf/ed By: Warren W. Schaefer, P.E. 44135
Greated by lndependent Thlyd Party: Yes
E�a/uatJon Reports
L11206 R6 AE Drawlna i572.vdf
; reated b Inde endent Thlyd Pa : Yes
�11206.17 Series 10/20 5/n /e Hun V n /S!n /e Hun TN le Com os/te 108"x 72"
i L/mits of Use C rt/fJcatlon Agency CertlfJcate
i Approved for use!n HVHZ:No � 1 A _g,_il-H-1090.ndf
i Approved for use outside HVHZ: Yes 1 . CAC,_gj1-N-1101.�f
IImpact Reslstant:No Q al/fyAssurance Contrat[Expl�at/on Date
� Deslgn P�essure: +35/-35 3/3i/2014
IOther:Conflguratfons of g/ass conform to latest ASTM E1300 I stallatJon instruct/ons
standard. 6 R6 1I Dra�fnn i572.v�
erlfled By: Wa�ren W. Schaefer, P.E. 44135
reated by Independent Thl�d Party: Yes
� E aluation Reporta
I �IS 6 R A Dr wln4 1572.vdf
; reated b Inde endent Th/rd Pa : Yes
�11206.18 Serles 10/20 S/n /e Hun VI l 5/n !e Hun Tr/ple Com o5/te 108"x 53.5"
http://www.floridabuilding.org/pr/pr_app_dtl.aspx?pa;ram=wGEVXQwtDqs6 WGOndIUH... 2/27/2012
r lorida 13uilding (:ode Unline Yage � ot �
�ILIm/fs of Use C�rttficatfon Ayency Cnrtlficate
� Apprpv8d for use in HVHZ:No � fL11206 R6 C CAC 411-H-1098.ndf
� Approved for use outslde HVHZ: Yes Q1�aiily Assurance Contrac!Explratlon Date
� Impact Resistant:No 11/19/20i3
I Design Pressure: +35/-35 i�istal/atlon Insi�uct/ona
Other:Configu�atJons of g/ass conform to latest ASTM E1300 FL11206 R6 II Ora v�ny_,i572.ndf
�standard. VeNf/ed By: Warren W. ;,chaefer, P.E. 44135
' Qreated by Independent Third Party; Yes
� EVe/uatlon Reports
i f(.11206 R6 AE Drawlno 1572.vdf
Created b Inde enden[Th/rd Pa : Yes
�1120b.19 Serles 10/20 Sln le Hun Vl� l Flxed Over S/n /e Hun Com oslte 30"x 76"
I'Limfls of Use CerHficat/on AQency Gart/flcate
Approved for use!n HVH2:No FL11206 R6 C CAC 41�-H-1091.Ddf
I Approved for use outsfde HVHZ: Yes Q�ality Assurance Contraet Explrat/on Dale
� Impact Reslstant:No Ii1/10/2013
! Des/gn Pressure: +35/-35 Irlslal/at/on Inst�ucdons
�' Other:Conflguratlons of glass conform to/atest ASTM E1300 F�,11206 R6 11 Oraw/na 1572 ndf
standard. V.erlf/ed 8y: Wa�ren W. 5chaefe�, P.E. 44135
Created by Independent ThJrd Party: Yes
E�a/uatlon Reports
; L 1206 R6 AE D�awlno 1572.odf
� dreated b Inde endent Th/rd Pa : Yes
i
�'11206.z0 Serles 10/20 Sin /e Hun VI 1 F/xed Over S/n /e Nun Com oslte 46"x 76"
L/mlfs of Use C rtlflcadon Agancy Certlflcste
Approved for use Jn HVH2:No �.11206_R6 C CAC 4l1-H-1089.ndf
Approved fo�use oulsJde HVH2: Yes QI�a/!ty Assurance Con[ract Expirat/on Dale
� impae!Res/atanG No 1�1/i1/2013
Deslgn Pressure: +30%30 Irjstallatlon Instructlons
� Other:Conf/gurations of glass conforr»to latest ASTM E1300 ��,�Q��¢�T_(�w�,y,���Q�
i standard. eNt7ed By: Warren W. ,5chaefer, P.E. 44i35
Qreated by Independent Th/�d Party: Yes
IEya/uation Reports
! f 11206 R6 AE Drawln_q i57��lf
� reated b Inde endent Thlyd Pa ; Yes
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Florida Building Code Online Page 1 of 2
�r'oduct Approval
USER:Pubf![User
Praduct A�nra�ai Menu>Product.or aaAlrcatron Sea!Gn>AqRIiG�(iQR.LlSR>APpI/fAtl0�1 DetsU
FL # FL11161-R2
Applicatlon Type Afflrmation
Code Verslon 2010
Application Status Approved
Comments
Archived
Product Manufacturer Pella Corporation
Address/Phone/Email 102 Main St.
Pella, IA 50219
(641)62Z-6096
pellaproductapproval@peNa.com
Authorized Signature 1oe Nayden Sandi Robinson
pellaprodwctapproval@pella.com
Technica!Representative Alan Hughes
Address/Phone/Emall 2000 Pro/Ine Place
Gettysburg, PA 17325
(717)33�-Ii65
hughesajQpella,com
Quality Assurance Representative Ali Zarghami
Address/Phone/Emall 102 Main St
PeNa, IA 502i 9
(641)621-1000
zarqhamiaCa�peifa.com
Category Windows
Subcategory HorizontaJ Slider
Compliance Method Certiflcatibn Mark or Listing
Certlfication Agency Window and Door Manufacturers Association
Validated By James L. 9uckner, P.E. at CBUCK Engrneering
Vallda'tion Checklist-Hardco{>y Received
RePerenced Standard and Year(of Standard) Standard Year
AAMA i01/1.S.2-97 1gg7
AAMA/WDMA/CSA 101/1.5.2/A440-OS 2005
Equlvalence of Product Standards
Certlfled By
1 affirm that there are no changes in the new F/o�lda Building Code which
affect my product(s)and my prociuct(s)are In compliance with the new
Florida Building Code.
Documentation from approved Evaluation or Validation Entlty yes No N/A
FL11161 R2 COC om liance LErtter FL11i61.Ddf
http://www.floridabuilding.org/pr/pr_app_dtl,aspx?param=wGEVXQwtDqttaGsIp3 Gvuna... 2/27/2012
Florida Building Code Online Page 2 of 2
Product 4 yroval Method Method 1'Option A
Date Submltted 12/21/20i1
Date Vallda[ed 12/21/2011
Date Pending FBC Approval
Date Approved 01/OS/2012
_..-------..... _�_—-------._._--------______------------.._._�—..------------ --- ----
�Su�mmary of Products
�FL# Model, Number or Name D' scrf tlon
�11161.1 Serles 10/20 Sliding Window Vln I Sllding Window Ox'or XO, 73-1/2"x 60')
I Llmits of Use C�rtlficalion Agency C�srtificafe
; Approved for use!n HVHZ:No PLi1161 R2 C CAC CC'L for Pella 6-30-09 411-H-i025.05-07.odf
� Approved for use outs/de HVH2: Yes Q�alily Assuranee Contrac!ExpiratFon Date
; Impaet Resistanf:No 05/OS/2013
; Design Pressure: +30/-30 Ir�stallation Instructlons
� Other:Configurations of glass conform to latest ASTM E1300. PL11161 R2 II i59�ff
; Veriffed By: Warren W. :ichaefer, P.E. 44135
; Created by Independent Thlyd Party: Yes
i Evaluatfon Reports
� FL1i161 R2 AE 1597.Odf
( Created 6 Inde endent Third Pa : Yes
i11161.2 Series 10/20 S/idln Wlndow Vi /S/rdin Window Ok'or XO, 73-1/2"x 36"
'Limlts of Use Cbrtlficatfon Apency CHrtificate
Approved for use!n HVHZ:No �L11161 R2 C CAC CCL for Pella 6-30-09 421-H-1025.09-11�
Approved for use oufs/de HVH2: Yes QUallfy Assurance Conlrsc[Expfratlon Date
Impact Resistant:No OS/OS/2013
DesFgn Pressure: +35/-35 I�istallalfon Instructlons
� Other:Configurations of g/ass conform to latest ASTM E1300. �11161 R2 II 1597,pJf
� Verl�ed By: Warren W. ;�chaefer, P.E. 44135
C�eated by Independent Third Party: Yes
� fvaluation Reports
j FLI1,161_R2_AE 1597_pdf
� Created b Inde endent Third Pa : Yes
i11161.3 Series 10/20 Slidin Wlndow Vln 15Ildln Window XOX 108"x 60"
�Limits of Use Certlflcalfon Ayeney Gartiffcate
� Approved for use in HVHZ:No FL1.1161_R2 C CA�CCL_for Pella�§,-30,�09 4i1-H_102�.01=.Q3�df
; Approved for use outside HVH2: Yes Q}�ality Assura»ce Contract Expira[ion Date
i Impact Reslstant:No 05/06/2013
` Design Pressure: +20/-20 Installatlon instructions
Other:Conflguratlons ofg/ass confo�m to latestASTM Ei300. _F�11i61 R2 II 2597.prlf
i VeNfied By: Warren W. :>chaefer, P.E. 44i35
! Created by tndependent Third Party. Yes
Evaluatfon Reports
FL11161 R2 AE 1597 pdf
Created by Inde endent Thlyd Pa : Yes
;11161.4 Serles 10/20 S/ldin W/ndow VI' !Slidin Window XOX, i08"x 48"
!Limifs of Use Certlficalfon Agency Certificate
i Approved for use fn HVHZ:No FL11161 R2 C CAC CCL for_Pe!la 6-26-09 411-H-1031.01-03�
I Approved for use outside HVHZ: Yes Quality Assurance Confract Explratfon Date
Impact Resistant:No OS/07/2013
Design Pressure: +30/-30 Installation Instruclfons
� Other:Configurations of glass conform to latest ASTM E1300. F�161_R2 II 1,�97 pdf
� Verified By: Warrert lN. ��chaefer, P.E. 44135
Created by Independent Third Party: Yes
fva/uatlon Reports
FL11161_R2 AE 159�df
Created b Inde endent Thlyd Part : Yes
i
�11i61.5 Ser/es i0/20 Slidin Window VIn I Slidln Wlndow XOX, 108"x 36")
�L/mlts of!!se C$rtfficatlon Agency CHrtfffcate
�� Approved for use in HVH2:No F�.1 i16i R2 C CAC CCL for Pella 6-30-09 411-H-1026 09-ii odf
Approved for use outside HVHZ: Yes Qualfly Assurance ConRract Expfrstion Date
I� impact Resistant:No 05/06/2013
Des►gn Pressure: +35/-35 Installatlon Insfructions
Olher:Configurations of glass conform to latest ASTM E1300. FL11161 R2 II 1597.odf
! VQrlfled By: Warren W. 6chaefer, P.E. 44135
� Created by Independent Thlyd Party: Yes
� Evaluatlon Reports
' F411161 R2 AE 1597.odf
�
� C,reated b Inde endent Thlyd Pa : Yes
http://www,flori dabui lding.org/pr/pr_app_dtl.aspx?param=wGE V XQwtDqttaGsIp3 Gvuna... 2/27/2012
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