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HomeMy WebLinkAbout13-14085 CITY OF ZEPHYRHILLS 5335-8TH STREET � , � (sis)�so-oo20 1�5 BUILDING PERMIT Permit Number: 14085 Address: 39040 SOUTH 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: EASY ACRES Est. Value: Parcel Numbe�: 13-26-21-0100-00000-0050 Improv. Cost: 2,998.00 Date Issued: 4/15/2013 Name: LAURIE TAMMY& LINDER STANLEY Total Fees: 75.00 Address: 39040 SOUTH AVE Amount Paid: 75.00 ZEPHYRHILLS, FL. 33542 Date Paid: 4/15/2013 Phone: (813)395-8197 Work Desc: REPLACE 10 WINDOWS SIZE/SIZE j��;'W � �j . / �� , � ��� . � 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 oomply 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 co�rections not made when inspections called d)work not ready for inspection when called e) permit not posted on job site f) plans not at job site g)work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this counry, and there may be additional permits required from other govemmental entities such as water management, state agencies or federal agencies. "Warning to owner: Your failure to reoord 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,Specificatlons Must Accompany Application.All work shall be pertormed in accordance with Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O. r e � CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER ���` ` � � � City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: �`�',,,�'''�S �7� ��°�� Date Received: �-��%`3 Site: J� 9 �'�T� �t/j,( � �i�, Permit Type: ,/���(�� �l� C�.Ji�'1 C/O�� 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. _ � �� Kalvin Swi er=P aminer Date Contractor and/or Homeowner (Required when comments are present) I I��I�N��Il�i�III lIIN�ill�!�1��i i�l z����6 ,. Rcpt:1312678 Ree: 10.00 DS: 0.00 IT: 8.00 ����E� 'O C 04/16/13 E. Nun9uia, Cpty Cls�k :-n.it Na. � 0 Q�s� .z.FolioNo. �3-a(,-a���100" aUO�' :. �.:►'�iz���ZSZGNED h by gives nofice that*.he improvemmts�will be madc ta'�ea��r�pt�iy,and�in aixordancx wi�Sectian 713.13-of e?tc�ida Statutas,the fol owiag uiformation is providad in this NOTTCE OF CO �NCBMSNT. _ i �•escriptior_of propeaity e�l de�lcript�on): S .0 � � /OD L-O� ;; S�treet(job;Adtiress: -- 2 � �. � �eaerd]descript3on of' provem�nts: o� ' � L' .p� �Lr.ier Infortnatlor. ' ��n :;�ia�e an�add�ss: " �{O c� ' Z ��lLLS . •3,3 l��o� u'" �; Name a�d add�ess of simp tideholder(if othet than owner) � �w� �)Interest ut ptnperty e ' �::oniracEor Jz�formadon ��''r �" � �s):Jame and addrts.v: . � �b;Teleghone No: - ax No: GL.. � Su.�ety informatiom � • � �M n �}Name and sddross; NA ' � m �}�,t,mount af Bond: Nt� • ' o �� ^' Talephone No•_N.� � �'a'�..r >��:�uer � ' � � a;Nsme aad address: NA - � � � N � b}Tslephone No: . N . Fax No: NA �" �- ,-. � � � ,. � Identity of person whtiia�th�,Stat�of�lorida desig�sted by owner upori wh�i'�i�Qr o�er doc'c�iS�nts may.be.�,, . � � &)NSme atld.Bddl'G4S� A ' ' •�. -� ..�'`: ` .��'" •�. ` 'r: :,`. �?Tei�phone No: l�i . :Fax�iti� NA � ' � ; • ; - � � , , ..• , ''" . I�addition to himseif,o er designstes the followiag person.DO recxive a c�npy tif't'�1d L,ionoz'�NotiiiCer qs�rovide,d i�Seato�'7.�3:�13��b�, orida Statutes; � � . • , s)Name and address: A • '� � b)Telephcine No. N Fax 3�10. ' NA �� ' • ` � ' yxpiration date of Nati of Comsnanc,�ment(the lzpiration dete is oae year froat the date of�r�!�cor�lin�anlete a aiff�t e�tt.da�'t8 ��ciY�ed}: : . , • , . �@NIIVG TO OWNRR: PAYMENTS MADB BY TH�OWN$R AFT&R TBE�I$!►�ON•4�'�N4'Y'iCE'�QF 3MMENCEMEN�'ARE ONSID�RED IMPI€OPEtt PAYM�N'1`8 UNDER ��3,_l'1�T l;$�C1rION�13.La1.FIA�DA 'p:.�iJ1`ES CAN REBULT YOUIt RkYIlVG TWIC�ROR IlI�OVEMENTS'PO Y btt PHO�►Afi7t.A NbTIC$OB�011�N�NT. �fi�'�E t�CORDED P03TffiD�ON THE JOBSIT�B8F08E TSE N$ti3T IIV � i'3N.IF YOU INCEND'tQ'�JBTAIIdFit�iAN�tC� :�'SJ'�,T YOUR L�ND� OIt AN ATTORNFX BEP'ORI�COMMRNCWG�VdRK O 'R�,CORDIN�G YOUR NOTfC�OF ' :;�iT�STN�E1l�E�T'i'. , ae of Fio ' �� ^ , ��r;Of � 10. • , � �owar er ' :Ad�hafi.ed � /�I'/�'1l11 U _�►-rl/�.% `�, .. (� Prin�N�nu , . . -`��— ::ongoin8. �d ed befvre me dus_�day of �2�O��by , �)['�t(E+t�_. � (ryDe af authoritY.a cer,tnamc, n$a)• • .. , . (namc of perty on f of who —� .Y-!��,�'S �A,M�OM� x;, ' f'a'.r �o,�!y xnown �R Prod ced Idanti8cation� t�o�ry s;�aa,re , . �o?IaentificaFion Froduced L' Name(Print) ��� � �- ��i�����, ��� . : . . �Sca.tioa�►ursuant w Saxiaa� 525,Fiorida S�s.Under penattia of Pa1�Y.t decian th�i have n�d tbe ' �od ttmot�d►q,�iOb�h�ell'�i it t�e UNe to�a,beitt of �cwiedge arid belfef: _ ,, . .� - , • � • ,v^_'w� .� :r � SignetutcofN aatln3igning(inl'me10),A.bove � • es�is-�esu-w�u �,i�y ui �tsNiiyiiinia rciini�nNNn�.auv�� -�- - - - --- Building Department rn e,.r�"t. Date Rsceived� --�Q� Phone entact i.or PermiWn �l 3 2(0� — �''1 q 4,75 Ovmers Name � M M r,r i Owner Phone Number �i 3 � 3 r7 S-S�9� Owners Address ��'r n�- Owner Phone Number Fse 8lmple TRleholdsr Nams � Owner Phona Number � Fee Simple Titleholder Address JOB/II�DRESS �QD�� ScuT� Ru�.. Z��P/�Ay��//S F�- 3 3-S�l 2 LOT# � SUBQ.IV,ISION �AS�/ I}C22.S" � PARCEL ID# i 3'z�"Z I• p O S"'O (OBTAINED FROM PROPERTY TAX NOTIGE) WORI�_PF�p08ED B NEW CONSTR 8 ApDIALT � SIC3N Q Q DEMOLISW INSTALL F2EPAIR PROF�OSED.U3E Q SFR � COMM � OTHER TYPE OF CON8TRUCTION Q BLOCK Q FRAME � STEEL [� DESCRIP'fION OF WORK ��.° /�C� O t d UN�f'S S��Z.� S��2-e_ L- /�Z D 6 BUILDIN(i SIZE [� � 8Q FOOTA(iE� HEI(iHT _� QBUILDING S ��,,��j t VALUATION OF TOTAL CONSTRUCTION l 27 QELECTRICAL � AMP SERVICE Q PROt3RESS ENERGY Q W.R.E.C. QPLUMBING $ �l QMECHANICAL � VALUATION OF MECHANICAL INSTALLATION � '�� QGAS Q ROOFING Q SPECIALTY � OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO G ��.t� 1�. '_� L�� BUILDER �t1 ' COMPANY L S NoM�, CeN"��2s� `N C. SIGNATURE 1 REGISTERED Y/ N FEE CURREP Y/N Address O �o� � �i 3 R�'A�d� ��-���' License# �G�G f S d ��-1 7 ELECTRICWN COMPANY 81�iNATURE REGISTEREO Y/ N FEE CURRE� Y/N Address License# � PLUMBER COMPANY 810NA?URE RE(31STERED Y/ N FEE CURRE� Y/N Address License# MECHANICAL COMPANY SIONATURE REGISTERED Y/ N FEE CURREA Y/N Address License# OTHER COMPANY SIONATl1RE RECiISTERED Y/ N FEE CURRE� Y/N Address Ltcense� � RE8IDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)set of Energy Forms;R-O-W Permit for new construcdon, Minimum ten(10�working days after submittal date. Requfred onsite,ConsWction Plans,Stormwater Plans w/Silt Fence installed, SAnitary FadlfUes 81 dumpster;Site Work Permit for subdivlsiansAarge projects COMMERCIAI Attach(3}complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit tor new oonstrucdon. Minimum ten(10)working days after submittal date. Required onsite,Constructfon Plans,Stormwater Plans w/Silt Fence f�stalled, Sanitary Fadllties 8�1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compNance SICiN PERMIT Attach(2)seb of Engineered Plans. ►RIfPROPERTY SURVEY required for all NEW constructlon. Directlons: Ftll out application completely. Owner 8�Contractor sfgn back of applfcatlon,notarized If over=2500,a Notice of Commencement is raquired. (AIC upgrades over s7500) " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from ovmer authorizing same OVER THE COUNTER PERMI7TINCi (Front of AppllcaUon Only) Reroofs fi shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) Drlveways-Not over Counter if on public roadways..needs ROW NOTICE Of DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictiQns" whicM cnay be mors.reatrictivs than County regulations. The undersigned assumes responsibility for compliance with any' appticable deed restrictions. UNLICEN�ED GAN�'RI4+�TORS AND COI�FTRACTOR RE3PONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be requfred to be licensed in accordance with state and local regul�tions. If the contfa�tor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor vfol�tion under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Buiiding Inspect(on Divfsion—Ltcensing Sec�tion at 727-8�7- 8009. Fu�thermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contrbetanBndicatontthat hefiis niot p ope�ly Iicensedila d is not enitled to permitting p�ivileges�in Pasco contraetor, that may County. TRdMSPO�tTATION IMP�►CTNTIUTIES IMPACT AND RE�OURCE RECOVEI�Y F�ES: The undersigned understan�s that Transportation Impact Fees and Recourse Recovery Fees may�pply to the const�uction of new buildings, chan e of � ...< use in existing buildfng�, or expansion of existing buildings, as specffied in Pasco County Ordinance number 89-0 'arti� ' 90-07, as amended. The undersigned also understands, that such fees, as may be due, will be ident�ied at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid pr`Itir to receiving a °certifi�ate of occupancy" or flnal power release. If the project does not involve a certificate of occupancy or final power release, the fees must be pafd prior to permit issuance. Furthermore, ff Pasco County Water/Sewer ImpBCt fees�re du�,they must be pafd prior to permit issuance in a�cord�nce with appflcable Pasco County ordinarr�es. CO�1$TRUCTION LIEN L.A►W(Chapte�713, Florida Stat'utes, as amended): If valuation of work is $2,500.00 or more, I ce�tify that I, the applicant, have been provided with a copy of the °Florida Construction Lien Lavu—Hor:�teowr�er�s Proee{�an hei�owner", Iree�tify that Ilhave btained a copy of thetabove d scribed document and promPse intgoad fait�to oth deli�rer it to the"owner"prior to commencement. CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that a1E work will be done in compiiance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indica#ed. I certffy that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of ali laws regutating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. i also certify that I understand that the regulations of other government agencies may apply to the inte�ided work, and't�ie� it is my responsibility to identiy what actions I must take to be in compliance. Such ageneies include but are not limited to: - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally 3er�sifive Lands,Water/Wastewater Treatment. - Southwest Florida Water Manag�ment District-Wells, Cypress Bayheads, Wetland Areas, Aitering Watercourses. Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. - Department of Health 8 Rehabllit�tfve Servfces/Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. Federal Auiation Authority-Runways. ( understand tMat the foilowing restrictions apply to the use of flll: Use of fill is not allowed in Flood Zone°V° unless expressly permitted. If the flll materfal is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If th� fill materfal is to be used in Flood Zone "A" in connection with a permitted building using stem wall constrwction, I cectify ths�t fill will be used only to flll the area within the stem wall. - If fill material is to be used in any area, I certify that use of such ���heiowner mayrbe'c(t d for vaolatl�g: properties. If use of fill is found to adversely aff@cfi adjacent prope�ties, the condi�ions of the buiiding permit issued under tMe attached permit application, for lots less than one (1) acre which are elevated by fili, an engineered drainage plan is required. If I am the AQENT F`OR T�1E�WNER'tructionis I funderstanid that a�s parat permit may be riequ9 ed fortiel ctrical work, this affidavit prior to commencing c plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the applicatlon: p�rrriit issued shall be constrwed to beal codesenor shall ss aincehof a pe mitp event thehBu dirig �Official from the�eafter set aside any provisions of the technic requiring a correction of errors in planermit is cotmmencediwi#hin sixam nthseof perm t P suaince,uoaff wo'rk authoerized by unless the work authqrized by such p the permit is suspended or abandonee Build ner10fficfali fo6a pe io�d notto exe edtn netyr(90� da.ys and will demo st ate may be requested, in writing, from th 9 justifiable caus�for the extension. If work ceases for ninety(90)consecutive days, th�Job is considered abandoned. WpR1�aG TO OaA1NER; YOUR FAtLURE TO�R�PROPER't'Y.TIF Y�U IN"�E�Tfl OBTAi�I FN+f�►NCC!ll�, CONSULT PAYtNG T1MaCE FOR IMPROVEMENTS TO YO WITH 1��WF����`�eR AN ATTQRNEY Bfr.FORE RECOFtDING�O'�t'CE�F�OIIIIMEI��II�NT FLORi[3�A JURAT(F.S.117.03) CONTRACTOR OWNER OR A(3ENT Subscrib8d and swom to(or afflrmed)before me fhis Subscribed and swom to(or affirmed)before me this �'by _�___.bY Who fs/are personally known to�e cr haslhave prod�ed Who islare personally known to me or has/have produced as Identlficadon. as identlflcatlon. Notary Pubiic Notary PubUc Commission No. Commission No. Name of Notary typed�P�inted or stamped Name of Notary typed,P�Inted or stamped ( ,� • !L^.i�J�ViC��s i� ��tT.r; ,�� �., '. ' !.. �. �. ._ �-- — ..__ G�T�RHbR SOLUTlf.�NS It�1ST�ALL.ED SAL�ES CO�1'�.RA�CT � _ _ � �,.,�.�.i.=C.gci-;, iAi� - --• • ..�ruM " .. -•— � �USTOMtFt : r—�. —" RFR: I ''� ,+^f�.f,�'', .,r��L.7�� .�. �'s�''x.l�E-'�� � . 1�✓_�f._. ;��.�L.'L,— — .—. 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I C;oritr��ct Tot�l ' ,,� �� � �'ap�licable tax.?s incfuc3e�l � .__— ___._ _. _..—.. �--- .—_.. . �. .�. �.. _�—., ..1— _.^—_._ ` �a��i;�;�i Ci ti'�s��TJ+1r'�f;. 5"�•�iaral:aw reqc�ir2s Lrnwe's *.o �ravide ya�yv?th Qhe p3mph�et Rc��vvafe P2ight. By slgnirty this Con!s;�ct, Gu3t�n��r , a�� �ar����;;ge�h;avi';�:-e;�Eav�c a r-�r��of thi�paraph�et befare wark Aeqan i��forming Custo�ncr of tho patentiaf risk of the leatl ha�rd expasurc? if4�y l�r�.C.4:tit0'�d��!'�ifi�t�o�p4lfOrmed iI:CUSf.ot?�lfl�'S dN►BNI�g urltt• �.. ._�__....,�_.._�_.._ ..._.�._..�—_ —M.._..,� ;^,.�:_,'';:;�� �_,��;r. �:;�::•:'c�; �c��r :�:ry�,t�,�,,Levrf:s�,r,d Lawti':;�:mploy�as ihe r��fit Ir take phetofl-�F,hs c'ail wu�-k performect a1 Ihe RremE�;as rElatr;f w th>� , ;;i,,�v' .'., . • -r,::,3`.�,;r->v,:�•�.: i �vir•'S�'!�i<;hi. 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A S�HLf:me�!a1 :�ny conlir�ye�cies th�t woald rna:cnally r,`�snge sai�i r,sti�a�eci,�ubs!�,ns;-:l ' .::'IC;;<:�:r. �9 u:.f.:,'icav.•:; _ ----- --. . ..._ . _ . _—. .�. �_. - ._•_ _---'- --_• •__' •-•— _(if a�F�lis:�ble inseri�str,tmer�af sur,h;x��ttirlgFn�:i�r:�)..__ •--_ !; '1"•.is (:tr,-•;-a�?at°�•,�;.��.�ttizi a`.!c9alrr,s by�;tlStiaKieP Of Lowe's wili h4 rosotved by BiNDINCi ARBITRATlON.Cu�tomar anG s.owe'S G3SYE{�F Ti 3�=�+S!% � '�'�';t;r;,k ;r C�s Ei�T do enforcc�Zis Contr�c:(EXCEPY for matters that may bo taken to SMALL CLAII►4S GOUR"�_Lowe�s and Custt�•ner's righEs w�!'' ; �,.:r�,r�•,�,,,tu SK� NErs;�t�L,aFebiTr�ATOF? and NOr a judge or jury, l.owe's at!d Customer ara entitlQd M a FAtF FEEARIR�G. Fsu�2h.=�ry.�:�':=''s� , .,...r•�s.:�;.r,-;..,:rp 3'N:nLEP,4t��Mtt'�RE LiM�7�C THAN REIL�E�APP�ICI,Si.F_Ii�riUUR�.Arbitratar efec:sions are aa enforcc;able a�;a�7y���urt�,��c�^� :�: � ->�,:,.i>;�•.:� r� v�s-.Y LiBRfTFr�i7.EV{EW SY A CbUFt7. Ft3R MORE DE7�!li.S:t�e�lsw ti�e setticts tf4�ecf ARBlTt�?P.'t iUN AGaE��el�rui.'�Vr•lit'�� :�r J'Jt '; . �t^.i�A:itii•c�. p=,%:'�„�.�Sw�'����C�.�.l�Ai3.i�i�i�.A�rq'JN kourl(�I!1 the'CEYiTiS,.F14'�t.`Oi3�1i10l77 Li SrtS f�OtSZC?l;S. JC, �f�.-}3 �.4,l.�I�I T�''`.�C) :^ca��t'sRA�:T'JN3';L C,•.UlPLET�:Al�1Q�'QU tiAW�REA,D TkiE"t'�RMS�aND CtiivCblT'FLhiS ��i?�'��"R€:y����+f�;�=�,i.c. ��=�r"'�� �;F:-t�'t��.::c�l�S?:ZAG?. SY S13�1?►�!G f3L�Li"31�l.YC3ti ARE ACKl�Jfllr4f[.EDC�EFlG THATYOU eiAVE RERQ,'1)NI)FRfiT�4.hl�? � k`."if1 Fn+ar'Yr.t";'i:; 'c LiE?'?�Fi1MS AN� CC?it{r1i'T�QPiS S�.T FOR'TSi Cf�AE..�.P<+1G�S UF Ti-lis CO�ITRAC'f YtaU ARE�NTfTL�[?7G��'� v�::�� (�5=�'i•ia`:, :�:�!�e t�d�rT:QT Ti-SL: TtMF taF S�G9d�T't1l�tE.�. __ s� �Po�� � %�c�a7� � L � . s- � .�.{.L''t',�;�^_`S`y`1.L1.�`11ii9``Li �tiSSii�:Ll �`�`�.i_v�.�i:��ii\�`i�i;.�7:-,1, f�!_1��111.t��;UfL1111��r.J � � �'��°" � \r .... �...1_�.�..\`is.i�L ��..r`�t°�.a'�?�_i/ � �- � ii .._x�1�.1..liL.L.�. 'J liia.,,�'F\„(�� � ,i �jp,:G'1'` �.Y �� I � � ����rt�F°���(_f � -- __ � � t�'��''���'�' �✓ � +=�--_ __ � � � STo rzQ 1 ��-y �l. 1 fZO � � D��(1`� IQ (�i�n�owS Florida I3uilding C:ode Unline 1 a�� 1 Vl � Producr Approval USFR:Aubllt User P..f..Qd1LGI.BOA[SiY.AI..MlaL>P[l2QVSf..RCARRIKA.UQ[I.�GACf.A>!1RGI/CAt(Q/t._ldSt�'APOI1GtlOB D�b!l FL # L11206-R6 App!lcaHon Type Revls/on Code Verslon � 2010 Appllcat/on Status Approved "�Approved y DCA.Approvals by OCA sha/l be rev/ewed and rat/fled by the POC artd/o e Cmmmisslon!f necessery. Comments A�chlved �; Product Manufacturer Pella Corporat/on Address/Phone/Emall i02 Meln St. Pella, IA 50229 (641)621-6(}96 pepaproductdPPro val�u pella.com Author/zed Slgnature TROY fARR tbfarr�pella.com � r � .;�C. - > r j��=. r. � r � Techn/cal Representative Joseph Hayd�n ' `i-`s ,;( r ,. ���"�-� � ,'�,r , �, r Address/Phone/Emall 102 Maln Str�et � _ j - � `{�'v��'� � � ;,;;��,�� ' �i-�i L i Pella, IA 502�9 r , �- ��):�' ; �� , , ' '�t (641) 621-6Q96 ' ' , _ � �3� i `� ,�,,,1.1;,��,'v /ahayden�pella.tom • ,_ , ," ;\� __ � _�'� Quallty Assurance Representative Andrew Ne1sCn Add�ess/Phone/Emal1 102 Ma/n St Pella, IA 50219 (642)621-3904 ;�t, ne/sona@pelfa.com _ �`��`�r,F, ..,t�x��. !a,�"t- �_ .�. � Cate o F'��- �'`•' -. 9 rY W/ndows ��?��,4,;r� . �_°���'�1�;`;r:� �� Subcategory S/nq/e Hung ''�t r°�.� ( °af dJ` ; �`�(t�+,j;��r, ``c� � CompUance Method Certlflcation Mark or Llst/ng 1C S J Cert/f/cat/on Agency Wlndow and Door Manufacturers As�oc/atlon Valldated By lames t. Buokner, P.E.at CBUCK Englneering �'; Val/datlo�Checkllst-Hardcopy Recelved Referenced Standard and Year(of Standard) S[andard �� AAMA 101/1.:5.2-97 �99� AAMA 101/I:S.2/NAFS-02 2002 AAMA/WOMA/CSA 101/I,S.2/A440-05 2005 Equlvalence of Product Standards Cert/fled By Product Approval Method Method 1 Opt�lon A Date Subm/tted 11/03/2011 http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqs6WGOndIUH,., 2/2?/2p}2 N lorida riuilding c:octe uniine = ug�� �1 � Date VaBdated i 1/07/2011 Date Pend/np fBC ApprovaJ Date Approved 11/10/2011 Summary of Products -'�__.Y.._...._____�__.._�._..Y.._ —_ �_ �.—_._._ FL# Mode/ Number or Name D scrl t/on 11206.1 Serles 10 F/an ed Sln le Hun V /Flan ed S/n le Hun Wlndow 54"x 90" L/mJts of Use C rt/flcatlon Ayency Certlflcate Approved for ure!n HVHZ:No FL11206 R6 C CAC CCL for Pella 6-30-09 411-H-103�.01-03.ndf Approved for use oulslde HVH2: Yes Q�allty Assurance Contract Expirallon Dafe impaet ResJstant:No 0,6/10/2013 Deslpn Proasure: +30/-30 Sry'alallatlon Instructlons Ofher:Conf/guratlons of glass conform to/atest ASTM E1300 FL,�11�6 g6 11 141gsp�lf standard. Verlfled 8y; Warren W. ;ichaefer, P.E. 44135 Qreated by Independent Thlyd Party: Yes E�alualfon Reports F 1 2 4 � � reated 6 Inde endent Th/�d Pa : Yes I 11206.2 SeNes 10 F/an ed Sln le Hun V I Flan ed Sln le Hun Wlndow 52-1/8"x 73" Limits o�Use C �tfflcaHon Ageney Certlflcate Approved for use!n HVHZ:No FL11206 R6 CAC�CL for Pella 6-30-09 411-H-1032.05-07.2df Approved for use oulslde NVH2: Yes Q�' eUty Assurance Contrae!�xplration Dete impac!Reslrtant:No Q4/20/2013 Des/pn Preasure: +50/-50 I�atallat/on Instruct/ona Olher:Configurat/ons of g/ass conform to/atest ASTM E2300 RLI1206 R6 l! 141�f Istandard. VeNfled By: Warren W, Schaefer, P.E. 44135 � Greated by Independent Thlyd Party: Yes Evaluatlon Reports I �1�,�,Q�&6 AE 141Q,psif �eated b Inde endent Third Pa ; Yes 11206,3 SeNes 10 f/an ed SIn /e Nun Vn /F/an ed S!n le Hun Wlndow 36"x 62" Llmlts of Use C rtlflcatlon A�enty Certlf/cafe Approved for use in HVHZ:No �Q�,g.�,����C,�'or Pella 6�,�Q=Q9 41(-H-1032.13-SS.vdf Approved for use outslde HVH2: Yes usNty Aasursnce Conlract Explrsllon Date � Impac!Resislan�:No 02/1 i/2013 Des/gn Pressure: +55/-55 1l►stallatlon instructJons � Other:Configuratlons of g/ass conform to/atest ASTM E1300 PL11206_g{ZII 1414.o�if standard. Verlf/ed By, Warren W. Schaefer, P,E, 44135 Created by Independent Thlyd Party: Yes ' Eva/uatlon Reports ! (?J,,�1205 R6 A�Qj_Q,p� i reated b Inde enden��Th1rd Pa ; Yes 11206.4 SerJes 10 fJan ed Sln /e Hun V n 1 Flan ed S/n /e Hun Wlndow 36"x 90" Limtts of Use rtlflca!!on Apency Certlf/cale Approved for uae Jn HVHZ:No L112���;�.�r Pe(la 6-30-09 411-H-1032 09-1�vdf Approved for uss outslde HVH2: Yes Q�allty Aasurance Contract Explrallon Date , Impac!Resis[snt:No Q2/09/2013 � Desl�n Pressure: +50/-50 ibstallatlon instruct/ons I' Other:Conflgurat/ons of glass conform to latest ASTM E1300 � 1{„L206 R6 11 1414.odf standard. IYer/f/ed 6y; Warren W.Schaefer, P,E. 44135 j Creaced by Independenf•Th/rd Party: Yes I EVa/uation Reportr I �LI1206 R6 AE 14j,Q�>,�[ � reated b Inde endent•Th/rd Pa : Yes �11206.5 Serles 10/20 Hlgh Performance Single V�ny/Hlgh Performance S/ng/e Hun�Twln Composlte(72"x 65- Hun 1•2„ �t/r»!ts of Use C�rtification Aqency Certlflcate Approved for use In NVH2:No 6 R6 C CAG�1-H-1093,vdf Approved for use outslde HVH2: Yes �1206 R6 C GaG 411-H-1095.ndf impac!Res/stant:No Quallty Assurance Corttrac!Expiretlon Date Des/yn Pressure: +50/-50 �1/17/20i3 � Olher:Conf/gurat/ons of glass conform to/atest ASTM Ei300 I�►slallatlon Instructfons standard, FL1,,,�20,�R,�„11 Or,��(„n�,,�572,n�1f VeNf/ed 8y: Wa�ren W. .Schaefer, P.F. 44135 �'reated by lndependen[Th/�d Party: Yes � E'yaluat/on Reporta 11 R �n9_1571.p�f reated b Inde endent Th/rd Pa : Yes 11206.6 Ser/es 10/20 Hlgh Performance S/ngle ny/Nlgh Performance S/ngle Hung W/ndow(42"x 72"J Hun I Lim/ts of Use C'ertiflcaflon Agenay Cert/ficate http;//www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqs6 WGOndIUH... 2/27/2012 r ioriaa tsuiiaing �oae un�ine 1 ag� � �. � Approved for use/n HVHZ:No - Approved for use outslde HVH2: Yes Q allty Assurance Coniract Expiratlon Date � impact Res/stanf:No 0,/07/2013 DesiQn Presaure: +50/-50 Sdstallallon Snatruct/ons Other:Conflguratlons of g/ass conform [o latest ASTM E1300 fL11206 R6 II Drawlna 15�2.ndf standard. Verifled 8y: Warren W. 5chaefer, P.F, 44135 Created by Independent Thlyd Party: Yes E�afuet/on Reports 6 R6 AE Drawln�1572.vdf ted b Inde endent Thlyd Pa : Yes 11206.7 SeNes 10/20 Sln le Hun V l Sln le Hun Wlndow 48"x 72" llm!!s of Use C rt/flcst/on Apeney Certlf/cate Approved for usa!n HVHZ:No 1 Pe - 4 Approved for use oufalde NVN2: Yes Q allty Asaurance Contract Exp/rat/on Daie Zmpsc!Rasislant:No 0 /04/2013 Des/pn Presrure: +35/-35 Ir�staNatlon Inslruc!/ons Other:Conf/guratlons of glass conform to latest ASTM E1300 �11206 R6 t1 Ora�g 1572.vdf standard. VeNf/ed Byr Warren W, 5chaefe�, P.E. 44135 Created by Independent Thlyd Partyr Yes E�rslusNon Reports E1��1�51�!3�A�[r7�Y1139�T�,.12�f ated b inde endent Thlyd Pa : Yes 11206.8 Series 1 D/20 Sln Je Hun V! I S1n le Hun Wlndow 48"x 59-1/2" Llmifa of Use C rtlflcatlon Ayency Cer!!//cate Approved/or use!n HVHZ:No 5 C C.AC CGG for Pella 10-20-09 411-H-1043.09.ndi Approved fc�use outside HVH2: Yes Q al/ty Assursnce Conl�act Expf�atlon Date Impaet Resistant:No 0I�/04/2013 Deslpn Presaure: +35/-35 I�istallaMon Instructlons Other:Coni/gurat/ons of g/ass conform to/atest ASTM E1300 � 11 Dratvina i572.vdf standard. ,erlfJed By: Warren W. 5chaefer, P.E, 44135 Oreated by Independent Th/rd Party: Yes E�afuatlon Reporta fL11�Q5 R6 AE Oraw/nA 1572.�df, d eated b Inde endent Thlyd Pa : Yes 11206.9 Serles 10/20 Sln le Hun V I Sln !e Hun Wlndow 36"x 59-1/2" !Imlts of Use C rHf/cal/on Apency Certlflcste Approved for use!n HVH2:No Approved for use outaJde HVHZ: Yes Q al/ty Assurance Conlract Exp/rallon Dete Impact Rea/stant:No 08/03/20i3 Deslyn Pressuro: +35/-35 S sfallstion instrucdons Olher:Conflguratlons of g/ass conform fo/atest ASTM E1300 11 Drawlno 1572.ndf standard, � rlfled By: Warren. W.Schaefe�, P.E. 44135 � dreated by Independent Th/rd Party: Yes i Eu�aluat/on Reports � F'Li1206 R6 AE Orew/ng 1572.vdf d ated b Inde endent Thi�d Pa : Yes ;11206.10 Ser/es 10 20 Sln !e Hun V /Sln le Hun Wlndow 48"x 84" j Llmita of Use C rtlflcatlo»Ayeney CorHflcate Approved for use/n NVH2:No fL11206 R6 C CaC_CCL for Pe!!a 10-20-09 411-H-1ne3�r ��rf Approved for use outslde HVH2: Yes � �206 R6 C er rr �r Pella 10 20 09 411 H]0"3 TS ndf Impact ResistanL•No Q al/�y Aarurance Contract ExplraHon Date DesJpn Pressuro: +35/-35 08/07/2013 Other:Conflguretlons of glass conform to latest ASTM E1300 I stallatlon instructlons standard. V�,�1206 R6 11_D�a�v/n,g 1572.vdf ,er/fled By; Warren W. >chaefer, P.E. 44135 � 0/eated by Independent Thlyd Party: Yes Eyaluat/on Reports � �L11206 R6 AE Draw/nv 1572 vdf ' d ated b Inde endent Thlyd Pa : Yes �11206.11 SeNes 10 20 S/n le Hun V! I Sln le Hun Wlndow 36"x 72" tfmlts of Uae C rtlfleatJon AQency Cart/f/eate Approved for use In HVHZ:No L_for Pella 10-20-09 411-H-104313 Ddf Approved for uae outs/de HVN2: Yes Q al/ty Assuranee Cont�act Expirai/on Date Impsct Rerlstan[:No 0 /03/2013 Des/pn Prossuro: +35/-35 I sia//atlon instructlons Other. Conf/guratlons of glass conform to latest ASTM E2300 F R6 II Drawlna 1572.vdf standard, ��Ifled By: Wa�ren W. 5chaefer, P.E. 44I35 /eated by Independent Thlyd Party; Yes E s/uatJon Reporta � f 11206 R6 AE QrawJno 1572 ddf ted b Inde endent Thlyd Pa ; Yes 11206.12 Serles 1 D/20 Sfn le Hun VI' !Sln le Hun Twln Com oslte 72"x 53.5" �Lfmlls of Use C,rtlflcatlon A�ency CertJficate http://www.floridabuilding.org/pr/pr_app_dtl.aspx?patam=wGEVXQwtDqs6 WGOndIUH... 2/27/2012 Florida Building C;ode Vniine -�b� . �. � Approved/o�use in HVH2:No f111206 R6 C CAC 411-H-1094.ndf Approved for use outside HVH2r Yes Qpa!lty Assuranee Conlract Exp/ratlon Dale Impact Reristant:No 1�1/17/2013 Deslyn Pressure: +35/-35 I�fstallatlon inslrucHons Other. Conflgurat/ons of glass conform to/atest ASTM E1300 �� standard. er/Aed By: Warren W. Schaefer, P.E. 44135 Oreated by Independent Thlyd Partyr Yes � EVafuatlon Reports �11206 R6 AE Dra�yjpo 1572.cdf eated b Inde endent Third Pa : Yes 11206.13 SeNes 10 20 S/n /e Hun V I Sln le Hun Twln Com os/te 96"x 53.5° Llin/ta of Use C rNflcstlon AQency CerNfleste Approved for nse!n HVNZ:No 1 0 I i-H-1099.cdf Approved lor use oulside HVHZ: Yes Q alJty Assurance Contract Explrat/on Date Impact Reslstanf:No 11/i9/2013 Des/pn Pressure: +35/-35 I�staUatlon Inslrucllcns Other:Conflguratlons of glass conform to latest ASTM E2300 6 R6 II Drawlna 1572.Ddf standard, rlfled 8y: Warren W. Schaefer, P.E. 44135 I Oreeted by Independent ThJrd Party: Yes Ei�aluatlon Reports AE Drawlnq Z,$7a.�df reated b Inde endent Thlyd Pa : Yes 112U6.14 Serles 10 20 S/n le Hun V I Sln le Hun Twln Com oslte 96"x 72" Um/ts o/l/se Cprtlflcet/on Apeney CerHflesle Approved for uae/a HVH2:No �'/�,j�Q6 R¢ C CAC 41 i-H;�,Q95/Ldf Approved fo�use outslde HVH2: Yes �i112Q5 R6 C CAC 411-H-ISOO.ndf impaet Resiatant:No Qj�allty Assurance Contract Explral/on Dafe Deslpn Pressure: +30/-30 lll/18/2013 O[har:Conflguratfons of g/ass conform to/atest ASTM E1300 I�alaNat/on instructions standard. � ,erlfled By: Warren W.Schaefe�, P.E. 44135 reated by Independent Thlyd Party: Yes I E aluation Reports g 1572.ndf , reated b Inde endent ThJrd Pa : Yes 12206.15 Serles 10/20 S/n !e Hun V I Sln le Hun 7Yvin Com oslte 72"x 72" timlts o/Use C rtlfJcaHon Apeney Cartlf/cate Approved for use!n HVHZ:No � R6 C CAC�1-N-1092.ndf Approved for use oulsfde HVH2: Yes Q allty Assurance Contract Explratfon Date impact Reslstant:No 1 i/17/2013 Deslpn Preasure: +35/-35 I stallatJon InatrucHons Other:Conflguratlons of glass conform to/atest ASTM Ei300 �standard. erlfled By: Warren W. 5chaefer, P.E. 44135 � �reated by Independent Thlyd Party: Yes E aluaHon Reports �L11206 R6 AE Drawlno 1572ndf reated b Inde endent Thlyd Pa : Yes 11206.16 SeNes 10/20 SIn le Hun V l f/xed Wlth Sln le Hun Flankers 108"x 72" L!mltt of Use C rtlflcatlon A�ency Cert/f/csfe Approved for ute!n HVHZ;No �L for Pella 411•H-950-02.ndi Approved for usa oulside HVH2: Yes Q a//ty Assuranee Confract Exp/rallon Date impact Reslstant:No 1i0/03/2015 DesJgn Pressuro: +30/-30 I�lata/latlon Instruttlons O[her:Conf/guratfons of glass conform to fatest ASTM E1300 f�111206 R6 11 Drawlnn 1572.�df standard. l{eNfled By: Warren W.Scheefer, P.E. 44135 i reated by Independent Thlyd Party: Yes E alustlon Reports A D q 1572.vdf reated b Inde endent Thlyd Pa : Yes 11206.17 Se�/es 10 20 Sln /e Hun V !S!n /e Hun TN !e Com osJte 108"x 72" i L!mlts of Use C,rllflca!!on Apency Certlfitate I Approved for use!n HVH2:No _CAC�i1-H-1090.vdf Approved for use outslde HVH2: Yes 06 R6 C CAC,�I-N-Ii0l.adf Impsct Reslstsnt:No Q allly Asauranee ConMact Expl�at/on Date Deslp»Presture: +35/-35 3/31/2014 Other:Configurat/ons of glass conform to/atest ASTM Ei 300 I stallatlon Instruct/ons standard, , 1206 R6 I! Drawlnsr i572.n� eNfled By: Warren W. Schaefer, P.E. 44135 reated by Independent Thlyd Party: Yes E aJuaHon Reports A i572.�df reated b Inde endent Thlyd Pa : Yes 11206.18 SeNes 10/20 S/n le Nun V l S1n le Hun Trl le Com oslte i08"x 53.5" http://wv�w.filoridabuilc�ing.org/pr/pr_app_dtl.aspx?pa#�am=wGEVXQwtDqs6WGOnctIUH... Z/27/2012 r ioriaa tsuiiaing i.,oae vniinC r ago ., v� ., Lfmlts of Use Cbrtificatfon Apency Certliicate Approved foruseln HVH2:No �1206 R6 C CAC�.1-H-1098.vdf Approved for use oufr/de HVHZ: Yes Q allty Assurance Contract Exp/rat/on Date Impaet Reslstanl:No 1�t/19/2013 Des/yn Pressuro: +35/-35 i�sfa!lat/on instruct/ons Other:Confl9uratlons of g/ass conform to latest ASTM E2300 f`L21206 R6 11 Draw/na 1572.ndf [andard. Verlfled 9y: Warren W. 5chaefer, P.E. 44135 Oreated by Independent Thlyd Party: Yes Eyaluation Reports � FL11206 R6 AE Orawlna i572.ndf Oreated b inde endent Thlyd Pa : Yes 11206.19 Serles 10/20 S/n /e Hun VI i Flxed Over SIn le Hun Com os/te 30"x 76" L!mlts of Use Cer!lfica!!on Apsncy CurHflcate App�oved for use in HVH2:No 6 R6 C CAC 411-H-109i.�f Approved for use outslde HVH2: Yes Q a!!ty Assurance Contract Explratlon Dafe impact Reslstanl:No lil/10/2013 Desl�»Pressure: +35/-35 ir�rtal/at/on lnrtrueNons Olher:Configurat/ons of glass conform to latest ASTM E1300 �y(pq 1572.ndf tandard. erlfled Sy: Warren W. 5chaefer, P.E. 44135 Qreated by tndependent ThJrd Party: Yes �aluatlon Reports ' 0 2572.�df reated b Inde endent Thlyd Pa : Yes 11206.20 SeNes 10/20 5/n le Hun V l flxed Over 5!n le Hu»p Composlte(46"x 76) tlmlts of Use C rt/f/csHon AQeney Cert/f/cste Approved for use ln HVH2: No 12 C 4 1-H-1089.odf Approved for use oulslde HVH2: Yes Q allty Asaursnce Contrsc�Exp/rst/on Date Impaet Reslstsnt:No 11/11/2013 Des/gn Presrure: +30/-30 ihsfsllatlon instruetions Other:Confipuratlons of plass conform to/atest ASTM Ei300 ��ILDrawiny 1572.�f standard. erlfied By: Warren W. 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