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WS-15-1362 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-246967 Permit Number: WS-6-15-1362 Scheduled Inspection Date: November 24,2015 Permit Type: Windows/Shutters Inspector: Rodriguez,Jorge In YP Inspection Type: Final p Owner: MURPHY, EDITH Work Classification: Garage Door Job Address: 161 NW 107 Street Miami Shores, FL 33168-4308 Phone Number (305)778-0029 Parcel Number 1121360100110 Project: <NONE> Contractor: HOME OWNER Building Department Comments REPLACE GARAGE DOOR Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-236144. 2X6 attachment not per NOA Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. November 23,2015 For Inspections please call: (305)762-4949 Page 11 of 25 0\0) Miami Shores Village I--, • r"N Building Department �IUN 052015/ 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 20 r 0 BUILDING Master Permit No.W61 PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: VJ 04 l�(W City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the uilding Historically Des' nated:Yes NO>< Occupancy Type: oad:"iil`,- 0— Construction Type: Flood Zone4 ror' BFE:"01C ZI FFE: OWNER: Name(Fee Simp Ti eholder): Y Phone#:30.3 . I •4 � qu Address: 16 I law rim City: State: Zip. I(p Tenant/Lessee Name: �vt n� Phone#: Email: CONTRACTOR:Company Name: Phone#: • , Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: i City: State: Zip: Value of Work for this Permit:$ [ 'cLSD -7 g Square/Linear Footage of Work: I Type of Work: ❑ Addition Alteration ElRepair/Replace El Demolition Description of Work: CTC SLS. .QJ f 5�11New'j 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$ TOTAL FEE NOW DUE$=1i& •L—+.J (Revised02/24/2014) i - Bonding Company's Name(if applicable) Bonding Company's Address _ City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for 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. , 1 u s. WARNIN TO ~OWNER. YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING-TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND 16'66VAIN FINAA'CING, tOASULT WITH YOUR LENDER OR AN ATTOkNEYG,9F0WE RECORDING YdQR NOTME Of COMMENCEMENT.',-', 4 4 t Notice to Applicant: As a condition to the issuance of a building permit with,an �t4maft?d value"exceedfhg L 12500,`th6' applicant must promise in gboii fbZh that a copy of the notice of commencement yd construction lien low 6rpFl}ure will b f}dq{ivgt 0 to the person whose property*s�ubjtct♦to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the firlst inspect' which occurs seven (7) days after the building permit is issued. -In A pbslpce of such posted notice, the inspection will not b �pproved and a rei etion fee will be charged. Signature Signature OWNER or AGE T CONTRACTOR The foregoing instrument was acknowle ged before me this The foregoing instrument was acknowledged before me this V4 20� by day of i l e< c. 20 1 rjby day of_ is personally who' p y known to 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: j'� S 4". g � L v ♦ Si n: c�. �d d„�i.E_.Zz.. Sign: Print: Print: ..PY>ret, ' ?2� o UAMMINU Seal: ;+r .•: MY COMMISSION#FFt64437 Seal: • :'a€ EXPIRES:September 30,2018 Bonded Thru Notary Publ c Undeiwriteta APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305)795.2204 Fax: (305) 756.8972 OWWR BUILDER DISCLOSURE STATEMEfNT NAME: C=L/ t ' "` . i��Jl� / DATE: fP• J 1 ADDRESS: � 0 Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,F.S 489.103(7).And I have read and understood the following disclosure statement,which entitles me to work as my own contractor;I further understand that I as the owner must appear in person to complete all applications. State law requires construction to,be done by a licensed contractor.You have applied for a permit under an exception to the law.The exemption allows you,as the owner of your property,to act as your own contractor even though you do not have a license.You must supervise the construction yourself.You may build or improve a one-family or two-family residence.You may also build or improve a commercial building at a cost of$25,000.00 or less(The new form states 75,000).The building must be for your own use and occupancy.It may not be built for sale or lease.If you sell or lease a building you have built yourself within one year after the construction is complete,the law will presume that you built for sale or lease,which is a violation of this exemption.You may not hire an unlicensed person as a contractor.It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances.Any person working on your building who is not licensed must work under your supervision and must be employed by you,which means that you must deduct F.I.C.A and with-holdings tax and provide workers'compensation for that employee,all as prescribed by law.Your construction must comply with all applicable laws,ordinances,buildings codes and zoning regulations. Please read and initial each paragraph. 1. 1 understand that state law requires construction to be done by a licensed contractor and have applied for an owner-builder permit under an exemption from the law:The exemption specifies that I,as the owner of the property listed,may act s my own contractor with certain restrictions even though.1 do not have a license. Initial 2. 1 understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial 3. 1 understand that,as an owner builder,I am the responsible party of record on a permit.I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name.I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits a d contracts. Initial 4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding.I may also build or improve a commercial building if the costs do not exceed$75,000.The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease.If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete,the law will presume that I built or substantially improved it for sale or le e,which violates the exemption. Initial 5. 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the construction Initial r 6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence.It is my responsibility to ensure that the persons whom I employ have the license required by lew an by county or municipal ordinance. Initial _ y 7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner-builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I,as an owner-builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property.My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner-builder and m aware of the limits of my insurance coverage for injuries to workers on my property. Initial 8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done.Any person working on my building who is not licensed must work under mfr direct supervision and must be employed by me,which means that 1 must comply with laws requiring the MAthbolding of federal income tax and social security contributions under the Federal Insurance ContribOtions Act(FICA)and must provide worvers compensation for the employee.I understand that my failure to follow these may subject to serious financial risk. " Initial 9. 1 agree that,as the party legally and financially responsible for this proposed Construction activity,I will abide by all applicable laws and requirement that govern owner-builders as well as employers.I also understand that the Construction must comply with all applicable laws,ordinances,building codes, and zoning regulatio . Initial 10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service,the United States Small Business Administration,and the Florida Department of Revenues.I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http://www.myfloridalicense.com/dbpr/pro/cilb/index.html Initial 11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: Initial 12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of t information that I have provided on this disclosure. Initial Licensed contractors are regulated by laws designed to protect the public.If you contract with a person who does not have a license,the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court.It is also important for you to understand that,if an unlicensed contractor or employee of an individual'or firm is injured while working on your property,you may be held liable for damages.If you obtain an owner-builder permit and wish to hire a licensed contractor,you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued,this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit.A copy of the property owner's driver license,the notarized signature of the property owner,or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this day of . 20 By who was personally known to me or who has Produce, there License(or, as identification. i f f l j` OWNE NOTARY ` ° _ '� ., .._ C 7iij ABOVE ALL GARAGE DOOR �s ( STIMATE ElINVOICE OF SOUTH FLORIDA SERVICEMAN l P.O. Box 9148, Ft. Lauderdale, FL 33310-9148 Tel: (305) 556-6633 - Fax: (305) 556-2609 INVOICE DATE U' C 24 HOUR EMERGENCY SERVICE wO i PO# www.aboveallgaragedoor_net / BILL T SHIP TO: AM LNE Salm-a- /`- 3 3 l CT 01 =1 , , , , 1111111 100185 << • • 1pg►� la-/2 TERMS OF PAYMENT: COD[:] NET 15 DAYS❑ NET 30 DAYS❑ NET 45 DAYS❑ SERVICES PROVIDED: RESIDEN L!_ ❑ COMMERCIAL SIZE OF DOOR ,eYZ CECTIO:NALDOO ROLLING DOOR OPERATOR DOCK LEVELERS ❑ REPAIR ❑REPLACE ❑ REPAIR ❑ REPLACE ❑ REPAIR ❑ REPLACE ❑ REPAIR ❑ REPLACE p SECTION ❑CURTAIN(SLATS) ❑ BELT Q RACK BAR ❑ HINGE ❑END LOCKS ❑ LOGIC BOARD ❑ TENSION SPRING ❑ ROLLER Q BOTTOM ANGLE ❑ LIMIT SWITCH ❑ HYDRAULIC ARM ❑ BOTTOM CABLE FIX Q BOTTOM RUBBER PROCKET ❑ CHAIN ❑CABLE ❑TRA RELAY ❑ SHOCK ABSORBANT ❑ LOCK ❑ST CAPACITOR ❑ HYDRAULIC HOSE ❑ NUTS&BOLTS ❑HE P T ,BE ❑TRANSFORMER ❑ CAPACITY ❑ BACK HANGS Q BA ❑CHAIN ❑ DOCK MODEL ❑TRACK VERT,HORZ. ❑SPRING ❑TRAVELER [] DOCK SIZE W H L ❑TRACK BRACKET Q SHAFT ❑ SNAFT ❑ DOCK PLATE BEARING PLATE ❑CONES ❑ MOTOR ❑ DOCK SEAL ❑SHAFT ❑NUTS&BOLTS ❑ LUBE&ADJUST Q DOCK BUMPER ❑SPRINGS,CONES ❑ANCHORS Q KEY SWITCH ❑ DOCK LIP ❑ BOTTOM RUBBER Q WINDLOCK Q SAFETY EDGE Q ANCHORS ❑ BALANCE,LUBE ❑BALANCE,LUBE ❑PHOTO EYE Q.MOTOR PUMP &ADJUST &ADJUST f��+ Q TIME D LAY OTHER COMMENTS: /4/�J� / ) L b(//A © � G� TOTAL S� []CASH ❑CHECK# ❑CREDIT CARD EXP. ZIP CODE ❑ MC ❑VS ❑ AMEX It. PRINT NAME TITLE SItATURTOTALAMOUNT SHOWN IS SUBJECT TO LATE CHARGE AND FINANCE CHARGE(SEE REVERSE SIDE FOR EXP ION OF CE CHAR ES) SERVICES AND/OR PARTS PROVIDED SUBJECT TO THE CONDITIONS NOTED ON BACK OF THIS DOCUMENT.3%PROCESSINGILLAP LY TO CREDIT CARD TRANSACTIONS.NO REFUNDS,ALL SALES ARE FINAL-30 DAYS WARRANTY ON LABOR FROM DATE OF SERVICE. WE/1 CONFIRM THAT THE INVOICED GOODS/SERVICES REFERENCED ABOVE HAVE BEEN RECEIVED IN FULL SATISFACTORILY,THAT THE UNDERSIGNED HAS THE AUTHORITY TO MAKE THIS STATEMENT ON BEHALF OF U S FOOD SERVICE AND THE TOTALAMOUNT DUE AS SHOWN ON THE INVOICE WILL BE PAID BY U S FOOD SERVICE ACCORDING TO TERMS TO BANKATLANTIC BUSINESS CAPITAL,LLC. ALL PAYMENTS FOR ABOVE ALL GARAGE DOORS OF S.FL,INC.MUST BE MADE PAYABLE TO AND REMITTED TO:BANK ATLANTIC BUSINESS CAPITAL,LLC. P.O.BOX 9148,FT.LAUDERDALE,FL 33310-9148. "THE LEADER IN HIGH PERFORMANCE AND RELIABILITY" e f M N 1.1 AN i€wt € i's:: .....€ua r.€E'€,€p 3Ylule ev Abavp li Garage,Dooro South Florida,€€io-.:_f A o,vs Afl ,upion Accounts nts€t:m ,ni#ng unpaid for i"riore ihan the €.ze;-Kiel T#n:f`aiio5,.,6'.`; £:re"€w bj.:..a'o the e'3sY.es s€:!` it.€t an Aterest nate ..€_,,.at ga :3n any unpaid tF2Z€a€lt.i:tr i"3? €::.€g€`te'erf P£i?,:ent F1i:E'L,3 prFi`year (1.5ipi. # £ ^:h). No interest chr "o{€ o F #to fee. ...-N,-D be paid i?":or," Inl on all invo,,ce%.�3w `{•3fl£. 't a Past d'ue>3:"•3+:'mcc—•:. 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EVEL-RE.Q.0VERY FEE Due w ow€E?w'E sed co t of s#ME i"Aoovo,AN .i.. v`£{i the €€ '};to wi .*iess a fuel r :;3b a ' to the t,},} ,3= . ga E>'€i e..,2ied to"'ual Its fiee[.of cor":;ri,'vmcia:ve i..>es'£ "%"'€T t #,t.tM :yes to:i}y €: l:,o E.A t.!'.a€'€ ei r t?.v.�::,1 f 0, ` i"he RESTOCKING FEE AND CANCELLATIONS k z.,...xiE:.,fir:.i€I,i€,`.r3v.:.iCn ght to cancel a p(',,nd€'3„J.,',`e . '':oweve.',Above Ali ou`:iH'ag.-,.%-,,e to ....3':3i.. prE'dd d E.:>S;3 rier agrees to r}n\,= ,..t all dammqs 9 dam},: node W rtbi:ae All on ofdor ano -" . °:}r xbo; ,, Ali o a I5rr. r€..*alook€€q fee to{;€ d^i;€1 3 t.:os(s E)` labor and t" i',fi€},E:.}>:?.t.,.€°'c,,d M €et£.#r"€vi'i'i E'€'i, „}i:sit:.•' ,, ,ar#i ^^��3Y<::sfE'e�aSf I _��`E WAR._....._:Ni T' Ahh 'e 4{I£' ,i;-':')] tE3 L"LtG$f3#'€e{:•E``ly a thirty(0)day+,'4?!3'E?'oy an se vke.There are description or.the face€ erE;�.C.;UST Otvl[E.R WANES ES APvY AND A€..i.,i`1 UE:T.';iPk°4RRAN'T i i:.`. SPEC!F CALLY i W'',LU DING ANY SND) ALL €P EE,13 :NARRANT IES OF M: Ci--iANTAB>t..€T'`•'' AN €MP1.' :t.3 k,"VARRANT E OF f i'N,..'SS €OR A CUSTOMER CARE DEPARTMENT ... ........................................................ f i:N, have any Eii"it€s ions or._:,;Fi'.:mes...... regarding to €t.€c.E€.y of rev vice yyE`£€..£_,,":4ed frLw i Sat e Ailz,:::i€i:1 , ..i._.e.:#'ti; Ronda,inn.a €dlorr'.;ac3' e AH Garage Door f Fen N t Tom, .,,i: ,. rf €i}t. p .r.se=Aad ,i3`v'`€€, <and..:F)h :}'spe,z:,€£to ,i_a : .t €:=€47 e nai.your€£>i;€#.€:sit - ' , , PHONE: -`ial 30`5-556-6633 Fax 30, Monday through.Friday StO AM to 510 PN1 M.Alt..: Above Ail Garage Door of oLAh Florida, Inc, 8900 NW i 1 meth pit€':het r 18 Please include your tali nwiie, Company name and "o3t3ove, Ali': nurnber or LD, €rEi.ud: g address and€ ate of service and/or installafiwi wiOt €ny correspoi'actenc e, F;. MIAMI•D.ADE C-F �",LPRODU"T CONTiZC�LSECnON 11805 SW 26 Strect,Room 20$ DEPARTMENT OF REGULATORY AND ECONOMi3 RESFlorida 33175-2474 BOARD AND CODE ADl1IMSTRATION DIVISION T(786)315-2590 F(786)315-2599 NOTICE OF ACCEPTANCE (TOA) �.y.miamidade_gov/ecmiomy Clopay Building-Products Company 8585 Duke Boulevard Mason,OH 45040 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has beenleviewed and accepted by liviiami--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 atter the expiration date stated below.The Miami-Dade County Product Control Section(1n Miami Dade County)and/or the AHJ(in areas other than i4liami 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 niay 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. -=s_ TiESCR%I TIv ;: r�tgl ai._ �7 tee3 Pan eetional Ga age T�3oar–u� to 4'0"—W--fdrev! Optional Impact Resistant Liter(DP +42.0,-48.0 PSF) APPROVAL DOCUMENT: Drawing No. 101702,titled"Single Car W7 Pan Door with Impact Resistant Liter',sheet 1 of 1,dated 06/1.3/2008,with revision 5 dated 01/06/2412,prepared by Clopay Building Products Company,signed and sealed by Scott Hamilton,P.E.,bearing the Miami-Dade County Product Control renewal stamp with the Notice of Acceptance number and expiration date by the T a. i-Dade County Product Control Section. MISSILE IMPACT RATING:Large and Small Hssile Impact Resistant LABELING:A permanent label with the manufaoturer's name or logo, 1400 West Market Street,Troy, OH 45373, model number,the positive and negative design pressure rating,indicate impact rated if applicable,installation instruction drawing reference number,approval number(NOA),the applicable test standards,and the statement reading `Miami-Dade County Product Control Approved'is to be located on the door's side track,bottoin angle,or inner surface of a panel. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TRWMATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials,use,and/or manufacture of the product or process.Misuse of this NOA as awendorsement 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 tl:e 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 Buildifug Official. This NOA renews NOA#12-0125.09 and consists of this page i and evidence pages E-1 and E-2,as well as approval document-mentioned above. The submitted documentation was reviewed by Carlos M.Utrera,P.E. NOA No 13-0625,06 rtiaMuo�wa coot+-it Expiration Date: August 21,2018 Approval Date: August 15,2013 PIA4 �C1J 7 Page 1 . Clopay Building Products Company NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS L Drawing No. 101702, titled"Single Car W7 Pan Door with Impact Resistant Lites", sheet 1 of 1,dated 06/13/2008,with revision.5 dated 01/06/2012,prepared by Clopay Building Products Company,signed and sealed by Scott Hamilton,P.E. B. TESTS "Subinitted under NOA#08-0618.03" 1. Test reports on 1)Uniform Static Air Pressure Test,Loading per FBC TAS 202-94 2)Large Missile Impact Test per FBC,TAS 201-94 3)Cyclic Wind Pressure Loading per FBC,TAS 203-94 4)Forced Entry Test,per FBC 24113.2.1,TAS 202-94 5)Tensile Test per ASTM E8 Along with marked-up drawings and installation diagram of 9'x 8',24ga steel garage door Model 94W7 with windows,prepared by American Test Lab,Inc.,Test Report No.ATLNC 0305.01-08, dated 05128/2008, signed and sealed by David W. Johnson, 2. Test report on Salt Spray per ASTM B 117 of painted G40 galvanized coated panels, prepared by Stork Materials Technology,Test Report-No.30160-04-63365, dated 01126/2005,signed by John D.Lee,P.E. C. CALCULATIONS "Submitted under NOA#08-0618.03" 1. Jamb anchor calculations,prepared by Clopay Building Products Company, dated 06/13/2008,signed and sealed by Scott Hamilton,P.E. D. QUALITY-ASSURANCE 1. Miami-Dade Department of Regulatory and Economic Resources(RER) 0 J<VJ3 Carlos M.Utrera,P.E. Product Control Exantiner NOA No 13-0625.06 Expiration Date: August 21,2018 Approval Date: August 15,2013 E-1 ClopayBuildiuk Products Company NOTICE OF ACCEPTANCE; EVIDENCE SUBMITTED E. MATERIAL CERTIFICATIONS 1.. Test report on Accelerated Weathering Using Xenon Are Light Apparatusper ASTM G155 of Lexan SLX2432T Clear Polycarbonate,prepared by Hurricane Engineering &Testing,Inc.,Test Report No. HETI-06-A002, dated 12/04/2006,signed by Rafael E.Droz-Sella,P.E. 2. Test xepor-t on Tensile Test per ASTM D63 8-96 of Lexan SLX2432T Clear Polycarbonate,prepared by Huirdcane Engineering&Testing,Inc., Test Repoi-t No. HE TI-06-T566,dated 12/04f2006,signed by Rafael E.Droz-Seda,P.E. 3. Test report on Tensile Test per ASTM D638-96 of Lexan SLX2432T Clear Polycarbonate,prepared by HinTicane Engineering&Testing, Inc.,Test Report No. HETI-06-T634, dated 12/04/2006,signed by Rafael E.Droz-Seda,P.E. 4. Test report on Self-Ignition Temperature per ASTM D1929, Rate of$urn per ASTM D635, and Smoke Density per ASTM D2843 of the Lexan Plastic,prepared by ETC Laboratories,Test Report No.ETC-06-1024-17496.0,dated 05/26/2006,signed by Joseph L. Doldan,P.E. T'. STATEMENTS 1. Statement letter of code conformance to 2010 FBC, dated 06/13/2013,signed apd sealed by Scott Hamilton,P.E. 2. Statement letter of no financial interest issued by Clopay Building Products Company, dated 06/1312013,signed and sealed by Scott Hamilton,P.E. Carlos M.Utrera,P.E. Product Control Examiner NORM 13-0625.06 Expiration Date. 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WIT)i IMPACT RESISTANT UT£S THE OCOV4ICNCNT5 OF THS 2002 7'to OAU.STELI ROTAER 1-3/I4'ai/TaS1' BUIldin Aro uctS 0365(JUKE BLVD. :� AHO 2610 COC. "14 STCCL OR KATON 1*11 ) MA$0N.OHIO 4$040 J 4TT+C NAW MAIOCR. VCR, Company i ,,, 77e_4SH7 :'N B 101702 Mo a \ \ \ Q\ \y 6 \ do Miami Shores Village \ `• 7�' � E �1Lt� 10050 N.E.2nd Avenue NW ourm, 0n:f'aara \ �: Miami Shores,FL 33138-0000 \ t\ t�t� �x�arcii�A4 Phone: (305)795-2204 � \� �AR", K .,:� 21" y�\ YR ' Itel�att /lit Expiration: 12112/2015 Project Address Parcel Number Applicant 161 NW 107 Street 1121360100110 Miami Shores, FL 33168-4308 Block: Lot: EDITH MURPHY Owner Information Address Phone Cell EDITH MURPHY 161 NW 107 Street (305)778-0029 MIAMI SHORES FL 33168- 161 NW 107 Street MIAMI SHORES FL 33168- Contractor(s) Phone Cell Phone $ 1,200.00 HOME OWNER Valuation: Total Scl Feet: 0 Type of Work:REPLACE GARAGE DOOR 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-6-15-55842 DBPR Fee $2.00 06/05/2015 Credit Card $50.00 DCA Fee $2.00 $76.20 !i Education Surcharge $0.40 06/15/2015 Credit Card $ 76.20 $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 ELECT AL,PLUMBING,MECHANICAL,WINDOWS,DOORS, ROOFING and SWIMMING POOL work. ,° OWNERS AFFIDA IT: c ify t t all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an zo n F 'her , I authorize the above-named contractor to do the work stated. June 15, 2015 Authors Signature:0 ner / Applicant / Contractor / Agent Date Building Depart nt Copy June 15,2015 1