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RF-15-1017 i SOUTH FLORIDA S.G. & ENGINEERING STRUCTURAL.GEOTECHNICAI.x 1-.NVIRONMENTAL ENGINEERING Testing Laboratory Certificate Number 04-0329.02 8060 West 2-3 Avenue Suite -7 Hialeah Florida 33016 Telephone: (305)826-3855. Fax: (305)826-8545 E Mail: soflaengineering(dyahoo.com ON SITF_; CONCENTRATED UPLIFT LOAD TF,S"PING ROOF III E IN ACCORDANCE WIFll MI-IRO-DADS 131JILDING CODE COMPLIANCF,TAS No. 106 SITE SPECIFIC INFORMATION Job Address: _113 NE 105 Street, Miami Shores , Florida Contractor: American Home Care Type of Tile: Approximate Height: Floor: Type of Access: Ok Scaffolds N/A Ladder Ok Approximate Square Footage N/A sq ft Required Testing Force: 35 lbs. Testing Equipment: F.G.E. 500 H X, Shimp Instrument Date Tested: "-2015 IS TEST UPLIFT TEST UPLIFF "1FST I l PLIhT TEST I�PLIP"r PI ILL 11fST UPLIFT LOCATION PULL TEST I.00.A I[ON PULL I ES I G I.OVIOA PI'I"111;111 LOCATION 11Sl' 1.0( \TIOA M LL IIiST 1 PASSED 13 PASSED 25 PASSED 37 PASSED 49 2 PASSED 14 PASSED 26 PASSED 38 PASSF,D 50 3 PASSED 15 PASSED 27 PASSED 39 PASSED 51 4 PASSED 16 PASSED 28 PASSED 40 52 5 PASSED 17 PASSED 29 PASSED 41 53 6 PASSED 18 PASSED 30 PASSED 42 54 7 PASSED 19 PASSED 31 PASSED 43 55 8 PASSED 20 PASSED 32 PASSED 44 56 9 PASSED 21 PASSED 33 PASSED45 57 10 PASSED 22 PASSED 34 PASSED 46 58 11 PASSED 23 PASSED 35 PASSFD 47 59 12 PASSED 24 PASSED 36 PASSED 48 60 IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL PA 106_THIS ROOF ASSEMBLY HAS PASSED ME ATATIC IJPL,IFT QUALITY CONTROL TEST,THIS PA 106 TEST HAS 13LFN PERFORMED IN FULL ACC'ORDANCL LO T1I1i REQUIREMENTS OF DADS COUNTY,WFH I NO DEVIATIONS Res ectfull Sub tted By. South FloridS. E,Engi naer,ering Arsa F, 1 lemlo Rel-istration Numbcr:38863 Seal I i SOUTH FLORIDA S.G. & ENGINEERING STRUCTURAL GLOTE(I INIC'AL&, I NVIRONIMENTAL ENGINFFAIN(l Testing Laboratory Certificate Number 04-0329.02 8060 West 23'`1 Avenue Suite-? Hialeah Florida 33016 Telephone: (305) 826-3855. Fax: (305) 826-8545 E Mail: soflaengineering(&yahoo.com INSPECTION REPORT Job Address: _113 NE 105 Street, Miami Shores . Florida Contractor: American Home Care Type of Tile: Approximate Height: Floor: Type of Access: Ok Scaffolds N/A Ladder Ok Approximate Square Footage N/A sgft Required Testing Force: 35 lbs. Testing Equipment: F.G.E. 500 H X, Shimp Instrument Date Tested: *4-*-2015 /S 4 4 Respectfully Sub ter. By, South Florida S.G. Reengineering rshadNar, PT Mori-lu Reaistr,:irion Numhcr:38863 Seal 1 OR .Q M.E.2(d Averiae ' I ni Shc►es, 738 892 ne: (3061796-220 �w f $t'�$t '� 1�1 i ' z 777,7 (309))762' 006 494$ H41Y a CEp CItI M a t.r r' pBir�S��# �6 (9514)554"0418 Powell Owne�"s P'ixone; 2400 �iKA ERIC HERNANLIEZ m� TotaigaaETe Feet: I Totai.Jovilaiatian. RA tL TIAO � ,.;� r��M-p;q®ptt(IN�►�ti�K is al.t©wltt?ON • Pipe ` E��a��o�r •,�tI` �'' �NI Rolf �ti, �. , . . phone0i DONE MONDAY ) r Yee SUILDIN 4,"a � lIAK L ` f®BPiNC afilt MO GONt MOH F 24 x THR900 QftT T " , 4 at T IS FbSE[�FC�Fi MPISpFCrt10N PU FFUbl MATERIALS 9S DtSP'I�+ *0 A Vt `i tl\5 BEEN APP fav b aI„ANS ARE REAL A�IARlAR34E E J WILE.BE MADE UNLES.$7H�pERMIT CAFtC� ESStSLF.APIC?�, t,l BE 4. UREE HI EXplwt�tS E yNl A LEC)IN THE REMQVAl4�R KEPI gGf~MENTa� �p�ICAN�'S RESFpNSIBII.IT' 1'CR EN UHE t`HAC W}12l t v �FFRCItkL NlI ►� Rrf s ��C,.� AI. INSFECT1aN. �" I _ 'r S 40 >.- '�W�N �'� � � � 11AP "1f EIS' kesu IR,'PROPR' 'Y� - 8119f,ORE, T H �moTic �,� fDER OK ,� . SITE y1ll"�` OF �a 'ty w,A POJEC I ME FinaL__ s R h s rrl �r s _ ctnd�n k SEin .P r coon I'> rourtt � Final Ft~tnde fah f�`ooltfo► a C7ccilrls 4"'"au h neer Enc�sure Geiliri Aou h > v Drivewa Rou'h PLUMBING COMMENTS Clrivewa -Base Tele hone Rau h ✓ Tin Ca Roof in Tele hone Final Pro cess TV Rough Ma in Pro rens ! Final Final Roof Cable Rou h Shutters Attachment Cable Final Final Shutters Intercom Rou h Mails and Guardrails + Intercom Final MECHANICAL ADA-compliance ATai`m Rou h INBIII_Gib N DATE INSP Alarm Final Under - end Pi e DGCUM NTS Fi a Alarm Rou h Solring,Gert" f ditiial rt Fina Sall Treatment e t`IobC Elevatlon Serve V ntilahon.Rou } ftainffilnit Mas batt 7-7 L".BTRI >° foo+d_Rad h, Ins�tlatlo Cert ate t SVMS yPy�r rd,Test hCf Final Serve' { Truax Celflcaabn' Final Ventllanon Pcot eater OWL MM�NS r MECl_ANJ ,G0141110 'S77777 f i rir11(ler t .. _ FntatAl SOUTH FLORIDA S.G. & ENGINEERING STRUCTURAL.GEOTECHNICAL K ENVIRONMENTAL ENGINEF,RING Testing Laboratory Certificate Number 04-0329.02 8060 West 23"'Avenue Suite "'7 Hialeah Florida 33016 Telephone: (305) 826-3855. Fax: (305) 826-8545 E Mail: soflaengineering(a)yahoo.com 06!30/2015 City of Miami Shores Villas Building and Zoning Department 10050 N E 2nd Avenue Miami Shores, Florida 33138 Ref: INSPECTION OF THE ROOF TRUSSES REPAIR(Chimney Area) Address: 113 NE 105 Street, Miami Shores. Miami Shores, Florida To Whom It May Concern: This letter is issued to inform you that a representative of South Florida S G E Engineering performed a visual roof trusses inspection for the roof trusses repair at the chimney area at the above referenced project, on 06/15/2015. Based on our visual observation and inspection,the trusses repair at the chimney area were found to be acceptable and in compliance with the approved plans and Florida Building Code. South Florida S G E Engineering appreciates the opportunity to assist you in this project. If there is any a question or comments, please do not hesitate to contact our office. If 1 can be' of further service, please call at(305) 826-3855. (305)305-0718. Sincerely, Arshad Viqar,, P.E Florida'Registration Number:38863 Seal: Miami Shores Village �CFTN JUN B 2015 Florida Building Department 1 -- 10050 N.E.2nd Avenue,Miami Shores, oda 33 38 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 20(b BUILDING Master Permit No.RF-4-15-1017 PERMIT APPLICATION Sub Permit No. F-1 BUILDING ❑ ELECTRIC ❑■ ROOFING Fff REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL r7 PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 113 NE 105 STREET City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 1121360050100 Is the Building Historically Designated:Yes NO Occupancy Type: 01 Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):ANNIKA ASHTON ERIC HERNANDEZ Phone#:954 554 0418 Address: 113 NE 105 STREET City: MIAMI SHORES State: FLORIDA Zip: 33138 Tenant/Lessee Name: NA Phone#: Email: CONTRACTOR:Company Name: AMERICAN HOME CARE Phone#: 954 646 2283 Address: 6701 CYPRESS RD APT 201 City: PLANTATION State: FLORIDA Zip: 33317 Qualifier Name: GEORGE W. PEARSON Phone#: 954 646 2283 State Certification or Registration M CCC056760 Certificate of Competency#: DESIGNER:Architect/Engineer: NA Phone#i: Address: City: State: Zip: Value of Work for this Permit:$ 3c aO Square/Linear Footage of Work: 9 5_ F-- Type of Work: H Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: REMOVE CHIMNEY AND CLOSED ROOF Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ n� TOTAL FEE NOW DUE$ a q. (Revised02/24/2014) Bonding Company's Name(if applicable) NA Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) NA 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature /L Signatur s OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 28 day of MAY 20 15 by 28 day of MAY 20 15 by ANNIKA ASHTONG who is personally known to GEORGE W. PEARSON ,who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Si n: Print: t�W Seal: rW.el = Notary Public State of Florida Notary Public-State ofJ L Ey oe? My Comm. Expires Jan 23,2017 My Comm.Expires Jan 21�� Commission#EE 867932 Commission#EE 86 •11111 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) AMERICAN HOME CARE 6701 Cypress Rd APT 201 Plantation, Florida 33317 CGCO55944 CCC056760 May 27, 2015 STATE OF FLORIDA COUNTY OF BROWARD Before me this day personally appeared George W. Pearson who being duly sworn, deposes and says that he will be only person working on the project located at 113 NE 105 Street, Miami Shores, Fl. 33138. Sworn to and subscribed before me this 27 day of May 2015 by Personally Known p1PRr PGBf��7KATHLEEN O STRICKLEY State of Floridaes Jan 23,2017# EE 867932 4u11 ♦SNOoRES �'l !e long olive?"e" Miami shores Village k-- NT &+ Building Department ZORiDA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner,must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if. 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances,Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: ".,�Z� '�--- Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this day of eiA LA7 _120 / 6-. BK A 145"ff To-A-) who is personally known to me or has produced as identification. Notary O�P�yY PVBI��. 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Miami Shores, Florida •��• �,•• . ...... .. . ...... R e: ROOF SHINGLE, SHEATHING TRUSSES ...... ... . ..... Address: 1 13 NE 105 Street • .. .. .. ...... Miami Shores, Florida • . . . . ...... . . . . ...... .. . • ••• Dear Sirs: This letter is issued to inform you that a representative of South Florida S G E Engineering performed a visual roof shingle, sheathing trusses inspection at the above referenced project on 6/15/15. Based on our visual observation, we found that the roof structure consist of prefabricated wood trusses spaced at 24" OC, covered with plywood sheathing 5/8"roof sheathing nailing to wood trusses with 21/2" ring shank nails @ 6"O.C. for field &4"O.0 for edges & corners and then followed with #30 felt w/tin cap over#90 asphalt felt and roof tiles. In order to enclosure the chimney open, we recommend to reinforce the roof trusses structure by installing 2"x4" longitudinally bracing as per summited drawings. Generally the roof structure looks good South Florida S G E Engineering appreciates the opportunity to assist you in this project. If there is any questions or comments, please do not hesitate to contact our office. If I can be of further service, please call (305) 826-3855 or(305)305-0718. Sincerely, Arshad Vigar-, P.E Florida Registration Nuirlber:38863 Seal: 3'-0" ll'-0"11'-0, 1 -0" NEW 2"x4" SY#2 PT WOOD BRACING SCOPE WORK ENCLOSURE CHIMNEY OPEN oBY, �o >, 'I USED NVBH 24 PT WOOD BRACING BUTTERFLY HANGER EXISTING 3'x3' REQUIRED G= 126# CHIMNEY OPEN MAX.REQ. UP LIFT=151# EXISTING �� '0" PREFABRICATED EXISTING 2, 0„ 6., 11, 6„ I 2, 0' , 1 _ _ _ WOOD TRUSSES - i PREFABRICATED - - - -- - 2'-0” 1_'-6" 1'-_6" 2'-0" WOOD TRUSSES EXISTING ROOF CHIMNEY OPEN PLAN DETAIL SCALE N.T.S ENCLOSURE ROOF CHIMNEY OPEN ,y PLAN DETAIL SCALE N.T.S �� - NEW 2"x4" SY#2 01, PT WOOD BRACING STRAP SCHEDULE I,6„ FOR ENCLOSURE # NOA No MANUF. . FASTENER MODEL UPLIFT GRAVITY I,6 CHIMNEY OPEN -- - - -- (LBS)-- (LBS) EXISTING NV—VUE NVBH-24 08-0326.11 702 1113 6— 8d JOIST 0 WOOD TRUSSES O BUTTERFLY HANGER 12— 8d HEAD DETAIL FOR ENCLOSURE ROOF OPEN CHIMNEY OR SIMILAR SCALE N.T.S . . . . .. . .. . . . . ... . ARSIIAD VIGAR, P.E SOUTH FLORIDA S.G. &E. ENGINEERING •.. . . .YACLOSURE CHDlNEY OPEN PROFESSIONAL ENGINEER LABORATORY TESTING&ENGINEERING WUAMM 38883 FEMTRAMM M,K13M 603097700= OWNER: 8080 WE8T 23rd AVE BUTTE 0 7 8080 WEST 23rd AVE SUITE 0 7 ••• ••• • HWLEAK FL 33018HALEAK ' • Ph (3=828-3855 Ph-c ��305-o71s "11 RJE S S: to 105 sr A mss,