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WS-15-2054 r s Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-243797 Permit Number: WS-8-15-2054 Inspection Date: September 21, 2015 Permit Type: Windows/Shutters Inspector: Rodriguez,Jorge Inspection Type: Final Owner: SEPTEMBRE, E THOMAS Work Classification: Garage Door Job Address:1119 NE 104 Street Miami Shores, FL Phone Number Parcel Number 1122320290040 Project: <NONE> Contractor: ALLIED DOORS SOUTH FLORIDA INC Phone: (954)942-8550 Building Department Comments REPLACE 1 EXISTING 16 X 7 01H GARAGE DOOR Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-243647. CREATED AS 40 REINSPECTION FOR INSP-241401. Failed El Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. For Inspections please call: (305)762-4949 September 18,2015 Page 1 of 1 y Miami Shores Village Building Department artment 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2011+ BUILDING Master Permit No. -:206-q PERMIT APPLICATION Sub Permit No. [;?4UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL [:]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP ( CONTRACTOR DRAWINGS `-C JOB ADDRESS: I I P a J� SA City Miami Shores County Miami Dade Zip: Folio/Parcel#: 1,1-2232. 09 R QD4 0 Is the Building Historically Designated:Yes NO_J4 _ Occupancy Type: Load: Construction Type:SE ,,L Mb Zone: BFEQQ:]]'�� FFE: OWNER:Name(Fee Simple Title(hol�der): T,� S'�iVJ"IPI(YlrJr� Phone#:Jv� ��`�) 7 9 Address: IM�� N yE,� tu4 City: bkIol.n,i sY Id ye,,5 State: Zip: 3130 _ Tenant/Lessee Name: 'v I Phone#: Email: 1 CONTRACTOR:Company Name: l 1��y� -FL-, LL0- Phone#: ��'l�2 �S�U Address: 1 5 1 SW ��J�o 1 l ulat City,:1 U �_0 5�j 1 State: fL,, Z i p: Qualifier Name: a is A{�e� I Phone#:"i 5�" 42-?5f50 State Certification or Registration#:CIJC�� Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 12-0Q-00 Square/Linear Footage of Work: 112- Type 12Type of Work: ❑ Addition ❑ Alteration ❑ New [2 Repa` � /,Replace ❑ Demolition Description of Work:'If-p l ao t l e x p -h nQ haul D c �I1 �-1 axadoa r Specify color of color thru tile: Submittal Fee$ Permit Fee$ `� ' 0� CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ �. (Revised02/24/2014) Bonding Company's Name(if applicable) � )A 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 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 occ s seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will n be approv nd a reinspection fee will be charged. Signature Signature 17 OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _W day I r t of N V v 20 IS' ,by �_day of l�Q�J'1 ,20 1 � by MaS SWffM bYr who is personally known to D h n�S �� who is personally known to mM,or who has produced as me or r who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: n• Sign: Print: PH pPY PX,�•• HENRY RAMIREZ ,� S I: _ eal: :'r�•,, HENRY RAMIREZ g,. +: MY COMMISSION#FF 102369 4`° e��; EXPIRES:March 16,2018 := MY COMMISSION#FF 102369 f 0 Bonded Thru Notary Public Underwriters EXPIRES:March 16,2018 .�4(1R.• Bonded Thra Notary Public Underwriters wwwwwwwwwwwwwwwwwwwwwwwwwww wwww �wwwwwwwwwwwwwwwwwwwwwwww w ww wwwwwwwwwwwww*www APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ' STATE OF FLORIDA �- DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850)487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 ROMANELLI, DENNIS M ALLIED DOORS SOUTH FLORIDA, LLC 151 SW 5TH CT POMPANO BEACH FL 33060 Congratulations! With this license you become one of the nearly one m7tfon Floridians licensed by the Department of Business and " Professional Regulation. Our professionals and businesses range STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. PROFESSIONAL,REGULATION Every day we work to Improve the way we do business in order to CBC033137 j$SUI D`:. 07/30/2014 serve you better. For information about our services,please log onto www.myfloridalicense.com. There you can find more information CERTIFIED B,UII NG CONTRAP'[LSR about our divisions and the regulations that impact you,subscribe ROMANELLi, V ENNi6 M'; to department newsletters and learn more abut the Departments ALLIED iJOQi :3 Q1JT `FI_O i A,LLC initiatives. Our mission at the Department is: License Eftic ier ty,Regulate Fairly. We constantly strive to serve you better so that you can serve your Customers. Thank-you for doing business in Florida, 13 CERTIFIED under the provisions of Ch,488.FS. and Congratulations on your new licensed Expas:van :AUp39,ZOIf1 1149730lt01 DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL,REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CM33137 The BUILDING CONTRACTOR Named below IS CERTIFIED ' Under the provisions of Chapter 489 FS. Expiration dater AUG,31,20 16 ROMANELLI, [DENNIS M ALUED DOORS SOUTH,r ^ LIIA LLC 151 SW 5THCT rr POMPANO BEACH -FL 33060 ISSUED, 07130/2014 DISPLAYAS REQUIRED BY LAW SEQ a L1407300001569 r BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT . 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2014 THROUGH SEPTEMBER 30,2015 {' DBA: Receipt#: 8 co rOR (BVILDI Business Name:ALLIED DOORS SOUTH FLORIDA LLC Business.Type:CONTR) w' Owner Name:DENNIS M ROMANELLI Business Opaned:10/01/1993 Business Location:151 SW 5 CT State/County/Cert/Reg:CBC033137 POMPANO BEACH Exemption Code: Business Phone;954-94 •ids J 4 � Rooms S@rata Emyee tlicftnes Professionals lb For Vendinj Business 061Yk Number of Machines: Vending Type: k 9 ' vColiection Cost Total Paid Tax Amount Transfer Fee o-,` 0 1� ;�� F a� 27.00 0.00 ;i1(5 �,0�.:, 0'. 6 0,00 27.00 .... sw THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS 4 THIS BECOMES A TAX RECEIPT This tax Is levied for the privilege of doing business within Broward County and Is non-regulatory in nature.You must most all County and/or Municipality planning a k and zoning requirements. This Business Tax Receipt must be transferred when +: WHEN VALIDATED the business is sold, business name has changed or you have moved the ; k, business location.This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. E' Mailing Address: ,fir yi #=P-13-00012167� t„ ALLIED DOORS SOUTH FLORIDA LLC Receipt ; 151 SW 5 CT Paid 08/14/2014 27.00 POMPANO BEACH, FL 33060 M ,i 2014 2 15 i 1 h ALLIE-2 OP ID:KG '4C[7►Ro� CERTIFICATE OF LIABILITY INSURANCE DA081TE 261201 Y► � 08/25/2014 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(les)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 CONTACT Douglas Jones Jag Insurance Group PNAMNE FAX 2151 LeJeune Road,Suite 308 A/c N0. o Ext): Arc No): Coral Gables,FL 33134 E-MAL Douglas Jones ADDRESS:Djones@jaginsgroup.com INSUREW AFFORDING COVERAGE NAIC S INSURER A:COLONY INSURANCE CO. INSURED Allied Doors South Florida LLC INSURER B: 151 SW 5th Court INSURER C: Pompano Beach,FL 33060 INSURER D: INSURER E• INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSRTYPE OF INSURANCE D BR POLICY POLICY EXP LIMITS LTR IWDL POLICY NUMBER MM/DD MMIDD A X COMMERCIAL GENERAL UA131 TTY EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTE CLAIMS-MADE Fx—]OCCUR X 103GL0000726-01 08/30/2014 08/30/2015 PREMISES Ea occurrence $ 100,00 X $2,500 BI PD Ded MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO-- LOC PRODUCTS-COMPIOPAGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $HIRED AUTOS AUTOS Per accident UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,00 A X EXCESS LIAB CLAIMS-MADE XS169667 08/30/2014 08/30/2015 AGGREGATE $ 3,000,00 DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETORIPARTNERlEXECUTIVE YIN E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? ❑N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yas,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space is required) CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED. State of FL Dept. of Business ContractorAC2% License #CBC033137 Garage Doors and openers installation CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE VILLAGE OF MIAMI SHORES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ATTN:BLDG&ZONING DEPT. 10050 NE 2ND AVENUE MIAMI SHORES,FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD ACC>R& CERTIFICATE OF LIABILITY INSURANCE °; 6118/20""Y'r' 06/18!2015 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 BYTHE 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(les)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). PRODUCEROSE C Risk Transfer Insurance Agency,LLC PHONE 866-481-9363 FAX 707 East Washington Street C No AIC Na Orlando,FL 32801 E dWL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A.-Technology Insurance Company,Inc. 42376 INSURED INSURER B: Engage PEO Labor Contractor for leased workers to:Allied Doors South Florida,LLC #151103 INSURER C: 3001 Executive Drive Suite 340 INSURER D: St.Petersburg,FL 33762 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:K88TFB9V REVISION NUMBER: 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. IL.RSR ADDL S B POLICY EFF POLICY EXP TYPE OF INSURANCE INSR WV0 POLICY NUMBER MIDD MMUDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED— COMMERCIAL GENERAL LIABILITY PREMISES Me occurrence $ CLAIMS-MADE r-1 OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ POLICY PRO-- LOC $ JECT AUTOMOBILE LIABILITY Ea BINEDaccideitSINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LI1B CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION TWC3453362 12/31/2014 12/31/2015 XY/N TORY STAT- I 10TH- ER AND EMPLOYERS'LIABILITY 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ F-1 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Coverage is extended to the leased employees of alternate employer in all states except in monopolistic states(ND,OH,WA,WY): Allied Doors South Florida,LLC #151103(Effective 6/21/15) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Village of Miami Shores AUTHORIZED REPRESENTATIVE 10050 NE 2nd Ave Miami Shores,FL 33138 Page 1 of 1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD �e ��.� �(rte - -�LL_ - _ . . -�� - - : ' - - �� IGC°. � - �. •, �X �-S-f-I -� � � �� .• ped }cyte c I F, . � - 1 . () AUG 1 205 3 3• - BY - - - PT ,ME OF 9 p. I' u na IL ' < Miami Snores !liilage O _ - � APPFfOVED BY DATE - ZONING DEPT - •.. ..: i .'. ." g2,LDG DEPT i• •: : : :•: •• SUE3JECT TO COMPLIANCE WITH ALL FEDERAL '<TATE AND C01INTY RULES AND REGULATIONS :. ••• • ••• • - • • _ - • 111 1 N 1b4 S+ I�1 aYv� l S l cy(-s, FL 3 3 3arr,A M4 4�� WORST CASE SCENARIO DESIGN PRESSURE CHART,ENCLOSED BUILDINGS ENTRE/NATIC FLORIDA BUILDING CODE 5TH EDITION(2014) DADE COUNTY FLORIDA 175 MPH EXPOSURE C EXPOSURE C EXPOSURE,D"'. E1fPQSURE:13 Mean Design Pressure Mean Design Pressure MengDesign DesS n prerre Door Door Roof Door Door Roof Door Door Roof Tjoor' Door" "Rod" Width Height Het ht PositNe N ative Width Hei ht Height Positive Negative Width Height Height Positive N alive Width Hei fcie Paw3&Ms Negative 8 35.6 -44.7 8 8 35.2 -44.0 8 7' 43.2C "54.2 8 �fl,8 427° `53.4": 15 9 8 15 34.9 -43.4 9 7 15 : "42.8 53.5 9 15 ,._422 -526 18 7 33.8 -41.0 16 8 33.4 -40.4 16 7 41.0 •49.8', 16: Ott 49,0 18 8 33.1 -39.7 18 7 40.6' 49.1 18 402 =4822 8 7 36.1 -45.3 8 8 35.7 -44.6 8 . 7 .43.7? MA 8�" 8' 9 7 35.7 44.6 9 8 35.4 43.9 9 7 43:3:' '-54.I r: 16 7 16 34.2 -41.6 16 8 16 33.9 -40.9 16 t-7 16 41A -W.4 16 8 18 ".410- F95 18 7 33.9 41.0 18 8 33.6 40.3 18 7 4F1< 49.6x" 18 8 7 36.5 -45.9 8 8 36.2 -45.1 87 " 44.T." "w55. 8 8 43 7 54 5 9 736.2 -45.2 9 8 35.8 -44.5 9 7 43.7 .54 6 i 9 8 433 53 8 17 17 1Z 17 ' 16 7 34.7 -42.1 16 8 34.3 -41.4 16 7" 18 7 34.3 -41.5 18 8 34.0 -40.8 18 1 'T1: 414 S0 2 18"_ _$ 41.1 •493 8 7 37.0 -46.4 8 8 36.6 -45.7 8 %< 7 44:6' -55.9= 8 8 9 7 36.6 45.8 9 8 36.3 -45.0 9 7 44 2='" 552= 8 8 43 = :3'' � , 16 7 18 35.1 42.7 16 8 18 34.7 41.9 16 -=76 1$ 413_ 51.4 16 8 18 7 34.8 142.0 18 8 34.4 -41.3 18 3 T 41.9" 50.7h 1$ 8 45 8 7 37.4 -46.9 8 8 37.0 46.2 8 7 45.41: -664 9 719 37.1 -46.3 9 8 19 36.7 -45.6 9 7 19 44.6=' 557:" 9 8 8'" 441 548: 16 7 -43.1 16 8 35.1 -42.4 16 7 42.7 ' -51,0r 16 8 423" »5 a1 18 7 35.35.5 2 -42.5 18 8 34.8 1 41.8 18 7 . 413_ -51,[- 18 "8 '41.9 =503 8 7 37.8 -47.4 8 8 37.4 -6.7 8 r rr 7 45:4` -57.0:'x: 8 8 44 61• 9 7. 2U 37.5 -46.8 9 8 20 37.1 -46.1 9 7 2a" 45.0' -562. 9 8 44.5 55:3 : 16 7 35.9 -43.6 16 8 35.5 -42.9 16T 43:1' -524> 36 :- 8 .A28"=" -5�5 18 7 35.5 ' 43.0 18 8 35.2 42.2 18 7 427: 51.$ 18 8 422' 50.7 8 7 38.2 -47.9 8 8 37.8 -47.2 8 7 45:8'' 57.5:: 8r 8 *k5.3 56:6 9 7 VZ` -47.3 9 8 37.5 -46.5 9 7 45.4: 56.7` 16 7 21 36 2 44.1 16 8 21 35.9 -43.3 16 7 21 434' 52.8 s 16- .$ 21" 43 0 " -•51.9 18 7 35.9 43.4 18 1 8 35.5 42.7 1 18 7 43.0" -520' 18 8 8 7 38.8 8.4 8 8 38.2 117.7 8 7 48.1` 579'- 8 5TID" 9 7 22 38.2 -47.7 9 8 22 37.8 -47.0 9 7 22= 45.T -571 9 $" 22 46,1 " .52 16 7 36.6 -44.5 16 8 36.2 143.7 16 '7 438 533> 16 ' 8 `433.- 18 7 38.3 43.8 18 8 35.9 43.1 18 7 43.4`- 52.5; 18 8 42.9 8 7 38.9 48.9 8 8 38.5 48.1 -58.41 8 9 7 38.6 -48.2 9 8 38.2 -47.4 9 7 46.1 -57.6 9^ 8 • .6 ••• 16 7 23 36.9 -44.9 16 8 36.6 44.2 16 7 44.1 " :-53.7; i6r�._ �$ . " � ,? -518 = •• 18 7 36.6 -44.2 18 8 36.2 1 -43.5 18 :r97:9, 43.T 52.9'. s "5 •i• 8 7 39.3 49.3 8 8 38.9 48.5 46 9 7 24 38.9 48.6 9 8 24 38.5 -47.9 97 24 46.4 -b8.0` 2 480 • 16 7 37.3 -45.3 16 8 36.9 114.6 16 7 44.5" -,54.4 a6r._e 8 : .:440 5351 • 18 7 36.9 -04.6 18 8 36.6 113.9 18 7 44.1' ` .3 •• 8 7 39.6 49.7 8 8 39.2 49.0 r.87 47.2 592= 8 8 46.7583"<. ••• 9 7 25 39.3 49.0 9 8 25 38.9 -48.3 9 74r,9,:,: 25" -46.8 58.4' 2d 16 7 37.6 45.7 16 8 37.2 -44.9 16 7 44.8' -54.4; •"?4i *$„ •• 44 8 -53'9!, ••• 18 7 37.3 45.0 18 8 36.9 44.3 18 7 44:4 53 6 3,9 .:,x527:,' •• • • • Notes: • • :•••:• •••••• 1) Design pressures have been calculated using procedures listed in ASCE 7-10,Chapter 30,Part 1,for Low-Rise§d IdIngs. • :0090: 2) The calculated ultimate wind pressures have been multiplied by 0.6 to convert to the nominal(ASD)design pressures shown. • ••• • • • 3) Pressures have been calculated based on an enclosed building,any roof slope,Risk Category II. •..• 4) The design pressures assume the entire door's width is in the end zone(zone 5)of the building. o 5) Most garage door openings will no be located completely in zone 5. Therefore individual �� ,,.*'"""'`•••� calculations will result in lower pressures. Ln +•' � .. „ Z 6) For mean roof heights less than 15',use 15'pressures. N , a o 7) This Table is only to be used in conjunction with Amarr Garage Doors. W E a"�•`.....••+w ; o J tL ■ � f � • t= 4 w i 165 Carriage Court.Winston-Salem,North Carolina 27105 Phone(336)744-5100.Fax(336)744-5815 www.amarr.com Ingp * � STATE IF ,■ � �v' a Ln- %� %A ■ .t+ amu`. "+ ,* 2 3 `•w "* in Y N FL ••$'■■wry■■+. * .B Cn vN MIAMI-DADE MIAMIDADE 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.mlamWad%1ov/econom1 Amarr Garage Doors 125 Carriage Court Winston-Salem,NC 27105 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 AHI(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 950 Heritage&6 000,2000 Steel Sectional Garage Door up to 16'-0"Wide(DP+45.8,-49.3 PSF APPROVAL DOCUMENT:Drawing o.IRC-9516-169-26, ' d"Mode1950 Heritage&Model 655 Oak Summit,(24 GA) 1000,2000,Short,Lon anels",sheets Ithrough 3 of 3,dated 03/14/2003,with revision C dated 02/04/2013,prepared by Amarr Garage Doors,signed and sealed by Tomas L.Shelmerdine,P.E.,bearing the Miami-Dade County Product Control revision stamp with the Notice of Acceptance number and expiration date by the Miami-Dade County Product Control Section. MISSILE IMPACT RATING:Large and Small Missile Impact Resistant LABELING:A permanent label with the manufacturer's name or logo,3800 Greenway Circle,14v mmp, Kansas,model number,the positive and negative design pressure rating,indicate im1:actj1tpd if a fllC'able, 6696V • installation instruction drawing reference number,approval number(NOA),the applicable lest staddarllc,and the statement reading'Miami-Dade County Product Control Approved'is to be locattdan the doors wide track,bottom angle,or inner surface of a panel. .... 0 :0..0 RENEWAL of this NOA shall be considered after a renewal application has been filed and'tltmj&s bee$h6?c4idnge ..... In the applicable building code negatively affecting the performance of this product. 040069 0 0 Deese ' TERMINATION of this NOA will occur after the expiration date or if there has been a revisionor changa K-1-4 0000.. materials,use,and/or manufacture of the product or process.Misuse of this NOA as an endovwRw0 of any product,for • sales,advertising or any other purposes shall automatically terminate this NOA.Failure to comply with am :c::°�of ••••:• this NOA shall be cause for termination and removal of NOA. • ADVERTISEMENT: The NOA number preceded by the words Miami Dade County,FloAda,and fopb4tl by thea expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then it shall bb done in its entirety. INSPECTION:A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA revises NOA#13-0503.08 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.Utrera,P.E. NOA No 15-0505.13 MIAMMADE CDUtUTY Expiration Approval Date:July 16,2015 Page 1 i Amarr Garage Doors NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS "Submitted under NOA#13-0503.08" 1. Drawing No.IRC-9516-169-26,titled"Model 950 Heritage&Model 655 Oak Summit,(24 GA) 1000,2000, Short,Long,Flush and Oak Summit Panels",sheets Ithrough 3 of 3;dated 03/14/2003,with revision C dated 02/04/2013,prepared by Amarr Garage Doors,signed and sealed by Thomas L.Shelmerdine,P.E. , B. TESTS "Submitted under NOA #13-0503.08" 1. Test report on Evaluation of Painted or Coated Specimens Subjected to Corrosive Environments per ASTM D1654&ASTM B117,prepared by Architectural Testing,Inc.,Test Report No.C5463.01-106-18,dated 04/03/2013,signed and sealed by Gary T.Hartman,P.E. 2. Test reports on 1)Uniform Static Air Pressure Test,Loading per FBC TAS 202-94 2)Large Missile Impact Test per FBC,TAS 201-94 3)Cyclic Wind Pressure Loading per FBC,TAS 203-94 4)Tensile Test per ASTM E8 5)Forced Entry Resistance Test per FBC,TAS 202-94 along with marked-up drawings and installation diagram of 9'x 7'24 ga steel garage door Model 950,prepared by American Test Lab,Inc.,Test Report No.ATLNC 0205.01-13R, dated 04/02/2013 and 06/13/2013,signed and sealed by David W.Johnson,P.E. 3. Test reports on 1)Uniform Static Air Pressure Test,Loading per FBC TAS 202-94 2)Large Missile Impact Test per FBC,TAS 201-94 3)Cyclic Wind Pressure Loading per FBC,TAS 203-94 along with marked-up drawings and installation diagram of 9'x 7'24 ga Model 950D Heritage with Durasafe,24 ga Sectional Steel Garage Door,prepared by American Test Lab,Inc.,Test Report No.ATL 0311.01-03R,dated 06/22/2006,signed and sealed by David W.Johnson, P.E. "Submilled under NOA#08-0718.03" C. CALCULATIONS ',Submitted underNOA#13-0503.08" .... 1. Anchor calculations prepared by Structural Solutions,P.A.,dated 04A 1/2413,signed sad 9698:0 sealed by Thomas L.Shelmerdine,P.E. •• • 699966 •. 2. Anchor calculations prepared by Structural Solutions,P.A.,dated 02/09t71l12,signed afld 009000 sealed by Thomas L.Shelmerdine,P.E. "Submitled under NOA#08'0718.103" 9 :....: D. QUALITY ASSURANCE •• •• •• ...... . . ..... 1. Miami-Dade Department of Regulatory and Economic Resources(Rr l..' ...... E. MATERIAL,CERTIFICATIONS •••••• 1. None. • V: F. STATEMENTS 1. Statement letter of code conformance to the 5'4 edit- (2014).FBC an o financial interest issued by Structural Solutions,PA.,dated 04/08/2015, d by mas L. Shelmerdine,P.E. arlos M.Utrera,P.E. Product Control Examiner NOA No 15-0505.13 Expiration Date: September 4,2018 Approval Date:July 16,2015 E-1 R't0 BALL Y 16 CA END CAP IIEffi@ STEM HIR QW 140A DIROASPFE TOP FIXTURES ROLLER VA,HIM STEN CRRIER HINGE ATTACKED VVI(4)114 4• GA'"AD BRACKET ATTACHED TD VMD RD.0 ADJUSTABLE ROLLER CARRIER it THI= 1R TRACK V."..80 8/B TRA�CITSPI.[CE� F11Ki11RE ATrACI{D V/ TTACHIH V/t0 1/4•x I/U• 7.16 C/f END CAP 1RtAHID <p 1/4•x 3/4.11fiI1 WAD BH.TS AND WIT; IR RH.LFA IIRACKE7 IIOL.T 6 IRlf PER IN 'i^: -.; lH•AND BOTTOM SCREYS AB.R7 ACHCOE SLIME ATTACIHD V/R4) /d•x - IHatiKT ATTACHED V/c0 3/d• 0 1/E'laOA R-TRUSS ATTACHED �P::•,-v>>:i, x 1/R•SILT AHD® PER DRACIOLT ~x V/tib VN x 3/4' _ .:.; HDI IEaD SCREVS AT '- ••' EACH CENTER STILE '\`jl''-��{:y{1,•/j` YPI AL TDP FI%TtIRES 4 26 t0 YW E MER FW$ ��R�A�pIg AT AIS 1SLpKya%IU�OH t r/BAKEO HR POLYESTER t4RSH 'ID JAN�B 5W (3)S/MMYTA i t�f8' gEEin HOW CAMS�� T� TYPICA ^AFE CENTER HINW R� A t)8/18'BRA.x t-D/R• B%'r ATTACHED TO JANE AT EL an BRACNEt Q)R-TRIRB q PER SECriCR 1 LBGTE WFID + RC.rw O IR OA.RALT4 TT STOP) ON TDP BECIImA ONLY c0001KdD AITAO 11 [1t 1/4'-20 . (RACK swICE/R68.Y R Htt man Pm STRUT )(IF RIM F TFIROIpiH E 6 4 B RaIRE 3)ON PAS 3 O..11LI STIFFENERBRACKET SPACIM G A e ILT� a I/e71%IB TttlOLS) QflRATNN FOR Wr UP TO 14'TALL r r"M Ell R-T 7p V/60 1/4•x 3/4•I= -FO.R 9tT.E E 4 IN PA R FDR STRUT�ACINGAGE 3 SCREVS AT EACH END SIRE AHO WS 1/4•x314• ST READ E SCRE S AT EACH CENTER SITlE 1E•-0'NA% *3 14&%IARHSAFE ROLLER INSIDE ELEVATION em ATtACM V/SIRm CpRRiFA{ATTACHED 7D"64133 ILLS. (2)1/4•X 3141 W(P)1/4•x 3/C4•NEX 4 UA,IMAIASM1iE NET BRAD=R£VS HEAD SCREAR9 PFR ARRIER 0HIMEf1/41TACHED AT g4 AND CENTER qy OISQlBOtQR OAIl STEEL R¢x READ SCIM CM.STEEL REI A 1f tAR00/18G ttlat�&HBA GOIAS 8! &H Ic LRmlim 14M TRRtABAFE nm m ROWS brellTMNT W 10RTON SEAT V/8r STEN ROLLER CARRIERS ATTAC&T EQUALS IBUI S2 VENTINORCS B IA13Bl1OF•I•� 1 mill I{.' TO END STILE W Cb 1/4•x 314• HER HEAD SMEYS PER SER 3FrnOW A-A(SIDE WEW C H®snlrmt�mR l O/DI/fl RB IRODUCCROViSM °°°11,4 SkE(wr SLIDE I=ERMAGES INTO ICAL MOROIr1Re NO locav ytogwmie Raft OF.SWN e`Q� EIV �,RJ 0 '{P9F .s°O�•��G S 1/EA%H 6A. (8•. e BAR OPT01113 ATTACH WIM V4•xVC X 3141 pir SIE O`Z'.'• 1R-t ATTACHE Vito SIVID7 HEAD WREvs uY $�s+•- 00405 SCREYS f1A0eL7 �- A. TYPICAL.AURASAFE END H04trE �{�.q) g1� STATE OF J�„ a�7ro viTN�'Tim-ItaOC 81'8•xSCRCW tn I'A° LARGE IISSLE �'o' A� O•' a �V�o pf/RAE. /r'a, P,.'�• 3 DER W (�PP1�D BY RdBTALIEN) MR WACr TO M A,U AND ttb JARS lei OP Atm IH�Tfl N FIM jHgy� o0sa(L.. O..I• `�,°°° 3 to R0 O0.CENTER STILES TOO-L-I.00 A7 THEA • • • • RD i' d,IS'S14R�lEEiT ,,° $f ""'TTHETW RT LARGE MISSLE FL TOB-I.-LOC AT THE T�ART Sctp)LTT/16 BUTION RAIL AND AHIESIVE PER RLwEAR� ; • • ; ; ��Scmum$TO INTERIOR FADE • • ; ;•• •! IMPACT RESISTANT arr :_:. .._. -::...:.,_._ ..__... TAS CARRUOE NG a>iN vwwu®.ws i.F.._..;....... .-.:meq... .. ..r..:;r. Y ID tlAtl BOTTOM DRACIOiT 1d0I)BI.080 SN6iTAQB N4 QA 1000,P.000 R"OAT,•rL g[EF} STECI. t3 GA T/OCI ATTACHED mom 8s�OA1C BIJAIMI�T�sPA NA)L000.1:000 TRACK THICUI Y/8•NIH sm VAN 1/4•X 314• g�&9'.I.OIIQ.YWISFE.MIO OA&OUNMIT PANELS D 1/4-80 x 8/0TRACK t8 GA.Or • •�L MERWIMOA)H RIIB • • • HEX MEAD SCREW SPLtIS IDX7 AND NUT PER 4100 • •6diO1EH1{EU.dP PWE • • • of Game By Od D)f@(W OKLBSHWI JNH RIRACIIET • • MD'4 EurtiA)• TPCLITN BA0Wt 0/14/0 >a0.EI�1 1.8F-a1 69-26 TRACK MOUNTNG•OE ••A.T.S. ;• • OLS IL • • ••• • • SPECIFICATIONS AND NOTES 1.ALL THE LOAD FROM THE DOOR IS TRANSFERRED TO THE VERTICAL TRACK, FROM THE TRACK THE LOAD IS TRANSFERRED TO THE VERTICAL JAMBS. THE HORIZONTAL JAMB OR HEADER RECEIVES NO PORTION OF.THE LOAD TRANSFERRED FROM THE DOOR. 2.EACH VER4CAL JAMBS RECEIM MAXIMUM DESIGN LOADS OF: +388.4 LBS & -384.4 LBS/FT 3:DOOR AND HARDWARE WILL BE DES 044 MANUFACTURED AND INSTALLED WRH STANDARDS AS SET FORTH BY DASMA. 4.DOOR SECTIONS SHAH BE 24 OA.[02(8 AIN.EXTERIOR SKIN ROLLED FOAMED.W/BAKED ON POLYESTER NISH INTERIOR OF GARAGE USE(1)8 1/9 R TRUSS PER CONSIST (&(SECTIONS 020OASSTTRRUUTS AT BOTTOM SECTION MAX.VADTH 16'0° S.DOORS OVER(4)SECTIONS REFER TO TABLES 1 AND 2 ON PAGE 3 7.SVPPORTINO STRUCTURAL ELEMENTS SHALL BE DESIGNED o BY A RECISTRED PROFESSIONAL ENGINEER FOR MIND LOADS DESIGN LOADS DOCATED ON THIS DRAVANO DJ ADDITION TO OTHER LOADINGS. +380.4 LBS/FT SEE NOTE 2 $ THIS APPROVAL REQUIRES THE MANUFACTURER TO DO TESTING —394.4 LBS/FT OF ALL COILS USED TO FABRICATE DOOR PANELS UNDER THIS NOTICE OF ACCEPTANCE. A MINIMUM OF 2 SPECIMENS SHALL BE CUT FROM EACH COIL AND TENSILE TESTED ACCORWNC TO ASTM E-8 BY A DADE COUNTY APPROVED LAB SELECTED AND PAID BY THE MANUFACTURER. EVERY 3 MONTHS.4 TIMES A YEAR.THE MANUFACTURER SHALL MAI.TO THIS OFFICE: A COPY OF THE TEST REPORTS VATH CONFIRMATION THAT THE SPECIMENS WERE .PRCfDU�•BIS"upBVfs� SELECTED FROM COILS AT THE MANUFACTURER PRODUCTION r LldR PBOPift ranyf3BD FACIUTHS. AND A NOTARIZED STATEMENT FROM THE =ao,A•RRtfl-i/a MANUFACTURER THAT ONLY COILS WITH YIELD STRENGTH OF �� BoB�gaCTaAE CNOMWW DADE COUNTYUNDERUSER THIS NOTICEOFOF TACCEPTAa�PANELS FOR bflnif(1� 0 1 MY as"0FBIeSO15 18y WOOD TUBE M A1RM110aom04wlTLaa komm mAva¢sae 8 tmmvfmm I"AI CIC WA16•x3'LAG SCREW STARTIIiG 6•FRDX ENDS 32'O.C.Q1/2•ENSEOHENT) a ROIDSBIfTC@�101sf'.IDID RR HLT[WIK OLT W111 X 4• TING •FRTBI ETD13 24'O.C.12 I/2•ERBUMM MS sRE ++alalLlaaa �� HILT[SLEEVE ANCHM 3/9•X 2-3/4'STAItYW5 61 FROM ENDS THEN Ir DM:.O u4•ERSEOXENn ITW/RMISET REDHEAD CTRU-3101.n SW X 4•STARTDW 6'FRW ENDS TBG#22•DC.Q I/2'ENIK8UNn DESIGN LOADS PI v •*pENgir'F�i'� +aDa PSF m P, APART)AT.8'DO.O 3/2'EKSEDXENTf -tm Pa49.3 PSF a�Q••V •.2�* 9 HLTI 1/4'X 2-314'KMD(-CDN B4 SCREW STARnNG 6'FRmS1 ENDS,USE PAM 1 d 4 0048 (y r� FASTENERS C31 APARri AT B•DG O f/4'EHBDHENn E {? SLEEVE ANC)®R 3/B'%E-3/•STARTING 6• ENDS 14'OL' O I/4' . v DWOKENn OR,USE FASTENERS FOR HOLUTM C-46 BLOCK) d STATE OF LARGE U11MA . K.AGS AND BOLTS CAN K CD1B7T FLUSH NUUNIING SURFACE. DIPACT oa �'a•A�� I KPREPARATION OF TtODD JAMBS REsrsTA1K rO��Oss/O...... • .. . • • • •. TE LOM BLOCIL D g FL °a84 its, e SSS • • • • • • SiR11CTURE STRUCTURE RUC711� STRUCTURE 1 1' 4 � �MO=GDO DADTAG GA 3080,2000 2-3/4•NDI -1/2'NIN 4• ( gm 8 I OD,AK d80M (OAK BUMNrf PANW • ••• JAMB 3' BHOBT.LOR ]D18H,AND AVAILABLE Glut S • • • 04's • • SS am IN Ba DSR Wf17/f8 Rm • • • • .• • Bf OM 6T A¢ WE 0/14M IRC-9516-169-26 N.TS. . • • • • • • • • •• • •• • • • • s>arsaa ••• • • • • ••• • • • •• •• • • • •• •• ••• • • • ••• • • STRUT SPACING(BASED ON RECOMMENDED SECTION Lfr 4—ti: M.1A..._.m h, w '"" � -"i- G''..lQt3Y'.ti7r 1 �_ss ® ®® m m m® mom �1 - mF,s m 1 - �- 1 11 Vc�•J� -S?3CS3L7EL7L-7® �'"�s� M7IL21 21 d,He&4, ! 9Lumse KEA mv--WR12Ku urn=WMIMME b�PN mlMffTV,jlr,=—,I ' ��- ��,��'�.,�`-__ •,, �. 1��' �� o fl'®� �� m®mail\'� . > ...�./ 'M=OM`R I �R7...*-�E'T�7C'�mm[c:�lfk�s�� ---•�mLrU�L�T�'" r a -m mss KMI�� ©r [es� JIL r s� .••- TRACK ATrACHMENTW777 m Eru�� ro©mss p ,. � MRg W.----- .��, .. 1. a�2?kn'•.x:t..�9E±•"r�rt..:sa � . x..aum-��...,�.., ��tt .��'�` '� ��a �` �. K � � SDE'�1C�L�CT�"I�fT.�� 1 • �, EMU MEE ®��Qfia�Y-i�ii►�•.+�.�-�y� TJyZ`'I[� 1141 ��{� �.,�=•win? �■' aWORMaq'-t3�:$ -. ,..tib' •�`r`-�n. �Q_`�'_fII 6 ] ©IC#iFfiiOml [ !I•�[5i 11 7iY�ffi,i��'�' r arm, ©E ,1�IDC�T7fTi3 lf[�. i,� ♦ . . �r7��a..-�Y[X aCSfliiY.':]�[:S':.�7LYLri..�.a��f[:��,� k" , i' , i � tE xu di k" ai E t � E � � t £� E3 •R s�� I Miami Shores Village10050 N.E.2nd Avenue NEMiami Shores,FL 33138-0000 Phone: (305)795-2204 Expiration: 02401123/2016 . °; Project Address Parcel Number Applicant 1119 NE 104 Street 1122320290040 E THOMAS SEPTEMBRE Miami Shores, FL Block: Lot: Owner Informatlon Address Phone Cell E THOMAS SEPTEMBRE 1119 NE 104 ST MIAMI SHORES FL 33138-2657 Contractor(s) Phone Cell Phone Valuation: $ 1,206.00 ALLIED DOORS SOUTH FLORIDA INC (954)942-8550 Total Sq Feet: 112 Type of Work:REPLACE 1 EXISTING 16 X 7 01 H GARAG Available Inspections: No of Openings:1 Inspection Type: Additional Info: Final Classification:Residential Review Building Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# WS-8-15-56714 DBPR Fee $2.00 08/27/2015 Check#:3298 $76.20 $50.00 DCA Fee $2.00 Education Surcharge $0.40 08/14/2015 Check#:3279 $50.00 $0.00 Permit Fee $110.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $126.20 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction nd zoning. ut Le,I authorize the above-named contractor to do the work stated. August 27,2015 Au ized SI nature:Owner / Applicant / Contractor / Agent Date Building Department Copy August 27,2015 1