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RC-10-687Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 lp-kPri Inspection Number: INSP- 156873 Permit Number: DEMO -3 -11 -396 Scheduled Inspection Date: April 14, 2011 Inspector: Bruhn, Norman Owner: REBELO, ALEJANDRO Job Address: 353 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Demolition Inspection Type: Final Work Classification: Building Phone Number Parcel Number 1132060136110 Building Department Comments DEMOLITION FOR GARAGE CONVERSION Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments April 13, 2011 For Inspections please call: (305)762 -4949 Page 3 of 17 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Expiration: 09/11/2011 Applicant 353 NE 94 Street Miami Shores, FL 33138- 1132060136110 Block: Lot: ALEJANDRO REBELO 1 Owner Information Address Phone Cell ALEJANDRO REBELO 701 BRICKELL Avenue MIAMI FL 33131- I Contractor(s) HOME OWNER Phone Cell Phone Valuation: Total Sq Feet: $ 5,000.00 436 1 Type of Demo: Building Additional Info: DEMOLITION OF GARAGE CONVERSION Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Amount $3.00 $2.25 $2.25 $1.00 $100.00 $3.00 $4.00 Total: $115.50 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -3 -11 -40294 03/24/2011 Check #: 401 $ 15.03 $ 100.47 03/08/2011 Check #: 369 $ 50.00 $ 50.47 03/07/2011 Check #: 369 $ 50.00 $ 0.47 03/24/2011 Cash $ 0.47 $ 0.00 Available Inspections: Inspection Type: Final 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. March 24, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date March 24, 2011 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING OWNER: Name (Fee Simple Title41de Address: City: Gt/'rke44 64! -e2j Permit No. Cfnir U --co y--+ Master Permit No 6 hone # -M.& R5 f State: Zip: 7 l s:5 Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 35-3 De q qL City: Miami Shores County: / Miami Dade Zip: r% 9( S. Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Phone #: Address: City: State: Zip: Qualifier Name: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ LI C00.00 Square/Linear F otage of Work: vgg ;p'. Type of Work: ❑Addition ❑Alterration ❑New j epair/Replace ❑Demolition Description of Work: COI /144 A C011erefrigOil (��;;�-� � t u u_ 1CW DJ ******** * * * * *x * * * * * * * * * * * * * * * *k * * * * * * ** Fees************* : * * * *x * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $�D Permit Fee $ /2. CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction.', I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC • OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all' work will be drone in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:" Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature The foreg day o who is per Owner or Agent ent was a 01' ,by bef re' , Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 , by o is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: lly known to me or who has produced L4tification and who did take an oath. NOTARY ' a LIC: Sign: Print: My Commission Expires: qT �1 ^fir *AC,' 4L. 1 N JT'yj ' 4c5=''' 1 APPROVED BY l��G / 1 - -d /1 Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009XRevised 3/15/09) Sign: Print: My Commission Expires: Zoning Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: �l�- C°a �� �„.; DATE: ADDRESS: 5 NE, .11 Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two- family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with - holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and initial each paragraph. 1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner - builder permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my pwn contractor with certain restrictions even though I do not have a license. Initial 2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. 3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts. Initial 4. I understand that I may build or improve a one family or two- family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or s bstantially improved it for sale or lease, which violates the exemption. rte' Initial 5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction. Initial 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial 7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner- builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner - builder and am aware of the limits of my insurance coverage for injuries to workers on my property. ^ (� Initial /o✓ 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow these may subject to serious financial risk. Initial _O 9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govern owner - builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. Initial OCK..// 10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry Licensing Board at 850487.1395 or http: / /www.myfloridalicense.com /dbpr /pro /cilb /index.html Initial 1/ 11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: Initial �. 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I have provided on this disclosure. Initial Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractors workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and retumed to the local permitting agency responsible for issuing the permit. A copy of the property owners driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. la2CLAri Was acknowledged before me this day of ,_20_g____ Bye) CP-'3A. 1 who was personally known to me or who has Produced there License orT '1,1---(-)1 c°2M° 2,0 as identification. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 156878 Permit Number: MC -3 -11 -397 Scheduled Inspection Date: July 05, 2011 Inspector: Perez, JanPierre Owner: REBELO, ALEJANDRO Job Address: 353 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060136110 Building Department Comments AC WORK OF GARAGE CONVERSION Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. July 01, 2011 For Inspections please call: (305)762 -4949 Page 7 of 32 1 Protect Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number tioniAlteration''. APPROVED Expiration: 09/11/2011 Applicant 353 NE 94 Street Miami Shores, FL 33138- 1132060136110 Block: Lot: ALEJANDRO REBELO Owner Information Address Phone Cell ALEJANDRO REBELO 701 BRICKELL Avenue MIAMI FL 33131- Contractor(s) HOME OWNER Phone CeII Phone Valuation: Total Sq Feet: $ 5,600.00 436 Tons: Additional Info: AC WORK FOR GARAGECONVERSION Classification: Residential Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Work: Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Work without Permit Fee Total: Amount $3.60 $2.94 $2.94 $1.20 $196.00 $3.00 $4.80 $198.00 $410.48 Pay Date Pay Type Invoice # MC -3 -11 -40295 03/07/2011 Check #: 369 03/24/2011 Check #: 401 Amt Paid Amt Due $ 50.00 $ 360.48 $ 360.48 $ 0.00 Available Inspections: 1 Inspection Type: Ventilation Final Hood Rough Duct Underground 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. March 24, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date March 24, 2011 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit NoilC Master Permit No. BUILDING PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL Owner's Name (Fee Simple Titleholder) Owner's Address '9 City Tenant/Lessee Name Email 7 -39 3 o/o/ Phone # State . Zip T3(341. 3 l3 U Phone # Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # 11 " 3 2 Is Building Historically Designated YES NO Contractor's Company Name Flood Zone Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. rtificate of Competency No. Contact Phone E -mail Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Square / Linear Footage Of Work: Type of Work: ['Addition ❑Alteration DNew Describe Work: C /43<e e. 41." V-44- ct42 ILA-A _ UN ``1- NN7 1 V €1 t' Repair/Replace ❑ Demolition o oo Dula Submittal Fee $a) Q Permit Fee $ t 50 1'9- CCF $ CO /CC Training/Education Fee $ Technology Fee $ Radon $ DPBR $ Zoning $ Notary $ Scanning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side -+ Bonding Company's Name (if applicable) Bonding Company's Address City State 1 Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 he approved and a reinspection fee will be charged. Signature (J Owner or Agent Signature Contractor The forego g ins ument was ac n �vledg s , N The foregoing instrument was acknowledged before me this day o ' 0 � , by 0 p !1 day of , 20 , by h is p- rsonally known to me or who has produced who is personally known to me or who has produced ll As identification and who did take an oath. as identification and who did take an oath. NOTA Y Sign: r UBLIC: NOTARY PUBLIC: E,� � >�' ,u �°G '�:: "", Sign: before m ' i L Print: Print: My Commission Expires: My Commission Expires: APPLICATION APPROVED BY (Revised 07/10/07) /anExamjner Engineer Zoning Clerk checked Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: -' .K DATE: ADDRESS: 3 t� �� l Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act es-your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two- family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with- holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and initial each paragraph. 1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner - builder permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. Initial 2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial C 3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts. Initial „2./- 4. I understand that I may build or improve a one family or two-family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease, which violates the exemption. 5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction. Initial Initial �..� 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial 7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner - builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner - builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial �- ' "°' 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow these may subject to serious financial risk. Initial 0/,--" 9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govem owner - builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. Initial =a/ 10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http : / /www.mvfloridalicense.com/dbor /pro /cilb/iindex.html Initial 11. I am aware of, and consent to; an owner- builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: Initial 6r�- 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that have provided on this disclosure. Initial Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractors workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and retumed to the local permitting agency responsible for issuing the permit. A copy of the property owners driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this day of /MA_, , 20 f who was personally known to me or who has Produced there License or ` Q14o! Z4' 1) as identification. -LLc I . OWNER Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address (where the work is being done): City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS ARI (AHRI) DATA SHEET REQUIRED Change Disconnecting means: YES ❑ NO ❑ ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # COND. UNIT MODEL # KW HEAT NOM TONS AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EERISEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4 "CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse /Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: Phone: State Certificate or Registration N. Certificate of Competency N. Signature Date: (Qualifier's signature only) Inspection Number: INSP - 159984 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number: EL -3 -11 -398 Scheduled Inspection Date: June 29, 2011 Inspector: Devaney, Michael Owner: REBELO, ALEJANDRO Job Address: 353 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Electrical - Residential _ Inspection Type: Rough Work Classification: Alteration Phone Number Parcel Number 1132060136110 Building Department Comments ELECTRICAL WORK OF GARAGE ENCLOSURE Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 159608. CREATED AS REINSPECTION FOR INSP- 159472. CREATED AS REINSPECTION FOR INSP- 159465. CREATED AS REINSPECTION FOR INSP- 156903. Add smoke / carbon monoxide detectors. Add kick plate. Install boxes or hi hats. No one home. New walls and ceiling rough O.K.. Add smoke / carbon monoxide detectors. ,f4digir 4- June 28, 2011 For Inspections please call: (305)762 -4949 Page 16 of 38 Protect Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 353 NE 94 Street Miami Shores, FL 33138- 1132060136110 Block: Lot: ALEJANDRO REBELO 1 Owner Information Address Phone Cell ALEJANDRO REBELO 701 BRICKELL Avenue MIAMI FL 33131- Contractor(s) HOME OWNER Phone CeII Phone Valuation: Total Sq Feet: $ 100.00 0 1 Type of Work: GARAGE ENCLOSURE Additional Info: Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Work without Permit Fee Total: Amount $0.60 $2.25 $2.25 $0.20 $150.00 $3.00 $0.80 $150.00 $309.10 Pay Date Invoice # 03/24/2011 03/07/2011 Pay Type EL -3 -11 -40296 Check #: 401 Check #: 369 Amt Paid Amt Due $ 259.10 $ 50.00 $ 50.00 $ 0.00 Available Inspections: I Inspection Type: Rough 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. March 24, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date March 24, 2011 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305). 762.4949 BUILDING Permit No. Ems! (- PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: ELECTRICAL Owner's Name (Fee Simple Titleholder) tit- 414,4Sia 616114 !0114) Phone # 78C, s93 c %9/ Owner's Address 75-) 42 9 // �y City G� `W% 5'44 .g,� State r-t . Zip 1 ;1�L�+ Tenant/Lessee Name Email Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # 3c-g tutqcfsf County Miami -Dade Phone # Zip Is Building Historically Designated YES sk011YC)) 01)1Vir Contractor's Company Name Contractor's Address City State Zip Qualifier Name Phone # NO Phone # Flood Zone State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ !� Type of Work: ❑Addition Describe Work: . 00 Square / Linear Footage Of Work: ❑Alteration :New ❑ Repair/Re lace ❑ Demolition ******** * ** * * * * * * * * * * * * * * * * * * * * *** * * * ** Fees************* * * * * * * * * * * * * * * * * * **** * * * * * * * * ** Submittal Fee $ Permit Fee $ CCF $ CO /CC $ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ See Reverse side --> Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate, and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a re- inspection fee will be charged. The foreg day o who is per NOTAR Owner or Agent gatrument was Y 2011 ,by Sign: Print: My Commission Expires: wledge.1 before onally latow&to me or who has produced q-24 7LIC: tification and who did take an oath. APPROVED BY Lek0 r Via, Signature Contractor The foregoing instrument was acknowledged before me this day of ,20_,by who is personally known to me or who has produced as identification and who did take an oath. mot/ A ')'2 -// Plans Examiner Zoning NOTARY PUBLIC: Sign: Print: My Commission Expires: Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: DATE: ADDRESS: S4 _.F� Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two- family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with - holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and initial each paragraph. 1. 1 understand that state law requires construction to be done by a licensed contractor and have applied for an owner - builder permit under an exemption from the law. The exemption specifies that 1, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. 2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial CAL) L) 3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts. Initial 4. I understand that I may build or improve a one family or two- family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease, which violates the exemption. ,' Initial cam~ l/ 5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction. Initial 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial 1.--- 7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner- builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner- builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial C.K. 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow these may subject to serious financial risk. Initial 9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govem owner - builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. Initial CL...." 10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http: / /www.myfloridalicense.com /dbpr /pro /cilb /index.html Initial 11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: Initial I E 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I have provided on this disclosure. Initial CL Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractors workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit. A copy of the property owners driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this day of RCC 20 . \ By (�.r Produced there License or who was personally known to me or who has OWNER as ident(f�9�l'pn. p�rlen;s s �,, ,s r Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 163646 Scheduled Inspection Date: August 23, 2011 Inspector: Bruhn, Norman Owner: REBELO, ALEJANDRO Job Address: 353 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Number: RC -4 -10 -687 Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Garage Enclosure Phone Number Parcel Number 1132060136110 Building Department Comments GARAGE CONVERSION Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 22, 2011 For Inspections please call: (305)762 -4949 Page 28 of 29 M iami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CERTIFICATE OF OCCUPANCYICOMPLETION CHECK LIST N, B• uilding permit card. ❑ Surveys (2 copies) Final as built - Required Items: Elevations of buildings showing all intended setbacks from property lines and other existing structures. Ingress+ Egress, required parking spaces, Wheel stops, stripping, and all paving to exterior. ❑ Certificate of Elevation — (Sealed by surveyor). Expiration date required on the form. Certificate of Insulation. S vCF0/2-'- 2t ❑ Certificate of Soil Treatment (Final treatment - original)\ CHAPTER 2913 -5 TERMITE PROTECTION: "This Building has received a complete treatment for the prevention of subterranean termites. Treatment is in accordance with the rules and lawn as established by the Florida Department of Agriculture and Consumer Services." H• ealth Department Approval Letter (On septic or private water). "' ar A pp� c pp Note: If the house is on septic tank, approval letter is required from Health Dpt. 1/4- U - ❑ Soil Compaction Letter (Density report is required) _ z r Final certification letter from the Engineer /Archite on mason , russes specia structure, etc) ❑ Backflow preventor certificate (Required on commercial projects only) C• ertificate of use. (Recorded in Miami -Dade Clerk of Courts) I t PLEASE NOTE THAT THE SAME ITEMS ARE REQUIRED FOR TEMPORARY CO `( • Emergency CO (Without 24 Hrs Processing) Additional fee is $80.00. • Temporary CO (Up to 90 days max) $75.00. • Residential CO fee is $150.00 • Commercial CO is $200.00 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 163994 Permit Number: RC -4 -10 -687 I Inspection Date: August 31, 2011 Inspector: Bruhn, Norman Owner: REBELO, ALEJANDRO Job Address: 353 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: F. Insulation Certificate Work Classification: Garage Enclosure Phone Number Parcel Number 1132060136110 Buildinct Deuartment Comments GARAGE CONVERSION Pass Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 August 31, 2011 Page 1 of 1 U /WAVE A. ACA MI JWIL A JL? CIFIIMM1f - 1111 (074 3131 AIvIEv 9 2SID STIRIEIE1� MIAMI SII-ICIRIES. IFILA. 3313S 754-231S m r 715 -1CC 4- FL LIC # AR 0011074 Date: August 27, 2011 Miami Shores Village Building Department 10050 N.E. 2nd Avenue Miami Shores, Florida 33138 Re: Permit # RC10 -687 garage enclosure Rebello Residence 353 N.E. 94th Street Miami Shores, Florida 33138 Folio # 11 -3206- 013 -6110 Attn: Building Department, ti I, Mark A. Campbell, having performed and approved the required inspections at the garage enclosure. I hereby attest to the best of my knowledge, belief and professional judgment, the insulation at the garage enclosure was installed in compliance with the approved plans and other approved permit documents. Should you have any questions or need any additional information please do not hesitate to contact me. Mark A. Campbell, Architect State of Florida: #0011074 Rebello CO insulation letter 8 -28 -11 AJAUF A. cA MIPIFELL A IRCIH1111ECT - 1111 (144 373 SI.E. 91NID S111REET 4tI i MI SI-ICRES, FLA. 3313 754-231S m r 7518 -7CCC 1/4\-LU Uf FL LIC # AR 0011074 Date: August 27, 2011 Miami Shores Village Building Department 10050 N.E. 2nd Avenue Miami Shores, Florida 33138 Re: Permit # RC 10 -687 garage enclosure Rebello Residence 353 N.E. 94th Street Miami Shores, Florida 33138 Folio # 11 -3206- 013 -6110 Attn: Building Department, I, Mark A. Campbell, having performed and approved the required inspections at the garage enclosure. I hereby attest to the best of my knowledge, belief and professional judgment, the insulation at the garage enclosure was installed in compliance with the approved plans and other approved permit documents. Should you have any questions or need any additional information please do not hesitate to contact me. Sincerely,,. Mark A. Campbell, Architect State of Florida: #0011074 Rebello CO insulation letter 8 -28 -11 Permit Number: RC- 4- 10-687 I Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 163995 Inspection Date: August 31, 2011 Inspector: Hernandez, Rafael Owner: REBELO, ALEJANDRO Job Address: 353 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: HRS Approval Work Classification: Garage Enclosure Phone Number Parcel Number 1132060136110 Building Department Comments GARAGE CONVERSION 4,:if Passe 7./f Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 August 31, 2011 Page 1 of 1 Charlie Crist Governor Ana M Viamonte Ros, M.D., KPH. State Surgeon General October 01, 2010 (Statewide Septic) P.o. Box 3865 Hollywood, FL 33083 RE: Contingency Letter Application Document No: AP977431 Centex Permit Number. 13-SC- 1276165 OSTDS Number. 358 NE 94 St Miami, FL 33138 Lot 12 -13 Block: 45 Subdivision: Miami Shores Dear Applicant This will acknowledge receipt of an application dated 09/01/2010 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. From a review of your completed application, it has been determined your existing system is adequate for the proposed use. This permit is granted for the conversion of the garage into a bedroom and storage room. There will no increase in fixture units and therefore no change in flow to the existing split system. There will be no increase in sewage flow or characteristics and no impact on the unobstructed area. APPROVED If you have any questions on this matter, please call our office at (305) 623 -3500. Enclosures cc: Sincerely, u Astrid Edwards, Engineer Specialist II Miami Dade County Health Dement 1725 NW 167 St, Opa Locka, FL 33056 Phone: (305) 623 -3500 Fax: (305) 623-3645 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 163996 Permit Number: RC -4 -10 -687 1 Inspection Date: August 31, 2011 Inspector: Bruhn, Norman Owner: REBELO, ALEJANDRO Job Address: 353 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: F. Special Inspector Letter Work Classification: Garage Enclosure Phone Number Parcel Number 1132060136110 Building Department Comments GARAGE CONVERSION Passed mil/ Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 August 31, 2011 Page 1 of 1 U MARE A. CAMI EEIL � ARCHITECT - 11 (1)74 373 3 N.F )7)M) STREET AAl1a1A�� Sil fij1 IES, VILA. 33135 754 -23115 ID r 75S- 7'IE5t f Date: August 27, 2011 Miami Shores Village Building Department 10050 N.E. 2nd Avenue Miami Shores, Florida 33138 Re: Permit # RC10 -687 garage enclosure Rebello Residence 353 N.E. 94th Street Miami Shores, Florida 33138 Folio # 11 -3206- 013 -6110 Attn: Building Department, J 1 I, Mark A. Campbell, having performed and approved the required inspections at the Garage enclosure. I hereby attest to the best of my knowledge, belief and professional judgment, the structural and envelope components of the above referenced renovation are in compliance with the approved plans and other approved permit documents. I also attest that to the best of my knowledge, belief and professional judgment, the approved permit plans represent the as -built condition of the structural and envelope component of the said structure. This document is being prepared in accordance with section 307.2 of the Florida Building Code and must be submitted to the Village of Miami Shores Building Department in conjunction with the application for a Certificate of Completion for the above referenced structure. Should you have any questions or need any additional information please do not hesitate to contact me. Sincerely ark A. Campbell, Architect State of Florida: #0011074 Rebello CO letter 8 -26 -11 D AA RE A. C tMIPII3EWL ARXCIHI11EIEC1 - 111 1)14 3131 b4Ev 912 NID S1IREIE4� MIAMI SH)IRIES, IFIL& 33113S 154 -2318 ip F 1518 -7CCi6 Date: August 27, 2011 Miami Shores Village Building Department 10050 N.E. 2nd Avenue Miami Shores, Florida 33138 Re: Permit # RC10 -687 garage enclosure Rebello Residence 353 N.E. 94th Street Miami Shores, Florida 33138 Folio # 11 -3206 -013 -6110 Attn: Building Department, I, Mark A. Campbell, having performed and approved the required inspections at the Garage enclosure. I hereby attest to the best of my knowledge, belief and professional judgment, the structural and envelope components of the above referenced renovation are in compliance with the approved plans and other approved permit documents. I also attest that to the best of my knowledge, belief and professional judgment, the approved permit plans represent the as -built condition of the structural and envelope component of the said structure. This document is being prepared in accordance with section 307.2 of the Florida Building Code and must be submitted to the Village of Miami Shores Building Department in conjunction with the application for a Certificate of Completion for the above referenced structure. Should you have any questions or need any additional information please do not hesitate tact me. Mark A. Campbell, Architect State of Florida: #0011074 Rebello CO letter 8 -26 -11 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 163997 Permit Number: RC -4 -10 -687 I Inspection Date: August 31, 2011 Inspector: Dacquisto, David Owner: REBELO, ALEJANDRO Job Address: 353 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: Declaration of Use Work Classification: Garage Enclosure Phone Number Parcel Number 1132060136110 Building Department Comments GARAGE CONVERSION Passed��J 7.17,-/. Inspector Comments / Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 August 31, 2011 Page 1 of 1 • 1111111 11111 11111 1 1111111111 I111I 11 j l r,. 1 0R,'.0E$-314 ,3 2• ; �° 275534 '?Y 4 r `9 ; o REt_Lr1�DED 12/16/2010 iJ: 55;?ri HARVEY n L iINerLFo' OF COURT : Ir?-DrDE COUNTY' FLORIDA LAST PAGE PREPARED BY: R f/ K L.C__ DECLARATION OF USE Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 KNOW ALL MEN BY THESE PRESENTS: S c.Vpc WHEREAS, the undersigned C4- ProY2 /4 Yio6 ri-W is /are the fee simple owner(s) of the following described property property") situated and being in Miami Shores Village, Florida: Lot(s) 12— 4 1 3 Block H c of PI 1 .t c S (4( 44 C C71,..77—• 1 (Subdivision), according to the plat thereof, as recorded in the Plat Book 0 Page 7 ° of the Public Records of Miami -Dade County, Florida, (address) Aft 9 (4 S + 1sv and WHEREAS, the undersigned owner(s) have sought certain development approval from Miami Shores and are providing this document in consideration thereof and to induce the Village to grant same: NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which is acknowledged, the undersigned do(es) hereby declare and agree: 1. That the Property will not be used in violation of any ordinance of Miami Shores Village or Miami -Dade County now in effect or hereinafter enacted. 2. That the property will be used for a single family residence only. 3. That he /she will not convey or cause to be conveyed the title to the above property without requiring the successor in titre to abide by all terms and conditions set forth herein. FURTHER, the undersigned declare(s) that this covenant is intended and shall constitute a restrictive covenant conceming the use, enjoyment and title to the above Property and shall constitute a covenant running with the land and shall be binding upon the undersigned, his/her successors and assigns and may only be released by Miami Shores Village, or its successors, in accordance with the codes, rules and regulations of said Village then in effect. c IN WITNESS WHEREOF, the undersigned has/have caused hand(s) and seal(s) to be affixed hereto on this 16 day of A7G. • ignature and Print WI P4144. CAM F y\\, IU Verb °- Signature and Print STATE OF FLORIDA ) _ hlyo, Q w COUNTY OF MIAMI -DADE ) '; . tvo k0 ,,t \. I HEREBY CERTIFY that on this day1�e q iAl( p red before me Or— CS 1 L�;(1 who is personally known to me or has produced (type of identification) as identification and he/she acknowledge that he /she executed th:foreg.o.i.n.g.,.free, ly and voluntarily, for ww w r rr,,,,��/ ;,;SIlVere�° 'i Signature and Print / Signature and Print ice-- n1 LvL purposes therein expressed. SWORN TO AND SUBSCRIBED before me on this v v day of �, \ , 20k 0 My commission expires: , ,1 . „"11 • ` S NOTARY PUBLIC, STATE OF FLORIDA'- •,,..: ... .•• *� \ -) $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): Address: 3 City: Inc /44-04( "O hi 5 Tenant/Lessee Name: Email: 1/ 4.-/ MAR 2 5 2011 BY...............000e0000 Permit No. Master Permit No. g 7- AM9FING. j-2_0 State: '5 313 Phone #: Zip: Phone #: 05--7gs'732Y JOB ADDRESS: l Y V City: Miami Shores �,/ County: Miami Dade Zip: 7 7 1 3 Folio/Parcel #: ! 6 ---32 0 x "(� % 3 R.1(0 Is the Building Historically Designated: Yes NO CONTRACTOR: Company Name: O / Fr} / C-12/-t Phone #: 76s7Ss 73 9 y Address: City: State: Zip: Qualifier Name: State Certification or Registration #: Certificate of Com Contact Phone #: DESIGNER: Architect/Engineer:% Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Addition Description of Work: ❑Alteration (❑N(e /� ❑Repair/Replace ❑Demolition ********* ** **+x**+x******* **** ******mu ***F * a: *a:**** *+ x**** ***+x **** ********************** Submittal Fee $ Permit Fee $ F CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ 64 a TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City t State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 no .: approved and a reinspection fee will be charged. Signatu The foreg �} g ins day 4111 dit Owner or Agent ment was a .1)_, llL, by Signature Contractor The foregoing instrument was acknowledged before me this who is personally known to me or who has produced a. As identification and who did take.Tn oath. NOTARY PUBLIC: Sign: Print: My Conunission Expires: er daeea_�;iv' 4� ******* * * * **** ****+x�x�x�x�x�aa�x� **** :a� *a: �xm � ********* **+x******** ** * * * *** * *** * * ** * * ** x***:r******* * *** **** **:x*** ** , 20 _, by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: APPROVED BY "34 '/5/' (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Plans Examiner Zoning Structural Review Clerk 1 Protect Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 353 NE 94 Street Miami Shores, FL 33138- 1132060136110 Block: Lot: ALEJANDRO REBELO Owner Information Address Phone Cell ALEJANDRO REBELO 701 BRICKELL Avenue MIAMI FL 33131- I Contractor(s) HOME OWNER Phone Cell Phone Valuation: Total Sq Feet: $ 15,225.00 0 1 Approved: Yes Comments: Date Approved: 1/6/2011: Yes Date Denied: 4/28/2010 Type of Construction: GARAGE CONVERSION Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: Bond Retum : Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential 1. Fees Due CCF CO /CC Fee DBPR Fee DCA Fee Education Surcharge Permit Fee Plan Review Fee (Engineer) Plan Review Fee (Engineer) Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Work without Permit Fee Total: Amount $9.60 $150.00 $6.86 $6.86 $3.20 $456.75 $60.00 $60.00 $36.00 $250.00 ($250.00) $12.80 $456.75 $1,258.82 Pay Date Pay Type Invoice # RC -4-10 -37658 03/24/2011 Check #: 401 04/22/2010 Check #: 103 Amt Paid Amt Due $ 1,008.82 $ 250.00 $ 250.00 $ 0.00 Available Inspections: Inspection Type: Framing i 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. March 24, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date March 24, 2011 1 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. VI 3 0'451 & ( 34/10t9OLIO NO. -I D — STATE OF FLORIDA: COUNTY OF MIAMI -DADE: 111111111111111111111111111111111111111111111 THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street/address: 2. Description of improvement: 3. Owner(s) name and address: Interest in property: 0 ii,e4 Name and address of fee simple titleholder. 4. Contractor's name, address and phone number: •1:.':tl_ N 2 01L 1 R0 159'608 OR BI; 27614 PSI 1387; (1P9) RECORDED 03/11/2011 10 :20 :15 HARVEY RL1VINp CLERK OF COURT MIAMI-DA DE COUNTY? FLORIDA LAST PAGE Space above rase ved for use of recording office 0- UZI�e� CIy> ijJ 4i spa& 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number: Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. i' Name, address and phone number: iV 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signature(s) • " "" ) or Owner(s)' zeejOffice Name Title /Office STATE OF FLORIDA COUNTY OF MIAMI -DADE rector/Partner/Manager Prepared By Print Name as acknowledged before me this i D day of The foregoing instrument wa la Individually, or ❑ as CI Personally known, or - for oduced the following type of identifi Signature of Notary Public: Print Name: (SEAL) VER FICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the facts stated In it are true, to the best of my knowledge and belief. .0' li 1 1 1 1 1 1 1 riip , Signs �� er(s) or B % Q 123.01 -62 PAGE 9/10 's A orizel cer /Director/Partner /Manager w By _O c D pff°:;_ „, sign ve:i a /� i �® 51ho C Dia Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit No. �O " Cog-7 Master Permit No. Permit Type: BUILDING ROOFING Owner's Name (Fee Simple Titleholder) ,,Z.—A-1,/;_:4 A j` --2, 0 Phone # -c6-- Ei ' C./ 0 f Owner's Address 2-) Ck Cityi-- U-"- -' „,k i 5 State -A - c Zip 3 �, )' Tenant/Lessee Name Email (' C_.:= CQ C c T Q �c'�`Yd; 353 a4 Job Address (wherr the work is being done) City Miami Shores Village Phone if FOLIO / PARCEL # County Miami -Dade Zip Is Building Historically Designated YES Contractor's Company Name Contractor's Address City Qualifier Name NO Phone # Flood Zone State Zip Phone # State Certificate or Registration No. Certificate of Competency No. 'Contact Phone E -mail Architect/Engineer's Name (if applicable) /5; 02-25” Value of Work For this Permit $ Type of Work: Describe Work: ❑Addition B Phone # Square / Linear Footage Of Work: 3' DAlteration ❑New ❑ Repair/Replace ❑ Demolition fa9e) Com veirslon ********* * * * * * * *,r * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * ** * ** * * * *x ** * * * * * * * * ** Submittal Fee $ Permit Fee $ eZCK CCF $ CO /CC $ Notary $ Training/Education Fee $ Technology Fee $ Sc anni Radon $ DPBR $ Bond $ Violation date: Structural Review. i $ 60- V "' 40, pi° 1 d Z o • ° Total Fee Now Due $ 60 L., ` 0-1 See Reverse side -- Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that. all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien . law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged.. Signature Owner or Agent The for - _oing ' trumentt'��was a • •' ledg- s before me day of �(�� ' , 20 )0, by _ who is personall known to me or who has produced entification and who did take an oath. NOT Sign: Print: My Commission Expires: Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 _, by who is personally known to me or -who has produced as identification and who did take an oath. NOTARY PU$LIC: y tit ODN , ilcA ' c° �J �" �,�v Sign: P ;' .:ffi,, Crs &: ,01.1:.‘ a rk .� GLi;p tk me 4 iev,0 My Commission Expires: ,gU BGTiDv33 : ric4e4e**** 9efe**** de**** kik*/***** 4e* J& 9c9e�e�eie4e�4aY9eiP9c�Y4e�IetlF9e9cic4r kYzie9e�te9e�Yk�Y�YietiktlFde4: deiFie**** 9e3r*** k9rk4e9c�YaY3kik�fir4e4e #ie�'e9eJe9:3rdrsY****k9eBedr* APPROVED BY 77)V ,14/ v 5h v,c 3'. Plans Examiner Zoning £ ',j'/t7-fi Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: �� "�Cl�L DATE: I ADDRESS: N Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two- family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with - holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and initial each paragraph. 1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner - builder permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. Initial 4,/ 2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial 3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts. Initial 4. I understand that I may build or improve a one family or two- family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or s »bstar)tially improved it for sale or lease, which violates the exemption. 5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction. Initial Initial 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial 7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner - builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner - builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow these may subject to serious financial risk. Initial 9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govem owner - builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. CP----"" Initial 10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http:// www. myfloridalicense .com /dbpr /prolcilb /index.html Initial 11. I am aware of, and consent to; an owner- builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: Initial 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I have provided on this disclosure. Initial Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and retumed to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this 3 day of , 20 `cki _\ who was personally known to me or who has Produced there License or as identificatioe60 b'0��;' %,,N co o • n°o: 14i `- Y • o o ip t t t10' Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 W N1 Permit No. Master Permit No. OWNER: Name (Fee Simple Titleholder): Address: i City: Tenant/Lessee Name: Email: gyp, MAR 0 3 2011 365 Zip: r 3/�� Phone #: JOB ADDRESS: i , b.,9 K City: Folio/Parcel #: Miami Shores County: It -326 t WOO Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: City: Miami Dade Zip: 57/r‘ NO Flood Zone: dutAlAtifiCif State: Phone #: Qualifier Name: State Certification or Registration #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Zip: Phone #: ificate of Competency #: Value of Work for this Permit: $ 5—etDe.. and Square/Linear Fo New Type of Work: ❑Address Description of Work: CObv 4,L1*t ?(04. ❑Alteration ge of Work: air/Re ❑Demolition ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * *x * * * ** Submittal Fee Scanning Fee $ Notary $ Double Fee $ Permit Fee $ CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL: WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC • OWNER'S AF'FIDAVITF: r 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: to ^an estimated value exceeding $250.0, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. , t , Signature The foreg day o who i personall �24• NOT Sign: Print: My Commission Expires: Cit Owner or Agent ment was 20 1) , by edged before me y known to me or who has produced NAs identification and who did take an oath. 2I L°IC:.. l tr APPROVED BY Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 , by who is personally known to me or who has produced as identification and who did take an oath. NOTA4tY I UBLIC: ,S, ) -z. ;�, d'., Sign: , r���� aye ,,�, Print: -.. , A a ��� , •� �: ° "S�' My Commission Expires: 4.,,° •.r (Revised 07 /10 /07)(Revised 06 /10 /2009XRevised 3/15/09) Plans Examiner Structural Review Zoning Clerk NAME: Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT DATE: 04 I 2.2 0 0 ADDRESS: OE- `Q14 — Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor, I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two- family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete. the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with- holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and initial each paragraph. 1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner- builder permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. Initial 2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. � Initial 3. I understand that, as an owner builder, I am the responsible party of record on a permit I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts. /(��� Initial `—%1C-- 4. I understand that I may build or improve a one family or two - family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease, which violates the exemption. �'� /') Initial �._..f"L_. 5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction. Initial a� 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial 7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner- builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner- builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow these may subject to serious financial risk. Initial Pe-- I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govem owner - builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. Initial 10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http:/ lwww. mvfloridalicense .com /dbor /prolcilb/index.html Initial C 11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: Initial CtC- 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I have provided on this disclosure. Initial Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and retumed to the local permitting agency responsible for issuing the permit. A copy of the property owners driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this day of 2010 who was personally known to me or who has Produced there License or114--- 0°1 4'illQs identific.tion. 1C.;(,) WIC Icl` O OWNER NOTARY DEVELOPMENT ORDER File Number: PZ -3 -09- 2009123 Property Address: 353 NE 94 Street Owner: Claudia Rebelo Address: 353 NE 94 Street, Miami Shores FL Agent: Mark Campbell Address: 373 NE 92" Street, Miami Shores 33138 Whereas, the applicant Claudia Rebelo (Owner), has filed an application for site plan review before the Planning Board on the above property. The applicant sought approval as follows: Special Approvals, Sections 600 & 523: Site Plan Approval, Garage conversion. Whereas, a public hearing was held on April 23 2009 and the Board, after having considered the application and after hearing testimony and reviewing the evidence entered, finds: 1. The application was made in a manner consistent with the requirements of the Land 't'evelopment Code of Miami Shores Village. 2. The conditions on the property and the representations made at the hearing merit consideration and are consistent with the requirements of the Land Development Code. The Board requires that all further development of the property shall be performed in a manner consistent with the site plan, drawirgs. and the conditions agreed upon at the hearing: 1) Applicant to secure necessary DERM or Department of Health approval for the septic system prior to the issuance of a village building permit. 2) A 5 foot landscape strip must be provided between the converted garage and driveway. 3) Applicant to obtain all required building permits before beginning work. 4) Applicant to meet all applicable code provisions at the time of permitting. Page 1 of 2 DO PZ- 3- 09- 2009123 Rebelo 0 PERMIT # 0 _ (Al CONTRACTOR: C SUBMITTAL DATE: All--1 I) 0 ADDRESS: 65:." J q41- RESUBMITAL ' ATES: PROJECT TYPE: C nv+eir &t l J• (J 6)4Y;07 0 ZONING 4-#4 `6--1 ( f FIRE X,V• clictaes ZSJe. 1/ Tbt I /4'/ 11 .k STRUCTURAL IMPACT FEES ELECT;,) c' - °' RICAL HRS/DERM PLUMBING NOC � MECH , ICAL BLDG r 5) Applicant to complete a covenant in the form of a "Declaration of Use" assuring the property is used only for a single family purpose, record the covenant and provide the planning director with a copy of the recorded document prior to the final inspection by the Building Official. 6) This zoning permit will lapse and become invalid unless the work for which it was approved is started within one (1) year of the signing of the development order by the board chair, or if the work authorized by it is suspended or abandoned for a period of at least one (1) year. Additionally, the applicant must, satisfy all applicable Miami Shores Village Codes, Miami -Dade County Codes, the applicable building and life safety codes required for development, and provide a copy of the development order to the Building Dept. The application with conditions was passed and adopted this 23`d day of April, 2009 by the Planning and Zoning Board as follows; Mr. Abramitis Yes Mr. Powell Yes Mr. Reese Yes Mr. Madson Yes Chairman Fernandez Yes Date Richard M. Fernandez Chair, Planning Board DO PZ -3 -09- 2009123 Rebelo Page 2 of 2 31111 11113111 11111 Mil 11111 1 El 1111 CFN 2010Rn84-3140 OR Bk 27524 P9 2534; lips) RECORDED 12/16/2010 14;55:20 HARVEY RUVINr CLERK OF COURT MIAMI -DADE COUNTY p FLORIDA LAST PAGE PREPARED BY: ALOACIDA•PLe -1-- DECLARATION OF USE IYliami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 KNOW ALL MEN BY THESE PRESENTS: S I4.vA WHEREAS, the undersigned C L x19/4 12,0 6 F-(..a is /are the fee simple owner(s) of the following described property property') situated and being in Miami Shores Village, Florida: Lot(s) 12-4 3 Block LI S of Pi iAwn t S LI V. . 1 (Subdivision), according to the plat thereof, as recorded in the Plat Book l t9 Page 7° of the Public Records of Miami -Dade County, Florida, (address) C 3 ArG ' 4 S 7.14 tsv and WHEREAS, the undersigned owner(s) have sought certain development approval from Miami Shores and are providing this document in consideration thereof and to induce the Village to grant same: NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which is acknowledged, the undersigned do(es) hereby declare and agree: 1. That the Property will not be used in violation of any ordinance of Miami Shores Village or Miami -Dade County now in effect or hereinafter enacted. 2. That the property will be used for a single family residence only. 3. That he/she will not convey or cause to be conveyed the title to the above property without requiring the successor in title to abide by all terms and conditions set forth herein. FURTHER, the undersigned declare(s) that this covenant is intended and shall constitute a restrictive covenant conceming the use, enjoyment and title to the above Property and shall constitute a covenant running with the land and shall be binding upon the undersigned, his/her successors and assigns and may only be released by Miami Shores Village, or its successors, in accordance with the codes, rules and regulations of said Village then in effect. IN WITNESS WHEREOF, the undersigned has/have caused hand(s) and seal(s) to be affixed hereto on this 16 day of AA- --- gnature and Print P(ViL CAA �5�ay:ra ,','��'''. �� Signature and Print STATE OF FLORIDA COUNTY OF MIAMI -DADE Q ��` . @�41a�� \0 ' . 71:- ��b ��-- C� t L�� who is rsonall known to me or has produced /�, ,�• I HEREBY CERTIFY that on this day�erAg��r�ap� red before me Pe Y p S) L'J C- (type of identification) as identification and he/she acknowledge that he/she executed the foregoing, freely and voluntarily, for . 20 -/ ``�pv1'��1 HEREBY CEr�lFY that this Is it Oil _t Seal. NOTARY PUBLIC, STATE OF FLORID• ••. •• CLERK, of Ctrcun � d u ;� r, F� 4 � �• c and Print Signature Signature and Print ' purposes therein expressed. SWORN TToo AN f me on this SPATE OF FLORDDA, u of fhr _ s/ny of WOO, r, 4i? Irg A d 30 WITNESS Ivy 77' l► LEGEND Of SURVEY ABBREVIATIONS ARC INSTANCE AC .... *t000N00TlOMNO CCALCW.*TED C.e .CATCM OMEN ....CLEAR Clam .C4+1ER w01 E NS 6NC0DAWMTAT p C. A011M pF NRVATUOB P O ....0011E0 m*N (00 P 0 a POSIT M 66ONPEMO OA—OWE NANO ELM MOW MEWS P0. RAT 0001. M 1NL.. PROPERTY CONCCONCRETE 01_.. EMMY POLE FD POUND CM... CONCRETE KOCK ER01GT11RE 0.01... 40E®IEAO UTIMIY LN v C.0 KENT OF COMPOUND CURVE 0.0 C.. PONT OF CCOSEENCEMENT MOO..0R60L.0 CM ...C%ORDNMANCE 0E .... 00A1NAOR EASSME 71. OM.... FEW N0ORANT NOVO . NAl10NAL 06001100 VESTICAL DAOMM PSC... PONT OT *29(0=CNNSIORE RAD MW RAOfAL 0.13NTO0INAY SEC. - SECTION 619 .SETpE0PME EWE ...MONMALE . Mm1n6Assuon CAW LO91 FENCE CELT CERTIFY TO: Alejandro Rebel* Lisette Pie Salazar, P.A. Attorneys' Title Insurance Fund, Inc. Bank 01 Americo, It's Successors And /Or Assigns As Their Interest May Appear LEGAL bESCRIPTION: Lot: 12 AND THE WEST 20 FEET OF LOT 13 Block: 45 Subdivision: Amended Plat Of Mlomi Shores Section No. 1 According to the Plat thereof as recorded in Plat Book: 10 Page: 70 Public Records of MIAMI -DARE County. Florida. ADDRESS: 353 NE 94 STREET MIAMI SHORES, FL 33138 Encroachments Noted: NONE LOCATION SKETCH SCALE: N1.5 NE. 95 5T AWES 4 a a...m.eM wedrm ommatrumoms Amp home on a1 worm 1a1M0. Foos mow.* ST.M.I a.mw. UPI aamya- d Sum m RI 11N 1mMP D LoFndsd for n1.TF. or Whom. moms onto ..tlaMt, he NW m Yy Mmes TO Sham M M mrMRN. This army to M 10 0. mod for (0010(0.. $o00. WM" or Moths. um tASYOm .mina OP.. um d Tartu 3. Kew. L.. 4 Cato *..rrteem cod MM. ...ra m m. N)4Cn0 ao 000 Army. 0) TO. Raw Mh1 ootko 1.0(0 Sawa dm..N INpty Ttlr .A. nhwl0.d props." .111 or .® a0 Y Ow F.". fkECES a 00111. .1M does m 01.0. Hatay at nit pin of MT aA. a.y .H .. *. •.Woes +armor. 1s .01. duM9s MEN roofilo Mar Naomi es sdd loknmN.O. E1 TIN WEN d Mood Wm. Nano inroad FM OM Mod d.serISMM and ao &IAN M 10 m.a.by a .Mars d Ws a. 7.341 r NOES. n uNFysmool 0.00( mEM. K 9tiF 01 Iom1.d. • pr•±i• .11. sew iworwarmd Yoram mon M.., tor 1 .. .. . fto.fMapes . -.r dopy . .0 .. Modm.wrt0(00. wools] E( 101 4 0 0 0 orb St0 tu. OM- .PEREA,P.5.6 M 04868 - STATE CIF PCALOA- • AV7 SAID L ^•TENIVITEO Wpm N easoasy rium pus•SrrdL • T . L re &mat , WADS: ARE 704)00500000 M011101AM off *AT) - E 1) 01DIMV, D MATTONS RBEEREO M.Lv.0 1929. a. 110* IS A 90vM0id0 02020 Sheet 1 01 2 FLOOD ZONE. X � I5 a FLOOD /IS ZONE IS ES NOT A FLOOD HAZARD ZONE PANEL NO.: 93/J COMMUNITY N. 120652 DATE OF FIRM: N07/17/1985 BASE FL00D: IA FINISH FLOOR: WA LOWEST NIA ADJ GRADE THOMAS J. KELLY, INC. L.B. #6486 SURVEYORS- MAPPERS -LAND PLANNERS 8125 SW 120 STREET PYNECREST, FLORIDA 33156 (786) 242 -7692 DADE (954) 779 -3288 BAWD (786) 242 -6494 DADE FAX (954) 779 -3260 BRWD FAX IDATE FIELD WORK (SCALE �VEY NO. 12/28/2006 1" '= 141.5. 06 -7233 UP GATE: 11 -18 -10 • SHEET 2 OF 2 THOMAS J. KELLY, INC. L.B. #6486 SURVEYORS-MAPPERS-LAND PLANNERS a125 SW 120 STREET PINECREST, FLORIDA 33136 IMO 242 -7692 DADE (954) 779 -3288 BRWD r7B6) 242 -6494 DADE FAX (954) 779 -3260 BAWD FAX 75'TOTAL R1w. /WE F ELVWORK 'SCALE 1" .301 "'. 12-28 -06 uP 9ATF -70 SURVEY NO. 06 -1233 LEGEND OF SURVEY ABBREVIATIONS A ARC DISTANCE AA:....AIR CO9 mONIND CCALCULATED C.8 .CATCH BALM ....CLEAR u .. CORER Vol ENC EACROAOSP9T PC. pow C CUTNATWE MP —.PPM !ROMPERS POE. PORT M BEOUPOUT O.M...OYEA MONO W* WATERMWEN PAL PLAT BOOM M MPABIIWBD PE. ...PROPERTY LBII CONS COMCN67E UP... uro.m PD4.9 P D POUND C83... CONCRETE BLOCK SERUM= O.0 L...OVEWtBAD UTILITY UM 99.0 POINT OP COMPOUND CURVE P.0 C.. PONT OD cOmata2ce1ERT SLOG..9UDBLr2 9Jt ... CROIW DISTANCE 'At .... 891E HYDRANT NOLO . NATIONAL OWOOITIL WIRIKAL DARIN Pat... MET OP REVFA98 CU991TWTE RAD RADIAL WOW DREW O9RNLY SEC ..SKIER/ 019 .9ETIROMPWE 9wN...9m99/ALA U.9 . MUTE EMSVI Drr Cw3' 9M10$1J299 MICE CERTIFY TO: Alejandro Rebelo Lisette Pie Salazar. P.A. Attorneys' Title Insurance Fund, Inc. Bank Of America, It's Successors And /Or Assigns As Their Interest May Appear LEGAL DESCRIPTION: Lot: 12 AND THE WEST 20 FEET OF LOT 13 Block: 45 Subdivision: Amended Plat Of Miami Shores Section No. 1 According to the Plat thereof as recorded in Plat Book: 10 Page: 70 Public Records of MIAMI -DADE County, Florida. ADDRESS: 353 NE 94 STREET MIAMI SHORES, FL 33138 Encroachments Noted: NONE LOCATION SKETCH SCALE n1 T. 5 : N E. 95 5T • A AD ur amro motor rom.eorawe w.. hem. we 9 mown sow. Prow motatAttp by .m .Orb.. LIEN Oro nttp d ham ore 9) 1Ntr woozy M aonhd (r mry 1 a ottlem9 mums .19 4 • 01. X9 m M N / Er MD Oen mAREntr ol►IMN.. 9. awry M oar to to WA f.re919.Mr9M. MNd•N•E. droiEA, r toy otter mo whim mimeo on- raN et 1f.o.. 3. key. LA. C) Cdr mberloNro m MIA moot At. .TD reatr 4 as MD AGM,. D) 11. Rea MlMaatIoa Harm Lamm in ma lopty toot MP rottoomed tonoNT 9n r A r9 M Pn. (NM rbcdlO re *MI ER ad 4n at moot. BrAENY to RA DMA AI M. RNa, 021etI kw P .AEnT►• ANNE,. I• 92 doom Hot mouth Rom MORN at mid Pdma tko. ED 11M dodo 4Wrod W.w wow vMTrd Pe Nm MEM drog1MA ad m ELI= to b P.Am.Lip or mmeta.., EN. sr rd. r• Imhof. P) 41. oT Ireond. Roo sew Astmemml 1.[l.Cgl Dor FL. Montan. mow, • Mow Mort. Iamb tot PE AEA, P.S. 8 M #4888 - 5rATE F P`JHLJ4- NOI Y91 D:1.E35 TMPRIMTED WPM Add IAOTPe'. 1 It st 00.1. MACE: APSTO ifi LS808ED rar191AM (59 rum • E Ir 9TIDWH. 51599TLDN5 AR3 LOOMED N.i.v.D 1839. E. 11081f A 90UMD'i19 IDILVEY Sheet 1 of 2. FLOOD ZONE. x Tai$ IS A FLOOD J4AZARD ZONE �/ THIS IS NOT A FLOOD HAZARD ZONE PANEL NO.: 93/3 COMMUNITY*. 120652 DATE OF FIRM: 07H7/18B6 BASE FLOOD: NIA FINISH FLOOR: NIA LOWEST NIA ADJ SPADE THOMAS J. KELLY, INC. L. B. #6486 SURVEYORS- MAPPERS -LAND PLANNERS 8125 SW 120 STREET PINECREST. FLORIDA 33156 (786) 242 -7692 DADE (954) 779 -3288 BRWD (786) 242 -6494 DADE FAX (994) 779-3260 BRWD FAX DATE FIELD WORK 'SCALE = NTS . 'SURVEY � 7NO. 12/28/2006 1" UP DATE: 11 -18 -10 d THOMAS J. KELLY, INC. L.B. #6486 StJRVE' \ORS- MAPPERS -LAN PLANNERS 8126 SW 1.20 STREET PINE REST, FLORIDA 33136 (7866 242 -7692 DADE (9M) 779 -3288 BRWD ' (786) 242 -6494 DARE FAX (954) 779 -3260 BRWD FAX 15' TOTAL R! W . '� DA { FIELD-WORK SCALE 1" 3O 1 (SURVEY NO. ' '. '12-28-C6 ° 06- -1233 UP4ATt?.I1 - -10 LtfAAL 13t C NJJ' 1 urrv: Lot: 12 AND THE WEST 20 FEET OF LOT 13 Block: 45 Subdivision: Amended Plat Of Miami Shores Section No. 1 According to the Plat thereof as receded in Plat Book: 10 Pages 70 Public Records of MIAMI -DADE County, Florida. ADDRESS: 353 NE 94 STREET MIAMI SHORES, FL 33138 Encroachments Noted: NONE LOCATION WATCH saALE1 N.T.S. N.E. ST NOTES= A) Al awreww wereedowats diem Seem we of apprwt .tlwe. gam w erehlp y %Ilse Rms. tsld .rewahr d fweas mot dstrwlwl. 1) Tide sway Y tsterW fr we*. r retinae purpose wfy smdwhr=y aw thh ow by taws to whew Is wAMtti. TW sway Y .at te be red h..wetwrlM.. Prr I7YO. &Up. r wry ether are widrt written .- T Thom J. WV. le.. C) Cede twlti@len.sd MHb seed we mat refloated se Ale sweep. 0) The Seed Idsw.tbm shew home owe mat M11y that the ..f..wed pprM tell r WE est M fres tree flsW1 or Swop widens art west. YebWiy se the pert ef es fig, wry door r - /Mnd. for say dm. that nuke free renews m sold l fenrrio. f) The l..d. dplat./ Woe we swayed per the IGpd dtsetiptiw and we delis .o b wwwhy r Who or MUM we awls or Iqud. /) Usdrawrl Geweedreats, M.M. aN Iowa. I h.nhy ow* the swsy.gres..td Imam rote hslwltd stew drds est J * bard of ter irt= Ls chestier lsrsew►L„yy L .c7 Flo. ttahA... J • AQQ.��PppE�RppEppA. P.S. di M. #4858 1/F $NOT VEAt30S.EiSD WITH AN FNV'i/W SURVEYORS'$ $ft41. NOWA 1. >J SHOWN. MUMS ARE To AN ASSURED 0811IDIAN ty PLAT). 1. If SHOWN. ELEVATIONS ARE REFERRED N.f:.V.0 1919. 3. THIS IS A soon may SURVEY. THOMAS J. KELLY, INC. L.B. #6486 SURVEYORS - MAPPERS -LAND PLANNERS 8125 SW 120 STREET PINECREST. FLORIDA 33156 (786) 242 -7692 DADE (954) 779 -3288 BRWD (786) 242 -6494 DADE FAX (954) 779 -3260 BRWD FAX FIELD WORK 'SCALE 'SURVEY NO. (DATE 12/28/2006 1" = NT.5 . t 06 -7233 THOMAS J. KELLY, INC. L.B. #6486 SURVEYORS - MAPPERS -LAND PLANNERS 8125 SW 120 STREET PINECREST. FLORIDA 33156 (786) 242 -7692 DADE (954) 779 -5288 BRWD (786) 242 -6494 DADE FAX (954) 779-3260 BRWD FAX (DATE FIELD WORK (SCALE 12-28-C6 1„ sue' ' 0IWE 233 J 0 Permit No: 10 -687 Job Name: January 6, 2011 Miami Shores Village Building Department Building Critique Sheet 2nd 1) Provide electrical and mechanical permit applications. 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit NO. RC -4 -10 -687 tion ge Enclosure Expires:Not Issued Folio Number:1132060136110 Owner's Name: ALEJANDRO REBELO Job Address: 353 94 Street Miami Shores, FL 33138- Owner's Phone: Total Square Feet: Total Job Valuation: 0 $ 12,000.00 Contractor(s) HOME OWNER Phone Primary Contractor Yes 1 Planning and Zoning Criteria and Comments Approved: No Date Denied: 4/28/2010 Comments: A 10 FOOT SIDE YARD SETBACK IS REQUIRED PLEASE IDENTIFY ON SITE PLAN " DECLARATION OF USE" MUST BE RECORDED AND PROVIDED TO THE PLANNING DIRECTOR BEFORE THE BUILDING OFFICIAL CONDUCT FINAL INSPECTION. 12/29/10 ACCORDING TO THE SITE PLAN PROVIDED AND BASED ON A 1/16 SCALE, THE SIDE YARD SETBACK PROVIDED IS 6 FEET NOT 10 FEET AS REQUIRED. Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Folio Number:1132060136110 Owner's Name: ALEJANDRO REBELO Job Address: 353 94 Street Miami Shores, FL 33138- Owner's Phone: Total Square Feet: Total Job Valuation: 0 $ 12,000.00 Contractor(s) HOME OWNER , Phone Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 1/6/2011: Yes Comments: " DECLARATION OF USE" MUST BE RECORDED AND PROVIDED TO THE PLANNING DIRECTOR BEFORE THE BUILDING OFFICIAL CONDUCT FINAL INSPECTION. Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Issue Date: Not Issu Permit NO. RC -4 -10 -687 ed Permit Type: Residential Construction Work Classification: Garage Enclosure Expires:Not Issued Folio Number:1132060136110 Owner's Name: ALEJANDRO REBELO Job Address: 353 94 Street Miami Shores, FL 33138- Owner's Phone: Total Square Feet: Total Job Valuation: 0 $ 12,000.00 Contractor(s) HOME OWNER Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: No Date Denied: 4/28/2010 Comments: A 10 FOOT SIDE YARD SETBACK IS REQUIRED PLEASE IDENTIFY ON SITE PLAN " DECLARATION OF USE MUST BE RECORDED AND PROVIDED TO THE PLANNING DIRECTOR BEFORE THE BUILDING OFFICIAL CONDUCT FINAL INSPECTION. Miami Shores Viitage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT #: f C 0 " LP '7 DATE: 5 2"14 ` ` v M2 /k C Met- Lc- ❑ Contractor ❑ Owner rchitect 1 Picked up 2 sets of plans and (other) 12 v S (& - .- rR7c2 '1 & Address: 3 A? 4 1- �r From the building de • . • • •n this date in order to have corrections done to plans And /or get C. my stamps. I and • ► • that the ply;; ee ; to be brought back to Miami Shores Villa Acknowledged by: !t% PERMIT CLERK INITIAL: RESUBMITTED DATE: (1#' It 270 PERMIT CLERK INITIAL: �.� Permit No: 10 -687 Job Name: May 11, 2010 Miami Shores Vivage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Building Critique Sheet 1) Plans must be approved by HRS for the septic system. 2) Provide receipt from Miami Dade planning and Zoning for impact fees. 3) Corrections for mechanical, structural and zoning must be completed. 4) Provide energy calculations, 3 sets. 5) Identify a secondary means of escape from the bedroom. 6) Provide an interior wall detail. 7) Show the height of the ceiling at the lowest point. Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 Job Address: Contractor: BUILDING DEPARTMENT 10050 N.E. SECOND AVENUE MIAMI SHORES, FLORIDA 33135 -2382 TELEPHONE: (305) 795.2204 FAX: (305) 756.8972 Review Comments for Mechanical Processor Permit No: ; 6 ,6 9viewer: Phone No: Date: kl7xill r Only the items preceded by an (x) must be corrected. ( ) I Need HVAC design schedule Miami Dade County Chapter 8. ( ) 2 No combustible in plenums. FBC -M 602.2.1. ( ) 3 Auxiliary and secondary drain systems required. FBC -M 307.2.3. ( ) 4 Air handler shall be mechanically attached to air system. FBC -M 603.7. ( ) 5 Equipment on roof over 16' require permanent access. FBC -M 603.5 ( ) 6 Need balanced return air. FBC -M 601.4. ( ) 7 Provide return air in bedroom and 1" undercut door. FBC -M 601.4. ( ) 8 Bathroom shall have window (3 square feet) or be mechanically ventilated. FBC -M 402.3.1. ( ) 9 Condensate drain need to be 3/4 "in diameter larger. FBC -M 307.2.2. ( ) 10 Air handling units in attics must meet all the requirements of (show Notice to Homeowner) FBC -M 306.3. { ) 11 Dryer vent shall not be longer than 25'. FBC -M 504.6. if not provide manufacturer's spec of dryer. ( ) 12 Outside air intake shall not be located closer than 10' from any hazardous or noxious contaminant. FBC -M 401.5. ( ) 13 Outside air required. FBC. -M 403.2 ( ) 14 Smoke detector required in system greater than 2000 C.F.M. FBC -M 606. ( ) 15 Fire damper required. FBC -M 607.1.2. ( ) 16 Mechanical equipment shall be designed and installed to resist wind pressures. FBC -M 301.13. ( ) 17 Appliance must be protected from damage. FBC -M 303.4. ( ) 20 Guards shall be provided to equipment located within 10' of edge of roof. FBC -M 304.10 ( ) 21 Miami Dade Fire approval for kitchen hoods and fire system required. Miami Dade Fire ) 22 Heat Load calculations required Miami Dade County Chapter 8 & FBC -M 312.1 23 Energy calculations Miami Dade County Chapter 8 & FBC -M 312.1 ( ) 24 Other Comment Sheet Mechanical Page of _ 07 /04R1.0 Permit No:49- /G7 — 6% Job Name: PA /0 , 2009 Miami Shores Viiiage Building Department ELECTRIC Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 c � to - ea/zS 5 tied j f`‘et- ee2` Pi ,2A- i e;' e d / & ( & .167 r i;- /<-' e' aZ /Z/ `S erg iz I h J 5 >1d-/---7"?/- J'C i, to td c_ 5 ,_ /', /6' Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Mike Devaney 305 - 795 -2204 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. L( 4 $ 7 Job Name i<6'45CL ®' Date 0 1- 4 ` / STRUCTURAL CRITIQUE SHEET 11 �,' 5 be ;p ��. ���di � 14,9 be ca/cijctC4 s d for Z 14. Area .54/11,40 talc 5113110 0AuDi Permit No: 10-687 Job Name: May 11, 2010 guILo/J c Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Building Critique Sheet ( 'id Fes, 1- ‘e-- A il Plans must be approved by HRS for the septic system. S S ? �'� Provide receipt from Miami Dade planning • Zoning for impact fees. SiTt S'i 'P ft' ° Corrections for mechanical, structural and onin • ust be completed. �0'Z -� 0 Provide energy calculations, 3 sets S, ,gs crfrc � �) Q_ Identify a secondary means of escape from the bedroom. per -i (Tao, f� r °i °1•D, Provide an interior wall detail. C CO- 1 S —, a ��� _, , VI Show the - height -of- the- at -at the lowest point. r. , `• � (�vn � � Pr-Pe � � z.r,�. �. S° 1 5 � a. Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 Miami Shores Villa Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. i —4 8 7 Job Name n(8‘4 Date % L •10 STRUCTURAL CRITIQUE SHEET (J (h'3 °iG. 1/ S S jl Q C�����G u E'I t� pt' the 1I -e- e i ere cuff !l ho wind to h Area (/JTt 2c( giviuy3 Lf1A- aei -O'7 .Csos' B f 1 Li-- v o LKi r hi i i' AA0 l C�9Y►r' �,�'( �c,v2 Pian'ning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Issue Date: Not Issu Permit NO. RC_4_1 0_687 ed Permit Type: Residential Construction Work Classification: Garage Enclosure Expires:NOt Issued Folio Number:1132060136110 Owner's Name: ALEJANDRO REBELO Job Address: 353 94 Street Miami Shores, FL 33138- Owner's Phone: Total Square Feet: Total Job Valuation: $ 12,000.00 0 Contractor(s) HOME OWNER Phone Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: No Date Denied: 4/28/2010' 12 Comments: A 10 FOOT SIDE YARD SETBACK IS REQUIRED PLEASE IDENTIFY ON SITE PLAN C " DECLARATION OF USE" MUST BE RECORDED AND PROVIDED TO THE PLANNING DI ECTOR BEFORE THE BUILDING OFFICIAL CONDUCT FINAL INSPECTION. Permit No: .99- Job Name: fi" E6�--- iQPjt ip ,2009 Miami Shores Viiiage Building Department ELECTRIC Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 >° C tec-re"rz 5 Se `44, 9 '2 e //v 6 �9 Pb �� � UGC c�G � �'"� ��. � t� ��-� � - Z Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Mike Devaney 305 - 795 -2204 Job Address: BUILDING DEPARTMENT 1 H • 1b05o N.E. SECOND AVENUE MIAMI SHORES, FLORIDA 33136.2382 TELEPHONE: (305) 795.2204 FAX: (3O5) 756.8972 Review Comments for Mechanical Processor Permit No: `✓ 1 D _6 89viewer: Contractor: Phone No: Date: Only the items preceded by an (x) must be corrected. ( ) I ( )2 ( )3 ( )4 ( )5 ( )6 ( )7 ( )8 ( )9 ( ) 10 ( ) 11 ( ) 12 ( ) 13 ( ) 14 ( ) 15 ( ) 16 ( ) 17 ( ) 20 ( ) 21 k121 Need HVAC design schedule Miami Dade County Chapter 8. No combustible in plenums. FBC -M 602.2.1. Auxiliary and secondary drain systems required. FBC -M 307.2.3. Air handler shall be mechanically attached to air system. FBC -M 603.7. Equipment on roof over 16' require permanent access. FBC -M 603.5 Need balanced return air. FBC -M 601.4. • Provide return air in bedroom and 1" undercut door. FBC -M 601.4. Bathroom shall have window (3 square feet) or be mechanically ventilated. FBC -M 402.3.1. Condensate drain need to be 3/4 "in diameter larger. FBC -M 307.2.2. Air handling units in attics must meet all the requirements of (show Notice to Homeowner) FBC -M 306.3. Dryer vent shall not be longer than 25'. FBC -M 504.6. if not provide manufacturer's spec of dryer. Outside air intake shall not be located closer than 10' from any hazardous or noxious contaminant. FBC -M 401.5. Outside air required. FBC. -M 403.2 Smoke detector required in system greater than 2000 C.F.M. FBC -M 606. Fire damper required. FBC -M 607.1.2. Mechanical equipment shall be designed and installed to resist wind pressures. FBC -M 301.13. Appliance must be protected from damage. FBC -M 303.4. Guards shall be provided to equipment located within 10' of edge of roof. FBC -M 304.10 Miami Dade Flre.ap royal .. for - kitchen =hoods and fire system required. Miami Dade Fire �\ M H at -- quired Miami Dade County Chapter 8 �C fBC - 312.1 Dade County Chapter 8 & FBC-M 312.1 � Comment Sheet Mechanical PAM ki utor--) 4..i ()K\i0,1\� r\--77\--04/so Ve77 Page , of APPENDIX 13-D Effective March 1,2009 FORM 1100B-08 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Residential Component Prescriptive Method B ALL CUMATE ZONES Compliance with Method B of Chapter 11 of the Florida Building Code, Residential or Subchapter 13 -6 of the Florida Building Code, Building may be demonstrated by the use of Form 1100B for single -and multiple- family residences of three stories or less in height, additions to existing residential buildings, renovations to existing residential buildings, new heating, cooling, and water heating systems in existing buildings, and site -added components of manufactured homes and manufactured bulldings.To comply, a building must meet or exceed all of the energy efficiency requirements on Table 11 B -1 and all applicable mandatory requirements summarized in Table 11B-2 of this form. If a building does not comply with this method, it may still comply under Method A of Chapter 11 orSubchapter 13-6 of the applicable code. PROJECT NAME. AND ADDRESS: RFBELO RESIDENCE 353 NE 94th STREET, MIAMI,FL BUILDER: PERMITTING OFFICE: MIAMI-DADE COUNTY OWNER: REBELO RESIDENCE PERMIT t 0 G g'7 JURISDICTION NO.: 2 3 2 6 0 0 . New construction including additions which incorporate any of the following features cannot comply using this method: skylights or othernonvertical roof glass, glass areas n excess of 16 percent of conditioned floor area, and electric resistance heat (See Notes to Table 11 B -1 on page 2). 2. FII in all the applicable spaces of the "To Be Installed" column on "Table 11B-1 with the information requested. All "To Be Installed" values must be equal to or more efficient than the required levels. 3. Complete page 1 based on the `To Be Installed° column information. 4. Read "Minimum Requirements for All Packages ", Table 11B-2 and check each box to indicate your intent to comply with all applicable items. 5. Read, sign and date the "Prepared By" certification statement at the bottom of page 1. The owner or owners agent must also sign and date the form. 1. New construction, addition, or existing building 2. Single - family detached or multiple -family attached 3. If multiple - family -No. of units covered by this submission 4. Is this a worst case? (yes/no) 5. Conditioned floor area (sq. ft.) 6. Glass type and area: a. U- factor b. SHGC c. Glass area 7. Percentage of glass to floor area 8. Floor type, area or perimeter, and insulation: a. Slab -on -grade (R- value) b. Wood, raised (R- value) c. Wood, common (R- value) d. Concrete, raised (R- value) e. Concrete, common (R- value) 9. Wall type, area and insulation: a. Exterior: 1. Masonry (Insulation R- value) 2. Wood frame (Insulation R- value) b. Adjacent: 1. Masonry (Insulation R- value) 2. Wood frame (Insulation R- value) 10. Ceiling type, area and insulation: a. Under attic (Insulation R- value) b. Single assembly (Insulation R- value) 11. Air distribution system: Duct insulation, location Test report required if duct in unconditioned space 12. Cooling system: (Types: central, room unit, package terminal A.C., gas, none) 13. Heating system: (Types: heat . r , - . , gas, LP -Gas, gas h.p., room or PTAC, none) 14. Programm e thermostat insta = • • n HVAC systems: 15. Hot w- system (Types: elec., , , gas, heat rec., ded. heat pump, other, none) I hereby certify that th the Florida Energy Code. ems( PREPARED BY: in compliance with Please Print CK 1. ADDITION 2. SINGLE FAMILY DETACH 3. 4. NO 5. 435 SQ. FT 60. _0.65 6b. _0.35 6c. _16 sq. ft. 7. _3.7% R= 0 lin.ft. 813. R= N/A sq.ft 8c. R= _N/A sq.ft. 8d. R= _N/A sq.ft. Be. R= N/A sq.ft. 9a-1. R= Q 464_sq.ft. 9a -2. R= sq.ft. 9b-1. R= 6.0 240 sq.ft. 9b-2. R= sq.ft. 10a. R =_30.0 sq.ft. 435 10b. R= sq. f - 11a. R= _6.0 ATTIC SPACE 11b.Test report attached? Yes No 12a. Type: THU -THE WALL A/C 12b. SEER/EER: 9.8 12c. Capacity: _12,000 Btu/hr 13a. Type: ROOM A/C 13b. HSPF/COP /AFUE: _N/A_ 13c. Capacity: _N/A_ 14. >Yes< No 15a. Type: _EXISTING EWH 15b. EF: 0.90 ATE: 12.02,10 2007 FLORIDA BUILDING CODE - BUILDING Review of plans and specifications covered by this ralcuhtion ird attes compliance with the Florida Energy Cale. Before construction is completed, thi ill be inspected for compliance in accordance with Section 553.908, F.S. BUILDING OFFICI DATE: 13-D.23 w ` APPENDIX 13 -D TABLE 1111-1 MINIMUM REQUIREMENTS (See Sete 1) All Climate Zones BUILDING COMPONENT PERFORMANCE CRITERIA INSTALLED VALUES: Windows (see Note 2): CFA LESS THAN 600 SQ.FT. %CFA =< 50% U- Factor = 0.65 SHGC = 0.35 %oICFA < =16% U- Factor = 0.65 SHGC = 0.37 %of CFA= 3.7% Exterior door I.. Wood or insulated 1-1..:• Walls - Ext. and Ad). (see Note 3): Frame Mass (see Note 3) Interior of wall: Exterior of walk R -13 14-6 R-4 R -Value = 13.0 R -Value = 6.0 R -Value = 4.1 Electric resistance heat See Note 10 Not X X Ceilings (see Notes 3 & 4) allowed R=30 R -Value = 30.0 Floors Slab-on-grade Over unconditioned spaces (see Note 3) No requirement R-13 R -Value = SLAB-ON -GRADE Hot water systems (storage type) Electric (see Note 5): Gas fired (see Note 6): 40 gal: EF = 0.92 50 gal: EF = 0.90 40 gal: EF = 0.59 50 gat EF =0.58 Gallons = EXISTING EWH EF= 0.90 Gallons =40 EF= Air conditl., , .. , -; ,.. 4 see Note SEER = 13.0 SEER = 9.8 - ALL NC Heat pump systems (see Note 8) SEER =13.0 HSPF = 7.7 SEER = N/A HSPF = Gas furnaces AFUE = 78% AFUE = N/A OII furnaces AFUE = 78% AFUE = N/A • .. . .,.., thermostat see Note 10 Must be Installed on all HVAC : - ,:. Installed? > Yes < No Dudworic (see Note 9) R-8, TESTED NA 11-4.2 Location: > Unconditioned space < R -Value = 6.0 Test report Conditioned space R -Value = o test Unconditioned space° Conditioned space Unvented attic assembly per 11806.4 with Insulation at the roof places Air Handler location: Unrxndtiortad attic° or garage Conditioned space or Unvented attic .== , ... .. r 8808.4 with insulation at the root .: : Requires test report No duct test =.. - • Location: Test report (1) Each component present in the As -Built home must meet or exceed each of the applicable performance criteria in order to comply with this code using this method; oth- erwise Method A compliance must be used. (2) Windows and doors qualfying as glazed fenestration areas must comply with both the maximum !-Factor and the maximum SHGC (Solar Heat Gain Coefficient) criteria and have a maximum total window area equal to or less than 16% of the conditioned floor area (CFA), otherwise Method A must be used for compliance. Exception& 1. Ad- ditions of 600 square feet (56 m2) or less may have maximum glass to CFA of 50 percent. 2. Renovations with new windows under z 2 foot overhang whose lower edge does not extend further than 8 feet from the overhang may have tinted glazing or double -pane clear glazing. Replacement skylights Installed in renovations shall be doublepaned or single paned with a diffuser. (3) R- Values are for insulation material only as applied in accordance with manufacturers' installation instructions. For mass walls, the "interior of war requirement (R-6) must be met except if at least 50% of the R-4 insulation value required for the "exterior of wall" is installed exterior of, or integral to, the wall. (4) Attic knee walls shall be insulated to same level as ceilings and shall have a positive means of maintaining insulation in place. Such means may include rigid insulation board or air barrier sheet materials adequately fastened to the attic sides of knee wall framing materials. (5) For other electric storage volumes, minimum EF = 0.97 - (0.00132 * volume). (6) For other natural gas storage volumes, minimum EF = 0.67 - (0.0019 * volume). (7) For all conventional units with capacities greater than 30,000 Btu/hr. For Small-Duct, High - Velocity units, Space Constrained units, and units with capacities less than 30,000 Btuthr see Table 13-607.AB.3.2A of the Florida Building Code, Building or Table N1107.AB.3.2A of the Honda Building Code, ResidenbaL (8) For all conventional units with capacities greater than 30,000 Btu/hr For Small -Duct, High - Velocity units, Space Constrained units, and units with capac8tes less than 30,000 Btu/hr see Table 13- 607AB.3.2B of the Honda Building Code, Building! or Table N1107.AB.3.2B of the Florida Building Code, Residential (9) All ducts and air handlers shall be either located in conditioned space or tested by a Class 1 BERS rater to be 'substantially" leak free. "Substantially leek free° shall mean distribution system air leakage to outdoors no greater than 3 cfm per 100 square feet of conditioned floor area at a pressure differential of 25 Pascal (0.10 in. wc.) across the entire air distribution system, including the manufacturer's air handier enclosure. Exception: New or replacement ducts installed onto an existing air distribution system as part of an addition or renovation. Such ducts shall either be insulated to R-6 or be installed in conditioned space. 10) The prohibition on electric resistance heat and the requirement for programmable thermostats do not apply to additions, renovations, and new heating systems installed in existing buildings. TABLE 1113-2 MINIMUM REQUIREMENTS FOR ALL PACKAGES COMPONENTS SECTION REOIRREMENTS CHECK Exterior Joints & Cracks N1106.AB.1.2 To be caulked, gasketed, weather - stripped or otherwise sealed. Max .3 dm/sq.ft. window area .5 cfm/sq.ft. door area. X X Exterior Windows & Doors N1106.AB.1.1 Sole & Top Plates N1106AB.1.2.1 Sole plates and penetrations through top plates of exterior walls must be sealed. Type IC rated with no penetrations (two alternatives allowed). X X Recessed Lighting N1106AB.1.24 Multistory Houses NI106.AB.1.2.5 Air barrier on perimeter of floor cavity between floors. N/A Exhaust Fans N1106.AB.1.3 Exhaust tare vented to unconditioned space shall have dampers, except for combustion devices with integral exhaust ductwork. X Water Heaters N1112A8.3 Comply with efficiency requirements in Table N1112.AB.3. Switch or dearly marked circuit breaker electric or cutoff ( gas) must be provided. External or built -in heat trap required for vertical pipe risers. N/A Swimming Pools & Spas N1112AB.2.3.4 Spas & heated pools must have covers (except solar heated). Noncommercial pools must have a pump timer. Gas spa & pool heaters must have minimum thermal efficiency of 78%. Heat pump pool heaters shall have a minimren COP of 4.0. N/A Hot Water Pipes N1112AB.5 Insulation Is required for hot water circulating systems (including heat recovery units). N/A Shower Heads N1112AB.2.4 Water flow must be restricted to no more than 2.5 gallons per minute at 80 path. WA HVAC Duct Constriction, Insulation & Installation All ducts, fittings, mechanical equipment and plenum chambers shall be mechanically at1 a ed, sealed, insulated R-6. and installed In accordance with the criteria of Section N1110.AB. Ducts In attics must be insulated to a minknum of R-6. X HVAC Controls NI107AB2 Separate readily accessible manual or automatic thermostat for each system. X 13 -D.24 2007 FLORIDA BUILDING CODE - BUILDING BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAMER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 372 -6339 www.miamidade.aov/buildingcodc NOTICE OF ACCEPTANCE (NOA) Nu-Vue Industries, Inc. 1055 E. 29 Street Hialeah, Florida 33013 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by Miami -Dade County Product Control Division and accepted by the Board of Rules and Appeals (BORA) 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 Division (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. BORA reserves the right to revoke this acceptance, if it is determined by Miami Dade County Product Control Division 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. DES R T-iON: Series NVSNP, NV/NVT-H, NVHC, NVSTA and NVHTA -Steel Wood Connectors. APPROVAL DOCUMENT: Drawing No. NU-5, titled "Skewed Nail Plate, NV358 kNV458 -rith Double NVTH Straps, NVTIUNVTHS Anchors & NVHC Hurricane Clips and NVSTA & NVHTA Heavy Duty Anchors with Seat ", sheets 1 through 4 of 4, dated 04/15/04, with last revision dated 07/05/09, prepared by Nu -Vue Industries, Inc., signed and sealed by Vipin N. Tolat, P.E., bearing the Miami -Dade County Product Control revision stamp with the Notice of Acceptance number and expiration date by the Miami Dade County Product Control Division. MISSILE IMPACT RATING: None LABELING: 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 ", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA renews and revises NOA # 04- 0510.03 and consists of this page 1 and evidence page E -1, as well as approval document mentioned above. The submitted documentation was reviewed by Carlos M. Utrera, P NOA No. 09- 0721AS Expiration Date: December 23,2014 Approval Date: September 30, 2009 Page 1 Nu - -Vpe Industries. Inc. NOTICE QF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS 1. Drawing No. NU -5, titled "Skewed Nail Plate, NV358 & NV458 with Double NVTH Straps, NVTH/NVTHS Anchors & NVHC Hurricane Clips and NVSTA & NVHTA Heavy Duty Anchors with Seat", sheets 1 through 4 of 4, dated 04/15/04, with last revision dated 07/05/09, prepared by Nu -Vue Industries, Inc., signed and sealed by Vipin N. Tolat, P.E. B. TESTS "Submitted under NOA # 04- 0510.03" Test reports on wood connectors per ASTM D and sealed by C. R. Caudel, P.E. Report No. Wood Connector 1. PT # 03 -4482 NVSNP3 2. PT # 03 -4625 NVHCL/R 3. PT # 04-4641 NVSTA -24H 4. PT # 04 -4698 NVTH24 5. PT # 03 -4590 NVTH26/NV458 6. PT # 04 -4642 NVHTA -24H 7. PT # 03 -4543 NVTH2O/NV358 1761 by Product Testing, Inc., signed Direction Downward Up& Sideways Up& Sideways Up& Sideways Sideways Up& Sideways Up& Sideways Date 09 /15/03 01/21/04 03/17/04 04/15/04 12/31/03 03/22/04 12/19/03 C. CALCULATIONS 1. Report of Design Capacities, dated 06/30/09, sheets 1 through 12 of 12, prepared, signed and sealed by Vipin N. Tolat, P.E. "Submitted under NOA # 04- 0510.03" 2. Report of Design Capacities dated 04/27/04, sheet 1 through 12, prepared, signed and sealed by Vipin N. Tolat, P.E. D. QUALITY ASSURANCE 1. Miami Dade Building Code Compliance Office (BCCO). E -1 1' 8/0 Carlos M. Utrera, P.E. Product Control Examiner NOA No. 09 -0721.05 Expiration Date: December 23, 2014 Approval Date: September 30, 2009 4u -Vue Industries. Inc. NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED E. MATERIAL CERTIFICATIONS 1. None. F. STATEMENT 1. Statement letter of code conformance, no financial interest and no change of product, dated 07/08/09, issued, signed and sealed by Vipin N. Tolat, P.E. G. OTHER 1. Notice of Acceptance No. 04-0510.03, issued to Nu -Vue Industries, Inc., approved on 12/23/04 and expiring on 12/23/09. g B 07 C I M. Utrera, P.E. Product Control Examiner NOA No. 09- 0721.05 Expiration Date: December 23, 2014 Approval Date: September 30, 2009 E -2 950' Hale pattern Is mtrrar Image of the appsite side Holes W di. TABLE 1 SKEWED NAIL PLATE 3 Supported &T bottom chord Product Code Steel Gouge 0 Allowable Loads (ibs) 0 Gravity Uplift I 0 (6) sd x US' a 594 0 1 °r I] 0 0 0 Hale pattern Is mtrrar Image of the appsite side Holes W di. TABLE 1 SKEWED NAIL PLATE 3 Supported &T bottom chord Product Code Steel Gouge Schedule Allowable Loads (ibs) Each End Gravity Uplift NVD4P3 ie (6) sd x US' 594 594 For Uplift, use two NVSNP3. one of top chord and one at bottom chord of the supporting and supported Trusses In compliance with section 2321.7 of the FBC. NVSNP3 installation Notes: 1. Use 6 nail holes in each flange. 2. Do not bend nail plate more than once. 3. Supporting member shall be In the acute angle side with other flange behind the end of supported member (see sketch.) General Notes; 1. Steel shall conform to ASTM A653, structural grade 33 (Min. yield 33 ksi) and a minimum galvanized coating of G 60 per ASTM A525. 2. Allowable loads are based on Latest Editions of Notional Desing specifications (NDS) for wood construction and Florida Building Code (FBC). 3. Design Toads are for Southern Pine species with a specific gravity of 0.55. Allowable loads for other species shall be adjusted accordingly. 4. Common wire nail values are based on NDS and have been reduced for Penetration Depth factor. 5. Allowable loads for wind uplift have been increased by a duration factor of 1.6 for anchors into wood only. Load values shown are, without 33% steel stress increase. 6. Allowable loads for more than a single connection cannot be added together. A design load which is divided into components in the direction given must be evaluated as follows: Actual Uplift p,ctugyit L gqctu tt Lp Allowable Uplift + Allowable Li + Allows lie L2 < -1'0 7. Allowable loads are based on 1Y" thick wood members unless otherwise noted. 8. Ali tie beams and grouted concrete masonry Moll comply with FBC. Concrete for tie beams and grout and mortar for concrete masonry shall be a minimum of 2500 psi. Concrete masonry shall comply with ASTM C90. 9. All tests have been conducted in accordance with Ast'tiklu . •sib le 1110A01/10 WIN N. TOLAT. PE (CIVIL) MINtate foie FL. Rte. / 12847 161E3 1422 :RN CREEK LANE HOUSTON, U 77088 'rr., 7i1_I, v Nu -Vue 1. ina. 1083 Hialeah, Florida —1069 East 29 33013 Street Miens (306) 694-0297 Fait (M) 696-0390 SKEWED NAIL PLATE DWG /: Sheet: Date: Revisions: Nil -5 1 of 4 At3. 0s. anal July 6. 2009 TABLE 2: NV358 — 14G Double NVTH Straps with 2 ply 18G seat Assembly Product code 14G Strap Product Code Dimension H (Inches) NV358-12 NV358 -14 NV358 -18 NV358 -20 NV358-22 NV358 -24 NVIH18 12 NVIH18 14 NV0t20 18 NYM24 20 NV1H28 22 NVR{28 24 NV358 -26 NV8430 28 NV358 -32 32 NV358-44 NV9H48 44 Total No. of Fasteners in 2 Straps 104 x r Total No. of Fasteners in Seat lad x 3" Allowable Loads (Ibs) mom L1 L2 8 8 2245 1881 1839 10 8 2525 2208 2068 12 8 2806 2452 2298 14 8 3086 2897 2528 18 8 3387 2942 2758 Notew 1. Minimum embedment Into concrete 4 ". 2. tide are neeeeary in atrape and seat to achieve design Toads. 3. Nab through ( chords)sha not force the truss piste on the ate side. 3p � MOB Slat 11.203% 1• P6 1 4'*. Commie Embalmed. Helen 01 Trues plate required to transfer load to bottom chord Reinforcements Required TABLE 3: NV458 — 14G Double NVTH Straps with 3 ply 18G seat Assembly Product Code 14G Strap Product Code Dimension H (Inches) NV458 -12 NV458 -14 NV458 -18 NV458 -20 NV458 -22 NV458 -24 NVRI16 12 NVRI18 14 NVRi20 18 NVIH24 20 NVIN28 22 NVM28 24 NV458 -28 NVfN30 28 NV458 -32 NVRI38 32 NV458 -44 NV 1148 44 21C 1 — Concrete Tie Bean or lie Bean formed with Concrete filled Masonry. Total No. of Fasteners to 2 Straps 10d x 3" Total No. of Fasteners in Seat 10dx3" Allowable Loads (Ibs) u 8 8 2245 2783 2078 10 8 2525 3131 2338 12 8 2808 3479 2597 14 8 3088 3827 2857 18 8 3387 4175 3117 VIPIN N. TOUT, PE (CIVIL) FL. MG. 12847 15123 I.A EAN CI= LANE 140 81014, TX 77088 )8G Seat Detail NV358 and NV458 titu000TOty sbo.�tsl+lods Areq to • Padositimbd Nu —Vue Industries, Ise. 1053 -4059 East 29 Street 11th, Florida 33013 Phone (305) 894 -0397 Fax (305) 894 -0398 NV358 & NV488 WITH DOUBLE NYT$ STRAPS DWG 1: NU-5 Sheet 2of4 Date: MM. 15, 2004 Revialone: July 5, 20119 Truss Nate required to transfer load to bottom chord TABLE 5 HURRICANE CUPS L2 Reinforcements Or Remdred Parallel L1 to waii Concrete Tie Bean or Tie Bean famed with concrete 1Ned masonry Product Code Description ., ae Od x We Allowable Loads fibs) t2 Header Mat UPIHi u NVHCR HURRICANE CLIP — RIGHT 18 8 8 525 253 333 NW. HURRICANE CUP — LEFT 18 8 8 525 263 333 For Uplift, use two dips, one on each side to comply with section 2321.7 of the FBC TABLE 4 Truss Anchors NVTH and Riveted Truss Anchors with Seat NVTHS H Length (In) Product Code Gauge seat Gauge strap No. of Fasteners it Strap 10d x 1.5° Maximum Allowable Load (Ibs) Uplift L1 L2 12 NVTH -18 NVTHS 212 18 14 14 NVH -18 NVTHS 214 18 14 16 NVTH -20 NVHS 216 18 14 18 NV1H -22 NVTHS 218 18 14 20 NVTH -24 NVTHS 220 18 14 22 NVTH-26 NVTHS 222 18 14 24 NVTH-28 NVTHS 224 18 14 28 32 44 NVTH -30 NVTH -36 NVIH -48 NVTHS 226 NVHS 232 NVTHS 244 18 18 18 14 14 14 Cross— Section 5 1032 580 525 6 1222 871 630 7 1275 783 735 8 1329 783 735 9 1383 783 735 10 1437 783 735 11 1490 783 735 12 1544 783 735 13 1598 783 735 NVTH, NVTHS Nu—Vue Industries, Ina. 1053 -1059 Bast 89 Bhaet Hielesb, Florida 88913 � 000 894-0397 ) N768 / 117688 ANCHORS & NY$C EURRICANE CUPS DWG 4: NU -5 3 o 4 Date: 4PIIM le. 2001 July 6. 2009 TABLE 6 TABLE 7 NVSTA —Heavy Duty Anchors with 14G NVTH Straps and 1 ply 20G seat Assembly Product Code 140 Strap Product Code Dimension H (inches) Total No. of Fasteners in Strap 10d x Ur Total No. of Fasteners In 20 GA. Seat Allowable Loads (Ibs) 10d x 1)¢° UpAR 6 L1 6 1.2 6 NVSTA -124 1401118 12 5 8 1308 700 1049 8 6 1428 780 1144 NVSTA -14H NVTH1B 14 7 8 1545 823 1239 NVSTA -1811 NV1112O 18 8 8 1884 887 1335 9 6 1783 950 1430 NVSTA -20N NYTN24 20 I1 NVSTA -22H NVTH28 22 e NVSTA -24H NV11428 24 NVSTA -26H NVTH30 28 u.• rA NVSTA -32H NV1H38 32 Holes Ota.',_' NVSTA -44H NViH48 44 ' EXL.Sesd h NVSTA 12H throght 44H 4' Min. Ccaerete Embedment. j y��► -- Trues p required to transfer Y;�,� uplNt to bottom chord Reinforced Concrete tie bean atn. 2/8 Top & Pattern Concrete Embedment UPLIFT NVHTA —Heavy Duty Anchors with 14G Double NVTH Straps and 1 ply 200 seat Assembly Product Code 140 Strap Product Code Dimension H (inches) NVNTA -12H NV1N18 12 NVHTA -14H NVTH18 14 N1MTA -16H NVTH2O 18 NVHTA -20H NVTN24 20 NVHTA -2214 NYIH28 22 NVHTA -24H NVTH28 24 NVHTA -2874 NVIN30 28 NVHTA-3211 NVni313 32 NVHTA -44N NVTH48 44 NVHTA 12H throght 44H ftuse uplift to plata bottom ct chord. traneter .-- tie beam Alin. 215 Tap & bottom Total No. of Fasteners in two Straps 10d x Total No. of Fasteners in 20 GA. Seat 10d x Allowable Loads (Ibs) U 6 11 L2 6 10 8 1772 2078 1050 1430 12 8 1994 1181 1831 14 8 2215 2898 1312 1812 18 8 2437 2858 1444 1994 18 8 2858 3117 1878 2173 1. Nails are necessary In straps and seat to achieve, dosing loads. 2. See note 6. sheet 1 for combined loading. 3. Nails through chords shall not force the truss plates. 4. For general notes. see sheet 1. 5. For higher uplift Foods. concrete shall be 3000 psi. 8. Hosed an min. 2500 pet concrete. %WPIN N. TOUT. PE (CIVIL) FL REG. # 12847 15123 CREEK LANE HOUSTON. TX 77088 l� sc� 20 CA. Seat Nu- Vu e Industries. Ina 1958 -1089 Zest 29 Sit Hialeah, Florida 88013 Phone 303) 894 -0397 Far 803) NVSTA & NVSTA HEAVY DUTY ANCHORS WITH BEST DWG #: NU-5 Sheet: 4 of 4 Date: APRIL 16. 8004 Revietoas July 5. 2009 Florida Building Code Online Page 1 of 2 Community Affairs Bets Home Log In User Registration Mot Topics Submit Surcharge Stats & Facts Publications ESC Staff BCIS site Map Links Search http:// www.floridabuilding.org /pr /prapp dtl. aspx? param= wGBVXQwtDgvldAvIteOYOyMR %2... 2/23/2009 Product Approval USER: Public User Eggist poars av t kleTn > Putturtarmugtotionleaul > Ajwt[rahon Lest > Application Detail FL # Application Type Code Version Application Status Comments Archived Product Manufacturer Address /Phone /Email Authorized Signature Technical Representative Address /Phone /Email Quality Assurance Representative Address /Phone /Email Category Subcategory Compliance Method Florida Engineer or Architect Name who developed the Evaluation Report Florida License Quality Assurance Entity Quality Assurance Contract Expiration Date Validated By Certificate of Independence Referenced Standard and Year (of Standard) Equivalence of Product Standards Certified By FL10739 New 2007 Approved r United Steel Products Company 703 Rogers Drive Montgomery, MN 56069 (727) 536 -7891 Ext 152 rlutz @gibraltarl.com robert lutz dutz@gibraltarl.com Robert Lutz, P.E. 11910 62nd Street North Largo, Fl 33773 (800) 443-6442 nutz@uspconnectors.com Structural Components Wood Connectors Evaluation Report from a Florida Registered Architect or a Ucensed Florida Professional Engineer F Evaluation Report - Hardcopy Received Robert Lutz PE -55409 PFS Corporation 12/31/2009 Terrence E. Wolfe P.E F Validation Checklist - Hardcopy Received FL10739 R4_CQlaindepenrience !lirntgr0001,pdf E1 -10734 RQ.CALLetter of_ Certifiication.fgrce,pdf Standard ASTM D1761 Yeas 2000 Florida Building Code Online Sections from the Code Product Approval Method Date Submitted Date Validated Date Pending FBC Approval Date Approved Method 1 Option D 05/15/2008 05/23/2008 05/28/2008 06/24/2008 Page 2 of 2 Summary of Products 1FL# 10739.1 !Model, Number or Name RT16M Limits of Use Approved for use in HVHZ: Yes Approved for use outside HVHZ: Yes Impact Resistant: N/A Design Pressure: N/A Other: Description_ MASONRY WALL RETROFIT CONNECTOR FOR REINFORCED BLOCK WITH OR WITHOUT TOP PLATE. UPLIFT = 1395V WITHOUT TOP PLATE, 1360# WITH TOP PLATE. Installation Instructions F110739 RO I1 RT16M.installatiopQQ01_pdf Verified By: Robert W. Lutz, P.E. 55409 Created by Independent Third Party: No Evaluation Reports FL10739_.RQAERT16 9.submittal.doCs0003.pdf Created by Independent Third Party: No DCA Administration Department of Community Affairs Florida Building Code Online Codes and Standards 2555 Shumard Oak Boulevard Tallahassee, Florida 32399 -2100 1850)437-1824, Fax (850) 414 -3436 2000.2005 The State of Fonda. All nghts reserved. C39ynant- and4)SCiaimgt Product Approval Accepts: Bob http : /hvww.floridabuilding.org /pr /pr app_ dtl. aspx? param =wGEVYQwtDgvldAvlteOYOyMR %2... 2/23/2009 GENERAL NOTES 1) STEEL SHALL CONFORM TO ASTM A653 STRUCTURAL GRADE 33, AND A MINIMUM GALVANIZED COATING OF G90. 2) FASTENERS ARE COMMON WIRE NAILS UNLESS OTHERWISE NOTED. 3) ALLOWABLE LOADS HAVE BEEN INCREASED BY A SHORT TERM DURATION FACTOR OF 60% FOR WIND LOAD CONDITION. NO FURTHER INCREASE IS ALLOWED. 18 GAUGE GALVANIZED PRODUCT CODE FASTENERS SCHEDULE ALLOWABLE LOADS RAFTER/ TRUSS W/ TOP PLATE MASONRY BLOCK F1 F2 F3 UPLIFT ( 160 %) RT16M (9) 10d x 1 -112. 4) 0 114" TAPCONS X 1 314" 630 480 115 1395# (9) 10d x 1 -112 (4) 16d A P4C1O4NS X 1O 3/4" O l2) ( 2) 1360# 4) ALLOWABLE LOADS ARE BASED ON THE NATIONAL DESIGN SPECIFICATIONS FOR WOOD CONSTRUCTION 2001 EDITION FOR SOUTHERN YELLOW PINE " (G =0.55 OR BETTER, AND MOISTURE CONTENT OF `2'. 19% OR LESS, ALL TESTS PERFORMED IN ACCORDANCE WITH ASTM D1761. = * 5) PENETRATION IS ASSUMED TO BE 1 1/2" INTO WOOD RAFTER & 1 3/4" OR MORE INTO WOOD PLATE. -7.1-0 6) ALLOWABLE LOADS FOR UPLIFT, :11'. F1 & F2 ARE NOT TO BE COMBINED. :. ,tN . mot, (*) INSTALL NOT TESTED (2) HOLES D FO LATERAL LOADS (2) - t111111,,,,�/ 1 11 i11i1 r,: UNITED STEEL PRODUCTS COMPANY 103 ROGERS DRIVE, MONTGOMERY, MN, 56039 PHONE (607) 3847333 NAME: RT16M DATE: 05/09/08 ROBERT W. LUTZ PROFESSIONAL ENGINEER (STRUCTURAL) FLORIDA REG. NO. 65409 SHEET: 1 OF1 DRAWING NO: 101 -02 MDADE