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RECEIVED
JUL 11 2011 CITY OF SANFORD
BUILDING & FIRE PREVENTION
BY:
PERMIT, APPLICATION
v 1 Qom'
Application No: J I g Documented Construction Value: $ 4 301
Job Address:0 Cve r o n- Y1+ter a o Historic District: Yes No
Parcel ID• c i.b Zoning: - •
Description of Work:
Plan Review Contact,Person: Title:
Phone: r • Fax: E-mail:
Property Owner Information /
e r /p
Name C e 1 = o U/o v Phone:• `4 6 I J 2 9_^ / g l 1_
Street: 2010q WVC V\ . l , ay+ Gcts_
II
Resident of property?
lCity, State Zip: Soly-o . r7 el Contractor
Information y Name
Phone: Street:
7 Fax: City,
State Zip: State License No.: Architect/
Engineer Information Name:
Phone: Street:
City,
St, Zip: Bonding
Company: Address:
Fax:
E-
mail: Mortgage
Lender: Address:
L40TVA
18 818810 m WWI
10 0161a - 0ddu9 y16,100 ° PERMIT
INFORMATION MS
ER do3 aongx3 .mmoD yM • SUN
33 N noviminoo Building
Permit Square
Footage: Construction Type No.
of Dwelling Units: Flood Zone: Electrical ,
y New_
Service — No. of AMPS: Mechanical (
Duct layout required for new systems) vaA
pslati ISnoW, dpooldT tobno8 No.
of Stories: 1
Plumbing,•
2 j ' New
Construction - No. of Fixtures: Fire
Sprinkler/Alarm No. of heads:
i
Applicatiow 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 wlillybe performed to :
meet standards of all laws regulating construction in this jurisdiction. I understand ihai-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 of permit is verification that I will notify the owner of the property of the requirements of Florida
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.
P_\_k
Signature of Owner/Agent U Date
M \ 0- e Tau
Prints Owner/Agent's Name
0 9— //-/1
DEBBIE BLANTON --
Notary Public - State of Florida
My Comm. Expires Fetr 25, 2015
W Commission #E EE 60182
Bonded Through Nallonal Notary Aun.
Owner/Agent is . Personally Known to Me or
Produced ID Type of ID F1 tsVC or "I I APPROVALS:
ZONIN 0-11-VILITIES: ENGINEERING:
COMMENTS:
Signature
of Contractor/Agent Date Print
Contractor/Agent's Name Signature
of Notary -State of Florida Date Contractor/
Agent is Personally Known to Me or Produced
ID Type of ID WASTE
WATER: BUILDING:
Rev
11.08
OWNER BUILDER STATEMENT/AFFIDAVIT
Altamonte Springs, Casselberry, Lake Mary, Longwood, Oviedo, Sanford,
Seminole County, Winter Springs
Florida Statutes are quoted here in part for your information to indicate the authority for exemptions for
homeowners from qualifying as contractors and to express any applicable restrictions and responsibilities.
OWNERS MUST PERSONALLY APPEAR AT THE BUILDING DIVISION TO SIGN THIS DOCUMENT
BY SIGNING THIS STATEMENT, I ATTEST THAT: (Initial to the left of each statement)
I understand that state law requires construction to be done by a licensed contractor and have applied for
an owner -builder permit under an exemption from the law. The exemption specifies that I, as the owner of
the property listed, may act as my own contractor with certain restrictions even though I do not have a
license.
I understand that building permits are not required to be signed by a property owner unless he or she is
responsible for the construction and is not hiring a licensed contractor to assume responsibility.'
n
I understand that, as an owner -builder, I am the responsible party of record on a permit. I understand that I
may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed
in his or her name instead of my own name. I also understand that a contractor is required by law to be
licensed in Florida and to list his or her license numbers on all permit and contracts.
I understand that I may build or improve a one -family or two-family residence or a farm outbuilding. I
may also build or improve a commercial building if the costs do not exceed $75,000. The building or
residence must be for my own use or occupancy. It may not be built or substantially improved for sale or
lease. If a building or residence that I have built or substantially improved myself is sold or leased within
in 1 year after the construction is complete, the law will presume that I built or substantially improved it
for sale or lease, which violates this exemption.
I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
I understand that I may not hire an unlicensed individual person to act as my contractor or to supervise
persons working on my building or residence. It is my responsibility to ensure that the persons whom I
employ have the licenses required by law and by city ordinance.
I understand that it is a frequent practice of unlicensed persons to have the property owner obtain an
owner -builder permit that erroneously implies that the property owner is providing his or her own labor
and materials. I, as an owner -builder, may be held liable and subjected to serious financial risk for any
injuries sustained by an unlicensed person or his or her employees while working on my property. My
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner -
y I
builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
I understand that I may not delegate the responsibility for supervising work to a licensed contractor who is
not licensed to perform the work being done. Any person working on my, building who Is not licensed
must work under my direct supervision and must be employed by me, which means that I must
comply with laws requiring the withholding of federal income tax and social security contributions
under the Federal Insurance Contributions Act (FICA) and must provide workers' compensation
for the employee. I understand that my failure to follow these laws may subject me to serious financial
MTJ risk.
Rev. 9.14.2009
I agree that, as the party legally and financially responsible for this proposed construction activity, I will
4
abide by all applicable laws and requirements that govern owner -builders as well as employers. I also
understand that the construction must comply with all applicable laws, ordinances, building codes, and
zoning regulations.
I am of aware of construction practices and I have access to the Florida Building Codes.
I understand that I may obtain more information regarding my obligations as an employer from the Internal
Revenue Service, the United States Small Business Administration, the Florida Department of Financial
Services, and the Florida Department of Revenue. I also understand that I may contact the Florida
Construction Industry Licensing Board at 1-850-487-1395 or at www.myflorida.com/dbpr/pro/cilb/ for
more information about licensed contractors.
I am aware of, and consent to, an owner -builder building permit applied for in my name and understand
that I am the party legally and financially responsible for the proposed construction activity at the address
listed below.
I agree to notify the building department immediately of any additions, deletions, or changes to any of the
information that I have provided on this disclosure or in the permit application package.
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person
who does not have a license, the Construction Industry Licensing Board, the Department of Business and
Professional Regulation and the building department may be unable to assist you with any financial loss
that you sustain as a result of a complaint. Your only remedy against an unlicensed contractor may be in
civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an
individual or firm is injured while working on your property, you may be held liable for damages. If you
obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for verifying
whether the = contractor is property licensed and the status of the contractor's workers' compensation
coverage.
Property Address:
11,Po q W
and capable of performing the reque
conditions specified above.
Signature of Owner -Builder
6 a - + e 0 S-
d V- do hereby state that I am qualified
construction involved with the permit application filed and agree to the
Form of Identification
Must be Photo ID)
Date
A violation of this exemption is a misdemeanor of the first degree punishable by a term of imprisonment
not exceeding 1 year and a $1,000.00 fine in addition to any civil penalties. In addition, the local
permitting jurisdiction shall withhold final approval, revoke the permit, or pursue any action or remedy
for unlicensed activity against the owner and any person performing work that requires licensure under
the permit issued.
Rev. 9.14.2009
T 1
r
ilCS\ro•uct j3proval' roauct or Arn TT• 1
A?
FL #
Application Type
Code Version
Application Status
Comments
Archived
Product Manufacturer
Address/Phone/Email
Authorized Signature
Technical Representative
Address/Phone/Email
Quality Assurance Representative
Address/Phone/Email
Category
Subcategory
Compliance Method
Certification Agency
Validated By
Referenced Standard and Year (of Standard)
FL4334-R4
Revision
2007
Approved
r
Masonite International
IL a ry
Suite 950
Tampa, FL 33609
615) 441-4258
sschreiber@masonite.com
Steve Schreiber
sschreiber@masonite.com
aw+
Exterior Doors
Swinging Exterior Door Assemblies
Certification Mark or Listing
National Accreditation & Management Institute,
National Accreditation & Management Institute,
Standard
TAS 201
TAS 202
TAS 203
NOTICE OF PROD, .'T CERTIFICATION
Company: Masonite International Corporation Certification No.:
1955 Powis Road Certification Date:
West Chicago, IL 60185 Expiration Date:
Product: Metal -Edge Impact Rated Steel Door w/Hollow Metal Steel Frame
Revision Date:
Specifications Tested To: TAS 201/202/203-94/ASTM E330
N1006591-R2 Page 2
06/14/2006
12/30/2010
12/18/2008
The "Notice of Product Certification" is only valid if the NAAU Certification Label has been applied to the product as described vAthin this document, The cerflfication
label represents product conformity to the applicable specification and that all certifiention criteria has been satisfied. This Product has been approved for Lc;dIng within
NAMI's Certified Product Listing at wwwAamicertification.coirt. NAMI's Certification Program is accredited by The American National Standards Insdinte (ANSI .
Configuration
Inswing
or
outswing
Glazed
or
Opaque
Maximum
Size
Design
Pressure
Pos/Neg
Missile
Impact
Rated
Test Report Number
Drawing Number &
Comments
X -
Sin le
I/S Opaque 330" x 678" 80/-80 Yes NCTLr210-1915.1,2,3
Anchor Detail-MA-FL0150-06
X
Single
O/S Opaque 310" x 618" 80/-80 Yes NCTL-210-1915-1,2,3
Anchor Detail-MA-FL0150.06
National Accreditation & Management Institute, Inc./11870 Merchants Walk Suite 202/Newp+ort News, VA 23606
Tel-757.594.8658/Fax-757.594.8659
NAMI AUTHORIZED SIGNATURE:
N
NE4.All NOTICE OF PRODUCT LINE
ERTIFICATION
Certification No.:
Date:
Revision Date:
Certification Program:
Company:
Code:
I,UO06591-R2 Page 1
06/14/2006
12/18/2008
Structural
Masonite International
M-703-1
The "Notice of Product Line Certification' is valid only when Administrator's Seal is applied to the upper
left hand portion of this form and a certification label is applied to the product. This certification seal
represents product conformity to the applicable specification and thin aU certification criteria has been
satisfied.
The products and systems listed below are approved for listing in the Directory of Certified Products at
www.NAMICertification.com. Please review, and advise NAMI immediately if data, as shown requires
corrections.
Company: Masonite International Corporation
1955 Powis Read
West Chicago, IL 60185
Product Line: Masonite Metal -Edge Impact Dated Steel Door with hollow Metal
Steel Frame
Test Report: NCTL-210-1915-1,2,&3
Section 1: General Description of the Products and Systems under this Certification
1.1 Frame: Jzmbs and head constructed fiom 4-5/8" 18 gauge steel.
Head/Jamb corners were mitered construction.
1.2 Door Slab(s) Construction: Slab constructed from 0.017" thick steel
skins. Top and bottom rail constructed from wood. Stiles of continuous
roll -formed steel employing a high impact styrene thermal barrier. Interior
cavity filled with rigid polyurethane.
Section 2: Additional Supportive Test or acceptance Data Provided with
Certification Documentation included':
2.1 Anchor Performance Calculation Report -Performed by Eric S. Nielsen,
P.E (Florida P.E. No. 41323)
2.2 Surface Burning Characteristics for Foam Filled Door performed by
Omega Point Laboratories to ASTM E84-98, "Standard Test Method
For Surface Burning Characteristics of Building Materials". Report No.
15977-104313.
This information is provided as a convenience for consumms, building departments and inspectors and is not considered part of
this certification
See additional Pages of Certification for Certified Product Line Matrix(s).
National Accreditation. & Management Institute, Inc.
11870 Merchants Walls Suite 202-Newport News, VA 23606
TEL(757) 594.8658 FA%(757)594-8659
o '*
SIDE -HINGED METAL -EDGE STEEL DOOR UNIT
6-8" SINGLE OPAQUE DOOR IN HOLLOW METAL FRAME
GENEM N0OT
I. EVALUATED FOR USE: IN LOCATIONS ADHERING TO
THE FLORIDA BUILDING CODE AND WHERE PRESSURE
REQUIREMENTS AS DETERMINED BY ASCE 7. MII,.,I)AUM
DESIGN LOADS FOR BUILDINGS AND CfiH-,R STRUCTURES.
DOES NOT EXCEED THE DESIGN PRESSURES LISTED.
2. 14URRICANE KOTaCTIVE SYSTEM (SHUTTERS) IS NOT REOUIRED_
z
cNll
18 GA HOI LOW' META t FPAM
TABLE OF CONTENTS
SHEET ol DESCRIPTION
ELEVATIONSATI GENERAL NOFES4CLOCATIONSS &_DETAI:_S
40* AlAV.
OVIPALL FRAME
35-3/4' MAX.
PANEL WIDTH
St-1407E OUTSIVING SINGLE QN1
40" AV
FrOV11,
111 IPAIII
35-314" MAX.
PANEL WIDTH
13 M
Li
SINGLE INSWING SINGLE UNIT
Date
Is— N.T.S.
jova. Sws
IZHK. BY.
314EEr 7 CF
9L•
WOOD OR STEEL 2X STUDS
USIUG COMPRESSION ANCHORS
FACTORf APPL!EO
COMPRESSION ANCHOR
U a EACH JAMB/r!EAD
CORNER (2 TOTAL)
B8 x 2' WOOD SCREW
U Total A A
48 x 2' WOOD SCREW
2) a BUT. OF EACH JAHB
C) a INTERICR OF FACE
4tRYVAILL(1) a EXTERICR OF FACETYP.) OOD OR STEEL STUDS
DOOR FRAN.
SECTION 4-4
R SHEATHING
STRAP ANCHORS 1N WOOD OR
STEEL 2X S103
12' MAX
1
STRAP ANCHOR (TYP.)
6) SCREWS IN EACH1 I I
X8 WOOD SCREW CTYP.)
WOCIL STUDSSTRAPANCH
B10 S.M.S..TYP)
STEEL STUDS
t WOOD 62 STEEL STUDS
DOOR FRAME
1 3/8' M1N.
SECTION A -A EMBEDMENT INTCr
WORD STUD
0.IB7' DIA. ANCHOR.
ATTACHMENT DETAIL
1. ANCHOR ANALYSTS FOR LOADING CONDITIONS PF.EPARED,
SIGNED AND SEALED BY ERIC S. NIELSON, DE
FLORIDA #41323) FOR EACH INSTALLATION METHOD.
WIRE ANCHORS IN CONCRETE
OP. HASONRY
1/8' DIA. SCRI
CONCRE7E CR WCN«Y USING
CONCRETE SCREW ANCHORS
BACK FTLL FRAME
L ACJACENT C.M.U.
M'U'
BUTTERFLY CLIP ASONRY OR CONCRETE
CELLS WITH GROUT _ NOT REQUIRED
TYP.) 3/16' IAMETER WIRE ,
NC3/8' DIA. CDRETo `
DOOR. FRAME
1°.' SCREW 4NCHOR '
DOOR FRAME
I 1/4'
SECTI=N A -A MINIMUM EMBEDMENT
8 x 5/8"
1 #'8 x 5/8"
0
STRIKE DETAIL
MACHINE SCREWS
10 x 1/2\
10 x i/2"
I #0 x 1/2
10 x 1/2"
4 x 1/2"
10 x 112'/
HINGE DETA!_
MACHINE SCREWS
1
o.s6z"fT .250"
TT zu
AftdM?DMU !NSWING THRESHOLG OUTSWING THRESHOLD
I;a 01h: 4 -p2_
HARDWARE SCHEDULE
1. KWIKSET MAXIMUM SECURITY SERIES GRADE 2 Imm 611C/06
CYL !NDRICAL AND DEADLOCK HARDWARE TO BE INSTALLED
i SC.s(F• N.T.S.
AT 5-1/2" CENTERLINE. D— BY SWS
2. 4" X 4" FJLL MORT SE BUTT HINGES. CHB. Br:
DRAWN-3 NO.:
Ot_0-06
or 2