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ROOFINGDate 7/0 Legal Description ZO t Owner / Lessee Owner's Address d7/5 Tenant // /C /T - )42// Contracting Co G /ic. v PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address 2/15M �~ (// sr /4- G/ 9 Qualifier � �� ` C � l � � SS# Phone / [) - '' 1 / .7 State 'tu l - ' Municipal # 7/ c/ 9 Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION /? ve/ Square Notary as to Owner ate/ My Commission Expires: ** * APPROVED: .i l y.✓L 444, - * Zoning 4/C%re /1 / U OFFICIAL NOTARY SEAL . - MARIA ESTHER OUNTIN J * COMMISSION NUMBER Q CC262186 V Y COMI*SSION MIIP. OF FAQ i . 30 1997 FEES: PERMIT RADON C.C.F. Fire Buiidin Tax Folio // 3.Z' -0/ -0/30 Address /(G Competency # Ins.Co. Estimated Cost(valuerc e'L' Notary as t My Comni s s i * Master Permit # Phone d 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 authori the above -na ed co tractor to do the work s ed. Signatu e of owner and /or Condo President S nature pf Contractor or Owner- Builder Date: or szpTQiiliN es :COMMISSION NUMBER CC255237 F s).. MY COMMISSION EXP. OF F.° :IAN. 20 1997 ** TOTAL DUE 6 Other Electrical Mechanical Plumbing Engineering PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date P C Job Address 0 Ale 71 ' « r Owner/Lessee / Tenant /./k ale( Owner's Address / Al /&E' 7/ s Contracting Co. / IJ (; g,ij- • %� . Qualifier Oelt.f 5 J / LE= State # C C 4 Ci /12. Municipal # Legal Description Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAROOFING PAy,1fNG FENCE SIGN WORK DESCRIPTION 110 K 7 1Z 4t P- ( Square Ft. /0 ,F,7 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. Siefiature o er and/or Condo President Date / r° { /), /6-/3- l? / Ifotary as to Owner ang/or Condo President Date My Commission Expires: o„ P * \ A1 J * `PEES: PERMIT APPROVED: Zoning Mechanical 44. OF nsi ' RADON MIRIAM MATA MY Commission CC371408 Expires May. 10, 1090 Bonded by ANB 80 0 -852 -5978 Historically Designated: Yes Tax Folio /1.92 r / 1 /C' *' Master Permit # Phone Address 7/ 7 , 5 /3 f-fiy.177 SS# Phone 2 o. Estimated Cost (value) 27504 Signature of Contractor or Owner-Builder Date A l J . 0 / /-3 9._S — � c.�'�3�1 /t -films , / 1 Notary as to Contractor or Owner - Builder Date My Commission Expires: * . MYCOMMi siat co3714oe * w'e'e MAY. 10. 1998 J), OF Re 800.862488778 C.C.F. 9 NOTARY TOTAL DUE 67 No MIRIAM MATH Building )l Electrical Plumbing Engineering 4 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. //37626 STATE OF FLORIDA COUNTY OF DADE ,.THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, an with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement., ° 1. Legal description of property and street address 2. Description of improvement: #67 3. Owner(s) name and address: Interest in property: Name and address of fee simple titleholder 4. Contractor's name and address: 123.01 - 112 7/94 PAGE 3 goo.. 0: / Sign ture of Ow er Print Owner's Name Sworn to and subscribed before me this � c day of /Q 19_95 My Commission Expires: Notary Public Print Notary's Name "i2/r/ Q /7-2 .Wl' 1 •MIRIAM MATA my La:Ar minion 7 td08 Expires May. 10,1998 Bonded by ANB 800.852-8878 o e. v a / JJC. 7 / �o 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond: $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes. Name and address: 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as pro- vided in Section 713.13(1)(b), Florida 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 different date in specified) Prepared by �- Address: ,zg6ze 5LCJ/ 2 / ' '1 7 33/ 03-0S-1995 02: 4OPM FROM t METRO -ADE PRODUCT NC). : Altusa Tile Alfareria del Turbio, S.A. Barquisimeto, Venezuela Yaur application for Product Approval of la i e under Chapter 8 of the Metropolitan Dade County Code governing the use of Alternate Materials and Types of Construction, and completely escribed in the plans, specifications and calculations as submitted by Redland Technologies. The Center for 4pplied Engineering, Inc., and Testweil Craig Laboratories & Consultants, Inc. has been recommended for acceptance by the Building Code Compliance Department to be used in Dade County, Florida under the specific and standard conditions set forth herein. The approval slta:: he \ .`i i for n period of three years. The Building Code Compliance Dep.a, -tment reserves the r: ht to secure a product or material at any time. fpr a S job.ite or manufacturer plant for quality control testing. If ptci::ct ^r ntater:al t<:i■ pertonn in the approved manner. the Code Compliance Department may revoke, modify or At:spend the uce of :uch p rod(ict or material immediately. The Building Code Compliar.;e Department resc:•.,>s the right to require testing of this product or material should any amendments to the South Florida Building Code be enacted affecting_ this product or?naterial. The eyper.se of such testing .Fill be incurred by the Manufacturer. • .ACCEPTANCE 9- 0914,n1 EXPIRES: ' FEB 14 1591 TO 6337640 P.01 METROPOLITAN DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING RUtLDiNQ CODE COMPLIANCE DEPARTMENT SUITE METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET MIAMI, FLORIDA 33130 -1563 (305) 375.2901 FAX (305) 375.2908 i✓ Raul Rodriguez Product Control Division Supervisor - PLEASE NOTE - THIS IS THE COVERSHFET. SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS. [WILDING CODE COMMITTEE I Hj 1.F� �.:' ^ !;.' ('t 1FAr ,'.i �' �:crt o� has E reviexved by the 11Ctrc?:.OI t•t a• - ., � ^roe ' t � n Dad: �::U,.1'.' .3Ui1Ci::E �r r ed by Ruuding Cade ..,� Committee to ce used :n Dae_ COUtlty . . , (:itaries Danger, P.E. Director Uuiidirg Cucc Cum_:iance Dep2[;:::et:: \l:t:eculita-: E2..e C:• r:r; t: Altiusa Tile ' Aii?areria del Turbio, S.A. Ba;quisimeto, Venezuela gltegory: & b- Category: Sub - . • PRODUCT CONTROL NOTICE OF ACCEPTANCE ROOFING SYSTEM APPROVAL . Prepared Roofing Tile Nail- oigMortar Set/Adhesive Set Clay Syzeina Alfareria del Turbio, S.A. (Altusa), located in Barquisimeto, Venezuela, manufacturers clay roof tile for nail -on, mortar set or ?dhesivc set applications. All tile is manufactured from natural Venezuelan cia }•s. This Produc C r , „ Pm uct C.Intmi .ahnmvals for' ocher file omfiie: lc S" ofile. Refer to annr n ., The " Altusa S" tile profile is available in a variety of natural clay colors and has matching trim pieces used for rake hip. ridge h and valley terminations. , Tl.e_e accessories are manufactured for all profiles and form a pan of this Product Control .Approval. Optional rubber or clay eave closures are also available. Altusa roof tiles 1 ?aye been tested in compliance with the South Florida Building Code requirements tJ :' =13y. !i11: -on mortar Sc[ n r adhesive .set minimum roof l.' S" ; � __ ci il,e applications. The r - 1 - �� :3i, - .,. _ _ l�'•I be =''1_ S- � irrurn g ;,)p� ? the 'A il -1..:153 S" tl;� tl T: , See ill 'Profile Dra'xir' ?ect!il;', i' tlll: rr.•• ! the c erfor -T a ?•.e. ere;,.re. any r t : Ind ohs:,. te: _,:cs and r I c sHerazion installation shall l h •\ stem' )pia .. ;tri " ?i ? ? caliulatl•_liTj !; 1 II I done a ° 1!:t71c"1: U �aSCu - ii_Ce:. . :1 Tablec i::_`�t�l. of this .Ap ro\al .1::'.T. "•.r (USA). lr.,.. 'ctstc� in Miami. I, Mi: i. r selling ant'_ distributing Altusa:.r its in the :' '- laic Gd t i o n. L :m porter liilu.' South Florida jurisdiction. Contact: Carlos ?. Fernandez General \tana".'. 664; Northwe:si Miami. FL. (= 47!.5S3() Product Control No.: _94 -09 01 Approval Date: FEB 2 2 T9y5 Expiration Date: FEB 1 4 1991 03 -09 -1995 02 :42PM FROM Product l Altusa'S' Clay Roof Tile 'Trim Pieces TRAD NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT `- 18W Nit 10" '2" thick varies wi= varies varyin g thickness Test Product Specific Description ASTM C 1167 High profile, interlocking, one - piece, 'S' shaped, clay roof tile equipped with two nail holes and a single roll. For direct deck nail -on applications only. ASTM C 1167 r . l' TO 63 3 7 640 P . 03 Product Control No.: 94- 0914.01 Accessory trim, clay roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile. Rival Rodr!,2' Product W30 Felt #43lCoated Base She t Mineral Surface Cap She t Lenzingtex -ZB 140 Underlayment Rainproof 1I Ice and Water Shield X10' pin_ Asphalt Cl ashing Cement TRADE AMES OF PRODUCTS MANUFACTURED OTHERS N/A N/A Ir /A 59" x � 64' roll 22 1 s /roll 30" x 75' roll 36" x 75' roll or 60" x 75' roil 36" 75' roll :N1- A Test Specificatipm ASTM D 226 type I1 ASTM D 2626 ASTM D 249 PA 104 PA 104 PA 103 ASTM D 312 type Iii or IV aST`. D Product T e_scHption Saturated organic felt to be used as a nailed anchor sheet. Saturated and coated organic base sheet for single or double ply underlayment. Mineral surfaced asphalt roll roofing for use as a top ply in a double ply underlayment system. Single ply, nail -or. underlayment. Single pay, nail -on underlayment with 2" self - adhering top edge. Self- adherine underla; men: for use as a ton ply inar o ur:deri. vme nt s> stem with approved F'30 or F43 as the base laver. Asphalt for bondine mineral surface cap to a tnech. at base sheet in a double ph u nde !a\ m:•rt s. stern. Cut bac... asphalt based, asbestos free, fiber reinforced. trowel g:radc cement Product Control No.: 94 0914.0] Manufacturer generic generic generic Lenzing Performance, Inc. PCA 4 94- 0527.05 Protect -O -Wrap. Inc. PCA = 94- 07I4.01 W.R. Grace Co. PCA 92 -1 :16.01 generic Ro:' rile Adhe ; ( 1 o:yFrAY i 6C") Till Nails TN- Screws • Ropf Tile Mortar ( "?)iic`fiteT" ") • Product alt Primer horizontal min. 1 "x4 "for use with vertical battens min. 1" .12" for use alone min: Sd x 21 or Oct x 3" min: =8x2S'.c "or min. riOx2' NIA Test $peciftcations ASTMD4I PA 114 Appendix E PA 114 Appendix E Wood Preservers Instintte LP - 2 PA 114 Appendix E PA 114 Appendix E PA 123 Se: PCA Product Control No.: Product DelUlAWA Cart back, asphalt based coating used to facilitate bonding of dissimilar materials. • Annular ring shank, hot dipped, electro�or • mechanically galv. roofing nails for use .in underlayment attachment. Corrosion resistant circular disc for use in underlayment: attachment Salt pressure treated or decay resistant lumber battens Corrosion resistant, screw, smooth or annular ring shank nails. Corrosion resistant, coated, coarse thread wood screws. Prepared mortar mix designed for mortar set roof tile applications. Two component poI) urethane adhesive designed for adhesive set roof tile • • cam_ o-+u -. u:• 94- 0914.01 Manufacturer generic generic generic generic eeneric generic Bermuda Roof Company, Inc. PCA 494- 0614.01 Polyfoam Products, Inc. PCA •94- 0401.01 � 'product Huiricane Clip 8: Fasteners I i Valley Flashing Drip Edge n min.':" width min. O. 60" thick Cllp astener min. $d x 1'/ min 26 ga. min. 1�6" width min 26 ga. min. 2" face flange min. 2" deck flange • Test Specification PA 114 Appendix E ASTM A 525 PA 111 Galvanized steel valley flashing Product Control No.: 94- 0914.01 Product DescriWiort Manufacturer Corrosion resistant generic bronze, aluminum, stainless steel, galvanized steel or plastic attachment clips for supplemental tile attachment. Clips are installed with corrosion resistant roofing nails compatible with the clip. A hurricane clip is required on all eave tiles. Galvanized steel drip edee generic generic SYSTEMS Deck Type: Wood, Non - insulated Deck Description: p New Construction ''i or greater plywood or wood plank. 1 SYSTEM A: Counter -Batten Application . Sloie Range: Horizontal Battens: R Tile: Comments: 1 2 ":12'; to 7 ":12" Note:I Counter - Battens, as noted below, are required for slope range ! 2 " :12" to less than 4 " :12" and are optional for slopes of 4 " :12" to i 7 ":12 ". For slopes exceeding 7 " :12 ", refer to System C. Underlayment: Install choice of approved underlayment system, noted on Page 1 or 2 of Dade County Protocol PA 118, in compliance with Section 3.02 of PA 1 1 8. Vertical Battens: Install; vertical battens of pressure treated or decay resistant lumber having minimum dimensions of nominal 1" x 2 ". Vertical Battens shall be set in a continuous bed of flashing cement '; thick and secured not greater than 24" : o.c. into the sheathing with approved, corrosion resistant fasteners. Vertical battens shall be positioned over the top chord of the roof trusses. S P1 ir:staii horizontal battens of pressure treated or deca. resistant lumber -,a\ i;,._ ! minimum dimensions of nominal i" x 4". ` Horizontal battens shall be installed 0\ er vertical battens at a spacing to provide a the overlap r.ot less than 3" ;� � � and ie'cured through the vertical batten and sheathe :n.` with apero%C•j_ rcsistard fasteners. (See P A „ � in ocimpiiance \. Ito PA i 8 usury one or the ar:17 cc =c''men: for batten applications noted in Table cn, :zed steal! pro\'ide sufficient ��iZil iii: ?.Clink:lT .-•. •,ie..i t,:, meet or exc-zi.=. t`c= r°auire :!,l ii nee .pith PA 1 i_ or r.a :27. !i'r re -rn,lf applicaticns. : ps arc required ';n al! cave t Ie rI. oed a" acce" Product Control No.: 94422lix..` A zasy , Red land Technologies • i ! Red land Technologies I . Tbe Center for Applied Engineering, Inc. 1 ! The Center for Applied 1 Engineering. Inc. The Center for Applied Efigincerin2, Inc. ; Ri T-ne fj.; • kiLi 7161-03 Appendix 111 7161-03 Appendix III 25-7200-1 94-084 94-083 7161-03 Appendix 11 TEST REPORTS 1. ezter Dazed A uc.1. :994 P064 P0'02 Project No 30 Tes: nMDC-7S Static Uplift Testing PA 102 (Quik-Drive Screws, Battens) Wind Tunnel Testing PA 108 (Nail-On) Wind Tunnel Testing PA 108 (Nail-On) Tunr.e! PA :OS mortar Sc: Wfthdrawal R.esis:zr:ce of s.rek% sham: nails Wins:: Driven Ran: PA :01.) e t Static Uplift Testing PA 102 Product Control No.: _24021141 Static Uplift Testing PA 102(A) Static Uplift Testing PA 101 (Mortar Set) Static Uplift Testing PA 101 (Adhesive Set) DWI Dec. 1991 Dec. 1991 Feb. 1995 May 1994 April 1994 D. ;99: Au2. :994 AL :F •;94 Sec SYSTEMS (CONTINUED) Peck Type: Wood, Non - insulated Deck Description: New construction 19 / 32 " or greater plywood or wood plank. SYSTEM B: Direct Deck Application Slope Range: Underlayment: Roofing Tile: Product Control No • 94- 0914.01 4 ":12' to 7 ":12" Note: System B is only acceptable in this slope range. For slopes less than 4 ":12 ", refer to System A. For slopes in excess of 7 " :12 ", refer to System C. Install choice of approved underlayment system, noted on Page 1 or 2'of Dade County Protocol PA 118, in compliance with Section 3.02 of PA 118. • Install tile in compliance with PA 118 using one of the approved methods of i attachment for direct deck applications noted in Table 3, attached. The method of attachment utilized shall provide sufficient attachment resistance expressed as a moment to meet or exceed the required moment of resistance determined in compliance kk ith PA 1 l i or PA 127. Comments: 1. For re -roof applications. plywood is an acceptable substrate. 2. Clips are required on all eave tile. Deck Type: beck Description: SYSTEM C: Slope Range: UnderIayment: Horizontal Battens: Roofing Tile: Comments: Wood; Non - insulated New construction 19 /32 " or greater plywood or wood plank_ Horizontal Batten Application. 4" :121 or greater Note: Horizontal battens, as noted below, are required for slopes in excel i of 7 ":12" and are optional for slopes of 4":12" to 7":12". For slope 1 less than 4" :12 ", refer to System A. Install; choice of approved underlayment system, noted on Page 1 or 2 of Dade County Protocol PA 119, in compliance with Section 3.02 of PA 119. Install! horizontal battens of pressure treated or decay resistant lumber having minimum dimensions of nominal 1" x 2" x 4 feet long allowing for a minimum %" gap between each 4 foot length. Horizontal battens shall be installed over the underiayment system spaced to provide a tile overlap not less than 3" and secured through the sheathing not greater than 24" ` ,.c. with appro corrosion.resistant fasteners. (See PA 119.) Install rile in comp!ianc ... ith P.; 119 using one attachment for batten applications noted in Table 3, the ttached. The 2 method of attachment utilized shall provide sufficient attachment resistance expressed as a moment to me o eX e`e tll: requirt:d moment of resistance determined in compliance with PA ! ]: or Pa, For re- rc.o; ;,p; , ii":iens. SYSTEMS (CONTINUED) 2. Clips are required for a!? Product Control No.: is ar. :c■_eptac ;.,ubstrate. Roofing Tile: Product Control No.: SYSTEMS I (CONTINUED) Deck Type: Wood,iNon- insulated Deck Description: New construction 19 /3 2 " or greater plywood or wood plank. SYSTEM D: Mortar or Adhesive Set Application Slope Range: 2 ":12 "! 7":12" Note: ; System D is only acceptable in this slope range. i linderlayment: Install: choice of approved underlayment system, noted on Page 1 of Dade Count Protocol PA 120, in compliance with Section 3.02 of PA 120. See System Limitation 47. Install] tile in compliance with PA 120 using one of the approved mortars or adhesives noted in this approval. Mortar or adhesive shall be applied in compliance with the mortar or adhesive manufacturer's Roofing Component Product Control Approval. The mortar or adhesive attachment shall provide sufficient attachment resistance expressed as a moment to meet or exceed the required moment of resistance determined in compliance with PA 115 or PA 127. The mortar and adhesive attachment data is noted in Table 4, attached. Comments: 1. For re -roof application:, '=/ pl \\good is an acceptable substrate. 2. For mortar set applications, the first three courses of tile shall be nailed with not less than one nail per :file, As an alternate, the first three courses of tile shall be aopiied in mortar o\er a sir..cle laver of minimum 12 gi wire mesh 12 _ re i� e_. oOeninis of nor iess than , \vhich Is mechanical!) attached :e the deck \\ ith not less than one rootInQ nail every 1 ft . For roof piIches from h to 7 ":12". every third tile of ever fifth course., beginning at the eighth courcc, mail he nailed with not less tha n one nail per tile. SYSTEM LIMITATIONS 1. The standard minimum roof pitch for "Altusa S ", nail -on, mortar or adhesive set tile applications is 2" rise in 12" run (2 " :1 "). The maximum roof pitch for mortar or adhesive set tile applications is 7" rise in 12" run (7 " :121. 2. All nail -on tile applications having a roof pitch less than 4 ":12" shall be installed over both vertical and horizontal battens ( "Counter- Battens "), as noted in System A. All nail -on tile applications having a roof pitch in excess of 7 " ;12" shall be installed over horizontal battens as noted in System C. 3. For nail -on applications, {'brass or stainless steel screws for mechanical attachment of tiles shall have a head diameter Larger than that of the preformed holes in the tile. 4. System installation shall be in compliance with the system specifications outlined in this Product Control Approval. Nail -on tile shall be attached using one of the methods of attachment noted in Table 3 of this Approval. 'Mortar or adhesive set tile shall be attached using an approved mortar or adhesive noted in this Approval. the data of which is noted in Table 4 of this Approval. The method of attachment utilized shall p rovide sufficient attachment resistance expressed as a moment to meet or exceed the required moment of resistance determined in compliance with Dade County Protocol PA 115 or PA 127. For nail -on the appiications. an ease clip, is required on all cave. it I•... 1' - tile. rc;r mortar set applications. the first three courses of tile shall be nailed with not less than one nail per tile. As an alternate, the first three courses of tile shall be applied in mortar over a single layer of minimum 12 aa. wire mesh with square openings of not less than \which is mechanically artached to the deck with not less than one roofing nail every 1 ft For roof pitches from 6•': to 7: 2••, every third tile of every fifth course. beginning at the eighth course. shall be nailed with not less than one nail per tile. For mortar or adhesive set tilt applications, a field static uplift test !>_, a Dade County accredited t.`s.i.; agency.. in compliance with Dade I. Protocol p� r � U�t\ • cv ;�C� I 1 I(,. s.:.,.. :^, _ re;;Llred r•- i iE':s 'Char :I. .7,:;\'3 after arplication to confer:•.'. tile .tdhesion. The results of iE _ ;':. l it ?. i :'j�� *i ;11: oC reported to the Buildin,'Z Official and the installer ' 't^ _ l ai:cr ,�;ai. = flat the application t - ��� , a:,::.i: - .it:il: C PA :06 '.zsil; ` r .e 3ppl :caton fails PA 106 testing the report ' ` t, r cr hail state which p�•� ~:c•n of the test �.�a; tailed; Category 'l (examination for loose tile) or Cate (uplift testln`' :1�, Sul)s:Llti r the install may repair not more than i r i it "••''G of !c :� : -i.23 tiles and '� :• t�. LIZ.' .I'.1CtC' ::'C^ rid' e. rake) tile with approved tile adhesive. The installer shall place an identitarle markinE or.. each repaired tile for future reference. Any PA 1( re -test shall not include any marked tile. For mortar or adhesive set file applications, 30'90 not iaol' a : :CE; . I' :er!t applications may - az installed perpendicular to the roof pitch Drior to iw . . 1O ills' •= _ � - _.- iii :e!V. :• :c b. :c' I :i:'.iPr : - . r�12nu'aeturer. Thereafter, 30:90 wider! :_.Till•. ^,t syste :'1s sled :. • aipllc nCe with .� County .. - i : : .•... .. -r31 :� .: ,;1C _ _. ��!t :1 CO ... pp :ndix 'A' of Dade <_'ounty Protocol P:\ :20. Raul. Product Control No.: 94- o914.01 SYSTEM LIMITATIONS (CONTINUED) Product Control No.: S. All titles shall bear the Imprint or identifiable marking of the manufacturers name or logo fo identification in the field.. 9. The i►ltusa "Altusa S" tile profile has been tested for both wind characteristics and static upli performance, therefore, attachment calculations for installation in compliance with Dade Coun Protocol PA 115 or PA 127 shall be done as a 'Moment Based System' 10. Applications for roofings permits shall include a completed Section II of the Uniform Building Permit, a copy of Altusa Tile's current specifications and details, a copy of this Product Contro Approval and a copy o f the Product Control Approval of any Roofing Component used in th proposed tile application.; Reference shall be made to appropriate data for the required fire rating. 11. The applicant shall retain the services of a Dade County certified testing laboratory to maintain ' i quality control in compliance with the South Florida Building Code and related protocols. 12. Any dmendments to these provisions shall be in compliance with Sections 203 and 204 of the S Florida Building Code. out}l Aitusa 'S' Tile Tile Profile Tile Profile DATA FOR ATTACHMENT CALCULATIONS Table 1: Aerodynamic Multiplier - X Of) from PA 108 Testing (ft) Batten Application 0.29 Tile . Profile Musa 'S' Tile Table 2:: Restoring Moments due to Gravity - M (ft -Ibt) from PA 102 Testing 3 ":12" or less Battens Direct Deck 4.47 5.35 4 ":12" Battens 4.40 Direct Deck 5.27 5 ":12" Battens 1 Direct Deck 4.31 1 5.16 6 ":12" Battens Direct Deck 7 " :12" or greater Battens Direct Deck 4.20 5.03 4. 08 N/A Table 3: Attachment Resistance Expressed as a Moment - M, (ft -Ibf) from PA 102 and PA 102(A) Testing TILE APPROVED APPLICATION ' NAILS 1 nail APPROVED SCREWS 2 nails 1 screw I2 screws Altusa 'S' Tile battens N/A I N/A Direct Deck 6.20 8.40 N/A i 26.80' N/A N/A 31.80 , 21.20 25.30 Screws for tile installation over battens shall be #8 x 2 long corrosion res ;s•an :, Cuik -D-ive :crews ,nstallee / in two manufactured holes located 1' " and 1 from the head of the tire. v Aitcsa 'S' Tile Table 4: Attachment Resistance Expressed as a Moment - M, (ft-Ibf) from PA 101 Testing Tile Profile Tile Application Mortar Set Adhesive Set 13 ri o & Lci i ontroi d.' X (ft') Direct Deck Application APPROVED FIELD CLIP WITH; 1 nail 1 2 nails 0.31 Attachment Resistance 24 50 66 ` APPROVED EAVES CLIP WITH: 1 nail 1 2 nails N/A 26.90 34•90 N/A - • 03 02:49P11 FROM • . . ; A r:rt iSA . cla !loot Tiles iGAIL:. L LOCKS PROFILE DRAWING Raul Rodriguez ALTUSA 'S' TILE TO 6337640 P.15 10' _ Product Control No.: 14 11 • : i i Ii Nt7T CE OF ACC 2TAN E• STAN ARI CONDITION 1. Extensions of Acceptance may be considered after a new application has been filed and the supporting data, test reports no older than ten (14) years, have been re- evaluated. All reports of re- testing shall bear the seal, signature and date of an engineer registered in the State of Florida. I' 2. Any 'revision or change in the materials, use, or manufacture of the product or process shall automatically be cause for termination, unless prior approval is granted for revisions or change. 3. Any,usatisfactory performance of this product or process or a change in Code provisions shall be grounds for re•evaluation. 4. This shall not be used as an endorsement of any product for sales or advertising purposes. 5. The • Notice of Acceptance number preceded by the words Dade County. Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is dt ; ;,,.: ed, then it shall be done in its entirety. 6. Product approval dr; where required for permit applications. shall be provided to the applicant by the manufacturer or his distributors unless otherwise noted in the Notice of Acceptance. The prints need not be re- sealed by an engineer. Failure to compl. : :• 1111 Stanuard Conditions shall be cause for termination of the Approval. This approv' supersedes all p cviuus approvals. Last Appriov'al `umber 94- 0106.18 METROPOLITAN DADE COUNTY. FLORIDA METRO -DADE FLAGLER BUILDING DUILPING CODE COMPLIANCE DEPARTMENT .SUITE 1603 METRO -DADE FLAGLER BUILDING 140 WEST HAGLER STREET MIAMI. FLORIDA 33130 -1563 (305) 375.2901 FAX (305) 375 -2908 Raul Rodriguez Product Control Division Supervisor , TOTRL P. 1E' Job Address: 49 4U C qi / 5 4. 123.01.158 APPENDIX 'E' METRO -DADE UNIFORM BUILDING PERMIT SECTION II MORTAR OR ADIESIVE SET TILE SYSTEMS 1. General 2. Documentation Contractor: The information provided in this Section is required to confirm Product Control Approval of the proposed tile system assembly; confirm compliance with the wind load requirements of Chapter 23 of the South Florida Building Code (SFBC); and confirm compliance with Sections 3403.5 and 3404 of the South Florida Building Code. The following documents are required for submission with the Uniform Building Permit application: ► Two (2) copies of the proposed tile system assembly's and associated roofing component's Product Control Approval(s). ► One (1) copy of the tile system assembly and/or roofing component(s) manufacturer's published application instructions and literature. ► All documents attached herein, filled out and completed in full. 3. Project Information Check one of the following: ❑ New Construction S r Re -Roof Nole: Mortar or adhesive set tile systems are not acceptable as recover applications. Mortar or Adhesive Set Tile Systems Page - 1 9 ,e} cQ iJjf //JC Process No. Is the deck solid s;, ed? (circle 'yes' or 'no') no Deck Type (check one of the following): ❑ Nominal '/2" Plywood (for re -roof only) Nominal ' / Plywood O Wood Plank " ❑ Other (fill in) Roof Pitch (fill in): " : 12" Note: Mortar or adhesive set tile systems shall not be installed at a pitch greater than 7W:12". Mortar or adhesive set tile applied at a pitch greater than 5 ":12" and less than or equal to 7 ":12" shall have the first three courses of tile nailed with not less than one nail per tile. As an alternate, the first three courses of tile may be applied in mortar over a single layer of minimum 12 ga. wire mesh with square openings of not less than '/ which is mechanically attached to the sheathing with not less than one nail per 2 ft Circle eves' or 'no' for each of the following: Have you attached two copies of the tile system manufacturer's Product Control A . royal for the proposed tile system? no Have you attached a copy of the tile system assembly and/or roofing component(s) manufacturer's published, application instructions and oihev4iterature no Is the proposed underlayment approved for use with this tile system assembly? no Job Address: Contractor: Project Information (continued): If the proposed undcrlaymcnt is self- adhered, have you complied with the venting requirements of Section 2913.3 (b), (c) and (d) of the South Florida Building Code? P!� no N/A Are all related accessories approved for use with this tile system assembly? Are the proposed edge metal attachment fasteners in compliance with the requirements of the South Florida Building Code (minimum 12 ga. annular ri ank, corrossion reisistant nails)? 4. The Tile System Assembly: The following information is required to confirm compliance with Subsections 3403.5(a) and (c) and Section 3404 of the South Florida Building Code. Tile: Tile Name: 5e4 S Manufacturer: Z 7VS4 ( o Tile terial: Clay ❑ Concrete ❑ Other: no no Product Control Approval Number: Mortar or Adhesive: W-6VJS07 Check one of the following which apply to the proposed tile securement for use with the proposed tile system assembly: Mortar or Adhesive Set Tile Systems Page - 2 ❑ Adhesive: Type: Manufacturer: ❑ Other: Type: Length: 0 N/A Underlavment: Length: Process No. X ,I Mortar: Manufacturer: ad PI7 /667//i Mixing Ratio: Tile Fasteners (for first three courses if roof pitch exceeds 5 ":12" and is less than or equal to 7":12"I: Check one of the following which apply to the proposed tile fasteners (for the first three courses) for use with the proposed tile system assembly: ❑ Minimum 12 ga. galvanized roofing nail: Note: All tiles shall be installed in compliance with the provisions set forth in the tile system assembly manufacturer's Product Control Approval and the minimum requirements set forth in Subsections 3403.5(c) and 3404.2 of the South Florida Building Code. Tile fasteners in the first three courses (if applicible) shall be of sufficient length to penetrate the sheathing a minimum of 1" or through the sheathing thickness a minimum of / ", whichever is less. The following information is required to confirm compliance with Section 3403.5(b) of the South Florida Building Code. Job Address: Underlayment (continued): Check all of the following which apply to the proposed underlayment for use with the proposed tile system assembly: ASTM #30 asphalt saturated felt with: 0 19" overlap O 66" overlap 5. Related Accessories: t3 4" overlap Manufacturer: e £ a'z 4 ° ❑ ASTM #15 asphalt saturated felt with: Manufacturer: /Mineral Surfaced Roll Roofing with: 0 19" overlap O overlap l p 4" overlap Manufacturer: tal 1 �,��� ❑ Other: Type: Manufacturer: Underlayment Fasteners (if applicable): Check one of the following which apply to the proposed underlayment attachment: ❑ Minimum 12 ga. electro- galvanized roofing nail with minimum 32 ga. x 1'/ tin can: Length: / / � Manufacturer: _ j ❑ Other: Type: Length: Manufacturer: O 19" overlap O 6" overlap O 4" overlap Contractor: Mortar or Adhesive Set Tile Systems Page - 3 Process No. Spacing (per tile system assembly Product Control Approval): Field: /. " o.c. Laps: — " o.c. Edge Metal (refer to Section 3408.2 of the South Florida Building Code): Type: Dimensions: g 3 Gauge or Thickness: Finish: /.� Note: All edge metal shall be nailed on the flange and nailed or clipped at the face in compliance with the provisions set forth in Dade County Protocol PA 111, marked Appendix 'U' in the South Florida Building Code. Adhesives (check one of the following): ❑ Cold Adhesive: Type: Manufacturer: Flashing Cement: Type: Manufacturer: Job Address: Contractor: Process No. Adhesives (continued): Additional Notes: Note: Application of adhesives shall be in compliance with the Roofing Component Product Control Approval and the minimum requirements set forth in Subsection 3403.5(e)(4)(cc) of the South Florida Building Code. Ventilation System (check one or more of the following): The following information is required to confirm compliance with Subsection 3401.4(e) of the South Florida Building Code. ❑ Ridge: Type Size lLJ' Soffit: Type Size fe Note: If underlayment is comprised of a self - adhered membrane, both soffit and ridge ventilation systems are required, unless a base sheet is applied as an anchor sheet below the self - adhered underlayment. Note: The Tile System Assembly shall be installed in strict compliance with the application instructions enumerated in the Product Control Approval. A permit shall be issued for application of the specified Tile System Assembly onlv. Any change to the specified Tile System Assembly shall require submission of a revised SECTION II with a copy of SECTION I, noting the permit number issued. Mortar or Adhesive Set Tile Systems Page - 4 Job Address: Ridge Venting: S" (U appbeabk ) Contractor: Dcck: Type: Underlayment Le / at WA�gDr� �i� el/ale/24e- A6 7 � 4zr Head Lap Dimension: Underlayment e 4 (minimum 2* unless otherwise specified Fastener: '7v 12" DETAIL #1 Job Site Identification: Mortar or Adhesive Set Tile Systems Page - 5 Process No. FILL IN APPLICABLE ROOFING COMPONENTS WIIICII MAKE UP TILE SYSTEM ASSEMBLY. INSERT ANY ADDITIONAL LEADERS INDICATING ADDITIONAL ROOFING COMPONENTS NOT SIIOWN ON THIS PAGE. (Where Roofing Component not uscd in Tile System Assembly, fill in with "N /A ". ) in the rile rystem assembly Product Control Mortar/Ad hesiv) a1 �I1 Tile: Tile Fastener: lA /Zt " lt Existing or Proposed Soft Venting: . Edge Metal tljter Fastener: I `$��, 4045 % c Bird Stop: / f i He 1 7 (tfapp11cabe) Edge Metal 6 or Gutter: 2 < � lie l e Job Address: Contractor: Ridgy Height: Eave Height: Roof Mean Height feet 9 feet *feet Insert Building Ridge Height, Eave Height and Roof Mean Height. Also insert applicable information pertaining to the building below. ( See ASCE 7-88 Fact Sheet Attached ) Exposurc Category: Classification Category: .7• At l lurricancc Occanlinc?: Y t/.1 Basic Wind Speed at Building Location. 110 mph Building Condition based on % of openings: (See Table 9 oJASCE 7-88) Ground Level BUILDING INFORMATION #1 Job Site Identification: Mortar or Adhesive Set Tile Systems Page - 6 Process No. a Job Address: Contractor: Sketch Roof Plan, indicating all dimensions, slopes and any roof top equipment. Also insert variable labeled "a" which represents perimeter and corner dimensions per Chapter 23 of the South Florida Building Code. (See ASCE 7 -88 Fact Sheet Attached) 7,5 BUILDING INFORMATION #2: Roof Plan with Perimeter and Corner Dimensions Job Site Identification: Mortar or Adhesive Set Tile Systems Page - 7 Process No. Job Address: 4, 57 de 9(S f Contractor: The undersigned certifies that the Mortar or Adhesive Set Tile System Assembly is in compliance with the plans, specifications, and details submitted by the architect. STATE OF FLORIDA - COUNTY OF DADE Before me this day personally appeared who, being first duly sworn, deposes and says that all information submitted herein is true and correct. My commission expires: Licensed Contract / Owner Signature 19 rr to and subscribed before me this (9 th day of n _ ,,por If. MIRIAM MAT 1� My CommissionCC371408 * Expires May. 1 0.1988 Notary Pu State of Florida o /SIC Process No. Mortar or Adhesive Set Tile Systems Page - 8 8 BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL ❑ Date 3- 7-3 19_ PLUMBING ❑ PERMIT N? 8529 Contractor's �? License No. ROOFING ❑ ❑ Work to be performed under this Permit Owner of Building dr't-)'/ r . Architect Contractor t •• or Builder ; .- . ,� — Legal Lot Description II BI Address of 414C7 , f (.7- Building ,c r1 C ' #_: k 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 -shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servapts or ettloyees. �' � n 1 Signed • C a--- ' •.a` r ', C " - t . ``- - ,1 „ �"� "" If SI'ECTOR) BY 1 " y In consideration of the issuance to me of this permit I agree to 'p: form the work covered hereunder in compliance with all ordinances and regulation. pertaining thereto and in strict conformity with the plans, drawings, state ents or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit Iasme responsibility for all work done b' e er, yself, my agent, servant or employee. CONTRACTOR or B LI) Subdi- vision Sq Ft Value of Project $ II Amount of II Permit $ BY AUTHORITY herefor shin a drawings, atatanenth tine if the work it itraotsd is the pa to the Owner of Building Architect or Builder ki Legal L Description Address of A Building 44 th In consideration of the issuance • In pertaining there � and in c o acapd�n permit ur or;builder Owft*Jf4 IMMO ELECMICAL PW101fCi • it it : 1�° •. Owner of Building Architect Contractor or Builder Description Lcit E Address of Building This permit herefor in strict drawing*, stet time if the *ode granted is the doe wipe In consideration of the issuance to permining thereto and in strict f oc In accspthtg this permit I I corrrswcroa OR D' Vi MIAMI e : -' < , VILLAGE BUILDING EM O:: .'2©©N DEPARTMENT APPLICATION ;LZAILDING PERMIT Application is hereby made for the approval of the c etailec. stato.ment of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is mace in complianc:. 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 he complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progre_ of the wor °s. Owner's Name and �e Registered Architect and /or Engineer.. _ Name and address of licensed contractor____ Location and legal description of lot to be bit' t on: Lo. Block Subdivision_ -- d -_ Street and Number where work is to be done Remarks Chairman - Member _ _ Member Council Approved State wok to be done and purpose of building (by floors ) __ _ ___________._ (1" — =�• s _ and for no other purpose. IVew Building Remodeling AGdition _ _. Repairs.._ -:_ "___ ______ __ No. of Stories To be constructed of Kind of foundatic'. __ Roof Covering =� . - c Estimated Total cost of improvements $ ______ it- _ Amount Zone cubage required Distance to next nearest building 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 rec.uire 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. ( Signed).,- -- -- STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duiy authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. Date 3 Disapproved Date____ (Signed) -- - -- Building Inspector Date. - may _Plan Cubage. of Permit $- Size of Building Lot__ PLANN BOAR D..__ _ DATE Member Member Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires _ to me well known, Member Date Disapproved Date NOTE: A charge of $1.00 will be made for making corer ions or changes _o this application after approval has been obtained from the Planning Board. A re inspection fee of $1.00 will be charged when sr: -h re .n.,pection is made necessary by improper notice for inspection or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby mode for the approval of the detailed statement or me 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..._.� µ �. �_ 1._._ _sass._._ ` ,19: O-ncr's Name and Address .. ........ : ?`aZ .� . . .4 ` � .: �..: No. . Str ! .:.. Registered Architect and /or Engineer s,.,. ,... ... •1 a .nn<rar Fame and address of licensed contractor... e -- c-- 4 - i - k . a r ' , , "i.4 / /r- ; ,.. A/° a . • : & sass_ Member Location and legal description of lot to be bGilt on: Lot Block Subdivision _ _.._... .__ Street and A'uasber where work is to be done - ' - •__. .....,�•- .. )7 _ State y ►•ork to be done and purpose of building (by floors) ;, "7-, - ,,- o Ca_ Ncw Building Remodeling Addition Repairs.. ' max � No. of Stories = ' '''` To lse, of Kind of foundation oof Covering e t' s' ' Y,. .k i:3 A _• ( Estimat f'� Total cost of improvements $ 1 ` ` ` ' Amount of Permit $. r r. Zone cubage required .Plan Cubage l ,i.:r f Z.2 .41 £ f e g and for no other purpose. 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 unrlersiZr,cd 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 tl;c 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. Rem.uks (Signed err'' -' — `. fi 4"� �`Y•� �j—�, 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 fads therein by him stated are true.. ,1� Permit No.._.... Z ' ' 1 Date 1�� I Read, Sworn to and Subscribed before me. Disapproved Da e.. l Notary Public, State of Florida (Signed) "'���+++ Building Inspector My Commission Expires PLANNING BOARD DATE Chairman 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 fman the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by Improper notice for inspection or faulty materials and/or worksnanship. STATE OF FLORIDA, COUNTY OF DADE. ss. i ' • 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. Owner's Name and Address 1 t No Street Registered Architect and /or Engineer • Name and address of licensed contractor ✓ Location and legal flescriptio n of lot to be built on: i T. , Lot '' Z 2 Block_ e ' d Subdivision_ `� Street and Number where work is to be done 11 ` '¢ ' { -_-;'_i' State work to be done and purpose of building (by floors)__ Date , 19 and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ ___Amount of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 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 s tractors, on work to be perormed under this permit, as are licensed by Miami Shores Village. / Remarks (Signed) Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No._ - " - Date i Read, Sworn to and Subscribed before me. Disapproved " bate r , Notary Public, State of Florida ( Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 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 Owner's Name and Address , Jo._� __ -� -. Street / - s. �'::: Registered Architect and /or Engineer - - -.. Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) . a 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 $ 0 e-'i-.,61,, i'''' Amount i....„ of Permit $ ,. -r Zone cubage required _Plan Cubage ` "'" Distance to next nearest building. Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such ublic notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performe d. under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, 1 COUNTY OF DADE. j ss • Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ,r aLre7 . L ? 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 L. j e° Date !I— - i' t ' Read, Sworn to and Subscribed before me. Disapproved �,� Date �� Notary Public, State of Florida (Signed) � (7:2 � / —,, Y Building Inspector ' Commission Expires PANNING BOARD DATE Chairman Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re-inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Member Member Member • 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 1•lorida, 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 New Building To be constructed of Date / S ���i No Street Registered Architect and /or Engineer Name and address of licensed contractor __ 'CA. •( __ J Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done L _ State work to be done and purpose of building (by floors )____ G : -__ r ____,z1._- d and for no other purpose. Remodeling. Addition Repairs No. of Stories Kind of foundation Roof Covering . 1 ;— £ 1 /if Estimated Total cost of improvements $___ • ° A 0 r Amount of Permit $ 19 -5 6 Zone cubage required flan 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 subcontraptors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) - , r"k" ( e 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 stated are tiue. Permit No \ } Date 4 r ° s 4 E ' Read, Sworn to and Subscribed before me. Disapprove ; Date (Signed) -- -.., - ` - - k.(.1' Notary Public, State of Florida building Inspector My Commission Expires to me well known, PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.