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ROOFING• Phone # Inspection Date Approved Correction Re- Insp'n Fee -Z473 _ MIAMI SH • RES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Build Inspection Request Date Type Insp'n I ) -.2RC Pe rmit No. , 5poq (� e 11 �0.thin1 A,4 Address 7 ��lL c Company r L5k 1 EN•G+■•EER John Busta Roofing 300 Northeast 91 Street Miami Shores, Florida Project: Dear Sirs; LG ENGINEERING SERVICES, INC. Consulting Engineers 2020 Northwest 7th Street Miami, Florida 33125 1 Tel: (305) 649 -6454 Fax: (305) 541 -3298 TILE UPLIFT TEST Residential Home 333 Northeast 91 Street Miami Shores, Florida Information provided by client: Permit Number: BPO4299 Date Completion: May 28, 2005 Roofing Contractor: John Busta Roofing LG Engineering Services, Inc. Project Number: LG05 -1436 (Testing Laboratory Certificate #00- 0224.07) June 6, 2005 In accordance with your request and authorization, a representative of LG Engineering Services, Inc. completed the Roof Tile Uplift Test at the above referenced project. This testing was perfoired in general accordance with Roofing Application Standard TAS No.106 -- Standard procedure for field verification of the bonding of mortar or adhesive set tile system and mechanically attached, rigid, discontinuous roof systems. The total of the tested roof surface area was less than 10000 square feet, and the mean height of the roof is less than 30 feet above ground surface. The type of tile used for this project was reported to be Monier Roof Tile. This tile was reported to have been foamed in place. At the time of this testing, one test for every corner, one test for every 100 square feet of roof tile in the perimeter area and one test for every 200 square feet of roof tile in the field area wer 3 ted. Initially the entire area of the roof was examine for loose tile. More than 10% of the ro . •' - • td in the field area and more than 20% of the roof tile at the roof perimeter and come "� • • ically examined. g ��� � Based on our test results, we conclude that the installation of the roof ti a tl above referenced project meets the test requirement outlined in the above mentioned prot col. Attached please find a copy of our test report for your review. LG Engineering Services, Inc. appreciates the opportunity of assisting you in this project. If you have any questions or if we may be of further assistance, please do not hesitate to contact the undersigned. Respectfully submitted; LG Engineering Services, Inc. 'GIo,ha rad Sonny Salleh, P.E. !Pr6ject Manager TILE UPLIFT TEST Residential Home 333 Northeast 91 Street Miami Shores, Florida • Test Number Test Load (lb!) Test Status 1 35 Pass 2 35 Pass 3 35 Pass 4 35 Pass 5 35 Pass 6 35 Pass 7 35 Pass 8 35 Pass 9 35 Pass 10 35 Pass 11 35 Pass 12 35 Pass 13 35 Pass 14 35 Pass 15 35 Pass 16 . 35 Pass 17 35 Pass 18 35 Pass 19 35 Pass 20 35 Pass 21 35 Pass 22 35 Pass 23 35 Pass 24 35 Pass Report of TILE UPLIFT TEST for Residential Home 333 Northeast 91 Street Miami Shores, Florida Project Number: LGO5 -1486 LG Engineering Services, Inc. — Tile Uplift Test Result -- Project Number: LGO5-1486, Page I Test Number Test Load (lbf) Test Status 25 35 Pass 26 35 Pass 27 35 Pass 28 35 Pass 29 35 Pass 30 35 Pass 31 35 Pass 32 35 Pass 33 35 Pass 34 35 Pass 35 35 Pass 36 35 Pass 37 35 Pass 38 35 Pass 39 35 Pass 40 35 Pass 41 35 Pass 42 35 Pass 43 35 Pass 44 35 Pass 45 35 Pass 46 35 Pass 47 35 Pass 48 35 Pass 49 35 Pass 50 35 Pass 51 35 Pass 52 35 Pass 53 35 Pass 54 35 Pass LG Engineering Services, Inc. -- Tile Uplift Test Result. -- Project Number: LGO5 -1486, Page 2 Test Number Test Load Obi) Test Status 55 35 Pass 56 35 Pass 57 35 Pass ' 58 35 Pass 59 35 Pass 60 35 Pass 61 35 Pass 62 35 Pass 63 35 Pass 64 35 Pass 65 35 Pass 66 35 Pass 67 35 Pass 68 35 Pass 69 35 Pass 70 35 Pass 71 35 Pass 72 35 Pass 73 35 Pass 74 35 Pass 75 35 Pass 76 35 Pass 77 35 Pass 78 35 Pass 79 35 Pass 80 35 Pass — — -- LG Engineering Services, Inc. — Tile Uplift Test Result -- Project Number: LG05-1486, Page 3 NOp1 H + + + + + + + + + + + + + + ++ + + + + + + + + + + + + ++ ++ + + + + + + + ++ + + + + + + + + + + + + + + + + + + + + + APPROX. <;00? tt;5f LOCA110N5 A■I2 PIMEN510N5 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building • Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Electrical �i*lc` / � , : t it Owner's Name (Fee Simple Titleholder) ~' / � A, '- Owner's Address � U7, .0 State /' .4f Tenant/Lessee Name /., Phone # , 17) Job Address (where the work is being done) ._ ' '.`" City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO X Contractor's Company Name 2 /7 Submittal Fee $ O CC Permit Fee $ Contractor's Address - 7-7 / ' - // . _ = 1 City Al/ , ,� State ' �- �, '� -� _ ,, ,� Qualifier �- ! - /! r f, " � / 7 i H Architect/Engineer's Name (if applicable) Phone # 4f- $ Value of Work For this Permit Type of Work: ❑Addition ❑Alteration ❑New Describe Work: / �L o Nota ry $ Training/Education Fee $ 1X/ Scanning $ /63 Radon $ i)teUC:,C G Permit No. � - Z a i Master Permit No. Plumbing Mechanical Phone # -' Zip Zip Zip Phone # - f --" Square Footage Of Work: . , '`t2 S/2 NB Repair/Replace ❑ Demolition ? aa -. (-7` /"'t/ i i /1/ ** ************************** FeeS * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** tr� CCF S z o Technology Fee $ Bond $ P Code Enforcement $ ,---- Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) Roofing Bonding Company's Name (if applicable) Bonding Company's Address City S to Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State- Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be approv d and a reinspection fee will be charged Signature NOTARY Sign: Print: :ho 10/14/03 gent The foregoing instrume t acknowledged before me this ls_ day ofr0 , 2001, by who is personally known to me or who has produced As identification and who did take an oath. P IC: .. ,' �'ti�:;, iii. • My Commission Exp' �,II nStion * * * * * ** * * * * * * * * *** - -� pp„�, it �i qy * *�k!!t * * *�F��k #7E 7rtl * * * * # * * * * * * ## * * * * * * * * * * * * * * # * * * * * * * ** State Certificate or Registration No. ( e frcate o Zip Signatur Competency Holder) Certificate of Competency No. 3 � , Contractor The foregoing instrument was acknowledged before me this Sk day of ((\(,WY`,,. , 20C}1, by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission 16 dl • .' 'o p ondod By National Note A4a k############################################ # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # * # # # # # # # # # * * * * * * # # # ## 3PPLICATION APPROVED BY: � AR — 8 2UUit Plans Examiner Engineer Zoning Floe Ida Building C d Edttion 2002 to Veocity Oilmicarte Zo linifonn Permit Application Rim. t _ E3 New fts Low Sinn* Rae A 7 A Re-Roofing COF CATES© Et Mechanically Fastened Tile Fe Mortath &lesiva Sean 0 Metal Pan AfShingiss 0 Woad ShinglesfShattaz COF s STEM INFORMATIM 2/ Rt. pair 0 Maintenance Florida Building Code Edition 2002 HIGH VELOCITY HURRICANE ZONE UNIFORM ROOFING PERMIT APPLICATION Fill in the specific Ro Assembly Components and Identify Manufact er (If a component is not used, .dentify as "NA ") System Manufacturer: NOA No: Design Wind Pressures, From RAS 1 Number of asteners Per Insulation Board Pmax l : Pmax 2: Pmax 3: Field Perimeter Corner Maximum Design Pressure, From the Speci NOA System: Deck: III trate Components Noted and Details Type: Applicable: oodblocking, Gutter, Edge Terminations, Gauge/Thichness: Stripping, , Flashing, Continuous Cleat, Cant Strip, Base Flashing, Counter - flashing„ Coping, Slope: Etc. Anchor/Base Sheet & No. of Ply(s): Anchor /Base Sheet Fastener/Bonding Material: Insulation Base Layer: Base Insulation Size and Thickness Base Insulation Fastener /Bonding Material: Top Insulation Layer: Top Insulation Size and Thickness: Top Insulation Fastener /Bonding Mate al: Base Sheet(s) & No. of Ply(s): Base Sheet Fastener /Bonding terial: Ply Sheet(s) & No. of Ply(s Ply Sheet Fastener /Bond g Material: Top Ply: Top Ply Fastener /Bonding Material: Surfacing: Section C (Low Sloped Roof System) or Calculations: Fastener Spacing for Anch r/Base Sheet Attachment Field: "o /c @ la... & rows @ "o /c Perimeter: "o/ @ laps & rows a "o /c Corner: ". /c @ laps & rows @ "o /c Indicate: Mean Roof Height, Parapet Height, Height of Base Flashing, Component Material, , Material Thickness, Fastener Type, Fastener Spacing Or: Submit Manufacturers Details that Comply with RAS -111 and Chapter 16 Parapet Wall Height Ft Mean Roof Height _ Ft Roof Slope: 4 :12 Florida Building Code Edition 2002 h Velocit Hurricane Zone Uniform Permit ••lication Form. Section D (Steep Sloped Roof System) Roof System Manufacturer eiON/_rf Notice of Acceptance Number: aZ, Minimum Design Wind Pressures, if Applicable (From RAS 127 or Calculations): / P1: ` 2/7 6 P2: lOO P3: /Pa Maximum Design Pressure ��.c � (From the NOA Specific System): Method of the attachment: 4 )/,OA,{ Steep Sloped Roof System Description Deck Type: Type Underlayme Insulation. Ridge Ventilation? Fire Barrier: Fasten Ceara Roof Height: me 7/30/45774-7YRE / 022_,4 N/ A VA er Type & Spacing dhesive Type Type Cap Sheet: 3 1g'77i1 m4P-s tlVviv,3mz° /," �/� o �f� c Roof Cover'ng: A �ll ' Type & Size Drip Edge: 202 Where to Obtain information Description Symbol PI or P2 or P3 Where to find RAS 127 Table 1 or by an engineering analysis prepared by PE based on ASCE 7 Design Pressure Mean Root' Height H Job Site Roof Slope 0 Job Site Aerodynamic Multiplier A NOA Restoring Moment due to Gravity M Mr NOA NOA Attachment Resistance Required Moment Resistance M. Calculated Minimum Attachment Resistance F' NOA Required Uplift Resistance F Calculated Average Tile Weight w NOA Tile Dimensions I= length vw width NOA All calculations must be submitted to the Building Official at the time of pennit application. M Required Moment Resistance* Mean Roof Height -{ Roof Slope 4, 15' 20' 25' 30' 40' 2:12 34.4 36.5 38.2 39.7 42.2 3:12 32.2 34.4 36.0 37.4 39.8 7 ° -- 28.4 32.2 33.8 35.1 37.3 6:12 30.1 31.6 32.8 34.9 6:12 26.4 28.0 29.4 30.6 32.4 7 :12 24.4 25.9 27.1 28.2 30.0 Florida Building Code Edition 2002 High Velocity Hurricane Zone Uniform Permit Application Form. Section E (Tile Calculations For Moment based tile systems, choose either Method 1 or 2. Compared the values for M with the values from MU 1f the Mr values are greater than or equal to the Mr values, for each area of the roof, then the tile attachment method is acceptable. Method 1 "Moment Based Tile Calculations Per RAS 127" (P x x .. , .� = ;'. . n - M 4 = Mrt NOA o M (P x A. _ r ,e - Mg: dri. = M 1, NOA M i tom / (P . x a <. � _ , �� �ti) - Mg: raw �i, = Mr ' . NOA M Method 2 "Simplified Tile Calculation Per Table Below" Required Motnent of Resistance (M From Table Below 30.`Q NOA 6/ *Must be used in conjunction with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared the values for F' with the values for F If the F' values are greater than or equal to the F values, for each area of the roof, then the tile attachment method is acceptable. Method 3 "Uplift Based Tile Calculations Per RAS 127" (P : x I: = x w: = ) - W: x cos 0: = F NOA F' (P : x I: = x w: = __J - W: x cos 0: = F NOA F' (P x I: = x w: _ ) - W: x cos 0: = F NOA F' PRODUCT tl~O T ®iL NOTIICE F A OEi,TAINcE II°olyffoaaann 11'a- uduct9, line. 2400 Spring- Stttcbner Bend Spring ,TX 77334I32 Your application for Notice of Acceptance (NOA)of: Two Component Polytttcetheaas Foam Adhesive under Chapter 0 of the Code of Mimi-Dade County goventing the use of Alternate Materials and Types of Construction, and completely described herein, has been reconunended for acceptance by the Miatni -Dude County Building Code Compliance Office (BCCO) under the conditions specified herein. This NOA shall not be valid alter the expiration date stated below. BCCO reserves the right to secure this product or material at any time from a jobsite or' manufacturers. plant for quality control testing. If this produce 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 k is determined by BCCO that this product or material fails to meet the requirements of the South Florida Building Code. The expense of such testing will be incurred by the manufacturer. ACCEPTANCE, NO.: Oi - (I�2I.tB2 EXPIRES: g /IW20OCe 111.81 TI1-1E COVERSH EFT 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 iv ianti -Dade County, Florida tinder the conditions set torth above. APPROVED: O6/ld /21101 11, Oa500011pe200011templatetlnotleo accaptante cover paao.dot MIA1M- LDAtDE COUNTY. FLORIDA METRO -DADS FLAGLEtt BUILDING BUILDING CODE COMrUntoce OFFICc A ITRQ -OADE ry„ tCLrlt DIMMING 140 WEST F1AGI.l R s 'r. sun": 1601 Mtni�tl. FLoRn),t, 33130 -1563 (305) 375 -2701 re1X (305) 373.290 coivraAcroR t.dcr,:nfslwr: saa'rlcvN 003)373.2527 FAX (3 C(DNTIIAL-T018 ENFORCEMENT DIVISION 0051373 - 2966 PAX (3O$) 373.290 Paouvcr co.VEIdot. (3051 )75-290 FAX (305) 373.6)39 Raul Rodrigues Chief Product Control Division E ADfrTI AL PA .F.S FOR SPE 1 ; A' �. OF `. .RA@ . OIV➢DITIOPIS nUffLDHNG F tet (}: III: REV FIN co tv unr Francisco I. Quintana. R.A. Director Miami -Dade County Building Code Compliance Office PolvFoagn Products, floc. ACCEPTANCE No. • 41 :02,1 � ROO1' llNG ASSEMBLY APPROVAL c a_gpaa�cro: Rooting Step- Root" rile Adhesive IvaaotQ i als: Polyurethane 0. SCOPE "1'his approves PoOgptro0 AOi1 6C0 as manufactured by Pelyi"esteat Products, Hue. as described in Section 2 of this Notice or 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 systean using fPolyprolti Ali 160. Where the attachment'ca lculations are done as n moment based system for single patty placement, wad as an uplift based system for double patty systems 1' Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability 2. PRODUCT DESCRIPTION Wi ncaeafnettnavel by Isdaat Polyptoq! AH160 isearnpro!,' RTF1000 I'roPack® 30 & 100 71YieneuslieenN N/A N/A N/A 2. a Coaa9pxantae: is or products nraatattPaectzeared by others: Any Miami -Dade County Product Control Accepted Roof Tile Apscinbly having a current NOA which list uplift resistance values with the rise of Potypro A1.1160 roof the adhesive, 2.2 Typical Physical Properties: Prplath TCSt Density ASTM 0 1622 Compressive ASTM D 1621 ASTM 0 1623 ASTM D 2127 ASTM E 96 ASTM 0 2 126 Test eetticadons PA 101 1.6 lbs. /It? 18 PSI Parallel to rise 12 PSI Perpendicular to rise 28 PSI Parallel to rise 1 0.08 Lbs. /Ft 3.1 Perlin / Inch Approval Date: .tu tse_ 4 2f1t10 Expiration Date: ( aay 8tD MN lima! +0.07% Volume Change © -400 P.. 2 . weeks :+6.0% Volume Chan 'e 4 ) :Humidity, 2 weeks Proxlaaet EtcsetriPtiez Two component polyurethane Dispensing Equipment l)ispcnsing Equipment Frank Zuloaba, 1dIt. Product Control Examiner f.Uvramaao Prodtsts, Inc, Note: The physical properties listed above are presented tas typicaal average vaalucs n$ determined by accepted ASTM test methods mid are subject to normal manufacturing variation. 3. L.11M1TATIONS 3.1t Fire classification is not part ofihis acceptance. Refer to the Prepared Roof Tile Assembly for tire rating. 3.2 Polypro'=? AH160 shall solely be used with flat, low, & high the profiles. 3.3 Minimum underlayments shall be in compliance with the Rooting Application Standard RAS 120, 3.4 RoofTile manufactures acquiring acceptance for the use of Potyproti AH160 root 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® A14160 roof file adhesive with their tile assemblies shall test in accordance with PA 101 and with section 10.4 as modified herein. F 4. 11NSTALLATIiON 4.1 Polypro® AH160 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of Polypro® AH160. 4.2 Polypro® AH 160 shall be applied in compliance with the Cornponent Application section and the corresponding Placement Details noted herein. The roof tilt assembly's adhesive attachment with the use of Potypro AH160 shad 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! 4 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 jhrisdiction. 4.3 Calibration of the Foamproo dispensing equipment is required before application of any adhesive. The mix ratio between the 'A" component and the "t3" component shall be maintained between 1.0 -1.15 (A) : 1.0 (13). 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® A1-1160 shall be applied with Foampro RTFI000 or ProPack'.' 30 & 100 dispensing equipment only. _ 4.7 Polypro+? A1.1160 shall not be exposed pcnnanc to sun!' " r MS ACCEPTANCE No.: 01-V21.02. Frank Znloaga, RRC Product Control Examiner 1'olyrorttn Prkdois Inc, ACCEPTANCE No.: 31- O571.M2 4.3 Tiles must be adhered in freshly ag flied aedhcsive. Tile must be set within 2 to 3 minutes after Polypro® AH160 has been dispensed. 6.9 Polypro® A1'1160 placement and rhinimutn patty evcigbt shall be in accordance with the 'Placement Details' herein. Each generic tile profile requires the specific placement noted herein. '1'ulcD ° rol'odre Flat Low, Hi High Profile (2 Piece Table Il: Adhesive Il'lncentent For Each Generic Tile Profile Profiles Flat, Low, High Profiles Pl.-at, Low t-ligh Profiles arretg Placement Detail f3 I Single Paiddy Weight Two Paddy Weight Min, (grafts) per paddy itine. (arparts) 35 N/A 17 /side on cap and N/A 34/ an N/A 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. Frank Zuloaga, R1.0 Product Control Examiner al Pr giasit&itvc. AINIESENE rk:ACEN SiNgLE PATH ACCEPTANCE No. ; OH-0521.02 'NT DETML Us CI tAl cAtel e tc210 thodittwaant Qtoe0 *aft cooltot VrAtszkvotat Era Maul ttaq thretzuh Moult ceroarn at;lcc=reo e4: G 4 to.," kat 1111.1te mutt rinotteso t migave a to 23 Kam ttiase 14 (wood 1:nti LM po tHo /Item cams etl 4c Piro sL-a3a It2 to. To 14 fmot cutst3 adgo chew tn. tattil Ma Co. to Mks orot . coma covet D. 1...A0 to Bawl man cl 0:a. Dan oloa and el orm rod tOM ate at d airOCIL Qvi tt3d29 Veda' dashIll Pt£4 Want?, TN Pada Usetv gave ctmln Dtil 4 d;4 60Mirrolg o4to pMmeattamt eme0 ptooto aratm Frank Zuloagn, RRC Proclast Control Examiner (f°OA__ d PPosA Oft$, UQOC. ADHESQvI PLACEMENT DETML 2 SINC Qpt�Q 9� 6 ACCEPTANCE N. OR- 0529.02 Frank Zuloaga, RRC Product Control Examiner Pohl' Ig_.g. ADHESIVE PLACEMENT DETAIL, 3 DoullLE PATTY Nall through plasalc can Slagle WO aro top of filo Slagle otet; candor 111c) Prridy lbonsocra tlfa) Pardy (crarior tflo) Sh4 Pa* on top of tho Frea Canute fdell through plastic corherit Aln.n 3 In. Slog phi? on unrieriayamt S1ngle paddy an top of tilo Ean Cerise Siagtapaddy between Ole East Conn I hi th.coscOmi she RA ease mono only &mit! ACCEPTANCE No. : 91-05LIA2 rratdc Zuloago, IkRC Product Control Examiner Singh) pad* tractor silo Single paddy belooso We 7 hi- a 7 In. mean also paddy osso vane way Faseta Ena closure 043 14N 0'00 roam Products,. ACCEPTANCE Flo.: OB- O52I.91 1. Renewal of this Acceptance (approval) shall be considered :flier a renewal application has been fled and lane original submitted documents, including test- supporting data, engineering documents. are no older than eight (It) years. 2. Any and all approved products shall be pemaaaacntly labeled wide 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 dac 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 Acecptance 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 tcranination 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. 3. 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 an product, for sales, advertising or any other purposes. 6, The Notice of Acceptance number pm ceded bv- the words (Miami -pads 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. iv-here 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 nccd not reseal the copies, 3. 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' Frank Zutoaga, ILRC Product Control t ' aminer 03/03/2004 10:36 MEDITERRFNEA` ROOF TILE ? 3057567165 ml A M 'OADE BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DiVISLON NOTICE OF ACCEPTANCE NOA Monier Lifctile, LLC 135 NW 20` Street Boca Raton, FL 33431 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been O re�vicweb c by Miami-Dade rDCounty d u and other a accepted by the Board of Rules and Appeals (BORA) to the Authority Having Jurisdiction (AHJ).. This NOA shall not bc valid after the expiration date stated below. The Miami -Dade County Product Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. if this -product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with thc High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Villa, Roll, and Capri Concrete Roof Tile LABELING: Each unit shall bear a permanent label with thc manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been fled and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, andlor manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any porticn of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall bc provided to thc user by the manufacturer or its distributors and shall be available for inspection at thc job site at the request of thc Building Official. This NOA consists of pages 1 through 7. Thc submitted documentation was reviewed by Frank Zuloaga, RRC ND. 027 D001 htIAMl -DADE COUNTY. FLORIDA METRO -BADE FLAGLER BUILDING l43 WEST FLAGLER STREET. SUITE 1603 MIAMi, FLOR1DA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2905 NOA No.: 02- 1205.05 Expiration Date: 11/16/07 Approval Date: 01/02103 rage 1of.7 03/03/2004 10:36 MEDITERRANERN ROOF TILE 4 3057567165 ROOFING ASSEMBLY APPROVAL Category: Roofing Sub - Category: Low Profile Roofing Tiles /Material: Concrete 1. SCOPE This renews a system using Monier Lifetilc Villa, Rol:, and Capri Concrete Roof Tile. as Fo manufactured Monier Lifetile LLC and described in Section 2 of this N o ti a of Building nor locations where the pressure requirements, as determined by applicable o exceed the design pressure values obtained by calculations in compliance with RAS 1 27 using the values listed in section 4 herein. The attachment calculations shall be done as a moment based system. 2. PRODUCT DESCRIPTION Manufactured by Applicant Monier Lifetile LLC Villa & Roll Monier Lifeitilc LLC Capri Tile Trim Pieces Test At!encv Redland Technologies Redland Technologies Redland Technologies The Center for Applied Engineering, Inc. :`4hs_conter, for Applied n g :.• .ng, Inc. Test Dimensions SpccifIcstions 1 =16'/" w = 13" Y1" thick L = 17 w= 12 3 /I- W thick 1= varies w = varies varying thickness 2.1 SUBMITTED EVIDENCE: PA 112 PA 112 PA 112 Product Detcription Low profile, interlocking, high pressure extruded concrete roof tile equipped with or c nail hole and double roll ribs. For direct deck or battened nail -on, mortar or adhcsivc set applications. . Low profile, interlocking, high pressure extruded concrete roof tile equipped with one nail hole and double roll ribs. For direct deck or battened nail -on. mortar or adhesive set applications. Accessory trim, concrete roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile. Test Name/Report Date Test Identifier - - 7161 - 03 Static Uplift Testing Dec. 1991 Appendix 111 PA 102 & PA 102(A) 7161 -03 Wind Tunnel Testing Dec. 1991 Appendix 11 PA 108 (!Tail -On) PO402 Withdrawal Resistance Testing of Sept. 1993 screw vs. smooth shank nails March, 1994 94-06013 Static Uplift Testing PA 101 (Adhesive Sct) May 1994 94 -084 Static Uplift Testing y PA 101. (Mortar Set) NO.027 D002 NOA No.: 02-1205.05 Expiration Date: I2 /16/07 Approval Date :01/02/03 03/03/2004 10 Tc,t� gr iey Redland Technologies Redland Technologies Professional Service Industries, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center fo' Applied Engineering, Inc. The Center for Applied Enbinecring, Inc. The Center for Applied Engineering, Inc. Celotex Corporation Testing Services n inc. Walker Engineering Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Waikcr Engineering. Inc. Walker Engineering. Inc. MEDITERRANEAN ROOF TILE - 3057567165 Test Ydeatifier P0631 - Letter Dated Aug. 1, 199 224- 25. 70 -1 25- 70 -7 75-709 Project No. 307025 Test #MDC - 25-718 -1 25- 7183_ 25- 721 -2 25. 7214. 528454 -2 - 520109 - Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Test N pre Wind Tunnel Testing PA 108 (Ivlertar Set) Wind Tunnel Testing PA 108 (Nail -On) Physical Properties PA 112 Static Uplift Testing PA 102 (4" Headlap, Nails, Direct Dcck, New Construction)O Static Uplift Testing PA 102 (4" Headlap, Nails, Battens) Static Uplift Testing PA 102 (4' Headlap, Nails, Direct Deck, Recover/Reroo Wind Driven Rain PA 100 Static Uplift Testing, PA 102 (2 Quik -Drive Scro,ys, Direct Deck) Static Uplift Testing PA 102 (2 Quik -Drive Screws, Battens) Static Uplift Testing PA 10? (1 Quik -Drive Screw, Direct Deck) (I Quik -Drive Screw, Battens) Static Uplift Testing PA 101 Aerodynamic Multiplier 25 -718 25 -109 2 5 -7491' 25 -758 25- 7SO -8 25- 7804 & 5 25- 73 - G Aerodynamic Multipliers Two Patty Adhesive Set System NO.027 Date July 1994 Aug. 1994 Sept. 199 Oct. 199 Oct. 199 Oct. 1994 Oct. 199 Feb. 1995 Feb. 1995 March, 1995 Sep. 1998 Dec. 1998 March 1999 March 1995 February 199 April 199 December 1996 April 1999 April 1999 D003 NOA No.: 02- 1245.05 Expiration Date: 17/16/07 Approval Date; gt07 /41 03/03%2004 10:36 3. LIMITATIONS 3.1 Fire classification . .s not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test shall be performed in accordance with RAS 106. 3.3 Applicant shall rett:in the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with TrtS 112, appendix 'A'. Such testing shall be submitted to the Building Code Compliance Office for review. Applications 3.4 Minimum underlayment shall be in compliance with the applicable Roofing App Standards listed section 4.1 herein. 3,5 30/90 hot mopped underlayment applications may be installed perpendicular to thc roof slope unless stated otherwise by thc underlayment material manufacturers published literature. 3.6 This acceptance is for wood deck applications. Minimum deck requirements shall be in compliance with applicable building code. 4. INSTALLATION 4.1 Monier Lifetile Villa, Roll, and Capri Concrete Roof Tile and its components shall be installed in strict compliance with Roofing Application Standard RAS 118, RAS 119, and RAS 120. 4.2 Data For Attachment Calculations Table 1: Average Weight (W) and Dimensions (I x w ) Length -I (ft) Width -w (ft) Tile Profile Monier Lifetile Villa and Ro11 Tile Monier Lifetile Cap.ri Tile Tile Profile Monier Lifetile ViNa, Roll and Ca• ri Tile Tile Profile Monier Lifetile 1 Battens Villa, Roll. and Capri Tile 5.57 MEUITERR:41E1:N ROOF TILE 4 3057557165 3 ":12" Weight -W (Ibf) 9.1 9.51 1.33 1.42 1.03 N0.027 D004 (ft ) Direct Deck A • •!%cation 0.289 Table 2: Aerod namic Multi.liers - X(ft) Batten Application 0.267 (ft 1. 08 Direct Deck Battens Direct Deck 6.18 Battens Direct Deck Battens Direct Deck 5.90 4 ":12" 5 ":12" 7 ":12" or reater Battens Direct Deck 5.09 5.73 Table 3: Restorin• Moments due to Gravit M. ft-lb 6 ":1'L" NOA No.: 02- 1205.05 Expiration Date: 12/16/07 Approval Date: 01/02103 Page 4 of 7 03/03.'2004 r Tile Profile Monier Lifetile Villa. Roll, and Capri Tile 10 :36 MEDITERRPNERN ROOF TILE 4 3057567165 Table 4: Attachment Resistance Expressed as a for Nail -On Systems Tile Profile Fastener Type Direct Deck (min 15/32" plywood) Monier Lifetile Villa, Roll, Polvfoam Pol Pro"' and Capri Tile Po I oam Pol Pro Lar.e •add acement of 54 rams of Pot Pro' 5 Medium addy Placement of 24grams of Pol Pro Moment - Mf (ft -Ibt) Direct Deck Battens (min. 19/32" plywood) 37.4 2 -10d Rin• Shank Nails 27.8 1 -10d Smooth or Screw 8.8 '[ 11.8 Shank rl 219 2 -10d o Smooth or Screw 16.4 Shank Nails 25 8 1 $/8 Screw 25.8 2 f/8 Screw 47.1 47.1 24.3 24.3 1 -11 0d Smooth or Screw Shank Nail (Field Clip} ^---� 19A 1 -10d Smootn or Screw II 19.0 Shank Nail Eave Clip) 3.5.5 2-10d Smooth or Screw 35.5 Shank NailsSField Clip) 2 -10d Smooth or Screw 31.9 Shank Nails (Eave CIipI 2 -10d Rin Shank Nails' 43.0 Installation with a 4" the headtao and tasterrers are located a min. of 21/2' from head of tile. 31.9 86 16 28.8 4.1 7.1 22.9 49.1 24.2 67.5 "' - 50.9 Tile Profile Tile Application Minimum Attachment Resistance 261 Ad Table 5: Attachment Resistance Expressed as a Moment M, (ft-lbf) for Two Pa Adhesive Set S stems uirements Monier Lifetile Villa, Roll. and Capri Tile 2 See manufactures Corn nent a roval for installation re 3 Flexible Products Company TileBond Average weight per patty 11.4 grams_ t PolyfOam Product, Inc. Avers ew ht er patty 8 grams_ Table 5A: Attachment Resistance Expressed as a Moment - Ulf (ft•lbf) for Sin le Patt Adhesive Set S s Tile Application 22.1 34,8 32.2 Minimum Attachment Resistance NO.027 D005 NOA No.: 02-1205.05 Expiration Date: 12/16/07 Approval Date: 01/02J03 Page 5 of 7 03/03/2004 10:36 MED I TERRFNEAN ROOF TILE -4 3057567165 Table 5B: Attachment Resistance Expressed as a Moment - Mt (ft-lbf) for Mortar Set 5 stems Tile Profile Monier l_ifetile Villa, Roll, and Capri Tile 5. LABELING All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo, or following statement: "Miami -Dade County Product Control Approved ". 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. applicable building Any other documents required by the Building Official or app code in order to properly evaluate the installation of this system. Mortar Set' PROFILE DRAWINGS rat Ho MONIER LIFETILE VILLA CONCRETE ROOF TILE Attachment Resistance 20.60 Villa N0.027 0006 NOA No.: 02- 1205.05 - Ezi lriation Date: 12/1161/7 Approval Date: 01102103 Page 6of7 03/03/2004 1Q:36 MEDITERRPMEAN ROOF TILE 4 30575671E5 v • • • •iV( riiry • r - • 4 MONIER LIFETILE ROLL CONCRETE ROOF TILE MONIER LIFETILE CAPRI CONCRETE ROOF TILE END OFT111$. ACCEPTANCE • • ".„, OA: `—,i".4"PrO4`••••••- . •A'?< .V.P • , --; • . d • e ' • k0.027 P007 . . . . . ' ' 4, 1 4 :::!ii 4 1: 1 1i 6 e .... 2 ::‘ 12. O ii ..„ ' • • , ',,-... 1 1 .6. , , , j,•,.' ..., ..,.. -, , ',1*: •. •,- •••••••••• J.4'.:U.'":,:;:i•'• • NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE //AT TIME OF FIRST INSPECTION PERMIT NO TAX FOUO NO//3206 `d/34510 STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and In accordance with Chapter 713: Florida Statutes, the following information is provided in this Notice of Cor rnencement 1. Legal description of property and street/address 2. Description of improvemen 3. Owner(s) name and address: �Y 3 Interest in property: Name and address of fee simple titleholder. 4. Contractor's name and addres ©� 5. Surety: (Payment b7d Name and address :N Amount of bond 3 6. Lender's name and address: # X different 46 i�.gp�pffled) Afk Notary Public Print Notary's Name My commission expires: 123.01.02 PAGE 4 V02 LORRAINE KELLER Notary Public - State of Florida • q My Commbabn Erp6ps A r 18.2006 Commission le DQ 300728 Bonded By National Notary Assn. CFN . 2004 - 80168615 OR Bk 22116 Ps 4070; (1Ps) RECORDED 03/12/2004 11:40:11 HARVEY RUVINE CLERK OF COURT MIAMI —DADE COUNTY, FLORIDA LAST PAGE SSG / A/f4p P/3 10 -70 y /GE9/ .f7 g 3 30 required by owner from contracfb BA )FLORIDA, COUNT OF DADE CERTIFY that t tr copy of the rt r, go N, ,itgw! , A D 2 WITNESS 7. Persons within the state of Florida designated by Owner upon whom no ces or other documents may be served as provided by Section 71313(1)(a)7.. Florida Statutes, Name and address: /fiA 8.. addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Fl • ride Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date Is 1 year from the date of recording unless a Sig tu6 of —� Prl Owner's Named 'L77 Prepared by , C 3 /> ut.1 71 : 2 -- Swom to and subscribed before me this day of Address:, a • n • 1 1111111 1111 1111111 11111 1111111 11111 111111 111 • • Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/9/2004 Applicant: MARTIN Owner: MEJIA JOB ADDRESS: 333 Contractor JOHN BUSTA Local Phone: 305 - 219 -9699 Parcel # 1132060136510 NE 91 Building Permit Permit Number: BP2004 -299 MEJIA MARTIN ST Contractor's Address: 300 NE 91 ST Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 17 & W1/2 LOT 18 BLK Fees: FEE2004 -2450 FEE2004 -2451 FEE2004 -2452 FEE2004 -2453 FEE2004 -2454 Description Building Fee CCF Training and Education Fee Technology Fee Scanning Fee Total Fees: Amount $325.00 $7.20 $2.40 $8.13 $12.00 $354.73 Permit Status: APPROVED Permit Expiration: 8/31/2004 Construction Value: $11,800.00 Work: RE -ROOF SLOPED AREA COLOR THRU Signed: (INSPECTOR) Signed: (Contractor or Builder) BY: Page 1 of 1 Total Fees: $3,,4.73 Total Receipts^ 0'�0 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. D Job Address-2- PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Legal Description Historically Designated: Yes Owner/Lessee / Tenant - - 1-4 ! r , Owner's Address Contracting Co. k m t I acs r 4yi c.IkC_ vl �aQ C , Address Po,. & ( (4-12g? e� .■ ' �_ SS# r s 7 Qualifier State # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION °S S U �' C( I � �- C7 ! W Q 1 (( 14 icy p (\c-OO 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. Square Ft. ›S 4 Signature Municipal # FEES: PERMIT 6 /0 ' RADON f owner and/or Cond President Date Not as to Owner and/or Condo President Date My Co fission Expires: __„ ALFRED D. MCCORMICK Notary Public, State of Florida My Comm. expires Mar. 16, 2002 No. CC725033 Bonded thru Ashton Agency, Inc. APPROVED: Zoning Building 'k ' , Mechanical Plumbing 13 Tax Folio , Estimated Cost (value) C.C.F. 4) NOTARY Master Permit # Competency # Sciar Ins. Co. Address Address Signature of Contractor or Owner uilder Date 4jh Not o Contractor or Owner - Builder My Corn^';F ^►p . ALFRED D. MCCORMICK Notary Public, State of Florida My comm. expires Mar. 16, 2002 No. CC725033 Bonded thru Ashton Agency, Inc. Electrical No 4 {5 ©3 Date BOND TOTAL DUE 4d �a Engineering Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 J q y 1110 )1p Qt) r . Registered Architect and /or Engineer ) fin i ) ?o ri,i Lt- C o • /5 N E /.5 Name and address of licensed contractor Location and legal delcripti of lot to be built on: , g V Subdivision _ Lot ! � W a ( Block Street and Number where work is to be done 3 33 N / 7- 1 State work to done and purpose of building (by floors), state exterior colors (submit samples) 4 © .1.J and for no other purpose. New Building Remodeling Addition Repairs To be constructed of Kind of foundation Roof Covering Fh 17 7 1 / 1:9 .....P5 Estimated Total cost of improvements S "f 0 0 Amount of Permit S .80/(12 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 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 obligatons 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) STATE OF FLORIDA COUNTY OF DADE. } SS. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Before me. the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared 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. Date Date No 3 3 -3 Street Air ? / L Date Read, Sworn to and Subscribed before me. No. of Stories Permit No. Disapproved (Signed) T Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Notary Public. State of Florida to me well known. 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 durin: progress of the work. Owner's Name and Address .. $1 Registered Architect and /or Engineer Name and address of licensed contractor.. Remarks. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT. Location and legal description of lot to be built on: Lot Block Subdivision._.. „... - Street and Number where work is to be done._. -. Stat work o be done and purpose of building (by floors) Date.. RA, No.,91 . Street_ - f i _ L� .4.. and for no other purpose. No. of Stories./ New Building Remodeling Addition Repairs. To be constructed of Kind of foundation foundatiorh Roof Covering Estimated Total cost of improvements $••1 d /S Amount of Permit S. 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 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. ,��� (Signed). . ���Z?/ i 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 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 sta a are true. Permit No._____ G 2- -7/ Date I 2- 1 Read, Sworn to and Subscribed before me. Disapproved _.__ Dgte. Notary Public, State of Florida ( Signed) � i ' 4 -4 Building Inspe or My Commission Expires to me well known, i LANNING BOARD DATE Chairman Member Member Member Member sass.. __•---_ --• -- _..____._.._ 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 nnado 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 , 19 Owner's Name and Address No Street Registered Architect and /or Engineer <) o 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) 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 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 5968, 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) 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/,/ / c Permit No 4� q �._ Date.__ -_ i , ` j r 7Read, Sworn to and Subscribed before me. Disapproved ( Signed) .!oi= D wilding Insp c •r Notary Public, State of Florida 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 51.00 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 Architect Contractor or Builder Legal Description Address of Building Lot PERMIT N? 13213 Work to be performed under this Permit CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA k BL Signed: Subdi- vision Value of Project $ 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. BY DATF. Contractor's License No BY Amt. of Permit $ AUTHORITY 195 — 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, statement -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. • 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 Address Carl Hoenes No. ___ 27D___IT$_ Street 111th- __St.:___ Registered Architect and /or Engineer Name and address of licensed contractor Sit e* ti__ _ Metal ___Specialty ___CD.____ 57.3. 3__I[___7lat_ ";.St_. Location and lea description of lot to be built on: Lot 17 & { 1$ Block 48 ubdivisio M/Shoees Sect. 1 Amend. 353 NE 91st St. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Date May 19 19 52 Street and Number where work is to be done State work to be done and purpose of building (by floors )____RQQt_.__ t tin calpet1 t o Sheathing_ 1 -90# slate mopped with h of asphalt Tile laved in rich mortar cement and for no other purpose. New Building X Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Tile 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 Mr Carl Hoenes 270 N E 111th St. 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 wof r rk �a to be i performed o under this permit, as are licensed by Miami Shores Village. Remarks A , (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 Date Read, Sworn to and Subscribed before me. Disapproved Date (Signed) 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. re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty maaials and /or workmanship. . Notary Public, State of Florida Building Inspector My Commission Expires MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request /- � Date — Cr r G C Type Insp'n ('� r �� ' P`�95 ����p�� Permit No. C'/ " c�'�S Name l (a 0,17 ' e e Address 3 ` / Company v U / Gt s r, Phone # Inspection Date 6 - 2- 7' - � Re- Insp'n Fee kc t MIAMI SHORES VILLAGE LSD BUILDING DEPARTMENT \\ 305- 795 -2204 Building Inspection Request Type Insp'n Permit No. Na Address Company alci- 9v( 7 Inspection Date ) �� n Approved Correction Re- Insp'n Fee