HomeMy WebLinkAbout12-13023 . - • CITY OF ZEPHYRHILLS
5335-8TH STREET ,--
(sis)�so-oozo 13023
BUILDING PERMIT
Permit Number: 13023 Address: 38604 TRELLIS AVE
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: ALPHA VILLAGE
Est. Value: Parcel Number: 35-25-21-005A-00000-1430
Improv. Cost: 2,878.00
Date Issued: 5/07/2012 Name: LULOFF, BRIAN
Total Fees: 75.00 Address: 38604 TRELLIS AVE
Amount Paid: 75.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/07/2012 Phone: (813)695-3631
Work Desc: REPLACE 7 WINDOWS SIZE/ SIZE
L 75.
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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 foliowing reasons: a)wrong address b)wndemned work resuiting
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 accessible.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
"Warning 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 fir�ancing,consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans, Specifications Must Accompany Application.All work shall be pertormed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O.
_ ,�2—P�
� CONTRACTOR SIGNAT RE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
. 1111111111111111111NIIfilllllilllllllllllllillllillllllllll
` 201206$993
Rcpt: 1430648 Rec: 10.00
D5: 0.00 IT: 0.00
N4TICE�OF CQMMENCEiV1�NT 04/24/12 K. Garc i a, �ptv C 1 erk
PAULq S 0'NEIL,Ph D PqSCO CLERK & COMPTROLLER�
PermitNo. _ 04/24/12 01:57pm 1 of 1
Tax Folio No. OR BK ���� PG �,(�,2�
35-,�,5-��- Qo�"�A. - aQOOC� - i �3c>
THE UNDERSIGNED hereby gives natice that the improvements will be made to real property,and in accordance wit�Section 713.13 of
#he Florida Statutes,the following infarmation is pro.vid"ed in this NOTICE OF COr%IMENCEMENT. ,
1.Description of property(Le ai descriptidn): A t ph.A V i I ll}�e. �5t�"re-5 �h!�S.rz,.� p.$2'� P9 S �°�I ��T !�3 v� ,�3 5�
a)Street(iob)Address: �8 0� � 2.__���Y �� S' �L �3 S�fC7 P� f Sa�.,�
2. General description of improvements•� �-:.;-^� ' 2A�l+G��"�'
3.Owner Information K R i s� '���A N
a)Name and addr•ess: � �, �.� � -�` � �e��,�� �l J� Z�d�.�.�1�,��C ,�� S�S-'[.f f7
b)Name and add�ess of ee simple titleholder(if other than owner) �—
c)Interest in properiy Owner
. ontractor Information
�Name and address: Lowes: ome.Ce ters c. .O.Box 8 Orlando.Ff.32878 ,
�iJ�Telephone No: l.�b'9—�'�4 2�:��0 _ ,Fax`No: r11 GC� . - ._
`5:S�ety I�ormation ' � -
.. ��j`.�?F�me;�d-adflress:=i�fi4 - - --
' b�Amount of Bogd: NA -
c}`�`�lephb�e No:�NA • " ' , �
6.�:�ni�er
a).�Tai�e=aiicl address: NA
b).Telepiione No: NA 'Fax.I�o: ;NA . ,
7.Id`entity of person within the State o€F�orida desigaa#ed hy owner upon whom riofices or other d�cuments may be served -
a)Name and.address=,NA
b}'Pelepliane No:_. NA : Fa�t No�NA : -
8. Iii:addiEfiori ta hitnself,:ovuner desi�i$tes the folIow�ig.�3eYSOn to�receive a.copy c►f tlie Lienor's Notice-as,�Qvided'it�Se�fic�t 713.13�I)(1�s�;:_„
FIori�da.Sfati►tes; ' , - - _ ' ` ' _
a I�iariie aiicf adclresss_NA � _ . - :;, . ' ,
'1' - ' -
•. ,::bj�<Telepl�one No. NA. � Eax:No;`" NA :,'. - - : � �..
,�9�EXp'iration date of l�Tatice of Com�i�ncemerit(th�~��tpirafibn d�te is one year f�oui`#Ite i�afe�of�recording,uql�s a-'differ�ri�'il��"is . ,�, �
sp�cified): - " � - : _
�
WARNING TO OWNI�R:ANY PAYMT3VT:3 N1ADE BX THE OW1V�R AFTER THE EXPIRATIOIV OF THI�NOTICE OF � -
COMMENCEMENT ARE CONSIDER�D IMPROPEli PAYMElNT'S UNDER CAAPTER 713,PART 1,SECTION 713.13.FI.ORiDA ,`
STAT�JTES CAN RESULT IN YOUR PAYPt iG TWICE F'OR IMPROVEMENTS TQ YOUR PROPERTY.A NOTICE OF CONfMENCEMENT
AJCfJ3T BE R�CORDEII AND POSTFiD ON THE JOBSITE BEFORE THE FI1t3T INSPECTION.IF YOU INTEND"TO OBTAIN�FINAI�VCING,
CON�ULT YOUR LENDER OR AN A'TTOItNE�Y BEF�RE COMMENCING�WORF:OR RECORDING YOUR NOTICE OF
CO1bIMENCE14iENT. � '
Stafe of Florida
County Of �{ �C ' 10.-� � ��' � .
igmture f or Oxmer'a Ai�t o 8 cer/Direa�/P ;na/Menega �
=�k1rRYI` KEITHBAHt,HEIM "•:.�` y Y__�_._`
� MY COMMISSION#EE137457 � Print N e ,
� EXPIRES:OCT 12,2015 � � � ,
The foregoiri instru en ac�Pl��l�16�f�91fNU� day of 0�-__,by�/� �i°�. ��,_.,..:
� e of authori
for ���� �� ry� g.officer,trustce,attomcy in fact)
�_ (name of party on beha(f of whom i sirument�executed). i
Personally Known OR Produced Identification � No �""�
tary Sigtature
Ty�pe of idenNfication Produced �L L Z- Name(Print).____ [✓�,.,K-/,-� �j ,�� ��,(�Ln,"
._qNp=_ —T•-`
Veri�cation pursuant to Section 92.525,Plorida Staiutes.Under penaities of perjury;I declare that I have read the foregoing and thaf the faots stated in it atie tiuo to�tHe:best of
my knowledge end be!'ref:
.
STORE#__,�� _ . (,�
_ - _ � ` 1S��gtts Te,Qf atucal Petson'Signi g line )Above
�, � �
STATE OF FLORIDA, COUt��'Y•t��#?44SE0��'
TH15 IS TC CERTIFY THA�'C#�;��1�EG,OIN�fS A
TRUE AND CORRECT CSbRY�F�'�E�Cf�l71UfENT
ON FILE Oh'OF PUBL1C�f��TrOf��tN 7HIS OFFICE
WITNESS MY HA�tG A �O�f ICIAL 5�A'��THIS
S�`- DAY OF ' ` �.�/�-
PA _A.S 'N�IL. CL f��OMPTROLLER
„_ / �,.
!�` - --�-� '' �2�•�t �CIEPlJT�' CLERk
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,.�.. �,,,, ,.,,..., vity vi �.cNt�yiinua rci�inir��Niwauvi� � �..-,.�.,-,.,�-.,��.�
. � Buliding Department
{�✓�o �c
Date Received � �7/ phone Contact for Permittin �d�3 Z _ `�'9�-
Owne�'s Name l� f�� �-- Owner Phone Number �3 -3��`'- Q7Z
Owne�'s Address � p b �� �S� Owne�Phone Number —�
Fee Stmple Titleholder Name Owner Phone Number �
Fee Simple Titleholder Address
JOB ADDRE33 3� T�� j S A�- Z�-P�i���i�JS �L 33 SY7.� LOT# / �3
SUBDIVI310N F� ��`T s pARCEL ID# 3-�Z.�-2-��D��R 'C�jp - ��1'30
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED B NEW CONSTR e ADD/ALT Q SIGN Q MOVE Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION � BLOCK Q FRAME Q STEEL Q OTHER
DE3CRIPTION OF WORK '�C.Y�AClL � �,J cIp �J S�L �;Z, � � �,, ���b�� � -
BUILDINO 31ZE 3Q FOOTAGE HEIGHT
0 BUILDING �$ -����, Q � VALUATiON OF TOTAL CONSTRUCTION
1
0 ELECTRICAL � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
0 PLUMBINO $ 2�Z3
� r J
Q MECHANICAL �� VALUATION OF MECHANICAL INSTALLATION
0 GAS Q ROOFIN(3 � SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS (� � FLOOD ZONE AREA QYES ONO
�
� � � �
BUILDER �,��` COMPANY -�e� , ,
SIGNATURE �`� REGISTERED N FEE CURRENT Y/N
Address � �t $1 �q'3 1 � F(,3 Z$7 g Ucense# C���5�{-1�
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
Address Llcense#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
Address License# —�
MECHANICAL COMPANY
SIGNATURE
REGISTERED Y/ N FEE CURRENT Y/N
Address L(cense# —�
OTHER
SIGNATURE COMPANY
REOISTERED Y/ FEE CURRENT � Y/N
Address l.icense# —�
RESIDENTIAL Attach(2)Piot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new constructlon,
Minimum ten(10)work(ng days after submittal date. Requlred onsite,ConstrucUon Plans,StoRnwater Plans w!Silt Fence installed,
Sanitary FacfllUes&1 dur,�pster;Site Work Permit fo�subdivisions/large pro)ects
COMMERCIAL Attach(3)sets of Butlding Plans;(�i)set of Energy�orms.R-O-W Perm(t`For new construcUon.
Mtnimum ten(10)werk(ng days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/S(It Fence Installed,
Sanitary FaGlides&1 dumpster.Site Work Permit for all new proJects.All commerclal requlrements must meet compliance
31GN PERMIT Attach(2)sets of Engineered Plans.
"*"PROPERTY SURVEY required for ali NEW constructlon,
Dlrections:
Fill out appllcatlon completely.
Ovmer&Contractor slgn back of appiicaUon,nota►ized
If over s2500,a Notice of Commencement Is�equired. (A/C upgrades over a5000)
'" Agent(for the contractor)or Power of Attomey(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
�
NpTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed" restrictions"
which may be more restrictive than County regulatfons. The undersigned assumes responsibility for compliance with any
applicable deed restrictlons.
UNLICENSED CONTRACTORS AND CONTRqCTOR RESPONSIBILITIE3: If the owner has hired a contractor or
contractors to undertake work, they may be req4ired to be Iicensed in accordance with state and local regulations. If the
contractor is not Iicensed as required by law, both the owner and cont�actor may be cited for a misdemeanor violation
under state (aw. If the owner or intended,contrpctor are uncertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County Buflding Inspection Division—Ucensing Secfion at 727-847-
8009. Furthermore, if the owner has hired a contractor or cont�acto�s, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they wiil be responsible. If you, as the owner s(gn as the
contractor, that may be an indicatfon that he is not properly Iicensed and is not entitied to permitting privfleges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPA�7 AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Atecovery Fees may appiy to the construction of new buiidings, change of
use in existing buildings, or expansion of existing buildings, as spec�ed 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
perrr�itting. It is further understood that Transportation Impact Fees and Resource Recvvery Fees must be pafd prior to
receiving a °ce�ti�c�te of occupancy" or flnal power release. If the proJect does not involve a certificate of occupancy or
flnai 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 prfor to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713, Fiorida 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 appiicant is someone
other than the"owne�", I certify that I have obtained a copy of the above described document and promise in good faith to
delfver it to the"owne�"prlor to commencement.
CONTRACTOR'SIOWNER'S AFFIDAVIT: I ce�tify that all the information in this appUcation 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 instaliation has
commenced prior to issuance of a permit and that ail 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 tY�at I understand that the regulations of otFier government agencies may apply to the intended work, and that it is
my responsibility to Identify what actions t must t�ke to be in compliance. Such agencies include but are not limited to:
- Depa�tment of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, WateNWastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
' Watercourses.
- Army Corps of Engineers-Se�walls, Docks, Navigable Watervvays.
- Department of Health 8� Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
. - US�Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways.
i understand that the followfng restrictioFlS appiy to the use of fill:
- Use of flll is not allowed in Flood Zone"V" unless expressly permitted.
- If the flll material is to be used in Flood Zone "A", it is understood that a drainage pian addressing a
"compensating volume" wfll be submitted at time of permitting which is prepared by a.professfonal engineer
Ilcensed 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 wali
construct(on, I certify that fill will be used only to flll the area within the stem wall. '
- if fili material is to be used in any area, I certify that use of such fill will not adversely affect adJacent
properties. If use of flll is found to �dversely affect adjacent properties, the owner may be cited for vfolating
the conditions of the building permit issued under the attached permit application, fpr lot5 less than one (1)
acre whfch are elevated by fll, an engineered d�ainage plan is required.
If I am the AGENT FOR THE OWNER, i promfse in good faith to (nform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plum6ing, signs, wells, pools, air conditioning, gas, or other installations not specifically ihciuded in the application. A
permft issued shaii be construed to be a Iicense to proceed with the work and not as authority to,vidiate, cancel, alter, or
set aside any provfsions of the technical codes, nor shall issuance of a permit prevent the Bufiding Official from thereafter
requlring a correction of errors in plans, construction or v(olations of any codes. Every permit issued shall become invalid
unless the work 8uthorized by such permit is commenced within six months of pe�mit issuance, or if work authorized by
the permit fs suspended or abandoned for a period of s(x(6) months after the time the work is commeneed. An extension
may be requested, in wrfting, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justiffable cause for the extension. If work ceas�s for ninety(90)consecutive days, th�job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RE�ORD A NOT{CE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YQUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WI Y R Y BE. R IN Y MENT.
FLORIDA JURAT(F.S. 11�03) � �
OWNER OR A(iENT. CONTRACTO `
Subscribed and swom afffrmed)before me thia Subscrlbed and m to(or affirme before me th s
by ' bY
Who islare personally known to me or has/have produced Who is/are Personaily known to me or has/have produced
as idendfica8on. as Identlflcatlon.
Notary Publlc Notary Public
Commission No. Commisslon No. '
Name of Notary typed,p�inted or stamped Name of Notary typed,printed or stamped
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Contract Totai �(�^•�J�
I • , "appfscable tazes included Q �
INQTIC�TO�G�IBTOMER:'Fscktp)law•,r,equir�i Loine's fio provide�y,ou witNi the pamphkt�Renovate�RiBht'�y►�igning:tliis.'C�nlra,ct; Cus�an��
i -. ao�Owiecl9es.tiaving recef�d•a•coQ�r•Qt tbls•PampFOe�.befdro•yro�l[bagsn�MoRnhtgCUStomsr:of t�ie;potsnlMt•rlgk of•1ha.isad�hai�d�,�s�(oaa�
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P•.H.OJ'O,REL�ASE:Eustangc,geants.'ta•LQw@'jr.�ixf L•o1Ni9`s;etiiptoj!ees•tNe'righ�:.so'take:pfiqit;Q�rep�jB�ofal('wcrlcpe'�•at�#je;pi'�t►Zi�e9 rel6tttedto,tht5
,GoFt�d,,a�r�iRe�ocd�tlY�9�nt$xC,�.ov�;s;�llrt9ht�.'�itl.e�d. i.ri�?.�eskl��nd•tqtheP�o�.�P�S�for.usainFall�msrtce,?,s , msd`rJ'�;+�i?M►lda��ni��fuity.
'Cu'stQ►'r�9r;autlio[ize§"Lovi+��s�ta�cQpy�t,i;'��;seFrapd putillsFi tha pTiotqpraphs In prl�r�andi"c�:e�ec�,�ir�i,,a,nd� ae��:�iat°4;a�a..-�Y us�-s��n •
ptloEqgiap'hs.for any lawfulp�rpo�e� ind �ing;��isi�ciUp,Had�ro,►„ariie�iny,..aavara'si►,�,;pl�blir�ty, inustr�cion; hafning�'end:vl�efi�oa,�;�.•.�y`�iniqai�i�
here;.Cilstortier agreqs!o die foragoing:•,,.: �. � [CU9tomer to initial to tii�I�}t�,� , . , , . '�_
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' ,Wor�i. co�p¢et�ce upp reas�o!abla aq IlabdlEy of GoMractq'r�andJqi�any spaCi r pt Cu �rr►�r..m �e<Qo (�).wFiich.is'ar�ipaEed'tu.#ie
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Safd,e�stfmat�ed substantlal comp�otlon data IC•not Of tha'v.=�er►de..i�stafecrtenE bf any oor�iingeincies,that would•�malwiell,y Nc�iafl�e said�estirifated 9i1b5tan'Tietl
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� , PAGE3.OF TH1S CONTRACT.BY SIGNING BEL.OW,YOU ARE AGKN01111L�bGING�THA�YOU H�E REi�f','�IV���1[QI'�"
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Product Approval �
USfR:Publlt User
• •
P�aduct_Aaacova!Meau>Pm_dvst Qr.Aaa/r��;i�n.��a!rn>ARD1(CallO�...�lSL>AaPllcatlon D N
FL # F 1152-R5
Application Type ffirmallon
Code Version 010
Applicatron Status ! Approved
Comments
Archived
Product Manufacturer Pe orporatlon
Add�ess/Phone/Email 102 Main St. ,
Pe!la, IA 50219 ALL WORIL SHALL COMPLY WITH ALL
(641)621-6096 �EVAILING COI)ES,FLORIDABUILDING
pe!lap�oductapprova/@pe//a.coCODE,NATIONA'�.ELECTRIC CODEAND
Authorized signature Joe Hayden Sand!Robinson CITY QF ZEPI�YR�IILLS ORDII�1AI�cEs
pellaproductapproval@pella.com
Technica/Representative Joseph Hayden
Address/Phone/Emaif 102 Main Street
Pella,IA 50219 �j ���� �
(641)621-6096 '`���\#F���r�` ���,"�"j`, s.i
jahayden@pella.com
i 3T`Y s��' ����iY'F�I�l�.��y`'�
QualityAssurance Representative Andrew Nelson p#�AN� EXAMfN�R ���
Address/Phone/Emai! 102 Main St
Pella, IA 50219
(641)621-3804
nelsona@pella.com
Category Windows
Subcafegory Double Hung
Compliance Method Certiflcation Mark or Listing
Certifrcatron Agency Wlndow and Door Manufacturers Association
Validated Sy James L. Buckner, P.E, at CBUCK Engineering
Validatlon Checklist-Hardcopy Received
Referenced Standard and Year(of Standard) Standard
Year
AAMA 101/I.S.2-97 1997
AAMA 101/L5.2/NAFS-02 2002
AAMA/WDMA/CSA 101/1.5.2/A440-OS 2005
Equivalence of Product Standards
Certifred By
I affirm that there are no changes In the new Florida 8uilding Code which
affect my product(s)and my product(s)are in comp!lance wrth the new
Flo�lda Building Code.
Documentatlon from approved Evaluation or Va/idation Entlty yes No N A
/
http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqttaGsIp3 Gvul V... 4/20/2012
--------__.__...b ...,,.., .,..�...., Yage 'l ot 4
Product Approval Method
Method 1 Option A
Date Suh,mltted 12/09/2017
Date Validated 12/09/2011
Date Pending FBC App�oval
Date Approved 12/14/2011
�-------------.__- -- ----------------
iSummary of Products - --------- ---------------------
FL# Mode/ Number or Name Descri tion i
i11152.1 Serles 20/25 Double Hung Viny/Doub/e Hun WJndow 48"x 62') j
Limits of Use Certification Agency Certiflcate �
! Approved for use/n HVHZ:No FL11152 RS C CAC 411-H-859 32-35 Ddf �
� Approved for use outside HVHZ: Yes FL11152 RS C CAC 411-H-862.36-.39.pdf �
' Impact Resistanf:No Quality Assurance Conlract Expira[ion Date �
� Design Pressure: +25/-25 04/18/2015 �
Other:Configurations of g/ass shall conform to current ASTM Insfa!lation Instruclions
;E1300 standard. FL11152 RS II In ta��arlon Orawina 1596 C odf �
Verifred By: Warren W. Schaefer, P.E. 44135
Created by Independent Third Party: Yes !
fvaluation Reports
FL11152 RS AE Installation Draw,rng_1,596 C..pdf �
Created b Incie endent Third Pa : Yes
11252.2 SeNes 20/25 Double Hung Viny!Doub/e Hun Window(36"x 72') �
Limits of Use Certification A enc Certificate ;
; Approved fo�use in HVHZ:No FLI1152 RS 9 y I
Approved for use outside NVHZ: Yes ------ �--C?.0 411_-H_859.24_27,pdf
' Impact Resisfant:No PL11152 RS C CAC 411-H-862 28-3�df �
; Design Pressure: +30/-30 Quality Assurance Contract Exp/ration Date i
: Other;Configurations of g/ass shall conform to current ASTM Ins�a�lat on Instrucfions I
�E1300 standard. FLi1152 RS II Installation Drawino 1596 C odf �
VeNfied By: Warren W. Schaefer, P,E. 44135
Created by Independent Third Party: Yes
Evaluation Reports •
FL11152 RS AE Installation Drawino 1596 C pdf
Created b Inde endent Thlyd Pa : Yes ;
1115Z.3 Series 20/25 Doub/e Hung Vin /Double Hun W/ndow(36"x 62') I
;L�imils of Use Certificatfon Agency CertifTcate �
pproved for use Jn HVHZ;No FLI1152 RS C CAC 411-H-859 28-31 pdf l
! Approved for use outside HVHZ: Yes FL11152 RS C CAC 411-H-862 32-35 vdf
; Impact Resistant:No Qual�ly Assurance Cont�act Ex ira[lon Date
Design P�essure: +35/-35 04/18/2015 P
Other:Configu�ations of glass shal!conform to current ASTM Insta/lation Instructions i
E1300 standard. FL11152 RS 11 Installation Drawino 1596 C odf �
Venfied By: Warren W. Schaefer, P.E. 44135
Created by Independent Third Party; Yes
Eva/uafion Reports
FL1.1,152 RS AE In.�tallation Orawing 159¢C,pdf �
Crea[ed by Inde endent Thr�d Party: Yes
11152.4 Se�ies 20/25 Doub/e Hun Vin /Double Hun Twin Composite(89"x 78') �
:Limits of Use Cert/ficatlon Agency Certl�cate '
Approved for use In HVHZ:No FLI1152 RS C CAC CCL fo�Pella 7 14 11 411 H$66 12 15 ndf �
i Approved for use outside HVHZ: Yes FL11152 RS C CAC CCL for Pella 7 14 11 411 H 86718 21 pdf i
Impac!Resistant:No Qua/Ity Assurance Cont�act Expirat/on Date
Desfgn Pressure: +20/-20 04/18/2015
Other:Confrgurations of g/ass shall conform to currenf ASTM Insla!!atlon Instructions �
E1300 standard. FL11152 RS II Installation Orawino 1596 C odf �
Verified By; War�en W. Schaefer, P.E. 44135 !
Created by Independent Third Party• Yes
EvaJuation RepoKs j
FLi1152 RS AE Installation D�awina 1596 C odf i
Created by Independent Third Party: Yes
;11152,5 Series 20/25 Doub/e Hun V/n /Doub/e Hun Twin Com oslte 96-1/2"x 71"
Limits of Use Certif/catfon Agency Cert/ficale �
Approved for use in HVHZ:No FLi1152 RS C CAC CCL for Pe!la 7-14-11 411-H-866.16-.19.odf �
Approved for use oulside HVHZ: Yes FL11152 RS C CAC CCL for Pe!!a 7 14 11 411 H 867 22 25 Odf i
impact Res/siant:No Qua/ity Assurance Contract Exp�ralion Date i
� Des/gn Pressure: +25/-25 04/28/2015
Othe�:Configurations of g/ass shall conform to current ASTM Insta/latlon instructions �
E2300 standard. FLi1152 RS 11 Installatlon Drawino 2596 C odf
�
VeNfled By: Warren W. Schaefe� P.E. 44135 ;
Created by Independent Third Party: Yes ;
I
http://www,floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqttaGsIp3 Gvul V... 4/20/2012
. ..,..u,. �,...u..�� ..,....., �.���,�,� Page 3 of 4
� Evaluatfon Reports
FL11152 RS AE Insta/lation Draw/nq 1596 C vdf �
Cr�ated b Inde endent Thlyd Party: Yes �
;11252.6 Serles 20/15 Doub/e Hun V!n I Doub/e Hun Twin Com osite 72-1/2"x 72"
;Limits of Use Certificalion Agency Certi�cate !
; Approved ior use in HVHZ:No FL11152 RS C CAC CCL for Pella 7-14-11 41i-H-866.32-.35.ndf I
� Approved for use outside HVHZ: Yes fL11152 RS C CAC CCL for Pella 7-14-11 411 H 867 38 41.odf ;
' Impact Reslstant:No Qua/rty Assurance Contract Expiration Da[e
Deslgn Pressu�e: +35/-35 04/i8/2015 �
; Olhe�:Configurations of glass shall conform to current ASTM Installation Instructions
;E1300 standard. fLi1152 RS II In tallat/on Draw/no i596 C vdf '
Verlfied By: Warren W. Schaefer, P.E. 44135
Creafed by Independent Thi�d Party: Yes
Eva/uaHon RepoKs !
PL11152 RS AE Installation Orewina 1596 C vdf i
C�eated by Independent Thlyd Party: Yes
i 11152.7 Series 20/25 Doub/e Hun Vlny/Doub/e Hung Trip/e Com osite(89"x 78') �
�Amits of Use Certificatlon Agency CeKi�cafe ;
pproved for use in HVH2:No FL11152 RS C CAC CCL for Pella 7-21-11 411 H 872 12 IS odf ;
; Approved for use outside HVHZ: Yes FL11152 RS C CAC CCL for Pella 7-2i-11 4i1 H 873 12 15 Ddf i
� Impact Resistant:No Qualfty Assurance Contract Expira[ion Dafe
Design Pressure: +30/-30 04/18/2015
Other:Configurations of glass shall conform to current ASTM insta//ation Instructions �
;E1300 standard. fL11152 R5 II Installation Drawina 1596 C odf j
Ve�lf/ed By: Warren W. Schaefer, P.E. 44135 '
Created by lndependent Third Party: Yes
Evaluat/on Reports
FL11152 RS AE Insta!latlon Drawino 1596 C•pdf
Created by Independent Third Party: Yes
i 1152.8 Se�ies 20/25 Doub/e Hung Viny/Doub/e Hun Tr/p/e Composite 108"x 72') �
�Limi[s of Use Certificat/on Agency Certiffcate
; Approved for use in HVHZ:No FL11152 RS C CAC CCL for Pella 7-21-11 411-H-872.16-.19 pdf ;
; Approved for use outslde HVHZ: Yes FL11152 RS C CAC CCL,_for,Pella 7,-21-11 411-H-873.1_6-,1.9.pdf i
! Impact Resistant:No Qua/ity Assurance Conlract Exp/rafion Dafe
Des/gn Pressu�e: +25/-25 04/18/2015 '
; Other:Configurations of glass shal!conform to cu�rent ASTM Instal/at/on Instructions !
!E1300 standard. FL11152 RS 11 Installation Drewing 1596 C odf �
Venfied By: Warren W. Schaefe� P E. 44135
Crea[ed by lndependent Third Party: Yes
Eva/ualion Reports
FL1i152 RS AE Installation Drawina 1596 C odf �
Creafed b Independent Third Party: Ves
11152.9 Se�ies 20/25 Doub/e Nung V/ny/Doub/e Hun TNp/e Com osite(108"x 62')
Limits of Use CertificatJon Agency Certificate ,
App�oved for use in HVNZ:No FL11152 RS CAC CCL for Pella 7-11 i 1 411 H 872 20 23�df �
; approved/or use outside HVHZ: Yes FL11152 R5 C CAC CCL for Pella 7 21 11 411 H 873 20 �3 vdf +
Impact Reslstant:No Quality Assurance Contrac!Ex lration Date
Design Pressure: +35/-35 04/18/2015 P '
Other:Configurations of g/ass shall conform to current ASTM Insta/lation Instructions
E2300 standard. EL11152 R5 II Installatlon Drawina 1596 C ndf I
Ver�fied By: Warren W. Schaefer, P.E. 44135 ,
Created by Independent Third Party: Yes �
Evalua[fon Reports
FL11152 RS AE Installation Drawing 1596 C adf
Created by Independent Third Party: Yes �
11152.10 Series 20/25 Doub/e Hun Viny/Doub/e Hung Wlndow(48"x 78')
;�mits of Use Certification Agency Certl�cate
pp�oved for use in HVHZ:No FL11152 RS C CAC 411-H-859 20-23 pdf
Approved fo�use outside HVH2: Yes L _ �CAC 41,1-H=862,20-,23,pdf
' ImpattRes/stant:No f_1��2 RS i
Design Pressure: +20/-20 Qua/ity Assurance Contrac!Exp/ration Date ;
Other;Configu�ations of g/ass shall conform to current ASTM Insta�/ation inst�uctions
E1300 standard. FL11152 RS II Installat/on Orawino 1596 C odf
Venfied By: Warren W. Schaefer, P.E. 44135 �
Created by Independent Third Party: Yes '
Evaluatlon Reports
FL11152 RS AE lnstallatlon Drawina 1596 C�df
Created 6 Inde endent Thlyd Party: Yes
�11152.11 SeNes 20/25 Double Hung V/n l Doub/e Hun Twin Composlte 96-1/2"x 53') i
:�mits of Use Certlf/cadon Agency Certif/cate
; pproved for use In NVHZ:No FL11152 RS C CAC CCL for PeNa 7-14-1i 411-H-866.24-.27.odf j
Approved for use outside HVHZ: Yes FLIi152 R5 C CAC CCL for Pella 7 14 11 411 H 867 30 33pdf �
Impacf Resistanf:No Qua/fty Assurance Conlract Explration Date
I
http://www,floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqttaGsIp3 Gvul V... 4/20/2012
_ ______ �__.�...b �,,..,, �.�,.,,� Yage 4 ot 4
I Design Pressure: +35/-35 04/18/2015 !
� Other:Configurations of glass shall confo�m to cu�rent ASTM Insta/lalion instructions i
'E1300 standard. FLs11152 RS II Installatton Drawina 1596 C odf
Veri�ed By: Warren W. Schaefer, P.E. 44135 j
C�eated by Independent Third Party: Yes �
Evaluatfon Reports i
fL11i52 RS AE Insta!lation Orawlno 1596 C.pdf '
Created by Independent Thi�d Party; Yes '
!11152.12 Serles 20/25 Double Hung Vin /Doub/e Hun Twln Composite(96-1/2"x 62') I
i L/mits of Use CertfficatJon Agency Certifcate
; Approved for use in HVHZ:No FL21152 RS C CAC CCL for Pella 7-14-11 411 H 866 20-.23_odf
: Approved for use outside HVHZ: Yes
FL11152 RS C CAC CCLforPella.7-14-11.411_-H-867.26_.29pdf �
� Impac!Resistant:No Qua%ity Assu�ance Coniract Expiration Date �
Des/gn Pressure: +30/-30 04/18/2015 I
' Other:Configuretions of g/ass sha!!conform to current ASTM installatfon Instruclions i
!E1300 standard. FL11 i52 RS II Installation Drawino 1596 C'odf �
Ver�fied By: Warren W. Schaefer, P.E. 44135
Created by Independent Third Party: Yes
Evaluation Reports
FL21152 RS AE Installation Drawino 1596 C edf '
Created by Independenf Thlyd Party: Yes �
'11 i52.13 Series 20/25 High Performance Double Viny!High Performance Doub/e Hung TwJn Composlte(72-1/2"x �
Hung 72')
:'Limfts of Use Certification A enc Certi�cate i
; App�oved for use in HVHZ:No 9 Y
FL11152 RS C CAC CCL for Pella 7-14-i1 411 H 866 28 31 odf �
`: Approved for use outside HVHZ: Yes FL11152 RS C CAC CCL fo�Pella 7-14-11 41 i-H-867.34-.37•pdf
Impacf Resisfant:No Quality Assurance Contract fxpiratfon Date
; Design Pressure: +50/-50 04/18/2015
; Other:Configurations of g/ass shaU conform to current ASTM Insta//at/on Inslructions i
;E1300 standard. High performance windows shall have metal t!lt FL21152 R5 II Installatlon Orawino 1596 C ndf
/atches on the bottom sash inteNock. Ven�ed By: Warren W. Schaefer, P.E. 44135
Created by Independent Third Party: Yes
Eva/uation Reports
FL12152 RS AE Installatron_Drawing_I596._C,pdf i
Created b Independent Thlyd Party: 1'es I
11152.14 Series 20/25 High Perfo�mance Double Vlny/High Performance Double Hung Window(48"x 72') i
' Hung ��
�Limils of Use Cerllfication Agency Certfflcate �
; Approved for use ln HVHZ:No FL11152 RS C CAC 411-H-859 48 Sl pdf �
; Approved for use outside HVHZ: Yes FL1i152 RS C CAC 411-H-862 24-27 odf �
Impact Res/stant:No Qualrty Assurance Contract Expiratfon Date
Design Pressure: +50/-50 04/25/2015 �
Olher:Configurations of g/ass shall conform to current ASTM insta!laflon Instruclions
,E1300 standard. High perfo�mance windows shal!have metal tllt FLi1152 RS II Installatlon Drawlno 1596 C odf
latches on the bottom sash interlock. Verlfied By: Warren W. Schaefer, P.E. 44135
Created by Independent Thlyd Pa �
rty: Yes
Eva/uaffon Reports
FL11152 RS AE Installation Drawina 1596 C_pdf
� C�eated by Independent Third Party: Yes ;
http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqttaGsIp3 Gvul V... 4/20/2012
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Florid� Building Code Online Page 1 of 2
��` Product Approvaf
USER:Publlc User � �
Product AAn�o�s�Mfl`nv>P(OflUGf Q{AppllG��{OA SCA(Gh>AtlRKCdL1CR I.�St>aPPJ�cat/on Dete
FL # fL11161-R2
Applicatlon Type Afflrmation
Code Version 2010
Appllcation Status Approved
Comments
Archived
Product Manufacturer Pe!la Corporation
Address/Phone/Emai! 102 Main St.
Pella, IA 50219
(641)621-6096
pellaproductapprova!@pella.com �R�[��� s�'�L��O
AILING��DES MPLY44-i;���, ,�, t
Authorized Signature 1oe Hayden Sand!Ro6inson (,'� F
pellaproductapproval@pella.com C,j D��N`��1�,9L ELE,C O�P 'y! ;J;�;�(j
�FZEP RHIL �r � :��3y`,�,�U
Technical Representative Alan Hughes
LSOR :,,,,, , ,.
Address/Phone/Emai! 2000 Prollne Place +;�{ }r�
Gettysburg, PA 17325
(717)338-1165
hughesaf ppella.com
'���;�
Quality Assurance Representative Ali Zarghami *,;�a���(���.�'��!
Address/Phone/EmaJl 10�Mafn St
Pella,IA So219 ^��� ����.jl., -., ��
(641)621-1000 NaS'� F� j t� ` -�
zarghamia@pella.com �M�r��p,
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Category Windows `'��-�
Subca[egory Horizonta!Slide�
Compliance Method Certificatlon Mark or Listing
Certlfication Agency Window and Door Manufacturers Associatlon
Validafed By lames L. Buckner, P.E, at CBUCK Engineering
Va!ldallon CheckNst-Hardcopy Received
Referenced Standard and Year(of Standard) a r Year
AAMA 101/I.5.2-97 1997
AAMA/WOMA/CSA 101/I.S.2/A4�10-05 2005
Equivalence of Product Standards
Certifled By
�r`1 affirm that there are no changes ln the new F/orida Bu1lding Code whlch
affect my product(s)and my prociuct(s)are/n compliance w/th the new
FloNda Bullding Code.
Documentation from approved Evaluation or Valldation Entity yes No N/A
FL21i¢1 R2 COC ComQliance Lette�FLi11¢1.,�df
http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqttaGsIp3 Gvuna... 2/27/2012
Florida Building Code Online i Page 2 of 2
�I
Product Approval Method Method 1 Optlon A �I
Date Submitted 12/21/2011
Date Valldated i2/21/2011
Date Pending FBC Approval I
Da[e Approved 01/OS/2012 I
--------�---- - - -- — ---- - - ---- - ----- ------------ _.._. ...�,--- -------�------__---------- ----�
;Summary of Products �
�FL # Model, Number or Name D' scrf tfon
i i 1161.1 Ser/es 10/20 Slldln Window V1n !Slldln Wlndo OX or XO 73-1/2"x 60"
!Limfls of Use Certlf/catlon Agen y C�rtlflcale
: Approved for use fn HVHZ:No FLi1161 R2 C CA CC'L for Pella 6-30-09 411-H-1025.05-07.pdf
; Approved for use outslde HVHZ: Yes Qualfty Assurance Contract Explratlon Date
Impact Resfstant:No 05/OS/2013
; Deslgn P�essure: +30/-30 Insfa/lation Inst� ct/ons
; Olher:Conflguratlons of glass conform to latest ASTM E1300. FL11161 RZ II 1 �If ,
VeNfied 8y: Warre W. :ichaefer, P.F. 49135
Created by Indeper�dent Thlyd Party: Yes
Evaluation Report
F„�.11161 R2 AE 1 9�df
, Created b Inde e dent Thlyd Pa : Yes
:11161.2 Series 10/20 SlidJng Window Vi !Slldin W/ndo OX or XO, 73-1/2"x 36"
�Lfmlts of Use Certfficalfon Agen y CerHficate
; Approved for use/n HVHZ:No F 11i61 R2 A CL for Pella 6-30-09 411-N-1025.09-11.odf
i Approved for use oufside HVHZ: Yes Qua!!ty Assuranee Conlract Expiratlon Dale
! impacf Reslstant:No OS/OS/2013
I Design Pressure: +35/-35 Instal/a[fon Instr cNons
O[her:Configurations ofg/ass conform to latestASTM E1300. �11CI R2 II IS �df
Verlfled By: War�e IW. :�chaefer, P.E. 44135
Created by Indepe�ldent Thlyd Party: Yes
Eva/uatfon Report�
; FL11,161_R2 AE l, 97.pdf
Created b Inde endent Third Pa : Yes
;11161.3 Serles 10/20 SIIdln Wlndow Vin /Slidln Window XOX 108"x 60"
;Limlts of Use Certiflcatlon Agency C�rtif/cate
` Approved fo�use!n HVHZ:No F�11161_R2 C CA_4._CCL for�!!a 6-3Q=09_411-H-2Q2�I:.Q3.�df
� Approved for use oulstde HVHZ: Yes Quality Assuranee Conrract Explration Date
� Impact Resistant:No OS/06/2013
� Design Pressure: +20/-20 Installation Instructlons
i Other:Configuratlons of g/ass conform to latest ASTM E1300. �11161 R2 11 159�df
Verif/ed By: Warren W. .Schaefer, P.E. 44135
Created by Independent Thlyd Party: Yes
Eva/uation Reports
F111161_R2 AE 1597.pdf
Created b Inde endent Third Party: Yes
11161.4 Se�les 10/20 Slldfn W/ndow Vln /5/ldin Window XOX, 108"x 48')
�L/mlts of Use Certification Agency Ce�rtificate �
Approved for use in HVH2:No F�11161 R2 C CAC CCL for Pella 6=26-09 411-H-1031.01_Q3.odf
� Approved for use oufside HVHZ: Yes Quallty Assuranee Contract Explrat/on Date
, Impact Resistant:No OS/07/2013
! Design P�essure: +30/-30 insta!lat/on Instruct/ons
� Other:Configuratlons of g/ass conform to latest ASTM E1300. F�161_R2 II 15�.7,p_df
Verified By: Warren W. ��chaefer, P.E. 44135
Created by Independenf Thlyd Party: Yes
Eva/uation Reports
�11161 R2 AE 159�df
Created 6 lnde endent Third Part : Yes
�11161.5 Series 10/20 5/ldin Window VIn /51ld/n Wlndow XOX 108"x 36"
I Limits of Use CArtificaffo»Agency Ce.rt/ffcate
; Approved for use in HVHZ:No fL11161 R2 C CAC�CL for Pel/a 6-30-09 411-N-1026.09-11.odf
� Approved for use outside HVHZ: Yes Quality Assurance Contract Expiratlon Date
i impact Resistant:No Ob/06/2013
; Deslgn Pressure: +35/-35 Insta/laf/on Instructfons
; Other:Configuratlons of g/ass conform to/atest ASTM E1300. FL11161 R2 II 1597.ndf
! Ve�/f/ed By: Warren W. Schaefer, P.E. 44135
Created by Independent Thl�d Party: Yes
Eva/uat/on Reports
�11161 R2 AE 1597.odf
Crea[ed b Inde endent Thfrd Pa : Yes
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: S
Date Received: ���- � Z.
Site: 3 �c� �� �/C�'(� s�
Permit Type: (°L �Gt�/�'1��� S� Z� ��?�
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Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑
This comtnent sheet shall be kept with the permit andlor plans.
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Kalvi /Switzer lans Examiner Date Contractor andlor Homeowner
(Required when comments are present)