CC-16-2142 ��t -o C� '142
Miami Shores Village �' t�'ermiTYI + rnrtterCialonation-
10050 N.E.2nd Avenue "'
tsisiccn Alt low
•.•• Miami Shores,FL 33138-0000
POW status::APPRt3 EP
`rye Phone: (305)795-2204
Fioxtt'�
"t9120 Expiration: 03/15/2017
Project Address Parcel Number Applicant
9025 BISCAYNE Boulevard 1132060110051-25
SHORES SQUARE INVESTMENT
Miami Shores, FL 33138-0000 Block: Lot:
Owner Information Address Phone Cell
SHORES SQUARE INVESTMENTS 3850 BIRD Road
MIAMI FL 33146-
Contractor(s) Phone Cell Phone Valuation: $ 2,800.00
BARI NATIONAL BUILDERS, LLC (954)537-4430
...,,.. ... Total Sq Feet: 264
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final PE Certification
Date Denied: Window Door Attachment
Type of Construction:BUILD DIVIDE WALL FOR NEW OF Occupancy Load: Tie Beam
Stories: Exterior: Slab
Front Setback:
Rear Setback: Termite Letter
Left Setback: Right Setback: Framing
Plans Submitted:Yes Certification Status: Store Front Attachment
Certification Date: Additional Info:BUILD DIVIDE WALL FOR NEW OFF Insulation
Bond Return: Classification:Commercial Drywall Screw
Fill Cells Columns
Scannin :4
Window and Door Buck
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Celling Grid
CCF $1.80 Review Planning
DBPR Fee $2.25 Invoice# CC-7-16-60803 Review Electrical
DCA Fee $2.25 07/29/2016 Credit Card $50.00 $201.30 Review Electrical
Education Surcharge $0.60 09/16/2016 Credit Card $201.30 $0.00 Review Building
Permit Fee $150.00 Review Structural
Plan Review Fee(Engineer) $80.00 Review Plumbing
Scanning Fee $12.00 Review Mechanical
Technology Fee $2.40
Total: $251.30
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 FIDA IT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction d zo g. re I authorize the above-named contractor to do the work stated.
September 16, 2016
Authorize Sig nature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
September 16,2016 1
Miami Shores Village
N ° Building Department JUL 29 ,2016
L 10050 N.E.2nd Avenue,Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20( 4
BUILDING Master Permit No. 1 -
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL
ry
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
Nko"n Pjv1d t,tit'j 9 031 CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: (� Flood Zone: BFE: oFFE:
OWNER: Nam-ee(Fee Simple Titleholder): ���;1-L IA.0 A. \,da���T:� ,�i Phone#: - I Q 7 1 O�
r
Address: � _I �
City: p j�� State: 1✓�`D r Z Zip:
Tenant/Lessee Name: M o c�J✓� XVN` 4\r r r,y\ paT k- f Anz!, Phone#:3 0'V ss\0
Email: 'M c�"j,.Vn vlvjr
CONTRACTOR:Company NameAn, i�"Al O ce�'� L %\) A t4�S AIL– Phone#: C7 is>
Address: 014LY)Sf®'til, �))
City: 6"%--e i:'0 State: pl� Zip:
Qualifier Name: '�St"N D', i 0 -6 Phone#:
State Certification or Registration#: 3 Certificate of Competency#:
DESIGNER:Architect/Engineer: Q �-� �\\ ►tib C� 'A k" No MZ Phone#:
Address: %Z`NSO 5\-.I `��-�� �C City:-13f-ejPr- State: klo Zip. 3
Value of Work for this Permit:$ o-0 Uz) Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ElNew ❑ Repair/Replace ❑ Demolition
Description of Work:
A"'<��J°. + ��\ ��o' DAL (.A
Specify color color thru tile:
L
Submittal Fee$ Permit Fee$ ( CCF$ CO/CC$
Scanning Fee$ ("Q) Radon Fee$ 2-5 DBPR$ l Notary$ y
Technology Fee$ Training/Education Fee$ 0 0 Double Fee$—
Structural Reviews$ Bond$ 16
TOTAL FEE NOW DUE$ 7-01 3 d
(RevisedO2/24/2014)
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 01 Signature
O R or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged beforemethis
?51 day of to 20 1 b , by _day of �L.�V'`� ,20 f --42 , by
V0f-ANl 10NA!L ,who is ersonally know to rn•li � '�� r-- ,wh is personally known to
me or who has produced as me or who has producedj 0'"`'� as
identification and who did take an oath. identification and who did take an oath. b`f D '®®®- 7-I3D Q
NOTARY PUBLIC: OTARY PUBLIC:
Sign: Si n: l �i7/1✓L�(�C
g Sig
-n-:
r Print: �Lf& O. r
Seal: JQiiO BE LA IROSA, R�`y"Ye MARIA C.CAMARA
I
^''• Seal: _¢' `�
Notary Public•State of Florida .= MY COMMISSION FF 143623
•i
Commission tY FF 946519 ;,: EXPIRES:November 2l,2018
° ,ePF i�op. Bonded Thru Notary Public UndervnHerc
*sa+�'�`�►`*�x��a4tExpires Apr 23,2020
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
SHORE SQUARE PROPERTIES, LLC
696 N.E. 125" Street
Miami, Florida 33161
(305) 893-9955
July 29, 2016
Re: Modern Martial Arts &Fitness, Inc.
9025 Biscayne Blvd.
Miami Shores, Fl, 33138
To Whom It May Concern:
Please be advised that Shore Square Properties, LLC as owner of the above referenced
property, hereby authorizes Modern Martial Arts &Fitness, Inc. (our Tenant),to apply
for a permit with the Bari National Builders, LLC and any other departments required
with the City of Miami Shores for same. Our Tenant understands that he is solely
responsible for any application fee or cost associated with the Permit application or
processing thereof.
This authorization is subject to approval by the appropriate governmental municipalities.
Si c rely,
Izhak
aging Member
STATE OF FLORIDA)
COUNTY OF MIAMI-DADE )
I HEREBY CERTIFY that to me persWally k n or who has/have
produced as identification and wh take an oath., this day
acknowledged before me that they d of J L, 2016.
woo JOA E R
,a?av Pie° •; Notary Public•State of Florida
My Commission Expires: •
commission#►FF 948519
c•• ••`-
M Comm.Expires Apr 23,
OF 5,°Po,, P y.fed through National Notary Assn
ublic
Prope Search Application- Miami-Dade County Page 1 of 1
� � OF
Summary Report
Generated On:7/29/2016
Property Information ,
Folio: 11-3206-011-0051 �� �•.
R i �
9031 BISCAYNE BLVD
Properly Address:
Miami Shores,FL 33138-3221 '
Owner SHORE SQUARE PROPERTIES LLC
Mailing Address 696 NE 125 ST
MIAMI,FL 33161 USA
Primary Zone 6200 COMMERCIAL-ARTERIAL
Primary Land Use
1611 COMMUNITY SHOPPING
CENTER:RETAIL OUTLET
Beds I Baths I Half 0/0/0
Floors 1 _
Living Units 0
Actual Area 41,619 Sq.Ft
A Y
Living Area 41,619 Sq.Ft
Adjusted Area 38,148 Sq.Ft
Taxable Value Information
Lot Size 1126,728 Sq.Ft
2016 2015 2014
Year Built 1962
County
Assessment Information Exemption Value $0 $0 $0
Year 2016 2015 2014 Taxable Value 1 $5,647,402 $5,134,002 $4,667,275
Land Value $5,576,032 $2,534,560 $1,226,727 School Board
Building Value $923,968 $2,688,616 $4,040,073 Exemption Value $0 $0 $0
XF Value $0 $0 $0 Taxable Value $6,500,000 $5,223,176 $5,266,800
__._....__._.__..._........_._......___.............__.___.__....._.._. .._..__. ._....
Market Value $6,500,000 $5,223,176 $5,266,800 City
Assessed Value $5,647,402 $5,134,002 $4,667,275 Exemption Value $0 $0 $0
Taxable Value $5,647,402 $5,134,002 $4,667,275
Benefits Information Regional
Benefit Type 2016 2015 2014 Exemption Value $0 $0 $0
Non-Homestead Assessment Taxable Value $5,647,402 $5,134,002 $4,667,275
Cap Reduction $852,598 $89,174 $599,525
Note:Not all benefits are applicable to all Taxable Values(i.e.County, Sales Information
School Board,City,Regional). Previous OR Book-
Price Qualification Description
Sale Page
Short Legal Description 11/07/2011 $8,000,000 27902- Not exposed to open-market;atypical
6 53 42 4847 motivation
ASBURY PARK PB 4-110 24432- Sales which are disqualified as a result
11/01/2005 $0
BEG 30FTW OF SE COR LOT 5 RUN 4515 of examination of the deed
W272.08FT N177FT W260.97FT TO E 02/01/2005 $0 23079- Sales which are disqualified as a result
R/W/L BISC BLVD NELY139.58FT 3255 of examination of the deed
09/01/1985 $1,850,000 12153- Deeds that include more than one
1995 parcel
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/ 7/29/2016
Detail by Entity Name Page 1 of 2
d I
a
Detail by Entity Name
Florida Limited Liability Company
SHORE SQUARE PROPERTIES, LLC
Fllina Information
Document Number L11000075982
FEI/EIN Number 45-2672348
Date Filed 06/30/2011
Effective Date 06/28/2011
State FL
Status ACTIVE
Principal Address
696 NE 125TH STREET
NORTH MIAMI, FL 33161
Mailing Address
696 NE 125TH STREET
NORTH MIAMI, FL 33161
Registered Agent Name &Address
Reyes, Daisy
696 NE 125TH STREET
NORTH MIAMI, FL 33161
Name Changed: 03/20/2014
Authorized Person(s) Detail
Name &Address
Title MGR
IZHAK, YORAM
696 NE 125TH STREET
NORTH MIAMI, FL 33161
Title MGR
LIPTON, ALAN
649 OCEAN BLVD
GOLDEN BEACH, FL 33160
Annual Reports
http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 7/6/2016
(ba 01 U0cn
NOTE: ALL SHEETS MUST BE REVIEWED
MIAMI-DADEJCQUNTY DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES
Aerbert S.Saffir Permitting and Inspection Center
11805 SW 26th Street(Coral Way) • Miami, Florida 33175-2474 • (786)315-2000
APPLICATION FOR MUNICIPAL PERMIT APPLICANTS
THAT REQUIRE PLAN REVIEW FROM MIAMI-DADE FIRE RESCUE
.� AND/OR ENVIRONMENTAL SERVICES
PROVIDE MUNICIPAL PROCESS NUMBER HERE
asJob Address ¢z Contractor No.
OE y� 09 Last four 4 digits of Qualifier No.
zW Folio 067 • Ql • Lam' 'GJ ��IZa �F ( ) 9
o w ¢a Contractor Name
�> Lot Block ¢�
v0 z0 Qualifier Name
o a Subdivisio PBpg OU.
�2 �z Address
Metes and bounds City State_Zip
[ ] New Construction on [ ] Demolish
Current use of property le
rn Vacant Land [ ] Shell Only
c
uj X Alteration Interior [ ] Addition Attached
W W [ l Alteration Exterior [ ] Addition Detached Descri tion of Work b
o [ ] Relocation of Structure [ ] Re-Roof p
[ ] Enclosure [ ] Foundation Only Sq. Ft. Ypits Floors
[ ] Repair [ ] Tent
[ ] Repair Due to Fire Value of Work Val oock
MBLD` [ ] Chg. Contractor Owner 1 S
a Category F [ ] Re-Issue a Add r s 25
[ ] tat
MELE z
MPLU m [ ] Re-Stamp ¢ City � (C =Cc i
¢ [ ] MLPG _ [ ] Revision w Phone
W [ ] Not Applicable for 3 Last four(4)digits of
IL [ ] MMEC ¢ o
[ ] FIRE Fire Owner's Social Security No.
w Name s Owner
z
1"W4
zg Addres 2. W W Address
0a. 1=z
w Y City State Zip 1 czi z City State_Zip
act ¢W
a Phone S— ' a Phone
OF
z 1 am requesting a Special eq st las Re vi RI) be s eduled as soon as possible. There is a minimum harg of
a ¢ one-hour.Please costa the it partme t or c nt //
LUgN l�
ww� 1 b'Request: Date:
mw� 2nd Request: Date:
¢
3'd Request: Date:
z
5 I am requesting Optional Plan Review(OPR)to be scheduled as soon as possible at the rate of$75 for each discipline.
Additional review fees may apply.
as
0
o 1 sl Request: Date:
P
F
ru- 2"d Request: Date:
LU3'd Request: Date:
M
123 01-192 1/16
•
Property Search Application-Miami-Dade County http://www.niianiidade.gov/propertysearch/#/report/sunmmury
FFICE OF R PROPERTY APPRAISER
1 R
Summary Report
Generated On: 1/4/2016
jj
Property Information
,.i
a Folies 11-3206-011-0051
- - _able_ ._------------- .____._..-._..._-._..._____--..--__-.-_..___---___---
;9031 BISCAYNE BLVD
Pi 2Fty Address: I
I Miami Shores,FL 33138-3221 t,
s ---- —��------- ---=--------------- -------
Owner 1SHORE SQUARE PROPERTIES LLC i
696 NE 125 ST e
Mailing Address i
MIAMI FL 33161
----------------------_----------------«-----__'___bele___-_-_____________--ebbe-_
Primary Zone ;6200 COMMERCIAL-ARTERIAL }
1611 COMMUNITY SHOPPING ® 3� "' 77
.
Primary Land Use
!CENTER: RET
AIL OUTLET ;tOF Beds/Baths/Half 0/0/0
Floors
.t
Living Units ;0 # N -fill
Actual Area ;41,619 Sq.Ft s
Living Area 41,619 Sq.Ft y'
Adjusted Area —— ;38,148 Sq.Ft Taxable Value Information
Lot Size 1126,728 Sq.Ft
--- 20151 2014; 2013
Year Built ;1962
County
Assessment Information Exemption Value $0 — $0; $0
Year 2015 2014 2013 Taxable Value $5,134,002 $4,667,275; $4,240,000
_._._ - _ - __abbe babe
___________—bell--ebbe_______________.._____ ___________________________—ebbe__ School Board
Land Value $3,548,384 $1,394,0081 , $1,115,206
___ Exemption Value $0 $0 $0
Building Value 1 $2,688,616 $4,590,9921 $3,124,794 _._. _
ebbe__ ---------------_t _-ebbe_-ebbe_ Taxable Value $6,237,000 $5,985,0001 $4,240,000
XF Value 1 $0 _�!
..�:.....�..._:::.__ ...._.:..:.W:.:...__....�w: .m.:..�:.. City
Market Value Ii $6,237,000 $5,985,0001 $4,240,000 -- -_ — — -- ebbe_.abbe_ --_
___----.--__ Exemption Vain $0 $0 $0
Assessed Value $5,134,002 $4,667,275; $4,240,000 __._.__----.__._--
Taxable Value' - ---'y _--$5,134,002 bleb_.—�667,275'!-----$4,240,000
_-- _
Benefits Information Regional
-----------------------------------------�::
babe ---_ ------------------
$01
Benefit j1ype 2015 20141 2013 Exemption Value — ; $01AssessmentI I1 Taxable Value $5,134,002 $4,667,275 � $4,240,000
Non-Homestead Cap1Reduction # $1,102,998 $1,317,7251
Note:Not all benefits are applicable to all Taxable Values(i.e.County,School Sales Information
Board,City, Regional). Previous
Sate i Price; BoOPage ; Qualification Description
i i
._._......-----a-.-. .__..._.............._. ._._..._._._.._............_..
Short Legal Description — — —_1 Not exposed to open-market;atypical
11/07/2011 1$8,000,000; 27902-4847 Imotivation
65342 _________________________i_____________'
ASBURY PARK PB 4-110 11/01/2005 $01 24432-4515 1 Sales which are disqualified as a
BEG 30FfW OF SE COR LOT 5 RUN ebbe; --1 result--examination--the deed
—
W272.08FT N177FT W260.97FT TO E 02/01/2005 1 $O1 23079-3255 Sales which are disqualified as a
1 1 ;result of examination of the deed
R/W/L BISC BLVD NELY139.58FT '� t"'"------
� �—�--
1 I 1 Deeds that include more than one
09/01/1985 1$1,850,0001 12153-1995!
pared
The Office of the Property Appraiser is continually editing and updating the tax roll.This website may riot reflect the most current information on record.The Property Appraiser and
Miami-Dade County assumes no liability,see full disclaimer and User Agreement at http://www.miamidade.gov/nfo/disclaimer.asp
Mersion:
1 of 1 1/4/2016 12:37 PM
MIAMI- ADE
If
FIRE ENGINEERING & WATER SUPPLY BUREAU
11805 SW 26 STREET, SUITE 150, MIAMI, FL. 33175
TELEPHONE (786) 315-2771 EMAIL:
www.miamidade.gov/mdfr
FIRE REVIEW DISAPPROVAL COMMENTS
DATE: 3/24/16 FD TRACKING NUMBER: M2016007874 REVIEWED BY: RICK GONZALEZ
NAME OF PROJECT: MODERN MARTIAL ARTS & FITNESS
ADDRESS: 9025 BISCAYNE BLVD MIAMI, FL.
PROVIDE RESPONSE SHEET ADDRESSING EACH OF THE COMMENTS AND INDICATE THE SHEET
IN WHICH CORRECTION IS FOUND—W NOT PROVIDED ORIGINAL FULL REVIEW FEE WILL BE
ASSESSED AGAIN
1. INDICATE ON PLANS THE CLASS OF REHABILITATION AS PER NFPA 101 CHAPTER 43—
(REMODELATION IS NOT AN APPROVED CATEGORY)
2. INDICATE ON PLANS THE TYPE OF OCCUPANCY AND THE OCCUPANT LOAD AS PER THE OCCU •ANCY
AND USE OF EACH ROOM OR AREA-TABLE 7.3.1.2—(THE OCCUPANCY IS ASSEMBLY,NOT ,
MERCANTILE,AND BOTH THE WAITING AREAS AND THE MARTIAL ARTS AREA&FITNESS ARE
FIGURED USING AN OCCUPANT LOAD FACTOR OF 15 SO.FT.NET PER PERSON- 2297SO.FT
DIVIDED BY 15=153 PERSONS AS THE MAXIMUM OCCUPANCY PERMITTED)
3. POST MAXIMUM OCCUPANT LOAD SIGN BY MAIN ENTRANCE
4. PROVIDE FLOOR ELEVATION ON BOTH SIDES OF ALL DOORS—MAX%z"—SCT.7.2.1.3
5. PROVIDE MINIMUM REQUIRED FLAME SPREAD CLASSIFICATION FOR INTERIOR FINISH—TABLE
A.10.2.2
6. DOORS SHALL SWING IN THE DIRECTION OF EGRESS TRAVEL WHERE SERVING A ROOM OR AREA
WITH AN OCCUPANT LOAD OF 50 OR MORE PERSONS—SCT. 7.2.1.4.2—(AS SHOWN IN SHEET A-2.0)
7. ANY DOOR IN A REQUIRED MEANS OF EGRESS FROM AN AREA HAVING AN OCCUPANT LOAD OF 100
OR MORE PERSONS SHALL BE PROVIDED WITH PANIC HARDWARE—SCT. 12.2.2.2.3—(AS SHOWN IN
SHEET A-2.0)
8. ADDITIONAL COMMENTS MAY FOLLOW ONCE ALL INFORMATION IS PROVIDED
* ALL CODE REFERENCES MENTIONED IN THESE COMMENTS ARE FROM FFPC/NFPA,FLORIDA FIRE
PREVENTION CODE AND NFPA 101 LIFE SAFETY CODE, UNLESS OTHERWISE NOTED..
• PROVIDE NEW SHEETS WITH ALL CORRECTIONS AND CHANGES HIGHLIGHTED OR CLOUDED.
• RETURN VOIDED SHEETS WITH FIRE DEPT. STAMPS FOR COMPARISON, OR FULL REVIEW FEE WILL BE
ASSESSED
• COORDINATE ALL CORRECTIONS & CHANGES THROUGHOUT THE ENTIRE SET OF PLANS.
* PROVIDE ALL INFORMATION ON THE PLANS
* FAST TRACK FOR REWORK
r
MIAMI-DADS MIAMI-DADE COUNTY
PRODUCT CONTROL SECTION
BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT(BNC) 11805 SW 26 Street,Room 208
BOARD AND CODE ADMINISTRATION DIVISION Miami,Florida 33175-2474
T(786)315-2590 F(786)315-2599
NOTICE OF ACCEPTANCE (NOA) www.miatnidadc,eoy/hui[dinglliomelasn
Signature Hardware,LLC
211 Endeavor
Rogersville,Missouri 65742
SCOPE:
This NOA is being issued under the applicable rules and regulations governing the use of construction materials.
The documentation submitted has been reviewed and accepted by Miami-Dade County BNC-Product Control
Section to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction
(AHJ).
This NOA shall not be valid after the expiration date stated below. The Miami-Dade County Product Control
Section (In Miami Dade County) and/or the AHJ (in areas other than Miami 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 manner, the manufacturer will incur the expense of such testing and the AHJ may immediately
revoke,modify,or suspend the use of such product or material within their jurisdiction. BNC reserves the right to
revoke this acceptance, if it is determined by Miami-Dade County Product Control Section that this product or
material fails to meet the requirements of the applicable building code.
This product is approved as described herein,and has been designed to comply with the Florida Building Code,
including the High Velocity Hurricane Zone.
DESCRIPTION: Series"Design Hardware 1000&2000"Panic Rim Exit Device-Component Approval
APPROVAL DOCUMENT: Drawing No"AD11-10",titled"Design Hardware Series 2000 Rim Exit Device",
sheets 1 through 3 of 3,prepared by MCY Engineering,Inc.,dated 04-13-11 and last revised on JUL 20,2011,
signed and sealed by Yiping Wang,P.E., 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 Section.
MISSILE IMPACT RATING: Large and Small Missile Impact Resistant
Limitation:
1.The Panic Exit Device component approval are to be used as an alternate in the single Outswing steel doors
(36"W X 84"H max panel),having current NOA. Lower design of door or the panic component shall control.
2. Electrical device installation is not part of this approval,such installation to be reviewed by AHJ.
LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo,New Taipei city,
Taiwan and series and following statement: "Miami-Dade County Product Control Approved",unless otherwise
noted herein.
RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no
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
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 NOA 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 NOA is displayed,then it shall
be done in its entirety.
INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors
" and shall be available for inspection at the job site at the request of the Building Official.
This NOA consists of this page 1 and evidence pages E-1,as well as approval document mentioned above.
The submitted documentation was reviewed by Ishaq I.Chanda,P.E.
NOA No 11-0414.11
�\ MIAMI-DADE COUNTY Expiration Date: September 22,2016
,\ f Approval Date: September 22,,2011
ge
Signature Hardware,LLC
NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED
A. DRAWINGS
1. Manufacturer's parts drawings and sections.
2. Drawing No"AD11-10",titled"Design Hardware Series 2000 Rite Exit Device",sheets 1
through 3 of 3,prepared by MCY Engineering,Inc.,dated 04-13-11 and last revised on JUL
20,2011,signed and sealed by Yiping Wang,P.E.
B. TESTS
1. Test reports on: 1)Air Infiltration Test,per FBC,TAS 202-94
2)Uniform Static Air Pressure Test, Loading per FBC TAS 202-94
3)Water Resistance Test,per FBC,TAS 202-94
4)Large Missile Impact Test per FBC,TAS 201-94
5) Cyclic Wind Pressure Loading per FBC,TAS 203-94
6)Forced Entry Test,per FBC 2411 3.2.1,TAS 202-94
Along with manufacturer's parts and section drawings of double outswing steel doors,marked
by Fenestration Testing Lab, Test Report No. FTL-6222, dated 05/18/10, signed and sealed
by Jorge Causo,P. E.
C. CALCULATIONS
1. Not applicable
D. QUALITY ASSURANCE
1. Miami Dade Building and Neighborhood Compliance Department (BNC).
E. MATERIAL CERTIFICATIONS
1. Tensile test report#FTL-6222,dated 05/18/10 prepared by fenestration Testing lab,
signed&sealed by Jorge Causo,P.E.
F. STATEMENTS
1. Statement letter of conformance and letter of no financial interest,prepared by MCY
Engineering,Inc.,dated 04-13-11 and last revised on JUL 20,2011,signed and sealed by Yiping
Wang,P.E.
2. Letter of authorization dated March 17, 2011 issued by Vision Hollow Metal Limited,
authorizing use of test report#FTL-6222 to obtain component NOA for panic hardware,
signed by Nick Sirgusa,President Vision Hollow Metal Limited.
3. Certificate of Organization issued by State of Missouri to Signature Hardware,LLC dated
June 7t',2001, signed by Matt Blunt, Secretary of State.
4. Certificate of Fictitious Registration dated 1/5/2006 in the state of Missouri,under Design
Hardware issued to Signature Hardware,LLC.
5. Distributor agreement dated July 22,2011 between Signature Hardware dba Design
Hardware,USA and Design Hardware Asia, Taiwan dated July 25,2011, signed by
Johannes Lopez and Chang Lu Chiu-Lan,respectively on behalf of their company.
6. Statement of lab compliance,as part of test reports&marked-up Dwgs referenced above.
G. OTHER
1. Design Hardware Panic devices &Lockwood mullion brochures/catalogs supplied by the
Vision Hollow Metal Limited per.NOA# 10-0623.02.
S�aS 1 . Q14&4410—
Ishaq 1.Chanda,P.E.
Product Control Examiner
NOA No 11-0414.11
Expiration Date: September 22,2016
Approval Date: September 22,2011
E-1
MIN.FRAME WIDTH 40" t
• 36"MAX.NOMINAL o
DOOR PANEL WIDTH a
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/ REINF. ! OUTSWING SINGLE STEEL DOOR V
—SEE SEPARATE HAVING
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//{{ APPROVAL,HAVING CURRENT NOA
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-DEADLOCK-5/8"LATCH BOLT DOOR i °' G 9
-2-1/2"UNDOGGED-PUSHBAR NEUTRAL REINF. W a
-1-13/16°DOGGED-PUSHBAR DEPRESSED e
DESIGN HARDWARE SERIES 2000 RIM PANIC EXIT DEVICE(LMI)-COMPONENT APPROVAL (X)
INTERIOR ELEVATION
MAX.DESIGN LOAD w
(FOR SIZES SHOWN ABOVE OR SMALLER) G
AS PERMITTED BY FW GCl
+75.0 PSF
GENERAL NOTES: 75.0 PSF
-THIS PRODUCT HAS BEEN DESIGNED AND TESTED TO COMPLY WITH THE REQUIREMENTS OF THE FLORIDA BUILDING 5-DOOR PANEL OPTION:STAINLESS STEEL A316 OR A304 MIN.20 GA.(0.032°THK.)Fy=47.5 KSI OR BETTER MAY QUALIFY
CODE 2007 EDITION INCLUDING HIGH VELOCITY HURRICANE ZONE(HVHZ). HAVING°MIL-CERTIFICATE°AS A VERIFICATION OF THE AVAILABLE MIN.YIELD STRENGTH.
DOOR FRAME OPTION:STAINLESS STEEL A316 OR A304 MIN.18 GA.(0.053 THK.)Fy-45.1 KSI OR BETTER MAY QUALIFY
-HARDWARES WERE TESTED FOR LARGE MISSILE IMPACT. HAVING"MIL-CERTIFICATE°AS A VERIFICATION OF THE AVAILABLE MIN.YIELD STRENGTH. ul N
-DESIGN HARDWARE SERIES 2000 RIM PANIC LOCATED AT 39 9/18°UP FROM BOTTOM EDGE OF THE OPERABLE PANEL. 6-REINFORCEMENTS: ' a
LIMITATIONS: 8.1-MIN.14"LONE PANIC BOX REINF.(1-3/16'x 4-3116"x 16GA)@ DOOR&HINGE STILES AT PANIC LOCATION AS REQUIRED. rQ
1 THE LOCKING PANIC HARDWARE PRODUCTS LISTED IN THIS NOA SHALL BE USED IN CONJUNCTION WITH CURRENT
8.2-MIN.1-M"x 1-3116'x 160A(.053)FULL LENGTH END CHANNEL @ TOP&BOTTOM OF THE DOOR PANEL IS REQUIRED.
- p
NOA'S UTILIZING SIMILAR LOCKING COMPONENTS.DESIGN PRESSURE RATING WILL BE LIMITED BY THE LOWEST 7-ELECTRICAL INSTALLED IS NOT PART OF THE APPROVAL&SUCH INSTALLATION MUST BE REVIEWED BY
RATED APPROVAL,THE PRODUCT CAN BE USED WITH HOLLOW-METAL STEEL DOORS HOLDING CURRENT NOA. CORRESPONDING BUILDING AUTHORITY. pppppp,lW6A ja
2-THIS HARDWARE COMPONENT IS APPROVED AS AN ALTERNATIVE DEVICE TO BE USED IN A SINGLE AN STEEL Q p (r)•••e• '
DOOR HOLDING CURRENT NOA.THE LOWEST DESIGN PRESSURE RATING OF THIS COMPONENT OR THE DOOR SHALL a®1FI@R(A'n P.E..'•.RECTION
APPLY. wVWd+N &axtW16"tlu •v PE�gI83 6dvc an>n
3-DOOR PANEL SHALL BE CORE FILLED WITH APPROVED PAPER HONEYCOMB OR CORE �N 77
COMPLYING WITH FBC OPTIONS.WITH MINIMUM OVERALL 1.75°THICKNESS.
4-DOOR PANEL FACE SHEET:MIN.20 GA.(0.032"THK.)STEEL Fy=47.5 KSI MIN.DOOR FRAME:MIN.18 GA.(0.053° j.CEiA.w.+... N pBARp°0 A1°
THK.)STEEL Fy-45.1 KSI MIN. � " P® 0 �..• ppm ADll-10
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PANIC BOX REINF. PANIC BOX REINF. MH
MAX.DOOR OPENING WIDTH 36'
MAX.FRAME WIDTH 4V' Z F
A SERIES 2000 RIM EXIT DEVICE NOTE: $
HOLLOW METAL STEEL DOORS&FRAME 0 d ti m
2 SIZES AND ITS ANCHORS&SUBSTRATE
AS PER DOOR CURRENT HOLDING NOA m
� m
1/4"-20P FLAT
HEAD SCREW
(4)1/4"SMS-20P
FLAT HEAD SCREW 6 0
(3)1/4"SMS-
20P FLAT a
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ROLLER STRIKE PLATE,``�,v'�eq
STEP#1 STEP#2 STEP#3 0 �D•....NG o,
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SERIES 2000 RIM PANIC EXIT DEVICE INSTALLATION :
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5 ROLLER STRIKE 6 STRIKE SHIM EN OVER $ L TCHBOLT FILLER PLATE 9 ASA FI LER PLATE
MOUNTING BRACKET
BILL OF MATERIALS
ITEM NO. MATERIAL QUANTITY DESCRIPTION MANFJSUPPLIERIREMARKS
Q STEEL 1 HEAD COVER DESIGN HARDWARE
STEEL 1 ACTUATING BAR DESIGN HARDWARE z
O3 STEEL 1 DOGGING DEVICE DESIGN HARDWARE
® STEEL 1 END COVER DESIGN HARDWARE
5� STEEL 1 ROLLER STRIKE DESIGN HARDWARE J° •• 'vE. ✓.
•.� R1DA RE RATWN �+
ere anon
6 STEEL 1 STRIKE SHIM DESIGN HARDWARE ,�` lyp g59 3
0 STEEL 1. END COVER MOUNTING BRACKET DESIGN HARDWARE
® STEEL 1 LATCHBOLT FILLER PLATE DESIGN HARDWARE TA, OF P�+�T�^•
O STEEL 1 ASA FILLER PLATE DESIGN HARDWARE ' T O ,a D11-10
em
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