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HomeMy WebLinkAboutColanerRevision090920WIDTH PER NOTES DE P T H P E R N O T E S 4" SLOPE CR-0 2 3" 0.024" ALUM. SKIN 1-LB EPS FOAM CORE PANELS. (FL#12225.1) 4TH WALL ATTACHMENTROOF OVERHANG 2X 3 3X 3 2X3 2 X 3 3 X 3 2 X 3 3X 3 R C 2X3 (TYP) CR-0 2 SR-3 3 2X8 PT JOISTS @ 16" O.C. DOUBLE 2X10 PT BEAM (TYP) 2X8 PT BLOCKING. (TYP) REMOVE AND REPLACE WOOD DECK 6X6 PT POSTS (TYP) 1X6 PT DECK BOARDS 2X8 PT RIM JOIST (TYP) WD-4 3 WD-3 3 WINDOW/DOOR SCHEDULE MARK TYPE WIDTH (INCH) HEIGHT (INCH)MANUFACTURER MODEL FPA # or NOA BUILDING PRESSURE (PSF) PRODUCT PRESSURE (PSF) A HORIZ. ROLLER WINDOW VARIES VARIES PGT HR-210 FPA #242.1 40.3 -43.9 ---- B SWING DOOR 36 80 PGT CD-290 FPA #331.1 40.8 -44.4 ---- ACCORDIAN SHUTTERS VARIES VARIES TOWN AND COUNTRY STREAMLINE FPA#13757.2 40.8 -44.4 100.0 -100.0 ALL DOORS AND WINDOWS SHALL BE INSTALLED PER MANUFACATURER'S SPECIFICATIONS AND WATERPROOFED PER FBC, LOCAL JURISDICTIONAL REQUIREMENTS, AND F.S. 553.842. A A B 2 X 3 EXISTING OPEN DECK THERE IS A SLEEPING ROOMS ADJACENT TO THE DECK.; HOWEVER, EGRESS THROUGH HOST IS UNAFFECTED BY CONVERSION TO SUNROOM. THE BEDROOM HAS AN EGRESS WINDOW. CATEGORY III SUNROOM EXISTING CONDITIONED SPACE AT 0.0' ASSUMED ELEVATION PROPOSED SUNROOM ELEVATION AT -0.33' CR-0 2 3X3 POST (TYP) SR-3 3 RC-4 2 3X3 3X3 3X3 2X 8 S M B E N D B E A M 2X 6 S M B E N D B E A M 3X3 3X3 2X 4 S M B EN D B E A M B 2X3 (TYP) R C R C R C R C RC RC RCRC 2 X 3 ( T Y P ) K I T C H E N / L I V I N G R O O M 4 T H W A L L A T T A C H M E N T BEDROOM ENCLOSE EXISTING OPENINGS EXISTING SGD INTO LIVING ROOM EXISTING EGRESS WINDOW IN HOST BEDROOM TRANSOM WALL. FILL IN WITH KICKPLATE TRANSOM WALL. FILL IN WITH KICKPLATE 2X 8 S M B E N D B E A M 2X 6 S M B E N D B E A M TRANSOM WALL. FILL IN WITH KICKPLATE STAIRS WITH CONCRETE SLAB LANDING (MIN. 3' x 3' x 4"). EXTEND AS REQUIRED FOR STRINGER DEPTH AND ATTACHMENT (TYP) 3" 0.024" ALUM. SKIN 1-LB EPS FOAM CORE PANELS. (FL#12225.1) Kaycan LTD, Contessa Vinyl siding (FL12192.5) installed per product approval requirements SR-7 2 SR-2 3 2 X 5 E N D B E A M 3X3 3 X 3 ( T Y P ) R C R C R C R C R C R C R C R C RC RC RC RC RC RC RC RC 3X3 3X3 3X3 3X3 STAIRS WITH CONCRETE SLAB LANDING (MIN. 3' x 3' x 4"). EXTEND AS REQUIRED FOR STRINGER DEPTH AND ATTACHMENT (TYP) A A A A FLOOD VENT V-1 LOCATION. INSTALLED ON WALL BELOW FRAMING. SHOWN HERE FOR CLARITY (TYP) M-5 4 Design Parameters 1.Building Occupancy Category, Paragraph 1604.5 and Table 1604.5: Risk Category I. 2.Basic Wind Speed, Table 1609C, State of Florida Debris Region & Basic Wind Speed, Paragraph 1609.3.1 and Table 1609.3.1 Equivalent Basic Wind Speed, VULT = 160 MPH 3.Exposure Category, Paragraph 1609.4.3 : D Applicable Codes, Regulation and Standards 1.The 6th Edition (2017) Florida Building Code, specifically Chapter 16 Structural Design, Chapter 20 Aluminum, and Chapter 23 Wood. 2.AA ASM 35 and Specifications for Aluminum Structure, Part 1-A of the Aluminum Design Manual prepared by The Aluminum Association, Inc. Washington, D.C., 2010 Edition 3.ASCE 7-10 General Notes 1.The contractor shall verify all dimensions prior to construction 2.All work shall comply with all local and regional ordinances. 3.Any deviation from this plan shall be reviewed by the engineer of record and is subject to approval. Specifications The following specifications are applicable to this projects : 1.Where concrete specification are required, whether in the screen enclosure scope or not, by one or more regulatory agency, the following specifications are applicable. 1.1.Concrete shall conform to ASTM C94 for following components: 1.1.1.Portland Cement Type 1, -ASTM C 150 1.1.2.Aggregate - Large Aggregate 3/4" max - ASTM C 33 1.1.3.Air entraining +/- 1% - ASTM C 260 1.1.4.Water reducing agent - ASTM C 494 1.1.5.Clean Potable water 1.1.6.Other admixture not permitted 1.2.Metal accessories shall conform to: 1.2.1.Reinforcing Bars - ASTM A615, grade 60 1.2.2.Welded wire fabric - ASTM A185 1.3.Concrete slump at discharge per chute not less then 3" or more than 5". Water added after batching is not permitted. 1.4.Prepare and place concrete per American Concrete Institute Manual of Standard Practice, Parts 1, 2 and 3 including hot weather recommendations. 1.5.Moist cure or polyethylene curing required. 1.6.Prior to placing concrete, treat the entire subsurface area for termites in compliance with the FBC. 1.7.All aluminum components embedded within concrete shall be coated with a bituminous paint or epoxy. 1.8.Fiber reinforced concrete per ASTSM C1116 is an acceptable alternative to 6X6 W1.4/W1.4 WWF. 2.Aluminum extrusions shall be 6005 T5 Alloy. 3.Fasteners are required to be corrosion resistant, minimum SAE Grade 2 or better zinc plate to ASTM B633, or stainless steel series "300". 4.All Self Mating Beam Sections are to be stitched with either #14 screws 6" from end 24" on center or #12 screws 6" from end 12" on center. 5.Screened enclosures containing swimming pools shall comply with the applicable requirements of FBC R4501.17 Residential Swimming Barrier requirements. 6.Door location shall be determined by contractor in the field. 7.When installing pavers over concrete slab or footing which are supporting aluminum members, such as continuous screen tracks or upright, the anchors must extend past the pavers and reach proper embedment into the underlying foundation. 8.All flashing and waterproofing shall be provided by the contractor. 9.Use of these plans acknowledges and accepts a limit of liability not to exceed design and engineering fee. 10.Vinyl and acrylic panels shall be removed when wind speeds exceed 75mph Roof Type Composite Screen Size NONE - SUN ROOM Foundation Design: New 12"x12" (2 #5 bar Cont.) thickened edge, 4" monolithic slab Concrete shall be a minimum 2,500 psi FIBERCRETE. Rebar 31" lap splice. Use 3" chairs. Per current edition of the Florida Building Code, Residential, Section 401.4.1, soils testing is not required for design using the presumptive bearing pressure of 1,500 psf. ALUMINUM MEMBER DIMENSIONS 2 x 2: 2" x 2" x 0.046" 2 x 3: 2" x 3" x 0.050" 2 x 4: 2" x 4" x 0.050" 2 x 5: 2" x 5" x 0.050" HOLLOW SECTIONS 1 x 2: 1" x 2" x 0.040" 1 x 3: 1" x 3" x 0.045" OPEN BACK SECTIONS 2 x 2 Snap: 2" x 2" x 0.045" 2 x 3 Snap: 2" x 3" x 0.050" 2 x 4 Snap: 2" x 4" x 0.045" SNAP SECTIONS 2 x 4 SMB: 2" x 4" x 0.044" x 0.100" 2 x 5 SMB: 2" x 5" x 0.050" x 0.100" 2 x 6 SMB: 2" x 6" x 0.050" x 0.120" 2 x 7 SMB: 2" x 7" x 0.057" x 0.120" 2 x 8 SMB: 2" x 8" x 0.072" x 0.124" 2 x 9 SMB: 2" x 9" x 0.072" x 0.124" 2 x 10 SMB: 2" x 10"x0.092" x 0.398" SELF MATING BEAM (SMB) MINIMUM FASTENER EDGE DISTANCE : 1/2" MINIMUM FASTENER SPACING : 3/4" SIMPSON TITEN HD OR EQUIVALENT CONCRETE SCREW ANCHOR : ITW BUILDEX OR EQUIVALENT SHEET MATEL SCREWS (SMS) : KB: KNEE BRACE 3 x 3: 3" x 3" x 0.125" 4 x 4: 4" x 4" x 0.125" 6 x 6: 6" x 6" x 0.125" COLUMNS RC: REC. CHANNEL SHEET SE A S I D E E N G I N E E R S Ce r t i f i c a t e o f A u t h o r i z a t i o n 3 2 0 4 8 42 6 5 6 0 t h C o u r t Ve r o B e a c h , F l o r i d a 3 2 9 6 7 ww w . s e a s i d e e n g i n e e r s . c o m - ( 7 7 2 ) 2 0 2 - 8 0 0 8 - i n f o @ s e a s i d e e n g i n e e r s . c o m Pr o j e c t A d d r e s s : Co l a n e r R e s i d e n c e 10 7 2 5 S O c e a n D r i v e Je n s e n B e a c h , F l o r i d a 3 49 9 7 Wh i t e A l u m i n u m Ed w a r d R o s k e PE # 7 2 2 2 8 1 NOTE: THIS DRAWING IS FOR ILLUSTRATIVE PURPOSES. DRAWING NOT TO SCALE. USE DIMENSIONS GIVEN. CABLE BRACING MAY TERMINATE AT SLAB IN DIFFERENT LOCATION. MAINTAIN ANGLE PER DETAIL. 0 8 / 1 4 / 2 0 ***NOTE - NOT ALL DETAILS ARE USED FOR THIS PROJECT. SEE PLAN FOR DETAIL CALL OUTS*** NOTCH UPRIGHT OR POST TO ACCEPT BEAM. SEE PLAN SHEET FOR MEMBER INFORMATION IF SCREEN WALL BENEATH COMPOSITE ROOF, 1" x 2" W/ (2) #10 x 2" SMS INTO SCREW BOSSES INTO UPRIGHT & (1) #14 X 2" SMS 6" FROM EACH SIDE OF UPRIGHT & @ 24" O.C. (2) 3/8" DIA THRU BOLTS 3" X 0.082 ALUM RECEIVING CHANNEL W/ #12 X 3/4" TOP AND BOTTOM AS END CAP COMPOSITE ROOF PANEL 1" X 1" X 1/8" ALUM ANGLE W/ (3) #12 X 3/4" SMS IN FLANGE INTO UPRIGHT. (BOTH SIDES OF UPRIGHT) BEAM. SEE PLAN SHEET FOR MEMBER INFORMATION 1/4" LAGS, 4" FROM ENDS & 18" O.C. MAX. 1" MIN LONGER THAN THE PANEL THICKENESS. W/ NEOPRENE WASHER ON EACH LAG COMPOSITE ROOF TO BEAM SCALE: NTS CR-0 2 FLASHING - INSTALL UNDER EXISTING DRIP EDGE RECEIVING CHANNEL #14 X 3/4" SMS @ 6" O.C. TOP AND BOTTOM W/ 1-1/2" DIA. NEOPRENE WASHER @ TOP SCREW ONLY COMPOSITE PANEL (2) 1/4" DIA. X 3" LAG SCREWS @ 6" O.C. COMPOSITE ROOF TO HOST SCALE: NTS CR-1 2 WOOD: (2) 1/4" x 3" LAG SCREWS, 6" FROM END & @ 16" O.C. CONC. (2) 1/4" DIA. x 2 1/4" CONCRETE SCREW ANCHOR, 6" FROM END & @ 16" O.C. SHIM AS NECESSARY IF OTHER THAN A PLUMB CUT FASCIA PURLIN / GIRT / O.B TO HOST CONNECTION SCALE: NTS M-1 2 PURLIN / GIRT / CHAIR RAIL SNAP OR SELF-MATING BEAM ONLY OPTION 1: (4) #10 x 1-1/2" SMS INTO SCREW BOSSES (TYP) WOOD: #10 x 3" WOOD SCREWS @ 6" FROM ENDS & 12" O.C. CONC. 1/4" DIA. x 3" CONCRETE SCREW ANCHOR @ 6"FROM ENDS & 24" O.C. OPTION 2: 2" x 2" x 1/8" ANGLE WITH (2) #10 x 3/4" SMS IN EACH FLANGE, EACH SIDE (TYP) COLUMN TO WOOD DECK FRAMING CONNECTION SCALE: NTS SR-7 2 (1) 3/8" DIA LAG SCREW ANCHOR EACH SIDE (4" EMBEDMENT INTO WOOD FRAMING - NOT INCLUDING DECK BOARDS) 2" x 2" x 1/8" ( x WIDTH OF INTERIOR REC CHANNEL) ANGLE. EACH SIDE OF POST SIDE VIEW FRONT SECTION VIEW (4) #14 x 3/4" SMS INTO POST, EACH SIDE. 1/4" DIA x 4" LAG BOLTS @ 12" O.C CO L U M N REC CHANNEL REC CHANNEL REC CHANNEL NOT REQUIRED ON DOOR INSTALLATIONS DECK BOARDS DECK FRAMING 1" x 2" O.B. ATTACHED EACH SIDE OF POST WITH #12 x 1-1/2" SMS @ 6" FROM BOTTOM AND 24" O.C. COLUMN PER PLAN. NOTCH COLUMN TO ACCEPT CARRIER BEAM 1" x 2" O.D. ATTACH TO UPRIGHT WITH (2) #10 x 2 1/2" SMS THRU UPRIGHT INTO SCREW BOSSES PLUS #10 x 1 1/2" SMS 6" FROM EACH SIDE OF UPRIGHT AND TYPICAL AT 24" O.C. MAX DETAIL AT CORNER (PLAN VIEW) ATTACH INSIDE FACE OF BEAM WITH COLUMN USING 2" x 2" x 1/8" x BEAM DEPTH LONG ANGLE WITH (8) #14 x 3/4" SMS INTO UPRIGHT AND (2) 1/2" DIA THRU BOLT WITH NYLOCK JAM NUT (JAM NUT WITH THREADLOCKER MAY BE USED, IN LIEU) INTO CARRIER BEAM. DO NOT OVER TIGHTEN. TIGHTEN ONLY UNTIL CONTACT. RC-4a 2 CARRIER BEAM TO COLUMN CONNECTION SCALE: NTS NOTE: IGNORE 1" X 2" O.B. AND CONNECTION IF SCREEN ISN'T BEING INSTALLED 7 3 4" MAX. RISER HEIGHT 1" NOSING 11" MIN. TREAD DEPTH DECK STAIRS SCALE: NTS WD-5 2 SHEET SE A S I D E E N G I N E E R S Ce r t i f i c a t e o f A u t h o r i z a t i o n 3 2 0 4 8 42 6 5 6 0 t h C o u r t Ve r o B e a c h , F l o r i d a 3 2 9 6 7 ww w . s e a s i d e e n g i n e e r s . c o m - ( 7 7 2 ) 2 0 2 - 8 0 0 8 - i n f o @ s e a s i d e e n g i n e e r s . c o m Pr o j e c t A d d r e s s : Co l a n e r R e s i d e n c e 10 7 2 5 S O c e a n D r i v e Je n s e n B e a c h , F l o r i d a 3 49 9 7 Wh i t e A l u m i n u m Ed w a r d R o s k e PE # 7 2 2 2 8 2 0 8 / 1 4 / 2 0 ***NOTE - NOT ALL DETAILS ARE USED FOR THIS PROJECT. SEE PLAN FOR DETAIL CALL OUTS*** COLUMN/BEAM/JOIST ATTACHMENT SCALE: NTS WD-2 3 H1Z H2.5Z ATTACH POST TO FOUNDATION WITH SIMPSONS ABU66Z FOR 6X6 POST (ABU44Z FOR 4X4 POST) PT POST PER PLAN ATTACH POST TO BEAM WITH SIMPSON BC46 (BC4 FOR 4X4 POST). ADD FILLER AS REQUIRED. BEAM PER PLAN. 6" MAX CANTILEVER JOISTS PER PLAN ATTACH JOIST TO BEAM WITH SIMPSON H1Z (H2.5Z ON BEAM EDGE) CONNECT DOUBLE BEAM WITH #10 x 2-1/2" EXTERIOR WOOD SCREWS @ 6" FROM ENDS AND 12" O.C. STAGGERED JOIST ATTACHMENT TO RIM JOIST OR LEDGER SCALE: NTS WD-3 3 ANGLED JOISTS: SIMPSON LS70Z (LS50Z FOR 2X6 JOISTS) JOISTS AT EDGE: SIMPSON LUC28Z (LUC26Z FOR 2X6 JOISTS) TYPICAL JOIST: SIMPSON LUS28Z (LUS26Z FOR 2X6 JOISTS) JOIST DECK BOARDS PER PLAN. SPACE FOR 1/8" FINAL GAP. ADJUST FOR PT DRYING AND SHRINKAGE. #10 x 2-1/2" 305SS DECK SCREWS FLAT HEAD DECK ATTACHMENT SCALE: NTS WD-4 3 BLOCK AT MIDSPAN. STAGGER BETWEEN JOISTS. SCREW ENDS WITH (2) #10 x 2-1/2" EXTERIOR WOOD SCREWS PURLIN / GIRT / CHAIR RAIL ATTACHMENT SCALE: NTS SR-3 3 PURLIN / GIRT / CHAIR RAIL WOOD: #10 x 3" WOOD SCREWS @ 6" FROM ENDS & 12" O.C. CONC. 1/4" DIA. x 3" CONCRETE SCREW ANCHOR @ 6"FROM ENDS & 24" O.C. 2" x 2" x 1/8" ANGLE WITH (2) #10 x 3/4" SMS IN EACH FLANGE, EACH SIDE (TYP) CO L U M N BEAM INSIDE OF REC. CHANNEL 2" x 2" x 1/8" ANGLE WITH (2) #10 x 3/4" SMS IN EACH FLANGE INTO MEMBER. (1) 3/8" DIA ANCHOR THRU BEAM INTO HOST. 2-1/4" EMBEDMENT FOR CONCRETE, 3-1/2" EMBEDMENT FOR WOOD TOP VIEW COLUMN TO HOST CONNECTION SCALE: NTS SR-2 3 (1) 3/8" DIA. ANCHOR THRU BEAM INTO HOST. EACH SIDE. CONC: 2-1/4" EMBEDMENT WOOD: 3-1/2" EMBEDMENT FRONT SECTION VIEW SIDE VIEW WOOD: #10 x 3" WOOD SCREWS @ 6" FROM ENDS & 12" O.C. CONC. 1/4" DIA. x 3" CONCRETE SCREW ANCHOR @ 6"FROM ENDS & 24" O.C. #10 x 3/4" SMS @ 6" FROM END AND 24" O.C. (4) #10 x 3/4" SMS INTO POST, EACH SIDE. 2" x 2" x 1/8" ( x WIDTH OF COLUMN) ANGLE. EACH SIDE BEAM CO L U M N CARRIER BEAM PER PLAN TRANSOM WALL UPRIGHT PER PLAN 2" x 2" x 1/8" x BEAM DEPTH INTERNAL ALUM RECEIVING CHANNEL W/ (4) #14 x 3/4" EACH FLANGE RECEIVING CHANNEL WITH MIN. (2) #12 X 3 4" SMS TO COVER OPEN END TW-5 3 TRANSOM WALL ON BEAM SCALE: NTS SHEET SE A S I D E E N G I N E E R S Ce r t i f i c a t e o f A u t h o r i z a t i o n 3 2 0 4 8 42 6 5 6 0 t h C o u r t Ve r o B e a c h , F l o r i d a 3 2 9 6 7 ww w . s e a s i d e e n g i n e e r s . c o m - ( 7 7 2 ) 2 0 2 - 8 0 0 8 - i n f o @ s e a s i d e e n g i n e e r s . c o m Pr o j e c t A d d r e s s : Co l a n e r R e s i d e n c e 10 7 2 5 S O c e a n D r i v e Je n s e n B e a c h , F l o r i d a 3 49 9 7 Wh i t e A l u m i n u m Ed w a r d R o s k e PE # 7 2 2 2 8 3 0 8 / 1 4 / 2 0 ***NOTE - NOT ALL DETAILS ARE USED FOR THIS PROJECT. SEE PLAN FOR DETAIL CALL OUTS*** MAX SPACING BETWEEN POSTS = 8FT MI N . 3 6 " R E S I D E N T I A L , 42 " C O M M E R C I A L , 48 " P O O L B A R R I E R PICKETS PER PLAN TOP RAIL PER PLAN POSTS PER PLAN BOTTOM RAIL PER PLAN 4" MAX. 4" MAX. (2" POOL BARRIER) TYPICAL RAILING PROFILE SCALE: NTS R-1 4 FLOOD VENT SCHEDULE MARK VENT SIZE W x L MANUFACTURER MODEL COVERAGE V-1 16"8"NON-ENGINEERED NON-ENGINEERED 128 SQFT PROPOSED FLOOR AREA = 222 SQFT, REQUIRING MINIMUM 2 VENTS. 5 PROVIDED NOTE: BOTTOM OF FLOOD VENT MUST BE NOT HIGHER THAN 12" ABOVE ADJACENT GRADE TYPICAL SKIRTING PROFILE SCALE: NTS M-5 4 12" MAX. FLOOD VENT SEE PLAN VIEW FOR VENT LOCATIONS DECK FRAMING CO L U M N CO L U M N VINYL SIDING (BREAKAWAY) SKIRTING. INSTALL PER MANUFACTURER'S REQUIREMENTS. ·2X4PT TOP PLATE, BOTTOM PLATE, BLOCKING, AND STUDS (@ 16" O.C.) ·END NAIL EACH STUD TO PLATE (AND BLOCKING TO STUDS) WITH (2) 16d RING-SHANK NAILS ·NAIL TOP PLATE TO BOTTOM OF FRAMING WITH (1) 16d RING-SHANK NAIL @ 16" O.C. ·FACE NAIL STUD TO COLUMN WITH (1) 16d RING-SHANK NAIL @ 16" O.C. ·MAXIMUM 8' O.C. COLUMN SPACING SHEET SE A S I D E E N G I N E E R S Ce r t i f i c a t e o f A u t h o r i z a t i o n 3 2 0 4 8 42 6 5 6 0 t h C o u r t Ve r o B e a c h , F l o r i d a 3 2 9 6 7 ww w . s e a s i d e e n g i n e e r s . c o m - ( 7 7 2 ) 2 0 2 - 8 0 0 8 - i n f o @ s e a s i d e e n g i n e e r s . c o m Pr o j e c t A d d r e s s : Co l a n e r R e s i d e n c e 10 7 2 5 S O c e a n D r i v e Je n s e n B e a c h , F l o r i d a 3 49 9 7 Wh i t e A l u m i n u m Ed w a r d R o s k e PE # 7 2 2 2 8 4 0 9 / 0 1 / 2 0 OFFICE USE ONLY: DATE FILED: _____________________________ PERMIT # _______________________________ REVISION FEE: ___________________________ RECEIPT # ______________________________ ______________________________________________________________________________________________ PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 (772) 462-1553 APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION LOCATION/SITE ADDRESS: ___________________________________________________________________________________ ___________________________________________________________________________________ DETAILED DESCRIPTION OF PROJECT REVISIONS: ___________________________________________________________________________________ ___________________________________________________________________________________ CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: ______________________ ST. LUCIE CO CERT. #: ____________ BUSINESS NAME: _________________________________________________________________ QUALIFIERS NAME: ________________________________________________________________ ADDRESS: _______________________________________________________________________ CITY: _______________________ STATE: _______________ ZIP: _______________________ PHONE (DAYTIME): ________________________ FAX: _____________________________ OWNER/BUILDER INFORMATION: NAME: ____________________________________________________________________________ ADDRESS:__________________________________________________________________________ CITY: _____________________________ STATE: __________ ZIP: __________________ PHONE (DAYTIME: ___________________________ FAX: _____________________________ ARCHITECT/ENGINEER INFORMATION: NAME: ____________________________________________________________________________ ADDRESS: _________________________________________________________________________ CITY: _____________________________ STATE: ____________ ZIP: ___________________ PHONE (DAYTIME): ___________________________ FAX: ____________________________ SLCCC: 9/23/09 Revised 06/30/17