70 NE 92 St (11)LG ENGINEERING SERVICES, INC.
Consulting Engineers C• I• v• i• L
North Office: South Office:
7370 N.W. 36" Street 13380 S.W. 131 Street
Suite 374 Suite 120
Miami, Florida 33166 Miami, Florida 33186
ENGINEER
Tel: (305) 994 -8128 Fax: (305) 994 -8135
Biscayne Construction Co., Inc.
1070 East 52 Street
Hialeah, Florida 33013
Project:
Dear Sirs;
TILEJJfLIFS TEST
Martin Residence
70 Northeast 92 Street
Miami Shores, Florida
Information provided by client:
Permit Number: 47074
Date Completion: November, 2000
Roofing Contractor: Biscayne Construction
LG Engineering Services, Inc. Project Number: LG00 -2085
(Testing Laboratory Certificate #00- 0224.07)
November 20, 2000
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.106 -- Standard
procedure for field verification of the bonding of mortar or adhesive set tile system and
mechanically attached, rigid, discontinuous roof systems.
The total of the tested roof surface area was less than 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 Bermuda 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 examine 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 requirement 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.
oh ad Sonny
Project Manager
TILE_UPLIET_TEST
Martin Residence
70 Northeast 92 Street
Miami Shores, Florida
!,/-1 7l'i
Salleh, F.E.
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
Martin Residence
70 Northeast 92 Street
Miami Shores, Florida
Project Number: LGOO-2085
LG Engineering Services, Inc. -- Tile Uplift Test Result -- Project Number: LGOO-2085, Page 1
Test Number
Test Load (lbf)
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: LGOO-2085, Page 2
Test Number
Test Load (Ibf)
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
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: LGOO-2085, Page 3
North
62
.1" H 4I
1 HS
s3
3y
L �
S
, 4
ci
1L
?
'0
} 7
17
7 G ?S
48
)1
7
i
4
0 6z 6 3
72
Si
2.
1 i
6
f2 6
rG 1
G
r ra
z
Approximate Test Location
LG Engineering Services, Inc. -- Tile Uplift Test Result -- Project Number: LGOO-2085, Page 4
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Q —? b -p2 11b Address 70 A &-- 72 ST/ ar Tax Folio // " 3.204. -1,11- Oo 2 o
Legal Description Historically Designated: Yes No
p
Master Permit # `7' , 7 7 C I
Owner/Lessee / Tenant ?h t nip #4-12.77/6
Owner's Address 7D , /L- Q' S' & 7 ' Phone 0...1 7.5 7 9903
Con Co. 2 s CGr t — LOwS! �t'vc7L) ( ..ve Address /07,0 � S772�E'7 -
Qualifier l 9A)4 4.0 A . L4 i N q Phone Pad bB8 -74*
State # r 4.3L Qs 2. Municipal # Competency #
Architect/Engineer Address
Bi gy Address
Ins. Co.
Mortgagor / Address 1
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICA ROOFING PAVING FENCE SIGN
WORK DESCRIPTION �% e940 e940 bj /57 - 7/6' 1201e- /A-6/‘ te-lI p � / '4 e-
Pl f sys (i-4 /i fe 4eXg 7;/P
Square Ft. arl Estimated Cost (value) its, 4 4SO
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 i •fiance with all applicable
laws re: ating construction and zoning. Furthermore, I authorize the above -named tractor to do the work
Owner and/or Con • o Pre
ssion Expires:
:OFFICIAL NOTARY SEAL
JOYCE E SUGGS
A RY PUBLIC STATE OF FLORIDA
•.:0MMJ`SION NO. CC737771
M Y COMMISSION EXP. APR. 27,2002
FEES: PERMIT l 8 "0 RADON
Date
Dae
6Avg°
OFFICIAL NOTARY SEAL
JOYCE E SUGGS
NOTARY PUBLIC STATE OF FLORIDA
rOMMISSION NO. CC737771
AlY CO,`M MISSION EXP. APR. 27,2002
C.C.F. _
�y . NOTARY BOND 1
TOTAL DUE 4' 9
APPROVED:
Zoning Building
Mechanical Plumbing Engineering
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO
STATE OF FLORIDA:
COUNTY OF 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: ?O N 6- Z S 7 2 a.Q
2. Description of improvement: / ��►:�
3. Owner(s) name and address: r
7o tV� q Z 2 fi- 13 5
Interest in property:
Name and address of fee simple titleholder:
Ai/4
4. Contractor's name and address: : )I SCC.' /■L CON sTav c.-r-teN ao, I N t_
(FA—Sr -S 2 sTa r°' bra -1 ,
f . Surety:(Payment bond required by owner from contractor, if,any
Name and address: q��A � °
Amount of bond $ /
1�. Lender's name and address:
:i'gnaturt 01 Ow er
Print Owners Name
Sworn to and subs
Notary Public
efore me this
Print Notary's arse RLBLC STAT OF FLORIDA
Ivry Commiss : �cpires:
e (LLg pail)
TAX FOLIO NO. 2 t ) 6 7 - 0/3 -002.0
44i'? n s142es, FL 33/3 e
0 0 8374719 2000 AUG 03 10:
t•.D -J
^an
e D.C.
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: ,V/,-
i3. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
3. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
Pre ared by: T G NA c ( 0
C7c viRjS
Address: (0
.31013
1230t -52 2/93
Contractor's Name:
❑ (Low Slope Application)
❑ (Asphalt/Fiberglass Shingles)
Ft.
1
Ft.
v
A
V
123.01-78 9/96
Fastener Type:
Appendix "L"
(JNIFORAI ROOFING PERM 1'1' APPLICATION
I'RUCLSS Nei.
BISCAYNE CONSTRUCTION CO, INC.
1070 E. 52nd Street Jolr midi ess:
Hialeah, FL 33013
ROOF CATEGORY
U (Nail-On Tile)
❑ ( Metal Roofs \Wood Shingles Shakes)
ROOF TYPE
❑ New Roof Lh Ite- rooiillg ❑ Recovering I.._l Repair I _l Maintenance
Flat Roof Area (fl 'e Sloped Roof Area (ft') 3 000 Total (IL') 3mq' Master Perini( No.
Exposure category (per ASCE 7 -88): I3uilding Classification categoiy (per ASCII 7 -88 table 1):
Deck type:
Field: Perimeter: Corner:
DETAIL I St 2
ROOF I!EICI11' AND SYS'I'Ef\I DETAILS
(Draw details as needed)
Alt A(: 111\1E
1'A(:IN
Page- 1
7 0 /VE 92 ,Sr 2e 7
Ll (Ntut tar- i \dliesive Sel 'file)
El
(UtIlcr)
ROOF PLAN
•
Appendix "E"
BISCAYNE CONSTRUCTION CO, 1011 FORRI ROOFING PEItnI rl• APPLICATION '
1070 E. 52nd Street I'ROCU S No.
H a ea , L 33013 __ - — -
S'L O1'LU LS' 1'S1 L1111)1 S'CIW'T ON
Ridge Venulellun,
hIEAN IIEICIIT /1 '
Deck type:
(P►nax1::4. •
Wood 14/22•' M',i)
Underlay mend 3O1 Fa/
.so - t - t�e/v/ /a44 ePwli
Insvi nllona
: D E T A I L L J
J
i a
r
Cop Shed: 90 4tirn /Vs
Roof Covering:] (1 "/04. 9 , ' 4 4, ,4,- /X4v
A/ Covering{
is
,v nrlp et,gel Yol Mr 011 141/ JI
'PILL CALCULATIONS
A, (Aerodynamic Multiplier): JI.Oli) -7 M S• 20 = M r1 : • v(.. I'CA: i/D • 90
(PmaX2: qt •C X ?1. (Aerodynamic Multiplier): 23.40 ) - M 5 • = M ± Z . ' I'CA: I /8.90
(Pmax3 :'%- x ?1, (Aerodynamic Multiplier): 2'I ` ) - Nl: S •LD = M �7 fk I'CA: ,/8. 90
Page -2
ATTACHMENTS REQUIRED
1) Fire Uiiectoly Listing Page
2) Dade County Piolluct Control
Notice of Acceptance -Cover Sheet
a) Spcci I is System Description
b) Spcci(ic System Limitation
c) General Limitations
d) Applicable ()clad Drawings
s
3) Municipal Permit Application
d) Ulhcr Component Approvals
APPENDIX "F "REQUIRED OWNERS NOTIFICA'IiON 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 (SI IIC) 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.
prvt 1. Aesthetics - Workmanship: 'I'Ire workmanship provisions of Chapter 3 are for the purpose of
providing that the roofing system meets the wind resistance and water intrusion performance standards.
Aesthetics (appearance) issues arc 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.
y " 2. Reuniting 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 SFI3C. (The roof deck is usually
concealed prior to removing the existing roof system)
3. Common Roofs: Common roofs are those which have no visible delineation between
neighboring 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.
Qiit 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. Tlie S1:13C provides the
option of maintaining this appearance.
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 rooting system. Ponding conditions may not be evident
until the original roofing system is removed. Ponding conditions should be corrected.
G. Overflow Scuppers (wall outlets): It is required that rainwater flow off so that the roof is not
o erloaded 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. 11 may be necessary to install overflow
scuppers in accordance with Chapter 23 of the SFL3C.
7. Ventilation: Most roof structures should have some ability to vent natural airflow through the
interior of the stnictural 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.
Owner's /A ent's Signature
Signature
5104 APPENDIX "F"
/��(J I � l
v ►,4.:! /. !:
Date
ontractor's
Signature
METRO -
PaoDLJcr CONTROL NOTICE OF ACCEPTANCE
Monier Lifetile LLC
135 N.W. 20 St.
Roca Raton, FL 33431
METROPOLITAN DADE COUNTY, FLORIDA
METRO -DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET, SUITE 1603
MIAMI, FLORIDA 33130-1563
(305) 375 -2901
FAX (305) 375 -2908
PRODUCT CONTROL DIVISION
(305) 375-2902
FAX (305) 372 -6339
Your application for Product Approval of:
Bermuda Flat Tile
under Chapter 8 of the Miami -Dade County Code governing the use of Alternate Materials and Types
of Construction, and completely described in the plans, specifications and calculations as submitted by:
Rcdland Technologies, The Center for Applied Engineering, Inc. and Professional Service
Industries, Inc..
has been recommended for acceptance by the Building Code Compliance Office to be used in Miami -
Dade County, Florida under the specific conditions set forth on pages 2 -8 and the standard conditions
on page 9.
This approval shall not be valid after the expiration slate 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 Office 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- 1121.13 Revises No.: 96- 0528.06
EXPIRES: 06/25/01 taul Rodrit, iez
Product Control Supervisor
'FIIIS IS TIII? COVI ?RSIIEE'I',SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
CONDI'T'IONS
BUILDING CODE COMMITTEE
This applkation for Product Approval has been reviewed by the Miami Dade County Building Code
Compliance Office and approved by the Building Code Committee to be used in Miami -Dar ounty,
( fr) e1/
Florida under the conditions set forth above.
Charles Danger, P.E.
Director
Building Code Compliance Dept.
APPROVED: 06 /2:i /98 1 Miami Dade County
Internet wall address: pos tnrster @huildIngcodeonitne.cont It!) Ilomepago: htlp : / /www.hulldingcodeonlino.com
MONIER. LIFETILE LLC Product Control No.: 97- 1124.13
Product
13erinuda Mat 'roc
Trim Pieces
1'
Rainproof 11
lee and Water
Shield
Wood fiat tens
"file Nails
TItAI)E NAMES 01? PRODUCTS MANUFACTURED OR
LABELED I3Y APPLICANT
Test
Dimensions Specifications
1= 15" PA 112
w = 10 /8"
I' /," thick
I = varies PA 112
w = varies
varying
thickness
TRADE NAMES 01? PRODUCTS MANUFACTURED OTHERS
Dimensions
30" x 75' roll
36" x 75' roll
or
60" x 75' roll
36" x 75' roll
Test
Specifications
PA 103
Vertical Wood Preservers
Min. 1 "x 4" Institute LP — 2
Horizontal
Min. 1 "x 4" for use
with vertical battens
or
Min. I "x 2" for use
alone
Page 2of9
Flat, interlocking, extruded
concrete roof tile equipped with
two nails holes. For mortar set or
adhesive set applications.
Accessory trim, concrete roof
pieces for use at hips, rakes, ridges
and valley terminations.
Manufactured for each tile profile.
Product
Description
Self- adhering
underlayment
PA 104 Single ply, nail -on
underlayment with
2" self - adhering top (with current NOA)
edge.
Salt pressure
treated or decay
resistant lumber
vattens
Min. 84 x 2 ' //" or PA 114 Appendix E Corrosion resistan
min, 10dx 3" screw or smooth
shank nails
Product
Description
Manufacturer
Protect -O -Wrap,
Inc.
W.R. Grace Co.
(with current NOA)
generic
generic
ran uloaga, RR
Roofing Product Control I:xan►incr
HOMER LITETILE LL.0 Product Control No.: 97 -1 124.13
Product
Tile Screws
Roof Tile Mortar
( "Ti IeTiteTm ")
ItoofTile Mortar
( "Quikrete4 hoof
Tile Mortar
rl 1 140")
Roof Tile Mortar
(" flONSALm
Roof Tile Mortar
Mix ")
Roof Tile
Adhesive
( "Polypro®i
A11160")
1 Iurricane Clip he
Fasteners
Dimensions
#8x 2 1/2" long
0.335" head dia.
0.131" shank dia.
0.175" screw thread
dia.
N/A
N/A
N/A
N/A
• Clips
Min. '/2" width
Min. 0.060" thick
Clip Fasteners
Min. 8d x I '/4"
Test
Specifications
PA 114 Appendix E Corrosion resistant,
coated, square
drive, galvanized,
coarse thread wood
screws
PA 123
PA 123
PA 123
See PCA
PA 114 Appendix E Corrosion resistant
clips with corrosion
resistant nails.
Page 3 of 9
Product
Description
Prepared mortar
mix designed for
mortar set roof tile
applications.
Prepared mortar
nix designed for
mortar set roof tile
applications.
Prepared mortar
mix designed for
mortar set roof tile
applications.
Two component
polyurethane
adhesive designed
for adhesive set
roof tile
applications.
Manufacturer
generic
Bermuda Roof
Company, Inc. with
current PCA
Quikretc
Construction
Products with
Current PCA
W. R. Bonsai Co.
with current PCA
Polyfoam :Products,
Inc.
PCA 894- 0401,01
Generic
n Zuloaga, RRC
Roofing Product Control Examiner
1V1t)NCER C.IFETILE LL,(' Product Control No.: 97•I 124.13
EVIDENCE SUI3MITTED
Test Atencx Test Identifier Test Name /Report Date
The Center for Applied 94 -084 Static Uplift Testing
Engineering, Inc. PA 101
(Mortar Set)
The Center for Applied 94 -060A
Enigneering, Inc.
Redland Technologies P0631 -01
Professional Service
Page 4 of 9
Static Uplift Testing
PA 101
(Adhesive Set)
Wind Tunnel Testing
PA 108
(Mortar Set)
224 -47099 Physical Properties
Industries, Inc. PA 112
May 1994
March, 1994
July 1994
Sept, 1994
ran Zuloaga, RRC
Roofing Product Control Examiner
MONIER LI E'FILE LLC Product Control No.: 97 -1 124.13
Underlayinent:
Roofing 'file:
Comment,:
SYSTEMS
I)ecic T,Ype: Wood, Non - insulated
Decic Description: New construction 19 /32" or greater plywood or wood plank.
SYSTEM D: Mortar or Adhesive Set Application
Slope Range: 2 " :12" to 7 ":12"
Note: System D is only acceptable in this slope range.
install underlayment system in compliance with Miami -Dade County
Application Standard PA 120. (See System Limitation #4.)
Install tile in compliance with Miami -Dade County Application Standard PA
120. (See "Data for Attachment Calculations" included in this Approval.)
1. For re -roof applications, 15 /32" plywood is an acceptable substrate.
Page 5 of 9
Frank Zuloaga, RRC
Roofing l'rimduct Control Examiner
.MONIED LIFETILE 1_,LC Product Control No.: 97 -1 124.13
SYSTEM LIMITATIONS
I. The standard ininintunt roof hitch for the Monier Lifetile 1.,LC's Bermuda Flat Tile high profile tile
shall comply with Dade County Application Standards PA 120.
2. 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. The tile profile listed herein has been
tested for both wind characteristics and static uplift performance , therefore, attachment calculations
for installation in compliance with PA 115 or PA 127 shall be done as an 'Moment Based System'
3. 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.
4. For 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.
All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo for
identification in the field.
6. Applications for roofing permits shall include a completed Section 11 of the Uniform Building
Permit, a copy of manufacturer'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.
7. 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.
K. Any amendments to these provisions shall he in compliance with Sections 203 and 204 of the South
Florida Building Code.
9. Fire classification is not part of this acceptance.
Page 6 of 9
Frank Zuloaga, Rite
Roofing Product Control Examiner
Table 2: Restoring Moments due to Gravity - M (ft -Ibf)
from PA 101 Testing
Tile
Profile
:i ":12" or
Tess
4 ":12"
5 ":12"
6 ":12"
7 ":12" or
greater
Monier
Lifetile Ll_C
Bermuda
Flat Tile
5.20
5.12
5.01
4.89
N/A
NCONIER LIFET1LE LLC
DATA FOR ATTACHMENT
CALCULATIONS
Table 4: Attachment Resistance Expressed as a
from PA 101 Testing
Tile Tile
Profile Application
Monier Lifetile LLC Bermuda Mortar Set
Flat Tile
Adhesive Set
Page 7 of 9
Product Control No.: 97 -1 124.13
Moment - M, (ft -Ibf)
Attachment
Resistance
39.00
118.90
Frank Zuloaga, RRC
Roofing Product Control Examiner
Table 1: Aerodynamic Multipliers - X (ft')
from PA 108 Testing
Tile
Profile
X (ft')
Batten Application
X. (ft')
Direct Deck Application
Bermuda Flat Tile
N/A
0.24
NCONIER LIFET1LE LLC
DATA FOR ATTACHMENT
CALCULATIONS
Table 4: Attachment Resistance Expressed as a
from PA 101 Testing
Tile Tile
Profile Application
Monier Lifetile LLC Bermuda Mortar Set
Flat Tile
Adhesive Set
Page 7 of 9
Product Control No.: 97 -1 124.13
Moment - M, (ft -Ibf)
Attachment
Resistance
39.00
118.90
Frank Zuloaga, RRC
Roofing Product Control Examiner
MONV R LTFETELE [.LC Product Control No,: 97 -1 124.13
PROFILE DRAWING
BERMUDA FLAT TILE
Page 8 of 9
9"
Frank Zuloaga, RRC
Roofing Product Control Examiner
IVIONIEIt LIFETIL.E LLC Product Control No.: 97 -1 124.13
Monier Lifetile 1,1,12 ACCEPTANCE NO.: 97- 1124.13
135 N.W. 20th St. APPROVED : June 25, 1998
Boca Raton, FL. 3343 1 EXPIRES : June 25, 2001
NOTICE OF ACCEPTANCE STANDARD CONDITIONS
1 Renewal of this Acceptance (approval) shall he 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: "Miami -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;
h) 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.
Any of die following shall also be grounds for removal of this Acceptance:
a) linsatisfactory performance of this product or process;
b) Misuse adds Acceptance as an endorsement of any product, for sales, advertising or any
other purposes.
6 The Notice of Acceptance number preceded by the words Miami -Dade County, Florida, and
followed by the expiration date may be displayed in advertising literature. If any portion of the
Notice of Acceptance is displayed, then it shall be done in its entirety.
7 A copy of this Acceptance as well as approved drawings and other documents, where it applies,
shall be provided to the user by the manufacturer or its distributors and shall be available for
inspection at the job site at all limes. 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 I through 9.
END OF Ti IIS ACCEPTANCE
Page 9 of 9
Frank Zuloaga, RRC
Roofing Product Control Examiner
tot iTtlt.l.F' \illi
I
1 opc_: ' NOTICE OF ACC'FPTANC'E
I'ol'ftl:ur► Products, 1110,
740(1 Sprint;- Incl►rler Road
`iI►rinf,,'TX, 7101
Your application for Product Approval of:
'.nlY.y'hatll. rotit1t_(g` P"IY11rn_A�I__1f�)! R09..c..cilc_.AtiktAvc
under Chapter 8 oldie hdianti -Dade County Code governing the use of Alternate Materials and Types of
i'r and completely described in the plans, specifications and calculations as submitted by:
The ('ruler I'nr Applied EitOuet:rlug, roc. and Mlles Laboratories Polymers Division
has 114011 recommended for acceptance by the Ruilding Code Compliance Office to be used In Dade County,
Mot iila under the. specific conditions set forth on pages 2.1 and the standard conditions on page 15.
approval shall mot h4 valid after the expiration data stated below. The IluikIing Code Compliance Office
rein rvt,s the l il?ht to si.curc: this product nr material at any time from e jobslte or manufacturer's plant for quality
control Icsling. It this prodo .t or material fails 10 perform in the approved manner, the 1luildin4 Code Compliance
Oftuce may revoke, 1110114, or suspend the use of such product or material immediately. The *Building Coda
Compliance: (Jftiee re,se.rv•s the right to revoke tills approval, if it Is determined by the Building Code Compliance
Oft ee that this product or material fails to meet the requirements oldie South Florida Building code.
fh� expense of such tasting will ho incurred by the rnrnufaclrtrer.
AC('I!:P')'ANC'l' NO.: 98. 11303.02 mews: 9E- 0402 0
F\ Ir1It.ES; II t/16/111 -
'f 'IyT`i1`i'11!r c' (1 rit;ti 11D1 .E,S FOR SPECIIt1C N D GENERAL
CONI) TIO.N`;
IiIlrLn1ryG (`oor coMAIITTYE
•
This application for Product A1Ilroval huts been reviewed by the Miami-Dade County fluilcling Code Compliance
Office. and approved by the Building Committee to be used In Mule County, Florida under the conditions set
fol I II idiom
.
A1'PIt °VI ?I1; (111/ ri /')8 1
lill�:io t mall UtIllteau: ptialinattlutl litintllou60(10011 hlt3.G0111
METROPOLITAN DADE COUNTY, FLORIDA
METRO -DADE F BUILDING
DUIL.DIND CODE COMPLIANCE OFFICE
METRO - DADE FLAGLER BUILDING
140 WEST FLAGLER STREET, SUITE 1603
MIAMI, FLORIDA 30130 -1563
(305) 375 -2901
FAX (305) 37.5.2900
PflOf►UCT CONTROL. DIVISION
(305) 375.002
FAX (305) 372.6330
`r C"--1
aul Rodriguez
Product Control Supervisor
Chnrlus Danger, P.E,
Director
Building Code Compliance Dept.
Miami -Dario County
loneputla; hllp :Ilwww.hulldlnocorlPOnlIna, corn
I't11_.1'l'OA1vl PRODUCTS, INC, Product Control No, :9R -O3,Q 10
PRODUCT CONTROL, NoTrc1?, OE ACCEPTANCE
ROOFING COMPONENT APPROVAL
I' I'rollur.ls, Product Control No,: 98- 0303.02
2400 Spring - S1 11i:b er Rot 1
Sprint', Texas 71383-1112 Approval Data: April 16, 1998
(tooting Component
Faslc•.ninlr /Adhesive
Roof file Adhesive
'Iwo Component Polyurethane
System Description
Expiration Date: Apr11_1_6,_2001
I'i�1} I,lalll Produi'1 , loc., produces two (t)mponenl e. xpan(IIIIU polytretltane adhesive for the AIIAChnle•nt
of clay and concrete; root tile. Polypro(l) Al - 1160 is specially designed for application of concrete and
clay roof tile. over a variety of molded: substr and underlayment materials.
l'olypro(10 adhesive is applied wills 1) oprietaty Fonrnproli) 1t'1'1: 1000 dispensing equipment. Approval of
ibis product is specific to the Iwo component mix and FoarnproQ+) far 1000 dispensing; equipment.
Alternative Illrthodi of dispensing will require a revision 10 Ihiy approval,
1)01;110 adhesive. shall he applied only by 'Qualified Applicators', licensed by Polyfonnl products, Inc.
Certificates and identification cards are 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. lox 1132
Spring, 'l'extts 77383 - 132
Phone: (713)350 -R888
F:'x: (713)288 -6150
I'a8e 2 of 15
Frank Zuloat,a,
Roofing Product Control ENdmilwr
• P(:11,Y1e0AI11 Pito I)t1CT;, INC. Product Control No,; 98-0303 02
Prudttel
I'oIyhrolt) AI1160
'I'RAI)E NAMES (A? PRODUCTS NXANY►FACTL1flI.D OR
LABELED BY APPLICANT
Test Product
pinlcnyinn4 S lEti l4gti9.Os Description
N/A PA 101 Two component
polyurethane
I'oumpro(1t) RTE 1000 NIA Sea Detail Attached Dispensing Equipment
Pir.a3Ot 15
Drink Zulonga, ItItC'
Roofing Product Control Examiner
POI ;YFOAI1I PltO lUCIS, INC;. Product Control No.: 08- X303.112,
1'rii
t hides layment
I lit
TRADE NAMES or PRODUCTS MANUFACTURED BY C)T 1!11ERS
Test Criteria
P 101
Product Des criptlon
PA 120 A ll Dade County Component Approved
products as detailed in Dade County
Application Standard PA 120
All Approved roof the systems having
tested in contplinnce with Dade County
Protocol PA 101, as detailed in the systems
section of this Component Approval
Page '1 of 15
Manufacturer
All Dade
County
A pproved
Products
All Dade
County
Approved
Products
,..,-----_-,9:-P-.7:-.---- :.„ ' . t
I'rs►�tl: L uloatta, It.RC
Rooting Produet Control 1xaminer
-14 .1t.v VOA (VI 1►12.OI11IC.," 1'S, INC. Product Control No.: 98.030).92
rl`I!.S') iZEI'Of't.S
'Petit_:\ g►_iic y Test Identifier Test Numc6Repoil Date
Center for Applied i19I -060 Miami Dada Protocol 04/08/94
I?nhiitecrii,g PA 101
Center for Applied 257818.1PA Miami Dade Protocol 12/16/96
Engineering PA 101
Caner for Applied 25-7438-3 SST[) 11 -93 10/25/95
Engineering
00141' ICH' Apl,lled 25- 743H -4 SSTD 11-93 10/25/95
Engineering
Center for Applied 25- 7438 -7 SST() 11 -93 11/02/95
Engineering
Center for Applied 2.5- '1492. SST!) 11.93 12/12/05
Engineering
Milos Laboratories N11 -- 589 -63I ASTM 1) 1623 02/01/94
Polymers lliviaion
It.anilech 1.nboratories, 0617 -92 ASTM F 108 01/30/93
Inc.
Sotilliwest Resr.arclt 01 ASTM E 108 1 1/16/91
Sonthwe.st Research 01- 6739- 0621(I 1 ASTM E 84 01/16/95
1nstituli:
"Trinity f ?nginrr.ring 7050.02.96 -1 PA 114 03/14/96
Page 5 of15
Frank ZuIoaRa, RRC
Roofing Product Control Examiner
POI ,VI"OAM PItODUC'1'S,1NC. Product Control No,: A301,(12.
l`t p irI t•ty Test
(litnsily ASTM D 1622
`1..VPICAI., PHHYSICA.f., PfkOP1711TIES
C;c►mpre: ;slur- AS`t'Ivt D 1621 18 PSI Parallel to rise
Strength 12 PSI Perpendicular to rise
"Tensile ;trenith ASTM 1) 1623 2$ I'SI Parallel to rise
`'Dater Absorption A`iTM C) 2127 0.08 Lbs. /1
Ivlillsture Vapor ASTM I; 96 3,1 Perm / inch
'I'iansirtisiiort
Dimensional ASTtvt 1) 2126 't0.07% Volume Change. @ .400 F., 2
',lability weeks
- 1-6,0% Volume Change: 0;158 I00%
Ilumidity, 2 weeks
Closed Cell
AS'FM [.) 2$56 $6%
1.6 Ibs, /11.
R
Note: 'l'Ite physical 1►rol►ertics listed tibovT are presented as typical average values as determined
by acealticd AS'I'IYl( lest methods and are subject to normal manufacturing variation,
Page 6 of IS
Frank 7..1110figa, RRC
Roofing Product Control t:xatitincr
1'01,YI )AIYI l FtOI)1JCTS, INC.. Product Control No,;, 98 - Q10ho2
SYSTEMS
fleck Type; Wood, Non-Insulated, New Construction /Reroof
Ileeh Desel it►tion: 1 /3," or greater, plywood or wood plank.
A; AcIhi'sive Set Application
Slop() I1angat 2 "12" In `,":12"
Underlay neat: Shall comply with Miarni•hade Rooting Application Standard PA 120
!tooling 'file: Any roof the assembly having a current shall be applied in compliance with the
Component Application section and the corresponding Placement [:retails of
this Notice of Aeceplanoe. The adhesive attachment shall provide sufficient
attachment resistance expressed as a mornent 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 waffle assembly NOA.
C,Illlln10111.9: 1, A11 'System Limitations' noted in the the Root' System Assembly Product
Control Approval shall apply,
1
t'atic 7 of 15
rdr►I: Zuloiiva, Rite
1t.00Iing Product Control Examiner
• 1 PRODUCTS, INC. Product Control No.: 95.0303 I,
li.crofint; 'file;
C
SYSTEMS
(CONTINUED)
I]ccic Type: Concrete, Haw Constr /Reroof
MCI( hesc•rilltlon: Hew construction
SYSTEM. It: Adhesive fiat Application
Slope it %ago; .. "' 1 ?" to 7":12"
IlmIcrluynteu1 / Install Approved nnderlrtyrnent system of one of the following:
Waterproofing:
1Indcrluyrncu1; (.10 /O0 Llol Mop) fully adhered In ti full mopping of A`iTM D 312 type IV
asphalt applied within the I'VT range. hack nailing and Zaps shall be in
coinpliance lvith Roofing Application Standard PA 120.
Any liquid applied roo ting system having a current NC)A for its rise as a tile
11 [ tit rlaymeent system.
Any waffle assembly having it current shall be applied in compliance with the
Component Application section and the corresponding Placement Details of
this Notice of Acceptance, The adhesive attachment shall provide sufficient
rtttac :in t resistance expressed as a nlnnlent to meet or exceed the required
moment of resistance determined in compliance with Miami -Dade County
Rooting Application Standards; PA 115 or PA I27. The adhesive attachment
data is noted in the roof tile assembly 140A,
I, All 'Syste n Limitations' noted in the tide Roof System Assembly Product
Control Approval or waterproofing component Roofing Component
Product Control Approval shall apply. as applicable,
Page 8or15
Frank Zuloaga, RRC;
Roofing Product Control examiner
lrOt,Y1'OANt t'ft.t)1)11C:`l'S, INC, Product Control No„ 98_Q1Q1,02
I. I'u401r140 AI 11 fill Ilk adhesive shall only be applied over an underlayment installed in compliance
with apptir.atir►n instructions; detailed in its NOA., lJnderlayment may be any underlayments or
uncle" laymen! sytite.nls listed Miami -Dade County Roofing Application Standard PA 120,
?..
Adhesive application shall be in accordance with the instructions provided herein. `fthe
manufacturer may provide additional instructions subsequent to this approval slate which may
prevail. Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by
Poly[oam Products, inc;.
Calibration ol'the, I oampro0 dispensing; equipment is required before application of any adhesive.
Tho Mix ratio between the "A" component and the "II" component shall be maintained between 1.0-
1.15 (A) ; 1.0 (f1). The dispense timer shall be set to deliver MS to 0.15 pounds per tile as
(Idernlined at calibration. Flo other settings shall be approved without revision of NOA.
Adhesive shall be dispensed in a 17 in' to 23 in' pad at time of application. The cured pad shall be
approximately 5" N. 11?. ", Foam placement shall he in accordance with the 'Placement Details'
heroin. Inch generic: tile profile requires a specific placement, as noted in Table 1, below
' . A►Ihern Ilk directly in freshly applied adhesive, Tile must be set within 2 to ;l minutes after foam
has been dispensed.
C't:)1'II'ONF N`t' APPLICATION
rabic. I; A.dhesivo I'lact•rctcttt her Each Generic "File Profile
Tile Placement
Profile Detail
l'\V- P1 ee ftai e1 fit
ShapLd 1/2
Double Roll 11.3
Flat
Page 9 of 15
frank Zuloatsa, FtRC
Rooting; Product Control Examiner
I OI YV()AM PRODUCTS, INC, Product Control No.: 98-019 102
SYSTEM LIMITATIONS
t'olypro0 AI11(11) adhesive shall he installed only hy'Qualified Applicators' approved and licensed
by I't)Iyfoam Prirduct9, Ina.
3. For adhesive set tile applications, a field static uplift test by ti Miami -Dade County accredited
testis(; avncy, in compliance with Miami-Dade County Roofing Application Standard PA 106,
shall he racluired not Tess than 72 hours after application to confirm tile adhesion.
1. Refer to application drawings published by the National Tile Manufacturers Association for
pentitiations and terminations, as well as the 'Placement Details' included with NOA.
S, Refer to the Roof Tile Assembly Product Control NOA for system acceptance with this Component.
(. It e. to the Prepared [tool' Tile Assembly for fire rating.
1. I'olyprct(l!) Al (160 shall not be exposed permanently to sunlight.
Poly' ro(lft A.11160 shall he applied with Foampro RTV 11)00 dispensing equipment only.
!1.
Poly foam Products inc. shill supply Building Official with a list of 'Qualified Applicators' approved
and licensed by Polyfo.uit Products, Inc.
Pa 1Il of 15
Frank Zuloagtt, RRC
Roofing Product Control Examiner
LO ;1'F nA lN1 1 I( :T,S,1NC.
Nell Ihruuyh tiwo +,
Iwhan 4..40
I &.' 1 ;•aid.
PLACEMENT DETAILS.
(CONTINUED)
•
Product Control No.://1-0101 02
Il5$ ly nwuyh •dh••Ir• la
achbr. 1i -:1) •giar• Inches
In C4181e01 with the Ilia,
Placement Detail 11 -I; Flat Profile
Pi1(T,e 141 of 13
— resale
iillik Zuloi�Ql�, fZRC -` __�,._
Itolatin3 Product Control Cxrlmincr
PO(,V'FOAM PM)I)TIC'cS, INC, Product Control No. :, 98
I'olyfunnr l rodticts, Inc.
1.$I)0 .91►ring- Stucl►nrsr 'Road
S11rin(;, '1'X. 77311.
)
This Acceptance contains pastes 1 through 1$.
END OrTIIIS ACCEPTANCE
Pogo 15 of I5
ACCEPTANCE NO: 98.O303,Oz
APPROVTh : April IC, 109.9
I??i.1'lltl 5 Ap_d_ Vii, 2001
A
NO C Ac_'CEPIANCLI;TANDARD C..ONL1"ITtONS
I+ newel of this Acceptance (approval) shall be considered after a renewal application has been filed and the
o igli l submitted documentation, including lest supporting data, en[ineering documents, arc no alder than
eight (f1) years.
2 r \ny and all approved products shall be permanently labeled with the manufacturer's name, city, slate, and the
following statement: "Mlatnl -Dade County Product Control Approved ", or as specifically stated in the
specific conditions (401I3 Acceptance,
1 It enewals of Acceptance will not be considered if:
to There has been a change itt the South Florida Building C:nde affecting the evaluation of rills proc and
tit: product is not in compliance with the code changes;
b) The product is no longer the, same product (Identical) as the one originally approved;
(:) lithe Acceptance holder has not complied with all the requirements of this acceptance, Including the
cot reel 1w:tidbit ion of die product;
d) 'fh.. Engineer wio oriOnaily prepared, signed ant' sealed the required documentation initially submitted,
IS no longer practicing the engineering profession.
:1 Any revision or cI1allt!C In the materials, use, and/or manufacture of the product or process Shall automatically
be cans;, tor termination of this Acceptance, unless prior written approval has been requested (through the
tiling of at revision application will appropriate fee) and granted by this office.
Any of me following 5haIl also he grounds for removal of this Acceptance:
ail l lnsaatisfactnry performance of this product or process;
h) Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any other
por pt15es.
'file TItttice of Acceptance number preceded by the word, Miami -Dade. County, Florida, and followed by the
,:xpiration date may be displayed itt advertising literature, It portion of the Notice of Acceptance is
,liy then it shall be clone in Its entirety.
'/ A copy of this Acceptance as ti 'ell as approved drawings and other documents, lvhere it applies, shall be
provlclecl to the user by tits manufacturer or its distributors and shall be available for Inspection at the job site
at all times. The copies need not be by the engineer.
d
Fannin to comply with any section of this Acceptance shall ba cause for termination and removal of
Acceptance.
Frank Zulonga, ItRC
Roofing Product Control I xa nincr
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal 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 J_IAtle 14 , 1962 ...
Owner's Name and Address.. A l bet° t Nelson No 70 street _...N.o__...E. 9.2 5 tr. e e t
Registered Architect and /or Engineer
Name and address of licensed contractor_.__ ._ V � __._ _a____ I_�1 _ L ,4' t . e . i R tt O g �.D. _ e � _ 1 !w___.Co.
Location and legal description of lot to be bui t on: 0 1
Lot Block Subdivision
Street and Number where work is to be done 70 N s E, 92
Street
State work to be done and purpose of building (by floors) Tear off old roof tin cap3_Q..2 mop 90f;
white cement shingle tile, (1 -story residence)
and for no other purpose.
New Building Remodeling Addition Repairs._. Re.- .rQO.f No. of Stories L
To be constructed of Kind of foundation Roof Covering Ti 1, e
Estimated Total cost of improvements $_._12.0.0.. Amount of Permit $ 8 o 00
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be per rmed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)._
STATE OF FLORIDA,
COUNTY OF DADE. ss
Before,me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 r the foregoing application, and that he did sign the same, and that all facts
therein by him stated are try.
2-77 Permit No
Disapproved
(Signed)
NNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Disapproved Date
Date
to me well known,
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
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.
Disapproved 6 3
(Signed)
MIAMI SHORES VILLAGE
ding" In P cto
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 Albert , N 1 S O n No' �? 0 Street N. E. 92nd S t.
Registered Architect and /or Engineer •........_ .... _ ... . -..
Name and address of licensed contractor 0 b e n o u r Roofing Co. 7357 N. IA J. Miami C t. Miami, F l a .
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 70 N. E. 92nd St.
State work to be done and purpose of building (by floors f e m o v e existing roof' and replace with
cement shingle tile roofing.
and for no other purpose.
New Building Remodeling Addition Repairs X No. of Stories
To be constructed of Kind of foundation Roof Covering 30 Sq S .
Estimated Total cost of improvements $ 4 5 0 0. 0 0 Amount of Permit $.. 6 0
Zone cubage required Plan Cubage
Distance to next nearest budding.. 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,.
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 -s6 1 p>ubliChotice
or notices as are required by the Act. The undersigned agrees to employ only s c subcon • ctors, on wo to be`perforrned/rider this
permit, as are licensed by Miami Shores Village.
Remarks (Sig ed) !�_'° . L/ „ . ( �.
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
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 state are true e
Permit No..__.___ 1 Date ° r _7 (=Read, Sworn to and Subscribed before me.
Date
Date.
mi3rch 22 76
to me well known,
Notary Public, State of Florida
My Commission Expires
PLANNINC BOARD DATE
Chairman Member
Nfcn ber 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 fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or fault
materials and/or workmanship.