RC-18-1564 (2)Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
mit
Permit NO. RC-6-18-1564
Permit Type: Residential °Construction
Work Classification: Alteration
Permit Status: APPROVED
Issue Date:.611812018
Expiration: 12/15/2018
Parcel Number
Applicant
533 GRAND CONCOURSE
Miami Shores, FL 33138-2464
1132060171350
Block: Lot:
JEROME HURTAK
Owner Information
Address
Phone
Cell
JEROME HURTAK
533 GRAND CONCOURSE
MIAMI SHORES FL 33138-2464
Contractor(s) Phone
IMBURGIA CONSTRUCTION SERVICE 305/525-5707
Cell Phone
Valuation:
Total Sq Feet:
$ 5,000.00
0
Approved: In Review
Comments:
Date Approved:: In Review
Date Denied:
Type of Construction: INSTALL USP GUSSETS ON EVER
Stories:
Front Setback:
Left Setback:
Bedrooms:
Plans Submitted: Yes
Certificate Date:
Bond Return :
Occupancy: Single Family
Exterior:
Rear Setback:
Right Setback:
Bathrooms:
Certificate Status:
Additional Info:
Classification: Residential
Fees Due
CCF
DBPR Fee
DBPR Fee
DCA Fee
DCA Fee
Education Surcharge
Permit Fee - Repairs
Scanning Fee
Technology Fee
Total:
Amount
$3.00
$2.25
$0.00
$0.00
$2.00
$1.00
$150.00
$9.00
$4.00
$171.25
Pay Date Pay Type
Invoice # RF-6-18-67837
06/18/2018 Check #: 9258
06/07/2018 Check #: 9249
Amt Paid Amt Due
$ 121.25 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Tin Cap
Final Roof
Final Roof
Cap Sheet
Review Roof
Roof in Progress
Renailing Affidavit
Review Structural
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 AFFIDAI ceat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and. g. F u ore,A authorize the above -named contractor to do the work stated.
Authorized Signature: 0' er / Applicant / Contractor / Agent
June 18, 2018
Date
Building Department Copy
June 18, 2018
1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
74 BUILDING ❑ ELECTRIC ❑ ROOFING
RECEIVED
JUN 0 7 1018 „ "
lU
FBC^ 20 l ")
Master Permit No.17,4 -r , SC03
Sub Permit No._ C 1 8-- I Sb9
❑ REVISION ❑ EXTENSION ❑ RENEWAL
PLUMBING ❑ MECHANICAL El PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
% J CONTRACTOR DRAWINGS
JOB ADDRESS: 6 33 ` 0 (Ap L % —o I,C ou r 3C--
City: Miami Shores 1� c-� County: Miami Dade Zip: 33t SS
Folio/Parcel#: L 1 3a t ( —V 1 I ' \ 3 S 0 Is the Building Historically Designated: Yes NO V
Occupancy Type: Load: Construction Type: i Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): CR-Owl C..b 6 yj W c I,`4 A. Ta - Phone#:
Address: e 33 Q.!ay., A 2
City: \ � D re5 State: PA Zip: 3 3 L 3 U y
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:`Company Na1me::.J. L_t
Addresssn: -1D` 41\ j��. ,(�17) kid A
City: IN 1 YI/1 I SFV'C State: �L - ip: 3-3 1 3 g
Qualifier Name: LOIA S, M 6 uVe:„G 1 A Phone 2i( 5la1S 6-ID 1
State Certification or Registration #: C CDC— 0 1 1( 01 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Square/Linear Footage of Work: �I
Type of Work: ❑ Addition Alteration El New ❑ Repair/Replace IT Demolition
T
Description of Work: h 'S4Q.kn LL 5 i— i\ A 1 li d 8 1,\`-- A V` oC
uc. -e-(-- S t) - erer•( a-.Va-ce c1vk,crlc roo- -\h.9
b(� 9 c L( Z� �.-,.,3
Specify color of color thru tile:
Submittal Fee $ ( • W _ Permit Fee $ 1 CCF $ CO/CC $
Scanning Fee $ Radon Fee $ 2 • C7 DBPR $ 2 ' 2c Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ l Z ( ' 2S
Value of Work for this Permit: $ 5► 0 b e
Phone#:
(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 ade 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 e absence of such posted notice, the
inspection will n • .. pr. - d a einspe tion f fP will -be charged.
Signatu
OWNER or AGENT
Signature
C'NTRACTOR
The foregoing instrument was acknowledged before { this The foregoing instrument was acknowledged before me this
(� day of 20 p , by 30 day of I14(,t , 20 / , by
,Ir r (; Yri-e !yam 71-a. i< , who is personally known to 04 Li/ .5 .---/-ii-e btro; I ck., , who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
identification and who did take an oath.
NOTARY PUBLIC:
Sign: Sign: ditC.L.t.
Print: A l-!.er!►,i .ii /Jfi FFf,�k7 Print: i) r
Seal: Seal:
•'tirµ;:' ;',.. CATHERINE A. DUFFIN
4, Notary Public - State of Florida
************* '# S,e•***600inixier*444 4104@ *** *****************
;� / My Comm. Expires May 14, 2021
{ Boade Ihreegh National Notary Assn.
APPROVED Y— "" —"-"'
Plans Examiner
Structural Review
CATHERINE A, DUFFIN
* °4Fa,L mis4! 14511 iil9t16ls ****************
Commisslon # GG 1042%
P/ My Comm, Expires May 14, 2021
Ifonded through ,National Notary Assn.
Zoning
Clerk
(Revised02/24/2014)
iL).
rs1
t)r k lam`
HOME I/I / U.S. PRODUCTS I/US/PRODUCTSI CONNECTORS WS/PRODUCTS/CONNECTORSI
/ TRUSS AND RAFTER TIEDOWNS I/US/PRODUCTS/CONNECTORS/TRUSS-RAFTER-TIEDOWNSI / ANGLES
Hurricane Gusset Angles
Truss and Rafter Tiedowns
Embossed gussets
improve lateral Toad
resistance
HGAM10 Hurricane Gusset Angle
JUN072018
3-1 /2"
HGAM Hurricane Gusset Angles U.S. 111SP Structural Connectors
Search
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Q Go To Advanced Product Search
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tLproduct/us/images/HGAM imagel.jpg)
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Note: 2 images total, scroll or swipe the thumbnails above to review all images. Click on a thumbnail to enlarge.
HGAM
Reference Series: HGAM1OKTA
Designed for attaching gable end trusses to wood top plates and masonry walls. For installation into grouted concrete tie beam or masonry bond beam. Provides
lateral and uplift resistance.
Materials: 14 gauge
Finish: G90 galvanizing
Code Reports: View Code Report Table
Resources
USP Product Catalog I/resources/literature-product-catalog)
Installation
• Use all specified fasteners.
• Install USP's WS15 Wood Screws into the truss and drill holes for wedge bolts. Install wedge bolts into concrete block per manufacturer's recommendation.
• WS Wood Screws and Wedge bolts are included with HGAM10 angles. Wedge -Bits are not included and must be ordered seperately Click here
(/us/products/connectors/concrete-masonry/mechanical-anchors/SD).
• Moisture barrier may be required.
Need Help or Have a Question? Contact Customer Service )/about-us/contact-us) or Call 800-328-5934 (tel://1-800-328-5934)
Load Table
Fastener Schedule
DF/SP Allowable Loads (Lbs.)'
LISP
Steel
Rafter/Truss
Plate
Uplift
F1
F2
F3
Qtyj Type2
Qty I Screw Anchor'
Stock No.
Ref. No.
Gauge
160%
160%
160%
160%
HGAM1OKT HGAM1OKTA 14 4 WS15 4 1/4" x 1-3/4"
915 1075 1110 740
1) Allowable loads have been increased 60% for wind or seismic Toads; no further increase shall be permitted.
2) WS15 Wood Screws. 1/4" x 1-1/2" long. are supplied with HGAM10KT.
3) Use Powers Wedge -Bolt+ 1/4" x 1-3/4" or DeWalt 1/4" x 1-3/4" Screwbott+ (included); or equal. installed
in accordance with manufacturer's specification.
View/ Download the above load table as a PDF tLproduct/us/tables/HGAM1OKT pdf)
Code Report Table
USP Stock#
HGAMIOKT
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ICC-ES IAPM0 FLORIDA LA I Y•
Drawing Library (/resources/cad-drawing-library)
Application Drawings
USP
Stock#
Download or View Files
FL17699
t/codes/f117699.pdf)
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Florida Building Code Online
Page 1 of 2
FLOniOA ONPAFTMFNT OF
Business & Professional Regulation
OFFICE OF THE
SECRETARY
BCIS Home ' Log In I User Registration Hot Topics Submit Surcharge Stats & Facts Publications FBC Staff BCIS Site Map Links Search
Product Approval
USER: Public User
Product Approval Menu > Product or Application Search > Application List > Application Detail
FL # FL17699-R1
Application Type Revision
Code Version 2017
Application Status Approved
Comments
Archived
Product Manufacturer USP Structural Connectors, a MiTek Company
Address/Phone/Email
14305 Southcross Drive
Suite 200
Burnsville, MN 55306
(952) 898-8635
ewalden@mii.com
Authorized Signature Erin Walden
ewalden@mii.com
Technical Representative Jim Collins, P.E.
Address/Phone/Email 14305 South Cross Drive
Suite 200
Burnsville, MN 55306
(952) 898-8602
jcollins@Mii.com
Quality Assurance Representative Todd Asche
Address/Phone/Email
14305 Southcross Drive
Suite 200
Burnsville, MN 55306
(952) 898-8602
tasche@mii.com
Category Structural Components
Subcategory Wood Connectors
Compliance Method
• • • •
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.•• •
Evaluation Report from a Florida Registerq 1 Araih tact or a Licensed
Florida Professional Engineer • • • • • • •
• • •
Evaluation Report - Hardcopy Received► • • •
•
Florida Engineer or Architect Name who developed Terrence E. Wolfe a • • •
the Evaluation Report
Florida License PE-44923
Quality Assurance Entity PFS Corporation • •
•• ••
Quality Assurance Contract Expiration Date 12/31/2020
Validated By Brian Jaks, P.E. • • •
• Validation Checklist - Hardcopy Received
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Certificate of Independence FL17699 RI COI Letter of Certification 9.;
Referenced Standard and Year (of Standard)
Equivalence of Product Standards
Certified By
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Standard Year
ANSI / AWC NDS 2015
ASTM D 7147 2005
Florida Licensed Professional Engineer or Architect
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https://www.floridabuilding.org/pr/prappdtl.aspx?param=wGEVXQwtDgvFGYZsjrZF... 12/18/2017
Florida Building Code Online
Page 2 of 2
FL17699 R1 Equiv 2017 FL17699 ASTM 1761 to D7147
eouivalance.pdf
Sections from the Code
Product Approval Method Method 1 Option D
Date Submitted
Date Validated
Date Pending FBC Approval
Date Approved
Summary of Products
09/25/2017
10/11/2017
10/17/2017
12/12/2017
FL #
Model, Number or Name
Description
17699.1
HGA10, HGAM10
Hurricane Gusset Angle
Limits of Use
Approved for use in HVHZ: Yes
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
Other:
Installation Instructions
FL17F99 R1 II HGA and HGAM Evaluation Report -
Verified By: Terrence E. Wolfe, P.E. 44923
Created by Independent Third Party: No
Evaluation Reports
r..17699 R1_ and HGAM Evaluation Report
Secured.pdf
Created by Independent Third Party: No
(Back'
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Under Florida law, email addresses are public records. If you do not want your e-mail address released in response to a public -records request, do not send
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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
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Chapter 455, F.S., please dick here
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https://www.floridabuilding.org/pr/pr app_dtl.aspx?param=wGEVXQwtDqvFGYZsjrZF... 12/18/2017