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952 NE 91 Terr (6)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Date Buildip�g Inspection Request ( Type Insp'n 7 fI 1)5fhl-61/ Permit No. IS P O9_ -51 Name . 9d Address - q_cc LV _ of Company —7 Phone # Cie) C9- / - ? — 7, 5-& Inspection Date Approved Correction ❑ Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 BuildiingInspection Request Date Type Insp'n 1A1 " -Y Permit No. OP 0 Name , / J f© � Address - • ( : c ' � C J G/ Company Phone # (96 ) .77 ! 7 V Inspection Date C / dv / 03— Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING bEPARTMENT 305- 795 -2204 Buil ing Inspection Request Date 1 , / Type Insp'n / v`` oo • Permit No. X1 ^ /5 O 9 Name _ ��A , Address AlE � / U Company .Th' C 06 /I/-C Phone # 05 ~q` - 7 T �� Inspection Date pproved Correction ❑ Re- Insp'n Fee ❑ Test Location Uplift Pull Test(P or F) Test Location Uplift Pull Test(P or F) Test Location Uplift Pull Test(P or F) Test Location Uplift Pull Test(P or F) 1 !7 3, 26 j 51 76 2 C/�� I Y 1 27 52 77 3 28 53 78 4 29 54 79 5 30 55 80 6 31 56 81 7 32 57 82 8 33 58 83 9 34 59 84 10 35 60 85 11 36 � 61 86 12 37 62 87 13 38 63 88 14 39 64 89 15 40 65 90 16 41 66 91 17 42 67 92 18 43 68 93 19 44 69 94 20 _ 45 70 95 21 46 71 96 22 47 72 97 23 48 73 98 24 49 74 99 25 50 75 100 SITE SPECIFIC INFORMATION Owner's Name G — Permit # Job Address • 152 N q t .F-• f kA f m_t t 0.I ( ft Roofing Contractor �' ?fit 13 4 Type of Tile: �l` ` " o ' - ■ i Date Installed: 1 Roof Height: (Z feet Roof Pitch: (f 5 Z I Type of Access to Roof: Scaffolds ✓ Ladder Other Approximate Square Footage of Roof I 1 5190 ft Required Testing Force: 35 lbs. Testing Equipment: Chatillion 100 Date Tested 3 -2 -05 IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL TAS 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL T ST. THIS REP BMITTED BY: Civil Engineer: Lab Certification # 98- 0608.04 State of FL Certificate Authorization # 4100 U.S. SOUTH Engineering & Testing Lab., Inc. 6065 N.W. 167th Street, Suite B -23 • Miami Lakes, Florida 33015 Telephone: (305) 558 -2588 • Fax: (305) 362 -4669 ON -SITE CONCENTRATED UPLIFT LOAD TESTING OF ROOF TILE IN FULL ACCORDANCE WITH METRO -DADE BUILDING CODE COMPILANCE PROTOCOL TAS 106 P.E. TEST RESULTS P = PASS, F = FAIL Project f (: 5 `i 9 3 SKETCH OF ROOF onommtformirtmairri INIMMINUIPIffim ■���� ■I. ■� /�Ilf.�l�clr711n�����1� �v��� ������il� ►�uiR =.tea X11 ■[�I� ■A�I�������� �����T�v��i�i��ri�vll��� r ►7v1����� ■t 111111111111111111111111■ 111II�0>11 "rJ ■It ■ ■ ■t ■n 111111E N11111111111111111 i °i °i � �������� rid %��!����� ■t ■�������� iiiiiIIIiIiiIII11 mlim ummmummomm.....0.0.... 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Z9i9Xl 6.9 br CHECKED BY SCAIF DATE MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 t� Building)nspection Request \`' Date _____ Type Insp'n it/`.i Permit No. P V -1 Si Name —( Address c , S q t -err Company 2 C1-CC J - C >C; C r' ) Phone # Inspection Date S/ L9 Approved ❑ Correction Re- Insp'n Fee El MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305-795-2204 (1 ) BuiylingInspection Request \ Date ---, Type Insp'n Y 1 "1 Permit-No. i NaeHl r Inspection Date Approved Correction Re-Insp'n Fee Address (1 1 ( 7)2 N-) .(7 F r Company C Phone # Type Insp'n Permit No. Name Address 'J '� C D WVL Company Phone # Inspection Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buildig Inspection Request Date MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 ,■1 Bui ding)nspection Request \`' Date 3 Type Insp'n 41 no i gcof /`�' Permit No. &P v - 1 S g • Name��'`' 1 Address q2 �� V ( r Company 11:27 GI- CC _C Phone # J 7 Inspection Date S/ Approved ❑ Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305-795-2204 ,` V BuldingInspection Request \V Date.--- ( 2 Type Insp'n Perrnp C. C -- i S c 1 • (.7 1 . • Address q :7- Z N t . ; rei 1 r ? _ Company i ( • (- C c )c. ........j Phone # Inspection Date Approved Correction Re-Insp'n Fee CI / / ' y 1 $ ' /fr MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date \)■ / ` © 5 Type lnsp'n � m) � tO Permit No. 8P - Name aS Address 9,3 9l re, Company Phone # Inspection Date Approved Correction Re- Insp'n Fee Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request 'bate \A 1\ o $ Type [nsp'n , /'(J 1 r.d �l -Is erm�t,No. 8P e / Name Addr`ess� Company Phone # Inspection Date A X0 4/e_ 9/ f'r BUILDING PERMIT APPLICATION FBC 2001 Owner's Address City k n 5(i1 aft.�'S State t Tenant/Lessee Name Contractor's Company Name Contractor's Address Z'o'SS t City S"I : AM State T ) - Qualifier IAiti G01 - . State Certificate or Registration No. C_GC-t 2 S 55 $ Value of Work For this Permit Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Code Enforcement $ Structural Plan Review. $ Job Address (where the work is being done) 15 Z t}& 1 :t City Miami Shores Village County Miami -Dade is .Building Historically Designated YES NO 4066) Permit No. Nat' ISS9 Master Permit No. Permit Type (circle): Building Electrical Plumbing Mechanical Owner's Name (Fee Simple Titleholder) �•E am SA V . \ ( 6TH a- Phone # q 1 S z. 0-C Zip 5'5/38 Phone # Phone # Zip 3313 e Zip 3'31 z7 Certificate of Competency No.t. REMOVED DEC a 2004 56 -/7 Architect/Engineer's Name (if applicable) tJ Phone # Square Footage Of Work: Type of Work: ❑Addition ['Alteration ❑Newby/ a "1"--:- q air/Replace❑ Demolition ( I/ ) Describe Work: 2e 0 �F t o - i - (u & fZJ J-ltL Rep ifocco eacrih�" v * ** v, * * * *, * * ** * *1 * * * * * * * * * ** F ees * * ** * * * * * * * * * * ** * * * * * * * * * * * * ** Submittal Fee $ 50 •OC) Permit Fee $ 3;25— CCF $ 360 coicc Notary $ - - Training/Education Fee $ 1 I ' 0 Technology Fee $ g,1 3 Scanning 5 a 1`` Radon $ Zoning Bond $ °� Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: 1 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose properly is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. 4Z . S .z.( - 8Z9 33 y 00.4 c. Signature Owner or Agent day of l The foregoing instrument was ac o / wledges before me thus "c:,���.',, 20 d 4, by or who is personally known to me or who has produced'' .13(,- — 1 (f NOTARY PZ)TBLI Sin • Print: CI 1,G. ..l • ( «C My Commission Expires: As idegtijiciti and who did take an oath. * * * * * * * * * * * * * * * * * * * * * * ** ******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Contractor The foregoing instrument was acknow edged before nee this - '� day of ()Cool v.l, bc.- 20 01, by ,. o l cl ze /e. <" who is personally known to me or who has produced as identification an who did take an oath. NOTARY PUBLTC''y _ Tr-STATE OF FLORIDA S. I, Castellanos My Commission Expires: Commission # DD362874 Bonded Thru Atlantic Bonding Co., Inc. r NOTAR PUBLIC-STATE OF FLORIDA S. I, Castellanos • � ,tsj9gJ,,», 2874 zp res: OCT. 14, 2008 Bonded Thru Atlantic Bonding Co., Inc. ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ,DEC 1 a 2111 APPLICATION APPROVED BY: Plans Examiner Engineer Zoning Chc 05/13/03 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12/14/2004 Applicant: LINDA GAIL Owner: HELDSTAB JOB ADDRESS: 952 NE 91 Contractor ISAACS ROOFING & INSULATION CORP Local Phone: 305 - 576 - 7411 Parcel # 1132060030130 Signed: (INSPECTOR) Signed: (Contractor or Builder) Building Permit Permit Number: BP2004 -1589 HELDSTAB LINDA GAIL TERR Contractor's Address: 2035 N. W. 1ST PLACE Page 1 of 1 Legal Description: PL OF BISCAYNE RIDGE PB 39 -41 E47.59FT OF LOT 6 & W35FT LOT 5 Fees: FEE2004 -12640 FEE2004 -12641 FEE2004 -12642 FEE2004 -12643 FEE2004 -12644 FEE2004 -12645 Description Building Fee CCF Training and Education Fee Scanning Fee Technology Fee Submittal Fee Total Fees: Amount $325.00 $3.60 $1.20 $21.00 $8.13 ($50.00) $308.93 Total Fees: $308.93 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 6/1/2005 Construction Value: $6,000.00 Work: RE -ROOF TILE TO TILE BARREL VOLCAN COLRTHRU BY: Dte A10 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. IZ/VI.:VZVU4 111 tA) A RECORDED COPY MUST UR POSTED ON THE JOB SITE AT TIM OF FERST INSPECTION PERMIT NO. TAX POLIO NO. STATE OA FLORIDA COUNTY OP DADE THE UNDERSIGNED hereby gives notice that improvements will bc made to certain real property, and u accordance with Chapter 713, Florida Statutes, the following infomialion is provided in this Notice of Commencement: 1. Legal description of property and street address: 2. Descripdoa of improvement: 3. Owner (3) name and address: ) (oda fckc 'Z Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and addre j 4 2L. 5. Surety: (Payment bond xqtz41 y Mbar from contractor, if any) Name and address: Amount of bond: S 6 Lender's name and address: 7. Persons within the State of (I) (a) 7.„ Florida Statzes: Name and address: 81n addition to himself, Qn2cr designates the following person (s) co receive a copy of the ljenor's Notice as provided in Section 713. 13 (1) (b) 7.. Florida Starutes;.. Name and ease; 9. Expirantoe date of this Notice of Contmeneement (the expiration dale is 1 year from the date of wording unless a different data is specific/1! aMtailf$ I )( immure of Owner Print Owner's Name Sworn to and subscribed Notary Public rint Notary's Name My Commission Expires: NOTICE OF COMMENCEMENT 77' ida designated by Owner upon sthora notices or other documents may bc served as provided by Section 713.1 46)//' this CLARA DEI. SOL NOTARY UBLIC STATE GT FLORIDA cosevaissav NO. DDC66141 1 OOMMISSIONEXP. OCT 21l i . . _ 7 7 PAGE Prepared 133': Xi,cs I t"CrsfZI• s 1PL- k 44/ `11 Address: Parra Id 1 High Velocity Hurricane Zone Uniform Roofing Permit Application MIAMI -DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION Master Permit No. Contractor's Name: Ci Low Slope ❑ Asphaltic Shingles E Prescriptive BUR -RAS 150 Are there Gas Vent Stacks located on the roof? ❑ Yes ❑ No If yes, what type? ❑ Natural Cl LPGX APIC Low slope roof area (ft. (-1) r ill, !el Roof Type ❑ New Roof Re- Roofing ❑ Recovering ❑ Repair ❑ Maintenance ,k5 ❑ Other: L Section A (General Information) Process No. Job Address: Roof Category ❑ Mechanically Fastened Tile ❑ Metal Panel/Shingles Roof System Information Steep Sloped area (ft. Section B (Roof Plan) Page 2 0 Wood Shingles/Shakes Total (ft. ortar /Adhesive Set Tile R I IV Page 1 of 1 1 11 111 II I M11100011 f 1 ll I 1 MILIMMEMEEKWUMMEMEUREEMEMEMEMERMEEREMEMEROMMOMMEEM !r WEEMZENMEMEMEMOREMEMEEMMEMEMEMEMEMEMONEENWEEEMEMEMI I! ' 1! ► ( Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. Include dimensions of sections and levels, dearly identify dimensions of elevated pressure zones and location of parapets. Perimeter Width (a'): 1 Corner Size (a' x a'): I I • High Velocity Hurricane Zone Uniform Roofing Permit Application Form MIAMI-DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION Roof Slope: I Roof Mean Height. Ap Ridge Ventilation: I oik Method of Tile Attachment: Alternate The Attachment Method: Clip Spacing for Metal Roof Panels 1 .. q j Perimeters: A Corners. Perimeter Width: 1 VI Section D (Steep Sloped Roof System) Sloped Systern Description 3 Page 4 Deck Type. r 5/8" Plywood gl Alternate Deck Type: I. A Underlayment type: insuiation/Fire Barrier Board: 1 A Optional Nailable Substrate: Fasteners: Page 1 of 1 I C .-. 3 - p i- Sheet 1--t li Type 1 / 13 Ad tIl hesiv l' e ld\r Tye7 1. C:) _kg/ 91.ir Roof Coverinr • . . _ Roof Covering Attachment Mlithed: .117 Drip Edge Size & Ga uge: kLacp 26 ga Drip Edge Material Type. nalvinized Metal „.. Drip Edge Fastener Type: 1 t 1 5PLA Hook Strip/Cleat ya. or weight:IN/A Roof System Manufacturer: 'pa e ell., A Lt UcarZ. A Notice of Acceptance Numherl 01 Q3 Z.- 8 Minimum Design Wind Pressures, If Applicable (from RAS 127 or Calculations): P 114161 HP 2: 1,1 - 57FP 3:1 . ( ' .1 1.$•_ Maximum Dersign Wind Pressures, {From the PCA Specific system): _ ..... • High Velocity Hurricane Zone Uniform Roofing Permit Application Form MIAMI-DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION Roof Slope: I Roof Mean Height. Ap Ridge Ventilation: I oik Method of Tile Attachment: Alternate The Attachment Method: Clip Spacing for Metal Roof Panels 1 .. q j Perimeters: A Corners. Perimeter Width: 1 VI Section D (Steep Sloped Roof System) Sloped Systern Description 3 Page 4 Deck Type. r 5/8" Plywood gl Alternate Deck Type: I. A Underlayment type: insuiation/Fire Barrier Board: 1 A Optional Nailable Substrate: Fasteners: Page 1 of 1 I C .-. 3 - p i- Sheet 1--t li Type 1 / 13 Ad tIl hesiv l' e ld\r Tye7 1. C:) _kg/ 91.ir Roof Coverinr • . . _ Roof Covering Attachment Mlithed: .117 Drip Edge Size & Ga uge: kLacp 26 ga Drip Edge Material Type. nalvinized Metal „.. Drip Edge Fastener Type: 1 t 1 5PLA Hook Strip/Cleat ya. or weight:IN/A Mlean'R f Height in Feet .� 15" 20' 25' 30' 40 ' Roof Slope ` 1 i 4 2:12 34.4 k5,k 38.2 39.7 42.2 3:12 32.2 34 4 36. 37.4 39.8 4:12 30 4 32.2 33.8 35 37 3 5:12 28.4 30.1 31.6 32.8 34.,: 6:12 26,4 28.0 29.4 30.5 32.4 x:11 2 24A 27.1 28 8 2 30 r High Velocity Hurricane Zone Uniform Roofing Permit Application Form MIAMI -DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION Section E (Tile Calculations) For Moment based the systems, chose either Method 1 or 2. Compare the values for Mr with the values from Mf. If the Mf values are greater than or equal to the Mr values, for each aea of the roof, then the tile attachment method is acceptable. Method 1 "Moment Based Tile Calculations Per RAS 127" P 1 . :K A ,306 , - Mg: __lf.(G', = Mrl: ?3 _._ NOA Mf: 24.(,).7 P 2: 9 . ... � .. I x A °'cos; - Mg: r .6() v Mrl: 2`T... i NOA Mf: ?k P 3: �5. x A ., 30 ! -1111g: 't-f - Mr1 (� ir`f `t I NOA Mf: 1 Method 2 "Simplified Tile Calculation Per Table Below" Required Moment of Resistance (Mr) From the Table Below: I_ NOA Mf: Mr Required Moment Resistance* This Table must be used in conjunction with a list of moment based tile systems endorsed by the Broward county Board of Rules and Appeals. Page 5 Page ! of 12/02 /2004 11 51 FAX 3055780119 I2 ACC SECTION 15/4 Td[GH VELO CITY m1RRXCANE ZONES REQVIRED OWNERS NO1IF[CATYON FOR ROOFING CONSIDEitATTLONS 1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of this section.. The provisions of Chapter 15 of thz Florida Butiaing Code, Building govern tlic minimum requirements and wards of tbeindustry four roofing (Totem 'installations; Additionally, the following Wane, should be addressed as part of the agreement between the one and the contractor. The owner's initial in the adjacent box indicates that the item has been explained. ' � j 1. A eathetlee Workmanship: The workinaaibip provisions of Chapter 15 high Velocity Hurricane nc) are for the purpose of providing that the rodln,g system meets the wind resistance;and water intrusion performance standards. Aesthetics (appearance) issues are not a conaiideration with respect to worloniaoship provisions.'Aesthetio issues such as color or architeatural appearance, that are not part of a zoning Dodo, ahovld be addressed as part of the, agreement between the owner and the ronttactor. � e2. Renalling'Wood Decks: When replacing roofing, the existing wood roof deck may have to be ailed in acco rdance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing roof system). . - �� -- 3. Common Roofs: Common roofs are those which have no visible delineation between neighboring its (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or oweer should notify the occupants of adjacent units of roofing work to be performed. G ! 4. Exposed Celliaags: Exposed, open beam ceilings are where the underside of the ;roof decking can be • viewed from below. The owner may wish to maintain the architectural appearance, fore, rooting nail penetrations of the underside of the decking may not be acceptable. The Florida Build' Code provides the option of maintaining this appearance. 1 /t 9 5. Pending Water: The current roof system and/or deck of the building may not well and may cause water to pond (accuroulete) in low-lying areas 'of the Fool,. Fondles can be an indication of sductunal distress and may require the review of a professional sttvotural engineer. Ponding May shorten' the life expectancy and performative of the: new roofing system. Pending conditions may not be evident until the original roofing system is ,removed. Pending conditions should be corrected. 6. Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof b not overloaded from a build up of water Perimeter /edge walls or other roof extensions may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install• overflow scuppxa in accordance with the Florida Building Code, Pitunbing. 7. Ventilation: Most roof :structures should have some ability to vent natural airflow through the interior f the structural assembly the building itself). The existing amount of attic ventilation shad not be reduced. It may be beneficial to in: milder additional venting which can result in extending the service life of the roof. C Tom.RCYJm1 WA"( /�f 2/dry Date Contractor's Signature MIAMI BUILDING CODE COMPLIANCE OFFICE iBCCO) PRODUCT co1:4TROL DIVrS1O!l NOTICE OF AAC(CEPTAN : (NOA j Sa05 NW 33 St, suite e-102 Miami, FL 33166 MIAMI DADS COUNTY, Fl.nR1DA MEIRO.DADL' PLAGLER BU :I.DJ r...1 140 WEST FL..4GLER STREET, SUITE 1603 M:AM1, FL(DXIrA 3;130.1583 (305) 373.7801 PAY (30S) )75 -340! 702i T T .l114 SCOPE: This NOA is being isiued under the app:'.casie `aloe and rezulationa 6o■oerniilg the use of constructdn:t rrurteriais The documentation submitted has brier, reviewed by the BCCO and acr.tpted by the Building Code and Product Review Corr/rtittt: to be used in :Miami Dade Coua and other at ea where allowed by the Authority Hiving Jurisdiction (ART). NOA shall not be valid after the expiratims date stated below, The BCCO (:ri M:an:.i Dade Cnumy) wndlor the AH? (in area other thal. Miami Dade County) reserve the right to 'naval :his product or material tested for quality assuraa :e purposes. 1# thls product to material faun to perform its the accepted mariner, the manufacturer will incur the expense of such testing and the Air may :rrr+:I.:di revoke, rnraii:'y, or suspend the use of suet; product or material within their jurisdiction. BCC() reserves the der, to revoke this acceptance. if i ::s deter -Tuned by 13f CO that this product o rrateria! fails zo meet the requiremcr. ?a of the applicable building code. ;'hl.$ product is approved as c;escribed herein, and has been &stet ed to comply with the South Florida Building Code, 1994 Edition for Mia.rri..Dade County or Plorida EuiJdmg Code. DESCRIPTION; Vulcan "S" Statue Clay Barrel Roofing Tile LABELING: Each unit shai'. bear a permanent label w;,t}1 the ran,. fac.turcr's ri°r-c or logo, city, state a.nd following statement: "Miami -Dade County Product Control Approved ". unless otherwise noted herein. RENEWAL of :his NOA. shall be convsidelect after a tenewa: application has been filed and the has bee,' no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur a.fte; the exp ;ra :'ion date or it there has beast a revisi -m or chant; in the materials, use, and/cr rna.nrtfarrure of the product or process;. Misuse cf this :40A .as all endorsement cf any product, for sakes, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section; of this NOA th.all be cause for termination and rernova! of NOA. ALDVERTISEM'ENT; The NOA tuber preceded by the wordy A4 :at?ri -pe County, Fianna, and followed by the expiration date 'nay be dispiryeri in advertising literature. If ar,y portion of the NOA. is disptaye~i, then it shat: be done in its entirety INSPECTION; A. copy of this entire NOA shall be provided to the usIC vy the manr,tfaeturer or its :lt4eributors and /hall be avd;lable for insp►,ction at -..ho job site at Lie request of the Building Official. 'This NOA consists of pages 1 Through The ,u5rnitted docutrentatio :a Wes reviewed by Frank Zulaaga, Ii1�C; NOA No.r 01.0828.01 8'spiratiotr Date: 11/27/07 Approval Date: 11/27/01 Nita 1 of 4 L [._;Mari / Erik: O.I rat - „ . r .. 'C✓ C,'a :ill;. _ l '1ddfl3 ll :'�(I -a 9 d� fl :.' 1 ran'. ?iT ca•aosed ROOFING ASSVriII3I, 'L' APPROVAL Category: Sub Category: Materiel: 1. SCOPE This new roofing system using Volr.an 'S" Sta'ue Clay plar*el Roofing T:.la as manufactured by Hacienda EL Volcar: described in Sertl :>n 2 oft ;is Notice of Acceptance, Fcr locatons .where the pressure req'Jirements. as determined by app).eshle Building Cede does not exc.. .d the deli pressure values 7btained by cate:114 (ins in compliance with RAS 127 using the viit^CS 1.>rted in settian 4 herein. late ar..uchirent calculations shall be done as a moment based aystern 2. PRODUCT DESCRIPTION � \'ttica`t •S' Statue Clay Ba, -rai RootingTile '1'rirn Pieces kcoflrtg Roofing T. ?let Clay thinualsaa Length: 1S.2 S" Width, 10.50 varying thickness Length: varies Width: varies varying thickness 2.1 SUBMITTED EVIDENCE: T AIaency IBA Cor.sultants, Inc. PRI Asphalt Technoioas, PRI Asphalt Technologies I. rrA . tY0/ Q':.1 LG+J .:'L�i�;: 0.1. at a .`.]or::. 'zest eetfigAtlOne Product 22gt:riatila High profile, one- pie,:e, 'S' shaped, clay roo PA 112 tilt: with a single roil. For diiet:t deck nail -cn, -nor'ar set, or adhesive set epp':icatione. Ac::essr:ry uzm, ciey :roof pieces for use at PA 112 hips, r', rid$ - er• and valley tetrttina:.ons. Manufactured for each the profile. Ititicitpsipste ipst hiee/12e sat Date. 2799 - 1 TAS ) 1 z 08/22/02 a.7i 002. - C2 - 0l '"AS 1)1 10/08;01 F'o1.Oi••02.01 TAS 201 1005;02 O: t i t'aaE i 3. L IMITATIONS 3.1 Fire clessilicat :ion is not I,an of this acceptance. 3.2 For mortar or adhesive act the applications, a stonc field uplift test sh.tll tr. perf in accordance with HAS 106. 3 3 Applicant shall retain the services of a 1Viiarni. Dec +.e, County Ccrr:ifi•1 Laboratory to perform quarterly test in eoccrdarce with PA 112, appendix 'A' S :.h testing shall be subtri:read to the Building Code Compliance Office_ for review;. 3 41 Minimum underlaytrtent shall be in carnpliat,ce with the applicable Roofing Applir_aunt:s Standards listed seetior 4,1 .herein, 3.f 30/90 hot mopped anderl.aytnertt applications may he instalkle perpendi: ular to the roof slope uulesc stated otherwise by the underlayment natal : manufac.tuers published literatire. 3.6 This acceptance is for wood deck applications, Minimum deck: requirements shall be in compliance with applicable building code, NOA No.t 01..0S211.0.1 t%xpiration DOD: 11/27/61 Approve? Date: 11/2 7/02 hip i -iddnS C343: T t-on? P "G;i7 4. INSTALLATION 4,; Volcan "S" Statue Clay Barrel Roofing T'ie and its cornporerts aila :1 be u,stalled in sirs: compliance with Roofing Application Standard RAS :20. 4.: Data For Attachment Calculations Table Average Weight (W) and Dimensions (1 x w ) Tile Profile Voloan "5" Statue CCiay I 6 43 � 1.52 � ' 0,85 f 8arrel Roofing Tile l Table 2: Aerodynamic Multi Liars - e) Tile (ft' Profile _ Direct Deck A Ileetl on IVolc*n "S" Statue Clay Soma Roofing TVs fi 0.3 _ 00 "r n Table 3: Plestoring Moments due to dirsvIty - M (ft•Ibf) I Tie Profile 3 ":12" 4 " :12" 5 7 712 " wit " :12.' 7 °:12" I 'Moan "S" Statue Clay Direct Deck Direct deck 1 Direct Deck ' Direct Deck D `reot Deck � T1l Sarre) RoofIne 4.86 4,&J L 4.73 4.63 4.52 4 Table 4: Attachment Resistance Expressed as a Moment y M, (ft -Ibf) --- f or Bingj Patty Aclhsalve Set Sltems _ Profile 1 Minimum Attachment J Barrel a r�l PaokpIq r nent pt 41 .' 4m$ G} r":92vPru'". S. LABELING All filet shall bear the imprint or identifiable marking of tht man•. facturer's name or logo, or following statement: "N.ian3i.Dade County Product Control Approved ", 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies czf the following: 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by the Building Official ar applicable building code it order to property evaiva:e the installation of this system. Tile Tile Application Resistance OE:t7T V[i:i ' .shw Weight-W (Ibt) length-1(ft) T .y Wicith.w (ft) NOA No.: 01- 0828.01 Expiration Date; 11/27!07 Approval Date: 1.1 /27/02 Page 3 of 4 t S i_J.f..S CaICjd cif T© :n rhl:' eo aRO +4 10101 •* SirROmg VOLCAN 'S' STATUE CLAY BARREL ROOF TILE PROFILE DRAWINGS • AA,n LS&LSOS7 01 END OF THIS ACCEPTANCE rOOF .L ^VA NOA Nu.. 01.0828.01 tiptra nor Mile: 11/27/07 Approval Date: 11e21/02 Pa$8 0 of 4 • - • , S31 7cidn 01a169 TO :T r0 U ):711 M1AMI•DADE PRODUCT CONTROL NOTICE OF ACCEPTANCE Polyfoam Products, Inc. 2400 Spring - Stuebner Road Spring ,TX 77383 -1132 The expense of such testing will be incurred by the manufacturer. APPROVED: 06/14/2001 MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 CONTRACTOR LICENSING SECTION (305) 375 -2527 FAX (305) 375 -2558 CONTRACTOR ENFORCEMENT DIVISION (305) 375 -2966 FAX (305) 375 -2908 PRODUCT CONTROL DIVISION (305) 375 -2902 FAX (305) 372 -6339 Your application for Notice of Acceptance (NOA) of: Two Component Polyurethene Foam Adhesive under Chapter 8 of the Code of Miami -Dade County governing the use of Alternate Materials and Types of Construction, and completely described herein, has been recommended for acceptance by the Miami -Dade County Building Code Compliance Office (BCCO) under the conditions specified herein. This NOA shall not be valid after the expiration date stated below. BCCO reserves the right to secure this product or material at any time from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner, BCCO may revoke, modify, or suspend the use of such product or material immediately. BCCO reserves the right to revoke this approval, if it is determined by BCCO that this product or material fails to meet the requirements of the South Florida Building Code. ACCEPTANCE NO.: 01-0521.02 EXPIRES: 05/10/2006 Raul Rodriguez Chief Product Control Division THIS IS THE COVERSHEET. SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS BUILDING CODE & PRODUCT REVIEW COMMITTEE This application for Product Approval has been reviewed by the BCCO and approved by the Building Code and Product Review Committee to be used in Miami -Dade County, Florida under the conditions set forth above. Francisco J. Quintana, R.A. Director Miami -Dade County Building Code Compliance Office 11s04500011pc200011 templates 4wdce acceptance cover page.dot Internet mail address: postmaster @buildingcodeonline.com • Homepagc: bttp : //www.buildingcodeonline.com Polyfoam Products. Inc. ACCEPTANCE No.: 01- 0521.02 ROOFING ASSEMBLY APPROVAL Category: Roofing Sub-Category; Roof Tile Adhesive Materials: Polyurethane 1. SCOPE This approves Polypro® AH160 as manufactured by Polyfoam Products, Inc. as described in Section 2 of this Notice of Acceptance. For the locations where the design pressure requirements, as determined by applicable building code, does not exceed the design pressure values obtained by calculations in compliance with Roofing Application Standard RAS 127, for use with approved flat, low, and high profile roof tiles system using Polypro® AH 160. Where the attachment calculations are done as a moment based system for single patty placement, and as an uplift based system for double patty systems 2. PRODUCT DESCRIPTION Manufactured by Applicant Dimensions Polypro® AH160 N/A Foampro® RTF1000 N/A ProPack ®30 & 100 N/A 2.1 Components or products manufactured by others: Any Miami - Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list uplift resistance values with the use of Polypro AH160 roof tile adhesive. 2.2 Typical Physical Properties: Test ASTM D 1622 ASTM D 1621 Property Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability ASTM D 1623 ASTM D 2127 ASTM E 96 ASTM D 2126 2 Test Specifications PA 101 1.6 lbsift 3 18 PSI Parallel to rise 12 PSI Perpendicular to rise 28 PSI Parallel to rise 0.08 LbsJFt 3.1 Perm / Inch Approval Date: June 14, 2001 Expiration Date: May 10.2006 Results +0.07% Volume Change @ -40 F., 2 weeks +6.0% Volume Chan _ e Humidity, 2 weeks Product Description Two component polyurethane Dispensing Equipment Dispensing Equipment Frank Zuloaga, RRC Product Control Examiner Polyfoam Products, Inc. ACCEPTANCE No.: 01- 0521.02 Note: The physical properties listed above are presented as typical average values as determined by accepted ASTM test methods and are subject to normal manufacturing variation. 3. LIMITATIONS 3,1 Fire classification is not part of this acceptance. Refer to the Prepared Roof Tile Assembly for fire rating. 3.2 Polypro® AH160 shall solely be used with flat, low, & high tile profiles. 3.3 Minimum underlayments shall be in compliance with the Roofing Application Standard RAS 120. 3.4 Roof Tile manufactures acquiring acceptance for the use of Polypro® AH160 roof tile adhesive with their tile assemblies shall test in accordance with PA 101. 3.5 Roof Tile manufactures acquiring acceptance for two paddy placement with the use of Polypro® AH160 roof tile adhesive with their tile assemblies shall test in accordance with PA 101 and with section 10.4 as modified herein. F — 1 2 - w MS 4. INSTALLATION 4.1 Polyproo AH160 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of Polypro® A11160. 4.2 Polypro® AH160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of Polypro® AH160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the uplift resistance determined in compliance with Miami -Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA 4.3 Polypro® AH160 roof tile adhesive and its components shall be installed in accordance with Roofing Application Standard RAS 120, and Polyfoam Products, Inc. Polypro® AH160 Operating Instruction and Maintenance Booklet. 4.4 Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, Inc. Polyfoam Products Inc. shall supply a list of approved applicators to the authority having jurisdiction. 4.5 Calibration of the Foampro dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the "B" component shall be maintained between 1.0 -1.15 (A) : 1.0 (B). The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved. 4.6 Polypro® AH160 shall be applied with Foampro RTF1000 or ProPack® 30 & 100 dispensing equipment only. 4.7 Polypro'l AH160 shall not be exposed permanently to su 3 Frank Zuloaga, RRC Product Control Examiner Table 1: Adhesive Placement For Each Generic Tile Profile TileProfile Placement Detail Single Paddy Weight Min. (grams) Two Paddy Weight per paddy Min. (grams) Flat, Low, High Profiles #1 35 N/A High Profile (2 Piece Barrel) # I 17 /side on cap and 34 /pan N/A Flat, Low, High Profiles #2 24 N/A Flat, Low, High Profiles #3 8 Polvfoam Products, Inc. 4.8 Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after Polyproc• AH160 has been dispensed. 4.9 Polypro® AH160 placement and minimum patty weight shall be in accordance with the Placement Details' herein. Each generic tile profile requires the specific placement noted herein. 5. LABELING All Polypro® AH160 containers shall comply with the Standard Conditions listed herein. 6. BUILDING PERMIT REQUIREMENTS 6.1 As required by the Building Official or applicable Building Code in order to properly evaluate the installation of this system. 4 ACCEPTANCE No.: 01- 0521.02 Frank Zuloaga, RRC Product Control Examiner Polvtoam Products, Inc. ADHESIVE PLACEMENT DETAIL 1 SINGLE PATTY 5 ACCEPTANCE No.: 01- 0521.02 1) Flaw enough adhesive to achieve 17 to 23 46°4 214 fm square Inches In contact wt h the pan tie ateepilitch **a 2 ) Turn coven u� Moo adman tta 112 tn. In. From Don install the Me. Nag woc *ado content 1 toPPIFon of the ems course cover tilt Abut to second case of Pen thee. Ensure we end of pen and awe lies are tpah dame Mae. Ems closure (molter shown) Is Facto Optimal Pehtbup Mortar cm loagRudtael Frank Zuloaga, RRC Product Control Examiner Polyfoam Products, Inc. ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY 6 ACCEPTANCE No.: 01 0521.02 Frank Zuloaga, RRC Product Control Examiner Polvfoam Products, Inc. ADHESIVE PLACEMENT DETAIL 3 DOUBLE PATTY Nall through plastic cement Paddy (between tile) Paddy (under tile) Sing paddy 3 in. under the x 3 in. Ugh paddy on under- layment Single paddy on top of tile bye course h. X 7 lit medium slze paddy eava Flub course only Nell through plastic cement t e - 3 in. x 3 In. paddy a n tmderlayment Single paddy on top of die Erre Course 7 ACCEPTANCE No. : 01-0521,02 SeNde PaddY between tile Ewe Closure 2 hi. x7 in. medium she paddy erre course only Fascia Single paddy under the Single paddy between the 2 in. x 7 In. ninon size paddy eave course only Frank Zuloaga, RRC Product Control Examiner Fascla Weep* Eave ChM dip edge Polvfoam Products, Inc. ACCEPTANCE No. : 01- 0521.02 1. Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and the original submitted documents, including test - supporting data, engineering documents, are no older than eight (8) years. 2. Any and all approved products shall be permanently labeled with the manufacturer's name, city, state, and the following statement: "Miami -Dade County Product Control Approval ", or as specifically stated in the specific conditions of this Acceptance. 3. Renewals of Acceptance will not be considered if a. There has been a change in the South Florida Building Code affecting the evaluation of this 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 approved. c. If the Acceptance holder has not complied with all the requirements of this acceptance, including the correct installation of the product. d. The engineer who originally prepared, signed and sealed the required documentation initially submitted, is no longer practicing the engineering profession. 4. Any revision or change in 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 office. 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 any other purposes. 6. The Notice of Acceptance number preceded by the words Miami-Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is displayed, then it shall be done in its entirety. 7. A copy of this Acceptance as well as approved drawings and other documents, where it applies, shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at all time. The engineer need not reseal the copies. 8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of Acceptance. 9. This Notice of Acceptance consists of pages 1 through 8. END OF THIS ACCEPTANCE 8 Frank Zuloaga, RRC Product Control Examiner . Polvfoam Products Inc. ACCEPTANCE No. : 01- 0521.02 NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED (For File ONL Y. Not part of NOA.) A. DRAWINGS: NONE B. TESTS: Test Agency Center for Applied Engineering Center for Applied Engineering Center for Applied Engineering Center for Applied Engineering Center for Applied Engineering Miles Laboratories Polymers Division Ramtech Laboratories, Inc. Southwest Research Institute Southwest Research Institute Trinity Engineering Celotex Corp. Testing Services Celotex Corp. Testing Services Celotex Corp. Testing Services Test Identifier #94 -060 257818 -IPA 25- 7438 -3 25- 7438 -4 25- 7438 -7 25 -7492 NB -589 -631 9637 -92 01- 6743 -011 01- 6739 -062b[1] 7050.02.96 -1 528454 -2 -1 528454 -9 -1 528454 -10 -1 520109 -1 520109 -2 520109 -3 520109 -6 520109 -7 520191 -1 520109 -2 -1 E -1 Test Namc/Renart Miami Dade Protocol PA 101 Miami Dade Protocol PA 101 SSTD 11 -93 SSTD 11 -93 11/02/95 SSTD 11 -93 12/12/95 ASTM D 1623 02/01/94 ASTM E 108 04/30/93 ASTM E 108 11/16/94 ASTM E 84 01/16/95 PA 114 03/14/96 Miami Dade Protocol PA 101 10/23/98 Miami Dade Protocol PA 101 12/28/98 Dole 04/08/94 12/16/96 10/25/95 Frank Zuloaga, RRC Product Control Examiner Polyfoam Products Inc. ACCEPTANCE No. : 01- 0521.02 NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED (For File ONLY. Not part of NOA.) C. CALCULATIONS: Walker Engineering, Inc., Evaluation of Tests. Dated 04/07/99 D. MATERIAL CERTIFICATIONS: NONE E. STATEMENTS: NONE E -2 Frank Zuloaga, RRC Product Control Examiner MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed staiement 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 D W;11- Building Inspector Registered Architect and /or Engineer 1-/ 4 f y & • NE L S O// Name and address of licensed contractor Q do^/ ` 3 e-• ' J 2 Location and legal description of lot to be built on: Lot Block 2 - Subdivision. Street and Number where work is to be done 7 .5 2 4 E 9l Date , 19' f No. _fStreet AC-E is y /c'e State work to be done and purpose of building (by floors )_______ �______ 1 c /''r h ct-' R. s o �J f'7 - r' - ( / and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of___ Kind of foundati n___ � e Ro f Covering ___ �� Estimated Total cost of impro ements $___ J Amount of Permit $_, Zone cubage required _Plan Cubage ` /— 7 Distance to next nearest building O r T L Size, of uildjng Lot' x 3 S 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 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) ' ' „ 6, C 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, bein by e first duly sworn, upon oath deposes a says .tha(he is the of the above . esc . ed cons uction, that he as I arefully re foregoing application, and that he did sign the same, and that all facts therein by h'. st ted are tr 'e. Permit No ________ , Date_ __� ___�_� J ' ead, Sworn to and Subscribed before me. Disapprove Notary Public, State of Florida ( Signed My Commission Expires PLANNING BOARD DATE Chair an 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 'inning Board. -e- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty and /or workmanship. Application is hereby made for the approval of the detailed stateiiu•nt or the plans and specifications herewith submitted for the build in or other structure herein described. This application Is made in compliance and conformity with the Building Ordinance of Miarnl shores \'rIl. ge, 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 cupy of approved plans and specifications must be kept at building during progreu of the work. Owner's Name and Address Registered Architect and /or Engineer ,,. • ,,, . 0 op Name and address of licensed contractor Location and description to be built on: Lott ,�:e A e ..... /....le. Bock Subdivision. ... . //�� Street and lumber where work is to be done .94 .. ..�_.7. / State work to be done and purpose of building (by floors) New Building Remodeling Addition Repairs To be constructed of Kind of foundation v Estimated Total cost of improvements $ 7 Q �� Amount of Permit r _ Zone cubage required Plan Cubage Distance .to next nearest building Size of Building Lot 1 '�_�.,2C.. /4Q � ................._........_ Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said budding. 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 obligation% as an employer of Libor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup dement, anti has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by Trim in thc work to be performed under this permit; and will post or cause to be posted for inspection on the site of th ork such public notice or notices as arc required by the Act. The undersigned agrees to employ only such subcontra ors on work t�!t j d 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 e. Permit No.._.._l....._ bate Disapproved :. Date (Signed) APPLICATION FOR BUILDING PERMIT MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT D P2- 4 Date..--.. —4/a _ No. 95 __. street _Alt If/ R Jr Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commission Expires a,.. <3 0 and for no other purpose. No. ��??of Stories Roof Covering.e.62l/,Eiler.. G 124T) PLANNING BOARD DATE Chairman Member Member Member Member .. - -•-- •-- ..._._..._.— ...._......_ Member Council Approved Date Disapproved Date NOTE: A cli.irgc of $1.00 will be made for making corrections or changes to this application after approval has hecn obtained fmrn the Pl.rnnir,;; I :o.rrd. A rc- m fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspevtirm or faulty materials and /or workmanship. T 2_ 7: S 64 2N: 2 Z49 � Y °.B CQ Q0 za °Z7 .2,94; 4 /fit M7( /(13iL0 MIAMI SHORES VILLAGE 7s 77/® BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed stateiiienr or rice plans and specifications herewith submitted for the build inc 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. Ocr's Name and Address i1 27 s.n Registered Architect and /or Engineer Name and address of licensed contractor State work to be done and purpose of building (by floors) (Signed) Disapproved Date 044 ..... Date Location and legal description iot - be built o . Lott 7 •J ! 9 1 kif Block Subdivision ...I � >� Street and Number where work is to be done 42 --pA7 ,A1 and for no other purpose. Ncw Building Remodeling Addition Repairs No. of Stories _ To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $....•/ 2 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 Honda Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied ss itli 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 he work such public notice or notices as arc required by the Act. The undersigned agrees to employ only such subcontractors, on wor performed under this pcnnit, as are licensed by Miami Shores Village. �) Rern.uks __._.__ (Signed)...._ 1J . 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 lie has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated re true. Permit Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commission Expires _. PLANNING BOARD DATE Chairman Member Member Member \fcmber .. 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 I'Luuuin Board. A re m ice of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL PLUMBING 0 PERMIT N9 33219 ROOFING la ❑ Work to be performed under this Permit Owner of/ Building t 1 -vt 'li Architect Contractor p 6: or Builder (i % Legal Description Address of Building 1644 Lot Y/ �'y i 2 NT ACTOR or BUILDER Date 19__ Contractor's / LC/C License No. Alelv4Ad //y, Subdi- j� /' 6 vtston v -t" iv„ t4./',.wf- L „.-4. / Sq Ft. !J t Value of $ I l I X111 Amount of Project ) ( ` 1' i 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 applica- tion 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 ora the 'plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employ Signed• 1 �'”' - (INSPECTOR) BY In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit i assume responsibility for all work done by either, myself, my agent, servant or employee. 140 A 200 10/14/9.70R 47.50 BY AUTHORITY J0