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967 NE 99 St (15)RINALDO CRUZ ?3P 01. PERMIT APPLICATION FOR MIAMI SHOR DatenAS C a I Job Address 967 N.E. 99 STREET Tax Folio 113206 - 034 -0270 I PArE33 Legg Description 1 /2 21 & 22 BLOCK 170 S EC T 8 PB 14 Historically Designated: Yes r No X Owner/Lessee /Tenant GEORGE E. LEVASSER Owner's Address 967 N.E. 99 STREET MIAMI, FL 33138 -2568 Contracting Co. Qualifier RINALDO CRUZ Address Master Permit # Phone ri5 -756 -6 SS# 265 - 74 - 2184 Phone 305 -226 -8155 Ins. Co. AUDUBON INDEMNI SUK LUS L 1 NI- 9 c 5 � p ( 2 /N.Lea. tk A t s g , AddreSS � l � ¥ 5 \ ‘4 S GU—de-7° KA Uti .(( �• 3 O-r - bet. t '3a 3 8 c - 3 o J 2®f Za 08 3 3 (6 1 Bonding Company Address Mortgagor OP 4 Address Permit Type (circle on ): ELECTRICAL PLUMBING MECHANICAIr ROOFING PAVING FENCE SIGN State # Architect/Engineer CGC005042 WORK DESCRIPTION DEN /EXCERCISE ADDITION Square Ft. 3 2 3. 57 Municipal# 422397 -0 Competency # Estimated Cost (value) $ WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the st ti • • iction. I understand that separate permits are required for ELECTRICAL, PLUMB pU ee. O CECAIA A * COMMISSION! NUMBER CCa94958 4' MY COMMISSION EXPIRES O F FAO u• V.28 2003 ature of Contractor or Owner -B ' • er OWNER'S AFFIDAVIT: I certify that all the foregoing info laws regulating construction and zoning. Furthermore, I authorize the a . ove- •. ork stated. ,. e CF: Signature-of ier en Date Notary as to Owner My Commission Expir . FEES: PERMIT RADON C.C.F. APPROVED: P6t+ a t i�,, ) w C pry SeexS + �� o Zoning 7 c rn F F wilding Mechanical if �' ' l ) / / Z ' . v i Plumbing Notary as to Contractor or Owner- My Commission Expires: NOTARY 11kay • CEOUA A SAA7BAC �^ * COMMISSION NUMBER OFROAL NOTARY y� CC884958 OF F` „4". MY COMMISSION EXPIRES .,,,,• 2$,20.R$ c oq / 4111 VILLAGE 5 10329 -1 N.W. 95 STREET CIRCLE FL 33172 in compliance with all applicable ilder BOND TOTAL DUE 2 ' a ce -- 3 ©Q. 044/ Date � Date i Electricall A42 n a t e rl 7)�z H /2010 / En �/ -e 17 S -0 i"kCIN MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Type Insp'n Permit Name V ���L1ZJlJ Address, Company Phone # For Inspector Approved ectio Re- Insp'n Fee ' • ��[ O3, Name & Date S sePC/14( W-13 ay to the (Mgr of .Ow Ivtsalau BMW Air 1:066009 L 5 51: O HARLAND J1aq In Or (l rtlrr of iworiuBANcNORTH MIAMI BRANCH 035 12411 Biscayne Boulevard rwt .elww North Miami, FL 33181 -2520 0 HARUND GEORGE E. LEVASSER CONNIE V. LEVASSER PH. 305 - 756-6395 967 NE 99TH STREET MIAMI SHORES, FL 33138 .SHORES VILLAGE I $ 957 FO ri Security ICS O � nllara Offil Features Details on / • 1 ^ T NORTH MIAMI BRANCH 035 12411 Biscayne Boulevard North Miami, FL 33181 -2520 GEORGE E. LEVASSER CONNIE V. LEVASSER PH. 305 - 756 -6395 967 NE 99TH STREET MIAMI SHORES, FL 33138 3 500 137 2006 LOOS ifrnrala 1:066009 15 5I: 3 500 13? 20'06 L004 63- 915/660 1 / —t / Bat? BRANCH 035 / Z — //— d1 Date 0 0 O l7 1005 63- 915/660 BRANCH 035 PRESTIGE 1004 $ 3o o. 00 � i " . ' r ' nllara PRESTIGE 4 Copy cf STAZE OF FLORIDA Cam'*= ZCATICN meER) AND DADE C) XJNTY CC iPEg, ICY LI V / Copy of current OCCUPATIONAL LICENSE from county or n _c_: ai t-/ .where « iness is 'located. - J Ch Certificate of Insurance for V il l a ge ). EUIL3 (G AiNn :cN :NG 100 N. N. 2 " Alf- 7 '.rr (3051 __C: TA. X: ''"` 7=z-=c77 EUIIDING RHIT /ENT' AC/CR$ RMISIc TTC'{ C^ tS LIABILITY (add_-es_` to • Miami Shc =es Certificate of Insurance for WORKER'S COMP (address& t- mi amp ShoresVillage) or if exempt /7 of Florida LES Form BCf -204, Const =ion Election to be Exempt. PLE'AS'E SUBMIT WERXTBING f'4FT" D OFF ent survey of the propel. (4.fL6k.ApA Certtificate of Elevation signed and sealed by Surveyor. Substantial Throvements CheCkli.st (contractor or owner) . . Four sets 9 /Two sets of DADE County v en s, wi losu res, :ndustr / Notice of Permit Application (signed by-person performing the work, licensed =tractor and the property owner, both signatures notarized). TWo sets of plans /dryings signed and sealed by registered architect or engineer. Occupancies by Group Classification must be on plans and permit application. All plans must include folio number and property address.. Amended plans, in addition to the above, must also include the 't number. Structural Calculations signed and sealed by _d or engineer when applicable. of energy calculations, signed and sealed signed a sealed Truss Plans (Engir.e --) . or State of Florida Products Apvrova s for roof mortar l s, exterior /garage doors, aluminum carports, screen shutters awnings, skylights, french doors and etc. Notice of Commencement ciou qcf &Yaw, JI ' a?s, Approvals from HRS, DADE County Impact Fee Section, Fire Department a Health Department (when applicable). DERM Warranty Deed or Other Proof of Ownership if Strut. dl Review fee 15:00 nces1 d ... MIAMI -DADE MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING PRODUCT CONTROL NOTICE OF ACCEPTANCE PGT Industries 1070 Technology Drive Nokomis FL 34274 CONTRACTOR ENFORCEMENT SECTION (305) 375 -2966 FAX (305) 375 -2908 PRODUCT CONTROL DIVISION Your application for Product Approval of: (305) 375 -2902 FAX (305) 372 -6339 Series PW 701 Aluminum Fixed Window - Impact Resistant (7/16" Laminated) under Chapter 8 of the Code of Miami -Dade County governing the use of Alternate Materials and Types of Construction, and completely described herein, has been recommended for acceptance by the Miami -Dade County Building Code Compliance Office (BCCO) under the conditions specified herein. This approval shall not be valid after the expiration date stated below. BCCO reserves the right to secure this product or material at anytime from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner, BCCO may revoke, modify, or suspend the use of such product or material immediately. BCCO reserves the right to revoke this approval, if it is determined BCCO that this product or material fails to meet the requirements of the South Florida Building Code. The expense of such testing will be incurred by the manufacturer. Acceptance No.: 99- 0218.01 Expires: 05 /20/2002 Approved: 05 /20/1999 Internet mail address: postmaster @buildingcodeonline.com BUILDING CODE COMPLIANCE OFFICE METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 CONTRACTOR LICENSING SECTION (305) 375-2527 FAX (305) 375 -2558 Raul Rodriguez Chief Product Control Division THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS BUILDING CODE & PRODUCT REVIEW COMMITTEE This application for Product Approval has been reviewed by the BCCO and approved by the Building Code and Product Review Committee to be used in Dade County, Florida under the conditions set forth above. rancisco Quintana, R.A. Director 1 of 3 Miami -Dade County Building Code Compliance Office Homepage: http : / /www.buildingcodeonline.com Owzm, PGT Industries ACCEPTANCE No.: 99- 0218.01 APPROVED MAY 2 0 1999 innovative EXPIRES MAY 2 0 2002 NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS 1. SCOPE 1.1 This approves an aluminum fixed window, as described in Section 2 of this Notice of Acceptance, designed to comply with the South Florida Building Code (SFBC), 1994 Edition for Miami -Dade County, for the locations where the pressure requirements, as determined by SFBC Chapter 23, do not exceed the Design Pressure Rating values indicated in the approved drawings. 2. PRODUCT DESCRIPTION 2.1 The Series PW 701 Aluminum Fixed Window - Impact Resistant and its components shall be constructed in strict compliance with the following documents: Drawing No 4214, titled "Impact Picture Window (0)" Sheets 1 through 4 of 4 dated 2/16/98, revised on 1/29/99, signed and sealed by Robert L. Clark, 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 Division. These documents shall hereinafter be referred to as the approved drawings. 3. LIMITATIONS 3.1 This approval applies to single unit applications only, as shown in approved drawings. 4. INSTALLATION 4.1 The aluminum fixed window and its components shall be installed in strict compliance with the approved drawings. 4.2 Hurricane protection system (shutters): the installation of this unit will not require a hurricane protection system. 5. LABELING 5.1 Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ". 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance 6.1.2 Duplicate copies of the approved drawings, as identified in Section 2 of this Notice of Acceptance, clearly marked to show the components selected for the proposed installation. 6.1.3 Any other documents required by the Building Official or the South Florida Building Code (SFBC) in order to properly evaluate the installation of this system. 2 of 3 Manuel ' erez, P.E. Product C Ol Examiner Product _ of Division PGT Industries ACCEPTANCE No.: 99- 0218.01 MAY 2 0 1999 EXPIRES MAY 2 0 2002 APPROVED NOTICE OF ACCEPTANCE: STANDARD CONDITIONS 1. Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and the original submitted documentation, including test supporting data, engineering documents, are no older than eight (8) years. 2. Any and all approved products shall be permanently labeled with the manufacturer's name, city, state, and the following statement: "Miami -Dade County Product Control Approved ", or as specifically stated in the specific conditions of this Acceptance. 3. Renewals of Acceptance will not be considered if: a) There has been a change in the South Florida Building Code affecting the evaluation of this product and the product is not in compliance with the code changes; b) The product is no longer the same product (identical) as the one originally approved; c) If the Acceptance holder has not complied with all the requirements of this acceptance, including the correct installation of the product; d) The engineer who originally prepared, signed and sealed the required documentation initially submitted is no longer practicing the engineering profession. 4. Any revision or change in the materials, use, and/or manufacture of the product or process shall automatically be cause for termination of this Acceptance, unless prior written approval has been requested (through the filing of a revision application with appropriate fee) and granted by this office. 5. Any of the following shall also be grounds for removal of this Acceptance: a) Unsatisfactory performance of this product or process. b) Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any other purpose. 6. The Notice of Acceptance 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 Notice of Acceptance is displayed, then it shall be done in its entirety. 7. A copy of this Acceptance as well as approved drawings and other documents, where it applies, .shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at all time. The engineer need not reseal the copies. 8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of Acceptance. 9. This Notice of Acceptance consists of pages 1, 2 and this last page 3. Manuel ' erez, P.E. Product Co Examiner Produc _ ' trol Division - END OF THIS ACCEPTANCE 3 of 3 96.000 MAX. 6.250 h m- 1 7.750 MAX. ON CENTER 48.000 MAX. 4 r 16.500 MAX. ON CENTER 6.750 zr Revision Material: Drawn Br D.B. RMeed BY D.B. Vendor No., LARGE MISSLE MPACT WINDOWS 1.) GLAZING: 7/16 (.454) LAMINATED W /INTERLAYER (.3/16" HS /.090 FILM /3/16" HS) 2.) CONFIGURATIONS: 0 3.) DESIGN PRESSURE RATING: +90 P.S.F., —90 P.S.F. 4.) ANCHORS: MAX. 6 1/4" FROM EACH CORNER (HEAD & SILL) MAX. 6 3/4" FROM EACH CORNER (JAMBS) MAX. SPACING AT HEAD & SILL: 17 3/4" MAX. SPACING AT JAMBS: 16.500" 5.) SHUTTER REQUIREMENT: NO SHUTTERS REQUIRED . 5.) REFERENCE TEST REPORT: FTL -1971 Date: 2/16/98 1/29/99 scale: N.T. Classification: °emlptIon: I �PEr Mdroor P.O. BOX 1529 NOKOMIS, FL. 34274 Arnovuo ES COmPLYINC WTr2. rrif EOUTR ROM A DUfLDINC CODE EY EullD.t:C C?: COmr.,;;;cZ OFE:CE accEF:a+rt, s:. c- -C1.- 0 2.1 8 • / 1 ' progressi CLASStechno/ogy `senoa /Model: 70 Item: S oet 1 1 ELEV. IMPACT PICTURE WINDOW. (.0). Sae: B °raring Na.: 421 " R ITEM DESCRIPTION 2 3 Frame Head & Sill Frame Jambs .688 x .500 Channel Glaz. Bead Seam Sealer Closed Cell Foam To.e Silicon Back bedding 7/16" _(.454) W /MONSANTO INTERLAYER 7/16" 6454) W/DUPONT INTERLAYER 4 5 6 ; x 1.000 Ph. Pn. SMS 7 8 9 10 ; 6 x .875 Ph. Fl. Self —ta V.T.{ 612241 612242 6533402 6SM55W 61308 62899C QTY. /LOCATION 1 VENDOR 1 ea. 2 4 4 between bead & .lass 1 Alumax Alumax Alumax Schnee — Morehead Stik — II Merchants Fasteners Dow Corning H.P.G. H.P.G. AF -12241 AF -12242 AF- 533402 SM5504 1308 899 7PWSW Bead screws. 2 1 2" from end 20" centers Fostec Revision Material: Dram 6y D.B. Revised er D.B. Vendor No.: bow: 2/16/98 1%29/99 Scale . T.S. APPROVED IS COMPLYING WITH THE SOUTH PyRIDA BUILDING CODE DA.T �/� ]'.O - PRODU TRW DIV S UN ' 4 BLRLDING CODE L:A CO'APBCE OFFICE ACCEPTANCE N0. IeS0 T�TITt TT TT'1 lv TT 9 CLASS progressive technology Classification: Prod. Colgan. I se;ea /M °70 I Rem: sheet: 2 al 4 Description: PICTURE WINDOW .. -. "' P.O. BOX 1529 sire: Drawing No.: Rer.: NOKOMIS, FL. 34274 B 4214 A VENDOR NO. 2.784 .437 1 7/16" (.454) W /MONSANTO INTERLAYER 7/16" (.454) W /DUPONT INTERLAYER /1 Z7 Revisions. Material•. brawn 8y D.B. Revised By D.B. Vendor No.: Doie: 2/16/98 1/29/99 Seale: N.T.S Classification Description: Yod. CaPw P.O. BOX 1529 51 e NOKOMIS, FL. 34274 8 APPROVED AS COMPLYING WITH THE SOUTH FLORIDA BUILDING CODE PBYP.00Lfrrii447 all DA BUILDING CODE COrIPL_.NCE FICE ACCEPTA:CE ND. 1 l - R 21 o f T' ^ C r ■ ro ressive LA r` techno /o gy s...a,w ro.p My Senn /Model: Item: 701 SECTS. Drawing No.: Sheet SECTION VIEWS - HORIZ. & VERT 4214 3 of 1/4" TAPCON .250 MAX. 1.250 4 •a 4 .4 • a 1 x WOOD BUCK TYP. HEAD. SILL JAMB 4 d. 4 #12 PANHEAD 1.250 �- - .250 --"- r--- MAX. TYP. HEAD, SILL JAMB Rev'sIons: tlatedal: er D.B. R"f"d BY D.B. Vendor No.: 2/16/98 Data: 1/29/99 4 2 x WOOD BUCK ' LASS technology ttwrr. tarp wnr.. awwr • or. a. w Classification: r'`1317 TYP. PICTURE WINDOW ANCHORAGE ate: Add... P.O. BOX 1529 N.T.S. NOKOMIS, FL. 34274 B APPROVED AS COMPLYING WITH THE SOUTH •RIDA BUILOING CODE BY DA � 1ri •• � �1��� PROD T C VERDI DIY.$ ON BUIL CODE COMPL;ANCE 0 ACCEPTANCE NG 9 9 — 021 ` 6 OI Rem: ANCH. 4 014 °towing No. !Rev, 4214 A • TIE UNDERSIGNED 11ee4y gives mod= dist i ap:ovens=wt1I 6e grade to =tin mai property, and is ac=rdanc with Gupta 7I3, Florida Stamm; the tbIlowing information is provided is this Natia of Conaaenc czi>+ (A) Real property to be as avid; I- Add; i= • 967 N.E. 99 STREET MIAFII, FL 33138 - 2568 2. Logs! Description; RES I DEICE . axo:dalg to she plat dtaaof as recorded is Plat Boss • ( 3 ) General d e s c i p t i e n of l m p r o v e r a e a > ; SINGLE FAMILY RESIDEiatt E /AD I TI ON cite pabiie records of Dade C3cn ey; rsoces • • (D) t. Ovraet: GEORGE E. LEVASSER Co' CLERK 2. Iaterest of O w n e r I n s i t e of smprove==c S WILE TITLE: MLDA 3. Name and address of too sfnipto titteitolde:; Ifottlerti:aa Owner: NONE CoatraC°: RI NALDO .CRUZ • S OF FLORIDA, COUNTY OF D ti N egA rn daddi tesur'GyaIIpay'�ni (SC i0aM23 rs'ce3. YCEi ∎'7iFY!i :aithis isatrue co PYO ( e • .Statutes) sad tie ama>z:ttof sae'sbaad, nor NGNE . original hied in This on _ of • wrrnfESS r> y � ;6t Seal. • HARV Y r; ; +' t' #=`K ,:' rucU ;l :arr.! CnunlvCO(Irls By th . _ p �• • Larder: NQNE • • (G) Na ase sad address of per=oa within Florida. other thaa.Owng, ttpoa whom adds= may be saved to =v1= . Spots Owners NONE.. • : • . Ee�oa is addldcn to Owna.de i8natsd to naive a copy of Bator'3 nods (Section 7t3.I3(I)(b), Florida Statutes): (I) . E a date end= of•Ca:a is ea:O tfan date is two (2) years from date of reeordag. e_ - GEORGEK. LEVASSER STATE OF FLORIDA trOT Y PiJEr C My cr=ssicn N O T I C E OF CO , ♦Czry n.' T. , • • 1R626474 2001 NOV 14 14 :45 .• • The f u r . g stunt was a c awiedgd befor_ me this l ?k TH DAY, OP. NOVEMBER, 200 1 BY GEORGE Is, LEVAS S AN INDIVIDUAL. te '- '.is pesserally to me Or has ► ° — .. _ on and did (did nog - o � P gv Pt,_ OFFICIAL IIUA A � * COMMISSION NUMBER • 4 -;i7c.^ Q CC884958 "?0, � .. � O c MY COMMISSION EXPIRES O F W NOV. V. 28.2003 C hLCCi'vk't, : l. �� +3�' ��C✓ miam> >nnrp.� I./Vg -IL . B4. MAP AND PANEL NUMBER 120652 0093 B5. SUFFIX J B6. FIRM INDEX DATE 7 -17 -95 B7. FIRM PANEL EFFECTIVE/REVISED DATE 3 -02 -94 B8. FLOOD ZONE(S) X B9. BASE FLOOD ELEVATION(S) (Zone AO, use depth of flooding) Area of 100yr -500yr OLIO # C.0.11. 9.87' For Insurance Company Use: Policy Number Company NAIC Number BUILDING OWNER'S NAME GEORGE E. LE VASSER BUILDING STREET ADDRESS (Including Apt., Unit, Suite. and /or Bldg. No.) OR P.O. ROUTE AND BOX NO. 967 NE 99th Street CITY iami Shores, PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) E 1/2 of Lot 21, all of Lot 22,Block 170 of SECTION NO A OF MTAMT SHfRRS,PR 14 -33 BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use Comments section if necessary.) LATITUDE/LONGITUDE (OPTIONAL) ( fie - ##' - ##.##" or ##.##### °) SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER I B2. COUNTY NAME Miam -Dade B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. 1_1 FIS Profile IX I FIRM LJ Community Determined IJ Other (Describe): 811. Indicate the elevation datum used for the BFE in B9: Ix NGVD 1929 LJ NAVD 1988 I_J Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? LJ Yes jr_ J No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 1_1Construction Drawings' IJBuilding Under Construction* LEjFinished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations — Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/AO Complete Items C3a -i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area-of Section D or Section G, as appropriate, to document the datum conversion. Datum 19 2 9 Conversion/Comments _ Elevation reference mark used MDC B -50 Does the elevation reference mark used appear on the FIRM? 1J Yes j1 No 11 . 06R(c:* ❑ a) Top of bottom floor (including basement or enclosure) O b) Top of next higher floor O c) Bottom of iowest horizontal structural member (V zones only) ❑ d) Attached garage (top of slab) O e) Lowest elevation of machinery and/or equipment servicing the building O f) Lowest adjacent grade (LAG) O g) Highest adjacent grade (HAG) N/A . — ft.(m) 8 4 f o,5 10 0 Mal ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N/A ❑ i) Total area of all permanent openings (flood vents) in C3h N/A sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER pSM 1683 TITLE ADDRESS SIGNATURE FEMA Form 81 -31, AUG 99 HOWARD C. GAMBLE Vice President 620 N FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE 10 10 26 Igo.; 1 W a N/A ft(m) N/A SEE REVERSE SIDE FOR CONTINUATION g ZN O.M.B. No. 3067 -0077 Expires July 31, 2002 Important: Read the instructions on pages 1 - 7; ENDED BY MDC - DERM - OCT.1999 SECTION A - PROPERTY OWNER INFORMATION STATE ZIP CODE Florida B3. STATE I FL 33138 HORIZONTAL DATUM: SOURCE: Li GPS (Type): LJ NAD 1927 LJ NAD 1983 LJ USGS Quad Map . IJ Other: ooa Plain COMPANY NAME A,R.TOUSSAINT & ASSOCIATES, INC, CITY STATE ZIP CODE 33161 North Miami F DATE Oct. 16, 2001 TELEPHONE (3 05) 891 -7340 REPLACES ALL PREVIOUS EDITIONS IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number 967 NE 99th Street CITY STATE P CODE Company NAIC Number 1 Miam Shores Florida 338 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F, Section C must be completed. El. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed – see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is I -1 -1 ft.(m) I_I_Iin.(cm) LJ above or 1_1 below (check one) the highest adjacent grade. E3. For Building Diagrams 6 -8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is LLI ft.(m) 1— Llin.(cm) above the highest adjacent grade. E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? 1 Yes 11 No 1 I Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, 8, and E for Zone A (without a FEMA- issued or community- issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS . CITY STATE ZIP CODE SIGNATURE COMMENTS G4. PERMIT NUMBER COMMUNITY NAME SIGNATURE COMMENTS FEMA Form 81 -31, AUG 99 DATE TELEPHONE SECTION G - COMMUNITY INFORMATION (OPTIONAL) I_I Check•here if attachments 1 —I Check here if attachments The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. IL The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. 1L A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or ZOna G3. LJ The following information (Items G4-G9) is provided for community floodplain management purposes. G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This perrnit has been issued for LJ New Construction IL Substantia Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: G9. BFE or (in Zone AO) depth of flooding at the building site is: LOCAL OFFICIAL'S NAME TITLE TELEPHONE DATE ft.(m) Datum: . ft.(m) Datum: II Check here if attachments REPLACES ALL PREVIOUS EDITIONS C.O.R. 9.87' BUILDING OWNER'S NAME GEORGE E. LE VASSER BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and /or Bldg. No.) OR P.O. ROUTE AND BOX NO. 967 NE 99th Street CITY Miami Shores, PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) E 1/2 of Lot 21, all of Lot 22,Block 170 of SRC.TTON NO R OF MTAMT SRORFS.PR BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use Comments section if necessary.) LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: ' SOURCE LJ GPS (Type): ( #!>° - ## - ##./kr or ##.###/t#°) LJ NAD 1927 LJ NAD 1983 U USGS Quad Map LJ Other. B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER 182. COUNTY NAME Miami Shores 1 20652 1 Miami -Dade O i) Total area of all permanent openings (flood vents) in C3h N/A sq. in. (sq. cm) CERTIFIER'S NAME TITLE ADDRESS SIGNATURE FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - AMENDED BY MDC-DERM -OCT. SECTION A - PROPERTY OWNER INFORMATION STATE Florida SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION HOWARD C. GAMBLE Vice President 620 D c t. 16. 2 0(1 O.M.B. No. 3067 -0077 Expires July 31, 2002 For Insurance Company Use: Policy Number Company NAIC Number B3. STATE FL ZIP CODE 33138 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. LJ FIS Profile 125_, FIRM L Community Determined LJ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: Lx J NGVD 1929 LJ NAVD 1988 LJ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Lj Yes j j No Designation Date: LJ Yes This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, 8 and C on this certificate represents my best efforts to interpret the data available. I understand that an false statement ma be . unishable b fine or im risonment under 18 U.S. Code, Section 1001. LICENSE NUMBER PSM 1683 DATE TELEPHONE t'30 5 R 91 1z B4. MAP AND PANEL NUMBER 120652 0093 -B5. SUFFIX J 86. FIRM INDEX DATE 7 -17 -95 B7. FIRM PANEL EFFECTIVE/REVISED DATE 3 -02 -94 B8. FLOOD ZONE(S) X y 89. BASE FLOOD ELEVATIONS (Zone AO, use depth of flooding) rea of 100yr -500 Flood Plain SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: LJConstrudion Drawings' 1,_ _pudding Under Construction* L Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed - se( pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations — Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/A0 Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area•of Section D or Section G, as appropriate, to document the datum conversion Datum 1929 Conversion/Comnients Elevation reference mark used MDC B -50 Does the elevation reference mark used appear on the FIRM? O a) Top of bottom floor (induding basement or enclosure) 11 . 06RQ4 O b) Top of next higher floor N/A ft( . ct l O c) Bottom of lowest horizontal structural member (V zones only) N/A . fL(m) l i : C.. o O d) Attached garage (top of slab) 10 .26 t>CQe4 - ; N O e) Lowest elevation of machinery and/or equipment W al . • servicing the building N/A . R(m) 8 O f) Lowest adjacent grade (LAG) 8 .4 ft. s b el .-4 �z.Q O g) Highest adjacent grade (HAG) 10 .0 ft.l# l' 3.4 a" al a O h) No. of permanent openings (flood vents) within 1 R above adjacent grade N/A o o 0 ej No COMPANY NAME A•R.TOUSSAINT & ASSOCIATES, INC. . CRY North Miami STATE F ZIP CODE 33161 BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 967 NE 99th Street CITY STATE CODE M Shores Florida 33 Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVES NAME SIGNATURE COMMENTS G4. PERMIT NUMBER LOCAL OFFICIAL'S NAME COMMUNITY NAME SIGNATURE COMMENTS Policy Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) SECTION G - COMMUNITY INFORMATION (OPTIONAL) G5. DATE PERMIT ISSUED TITLE DATE Company NAIC Number I_ Check here if attachment SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F, Section C must be completed. ' El. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed — see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is I I 1 ft.(m) _1 I _I above or 1 below (check one) the highest adjacent grade. E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is 1 I 1 ft.(m) 1 I lift(cm) above the highest adjacent grade. E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? 1_.1 Yes 11 No 1_1 Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA - issued or community- issued BFE) or Zone AO must sign here. ADDRESS CITY STATE ZIP CODE DATE TELEPHONE (_I Check here if attachments The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. (J The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. LJ A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zc. ne3 M.% G3. 1J The following information (Items G4-G9) is provided for community floodplain management purposes. G6. DATE CERTIFICATE OF COMPUANCE/OCCUPANCY ISSUED G7. This permit has been issued for 1J New Construction L Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: ft.(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: . ft.(m) Datum: TELEPHONE 1I Check here if attachments FEMA Form 81 -31, AUG 99 REPLACES ALL PREVIOUS EDITIONS APPLICANT: PROPERTY STREET ADDRESS: LOT: 1 , � ; 2 , BLOCK: PROPERTY ID #: SYSTEM DESIGN AND SPECIFICATIONS T A N D R A I N F I E L D FILL 0 T H E• R a ) [GALLONS) ) [GALLONS ] GALLONS LOCATION OF BENCHMARK: I( m ELEVATION OF PROPOSED SYSTEM BOTTOM OF DRAINFIELD TO BE [ REQUIRED: S!f'ECIFICATIONS BY: APPROVED BY: DATE ISSUED: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & CONSTRUCTION PERMIT FOR: [PI] New System [ (] Existing System [ -)] Repair [ pi] Abandonment (f '7 t/ .' 7 :) SUBDIVISION: s (; 4 .1 a « [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS• AND STANDARDS OF CHAPTER 10D -6, FAC. REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. DEPARTMENT OF HEALTH APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. / GPD](SEPTIC TANK' AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:( ] / GPD] ° °"" CAPACITY MULTI- CHAMBERED /IN SERIES:( ) GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS) K [ .__ 1 GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ) [ -' ' ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM I [ _ ] SQUARE FEET TYPE SYSTEM: CONFIGURATION: SYSTEM [•-'] STANDARD [ ],FILLED [ ) TRENCH [ 4 BED INCHES S ITE [ l y] [0CHES%FT1 [ABOVE[BEL0WJ BENCHMAR /REFE E.. PO1Nt) A r� ] [IUCHESIFT ] [ABOVE( /BELOW ]4 BENCHMARK /REFERENCE POINT,- DM 4016, 10/96 (Replaces HRS -H Form 4016 [page 1) which may be used) (Stock Number: 5744 -001 - 4016 -0) t W] Holding Tank [ t ] Temporary /Experimental [ /',] Other(Specify) � ' i EXCAVATION REQUIRED: [,1,)'$ INCHES TITLE: Applicant Chapter 10D -6, FAC AGENT: e PERMIT # DATE PAID FEE PAID $ RECEIPT # ] MOUND [ ] ] JK� ,r_. L• lil1�� AJ OI -33� C: ( L O W , 1C `ihipt TITLE : C;;,' i'lalll' ' Net ?: EXPIRATION DATE: is CHD Page 1 of 2 INSTRUCTIONS: PERMIT NUMBER: Permit tracking number by County Health Department. APPLICATION FOR: Check type of permit; if "Other" specify type in blank. APPLICANT: Property owner's full name. TELEPHONE: Telephone number for applicant or agent. AGENT: Property owner's legally authorized representative. MAILING ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION or PROPERTY ID #: 27 character ID number for property. (Health Department may require property appraiser ID# or section /township /range /parcel number.) SYSTEM DESIGN AND SPECIFICATIONS: TANK: Minimum specifications from Chapter 10D -6, FAC. DRAINFIELD: Minimum specifications from Chapter IOD -6, FAC. OTHER: Other specifications, such as operating permit requirements, low- volume flush toilets, variance provisos. SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed. APPROVED BY: County Health Department personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by County Health Department. EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the date issued. CONSTRUCTION PERMIT FOR: [`'] New System ['i] Existing System ((" �] Repair ( '] Abandonment APPLICANT: PROPERTY STREET ADDRESS: LOT: PROPERTY ID 1: SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6, FAC. REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. DEPARTMENT OF HEALTH APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. SYSTEM DESIGN AND SPECIFICATIONS T A [ N [ K [ D ( ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM R ( ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ -'] STANDARD [ ] FILLED ( ] MOUND [ ] I CONFIGURATION: ( 1 TRENCH [ .j BED ( ] N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ ,.] [INCHES /FT] (ABOVE /BELOW) BENCHMARK /REFERENCE. POINT._ / E BOTTOM OF DRAINFIELD TO BE [ ] [INCHES /FT] (ABOVE /BELOW] BENCHMARK /REFERENCE POINT, L D FILL REQUIRED: ( ' ] INCHES O T � H E • R j SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: [GALLONS / GPDJ CAPACITY MULTI- CHAMBERED /IN SERIES:( ] ) GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE MATE ( ] PER 24 HRS NO. OF PUMPS: [ ] BLOCK: -.a SUBDIVISION: STATE OF FLORIDA PERMIT 1 DEPARTMENT OF HEALTH DATE PAID ONSITE SEWAGE DISPOSAL SYSTEM FEE PAID $ CONSTRUCTION PERMIT RECEIPT 0 Authority: Chapter 381, FS & • ] [GALLONS/ GPD] SEPTIC TANK /AEROBIC UNIT CAPACITY DH 4016, 10/96 (Replaces HRS -H Form 4016 [page 1) which may be used) (Stock Number: 5744 - 001 - 4016-0) Chapter 10D -6, FAC [ ] Holding Tank [ °f Temporary /Experimental [ ] Other(Specify) AGENT: (SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] (OR TAX ID NUMBER] EXCAVATION REQUIRED: ( "J INCHES DI_ 10) '.5)Ial 1L TITLE:; •:3 TITLE: I nstaller /Contractor MULTI- CHAMBERED /IN SERIES:[ EXPIRATION DATE: CHD Page 1 of 2 INSTRUCTIONS: PERMIT NUMBER: Permit tracking number by County Health Department. APPLICATION FOR: Check type of permit; if "Other" specify type in blank. APPLICANT: Property owner's full name. TELEPHONE: Telephone number for applicant or agent. AGENT: Property owner's legally authorized representative. MAILING ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION or PROPERTY ID #: 27 character ID number for property. (Health Department may require property appraiser ID# or section /township /range /parcel number.) SYSTEM DESIGN AND SPECIFICATIONS: TANK: Minimum specifications from Chapter 10D -6, FAC. DRAINFIELD: Minimum specifications from Chapter 10D -6, FAC. OTHER: Other specifications, such as operating permit requirements, low- volume flush toilets, variance provisos. SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed. APPROVED BY: County Health Department personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by County Health Department. EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the date issued. APPLICANT: ,��orie LOT: 645k Y / Lot BLOCK ' ) 4A11 Ulf Z.7_ P‘ERTY ID #: 11- 3 2 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM 4� SITE EVALUATION AND SYSTEM SPECIFICATIONS =4 TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [-•� YES [ ] NO NET USABLE AREA AVAILABLE: 0.10 ACRES TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [RESIDENCES -TABLE 1 / OT ER -TABLE 2] AUTHORIZED SEWAGE FLOW: 500 GALLONS PER DAY [1500 GPD /ACRE 0 500 GPD /ACRE UNOBSTRUCTED AREA AVAILABLE: 3Q0 SQFT UNOBSTRUCTED AREA REQUIRED: Co Co SQFT BENCHMARK /REFERENCE POINT LOCATION: ELEVATION OF PROPOSED SYSTEM SITE IS 3Z. INCHES FT THE MINIMUM SETBA K WHICH SURFACE WATER: p! FT WELLS: PUBLIC: N FT BU4LDING FOUNDATIONS: SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [ �NO 10 YEAR FLOODING? [ ] YES [�NO 10 YEAR FLOOD ELEVATION FOR SITE: iJ / 11 FT MSL /NGVD SITE ELEVATION: FT MSL /NGVD SOIL PROFILE INFORMATION SITE 1 Munsell,# /Color Texture i ® 1 Lt'ki-C1 Sc-- �l o• c .1 Depth _c�to to Al- 13 to to 0 t to to to USDA SOIL SERIES: lr }je,...„ L 4... OBSERVED WATER TABLE: ti INCHES [ABOVE / BELOW] EXISTING GRADE. TYPE: PERCHED / APPARENT] ESTIMATED WET SEASON WATER TABLE ELEVATION: ( INCHES [ ABOVE / BELOW,] EXIS ;ING GRADE. moil WATER TABLE VEGETATION: [ ] YES [.1 JJ J N0 MOTTLING: [ ] YES [ NO DEPTH: A INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: 0• DEPTH OF EXCAVATION: FY/I INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH [ BED [ ] OTHER (SPECIFY) REMARKS /ADDITIONAL CRITERIA: SITE EVALUATED BY: iif9e 1-4. M t\an DH 4015, 10/96 (Replaces HRS -H Form 4015 [Page 3) which may be used) (Stock Number: 5744- 003 - 4015 -1) / 7 SUBDIVISION: 4-PC lipet tid. S toir d 4;11 5 / (e 5 06 3 0 O [Section/Township/Range/Parcel No. c ► ax ID Number CAN BE MAINTAINED FROM THE DITCHES /SWALES: LIMITED USE: 0 FT 5 FT PROPERTY LINES: ,"T•; • 3 • F E / 1 O M 3L PERMIT # <+ V OTHER QUA LIFIED PERSON. ENGINEER'S MUST ] [ABOV3IBELO BENCHMARK FERENCE POINT PROPOSED SYSTEM TO THE FOLLOWING FEATURES: JVI,� FT NORMALLY WET? [ ] YES PRIVATE: �/ Q FT NON - POTABLE: /0 FT POTABLE WATER LINES: /0 FT C) SOIL PROFILE INFORMATION SITE 2 Munsell Color Texture Depth L 4- O to r. • .54. - GI 1. o . to Z 13 to \ to to to to t0� USDA SOIL SERIES: V r .. L4 DATE: /0-30- O1 Page 3 of 3 INSTRUCTIONS: PERMIT NUMBER: Permit tracking number by County Health Department. APPLICANT: Property owner's full name. AGENT: Property owner's legally authorized representative. LOT, BLOCK, SUBDIVISION: Lot, block, and subdivision for lot. PROPERTY ID NUMBER: 27 character number for property (property appraiser ID number or section /township /range /parcel number). PROPERTY SIZE: Check if property at site conforms to submitted site plan. Record net usable area available - lot area exclusive of all paved areas and prepared road beds within public rights -of -way or easements and exclusive of streams, lakes, normally wet drainage ditches, marshes, or other such bodies of water. SEWAGE FLOW: UNOBSTRUCTED AREA: MINIMUM SETBACKS: Record the estimated sewage flow for the establishment from Table 1 (residence) or Table 2 (non - residential), Chapter 10D -6, FAC. Record the authorized sewage flow for the lot based on net usable area and water supply (1500 gallons per day per acre for private water supplies and 2500 gpd per acre for public water supplies). If authorized sewage flow does not equal or exceed the estimated sewage flow, the application must be denied. Record the square feet of unobstructed area available and the amount required. Unobstructed area must be at least 2 times as large as the drainfield absorption area and at least 75 percent of the unobstructed area must meet minimum setbacks in Chapter 10D -6, FAC. The unobstructed area must be contiguous to the drainfield. BENCHMARK INFORMATION: Record the location of the benchmark. If using a surveyor's benchmark record the actual elevation. Record the elevation of the proposed system site in relation (above or below) to the benchmark. Record minimum setbacks which can be meet to all listed features. Actual measurements must be recorded or "NA" for nonapplicable features. Features on site plan or within 75 feet of the applicant lot must be measured. The location of any public drinking well within 200 feet of the applicant's lot must also be verified. FLOOD INFORMATION: Record information on lot's subject to flooding. For lots subject to flooding record 10 year flood elevation for site and actual site elevation. SOIL PROFILE INFORMATION: Two soil profiles within the proposed absorption area to a minimum depth of 6 feet or refusal are required. Soil identification will use USDA Soil Classification methodology (Munsell colors and USDA soil textures). Refusals must be clearly documented. Provide USDA soil series if available, record "UNK" if the series cannot be determined. WATER TABLE: Record the depth of the observed water table at the time of the evaluation. Mark "perched" or "apparent" as appropriate. Record the estimated wet season water table elevation based on site evaluation, USDA soil maps, and historical information. Indicate if there is high water table vegetation present. Indicate if mottling is present and depth. SOIL TEXTURE: Record soil texture or loading rate for system sizing. DEPTH OF EXCAVATION: If applicable record depth of excavation required. Record "NA" if not applicable. DRAINFIELD CONFIGURATION: Check drainfield configuration required. If other, specify type. ADDITIONAL CRITERIA: Record any additional remarks pertinent to site or installation. Ex. dosing required. SITE EVALUATED BY: Signature of evaluator, title, and date of evaluation. Professional engineers must seal all documents submitted. ELEVATION WORKSHEET ELEVATION OF BENCHMARK / REFERENCE POINT IS: BENCHMARK SITE I SITE 2 SITE 3 [ + ] SHOT H.I. H.I. H.I. H.I. [ - ] SHOT [ - ] SHOT [ - ] SHOT L C e G \ n t; (•,-,...) -, • - IUI ■ t U11 ■■■1 M L� [V\ :11 q 1 IR■■ 1 I - r ■ I � : � P I fS4 row i 9 I 1 i Scale: Each block represents 10 feet and 1 inch = 40 feet. Lea STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number PART II - SITEPLAN C')( i 54 I Notes: Site Plan submitted by: r) , c :e A4- t4. /! rte. Plan Approved ;/ Not Approved / - p, Date By <` �� ` � � / - rl , x�— -- `( County Health Department _ 1 / ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS -H Form 4015 which may be used) (Stock Number: 5744 -002 - 4015 -6) Page 2 of 4 Scale: Each block represents 10 feet and 1 inch = 40 feet. Site Plan submitted by: Rlan Approved Ety STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number Notes: • ALL CHAN MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS -H Form 4015 which may be used) (Stock Number: 5744 -0024015 -6) PART II - SITEPLAN Not Approved Date County Health Department Page 2 of 4 - - - __ - - -_ , - - m� I ■ 1 • .■.■■ ■ I .. , ; , I : _______ cr. . ._ ; 1 ._..... IIII it , ! . � i 7 Iq � I C c �°'C'_ 1 v fD , Scale: Each block represents 10 feet and 1 inch = 40 feet. Site Plan submitted by: Rlan Approved Ety STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number Notes: • ALL CHAN MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS -H Form 4015 which may be used) (Stock Number: 5744 -0024015 -6) PART II - SITEPLAN Not Approved Date County Health Department Page 2 of 4 NOT: This form must be submitted to the Building Department with the permit application. Thank you. MIAMI SHORES VILLAGE BUILDING DEPARTMENT, 10050 N. E. 2nd AVENUE, MIAMI SHORES, FL 33138 (305) 795 -2204 FAX: (305) 756 -8972 SUBSTANTIAL IMPROVEMENTS CHECKLIST/WORKSHEET Date: Permit No.: Owner's Name: Pilings GEORGE F. LEVASSER Owner's Address: 967 N.E. 99 STREET MIAMI, FL 33138-2568 Telephone Number: 305 - 756 -6395 Job Site: SAME AS ABOVE Folio Number (required): 113206- 034 -0270 TYPE COST 1. Structural Fill 2 . All structural elements including: Spread or continuous foundation footings Bearing walls, tie beams and trusses Wood or reinforced concrete roofing Wood flooring or concrete slabs 3. Bathroom tiling and fixtures 4. Interior partition walls 5. Built -in appliances 6. HVAC equipment 370 1875. N/A 495 3675 635 N/A 375 N/A 90P Substantial Improvements Checklist (coned) 7. Installed tiling over subflooring 9. Windows and doors 13. Demolition costs 14. Tiling of roof 15. Re- carpeting of a floor 16. Painting 17. Rewiring of an existing electrical system 18. Light fixtures and ceiling fans Building Official Signature COST 750 300 • 8. All stucco, plaster, drywall finished, or other decorative finished - - 1 825 N/A 10. Complete reconstruction, alteration or addition of plumbing N/A 11. Complete reconstruction, alteration or addition of electrical service - N/A 12. Kitchen cabinets N/A 600 450 Items 7 through 18 sub total 4625 Items 1 through 6 sub total 8325 TOTAL 12950 * * * * * * * * * * * * * * * * * * * * * ** *FOR OFFICE USE ONLY * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Calculate fair market value as follows: ,Tax Appraisal times 1.2 = Fair Market Value of Structure 50% of Fair Market Value = id , MIAMI-DADE PRODUCT CONTROL NOTICE OF ACCEPTANCE PGT Industries 1070 Technology Drive Nokomis FL 34274 CONTRACTOR ENFORCEMENT SECTION (305) 375 -2966 FAX (305) 375 -2908 Your application for Product Approval of: PRODUCT CONTROL DIVISION (305) 375 -2902 FAX (305) 372 -6339 Series PW 701 Aluntinum Fixed Window - Impact Resistant (7/16" Laminated) under Chapter 8 of the Code of Miami -Dade County governing the use of Alternate Materials and Types of Construction, and completely described herein, has been recommended for acceptance by the Miami -Dade County Building Code Compliance Office (BCCO) under the conditions specified herein. This approval shall not be valid after the expiration date stated below. BCCO reserves the right to secure this product or material at anytime from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner, BCCO may revoke, modify, or suspend the use of such product or material immediately. BCCO reserves the right to revoke this approval, if it is determined BCCO that this product or material fails to meet the requirements of the South Florida Building Code. The expense of such testing will be incurred by the manufacturer. Acceptance No.:99- 0218.01 Expires:05 /20/2002 Raul Rodriguez Chief Product Control Division THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS BUILDING CODE & PRODUCT REVIEW COMMITTEE This application for Product Approval has been reviewed by the BCCO and approved by the Building Code and Product Review Committee to be used in Dade County, Florida under the conditions set forth above. Approved:05 /20/1999 Internet mail address: postmaster @buildingcodeonline.com MIAMI - DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 CONTRACTOR LICENSING SECTION (305) 375 -2527 FAX (305) 375 -2558 rancisco Quintana, R.A. Director 1 of 3 Miami -Dade County Building Code Compliance Office Homepage: http : / /www.buildingcodeonline.com PGT Industries innovative NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS 1. SCOPE 1.1 This approves an aluminum fixed window, as described in Section 2 of this Notice of Acceptance, designed to comply with the South Florida Building Code (SFBC), 1994 Edition for Miami -Dade County, for the locations where the pressure requirements, as determined by SFBC Chapter 23, do not exceed the Design Pressure Rating values indicated in the approved drawings. 2. PRODUCT DESCRIPTION 2.1 The Series PW 701 Aluminum Fixed Window - Impact Resistant and its components shall be constructed in strict compliance with the following documents: Drawing No 4214, titled "Impact Picture Window (0)" Sheets 1 through 4 of 4 dated 2/16/98, revised on 1/29/99, signed and sealed by Robert L. Clark, 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 Division. These documents shall hereinafter be referred to as the approved drawings. 3. LIMITATIONS 3.1 This approval applies to single unit applications only, as shown in approved drawings. 4. INSTALLATION 4.1 The aluminum fixed window and its components shall be installed in strict compliance with the approved drawings. 4.2 Hurricane protection system (shutters): the installation of this unit will not require a hurricane protection system. 5. LABELING 5.1 Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ". 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance 6.1.2 Duplicate copies of the approved drawings, as identified in Section 2 of this Notice of Acceptance, clearly marked to show the components selected for the proposed installation. 6.1.3 Any other documents required by the Building Official or the South Florida Building Code (SFBC) in order to properly evaluate the installation of this system. 2 of 3 ACCEPTANCE No.: APPROVED EXPIRES MAY 2 0 2002 Manuel Product of Division 99- 0218.01 MAY 201999 erez, P.E. Product C 931 Examiner PGT Industries ACCEPTANCE No.: APPROVED EXPIRES 9. This Notice of Acceptance consists of pages 1, 2 and this 1. t page 3. 99- 0218.01 MAY 2 0 1999 MAY 2 0 2002 NOTICE OF ACCEPTANCE: STANDARD CONDITIONS 1. Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and the original submitted documentation, including test supporting data, engineering documents, are no older than eight (8) years. 2. Any and all approved products shall be permanently labeled with the manufacturer's name, city, state, and the following statement: "Miami -Dade County Product Control Approved ", or as specifically stated in the specific conditions of this Acceptance. 3. Renewals of Acceptance will not be considered if: a) There has been a change in the South Florida Building Code affecting the evaluation of this product and the product is not in compliance with the code changes; b) The product is no longer the same product (identical) as the one originally approved; c) If the Acceptance holder has not complied with all the requirements of this acceptance, including the correct installation of the product; d) The engineer who originally prepared, signed and sealed the required documentation initially submitted is no longer practicing the engineering profession. 4. Any revision or change in the materials, use, and/or manufacture of the product or process shall automatically be cause for termination of this Acceptance, unless prior written approval has been requested (through the filing of a revision application with appropriate fee) and granted by this office. 5. Any of the following shall also be grounds for removal of this Acceptance: a) Unsatisfactory performance of this product or process. b) Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any other purpose. 6. The Notice of Acceptance 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 Notice of Acceptance is displayed, then it shall be done in its entirety. 7. A copy of this Acceptance as well as approved drawings and other documents, where it applies, shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at all tinge. The engineer need not reseal the copies. 8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of Acceptance. Manuel ' erez, P.E. Product Co Examiner Produc . trol Division " — END OF THIS ACCEPTANCE 3 of 3 96.000 MAX. 6.250 y 17.750 MAX. ON CENTER 48.000 MAX. L- 16.500 MAX. ON CENTER 6. It Revisions:_ uoteriec D'" 6"' D.B. Revised By: D.B. Vendor No.: LARGE MISSLE MPACT WINDOWS 1.) GLAZING: 7/16 (454) LAMINATED W /INTERLAYER (3/16" HS /.090 FILM /3/16" HS) 2.) CONFIGURATIONS: 0 3.) DESIGN PRESSURE RATING: +90 P.S.F., —90 P.S.F. 4.) ANCHORS: MAX. 6 1/4" FROM EACH CORNER (HEAD & SILL) MAX. 6 3/4" FROM EACH CORNER (JAMBS) MAX. SPACING AT HEAD & SILL: 17 3/4" MAX. SPACING AT JAMBS: 16.500" 5.) SHUTTER REQUIREMENT: NO SHUTTERS REQUIRED . 5.) REFERENCE TEST REPORT: FTL -1971 Cote: 2/16/98 Dots: 1/29/99 Scala: Mdma= P.O. BOX 1529 S:: Droving No.: N. T.S. NOKOMIS, FL. 34274 B 4214 Classification: ArPBJVED AS COMPLYING YPTti rat SOUTH Et0ni01 BU10iNG CODE OAT BY EUR0..':G CODD: COttr`_..:CE OFFICE ACE:;A:eC! N3. 4 1 Q-0218 .01 PM area. Co P T I se,re,iw+ 70 I rtes,: ELEV. 'progressive GLAS.stechnolo9Y s.s■e• or.r re. sneer 1 a 4 Desolation: IMPACT PICTURE WINDOW. (.0). Rev: A ITEM DESCRIPTION 1 Frame Head & Sill 2 Frame Jambs 3 .688 x .500 Channel Glaz. Bead 4 Seam Sealer 5 Closed Cell Foam Tope 6 #8 x 1.000 Ph. Pn. SMS 7 Silicon Bock bedding 8 7/16" (.454) W /MONSANTO 1NTERLAYER 9 7/16" (.454) W /DUPONT 1NTERLAYER 10 #6 x .875 Ph. Fl. Self —tap V.T.# 612241 612242 6533402 6SM55W 61308 781 PQA 62899C 7PWSW 1 ea. 2 4 4 (between bead & glass) 8 (Frame Assy. screws) 1 1 Bead screws. 2 1/2" from end, 20" centers Revisions: otenon. 7nm By: D.B. R,HSea D. B. Vendor No.: QTY. /LOCATION Dote. 2/16/98 1/29/99 sc le: N.T.S 1 TT TT T T1 lV T T progressive ro ressive technolo gy swrrmrorq yus.. or. a_... /ossification: Description: Prod. c°47 Address: P.O. BOX 1529 NOKOMIS, FL. 34274 VENDOR Alumox Alumox Alumox Schnee — Morehead Stik —ll Merchants Fasteners Dow Corning H.P.G. H.P.G. Fastec sefee /Modes I nun: 701 PICTURE WINDOW -- Sae: sire. 8 D,o.ing No.• 4214 VENDOR NO. AF -12241 AF -12242 AF- 533402 SM5504 1308 899 APPROVED AS COMPLYING WITH THE SOUTH fl RIDA BUILDING CODE OAT n __ ?" BY PRODU ROI DIY S ON BUILDING CODE COMPLIANCE OFFICE ACCEPTANCE NO. Sheet: a, 4 2.784 .437 1 7/16" (.454) W /MONSANTO INTERLAYER 7/16" (.454) W /DUPONT INTERLAYER // /r/ RaHsans: Ma teriel: D.B Revised Ei D.B. Vendor No.: 2/ 16/98 1 /29/99 Sea /a: N.T. S ac„mcatIon: Description: Address sod. wPw P.O. BOX 1529 NOKOMIS, FL. 34274 Site: B APPROVED AS COMPLYING WRH THE SOUTH FLORIDA BUILDING CODE yq OA /& • /r 9 l l BY �AT1� PP.00I i ...i ROL O'S S. BUILDING CODE COt.PI_,NCE F:CE ACC:iTA!:GE tiO 4q ' nit (2.1 T '� 9 1ve / ■ ^ T ro ressrve LA S technoloY ! s.rrrrorq wyar. — — s..tis ea.rr Sere /Model: Item: Sheet 701 � SECTS. SECTION VIEWS — HORIZ. & VERT 3 a14 Drawing No.: + Rar.: 4214 A 1 /4 " TAPCON .250 MAX. 1.250 •d a • d 1 x WOOD BUCK TYP. HEAD, SILL JAMB 4 d' 4 #12 PANHEAD 1.250 I---- • .250 -- �-- MAX. TYP. HEAD, SILL JAMB Rav/.ron.: • 4 2 x WOOD BUCK • APPROVED AS COMPLYING WfTH THE SOUTH r'fOA MOLDING CODE DAT PRO 77e7 ce,6 7 0,c0 C ! VS fl MPL'J,N O CF " F ACCEPTANCE NG. 11-0211E 41 'progressives LASS technology .+r• e.• l Err. • a.•, A ar. oar. sede,/,uaeer: Rem.• ANCH. 1 5neee 4 ee 4 1 701 AA:West: uaa:."Ko„o Drawn By We: . e: .o<fptlon: D. B. /16 /98 TYP. PICTURE WINDOW ANCHORAGE Revised ey D.B. 01.2,29/99 V ndo, Na.: score: Add', :.: P. 0. BOX 1529 Size : ^ Droving No: Rev: N.T.S. NOKOMIS, FL. .34274 4214 It FROM : A. C. GLASS FAX NO. : 305 - 554 -6996 11;17 OCT 19. ZLQ1 ID; P!:T :NE4.1 TREE TEL NCI: (941) 480 -1900 14/18••01 THHU tc:r)c PAX sob :!726329 eCCO PROD1t r,._; ?TROL DIV Mi MIN October 18, 2001 MT. Robert L Clark, P.E. POT Industries 1070 Tec Drive Nokomis, PL 34275 Re: Series SE1-701 Aluminum Singta Hung Window-Impact Resistant; Renewal !'o. 01- 11629.011 Dcar Mr. Clark: This is to inform you that thr. Notice of Proposed Action for the above referenced product under said renewal number has been isst:ed a gent to the Buiidin g Con and Product Review Committee for their final review on October 12, 20.0 :. We expect that their review wi :1 bit car,:pleted within 20 days, at which time the Nrotieo of Acceptance (NOA) wil i be issur4. By means of this letter we arc cYterc'ing the expiration of :he below listed NOA from the original of October 22, 2001 expiration ditto ter November 75, 2001 to ccovcr the committees final review time. Please attach n copy of his letter to the existing NOA at time or permitting. 98- 023.01 Scrics S14-70t Single Hong Window - New Expiration Date November 15, 200 impact Rcaistann This letter expires November 1S, 2001. We hope this addresses your concerns. should you require any F,;nher in,t rrnaticn an this , irtttcr ptcase feel free to cont; at this office. Sincerely, Raul Rodriguez Chief, Product Control Division cc Frorcis:0 J. Quintana, 2. A. Director NOA FIB M0�01,0/ t.:rct.b1TCPASTATOSnrForo,.u& _. •• • .. -, 1. w Oct. 29 2001 i0:52AM P1 412527'9 f"-it ; s %G 1? Jut MIAMI -DADYs COUNTY, FLOREDA METRO FI..AGLER B U11..DING 0 LIMN G COD) CVMPLIANCG OFF)(:t, METRO -DADC FLAOLCR BUILDING 14C WEST FL,eC LER STREET, mil rE IiiO) MuoMt, +.;:,Ott!D,\ 33I3:1•1 ()t)9)'173 -291 t PAX (3051373 -2908 MM .:CT cohrraOL D1V(StQN (305)375 -2903 rAX (305) 112.63)9 MIAMI -DADE L _ PRODUCT CONTROL NOTICE OF ACCEPTANCE Vinyl Tech/Progressive Glass Technology 1070 Technology Drive Nokomis FL 34275 CONTRACTOR ENFORCEMENT SECTION (305) 375 -2966 FAX (305) 375 -2908 PRODUCT CONTROL DIVISION Your application for Product Approval of: (305) 375 -2902 FAX (305) 372 -6339 Series SH -70I Aluminum Single Hung Window -Impact Resistant (5/16" Laminated) . under Chapter 8 of the Metropolitan Dade County Code governing the use of Alternate Materials and Types of Construction, and completely described in the plans, specifications and calculations as submitted by: Applicant , along with Drawing No. 4040, sheets I thru 4 of 4. has been recommended for acceptance by the Building Code Compliance office to be used in Dade County, Florida under the specific conditions set forth on pages 2 et. seq. and the Standard Conditions on page 3. This approval shall not be valid after the expiration date stated below. The Office of Code Compliance reserves the right to secure this product or material at anytime from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner, the Code Compliance Office may revoke, modify, or suspend the use of such product or material immediately. The applicant shall re- evaluate this product or material should any ammendments to the South Florida Building Code be enacted affecting this product or material. The Building Code Compliance Office reserves the the right to revoke this approval, if it is determined by the Building Code Compliance Office that this product or material fails to meet the requirements of the South Florida Building Code. The expense of such testing will be incurred by the manufacturer. Acceptance No.:98- 0223.01 Raul Rod i t guez Product Control Supervisor THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS BUILDING CODE COMMITTEE Expires:10 /22/01 This application for Product Approval has been reviewed by the Metropolitan Dade County Building Code Compliance Department and approved by the Building Code Committee to be used in Dade County, Florida under the conditions set forth above. Approved:10 /22/98 -1- Internet mail address: postmaster ©buildingcodeouline.com MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 CONTRACTOR LICENSING SECTION (305) 375 -2527 FAX (305) 375 -2558 s Ir anger, Director Building Code Compliance Dept. Metropolitan -Dade County Homepage: http : / /www.buildingcodeonline.com Vinyl Tech/Progressive Glass Technology ACCEPTANCE No.: 98- 0223.01 APPROVED OCT •2 2 1998 EXPIRES : OCT 2 2 2001 NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS 1. SCOPE This approves an aluminum single hung window, as described in Section 2 of this Notice of Acceptance, designed to comply with the South Florida Building Code, 1994 Edition for Miami - Dade County, for the locations where the pressure requirements, as determined by SFBC Chapter 23, do not exceed the Design Pressure Rating values indicated in the approved drawings. 2. PRODUCT DESCRIPTION The Series SH -701 Aluminum Single Hung Window — Impact and its components shall be constructed in strict compliance with the following document: Drawing No. 4040, titled "SH -701 Aluminum Single Hung window" Sheets 1 thru 4 of 4, prepared by manufacturer, dated 2/9/98 and revised on 08- 18 -98, signed and sealed by Robert L. Clark, 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 Division. These documents shall hereinafter be referred to as the approved drawings. 3. LIMITATIONS 3.1 This approval applies to single unit applications only, as shown in approved drawings. 4. INSTALLATION 4.1 The aluminum single hung window and its components shall be installed in strict compliance with the approved drawings. 4.2 The installation of this product will not require a hurricane protection system. 5. LABELING 5.1 Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ". 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Duplicate copies of the approved drawings, as identified in Section 2 of this Notice of Acceptance, clearly marked to show the components selected for the proposed installation. 6.1.3 Any other documents required by the Building Official or the South Florida Building Code (SFBC) in order to properly evaluate the installation of this system. -2 1.sha k. cit4UclG _. .... Ishaq I. Chanda, P.E., Product Control Examiner Product Control Division 7 2.000 --- • MA 7. 0I1 CENTER 5(55 MAX. LIT ELEVATION LARGE MISSLE .'.'=ACT WINDOWS 7.) cuzac: 5/16 54MIN4T(5 IY/OUPONT cITERLAIER (ver onn./z?c er■o.) 2.) conricuRArlays, 3.) DESIGN PRESELIPE 480 P.S.F.. —50 F.SJ. (KNERE WATER iNnuRATIoN Fro. (5 nor worn.) 467 P.S.F.. —50 P5 :WHERE WATER INFUTRADON REO. (5 NE(DED) 4.) ANCHORS: ).(4X. 5 3/4" PROM (+CH CORNER (HEAD & SW MAX. 6' FROM (ACM CORNER (JAMBS) 0(46 SPACING AT HE4::. & SILL 73.003 MAX. SPACING AT .74.1.'55: 7.1.125 .5.) SHUTTER Rrov:4(140.7. NO SKITTERS 8.000 CM 1 FLANGED FRAME HEAD Plum. 6063-15) 2 FLANGED FRAME SILL (Alum. 6063-T5) 3 FLANGED FRAME JAMB (Alum. 6063-15) 4 FIXED MELTING RAIL (Alum. 6063-15) 5 SASH TOP RAIL (Alum. 6063-T5) 6 SASH BOTTOM RAIL jAlum. 6063-15) 7 SASH SIDE R4IL (Alum. 6063-15) 8 GLAZING BEAD (Alum. 6063-15) 9 WEATHERSTRIP - VINYL BULB 10 SILICON 11 5/16" .350 W/MONSANTO INTERLAYER 17 - 3716" .350 W DUPONT INTERLAYER 13 it; x .750 PHIL. PN. HD. 14 SWEEP L4 TCH 15 16 17 18 19 20 21 22 23 SCREEN BALANCE 13 1/8" ON CENTE? x .625 PHIL FLT. HD. wirioLoAD ADAPTER (Alum. 6053-T5) x .375 PHIL. PM. TEK WEATHERSTRIP - VINYL BULB\S4SH SASH TOP GUIDE BALANCE COVER UtbL:HIP 1 1UN isCATHERSTRIP - PILE\FINSEAL 24 SASH FACE GUIDE 25 /6 x .500 PHIL. FLT. HD. 26 SitSH STOP (Alum. 6063-T5) 27 65 x 1.000 PHIL. P.H. SMS 28 SFA1.1 SEALER 29 WINDLOAD ADAPTER (PLASTIC) Revirions: y • D.B. Revistel D.B. Vendor 0014: 2/9/98 8/13/98 Scele: /V. T.S. V.T. # 612225 612226 612227 612228 612229 612230 612231 653457! 6TP247K 62899C 7658PFAA 7858WW 612236 78X38PPT 6TP249K 61062W 71087 76? I2FPAW 612244 78X 1PPA 6SM55W 61207 AdOre:sr 1 1 2 2 8 Clott.1144HoN 134s4rIplIon: QTY. / LOCATION 8 (1 per Glazino Bead) 2 H.P.G. 2 2 00 ottoch Bolonces to Jombsr AQUA FASTENERS 2(11.5" from end of vent top roil) MINIATURE DIE CASTING 4 (if width is ) = 42") 2 (Sweep Lotch Screws) MERCHANTS FASTENER 4 when using 2 Sweeg Lctches) 2 0 frame iambs, 30 from bo I.) ALUMAX 4 Windlood Adopter Screws) MERCHANT'S FASTENER 1 o I Vent Bottom Roil) TEAM PLASTICS 2 1 per each bolonce) MASTER TOOL 1 VINYL TECH.\PGT 2 1 per each bolonce) ALUMAX ALUMAX ALUMAX ALUMAX ALUMAX ALUMAX ALUMAX ALUMAX TEAM PLASTICS DOW CORNING W173ORG CALDWELL VENDOR ' 2 1 0 each (rome lamb) 3 0 vent lambs & vent top roil) SCHLEGEL CORP. 2 (1/vent lamb. 2.5" from bot.) VINYL TECH.\PGT (sosh face ouide screws) SCHERER IND. PROD. 2 (0 top of eoch frame iornb) ALUMAX 4 (Frome & Vent Assy. screws) MERCHANTS FASTENER SCHNEE/MOREHEAD 2 (0 frame jambs, 30 from bot.) PROTOTYPE VENT SIZE: 50 1/2" x 38 1/4" ihratalvet 0,07, Geenalet lero6. Cct+;oty: I 5.4■;,4/1.14444: SH 701 P.O. BOX 1529' NOKOMIS, FL. 34274 APPROVED PS COMPLYING WITH THE SOUTH FLORIDA EU:LDING 6005 DATFOCia+LE 22 79 9 By ISH CAN4 ttek...A PRODUCT CONTROL DIVISION 85110IN5 CODE COMPLIANCE OFFICE AccEPTANC NO.9 - 023 .0 Sac VENDOR 1 Ar— 12225 AF-12121 AF-12227- , AF- 12228 AF-12229 AF- 12230_ AF-12231 AF-534574 TP-247 899 PGT.214.XX AF-12236 TP-249 5TAVE FS7826-187 AF-12244 SM5504 WC996-12C 7 progressiveal Sheet: of 4 SH-701 ALUM. SINGLE HUNG Dro■gng No, 4040 I A .737 06 LJ 34.500 DAYLIGHT OPENING ACTIVE ROUGH OPENING 34.500 DAYLIGHT OPENING P. G. T. - 1.123 L._ kgr VERTICAL SECTION 2.330 EXTERIOR INTERIOR 53.125 49.625 DAYLIGHT OPENING 48.250 DAYLIGHT OPENING HORIZONTAL SECTION .1' 21 2.710 APKOYED AS COMPLYING WON THE SOUTH FLORIDA BUILDING CODE DATF OctoluJi 22 i BY 151 PRODUCT CSNTROL ONTS:GN BUILDING CODE COMPLIANCE OFFICE ACCEPT/VICE NO.q?) ROUGH OPENING .6551 EX TERIOR Ro JGH o E-wmc - 2.75-1 INTERIOR /1,4)7 tX b "'" D.B. Revised By: as Revitions: licfcr;ut: Veneto 2/9/98 Dcle: 8/78/98 Al.T.S progress/yea/I sst,,noio anoisclop Pat, O./ Were Cks,iticotkm: sH Ser.:es/U.1cl: 701 Descnpfron: CROSS SECTIONS-- P.O. BOX 1529 NOKOMIS, FL. 34274 SECT. 1" 2 a 4 I Size: Orow;n9 lio,: B 4040 A 1 /8 " --� ANNEALED .090 -- 1/8 • ANNEALED .500 5/16 "(.350) W /MONSANTO INTERLAYER OR 5/16"(.350) W /DUPONT INTERLAYER O.PPRO,;u CCSL'LYING WITH THE SOUTH FLORIDA BUILDING CODE D:T( 0(INA Lg98 a r t. ci aKdc PB70UCT CONTROL DIVISION ., BUILDING CODE CO16PL0/ICE OFFICE ACCEPT:"' • O 4 -6_2223 . n / `J Revisions: Material: vendor Mb.: Dole: 2/9/98 8/18/98 Drown br: D Revnrd D. B. Scale: 1X .rare w ow oy greet. 'progress ;veCIA StecInotoq} r;o::on: P rod. cos : Se. es /u dec X 701 Addrad: P.O. BOX 7529 y " NOKOMIS, FL. .34274 I B IS re J a 4 Descriiplion: GLAZING OPTIONS Oro..ng Re.: 4040 Rev: A 1 A. WOOD BUCK • 11 • 1.250 2 x WOOD • 1 1 BUCK TYP. HEAD TYP. .250 AtAX. 1/4" TAPCON 4 2. • • . • • • rrP. HEAD .250 MAX. 1.500 1.250 /12 PANHEAD r .250 MAX 2 x W000 BUCK TYP. JA MAX. TYP. Aire 2 x WOOD BUCK TYP. SILL Revisions: Naleriok /e/A/ Drown By: D.B. Revised Br D.B. Vendor No, Dote: Description: 2/9/98 o :/ N.T.S. VIN=YL TE /progressive a ASStechnolo ••••.••• •ISia.* • 0.4.• 4. Mr.. Classification: Prod. c 'g g i7 I I" ANCH. i 4 a 4 TYPICAL SINGLE HUNG ANCHOR4GE (1/4" TAPCON /OR #12 PAI Md.. P.O. BOX 1529 NOKOMIS, FL. 34274 orCwil9 4040 APPROVED AS COMPLYING WM THE SOUTH FLORIDA BUILDING CODE DATF De 22 e .. I Skal I • ..etKr).. PAODUE7 CI:VLS:ON BUI113:;r: E"JOE COMPLIANCE OFFICE NO.ge •-.9221-112J.. Vinyl Tech/Progressive Glass Technology ACCEPTANCE No.: 98- 0223.01 APPROVED ; OCT 2 2 1998 EXPIRES Our 2 2 2001 NOTICE OF ACCEPTANCE: STANDARD CONDITIONS 1 Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and the original submitted documents, including test - supporting data, engineering documents, are no older than eight (8) years. 2. Any and all approved products shall be permanently labeled with the manufacturer's name, city, state, and the following statement: "Miami -Dade County Product Control Approval ", or as specifically stated in the specific conditions of this Acceptance. 3. Renewals of Acceptance will not be considered if: a. There has been a change in the South Florida Building Code affecting the evaluation of this product and the product is not in compliance with the code changes. b. The product is no longer the same product (identical) as the one originally approved. c. If the Acceptance holder has not complied with all the requirements of this acceptance, including the correct installation of the product. d. The engineer who originally prepared, signed and sealed the required documentation initially submitted, is no longer practicing the engineering profession. 4. Any revision or change in the materials, use, and/or manufacture of the product or process shall automatically be cause for termination of this Acceptance, unless prior written approval has been requested (through the filing of a revision application with appropriate fee) and granted by this office. 5. Any of the following shall also be grounds for removal of this Acceptance: a. Unsatisfactory performance of this product or process. b. Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any other purposes. 6. The Notice of Acceptance 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 Notice of Acceptance is displayed, then it shall be done in its entirety. 7. A copy of this Acceptance as well as approved drawings and other documents, where it applies, shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at all time. The engineer needs not reseal the copies. 8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of Acceptance. 9. This Notice of Acceptance consists of pages 1, 2 and this last page 3. END OF THIS ACCEPTANCE -3 I S 44 1 lt.atid Ishaq I. Chanda, P.E., Product Control Examiner Product Control Division State # D1108778 Permit Type (circle one): BUILDING Municipal # /y 2 e Z Competency # WORK DESCRIPTION E c c TR-- C4 L FcTL A Oki Square Ft. Es'tirlated Cost (value), 700 06 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 ° N.E. 2nd Avenue • Miami Shores, Florida 33138.305- 795 -2204 Date 02- Z -ZQJb Address c7 N/ ?? 57 Tax Folio ' Legal Description /� Historically Designated: Yes No k./ 5 2k... \ 611 —& C. I Owner/Lessee/Tenet 6 f.(7/7-‘n 2-..-- VA 1 Master Permit # Owner's Address ' 7 A/ F Q -! Phone Contracting Co. ,/� /- .5 I L 5 ci z "` n Address Qualifier ULA L-(O & g(J1/ /D - 5' / Phon( 55 (1-05 ,2v Ins. Co. < (ASU IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS 850.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. PLUMBING MECHANICAL ROOFING WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for all disciplines. 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. Furthermore, I authorize the above named contractor to do the work stated. igndture of owner and/or Condo President Notary as to Owner and/or Condo President My Commission Expires Date Date Notary as to s��� JZ ature of Contractor or Owner Builder �L 08‘13- ao9- 3�- o54-.o ontr My Commission E erABfil , er P9 E =t:;. _.? Z. �FF\.O FEES: PERMIT !�J g ---0 RADON C.C.F NOTARY - 0 G BOND APPROVED: Zoning Building Electrical Mechanical Plumbing TOTAL DUE Structural Engineer ITEM 3ATH TUB UNIT FEE ITEM SW I TC1 OUTLETS • UNIT FEE ITEM SPACE HEATERS UNIT FEE 310ET LIGHT CUTLETS CENTRAL HEATING 11SHWASHER RECEPTACLES A/C (WIND) 1ISPOSAL SERVICE TEWORARY A/C (CENTRAL) )KINKING FOUNTAIN SERVICE SIZE IN MPS, DUCT WORK 'LOOK GRAIN SERVICE REPAIR/I€TER CHANGE REFRIGERATION IREASE TRAP APPLIANCE OUTLETS PROCESS ANO PRESS PIPING NTERCEPTOR RANGE TOP UhDERGROUNO TANKS .AVATORY OVEN ABOVE GROUND TANKS .AUNDRY TRAY _ WATER HEATER U.F. PRESSURE VESSELS :LOTHES WASHER MOTCRS 0- 1 If STEAM BOILERS LOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS ;INK, POT /3 COMP. MOTORS OVER 3- 5 NP MECHANICAL VENTILATION ;INK, RESIDENCE MOTCRS OVER 5- 8 NP TRANSPORTING ASSEk6LIES ;INK, SLOP MOTCRS OVER 8- 10 HP ELEVATORS/ESCALATORS . EWORARY WATER CLOSET MOTORS OVER 10- 25 NP FIRE SPRINKLER SYSTEMS .RIVAL ROTORS OVER 25-100 HP CCOLIM TOWERS LATER CLOSET ROTORS OVER 100 NP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION LATER SUPPLY TO: AIR CONDITIONERS • A/C UNIT STRIP HEATER . FIRE SPRINKLER j GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE - GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWI1 ING POOL • CUTLETS C0 €RCIAL WATER SERVICE . SIGN TUBES EWER CONNECTIONS SIGN TRANSFORMERS TILITY- SUER SIGN TIME CLOCK TILITY -WATER FIXTURES EPT I C TANK ANTENNA FLAY TELEVISION OUTLETS lAINFIELO, 4' TILE/RES. VIOLATION WP & ABANDON SEPTIC TANK REINSPECTION OAKAGE PIT CU. FT. ATCH BASIN ISOtWRGE WELL ]MESTIC WELL LEA CRAIN 70F INLET 7LAR WATER HEATER IRE STAM,PIPE _ 301. PIPING • AWN SPRINKLER SPRINKLER SYSTEM .S RANGE :TER SET (GAS) VS PIPING PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL MECHANICAL Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Printed: 2/20 /2002 Applicant: CONNIE Owner: LEVASSER Contractor B & B ELECTRICAL INC EULALIO I ABEtsteViDEB115 W 50 PL Local Phone: (305) 557 -0824 Parcel # 1132060340270 Job Address: 967. NE 99 ST Permit Status: Work: ELECTRICITY FOR ADDITION If there is no permit packar fee is $50.00, which must be This Permit is granted to the contras ordinances pertaining thereto and with and approved by the proper municipal authorization. A further condition upor ordinances and regulations pertaining by his agents, servants or employees. Signed Signed: Approved Permit Expiration: C In consideration of the issuance to r with the plans. drawings. - statements f Cellular: Legal Description: Electrical Permit Permit Number: EL2002 -60 8/19/2002 LEVASSER CONNIE Page 1 of 1 MIAMI SHORES SEC 8 PB 14 -33 E1/2 LOT 21 & ALL LOT 22 BLK 170 LOT SIZE Construction Value: - _- ^ ^° % - ^ -^ Look for blue background on the front of this check, and the imageSafe® logo on back, If not present. do not cash. ..-•- �.�.,...,.. S 0 Total Fees: $0.00 Total Receipts: $0.00 :�.� -- �� •h..:..+.�; +o fur inan wfnm to verify. there will be no inspections.- Re- inspection B. & B. ELECTRICAL, INC. 1115 W. 50TH PL. 305- 557 -0824 HIALEAH, FL 33012 2418 DATE 0 2_ - _Q- 2....o6 Z As 6 - 27/6319 h' ftL i 4-62E UILLhGE. $ .c7 ,51) 4)(f.) NafionsBank PAY TO THE ORDER OF Nations Rank. N.A. FOR `� 11'00 24181 1' :06 31002 ? ?': 00010203096 ?um =•:H i 'T 06.3 t GY2TT DOLLARS 0 ow Inc40.