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RC-09-1319 (2)Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 135134 Permit Number: RC -8 -09 -1319 Scheduled Inspection Date: February 10, 2010 Inspector: Bruhn, Norman Owner: LALANNE, ROSE Job Address: 190 NE 91 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HARVEST TRUST DEVELOPMENT GROUP Permit Type: Residential Construction Inspection Type: Slab Work Classification: Addition /Alteration Phone Number Parcel Number 1131010190080 Phone: (305)720 -8517 Building Department Comments ADDITION OF 1 CAR GARAGE Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments je .,? e/c 443.1 -{, 7;4 -dL - February 09, 2010 For Inspections please call: (305)762 -4949 Page 18 of 21 Notice of Preventative Treatments for Termites (As required by Florida Building Code (FBC) 104.2.6) Krypton Pest Control Co. 2215 West 78th. St., Hialeah, FL 33016 Dade: (305) 828 - 2999 / Broward:(954) 779 -1535 190 N. E. 91 S7 MIAMI SNORES F 2/2/10 Date CyPER TC Product Used 0. 25% Percent Concentration Address of Treatment or Lot/Block of Treatment Time 10 :00 A.(7. Applicator RAUL RODRIQUEZ Cy/PERNETflRIN 30 GALLONS Chemical used (active ingredient) Number of gallons applied 900 S? Area trreated (square feet) Linear feet treated AD70TNINC SJ.4R Stage of treatment (Horizontal, Vertical, Adjoining Slab, retreat of disturbed area) As per 104.2.6- If soil chemical barrier method for termite prevention is used, final exterior treatment shall be completed prior to final building approval. If this notice is for the final exterior treatment, initial and date this line I NI NON e • ALL STATE ENGINEERING AND TESTING CONSULTANTS, INC. TESTING LABORATORIES- ENGINEERS - INSPECTION SERVICES - CHEMIST - DRILLING - ENVIROMENTAL SERVICES 2380 West 78th Street, Hialeah, Florida. 33016 - Phone: 305- 888 -3373 Fax: 305- 888 -7443 PROCTOR COMPACTION TEST ASTM D -1557 Date February 2, 2010 Order Number 10 -0054 Client NU Construction Address 18495 S. Dixie Highway Miami, FL 33157 Project SFR (Addition) Address 190 NE 9151 Street Miami Shores, FL Sample Location Stock pile at the job site Soil Description Fine silica sand with pieces of rocks Sampled by Raza Reported to TEST RESULT` Laboratory Number: 10 -0082 Sample Number: 01 The following compaction test was conducted in accordance with the standard methods for Moisture/Density relations of soil using a 10 Ib. Hammer and 18" drop A -ASHTO designation T- 180 -C. Optimum Moisture 100% Max. Dry Density 98% Dry Density 95% Dry Density Gradation test passing 3/4" Siev 9.4 105.3 103.2 100 96.50% Sampled By Tested By: Technician Signature Certificate #: Raza Jose Typed By: SF Dry Density vs % Moisture 5 6 7 8 9 10 11 12 13 10. „`", 1 40 11 HIlIHh» 11 NH i 11111.11111101111 1111 ;,;151 ,!, 1111 ' '!Il,H SIT` 1111 VIII I HIIH11► ! 1 HIHHH ' HH* ' 1 1;P: 11 III ior:OFHH ii i 1 % MOISTURE aseem Quadri, .P E. # 51 ALL STATE ENGINEERING & TESTING CONSULTANTS, INC. Should any subsoil conditions in the property (area) tested be found different from those encountered on the tested locations reported on our Density Test, All State Engineering & testing Consultants, Inc. is not to be held responsible. As a mutual protection to client, the public and ourselves, all reports are submitted as the confidential property of clients, and authorization for publication of statements, conclusions or extracts from our reports is reserved. 4 .. ALL STATE ENGINEERING AND TESTING CONSULTANTS, INC. TESTING LABORATORIES- ENGINEERS - INSPECTION SERVICES - CHEMIST- DRILLING - ENVIROMENTAL SERVICES 2380 West 78th Street, Hialeah, Florida. 33016 - Phone: 305- 888 -3373 Fax: 305- 888 -7443 Field Density Test of Compacted Soils ASTM D -5195 Client: NU Construction Order # 10 -0054 Address: 18495 S. Dixie Highway Miami, FL 33157 Date: 2/3/10 Project: SFR (Addition) Gauge # 16407 Address: 190 NE 915t Street Miami Shores, FL Phone No: 12" Attention: Lab ID # Location 10 -1226 Garage Slab on Grade at NW Area 10 -1227 Garage Slab on Grade at Center Area 10 -1228 New bathroom Slab on Grade at Center Area 7.9 7.3 Description of Material Fine silica sand with pieces of rocks Back Fill 10 -1228 Sub grade Base rock Sampled By: Raza Tested By: Jose Laboratory Identification Number 10 -1226 10 -1227 10 -1228 Test Number 1 2 3 Depth in Inches 12" 12" 12" Field Density LB /Cu Ft. (Dry Density) 104.1 103.9 103.2 Moisture Contents 8.74 7.9 7.3 Maximum Density In the Field ( %) 98.9 98.7 98.0 Compaction Requirement by Specs % of Maximum Density 98% 98% 98% 100% Maximum Density (Lab) 105.3 105.3 105.3 Proctor T- 180 AASHTO Method C 10 -0082 10 -0082 10 -0082 Optimum Moisture ( %) 9.4 Typed By: SF Tested by: Babar Raza Signature: Certificate #: Respectfully submitted by, aseem Quadri, P.E. # 5 481 ALL STATE ENGINEERING & TESTING CONSULTANTS, INC. Should any subsoil conditions in the property (area) tested be found different from those encountered on the tested locations reported on our Density Test, All State Engineering & testing Consultants, Inc. is not to be held responsible. As a mutual protection to client, the public and ourselves, all reports are submitted as the confidential property of clients, and authorization for publication of Statements, conclusions or extracts from our reports is reserved. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: INSP - 161544 Permit Number: RC -8 -09 -1319 Inspection Date: July 01, 2011 Inspector: Bruhn, Norman Owner: LALANNE, ROSE Job Address: 190 NE 91 Street Miami Shores, FL 33138- Project <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: Survey Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010190080 Building Department Comments ADDITION OF 1 CAR GARAGE (1 7 670/ Passed Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until Friday, July 1, 2011 July 01, 2011 For Inspections please call: (305)762 -4949 Page 2 of 2 Page 1 of 1 M.E.91sm STREET 70' RIGHT—OF—WAY (BY PLAT) 20'± ASPHALT PAVEMENT LOCATION SKETCH SCALE: NTS JUN 2 () 'a"" 8'f ASPHALT PAVEMENT 10' GRASS PARKWAY N.E. 91st STREET (NO..I.D.) "5' CONC.SIDEWAIK. 1355.00 (R &M) F.NAIL --n CONC. WALK Q', L4= 89'39'30' R= 25.00' A =39.12' 38.90' PLANTER 25.85' F.GF.. (ND CBS ONE STORY RESIDENCE # 190 F.F.ELEV. = 11.05' 18.50' 27.90' N 1.4) r.,— Q - -4 f` :i',K; I (-) c,c '(1 VVI11 I All 1 I I i)[ Ilnl_ PLANTER ASPHALT SURVEY FOR: VILBRUN LALANNE AND ROSE LA.LANNE, 190 N.E. 91ST ST., MIAMI SHORES, FL. 33138. ASPHALT 35.20' I No I.D.) ASPHALT 6 135.00' (R &M) NOT VALID UNLESS EMBOSSED WITH SURVEYOR'S SEAL REVISED: REMAINDER OF LOT 11 BLOCK 7 ABBREVIATIONS: SYUK =SIDEWALK CBS = CONCRETE BLOCK STRUCTURE, CLF =CHAIN LINK FENCE, PL= PROPERTY LINE, DUE = DRAINAGE UTILITY EASEM ENT, IP =IRON F= FOUND, AIC =AIR CONDITIONER PAD, P /C= PROPERTY CORNER, DIH =DRILLED HOLE, IMF =WOODEN FENCE, RES= RESIDENCE, CL- CLEAR, RB =REBAR, UE =UTILI Y EASEMENT, CONC= CONCRETE SLAB, RA/WRIGHT OF WAY, DE= DRAINAGE EASEMENT, C/L= CENTER LINE, O =DIAMTER, TYP=TYPIAL, M= MEASURED. R= RECORDED, ENCR= ENCROACHMENT, COMP = COMPUTER, ASH = ASPHALT, N/D =NAIL & DISC, S =SET, FEE= FINISH FLOOR ELEVATION, 0 /S= OFFSET, P/P =POWER POLE, OHP =OVERHEAD POVaERLINE, WM =WATER METER WOOD FENCE— MASONRY WgLL= CONCRETE= MAINTENANCE & DRAINAGE EASEMENT= LEGAL DESCRIPTION: LOT 10 AND .THE NORTH 33 FEET OF LOT 11 1 OF EL PORTAL SECTION 2 ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 9 OF THE PUBLIC RECORDS MIAMI —DADE COUNTY, FLORIDA ELEVATION BASED ON LOC. # 3101 DCBM# "GS-2—R ELV. 8.68 r TYPE OF SURVEY: BOUNDARY SURVEY SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) UNDERGROUND ENCROACHMENTS NOT LOCATED,. 6) ELEVATIONS ARE BASED ON NATIONAL GEODE IC VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING INFORMATION. 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB PAGE i HEREBY CERTIFY That the survey represented thereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements other than as shown hereon. ADIS N. NUNEZ REGISTERED LAND SURVEYOR STATE OF FLORIDA #5924 BLOCK 7 SUBDIVISION AT PAGE SINCE 1987 BLANGO SURVEYORS ING. Engineers • Land Surveyors • Planners • LB # 0007059 555 NORTH SHORE DRIVE MIAMI BEACH, FL 33141 (305) 865 -1200 Email: biancosurveyorslnc@yahoo.com Fax: (305) 865 -7810 SUFFIX: L DATE:9 /11/x9•. BASE: N/A COMMUNITY # 120652 DWN. BY: JOB No. 11 -368 FLOOD ZONE: PANEL: 0302 DATE: SCALE: 4/28/11 1 ° =20' F. Blanco Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: INSP - 161543 Permit Number: RC -8 -09 -1319 Inspection Date: July 01, 2011 Inspector: Bruhn, Norman Owner: LALANNE, ROSE Job Address: 190 NE 91 Street Miami Shores, FL 33138- Project <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: Insulation Work Classification: Addition /Alteration Phone Number Parcel Number 1131010190080 Buildinst Department Comments ADDITION OF 1 CAR GARAGE Passed G��,/J , �� Inspector Comments / Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 July 01, 2011 Page 1 of 1 JUN 2 RECD May 31, 2011 Building Department Miami Shores Village Building Department 10050 N.E. 2nd Ave Miami Shores, FL 33138 RE: Garage Addition 190 N.E. 91st Street Miami Shores, FL 33138 I, Vilbrun Lalanne, had performed the insulation using insulation material R -30 according to the approved plans. Furthermore, it was inspected by the Village Building Department and it passed . As result, this letter is a certificate of insulation completion. Should you require further clarification please do not hesitate to contact me at ( 305) 333-2870 at your convenience. Vilbrun Lalanne Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 121605 Permit Number: RC -8 -09 -1319 Inspection Date: July 01, 2011 Inspector: Bruhn, Norman Owner: LALANNE, ROSE Job Address: 190 NE 91 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: Final PE Certification Work Classification: Addition /Alteration Phone Number Parcel Number 1131010190080 Building Department Comments ADDITION OF 1 CAR GARAGE Passed` if Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 July 01, 2011 Page 1 of 1 AtAIRE Aa CAnWIDI13IEILIL a �IRCIHI1fIEClf 11C74 373 S.E. 92%1D STREET MIIA MII SUCUIES. VLA. 3313S 754-231S u r 7 (55-7 MG Date: June 6, 2011 Miami Shores Village Building Department 10050 N.E. 2nd Avenue Miami Shores, Florida 33138 Re: Permit # garage addition Lalanne Residence 190 N.E. 91st Street Miami Shores, Florida 33138 Folio # 11- 3101 -019 -0080 Attn: Building Department, JUN 20RF n I, Mark A. Campbell, having performed and approved the required inspections at the Garage addition. I hereby attest to the best of my knowledge, belief and professional judgment, the structural and envelope components of the above referenced renovation are in compliance with the approved plans and other approved permit documents. I also attest that to the best of my knowledge, belief and professional judgment, the approved permit plans represent the as -built condition of the structural and envelope component of the said structure. This document is being prepared in accordance with section 307.2 of the Florida Building Code and must be submitted to the Village of Miami Shores Building Department in conjunction with the application for a Certificate of Completion for the above referenced structure. Should you have any questions or need any additional information please do not hesitate to contact me. Mark A. Campbe Architect State of Florida: #0011074 Lalanne CO letter 6 -21 -11 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: INSP- 121602 Permit Number: RC -8 -09 -1319 Inspection Date: July 01, 2011 Inspector: Bruhn, Norman Owner: LALANNE, ROSE Job Address: 190 NE 91 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: F. Elevation Certificate Work Classification: Addition /Alteration Phone Number Parcel Number 1131010190080 Building Department Comments ADDITION OF 1 CAR GARAGE Passed 7-r/ Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 July 01, 2011 Page 1 of 1 P �y�D U.t. ARTMENT OF HOMELAND SECURITY Federal Emergency ManagernentAgency National Flood Insurance Program ELEVATION CERTIFICATE JUN 2 J PET important Read the instructions on pages 1 -9. OMB No. 1660 -0008 Expires March 31, 2012 A1. Buiidin VIL SECTION A - PROPERTY INFORMATION AND ROSE LALANNE A2. Building NE Street _AdST, ( including Apt., Unit, Suite, and /or Bldg. No.) 11 -368 or P.O. Route and Box No. FLORIDA SHORES Slate 33138 .. ........ .... ..... ... For insuiance`Company:Use PolicfN irribe&; ZIP Code A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 10 AND THE NORTH 33' OF'LOT 11, BLOCK 7, EL PORTAL SECTION 2, P.B. 9, PAGE 115. A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessorryy etc.) RESIDENTIAL Ad. Latitude/Longitude: Lat. N25°51 .518 - Long. W80°11.618 Horizontal Datum: 0 NAD 1927 4 NAD 1983 A6. Attach at least 2 photographs of the :building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1A A8. For a building with a crawlspace or enclosure(s): N/A A9. 'Fora building with an attached garage: N/A a) Square footage of crawlspace or enclosure(s) sq ft a) Square footage of attached garage / sq ft b) No. of permanent flood openings In the crawlspace or N/A b) No. of permanent flood openings in the attaiip garage enclosure(s) within 1.0 foot above adjacent grade Ni c) Total net area of flood openings lc A8.b sq in d) Engineered flood openings? 0 Yes g No within 1.0 foot above adjacent grade c) Total net area of flood openings In A9.b N/A sq in d) Engineered flood openings? 0 Yes it No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number VILLAGE OF MIAMI SHORES 120652 B2. County Name MIAMI -DADE B3. State FLORIDA B4. Map/Panel Number 1208600302 B5. Suffax •• • L B6. FIRM index Date ., 9/11/09 B7. FIRM Panel Effective/Revised Dale 9/11/09 B8. Flood Zone(s) r X B9. Base Flood Elevation(s) (Zone AO, use basefiood depth) N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth - entered in Item B9. D F1S Profile 12 FIRM Community Determined D Other (Describe) B11. Indicate elevation datum used for BFE in Item B9: Q' NGVD 1929 Q NAVD 1988 0Other (Describe) • 912. Is the building located in Goastai Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date N A 0 CBRS D OPA 0 Yes D No SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based an: 0 Construction Drawings* ❑ Building Under Construction* !f Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a -h below according to the bulkiing diagram specified in item A7. Use the same datum as the BFE. Benchmark Utilized GS -2 -R Vertical Datum NGVD 1929 Conversion/Comments N/A a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) Lowest adjacent (finished) grads nextto building (LAG) 9 .40 D feet Highest adjacent (finished) grade next to building (HAG) 9 .60 n feet Lowest adjacent grade at lowest elevation of deck or stairs, including N/A ._D feet structural su..Ott f) g) h) Check the measurement used. 11 05 IA feet D meters (Puerto Rico only) N/A feet meters (Puerto Rico only) N A D feet 0 meters (Puerto Rico only) N f A _D feet 0 meters (Puerto Rico only) 10 .2.QE feet 0 meters (Puerto Rico only) 0 meters (Puerto Rico only) 0 meters (Puerto Rico only) 0 meters (Puerto Rico only) , SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information..( certifyhat the Information on this Certificate represents my bast efforts to interpret the data available. I understand that any wise statement may be punishable by fine Dr imprisonment under 18 U.S. Code, Section 1001. ® Check here if •comments are provided on back of form. Were latitude and longitude in Section A.provided by a licensed land surveyor? }Yes 0 No Certifies s Name ADIS N. NUNEZ Title Company Name REGISTERE, LAND SURVEYOR BLANCO SURVEYORS, Address City License .Number 5924 INC. State ZIP Code Signature 4 %/11 FEMA Fo' 81 -3 , Mar 09 A 33141 Telephone 305 865 -1200 See averse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., ,Unit, Swipe,. and/or Bldg. No.) or P.O. Route and Box No. 190 N.E..91 ST. City MIAMI SHORES FLORIDAstate 33138 ZIP Code SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CO NUED Copy both sides of this Elevation Certificate tor (1) community official, (2) Insurance agent/company, and (3) building owner. Comments C2.e A C ELEVATION. II a ►11 11 •: •• CROWN OF THE ROAD ELEVATION: 9.95' ON CENTERLINE ON CENTER OF. ROAD. BM# GS -2- Signature SECTIOn LOCATOR: 3101 ELEV: 8.68' / 4/14011 E ILDING ELEVATI Check here if attachments a ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is Intended to support a LOMA or LOMR - -F request, complete Sections A, B, and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. in Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade-(LAG). a) Top of bottom floor (including basement, crawspace, or enclosure) is _ Dfeet Dmeters above or Dhelow the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is _ Qfeet meters [ above or Dbelow the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A items 8 and/or 9 (see es 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building Is . _ 0 feet 0 meters 0 above or below the RAG. E3. Attached garage (top of slab) is 0 feet 0 meters 0 above or 0 below the FLAG. E4. Top of platform of machinery and/orequipment servicing the building is _ 0 feet 0 meters 0 above or 0 below the HAG. E5. Zone AO only f no flood depth numberis available, is the top. of the bottom iloorelevaied in accordance with the community's floodplain management ordinance`? :0 Yes 0 No 0 Unknown. The local official frrustoer8 this :information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA- issued or community issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are somata the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address Signature City State ZIP Code Comments Date Telephone 0 Check here if attachments SECTIONS - NITY 1NF A TION (OPTIONAL} The local official who is authorized by law orordinance to administer the community's ftooripiain management ordinance can complete Sections A, 8, C (or E), and G of this Elevation Certificate. Complete the applicable items) and sign below. Check the measurement used in items G8 and G9. 01. 0 The information In Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data In the Comments area below.) 02. 0 A community official =completed Section € for a building kacated in Zone A (without a :FEMA- issued =community-issued BFE) or Zane AO. 03. 0 The following .information (Items G4-G9) is provided for comm floodplain ananagementpurposes. 04. Permit Number G5. Date Permfissued 06. Date Certificate Of Compliance/Occupancy issued 07. This permit has been Issued for. Q New Construction 0 Substantial improvement 08. Elevation of as- built lowest floor (including basement) of the building G9. BFE or fin Zone AO) depth of flooding at the building site 010. Community's design flood-del/Allan Local Official's Name ❑ feat 0 meters. (PR) Datum 0 feet 0 meters (PR) Datum 0 feet 0 meters (PR) Dattun Titie Community Name a Telephone Signature Date Comments FEMA Form 81 -31, Mar 09 ❑ Check here If attachments Replaces all previous editions Building Photographs See Instructions for Item A6, Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 190 N.E. 91 ST. 11_368 City MIAMI SHORES State FLORIDA 'surer ce Iorripany ZIP Code 33138 Comnarr.NAIC NVurriber If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View "; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. DATE TAKEN: 4/28/11 FRONT VIEW Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: INSP - 121603 Permit Number: RC -8 -09 -1319 Inspection Date: July 01, 2011 Inspector: Bruhn, Norman Owner: LALANNE, ROSE Job v Address:190 NE 91 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: F. Termite Letter Work Classification: Addition /Alteration Phone Number Parcel Number 1131010190080 Building Department Comments ADDITION OF 1 CAR GARAGE Passed 7 Inspector Comments ` Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 July 01, 2011 Page 1 of 1 Certificate of Compliance for Termite Protection As required by Florida Building Code (FBC) 1816.7) Krypton Pest Control Co. 2215 West 78th, St., Hialeah, FL 33016 Dade: (305) 828-2999 / Broward:(954) 779 -1535 190 NE 91 STREET,MIA4MI SHORES, FL. 33138 Address of treatment or Lot/BIk# of treatment SOIL TREATMENT Method of termite treatment - soil barrier, wood treatment, bait system, other (describe) The building has received a complete treatment for the prevention of subterranean termites. Treatment is in accordance with rules and laws established by the Florida Department of Agriculture and Consumer Services. . ,. i.k1J Author ed Signature ;•;•,;•; r;•7;x:13 Mi, J JUN 2 J RE CD Notice of Preventative Treatments for Termites (As required by Florida Building Code (FBC) 104.2.6) Krypton Pest Control Co. 2215 West 78th. St., Hialeah, FL 33016 Dade: (305) 828 - 2999 / Broward: (954) 779 -1535 190 N. E. 91 A d 7 s s or 7 ,4rePI m eLL o r Lot/Block of Treatment 612211 1 Time 9:00 All Applica AUL RODRIQUEZ CYPE.P TC Cf RERP?E7ILRIN 2 GALLONS Product Used Chemical used (active ingredient) Number of gallons applied PeOrcent Concentration AD2OININ.C/ SLAB Area trreated (square feet) Linear 'feet seated Stage of treatment (Horizontal, Vertical, Adjoining Slab, retreat of disturbed area) As per 104.2.6- If soil chemical barrier method for termite prevention is used, final exterior treatment shall be completed prior to final building approval. If this notice is for the final exterior treatment, initial and date this line 6122111°L-* ettovimigorkomk k) ----- • A ; ' • Aie :U7 trf • A tki ;7- Jo It - 4-7 lit? 4/ , - • M-erCUVIE -MI6: 0 2069' f .. . • • • .7.07 3 S., • • • :.• i • • . . .) . • • ) d leg P.E. #038398 491 305)823-3938 c4w5 • • • • • • • • • • • • • • • • • • • • • • • • . ".7 . • •: t 0 tq 0 AJE 7f TIST • • • • • ) • •••46s • • • • • • • 0 • 41, • • • • • :. . "";:: • f , ; - I . . . ----45:7)0S1.1C. ii4.7-tedi 0 Wwa rd A. UNDERli:RE, SULVIVGIENGINEERS - 1 • • ---- 41. 3.3z. ../.7b9pitsk.. P.E. #038398 (305)823-3938 - 1d15( tro-v tdv riWr • 4•-• /toy A 5, IT • . • - 7.— - • • '• • • •••2 • ,• .4••••••••••••■•:+.‘wee.,..4...' "*.?*• SZ-417, — —3 —" • : - - . •-• i : . . - z .."--sitexots •• • '3":- - - - -it 3. siviAL, ;.• . i . . . . . —.: ....4. . . 3. .. - • • • • • • • CA _ was. •-•:- • - • tot).4- t3,14 4-3 rt.A4? Edward A. LAMERS„.P.E. iNGINEERS • • • • P.E. #038398 (305)823-3938 CkCCJ • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 3 ••••: ,.: : • 4--- -•-: -., . i . . : . . . . . . . . . 3 : . . . .1' . . ,:. •. • .134r - . _ 3e 1.ce • . • • • i, • • • r• . .,,, ,, • . • • - z • -kit:74-4r tf-pte7r. • • • • . 5." • aiwctrd A •LitIDEttiRE. t5NSULZIWG ENGINEERS • • - • • • • • PE. #038398 (305)823-3938 1 :PciwciCd A. :LANDIRS., RE. •CONSULT G ENGINEERS • •••• •• •. •• • • • • • •• • •••• ..•• • • • • •••• •••• P.E. #038398 (305)823 -3938 4-x3 1i tc /of') t hiS—yJ pN ii) s _....A....„,„ pc3x 0. epbe PtAA- c s 1-)(4)(s– ‘44 1.CA7 :Edward A. : MD MMM RE. 'CONSVCT IW ENGINEERS .. • • RE. #038398 (305)823 -3938 •• .. .. .. . . .EdwQrd A. :LANDERI, RE. .CONStitTft ENGINEERS P.E. #038398 (305)823 -3938 ciktv ... . • .... . ...... • .;.: :.:. TABLE3,2,1.2: Reinforced Wall Properties for Load Combinations Not Including Wind or Seismic ponoratp Masonry Wall Prapefi Steel Reinforcement Progenies , In 00 1 • ... r Effective Depth , din 3.8125 in Fr- 60,001 psi Arranged nged by lncreasMg MR) ' Out -of: Plane Resisting Moment and Shear for Bars Positioned In the Center of the Wall ..... • • • • t ••••••. • Bar Size 7 8 6 e 7 6 4 7 8 5. 7 8 8 6 7 4 6 8 7 6 8 6 7 n 1,350 pef 0 1,500 pet Bar Bar Bar Spacing A, MR Bar Spacing Bar Spacing 2/ t n- •, SSize n Size e n na in-lb/ft Size 8 8 18 18 24 18 8. 24 32 40 16 32 as 40 32 24 48 18 40 86 66 32 64 48 64 i wr 1.19 20,072 0.90 19,008 0.66 17,730 0.69 16,809 0.47 18,221 0.48 16,680 0.40 15,040 0,33 14,499 0.30 14,301 0.30 14,067 0.30 13,987 0.24 13,160 0.23 13,134 0.23 12,972 0.22 12,898 0.20 12,468 0.18 12,103 0.17 11,760 0.16 11,506 045 11,374 0,16 11,374 0.13 10,836 0.17 10,684 0.13 9,748 0.12 9,898 0.16 9,349 0.11 9,105 0.11 8,830 4 8 5 7 5 4 8 4 6 5 8 6 6 7 5 4 4 6 5 4 4 6 4 4 24 72 58 40 72 84 48 32 96 0,10 0.13 0.09 0.09 0.10 0.08 0.08 0.08 0.10 72 0.07 96 0.08 86 0.07 40 0.08 120 0.08 84 0.08 96 0,08 120 0.08 72 0.05 48 0.08 86 0.04 120 0.04 98 0.04 64 0,04. 72 0.03 120 0.03 9e 0.03 120 0.02 8,311 8,310 7,804, 7,763 7,582 8808 6,306 6,232 8,070 5,887 6,578 5,086 4,986 4,881 4,582 4,649 4,339 4,264 3,658 3,842 3,254 3,198 2,843 2,803 2,132 1,708 Bar Spacing In A in-lb/ft 8 8 1. .9 21,880 8 72 0.13 8,928 7 8 0 0 20,847 4 24 0.10 8,348 8 8 0.81).- -19,201 7 72 0.10 8,114 8 18-- 0,589 18,058 8 86 0.09 7,840 6 8 0.47. 17,611 5 40 0.09 7,786 7 18 0,45 16,963 8 84 0.08 6,860 8 24 0.40 16,306 It , --, .,. 9,ft ..:.-p..o...: -A690, , 6 18 0.33 15,880 1 5 J 48 10.08 1 6,834. 4 8 0.30 15,381 1 rr- 3's > . Mae- _ -5, 3'f 7 24 0.30 15,198 6 72 0,07 8,097 8 32 0.30 18,118 7 98 0.08 8,085 8 40 0.24 14,181 6 88 0.07 6,800 5 16. 0.23 14,127 8 120 0.08 6,357 8 24 0.22 13,8871 6 64 0.06 4,,9 00 8 48 0.20 - 13,392 7 120 0.06 4,858 7 40 0.18 12,9821 6 96 0,08 4,673 8 32 ,0.17 12,592 6 72 0.05 4,368 8 24 , 0.18 ' 12,318 4 48 0,06 4,278 4 18 0.15 12,171 4 56 0.04 3,887 7 48 0.16 12,171 6 120 0.04 3,888 8 66 0.17 11,479 6 96 0.04 3,287 6 40 0.13 10,888 4 64 0.04 3,209 7 86 0.13 10,432 4 72 0.03 2,852 8 84 0.18 10,044 6 120 0,03 2,814 32 0.12 9.643 4 98 0.03 2,139 8 48 6,11 9146 i 4 120 0.02 1,711 1 :►- ,, r,, * 1,350 pal 1'm 1,500pe1 Vfic( se ar-r- Z-Vite y ........ 6 ttitif of% ouot ryf.4 7., 5$ Z4 -1>c - cdf.-1 -40,14-0 0 er - 376 *717 4-7 d X Ze st.-r" 41? 0 ••• .6olvi;Aaord A. IANDERS, P.E. • • CON5W1NG ENGINEERS • ••• • • • • • • • • • P.E. #038398 (305)823-3938 arK,c.) /747 • WINDO2 v2 -21 Detailed Wind Load Design (Method 2) per ASCE 7 -02 Analysis by: LANDERS Company Name: EDWARD A. LANDERS, P.E. Description: LALANNE RESIDENCE, 190 NE 91ST DTREET, MIAMI SHORES, FLORIDA User Input Data Structure Type Building Basic Wind Speed (V) 146 mph Struc Category (1, II, Ill, or IV it Exposure (B, C, or 0) C Struc Nat Frequency (n1) 1 Hz Slope of Roof 3.0 :12 Slope of Roof (Theta) 14.0 Deg Type of Roof Hipped Kd (Directonality Factor) 1 Eave Height (Eht) 10.00 ft Ridge Height (RHt) 14.00 ft Mean Roof Height (Ht) 12.00 ft Width Perp. To Wind Dir (B) 45.00 ft Width Paral. To Wind Dir (L) 75.00 ft Calculated Parameters Type of Structure Height/Least Horizontal Dim 0.27 Flexible Structure No Calculated Parameters Importance Factor 1 1 Hurricane Prone Region (V >100 mph) Table 6 -2 Values Alpha = 9.500 zg = 900.000 At = 0.105 Bt = 1.000 Bm = 0.650 Cc = 0.200 1= 500.00 ft Epsilon = 0.200 Zmin = 15.00 ft Gust Factor Category l: Rigid Structures - Simplified Method Gust1 For rigid structures (Nat Freq > 1 Hz) use 0.85 1 0.851 Gust Factor Category 11: Rigid Structures - Complete Analysis Zm Zmin 16.50 ft lzm Cc * (33/z) ^0.167 0.2245 Enclosed Buildings Lzm I *(zm /33) ^Epsilon 435.28 ft Q (1/(1 +0.63 *((B +Ht) /Lzm) ^0.63)) "0.5 0.8212 Gust2 0. 925*(( 1+ 1.7 *Izm *3.4 *Q) /(1 +1.7 *3.4 *Izm)) 0.8316 Gust Factor Summary G 'Since this is not a flexible structure the lessor of Gust1 or Gust2 are used 1 0.831 • Fig 6-5 Internal Pressure Coefficients for Buildings, Gcpi Condition Gcpl Max + Max - bpen Buildings 0.00 0.00 Partially Enclosed Buildings 0.55 -0.55 Enclosed Buildings 0.18 -0.18 Enclosed Buildings 0.18 ` -0.18 •••• • • • •• • • •• • • • • • • •••• • • •••• • • • • • • • • • • • • • t velopenv Meca Entelip1ises roc. Copyright 2006 • • • • •••• • • •••• • •••• • • •• • • EDWARD A. LANDERS, P.E. 4/6/2009 Page No. 1 of 4,,\ 1 4/6/2009 WINDO2 v2 -21 Detailed Wind Load Design (Method 2) per ASCE 7 -02 6.5.12.2.1 Design Wind Pressure - Buildings of All Heights Eiev ft Kz Kzt qz Ib/ft" 2 Pressure (Ib/ft" 2) 2.01*(15/zg)A(2/Alpha) Windward Wall* Leeward Wall Total Shear Moment +GCpI -GCpI +GCpI -GCpI + /-Gcp1 (Kip) (Kip -ft) 15 0.85 1.00 46.32 22.48 39.18 -22.46 -5.79 44.94 30.34 227.52 • • • ive forces act toward th f e ace and Negative forces act away from the face. Figure 6-6 - External Pressure Coefficients, Co Loads on Main Wind -Force Resisting Systems Method 2) L L Variable Formula Value Units Kh 2.01*(15/zg)A(2/Alpha) 0.85 Kht Topographic factor (Fig 6-4) 1.00 Qh .00256 *(V) "2 *I*Kh *Kht*Kd 46.32 psf Khcc Comp & Clad: Table 6 -3 Case 1 0.85 Qhcc .00256*VA2 *I *Khcc *Kht *Kd 46.32 psf Wall Pressure Coefficients, Cp Surface Cp Windward Wall (See Figure 6.5.12.2.1 for Pressures) 0.8 Roof Area (sq. ft.) Roof Pressure Coefficients, Cp Reduction Factor 1.00 Calculations for WInd Normal to 45 ft Face Additional Runs may ha seq'd for other wind directions Leeward Walls (Wind Dir Normal to 45 ft wall) Leeward Walls (Wind Dir Normal to 75 ft wall) Side Walls Cp Pressure (psf) +GCpI -GCpI -0.37 -0.50 -0.70 -22.46 -5.79 -27.60 -10.92 -35.30 -18.63 Roof - Wind Normal to Ridge (Theta > =10) - for Wind Normal to 45 if face Windward - Min Cp Windward - Max Cp Leeward Normal to Ridge Overhang Top (Windward) • • Saethang I op•(•Leeward) •Qyorhang Bpttont (Applicable on Windward only) -0.54 -0.04 -0.46 -0.54 -0.46 0.80 • • •••• • • • • • • • • • • • • • •.Seveiope! ty Meca Ente?rises,•Inc. Copyright 2008 EDWARD A. LANDERS, P.E. • • • • •••• • • •••• • • • •••• • • •••• -29.14 -9.72 -26.06 -20.80 -17.72 30.82 -12.46 6.95 -9.38 -20.80 -17.72 30.82 Page No. 2 of 40 k WINDO2 v2 -21 Detailed Wind Load Design (Method 2) per ASCE 7 -02 Roof - Wind Parallel to Ridge (Ali Theta) - for Wind Normal to 75 ft face Dist from Windward Edge: 0 ft to 24 ft - Max Cp -0.18 Dist from Windward Edge: 0 ft to 6 ft - Min Cp -0.90 Dist from Windward Edge: 6 ft to 12 ft - Min Cp -0.90 Dist from Windward Edge: 12 ft to 24 ft - Min Cp -0.50 Dist from Windward Ed • e: > 24 ft -0.30 Horizontal distance from windward edge Kh = Kht = Qh = Theta = -15.27 -43.01 -43.01 -27.60 -19.89 1.40 -26.33 -26.33 -10.92 -3.22 Figure 6 -10 - External Pressure Coefficients, GCpf Loads on Main Wind -Force Resisting Systems w/ Ht <= 60 ft 2.01 *(15 /zg) ^(2 /Alpha) Topographic factor (Fig 6-2) 0.00256 *(V) ^2 *lmpFac *Kh *Kht *Kd Angle of Roof 0.85 = 1.00 = 46.32 14.0 Deg Transverse Direction Longitudinal Direction Torsional Load Cases = pf - GCpI •••• • • • • • • •fiagre 6 -11 - External Pressure Coefficients, GCp •••• • • • • • • • • • • • Nvelopel h Meca Enterprnseelnc. Co • • • • pyrlght 2006 EDWARD A. LANDERS, P.E. qh (GC • • ••• •••• • • • • • • • •••• •••• • • • 4/6/2009 Page No. 3 of 4 C�� iVlf nd Pressures on Main Wind Force Resisting System Surface GCpf +GCpf -GCpf qh (psf) Min P (psf) Max P (psf) 1 0.48 0.18 - 0.18 46.32 13.80 30.48 2 -0.69 0.18 -0.18 46.32 -40.30 -23.62 3 -0.44 0.18 - 0.18 46.32 -28.53 -11.86 4 -0.37 I 0.18 . -0.18 46.32 -25.66 -8.99 5 -0.45 0.18 -0.18 46.32 -29.18 -12.51 6 -0.45 0.18 -0.18 46.32 -29.18 -12.51 1E 0.72 0.18 - 0.18 46.32 25.20 41.88 2E -1.07 0.18 - 0.18 46.32 -57.90 -41.23 3E -0.63 0.18 -0.18 46.32 -37.34 -20.66 4E -0.56 0.18 -0.18 46.32 -34.09 -17.42 = pf - GCpI •••• • • • • • • •fiagre 6 -11 - External Pressure Coefficients, GCp •••• • • • • • • • • • • • Nvelopel h Meca Enterprnseelnc. Co • • • • pyrlght 2006 EDWARD A. LANDERS, P.E. qh (GC • • ••• •••• • • • • • • • •••• •••• • • • 4/6/2009 Page No. 3 of 4 C�� 4/8/2009 WINDO2 v2 -21 Detailed Wind Load Design (Method 2) per ASCE 7 -02 Loads on Components and Cladding for Buildings w/ Ht <= 60 ft a= 4.5 =_> a Hipped Roof 7 < Theta < =27 4.50 ft Double Click on any data entir line to receiv Component width (ft) Span (ft) Area (ftA2) Zone GCp Wind Press (1b/ft"2, Max Min Max Min DOOR 3 7 21.00 4 0.94 -1.04 52.02 -56.66 GARAGE DOOR 9 7 63.00 5 0.86 -1.12 48.12 -60.11 WINDOV 30.00 B 6 4 24.00 4 0.93 -1.03 51.55 -56.18 C 1.5 7 10.50 4 1.00 -1.10 54.49 -59.12 12.00 RAFTERS 2 10 33.33 1 0.40 -0.85 26.66 -47.61 RAFTERS 2 10 33.33 2 0.40 -1.44 26.66 -74.98 RAFTERS 2 10 33.33 3 0.40 -1.44 26.66 -74.98 0.00 0.00 Enter one 1 through 5, or 1 H through 3H for overhangs. •••. • • • • • •• • • •• • • • • • •••• • • • • •••• • • �• • • • • Develop:d by Meca Ent ieseKInc. Copyright 2006 EDWARD A. LANDERS, P.E. Page No. 4 of 4 • • f•••• •••• •••• • • • • • • •••• •••• • • • N. E. 91 6 r E:E 9 70' RIGHT—OF—WAY (BY PLAT) 20'± ASPHALT PAVEMENT LOCATION SKETCH SCALE: NTS N.E.91st STREET 8't ASPHALT PA VEMENT SCALE: 1 " =20' 10' GRASS PARKWAY • •••• e ••• F.NAIL F.NAIL --e CONC. WALK PLANTER • •••• • 17.85' 25.85' F.I.F. (NO CBS ONE STORY RESIDENCE # 190 F. F.ELEV.. = 11.05' 27.30' CONC. 18.50' PLANTER ASPHALT SURVEY FOR VZLBRUN LALA1'?NE AND ROSE LALANNE, 190 N.E. 91ST ST., MIAMI SHORES, FL. 33138. 35.20' 135.00' (R &M) 1/2" (NO 1.D.) REMAINDER OF LOT 11 BLOCK 7 NOT VALID UNLESS EMBOSSED WITH SURVEYOR'S SEAL ABBREVIATIONS: SWK= SIDEWALK, CBS = CONCRETE BLOCK STRUCTURE, CLF =CHAIN LINK FENCE, PL= PROPERTY LINE, DUE = DRAINAGE UTILITY EASEM ENT, IP =IRON PIPE, F =FOUND, A/C =AIR CONDITIONER PAD, P /C= PROPERTY CORNER, D/H= DRILLED HOLE, V F= WOODEN FENCE, RES= RESIDENCE, CL- CLEAR, RB= REBAR, UE= UTILITY EASEMENT, CONC= CONCRETE SLAB, RA+RIGHT OF WAY, DE =DRAINAGE EASEMENT, C/L= CENTER LINE, 0= DIAMTER, TYP= TYPICAL, M= MEASURED, R= RECORDED, ENCR= ENCROACHMENT, COMP= COMPUTER, ASH = ASPHALT, N/D =NAIL & DISC, S =SET, FEE = FINISH FLOOR ELEVATION, 0!S= OFFSET, PIP =POWER POLE, OHP= OVERHEAD POWERLINE, WM =WATER METER WOOD FENCE= 1 1 I l 1 I l l ELEVATION BASED ON LOC. # MASONRY WALL= I 3101 CONCRETE= 1• °':3••V_•'3:vo s;•:••1;•:••s:•.• 1:•:••3:•:•1 DCBM# GS -3—R ELV. 8.68' TYPE OF SURVEY BOUNDARY SURVEY MAINTENANCE & DRAINAGE EASEMENT= M & D.E. SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING INFORMATION. 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB PAGE LEGAL DESCRIPTION: LOT 10 AND THE NORTH 33 FEET OF LOT 11 BLOCK 7 OF EL PORTAL SECTION 2 SUBDIVISION ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 9 AT PAGE 115 OF THE PUBLIC RECORDS MIAMI —DADE COUNTY, FLORIDA i HEREBY CERTIFY That the survey represented thereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements other than asshown hereon. ADIS N. NUNEZ REGISTERED LAND SURVEYOR STATE OF FLORIDA #5924 SINCE 1987 BLANGO SURVEYORS INC. Engineers • Land Surveyors • Planners • LB # 0007059 555 NORTH SHORE DRIVE MIAMI BEACH, FL 33141 (305) 865 -1200 Email: blancosurveyorsInc@yahoo.com Fax: (305) 865 -7810 FLOOD ZONE: X PANEL: 0093 DATE: 4/2/07 SCALE: 1 " =20' SUFFIX: j DATE: 7/17/95 BASE: N/A COMMUNITY # 120652 DWN. BY: F. Blanco JOB No. 07- 463 •••• • ? . .: • 3 L,` • •- ••• • ••• 4. �a,.v . • • ••s.� •••1 • • D • ••.• • • • • •••• • • • A •••• ,• . • fie • •• • • •• • • • • • • • • • • • • • • • • •• Miami shores Village Buildingl Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Da/— /31 Job'Name , q A/di fk* Date gig c/0 STRUCTURAL CRITIQUE SHEET d t7 hem`) 7-5-1 re? eA s /lam s rte,, 70-z. (&-a yc aver f3 -crvm) /: 17 D f ' ,fG I d uie,d, Al ,4 Sao- Reaf-AffleAt4 heatr a0el1 rad. On V5-2 r t4gscia fhat.dei b e 2)4 to ? c i!a4 e ;hP ad he Flush wcA SIlk G'evt. PvdYz 1 11S 'r cabs ea o. ,c,) Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 190 91 Street Miami Shores, FL 33138- Owner Information Expiration: 04/07/2010 ROSE LALANNE Address 1131010190080 Block: Lot: 190 NE 91 ST MIAMI SHORES FL 33138 -2810 ROSE LALANNE Phone CeII Contractor(s) Phone Cell Phone HARVEST TRUST DEVELOPMENT GR (305)720 -8517 0= Valuation: Total Sq Feet: Approved: Yes Comments: TOTAL AREA OF ALL FLAT ROOFS CAN NOT EXCEED 300 SQUARE FEET OR 15 PERCENT OF Date Approved: 9/30/2009 : Yes Date Denied: 8/10/2009 Type of Construction: ADDITION 1 CAR GARAGE Stories: 1 Front Setback: 35 Left Setback: 25 Bedrooms: 3 Plans Submitted: Yes Certificate Date: Bond Retum : Occupancy: Single Family Exterior. Rear Setback: 25 Right Setback: 16 Bathrooms: 2 Certificate Status: Additional Info: Classification: Residential Fees Due CCF CO /CC Fee DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Plan Review Fee (Engineer) Plan Review Fee (Engineer) Radon Surcharge Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $15.00 $150.00 $1.68 $5.00 $750.00 $60.00 $60.00 $1.68 $21.00 $250.00 ($250.00) $22.33 $1,086.69 Invoice # RC -8-09 -35730 RC -8-09 -35730 Check #: 1065 Total Amt Paid Amt Due $ 1,086.69 $ 250.00 4783-64$1, $ 1,086.69 $ 1,086.69 $ 0.00 $ 25,000.00 For Inspections please call: (305)762 -4949 Available Inspections: i 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 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 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. October 16, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy October 16, 2009 Date 1 Project Address 190 91 Street Miami Shores, FL 33138- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Owner Information Parcel Number Applicant 1131010190080 Block: Lot: Address , .. 190 NE 91 ST MIAMI SHORES FL 33138 -2810 Phone ROSE LALANNE Cell Contractor(s) Phone CeII Phone HARVEST TRUST DEVELOPMENT GR (305)720 - 8517 ()_ _ Valuation: Total Sq Feet: Approved: Yes Comments: TOTAL AREA OF ALL FLAT ROOFS CAN NOT EXCEED 300 SQUARE FEET OR 15 PERCENT OF Date Approved: 9/30/2009: Yes Date Denied: 8/10 /2009 Type of Construction: ADDITION 1 CAR GARAGE Occupancy: Single Family Stones: 1 Front Setback: 35 Left Setback: 25 Bedrooms: 3 Plans Submitted: Yes Certificate Date: Bond Return : s Exterior: Rear Setback: 25 Right Setback: 16 Bathrooms: 2 Certificate Status: Additional Info* Classification: Residential Fees Due CCF CO /CC Fee DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Plan Review Fee (Engineer) Plan Review Fee (Engineer) Radon Surcharge Scanning Fee Submittal Fee Submittal Reversal Fee Technoklgy Fee Total: Amount $15.00 $150.00 $1.68 $5.00 $750.00 $60.00 $60.00 $1.68 $21.00 $250.00 ($250.00) $22.33 $1,086.69 Invoice # RC -8-09 -35730 RC -8-09 -35730 Check #. 1065 Total Amt Paid Amt Due $ 1,086.69 $ 250.00 $ 1,086.69 $ 1,086.69 $ 0.00 $ 25,000.00 336 For Inspections please call: (305)7624949 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 F. Termite Letter F. Elevation Certificate Applicant Copy For InspecAions, Call (305) 795 -2204. Requests must be rece>:,9ed by 3 pm for following day inspections. NOTICE: In addition to the requirements of this permit, , nay be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that m, f•)und sn GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT the public records of this county. DIS, RICTS, STATE AGENCIES, OR FEDERAL AGENCIES. October 16. 2009 Aetos 60V'Seo 'woof olI Subs i°1i31®c fir Tel: (305) 795.2204 Fax: (305) 756.8972 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BUILDING PERMIT APPLICATION FBC 2004 AUG 0 7 200 9 �► B Ye ______ee______m. Permit NoRCEP Pt 3 I Master Permit No. Permit Type (circle) Building Roofing Owner's Name (Fee Simple Titleholder)) V I( 661/ N La t A 0 14 e. Phone # So f- 333-287 0 Owner's Address ___) 10 i.JE 43 1 5 r City /4/Arl tiliaiv'�'. State r't-- Zip 73/7 7 Tenant/Lessee Name Phone # Job Address (where the work is being clone) q O r J 5 City Miami Shores Village County Miami -Dade FOLIO / PARCEL # l / 31 °)— D19 — 0cper'0 zip 33133 Is Building Historically Designated YES Contractor's Company Name c1 9 r�" t Y tic r Q=`il Pi�f ITV eset phone # J6�-"72d 1 Contractor's Address 1 a t( S • DOC /te. 401 ik 1 2'� City T "! / %'vii I State___L Zip Qualifier Name LIu4 104-# tr -Ar yl et..."..ci .e;'L_ Phone # 3 O3 —no - -r1 State Certificate or Registration No. C_ 1 32 5 cop Certificate of Competency No. Architect/Engineer's Name (if applicable) 11"t .k e (3v .- Phone # .36) 3v 37 Value of Work For this Permit $ 7 ®(Yd Square / Linear Footage Of Work: Type of Work: IL dtion Describe Work: 33 Ste. ['Alteration []New ❑ Repair/Replace ❑ Demolition C ---45 0U** : **** * * * ***** * ***1:*** ** x******** *** Fees+ * ******** ** :****** * *********** Permit Fee $ Notary $ Training/Educatio ,,n Fee $ Scanning $ 2l `00 Radon $ 1 •(0 O j Bond $ Code Enforcement $ Structural Review. $ 60/ b'° f Gj®. G7 DPBR $ CCF $ 15.• * * * * * * * * ** Technology Fee $ 1 �• Zoning $ Double Fee $ Total Fee Now Due $• 1111 See Reverse side -+ Bon Bond' City Mortg Mortg City Applic comme cons WELL OWN applica "WA PAYIN CONS COM Notice t promise Z whose p for the inspectio ill not TS nw Signature} ec o 43 ‘^ c, - w ..z ‘s,.. • ., --9 Z" ,. m O • Z IC N 4 c- occurs seven (7) days after the building permit nd a reinspection fee will be charged. 2 cc O Z 0 :hat no work or installation has at ,nnddards of all laws regulating F'' K, PLUMBING, SIGNS, bc-c- e in compliance with all T ry ,21 RESULT IN YOUR CO OBTAIN FINANCING, a G ; OCR NOTICE OF V A W i Owner or Agent The foregoing instrument was acknowledged before me this day of �, 20 C9, by V e-^�e- who is personally known to me or who has produced 1d . L. As identificatkpnWAurho did take an oath. NOTARY PUBLIC: Sign: Print ' MA 4� ttGE i,. D .6L NO My Commission Expires: APPLICATION APPROVED BY: (Revised 07/10/07) * * * V ►ing $2500, the applicant must to ;ill be delivered to the person 2 must be posted at the job site s issued `F In the absence of such posted notice, the Signatures tor' The foregoing ins ment was acknowledged before me this-' day of , 200,, by atuurrav who is personally own to me or who has produced a• as identification and who did take an oath. NOTARY PUBLIC4s' 0°E. M4 "1.,� • � : kV ;Ge�� Sign: Print: • COUNCIL My Commission Lg3ePS: ' oo 1ry' . ,4. i ' 1;p 1 Q � 4 "I„ t►"` �? Plans Examiner Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Job Name r /G lti?WWI CRITIQUE SHEET re, fie- X/� Ste - zev� -N � �,-',k � t lrizazio,t d /A. , -' i'iz ®i, , e tvf ° u' >`'e, h.. rep 5 e- 0.4' '/ 7x TO Oa/Ice itt -ems'' sA''itr )7w7`7GT€P1z9 Fe" Be. 5 Jreoill Y i34pj -, HPPoX;PE- L3fr--A' ow/ e VA-A--?‘01- ?e-#1 (0,0V 1 z e- PAtee_2-r ev-r --eI rd E xl$T ?;4. l� �� 1-1- ro M - "A k - .9„"/9-0o. -,4` fr )'4I 4, ir2p. ' `%0104-- Zay . C 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 c� Permit No. RCA\ —l3! Master Permit No. BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING / / g OWNER: Name (Fee Simple Titlehai_der): V ( mil. in /� %� ` vG - Phone #: vO — ) eit v/ Address: , t 1 0 iv, 6- g l rkvz, - City: 11, . State: Zip: �' a < re ri lQrrn•� p: Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 1 t 0 I J e 6 g l OW/ City: Miami Shores County: Miami Dade Zip: 3 < 3S? Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: VI G- & le-0m L. YY z- 4- '/1/ Phone #: 3`-'? 5)-- 87 (1) Address: 19,0 lu G. a/ eiptQ Qi.) City: (.0-0147 c 4 `.. State: F(--- Zip: ' ? / 3 r Qualifier Name: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: °Address °Alteration r ,, °New ORepair/Replace ❑Demolition Description of Work: � ...e— " 1 C I L. COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by: ********* ** * *** ** ** * **** * * ** ***** ** *** *F * * * * * ** *** *** ** **** * *** ** ,rat ** **** ** *** * ** * ** Submittal Fee $ Permit Fee $ 1 °oo CCF $ CO /CC $ Scanning Fee $13.. OD Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE (Win Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be ';. roved an < reinspection fee will be charged. Signature Owner or Agent Contractor The foregoing in trument was acknowledged before me this The foregoing instrument was acknowledged before me this day of (3 ,201_0i,by V IL 1S2vN L4,At tdayof ,20 ,by who is personally known to me or who has produced 1 27 who is personally known to me or who has produced As identification and,h�\5iliip'z,oath. as identification and who did take an oath. NOTARY PUBLIC: ��' ��'yp i res p� '% NOTARY PUBLIC: 0310612012 Sign: / ►� _ ° UOT�Y PU6lIC = Sign: Print: ammIsson ' ;� ..DD165901.• °. Print: - oF . \-\"\\\`\\- My Commission Expires: rP'N�aaaealak0- My Commission Expires: ***** *> tint * * ***le** * ** * **** ** * * * ** **** rat *,ti•,t•*,r********* *** *,t*** ** ****,r*** ** *><r******** re******* *:r ****** * *****re><* ** APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07 /10107)(Revised 06 /10 /2009)(Revised 3 /15 /09)(rev6 /4/10) NAME: Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 R BUILDER DISCLOSURE STATEMENT ADDRESS: t f. DATE: /O /l f //0 Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two- family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption, You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with - holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and initial each paragraph. 1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner - builder permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. Initial IJ L 2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial h Z- 3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts. Initial 4. I understand that I may build or improve a one family or two- family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy: It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease, which violates the exemption. Initial 5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction. Initial VL 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial V 7. I understand that ft is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner - builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner - builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial V 1- 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow these may subject to serious financial risk. Initial V 9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govem owner - builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. Initial rs L- 10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http : / /www.myfloridalicense.com /dbor /pro /cilb/iindex.html Initial 11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I am the party Dally and financially responsible for the proposed construction activity at the following address: Initial VZ.--- 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I have provided on this disclosure. Initial (/ Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this � day of 1 , 20 t C") By " t f�-' `- L who was personally known to me or who has Produce, there Li •- s.. •r as identification. OWNER IS $,/ i,// OT��4%062012 % /� ROTARY PUBLIC . Commission # DD7659 ' OFF`a, .,\\' 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Permit N. Owners Name (Fee Simple Title Holder): ! + (4)ex Phone #: % Us) 7 - `1" J !j) /VE 9/ State : C Zip Code: f 2 j' Owner's Address: City: p( ob Address (Of where work is being done): /9'i A? q ( d City: Miami Shores State: Florida Zip Code: Contractor's Company Name: 6-60M,14, I d Phone #: Address: City: State: Zip Code: Qualifier's Name : Lic. Number: Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: Describe Work: 1-0,9-:) I hereby certify that the work has been abandoned andlor the contractor/architect is unable or u willing to complete the contract. I hold the Building Official and the iami Shores harmless for all legal involvement. Signature owner or Agent The foregoing in ° 1 ment was aknowledged before me The foregoing instrument was aknowledged before me this [! day of c� ,20t�;by this day of , 20 by Signature Contractor or Architect Who is personally known to me or who has produced °00\111111 'fertivtification. Notary Public: Sign: Seal: ,sy 402 fffrfliflll\ \ \ \\ who is personally known to me or who has produced as indentification. Notary Public: Sign: Seal: ACORD . CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 12/6/2010 PRODUCER (954)943 -5050 FAX: (954)943 -5417 Frank H. Furman, Inc. 1314 East Atlantic Blvd. P. O. Box 1927 Pompano Beach FL 33061 THIS CERTIFICATE IS 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 THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Certified Roofing Specialists Inc 3440 N W 25 Ave Pompano Beach FL 33069 INSURER A: Crum & Forster Specialty INSURER B: Nat iOaal Fire InsHartford INSURER C:AmeriCan Cab Co Reading INSURERD:Steadfast Insurance Co INSURER E: Continental Casualty Co COVERAGES 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 POL CIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD'L JNSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DDIYY) POLICY EXPIRATION DATE (MMIDDIYY) LIMITS A GENERAL X UABILITY COMMERCIAL GENERAL LIABIUTY 0L0191112 5/1/2010 5 / 1 / 2 011 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrence) $ 100, 000 MED EXP (Any one person) $ Excluded CLAIMS MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 X $7 MIL PER PROD CAP PRODUCTS - COMP /OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: -1 POLICY nI JEC 1-1 LOC B AUTOMOBILE X — X X 1 LIABILITY ANY AUTO ALLOWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 4014422653 5/1/2010 5/1/2011 COMBINED SINGLE LIMIT (Ea accident) $ 1, 000, 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE UABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGO $ D EXCESS/UMBRELLA T1 11 LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ AUC534616305 5/1/2010 5/1/2011 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 $ $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 414422667 5/1/2010 5/1/2011 X I TORY LIMBS I J ER E.L EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 1,000,000 E.LDISEASE - POLICYLIMIT $ 1,000,000 E OTHER LEASED /RENTED EVTIPAIENT 2076243854 5/1/2010 5/1/2011 ANY ONE ITEM $300,000 A ooeuR iacE $300,000 ? DEDUCTIBLE $1, 000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS (305) 756 -8972 Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Frank Furman, Jr /CS ACORD 25 (2001/08) INS025 (0108).08a Page 1 of 2 November 17, 2010 Mr. Luciano Fernandez Harvest Trust Development RE: Vilbrun Lalanne — Construction Agreement Property Address: 190 NE 91st Street, Miami Shores, FL Date of Agreement: 07/24109 NOV ECER 4 2010 c To Whom It May Concern Mr. Luciano Fernandez has taken more $33,000.00 out of 35,000.00 from me and has decided to abandon the project. I've tried every route to solve this matter he has refused to work it out. On July 27, 2010, Architect Mark A. Campbell inspected my residence and completed a list of deficiencies describing the work that has not been completed by the Contractors and all of the problems with the project before the project can be considered substantially completed. Included in this list of deficiencies is the following: 1. The plumbing for the connection to the septic tank has not been completed. 2. The west window in the new laundry doesn't close properly. There is some cement in the frame and the handle comes off. 3. The drywall has not been installed on the walls and ceiling with the insulation 4. There is no electrical panel cover, fixtures or outlet covers installed to date 5. The stucco is not completed 6. The painting of the interior and exterior is not completed. 7. The new roof has a leak at the vent stack over the new laundry room. 8. The front door column or work has not completed and the new door has not been selected by the owner for the allowance amount. 9. The drywall repair in the new media room has not been completed. Therefore starting today, I want to inform you that your services are no longer needed for this project • ru -n ru 1941" 1:141 m S- at IQ O r a c, icc;n 6:431479 OD' 13-. it 173 LU '-4 Return Receipt Fee rev) „043 rr.s ct Cr (Endorsement Required) ci e- Restricted Delivery Fee tnr r..o) p (Endorsement Required) N - 'II Total Postage & Fees 4-1 0 1:3 t r-I a-4 eco9 -1519 PIO NE 91 SF 6 U.S Postal Service. CERTIFIED MAIL,. RECEIPT (Domestic Mail Only; No insurance Coverage Provided) For delivery information visit our website at www.usps.comD :!,66646. Postage Certified Fee 80.44 $2.80 $0.(0 10.00 0118 $3.24 Here t? 9 Vie) / Sent Tot r - tai Fe,A.riansit.1.1cactz' Di2 or PO Box No. I tt street, Apt. No.; , City State, Z!P+4 .11$,For431800, August:2006 -- See Reverse lei InstrucOons USPS - Track & Confirm Page 1 of 1 om gI Wag I Sian In Track & Confirm Se h Results Label/Receipt Number: 7010 1670 0001 6803 2628 Expected Delivery Date: November 20, 2010 Class: First -Class Mail® Service(s): Certified Mall° Status: Delivered Your item was delivered at 1:16 pm on November 22, 2010 in MIAMI, FL 33157. Detailed Results: • Delivered, November 22, 2010, 1:16 pm, MIAMI, FL 33157 ■ Acceptance, November 19, 2010, 4:37 pm, MIAMI, FL 33153 0 Track & Confirm FAQs. Truk & Enter Label /Receipt Number. Track & Confirm by email Get current event information or updates for your item sent to you or others by email. Site Man Customer Service/ Forms Gov't Services Careerg Privacy Policy Terms of Use Business Cust.mer Gateway Copyright© 2010 USPS. All Rights Reserved. No FEAR Act EEO Data FOIA i54`n��Ei�E3RiP- Ih�sr'?�H� a`7i'c7�rv. http:// trkcnfrml. smi. usps. com/ PTSlnternetWeb /InterLabelnquiry.do 11/24/2010 r 0 September 8, 2010 Mr. Norman Bruhn Building Official/Director Dear Mr. Bruhn, SEP 0 9 40 s BY:....................... I am asking you to please grant us an extension for these permits: PL -10 -09 -1616; EL- 10 -09- 1617; and RC -8 -09 -1319. Below are the reasons: On July 23, 2009, I entered into an agreement with the contractor, Harvey Trust Development to build a garage to my home for the price of $35,000 dollars. This contract was drawn based on the plans put together by the architect, Mark Campbell. The Harvest Trust Development began working on this project shortly after the signing of the contract. While working on the project, Mr. Luciano Fernandez, the president of Harvest Trust Development, would contact me and advise me that he was in need of an item, in order to complete a particular task. Every time Mr. Luciano would ask for an item necessary to complete this project I would pay him. Furthermore, I made incremental payments to Harvest Trust Development in accordance with the contract. Before beginning the 2010 year, I paid Harvest Trust Development a total amount of $ for all that it completed thus far and this includes_ In January 12, 2010, my family was a victim of the earthquake that occurred in Haiti. During that time through the present, my family and I have being mourning the loss of our loved ones. However in the month of January, Harvest Trust Development continued to work on the project but in preceding months less work was done on the project. Mr. Fernandez, throughout this time continually asked me for money concerning supplies and payments toward his company. Finally in late April, Mr. Fernandez asked me to make another payment to Harvest Trust Development and I disagreed to pay because up to that point I had paid Harvest Trust Development an amount of approximately $33,000. Thus, if I had paid the amount asked by Mr. Fernandez I would have paid the total amount agreed upon in the contract while the project has/ is not completed. Consequently, Harvest Trust Development discontinued working on the project approximately early March of 2010. From early -March through late August, I have been actively trying to find a resolution with the contractor with the aid of attorneys. However I have been unsuccessful, the contractor does not want to fulfill his promise and obligation to me. On July 27, 2010, Architect Mark A. Campbell inspected my residence and completed a list of deficiencies describing the work that has not been completed by the contractors and all of the problems with the project before the project can be considered substantially completed. Included in this list of deficiencies is the following: 1. The plumbing for the connection to the septic tank has not been completed. 2. The west side window in the new laundry doesn't close properly. There is some cement in the frame and the handle comes off. 3. The drywall has not been installed on the walls and ceiling with the insulation 4. There is no electrical panel cover, fixtures, or outlet covers installed to date. 5. The stucco is not completed. 6. The painting of the interior and exterior is not completed. 7. The new roof has a leak at the vent stack over the new laundry room. 8. The front door column or work has not completed, and the new door has not been selected by the owner for the allowed amount. 9. The drywall repair in the new media room has not been completed. Two weeks after Mr. Campbell, Mr. Fernandez had promised that he's working on a plan to complete the project. I have yet to receive anything from Mr. Fernandez. 4 I am sorting out the next step with my legal advisor. In the meantime your cooperation would be very much appreciated. Mr. QSZ, 55-)10 4 ely, d Mrs. Lalanne Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. o '- /319. Job Name LALA tWi f " Date 0. "%d9 STRUCTURAL CRITIQUE SHEET Q Dn ,Rea.7) so iei`. re -1 r��e r4l ?es 11 s S. ( ?--z. ((araqc Oyer ,3-445s) Saheatule.d. t 6XI2our! , #3 ('G c., C Aim Ar RepbfJVr /ems i-as %pi rad, A 0-7 121 • o ap '9.z3 —cr y OA 11$+2 , f »cia Mould b. e 2x kJ? --v ID 2 X GCS 2 - 6- cd-e sh e4t-i be 'Rush w j % 5//,j -a.t . pvdr Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 7952204 Fax: (305) 756.8972 Permit No. 131 Job Name Date CHANICAL CRITIQUE SHEET CAA- g« c L• a r\e-e„) (0.-0 /.) fleb.,,,-) Na lac- LA. -) j1(Itaz; P IzeAA_ Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Issue Date: Not Issued Expires:Not issued Folio Number:1131010190080 Owner's Name: ROSE LALANNE Job Address: 190 91 Street Miami Shores, FL 33138- .• ............... •••• ........ ••••• ......... ••• Owner's Phone: Total Square Feet: 336 Total Job Valuation: $ 25,000.00 •••••• ........ •• ............ ......... •••••• • .. -•••••••• ............... Contractor(s) Phone Primary Contractor HARVEST TRUST DEVELOPMENT GROUP (305)720-8517 Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 9/3/2009 : Yes Comments: TOTAL AREA OF ALL FLAT ROOFS CAN NOT EXCEED 300 SQUARE FEET OR 15 PERCENT OF EXISTING SLOPED ROOF AREA WHICHEVER IS GREATER. 9/3/09 REDESIGNED, FLAT ROOF NOW WITHIN 15% OF EXISTING SLOPE ROOF. Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit MO. RC -8 -09 -1319 Issue Date: Not Issued Expires: Not Issued Folio Number:1131010190080 1 Owner's Name: ROSE LALANNE Owner's Phone: Total Square Feet: 336 Job Address: 190 91 Street Miami Shores, FL 33138- Total Job Valuation: $ 25,000.00 Contractor(s) Phone Primary Contractor HARVEST TRUST DEVELOPMENT GROUP (305)720 -8517 Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 9/30/2009 : Yes Comments: TOTAL AREA OF ALL FLAT ROOFS CAN NOT EXCEED 300 SQUARE FEET OR 15 PERCENT OF EXISTING SLOPED ROOF AREA WHICHEVER IS GREATER. 9/3/09 REDESIGNED, FLAT ROOF NOW WITHIN 15% OF EXISTING SLOPE ROOF. 9/30/09 NEW PLAN SUBMITTED, REVIEWED AND APPROVED BY PLANNING Mia i shores Vjiiage Building Department RECEIPT PERMIT #: (C r 3 ( 9 DATE: I, P1 pr, -4t. C vv Pl3 t� 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 o Contractor ❑ Owner ?Irchitect Picked up 2 sets of plans and (other) Address: q v Cl I S i From the building department on this date in order to have corr:ctions done to plans And/or get Co • stamps. I unde and that the plans need to ( e brought back to Miami Shores Vi . ge Building Departure t ton i / ' permitting p •vt Acknowledged by: PERMIT CLERK INITI RESUBMITTED DATE: PERMIT CLERK INITIAL: Mardi Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. D'- /31 9. Job Name 1ALA V k" Date /2s%a 9 © Cc 14 __ r7g4e STRUCTURAL CRITIQUE SHEET ,94/? S'cibeet7 re-1 r e m r s 736- ((arafe Oaor n cf sched Arai) .Ar Real-Air aim 441 te% fti'raol, 'f 2 r / a5cia fhaii/d b e i j? cr 'ad-e shp 4be Flush wj% 54tig). ‘etA,.. 7vdrs Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 —Permit No. Job Name Pitertrowiti CRITIQUE SHEET re, fie_ ,z/ " Few z-•• e- ree lk,/� 4-ei'�zeP, ee9 L /fir# Y- 8 ,z7 re oat/ az 4"- .5 it T ' / / T' e- 5 ir®irs s A,e?y HOPeX# ,4 ro xie c ein 7?-ci t T" E. X //7 r P 9Pie 4P41 ii fir 677 BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) Trinity Glass International 4621 192"d Street East Tacoma, WA 98446 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: 6'-48" Outswing Opaque Fiberglass Door w/ wo glazed Sidelites-LMI APPROVAL DOCUMENT: Drawing No. S -2729, titled "Opaque Fiberglass Outswing Door ' ", sheets 1 through 12 of 12, dated 10/05/06 and last revised on 01 -14 -2008, prepared by RW Building Consultants, Inc., signed and sealed' by Lyndon F. Schmidt, P.E., bearing the Miami -Dade County Product Control Approval stamp with the Notice of Acceptance number and approval date by the Miami -Dade County Product Control Division. MISSILE IMPACT RATING: Large and Small Missse Impact 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 consists of this page 1 and evidence page E -1, as well as approval document mentioned above. The submitted documentation was reviewed by Ishaq L Chanda, P.E. MIAM1 -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 www.buildingcodeonline.com APPROVED NOA No 06- 1113.05 Expiration Date: February 21, 2013 Approval Date: February 21, 2008 Page 1 A, DRAWINGS 1. Manufacturer's die drawings and sections. 2. Drawing No. 5 -2729, titled "Glazed Fiberglass Outswing Door ", shuts 1 through 12 of 12, dated 10/05/06 and last revised on 01 -14 -2008, prepared by RW Building Consultants, signed and sealed by Lyndon F. Schmidt, P.E. B. TESTS 1. Test reports on 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) Forced Entry Test, per FBC 2411 3.2.1 and TAS 202 -94 5) Small Missile impact Test per FBC, TAS 201 -94 6) Cyclic Wind Pressure Loading per FBC, TAS 203 -94 along with rammed-up drawings and installation diagram of6'0 x 6'11 Opaque Fiber Cass Outswing doors w/ glazed sidelites, prepared by Testing Evaluation Laboratories, inc., Test Report No. TEL-06-0918-2, dated 10 /1006, signed and sealed by Wendell W. thy, P.R. 2. Addition test rat No. TES- 091$ -2, per TAS 201, 202 and 203 -94 for 6'0 x 6'S Glazed Fiber Glass Outswing doors w/ glazed sidelites, issued by Testing Evaluation Laboratories, Inc. C. CALCULATIONS 1. Anchor verification calculations and structural analysis, complying with FBC -2004, prepared by RW Building Consultants, Inc., dated 11/03/06, signed and sealed by Lyndon F. Schmidt, P.E. 2. Glazing complies w/ ASTM E13OO- 98/02. D. QUALITY ASSURANCE 1. Miami Dade Building Code Compliance Office (BCCO). E. MATERIAL AL CERTIFICATIONS 1. Notice of Acceptance No. 05- 1206.01 issued to Trinity Glass interntatian, for their Unfinished Fiberglass Door Skin, expiring on 03/02/11, 2. Notice of Acceptance No. 07-0828.01 issued to Trinity Glass International, for their Trinity Lite Frame, expiring on 07/03/12. 3. Notice of Acceptance No. 05- 1201102 Issued to DuPont DeNeumours, Inc. for their "Butacite PVB Interlayer", expiring on 12/11/10. 4. Test Report No. ETC -0a-7l 1- 17122.1, prepared by ETC Laboratories., issued to Trinity Glass International, did 10/19/05 and revised on 01/020/8, Polyurethane Foam, tested. per ASTM 1929 D "Self Ignition Temperature"; ASTM E84 "Flame Spread halm" and "Smoke Developed Index", signed and sealed by Joseph Labora Mitten, P.E. • STATEMENTS 1. Statement letter of conformance and 110 financial interest, dated 01/14/08, signed and sealed by Lyndon Schmidt, P.E. 2. Statement letter of lab compliance as part of test report. G. OTHER • • • • • 1.. ` DSiE -814" Silicone Adhesive Sealant by Tong Yang S cline, co, c,\ 1 . • • • ••.• • Meg . Chanda, P. E. • • • • • • • • • Product Control Examiner • ...... NOANo06- 1113..03 • • • • • • .. Expiration Date; February 21, 2013 • • • • • • • • • • Approval Date: February 21,2# • • • •••• ...... • ...... • • • ...... ...... • ••. • • • • • I N T E R N A T I O N A L 4621 192nd STREET EAST TACOMA, WA 98446 TEL 253- 875 -7300 FAX: 253- 875 -7301 OPAQUE FIBERGLASS OUTSWING DOORS WITH & W /OUT SIDELITE(S) i "IMPACT" 0 I_ b=oo °gwo n "� o m. GENERAL NOTES 1. THIS PRODUCT HAS BEEN EVALUATED AND IS IN COMPLIANCE WITH THE 2004 FLORIDA BUILDING CODE INCLUDING THE HIGH VELOCITY HURRICANE ZONE° (HVHZ'). 2. PRODUCT ANCHORS SHALL BE AS USTED AND SPACED AS SHOWN ON DETAILS. ANCHOR EMBEDMENT 70 BASE MATERIAL SHALL BE BEYOND WALL DRESSING OR STUCCO. 3. WHEN USED IN THE HVHZ° THIS PRODUCT COMPLIES WITH SECTION 1626 OF THE FLORIDA BUILDING CODE AND DOES NOT REQUIRE AN IMPACT RESISTANT COVERING. 4. WHEN USED IN AREAS OUTSIDE OF THE "HVHZ" REQUIRING WIND -BORNE DEBRIS PROTECTION THIS PRODUCT COMPLIES WRH SECTION 1609.1.4 OF THE FLORIDA BUILDING CODE AND DOES NOT REQUIRE AN IMPACT RESISTANT COVERING. 5. FOR 2X STUD FRAMING CONSTRUCTION THE ANCHORING OF THESE UNITS SHALL BE THE SAME AS THAT SHOWN FOR 2X BUCK MASONRY CONSTRUCTION. 6. SITE CONDITIONS THAT DEVIATE FROM THE DETAILS OF THIS DRAWING REQUIRE FURTHER ENGINEERING ANALYSIS BY A LICENSED ENGINEER OR A REGISTERED ARCHITECT AND TO BE APPROVED BY BUILDING OFFICAL 7. 1X AND 2X W000 BUCKS BY OTHERS MUST BE ANCHORED PROPERLY 70 TRANSFER LOADS TO STRUCTURE AND TO BE REVIEWED BY BUILDING OFFICIAL 150.25" MAX. OVERALL FRAME WIDTH W /1X MUI1ION REINFORCEMENT 148.75" MAX. OVERALL FRAME WIDTH W/0 1X MUWON REINFORCEMENT 74.00" MAX. OVERALL FRAME WIDTH 36.38" MAX. PANEL WIDTH w /ASTRAGAL 37.375" MAX. 8. FOR DESIGN PRESSURE RATING SEE CHART UNDER EACH PRODUCT ELEVATION. 9. THIS PRODUCT MEETS THE WATER REQUIREMENTS FOR THE HIGH VELOCITY HURRICANE ZONE (HVHZ). TABLE OF CONTENTS 1 TYPICAL ELEVATIONS, DESIGN PRESSURES & GENERAL NOTES 2 DOOR / SIDELITE PANEL CROSS SECTIONS & GLAZING DETAIL 3 HORIZONTAL CROSS SECTIONS 4 HORIZONTAL CROSS SECTIONS 5 HORIZONTAL CROSS SECTIONS 6 VERTICAL CROSS SECTIONS 7 FRAME ANCHORING DOUBLE & DOUBLE BOXED UNITS 8 FRAME ANCHORING SINGLE & SINGLE BOXED UNITS 9 FRAME ANCHORING CHS UNITS 10 COMPONENTS 11 ASTRAGAL DETAILS 12 BILL OF MATERIALS & COMPONENTS OXXO (BOXED) DOUBLE OPAQUE DOOR W /SIDELITES (BOXED) DESIGN PRESSURE (PSF) W/0 MUWON REINFORCEMENT DETAIL (2/3) +55.0 -55.0 W /MUWON REINFORCEMENT DETAIL (3/4) +60.0 -60.0 74.25° MAX. OVERALL - FRAME WIDTH 37.375° MAX. SDL FRAME WIDTH CHS1 111.00" MAX. ..__.OVERALL FRAME WIDTH 37.375" MAX. SDL CHS WIDTH Eg ACTIVE A OX OR X0 (CHS MULL) SINGLE OPAQUE DOOR w /SIDELITE (CHS MULL) DESIGN PRESSURE (PSF) +60.0 I -60.0 ACTIVE 21.00" MAX. D.LO. OX0 (CHS MULL) SINGLE OPAQUE 000R W /SIDEUTES (CHS MULL) DESIGN PRESSURE (PSF) +Bo.o 1 -60.0 74.00° MAX. OVERALL FRAME WIDTH 36.38° MAX. PANEL WIDTH W /ASTRAGAL DOUBLE OPAQUE D00R DESIGN PRESSURE (PSF) +60.0 I -60.0 75.62° MAX. 0.A. FRAME WIDTH W /1X MUWON REINFORCEMENT 37.375" MAX. SDL FRAME WIDTH 37.50" MAX. FRAME WIDTH 16E1. qtrA SINGLE OPAQUE DOOR DESIGN PRESSURE (PSF) +65.0 1 -65.0 113.75" MAX. OVERALL FRAME WIDTH W /1X MUWON REINFORCEMENT 37.375" MAX. SDL FRAME WIDTH .75° MUWON REINFORCEMENT X0 OR OX (BOXED) SINGLE OP O 000R W /SIDELITE (BOXED) DESIGN PRESSURE (PSF) +60.0 1 -60.0 .75" MUWON REINFORCEMENT 1 nJ 1 aa-- a ••• • • 75" • MU N • • REINFip W • OX0 (BOXED) SINGLE OPAQUE DOOR W /SIDELRES (BOXED)RR DESIGN PRESSURE (IPS) • • • • • • • +so.° I -81ct • • In LI g- Z a sz P4 2 s to El R ••"i DATE:')! /05f06 • a to 0 Tn • • • SCAM N.T.S. DWG. ay: EW cro:. ac• LFS DRAM 110.: S X2779 • i • .4 • o• • 1• 0 m 0 • N 0 •• • ••• •• • • • • • • ••• • • • •• • • • • •• • . • ••• • • • • • • • ••• • • • • • • • . • • •• • • • • •• • • •• •• • • ••• • r • EXIMISIE 8.12 INTERIOR SEE DETAIL 1 2 SID IEUTE PANEL SECTION SILICONE FRAME (MATERIAL PC /ASA) SEALANT SIDELOLTEstlE1 0 2 FIBERGLASS YARN REINFORCEMENT 1" O.A. GLASS INTERIOR I IAI EXTERIOR THICKNESS 1/8" TEMPERED GLASS FIBERGLASS SKIN 0.079" MIN. THICKNESS DETAIL 1 DOOR & SIDE LITE DETAIL ILLUSTRATION 1/2" GLASS BITE STRUCTURAL SIUCONE BY DONG YANG SILICONE CO. SWIGGLE 1/8" HS GLASS .090" PVB INTERLAYER DUPONT BUTACITE 1/8" HS GLASS SCREW, STEEL Approved as ca:y lying Flandss [;wiJi�mllyi Nan - II3.OT Miami Dada Control GLAZING DETAIL �D O EXTERIOR INTERIOR 4 DOOR PANEL SEE DETAIL 1 O HORIZONTAL CROSS SECTION 2 DOOR PANEL 0 2 22 GLAZED VERTICAL CROSS O OPAQUE VERTIgAL CI SS SECTION SIDEU7E PANEL 2 SECTION DOU PALL : 0 a. 0 CY 0 0 w N J i o_ as a B W K K aCO N COIL 141606 scuE N.T.S. 3 • • • oat+ en EW ct¢c 9Y: LFS 0 in • • • • • • . • • ••• osulta•vo.. • S14-2t9 • �• •• E. • 0• �. • • Z• m' 3 d • •• • o• • ''._2_, Lt ' • • • ••' ••• • • • • • • • • • • • • ••• • • • • • • • •• •• • • ••• • • • • • • • ••: ••• • • • • • • • • • • • • • •• •• ••• • • • • a • SEE NOTE 1 SHEET 3 INTERIOR SEE NOTE 7 SHEET 1 1/4" MAX. SHIM SPACE (TYP) 1.14" MIN. PENETRATION EXTERIOR C) 3 1 HORIZONTAL CROSS SECTION @ SIDELITE JAMB 19.7" FROM END & 27.4" MAX. 0.C. SEE NOTE 1 SHEET 3 eNI N SEE NOTE 7 SHEET 1 • • • 1 -3/8" MIN. EMB. (TYP.) 1/4° MAX. -1 1 —SHIM SPACE NINI 10,17 ,00. 0 VERTICAL CROSS SECTION 3 6" FROM END & 27.4" MAX. 0.C. 0 SEE NOTE 1 SHEET 3 INTERIOR EXTERIOR SHOWN W /1X SUB —BUCK SUBSTITUTING CONCRETE SCREWS FOR SCREWS INTERIOR NOTES 1. ITEM #48 — #9 X 2 -1/4° PFH SCREWS THRU JAMB INTO SIDELITE LOCATED 6 ", 27 ", 50 -1/4 ", & 72 -1/8° FROM TOP OF FRAME TYP. BOTH SIDE JAMBS. 2. SIDELITE IS GLAZED, DOOR IS OPAQUE. 0 MULLION UNIT — W /OUT REINFORCEMENT NON— RENF. MULL C) 3 2_ HORIZONTAL CROSS SECTION ® HINGE JAMB EXTERIOR ®® INTERIOR SEE NOTE 7 SHEET 1 ApP+'Ot'eb m eemPlYiuB with dm Fm "aas Date • �• S fto•1 Div' u u ar� m. 1/4" MAX. SHIM SPACE (TYP.) 1.14" MIN. PENETRATION DE MME IMTEBLO i 4 1 411111M1 .. 1 1 \ •• NOT SHOWN INACTIVE • • • • • •• • •• ••• 33 HORIZONTAL CROSS SECTION 3 ® ASTRAGAL • • • •• • • • • • • ••• • • • • ••• • O 1 W N ag as mo �5O oq5 • • ••• • • • 19/05 O6 • sc•Le • N.T . • z 0 • • mr•. Bn EW cto Bw LFS F 2 i sxcg• 3 !4 ••• • • • • • • • • • •• •• • ti x q• •• C• No e• • • •• • m d • • • • °m • • • • ®• • • • •• • • • • • c • c • • • ••• • • • • • • • ••• • • • • • • • • • • • • •• •• • ••• • • 1 X ; NOT SHOWN 1/4" MAX. SHIM SPACE (TYR) '?.. 0 HORIZONTAL CROSS SECTION LATCH JAMB 1.14" MIN. PENETRATION SEE NOTE 7 SHEET 1 19.7" FROM END & 27.4" MAX. O.C. SEE NOTE 1 SHEET 3 INTERIOR 6" FROM END & 27.4" MAX. O.C. OCC)00 mpg SEE ET NOTE 1 SHE 3 1 I I I 11111111114411 19.7" FROM END & 27.4" MAX. O.C. MELO 6" FROM END & 27.4" MAX. O.C. NOT SHOWN MUWON W/ 1X REINFORCEMENT 0 HORIZONTAL CROSS SECTION LATCH JAMB INTERIOR MULLION UNIT — WITH 1X REINFORCEMENT C) HORIZONTAL CROSS SECTION HINGE JAMB EXTERIOR Approved o complying with Ow FloridaletosillitCrw, woA# az -ut3-6,3- Miami Dade Product COMMi 13)Yiltral `C 11 4 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • °°°°°°°° c• 1 20 • • V • ue • • 1 2/C.SCI6 SIALE: owo.Br EW CHIC. Fra LFS 0,•=0 er, • • • FL46-2AB9 • • • • • • • ■ • a • • • • • • • • • • • 2 • e • ® • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • ( t • • • • • • • • • • • • • • • • 0 HORIZONTAL CROSS SECTION LATCH JAMB 1.14" MIN. PENETRATION SEE NOTE 7 SHEET 1 19.7" FROM END & 27.4" MAX. O.C. SEE NOTE 1 SHEET 3 INTERIOR 6" FROM END & 27.4" MAX. O.C. OCC)00 mpg SEE ET NOTE 1 SHE 3 1 I I I 11111111114411 19.7" FROM END & 27.4" MAX. O.C. MELO 6" FROM END & 27.4" MAX. O.C. NOT SHOWN MUWON W/ 1X REINFORCEMENT 0 HORIZONTAL CROSS SECTION LATCH JAMB INTERIOR MULLION UNIT — WITH 1X REINFORCEMENT C) HORIZONTAL CROSS SECTION HINGE JAMB EXTERIOR Approved o complying with Ow FloridaletosillitCrw, woA# az -ut3-6,3- Miami Dade Product COMMi 13)Yiltral `C 11 4 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • °°°°°°°° c• 1 20 • • V • ue • • 1 2/C.SCI6 SIALE: owo.Br EW CHIC. Fra LFS 0,•=0 er, • • • FL46-2AB9 • • • • • • • ■ • a • • • • • • • • • • • 2 • e • ® • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • ( t • • • • • • • • • • • • • • • • SEE NOTE 1 SHEET 3 INTERIOR 0 5 1 HORIZONTAL CROSS SECTION 0 HINGE (CHS) W /INTEGRAL MUWON CHS MUWON ATTACHMENT AT SILL (2) #56 THRU SILL INTO MUWON INTERIOR 121E_6L46 1 NOT SHOWN CHS MUWON ATTACHMENT AT HEAD (2) #56 THRU HEAD INTO MUWON M SHEET03 1 J' I SEE Mar"' J* 1 1 ISM 1 e a_ :5 (,d.�._d �� •: t.7 :� 0 0 5 2 HORIZONTAL CROSS SECTION ® LATCH (CHS) W /INTEGRAL MUWON Apl••e4 .,20•,01417/3 with Dm Florida Built %Id 6 maaaiNOM Dade— r •• • • • • ••• • • •• • •• • • • • •• • • E uG erg) o 0 D: ow y C MO > Wg 14 IA AA '4 '4 • cio i •I/r>5,�r76 sc N.T.S • e • • • z Z 0 • • • • • IMO. eY: EW • 41. • • • 1741. BY:�,,, � LfS S.2A29 • • SHW 5 .1$ • •• • ••• • • • • • • • • • • • • ••• • • • • • • • •• •• • • ••• • • • z •• • u• • & t • od• •• • f • • • • • 06:4:41 • S•• q • • • ••• • • • • • • • • • • • • • •• •• ••• • • SEE NOTE 7 SHEET 1 Cli)VERTICAL CROSS SECTION HEAD JAMB — DOOR 2-1/2" MIN. FROM EDGE (TYP.) 2-1/2" MIN. FROM EDGE (TYP.) 0 VERTICAL CROSS SECTION SHOWN W/lX SUB—BUCK SUBSTITUTING CONCRETE SCREWS FOR SCREWS 2-1/2" MIN. FROM EDGE ('TYP.) 2-1/2° MIN. _FROM_Fp_QF (TYP.) VID7TICAL CROSS SECTION OU7SWING THRESHOLD — DOOR SEE NOTE 7 SHEET 1 • . • • . • .• • or 111111111111111PMENSIMIll elljAmo mr, I__ SOO Z w SEE NOTE 1 INTERIOR EXTERIOR 0 VERTICAL CROSS SECTION HEAD JAMB — SIDELITE 2-1/2" MIN. 1 2-1/2" MIN. FROM EDGE FROM EDGE (TM.) (TYP.) CDVERTICAL CROSS SECTION OUTSWING — SIDELITE Annoyed as manplying.ith the Florida Molding Code '10Att 0 3,ki Dade Product Control •• ••• • • • • • •• • • •• ••• 1. ITEM #48 — #9 X 2-1/4° PFH SCREWS THRU HEAD & SILL JAMB LOCATED ar PRQM EACH FRAME END: OD 1:7N; CENTER LINE • • • • • • • • • • IJ O) <3°4 • • • • • • 1 DM. EW o LFS or0.40.:, • • S•27129 • • • • sinir6 op 1 .111a • • • 11 • • II • to ri • al • • ri • • • a • • • • • • • • • • 1 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 555 • • • • •• • • • • • • • • •• • • • • MASONRY OPENING — 4.5" 6' I-- 4° — FRAME f 2X BUCK WAX BUCK INSTALLATION OR ,w /1X BUCK f INSTALLATION SEE NOTE 1 TIP. HEAD & JAMBS ACTIVE 1 SEE DETAIL 1 ASTRAGAL \ — SHOWN FOR REFERENCE 6'A TYP. SILL SEE NOTE 1 SEE DETAIL 2 I INACTIVE 1 FRAME ANCHORING XX ( OUTSWING) 6° 4" 4.4 4" MASONRY' OPENING FRAME 2X BUCK 0 1 N TYP. JAMB JAMB ( TO AMB N. W/0 3/4° MULLION ACTIVE I r- I 11 \SEE DETAIL 1 ASTRAGAL\ SHOWN FOR REFERENCE O TYP. SILL SEE NOTE 1 SEE / DETAIL 2 1 1 INACTIVE 1 U ti ro -I r- 4' W /2X BUCK INSTALLATION W /1X BUCK INSTALLATION SEE NOTE 1 TYP. HEAD & JAMBS ® BUCK INF. MULL, FRAME ANCHORING OXXO (BOXED ) OUTSWING TYP. JAMB TO JAMB W/3/4" r !MULLION I` 1..._ 0.75" MULLION REINFORCEMENT W /2X BUCK INSTALLATION W/1 X BUCK INWALLATION SEE NOTE 1 DETAIL 1 ® HEAD EXITERIOR DET SILL 2 NOTES: W/2X BUCK INSTALLATION W /1X BUCK INSTALLATION SEE NOTE 2 Approved as comp' Florida B g Date Infp s Miami Dade Product Control STRIKE AT PLE DETAIL ® ASTRAGAL 0 0 0 ipit, iI alp sT . f26- •Z no ±- M v HINGE DETAIL 1. 1/4" ELCO OR ITW CONCRETE SCREWS ANCHORING FRAME ANI[/dR $i : • • REQUIRE A MINIMUM 2 -1/2° CLEARANCE TO MASONRY EDGES•4ND A MINIMUM!, 4' CLEARANCE TO ADJACENT CONCRETE SCREWS WITH MINIMUM *I EMBEDMENT. • • ••• • • 2. 3/16° CONCRETE SCREWS ANCHORING ASTRAGAL STRIKE PLATE AT HEAD OR SILL REQUIRE A MINIMUM 2" CLEARANCE TO MASONRY EDGES AND A MINIMUM • 2 -5/8° CLEARANCE TO ADJACENT CONCRETE SCREWS UNLE.S43•OT1R4/ISE • NOTED BY CONCRETE SCREW MANUFACTURER. • • • • • • • • ••• • • • • 0 0 a c a • • • • • • •C•E N.T.S. awB. BY: EW GHK.Br. L� • °•�"� rn.: • • • 6 -2g29 • • si l 7 ••• • • • • • • • • • • • • ••• • • • • • • • •• •• • • ••• • • • ••• • • • • ••• • • • • • • • • • •• •• • • 6" MASONRY OPENING FRAME FRAME ANCHOR NG W/2X BUCK INSTALLATION OR BUCK MASONRY INSTALLATION OPENING SEE NOTE 1 io TYP. HEAD & JAMBS 0 BUCK 6;\ TYP. SILL SEE NOTE 1 -: MASONRY OPENING 1l W /2X BUCK INSTAUATION OR W /1X BUCK INSTALLATION SEE NOTE 1 TYP. HEAD & JAMBS 0 BUCK 1 1V / /— N TYP. JAMB PTO JAMB W/3/4" MUWON N 0.75" MUWON FRAME ANCHORING X0 OR OX (BOXED) W /MULLION REINFORCEMENT - 4" t1 W /2X BUCK INSTALLATION OR W /1X BUCK INSTALLATION SEE NOTE 1 TYP. HEAD & JAMBS 0 BUCK 0 0.75" 4-- MUWON FRAME ANCHORING Ox0 (BOXED) W /MULLION REINFORCEMENT MUWON TYP. SILL SEE NOTE 1 TYP. SILL SEE NOTE 1 STRIKE PLATE DETAIL 0 JAMB Approved as complying with the Florida Codc Dale 2 ?e 32 NOM 0 — .0j Miomi Dade conttoi _'` ,fee(. t..4 -1 INGE DETAIL 00 0 no I Tv •• • •• • • NOTES, • 1. 1/4" ELCO OR M4, M4, CONCRETE SCREWS ANCHORING • • • : FRAME AND /OR SILL REQUIRE A MINIMUM 2-.112" • • • CLEARANCE TO MASONRY EDGES AND A MINIMUM 4" CLEARANCE TO ADJACENT CONCRETE SCREWS WITH MINIMUM 1 -1/4" EMBEDMENT. •• • • • • •. • • • • • • • • • • • •• • • • • •• ••• • • • • • •- • • • • • • • • • • • • • •• •• 0 tuota 0gv, 0 0 ET. 0 • • Ml€ w o< Fri sZO • •M • •A 1 OM5, 6• • • � sCLL N.T.S. Owo. ew EW oft ew LFS. pwngb ea; • • s• 8 oF3* • • • • ••• • • • • • i 1 1 9 5 m • vs O. • • re • 0 • ••• • • • • • • • • • • • • • •• •• ••• • • 6° MASONRY OPENING FRAME 2X BUCK I.i / / 11/ / -/ CHS MUWON SHOWN FOR - REFERENCE MASONRY OPENING ACTIVE 4" W /2X BUCK INSTALLATION OR W /1X BUCK INSTALLATION SEE NOTE 1 1YP. HEAD & JAMBS 0 BUCK fYP. SILL 44 SEE NOTE 1 FRAME ANCHORING OX OR XO (CHS) W /INTEGRAL MUWON 4° 4° +- 4" 4" / /CHS L MUWON SHOWN FOR REFERENCE ACTIVE J FRAME ANCHORING OX0 (CHS) W /INTEGRAL. CHS MULLION W /2X BUCK INSTALLATION 33 OR IN/1X BUCK INSTALLATION SEE NOTE 1 TYP. HEAD & JAMBS 0 BUCK OTYP. SILL 44 SEE NOTE 1 II ro STRIKE PLATE DETAIL 0 MUWON NOTES: Approved as comply3ugwIthths taoA#aA -rrr 3 • aS M��ivvnor+ Dadc product Control. 44r ,„,i .0, ti'w• • • • • • • •• • •• • • • • • • •• ••• •• 1. 1/4" ELCO OR ITW CONCRETE SCREWS ANCHORING FRAME AND /OR SILL REQUIRE A MINIMUM 2 -1/2" CLEARANCE TO MASONRY EDGES AND A MINIMUM 4" CLEARANCE TO ADJACENT CONCRETE SCREN WI1-I • MINIMUM 1 -1 /4" EMBEDMENT. • • • • • • . • • E • • • •,o . ,z N jo O A A BB K1' 0 �4 • • • oa• 10/45f06• � • SCALD N.T.S. ows ar. EW of en LFS• °z m • of • • • ; • —Z72� • agog ..3,&• :.° ••• • • • • ••• • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • •• •• ••• ••. • • •• . • n 1.562" n �{ 1.562" 11 TOP RAIL D0OR OBOTTOM MIL DOOR .780" r 1 N t0 SIDELITE STILE 4.560" u 0 0 u 0 N 0 @TOP RAIL SIDELITE 1.562" 47 BOTTOM RAIL SIDELITE OLATCH STILE SUPPORT N 0 F- 16 2.362" 111111111 17 LOCK BLOCK HINGE STILE EDGE LATCH STILE EDGE 1.220" 4.560" if 2.435" --.1 - j 19 SILL -TO -JAMB KIT DETAIL OPTIONAL 0 0 1 0 U) J 2.362" ._L 0 r. 1.250" ).())/ 11.22-r_ 13 HINGE STILE SUPPORTER 000 1.983" 3.983 " —� q �0 ® ® 0 0. I® HINGE JAMBS — 3.250" F+- 2.250" --^1 00® 1X REINFORCED MULLION ,,r,�BwH§tlm NO4 0 - 2.500" $mss � 54 CHS INTEGRAL MULLION CHS (OX, 0X0) 00 0 11•••e; • • • • • . • : • •• 2.250" I+ MULMA • • • • • W /00/ REINFFRCF�4ENT • • • • • • • • • • • • • ••• re 0 ao 8 • • 10 P 8 2 • rc It N.T.S 2 6 z 0 • • rwo. BY: EW ti.B LF$ • N04 • • • s 2!2 9 • • ssta ,ZQ, 12• z a• 0 0 • o• • p• • 0 • • lo!!!0i0i •• • •• • • • • ••• • • • • •• ••• • O DEAD BOLT LATCH (THRU HOLE) .016* (BUND HOLE) O 0 u ALUMINUM ASTRAGAL ASSEMBLY BY ENDURA PRODUCTS OALUMINUM ASTRAGAL BY ENDURA PRODUCTS 0 e 40 ALUMINUM ASTRAGAL BY ENDURA PRODUCTS 0 1.625" ro- 0 1.625" it TOP BOLT RETAINER MAIL: HOPE LENGTH: 4 3/4" NOTE 19.625 I 47 TOP BOLT RETAINER MATL: ALUMINUM LENGTH: 9 3/4" ANAoYed esPh^iagwkLfhn yIs -1 1 Mimni i de mduq C 7 By •• ••• • • 42 SLIDE BOLT ROD • • • • • • • • STEEL • •• • • •• ••• •• 1. (12) OF ITEM #48 ASTRAGAL RETAINING SCREWS LOCATED (2) ® 2 -1/2 ", (1) @ 3 -1/2 ", (1) 0 10 -1/2 ", (1) ® 18 -1/2 ", & (1) 6!•2$ -142" FROM • THE TOP OF ASTRAGAL AND (2) 0 2 -1/2 ", (1) 0 3 -1/2 (1) —1/2 ", • (1) ® 18 -1/2 ", & (1) ® 26 -1/2" FROM THE BOTTOM 0•AgRVA • • • • • • • • • ••• E Q • • • • • • • s one 10 0 N Z 0 • °z i �a. w SCALE. N.T. MI EW aa.•ev: LFF • • +4 N04 • • • S-2I2:•• • • exm•,_LL OF 124P ••• • • • • • • • • • • • • ••• • • IS • • • • •• •• • • ••• • • • ••• • • • • • • • • • • • • • •• •• ••• • • • • t • • • • • • • • ••• • • • • ••• • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • •• •• • • • •• •• 0 •• • • • ••• • • Documents Prepared Byt r D BUILDING CONSULTANTS. INC. P.O. Box 230 Whim FL 33898 Phone No.: 813.889.9197 FIo1da Board of Professional Engineers Cer88aats Of Au rix. w• No. 9813 yep Lyndon. F. Schmidt P.E. No. 4.3409 REM DESCRIPTION MATERIAL REM DESCRIPTION MATERIAL 1 FIBERGLASS SKIN BY TRINITY 0.079' MIN. THK. W /REERGIASS YARN RUNT. FIBERGIASs 45 LVL SIDELRE TOP RAIL POPLAR 2 SIDELRE JAMB - FINGER -JOINT PINE WOOD 48 LYL SIDELTTE STILE POPLAR 3 HINGE & LATCH JAMB - FINGER -JOINT PINE WOOD 47 LVL SIDELAE BOTTOM RAIL POPLAR 4 HEAD JAMB - FINGER -JOIN' PINE WOOD 48 19 X 2 -1/4" SELF DRIWNG SCREW STEEL 5 1/4" x 3-3/4° TAPCON (ELCO OR TIM) STEEL 49 10-32 X 5/8° MACHINE SCREW STEEL 6 U4. LATCH STILE SUPPORTER POPLAR 50 =SWING SIDEUTE SPACER PVC 7 OUTSWING THRESHOLD (HIGH RISE 711.EXENDURA PRODUCTS INC.) ALUM. /COMP. 51 110 X 2.0" PFH WOOD SCREW STEEL. 8 STRIKE PLATE SCREW 18 X 2.0" PFHWS (2 REQUIRED PER STRIKE PLATE) STEEL 52 DEAD BOLT STRIKE STEEL 9 COMPOSITE BOTTOM RAIL PVC 53 IX MUWON RENFORCEMBYT WOOD 10 0008 PANEL CORE FOAMED IN PLACE BY TRINITY POLYURETHANE 54 INTEGRAL MULLION (CHS) WOOD 11 COMPOSTTE/WL TOP RAIL PVC /L.VL 55 16 X 1 -l/4" PPM DRYWALL SCREW sma. 12 .WEATHERSTRIP 0E80650 0-10N FOAM 56 /8 X 2 -1/4' PFH SELF' DRILLING SCREW STEEL 13 LVL HINGE STILE SUPPORTER POPLAR 57 STAPLE 18 GA GAL.V. 7/16" CROWN x 1 -3/4" LONG STEEL 14 COMPOSITE HINGE STILE EDGE PVC 15 BEAD 1/4° wood LPRODUCT: OPAQUE FIBERGLASS OUTSWING DOORS WITH & W /OUT SIDELTTE(S) PART OR ASSEMBLY: BILL OF MATERALS & COMPONENTS 16 COMPOSITE LATCH STILE EDGE pvc 17 LVL LOCK BLOCK POPS 18 3.983' X 4.0° HINGE MIN. 0.098" THICK STEEL 19 SILL TO JAMB KIT (OPTIONAL)* PC /ASA 21 22 KWIKSET IATCH GRADE II KWIXSET DFADBOLT GRADE 9 STEEL STEE, 4.563" TO La 'co N o 2 3 STRIKE PLATE STEEL 23A FLUSH BOLT STRIKE PLATE 0 HEAD STEEL o c ")¢ oil. d n Q; 238 FLUSH BOLT STRUT PLATE AD SILL STEEL 2 4 HINGE TO JAMB SCREW 19 X 5/8" PFHWS (3 REQUIRED EACH HINGE) STEEL g'4. .,, �y _ -- 1 25 3/16" X 3-1/4' TAPCON STEEL, iJ 26 27 16065 70 DOOR SCREW 19 X 1.0" PFHWS (4 REQUIRED EACH HINGE) LITE FRAME SCREW 18 X 1 -1/8' SELF' iHRFA6ING 57551. STEEL t� cE,L,U p 3.068" COMPOSITE O OUTSWING THRESHOLD REVISED PER DADE LETTER REVISED PER DADE NOTES y Z O S r6 28 1.! INSULATED LAMINATED GLASS (INTERLAYER DUPONT BUTACIfE) 1/8" TEMPERED - AIR - 1/8" HS - .090' P18 - 1 /8' HS GLASS HIGH RISE TYPE 1OVed89pmnplYtog with the M 4 NNO ;r 2.010" t+- On; .op st Coin 29 2X BUCK WOOD 30 10 BUCK W000 31 MASONRY CONCRETE 32 MULLION BASE KIT* PC /ASA 33 JAMB TO BUCK SCREW 110 X 2.5" PFH WS WITH MIN. 1.14' DAB. STEEL 35 LATEX CAULK LATEX 38 1/4" MAX. SHIM SPACE WOOD 37 LITE FRAME BY TRINITY UNDER SEPERA7E N.0A.* PC /ASA .' • e ��± =]' n• z Ell ' •� 38 SCREW PLUG AA MIINNUM BY 4� ! 1 LS ` ' '• �:� • 40 ASTRAGAL (END110 PRODUCTS INC.) t • • • I • • • • • • • • • • • •• 50 SIDEJTE SPACER • • • • • • • OUTSWING 41 BOLT RETAINS'? - 42 FLUSH BOLT STEEL Iu7e 7 0/115 6 i 43 3/l6" x 2 -1/4` TAPCON (ELCO OR 11W) STEEL SCALE: N.T.S. 44 1/4" X 2 -3/4" TAPCON (ELCO OR RW) STEEL DWG BY: EW o * PC /ASA- POLYCARBONATE/ ACRYLONITRILE STYRENE ARYATE • • • • • • • • • • • • • • •.• ••• ••• j • • �cao 'lf 4 Ep,; a • $-2029 • • c a .0 12 of 129 • t • • • • • • • • ••• • • • • ••• • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • •• •• • • • •• •• 0 •• • • • ••• • • • • • • fir. • ••;.•• • • • ,_.. • • M IA M IDADE BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 DAB Door Company Inc. 12195 NW 98th Avenue Hialeah Gardens, FL 33018 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed 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: Sectional Garage Door 9'- 4" Wide. APPROVAL DOCUMENT: Drawing No. 01-09, titled "Sectional Residential Garage Door", dated 02/01/01 with last revision on 02/28/06, sheets 1 through 3 of 3, prepared by Al- Farooq Corporation, signed and sealed by H. Farooq, 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 LABELING: Rath unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved or MDCPCA ", 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. LIMITATION: This approval requires the manufacturer to do testing of all coils used to fabricate door panels under this Notice of Acceptance. A minimum of 2 specimens shall be cut from each coil and tensile tested according to ASTM E -8 by a Dade County approved laboratory selected and paid by the manufacturer. Every 3 months, four times a year, the manufacturer shall mail to this office: a copy of the tested reports with confirmation that the specimen were selected from coils at the manufacturer production facilities. And a notarized statement from the manufacturer that only coils with yield strength of 39000 psi or more shall be used to make door panels for Dade County under this Notice of Acceptance 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. Tlsis•NOA renews NOA # 01- 0516.03 and consists of this page, evidence page as well as the approval document mentioned above. • • • • TThe submitted documentation was reviewed by Cand Font PE. �z • • • • •• •• • • • •• • ••• •••• •• • • • • • NOA No 05- 0915.09 Expiration Date: August 09, 2011 Approval Date: April 13, 2006 Page 1 DAB Door Company Inc. NOTICE OF ACCEPTANCE: EVIDENCE PAGE • A. DRAWINGS 1. Drawing prepared by Al- Farooq Corporation, titled "Sectional Residential Garage Door ", Drawing No. 01 -09, dated 02/01/01, with last revision on 02/28/06, sheets 1 through 3 of 3, signed and sealed by H. Farooq, PE. B. TESTS 1. Test report of large missile impact test per PA 201 and cyclic wind pressure test per PA 203 on " Sectional Residential Garage Door ", prepared by Hurricane Engineering & Testing, Inc., report No. HETI 01 -974A, dated 01/29/01, signed and sealed by H. M. Medina, PE. 2. Test report of Uniform Static Air Pressure Test Per PA 202 and Force Entry Resistant Test on "Sectional Residential Garage Door ", prepared by Hurricane Engineering & Testing, Inc., report No. HETI 01 -969, dated 01/18/01, signed and sealed by H. M. Medina, PE. C. CALCULATIONS 1. Calculations dated 04/10/01; pages 1 through 8 of 8, prepared by Al- Farooq Corporation, signed and sealed by H. Farooq, PE. 2. Calculations dated 08/09/95, page 1 through 5 of 5, prepared Al- Farooq Corporation, signed and sealed by H. Farooq, PE. D. MATERIAL CER1 iCATIONS 1. Test report of Tensile Test per ASTM E 8, report No. HETI 01 -T019, prepared by Hurricane Engineering & Testing, Inc., dated 03/01/01, signed and sealed by H.M. Medina, PE. E. STATEMENTS. 1. Code Compliance letter issued by Al- Farooq Corporation on 08/22/05 prepared by Al- Farooq Corporation signed and sealed by H. Farooq PE. 2. Tensile test and Affidavit prepared by DAB Door Company Inc on 01/10/06 signed by R. Berger and notarized by T. Bolanos. F. QUALITY ASSURANCE. 1. Building Code Compliance Office. •••• • • • • • • • .. • • • • • •••• • • • •••• ▪ • • • • • • • •• •• •• • • • ••• • • •••• • • • •••• • • E -1 • •• • • • • • • • • •. • • • • • •••• • • •••• • • •••• Candi s F. F u nt, PE. Senior Product Control Division NOA No 05- 0915.09 Expiration Date: August 09, 2011 Approval Date: April 13, 2006 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • DOOR HEIGHT CONSISTS Of r 111'-6r 2 SECTIONS 18' 2 SECTIONS 21" r-r 1 5001106 18- 3 SECTIONS 21' 7' 4 SECTIONS 21' - 7-3" - - 1-e 3 SECTIONS 18" - 7*-9" 4 SECTIONS la" 1 SECTION 21' 8' 3 SECTIONS 18" 2 SECTIONS 21 17-3" 2 SECTIONS 18".3 SECTIONS 21' 13.-8' 1 SODOM 18' 4 SECTIONS 21" 8'-9' 5 5E014065 21" - 9' 6 SECTIONS 18" - 1E-3" 5 SECTIONS 18' 1 SECRETS 21" EILEr 4 SECTIONS 18" 2 SECTIONS 21" 8-9" 3 SECTIONS 18" 3 SECTIONS 21" 10" 2 SECTIONS 18' 4 SECTIONS 21' 10.-3' 1 SECTION 18" 5 SECTIONS 21' 18-8' 6 SECTIONS 21' - 16"-9" 6 SECTIONS 18' 1 SECTION 21' 11' 5 SECTIONS 18" 2 SECTIONS 21' ' 11'-3' 4 SECTIONS 18'2 SECTIONS 21' 11'-8r 3 SECTIONS 18' 4 SECTIONS 21' 1l'-9' 2 SECTIONS 18' 5 SECTIONS 21' 12' 1 SECTIONS la" a SECTIONS 21' 11-3" 7 SECTIONS 21" - 11-r 6 SECTIONS 18' 2 SECTIONS 21" 12'-9" 5 SECTIONS 18' 3 SECTIONS 21" 13' 4 SECTIONS 18' 4 SECTIONS 21" • 13*-3' 3 =now 18' 5 SECTIONS 21' • 11-6" 2 SECTIONS 18' 8 SECTIONS 21' • 13'.-9" 1 SECTION 18' 7 SECTIONS 21' 14' 8 SELI10193 21' - 14'-3* 8 SECTIONS 18" 3 SECTIONS 21" • 14'-6" 3 SECTIONS 113' 4 SECTIONS 21' • 14'-9' 4 SECTIONS 18" 5 SECTIONS 21' 15 3 SECTIONS 18" 8 SECTIONS 21" 15L3' 2 SECTIONS 18' 7 SECTIONS 21" 15'-6" 1 SECTION 18" 8 SECTIONS 21' • 15*-9' 9 SECTIONS 21' - Ur 8 SECTIONS 18" 4 SECTIONS 21' • .071' X 771/2' GALV. STEEL UM ROLLER HINGE VI/ (6) #14 X 5/13' SMS .071' X 7-1/2" GALV. STEEL 065156 1415011 W/ (4) #14 X 1/2' SUS 1 LOCK 2/ DOOR 15/16'W X .15 THK. SPRING LOADED SUDE BOLT LOCK ( FASTENED W/ (4) #14 X 1/2" S.M 5/8" MK LOCK CONFORMS TO CHAPTER 10 SECTION 1008.1.8.3 0 RF_GARDING GARAGE DOORS X 1-1/2' X 6-1/2' X .1' STEEL WITH (2) #14 X 3/4' SELF DRILLING SCREWS 7 X 7 GAOL AIRCRAFT TYPE CABLE & 4000-PRESS SLEEVE , W/ 4.416. 5 TO 1 SAFETY FACTOR' OUTSIDE KEYED LOCK LOCK BAR LOCKING SHOWN OPTIONAL DOOR VIEWER TO BE INSTALLED AT CENTER STILE ff-4' INSIDE ELEVATION RAISED PANEL EMBOSSED DOOR 1. THIS PRODUCT HAS BEEN DESIGNED AND TESTED TO COMPLY WITH THE REQUIREMENTS OF THE FLORIDA BUILDING CODE 2004 EDMON INCLUDING HIGH VELOCITY HURRICANE ZONE. , 2. ANCHORS SHALL BE AS USTED, SPACED AS SHOWN ON DETAILS, ANCHOR EMBEDMENT TO BASE WYEFTIAL SHALL BE BEYOND WAU. DRESSING OR STUCCO. 3, AU. BOLTS, NUTS AND WASHERS SHALL BE ZINC PLATED CARBON STEEL 4. ANCHORING OR LOADING CONDMONS OTHER TITAN THOSE SHOWN IN THESE DETAILS ARE NOT PART OF THIS APPROVAL 5. A 3311 INCREASE IN ALLOWABLE STRESS IS USED IN DESIGN OF WOOD ANCHORS ONLY. DAB DOOR MODEL 824 MAX. SIZE 9'-4* WIDE X 16*-0" HIGH DESIGN PRESSURE RATING =, + 50.0 PSF ' — 60.0 PSF • THIS PRODUCT IS RATED FOR LARGE MISSILE IMPACT EA-77A-71U55Y0UN FAR000 STRUCTURES NA PE # 18557 C.A.N. 3538 4702DI ,2 MAR 0 8 20{6—atti Caorei DITITion 8E 'IP- 8 o g a•r-..,•lo .03=c4 V.H I X. 0,40 CI La c.) 2 I figEi 2 0 2 12 2 ,F4 2 a drawing no. 01-09 sheet 1 of 3 I ! t ■ CENTER STILE / r ' i - 1 . g 'L g \ / \ / \ / i I i I "------_, / \ / / , N .71=1 / WWI i - - Iv .".\ i 1 1IM1 , Ii 11014 3S, 0. Tr H Sr I DES) ' 4 I 1 PM IIIIMIIMIIIIr/ IlIi I I0I IE/ 1l1l lI Pi . • • _ A * A A i \ \ .•=N ■•■•••. ••■ 1 /...... 1 \ OPRONAL varr' OPTIONAL FLUSH FACE , MAXIMUM OPENING AREA WOOD GRAIN DESIGN 120 SQ. MAX. DOOR WIDTH ' ff-4' INSIDE ELEVATION RAISED PANEL EMBOSSED DOOR 1. THIS PRODUCT HAS BEEN DESIGNED AND TESTED TO COMPLY WITH THE REQUIREMENTS OF THE FLORIDA BUILDING CODE 2004 EDMON INCLUDING HIGH VELOCITY HURRICANE ZONE. , 2. ANCHORS SHALL BE AS USTED, SPACED AS SHOWN ON DETAILS, ANCHOR EMBEDMENT TO BASE WYEFTIAL SHALL BE BEYOND WAU. DRESSING OR STUCCO. 3, AU. BOLTS, NUTS AND WASHERS SHALL BE ZINC PLATED CARBON STEEL 4. ANCHORING OR LOADING CONDMONS OTHER TITAN THOSE SHOWN IN THESE DETAILS ARE NOT PART OF THIS APPROVAL 5. A 3311 INCREASE IN ALLOWABLE STRESS IS USED IN DESIGN OF WOOD ANCHORS ONLY. DAB DOOR MODEL 824 MAX. SIZE 9'-4* WIDE X 16*-0" HIGH DESIGN PRESSURE RATING =, + 50.0 PSF ' — 60.0 PSF • THIS PRODUCT IS RATED FOR LARGE MISSILE IMPACT EA-77A-71U55Y0UN FAR000 STRUCTURES NA PE # 18557 C.A.N. 3538 4702DI ,2 MAR 0 8 20{6—atti Caorei DITITion 8E 'IP- 8 o g a•r-..,•lo .03=c4 V.H I X. 0,40 CI La c.) 2 I figEi 2 0 2 12 2 ,F4 2 a drawing no. 01-09 sheet 1 of 3 • • ••• • • • ••• •. •• • • • • • •• .. • • • • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • • • • • • • • ••• • • • • • ••• • • • • • • • • • • • • • • • • • • • •• • • • • • • • ••• • • • • • • • • • • • • • • • • • • • • • • •• • • • • •• • • •• • • • • •• ••• •• • • • • • • • • • ••• •• OPTIONAL STOP MOULDING / BY 000R INSTALLER STEEL TRACK BRACKET FASTENED TO WOOD JAMB WITH 5/18' X 1 -5/8' LAG SCREW ONE PER BRACKET SOUTHERN PINE + 0.55 S.G. P4 X 5/8' 5115� 8 PER HINGE 24 GA. STEEL PANEL 3/18' ALUM RIVETS FLAPS BENT OVER PANEL 1/2' PUNCHED HOLES 0 4' 0.C. STX ID BRASS DOOR VIEWER ' BY 'SCHLAGE SECURITY HARDWARE' INSTALLED IN 9/16' DIA. HOLES IN CENTER STILE ' POSITIONED AT EYE LEVEL ! 1/2' X 1 -3/4' X .059' FORMED STEEL GLUED TO PANEL AND SECURED 10 END SOLE WITH 3/19' POP RIVETS 0 12' 0.C. ' 34' X 2' X 2 -1/2' X 18 GA 51EEL DO STILE, CONNECT TO PANELS WEH FLAPS AND 3/18' ALUM RIVETS SEE DETAIL ABOVE END STILE 1 -7/8' X 2 -5/8' X .048' STEEL CENTER STILE, GLUED AND RIVETED TO PANEL W/ (4) 3/18" RIMS • POP RIVETS $14 X 5/8' S.M.S. . • 4/ HINGE 4' MIN. EDGE DISI. 3/8' HILTI HLC SLEEVE ANCHORS 4 t 1 -1/4' MIN. EMBED INTO / GROUT FILLED 1 PER B��CONCRETE BLOCKS + 3/4' MAX. ✓ 1.9" X 2.19' X 3.3' X .102' • STEEL TRACK BRACKETS SEE SHEET 3 FOR SPACING 2 -1/8' X .078' GALV. STEEL TRACK FASTENED TO TRACK PLATES W/ 1 4-20 X 5/8' TRUSS HD. ' MS & LOCK NUT ' 7/18" PUSHNUT INSTALLED ON ROLLER SHAFT 7 -1/2' X .050' GALV. STEEL CENTER HINGE SECTION 1/4-20 SS BOLT & NUT `/ INTERIOR SIDE 7 -1/2' X .071' END ROLLER HINGE J 1.82' DIA. X .50' ROLLERS W/ .44 DIA. X 4-1/4' STEM Emir: DR. HUMAYOUN P38000 STRUCTURES FLA. PE i 18857 CAN. M,8 MAR 0 8 2006 • • ••• • • • ••• •• •• • • • •• •• • • • • • • • • • • • • • • • • • ••• • 6 • • • • • • • • ••• • • • ••• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• 6 p • 6 • • ••• • e i1 ••It •• • 2" G• • POP RIVETS / 5/16" X 1 -5/8" LAG SCREWS INTO WOOD OR • 5/16' SLEEVE ANCHORS • HORIZ. TRACK SUPPORT. • QAKy • "SLI0IDDE FASTENED TO BRACKET WITH 1 -1/4' EMBED INTO MASONRY ADUU. CENTER SUPPORT RECD. ON DOORS ' DRUM EXCEEDING 8 FT. IN HE :7014:35414-stet X 3/4' HEX HEAD • 3 PER BRACKET' O II • NU1S. / O I I 2JI " I 2-1/2" % 4-1/4" X J' STEEL PLATES ci] WELDED TO 1 -1/2" X 1 -1/2" X .089' ANGLE •� • FASTENED TO TRACK WITH (4) 1/4-20 SS. BOLT & NUTS. �� / FORMED STEEL • • • • • (2' 3116 "POPS RIVETS III • STEEL ■1! III HORIZONTAL REINFORCEMENT 1/2' X 1 -34 "X.059' ' WITH • • TO PANEL AND FASTENED TO • • • • f-7/8" X 5-1 /2" X 3" X .1' • • • ROLLER BRACKET (0008((03� FASTENED W/ (8) / 14 X 5 /8` S.M.S. HORIZONTAL REINFORCEMENT / 1/2' X 1 -3/4' X .058' FORMED 51EE1. GLUED TO PANEL AND FASTENED TO VERTICAL STILES WTIH • (2) 3/16' POP RNEIS • 8 /18' MEETING RIB • /16' 01A X 3 -3/4' ROLLER SHAFT • N La 0 = OPIXINAL_ INSULATIONS BY 'APACHE 880111/013 ci ro a i- FEPS -EXPANDED - ANDED POLYSTYRENE • N.O.A. # 01- 1108.09 • OR 3O -25 POLY- ISOCYANURATE DENSITY = 2.0 P0F N.0A. f 01- 1108.08 • SECTION A -A / 14 G4. GALV. STEEL. ROLLER HINGES FASTENED ' W /(4) #14X5/8'085 • MIN. .024" ROLL FORMED STEEL PANEL DRAWING OUAUTY 3-40 • MN. YIELD STRENGTH a 39 K51 • WNW PRIMER AND BAKED -ON . POLYSTER PAINTED TOP COAT • APPLIED TO BOTH SIDES OF STEEL • 12 GA GALV. STEEL / 801T01L BRACKET FASTENED W/ (4) /14 X 5/8' SINS BOTTOM SEAL ' .056 ALUM PLATE / WITH 1/8' X 1' S.M.S. • 48' O.C. • AND RUBBER WEATHERSTRIPPING , ▪ OPENING HEIGHT PLUS 12' / DOOR • SECTION HEIGHTS BRACKET PLACEMENTS HEIGHT 1ST 2N0 3RD 4TH 5TH B1 82 83 84 65 88 87 88 6'-0' 18' 18' 18' 18' N/A '1" 11 -3/4" 23' 34" 45° 56" 87" - 6'-8' 21' 18' 18' 21° N/A • 1° 11 -3/4" 23" 34" 45° 58' 67° - 7' -0' 21'21' 21' 21' N/A .1' 11 -3/4" 23' 34° 45" 56' 87' 78 -1/4° 7' -6" 18' 18' 18° 18° 18' • 1' 11 -3/4' 23° 34" 45" 56" 67" 78 -1/4' 8'-0' 21'18' 18' 18' 21' . 1' 11 -3/4° 23" 34" 45" 56' 87" 78 -1/4" FOR DOORS MORE THAN 8 FT. HIGH. USE ADDTITONAL TOP BRACKETS AT 10' 0.C. 14 GA GALV. STEEL TRACK / 2 X 3-1/2' X 12 GA TRACK BRACKETS . 2 -3/18' HIGH • NECTED TO TRACK /44" BOLTS & NUT WITH ONE 1/ S STEEL STRUCTURE 8Y OTHERS • MUST SUPPORT THE LOADS IMPOSED BY OOOR SYSTEM 1/4' 4 HEX HEAD M.S. • LOCK NUT 0 12" 0.C. 1 P 1 IR&CK-0211EQUEMN HIL11 HLC SLEEVE ANCHOR SPACING ANCHOR STRUCTURE EMBED SPACING 3 /8' CONC. BLOCK 1- 1/4 '12 -1/2' CONC. 1 -1/4" 15' CONC.. MIN. 3000 P51 1-1/4" S� ANGLE 14 GA i .102" GA GAL}(. STEEL. FLAT= BRACKET * 3 LONG 0 *12' 0.C. NECTED TO CONT. W/ (3) SPOT WELDS ATN W EACH SIDE . WOOD FRAME BUILDINGS , ALTER A TRe K INSTA I ATION STUD WALLS OR DOOR OPENING SHALL BE FRAMED SOLID • OR BY NOT LESS 000 51/05. PRESSURE TREATED GRADE 2 / STUD WALLS TO BE CONT. FROM FOOTING TO TIE BEAM. WOOD BUCK CONNECTION TO MASONRY • TRACK SHALL 8E SECURED WITH TRACK BRACKETS TO PRESSURE TREATED 2X6 WOOD JAMBS WHICH SHALL BE ANCHORED TO . GROUTED REINFORCED MASONRY BLOCK WALL OR CONC. COLUMN WITH 1/4° TAPCONS BY 'ELC0' • WITH 1 -3/4" MIN. EMBED AND SPACING OF 10" 0.C. INTO BLOCK WALLY 14' O.C. INTO 3000 PSI CONCRETE. . THE R �O WITH BLOCK 6 BARS EXTENDING I FOOTING AND N IRE BEAMS ALL BARB WALL BE CONTINUOUS FROM TIE 8FAY5 TO PoOHNO. • Engt: OR STRUCTURES I 848003 ETA 3538 AR 0 8 zoos 14 GA GALV. STEEL TRACK . FASTENED 11 //hz0 Txxcx PLATES //8" 13D 113. SLOTTED G.5. 4N 15CK NUT • La 0 La aJ0_ 0 W 0 drawing no. 01 -09 (sheet 3 of 3 • JELD -WET 32 In. x'80 In. RH Fire Rated Steel Door IS NBM - 418548 at The Home De... Page 1 of 2 • • • • • • ••• • • • • •• • NOW larger *t? IBe the tiret to wets it review. Write a review fora chance to win a $250 OIS Card. Leam More. JELD -WEN 32 In. x 80 In. RH Fire Rated Steel Door 1S NBM Modal a 418348 Store SKUC 418548 $199.00 /Each Not Sold Online Sold At Your Loo4 Store Add to My List - Product shown is normally canted et your loco store: availability may very. -Local store prices may very from those displayed. Description Fire rated steel door provides protection to your most valuable possessions Perfect for the passageway between your living quarters and the garage Energy Star rated to save you money Factory primed, ready to paint Backed by a Umited Lifetime Warranty Factory primed. ready to paint Security and protection of a steel door MFG Brand Name : JELD -WEN MFG Model*: 418548 MFG Rart # : 304898HD SpecIUgatlons Door Glass Type : None Door String : RH Framing Type : Pre Hung Jamb Depth : 4.5825 In. Overall Height : 81.75 In. Overall Width : 33.5 In. Type of Door : Fire-Door Reviews • •• radio Warra ty >rakanty information on this product, please call our Internet Customer Service nt r� 1-800- 435 -4654. • • • a.e. •• Review and Rate Products Share your opinion about products youl've purchased with others. Write reviews and rate products on a scale from 1 to 5.15's easy and takes only a few minutes. Review Writing Guidelines: Focus on the product features and your experience with them. Provide details about why you like or dislike the product. Things to avoid: • Obscenities, discriminatory language, or other language not suitable for public forums • Advertisements, "spam" content, or references to other products, offers or Web sites • E -mail addresses, URLs, phone numbers, physical addresses or other forms of contact information • Critical or spiteful comments on other reviews posted on the page or their authors peainawore • Rig • • ;•yr• • ��, �1 @i review the Description tab for any special delivery circumstances and/or exceptions. • • • • • r r . ♦ tEpafrklfi re • • 6 • • • • • • •••• • • http: / /wIO* homedepot.com/webapp /wcs/ stores/ servlet/ProductDisplay ?1angId = -1 &storeId =... 8/7/2009 JEL EN WINDOWS & DOORS FIRE DOORS Overview • • • • • • • • • 00••• Fire ratings are available in most JELD -WEN door product lines. There may be restrictions based on size and regional availability, so please use this sheet as a reference and discuss further with your JELD -WEN supplier. All door slabs must be used with fire -rated door systems for true fire protection. A door system consists of the door slab, frame, hardware and components. ior Doors fart duct ype Custom Wood Doors 20- minutes, 45- minutes, 60- minutes, 90- minutes 1 2f mHlutes, 20- minutes • Fire -rated solid core • 1 -3/4' doors 45- minutes • FyreWerks core • 1 -3/4° doors 60-minutes • FyreWerks core • 1 -3/4° doors 90-minutes 20-mi Available with all -panel doors. • FyreWerks core • 1 -3/4° doors * rirrated solid core • 1 -3/4 doors Fiberglass Doors 20- minutes 20- minutes • Fire -rated solid core • 1 -3/4° doors • Laminated Veneer Lumber (LVL) stiles & rails • LFI- capped top rail and PVC capped stiles and bottom rails 45 mutes 1 60- minutes, 90 minutes 0-minutes • Wood edge - minutes • Steel edge nute 90- minutes • Steel edge teel edge • Door 3126 • Odor3130 • Door 3144 • Door 3182 Available with all -panel doors. Inte Custom Wood Doors .om Carved Doors Molded Doors lush Door 20-minutes, 45- minutes, 60- minutes, 90- minutes 2 u 20- minutes, 45- minutes, 60- minutes 20 tttiiniates, 45 -mina' 60 minutes, 90 -mina 20- minutes • Fire -rated solid core • 1 -3/4° doors 45- minutes • FyreWerks core • 1 -3/4° doors 60- minutes • FyreWerks core • 1 -3/4" doors 90- minutes • FyreWerks core • 1 -3/4° doors 20 minutes • :Fire -rated solid to • 1 -3/4' doors 20- minutes • Wood -based panel core • 1 -3/4° doors Available with all -panel doors. Ava €€able with all raised panel-Tin-Om; 45- minutes • Solid mineral core • 1 -3/4° doors 60-minutes • Solid mineral core • 1 -3/4° doors Wood -based panel core 1 -3/4' doors 20- minutes 45- minutes Available in all models. •r•• • • 0000 Available in all models. ood -based panel core or mine 3/4' doom 0 00• • s • ••• •••• •••••• •••• pd -based panel core or mineral core 14' doors • Solid mineral core • 1 -3/4° doors • • • • • • • 0000 • • •• • • • • • •• •• i •2 JELD -WEN, UEFA -4EN, the JW icon and Reliability for real life are trademarks or registered trademarks of JELD -WEN, inc., Oregon, USA. All other trademarks are the property of their • ressmctiat owners, JELD-WEN reserves the right to change product specifications without notice. Please check our Web site, www.jeld- wen.com, for current information. 10-577 02/09 •••• • •••••• RELIABILITY for real life' IJ MIAMI•DADE. COUNTY BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) Ability Windows Corporation 1390 B. Hammondville Road Pompano Beach, FL 33069 SCOPE: 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/buildingcode 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 "PA -3 " Aluminum Awning Window — N.I. APPROVAL DOCUMENT: Drawing No. ATW -PA3, titled "Series PA -3 Aluminum Awning Window ", sheets 1 through 3 of 3, prepared by Ability Windows Corporation, dated 05/09 /2002, with the latest revision "2 ", dated 07 /01/2007, signed and sealed by Kelvyn A. Whitfield, P. R, bearing the Miami -Dade County Product Control Revision stamp with the Notice of Acceptance number and expiration date by the Miami - Dade County Product Control Division. MISSILE IMPACT RATING: None LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ,tVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed • J7 expisation.date may be displayed in advertising literature. If any portion of the NOA is displayed, then .ii shall be ci 'jots entirety. 'IsP prt `N' :: copy of this entire NOA shall be provided to the user by the manufacturer or its &str1'bu 'an 'all be available for inspection at the job site at the request of the Building Official. � and renews NOA # 01-1129.02 and consists of this page 1 and evidence page E -1, as well • • xe ee Approval cigct mentioned above. e Sa1bt utrc inentation was reviewed by Jaime D. Gascon, P.E. • • .... • • • • NOA No. 07- 0731.10 Expiration Date: July 05, 2012 • Approval Date: December 27, 2007 Page 1 Ability Windows Corporation NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS 1. Manufacturer's die drawings and sections. 2. Drawing No. ATW -PA3, titled "Series PA -3 Aluminum Awning Window ", sheets 1 through 3 of 3, prepared by Ability Windows Corporation, dated 05/09/2002, with the latest revision "2 ", dated 07/01/2007, signed and sealed by Kelvyn A. Whitfield, P. E. B. TESTS 1. Test report 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 Along with installation diagram of an aluminum awning window, prepared by Fenestration Testing laboratory Inc., Test Report No. FTL 3012(01037) dated 04/03/2001, signed and sealed by Luis Figueredo, P. E. (Submitted under NOA# 01- 1129.02) 2. Test report 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 Along with installation diagram of an aluminum awning window, prepared by Fenestration Testing laboratory Inc., Test Report No. F113015(01036) 3015(01036) dated 03/19/2001, signed and sealed by Luis Figueredo, P. E. (Submitted under NOA# 01- 1129.02) C. CALCULATIONS 1. Anchor verification calculations and structural analysis, complying with FBC -2004, prepared by Kelvyn A. Whitfield, P.E. Consulting Engineer, dated 07/01/2007, signed and sealed by Kelvyn A. Whitfield, P.E. Complies with ASTM E1300 -98 D. QUALITY ASSURANCE 1. Miami Dade Building Code Compliance Office (BCCO). E. MATERIAL CERTIFICATIONS ICATIONS 1. None F. STATEMENTS 1. Statement letter of conformance, no financial interest, and compliance dated 07/01/2007, signed and sealed by Kelvyn A. Whitfield, P.E. 2. Statement letter of compliance by Fenestration Testing Laboratory, Inc., dated • • • • 12/05/2001, signed and sealed by Luis Figueredo, P. E. • • • • • • • • • (�`Itbmitted under NOA# 01- 1129.02) • • #'••.OTHER • •' •' 1. : Nofce of Acceptance No. 01- 1129.02, issued to Ability Windows Corporation for •• •• • ••• Nil Series "PA -3 Aluminum Awning Window ", approved on 07/05 /2002 and :. do ring on 07/05/2007. •••• •••• • • • • • • • • ••.•• •••• • • • • • •• • • • • • • • • • •• • • • • • •••• • • •••• E -1 4 Jaime D. Gascon, P.E. Chief, Product Control Division NOA No. 07- 0731.10 Expiration Date: July 05, 2012 Approval Date: December 27, 2007 • • .. • • • • • • • • • • • • • • • • • ... • • • • • • ••• • .. • • • • • • • • • • • TESTED SIZE (FR -30 2) TESTED SIZE (FTL -3015) SERIES PA -3 ALUMINUM AWNING WINDOW TYPICAL ELEVATIONS VIEWED FROM EXTERIOR SCALE 1/2" = 1' -O' COMPARATIVE ANALYSIS CHART we ANNEALED GLASS) NUMBER OF VENTS WINDOW SIZE (INCH) DESIGN LOAD (PSF) NUMBER OF ANCHORS WIDTH HEIGHT POSMVE NEGATIVE HEAD/SILL JAMBS 2 19 1/8 28 +55.3 -80.0 2 2 26 1/2 26 +55.3 -80.0 2 2 37 26 +55.3 -80.0 3 2 531/8 28 +55.3 -55.3 3 2 3 19 1/8 38 3/8 +55.3 -80.0 2 3 28 1/2 38 3/8 +55.3 -80.0 2 3 37 38 3/8 +55.3 -80.0 3 3 53 1/8 38 3/8 +55.3 -55.3 3 3 4 19 1/8 50 5/8 +55.3 -80.0 2 4 26 1/2 50 5/8 +55.3 -80.0 2 4 37 50 5/8 +55.3 -80.0 3 4 53 1/8 50 5/8 +55.3 -55.3 3 4 5 19 1/8 63 +55.3 -80.0 2 4 26 1/2 83 +55.3 -80.0 2 4 37 83 +55.3 -86.0 3 5 53 1/8 63 +55.0 -55.0 3 5 DRAWING INDEX SHEET 1. - GENERAL NOTES. ANCHOR NOTES. TYP. ELEV.. ANCHOR LAYOUT, COMPARATIVE ANALYSIS CHART. SHEET 2. -CROSS SECTIONS AND DETAILS. SHEET 3. -PARTS UST, BILL OF MATERIALS r GENERAL NOTES 1. PRODUCT APPROVAL DRAWINGS ARE BASED ON TEST REPORTS NUMBERS FTL -3012 AND FTL -3015, AS LLJSGjiD YO3RD1NGLY FOR EACH UNIT (SEE ELEVATIONS) 2. DRAWINGS PROVIDE ANCHOR INFORMATION FOR WOOD FRAME. METAL STRUCTURES, AWMINUM MUWONS & STRUCTURAL CONCRETE/CBS CONSTRUCTION. (SEE ANCHOR NOTES BELOW) 3. WINDOW MINIMUM HARDWARE REQUIREMENTS: A. ONE (1) SURFACE MOUNT ROTO OPERATOR, WITH 1.0. No. 1962 202 USA, LOCATED AT LOWER RIGHT FRAIE CORNER. 8. ONE (1) STEEL TORQUE BAR, LOCATED AT FRAME SILL. C. TEN (10) 0.180' BY 0.800' LONG STAINLESS STEEL. PIN. LOCKING INTO AUTOMATIC HOOK LOCK IN NARK= ASSEMBLY, LOCATED AT EACH VENT JAMB RNL, AT 5_3/e FROM BOTTOM. D. TWO (2) ALUMINUM CAST HARNESS ASSEMBLY, ONE AT EACH MME JAMB. 4. WEATHERSTRIPPING REQUIREMENTS: A SINGLE ROW BULB TYPE VINYL WEATHERSTRIP (No. 3- 2003C), AT BOTTOM RAIL VENTS ON THE INTERIOR AND EXTERIOR AND AT PERIMETER OF FRAME ON THE INTERIOR AND FRAME JAMBS ON THE EXTERIOR. B. SINGLE ROW BULB TYPE VINYL WITH FLAP WEATHERSTRIP (No. 3- 2007A), AT FRAME HEAD. 5. GLAZING METHOD: EXTERIOR GLAZED WETH 0.300" GLAZJNG PENETRATION, USING CLEAR COLORED SILICONE AND ALUMINUM ROLL FORMED GLAZING BEAD. 6. ALL FRAME MEMEBERS ARE ALUMINUM ALLOY 6063 -T8 7. MIAMI -DADE COUNTY APPROVED HURRICANE PROTECTION SYSTEM (SHUTTERS) ARE REQUIRED. ANCHOR NOTES 1/4" 0 TAPCON; - INTO 2BY WOOD BUCKS OR WOOD STRUCTURES, 1 -3/8" MIN. PENETRATION. - THRU 18Y WOOD BUCKS INTO CONCRETE OR MASONRY, 1 -1/4' MIN. PENETRA - DIRECTLY INTO CONCRETE OR MASONRY, 1 -1/4' MIN. PENETRATION. i14 SAPS OR SELF DRILLING SCREWS. - INTO METAL STRUCTURES: STEEL 12 GA MIN. (Fy = 36 1451 MIN.) ALUMINUM: 1/8' THICKNESS MIN. (ALLOY 8083 -T5 MIN.) (DISSIMILAR MATERIALS IN CONTACT TO BE GLAVAMZED OR PANTED WITH ANTICORROSIVE PAINT. $10 SMS OR CFI F DRI I IN SORFWC• - INTO MIAMI -DADE COUNTY APPROVED MUWONS (NO SHIM SPACE) EDGE DYSTANCES: - INTO CONCRETE AND MASONRY: 1 -1/4' MINIMUM - INTO METAL STRUCTURES: We MINIMUM - INTO WOOD SUBSTRATE: 5/8' MINIMUM RODUCT REVISED complying with the Ftmide Building Code Accer,t oca No. iL E� � .ate • /lT�'_ 0 A THIS PRODUCT HAS BEEN DESIGNED AND TESTED TO COMPLY WITH THE REQUIREMENTS OF THE FLORIDA BUILDING CODE. 2004 EDR10N FOR THE HIGH VELOCITY HURRICANE ZONE (HMO GLASS CAPACITIES ON THIS SHEET ARE BASED ON AMU E1300 -02 KELVYN WHITFIELD, P.E. MECHANICAL. /STRUCTURAL FL No. 24140 1002 N.E. 118th STREET MIAMI, FL 33181 9 ATW -PA3 r1oFS J • • ••• • • • 4011 SO 00 • • • •• •1 • • • • • • • • • • • • • • 011 • • • • • • 1 • • • • • • ••• • • it • 0110 • • • • • • • • • • • • • •d' • • ■' • • • 11P IN TION TYP. INSTALLATION • • It N INTO METAL STRUCTURES • �$1 . • •. • •a••• li►aw�. • • • • i�. DO 4040 • a • • NO , , X P.T. BUCK TYP. • • 1/4* *MMAX. SHIM �' TYP. ANCHORS 31 410 SPAC(SEE ELEV. FOR �IG) 1YP. ANCHORS (SEE ELEV. FOR SPACING) 8/8'T. -- i1 )VERTICAL SECTION SCALE; HALF SIZE 1/4" SHIM MAX, 1X P.T. WOOD BUCK BY OTHERS, TYP. TYP. ANCHORS (SEE ELEV. FOR SPACING) 1/4• MAX. SHIM 1TP. INSTALLATION INTO MULLIONS TYP. ANCHORS (SEE ELEV. FOR SPACING) (NO SHIM SPACE) 1 1/4* MIN. EMBED. MIAMI -DADE COUNTY APPROVED MULLION ANCHOR �D MULLION NOA. 1YP. INSTALLATION INTO WOOD SUBSTRATE 1X P.T. WOOD BUCK BY OTHERS, TYP. 1/4* SHIM MAX. • WOOD SUBSTRATE 1X OR 2X P.T. WOOD BUCK BY 01HER5, lYP. TYP. ANCHORS (SEE ELEV. FOR SPACING) GLASS DETAU. SCALE: FULL SIZE DADE COUNTY APPROVED HURRICANE PROTECTION ,TmitM ( SHUTTERS) ARE REQUIRED FOR ALL INSTAUATIONS PRODUCT REVISED as comptyingwith the klatch Banding Coax Accept n e No 0 Expi�s a : O. 1lt7�%0�2 Division 1YP. ANCHORS (SEE ELEV. FOR SPACING) TYP. ANCHORS (SEE ELEV. FOR FOR SPACING) TYP. INSTALLATION INTO CONCRETE EXTERIOR FRAME WIDTH FRAMING OPENING 1/4* MAX. SHIM 1BY OR 2BY P.T. WOOD BUCK, BY OTHERS. %21 HORIZONTAL SECTION �� SCALE: HALF SIZE KELVYN WHDFIELD, P.E. MECHANICAL/STRUCTURAL FL 1002 N.E. 116th STREET MIAMI. FL 33181 t 1 0 TYP. INTOISD INSTALLATION • • SOO • • • 0416 •• •S • • • •S •• • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • ••• • • • • ••• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • r-• 1.932' ••• • • • • • • • • 1 • • • • • • • •• • •• • • • •• • • • • • • .• • •• • OI• • • op • • ', ▪ • • m �FF- 1.61#•'"'x'1 3-55 FRAME HEAD FRAME SILL r1-374'1_1-1142. a . —1640.1-n- 3-41D FRAME JAMB 3-23A VENT TOP 3 -24 VENT BOTTOM 3-50 BOTTOM VENT BOTTOM 3 -25 VEM JAMB BILL OF MATERIALS 113 - L i. • ESCRIFEON • WANT11r �I'r^�M!>RTI! • ifs:=-# iRl �P,`� IMMRIIIMMIMMUMINM p• inniaFiENEMEMMVi MI ZIO IM ff►^/ arl • ^ ilRa iSaSi �a�1i1P1��TJ • ►, ;r�ag�1• .:,:L ': 1��ic�� :�:1 i,a.u1 U ALUM. ALUM. VENT JAMB RAIL as BOTTOM VENT VENT INGE 2 PER VENT MnI _____ Fiji;a.i MEIIIEZ=MMErril'ao =EMU, ,, ■Lt--millN MI 11111=11 i!PtL1 rV7 1:71= 'IL aa'a7!, • a':. • L['i-Wt7C,a, ER WINDOW 3 -3041 0 FRI 67 F T• ' •. BUSH NO Faaiwri ... M E M I I M M T R I E NEEMlI:TW T3a_ L F1g:i.ayi 11111EMINIIIAlatattglAllWa ANNEALED r:.a ?►71:7s". IMMENEM Kid /�;75•?gl•7a.1� I IF'�'_'II•>•i�t'T� + a.: • ©�a37,T i,_ 1_ 0 3 -8000 WTf8T1! HOOK TO _ L RIVET muraa4i W711 F":1:1110111111114_ NIFFLICI2111,r7:,'NEPE CSC♦ as p 11;7. `Iri ®mm 7I3s f • ['!`JYci•Ira:7 :g.rt'm CIIIMMIIE1aLMWIW 12l:: -I -a, COVER PLATE . BAR KARIi 2 PER WINDOW PTT ns'.V1SE0 Et1Gti�?R: Cc:u .0 -:; raa a7 -0731. l0 L Pi`ccaa c marut Atumi Division KELVYN WHITFIELD, P.E. MECHANICAL/STRUCTURAL FL .Na. 24140 1002 N.E. 11861 S,tthl MfAK FL 33161 t .8. g 1 g 1 ATW —PA3 8FQEt 3 OF 3 t, ocl -131a 1I14ktr ( JUN 2JR inb Miami Shores Village Lo-'ANmE-, Building Department. �.13��0 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CERTIFICATE OF OCCUPANCY /COMPLETION CHECK LIST ❑ Building permit card. Surveys (2 copies) Final as built - Required Items: Elevations of buildings showing all intended setbacks from property lines and other existing structures. Ingress+ Egress, required parking spaces, Wheel stops, stripping, and all paving to exterior. A;,� Certificate of Elevation — (Sealed by surveyor). Expiration date required on the form. Certificate of Insulation. Certificate of Soil Treatment (Final treatment - original)\ ten l c%tG to e- GC'' 's CHAPTER x'913 -5 TERMITE PROTECTION: "This Building has received a cdmplete treatment for the prevention of subterranean termites. Treatment is in accordance with the rules and lawn as established by the Florida Department of Agriculture and Consumer Services." ealth Department Approval Letter (On septic or private water). Note: If the house is on septic tank, approval letter is required from Health Dpt. Soil Compaction Letter (Density report is required) Final certification letter from the Engineer /Architect (on masonry, trusses, special structure, etc) Backflow preventor certificate (Required on commercial projects only) Certificate of use. (Recorded in Miami -Dade Clerk of Courts) PLEASE NOTE THAT THE SAME ITEMS ARE REQUIRED FOR TEMPORARY CO Emergency CO (Without 24 Hrs Processing) Additional fee is $80.00. Temporary CO (Up to 90 days max) $75.00. Residential CO fee is $150.00 Commercial CO is $200.00 p Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 0,,‘\,5\5 Inspection Number: I NSP- 155228 Permit Number: EL -10 -09 -1617 Scheduled Inspection Date: January 25, 2011 Inspector: Devaney, Michael Owner: LALANNE, ROSE Job Address: 190 NE 91 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Electrical - Residential Inspection Type: Final Work Classification: New Phone Number Parcel Number 1131010190080 Building Department Comments NEW Garage with New electrical Passed 13/ 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- 125980. Not ready. garage receptacles to be G.F.I. protected.All fixtures , devices & appliances to be installed. Arcfault breakers to be installed. January 24, 2011 For Inspections please call: (305)762 -4949 Page 17 of 19 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. F-LQS:1- 161 Master Permit Noi2CL R " 31 Permit Type: Electrical j / I > �p �7 OWNER: Name (Fee Simple Titleholder)): If i L- $ (it N 1- / f4 IV/V Phone#: JCS" `�s� 7 - ?ems/ Address: l [ 0 & (3 1 (.41-4 City: ! a a?d state: J L- Zip: 3S- 0-32i 3 Tenant/Lessee Name: Phone #: U 5 73 ?f C1/ Email: JOB ADDRESS: Igo N- 6 G [ Aa / City: Miami Shores County: Miami Dade Zip: '3 6 3 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: 4 CONTRACTOR: Company Name: 4.4 LLB. / // / Phone #: Address: City: State: Zip: Qualifier Name: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: DAddress �� // ❑Alteration x Description of Work: ❑New ORepair/Replace ❑Demolition :****** * ** x************** * ******* x ****�-- * peees**** �x+ xa: x��x* �xx�: ��x�x�x�xx�x�x�x��xx�x� ****** * * *+x�x�x�x+x+x *�:*** Submittal Fee $ Permit Fee $15 - W CCF $ CO /CC $ Scanning Fee $6 7 - Q Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ `O 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 'c ur: even (7) days after the building permit is issued. In the absence of such posted notice, the inspection will no approve' an' a reinspection fee will be charged. Signature �if/ALizr -- Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 1� The foregoing instrument was acknowledged before me this day of \ Z:3 , 20X6 , by V l 1-192-0 M 11\L day of , 20 _, by who is personally known to me or who has produced l who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: �l 612012 d Sign: Print: - �p� �BV @UBl1C = Print: My Commission Expires: Commission ;'7 My Commission Expires: * * * * * * * * * * * ** NOTARY PUBLIC: APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) M iami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: V/L Sr✓ 4-/4/Y/DATE: /o/ /q /c9 ADDRESS: i q Q Ri (61,(Q h. Ank, P 33138 Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two- family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with - holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and initial each paragraph. 1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner- builder permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. Initial ✓ 1.— 2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial II �— 3. I understand that, as an owner builder, I am the responsible party of record on a permit I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts. Initial (/ L 4. I understand that I may build or improve a one family or two- family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease, which violates the exemption. Initial f / 4- 5. I understand that, as the owner - builder,. I must provide direct, onsite supervision of the construction. Initial Vi-- I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial v 7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner - builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner - builder and am aware of the limits of my insurance coverage for injuries to workers on my property. a Initial V / L 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow these may subject to serious financial risk. Initial V L 9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govem owner - builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. Initial V 10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http: / /www.myforidalicense.com /dbpr /pro /cilb /index.html ,V /Z_ Initial 11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: Initial 1 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I have provided on this disclosure. i j L Initial I/ Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractors workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this l day of LC) ,20 By -Y40 5(3-32LIOwho was personally known to me or who has Produced there Lic-nse or -v 1 tVK as identification. A.A. WNER ,ems 4,/ --:S:03 017 IC u, Commission 9 .' s �• D0765901; - p /U`R1111,11 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR 1 ARCHITECT Permit N. '"Owner's Name (Fee Simple Title Holder): V1 I i Q fil2e, Phone #: ��) 7-57- Owner's Address: f � D A/ � � l � City: 1(1 Yn i nine5 State : F L Zip Code: 3?/? -Job Address (Of where work is being done): City: Miami Shores State: Florida Zip Code: *Contractor's Company Name: 00Yl .e 4 Eur (CI e Phone #: Address: City: State: Zip Code: Qualifier's Name : Lic. Number: Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: Describe Work: 0-VI Ce?/1-- ,4- eiC, 41- OYI I hereby certify that the work has been abandoned andlor the contractorlarchitect is unable or unwilling to complete the contract. I hold the Building Official and the Mu ' Shores harmless for all legal involvement. ) Signature //LA, , Signature owner or Agent Contractor or Architect The foregoing in 'trument was aknowledged before me The foregoing instrument was aknowledged before me this V9\ day of (0 ,20 [Qv V iLA5fZ °`t' this day of , 20 by Who is personally known to me or who has produced who is personally known to me or who has produced as indentification. as indentification. \\`��w,, 111JlIty Notary Public: ,`` . _ ,s ' e‘Ns �. . Sign: � N �C)‘1' % %\tt cc w Seal: '4114414141t IWAWN\\ Notary Public: Sign: Seal: USPS - Track & Confirm P i Page 1 of 1 Home 1 Halo Sian In Track & Confirm Se h Results Label /Receipt Number: 7010 1670 0001 6803 2949 Expected Delivery Date: November 9, 2010 Class: First -Class Mail® Service(s): Certified Malin' Status: Delivered Your item was delivered at 10:27 am on November 09, 2010 in MIAMI, FL 33125. Detailed Results: ■ Delivered, November 09, 2010, 10:27 am, MIAMI, FL 33125 • Acceptance, November 08, 2010, 10:56 am, MIAMI, FL 33153 Opt Track & Conflrm FAQs Enter Label /Receipt Number. Track & Conflrm by email Get current event information or updates for your item sent to you or others by email. Site Mao Customer Servic@ Forms Gov't Services Careers Privacy Policy Terris of Use Business Customer Gateway Copyright© 2010 USPS. All Rights Reserved. No FEAR Act EEO Data FOIA t ;,wl`I`Fa.m 4, t Etomi7A"gi ti Cm' ,W http:// trkcnfiml. smi. usps. com/ PTSlnternetWeb /InterLabelInquiry.do 11/24/2010 7010 1670 0001 6803 2949 U.S. Postal Service,.., CERTIFIED MAIL,. RECEIPT (Domestic Mail Only; No Insurance Coverage Provided) For delivery information visit our website at wwwusps comu MASI Postage Certified Fee Return Receipt Fee (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Postage & Fees $0.4+ :2.80 $0.00 0118 $0.00 $3.24 City. State, Z!P +4 eAtA PS Form '3800. August 2))06 08/201 3 \ � ° m me.e.e? 0c2 W November 17, 2010 Mr. Angel Romero CPS Electric, INC RE: Vilbrun Lalanne — Construction Agreement Property Address: 190 NE 91st Street, Miami Shores, FL Date of Agreement: 07/24/09 To Whom It May Concern Mr. Luciano Fernandez has taken more $33,000.00 out of 35,000.00 from me and has decided to abandon the project. I've tried every route to solve this matter he has refused to work it out. On July 27, 2010, Architect Mark A. Campbell inspected my residence and completed a list of deficiencies describing the work that has not been completed by the Contractors and all of the problems with the project before the project can be considered substantially completed. Included in this list of deficiencies is the following: 1. The plumbing for the connection to the septic tank has not been completed. 2. The west window in the new laundry doesn't close properly. There is some cement in the frame and the handle comes off. 3. The drywall has not been installed on the walls and ceiling with the insulation 4. There is no electrical panel cover, fixtures or outlet covers installed to date 5. The stucco is not completed 6. The painting of the interior and exterior is not completed. 7. The new roof has a leak at the vent stack over the new laundry room. 8. The front door column or work has not completed and the new door has not been selected by the owner for the allowance amount. 9. The drywall repair in the new media room has not been completed. Therefore starting today, I want to inform you that your services are no longer needed for this project Vilb Ian nve, t Oci (D Li. November 17, 2010 Mr. Angel Romero NOV ?4101 BY: .................. To Whom It May Concern Mr. Luciano Fernandez has taken more $33,000.00 out of 35,000.00 from me and has decided to abandon the project. I've tried every route to solve this matter he has refused to work it out. On July 27, 2010, Architect Mark A. Campbell inspected my residence and completed a list of deficiencies describing the work that has not been completed by the Contractors and all of the problems with the project before the project can be considered substantially completed. Included in this list of deficiencies is the following: 1. The plumbing for the connection to the septic tank has not been completed. 2. The west window in the new laundry doesn't dose properly. There is some cement in the frame and the handle comes off. 3. The drywall has not been installed on the walls and ceiling with the insulation 4. There is no electrical panel cover, fixtures or outlet covers installed to date 5. The stucco is not completed 6. The painting of the interior and exterior is not completed. 7. The new roof has a leak at the vent stack over the new laundry room. 8. The front door column or work has not completed and the new door has not been selected by the owner for the allowance amount. 9. The drywall repair in the new media room has not been completed. Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 190 91 Street Miami Shores, FL 33138- 1131010190080 Block: Lot: ROSE LALANNE ROSE LALANNE 190NE91ST MIAMI SHORES FL 33138 -2810 Valuation: Total Sq Feet: Type of Work: ELECTRICAL Additional Info: ADDITION Classification: Residential Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Permit Technology Fee Reinspection Fee Reinspection Fee Scanning Fee Submittal Fee Submittal Reversal Fee Total: Amount $1.80 $0.60 $200.00 $5.00 $0.00 $75.00 $3.00 $50.00 ($50.00) $285.40 Pay Date Invoice # 10/01 /2009 03/25/2010 03/25/2010 Pay Type EL -10-09 -36024 Check #: 3541 Check #: 1093 Cash Amt Paid Amt Due $ 50.00 $ 160.40 $ 160.00 $ 0.40 $ 0.40 $ 0.00 Invoice # EL -3-10 -37430 03/29/2010 Credit Card $ 75.00 $ 0.00 $ 2,100.00 Available Inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Rough Rough Rough Rough W. W. Underground Applicant Copy For Inspections, Call (305) 795 -2204. Requests must be received by 3 pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that may be found in GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT the public records of this county. DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. March 31, 2010 2 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. a- PERMIT APPLICATION Master Permit No. / P l.3 { `7 FBC 20 Permit Type; ELECTRICAL Vi/brvil l �^ Owner's Name (Fee Simple Titleholder) ` a- m K Phone # 36f- - 377 0 Owner's AdSlrps 4 0 ( / City 1U1444., k . State Zip 321 Tenant/Lessee Name Phone # Email - Job Address (where the work is being done) / 01 f' City Miami Shores Village County Miami -Dade Zip 3 3/ 3 FOLIO / PARCEL # / % — 3 / o / -- 01i- 6) a Pa Is Building Historically Designated YES NO e!' Flood Zone Contractor's Company Name CPS Sew~'" " c- -, ,Lyl ( Phone # 30- 96 2-9 7 f ,, Contractor's Address 0 4 t ZJ 1 ' State J L...- Zip 3 3 /d- T 6-C (4 ZI--V Phone # 3e, S g 6a 0, 7 Y 01-. Certificate of Competency No. a 0 0 0/ 723 3 City J2ldWI Qualifier Name State Certificate or Registration No. E %LCD O /1 c7 2, a Contact Phone E -mail Architect/Engineer's Name (if applicable) “A - . a °L Phone # 3413.7 o0 ■ - Value of Work For this Permit $ °- Square / Linear Footage Of Work: _alt., Type of Work: ['Addition DAlteration ew ❑ Repair/Replace ❑ Demolition Describe Work: )1 e t.L> / CO-a- • /t ** ******* *7:** � *** *�x�x *�x********** ****F ****x�x�** ** ***** * *** * *** * * *s* *mix * * ** * * * *** *** 4' U Submittal Fee $ 50. Permit Fee $ � CCF $110' CO /CC $ Notary $ Training/Education Fee $ 00 (GO Technology Fee $ 5 Scanning $ Do Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ 1(00.40 See Reverse side -> Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for El RCTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFN'IDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be ice: roved a reinspection fee will be charged. Signature Y Owner or Agent The foregoing instrument was acknowledged before me this /i day of , 20 C) , by 101( °1 L.�A4✓t who is ersoiiall known to me or who has produced P Y P As identificatyq 1 yd who did take an oath. vitt 4, •`, %.0 twAR .. u. l��,i - Ai., : Sign: NOTARY PUBLIC: Print: ► o ••'L ep OVN�ts ~� vo My Commission Expires: % *'17 •• • * D 6'�.�' �✓ ,; ®s0000pUB c, S*cve, APPROVED BY Signature Contractor The foregoing instrument was acknowledged beforeme this ZZ day of gale , 20 Oi , by who is personally known to me or who has produced as identify tion and who did take an oath. NOTARY P B>�a'!1'ARg0 ,.,gyp • 44 . Oj S 4. i Sign: Print: ;wool 1 y • . Goal" 1ry•° tC My Commistpft.aqfi 1.'111 iCi a i�o p,°seNS ************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 9 2 % 'Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07XRevised 06 /10/2009) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL Owner's Name (Fee Simple Titleholder) 9 � , 4 Phone # Owner's Address ♦ _J ��j► Co�°"L City 1410 Yn i Ores State FL Zip 3/ f 3 X Tenant/Lessee Name Phone # Email G Job Address (where the work is being done) '� 1C)' City Miami Shores Villa. a County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone Contractor's Company Name DLO Y? e 1Q / I k . Phone # 1 9 ) 7 5 7 9 ( Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail Permit No.r 0 " 1 (&- I Master Permit No. 12C. '" 13 )9 Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Square / Linear Footage Of Work: Type of Work: ❑Additi n ❑Alteration ['New El p p air/Re lace ❑ Re Demolition Describe Work: A d c l L Ci ct /Q, (a cz ***************************************pees****** * ** ** ** * ** * * * * * *** * * * * * **** * **** Submittal Fee $ Permit Fee $ 75 CO CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ 3.03 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ "78 • b� See Reverse side -÷ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOIT FRS, 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 occur. seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not approv . a .. a reinspection fee will be charged. Signature Owner or Agent Signature Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 0 ,20 by\I epfzum LALANNR day of Y , 20 , by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: I mo/ e`vev' \�,1� I@/. " Sign: _ 0 : ...../ .. � '�� Sign: • 17\111 /O0112vi Print: My Commission Expires: Print: • = My Commission Expires: sTCommission DQ1659Q1h�Q�� *414.F . • 44Q'�`• **** ********* ****ok*ak $****daeR*ek** k***** *** k******* c** * * * *********** k***** ** k *****ik*************** kak**$yF*.k***** APPLICATION APPROVED BY Plans Examiner Engineer (Revised 07/10/07) Zoning Clerk checked Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 // OWNER BUILDER DISCLOSURE STATEMENT NAME: �/ 1 1 iI D f U n Lola n Yi 2 , DATE: /0 /9 / ADDRESS: 110 AI E 91 E L 3 3 f 3 Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two- family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with - holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and initial each paragraph. 1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner - builder permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. 2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. 3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license ambers on permits and contracts. Initial 4. I understand that I may build or improve a one family or two- family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or, ubstantially improved it for sale or lease, which violates the exemption. ' Initial 5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction. 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial 7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner- builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully a as an owner - builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not censes to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compen ation for the employee. I understand that my failure to follow these may subject to serious financial risk. Initial 9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govem owner - builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. 10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http : / /www.mytloridalicense.com /dbor /pro /cilb /index.html Initial 11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: Initial 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the informati have provided on this disclosure. Initial Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractors workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. tt'�• Was acknowledged before me this 1 day of i v , 20 O By \J I LLLoNJ LALANK3C, who was personally known to me or who has Produ there Li - se 'r as identification. OWNER NOTARY ' - 03/06/2012 `: N ��m�R spUBl1C �'•. pp� one . /1".//: • 85901,. •'' F F1.Q�,0`. 1Fi !If{%%N' Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR 1 ARCHITECT Permit N. �� Owner's Name (Fee Sim le Title Holder): V / I -UV/ ;;Z-'4"e -- Phone #: Owner's Address: l 0 N, 6 q l & City: `i- .= ��,�t State : Zip Code: . Job Address (Of where work is being done): f 9 0 r- £ i (s --4-u-4- City: Miami Shores State: Florida Zip Code: ' 3 / 3V Contractor's Company Name: V (-- 6 I--1 --z h-tWV one #: 3D c -7 S7- "ale Address: /9 0 A), 6 1 i V1u City: �.: wu� State: (Z Zip Code: 3 ? / 3`.g Qualifier's Name : Lic. Number: Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: Describe Work: (A d 4,1-6ye, cal414 I hereby certify that the work has been abandoned and/or the contractorlarchitect is unable or unwilling to complete the contract. I hold the Building Official and the MI Shores harmless for all legal involvement. Signature./ Al, , j 1,/► Signature owner or Agent Contractor or Architect The foregoing ins ment was aknowledged before me The foregoing instrument was aknowledged before me this ti day of IL) ,2d -(by \I ) t—A4-1"Ahis day of , 20 by Who is personally known to me or who has produced who is personally known to me or who has produced as indentification. as indentification. ``\\ \\1\1111111111/ Notary Public: \ens Si Sign: — — I Seal: NOTARY PUBLIC Commission # DD765901..' �/Ir11111111\\ \\ Notary Public: Sign: Seal: USPS'- Track & Confirm Page 1 of 1 Home Bela 1 Sian In Track & Confirm Search Results Label /Receipt Number: 7010 1670 0001 6803 2932 Expected Delivery Date: November 9, 2010 Class: First -Class Mail® Service(s): Certified Mail'" Status: Delivered Your item was delivered at 2:40 pm on November 09, 2010 in MIAMI, FL 33184. Detailed Results: • Delivered, November 09, 2010, 2:40 pm, MIAMI, FL 33184 ® Arrival at Unit, November 09, 2010, 6:13 am, MIAMI, FL 33184 . Acceptance, November 08, 2010, 10:55 am, MIAMI, FL 33153 Qpti Track & Confirm FAQs Tr Track & Conflrm by email Get current event information or updates for your item sent to you or others by email. Site Mao Customer She Forms Gov't $ervices Careers privacy Policy Terms of Use Business Customer Gateway Copyright@ 2010 USPS. All Rights Reserved. No FEAR Act EEO Data FOIA 61, 4. &5orob http:// trkcnfrml. smi. usps. com/ PTSlnternetWeb /InterLabellnquiry.do 11/24/2010 U.S. Postal Service rrs CERTIFIED MAILTr, RECEIPT (Domestic. Mail, Only; No insurance Coverage Provided) For delivery information visit our webstte at www.usps.comB Postage + $ Certified Fee Retum Receipt Fee (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Postage & Fees $0.44 $2.80 $0.tt $0.00. $3.24 0118 1108 Here ,PS Form 3800 August 2006 °•r November 07, 2010 To Mr. Michael Gomez Viking A/C NOV MVYMM)fil 2 2010 gll BY: MCO —KOZCO Mr. Luciano Fernandez has taken more $33,000.00 from me and has decided to abandon the project. I've tried every route to solve this matter he has refused to work it out. On July 27, 20,10, Architect Mark A. Campbell inspected my residence and completed a list of deficiencies describing the work that has not been completed by the Contractors and all of the problems with the project before the project can be considered substantially completed. Included in this list of deficiencies is the following: 1. The plumbing for the connection to the septic tank has not been completed. 2. The west window in the new laundry doesn't close properly. There is some cement in the frame and the handle comes off. 3. The drywall has not been installed on the walls and ceiling with the insulation 4. There is no electrical panel cover, fixtures or outlet covers installed to date 5. The stucco is not completed 6. The painting of the interior and exterior is not completed. 7. The new roof has a leak at the vent stack over the new laundry room. 8. The front door column or work has not completed and the new door has not been selected by the owner for the allowance amount. 9. The drywall repair in the new media room has not been completed. BUILDING PERMIT APPLICATION Master Permit No. 0 /3/ FBC 2004 Permit Type (circle): iartg 10 6 Cfferi%) 1 c.4 -L'. Owner's Name (Fee Simple Titleholder) Vi (e. t Phone # r -LP-7 0 Owner's Address p% 0 NIS al l 5 T City /444 SL'i? .f State f-/ Zip TS / 3? Tenant/Lessee Name Phone # Miami Shores Village OknaniCaC Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. k" t 0 01 - I (p2)0 Job Address (where the work is being done) l ' 0 WS 'T / 5 City Miami Shores Village County Miami -Dade Zip 37 1 317 FOLIO / PARCEL # 1 1 31 o t -- ®1 -° 0 (jJ o Is Building Historically Designated YES NO Contractor's Company Name V1 141 Jed 14 / C._ Contractor's Address 1 s Phone # h 3a S ' as 9 • q ci 4 Q--- City NW R. ` State F L ,. Zip 3318 "I Qualifier Name M l h0 .€ Phone # 7& 41,88 831 State Certificate or Registration No. C1.0 -4 f5 f 4751-1 Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ 41.0a Square / Linear Footage Of Work: Type of Work: []Addition ['Alteration ta6js'w Cl Repair/Replace ❑ Demolition Describe Work: 1 /VC- ro,f ** * * *** * ***** *** ****** * * *** ***** * F * *a * * * * * *** * **** *** * * * ** * * * * * * * *** * * ** Submittal Fee $ Permit Fee $ tol CCF $ 'O•{ Qt,! CO /CC Notary $ Training/Education Fee $ Technology Fee $ 5-13- Scanning $ 3 Radon $ t. CIS DPBR $ 1.9 S Zoning $ Bond $ Code Enforcement $ Double Fee $ ' I Structural Review. $ Total Fee Now Due $ id `-'F See Reverse side -* Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOII.F,RS, 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 n the absence such posted notice, the inspection will not be approved . a reinspection fee will be charged. Owner or Agent The foregoing instrument was acknowled ed befo e me this 2.r The foregoing instrument was a day of ,20 0 /, by V'i , day of ' ii 1 , 20 Oct, b who is Signature ntractor owledged bgfore me this who is personally known to me or who has produced As identifiecct�ip;i�w; o did take an oath. NOTARY PUBLIC: •° o E 441 ''1 ve,� • U,�.•• .. t SI ... o me or who h produced as identification and who did take an oath. NOTARY PUBLIC: Sign: O Sign n - ie F iCqN qE Print: Pri • cocc f A ' ▪ Ow� ' My Commission Expires: °.* • G.R ¢ 0.11:•: •e(s" My APPLICATION APPROVED BY: (Revised 07/10/07) 1 te�i! v rte' ria. 3Vii" � * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning AGAMI-DADE COUNTY TAX COLLECTOR 140W. FLAGLER $T, zith FLOOR MIAMI, FL 33130 2008 LOCAL. OU MIAMI-DADE COUNTY EXPIRES SEPT.. MUST Oe'DISALANVOAM PL PURSUANT TO COURrit THIS IS NOT A BILL-DO NOT PAY 613636-0 RENEWAL BUSINESS NAME / LOCATION RECEIPT NO. 591848- 8 VIKING CONSTRUCTION GROUP LLC STATE* CAC1814757 12250 SW 2 ST 33184 UNIN DADE COUNTY FIRST-CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 -; OWNER VIKING CONSTRUCTION GROUP LLC Sec. tlifPlEjt6ilrligCHANICAL CONTRACTOR HtS i9 ONLY A LOCAL USINESS TAX RECEIPT. IT OES NOT PERMIT THE OLDER TO VIOLATE ANY XISTING OR REGULATORY R ZONING LAWS OF THE OUNTY OR CITIES. NOR OES IT EXEMPT THE OLDER FROM ANY OTHER ERMIT OR RECEIPT EQUIRED BY LAblf.THIS IS OT A CERTIFICATION OF iE HOLDER'S OUALIFICA- ON. WMENT RECEIVED IANII.DADE COUNTY TAX DI.LECTOR: 12/31/2008 09010076001 000090.00 SEE OTHER SIDE WORKER/S 1 DO NOT FORWARD VIKING CONSTRUCTION GROUP LLC MICHAEL GOMEZ PRES 12250 SW 2 ST MIAMI FL 33184 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 GOMEZ, MICHAEL VIKING CONSTRUCTION GROUP LLC 14975 SW 48TH TER, APT G MIAMI FL 33185-4456 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 mirw.myfloridalicense.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 (850) 487-1395 STATE OF FLORIDA AC# 40621149 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CAC1814757 10/01/08 088052481 CERTIFIED AIR CORD CONTR GOMEZ, MICHAEL VIKING CONSTRUCTION GROUP LLC IB OERTirIED undor tho provisions of ch.489 lopiratiost date: AUG 31, 2010 L08100101320 06214.9. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ# 1,08100101320 , . DATE BATCH NUMBER .. LICENSE NBR 10/01/2000 0880E2481 CAC1814751 The CLASS A AIR CONDITIONING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2010 GOMEZ, MICHAEL VIKING CONSTRUCTION GROUP LLC 12250 SW 2ND STREET MIAMI FL 33184 CHARLIE CRIST GOVERNOR DISPLAY-AS REQUIRED BY LAW CHARLES W. DRAGO SECRETARY SIN STATE OF FLORIDA FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION .tits certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. 06 -18 -2009 EFFECTIVE DATE: PERSON: FEIN: 06/18/2009 EXPIRATION DATE: 06/18/2011 GOMEZ 743214882 BUSINESS NAME AND ADDRESS: VIKING CONSTRUCTION GROUP LLC 12250 SW 2ND ST MIAMI FL 33184 -1502 MICHAEL SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED AC CONTRACTOR 2- CERTIFIED RESIDENTIAL CONTRACT i #PNF NT Pursuant to Chapter 440. 05(14), U.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this =ert on may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05 {12), F.S., Certificates of election to be exempt... apply only within the ,cons at the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05113), F.S., Notices of election to be exempt and certificates of 9iectinn to be exempt shall be subject to revocation it, at any time alter the • filing 01 the notice or the issuance of the certificate, the person named on the notice er certificate no longer meets the requirements of this section tor issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate tv meet the requirements of this section. DWG- 252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 SINK CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * QUESTIONS? (850) 413-1609 06 -26 -2009 CONSTRUCTION INDUSTRY EXEMPTION ih;s certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: PERSON: FEIN: 06/26/2009 EXPIRATION DATE: 06/26/2011 GOMEZ MARCOS 743214882 BUSINESS NAME AND ADDRESS: VIKING CONSTRUCTION GROUP LLC 1'2250 SW 2N0 ST MIAMI. FL 33184 SCOPES OF BUSINESS OR TRADE: CERTIFIED AC CONTRACTOR 2- CERTIFIED RESIDENTIAL CONTRACT * tn.c.tnTANT: Pursuant to Chapter 440 . 05(14), F.S., an officer of a corporation who elects exemption from this chapter by tiling a certificate of election under this ctwa may net recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the .,soott et the business or trade fisted on the notice of election to be exempt. Pursuant to Chapter 440.05113), F.S., Notices of election to be exempt and certificates of Oen to be exempt shall be subject to revocation if, at any time after the tiling of the notice or the issuance of the certificate, the person named on the notice or aeui €kale nu 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 csmed so the certificate to meet the requirements of this section. QUESTIONS? (850) 413-1609 ro- .-. ...v.nw, TON MI- r.rra ant nr4nrrn nn n• Policy Number: 081354 Date Entered: 2/19/2009 CERTIFICATE OF LIABILITY INSURANCE DATE (AM/DD/YYTY) 2/19/2009 I-T-ler.,UCER FLORIDA BANKERS INSURANCE 81.7 SW 122 AVE MIAMI, FL 33184 F-Tone (305)225-1243 Fax. (305) 225-5053 VIKING CONSTRUCTION GROUP LLC 12250 SW 2 ST MIAMI, FL 33184 THIS CERTIFICATE IS 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 THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A:AMERICAN VEHICLE INSURANCE INSURER 13' INSURER C: INSURER D. INSURER E: NAIC # COVERAGES fl-ET 1 POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 'NY 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 .at_iCE-s AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS IR A0D`L. .INS.RD TYPE F INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (IINVDD/YYTY) POUCY EXPIRATION DATE IMMIDDITYYTI . _.. OMITS ENERAL LIABILITY 1 A COMMERCIAL GENERAL LIABILITY , I CLAIMS MADE I -I OCCUR • , . . ; 081354 12/2/2008 12/2/2009 EACH OCCURRENCE $100,000 $100,000 DAMAGE 115 RENTE D PREMISES (Ea onourrence) MED EXP (Any one person) 5,000 $ PERSONAL & ADV INJURY 1 $ 1 0 0 , 0 0 0 $ 200 , 000 $ 100,000 GENERAL AGGREGATE PRODUCTS - COMP/OP AGG . . GENT AGGREGATE LIMIT APPLIES PER • • [ PRO- I 1 • . POLICY 1 JECT ' 1 LOC ' . AUTOMOBILE LIABILITY ANY AUTO .• • ALL OWNED AUTOS ,• . I SCHEDULED AUTOS ; HIRED AUTOS • • I ' , I NON-OWNED AUTOS ; • - i - -,-- COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) _ GARAGE LIABILITY ANY AUTO . - ----, I • AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS/ UMBRELLA UABIUTY ' 1 OCCUR ! I CLAIMS MADE • . , . : DEDUCTIBLE I - ! RETENTION EACH OCCURRENCE $ AGGREGATE $ $• $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y t N WC STATU- 1 1 OTH- TORY LIMITS i L ER E.L. EACH ACCIDENT $ i IY PROPRIETOR/PARTNER/EXECUTIVE :-.IiT1t,',ER1MEIVIBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ (Mandatory M NH) v.-vs,:msmtemicim I ; SI-,ECIAI. PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER ;H i)ESCRtPTION OF OPERATIONS/ LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS iAC CONTRACTOR CERTIFICATE HOLDER CANCELLATION CITY OF DORAL ACORD 5 (2009/01) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL3 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBUGATION OR LIABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 0 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Forrns Boss Plus software. vvww.ForrnsBosscom; Impressive Publishing 800-208-1977 Policy Number: GL- 0510030347 -00 Date Entered: 8/20/2009 CERTIFICATE OF LIABILITY INSURANCE DATE (MMJDD/YYYY) 8/20/2009 `PRODUCER FLORIDA BANKERS INSURANCE 817 SW 122 AVE MIAMI, FL 33184 Phone. (305) 225 -1243 Fax: (305) 225 -5053 1 E° VIKING CONSTRUCTION GROUP LLC MR MARCOS GOMEZ 12250 SW 2 ST MIAMI, FL 33184 THIS CERTIFICATE 1S 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 THE POLICIES BELOW. INSURERS. AFFORDING COVERAGE NSURERA:AMERICAN VEHICLE INSURANCE INSURER B' INSURER C. INSURER D INSURER E. NAIC # OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE POLiCiES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. t ADDI POLICY NUMBER a; S YSRD TYPE OF INSURANCE _. __- ATE( RAM /DDCTfYYYY1� DATE, THE POLICY PERIOD INDICATED. NOTWITHSTANDING TO WHICH THIS CERTIFICATE MAY BE ISSUED OR TERMS, EXCLUSIONS AND CONDITIONS OF SUCH �._ LIMITS - EACH OCCURRENCE s 1 , 000 , 000 DAMAGE TO RENTED $ 1 000 000 PREMISES (Ea occurrence) , r MED EXP Any one person) $5,000 PERSONAL & ADV INJURY $100,000 GENERAL AGGREGATE $1,000,000 PRODUCTS - COMP /OP AGG $ 1 , 000 , 000 tl GENERAL LIABILITY • COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER' POUCY PRO- JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS LURED AUTOS NON-OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ $ GARAGE LIABILITY ANY AUTO I AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY AGG S $ $ EXCESS t UMBRELLA LIABILITY EACH OCCURRENCE - AGGREGATE _ $ $ $ $ I OCCUR E 4 CLAIMS MADE DEDUCTIBLE RETENTION 8 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y f N WC STATU- OTH- TORY LIMITS. ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE:' $ - E.L. DISEASE - POLICY LIMIT $ h riy PROPRIETOR /PARTNER /EXECUTIVE � %Fr�CER;MEMBER EXCLUDED', (Mandatory in NH) if ,.as descnna antler Ar'ECAL PROVISIONS below OTHER i DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CITY OF MIAMI BEACH 1700 CONVENTION CENTER DR MIAMI BEACH FL 33139 ACORD 25 (2009/01) SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAILS DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED B FAILURE 0 DO SO SHALL IMPOSE NO OBLIGATION OR UABIUTY 0 ' NY KIND UPON.' INSURE ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 0 1988 -2009 ACORD The ACORD name and logo are registered marks of ACORD ng Forms Boss Pius software. www.FormsBoss.com: Impressive Publishing 800 - 208 -1977 RATION. All rights reserved. Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Parcel Number Expiration: 10/17 /2010 Applicant 190 NE 91 Street Miami Shores, FL 33138- 1131010190080 Block: Lot: VILBRUN LALANNE Owner Information Address Phone Cell VILBRUN LALANNE 190 NE 91 Street MIAMI SHORES FL 33138 -2810 Contractor(s) Viking Construction Group, LLC Phone Cell Phone Valuation: Total Sq Feet: Tons: Additional Info: A/C INSTALLATION &DUCT WORK Classification: Residential Approved: In Review Comments: Date Denied: Date Approved:: In Review Type of Work: MECHANICAL Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Permit Technology Fee Radon Surcharge Scanning Fee Submittal Fee Submittal Reversal Fee Total: Amount $0.60 $1.95 $0.20 $150.00 $3.75 $1.95 $3.00 $50.00 ($50.00) $161.45 Pay Date Pay Type Invoice # MC -10 -09 -36068 10/02/2009 Check #: 3542 $ 50.00 $ 111.45 04/20/2010 Check #: 1612 $ 111.45 $ 0.00 Amt Paid Amt Due Available Inspections: Inspection Type: Final In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy April 20, 2010 April 20, 2010 Date 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Expiration: 10 /17/2010 Applicant 190 NE 91 Street Miami Shores, FL 33138- 1131010190080 Block: Lot: VILBRUN LALANNE Owner Information VILBRUN LALANNE Address 190 NE 91 Street MIAMI SHORES FL 33138 -2810 Contractor(s) Viking Construction Group, LLC Phone Cell Phone Phone Cell Valuation: Total Sq Feet: NSOMMOsismalfg $ 400.00 390 Tons: Additional Info: A/C INSTALLATION &DUCT WORK Classification: Residential Approved: In Review Comments: Date Denied: Date Approved: : In Review Type of Work: MECHANICAL Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Permit Technology Fee Radon Surcharge Scanning Fee Submittal Fee Submittal Reversal Fee Total: Amount $0.60 $1.95 $0.20 $150.00 $3.75 $1.95 $3.00 $50.00 ($50.00) $161.45 Pay Date Pay Type Invoice # MC -10 -09 -36068 10/02/2009 Check #: 3542 04/20/2010 Check #: 1612 Amt Paid Amt Due $ 50.00 $ 111.45 $ 111.45 $ 0.00 Available Inspections: Inspection Type: Final Applicant Copy For Inspections, Call (305) 795 -2204. Requests must be received by 3 pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that may be found in GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT the public records of this county. DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. April 20, 2010 2 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 190 91 Street Miami Shores, FL 33138- Owner Information Parcel Number Applicant VILBRUN LALANNE Address 1131010190080 Block: Lot: 190 91 Street MIAMI SHORES FL 33138 -2810 VILBRUN LALANNE Phone Cell Contractor(s) AA1 Contractors Inc. Phone Cell Phone Valuation: Total Sq Feet: $ 1,500.00 Type of Work: Re Roof Additional Info: FLAT ROOF Classification: Residential Fees Due Amount CCF $1.20 Education Surcharge $0.40 Permit Fee - New Roof $250.00 Permit Technology Fee $0.00 Scanning Fee $9.00 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Technology Fee $1.60 Total: $262.20 Invoice # Total Amt Paid Amt Due RF- 10- 09- 36067 $ 262.20 $ 212.20 RF -10-09 -36067 $ 262.20 $ 262.20 Check #: 3540 $ 0.00 For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Tin Cap Final Roof Roof Review Roof in Progress Renailing Affidavit 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 ttie work stated. Authorized Signature: Owner Applicant / Building Department Copy Contractor / Agent January 20, 2010 Date January 20, 2010 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: -Meeltattieal 1 00600 Owner's Name (Fee Simple Titleholder) Owner's Address Igo N . City tt t liav'% t J State Tenant/Lessee Name E -MAIL: Permit No. R F' f0" 01- I (pZS Master Permit No. �o5 -- _-� tC- B`U°i-i3161 Phone # 30A-: 733. 2,7b Zip 31'& Phone # Job Address (where the work is being done) l R® 1 , / S'rL City Miami Shores Village County Miami -Dade Zip 5 7i 7? FOLIO / PARCEL # If '3)0)-- ! 421— 0 O� Is Building Historically Designated YES NO 1/--- Contractor's Company Name 4/- + + (.eg3 ( ,�C Phone # 30S- c��G 06 73 Contractor's Address �, w / 33 c r City 1"41Lv+.t State , Zip 331 Sc4 Qualifier Name W ti bed-- C.�C� Phone # -30S- 5q(0 O?, 7 3 State Certificate or Registration No. C.0 C i 3, ,$(o 16-7 E -MAIL: A'd Com e , 6 yqkeat. . C‘2'u,' Architect/Engineer's Name (if applicable) Certificate of Competency No. Value of Work For this Permit $ 000 491) Phone # Square / Linear Footage Of Work: 3 3 0 Type of Work: ['Addition ['Alteration New Describe Work: ,(J. , e ve'ed- ❑ . Repair /Replace ❑ Demolition ************oY s: ******* ************"*** ** Fees**M***''' f, YaYxxxxx ,Ya4xx*,Yxx***.°e**** **** ****,e,Yxe* Submittal Fee $'� Notary $ Scanning $ R• 00 Permit Fee $ CCF I.2C C.A{EE-� S° Training /Education Fee $ 0 40 Technology Fee $ 1. (07 Radon $ Bond $ Code Enforcement $ DPBR $ Zoning $ Double Fee $ Structural Review. $ Total Fee Now Due See Reverse side —+ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City 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. 1 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: 1 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 com e t must be posted at the job site for the first inspection ich occu _ s n (7) days after the building permit is iss c uch posted notice, the inspection will not be ' !ved a d ' spection fee will be charged Signature A .Las-,. Al Owner or Agent The foregoing instrument was ack� edged bef�� this day of , 200'1 , by 1� /jt►�"✓►� nn ' who is personally known to me or who has produced 0, L As identification and who did take an oath. nnt NOTARY PUBLIC: ��Qoitd •fit n Sign: •'— ez .�....-- Print: • % n cs, :.. My Commission Expire0°'1• `® ®UH ® CtL ' ` My C xx**** xx*de*********** *s *wwv* o�k 'ba4xxxxx:Yx ****wx9: xxx xx*xx &xxx*** sosouilsw- Signature Cs ntractor The foregoing instrument was acknowledged before me this 90( day of ` �e:.._ , , 20‘.., by who i to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: APPLICATION APPROVED BY: (Revised.02/08 /06) **Ic xxaYuo:****xx9:xxxxaY x &a:******** Plans Examiner Engineer Zoning titutoOlkOacd R >:.744. Z/Vy a 1 AL r_, 7r . _1..'3.. .Z tc�.�""ai^ •�F��Y•'k' -.T :TZ�.SCZS._.W. x�i_�.�?'�L`ct4. SEE OTHER SIDE GO NOT FORWARD AAI. CONTRACTORS INC WILBERT ©OMEZ PRES 245 SW 133 CT MIAMI FL 33184 27 00Z/0E/3 1 N Q, DO NOT FORWARD AAI CONTRACTORS I NC WILBERT BOMEZ PRES p 245 SW 133 CT MIAMI FL 33184 m „tl��,ll „s�lll}.1 ►sl�tj „�II� nulltl,l, ►a,d d a Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 REQUIREMENTS FOR ROOF PERMIT Permit application must be accompanied by: r 2r17„rV. BLDG _ SUBJECT TO C'' STATE AND C' r PERMIT APPLICATION (SIGNED AND NOT ARIZED BY BOTH OWNER AND CONTRACTOR) ❑ 2 COPIES OF THIS PACKAGE ❑ 2 COPIES OF ALL PRODUCT APPROVALS ❑ SUBMITTAL FEE ❑ NOC (RECORDED AT TIME OF PICKING UP PERMIT) • • • . • • • • .• • • • ••• • • • •••• ,, • • • • • • • • • • • ••• •• •.• • • • • • • • • •' • • • •• • • • • s:, •. • • • • • • • • • • .00 • • • • • • • • •• •• '• • • 000 • • • •• •• • • Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 AFFIDAVIT OF COMPLIANCE WITH ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE -BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PURSUANT TO SECTION 553.844 F.S. To: Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores, Fl 33138 Re: Owner's Name: Property Address: Roofing Permit Number: Date: Dear Building Official: certify t t I have improved the roof to wall connections of the referenced property as required by the Manual of Hurricane Miti• :tion Retrofits for Existing Site -Built Single Family Residential Structures as adopted by the Florida Building Come ission by Rule 9B -3.047 F.A.C. Signature State of Florida County of Dade Print Name The undersigned, being the first duly sworn, deposes and says that he/she is the owner for the above property mentioned. Swom to and subscribed before this day of . • • ..20 •• ••• : ; • • • • Notary Public, Sate of Florida at Large • • • • • (SEAL) Revised on 5/21/2009 . ••• •. •• •• • • • • • •••• • • •••• • • • • •••• • • •• • .•.. • • • • • • • • • ••• • • • • • • • • •.. • • •• • • . • • • • • •• • • • • ••• • • • • • • • • • • • • • •• •• ••• • • FINAL COMPLIANCE To: Re: Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNERS'S AFFIDAVIT OF EXEMPTION ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE - BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PERSUANT TO SECTION 553.844 F.S. Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores, Fl 33138 Owner's Name: o 5-e.. _ 4 Property Address: Roofing Permit Number: Dear Building Official: Date: 1 - — Iry AI & 91 5' (4/ Ate ne - iG )-s certify that I am not required to retrofit the roof to wall connections of my building because: v-The just valuation for the structure for purpose of ad valorem taxation is Tess than $300,000.00. Please attach proof of ad valorem taxation. o The building was constructed in compliance with the provisions of the Florida Building Code (FBC) or with the provisions of 1994 edition of the South Florida Building Code (1994 SFBC) Signature ytiist$titeroa Ia tI UEs ire 4441,,NA, ei 47,E .0 1Q � State f Florida ''' �`� c.P.IZ The undersigned, being the first duly s°iaryi, and says tat he /ghztitree Dv t aeo orl a e ®�,�� ;��, County of Dade '` 64-/Cc-e--//4 c— Print Name °i P d'„ a •• ••• • • • • • •• • • Sworn to and subscribed before me this Notary Public, Sate of Florida at Large the above property mentioned �p darof "• ?• %k • ,7,,Q /U • • When the just valuation of the structure for purpose of ad valorem taxation is equal to or more than $300,000.00 and thg buildigg was not constructed with FBC nor a 1994 SFBC. Then you must provide a building application from a General Contractor for theitof t Wall c$nnnr 1 n Aricane Mit galion. • •• • •• • ••' .• •• • •• • ••• • Revised on 5/21/2009 SECTION R4402.13 HIGH VELOCITY HURRICANE ZONES — REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 84402.13.1 Scope. As it pertains to the section, it is the responsibility of roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of the section. The provisions of Section R4402 govem the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner ant the contractor. The owner's initial in the designated space indicates that the item has been explained. 1. __ Aesthetics-Workmanship: the workmanship provisions of Section R4402 are for the purpose of providing that the roof system meets the wind resistance and water instruction performance standards. Aesthetics (appearance) are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. 2. Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Section R4403. (The roof deck is usually concealed prior to removing the existing roof system). 3. Common roofs: Common roofs are those which have no visible delineation between neighboring units (Le., townhouses, condominiums, etc.) In buildings with common roofs, the roofing contractor and /or owner should notify the occupants of adjacent units of roofing to be performed. 4. dam-- Exposed Ceiling: Exposed, open beam ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance; therefore, roofing nail penetration of the underside of the decking may not be acceptable. This provides the option of maintaining the appearance. 5.Ponding water: The current roof system and /or deck of the building may not drain well and may cause water to pond (accumulate) in low -lying areas of the roof. Pounding can be an indication of structural distress and may require the review of a professional structural engineer. Pounding may shorten the life expectancy and performance of the new roofing system. Pounding conditions may not be evident until the original roofing system is removed. Pounding conditions should be corrected. 6. Vt— Overflow scuppers (wall outlets): It is required that rainwater flows off so that the roof is not overloaded from a buildup of water. Perimeter /edge wall or other roof extension may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance with the requirements of Sections R4402, R4403 and R4413. 7. Ventilation: Most roof structures should have sortie ability to.veit natJral airflow through the interior of the structure assembly (the building itself) :The exttir1gan3ot ntof Attic ventilation shall not be reduced. It may be beneficial to consider additional �erdingln�hilh ian resit ii sanding the service life of the roof. Owner /A nt's Signature ` Date Revised on 7/9/2009 LD • •• • • • • •• Cor:traolorSigpe rr•: • • • •• •• • • Date ••• • • .••• ••• • • • • • • • • • • OOOOO • • • • •• •• • • • • ROOF ASSEMBLIES AND ROOFTOP STRUCTURES SECTION 4402.14 HIGH- VELOCITY HURRICANE ZONES UNIFORM PERMIT APPLICATION Florida Building Code Edition 2007 High - Velocity Hurricane Zone Uniform Permit Application Form. INSTRUCTION PAGE COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING PERMIT APPLICATION FORM AND ATTACH THE REQUIRED DOCUMENTS AS NOTED BELOW: Roof System Required Sections of the Permit Application Form Attachments Required See List Below Low Slope Application A,B,C 1,2,3,4,5,6,7 4,5,6,7 Prescriptive BUR -RAS 150 A,B,C Asphaltic Shingles A,B,D 1,2,4,5,6,7 1,2,3,4,5,6,7 Concrete or Clay Tile A,B,D,E Metal Roofs A,B,D 1,2,3,4,5,6,7 1,2,4,5,6,7 1,2,3,4,5,6,7 Wood Shingles and Shakes A,B,D Other As Applicable ATTACHMENTS REQUIRED: 1. Fire Directory Listing Page 2. From Product Approval: Front Page Specific System Description Specific System Limitations General Limitations Applicable Detail Drawings 3. Design Calculations per Chapter 16, or If Appliablg, FAS927 or RAS 128 •• •••: : • ••• • • = 4. Other Component of Product Approvat • .. • • • • • 5. Municipal Permit Application 6. • • -••• ••• Owners Notification for Roofsnc4 Co2sideretien (gerooi3ngiD;Iy) 7. . •• • • • Any Required Roof Testing /Ca+culation Documentation • FLORIDA BUILDING CODE — BUILDING ••• • • • • • • • • • • • • •• •• • • • • ••• • • • • • ••• • • • • • • • • • • • • • •• •• • ••• • ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 High - Velocity Hurricane Zone Uniform Permit Application Form. Section A. (General information) Master Permit No. -}/'� C �j ' O Ct 3 rr) -1 Process No. Contractor's Name l' /a 4 CAW 1--r 0. C •Lc 1®y C • Job Address 1 °I 0 /Lf E- of t `64- 33 t 3'e3 tow Slope ❑ Mechanically Fastened Tile ❑ Mortar /Adhesive Set Tile ❑ Asphaltic ❑ Metal Panel /Shingles ❑ Wood Shingles /Shakes Shingles ❑ Prescriptive BUR -RAS 150 ROOF TYPE ;,21--New Roof ❑ Reroofing ❑ Recovering ❑ Repair ID Maintenance ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Section R (Rnnf Plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. Include dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and location of parapets. Total (SF) 42S C.) / 0 i J •• • •• • • • • T• • .. i • • • • • • • • -• • • • • • • • • • • - • • • •• • • • • • ••• • • • • • • • • • • •• • ••• • • • • • • • • • • • • FLORIDA BUILDING CODE — BUILDING • • • • • • • ••• • • • • • • • ik • • • • • • • • • •• • • • • • ••• • • ••• • • • • • • • • • • ••• • • • • • • • • • • • • • . • •• •• • •• •• ••• ••• • • ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 High - Velocity Hurricane Zone Uniform Permit Application Form: Section C (Low Slope Application) Fill in specific roof assembly components and identify manufacturer (If a component is not used, identify as "NA ") System Manufacturer: Product Approval No.: Design Wind Pressures, From RAS 128 or Calculations: Pmaxl: '10:2 Pmax2: - $.9 . (- Pmax3? 3 Max. Design Pressure, from the'specific Produc ., Approval system: Deck: Type: Gauge/Thickness: 57 Slope: %._. - Anchor/Base Sheet & No. of Ply(s):4 Igsf 3 e Anchor /Base Sheet Fastener /Bonding Material: p_c 5-4 f Insulation Base Layer: Base Insulation Size and Thickness: Base Insulation Fastener /Bonding Material: Top Insulation Layer: Top Insulation Size and Thickness: Top Insulation Fastener /Bonding Material: At Pr' Base Sheet(s) & No. of PIy(s): Base Sheet Fastener /Bonding Material: Ply Sheet(s) & No. of PIy(s):c2 C Ply heet Fastener /B n ing Material: S fiM Avi:0+ ye Top Ply: (/9f Ole c.7" Top Ply Fastener43 nding Material• I t FLORIDA BUILDING CODE -- BUILDING Surfacing: Fastener Spacing for Anchor /Base Sheet Attachment: Field: / " oc @. Lap, # Rows )—@ q " oc Perimeter: &" oc @ Lap, # Rows �t @ CCD" oc Corner: q " oc @ Lap, # Rows CO @ L " oc Number of Fasteners Per Insulation Board: Field et Corner Illustrate Components Noted and Details as Applicable: Woodblocking, Gutter, Edge Termination, Stripping, Flashing, Continuous Cleat, Cant Strip, Base Flashing, Counter - Flashing, Coping, Etc. Indicate: Mean Roof Height, Parapet Height, Height of Base Flashing, Component Material, Material Thickness, Fastener Type, Fastener Spacing or Submit .• • • • •• • • • • • • • • • • • CS.* it tlti( *4-2 ‘5 NAY, )\`\t`°k 9 04s arapet Height_........ ••• • • • • • •• • • • • • • • • •• • . • • • • • • • • • •• ••• • • • • •• • • • • ••• • • • ••• • • • • • • • • • • :. • • • • • • ••• ••• • . • • • • • • • • • • •• •• ••• • • • • • ••• • • • • • • • • • ••• • • • • • • • • • • • • • • • • • • • .• •• • • Mean Roof Height ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 High - Velocity Hurricane Zone Uniform Permit Application Form. .Section D (Steep Sloped Roof System) Roof System M`a ufacturer: Notice of Acceptance NN Minimum Design Wind Pr ss s, If Applicable (From RAS 127 or Calculations): P1: P2: P3: Maximum Dpgn Pressure \ (From th - Product Approval Specific Systerk: Deck Type. Roof S Type Underlay \ Insulation: Fire Barrier: Ridge Ventilation? Fastener pe & Spacing: Adhesive Type: Type Cap Sheet: Mean Roof Height: Roof Covering: •�re:&:Siie pAZp : :: • ryEdges • • • • • • • • •3 3 :� • ••• •• . • .• rnei ••• • • ••• •.• ••• 0 • • • • •••• ::• :.•• • • • • •• • • ••• • • • • • FLORIDA BUILDING CODE — BUILDING • • • ••• • • •11,11, • • • . • • • • • • • ••• • • • • • • • • • • •• • •• •: .••• ••• •• • ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 High - Velocity Hurricane Zone Uniform Permit Application Form. Section F (Tile Calculations) For Moment b '•. tile systems, choose either Method 1 or 2. Compare the values for Mr with the values from Mf. if the values are greater than or equal to the Mr va s les, for each area of the roof, then the tile attachment method is acceptable. Method I "Moment Based Tile Calculations Per RAS 127" (PI: x 2 = ) - Mg: = Mri Product Appr.val Mf Required Mom (P3: x2. — ) - Mg: it of Resistance (Mr F = Mr" = Mr3 Product • proval Mf Produ. Approval Mr Method 2 "Simplified Tile Calculations Per Table Be w" Mr required Moment Resista,'ce* Mean Roof Height —> Roof Slope a av4U1.1. rspp.uvai r 20' 25' 30' 40' 2 :12 34.4 36 5 38.2 39.7 42.2 3:12 32.2 34 4 i 36.0 37.4 39.8 4.12 30.4 49 7 33.8 35.1 37.3 5:12 28.4 301 316 32.8 34.9 6:12 26.4 �8 0 29 4 39.5 32.4 7:12 24.4 2 271 28.2 30.0 *Must he used in conjunction with a list of moment based For Uplift based tile systems use Method 3. Compared the v for each area of the root', then the tile attachment method es s acre stems endorsed by the Broward County Board of Rules and Appeals. br F' with the values for Fr. If the F' values are greater than or equal to the Fr values. table. Method 3 oment Bn. d Tile Calculations Per RAS 127" (PI• x L x w: _ ), W: x co 0 = Fri Product Approval F ) - W: x cos g = Fr2 Product Approval F' (P2: x L = w: tP xi. xw := ... .. ....., .. — . ri Where to Obtain nformation a av4U1.1. rspp.uvai r Description Symbol Where to find Design Pressure 11 or P2 or P3 RAS 127 Table I or by an e ` ineering analysis prepared by PE based on ASCE 7 Mean Roof Height H Job Site Roof S dpe 0 Job Site Aerodynamic M tiplier A Product Approval Restoring Mo ent due to Gravity MS Product Approval Attar meat Resistance Mr Product Approval Require 4ment Resistance Mg Calculated • • • ', • • • • • Minimum Attachment Resistance F. • • • ••7, Product Approval • • • • • • • • • ••• • • • • • • /Reuired q Uplift Resistance Fr Calculated Average Tile Weight W Product Approval • • • • • • • • • • • • • Tile Dimensions L =length W = width —• • • •• • ••• Product Approval • • • • • • • • • .• • • i•i All calculations must be submitted to the building of icial at the time of permit application. _ • FLORIDA BUILDING CODE -- BUILDING ••• • • • • • • • • • • • • • •• •• • • • • ••• • • • • • • • • • • • • • • • • •• •• • ••• • MIAMIDADE BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) GAF Material Corporation 1361 Alps Road Wayne, NJ 07470 MJAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 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 the BCCO and accepted by the Building Code and Product Review Committee to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AIM. 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 High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: GAF Conventional Built -Up Roof System for Wood Deck. 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. •••• • • • 1SPEC copy of this entire NOA shall be provided to the user by the manufacturer or its distributors • "' ,g be ,able for inspection at the job site at the request of the Builcing.O iicie . • •••••• �'• •t;� • •' •• • •• ••• • • • • • • r • • • t� . N ' re s•?•TOA #02- 0408.09 and consists of pages']. throw h1; : : • • : • • •••••• ••••• • • • • • • •••••ri; •�•• • •i • • •••••• • 000000 • • • 00000 • • ••••■ •••••. • •0.0j0 • • • 000000 ROOFING SYSTEM APPROVAL Category: Sub- Category: Deck Type: Maximum Design Pressure Fire Classification: Roofmg BUR Wood -75 psf See General Limitation #1 TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT: TABLE 1 Product GAF Asphalt Concrete Primer (MatrixTM 307 Primer) GAF Mineral Shield® Granules GAF WeatherCoat® Emulsion (MatrixTM Fibered 305 Emulsion) GAF Premium Fibered Aluminum Roof Coating. (MatrixTM System Pro Aluminum Roof Coating Fibered 301) GAF Jetblack All Weather Plastic Cement (MatrixTM Standard Wet/Dry Roof Cement 204) RUBEROID® Modified Bitumen Flashing Cement 7etblack Premium Flashing Cement • • C7AFGLAS® #75 • • • • •• •• • • • • • • 4151 GLASr#80 jUltima • •'Base Sheei •; • •: t AFGLAS Hear Ply TM 6 •• • • •••••• •• • ••• •••• • • • • • • • •• •••• • • 0000 ••••• ••• 00000 • 000.0 • • • • • Dimensions 5, 55 gallons ASTM D 41 60 lb. bags ASTM D 1863 5 gallons 1, 5 gallons ASTM D 2824 Test Product Specification Description Asphalt concrete primer used to promote adhesion of asphalt in built -up roofing. Granules for surfacing of exposed asphalt, cold process cement or emulsion. GAF Mineral Shield® Granules shall be used for flashing applications only. ASTM 1227 Surface coating for smooth surfaced roofs. 1, 5 gallons 5 gallons 5 gallons 3937" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide Fibered aluminum coating. ASTM D 3019 Refined asphalt blended with a mineral ASTM D 3409 stabilizer and fibers. Permits adhesion to wet and dry surfaces. ASTM D 4586 Fiber reinforced, polymer modified Flashing cement ASTM D 4586 Asphalt flashing Cement ASTM D 4601 ASTM D4601 ASTM D 1111.8 •• Asphalt impregnated and coated glass mat base sheet. As.pltaltimpregfateclafid coated, fiberglass 'bate take. • ••: •• '°yte:Viesp alCii piagna• ted glass felt with Whalt coating. • ••• • • • • • •• • • ••• • • •'• IOW No: 03. 0501.05 • • • • • • BlibTatfpn Date: 11/04/08 • • • ' • ' •Approval Date:10/23/03 Page 2 of 21 • • • ••• • • • ••• • • • • • • • • • • ••• • • • • • • '•• • • • • • •• • • •• '' ••• • • • • .00.0. • • 000000 • • • •0000 • • 00000 • • ••...• • • 000000 • • • 0000•. Product GAFGLAS Ply 4® GAFGLAS® Mineral Surfaced Cap Sheet GAFGLAS® STRATAVENT® Eliminator Perforated GAFGLAS® Flashing GAFGLAS® STRATAVENT Eliminator Perforated Nailable RUBEROID® SBS Heat - We1dTM Smooth RUBEROID® SBS Heat - We1dTM Granule RUBEROID® SBS Heat - We1dTM 170 FR RUBEROID® SBS Heat - We1dTM PLUS RUBEROID® SBS Heat - Weld PLUS FR RUBEROID® SBS Heat - We1dTM 25 RUBEROID Modified Base Sheet Ruberoid® 20 •••• 0 • • • •• • • Ruteroidllp' Mo Granule •••• •••• • • • 000000 • •• • • ••• •••• • • • • • • • •• • • •• • • • .0000• 0000• •••• •••• • •••• •• • 0 .••. • • •••• Dimensions 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37' (1 meter) wide Various 39.37" (1 meter) wide 1 meter (39.37 ") wide 1 meter (39.37 ") wide 1 meter (39.37 ") wide 1 meter (39.37 ") wide 1 meter (39.37 ") wide 1 meter (39.37 ") wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide Test Product Specification Description ASTM D 2178 Type W asphalt impregnated glass felt with asphalt coating. ASTM D 3909 Asphalt coated, glass fiber mat cap sheet surfaced with mineral granules. ASTM D 4897 Fiberglass base sheet impregnated and D 3672 coated on both sides with asphalt. Surfaced on the bottom side with mineral granules embedded in asphaltic coating with factory perforations. Asphalt coated glass fiber mar flashing sheet available in three sizes. Fiberglass base sheet impregnated and coated on both sides with asphalt. Surfaced on the bottom side with mineral granules embedded in asphaltic coating. Non -Woven Polyester mat coated with polymer-modified asphalt and smooth surfaced. ASTM D-6164 Non -Woven Polyester mat coated with polymer modified asphalt and surfaced with mineral granules. ASTM D 4897 D 3672 ASTM D-6164 ASTM D -6164 ASTM D -6164 ASTM D-6164 ASTM D-6164 Non -Woven Polyester mat coated with fire retardant polymer modified asphalt and surfaced with mineral granules. Non -Woven Polyester mat coated with polymer modified asphalt and surfaced with mineral granules. Non -Woven Polyester mat coated with fire retardant polymer modified asphalt and surfaced with mineral granules. Non -Woven Polyester mat coated with polymer- modified asphalt and smooth surfaced. ASTM D4601, Premium glass fiber reinforced SBS - Type II, UL modified base sheet Type G2 BUR ASTM D 6163 SBS modified asphalt base sheet and ASTM D 5147 interply sheet reinforce with a glass fiber mat. ASTM D 6222 Non -woven polyester mat coated with ASTM D 5147 •pc�, pry redifcasptalt and surfaced with m ne g4.nbless. • 00 • ••• ••• •• • 0 •• • • ••• • • • . • • • • • • • • • •• • • • ••• • .0 • • • • • is No: 03- 0501.05 • 0 0 : • lisp- Kaden Date: 11/04/08 • • .0 0410 •Approval Date:10/23 /03 Page 3 of 21 • • ••• • • ••• • • • • • • • • • • • • • ••• • • • • • • ••••• •0 .•0 •• •00 ••• • • • • • •.••.. • •...S. •• • 00000 • • ••••• • • ••..•• • • •••••• •• • Product Ruberoid® Mop Plus (Granule) RUBEROID MOP Smooth RUBEROID® MOP 170FR RUBEROID® MOP FR RUBEROID® TORCH Smooth RUBEROID® TORCH Granule RUBEROID® TORCH PLUS (Granule) RUBEROID® TORCH FR RUBEROID 170FR TORCH RUBEROID® 30 RUBEROID® 30 FR RUBEROID ULTRACLAD® SBS • • • RUBERa173 ] ual FR •••• • •• •••• • • • ••• •••• • • • • • • •• •••• • • • • • • • •• •• • • .••.•• •••• • •••• • •••• •••• • • • Dimensions 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) Wide 39.37" (1 meter) wide 39.37' (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) Wide Test Specification ASTM D 6222 ASTM D 5147 ASTM D 6164 ASTM D 5147 Product Description Non -woven polyester mat coated with polymer modified asphalt and surfaced with mineral granules. Non -woven polyester mat coated with polymer - modified asphalt and smooth surfaced. ASTM D 6164 Non -Woven polyester mat coated with fire ASTM D 5147 retardant polymer modified asphalt and surfaced with mineral granules. ASTM D 6164 Non -Woven polyester mat coated with fire ASTM D 5147 retardant polymer modified asphalt and surfaced with mineral granules. Heavy duty, polyester reinforced, asphalt modified bitumen rfiembrane, smooth surface. ASTM D 5147 ASTM D 5147 ASTM D 6222 ASTM D 5147 ASTM D 6222 ASTM D 5147 ASTM D 6222 ASTM D 5147 ASTM D 6163 ASTM D 5147 Asphalt impregnated, coated felt, surfaced with mineral granule. Heavy duty, polyester reinforced, asphalt modified bitumen membrane, granule surface Heavy duty, polyester reinforced, coated with fire retardant asphalt modified bitumen membrane, granule surface. Heavy duty, polyester reinforced, coated with fire retardant asphalt modified bitumen membrane, granule surface. Non -woven fiberglass mat coated with polymer modified asphalt and surfaced with mineral granules. ASTM D 6163 Non -woven fiberglass mat coated with fire ASTM D 5147 retardant polymer modified asphalt and surfaced with mineral granules. ASTM D 6298 Woven fiberglass mat coated with Polymer ASTM D 5147 modified asphalt and surfaced with aluminum, copper or stainless steel foil. ASTM D 6164 Non -woven polyester and fiberglass mat ASTM D 5147 •cZatQd with file rrtap Vnt, polymer modified • asphlltoand with mineral granules. .•• • • ••• •• • .° • • • A•TgA No: 03- 0501.05 • • • • • • • • • • l litat on Date: 11/04/08 • • • • • • • •Approval Date:10/23 /03 • • Page 4 of 21 • • • • • • • • • • • ••• • • • ' • • • ••• • • • • • • • • • • •• •• ••• • • • • • • • • • •0.000 • • • •0••• • • 00.00 • • •00.00 • • 000000 • • •:••.� Product Vent Stacks (metal and plastic) GAF Aluminum Emulsion GAF Aluminum Roof Paint (Matrix® System Pro Aluminum Roof Coating Fibered 302) GAF Built -Up Roofing Asphalt RUBEROID MOD Asphalt, Asphalt L & Asphalt P Tile -Mate Base Sheet Tile -Mate Cap Sheet Shingle- Mate'FM Underlayment TopCoat® Surface Seal SB (Matrix 602 SB Coating) GAF WeatherCote® MB+(Matrix 715 MB Coating) TopCoat MB +(Matrix 715 MB Coating) WeatherCoteTM (Matrix 531 WeatherCote® Rlastomeric Flashing Grade) Matrix Low VOC Matrix 101 System Pro SBS Adhesive • •(uberoid ®MB) Matrix • • •20$ System. rfd $BS Al.asshing • • ' . 4RnteroidVMB vIatrix 4.02 Select • • :•,.dhesive •••• • •••• 0.000 00000 • • •• • • • . • •••• • •• . •••• Dimensions 5 gallons 5 gallons 100 lb. cartons, bulk 60 lb. kegs 39.37" (1 meter) wide 39.37' (1 meter) wide 4 sq. roll 30 lbs. 5 gallons 5 gallons 5 gallons 5 gallons 5 gallons 5 gallons 5 gallons 5 gallons Test Specification PA 100(A) ASTM D 1929 ASTM D 635 None ASTM D2824, Type I Product Description One way valve vent used to relieve built-up pressure within the roof system. GAF Vent Stacks are available in metal or plastic. Mineral colloidal bituminous emulsion with reflective aluminum flakes Non- fibered aluminum pigmented, asphalt roof coating ASTM D312, Interply mopping and surfacing asphalt Types I,II,11I and IV SEBS modified asphalt ASTM D4601 Asphalt impregnated and coated, fiberglass base sheet ASTM D 3909 Asphalt coated, glass fiber mat cap sheet surfaced with mineral granules. Fiberglass reinforced shingle underlayment Surface coating for smooth surfaced and mineral surfaced roofs. Surface coating for smooth surfaced and mineral surfaced roofs. Surface coating for smooth surfaced and mineral surfaced roofs. Surface coating for smooth surfaced and mineral surfaced roofs. Surface coating for smooth surfaced and mineral surfaced roofs. ASTM D3019 Cold Applied Modified SEBS Asphalt Adhesive ASTM D3019 Cold Applied Modified SEBS Asphalt Adhesive — Flashing Grade. • . • •• ASTM D34119 t &dn%•apl1ec=Modif•iesl SEBS Asphalt • •• .•. •• • • •.• •• • ••• • :• 110/t No: 03- 0501.05 • • . • 0 i • • E ir�ttIDn Date: 11/04108 • • • • • �,• • • • • • #pprrval Date:10 /23/03 • Page 5 of 21 ••• • • • • • • • • • • • ••• • : • • •••••• • • 000000 Polyisocyanurate foam insulation Product (Ruberoid ®MB) Matrix 202 Select SBS Flashing Matrix 203 Standard Plastic Cement Matrix 213 Gun Grade Plastic Cement Matrix 103 Cold Adhesive Matrix 303 Select Fibered Aluminum Matrix 304 Select Non - Fibered RUBEROID® Modified Bitumen Adhesive Test Product Dimensions Specification Description 5 gallons ASTM D4586 Cold Applied Modified SEBS Asphalt Adhesive — Flashing Grade. 5 gallons ASTM D4586 Standard Plastic Asphalt Roofing Cement 5 gallons ASTM D4586 Standard Plastic Asphalt Roofing Cement Caulk Grade. 5 gallons ASTM D3019 Cold Applied Asphalt Adhesive. 5 gallons ASTM D 2824 Fibered aluminum coating. 5 gallons ASTM D2824, Non- Fbered aluminum pigmented, asphalt Type I roof coating. 5 gallons ASTM D 3019 Fiber reinforced, rubberized Adhesive Type III APPROVED INSULATIONS: Product Name GAFI'EMP Isotherm R, RA, RN & Composite, EnergyGuard RA GAFTEMP® Composite A & N (BMCA)GAFTEMP® Fiberboard GAFTEMP® Permalite GAFTEMP GAFCANTTM GAFTEMP Permalite Recover Board GAFTEMP GAFEDGETM Tapered Edge Strip (BMCA) GAFTEMP® High Density Fiberboard BMCA EnergyGuard, RA TABLE 2 Product Description Manufacturer (With Current NOA) GAF Materials Corp. Polyisocyanurate foam insulation Polyisocyanurate foam insulation with high density fiberboard or Permalite perlite insulation. Fiberboard insulation. Perlite insulation board. Cut perlite board Perlite recover board Tapered perlite board High density wood fiberboard insulation. Polyisocynurate foam insulation BMCA Composite EnergyGuard, RA Polyisocynurate /wood fiberboard composite Polyisocyanurate foam insulation .••• • • • • •• • •• • • • • • •PPROX • • • • • •••• • • • White Line" "" •• •• •• • • • • • •• ....... • ...;^ 00000 00000 • I, • • <�o • • 6rp.Vv • •• • • •• • •• • • • • • • • 00000 •.••• • • 00000 • • 000000 • • •.•••• ••••• GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. BMCA BMCA Apache Products Co.. • Apache Products Co. NOA No: 03- 0501.05 Expiration Date: 11/04/08 Approval Date:10/23 /03 Page 6 of 21 • • ....•• • • 000000 • • • .....• • • • • ...••: • 000000 • • • 00000 APPROVED INSULATIONS: Product Name ACFoam I, II & Composite ISO 95+ ISO 95+ Composite Wood Fiber High Density Wood Fiberboard Perlite Insulation Dens Deck ENRG'Y -2 & ENRG'Y 2 PLUS, UltraGard Gold FiberGlass Roof Insulation Structodek Multi -Max & FA Paroc Base Board Paroc Cap Board APPROVED FASTENERS: Fastener Number Product Name TABLE 2 Product Description Polyisocyanurate foam insulation Polyisocyanurate foam insulation Polyisocyanurate/perlite ridged insulation Wood fiber insulation board Wood fiber insulation board Perlite insulation board Water resistant gypsum board Polyisocyanurate foam insulation Glass fiber/Mineral fiber insulation Wood fiber insulation board Polyisocyanurate roof insulation Rockwool insulation GAFTITTE® (Drill-Tec ®) #12 Standard & #14 Heavy Duty Roofing Fastener GAFTITE (Drill -Tec ®) ASAP GAP ii lb® (Drill -Tec ®) Base Sheet Fastener and Plate 4. Galvalume Plates (Drill - Tec® Metal) • • Poilypropylene Plates • • • • •(Vrili Tec® Plastic) . • • • • . 6. • Dekfast Fasteners #12, #14 •••• •••• 5. #1!. •. •• ••••• •... .. *.• . • • . . • • . • • TABLE 3 Manufacturer (With Current NOA) Atlas Energy Products Firestone Building Products, Inc. . Firestone Building Products, Inc. generic generic generic G -P Gypsum Corp. Johns Manville Johns Manville Masonite. RMax, Inc. Partek, Inc. Product Manufacturer Description Dimensions (With Current NOA) Insulation fastener for • GAF Materials Corp. steel, wood & concrete decks. Pre- assembled GAF FITE Fasteners and metal and plastic plates. Base sheet fastening assembly. Round galvalume stress plates. Round polypropylene stress plates. Insulation fastener for wood, steel and concrete decks 3" and 31/2" 3" and 3 Vi" GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. Construction Fasteners Inc. NOA No: 03- 0501.05 Expiration Date: 11/04/08 Approval Date:10/23 /03 Page 7 of 21 • • ••..•. • • 000000 • • • • ••.•• • • • • • • • 000000 APPROVED FASTENERS: Fastener Number 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. •••• • • • •• • •••• • • •••• • •• • • ••• •••• • • • • • •• • "' • ••• *• Product Name Dekfast Hex Plate Dekfast Lock Plate #12 Roofgrip Fasteners Metal Plate Gearlok Plastic Plate Glasfast Fastener Olympic Fastener #12 & #14 Olympic Fastener ASAP Olympic Polypropylene Olympic G -2 Olympic Standard Insul-Fixx Fastener Insul-Fixx S Plate Insul-Fixx P Plate Tru-Fast 22. Tru Fast Plates 23. Tru-Fast Plates • •• • •. • • • • - • • . •• •• • • .••.•• ••••• ••• •••• • •••• • •• • • . • • TABLE 3 Product Description Galvalume hex stress plate. Polypropylene locking plate. Insulation fastener for wood and steel. Galvalume stress plate. Polypropylene round plate Insulation fastener assembly with recessed plastic plate Insulation fastener Pre - assembled Insulation fastener and plate Polypropylene plastic plate 3.5" round galvalnme AZ55 steel plate 3" round galvalume AZ50 steel plate Insulation fastener for steel and wood decks 3" round galvalume AZ50 steel plate 3" round polyethylene stress plate Insulation fastener for steel and wood decks 3" round galvalume AZ55 steel plate Polyethylene plastic plate Dimensions 2 7/8" x 314" 3" x 3 1/4" Manufacturer (With Current NOA) Construction. Fasteners Inc. Construction Fasteners Inc. ITW Buildex Corp. 3" round ITW Buildex Corp. 3" square 3.2" 3.25" round 3.5" round 3" round 3" round 3" round 3" round 3" round ITW Buildex Corp. Johns Manville Olympic Manufacturing Group, Inc. Olympic Manufacturing Group, Inc. Olympic Manufacturing Group, Inc. Olympic Manufacturing Group, Inc. Olympic Manufacturing Group, Inc. SFS /Stadler SFS /Stadler SFS /Stadler The Tru-Fast Corp. The Tru-Fast Corp. The Tru -Fast Corp. NOA No: 03-0501.05 Expiration Date: 11/04/08 Approval Date:10/23 /03 Page 8 of 21 • • • • •0••1• • • • •••000 ..0.0 • • 0.100 • • • • 01.00• • • •:•••� EVIDENCE SUBMITTED: Test Agency Factory Mutual Research Corp. Factory Mutual Research Corp. Factory Mutual Research Corp. PRI Asphalt Technologies, Inc. PRI Asphalt Technologies, Inc. IRT of S. Fl. IRT of S. Fl. ••• • • • • •• • •••• 0 • 0110 • •• • • •••• • • • • • •• •••• • • •••• • •• • • • • • • • • • • 1•..•• •• •• • • 10.00• • • • •• • • • • • Test Identifier FMRC 1996 J.L 2B8A4.AM J.L 3B9Q1.AM J.L OD0A8.AM J.L 0D1A8.AM 1.I.0Y9Q5.AM GAF -012 -02-02 GAF - 020 -02 -01 02-005 02 -014 Description Current Insulation Attachment Requirements Wind Uplift FMRC 44704 Wind Uplift FMRC 4470 - PA 114 Physical Properties ASTM D 4977 TAS 114 TAS 114 Date 01.01.96 07.02.97 01.08.98 07.09.99 07.29.94 04.01.98 11.06.01 02.01.02 01.18.02 03.22.02 NOA No: 03- 0501.05 Expiration Date: 11/04/08 Approval Date:10/23 /03 Page 9 of 21 • • • • • • • •; ... • • • (Maximum Design Pressure -45 psf, See General Limitation #7) • • 0000 • • • • • ••0••• •••••• • . • • •• 0•• • • ...... • • .... • ••• 000. 0. .. 0 . • • ,0000 • .... • �J��f` %I •.• • •••• ..• .:.o • • V ?....::. 0.. 000000 • ..0..• (pt°\< .. • . • • • • 0000.. • • 000.0 •••• APPROVED ASSEMBLIES Deck Type 1I: Wood, Insulated Deck Description: 19/32' or greater plywood or wood plank System Type A (1): Anchor sheet mechanically fastened, all layers of insulation adhered with approved asphalt. All General and System Limitations shall apply. One or more layers of any of the following insulations. Insulation Layer (Table 2) Insulation Fasteners Fastener (When applicable: Steel plate only =S, platic plate only (Table 3) Density /ft2 =p) ACFoam -I, ENRGY 2, GAFTEMP® Isotherm R, E'NRG'Y 2 Plus, GAFTEMP Isotherm RA, GAFTEMP Isotherm RN, GAFTEMP Composite, GAFTEMP Composite A, GAFTEMP Composite N, BMCA EnergyGuard, BMCA EnergyGuard Composite, EverGuard ISO, ISORoc, EnergyGuard RA, EnergyGuard RA Composite Minimum 1" thick N/A NIA BMCA High Density Wood Fiber, GAFTEMP® High Density Wood Fiber, GAFTEMP RecoverBoard, Wood Fiber, GAFTEMP® Fiberboard Minimum 1/i" thick N/A N/A Perlite, GAFTEMP® Permalite®, Permalite Tapered, Faroe Minimum 3/" thick N/A N/A Fiberglas (Min. 15/16" thick) N/A N/A Note: All insulation shall be adhered to the anchor sheet in full mopping of approved hot asphalt within the EVT range and at a rate of 20-40 lbs/100 ft2. Please refer to Roofing Application Standard RAS 117 for insulation attachment. Insulation listed as base layer only shall be used only as base layers with a second layer of approved top layer insulation installed as the final membrane substrate. Composite insulation panels may be used as a top layer placed with the polyisocyanurate side facing down. GAF requires either a ply of GAFGLAS STRATAVENT® Eliminator Perforated laid dry or a layer of GAFTEMP® PERMALITE or wood fiber overlay board on all isocyanurate applications. Anchor sheet: GAFGLAS #80 UltimaTM Base Sheet, STRATAVENT® Eliminator Perforated Nailable, RUBEROID Modified Base Sheet, RUBEROID® 20, RUBEROID SBS Heat We1dTM Smooth or RUBEROID SBS Heat-Weld 25 base sheet • mechanically fastened as described below; Fastening Options: GAFGLAS® Ply 4 ®, GAFGLAS Flex P1yTM 6, GAFGLAS #75 Base Sheet or any of above Anchor sheets attached to deck with approved annular ring shank ,,.. nails and tin caps at a fastener spacing of 9" o.c. at the lap staggered and in two • .. • • • ," • rows 12" o:c. in the field. • NOA No: 03- 0501.05 Expiration Date: 11/04/08 Approval Date:10/23 /03 Page 10 of 21 • • 000000 GAFGLAS® Ply 4 ®, GAFGLAS Flex P1yTM 6, GAFGLAS #75 Base Sheet or any of above Anchor sheets attached to deck with Drill-Tec (GAFITI E) #12 or #14 Screws and 3" Plates, 12" o.c. in 3 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 12" o.c. in the field of the sheet. (Maximum Design Pressure —45 psf, See General Limitation #7) GAFGLAS Flex PlyTm 6, GAFGLAS #75 Base Sheet or any of above Anchor sheets attached to deck with approved annular ring shank nails and tin caps at a fastener spacing of 9" o.c. at the 4" lap staggered and in two rows 9" o.c. in the field. (Maximum Design Pressure 52.5 psf, See General Limitation #7) GAFGLAS #75 Bate Sheet or any of above Anchor sheets attached to deck with Drill-Tec (GAY ME) #12 or #14 Screws and 3" Plates, 12" o.c. in 4 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 9" o.c. in the field of the sheet. (Maximum Design Pressure —60 psf, See General Limitation #7) Any of above Anchor sheets attached to deck approved annular ring shank nails and 3" inverted Drill-Tec (GAFI7.TE) insulation plates at a fastener spacing of 9" o.c. at the 4" lap staggered in two rows 9" in the field. (Maximum Design Pressure —60 psf, See General Limitation #7) GAFGLAS #75 Base Sheet or any of above Anchor sheets attached to deck with Drill Tec (GAFTITE) #12 or #14 Screws and 3" Plates, 8" o.c. in 4 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 9" o.c. in the field of the sheet. (Maximum Design Pressure —75 psf, See General Limitation #7) Base Sheet: (Optional) Install one ply of GAFGLAS® #75, GAFGLAS #80 Uhlman' Ultra Base Sheet, GAFGLAS STRATAVENT® Eliminator Perforated, RUBEROID Modified Base Sheet, RUBEROID Mop Smooth, RUBEROID® 20 RUBEROID SBS Heat Weld Smooth or RUBEROID SBS Heat-Weld directly over the top layer of insulation. Adhere with any approved mopping asphalt applied within the EVT range and at a rate of 20-40 lbs./sq; (see General Limitation #4). Ply Sheet: One or more plies GAFGLAS PLY 4 ®, GAFGLAS Flex Ply 6 sheet, #80 Ultima, RUBEROID Mop Smooth or RUBEROID 20 adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20- 40lbs.sq. Cap Sheet: (Optional) One ply of GAFGLAS® Mineral Surfaced Cap Sheet adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs. /sq. Surfacing: (Required if no cap sheet is used) Install one of the .following: 1. GAF Special Roofing Bitumen with an application rate of 20 lbs.sq with an application rate of 1.5 gal./sq.; or GAF WEATHER COAT® Emulsion (Matrix 305 Fibered Emulsion) with an application rate of 3 gal. /sq.; or GAF Premium Fibered Aluminum Roof Coating (Matrix System Pro Aluminum Roof Coating Fibered 301) with an application rate of 1.5 gal. /sq. 2. Asphalt flood coat at an application rate of 60 lbs./sq. t 20 %; plus gravel or slag with an application rate of 400 lbs. /sq. & 3001bs.sq., respectively. 3. Top Coat Surface Seal SB (Matrix 602 SB Coating), Top Coat MB Plus (Matrix 715 MB Coating), GAF WeatherCote or WeatherCote LOW -VOC applied at rate of 1 -1.5 gal/sq. •..Maximum Design • • 0 .tl r ssurea • • ; See Fastening above. • • • ••• 1.• • • 00000 • • ••••o • • 0001• • . .. • :•• 0000• • •• ••••• ••••• • • •• • • • • •••• • 0000. •1•••• • 000000 • • • NOA No: 03- 0501.05 Expiration Date: 11/04/08 Approval Date:10/23 /03 Page 11 of 21 .00.. • ..... • 0000• • •• OOOOOOO • OOOOOO • Deck Type 1I: Wood, Insulated Deck Description: 14/32' or greater plywood or wood plank System Type B: Optional base sheet laid dry; base layer of insulation mechanically fastened, optional top layer adhered with approved asphalt. All General and System Limitations shall apply. One or more layers of any of the following insulations. Insulation for Base Layer (Table 2) (When applicable: Steel plate only =S, platic plate only =P) (Table 3) ACFoam -I, GAFTEMP® Isotherm R, BMCA EnergyGuard, EnergyGuard RA Minimum 13" thick 1, 2, 6, 9, 13, 14 & 21S Insulation Fasteners Fastener Density /ft2 1:3 ft2 E'NRG'Y 2, GAFTEMP Isotherm RN Minimum 14" thick 1,'2,6S,9, 13, 14 & 21S 1:3 ft2 E'NRG'Y 2 Plus, GAFTEMP Composite N, BMCA EnergyGuard Composite, EnergyGuard RA Composite Minimum 1.5 thick 6S, 9, 18 & 21S 1:3 ft2 Perlite, GAFTEMP® PERMALITE Minimum 3 /a" thick 0 1S(3.5 "), 6S, 9, 13, 14 & 21S Fiberglas Minimum 13/16" thick 1, 2, 6, 9, 12, 13, 14 & 21S Wood Fiber, GAFTEMP® Fiberboard, GAFTEMP High Density Fiberboard Minimum 1" thick 1, 2, 6, 13,14 & 21S 1:2 ft2 1:2.67 ft2 1:4 ft2 Note: Base layer shall be mechanically attached with fasteners and density described. Insulation panels listed are minimum sizes and dimensions; if larger panels are used the number of fasteners per board shall be increased maintaining the same . fastener density (See Roofing Application Standard RAS 117 for fastening details). GAF requires either a ply of GAFGLAS STRATAVENT® Eliminator perforated laid dry or a layer of GAFTEMP® PERMALITE or wood fiber overlay board on all isocyanurate applications. Insulation for Top Layer (Table 2) Insulation Fasteners (When applicable: Steel plate only =S, platic plate only =P) (Table 3) Any of the insulations listed for Base Layer, above. N/A Fastener Density/ft2 N/A High Density Wood Fiber, GAFTEMP® High Density Wood Fiberboard, PERMALITE Board Minimum V2" thick N/A 0 Recover N/A Paroc Minimum 3/4" thick N/A N/A Note: Optional top layer of insulation shall be adhered with approved asphalt within the EVT range and at a rate of 20 -40 lbs/100 ft2. Please refer to Roofing Application Standard RAS 117 for insulation attachment. Composite insulation boards used as a top layer shall be installed with the • J4glyisocyanurate face down. • • •• • • • • OOOOO •• • •• 00000 •••• • • • 00000• 00;000 • NOA No: 03- 0501.05 Expiration Date: 11/04/08 Approval Date:10/23 /03 Page 12 of 21 • • •0•••w • ••o••• • • •oo•o• •0000 • • •o••• • • 000••o • • 000000 • • Base Sheet: Ply Sheet: Cap Sheet: Surfacing: (Optional) Install one ply of GAFGLAS® #75, GAFGLAS #80 ULTIMAA Base Sheet, GAFGLAS® PLY 4 ®, GAFGLAS® PLY 6 ®, GAFGLAS Flex Ply 6, GAFGLAS STRATAVENT® Eliminator Perforated(laid dry), RUBEROID Modified Base Sheet, RUBEROID Mop Smooth or RUBEROID® 20 directly over the top layer of insulation. Adhere with any approved mopping asphalt applied within the EVT range and at a rate of 20-40 lbs.sq; (see General Limitation #4). Two or more plies of GAFGLAS® PLY 4 ®, GAFGLAS F1exP1y' 6 ply sheet, #80 Ultima, RUBEROID Mop Smooth or RUBEROID 20 adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs. /sq. (See specification number for appropriate number of plies). (Optional) One .ply of GAFGLAS® Mineral Surfaced Cap Sheet adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbsJsq. (See GAF application instructions for approved method of installation). (Required if no cap sheet is used) Install one of the following:) 1. GAF Special Roofing Bitumen with an application rate of 20 lbs.sq with an application rate of 1.5 gal./sq.; or GAF WEATHER COAT® Emulsion (Matrix 305 Fibered Emulsion) with an application rate of 3 gal /sq.; or GAF Premium Fibered Aluminum Roof Coating (Matrix System Pro Aluminum Roof Coating Fibered 301) with an application rate of 1.5 gal. /sq. 2. Asphalt flood coat at an application rate of 60 lbs./sq. ± 20 %; plus gravel or slag with an application rate of 400 lbs./sq. & 300 lbsJsq., respectively. 3. Top Coat Surface Seal SB (Matrix 602 SB Coating), Top Coat MB Plus (Matrix 715 MB Coating), GAF WeatherCote or WeatherCote LOW -VOC applied at rate of 1 -1.5 gal/sq. Maximum Design Pressure: -45 psi; (See General Limitation #7) •••• • • • •• • •••• �• U` ►'```'f ..• ••• "9.1:f S • • • O 000 • • •• • • • • •• • •• • • • • • • • ••• •• • ••• •••• • ••o••• • 000••• • •• • NOA No: 03- 0501.05 Expiration Date: 11/04/08 Approval Date:10/23 /03 Page 13 of 21 Deck Type 1I: Wood, Insulated Deck Description: 19/32' or greater plywood or wood plank System Type C: One or more layers of insulation simultaneously attached; Base layer optional. All General and System Limitations shall apply. One or more layers of any of the following insulations. Insulation for Base Layer (Table 2) Insulation Fasteners Fastener (When applicable: Steel plate only =S, platic plate only =P) (Table 3) Density /ft2 ACFoam -I, GAFTEMP® Isotherm R, GAFTEMP Isotherm RA, GAFTEMP Isotherm RN, BMCA EnergyGuard, EnergyGuard RA Minimum 1.3" thick N/A N/A E'NRG'Y 2 Min. 1.4" thick N/A N/A ISORoc, E'NRG'Y 2 Plus, GAFTEMP Composite A, GAFTEMP Composite N, BMCA EnergyGuard Composite, EnergyGuard RA Composite Minimum 15" thick N/A N/A Perlite, GAFTEMP .. PERMALITE Minimum 3 /a" thick N/A N/A Fiberglas N/A N/A Minimum 15/16" thick Wood Fiber, GAFTEMP® Fiberboard, GAFTEMP High Density Fiberboard Minimum 1" thick N/A N/A Note: All layers shall be simultaneously fastened; see top layer below for fasteners and density. Insulation panels listed are minimum sizes and dimensions; if larger panels are used, the number of fasteners shall be increased maintaining the same fastener density. Please refer to Roofing Application Standard RAS 117 for insulation attachment. GAF requires either a ply of GAFGLAS STRATAVENT® perforated laid dry or a layer of GAFTEMP® PERMALITE or wood fiber overlay board on all isocyanurate applications. Insulation for Top Layer (Table 2) Insulation Fasteners Fastener (When applicable: Steel plate only =S, piatic plate only =P) (Table 3) Density /ft2 ACFoam -I, GAFTEMP® Isotherm R, BMCA EnergyGuard, EnergyGuard RA Minimum 1 3" thick 1, 2, 6, 9, 13,14 & 21S 1:3 ft2 E'NRG'Y 2, GAFTEMP Isotherm RN Minimum 1.4" thick 1, 2,.6S, 9, 13, 14 & 21S 1:3 ft2 E'NRG'Y 2 Plus, GAFTEMP Composite N, BMCA EnergyGuard Composite, EnergyGuard RA Composite Minimum 1.5 thick 6S, 9, 18 & 21S 1:3 ft2 Perlite, GAFTEMP® PERMALITE ® • • ; iVjinimum 3 /1,thick 1S(3.5 "), 6S, 9, 13,14 & 1:2 ft2 • ' • 21S OOOOO • • • _`�� l'j • NOA No: 03-0501.05 • • • . Expiration Date: 11/04/08 • •«.;, • •••••• • • • • i r►; • • • • Approval Date:10/23/03 ��•�• • ••• �t,nS� •••• Page 14of21 • • •••• • • ••••• • • •••• •••• • • • • • •• •••••• • • • • • •• • • •••••• • .• • • • Fiberglas Minimum 15 /16" thick 1, 2, 6, 9, 12, 13, 14 & 1:2.67 ft2 21S Wood Fiber, GAFTEMP® Fiberboard, GAFTEMP High Density Fiberboard Minimum 1" thick I, 2, 6, 13,14 & 21S 1:4 ft2 Note: Insulation panels listed are minimum sizes and dimensions; if larger panels are used, the number of fasteners shall be increased maintaining the same fastener density. Please refer to Roofing Application Standard RAS 117 for insulation attachment. GAF requires either a ply of GAFGLAS STRATAVENT® Eliminator Perforated laid dry or ' a layer of GAFTEMP® PERMALITE or wood fiber overlay board on all isocyanurate applications. Base Sheet: (Optional) Install one ply of GAFGLAS® #75, GAFGLAS #80 Ultima''M Base Sheet, GAFGLAS® PLY 4 ®, GAFGLAS F1exP1y" 6, GAFGLAS® STRATAVBNT® Eliminator Perforated (laid dry), RUBEROID Modified Base Sheet, RUBEROID Mop Smooth or RUBEROID® 20 directly over the top layer of insulation. Adhere with any approved mopping asphalt applied within the EVT range and at a rate of 20-40 lbs.sq.. If base sheet is applied directly to polyisocyanurate insulation only a spot or strip mopped application as detailed in this approval the use of an overlay board is approved; see General Limitation #4. Ply Sheet: Two or more plies of GAFGLAS® PLY 4 ®, GAFGLAS® PLY 6 ®, GAFGLAS FlexPly 6 ply sheet, #80 Ultima, , RUBEROID Mop Smooth or RUBEROID 20 adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs./sq. Cap Sheet: (Optional) One ply of GAFGLAS® Mineral Surfaced Cap Sheet adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs.sq. Surfacing: (Required if no cap sheet is used) Install one of the following:) 1. GAF Special Roofing Bitumen with an application rate of 20 lbsfsq with an application rate of 1.5 gal /sq.; or GAF WEATHER COAT® Emulsion (Matrix 305 Fibered Emulsion) with an application rate of 3 gal/sq.; or GAF Premium Fibered Aluminum Roof Coating (Matrix System Pro Aluminum Roof Coating Fibered 301) with an application rate of 1.5 gal/qsq. 2. Asphalt flood coat at an application rate of 60 lbs./sq. ± 20%; plus gravel or slag with an application rate of 400 lbs./sq. & 300 lbs./sq., respectively. 3. Top Coat Surface Seal SB (Matrix 602 SB Coating), Top Coat MB Plus (Matrix 715 MB Coating), GAF WeatherCote or WeatherCote LOW -VOC applied at rate of 1 -1.5 gal/sq. Maximum Design Pressure: -45 psf; (See General Limitation #7) ••••. • • • • • • ...11. •• ...... • • • ••• .010• • •• .. . •.0• . • • • • • • • 1. ...0.. • • • • .. • • .. • • • • • •.• • •••• ••••1 .1101. • • •. • • • NOA No: 03- 0501.05 Expiration Date: 11/04/08 Approval Date:10/23 /03 Page 15 of 21 • • • 000000 • • •:•••• .•••• • • ••••• • • 0000000 • ••.••• • Deck Type 1I: Wood, Insulated Deck Description: 19/32" or greater plywood or wood plank System Type D (1): Insulation and Base sheet simultaneously All General and System Limitations shall apply. One or more layers of any of the following insulations. Insulation Layer Insulation Fasteners Fastener (Table 3) Density /ft2 ACFoam -I, E'NRG'Y 2, GAFTEMP® Isotherm R, E'NRG'Y 2 Plus, GAFTEMP Isotherm RA, BMCA EnergyGuard, BMCA EnergyGuard RA, GAFTEMP Isotherm RN, GAFTEMP Composite, GAFTEMP Composite A, GAFTEMP Composite N loosely laid with firmly butted joints. Minimum thickness, 1.3". GAFTEMP High Density Fiberboard, GAFTEMP Fiberboard, minimum thickness 1 ". Base Sheet: Install one ply of GAFGLAS® #75, GAFGLAS #80 •ltima'M Base Sheet, GAFGLAS® STRATAVENT® Eliminator Perforated or RUBEROID® 20 base sheet applied over the loose laid insulation with 2" side laps mechanically fastened as described below; Fastening Options: GAI'TITE #12 or #14 Screws and 3" Plates are installed through the base sheet and insulation in 3 rows 12" o.c. One row is in the 2" side lap. The other rows are equally spaced approximately 12" o.c. in the field of the sheet. (Maximum Design Pressure —45 psf, See General Limitation #7) GAFTTTE #12 or #14 Screws and 3" Plates are installed through the base sheet and insulation in 4 rows 8" o.c. One row is in the 2" side lap. The other 3 rows are equally spaced approximately 9" o.c. in the field of the sheet. (Maximum Design Pressure —75 psf, See General Limitation #7) GAFTITE #12 or #14 Screws and 3" Plates in 4 rows 12" o.c. One row is in the 2" side lap. The other rows are equally spaced approximately 9" o.c. in the field of the sheet. (Maximum Design Pressure —60 psf, See General Limitation #7) Ply Sheet: One or more plies GAFGLAS PLY 4 ®, GAFGLAS® PLY 6® Ply, GAFGLAS F1sxPly 6 sheet, #80 Ultima or RUBEROID 20adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs./sq. Cap Sheet: (Optional) One ply of GAFGLAS® Mineral Surfaced Cap Sheet adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs. /sq. Surfacing:. (Required if no cap sheet is used) Install one of the following: GAF Special Roofing Bitumen with an application rate of 20 lbsfsq with an application rate of 1.5 gal./sq.; or GAF WEATHER COAT® Emulsion (Matrix 305 Fibered Emulsion) with an application rate of 3 galisq.; or GAF Premium Fibered Aluminum Roof Coating (Matrix System Pro Aluminum Roof Coating. Fibered 301) with an application rate of 1.5 gal. /sq. •••• • • •• •• • •••• • •••• • •• • • • •• ••••. • •••• • • •• • • • • • •• • • •. • • • • ••• •• • •••• •••• • •••• .••.•• 000000 • • •• • • • • • NOA No: 03-0501.05 Expiration Date: 11/04/08 Approval Date:10/23/03 Page 16 of 21 • •••••• • • 1.11.. • • 1111.. 00000 • • 00000 • • ..••S• • 0.00. • • Asphalt flood coat at an application rate of 60- lbs. /sq. ± 20%; plus gravel or slag with an application rate of 400 lbs. /sq. & 300 lbs. /sq., respectively. Top Coat Surface Seal SB (Matrix 602 SB Coating), Top Coat MB Plus (Matrix 715 MB Coating), GAF WeatherCote or WeatherCote LOW-VOC applied at rate of 1 -1.5 gal/sq. Maximum Design Pressure: See Fastening Above • •••• • • •• • ••••• ••••• • •• • • • ••• 0000 • • •••• • • •• • • • • • •• • •• • • • • • • •• •• • ••• •••• • 10.00• • 000000 • •• • • • NOA No: 03- 0501.05 Expiration Date: 11/04/08 Approval Date:10/23 /03 Page 17 of 21 • • ...... • • 000000 • • 00000 • • 00000 • oio 000000 • • 000000 • • Deck Type 1: Wood, Non - insulated Deck Description: 19/32" or greater plywood or wood plank decks System Type E (1): Base sheet mechanically fastened. All General and System Limitations shall apply. Base sheet: GAFGLAS #80 UltimaTM Base Sheet, STRATAVENT® Eliminator Perforated Nailable, RUBEROID Modified Base Sheet, RUBEROID® 20, RUBEROID SBS Heat- We1dTM Smooth or RUBEROID SBS Heat -Weld 25 base sheet mechanically fastened to deck as described below; Fastening Options: GAFGLAS® Ply 4 ®, GAFGLAS Flex P1yTM 6, GAFGLAS #75 Base Sheet or any of above Base sheets attached to deck with approved annular ring shank nails and tin caps at a fastener spacing of 9" o.c. at the lap staggered and in two rows 12" o.c. in the field. (Maximum Design Pressure —45 psf, See General Limitation #7) GAFGLAS® Ply 4 ®, GAFGLAS Flex PIyTM 6, GAFGLAS #75 Base Sheet or any of above Base sheets attached to deck with Drill-Tec (GAI( 1TJ. E) #12 or #14 Screws and 3" Plates, 12" o.c. in 3 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 12" o.c. in the field of the sheet. (Maximum Design Pressure —45 psf, See General Limitation #7) GAFGLAS Flex P1yTM 6, GAFGLAS #75 Base Sheet or any of above Base sheets attached to deck with approved annular ring shank nails and tin caps at a fastener spacing of 9" o.c. at the 4" lap staggered and in two rows 9" o.c. in the field. (Maximum Design Pressure —52.5 psf, See General Limitation #7) GAFGLAS #75 Base Sheet or any of above Base sheets attached to deck with Drill-Tec (GAFTITE) #12 or #14 Screws and 3" Plates, 12" o.c. in 4 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 9" o.c. in the field of the sheet. (Maximum Design Pressure —60 psf, See General Limitation #7) Any of above Base sheets attached to deck approved annular ring shank nails and 3" inverted Drill-Tec (GAFTITE) insulation plates at a fastener spacing of 9" o.c. at the 4" lap staggered in two rows 9" in the field. (Maximum Design Pressure —60 psf, See General Limitation #7) GAFGLAS #75 Base Sheet or any of above Base sheets attached to deck with Drill-Tec (GAFTITE) #12 or #14 Screws and 3" Plates, 8" o.c. in 4 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 9" o.c. in the field of the sheet. (Maximum Design Pressure —75 psf, See General limitation #7) Ply Sheet: One or more plies of GAFGLAS® PLY 4 ®, GAFGLAS 0 PLY 6® ply sheet, #80 Ultima., RUBEROID MOP Smooth or RUBEROID 20 adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20- 40 lbs. /sq. Cap Sheet: (Optional) One ply of GAFGLAS® Mineral Surfaced Cap Sheet adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs. /sq. ••• • • • • • •••• • • •• • • • ••• •••• • • •••• • • • • ••••." • •• • • • • • • •• •. • ••• •••• •••••• • •.•.•• • •• • • • NOA No: 03 -0501.05 Expiration Date: 11/04/08 Approval Date:10/23 /03 Page 18 of 21 • ••••* •.•..• • • o • 0000 ••••• • • ••••• • • • •••••• • Surfacing: (Required if no cap sheet is used) Install one of the following: 1. GAF Special Roofing Bitumen with an application rate of 20 lbs. /sq with an application rate of 1.5 gal. /sq.; or GAF WEATHER COAT® Emulsion (Matrix 305 Fibered Emulsion) with an application rate of 3 gal. /sq.; or GAF Premium Fibered Aluminum Roof Coating (Matrix System Pro Aluminum Roof Coating Fibered 301) with an application rate of 1.5 gal. /sq. 2. Asphalt flood coat at an application rate of 60 lbs. /sq. t 20 %; plus gravel or slag with an application rate of 400 lbs.sq. & 300 lbs. /sq., respectively. 3. Top Coat Surface Seal SB (Matrix 602 SB Coating), Top Coat MB Plus (Matrix 715 MB Coating), GAF WeatherCote or WeatherCote LOW -VOC applied at rate of 1 -1.5 gal/sq. Maximum Design Pressure: See Fastening Above •••• • • • • •• •••• ••••• • •• • • • •• ••••• s •••• • • •• • • • • 0. • •• • • • • • • • •••• • •• •••• ••••• ••••• •.•••• 000000 • • •• • • • NOA No: 03- 0501.05 Expiration Date: 11/04/08 Approval Date:10/23 /03 Page 19 of 21 • • • • • ••••• • • • • • • •••••• • Membrane Type: Deck Type 1: Deck Description: System Type E (2): Anchor sheet: Ply Sheet Cap Sheet: Maximum Design Pressure: Maximum Slope: •••• • • • •• • ••••• ••••• • • • • ••• • • • • •• • • •• • • • • • •• •• .01 •••• • • •••••• • • •• • • • BUR Wood, Non - insulated 19 /32" or greater plywood or wood plank Tile Underlayment, Base Sheet mechanically attached. GAFGLAS® #80 Ultimarm Base Sheet, RUBEROID® 20 or Tile -Mate Base Sheet applied with a minimum 2" side lap and a minimum 6 "end lap. Base sheet may be applied at a right angle (90 °) to the slope of the deck with approved annular ring shank nails and tin caps at a fastener spacing of 6" o.c. at the 2" side lap, and two 12" o.c. staggered rows along the center of the sheet. (Optional) One, or more plies GAFGLAS PLY 4® Ply, GAFGLAS F1exPlyTM 6 sheet, GAFGLAS #80 Ultiman% RUBEROID MOP Smooth or RUBEROID® 20 adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20- 40lbs.sq. One ply RUBEROID® MOP, RUBEROID® MOP PLUS or Tile -Mate Cap membrane may be applied at a right angle (90°) to the slope of the deck* adhered in a full mopping of Type W asphalt applied within the EVT range and at a rate of 20-40 lbs. /sq. Membrane shall be backnailed to deck with approved annular ring shank nails and tin caps in accordance to applicable Building Code. No nails or tin caps shall be exposed * Membrane may also be installed parallel to the slope of the roof (i.e. strapping). If membrane is strapped, then anchor sheet and ply sheet must also be strapped. Refer to tile manufacturer's NOA. Must Comply with Roofing Application Standard RAS 118, RAS 119, RAS 120 and applicable Building Code. NOA No: 03-0501.05 Expiration Date: 11/04/08 Approval Date :10/23/03 Page 20 of 21 • • • • • 00000 • • 00000 • • 0000•: • 0000• •••• WOOD DECK SYSTEM LIMITATIONS: 1 A slip sheet is required with Ply 4 and Flex Ply 6 when used as a mechanically fastened base or anchor sheet. 2. Minimum 1 /a" Dens Deck or Yi Type X gypsum board is acceptable to be installed directly over the wood deck. GENERAL LINIITATIONS: 1. Fire classification is not part of this acceptance, refer to a current Approved Roofmg Materials Directory for fire ratings of this product. 2. Insulation may be installed in multiple layers. The first layer shall be attached in compliance with Product Control Approval guidelines. All other layers shall be adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs./sq., or mechanically attached using the fastening pattern of the top layer 3. All standard panel sizes are acceptable for mechanical attachment. When applied in approved asphalt, panel size shall be 4' x 4' maximum. 4. An overlay and/or recovery board insulation panel is required on all applications over closed cell foam insulations when the base sheet is fully mopped. If no recovery board is used the base sheet shall be applied using spot mopping with approved asphalt, 12" diameter circles, 24" o.c.; or strip mopped 8" ribbons in three rows, one at each sidelap and one down the center of the sheet allowing a continuous area of ventilation. Encircling of the strips is not acceptable. A 6" break shall be placed every 12' in each ribbon to allow cross ventilation. Asphalt application of either system shall be at a minimum rate of 12 lbs. /sq. Note: Spot attached systems shall be limited to a maximum design pressure of -45 psf. 5. Fastener spacing for insulation attachment is based on a Minimum Characteristic Force (F) value of 275 lbf., as tested in compliance with Testing Application Standard TAS 105. If the fastener value, as field - tested, are below 275 lbf. insulation attachment shall not be acceptable. 6. Fastener spacing for mechanical attachment of anchor/base sheet or membrane attachment is based on a minimum fastener resistance value in conjunction with the maximum design value listed within a specific system. Should the fastener resistance be less than that required, as determined by the Building Official, a revised fastener spacing, prepared, signed and sealed by a Florida Registered Engineer, Architect, or Registered Roof Consultant may be submitted. Said revised fastener spacing shall utilize the withdrawal resistance value taken from Testing Application Standards TAS 105 and calculations in compliance with Roofing Application Standard RAS 117. 7. Perimeter and comer areas shall comply with the enhanced uplift pressure requirements of these areas. Fastener densities shall be increased for both insulation and base sheet as calculated in compliance with Roofing Application Standard RAS 117. (When this limitation is specifically referred within this NOA, General Limitation #9 will not be applicable.) 8. All attachment and sizing of perimeter nailers, metal profile, and/or flashing termination designs shall conform with Roofing Application Standard RAS 111 and applicable wind load requirements. 9. The maximum designed pressure limitation listed shall be applicable to all roof pressure zones (i.e. field, perimeters, and comers). Neither rational analysis, nor extrapolation shall be permitted for enhanced fastening at enhanced pressure zones (i.e. perimeters, extended . comers and comers). (When this limitation is specifically referred within this NOA, General Limitation #7 will not be applicable.) 10. All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and Rule 9B -72 of the Florida Administrative Code. • .• 0.00• • •••• • • •• • •••• • • 0••• • ••• "• • •• • •• • • • • ••• • • • • • • • •• •• ••• •••• •••••• • 0000•• END OF THLS ACCEPTANCE NOA No: 03-0501.05 Expiration Date: 11/04/08 Approval Date:10/23/03 Page 21of21 www.sunmz.Org - Department of State -10-Etkit TM:EN y .0 T E Page 1 of 2 Home Contact Us E-Filing Services Document Searches Forms Help Frgligua on-Is Next On _WA REAurn Tollst No Events No Name History Detail by Entity Name Florida Profit Corporation AA1 CONTRACTORS, INC. Filing_Information Document Number P06000048536 FEUEIN Number 204633080 Date Filed 04/05/2006 State FL Status ACTIVE Effective Date 04/04/2006 Principal Address 245 S.W. 133 COURT MIAMI FL 33184 US Mailing Address 245 S.W. 133 COURT MIAMI FL 33184 US Registered Agent Name & Address GOMEZ, WILBERT 245 S.W. 133 COURT MIAMI FL 33184 US Officer/Director Detail Name & Address Title P GOMEZ, WILBERT 245 S.W. 133 COURT MIAMI FL 33184 US Annual Reports Report Year Filed Date 2007 01/10/2007 2008 01/08/2008 Document Images 01/08/2005 ANNUAL REPORT 01/10/2007 -- ANNUAL REPORT 04/05/2006 Domestic Profit ' DI° rEn-iity Name Search http://www.sunbiz.org/seripts/cordet.exe?action=DEIFIL&Mq_doc_ number=P0600004853... 9/9/2009 STATE OF FLORIDA ,DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE TALLAHASSEE GQMEZ WILBERT 245 CONTRACTORS RT INC MIAMI FL 33184 Congratutationel 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 harbaque 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 tog onto www.myfloridallcaense.com. There you can fit 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! ACS 3791581 DETACH HERE • STATE OF FLORIDA 3717 DEPARTMENT OF BUSINESS . ' PROFESSIONAL, REt3U !tON. ,;. CCC3.328617 05/27/0'8 ''4710313 .. CEVTIFIErt : ROOFING CONTRACTOR NIZiB T RI�CTORS INC x$ exatessatto under the pray-Jaimeog Ch.48'. *phaeton data, AUG 31, 2010 L0806210021 1 XN"BO RRrTxo f2K X RAGO M SECRETARY TNIS IS NOT A SILL-DO POT PAY' RENEWAL RIECEIPT NO. 612672-6 TEN MC1511878 7,412-9. Sumess NAME AA1 C0t4 245 SW 33184 ORIN FIRST-CLASS U.S. POSTAGE PAID MAK FL PERMIT NO. 231 OWNER AA1 CONTRAI# See, Type of 196 RE ea 0 P 11414 IfRVirt QZONtNGtAW$ N00 pyytit 0000 SAO SEE OTHER ME DO NOT FOFPNAREI AA1 CONTRACTORS INC WILBERT GOMEZ PRES 245 SW 133 CT MIAMI 19. 33184 1.11.A.A.hd.L.H.AJAL.Wddlibt ALEX SINK CHIEF FINANCIAL OFFICER DEPARTMENT O F FINANCIAL IAL SERVICES DIVISION OF WORKERS' COMPENSATION w- * * CERTIFICATE OF EI,ECTiOIV TO BE EXEMPT FROM FLORIDA WOiii IS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. 12 »27 -2007 EFFECTIVE DATE: PERSON: FEIN: 02/20/2008 • LEVY 861148028 BUSINESS NAME AND ADDRESS: NORTH AMERICA DEVELOPMENT GROUP CORP 3550 NW 1STM STREET MIAMI FL 3212E SCOPES OF BUSINESS OR TRADE: 1- CONCRETE WORK EXPIRATION DATE: 02/19/2010 ROBERTO ttdPORTANT: Pursuant to Chapter 440 . 061141 F.S., an officer id corporation who elects exemption from this chapter by filing a certificate al electiae under this section may not recliner benefits et compensation under this chaplet. Forsoant to Chapter 440.06tlZ1, E.s., CenlNcttles of eletx*on to be exaaq►t... eppiy only (onbia Use scope of the business or trade listed on the sotico of wooden to be exempt. Pursuant to Chapter 440.06(10, F.S., Notices ef election to ba a mtpl and certificates of election to be exethpt Steli be subject to revocation 11, et any time attar the flung of the notice or the Issuance of the certificate, the person gamed on the nonce or Certificate an tattler mints the requirements of this section for issuance of a certificate. The department shall revoke a certificate at atty time Far failure of the person named on the certiftoath le mast the requirement of this saran. QIIESTIONS7 (850) 413 -1 DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-08 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DNISION OF WORKERS' COMPENSATION CONSTRUCl'ZON INDUSTRY CERTIFICATE OP ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 02/20/2008 PERSON: ROBERTO LEVY FEIN: 651146026 BUSINESS NAME AND ADDRESS: WORTH AMERICA DEVELOPMENT GROUP CORP 355o NW 15TH STREET MIAMI, FL 33125 EXPIRATION DATE: 02/10/2010 SCOPE OF BUSINESS OR TRADE; 1- CONCRETE WORK IMPORTANT 0 F Pursuant to Chapter 440.05(14), F.S., mt 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 componsstion under 'MIS 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 Iisted on the notice of etection to lift exempt. 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 meet: 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 certiflcote to moat the requirements of this section. QUESTIONS? (8501 413-1609 CUT HERE * Carry bottom portion on the job, keep upper portion for your records. )WC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -08 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 lck Inspection Number: INSP- 169171 Permit Number: PL -10 -09 -1616 Scheduled Inspection Date: January 27, 2012 Inspector: Hernandez, Rafael Owner: LALANNE, VILBRUN Job Address: 190 NE 91 Street Miami Shores, FL 33138- Project: <NONE> Contractor: LONCUS PLUMBING CONTRACTORS INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010190080 Phone: 305 -383 -9259 Building Department Comments plumbing Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FO NSP- 125972. no access January 26, 2012 For Inspections please call: (305)762 -4949 Page 13 of 17 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 A / II ,° ^, Permit No.V ig O-0 Master Permit No. % / ,/ Permit Type: Plumbing / Owner's Name (Fee Simple Titleholder) V /' b �'1/j� L.o4 / �i lit Yi Phone # Owner's Address / C 0 t/e" di/ 5 J City t4 p9.4 t Sl -t+res Tenant/Lessee Name E -MAIL: 1,.(„/ Ewf € { Job Address (where the work is being done) 1 el 0 J { 5 City Miami Shores Village County Miami -Dade FOLIO /PARCEL# (1— 31 0) — ®, 9 — Oak) Is Building Historically Designated 3c6:-. 724 F')7 State Zip 33 i, ' Phone # YES NO Contractor's Company Name OC..tS Contractor's Address e3e) City 1Q ( 1 State —a e • Qualifier Name Zip Phone # BO 2-'t OC , Zip S a l t 4. State Certifi ate or Registratio o. _p _ t 1Z. ') Certificate of Competency No. E -MAIL: LQN)ctt.S �O✓ Architect/Engineer's Name (if applicable) iLteliet. Phone # 7 • 5.2-44# 3 6 37 Phone # S Y, Value of Work For this Permit $ Square / Linear Footage Of Work: 3 3 c Type of Work: on ❑A lte/rration ONew rj(%i v K. t7 \n....• Describe Work: O Repair /Replace J4/ 8-"a) Demolition J xsr * * * *x * ** * *** *** * * * * * * * * ** ** ** * *** *Fees, *x * ** Submittal Fee $ - Permit Fee $ Notary $ Training /Education Fee $ Scanning $ 00 Radon $ f • CQ`6 DPBR $ Bond $ Code Enforcement $ ****** ****** *** x********** * *** *** CCF $4,0•V CO /CC �'' Technology Fee $. 1-'L Zoning $ Double .Fee $ • Structural Review. $ Total Fee Now Due $ 15 .11 See Reverse side -+ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender'4. Name (if applicable) Mortgage Lender's Address City Zip 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 perfor►ned 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 ch occurs seven (7) days after the building permit is issued. In the absence f such posted notice, the inspection will not be a ved an.. reinspection fee will be charged. Owner or Agent Contr . ctor day of c2ip , 20 0i, by Lit tiNVIA The foregoing instrument was acknowledged before me this / 9 The foregoing inst snt was acknowledged before me is 0% day o Signature >2' •by, 41 who is personally known to me or who has produced a. j_ As identification . nd who did take an oath. ua' NOTARY PUBLIC: ,x.0'1 1%% I ARQ ,, 9o.••....4 ". 9.20 • Sign: Print: My Commission Expires: �� .,.• cauNOtk A 6'16 '•:••. onally know who did take an oath. APPLICATION APPROVE (Revised 02/08/06) My Commission Expires: **************************,***** * * * * * * ** ** * *** ** * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 190 91 Street Miami Shores, FL 33138- Owner Information Parcel Number Applicant Address VILBRUN LALANNE 1131010190080 Block: Lot: 190 91 Street MIAMI SHORES FL 33138 -2810 ROSE LALANNE Phone Cell Contractor(s) Phone LONCUS PLUMBING CONTRACTORS 305 -383 -9259 Cell Phone Valuation: Total Sq Feet: Type of Work: PLUMBING Type of Piping: Additional Info: Bond Retum : Classification: Residential Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Permit Technology Fee Radon Surcharge Scanning Fee Submittal Fee Submittal Reversal Fee Total: Amount $1.20 $1.68 $0.40 $190.00 $4.75 $1.68 $3.00 $50.00 ($50.00) $202.71 Invoice # PL -10-09 -36023 PL -10-09 -36023 Check #: 3539 Total Amt Paid Amt Due $ 202.71 $ 152.71 $ 202.71 $ 202.71 $ 0.00 $ 1,800.00 For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Top Out Re Pipe Main Drain Heater Water Service Final Water Main Lavatory Underground In consideration of the issuance to me of this permit,. I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. February 01, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy February 01, 2010 Date 1 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 BELLOy REMBLRTO LONCUS PLUMBING CONTRACTOR INC 882 S.W. 68TH COURT MIAMI FL 33144 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.myfloridafcense.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 5TAT of FLOii1DA AC# 4 4 9 8 4 9 5 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CFC1428066 08/07/09 087048433 CERTIFIED PLUMBING CONTRACTOR BEZrLO, REUBERTO LONctTO MAIMING CONTRACTOR INC il9 CERTIMED =Aar thee proviaions o£ Ch. 488 ree •sswt,edtian doto. AUG 31. 2010 L09380700190 Ac# 4498495 STATE OF FLORIDA • • DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY .T,ICRN5ING,. BOARD SEO T.409080700190 08/0712009 087048433 LICENSE =R C>d'C1428066 The PLUMBINt CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2010 BELLO, RENBERTO LONCUS PLUMB /NO CONTRACTOR INC 882 S.W. 6 8TH COURT MIAMI VI. 33144 CHARLIE CRIST GOVERNOR DISPLAY AS REQUIRED BY LAW CHARLES W. DRAGO SECRETARY ACOR'D. CERTIFICATE OF LIABILITY INSURANCE x/2010 PRODUCER Serial 1'121804 UNDERWRITERS, No ABA PABLO M CONDE A062661 87$6 sw 8 ST MNAMi, FL. 33174 THIS CERTIFICATE IS ISSUED 'AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ALTER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW - INSURERS AFFORDING COYER AGES i MAC* INSURED LONCUS PLUMBING CONTRACTOR CORP. 882 SW 68 CT MIAMI, FL 33144 I INSURER A: NORTH POINTE INSURANCE CO. INSURER e: BUSINESS FIRST INSURANCE CO __.. INSURER 0: INSURER tr INSURER a: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN IS SUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT'NITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 8E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDMONS OF SUCH POLICIES, AGGREGATE LAWS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER tiq wTETEt . ey,DDDMY LIMR3 A OMR& it LIABRRY OOMm IALtiENE:RALL)ABIUTY CLS 1335309300129933 11/14/2009 11/14/2010 EACH OCCURRENCE 500,000 PR I °,� 1 $ 100,000 EMI III C1AIN8 MADE X OCCUR MED EXP (AM wt3 penal) $ t000 PERSONAL 8 ADV INJURY $ 500,000 G5NERALA0CC)RREGATE $ 1,000,000 CNENI.ACIOREGATF UNITAPPLIESPER POUOY P4 • LOO 2MWS- COMP/OPAGG S 1 000 000 AUTOMOBILE • ■ • In La6I11TY ANY AUto ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS SINGLE UMTf $ pD1LY INJURY - WORN' INJURY (Per L GARAGE UABIJTY ANY AUTO AUTO ONLY EA ACCIDENT 3 OTHER THAN EA ACC 5 AUTO ONLY: AGO 3 EXCESS/UMBRELLA ■ LIAINLITT OCCUR . CLAIMS MADE DEDUCTIBLE RETENTION $ EACH O( U RENCE $ AGGREGATE ---- ig $ $ $ R wORKERtS EMPLOYEES' LIABILITY NPEN A AND ANT PR IETORmARTrlr�w�CUT1ve OFFICERMEMSEtE%CLUDEDZ $ PEECIAI PROVISIONS bow 0521 -01010 08/13/2009 08113/2010 11.1, x FL ELEAOHACGDENT 1,000,000 EI DISEASE- EA EMPLOYED S 1,000,000 EL DISEASE - POLICY LIMIT 3 1,000,00 OTTER DESCRIPTION OF A'RCNSROCATIONSAfE11I LENEXC .LISIONS ADDEO BY ENDORSEMEETTSPECIAL FROYIk1dN4 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VIUAGE 10060 NE SECOND AVE MIAMI SHORES, FL 33138 -2382 I SHOULD ANY OF THE ABOVE DESCFI5ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THE THE ISSUING INSURER WILI. ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TG no LEFT, BUT FAILURE TO DO SO SHAH IMPOSE NO OBUOAIION OR UABIUTY OF ANY IONO UPON TI4E INSURER, ITS AGENTS OR REPRESENTATIVE$, HOI �ODREP,SENTATIVE ARA UND>= RNIRITF.RSS INC .or AUTTHj/ OACORO CORPORATION 1$$8 mIFMPROIGERTPROS.FP6 PDF created with pdfFactory trial version www.odffactory.com DATE_* J0/13/2009 TIME: 11149:U3 3 MIAMI - DADE eUUN 1 Y, rLU1IILPM rinMl\Vm arcr-runt I 11,11111•11V R TAX COLLECTION DIVISION 140 W. FLAGLER STREET _ MIAMI, FLORIDA 33130 LOCAL BUSINESS TAX LBTR YEAR: 2010 OCLM031' ACCOUNT FILE MAINTENANCE ACCOUNT a 591873-6 COMM—DATE: B U S I N E S S m DELETE --ST: NAME; LONCUS PLUMPING CONTRACTOR INC AtJDR 1 1331 SW 84 CT ZIP: 33 144 MUN: 30 ZONE: 07 C O R P / O W N E R ( M A I L I N G NAME: LONCUS PLUMBING CONTRACTOR INC ADDR1 1.321 SW S4 CT ZIP: 33144 HOME OFF10Et Y O T H E R I N F O R M A T I O N : PP— FOLIO: 00 000000 SSN /EIN: E RE—FOLIO: 30 4 310 033 0010 F I CTNM I LBT RCPT SEC TYPE AMOUNT —DUE O/R PD 617415-5 196 PLUM P 11 2006 ENTRY— TYPE —DTEt W 11/14/200, INSP— ID— DT'E.1 00/00/000+ SUITE4 PHONE: ( 305 ) 212 1004 C/O: %BURY BELLO PRES CITYI MIAMI STATE: FL, 650832099 BAI:+CH; I LAST — TRANS —DTE: 11/14/2006 �± . . . x . . . . A . a . . . . . a Pe LEGAL INSP —ID INSP —DATE HOLD —LIC mrAMOADE TAX COLIFtitio .p F 1 41ENU CLE `AR =P REVSCREEN F4 =MORERCT ENTER =RCT F9=UPD F 12 =PAFF'L F 13= FTX IMPORTANT; 'SIR INFORMATION HEREIN DOES NOT NECESSARILY CONTAIN Va�1 UT#'NITH REGARDS TO REAL ESTATE CLOSINGS AND OTHER SIMILAR ACTIVITIES. MIAMI'DADE OIINT DATE: 10/13/2009 TIME: 11 :49:06 ACCOUNT: 591873-6 MIAMI - DADE COUNTY, FLORIDA FINANCE DEPARTMENT TAX COLLECTION DIVISION 140 W. FLAGLER STREET MIAMI, FLORIDA 33130 LOCAL BUSINESS TAX LBTR YEAR: 2010 OCLH031i RECEIPT FILE MAINTENANCE LONCUS PLUMBING CONTRACTOR /NC 1331 SW 84 CT RECEIPT: 61 7415 -5 RENEWAL COMM —DATE: 1.1 S006 E NTRY-- TYPE —DTE: W STATUS; LAST—TRANS—DATE: 10/13/2009 INSP-- ID —DTE: SEC TYPE ITEMS 196 PLUM 3 JOB CLASS: STATE: CFC1428066 EXEMPT —CD: CITY RECEIPT /ZONING HOLD— APPL.1 C LEGAL: WARNING Is: PREV —YRS: YEAR 2009 TRANSF —FROM: iM: TRANSF —TO : NAICS: CAT /NAIC S1 23822 DESCRIPTI.ON PLUMBING CONTRACTOR CC: HOLD: Y VET --ID. PERMIT: MUN —CONT HOLD —REC: INSP RCM: .00 YEAR: 2008 11/14/20CU 00 00 0000 PRV —'IRS: .0t CURRENT: 75.0( PENALTY: .0( DELC PEN: .0C C - SVC- CHS: .0( TRANSFR1 .0C SHERIFF: .0C ADJUST s .0( EXEMPT : .0C a 00 TOTAL : 75.01 Y PAID 75.0C ORIO - -REC: DUE : .0C F1 =MENU CLR =PREY F2 =FMHST F3 =PMTS F'4 =M0PE F5= MEMINQ F6=MUNINI► F9 =UPD F10=MEMADD F i i =MUNA- LIED F 12 =APPS F13=HELP F 15 =CONTR F 1 ^o=CNTRL IMPORTANT: THE INFORMATION HEREIN DOES NOT NECESSARILY CONTAIN ALL PERTINENT FACTS WITH REGARDS TO REAL ESTATE CLOSINGS AND OTHER SIMILAR ACTIVITIES. *MEMOS* NOTE: ALL SHEET MUST BE REVIEWED MIAMI -DADE COUNTY BUILDING DEPARTMENT P +c� D P '7Z 'o . Herbert S. Saffir Permitting and Inspection Center . 1 + 11805 SW 26th Street (Coral Way) • Miami, Florida 33175 -2474 • (786) 315 -2100 APPLICATION FOR MUNICIPAL PERMIT APPLICANTS THAT REQUIRE PLAN REVIEW FROM MIAMI -DADE FIRE RESCUE AND /OR DEPARMENT OF ENVIRONMENTAL RESOURCES MANAGEMENT P�ROVIDE MUNICIPAL PROCESS NUMBER HERE LOCATION OF IMPROVEMENTS ` A Job Address (5 0 Nv ei ( 5r CONTRACTOR INFORMATION Contractor No. CaC 1.3z9 c cap Last four (4) digits of Qualifier No. / 7 Folio //,? //a/ 4) / (47 acs Contractor Name ,eft kx I<1 Lot (( Block —1 Qualifier Name P, m _l 4i Subdivision Z- (76 PB pg — a. Address . > 1 Metes and bounds City 1-4( dPrrst I Stat Zip 33 TYPE OF IMPROVEMENTS [ ] New Construction on Vacant Land [ ] Alteration Interior [ ] Alteration Exterior [ ] Relocation of Structure [ ] Enclosure [ ]Repair [ ] Repair Due to Fire [ ] Demolish [ ] Shell Only [ ] Addition Attached [ ] Addition Detached [ ] Re -Roof [ ] Foundation Only Current use of property �'7 C Description of Work ,�.. y Sq. Ft. / Cam✓ A v Units / Floors Value of Work PERMIT TYPE [ MBLD* Category REVIEW STATUS [ ] Chg. Contractor [ ] Re -Issue [ ] Re -Stamp [ ] Revision [ ] Not Applicable for Fire OWNER'S NAME Owner t 1, I �YvinLGiLt Low Address (4 0 b T ( r- , ] MELE City �.. Q Stat Zip 3 7! 3? Phone Ns [ ] MLPG Last four (4) digits of Owner's Social Security Nom io.(Z 2— [ ] MMEG [ ] FIRE PERSON TO PICK UP PLANS Name L<JUA' t �i �-- ARCHITECT / ENGINEER Owner 1`�` G. c�- /f'ry -AP e Address Address 1 v 5 r 5 L' A X1 ``- ` ( City State Zip City 1Pt (1)'v' -'t I State_ Zip TV, Phone (.1)f-- 5-243' ' ° .-?637 Phone ` 7 -- t i FIRE SPECIAL REQUEST PLAN REVIEW (SRI) a I am requesting a Special Request Plan Review (SRI) to be scheduled as soon as possible at the rate of $190 for the first hour and $65 per each additional hour in addition to the review fees. Minimum charge one -hour. 1st Request: Date: 2nd Request: Date: 3r' Request: Date: GERM OPTIONAL PLAN REVIEW (OPR) / am requesting Optional Plan Review (OPR) to be scheduled as soon as possible at the rate of $75 for each discipline. Additional review fees may apply. 1st Request: Date: 2"d Request: Date: 3b Request: Date: 123_01-192 3/08 BUILDING PERMIT CATEGORIES CATEGORY DESCRIPTION PERMIT TYPE BUILDING 01 GENERAL BUILDING - COMMERCIAL MBLD 02 SUB - GENERAL BUILDING - RESIDENTIAL MBLD 08 CANVAS AWNING MBLD 10 COMMUNICATION TOWER MBLD 15 DEMOLITION MBLD 29 METAL AWNING & STORM SHUTTER MBLD 48 SCREEN ENCLOSURES MBLD 55 SWIMMING POOL MBLD 56 TENNIS COURTS (SURFACE PAVING) MBLD 86 TRAILER TIE DOWN MBLD 88 WALK -IN COOLER MBLD 91 MARINAS MBLD 92 LOW SLOPE APPLICATIONS (GRAVEL, SMOOTH MODIFIED, SINGLE PLY) MBLD 95 SHINGLES (ASPHALT, FIBERGLASS) MBLD 96 SHINGLES (METAL ROOFS/WOOD SHINGLES & SHAKE) MBLD 97 STAGE 2 VAPOR RECOVERY SYSTEM MBLD 99 SOIL IMPROVEMENT MBLD 0100 BULK STORAGE PROPANE TANK MBLD 0101 REMOVABLE STORM PANELS MBLD 0107 TILE ROOF MBLD 0110 WATER MAIN MBLD 0111 SITE PLAN MBLD 0112 INDOOR EVENT /EXHIBIT MBLD ELECTRICAL 04 FIRE ALARM SPECIALTY MELE 16 SPECIALTY WIRING MELE 38 GENERATORS MELE LPGX 01 LIQUEFIED PETROLEUM GAS MLPG 02 MISCELLANEOUS MLPG 04 LIQUEFIED PETROL. GAS /STATE MLPG MECHANICAL 09 ABOVE/BELOW GROUND TANKS /PUMPS & POLLUTANT STORAGE SYSTEM MMEC 38 COMMERCIAL HOODS MMEC 43 FIRE CHEMICAL MMEC 46 SPRAY BOOTHS MMEC 48 SMOKE CONTROL MMEC 52 RESIDENTIAL ELEVATOR MMEC FIRE 32 FIRE SPRINKLER FIRE 4r PERMIT If: 13-SC-997585 APPLICATION #:AP931307 STATE OF FLORIDA DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID* SYSTEM RECEIPT # CONSTRUCTION PERMIT FOR: OSTDS Abandonment APPLICANT: Vilbrun Lalanne Documba #: PR781034 PROPERTY. ADDRESS: 190 NE 91 -St LOT: 11 Miami, FL 33138 BLOCK: 7 SUBDIVISION: PROPERTY ID #: 11- 3101 -019 -0080 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION A 381.0065, F.S., AND CHAPTER 64E -6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE ii SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND. VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ ] GALLONS / GPD CAPACITY A [ ] GALLONS / GPD CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ ] SQUARE FEET SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [ ] BED [ 1 N F LOCATION OF BENCHMARK I ELEVATION OF PROPOSED SYSTEM SITE [ 1 [ / ] [ ABOVE /BELOW ] BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ ] [ / ] [ ABOVE / BELOW 1 BENCHMARK /REFERENCE POINT L D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: [ ] INCHES 0 T H E Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The tank shall be filled with clean sand or other suitable material, and completely covered with soil.Have the system inspected by the health department after it has been pumped and ruptured but before it is filled with sand and covered. R SPECIFICATIONS BY: -I•RO N •SPINA T : -Legacy APPROVED BY fir-._ TITLE: 0 Dade CHD N Ospina DATE .ISSUED: 08/03/2009. EXPIRATION DATE: 11/01/2009 DH 4016, 10/97 (Previous Editions May Be Used) Page 1 of 3 v 1.1.4 AP931307 SE -1 STATE OF FLORIDA =�f DEPARTMENT OF HEALTH �, Vie, of ONSI T E SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL APPLICa NT AGENT: PROPERTY ADDRESS- PERMIT NO. DATE PAID: FEE PAID - RECEIPT #- LOT: BLOCK: SUBDIVISION: CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. [ TANK INSTALLATION [011 TANK SIZE [1] [2] [02] TANK MATERIAL [03] OUTLET DEVICE [04] MULTI - CHAMBERED [Y [05] OUTLET FILTER [06] LEGEND [07] WATERTIGHT [08] LEVEL [09] DEPTH TO LID SETBACKS [27] SURFACE WATER FT E.- ] [28] DITCHES FT [29] PRIVATE WELLS FT [30] PUBLIC WELLS FT [311 IRRIGATION WELLS FT ] [32) POTABLE WATER LINES FT [33] BUILDING FOUNDATION x FT PROPERTY LINES " FT OT.kaEF,l.. FT DRAINFIELD INSTALLATION [10] AREA [1] [2] [11] DISTRIBUTION BOX HEADER [121 NUMBER OF DRAINLINES [13] DRAINLINE SEPARATION [14] DRAINLINE SLOPE [15] DEPTH OF COVER [161 ELEVATION [ABOVEBELO [17] SYSTEM LOCATION [18] DOSING PUMPS [19] AGGREGATE SIZE [20] AGGREGATE EXCESSIVE FINES [21] AGGREGATE DEPTH FILL / EXCAVATION *TERIAL ] ] ] . [22] 1 . [23] 1 [241 ] r [25] ] [26] FILL AMOUNT FILL TEXTURE EXCAVATION DEPTH AREA REPLACED LACEMENT MATERIAL'::;. [341 [3N ry emu= •:; FILLED / MOUND SYSTEM [36] DRAINFIELD COVER [37] SHOULDERS [38] SLOPES [39] STABILIZATION ADDITIONAL INFORMATION [40] UNOBSTRUCTED.AREA [41] STORMWATER RUNOFF [42] ALARMS [43] MAINTENANCE AGREEMENT [44] BUILDING AREA [451 LOCATION CONFORMS WITH SITE PLAN [46] FINAL SITE GRADING [47] CONTRACTOR [48] OTHER ABANDONMENT 91 TANK PUMPED / / TANK CRUSHED & FILLED • EXPLANATION OF VIOLATIONS / REMARKS: CONSTRUCTION [APPROVED /DISAPPROVED]: FINAL SYSTEM [APPROVED /DISAPPROVED]: DH 4016 (Page 2), 10/97 Vrevlous Ed[twns May Be Usecd) Stack Number 5744- 002 - 4016 -4 'PT 1: Appli.ant PT 2: Installer /Cantmctor PT 3: Builoirrg Departmen PT 4: Health Department HD DATE: CHD DATE: Page 2 of 3 Fn 1:lN ✓� ISgrr • Inspector -4� iE Address DIVISION OF Environmental Health Florida Department of Health Miami -Dade County Health Department Strte40 OSTDS /Well Division 11805 SW 26 St: •Miami, FL 33175 V r f Date g(2-679 D OSTDS #l3 — = -< -s.S- +-� 13/3 STATE OF FLORIDA DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID :. SYSTEM RECEIPT #: DOCUMENT #: PR781035 PERMIT # :13 -SC- 997566 APPLICATION #: AP931308 CONSTRUCTION PERMIT FOR: OSTDS Abandonment APPLICANT: Vilbrun Lalanne PROPERTY ADDRESS: 190 NE 91 St Miami, FL 33138 LOT: 11 BLOCK: 7 ' SUBDIVISION: PROPERTY ID #: 11- 3101 - 019 -0080 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]. [OR TAX ID NUMBER] SYSTEM MOST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E -6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ ] GALLONS / GPD CAPACITY A [ ] GALLONS / GPD CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [10,103024 CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 FIRS #Pumps [ D [ ] SQUARE FEET SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [ ] BED [ 1 N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ ] [ / ][ABOVE/BELOW DEIENCHMARIC/REFERMICE POINT E BOTTOM OF DRAINFIELD TO BE [ ]I / 1IABOVE/ BELOW]BENCBMARK /REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ ] INCHES 0 T H E R SPECIFICATI• • BY: PEDRO N 0 +^ TITLE: - Legacy Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The tank shall be filled with clean sand or other suitable material, and completely covered with soil.Have the system inspected by the health department after it has been pumped and ruptured but before it is filled with sand and covered. APPROVED - TITLE: 0 N Ospina Dade CHD DATE ISSUED: 08/03/2009 EXPIRATION DATE: 11/01/2009 DH 4016, 10/97 (Previous Editions May Be Used) Page 1 of 3 v 1.1.4 AP931308 SE -1 (4 Pi3I30 STATE OF FLORIDA PERMIT NO {1 — : ' i )4-b DEPARTMENT OF HEALTH DATE PAID. ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID. CONSTRUCTION INSPECTION AND FINAL APPROVAL RECEIPT #• APPLICANT* AGENT. Al PROPERTY ADDRESS: 1 VC) A f LOT:$ /1 BLOCK: _7 SUBDIVISION: PROPERTY ID #.11 3 / , t2 110 C1 f CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK INSTALLATION [01] TANK SIZE [1] [2] [02] TANK MATERIAL [03] OUTLET DEVICE [04] MULTI - CHAMBERE [05] OUTLET FILTER [06] [07] [08] [09] LEGEND WATERTI LEVEL DE TO LID DRAINFIELD INSTALLATION [10] AREA [1] [2] [11] DISTRIBUTION BOX HEAD. [12] NUMBER OF DRAINLINES_ [13] DRAINLINE SEPARATION [14] DRAINLINE SLOPE [15] DEPTH OF COVER [16] ELEVATION [AB EBELOW] BM [17] SYSTEM LOC ION [18] DOSING PU PS [19] AGGREG E SIZE [20] AGGREGATE EXCESSIVE FINES [21] AGGREGATE DEPTH FILL / EXCAVATION MATERIAL,/ •[22] FILL AMOUNT 0] FILL TEXTURE [24] EXCAVATIO EPTH [25] AREA REP CED [26] REPLAC ENT MATERIAL SETBACKS [ 1 [27] SURFACE WATER r FT [ 1 [28] DITCHES FT [ 1 [29] PRIVATE WELLS FT [ ] [30] PUBLIC WELLS FT [ 1 [31] IRRIGATIO ' ELLS FT [ ] [32] POTA: WATER LINES FT [ ] [33] BUI DING FOUNDATION FT [ ] [34] PROPERTY LINES FT [ ] [35] OTHER FT ] ] FILLED / MOUND SYST (36] DRAINFIEL ' OVER [37] SHOUL [38] SLOPES [39] STABILIZATION ADDITIONAL INFORMATION [40] UNOBSTRUCTED AREA [41] STORMWATER RUNOFF [42] ALARMS [43] MAINTENANCE AGREEMENT [44] BUILDING AREA [45] LOCATION CONFORMS WITH SITE PLAN [46] FINAL SITE GRADIN [47] CONTRACTOR [48] OTHER r ABANDONMENT [ J [49] TANK PUMPED I /9_ [ 1 [50] TANK CRUSHED & FILLED EXPLANATION OF VIOLATIONS / REMARKS: [ 1 [ 1 [ 1 [ 1 CONSTRUCTION [A R D/DISAPPROVED]: FINAL SYSTEM [API 0/DISAPPROVED]: DH 4016 (Page 2), 10/97 (Previous Editions May Be Used) Stock Number. 5744 - 002 - 4016 -4 CHD DATE. CHD DATE. PT 1: Applicant PT 2: Installer /Contractor PT. 3: Building Department PT 4: Health Department . Page 2 of 3 Ent F r d5 � y § • , I9«4£1 £3\ 0A§a y' 26 z2 - &!G m \ q .3J} STATE OF FLORIDA DEPARTMENT. OF HEALTH ONSITE SEWAGE TREATMENT .AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: \Mbrun Lalanne PERMIT #: 13-SC-997564 APPLICATION #: AP931306 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR781688 PROPERTY ADDRESS: 190 NE 91 St Miami, FL 33138 LOT: 11 BLOCK: 7 • sueerVISION: PROPERTY ID #: 11-3101-019-0080 [SECTION, TOWNSHIP, RANGE, PARCEL NONMI2Mq: [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND 'CHAPTER 64E-6, F.A.C. 'DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PffaroRtaNce FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, 'REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS-PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T 1,050 ] GALLONS / GPD Seotic CAPACITY A [ ] GALLONS / GPD N/A CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY (maximum CAPACITY SINGLE TANK: 1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY E ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ D [ 500 1 SQUARE FEET SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ 1 I CONFIGURATION: [x] TRENCH [ ] BED [ 1 N F LOCATION OF BENCHMARK: FFE: 11.05' NGVD I ELEVATION or PROPOSED SYSTEM SITE 18.00 3[1 INCHES I/ FT 1 [ ABOVE E BOTTOM or DRAINFIELD TO BE L D FILL REQUIRED: 0 T E R [ 0.00] INCHES E 48.00 1 [ INCHES FT ] [ ABOVE BENCHMARK/REFERENCE POINT BENCHMARK/REFERENCE POINT EXCAVATION REQUIRED: [ 30.003 INCHES 1.-Install a 1050 gal min. category-3 septic tank with an approved filter. 2.-The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E-6.013(3)(f), FAC. 3.-Install 500 sf of drainfield in trench configuration. 4.-Invert elevation of drainfield to be no less than 7.55' NGVD. 5.-Bottom of drainfield elevation to be no less than 7.05' NGVD. 6.-An abandonment permit for the existing septic tank is required prior to final inspection approval. SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: Astrid V Edwards Astxid V Edwaxcle 08/10/2009 TITLE: Engineer Specialist II TITLE: Engineer Specialist II DE 4016, 10/97 (Previous Editions May Be Used) v 1.1.9 AP931306 Dade EXPIRATION DATE: 02/10/2011 5E794100 b CHD Page 1 of 3 STATE OF FLORIDA DEPARTMENT OF'HEALTH ,O.NSITE sEWAGE, :TREATMENT cONSTRUCTIONI NSPEGTipw P,PR APPLICANT: AGENT: PROPERTY. ADDRESS: LOT: it, BLOCK:. CHECKED . [X] ITEMS. TANK INSTALLATION. [01]: TANK SIZE [1'J [021. • TANK-MATERIAL [03]: OUTLET DEUC E [04] MULTI - CHAMBERED .i.g ]: • [05r. OUTLEr.FI T R - .[06]: LEGENIS a [07I. WATERTIGt' [QB} LEVEL INFrEo 1NS'fACtAT [10] AREA [1] } SQI [111 'fibISTRIBUT10(}Y`HOX ` HEADER_ [121:-; NUMBER. OF. ®RA1NLtj4Eg ' [13] —.::' DRAINUNE SEPARATION , . ' ' [14] :. :DRAINLINE'SLOPE [15} . .: DEPTH' OF COVER :: ELEVATION;[ABQK SYSTE LOCATION P az ,„� [.18] °• .'DOSING..PUMPS' • • [:16] AGGREGATE SIDE [20] 'AGGREGATE EXCESSIVE FINES' [21] ': AGGREGATE DEPT f..1#. "; SETBACKS ] ' ; • [27} sUAFACE CATER ] .: [29].- ;., • ] [30]--POSLIC •t tELL1s i [31] IRRIGATION WELD [32 }: POTABLE.WATERLINE$ ].: •. [33},' BUILDING :FOUNDATION.' ION.' .. ;:[34] PROPERTY & INES .-- FILLED`fIVI -SYST'E ..._'- [36] DRAINFIELD C(?L�ER.: [37] ...: SHOULDERS [ ]; • [39] STABi61ZATtON . ADDf1ONAL: INFORMATION . [ i . [40] UNOBSTRUCTED AREA [ ] : [41].. STORMWATER RUNOFF ALARM [• 1 . • •. [43] MAINTENANCE AOREEME IT': r. ] , [44] BUILDING AREA [ ... ] - [45].. LOCATIQN CONFORMS WITH [ } [461 FINAL SII E G.RADING..;�• [.. 1 ,.: •[47].:. . ,.CONTRACT•R- • [ ]' [48] OTHER ABANDQNMENT [ . ] [49] TANK. PUMPED:y� [ ] .. [50] TANK :CRUSHED.& FILLED. .` %. FILL t. EXCAVATION MATERIAL' FILL AMOUNT 5 Z FILL'TEXTURE`' • EXCAVATION DEPTH AREA REPLACED REPLACEMENT MATERIAL [22] [23] [24].. [25] [26] EXPLANATION OF VIOLATIONS / REMARKS: [ i [.. ] [ .: ] CONSTRU APPROVE ISAPPROVE FINAL SYS [A O DISAPPROVED]: CHD . DATE.. ° .:._: .... .. r. CHD DATE Pa Oe 2 of 3 01-3 4016 (Page 2), 10/97 (Previous Editions May Be Used) Stock Number. 5744 - 002. 4016 -4 PT 1: Appttcant PT 2: instatter/Conteactor PT 3: Building Department -. PT 4: Heafth. Depaciment c 1 8 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number INSP- 122000 Permit Number. PL -8-09 -1351 Scheduled Inspection Date: August 27, 2009 Inspector Levrock, James Owner: LALANNE, VILBRUN Job Address: 190 NE 91 Street Miami Shores, FL 33138- Project: <NONE> Permit Type: Plumbing - Residential Inspection Type: Underground Rough Work Classification: Addition/Alteration Phone Number Parcel Number 1131010190080 Contractor: ALL PRO SEPTIC & SEWER INC / ALL PRO PLUMBING SEP' Phone: (305)635 -3002 Building Department Comments ABANDON (2) TANKS AND INSTALL A NEW SEPTIC TAKE AND DRAINFIELD AS PER DEPARTMENT OF HEALTH. Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. ii A..n..c+ 9C 9AA0 For Inspections please call: (305)762 -4949 Done 7 of 'I 4