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WS-13-1709 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-196168 Permit Number: WS-7-13-1709 Scheduled Inspection Date: September 16,2013 Permit Type: Windows/Shutters Inspector: Naranjo, Ismael Inspection Type: Final Owner: PEGG,JOHN Work Classification: Garage Door Job Address:333 NE 103 Street Miami Shores, FL 33138-2432 Phone Number Parcel Number 1121360130250 Project: <NONE> Contractor: A SUPER GARAGE DOORS, INC Phone: 3051252-1772 Building Department Comments REPLACE EXISTING GARAGE DOOR Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 13,2013 For Inspections please call: (305)762-4949 Page 14 of 38 �' • °� = f Miami. Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Q I Tel:(305)795.2204 Fax:(305)756.8972 V l INSPECTION S PHONE NUMBER:(3115)762.4949 IBC 20 BUILDING Permit No. PERMIT APPLICATION Master Permit No. 0 RM Permit Type: WELDING ROOFING JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 3 J _ Folio/Parcel#: 43 / Is the Building Historically Designated:Yes NO Flood Zone: Q OWNER:Name(Fee Simple Titleholder): 1tG Phone#: Address: -3 3 3 L City: ���'�^l J� �d'r1—�'J! State: TenantUssee Name: Phone#: S Email: tMCt... �ftO • Cow CONTRACTOR:Company Name: bl!'d hone#: Address: 4z— ' City: l�—r" *Y State Zip: � � ©/ V Qualifier Name: (f 11q-A to-S lq-' 72 C/!A� Phone#: ,3oS•'& -/77,2 State Certification or Registration# Certificate of Competency#: S (2-0 r3 Contact Phone#: S ' Email Address: /--/,A DESIGNER:Arcbitect/Engineer. � Phone#: Value of Work for this Permit:$ V. ey o SquarelLinear Footage of Work: J �� Type of Work: OAddition OAlteration ONew *air/Replace ODemolition Description of Work: /P_(F Al-A 64F C K I Y 77pGv G 6-t L-20 A o Color thru tile: Submittal Fee$ Permit Fee$ I�J• CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ 'Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and AIR CONDITIONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be 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 the absence of such posted notice, the inspection will not be proved and a reinspection fee will be charged v Signature Signature Owner or Agent Contractor The fore ping instrument was acknowledged before me this The foregoing instrument was acknowledged before me this ? ' day of 51� ,20 S,by J--� day of_N4(oQ Z- 20�0 by C_4N&L6 S 9-0%7-- who is personally known to me or who has produced who is personally known to me or who has produced e-•^t S�> As identification and wkR�#i ugvg^ as identification and did take an oath. <� J v� tttutli did P C: �`� `a4 - ®,j''iv NOTARY PUBLIC: �`����5 �4��i� Sign: - = Sign: Pant: : to' ,1�t�90�rn Pant: My Commission Expires: � My Commission Expires� ;���``ems• APPROVED BY 0 Plans Examiner Zoning Structural Review Clerk (Revised 3 112/2012XRevised 07/10/0)(Revised 06110/2009)(Revised 3/15109) LOT-10 LOT 9 LOT-8 LOT-7 a BLOCK$118 BLOCK-118 BLOCK-118 'BLOCK-118 9.750 9.90 �y 10.05 g _a 15'ALLEY(N.A.P.) x/ a' T ti ld F.I.P 11rv. Oil PVMT. pi V-1 NO CAP 100.00' NO CAP ° + 4'C.t.F. 0.40CL 11 T 9124 LOT-16 , v $ LOCK-118 9.80 1.01CL. L t. 9.68 ix M ( 9.98 �-- g LOT-17 /"— \x x BLOCK-118 x 9.90 vol�. 11.60' m 21.40' S . . 10. � � inp / u' C.S.• ' 1:90 + 10.40 99.880 1 0.00 27.72' ih ® 0.10 GL 15.40' (11.42' 9.70 23.91 x�_ LOT-18 LOT-15 ONE STORY BLOCK-118 BLOCK-118 RES.�333 F.F.E=12.40' o GARAG ELEV=10.05' 10.03 'A 1s.2 ' A/C x 0 40'CL a 0.80 CL 14.70' 94 C.P. • " 15.40' 2J 49' x C.B.W. 10.10 11. 9.90 92 x 10.20 C.B.W. v q N I N r- M P m 150' 9.80 9.70 F.I.P 112" ;100.00' y: B.C. NO CAP * �r 5`NONC,SO • NO CAP F.LP1/2° NO CAP 9.85 V V c 20'Pte, c ` U, P �,J�am;ShMoilla gP llu 1 10.60 STREET 10 3'ASP IALT ZONNG DEFT T F" BLDG DEFT SUBJECT (0 CCNIPUP1,1C.E WITH ALL FEDERAL STATE ANv CC_IJN'i f aLjL S AND REGULATIONS �. � 1 ��`.yj� i�XS .i.f Y& � t ¢b �} P-L.aY'� t �� x � ; �. �: � �" �� �� g d Z WORST CASTE DESIGN PRESSURE CHART RETROFIT GARAGE DOOR - COMMERCIAL SIZES 1-75-MPH., P S.0 , .C, 2O O FLORIDA RUILDIN.G CODE .(A , 7-1'ID) ... . ._ ADE CO., FLORIDA THE CHARTS BELOW ARE DETERMINED FOR THE WORST CASE SCENERIO,BASED ON an k" THE FOLLOWING ASSUMPTIONS: B I PRODUCTS 1)THE ENTIRE GARAGE DOOR OPENING IS ASSUMED TO BE IN THE END ZONE(ZONE 5) t�J ACCORDING TO ASCE7 CALCULATION METHODS. A Oriffui C.:carrtpu y 2)BASED ON ENCLOSED BUILDING,ANY ROOF SLOPE. 3)ULTIMATE WIND SPEED CONVERTED TO DESIGN WIND SPEED PER TABLE 1609.3.1. NO OTHER LOAD FACTORS OR REDUCTIONS ARE ALLOWED. NOTE 1:SPECIFIC,INDIVIDUAL GARAGE DOOR OPENINGS WILL MOST LIKELY NOT REQUIRE THE OPENING TO BE COMPLETELY IN ZONE 5 BY CALCULATION.THEREFORE INDIVIDUAL CALCULATIONS WILL MOST LIKELY RESULT IN LOWER NEGATIVE DESIGN PRESSURES THAN SHOWN ON THESE CHARTS. NOTE 2:DOORS LARGER THAN THOSE LISTED MAY USE THE DESIGN PRESSURE FOR THE NEXT SMALLEST DOOR BECAUSE DESIGN PRESSURE DECREASES AS OPENING SIZE INCREASES.FOR EXAMPLE,A 16'x10'OPENING CAN BE ASSUMED TO HAVE THE SAME DESIGN PRESSURE AS A 16'x8'OPENING BECAUSE ACTUAL CALCULATIONS WILL SHOW THE 16'x10'TO HAVE A LOWER DESIGN WORST CASE DESIGN PRESSURES (PSF) MEAN ROOF HEIGHT UP TO 15' 16' 17' 18' 19' 20' 21' 8'x7' +35.6 -44.7 +36.01 -45.2 +36.4 -45.7 +36.8 -46.3 +37.3 -46.8 +37.7 -47.3 +38.0 -47.7 N 8`x8' +35.2 -44.0 +35.7, -44.5 +36.1, -45.0 +36.5 -45.5 +36.9 -46.1 +37.3 -46.6 +37.6 -47.0 55 9'x7' +35.3 -44.1 +35.7 -44.6 +36.1 -45.1 +36.5 -45.6 +36.9 -46.1 +37.4 -46.7 +37.7 -47.1 0 9'x8' +34.9 -43.4 +35.3, -43.9 +35.8 -44.4 +36.2 -44.9 +36.6 -45.4 +37.0 -45.9 +37.3 -46.3 z 16'x7' +33.8 -41.1 +34.2 -41.6 +34.6 -42.0 +35.0, -42.5 +35.4 -43.0 +35.8 -43.5 +36.1 -43.9 w 16'x8' +33.4, -40.4 +33.8 -40.9 +34.2, -41.3 +34.6 -41.8 +35.0 -42.3 +35.4 -42.8 +35.7 -43.1 o 18'x7' +33.5, -40.5 +33.9, -40.9 +34.3, -41.4 +34.7, -41.9 +35.0, -42.4 +35.4, -42.8 +35.8, -43. 18'X8' +33.1, -39.8 1 +33.5, -40.2 +33.9, -40.7 +34.3, -41.2 +34.7, -41.6 +35.1, -42.1 +35.4, -42.5 WORST CASE DESIGN PRESSURES (PSF) MEAN ROOF HEIGHT 22' 23' 24' 25' 8'x7' +38.3 -48.2 +38.7, -48.6 +39.0, -49.0 +39.4, -49.4 w 8'x8' +38.0 -47.4 +38.3 -47.8 +38.6, -48.2 +39.0, -4 .6 N 05 9'x7' +38.0 -47.5 +38.31 -47.9 +38.7 -48.3 +39.0, -48.7 C7 9'x8' +37.6, -46.7 +38.0, -47.2 +38.3 -47.6 +38.6, -48.0 z 16'x7' +36.4, -44.3 +36.7, -44.6 +37.0 -45.0 +37.4, -45.4 W 16'x8' +36.0, -43.5 +36.3 -43.9 +36.7, -44.3 +37.0 -44.7 CL 18'x7' +36.1 43.6 +36.4 44.0 +36.7 44.4 +37.0 44.7t� �aa�#$ � 18'x8' +35.7, -42.9 +36.0, -43.2 +36.3, -43.6 +36.6, -44.0 �+►�� � ..4 $ � ei iG THIS CALCULATION T IS ONLY VALID No 63206 FOR THE FOLLOWING BRANDS: CLOPAY, IDEALg AND HOLMES. ,� R STATE OF w' �0 i Scott Hamilton, P.E. 4 R 1O�R'- 'k DUKE O 4D5040 N" w7'y J", (513) 770-4800 signatu e 4J27J2012 FLORIDA P.E. No. 63286 File: DADE CO WORST CASE 2010 C. F Y', r MI ODE MIAMI-DADE COUNTY s PRODUCT CONTROL SECTION DEPARTMENT OF PERMITTING,ENVIRONMENT,AND REGULATORY 11805 SW 26 Street,Room 208 AFFAIRS(PERA) Miami,Florida 33175-2474 BOARD AND CODE ADMINISTRATION DIVISION T(786)315-2590 F(786)315.2599 NOTICE OF ACCEPTANCE (NOA) ww.iniamidgde.gov/pera/ Clopay Building Products Company 8585 Duke Boulevard Mason,OH 45040 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials.The documentation submitted has been reviewed and accepted by Miami-Dade County PERA-Product Control Section to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). . This NOA shall not be valid after the expiration date stated below.The Miami-Dade County Product Control Section(In Miami Dade County)and/or the AHJ(in areas other than Miami Dade County)reserve the right to have this product or material tested for quality assurance purposes. If this product or.materlal 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. PERA reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein,and has been designed to comply with the Florida Building Code, including the High Velocity Hurricane Zone, DESCRIPTION: Steel Sectional Garage Door up to 9'-0"Wide w/Optional Impact Resistant Lites APPROVAL DOCUMENT: Drawing No. 101706,titled"Single-Car Steel Pan Garage Door with Opt.Impact Resist. Lites",sheet I of 1,dated 11/18/1996,with revision 8 dated 01/2012,prepared by Clopay Building Products Company, signed and sealed by Scott Hamilton,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 Section. MISSILE IMPACT RATING:Large and Small Missile Impact Resistant LABELING:A permanent label with the manufacturer's name or logo,manufacturing address,model number,the positive and negative design pressure rating,indicate impact rated if applicable,installation instruction drawing reference number,approval number(NOA),the applicable test standards,and the statement reading`Miami-Dade County Product Control Approved' is to be located on the door's side track,bottom angle,or inner surface of a panel. RENEWAL of this NOA shall be considered after a renewal application has-been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials,use,and/or manufacture of the product or process.Misuse of this NOA as an endorsement of any product,for sales,advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. LIMITATION:This approval requires the manufacturer to do testing of all coils used to fabricate door panels.A minimum of 2 specimens shall be cut from each coil and tensile tested according to ASTM E-8 by a Miami-Dade County approved laboratory.Every 3 months,the manufacturer shall mail to this office a copy of the tested reports. Only coils with average yield strength of 27,000 psi or more shall be used to make door panels for Miami-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, This NOA revises NOA#08-0724.04 and consists of this page 1 and evidence pages E-1 and E-2,as well as approval document mentioned above. Thd submitted documentation was reviewed by Carlos M.Utrera,P.E. MIAMGDADB OUN NOA No 12-0125.11 Expiration Date: September 25,2013 Approval Date: April 5,2012 � � �1� Page 1 Clopay Building Products Comuanv NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS 1. Drawing No. 101706,titled"Single-Car Steel Pan Garage Door with Opt. Impact Resist. Lites", sheet 1 of 1,dated 11/18/1996,with revision 8 dated 01/2012,prepared by Clopay Building Products Company, signed and sealed by Scott Hamilton,P.E. B. TESTS "Submitted under NOA #08-0724.04" 1. Test reports on 1)Uniform Static Air Pressure Test, Loading per FBC TAS 202-94 2) Large Missile Impact Test per FBC, TAS 201-94 3)Cyclic Wind Pressure Loading per.FBC,TAS 203-94 4) Forced Entry Test,per FBC 2411 3.2.1,TAS 202-94 5)Tensile Test per ASTM E8 Along with marked-up drawings and installation diagram of Clopay 9'x 8',24 ga, steel garage door Model 94W9 with windows,prepared by American Test Lab, Inc., Test Report No.ATLNC 0610.01-08, dated 07/16/2008,signed and sealed by David W. Johnson,P.E. 2. Test report on Salt Spray per ASTM B 117 of painted G40 galvanized coated panels, prepared by Stork Materials Technology,Test Report No. 30160-04-63365,dated 01/26/2005, signed by John D. Lee,P.E. C. CALCULATIONS "Submitted under NOA #08-0724.04" 1. Jamb anchor calculations,complying with FBC 72004,prepared by Clopay Building Products Company,dated 07/22/2008,signed and sealed by Scott Hamilton,P.E. D. QUALITY ASSURANCE 1. Miami-Dade Department of Permitting,Environment, and Regulatory Affairs(PERA) Z7' Z°I� Ca/I_0S jnu ttr m P.E. Product Control Examiner NOA No 12-0125.11 Expiration Date:September.25,2013 E+I Approval Date:April 5,2012 • I Clouay Building Products Comaany it NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED E. MATERIAL CERTIFICATIONS "Submitted under NOA #07-0807.14" 1. Test report on.,Accelerated Weathering Using Xenon Arc Light Apparatus per ASTM G155 of Lexan SLX2432T Clear Polycarbonate,prepared by Hurricane Engineering &Testing, Inc.,Test Report No. HETI-06-A002,dated 12/04/2006,signed by Rafael E.Droz-Seda, P.E. 2. Test report on Self-Ignition Temperature per ASTM D1929,Rate of Burn per ASTM D635, and Smoke Density per ASTM D2843 of the Lexan Plastic,prepared by ETC Laboratories,Test Report No.ETC-06-1024-17496.0,dated 05/26/2006, signed by Joseph L. Doldan,P.E. F. STATEMENTS 1. Statement letter of code conformance to 2007 and 2010 FBC,dated 0.1/19/2012, signed and sealed by Scott Hamilton,P.E. "Submitted under NOA #08-0724.04" 2. Statement letter of no financial interest issued by Clopay Building Products Company, dated 07/18/2008, signed and sealed by Scott Hamilton,P.E. d3 Zy ,ZO lZ Carl k Utrera,P.E. Product Control Examiner NOA No 12-0125.11 Expiration Date: September 25,2013 E-2 Approval Date:April 5,2012 a ° " CLOPAY MODELS 84A 93 94 98• IDEAL MODELS 4RST 4F HOLMES MODELS 48 488 ENO EN - 16 GA. GALVANIZED END STILES ATTACHED TO DOOR SKIN WITH PATTED TOG-L-LOC SYSTEM E(2) AT TOP INSIDE•(2) BOTTOM INSIDE. (4) ALONG OUTSIDE EDGE OF 18'SECTIONS STILE - - Qc (6) ALONG OUTSIDE EDGE OF 21'SECTIONS] AND SEPARATE 18 GA GALV. INNER DOUBLE END STILES ATTACHED TO TOP AND BOTTOM RAIL WITH PATENTED TOG-L-LOG SYSTEM. INTER. LOCK INTERMEDIATE STILE BETWEEN EACH EMBOSS LOCATION.ATTACHED W/PATENTED STIR BAR A- moms T00-L-L(}C SYSTEM {TOP& BOY) AND t1RETHANE ADHESIVE (ALONG CENTER). OUTSIDE GUIDE A- sao0a ADDED OPT16ii-&IM, WQflEWF DESIGN LOAD --►-A THIS PRODUCT CONFORMS TO SNAP LATCH ENGAGES HANDLE I—2" THICK ONE ROW OF IMPACT-RESISTANT GLAZING IN EITHER THE REQUIREMENTS OF THE 2007 LOCK BAR 1 TOP SECTION (SHOWN)OR NEXT-TO-THE-TOP ONTO VERTICAL TRACK. AND 201 FBC. ENGAGES IN SERA B o � fs to fs SECTION (NOT MOWN). Q ONE SNAP LATCH ON TRACK ON 0 %8 MAX. GLAZING SIZE IS 18-1/2'x 11". EACH SIDE OF DOOR. EACH SIDE GLAZING IS INJECTION MOLDED GE LEXAN SLX2432T, nUTSIDE KEYED LOCK OF DOOR. AN APPROVED CC2 PLASTIC IN ACCORDANCE WITH INTER• LOCK BAR LOCK OPTION I8C/F8C 2608. SECTION B-9 FOR ASSEMBLY DETAILS. SECTION B-8' STILE ROLLER BRACKET TOP ej f'RL7Ut1tT •.. �, ETASL '0' OUTSIDE KEYED-----A' EYED END EACH/BRACKET ATTA ATTACHED HANDLE STILE SLIDE BOLT `� atsaiDRyflyingtlNri�tlsePtGIIi41s END LOCK ENGAGES W/(4) #14x5/8" SHEET I Br 'CoNk INSIDE HANDLE STILE INTO VERTICAL METAL SCREWS. ANBC13�taaDe N0 ! �I DETAIL 'D' `- HIGH BOND AP£ SIUTSIDE KEYED LOCK LOCK ON EACH IS % SNAP LATCH LOCK OPTION d OPTIONAL DECORATIVE 9P�4NAl.DECORATIVE SIDE OF DOOR. SNAP-IN INSERT FRONT FRAME FACADE MliMftd PtVdttit�0l1hY# ` STRRICTIRAL.SILICONE SEALANT ImsfuE 511OF BOLT SHIP (JIP-JOINTS. 1 (BETWEEN STEEL SKIN AND FRAME). LOCK OPTION 14 GA GALV. STEEL. D.LEE J 24 GA (0.0239" MiN. THICK) DDS STEEL. END ASTENED TO END LOCK POSITION (BOTH SIDES). SEE I EXTERIOR SKiN WITH G-4o GALVANIZING, STILES W/(4) #14x5/8" LAYOUT OF EACH LOCK FOR DETAILS. / BAKED-ON PRIMER AND'A BAKED-ON A SHEET' METAL SCREWS \`�• .i�--POLYSTYRENE RETAINER POLYESTER PAINTED TOP COAT APPLIED TO & (2) 1/4" SELF IMPACT RESISTANT FASTENED TO FRAME WiTH BOTH SIDES OF STEEL SION. (ASTM No. A653). TAPPING SCREWS. ONE-PIECE INJECTION (TO #8 x 3/4" PAN HEAD MOLDED CE LEXAN ONE 4" TALL, 16 GA —_ —— SLX2432T FRONT ItE OPTIONAL STOP MOULDING BY DOOR INSTALLER (TO SUIT) 16 GA. MIN. GALV. STEEL ENO STILE SECTION, PER DOOR — — FRAME &GLAZING, ///""" SECTION, ATTACHED WITH l LOCATION OF OPTIONAL VENTS.® --`i"-A J 18 GA GALV. STEEL DOUBLE END STILE I (MAX SIZE: 60 SO. INCHES) a /j TAPPI1/4'x3/4" G xS REW PER III-----------�---- 'I•H ;..a,;t,i; ,✓s ;,,, MAX. DOOR WILD 9'-o° 20 GA GALV. STEEL INTER STILE. (1) INTER, CENTER AND ENO STILE STILE BETWEEN EACH EMBOSS. INSIDE ELEVATION 4) #14x5/8" SHEET LOCATION. AA0 ETAL SCREWS 18 GA CAL.V.STEEL CENTER HINGE 2-1/2°x12 OA. GALV. STEEL TRACK FASTENED TO INTER. STILLS W/(4) EACH /-1/4" WIDE x 16 GA GACV.BRACKETS FASSTENED TO W000 JAMB #14x5/8"SHEET METAL.SCREWS. STRAP. (3) MIN. PER SECTiON WITH 5/18 xt-5/8" LAG SCREWS. 7/16°PUSHNUT FASTENER INSTALLED (SEE INSIDE ELEVATION). EACH DOOR HEMIT' "BEROF V47APPING O ON ROLLER SHAVE FOR UNRESTRICTED STRAP ATTACHED WITH (3) SECTIONS' 2"GALV. STEEL.TRACK FASTENED TO 67 TO77 q x3/4° SELF 12 GA. CALV..STEEL.TRACK BRACKETS. �� OPERATION. 1/4"x S ( SELF TDOOR,T'�mST 5 SCREWS TRACK ATTACHED TO EACH BRACKET t4 CA. GALV.STEEL ROLLER HINGES FASTENED TO ENO STILES SCREWS (TWO TO DOOR, ONE TO g0'T0low a 14 C.A. END HINGE 18 GA_ INTERMEDIATE HINGE WITH ONE 1/4°x5/8° BOLT&NUT. W/(4) EACH #14x5/•8`SHEET METAL SCREWS AND (2) 1/4'SELF C"pi'4h1NEl-)• 109•TO123' 7 � OR TWO 1/4"RIVETS. TAPPING SCREWS PER ROLLER HINGE. 13 GA GALV. STEEL BOTTOM 1216'70140' BRACKET ATTACHED WITH (2) 147 TO iGT 9 I 2° STEER LONG STEM ROLLER tsa 10 JAMB CONFIGURATION SC4REWS." SHEET METAL 'SECTIONS ARE EOHER*'OR2/" TRACK CONFIGURATION ABOVE THE DOOR OPENING DOES NOT AFFECT THE WIND LOAD RATING. JAMB TO SUPPORTING STRUCTURE ATTACHMENT dcLVINYLL WEATHEERSIORfP. TRACK CONFIGURATION TRACK COPIFI(SIRATiON HORIZONTR U!S'� U SLIT 1 ALL THE LOAD FROM THE DOOR IS TAAASFERRFD TO THE TRACK AND THEN FROM THE TRICK TO THE 2x8 VERTICAL SYP(GRADE f2 OR BETIM)JAMBS.NO LOAD DOORS UP TO 8'0" HIGH �U+�VOU FROM THE DOOR IS TRANSFERRED TO THE HORIZONTAL(TOP)JAMB. DOORS UP TO 16'0" HIGH CE� HANG 2. ALL JAMB FASTENERS MAY BE(BUT ARE NOT REWA ED TO BE)COUNTERSUNK TO PROMDE A FLUSH MOUNTING%MACE, HORIZONTAL TRACK SUPPORT BY DOOR COUNTERBALANCE #REWIRED ON 3. A 1/3 STRESS INCREASE FOR VAND LOAD WAS=USED IN THE CALCULATION OF ALLOWABLE LOADS FOR ANCHORS AND FASTENERS FOR STM CONCRETE AND DOOR INSTALLER (TO SUIT) SYSTEM 6' HIGH WOOD FRAME BUILDINGS DOORS OVER MASONRY. DOOR COUNTERBALANCE SYSTEM STUD WALLS OF BOOK OPENING SHALL BE FRAMED SOLID BY NOT LESS TIM(3)2x4 WENINGS UP 10 Iro-W)OR(3)2x8(oPcom UP To 180V]PRESSIRE TREATED SYP(GRADE E2 OR BETTER)WOW SIUIS OF A STRESS GRADE NOT LESS 11-M 1200 PSI NOMINAL EKIREME FIBER STRESS IN MENDING%).STUD WALLS TO I 13 GA. GALV. STEEL FLAG BRACKff. DTF BE CONTINUOUS FROM FOOTING TO 11E BEAMS. 13 GA. GALV. STEEL FLAG BRACKET. '� BLOCK WALL OR CONCRETE I $' 84• 2x8 STP(GRADE/2 OR BETTER WOOD JAMB SMALL BE 94CRORED TO(ROUT REWORCEO BLOCK WALL OR CONCRETE COLUMN.BLOCK WALL CELLS SHALL BE FILLED- WITH CONCRETE AND RE84FORC£0 WITH REINFORCING BARS EXTENDING INTO THE FOOTWC AND INTO ME BEAMS.ALL BARS SHALL BE CONTINUOUS FROM THE TIE UENAS i- .6* 18E TO FOOTING PER HOCK WALL OR CONCRETE COLUMN.BLOCK WALLS AND CONCRETE COLUMNS TO BE DESIGNED BY THE BULDING 04GDM OR ARCHREGT OF RECORD. �C a4• 11r 2x6 JAMB TO .SUPPORTING STRUCTURE ATTACHMENT m = me' 11s [D 7fi" (7'6° & 8'0° H DOORS ONLY) DOOR o TRACK CONFIGURATION z HEIGHT "L" 11 O• 134 NOT TO BE USED FOR ATTACHMENT OF TRACK BRACKETS). MAXIMUM 2'GAIN.STEEL TRACK. 67'-6 70 8 11•s Iw " TRACK 1HICKNFSS:0.083'. DISTANCE WASHERS 63" -0 76 I irs' i4r a�s'T CENTER STEEL 7-6 82 (341 i48 I 2'IdU.V.STEEL TRACK, 13,$, 1�. BUILDING TYPE FASTENER TYPE FASTENERS WASKR S TRACK TFBCKNESS:0.083". OR 14'-0• 180' 1/4'x 3'(1-1/4'EMBED)UW TATWI CONt72EtE ANCHOR(2-1/2'MIN.EDGE DISTANCE} 7' /'OA.ORO 14'4' lw 2080 NCRETE 1 4 x 4 1-3 4 T R 2— Z M E 1 TAP.2-1/2"x12 G0.GALA. STEEL TRACK BRACKETS. z TAP.2-1/2'x12 GA. CAW.STEM tRLCK ' 1 4 - 4eBE0 I .EDGE DISTANCE 0 x 8 TRACK SWIS PER SIDE FOR DOORS UP TD 7'0"HIGH). qq BRACIfETS' 1S8' 178• 1 2 x 4 2-1 4 M- WEOG I 0 ANC ht 2 IN 38° {7 TRACK BRIOS PER SIDE FTRN DOORS 7$'TO B'0'HIGH), z T'— EACH TRACK BRACKET ATTACHED TO ODOR JAMB WITH(1)5/18'x T-s/8"TAG sa ,� D 2- I . E 16 3 a z EACH IAAG(BRACKET ATTACHED TO DOOR JAMB NRItT(t) �T 12-14 SCREW. •- FIRST ANC{ gpT�pM NOM ��pF M N ONCE. 8/18'X 1-5/e'LAO SCREW. q. TAP. TfTA(2C AITACN[:D 70 EACH BRACKET WITH HIGHEST ANCH CREW INSTMLEU AT lfASt 1—AS /TyET4WLO FJGHT. 1 TRUCK AttACHEO TO EACH BRACKET WITH ONE 1/4'x5/8' 0O 24" BOLT Qe NUT.OR TWO 1/4'RIVETS. 12"-14" ONE RrvE St/4 x3/8'BOLT Sc NUT,CN7 TWO 1/4- "S HA TO E. TAP• FLORIDA 63280 DESIGN LOADS: +62.0 PSF & -72.0 PSF. G L2 CL ���x"'""n`"A18 cmc AY vaamn xAYxa 10" 1 ° ®��® �� CLOPAY BUILD G PR UCTS COMPANY w -2F143 W9 9'0°W x 16'0'H 3-1/2" '.�`"� { i P MASON. CH 4SU40 X11 18 98 °_CAR STETS PAN GARAGE DOOR 3-1/2" Building Products MWW Company (513) 770 - 4800 °f' B 101708 MO 09/10/2013 09:33 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES �j001 *** TX REPORT *** ********************* TRANSMISSION OK TX/RX NO 3942 RECIPIENT ADDRESS 919414269052p4102 DESTINATION ID ST. TIME 09/10 09:53 TIME USE 00'52 PAGES SENT 2 RESULT OK Miami hares Village Building Department _ a..�. 1€050 N,.':,2nd Avenue wn Miami Shores, Florida 33138 tlt 011�- Tel: (305) 1135.2204 €ax. (305) 7 63.89,72 Permit: No. A}C .3-1739 AUgUSt i M 2013 Rage I of Building Critique Sheet I. Plea$0 see structural commonts Structural Critique Sheet 2. Drawings are inromplete. Also structural calculations area riot provided, 3, Provide layout of members and foundations. 4, Provide complete Structural notes with design code reference, design load criteria, wind load criteria, material specification Etc. W;f;hdi Ashraf Building Official & :structural Reviewer x. ' 09/09/2013 14:33 3055584385 FRASES UNIVISTA INS PAGE 01/01 DATE(MM1D5 Y} CERTIFICATE OF LIABILITY INSURANCE � 09109!13 !�!'=• — — '— — —' — - — T_.THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION PRODUCER Froses&Frases insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 5800 w 16th Avenue I HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Hialeah,FL 33012 AI.-MR.HE C011E12Ag6 AFFORpED�Y THE POLL-C1ES RE�W,_.- Phone (306)558-1333 Fox (305)558-4385 INSURERS AFFORDING COVERAGE NAIC INSURER Ascer dent Undenwters,LLC I INSURED SUPER GARAGE"DOORS CORD F-INSURER e; — 15718 S Dix+e Hway 0 414 RER C: —'Miami,FL 33176- RER D:RER E: INSURER F: COVERAGES POLICIES OF INSURANCE uSTSD HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS:_, _T• IP'OwCY EFFECTIVE POLICY EXPIRATION LIMITS _ IN8R /1DO'L TYPE OF INSURANCE POLICY NUMBER tt DATE.011D�_ LV INSRD .. .� -I EACH OCCURRENCE GENERAL LIABILITY I AMA O RANTED 100,6001 ©COMMERCIAL GENERAL LIABILITY GlL-70531-1-2 II 11/09/12 11/09/13 PREMISES(Ea ooa,ranee -• — ❑❑ CLAIMSMADE W OCCUR } I I MED EON(Any D person) 5;� A ❑ I I PERSONAL&ADV INJURY X00,000 ` ❑ —. . GENERAL A130REGATE 300,000 ❑ PRODUCTS-COMPlOP AGG 300,001} GENII-AGGREGATE LIMrr APPLIES PER: ❑ POLICY []V PROJECT ❑ LOC O LIAt�ILITY COMBINED SINGLE LIMIT l AUT Mo91LE � (E,s sccidellt) ED AUTO ❑ ALL OWNED AUTOS BODILY INJURY ❑ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY ❑ NON OWNED AUTOS (Per acddent) ❑ PROPERTY DAMAGE PeraeddenU _ "1 GARAGE LIABILr1Y AUTO ONLY-EA ACCIDENT [� ❑ OTHER THAN EA ACC ANY AUTO AUTO ONLY: AGG EACH OCCURRENCE SXCESS&IMBRELLA IJAI31LIl Y — ❑ OCCUR ❑ CLAIMS MADE AGGREGATE _ ❑ DEDUCTIBLE (� RETENTION $ _ WORKERS COMPENSATION AND ❑QRy��� ❑ ER H. EMPLOYERS LIABILITY _ ANY PROPRIETOR!PARTNER/EXECUTIVE E.L,EACH ACCIDENT OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE Nyes,desca'Ibe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT _ OTHER J DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Att: Building Department CERTIFICATE HOLDER _ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL City Of Miami Shores 30 WRnTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 10050 ne 2 eve THE LE a BUT ILURPs TO DO SO SHALL IMPOSE NO 013LI18ATION OR LIABILITY A1fi8lmi Shores 33138 OF A KIND U N THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUT RIZZI:D PRESENTATIVE L ACdRD 25(20011118)OF ••- • •®ACORD C6RPOI7ATION 1988 FROM FAX Nil. Sep. 09 2013 03:35PM P1 03-28-2012 JEFF AT WATER S7'ATF- OF FLORIDA cNi f,RNANCIAL 01MICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERW COMPENSATION * CERTIFICATE OF ELEVnON To BE EXEMPT FROM FLORIDA WORKS W COMPiENSATION LAIN � CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' CompenSlirtion law, EFFECTIVE DATE: 03/28/2012 EXPIRATION DATE: 03/28/2014 PERSON: RUIY CARLOS Felft 280082879 BUSINESS NAME AND ADDRESS: A SUPER GARAGE DOOR I14C 681 E 7TH STREET HMSAH FL 33010 SCOPES OF 1USINF-SS OR TRADE: 1- GARAGE DOOR INSTALLATION IMP011TANT: Parsnnt to Chapter 440 . 0504!, f.$.. as officer of a comaratiox arbo olects exemption from this cbaplar by filing a catuffeate of alectfoa odder this section may eat recover Dowits or compensation mider this chapter. Puranant to Chapter 440.D5i12f, F.S.. Certificates of election to tae exempt... apply oaiy wime me =ape of the business or trade i4sted as the notice of election to be exempt. Pamsoi to Lbapter 44Dmos), cs.. Notices of election to be exempt apd certificates of eiectfon to be exempt shelf he soDject to revocation o, at any time after the filing of the natiee or the issuance of the certificate, the porsom named on the notice or certificate ao !anger weals the regnNemoats of tuft saelee for issusaae of a certifitate. The 4epattmeat omit revoke a cettffkate at say, time for faflore of the parses named on the Cermicata in meet the regn!►nmams of mfa section. =MOW? 4850) 413-1609 UWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT IiEVISF.I) 01-11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF PIKANCIAL SS"CES F IMPORTANT DIViSION OF WORKERS'COMPMsATION Pursuant to Chapter 440.05(14), F.S., an officer of a corpomion who CONSTRUCTION IND><}STRY O elects exemption from this Chapter by filing a certificate of election CERTIFICATE E nit ELECTIb1J TO BE EXEMPT FROM F.LCgq DA 1-under this Section mw Ott recover benefits or ComPe Derr uftder Slit WORKERS'COMPENSATION LAW ©undo ar. EFFECTIVE 03/28/2012 EXPIRATION DATE: 03/28/2014 Pursuant to PERSC7N: CARL05 RUIZ H Chapter 4411.050Z, F.S., Certificates of election to be axamPt,.- apply only within the scope of the business or trade listed on FEiN: 2SM82879 R A SUP ER GARAGE DOOR WC notice of election to be exempt BUSINESS AID ADDRESS NAME A ADDRESS E Pursuant to Chapter 440.05031, F.S., Notices of election to be exempt 85 1 A P and certificates of election to be exempt shell be subject to revocation HLA E 7TH ST IG if, at time after the filin of the pof" or the issuance of the HIALeAw. FL 3aata certificate, the person !touted an the notice or wdfisnts no ianger meats the requirements of this section for issuance of A nertifiale. The depar-tment Shah revoke a certificate at any time for failure of the SCOPE OF BUSINESS OR TIRADE person named an the certificate to meet Cite requirements of this 1- GARAGr: DOOR tNSTAU.wtwx section. auMONS? (850) 413-1609 CUT HEM iE Carry bottom portion on the ,fob, keep upper portion for your records. OWC-252 CERTIFICATE OF ELECTION TO BE EjkgvT REVISER 01-11 FROM,: FAX NO. Sep. 09 2013 03:36PM P2 �`•.Y2;��y,���;•�"F;P'�'at:+`',ay1,�'ym j.3;s •••a;•�•;;`fi':,:•... rr��,Y ,cy: 'i:�,�.;.,T r.,na, Ls►R134r.�C'�:•...•i'•• $ 'o:':•.:::i-': � FIR;•q R,Y•. "'�'•�•�'''.is•4,1:'':wIWM��p/' ,s: r�'1 �•��}�� ..�,{„+: ,,3 r :^°87'A7E:0 :FtOFItDA' FlRST-CLA ";, O POSTAL '�_... :.�44`rl�LVl�....i.':•:v.fit ia'..'.'.. •ri..!}.d u�J'�1,+� '•,- •1Q,p�q/� �yp.�ls '•i:'.+; �.v. •�r'�."'" A 'F{' it i'In,. 611.x_.::u':i'�r�.:it,•'e.4�IfY>,7'F.' '�"�i:�Y'�:W'IV.,;; /AF7�..HT-40d.. r Mwql �'. ART. PERMIT N4»231 ..C, .+».R._ $ill:+. t'1.:ie•:;.+:,>:»:.<'A>$...'CY'?�t�;t 535��4gg97-2 THIS IS NOT A BILL—DO NOT PAY SuA"%UP m6kT4jFNDOOR INC -la 651 E 7 ST CC #� 4By�0537 559262'2 33010 HIALEAH OWNER i A SUPER GARAGE DOOR INC O .TY BUILDING CONTRACTOR WORKER/S Ii Ws �' OTNLY A iocnL I VOEs NOT P .rr ROLM m na.AYE ANY E(MM REMXA'rm OR b0� � � I TNE o � Do NOT FORWARD I nRo wma By LAW, C MPHO� UHQNa A SUPER GARAGE DOOR INC 6AI1LOS A RUIZ PRES i b51 E 1 """cc,t°� R TAk HIAL EAH F T 09 /20/2012 L 33010 60080000189 . 000045,00 �,►�;��„l 1,lit Its }:fifft,==f„f=f���„ff,a 1 SEE OTHER SIDE _ FROM : FAX NO. Sep. 10 2013 08:52AM P1 y of ply City of Hialeah FSC ]Business Tax 2012-13 '4E�eP01►��� �� Receipt faw,ws�e,vm�,.� � Fw�oi'0�"'aFr ft—M,4040— Mayor CarjQS Hernandez Y ' '•'' :�C'i'3Uf]d'FIl'I •.QP... :y•'. , .�;•c�brv;.;.,;;*;a..;,,,. <.i�(r ;�,�,, �„�,;Q.�,,g;,,..:.,•••f,:,;n;.•.: ', h,t3'!3^.� t yF�,� '.w ,.;t,,'r;.,' ':3; ,,.;�!�..'`'•,a..•An .y r T?+:'�•,G,v:. a ..:1•.:• �i26g w h.l. ".5}r;;•;;�; ..:ir•'•t.;: $ ,c.;<t.•,..�>,.`y, ,ss• !a�.'� �•:;°• • ,r';p1N i�+s7.( �. +7i�•': •., t '$ . .,'••+•,'•' :,'� ,. 2•°",Y„s°�Cj-WP.:�,"„ +' .. _ 'iw• r';L:• ..t^f��:r•:.,.I, 10Y1ti(�$': ;;it: :•ii'•:',.;::7..• .a;.4;., ,a?_•(. ..'^b.t-.i -.,-l;j. ,`:�+ ':k ^..;+ 'C•:::t;�:`si.. °,: .,t•,..�'r,•,:•:. rnl.,'• a• �:'• ,Yl `1 Y�• h Z :ir.a,(° �':i°,,,/° •.:• ';:�:� •Y:.W.'� .1 `'"ti t•SW.. ,n*. ``„�•�..}4.!'•:.�!:^�,NY`. +,.fJ:, ✓I•'•W� .k�° .•JET-::,Xv,"::•Y';':,,,q; 1.5 ,l�dyy,��yy: '.:k:.��17•`•,'�S,'••:ti :i7•;l�.D,�.r$r31Jii�@$S�$'� `"i�+ •^ :••,-•s�i� •,',`�a'... :!511C.rli.':,;... .,.,G.uI:,,In,i,�•1 F.:el;:M".rv.•w ;.4 ..r i.,,..,.' .; •. ;:...: •:.`•'�°rs:>..,-.:°'. .rr "::au+..,:•:'..<" '�:t:' >..;,t;.::°:..�•' �.rK•:'t:�;,,,F ,:f•?r�:'%�:•_`;:i;k„";.t3',.^° �:Y•.••• ... .. „ •• ,• ...�:::�i:i�+: ` :!..�:.'n ..."J °'4.'�;.•Y:^. ..7; :•„4i•w.. �::i;:/",+'•�.'+^'v,J a'::•?.:✓�-..;v{�,�i'". ��„�.. .,,. 2i,.:,:,,,: ^�,�"'net•.'"A<,:d'::"w>�.�.:1•:ib.A 1,7 °��•� • .. n'•�'a'. ,iii" �}lC.... , ,.. .; :': •'•:• ::..'....'•,^'..'�.•:?°.•:••.;�:.•^k+i:.:':• ,e.v f �� r°bt"'!"w'.t:' „:arres't;::'4 '•�'?:7,:. • � r`f,�it'3C'. : •+::•°.:":.'�`••'. ':°i v.�.+.•::r,e•d•,;..in•':t ".'i'u'"rY!;';k• Ic 7,q ' ",'v i.�••.. .... .. .. •':;:': "� ,.9,'�:�.•v:R?::�{° .ii:+�.,t�N•n '`n'Y�•�•,• Mrs Is NO ew of 't ''��4$Sr'¢'ti�'�• •F r;�''•%'r FIR:Yi`-CLASS US.POSTAGE t PAIP MAW FL PRRNNO 231 S$5�97 `2 T�4115 tS NOT A BILL-00 NOT PAY g� �6WArV•OOR INC ,pp RppE�fEWAE. 651 E 7 'ST CC *"48501537 559262-2 33010 HIALEAH OTUPER GARAGE DOOR INC Ser' OMTV BUILDING CONTRACTOR WORKERS rim >e M w yo 1 EMM"" SOON"IT�pmum 00 NOT FMWyARD FS PRW1 ANtMMIgg kbt A�vvr:a .T".8 A SUPER GARAGE DOOR INC CARLOS A RUIZ FIRES PAW MW ao 651 E 7 ST DAOB HIALEAH PL 33010 � Wt1N�°r snu 60080000189 800045.00 {i F1�Fiif�S�lF}}FSl��I�}lii�ii�i il�i Fl}6{1}i��Fril iiFi�filfi��� ^. SEE OTHER SIi7E Tradid Board 0 UN $ 1x4TIFiC11i1='OF COMP•E'TEIY.C'Y IMA so 'R INC S•n _<. Y./"�lyrY�>.�. usn..C,"'�: .•j.�:>k'.h:j,•'' '`,.,, ��S �^'��(.] vi.1�6T Q':Yl�iy:'�,�'�'?vR�+ 1' ti�• Is Odd under ttae praftlorW.yp# !p af= a 03-28-2012 JEFF ATWATER STATE OF FLORIDA CHW FINANCIAL OFFICER DEPARTMENT Cw FINANCIAL. SERVICES DIVISION OF WORKERS- COMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS COMPENSATION LAW �e CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation taw. EFFECTIVE DATE., 03/28/2012 EXPIRATION DATE: 03128/2014 PERSOI* RUIZ CARLOS FEIN: 260087879 BUSINESS NAME AND ADDRESS: A SUPER GAR"ASE DOOR INC 651 E 7TH STREET HIALEAH FL 33070 SCOPES OF BUSINESS OR TRADE. 9- GARAGE DOOR IMAL.LATION iMPWTANT Parsaaot to Chapter 440 . 0504), F,S., an officer of a ewporation who elects exemption from this rdtapter by filing a certificate ei elecfioa aador this seceiett may nor Mower heeetita a eompaasatien varier this rhapear. Perwaet to Chapter 44R.85itV, F.3., Ceftificatga of elaatioe to hp examp;.. apply only wi;bin the scope of the easitteSa of trade abed tt the aetiu of election li be exempt, Pursean to Chspter 44o.05it$i; F.S., Hellas of election to he exampt av4 certificates of eltrttloe to be exoatpt shall be abject to revocation if, at any Lima an of the Filing of the aatice w the issuance of the certificate, the person named oa the notice or aoltifTcate no longat• meets the rageireoxamns of his mown for issuance of a ca rotate. The department sbeii revoke a eeruficate at any lime far fauore of the person MOW on the cortifitaste to meet the regef►ameals of thi4 :action. DWC-252 CERTIFICATE OF ELECTION TO HE EXEMPT REVISM 01-11 QUESTIONS? 1850) 413-1809 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA ENEPARTMENT OF FWANt3AL sMWIM IMPORTANT TION ORKERV=x0m rNDU�Y77t 0 Pursuant to Chapter 440,051141, F.S., an offlcer of a corporation who CmI117CCATeOFELECTION TO W EKOVT ftOM pLORM sleets exemption from this chafrter by filing a certificate of election WOMERS CONIPENS '"ON LAW L under this section tray not recover benefits or coMpensation under this EFFECTIVE' 03/28/3012 EXISMATION DATE; 03/28/2014 D chapter. P�SUiU: CARL,OS 18JIZ Purstimit m Chapter 440.D5112), F.S., Certificates of sleetiott to be H exempt-, apply only witidn the Scope of the business or trade listed on FEftt 280082818 R the notice of election to be exempt. BUSINESS SIiA,SS INANE islW ADDRESS- E Pursuant to Chapter 4.{0.0503), FA. Notices of election to be exempt A SuPiR cAn,a6E ogBR oiC 6 and certificates Of election to be exempt Shelf be subject to revocation MML11At, :z 39oto If, m any time after the filing of the notice or the issuams of the Certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The SCOPE QF BUSINESS oR 7F;Ap de ent shall revoke a certificate at ally time for failure of the I- GARAM twos INSTALLATION person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413-1609 CUT HERE +� Carry bottom portion on the jab, keep upper Portion for Your records, DWC-852 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 Td WHbS:80 2t0Z OT .daS '0N Xti.d WON-4 FROM : FAX NO. Sep. 10 2013 08:56AM P1 .,5 03-28-2012 JEPI' ATWATER STATE OF FLORIDA C141EF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * CERTIFICATE OF EtECT101114 TO BE EXEMPT FROM FIARIOA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 03128/2012 EXPIRATION! DATE: 08/2812014 PERSON: RUIZ CARLOS MIN; 260082879 BUSINESS NAME AND ADDRESS: A SUPER GARAGE DOOR INC 8S1 E 71-M STREET HIALEAH FL 33014 SCOPES OF BUSINESS OR TRADE: 1- GARAGE DOOR INsTALLATIoN '110041'ANT, Pursuant to Caaptar 449 . 03(14) F's" an oftker of a corporatlo" who elects exemption from this ehap[er oy filing a aeruY#eaea e! election nedsr this 4eetieR may not recover benefits air cemveasattan tracer this chapter. Prerwaet IS Chapter 440.85(12), f.s., Cortificates of election to be exempt.. apply aely winjo the scope of tire losing. or trade listed on the notice of ejection to he exempt. Personal to Chapter 440.013), F.B.. Notices at elective to be exempt and certitteet" of election to be esemgt shell be subject to revocation ff. at any time after the Filing of the notice or the #smaao oI the Corti€#cafe, tlIe person named ou the gatfce or certificate an longer meats the requirements of ads Swann for issuance of a certificate. The aepartmeat shai# revoke a certificate at guy time for failure al the petaon named on the certificate to meet the requirements of Ibis section. OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 QUESTIONS? (850) 413-1609 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA MWARTMENT CW FINANCIAL SI:WC9S IMPORTANT DIVIMON Or-WORKERS'COMPENSATION F PtrrSURIM to Chapter 440.05(14), F.S., an officer of a corporation who CONSTRUCTION INDUSTRY O elaets exemption from this chapter, by filing a certificate of election CERTIFICATE OF ELECTM TO OF EXEMPT FROM FLORIDA L under this section may not recover benefits or ea WORKERS COMPENSATION LAW D chapter. mpertsatlon ender this EFFECTIVE: 08/28/2012 EXPIRATION DATE: 03/28/2014 Pursuant to Chapter 44I 0500, F.S., Certificates of election to be PERSON: CARLO5 RUIZ H exempt- apply only within the scope of the business or trade listed on FEIN 200482879 R the notice of election to be exempt BUSINESS NAME AND ADDRESS A SUPER GARAGE DOOR WC E Pursuant to Chapter 440.05(131. F.S.. Notices of election to be exempt and Certificates of election to be exempt shalt be srtbjW to revocation HIA a �Tr# 33010 if. at any time after the fill of the notice w the issams of the rrlaatdAH, a[ a3oro certificate, the person named on the notice or cerdfiicate no longer meets the requirements of this section for issuumc of a Certifione. The department shall revoke a certificate at any time for failure of the SCOPE OF BUSINESS OR TRADE: parson named on the certificate to meet the requiremaInts of this I' GARAGE DOOR INSTALLATION Section. QUESTIONS) 18501 413-1608 CUT HERE Carry bottom Portion on the job, keep upper portion for your records. ❑wC-Z52 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11