ROOFINGLG ENGINEERING SERVICES, INC.
Consulting Engineers
North Office:
7370 N.W. 36ih Street
Suite 374
Miami, Florida 33166
South Office:
13380 S.W. 131 Street
Suite 120
Miami, Florida 33186
Tel: (305) 994 -8128 Fax: (305) 994 -8135
M. I. S Corporation
10221 Southwest 16`' Street
Miami, Florida
Project:
Dear Sirs;
TILL UPLIFT TEST
Astreve Residence
258 Northeast 92 Street
Miami, Florida
Information provided by client:
Permit Number: 45263
Date Completion: November 19, 1999
Roofing Contractor: M. I. S. Corporation.
LG Engineering Services, Inc. Project Number: LG99 -1538
(Testing Laboratory Certificate #99- 0609.01)
November 22, 1999
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
performed in general accordance with Roofing Application Standard RAS No.16 -- 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 5000 square feet, and the mean height of
the roof is less than 20 feet above ground surface. The type of tile used for this project was
reported to be Altusa 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 were
tested. Initially the entire area of the roof was examined for loose tile. More than 10% of the
roof tile located in the field area and more than 20 % of the roof tile at the roof perimeter and
corner were physically examined.
Based on our test results, we conclude that the installation of the roof tile at the above referenced
project meets the test requirelinent outlined in the above mentioned protocol. 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.
TILE UPLIFLTEST
Astreve Residence
258 Northeast 92 Street
Miami, Florida
ohamad Sonny Salleh P.E.
Project Manager
Test Number
Test Load (lbf)
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
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Report of
TILE UPLIFT TEST
for
Astreve Residence
258 Northeast 92 Street
Miami, Florida
Project Number: LG99 -1538
LG Engineering Services, Inc. -- Tile Uplift Test Result - Project Number: LG99 -1538 Page I
Test Number
Test Load (Ibf)
Test Status .
24
35
Pass
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
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
LG Engineering Services, Inc. -- Tile Uplift Test Result - Project Number: LG99 -1538 Page 2
Test Number
Test Load (lbf)
Test Status
53
35
Pass
54
35
Pass
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
90
35
Pass
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
LG Engineering Services, Inc. -- Tile Uplift Test Result - Project Number: LG99 -1538 Page 3
North
75
d5
1
71
Approximate Test Location
LG Engineering Services, Inc. -- Tile Uplift Test Result - Project Number: LG99 -1538 Page 4
q PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date , / </9' Job Address ISS L %` Tax Folio
Legal Description
Owner/Lessee / Tenant LC'(ZILQ.--\
Owner's Address o o " -
Contracting Co. ,ZS
Qualifier ! l v rlI r (3 t
State # C CU C 0 U 4 Ma- Municipal #
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL
Signature of o
APPROVED:
Zoning
Mechanical
FEES: PERMIT
Historically Designated: Yes
RADON
a'-7?
ZN 5aiv 7r
Date
c�G
o . as o • er and/or Confident
My Commission Expr'ie
ry Public, State of Florida
'�•� ORLANDO NUNEZ
commission # '"!Ja Comm Expires es Ma 5
18, 2002
C.C.F.
Phone
No
Master Permit # 9:5 -, 07/ 3
Address /0 2 t ) /' ST . /1/41(
SS# - , Phone
Competency # Ins. Co.
Address
Address
OOHING ' AVING FENCE SIGN
WORK DESCRIPTION �� l _ —�� �� ���
Square Ft. Q., 4cn Estimated Cost (value)
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 OF 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.
Notary as to Contractor o er- Builder
My Commission Expires:
;;� ;,�,, Notary Public, State of Florida
' ,• `` ` = ORLANDO NUNEZ # CC 725791
• ' a ` Comm, Expires Mar. 18, 2002
NOTARY BOND
TOTAL DUE
` / 1t s
Building t Electrical
Plumbing Structural Engineer
if > NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
998414 -590 1999 AUG 10 09: ',7
PERMIT NO. TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF 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 Commencement.
1. Legal description of property and street address: IS
2. Description of improvement: `f \ \
3. Owner(s) name and address: -_C Z1Q._.- •
. t.� �,� �. � N■\
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: �2TS C �ff d r frT 7 °j "
/0'22/ Sw / ST
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: 4'
8. In addition to himself, Owner designates the following person(s) 10 receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address: /11/d
9. Expiraton date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
Signature of Owner
Print Owners Name ‘01Z1
Sworn to and subscribed before me this
Notary Public
Print Notary's Name
r
My Commission Ext i es: 'a..
0
Commission # CC 725791
Comm. Expires Mar. 18, 2002
h
T Cr nnIDA
COUNTY ;,,
8Y CERTIFY tier this is a trre�tpy of the
f' I e in f h s /�(
W TNEcS n'y
tAR E,t UVII
d Of iciai seal.
ER
A D 9
Cir'uit nd County Courts
D.C.
•
Prepared by: 41€Z, v L
Address: , /cD Z / .S`&t. /4 5/
L 4A1/, / L ;
331 '3T
123 2/93
Ft
•5
Contractor's Name: S C)
irr rA4T O t.)
❑ New Roof
DETAIL 1 & 2
*Includes Mortar a d Adhesive Set Tile
Appendix "E"
UNIFORM ROOFING PERMIT APPLICATION
PROCESS No.
.Job Address:
ROOF CATEGORY $Mortar-Set ❑ (Low Slope Application) ❑ (Nail-On Tile) Tire) *
❑ (Asphalt/Fiberglass Shingles) ❑ ( Metal Rno\Wood Shingles Bt Shakes) ❑ (Other)
ROOF TYPE
e- roofing ❑ Recovering ❑ Repair ❑ Maintenance
Flat Roof Area (ft ___ _ Sloped Roof Area (ft 2 400 (ft2) 2 4004' Master Permit No.
Exposure category (per ASCE 7 -88): Building Classification category (per ASCE 748 table 1): 7
ROOF REIGHT AND SYSTEM DETAILS (Draw details as needed)
Page - 1
ROOF PLAN
Deck type:'
Appendix. "E"
UNIFORM ROOFING PERMIT APPLICATION
PROCESS No.
Ridge V m on?
wANHEGar 12 N9-
z Underiayment:
Insaiadon:
ROOFSLCUY
DETAIL 3.
- SLOPED SYSTEM DESCRIPTION
Cap Sheet:
Roof Covering:
Page -2
Fastener type & spacingl 1 - CA-x ( 4 (? S_
/fti1 /c /
,4( 51
qd
Drip edge ' 3 ff ,24 6,*
ATTACHMENTS REQUIRED
(u.
1) Fire Directory Listing Page
2) Dade County Product Control
Notice of Acceptance -Cover Sheet
a) Specific System Description
b) Specific System Limitation
c) General Limitations
d) A pplicble Detail Drawings
3) Municipal Permit Application
4) Other Component Approvals
(Pmaxl: d c 3 x)1. (Aerodynamic Multiplier): • 7
(Pmax2: /° 2- X (Aerodynamic Multiplier): r 3 /
(Pmax3: ° I 1- x X (Aerodynamic Multiplier): r /
TIL ' CALCULATIONS
) _ .s __ _ = M i s l 7 -I PCA:
) - M:S-
�J _ m . : .2 4. v PKA:
) - 1'( =Mr3 d PCA:
APPENDIX "F "REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS
As it pertains to this Appendix "F ", it is the responsibility of the roofing contractor to provide the owner
with the required roofing permit, to provide the owner with this appendix and to explain to the owner the
content of this form. The provisions of Chapter 34 of the South Florida Building Code (SFBC) govern
the minimum requirements and standards of the industry for roofing system installations. Additionally,
the following items should be addressed as part of the agreement between the owner and the contractor.
The owner's initial in the adjacent box indicates that the item has been explained.
_ 1. Aesthetics - Workmanship: The workmanship provisions of Chapter 34 are for the purpose of
providing that the roofing system meets the wind resistance and water intrusion performance standards.
Aesthetics (appearance) issues are not a consideration with respect to workmanship provisions. Aesthetic
issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as
part of the agreement between the owner and the contractor.
/A 2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be
renailed in accordance with the current provisions of Chapter 29 of the SFBC. (The roof deck is usually
concealed prior to removing the existing roof system)
,2 3. Common Roofs: Common roofs are those which have no visible delineation between
neighboring units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing
contractor and/or owner should notify the occupants of adjacent units of roofing work to be performed.
o f ,4 4. Exposed ceilings: Exposed, open beam ceilings are where the underside of the roof decking
can be viewed from below. The owner may wish to maintain the architectural appearance, therefore,
roofing nail penetrations of the underside of the decking may not be acceptable. The SFBC provides the
option of maintaining this appearance.
, Y 7 .9 5. Ponding Water: The current roof system and/or deck of the building may not drain well and
may cause water to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of
structural distress and may require the review of a professional structural engineer. Ponding may shorten
the life expectancy and performance of the new roofing system. Ponding conditions may not be evident
until the original roofing system is removed. Ponding conditions should be corrected.
6. Overflow Scuppers (wall outlets): It is required that rainwater flow off so that the roof is not
overloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this
discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow
scuppers in accordance with Chapter 23 of the SFBC.
.e 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the
interior of the structural assembly (the building itself). The existing amount of attic ventilation shall not
be reduced. It may be beneficial to consider additional venting which can result in extending the service
life of the roof.
wner's /Agent's Signature
Signature
5104 APPENDIX "F"
1 / e7 /2
Date Contractor's
Signature
� '7
4 t ETRO3
Almar (USA), Inc.
6645 Northwest 77th Avenue
Miami, FL 33166
Your application for Product Approval of:
Altusn Tile Nail -On, Mortar Set or
APPROVED: 02 /13/97
1
METROPOLITAN DADE COUNTY. FLORIDA
METRO -DAOE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET, SUITE 1603
MIAMI, FLORIDA 33130 -1563
PRODUCT CONTROL NOTICE OF ACCEPTANCE FAX (305) 375.2906
e Piece "S" Tile Roofing Tile
PRODUCT CONTROL DIVISION
(305) 375.2902
FAX (305) 372 -6339
under Chapter 8 of the Metropolitan Dade ounry Code governing the use of Alternate Materials and Types of
Construction, and completely described in the plans, specifications and calculations as submitted by:
Redland Technologies, The Center for Applied Engineering, Inc.
has been recommended for acceptance by the Building Code Compliance Office to be used in Dade County,
Florida under the specific conditions set forth on pages 2 -16 and the standard conditions on page 17.
This approval shall not be valid after the expiration date stated below. The Building Code Compliance Office
reserves the right to secure this product or material at any time from a jobsite or manufacturer's plant for quality
control testing. If this product or material fails to perform in the approved manner, the Building Code .
Compliance Office may revoke, modify, or suspend the use of such product or material immediately. The
Building Code Compliance Oface reserves the right to revoke this approval, if it is determined by the Building
Code Compliance Office 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.: 97- 0918.02 Renews 96-1030.03
EXPIRES: 02/13/00
Raul Rodriguez
Product Control Division
Supervisor
THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
CONDITIONS
BUILDING CODE COMMITTEE
This application for Product Approval has been reviewed by the Metropolitan Dade County EipliMing Code
Compliance Office and approved by the Building Code Committee to be us . in #ade County, F la under the
conditions set forth above. y
Charles Danger, P.E.
Director
Building Code Compliance Dept.
Metropolitan Dade County
Applicant:
Altusa Tile
;Alrareria del Turbio, S.A.
Barquisimeto, Venezuela
Category: Prepared Roofing
Sub-Category: Tile
Type: Nail - on/Mortar Set!
Sub- Tvpe,: Clay
PRODUCT CONTROL NOTICE OF ACCEPTANCE
ROOFING S \'STEh1 APPROVAL
Contact:
Carlos 1. Fernandez
General Manager
Altusa Tile, Almdr (USA), Inc.
6645 Northwest 77th Avenue
Miami, FL 33166
(305) 471 -5830
Product Control No.: 97 0918.02
Product Control No.: 97 0918.02
Approval Date: February 13, 1997
Expiration Date: February 13, 2000
Svstem Description
Alfareria del Turbio, S.A. (Altusa), located in Barquisimeto, Venezuela, manufacturers clay roof
tile for nail -on, mortar set or adhesive set applications. All tile is manufactured from natural Venezuelan
clays. This Product Control Approval relates to Altusa's "Altusa S" tile profile. Refer to appropriate
Product Control Approvals for other tile profiles.
The "Altusa S" tile profile is available in a variety of natural clay colors and has matching trim
pieces used for rake hip, ridge hip, and valley terminations. These accessories are manufactured for all
profiles and form a part of this Product Control Approval. Optional rubber or clay eave closures are also
available.
Altusa roof tiles have been tested in compliance with the South Florida Building Code
requirements for clay, nail -on, mortar set or adhesive set tile applications. The minimum roof slope for
the "Altusa S" nail -on tiles shall be 2 ":12 ". See the "Profile Drawing" section in this approval for the
"Altusa S" profile drawing. The "Altusa S" profile has been tested for both wind characteristics and static
uplift performance. therefore, any consideration for installation shall be done as a 'Moment Based
System'. Data for attachment calculations is noted in Tables I through 4 of this Approval.
Aimar (USA), Inc., located in Miami, Florida, is the sole approved importer under contract for
selling and distributing Altusa products in the South Florida jurisdiction.
Frank Zuloaga
P��n� FYiminer Product CnntrcI Division
TRADE NAMES OF PRODUCTS MANUFACTURED OR
LABELED BY APPLICANT
Test Product
Dimensions Specifications Description
1= 18 '/ PA 112 Hiah profile clay roof tile for direct
w = 10 'A" deck or battened nail -on, mortar or
Y thick adhesive set applications.
Head -lap min,
2
Exposure max.
16% :"
I = varies
w = varies
Product Control No.: 97- 0918.02
PA 112 Accessory trim, clay roof pieces for
use at hips, rakes, ridges and valley
terminations.
Frank Zuloaga
Plans Examiner. Product Control Division
;43 Coated Base
Sheet
Mineral Surface Cap
Sheet
Rainproof II
Ice and Water Shield
Mopping Asphalt
TRADE NAMES OF PRODUCTS MANUFACTURED OTHERS
Dimensions
N/A
N/A
N/A
Lenzingtex -ZB 140 59" x 164' roll
Underlayment 22 lbs /roll
30" x 75' roll
36" x 75' roll
or
60" x 75' roll
36" x 75' roll
N/A
N/A
Test
Specifications
ASTM D 226
type 11
ASTM D 7626
ASTM D 249
PA 104
PA 104
ASTM D312
type 111 or IV
ASTM D 4586
4
Product
Description Manufacturer
Saturated organic felt generic
to be used as a nailed
anchor sheet.
Saturated and coated
organic base sheet for
single or double ply
underlayment.
Mineral surfaced
asphalt roll rooting
for use as a top ply in
a double ply
underlayment system.
Single ply, nail -on
underlayment.
Single ply, nail -on
underlayment with 2"
self - adhering top
edge.
PA 103 Self - adhering W.R. Grace Co.
underlayment for use with current PCA
as a top ply in a two
ply underlayment
system with
Approved 430 or 443
as the base layer.
Asphalt for bonding a
mineral surface cap to
a mech. attached base
sheet in a double ply
underlayment system.
Cut back, asphalt
based, asbestos free,
fiber reinforced,
trowel grade cement
for repair and flashing
applications.
Product Control No.: 97- 0918.02
Frank Zuloaga
Plans Examiner, Product Control Division
generic
generic
Lenzing
Performance, Inc. .
with current PCA '
Protect -O -Wrap, Inc.
with current PCA
generic
generic
Asphalt Primer
Wood Battens
Test Product
Dimensions Specifications Description ;Manufacturer
NiA ASTM D 4I Cut back. asphalt generic
based coating used to
facilitate bonding of
dissimilar materials.
min. 12 ga. with
' /," head
min. 32 ga.
min. 1'4" o.d.
max. 2" o.d.
horizontal
min. I" x 4" for use
with vertical barrens
or
min. I" x 2" for use
alone
PA 114
Appendix E
PA 114
Appendix E
Annular ring shank,
hot dipped, electro or
mechanically gale.
roofing nails for use
in underlayment
attachment.
Corrosion resistant
circular disc for use in
underlayment
attachment
vertical Wood Preservers Salt pressure treated
min. 1" x 4" Institute LP - 2 or decay resistant
lumber battens
Hurricane Clip & Clips PA 114 Corrosion resistant
Fasteners min. '/ :" width Appendix E bronze, aluminum,
min. 0.062" thick stainless steel,
galvanized steel or
Clp Fasteners plastic attachment
min. 8d x I' /4" clips for supplemental
tile attachment. Clips
are installed with
corrosion resistant
roofing nails
compatible with the
clip. A hurricane dip
is required on all
nail -on eave tiles.
Product Control No.: 97- 0918.02
generic
generic
generic
generic
Roof Tile Mortar N/A PA 123 Prepared mortar mix Bermuda Roof
( "TileTiteTM ") designed for mortar Company, Inc.
set roof tile with current PCA
applications.
Product
oar Tile Mort
( "Quikrete Roof 1
Tile Mortar "1140")
Valley Flashing
Dimensions
N/A
N/A
min. 26 ga.
min. 16" width
min. 26 ga.
min. 2" face flange
min. 2" deck flange
Test Product
Specifications Description
PA 123 Prepared mortar mix
designed for mortar
set roof tile
applications.
See PCA
ASTM A 525
PA 11
Product Control No.: 97 -0918.02
Two component
polyurethane adhesive
designed for adhesive
set roof tile
appl ications.
Galvanized steel generic
valley flashing
Galvanized steel drip generic
edge
Frank Zuloaga �~
Manufacturer
Quikrete Construction
Products
with current PCA
Polyfoam Products,
Inc.
with current PCA
TEST REPORTS
Produc: Control No.; 97- 0918.02
Test Agency Test 1 . e Test Name/Report Date
Testwell Craig Laboratories Lab. #AAP -2 ASTMI 1 167 Oct. 1994
& Consultants, Inc.
Redland Tccbnologics 7161 -03 Static Uplift Testing Dec. 1991
Appendix III PA 102
Redland Technologies 7161-03 Wind Tunnel Testing Dec. 1991
Appendix 11 PA 108
(Nail -On)
Redland Technologies Letter Dated Aug. 1, 1994 Wind Tunnel Testing Aug. 1994
PA 108
(Nail -On)
Redland Technologies P0631 -0I Wind Tunnel Testing July 1994
PA 108
(Mortar Set)
Redland Technologies PO402 Withdrawal Resistance Testing Sept. 1993
of screw vs. smooth shank nails
Redland Technologies 7161 -03 Static Uplift Testing Dec. 1991
Appendix 111 PA 102(A)
The Center for Applied 94 -83 Static Uplift Testing April 1994
Engineering, Inc. PA 101
(Adhesive Set)
The Center for Applied 94 -084 Static Uplift Testing May 1994
Engineering. Inc. PA 101
(Mortar Set)
The Center for Applied 25- 7200 -1 Static Uplift Testing Feb. 1995
Engineering, Inc. PA 102
(Quick -Drive Screws, Battens)
The Center for Applied Project No. 307025 Wind Driven Rain Oct. 1994
Engineering, Inc. Test #MDC -78 PA 100
Frank Zuloaga
Plans Examiner. Product Control Division
Deck Type:
Deck Description:
SYSTEM D:
Slope Range:
Undcrlavment:
Roofing Tile:
Comments:
Wood, Non - insulated
New construction i /,," or greater plywood or wood plank.
SYSTEMS
(CONTINUED)
Mortar o Adhesive Set Applicati
Product Control No.. 97 - 0918.02
2 ":1 to 7":12"
Note: System D is only acceptable in this slope range. For slopes in excess
of 7 ":12 ", refer to System C.
Install underlayment system in compliance with Dade County Application
Standard PA 120. (See System Limitation #5.)
Install tile in compliance with Dade County Application Standard PA 120.
(See "Data for Attachment Calculations" included in this Approval.)
1. For re -roof applications, "/ plywood is an acceptable substrate.
Frank Zuloaga
r n
1 n'
PROFILE DRAWING
ALTUSA "S" CLAY ROOF TILE
ACCESSORIES
10-1/' 2"
GOvG SAN.
LOCKS
13
Product Control No.: 97- 0918.02
Frank Zuloaga
P1��� FY1minrr Product Control Division
PROFILE DRAWING
APPROVED SCREW
Product Control No.: 97 - 0918.02
Frank Zuloaga
Plans Examiner Product Control Division
Table 2: Restoring Moments due to Gravity - M (ft -Ibf)
from PA 102 Testing
Tile
Profile
. 3 " :12"
or less
4 ":12"
5 ":12"
6 ":12"
7 ":12" or
greater
Battens
Direct
Deck
Battens
Direct
Deck
Battens
Direct
Deck
Battens
Direct
Deck
Battens
Direct
Deck
Altusa 'S' Tile
4.47
5.35
4.40
5.27
4.31
5.18
4.20
5.03
4.08
N/A
Tile
Profile
Table 4: Attachment Resistance Expressed as a Moment - M (ft-Ibf)
from PA 101 Testing
X (ft')
Direct Deck A.plication
Tile
Profile
Tile
Application
Attachment
Resistance
Altusa 'S' Tile
1 nail
Mortar Set
24.50
Adhesive Set
66.50
Tile
Profile
A. (ft')
Batten Application
X (ft')
Direct Deck A.plication
Altusa 'S' Tile
0.29
0.31
Table 3: Attachment Resistance Expressed as a Moment - Mr (ft -Ibf)
from PA 102 and PA 102(A) Testing
Tile
Profile
TILE
APPLICATION
APPROVED
NAILS
APPROVED'
SCREWS
APPROVED
FIELD CLIP
WITH:
APPROVED
EAVES CLIP
WITH:
1 nail
2 nails
1 screw
2 screws
1 nail
2 nails
1 nail
2 nails
—
!Altusa 'S' Tile
Battens
N/A
N/A
N/A
26.80
N/A
N/A
N/A
N/A
Direct Deck
8.20
8.40
28.70
58.20
21.20
25.30
26.90
34.90
DATA FOR ATTACHMENT
CALCULATIONS
Table 1: Aerodynamic Multipliers - (ft')
Product Control `'o.: 97- 0918.02
' 1. Quik•Drive screws installed in two manufactured holes located 1 and 1 ° /e" from the head of the tie.
Frank Zuloaga
Ptnns Fviminer Pr..rlurr f'nntrnl fivisinn
BIRD STOP
NAIL
HOLE
NAIL
HOLE ---
14
Product Control No.: 97 - 0918.02
GABLE-RAKE
.0111W
ran uloaga
pb�� FYirrin'r Prr.}nrt ('nntrnl Nvision
SYSTEM LIMITATION'S
Product Control No.: 97- 0913.02
I The standard minimum roof pitch for Altusa "S" high profile tile shall comply withDade County
Application Standards PA 1 18, PA 119 or PA 120. depending on the method of installation.
2. For nail - on applications, fasteners for mechanical attachment of tiles shall have a head diameter
larger than that of the preformed holes in the tile.
3. System installation shall be in compliance with the system specifications outlined in this Product
Control Approval. The method of attachment utilized shall provide 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. Altusa "S" tile profile has been tested
for both wind characteristics and static uplift performance, therefore, attachment calculationsfor
installation in compliance with PA 115 or PA 127 shall be done as a 'Moment Based System'.
For mortar or adhesive set tile applications, a field static uplift test by a Dade County accredited
testing agency, in compliance with Dade County Protocol PA 106, shall be performed.
5. For mortar set tile applications, 30/90 hot mopped underlayment applications may be installed
perpendicular to the roof pitch unless stated otherwise by the underlayment material manufacturer's
published literature.
6 All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo for
identification in the field.
7. Applications for roofing permits shall include a completed Sectionll of the Uniform Building
Permit, a copy of Almar USA's current specifications and details, a copy of this Product Control
Approval and a copy of the Product Control Approval of any Roofing Component used in the
proposed tile application. Reference shall be made to appropriate data for the required fire rating.
8. The applicant shall retain the services of a Dade County certified testing laboratory to maintain
quality control in compliance with the South Florida Building Code and related protocols. Samples
taken shall be in compliance with Dade County Protocol PA 112, Appendix 'A'.
Frank Zuloaga
Pllnc FY3minrr Product Control Division
Product Control No.: 97 - 0913.02
Tfl FAI
Altusa Tile, Almar (USA), Inc.
6645 Northwest 77th Avenue.
Miami Fl 33166 .
ACCEPTANCE NO.: 97- 0918.02
APPROVED : February 13, 1997
EXPIRES : Fcbruary 13.2000
NOTICE OF ACCEPTANCE STANDARD CONDITIONS
1. Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and
the original submitted documentation, including test supporting data, engineering documents, are no older
than eight (8) years.
2. Any and all approved products shall be permanently labeled with the manufacturer's name, city, state, and
the following statement; "Dade County Product Control Approved ", or as specifically stated in the specific
conditions of this Acceptance.
3. Renewals of Acceptance will not be considered if:
a) There has been a change in the South Florida Building Code affecting the evaluation of
this product and the product is not in compliance with the code changes;
b) The product is no longer the same product (identical) as the one originally approved;
c) If the Acceptance holder has not complied with all the requirements of this acceptance,
including the correct installation of the product;
d) The engineer who originally prepared, signed and sealed the required documentation
initially submitted , is no longer practicing the engineering profession.
4. Any revision or change in the materials, use, and/or manufacture of the product or process shall
automatically be cause for termination of this Acceptance, unless prior written approval has been requested
(through the filing of a revision application with appropriate fee) and granted by this office.
5. Any of the following shall also be grounds for removal of this Acceptance:
a) Unsatisfactory performance of this product or process;
b) Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any
other purposes.
6. The Notice of Acceptance number preceded by the words Dade County, Florida, and followed by the
expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is
displayed, then it shall be done in its entirety.
7. A copy of this Acceptance as well as approved drawings and other documents, where it applies, shall be
provided to the user by the manufacturer or its distributors and shall be available for inspection at the job
site at all times. The copies need not be resealed by the engineer.
8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of
Acceptance.
9. This Acceptance contains pages 1 through 17.
END OF THIS ACCEPTANCE
17
Tel T r -i,. T- ; r.
Fran Zuloaga
Plans Examiner, Product Control Division
•
^ r •
PRODUCT CONTROL NOTICE OF ACCEPTANCE
Polyfoaln Products, Inc.
2400 Spring- Sttlebner Road
Spring, TX. 77333
Your application for Product Approval of:
Polvfoam Products "Polvpro AH -160" Ronf Tile Adhesive
under Chapter 8 of the Miami -Dade County Cods: governing the use of Alternate Materials and Types of
Construction, and completely described in the plans. specifications and calculations as submitted by:
The Center for Applied Engineering, Inc. and Miles Laboratories Polymers Division
has been recommended for acceptance by the Building Code Compliance Office to be used in Dade County.
Florida under the specific conditions set forth on pages 2 -14 and thc standard conditions on page 15.
This approval shall not be valid after the expiratiun date stated below. The Building Code Compliance Office
reserves thc right to secure this product or material at any time from a jobsite or manufacturer's plant for quality
control testing. I f this product or material rails to perform in the approved manner, the Building Code Compliance
Office may revoke. modify, or suspend the use of such product or material immediately. The Building Code
Compliance Office reserves thc right to revoke this approval, if it is determined by the Building Code Compliance
Office 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.: 98- 0303.02 Renews: 96- 0402.02
EXPIRES: 04/16/01
THIS IS TITF. COVERSIIF..F.T, SEE ADDI'T'IONAL PAGES FOR SPECIFIC AND GENERA',
CONDITIONS
BUILDING CODE COMMITTEE
This application for Product Approval has been reviewed by the Miami•Dadc County Building Codc Compliance
Ofice and approved by the Building Cede Cotntt :lace to be used in Dade County. Florida under the conditions set
forth above.
A I'I'RO V E D: 04/1.6/98 1
Internet malt address: po $tmaeler @buildingcodeonlIne.com
OPP 7a •eq tt:dt
METROPOLITAN DADE COUNTY. FLORIDA
METRO -OAOE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE
METRO•OAOE FLAGLER BUILDING
140 WEST FLAGLER STREET. SUITE 1603
MIAMI. FLORIDA 33130 -1563
(305) 375.2901
FAX (305) 3'15 -2908
PRODUCT CONTROL DIVISION
(305) 375-2902
FAX (305) 372-6339
aul Rodriguez
Product Control Supervisor
LAT, j
Charles Danger. P.E.
Director
Building Codc Compliance Dept.
Miami -Dade County
Momepage: http : //www.buildingcodeonitne.corn
954 475 1 4 5 2 ! G ! . 2
Apr -29 -98 11 :39A Polyfoam Products Inc.
POLYFOAM PRODUCTS, INC.
Applicant:
Polyfoam Products, Inc.
2400 Spring - Stucbner Road
Spring, Tcxas 77383-1132
Category: Roofing Component
Sub- Category: Fastening/Adhesive
ape: Roof Tile Adhesive
Sub -Type: Two Component Polyurethane
PRODUCT CONTROL NOTICE OF ACCEPTANCE
ROOFING COMPONENT APPROVAL.
System Description
Polyfoam Products, Inc., produces two- component expanding polyurethane adhesive for the attachment
of clay and concrete roof tile. Polypro® A1-1160 is specially designed fur application of concrete and
clay roof tile over a variety of roof deck substrates and underlayment materials.
Polypro® adhesive is applied with proprietary Foampro® RTFI000 dispensing equipment. Approval of
this product is specific to the two component mix and Foampro® RTF1000 dispensing equipment.
Alternative methods of dispensing will require a revision to this approval.
Polypro® adhesive shall be applied only by 'Qualified Applicators', licensed by Polyfoam Products. Inc.
Certificates and identification cards arc issued to applicators upon successful completion of a application
training program. Approval of this adhesive system is contingent upon application by a 'Qualified
Applicator.
Contact:
Pat Murray
P.O. Box 1132
Spring, Texas 77383-1132
Phone: (713)350 -8888
Fax: (713)28R-6450
Page 2 of 15
954 475 -1462
Product Control No.: 98- 0303.02
Product Control No.: 98-0303.02
Approval Datc: April 16, 1998
Expiration Date: April 16, 2001
Frank Zuloaga. RRC
Roofing Product Control Examiner
P.03
Apr -2 -98 11:39A Polyfoam Products Inc.
954 475 -1462 P.04
• . POLYFOAM PRODUCTS. INC. Product Control No.: 98- 0303.02
Product
Polypro0 A11160
TRADE NAMES OF PRODUCTS MANUFACTURED OR
LABELED BY APPLICANT
Foampro® RTFI000 N/A See Detail Attached Dispensing Equipment
Test Product
Dimensions Specifications Description
N/A PA 101 Two component
polyurethane
Page 3 of 15
Frank Zuloaga, RRC
Roofing Product Control Examiner
Apr -29 -98 11:39A Polyfoam Products Inc.
• • POLYFOAM PRODUCTS, INC.
Product
Underlayment
Roof Tile
Test Criteria
PA 101
Page 4 of 15
Product Dcscription
954 475 -1462
Product Control No.. 98- 0303.02
TRADE NAMES OF PRODUCTS MANUFACTURED BY OTHERS
PA 120 All Dade County Component Approved
products as detailed in Dadc County
Application Standard PA 120
All Approved roof tile systems having
tested in compliance with Dade County
Protocol PA 101, as detailed in the systems
section of this Component Approval
Manufacturer.
All Dade
County
Approved
Products
All Dadc
County
Approved
Products
rank Zuloaga, RRC
Roofing Product Control Examiner
P.05
Apr -29 -98 11:40A Polyfoam Products Inc.
TEST REPORTS
Test Agency
954 475 -1462 P.06
• POLYFOAM PRODUCTS, INC. Product Control No.: 98- 0303.02
Test Identifier Test Name/Report Date
Center for Applied #94 -060 Miami Dade Protocol 04/03/94
Engineering PA 101
Center for Applied 257818 -IPA Miami Dade Protocol 12/16/96
Engineering PA 101
Center for Applied 25- 7438 -3 SSTD 11-93 10/25/95
Engineering
Center for Applied 25- 7438 -4 SSTD 11-93 10/25/95
Engineering
Center for Applied 25- 7438 -7 SSTD 11 -93 11/02/95
Engineering
Center for Applied 25 -7492 SSTD 11-93 12/12/95
Engineering
Miles Laboratories NB- 589 -631 ASTM D 1623 02/01/94
Polymers Division
Ramtech Laboratories, 9637 -92 ASTM E 108 04/30/93
Inc.
Southwest Research 01- 6743 -011 ASTM E 108 1 1/16/94
Institute
Southwest Research 01-6739-06213[1j ASTM E 84 01/16/95
Institute
Trinity Engineering 7050.02.96 -1 PA 114 03/14/96
Page 5 of 15
Frank Zuloaga, RRC
Roofing Product Control Examiner
Apr -29 -98 11:40A Polyfoam Products Inc.
. POLYFOAM PRODUCTS, INC. Product Control No.: 98- 0303.02
TYPICAL PHYSICAL PROPERTIES
Pronerty Ii
Density ASTM D 1622 1.6 Ihs. /ft.'
Compressive ASTM D 1621 18 PSI Parallel to rise
Strength 12 PSI Perpendicular to rise
Tensile Strength ASTM D 1623 28 PSI Parallel to rise
Water Absorption ASTM D 2127 0.08 l.bs. /Ft
Moisture Vapor ASTM E 96 3.1 Perm / Inch
Transmission
Dimensional
Stability
Closed Cell —
Content
ASTM D 2126
ASTM D 2856 86%
954 475 -1462 P.07
Results
+0.07% Volume Change -40 F., 2
weeks
+6.0% Volume Change 0158°F.. 100%
Humidity, 2 weeks
Note: The physical properties listed above are presented as typical average values as determined
by accepted ASTM test methods and are subject to normal manufacturing variatiun.
Page 6 of 15
Frank Zuloaga, RRC
Roofing Product Control Examiner
Apr -29 - 98 11:40A Polyfoam Products Inc.
. ' POLYFOAM PRODUCTS, INC. Product Control No.: 98 - 0303,02
Deck Type: Wood, N on- insulated, New Construction /Reroof
Deck Description: 15/32" or greater, plywood or wood plank.
SYSTEM A: Adhesive Set Application
Slope Range: 2 ":12" to 7 ":12"
Underlayment: Shall comply with Miami - Dade Roofing Application Standard PA 120
Roofing Tile:
Any roof tile assembly having a current shall be applied in compliance with the
Component Application scction and the corresponding Placement Details of
this Notice of Acceptance. The adhesive attachment shall provide sufficient
attachment rcsistancc expressed as a moment to meet or exceed the required
moment of resistance determined in compliance with Miami-Dade County
Roofing Application Standards PA 115 or PA 127. The adhesive attachment
data is noted in the roof tile assembly NOA.
SYSTEMS
Comments: 1. All 'System Limitations' noted in the tile Roof System Assembly Product
Control Approval shall apply.
I'age 7 of 15
954 475 -1462 P.08
Frank Zuloaga, RRC
Rooting Product Control Examiner
Apr -29 -98 11:40A Polyfoam Products Inc.
POLYFOAM PRODUCTS, 1 Product Control No.: 9S- 0303.02
SYSTEMS
(CUNTTNUF.D)
954 475 -1462 P.09
Deck Type: Concrete, New Construction /Rcrouf
Deck Description: New construction
SYSTEM 13: Adhesive Set Application
Slope Range: 2":12" to 7":12"
Undcrlaymcnt / Install Approved underlay/nent system of one of the following:
Waterproofing:
Underlayment: (30/90 Hot Mop) fully adhered in a full mopping of ASTM D 312 type I V
asphalt applicd within the ENT range. Back nailing and laps shall be in
compliance with Rooting Application Standard PA 120.
Roofing Tile:
Comments:
Any liquid applied roofing system having a current NOA for its use as a tile
underlaymcnt system.
Any roof tile assembly having a current shall be applicd in compliance with the
Component Application section and the corresponding Placement Details of
this Notice of Acceptance. The adhesive attachment shall provide sufficient
attachment resistance expressed as a moment to meet or exceed the required
moment or resistance determined in compliance with Miami -Dade County
Roofing Application Standards PA 115 or PA 127. The adhesive attachment
data is noted in the roof tile assembly NOA.
1. All 'System Limitations' noted in the tile Roof System Assembly Product
Control Approval or waterproofing component Roofing Component
Product Control Approval shall apply, as applicable.
Page 8 of 15
Frank Zuloaga, RRC
Roofing Product Control Examiner
Table 1: Adhesive Placement For Each Generic Tile Profile
Tile
Profile
Placement
Detail
Two -Piece Barrel
#1
'S' Shaped
#2
Double Roll
#3
Flat
#
Apr -29 - 98 11:41A Polyfoam Products Inc.
. POLYFOAM PRODUCTS, INC. Product Control No.: 98- 0303.02
COMPONENT APPLICATION
1 Polypro® Al [160 tile adhesive shall only be applied over an underlaymcnt installed in compliance
with application instructions detailed in its NOA.. Underlayment may be any underlayrnents or
underlayment systems listed Miami -Dade County Roofing Application Standard PA 120.
2. Adhesive application shall be in accordance with the instructions provided herein. Tthe
manufacturer may provide additional instructions subsequent to this approval date which may
prevail. Installation must he by a Factory Trained 'Qualified Applicator' approved and licensed by
Polyfoam Products, Inc.
3. Calibration of the Foampro® dispensing equipment is required before application of any adhesive.
The mix ratio between the "A" component and the "A" component shall be maintained between 1.0-
1.15 (A) : 1.0 (B). The dispense timer shall be set to deliver 0.08 to 0.15 pounds per tilt as
determined at calibration. No other settings shall be approved without revision of NOA.
4. Adhesive shall be dispensed in a 17 in' to 23 in' pad at time of application. The cured pad shall be
approximately 5" x 12 ". Foam placement shall be in accordance with the 'Placement Details'
herein. Each generic tile profile requires a specific placement. as noted in Table 1, below
5. Adhere tilt dircctly.in freshly applied adhesive. Tile must be sct within 2 to 3 minutes after foam
has been dispensed.
Page 9 of 15
954 475 -1462 P.1O
Frank Zuloaga, RRC
Roofing Product Control Examiner
r cr'r_c ra, ct_
Z
Apr -29 -98 11:41A Polyfoam Products Inc.
SYSTEM LIMITATIONS
Page 10 of 15
954 475 -1462 P.11
• POLYFOAM PRODUCTS, TNC. Product Control No.: 98- 0303.02
2. Polypro® A1[160 adhesive shall be installed only by 'Qualified Applicators' approved and licensed
by Polyfoam Products, Inc.
3. For adhesive set tile applications, a field static uplift test by a Miami -Dade County accredited
testing agency, in compliance with Miami -Dade County Roofing Application Standard PA 106,
shall be required not less than 72 hours after application to confirm tile adhesion.
4. Refer to application drawings published by the National Tile Manufacturers Association for
penetrations and terminations, as well as the 'Placement Details' included with NOA.
5. Refer to tile Root Assembly Product Control NOA for system acceptance with this Component.
6. Refer to the Prepared Roof Tile Assembly for fire rating.
7, Polypro® AH 160 shall not be exposed permanently to sunlight.
8. Polypro® A14160 shall be applied with Foampro RTF1000 dispensing equipment only.
9. Polyfoam ProductsTne. shall supply Building Official with a list of 'Qualified Applicators' approved
and licensed by Polyfoam Products, Inc.
Frank Zuloaga, RRC
Roofing Product Control Examiner
t •, 1
Apr -29 -98 11:41A Polyfoam Products Inc.
POLYFOAM PRODUCTS, INC.
U wMr l.tm.
2) 7 .w.. .w... .o..1f. dew.
• 1... A.a`1.. 1/r 1. 1"
tws U. d. ..Ip..1
....r 111.. Thom .w. /tll ta..
1 )•1w...w..mA .IA..1..
I. .e Ai.w 17 to 27 .o.
iw. Awe Iw ..wt..t ..11h the
pow ell..
R..w... I. porno. of U..
.... oaru. dl.. Att..t to
....wa ...... pow 1(1.o.
!wow. .... .w. M Owl wet
••••• than .r. It■A 01 moo.
Iiw..
1....I..... (mortal. .Mw.
PLACEMENT DETAILS
Moll throw. p1..Ut Powwow'
954 475 -1462 P.12
Product Control No.: 913- 0303
OW* ommilcoll...L.
-�' ,/
•
Placement Detail NI: Two -Piece Barrel Profile
Pagc 11 of 15
I..mlt •.er4
berme require/ by seq.)
Optlwol
►mlwWp an or
.•. 1 ...olt.rlw.1
of en..
I A..U I..
Frank Zuloaga, RRC
Roofing Product Control Examiner
Apr -29 -98 11:41A Polyfoam Products Inc.
POIXFOAM PRODUCTS, INC.
Moll 1IVwyA pI..11..-•w -..l
(..1.... •••*••• ny s.4.t
PLACF.MENT DETAILS
(CONTINUED)
u.a..i- y•■•••■
Page 12 of 15
AMy ..w.., Mil--I-- l-
--•lo••• 17 1. >n .M•-
Iw.A-- 1. --r-.-- •.MA (A-
tll.,
Placement Detail 112: 'S' Shaped Tile Profile
954 475 - 1462 P.13
Product Control No.: 9S- 0303.02
D•ly !Igo
Frank Zuloaga, RRC
Roofing Product Control Examiner
•
•
•
Apr -29 -98 11:41A Polyfoam Products Inc_
POLYFOAM PRODUCTS, INC_
N.Y IM..gh p1..11...w.w1
I�hw. r.QWrr/ try *1.60
1... Corm.
PLACEMENT DETAILS
(CONTINUED)
4.. w....Jy. Lr�
....1.. A.Vr.d...11.V
bow la+.pl..iw.
Page 13 of 15
..hi... 17.21 .�....� I...1...
1...wh1 .AM 1h. 111.
Placement Detail t13: Double Roll Profile
954 475 -1462 P.14
Product Control No,.: 98- 0303.02
WV. CI..r..
Frank Zuloaga, RRC
Roofing Product Control Examiner
Date
Legal Description
Owner / Lessee / Tenant 46c %r Master Permit #
Owner's Address 25 7 J Phone 77-� 766C
Contracting Co. /- 1 ( 41 Address 72-57,x/6 2
Qualifier / ? / 7 . 7.- SS# Phone 7'�- 3?Zi
State 494/0247.1 municipal # Competency # K8/ Ins .Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL 'OOFING PAVING PENCE SIGN
WORK DESCRIPTION ��°�i�� ' / / / /e ,
Or
Square Ft. ® Estimated Cost(value) ,222
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'wosk will
be don- in compliance w all applicable laws regulating co' ruc io and zon Fur hermor'e, I
authojze the above-nad co • tr: ctor- -to" do the work stated ! /
- W i t / #401Lik # _, ■/>, .,,,/ r
/or Condo President Q ntr,ct'. r Own-- owne o Da . y
:� � " OFFICIAL. SEAL" . T , , /�[. S
, � r Alfred McKnight % �, '� /� , ,� �
` , ; o ,? My Commis f es $/31/
Nota as to Own 6 dgmki �i�� et1227G "stractor or Owner - Builder`
y Con otary as t•
My I.mmission Expires': " " '
** * * * *
P'° FEES: PERMIT ? �, RADON C.C.F.
APPROVED:
Zoning
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
C/ Job Address 2.-g /A'r 5 ;7 2 4:=5/ 4 71-
C 4 "' s Tax Folio
* * * *
Fire
Bui
Mechanical Plumbing
uilder
Sign
Dat
My Commission Expires:
111
Other
Electrical
Engineering