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WS-15-2976 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-248460 Permit Number: WS-11-15-2976 Scheduled Inspection Date: January 13,2016 Permit Type: Windows/Shutters Inspector: Rodriguez,Jorge Inspection Type: Final Owner: , Work Classification: Door Replacement Job Address:1273 NE 92 Street Miami Shores, FL Phone Number Parcel Number 1132050270260 Project: <NONE> Contractor: GON GAR CORP Phone: (786)258-1213 Building Department Comments REPLACE FRONT DOOR Infractio Passed comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. January 12,2016 For Inspections please call: (305)762-4949 Page 9 of 31 Permit NO. WS-11-15-2976 eyxO1? s t®` Miami Shores Village18C7t?it T jge,Wind ws/S ll1 10050 N.E.2nd Avenue NE Work Oesslfication-vootvipIaCemant r= Pt t Miami Shores,FL 33138-0000 Permit status-APPROVED Phone: (305)795-2204 �tORN4' issue p . 121 9/2q Expiration: /26/2016 Project Address Parcel Number Applicant 1273 NE 92 Street 1132050270260 Miami Shores, FL Block: Lot: JJ GLOBAL INVESTMENTS LLC Owner Information Address Phone Cell i =GLOBAL INVESTMENTS LLC FL 2250 NE 123 Street N MIAMI FL 33181- Contractor(s) Phone Cell Phone Valuation: $ 800.00 GON GAR CORP (786)258-1213 Total Sq Feet: 0 Type of Work:REPLACE FRONT DOOR Available Inspections: No of Openings: 1 Inspection Type: Additional Info: Final Classification:Residential Review Building Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee InVoiCe# WS-11-15-57883 $2.00 11/25/2015 Credit Card $50.00 $74.60 DCA Fee $2.00 Education Surcharge $0.20 12/29/2015 Check#:1098 $74.60 $0.00 Permit Fee $110.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $124.60 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the f rmation is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhe ni authori he ab o e- me contractor to do the work stated. December 29, 2015 Authorized Signature:Owner / Applica / Contractor / Agent Date Building Department Cop December 29,2015 1 Miami Shores Village . n Building Department uv 2 r- ZU15 ` 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 'r FBC 201' �— BUILDING Master Permit No. <d ' t PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1.2 3 C,7' 9,2 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: s^ OWNER: Name(Fee Simple Titleholder): Phone#: ,�F` ,229130 Address: a City: r(,94� p ! i State: �� Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: 04/G,QPe 6,0R, Phone#: Address: T ?4 City: � �� e State: Zip: Qualifier Name: �,g42 70 �,��Gr.O Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this`'Permit:$ X00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Q Description of Werk: ®' Specify color of color thry tile.- Submittal ile:Submittal Fee$ ST)� M Permit Fee$ V CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ `I (Revised02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature c2a,4G OWN CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this �—day of ��/ ,20 , by p day of ��A��,r- lD� 20 1 S •by . ] n �t�t i �,who is personally known to .4 t b@✓4 CQoLirq,-,J9 who is personally known to me or who has produced as me or who has produced identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sig . e Print: It cLf--S Prin Y P Q1►R»4g_ Y D WIIJ,l�M4S Seal: *�': •• AMY DWU MS Seal: *� '•WK, MY C}w1isN,M t FE 1"176s ERi'lRE� lerch 1,2046 EXP)Af:S:larch 1,2016 ''1lFo owed Th Budge)Not qS'*' FpF�pP B�ded?IY1I BlNget�'$EIYkBB kk*+Iek*N*k+k+k***k**kk+kkk*kk kkk#kkkkkk+k*k+k*kk*kk****k*kk**k+k*k&kkNrk*okkkk*kk+kkkkkkkkffikkkkkkkkkkk*&k�kkkkN*k*kkkk APPROVED BY l ' Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Property Search Application-Miami-Dade County Page 1 of 1 A""'PERTa a APPRAISER OFFICEOF THE PRU y Summary Report Generated On:11/25/2015 Property Information Folio: 11-3205-027-0260 1273 NE 92 ST Property Address: Miami Shores,FL 33138-2936 r , Owner JJ GLOBAL INVESTMENTS LLC c 2250 NE 123 ST -p1 Mailing Address NORTH MIAMI,FL 33181 USA Primary Zone 1100 SGL FAMILY-2301-2500 SQ Primary Land Use 0101 RESIDENTIAL-SINGLE t FAMILY:1 UNIT Beds/Baths I Half 2/2/0 a., Floors 1 Living Units 1 r Actual Area Sq.Ft Living Area Sq.Ft Iai ofograip . Adjusted Area 2,232 Sq.Ft Taxable Value Information Lot Size 9,375 Sq.Ft 2015 2014 2013 Year Built 1971 --- County Assessment Information Exemption Value $0 $0 $0 34,012 Year 2015 2014 2013 Taxable Value $404,154 $367,413 $3 Land Value $285,750 $253,500 $171,000 School Board Building Value $164,409 $161,418 $162,679 Exemption Value $0 $0 $0 XF Value $323 $328 $333 Taxable Value 1 $450,482 $415,246 $334,012 Market Value $450,482 $415,246 w$334,012 City Assessed Value $404,154 $367,413 $334,012 Exemption Value $0 $0 $0 Taxable Value $404,154 $367,413 $334,012 Benefits Information Regional Benefit Type 2015 2014 2013 Exemption Value $0 $0 $0 Non-Homestead Cap Assessment Reduction 1 $46,328 $47,833 Taxable Value 1 $404,154 $367,413 $334,012 Note:Not all benefits are applicable to all Taxable Values(i.e.County, School Board,City,Regional). Sales Information Previous OR Book- Short Legal Description Sale PriceOR Qualification Description 5 53 42 01/05/2015 $413,000 29470- Financial inst or"In Lieu of Forclosure" BAY LURE PB 44-63 1890 stated LOT 15 BLK 2 27249- Financial inst or"In Lieu of Forclosure" LOT SIZE 75.000 X 125 03/03/2010 $210,100 4679 stated OR 19451-0246 12 2000 4 12/01/2000 $0 19451- Sales which are disqualified as a result 0246 of examination of the deed 05/01/1997 $199,000 17655- Sales which are qualified 4107 The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at hftp://www.miamidade.gov/info/disclaimer.asp Version: http://www.miamidade.gov/propertysearch/ 11/25/2015 Detail by Entity Name Page 1 of 2 D n * • ` l .. Detail by Entity Name Florida Limited Liability Company JJ GLOBAL INVESTMENTS LLC Filing Information Document Number L14000169926 FEI/EIN Number 47-2235146 Date Filed 10/31/2014 Effective Date 10/31/2014 State FL Status ACTIVE Principal Address 1735 NE 157 TERR NORTH MIAMI BEACH, FL 33162 UN Mailing Address 1735 NE 157 TERR NORTH MIAMI BEACH, FL 33162 UN Registered Agent Name &Address VASCONEZ, RAFAEL 1748 NE 159 TERR MIAMI, FL 33162 Authorized Person(s) Detail Name&Address Title MGR RUIZ, JULIAN J 1735 NE 157 TERR N. MIAMI BEACH, FL 33162 Title MANA RUIZ, JUDITH 1735 NE 157 TERR N. MIAMI BEACH, FL 33162 Annual Reports Report Year Filed Date http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entit... 11/25/2015 Detail by Entity Name Page 2 of 2 2015 04/30/2015 Document Images 04/30/2015--ANNUAL REPORT View image in PDF format 10/31/2014-- Florida Limited Liability View image in PDF format Copyright;�c)and Privacy POI€ties State of Florida,Department of State http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entit... 11/25/2015 soon Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tei: (305) 795.2204 CONTRACTORS' REGISTRATION Fax: (305) 756.8972 IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURA(eNOITICETO DAfffifidavit)(Workers Compensation EXEMPTION must haNER fo a(dCon:tra:ctor IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT, D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 Certificate must specify the description of operations or contractor license number. rrrrrrrrrrrrrrrrrrrr■ t��.y�.r� ■rrrrrrrrrrrrrrrrrrrrrrrrr■ ■rrrrrrrrrr BUSINESS NAME: ti 6 ,D cZ co BUSINESS ADDRESS: 17 G'� S .S PL CITY G' �lZ'� STATE ZIP -:353J2- BUSINESS :353J2-BUSINESS PHONE: (��l F,qX NUMBER(____) CELL PHONE( ) QUALIFIER'S NAME:_ 46"3C7_t-0 �1 A QUALIFIER'S LIC NUMBER:_ C /%C', 4 7<? STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROfftStONAL R atiLATIO14 coNSTRUCTION INDUSTRY LICENSING BOARD (850)487.1395 1w NORTH "ROE STREET TALLAHASSEE FL 32399-0763 GARCIA,ALSERTO N C-.AA CORM 2201 SW 5 P1, FORT LAt1DE RCX.E f L 33312 rv± d> ' 1NAih.lhis lic�rwwyournp onrr Gf t t+ta °tptl+Si"kmnwi by tba iMprawfienan# owwAfts NO s stonal R 1yay�t� � W $WV W%i0 0"GO _ STATE OF FLORIDA F&X'F7 lf4wnill7stnmg ..... ('ROFESSK)WN4ff�4.��,.IY� v' x � day w& t<tv.*pooto thta r+ray wa do bustnfta in order to you o ar Forintra 000 dibout mx sus.~Jag 000 7Wft _cam Tb m yoU Mfq)d more ktwmsW CERTIPIEG�s aur dmm"wid the legWa6mit#vo v,qmd frau.WA*crbe arcnwat newpiottr_rx and taarn mreo abmg the 0WW%rrWW11 CON R ru ssiorl at ttm Owm4mmmi it Lkonov Eby.Raper Fairty "way s& to se � sits mat you con soya yox Drat you tard ng WF10 da, qtr cu.as watu4moolman.yarnow400043 4 t#d# a1 HER K SCOTT GOM-E'RNOR'S, DEPARTMENT OF-- IN #' 'C,�+�, �R a Wow:ts Iq FS •, x ALL= � r xl a �2 POP �7, 0. w (MMAMfttl "ice"t Aw ARD Tyy=, VOUSINEWT X, Wit VAOD OICTOBER4 THRO()jai! SEPTEM OV. 30 010" Ohl fltr ..:��_.t IIreea Lcsatort, Y:'t'i ;its 5 PL �kRo�ctt �Csr sUWA �$a -00 a' THtS,RECEIPT MUST . t41 Otift PLACE? THI B GUfiA Y €MOAT **WOON M Itivilopw o!doh Nj ya_ rot: * 46 flakoo, Yw must ffmat veil� thpu '," 'k saw, Wain*** rmm his d ltd't X20 Ate 5 VOR'T, IAW a �,� p"" � Its,I�w�� __ ✓�"�y,:++i`��i'�uyi�,i wig hili S��k�lu • ' � CERTIFICATE OF LIABILITY INSURANCE ;;/2�D°r"'"' THIS CERTIFICATES ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:ItISO certificate holder is an ADDITIONAL INSURED,the poilcoss)nuat be endorsed NSUBROGATION IS V=VED,subject to the terns and conditions of the policy,certain policies may require an endarsommit.Astolement on We certtticate does not confer rights to the certificate holder In Hou of such a s. PRODUCER NAM- MARTAM ALONSO Florida Bankers Insurance PHONE (305)266-6493- A/ do: (305)262 79 7278 SW 8 Street R manta@flrldabarikersinsurance.ctun Miami,FL 33144 PRODUCER Phone (305)266-6493 Fax (")262-06678 INSURER AFFORDING COVERAGE NAICa INSURED NSURERA: FEDERATED NATIONAL INSURANCE COMPAN GOMGAR CORP. INSURER B: INFINITY INSURANCE COMPANY 22M SUN 5 PL INSURER c: FT LAUDERDALE,FL 39312 INSURER D: INSURER E' (954)577$81$ INSURER P: COVERAGES CERTIFICATE MMSER: REVISION HUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THEPOUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREW-NT;TERM ORCONDITION OFANY CONTRACT OROTHER DOCUMENTWITf4RESPECT To WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUB QCT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.CIVETS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AUM TYPEOFINSURANCEWWII51JI514 mUCYEPF POLICY EXP TPOLICY YlYYLR MLuffy GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00D.00 OUME TO RENTED COMMERCIALGENERALLIABILM PREMISES Eaomarence s 1()0,000.00 ❑ CtAIS*ADE 0 OCCUR GL-0504012201-01 MED EXP(Any am per=) 3 5,000.00 A ❑ N N 06/122015 O6t12=6 PERS,ONAL&ADV NWNRY 3 9 0m ommo ❑ GENERAL AGGREGATE S 20001000.00 GENT AGGREGATE LW APPLES PER: PRODUCTS-COMPIOP.AGG S 1,mo,0DO.00 Q POLICY ❑ ❑ LOC $ AUTOHOELE'LiAmurry COMBINED SINGLE LNllT $ (Ea aoddenl) ❑ ANY AUTO BODILYINJURY(Per pasm) $ 25,0 .00 ❑ ALL-ONNEDAUTOS N N 508800012351 08115J�15 08J15i2<d16 1 BODILY NJURY(per w4ded $ 50,000,00 B 0 scHEmiLEDAuros PROPERTY DAMAGE $ 25,000.00 ❑ HIRED AUTOS (Por aadeenl) ❑ NON-OWN@AUTOS $ p a ❑ UMBRELLA LIAR ❑ OCCUR EACH.00CURRE14CE ❑ EXCESS LIAR CLAMS-MADE AGGREGATE $ ❑ DEDUCTIBLE $ RuremoN s S WORKERS COMPENSATION WC STAIWas AND EMPLOYERS LIABILITY 0 ER ANY PROPRIETORIPARTNERIEXEC NTIVE WINN/A EL EACH ACCIDMY $ OFACERIMEMBER EXCLUDED? 0guKtagwy in NH) E.L DISEASE-FA EMPLOYE $ 8H yeas AaeaBta under DESCRIPTION OF OPERATIONS below EL.DfSE16SE-POLICY LUff $ MSCRDrTION CF OPERAIMS I LOCATNONS I VEFWLES(Att eh ACORD*I,AddaosW Ra arks Sdwdde.Nrmoro spaao 19required) UC#CGC15M78 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN MIAMI SHORES VILLAGE BLDG DEPT ACCORDANCE WTH THE POLICY PROVISIONS. 10050 NE 2na AVE MIAMI SHORES,Fl,33138 AUTHORIZED REPRESENTATIVE MARTAALONSO ®1988-2009 ACORD CORPORATION. All rights reser ACORD 25(2MM9)OF The ACORD name and logo are registered marks of ACORD 71 �,,,t t n �p K SO I 1* A �yOk 4 Y' 2' r 4� t P I(i' A00 Aµ c bN w' �'"'P „ -Coo SEP, jq .- Ali a�i ' t M Cit' 1'N Oki a 4 .x Ar Ek„ - `I. ,� IVliyiflt,E�sh.s�: "il`WI�Vil��llllllll III ��I Il�i�lil'li$ GONGAR CORP. Date: 11/25/2015 State of Florida County of Miami-Dade Before me this day personally appeared JJ GLOBAL INVESTMENT LLC who, being duly sworn,deposes and says: That he or she will be the only person working on the project located at: 1273 NE 92nd ST Miami Shores, FL 33138 Sworn to(or affirmed)and subscribed before me this 2 day of /00-eu.�,/ 20_ZE by Personally know OR Produced identification � A— Type of Identification Produced �)- (..,- ro Y PU�i� W&JKY D YYILLI M my vomm*"4 a IW6 wzm EXPIRES:Memo 1,2416 Jj1 6411d8d 1hIU B ry$MVICC6 _ Print.Type or Stamp Name of Notary Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner— Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers'Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers'compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if. 1. The officer owns at least 10 percent of the stock of the corporation,or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: 4Ower State of Florida County of Miami-Dade The foregoing was acknowledge before me this day o f n 00 f,".-.,/ 20�� `^ �`�� L who is personally known to me or has produced as identification. Notary: 10 4b —� AW SEAL: s W 6'EE 195276 *= t fX2iflft Moth 1,2116 Bor6d?WgyLgeiNotmYWOM tEOF F�0 REPLACEMENT OF FRONT DOOR tW 12.60' y20.70'- "ywyjy I I 1 I � v. 54- 03' w � 0.03' { CONCRETE D/W ww PARKWAY •• ••• •• • • • •• NOA#N1011082-R1 MODEL:IELD-LIVEN EXT.DOOR ��r ^ASPHALTPAIAM•ENT w J • ••. . .•. ... ... 00 . .. .. •.. . .• .. ... . • ... . . ,1V24/2015 Florida Building Code Online • - � �'•�NV, �' ��. ♦# lief i� t= n 11 •# • v u c riteDeparUrWtof BCIS Home I Log In•I U*s'ar Regisfratl8r:j Hot Topics I Submit Surcharge Stats&Facts Publications FBC Staff BCIS Site Map Links Search Busines PRrofessigQOPrSCLUPC2AgWsipmroy:0a0USER* lic ••• e ulation . . . . . .. . .. . . . . . ... .. Product Approval Menu > Product or Application Search >Application List>Application Detail a �t FL # FL14569-R7 Application Type Revision Code Version 2014 Application Status Approved *Approved by DBPR. Approvals by DBPR shall be reviewed and ratified by the POC and/or the Commission if necessary. Comments Archived ' Product Manufacturer ]ELD-WEN Address/Phone/Email 3737 Lakeport Blvd Klamath Falls, OR 97601 (800) 535-3936 fbcl@jeld-wen.com Authorized Signature Kaede McLaughlin fbcl@jeld-wen.com Technical Representative ]ELD-WEN Corporate Customer Service Address/Phone/Email 3737 Lakeport Blvd. Klamath Falls, OR 97601 (800) 535-3936 customerserviceagents@jeld-wen.com Quality Assurance Representative httpsJ/Horidabdiding.orgtpr/pr app o.aspx?param=wGEVXQwtDquxTVBjriRcYg%2fDEHWlXNZWlDOuyPOG87LWwGxpHtrgMQ%3d%3d 1/5 111124/2015 Florida Building Code Online AddreWPhorrefiEmeil �• •� . . . . : . . . . . . . ... . . . . ... Category Exterior Doors Subcgtegory Swinging Exterior Door Assemblies .. .. . . . .. . . . . . .. . . .. Comphahee Me ;vd•.' .:. Certification Mark or Listing .. . . . .. ... .. CertifutiQi1�4�e7cY 9 00 •• National Accreditation & Management Institute Valid4r.; jy, ••• - :•� National Accreditation & Management Institute so Referenced Standard and Year (of Standard) Standard Year TAS 201 1994 TAS 202 1994 TAS 203 1994 Equivalence of Product Standards Certified By Product Approval Method Method 1 Option A Date Submitted 11/11/2015 Date Validated 11/13/2015 Date Pending FBC Approval Date Approved 11/20/2015 Summary of Products FL# Model, Number or Name Description 14569.1 Contours Steel, Wood Edge Full Lite Door, Outswing, 6-0" x 6'-8" httpsl/floridabdiding.org(pr/pr app o.aspx?param=wGEVXQwtDquxTVBjriRcYg°/a2fDEHW1XNZWlDOuyPOG87LWwGxpHtrgMQ%3d%3d 215 11/24/2015 Florida Building Code Online Limit§pf•pse• ••! 9 • •e. Certification Agency Certificate Appr)Ved fog u*g�inWAZ:•Yes FL14569 R7 C CAC NI006255-R7 Certificate.Ddf AppdDved W upgoitsiae IIVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: Yes 09/30/2019 Design Pressure: +60/-60 Installation Instructions Ot er:•Orodusf m0Si•be jrtsta:" per manufacturer FL14569 R7 II JW0509-03 Installation.pdf instructions as sfated.oh diaMAg JW0509-03 Verified By: Hermes Norero 73778 • Created by Independent Third Party: Yes ... ... ... . ... . Evaluation Reports • •• :0• .• FL14569 R7 AE PER3392.pd . . . . .. f • • • • • • Created by Independent Third Party: Yes . ... . • • • • • • • 14569.2 0 ••Contours Steel, Wood Edge Full Lite Door, Inswing, 6'-0" x 6'-8" Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL14569 R7 C CAC NI006255.02-R3 Certificate.pdf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: Yes 06/30/2019 Design Pressure: +60/-65 Installation Instructions Other: FL14569 R7 II 1WO509-04 Installation.pdf Verified By: Hermes Norero 73778 Created by Independent Third Party: Yes Evaluation Reports FL14569 R7 AE PER3393.pdf Created by Independent Third Party: Yes 14569.3 Contours Steel, Wood Edge Full Lite Door, Outswing, 6'-0" x 8'-0" Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL14569 R7 C CAC NI006254-R5 Certificate.pdf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: Yes 09/30/2019 Design Pressure: +50/-50 Installation Instructions Other: FL14569 R7 II JW0509-01 SS 2015-07-02.pdf Verified By: Hermes Norero 73778 Created by Independent Third Party: Yes Evaluation Reports FL14569 R7 AE PER3391.pdf Created by Independent Third Party: Yes 14569.4 Contours Steel, Wood Edge Opaque Door, Inswing/Outswing, w/ or w/o Impact & Non- Impact Rated Glazed Sidelites, 12'-0" x 6'-8" Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL14569 R7 C CAC NIO11062 NI011062.01 Certificate.pdf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: Yes 04/30/2020 Design Pressure: N/A Installation Instructions httpsl/loridabLiiding.org/pr/pr app o.aspx?param=wGEVXQwtDquxTVBjriRcYg%2fDEHWlXNZWlDOuyPOG87LWwGxpHtrgMQ%3d%3d 315 1'1(24/2015 Florida Building Code Online Oth FL14569 R7 II 3W032012FL Installation.pdf . ... . . . ... i Verified By: Hermes Norero 73778 . . ... . . . . ... Created by Independent Third Party: Yes Evaluation Reports FL14569 R7 AE PER3321.pdf '•• ••� Created by Independent Third Party: Yes .. .. . . . .. . 46ntd'urs Steel, Wood Edge Opaque Door, Inswing/Outswing, w/ or w/o Impact & Non- Impact Rated Glazed Sidelites, 8'-4" x 8'-0" Limits ofaJLe: :. • Certification Agency Certificate Approved tort dsj1e jWZ:.Yes FL14569 R7 C CAC NIO11061-R1 Certificate.pdf Approved#or usd dutftd'NVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: Yes 04/30/2020 Design Pressure: +45/-45 Installation Instructions Other: FL14569 R7 II JW072012FL Installation.pdf Verified By: Hermes Norero 73778 Created by Independent Third Party: Yes Evaluation Reports FL14569 R7 AE PER3322.pdf Created by Independent Third Party: Yes 14569.6 Contours Steel, Wood Edge j Opaque Door, Outswing, w/ or w/o Sidelite, 8'-11" x 6-8" Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL14569-R7 C_CAC-NI011082=R1 Certificate.Ddf Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date Impact Resistant: Yes 08/31/2019 Design Pressure: N/A Installation Instructions Other: FL145-69 R7 II S-2104 Installation.pdf , Verified By: Hermes Norero 73778 - Created by Independent Third Par Yes Evaluation Reports I-FLI-4569 R7 AE PER3398.pdf_ Created by Independent Third Party: Yes 14569.7 Contours Steel, Wood Edge Opaque Door, Outswing, w/ or w/out Sidelites, 8'-11" x 8'-0" Limits of Use Certification Agency Certificate Approved for use in HVHZ: Yes FL14569 R7 C CAC NI011096-Rl-NI011096.01- Approved for use outside HVHZ: Yes R1 Certificate.pdf Impact Resistant: Yes Quality Assurance Contract Expiration Date Design Pressure: N/A 08/31/2019 Other: Installation Instructions FL14569 R7 II S-2108-01.12d Verified By: Hermes Norero 73778 Created by Independent Third Party: Yes Evaluation Reports httpsJ/floridabdlding.orgtpr/pr app o.aspx?param=wGEVXQwtDquxTVBjriRcYg%2fDEHWlXNZWlDOuyPOG87LWwGxpHtrgMQ°/,3d%3d 4/5 111/24/2015 Florida Building Code Online • ••• • ... FL14569 R7 AE PER3832.12df •• •• • • •• •• • Created by Independent Third Party: Yes . . . . . . . . . . . . ... . . . . ... • • • ••• • ••• Back Next •• •• • • • •• • • • • • •• • • •• Contact Us :: 1940 North Monroe Street,Tallahassee FL 32399 Phone: 850-487-1824 the S1!taiof9?l@r ?1§ani RA19M employer. Copyright 2007-2013 State of Florida. :: Privacy Statement :: Accessibility Statement :: Refund Statement • ••• • • • • •• • Under jr,( de law,oeraailiaaidr sses are public records. If you do not want your e-mail address released in response to a public-records request, do not send electronic mai to hil entity.2nSleatlotorfttct the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. *Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one.The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. To determine if you are a licensee under Chapter 455, F.S., please click here . Product Approval Accepts: a httpsl/floridabLilding.orgtpr/pr app dtl.aspx?param=wGEVXQwtDquxTVBjriRcYg°/a2tDEHWlXNZWlDOuyPOG87LWwGxpHtrgMQ%3d%3d 5/5 NOTICE OF PRODU�T�CTIFIC,AI�TION Company: JELD-WEN Exterior Dobrs Certification No.: NIOI 1082-RI q, 3737 Lakesport Drive Certification Date: 05/01/2012 Klamath Falls,OR 97601 0 ... Expiration Date: 08/31/2019 Revision Date: 05/05/2015 J„}�°y Product: "Energy Saver/ContD3yr';�.pagggpaadl-Edi Steel Door w/or w/o Sidelite(wood frame) O� ':>.. °^ar` Specfification: TAS 201/202/203-94 O 000 . . . .. ... .. ' The"Notice of Product Certification"is only valid if the NAMI Certification Label has b`et:aeplkoeJ bathe product as described within this document. The certification label represents product conformity to the applicable specification and that all certlficatiencriteria 1aa bUssatislied. This product has been approved for listing within NAMI's Certified Product Listing at www.Namicertification.com. NAMI's Certification Program is accredited by The American National Standards Institute(ANSI). r Inswing Glazed Design Water Missile Test Report Number Configuration or or Maximum Pressure Test Impact Drawing Number& Outswing Opaque Size Pos/Neg Pressure Rated Comments (—J) X O/S Opaque 3'2"x 6'10" +66/-70 10.0 psf Yes CTLA-696W Max Panel Size:3'0"x 6'8" Single Installation Details:5-2104 1-8) Q-% OX/XO O/S Door-Opaque 415"x 6'10" +66/-70 10.0 psf Door-Yes CTLA-696W Max Panel Size:3'0"x 6'8" Single w/Sidelites Sidelite-Glazed Sidelite-No Sidelite DLO:6"x 51"(1/8"Tempered Glass) Installation Details;5-2104(1-8 OXO O/S Door-Opaque 5'10"x 6'10" +66/-70 10.0 psf Door-Yes CTLA-696W p Max Panel Size:3'0"x 6'8" �-1- Single w/Sidelites Sidelites- Sidelites-No Sidelite ALO:6"x 57"(l/8"Tempered Glass) Glazed Installation Details:S-2104(1-8) XX O/S Doors-Opaque .6'3"x 6'10" +57/-57 8.55 psf Doors-Yes CTLA-696W Double Max Panel Size:3'0"x 6'8" Installation Details:S-2104(1-8) OXXO O/S Doors-Opaque 8'11"x 6'l 0" +57/-57 8.55 psf Doors-Yes CTLA-696W Max Panel Size 3'0"x 6'8" Double w/Sidelites Sidelites- Sidelites-No Sidelite DLO:6"x 5'3"(1/8"Tempered Glass) Glazed I I I Installation Details:S-2104(1-8) National Accreditation&Management Institute,IncJ4794 George Washington Memorial Highway/Hayes,VA 23072 Tel: (804)684-5124/Fax:(804)684-5122 �� I LA S6 1P NAMI AUTHORIZED SIGNATURE: t ♦ Cp VO,tAat�N+� •'Nm n ^m T^ ""3 �II PNpp m OSC!p y1� bb Nn� m' 33 'b HOP 1�cn� 14 o gA rn -281 p-t�l i.81 16 ~ 2 n �� ' 5�. gill 3 MAT Tn b > •3'•c�'^ ;, q. gjB12 � a �'<•mN =�.aa3� 'S In � $�� F53 � 5�� m /v��,FJ �a�� 3 ��m cn R N 5•� o �a �S � Ai por't• CD slLjo a x rm x rs N � ��Ns GI INJf• � �t"c� m H Cn 4 a� cps: P jail < • • • 0000• U r • • • • yV o O m •• • • • 1g 7j Q ,��U 0000•• 00 S 0000••. • 00000 g94 _mm ��g 0000•• • • 'm'�� 0000• a�aT 0000 •• • • 0 3° • • • • • x m g j m O U N 4i 6 • • 0 • a $ . . 0000• r N --- 11 • 8Ra 5i • 9 • �u • 3^ • • • 0966• • A® N O M •• •,♦ • ?-4 O \ ` 6• r G r Oq ZI;NN Oq ?w-til SEAlot ' m- PRooacr: F 120 15 MOWED TO MEET THE 5TH ED. SIM CONTOURS STEEL DDDR,WOW EDGE JELD-WEPT,INC. ,o E 01 12 MODIFIED TO MEET THE 2010 FBC J1A 5--B'OPAQUE OU15117NG IMPACT DOOR UNITS 3737 LAKEPORT BLVD. T 107 MOOBTED TO MEET THE 2004 FBC JWJ WITH!e WDTIOUT NON-IMPACT SWM KLAMA1if FALLS,Dft 97�f $ o - CID 22 O2 ADOED TRWTY UTE FRAME ZRK PART OR ASSEMBLY: H o e os 02 GMM REY151ON UH GENERAL NOTES AND PH.541.8823451 A 14 02 GENERAL REVISWTJH TYP rAL ELEVATIONS PATE RLMSIOM BY N �� _�•' ►Z O UV �F s�� o FO 2 U b _"� F- 64) ch STA • A ?c 2 \ X W O t y+� m V OWt .P NO U F- rr7 N V ch 41 •.• • W W • • • • W p b Os V 4f N a N O W m G1 U A N•.�yOQ. Nd V O. !N.4a IV (O/�Abd Gzf/Vr�T N r •1 r b Of 8V i tH�. ...... C� N � a��C a ".�jj �(�u�N YS G.r r OD Ol Of T fa O�W�r� �� O k �� • • 60906 ,�_' r� O l+-177�� 1 Cf Ob m p 00 �1 0 00 ��i{ •••••• g CZ'f �� Z �y� `� �� Z N.�NN� C�Cp p�� _ `�t7S; S. .tA�� i rA�. •••••• x � m y� mR6$mc'c� at� Ng �� c 6f� • • s m ••••• m �N-"c� N � 2zp Om?2 ; rp�7 og — n� 00 06:• • o � S m • �,.��d* •yF �� z �g � � � .r� 2 � � � p'�m off„ � m � m p s FFR�~•�� " a 03 6 a g PRODUCT: F 120 15 uoDfrtEo ro uEEr Tr1E 5T►+cn.Fec s COMM srm Dw.wow WCE JELD-WEN,IN--. CA E 01 Q MODIW TO MEET THE 2010 PBC !u e'-C DPAOUE oOrs W WPACT DOW WM 3737 LAKEPORT BLVD. Vi D oit o7 T M 2004 -OH&W W NONJUPACT 90aM KLAMATH FALLS,OR.91601 o rZ " I 22 02 PART OR ASSEMBLY: S � o uos a6 a2 VERTICAL CROSS SECTIONS PH.541.882.3451 °D A 03 14 02GEMYALT AND BILL OF MATERIALS DATE AENSIONS BY o _ a b" .Li� N o rq 01 m N D N \ vim V V toil \ 01 \ \\\ N \ N ��!! 9999•• • 9999• •• • • • 2O2 •••: • �••••• 9999• rn V 9999 • • 9 9999• 000 ...�n ••• • •• 9999 i*1 • • y 'in 9999 • • ••• 9999 .�.� ED '•• • 00 • a900 • N 999,9 • • • n • • cn • • 990.0 o ^ 999••• o z z • �� • • =Q/ ••• • ,�z • 000 •9•••=1 - • 9 • • • • o ` • • IIIIIitIITl+! N to� � W l� z_ i M all b s • N a g o 4 PROD rr F T 20 15 WDm TO MEET THE 51H ED.RE Stw CaWM SRR DO VIOOD EXE JELD-WEN,INC. o E Ot 12 AFDDM TO MEET THE 2010 FBC dtA C-8.OPAMT OtA57iW u�ACT DOOR UWIS `; 3737 LAKEPORT BLVD. Nbz Tn z � 0 07 t 1 0 NOIXFlED t0 MEET THE 2004 FITC .IHtJ WlJH&YRTHOUT A0N-BIPACT SIDE111E5 o — C 10 22 OZ ADDED Lnr TwE PART OR ASSEMBLY: KLANATHFALL$,OR.9760} " o B O8 Oe 02 GMAL REVISION rrH HORIZONTAL CROSS PH.341.8823451 A 03 I4 02 04M REW" Tm SECAONS DATE REVISIONS BY C !- Cv,o�, m tUn a tCn� Ny -• Z r— -�..Y` W �I ERA " FM , oNZn aQ� oa `�`�a � •-��ao a�a azo � .: �w w �� loll!�xxN ~ ��mC�N oa omiWiKc�i k K' -W to a _ zx. nainm xC3 N o \\\ to mBOA $L. � c a o Ln = myyZO�Q�� N \CA a y��m 'lnu1Q� CO-•^C 2�' 2 AO o [y \ �\ A K N oo~ U N oorl _P3 tn O Z(r pp0 V \\ ^� kf* a.. O t7 R• fA tA ?� a ��m a C �' Z�O � L y • • C _ bpE m mO 2 _ . :0000• • .. '• •0000• o �+1 �n 2 ti•� a ��p Vf ••.' 0000•• •• D �1 .•0f•.•• _ • • 0 0000•• t••,Y• • 0 0 Qom` �f 0000•• 0 • • �i' • 0 p • � .. 0000 0:00•• 0000• e00: •• :•: 0000• '' t11 O 10 ••• • 0000•• DS '•♦Y'�•••�• 4WI47 • • y,�,,• to A •' • • • pD i N '•.. '" L. • �_ // O tTtz r _.• •. 000000 :0000: CC 1 V •0.00 • • / / / / - Q� ••• • EnxtA Otn N Dn a -o'o - r�� ch I� =z rq W c [n U -t a OD ```,11111111t1/71� a�_ (N.i U L4 p �D 9 � •., V � to :b Z �xyc z m !l11111tWo% tn N Otn g A R 0C'f Z Cf v! W V > � OD m• Q PRODUCT: JELD-WEN,INC. Fi. F 1 20 15 fJODIFlEO r0 MEET ME 5TH m. SMCONTOURS STM DOOR,WOOD EDGE e M5 1 12 wonwm TO SET THE 2010 FBC lu 6'-8'OrAWE o PMW 01PACT DOOR L"M 3737 LAKEPORT BLVD. (A ti H z 1 DO 11 0 MONO TO MEET TW 2004 FBC 50 WON k WIRW NW-WACT Sm£ufEs KLAMATH FALLS,OR. 97601 C 10 22 02 AMM 1RiN1fY LITE FRAVE Z PART OR ASSEMBLY: in 01 -0 8 os cEHERAL REWSIDN TJH HORIZOMAL CROSS SECTIONS PH.541.882 3451 - A OJ 14 d GMERu-MMM TJH AND NOTES 1MTE flENSIONS BY 0 nm-1 a' ! I 1 1 1 FYI cn _Fn FaU� u� O Pe F4 r 'cd m • • 0000•• • 0996•• nxj th 6 0• p •006•• 6 CA 0 :10660: `n� ( mm�' •999 • 6 • • • • 0 000 W N U` 2 •909•• Cw • • 999 • • •9• $ `' v�^i •9.96• g • •9• • ••99 •66•0• w6A 9 06 z I I l I F 0 00 • \ •• 6666 —I 1 I 1 1 • U e„ rT1 IY �r N �ttulr nnq,�� o ,� .. '•IVCD ?m r F7 -w v R r NEER'*"per $ v�zo cn l•111tAtt, f� N L1 V is�vn s 0 4 PRODUCT: c� F l 20 15 mama TO U r INE 51H ED.FW SIM CONWIM sm AM%wow Em JELD•WEN,INC. o1 12 MQI11fTEQ TO MW THE 2010 FEC 6•--B•VWX QUTSM mPAff ODOR MIS 3737 LAKEPORT BLVD. or AA70M TO MEET WE 2004 WITH&*Mff NON-WALT WanES KLAMAtfIFALLS,OR 97601 a 2 1Q 2 02 PART OR ASSEMBLY• { ` HPH.541.882.3451y2OEQ<oz O � O6 m DATE REVISIONS BY r m I I I I � 1' •� b 0 V w A as p w N - O O S T 7 CUR 0000•• - u W i„ • ••• � • 0000•• i- a •• • • • • • 0000•• • 00.000 -_ • ••0••• Wrn,N � • . . . • �Vl I-`_'• .' . .. 00000 • .. .. .. . ...... ...... • 0 • • = m • 0 • • • •0000 rn `: • • •000000 • • �'. v, • .60 0000•• N 00 0 • • • 00 0 o2�n :gym �*i a irn/I m A `��Tluuurht/ s 1 ! 1 1 t 1 � z�` "� 9 �.�•��` �T l t 1 l f I 1 � Q NF .......•off = � v z ¢ PRODUCT: JELD-WEN,INC. 010OW2 4f0lHfIED TO E Tmw 5TH ED. StAi CWMM SIM DOOR.W000 EDGE MODrTiED TO l�EE7 TtIE Toro TTTc dlA 6'-6• E 019SVNG aNCT DDDR uRns 3737LAKEPORTBLVD. z ON&P1R W NW-WPACT SroEtlfES KLAMATH FALLS,OR.97601 AM TMWr LITE PART OR ASSANCHDRtNC LOCAnaxs PH.541.882.3451 AND DETAILS REMOM BY . 2 X ti O N 40 N V -p O N a� Z 4.m m m Un� AN O VO N n f1 � • X � [... n +• 2 W m V � �O n U rhe O R�7 O• n 3b+ m� a � � • 0000•• 17 :0 • ••• • 0000• • 0000•• • 0000•• • 0000• •00Y•• • • y 0000 -•• • 000•Y • ZI 0000•• • 0000 AO O 0000 - � 0000•• • ••• 0000• N •• •• O •• • 0000• 0000•• • w � • • • 0000-•• to •00.00 N • • 0 s}}::{{ J N •• • • ••• • • •• • m 44 V 88 f.l N N `��1I11111fff�� x P tiLC�R• O-d ,` n b y y � ��ffffNlltllll�� [n� z�,�� v 0 y, ZA a �; n � tfo > $ � ism 8 r7 F 1 20 15 MOMM TO MEET TRE 5TH ED. SM PRODUCT: ' caHrouRs s/Ea DOOR,woos EOCE JELD•WEN,INC. w 9 to O1 12 MDO M TO MEET THE 2010 FBC AA 6'-8'OPAOUE OUjMG IMPACT DOCK UMM I" ti 1n 2 I 0 7 1 107 MODITIED TO MEET THE 2004 FOC Mi NO a WNW HOM-WALT SlOaM 3737 LAKEPDRT BLVD. o — c iO 2 02 TRIHRY iTiE FRAM x PART OR AssEMBLr: KLANATHFA"OR..87801 ' ICb H o B 06 O6 2 CEN L81 A M 14 2 GERM Rai-MM TryT cuzlHc DETNLS PH.SQf.882 3451 DATE REVISIONS 8Y mz. MY POCZ89109 Hd stiv3rtodiroa 1wn HN HNOors lYHWM �� a a 'i � , t09L6'd0`S71t+d HIVWI1IH WISP GSW NO u+vd )I 3 Stn AaNW1 a^ smm Lxdm-NON.Ln%IN 8 im rw• oai i00 3H1 133n 01 03L OOn I I 0 I VAN ISOd.UYILBLE SIM M tO1M DHAM 0 YWdO.9-.9 v>r aai oloz ant B31V of 03WM zc to 3 " ONI`N3M-Q73P 3003 000M'mm ms sanoiNw YRS OH!'03 HIS 3MLM 01 03MOn I Ol ► .1 aoad LU 0 o y L N x � rtL ci Pa. tn L #live ITT C. 0 0 L tV O ^• � 2 0 •.• • ••• 0 •• b 1 . • ••..•• N 0000 ••••••• ..• • •..• .0 so .0 AS M O ••••.• I .:. ... .....: 0 0 N R o b /0 0Oo N a Z ci O ^ � o o kt k " a rz ago N O O � C O O� R t L BUILDING DROPS . 398 East Dania Beach Suite 338 A Perfect Solution in Every Drop Dania Beach,.8 33004 ere s 954.399.8478 PH Certificate of Authorization:29578 954.744.4738 FX contact@buildingdrops.com Product Evaluation report _ of JELD-WEN, inc. Contours Steel Door, Wood Edge 6'-8" Opaque Outswing Impact Door Units With & Without Non-Impact Sidelites for Florida Product Approval Deport No. 3398 .' 0000. • 0000;. 0000.. _ Current Florida Building Code •••;•• """ 0000.. 0000.. 0000 •• • Method: 1 —A (Certification)....' : '••' ••••• Category: Exterior Doors •••••• ""' . . . 0000.. Sub—Category: Swinging Exterior%Al iAssemblies .• 0000. . . . 0 • 0066.. • 0000.. Product: Contours Steel Door, Wvod Ellge :00 90: Material: Steel/Wood so • • ' 9 ' Product Dimensions: 107"X 81.25"(Maximum) " Prepared For: JELD-WEN, inc. 3737 Lakeport Blvd. Klamath Falls, OR. 97601 �%%"s F. Prepared by: �.��<,Q;;•• ' .,�,p�% Hermes F. Norero, P.E. � ' • O Florida Professional Engineer#73778 = * 7 -. Date: 02/02/2015 -o T T = Contents - 0T ....�P•�'?�� Evaluation Report Pages I—4 fill Reason: Digitally signed by Hermes F.Norero,P.E. 'llllJ�fift+�� Reason:I am approving this document Hermes F.Norero,P.E. Date:2015.02.18 12:18:39-05'00' Florida No.73778 .a •• I .a BUILDING DROPS 015 A Perfect Solution in Every Drop Date: 0 Report No:o: 33 33988 Certificate of Authorization:29578 Manufacturer: JELD-WEN,Inc. Product Category: Exterior Doors Product Sub-Category: Swinging Exterior Door Assemblies Compliance Method: State Product Approval Method(1)(a) Product Name: Contours Steel Door,Wood Edge 107"X 81.25"{Ma)dmum) Scope: This is a Product Evaluation Report issued by Hermes F.Norero,P.E. (FL#73778)for1ELD-WEN,Inc. based on Method la of the State of Florida Product Approval,Florida Department of Business and Professional Regulation-Florida Building Commission. . Hermes F.Norero,P.E.does not have nor will acquire financial interest in the company manufacturing or distributing the product or in any other entity involved in the approval process of the product named herein. _ • ...... ...... This product has been evaluated for use in locations adhering to the current Rlodda Bui"agbode. •• �;• ...... • See Installation Instructions S-2104,signed and sealed by Hermes F. Norero`jiFy(FL#7�7781for specific use parameters. .... • •• ...... . ... ..... Limits of Use: "'•• ' 1. This product has been evaluated and is in compliance with the current Fldrida BUd'kr gCode,o•••� including the"High Velocity Hurricane Zone"(HVHZ). : ••• •• • ;" 2. Product anchors shall be as listed and spaced as shown on details. Rncho�embe4limnj into substrate material shall be beyond wall dressing or stucco. 3. When used in areas requiring wind borne debris protection this door product complies with Section 1609.1.2 of the current Florida Building Code and does not require an impact resistant covering on outswing doors. 4. Non-Impact sidelites do require an impact resistant covering when used in areas requiring wind borne debris protection to comply with Section 1609.1.2 of the current Florida Building Code. 5. Site conditions that deviate from the details of drawing S-2104 require further engineering analysis by a licensed engineer or registered architect. 6. See Installation Instructions 5-2104 for size and design pressure limitations. Hermes F. Norero,P.E. Florida No.73778 Page 2 of 4 BUILDING DROPS 015 A Perfect Solution in Eve Drop Date: 0 8 Every P Report Noo:: 3 33398 Certificate of Authorization:29578 Quality Assurance: The manufacturer has demonstrated compliance of products in accordance with the Florida Building Code for manufacturing under a quality assurance program audited by an approved quality assurance entity through National Accreditation& Management Institute,Inc.(FBC Organization#QUA1789). Performance Standards: The product described herein has been tested per: • TAS 201-94 • TAS 202-94 s TAS 203-94 Referenced Data: 1. Product Testing performed by Certified Testing laboratory,Inc. (FBC Organization#TST1577) Report#:CTLA696W, Report Date:11/01/2001 2. Quality Assurance ...... ...... National Accreditation and Management Instit'iixe' • ...... • (FBC Organization#:QUA1789) •••••• ••••• 3. Component Material Testing of Dylite Expandalj2 MotyrenFlay•. ....... . .. ..... Intertek Testing Services NA,Inc. ' .. . . .. ..... ASTM E84-08 • ' ' '. • 08 00 Report#:3113726SAT-001 R1 Report Date:031;j JQ09 • Equivalence of Test Standards: •• • ` ••• Various test standards have been evaluated for differences in test methodology,if any,between tested editions of the test standards listed below and those editions referenced in the current Florida Building Code. JELD-WEN,inc.has tested their products to the following test standard edition(s): 1) ASTM E84-08 Chapter 35 of the current Florida Building Code references the following editions of the above mentioned test standards: 1) ASTM E84-09 After review of the above mentioned referenced standards and editions,it has been found that no significant technical changes have been made to the test standards that would affect the results.All referenced standards have been found to be equivalent.All materials test results meet minimum requirements of the current FBC including HVHZ provisions. Hermes F.Norero,P.E. Florida No.73778 Page 3 of 4 /(/A\\ BUILDING DROPS 015 A Perfect Solution in Eve Dro Date: 0 o: 33 8 6 Every p Report No: 3398 Certificate of Authorization:29578 Installation: 1. Approved anchor types and substrates are as follows: Through Frame Installation: A. For two by(2X)wood buck substrate,use#10 Wood Screw type installation anchors of sufficient length to achieve a minimum embedment of 1.50"into the wood substrate. B. For concrete or masonry substrate where one by(1X),non-structural,wood bucking is employed,use 3/16"diameter ITW Tapcon type concrete screw anchors of sufficient length to achieve minimum embedment of 1.25"into concrete or masonry. C. For concrete or masonry substrate where wood bucking is NOT employed,use 3/16" diameter ITW Tapcon type concrete screw anchors of sufficient length to achieve minimum embedment of 1.25"into concrete or masonry. Refer to Installation Instructions(S-2104)for anchor spacing and more details of the installation requirements. Design Pressure: ! ••• . . •• Design Pressure XX,OXXO X,OXO,XO,Jj;.. • • • Outswing Positive 57 PSF* Positive 66 P61* •• ' Negative J 57 PSF Negative -70**- • "� '�: • *Units meet water infiltration requirements corresponding to noted ddad: .4,�:• �„ pressures. •�, . ' • • • •.••• •• • • • • Hermes F. Norero,P.E. Florida No.73778 Page 4 of 4