RC-18-1564Miami Shores Village
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 (7,+,g•
BUILDING
PERMIT APPLICATION
El BUILDING ❑ ELECTRIC ❑ ROOFING
JOB ADDRESS: o 3 3
RciB Isb Fsc zon
Master Permit No.-PifV D - I `44-
Sub Permit No. fC 60`" ) / s �,
EVISION ❑ EXTENSION El RENEWAL
Ej PLUMBING ❑ MECHANICAL El PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
6'1214,vd � �rf e
City: Miami Shores 11 County:
Folio/Parcel#: // 3 b %r) c 3 J^ b
Occupancy Type:
Load: Construction Type:
Miami Dade Zip:
Is the Building Historically Designated: Yes NO 1/
Flood Zone:
BFE: FFE:
OWNER: Name (Fee Simple Titleholder): e 2 -6) - - ✓L 1 TA1` Phone#:
Address: dJ 3 3 C /L,AArci
City: At 14.. 1. SA0 4_ e 5 State: ?-
Tenant/Lessee Name:
Email:
Phone#:
Zip: $3J ) O
CONTRACTOR:Company Name.-- Ai b & h 3 -61__
Address: 7.S-9,d.- Al-
A-- 0 0
City: M 1402( S /) (r A- c-S State: / 7
Qualifier Name: vets -/ S 7-71.4 gc, gI a. Phone#:
/�
State Certification or Registration #: (_ :c.C 6 / 1 , 0 [ Certificate of Competency #:
DESIGNER: Architect/Enginee •
Address:
Phone#:
City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Additk ❑ Alteration [ New ❑ Repair/Replace ❑ Demolition
5-'U P s-1-1-1-1--F c �f ►�.�P s c n 5. - 20,1e, 4-111Gr4, (v � usP
fit/ ur-K
Specify color of color thru tile: _
Description of Work:
Phone#:305—SZS--Sj01
Zip: 33 (33
Submittal Fee $ Permit Fee $ . CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ V) • 00 Bond $
TOTAL FEE NOW DUE $ I O 1 - 03
(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 absence of such posted notice, the
inspection will not droved and a - pec "on ee rW be charged.
Signature
OWN'' or AGENT
Theforegoing
�/foregoing instrument('was acknowledged before me this
26 day of tV-�, 20 / 2' , by
r b ft ,( , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
APPROVED BY
CATHERINE A, DUFFIN
Notary Public -State of Florida
' = Commission M G 104296
Hooded through Maria nryssn,
,
**
Signature
CONTRACTOR
The foregoing instrumentntwas acknowledged before me this
day of %/ L %-i , 20 / ' , by
(le . l ���,�,-J f '�- , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
******************
Plans Examiner
Structural Review
4/4er-/ L-r
CATHERINE A, DUFFIN
Notary Public - Stab:: of Florida
Comrnlsslnn 6 GC 104296
' (s+f*,t3Ip if,”*j, 2 P**
N r; ,01;I,:,N;;iwThor iaryAssn.
****************
Zoning
Clerk
(Revised02/24/2014)
rev IB -\144-
270
Connectors for Cola -Formed Steel Construction
LTA2, S/HGAM10 and H1OS Seismic and Hurricane Ties
The LTA2 develops high uplift at a minimum heel height.
Great in areas where a strap over the heel is not required.
The side tab acts as a locator in the masonry block and the
four embedded hooks provide for a positive bond in the
concrete grout.
The H1OS and the S/HGAM10 attach to
and provides good uplift resistance
Material: See table
Finish: Galvanized
Installation:
• Use all specified fasteners; see Gene
• S/HGAM10 can be installed into grout
• Tden° 2 screws are provided
r„ ^�
• Hurricane ties do not replace solid blocking 8
• Attach to grouted concrete block with a minimum
one #5 rebar horizontal in the top 'lintel block
Codes: See p. 11 for Code Reference,Key.Chart-
tv 12f711 S1C r' VII 1age
' LTA2
BY U.S. atent 6,56p,9443
Ordering Information: ZONING D E PT
• The HGAM10KT is a kit of (10) connectors with--
(40)1/4" x 23/4" Titen 2 screws. 1 El D G D EII' T
1.0 C(,P,IPLIFNCE
✓I H ALL
SIMPSON
Strong=Tie
Typical LTA2 Instj&tidrf .
(perpendicular to wan), •
•• • ••••
• • •
•. •
CO Rangesfacem •
•
tin. edge distanra=114"
Model No.
Connector
Material
Thickness
mil (ga.)
STATE ANFastdnerS11Y ril✓L_': AND i
LAllow le �P . IlftLoad(ib.)
� ,
Code
Ref.
To Rafter/
Truss'
To
CMU
To
Concrete
33 mil
(20 ga.)
43 mil
(18 ga.
LTA2
perpendicular -to-
wall installation
43 (18)
(10) #10
Embed
Embed
1,295
o 1,425
170
LTA2
parallel -to -wall
installation
43 (18)
(10) #10
Embed
Embed
1,295
. 1,390
S/HGAM1OKT
68 (14)
(4) #14
(4) Y4" x 234" Titen 2
(4)1/4" x 134" Titen 2
810
850
IP1,
L2,
FL
H1OS
43 (18)
(8) #10
(2) W x 4" Titen HD
(2) 3'a" x 4" Titen HD ,
915 "
1,245
1. Min. f'm = 1,500 psi and fc = 2,500 psi.
2. Minimum edge distance is 11/2" for Titen• 2 screws.
3. The products shall be installed such that the Then 2 screws and Idea HD° anchors
are not exposed to the weather
4. See p. 204 for Titen 2 screw information and p. 189 for Titen HD information.
5. See pp. 138 through 171 for more information on Simpson Strong -Tie fasteners.
S/HGAM1 0
Moisture barrier
not shown
#5 rebar
• •
•
%Veal LTA2 Installation
(parallel to ft % • . •
•
#5 rebar
• min.
H1OS
H1 OS Installation
•
••
•
•
•
•
• •
•
••
•
•
•
C-CF-2017 02017 SIMPSON STRONG -TIE COMPANY INC.
•
6/25/2018
Florida Building Code Online
P.OPFOA OF •AAT FGNT OF
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Product Approval
USER: Public User
Product Agproval Menu > product or Agpllcation Search > 9gplIcation List > Application Detail
FL #
Application Type
Code Version
Application Status
Comments
Archived
Product Manufacturer
Address/Phone/Email
FL11473-R4
Revision
2017
Approved
1.1
Simpson Strong -Tie Co.
2221 Country Lane
McKinney, TX 75070
(800) 999-5099 Ext 3027
kcullum@strongtie.com
Authorized Signature Keith Cullum
kcullum@strongtie.com
Technical Representative Keith Cullum
Address/Phone/Email 2221 Country Lane
McKinney, TX 75069
(800) 999-5099 Ext 3027
kcullum@strongtie.com
Quality Assurance Representative Shelby Short
Address/Phone/Email
Category
Subcategory
Compliance Method
5956 W. Las Positas Boulevard
Pleasanton, CA 94588
(800) 999-5099
sshort@strongtie.com
Structural Components
Wood Connectors
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Evaluation Report from a Florida Registered Architect or a Licensed Florida
Professional Engineer
0 Evaluation Report - Hardcopy Received
Florida Engineer or Architect Name who developed the Jeffrey P. Arneson
Evaluation Report
Florida License PE-58544
Quality Assurance Entity Benchmark Holdings, L.L.C.
Quality Assurance Contract Expiration Date 12/31/2018
Validated By Ted Berman, PE
fit Validation Checklist - Hardcopy Received
Certificate of Independence FL11473 R4 COI Arneson Cert of Independence 2017-10-06.0f
Referenced Standard and Year (of Standard)
Equivalence of Product Standards
Certified By
Standard Year
AISI S100 2012
ANSI/AWC NDS 2015
ASTM D7147 2005
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Sections from the Code
Florida Building Code Online
Product Approval Method
Date Submitted
Date Validated
Date Pending FBC Approval
Date Approved
Summary of Products
Method 1 Option D
10/06/2017
10/20/2017
10/20/2017
12/12/2017
FL #
Model, Number or Name
Description
11473.1
DETAL20
Limits of Use
Approved for use in HVHZ: Yes
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
Other:
Double Embedded Truss Anchor • •
Installation Instructions • • • • • • • •
FL11473 R4 II SIM20174, Med 201711.0, i9.adf
Verified By: Keith Cullum, P.E.•76846 (CA) •
Created by Independent AIM May: Yes
Evaluation Reports • • • • • • •
FL11473 R4 AE SIM201i0.1 •Soared 2011-10.15 ggif
Created by Independent W4 early: Yes • • • •
11473.2
FGTR, FGTRHL, FGTRHR
Girder Retrofit Anchor
•. .. •
• • w II •
•
•
•
•
•
•
•
•
•
•
•
Limits of Use
Approved for use in HVHZ: Yes
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
Other:
Installation Instructionsi • • : • •
FL11473 R4 II SIM2017 Se _d 2017- b'.1�1�%.odf
Verified By: Keith Cullum, P.E. 96846 (CA) • • •
Created by Independent Thud Party: Yes • • •
Evaluation Reports
•• •
FL11473 R4 AE SIM201701 Sealed 2017-10-19.pdf
Created by Independent Third Party: Yes
•
•
•
•
.
•
11473.3
HETA12, HETA16, HETA20, HETA24,
HETA40
Embedded Truss Anchor
Limits of Use
Approved for use in HVHZ: Yes
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
Other:
FL31473 R4 II SIM201701 Sealed 2017 10 19.pdf
Verified By: Keith Cullum, P.E. 76846 (CA)
Created by Independent Third Party: Yes
Evaluation Reports
FL11473 R4 AE SIM201701 Sealed 2017-10-19.pdf
Created by Independent Third Party: Yes
11473.4 HETAL12, HETAL16, HETAL20
Embedded Truss Anchor
Limits of Use
Approved for use in HVHZ: Yes
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
Other:
Installation Instructions
FL11473 R4 II SIM201701 Sealed 2017-10-19.pdf
Verified By: Keith Cullum, P.E. 76846 (CA)
Created by Independent Third Party: Yes
Evaluation Reports
FL11473 R4 AE SIM201701 Sealed 2017-10-19.p1
Created by Independent Third Party: Yes
11473.5
HGAM10, HM9
Masonry retrofit connector
Limits of Use
Approved for use in HVHZ: Yes
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
Other: Multiple/additional connectors required to achieve 700
Ibs uplift in HVHZ when using HGAM10 to anchor SPF
truss/rafter to wall.
Installation Instructions
FL11473 R4 II SIM201701 Sealed 2017-10-19.pf
Verified By: Keith Cullum, P.E. 76846 (CA)
Created by Independent Third Party: Yes
Evaluation Reports
FL11473 R4 AE SIM201701 Sealed 2017 10 19.p�
Created by Independent Third Party: Yes
11473.6
HHETA16, HHETA20, HHETA24,
HHETA40
Heavy Embedded Truss Anchor
Limits of Use
Approved for use in HVHZ: Yes
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
Other:
Installation Instructions
FL11473 R4 II SIM201701 Sealed 2017-10-19.pdf
Verified By: Keith Cullum, P.E. 76846 (CA)
Created by Independent Third Party: Yes
Evaluation Reports
FL11473 R4 AE SIM201701 Sealed 2017-10-19.pdf
Created by Independent Third Party: Yes
11473.7
LGT2, LGT3-SDS2.5, LGT4-SDS3
Girder Tiedown
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2/3
6/25/2018 Florida Building Code Online
Limits of Use
Approved for use in HVHZ: Yes
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
Other:
Installation Instructions
FL11473 R4 II SIM201701 Sealed 2017-10-19.p f
Verified By: Keith Cullum, P.E. 76846 (CA)
Created by Independent Third Party: Yes
Evaluation Reports
FL11473 R4 AE SIM201701 Sealed 2017-10-19.p�[
Created by Independent Third Party: Yes
11473.8
LTA2
Lateral Truss Anchor
Limits of Use
Approved for use in HVHZ: Yes
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
Other:
Installation Instructions
FL11473 R4 II SIM201701 Sealed 2017-10-19.Df
Verified By: Keith Cullum, P.E. 76846 (CA)
Created by Independent Third Party: Yes
Evaluation Reports
FL11473 R4 AE SIM201701 Sealed 2017-10-19 R f
Created by Independent Third Party: Yes
11473.9
META12, META16, META18, META20,
META22, META24, META40
Embedded Truss Anchor ••••
• •
• • ••••
Limits of Use
Approved for use in HVHZ: Yes
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
Other:
Installation Instructions • • • • ••••
FL11473 R4 II SIM201721 gaj d 2017=1,(- 9.bdf
• •
•
•
•
•
Verified By: Keith Cullum, P. •76846 (CA)
Created by Independent 111fi•111 y: Yes •
Evaluation Reports •••• • • •
FL11473 R4 AE SIM20011Seafed 2011-10.1 pdf
Created by Independent T Yes • • • •
• • • • •
11473.10
MGT, VGT, VGTL, VGTR
•• •• •• •
Girder Tiedown •••
•••••
•
Limits of Use
Approved for use in HVHZ: Yes
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
Other:
Installation Instructions • • • •
FL11473 R4 II SIM2017(11 Sealed 2017---1 '- iidf
•
•
•
Verified By: Keith Cullum,4P.E.•Q6846 (CA)•• .
Created by Independent Thdd Party: Yes • • •
Evaluation Reports • • •
FL11473 R4 AE SIM2017o1 Sealed 2017-10-19.Rdf
Created by Independent Third Party: Yes
11473.11
MSTAM24, MSTAM36, MSTCM40,
MSTCM60
Strap Tie for Masonry
Limits of Use
Approved for use in HVHZ: Yes
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
Other:
Installation Instructions
FL11473 R4 II SIM201701 Sealed 2017-10-19.pdf
Verified By: Keith Cullum, P.E. 76846 (CA)
Created by Independent Third Party: Yes
Evaluation Reports
FL11473 R4 AE SIM201701 Sealed 2017-10-19.pdf
Created by Independent Third Party: Yes
11473.12
MTSM16, MTSM20, HTSM16, HTSM20
Twist Strap for Masonry
Limits of Use
Approved for use in HVHZ: Yes
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
Other:
Installation Instructions
FL11473 R4 II SIM201701 Sealed 2017-10-19.pdf
Verified By: Keith Cullum, P.E. 76846 (CA)
Created by Independent Third Party: Yes
Evaluation Reports
FL11473 R4 AE SIM201701 Sealed 2017-10-19.p�1f
Created by Independent Third Party: Yes
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Contact Uk :: 2601 Blair Stone Road Tallahassee FL 32399 Phone: 850-487-1824
The State of Florida is an AA/EEO employer. coyyht 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 e-mail address released in response to a public -records request, do not send electronic
mail 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 dick here .
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