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RC-11-311I aA - Ai-1roA3 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. ° 11 PERMIT APPLICATION Master Permit No. FBC 20 FEB Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): ,k-g`.--re) /a' ev Ck' Z----- Phone #: 60-0 5 2- - 8-z-,-3 -3 Address: /4 © . c 92 S .r City: PI (4"n2 S R. -S State: Zip: 33138' Phone #:� cd72- -`1- Tenant /Lessee Name: Email: .4' t T ?p7 Z" o e r9 G- - /ln A-z L , GP'w, JOB ADDRESS: its o n( � . 9 2_ s r City: Miami Shores County: Miami Dade Zip: 3 3 I1 -g g Folio /Parcel #: Is the Building Historically Designated: Yes NO ■ Flood Zone: CONTRACTOR: Company Name: f}TL A nr ^r rc rN�6' A N V c5_ Phone #: I) d Address: c2.0 d C4. 2 C S Stu i' 2 3 City: 4.) P . State: r'Z- Qualifier Name: /M T /A 2- ..1-1-ril es Phone #:(S `.-) 351S - 48f State Certification or jRegistration #: C 7 6. /go g 6 '2-- Certificate of Competency #: Contact Phone #: (n or `) 3 c ` 4- r it"' Email Address: '4 7-4A-NI T` �'L'tJ6 S e � v 6) �' T�A-41A , Co 44 DESIGNER: Architect /Engineer: IM1 /AZ 741 h41 Phone #: (J i� `� Zip: 3 3 4i / 3 Value of Work for this Permit: $ 379 c9s ` r Square /Linear Footage of Work: Type of Work: ❑Address ❑Alteration New ❑Repair/Replace ❑Demolition Description of Work: e. L O S C n's, r / ■j 67 / z,"r 2)a, yis TAIL- 6/.1 t'1,-) be-w AO' l�l'� vJ PEtJ % \N6 //t-S-1- A -C-L_ » /2oAr7- VJac, COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by: 3,h � p /******** * * * * * ** * * * * *** * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ 50 ' 00 Permit Fee $ c. CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training /Education Fee $ Technology Fee $ Double Fee $ Structural Review $ ;°6 " ‘ti TOTAL FEE NOW DUE $ ' ✓• 1 9 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 approved and a reinspection fee will be charged. Signature The fore . n instrument was 01,b Owner or Agent day of ao,+ *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *** * ** : *: ; *:: * *** * *** * * * * * * *** * * * * * ** * * * ** * * * * * * ** * *.* ** Sign: Print: My Commission Expires: APPROVED BY 7g 3/1/,) (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10) Plans Examiner Structural Review Clerk STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 02/19/2010 PERSON: IMTIAZ AHMED FEIN: 320024359 BUSINESS NAME AND ADDRESS: ATLANTIC ENGINEERING SERVICES INC 200 C2 CROSSWINDS DR WEST PALM BEACH, FL 33413 EXPIRATION DATE: SCOPE OF BUSINESS OR TRADE: CERTIFIED GENERAL CONTRAC:TOR 02/19/2012 IMPORTANT F Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election L under. this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be H exempt... apply only within the scope of the business or trade listed on E the notice of election to be exempt. R E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1609 2009 -15549 STATE OF FLORIDA PALM BEACH COUNTY LOCAL BUSINESS TAX RECEIPT EXPIRES: SEPTEMBER 30, 2 0 1 1 CNTY $27.50 ATLANTIC ENGINEERING SERVICES INC AHMED IMTIAZ " LOCATED AT 4524 GUN CLUB RD #212 WEST PALM BEACH FL 33415 This receipt is hereby valid for the above address for the period beginning on the first day of October and ending on the thirtieth day of September to engage in the business,profession or occupation of: GENERAL CONTRACTOR CGC1508962 ANNE M. GANNON TAX COLLECTOR, PALM BEACH COUNTY OC -032 CLASSIFICATION TOTAL $27.50 THIS IS NOT A BILL - DO NOT PAY PAID. PBC TAX COLLECTOR $27.50 BTR 602 01820553 09/22/2010 THIS DOCUMENT IS VALID ONLY WHEN RECEIPTED BY TAX COLLECTOR Planning and Zoning C Miami Shores Village - 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 e is Permit NO. RC-2-11-311 Issue Date: Not Issued Expires:NOt Issued Folio Number:1132060133290 Owner's Name: RICHARD CAINES Job Address: 100 92 Street Miami Shores, FL Owner's Phone: Total Square Feet: 0 Total Job Valuation: $ 5,000.00 Contractor(s) ATLANTIC ENGINEERING SERVICES INC Phone (561)358 -4140 Primary Contractor Yes 1 Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 2/24/2011: Yes Comments: NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF MIAMI -DADE: 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: 11111111111111111111111111111111 Illl111111111 C F ilk 201 1 IR 0 3.2 _ s 8.. 0 OR ak 27593 ' =1 2076; c1p0 RECORDED 02/25/2011 09:55:03 HARVEY R:UV°INt CLERK OF COURT MIAMI-DADE COUNTY= FLORIDA LAST PAGE Space above reserved for use of recording office /ems a-E L72_ r M/ r',Sii-or= -C-S 33i30 2. Description of improvement: : S L R " r - R - a e " w 7 bra f' b f A r S - - • 4 U _ / A r l ` • 'roce.f- . tejilriAJ ®PL-71V-e5.1-6; /' iAr . 4- _ . -r'7- F> i2. LC/At-S-70 E o ri° '�i� � le--. S ` _ 1 s' 3. Owner(s) name and address: Interest in rop e 1-tY: 6.760-N6 R. / 3 i 3` p Name and address of fee simple titleholder: 4. Contractor's name, address and phone number: ATL r*-AJ rif 61(' eery» rr -5C Acr` E-0 T-0' C-''.2-- r, G 2- cTn S " r znrpS j' _ r °/ &a19iT itit3a''F 5. Surety: (Payment bond required by owner from contractor, if any) STATE OF FL R A, n ccp1 +rhe Name, address and phone number: I HERESY CERTIFY that this is a true A 7 of Amount of bond $ onginal filed in thr on •G ----- - 11---_ LJI✓ AU 20 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whggi Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number: 9• . HAR uu �erxgms pr � 11-1) . C. // 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. Name, address and phone number: 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 YO R NOTICE OF COMMENCEMENT. Signature(s) of Prepared By Print Name Title /Office ner(s) or Owner(s)' thorized Officer /Director /Partner /Manager . // Prepared By Ga )e4 . J %8'T Print Name J /7/4— 5'7 Title /Office STATE OF FLORIDA COUNTY OF MIAMI -DADE The f. . of i trument By ❑ Individually, or as ❑ Personally known, or owled. -d before me this • for produced the following type of identific Signature of Notary Public: Print Name: (SEAL) -7 A ,g,rliTlY�ll�ll��JE/,_AI, VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the fac.- stated in it are true, to the best of my knowledge and belief. Signatur By of Owner(s) or Owner s Authorized Officer /Director /Partner /Manager who signed above: 123.00 PAGE 3 3/10 NOTARY ILL' 3IC -STATE GR PLC t DA t"'N Claudia V. Cubil,ks Commission * DD717923 pines: S P. 23, 2011 Anam501011WCO.,111C By 1) (tf1--� 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./We — 2 — Master Permit No. Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder) �..°TM . I (C l4� c t Phone #: Address: /0 o) ! , .1( Ct £ t City: in/ yei j Vidul State: Zip: 3 3 / 3 d Tenant/Lessee Name: Email: Phone #: JOB ADDRESS: A..)0 City: Miami Shores County: Miami Dade Zip: 3 f 3 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: i s / .' .t I'd "- Phone #: ,,�`j;l - .'3.,S-4/VC! Address: ° it` t.?S Chi 1 /G' 0,,‘ City: `� /3% State: L Zip3 3 Qualifier Name: Phone #: State Certification or Registration #: (_1;.; `` 1, j (?'7 Certificate of Competency #: Contact Phone #: 5& J -.3 - 7/ y Email Address: DESIGNER: Architect/Engipeer: / Phone #: Value of Work for this Pe t') Square/Linear Footage of Work: Type of Work: ❑Additio ❑Alteration ❑New ❑Repair/Replace ❑Demolition 1/7=j• (2,4 Description of Work : . -){ 44*****"**************************** * * ** Fees * ** * **** * * * * * * * * * * ** * ** * * * * * *l ** ** * * * * * * * * ** Sub Permit Fee $ ,] J CCF $ CO /CC $ Scanning'kee Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ 60'1n TOTAL FEE NOW DUE $ 1 `o .0CD 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 willltjit he approved and a reinspection fee will be charged. Signature /�ti1/ �4� Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 I/, byG/' t1 85 who is personally known to me or who has produced,. D L, As identification and who did take an oath. NOTA' PUBLIC: Sign: Print: My Commission Expires: APPROVED BY Signature s✓� �IX /✓LC+Q.�. Contractor The foregoing instrument was acknowledged before me this day of 7� , 20 11 , by /1)1 7h42_ 1-44 who is personally known to me or who has produced / as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commissio *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 017�/ ,43. 6—,'31 is (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Plans Examiner Structural Review Notary Public State of Florida at v R'Jrana A4y Commission DD710385 moo? Fxp.ra/ 11/16/2011 *w * ** ** ** * * * * * * * ** Zoning Clerk 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 Permit Type: BUILDING RECEIVED JUL FBC 20 Permit No. j c° 2` 1 131 I Master Permit No. ROOFING JOB ADDRESS: /®o . ° q e Zip: 33138 City: Miami Shores Folio/Parcel#: Is the Building Historically Designated: Yes County: Miami Dade NO Flood Zone: OWNER: Name (Fee Simple Titleholder): S 70 I s*I R06 6 Cf2Gi e Phone#: ( ' 17) T 8772 Address: %® C q 2 Si City: /fn iA-114 e S 5 State: zip: 33 t 3 cs' Tenant/Lessee Name: Phone#: Email: CONTRACTOR Company Name: T L- /k r° (e �� £ER e Address: -2-e) 6 C 2- CZ0$S 6,5-14-r sys >g. I City: ti./ ' P • State: Qualifier Name: /fv i A - -,'h Ph °.(5 -6 J %35:;§ - 4t//(o Zip: 334-1 ?, Phone: C57) l) 3 5&- (Of State Certification or Registration #: eG G / ,so 6 2- Certificate of Competency #: ContactPhone#: 6C6' 35 &_ /fl L c' Email Address: c C6-n16/5E-tic v e k1.0`i f}1 oli.L �O4 DESIGNER: Architect /Engineer: Phone#: Value of Work for this Permit: $7/7.2 , Type of Work: OAddition DAlteration Description of Work: New ear Footage of Work: DRepair%1Zepiaee r ODemolition Color thru tile: ** ****************** ** ******a *** ******F *** * *** * **s4***** **** ********* * *** ** ***** ** Submittal Fee $ Permit Fee $ QS -03 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 CONDmONERS, 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose prope • subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first tf, ection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspectio ill not be approved ai reinspection fee will be charged Signature The fore ' in day of wh Signature - p — Owner or Agent v Contractor instrument was ac owl -' ged befo 9 The foregoing instrument was acknowledged before me this /e day of -T L-Y ,20/2_-, by 7//1774 -2— t--6 r who has produced who is personally known to me or who has produced, CL b --j_ as identification and who did take an oath. As identification and who did take an oath. NOTAR ' UBLIC: . Sign: Print a My Commission Exp 2 � • _ My Comm. Expires s�r��" ,$: Commission * EE 128810 ! e h National Notary Assn. ';o.� BondedThroug NOTARY PUBLIC: Print: ' i nrir l2 An 441 My Commission Expires: �'`;•• •P6°�• KATHY R YRANA * * MY COMMISSION :# EE 1 166 ,� '„ , EXPIRES: November 16, 2015 FOF c4O &We n n Budget N r Sento ********* * * * * * * * * * * * * * * * * * * * * * * * * * *****+ nix** * ********* **+x****** * ** *+a+>< ************** * * *** * * ******* * *****m**** APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: I NSP- 177227 Permit Number: RC -2 -11 -311 Inspection Date: August 09, 2012 Inspector: Bruhn, Norman Owner: ROBERGE, KERRY & GASTON Job Address: 100 NE 92 Street Miami Shores, FL Project: <NONE> Contractor: ATLANTIC ENGINEERING SERVICES INC Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Addition/Alteration Phone Number Parcel Number 1132060133290 Phone: (561)358 -4140 Building Department Comments CLOSE EXISTING FRONT DOOR AND INSTALL IMPACT WINDOWS. CREATE A NEW OPENING FOR ENTRANCE DOOR LIC AND INS MUST BE UPDATED FOR BUILDING AND ELECTRIC PERMIT. Passe ' Inspector Comments • c....., , Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until August 09, 2012 For Inspections please call: (305)762 -4949 Page 1 of 1 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 - 161024 Permit Number: EL -6 -11 -991 Scheduled Inspection Date: August 08, 2012 Inspector: Devaney, Michael Owner: ROBERGE, KERRY & GASTON Job Address: 100 NE 92 Street Miami Shores, FL Project: <NONE> Contractor: BAILEY ELECTRIC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060133290 Phone: (954)981 -6770 Building Department Comments RE- LOCATED LIGHT EXTERIOR 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- 160915. Need to add smoke carbon monoxide detectors. August 07, 2012 For Inspections please call: (305)762 -4949 Page 1 of 33 08/07/2012 10:08 00000000000000000003 FAX 106463-3 BUSINESS NAME /! -OCAT ON BAILEY ELECTRICAL CONST CORP DUINi3 BUS IN DADE CO THIS IS NOT A BILL - DO NOT PAY F RST-ci AS$ U.S. POSTAGE. • PAID M AMI, F1, PERMIT NO. 231 RENEWAL RECEIPT NO. 106463 -3 CC # 000017022 OWNER BAILEY ELECTRICAL CONST CORD ' Sem 'Typo eff lieuttsose WORKER /S This tiro. CTRICAL CONTRACTOR 1 e U 8S Th* REtta�T. £r DOER NOT THE IMMO REGULATORY OR 2ONING LAWS. OF THE MUM OR caTIES. IM DOES IT ► A MO,�Awnr ane n Maur OR LMOSE UCH �"o ni,CN6OF THE ROWERS OILUSICA, HOWL PA_ 1'=lico YEn ,OD{AiiY' TAX 09/12/2011 09010220001 000075.00 SEE OTI$FA SIDE 0d NOT FORWARD BAILEY ELECTRICAL CONST CORP BARRY FLOYD PRES 3521 SW 35 ST HOLLYWOOD FL 33023 1,, 11,„ 11, 11,,,„ 1, 1„ 11„ 11 ,,h,I1f,111 all ,,,,i,1„,111211 b1AX COLL E COUNTY 201/ MUNICIPAL CON4TRACTOR'S 2012 FIR6T -CLASS FAX CO! i EC TOR TAX RECEIPT U.S. POSTAGE i 140W. FLAGLER ST. MIAMI -DADE COUNTY - STATE OF FLORIDA 1st •FLOOR PAID MIAML FL 3313o PURSUANT To COUNTY CODE SEC. 10 -24. Num FL EXPIRES SEPT. 30, 2012 PERM' NO. 231 THIS IS NOT A BILL -, DO NOT PAY RECEIPT NO. 30- 1064633 CC NO; 000017922 9USiNESS NAME / LOCATION 'BAILEY ELECTRICAL CONST CORP D4 /NO BUS IN BADE CO OWNER ;BAILEY ELECTRICAL CONST CORP SEE BACK OF RECEIPT' FOR A LIST or MON- PARTICIPATING MUNICIPALITIES RECEV HOMES MU% register in the city whets wp5 is to ba done. PAYMENT RECEMEb FROH DEOOt7MY.TAX GO 06/2011 02260007001 000200.00 RECEIPT HOLDER MAY DO BUSINESS AS A CONTRACTOR AS SPECIFIED HEREON. ELECTRICAL CONTRACTOR DO NOT FORWARD BAILEY ELECTRICAL CONST CORP BARRY FLOYD PRES 3521 SW 35 ST HOLLYWOOD FL 33023 18 PAGE 03/04 08/07/2012 10:08 00000000000000000003 t 7/30/2012 12:35 Lean Insurance FAX ienlfer Garcia- >VILLAGE OF IMIAMI PAGE 02/04 1/1 CERTIFICATE OF LIABIUTY INSURANCE Mae 7/30/2oi2 i Producer: Lion Insurance Company 2739 U.S. Highway 19 N. • Holiday, FL 34691.Otd� (727) 938 -5562 This Cereiflate Is issued ilea matter of Information only and confers no rights upon the eo,:tftaate tialdar. This Carsitt®ta does not amend, extend or altar �' the porsiea heloar, Insurers Affording Coverage NAIL # Instimd: South East Personnel Leasing, Inc. & Subsidialieg 27391 J.S. Highway 19 N, Holiday, FL 34691 um . • piny ui nce pi ` 75 Mama B: 'newer C: Instuer D: - Maurer 1:: • Coverages . OSLe`es. a15urmnce ed,.:'. Nye•= - leme to me el, - •rem -,. a... - tlr, -g...i .,:.,., .C,m '":,∎^"�"- 'F"':im 8t1yrg6Wrem9nt.twin or ...r. cm,, C-�.St a0 +BT•OC rtifiCatemoYbe issued ormeye artein. the InsureeteaRardedb' meD0ftdesdesalbea herein lesubjedro all the terms. exd ens. old conditions cf9ucbookies. AQgregate Welts Awn may have been reduced ty paid derma. IN53 Lift ADDL tN5R130 Type of Insurance Poky Number Potiey8feeitve Date (MM/DDAN) Policy emindise Ds% (MM/DD Limits ENERAL • • • LABILITY Commercial General Liability • claims Made C0 cx..,, EadeOccunonco Oimmieinrantedpr6rrflsaa(BA oecurronc$) 3 M sd Mo Pining Adv ih[tey n e- -, al aggregate iii111t appoes pm" II Parry ❑ ?Meet ❑ LOC Gornto' At Bate Prrducts. Com/Op AN UTOMOBILE ■ IIown Ill II ■ I LIABILITY MY AJ10 All ed AutcsHerSi Sctredded Autos kred Autos Non.OaatedAaos Comb rod $ing'e Limit (EA AcNd $ (Pw NMI) $ BodIN ni (PerACtldenti $ Properly berme (PerACcidene) EXCESS/UMBRELLA LIABILITY ■ Osar' II Claims MoKla Dedutoie ocwnume • Ag$ro®eaa A Workers Compensation end Empbyers' Liability An ist Mme nereemmuti +e eifirer memeer exetudad7 NO If Yea, dearnbe tinder tepeaial provision bs1 W, WC 71848 01101/2042 01/012013 X 1WOStatu I Wry Limits I 1 OTH- ER ' S.L. Egch Aecidoed 000.00 EL Dismiss • Fat irptpyee - $1.000.000 s► E.L. Disease- Pokey Limits 59.040.00 other Lion Insurance Com •1:,r, is A.M. Rea Cam :`U. rated A- Excellent . AMB # 12,316 Desodpttorts of Operdtlonsll ocatonsNehlcies/Exrchrslons added by Lndorsem9 f5pechtl Provisions: Chant ID: 0345422 Coverage only applies to.actiVe employee(s) of South East Employee Leasing Services, Inc. that are leased to the following *Client Company: Florids'ikndespeopke, LLC Coverage only applies to injuries Incurred by South East Personnel Leasing, Inc. t0. Subsidiaries active employee(s) , while working in Florida. Coverage does not apply to statutory employee(s) or Independent contractor(s) of the cunt Company or any other entity, A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 9372138 or by caillna (727) 938 -5562. Project Name: . Coverage only applies to active employees(s) of South East Personnel Leasing, Inc and Ws Subsidiaries that are leased to the towing "Client Company' Florida . Tradespeople. LLC for Temporary Assignment To BAILEY ELECTRIC/ NB SCOTT LIGHT POWER& SIGN. FAX:561 -870 -2774 &12+54-986-2878 /ISSUE 07.3012 (JG) .:, ,.. !, il „ h' +' / ' CANC®.LA VILLAGE OF MIAMI SHORES BULLING DEPT ATTIkVALLI6 1oosD NE 2ND AVE MifU4fl5h+PR13S FL X138 S fi o u r d err 4 the a b o v e described potdes be eaxeuadbetore t h e o¢ ion d i e s ther'air. s etrp disuret wit endeeverto men 3Ddeyswdmss itotttate tee ceNficateholder wed itthin�t .bntfaileetse somaiimposeno oWgjE t orpat tatyor any Sand epos rte igai>ree, be egert or represen1aivee. - ".its . 08107/2012 10:08 00000000000000000003 FAX PAGE 04/04 CTQB Construction Triodes QL ang Hound USINSSS CEICTfP 1CATE OF COMPETENCY 000017022 BAILEY Eutcr CONst cow, D.B.A.. SCOTT .R CHARLES 1sr .the qf loot . 07/25/2012 A f 10: 49 THIS CERTIFICATE i8 ISSU CERTIFICATE DOES NOT BELOW, Tests CERTIFICA REPRESENTATIVE OR PRO IMPORTANT: If the cfrrtlfica the terms and conditions of t certificate hoIdor in lieu of s PRODUCER INDEPENDENT INS 6827 Sunset Str Sunrise, FL 333 tNSu ED 00000000000000000003 FAX PAGE 02/03 il i ) CERTIFICATE OF LIABILITY INSURANCE C7A,'E/20 reel D AS A MATTER OF INFOgMATFON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. (THIS 3/12/2012 I FFIRMATIVELY OR NEGATIVELY AMEND, EXTEND QR' ALTER THE COVERAGE AFFORDED SY THE POLICIES E OF INSURANCE DOES NOT CONSTITUTE A CCINTHAC7 BETWEEN THE ISSUING rNSUREtRisj, AUTHORIZED UCIcR, AND THE CERTIFICATE HOLDER, rctlder is art ADDITIONAL INSURED, the poiicy(iesj must be endorsed. if SUBROGATION 18 WAIVED, subject to e policy, certain pollcres may require an endorsement. A statement on this certificate does not confer rights to ills ch endorsement(!!). BAITZY EL DBA BOB 3 3521 SW 3 HOLLYWOOD, 954- 981 -6 THIS IS TO CERTIFY THAT T INDICATED. NOTINITHSTAN CERTIFICATE MAY eE ISSU EXCLUSIONS AND CONDITIO Nen. LTR I TYPE Or INSURAN GENERAL LIABILITY P 3 CE ZNC NAME ANN C SOLED t4J N 6rtt; (954. ) 583 -7100 Abbrr ssindinsX@aoj .cons ._.,. INS/Metal1 OROI1G CCM/A/46E (44H0):(9 ;i) 58Q -5300 CTRIC .. LI,C � I IN3uRER A B ..MO IWC7NUN T . OTT LI GHT POWER & SZGN IURRER vEaViaEci� R N�O_� io FrNIsRgrxE n riIc'�N" S c c>rCd,PO isz zY ST I INSURER FL 33023 ( . ... .. 70 L rNSUR.P E i raSUR[R CDR- I'IFICATE NUMBER• POLICIE:a : ?F INSURANCE LISTED BELOW ;IAVE ifi>rEN ISSUED REVISION NUMBER; ING ANY REOUFREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 1AnTr VREF PECT TO WHICH THig I D OR MAY PERTAIN, THE INSURANCE AFFORDED 8Y THE POLICIES DESCRIBED HE -REIN 1$ SUBJECT TO ALL THE TERMS, S OF SUCH POLICIES COMETS SHOWN MAY HAVE BEEN REDUCED 8Y PAID CLAIMS, 11ADDL -rites*, ' . . jA3 r `i, YYI tNrMVOISrrYYPI ' X : COMMERCIAL GENERAL L A81LI"rY • CLAlm8 -MADE I X OCCUP. ; A t GEN'L AGGRATE LIMIT APP EC3 It+CT AUTOM08It f L,UIBILFTY ANY AUTO ALL OWNED AUTos HIRED AUTOS AU NO AU es PER. Lcc OsUI.E4D •(7WNED ?6s _TIt s 1 Pot ICY NUMBER P I-1 Ear ! POOt'Y rX UMBRELLA LtA2 X n X I EXCESS LIAR I DEE) ? LR 'TT_ryTIDNS WORKERS COMPENSATION ANLI EMPt.OYERS' LIABILI`Y MY apOpRtEroR(PARYNgRrfXECld 1 CFFICr?kAI MI9CR EXCLUDED? I Iirr #04akon In NH) !! If yes. tleacrfbe under DESCRIPTION, OF OPERATIONS )CCU* ;LAIM$�MLApE j IE DES �RI r'TION O>= OPERATIONS r LOC l 0N3 a VE-r!CLES. (Attach ACOt? 1 1, s scr, ELECTRICAL CONT TOE - 0 0 Atldiiebnal Remer %5 9Gteduk, if mare space IS r941RFOCf) ICL2345070A XL2550017A LIMN, TEACH occv,�RENCE 1$ 1,000,000 ' rPRMI3L L',u e ? s 100 00 N :ED EXP(Any bite earsent 1 ./ 8 03/O6/2Oi2 P3/U6f20.13 I $ 5 r 00 I IPERSONAL s AL3viNJURY $ 1 000 r.0 00 1 i GENERA,, AGGRE.;AIE • I s 2,000,000' , 000, 000 i !!` PRoDucrs . COMP /0a AGG I S 2, 00 0, 0 0 0 1 3 0 .� , crk_dertt) BODILY INJURY (Par poraon) $ BODILY INIURY'Per acod¢ntll PROPERTY DAMAGE (P.nr accitlent) .. $ 9 IO3/O6/202.2 1112/o5/2O .3 EACH OCCURRENCE AGO R4GATE CEF TiF1CATE MXAMI SHOD" 5 VILLAGE BLDG DEPT 10050 NE -nd AVENUE MIAMI S1l0'• - S, FL, 33138 ACORD25(201 OM) The ACORI7 name and logo are rogISIered marks of ACORD CANCELLATION ..1$ 2,000,000 $ ;OTH, TORY LIMITS I ER E L. EACH ACGIGENT i3 $ C.( OISFASE • EA EMPLOYE, $ F. i•• DisEASE - POLICY LINUT 9 2,000,0001 SHOULD ANY OF THE AfovE DESCRIBED POLICIES DE CANCELLED E1wFORE I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE M TN THE POLICY PROVISIONS. AUTHORIZED RC-PRFSSENTATIV£: t 1988 -2010 ACORD CORPORATION. All rights reserved. ,lam 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 Permit ype: Electrical /o /0 9ade,Cr6CE6 i JOB ADDRESS: ECE VED JUL 2 5 FBC 20 Permit No. El 0-99' Master Permit No :KO.1) -- 1 City: Miami Shores County: Miami Dade Folio/Parcel#: Is the Building Historically Designated: Yes NO ' Zip: Flood Zone: OWNER: Name (Fee Simple Titleholder): As-rem 75 0 1 E ( £ Phone#6. S) ,..5—C — 2-03 Address: / D ® /U F , a., ce r4 E F % City: M 1 AM( S / 1Z1' 5 State: F • Zip: Tenant/Lessee Name: '�� Phone#: Email: 2 CONTRACTOR: Company Name: Aq / Address: s®? / . £L-3 . 4- City: g_ 7— Peg-te State:_ F L Phone #: 9.571/ F G, 7 7 co Zip: 3 3 D Qualifier Name: C t f 5C-67 r Phone #: ¶.$ I cT . 4 7 7 40 State Certification or Registration #: E) t3 016 ®Z Certificate of Competency #: P7eD Z Contact Phone #: �7 i - 9 ff /- 6 `7 ® Email Address :'X o I sC° err 7 L 1 6 4 ri,u c 4 An- .0e tet DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: OAddress DAlteration Description of Work: UNew ORepair/Replace DDemolition ***** **+ x****** *+€ *********+x**** *+xt�xx� *+�***F �xa�* �xx�****, �************+ x�r* .xa��x�x�n+x****+xa��x�x+x�x*** Submittal Fee $ Permit Fee $ 1 50•0D CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ • o e.. 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. _t understand that a separate permit -must be sec ured -for LTC'Y'RICAL 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 brochu ' will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commenceme , t must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the abs nc . such posted notice, the inspection wig t be approved and a r inspection fee will be charged. Signature The for day of who is NOTA Owner or 'gent g instrument as J _ by r who has produced entification and who did take an oath. Sign: Print: My Commission Expire 2 Notary Pubitcres SeP 23 015 Y Commission #6 EE taT Assn. a'T= Y °o-' Bonded Through National No Signature / e.ecji C �' Contractor The foregoing instrument was acknowledged before me this. gg day of 20 L, by Bo 6 S tJ who is personally known to me or whedueed as identif a io and who -diiid take an oath. NOTARY PUBLIC: ***** **+ x**m ***** ***** *** *********+x***+x*******a *** * *** *** ** *** ** **** :**** ***** **** *m+x******+x ******* ** **** *** APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Miami Shores Village ' n Department JUN ° 1 011 Builds Building p 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 4. Permit NoR L,--- — t/- 3 1/ Master Permit No. ELC ( - 1 Permit Type: Electrical O W N E R : N a m e ( F e e Simple T i t l e h o l d e r ) : ( S (O eckcC Phone (cam, )S(Q Addresi ,r` - —14 cQ City: f litai( s'eicotc State: F Zip: 33(3 Tenant/Lessee Name: —.. --,, Phone#: Email: JOB ADDRESS: N C Q e/(/ 9 L" City:augLic iiami Shores �,� C Folio/Parcel#: Is the Building Historically Designated: Yes z. NO '' Flood Zone: CONTRACTOR: Company Name: {Sal e I P 'p Phone#: 9Sy 9K/ °' % 7767 Address: 3.5.2 ( 5 tt) .11k City: Ali s t P� t ff— State: P'L. Qualifier Name: PO b e,,- Sc tf State Certification or Registration #: Email Address: Zip: 330.3 Phone#: 9S�/ - 9521 - 677o R 0,00 Contact Phone#: 9SN-9 R l— t, 700 7 a Certificate of Competency #: J 76 .22 DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ Square/Linear Footage of Wog/if—el . ep I Repau Type of Work: DAddress Al erasion ONew Description of Work: /R lace L7Deomlition Se4 C>C2, * * *** * * * * **** *** ***** * ************* Submittal Fee � ' Permit Fee $ /5—°1 e° 0 CCF $ CO /CC $ t , Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ 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 commence ' t must be posted at the job 'se of such posted noti the for the first inspection which occurs seven (7) days after the building permit is issued. In t inspection will t be approved and a rnspection fee will be charged. Owner or Agent The foregoing instrument was acknowledged before me this 1 day of ,'�i�. who i ,20_V,by to me or who has produced NOTARY PUB Sign: Print: As identification and who did take an oath. PUBLIC: �``� ®\�w��ti��utii irrrrr� '''' My Commission Expires: * * * * * * * * * * * * * * * * * * * ** APPROVED BY 11111111111111 * * * * * * *****+RAM+NON+k***16* * *+ *** ***** F****+Y+R#+M* ****AMY****** ** The fore _ g instrument was acknowledged before me this.426 day of qk , 20 j(, by po loer± who is personally known to me or tie -has preduEed- aQ v«� n .._.7 who eiik t 1 o is NOTARY PUBLIC: *4 M' COMM SION # E i I 87 xpl,, ‘revd— °L —plans Examiner Structural Review (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning 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 100 NE 92 Street Miami Shores, FL 1132060133290 Block: Lot: KERRY ROBERGE Owner Information Address 100 NE 92 Street MIAMI SHORES FL 33138- Phone CeII Contractor(s) BAILEY ELECTRIC Phone (954)981 -6770 Cell Phone Valuation: Total Sq Feet: $ 500.00 100 1 Type of Work: RE- LOCATE LIGHTS EXTERIOR Additional Info: Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $2.25 $2.25 $0.20 $150.00 $3.00 $0.80 $159.10 Pay Date Pay Type Invoice # EL -6 -11 -41077 06/01/2011 Cash 06/08/2011 Credit Card Amt Paid Amt Due $ 50.00 $ 109.10 $ 109.10 $ 0.00 Available Inspections: 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. June 08, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date June 08, 2011 1 CERTIFICATE OF LIABILITY INSURANCE i DATE (MM/DD/YYYY) 15/26/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the poiicypes) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER INDEPENDENT INSURANCE INC 6827 Sunset Strip Sunrise, FL 33313 INSURED BAILEY ELECTRIC CONSTRUCTION CORP . i DBA BOB SCOTT LIGHT, POWER & SIGN 3521 SW 35 ST HOLLYWOOD, FL 33023 954- 981 -6770 NAMEACTANN C SOLED itkigNa,Ext); 954) 583 -7100 t AD IEss_indinSl @aol . com epic No)_ {954) 584 -5100 MWRERM AFFORDING COVERAGE INSURER A . MOUNT VERNON FIRE INS CO INSURER 13 3 ________ INSURER C : • INSURER O;�_••_. INSURER E . INSURER F : NAIC4 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCI USIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR _ ADDL STBdt • -.._ • . .. Ifn�jT CY FFF : _POLR:Y tXP. -- _ -..... • L-R TYPE Or INSURANCE INSR VIND POLICY NUMBER (MM/ODNYYYI • {MM/ODIYYYYI , LIMITS GENERAL LIABILITY DAMAGE. I U kLN I ED X COMMERCIAL. GENERAL LIABILITY PREMISE .,( eCCJItIe1q3i . `-.. 1 ©O, 000 CLAIMS -MADF X OCCUR ✓ MED EXP iAny cme person, $ 5,000 03/06/2011.03/06/2012 L'tERSONA}SAININJURY $ 1,000,000 EACH OCCURRENCE s 1,000, 0{30 . GENT_ AGGREGATE LIMIT APPLIES PER POLICY PRO JECT JECT AUIOMOBILE I (ABILITY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS GENERAL AGGREGATE $ 2,000,000 I PRODUCTS - COMP/OP ACG $ 2,000,000 • COMBINED SINGLE LIMIT 1L3 accident) BODILY tNJURY (Per person: • BODILY INJURY ,Per aci xic u $ PR0l t 1d 1 Y I5AMAC _ • a (Per acclde•t) UMBRELLA tIAB OCCUR EXCESS LIAR CLAIMS -MADE DED RETENTION$ EACH OCCURRENCE AGGREGATE. WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNFR /EXECUTIVE O: I ICER/MEMBER IXCLUDED7 (Mandatory In NHt If yes describe under DESCRIPTION OF OPERATIONS below YIN N/A WCSIATU• OIH [DRY LIMITS Eft E.L. EACH ACCIDENT S _ E L DISEASE - LA EMPLOYEES � E L DISEASE POLICY LIMIT $ DESCRIPTION OF OPERATIONS /LOCATIONS / YUMA ES (ARectt ACORD lUt Additional Remarks Stedute If Irmo space is metaled) ELECTRICAL CONTRACTOR CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BLDG. DEPT. 10050 NE 2nd AVENUE MIAMI SHORES, FL. 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD25 (2010/05) 0 1. 8 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD g 5/26/2011 16:27 Lion Insurance LION INSURANCE COMPANY- }MIAMI SHORES 1/1 CERTIFICATE OF LIABILITY INSURANCE 1 5/26/2011 produce: Lion Insurance Company 2739 U.S. Highway 19 N. Holiday, FL 34691 (727) 938 -5562 This Comte M Issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by *e policies below. Insured: South East Personnel Leasing, Inc. 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurers Affording Coverage Nttettrar A: Lion Insurance Company NAIC • 11075 Insurer 8: Insurer C: Insurer D: Insteer E: Coverages fhe polled of Inslwence head WOW reve been leaned to the hawed owned above for the poio/period Indicated. htioltratatingling any requirement, barn or condition of any corarBct or Omer documettWNh respect toenail this certificate may be Issued or may pertain. the imarance afforded by the polides described herein is subject to the terms, exclusions, and conditicas of such policies. Agate lints sham may hate been reduced ty paid claims. pVSR LTR ADDL NERD Type of Insurance Pokey Number GENERAL LIABILITY Commercial General Liability Claims Made El Occur General aggregate Omit applies per: 3 Policy 0 PreeCt 0 LAC MR Policy Effective Date (MM/DD/YY) Poky Expiation Dote MM/DD Limits Each Occurrence Damage to rerled premises (EA oetamence) Med Bop 8 Personal Arty !Allay General Aggregate i Products - Comp/Op Agg AUTOMOBILE LIABILITY Maar POI Any Auto Ai Owned Autos Scheduled Autos Fired Autos No : anted Autos Combined Since Limit (EA Acdderd) Bedift, (per Pin) Email (PerACdderd) 3 Property Damage (Per Accident) a EXCESS/UMBRELLA LIABILITY odes 0CidrrsMade Deductible Each Occurrence Aggregate A Workers Compensation and Empbyers' LiabMy Any proprietixfpetnedexeculive omaer/member excluded? If Yes, describe under special provisions below. WC 71949 01/01/2011 01 /01/2012 X I tow L 1 I ER E.L. Each Accident $1,000.000 E.L. Disease- Ea Employee S1,000,000 E.L. Disease - Poky Limits 81.000,000 Omer Lion Insurance Company is A. M. Best company A- (Excellent). AMB # 121116 Descriptions of Operations /LocatlonsNalUdes&Exchaslons added by Endorsement/Special Provisions: tit ID: 8345.022 Coverage only applies to active employee(s) of South East Personnel Leasing, inn. that are leased to the fallowing °Clentt Company': Florida Tradespeople, LLC Coverage only applies to !ludas incurred by South East Personnel Leasing, Inc. active employe el (s) , while worldng In Florida. Coverage does not apply to statutory employee(s) or Independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937-2138 or by calling (727) 938 -5562. Project Name: Coverage only applies to active employee(s) of South East Personnel Leasing, Inc that are leased to the folowing "Cleft Company" Florida Tradespeople, LLC for Temporary As sigrsnent To BOB SCOTT POWER LIGHT & SIGN Only* FAX: 561 - 670 -2774 & 954-985.2876 / ISSUE 05-26-11 (SD) CEITTIFlCATE HOLDER MIAMI SHORES VILLAGE BUILDING DEPARTMETN ATTN: VALUE 10080 NE 2ND AVE MIAMI SHORES, FL 33138 CANCELLATION Bosin Dabs: 3/29/2010 any efts above described potdes be canceled before the estraden date thereof, the Ise ing tNi endeavor to mail 30 days Written notice to the Certificate holder named tone Felt, buttaineto do so shall impose no obligation ortabiityof any Land upon the Insurer, fts agents or remesentattyes. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 SCOTT, ROBERT C BAILEY ELECTRICAL CONSTRUCTION CORP. 3521 51435TH ST HOLLYWOOD FL 33023 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better, For information about our services, please log onto www.myfioridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE STATE OF FLORIDA (850) 487-1395 AC# STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ERA007602 09/21/10 108081075 REG ELECTRICAL CONTRACTOR SCOTT, ROBERT C BAILEY ELECTRICAL CONSTRUCTION C (INDIVIDUAL XUST-NEET ALL LOCAL LICENSING REQUIRMMINTS PRIOR TO CONTRACTING IN ANY AREA) HAS REGISTERED under ths provisions of Ch.489 Expiration date: AUG 31, 2012 L10092102586 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD SEQ# L10092102586 DATE BATCH NUMBER LICENSE NBR 09/21/2010 108081075 ERA007602 ditiona1 Business Qualification The ELECTRICAL CONTRACTOR Named below HAS REGISTERED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2012 (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) SCOTT, ROBERT C BAILEY ELECTRICAL CONSTRUCTION CORP. 3150 PEMBROKE ROAD HALLANDALE FL 33009 CHARLIE CRIST GOVERNOR DISPLAY AS REQUIRED BY LAW CHARLIE LIEM SECRETARY MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130 2010 LOCAL BUSINESS TAX RECEIPT 2011 MIAMI -DADE COUNTY - STATE OF FLORIDA EXPIRES SEPT. 30, 2011 MUST BE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER 8A - ART. 9 & 10 CT A Rai_; 106463 -3 BUSINESS NAME 1 LOCATION BAILEY ELECTRICAL CONST CORP DOING BUS IN DADE CO OWNER BAILEY ELECTRICAL CONST CORP Sec. Type of Business THIS Is 1I9Y6A ELECTRICAL CONTRACTOR BUSINESS. TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S QUALIFICA- TIONS. PAYMENT RECEIVED MIAMI -DARE COUNTY TAX COLLECTOR; 09/02/2010 60020000561 000075.00 Sim €. OTHER SIDE MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130 FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 RENEWAL RECEIPT NO. 106463 -3 CC # 000017022 WORKER /S 1 DO NOT FORWARD BAILEY ELECTRICAL CONST CORP BARRY FLOYD PRES 3521 SW 35 ST HOLLYWOOD FL 33023 1b3B 11819 2010 MUNICIPAL CONTRACTOR'S 2011 TAX RECEIPT MIAMI -DADE COUNTY - STATE OF FLORIDA PURSUANT TO COUNTY CODE SEC. 10 -24 EXPIRES SEPT. 30. 2011 RECEIPT NO. 30-1064633 CC NO: 000017022 BUSINESS NAME 1 LOCATION BAILEY ELECTRICAL CONST CORP DOING BUS IN DADE CO OWNER :BAILEY ELECTRICAL CONST CORP SEE BACK OF RECEIPT FOR A LIST OF NON - PARTICIPATING MUNICIPALITIES Receipt holder must register in the city where work is to be done. PAYMENT RECEIVED MIAMI-DADE COUNTY TAX COLLWq202 /2010 60020000563 000200.00 FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 RECEIPT HOLDER MAY DO BUSINESS AS A CONTRACTOR AS SPECIFIED HEREON. ELECTRICAL CONTRACTOR DO NOT FORWARD BAILEY ELECTRICAL CONST CORP BARRY FLOYD PRES 3521 SW 35 ST HOLLYWOOD FL 33023 1 0001 0002 0004 0037 Hemrinio 4mwle2 P.E. Secretary of the Board QUALIFYING TRADE(S) ELECTRICAL BURGLAR ALARM FIRE ALARM SPECLT LOW VOLTAGE SPECIALTY AMami,Dede County retaais ep property ri9tds Mrein. STATE OF FLORIDA DEPARTMENT OF HEALTH , ONS.I SEWAGE TRA i°I NT AND DISPOSAL SYSTEM CONSTRUCTION 'INSPECTION AND FINAL APPRQItAL PEI� N :RECEIPT #: PROPERTY ADDRESS:... LOT:.L_. SU$DIV }SION ;::....:f yam:..• *r..r? - CHECKED ITEMS ARE . NOT TANK INSTALLATION i',_ [ j 1011 TANK SITE {1y{ C. [21 f 1021 TANK MATERIAL.. :a "••: - - - - -- -- -. _= - - _ = -. - _.- = =_ =.T_.. • IN •'COMPLIANCE WITH.;: STATUTE. - OR RULE AND MUST .::':BE •.CORRECTED • 1 ] 1.:. [291 DATE WELLS'. • 1 [301. : PUBU WA LS • • 1 .:[311 • • .IRR . ' l : [321 oT INES - A • 1 [331ION 1 ] S` .:1351 OTC► • [ 1 1031 f '�1 1041 OUTLET DEVICE MULTI-CHAMBERED ' [Z'/ N 1. 1 '1 1051 OUTLETFILTERf : [' A 106I LE-GEMD, i [ jl [071 WATERTIGHT ) [08] LEVEL 1 1... .[09) DEPTH TO LtD : SETBACKS 1271 ,E wATE:R [281 DRAINFIELD .INSTALLATION (101 AREA [i1 ;41.S [21 " °� - :). 939- [111 DISTRIBUTION BOX HEADER 1121. NUMBER OF [131 DRAINUNE SEPARATION 114) DRAINUNE SLOPE [151 DEPTH OF COVER La._ I [161.: ELEVATION [ABOV .. OVV,1 l 1171 SYSTEM LOCATION [18) DOSING PUMPS [19) AGGREGATE SIZE N 1201. AGGREGATE. EXCESSIVE FINES.: [211 AGGREGATE DEPTHS : F ,• FILL / EXCAVATION MATERIAL' [ +. [22] FILL :AMO[1NT <" • ['. • l [23) FILL TEXTURE [. [241 EXCAVATION DEPTH 1 1 [25] : AREA REPLACED 1 1 [261 ..:. : `REPLACEMENT MATERIAL . . FILLED /. MOUND .'SYSTEM: .... [361 DRAtNFIELD COVER 1371 HERS 1331: .1391 STAATtON.. ADDITIONALT#!N` [,,,,-1. 1401 UNWEA t [411} [ 1 [b21 1 1 [431 489AttrENAIteE AGREEMENT .. 1441 OI [ 1 [451 .: -1-CCOCKINIVONFORMS WITH SITE PLAN [ 1 [461 FINAL SITEGRPRING [ _.-1 [471 CONTRAC [ ] 1481 ' OTHER ABANDONMENT .. : ,r [491' TANK PUMPED > <<:' %•:? .......::...f..:.: ' .:. ./t t .. / 1oo1.'::,.: TANK CRUSHED .$ I�iL:ED =:' ::' . EXPLANATION :OF•VIOLATIONS !REMARKS: ,.I • 1: •1:. l .I:'. 1 `1. . CONSTRUCTION °f a SAPPROVEn .. DATE > ' FINAL SYST -E [APPR#E[I/DISAPPROVED): `- DSH o dgy 4o Nun r1B :4004* evious Editions Mar BUed) 4 - 4016 -4 1 MIAM 3 COUNTY BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) Jeld -Wen, Inc. (OR) 3250 Lakeport Drive Klamath Falls, OR 97601 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. DESCRIPTION: Series "6100 S/H & 6400 D/H Premium Atlantic" Aluminum Single -/ Double Hung Windows - L.M.I. APPROVAL DOCUMENT: Drawing No. JELD0093, titled "Premium Atlantic 6400 D/H & 6100 S/H Alum. Window, LMP', sheets 1 through 8 of 8, prepared by PTC, LLC, dated 08/11/09 with revision "A" dated 12/17/09, signed, signed and dated 02/11/10 by Robert J. Amoruso, 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: Large and Small Missile Impact Resistant 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 revises NOA No. 07 -0717.05 and consists of this page 1 and evidence pages E-1 and E-2, as well as approval document mentioned above. The submitted documentation was reviewed by Jaime J. Gascon, P. E. MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1107 MIAMI, FLORIDA 33130 -1563 (305) 375 -2902 FAX (305) 372 -6339 www.miamidade.Gov /buiidinacode MIAMFDADE COUNTY APPROVED NOA No. 09-0916.05 Expiration Date: December 12, 2012 Approval Date: March 17, 2010 Page 1 Jeld -Wen, Inc (OR) NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS 1. Manufacturer's die drawings and sections. 2. Drawing No. JELD0093, titled "Premium Atlantic 6400 D/H & 6100 S/H Alum. Window, LMI ", sheets 1 through 8 of 8, prepared by PTC, LLC, dated 08 /11/09 with revision "A" dated 12/17/09, signed, signed and dated 02/11/10 by Robert J. Amoruso, P. E. B. TESTS 1. Test reports on: 1) Air infiltration Test, per FBC, TAS 202 -94 2) Uniform Static Air Pressure Test, Loading per FBC TAS 202 -94 3) Water Resistance Test, per FBC, TAS 202 -94 4) Large Missile Impact Test per FBC, TAS 201 -94 5) Cyclic Wind Pressure Loading per FBC, TAS 203 -94 along with marked -up drawings and installation diagram of double-/ single hung windows, prepared by National Certified Testing Laboratories, Inc., revised Test Report No.'s NCTL - 210 - 3588 -3 and NCTL- 210 - 3209 -4, dated 01/06/10 respectively, signed and sealed by Gerard J. Ferrara, P. E. 2. Test reports on: 1) Air infiltration Test, per FBC, TAS 202 -94 2) Uniform Static Air Pressure Test, Loading per FBC TAS 202 -94 3) Water Resistance Test, per FBC, TAS 202 -94 4) Large Missile Impact Test per FBC, TAS 201 -94 5) Cyclic Wind Pressure Loading per FBC, TAS 203 -94 along with marked -up drawings and installation diagram of double-/ single hung window, prepared by National Certified Testing Laboratories, Test Report No. NCTL - 210 - 3209 -4, dated 08/16/07 respectively, signed and sealed by Gerard J. Ferrara, P. E. (Submitted under previous NOA No. 07 -071 Z05) 3. Test reports on: 1) Air infiltration Test, per FBC, TAS 202 -94 2) Uniform Static Air Pressure Test, Loading per FBC TAS 202 -94 3) Water Resistance Test, per FBC, TAS 202 -94 4) Large Missile Impact Test per FBC, TAS 201-94 5) Cyclic Wind Pressure Loading per FBC, TAS 203-94 6) Forced Entry Test, per FBC 2411 3.2.1, TAS 202 -94 along with marked -up drawings and installation diagram of double hung window, prepared by Certified Testing Laboratories, Test Report No.'s CTLA -744W and CTLA- 744W1, dated 10/15/01 and 01/23/02 respectively, signed and sealed by Ramesh Patel, P. E. (Submitted under previous NOA No. 02 -0408.02) Jaime J. Gascon, P. E. Chief, Product Control Division NOA No. 09-0916.05 Expiration Date: December 12, 2012 Approval Date: March 17, 2010 E -1 Jeld -Wen, Inc (OR) NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED CALCULATIONS 1. Anchor verification calculations and structural analysis, complying with FBC 2007, prepared by PTC, LLC, dated 08/11/09 and 02/11/10, both signed and sealed by Robert J. Amoruso, P. E. Complies with ASTM E1300 -04 D. QUALITY ASSURANCE 1. Miami Dade Building Code Compliance Office (BCCO). E. MATERIAL CERTIFICATIONS 1. Notice of Acceptance No. 09- 0312.03 issued to E.I. DuPont DeNemours & Co., Inc. for their "DuPont Sentry Glass® Interlayer" dated 05/13/09, expiring on 01/14/12. 2. Notice of Acceptance No. 09- 0312.02 issued to E.I. DuPont DeNemours & Co., Inc. for their "DuPont Butacite® PVB, Interlayer" dated 05/13/09, expiring on 12/11/10. 3. Notice of Acce p tance No. 08- 0206.01 issued to Solutia Inc f o r their "Saflex ez HP Glass Interlayer" dated 04/17/2008, expiring on 04/17/2013. F. STATEMENTS 1. Statement letter of conformance and no financial interest, dated August 11, 2009, signed and sealed by Robert J. Amoruso, P. E. 2. Laboratory addendum letter for Test Report no.'s NCTL - 210 - 3588 -3 and NCTL- 210- 3209 -4, issued by National Certified Testing Laboratories, Inc., dated January 06/2010, signed and sealed by Gerard J. Ferrara, P. E. 3. Laboratory addendum letter for Test Report no.'s CTLA -744W and CTLA- 744W1, issued by Certified Testing Laboratories, Inc., dated November 13, 2002, signed and sealed by James Blakely, V.P. (Submitted under previous NOA No. 02-0408.02) 4. Laboratory compliance letters issued, as part of above referenced test reports. (Submitted under previous NOA No's. 02- 0408.02 and 07-0717.05) 5. Sales agreement dated November 30, 2004 between Seasonshield, Jeld -Wen and William J. Gills, signed by William J Gills. (Submitted under previous NOA No. 07- 0717.05) G. 0111hRS 1. Notice of Acceptance No. 07- 0717.05, issued to Jeld -Wen, Inc (OR) for their Series "Premium Atlantic "6400" Aluminum Single Hung / Double Hung Windows ", approved on 10 /112 /07 and expiring on 12/12/12. 2. Sales agreement between Seasonshield, Inc. and Jeld -Wen, Inc. (Submitted under previous NOA No. 07-0717.05) /�.d ' Jaime J. Gascon, P. E. Chief, Product Control Division NOA No. 09-0916.05 Expiration Date: December 12, 2012 Approval Date: March 17, 2010 E -2 JELD -WEN PREMIUM ATLANTIC 6400 DOUBLE HUNG & 6100 SINGLE HUNG ALUMEVUM WINDOW, LMI INSTALLATION ANCHORAGE DETAILS GENERAL NOTES: 1. THIS PRODUCT IS DESIGNED TO COMPLY WITH THE HIGH VELOCITY HURRICANE ZONE (HVHZ) OF THE 2007 FLORIDA BUILDING CODE (IBC) AT THE DESIGN PRESSURE(S) STATED HEREIN. THE PRODUCT DETAILS CONTAINED HEREIN ARE BASED UPON SIGNED AND SEALED TEST REPORT I/ NCR - 210.35883 DATED 01106/10, CTLA -744W, DATED 10/1601, CTU4744W1. DATED 0123102, NCTL- 210 - 3208.4, DATED 01/08110 AND ASSOCIATED LABORATORY STAMPED DRAWINGS AND WERE TESTED IN ACCORDANCE WITH CURRENT DADE COUNTY PROTOCOLS. 2. ADEQUACY OF THE EXISTING STRUCTURAL CONCRETE MASONRY AND 2X FRAMING AS A MAIN WIND FORCE RESISTING SYSTEM CAPABLE OF WITHSTANDING AND TRANSFERRING APPLIED PRODUCT LOADS TO THE STRUCTURE IS THE RESPONSIBRRY OF THE ENGINEER OR ARCHITECT OF RECORD. 3. 1X PT BUCKS AND 2X PT WOOD FRAMING (WHEN USED) SHALL BE DESIGNED AND ANCHORED TO PROPERLY TRANSFER ALL LOADS TO THE STRUCTURE BUCK DESIGN AND INSTALLATION IS THE RESPONSIBILITY OF THE ENGINEER OR ARCHITECT OF RECORD. 4. IN AREAS WHERE WIND -BORNE DEBRIS PROTECTION REQUIREMENTS EXIST, USE OF AN APPROVED MIAMI DADE IMPACT PROTECTIVE SYSTEM IS NOT REQUIRED. 5. WINDOW FRAME MAMMAL: ALUMINUM ALLOY: 808345 (FRAME HEAD, S&L, JAMB) 8083 -T8 (SLIP -ON NAIL 804) 8. GLASS MEETS THE REQUIREMENTS OFASTM E1300. 7. DESIGNATIONS 'X' AND *0* STAND FOR THE FOLLOWING: X OPERABLE PANEL O: FIXED PANEL & A 1/3 INCREASE IN ALLOWABLE STRESS FOR WIND LOADS WAS NOT USED IN THE DESIGN OF THE PRODUCT(8) SHOWN HEREIN. WIND LOAD DURATION FACTOR (Cd = 1.0) HAS BEEN USED FOR WOOD ANCHOR DESIGN. TABLE OF CONTENTS SHEET REV. SHEET DESCRIPTION 1 A GENERAL NOTES, INSTALLATION NOTES & D.P. CHART 2 A DOUBLE -HUNG ELEVATION & ANCHOR LAYOUTS 3 A SINGLE -HUNG ELEVATION & ANCHOR LAYOUTS 4 A VERTICAL SECTIONS 5 A VERTICAL SECTIONS 8 A HORIZONTAL SECTIONS 7 A GLAZING 8 CORNER DETAILS 8 A BILL OF MATERIALS & COMPONENTS INSTALLATION NOTES: 1. ONE (1) INSTALLATION ANCHOR IS REQUIRED AT EACH ANCHOR LOCATION SHOWN. 2. THE NUMBER OF INSTALLATION ANCHORS DEPICTED IS THE MINIMUM NUMBER OF ANCHORS TO BE USED FOR PRODUCT INSTALLATION. 3. SHIM AS REQUIRED AT EACH INSTALLATION ANCHOR WITH LOAD BEARING SHIM(S). MAXIMUM ALLOWABLE SHIM SIZE IS 114 INCH. SHIM WHERE SPACE OF 1/18 INCH OR GREATER OCCURS. SHIM(S) SHALL BE CONSTRUCTED OF HIGH DENSITY PLASTIC OR BETTER. 4. FOR INSTALLATION INTO WOOD FRAMING, USE 610 WOOD SCREWS OF SUFFICIENT LENGTH TO ACHIEVE 1 12 INCH MINIMUM EMBEDMENT. MINIMUM EDGE DISTANCE IS 3/4 INCHES. 5. FOR INSTALLATION THROUGH IX PT BUCK TO CONCRETE / MASONRY, OR DIRECTLY INTO CONCRETE /MASONRY, USE 1/4 INCH OW TA'CONS OF SUFFICIENT LENGTH TO ACHIEVE 1 -114 INCH MINIMUM EMBEDMENT (FOR MASONRY) & 1-3/4 INCHES (FOR CONCRETE). MINIMUM EDGE DISTANCE IS 2-1/2 INCHES FOR LOTH CONCRETE & MASONRY. 6. INSTALLATION ANCHORS ARE TO BE LOCATED THROUGH PERIMETER OF NAILING FIN WHEN APPLICABLE . 7. MINIMUM EMBEDMENT AND EDGE DISTANCE EXCLUDE WALL FINISHES, INCLUDING BUT NOT LIMITED TO STUCCO, FOAM, BRICK VENEER AND SIDING. 8. FOR CONCRETE BLOCKAPPUCATIONS DO NOT INSTALL INSTALLATION ANCHORS INTO MORTAR JOINTS. 8. INSTALLATION ANCHORS SHALL BE INSTALLED IN ACCORDANCE WITH ANCHOR MANUFACTURER'S INSTALLATION INSTRUCTIONS AND ANCHORS SHALL NOT BE USED IN SUBSTRATES WITH STRENGTHS LESS THAN THE MINIMUM STRENGTH SPECIFIED BY THE ANCHOR MANUFACTURER 10. INSTALLATION ANCHOR CAPACITIES FOR PRODUCTS HEREIN ARE BASED ON SUBSTRATE MATERIALS WITH THE FOLLOWING PROPERTIES: A. WOOD - MINIMUM SPECIFIC GRAVITY OF 0.58. B. CONCRETE - MINIMUM COMPRESSIVE STRENGTH OF 3182 psi AND COMPLIES WITH AG 301, ACI 318-05 AND AO 355 C. MASONRY- STRENGTH CONFORMANCE TO ASTIN C-90 AND ACI 530-05, GRADE N, TYPE 1 (OR GREATER). GLAZING OPTIONS DESIGN PRESSURE RATING (PSF) IMPACT RATING 1,2,384 +80.01 -80.0 LARGE MISSILE IMPACT PROJECT # 309-0710 S s f a$ 1 O JI4F P hi Robert J. Aogf1 P.E. Florida 8.5. No.49752 53114" MAX. OA FRAME WIDTH —� 501/2° MAX OA SASH WIDTH 48 3/4" MAX. O.A. D.L.O. WIDTH 76 /4° MAX OA FRAME HEIGHT 37" 32 3/4" MAX. MAX O.A. O.A. SASH D.L.O. HEIGHT HEIGHT 37" 32 3/4° MAX MAX OA OA SASH D.L.O. HEIGHT HEIGHT ELEVATION DOUBLE HUNG FLANGE ELEVATION EXTERIOR VIEW 6" MAX FROM CORNERS (TYP.) J F L 4" MAX FROM �I CORNERS (TYP.) 3° (TYP.) 1.0" MAX. O.C. (TYP.) STEEL REINFORCEMENT WEEP NOTCH (0.5" x LEG HEIGHT) 4" MAX FROM CTR. OF MEETING RAILS (TYP.) ALL CORNER SPACING IS FROM INTERIOR BUCK 138 (TYP.) 4" MAX FROM CTR. OF (TYP.) MEETING RAILS 4 SPACES 7" MAX. O.C. (TYP.) ANCHOR LAYOUT DOUBLE HUNG FLANGE INSTALLATION EXTERIOR VIEW 3" (TYP.) 751/4" MAX OA FRAME HEIGHT 37" 32 3/4" MAX. MAX OA OA SASH D.L.O. HEIGHT HEIGHT { f 37" 32 3/4" MAX MAX OA OA SASH D.L.O. HEIGHT HEIGHT 531/4" MAX. OA FRAME WIDTH 501/2" MAX OA. SASH WIDTH 46 3/4° MAX. OA D.L.O. WIDTH ELEVATION DOUBLE HUNG FIN ELEVATION EXTERIOR VIEW 3" MAX. FROM CORNERS (TYP.)1 r o. MAX 6" O.C. (TYP ) 3" MAX. FROM r CORNERS (TYP.) L 6 MAX O.C. (TYP.) 0 x� 0 STEEL REINFORCEMENT WEEP NOTCH (0.5" x LEG HEIGHT) ANCHOR LAYOUT DOUBLE HUNG FIN INSTALLATION EXTERIOR VIEW PROJECT # 309-0710 5 a z O %U Z o °a ow cp 2 ca T. a y� y E 1 !j el PRODUCT REVISED m =Raying vM th Fladdx / Building cpoO-O-16.05 Amplence Data ' •1� Dade PooduttCooud D)Adon Robert J. Mmnso, PE. Florida P.E. No.49752 0 ,,x rojr v 0 ELEVATION DOUBLE HUNG FIN ELEVATION EXTERIOR VIEW 3" MAX. FROM CORNERS (TYP.)1 r o. MAX 6" O.C. (TYP ) 3" MAX. FROM r CORNERS (TYP.) L 6 MAX O.C. (TYP.) 0 x� 0 STEEL REINFORCEMENT WEEP NOTCH (0.5" x LEG HEIGHT) ANCHOR LAYOUT DOUBLE HUNG FIN INSTALLATION EXTERIOR VIEW PROJECT # 309-0710 5 a z O %U Z o °a ow cp 2 ca T. a y� y E 1 !j el PRODUCT REVISED m =Raying vM th Fladdx / Building cpoO-O-16.05 Amplence Data ' •1� Dade PooduttCooud D)Adon Robert J. Mmnso, PE. Florida P.E. No.49752 531/4" MAX. OA FRAME WIDTH 50112" MAX. OA SASH WIDTH 46 3/4" MAX. OA D.L.O. WIDTH 37° 32 3/4° MAX. MAX OA OA SASH D.L.O. 761/4" HEIGHT HEIGHT MAX O.A. FRAME HEIGHT 37" 32 3/4' MAX MAX OA O.A. SASH D.L.O. HEIGHT HEIGHT ELEVATION SINGLE HUNG FLANGE ELEVATION EXTERIOR VIEW 6' MAX FROM r-H CORNERS (TYP.) 4° MAX FRONT CORNERS (TYP.) Fr (rep.) 4" MAX FROM CTR. OF MEETING RAILS (TYP.) 10" MAX O.C. (TYP.) % I.� III o 1 0lull l 0 1 xA 1 1 1� %II STEEL REINFORCEMENT WEEP NOTCH (0.5" x LEG HEIGHT) 134' ALL CORNER SPACING IS FROM INTERIOR BUCK 4" MAX FROM CTR. OF MEETING 7 [RAILS (TYP.) [3* (TYP.) I 4 SPACES 7' MAX. O.C. (TYP.) ANCHOR LAYOUT SINGLE HUNG FLANGE INSTALLATION EXTERIOR VIEW 531/4" MAX. OA ~- FRAME WIDTH —~ 501/2" MAX OA SASH WIDTH 46 3/4' MAX. OA D.L.O. WIDTH 761/4" MAX. OA FRAME HEIGHT 37° 32 3/4" MAX. MAX. O.A. OA. SASH D.L.O. HEIGHT HEIGHT 37" 32 3/4" MAX MAX OA O.A. SASH D.L.O. HEIGHT HEIGHT ELEVATION SINGLE HUNG FIN ELEVATION EXTERIOR VIEW 3" MAX. FROM r CORNERS (TYP.) 3" MAX FROM CORNERS (TYP.) ..L L 6" MAX. 3- O.C. (TYP.) 6° MAX. h- O.C. (TYP ) O 0 0 A x 0 STEEL REINFORCEMENT WEEP NOTCH (0.5" x LEG HEIGHT) ANCHOR LAYOUT SINGLE HUNG FIN INSTALLATION EXTERIOR VIEW PROJECT # 309 -0710 N t4 3 of z E i „g 12. •05 Robo tJ. Amonmo. P.E. Florida P.9. Na 49782 1X WOOD BUCK BY OTHERS (SEE GEN. NOTE 3, SHT. 1) SEALANT BETWEEN FLANGE & SUBSTRATE W/ VULKEM 118 OR EQUIVALENT STRUCTURAL ADHESIVE SEALANT EXTERIOR FINISH BY OTHERS PERIMETER SEALANT BY OTHERS MAX. OA FRAME HEIGHT 76 1/4" EXTERIOR 2818 °MIN. EDGE DISTANCE 3/18” ITW TAPCON INSTALLATION ANCHOR CONCRETE BY OTHERS (SEE GEN NOTE 2, SHT. 1 & INSTALLATION NOTE 10, SHT. 1) 1 3/4' MIN. EMBEDMENT f 1/4" MAXJ SHIM SHIM AS REQ'D. (SEE INSTL NOTE 3, SHT 1) SEE DETAIL 6 INTERIOR ON SHEET 7 O VERTICAL SECTION DOUBLE HUNG FLANGE INSTALLATION CONCRETE SUBSTRATE 0 00 0..,��I O / r SEE GLAZING DETAILS O , — ��% ON SHEET 7 (ALL UNITS) 0 O VERTICAL SECTION MEETING RAIL (ALL UNITS) SEE DETAIL 7 ON SHEET 7 0 I I 0 O 0 1IML 0 INTERIOR O ,T 0 0 •'0Il \r 00 Fi= ��TT „��I 0 EXTERIOR PERIMETER SEALANT BY OTHERS SEALANT BETWEEN FLANGE & SUBSTRATE WI VULKEM 118 OR EQUIVALENT STRUCTURAL ADHESIVE SEALANT SHIM AS REQ'D. (SEE EXTERIOR FINISH INSTL NOTE 3, SHT 1) BY OTHERS VERTICAL SECTION A DOUBLE HUNG FLANGE INSTALLATION CONCRETE SUBSTRATE 1/4" MAX SHIM 1X WOOD BUCK BY OTHERS GEN. NOTE 3, SHT. 1) CONCRETE BY OTHERS (SEE GEN NOTE 2, SHT. 1 & INSTALLATION NOTE 10, SHT. 1) 1 1/2" MIN. EMBEDMENT SHEATHING BY OTHERS SEALANT BETWEEN FLANGE & SUBSTRATE W/ VULKEM 118 OR EQUIVALENT STRUCTURAL ADHESIVE SEALANT PERIMETER SEALANT BY OTHERS EXTERIOR FINISH BY OTHERS EXTERIOR MAX. O.A. FRAME HEIGHT 781/4" #10 WOOD SCREW INSTALLATION ANCHOR 2X WOOD FRAME BY OTHERS (SEE GEN NOTE 2, SHT 1) 314" MIN. EDGE DIST. f 1/4" MAXSHIM SHIM AS REQ'D. (SEE INSTL NOTE 3, SHT 1) INTERIOR VERTICAL SECTION DOUBLEHUNG FIN INSTALLATION WOOD FRAME SUBSTRATE INTERIOR SHIM AS REQ'D. (SEE INSTL NOTE 3, SHT 1) 1/4" MAX SHIM PERIMETER SEALANT BY OTHERS SEALANT BETWEEN FLANGE & SUBSTRATE W/ WLKEM 118 OR EQUIVALENT STRUCTURAL ADHESIVE SEALANT EXTERIOR FINISH BY OTHERS 1 1/2" MIN. EMBEDMENT SHEATHING BY OTHERS 3/4' MIN. EDGE DIST. PROJECT # 309 -0710 N a 1 9 CO 0 0 ■ o s.2 9y 2X WOOD FRAME BY OTHERS (SEE GEN NOTE 2, SHT 1) O VERTICAL SECTION DOUBLE HUNG FIN INSTALLATION WOOD FRAME SUBSTRATE #10 WOOD SCREW INSTALLATION ANCHOR Robert J. Ammo, P.E. FlorMa P.E. No.49752 1X WOOD BUCK BY OTHERS (SEE GEN. NOTE 3, SHT. 1) SEALANT BETWEEN FLANGE & SUBSTRATE W/ VULKEM 116 OR EQUIVALENT STRUCTURAL ADHESIVE SEALANT EXTERIOR FINISH BY OTHERS PERIMETER SEALANT BY OTHERS MAX. O.A. FRAME HEIGHT 76 1/4" EXTERIOR 2 W8" MIN. EDGE DISTANCE 3116" ITW TAPCON INSTALLATION ANCHOR CONCRETE BY OTHERS (SEE GEN NOTE 2, SHT. 1 & INSTALLATION NOTE 10, SHT. 1) 1 3/4" MIN. EMBEDMENT 1/4" MAX SHIM —t SHIM AS REQ'D. (SEE INSTL NOTE 3, SHT 1) SEE DETAIL 4 ONSHEET7 O VERTICAL SECTION SINGLE HUNG FLANGE INSTALLATION CONCRETE SUBSTRATE SEE DETAIL 6 ON SHEET 7 0 m i � �jT_ 0 © �l \� m 00 �- ,�,t�r 0 EXTERIOR PERIMETER SEALANT BY OTHERS SEALANT BETWEEN FLANGE & SUBSTRATE W/ VULKEM 116 OR EQUIVALENT STRUCTURAL ADHESIVE SEALANT EXTERIOR FINISH BY OTHERS INTERIOR INTERIOR SH M AS READ. (SEE INSTL NOTE 3, SHT 1) O VERTICAL SECTION SINGLE HUNG FLANGE INSTALLATION CONCRETE SUBSTRATE 1/4' MAX SHIM 1X WOOD BUCK BY OTHERS (SEE GEN. NOTE 3, SHT. 1) CONCRETE BY OTHERS (SEE GEN NOTE 2, SHT. 1 & INSTALLATION NOTE 10, SHT. 1) 1 112" MIN. EMBEDMENT SHEATHING BY OTHERS SEALANT BETWEEN FLANGE & SUBSTRATE W/ VULKEM 118 OR EQUNALENT STRUCTURAL ADHESIVE SEALANT PERIMETER SEALANT BY OTHERS EXTERIOR FINISH BY OTHERS #10 WOOD SCREW INSTALLATION ANCHOR 2X WOOD FRAME BY OTHERS (SEE GEN NOTE 2, SHT 1) 314" MIN. EDGE DIST. dip, 00 o 0 x , ,I 1, mm 0 1/4" MAXJ SHIM SHIM AS REQ'D. (SEE INSTL. NOTE 3, SHT 1) EXTERIOR INTERIOR MAX. O.A. FRAME HEIGHT 761/4" CD VERTICAL SECTION SINGLE HUNG FIN INSTALLATION WOOD FRAME SUBSTRATE EXTERIOR PERIMETER SEALANT BY OTHERS SEALANT BETWEEN FLANGE & SUBSTRATE W/ VULKEM 116 OR EQUIVALENT STRUCTURAL ADHESIVE SEALANT EXTERIOR FINISH BY OTHERS INTERIOR SHIM AS REQD. (SEE INSTL. NOTE 3, SHT 1) 1 1/2" MIN. EMBEDMENT SHEATHING BY OTHERS CD VERTICAL SECTION SINGLE HUNG FIN INSTALLATION WOOD FRAME SUBSTRATE 1/4° MAX SHIM 3/4" MIN. EDGE DIST. 2X WOOD FRAME BY OTHERS (SEE GEN NOTE 2, SHT 1) #10 WOOD SCREW INSTALLATION ANCHOR PROJECT # 309-0710 i z gu w 2 0 QW a 03 0 U z PRODUCT REVISED as complying with theFlaida p,ee o L05 Doc Robe'tJ. Amoroso, P.E. Flmda P.E. No. 49752 114" MAX SHIM 3/4" MIN. EDGE DIST. 2X WOOD FRAME BY OTHERS (SEE GEN NOTE 2, SHT 1 0 #10 WOOD SCREW INSTALLATION ANCHOR 1 112" MIN. EMBEDMENT SHEATHING BY OTHERS EXTERIOR FINISH BY OTHERS SEALANT BETWEEN FLANGE & SUBSTRATE W/ VULKEM 116 OR EQUIVALENT STRUCTURAL ADHESIVE SEALANT PERIMETER SEALANT BY OTHERS SHIM AS REQ'D. (SEE INSTL NOTE 3, SHT 1) SEE DETAIL 6 ON SHEET 7 O HORIZONTAL SECTION DOUBLE HUNG FIN INSTALLATION WOOD FRAME SUBSTRATE 3/4" MIN. EDGE DIST. 2X WOOD FRAME BY OTHERS (SEE GEN NOTE 2, SHT 1) 8#10 WOOD SCREW INSTALLATION ANCHOR 1 112" MIN. EMBEDMENT f --1/4" MAX SHIM SHIM AS REQ'D. (SEE rAlr INSTL NOTE 3, SHT 1) 0000 SHEATHING BY OTHERS [ EXTERIOR FINISH 0 BY OTHERS SEALANT BETWEEN FLANGE & SUBSTRATE W/ VULKEM 116 OR EQUIVALENT STRUCTURAL ADHESIVE SEALANT PERIMETER SEALANT BY OTHERS 'SEE DETAIL 5 ON SHEET 7 O HORIZONTAL SECTION SINGLE HUNG FIN INSTALLATION WOOD FRAME SUBSTRATE INTERIOR EXTERIOR MAX. O.A. FRAME WIDTH 53114" INTERIOR EXTERIOR MAX. OA. FRAME WIDTH 531/4' 1/4" MAX. SHIM SHIM AS REQ'D. (SEE INSTL. NOTE 3, SHT 1) 1 114" MIN. EMBEDMENT MASONRY BY OTHERS (SEE GEN NOTE 2, SHT. 1 & INSTALLATION NOTE 10, SHT. 1) 16" ITW TAPCON INSTALLATION ANCHOR 25/8 MIN. 79 EDGE DISTANCE PERIMETER SEALANT BY OTHERS 1X WOOD BUCK BY OTHERS (SEE GEN. NOTE 3, SHT. 1) EXTERIOR FINISH SEALANT BETWEEN FLANGE & BY OTHERS SUBSTRATE W/ VULKEM 116 OR EQUIVALENT STRUCTURAL ADHESIVE SEALANT O HORIZONTAL SECTION DOUBLE HUNG FLANGE INSTALLATION MASONRY SUBSTRATE SHIM AS REQ'D. (SEE INSTL NOTE 3, SHT 1) 1/4" MAX SHIM 1 1/4° MIN. EMBEDMENT MASONRY BY OTHERS (SEE GEN NOTE 2, SHT. 1 & INSTALLATION NOTE 10, SHT. 1) 16° ITW TAPCON INSTALLATION ANCHOR PERIMETER SEALANT BY OTHERS EXTERIOR FINISH BY OTHERS 25/8° MIN. EDGE DISTANCE 1X WOOD BUCK BY OTHERS (SEE GEN. NOTE 3, SHT. 1) SEALANT BETWEEN FLANGE & SUBSTRATE W/ VULKEM 118 OR EQUIVALENT STRUCTURAL ADHESIVE SEALANT O HORIZONTAL SECTION SINGLE HUNG FLANGE INSTALLATION MASONRY SUBSTRATE PROJECT # 309 -0710 -R a a$ 8a o PR wihtheFbmida Banding A 1 0 1Fi.05 EspImdon . tzsEir .0 It Division Robert J.Mroruso.P.E Florida P.E. No. 49752 11/32" (NOMINAL THK.) LAMINATED UNIT CONSISTING OF: 1/8" ANNEALED GLASS, 0.090" DUPONT SENTRYGLAS® PLUS INTERLAYER, � 1/8" ANNEALED GLASS 3/4° MIN. GLASS BITE GLAZING DETAIL 1 (GLAZE TYPE A) /� 11/32° (NOMINAL THK.) LAMINATED UNIT CONSISTING OF: �1/8° ANNEALED GLASS, 0.090° DUPONT BUTACITE INTERLAYER, 1/8° ANNEALED GLASS 3/4" MIN. GLASS BITE 1 11/32° (NOMINAL THK.) LAMINATED UNIT CONSISTING OF: 118° ANNEALED GLASS, 0.090° SOLUTIA PVB INTERLAYER, 1/8" ANNEALED GLASS 314° MIN. `EXT. GLASS BITE INT. GLAZING DETAIL 3 (GLAZE TYPE C) NT. GLAZING DETAIL 2 (GLAZE TYPE B) i 11/32° (NOMINAL THK.) LAMINATED UNIT CONSISTING OF: 1/8" ANNEALED GLASS, 0.090" DUPONT PVB INTERLAYER, 1/8" ANNEALED GLASS 3/4° MIN. GLASS BITE INT. ! GLAZING DETAIL 4 (GLAZE TYPE D) DETAIL 5 STANDARD TOP SASH DETAIL 6 BOTTOM MAIN FRAME LOWER CORNER DETAIL 7 PROJECT # 309-0710 co i a8 0 0 3S N m.�m "°° nom Zit 5 Building Cede Division RabatJ. Amoroso, P.E. Florida P.E. No. 49762 0 FRAME HEAD 6063 -T5 ALUMINUM 0.050' TYP. THK. 1.572' 1 1 0 FRAME SILL 6063 -T5 ALUMINUM 0.060" TYP. THK. 2.813 "--.-1 0.792' BILL OF MATERIALS ITEM # PART# DESCRIPTION MATERIAL MANUFACTURER 1 11395 FRAME HEAD ALUMINUM 6083 -T5 INDALEX / EXTRUDERS 2 11344 FRAME SILL ALUMINUM 8083 -T5 INDALEX / EXTRUDERS 3 60IGLB GLAZING BEAD ALUMINUM 6083-T8 INDALEX /EXTRUDERS 4 60NSI PULL RAIL FOR TOP SASH/ LIFT RAIL FOR BOTTOM SASH ALUMINUM 8063 -T8 INDALEX /EXTRUDERS 5 sorts TOP SASH INTERLOCK ALUMINUM 8063 -T5 INDALEX / EXTRUDERS 6 601BVI BOTTOM SASH INTERLOCK ALUMINUM 6083 -T6 INDALEX /EXTRUDERS 7 11343 FRAME JAMB ALUMINUM 8083 -T5 INDALEX /EXTRUDERS 8 80IVJS SASH JAMB STILE ALUMINUM 6063 -T8 INDALEX / EXTRUDERS 9 PILE WEATHER STRIP VINYL / WOOLPILE 10 DOW CORNING 995 SILICONE SILICONE DOW CORNING O GLAZING BEAD 6063 -T8 ALUMINUM 0.050' TYP. THK. r 0.752• 0.080' L 1 ® PULL RAIL / LIFT RAIL 8083 -T6 ALUMINUM 0.050' TYP. THK. . 1.756" 2.325* 1.130' 0.937' -' - I+7 11 601GLVB VINYL WEDGE (DUROMETER = 75) VINYL 12 GLASS (SEE GLAZING DETAILS ON SHEET 7) GLASS 13 CRS STEEL REINFORCEMENT, (1/2' X 5/8° X FULL LENGTH) STEEL, ASTM A-36 14 ALUMINUM SPRING LOCK (2 EACH AT HEAD & SILL) ALUMINUM 15 FIBERGLASS MESH SCREEN FIBERGLASS 18 METALLIC CAM LOCK (2 -10' FROM EACH END OF MEETING RAIL) DIE -CAST METAL 17 64SHBKT FIXED SASH BRACKET (8100 SINGLE HUNG ONLY) ALUMINUM INDALEX / EXTRUDERS 18 3/16' IlW TAPCON - INSTALLATION ANCHOR STEEL MA/ 19 BULB VINYL WEATHER STRIP VINYL 20 #8 X 5/8' P.P.H. S.M.S. STEEL 21 #10 PAN HEAD WOOD SCREW - INSTALLATION ANCHOR STEEL 22 SCREEN FRAME ALUMINUM 23 HOLLOW VINYL SCREEN SPLINE VINYL 5® TOP SASH INTERLOCK 6063 -T6 ALUMINUM 0.050' TYP. THK. - 1.199' 2.006' -+-I �-- 0.937' BOTTOM SASH INTERLOCK 6083 -T8 ALUMINUM 0.050° TYP. THK. 0.937" 0 FRAME JAMB 8083 -T5 ALUMINUM 0.050' TYP. THK. 1.812" 2.257' 1.112° 24 45222 SLIP -ON NAIL FIN ALUMINUM 6083 -T8 INDALEX / EXTRUDERS 25 #8 X 2° PAN HEAD S.M.S. STEEL 28 64SSTOP SASH STOP (NOT SHOWN) - 2/ JAMB DM;1 /JAMB SM VINYL 27 84SCAM SASH CAM ALUMINUM 28 84BG BALANCE GUIDE VINYL BALANCE TAKE OUT CLIP STEEL 30 64GASK-1.2 FRAME HEAD GASKET FOAM 31 64GASK -3,4 FRAME SILL GASKET FOAM 32 SASH DUST COVER ALUMINUM ()SASH JAMB STILE 8 VINYL WEDGE 6063 -T6 ALUMINUM VINYL 0.045• TYP. THK 0.050' TYP. THK. 0.037• -►{ (h"- 0.919' F 0.305' by " "?y � I k 0.408" 13 REINFORCEMENT ASTM A-38 STEEL �-►{ - 0.625° 0.60° 1 0 SPRING LOCK ALUMINUM I-- 0.765' 0.828' is SASH LOCK DIE CAST METAL %S.Kr 17 NIXED SASH BRACKET ALUMINUM 0.070' TYP. THK. 0 SLIP -ON NAIL FIN 8083 -T6 ALUMINUM 0.050' TYP. THK. Ji375' 0275'- -+7 27 SASH CAM ALUMINUM 0.063' TYP. THK. PROJECT # 309 -0710 0 co le a a$ rex we Rz g m 0 A z �z numucrtaavisw :a complying mowtm nd& Miffing Mk o 1.05 _.Ore. -vA[st o12. Mind DiViSiDO BALANCE GUIDE VINYL 0.149' TYP. THK. TAKE OUT CLIP STEEL ® SASH DUST COVER ALUMINUM 0.050' TYP. THK. O FRAME HEAD GASKET FOAM 0.080' TYP. THK. 0575' 1.687" f 2 803" �� -0716• 1.602' 31 FRAME SILL GASKET FOAM 0.060" TYP. THK. SASH STOP VINYL 0.080' TYP. THK. 1 0.76" 1.048" -►1 Robert J. Amoroso. P.E. Florida P.E. No.49752 to BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) Jeld Wen, Inc. (OR) 3737 Lakeport Boulevard Klamath Falls, OR 97601 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. DESCRIPTION: Series 6'8" W/E Outswing Opaque Steel Doors - L.M.I. - w /wo Sidelites -- N.I. APPROVAL DOCUMENT: Drawing No. S -2104, titled "Series Wood Edge Opaque Outswing Steel Impact Door Up to 9'-0 "x 6' -8" with and without Non - Impact Sidelites ", sheets 1 through 8 of 8, dated 09/11/2001 with revision E dated 09/15/2008, prepared by PTC, LLC, dated 11/09/2008, signed and sealed by Eric S. Nielsen, P.E., bearing the Miami -Dade County Product Control Revised stamp with the Notice of Acceptance number and expiration date by the Miami -Dade County Product Control Division. MISSILE IMPACT RATING: Large Missile And Small Missile Impact Resistant (Doors) w/ wo Non - Impact Resistant (Sidelites) LIMITATION: Miami-Dade County Approved Impact Resistant Shutters or Protection Devises are required for the Sidelites. 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 revises and supersedes NOA No. 07- 0731.04 and consists of this page 1 and evidence pages E- land E -2, as well as approval document mentioned above. The submitted documentation was reviewed by Jaime D. Gascon, P.E. MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 372 -6339 www.miamidade.gov/bniidingcode 11 raeg NOA No. 08- 1015.05 Expiration Date: August 15, 2012 Approval Date: December 12, 2008 Page 1 Jeld -Wen. Inc. (OR) NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS 1. Manufacturer's die drawings and sections. 2. Drawing No S -2104, titled "Series Wood Edge Opaque Outswing Steel Impact Door Up to 9' -0 "x 6' -8" with and without Non - Impact Sidelites ", sheets 1 through 8 of 8, dated 09 /11/2001 with revision E dated 09 /15/2008, prepared by PTC, LLC, dated 11/09/20087, signed and sealed by Eric S. Nielsen, P.E. B. TESTS 1. Test reports on: 1) Air Infiltration Test, per PA 202 -94 2) Uniform Static Air Pressure Test, Loading per PA 202 -94 3) Water Resistance Test, per PA 202 -94 4) Forced Entry Test, per PA 202 -94 5) Cyclic Wind Pressure, Loading per PA 203 -94 6) Large Missile Impact Test, per PA 201 -94 Along with marked -up drawings and installation diagram of Outswing and Inswing wood edge opaque steel door, prepared by Certified Testing Laboratories, Test Report No. CTLA 696W, date 11/01/2001, signed and sealed by Ramesh Patel, P.E. (Submitted under NOA # 02- 1211.18) C. CALCULATIONS 1. Anchor verification calculations and structural analysis, complying with FBC -2004, prepared by PTC, LLC, dated 07/11/2007, signed and sealed by Eric S. Nielsen, P.E. Complies with ASTM E 1300 -02 (Submitted under NOA # 07- 0731.04) D. QUALITY ASSURANCE 1. Miami Dade Building Code Compliance Office (BCCO). E. MATERIAL CERTIFICATIONS 1. None F. STATEMENTS 1. Statement letter of conformance, no financial interest and compliance, dated 07/19/2007 by PTC, LLC, signed and sealed by Eric S. Nielsen, P.E. 2. (Submitted under NOA # 07- 0731.04) 3. Laboratory addendum letter for Test Report no. CTLA -696W, issued by Certified Testing Laboratories, dated 04 /11/2002, signed and sealed by Ramesh Patel, F.E. (Submitted under NOA# 02- 1211.18) 4. Laboratory compliance letter for Test Report no. CTLA -696W, issued by Certified' Testing Laboratories, dated 11/11/2001, signed and s I y R, esh Patel, F.E. (Submitted under NOA# 02- 1211.18) I/ - / Jaime D. scon, P.E. Chief, Product Control Division NOA No. 08- 1015.05 Expiration Date: August 15, 2012 Approval Date: December 12, 2008 E -1 Jeld -Wen, Inc. (OR) NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED G. OTHERS 1. Notice of Acceptance No. 07- 0731.04, issued to Jeld -Wen, Inc. (OR.) for their Series "6'8" W/E Outswing Opaque Steel Doors - L.M.I. - wlwo Sidelites — N.I. ", approved on 12/20/2007 and expiring on 08/15/2012. H. LIMITATIONS 1. Miami-Dade County Approved Impact Resistant Shutters or Protection Devises are required for the Sidelites. 2. Miami -Dade County Approved Impact Resistant Shutters or Protection Devises are NOT required for the Doors. Jaime D. Ga on, P.E. Chief, Product Control Division NOA No. 08- 1015.05 Expiration Date: August 15, 2012 Approval Date: December 12, 2008 E -2 JE ® Steel Er 'WOOD EDGE OPAOLWS7EZ007$ RH /IPAOTOMRUMW WM10 NflHDUTat3ATs GENERAL NOTES 1. DRS PRODUCT W DES1241) TO COMPLY 611H THE CURRFl4T FLORIDA 81JD.0M S CODE AND fill VELOCITY HIJRRCNIE ZONE iiVHZ' REQUIREMENTS. 2. 111000 BUCKS BY 011E13 MUST BE AMORE) PROPERLY 10 ?WA RR LOADS ID THE SIRUCTIME 3. PRODUCT ANCXEIS SHALL 65 AS USIED AND SPACED PER MOM LOCATION DA78T3S ANCHOR E► M5NT TO BASE MAIE8N. SHALL. 85 BEYOND WALL DRESSING OR STUCCO. 4. SEE NILE 1 01 11BS SHEET FOR DESIGN PRESSURE RAM 5. 711E PRODUCT MEEIS 113 WATER REOIIRE ENTS FOR iMIY ZONES. SEE 715 DESIGN PRA CHART EEl0Z 6. DOORS ARE IMPACTED AND D0 NOT REQUIRE WAM1 -DADE APPROVED IMPACT RESISTANT SHUTTERS. 7. MME-DD' APPROVED IMPACT RESISTANT SHUTTERS ARE REQUIRED FOR SEEMS. 0. 110511185.185411011170114140 CAN BE USE0 Ph A S810LE OR 001161E CCMI;URATXRI. Itr BNTGG81SUlATEDSIEB .DDOAIlensnornbst7eneodg j COMPO• Eat 24 go. (0.020 mfni mm Memos Gaho*zad Stmt A -525 eormmdal quly - per ALSIR 620 wf h average mfnMxxn yhdd (Expandist polystyrene sbung8u Fy(4 with 1.0 to 1.25 Wald density; by DastitmeLlettatraz The cloths and inactive panels are constructed from 240A. (0.0220' min.) gahsaized steel. The face sleet tops and bottoms are tend 60' ors the trip and bottom rah. The top LSI. roll f/INSU as 1.01' +ride x 1.042' high. 7 e steel bottom roll is roll famed 0.021' galvanized steel 1.67' wide x 121' high. The dies of the fax sheet are ton fanned the LW. latch eble and Ponderosa Dee hinge stile wtdch msasire 1.67", 1.0.. The interior amity le Mal with pa/ystyners. The to the pots/one. face Fbr • 111. . The s h is from 24G4. (0.020' mt.) galouised steel The edges of the face sleet are tend 60' meet its polystrene oxs and glued to R. The sideie gels are routed to receive the Mt. tip LIe Frames ar the optional Tdniy tight Frames. (See sheet 7 far g detab.) The 1Re frames are sealed w/ 050 giasti• compound on the exterior. The frames are constructed from Ponderosa Pine jambe l me mortised and butt jailed jambs and attached with (3) 160*. Y x 7/18' crown wire staples. The taste use a standard burro face PerNe 8.8.11 metering 4.041' deep x 1.0' high. the threshold 1s attac hed to the frame stth (3) 1604. Y x 7/18' croon wire stales rABLEOF00N emi Wit 11•111111111E; 2 G57/ Wit. © J n m - 2.2-'0 F. • a ' T 1 ar ILL OF f• AND DET 748' MAX 0A FAME 88011 .875. .125' 3 5.825" �T1OA 38' MAX OA W/ P4lfL W10TH 8115' MAE 0A MOE HEIGHT are MAX. 0.4. MEL HfIG1B 0.625' • El El ACME 0 0 131,01 DOIMIA OUISI7IG IMPACT UNIT ()OM) 12111111i3LEME 15.5' MAX 0A SERE FRAME 80MH 14' MAX OA PAWS. KITH 80' MAX, 0A PANEL 110513 8125' MAX 0A FW{ME HEIGHT 6' MAX 0A DLO. WIDTH 83.125' MAX. OA D.1.0. 100145 h! .875' TIP. 81.25' MAX 0A FRAME HEIGHT 80' MAX 0A PANEL HEIHT 37.75' MM OA FRAME' worn _3(e It& 0A - 'WEL WWI 0.75' - 0.625 501GLE 011589116 OMPACT 101211b 773I 1;:5„ a.aACOK .875 IMP. 107' MX 0A ROME MTH -- .125' -►-- .79 MAL 38.625' MAX OA BAR M. PANEL IIIOW - 38' MAX OA W/ 114131 WIDTH 15.5' MNL 0A SLOW FRAME WIDTH 14' MAX OA PANED. WEN 0.625' 8D' MAX. OA PANG HEIGHT 6' MAX 0A DLO. SEIM DOPER 8125' 674X. OA FRA1& HEIGHT 61125' MAX OA DLO. HEIGHT 5.75' paw 0WS8m IMPACT Utl>1 (011X0) N/ NON - IMPACT cum n1s VEII'fD FROM E17EAI1R are: 9- 1 -0 DESGN PP6SURE RUNG-111•V623 ifLOMnat WODI REM 6 REED S I R E cam LIIt ( 4 ac 710. 0 x 0 ) WM N71 -WIDGT SWIMS +tta e7 ;es -70 Pi 1x11UNE MCA or (x11, cox •• 0DfO) OM I -DPwer S0058 +57 pi -57 pm PRODUCT REVISED ea malting w am Plaids t L oar. BY: S. SAFFELL. =WV ma c S -2104 1.50' MIN. 0.25' EMB- MAX. SHIM Mme/ BY OTHERS ULNAS q) EE DETAIL 7./''- ON SHEET 5 81.25" MAX 0A FRAME HEIGHT SEE NOTE 9 ON SHT. 0 1.34" MIN. EMB. EN— 111 O 1.75' MIN PANEL THK. 80.0" MAX. 0A. PANEL HEIGHT 1.75" MIN. .625" .50" MINI CONCRETE/ ' Di57 BY MASONRY OTHERS L'A1 VERTICAL �� S QN HI M LD 0.25" MAIL SHIM 1.50' MIN. B. CO MASONRY BY OTHERS Q1 x DETAIL 7 014 SHEET 5 SEE NOTE 6 ON SHT. 4 1.75' MIN PANEL THK. SEE NOTE 2 ON SHT 4 81.25" MAX. 0.A. FRAME HEIGHT 0.125" MIN. GLASS 114K. SEE GLAZING DETA1S, SHEET 7 SEE NOTE ON SHT. 4 SEE NOTE 8 ON SHT. 4 SEE NOTE 8� ON SHT. 4 1:EE DETAIL 7 ON SHEET 5 1.25" 75 50" M. MIN. MIN. EDGE DI .. EMB. VERRICAL CROSS SECTION SEE N01E 3 ON SH1: 4 80.0" MAIL 0A. PANEL HEIGHT SEE NOTE 3 014 4 MASONRY BY OTHERS KW 11111rill 1WUI t• 1.I4 _t ( illii °.. :arIK'�t13!Ir r i•fi:i•r''1< 5� 1�1�M • �- il:l0M1111 ��[•�.ril` ,:.�3,t''.i1�1L•' j •iii ri7i. R, �! {I 1♦ . 7Tr !iLr i� j • - ULLION *' � 5571 r,€7T �'";c>it ., t (.t- r.a . L, Y .* .;ii;ia't'. e > tEIrJL%' m74 w000 3' IE•1;• 111'-l' .r i I, Irar a•:. •,a:i• 7ii! �1- • ETALIETAINT 111111111111 [F t -k77• E)• ._ :• ,�_4 +:ate �1 Eu..::.It r 7 tI7i ?' r-Xi�j 7lro1 �_ta?ijxJ:l1♦� • rQ�J:r�. r ,� ■? • EF714.•• J LEffe%111'„ia.i•1 4 F31r 7T UU:l.'i.? ?E[ VPiLWIrili EiiYaiffa"wr, ,,ir 1wE7ca Erd, "1 .10.rte IFFA E ..ii! a ■ [ :N . ifi 1Tt?.Y�! .91:.:!11L•L ', v� +;;i WA E?Z�i#"7rTa"3�T. ? ' 020 I!...' ax wJ i-1•1 IIK:11'2J2.13!11ita 71-WAC -12 Iff.'I1 •1�( •TTI♦ r i1<•TTci'�"':', x.i Al ©ii' il r #L }fMLII_�� .r LIWITiLMI X1125.? IVA E7[ : r''_ IWilaWinlir1=13�a`. -. ?;ma x=. t iI..: f' 3 'a:i q„'>_ col sTre414-igais, CZ1I '4 a a, r +FS_ C - "r lar:U! /• tll.?a' •rji 167 ,Jr z... ird, a z•' a f:lst . r' ICA Cril-3i 111WW/FAIr'': 374., , r ll/)1 71x3. .,_ $1 .•' c ?t • 1 99 Wi' •,T.^7411 ;[ +1...•i•11:FYI_t1I_}ri•i:�:!! 3i1,7 .50 !i . 7ri �bs 9!tch;i- ii.ul..1_'.,. a` ICA! l t ∎.1Q?`,!Li•1 7G i '>. PRODUCTREVISBD aomplping thowltB Plmlds o 1IgCode A ooapmmeNoO Iffi" Prepared BY: 8Na 6 Reeds P. 6 N0. 41363 MC, Lte 1535 Cagayan ftwt, Sults 425 RP:idegtik Thrift 32155 O„Nlm6 at kgataika J. 2036 DAVIVINO PTO, LLC Phone: 321- 890 -1768 Fax 321- 890 -1789 S-2104 :ter _L. Or SEE NOTE 4 ON SHE 4 SEE NOTE 7 ON SHE 4 FRODUCTREVD as complying with the FI Batt* Coda AcceiganceNe RqdralkaElsae • MUM 1.75' MN. PANEL WK / / / / / /��` j / /// / / /../ //< :. :r : k ° . , . L f .. •1 SEE DEEM. 5 ON SIIEET 5 SEE DEM. 5 ON SHEET 5 CONCRETE MASONRY BY OTTERS 'BY OTHERS 1.5e MR ENKA 0.25" MX SH91 E JAL. SECTION (1] it -r. !':1 7. elks jc, 'iivre. nr,: i :7 0.25* MAX SHI 1 17.50* MW. EMBED. SEE NOTE 1 ON 5M 4 ASIRA* THROW 60!15 (2) TOTAL: (1 EACH) 0.31• DM x 9.0* L0. AT TOP & BOTTOM SEE NOTE 1 SHE 4 1.! % % / /`� 1.75 MAY PANEL THK OEM \ FRODucrREV1SED gs complying %WasFlorida BeikEng Cod *V- OS ERA' ....n . w. .I.}(LTF •iZ ASTRAGAL TO STILE ATMcHMENT NOTE: RBI 24 NOT SHOVN THN WEW FOR,CLARIIY• SEE NOTE 4 SHT. 4 SEE DETAE 1 ON MS SHEET e NORIZw SS SECTION Ao, o P.Ct 023 ' ' &Ate CIO Poddelp. MSS esc eater a araeraee xa Mil Alir ILO Me Mt lia -690 -1788 Fee 321 -880 -1789 06E 9- 1-01 tam N.7S. 090..* JNil OK BYe £ SAFFELL eW919 t10.t 5-2104 IOW .1—a . T4 COOS GO �...:: •1.117 fi - 1.75.1M. PAR Hilt SEE C AIN° OFTANA SHEET 7 SEE NOTE ON SHT. 4 sir NON ON SE 4 SEE 17001E 8 ON SHE 4 0.75' SEE NOTE 5 ON SHE 4 SEE DEiTfL 6 ON SHEET 5 SEE NOTE 5 0414 l✓ 0877a 5 ON SHEET 5 - 0.75" HORi NTAL C O G L{ln 1. SPACING FOR REM 128 NE 110.4 r PSI SOROS ATTA0125 TIE AYPERN . ASTRAGAL TO THE INACTIVE DOOR IS AS FOLLOW: MUM TOP DONN &1TE 80TTQM1W 10; 25; 40*, 8.5; 13.0: 180. 8.2100' 2. SPACING FOR not 123 THE 18 x 1 1/2 PIASCREW SAS FOLLOW TOP & BOTTOM. HORTLONTA1.tY. SI1fl.0E Pia 3.0.11 FRZON EACH CORNER. iTE 510E8 terbxtr. FOR THE sow wok ,'01.0: 13 " 18.0*, 39.0. 520` & 3 SPASM FOR OEM 131 THE IEGI x 3/4 BRAD TRW NAN. AMMO TIE QUARTER ROUND TO TIE SMITE AND In 10 TTE:1641Q X.1' B 40 SW 11AE AITA13140:1147; MLUI11. CPI 0 THE 1RR!lOR 814R VISTSEELY, IS AS MOWS: Jima 80170180 I7O NTATLY (FOR TIE 318" QUARTER ROUND* 1.25" 7 FROM EACH C0R R 711 (1) IAN& WW -SPACE g& TEE SIDES VER71OILLY (HER BOTH 3/8' OINRiER ROUND & MULLION CAM ur FROjf EACH & SX MORE EQUALLY SPICED ON THE FED. 4. N1EN ATTAC NG 11E STRIKE PLATE TO TIE 44118 AND aUa USE HEN 128, A /B It 2 t/2' PM 11000 S x. WHEN ATTACH THE STRIKE PRATE TO THE JAMB AND SI)EIDE JAMB AT DE MULLAH USE ITEM 124. A 18 x 2' PM KM SOME 5. SPACING 1104 REM 125 RE 18 x 2 1f2" PFH 0000 SCRS& ATTACHING HE ASS TOGET IN AT TIE AMOK iS AS MOBS: 6.0* FROM EACH VERTIOI. CORNER NTTH (4) MORE MOS EQUALLY SPACED ON 1THE FIELD, & THE SLICE PANEL 6 SEWED INTO THE SIDEUTE JAIN TV/ 11EM 129 SILICONE CON ON THREE SIDES An 3/B' QUARTER ROUNDS SECiJRE NTBI BEY 131 SID TRW 14S LS x 3/4' LONG. 7. WEN ATDICHING TFE HINGE N1E TO THE 441/8 AND BUCK USE ITEM 127, A 110 x 2' PFH SCREW. *7111 ATTACHING THE HINGE iO THE NM AND SOME JAMB AT THE ARILUON USE REM 114, A 110 x 1 3/4" PFH 1000 SCREW. 8. VAC= FOR 4781149 DE 18 x 1 1/2' PAM SCREW (TRIIIY 1.1113111510 HS AS FOLLOW$ seam MIME FROM THE TOP DOWN VERRCA LY: 3.25; 180828. 328125. 47.5825' & 82825'. ZEN UDi114ME TOP & BOTTOM. FROM THE LEFT: ME (1) SCREW AT 4.4375 ". 9. ALTERNATE CONCREIE/MASOIIRY RETALIATION ANCHORS OF EOIRVALENT PERFORMANCE CHARACTEIBSTICSS CAN BE USED UPON APPRCV C THE ARCHIIECT OR EN OF REC0R0 RJR THE PROJECT OF INSTALLAiTOAL 10. 1151: 881151 WHEN AMSTALUNr INTO 14000 SUBSTRATE AT HEAD R JAMBS. WE ITEM 125 WHEN INSTALLING PIT0 MUttt016. USE REM 118 WHEN RLSTALLIYG INTO CONC1k?Ef4NSONRY SUBSTRATE AT MIRE 5815. 611 5T1P19 ©HORIZONTAL CROSSN�B AT SiDELiTE TO H! GE SO G SHT.43 SEE GLAZING DEWS, SHEET 7 PRODUCT REV ED 01 can lyrogwish Or Ram 13.4• s Chao Ala •• • 111==17.`. DiviWau SEE MARIO DETAA,S, SHEET 7 EXTERIOR- INTERIOR SEE NOTE 2 ON SIC 4 NOTE B ON SHE 4 4 1.511 MN EMBED. SEE 0ETAi. 5 ON SHEET 5 0.25' MAZ SHIM 8110 8. 065) Theft P. E. 1m. 413U 1535 Cegoonneritt. Sults C25 Recidalp, Fields 32535 tWt Ord* 4/d aktleala2,101 Premed Bp W Phone: 321-690-17811 Fee 321 -690 -1789 Dams 9 -11 -0 1 sans 1LT.1 an. an ,INtI ant. int S. SAFFEL. coma tea 5-2104 sir _4_0, 11- nag t0lz -s MI SPAM r13Os s Y Pit WI IMO .stir +- l0-i -90 tell - -lE£ 9911- -ilf Id 0n �d d CIS 1311=PAMON A 411•1111+10 Stil SI r ri a* asa ISM NI 3 �8vY3 . SHOHOW NOtlY 7W199 901 )NS NOOO 133115 NO ~ � N. Ol 31ON 3 YAWN 01 MOM MIMS rum WOO fritf 01 .ri FTEIC 31VId 3I9dIS 11 15Y 31YM 3991S 1V'JVISV 0701631 9 L o - £ 1Y130 a;01►r arjl o - z '9.130 [.:rn•1 ,,n:r 1Gr,o 'wet - Tr "P'R "' v11 t'd: 'H ?Wed A" it —3. •N1 .St /FU! 1 opZsaurtlx"V ansuou.t31cIoi d sow . l£ :1N$ 6911 NO 9 INCIO 335 9T 0. S3DYds . l£ 'MS SOU NOab,. t .W130 33s .9191 NUN 31'00 10 'WI .5l5L MOEN TO S911 NO * MOO 33S "o 4." Jrq'i " `t1I C.(1, 1 .pIIY :Tel WS Srl NO ...I-1 &gal I 7f6 S911 NO l W.130 335 HM ?NW Y0 74M .S'*L 1N9QH Mkt 10 Arm 00187 D M7H EI E lFS at rr LOG 1Pi V MEO FROM 91TERIOR 81.25' Y Mt oN St1EET 5 Fes. T-1 ►mall 5.57' I 1 3825° �37 FINE MOW 4 PRODUCT REVISED es complying with the H Building Cab Pd GRAM r NE emir NO Mtigi-MUMMEAKMANCHMACIME VIEWED FROM 511ER08 Moeda P. Q, � E�. No. 41323 Snits CES Pactdoo* Mafia 32258 PPE *Mods a p11sYas 113. 25136 Pteptad Arbrianiri Phew 321-888 -1788 Fee 31t- 897 -11811 9- 7-01 was N.T.S. 01111, en JIRI MK. era S SAFFELL ORONO 11114 S-2104 . 911Et � eF� son .OEM 1 OOL LAE i Ste[£ TIME or WEED GLASS SPARTECH POLY= PP5530 C13 GIAZMIG DEtA9" 3 AMOY UTE F r INSULATED TEIWERED GLASS LUPOY W -5007. x123' TEMP. GLASS 0.125' TEMP GUMS Eelo srreri fbewo 1. E. No. 41323 ins oe P : cis MI Coln* . ke a tie a1 aa33 ntonucruvisto Blinding OXki._ MCCOMD3 14" EXPbStiOn Date Division 7tT E? - P/oduutC� " PRCERICTea �P.G Y VIS® �B wthi 6n Flofl a Bane% Code No " ; s • ?Mani Pawed 13p Phone J2�' tt 890 -1751 Fae 321- 500-171 o+o* 9-t, -0 sae 'LT.& OVA VII .AI1 au. ae S. SAFFEIL awao 5-2104 %mu a?� 3NW VS0O3COIOd 031MOP 8rift4C) zerwriarass 103SM 141X . 0)198d AO - turtfnrnv 030IING" (2) 111111=1-35rnirrEgiarNMI) 1 1 ;,46.VM .003 139.° /////./ /` .u.1 Appotaotwin.suptom. riQ&L liLS 1NL 416970 .* V (!* WA) 300(;)z 3f zrw LS � ROMPS Is71 afr* -11— 7 0 0 0 0 ,C1. 911 -.U.11:&111,1111I: jri •d :rfl 31,727"710010 56014 07,65 . 31(73ks .onnlf1= 0 Lai 11 .1.,■,! 1.0 TJ LI ar0 aro 0 7i01L0NDV4QLNOI • V1708 Olen ,A X YtO . . xtro • WE01.19/ .0O7 74' 0) ■:10delkEld 411 _1T 5110 N07-0 r 4-N austeme tassuno OHM AT • .! 11114 : Egg. 41 2 :C. ,./4 .63 L: .dro. 1-• *DV •4-1 .01.0 -41- „Tir0 -1 k- QUNV gPe3 EclIPPEI ,qj 'VW � O Rid MEd VSO1L30110d CHINO' trEltiti werzta .L_ „ao .srt Agri *gt° 447 117 (TA IftWarinvzi 7331S LIZO'0) Val 6i) Vintantite March 28, 2011 To All Concerned, This letter authorizes, Gaston A. Roberge, to negotiate and obtain any and all bids, quotes, estimates, building permits or other permits required This is specific to my property located at 100 N.E. 92nd Street, Miami Shores, Florida 33138. This is retroactive to closing date of January 18, 2011. Respectfully submitted, i4fr- Kerry A. Roberge, Owner .mil Sworn to me this 28th day of h 2011, Kerry A. Roberge, personally known to me. KARETA A. NOONE- OLSHFSKI Notary Public, State of New York No. 01N02903933 Maned in Jefferson County , 3 Commission Expires September 30. OP ID: TB IttiC OWE: �., -- CERTIFICATE OF LIABILITY' INSURANCE DATE (MM/DD/YYYY) 03/02/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 407 -849 -1988 Walker Ins. & Fnci. Svcs., Inc P.O. Box 532115 407 -849 -1972 Orlando, FL 32853 -2115 Deborah J Hall, CIC, CRM, CRIS CONTACT ME: PHONE FAX (ANC, No. Ext): (A/C, No): E -MAIL ADDRESS: PRODUCER ATLAN -8 CUSTOMER ID N: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Atlantic Engineering Services, Inc. 200 C2 Crosswinds Drive West Palm each, FL 33413 INSURER A: Mid-Continent Casualty Co. INSURER B : Ironshore Specialty Insurance 04-GL- 000787906 INSURER C : 04/18/11 INSURER D : $ 1,000,000 INSURER E : PAMAGES (RENTED PREMISES (Ea occurrence) INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL ■ : SUBR .■AA. POLICY NUMBER POLICY EFF M DL4 POLICY EXP M DkUl1 LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR 04-GL- 000787906 04/18/10 04/18/11 EACH OCCURRENCE $ 1,000,000 X PAMAGES (RENTED PREMISES (Ea occurrence) 100,000 $ • CLAIMS -MADE X MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 X POLICY PRO- PRO- LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA UAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS Y / N N / A WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ below E.L. DISEASE - POLICY LIMIT $ B Professional Liab. 000234300 04/09/10 04/09/11 Per Occur 250,000 Aggregate 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CANCELLATION MIAMI -2 Miami Shores Village Building Dept cubillosv ®miamishoresvillage.c 10050 N.E. Second Ave. Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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:1132060133290 Owner's Name: RICHARD CAINES Job Address: 100 92 Street Miami Shores, FL Owner's Phone: Total Square Feet: Total Job Valuation: 0 $ 5,000.00 Contractor(s) ATLANTIC ENGINEERING SERVICES INC Phone Primary Contractor (561)358 -4140 Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 3116/2011: Yes Comments: Permit No: 11 -311 Job Name: March 3, 2011 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 1) The door product approval does not meet the design wind Toads. 2) The sidelight does not have impact resistance. Provide shutters or a new product. 3) The product approvals submitted are poor copies, please provide good copies. Plan review is not complete, when all items above are corrected, we will doa 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-Dade My Home My Home Show Me: Property Information Search By: Select Item MText only Properly Appraiser Tax Estimator PrOpo Co, Jarison Summary Details: Folio No.: 11-3206-013-3290 Property: 100 NE 92 ST Mailing KERRY A ROBERGE Address: 1 Living Units: 100 NE 92 ST MIAMI Adj Sq Footage: SHORES FL Lot Size: 33138- Property Information: Primary Zone: 1000 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds/Baths: 3/3 Floors: 1 Living Units: 1 Adj Sq Footage: 2,153 Lot Size: 13,000 SO FT Year Built: 1951 $0/$300,485 MIAMI SHORES SEC 1 City: AMD PB 10-70 LOTS 13 Legal Description. & 14 BLK 24 LOT SIZE IRREGULAR OR 21141- 3026 03 2003 1 COC $0/$300,485 26521-4730 07 2008 3 OR 27595-2443 0111 01 Assessment Information: Year: 2010 2009 Land Value: $117,392 $130,548 Building Value: $183,093 $195,681 Market Vaiue: $300,485 $326,229 Assessed Value: $300,485 $326,229 Taxable Value Information: Year: 2010 2009 $430,000 Applied Applied Taxing Authority: ExTeamxapbtigen/ ExTeamxapbtigen/ of examination of the Value: Value: Regional: $0/$300,485 $0/$326,229 County: $0/$300,485 $0/$326,229 City: $0/$300,485 $0/$326,229 School Board: $0/$300,485 $0/$326,229 Sale Information: Sale Date: 1/2011 Sale Amount: $430,000 Sale 0/R: 27595,2443 Sales Sales qualified as a result Qualification of examination of the Description: deed View Additional Sale Additional Information: Click here to see more information for this property: Community npvelnnmpnt flHtriot Page 1 of 2 ACTIVE TOOL" SELECT "E galk 91' • to tot . Aerial Photography - 2009 0 - 1136 t,liv Home !Property information 1 Property Taxes I My Neighborhood 1 Properly Appraiser Home 1 Using Our Site 1 Phone De-ectory I Privags I Disclaimer If you experience technical difficulties with the Property Information application, or wish to send us your comments, questions or suggestions please email us at Webmaster. Web Site © 2002 Miami-Dade County. All rights reserved. http://gisims2.miamidade.gov/MyHome/propmap.asp !DADE Legend Property Boundary Selected Property Street Highway Miami-Dade County Water 3/28/2011 3t� Professional Practice Management, Inc. SINCE Kerry A. Roberge, President / lJ M� 0'iA -e / bG /1 an/6-er-n/1 44- //or% e._-- 71-e9 ;'t- 1116 Arsenal Street, Suite 504 Watertown, NY 13601 /4 /) 6e e_- 7 ,j'J e.- �?s /7i'G e-e ssr,� e- y/ 4,- K7 .4 - / f / �<33/ 3zF /iii. -£7 17'541 A s / / / e'S Telephone (315) 782 -2620 • Toll Free (800) 924-2620 • Fax (315) 788 -4980 • E -Mail: ppm @ppm- inc.net www.ppm - inc.net DURABLE POWER OF ATTORNEY FOR FINANCE OF A KERRY ROBERGE ARTICLE I Creation I, Kerry Roberge, as Principal and a resident of the State of Florida designate my son, Gaston A Roberge to serve as Attorney -In -Fact (my "Agent ") for me and to act as the guardian or limited guardian of my estate should guardianship proceedings become necessary or desirable. ARTICLE II Effectiveness; Effective Immediately This Power of Attorney shall become effective immediately and shall survive and continue during my disability, incompetence, incapacity, or partial incapacity. This Power of Attorney shall not be affected by my subsequent disability or incapacity or by lapse of time, except as provided for in section 709.08 of the Florida Statues. Disability, incompetence, incapacity or partial incapacity shall include, without limitation, my inability to manage my property and affairs or caring for myself effectively, for reasons such as mental illness, mental deficiency or other mental incapacity, physical illness or disability, advanced age, senility, chronic use of drugs, chronic intoxication, which may be evidenced by a written statement of my regularly attending physician or' two other qualified physicians or by court order. ARTICLE III Powers My Agent shall have all powers of an absolute owner over my assets and liabilities, whether located within or without the State of Florida, including, without limitation, the following power and authority: A. Power relating to real property transactions. I empower my attorney- in -fact to: 1. accept as a gift or as security for a loan, reject, demand, buy, lease, receive, or otherwise acquire an interest in real property or a right incident to real property; 2. sell, exchange, or convey, with or without covenants; quitclaim; release; surrender; mortgage; encumber; partition; consent to partitioning; subdivide; apply for zoning, rezoning, or other DPOAF of Kerry Roberge Page 1 of 17 Initials: Date: p9 4/ A DATED this 02k day of f e' 4,ru,$4, -7 , 20 !( . Roberge, �cipal Social Security Number: 05-2 7 - a ` 6 76-1 Residing at: 100 N. E. 92 Street Miami Shores, FL 33138 A The principal is personally known to me and I believe the,principal to be of sound mind. I am eighteen (18) years of age or older. I am not related to the principal by blood or marriage, or related to the attorney -in -fact by blood or marriage. The principal has declared to me that this instrument is his power of attorney granting to the named attorney -in -fact the power and authority specified herein, and that he has willingly made and executed it as his free and volun . act for the purposes • erein expressed. [Witness atur e ] N Eel) T. 3) ey [Print Name] [Witness Signature] [Print Name] DPOAF of Kerry Roberge Page 16 of 17 Initial : _ ( Date: STATE OF FLORIDA } COUNTY OF lila Q,(/(1 ^ j /.A ctsl Ss. A nn 1 This is to certify that on this 0C day of l# 6 , 20 ,J , before me, the undersigned Notary Public in and for the State of Florida, d y commissioned and qualified, personally appeared Kerry Roberge, to me known to be th person described in and who 'executed the within and foregoing Power of Attorney, and acknowledged to me that he signed the same as his free and voluntary act and deed, for the uses and purposes therein mentioned. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official t ie day .•• -. r.t:b, e 'tten. I , IL" No ignatur Print Name: NOTARY PUBLIC in and for the State of Florida, residing at 1OC6O NI S NOTARY FOLIC -STATE W Mina Claudia V. Cubill s ,AI `:. Commission ,fig DD717 23 �e %V I:zpi-;ez: S P. 23, 2011 EU;�3ii D OFF o itg%DCadre. My commission expires: DPOAF of Kerry Roberge Page 17 of 17 Initials: Date: Project Address 100 NE 92 Street Miami Shores, FL Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Owner Information Address Parcel Number 1132060133290 Block: Lot: Applicant Phone RICHARD CAINES Cell RICHARD CAINES 100 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone CeII Phone ATLANTIC ENGINEERING SERVICES I (561)358 -4140 Valuation: Total Sq Feet: Approved: Yes Comments: Date Approved: 3/16/2011: Yes Date Denied: Type of Construction: OPENGINGS ALTERATION Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Yes Certificate Date: Bond Return : Occupancy: Single Family Exterior Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Plan Review Fee (Engineer) Scanning Fee Technology Fee Work without Permit Fee Amount $3.00 $3.37 $3.37 $1.00 $225.00 $60.00 $21.00 $4.00 $225.00 Total: $545.74 Pay Date Pay Type Invoice # RC -2 -11 -40150 03/29/2011 Credit Card 02/24/2011 Credit Card Amt Paid Amt Due $ 495.74 $ 50.00 $ 50.00 $ 0.00 $ 5,000.00 0 Available Inspections: Inspection Type: Final PE Certification Drywall Miscellaneous Window Door Attachment Tie Beam Final Framing Insulation Truss Insp Columns Foundation Window and Door Buck Fill Cells Columns Wire Lathe Declaration of Use F. Termite Letter F. Elevation Certificate In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compli ince with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the profar 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. Futherrnore, I authorize the above -named contractor to do the work stated. March 29, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date March 29, 2011 1