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1997 Re-roofOwner l c PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY Date- & p 20 .4'7 Job Address 9 NE 9\ Ikv-v- cQ at cAics FI. 3� Legal Description Contracting Co. Owner's Address / L 2- /Y 6 5'/ i e/i2 - 6 - -"e/re1 7 °° Qualifier MAa✓C/ / , Gt�C2 SS# Phone S - 1-7 State # G� 6 �o 9-6 0 Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Typ.: ROOFIN BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING Application is hereby made for a permit to do separate permits are required for Electrical, WORK DESCRIPTION - /L / /6 G //'" Square Ft. WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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 THE NOTICE. A BACKFLOW PREVENTION DEVICE PERMIT AND CERTIFICATION TEST MAY BE REQUIRED IN ACCORDANCE WITH ORDINANCE #825. CALL THE PUBLIC WORKS DEPT. AT 787 -1001 OR VISIT THEIR OFFICE AT 1815 N.E. 150 ST. QIIt€R'S AFFIDAVIT: 1 certify that all the foregoing Inforiatlon is accurate, and arl ex* w II be done In compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize ignatu.l of Property Owner or Condo Pres. ADMINISTERED OATH ❑ SWORN TO & .u;SCRIBED BEFORE ME THIS DA Le'' 19 Signature of NOT My My Comm. Expires Jan 5, 1 9 V No. CC431861 (Print, Type, or Stamp Commissioned Name) Personally Known ❑ or Produced I.D. ❑ Type of I.D. produced Zoning Mechanical FEE Competency # Building Plumbing Tenant Address S g Master Permit # /V% Tax Folio Day -Time Phone 7 r U Z Z 3 5 ' 27Y0 7 Ins. C work & installation as indicated. I understand that Plumbing, Signs, Pools, Roofing, & Mechanical work. Estimated Cost a.tt re of Contractor FENCE SIGN the work stated. ADMINISTERED OATH ❑ SWORN TO & Sjv BEFORE ME THIS DAY A s Signature of NOTARY t Con tractor ssetl L. Van � aush Notary Public, State o2 r utrl {!;} Wilt Comm. Expires Jan 5, 13e.� No. CC431R81 (Print, Type, or Stamp Commissioned Name) Personally Known ❑ or Produced I.D. Type of I.D. produced Electrical Engineering Contractor's Name: p/. Appendix "E" UNIFORM ROOFING PERMIT APPLICA.TIO.N PROCESS No. OW Job Address: 90 A t' fil;: ROOF CATEGORY (Low Slope Application) ❑ (Nail -On Tile)' (Mortar - Adhesive Set Tile) ❑ (Asphalt/Fiberglass Shingles) ❑ ( Metal Roofs\Wood Shingles & Shakes) ❑ (Other) ROOF TYPE ❑ New Roof Pi Re- roofing ❑ Recovering ❑ Repair 0 Maintenance Flat Roof Area (ft) / 2 - 15 - 1) Sloped Roof Area (ft') / 5 Total (ft') 71 . Mastcr Permit No. Exposure category (per ASCE 7 - 88): Building Classiti a category (per ASCE 7 -88 table 1): ►1 Ft. Ft. 123 01-76 9/96 ROOF HEIGHT AND SYSTEM DETAILS , �✓ � } ,t 7 (Draw details as needed) � t t il � L /(0" H` o t q � i1 L� Zi �y � 9 ��c � p D I ' . � � �a aO t1 "+ ' i ROOF PLAN , Uf ��, 0 h Deck type: W(II L' 2 €7 /€460 4: b 0.490 ji b ojit ON fee A'fT CH(r1ENT Fastener Type: I" e/4-IL SFAt7ILVt Field; 1 Perimeter: to Corner :a DETAIL 1 & 2 Page- 1 — 1 ' 1 1 , 1 1 1 1 1 0 Ridge V rulotion7 �ba 1 MEAN HEIGHT Deck type: j UnderlayInent: '3 0 �{ 4LA A 4 (4 l l L `� I ) Insulation: �.'� 13. , t � X 7-6 3- b Woo 1 1) . r -C 13 E T I L o 13""T Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. 'l \ \5 .� ✓ � v i,c° r � P y o ‘ i/k \Ytt A /t ROOT SLOP! 3 (Pmaxl: )c -3 x (Aerodynamic Multiplier): (Pmax2: /D ( X ?4. (Aerodynamio Multiplie (Pmax3: X (Aerodynamic Multiplier): ,LOPED SYSTEM DES'CR1PJ'JQN Fastener type & spacing: lye s Pe4iL.5 6 "o,c 2 1, € ) , c , C 1 ;1 1 / 2 -44 Aiorskio /� Qe�t ra ;'ta b ! 2 "� C Cap Sheet: � � Roofiovbring: 1� 'L_ , /e � -rct • y l TILE CALCULATIONS :�.3� =Met: /y�t PCA: X6.,6/ Q ) - M = M Z Z" ' PCA: -P4 ' , / •'�/g M 4d = M Zt? ±LgPCA: 86 Page -2 P Drip edge: zi ( 4 / z4 G Qa 9 , 12 -C ATTACHMENTS REQUIRED 1) Firc Directory Listing Page 2) Dade County Product Control Notice of Acceptance -Cover Sheet a) Specific System Description b) Specific System Limitation c) General Limitations d) Applicable Detail Drawings 3) Municipal Permit Application 4) Other Component Approvals G ling" at 1 -1/2 od fiber, glass , osite, perlite/ phenolic, any 4' or "GAFGLAS in any of the ibrane Systems f the following wing noncom - e used in any the following , loose laid or ed system. 1000 Lbs /sq. d fiber, glass - , site, perlite/ phenolic, any 'r G3. h or granule); granule) or ;dicoat of hot 2 or G3. or granule), granule) or fiber, glass or G3. or granule), or "Ruberoid te, urethane, Le, phenolic, or granule), r granule) or or G3. or granule), cq or Grundy '4 in. min, to /urethane or G3. or granule), granule) or ROOF COVERING MATERIALS (TEVT) ROOFING SYSTEMS (TGFU) — Continued Insulation (Optional): One or more layers perlite, wood fiber, glass fiber, isocyanurate, urethane, perlite /isocyanurate composite, perlite/ urethane composite, wood fiber /isocyanurate composite, phenolic. Base Sheet Two or more layers of Type G2 or G3. Ply Sheet (Optional): One or more layers of Type G1. Membrane: One or more layers of "Ruberoid Torch" (smooth or granule), "Ruberoid Torch Plus" (granule), "Ruberoid Mop" (smooth or granule) or "Ruberoid Mop Plus" (granule). Surfacing: Karnak No. 97, 1 - 1/2 - 3 gal /sq or gravel. 8: Deck: NC Incline: 1/2 Insulation: One or more layers perlite, glass fiber, 3/4 in. min, isocyanurate, urethane, perlite /isocyanurate composite, perlite /urethane composite, phenolic, 1 -1/2 in. min. • Base Sheet (Optional): One or more layers of Type G1, G2 or G3. . Membrane: One or more layers of "Ruberoid Torch" (smooth or granule), "Ruberoid Torch Plus" (granule), "Ruberoid Mop" (smooth or granule) or "Ruberoid Mop Plus" (granule). Surfacing: "AL MB Aluminum Roof Coating" at 1 -2 gal /sq. • Deck: C -15/32 Incline: 1/2 Insulation (Optional): One or more layers perlite, glass fiber, 3/4 in. min, isocyanurate, urethane, perlite /isocyanurate composite, perlite/ urethane composite, phenolic, 1 -1/2 in. min. Base Sheet: One or more layers of Type G2 "GAFGLAS #75 Base Sheet ", hot mopped or mechanically fastened in place. Ply Sheet One or more layers of Type 61 "GAFGLAS Ply 4 ", hot mopped in place. (Membrane: "Ruberoid Mop FR" (granule). Surfacing (Optional): GAF Fibered Aluminum Coating at 1 -1/2 gal /sq or GAF Weather Coat Emulsion at 3 gal /sq. 10. Deck: C -15/32 Incline: 1/2 Insulation (Optional): One or more layers perlite, glass fiber, 3/4 in. min, isocyanurate, urethane, perlite /isocyanurate composite, perlite/ urethane composite, phenolic, 1 -1/2 in. min. Base Sheet: One or more layers of Type G2 "GAFGLAS #75 Base Sheet ", hot mopped or mechanically fastened in place. Ply Sheet: One or more layers of Type 61 "GAFGLAS Ply 4 ", or "GAFGLAS Ply 6" hot mopped in place. " Membrane: "Ruberoid Torch FR" (granule). Surfadng (Optional): GAF Fibered Aluminum Coating at 1 -1/2 gal /sq or GAF Weather Coat Emulsion at 3 gal /sq. 11. Deck C - 15/32 Incline: 1/2 Insulation: Isocyanurate, 2 in. min., wood fiber, perlite or glass fiber, any thickness, hot mopped or mechanically fastened in place. Joints offset 6 in. Base Sheet: One or more layers of Type G2 "GAFGLAS #75 Base Sheet ", hot mopped or mechanically fastened in place. Ply Sheet (Optional): One or more layers of Type 61 "GAFGLAS Ply 4" or "Ply 6" hot mopped in place. Membrane: "Ruberoid Torch FR" (granule). Surfacing (Optional): GitiF Fibered Aluminum Coating at 1 -1/2 gal /sq or GAF Weather Coat Emulsion at 3 gal /sq. 12.'Deck: C -15/32 Incline: 1/2 Insulation (Optional): Isocyanurate, perlite or glass fiber, any thickness, hot mopped or mechanically fastened in place. Joints offset 6 in. Base Sheet: One or more layers of Type G2 "GAFGLAS #75 Base Sheet ", hot mopped or mechanically fastened in place. Ply Sheet: One or more layers of Type 61 "GAFGLAS Ply 4" or "Ply 6", hot mopped in place. Membrane: "Ruberoid Torch FR" (granule). Surfacing (Optional): GAF Fibered Aluminum Coating at 1 -1/2 gal /sq or GAF Weather Coat Emulsion at 3 gal /sq. 14. Deck: NC Incline: 1/2 Insulation (Optional): Isocyanurate, wood fiber board, perlite, glass fiber, any thickness, hot mopped or mechanically fastened in place. Joints offset 6 in. Base Sheet: One or more layers of Type G2 "GAFGLAS #75 Base Sheet ", hot mopped in place. Ply Sheet (Optional): One or more layers of Type G1 "GAFGLAS Ply 4" or "Ply 6" hot mopped in place. Membrane: "Ruberoid Torch FR" (granule). Surfacing (Optional): "GAF Fibered Aluminum Coating" at 1 -1/2 gal /sq or GAF Weather Coat Emulsion at 3 gal /sq. 14. Deck: NC Incline: 1/2 Insulation (Optional): Isocyanurate, wood fiber board, perlite, glass fiber, any thickness, hot mopped or mechanically fastened in place. Joints offset 6 in. Base Sheet: One or more layers of "GAFGLAS #75 Base Sheet ", hot mopped in place. Ply Sheet (Optional): One or more layers of "GAF GLAS Ply 4" or "Ply 6" hot mopped in place. Membrane: "Ruberoid Torch FR" (granule). Surfacing (Optional): GAF Weather Coat Emulsion applied at 3 gal /sq or LOOK FOR MARK ON PRODUCT ROOF COVERING MATERIALS (TEVT) 13 ROOFING SYSTEMS (TGFU) — Continued GAF Fibered Aluminum Coating at 1 -1/2 gal /sq. 15. Deck: C -15/32 Incline: 1/2 Insulation (Optional): Perlite, fiber glass, isocyanurate, urethane, perlite isocyanurate composite or phenolic. Base Sheet: One or more layers Type G2 or G3 base sheet, hot moppe. or mechanically fastened. • Ply Sheet (Optional): One or more layers Type G1, hot mopped in place Membrane: "Ruberoid Mop FR" or "Ruberoid Mop 170 FR" (granule). 16. Deck: C -15/32 Incline: 1/2 Insulation (Optional): Perlite, fiber glass, isocyanurate, urethane, perlite isocyanurate composite or phenolic, offset 6 in. from joints. Base Sheet: One or more layers of Type G -2 or G -3 base sheet, ho mopped or mechanically fastened. Ply Sheet (Optional): One or more layers of Type G -1, hot mopped place. Membrane: One layer of "Ruberoid Torch" or "Ruberoid Mop" (smooth) Membrane: One layer of "Ruberoid Torch FR" or "Ruberoid Mop FR (granule) 17. Deck: NC Incline: 1 Insulation (Optional): Perlite, fiber glass, wood fiber, isocyanurate urethane, perlite /isocyanurate composite or phenolic. Base Sheet: One or more layers Type G2 or G3 base sheet, hot moppe, or mechanically fastened. Ply Sheet (Optional): One or more layers Type 61, hot mopped in place Membrane: One layer of "Ruberoid Mop FR" or "Ruberoid Mop 170 FR (granule). 18. Deck: NC Incline: 1/2 Insulation (Optional): Perlite, fiber glass, wood fiber, isocyanurate urethane, perlite /isocyanurate composite or phenolic. Base Sheet (Optional): One or more layers of Type G -2 or G -3 bas, sheet, hot mopped or mechanically fastened. Ply Sheet (Optional): One or more layers of Type G -1, hot mopped ii place. Membrane: One layer of "Ruberoid Torch" (smooth), "Ruberoid Mop (smooth). Membrane: One layer of "Ruberoid Torch FR" (granule). 19. Deck: NC Incline: 1/2 Insulation (Optional): One or more layers of perlite, glass fibei isocyanurate, urethane, perlite/isocyanurate composite or phenolic, an thickness. Base Sheet: One or more plies 61 or G2, hot mopped or adhered witf Karnak Chemical Co. "No. 81" or Gibson -Homan "No. 6160" cold appliec adhesive at 1 -1/2 gal /sq. Membrane: One layer of "Ruberoid Mop FR" or "Ruberoid Mop 170 FR (granule), hot mopped or adhered with Karnak Chemical Co. "No. 81" o Gibson -Homan "No. 6160" cold applied adhesive at 1 -1/2 gal /sq. 20. Deck: C -15/32 Incline: 1/4 Insulation: Polyisocyanurate, any thickness. Base Sheet: "GAFGLAS #75 " (Type G2), mechanically attached. Membrane: One or more plies of "Rubberoid Torch (smooth). Membrane: "Ruberoid Torch FR" (granule). 21. Deck: C -15/32 Incline: 1/2 Insulation (Optional): Polyisocyanurate, wood fiber, perlite, glass fibe any thickness, hot mopped or mechanically fastened. Base Sheet: One or more plies of Type G2 "GAFGLAS #75" or "Ruberoid 2C FR" base sheets, hot mopped or mechanically fastened. Membrane: One or more plies of "Ruberoid 30 FR" hot mopped in place 22. Deck: C - 15/32 Incline: 1 Insulation (Optional): Polyisocyanurate, wood fiber, perlite, or glass fiber any thickness, hot mopped or mechanically fastened. Base Sheet: One or more plies of Type G2 "GAFGLAS #75" hot mopped oi mechanically fastened. Ply Sheet One or more plies of "Ruberoid 20" or "Ruberoid 20 FR ", hot mopped in place. Membrane: One or more plies of "Ruberoid 30 FR ", hot mopped in place Class B - Fully Adhered 1. Deck: C -15/32 Incline: 1/2 Insulation (Optional): One or more layers perlite, wood fiber, glas fiber, isocyanurate, urethane, perlite/isocyanurate composite, perlite, urethane composite, wood fiber/isocyanurate composite, phenolic, an thickness. Base Sheet: Two or more layers of GAF G -1, G -2 or G -3 base sheet, hot mopped or mechanically fastened in place. Membrane: One or more layers of "Ruberoid Torch" (smooth or granule) "Ruberoid Torch Plus (granule), "Ruberoid Mop" (smooth or granule) ot "Ruberoid Mop Plus" (granule). Surfacing: Karnak No. 97 applied at nom 1 -1/2 gal /sq. 2. Deck: C -15/32 Incline: 1/2 Insulation (Optional): One or more layers perlite, wood fiber, glass fiber, isocyanurate, urethane, perlite/isocyanurate composite, perlite- urethane composite, wood fiber/isocyanurate composite, phenolic, any thickness. ® D e b 1 � Otand N- 1- 2- 20 /30FRt RUBEROID Specifications N -1 -2 -20/3 FRt 2" Min Side Lap Naltahle Deck Sheathing Paper (11 required) Base Sheet RUBERDID 20 Steep Asphalt ASTM Type 01 or IV 4" Min Me Lap RUBEROID 90 or 90 FR Substrate — Nailable decks including wood, plywood, structural wood fiber, acceptable precast nailable decks, poured gypsum, lightweight insulating concrete (LWIC)- see 'Lightweight Insulating Concrete Decks' page 10. Slope —Up to 1 inch per foot for light weight insulating concrete; up to 3 inches per foot for other decks Materials Base Sheet GAF Materials Corporation Steep Roofing Asphalt ASTM D -312 Type III or IV RUBEROID 20 RUBEROID 30.or 30FR Approximate Weight Per Square Total 215 -275 lbs. 1 These specifications can be applied using RUBEROID Modified Bitumen Adhesive. References to cold applied installations require the specification designation to be followed by a "(CA)" to indicate that it is to be cold applied. UL Approvals for cold applied constructions are pending. Contact GAF MC Technical Services for current status. General Design and Application Considerations detailed in this Manual shall apply in addition to the following recommendations and specifications. Application Recommendations 1. Starting at the low point of the roof, install one ply of a GAF Materials Corporation base sheet. Acceptable base sheets include RUBEROID Modified Base Sheet or GAFGLAS #75 Base Sheet, STRATAVENT Nailable, Ply 4 sheet and Ply 6. If GAFGLAS Ply 4 or Ply 6 are to be used as a base sheet, a sheet of sheathing paper must first be installed with minimum 2 inch side laps and 6 inch end laps to prevent any bleed through attachment. Whichever base sheet is used, it must be installed with 2 inch side laps and 6 inch end laps. Note: On newly poured lightweight insulating concrete or gypsum decks, a mechanically attached STRATAVENT Nailable is required. This base sheet must be nailed along the 2 inch side laps on 9 inch centers and nailed in the field of sheet in two rows, on staggered 18 inch centers. Use fasteners with integral metal heads at least 1 inch in diameter or square that are recommended by GAF Materials Corporation or the deck manufacturer. See' Nailing of Base Sheet" on page 20. 2. At the low point of the roof, and starting with a half width roll (approx. 19 inches), install one ply of RUBEROID 20 in a continuous mopping of Steep Roofing Asphalt ASTM D -312 Type III or IV, applied at the rate of 25 lbs. ± 20% per 100 square feet of roof area. The RUBEROID 20 sheet must be posi- tioned to provide 4 inch side laps and 6 inch end laps. 3. Again, at the low point of the roof, and starting with a full roll, install one ply of RUBEROID 30 in a continuous mopping of Steep Roofing Asphalt ASTM D -312 Type III or IV, applied at the rate of 25 lbs. ± 20 per 100 square feet of roof area. The RUBEROID 30 sheet must be positioned to provide 4 inch side laps and 6 inch end laps. For more extensive UL Classifications, see page 6. UL Chart Key 1. Substrate C = Combustible and noncombustible substrates Combustible = Wood planks, boards, etc., plywood (min. 15 /12 inch thickness),oriented strand board (min. 1 /2 inch thickness). NC = Noncombustible only Noncombustible = Steel, structural and precast concrete,lightweight insulating concrete, gypsum, structural wood fiber, etc. 2. Slope Maximum slope allowed, in inches per foot of rise. Guarantees Available __Specification RUBEROID Liberty_ RUBEROID N -1 -2 -20/30 10 10 N -1 -2 -20/30 FR 10 10 OAF MAMMALS CORPORATION Note: Steep Asphalt should be mopped at a minimum temperature of 400° F (with a target temperature of 425° F) or 20° F above the EVT, whichever is higher. Walk or press the seam to provide for '/4 inch asphalt flow out to assure sound laps. RUBEROID FR UL Classification UL Class Substrate Slope Specification A C 1' N -1 -2 -20/30 FR i 53 RUBEROID® Specification 1 -2- -MG, 1 -2 -1 -MSG and 1 -2 -1 -MGFR Substrate —Decks insulated with GAFTEMP° Isotherm, Composite or PERMALITE°. See "Application Recommendation #3." Slope —Up to 3 inches per foot. Materials GAF Materials Corporation Asphalt/Concrete Primer (when applicable) GAFTEMP Insulation GAFTITE° Fasteners (if required) GAF Materials Corporation Steep Roofing Asphalt ASTM D-312 Type III or IV GAFGLAS° Ply 4 or PLY 6° (2 plies) , + RUBEROID MOP or MOP 170FR : Approximate. Weight Per Square Total: 195 - 215 lbs.' *Plus weight of insulation, fasteners, pour coat and gravel. General Design and Application Considerations detailed in this Manual shall apply in addition to the following recommendations and specifications. Application Recommendations 1. On structural concrete decks, insulation may be secured with Steep Roofing Asphalt ASTM D -312 Type III or IV or the GAFTITE Fastening System. If Steep Roofing Asphalt is to be used, the concrete deck must be primed with Asphalt/Concrete Primer at a rate of 1 -2 gallons per 100 square feet and allowed to dry. 2. For steel decks, insulation must be mechanically attached throughout the entire roof area using GAFTITE Fasteners and Plates. See 'Suggested Insulation Fastener Patterns', page 8, or the current GAFTEMP Catalog and Factory Mutual Loss Prevention Data Sheet 1 - 28 for attachment patterns. 3. Starting at the low point of the roof, apply two plies of GAFGLAS Ply shingle fashion; lapping each sheet 20 /5 inches over the preceding sheet; solidly mop- ping to the GAFTEMP PERMALITE° or Composite Insulation in a solid mopping of Steep Roofing Asphalt ASTM D -312 Type III or IV, applied at the rate of 25 pounds per square, plus or minus 20 %. Over DAFT MP Isotherm. an overlay of GAFTEMP Permalite or Composite (Perlite side up) Insulation is required prior to the attachment of the GAFGLAS Ply felt, 4. Starting at the low point of the roof, embed a sheet of RUBEROID Membrane in a solid mopping of Steep Roofing Asphalt ASTM D-312 Type III or IV applied at the rate of 25 pounds (plus or minus 20 %) per 100 square feet. Apply subsequent sheets of RUBEROID MOP (Granule) providing for 4 inch side laps and 6 inch end laps. Note: The Steep Roofing Asphalt should be mopped at a minimum temper- ature of 400° F (with a target temperature of 425° F) or 20° F above the EVT, ,I:Y lYpffXf1� OAF 11/31ERIALS CORPORATION whichever is higher. Walking or pressing the seam and providing for 1 /4 inch to %7 inch asphalt flow -out should be done to assure sound laps. 5. For specification I -2 -1 -MSG, a surfacing of a pour coat and gravel is required. On slopes up to 3 inches per foot, the top pouring must be GAF MC Steep Roofing Asphalt (ASTM D312, Type III or IV). Over the entire surface, apply a uniform coating of Asphalt at the nominal rate of 60 pounds per 100 square feet. While still hot, apply not less than 400 pounds of gravel or 300 pounds of slag per 100 square feet. In the North and South Zones only, on slopes up to 1/2 inch per foot, a top pouring of GAF MC Flat Roofing Asphalt (ASTM D312, Type II) may be used. RUBEROID FR UL Classifications UL Class Substrate Slope Insulation Specification A C X" 3C I -2 -1 -MGFR A NC 1" 30 I -2 -1 -MGFR For more extensive UL Classifications, see page 6. UL Chart Key 1. Substrate C = Combustible and Noncombustible Combustible = Wood planks, boards, etc., plywood (min. "/32 inch thick- ness), oriented strand board (min. 72 inch thickness). NC = Noncombustible only Noncombustible = Steel, poured or precast structural concrete, lightweight insulating concrete, gypsum, structural wood fiberboard, etc. 2. Slope Maximum slope allowed, in inches per foot 3. Insulation 3C = GAFTEMP Isotherm, and Permalite, any thickness. 3D = GAFTEMP Isotherm, Regular and High Density Fiberboard, PERMALITE and Composite Board, any thickness When constructed using premium PLY 6 felts, this specification meets the demanding requirements of a GAF CompositeRoof system. Guarantees Available Specification RUBEROID Liberty RUBEROID I 2 - 1 - MG, I - 2 - 1 - MGFR 15, 12, 10, 5 12, 10 I - 2 - 1 - MSG 15,12,10, 5 12, 10 41 FLORIDA ME17100ADE METfIOp M ETnO N D DE LtGLER COUNTY, GAF Materials Corporation 1361 Alps Road Wayne, NJ 07470 DUILDINO CODE COMPLIANCE DEPARTMENT SUITE 1603 METRO•DADE FLAOLER BUILDING 140 WEST FLAOLER STREET MIAMI, FLORIDA 33130.1563 (306) 376.2001 PRODUCT CONTROL. NOTII'F OF ACCEPTANCE FAX (706) 376.2006 Your application for Product Approval of GAF Materials Corporation Modified Bitumen Roof Systems under Chapter 8 of the Metropolitan Dade County Code governing the use of Alternate Materials and types of Construction, and completely described in the plans, specifications and calculations as submitted by Construction Research Laboratory, Inc., Factory Mutual Research Corporation, South Florida Test Service, Underwriters Laboratories, Inc. and Dynatech Engineering, Inc. has been recommended for acceptance by the Building Code Compliance Department to be used in Dade County, Florida under the specific and standard conditions set forth herein. The approval shall be valid for a period of three years. The Building Code Compliance Department reserves the right to secure a product or Material at any time for a jobsite or manufacturer plant for quality control testing. If product or material fail to perform in the approved manner, the Code Compliance Department may revoke, modify or suspend the use of such product or material immediately. The Building Code Compliance Department reserves the right to require testing of this product or material should any amendments to the South Florida Building Code be enacted affecting this product or material. The expense of such testing will be incurred by the Manufacturer. PRODUCT NO. : ACCEPTANCE NO.: 95-0330.06 EXPLRES: NOV 1 fl 1997 ul Rodriguez Product Control Division Supervisor - PLEASE NOTE - THIS IS THE COVERSHEET. SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS. BUILDING CODE COMMITTEE This application for Product Approval has been reviewed by the Metropolitan Dade County Building Code Compliance Department and approved by the Building Code Committee to be used in Dade Co lorida under the conditions set forth above. APPROVED: MAY O 4 1995 "' axles Danger, P.E., Director Building Code Compliance Department Metropolitan Dade County Applicant: GAF Materials Corporation 1361 Alps Road Wayne, NJ 07470 Category: Membrane Roofing System Sub- Catego Built -up Roofing Type Modified Bitumen Sub -Type; SBS, APP SYSTEMS PRODUCT CONTROL NOTICE OF ACCEPTANCE ROOFING SYSTEM APPROVAL System Description Product Control No.: 95- 0330.06 Approval Date: Expiration Date: MAY 0 4 1995 NOV 1 0 1997 GAF Materials Corporation has been manufacturing commercial roofing products for more than 100 years. GAF produces a wide range of roof products for built -up roofing systems. The modified bitumen products include both APP and SBS products in smooth, granule and fire rated versions. In addition, GAF offers two ply modified systems to meet the specification requirements for multilayer SBS modified specifications. GAF products are distributed through a wide network of roofing wholesale distributors throughout the South Florida area. GAF provides warranted systems over various insulated and non - insulated substrates, copies of which can be obtained from GAF and can be found in the Ruberoid Modified Bitumen Application and Specification manual published annually. GAF roof system assemblies have been extensively tested at Factory Mutual Research Corporation and Underwriters Laboratories. GAF modified bitumen membranes have been tested in compliance with ASTM D 5147 test requirements. r ■ Contact: William J. Woodring Director of Technical Services (201) 628 -3000 2 Product Control No.: 95- 0330.06 Test Agency Construction Research Laboratory, Inc. Factory Mutual Research Corporation South Florida Test Service Underwriters Laboratories, Inc. Dynatech Engineering, Inc. Test Identifier #4818 J.I. OT4A 1.AM J.I. 1 V7AO.AM J.I. 1 V8A4.AM J.I. 1R1A6.AM J.I. 0T2Q4.AM J.I. 0Q6A6.AM J.I. 2M0A4.AM J.I. 3X3A2.AM J.I. 0Y9Q5.AM J.I. 3X3A2.AM GAF -53 -X -915 R1306 3600.02.95 Test Reports 13 Test Name/Report Wind Uplift Wind Uplift Wind Uplift Wind Uplift Wind Uplift Wind Uplift Wind Uplift Wind Uplift Wind Uplift Wind Uplift Wind Uplift Physical Properties Fire Classification Wind Uplift, Small Scale Raul Rodriguez Product Control No.: 95 -0330.06 Datc 07/10/87 08/26/92 07/16/92 06/28/93 11/15/91 10/17/91 07/16/91 03/21/87 08/02/94 07/29/94 08/02/94 03/08/91 08/01/94 02/02/95 Membrane Type: Deck :Type 31: Deck Description: System Type A: All General and System Limitations apply. Insulation Base Lamm Approved Type(s): ACFoam - II Minimum: 1.75" x 4' x 4' N/A E'NRG'Y -1 Plus, E'NRG'Y -2 Plus Minimum: 1.5" x 3' x 4' N/A E'NRG'Y -2, PSI -25, ISO -95, GL, GW Composite Plus Minimum: 1.4" x 3' x 4' N/A Fiberglas Minimum: 15/16" x 4' x 4' N/A GAFTEMP® Isotherm R, Hy -Therm AP, Pyroz, White Line, UltraGard Gold Minimum: 1.3" x 4' x 4' N/A N/A N/A Gypsum Board Minimum: 'A" x 4' x 8' GAFTEMP® Composite, ACFoam Composite Minimum: 1.5" x 4' x 4' GAFTEMP® Permalite Minimum: 'A" x 2' x 4' Minimum: 1.2" x 4' x 4' SBS Concrete Decks, Insulated, New Construction 2500 psi structural concrete or concrete plank One or more layers of insulation adhered with approved asphalt. Fastener alyFg N/A N/A Thermal Hy -Tec, Hy -Tec 2, Energy Lok Fastening Fasteners Detail No, Per Board N/A N/A N/A N/A 64 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Product Control No.: 95- 0330.06 Fastener Density N/A N/A N/A 46416 Raul Rodriguez N/A N/A N/A N/A N/A N/A N/A N/A Insulation Fastener Fastening Fasteners Base Layer 1XD.0 Detail No, Per Board Thermax TRI -STAR, Hytherm Premier, ACFoam -I Minimum: 1.2" x 3' x 4' N/A N/A N/A N/A Insulation Fastener Fastening Fasteners Fastener Base or Top Layer MPS Detail No, Per Board Densice Approved Type(s): GAFTEMP® High Density Fiberboard, GAFTEMP® Fiberboard Minimum: 'A" x 4' x 8' N/A GAFTEMP® Permalite Minimum: V2" x 2' x 4' N/A GAFTEMP® Composite Minimum: 1.5" x 4' x 4' N/A Base Sheet: Ply Sheet: Membrane: Surfacing: 65 N/A N/A N/A Product Control No.: 95- 0330.06 Fastener Density N/A N/A N/A N/A N/A N/A Note: %," Permalite is permitted where used in combination with a venting base sheet. Note: All insulation shall be adhered to the deck in full moppings of approved asphalt at an application rate of 25 lbs./sq. ± 15 %. Refer to Dade County Protocol PA 117 for insulation attachment requirements. GAF requires a GA}TEMP® Permalite or wood fiber overlay board on all isocyanurate applications. One ply of GAFGLAS® Ply 4, GAFGLAS® Ply 6 ®, GAFGLAS® #75, GAFGLAS® Stratavent® (Vent Ply) Perforated or Ruberoid® 20 adhered to the insulation in a full mopping of type III or IV asphalt at an application rate of 25 lbs. /sq. ± 15% or adhered in a strip or spot mopping of type III or IV asphalt; see General Limitation mitation #4. (Optional) One, two or three plies of GAFGLAS® Ply 4, GAFGLAS® Ply 6 ®, or a single ply of Ruberoid® 20 fully adhered in type III or IV asphalt at an application rate of 25 IbJsq.* 15 %. One ply of Ruberoid® Mop Granule, Ruberoid® 30, Ruberoid® 30 FR, Ruberoid® 170 FR, Ruberoid® Mop Plus Granule or Ruberoid® Mop FR in type III or IV asphalt at an application rate of 25 lbJsq. * 15 %. (Optional) Install one of the following: 1. Gravel or slag applied at 400 IbJsq. and 300 IbJsq. respectively in a flood coat of approved asphalt at 60 IbJsq.. Raul Rodriguez Maximum Design Pressure: Maximum Fire Classification Maximum Slope: Specification No.: -90 psf; see System Limitations for specific systems with higher design pressures (Strip or spot mopping only to -45 psf). Class 'A'; see General Limitation #2. 2:12; see General Limitation #3. Product Control No.: 95- 0330.06 1 -0 -2- 20430, I- 0- 2- 20 /30FR, I- 0- 2- 20/MG, I- 0- 2- 20/MGFR, I- 0- 2- 20/MGPFR, [- 1 -1 -MG, I -1 -1 -MGFR, I -1 -1 -MGP, I -1 -1- MGPFR, I -1 -2- 20/30, I- 1- 2- 20/30FR, 1- 1- 2- 20/MG, I- 1- 2- 20/MGFR, I- 1 -2-20/MGP, I- 1 -2-20/MGPFR, 1- 2 -1 -MG, 1 -2 -1 -MGP, I -2 -1 -MGFR, I -2 -1- MGPFR, I -3 -1- MGPFR, I -3 -1 -MGP 66 Raul Rodriguez Fastening: Note: PIy Sheet: Membrane: Surfacing: Membrane Type: SBS Deck Type 1: Wood, Non - insulated Deck Description: 19 / 72 " or greater plywood or wood plank decks System Type E: Base sheet mechanically fastened. All General and System Limitations apply. Base Sheet: Product Control No.: 95- 0330.06 One ply of GAFGLAS® Ply 4, GAFGLAS® Ply 6 ®, GAFGLAS® #75 or GAFGLAS® Stratavent® (Vent Ply) for Nailable Decks mechanically fastened as described below: Base sheet shall be lapped 4" and fastened with approved roofing nails and tin caps 9" o.c. in the lap and two rows staggered in the center of the sheet 12" o.c.. PIy 4 and Ply 6® applications require sheathing paper over the wood deck before application of base sheet. (Optional) One, two or three plies of GAFGLAS® Ply 4, GAFGLAS® Ply 6® or a single ply of Ruberoid® 20 in type III or IV asphalt at an application rate of 25 lb. /sq. ± 15 %. One ply of Ruberoid® Mop Granule, Ruberoid® Mop Plus Granule or Ruberoid® Mop FR in type III or IV asphalt at an application rate of 25 lbisq. ± 15 %. (Optional) Install one of the following: 1. GAFGLAS® Mineral Surface Cap Sheet in type III or IV asphalt at an application rate of 25 IbJsq. ± 15 %. Maximum Design Pressure: -60 psf. Maximum Fire Classification: Class 'A'; see General Limitation #2. Maximum Slope: 3:12; see General Limitation #3. Specification No.: N- 1 -1 -MG N -1 -1 -MGFR, N -1 -1 -MGFR, N -1 -2- 20/30, N - 1 - 2 - 20/30FR, N- 1 -1 -MGP 41 Wood Deck System Limitations: 1. A red rosin sheet shall be installed on all wood plank decks to eliminate asphalt seepage and bonding of base sheet to wood plank deck. A red rosin sheet may also be installed on plywood decks as an option. A red rosin sheet is required on all applications where Ply 4® or Ply 6® is used as an anchor sheet. 2. Pre - assembled 'Cap Nail' shall not be used for base sheet attachment. 3. Fasten anchor sheet 9" at the lap and 18" in two staggered rows centered on the Ace. Approved to - 45 psf 4. See PA 117 for extrapolation of data for higher design pressures. 42 Raul Rodriguez Product Control No.: 95- 0330.06 - General Limitations 168 Raul Rodriguez Product Control No.: 95- 0330.06 1. All asphalt shall comply with ASTM D 312 type [II or type IV requirements. All proposed asphalt producers must be approved by the applicant. 2. Fire ratings are determined by a combination of slope, deck type and assembly. Refer to current Underwriters Laboratories Roofing Materials Directory or other fire testing data listed by an approved listing laboratory agency. Fire ratings shall be in compliance with Sections 3401.5 and 3401.6 of the South Florida Building Code. 3. Maximum, slope range shall vary for each system; consult current Underwriters Laboratories Roofing Materials Directory and manufacturer's specifications for compliance with design criteria for each project. 4. An overlay /recovery board insulation panel is required on all applications over closed cell foam insulations when the base sheet is fully mopped. If no recovery board is used the base sheet may be applied using spot mopping with approved asphalt, 12" diameter circles, 24" o.c.; or strip or spot mopped 8" ribbons in three rows, one at each sidelap and one down the center of the sheet allowing a continuous area of ventilation. Encircling of the strips is not acceptable. A 6" break shall be placed every 12' in each ribbon to allow cross ventilation. Asphalt application of either system shall be at a minimum rate of 12 lbsisq.. Note maximum design pressure restrictions on spot attached systems. 5. Any amendments to these provisions shall be in compliance with Sections 203 and 204 of the South Florida Building Code. 6. All work shall be performed by a Contractor licensed to do roofing work in Dade County. Contractor shall be familiar with the details and specifications published by the manufacturer. 7. ti In re- roofing applications, moisture content in an existing built -up roof must be in compliance with Section 3401.9(c) of the South Florida Building Code. 8. Prior to application, all existing roof surfaces used as a bonding substrate shall be tested for uplift resistance in compliance with Dade County Protocol PA 124 to the calculated design pressure of the roof deck. 9. If required, any Factory Mutual Approved vapor barrier in conjunction with proprietary or approved adhesives may be used prior to the application of the insulation layer. 10. Perimeter and corner areas shall have an increase in fastener density for both insulation and base sheet in compliance with Dade County Protocol PA 117 of the South Florida Building Code. 11. All attachment and sizing of perimeter nailers and metal profile designs shall conform with Dade County Protocol PA 111 of the South Florida Buil • g C •' e. Product Control No.: 95 0330.06 12. Flashings shall be installed according to the manufacturers standard details, and may be applied in cold application adhesive, approved asphalt or may be applied in conjunction with an approved torch applied modified bitumen membrane. Specific details, approved by the manufacturer, shall be submitted with the Section II Permit Application. 13. Roll good materials shall be stored in strict compliance with GAF Materials Corporation requirements. 14. Consult current Underwriters Laboratories Directory for the appropriate coating for each roofing assembly to obtain the required fire rating. The assembly shall be installed in strict compliance with Chapter 3401.5 and 3401.6 of the South Florida Building Code for maximum fire classification. 15. Asphalt moppings shall be with applied with asphalt approved by the applicant and shall be approved in compliance with equiviscous temperature (EVT) methods of asphalt application. Asphalt containers or bulk tickets shall indicate an EVT, finished blowing temperature (FBT) and flash point. Asphalt types and temperature ranges shall be in compliance with Subsection 3403.4(a)(3) of the South Florida Building Code. 16. Insulation may be installed in multiple layers. The first layer shall be attached in compliance with Product Control Approval guidelines. All other layers shall be adhered in a full mopping of approved asphalt at an application rate of 25 lbs/sq. t 15 %, or mechanically attached using the fastening pattern of the top layer. Refer to manufacturer's literature and/or the NRCA Roofing and Waterproofing Manual for correct application procedures of insulation panels in approved asphalt or adhesive. 17. Pre - assembled cap nails may only be used for termination of fully bonded surfaces such as mechanical termination at wood blocking, head and side laps, and base flashing terminations. Cap nails shall not be used for the mechanical attachment of a base sheet. Tin caps are required by the South Florida Building Code. 18. The submission of system specifications and details shall accotnpany the Section II Building Code Permit. This information is available in the publications listed in the 'System Description' of this Product Control Approval. The . submission of these documents; as well as the proper application and installation of all materials shall be the sole responsibility of the contractor. 19. All standard panel sizes are acceptable for mechanical attachment. When applied in approved asphalt, panel size shall be 4' x 4' maximum. 20. Fastener spacing for base sheet attachment is based on a minimum withdrawal resistance value of 250 Ibf as tested in compliance with Dade County Protocol PA 105. If the fastener values as tested are below 250 lbf a professional engineer may submit a revised fastener spacing utilizing the withdrawal resistance value taken from Dade County Protocol PA 105. Calculations shall be based on a rupture value (the fastener stress plate pulling over ti.lt base ply) of n9t moty th 90 Ibf.. , ) Raul Rodriguez l 169 21. Fastener spacing for insulation attachment is based on a Minimum Characteristic Force (F') of 300 Ibf. as tested in compliance with PA 105. If F' as field tested, is below 300 Ibf. insulation attachment shall not be acceptable. 22. GAF does not allow application of roof coatigs, other than a pour coat of asphalt and gravel, over its granule surfaced Ruberoid® products. 23. In addition to the requirements of this Product Control Approval and the South Florida Building Code, applicator shall follow the manufacturer's specifications. 170 Product Control No.: 95 0330.06 Raul Rodriguez ,,/zti '!TPOOAOE £.RQRIICT CONTROL. NOTICE OF ACCEPTANT'` Pioneer Concrete Tile 1340 Southwest 34111 Avenue Deerfield Beach, FL 33442 Your application for Product Approval of: Plonrer Concrete 7111. Nail -Ow. Along S. or .4 &wr Sd 'Nodemle' Ceecnsr Reeller TRe under Chapter 1 of the Metropolitan Dada County Code governing the use of Alternate Materials and Types of Construction. and completely described in the plans, specifications and calculations as submitted by Rellend Techwderka, The Canter jar Applied &rrasertts. Tee and Te mil Craig Laeweade A Coesahaed, inc. has been recommended for acceptance by the Building Code Complance Department to be used In Dade County. Florida under the specific conditions so forth on pages 2 through 17 and the standard conditions so forth on pap I. The approval shall not be valid after the expiration dale stated below. The Building Coda Compliance ORkt reserves the right N secant this producs or material at any time for jobsise or manufacturers plant for quality control testing. If this product or material fails to perfone in din approved mapper. the Building Coda Compliance Office may revoke, modify or suspend the use of such product or material immediately. The applicant shall re- evaluate this product or material should any amendments to the South Florida Building Code be enacted affecting this product or material. The Building Code Compliance OlTice reserves the right to revoke this approval. if it is determined by the Building Code Compliance Office that this product or material fails to the requirements of the South Florida Building Code. The expense of such testing win be . th Accepta•s: No.: 901110 02 Revises No, 93422102 I Rodrig D EC 1 3 1997 'Nikes: Aires: Product Control Supervisor THIS 15 THE COYFRSHFFT SCE ADDITIONAL PAGES F11R SPECIFIC AND CENTRAL. CONDITION] Approved: r t 7 2 6 1995 S till f1ING CCIDF COMMITTU This application for Product Approval has been reviewed by the Metropolitan Dade County Building Code Compliance Department and approved by the Building Code Committee to be used in Dade County. Florida under the conditions set fords above. HA METROPOLITAN DAOE COUNTY. FLORIDA METRO-DADE FLAGLER BUILDING 'MOM COOL CO6a1U14036 °MCI SUITE 1601 MftnCsoAOE FLAGLER 0U 004O 140 WEST FLAMER STREET 10AMI. manna 17130.1sI3 0061 775-7901 FAX (7o0 9571011 MR000CT COIITfOI SECT1pN ( 775-2901 FAX post 774110 harts Ganger. P.F Director Buiktain Cods Canalising 1Jepe. Metropolitan Dade County Anidifattr Pioneer Concrete Tik 1340 Southwest 34th Avenue Deerfield Beach, FL - 11442 Cat w tg t � ti � o � f �� ,, Su�SIILGgosT Rcpt: Suh -Tytm: PRODUCT CONTROL. NOTICE or ACCErTANCIL Roorenc SYSTEM A rraovAL Pre•ared Roofing le Tik Set/Adhesive Set S Descri tp ion Product Camel No.: 9S -0710 02 Product Control 140.: Approval Date: Expiration Date: 94.0110 02 SEP 2 6 1995 DEC 1 3 1991 Pioneer Concrete Tile is a domestic manufacturer of concrete roof tile with manufacturing facilities stretching from the West Coast to the Southeast. All tilt is manufactured from extruded concrete consisting of Portland Cement. plasticizer. iron and metallic oxides, and bknded aggregates This Product Control Approval retires to Pioneers • ice •' tilt erofila. Refer to innromiate Prnduei Control Approvals for other Ile epr f Ins. Pioneer the is fabricated with a wide ridged and grooved sidelap providing a water channel at vertical joints. The ridged sidelaps provide a self - aligning function. creating a uniform appearance. All profiles have matching trim pieces used for rake hip, ridge hip, and valley terminat Tile system accessories are also available to make up a complete tilt system. Pioneers 'Hacienda' roof tilt has been tested in compliance with the South Florida Building Code requirements for concrete. nail -on, mortar set and adhesive set tile applications. The minimum roof slope for Pioneer's 'Hacienda' nail -on, mortar set or adhesive set tiles shall be 2':12'. See the "Profile Drawing" section in this Approval for the 'Hacienda' profile drawing. The Pioneer 'Hacienda' tile profile has been tested for both wind characteristics and static uplift performance. therefore. any consideration for installation shall be done as a 'Moment Based System'. Data for attachment calculations is noted in Tables 1 through 4 of the Approval. Contact: Joe Zambruski Customer Service Representative 1340 Southwest 34th Avenue Deerfield Beach, FL 33442 (800)f2 -4152 HA F Plan aminer. Product Control, Division. TRADE NAMES of PRODUCTS MANUFACTURED OR LASELED sr APVUCAMT 1+ I7' /.' w - 13' W dock 1.v varies w - varlet varying thickness Test SRIECKIIIERIS PA 112 ?redact Diittiotioa Low profile, interlocking, high pressure eauuded concrete roof rile equipped with one nail hole and double roil ribs. For direct deck or battened nail -on. mortar or adhesive set applications. PA 112 Accessory rim, concrete roof pieces for use al hips, takes, ridges and valley terminations. Manufactured for each the profile. HA2 ammer, Product Control, Division. • 141 Coated Base Sheet TRADE NAMES OF PRODUCTS MANUFACTURED OTHERS Tat Qimnsoos Sostifitafltut WA ASTM D 226 N/A ASTM D2626 NIA Lenaingtu -2B 140 S9': 16/'roU UndetlaymeM 22 tbsfroll Rainproof 11 30' s 75' roll 36' s 73' roll or 60' s 75' roll Ice and Water Shield 36' a 73' roll NIA , •WA VP 11 ASTM D 219 Mineral surfaced asphalt roll roofing for use as a top ply in a double ply underlayment system. PA 104 PA 104 PA 103 ASTM D112 type III or IV • r Product Control No.: 91-0110 61 Product 4ssttiWlea Saturated organic Feb to be used as a nailed anchor sheet. Saturated and coated organic base sheet for single or doubk ply underlayment. Single ply, nail -on Larking underte ment. Performance. Inc. with current PCA Single ply, nail -on underlayment with 2' self- adhering top edge. Self - adhering underlayment for use as a top ply in a two ply underlayment system with Approved 130 or 44 3 as the base layer. Asphsh for bonding a mineral surface cap to a mech. gnashed base sheet in a double ply underlaynsent system. ASTM D4516 Cu* back, asphak based, asbestos free, fiber reinforced, trowel grade cement for repair and flashing applications. Manfanaca generic generic Protect-0-Wrap. Inc. with current PCA W.R. Grace Co. with current PCA generic generic Wood Battens Tik Nails T i Roof Tile Mortar ('TileTiteTM') Roo wM a1ar ('Quikretet Roof Tile Mortar Y1 t101 Dkunsion WA min. 12 ga. with '/.- head mm. 32 ga. min. o.d. MAUL 2' o.d. naiad mix 1 - a1' hotiznnial min. I" x 4" for use with vertical battens or min. 1' s 2' for use alone min. tdx2W min. 10d a 3' Yg it 2W long 0.335' head dia. 0.131• thank dia. 0.123' screw thread diameter N/A WA Test SYKifealio i ASTM 041 PA 114 Appendix E PA 114 Appendix E Wood Preservers Sat pressure treated Institute LP - 2 or decay resistant lumber battens PA 114 Appendix E PA 114 Appendix E PA 123 PA 123 Produce Cannel 14n.: 914111110) Product lkter1nll0. Cut back. uplink baud coating used Is facilitate bonding of dissimilar materials. Annular ring shank. hot dipped. electro or mechanically gal.. roofmg nails fur use in underlaymesls attachment_ Corrosion resistant circular disc for use in undcrlayment enactment Corrosion resistant, screw Of smooth shank nails. Corrosion resistant, coated. square drive, galvanized. coarse thread wood screws Prepared mortar mix designed for mortar set roof tit application. Prepared mortar n.ix deli fed for mortar serrsf engin:alums. Ma.afactacsc generic generic generic generic generic generic Bermuda Roof Company. Inc. with current PCA Qu.krete Conror ctio Pr Au. n .:d cr tarn Pt :A 4 ?Assiut Dimuuions Roof Tile Mortar N/A ("BONSALm Roof Tile Mortar Mix") Roof Tile Adhesive ( AH 1607 Hurricane Clip & Fasteners N/A Clias min. 'A" widi11 min. 0.060' thick Clin F sat tenets min gd a I'A' min. 26 ga. min. 16' widd min. 26 ga. mm. 2' face flange min 2' deck flange Ter Spcilkatle PA 123 Product Prepared manse mil designed for mortar tit roof lit appl.canrons. See PCA Two component polyurethane adhesive designed for adhesive set roof rile applications. PA 114 Appendix E ASTM A S23 PA 111 a HAS Product Control No.: 9141370 0) Corrosion resistant bona. aluminum. stainless steel. galvanized steel or plastic attachment clips for supplemental the attachment. Clips are installed with corrosion resistant roofing nails compatible with the clip. A hunicane clip is required on all nail-on eave tiles. Galvanized steel valley flashing Galvanized steel drip edge Ma/Y W R. Bonsai Co. with current PCA Polyfoam Products. Inc. with cunenc PCA generic generic generic Fronk Plans E rner, Product Control. Division. Vertical Battens: Comments: SYs rEms Deck Type: wood. Non - insulated Deck Description: uroctioa greater plywood or woodplank. SYSTEM A: Counter tten Application Slope Range: 2':12' to 7" Note•. Conn B as sated below. are required for slope range :12" his than 4 ":12" and are optional for slopes of 4 ": 7 ":12 ". slopes eaceedlea 7 ":12 ". refer to System Uaderlayment: Install underlaymem - in compliance wi County Application Standard PA 1 IS. Install vertical battens in corn • - with Dade Cowry Application Standard PA 1111 Hortaootal Battens: Install ntal battens in compli . with Dade County Application PA 1111. 2,atfi6 =Tilr Install tile in compliance with Dade County .plication Standard PA 11$. (See Data for Attachment Calculations' included' is Approval.) I. For re-roof applications. "I, plywood is an acceptabl castrate. Product Camel Ns.: oiA_ )30 0 SYSTEMS (CONTINUED) Deck Type: Wood. Non - insulated Deck r onstruction " /,; or greater plywood or wood plank SYSTEM B: Slope Range•. Underlaymeat: Roofing Tile: Comments: i Peados Coned No.: 9i - 0110 02 Direct Deck Application 4 1":12" to 7':12" Note: System B is only acceptable In this dope range. For slopes less than 4":12". refer to System A. For slopes in escess of 7 ":1I ", refer to - System C. Install underlayme t system in compliance with Dade County Application Standard PA 1111. Install tile in compliance with Dade County Application Standard PA Ilt. (See "Data for Attachment Cakulationi included in this Approval.) 1. For re-roof applications. ca l,; plywood is an acceptable substrate. SYSTEM LIMITATIONS 1. The sten:bud minimum market for Pioneers 9lacienda'. low profile the shall comply with Dade County Application Standards PA lit PA 119 at PA 120. depending on the method of installation. 2. For nail - oe applications. fasteners for mechanical attachment of tiles shall have a head diameter larger than that of the preformed holes in the tile_ 3. System installation shall be in compliance with the system specifications outlined in this Product Control Approval. The method of attachment utilized shall ptovide sufficient attachment resistance expressed as a moment to meet or exceed the required moment of resistance determined in compliance with Dade County Protocol PA 115 or PA 127. The Pioneer 'Hacienda' tile profile has been tested for both wind characteristics and static uplift performance, therefore, attachment calculations for installation in compliance with PA 115 or PA 127 shall be done as a'Moment Based System'. 4. For mortar or adhesive set tik applications, s field static uplift test by • Dade County accredited testing agency. in compliance with Dade County Protocol PA 106. shall be performed. 5. For mortar tat tile applications. 30/90 hot•mopped underlayment applications may be installed perpendicular to the roof pitch unless stated otherwise by the urderlsyment material manufacturers published literature. 6 All tiles shall bear the imprint or identifiable marking of the manufacturers name or lobo for identification in the field. 7. Applications for roofing permits shall include a completed Section 11 of the Uniform Building Permit, a copy of Pioneers current specifications and details, a copy of this Product Control Approval snd a copy of the Product Control Approval of any Roofing Component used in the proposed tile application. Reference shall be made to appropriate data for the required fire rating. 9. The applicant shall retain the services of a Dade County certified testing laboratory to maintain quality control in compliance with the South Florida Building Code and related protocols. Samples taken shall be in compliance with Dade County Protocol PA 112. Appenditt 9. Any amendments to these provisions shall be in compliance with Sections 293 and 204 of the South Florida Building Code. DATA FOR ATTACHMENT CALCULATIONS T11. - Proille Pioneer Hactendi Table 1: Aerodynamic Multipliers • k (11ti Z. (ft') flatten Application 1 (f*) Direct Oeck App leaden 0 27 0 .29 ._ Table 2: Restoring Moments due to Gravity - IM (1t -Ibf) TIle 3':12' 4 -:1r S':tr a -:lr r:lr or Profile greater Battens Direr Beaune Meet Battens Olen Seams Meet Battens Direct Oec* O. Dees Dec* Dec* 5.57 5.30 5.40 GAS 5.31 5.24 510 5.00 MA TIN Tile Approved Approved Approved Approved Profile Application Nails Screws' Field CBp With: Ewe alp With: Table 3: Attachment Resistance Expressed as a Moment • M, (R -Ibf) for Natl-On Systems' 3.30 5.50 22 49.10 24 20 34 90 22.10 32.20 ' Ono noted in Table 3 is tor installation with a 3 head ' Approved screws are ss noted in the "frsds Names of Products Manufactured Be Others' and 4rofaa Orawvr t' sections oI this Approval. Caps on eau till are not required tor this attachmerd configuration legless the Required MomM of Renstance exceeds the values noted above. t Table 3-A: Attaclmnnt Resistance Expressed as a Moment • M, (ft -Ibf) for Nail -On Systems TIN Profile madends Tile Profile DATA FOR ATTACHMENT CALCULATIONS (CONTINUED) TIN Application Deed Oeet New Conatnrdhon (nom "In d.wOod) Direct Deck Recover/Remo' (min. "y,; plywood) Battens New Commit lion Tile Application Mortar Set Adhesire Set Prodoa Control No 9i-0170 61 , Two (2) 10d at r long nails' 67.50 43 00 50.90 Ti• nsta6ation with a s' headt•p using two (2) Approved 10d x T long pdynrr coated, corrosion resistant. ring shank nits installed in mvaAadured hobos located 2W from Me head ol the tile. Cips on time tile are not rewired for this attachment configuration unless the Required Moment of Resistance exceeds the vM+es noted stwv. Table 1: Attachment Resistance Expressed as a Moment - (ft -Ibf) for Mortar or Adhesive Set Systems Attachment Resistance 20.60 66 61 r UNIVERSAL RAKE PionLE DRAWINGS PI00.NEER HACIENDA TILE TRI ►I PIECES Prodaa Control Ho. ....22)&312.11/._ - HIP & RIDGE 5 PROFILE DRAWtNCs (CONTINUED) APPROVED SCREW FOR SCREW DATA IN TABLE 3 name Concrete Tile 1340 Southwest 34th Avenue Deerfield Bach, FL 33442 'ACCEITANC( NO.: 95- ®73Q� 2 995 APPROVED T EXPIRES • S t NOTICE OF ACCEPTANCE SIANDARO CONDITIONS 1. Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and the original submitted documentation, including test supporting data, engineering documents. are no older . than eight (1) years. 2. Any end all approved products shall be permanently labeled with the manufacturer's name. city sate. and the following susemenc 'Dade County Product Control Approved', or as specifically stated in the specific conditions of this Acceptance. 3. Renewals of Acceptance will not be considered if: t) Thee has ben s change in that South Florida Building Code alTecting the evaluation of Nis product and the product is not In compliance with the code changes: b) The product is no longer the same product (identical) as the one originally approve!: c) If the Acceptance holder has not complied with all the requiemems of this acceptance, including the correct installation of the product•, d) The engineer who originally prepred. signed and seated the required documentation initially submitted , is no longer practicing the engineering profession. 4. Any revision or change m the materials, use. and/or manufacture of the product or process shall automatically be cause for termination of this Acceptance. unless prior written approval has been requested (through the filing of a revision application with appropriate fee) and granted by this afire. 5. Any of the following shall also be grounds for removal of this Acceptance: a) Unsatisfactory performance of this product or process: b) Misuse of this Acceptance as an endorsement of any product for sales, advertising or ray other purposes. 6. The Notice of Acceptance number preceded by the words Dade County. Florida. and followed by the expiration date may be displayed in advertising literature. 11 any portion of the Notice of Acceptance is displayed, then it shall be done in is entirety. 7. A copy of this Acceptance as well u approved drawings and other documents, where it applies. shall be provided to the user by the manufacturer or its distributor and shall be availabk for inspection at the job site at all times. The copies need no be resealed by the engineer. 1. Failure to comply with any section of this Acceptance shall be cause for termination and removal of Acceptance. 9. This Acceptance contain pages 1. through 11. END Or THIS APPROVAL (, 1 7 t HA17 Fn Ptsns oduct Control. Division. l r' Date 67) `I PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address CI 2 2 ttic - Cif iZ'2 Tax Folio (/ - 3Zo G t 3o o o 03 n Legal Description Historically Designated: Yes No Owner/Lessee / Tenant PO /4., 2 /` v r, o L (>4, 5 r , ' Master Permit # L 1 1575 Owner's Address G1 7 7 /ti Contacting Co. r(� . pow (= . i e Address 2 7 3 v c.,,- 7 t- s 1 Qualifier / '/ r c r a ( Aar, S 2 SS# Phone 5 5 7 - /6. Fr State # C c c o 5 2 y d o Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Square Ft. 2 - 2 5 �?I 7Z•2 9)9 Signature of owner and/or Cond• `re ent Date Signature �f 1 Notary as to Owner and/o Condo President Date My Commission Expires: FEES: PERMIT RADON Phone ef S Fr - Z 2 3 S Permit Type (circle one): BUIILDING ELECTRICAL PLUMBING MECHANICA ROOFING PAVING FENCE SIGN WORK DESCRIPTION •e roc - y i 4.e 80, -hfe Boa c � - /✓ UO 144 �' 0•. jG� d -ec k Co Ad t •os) ,/e Se2 Estimated Cost (value) J / ') 0 0 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work stated. or Owner- Builder Date Notary as to Contractor or Owner - Builder Date My Commission Expires: APPROVED: Zoning Building 1 Electrical 19/17 Mechanical plumbing Engineering NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO STATE OF FLORIDA COUNTY OF 9782767 15 1997 JUN 20 12:54 THE UNDERSIGNED hereby gives notice that improvements will be made to cerlain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement 1. Legal description of property and street address 9 27. NE � I tQ tett J Liol i a O v S C I. 3 �r /3)ocic Su6div . PeP. Re Qo 2. Description of improvernenl: 3. Owner(s) name and address Interest in property: Name and address of fee simple titleholder: d. Contractor's name and address 5. Surety:(Payment bond required by owner from contractor, if an Name and address: Amount of bond E 6. Lender's n:trne and address bl`-t ( fA t?m D I.(l S 21 "7 3v IN 7 �� s �� ' 17 3 3‘ 7. Persons within the State of Florida designated by Owner by Section 713.13(1)(a)7 , Florida Statutes. Name and address: 8. In addition to himself. Owner designates the following per "n(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes Name and address: 9. Expiation date of !his Notice of Commencement: (the expiration date is 1 year from the date of recording unless a dilfereut date is specified) yPeat-v- TAX FOLIO NO / / - 32010 -0 0 Go nor Print Owners Name Sworn 10 and subscribed bet me this - Z- of ' , 19 1 7 . — _ da y % ... 1 � Notary Public _ %��!!i! � ... Van Baush Print Notary's Name Notary Public, State o aly C Jm1 T Ev tires Jan 5, ling My Commission Expires: _ _ No.CC431861 STATE OF FLORIDA, COUNTY Of DADE I HEREBY CERTIFY that this is a 1 e copy tho original fi • s office on _ 19 W ?NE = m • • • and Official Seal. HAR EY RUV ' CLERK, of Circuit and County Cour& on whom notices or other documents may be served as provided � nMn \haSR1 Prepared by: 2 gee Li Address: 27 ✓ ?�- A- � der G F 1230152 2NJ Test Location Uplift Pull Test (P or F) Test Location Upl'ft Pull Test P or F) Test Location Uplift Pull Test (P or F) 1 piti 55 26 I1ff SS 51 2 27 52 3 28 53 4 29 54 5 30 55 6 31 56 7 32 57 8 33 58 9 34 59 10 35 60 11 36 61 12 37 62 13 38 63 14 39 64 15 40 - 65 16 41 66 17 42 67 18 43 68 19 44 69 20 45 70 21 46 71 22 47 72 23 48 73 24 49 �� 74 25 Ni 50 75 Du Quesne & Associates, Inc. Consulting Engineers Testing Laboratory ON -SITE CONCENTRATED UPLIFT LOAD TESTING OF ROOF TILE IN ACCORDANCE WITH METRO -DADE BUILDING CODE COMPLIANCE PROTOCOL PA 106 SITE SPECIFIC INFORMATION Owner's Name: / 44 /4/ A A D /4 f Permit 4 92 ! C �3 Job Address 9ZE qi T /V( ( S Roofing Contractor -0121 O t /�. 7 Type of Tile: Pl .—/�2- ,20L.—L_. Date Installed 7 17 qZ Approximate Roof Height. / 7 feet Roof Pitch 3 1 Type of Access to Roof: Scaffolds 1- Ladder Other Approximate Square Footage of. Roof /700 ft 2 Required Testing Force: 35 lbs. Testing Equipment: Chatillion DFIS 100 Date Tested 7 . 2 / e Du Quesne, P.E. Engineer 24513 Du Quesne & Associates, Inc. E.B. License #0005245 Lab Certification #940318.01 TEST RESULTS P = 'PASS, F = FAIL Environmental • Civil • Structural Building Inspection Services SKETCH OF ROOF IN BACK IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL PA 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST. 7821 S.W. 24th Street • Suite 104 • Miami, Florida 33155 • Telephone (305) 264 -1425 • Fax (305) 264 -1426 UTR No 12686 Please Note: This form is not valid unless Company logo appears in color (burgundy) $KETCH OF ROOF JOB SHEET NO OF CALCULATED BY DATE CHECKED BY DATE SCALE NOTES. $KETCH OF ROOF JOB ? 'VE (1/ 1 ER Al i S� SHEET NO //��.�' OF CALCULATED BY 1 `-^"( DATE 7-2/ �I CHECKED BY DATE SCALE 3+3 34- 32. 3E 3 99 t3' 27 10e 16 18 � tisDo 1 Z6 /5 NOTES: DuQuesne & Associates, Inc. Consulting Engineers Engineering, Testing & Environmental Services The PA 106 test reported in report No. f2-, a has been performed in full accordance to the requirements of Dade County, with no deviations. Du Ques e, P.E. esne & • iates, Inc. Laboratory Compliance Letter nut S.W. 24t'" Street, Suite t+1O4. Miami. Florida 33155/felephone (305) 264 -1425 Fax (303) 264 -1426 Du Quesne & Associates, Inc. t il , -A Consulting Engineers Testing Laboratory Owner's Name: / - M / r1 /` /I /5 CW6L W r /. Permit # Job Address. q22 NE C 9/ TT /�,. /(/1/ ( / (; -- (2 /2C _ - 7 / Roofin Contractor fL- - U 12--- - 7 /-)/ /Z .�1-- T ."Y7 Type of Tile: /' /V . 72 -V.. _'` Date Installed / 7 — (-? 7 Approximate Roof Height: • ,l r feet ! Roof Pitch ' Z Type of Access to Roof: Scaffolds Approximate Square Footage of Roof: / 700 ft' Required Testing Force: 35 Ibs Testing Equipment: Date Tested Uplift Pull Test (P or F) Test Location .: 2 3 28 4 29 5 l! 30 6 7 8 9 10 11 12 37 13 l' 38 14 15 16 17 18 ;l 43 19 20 21 22 23 24 25 ON -SITE CONCENTRATED UPLIFT LOAD TESTING OF ROOF TILE IN ACCORDANCE WITH METRO -DADE BUILDING CODE COMPLIANCE PROTOCOL PA 106 -� -- 2/ q 7 THIS "REPORT SUBMITTED BY : ( lone Du Quesne, P.E. Civi Engineer E. 24513 Du •uesne & Associates, Inc. E.B. License #0005245 .. lab Certification #94-0318.01 SITE SPECIFIC INFORMATION TEST RESULTS P PASS, F = FAIT. Test Location 26 27 31 32 33 34!! :. 35 36 I ; 39 40 42 44 45 46 47 48 50 ,// Ladder Chatiliion DF15 100 Uplift Pull Test (P or F) Yff S.S'; 49 SKETCH OF ROOF IN BACK UTR Environmental • Civil • Structural Building Inspection Services Test Location 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 72 73 74 75 Other Uplift Pull Test (P or F) 7821 S.W. 24th Street • Suite 104 • Miami, Florida 33155 • Telephone (305) 264 -1425 • Fax (305) 264 -1426 r IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL PA 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST. Please Note: This form is not valid unless Company logo appears in color (burgundy) 5KETCH OF ROOF JOB ? /Vi,4/W OF SHEET NO ,cR� ( ^'� CALCULATED BY ' 1 ( DATE / �� ^ 97 CHE CKED BY DATE SCALE 111111111111 1 IMENIMERVERIBMINE MMEMMEMOMMEMEMEMITEMMMMOMMUMMEM MMEMINIMMOMMEMMEMEMERNMEMIIMMEMM immussammumaimaszmmommummommum IIIMMEMMEWMINEMMOMMEMOMMEMEMEMMEM MEMEMMRORMIIMMOOMMENMEMEMMUMMINIM NOTES. Owner's Name and Address Registered Architect and /or Engineer...- ...... Name and address of licensed contractorf ° beg, Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 9 3 2 1" State work to be done and purpose of building (by floors) Permit No______ ......... Disapproved (Signed) C.� MIAMI SHORES VILLAGE Z - Date BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. ate Date... _..� _.. - ....... _ No //SC Street <T Building Inspector New Building Remodeling Addition To be constructed of Kind of foudation Estimated Total cost of improvements $ � - �._... / /6i d and for no other purpose. Repairs No. olStgries PLANNI c BOARD DATE ..__ ..._. . .181!. f Covering . P Read, Sworn to and Subscribed before me. Amount of Permit Zone cubage required _Plan Cubage Distance to next nearest building.. Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to • The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Perm:ment Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be post for inspection on the site of the work such public notice or notices as arc required by the Act. The undersigned agrees to employ only su subcontractors, on w jk to be performed under this pennit, as are licensed by Miami Shores Village. Remarks ( Signed ), STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notaiy public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the . of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated ar Notary Public, State of Florida y -- Commission Expires to me well known, Chairman Member Member Member Member .. _..- ._-.___.._._-•-- •-- •--- _- • --.._ Member -- --_ Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained Fmm the Planning Board. A re fee of SI.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby wade for the approval of the detailed statement of the plans and specifications herewith submitted for the build - ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address a S 14/ 10/ 12 — No Street/ Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done.., ?- .& L 5 P/ _ Disapproved (Signed) Building Inspc tor State wor to be done and pur os� it building (by floors). t Date 1,T 1i6 Date. 6 PLANNING BOARD DATE and for no other purpose. New Building Remodeling Addition Repairs No. of Stor s To be constructed of Kind of foundation Roof Covering i Estimated Total cost of improvements $ J J Amount of Permit $. Zone cubage required -Plan Cubage Distance to next nearest building. Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of Libor under the Florida \Vorkmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only suc subcontractors, on wor to be performed under this pennit, as are licensed by Miami Shores Village. ^V Remarks (Signe --- STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. / Permit No .____/ Y3 5 Date 4 /./.. ?_.fit -__ -- Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires Member Member Chairman Member Member ...... Member — Council Approved Date Disapproved NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice materials and /or workmanship. Date has been obtained from for inspection or faulty MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build - ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. 14 Date./ F .s n , 1 .. _ Owner's Name and Address�� 'Z tic NO 2 , Street t F 1� R egistered Architect and /or Engineer ,... .,,•,,, ,•,,,,,,,,,,,,,,,,,,,,,,- .,_ Name and address of licensed contrActor l!al S e- Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 9 ‘, 7 2 i'(i ' State wo to one and purpo of building (by floors) d / -- 3 d GC Disapproved (Signed) L:/72 ....i Building In ector ...... ✓S AW / - z� or notices as are required by the Act. The undersigned agrees to employ only suc permit, as are licensed by Miami Shores Village. Remarks (Signe and for no other purpose. New Building Remodeling Addition Repairs No. of Stories...,,, _ G To be constructed of ‘ Kind of foundation Roof Covering. a Estimated Total cost of improvements $ /9( Amount of Permit Si. Zone cubage required .Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to.. The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Perimment Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice i subcontractors, on work to be performed under this STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construe on, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him sttsed i re- trt Ge. ��, „ 7 Permit No..__.__ { _ j � Date Read, Sworn to and Subscribed before me. P ate My Commission Expires Notary Public, State of Florida PLANNING BOARD DATE Chairman Member Member Member Member .. ... Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date Mph 12. , 19 Owner's Name and Address ... Graf/ ..Sull1van' No 922 Street N.E. 91 Terrace Registered Architect and /or Engineer ContractortieAi1'Oon Ine. 36th & Biscayne Blvd.. Name and address of licensed contractor Acme Supply Coca 2670 N W 75 Sts Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 922 N Er. 91 Terrace State work to be done and purpose of building (by floors) APP.L7 Ply B ni1t. p & Gravel ROOF and for no other purpose. New Building Remodeling Addition X Repairs No. of Stories To be constructed of Kind of foundation Roof Covering.... 1. Ply d ,1 ' Estimated Total cost of improvements $ 118.75 Amount of Permit $ 5..O0 Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed).ACMet Stipp STATE OF FLORIDA, ss BY: COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No Cv s °i � Date _ J _ Read, Sworn to and Subscribed before me. Disapproved ,...,_ (Signed) c.......)/</, ` L� Notary Public, State of Florida My Commission Expires i•` Building I sp‘ctor PLANNING BOARD DATE Chairman Member Member Member Member . Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Owner's Name and Address MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. a Registered Architect and /or Engineer... - .. Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) Date ° o� — - No..e�— Street... and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required .Plan Cubage Distance to next nearest building. Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida, Pennanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No . C 7 Date_. /7-- _ r 7 Read, Sworn to and Subscribed before me. Disapproved ,. _ Date Notary Public, State of Florida (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mianii Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Mianii Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address Registered Architect and /or :! ineer..._ Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done __ .._. State work to be done and purpose of building (by floors)._ STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT • Notary Public, State of Florida and for no other purpose. New Building Remodeling Addition Repairs No. fl To be constructed of Kind of foundation Roof Covering. N S � '_! Estimated Total cost of improvements $._._t '. Amount of Permit $ d + -� Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent SuPplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be po ed for inspe do the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ q ly I ch ub ontt(ct n work . be 4 performe u , der this permit, as are licensed by Miami Shores Village. � Remarks (Signed) Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No._ _ _2.� Date Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Addressl ' 6 ' S L f t /AW Disapproved L-v d ( Signed) MIAMI SHORES VILLAGE Date Date l Building Inspe4tor BUILDING INSPECTION DEPARTMENT `PLANNING BOARD__ z 7 Date Registered Architect and /or Engineer Name and address of licensed contractor_, /27i4 Z: J` e Location and legal description of lot to be built on: Lot Block Subdivision �+ Street and Number where work is to be done____ Sta work to be done and purpose of building (by floors) ,J s/ , ziovj / 05;i- A7 03 $ r' 4A04 elA/A7 7 - �-t_a /'z OO=e°/ -Ayexi/ 4 eo, 7 oT__ -T %>/2 ,77., , 19'7 No._7 Street 9/ Tze DATE and for no other purpose. New Building Remodeling Addition Repairs L- No.ories._../ To be constructed of Kind of foundation Roof Covering_ Estimated Total cost of improvements $___ 2J CP 67 Amount of Permit $ Zone cubage required _Plan Cubage____ Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor___ I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to Read, Sworn to and Subscribed before me. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractor,, on work performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared - to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. c. Permit No // 1 Notary Public, State of Florida My Commission Expires Chairman _____ ___ _ _ . Member Member _ . Member Member _ _ _ Member Council Approved ___Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building D D PERMIT N° 5509 Architect Contractor Jr or Builder Legal Lot Description MIAMI SHORES VILLAGE, FLORODA Work to be performed under this Permit B Address of Building /7 Subdi- vision Value of Project $ 3 (DATE 195— f Cantractor's ,. License No. Amount of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of /the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings, or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed t '�/ - / ! BY `" ''' INSPECTOR 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 ac- cepting this permit assume responsibility for- all work / ; done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER vrY AUTHORITY 6 BUILDING ELECTRICAL PLUMBING ROOFING MIAMI SHORES VILLAGE. FLORI` ®A ❑ ATF ,/" 195 7 PERMIT N? 5125 Contractor's License No. 7,9 Work to be performed under this Permit � Owner of Building ' 64.— Architect _ Contractor or Builder ,, j � , Legal Lot. Description I Bl Address of G °"I d's� Value of Amount of Building at 7/ C r' /4 '� . r Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equ or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings cr in the statements op ecificg ons and that he assumes responsibility for work done by his agents, servants or employees. / Signed. INSPECTOR BY Subdi- vision 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..c4,n,,formity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami S iesWilkige. In ac- cepting this 4rmiLI assun{e reiplinsibilibi for all work done by either, myself, my agent, servant or employee:' F 2 ..� . ., CONTRACTOR OR BU DER ^�/ BY AUTHORITY 6 ue' BUILDING ELECTRICAL PLUMBING ROOFING Architect Contractor or Builder Legal Description Lot MIAMI SHORES VILLAGE. FLOR= DA ❑ DATF ❑ PERMIT N? 6884 Co tractor's Li. ense No. Owner of Building. L. r, a Address of 4,1 Building G. - • -, This permit is granted to the contractor or builder named above to construct the building or to install the equipmOnt or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be {performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authori ies. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications acid that he assumes responsibility for work done by his agents, servants or employees. Signed. ?.w .r sit, r z c 4 :•'^`^— • -!� �.BY INSPECTOR 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent servant or employee. CONTRACTOR OR BUILDER Work to be performed under this Permi 2 B1 '?e r L) 7..0 Subdi- vision Value of (( Project $ 1/? 2 C BY AUTHORITY c Amount of „0 5" — Permit $ 8 a., v Owner's Name and Address. C9 l V a N Name and address of licensed contractor -Jo e S Street and Number where work is to be done Disapproved �__ ._ -_ Date f . (Signed) (-_ \ C Building Inspector MB MB SH•RES VOLLA E BUILDING INSPECTION DEPARTMENT A P U C AT O N F !aJ R rr Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the bui5d- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Registered Architect and /or Engineer a be a 9 f4 0 o %• //m e .ye p e: State wor to bee and purpose f uilding (by oors) U1LDONS PE Location and legal description of lot to be'built on: Lot Block Subdivision /� 7' 07- o'/ RAJ OT cs-7-PF 72 Date - I '2 .. 19 / No.9 o2 Street N 2/ 779, and for no other purpose. New Building Remodeling Addition Repairs No. of Stories / To be constructed of " / Kind of foundation /f'e 1a C / Roof Covering a s� Estimated Total cost of improvements $ J Amount of Permit $ c. 0 one cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live Load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated ar true. Permit No Date �. Read, Sworn to and Subscribed before me. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this .permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this pennit, as are licensed by Miami Shores Village. Remarks (Signed) Oe 7 STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared Notary Public, State of Florida \ My Commission Expires 7 PLAN,INC BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of ,51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials :end /or workmanship. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws c•f the Statt. of Florida. all ordinances of Mi.nnr Shores Village and all rules and regulations of the Building Divi;,iou of Miami Shore-. \ illage •h.ul be complied with, whether herein specified or not. A copy of approved plans and specifications must. be kepi at building during progress of the work. Owner's Name and Address 1.,t--0 1 ,n Registered Architect and /or Engineer._ Name and address of licensed contractor Location an 1 al decrypon Iqt to be built on: t o Lot E _ ' � Yilock. Subdivision �t Street and Nu ber where work is to be done. State work to be done and , pu of building (by floors)__.__ { New Building_ To be constructed of Estimated T tal cost of improvements $_- Zone ..cubage required. __.. STATE OF FLORIDA, COUNTY OF DADE. ss. - -- - -- -- -- - - - -- Permit No Disapproved 4 i _ y Date ( Signed) - 1 ' Building Inspector r' Chairman Member Member Council Approved MIAMI SHG -RES VILLAGE Date BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Remodeling__C Addition._... _ _.. ._ __ Kind of foundation. Date j C No -__ -- -_ --. Street_ . • �J a -Plan Cubage_______ /, : -5 Lt `, PLANNING BOARD DATE Member .- Member _ Member Date Disapproved r,. and for no other purpose. Repairs.. - _ No. of Stories Rgof Covering . a ff Amount c•`, Permit $_. _ Distance to next nearest building__ . _ _. Size of Building Lot - Maximum live load to be borne by each floor hereby submit all the plans and specilic•ationsfor said building. All notices with reference to the building and its construction may be sent to. < -� S L , The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Ccncral Laws of Florida. Permanent Suppli.ment, and has complied with the provisions thereof, and will require similar commiiance from all contractors or sub - contractors employed by hint in the work to be pert. -coed under this permit: and will post or cause to be posted for inspection on the site of the work such public note e or notices as are required by the Act. The midi r.igncd agrees to employ only such subcontr,.ctors, on work to be perform- d. imder this permit as are licensed by Miami Shores Village. rs 4 Remarks - (Signed) !t -v.'� ti 2 ? Notary Public State of Florida My Com:nission Expires. Read, Sworn to and Subscribed before me. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first dilly sworn, upon .ath deposes ancil says that he is the of th abov, described . .nstruction. C. h. y j '." eially read &he •regoing application, and that he did sign the same, and that all facts therein by him stated are true. Date NOTE: A charge of $1.00 will be made for snaking corrections cr ?hanges to this application .hft< -r approval has hem' obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is ma.ie necessary by improper notice for inspection or l,o.ity materials and /or workmanship. 9 ,9 /7