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RF-14-1723Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-220099 Permit Number: RF -8-14-1723 Scheduled Inspection Date: September 24, 2014 Permit Type: Roof Inspector: Rodriguez, Jorge Inspection Type: Final Roof Owner: GOLDSMITH, PETER Work Classification: Repair Roof Job Address: 141 NW 96 Street Miami Shores, FL 33150- Phone Number Parcel Number 1131010250110 Project: <NONE> Contractor: EARL W JOHNSTON ROOFING, INC. Phone: 954-989-7794 Isunamg uepartment comments REPLACE EXISTING SKYLIGHT 2 X 2 INSPECTOR COMMENTS False Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. September 23, 2014 For Inspections please call: (305)762-4949 Page 16 of 25 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-219938. CREATED AS REINSPECTION FOR INSP-219838. CREATED AS REINSPECTION FOR INSP-217448. Could not find pictures of framing around skylight Same comment as before Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. September 23, 2014 For Inspections please call: (305)762-4949 Page 16 of 25 AC132 Engineering Inc. Testing & Engineering Services Certification of Authorization # 8131 Tel: 954-245.8976; Fax: 954.301.7776 5230 NE 18 Avenue Fort Lauderdale, FL 33334 Roof Tile Uplift Test Report Attention: Miami Shores Village, Building Division, 10050 NE 2nd Avenue, Miami Shores, FL 33138 Client: Earl W Johnston Roofing, Inc. Test Date: 9/19/2014 Permit # RF -8-14-1723 Property Address: 141 NE 96 Street, Miami Shores, FI Roof Pitch: Type of Tile: Roof Area: 3 in 12 1 Hanson Roof Tile 1 0.1 squares Tile Attachment Method: Two Component Polyurethane Foam Adhesive -Poly Pro H 160 Field Instrument : IMADA Force Gauge 0-100 Serial number: 243454 Test Location Total Number of Tests Field Uplift Pull Test Test results Perimeter Area: n/a n/a As per FBC 2010 Passed Field Area: 0.1 sq 1 As per FBC 2010 Passed No. of Corner: n/a n/a As per FBC 2010 Passed Ridge Areas: 4 pcs 1 As per FBC 2010 Passed Important: These laboratory results can change due to future weather impacts and/or unavoidable roof traffic. Therefore, this report represents the TAS 106 results at the time of the test. Please see attached a Roof Sketch for this project. Cordially, nc. (NOA 09-1005.01) Antonio ycw4lekdo, PE Fla. Reg. No: 36466 111 1� ACBZ Engineering Inc. Enpneermg and Laboratory Services 5230 NE 18' Avenue Fort LaudeFdale, Florida 33334 Phone: (954) 245-8976 Fax: (954) 301-7776 BUILDING Miami Shores VillageF;—" -; 7 "' `_'4 Building� �;ug e 1 o14 Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 $i Te1: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. PERMIT APPLICATION Master Permit No.f2i� H2,`3 FBC 20 Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): A(A/2 6.1,0,5.w7W_ Phone#: Address: /I// N w 7t Sr City: A114m; SHOAS State: Zip:S31 Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: /�f1 A) A! '76 SO' City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: 44 e,) eT0 'Ns%®c. eiyc- Phone#: Fj-y J'd�`/ 7.7FY Address:. -7a/ Pwitty Sr City: /{m/`�rad®ga State: zip: 1XV V Qualifier Name: &"e96ZL &J 15 RdJTo A Phone#: My x7 j y State Certification or Registration #: CCC M 7 0 7,3 Certificate of Competency #: Contact Phone#:TJ'y / 0 27?Y Email Address: DESIGNER: Architect/Engineer: Phone#: PfMCC / FXAM)e� Value of Work for this Permit: $ 0 6s– Square/Linear Footage of Work: �4° a' 5xyzi4mr Type of Work: OAddition OAlteration ONew 4epair/Replace ODemolition Description of Work: Af dPIWOL -4rx,5157z-aa- S/rx tEcli% 2"-X of Submittal Fee $ � Permit Fee $ ¢ CCF $ i . l30 CO/CC $ Scanning Fee $ Radon Fee $ �'DBPR $ 2-03 Bond $ Notary $ Training/Education Fee $ ® ' W Technology Fee $ Double Fee $' Structural Review $ TOTAL FEE NOW DUE $ 1 Few Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip 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 y of the recorded notice of commencement must be posted at the job site for the first inspection which occurs sevMec ays aft he building permit is issued. In the absence of such posted notice, the inspection will not be approj* apo r 11tonfee wi a charged. Signature Signature Own or Agent Contractor The fore,oing�instrument was acknowledged before me thi&— The fore 'ng instrument was acknowledged before me this day of I ""' , 20,, by ��/2 JZ ®l D�e�t7it day of , 20 h, by Mgt 0 "y,05 IV , who is personally known to me or who has produced who is person y 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: e V Print: r My Commission APPROVED BY NOTARY PUBLIC: �`Ol"'Pa Notary Public State of Florida Meg A Romeo My C pA- g My Commission EE 202823 '�-®F',vd' Expires 06/22/2016 (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Notary Public State of Florida Meg A Romeo My Commission EE 202823 Expires 06/22/2016 Plans Examiner Zoning Structural Review Clerk V STRUCTURES n -TF -A T Florida Building Code Edido MO-Velaft Hunicaw Mme UnftrM-pSMdt-A0011caMn-,ft-ft,-, 110000AM—eneral Iriftirmeitipa- I_j I O COMPALL r' ER H Permit Noe Process No. 117E AND C-0 l INTY RULES AND RF(AU! AT!ONS contractoes Name &AW1. 4) rJV&A/ :LloA) ROW JAX Job Address /Y/ A14J ?6 5'r ROOF CATEGORY E3 Low Slope E3 Mechanically Fastened Tile 13 Mortad 13 Asphaltic Shingles 13 Metal ParmliShingles 0 Wood Shin a :A 14 13 Prescriptive BUR -RM 150 ROOFTYPE 0 New Roo? Reroofing 13 Recovering Repair 0 Maintenance ROOF SYSTEM INFORPAA71ON Low Slope Root Area (SF) Steep Sloped Root Area (SF) Total (SF) Section B (Roof Plan) Sketch Root Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. Include dimensions of sections and levels, clearly ldenft dimensions of elevated pressure zones and location of parapets. 0000 0000 ***:Do • 0000 0000 0 0 0000 0008 .0 . ..................... ...... : 0 o 0 0 ........ 0 ..................... ........................................................................................................................ 00 ................................................. ............................................................................................. 0 .......................I........4............................................... ..................................................................................... ...................I......................................... 900:0 .................................................. ......... .........I.................. .............................. ............................................. ................................................................................ :060T..................................,.....I............... ...... ... I ............................................................... 10.0 EM MNE ME MEN MEN ME 'ME 0 ,MEN M! ,MEN 0 15-W **Do:* @*see* 0 DO 0 0 GOOD* 008000 0 00906* :DODO: 0 0 COUNTY . MIAMI -DADS COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) Miami, Florida 33175-2474 BOARD AND CODE ADMINISTRATION DIVISION T (786) 315-2590 F (786) 315-2599 NOTICE OF ACCEPTANCE (NOA) www.miamidade.Qov/economy, Maxim Industries, Inc. 1630 Terre Colony Court Dallas, TX 75212 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 AHJ 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. DESCRIPTION: Model MAX DGCM 07 Curb Mount Aluminum Skylight APPROVAL. DOCUMENT: Drawing No. MAX DGCM 07, titled "Maxim Impact Glass Curb Mount Skylight", prepared by Maxim Industries, Inc, sheets 1 and 2 of 2, dated 12/12/2012, signed and Sda*Ied by Richard Boyette, P.E., bearing the Miami -Dade County Product Control renewal stamp• with the Notice of • • • • • Acceptance number and expiration date by the Miami -Dade County Product Con%jC51ition. • •: • • • • • MISSILE IMPACT RATING: Large and Small Missile Impact Resistant ... : • • • LABELING: Each unit shall bear a permanent label with the manufacturer's name o 0 togo, city)*sate,:000 • • model/series and following statement: "Miami -Dade County Product Control ApprQygd;, unless ptherwise..;.. • .... noted herein. . .. . ...... RENEWAL of this NOA shall be considered after a renewal application has bee4 ftQ tnd there Lias been no change in the applicable building code negatively affecting the performance ofthis products....:. 000000 TERMINATION of this NOA will occur after the expiration date or if there has 601 iCrevision archangi"•': in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA renews NOA # 07-1105.05 and consists of this page 1 and evidence page E-1, as well as approval document mentioned above. The submitted documentation was reviewed by Carlos M. Iltrera, P.E. NOA No. 12-1022.02 Miar'i•owneeounirr Expiration Date: January 10, 2018 #01,1110 fApproval Date: January 17,201 6 Page 1 Maxim Industries, Inc. NOTICE OF ACCEPTANCE: EVIDENCE SUBNIITTED A. DRAWINGS 1. Drawing No. MAX DGCM 07, titled "Maxim Impact Glass Curb Mount Skylight", prepared by Maxim Industries, Inc, sheets 1 and 2 of 2, dated 12/12/2012, signed and sealed by Richard Boyette, P.E. B. TESTS "Subndtted under NOA # 07-1145.05" 1. Test reports on 1) Air Infiltration Test, per FBC, TAS 202-94 2) Uniform Static Air Pressure Test, Loading per FBC TAS 202-94 3) Water Resistance Test, per FBC, TAS 202-94 4) Large Missile Impact Test per FBC, TAS 201-94 5) Cyclic Wind Pressure Loading per FBC, TAS 203-94 along with marked -up drawings and installation of the Maxim Impact Glass Curb Mount Skylight, prepared by Hurricane Test Laboratory LLC, Test Report No. T482- 0604-07, dated 10/09/2007, signed and sealed by Vinu J. Abraham, P.E. C. CALCULATIONS "Submitted under NOA # 07-1105.05" 1. Anchor calculations dated 10/28/2007, prepared, signed and sealed by Richard Boyette, P.E. 6666 D. QUALITY ASSURANCE • . . 6666 6666.. 1. Miami -Dade Department of Regulatory and Economic Resoi}ices (RER) • • • • 6666 ... 600000 666606 0 E. MATERIAL CERTIFICATIONS6666 6666 . . 6 • • " 1. Notice of acceptance No. 11-0624.02 issued to E.I. DuPont DA-t0mours aX!o., Inc": for their SentryGlas Interlayer, approved on 05/10/2012 and PSP g on f7,�l•�f20l�.;;;;0 6666.. .• F. STATEMENTS• . . . . 6666.. 1. Statement letter of code conformance to 2010 FBC issued by°RiQhvd Bdyette, dated....: 12/23/2012, signed and sealed by Richard Boyette, P.E. "" ' 2. No financial interest letter issued by Richard Boyette, dated 09/11/2012, signed and sealed by Richard Boyette, P.E. "Submitted under NOA # 07-1105.05" 3. Code compliance letter dated 10/29/2007, issued, signed and sealed by Richard Boyette, P.E. 0//,0//;W 13 Carlos M. Utrera, P.E. Product Control Examiner NOA No. 12-1022.02 Expiration Date: January 10, 2018 E -1 Approval Date: January 17, 2013 Detail #1: Frame, Gutter Seat & Glass Section Detail Dow CDtdng 795 Sliftwe BdcD hg Seams Glaw bite = U75" 7/8" fnsftW Glass: 1/8" Tempemd - 3/8" & apace w/ dedmrd Ned staWew Sped apaW - Lamhrebad Gass (1/8" annealed gkvs - ffAr Sentry Qw@ irmi4w- ur amaw w glass) Down QWft 795 Curb Bads See "• Nobe Below * Mlnrmwn d —r from afla7hlnaln fianm to 1 WI sufa e fcr ditfm or BMR wkhoht bWlla m. F�r bhsulom and that tffe add bhsafadoh or root ft tfddaww m 4" mbhbman hdgfd *'k C1mb back = NW*W Soahem yepaw pbhe 2 X 6 Yddh dqW set on bAWfth mWmhnn 1/8' W bead of Dow Conbug 795 d1— buUft qWW& Ithstapatimh fasbmm are sbbdm sled #12 X 1S" wkh o*dnmh L27 wnbedment located 3.5" from each cmrter and cerda nm) mum 9" on catu Detail #3 Glazing Detail DESIGN, PRESSURE,,= +60psf /,-100ps] .opo" We TS Bmuded ohm*= frame. Htemd and rodded at tour owran 6063 75 paraded al ffT JA t creat. Pbved and welded at tour a mees MWmum #12 X 1.51 stalnfew steel fasbdher with adnimm 1.2V enbedrterL 35" iron each omm & mmahft=9" o a # Mmum 12d nail or #6 X 31/4" staWen dad festf w — 6" o e with mWhmnn eabeddm d of 2" /D'af't•, - 5/8" PVMW dedL **Roof dedy f m.Mg by oti m AD roof deids Shap oompfy with the FAdda Building Code 1/8" Tempered Stainless sbod des[carrt filled tube with primary & secondary seals. 3/8" Height X 1/Z° Depth ...--.--.– ksn*mted Glas�t�t 1,/B" aTnrtealle'd gla�ss� ._0_900"" '`, 0.: : Duos S�rt4� Glassy interlayer - V r wneaW •• • • •gam••• • 08 Soo 00 0 a 0 60 FURY heffarc weided miter @ four comers f►-' r. • • �• w� • •, i'- r Fully helarc welded miter @ four comers :•ELPF #••42.4 •. ; ; ��� 46:il G0TITLE: MAXIM IMPACT GLASS CURB MOUNT SKYLIGHT &4 JT43LV0- • • DRAWING NO.: MAX DGCM 07 DATE: 2012.12.12 ROYAL PALM BCH FL i HURRICANE RESISTANT DRAW BY: DJT REVISION: #2 -%.-l��Et:• • : S K Y L 1 G H T S SCALE: NTS • • • • 1630 Terre Colony Court Dallas, Texas 75212 B° /pin • • • • 1'i 888.222.4898 P: 214.905.2021 F: 214.905.2024 SHEET: 1 OF 2 170m JIM r ! ! + + Frame Vllidth = 60.625" 14, Wto 8 U U rn c L n M Ln If rn c `c a jO DL Opening = 58.375" 9-- 3.5" from Max 9"( L Notes: 1. This skylight is designed to comply with all zones, Including the HVHZ, of the Florida Building Code. 2. This skylight meets small & large misste Impact resistance (TAS-201/ASTM E1886/ASTM E1996) and no other protection is required. 3. All framing and roof deck is by others and must comply with Florkla BVdIV rode. • 4. All sizes equal to or less than the test size total square loo e a e to ge scceptE d e under this NOA. • • • • • • • • • • • S. Fasteners used to attach skylight to wood curb are to Ir4itninirn x'l�" siai�less� • steel with minimum embedment of 1.25" Comer Detail see Detail #2 & #4) nstallation Fastener Others (see note 5 Frame Detail see Detail #1 & #2) Gutter Seat Detail see Detail #1 & #4) Glass Detail see Detail #1 & #3) Bill of Materials: 1. 6063 T5 Extruded Aluminum Frame mitered and welded at four comers. Manufacturer - Maxim 2. 6063-T5 Extruded Aluminum Gutter mitered and welded at four comers. Manufacturer - Maxim 3. Dow Coming 795 Silicone Building Sealant located between aluminum frame and glass (glass bite) and glass and gutter. Manufacturer - Dow Coming 4. 7/8" Insulated glass with Sentry Glass Interlayer: 1/8" Tempered - 3/8" stainless steel desicant filled tube (air space) - 2 pcs 1/8" annealed with .090" Sentry Glass interlayer. Manufacturer - DuPont S. #12 X 1.5" Stainless steel fasteners 3.5" from each comer, maximum 9" on center with minimum embedment of 1.25". YAL PALM BCW FL 33411 ��F� . •. . . HURRICANE RESISTANT ."�j •,. • • • S K Y L I G H T S • • • • • 1630 Teas Colony Comt Dallas, Texas 75212 • •P: 888.222.4898 P: 214.905.2021 R 214905.2024 APC YED - 12 .�".a ,—,:.1.."....... TITLE: MAXIM IMPACT GLASS CURB MOUNT SKYLIGHT DRAWING NO.: MAX DGCM 07 DRAW BY: DJT SCALE: NTS SHEET: 2 OF 2 DATE: 2012.12.12 REVISION: #2 OWnees Nkification Form i$VHZ 2010 e "Deflv1-- ing ExCe/1--ce Every Day" SECTION 1524 HIGH VELOCITY HURRICANE ZONES— REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 Scope. As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of this section. The provisions of Chapter 15 of the Florida Building Code, Building 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 and the contractor. The owner's initial in the designated space indicates that the item has been explained. Il ° Aesthetics -workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane Zone) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion 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 .-enailed 1n accordance with the current provisions of Chapter 16 (.High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing roof system). M-3-3. Common roofs: Common roofs are those which have no visible delineation between neighboring 2nits (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or )caner should notify the occupants of adjacent units of roofing work to be performed. �E 4° Exposed ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be dewed from below. The owner may wish to maintain the architectural appearance; therefore, roofing nail )enetrations of the underside of the decking may not be acceptable. The owner provides the option of naintaining this appearance. 50 bonding water: The current roof system and/or deck of the building may not drain well and may .ause water to pond (accumulate) in low-lying areas of the roof. Ponding can be an indication of structural listress and may require the review of a professional structural engineer. Ponding may shorten the life xpectancy and performance of the new roofing system. Ponding conditions may not be evident upt1-tje original oofing system is removed. Ponding conditions should be corrected. 0900 • • • • • • 9�° Overflow scuppers (wall outlets): It is required that rainwater flow off so fffdC ie roof's riot verloaded from a build up of water. Perimeter/edge walls or other roof extensions ma • • • • • • • y ��k this discharge !f • • • verflow scuppers (wall outlets) are not provided. It may be necessary to install overflow uppers iw accordaaoe• - dth the requirements of; Chapter 15 and 16 herein and the FloridaBuilding Code, P11MM "'.: • • • • • .. .. •• 0000-0 9° Ventilation: Most roof structures should have some ability to vent natural a e% through the ...0: - iterior of the structural assembly (the building itself). The existing amount of attic ventilation shall $ot'be • • 0*9000 ;duced. Exception: Attic spaces, designed by a Florida-licen �l engineer or registerecl•arcl2itect to;a;'llfliinatt 1e attic venting, venting shall ngbe r it //r - 0090 Vner's/Agent's Signature: ontractor's Signature: roperty Address:;/y/ Date: Permit Number: To: Re: % VillapMiami Building 1 i1 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 Date: 10050 NE 2nd Ave Miami Shores, FI 33138 Owner's Name: Pz-' 6( -O -Sb -e Li Property Address: /Y pier 96 Sf- Roofing Permit Number: Dear Building Official: I I'�/2 Ca/,®,Soy®/H certify that I am not required to retrofit the roof to wall connections of my building because: ti(fhe just valuation for the structure for purpose of ad valorem taxation is less than $300,000.00, Please attach proof of ad valorem taxation. ❑ The building was constructed in co liance with the provisions of the Florida Building Code (FBC) or yv tithe provisions . . of 94 diti t e lodda B i ing Code (1994 SFBC) "" 906000 .. . .. P/////////���``` Cilo/'1 G.` 0000 0000.. 0 00009 00000' .0.0. Signature Print Name .0 •00• 0 0 0 ••:..• 0000 .. 0000.0 0 0000.. State of Florida0000% 0000.. County of Dade0000 :0000: .. The undersigned, being the first duly swom, deposes and says that he/she is the owner for the above property mentioned. Sworn to and subscribed before me this day of �V1 - - - � - - - w _ - _ a _T -- Notary _ Notary Public, Sate of Florida at Large .04sY m76�� Notary Public State of Florida Meg A Romeo oe My Commission EE 202823 Expires 06/22/2016 ® When the just valuation of the structure for purpose of ad valokm*&ation is equal to or more than $300,000.00, and the building was not constructed with FBC nor a 1994 SFBC. Then you must provide a building application from a General Contractor for the Roof to Wall connection Humcane Mitigation. Revised on 5/21/2009 EARL W. JOHNSTON O ® INC. IN BROWARD 5721 DEWEY STREET 954-989-7794 HOLLYWOOD, FLORIDA 33023 www.johnstonroofing.com 954-989-5666 FAX 800 -940 -LEAK LICENSED & INSURED CC 0057073 STATE CERTIFIED NAME GOLDSMITH. PETER PHONE -305-751-7185 DATE 07/07/2014 ADDRESS 141 NW 96 STREET MIAMI SHORES FL 33150 JOB DESCRIPTION SLIGHT REPLACEMENT JOB ADDRESS SAME TERMS_ 50% AT SIG TNG/ BALANCE UPON COMP( ETION _ E ARE PLEASED TO SUBMIT THE FOLLOWING PROPOSAL. ;SPECIFiCATIA11Bs PROPOSAL INCLUDES REMOVING ALL DEBRIS, REMOVE AND REPLACE EXISTING SKYLIGHT WITH HI IMPACT DADE COUNTY APROVED INSTALL ROOFING LAYERS INSTALL TILES To MATCH S CWSE AS PO4STR1 REPAIR IS GUARANTEED 12 MONTHS FOR IABOR AND MATERIAL We agree to perform and complete the work in a workmanlike manner for the sum of t 2,065.00 TWO THOUSAND SIXTY IMM AND 00/100Dollars 'You the buyer may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.' If you the buyer wish to cancel this transaction after your right to cancel has passed, you the buyer shall'pay Earl W. Johnston Roofing, Inc, liquidated damages of $250.00 plus any cost Incurred. ADDITIONAL TERMS & CONDM- ONS 1. No carpentry work, woodwork, gutter work, or painting, whatever is included in this contract unless mentioned in specifications. 2. .(EARL W. JOHNSTON ROOFING, INC. carries full insurance as required by Florida law, but shall not be held responsible for damages either before commencement of or during said work, caused by strikes, war, ads of God, sudden rains, wind storms, or any event beyond our control. 3. It a only work to be done or guaranteed Is as set forth in this contract, no premises, verbal or otherwise will be valid. 4. FJ RL W. JOHNSTON ROOFING, INC. does not guarantee against leakage due to footwear, building construction, fire, hail, hurricanes, termites, etc, or any event beyond our control. S. In the event l4kage occurs in work completed by EARL W. JOHNSTON ROOFING; INC. contractee must notify EARL W. JOHNSTON ROOFING, INC. EA RL W. JOHNSTON ROOFING, INC. will then repair said leak at no charge to contractee, providing artide #4 of this section doesn't apply and said jo completed has been promptly paid in full and warranty is In effect 0.0 • 6. ork done, of attempted to be done, on this roof by other than EARL W. JOHNSTON ROOFING, INC or their aLShodz%d agent?*Wg'the • • • • • • rrantor from any further obligation hereunder. . • . • 7. L W. JOHNSON ROOFING, INC. will not be held responsible for damage to sidewalks, driveways, lawns, fences, sprinkler syctemc�etc, where • • sa must be crossed to gain access to building. .. 0:00 . • • • .... • 8. s warrantee is not assignable and is not subject to alterations, except by wrftten agreement executed by an oft"ft"Ahe warrantdt. :0006: 9. In the event payment is not made as slated In spedflcations, costs of collection including all attorney fees, court :m" r flection agenoglees are�to - be paid by owner or owner's agent. 10. interruption in the work which is the fault of owner or owner's agent will be billed according to time and ma • • • • 00000 d and payable upon receipt of bill. ;� 0 0.:: "amVshall "' • ... •. ....• to lite nature of (roofing EARL W. JOHNSTON ROOFING, INC shall not be (table for damages to walls, ceilings,• interior furniture, fixtures, •• de corations, stock or equipment, air conditioners, solar heaters, screenings, swimming pools, patios, etc. Either *1dh ,'during, or after said leakage ' . or otherwise. • . • • . • • • • • 12. bt a to the nature of roofing work, we strongly recommend that tate following be completed by the customer priop to 0 roommertcing work. • * • • o f 1. Cover furniture with a drop doth. .. • .... . . 2. Remove any lamps, art objects or other breakable items from room. • ; 3. Remove any debris that may have fallen in swimming pool after each phase of roof work. AI ough we take all due care, EARL. W. JOHNSTON ROOFING, INC. can not be responsible for any dirt or small debris that might fall through sheathli ig on exposed ceiling type roofs, therefore there may be some dean* up (vacuuming, dusting, etc.) required of the customer after completion of the job. You are hereby authorized to furnish all material and labor required to complete the work according to the terms itlons proposal and con for which we agree to pay the amounts itemized above. `t SIGNA RE OF SALES REPRESENTATIVE SIGNATURE OF O OWNERS AGENT? UNSIGNED CONTRACir PRICE IS SU83ECIr TO CHANGE ASR 30 DAYS 'Property Search Application - Miami -Dade County Page 1 of 7 Address Owner Name Folio SEARCH: 141 NW 96 ST PROPERTY INFORMATION Folio: 11-3101-025-0110 Sub -Division: BONMAR PARK RESUB OF BLK 3 Property Address 141 NW 96 ST Miami Shores , FL 33150-1714 Owner 1414•• PETER GOLDSMITH Mailing Address 1414•• 141 NW 96 ST MIAMI SHORES, FL 33150 1414 • Primary Zone 0800 SGL FAMILY -1701-1900 SQ 1414 . Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT • Beds / Baths / Half 2/2/0 Floors 1 Living Units 1 Actual Area 2,089 Sq.Ft Living Area 2,033 Sq.Ft Adjusted Area 1,996 Sq.Ft .1414••• • • .1414••• 1499•• '1414•••• • • • ♦1414••• i http://www.miamidade.gov/propertysearch/ 8/6/2014 1414•• • • 1414•• 1414 • 1414 • 1414•••• 1414 . • 1414•••• • 1414•• r•r• 1414•• 1414•• 00.00• ••• • •• •• •• 0000•• • •0000• •• • X00• • 0000 .1414••• • • .1414••• 1499•• '1414•••• • • • ♦1414••• i http://www.miamidade.gov/propertysearch/ 8/6/2014 'Prdperty Search Application - Miami -Dade County Page 3 of 7 Tax Comparison Tax Estimator (hftp:/Avww.miamidade.gov/PAPortaVTaxes/TaxComparlson.aspx? (hftpJAvww.miamidade.gov/PAPortallTaxesfraxEstimator.aspx) folio=1131010250110) View Taxes (httpsJ/www.miamidade.county- taxes.com/pubiiGreal_estate/parcelstl 131010250110) ASSESSMENT INFORMATION Year Land Value Building Value Extra Feature Value Market Value 2014 2013 $116,696 $77,798 $135,329 $135,329 $1,770 $1,792 $253,795 $214,919 2012 $62,379 $151,121 $2,083 $215,583 IAssessed Value $218,142 $214,919 $106,557 TAXABLE VALUE INFORMATION • • •••+r •6••6• Exemption Value $50,000 $50bp� • • • §50,000 • • --. ___44_4__4 _ -4 • • • Taxable Value $168,142 $164 IN " �• 156,557,•.•... _-- 9999•• 9000 9999 • • BENEFITS INFORMATION"""00 **so** 4444 .. 4444.. f Benefit Type 2044 201 • • • • ••6••• Save Our Homes Cap (http:l www.miamidade.gov/pa/amendmenL10.asp) Assessment Redijcdon $19,893• • • • • • • 6400•4 Homestead (httpJ/www.miamidade.gov1pa/exemptions_homestead.asp) Exemption • $2jj060 $25,00 • Second Homestead (http:l www.miamidade.gov/pa/exemptlons_homestead addltlonal.asp) Exemption $25,000 $25,00' Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). FULL LEGAL DESCRIPTION http://www.miatnidade.gov/propertysearch/ 8/6/2014 2014 2013 2012 COUNTY ------ ---- --- -- Exemption Value $50,000 $50,000 $50,000 Taxable Value $168,142 $164,919 $56,557 j SCHOOL BOARD Exemption Value $25,000 $25,000 $25,000 Taxable Value $193,142 $189,919 $81,557 `CITY Exemption Value $50,000 $50,000 $50,000 Taxable Value $168,142 $164,919 $56,557 REGIONAL sees • • •••+r •6••6• Exemption Value $50,000 $50bp� • • • §50,000 • • --. ___44_4__4 _ -4 • • • Taxable Value $168,142 $164 IN " �• 156,557,•.•... _-- 9999•• 9000 9999 • • BENEFITS INFORMATION"""00 **so** 4444 .. 4444.. f Benefit Type 2044 201 • • • • ••6••• Save Our Homes Cap (http:l www.miamidade.gov/pa/amendmenL10.asp) Assessment Redijcdon $19,893• • • • • • • 6400•4 Homestead (httpJ/www.miamidade.gov1pa/exemptions_homestead.asp) Exemption • $2jj060 $25,00 • Second Homestead (http:l www.miamidade.gov/pa/exemptlons_homestead addltlonal.asp) Exemption $25,000 $25,00' Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). FULL LEGAL DESCRIPTION http://www.miatnidade.gov/propertysearch/ 8/6/2014 Property Search Application - Miami -Dade County Page 4 of 7 RESUB OF BLK 3 OF BONMAR PARK PB 42-60 LOT 11 BLK 3 LOT SIZE 75.000 X 115 OR 17069-0573-7412951 SALES INFORMATION Previous Sale Price OR Book -Page 06/16/2014 $470,000 29203-1664 (httpJ/www2.miami-dadeclerk.comtPublic-Records/Search.aspx?search=3&Rec Book=292036 04/09/2012 $285,000 28069-1161(http://www2.miami-dadecierk.com/Public-Records/Search.aspx?search=3&Rec Book=280696 12/01/1995 $93,000 17069-0574(http://www2.miami-dadeclerk.com/Public-Records/Search.aspx?search=3&Rec Book=l7069i 10/01/1987 $77,000 13466-1138 (httpJ/w Av2.miami-dadecierk.coni/Public Records/Search.aspx?search=3&Rec Book=134666 05/01/1975 $46,000 00000-00000(http://www2.miami-dadeclerk.comtPublic-Records/Search.aspx?search=3&Rec Book=000006 01/01/1975 $36,833 00000-00000 (httpJ/www2.miami-dadeclerk.com/Public-Records/Search.aspx?search=3&Rec Book=000006 For more Information about the Department of Revenue's Sales Qualification Codes (httpJ/dor.myflorida.com/dor/property/rp/dataformatslpdf/s, 2014 2013 2012 LAND INFORMATION Land Use Muni Zone GENERAL R-14.25, R-15 BUILDING INFORMATION PA Zone Unit Type 0800 - SGL FAMILY -1701-1900 SQ Front Ft. Units Calc Value 75.00 $116,696 Building Number Sub Area Year Built Actual Sq.Ft Living Sq.Ft Adj Sq.Ft Calc Value 0000 1 1 1951 2,089 2,033 1,P96 : j135,329 ****so 9 • • • : • Building Sketches Availabiel(/PAPortaVPropertySearch/Sketch.aspx7Folio=1131010250110&year=2014) *00:00 • • • • • • • • • • • • • -, 0000•• EXTRA FEATURES 0900 0000 90.90' . ...... ... . ..... • • Description Year Built 00 tAlts Ca%1/alue • • •: • •••••• • • Chain-link Fence 4-5 ft high 1990 : � 280 •000• • 11,770 + • • • � • 0 • • • 0000•• - - ---- - - — •• 0 .___,. sees --• • ADDITIONAL INFORMATION .•:• " The information listed below is not derived from the Property Appraiser's Office records. It Is provided for convenience and is derived from other government agencies. http://www.miamidade.gov/propertysearch/ 8/6/2014 6666.. 6666.. 6 666666 6666. 6666. .6666. 66666. ..6666 )Dc- F IV -122Z "ASCE702W.xls" Program Version 1.7 WING LOADING ANALYSIS - Wall Components and Cladding Per ASCE 7-10 Code for Buildings of Any Height Using Method 2: Analytical Procedure (Section 6.) Job Name: 141 NW 96 STREET I Subiect: Job Number: Wind Speed, V = Bldg. Classification = Exposure Category = Ridge Height, hr = Eave Height, he = Building Width = Building Length = Roof Type = Topo. Factor, Kzt = Direct. Factor, Kd = Enclosed? (Y/N) Component Name = Effective Area, Ae = 170 mph (Wind Map, Figure 6-1) III (Table 1-1) C (Sect. 6.5.6) 15.00 ft. (hr >= he) 15.00 ft. (he <= hr) 40 00 ft. (Normal to Building Ridge) 30.00 ft. (Parallel to Building Ridge) Gable (Gable or Monoslope) 1.00 (Sect. 6.5.7 & Figure 6-4) 0.85 (Table 6-4) Y W (Sect. 6.2 & Figure 6-5) Girt (Girt, Siding, Wall, or Fastener) 208 Ift.A2 (Area Tributary to C&C) Plan n hr he L Elevation Roof Angle, 0 = 0 00 deg. Mean Roof Ht., h = 15 00 ft. (h = he, for roof angle <=10 deg.) Wall External Pressure Coefficients, GCp: GCp Zone 4 Pos. = 0.69 (Fig. 6-11A, GCp is reduced by 10% for roof angle <=10 deg. ) GCp Zone 5 Pos. = 0.69 (Fig. 6-11A, GCp is reduced by 10% for roof angle <=10 deg. ) GCp Zone 4 Neg. = -0.78 (Fig. 6-11A, GCp is reduced by 10% for roof angle <=10 deg. ) GCp Zone 5 Neg. = -0.84 1 (Fig. 6-11A, GCp is reduced by 10% for roof angle <=10 deg. ) Positive & Negative Internal Pressure Coefficients, GCpi (Figure 6-5): • 0 : •GCpi Coef. 0.18 (positive internal pressure) -GCpi �o�e#•�=l 0.16 (negative internal pressure) 6666.: 6 If z <= 1t thed: Kz ; 2.01 *(15/zg)^(2/a) , If z > 15 then: Kz = 2.01 *(z/zg)^(2/a) (Table 6-3, Case 1 a) • • •' a ! 9.50 (Table 6-2) ... .......__ 900 ... (Table 6-2) 6 6 6 66 Nil= 0.85 (Kh = Kz evaluated at z = h) 96900 '... 1.15 (Table 6-1) (Importance factor) Velocity PressMr oq&= 0.00256*Kz*Kzt*Kd*V"2*1 (Sect. 6.5.10, Eq. 6-15) 6";•0 ••:qpm- 61.39 psf qh = 0.00256*Kh*Kzt*Kd*V"2*I (qz evaluated at z = h) DelrrWet Extdmal'Wind Pressures (Sect. 6.5.12.4): For* W= 60 ft.: p = qh*((GCp) - (+/-GCpi)) (psf) For h > 60 ft.: p = q*(GCp) - qi*(+/-GCpi) (psf) where: q = qz for windward walls, q = qh for leeward walls and side walls qi = qh for all walls (conservatively assumed per Sect. 6.5.12.4.2) 1 of 3 1:06 PM �I Plan n hr he L Elevation Roof Angle, 0 = 0 00 deg. Mean Roof Ht., h = 15 00 ft. (h = he, for roof angle <=10 deg.) Wall External Pressure Coefficients, GCp: GCp Zone 4 Pos. = 0.69 (Fig. 6-11A, GCp is reduced by 10% for roof angle <=10 deg. ) GCp Zone 5 Pos. = 0.69 (Fig. 6-11A, GCp is reduced by 10% for roof angle <=10 deg. ) GCp Zone 4 Neg. = -0.78 (Fig. 6-11A, GCp is reduced by 10% for roof angle <=10 deg. ) GCp Zone 5 Neg. = -0.84 1 (Fig. 6-11A, GCp is reduced by 10% for roof angle <=10 deg. ) Positive & Negative Internal Pressure Coefficients, GCpi (Figure 6-5): • 0 : •GCpi Coef. 0.18 (positive internal pressure) -GCpi �o�e#•�=l 0.16 (negative internal pressure) 6666.: 6 If z <= 1t thed: Kz ; 2.01 *(15/zg)^(2/a) , If z > 15 then: Kz = 2.01 *(z/zg)^(2/a) (Table 6-3, Case 1 a) • • •' a ! 9.50 (Table 6-2) ... .......__ 900 ... (Table 6-2) 6 6 6 66 Nil= 0.85 (Kh = Kz evaluated at z = h) 96900 '... 1.15 (Table 6-1) (Importance factor) Velocity PressMr oq&= 0.00256*Kz*Kzt*Kd*V"2*1 (Sect. 6.5.10, Eq. 6-15) 6";•0 ••:qpm- 61.39 psf qh = 0.00256*Kh*Kzt*Kd*V"2*I (qz evaluated at z = h) DelrrWet Extdmal'Wind Pressures (Sect. 6.5.12.4): For* W= 60 ft.: p = qh*((GCp) - (+/-GCpi)) (psf) For h > 60 ft.: p = q*(GCp) - qi*(+/-GCpi) (psf) where: q = qz for windward walls, q = qh for leeward walls and side walls qi = qh for all walls (conservatively assumed per Sect. 6.5.12.4.2) 1 of 3 1:06 PM A 0000.. 0000.. ...00. 0000. 0000. 0000.. 0.000. 0009.. 9.0. 0000 0000.. ... . 0000 0000 . 0000 .. 0 ..0. 0000.. 0000 . 0000.. 0000 . 0 0000 .999.. 00.00. . .. 0 . . "ASCE702W.xls" Program Version 1.7 Wall Zones for Buildings with h <= 60 ft. WALL ELEVATION Wall Zones for Buildings with h > 60 ft. 3of3 4 1:06 PM F F � r F , , F F � F r , f , ( 3' F co ' r , F , t , F F r F F , WALL ELEVATION Wall Zones for Buildings with h > 60 ft. 3of3 4 1:06 PM "ASCE702W.xls" Program Version 1.7 ............. .. 0000. ._ _......... _...._ ...___....__.___ Forz = he: 15 .00 0.85 61.39 53.44 58.97 53.44 -62.68 For z = h: 15.00 0.85 61.39 53.44 -58.97 53.44 -62.68 Notes: 1. (+) and (-) signs signify wind pressures acting toward & away from respective surfaces. 2. Width of Zone 5 (end zones), 'a'= 3.00 Ift. • �e Per Code Section 6.1.4.2, the minimum wind load for C&C shall not be less than 10 psf. • ...; 4. Refereng* : a. ASCE 7-10, "Minimum Design Loads for Buildings and Other Structures". • � � • � 0 See ; b. "Guide to the Use of the Wind Load Provisions of ASCE 7-10" •;•••• • • by: Kishor C. Mehta and James M. Delahay (2010). • 0000.. Sege 00 6• .. . . e 0000. beg a Seg*** 0000. Sege Sege g • 0000 0000 0000.. • • • 08.060 .0066. • .e.. ...egg • . . . 6 • 00• 00.. 00 0000 e • 0 000g 2of3 Gw Amage- EARJO01 OP ID: MC '44C�4C>Ro CERTIFICATE OF LIABILITY INSURANCE 70611M9/14M THIS CERTIFICATE IS ISSUED'AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:. If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 321-725-7000 J.W. Edens & Company Commercial Ins of Brevard, Inc 321-725-7856 325 Fifth Avenue, Suite 108 Indialantic, FL 32903 NAAMNE:ACT PHONE FAX A/C E Ext : A1C, No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # Phillip Lane INSURERA:AXIs Surplus Ins. Co. 26620 EACH OCCURRENCE $ 1,000,000 INSURED Earl W. Johnston Roofing Inc. 5721 Dewey Street Hollywood, FL 33023-1917 INSURER B: INSURER C: FLGLN00564AX 07/01/14 INSURER D: INSURER E; MED EXP (Any one person) $ 5,000 INSURER F: COVERAGES CERTIFICATE NUMBER RFVISInN NI IMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTRR TYPE OF INSURANCE ADD WVDB POLICY NUMBER POLICYEFF MMfDD EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I 5w] CLAIMS MADE OCCUR FLGLN00564AX 07/01/14 07/01/15 DAMAGE TO RENTED 60,000 ENT DPREMISES Ea occurrence $ 50,00 PREMISES MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIM17 APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO n LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Perdent $ acc) NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE $ Paraccitlent UMBRELLA UAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS UAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILnYY / N ANY PROPRIEfOR/PARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? N ! A TORY LIMIT. ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) Work Performed - Roofing License # CCC067073 CERTIFICATE HOLDER CONCFI I OTIAN MIAMISV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Building Departmenet 10050 NE 2nd Ave Miami Shores Village, FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD