HomeMy WebLinkAbout12-13544 CITY OF ZEPHYRHILLS
5335-8TH SIREET
(si3)�so-oo20 13544
. BUILDING PERMIT
Permit Number: 13544 Address: 38920 5TH AVE
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-17400-0010
Improv. Cost: 12,250.00
Date Issued: 10/22/2012 Name: SANTA CRUZ, THOMAS DAVID
Total Fees: 105.00 Address: 38920 5TH AVE
Amount Paid: 105.00 ZEPHYRHILLS, FL. 33542
Date Paid: 10/22/2012 Phone: (813)783-2085
Work Desc: REPLACE 11 WINDOWS SIZE/SIZE
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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 wmply with Florida Statute 553.80(2)(c)when extra inspection
trips are necessary due to any one of the following reasons: a)wrong address b)condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d)work not ready for
inspection when called e) permit not posted on job site� plans not at job site g)work not aoaessible.
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.
"Waming to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans,Specifications Must A000mpany Application.All work shall be pertormed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O.
CONTRACT SIGNATURE PERMIT OFFI R
PE EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
` 87���0°� City of Zephyrhills Permit Application Fa�-e��-�aaooz�
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ownsrs Nam. � own.r Pnon•Numb..
Ownsfs Addn�s CN �- � �` Ownsr Phon�Nwnbx
Fw Simpl�Tidshold�r Name Owner Phone Numbsr
Fes SfmpM Tklehold�r Addross
JOB ADDRESS 1-�W 3 C� LOT/ ���
SUBDIVISION PARCEL IDD � ^Z � � ' �
(OlTANm FROM PROPERTY TA7I NOTICF)
WORK PROPOSED � NEW CONSTR 8 ADp/ALT Q SIGN � O pEMpLISH
INSTALL REPAIR
PROPOSED USE - SFR Q COMM O OTHER
TYPE OF CONSTRUCTION Q BLOCK � FRAME � STEEL Q ",
DEBCRIPTION OF 1NORK �D W P V �i W r'(/IL S � .
BUILDINC 81ZE SQ FOOTAGE�� FIEI(iHT �_�
BUILDING S �a �S� VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL j AMP SERVICE Q PROGRESS ENERGY O W,R.E.C.
QPLUMBING j .�-
D�C��� S VALUATION OF MECHANICAL INSTALtATION
QG� Q ROOFING � SPECIALTY O OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA OYES NO
BUIL�R � ` COMPANY S� !JA W J11�.� ��
SIGNATURE REGISTERED Y/ N �E Cur�tEn Y/N
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ELECTRICIAN COMPANY
SNiNATURE r�asrEr�o Y/ N �E curu�n Y/N
Addross
License#
PLUMBER � COMPANY r
SIGNATURE REOISTERED Y/ N FEE CURREA Y/N
Mdross License# �-�
MECHIWICAL COMPANY --�
316NATURE REpI3TERED Y/ N FEE CURRE� Y/N
Addrsss
License#
OTHER � COMPANY -�
SiGNA7URE REGISTERED Y! N FEE CURRE� Y/N
Addnss License# -�
1111111111111111111111111111111111111111111111111111111111111111111
RESIDENTIAL Attach(2)Pbt Plans:(2)seta of BW Wing Plens;(1)set of Energy Fortns;R-O-W Pertnk for new construction,
Minimum ten(10)workirq days after aubmittal date. ReqWred orbite,Conshuction p�ara,Stortnwater Plans w!Silt Fence instelied,
Sanitary FaGildes 6 1 dumpate►;Site Work Pertnit for subd'MsionaAarge prpjecb
COMMERCIAL Altach(3)oanpbte sets o(g�Hding plans plus a Ufe Satety Page;(1)set of Energy Fortns.R-0-W Pertnit for new cwutruqiwi.
Minimum ten(10)waking days after wpmittel da[e. Requlred oneite,Constnktion plen,Stortnwater p�erm w/Silt Fence installed.
Sarifary FacNitlea 6 1 dumpeter.Site Work Pertnil for aM new projecta.All commerciai requirements must meet complfance
SIGN PERMIT Atfacff(2)seta d Enpineered Plans.
""PROPERTY SURVEY required Tpr dl NEW consVUCtion.
Dinetlons:
Fill out appiicatiqi completely.
Owner 8 Contraaw alpn back of appication,notaAzed
If owr f2300�a Notlp M Com�nt b nquirod. (MC uppnd�s over i7300)
•• Agent((or►he contractor)a Power d Attorney(for the owner)would be someone witA notarized letler trom owner authorizing same
OVER THE CWN7ER PERMITTING (FroM of Applicatbn pMy)
Reroofa N shir�gles Seweis Service Upgrades A/C Fences(PIONSurveylFoot+Be)
Drlv�ways-Not over CouMer H on pudic roadways..needs ROW
NOTICE OF DEED RESTRICTION3: The undersigned understands that this pertnit may be subject to"deed"restrictions"
, which may be more resUictive lhan County regulations. The undersigned assumes respcxisibility for c�mplianoe wfth any
applicable deed restrictions.
UNLICENSED CONTRACTOR3 AND CONTRACTOR RESPONSIBIUTIE3: If the owner has hired a contrador or
contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the
cbntractor is not Ncensed as required by law, both the owner and oontractor may be cited for a misdemeanor violation
under state law If the owner or intended contrador are uncertain as to what Hcensing requiremenis may apply for the
intended work,they are advised to contact the Pasco County Building Inspection pivislon—U�nsing Sectfon at 727-847-
8009. Furthermore, If fhe owner has hired a contractor ar contradors, he is advised to have the contractor(s) sign
portions of the"contractor Bbck"of this appiication for which they wifl be responsible. If you,as the owner sign as the
contractor,thet may be an indicatbn that he is not properiy Ncensed and is not entitled to pertnitting privileges in Pasco
County.
TRANSPORTATION IMPACTNTILiT1E3 IMPACT AND RESOURCE RECOVERY FEE3: The undersigned understands
that Transportation Impact Fees and Reoourse Recovery Fees may appy to the oonstruction of new buildings,change of
use in existing buildings,or expansion of existing buildings,as specified in Pasco Counry Ordinance number 89-07 and
90-07,as amended. The undersigned also understands,that such fees,as may be due,will be idenGfied at the time of
permitting. It is furthe�understood that TransportaUon Impact Fees and Resource Recovery Fees must be paid priw to
receiving a'certlficate of occupancy'or flnal power release. If the project does not invohre a certificate of occupancy or
finel power release, the fees must be paid prior to permit issuance. Furlhemare, if Pasco Counry Water/Sewer Impact
fees are due,they must be paid�to pertnK fssuance in accordance with applicable Pasco County ordinarwes.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valua8on of work is$2,500.00 or more,I
certify that I, the applicant, have been provided with a copy of the "Flaida Construction L�n Law—Homeowner's
Protectlon Guide'prepared by the Flo�ida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner',I certify that I have obtained a copy of the above described document and promise in good faith to
deliver H to the"owner prior!o commencement.
CONTRACTOR'3/OWNER'S AFFIDAVIT: I certify that all the infortnatan in this application is accurate and that alt waic
will be done in compNance with aR applicable laws regulatlng construc�ion,zoning and land development. Applicabon is
hereby made to obtain a permit to do work and installaUon as indicated. I certify that no work or installatlon has
commenced prior to issuance of a pertnit and that all work will be performed to meet standards ot all laws regulaGng
c�nsUuction, County and Clty codea, zoning regulatlons, and land development regulations in the jurisdiction. I also
certify that I understand that the regulaUons of other govemment agencies may apply to the intended work,and that it is
my responsibillty to identlfy what actions 1 must take to be in comptiance. Such agencies indude but are not limited to:
- Depertment of Environmental Protection-Cypress Bayheads, WeUand Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatrnent.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps aF Engineers-Seawalls,Docks,Navigable Watervvays.
- Department of Health 8 Rehabilitative Services/EnvironmeMal Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the folbwing restrictions appy to the use of fill:
- Use of fill is not allowed'm Flood Zone•V"unless expressly permitted,
- If the fill material is to be used in Flood Zone "A', it is understood that a drainage plan addressing a
"compensadng volume'wiN be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Fbrida.
- If the fill material is to be used in Flood Zone "A° in con�ection with a pertnitted build'mg using stem wall
constructlon,I certify that fill wiA be used only to fill the area within the stem wail.
- If fiA material is to be used in any area, I certify that use of such fiil will not adversety affect adjaceM
properties. If use of fill is tound to adversely affect adjacent properties,the owner may be cited for violaGng
the conditions of the building permit issued under the attached permit application, for bts less than one(1)
acxe which are elevated by fill,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER,1 promise in good fafth to inform the owner of the permitting conditions set forth in
this affidavft prior to commenang construction. 1 understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pods, air conditioning, gas, or other installations not speciflcally induded in the application. A
pennil issued shall be construed to be a license to proceed with the Kr�and not as authority to violate,cancel,aker,or
set aside any provisions of the technical codes,nor shall issuance of a permk prevent the Buildfng Official from thereafter
requiring a correcdon of errors in plans,constructlon or valations of any codes. Every pertnk issued shal�become invaHd
unless the work authorized by such permit is commenced within six months of permN issuance,or ff work authorized by
the permit is suspended or abandoned for a period of six(8)months after ihe time the work is commenced. M extensan
may be requested, in writing,from the Buiiding Official for a period not to exceed ninety(90)days and will demonstrate
justifiable cause for the extension. If woric ceases for ninery(90)consecutive days,the job is considered abandoned.
WARNING TO OWNER: YOUR FAIIURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
N R IN Y T.
FLORIDA JURAT(F.S.117.03)
OWNER at A(�ENT CONTRACTOR
Subscribed and swom to(w afffm�ed)before me this ubeaibed y ro(w a111rmed) tlda
by ► r by
wno idare pereona�y knoam eo me w naaAieve proauced m,o wereperao�any known a me w n produced
as Identlflcalion. ,�f�`r4.r as ide�ation.
Notary PubNc I�. Notery Public
Commissbn No. Commi ' No.
Name d Notery tYPed.Prin�d or stamped Name of Nota
�Y bPed,PrinMd w stamped
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
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Contractor/Homeowner: � � `
Date Received: �� - ��— �2
Site: JC�9� S�� f��
Permit Type: �� �ir�� �d�-tJ ,����Q��° S�2E/S�{
Approved w/no comments. Approved w/the below comments: ❑ Denied w/the below comments: ❑
This comment sheet shall be kept with the permit and/or plans.
�
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Kalvin witze — lans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
Permit Number __ _ _ IIIIIIIIIIII IIIIIIIIII IIIII IIIIIII�IIIIIIIIIIIIIIIIIIIIIIIII
Parcel ED lVumber ��.��=-�1���.�M1�_:�_ .._.__.__--
l�����'� ���� 2012172418
� � g � � E � � � � � � � N � � M � � T Rcpt:1467126 Ree: 10.00
State of Florida , DS: 0.00 IT: 0.00
_ " 10/11/12 S. Shul4.z, Dpty Clerk
TNE UNDERSIGNED hereby gives notice fhat improvements will be made to certain real property, and in accordance with Section 713.13 of fhe
�lorida Statutes,the failowing information is provided in this NOTICE OF COMMENGEMENT.
�I.Description of praperty(legal description): , � � . • •' ` ,�#,
�...��--���_..��.�_���,.�=i.0 P�--i P� _� �._, _�v_,_,,�i-�_.�.
a)Street(job)Address: �' �° • , , -_ _.-
_t_���_...1-�_'�.--- --fl-�_.�__.._:ZR.�F..�,�..r�s1l�_--��_----�-�-�..�`�..________-____.._..___------...._
2.General descripfion of improvements:
-.-----__._. __._.__.__....._._
3.Owner Information or Lessee in#�tio � ' � R ! � ��-�""''�-'-•"�'_"�.'°._...._
___. _ _
...___. _._.__ ._---. _..__._.._. ... _
_._. _.__._. __._. ___
--.._ _�. _..._ _.
. �`'-y�'!1.-.. �y.�!_�_'!`�•- _-�.i!!v�""°-- --•
. ._.__,.__...._..�._._.
n if the Lessee contracted for the improvement: � -`- �-" ��
a)Name and address: "�,�r��` � c �, A 1
b)Name and address of fee simple Eitieholder(if diffa ere�nt tha�n Owne�te�d a ovej �� rV L � ��`l � �
__�,.�..,�.�..�_ _�.�:zY--
c)fnterest in property: C�i+�.1 a/ ------ -------_..-_--_._.____._
..�...._
- ----- -�____._..___._._--
__.___._.__.,._.__. .__..._____.__._._..____.__.._..,,.----...__.__........_._--..--..,_�..__.-.--.--
.Contractor Information
a)Name a�d addt'�S&; ���.�t� � � r
(` c�
�.5.-�..._._��_�.�- - �a-�.._..._1_`�_)..�..---�.��1 Q�� • � ., �
b)Telephone No.: -1U���._�._���? Y
_1.'��-�W..��'-�_�-�_.. ..._. _.__._. .._ Fax No..(optional) �
5.Surety(if appiicable,a copy of the payment bond is altached) "�7.�-a�S3-' ����--��.-.---._..-__.._ ___
aj Name and addres�;
_.___.�-------------___,__.___.__.._.�__------�--__ ._...�_---__.__----- -_..__ ._._
b}Telephone No.: -----. --_-..--_---..--_r�___._..
_—____ _�_.._..._._._._�____.._..__..-�..---.-.......,_�_.._.__..�...._�_
c}Amount of Bond: $ ------ ._._.__ ___,.,__
B.L811CI@I' --____._.__._... _.__------ _PAULq S 0'NEIL,P -----•..t
\ 10/11/12 h D PqgCO CLERK $ COMPTROLLER �
a)Name and address: OR gK ��4�p� 1 of 1
_.�____..._____.._.___...______.._._._..__. __._._.------ ---.............. ....__._ 6 PG
b)Telephorze No.: ���� __
7.Persons within the State o#Fiorida designated by Owner upon whom notices or other documents may be served�as provided by Section
713.13(1)(a)7.,Florida Statutes:
a}Name and address;
-..------.---. ._._._.._.___._---......._._._........__..__.____.__._----_._..---..__�__._..
b)Telephone No.: ' '
-- -- --_.._..__---...---.-_�__.___�..�__-------
$.a.in addition to himselP or herself,Owner designates Fax NQ.:(optional}
_____
_._.�.__.._._...._.._,...w..._.__._.__
tQ rec�ive a copy of the Lienor's Notice as provided in Section 713.13(1)(bj,Florida Statutes.~� �f �^ '����"��`--'� "'�
b)Phone Number of Perso,n or en6ty designated by Owner:
9•Expiration date of notice of commencement(fhe expiration date may not be before the completion of construction and final payment to the
conVactor,but will be 1 year from the date of recording unless a different date is speciiied�:
; WARNING TO flWNER: ANY PAYNIE'NTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE.lVOTICE OF COMMENCEMENT ARE
° CONSIDEREa IMPROPER PAYMFNTS UNDER CHAPTER 7'!3,PART!,SfCTIQN 713.13,FLORIDA 5TAT�ITES,AND CAN RESULT IN YOUR
' FAYING TWICE FOR IMPRQVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECQRDED AND POSTED ON
i THE JQ$ SITE gEFORE THE FlRS7 lNSPECTION, tF YOU INTEND TO OBTAlN FINANCIiVG, CONSULT WITH YOUR LENDER OR AN
; ATTORNEY BEFORE CQMMENCIMG WORK QR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of peryury,I declare that I have read the fnregoing notice of commencement and that the facts sta-� ted the�ein are f�ue to the bes ot f my
no ed e and belief.
� ---� �Cy.►��/
(Sigrtalure of Owner or Lessee,or Owne s or l ee's(Aufhonzed O�cerlDireclodPariner/Mana er /��'�L�.°�.5��'—�—" '�"�� �U�
The foregoing instrumen was acknowledged before me this {1 da of {Pnnt Name and Provide Signatorys TitlelOffice) '—"'���
b � � -�-�• - y -- � �'3C'.�.ir';. ,__._..._._. �20 �'L
Y -tl iwa� a�v1'L as �.. . __.._...L.._....._------_-._
".""�°'—_� _._�._�;��.____..._�__..._____._-_--- ��YPe oiaulhoriry,e.g.o�'icer,trustee,atlwney In fact)
for � ^��`--
-� . ,as
_.__. .____. .___.......---._.___....
._.__._ ._._ ._..._...___ ._._
.. -- --•._.__.... _.._.
(Name of Person) °-- •---._.....___._ ----- ........__..__.._.�..._....._....,.--•-------
fOr (type oF authorily,...e.g.oncer,trustee,attorney in tact)
_..._._-----.___....____._..,________��...---------�-�____..__�.___.__.
(name of par�j on behalf of whom instrument was executedj.
Personaify Known [] Produced ID • '
Type of 10 .___._�_.__._��.��-_..�._---. -._.___ �otary Signaturs ' a°�;�Y � D.ROBEY
-
Print name -._.._._.._. .---- •-.--_. . *_ _*. I(�tEE#�&1A. .___....._.
-------_ .._... ..
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* • � �C �,4°�,A�`� �;s� �°l.G�tlI�L�, GOQJNTY OF PASCO
* • �,��.h` • '{ �F�;� ��Ta e���ri�Y�r�;,'�l"THE FOREGOING IS A
�r � rr,�,., Tf�U��Nf�GU�4:EC1'COPY OF THE DOCUMENT
"':; .' * ON�'iL�Q(� G� F'U�LIC��CORD IN THIS OFFICE
�•, �8��� . * WITNES�,��fiY ri/�NL�/�ND��l�jIAL SEAL THIS
.9 ' _ �'=—` --
� . � p���p� �. C-- �
'�pF���pp ,�AUL�CU'N�1�.;CLERK& COMPTROLLER
` ' ----�t-���-�--�•t-\�--- �i=U i t :;i_EKI�
Southwest Florida Construction, Inc.
License#CBC05�307
1_575 Quail Dr.
� Dunedin, FL 34698
Phone: 727-269-5702 • Fax: 727-947-7b65
ONTRACT
;
PURCH�►.SER NAIu�: Phone: Date:
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���: Celi Phone E-mail
�;�� a �� /�
srecc: zip:
�.�� /� ;- l s -� .�' �-� �
Sales Rep: Othrr Phone
� � I'/ } j�'Ji,.v�'�9TJ L,L�i%L C�L4��" , ..��i✓,�y"',f2�l...I'/ i/
c�«�n�;�;oo ofw�: �.. �� t� �` ��lU
},�.�,�-, �P�=�cs.v .11�v�!C"��°''''fr L�'.c�"..�c>e�v S 6�. ?�, �.,c3�.,- .-�,`-..._
SI✓i ��� � r G7—i�L� �. P���I� �-.f✓C!�s'E9^r N 1S�S�... C"J�
�!„�i, ,CNc�r c $`�'r`- �
�1� b e �.-�s
-wl►ich is furd►er described in the detailed spocification shoet attachod huew as Exhibit"A°end initieled by t6e peRies.
Tlie above wak will be completed in aQOOtdance with the terms,conditions and spocificetioos henia,with PaYmeat w be medc e000rdeixx with the
following paymeat schodule: � ��
�. PRICE � �a,.�s�� -
���,� a�►-
2. TAX S �
3. TOTAL $ �� Z-�d -
4. DOWN PAYMENT S � G�'•
5. BALANCE � �, Z��'C.� UPON COMPLETION OF WORK
PAYMENT TO BE MADE BY CHECK PAYABLE TO"SOUTHWEST FLORIDA CONSTRUCTION.INC:'WHICH CHECK IS DUE
AND PAYAI3LE AT SUUTHWFST FLOR[DA CONSTRUC"TIUN.INC. OFFICE AT THE ADDRESS SET FORTH ABOVE.
AI,L APPLICABLF DISCOUNTS HAVE BEEN APPI.IED.
sl)Y�R'�RGHT'I'V(:AN(:EL
TRL4 IS A HOME SOLICffATION SAL&AND IF YOU DO NOT WANT 1'HE GOOD6 OR SERVICE3,YOU MAY CANCEL THIS AGRL►EMENf BY
PROVmING WRTITEN NOT[CE 1'O'T�SELLER 1N rER30N,BY TELEGRAM OR BY MA1L TBIS NOTICE M1�4!'1TiDiGTS TBAT YOU DO NOrf
WANT THE G0011B OR SERViCES AND MUST BE DELIVERED OR�ObTMA�D BEFORB MIDAIICHT OF THB'I'HOtD DUSINESS DAY AFI'ER
YOU SIGN THI.4 AGREEMENR'. IF YOU CANCEL 77II.9 AGREEMENT,'I'�SELI.ER MAY IVOT KEF.t ALL OR TART Olr ANY CASH DOWN
PAYM6IVT.
NOTE: RETAII.SALES TAX MUST BE CHARGED UNLESS TI�CUSTOMER SIGNS'fHE FOLIAWING: I csrtity
that I own the land on whic6 t6e stracture I am improving is permaoeotly af[i:ed. Furt6ermore,I have fikd a declaratioo wiW the
Property Appraiser requating the strncturc be asses�ed aa ralty and it bean "RP"decal.
� .� .
SiQnature• � :-
STATUTORY NOTICE REGARDING CONSTRUCTION LIENS: ACCORDING TO
FLO . - , FLORIDA STATUTES ,
THOSE WHO WORK ON YOUR PROPER OR PROVIDE MATERIALS AND SERVICES
ARE NOT PAID IN FULL HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT
AGAINST YOUR PROPERTY. THIS CLAIM IS KNOWN AS A CONSTRUCTION LIEN. IF YOUR
CONTRACTOR OR A SUBCONTRAGTOR FA1IS TO PAY SUBCONTRAGTORS, SUB-
SUBCONTRACTORS, OR MATERIAL SUPPLIERS, THE PEOPLE WHO ARE OWED MONEY
MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE PAID YOUR
CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR, YOUR CONTRACTOR
MAY ALSO HAVE A LIEN ON YOUR PROPERTY. THIS MEANS IF A LIEN IS FILED YOUR
PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR, MA'I'ERIALS, OR
OTHER SERVICES THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FAII.ED
TO PAY. TO PROTECT YOURSELF, YOU SHOULD STIPULATE IN THIS CONTRACT THAT
uF��tF. ANY PAYMENT IS MADE, YOUR CONTRACTOR IS RE(�UIRED TO PROVIDE YOU
- - ----- ---..... ...�, n�DCAN u rn�rnANY THAT HAS
�.��' h �� l s .�-'�.. �p` ,,,�-�' �,
Sales Rep:• , Other Phune
Gene�a!Description of Worlc: � .,�yZC�E-t°_ C!r,��lU�'1�,'�"��'7� ��•'�L L'���5' , _•[,�✓S'�t./'/ //
�/✓��'s"a'u�7 Z''r..ti� J�.L�P_L•�--y C7�t/ .�crb lC ���'���/`r t�'���C'Zt/.� t t1 i �j �,L.,t'1 ts.� ..��..
,.�4.,4s C'.i+.-C%I"�C SC'�'+.- •tr'-"4 +�`s�'c_.S S'. ��''.!^IY►r�7`� �Lit.G"-�vl.�LC3", f-J /-�-r'�S G'—� C"Jr^'
c��J _ t .��r- ..S �
-which is fucther described in the ddailed spxification s6eet attachcd hereto as Exhibit"A"and iuitialed by the pa�ties.
'Ibe above work wiU be completed in sccordance witb the tenns,cwaditions and spxificatioas herein,with paymwt to be a�de aocordanc�e with the
following payment schedule:
�. PRICE s �a.�so ����s• �- a,� �c_
2. TAX s °--�j
3. TOTAL S_/�?.Z�d
4. DOWN PAYMENT S_ �i. f�G
5• BALANCE S �. Z S"L3 UPON COMPLETION OF WORK
PAYMENT TO BE MADE BY CHECK PAYABLE TO"SOUTHWEST FLORIDA CONSTRUCTION.INC:'WHICH CHECK IS DUE
AND PAYABLE AT SOUTHWEST FLURIDA CONSTRUCI'ION,INC. OFFICE AT THE ADDRESS SET FORTH ABOVE.
ALL APP[,ICABI.E DISCOUNTS HAVE BEF.,N APP[,IED.
BUY K• W:HTTU '�NC� •
PRO�YmWG��I7�N�O�T[CL�T�;�R IIY P�ERS��[�B, Y'1'L�i.�LG1'�N BUYB O��1��SCES'NOT Cl:� IIC DICA�TBA?YO 1�D0 NOTY
WANT THE COODB OA Sl:RVK�4 AND MUST BL DBLIVERL�D OR PO6TMA�D BEFORB b�NIGHT OF THS 1'HDiD BUSINfBS DAY AFI'EA
YOU BIGN Tf�S AGREEI1�Kf. IF YOU CANCEL 1'HIS AGREEMEI�T,7'H6 SELL�A MAY NO'f KBE!ALL OA tART OF ANY CASH DOWN
TAYMEN'!'.
NOTE: RETAQ.SALFS TAX MU3T BE CflARGED UNLESS THE CUSTOMER SIGNS T�FOLI.OW�tG: I oertity
that I own the laod oo w�6ieY t�e atructure I am improvieg fs permseentiy afl�ed. Furt6ermore,I 6ave fikd a dee4ratioa wit6 the
Property Apprafiser requestiog the ttruMare be asses�ed aa realty and it bearo "RP"deuL
�
Si�natere• � :.
� STATUTORY NOTICE REGARDING CONSTRUCTION LIENS: ACCORDING TO
, FLORIDA STATUTES),
THOSE WHO WORK ON YOUR PROPER OR PROVIDE MATERIALS AND SERVICES AN�
A.RE NOT PAID IIY FULL HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT
AGAINST YOUR PROPERTY. THIS CLAIM IS KNOWN AS A CONSTRUCTION LIEN. IF YOUR
CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SUBCONTRAGTORS, SUB-
SUBCONTRACTORS, OR MATERIAL SUPPLIERS, THE PEOPLE WHO ARE OWED MONEY
MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE PAID ypUR
CONTRACTOR IN FULL. IF YOU FAII, TO PAY YOUR CONI'RACTOR, YOUR CONTRACTOR
MAY ALSO HAVE A LIEN ON YOUR PROPERTY. THIS MEANS IF A LIEN IS FILED YOUR
PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR, MATERIAI,S, OR
OTHER SERVICES THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FAII.ED
TU PAY. TO PROTECT YOURSELF, YOU SHOULD STIPULATE IN THLS CONTRAGT THAT
BEFORE ANY PAYMENT IS MADE, YOUR CONTRACTOR IS REQ UIRED TO PROVIDE YOU
WITH A WRITTEN RELEASE OF LIEN FROM ANY PERSON (�R COMPANY THAT HAS
PROVIDED TO YOU A �'"NOTICE TO OWNER". FLORIDA'S CONSTRUCTION LIEN LAW IS
COMPLEX AND IT IS RECOMII�NDED THAT YOU CONSULT AN ATTORNEY.
[HEREBY CER'I'IFY THAT I HAVE READ AND FUI,L,y UNpERSTAND Tf�PROVISIONS OF TFDS CONTRACT,
INCLUDING TEIE TERMS AND CONDITIONS CONTAINED ON TI� REVERSE SIDE, AND I AGREE TO ALL OF TI�
PROVISIONS,TERMS AND CONDITIONS Tf�REOF.
�" 'l SOUTHVVN:ST FIAIt1DA CONSTRUCI'ION,INC.
� � � �.
aser �
BY: �Z
aser
� AS:
Exception Sheet With drawin� C nl,,�,,�,2,,
Window Size Type Series Impact/Non
Screen Haif/Full Obscure Y/N Grids Color
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� � � � tit to
Florida Building Code Online Page 1 of 5
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, � . BCIS Mome Luq[n User Reqistration Hot Topics SubmR Surcharqe StatS 9 Facts Publkatfons FBC SWff BCIS Stte Map Links Search
Busines ���
Professi�nal � Product Approval
US[R:Publk User
j•.-, N�s ' �-i }�-,
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� Pr�r_uc:t r�pp�,'.<;I FL',,:>GroduCt or ADGIi�aGOn Search> DDlicatibn LiSt>AppliCatbn Mta
'�`�::�'�� '. 'k��.'^�'
� •, FL# FL5167-R11
����"x" :.. .. �� APPlication TYpe �' Revislon
Code Verslon � 2010
Applicatlon Status Approved
*Approved by .Approvals by DCA shall be revlewed and
ratifled by th POC and/or the Commission if necessary.
Comments
Archived
Product Manutacturer onton w�ndows ALL 6V0[{K SHALL;'Oiv1PLy'v�%jTfiALL
Address/Phone/Email �cochrane nve PREVAILNG CODEC,FLORIDA BUILDING
Pennsboro,WV 26415
(800)746-6687 ext zs�DE,NATIONAL LLECTRIC CODE AND
tiffany_davles�simontor�tp�OF ZEAHYRHILLS ORDINANCES
Authorized Signature Tiffany Davies
tiffany_davles�si monton.com
Technical Representative Tiffany Davies
Address/Phone/Emall PO Box 1646 `�,
5300 Briscoe Road � �s�V [},[�T�
Parkersburg,WV 26102 ;,;�'�"}o � ` � -
(800)542-9118 Ext 9329 � ��ZEPHYRHIL
tiffany_davies(i�simonton.com �.,G�j� �XAM'N�R (.S .
Quality Assurance Representative AAMA �
Address/Phone/Email 1827 Walden Office Square
Sulte 550
Schaumburg,IL 60173
(847)303-5664
webmaster�aamanet.org
Category Windows
Subcategory Double Hung
Compliance Method Certiflcation Mark or Llsting
Certiflcation Agency American Architec[ural Manufacturers Association
Validated By American Architectural Manufacturers Assoclation
Referenced Standard and Year(of Standard} Sta�dard Year
AAMA 450 2006
AAMA 450 2010
AAMA/WDMA/CSA 101/I.5.2 A440 2005
Equivalence of Product Standards
Certifled By
http://www.floridabuildin�.or�/pr/pr app dtl.asnx?param=wGEVXOwtDcttZMlu87ctOK... 10/11/2012
Florida Building Code Online Page 2 of 5
Product Approval Method Method 1 Option A
Date Submitted 03/27/2012
Date Validated 03/27/2012
Date Pending FBC Approval
Date Approved 04/06/2012
�Summary of Produets
F�* Model Number or Nama Deseri (on '
5167.1 07-09,07-10 and 07-20 ReHectlons 5500, Prism Platinum, Sears 9300 Vinyl
Double Hun
Limits ot Use Cartification A�ancy C.rtiflpte
Approvad for usa in HVHi:No FL5167_R11 C CAC 07-09 DH 37x84 R60 odf
Approved for us�outsida HVHZ:Yes FL5167 Ri i C CAC 07-10 07-20 waiver to 07-09 odf
Impact Reststant: No Qusl(ty Assuranca Contrad Exp(ration Data
Dasiyn Pressura: +60/-60 07/28/2013
Other:37x84 Installation Instrodions
FL5167 R11 lI IN0103 07-09 07-10 07-20 DH 2X pdf
Verlfled By:American Architectural Manufadurers
Association
Created by Independent Third Party;
Evaluatlon Reports
Created b Inde ndent Third Pa .
5167.2 07-09,07-10 and 07-20 Reflecdons 5500, Prism Platinum,Sears 9300 Vinyf
Double Hun
Limits of Usa Cart(fiution Ayancy Certtflcata
Approvad for use in HVH2:No FL5167_Ri l C CAC 07-09 DH 36x63 R50 odf
Approved for usa outsida HVHZ:Yes FL5167 R11 C CAC 07-09 DH 37x76 R65 odf
Impact Resistant:No FL5167 Ril C CAC 07-09 DH 42x64 R50 odf
Design Pressure:N/A FL5167 R11 C CAC 07-09 DH 47x71 RSO pdf
Other:48x80(+/-25 PSF),56x84(+/-25 PSF), 53x76 FL5167 R11 C CAC 07-09 DH 48x80 R25 pdf
(+/-50 PSF), 36x63(+/-50 PSF),42x64(+/-50 PSF), FL5167 Ril C CAC 07-09 DH 53x76 R50�df
7x71(+/-50 PSF),37x76(+/-65 PSF) FL5167 R11_C CAC 07-09 DH 56x84 R25 odf
FL5167 R11 C CAC 07-10 07-20 waiver to 07-09 df
Quality Assuranee Contrad Expirstlon Data
03/13/2013
InstsltaHon Instrudions
FL5167 Rll II IN0067 07-09 07-10 07-20 DH 2X pdf
Verified By;American Architectural Manufacturers
Assocladon
Created by Independent Thlyd Party:
Evaluatlon R.ports
Created b Inde ndent Thlyd Pa :
5167.3 07-09,07-10 and 07-20 Reflectlons 5500, Prism Platinum,Sears 9300 Vinyl
Double Hun with Transom
Llmits ot Use Certiflcation Ayaney Certiflcate
Approved for usa in HVH2:No FL5167 Ril C CAC 07-09 PNJ aver DH 37x107
Approvad for uso outstda HVHZ:Yes R65.odf
Impact Resistsnt: No FL5167 Ril C CAC 07-09 P�J over DH 53x107
Desiyn Prassure:N/A R55. df
Other:53x107(+/-55 PSF)&37x107(+/-65 PSF) FL5167 Rl i C CAC 07-10 07-20 waiver to 07-09 df
Qusltty Assuraneo Contract Expiration Date
04/14/2013
Installation Inst�uctions
FL5167 Rll Il 1N0063 07-09 07-10 07-20 DH w
ransom 2X. df
Verifled By:American Architectural Manufacturers
Associadon
Created by I�dependent Thlyd Party:
Evsluation Reports
Created b Ind ndent Third Part :
5167.4 07-20(Nalling Fin Installation) Reflections 5500, Prism Platinum,Sears 9300 Vinyl
Double Hun
Limits of Usa Cartifleation Apaney Certificate
Approved for usa in HVM2: No FL5167 R11_ C CAC 07-20 DH 37x76 R65 odf
Approvad for use oubide HVHZ:Yes FL5167 R71 C CAC 07-20 DH 53x76 RSO.odf
Impact Rasistant:No FL5167 R11 C CAC Sim 07-20 DH 56x84 R15 r�df
http://www.floridabuildin�.org/pr/nr app dtl.aspx?param=wGEVXOwtDQtZMIu87QOK... 10/11/2012
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