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RF-13-1675 p Miami Shores Village - � Building Department JUL 2 6 2013 L� 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 d INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit No. PERMIT APPLICATION Master Permit No. Permit Type: BUILDING ROOFING JOB ADDRESS: Q SSG! �J C`^� A Ga oG GrY ,, gL Gias . eL -?S124 1 City: Miami Shores County: Miami Dade Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): A Sr'O�C[4.yt dw _ Phone#:.30.57 7e_7 7-746 City: State: Zip: Tenant/Lessee Name: Phone#: Email: t - CONTRACTOR:Company Name: f/l v® ' �� %Phone#: Address: City: - State: Zip: Qualifier Name: -� Phone#: 2 ft1q 2- 22 / State Certification or Registration#: 6L ?Z ff�Certificate of Competency#: Contact Phone#: Email Address: DESIGNER:Architect/Engineer: Phone#: R S^ '.:�-' ... .-..ia✓'�d Lrt_=�nB� bt➢as4Lj5 � ...?_ '^ :.,.,_. _.�nn'`�:' Y &-.a° dui,�) Val4e of Work for this Permit.$ Square/Linear Footage of Work. Typo f, Work: DAddifion f CIAl ' lion ONew ` epair/Re lace ODemolition T D"�ription of Work: Color thru tile: Submittal Fee$ Permit Fee$ O t)�' CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ 044 -VU Bonding Company's Name(if applicable) Q 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 commenceqent must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the Jb ence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. }� Signature 'ReJ zea SA, t, Signature Arlo-) ( � Owner or Agent Contractor The foregoing instrument was acknowledged before me this I r The foregoing instrument was acknowledged before me this day of ,20 Lf,by day of J u/ 20,tj1_,by , who is personally known to me or who has produced who is personally 1 own to me or who has produced_r &,eS As identificati x^tnd who did take an oath. r identification and who did take an oath. NOT AR L O LI ALEJANDRA BRITO Si ?. ` Notary Public-State of Florida �4w'r °el;.� ALEJANDRA BRITO �: S Public-State fforida oar Commission#DO 1000541 " y Comm.Expires Jun 10,2014 Print: F`a•' t: �,: Com slon DO 1000541 My ommissio Expires: APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 5/2/2012)(Revised 3/12/2012)XRevised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) IL SECTION R4402.13 HIGH VELOCITY HURRICANE ZONES—REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS R4402.13.1 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 govern 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� 11AP co�' 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. 1 �; 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./L GS Common roofs:Common roofs are those which have no visible delineation between neighboring units(i.e.,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. K4. w-C-" Exposed Ceiling:Exposed,open beam ceilings are where the underside of the roof docking 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 w a S 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-long 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. X 6. Overflow scuppers(wall outlets): It is required that rainwater flows off so that the roof is not overloaded from a buildup of water.Perimetededge 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. X 7. (& G S Ventilatlon:Most roof structures should have some ability to vent natural airflow through the interior of the structure assembly(the building itself).The existing amount of attic ventilation shall not be reduced.It may be beneficial to consider additional venting which can ult i ending the service life of the roof. caner/Agent's Signature Date Contractor Signatu Date Revised on 7/912009 LD : l HIGH-VELOCITY HURRICANE ZONES f sm UL COP c Florida Building Code Edition 2010 High Velodty Hurricane Zone Uniform Pwmft ApplimOon Forth. Section A (General Information) Master Permit No. Proses Na. Contractor's Name GO L 5 �cJ c. f Job Address r' ""[ '96 : ROOF CATEGORY ❑ Low Slope ❑ Mechanically Fastened Tile ❑ Mortar/Adhesive Set Tile Asphaltic ❑ Metal PanellShingles ❑ Wood Shingles/Shakes C Shingles ❑ Prescriptive BUR-RAS 150 ROOF TYPE ❑ New Roof 1' Reroofing ❑ Recovering ❑ Repair ❑ Maintenance 1- ROOF SYSTEM INFORMATION Low Slope Roof Area(SF) Steep Sloped Roof Area(SF) Total(SF) Section B (Roof 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. 00 N vi . cn D C r— O -0 m�1 • m O _ - n CA p m v - J. p > N ■ _ m• _ { ■ • • Shingle Roof System HVHZ Electronic Roof Permit Form Section D Shingle Roof System Roof System Manufacturer: GAF Notice of Acceptance Number: 12-1127.03 Fill in the specific roof assembly components.if a component is not required, insert not applicable(n/a)in the text box. Deck Type: 5/8" PI ood yw Optional Insulation: NA +4 Optional Nailable Substrate: NA _ Optional Nailable Substrate Attachment: NA UndedaymentBase Sheet Type: Roof Slope: 3 "/12" ASTM FELT 30#D226 Fastener Type for Basesheet Attachment: Roof Mean Height: 14 ft. 1-1/4 RS NAIL AND TIN CAP 1-5/8" (Maximum roof mean height 33 ft.) Optional Peel&Stick Membrane: Optional Ridge Venting: 0 Yes @ No NA Shingle Type: Ridge Vent NOA Number: NA GAF ROYAL SOVERING 3 TAB SHINGLE Installed Ridge Venting: NA lineal ft. Drip Edge Size&Gauge: 13"face 26 ga. Installed Ridge Venting: NA ft.2 Drip Edge Material Type: Galvinized Metal -== Existing Soffit Intake: NA ft.2 Drip Edge Fastener Type: Note: In no case shall the amount of exhaust 1-1/4" RS NAIL 4"OC ventilation at the ridge exceed the amount of Hook Strip/Cleat gauge or weight: soffit ventilation. --Select Hook Strip- , ONLINE CERI-IFICATIONS 111 TFWZ.R21 Prepared Roof-covering Materials Paae Bottom Prepared Roof-covering Materials Sep General Information for Prepared Roof-covering Materials R21 GAF MATERIALS CORP 1361 ALPS RD WAYNE,N]07470 USA Asphalt glass fiber mat.shingles-"Royal Sovereign,""Sentinel,"'nmberiine@ HD,""Timberline@ Natural Shadow,""Timberline@ Ultra HD," "Timberline@ Cool Series,""Timberline@ Majestic,""Timberline@ Majestic 30,""Timberline@ American Harvest—,""Timberline@ ArmorShield'" II,""Marquis@ WeatherMax@,"".Grand Canyon—,n"Grand Sequoia@,""Camelot @,""Camelot@ 30,"'Camelot@ II,""Camelot®IR,""Capstone@ "Capstone@ Impact Resistant IR""Country Mansion @,""Country Mansion@ II,""Grand Slate @","Grand Slate@ II,""Slateline@,""Woodland @," and"Monaco"'"for Installation as Class A prepared roof covering.Suitable for installation on minimum 3/8-in.thick plywood roof decks in combination with minimum.one ply"Shingle-Mate"or Type 15 or Type 30 underlayment.Also Classified in accordance with ASTM D3161,Class F. Also Classified in accordance with ASTM D3462. Asphalt glass fiber mat shingles-"WeatherBlocker Starter Strip Shingles"and"Pro-Start`"Starter Strip Shingles"for installation as Class A roof covering.Suitable for installation on minimum 3/8-in.thick plywood in combination with minimum one ply"Shingle-Mate"or Type 15 or Type 30 underayment.Also Classified in accordance with ASTM D3161,Class A.Also Classified in accordance with ASTM D3462. Asphalt glass fiber mat shingles-"Royal Sovereign,""Sentinel,""Timberline@ HD,""Timberline@ Natural Shadow,"'Timberline@ Ultra HD," "Timberline@ Cool Series,""American Harvest,""Marquis®WeatherMax @,""Grand Canyon—,""Grand Sequoia @,"and"Camelot @"for installation as Class A prepared roof covering when used with minimum Type 30 underlayment over existing wood shingle roof. Asphalt glass mat and hip and ridg`ie shingles-"Timbertex Hip and Ridge"for Installation as Class A prepared roof covering.Also been evaluated In accordance with ASTM D3161,Class F when Henkel"PL Roofing and Flashing Sealant"or Sonneborn"NP1 Gun-Grade Polyurethane Sealant"Is applied as specified in manufacturer's application instructions."Also Classified in accordance with ASTM D3462. "Seal-A-Ridge @,""Seal-A-Ridge@ ArmorShieldTM"and"Z-Ridge"for installation as Class A prepared roof coverings. Last Updated on 2012-03-22 Questions? Print this page Notice of Disclaimer Page Top O 2012 UL LLC The appearance of a company's name or product in this database does not in Itself assure that products so identified have been manufactured under UL's Follow-Up Service.Only those products bearing the UL Mark should be considered to be Listed and covered under UL's Follow-Up Service.Always look for the Mark on'the product. UL permits the reproduction of the material contained in the Online Certification Directory subject to the following conditions: 1.The Guide Information,Designs and/or Listings(files)must be.presented in their entirety and in a non-misleading manner,without any manipulation of the data(or drawings).2.The statement"Reprinted from the Online Certifications Directory with permission from UL"must appear adjacent to the extracted material.In addition,the reprinted material must include a copyright notice in the following format: "©2012 UL LLC". http://database.ul.com/cgi-bin/XYV/template/LISEXT/1FRAME/showpage.html?name=T... 4/18/2012 NEW MIAMI-DADS COUNTY PRODUCT CONTROL SECTION DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES(RER) 11805 SW 26 Street,Room 208 BOARD AND CODE ADMINISTRATION DMSION Miami,Florida 33175-2474 T(786)315-2590 F(786)315-2599 NOTICE OF ACCEPTANCE OA www.miamldade.eov/economv GAF 1361 Alps Road. Wayne,NJ 07470 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 RER-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 material fails to perform in the accepted manner,the manufacturer will incur the expense of such testing and the AHD may immediately revoke,modify,or suspend the use of such product or material within their jurisdiction. RER 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 of the Florida Building Code. DESCRIPTION: GAF Royal Sovereign®Shingle 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 renews and revises NOA#12-0313.11 and consists of pages 1 through 4. The submitted documentation was reviewed by Alex Tigera. NOA No.: 12-1127.03 MIAME�� Expiration Date:04/22/18 APPROVED Approval Date:04/18/13 Page 1 of 4 i i I ROOFING ASSEMBLY APPROVAL Category Roofing Sub-Cateeory: Asphalt Shingles Materials 3-Tab Deck Type: Wood SCOPE This approves GAF Royal Sovereign®Shingle as manufactured by GAF as described in this Notice of Acceptance, designed to comply with the Florida Building Code and the High Velocity Hurricane Zone of the Florida Building Code. PRODUCT DESCRIPTION Product Dimensions Test Product Description Specifications GAF Royal Sovereign®Shingle 12"x 36" TAS 110 Fiberglas reinforced heavy weight asphalt roof shingle,with a 3-Tab profile MANUFACTURING LOCATIONS 1. Savannah,GA. 2. Tuscaloosa,AL. 3. Tampa,FL. 4. Mt.Vernon,IN. 5. Mobile,AL. 6. Dallas,TX. 7. Myerstown,PA. 8. Fontana,CA. 9. Minneapolis,MN. EVIDENCE SUBMITTED Test Agency Test Identifier Test Name/Report Date Center for Applied Engineering TAS 100 02/23/94 ASTM D3462 257966 03/21/97 PRI Asphalt Technologies,Inc. TAS 100 GAF-105-02-01 1 1/14/05 TAS 100 GAF-182-02-01 02/07/08 PRI Construction Materials Technologies,Inc. TAS 100 GAF-332-02-01 01/17/12 TAS 100 GAF-376-02-01 10/15/12 TAS 100 GAF-153-02-01 11/30/06 Underwriters Laboratories,Inc. TAS 107 05CA48258 11/28/05 TAS 107 05CA47804 11/11/05 TAS 107 08NK02337 03/12/08 TAS 107 08NK12906 10/10/08 TAS 107 11CA47919 12/03/11 ASTM D 3161 /TAS 107 09CA41642 09/28/10 ASTM D 3161 /TAS 107 09CA38549 10/30/09 NOA No.: 12-1127.03 MIAMFDADE _IAPPROVEDI_____ Expiration Date:04/22/18 Approval Date:04/18/13 Page 2 of 4 ASTM D 3462 ASTM D3462 09/12/06 ASTM D 3462 08NK02337 03/12/08 ASTM D 3462 09CA21715 05/20/09 ASTM D 3462 08CA61515 07/15/09 ASTM D 3462 11CA47919 12/03/11 LEMTATIONS 1. Fire classification is not part of this acceptance; refer to a current Approved Roofing Materials Directory for fire ratings of this product. 2. Shall not be installed on roof mean heights in excess of 33 ft. 3. All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and Rule 9N-3 of the Florida Administrative Code. INSTALLATION 1. Shingles shall be installed in compliance with Roofing Applications Standard RAS-115. 2. Flashing shall be in accordance with Roofing Applications Standard RAS-115. 3. The manufacturer shall provide clearly written application instruction. 4. Exposure and course layout shall be in compliance with Detail"A",attached. 5. Nailing shall be in compliance with Detail`B",attached. LABELING 1. Shingles shall be labeled with the Miami-Dade Seal as seen below,or the wording"Miami-Dade County Product Control Approved". MIAMIDADE R= ,...I BUILDING PERMIT REQUIREMENTS 1. Application for building permit shall be accompanied by copies of the following: 1.1 This Notice of Acceptance. 1.2 Any other documents required by the Building Official or the applicable code in order to properly evaluate the installation of this system. NOA No.: 12-1127.03 M1AM4�1DEC Expiration Date:04/22/18 APPROYE Approval Date:04/18/13 Page 3 of 4 d r ! • DETAIL A COURSE LAYOUT 1st Course of Shingles 2nd Course of Shingles 3rd Course of Shingles 6° g° 5° • Drip Edge DETAIL B OVERALL DIMENSIONS AND NAILING PATTERN 36" LID In END OF THIS ACCEPTANCE NOA No.: 12-1127.03 MIAMFt�,DECOUNTY Expiration Date:04/22/18 Approval Date:04/18/13 Page 4 of 4 i MIAMFDADE Florida Department ofEM 4 f6A Environmental Protection Miami-Dade DERM Air Quality Management D'visiori Divisiol� o Air Resource,Management 701 N.W.IstCourt,Zn Floor ' Miami,Florida 33136 l NOTICE OF DEA40LI`f ION OR ASBESTOS REN VATION TYPE OF NOTICE(CHECK O E ONLY): ORIGINAL ❑ REVISED ❑ CANCE"TION ❑ COURTESY TYPE OF PROJECT(CHECK ONE ONLY): ❑ DEMOLITION ❑ RENOVATION ROOM G IF DEMOLITION,IS IT A ORDERED DEMOLITION? ❑YES ❑ NO IF RENOVATION: X111 IS IT IS I Process# l AN EMERGEN RENOVATION.OPERATION? ❑YES ❑ NO File# 7 A PLANNED RENOVATION OPERATION? ❑.YES ❑ NO �Proc 1. Facility Name Address State City ^- ,� 4� Coun , Site Consultant Inspecting Site Buildin Size <�z g (Square Feet) #of Floors-----/ Building A e in Years Prior Use: ❑Scho*CollegefUniversity ❑Residence ❑Small Business Otter Present Use: ❑SchooVCollege/University.. ❑Residence Small Business Other. �I 11. Facility Owner A;,v- s'r Phone( ) Address city -.-f State ip III. Contractor's Name Phone ff Address 2 ,-1 City 42 - Sta zip Is the contractor exempt m licensure under section 469.Ob2(4);FS:? ❑YES ❑ N IV. Scheduled Dates: (Notice must be ark 0 worki days before the project start date) h t� , (�•1 As)�estos Removal(mm/dd/yy)Start. ish: � � Demo/Renovation( m/dc�/yy}Start: Finish:�_.�! V. Description of planned emolition or renovation work to be performed and methods to be employed,incl�rding demolition or renovation techniques to f be used and description of affected facility components. II Procedures to be Used(Check All That Apply): f j ❑ Strip and Remova 1❑ I Glove Bag ❑ Bulldozer ❑ Wrecking Ball ❑ I Wet Method. I E1.1 Dry Method I ❑I Explod I❑ I Burn Down 1 OTHER: VI. Procedures for Un expected RACM: �. VII. Asbestos Waste Transpo er.Name 22 `>' Address 'ri City >_, StateZip ___ Vill.Waste Disposal Site: fyame r Address' r City' a �, e'i State y Zip Ate MAN GIDAW=VM" IX. RACM or ACM:Procedurre,including analytical methods,employed to detect the presence of RACM an Irm Amount of RACM or ACME` In Co square feet surfacing material square feet cementitious ma linear feet p pe. square feet resili floor'ng t , cubic feet of RACM off facility components square feet asr as I a$e _ "Identify and describesurfacing material and other materials as applicable: I certify that the above information is correct and that an individual trained in the provisions of this regulati n(40 CFR Part 61,Subpart M)will be on- site during the demolition�or renovation and evidence that the required training has been accomplished by his person will be available for inspection during normal,business hours._I haveiread a"'d understood the additional information provided on the back of this form. ! _ r (Print Name of Owner Rer tor) JjI (Signature of Owner/Qpe ator) P (Date)' (Contact phone#) ,: ., DERM U$E ONLY r j Postmark/Date Received I¢# ' 161 01-158 10/10 DISTRIBUTION: M!6ite DERM Yel low=Applicant Pink—Reserve Gold-Res rve u DISCLAIMER w This "NOTICE OF DEMOLITION OR ASBESTOS RENOVATION" is required pursuant to the provisions of 40 CFR 61 Subpart M and Rule 62-257.301, F.A.C. and must be submitted prior to any demolition or regulated asbestos abatement activity.This document is an Asbestos Notification only and is not a permit. This NOTICE OF DEMOLITION OR ASBESTOS RENOVATION does not constitute a waiver of or approval for any federal, state, county, or local permits that may be required for this facility. INSTRUCTIONS for COMPLETING NOTICE OF DEMOLITION OR ASBESTOS RENOVATION The state asbestos removal program requirements of s. 376.60, F.S., and the renovation or demolition notice requirements of the National Emission Standards for Hazardous Air Pollutants (NESHAP), 40 CFR Part 61, Subpart M, as embodied in Rule 62-257, F.A.C., are included on this form. Check to indicate whether this notice is an original, a revision, a cancellation, or a courtesy notice(i.e., not required by law). If the notice is a revision, please indicate which entries have been changed or added. Check to indicate whether the project is a demolition or a renovation. If you checked demolition, was it ordered by the State Ica a Nc , so, in a ddition to the information required on the form,the owner/operator must pr , d e ' a ering the demolition, the title of the person acting on behalf of the agency, the auth$-its or, demolition, the date of the order, and the date ordered to begin. A copy of the order must add b otification. If you checked renovation, is it an emergency renovation opel1oiso, m addition to the information required on the form, the owner/operator must provide the date and hour th L rred, the description of the sudden, unexpected event, and an explanation of how the event cause un e n s or would cause equipment damage or an unreasonable financial burden. If you checked r o i tdrenovation operation, please note that the notice is effective for a period not to exceed ough December 31. I. Complete the facility information. This section desc&@ft its .k 6R*Waor demolition is scheduled.This address will be used by the Department in Prov' "hen e of the consultant or firm that conducted the asbestos site surve /ins a us k ate box to indicate whether the prior use of "nMT '' Y ege, or universi i as "residential dwelling" is defined in Rule 62- ; 1 e s def' .S.; or other. If"other" is checked, identify the u'se..' le�asse�o ow t e sa a instructions for "present u e." . WWI s II. Complete the facility owner information. (, 1b &K III. Complete the contractor;information. eevlewal-) IV. List separately the scheduled.start and finish dates (month/day/year) for both the asbestos removal portion of the project and,tiP,;,rVngvation or demolition portion of the project. V. Describe and check the methods and procedures to be used for a planned demolition or renovation. Include a description of the affected facility components. (Note: The NESHAP for asbestos, which is adopted and incorporated by reference in Rule 62-204.800, F.A.C., requires obtaining Department approval prior to using a dry removal method in accordance with 40 CFR section 61.145(3)(c)(i).) VI. Describe the procedures to be used in the event unexpected RACM is found or previously nonfriable asbestos material becomes crumbled, pulverized, or reduced to powder after start of the project. VII. Complete the asbestos waste transporter information. VIII. Complete the waste disposal site information. IX. List the amount of RACM or ACM of each type of asbestos to be removed. (Note: A volume measurement of RACM off facility components is only permissible if the length or area could not be measured previously.) Identify and describe the listed surfacing material and other listed materials as applicable. A Florida Department of ®�'DE 17A Environmental Protection Miami-Dade DERM Air Quality Management Division Division of Air Resource Management 701 N.W.1st Court,2nd Floor it NOTICE OF DEMOLITION OR ASBESTOS REN VATION ' M iami,Florida 33136 II. TYPE OF NOTICE(CHECK ONE ONLY): ORIGINAL ❑ REVISED ❑ CANCE LATIQN ❑ COURTESY TYPE OF PROJECT(CHECK ONE ONLY): El DEMOLITION 11 RENOVATION 11 ROOFI G IF DEMOLITION,IS IT AN ORDERED DEMOLITION? ❑YES ❑ NO IF RENOVATION: IS IT AN EMERGENCY RENOVATION OPERATION? ❑YES ❑ NO File# ' IS IT A PLANNED RENOVATION OPERATION? ❑YES ❑ NO Process# 1. Facility Name Address 4 Ciry 9State Zip Coun Site Consultant Inspecting Site FI to Building Size (Square Feet) of Floors Building A e in Years 9: Prior Use: ❑School/College/University ❑Residence ❑Small Business Ot er Present Use: ❑School/College/University ❑Residence ❑Small Business Ot er }k' Il. Facility Owner Ya Phone Address Ciry ='s State Zip 1 .111. Coniraclor's Name_ Phone(_ Address Ciry State Zip ' Is the contractor exempt rom lfcensure under section 469.002(4);ES.? ❑YES ❑ N IV. Scheduled Dates: (Notice must be ostmark 0 worki,4 days before the project start date) 'I Asbestos Removal(mm/dd/yy)Start '' °Finish: 1 ` ° Demo/Renovation(I m/dd/yy)Start: Finish: { V. Description of planned demolition or renovation work to be performed and methods to be employed,inc ding demolition or renovation techniques to be used and description of affected_facility components. Procedures to be Used(I heck All That Apply): { ❑ Strip and Remova ❑ Glove Bag [] Bulldozer ❑ Wrecking Ball r ❑1 Wet Method- ' ❑I Dry Method . ❑ Explode I ❑ I Burn Down II•.i OTHER: y: u VI. Procedures for Unexp er:Name `Phon ed RACM: VII. Asbestos Waste Trans i4 Address- Ciry State - Zip VIII.Waste Disposal,Site:`Name I Address-. City - State y zip - -" Alf Q,U Tt NlAi AGEAAENT DIMSfON IX. RACM or ACM:.Procedure,including analytical methods,employed to detect the presence of RACM an NO s Amount of RACM or ACM* Ubinl !d In Cbffpbme W& square feet urfacing material square feet cementitious ma r1 linear feet pjpe square feet resili t floo•ng cubic feet of RACM off facility components square feet asph P• D ' *Identify and describe surfacing material and other materials as applicable: i I certify that the above information is correct and that an individual trained in the provisions of this regulati n(40 CFR Part 61,Subpart M)will be on- site during the demolition',or renovation and evidence thatthe required training has been accomplished by is person will be available for inspection } during normal business h¢urs.-I have,read a6d understood the additional information provided on the back of this form, (Print Name of Owner/Operator) (Signature of Owner/Ope ator) (Date) (Contact phone#) �F ' i DERM USE ONLY Postmark/Date Received I # �l 1,61, 1-15810/10 DISTRIBUTION: White-DERM Yellow-Applicant Pink-Reserve Gold-R rve DISCLAIMER This 'NOTICE OF DEMOLITION OR ASBESTOS RENOVATION" is required pursuant to the provisions of 40 CFR 61 Subpart:M,and Rule 62-257.301, F.A.C. and must be submitted prior to any demilplition or regulated asbestos abatement activity.This document is an-Asbestos Notification only and is not a permlrt't This NOTICE OF DEMOLITION OR ASBESTOS RENOVATION does not constitute a Waiver of or approval for any federal, state, county, or local permits that may be required for this facility. ; INSTRUCTIONS for COMPLETING NOTICE OF DEMOLITION OR ASBESTOS RENOVATION The state asbestos removal program, requirements of s. 376.60, F.S., and the ren ation or demolition notice requirements of the National Emission Standards for Hazardous Air Pollutants (NESH P), 40 CFR Part 61, Subpart M, as embodied in Rule 62-257, F.A.C., are included on this form. Check to indicate whether this notice is an original, a revision, a cancellation, or a co i esy notice(i.e., not required by lavO. If the notice is irevision, please indicate which entries have been changed added. Check to indicate whether the project is a demolition or a renovation. If you checked demolition, was it ordered by the State or 1,R al o, in addition to the R must prole information required on the form,the owner/operator m te e ering the demolition, r r r the title of the person acting on�behalf of the agency, the auth6ftlr e d t demolition, the date of the order, and the date ordered to begin. A copy of the order must also be attache the tification. the K, - 43 e If youchecked renovation" is it an emergency renovation o 0)MAIM o e inforniation required f , 1949A on the form, the owner/operator must provide the date and hour the ierne - o c rred, the description of the I sudden, unexpected event, and an explanation of how the event caused tnsl s or would cause equipm ent damage or an unreasonable financial burden. if you checked re ovPp�, . 'it Ae renovation operation, ro please note that the notice is effective for a period not to exceed renovation ugh December 31 1. Complete the facility information. This section desc&PAT r demolition is scheduled,This address will be used by the Department insR Provide the name of the consultant or firm that conducted the asbestos site survey/inspect* se k"riate ,; rrj�_Srp box to indicate whether the prior use of tWftAf9ElWflMWf X r sil e as "residential dwelling" is,defined in Rule 62-257.2 .;.s 11 as fine S.; 90 F. 98P. ­q t or other. If"other" is checked, identify the A191161ase e a insfructip 5 0 pres, n [I. Complete the facility-owner information, iZob � Ill. Complete the contractor.information. IV. List'separately the scheduled-start and finish dates (month/day/year) forbo'th th ellasbestos removal portion of the project and the-Tenomation.or demolition portion of the project. V. Describe and check the methods and procedures to be used for a planned demo�ition or renovation. include a description of the affected facility components. (Note: The NESHAP for asbestos, which is adopted and incorporated by reference in Rule 62-204.800, F.A.C., requires obtaining Deparqlnent approval prior to using a dry removal method in accordance with 40 CFR section 61.145(3)(C)(i).) cl VI. Describe�the procedures to be',used in the event unexpected RACM is found or previously nonfriable:asbestos material becomes crumbled, pulverized, or reduced to powder after start of the roject VII. Complete the asbestos waste transporter information. VIII. Complete the waste disposal site information. IX. List the amount of RACM or ACM of each type of asbestos to be removed'. (Note�, A volume measurement of RACM off, facility components is only permissible if the length or area could not be measured previously.) Identify and describe the listed surfacing material and other listed material's" as a pp licable. . 1111111 lilt 1111 1111111! 1 CFilk 201ZiR°.0587499 OR I k 28743 Ps 0981; (fps) RECORDED 07/26/2013 13:43=48 . HARVEY ADE O TR DART NOTICE OF COMMENCEMENT -D C NYFLLORI A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION LAST PAGE PERMIT NO. TAX FOLIO NOj 1- 2 06-0 -00 STATE OF FLORIDA: COUNTY OF MIAMI-DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property,and In accordance with Chapter 713,Florida Statutes,the following information Is provided In this Notice-of Commencement. Space above reserved for use of recording office 1.L al descripti of property and street/address: o' 4 C djae-0 114,49&.4 0A r 2.Description of im rovement: 3.Ownerts)name and a S 66 Interest In property: Z Name and address of fee simple titleholderr 4.Cgntra or's name,add n3ss d phone number O a , r 5.Surety ayment bond required by owner from contractor,If any) Name,address and phone number. Amount of bond$ 6.Lender's name and address: 7.Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7.,Florida Statutes, Name,address and phone number. 8.In addition to himself,Owners designates the following person(s)to receive a copy of the Lienor's Notice as provided In Section 713.13(t)(b),Florida Statutes. Name,address and.phone number 9.Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date Is spwAed} WARNING TO OWNIEFL ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13.FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signature(s)of (s)or )`A horized Offlcer/Director/Partner/Manager r )( 4 Prepared By r Prepared tt�� Print Name Print Name Title/Office Title/Office STATE OF FLORID COUNTY OF MIAMI-DADE j The foregoing instrument was acknowledged before me this�day of zap By ❑Individually,or ❑as v - for PqY P;; ❑Personally known,or roducetl the following type of Identiflc ion: °` Ida Signature of Notary Public: " M 14 Print Name: °•� f<�::' COMMISS (SEAL) VERIFICA'nON PURSUA NIT!TO SECTION 92-525,FLORI r i u 1 declare that I have read the forego in and o Under Haft f ff , penalties o perjury, 9 vng�rialirlad that the facts stated in it are true,to the best of my knowledge and belief. A D Signatures)of Owners)or Owmer(s)'s Authorized Offlcer/Director/P e: ` By By oc 123.01-52 PAGES 3N0 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-195948 Permit Number: RF-7-13-1675 Scheduled Inspection Date: August 13,2013 Permit Type: Roof Inspector: Rodriguez,Jorge Inspection Type: Final Roof Owner: OLARTE,GERARDO Work Classification: Tile Job Address:8729 NE 4 Avenue Road Miami Shores, FL 33138- Phone Number Parcel Number 1132060460001 Project: <NONE> Contractor: JALCO CONSTRUCTION INC Phone:(786)222-1873 Building Department Comments Infractio Passed Comments SHINGLES INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 12,2013 For Inspections please call: (305)762-4949 Page 20 of 51 i