WS-16-676 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-255282 Permit Number: WS-3-16-676
Scheduled Inspection Date: March 25, 2016 Permit Type: Windows/Shutters
Inspector: Rodriguez, Jorge
Inspection Type: Final
Owner: BRADLEY, JAMES Work Classification: Garage Door
Job Address:30 NE 106 Street
Miami Shores, FL 33138-2035 Phone Number
Parcel Number 1121360060060
Project: <NONE>
Contractor: BLACKJACK GARAGE DOORS INC Phone: (786)863-8920
Building Department Comments
REPLACE GARAGE DOOR Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-254723. Door must be installed
per NOA
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
March 24, 2016 For Inspections please call: (305)762-4949 Page 14 of 28
Miami Shores Village
4� 10050 N.E.2nd Avenue NE '
£ M
Miami Shores, FL 3313&0000
Phone: (305)795 2204
r _
�211201fi Expiration: 09/17/2016
Project Address Parcel Number Applicant
30 NE 106 Street 1121360060060
Miami Shores, FL 33138-2035 Block: Lot: JAMES BRADLEY
Owner InformatiAddress Phone Cell
F. > mon�...
JAMES BRADLEY 30 NE 106 Street
MIAMI SHORES FL 33138-2035
Contractor(s) Phone Cell Phone Valuation: $ 1,200.00
BLACKJACK GARAGE DOORS INC (786)863-8920
,...... .,. Total Sq 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 Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
Invoice# WS-3-16-59017
DBPR Fee $2.00 03/15/2016 Credit Card $50.00 $76.20
DCA Fee $2.00
Education Surcharge $0.40 03/21/2016 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 ELECTRICAL, PLUMBING,MECHANICAL,WINDOWS,DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFI AVIT: I rti qat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction an zoni Fu a re, I authorize the above-named contractor to do the work stated.
March 21, 2016
th iz cl Signature:Owner / Applicant / Contractor / Agent 7ate
Building Department Copy
March 21, 2016 1
• � �`� Miami Shores Village RECEIVE�
MAR 15 2016
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY
Tel:(305)795-2204 Fax: (305)756-8972
3� INSPECTION LINE PHONE NUMBER:(305)762 4949
FBC 20
BUILDING Master Permit No. u,6 c6— C,:5>--76
PERMIT APPLICATION Sub Permit No.
,UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
PLUMBING ❑ MECHANICAL 7PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores//��, /,r_^ County: Miami Dade Zip: ��?13�
Folio/Parcel#: ( I� ,7i�i?_L- J�tJ— wV1 ) Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: (Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): J �ra l Phone#: 664) 2'P0
Address: 2,0 NE to t_-,"G
City:
�1Vlo&Ls State: �'Z- Zip: 3 3 3
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: CC_V C DffU ,:TPC-Phone#:�����S�G� ZC3�
Address:
� /I�3�1�� Sly I-�rrcC
City: I" La mak-, State: T=Ib &-i Zip: `� rl0
Qualifier Name: J-7 r nL� C1riVl r) Phone#:
(_i6 ROO
State Certification or Registration#: ��9's UboZ� Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ ' G�� Square/Linearr Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work:
f e o ki(L C,_26A
Specify color of colorthru tile:
Submittal Fee$ � Permit Fee$. ( 'd CCF CO/CC$
Scanning Fee$ ��\ Radon Fee$ ' 5 DBPR$ �J Notary$
Technology Fee$ `G t^� 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.....
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 on 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.
Signa*,;;: Signature
OWNER orA NT CONTRACTOR
The foregoing instrument was acknowle a this The foregoing instrument was acknowledged beforemethis
Y111-11clay of c-V L yl 20 1 by /q"'I day of 14)1� 20 / by
_ f I� �
11°5 (C �`E who is personally known toY✓!l' �Q ��y 1'1� who is personally known to
me or who has produced �A `'(—LI4LI Z—Q�z—C.:U as me or who has produced h IS0 Zl�fS6'Z�1�1 'vas
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign. I� Sign:
'�Z7LU(TJ
Print: l C. Print:
�' °''' �'"'�""' ISAI3EL ZU GA
Seal: s 4i;:. ISABEL ZUNIGA Seal: A ,
MY COMMISSION#FF1 73394
MY COMMISSION#FF173394
EXPIRES.Novembe2,2018 '��„�+! ' EXPIRES November 2,2018
C�
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 02/24/2014)
Inc. IB"C"ACIK GAVACIE
;TFlgP �D�rg UCCUS
Date: March 14, 2016
State of Florida
County of Miami-Dade
Before me this day personally appeared Ernesto Govin who, being duly sworn
deposes and says:
That he will be the only person working on the project located at 30 NE 106th St
Miami Shores, FL 33138
Sworn to me and subscribed before me this 14th day of March. 2016, by Ernesto
Govin.
Type of identification produced: G 150-200-86-248-0
rV1 C5� 6o,11 �.
�IIgII�
:°
`'` • '
` ISABEL ZUNIGA
,A :
4. , o•. MY COMMISSION#FF173394
••`•:;!o.r '' EXPIRES November 2,2019
(407)398.0153 Floridallota Servlce.com
• 5�►ORE
S
• 1 Rc.1"
s�
Miami shores Village
mail ,_ uu,M
Building Department
10050 N.E.2nd Avenue
ORiDA
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner - Workers' Compensation Insurance Exemption
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05
allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to
obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure:
An employer in the construction industry who employs one or more part-time or full-time
employees, including the owner,must obtain workers' compensation coverage. Corporate officers
or members of a limited liability company (LLC) in the construction industry may elect to be
exempt if.
I. The officer owns at least 10 percent of the stock of the corporation, or in the case of
an LLC,a statement attesting to the minimum 10 percent ownership;
2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State, Division of Corporations;and
3. The corporation is registered and listed as active with the Florida Department of
State, Division of Corporations.
No more than three corporate officers per corporation or limited liability company members are
allowed to be exempt. Construction exemptions are valid for a period of two years or until a
voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use
day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will
be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of
workers' compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Si
r
State of Florida
County of Miami-Dade
The foregoing was acknowledge before me this y t day of 20-1—L.
who is personally known to me or has produced
as identification.
Notary.
.'o' "ti ISABEL ZUNIGA
SEAL: e•': ) MY COMMISSION*FF173394
.o'r.
EXPIRES November 2,2018
(407)3BB•0153 Floddallote Serylce.com
G()S _ ; 30
...... . . . .
MAR 16 2016
• ...... j 3�S
...... CITY
. .. .. ..
..... ... . ...... BY:
..... . ....
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7n\ ED BY DATE ,
z
[ZONING DEPT
BLDG DEPT
SUBJECT fO CCh1PLIANCE WITH ALL FEDERAL
STATE ANL) OUN-1Y RULES AND REGULATIONS
..
AL FAROOQ CORPORATION
AllUs CONSULTING ENGINEERS & PRODUCT DEVELOPMENT
WIND LOAD TABLES FOR COMPONENTS& CLADDING
WIND STANDARD: ASCE 7-10,FBC 2010/201.1 EDITION
GARAGE DOORS ONLY
Count : Miami Dade Fi_ue re 1:
Wind Speed : 175 MPH h
Risk Category : II
Exposure Category : C e
1.Client
2.Project Name: (Residential Proiects Onlv)
3.Project Address: V
P gar n'� _SV)c)v- s 1Pkw6P% 38
CTIA' SIATE ZIP
4.Building Height: ( (See Figure 1 above) 5.Door Size: D
MAXIMUM DESIGN LOADS FOR BUILDINGS EQUAL OR LESS THAN 25 FEET.
MEW— FOR BULIDING WITH ROOF SLOPE>10 DEGREE FOR BULIDING NUTH ROOF SLOPE<10 DEGREE
ROOF DOOR N1IDTII DOOR NVIDTH
11T, 841'. 9 FT. 12 FT. 16 FT. 18 FT. 8 FT. 9 FT. 12 T. 16 T. 18 FT.
(FT) PSF( )I PSF(-) PSF(+) PSF(-) PSF(+) PSF(-) PSP(+) PSF(-) PSF(+) PSF(-) PSF(+) PSF(-) PSF(+) PSF(-) PSF(+) PSF(-) PSF(+) PSF(-) PSF(+) PSF(-)
5_ 38.1 49.7 37.5 48.5 36.0 45.5 34.5 42.5 33.9 41.3 34.9 45.4 34.4 44.3 33.0 41.6 31.7 38.9 31.1 37.8
16 38.6 50.3 38.0 49.1 36.4 46.1 34.9 43.0 34.3 41.8 35.3 45.9 34.8 144.8 33.4 42.1 32.0 39.3 31.5 38.2
17 39.0 50.9 38.4 49.7 36.9 46.6 35.3 43.5 34.7 42.3 35.8 46.5 35.2 45.3 33.8 42.6 32.4 39.8 31.9 38.7
18 39.5 51.5 38.8 50.2 37.3 47.1 35.7 44.0 35.1 42.8 36.2 47.0 35.6 45.8 34.2 43.0 3 2.8 40.3 32.2 39.1
19 39.9 52.1 39.3 50.8 37.7 47.7 36.1 44.5 35.5 43.2 36.6 47.5 36.0 46.4 34.6 43.5 33.2 40.7 32.6 39.6
20 40.4 52.7 39.7 51.4 38.1 48.2 36.5 45.0 35.9 43.7 37.0 48.1 36.4 46.9 35.0 44.0 33.5 41.2 33.0 40.0
21 40.8 53.3 40.2 51.9 38.6 48.7 37.0 45.5 36.3 44.2 37.4 48.6 36.8 47.4 35.4 44.5 33.9 41.6 33.3 40.4
22 41.3 53.8 40.6 52.5 39.0 49.3 37.4 46.0 36.7 44.7 37.8 49.1 37.2 47.9 35.7 45.0 34.3 42.1 33.7 40.9
23 41.7 54.4 41.0 53.1 39.4 49.8 37.8 46.5 37.1 45.2 38.2 49.7 37.6 48.5 36.1 45.5 34.7 42.5 34.1 41.3
24 42.2 55.0 41.5 53.7 39.8 50,31 38.2 47.0 37.5 145.7 38.6 50.2 38.0 49.0 36.5 46.0 35.0 43.0 34.4 41.8
25 142.61 55.6 41.9 54.21 40.3 50.91 38.6 47.51 37.9146.21 39.0150.71 38.4 149.5J 36.9146.51 35.4 43.5 34.8 42.2
Notes :-
-h =Eave height for roof slope<_10 degree.
- Table above shows maximum design load for shorn building height in end zone.
•• •.•
For any other condit:)ns/zo»es.d:sign loads to hey evahrated on project basis
Disclaimer:- . •; ••
- This document is not v•alid'V�hotr hc0ni4os:e4 jL*al of an engineer employed
by Al-Farooq Corporation
-No portion of this JQczM4&t may be 4ged or rFroduced in any manner. JJAVAD ,�P.E.
(except, howerethyt pQrti tri of iSCE -10 sed orth herein). FL#70592 EB CAN#3538
9360 Sunset Dris e,Suite 2!0 1&bat$i, 33,f3 J.T: 3015.264.8100 I F:305.262.6978 vv-vv-w.afceng.com I alfarooqrafeeng.com
VV
M IAM 1-117ADE AIIAlYn-DADS COUNTY
PRODUCT CONTROL SECTION
It 805 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) mnvminmidnde.zov/economy
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 constriction
materials.The documentation submitted has been reviewed and accepted by Miami-Dade County RFR-
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 AM (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 A14J 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: Steel Pan W8 Sectional Garage Door up to 91-0" Wide(DP+54.0,-62.0 PSF)
APPROVAL DOCUMENT: Drawing No. 103287, titled"Pen Door 9'W+54/-62 PSF", sheet 1 of 1, dated
03/03/2005,with revision 05 dated 02/2015,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 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,manufacturing address,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,
bottom 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.
TERMINATION 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 an endorsement of
any product, for sales,advertising or any other purposes shall automatically terminate this NOA.Failure to
comply with any section of this NOA shall be cause for termination and removal of NOA.
ADVERTISEMENT:The NOA number preceded by the words Miami-Dade County,Florida,and followed
by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then
it shall be done in its entirety.
INSPECTION: copy of tl1isjtg4i-rc NOA s4q,11 be provided to the user by the manufaettirer or its
distributors and shOLbe nvat4a*MC:f0j tt;specrion at the job site at the request of the Building Official.
This NOA renews NOM;A-Q22S.t)4,t consists of this page 1 and evidence page E-1,as well as approval
document mentioned above. •
The submitted t1pcgpentatiQnyy6is reviewed by Carlos M.Utrera,P.E.
• NOA No 15-0603.02
CMIAMIiVADE C01ONTY ... ;• Expiration Date: September 15,2016
! yQ fs Approval Date: .iuly 30,2015
Page 1
• ... •.
CIopay Buildine Products Company
NOTICE OF ACCEPTANCE: EVIDENCE SUBNIITTED
A. DRAWINGS "Submitted ander NOA #15-0225,04"
1. Drawing No. 103287,titled"Fan Door 9'W",sheet 1 of 1, dated 03/03/2005,with last
revision 05 dated 0212015,prepared by Clopay Building Products Company, signed and
sealed by Scott Hamilton, P.E.
B. TESTS "Submitted under NOA #OS-0316.01"
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,TAS 202-94
5)Tensile Test per ASTM E8
Along with marked-up drawings and installation diagram of Specimens A,B,C and D Clopay
Model 94, 9's 8' 24 gauge garage doors,prepared by American Test Lab,Inc,,Test Report
No.ATLNC 0827.01-04,dated 10/22/2004, signed and sealed by William F.Wescott,P.E.
C. CALCULATIONS "Submitted underNOA#05-0316.01"
1. Fastener Attachment Calculations prepared by Mark Westerfield, P.E.,Sheets 1 &2,dated
03/03/2005, signed and sealed by Mark Westerfield,P.E.
D. QUALITY ASSURANCE
1. Miami-Dade Department of Regulatory and Economic Resources(RER)
E. MATERIAL CERTIFICATIONS
1. None.
F. STATEMENTS
1. Testing contracted letter issued by American Test Lab,Inc.,dated 05/28/2015,signed by
Keith Owen.
"Submitted under NOA#I5-0225.04"
2. Statement letter of code conformance with the 2010 and the 51' edition(2014)FBC issued by
Clopny Building Products Company, dated 02/18/201.5,signed and sealed by Scott Hamilton, v
P.E.
"Submitted under NOA ii 10-0908.07"
3. Statement letter of no financial interest issued by Clopay Building Products Company,dated
08/;TWO 05 sighed pads sealed by Scott Hamilton,P.E.
00 : • •• �7 21 fZQ
• Carlos M.Utrera,P.E.
• Product Control Examinee
•` • NOA No 15-0603,02
•••.40 ;•• • Expiration Date: September 15,201 G
Approval Date:July 30,2015
•.. E-1
.; ••• 0 0
4 3
2 i
H£V19IONS
MQUIS MO Ar__B4A n4-_211_tig9124 GAUGE
MOOFIS +101 MES 48 124 GAUGE t TIM No, ZONE: DATE: ECN ND, APPVD: DESCRIPTION
MODELS IDEAL. 4F- 4R51 H45T 124 GA 04 - 1/2012 - SH AFFIRMED COMPLIANCE WRH 2010 FOC
um ata[z APrcxm,➢[nan awl anll o•,unto un f,au ro.Ll.tv—vw va It'^u 05 - 2/2015 - SN IIPOAIEG CGOE COMPLIANCE STATEMENT.
100-I-Im smm ILL,IC_—It)Ctxall[f rr,n[
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