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1802 Seminole Rd (vault) ,,S�L�f�✓r3 J•i, CITY OF ATLANTIC BEACH r. y 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 J��fi�Jr Application Number . . . . . 06-00032354 Date 2/24/06 PP 1 Property Address 802 SEMINOLE RD Tenant nbr, name . . . . . . ADD FIREPLACE/& WINDOWS Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 25000 Owner Contractor ---------- ------------------------ HUGHES, KATHY BARNES HENDERSON CONSTRUCTION 1802 SEMINOLE ROAD 3317 ROYAL PALM DRIVE ATLANTIC BEACH FL 32233 JAX(90 BEACH FL 32250 (904) 424-9678 ----------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . 77 . 50 Permit Fee . . . . 155 . 00 Plan Check Fee Issue Date . . . . Valuation . . . . 25000 Fee summary Charged Paid Credited ----Due--- ----- ---------- - Permit Fee Total 155 . 00 155 . 00 . 00 . 00 Plan Check Total 77 . 50 77 . 50 . 00 . 00 Grand Total 232 . 50 232 . 50 . 00 . 00 w 4 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING,CODES. It BUILDING OFFICIAL 0—IN CITY OF ATLANTIC BEACH Cc. ri 1:1i�;:r BUILDING / ZONING DEPAR'T'MENT D. Ford`1l . Hig ins r� 800 Seminole Road iJ I Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # � 6 " �.2.3 Property Address: /�Q J ��'�a` 2d Applicant: #6� 04a 441-2 6)74 r 7-0 f#m,'/y ;Q60,% Project: wi S TH This permit application has been: [P�Approved Reviewed and the following items need attention: Please re-submit your application when these items have been completed./ Reviewed By: 4-,( Date: Date Contractor Notified: f .01 CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION (Alterations & Additions) FE �� :! t Dater 7 oo& J Address: /�� /•�%/V'C}L� D/�� fz.wr,iC, t�G , ;�z t:3 2 33 Owner of Property: -rhL HJ r-til E Address: `®� t jFM Q (: i'SD Telephone: 2467 � Z Legal DescnptfiTi: oc t mbey� Lot Number: Zoning District: Contractor: 131}13me New P 01 a" L LC ,State License Number: ' Contractor Address: 3311 RO L✓Yl � \c N Kc 41(1"I FL, 3ZZ.Ste_ Telephone: 42.4— Q 6 1 T? @ t I blitFax: Describe ppro�posed use and work t be done: AAOYi le, V l�'1n0yr .u0 �t„� r� 01?o795 Present use of land or building(s): J.-W oLAc' r4-f.►*4 Valuation of proposed construction: Dimensions of the added space: feet x feet Will this project involve: ❑ Heating&Air- ❑ Plumbing ❑ Electrical ❑ Fireplace Conditioning Is approval of Homeowner's Association or other private entity required? — If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material, w the addition of 5% or inore •r Tip E; or the removal of any trees? Applicant certifies that no change in site grade, impervious area or fill material will be used on this project. ❑ YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. [✓]NO. Applicant certifies that no trees will be removed for this project. ❑YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 .Fax: (904)247-5845 • http://www.ci.atiantic-beach.fl.us Page 2 Revised 8/04 In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. Address and contact information of person to receive all correspondence regarding this application(please print). 12 Name: W— /� IIS 7770 Mailing Address:Telephone: 7 Fax: �., ' Ila E-Mail: to mffjk�ev too I hereby certify that I have read and examined this application and attached documentation and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with,whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Owner:_--e M-l! i Date: T' AS TO OWNER: p Sworn to and subscribed before me this 0 day of ,200 • State of Florida,County of Duval Notary's Signature: ` ti'pY'P••., JANICE M.BOUNDS := MY COMMISSION#DD 331352 - ❑ Per know p•. EXPIRES:October 12,2008 ^., Bonded Thm Notary Public Underwriters produced identification Type of identification produced P L b L. Signature of Contractor: Date: AS TO CONTRACTOR: Sworn to and subscribed before me this day of__. fes ,20 0� . State of Flarida,County of Duval Notary's Signae: ti;wY'by'•., SHERRY J.ROGERSON MY COMMISSION#DD 114953 • EXPIRES:June 7,2006 ❑ Personally known Bonded Thru Notary Public underwriters ❑ Produced identification Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 • Fax: (904)247-5845 •http://www.ci.atiantic-beach.fl.us ,. Revised 8/04 Page 3 i� Doc#2006057350,OR BK 13078 Page 248, Number Pages: 1 Filed&Recorded 02/17/2006 at 09:18 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING$10.00 NOTICE OF COMMENCEMENT State of County of Tax Folio No.-zyem)z-6150t"l�'lf,� To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved: ,oq Z&A/52 (./yzr L T Z &A,Z Address of property being improved: /N7 -- General description of improvements: < Owner: Address: Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner):. Name: Address: ontractor: ow -1 Address: Phone No: L Fax No: R /- Surety(if any): X11- Address: Amount of Bond Phone No: Fax No: Name and address of any person making a loan for the construction of the improvements. Name: A.-'%tress: F ne No: Fax No: Nar'� :af person within the State of Florida,other than himself, designated by owner upon��.:�m notices or other doc+.►:;vents may be served: Name: Address: Phone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statues. (FiA in at Owner's option). Name: Address: -: ,0 1144 P142M Phone No: - Fax No: j PIZ) /C _ Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY (�- Signed: ate: �� G 6 Before me tfiis X day oft'U rU in the County of Duval, State of Flori a,has personall app d c� h rYl .HU JANICE M.BOUNDS V ... ; =� .. MY COMMISSION#DD 331352 EXPIRES:October 122008 Notary Public at Large, S o/Flo County of Duval. � = , B"' Thru N-ry Pub c Underwriters My commission expires: Personally Known: or 'Dk Produced Identification: EL .L . PSR-3844 1588? DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH P h i�hl T I N 1, -11 A T 10 N LOCATION INFORMATION "ermit Number* 15892 gess - 1802 SEMINOLE ROAD Permit TvPe:MECHANICAL ATLANTIC BEAc'F— FLORIDA 32233 lass of Work :ALTERATION ------- -- LEGAL DESCRIPTION - -------- - ,. Constr . Type:WOOD FRAME Block, Lot , Twp* Proposed Use, Section: 0 Subd-O Rng , Dwellings : 1 subdivision: Est . Value: Improv .- Cost : 0 .00 Total Fees : 37 . 00 Amount Paid: 37 .00 PND AIR )WNER INF"ARMATION APPLICATION FEES -- -- - --- - 3ame : HUGHS -ERM i T -1r 11-,-:0-21 SEMINOLE ROAD ATLANT T E;;CH ; FLORIDA -3 2 2 Phone, �C,412149-1251 CCITNTR-r-I'7TOR INFORMATION Nam, e : OCEAN STATE HEAT & AIR Addr : 1.476 ATLANTIC BLVD. NEPTUNE BEACH , FLORIDA L i c MHAR-78Exp: NOTES: NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS-99 ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. DAP. 211CIA, $37.00 14 6A CHECKS 12643 00100003221000 ATLANTIC BEACH BUILDING DEPARTMENT By: BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC BEACH, FLORIDA 31132 APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT — Applicant to complete all items in sections I, II, ill, and IV. LOCATION Street Address: 18CZ SEM wia.E Qta- t-h Intersecting $Ireefu Between lg And �rnsnlG--G BUILDING $ub-division ll. IDENTIFICATION — To be completed by all applicants . In consideration of permit gi„en for doing this work at described in fl,* above statement we hereby agree to perform said wolk in accordance with the attacI%pd plant and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards of gocd wact ce listed therein, Naawo of Mechanical Cankaafors C-oakacfor (Print) O C E A NF}►6 A/C- Master . OC-oy9 3ku Mprty O.n•r (�r5 uCi s4aafvre of Owner Signature of ar Aati,or ted Agent o Architect or Engineer IIB. Com! INFORMA A' Typo of Aeatinq 6. IS OTHER CONSTRUCTION BEING DON[ ON [�f�ec+nc —` THIS BUILDING OR SITE? �O Q 644 —❑ LP Q Natural Q Central Utility IF VES, GIVE NUMBER OF CONSTRUCTION ❑ �� PERMIT Q Of4as, — specify IV. WK>4 NICAL 1QUWW*(T TO RE INSTALLSD NATURE OF WORK (Pn6"4e Complete Jid of cot"peM"h e"ped of Mh"I R TUReeidentlal or ❑ Commercial 0/,—H0a1 ❑ Space ❑ & Recessed (7Gnth) O /IoM El Now Building ��'Ce^� r►1 13Room C�7 edCMM) —Existing Building ❑ D"ct System.- Mater4 TUICIRa.a "placement of existing system I./aairnw" capecity a1.nt. ❑ New Installation(No system prevlousty Installed) ❑ R.h;q.,et;oa, Q Extension or add-on to existing system C) coolieg lower: Capacity •pa" ❑ Other — Specily ❑ F+n apnnkiM: NYrwlter e/ le.ada (3 Efevater O IsA*41t O Esulefer_(µeabe,) Q 6eaoG4e pYm+ee (twn,ber) THIS SPACE FOR OFFICi UN ONLY Ike w; I ❑ T"k (nttntltar) Renterls Q LPG c"i*&e ("YTber) ❑ URPred preuYre veasM ❑ Eek„ Permit Appnr"J by Oe+s ❑ Ottw — Specify Pertwif R.. LIST ALL EQUIPMENT Ant COND(TIONINC AND REFRIGERATION EQUIPUENT CAP,dty Numt4r Units Dercrlpttaa M0"Number Manufacturer (')bat) �' :.i s_ FOR OFFICE USE ONLY Date---------7=.Saf19*"e Permit #---•---•................Fee F ATLANTIC BEACH Valuation $.... .. ................... . ........ FLORIDA House #--- ......$ m ..... . . .. 1978 City OF ATLANf eLICATION FOR BUILDING PERMIT ...... ...... . ...... ..... . ....... BF54CH -----------------r------------------------ ..A Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure described. This application is made in compliance and conformity with the Building Ordinance of the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether herein specified or not. The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub- contractors engaged by him are duly licensed in the City of Atlantic Beach, Florida. To prevent delay or embarrasment regard- ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can be verified. 2.44 Date... . - ------I...................--------------P 19 --------------- ----------- Owner ...... ..... -------------------------------------Address--- ......... -Telephone Nox------ ------- --------------- ...... ..T kkA----Telephone NoAq-M141 Z--- Architect. L---------........... 00, __ _1 --------- --- rw ---Address -- -------_-----------Te ............... - ------------------- ------ Contractor BuildeAk qwtt— R dressA0.*"%*A_&Vk0.......Telephone No.;W _?-C1 !-----------------------Address.. . - V -'-----Telephone---------------------------------------- ----------------------Sub Division.Sq&,%)A-__**_ .es'_ -------- --------Zone--------------- LotNo-------4-----------------------------------..-Block No... 0 ------------_Su. Street--- ----- ----- --Side Between---------' --------------and...........I-W-------- ........... Valuation ---------- ...For what purpose will building be used. _MCwr.Type of construction__1F_.."_ - Dimensions of Building49_'3(__1#V......---------Dimensions of Lot- -- 09-------- ----------Size of Footings..- --- ----- 1'.-- .1�--------- Size of Piers-------- ---------------- -----Size of Sills--------- ---- ------Greatest Sill Span in ft.--- ----------------------Type Roof---I ------- How will Building be Heated? -------._...._.._...._..__Will Will Building be on Solid or Filled Ground? ------------------ Size of Ceiling Joists.._-.---.__ ----------------- Distance on Centers- ____ .............................. Greatest Span._.__..._-_.._...._..-_..._.--__---.____.--- pp Size of Floor Joists----------------------------------------------- Distance on Centers ... . ........................... Greatest Span....................................------- Size of Rafters --------------------------------------_----------- Distance on Centers ---------------------------- Greatest Span--------•--------------------------------- This rectangle is to represent the lot. Locate the building or buildings in the APPROVED right position. Give distance in feet from CITY OF ATLAIV2 BEACH all lot-lines and existing buildings. eu!LDI G OFF:C:: REAR LOT LINE Two copies of plans and specifications shall 819 be submitted with application. Inspections required. 1. When steel is in place and ready to pour footing- BZZ I Xd Z 2. When steel is in place and ready to pour columns and/or linti3l" 3. When steel is in place and ready to pour beam. E-4 4. When framing is completed. 5. When rough plumbing is completed,and ready to cover up. 6. When septic tank drain field or sewer is laid but before it is covered. 7. Electrical inspection by City of Jacksonville. 8. Final inspection. Note: In case of any rejection,re-inspection MUST be called for after corrections are made. FRONT OF LOT In consideration of permit given for doing tnwork scribed in the above statement, we hereby agree to perform said work in accordance with the attached p an Oec s, which are a part hereof, and in accordance with the building regulations of the Cit ntic ach. 0? Signature of Builder- ------ -- ---- Address.vo. --- ------- ..... . ....... ........ ------------ . ..................... ....... Signature of Owner.._with -------------- Addressd/S.7'9------!A...11;W. - --_ ---------- DEPARTMENT OF BUILDING PERMIT NO. 3796 CITY OF ATLANTIC BEACH. FLORIDA PERMIT TO BUILD 'E THIS PERMIT MUST BE POSTED ON JOB Date g'4t7 8 19 Valuation$ PLUMBING Fee$ 3-1.00 id to City Treasurer, and is ' until above see has been pa This permst not valid bcable provisions of tae• sebject to revocation for violation of app P lumbi ,I This is to certify tha Fred 'W- Fair 2 bath Z lavatories, to install 1 sink, 1 disposes has permission to buil 1 water heater, 1 dishwasher, Ubs, 2 Closets• d 1 ,.ra sh ngae 01 RIal —Zone Classification rSSD cr,�k9 Owned by Bloc' 1 Lot- 180 2 S 'nole Bea Roa cl eax� I House No i I to approved plans which are part of this permit CONCRETE FORMS According AND FOOTINGS MUST BE IN SPECTED BEFORE POURING. I PERMIT VOID SIR MONTHS k AFTER DATE OF ISSUE %9 material, rubbish ansa inn O Building �— —� Z from this work must not be�cleared up i public space, and must be and hauled away by either contractor or owner. I1 Dairbi,s nKT Buil fns Of !� CONTRACTOR PERMIT DATE e FOR E OFFICE NUMBER USONLY PLUMBING ELECTRICAL I SEWER I WATER I 4i E r CIU-Timm -94sq PIrl 5 f;Fil.-ss M TFA v?fS{ .!`� '�f�i ,;�: �'f.A.r€131Hb `MP FIX7VRE'.'* M-95 19 FY ��.Pr0f?Fr�e�+i, WT- �`E f�'OS r+El°EAfS U) `YOM OF TNE 5f: " 3T!?pstr+?tr1�" #��atFff"fA'f& '1°ear DEPARTMENT OF BUILDING 3791 CITY OF ATLANTIC BEACH, FLORIDA PERMIT NO. ' PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Date $/t/_78 —19 Valuation$ Fee $ 119 00 �. This permit not valid until above fee has been paid to City Treasurer, and is subject to revocation for violation of applicable provisions of Lw. This is to certify that Al Tore. Inc has permission to buil' a residential Classification s/f dwelling Zone Owned by Al Tore Inc. Lot _Block 1 SSD— House No. 1-802 S e—m ina 1 e RPa eh RnAd. According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE 110. ► 0 Building material, rubbish and debris from this work must not be placed in public space, and must be cleared up and hauled away by either contractor * or owner. i Bill r�; Davis i i Building official. tEEI K FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING -y V eat G i ELECTRICAL i SEWER v �a CITY C@` AnflPxnC BEAD WATER COt+CPECTO OK DATE LOCATI M O4Q1E.9�,- PL.tM NG FG FW__ WSM BLIT LMR OR CONT VCTCR__ TYPE OF 8UI LDl ND _ Z- M714RDO)1 GIiOLIP COG 6 STOW OF ,- __SKMER STALL, DOESTI C (2 UNITS) WAYS CLOSET, LAVATORY S BAMM Oft STALL (8 UNPTS) ,.___ POOtS MOW) PER MW (3 UMI --umm (vol" OR lie T1 T OVER __v.___S t .. S I W (3 UNITS) tfA D SIMER) Q2 Ut%'IS) $S �I�) FL185 MG RINT SINK (8 UNITS) C�rl�'T _ _X30 4°lidi'!Ell S U NN & 'MAY 0 USI"9"a c -SERVO CE SINK-'TRAP STAND (3 UNITS', .r.e° O� S 1 N,C-P TRAP �2 UN!TS) ____ _00MI NATI ONi SOW & TRAY WOOD DQ SI't}SlV_,, WIT Q4 UilTS) _20T, SQX UW S)NIC (4 UNITS) ____F)TA L M T OR CUSPI DM C 1 LNO T) _______URO NAL, PEDESTAL, SYPHON JET, BLOWOUT (8 UNITS) -DENTAL LAVATMY Q i UN9 T) N'�, lel LOP 84 Ut1 T5) U3I NK116 FQWAO N Cl UNIT) �R6 Q2 lDR�"5) WSTALL, WASHOUT (4 UNITS) ,�_OI Si1lNtS�R —URINAL TROUMI $EACH 2—FT. SECTION FLOOR DRAMS (I U19 T) (2 UNITS) _ KM9E11 SINK (2 UNITS) -,I.- ND MCHI NE (RES.) (3 UMTS) ___�L_KI TC EN SINK M/FOW KAM GRI WSH SINK. 004 SET (F FAUCETS (3 UNITS) `2 UMTS) LAVATIMY (I t41M MATDt CLOSET, TAW-MAAT® (4 UMTS) LAVATORY, BARBER, BEMM PARLOR Q2 MOTS) IfATER CLOSET, VALVE-OPERATED (8 UNITS) LI4VATORY, SUlGEONS Q2 UQ TS) LAMOW TRAY Q2 LINO YS) MAP SHOWING BOUNUAkY SORVI;Y OF LOT I , BLOCK 1, SELVA MARINA UNIT NO. 9, AS RECORDED IN PLAT BOOK 36, PAGE 20 OF THE' CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. CERTIFIED TO: KATHLEEN & WALTON HUGHES, COMMONWEALTH LAND TITLE & DUVAL FEDERAL C/Tj,'P." or THERE ARE NO VISIBLE EASEMENTS TO OUR KNOWLEDGE EXCEPT FOR THOSE SHOWN. e� R ��w�gNTj�FO 4p, °F too o r zB r z7 �N z� N. x - O � o Ca.,,C.SLAB z� , .o moo.7 • z— �'OS ti /- STORyf�Z4ME s_ g 24„ ((� LA % v GO¢ • SEM /NOLE ROAD , ' RECORDS 'UTjlis Mrralltu pPPa Made the 25 day of November A.D. 19 86 by Cheryl H. Wienbarg , single hereinafter called the grantor, to her husband �1 Kathleen M. Hughes and Walton M. Hughes , wwhose post office address is: 1802 Seminole Road , Atlantic Beach , Florida 32233 Located in Duval County , Florida hereinafter called the grantee: he parties to representative use anierm assiens of thetindividuals.and the su cessors"grantor" and "erantee" 'and assignsnclude alltof corpo atiions)s instrument an the heirs, 1rRal WitIiFSSFtIi: That the grantor, for and in consideration of the sum of$ TEN & N 0/ 10 0and other valuable considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, — _—releases, conveys and confirms unto the grantee, all that certain.land situate in -Duval County, Florida, viz: Lot 1 , Block 1 , SELVA MARINA, Unit 99 as recorded in Plat Qy Book 36 , page 20 of the current public records of Duval County , Florida. SUBJECT TO covenants , restrictions , easements of records and taxes for the current year . Z LU 0 J o J} STATS of FLORIDA�I ZE DOCUMENTARY STAMP TAX'I ..,.,^,r,> zo m o= DEPT.OF REVENUE c� r" w � s � . o' _ o v '� = PB. — DEC 10'86 /'i 46 5_00, I � Uw = 11029 E Q Q V 0 � � _j � �'- n u. C) JCr� til u, a > LLI �� t) 0_j _j u! Q Z 3—mi: ` z -� °' voTiLDgFtjjfr with all the tenements, hereditaments and appurtenances thereto belonging or in anywise waorni _ > In 0 . = z o aI'1jer�ta,ning. H TQ �HMbF allb to �iolb, the same in fee simple forever. ,A11b the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple;that the grantor has good right and lawful authority to sell and convey said land;that the grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever;and that said land is free of all encumbrances, except taxes accruing subsequent to December 31, 19 86 �riTtlil'SS 3Mjjereof, the said grantor has signed and sealed these presents the day and year first above written. Signed, sealed an dehvered in our presence: Chert' Wienbarg STATE OF Florida COUNTY OF Duval I HEREBY CERTIFY that on this day,before me,an officer _ _ � • , -- __,-- --,_.."....tea,,,.,a.,t•r�r�rcz,t,ally aooeared CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 �r31i1�r Application Number . . . . . 05-00029934 Date 4/22/05 Property Address . . . . . . 1802 SEMINOLE RD Tenant nbr, name . . . . . . REPL WINDOW/PATIO SLIDERS Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 20115 Owner Contractor ------------------------ ------------------------ HUGHES, KATHY LOWE ' S HOME CENTERS INC 1802 SEMINOLE ROAD 12945 ATLANTIC BLVD ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225 (904) 486-4701 ---------------------------------------------------------------------------- Permit BUILDING PERMIT Additional desc . . Permit Fee . . . . 135 . 00 Plan Check Fee 67 . 50 Issue Date . . . . Valuation . . . . 20115 Fee summary Charged Paid Credited Due Permit Fee Total 135 . 00 135 . 00 . 00 . 00 Plan Check Total 67 . 50 67 . 50 . 00 . 00 Grand Total 202 . 50 202 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILD ODES. 7 INC*% .rr BUILDING OFFICIAL CITY OF ATLANTIC BEACH Cc. D Y S`' BUILDING / ZONING DEPARTMENT i9 ins r 1 v 800 Seminole Road Doerr Atlantic Beach,Florida 32233 (904)247-5800R E C E �_v E C (904)247-5845 Fax www.coab.us Y OF ATLANTIC 6NcCH CITY PLAN REVIEW COMMENTS MAR 22 2005 Permit Application # 05— Zg 9 :�-:4 �c Property Address: -- Applicant: Project: This permit application has been: Approved r7 Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: t,,4 Date: 31�2q f co Date Contractor Notified: RECEIVED ' CITY OF ATLANTIC BEACH BUILDING &ZONING S' + Js MAR 2 2 2005 l�1 61 CITY OF ATLANTIC BEACjHBY PERMIT APPLICATION FOR REPLACEMENT OF WINDOWS, SKYLIGHTS GARAGE DOORS OF SINGLE—FAMILY OR TWO-FAMILY (DUPLEX) CONSTRUCTION Date: aJ' Q2 -05 Job Address: 0001690',"& R."t Owner's Name: Q ie eV\ p, �' " Address: 160?, �eh^i yIOI 2 Ail Qn1�L 1✓Ch , ISL Phone: 2`6' 22-42 Legal Description: Block Number: Lot Number: Zoning District: ((�� Contractor: LD(206_6 State License Number: cRc d� �3 Address:: Phone: 4d �7UI ry City: State: R, Zip: ,KFax: U 46(o 41710 Describe proposed use and work to be done: Present use of land or building(s): �Z - Valuation of proposed construction: ZO 1 1 Is approval of Homeowner's Association or other private entity required? If yes, please submit with this application. Building Data: Mean Roof Height (ft) Building Width (ft) Building Length (ft) Roof Slope *Window Elevation from Grade (ft) Window Height (ft) Window Width (ft) Measurement from corner of building to window (ft) rye" #0A ode A, WIVIdau) 5-o" s CL 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 - Fax: (904)247-5845 - http://www.ci-atlantic-beach.fl.us Page l Revised 1/27/03 Procedure: In order to expedite issuance of permits provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. In addition to the building data,the following information is required: 1. Manufacturer's Test Report 2. Installation Procedures 3. Window Description/Type 4. Garage Door Description/Type 5. Skylights Description/Type 6. Elevation View of Window Locations I hereby certify that all information provided with this application is correct. Signature of Owner: / / Date: S/ I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. 1.understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required.. Signature of Contractor: Q Date: G Jr Address and contact information of person to receive all correspondence regarding this application (please print). Name: LO W 0S -- fil•A-(?t o4 1 L L Mailing Address:` 1A 9 V T I+Wag TZ C i3 L USO �j4-t(' � � 2 Z�S Telephone: 90 VIM,Y70/ XN67ax: E-Mail: AS TO OWNER: Sworn to and subscribed before me this day of � 1.A,(i� ,20 OS State of Florida,County of Duval ;O�. DOUGLAS S.EKERN Notary's Signature: " MY COMMISSION#DD 318725 V EXPIRES:May 12,2W8 BondedThmNotaryP01i, r ia"Rers Personally known Produced identification Type of identification produced rL DL }-�aa�-513_5Z-s99-v AS TO CONTRACTOR: ,� '^ Sworn to and subscribed before me this oday of4I 1.� ) ,2061 State of Florida,County of Duval JENNIFERSCHLUETER Notary's Signature: = ' 1 r„ ;.: MY COMMISSION#DD 12130 • 0. EXPIRES:May 27,2006 ❑ Personally known Banded Thru Notary Public Underwriters E;4-roduced identification Type of identification produced Wil.IOU 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 Fax: (904)247-5845 • http://www.ei.atiantic-beach.fl.us Page 2 Revised 127/03 LOWENS Companies Ine. 8529 South Park Cr. Suite 430 Orlando,Florida 32819 Bus.407/370-2872 Fax.407/352-6309 Limited Power of Attorney Date: S� To: Building Department From: Rebeca Alicia Banuelos-Bernard I hereby name and appoint Maria O'Reilly of Lowe's,/H�/oome Cent e ,Inc.to be my lawful yyfJj�� attorney in fact to act for me and apply to (Y�i &E l for a permit for work to be performed at a location described as: /�& a Lai � PL Address of Job) (Owner of Property) And to sign my name and do all things necessary to this appointment. Thank you for your assistance. Sincerely, C .;Lk rRebeca Alicia Banu s-Bernard Regional Installed Sales Manager Primary State Qualifier CRC 057468 V Sworn to and subscribed befo e e this�k of ,2004. No.public ,arAY:ye,; Rebecca Velez My commission expires * MY COMMISSION# DD176963 EXPIRES ,a January 12,2007 %�''•••'o°'�' BONDED THRU TROY FAIN INSURANCE,INC 03/i3i;2005 10:11 9047370769 PELLA WINDOW DOOR CO PAGE 07/10 FILE COPY M I,A MI DUA MIAMI-DADE COUNTY,FLORIDA METRO-DADE FLACLER BUILDING t BUELDINC CODE COMPLIANCE OFFICE(SCCG) -148-NYEST-FL-A-GLEft-S MST,-S•U T-E-t6Q3 _. PRODUCT CONTROL DIVISION MIAMI,FLORIDA 33130-1563 (305)375-2901 FAX(305)375-2903 NOTICE OF ACCEPTANCE_(NOA) Pella Corporation 102 Main Street Peds,IA 50214 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials, The documentation submitted has been reviewed by Miami-Dade County Product Control Division and accepted by the Board of Rules and Appeals(BORA)to be used in Miami Dade County and other areas where allowed by _ the Authority Having haisdiction(ATJ)..__—,-- --.__..__... .__. -.--- ----------.•.--- This NOA shall not be valid after the expiration date stated below. The: Miami-Dade County Product Control i Division (1n Miami Dade County) and/or the AHJ (in areas other than Mimi Dade County) reserve the right to have this product or material tested for quality assurance purposes.If this product or material fails to perform in the accepted mariner, the manufacturer will incur the expense of such testing and the AHJ may immediately t revoke,modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right t to revoke this acceptance,if it is detemlined by Miami-Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. i This product is approved as described herein,and has been designed to comply with the High Velocity Hutrtaane Zone of the Florida Building Code. ; DESCRIPTION:Aluminum Clad Wood Casement Window APPROVAL)DOCUMENT:l m-Mng No. 1030,titled"Aluminum Clad Vented Casement Window",sheets h through 3,prepared by W.W.Schaefer Engineering&Consulting,P.A., dated I2Jl/00,signed and sealed by i Warren Schaefer,k.E.,bearing the Miami-Dade County Product Control Renewal stamp with the Notice of i Acceptance number and expiration date by the Miami-Dade County Product Cotitroi Di'�ision. MISSILE bVACr RATING:Large and Shall Missile Impact LABELING:Each unit shall bear a permanent label with the manufacturer's name or logo,city,state and following statement: "Miami-Dade County Product Control Approved",unless otherwise noted herein. a RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no t change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the i materials,use,and/or manufacture of the product or process,Misuse of this NOA as an endorsement of any ' product, for sales,advertising or any other purposes shall automatically terminate this NOA.Failure to comply with any section of this NOA shall be cause for termination and removal of NOA, ADVERTISEMENT: The NDA number preceded by the words Miami-•Dadc County, Florida, and followed by - the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then it shall be done in its cntirery_ INSPECTION:A copy of this entire NOA shall be provided to the user by the rnanufacturec or its distributors and shall be available for inspection at the job site at the request of the Building Official, ' This NOA renews SOA#01-0124.04.and,consists of this page I as well as approval document mentioned above. The submitted dQcurnentaijon was reviewed by.Manuel Perez,Q.E. NOA No 62-8738.12 a Expirztion Date: 'September 16,2007 Approval Date: August 29,2002 page I ■ [03110/7005 10:11 9047370769 PELLA WINDOW DOOR CO PAGE 08/10 1 0004-�Z9-144 rose v'.xw7 en.-etcCr..a c0e --r»a— Ta �a r.*a � a; � 61ZOS V1 "e'113d .ree�ro�n.,oMs oor � _- 1-291S NItlY'I bOl Yd •9HalrlsNOJ'R NOIiN2lOdifO� YTT3d KS A ' OHRMMSN3 10-42YN, Booz s o Isar � I6a= yry u avaxr,�eNat. o. SMOOMM bNJV35W Q3Jf3A CM MrINIMA7121 a g � ' ig �. � {J 999 l UJ Cl- LAJ m - o pcn� Wl � �� a- k4 - -LTW � ¢ x K� Bp TF- W. u f9Q co W�W 1"-'L w LLJ UJ LLJ � W S i w } n f oro N �\ j Qr W w#2 �' Fg 9 = o md'a S ac4cli IL �ha o o Ss 7 y 4WD y7 Q :Z� a-�'0 Xesv.eli ss 8 yet 34 C oaF �.3-0 xv. �9- 5pE 'H'1 �•� _1L � W�y= r�� Y�� Y N w LU 4 f o s e vi LIQ+ n 0'1'd Yh1 ,�/L S9 rp W bLL tj eg t5'^ ( �S n ` log ED iL �u v 03110` 005 10:11 9047370769 PELLA WINDOW DOOR CO PAGE 09/10 000[•-lt9—IbA cmc-ut-Ms'7ni roc,-arc-iss7*tw .r.�, t�er++�''�d�nu.� sg' sitar Yl 'b1"Z�d ES.E .4=.3tt15 NIYLR LOC / MZ vice a."rniwa en " Yd '4MIL"1f75H0.7 76 //fi`.f��/` NOLMOdaoo YM t ONW39NI5N3 kdA YMUS 'JA A s 5- 7rro a oi.mrAnwuewn yr SIAL Hbh WYOSYJ G31NBA wu nnNirfn-m v _.. ..... _ W.. -"--- -- 4 � � y � Y n CD Z d s a W g ul c b co I J Q O ` n U 7 N m S Z t3t J v t] z r W � 4 W yp i. t? 63/10/2005 10:11 9047370769 PELLA WINDOW DOOR CO PAGE 10110 I i OOOt—tZ9—t>q to��sc-In sre iw•eu-ue fMow N 7IW� '�� 6lZOs YI YT13d 2UNW49HIDM3 umv 7Mmhy�arnf mw '714 oNOt1VWIA p�YMd mu3wm m -A Yd 4 " 4 ' 'Woorws 1tt yosv, a3ix�n avio ►mr3trl� i { r, r liw o uardnlsfo o. 4 O FN o l! n ! §5.1 � 3s � � v I b ass�ap Ad l Q Pf W rr1 �[X x 6h tiN ��L '.FM V1 X rrnin`•o- v y_y Rod yJ a TPI, '► N o 4C �a6� d4 ao.a2i,�� i.-no ev+n K Y0. ESz CL rpy vw Y ��fggy� W ti iE -F h e m 1 Ir Ld J " Q F- C) o W 'J s V LIJ m EQ Lr)l o F a �.� u as FILE COPY - NOTICE THIS DOCUMENT IS BEING PROVIDED FOR THE LIMITED PURPOSE OF OBTAINING BUILDING CODE APPROVAL. ACTUAL TEST RESULTS PROVIDED HERIN SUPPORT AND, IN SOME CASES, EXCEED PUBLISHED PERFORMANCE CLAIMS. SEE PRODUCT LITERATURE FOR COMPLETE PERFORMANCE INFORMATION. AAMAINWWDA 101/I.S.2-97 TEST REPORT Rendered to: PELLA WINDOWS AND DOORS SERIES/MODEL: 30 APPROVED TYPE: PVC Sliding Glass D064TY Or ATLANTIC BEACH BUILDING OFFICE MAR 2 3 2005 By. Title Summary of Results AAMA Rating SGD-R50 71 x 80 Operating Force (In Motion) 5 lb max. Air Infiltration 0.15 cf rdft2 Water Resistance Test Pressure 7.5 psf Uniform Load Deflection Test Pressure ±50.0 psf Uniform Load Structural Test Pressure ±75.0 psf Forced Entry Resistance Grade 10 Reference should be made to ATI Report No. 01-43925.02 for complete test specimen description and data. e Architectural Testing AAMA/NWWDA101/I.S.2-97 TEST REPORT Rendered to: PELLA WINDOWS AND DOORS 2000 Proline Place Gettysburg, Pennsylvania 17325 Report No: 01-43925.01 Test Date: 02/06/03 Through: 02/12/03 Report Date: 07/03/03 Expiration Date: 02/12/07 Project Summary: Architectural Testing, Inc. (ATI) was contracted by Pella Windows and Doors to perform tests on a Series/Model 30, PVC sliding glass door. The sample tested successfully met the performance requirements for a SGD-R50 71 x 80 rating. Test Specification: The test specimen was evaluated in accordance with AAL /NWWDA 101/I.S.2-97, Voluntary Specifications for Aluminum, Vinyl (PVC) and Wood Windows and Glass Doors. Test Specimen Description: Series/Model: 30 Type: PVC Sliding Glass Door Overall Size: 5' 11" wide by 68-1/8" high Panel Size: TO-1/4" wide by 6' 5" high Screen Size: 3' 0-7/16" wide by 6' 5-5/8"high Finish: All PVC was white. Glazing Details: The 3/4" insulating glass was fabricated using two sheets of 1/8" thick clear tempered glass and steel InterceptTM spacer system. Each panel was exterior glazed against dual-sided adhesive foam tape and secured using PVC glazing bead. 130 Derry Court ,y York, PA 17402-9405 phone: 717.764.7700 fax: 717.764.4129 www arrhtpct rnm i Page 2 of 5 { Test Specimen Description: (Continued) Weatherstripping: Descriptio Quanti Location 0.187' backed by 0.210" 1 Row Top rail, bottom rail, active meeting high polypile with fin stile 0.270" backed by 0.230" 1 Row Fixed meeting stile high polypile with fm7 Frame Construction: The frame was constructed of extruded PVC with mitered and welded corners. The fixed meeting stile was secured to the head and sill using two #8 x 2-1/2" screws with washers. The top and bottom fixed rails were attached to the head and sill using two #8 x 2-1/2" screws located V and 2" from each end. Fixed rail joinery was sealed with silicone. A PVC screen roller track was used at the exterior sill channel and a PVC panel roller track with a stainless steel cap was used at the interior sill channel. Panel Construction: The panel was constructed of extruded PVC with mitered and welded comers. Screen Construction: The screen was constructed of roll-formed steel with mitered and -keyed corners. Each corner was secured using four #6 x 3/4" screws. Adjustable rollers were use at the top and bottom rails, 5-1/2" from each end secured using one #8 x 1/2" screw. A PVC handle with lock and adjacent keeper were used at the midspan of the latch stile. The fiberglass mesh was secured using a flexible vinyl spline. Hardware: Descri tp ion Quantit Location Lock handle assembly 1 Midspan of lock stile Lock keeper, secured 1 Midspan of the locking jamb using four#8 x 2-1/2" screws Metal roller assembly 2 Each end of bottom rail PVC anti-lift out brackets 2 2" and 30" from jamb/head corner on the active panel 01-43925.01 Page 3 of 5 Test Specimen Description: (Continued) Drainage: Description Quantit Location 3/16" wide by 5/8" 2 3-1/2" from each end of bottom rail slot 1/4" wide by 1-1/2" 2 1" from each end of sill draining the long slot interior channel to the hollow below 1/4" high by 1-1/2" 8 Four each end of sill draining the long slot interior hollow to the exterior hollow 5/32" high by 1/2" 2 Each end of the sills exterior wall long slot draining the exterior hollow 1/4" diameter hole 2 Each end of the sill screen exterior channel draining to the hollow below Reinforcement: Steel reinforcement was used in the lock stile (Drawing #HP30-40B), the active meeting stile (Drawing #HP30-41), and the fixed meeting stile (Drawing #HP30-42C). Installation: The door frame was installed into a #2 Spruce-Pine-Fir wood test buck. The integral nail flange was set against a bed of silicone and secured with #6 x 1-1/2" drywall screws with washers, located 6" from each corner and 8" on center(38 total). Test Results: The results are tabulated as follows: Paragraph Title of Test-Test Method Results Allowed 2.2.19.5.1 Operating Force To open 14 lbs max. 30 lbs max. In motion 5 lbs max. 20 lbs max. 2.1.2 Air Infiltration(ASTM E 283-91) @ 1.57 psf(25 mph) 0.15 cfin/fI2 0.3 cfm/ft2 max. Note #1: The tested specimen meets the performance levels specified in AAMA/NWWDA 1011I.S. 2-97 for air infiltration. 1 Page 4 of 5 Test Results: (Continued) Paragraph Title of Test- Test Method Results Allowed 2.1.3 Water Resistance (ASTM E 547-00) (with and without screen) WTP =2.86 psf No leakage No leakage 2.1.4.1 Uniform Load Deflection (ASTM E 330-97) (Deflections reported were taken on the fixed meeting stile) (Loads were held for 52 seconds) @ 15.0 psf(positive) 0.24" See Note#2 @ 15.0 psf(negative) 0.35" See Note#2 Note #2: The Uniform Load Deflection test is not an AAMAINWWDA 101/I.S.2-97 requirement for this product designation. The data is reported for information only. 2.1.4.2 Uniform Load Structural (ASTM E 330-97) (Permanent sets reported were taken on the fixed meeting stile) (Loads were held for 10 seconds) @ 22.5 psf(positive) 0.01" 0.30" max. @ 22.5 psf(negative) <0.01" 0.30" max. 2.2.19.5.2 Deglazing Test (ASTM E 987-88) In operating direction at 70 lbs Lock stile 0.14"/28% 0.50"/100% Meeting stile 0.13"/26% 0.50"1100% In remaining direction at 50 lbs Top rail 0.11"122% 0.50"1100% Bottom rail 0.10"/20% 0.50"/100% 2.1.7 Welded Corner Test Meets as stated Meets as stated 2.1.8 Forced Entry Resistance (ASTM F 842-97) Type: A Grade: 10 Lock Manipulation Test No entry No entry Test A 1 through A6 No entry No entry Lock Manipulation Test No entry No entry 01-43925-01 Page 5 of 5 Test Results: (Continued) Paragraph Title of Test - Test Method Results Allowed Optional Performance 4.3 Water Resistance (ASTM E 547-00) (with and without screen) WTP = 7.5 psf No leakage No leakage 4.4.1 Uniform Load Deflection(ASTM E 330-97) (Deflections reported were taken on the fixed meeting stile) (Loads were held for 33 seconds) @ 50.0 psf(positive) 0.86" See Note#2 @ 50.0 psf(negative) 1.03" See Note#2 4.4.2 Uniform Load Structural (ASTM E 330-97) (Permanent sets reported were taken on the fixed meeting stile) (Loads were held for 10 seconds) @ 75.0 psf(positive) 0.02" 0.30"max. @ 75.0 psf(negative) 0.04" 0.30"max. Detailed drawings, representative samples of the test specimen, and a copy of this report will be retained by ATI for a period of four years. The above results were secured by using the designated test methods and they indicate compliance with the performance requirements of the above referenced specification. This report does not constitute certification of this product, which may only be granted by the certification program administrator. This report may not be reproduced, except in full, without the approval of Architectural Testing. For ARCHITECTURAL TESTING, INC: Scott Gill J eph . Reed, P.E. Technician ire - Engineering mid sten g SG:nlb 01-43925.0100 26 # �t„ DOCUMENT CONTROL ADDENDUM 901-43925.00 Current Issue Date: 07/03/03 Report No.: 01-43925.01 Requested by: Aaron Hancock, Pella Windows and Doors Purpose: AAMA/NWWDA 101/l.S.2-97 testing of a Series/Model 30, PVC sliding glass door. Issued Date: 03/13/03 Comments: Certification copy of report to John Kent at Window and Door Manufacturers Association. Report No.: 01-43925.02 Requested by: Aaron Hancock, Pella Windows and Doors Purpose: Revise Report No. 01-43925.02. Issued Date: 07/03/03 Comments: Florida P.E. seal required on report. NOTICE THE LIMITED PURPOSE OF OBTAINING BUILDING CODE APPROVAL. ACTUAL TEST RESULTS PROVIDED HERiN SUPPORT AND, PERFORMANCE FILE:00-541 , IN SOME CASES, EXCEED PUBLISHED PERFORMANCE CLAIMS. SEE PRODUCT LITERATURE FOR COMPLETE PERFORMANCE INFORMATION. PERFORMANCE TESTING INC. 4076-148th Ave.N.E. - Redmond,Washington 98052-5165-(425) 883-9788 (425)869-5266 SPECIFICATION CONFORMANCE TEST REPORT, PERFORMANCE FILE: 00-541 DATE OF REPORT: 9/6/00 DATE TEST STARTED: 8/8/00 TEST COMPLETED: 9/6/00 CLIENT: Viking Industries, Inc. P.O. Box 20518 _ Portland, OR 97220 SERIES & MODEL: 8500/9500 Series Vmyl Sliding Glass Door `- TEST STANDARDS: AAMA/NVWVDA 101/I.S.2-97 Voluntary Specification for Aluminum, Vinyl(PVC) and Wood Windows and Glass Doors. CMBSO/CAWM 301-90,Forced Entry Resistance Test for Windows SPECIFICATIONS: SGD-R25 71 1/2"wide by 81 1/2"high Type I Door(see PTI report#00-542) DESCRIPTION OF SAMPLE TESTED CONFIGURATION& SIZE: OX measuring 71 1/2"wide by 81 1/2"high. PANEL/FIXED LITE: One interior sliding panel measuring 36 5/8"wide-by 79"high. The ? fixed lite measure 33 3/16"wide by 75 5/8"high. GLASS&GLAZING: All glass measured 3/4 overall using two panes of double strength , tempered glass. All glass was set on blocks,placed against double sided adhesive foam glazing tape and retained on the exterior with vinyl snap beads. s WEATHER-STRIPPING: Woolpile with a center fin measuring 0.210"was applied to the exterior perimeter of the sliding panel and the interior face of the fixed interlock. 1 This report contains 21 pages PERFORMANCE FILE:00-541 DESCRIPTION Continued HARDWARE: The sliding panel lead stile contained a lock/handle assembly double screw connected using#8 x 2 1/8" screws and a cam lock double screw connected using# 6 x 1/2" screws. The lock engaged a keeper screw connected using four#10 x 2 1/2" screws to the frame jamb. The panel bottom rail contained tandem rollers fitted into milled slots and single screw connected using#14 x 1/2" screws at each end and operated on a stainless steel insert located on the snap-in sill track. These milled slots were also located in the top rail. Two snap in anti lifts were placed in the frame head above the sliding panel. WATER DRAINAGE: The snap-in sill track was cut short 1/2"at both ends. The interior sill pocket drained from a 5/8"x 3/16"slot approximately 1 1/4"from the jambs to the exterior through a i"x 1/8" slot approximately 2 1/2"from the exterior comers. The snap-in screen sill track was cut short a 1/2" from each end and water drained to the exterior through a 3/8"x 1/8" slot in the exterior leg approximately 1 1/2"from the exterior corners. The sliding panel glazing pocket drained through a 5/8"x 3/16" slot approximately a 3 1/4"from the interior comers. These weeps were also located in the sliding panel top rail. FRAM[EJPANEL: White vinyl extrusions with welded comers. The fixed interlock was fitted and double screw connected using#6 x 2" screws to the head and sill. Snap-in filler bars were placed in the head and sill of the fixed lite. REINFORCEMENT: 18 gauge steel reinforcement was held in the fixed and sliding interlocks using three#6 x 5/8" screws and in the panel locking stile using two#6 x 5/8" screws. Detailed assembly drawings showing the wall thickness of all members, corner construction, and hardware have been compared to the test sample and are attached to this report. Cross sections of the sample will be retained by Performance Testing for a period of 4 years. AAMA TEST RESULTS Paragraph Number Title of Test Measured Allowed 2.1.2 Air Infiltration per ASTM E283-91 CFM per square foot of door area @ 1.57 PSF 0.1 0.3 Reported to the second decimal 0.08 Total CFM 3.39 2 This report contains 21 pages PERFORMANCE FILE:00-541 AAMA TEST RESULTS continued Paragraph Number Title of Test Measured Allowed 2.1.3 Water Resistance per ASTM E547-96 @ 2.86 PSF Leakage after 4 Cycles of 5 minutes With and without screens None None 4.3 Optional Performance Water Resistance per ASTM E547-96 @ 6.00 PSF Leakage after 4 cycles of 5 minutes None None Per ASTM E331-96 @ 6.00 PSF one cycle of 15 minutes None None 2.1.4.2 Uniform Load Structural Test ' per ASTM E330-96 _- Damage from load of _ +22.5 PSF None None -22.5 PSF None None Inches of Permanent Set 0.039" 0.31b" 4.4.2 Optional Performance Uniform Load Structural Test per ASTM E330-90 Damage from load of +37.5 PSF None None -37.5 PSF None None Inches of Permanent Set 0.050" 0.316" 2.1.8 Forced Entry Resistance See PTI report#00-542 Per CMBSO/CAWM 300-96,Forced Entry Resistance Test for Sliding Glass Doors Complies No Entry 2.1.7.1 Welded Corner Test per AAMA 101-93 App. A fractures along entire weld line: None None 2.2.19.1 Definition Complies 2.2.19.4 Test Sample Requirements Complies 3 This report contains 21 pages PERFORMANCE FILE:00-541 AAMA TEST RESULTS continued Paragraph Number Title of Test Measured Allowed 2.2.19,5.1 Operating Force Maximum lbf to open 16 30 Maximum lbf in motion 7 20 2,2,19.5,2 Deglazing per ASTM E987-88 Percentage of deglazing: 70 lbs on stiles 8% <100 50 lbs on rails Nil ,<100 CMBSO/CAWM TEST RESULTS Title of Test Measured Allowed Disassembly/Manipulation Completed/No Entry Test A 800 pounds No Entry No Entry Test B 800/200 pounds No Entry No Entry Test C 800/200 pounds No Entry No Entry Test G Hand Manipulation No Entry No Entry Test D 800/50 No Entry No Entry Test E Panel Lifted 800/200 No Entry No Entry Test F Panel Lifted 800/200 No Entry- No Entry Test G Hand Manipulation No Entry No Entry The test sample was in operable condition following testing. There was no breakage of glass or any permanent damage to any structural component or hardware_ No conclusions of any kind regarding the adequacy or inadequacy of the glass in the test specimen may be drawn from these results. 1 4 This report contains 21 pages PERFORMANCE FILE: 00-541 CONCLUSIONS The above results were secured using tests conducted in accordance with applicable ASTM, M CBSO/CAWM test methods and indicate compliance with the performance requirements of the above referenced specification. No corrective actions were necessary to achieve these results. All forced entry test loads were held for 1 minute. This report does not constitute certification of this product. Certification may only be granted by the administrator of an approved certification program. PROPRIETARY INFORMATION This report may not be copied or reproduced in any form, in part or in whole, without the express written consent of Viking Industries, Inc. and Performance Testing, Inc. John De Rose President 5 This report contains 21 pages THIS DOCUMENT IS BEING PROVIDED FOR THE LIMITED PURPOSE OF OBTAINING BUILDING CODE APPROVAL. ACTUAL TEST PERFORMANCE FILE: 00-542 RESULTS PROVIDED HERIN SUPPORT AND, IN SOME CASES, EXCEED PUBLISHED PERFORMANCE CLAIMS. SEE PRODUCT LITERATURE FOR COMPLETE ' �. PERFORMANCE INFORMATION. PERFORMANCE TESTING INC. 4076• 148th Ave'N.E. - Redmond,Washington 98052-5165 -(425) 883-9788 (425)869-5266 SPECIFICATION CONFORMANCE TEST REPORT PERFORMANCE FILE: 00-542 DATE OF REPORT: 9/15/00 DATE TEST STARTED: 8/7/00 TEST COMPLETED: 9/15/00 CLIENT: Viking Industries, Inc. P.O. Box 20518 Portland, OR 97220 SERIES & MODEL: 8500/9500 Series Vinyl Sliding Glass Door - TEST STANDARDS: A 101/I_S.2-97 Voluntary Specification for Aluminum, Vinyl(PVC) and Wood Windows and Glass Doors. CMBSO/CAW_4 301-90, Forced Entry Resistance Test for Windows SPECIFICATIONS: SGD-R20 95 3/8"wide by 81 1/2"high Type I Door DESCRIPTION OF SAMPLE TESTED CONFIGURATION & SIZE: OX measuring 95 3/8"wide by 81 1/2"high. PANEL/FIXED LITE: One interior sliding panel measuring 48 9/16"wide by 79 1/8" high. The fixed lite measure 45 3/16"wide by 75 5/8"high. GLASS & GLAZING: All glass measured 3/4 overall using two panes of double strength tempered glass. All glass was set on blocks, placed against double sided adhesive foam glazing. tape and retained on the exterior with vinyl snap beads. WEATHER-STRIPPING: Woolpile with a center fin measuring 0.210"was applied to the E exterior perimeter of the sliding panel and the interior face of the fixed interlock_ -� 1 This report contains 21 pages PERFORMANCE FRE:00-542 DESCRIPTION Continued HARDWARE: The sliding panel lead stile contained a lock/handle assembly double screw connected using 98 x 2 1/8"screws and a cam lock double screw connected using#6 x 1/2" screws. The lock engaged a keeper screw connected using four#10 x 2 1/2" screws to the frame jamb. The panel bottom rail contained tandem rollers fitted into milled slots and single screw connected using#14 x 1/2" screws at each end and operated on a stainless steel insert located on the snap-in sill track. These milled slots were also located in the top rail. Two snap in anti lifts were placed in the frame head above the sliding panel. WATER DRAINAGE: The snap-in sill track was cut short 1/2" at both ends. The interior sill pocket drained from a 5/8"x 3/16" slot approximately 1 1/4"from the jambs to the exterior through a 1"x 1/8" slot approximately 2 1/2" from the exterior comers. The snap-in screen sill track was cut short a 1/2"from each end and water drained to the exterior through a 3/8"x 1/8-" slot in the exterior leg approximately 1 1/2"from the exterior corners. The sliding panel glazing pocket drained through a 5/8"x 3/16" slot approximately a 3 1/4"from the interior corners. These weeps were also located in the sliding panel top rail. FRA MPANEL: White vinyl extrusions with welded corners. The fixed interlock was fitted and double screw connected using#6 x 2" screws to the head and sill. Snap-in filler bars were placed in the head and sill of the fixed lite. .� REINFORCEMENT; 18 gauge steel reinforcement was held in the fixed and sliding interlocks using three 96 x 5/8" screws and in the panel locking stile, cut back approximately 14"from each end and held using two #6 x 5/8" screws. Detailed assembly drawings showing the wall thickness of all members, comer construction, and hardware have been compared to the test sample and are attached to this report. Cross sections of the sample will be retained by Performance Testing for a period of 4 years. AAMA TEST RESULTS Para graph Numt,er Title of Test Measured Allowed 2.1.2 Air Infiltration per ASTM E283-91 CFM per square foot of door area @ 1.57 PSF 0.1 0.3 Reported to the second decimal 0.13 Total CFM 722 2 This report contains 21 pages PERFORMANCE FILE:00-542 AAMA TEST RESULTS continued Paragraph Number Title of Test Measured Allowed 2.1.3 Water Resistance per ASTM E547-96 @ 2.86 PSF Leakage after 4 Cycles of 5 minutes With and without screens None None 4.3 Optional Performance , Water Resistance per ASTM E547-96 @ 5.25 PSF - Leakage after 4 cycles of 5 minutes None None 2.1.4.2 Uniform Load Structural Test per ASTM E330-96 Damage from load of +22.5 PSF None _None -22.5 PSF None None Inches of Permanent Set 0.094" 0.31T' 4.4.2 Optional Performance Uniform Load Structural Test per ASTM E330-90 Damage from load of +30.0 PSF None None -30.0 PSF None None Inches of Permanent Set 0.235" 0.31T' 2.1.8 Forced Entry Resistance Per CMBSO/CAWM 300-96,Forced Entry Resistance Test for Sliding Glass Doors Comperes No Entry 2.1.7.1 Welded Comer Test per AAMA 101-93 App. A fractures along entire weld line: None None 2.2.19.1 Definition Complies 2.2.19.4 Test Sample Requirements Complies 3 This report contains 21 pages PERFORMANCE FILE:00-542 AAMA TEST RESULTS continued Paragraph Number Title of Test Measured Allowed 2.2.19.5.1 Operating Force Maximum lbf to open 18 30 Maximum lbf in motion 8 20 2.2.19.5.2 Deglazing per ASTM E987-88 Percentage of deglazing: 70 lbs on stiles 6% , <100-: 50 lbs on rails Nil <100 CMBSO/CAWM TEST RESULTS Title of Test Measured Allowed Disassembly/Manipulation Completed/No Entry Test A 800 pounds No Entry No Entry Test B 800/200 pounds No Entry No Entry Test C 800/200 pounds No Entry No Entry Test G Hand Manipulation No Entry No Entry Test D 800/50 No Entry No Entry Test E Panel Lifted 800/200 No.Entry No Entry Test F Panel Lifted 800/200 No Entry No Entry Test G Hand Manipulation No Entry No Entry The test sample was in operable condition following testing. There was no breakage of glass or any permanent damage to any structural component or hardware. No conclusions of any kind regarding the adequacy or inadequacy of the glass in the test specimen may be drawn from these results. 4 This report contains 21 pages PERFORMANCE FILE: 00.542 J CONCLUSIONS The above results were secured using tests conducted in accordance with applicable ASTM, CMBSO/CAWM test methods and indicate compliance with the performance requirements of the above referenced specification. No corrective actions were necessary to achieve these results. All forced entry test loads were held for 1 minute. This report does not constitute certification of this product. Certification may only be granted by the administrator of an approved certification program_ PROPRIETARY INFORMATION This report may not be copied or reproduced in any form, in part or in whole, without the express written consent of Viking Industries, Inc. and Performance Testing,Inc. John De Rose President 5 This report contains 21 pages MIAM' I•DADE MIAMI-DADE COUNTY, FLORIDA Cur ERPY METRO-DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO-DADE FLAGLER BUILDING 140 WEST FLAGLER STREET,SUITE 1603 MIAMI, FLORIDA 33130-1563 PRODUCT CONTROL NOTICE OF ACCEPTANCE (305)375-2901 FAX(305)375-2908 Premdor Entry Systems CONTRACTOR LICENSING.SECTION 911 E. Jeferson, P.O. Box 76 (305)375-2527 FAX(305)375-2558 Pittsburgh ,KS 66762 CONTRACI'OR I•:Nr•OIiC:I:i1I:N"r Dn*ISION (305)375.2966 FAX(305)375-2908 PRODUCr CONTROL.DIVISION (305)375-2902 FAX(305)372-6339 Your application for Notice of Acceptance (NOA) of: Entergy Series Single Flush(Embossed) Outswing/Inswing Residential Insulated Steel Door-Impact under Chapter 8 of the Code of Miami-Dade County governing the use of Alternate Materials and Types of Construction, and completely described herein, has been recommended for acceptance by the Miami-Dade County Building Code Compliance Office (BCCO) under the conditions specified herein. This NOA shall not be valid after the expiration date stated below. BCCO reserves the right to secure this product or material at any time from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner, BCCO may revoke, modify, or suspend the use of such product or material immediately. BCCO reserves the right to revoke this approval, if it is determined by BCCO that this product or material fails to meet the requirements of the South Florida Building Code. The expense of such testing will be incurred by the manufacturer. ACCEPTANCE NO.: 00=0720.05 EXPIRES: 08/25/2003 Raul Rodriguez Chief'Product Control Division THIS IS THE COVERSHEET SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL. CONDITIONS BUILDING CODE & PRODUCT REVIEW COMMITTEE This application for Product Approval has been reviewed by the BCCO and approved by the Building Code and Product Review Committee to be used in Miami-Dade County, Florida under the conditions set forth above. 1 p Francisco J. Quintana, R.A. I.1TY Or'gTLAN711CBEAC}i Director 6UILDING OFFICE Miami-Dade County APPROVED: 09/14/2000 Building Code Compliance Office MAF 2 3 1005 \\045000I\pc2000\\cemp1aces\notice acceptance cover page.doc Internet mail address: postmaster@buildingeodeonline.com Homepage: littp://www.buildingcodeonline.coni Premdor Entry Systems ACCEPTANCE NO.: 00-0720.05 APPROVED SEP 14 2000 EXPIRES August 25, 2003 NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS 1. SCOPE 1.1 This renews the Notice of Acceptance No. 97-0204.08, which was issued on August 251', 1997. It approves an outswing / inswing residential insulated steel door, as described in Section 2 of this Notice of Acceptance, designed to comply with the South Florida Building Code (SFBC), 1994 Edition for Miami-Dade County, for the locations where the pressure requirements, as determined by SFBC Chapter 23, do not exceed the Design Pressure Rating values indicated in the approved drawings. 2. PRODUCT DESCRIPTION 2.1 The "Entergy" Series Single Flush (Embossed) Outswing / Inswing Residential Insulated Steel Doors — Large Missile Impact Resistant and its components shall be constructed in strict compliance with the following documents: Drawing No 31-1015-EW, titled "Entergy Wood Edge Steel door," Sheets 1 through 6 of 6, prepared by manufacturer, dated 2/18/97 and latest revised on 08-21-00, bearing the Miami-Dade County.Product Control approval stamp with the Notice of Acceptance number and approval date by the Miami-Dade County Product Control Division. These documents shall hereinafter be referred to as the approved drawings. 3. LIMITATIONS 3.1 This approval applies to single unit applications of a single outswing/or inswing door, as shown in approved drawings. 3.2 Refer to corresponding design pressure table, for water infiltration requirements. 4. INSTALLATION 4.1 The outswing/or inswing residential insulated steel door and its components shall be installed in strict compliance with the approved drawings. 4.2 Hurricane protection system (shutters): the installation of this unit will not require a hurricane protection system. 5. LABELING 5.1 Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami-Dade County Product Control Approved". 5.2 The door slab itself shall also bear a permanent label, at the door inside edge, with the manufacturer's name or logo, city and state. 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance 6.1.2 Duplicate copies of the approved drawings, as identified in Section 2 of this Notice of Acceptance, clearly marked to show the components selected for the proposed installation. 6.1.3 Any other documents required by the Building Official or the South Florida Building Code (SFBC) in order to properly evaluate the installation of this system. IS1^tin 1 . Lltia.w9-, Ishaq I. Chanda, P.E., Product Control Examiner Product Control Division 2 of 3 Premdor Entry Systems ACCEPTANCE NO.: 00-0720.05 APPROVED SEP 1 4 2000 EXPIRES August 25, 2003 NOTICE OF ACCEPTANCE: STANDARD CONDITIONS 1. Renewal of this Acceptance (approval)shall be considered after a renewal application has been filed and the original submitted documentation, including test supporting data, engineering documents, are no older than eight(8) years. 2. Any and all approved products shall be permanently labeled with the manufacturer's name,city, state, and the following statement: "Miami-Dade County Product Control Approved", or as specifically stated in the specific conditions of this Acceptance. 3. Renewals of Acceptance will not be considered if: a) There has been a change in the South Florida Building Code affecting the evaluation of this product and the product is not in compliance with the code changes; b) The product is no longer the same product(identical) as the one originally approved; c) If the Acceptance holder has not complied with all the requirements of this acceptance, including the correct installation of the product; d) The engineer who originally prepared, signed and sealed the required documentation initially, submitted is no longer practicing the engineering profession. t 4. Any revision or change in the materials, use, and/or manufacture of the product or process shall automatically be cause for termination of this Acceptance, unless prior written approval has been requested(through the filing of a revision application with appropriate fee) and granted by this office. 5. Any of the following shall also be grounds for removal of this Acceptance: a) Unsatisfactory performance of this product or process. b) Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any other purpose. 6. The Notice of Acceptance number preceded by the words Miami-Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is displayed, then it shall be done in its entirety. 7. A copy of this Acceptance as well as approved drawings and other documents,where it applies,shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at all time. The engineer need not reseal the copies. 8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of Acceptance. 9. This Notice,of Acceptance consists of pages 1, 2 and this last page 3. L�A Ishaq I. 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EMBEDMENT (TYP) x UNITS SHAH 11910 OiLY AT MIN METED BY A CANOPY CR (2) PER NERD JAMB OVERHANG SUCH iHAI a ANGLE[10 THE EDGE OF CANDY 0R mm 10 STEL IS EESS THAN 15[GEES DESS UNIT IS D1,SICII IN 114' GAP MAX, NDN-1MBItABIE AREAS VU THE IRl1 AND If AREA R DESIGNED TO ACCEPT VATER DFILTRAiIN .750' VHERE VATER INFILIMIlm VHEIF VAIII INIRIRATBII l� BUIRD01 IS CEDED KDIBRM IS N01 Ell Positive Not Approved +76.0 sf Negative Not Approved -76 psf 1,25' ° ° e MATERIALS LIST ITEM NO. DESCRIPTION PART FIBER CANTS VOOD-HEAD JAMB EV-12 11/4'z 4 9/16' Mil.TO BE VOOD °e COMPRESSION VEATHERSTRIP LOXSEAL 9650(BRONZE) ° • O O - TRK AM EV-10 11/4'z 4 9/16' NTT, TO BE VMD FIXED THRESHOLD e ee .o a TOP CHANNEL EW-05GA STEEL 8111/16' INTERIOR 79 5/16' © STEEL SKiN 26 go,(.011 +.002 -A0) 6141SDObRbPD' MAX a •/, ° EXTERIOR O] POLYURETWE FAN COW BASF FOAM - DENSITY 24 TO 2.5 lbs./Fe BOTTOi CHANNEL EV-04 ,X BPI) W(F1D LICK BLOCK EV-08 4'VIDE V09D STRIKE STILE EV-07 1 II/16'X 15/16'X 79 5/16'NTL TO BE VOOD VOOD HINGE STILE EV-06 111/16'X 15/16'X 195/16'Mil.TO BE VOOD TOCK FILLER PLATE EV-09 .050 THICK PLASTIC 4'x4' HIG EV-15 .091 THiCK(STEEL) VOOD-HINGE JAMB V 11/4' x 4 9/16'MTI,TO BE VOOD 4 610 x 3/4' VOOD SCREVS (4)SCREVS PER HIDE © m x 2' F}IW,S, 10 SCREVS PER HiNGE Apppp�EDAS ,K� Tht to N 1DE 1 34V pf N INN V VI vm 10(N 1011 R �seas�a�r 0=00A His aa 1. 25' spun{ ��4°;o°° 610 x 3/4'F.U.S. 2)SCREWS PER HINGE NA�A- 9O 68 x 2' Fus. 2)AT EACH STRIKE PLATE �' Ik4 pacoomo0 L9CKSEi VIKSET BRAND 200 LOCK DAO C9JNIY MOOIFICAIIEINS a/m JO ERAS IBES!ma,1K ' 1G ' a DADS C(JUNTY MODIFICATIONS � JD 2 BY WOOD BUCK DICK.U1111,11i C[N1.1D1'S A AABL PAGE 4 (M STYLES) 8-1 RS 11 1.1 0511 �1 BY — ?mf NNC NT R Y WOOD FOGE STEEL M z 1114' MINIMUM EMBEDMENT OR H R.S. I DATE P(1-97 XA11 W.- 3/16' C F3/16' PFH TAPCONS WITH MR N110 MIN 31-1015-N 1112'MIN. EMBEDMENI (TYP) 9li111I10 n SHEET 2 OF b INS�ING (2) PER HEAD JAMB 1`1151K IS OR T"solE11ER C X00'4A% GOINk) 13 INTERIOR © 0 0 12 B , e• • 0' 0, , 1 °, p , p.pj s,. , d"p' p ,p ,o 19/16' EXTERIOR �D 125' 2 X WOOD BUCK 1011/4' MIN EMBEDMENT OF SCREW INTO WOOD OR 2 X WOOD BUCK 3/16' PFH TAPCONS W/1112' MINIMUM EMBEDMENT 37.50' 1/4' GRP MAX, MAX SHIM A- A INSWING AOE MY GFICATI()rIS APPRN@ASCOMRYING11AmH lwiI.-0 MIR[PSG iC W, APE COUNTY HODIFICATIONS � So�N foAa_mdi��uccoOE Olii fq Ul[SS DIED,S(D gi11.1aS A OR PAGE d (DU ONIONS) -&% RS GATE K� ��2soa [(R Pl ENT RYWSTEEL MDR R.S. pAl[ - - 1�11� SCALE. PRODUCTCONiROIOM g Tfl MRV MIN 31-1015-EW MX COOS l�lIIPIUNCE OfFlCE AccEvru�aa.�-oY�o'os �IL�[[ERsal /"\ SHEET 3 DF 6 �(IS�6,NS.6616P �VISNM l[(((4 C I 2 BY WOOD BUCK 110 z 11/4' MINIMUM EMBEDMENT OR 11 3/16' Pf H TAPCONS WITH 4.563' 1 1/2'MIN, EMBEDMENT (TYP) DESIGN PRESSURE RATINGS (Outswin Doors) (2) PER HEAD JAMB VIINIul CAVP'I ER MERE Wa BEEi( I HERE VAiER 111,11ml WE" REOUffil IS(10 REDIDR 1 IS m1 Ell 1/4' GAP MAX. Positive +55.0 psf +16.0 sf +16,0 sf lNegative -1 , f -1 . f -1 . f x UNITS MI.K DISiALLEP ALT Al LDCA111NS PROKCTEB BY A CO OR OVEN SSI DNl DE AMIE BEiVEEN 11 N Of CWY R OVGN 750' 10 Sill IS LESS THAN 6 ICREES DESS MIi IS D6TALLEO IN O 0-HABIiAKE AREAS ARE THE MIT ANB DE AREA ARE[SKII 10 ACCEPT VATER IM ILiRAiIEN. 1.25' ° MATERIALS LIST ITEM NO. DESCRIPTION PART NUMBER C@1�ENTS 0too 0 VOOD-HEAD JAMB EV-12 11/4'x 19/16' Mil. TO BE VOOD © °',°°° aov�,uutywcwmimE COMPRESSION VEATHERSTRIP L XSEAL 9650(BRONZE) � )ATE�' �� VOOD-STRIKE AH EV-10 11/4'x 4 9/16' MTI, TO BE VOOD ]O I Ga 40 BUMPER iHRESHOLD _ 4' 4 ' pgoq "ON TOP CHANNEL EV-OS 120 GA STEEL e 91 11/16' e ° lN1n,GNmuAeC OFFM © STEEL SKIN 26 gu•(.011 +.002 40) amilw2S;ISIm MAX EXTERIOR 79 5/16' ° �11:23�°W 1Q PIYURETHANE FOAM CORE BASF FOAM - DENSITY 2,11 TO 2.5 hd © BOTTOM CHANNEL -4 °. ° �'° INTERIOR ° ° •' ° VOOD LOCK BLOCK EV-08 4'VIDF _ WOOD STRIKE STILE EV-07 111/16'X 15/16'X 79 5/16'Hil,TO BE VWD • ° VOOD HINGE STILE EV-06 111116'X 15/16'X 79 5/16'MI.TO BE VOOD LOCK FILLER PLATE EV-09 .050 THICK PLASTIC 4' 4' H EV-15 .097 THICK(STEEL) ° VOOD-HINGE JAMB V- 11/4'x 4 9/16' Mil.TO BE VOOD ® °°° 1 4/ 110 x 3/4' VOOD SCREWS (4)SCREWS PER HINGE © 110 x 2'F KVS. 10 SCREVS PER HINGE O IN FHVSFViRI I Vf 0011 R m nen o rf m m la vam 1110 x 3/4' F.H.V.S. 2)SCREVS PER HiNGE —� 18 x 2' F.KV.S, 2)AT EACH STRIKE PLATE 0 LOCKSET VIKSET BRAND 200 LOCK 2 BY WOOD BUCK PAPE ClD1NTY MODIFICATIONS mm JO 4.563' jjI ,O1ESfil,(RAC. ' [L N� DADE COUNTY CODIFICATIONS JD DIEM,Ulla mill,Sl alt iQ'S A ADDED MW 4(Df1OR STYLES) � RRS 11R 012 111E 9 FNI NtIIIC: TE W STEEL DOOR E_SEIM #10 z 11/1' Il NiMUM EMBEDMENT OR er R, . 111E I—PO-97 m(1 i W 3/16' PFH TAPCONS WITH PREMDOR ENTRY MIK 31-1015-N 11/2' MIN, EMBEDMENT (TVP) �IL,�ff(�p1 /p\ Sf�EE1 4 (]F 6 (2) PER HEAD JAMB PIiiS6,KS X16? 101300 C 36m,mx (01N,u i 13 ,�, EXTERIOR 12 o •° a ,.' •�•• a, +, e ° .p a p' .p • °', e ° °' � °e, e•a o. v° .o•. o•;po, r e o °, O 19/16' INTERIUR 0 1�11/4' MIN EMBEDMENT OF SCREW INTO WOOD OR 125 2 X WOOD BUCK 2 X WOOD BUCK 3/16' PFH TAPCONS W/11/2' MINIMUM EMBEDMENT 37.50' 1/4' GAP MAX. MAX ETD A-A MINING AK COUNTY MODIFICATIONS [R.C 01,TRK ' is NI'i B OAK COUNTY MODIFICATIONS 13m IT f1i�SlllrS 115IUiEI,Jia ga11a S A PA6E DDED l (DOOR l)P11QNS) ��s RS APPROVEDASCOEIPIYINGN1iNiHE i11! 0604411E Bi Zft� 0 PARINi R Y W 1 R lqj l d d sr , I.C 6111 OQ BT U, TAR - - 1�i1 a[: Wa RNT ENTRY MIK 31115-EW auxcoDEd*%tomQ 11.Elm /"1 SHEET 5 T 6 ACCEPiAE .QQ 121J D� Pf11JBDR6, 6616P �ViJllllfli[R C v OTHER BOOR SERB STYLES (FLUSH/MUSSED) 36' - i MAXT _ I ®® ono 19 5/16 MAX ® ® Dun Dd BLANK TOP 6-PANEL 4-PANEL 9-PANEL 61 68 69 8-PANEL CROSSBUCK 4-PANEL onOnocon non $i . non RHO Ono 19 7� —i 9 �oal, W-PANEL 18-PANEL FLUSH 12-PANEL I-PANEL 5-PANEL 5-PANEL 5-PANEL 5-PANEL EYEBROW W/SCROLL EYEBROW EYEBRDW W/SCROLL ��IpvEfl as C4!lPPflNG 191TH THE souiHF / Zooe ERII(S I�LSS l�l(9,f RRC ' UEC R'� ' r (11919.C mil,M I Ts RI m C<NRIII minim IVA, d ar c�,�,ati N Nlull [VIN 10111 . PRODOCfCOHIROtWA I I Pel W.-CNTERGT VMD EDGE SHE M BUItDM6C0oE�O1ApWNCfOfFICEtoR.S. �(E 9-25-981 m(1: SCREE ACCEDIRECENO.Cb.o zob5 RNR ENTRY SYSTEMS 1-1015-N V.11110 SHEE16 fF 6 PI1iN,K O [VISTA 01ER CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING • 800 SEMINOLE ROAD-ATLANTIC BEACH, FL 32233-TEL: 247-5826-FAX: 247-5877 PERMIT INFORMATION LOCATION INFORMATION Permit Number: 19522 Address: 1802 SEMINOLE ROAD Permit Type: SIDING ATLANTIC BEACH, FLORIDA 32233 Class of Work: ALTERATION Township: 0 Range: 0 Book: Proposed Use: Lot(s): Block: Section: 0 Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: 9,742.00 OWNER INFORMATION Date Issued: 1/28/2000 Name: HUGHES, KATHY Total Fees: 90.00 Address: 1802 SEMINOLE ROAD Amount Paid: 90.00 ATLANTIC BEACH, FLORIDA 32233 Date Paid: 1/28/2000 Phone: 904)246-2242 Work Desc: VINYL SIDING CONTRA R S :`` T _AP '-i,QN FEES FLORIDA GEORGIA CONTRACTORS,INC. PERMIT 90.00 Irts ections-Re uired-�-, I NOTICE- INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. Cly-- ` ATLANTIC BEACH BUfLDING DE-PT- 2101100 E 2101100 01 Receipt:$*a314 3221090 1404 CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS, OR ALTERATIONS MOVING,DEMOLITIONS Owner(s) : Job Address: one: o� 7Kp -�aa Lot # Block or Unit # Subdivision: d1t0_P7"4A Contractor: Florida Georgia Contractors State License #CRC041040 Address:] 1433 saints Rom__ Phone No: (904)641-7010 city Jacksonville State Florida Zip Code 32246 Describe work to be done: Present use of building: I`CIe5/C -eflc Valuation of Proposed Construction: 49 7 4y_1.q• o 0 Proposed use: Is this an addition? A10 _ If yes, what are the dimensions of the added space: ft. X ft . Will the added area be heated and cooled? New electrical (or increase) ? New plumbing fixtures? New fireplace? New Heat/AC? SUBMIT THREE (COMMERCIAL) TWO (RESIDENTIAL) COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER: ✓ / Date:— Signature ate:Signature CONTRACTOR- AS ONTRACTOR AS TO OWNER: q Sworn to and subscribed before me this day of L [�7'Y� L� 191f NOTAR PUB I AS TO CONTRACTOR: Sworn to and subscribed before me this 8 day of 5I�- , 19 �J VICKEY STURGEON MY COMMISSION#CC 855094 NOTARY LI � p� EXPIRES:Jul]5,2003 OF{Vo kk - 3N01-ARY Fla Notary service&Bonding Co. Notice of Commencement Book 9520 Page 1632 State of Florida County of D oo k 95#:�ppo24 12663 B The undersigned hereby informs all concerned that improvements will be Page: 1632 made to certain real property, and in accordance with Section 713-13 of Filed 8 Recorded the Florida Statutes (Revised 10-1-96), the following information is 01/19/00 08:31:54 AM provided: HENRY W COOK CLERK CIRCUIT COURT Legal Description of Property: Af 1 �)0&c ' DUVALCOTY TRUST UN $ 1.00 RECORDING $ 5.00 General,Description of Improvements: 1 I `Jl Cc Owner's Name: K01,4JI Address: / PO;, ru erlc�� City: G�l. �l Zipcode: .3ZZ 33 Owner's Interest in Property: 100°/ Fee Simple Title holder(if other than Owner): Name: N/A Address: Contractor: Florida-Georgia Contractors, Inc. 11433 Saints Road �p Jacksonville, Florida 32246 �l Telephone: (g4) 641-7010 Fax: 904 ) 642-9156 Surety: Not Applicable Lender's Name and Address: Not Applicable Persons within the State of Florida designated by the Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes: Name: None Address: Telephone: (_� Fax(_) In addition to himself, owner designates the following person(s)to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes: Name: Nnna Address: r Telephone: (_) Fax(_) Unless otherwise noted in this paragraph the expiration date of this Notice of Commencement shall be one(1) calendar year from the date of recording: /� j r,u Owner's Name(Printed); !�1 � ,l`� Orf VICKEY STURGEON ,a MY COMMISSION*CC 855094 EXPIRES:Jul 15,2003 Signature: t� 1CN)3NbTARY FIa Notary Service 8 Bonding Co. and subscribed before me this O'S' day of,�e , 199_ Notary Public: This dmument preNred by:Florida-Georgia Contractors, 11433& qlRoad,lacks 'Ic,Florida 32246 PSR-3844 11923 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH ---- PERMIT INFORMATION --- - - LOCATION INFChMATION ----- Permit Number : 11923 Address : 1802 SEMINOLE ROAD Permit Type:FENCE ATLANTIC BEACH . FLORIDA 32233 Class of Work:NEW --------- LEGAL DESCRIPTION ----------- Constr . Type:WOOD FRAME Block: Lot : Twp : 0 Proposed Use : Section: 0 Subd:O Rng: 0 Dwellings : 1 Subdivision: Est . Value: 0 .00 Improv . Cost : 1 , 300 . 00 Total Fer,,,-q-: 10 .00 Amount 10 .00 Da /1 onc ,e ----- --- 71TION --- --- APPLICATION FEES --- Name m IFLlIT 10 . 00 AddIPPRI E ROAD FLORID& Pho 1 --- R FORMATT,' Nam !ER , WN Addy: L L i c � _,�.�� Exp T v94 1 NOTES: NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANIC'S LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYINGTWICE FORTHE BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. ATLANTIC BEACH BUILDING DEPARTMENT By: APPLICATION FOR FENCE PERMIT Owners name_ it � ✓�_ keo--- Phone _�_ �"6 _-�a q D— Job AddressAQ-da---5- em 1 Vl --_- - - ---------- ---- ---Block and/or Unitg,_------Subdivision S,�IU(S- Contractor if different. from owner ------------------------------- -------------------------------------------------------- Valuation of fence R_(�)00 i, , _____ Corner or interior lot_C_-cUt%_ !_�_k V_" Type conatruction_W�aL-0- _---_--_ __ - -- Show location and height of fence as well as location of street(s). Owner signature J r _-_._-Date Contractor signature---------------------------------Date--____-- MAP STOWING BOUNDARY SURVEY OF u).r l , BI,OCK 1 , SEL,VA MAR INA UN IT NO. 9, AS RECORDED 1N PLAT BOOK 36, PAGE 20 OF THE' CIIRRI;NT PUBLIC RECORDS OF DUVAL. COUNTY, FLORIDA. CERTIFIED TO: KATHLEEN & WALTON I{UGHES, CO21C)NL•IIsALTH LAND TITLE & DUVAL FEDERAL THERE ARE NO VISIBLE EASEMENTS TO OUR KNOWLEDGE EXCEPT FOR THOSE SHOWN. L 7- ZB L o r 77 �J z Al 8 O x Rp �-05 �- 24"E4VZ7 5 P M� Z4• `�l � ;�. • •.. $ ill ink, 0¢ o SEM //VOL E .4 O A O CITY OF ATLANTIC BEACH DGfn'A1L31 T IVIS VT OF DUILDII`VG 800 Seminole Road -Atlantic Beach, FL 32233 - Tel: 247-5826 - Fax: 247-5877 PLUMBING PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 20676 Address: 1802 SEMINOLE ROAD Permit Type: PLUMBING ATLANTIC BEACH, FLORIDA 32233 Class of Work: ALTERATION Township: 0 Range: 0 Book: Proposed Use: Lot(s): Block: Section:0 Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: OWNER INFORMATION ^vale issued: 9/2502000 Name: HUGHES, KATHY Total Fees: 50.00 Address: 1802 SEMINOLE ROAD Amount Paid: 50.00 ATLANTIC BEACH, FLORIDA 32233 _ Date Paid: 9/25/2000 _ I _Phone: (904)246-2242 Work Desc: REPIPE/10 FIXTURES - CONTRACTOR(S) I APPLICATION FEE_ S LARRY TEAGUE AND SONS PERMIT 50.00 I — --------- ----- _-- -. _-- FINAL ------ --__ lnsppcfions Required____ i - --- NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR R ViOiLA T]ON OF APPLICABLE PROVISIONS OF LAW. $50.0014 Date: 9/25/08 01 Receipt: 0991659 AT TIC B CH UILD T. CHECKS 00108003221000 CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road - Atlantic Beach, FI 32233 - Tel. (904) 247-5826 ROOFING PERMIT PERMIT INFORMATION LOCATION INFORMATION _. 1 Permit Number: 21744 Address: 1802 SEMINOLE ROAD Permit Type: RE-ROOF ATLANTIC BEACH, FLORIDA 32233 Class of Work: ALTERATION Township: 0 Range: 0 Book: Proposed Use: Lot(s): Block: Section: 0 Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: OWNER INFORMATION, Date Issued: 4/10/2001 Name: HUGHES, KATHY Total Fees: 75.00 Address: 1802 SEMINOLE ROAD Amount Paid: 75.00 ATLANTIC BEACH, FLORIDA 32233 Date Paid: 4/10/2001 Phone: (904)246-2242 Work Desc: RE-ROOF ___ � CONTRACTORS . n SAF RLICATION FEES_ CHAMPION ROOFING SERVICE, INC. PERMIT.. 75.00 .r w� 'Al FINAL �� w a �> NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NO'S BE PLACEDIN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER r "FAILURE TO COMPLY WITH THE l NStRUCTION LIEN LAW CAW ESULT IN THE PROPERTY OWNER PAYING TIMCE,#bR EULDING.IMPROVEMENTS" I ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW_ t $75.00 14 ITY OF ATLANTIC BEACH Date: 4/18/81 81 Receipt: 0048069 CHECKS 00100003221080 a D O o O m y O m � a - a \ ry � N U O N I S� a �, G1 Q 0� a3om 2 �'D fb o �a o 00 c 0 s � g y � Q (D 1 O �� l D � � NO 00 0 m '\ o(D a �+ 2 � � a 0 0 L CITY OF ATLANTIC BEACH ROOFING PERMIT APPLICATION JOB LOCATION: 1802 SEMINOLE ROAD, ATLANTIC BEACH, FL 32233 OWNER OF PROPERTY: KATHLEEN HUGHES TELEPHONE:: 904-246-2242 CONTRACTOR: CHAMPION gooFTNG SF;RVTCRS, TNC_ CONTRACTOR'S ADDRESS: 3734 SPRING PARK ROAD, JACKSONVILLE, FL 32207 ZIP: STATE LICENSE NUMBER: CCC 057402 TELEPHONE: 904-396-4642 DESCRIBE WORK TO BE PERFORMED: RE-ROOF WITH SAME TYPE OF MATERIAL rS, 00 VALUATION OF PROPOSED CONSTRUCTION 12,530.00 (�0 MATERIALS TO BE USED: ARQHITECFAJRAL SHINGLES SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: SWORN TO AND SUBSCRIBED BEFORE ME THIS 3 DAY OF APRIL Zc�� } w,� Angela H Smith AS TO OWNER: * *MY Commission CC874337 Expires September 26,200NOTA BL1C SWORN TO AND SUBSCRIBED BEFORE ME THIS '2) DAY OF AtX ► 2CQ) 4d >y�Angela H Smith AS TO CONTRACTOR*. My Commission CC874337 i,,,,V Expires SePtember 26,2003 N0 AR U BLIC Liability Insurance Supplied Workers Compensation Insurance Supplied Contractor License Information Supplied Occupational License Information Supplied NOTICE OF COMMENCEMENT TO WHOM IT MAY CONCERN: The undersigned hereby informs all concerned that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. Description of Property 1802 SEMTNOT,F. RoAn., A'PT auzTc_ $1E_4QH, FL -12?33 General Description of Improvements RE-ROOF WITH ARCHITECTURAL SHINGLES Owner KATHLEEN HTTcHFRrM n Address: SAME AS ABOVE - 1802 gFMTmnT.R ROAD. ATT,ANTTC' RRAC'H., PT. Owner's interest in site of improvements: Fee Simple Title Holder (if other than owner) Name Address Contractor CHAMPION ROOFTNG SFRVTrEs F TNC Address 3734 SPRING PARK ROAD JACKSONVILLE, FT, 37207 Surety (if any) Address Amount of Bond Name of person within the State of Florida designated by owner upon whom notices or other documents may be served: Name Address In addition to himself, owner designates the following person to receive a copy of the Leinor's Notice as provided in Section 713.13(1)(F), Florida Statutes. (Fill in at Owners option). Name Address: Sworn to and subscribed before me this: day of _ Angela H Smith * r *My Commission CC874337 ry Expires September 2e,2m NotaIc ACORD CERTIFICATE OF LIABILITY INSURANCE t]:ATE(MM/DD/YY) /29/2000 PRODUCER (321)725-7000 FAX (321)725-9333 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Corporate Risk Management HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. BOX 789 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Melbourne, FL 32902-0789 INSURERS AFFORDING COVERAGE INSURED Champion Roofing Services, Inc. INSURER A, Transportation Insurance Co. 3734 Spring Park Road INSURER B. Jacksonville, FL 32207 INSURER C: INSURER D INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY B2024591028 01/03/2001 01/03/2002 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ 50,000 CLAIMS MADE X OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PROECT LOC J AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per Person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ E.L.DISEASE-EA EMPLOYE $ E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER; CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATI0 LIABILITY OF ANY KIND UPON THE C ANY,ITS AGENTS R R RE ATIV Insured's Copy AUTHORIZED REPRESENT IV Cind A. Bro A�, CERTIFICATE OF LIABILITY INSURANCE `ERS`"ATE"1 IDA °C7.IC{,{-1)1,77 PAOOUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Hanafin Bates &. AssoCiatas ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 8144 Walnut Hill bane N1091 HOLDER. THIS CERTIFICATE DOES NOT AMEND, OR Dallas, TX 75211 ALTER THE COVERAGE AFFORDED RY THE POLICIES BELOW. 214 214-146.1501 fax: 425-671-4667 INSURERS AFFORDING COVERAGE INSURED INSURER A. American casualtyIns. Co. of ReadingPenne lvani Champion Roofing Services, Inc . INSURER 8: 3734 Spring Park Road INSURER C. Jacksonville, FL 32207 INSURER O: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE POLICY NUMBER DATEYEFFECTIVE OPO SIT Y MXPIRATION LIMITS GENERAL UABIUTY- EACH OCCURRENCE - S COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one Iva) S CLAIMS MADE F�OCCUR MED EXP(Any ons person) S PERSONAL&ADV INJURY S GENERAL AGGREGATE S GENI AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG S POLICYPRO• JECT F—ILO-C AVTOMOa1LE UABIUTY ANY AUTO COM81NEO SINGLE LIMIT (Es aCWenq S ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) S HIRED AUTOS BODILY INJURY NON.OWNED AUTOS (Pt(KOOenI) S PROPERTY DAMAGE (Par Vo6eN) S GARAGE LIABILITY AUTO ONLY.EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG S EXCESS LIABILITY EACH OCCURRENCE S OCCUR ❑CLAIMS MADE AGGREGATE S S DEDUCTIBLE S RETENTION S S WORKERS COMPENSATION AND WC247859437 9/1/2000 9/1/2001 X TIC I ATlR EMPLOYER3'L1ABIL7TY A E.L.EACH ACCIDENT S 1,000,000 E.L.DISEASE.EA EMPLOYEE S 1,000,000 OTHER E.L.DISEASE.POLICY LIMIT S 1,000,000 LIMIT S LIMIT S DESCRIPT10N OF OPERATIONSILOCATOONSIVEHICL.ESIEXCLUSIONS ADDED GY ENOOR31MENTISPECULL PROVISIONS 1. Project Information Valid in all states except Nevada, North Dakota, Ohio, Washington, West Virginia, Wyoming and Maine 2. Insured is afforded Workers Compensation G Employers Liability as a co-employer under the policy for employees leased from AMS Staff Leasing, Inc. CERTIFICATE HOLDER A.L.AooRwNINSURED:INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE T-HE EXPIRATION DATE THEREOF,THE 133UW0 INSURER WILL ENOEAVOR TO MAIL 70 DAYS WRITTEN Insured I s Copy NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAR-VRE TO DO 30 SHALL IMPOSE NO OBUGATION OR LIMILITY OF ANY KIND UPON THE 043URER,ITS AGENTS OR Re PRESENTATTVE3. AUTHORIZED RCPR[3ENTATTVE <-- Annan 75.5 171971 �i 0 A,CORO CORPORATION 1988 STATE OF FLORIDA r•'L OFPARTNrNT OF RUSINFSS AND PROFESSIONAL REGULATION - ONST 14DUSTRY LICENSING BOARD (904) 727-6530 rM E ` 7950 ARLINGTON EXPRESSWAY S TF 300 JACKSONVILLE FL 32211-7467 WIEDEN119FFT, CH'?TSTOPHER JOHN CHAMPION R7CIFING SFRVICES INC 3734 SPRINS PARK RD JACKS71NVILLE FL 32707 STATE OF FLORIDA AC# 5880L["' @ EPAR TM ENT OF BUSINESS AND PROFESSIONAL REGULATION CC '—C057402 06/14/2000 99902177 CERTIFIED ROOFING :-CONTRACTOR WIEDENHOEFTi CHRISTOPHER JOHN CHAMPION 'ROOFING'-SERVICES-;INC= - V. �r IS CERTIFIED under the provisions of Ch.4 89 R Expiration Date: AUG 319 20 0 2 DETACH HERE n - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- >C# "� STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION C9NST INDUSTRY ° LICENSING BOARD LICEYStF MBR �/i4/?.00'? 9432177 CC -C3574n2 The RQOJ=ING CONTRACTOR -----------`-- --- - -- . Vamed below S EE R T I F i E D Jnder the provisions oChapter 48,9 FS. xpiration date: AUG31t ?002 WIFDL440EFT9 CMIISTOP'i:R J3HN . �HAMPION ROOFTNG SFRVICFS INC 3734 SPRTMS PARK RD ' JACKSONVILLF FL 32207 JEB 3USH CYNTHIA A. HENDERSON GOVERNOR DISPLAY AS REQUIRED BY LAW SECRETARY 2000-2001 OCCUPATIONAL LICENSE TAX LYNWOOD ROBERTS OFFICE OF THE TAX COLLECTOR CITY OF JACKSONVILLE and/or COUNTY OF DUVAL, FLORIDA 231 EAST FORSYTH STREET ROOM 130, JACKSONVILLE, FL 32202 PHONE: (904)630-2080 FAX: (904)630-1432 Note - A penalty is imposed for failure to keep this license exhibited conspicuously at your establishment or place of business. This license is furnished in pursuance of chapter 770-772 City ordinance codes. WIEDENHOEFT, CHRISTOPHER J 02 CHAMPION ROOFING SERVICES INC 3734 SPRING PARK RD JACKSONVILLE, FL 32207-5736 ACCOUNT NUMBER: 112902-0000-7 LOCATION ADDRESS: 3734 SPRING PARK RD 32207-5736 DESCRIPTION: QUALIFYING AGENT, CONTRACTORS County License Code: 770.000-005 County Tax: N/A Municipal License Code: 772.325 Municipal Tax: $100.00 Total Tax Paid: $100.00 VALID FROM OCTOBER 1 , 2000 TO SEPTEMBER 30, 2001 RCPT #: 001T003182 DATE : 8/24/2000 AMT: $100.00 ATTENTION ***The Following Construction Contractors Require Additional Licensure*** ALARM POOL ALUMINUM/VINYL RE S.D E N T 1#"'%'L R0v1r:ING ELECTRICAL SHEET METAL SOLAR MECHANICAL PLUMBING IRRIGATION GENERAL CARPENTRY WATER TREATMENT UNDERGROUND UTILITY HEATING AIR CONDITIONING REFRIGERATION This is an occupational license tax only. It does not permit the licensee to violate any existing regulatory or zoning laws of the County or City. Nor does it exempt the licensee from any other license or permit required by law. This is not a certification of the licensee's qualification. TAX COLLECTOR THIS BECOMES A RECEIPT AFTER VALIDATION CITY OF ATTIC .&_zjC.=i APPLICATION FnR PLD?SGIKG Pr I1 �•CB LCCAT:ON:��_��I77.�I�.C�.... OWNER OF PpOprR,�v. ?LZ,r,[_TITJ CONTRACTOR LARRY TEAGUE PLUMBING CCtiTR_AC:.OR' S 7,DDFESS:—�__�f�i,��„�,L��tiC/�.�1 S"'7E LICENSE \;j r BE= 6 HOW MAt^! OF THE FOLLOWING FIXTURES INSTA ,LED SiN"s "SHOWERS —_- LAVATORY - �N'A^ER HEAT=RS SATH =U?S s —DISHWASHERS a RIVALS — J.S POSA',S CLOSETS --WASHING K :''HINE LOOR DRAINS SHOWER PANS c,WER WATEF FEP-TPE OTnE1 TOTAL FIX^URES: x 53 . SC -4- MINIMUM MINIMUM PERMIT FEE — $25. 00 SIGNATURE 0- OWNER: SIGNATURE OF CONT INSTALLATION OF PLT. INC AND FIXTURES MUST BE IN ACCCRDANCE WITH LHE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-582c' SEWER CONNECTIONS MUST BE CAT-LED INTO PUBLIC WORKS FOR INSPECT'_"GC: PRIOR TO COVERING Ur - (904) 247-5834 PSR-3844 7617 DEPARTMENT OF BUILDING — CITY OF ATLANTIC BEACH -- PERMIT INFORMATION - - - ------ LOCATION INFORMATION ------ rmir Number ' 7617 ' 1.-ess : 1802 SEMINOLE ROA Permit Type: MECHANT( ?�L ATLANTIC BEACH , FLORIDA 3223 ass of Work : ALTERATION ------ LEGAL DESCRIPTION --------- ?,nnstr Tvna: WO OP FRAME Flock: E<'tiOn' �r.oposed Use . SINGLE FAMILY Township- RN(-',, 0 ,E-? ?ingf : 1 Code . 0 <bdivision. 7 t i,mat ed Value: $0 .00 ;.nrj .OV . 00,s t 0 on Total Fi S37 .0" NSFR n ------- - _ WNEP INFI',FMATION - APPLICATION FEES N 3Ttt ~w'" TT 3!4_,:Z HERMIT _ _ n r, ;dres EM tt)LF. ROAD MATER.. IMFAI T FEE 13EA FLORIDA S E ,I .,,FEE Phor '}01 - 4c �2: ': RADON GAS-H.R . S . $0 .00 ------ CONT1RA'TOR INFORMATION ------ RADON GAS - 5% $0 . 00 Name ' OCEAN STm,TE HEAT & CAPITAL IMPROVE. $0_. 00 'dress,: _14"r A' L-,.NTIC BLVD- SEWER TAF 50 . 00 NEPTUNE �EA� H , FLORIDA 32233 HYDRAULIC SHARE 50 . 00 MHAR-78� Ti7ne : CROSS CONNECTION * ? ? « w SEC.H IMPACT FEE $O .00 CON. SC- OTHER. w r � . 0 NOTES: NOTICE —ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS." ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. ATLANTIC BEACH BUILDING DEPARTMENT 8perator: CRYSTAL Date: 12/03/93 00 Receipt: 0014882 By: (37.00 oa BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC BEACH, FLORIDA 32233 APPLICATION FOR MECHANICAL PERMIT _ CALL-IN NUMBER IMPORTANT — Applicant to complete all items in sections I, ll, III, and IV, I, LOCATION Street Address: f ,S�M /V< OF Infersecting Streets: Between And BUILDING Subdivision II. IDENTIFICATION — To be completed by all applicants In consideration of permit given for doing the work as described in the abcve statement we hereby agree to perform said work in a-ccordance with the attached plans and specifications which are a part hereof and in accordance witn thn City of Jacksonville ordinances and standards of good practice listed therein. Name of Mechanical Contractors ^ Contractor (Print) / Master CI'� SO Z LIU Name of Property Owner Signature of Own Signature of or Authorized Agent Architect or Engineer I i I. GENERAL INFORMAtION A. Type of heating fuel: B. IS OTHER CONSTRUCTION BEING DONE ON 6(Electric THIS BUILDING OR SITE? ❑ Gas—❑ LP ❑ Natural ❑ Central Utility IF YES, GIVE NUMBER OF CONSTRUCTION ❑ Oil PERMIT ❑ Ofher — Specify IV. MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK (Provide Complete lift of components on back of this form) Residential or C Commercial ® Heat ❑ Space ❑ Recessed O �'Central O Floor New Building Air Conditioning: ❑ Room (t] Central Existing Building ❑ Duct. System: Material Thickness replacement of existing system Maximum capacity c f m New installation(No system previously installed) ❑ Refrigeration ❑ Extension or add-on to existing system ❑ Cooling tower: Capacity g,p,rm. Other — Specify ❑ Fin sprinklers: Number of heads ❑ Elevator ❑ Manlift ❑ Escalator (number) THIS SPACE POR OFFICE USE ONLY ❑ Gasoline pumps (number) (11111,0001"") ❑ Tanks (number) Remarks ❑ LPG containers (number) ❑ Unfired pressure vessel ❑ bih►n Permit Approved by pate ❑ Other — Specify Permit Fee LIST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT tY AASNumber UnfL Description ![pawl Number Manufacturer AWL'? i�d15oW 6•� I i.v• . N - v a. , El.. a '' = - a '' ~ WTTO c1Gt� IN�/ ?"O ��5' ©til JNb � tUpel��p �O► L Gird�2? 18 , '`1 ' �� \/�tvt roY Q ID los.s9FAA � 0 0 Ct 1 I �J1t�: li aST14;cTi 4 L;.J10 _Q 105. 07' - — S=M (IOT G'T•y OIG ^7�AN•i4; gu,�b�K.. : h�rprQa r �., 2¢�I . X066 v,�o�ry� �. PASTo�r� , p►��Sine�►T. O C1 RMAUTIC MAN IIJAWSIV It. 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