HomeMy WebLinkAbout115 Academy Ave (2)D MAYZ011 Application
No. CITY
OF SANFORD BUILDING &
FIRE PREVENTION PERMIT
APPLICATION Documented
Construction Value: $ Job
Address: Parcel
ID: .;-,01'3c _S15-40OC" _ 03CIIo Description
of Work: J — /
Historic
District: Yes No Zoning:
Plan
Review Contact Person: o r rz, Om ovd- Title: 'r' e c'"o [,-e r` Phone:
L(d"+ 9i 21. 0200 Fax: E-mail: JA i /YN0 aJ. L(' 6 Me i I . c,007iProperty
Owner Information Name -
P4o (1 ; (t ck(YtS Phone: Street:
I3" 49Pt —Q u-e Resident of property? City,
State Zip: L, , 'G Contractor
Information ff
Name
ont T;3C Phone: {Cj • pia 1^ a30 Street:
lei a Lt1)c^ Fax: City, State
Zip: _(Jkt-fcr f- FG 3 2i9,2 State License No.: ArchitectlEngineer Information
Name: Phone:
Street: A
Fax: City, St,
Zip: E-mail: Bonding Company:
Mortgage Lender: Address: Address:
PERMIT INFORMATION
Building Permit
IB Square Footage:
Construction Type: No. of Stories: No. of
Dwelling Units: Flood Zone: Electrical Plumbing
New Service -
No. of AMPS: New Construction - No. of Fixtures: Mechanical (Duct
layout required for new systems) Fire Sprinkler/Alarm No. of heads:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no
work or installation has commenced prior to the issuance of a permit and that all work will be performed to
meet standards of all laws regulating construction in this jurisdiction. I understand that a separate permit
must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and
air conditioners, etc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE
OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
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 districts, state agencies, or federal agencies.
Acceptance ofpermit is verification that I will notify the owner of the property of the requirements ofFlorida
Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
r
Signature of er/Agent Date
Print Owyt:r Agent's Name '
Signature o otary-State ofFlorida Date
1WIl GAOL E HEMMER
MY COMMISSION # DD758257
EXPIRES February 12, 2012
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONIN '• 1 UTILITIES:
COMMENTS:
Rev 11.08
A amw- /!
S' attire ofContractor/Agent Date
Print C tractor/Agent's Name
Signature ofNotary -State of Florida ate
1/ GAIL E HEMMER
e MY COMMISSION # DD758257
EXPIRES February 12, 2012
407 398.0153 Floddalloten/Servicomm
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
ENGINEERING: FIRE: BUILDING: o? 1
Seminole County Property Appraiser Get Information by Parcel Number Page 1 of 2
DAVW JOHNSON. CFA.ASA 2 3 dM&S78 9 tp 11 12 13 id 5
1•+, :
I PROPERTY
APPRAISER
ACADEMY
AVE 11y .
46 d4 43 42 4 40 39 33 37 35 35 31 kSEMINOLEC0eNTYFL
rt
n,-r L/ 4
1101,"
E.FniSrs7 sAHFasenFc.
3277t-t4ti8 d8 d9 &3 61 fit Gi b4 d6 B3 61 &8 60 t f 7508 407-
t36530THO5 IR VALUE SUMMARY
VALUES 2011
2010 GENERAL Working
Certified Value Method
Cost/Market Cost/Market Parcel Id: 35-19-30-515-0000-0390 Number of
Buildings 1 1 Owner. WILLIAMSROYCEE & Depreciated Bldg
Value 31,617 37,082 Own/Addr: EARTHERLEAN P Depreciated EXFT
Value 0 0 Mailing Address: 115 ACADEMY AVE Land Value (
Market) 10,000 12,000 City,StateXpCode: SANFORD FL 32771 Land Value
Ag 0 0 Property Address: 115 ACADEMY AVE SANFORD 32771 Subdivision Name:
ACADEMY MANOR UNIT 01 Just/Market Value 41,617 49,082 Tax District:
S1-SANFORD Portablity AdJ 0 0 Exemptions: 00-
HOMESTEAD (1994) Save Our Homes AdJ 0 6,280 Dor: 01-
SINGLE FAMILY Amendment 1 AdJ 0 0 Assessed Value (
SOH) 41,617 42,802 Tax Estimator
2011 TAXABLE
VALUE WORKING ESTIMATE Taxing Authority
Assessment Value Exempt Values Taxable Value County General
Fund 41,617 41,617 0 Amendment f
adjustment is not applicable to school assessment) Schools 41,617 25,000 16,617 City Sanford
41,617 25,000 16,617 SJWM(Saint
Johns Water Management) 41,617 25,000 16,617 County Bonds
1 $41,6171 25,0001 16,617 The taxable
values and taxes are calculated using the current years working values and the prior years approved millage rates. 2010 VALUE
SUMMARY SALES Tax
Amount (without SOH): $366 Deed Date
Book Page Amount Vac/Imp Qualified, 2010 Tax
Bill Amount: $271 Y Find
Comparable
Sales within this Subdivision Save Our
Homes (SOH) Savings: $95 2010 Certified
Taxable Value and Taxes DOES NOT
INCLUDE NON -AD VALOREM ASSESSMENTSLAND LEGAL
DESCRIPTION Land Assess
Method Frontage Depth Land Units Unit Price Land Value PLATS: Pick... LOT 0
0 1.000 10,000.00 $10,000 LEG LOT 39 ACADEMY MANOR UNIT 1 PB 13 PG 93 BUILDING INFORMATION
Bid Num
Bid Type Year Bit Fixtures Base SF Gross SF Living SF Ext Wall Bid Value Est Cost New Building
Sketch
1
SINGLE FAMILY 1961 3 1,021 1,221 1,021 CONC BLOCK $31,617 $45,167 Appendage/ Sqft
CARPORT UNFINISHED / 200 NOTE: Appendage
Codes included in Living Area: Base, Upper Story Base, Upper Story Finished, Apartment Enclosed Porch F/nished,BaseSemi Finshed
OTE: Assessed
values shown are NOT certified values and therefore are subject to change before being finalized for ad valorem tax purposes. Ifyou recently
purchaseda homesteaded property yournext ear's property tax will be based on Just/Market value. http://www.scpafl.
orglweb/re web.seminole county_title?parcel=35193051500000390&c... 5/16/2011
LBUTED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 1 -2,`3 1 0
I hereby name and appoint: Sb t3 ) k,.N >/v-\,d iN
an agent of 2EM 16 K)S J-U-j ('
Name ofCongwy)
to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things
necessary to this appointment for (check only one option):
O All permits and applications submitted by this contractor.
Im The specific permit and located at:
weer Address)
Expiration Date for This Limited Power ofAttorney: J A , ao k,
License Holder Name: It 6yy\ 1- 5 b L
State License Number:
Signature of License Holder:
STATE OF FLORIDA
COUNTY OFS rn, v
9.51(3
The foregoing instrument was acknowledged before me this 2 2 day of — fT,
2002L, by %Lrn4 e- 6. C'oo- who is o hers Wally known
to me or o who has produced
identification and who did (did not _tak an oath.
Aad 4 L
Signature
Notary Seal) ( C¢-t % L— . 17emmew-
Print or type name
Notary Public - State of
Commission No. K 7
My Commission Expires: feZ
as
Rev.3/27/07) 01 . OAIL E HEMMER
MY COMMISSION,#( 1)1)75825i
ipd; EXPIRES February 12, 2012
q07) 398-0153 FloridallotaryService.com
Coo -- C(`ecj- nS
1
Ljtvv 4 r irk, Fl- Cow'
3a-
9a TO: -
G
Grata
CONTRACTORS
INVOICE WORK
PERFORMED AT: ON -
ljpl. YOUR
WORK ORDER NO. OUR Bib NO. DESCRIPTION &
WORK PERFORMED I
j
i
i
WA
All
Material is guaranteed to be as specified, and the above work was performed in accordance with the drawings and specifications provided
for the above work and was completed in a substantial workmanlike manner for the agreed sum of Dollars ($
This
is a Partial Full invoice due and payable by: Month
Day Year in
accordance with our Agreement Proposal No. Dated Month
Day Year NC3822
CONTRACTORS INVOICE
Florida Building Code Online Page 1 of 4
PERMIT # // r fliodr
A _ OFFICEr =r:1
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Product Approval
USER: Public User
Pno0uct Approval Menu > Product or Application Search > Application Ust > Application Detail
i FL # FL10701-R1
Application Type Revision
Code Version 2007
Application Status Approved
Mr Comments
Archived
Product Manufacturer JELD-WEN
Address/Phone/Small 3737 Lakeport Blvd
Klamath Falls, OR 97601
800) 535-3936
fbc@jeld-wen.com
Authorized Signature Janet Gerard
fbc@jeld-wen.com
Technical Representative Steve Saffeil
Address/Phone/Email 3737 Lakeport Blvd
Klamath Falls, OR 97601
541)882-3451 Ext2900
stevesa@jeld-wen.com
Quality Assurance Representative
Address/Phone/Email
Category Exterior Doors
Subcategory Swinging Exterior Door Assemblies
Compliance Method Certification Mark or Listing
Certification Agency National Accreditation & Management Institute,
Validated By National Accreditation & Management Institute,
Referenced Standard and Year (of Standard) Standard Year
AAMA/NWWDA/101/I.S.2-97 1997
ASTM E330 2002
ASTM E331 2000
Equivalence of Product Standards
Certified By
Product Approval Method Method 1 Option A
h4://www.floriclabuilding.org/pr/pr app_dtl.aspx?param=vvGEVXQwtDgvIdAvIteOYO... 4/19/2011
JELD WEN® Steel
B'-0"i 8'-0"SIROLEIN3H7NO OPAQUE STEEL EAOE
IMPACT STEEL DOOR IN WOOD FRAME
0
3'—I 3/4' CIA>
GENERAL NOTES ' fRAU£ K O7}I m3' OA1. THIS PRODUCT IS DESIGNED TO COMPLY WITH THE FLORIDACd2004BUHDINGCODES (W/2005. 20GS SUPPLEMEMTS) AND ' PANEI. NbTH — () fi
r-
HIGH VELOCITY HURRICANE ZONES' (M'HZ) REQUIREMENTS. 3'-} 3/4• OA. Z O2. WOWTOOTRANBSFER LOADS TCKSBYOTHEMUSTSTRUCSHOREDPROPERLYwlx. FRUIE W NNCIAZ W ty N3. PRODUCT ANCHORS SHALL HAS LISTEDEMBEDMENTAND SPACED ' PANf1 wOrN wYtiw
M SHOWN A DETAILS, ANCHOR EMBEDMENT TO BASE Q SMATERIALSHALLBEBEYONDWALLDRESSINGORSTUCCO.
4. IMPACT RESISTANT SHUTTERS NOT REQUIRED.
5. DESIGN PRESSURE RATING SHALL BE AS FOLLOWS:
FOR 8'0" WOOD FRAMES - SEE TAKE SHEET 1 ® ® ' c+0 x dFOR8'0' WOOD FRAMES -SEE TABLE SHEET 1 j4( 6. THIS SYSTEM WAS TESTED FOR 2.86 LBS. WATER PRESSURE
AS PER ASTM-
PRODUCT OE
31.
7. THIS PRODUCT GOES NOT MEET THE WATER REQUIREMENTS
FOR 'HVHZ'.
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DOOR LEAF CONSTRUCTION:H d+
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minimum average yield strong Fy-26,240 psi. n
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2
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steel cities with a wood lack b k reinforcement. The IOhingestilecontainsaMDFboardforaddedhingesupport. `
Frame Construction (9eth Frame ea)• The head JambeRI r
and a Jambe are mortised, butted and 'Joined using3
PRODUCT RENEWED o. V8' x 2" wine staples. An aluminum adjustable Insg ' ugDUCT RENEWEDtthhresholdwooUnitiazedattheegl. An optional aluminum
ADA threshold Is available. 0"agCoe
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RMIT # PE
R
W R W Building Consultants, Inc.
B Consulting and Engineering Services for the Building Industry
C P.O. Box 230 Valrico. FL 33595 Phone 813.659.9197 Pacsimite 813.754.9989
Florida Board of Professional Engineers Certificate of Authorization No. 9813
Product Evaluation Report
Report No.: FL 6142.6 RI
Date: October 1, 2008
Product Category: Exterior Doors
Product sub -category: Swinging Exterior Door Assemblies
Product Name: Distinction Series Glazed Fiberglass Door
Lip Lite Screw Frame inswing / Outswing
Non -Impact"
Manufacturer: Nan Ya Plastics Corporation
Plastpro Inc.
9 Peach Tree Hill Road
Livingston, NJ 07039
Phone:800-779-0561 Facsimilc:973-758-4001
Scope: This is a Product Evaluation report issued by R W Building Consultants, Inc. and Lyndon F. Schmidt,
P.E. (System ID ff 1998) for Nan Ya Plastics Corporation, Plastpro Inc. based on Rule Chapter No. 9B-
72.070, Method ld of the State of Florida Product Approval, Department of Community Affairs -
Florida Building Commission.
RW Building Consultants and Lyndon F. Schmidt, P.E. do not have nor will acquire financial interest
in the company manufacturing or distributing the product or in any other entity involved in the
approval process of the product named herein.
This product has been evaluated for use in locations adhering to the Florida Building Code (2007
Edition).
See Drawing No. FL-6142.6 prepared by R W Building Consultants, Inc. and signed and sealed by
Lyndon F. Schmidt, P.E. (FL 9 43409) for specific use parameters.
ZV
Lyndon F. Sclunidt, P.E.
FL No. 43409
October 1, 2008
RAA - Projeets\Projccl FoldcrslProj 801 - 900yt18931PF 893 RRE. Word Doc - ovals apps cic\6142411, 6142.6 Rl.doc
Sheet 1 of 3
NAN YA PLASTICS CORP.
PLASTPRO INC.
9 PEACH TREE HILT. ROAD
UVINGSTON. NEW JERSEY 07039
DISTINCTION SERIES
GLAZED FIBERGLASS DOOR
LIP LITE SCREW FRAME
INSWING / OUTSWING
NON -IMPACT'
GENERA. NOTES
I. This prooucthas been evduatedend isin compliance withthe 200i Rorido
Bu1d'ing Code (FBC) stnleturol rmquiremenls exclud'ng the -High Ve ocity
Hurricone Zone (HVHZJ.
2. Product anchorsshot be as Itstedand spacedasshown on detais. Anchor
embedment to base, mctmial shall be beyooa wall dressing or stucco.
3. when used in oreas requiring wind borne debris protection. ft product is
required to be protected with on Irrpec-resistant coverin0 that complies with
Section 1609.1.7 of the 2007 F6C. _
4. For 2x stud homing comfnsction. anchoring of these untrs shall be the some as
that shown for 2x tuck masonry construction.
S. Site conddions that deviate tom the detolls oftha drawing require further
engineering analysis by a licensed engineer orregistered architect,
MALE OF COMM
SHE N D=UMON
I typical a ",on, dodpn Proalros Znonoral noes
2 Door panel detot,
3 HmrCOntal cross smahOPS
4 Voniod cross socn=
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6 Fromm anchornn- IX buck masonry cofrtnrM
7 B91of Malorca, gWna dota0 & compcnonts '
37W MAX.
I_ OVERALLworn
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INSWING 37.50-x82A0-
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47.0 SO.O
OUTSWING 374VxOUT 50.0 SO.0
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EXTERIOR
INTERIOR I
EXTERIOR
INTERIOR 40
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VERTICAL CROSS SECTION 4 VERTTCAtCROSSSECTION crec
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LFS 4
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MASONRI
OPENING
2x suc
BUCK ANCHORING
1\ N
TYP. HE. HEEAD &
MASONRY—
JAMBS —
OPENING
FRAME u i
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U SUCK
f
0'
SIRIKEJAMB FRAMEANCHORING NINGEJAMB
Mw,4nry2Xbuck conslrJCDon NOTES:
1.
1/4" Etco concrete screws anchoring 2X buck require a minimum I' cieorance to masonry edges, a 1-114" minimum embedment
and a minimum 4" clearance to odjacent concrete screws. Substtlutlon of equal concrete screws from a different
suppllermay have d iforen redgedistance and center dtstoncorequlromenis. Concrete screw locations at the comers
may be odjusted to mointoln the minlmurn eogo distance to mortorJolnts. tf concrete scrowtocatlons noted as WAX.
ON CENTER" must be odJustcd to malnto n the minimum edge distance to mortar Joints, oddltlonotconcrete Screws
may be required 70 ensure tale maximum on Confer dimension Isnot eXceoded. tATCHADEADBOUDETAI[
HINGEDETAII z
i 09
03 08 r
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6142.E c
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1 9
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ggo3nQgEbJAMBS — QQ
OPENINGONRY NOTE 1
t t HINGEWAIL
FRAME o
N
N ypp 1A b OGS
IXSUCK
G SEE NOTE 2 Ix>
4
G SEE NOTE 2
STRIXE JAMS FRAME ANCHORING HINGE JAMB
27
LATCH 6 DFAa80lT DETAftMownrytXtuckcomruceonNOTES:
1.
1/4" IT1N concrete screws anchoring frame and/or sBl require o minimum 2-lt7clooronce to masonry edges d 1-1/4" minimum emacdmeni and c minimum
3" clearance to adjacent concrete screws. SubsUbAon of squat concrete screws from a different supaller may have different edge distance and
center distance requirements. Concrete spew Iocctfons et the comers may be adjured to molnic the minimum odgo divorce to martar joints. IfconcretescrewloCOtionsnotedOSMAX. ON CENTER' mu;t ooadjusted to maintain the minimum edge dMtoneo to mortar joints. Odditional concrete
screws maybe requiredtoensurethe maximum on center dimension Is not exceeded. 2.
3/16" I'Twconcrete screws anchoring frome and/orsfB require a minimum2-6/6" Gearonce to masonry edges. a I.1/-d" minimum cmbodmcnt and o mWrnum
2-7/4" clearance to adjacentconcrete screws unfess otherwise noted by concrete screw manufacturer. er. LFS 4
NC' FL-
6142.6 n
orJ
SAL OF MATERIALS
MEM DESCRIMON MATERIAL
A IXBUCK SG>-0.55 WOOD B
2X BUCK SG >= 045 WOOD C
I/4"MAX. SHIM SPACE 0
1 /4" X 2.3/4-PFH ELC0 CONCRETE SCREW STEEL E
MASONRY • 3.192 PSI MIN. CONCRETE CONFORMING TO ACI 301ORf-CLLOW BLOCK CONFORMING TO ASTM C9C 3/
16" X 3-1 /4' PrH ITW CONCP.ETESCREW CONCRETE
G
STEEL H
I [IV x3-li4'PFHiTWCONCRETE SCREW 6TEEL J l /
4' X 3.3!4' PFH TTW CONCRFIE SCREW STEEL K 410
X 2' FFHWOOD SCREW STEEL L 8
X 2-1,7 PFH WOOD SCREW STEEL M 8
X 2' PFH WOOD SCREW STEEL 7 FORCE
5 WEATHER STRIPPING BY ENDURA FOAM 6 1
COMPRESSION WEATHER STRIP QLON 650 BY SCHLEGEL FOAM9 4"
X 4" BUTT HINGE 10 49
X 1" PFH WOOD SCREW STEEL 1' 49
X 3/4' PFH WOOD SCREW STEEL 17 KWIKSET
KEYED ENTRY GRADE 2 STEEL 18 KWIKSET
DEADBOLT GRADE 2 STEEL 2O FNGER
XINTED PINE FRAME. HEAD & HINGE JAMBS WOOD 2' POLYFIBER
JAMB COMP, / VINYL 27 LATCH
STRIKE PLATE STEEL 28 DEADSOLT
PLATE STEEL 30 INSWING
VINYL DOOR BOTTOM SWEEP BY ENDURA VINYL 31 92
OUTSWING
BUMF
THRESHOLD _ VINYL DOOR
BOTTOMSWEEP 48628 BY HOLM IND. T ' ALUM./ WOOD PVC 33
INSWING
ADJUSTABLE THRESHOLD BY ENDURA ALUM. / WOOD 34 INSWING
ADJUSTABLE ALUMINUM THRESHOLD BY DLP ALUM. / WOOD AO DOOR
PANEL - SEE DOOR PANEL DETAIL SHEET FOR CONSTRUaI0N DETAILS Al DOOR
SKIN MIN.0.07S'THICK) FIBERGLASS 42 TOP
RAIL CELLl1LAR/PVC 43 LATCH &
HINGE STILE CELLULAR/PVC 44 REINFORCEMENT
WOOD FOR LOCKS i217' LONG WOOD 45 BOTTOM
RAIL CELLULAR/PVC 46 POLYURETHANE
FOAM BY NAN YA POLYURETHANE 47 CONTINUOUS
LATCH & HINGE STILE REINFORCEMENTWOOD 49 GLAZING
COMPOUND SIUCONE 55 UP
UTE ODL./WES'TERN REFLECTIONSHP POLYPROPYLENE 56 GLAZING
SPACER ALUM. 57 1
48x1-1/7'PFH LITE FRAMESCREW STEEL N \ i
2ta'- - -
2.
13' O20 HEA
b i0mo SAT
I-
I
AOJusraeLEpyswlNc
TWRFSHOID
I --T
1
1--
244" ---h-- 213- 21 N
ADdSr PM/.b0(;Ofnb 1 ADJLra6LE
INSWING
THRESHOLD U 4.
68"
iw r
t
r
I
Si at1MP
RESRO(0 ASTGLASS 1"
MIN. SITE GLASSTHK. z
rr • 49
1/8"TEMPEPED GLASS AIRSPACE OPTIONAL
DECORATIVE
INSERT
ay
r y
AIRSPACE I
Ar
TEMPSUD
GLASSGT GL4TMG
arc
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03 0 `•
D N.T.
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6142.E
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Lu
SEMINOLE COUNTY PRODUCT APPROVAL PERMIT APPLICATION INFORMATION
IT IS THE APPLICANT'S EXCLUSIVE RESPONSIBILITY TO VERIFY THAT SPECIFIC PRODUCTS HAVE BEEN
INSTALLED IN ACCORDANCE WITH THEIR LIMITATIONS (FOR EXTERIOR: WINDOWS, DOORS, GARAGE
DOORS, SKYLIGHTS AND SHUTTER SYSTEMS NEED TO MEET THE MINIMUM REQUIRED DESIGN
PRESSURES FOR THE PROJECT). SPECIFIC COMPLIANCE WILL BE VERFIED DURING FIELD INSPECTIONS.
TYPE MANUFACTURER
EXTERIOR D••-
SWINGING-_s
MODEL # /SERIES
RESERVED FOR
PLANS EXAMINER
USE
FLORIDA APPROVAL #
INCLUDE DECIMAL
IF APPLICABLE
FLORIDA APPROVAL
pdf FILE #
IF APPLICABLE
MIAMI / DADE
N.O.A.
IF APPLICABLE
L 1O o
It
SLIDING
is
Is
OVERHEAD
9.
is
OTHER
WINDOWS
SINGLE HUNG
DOUBLE
HUNG
HORIZONTAL
ROLLING
CASEMENT
FIXED
SKYLIGHT
OTHER
SOFFITS
SOFFITS
2 of 3
j
RESERVED FOR FLORIDA APPROVAL # FLORIDA APPROVAL MIAMI / DADE
TYPE MANUFACTURER MODEL # / SERIES PLANS EXAMINER (INCLUDE DECIMAL) pdf FILE # N.O.A.
USE IF APPLICABLE IF APPLICABLE IF APPLICABLE
ROOFING
SHINGLES
METAL
TILE
OTHER
SHUTTERS
ROLL -UP 7_71
PANELS
PLYWOOD CHECK HERE IF THIS METHOD IS CHOSEN
OTHER
STRUCTURAL•
SINGLE HUNG
P•
HURRICANE
ANCHORS SPECIFY MANUFACTURERS)
ENGINEERED
LUMBER
LINTELS
INSULATION
FORMS
OTHER
CONTRACTOR or OWNER/CONTRACTOR SIGNATURE: DATE:
THE FOLLOWING ALTERNATIVES ARE ACCEPTABLE IF HE PROPOSED PRODUCTS DO NOT HAVE VOLUNTARY STATE APPROVAL OR
SEMINOLE COUNTY ACCEPTANCE:
Copy of product approval/testing information and copy of listing -or- report from a Product Certification Agency approved by the Florida
Building Commission for each different covered product. Approved product certification agencies are shown at www.floridabuilding.org
click on the product approval button, then click on the organization search tab).
Copy of product approval/testing information from a Florida Building Commission approved Product Evaluation Entity or Product
Testing Laboratory and documentation showing the manufacturer has a Florida Building Commission approved Quality Assurance
Agency on retainer. Submittals are required for each different covered product. Approved Product Evaluation Entities, Product
Testing Laboratories and Quality Assurance Agencies are shown on the above referenced website (click on the product approval
button, then click on the organization search tab).
3 of 3