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EL-14-787 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-234522 Permit Number: EL-4-14-787 Scheduled Inspection Date: June 12,2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: RODRIGUEZ, ROGER Work Classification: Alteration Job Address:9425 NW 2 Court Miami Shores, FL Phone Number Parcel Number 1131010150340 Project: <NONE> Contractor: LIGHTGATE INC Phone: 305-554-4820 Building Department Comments REPLACE OUTLETS, SURFACE LAMPS &SMOKE Infractio Passed comments DETECTORS. INTERIOR REMODELING INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-233471. CREATED AS DT REINSPECTION FOR INSP-231471. CREATED AS REINSPECTION FOR INSP-2 31454. 04/02/2015 Cancelled by Julio Rocha Failed ❑ Cancelled by Rocio 12 may 2015 F P L notified to connect service. Correction ❑ - �� Needed Re-Inspection ❑ �� ,��`` ,� Fee No Additional Inspections can be scheduled until re-inspection fee is paid. June 11,2015 For Inspections please call: (305)762-4949 Page 9 of 26 �. Miami Shores VillageC IVE Building Department ASR i B 2014 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: Tel: (305)795.2204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit No:.T"' L I — PERMIT APPLICATION Master Permit No. PSC', Permit Type: Electrical JOB ADDRESS: -S 13 QL City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: I k'73(0 ( Is the Building Historically Designated:Yes NO X Flood Zone: OWNER:Name(Fee Simple Titleholder): E4-f e &avw Phone#: =5f f&r-09 0; Address: CA.9 6(9>-- City: State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Phone#: Address: Aa l so 101 �►'�' 10 City: 1 a N ( State: z- Zip: -I + Qualifier Name: GI+/I Gtl AAI Phone#: State Certification or Registration#: C l 1®d S V 2 0 Certificate of Competency#: Contact Phone#: Email Address: "DESIGNER-- teef/Etihe� 06 r4VP-,& A-9 L9 Phone#: µ Value of Work for this Permii,$' 01 Square/Linear Footage of Work: ylte-of eke _ ddr �s_ $ .. .! Alteration 33Qe ❑Repair/Replace ❑Demolition Description of Work: 'i- Ps. ietiec 40&2 Submittal Fee$ Permit Fee$ A7% CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ 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 ELECTRICAL WORK,PLUMBING, SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and AIR CONDITIONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature '/ �' Signature 9123 er sc a t�,. ern us Owner or Agent Contra or The foregoing instrument was acknowledged before me this fJ— The foregoing instrument was acknowledged before me this r l day of C ,20�,by e(JJ9►C Jj Q N Of LO day of Y�P+Z ,20 ,by ✓I �" C� who is��As o me or who has produced who is personally known to me or who has produced identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY CONSTANTINO ARIAS Jr. e`.; Notary Public-State of Florida a• •?My Comm.Expires Mar 14,2016 Signrooa , sr Commission#EE 172560 ••„ ,•``• BotuNd Through National Wary Print: ”"' ' Print: M Commission Ex ;•� RO My t e Of Florica V My Commission Expires: My Comm.Expires Oct 24.201 i •.,,els&$ • Commission N FF 066091 APPROVED BY f Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009XRevised 3/15/09) :Fortun Insurance To:LIGHTGRTE, INC, 0185FL00004127 (13057568972) 09:23 04/16/14 EST P9 3-3 Ac©® CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DDNYYY) 41-� 4/16/2014 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 pollcy(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 NA T Mercy Campuzano Fortun Insurance, Inc. PHONE (305)445-3535 FAX (866)415-0825 365 Palermo Ave. ADOILSS:mercy.campuzano@fortuninsurance.com INSURERS AFFORDING COVERAGE NAIC 0 Coral Gables FL 33134-6607 INSURERA:Granada Insurance Co INSURED _INSURERB:Technology Ins Co LIGHTGATE, INC INSURER C: 1421 SW 107Th AVENUE INSURER D: SUITE 101 INSURER E: MIAMI FL 33174 INSURER F: COVERAGES CERTIFICATE NUMBER-CL12102204381 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. INSR S POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDNYYYV IMMIDDNYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 50,000 A CLAIMS MADE OCCUR 0185FL00004127 0/20/201310/20/2014 MEDEXP(Any one persan) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GFIJERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 X I POUCY PRO- 1ECT F-1 LOC AUTOMOBILE LIABILITY M I I LI Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS AUTOS PROPERTY—DAMAGE (Peraccident) $ $ UMBRELLA LIAROCCUR EACH OCCURRENCE $ EXCESS LWB HCLAIMS-MADE AGGREGATE $ DED RETENTION S $ B WORKERS COMPENSATION WC STATU- OTH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTNE Y!N OFRCER/MEMBEJR EXCLUDED? NIA EL.EACH ACCIDENT $ 500,000 (Mandatory In NH) TWC3350950 /23/2013 /23/2014 E.L.DISEASE-EA EMPLOYEE $ 500,000 if yyes descrbe under DESGrRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more apace is required) Electrical Contractor#EC13003130 CERTIFICATE HOLDER CANCELLATION (305)756-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shore Village Bldg Dept ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Hector Forton/IZ ACORD 25(2010105) O 1888-2010 ACORD CORPORATION. All rights reserved. INS02.5 n1 Thea Arnpn name%anA I nn ars+rnni-ararf marks of arnRn APR— —2014 06 :38 AM LIGHTGATE. INC. 3855592183 P. 02 a • aottaz Local Business Tax Receipt Miami—bade County, State of Florida -T14I8 IS NOT ABILL-DO NOT PAY LBT 3761369 RUYINEGG NAM!/LOCA MON A110191P r NO. EXPIRES LIGHTGATE INC RENEWAL SEPTEMBER $0, 2014 7472 NW 8 ST $9261962 Must be displayed at place of business MIAMI FL 33126 Pursuant to County Code Chapter SA-AR.9&10 OWMR BEC.TYPE or RUSIN®Ss PAYMfiNT RtiC61V911 LIGHTGATE INC 196 ELECTRICAL CONTRACTOR sy TAX COLUCTOR Worker(s) 3 EC13003130 $75.00 08/20/2013 UHS1-13-447171 This Local HuslunTax Receipt only confirms palnaent of the Local Business rax,The Reasipptt I$not a license, parmiL or a caa fieatlon of the holder's qualifimmons,to de business.Hower mm comply with any govemmemal or naupovemmemei rep latory Iowa end requiremems which apply to the business. The RECEIPT N0,above must be displayed an all commercial vehicles-Miaml-4Deds Code Svc fie-27t For more iudarmatlon,visit f .,;sra►r o*:l�filemi*`_~�. :AC#'•rm 2 0 6 D a 6 ?' bERl t'T OF';::$*SZNRSS AND ! P.TiSO *_1GL�r�ATION l ` PIC 13dQ 13 y 07*/17/12 120030205 i C1I�RT' L? E i` ELECTRICAL CONTRACTOR E TJS,:?,•F`�ANCISGO11MNE LICiH'LaATL 7:NC ,'ZS 'C$� 8z`SD caner the provisions of M,489 Fz. :, s�iYuttisa dxEii A17i3 3Z. 2014 L12071703.597 ! d Miami Shores Village Building Department won 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 I� Tel: (305)795.2204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER: (305)762.4949 Vl� FBC 20 BUILDING Permit No. PERMIT APP Master Permit N 71 Permit Typ BUIL ROOFING JOB ADDRESS: q 7_-L-r o u :2 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: ,--:5 t ® t © ( Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): c—�L(+er 40AA.� Phone#: Address �II to 0->- City: 1 Le7A 4 State: Zip: 353f)!(6 Tenant/Lessee Name: � Phone# Email: JL0,I'P; &_-�E &L •dVYA/L CONTRACTOR: Company Name: Ql!�' 4 t)i7W A Phone#: 3 cs ; y Address: S G r City: State• Zip: fj� z Qualifier Name: ® / Phone#: State Certification or Registration#: 7 6 L Certificate of Competency#: Contact Phoneft f Email Address: �� G b v J �i o DESIGNER: Architect/E gineer: � •� 1 69 �e9L4S Phone#: 95q' 0� `7 Value of Work for this Permit: r Footage of Type of Work: ❑Addition -dAlterarion iRepair/Replace ODemolition Fc , 'D of Work: tea' e- CO/A.9 C0 S Color thru tile: Submittal Fee$V Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ t� Bonding Company's Name(if applicable) ' 6 , Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING, SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and AIR CONDITIONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of 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 such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature A-(,4z Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this CThe forego* ins ent was acknow edged before m this day of ,20_,by 1001 Q 14 Of day of ,20l ,by(,/, who is sonally kno to me or who has produced who is ersonal 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: NOTARY PUBLIC: 04u Sign: 0 " ° ''• Sign: s o• Print: Notary , to of Flafda Print: �'�� 1 . r 0024 My Commission Expires: „` 7881 My Commissi n Exp + APPROVED BY Plans Examiner Zoning ` I( 1 I Structural Review Clerk (Revised 5/2/2012)(Revised 3/12/2012))(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) Report Viewer Page 1 of 1 FE Image JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION CERTIFICATE OF ELECTION TO 13E EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the indMdual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 215=14 EXPIRATION DATE: 2/5/2016 PERSON: RUDGE REMON FEIN: 651025183 BUSINESS NAME AND ADDRESS: RUDGE WOOD FLOORING INC 2334 NW 78 ST MIAMI FL 33147 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL CONTRACTOR Pursuant to Chapter 440.06(14),F.6.,an officer of a corpombcn who elects exemption from this chapter by Rarg a cortitkate of election under thus section may :at recover benefits or ConlpeMatiOn urroer thi1chapter.Pursuant to Chapter 440.08(12),F.3.,Certificates of election to be exempt..,apply only within the scope of Vre bueinee6 W iratle kstetl on the riotiCe of elechan to be exempt Pursuant to Chapter 4411.x(13}},,F.S..Notices of election to De exert ar:d cer6gcates at election to be exempt shell be subject to ravaeatbn g,of arty tirtre attar MB bip:®®of Ne notice orthe lasuance ofthe cerdMate.the person nemetl on the notice or certificate no longer meets me requlrehmnffi oftltle section for Bsuance of a oertifkete.The department shell revoke a cemfiW at any time fpr failum of the pereon monad on the certificate to meat the requirements of thio section. DFS-F2-OVVC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07.12 QUESTIONS?(850)413-1600 https://apps8.fldfs.com/crreportviewer/reportViewer.aspx?data.=kd..: 2/6/2014 12/24/2009 16:28 3056960254 RUDCO PAGE 01/01 • 'Retort Viewer Wage of !t a image JEFF ATWATER STATE OF FLORIDA cHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DNIMON OF WORKERS'COMPENSATION •*CERTIFkATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW* CONSTRUCTION INDUSTRY EXEMP710N This certifies that the individual listed below has eleaksd to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 2/5/2014 EXPIRATION DATE: 21"016 PERSON: RUDGE REMON FOR: 851025163 BUSINESS NAME AND ADDRESS: RUDGE WOOD FLOORING INC 2334 NW 78 ST MIAMI FL 33147 SCOPES OF BUSINESS OR TRADE; LICENSED GENERAL CONTRACTOR Fansµsm h 00.XOnACIvpM 440.06(10).�,9..en oaa.rd■coryoro0on wta ekcoa ar■■+v�n from rhb ohopaar by®ngg■a,GGmt¢of NeAbn onoerenti aaoVon may IIW n000wN DenOna<ormmpar oil WWW tl+bCh■atOn•Our■vaotb CIro090r440.OS172i R.GCu4M�Wo Of ebotbnbW■xonpL..00DNMIV MMIntM.eopa 011M�(Mn albatle IbIN 1nUwe ip(laa M.I■NMI W b s■mnyt�WOVar4 W C71■pOn R40.o�t13.c 6..N0401a lM iMMIO+n b los e[W/pt all0 Od1000hH?r abUbn l0 ■a■ali Da auEloatto rOw00e1�+e,■!my tiMe agar Na folnpp as be n■ac.orfla�anoo H the rotlam�.th*baraon name0 a+Me no■eo W Oaltlfl WU rp�9N m■m}h■nmWramana NMIa Qe4tlOn av d■uoa0 O1G OOrO11G0f0.The tlsp■ran.,■■aaN Nvoke a Oe41ai0i0a■t ory ioY�M1 T0NW00l0+0 a.e.rn n.raao on We oertlGeea N m..++h.hyuoam4Mo ot7+k eeoaen. DF6-F2•0WC-252 CERTIFICATE OF ELEGTION TO BE IXEMPr REv18ED 07-12 QUESTION57(030y413-16ft https://apps8.fldfs.com/Ctreportviewer/reportViewer.aspx?data--kd... 2/6/2014 r a o c#t--v x v-e r og G, Cir®4. f��r t /� x : 36 S'• s'd°r ! 1F. &P6'3 tr C ,cit RUILDINO DEPARTMENT QUESTIONNAIRE (if you have performed work in multiple jurisdictions, make additional copies of this form and have it completed by at least two [2] building departments.) TO: Building Official- This is a mandatory form needed foufludir ga&fta,Na earq Blease heli tip mwiv by ftlka out the,f+fra►lawriw Questionnac .'f*" The following individual is currently on probation with the Florida Construction Industry Licensing Board (CILB). Please complete this form and sign, if you have any questions or concerns, please contact David Spingler with the CILB at 850.717.1405 or via email at david.sninglerO-)myfloridalicense.com. This form once completed may be emailed or faxed to my attention at 850.617.4457. Thank you for your assistance. PTT. SUBJECT: REMON RUDGE,Hearing Date:January 15, 2015 C License#(s): CGC1506495 NOV 2 4 2014 On behalf of the building department,the following answers are supplied. BY: 1. Has the above named contractor pulled any permits or called for any inspections in your jurisdiction during the last six months? If your answer is "no", you do not need to answer questions 2 through 6, unless applicable=YES NO 2. Has any of the contractor's work been issued a stop work order in the last six months? If yes, please provide supporting documentation. YES 3. Has the contractor failed to obtain permits on time? If yes, please state amount and any fines that may have been imposed. YES NO 4. Has any local discipline been started or completed against thi ntractor in the last six months? YES 5. Have there been any serious code violations by the contractor in the last six months? If so, please explain. YES O 6. In general, do you have any adverse comments concerning this contractor's performance during the last six months? If so, please provide brief details and atr�NO�nal sheets, as necessary. YES TO BE COMPL BUILDING OFFICIAL PROVIDING ABOVE ANSWERS: Building Official's Signature Date-- Printed Name: Jaaa jz License* ?c/ 1666 Job Title: /",:2 Phone#: &s-' 22p`7 Name of Building Department: µi �vZ�✓ LZ �o 1 Miami Shores Village rjFT , Building Department 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 I (� LD I N G Master Permit No.�� `� ` 1 2L PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP NTRACTOR DRAWINGS JOB ADDRESS: ��.1 UCJ City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: I Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholde Address 'L _C City: 4WState: Zi Tenant/Le ee Name: Phone#: Email- ONTRACTOR:C pany Name:21Vf '4 Phone#: ® �7 ddr / City: State: Zi Qualifier Name: � �— one#: tate Certification or Registration#: CCA fete of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New �, Repair/Replace ❑ Demolition Description of Work: � j �� 4a, Specify color of color thru tile: Submittal Fee$ Permit Fee$ —4S ' (J�3 CCF$ CO/CC$ Scanning Fee$ v Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ U . (Revised02/24/2014) 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. "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 bsence of such sted notice, the inspection will not be approved and a reinspection fee will be charged. Signature IL Signature OWNER or AGENT CONTRACT The foregoing instrument was acknowledged before me this The orego' g ins t was acknowledged before me this 2`1 r 1 day of Id/� c 6' ® A ,20 J by day of G 20_Z41 , by who is ersonally know to a o ti who is personally known to me or who has produced as me or who has produced 0 as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: 0 Sign: .n Print: 00 Irl �Dl aWa Print: j' y„�COAI�ISSION#FF005968 M Seal: Seal: ''�.'�o"� .••`°WWWAARONNOURYAM h •• CSttierine Lorean Mondes Canmialm 0 FF 160487 a *** **** ***.** ** ******* ***** * ** ****** *** ******* *** *** ** ••......,.•• 1 eT FLomDA No Tr Q APPROVED BY e �'/� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) F la Building Code Online •� Page 1 of 2 '` I BCIS Home Log In User Registrations Hot Topics Submit Surcharge Stats&Facts Publications FBC Staff I BCIS Site Map Links ! Search Business . Professional U ER: uccUApproval I� �11t�11 Pro0uri Ai;j, j>Product or Auui¢aUon >gguhca¢ioo +.>Application Detail FL# FL15558 Application Type New Code Version 2010 Application Status Approved *Approved by DBPR.Approvals by DBPR shall be reviewed and ratified by the POC and/or the Commission if necessary. Comments Archived Product Manufacturer JELD-WEN Address/Phone/Email 3737 Lakeport Blvd Klamath Falls,OR 97601 (541) 205-1171 garyr@jeld-wen.com Authorized Signature Gary Rollinson fbc@jeld-wen.com Technical Representative Steve Saffell Address/Phone/Email 3737 Lakeport Blvd Klamath Falls,OR 97601 (541)882-3451 Ext 2900 stevesa@jeld-wen.com Quality Assurance Representative Address/Phone/Email Category Exterior Doors Subcategory Swinging Exterior Door Assemblies Compliance Method Certification Mark or Listing Certification Agency National Accreditation&Management Institute Validated By National Accreditation&Management Institute, Referenced Standard and Year(of Standard) Standard Year TAS 201 1994 TAS 202 1994 TAS 203 1994 Equivalence of Product Standards Certified By httP://www.floridabuildinL.Org/nr/nr ann rirl a�,,.,�,,.,, is Building Code Online Page 2 of 2 Product Approval Method Method 1 Option A Date Submitted 05/01/2012 Date Validated 05/01/2012 Date Pending FBC Approval Date Approved 05/06/2012 ---_ ----- Summary of Products FL# 11114odel,Number or Name IDescription 15558.1 Energy Saver/Contour Opaque Wood Edge Steel Outswing Door w/or w/o 11 Sidelites I Limits of Use Certification Agency Certificate Approved for use in HVHZ:Yes F' I.;',5P, R.0 C CAC 111011082.OdF Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Date Impact Resistant:Yes 08/31/2015 Design Pressure: N/A Installation Instructions Other: Refer to Installation Instructions S-2104 for 5-;V), SS.Odf sizes,configurations,design pressure ratings,and Verified By: Hermes F. Norero,P.E. Florida P.E. 73778 Installation details. Created by Independent Third Party:Yes Evaluation Reports 1_55L`- RO AE PER2035 SS.Odf Created by Independent Third Party:Yes Contact Us::1940 North Monroe Street,Tallahassee FL 32399 Phone:850-487-1824 The State of Florida is an AA/EEO employer.Copyright 2007-2013 State of Florida.::Privacy Statement::Accessibility Statement::Refund statement Under Florida law,email addresses are public records.If you do not want your a-mall address released In response to a public-records request,do not send electronic mall to this entity.Instead,contact the office by phone or by traditional mall.If you have any questions,please contact 850.487.1395. *Pursuant to Section 455.275(1),Florida Statutes,effective October 1,2012,licensees licensed under Chapter 455,F.S.must provide the Department with an email address If they have one.The emails provided may be used for official communication with the licensee.However email addresses are public record.If you do not wish to supply a personal address,please provide the Department with an email address which can be made available to the public. To determine If you are a licensee under Chapter 455,F.S.,please click ere. Product Approval Accepts: RED ROOM ECeEct M SlY'tYrlt�'S!�..�•.'i . MM� a..A.- http://Www.floridabuilding.ora/nr/nr nnn 'if] NOTICE OF PRODUCT CERTIFICATION . It Company: ,XELD-WEN ,Exterior Doors Certification No.: NI.OI1.082 3737.Lakeport Boulevard Certification Date: 05/OJ/2012 ► Klamatb ,Falls,OR 97601 Expiration Date: 08/311201.5 �1 Product: "Energy Saver/Contour" Opaque Wood-Edge Steel Door w/or w/o Sidelites (wood frame) Specifications Tested To: TAS 20.1/202f203-94 The"Notice of Product Certification" is only valid if the NAMI Certification Label has been applied to the product as described within this document. The certification label represents product conformity to the applicable specification and that all certification criteria has been satisfied. This product has been approved for listing within NAMI's Certified Product Listing at www.Nam icertifteation.com. NAMI's Certification Program is accredited by The American National Standards Institute(ANSI). Inswing Glazed Design Nater Missile Test Report Number Configuration or or Maximum Pressure Test Impact & Outswing Opaque Size Pos/Veg Pressure Rated Comments (psf) X O/S Opaque 312"x 6'10" +66/-70 10.0 psf Yes CTLA-696W Single Max Panel Size: 3'0"x 6'8" Installation Details: S-2104 1-3) OX/XO O/S Door-Opaque 4'5" x 610" +66/-70 10.0 psf Door-Yes CTLA-696W Single w/Sidelite Sidelite-Glazed Sidelite-No Max Panel Size: 3'0"x 618" Sidelite DLO:6"x 513"(1/8"Tempered Glass) _ Installation Details: S-2104 1-8 OXO O/S Door-Opaque 5110"x 6110" +66/-70 10.0 psf Door-Yes CTLA-696W Single w/Sidelites Sidel it es-G lazed Sidelites-No Max Panel Size: 3'0"x 618" Sidelite DLO:6"15'3"(1/8"Tempered Glass) Installation Details: S-2104(1-8) XX OIS Doors-Opaque 6'3"x 6'10" +57/-57 8.55 psf Doors-Yes CTLA-696W Double Max Panel Size: 3'0"x 6'8" Installation Details: S-2104(1-8) OXXO O/S Doors-Opaque 8'11"x 6'10" +571-57 8.55 psf Door-Yes CTLA-696W Double w/Sidelites S idelites-G lazed Sidelites-No Max Panel Size: 3'0"X 618" Sidelite DLCO:6"x 5'3"(118"Tempered Glass) Instillation Details: S-2104 I-8 National Accreditation&Management Institute,Inc./4794 George Washington Memorial Highway/Hayes,VA 0 Z Tel: (804) 684-5124/Fax: (804)684-5122 NAMI AUTHORIZED SIGNATURE: 7025'MAX. OA FRAME WIDTH 74.5'MAX.OA FRAME WIDTH 75• 75'MULL 15.5 MAX.OA '�LG®� .875'TYP. .125" TYP. BAR TYP. SIOELITE FRAME WIDTH jEL N® epi 36.625'MAX.OA �.� OA .875' 6'MAX O.A. 14'MAX. OA PANEL WIDTH '{ TYp.JrI PANEL W1DIN PANEL WIDTH ENERGYSAVER/CONTOUR6'•6'WOODEDGEOPAQUESTEELOUTSW(MG W/ Pia TM I a IMPACT DOOR UNITS WI7M&W/TNOUT SlDEUTES m Cdr i ® ® ® ® ® ® z e GENERAL NOTES 6'MAX asW� co 80.INACTIVE ACTIVE % 0 MOTHO W Y� o� 1. THIS PRODUCT IS DESIGNED TO COMPLY WRH THE CURRENT FLORIDA BUILDING 80' MAX. C CODE AND HiGH VELOCITY HURRICANE ZONE IWZ'REQUIREMENTS. MAX. OA 63.125' 2. WOOD BUCKS BY OTHERS,MUST BE ANCHORED PROPERLY iO TRANSFER OA PANEL MAX. ' a LOADS TO THE STRUCTURE PANEL HEIGHT OA 3. PRODUCT ANCHORS SHALL BE AS LISTED AND SPACED PER ANCHOR LOCATION HEIGHT a D.L.O. DRAWINGS.ANCHOR EMBEDMENT TO BASE MATERIAL SHALL BE BEYOND WALL ® 8125' G HEIGHT DRESSING OR STUCCO. 81.25' MAX. 4. SEE TABLE 1 ON THIS SHEET FOR DESIGN PRESSURE RATINGS. MAX ® OA 5. THIS PRODUCT MEET THE WATER REQUIREMENTS FOR'HVHZ'ZONES. SEE OA FRAME THE DESIGN PRESSURE CHART BELOW. FRAME HEIGHT6 G 6. DOORS ARE IMPACT RATED AND DO NOT REQUIRE MIAMI-DADE HEfGHi z� APPROVED IMPACT RESISTANT SHUTTERS. r 7. MIAMI-DADE APPROVED IMPACT RESISTANT SHUTTERS ARE REQUIRED FOR SIDEiJTESgo a o x o B. SiDELTTES ARE AN OPRON AND CAN BE USED IN A SINGLE OR DOUBLE etF OL WING IMPACT g UNIT(0X0)W/NON-IMPACI CONFIGURATION. A 0.75' 0.625' 2 Siru_L M VIEWED FROM 17(TERIOR �n I 0.625' RESIDENTIAL INSULATED STEEL DOOR(GDmmon to all frame ca Wansl DOUEIc WE cWING IMPACT UNIT(XX) 107'MAX OA FRAME WIDTH MAX. OA oz ¢%Z ;' 37.75'MAX OA VIEWED FROM EXTERIOR .875' .125" .7755""MULL SIDEUTE FRAME WIDTH W�o w COMPONENTCONSTRUC770NS: FRAME WIDTH Face sheets: 24 ga. (0.020 minimum thickness,Galvanized Steel A-525 T36.625*MAX OA 36'MAX. OA 14'MAX.OA w 3 o commercial quality-AKDQ per ASTM 620 with average minimum yield 36'MAX OA PANEL WIDTH PANEL WIDTH PANEL WIDTH �� K strength Fy(mre.)=24,600 psi. 875'IYP. PANEL WIDTH II W/ASTRAGAL = a p Core design: Expanded polystyrene with 1.0 to 1.25 Ibs./cf density,by Fo JELD-WEN, INC. ® ® ® ® a a Door Panel Construction•The active and inactive panels are constructed from ® ® 6•ptgX 24GA (0.020'min.)galvanized steel. The face sheet fops and bottoms are INACTIVE ACTIVE OA D.LO. 5 N bent 90• over the top and bottom rrnls. The top LVL rail measures 1.67° WIDTH wide x 1.042'high. The steel bottom rail is roil formed 0.021 galvanized 80' 80' G steel measuring 1.67'wide x 121'high. The sides of the face sheet are MAX. rug formed onto the LVL latch stile and Ponderosa Pine hinge stile which MAX. OA 63.125" e a measure 1.67'x 1.0. The interior cavity is filled with poystyrene. The PANEL PANEL MAX. w face sheets are glued to the polystyrene. HEIGHT HEIGHT OA W w Fixed Lite Const.:The sash is constructed from 24GA (0.020'min.)galvanized ® 4 D.L.O. �i Q steel. The edges of the face sheet are bent 90'over the polystyrene core ® 8125' G HEIGHT and glued to it.The sidelite panels are routed to receive the OOL UP Lite 81.25' C D MAX. Frames or the optional Trinity Light Frames (See sheet 7 for glazing OA 00 OA f2 details.) The rte frames are sued w/QSD gk¢ing compound on the FRAME FRAME 8 8 exterior. FRAME HEIGHT � 8 Frame Construction:The frames are constructed from Ponderosa Pine jambs o 0 0 measuring 125"wide x 4.5625'deep. The door and sideite head jambs are mortised and Mitt joined to the side jambs and attached with(3) 16GA. ^0 0 0 0 2'x 7/16'crown wire staples The units use a standard bump face Pemko pQUBLE OL�WING IMPACT SWi threshold measuring 4.041'deep x 1.0'high.The threshold is attached to o the flame with 3 16GA 2'x 7 16'crown wire staples. t111tttlr� g UNIT(OXXO)W/NON-IMPACT e m 0.75' 0.625' ``�% F O SIDEllTES VIEWED FROM EXTERIOR w o v m¢ TABLE OF CONTENTS 0.625' � DAM 9-il-Ol aNri F OUTS l IMPACT UNIT(X) SHT CRIPTION VIEWED FROM UR RK)R Z�:': ��% Prepared EJy. scute N.T.S. DES 1 GENERAL NOTES AND TYPICAL.ELEVATIONS TABLE 1: 7 -* _ owe.BY. JWJ 2 VERTICAL CROSS SEC7TONS AND BILL OF MATERIALS DESIGN PRESSURE RATING-W X WATER CHK By.S. SAFFELL. 3 HORIZONTAL CROSS SE;TTONS 6�� OVFAIRATX)N REQU111ENf 4 HORIZONTAL CROSS SECTIONS AND NOTES SME DOOR UNIT(4 A X0,0x0) +65 psf-7D pid �� DRAW NG N0 5 ANCHORING L�A710NS AND DETAILS •' W/WO N�1-116'ACT SiDBJIES Digitally signed by Hermes F Norero,P.E.P.E ��i�K, r•e.+n �_�� BUILDING DROPS, INC S-2104 6 ANCHORING LOCATIONS AND DETAILS DOUBLE DOOR WT(A 0,%xxv,OXXO) +57 Psi-57 psi {yrs Reason:I am approving this document A � Phone 407-644-6957 Fax:407-644-2366 sHEr 1 or 8 7 GLAZING DETAILS W�0 NOV-WACT Sm8lfES ate:2012.05.01 17:5195-04'00' rmh: qr, Rbc 8 11 COMPONENTS � . ' SEE NOTERWK-SErITTAN 700 SERIES DEAD22 SEE NOTE 4 25 19 20 4 52 7 1 15 13 6 5 6 3 20 19 2 SEE NATE 7 ON SHT 4 21 42 34 ON SHT. 4 0 10 EXTERIOR 1.750'MIN. V F^ chi PANEL THK. O ,' z O Q N e. CONCRETE BY OTHERS 4,. °' 1 INTERIOR INTERIOR0.75" 51 10 10 51 EDGE DI .,d° \\� 1 17 17 1 /�� 0.75°MIN. o x0 .a SEE DETAIL 5 SEE DETAIL 5 .n° EDGE DIST. wo¢ o n. ON SHEET 5 ON SHEET 5 d (�HORIZONTAL CROSS SECTIONp HOGERIZONTAL CROSS SECTION s ¢aZ i o,W 0.250'MAX. 0.250'MAX. SHIM a o ^r LATCH JAMB TO BUCK HINJAMB TO BUCK -2j.S m 1.50"MIN. ww z SHIM 1.50"MIN. CONCRETE/ EMBED. EMBED. g3 '22 MASONRY c�ioy o BY OTHERS a o SEE NOTE 1 o g ON SHE 4 26 40 a a ASTRAGAL THROW BOLTS (2) TOTAL; (1 EACH) 17 15 1 7 40 52 7 21 42 34 EXTERIOR 0.31"DIA x 9.0'LG. AT TOP&BOTTOM 5 3 N 1 15 All CTNF Acn o SEE N07E11 26 1 SHT. 4 �yWCoo�� i0 e E1 9 9 DETAIL 1 �� ASTRAGAL TO STILE ATTACHMENT o 0 0 0 1.750"MIN NOTE: ITEM 24 NOT SHOWN THIS o^ o yr PANEL THK \ VIEW FOR C` {t t I tUgrr� ^o o o INTERIOR �� ES F. SEE NOTE 4 SEE DETAIL PreparedSCAMN.T.S. ON SHL 4 24 1 ON THIS 10 1 17 SHEEP -* * : on.BY. JWJ Q cHr.s+':S. SAFFELL HORIZONTAL CROSS SECTION °w0 N0' AT IMPERIAL ASTRAGAL '•T v.c No• ��.` BUILDING DROPS, INC. S-2104 f�i Phone.407-644-6957 �m a .y R3��a Fax:407-644-2366 94EL7—L of 8 SEE NOTE 4 13 6 5 6 3 28 9 44 14 SEE NOTE 7 3 ON SHT. 4 24 44 28 9 4 52 7 1 15 21 42 34 ON SHE 4 4 4538 32 EXTERIOR SEE NOTE 3 1.750'MIN. g ON SHE 4 31 EXTERIOR PANEL THK. 36 17 m cda in ,. 3 ccl . OWN /j//////// •. '. I'II 23 -3 cn a SEE GLAZING 36 // INTERIOR 10 / �� SEE NOTE 2 2 SHEET 7 // NN 10 SEE NOTE 5 25. �' \� ON T. 4 z SEE NOTE 6 /// ��\ 25 NOTE 5 i 1 i 7 i ON SHL 4 //// ��\ 29 SEE NOTE 6 o ON SHT. 4 29 / \ ON SHT. 4 ON SHi. 4 o x�n SEE DETAIL 5 SEE DETAIL 5 ON SHEET 5 0.750' ON SHEET 5 39 0.750' SEE GLAZING �n 39 DETAILS, SHEET 70 00 F HORIZONTAL CROSS SECTION G HORIZONTAL CROSS SECTION o lz o AT SIDELITE TO LATCH JAMB A7 SIDELITE TO HINGE JAMB ozo m � W�3 6 O NOTES: CONCRETE/ SEE NOTE 3 a MASONRY 51 19 20 4 31 3 0 'a1. SPACING FOR ITEM 126 THE 110 x I"PFH SCREWS ATTACHING THE IMPERIAL ASTRAGAL TO THE INACTIVE DOOR IS ON SHT. 4 0 AS FOLLOWS: FROM THE TOP DOWN & THE BOTTOM UP 1.0, 2.5, 4.0, 5.5", 13.0, 18.0"& 26.0' BY OTHERS a ELI 2. SPACING FOR ITEM 123 THE 18 x 1 1/2'PLASCREW IS AS FOLLOWS: SEE GLAZING 5 F F TOP &BOTTOM HORIZONTALLY,I Y SID LITE PAN 3.0"IN FROM EACH CORNER. 32 36 38454 DETAILS, SHEET 7 ON THE SiDES. VERTICALLY.Y. FOR THE SIDELITE PANELS: 3.0*, 13.0", 26.0, 39.0, 52.0'& 63.0° 3. SPACING FOR ITEM 131 THE 16GA x 3/4'BRAD TRIM NAIL ATTACHING THE QUARTER ROUND TO THE SIDELITE AND s o v ITEM 19 THE 16GA. X i"BRAD TRIM NAIL ATTACHING THE MULLION CAP TO THE MULLION BAR VERTICALLY, IS AS � EXTERIOR FOLLOWS: TOP&BOTTOM HORIZONTALLY(FOR THE W-QUARTER RQ UND- 1.25°IN FROM EACH CORNER WITH (i) NAIL MiD-SPAN. ON THE SiDES VERTICALLY(FOR BOTH 3/8'QUARTER ROUND &MULLION GAPS 1.25'FROM EACH END &SIX MORE EQUALLY SPACED ON THE FlELO. ° ° s Q. WHEN ATTACHING THE STRIKE PLATE TO THE JAMB AND BUCK USE ITEM 125, A 18 x 2 1/2'PFH WOOD SCREW a,. 0.125"MIN. INTERIOR 3 is WHEN ATTACHING THE STRIKE PLATE TO THE JAMB AND SIDELITE JAMB AT THE MULLION USE ITEM 124,A 18 x 2" ° GLASS THK. B PFH WOOD SCREW. A . ' o c 8 i. SPACING FOR ITEM 125 THE 18 x 2 1/2'PFH WOOD SCREWS ATTACHING THE JAMBS TOGETHER AT THE MULLION, °a• •° IS AS FOLLOWS 6.0'FROM EACH W R77CAL. CORNER WITH (4) MORE SCREWS EQUALLY SPACED ON THE FlELD, SEE�ON SHL 2 2 ITE a^N N 0000 THE SIDEL PANEL IS SECURED INTO THE SIDEL(fE JAMB W/ITEM 129 SILICONE CAULK ON THREE SIDES AND e. / 4 HORIZONTAL CROSS SECTION 3/8'QUARTER ROUNDS SECURED WITH ITEM 131 BRAD TRIM NAILS x 3/4"LONG. 0.75°MIN. ° �� 29 SEE NOTE 6 4��jAi��rif4 ITE' 70 BUCK g o o WHEN ATTACHING THE HINGE TO THE JAMB AND BUCK USE ITEM 127,A 110 x 2"PFH SCREW WHEN ATTACHING EDGE DIST d0. ON SHL 4 ��`SS F. O'��ii THE HINGE TO THE JAMB AND SiDEUTE JAMB AT THE MULLION USE ITEM 114,A 110 x 1 3/4"PFH WOOD SCREW. < � DATE' 9-11-01 L SPACING FOR ITEM 149 THE 16 x 1 i12'PANHEAD SCREW(TRINITY UTEFNAME) IS AS FOLLOWS o; SEE DETAIL 5 ,��i A �� EUTE LITEFRAME FROM THE TOP DOWN VERTICALLY• 3.25° 18.0625; 32.81257, 47.5625'& 62.625'. '0 ON SHEET 5 �: 7 O Prepared By scntF N.T.S. SIDEIJTE L1TffRAME TOP&BOTTOM 0.250'MAX FROM THE �T ONE(i) SCREW AT 4.4375'. a ° '< * , it= MO.�` J W. • ALTERNATE CONCRETE/MASONRY INSTALLATION ANCHORS OF EQUIVALENT PERFORMANCE CHARACTERISTICS CAN 8EL � v . T T cc ti Q cNx.ar.S. SAFFELI. USED UPON APPROVAL OF THE ARCHITECT OR ENGINEER OF RECORD FOR THE PROJECT OF INSTALLATION. SHIM :-1 '• • . l DRWNG NO.: 50"MIN . O 9. USE ITEM 151 WHEN INSTALLING INTO WOOD SUBSTRATE AT HEAD &JAMBS. USE ITEM 125 WHEN INSTALLING INTO ° ��'.` BUILDING DROPS, INC. S-2104 MULLIONS. USE ITEM 116 WHEN INSTALLING INTO CONCRETE/MASONRY SUBSTRATE AT SiDEUTE SILLS. fni ".Thal Phone:407-644-6957 rare Iqr x�:`xes�e Fax:407-644-2366 srafr 4 OF 8 74.50'MAX. OA FRAME WIDTH 70.25'MAX. OA FRAME WIDTH SEE DETAIL 2 ^�ON THIS SHE G SEE DETAIL 4 4.50°TYP. 9.00°7YP. g l¢ .00'TYP. ON THIS SHE 3.00°TYP- 6.58° 6.00°TYP. �j F o i i 6.00' 12.50° 3.00' .00'TYP. Z oc ci t 6.00°TYP.TYP. TYP. SEE DETAIL 4 til 00'TYP. 7.375° ON THIS SHE 6 7YP. , I I I I ITWT, �q 6 �• _I III 1 I I 1_ 7.375' - _ - - C gL �L -� 51 51 TYP M O=. T1P. TYP. - SEE NOTE 5 - - 31' 31' 5 ON SHEET 4 5 SPACES SPACES 0 13.85' SEE DETAIL 6 ® 13.85° SEE DETAIL 5 �ONTHIS SHE ON THIS SHE _ 8125' 81.25' -" r �. �o MAX. I 0A 25 o x z FRAMEHA FRAME 15.50' TYP. _ _ yea �cJn HE HT _ 5. 50-1 1 _ o� a 31' moo m z _ m U 31' 36.625' 16 4903 36.625° 16 T i1P. o TYP. IL _i 1 11 1 1 a 3.00° .00'TYP. 5' 0�� DO'TYP. 12.125° 3Z 3.00' 7.00'TYP. 6.00 YP 7.00°TYP. TYP .15'MIN. o i C-SINK. N W N SEE DETAIL 3 / ON THIS SHT. SINGLE DOOR WITH SIDELITES ANCHOR LOCATIONS / R us o DOUBLE DOOR WITHOUT SIDELITES ANCHOR LOCATIONS VIEWED FROM INTERIOR VIEWED FROM INTERIOR \ W 16 51 25 \ �_ 5 5 SEE NOTE 10 \\ 25 16 14 2 SEE NOTE \ / ON SHEET 4 z o 0 0 0 -� 7 SHEET 4 \ � DETAIL / `11 p /� \ + j �p�Os'F O Q4uMERSINK FOR INSTALLATION ANCHORS W Q o o 6 / \ 5. I I 5.50' Dnp 9-11-Ot p /41 � 6 ' 24 SEE OTE ��' AO 1L P��B,. SCALE N.T.S. DWG.BY: JWJ L / T/(T t � = trot.ar.S. SAFFELL \ / DRAMNO NO.: 52 52 � 0T / p P'' �` BUILDING DROPS,INC S-2104 HEAD JAMB DETAIL 3 — ® THRESHOLD AETNL 4 DETAIL 5 DETAIL 6 fa�� A + ` Phone:407-644-6957 ASTRAGAL STRIKE PLATE ASTRAGAL STRIKE PLATE HINGES TO JAMB & DOOR STRIKE PLATES TO ASTRAGAL STRIKE PLATES TO JAMB cevE gs ns` +�e I=407-644-2366 SHEET 5 OF 8 107.00"MAX. OA FRAME WID711o 37.75'MAX. OA Rm • x FRAME WIDTH -+ SEE DETAIL 2 Cj o v' ON SHEET 5 4.50'TYP. SEE DETAIL 4 Z W N 7Z 16.41'TYP. ON SHEET 5 Y 3.00' DO"TYP. 13.41"TYP. 6.00" p g . j 3.00' 00"TYP. FR 6.00'TYR T-6 TYP. .00' .00'TYP. �' SEE DETAIL 4P. I 1 1 I IIII 7.375' 6 T1P. 6 TYP. 7.375' ON SHEET 5 51 TyP, 7YP.S SEE NOTE 5 31' SACES SPACES 5' 28 ON SHEET 4 ®P13.$5 ® 11.54' 31" o ky y - o 81.25' - SEE DETAIL 5- MAX \�ON SHEET 5 81.25° ON SHEETSEE L56 oa o3 MAX. o OA OA - - Boz coo FRAME ) 'R HEI HT - 5.50.1 H 5.50' J J a�s m o� Y - oiz 2 31" 31' W Po36.625" 36.625' t 6 TYP. 5 1 1 I I l I � i I 1 I I I 3.00' 3.00'iY. .00"W. 6.00' 3.00' 7.00 TYP. 7.00'TYP. W. TYP. `� o i -0 z � 8P, SEE DETAIL 3 SINGLE DOOR WITHOUT SIDELEES ANCHOR LOCATIONS o" ON SHEET 5 VIEWED FROM INTERIOR s DOUBLE DOOR WITH SiDELDES ANCHOR L0CA710NS 0000 WENED FROM INTERIOR `"InIV F U(O�'`,,, W �tv .• A �� DATE 9-11-01 7 O Prepared By. SCALE: N.T.S. * -* DWG.er: JWJ a T CHK.BY.S. SWELL �O Q•,�•�V DRAWING NO.: �i •• p.i 1p,• �� BUILDING DROPS, INC. $-2104 Phone:407-644-6957 FIPE q� ai>�akne Fac 407-644-2366 SHtfr 6 OF 8 1 50 30 3 R EXTERIOR 50 > m mew 0.125°MIN. TEMP. GLASS O N THICKNESS Y �- M INTERIOR 0.50' GLASS BITE 17 29 50 29 46 50 38 2 SEE NOTE 2 ON SHT. 4 EXTERIOR 0.500"MIN. io GLAZING DETAIL 1 GLASS THK. 0.125°TEMP. " 0.250°ALR �° v ODL LITE FRAME SINGLE PANE €: GLASS oa a SPACE 1/8'TEMPERED GLASS o,� o SPARTECH I o az z POLYCOM PP5530 C13 ' a=S m O v lii� 0 .25'x .50" 0.125°TEMP. INTERIOR 0.50 INTERCEPT GLASS Vas o GLASS STEEL SPACER 50 BITE ~ a 17 29 29 48 50 45 49 SEE NOTE 8ON SHE 4 g R N N 5 EXTERIOR 0.125"TEMP. GLAZING DETAIL fPln GLASS TRINITY LITE FRAME N N W ii'1141p. 1/2'INSULATED TEMPERED GLASS o LUPOY EU-5007 1.000"MIN. 0 0 GLASS THK. 750"AIR SPACE 45 0.125°TEMP. NOTE c o 75°x .50"INTER ALL GLAZING CONFIGURATIONS o INTERIOR 0.50"STEEL SPACER GLASS SHALL COMPLY WITH SAFETY GLASS GLAZING REQUIREMENTS OUTLINED a oAs"' BITE IN FBC SECTION 2406. o 50 4 49 �� 48F DATE: 9-11-01 GLAZING DEFAILSCALE. N.T.S. TRINITY LITE FRAME -* * _ DWG.BY.. JWJ 1'INSULATED TEMPERED GLASS y Q cNK ay.-S. SAFFELL LUPOY EU-5007 DRAWING NO.: Jw �� BUILDING DROPS, INC• S-2104 {moiA +�6` Phone.,407-644-6957 Imre ,yr %29= Fox.407-644-2366 SHEET_L OF_15-_ 1.670" --T 1.670' 1.670' 1.670" 4.5625* 2.188' 1.210" 1.000* 0'750' �2zffl cs 1.000* 1.042' 1.250" 0.500 -J ca DOOR BOTTOM PAL DOOR HM STI 24GA (0.021� STEL 13 FINGER JOINTED PONDEROSA DOOR LATCH STILE (DM&kOP R111 WOOD JAMB LVL FINGER JOINTED 7-� PINE WOOD (± 44 j PONDEROSA PINE i-g 0.513' 0.125' -1 It �- 1.645, 0.529- 0_1° . 1 0.380" 0.5 1.544' 1.544" 1.586* L 2- 0.140* 1.750' 1.750-: 1�.75 530. 0. 2.521 2.519 Z621' CORNER BLOCK FOR COMPRESSION WEATHERSUP ODL LITE FRAM CoQ 33 SVR 130TTOM PAIL SCHLEGEL Q-LON ODS 65045 OAL��-$OLYPROP. tno MOF x 3.0'LONG TRINITY PLASTIC LITE KIT WIER111 TRINITY PLASTIC Uff KIT MATERIAL OR PLASTIC LITE KIT MATERIAL 1.500" APPROVED UNDER MAJQL-09-8-01 1APPROVED UNDER YQLjQZ--082BQjAPPROVED UNDER BOA 110-1209-01l 1.250' 0.868' 0.375' 29,i Irr 0.482' 0.585" - !Q 0.375* T to 0.624" 0 QUARTER ROUND 1 675 T @)AL"SIDRff STOP 2.040" 0 PINE 1.750* ASTRAGAL HAS Two um' 2.500n 0 16 aO 2.137'1.012'E 0 0 0 0 DW. x 9 LONG BOLTS, 0 --j®0.0.097" - L Ilk Mafl&il 1 ON TOP, I ON BOTTOM LLO 1 0 1I I1.025" 1.381' 4.000' ASTRAGAL UYETL41.) DOOR LATCH STRIKE PLATE DOOR LATCH DEAD ASTRAGAL STRIKE PLATE BOLT STRIKE PLA MULLION HAGER STEEL BUTT HINGE 40 6063-T6 ALUMINUM 0 (IMPERIAL 0.125-STEEL) STEEL STEEL PINE(81.25'LONG) 04-x 4*x 0.097*THK. STEEL 11.875' 1.000, 0.582 DIA. VARIES WITH NUN HARDWARE USED 4.041 BUMP FACE THRESHOLD N 09 L6 t75 1.381 8 BY PEMKO 4.000' INSERT Oxim 9-11-01 Prepared By: SCAM N.T.S. 7 BY. Jwj Mr. CHK By.S. SAFFELL Q DRAWING NO.: WOODLOCK BL PhonOULDING DROPS, INC. S-2104 Se; - I FINGER JOINTED PONDEROSA PINE WE For 407-644-6957 407-644-2366 SHEET 8 or 8 127 W. Fairbanks Ave. BUILDING DROPS Suite 438 Winter Park,FL 32789 A Perfect Solution in Every Drop 407.644.6957 PH Certificate of Authorization:29578 407.644.2366 FX contact@buildingdrops.com Of JELD-WEN, inc. Energy Saver/Contour Wood Edge Opaque Steel Outswing Door w/ or w/o Sidelites for Florida Product Approval Florida .Building Code 2010 Per Rule 9N-3 Method: 1 —A (Certification) Category: Exterior Doors Sub— Category: Swinging Exterior Door Assemblies Product: Energy Saver/Contour Wood Edge Opaque Steel Outswing Door w/or w/o Sidelites Material: Steel/Wood Product Dimensions: 107-X81.25-(Maximum) Prepared For: ,e`�tiatialar►to��,� F. 0 0 Prepared by: . e s 'o T T �Y Z oft Florida Professional Engineer#73778 ® � ° Date: 05/01/2012 Evaluation Report ntents: Pages 1 —4 �/s'9/0NAt-�N ®®off` Installation Details Pages 5 "11111111`1 Digitally signed by Hermes F Norero,P.E. Hermes F. Norero, P.E. Reason:I am approving this document Florida No.73778 Date:2012.05.01 17:42:30-04'00' BUILDING DROPS FL#: A Perfect Solution n Every Drop Date: 05/01/2012 iiE Report No: 2035 Certificate of Authorization:29578 Manufacturer: JELD-WEN,inc. Product Category: Exterior Doors Product Sub-Category: Swinging Exterior Door Assemblies Compliance Method: State Product Approval Rule 9N-3.005(1)(a) Product Name: Energy Saver/Contour Wood Edge Opaque Steel Outswing Door w/or w/o Sidelites 107"X 81.25" (Maximum) Scope: This is a Product Evaluation Report issued by Hermes F. Norero, P.E. (FL#73778)forJELD-WEN,inc. based on Rule Chapter No.9N-3.005, Method 1a of the State of Florida Product Approval, Department of Community Affairs-Florida Building Commission. Hermes F. Norero, P.E.does not have nor will acquire financial interest in the company manufacturing or distributing the product or in any other entity involved in the approval process of the product named herein. This product has been evaluated for use in locations adhering to the 2010 Florida Building Code. See Installation Instructions 5-2104,signed and sealed by Hermes F. Norero, P.E. (FL#73778)for specific use parameters. Limits of Use: 1. This product has been evaluated and is in compliance with the 2010 Florida Building Code, including the"High Velocity Hurricane Zone" (HVHZ). 2. Product anchors shall be as listed and spaced as shown on details. Anchor embedment into substrate material shall be beyond wall dressing or stucco. 3. When used in areas requiring wind borne debris protection this product complies with Section 1609.1.2 of the 2010 Florida Building Code and does not require an impact resistant covering on outswing doors. 4. Non-Impact sidelites do require an impact resistant covering when used in areas requiring wind borne debris protection to comply with Section 1609.1.2 of the 2010 Florida Building Code. 5. Site conditions that deviate from the details of drawing S-2104 require further engineering analysis by a licensed engineer or registered architect. 6. See Installation Instructions S-2104 for size and design pressure limitations. Hermes F. Norero,P.E. Florida No.73778 Page 2 of 5 BUILDING DROPS FL#: A Perfect Solution in Eve Dro Date: 05/01/2012 ry p Report No: 2035 Certificate of Authorization:29578 Quality Assurance: The manufacturer has demonstrated compliance of door products in Accordance with the Florida Building Code and Rule 9N-3.005 (3)for manufacturing under a quality assurance program audited by an approved quality assurance entity through National Accreditation&Management Institute,Inc. (FBC Organization#QUA1789) Performance Standards: The product described herein has been tested per: • TAS 201-94 • TAS 202-94 • TAS 203-94 Referenced Data: 1. Product Testing performed by Certified Testing Laboratory,Inc. (FBC Organization#TST1577) Report#:CTLA696W, Report Date: 11/01/2001 2. Quality Assurance National Accreditation and Management Institute (FBC Organization#:QUA 1789) Hermes F. Norero,P.E. Florida No.73778 Page 3 of 5 BUILDING DROPS FL#: Date: 05/01/2012 A Perfect Solution in Every Drop Report No: 2035 Certificate of Authorization:29578 Installation: 1. Approved anchor types and substrates areas follows: Through Frame Installation: A. For two by(2X)wood buck substrate, use#10 Wood Screw type installation anchors of sufficient length to achieve a minimum embedment of 1.50"into the wood substrate. B. For concrete or masonry substrate where one by(1X), non-structural,wood bucking is employed, use 3/16"diameter ITW Tapcon type concrete screw anchors of sufficient length to achieve minimum embedment of 1.25"into concrete or masonry. C. For concrete or masonry substrate where wood bucking is NOT employed,use 3/16" diameter ITW Tapcon type concrete screw anchors of sufficient length to achieve minimum embedment of 1.25" into concrete or masonry. Refer to Installation Instructions(S-2104)for anchor spacing and more details of the installation requirements. Design Pressure: Design Pressure XX,OXXO X,OXO,XO,OX Positive 57 PSF* Positive 66 PSF* Outswing Negative 57 PSF Negative 1 70 PSF *Units meet water infiltration requirements corresponding to noted design pressures. Hermes F. Nore Florida Nc Pai .ore E• ego{5 BUILDING DROPS FL#° Date: 05/01/2012 A Perfect Solution in Every Drop Report No: 2035 Certificate of Authorization:29578 Installation Method JELD-WEN, ine. Energy Saver/Contour Wood Edge Opaque Steel Outswing Door w/ or w/o Sidelites -i CM" 1T'- x.50•• I II ll I I 111 Ill I I II _ 1 _ ' 2 —I IIS i I Ill I'I i i i �r L ;Y". Y I II III I I III II I 1 _I 1 I I— I Ij I, I Ili Hermes F. Norero,P.E. Florida No.73778 Page 5 of 5 1 " 6!-r 6'-0" 12'-4" W-s" A ZING AC 9 Imp gn SHED 8 vv �u2 W1 t " 4'-11" O _ ' B CLOSED KITCHEN DINING ROOM � BEDROOM � B c Miami Shores Village SH-1 ' f AP 10VED ®1P DATE • • ••• • RAISING FLOOR BLDG DEPT f �� ••• •• • SEE DETAIUG! • • '•• • SU13,JFCTTOCOMPUANCEWrMA&FEDE ••••• •••• • •• ••• w I STATE AND COUNTY RULES AND REGULATIONS CI�GSI�••.• ••SA ••. I � . — p/�yp�{� • • • ILIYIIVG \e�oltll f7 •• .••• oo: A SH1 BYe — 8" 13'-0" T.r 3�n 1 C-1 A/C N Cwv1 f-On 111-0 1 ® 5'-2n -2n BEDROOM 9 c g W7►=y r.ln s'-11" - I TO n 13'-/ n :Fortun Insurance ToUGMATE, INC, TWC3403490 (13057568972) 15:16 05/13/14 EST P9 3-3 A400RE0CERTIFICATE OF LIADATE BILITY INSURANCE 5/13/2014YY) 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 pollcy(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 NAME: Mercy Canpuzano Fortun Insurance, Inc. PHONE (305)445-3535 FAXA/C (866)415-0625 365 Palermo Ave. E-MAILApDgrSs.mercy.catapuzano@fortuninsurance.com INSURERS AFFORDING COVERAGE NA)C# Coral Gables FL 33134-6607 INSURERA:Granada Insurance Co INSURED INSURERS Trust North America Company LIGHTGATE, INC INSURER C: 1421 SW 107TH AVENUE INSURER D: SUITE 101 INSURER E: IMIAMI : AMI FL 33174 INSURER F: COVERAGES CERTIFICATE NUMBER-CL12102204381 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. IILTRNSR I TYPE OF INSURANCEADDLSUBR POLICY EFF POLICY EXP POLICY NUMBER LIMITS GENERAL LIABILITY FArH OCr_uRRENCE 4 11000,000 X COW&RCIAL GENERAL LIABILITY DAMAGE PREMISESTO FEN-TED N ants $ 50,000 A CLAIMS-.MADE OCCUR 0185FL00004127 0/20/2013 0/20/2014 MED EXP(Any one person) $ 1,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L.AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP ACG $ 2,000,000 X F"Ir.Y PRO- i Or. $ AUTOMOBILE LIABILITY COINED SINGLE LIMI= Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-NIADE AGGREGATE $ DED I I RETENTION $ B WORKERS COMPENSATIONWC STATU- OTH AND EMPLOYERS'LABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y!N OFRCER/MEKOER EXCLUDED? El N/A EL.EACH ACCIDENT $ 500,000 (Mandatory In NH) TWC3403490 4/23/2014 /23/2015 E.L.DISEASE-EA EMPLOYE x-500 000 If yyes describe under DESGtRIPTK)1V OF OPERATIONS below EL.DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attaeh ACORD 101,Additional Remarks Schedule,If more wee IS required) Electrical Contractor#EC13003130 CERTIFICATE HOLDER CANCELLATION (3 05)756-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shore Village Bldg Dept ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Hector Fartun/IZ r ACORO 25(2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved. INS02512nimm nt Tho Ar nRrn nam"anti Innn aro ranictarorl marks of arnRr1 Miami Shores VillagL7J Building Department2Q 2VOY410050 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 BUILDING Master Permit No.RC-3-14-426 PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING FE-1 REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9425 NW 2 CT City: Miami Shores County Miami Dade zip: Folio/Parcel#:11-3101-015-0340 Is the Building Historically Designated:Yes NO X Occupancy Type: R-1 Load: Construction Type: CBS Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):ELITE HOME PARTNERS LLC Phone#:305-905-6913 Address:2300 WEST 84 ST#602 City: HIALEAH State: FLORIDA Zip: 33016 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: RUDGE WOOD FLORING Phone#: Address: G City: State L ;z.? Qualifier Name: d Phone#: !J. State Certification or Registration#: 1.�� G7. Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑■ Alteration ❑ New ❑ Repair/Replace Demolition Description of Work: Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ [z Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ A9 • Op (Revised02/24/2014) 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. "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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the a ence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature-/ Signatur OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The oKngument wasackknowledged before me this da ofMIN ZO by / 4 20 l tv ,by MOho is personally know to OA, 41 W4 i is personally known to me or who has produced as me or who has prod&d �[/ C__— as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: ($� Print: pr� nu+a, `pn / / P(Z Agee Seal: IME ROtA �o~• :�`=� �' ,}tRf.VO4,2017 yotuy Puetk.SWe of Florida ^omm.Expires Oct 24.2017 ' �„ `' �tyOZpRYc�► mnilti3�11/FF 066091 `°°• ,: �'' *�x� nx�+A**** APPROVED BY Plans Examiner Zoning re(_ Structural Review Clerk (Revised02/24/2014) Miami Shores Village Building Department 4f'7 MAY 161 ZQ14 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� BUILDING Master Permit NoT&_3—/qqL c'),t 477 LICATION Sub Permit No. ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP [� Q r, CONTRACTOR DRAWINGS JOB ADDRESS: 7 OBJ C City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: p�Flood Zone: y/ BFE: GAFFE: j OWNER:Name(Fee Simple Titleholder): Address: 3 W City: State: ?--'(-, Zip: _ f 6 Tenant/Lessye�e�Naame: Phone#: Email:,.l�L^ Af-5— (& ^Pvt,-,--bEb'� CONTRACTOR: ompany Nam U � f tp®®� 7' L Phone#: 7f&_3� 43-7� Address: "c City: State: Zip: ems,—� Qualifier Name: ' Phone#: Cb ®� to Certification or Registratio E Jam+ ¢�SCCertificate of Competency#: DESIGNER:Architect/Engineer:_�Mill [� $e 9 4 6 Phone#: Address: � r I��.� L-X",4�� pity: State: Zip: ®L� Value of Work for this Permit:$ ��rSquare/Linear Footage of work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/lkeplace' ❑ Demolition Description of Work: c 1. 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$ (Revised02/24/2014) 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..... I 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 absenc of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature ,�� - ' Iforinstrument OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged beforemethis was acknowledged before me this dtay of hh ,,1"`�/�`t: ,20 14 .by 20 f' t� , by 11/11 KAl 1"l o is personal) know to who is personally known to me or who has p duq •, as me or who ha produce _ as :a• •°� lic-State of Florida identification an b a ' StIU AMENAM take an oath. ;s, o,, Y Expires Oct 24.2017 oa %COMMISSIONFF0059613 NOTARY PUBLIC. -'%t Commission I FF 088091 - �I�gpy �20 7 =.'. Sign: Sign: Print: Print: � i/ �� !� C e,. Sea k Seal: APPROVED BY / Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village c Building Department 20 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 BUILDING Master Permit No. ac--3 -)�'-4j�46 PERMIT APP ICATI N Sub Permit No. ❑BUILDING ELECTRIC ROOFING REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP r ➢� CONTRACTOR DRAWINGS JOB ADDRESS: � , "� � City: Miami Shores County: Miami Dade zip: Folio/Parcel#: Is the Buildiltg Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:4[e� -b OWNER: Name(Fee Simple Titleholder): *Phtne#: BOA Address: 00 o City: State: Zip: I Phone#: Email: CeIA14 - CONTRACTOR:Company Name: !�!,,hr C;'� vft-l-e— Phone#: 3ct�j--26 / `2.3 VV Address: / City: 4, State: �`` � Zip: 3am17 Qualifier Name: �t2 � �� Phone#: State Certification ro Registration#, Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 20 1 , Specify color o color thru tile: - Submittal Fee$ Permit Fee_$_ CCF$ �C Scanning Fee$ T Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ c TOTAL FEE NOW DUE$ PH - (Revised02/24/2014) 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. "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." ,Votice to Applicunt: As u condition to the issuance of a building permit with an estiah7ted 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. Ignature �'�"�� iJ Signature D OWNER or AGENT CO RACTOR The foregoing instrument was acknowledged before me this The fore oing instrument was acknowledged before me this 1�ndav of 1"f P /� 20 , by day of 20 , by KA 11.(� �(, l�dh ersonally known / s ersonally known to me or who has produced as me or who has produced L. as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Pr' t: 41, Pri ILENA ROMERO Se Ir. `= Notary Public-State 01 Floft Se ILENA ROMERO f PJI My Comm.Expires pq `,�• N'r;,' °ubiic-Stat of FI 2017 ' 'y C mm.Ex a da ,'••.°F��•�' Commission#FF Y h' sows 0660MI �/ pires Oct 24. 2017 Comrnrssior►N � APPROVED BY Plans Examiner Zoning Structural Review Clerk (RevisedO2/24/2014)