HomeMy WebLinkAbout432 Summerlin AveCITY OF SANFORD
JAN 0 5 2016 BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No.
Documented Construction Value: $ q % '
Job Address: Historic District: Yes No
t `
Parcel ID: saS Oow) - c)(0 (a Residential R Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: ;p U C - 5 -e, -z -
Plan Review Contact Person: -T\ y\ (` y Title:
Phone: —1o-7-(a37 ` &44 00 Fax: Email: ' M . bS O-NVP- U
Property Owner Information
Name S-9--c"n W\\Vje Phone:
Street: \Nv-4. Resident of property?
City, State Zip: ` L _t>a771
Contractor Information
Name Q,\Ay,)Ow 3
Street: 6,Np- `i M
City, State Zip: o aa '7J__6
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Phone:
Fax:
7,)-?- S- V"
State License No.:
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
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.
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. # q 9 -OD
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5th Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
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 at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
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.
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Signature of Contractor/Agent Date
TM V M0.1 1 C
Print Contractor/Agent's Name
MARYLOU SESAK
MY COMMISSION #FF146073
EXPIRES July 29, 2018
407) 39a-0153
FioridallotaryService.com
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS
COMMENTS:
ZONING: AA UTILITIES:
ENGINEERING: FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures,
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING: C I, I2'
Revised: June 30, 2015 Permit Application
REQUIRED INSPECTION SEQUENCE
RP# 16 4K
BUILDINGPERMIT
Min Max Inspection DDescri tion
Footer / Setback
Stemwall
Foundation / Form Board Survey
Slab / Mono Slab Pre our
Lintel / Tie Beam / Fill / Down Cell
Sheathing — Walls
Sheathing — Roof
Roof Dry In
Frame
Insulation Rough In
Firewall Screw Pattern
Drywall / Sheetrock
Lath Inspection
Final Solar
Final Roof
Final Stucco / Siding
Insulation Final
Final Utility Building
Final Door
Final Window
Final Screen Room
Final Pool Screen Enclosure
Mobile Home Building Final
Pre -Demo
Final Demo
Final Single Family Residence
Final Building (Other)
REVISED: June 2014
Address: 4/32 AVE
ELECTRICAL PERMIT
Min Max Inspection Description
Electric Underground -
Footer / Slab Steel Bond '
Electric Rough-
T.-U.G.
Pre -Power Final =
Electric Final
y
Min Max Inspection IDescri tion =
Plumbing Underground
Plumbing Sewer
Plumbing Tub Set -
Plumbing Final
MECHANICALIPEItMIT
Min Max Ins ection Description -
Mechanical Rough
Mechanical Final
Min Max Inspection Description
Gas Underground
Gas Rough
Gas Final
Contract - Detailed
Pella Window and Door Showroom of Longwood
350 West State Road 434
Longwood, FL 32750
Phone: (407) 831-0600 Fax: (407) 937-3282
Sales Rep Name: Piper, Benjamin
Sales Rep Phone: 386-316-5384
Sales Rep Fax:
Sales Rep E -Mail: piperbi@Pella.com
Customer Inf6irpiation Pr6JeWDei'1v6rV AdOr'45s Oedeir. Information . .... .
Jean Wilke Wilke,Jean,1651285 Quote Name: Wilke,Jean,1651285
432 S Summerlin Ave 432 S Summerlin Ave
Order Number: 721581371`7
SANFORD, FL 32771-2256 Lot# Quote Number: 7310381
Primary Phone: (407) 3221529 SANFORD, FL 32771-2256 Order Type: Installed Sales
Mobile Phone: County: Wall Depth:
Fax Number: Owner Name: Payment Terms: 3% /Cash In Advance
E -Mail: jwilke432@gmaH.rom Jean Wilke Tax Code: CAP IMP 2
Contact Name: Owner Phone: (407) 3221529 Cust Delivery Date: 01/11/2016
Quoted Date: 10/28/2015
Great Plains #: 1001903093 Contracted Date: 1111612016
Customer Number: 1006397460 Booked Date: 11123/2016
Customer Account: 1001903093 Customer PO 9:
10 None Assigned
ADDPRRMCOR020001 - Delivery & Disposal Qty
I
For more Information regarding the finishing, maintenance, service and warranty of all Pella® products, visit the Pella® website at www.pella.com
Printed on 121912015 Contract - Detailed Page 1 of - 10
Customer: Jean Wilke Project Name: Wilke,Jean.1651285 Order Number. 7216BP7F7 Quote Number: 7310381
Project Checklist has been reviewed
Sj P as, r . W', L lk c-
ustomer Name (Please prinq
Yl - l'i- r
Date
Credit Card Approval Signature
Date
1p` T
For more information regarding the finishing, maintenance, service and warranty of all Pella® products, visit the Pella® website at www.palla.com
Printed on 11/16/2016 Contract - Detailed Page 8, of
Taxable Subtotal 2,886.73
Sales Tax @ 0% 0.00
Non-taxable Subtotal 1,874.99
Total 4,761.72
Deposit Received 3,866.00
mount Due 906.72
For more information regarding the finishing, maintenance, service and warranty of all Pella® products, visit the Pella® website at www.palla.com
Printed on 11/16/2016 Contract - Detailed Page 8, of
350 state Road 434 W
Longwood, Florida 32750WINDOWSDOORS4078310600
FAX: 407 339 7742
Authorization Letter / Power of Attorney
I, James Samuel Rowland, do hereby authorize the following persons to act as agents on
behalf of myself and Pella Windows & Doors to pull and sign for any permits submitted
under my Florida State contractor License number CBC046712.
Authorized Persons:
Brian Kirby
Timothy O'Malley
Christine O'Malley
Martin Sterling
Regards,
Samuel Rowland
Qualifier CBC046712
Pella Windows & Doors
STATE OF FLORIDA
COUNTY OF LAKE
Don Kirby
Erick DeDios
John Christianson
Gary Barson
Jon Thomas
Aaron Hallich
Charles O'Neil
Owner: Jean Wilke
Address: 432 S. Summerlin Ave
Sanford, FL 32771
The foregoing instrument was acknowledged before me this - gg day of be L- , 201S
by JAMES SAMUEL ROWLAND, who is personally known to me.
Co, )henna MofIFS
Print Name
My commission expires:
Seal
CATHERINE
NOTARY PUBLIC
STATE OF FLORIDA
Caren# FF899507
E)Ires 7/1312019
VIEWED To BE THE BEST"
RECORD COPY
City of Sanford JAN 0 5 2016
Building and Fire Prevention,-
Product
revention
Product Approval Specification Form
ING
Permit # #
1 6 1 8
FPAR
p_
Project Location Address Suw"w1-e- %Y—
As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the
information and product approval number(s) on the building components listed below if they are to be
utilized on the construction project for which you are applying for a building permit. We recommend that
you contact your local product supplier should you not know the product approval number for any of the
applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in
accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product
Approval can be obtained at www.floridabuilding.org.
The following information must be available on the jobsite for inspections:
1. This entire product approval form
2. A copy of the manufacturer's installation details and requirements for each product.
Category / Subcategory Manufacturer Product Florida Approval #
1. Exterior Doors
Swinqinq err.G:-Cc-v c, , c `C 0. / a 3S• j_
Sliding
Sectional
ROTI Up REVIEWED POR CODE COMPLIANCE
Automatic
Other PLANS EXAMINER
2: Windows nATG
Sino
le Hun
Horizontal Slider
Casement
Double Hun
Fixed G DIVISION
Awning_
Pass Through LICENSE TC PROCEED WITH THE WORK AND NOT AS
Projected TECHNICAL
Mullions
Wind Breaker
CODES, NOF SHALL ISSUANCE OF A PERMIT PREVENT
REQUIRING A CORRECTION OF ERRORS IN PLANS,
Dual Action CONSTRI JCTION OR VIOLATIONS OF THIS CODE
Other
June 2014 1
Category / Subcategory Manufacturer Product
Description(including
Florida Approval #
decimal
3. Panel Walls
Sidin'
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles
Underla ments
Roofing Fasteners
Noristructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Builfup roofing
System
Modified Bitumen
Single Ply Roof
S stems
Roofing slate
Cements/
Adhesives /
Coating
Liquid Applied
Roof'ing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.R.S. Roof
Panels
Roof Vents
Other
June 2014 4
Category / Subcategory Manufacturer Product
Description
Florida Approval #
include decimal
5. Shutters
Accordion
Bahama
Colonial
Roll'6p
E ui' bent
Other
6. Sk' lights
Sk li' hts
Other
7. Structural
Com onents
Wood Connectors /
Anchors
Truss Plates
Engineered Lumber
Railin
Coolers/Freezers
Concrete Admixtures
Precast Lintels
Insulation Forms
Plastics
Deck / Roof
Wall
Prefab Sheds
Other
8. New Exterior
Envelope Products
Applicant's Signatu
Applicant's Name l i,, o /h w le -7_
Please Print)
June 2014 3
1
DGU
DBR
Customer: Jean Wilke Project Name: Wilke,Jean,1651285 Order Number: 7215BP7F7 Quote Number: 7310381
Line # 'Location; "' Attributes
15 None Assigned
ADDPRRMCOR020004 - Permit Fee - CBC 046712 Qty
1
Line # . Location: Attributes
25 Back Door x
Therma Tru Door Qty
1
l6`'
a
Customer Notes: 2'8" x 6'8"Left Hand Inswing, Clessic-Craft Oak Grain, 30 Grills, Single door, Double Bore, Rot -proof Bottom Jamb
Door cut down to custom height to fit opening
INSTARMCOR900011 -Additional Labor - (1/2 Hour) Qty 1
PREFINMCOM020006 - Entry Door Finishing/Panel, 1 color both sides Qty 1
INSTARMCOR010016 - Entry System Wood Single w/o Sidelights Qty 1
QUOMATMCOM020503 - Non -Pella Door Installation Kit (caulk, tape, foam, tap -con) Qty 1
INSTARMCOR900040 - Stucco Cut-out Qty 1
INSTARMCOR900023 - Lead Safe Install Qty 1
INSTARMCOR900041 - Stucco Repair, Lineal Ft. Qty 17
QUOMATMCOM010177 -.Jamb Extension 3 %" Prefinished (LF) Qty 17
For more information regarding the finishing, maintenance, service and warranty of all Pella® products, visit the Pella® website at www.pella.com
Printed on 12/9/2015 Contract - Detailed Page 2 of 10
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jr• ; fy;;o,4_ SCIS Home Log In : User Registration Hot Topics Submit Surcharge Stats & Facts i Publications FBC Staff ;, BCIS Site Map Links Search
Business'",)
Professional ;) Product Approval
USER: Public User
Regulation
rfi?= Product Approval Menu > Product or Application Search > Application Lis[ > Application Detail
FL FL15225-R3
Application Type Revision
Code Version 2014
Ajp^ation Status -1 pp. o ed
Approved by DBPR. Approvals by DBPR shall be reviewed and ratified
by the POC and/or the Commission if necessary.
Comments
Archived
Product Manufacturer Therma-Tru Corporation
Address/Phone/Email 118 Industrial Drive
e Edgerton, OH 43517
419) 298-1740
rickw@rwbldgconsultants.com
Authorized Signature Vivian Wright
rickw@rwbldgconsultants.com
Technical Representative
Address/Phone/Email
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 Ryan J. King, P.E.
Validation Checklist Hardcopy Received
Referenced Standard and Year (of Standard) Standard Year
101/I.S.2 1997
ASTM E1886 2002
ASTM E1996 2002
ASTM E330 2002
TAS 201, 202, 203 1994
Equivalence of Product Standards
Certified By
Product Approval Method Method 1 Option A
Date Submitted 06/13/2015
Date Validated 06/28/2015
liLtps'://flor'iclabuilding.or;/pr/pr_app_ctti.aspx':'aram=WGE VXQLbrtDgyj3y V VKJZI QRAS... 12/23/201 j
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F .
t
Qom•`,' -J•2 OJ '
Date Pending FBC Approval
Date Approved 07/05/2015
t
4
ST22Wry of Products i
Model, Number or Name Description
15225.1 a. "Classic -Craft" and "Benchmark 6/8 and 8/0 Opaque and Glazed Fiberglass Door with and
by Therma-Tru" without Sidelites. Inswing and Outswing
Li . of Use Certification Agency Certificate
pproved for use in HVHZ: No FL1522S R3 C CAC 15225.1 NAMI certs.odf
Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date
Impact Resistant: No 12/31/2021
Design Pressure: N/A Installation Instructions
Other: See INST 15225.1-68 (6'8 Door Products), INST FLIS225 R3 II INST 15225.1-68.ndf
15225.1-80 (8'0 Door Products) and INST 15225-68M (68 FL15225 R3 II INST 15225.1-80.pdf
Door Products Direct to Masonry) for installation FL15225 R3 II INST 15225-68M.odf
instructicns. (,`dote - Glazing Shall comply .ith ASTM E1300- Ver fied By: Lyndon F Schmidt, P.E. 4341.9
04) Created by Independent Third Party: Yes
Evaluation Reports
FL15225 R3 AE Eval15225.1-68.pdf
FL15225 R3 AE EVAL 15225.1-80.odf
FL15225 R3 AE EVAL 15225-68M.odf
Created by Independent Third Party: Yes
15225.2 b. "Construction Series" and 6/8 Opaque Steel Door with and without Sidelites. Inswing
Benchmark by Therma-Tru" and Outswing
Limits of Use Certification Agency Certificate
Approved for use in FWHZ: No FL15225 R3 C CAC 15225.2 NAMI certs.®df
Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date
Impact Resistant: Yes 12/31/2021
Design Pressure: N/A Installation Instructions
Other: See INST 15225.2-68 (6'8 Door Products) and INST FL15225 R3 II INST 15225.2-68.odf
15225-68M (6'8 Door Products Direct to Masonry) for FL15225 R3 II INST 15225-68M.odf
installation instructions. (Note - Glazing Shall comply with Verified By: Lyndon F. Schmidt, P.E. 43409
ASTM E1300-04) Created by Independent Third Party: Yes
Evaluation Reports
FL15225 R3 AE EVAL 15225.2-68.pdf
FL15225 R3 AE EVAL 15225-68M.odf
Created by Independent Third Party: Yes
15225.3 c. "Fiber -Classic" and "Benchmark 6/8 and 8/0 Opaque and Glazed Fiberglass Door with and
by Therma-Tru" without Sidelites. Inswing and Outswing
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL15225 R3 C CAC 15225.3 NAMI certs.odf
Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date
Impact Resistant: No 12/31/2021
Design Pressure: N/A Installation Instructions
Other: See INST 15225.3-68 (6'8 Door Products), INST FL15225 R3 II INST 15225.3-68.odf
15225.3-80 (8'0 Door Products) and INST 15225-68M (6'8 FL15225 R3 II INST 15225.3-80.pdf
Door Products Direct to Masonry) for installation FL15225 R3 II INST 15225-68M.pdf
instructions. Note - Glazing Shall comply with ASTM E1300- Verified By: Lyndon F. Schmidt, P.E. 43409
04. (This product approval requires the use of "]" part Created by Independent Third Party: Yes
number doors and Sidelites, which have been stained or Evaluation Reports
painted within 6 months of installation - Excludes Opaque FL15225 R3 AE EVAL 15225.3-68.1)df
Benchmark Door Panels.) FL15225 R3 AE EVAL 15225.3-80.odf
FL15225 R3 AE EVAL 15225-68M.odf
Created by Independent Third Party: Yes
15225.4 d. "Premium Series" and 6/8 and 8/0 Opaque and Glazed Steel Door with and without
Benchmark by Therma-Tru" Sidelites. Inswing and Outswing
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL15225 R3 C CAC 15225.4 NAMI certs.odf
Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date
Impact Resistant: Yes 12/31/2021
Design Pressure: N/A Installation Instructions
Other: See INST 15225.4-68 (6'8 Door Products), INST FL15225 R3 'II INST 15225.4-68.odf
15225.4-80 (8'0 Door Products) and INST 15225-68M (68 FL15225 R3 II INST 15225.4-80.odf
Door Products Direct to Masonry) for installation FL15225 R3 II INST 15225-68M.odf
instructions. (Note - Glazing Shall comply with ASTM E1300- Verified By: Lyndon F. Schmidt, P.E. 43409
04) Created by Independent Third Party: Yes
Evaluation Reports
FL15225 R3 AE EVAL 152.25.4-68.odf
FL15225 P,3 AE EVAL 15225.4-80.odf
FLIS225 P,3 AE EVAL 15225-68M.odf
Created by Independent Third Party: Yes
15225.5 e. "Smooth -Star" and "Benchmark 6/8 and 8/0 Opaque and Glazed Fiberglass Door with and
by Therma-Tru" without Sidelites. Inswing and Outswing
haps://tioriciabuilclinc,.ori/pr/pi_app_citl.asps'?pa;:ain=%vGE'V,,-,,v f)gv3yVVKJZ1QRAS... 12/23/2015
lel
Limits of Use
Approved for use in HVHZ: No
Approved for use outside HVHZ: Yes
Impact Resistant: No
Design Pressure: N/A
Other: See INST 15225.5-68 (6'8 Door Products), INST
15225.5-80 (8'0 Door Products) and INST 15225-68M (6'8
Door Products Direct to Masonry) for installation
instructions. Note - Glazing Shall comply with ASTM E1300-
04. (This product approval requires the use of "]" part
number doors and sidelites, which have been stained or
painted within 6 months of installation - Excludes Opaque
Benchmark Door Panels.)
15225.6
I
f. "Premium Series", "Construction
Series" and "Benchmark by
Therma-Tru" with Transoms
Limits of Use
Approved for use in HVHZ: No
Approved for use outside HVHZ: Yes
Impact Resistant: No
Design Pressure: N/A
Other: See INST 15225.6-68 (6'8 Door Products) and
15225.6-80 (8'0 Door Products) for installation instructions.
Note - Glazing Shall comply with ASTM E1300-04)
Certification Agency Certificate
FL15225 R3 C CAC 15225.5 NAMI certs.odf
Quality Assurance Contract Expiration Dane f
12/31/2021
Installation Instructions
FL15225 R3 II INST 15225.5-68.pdf
FL15225 R3 II INST 15225.5-80.odf
FL15225 R3 II INST 15225-68M.odf
Verified By: Lyndon F. Schmidt, P.E. 43409
Created by Independent Third Party: Yes
Evaluation Reports
FL15225 R3 AE EVAL 15225.5-68.odf
FLI.S225 R3 AE EVAL 15225.5-80.pdf
FL15225 R3 AE EVAL 15225-68M.odf
Created by Independent Third Party: Yes
6/8 and 8/0 Opaque and Glazed Steel Door with Transoms.
With and without Sidelites. Inswing and Outswing
Certification Agency Certificate
FL15225 R3 C CAC 15225.6 NAMI certs.Ddf
Quality Assurance Contract Expiration Date
12/31/2021
Installation .Instructions
FL15225 R3 II INST 15225.6-68.odf
FL15225 R3 II INST 15225.6-80.odf
Verified By: Lyndon F. Schmidt, P.E. 43409
Created by Independent Third Party: Yes
Evaluation Reports
FL15225 R3 AE EVAL 15225.6-68.pdf
FL15225 R3 AE EVAL 15225.6-80.Ddf
Created by Independent Third Party: Yes
Sack tlext
Contact Us :: 1940 North Monroe Street, Tallahassee FL 32399 Phone: 850-487-1824
The State of Florida is an AA/EEO employer. Coovriaht 2007-2013 State of Florida.:: Privacy Statement :: Accessibility Statement :: Refund Statement
Under Florida law, email addresses are public records. If you do not want your e-mail address released in response to a public -records request, do not send
electronic mail to this entity. Instead, contact the office by phone or by traditional mall. If you have any questions, please contact 850.487.1395. -Pursuant to
Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address If
they have one. The emalls provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to
supply a personal address, please provide the Department with an email address which can be made available to the public. To determine If you are a licensee under
Chapter 455, F.S., please click here .
Product Approval Accepts:
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https:Hi9oridabuildin(,. c.rc/'pztpi-_,ipp_dtl.asps?paras'=-vvGEVXQiv-tDgv3yV V K fZi 12/23/2 -
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TI—IERMA TRU DOORS
1 18 INDUSTRIAL Dn., EDDEnTDN, DIH 43517
Classic -Craft"
6'8" SINGLE AND DOUBLE OPAQUE OR GLAZED PANELS
W/ & W/OUT SIDELITES
INSWING / OUTSWING
INSULATED FIBERGLASS DOOR WITH WOOD FRAMES
General Notes
1. This product anchoring drawing has been developed in compliance with the 5111 Edition
2014) Florida Building Code (FBC) excluding the "High Velocily Hurricane Zone". See the
Certification Agency Certificate for sizes, specifications and ratings.
2. Product anchors shall be as listed and spaced as shown on details. Anchor embedment
to base material shall be beyond wall dressing, stucco, foam, brick and other wall
coverings.
3. Wood screws shall be installed following installation instructions of ANSI/AF&PA NDS 2012.
All other fastener types to be installed following fastener manufacturer's installation
instructions.
4. Gastener embedment depths, edge distances and center -center distances shall be as
specified by the fastener manufacturer but in no instance shall they be less than shown in
Ihis drawing.
5. Where shims are used, they must be a "rigid / sliff"material that complies with the
requirements of the FBC.
6. Posilive and negative design pressure requirements for use with this drawing shall be
determined by others for specific jobs in accordance with the governing code.
7. Sile conditions not covered by this drawing are subject to further engineering analysis.
OVERS
LL FRAME WIDTH —
DOUBLE W/ SIDELITES OXXO
MAX DESIGN PRESSURE
47.0 -47.0
TABLE OF CONTENTS
SHEET 6 DESCRIPTION
1 Typical elevations, design pressures & general notes
2 Buck anchoring
3 Frame anchoring
4 Frame anchoring & bill of materials
5 Horizontal & vertical cross sections
G Vertical cross sections
OVERS
LL FRAME WIDTH —
DOUBLE W/ SIDELITES OXXO
MAX DESIGN PRESSURE
47.0 -47.0
37.50" MAX.
OVERALL
WIDTH
fj--7'I r--71
4
h
5
O'2 5 I II 11 II
I II 11 II
5 e
II 11
b LL r- Ir I I t
f \\
S\\\
rrllr ll1
Z CI ni
U N L
y 12 _-IJ
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I I I I
L J jl
66.50" MAX.
OVERALL. WIDTH Tt
N, z51V11.
i •'•.
p.Ua•
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II 11 II 1' II II
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SINGLE W/ SIDELITES OXO
MAX DESIGN PRESSURE
47.0 -47.0
74.50" MAX.
OVERALL WIDTH
1 2 3
5 5 5
53.0" MAX. _
OVERALL WIDTH
1 2 3
5 5 5 (
I 1' ' 1'
II
I II 11 II II II it 71 Irli
1111 II 11 11itIt II II II II II II
i; i i i
I I I I
L J jl
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I I 1t
5
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1
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A -S
SINGLE X DOUBLE XX
MAX DESIGN PRESSURE MAX DESIGN'PRESSURE
77.0 -77.0 4.47.0 -47.0
LOCK HARDtYARE MFG A SERIES
Kw1Y.SETSIGNANRESERlES IATCII
KWIKSErSIGNATURESERfES7110 DEADBOLT
SINGLE W/SIDELITF- OX
MAX DESIGN PRESSURE
47.0 -47.0 DATE: ?121112
SCAM N.T.S.
MG. BY. JI<
CHK. IN: LFS
DRAWING NO.:
FL -15225.1 -
SHEET _L Or' 6'
MASONRY
OPENING
2X BUCK
MASONRY
OPENING
NOTES:
I. 2.X buck min. S.G. 2 0.55. 2X BUCK
CONCRETE ANCHOR NOTES:
I. Concrete anchor locations at the comers may be adjusted to maintain the min.
edge distance to mortorloints.
2. Concrete anchor locations noted as "MAX ON CENTER" must be adjusted to
maintain the min. edge distance to mortorioints, additional concrete anchors
n.iay be required to ensure the "MAX. ON CENTER" dimension ore not exceeded.
3. Concrete anchor table:
MIN.-CiFARANCe, MIM-CLIFARANCE- ANCHOR*: '
T . O*MASn"Pv- TrIADJACENT"
4"'
4
4"
4"
4" 4"
SIzrEMBEDMENT:".`:.......
m
Lj
EDGr ANCHOR"'.
ITW
1/4- 4" TAPCONO
OZMULLION
fit
I I MULLION
1/4" 1-1/4"
Z Li
9m@W
MASONRY74 IISHOWN FOR MASONRY II SHOWN FOR
2X
TYP. HEAD OPENING TYP II REFERENCE 7._4
OPENING TYP II REFERENCE II
II
JAMBS I HEADII HEAD I I II
ASTRAGAL
JAMBS
II
JAMBSII
II
II
II REFERENCE II
itII
II
2X BUCK--/
II
2X BUCK -/II II
MASONRY-] DOUBLE W/SIDELITES
BUCK ANCHORINGOPENING
3
MULLION
SHOWN FOR 6
II
II
REFERENCE I I
II II
II II
L3 C;
SINGLE DOOR SINGLE W/SIDELITE SINGLE W/SIDELITES
BUCK ANCHORING BUCK ANCHORING BUCK ANCHORING
MASONRY
OPENING
NOTES:
I. 2.X buck min. S.G. 2 0.55. 2X BUCK
CONCRETE ANCHOR NOTES:
I. Concrete anchor locations at the comers may be adjusted to maintain the min.
edge distance to mortorloints.
2. Concrete anchor locations noted as "MAX ON CENTER" must be adjusted to
maintain the min. edge distance to mortorioints, additional concrete anchors
n.iay be required to ensure the "MAX. ON CENTER" dimension ore not exceeded.
3. Concrete anchor table:
MIN.-CiFARANCe, MIM-CLIFARANCE- ANCHOR*: '
T . O*MASn"Pv- TrIADJACENT"
4 4"'
4 4..
48
Wb
In
SIzrEMBEDMENT:".`:.......
m
Lj
EDGr ANCHOR"'.
ITW
1/4- 4" TAPCONO
OZ
REFERENCE II SHOWN FOR
fit
ELCO
1/4" 1-1/4"
Z Li
9m@W
4"
ULTRACO Ne
3 5 q'%
03 IL (L 1,
C;
E ' 2Z
II
II REFERENCE 2X
4 4"'
4 4..
48
Wb
InV)
Cs m
Lj
U. Z—
In
0
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MULLION II II
SHOWN FOR II MULLION
IIHEAD
OZ
REFERENCE II SHOWN FOR
fit a R Z'
HEAD
11,%
foto
Z Li
9m@W
o It
JAMBS
3 5 q'%
03 IL (L 1,
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E ' 2Z
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4 4..
48
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n
In
0
4 II
II
TYP.
II
4 II
MULLION II II
SHOWN FOR II MULLION
IIHEADTYP. REFERENCE II SHOWN FOR
JAMBS II ASTRAGAL HEAD II REFERENCE II
SHOWN FOR
o It
JAMBS II IIII
II REFERENCE 2X II
BUCK II IIII
II
it
II
ASTRAGAL
SHOWN FOR
II Ci II
II
II REFERENCE II
itII
II II
II
II II
DOUBLE DOOR
BUCK ANCHORING MASONRY-] DOUBLE W/SIDELITES
BUCK ANCHORINGOPENING
ATE: 2121112
SCALE: N.T.S.
MG. BY: J9
HK. BY: LFS
RAVANG NO --
FL- 15225.1-68 C- C
SHEET _L OF_.6E_
C3
Wb
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Cs m
L, UQW:
n
In
0
D
0
4
V) z
w
o It
D
t2
ATE: 2121112
SCALE: N.T.S.
MG. BY: J9
HK. BY: LFS
RAVANG NO --
FL- 15225.1-68 C- C
SHEET _L OF_.6E_
0; IN
3" PAIRS 30
D" 4"
J I
MULLION v
SHOWN FOR _
REFERENCE
BUCK INSTALLATION
BUCK INSTALLATION
HEAD & JAMBS
12
a
no
a no 0 Z
m
IINSTALLATION aj m>:
Z QW/2X BUCK o E m o aINSTALLATIONPO {
W/1X BUCK— nim
to of w - c
a TYP. HEAD & D, o .6z
JAMBS
v 13
SEE
AIL "2
ANCHOR•
73„ —I I— 3" 3 TYP.
TYP.
T o
N
F -a W
3" —I
T
MULLION
EMBEDMENT:..:..:;.. TQ:MA'SONRY...*.`
tie SHOWN FOR It
Y w
EDGE.:: ;?:.;!
J
REFERENCE
1/4"
a
4„
ITW
TAPCON® 3/16"
X a N 1) N V)
EL
A W/2X BUCK INSTALLATION ai
a
DATE.. 2/21/17_
SCALE: N. T. M.:
DING. BY. JI( M
CHK. BY: LFS
9 W/1X BUCK INSTALLATION U
o
a
O6
0•'
SHEET 5 -or 6
TYP. HEAD & JAMBS
d o N
16 16
SEE
DETAIL "4"
n
o 2,(
011
16 SEE
n DET
NV)
12 •iia 5Jill 2
AIL
1
I —
D" 4"
J I
MULLION v
SHOWN FOR _
REFERENCE
BUCK INSTALLATION
BUCK INSTALLATION
HEAD & JAMBS
12
a
no
a no 0 Z
m
IINSTALLATION aj m>:
Z QW/2X BUCK o E m o aINSTALLATIONPO {
W/1X BUCK— nim
to of w - c
a TYP. HEAD & D, o .6z
JAMBS
v 13
SEE
AIL "2
C,. D E µ „C.. "D" "A „B,. "
A VIEW "C"—"C" SINGLE DOOR W/SIDELITES VIEW "E•'—"E" ^VIEW "D"—"D" SINGLE DOOR W/SIDELITE VIEW "B"—"B" 5_INGLE. DOOR
VIEW SHOWN W/ OPTIONAL
CORRUGATED FASTENERS. REIT /30 (W.
ALL SIOELRE TO DOOR LAMB
CONNECTIONS) W/2X
BUCK2 SIDELITE NOTES: ,
O
INSTALLATION 1. The sidelife is direct set into the jamb with (12) N8 x 2" pfh. wood scfews. There ore (4) of
each vertical jamb, from the top down at 13.5, 31'; 48.5'& 66". There are (2) at the header at 4" from 0 W/1 X BUCK 1
1 the outside comers of the frame. There are (2) at the sill, 4" from the outside corners.
INSTALLATION 2. For optional sidelife construction with staples, sidelife is direct set into the jamb with (4),'116"
X 13/4" 16 go. staples along each jamb (6" from ends and equally spaced
thereafter). CONCRETE ANCHOR
NOTES: 1.'Concrete anchor locations of the corners may be adjusted to maintain the min. DETAIL "6" DETAIL "
2" edge distance to
mortarjoints. 2. Concrete anchor locations noted os "MAX. ON CENTER" must be adjusted
to maintain the min. edge distance to mortarjoints, additional concrete anchors W/2X BUCK
2 S moy be required to ensure the "MAX. ON CENTER" dimension are not exceeded. INSTALLATION
OB I • 3. Concrete anchor table: u, 1X
BUCK ANGHQR•. ANCHOR• MLN.`.i;:•:: MIN:;C ARANGE:"MINS• Q•I,
EARANCE•
Co EMBEDMENT:..:..:;.. TQ:MA'
SONRY...*.`
DETAILS"
1'.
EDGE.:: ;?:.;!
J
ITW TAPCON ® 1/4" 1.1/4„ T.
4„ C,. D E µ „C.. "D" "A „
B,. "A VIEW "C"—"C" SINGLE DOOR W/SIDELITES VIEW "E•'—"E" ^VIEW "D"—"D" SINGLE DOOR W/SIDELITE VIEW "B"—"B" 5_INGLE.
DOOR VIEW SHOWN W/
OPTIONAL CORRUGATED FASTENERS. REIT /30 (
W. ALL SIOELRE TO DOOR
LAMB CONNECTIONS) W/
2X BUCK2 SIDELITE
NOTES: ,
O INSTALLATION 1. The sidelife is direct set into the jamb with (12) N8 x 2" pfh. wood scfews. There ore (4)
of each vertical jamb, from the top down at 13.5, 31'; 48.5'& 66". There are (2) at the header at 4" from 0 W/1 X BUCK
1 1 the outside comers of the frame. There are (2) at the sill, 4" from the outside
corners. INSTALLATION 2. For optional sidelife construction with staples, sidelife is direct set into the jamb with (4),'
116" X 13/4" 16 go. staples along each jamb (6" from ends and equally
spaced thereafter). CONCRETE
ANCHOR NOTES: 1.'Concrete anchor locations of the corners may be adjusted to maintain the min. DETAIL "6"
DETAIL "2" edge distance
to mortarjoints. 2. Concrete anchor locations noted os "MAX. ON CENTER" must be
adjusted to maintain the min. edge distance to mortarjoints, additional concrete anchors W/2X
BUCK 2 S moy be required to ensure the "MAX. ON CENTER" dimension are not exceeded.
INSTALLATION OB I • 3. Concrete anchor table: u,
1X BUCK ANGHQR•. ANCHOR• MLN.`.i;:•:: MIN:;C ARANGE:"MINS• Q•
I,EARANCE• EMBEDMENT:..:..:;.. TQ:MA'SONRY...*.` TO`
ADJA'CENT::,; EDGE.:: ;?:.;!
z:
ANCNO$`•>:•.... ITW TAPCON ® 1/4" 1.1/4„
T.
4„ ITW TAPCON® 3/16" 1-1/
4„ 3" INSTALLATION 12
1 C
C _ C
1 1 . DETAIL "I "
DETAIL "4"
rL 6
o ¢ a
N
g a DATE.. 2/
21/17_ SCALE: N.
T. M.: DING. BY.
JI( M CHK.
BY: LFS
DRABWC
NO.: W FL -15225.1-
68 0•' SHEET 5 -
or
o' 46
M
y D
1 VIEWF C --"C"
IN n oN
7" PAIRS 30 ^ o - "A"
3•• 3" TYP. _
14 3L Lll I I 3" {-F ` 3" 16,.
I II II
J
C" "E"
DO B DOOR W/ IDDOBDOORIDIT
III I II
SEE NOTE 311
II
A
SHEET 3 II SEE DETAIL "3" o
I
II
ASTRAGAL)
f II MULLION
S
SHOWN FOR II SHOWN FOR
STEEL
1
REFERENCE II REFERENCE
a
ONLY II
wINSTALLATION
16
16 II
16II
7YP. HEAD In
12
II5
u 5
II
II
J
C" "E"
DO B DOOR W/ IDDOBDOORIDIT
SEE II 8 a
DETAIL "4"
SEE
o c) - = 16 II DETAIL
16 N o\ - II
16
12 1 11
cs
5
eL = _ — / II _
11 r LTff
A"
VIEW "E" -"E" DOUBLE DOOR _VIEW A" -'A"
SHOWN W/ OPTIONAL CORRUGATED
FASTENERS, REM 130 (TYP. ALL
SIDELffE TO DOOR JAMB CONNECTIONS)
W/2x BUCK 2
INSTALLATION
W/1X BUCK
INSTALLATION 12 1 C
Item
ITT
Material
A
1F
o
I
X 1-3 4 PFH WOOD SCREW
S
Zx
SEE DETNTALLATON
ILI
A3
STEEL
1 210 x 314" LG. PFH WOOD SCREW Hine to Frame
WI /
I
2 X BUICK
INSTALLATIONW/1X
a
BUCK n _-_
wINSTALLATIONIII
8 x 2-1 2 LG- PFH WOOD'SCREW
7YP. HEAD In
4
I
W/1X BUCK
ASTRAGALNSTALLATION
tc
JAMBS iv SHOWN FOR IITYP. HEAD &
yu
p
1/4" x 3-3. 4" ITW PFH CONCRETE SCREW STEEL
REFERENCE II JAMBS -
ns" a u< 9 o d •
ONLY II
II
STEEL
SEE II 8 a
DETAIL "4"
SEE
o c) - = 16 II DETAIL
16 N o\ - II
16
12 1 11
cs
5
eL = _ — / II _
11 r LTff
A"
VIEW "E" -"E" DOUBLE DOOR _VIEW A" -'A"
SHOWN W/ OPTIONAL CORRUGATED
FASTENERS, REM 130 (TYP. ALL
SIDELffE TO DOOR JAMB CONNECTIONS)
W/2x BUCK 2
INSTALLATION
W/1X BUCK
INSTALLATION 12 1 C
Item
ITT
Material
A 10 x 2-1 2 PFH WOOD SCREW STEEL
46
X 1-3 4 PFH WOOD SCREW STEEL
Zx
10 X 1 PFH WOOD SCREW STEEL
1 210 x 314" LG. PFH WOOD SCREW Hine to Frame
I4m
2
Z: 12 o m
3 8 x 2-1 2 LG- PFH WOOD'SCREW STEEL
4
j
IFff711p1
tc
5 1/4" x 1-314" ITW PFH CONCRETE SCREW STEEL
0 n m z
m U N
Zto
1/4" x 3-3. 4" ITW PFH CONCRETE SCREW STEEL
V U N
M
ns" a u< 9 o d • Q
STEEL
pm
MASONRY — 3000 PSI MIN. CONCRETE CONFORMING TO ACI
3D1 OR HOLLOW BLOCK CONFORMING TO ASTM C90
j 0
SEE II 8 a
DETAIL "4"
SEE
o c) - = 16 II DETAIL
16 N o\ - II
16
12 1 11
cs
5
eL = _ — / II _
11 r LTff
A"
VIEW "E" -"E" DOUBLE DOOR _VIEW A" -'A"
SHOWN W/ OPTIONAL CORRUGATED
FASTENERS, REM 130 (TYP. ALL
SIDELffE TO DOOR JAMB CONNECTIONS)
W/2x BUCK 2
INSTALLATION
W/1X BUCK
INSTALLATION 12 1 C
Item DESCRIPTION Material
A 10 x 2-1 2 PFH WOOD SCREW STEEL
10 X 1-3 4 PFH WOOD SCREW STEEL
C 10 X 1 PFH WOOD SCREW STEEL
1 210 x 314" LG. PFH WOOD SCREW Hine to Frame STEEL
2 10 x 2 ' LG. PFH WOOD SCREW STEEL
3 8 x 2-1 2 LG- PFH WOOD'SCREW STEEL
4 11/4" x 2-314" PFH ELCO OR ITW CONCRETE SCREW STEEL
5 1/4" x 1-314" ITW PFH CONCRETE SCREW STEEL
9 1/4" x 3-3. 4" ITW PFH CONCRETE SCREW STEEL
11 3116" x 3-114" ITW PFH CONCRETE SCREW STEEL
12 1/4" x 3-114" ITW PFH CONCRETE SCREW STEEL
13 MASONRY — 3000 PSI MIN. CONCRETE CONFORMING TO ACI
3D1 OR HOLLOW BLOCK CONFORMING TO ASTM C90 CONCRETE
16 1 4" X 2-7/4" PFH ITW CONCRETE SCREW STEEL
20 HEADER JAMB SUGAR PINE, SG >= 0.34 WOOD
21 3/4" THK. PRESSURE TREATED SIDELITE PAD WOOD
30 112 " X 1" X 25 GA. CORRUGATED FASTENER STEEL
I _
N
o¢
N
O i
z c
DATE: 2/21/72
SCALE: N.T.S. `
DWG. BY: JK u
CHK. BY: LFS i
DRAWING NO.:
D
FL -75225.1-68
SHEET 4 OF 6 Q
W/2X BUCK 3
INSTALLATION
1
DETAIL "I'
p '
W/1 X BUCK 1 1
INSTALLATION
B
DETAIL
ATTACH ASTRAGAL THROW BOLT
STRIKE PLATE TO FRAME
n_ C
AS SHOWN.
DETAIL "4"
I _
N
o¢
N
O i
z c
DATE: 2/21/72
SCALE: N.T.S. `
DWG. BY: JK u
CHK. BY: LFS i
DRAWING NO.:
D
FL -75225.1-68
SHEET 4 OF 6 Q
TJ
z
ix BUCKJ f
Ncc;
etJ%
U
cl T
INTERIOR EXTERIOR
HEAD JAMB
To lx sub -buck
Inswing shown
zl
E d
U r.
Ci
1.25-L-1
INTERIOR EXTERIOR
HEAD JAMB
To wood frame
Inswing shown
EMB.
2X BUCK
INTERIOR
4
A
4,A
INTERIOR
EXTERIOR
MAX.2S"X
HIM SPACE
I .16'MIN.
EMB . 2Y MIN. EMB.
Typ.
4_VERTICAL SIDE JAMB
To 2x sub -buck
Inswing shown
INTERIOR
TNJ IN
EXTERIOR JL 0.15" MIN.
C -SINK
0.25" MAX.
SHIM SPACE
1.15" MIN.
EMB.
VERTICAL SIDE JAMB
To wood frame
Inswing shown
DATE: 2121112
SCALD N.T.S.
MG. BY: JK a
CHK. BY: LFS
OMWI14C NO.;
FL -15225.1-68
SHEET: 5 of 6 -
ry
vo
etJ%
Z'6 d
4
00
C14, Z
n D 6 ii R
M a IL.,
Z
o
2X BUCK U rn E 0 Z
C
J.:
A
INTERIOR EXTERIOR
Q:
HEAD JAMB
0
To 2x sub -buck
Inswing shown
zM
0
INTERIOR
TNJ IN
EXTERIOR JL 0.15" MIN.
C -SINK
0.25" MAX.
SHIM SPACE
1.15" MIN.
EMB.
VERTICAL SIDE JAMB
To wood frame
Inswing shown
DATE: 2121112
SCALD N.T.S.
MG. BY: JK a
CHK. BY: LFS
OMWI14C NO.;
FL -15225.1-68
SHEET: 5 of 6 -
ry
vo
INTERIOR.
INTERIOR
j EXTERIOR
Q
n ct
r: Z
ice' •.......••
1-"\ VERTICAL CROSS SECTION
6 Inswing configuration
INTERIOR EXTERIOR
z d 16
4VERTICAL CROSS SECTION
6 Inswing configuration
EXTERIOR
XE
m
r17-111
INTERIOR
21 VERTICAL CROSS SECTION
6 Outsvving configuration
EXTERIOR
z p:
Q w n
INTERIOR
VERTICAL CROSS SECTION
6 Oulswing configuration
EXTERIOR INTERIOR
IS
Q
n ct
r: Z
ice' •.......•• j j rn
0 n o
INTERIOR EXTERIOR
m z i
O V \ N
Do QI
20 \\Vd
Np
a
C;
m a a i°
a
vZ
21 12
13 •,
O
a O
O
J F
3 VERTICAL CROSS SECTION w r Enw
o
6
w
G
D
a
U
O
a
EXTERIOR INTERIOR
Q
n ct
6 VERTICAL CROSS SECTION
G Outswing configuration
o
i
N
O
2/21/12
SCALE: N.T.S.
owc. BY: JK
MK. rrr: LFS 3
DRAM14C NO.: °
n
FL -15225.1— 68
SHEET 6 of 6
Irl w aa unuw+rW w+a w wwl ulw>e ammn(u r nr i> I
i'MRirANNE 11ORSEr SEMINOLE COUNTY
THIS INSTRUMENT PREPARED BY: CLERK OF C:IRCUI'T COURT & C:ONPTROLLER
Name: Pella Windows and Doors BK 8616 F`9 1446 (09s)
Address: 350 SR 434 W. CLERK'S Y 2016005126
Longwood, FL 32750 RECORDED 01/14/2016 02aI_ig."28 P11
RECORDING FEES $1.00
NOTICE OF COMMENCEMENT
RECORDED BY hdevore
Permit Number:
q
Parcel ID Number:
i The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the
following information is provided in this Notice of Commencement.
1. DESCRIPTION OF PROPERTY: (Legal description of the operty and street address if available)
L }s ram a (o 8 -oK %,- \e G3
t 3a S v vti •,r.e r\. U2
2. G ERA DESCRIPTION OF IMPROVEMENT:
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR \( THE'IMPROVEMENT:
Name and address: C e `n `t` i ,\`fie. '3a sy Yhy'-yec\y\ i . o.v a- rG –ba -7-7/
Interest in properly: 6wVN-e-/L– -
Fee Simple Title Holder (if other than owner listed above) Name: A l 1 i
I l7
Address:
4. CONTRACTOR: Name: Pella Windows and Doors Phone Number: 407-831-0600
Address: 350 SR 434 W. Longwood, FL 32750
5. SURETY (If applicable, a copy of the payment bond is attached): Naive:
Address: Amount of Bond:
6. LENDER: Name: r __ Phone Number:
Address:
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section
713.13(1)(a)7., Florida Statutes.
Name: Phone Number:
Address'
8. In addition, Owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number:
9. Expiration Dale of Notice of Commencement (The expiration is 1 year from dale of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE
CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and
b e lief.
B
V d,V
Signature of Owner or Lessee, or Owner's or Lessee's (Print Name and Provide Signatory's Tillef0frice)
Authorized Ofllcer/Director/Partner/Manager)
State of _ _ I `County ofSz m
The foregoing instrument was acknowledged before me this
r
day of I " 20 T
by —
7:51- a\(\ UV\ - Who Is personally known to me O OR
Name of person making statement
who has produced identification K type of identification produced:
CIinISTINEUMALLEY
MY COMMISSION If FF 087307
n } EXPIRES: January 29, 2018
BondedThruNotaryPubliicUnderwriters – Notary Signature ,z-el "
L'FKTIF[ED COPY– NIA RYA NNE MORSE '
CLEF",t F TFi£ CIRC T URTAND
CO P7ROLL[R rl,
JAN 1.4 01 SEM _, C' N LORIDA r fp1isrfcou
toeee
BY
y _00111Y CLEMt ,