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ROOFINGDat Type Insp'n Permit No. Name Address MIAMI SHORES VILLAGE BUILDING DEPARTMENT c r 305- 795 -2204 Building Inspection Request ✓ Approved Correction Re- Insp'n Fee Company Phone # Inspection Date Test Location Uplift Pull Test(P or F) Test Location Uplift Pull Test(P or F) Test Location Uplift Pull Test(P or F) Test Location Uplift Pull Test(P or F) 1 1 �� 26G 51 76 2 ; 27 52 77 3 28 53 78 4 29 54 79 5 30 55 80 6 31 56 81 7 32 57 82 8 33 58 83 9 34 59 84 10 35 60 85 11 36 61 86 12 37 62 87 13 38 63 88 14 39 64 89 15 40 65 90 16 41 66 91 17 42 67 92 18 43 68 93 19 44 69 94 20 45 70 95 21 46 71 96 22 47 72 97 23 48 73 98 24 49 74 99 25 I.. 50 75 100 .. • Owner's Name Job Address Roofing Contractor. Type of Tile: 6065 N.W. 167th Street, Suite B -23 • Miami Lakes, Florida 33015 Telephone: (305) 558 -2588 • Fax: (305) 362 -4669 ON -SITE CONCENTRATED UPLIFT LOAD TESTING OF ROOF TILE IN FULL ACCORDANCE WITH METRO -DADE BUILDING CODE COMPILANCE PROTOCOL TAS 106 Date Installed: Approximate Roof Height: feet Roof Pitch: 4 1 Z Type of Access to Roof: Scaffolds Other Approximate Square Footage of Roof: 7 sop ft2 \--- Required Testin Force: 35 lbs. , f - Testing Equipment: Chatillion 100 Date Tested -'2:3 — 0 `T IN ACCORDANCE V'JtTN T.H CRI'i ERIA OF PROTOCOL TAS 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY COIF (ROL TE THIS PEED.:MITTED BY: Civil Engineer: Lab Certification # 98- 0608.04 U.S. SOUTH Engineering & Testing Lab., Inc. P.E. State of FL Certificate Authorization # 4100 SITE SPECIFIC INFORMATION TEST RESULTS P = PASS, F = FAIL PRINTED BY: UNIQUE GRAPHICS: 954 - 484 -9923 FAX: 954-484 -9967 Project N e 5 •-• IM111•117.1b matimummum / I I •■■ to` 1 NUM 11110) Abb. IM111111111111111111111 111•1111111111111111111111121111 NNEMIIIMEIMIIMMININS11111111111111N 111111111111111111111110 MENEM JAREN NOTES* C),L.9 Anse .e.g 654 42: I 2. - 1 11, 6 10 /ft JOB 15 13 .r- " IF I - SHEET NO eF CONTRACTOR .Vett) # 1.4=te.. 7.0-0.ct CHECKED 3" DATE 'CAL= �.: Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2001 $ Value of Work For this Permit Total Fee Now Due $ U 3 (Continued on opposite side) Miami Shores Village 4io,too Permit No. 15rZG(a -l-- 2.t Master Permit No. Permit Type (circle): Building ((�� Electricall Plumbing Mechanical Owner's Name (Fee Simple Titleholder) O c Y1 W I \ ee I er Phone # ' 3 0 ,5 767 ` 1 b5 Owner's Address q 15 NE clay\ de..si--1 City \ \ t. W11 , Cj ) 0 rSS State PL Zip 3) 3 q Tenant/Lessee Name Phone # Job Address (where the work is being done) vl ` 1VE 9ahcl City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name kawck,kk 1 O orf k h6 Phone # 305 Contractor's Address 1 - ° - ‘1 3 ) O, ) C `7I D51 City ' or I A t & OA \ State � Zip 3 2 / 53 Qualifier PGt,(,x 1 -Ko\w c le i Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: a 30D Type of Work: DAddition ❑Alteration :New LJ Repair/Replace ❑ Demolition Desc ' e ork: `- re0l,r off e >4 i n5 '-1- % le ro oP e p I w! h c bA e i M o n; er q `I--I-!o -cor\cr& e co l,r� -I ro k± a_If i Ies +he 5a, ' e co/or —File rte _5 yg - erv,, OA - 1\ ‘75 ****************************Fees****************************** Submittal Fee $ " . Permit Fee $ ."-- CCF $ f`t� 6 Notary-SS. 0 0 ' Training/Education Fee $ . , , 0 Technology Fee $ '7 e Scanning $ 1 cA ~— Radon $ Bond $ Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will riot be approved and a reinspection fee will be charged. ✓ f.�i /) SlgnatUr� ? J / C /ij .4 Signature \ 9a/O Owner or Agent The foregoing instrument was acknowledged before me this / foregoing instrument was acknowledg- . before me thi day of t1,-.1- , 20 C. -1, by Dew ,,iel /). W k e i' / r i2 , day 1, 21)\-\, by I known to or who has who is personally known to me or who has produced who is personally produced NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * APPLICATION APPROVED BY: Chc 10/14/03 As identification and Jo did take an oath. (Certificate o omp cy Holder) ************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Contractor as- identification and who did take an oath. Print: i • 4 - 1 MY COMMISSION # DD 191809 My Con on Expires': July 8, 2007 Kira* WOW lluWiiItcoloMNrs* **************** * * * * * * * * * * * * * * ** ** * * ** * * * * * * * ** State Certificate or Registration No. Certificate of Competency No. *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** MAR - 4 200" Plans Examiner Engineer Zoning a NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION CFN 20048014.4637 OR Bk 22089 Ps 28187 (1a9) PERMIT NU. TAX FOLIO NO. RECORDED 03/03/2004 12:42:37 HARVEY RUVIN► CLERK OF COURT STATE OF FLORIDA: MIAMI -DADE COUNTY' FLORIDA LAST PAGE COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street/address: 6 19 5 " Si\oreS PL- 3313' 2. Description of improvement: IRe --rn 3. Owner(s) name and address: whed(e.r q rS r/ � g)_ha L S-'. irv` I ■GI,IM. f Sh oreL Q1.- -33138 Interest in property: c ft-Ner Name and address of fee simple titleholder: 4. Contractor's name and address: L331 63 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owners 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: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a �r1 date is : eci - d) Z , Notary Public Print Notary's Name My commission expires: '• u.w AAA) : Signature of Owner j / , '� / Print Owner's Name7O/✓/9 he) 1/ 6 1h( ". 2 47) Prepared by Sworn to and subscribed before me this : - of rn4 '- h , 20 0 Y. 123.01 -52 PAGE 4 8/02 JOHN MIUTANA EXPIRES: July 8, 2007 a CO\%‘ FLORIDA, COUNTY OF DAD -- ,VASE OF FLORIDA HEREBY CERTIFY that this is a tr gala' file •/ his office •n .14 fr.ci31 Scat. my ha r. a nd 0 nt Courts .f Circuit and Cou D.C. .�' W HA' A� he 1111111111111111111111111111111111111111111 riot i aw1 3 D 1 144 ia►ni Pecwi Address: Ka. 141 1 FL 33 1 ` 1 Florida Building Code Edition 2002 • High Velocity Hurricane Zone Uniform Permit Application Form. 1 Section A (General Information) Master Permit No. Proce s o. Contractor's Name eWIlit-la, CI\ Job Address ROOF CATEGORY ❑ Low Slope ❑ Mechanically Fastened Tile LJ Mortar /Adhe� we SQalls ❑ Asphaltic ❑ Metal Panel/Shingles ❑ Wood Shingles/Shakes Shingles ARE THERE ❑ Prescriptive BUR -RAS 150 GAS VENT STA YES ❑ NOr► ROOF TYPE TYPE - NATURAL ❑ LPGX O ❑ New Roof � Re-Roofing ❑ Recovering Repair ❑ Maintenance 9 p M ante ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF) X56) .20 Section B (Roof Plan) Sketch Roof Plan: illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. 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N.■■ 1 riM■ M■ M ■ Ia ■ ■I.MN...N■Ia. ■au. ■N■■als.N ■ ■■i■. ■ ■N■ ■MMI ■ ■I■ ■N■ ■a■IinaNNl ■ ■ls ■M■■ �i■�\■■ ■■■■I ■M ■uIu ■ ■■ ■ ■ ■ ■ ■ ■ ■IMM IEu■■ a■ ■II■ ■m■ ■I■UI ■■IMI.aE ■lsMm ■ ■ ■Nlsls■ %: ■ ■ ■ ■ ■IMI.:� ■III■ ■II■MININXI ■ ■■ ■■lM.Ni 1 I )MmE commmmmiumm MMm m mmmEEmE :n om :C ■ 1 i m mo m " _ im i m pri Cm C : u :M: ma .i �mmmmmo■■aMMI .1 UNIT■ M■■ MMON IN■■■ ■■ N■■■■■■N■■■■N■I■N■ar , •ri,li ■mNC■■■■ ■I■■■G■NMM■■■■m■ M ■a;•■�uIE■MmrI■Mmmom IEMEm � MM mMMMXEMONIMMEMMEMM M MMEMEEMMOSEMMMMmMIMEEEEMMMM ■ ` E' I .. mmMmimm: M MIBMIS W W: 1 ■ N■ NN■■ ■■■N■ ■aM ■ ■■■■■■■■N■■N■■■■I■■■■■ ■■■INN■■ ■■■MI■■■■■OM M■MnN ■ ■MM ■*MWMPI eLf-YM Notice. of Acceptance Number: o; _ 1 J l 1 D o 8 Minimum Design Wind Pressures, if Applicable (From RAS 127 or Calculations): l P1: (1 b P2: IOU P3: 001t Maximum Design Pressure From the NOA Specific System Method of tile attachment: Po 11l occ wt. cui- f t,,e i ue Steep Sloped Roof System Description 1 L Y b pe Underlayment: 1 n � 30 �N sulatlon: l A- ire Barrier: I Iv astener Type & Spacing: dhesiveType Cap Sheet: X 10 Sl e Type & Size Drip go: 1 - L Florida Building Code Edition 2002 High V _ ... Hurricane Zone Uniform Permit • • • Form. Section E Nile Calculations) For Moment based tile systems, choose either Method 1 or 2. Compared the val for M,with the values from M lithe Mtvalues are f, then the tile attachment than Is or equal a the Mr values, for each area of the roo tdtchment method Is acceptable. nt Base/1111e Cale Mg:— „ U Me, — Mg: Mg: Per RAS 127" NOA 1171 t NOA 117E NOA hik Method 2 "Simplified Tile Calculation Per Table Below" Required Moment of Resistance (M From Table Below NOA be used in conjunction with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based ale systems use Method 3. Compared the values for F' with the values for F.. If the F' values are greater than or equal to the F, values, for each area of the roo4 then the We attachment method is acceptable. Method 3 "Uplift Based Tile Calculations (P,: z1• w: ) —W z' cos B: (Ps: zI: a z w :s� —W z (Ps: zl• cos 8: z w :�� —W: zcos9: Per RAS 127" Fn: F,y NOA F , NOA NOA F Dodge hum* Mean Roof Roof Aodytando Resenting Mamma due to Citadgr Attachment Redeems lieim=Armlet Redolence ReaYana Realm. A fie Ile I w • 1; Calculated applicadcd • Description Where to Obtain Information • Symbol Where to find P1 aeP2orP3 RAS 127 Table I orbyan a dee:mg' analysis pemeted by PEbased 7 H 9 A t' length NOA Ire aid& AU a adnims mart be submitted b the Bidding Otbeiai lathe time al Job site Job Sa NOA NOA NOA Cakohted NOA • SECTION 1524 HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of this section.. The provisions of Chapter 15 of the Florida Building Code, Building 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. „ ltd/ 1. Aesthetics - Workmanship: The workmanship provisions of Chapter 15 (High • Velocity Hurricane Zone) 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. 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 16 (High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing roof system). ' its/ 3. Common Roofs: Common roofs are those which have no visible delineation between neighboring units (i.e. townhouses, condominiums, etc.). In buildings with coin roofs, the roofing contractor and/or owner should notify the occupants of adjacent units of roofing work to be performed. 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 Florida Building Code provides the option of maintaining this appearance. f 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 the Florida Building Code, Plumbing. 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. C: IDOCIM E- Ikmp1LOCALS- I\ Temp \SECTION 1S21.doe Date Contractor's Signature 11116 .2/2u2u3 11:20 9544914489 f • • MIA BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODI CT CONTROL DlVIS ON NOTICE OF ACCEPTANCE (NOA) Ylonic.- Lifctilc, LLC I35 NW 20 Street Boca 1: 2ton, FL 334:31 .:. . ABC 4130 - TILE PAGE ft] I AMI - DADECCLNTY FLORIDA METRO -DIJJF FLAGLFI: BUILDING 140 WEST FLACLER STREET. SUITE 1603 `ttAM1. FLCRID/ 33130 1563 (305) 375 -2901 (3•)5) 375 -29CS SCOPE : This NOA is being issued under the applicable rules and regulations governing thc use of;ons:ruet c-t rt ter.als. The do' :umcntation submitted has been reviewed by Miami -Dade County Product Cont,o: Tvisicr. and icceptcd by the ;3oard of Rules and Appeals (BORA) to be used in Miami Dadc County and other ar=s wr.c al;nwed by the Authority Having Jurisdiction (AHJ). This N )A shall not be valid after the expiration date stated below. The Miami Dade Cour.ry Prod.:(: Cc-a-al Divisio 1 (In Miami Dade County) and/or the AHJ (in areas other than Miami Dadc County) -es:rve 'ic fi to have th s product or material tested for quality assurance purposes. If this product or water::: fails to pct form in the acc pted manner, :he mrInufacturer will incur the expense of such testing and the AHJ :. y tmr edia'ely revoke, modify, or su.pend he use of such product or material within their jurisdiction. BORA reserves the right to revo a this acceptance, if it is determined by Miami -Dadc County Product Control :ha: • his , rodi:c• , matcria fails to meet '.he requirements of thc applicable building code. This pr''duct is approved as described herein, and has been designed to comply with the t i:_` V'c!nc ! t-rr i.aric Zone of thc Florida Building Codc. DESCUPTION: Atlantis Shake & Slate Concrete Roof Tile LABE ,1NC: Each unit shall bear a permanent label with thc manufacturer's name or :occ..it followii.g statement: "Miami -Dadc County Product Control Approved ", unless otherwise RENEWAL of this NOA shall bc considered after a renewal application has been filed and :` ere h :.s be :n no change n the applicable bui'dtng code negatively affecting the performance of this procu:•_ TER.VI INAT1ON of :his NOA will occur after the expiration date or if thcte has been a ste ;; : f;c :,, materia s, use, and/or inanufacture of the product or process. Misuse of this NOA as ar. c x- product for sales, advertising or any other purposes shall automatically terminate this NO:\. Fa: :u -e :o c with an:: section of thi s NOA shall bc cause for termination and removal of NOA. ADVEIZTISEMENT: The NOA number preceded by thc words Miami -Dad_ Cour.ty. ar : fo :lowed by the expiration date may be displayed in advertising literature. If any portion o` thc NOA : - sY;a•�cd 'n Y :t sha:i be done in its entirety. INSPE'IT1ON: A cony of this entire NOA shall be provided to thc user by the ntanufac:•...e • C: 1::; and sha. I be available ,:or inspection at the job site at the request of the Building Official. • This NC•A consists of ;ages 1 through 6. The sub nittcd documentation was reviewed by Frank 7.uloaga. RRC NOA tio.: 0'.- 12 :'.08 Expiration Da'e 12/:6107 Approval Dare 01/( 9/03 Page: of6 111V 28/2003 11:20 ROOFING ASSEMBLY APPROVAL C:.tcgory: Su b- Category: M itcrial: 2. PRODUCT DESCRIPTION :Vanufactured Applicant vto licr Lifetile Atli ntis Shake and Slat: Tilc Trirt Pieces Test Aunty Red'.:•nd Tcchnolog cs Thc ( enter for Applicd Env ccring, Inc. Thc ( cnter for Applied Engtrccring, Inc. The ( cntcr for Applicd Engir :cring, Inc. The (enter for Applicd Engir.:cring, Inc. 9544914489 Roofing Flat Frofile Roofing Tiles Concrete 1. SCOPE This renews a system using Monier Lifetile Atlantis Shake & Slatc Rix T: c. as manufactured Monier Lifetile LLC and described to Section 2 of this Noticc a Accen :_-cc. For locations whcrc the pressure requirements, as determined by applicable BL: d.:rg Coe: do, s not exceed the design pressure valucs obtained by calculations in compliance wi':, R.AS 12 s;: g th valucs listed in section 4 herein. Thc attachment calculations shall be dohs :s a rr.cr:-nt )ascd system. Dimensions 1= 15" w = 10 3 4," 1''y •thick 1= varies w = varies varying thickness 2.1 SUBMITTED EVIDENCE: Test Product Specifications Description PA 112 Flat, interlocking. high pressure concrete shake and slate roof ti :c ec_:po with two nail holes. For :!:-rct dec:: -^o tae or adhesive set applications. PA 112 Accessory trim, concrctc roof piece for ;se at hips, rakes, ridges art c v. lry tcr- cn ,. Manufactured, for cash, t: :c :,rofilc Test Identifier 7161.03 Append :x 111 94 -060A 94 -084 25 - 7094 -2 25- 7094 -S 25- 7094 -5 • ABC 14130 - TILE Te t \amciRcp_ort D.:c Static 1Jpii. Tesnr. PA 102 & PA 102(A• Static Uplift Tcst:n; PA 101 (Mortar Sets (Adhes:vc Set) Static Uplift Tcst:n_ PA :02 (4" Hcadlap, Ncw Construction. Static Uplift Testing PA 102 (4" Ilcadlap, pia ;ls, B�t c Static l.'pl Tt PA :02 (4" Hcadlap, Na'is, Dir_c: Jock, RecovertRcroof; 139:: Vay • NOA No.: 0 .1-11' 1.011 Expiration Da :r 12 a�7 Approval Dace 01119i'C3 Dice: af 6 2/28/2003 11:20 Walk :r Engineering, Inc Walk.:r Engineering, Inc. Walk :r Engineering, Inc. 9544914489 ABC $U 30 -TILE =AGE 0:: Test Aoen___y Test Identifier Test N-ame/Re port D ire The Center for Applied 25- 7183 -6 Static Uplift Testing F;5 :995 Enb veering, Inc. PA 102 (2 Quik -Drive Screws, Di rect The Center for A plied Deck) p` 25-7183-5 Static Uplift Testin:+ = 1995 Eng Inc. PA 102 (2 Quik -Drive Screws, Ba : :�.$) The Center for Applied 25- 7214 -1 Static Uplift Testing V. Eng ncering, Inc. - - 995 PA :02 (1 Quik -Drive Screw, D.- z: Deck) The Center for Applied 25- 7214 -5 Static Uplift Testir.2 M:.:- 1995 Engi r coring, Inc. PA 102 (1 Quik -Drive Screw, Bar.e -s) Redl ind Technologies 7161 -03 Wind Tunnel Testing ' Appendix 11 PA 108 (Nail -On) Red1 Ind Technologies Letter Dated Aug 1, 1994 Wind Tunnel Testing ;, -g •,c;< PA 108 (Nail -On) Rcdi.tnd Technologies P0631 -01 Wind Tunnel Testing P. 994 PA 108 (Mortar Sc:) Red, ind Technologies PO402 Withdrawal Resistance c:: ;g S__._ ,(..; of screw vs. smooth shay. ills The .tenter for Applied Project No 307025 Wind Driven Rain Oct. 94 Engi•teering, Inc. Test #MDC -77 PA 100 Professional Scrvicc 224 - 47099 Physical P :o crtic5 S 9 Indu: tries, Inc. PA 1 , 2 Cclo cx Corporatioi Testing 520109 -1 Static C :p.;ft Test:-, t :. :9 "s Scrv: cc 520111-�1 1'A : 0 t !v1 : 9')9 520191 -1 Walk cr Engineering, Inc. Calculations Acrodynam,c ;Au!:: -- 5 Walker Engineering, Inc. Calculations vlomcn: u; Gcavit ■ S. :. ':99 Wall, cr Engineering;, Inc. Calculations 25 -7094 P ±_ : r,, 6 Walks Engtneenng;, Inc. Calculations 25-7496 A; '- 95 Walk :r Engineering:, Inc. Calculations 23 -'534 r . -_ 25-780415-8 - 25-7804-4 & 5 25- 7S4S -6 Calculations 2 -' 18. M:.7.:' !)‘../, Calculations Aerodynamic M ,l:crs A:7: : `•?si Calculations Two Patty Adhesive Sc: $v>er:i .k7-1 • c:ry NOA No.: C2 -12 :_+1S Exptratioo Date:. 15/07 Approval Date: 31 ''9/03 Pte. .d6 12/28/2003 11:20 3. LIMITATIONS 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test shall be :::. -- X :- accordance with RAS 106. 3.3 Appl:.cant shall retain thc services of a Miami -Dade County Certified Labora;o-. -:"- quarti:rly test in accordance with TAS 112, appendix 'A'. Such testing shall be sub to the Building Code Compliance Office for review. 3.4 Minimum underlaymcnt shall be in compliance with thc applicable Roofir.F Standards listed section 4.1 herein. 3.5 30/90 hot mopped undcrlayment applications may be installed perpendicular :c s._ unles :; stated otherwise by the underlaymcnt material manufacturers published 3.6 This acceptance is for wood deck applications. Minimum deck requirement: s-.:.: x •- comp 'iancr_ with applicable building code. 3.7 May Ix installed on slopes 7:12 and greater with a rrinimurn of two screws. 4. INSTALLATION 4.1 Monier Lifetile Atlantis Shake and Slate Concrctc Roof Tile and its compere- -t installed in strict compliance with Roofing Application Standard RAS 118. F.r5 RAS .20. 4.2 Data For At:achment Calculations f Tile Profile Tile Profile Mon er Lifetile Atlantis Shal e & Slate Tile • 4544914489 Direct Deck 6.0 ABC 44130 -T Il_E Table 1: Average Weight (W) and Dimensions (I x w ) Weight -W (Ibf) I Length-1(ft) Monier Lifetile Atlantis Shake & 8 ti 1 1. 25 I} SI: ate Tile Table 2: Aerodynamic Multipliers - a. (ft Tile X (ft Profile Direct Deck Applicatior Monier Lifetile Atlantis Shake & Slate Tile 0.24 Table 3: Restoring Moments due to Gravity - M9 (ft-Ibf) 3 ":12" 4 ":12" 5 " :12" 1 6 ":12" Direct Deck ' Direct Deck 5 9 _. L -- 5.8 Width -M 't. Direct Deck r NOA No.. 0 :- : : ;128 Expiration Date: :11411 i Approval Date: C: 'r ;' .3 Pair ci 6 11112/28/2003 11:20 9544914489 ABC 14 130 -TIL.E PA S Table 4: Att ent R esistan ce Expre ssed as a Moment - for Nail -On Systems Tile Fastener Type Profile M. mier Lifetile At antis Shake & SI. ite Tile 2-10d Rin Shank N s ii s -10d Smooth or Screw Shank Nail 2-10d Smooth or Screw Shank Nails 1 #8 Screw 2 #8 Screw 1 - 10d Smooth or Screw Shank Nail (Field Ctip) 1 - 10d Smooth or Screw Shank Nail (Eave Clip) 2 -10d Smooth or Screw Shank Nails (Field Clip) �2 -10d Smooth or Screw _Shank Nails (Eave Clip) Direct Deck Direct Deck (min 15/32" (min_ 19/32" plywood) Plywood) 30.9 38.1 7.3 9.8 14.0 30.8 51.7 24.3 19.0 35 5 31.9 18.8 30.8 51 7 24.3 Batt ins " 172 7.• l - 18.2 24.. 24. 193 - L 3c c. I._ 31 2 -10d RIn Shank Nails' j 50.3 65.E Li Installation with a 4" tie headlap and fasterners are located a min. of 2%, from heaa of tibe. ' - 8 22.1 34 3 32. Table 5: Attachment Resistance Expressed as a Moment M. ;ft -lbf) for Two Patty Adhesive Set Systems __1 Tile Profile Tile Application Minimum Attachrr er.t I Resistance Mc tier Lifetile Atlantis Shake & Slate Tile v .... - Adhesive 2 See manufactures component appmval for installation requirements. 31.3'' 3 Flexible Products Ccnpany Tile8ond Average weight per patty 13 9 grams Polyfoam Product, Inc.. Average we■ht per patty 8 grams. Table 5A: Attachment Resistance Expressed as a Moment - M. (ft -Ibf) for Single Patt y Adhesive Set Systems Tile Profile Tile Application L_ Mo leer Lifetile Atlantis Shake & Slate Tile PolyPro DA " PolyPro 4 Large paddy pl:3cemeit of 45 grams of PoIyF -o'er 5 Medium paddy placement of 24 grams of PolvPro TM Table 58: Attachment Resistance Expressed as a Moment - for Mortar or Adhesive Set Systems Tile Tile Profile Mc mer Lifetile Atlantis Shake & Slate Tile Application Mortar Set Minimum Attachr ^,ent . Resistance 118.9 1 Attachment Resistance 39.0 'Oa► .as Expiration Datc: 12/ 611)7 Approval Date: 01P19/113 Page :: or 6 N L r zo/ Znn,1 11: 211 9544914489 • S. LABELING All tiles shall bear the imprint or identifiable marking of the manufacturer's =me in lo or following statement: "Miami - Dade County Product Control Approved ". 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by the Building Official or applicable bt i;d:rg code in order to properly evaluate the installation of _his system PROFILE DRAWINGS M ABC $4130 -TILE VMONIER LIFE - 11t_E :ATLANTIS SII,IKE & SLATE CONCRETF. ROOF TILE. END OF THIS ACCEPTANCE. i 7' r NOA No.: 0:- 1211.08 Expiration Date: 1211 ii07 Approva! Date: 01/0 )/03 Page 6 of 6 PAGE OE. p L=" MIAM ,\ PP1t OVF D: 06/(4'2()01 • •4c • :c '^N ' 1 ,= iSJOO,•c100011t„*p :3,cslnouc• 3tc.porec• co.e, Nt�.dor +tcrnet moil raiders: poltmaster@bv11d1neeuJeonline .cam • Ifelncpagc: Attp ; / / hMw _ bwflJrng Raul Rodriguez ill i. s r COVF1: Chief Product Control Division j T1 '- - -- SIt f:I?T 4F DI 0 NAt, P C S FOR SPECS Y 7 l 11 Ii 11 nt CD f v -Qat 'VS Ott :I2A ��'iC !' I2 CT 12 F / -l'!'5 n for [c 'rd::ct A :',•dc and ratio Product r Pr d p,prov'1 Its been reviewed by the l3CC0 and approved Co:nm,ttcz to be used i ; vtianti F' :; : : : : :a5cvc. -Dade Count by the Building Y. orida under the conditions sit 1 'rancisco 1. Quintana. R.A. Director tili i -Dnde County, nuiiding Code Compliance OTrc:u etdoonllne.co )l, -dd .S Ca ;,c ' • .._I" _---�_ MIA MI - DADE C0UNTY. FLORID �-- METRO-DADE Ft.AGLER DUILDIN U UILDINC COb P R A CT ML'Yll r COMPLIANCE A0LE LDIN N N__ A.CA t4 '1y �Gl[R SrRpn :CU 1 0 fu :rm Products, Inc. l (3 0 3) y r MIAMI, r 1 t *ij )313.1 ? ' iy Spring o ucbncr Rout/ t/ t!)1 )7 s' ) �I FAX UtIS))7s.2 Spring .TX 77383- �t> 1132 ►nll -1c o ( urcr. , eterk: x r . n)or • (1031)75._3,7 FAX 001i37j_2J3, comtAt.rott 1- y1-01th:M (30) 373.29m 1'AX (3D3� your application for Notice ol'ncccp(�711Cc 7'•vu COm�roncnt f olyurcfArnc Fn ;l I OA) of: l'ROOu( . 0 Orn•KOI_ulvegiohl m Adflcyi 13u3)) %!- :ao z r A�Oosl3r_�3)• i ,ln: n:Itr cr Ch�pltr 8 of the Code of-Miami-Dade County governing the usc of Alternate C aPie and fompletely described herein ('o,:r:ly O i an co etel li,�nce OtOffice D • has been r ecommended for acceptance b is Types of ( CCO under tr the conditions specified herein. tl. Miami-Dude This N"OA 51:.11 no: be va1;d - Ui:uCS or rrta:encl °t an °her the expiration dace stated y tim from a � below. $CCO reserve the right sect rU :1�,ct or material tails to me f perform ;n tho tc or manufacturer's cs t,J ti net. of s:rC;l approved manner, BC CO y quality n this p roduct cr n co al immediately. CO ma Y control testing. Jf this - determined m Sue by BCCO (hat y DCCO reserves the ri ht to yoke, modify, or suspend the 'r±in a this product or material fail to meet the requirements evolv thi approval, Co..c. if it is ► of the Soutlt Florida 1 c`r2cnsc of such (i.:stin b will he incurred by ;he Mnnuraclurcr. .ICCt:PTANCE NO.: 014521.n2 F 05 /I 0 , , i os.1 57$ 1042 PnlYfttt► m_P uctsd IZoOFINC ASSEMBLY APPROVAL CnIt.�n RooIi,i tiuh Cut ern ryl floor Tile Adhesive hinteri# Iv: Polyureth SCOPr This itpproves I'olyprur AII160 as ttlanutacturctl by Puryrnant Products rlrscribCJ in Section 2 of - this Notice of For the locations t� ' Inc. as pressure requirements, as determined h a he;c the design requirements, o thc design pressure value, obtained by calculations a in complin ce not exer ati Standard RAS 127, for use with approved flat, low, and high r ofin Po(yprot7L All 160. Where thc attach,nent calculations arc done :u � Application bo pro roof tiles system scd system using for sin&;e p ;try placement. and as an uplift bussed system for double arty moment ems s patty systems 2. PRODUCT DESCRIPTION M:Inuf,tctu by Ap ,lic:tnt Earat Mani Polypraci) A H l 60 N/A I'aanlproD RTf'1000 N/A P'ot'acksp 20 ;CO N/A I'rnr cril Density Slrcngth Tu 1s;:c Scrc,t01 N',lcr AI:Snr,7tiC„ V1oistt.rc Vapor Tr ;ns•tiissin ,1 t7init n)7C•ra' St�htlttr 2.I Components or products manufactured by others: Ally M,i :mi - Dade County Product Control Accepted Roof rile Asse::1Ol l, :, s current NOA w list uplift rtsi vi!u`s with tltc use of Potypro At 1160 roof" the adl:rsir:. 2.2 T) pic:11 Physic:1i Properties: Cc !feet c ASTM 0 1622 1.6 lbs /rt.' � ASTNI n 1621 13 PSI Para(lel to rise ASTLt 0 IG?2 12 PSI Pcrpcnclicutarto :se _ 8 PS1 Parn.lcl lo rise ASTN1 D 2127 0.08 Losj1:12 ns'r%t E 96 ) Perm / Inch A S TAI 0 2'26 L7::bt:es(9 'ON X5d POLITOAN PRODUCTS, INC. Test S tcciltutttnns PA rot i.LdCm NI A 2E ACCEPTANCE No.: 01-lltit_D2 Approval Date .lu 4 'aa Expiration Date: Mar ID 7 9iy = 1.Q7y, volume C �,l Vic: weeks ,, J s.a:w Volt911: Chat' g 11::i1,ittity, 2 wt:elr Product Two component Potyurcthane Dispensing ESuipment I Equipment Frank ?.uloage, KltC Product Control E sni;ner • • •!. M _Cr -IlLa i • . - -•. • nw y s a s) a 10,12 Pot rfoam P roducts „ ACCEPTANCE No. : 91- 052I.o4, Note: Tbc physical propc,•tics listed above me Prescrrted a • necepted ASTM Icst nictlhods nutd are subjcc( to „ s typical average turi values N determined by ornlnl rnnnufacturiao yariation. J. LIMITATIONS 3.1 Fire classification is net part of this acCeptance. Refer to the Prepared Roof Tile Assembly for fire rating. 3.2 !'Olypro8 A1 shall sold be 3.3 Minimmtrn underlaynlcn :s shall be compliance with t he Roofing Application Standard RAS 120. B pplication 3.4 Roof Tile mar;ul:ictilres acquiring acceptance for the use of Po!y -ro® AI'! 160 roof 3.5 tile adhesive with their the assemblies shall test in accordance with PA 101. Roof Tile mattt,factures.acquiring acceptance for two paddy placement wit the use of PolyproC AI roof tile adhesive with their tile assembes accordance with PA 1 cr7 and with section 10.4 as modi(ie4 herein. shall tut in - F - 4. INSTALLATION 4.1 Polyp; o® AH i 60 r.ay be used with any roof tile assembly havin lists uplift resistcnce values with the ►:se of Polypro® AH 160, e a current NOA that 4.2 Polypro® A1-4160 shall be applied in compliance with the Compenent sections and (!'c cor-espondirlg Placement Details noted Herein. The ro fppecation assembly's adhesive attachment with the use of Polypro® Al-1160 shall provide s::(l;c :en: a :!azhmert; resistance, expressed as an uplift based systerl, to nice: cr exceed the uplift resistance determined in cotttpitar.cc with Miami -Dade County Rocfing App:ica :ton Standards RAS 127. The adhesive attachment data is noted in Cie roof tile assembly 'BOA 4.3 'elyproe Al ( 160 -cot file adhesive and its components shat! be :rivalled in accordance with RCofing Application Standard RAS 120, and ?o ;yfzat:t Prcducts. Inc. Polyprce AH :60 Opera :ins instruction and Maintenance Bookl 4.4 (nstal:ation must be by a Factory Trained 'Qualified Applicator approved and licensed by Pc :yfoam Proci cts. Inc. Polyloarn Prcducts Inc shall sup*!y a !ist o;'approved applicators to the a: having jurisdiction. �.5 a Ca :i :rl :ion cf :!•e i dispensing equipnvcnt is require: b ; . .; �dl :cs :vc. T;• g . e applic :lion of Y :c mix ratio .:etwecn the *A” component and :!`e '3' component slta :l be n'iintained between ! 0• ..I5 (A) : 1 0 (13). The dispense ::rner shit) be set to deliver 0.0' 75 :o 0 15 pct..tds per tile as determined at calif;. :i No outer settings sl :a:: 5e aoprcvcd. 4.6 Polypro® '11.1 i CO shall 5c applied with Foa:npro R'1'F 1 000 or ProPack® 30 & 100 dispensing cqui. iron: orgy 4.7 PolyprodD' 11160 sha :I trot Lc exposed pet nt;,ncntly t0 Suns 3 POLITOAY PRODUCTS,IVC. MS ..:.eCt .A- . T - , ':_ Frrna Zutmsa, RRC Pf°C+jc: Control Examiner 1,4 - ('2M ^n rn vuv ® 004 7r; .` ,Polyfoam Product. INC. ACCEPTANCE No.: 0 1 - 052107 a•. Tiles must be adhered in freshly 4.9 Y PPl d ,le must be set within 2 to 3 yp o ®AH 1G0 has bcc • minutes after pot r 1e adhesive. 7 Pol ro® n dispensed. YP AH 1 60 p.accmcnt and minimum patty weight shall be it accordance with the 'Placement Details' herein. Each generic the profile rcquire3 tli notcd herein. Table 1: Adhesive Placement For !nth Ctneric Tile Prorl rte 1 ce - - Flat. Low. Hi.h Profilc High Profile (2 Pircc 13arr.1) Flat, Low. High Profiles 5. LAI3ELINC A11 Polypr oe Ali 160 containers shnil comply with the Standard Conditions listed herein. 6. BUILDING PERMIT REQUIREMENTS 6.1 As required by :he Building Official or applicable Building; Code in order to property evaluate the installation of this system. 99t/SEE :9c 'CN Aid 4 Pr:u,k Zuloogo, RAC Product Control E .miner X7 A ddi S OE& 9 L : ? hi'! Ep -50 -aw Qocs 4'01v 2112N Prodii s !:;t_ r,nt.,rea g∎t+tdwr ttWn 1.O..t Y t..ra SIP Pa - Ns 11:'," twos 444k •••■ NO tt#t an I0 Is 11w ltew omit t r‘ t imua Ilr IA. A CCEPTANCE 11 c.: 01- 0521.02 ADHESIVE PLACEMENT DETAIL 1 SINCLE PATTY c ruLlrviut rRODUCTS,INC. 9. C:99 'ON Xdd _ w ... :'ICI. �i' ,s Fran Zui[ k C Procluc::'_:1 Etaminc:r Zoos rOjyroiiril Products, ON XV.d _ _ • r ii 0 DUCTS , INC. A CCEPTANCE : 01-0n1.02 A DHESIVE PLACEMENT DETAIL 2 SINGLE PATTY 6 FraJlIc Z..roafp, RRC Product Etat:11=r . TcdfsS ;;;: : qo a 007 • 5 , paddy o' top oI lt le Palrto �n1 Product Tnc. Nap IAroupP phi 311c romeant 2 + * bys L.Unr a tg0501 002 k 17 41,4*W 1 t<ra pedal) sue FLick COME Mil Slnpl. peel en top 01 14 tan Jl " Vail through plaftk c.cnftnl Single p40y on undenayrricn� Snip ?odd, ' . an top of Iu• f :. iM1.pa. under 13e O f 5,r,ii paid, In. under U+a a] $bol p•ddl on undo,- bean. of '0 XS..1 V ACCEPTANCE No, : 011 102 AUIIESIVE PLACEM UODULEPATTY DETAIL Pad11 (bor.'s,' 111. Peat (under Obi 7 )17 A CQI ^.�. Mai tlroupe y'iflh caftan' '1Mad Slnra N ddl under 1>I1 atft.nt Slaj a paddy Eatr.a� O ob i aLa Pt.11 uw (curso only s 4In. 7 .n. 41411 arid► on Iapnenl `\ ad4w w 3.4. war b•Neen :Ile Eaw Zoos, 7 h a 114. Nay F oat ►dR u.r caws. awl, Fronk Zuloasz. R.RC 1'rods,c! Control Examiner '-'- �.ia:'"`�:r:_t -. ,r - ..._ . �. :�•: ;tat ; :� :. YON 13:10 FAI 654 376 104? "- -- PGLYFOAI( PRODUCTS, INC. polY fen ne Pradurfs I shall be considered alter a r Itcrtc��a; or this Acceptance (approvat) and the l of t i cccplar s s„ ue_"%- otde: tha ei •ht bnLlled dOCUllle nl $, ntChtdiiig Iej 71i )Orlin �tr071 h s been fG.d S �y) years. t PI S data. ;-ne:, -' ink decu..ICIItS. Zit: no 2 ed r' Ar and all approved prcn,'uets shall be A n y :Imo the follow p permanently labeled with the ng statement Mianii -Dade County I'roduc.. =�fae rs anent, :Is specifically stated in the specific conditions of this Acceptance. - '�.tral Approval or � 3. 1ter.thval5 of Acceptance ►.• :)1 not be considered if. a. There has been a ctrl :Ibe in .01t: $pulls Florida Building Cod product and the prcd is not in compliance with the code chl,la• -• -_ I: Ti e Viaduct is no :caber the same product -`'° the evaluation of .I : :� c l' the Acceptance hale'er has not complied with I, a ll the D ' rees - -:� cs or this '� =' approved. Ir : :uding the correct installation ofthe product. d. Th enginee who Criaura :J rS ateepta.:,e Y pfepared signed and scaled the rec_. cb. su5mirrcd, is no lcnber practicing the en nucrin ' 4 g 8 profession. n:ly revision or change i :t the materials, use, and/or manufacture e' ;�tcrt : :: ;calf b: cause io: termination of this : t•' r'= c m : : ().`tro the : '; Acceptance. unless pr:: nr'oduet or proces s till g of a revision application with rc : �' approval Ass bl .5 �ff,ce. PP V" := . - and —� g:rntcd b)• �ha 5 Anv of the following shall a :so be grounds f a i :S: I l.aCIO r Of RntO�•aI Of this ACCep!z,z, r)• per•o. mace of this product cr process. c :!tar purposes. Misuse of this AC :cpinacc as an endorsement of any produ:: i= :c; . advertising or � : f ' Th Net ice of Accepla, by J1e ace number rece preceded the words Miaini-Daa: C-:::. .•, Florida, and foiio c: rx, r :non Cat: r. :a be Cr sp ' Acceptance :s Ci advertising literature. - -c - ion of the f sP .a)'t d, L'l. :: w entirely all be Con ;il its entirdv Nolrc: 7. A copy or lha Ac :c p :a : :�� I Zs we:l as approved drawtn5s and other dc_:: -_� whcrc it applies, s 5. ^,:g•;:Cw Io the by . tl : he manufacturer or its distributers poi s. .t all (line cng.nccr need rc: r s al I and she. :::bl fur inspection c. c the copres. Failure :o comply Iv :n)• section. of this Acceptance SIinII be cause Acceptance y. T Nc! :c: of A :ccp!ar_, cor.sists cfpgcs 1 through 8. END OF T1t1S ACCEPTANCE Xd_ 7il O1" N, :iT- - ACCEPTANCE No.:. 01 : :_ osiz. RRC Cantro1 Ewmincr -F "L'1aticn and rumen::: cr Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2004 -291 Printed: 3/9/2004 Applicant: DONALD WHEELER Owner: WHEELER DONALD JOB ADDRESS: 975 NE 92 ST Contractor KAWALEK, PAUL RICHARD Local Phone: 786 277 - 9540 Parcel # 1132060060030 Signed: (INSPECTOR) Building Permit Contractor's Address: P.O. BOX 531051 Permit Status: APPROVED Permit Expiration: 8/30/2004 Construction Value: $10,400.00 Work: RE -ROOF MONIER ALL FLAT CONCRETE COLOR THRU Page 1 of 1 Legal Description: GOLDEN GATE PARK AMD PB 7 -54 LOT 2 LOT SIZE 50.000 X 140 OR 12420 -769 Fees: Description Amount FEE2004 -2465 Building Fee $300.00 FEE2004 -2466 CCF $6.60 FEE2004 -2467 Notary Fee $5.00 FEE2004 -2468 Training and Education Fee $2.20 FEE2004 -2469 Technology Fee $7.50 FEE2004 -2470 Scanning Fee $12.00 Total Fees: $333.30 Total Fees: $333.39 Total Receipts: $0.00 O _, , -)\ 3,S 0 (413 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: t Application is hereby mode for the approval of the detailed statement or toe plans and specifications herewith submitted for the build inc or other structure herein described. This application Is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address Disapproved (Signed) MIAMI SHORES VILLAGE 7‘ 9- AZ 13 BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT L _._....._.__ 1!1L. eft. _ No...._. . StreetlY F .... r1.�!'!0..,5�'1� Registered Architect and /or Engineer Name and address of licensed contractor ._.C..CU Location and legal description of lot to be built on: �� Lot Block Subdivision.. .a 1 � '1: G (/ .f..06 of '#) 6 Street and Number where work is to be done C1 7 1 in _... _....._....: : __ _ M -- /_._....__ State work to done and purpose of building floors) � _ L1 .E_ 1,,,,y \.. S �__.......1.1.. 1..- .?..o.. ..FE.L . /- do Fe aJ Building Inspector .and for no other purpose. New Building Remodeling Addition Repairs No. of Stories _ To be constructed of Kind of '. foundation Total cost of improvements $ .20.U.. Q.(1 ) Amount of Permit $... Zone cubage required plan Cubage Distance .to next nearest building Size of Building Lot \faaiunum 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 sith the provisions thereof, and will require similar compliance from all contra ors or sub-contractors tployed by him in tkc work to be performed under this permit; and will post or cause to be posted for ins ion ` s' of the wor ch public ice or notices as are required by the Act. The undersigned agrees to employ only such subs t jd k to . Pe( ed unr this permit, as are licensed by Miami Shores Village. Remarks (Signed Roof Covering ILe... • ............._ -- STATE OF FLORIDA, COUNTY OF DADE. ss ' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts thcrcin by him stated ( e true. Permit No.. __^'N r Date... Y Read, Sworn to and Subscribed before me. ^ C Date Notary Public, State of Florida My Commission Expires _...._..._. _. _ PLANNING BOARD DATE Chairman Member Mcrnbcr 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 hecn obtained from the Plarmir.g Board. A re inspection fce of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anti /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. o R Date , 19.1_ %S s J L:. 9' 5z Owner's Name and Address Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot_______ G� Block New Building Street and Number where work is to be done State work to be done and purpose of building (by floors) Subdivision A Date Remodeling Addition Repairs No. of Stories--- - , oof Covering To be constructed of Kind of foundation Estimated Total cost of improvements $ ' cCgo Amount of Permit $ Zone cubage required .Plan Cubage Distance to next nearest building ___________Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to x The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subc ntractors; n work t9 be. performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) and fo o otrier purpose. STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. �� Permit No Date 7/� ?0/ Read, Sworn to and Subscribed before me. Disapproved (Signed) ___t Building Inspector U My Commission Expires Notary Public, State of Florida PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re-inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ DATE "' ' '/ l9 ELECTRICAL ❑ PLUMBING NG •, ' PERMIT No - 5112 Contractor's F . ". �:, ❑ License No. t / ROOFING /2-'' ❑ t Work to be performed under this Permi Owner of Building - -- . Architect Contractor or Builder Legal Lot 11 Description Bl Address of , t Value of I Amount of ,) Building .°` 1/ * " r / Project $ I Permit $ " ? This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit h granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed- INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER Subdi- vision BY AUTHORITY ABBOT I*"