WS-19-422Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 03/15/2019
Location Address Parcel Number
1700 NE 105TH ST, Miami Shores, FL 33138 1122300500001
Contacts
Permit NO.: WS -02-19-422
Permit Type: Windows/Shutters
Work Classification: Garage Door
Permit Status: Approved
Expiration: 09/11/2019
Description: REPLACE GARAGE DOOR Valuation: $ 5,377.00
Inspection Requests:
r 762-4949
Total Sq Feet: 0.00
Fees
JORGE BENAVIDES Owner
1700 NE 105 ST 409, MIAMI SHORES, FL 331382141
Contractor
JEROME PAYNE
COAST TO COAST GARAGE
DOORLc2cga10501NW50ST106, SUNRISE, FL 33351
Business: 9546531600 or@live.com
50.00
CCF 3.60
Description: REPLACE GARAGE DOOR Valuation: $ 5,377.00
Inspection Requests:
r 762-4949
Total Sq Feet: 0.00
Fees Amount
Application Fee - Other 50.00
CCF 3.60
DBPR Fee 2.00
DCA Fee 2.00
Education Surcharge 1.20
Scanning Fee 9.00
Structural Review ($45) 45.00
Technology Fee 2.75
Windows/Shutters Fee 60.00
Total: 175.55
Payments Date Paid Amt Paid
Total Fees 175.55
Credit Card 02/25/2019 $50.00
Credit Card 03/15/2019 $125.55
Amount Due: 0.00
Building Department Copy
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 foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Signature: Owner Applicant / Contractor / Agent Date
March 15, 2019 Page 2 of 2
BUILDING
PERMIT APPLICATION
Miami Shores Village c V E
Building Department FEB 2 5 2619
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: C
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
dBUILDING ELECTRIC ROOFING
PLUMBING MECHANICAL PUBLIC WORKS
JOB ADDRESS: 1-100 A% 105 S-)-
FBC 201?
lffn
Master Permit No. N S 2= 1' I— 4 Z Z
Sub Permit No.
REVISION EXTENSION RENEWAL
CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zi p: 33 t _!P
Folio/Parcel#: 11 a 9-10 0 $o ®ao Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): wrCL '0C'V1o\ I/ e j Phone#:3yS ` 6 7 N
Address: / %00 K 7;- 4p5 5--
City: VMCAA!j State: t= ( Zip: -3-3j-S,?
Tenant/Lessee Name: Phone#: DS %18 7a7 S"
Email: Shor e6 C )redo & a,4. ne+
CONTRACTOR: Company Name: C io Com- ('ramt, bov, Phone#: 93 6S3 G o 0
Address: 10570/ 14 k1 5-O Sf
City: Syhr+Sy_ State: Zip: 333
Qualifier Name: macro v P,!.4 v. -e- Phone#: 1154-r-07 90 SLf
State Certification or Registration #: Certificate of Competency #: ri B S NO 0
DESIGNER: Architect/Engineer: Phone#:
Address
Value of Work for this Permit: $ 5 31 T 00 Square/Linear Footage of Work:
State: Zip:
Type of Work: Addition Alteration New Q epair/Replace Demolition
Description of Work: LO C; --( !L Q 066YZ
Specify color of color thru tile:
Submittal Fee $
S 011 J Permit Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $,
Revised02/24/2014)
Radon Fee $
Training/Education Fee $
CCF $ CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State
Zip
2C.
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 a0roved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoio instrument was acknowledged before me this
5 day of I atnll rte/ 20 / g by
btq-t er1q/1`d S ,, who is personally known to
me or who has producedgS/q z q Z qO '1l as
identification adtakaApith.,., ,,,
NOTARY PU
KEMISHAPAYNE
MY COMMISSION # GG 150739
EXPIRES: May 18, 2019
OF F•' Bonded Thru Notary Public Underwriters
Sign:
Print:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
ll.t` .
day of Fobeu 20 1 '1 by
who is personally known to
me or who has produced
identificati
NOTARY
Sign:
Print:
who did take an oath.
DELROY WILSON
Notary Pubhr . of Florida
J10 23394117
mm. Expires Jul 1, 2022
Seal: Seal:
as
APPROVED BY 3 Plans Examiner Zoning
v Structural Review
Revised02/24/2014)
Clerk
Coast To Coast Garage Door
P.O. Box 590929
Tamarac, FL 33359
Billing Address
The Shores Condominium
1700 NE 105 St
Miami Shores, Fl 33138
theshorescondo@att.net
305-893-6741
Job location
Estimate
Date Estimate #
6/8/2018 2156
Customer W.O.# P.O. No.
Description Qty Rate Contract # Total
Furnish Material & Install 1 3,027.00 3,027.00
Custom Rolling Steel Door: Miami Dade Code
Dimensions: 6'3" x 6'10"
Slats: Flat
Color: White
Hoist Operation: RH Chain
Mounting: Outside Mount to Concrete
Other Specifications: Install one 30 steel tube on the left
side of the opening to mount the left side track.
Engineer drawing 1 2,000.00 2,000.00
Permit fees for job 1 350.00 350.00
PRICE STILL VALID THROUGH 01/31/19
e 97
e
N
Estimate is valid for 30 days
Total $5,377.00
A x7
This is a estimate only, This estimate is for completing the job described above, based
on our evaluation. It does not include additonal labor or material which may be 4requiredifproblemarise. Upon acceptance of this estimate a 50% deposit is required. Signature
All Credit Card Transaction Subject to 4% Processing Fee.
1
E-mail Web Site P # I Fax #
SERVICE@C2CGARAGEDOORS.COM I COAST2COASTGARAGEDOOR.COM 954-653-1600 954-840-9257
Lie # BWD 13 -GD -18700-X, 15 -F -19807-X :PB U-22055 :MD 17BS00060 :MC GD6891
2/20/2019 Detail by Entity Name
Department of State / Division of CorWrations / Search Records / Detail By Document Number /
Detail by Entity Name
Florida Not For Profit Corporation
THE SHORES CONDOMINIUM, INC.
Filing Information
Document Number 707621
FEI/EIN Number 59-1095398
Date Filed 07/21/1964
State FL
Status ACTIVE
Last Event AMENDMENT
Event Date Filed 06/27/2012
Event Effective Date NONE
Principal Address
1700 NORTHEAST 105TH STREET
MIAMI, FL 33138
Changed: 04/22/2000
Mailing Address
1700 NORTHEAST 105TH STREET
MIAMI, FL 33138
Changed: 04/22/2000
Reaistered Aaent Name & Address
Jara & Associates, PA
10271 Sunset Drive
Suite # 103
Miami, FL 33173
Name Changed: 01/24/2017
Address Changed: 04/12/2018
Officer/Director Detail
Name & Address
Title Treasurer
STUBBS, PATRICIA
1700 NE 105 ST #211
http://search.sunbiz.org/Inquiry/Corpora ionSearch/SearchResultDetail?inquirytype=EntityName&directonType=lnibal&searchNameOrder=SHORESCONDO. 1/3
2/20/2019
MIAMI SHORES, FL 331381.
Title VP
Sepe, Ellen
1700 NORTHEAST 105TH STREET
417
MIAMI, FL 33138
Title Secretary
Grable, Jane
1700 NE 105 ST #117
MIAMI, FL 33138
Title VP
Weber, Michael
1700 N.E. 105 th St.
419
Miami Shores FL, FL 33138
Title President
Benavides, Jorge
1700 N.E.105 St
409
Miami Shores, FL 33138
Annual Reports
Report Year Filed Date
2017 01/24/2017
2018 04/12/2018
2018 09/10/2018
Document Images
09/10/2018 — AMENDED ANNUAL REPORT
04/1212018 — ANNUAL REPORT
01/2412017 — ANNUAL REPORT
12!14/2016 — AMENDED ANNUAL REPORT
03/18/2016 --ANNUAL REPORT
01/25/2015 --ANNUAL REPORT
04/02/2014 — ANNUAL REPORT
03/31/2013 — ANNUAL REPORT
06/27/2012 — Amendment
02/0912012 — ANNUAL REPORT
01/27/2012 — Req. Agent Change
01/19/2011 — ANNUAL REPORT
09/27/2010 — Rea. Agent Change
05/04/2010 — ANNUAL REPORT
Detail by Entity Name
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i
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http://search.sunbiz.orglinquiry/CorporationSearc[VSearchResultDetail?i aqui rytype=EnbtyN ame&direcbonType= lniti al&searchNam eOrder=SHORESCON DO.'.. 2/3
tiV(iRx REQDES T APPLICATION
C ('Fr C o t ntU M Unit
Owner's Name
I hereby request
approval from the Board of Directors for the following
licensed
modification or alteration to my unit that will be performed by o
contractor.
Electrical work
plumbing work
Carpet installation
Windows
Other work
Tile installation
Description of the wort _
Von nrnst
rade our spa went (other than paint or carpet) Y
Before yon decide to upgrade YtheBoard of Directors and/or Miami Shares Village. obtain permission from .
A capY'of the pians,
specifications and permits, and a description of the
alib
n ed
work to `be performed must be submitted for consideration and app Y he
Miami Shores Village Building Department (305-795-2204).
It is the owner's responsibility
to ensure that the connrti e dumpst
emoves all excess
construction material or building debris. It cannot be placed
Window frames must be gray in color to look like aluminum. Windows must be
Two (2) panels over Two (2) panels. Glass must be clear co
damagto the building or
I as the unit owner
acknowledge responsibility for anye. ShtireseCondom alum Inc.
personal injuries that may occur during thwaye
responsible for damage or
project. Th
theft
its officers and employees are in no0.00deposiit is required and will beof nded f
apartment or my belongings. (A $20 p
no damage to the property is reported.)
and agree to the statements made above.
Date
owner's signature
V
14J plate: Approved by: ---
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CONTRACTORS' REGISTRATION
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 INSURANCE*
Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit)
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
0 Certificate must specify the description of operations or contractor license number, 60
rrrrrrrr r rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr rrrrrrrrrrrrrrr rrrrrrrrrrrrrrrrrrrr urrrrr
BUSINESS NAME: QQCVs- A C0CZ-S-V GC v C,,C C
BUSINESS ADDRESS: _ I I-) , t I Kl oo) tt I S I IN (n CITY STATE {-= Z
ZIP
BUSINESS PHONE: U 5 3 ( Ln 0 L FAX NUMBER15cl ) x,40 q,-) 5 '-1
CELLPHONE( QUALIFIER'S NAME:
QUALIFIER'S LIC NUMBER: S 00 l) LO I)
CTO--
Construction Trades ualifying Board
INESS CERTIFICATE OF COMPETENCY
17BS00060
TO COAST GARAGE DOOR LLC
D.B.A.:
gl '01,
1
PAYNE JEROME
Is certified under the Provisions of Chapter]o of Miami -Dade County
QUALIFYING TRADE(S)
0022 GARAGE & INDUS DOOR
Jaime D. Gascon, P.E.
Secretaryofthe Board , ...._%..
rw.,.\
bti Dade Carty retains as property n9 is hereein. www.miartbade.pavhaxomy
BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT
115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000
VALID OCTOBER 1, 2018 THROUGH SEPTEMBER 30, 2019
DBA: Receipt #: 189- THER TYPES CONTRACTORBusinessName: COAST TO COAST GARAGE DOOR Business Type: ( INSTALL GARAGE DOOR)
Owner Name: JEROME PAYNE Business Opened:02/01/2013
Business Location: 10501 NW 50 ST #106 State/County/CertfReg:CC#13-GD-18700-X
SUNRISE Exemption Code:
Business Phone: 9546079054
Rooms seats Employees, Machines Professionals
3
For vending Business Only
Number of Machines: Vendina Tvoe:
Tax Amount Transfer Fee' NSF Fee L Penalty Prior Years • Collection Cost Total Paid
27.00 0.00, 0.00 0.-00 0.00 0.00 27.00
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is
non -regulatory in nature. You must meet all County and/or Municipality planning
WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when
the business is sold, business name has changed or you have moved the
business location. This receipt does not indicate that the business is legal or that
it is in compliance with State or local laws and regulations.
Mailing Address:
COAST TO COAST GARAGE DOOR Receipt #02C-17-00004307
10501 NW 50 ST #106 Paid 09/25/2018 27.00
SUNRISE, FL 33351
2018 -2019
Municipal Contractor's Tax Receipt
Miami—Dade County, State of Florida
THIS IS NOT A BILL — DO NOT PAY
CC NO: 17BS00060
BUSINESS NAME/LOCATION RECEIPT NO.
COAST TO COAST GARAGE DOOR LLC
DOING BUSINESS IN DADE COUNTY 7562921
EXPIRES
SEPTEMBER 30, 2019
OWNER TYPE OF BUSINESS
COAST TO COAST GARAGE DOOR LLC SPECIALTY BUILDING CONTRACTOR
C/O JEROME PAYNE
Restricted to City of Miami Shores
MIMIAM 11=1111E For more information, visit www.miamidade.novhaxcollector
Pursuant to County Code
Sec 10-24
PAYMENT RECEIVED
BY TAX COLLECTOR
37.50 02/20/2019
0229-19-004071
AC40R f CERTIFICATE OF LIABILITY
INSURANCEDATEIMWDDNM)
02/19/2019
THIS CERTIFICATE IS ISSUED AS A 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: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the
terms and Conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such sndorsement(s).
PRODUCER CONTAc
ROXANA LEE
ACCESS ADVANTAGE INSURANCE CORPORATION PM0NE FA%
5930 PEMBROKE ROAD EDMless: infill aaiCotp.Co.
HOLLYWOOD, FL 33423 INSURERISI AFFORDING COVERAGE NAIL H
INSURED
COAST TO COAST GARAGE DOOR LLC
10501 NW 50TH STREET, Suite #106
SUNRISE. FL 33351
INSURER A: SCOTTSDALE. INSURANCE COMPANY
IN5URER e
3NSURER C : - —
INSURER D :
INSURER E:
COVERAGES CERTIFICATE NUMBER- REVISION NUMBER -
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TERMS,
EXCLUSIONSAND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
EXp, ILTRTYPEOFINSURANCEitrigggIwvn. POLICY NUMBER (MMMQIYYYYI IMMADOIYYYYILIMITS
I GENERAL LiA61LITYEACHOCCURRENCEi. 1j $2, 0i< CJMMERCIALGENERALLIABILITYCOMMERCIAL
DAMAGE T{5 RENTED"--_
PREMISES(Caoccurronco),_ S IOD,Dii
CLAMS-MADE jw OCCURF
I
MED EXP (Anyone parson) I S 5.004
A i 1 CPS2911941 10129/2018 10129/2019 PERSONAL a ADV INJURY 1$2.000,000
l
I
i
GENERAL AGGREGATE I S 2.400,0010
j' _._._ _... _.........
PRODUCTS COMPIOPAGG € 5 2 40Q.000GEMLAGGREGA'DE LIMIT APPLIES PER,
POLICY Ic LOC
AUTOMOBILE LIABILITY COMBINED. SINGLE LIMIT
BODILY INJURY (Per person) SANYAUT,')
SCHEDULEDALLOVVNECF--
BOD':LY INJURY tear ad0caon$ AUTOS AUTOS
i PROS'ERTY DkAilaaEHIREDAUTOSiNON-O:bNEDAUTOS I ilPeS,3cutleng.__ ' _
g..
r
UMBRELLA U" OCCUR r r I
f '1
EACH OC C UrfRENCE SH. .-...._._... . .._....__......
EXCESS UAB CLAIMS -MADE AGGREGATE S
I `_.D RETENTION$ i 5
WORKERS COMPENSATION ViC STATU OTH..
AND EMWAYERT LIABILITY YIN
Y Lf MFS ER ......
IANYPROPRIETOR113r. NEWEXr-uT VE.."- i StlEACHACCIDENTOFFiGF,'MEM8FR EXCLUDED' NtA;:'
IMandatory in NH) I E.L. DISCASE - EA EMPLCYEC S
yes, desubs, undar
i i I l E DISEASE - POLICY LIMIT I S
DESCRiPTDON OF OPERATIONS I LOCATIONS I VEHICLES IAttaeh ACORD 101, Addhlonal Remarks SchodWe, N more space Is required)
Machinery or Equipment industrial installation, service or repair, Carpentry, Door, Window or Assembled Millwork installation metal, Fence Erection Contractors
Miami Shores Building Department
10050 NE 2nd Ave
Miami Shores, FL 33138
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
I
1988-2010 ACORD CORPORATION- All riahts ritgArvpcl_
ACORO 25 (2010/05) The ACORD name and logo are registered marks of ACORD
CisacAil.:
ACORN® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
2/20/2019
THIS CERTIFICATE IS ISSUED AS A 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: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER NAME: James Abelson
CONTACT
RTI Insurance Services of Florida, Inc. P""
6371 Business Blvd Suite 200 o . 941-487-4022 FAX No : 941-328-6711
E-MAILADDRESS: James@trustrti.comSarasotaFL34240
INSURERS AFFORDING COVERAGE NAIC A
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY
PRO
LOCECT
OTHER:
INSURER A: Florida Citrus, Business & 31259
INSURED COAST01
INSURER B
LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS
NON -OWNED
AUTOS
COAST TO COAST GARAGE DOOR, LLC
Jerome Payne INSURER C :
COMBINED SINGLE LIMIT $
Ea accident
INSURER 0:
BODILY INJURY (Per accident) $
PO Box 590929
Tamarac FL 33359 INSURER E:
INSURER F:
OCCUR
CLAIMS -MADE
COVERAGES CERTIFICATE NUMBER: 1008444877 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NRILTR TYPE OF INSURANCE
ADDL SUBR
POLICY NUMBER
POLICYEFFM
DIDY/
YYYY MM/DD1YLICYYYLIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE r_1 OCCUROCCUR
EACH OCCURRENCE $
DAMAGE TO RENTED
PREMISES Ea occurrence $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY
PRO
LOCECT
OTHER:
GENERAL AGGREGATE $
PRODUCTS -COMP/OPAGG $
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS
NON -OWNED
AUTOS
COMBINED SINGLE LIMIT $
Ea accident
BODILY INJURY (Per person) $
BODILY INJURY (Per accident) $
PROPERTY DAMAGE
er accidentP $
UMBRELLA LIAR
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE $
AGGREGATE $
DED I I RETENTION $
A WORKERS COMPENSATION
EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED? ElNIA
Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Y 1D652686 7/16/2018 7/16/2019 X PER ---------F--7H- 0TANDSTATUTE
E.L. EACH ACCIDENT $ 1,000,000
E.L. DISEASE - EA EMPLOYE $ 1,000,000
E.L. DISEASE - POLICY LIMIT $ 1,001),000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
License Number-17BS00060
IiCR I iri%,m 1 C rIVLUCR
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Miami Shore Building Department
10050 NE 2nd Ave
AUTHORIZED REPRESENTATIVEMiamiShoresFL33138--1> . ..,.___)
1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
GENERAL NOTES:
1) DESIGN AND CONSTRUCTION SHALL CONFORM TO THE FOLLOWING REQUIREMENTS:
FLORIDA BUILDING CODE (FBC) 6TH EDITION (2017)
ASCE 7-10
THE 2010 ALUMINUM DESIGN MANUAL
DESIGN WIND PRESSURES DERIVED FROM ASCE 7-10 AND PER FBC SECTION 1609
ULTIMATE WIND SPEED: 175 MPH
RISK CATEGORY: II
EXPOSURE CATEGORY: D
2) ALUMINUM MATERIAL: SHEET METAL IS 5052-H32 UNDER ASTM 8209, EXTRUSIONS ARE 6063-T5 UNDER
ASTM B221, STRUCTURAL IS 6061-T6 UNDER ASTM B211 WITH FTY=35KSI AND FTU=38KSI, UNLESS
OTHERWISE STATED. ALUMINUM WELDS WLL USE 5356 ALLOY WITH MINIMUM SHEAR STRENGTH OF
17KSI. ALL WELDING TO CONFORM TO AWS STANDARDS. ALL BOLTS AND SCREWS IN CONTACT WITH
ALUMINUM ARE STAINLESS STEEL A304/A316 GRADE STAINLESS STEEL.
3) STRUCTURAL STEEL SHAPES SHALL BE FABRICATED FROM THE FOLLOWING MATERIALS AND SHALL BE
GALVANIZED, UNLESS NOTED OTHERWISE:
PLATES AND BARS: ASTM A36, FY=36 KSI
ALL ROLLED STEEL: ASTM A36, FY=36 KSI
ALL SHAPES: ASTM A992
SQUARE AND RECTANGULAR SECTIONS: ASTM A500, GRADE B, FY=46 KSI
ALL ANCHOR RODS: ASTM A325
4) WHERE REQUIRED ALL FASTENERS TO BE #12 X 1-
1/2" OR GREATER 18-8 SERIES 300 NON-MAGNETIC
ALLOY, STAINLESS STEEL, OR CADMIUM PLATED OR OTHERWISE CORROSION RESISTANT MATERIAL AND
SHALL COMPLY WITH APPLICABLE CODES.
5) CONCRETE SHALL HAVE A MINIMUM COMPRESSIVE STRENGTH OF 3000 PSI AFTER 28 DAYS, CONCRETE
SHALL BE INSTALLED ON WELL COMPACTED SOIL TO OPTIMUM DENSITY.
6) INSULATE DISSIMILAR MATERIALS TO PREVENT ELECTROLYSIS.
7) SOIL BEARING CAPACITY FOR FOUNDATIONS: EXISTING, ASSUMED TO BE WELL COMPACTED AT 2000 PSF
8) ENGINEER HAS NOT VISITED THE JOB SITE AND SHALL NOT BE HELD RESPONSIBLE OR LIABLE IN
ANYWAY FOR ERRONEOUS OR INACCURATE DATA OR MEASUREMENTS THAT HAVE BEEN PROVIDED BY
THE CONTRACTOR. WORK SHALL BE FIELD VERIFIED BY THE CONTRACTOR AND THE ENGINEER SHALL BE
NOTIFIED OF ANY DISCREPANCIES PRIOR TO CONSTRUCTION.
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ONINO DEPT
DATE: 02/07/2019
DSGN: E. KENNEDY
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ONINO DEPT
DATE: 02/07/2019
DSGN: E. KENNEDY
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DNG. No.
1
of 1
MIAMaDIADE MIAMI-DADE COUNTY
04 IL110 PRODUCT CONTROL SECTION
11805 SW 26 Street, Room 208
DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) Miami, Florida 33175-2474
BOARD AND CODE ADMINISTRATION DIVISION T (786) 315-2590 F (786) 315-2599
NOTICE OF ACCEPTANCE (NOA) www.miamidade.¢ov/economy
DAB Door Company, Inc.
12195 NW 980 Avenue
Hialeah Gardens, FL 33018
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 RER-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. RER 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: Steel Roll -up Garage Door up to 22'-0" Wide with Optional I light@d Slajj • • • : •
APPROVAL DOCUMENT: Drawing No. 08-11 Rev C, titled "Rolling Type Garag@'1288e% sheets•]• • 0 0 0 0 :.
through 4 of 4, dated 12/26/2008 and last revised on OCT 11, 2017, prepared by Al-)•arooq'CorporatiUn, • •
signed and sealed by Javad Ahmad, P.E., bearing the Miami -Dade County Product 0A761aevis>:on Ainp • www
wwwwwwiththeNoticeofAcceptancenumberandexpirationdatebytheMiami -Dade County
Ow'
jQ4uct Control •
Section. 00.
000
MISSILE IMPACT RATING: Large and Small Missile Impact Resistant :90:0:
LABELING: A permanent label with the manufacturer's name or logo, manufactur9ng ad1ress, q a"o •
number, the positive and negative design pressure rating, indicate impact rated if apl!4q, b1C, instiIlat on 0 0 0 0
instruction drawing reference number, approval number (NOA), the applicable test standards, and $lig: •
statement reading `Miami -Dade County Product Control Approved' is to be located on the door's side track,
bottom angle, or inner surface of a panel.
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 Oficial.
This NOA revises NOA # 14-0814.06 and consists of this page 1 and evidence pages E-1, E-2 and E-3, as
well as approval document mentioned above.
The submitted documentation was reviewed by Ishaq I. Chanda, P.E.
NOA_No. 17-1010i
Expiration Date: November 04, 2019
Approval Date: December 14, 2017
Page 1
DAB Door Company, Inc.
NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED
1. Evidence submitted in previous files
A. DRAWINGS
1. Drawing No. 08-11, titled "Rolling Type Garage Door", sheets 1 through 4 of 4, dated
12/26/2008, with revision B dated 07/29/2014, prepared by Al-Farooq Corporation,
signed and sealed by Javad Ahmad, P.E.
B. TESTS "Submitted under NOA # 09-0916.01 "
1. Test reports on 1) Uniform Static Air Pressure Test, Loading per FBC, TAS 202-94
2) Forced Entry Test, per SFBC 3603.2,
Along with marked -up drawings and installation diagram of Flat Slat Rolling Doors,
prepared by Hurricane Engineering & Testing, Inc., Test Report No. HETI-08-2221,
dated 12/11/2008, signed and sealed by Candido F. Font, P.E. .
2. Test reports on 1) Large Missile Impact Test per FBC, TAS 201'-84r : ..
2) Cyclic Wind Pressure Loading per FBC, TA3 i!06-94 '..'
Along with marked -up drawings and installation diagram of 17110311 Rolling Doors,
prepared by Hurricane Engineering & Testing, Inc., Test Report No OHETC09 2222, 9 00
dated 12/11/2008, signed and sealed by Candido F. Font, P.E. ......
3. Test report on Tensile Test of 22 Gage Galvanized Steel per ASTU 49 8-01' Prtpared
by Hurricane Engineering & Testing, Inc, Test Report No. HETIV;T176, dated on
12/16/2008, signed and sealed by Candido F. Font, P.E. :...:.
C. CALCULATIONS
1. Structural and anchor calculations prepared by Al-Farooq Corporation, dated
07/28/2014, signed and sealed by Javad Ahmad, P.E.
Submitted under 1VOA # 09-0916.01 "
2. Calculations of Series 22' Rolling Steel Door, prepared by Al-Farooq Corporation,
dated 07/24/2009, signed and sealed by Arshad Viqar, P.E.
1sA- l . LL" -A-
isha 1. Chanda, P.E.
Product Control Examiner
NOA No. 17-1018.10
Expiration Date: November 04, 2019
Approval Date: December 14, 2017
E -1
DAB Door Company, Inc.
NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED
D. QUALITY ASSURANCE
1. Miami -Dade Department of Regulatory and Economic Resources (RER)
E. MATERIAL CERTIFICATIONS
1. Notice of Acceptance No. 14-0311.08, issued to Insulfoam, LLC, for their
Insulfoam Expanded Polystyrene Insulation, approved on 08/14/2014 and expiring on
11/29/2017.
2. Notice of Acceptance No. 11-0926.07, issued to Dyplast Products, LLC, for their
Expanded Polystyrene Block Type Insulation, approved on 11/10/2011 and expiring
on 01/11/2017.
3. Notice of Acceptance No. 11-0926.06, issued to Dyplast Products, LLC, for their
Dyplast ISO -C1 Polyisocyanurate Insulation, approved on 11/10/2011 and expiring on
01/11/2017.
4. Notice of Acceptance No. 10-1129.04, issued to Cellofoam Norf%A*rntrica tqc, or
their Expanded Polystyrene Block Insulation, approved on 02/24/-201.1• and
expiring on 02/24/2016. """ •
F. STATEMENTS '
1. Statement letter of code conformance to the 5th edition (2014) FW;1 no financial
interest issued by Al-Farooq Corporation, dated 07/25/2014, signed alid sealed&.
Javad Ahmad P.E. •
Isha(f 1. Chanda, P.E.
Product Control Examiner
NOA No. 17-1018.10
Expiration Date: November 04, 2019
Approval Date: December 14, 2017
E -2
DAB Door Company, Inc.
NOTICE OF ACCEPTANCE: EVIDENCE SUB
2. New Evidence submitted.
A. DRAWINGS
1. Drawing No. 08-11 Rev C, titled "Rolling Type Garage Door", sheets 1 through 4 of 4,
dated 12/26/2008 and last revised on OCT 11, 2017, prepared by Al-Farooq Corporation,
signed and sealed by Javad Ahmad, P.E.
Note: This revision consist of editorial changes to comply with FBC 2017.
B. CALCULATIONS
1. None
C. QUALITY ASSURANCE
1. Miami Dade Department of Regulatory and Economic Resources (RER).
D. MATERIAL CERTIFICATIONS
1. Notice of Acceptance No. 17-0221.06, issued to Insulfoam, LLC, for their6046
Insulfoam Expanded Polystyrene Insulation, expiring on 11/29/202f. ' 000* 000.0 0000..
2. Notice of Acceptance No. 16-1108.04, issued to Dyplast Products, LVC, for tbgit.Dyplast
ISO Polyisocyanurate Insulation, expiring on 01/11/2022.
0000'
3.
C1 0000..
Notice of Acceptance No. 15-1203.04, issued to Cellofoam North Arca Inc. for,,
their Expanded Polystyrene Block Insulation, expiring on 02/24/20N:00'
0000
0000..•
0000.•
0000..
E. STATEMENTS•
0000..
1. Statement letter of conformance to FBC 2014 (51h Edition) and FBC 2017 (6th rdititin),
prepared by Al Farooq Corporation, dated 10/11/17, signed and sealed0b Javad Ahmad,
0:
P.E. 0000
F. OTHER
1. This NOA revises NOA #14-0814.06, expiring 11/04/19.
11,.k. C. ,1,
Ishaq I. Chanda, P.E.
Product Control Examiner
NOA No. 17-1018.10
Expiration Date: November 04, 2019
Approval Date: December 14, 2017
E -2
TO
22 GA COLD FORMED STEEL. (ASTM A653)
MIN. YIELD STRENGTH OF 50000 PSI
GALVANIZED ACCORDING TO ASTM A-525
WITH A COATING DESIGNATION OF G-90
EXTERIOR AND INTERIOR
81S
2.430
2.986
L——
INSU D SST C0E` R
24 CA COLD FORMED STEEL
Q
1.750
188
687
j—
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WIND LOCK 'A'
HOT ROLLED STEEL ANGLE
O
0
B
m 2.062
jI
2.375-
7,
700 too
WIND LOCK 'B'
14 CA COLD FORMED GALV. STEEL
r -- A
GENERAL NOTES
L THIS PRODUCT EEpL f IGN D
III[[[JJJD TESTED TO COMPLY WITH THE
REQUIREMENTS pF TFiE OT4 (5T j 01 /•[017 tTH•EDTTIORrFLORIDA
BUILDING CODE•INCLUOING H H ffY URCAME 2ENE9(HVHZ).
2. ANCHORS SHALLOBE AS
ANCHOR EMBEDMEW O BWEOWEDWTWLAI•SH
LSF4kCEIbSH$ $
EYObd AILS
ALL
DRESSING OR WICCO. • • • • • • • • •
3. GUIDE AND WALL ANGLES SHALL CONFORM TO ASTM '0• ,4
4. ALL BOLTS, NRINpUfTTS AND
yWAASHERS
SHALL BE ZINC PLATED CARBON STEEL
5. ANCHTHESEODEfFYS_A/RE ND IT'•P>Q2T
OFCOND
IS•APPROR LI
0ITIOOTHER
THOi:.HOWN0
6. SLIDANDESHAW 111 /4'
DURING
INSTALL6p
NDEACH
l'BOifOM+
HV:t S • • •
7. ALL WELDINCa I COryL 2M TO AWS &TE@r RIGULATIO•S AND &B.4
USE E70XX CTRO S AND 39'1%0 FILLET SIZE. • •
PRODUC F REVWIE0
TM with H[ Fkd•
Antalu Luo l::-01 B •l C
I
MAXIMUM DESIGN LOAD RATING ;=:+ 60A`PSF
FOR SIZES SHOWN OR SMALLER)60.0PSF7
THIS PRODUCT IS RATED FOR LARGE MISSILE IMPACT
TE OF .•
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drawing no.
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METAL
WIND LOCK 'B'
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4' DIA. SEMI -1 BUUR
STEEL RIVETS
2/ LOCK WIND LOCK DETAIL
IN
LACK 'A'
ERY SLAT
0
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OPTIONAL INSULATIONS: 22 GA.
BY 'D acr PRO .TS I -'
22 GA RIPPED FLAT SLAT
ISO -25 POLY-ISOCYANURATE RIPPED FLAT SLAT
DENSITY - 20 PCF
N.OA 016-1108.04
2" X 3/16'
IOR '
RY
DENSITY
FO.
0 "
MEM 2" X 3/18"
STEEL BAR CONT.
I DENSITY 7.03 PCF STEEL BAR CONT. SLIDE LOCK
m
N.OA /15-1203.04 BY 'RDP'
O OR 3/8' X 1' CARRIAGE BOLT
INSLHY IIE=AM LI NE=AM LIN (2) 1/4" X2"
O 12" O.
C.
DENSITY - OA2 PCF CARRIAGE BOLT
N.OA /17-0221.06 D 3' O.
C.
tr 2" X 2" X 1/8"
I STEEL AN
8' LONG AT EACH END
W
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WEATHERSTRIPPING
WEATHERSTRIPPING
MLODUc F REVISED
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ides/'• -
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I Z' GUIDE ANCHOR SPACING - INCHES
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MINIMUM INTO 3000 PSI CONC. INTO 4000 PSI CONC.
MAXIMUM ANCHOR LOADS UPTO LOADS UPTO LOADS UPTO
DOOR WIDTH EMBEDMENT60 PSF 50 PSF 60 PSF
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18 FT.
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7 10 8
dN6 1/2' MIN. <
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AND 10' O.
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GROUND SQUARE)
AT 5' FROM EACH END
AND 10" O.
C. MAX.
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A
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Z' GUIDE DETAIL 1/2' X 3/16' WINDLOCK BAR
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MAXIMUM SLIP
DOOR WIDTH INCHES
UPTO 14 FT. 1/2
18 FT. 5/8
22 FT. 3 4
BOLT OPTION,
5/8' DIA MACHINE BOLTS (ASTM A449)
TAPPED IN 1/4' MIN. STEEL
MAXIMUM ANCHOR SPACING -INCHES
DOOR WIDTH UPTO 40 PSF UPTO 50 PSF UPTO BO PSF
UPf0 1
18
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22 FT. 10 6 6.
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WFin OPTION:
GUIDE ANGLE SECURED TO
MIN. 1/4' THICK STEEL STRUCTURE
WITH 3/16' WELDS
AT 5" FROM BOTTOM AND 10' O.
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SEE SCH. FOR WELD LENGTS
MAXIMUM WELD LENGTHS
DOOR WIDTH UPTO 40 PSF UPTO SO PSF UPTO OPSFUPTO
14 FT. 1' 1'
18FT.'1-1 8"122
FT. 1-1 8' 1-1 4" 1
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WITH WASHER AND FLANGED NUT
AT 4' FROM BOTTOM & 10. O.
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4) AT 2. O.
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AT TOP OF TRACK
ADDmONAL
3-1/2' X 3-1/2" X 1/4'
STEEL ANGLE
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FFOORCES ON GUIDE FT.
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DOOR WIDTH SIGN SHEAR ION SHEAR SKkI SHEAR
PTi {BFT. 293 101 7 13633 440 1702
184 T. 3'* S 7 19 56 418
22 439 2024 567 253 88 43
WFin OPTION:
GUIDE ANGLE SECURED TO
MIN. 1/4' THICK STEEL STRUCTURE
WITH 3/16' WELDS
AT 5" FROM BOTTOM AND 10'
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SEE SCH. FOR WELD LENGTS
MAXIMUM
WELD LENGTHS
DOOR WIDTH
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18FT.'1-1 8"
122FT. 1-1 8' 1-1 4" 1
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AT 4' FROM BOTTOM & 10.
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4) AT 2.
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MAXIMUM ANCHOR LOADS UPTO LOADS UPiO LOADS UPiO LOADS UPTO LOADS UPTO LOADS UPTO
DOOR WIDTH EMBEDMENT 40 PSF 50 PSF 60 PSF 40 PSF 50 PSF 60 PSF
UPTO a Fr. 10 10 10 10 10 10
18 FT.
22 FT.
5.
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7.
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5