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795 NE 95 St (8)Company Inspection Date Approved Correction Re- Insp'n Fee MIAMI SHORRS VrLLAGE G Q BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date rod Type Insp'n 1 �,r ` Permit No.6P () �" (� 3. Name DUloacP Address 7q 3 I c ✓ s± l --- Phone # 0 PAJ A-1 BUILDING PERMIT APPLICATI FBC 2001 Permit Type (circle): Building Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Villaee Miami Shores Village Building D epartment SE_t Electrical Plumbing Mechanical Owner's Name (Fee Simple Titleholder) Owner's Address 1 9 S City M t € - vw 9n 0 r State Zip '33 36 Phone # Phone # 915 NE Permit No. BPbo3 • 1'f13 Master Permit No. County Miami -Dade Zip Is Building Historically Designated YES NO I t .� Contractor's Company e & trJ& l R tC f h t Phone # 3() 5 Contractor's Address t l� t ® , J t o mN 1 3 f W11 .State Zip /3 3 J Architect/Engineer's Name (if applicable) Architect/Engineer's Address City $ Value of Work For this Permit 1. too Number of: Bays Type of Work: Describe ork: C 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Qualifier �t w Lid Wit C i` Phone # State Zip Stories Families County Escrow Fee $ CO Permit Fee $ t ( I C ) oU Education/Training Fee $ Tech $ `ode Enforcement $ Bond $ Square Footage Of Work: 6 So Bedroom Addition Alteratkon • ._ .. _ I MEMMIg i arlantragiraffl alla * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Scanning $ Struct. $ Baths R : air/Replace ❑ Demo rtn ' e • l of & &nQ.nek Notary $ erR ON 9 d3S Radom ■us Plans Check Fee $ Total Fee Now Due $ (Continued on opposite side) � 30.00 Cheep' 3!0(00 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 not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of . 20 , by who is personally known to me or who has produced State Certificate or Registration NO. As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Signature (Certificate of Competency Holder) Certificate of Competency No. ************** 4 ****************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: chc7/7ro3 NOTARY PUB Sign: Print: i My Commission Expires: AituP Vetitat. Contractor The foregoing instrument was acknowledged before me this day of � � � - ,20 C ,bY t(!LA 1(1I11 k (_, who is personally known to me or who has produced as identification and who did take an oath. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 9 ' \»\ e 3 Plans Examiner Engineer Zoning b3 — I'f ? Florida Building Code Edition 2002 High Velocity Hurricane Zone Uniform Permit Application Form. Master Permit No. Q& � ` 4 K Process Contractor's Name 1 A q 95 W ff £75+h Job Address Ii Low Slope ❑ Asphaltic Shingles LJ New Roof LSO.% Section A (General Information) d ROOF CATEGORY ❑ Mechanically Fastened Tile ❑ Metal PaneUShingles ❑ Prescriptive BUR -RAS 150 ROOF TYPE 0 . Mortar /Adhesive Set Tile ❑ Wood Shingles /Shakes ARE THERE GAS VENT STA YES ❑ NO TYPE-NATURAL ❑ LPGX 0 Re gflng ❑ Recovering ❑ Repair ❑ Maintenance 1 ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF) a J V b5P Section B (Roof Plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. 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IMMM •• MCCE •• M M i • M eM non G:.., ::m �3E ialor F 4M:' EM•E?M MIME E■M■EE.EMrommmECC mmm ■ • : UU IAMEPI Nk.•■ I■■ ■•U I MMMM • MM•MMMECI MMMM ••MMMM mwi:w2 i =Miw!MMMI N I � CME•ME•MCM: �MMCMEEG: •EEEM I GC• M• MCG CMECMMMC C•MMGEMEC:MMM:Muvw:M::::M :EGEI::•ECM•MEEM: ..■.■■■■■■■■■■■•■■■ ■■■mE■mmmE■EE11mm■■Emm11Em■ : = = --- ■ ■■ ■1111■■■ ■m■ System Manufacturer. 1k/ • , Type: A 0 J GaugeTrhickness: 5/4 Slope: D Base Insulation Size and Thickness: Base Insulation Fastener /Bonding Material: Top Insulation Layer: Top Insulation Size and Thickness: Top Insulation Fastener /Bonding Material: Base Sheet(s) & No. of PIy(s): Base Sheet Fastener /Bonding Material: ri gn Velocity Hurricane Zone Uniform Permit Application Form. Section C (Low Sloped Roof System) Fastener Spacing for Anchor /Base Sheet Attachment I Field:, ' oc @. Lap, # Rows @ _ - oc Perimeter: b • oc @ Lap, # Rows @ 6•0c Corner. _` • oc (g Lap, # Rowt q @ Hoc Number of Fasteners Per Insulation Board Field Perimeter Corner Illustrate Components Noted and Details asApplicable: Woodblocking, Gutter, Edge Termination, Stripping, Flashing, Continuous Cleat, Cant Strip, Base Flashing, Counter- Flashing, Copjg, Etc. • Indicate: Mean Roof Height, Parapet Height, Height of Base Flashing, Component Material, Material, Thickness, Fastener Type, Fastener Spacing or Submit Manufacturers Details that Comply with RAS 111 and Chapter 16. Fill In Specific Roof Assembly Components • and Identify Manufacturer (If a component Is not used, Identify as "NA') NOA No.: Off -- o g'I. JD Design Wind Pressures, From RAS 128 or Calculations: Pmax1 : ' Pm2' : Prr.2r. ?1 Max. Design ge s, re�From the Specific NOA Stem: " Anchor /Base Sheet & No. of Ply(s): 1 Ply bl s6i f /k r / a h et,Fas / di M rl: 9 tae, t �-I IS �Jbjg�� - ia ` r 7 Laps Insulation Base Layer: v p :y( ). p l y L' b er JJ) J {. PIy heet F aste /Bondiing Material: ph�L> Top Ply: Gt Medt- ed. Q t Ii,tren ToPty fastener/ Bonding Material: Surfacing: GNP Mo,d- ��d R . - en &t M, r er uP X3 ty 1∎, /chip nlh i y-(4 b erg biz -seshe V • •=‘ • e FT. Parapet Heiaht 1 0 Mean f :�rf Height a MIAM BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) GAF Material Corporation 1361 Alps Road Wayne, NJ 07470 MIAMI -DARE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by the BCCO and accepted by the Building Code and Product Review Committee to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted mamier, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: GAF Ruberoid® Modified Bitumen Roof System for Wood Decks. LABELING: Each unit shall bear a permanent label with the manufacturer's name, or logo, city, state and following statement " Miami -Dade County Product Control Approved ", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be dsplayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA consist of pages 1 through 33. NOA No: 024408.10 Expiration Datic 11106103 APIr'h'd DM= 08123102' ri 1 at38 The submitted documentation was reviewed by Frank Zuloaga, RRC. r ROOFING SYSTEM APPROVAL Category: Sub - Category: Deck Type: Maximum Design Pressure Fire Classification: TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT: TABLE 1 Product GAF Asphalt Concrete Primer (Matrix" 307 Primer) GAF Mineral Shield® Granules GAF WeatherCoat® Emulsion (Matrix" Fibered 305 Emulsion) GAF Premium Fibered Aluminum Roof Coating (Matrix" System Pro Ahrminum Roof Coating Fibered 301) GAF Jetblack All Weather Plastic Cement (Matrix"' Standard Wet/Dry Roof Cement 204) GAFGLAS #75® GAFGLAS #80 UltimaTM Base Sheet GAFGLAS Flex Ply" 6 GAFGLAS Ply 4® GAFGLAS®Mjneral Surfaced Cap Sheet Roofing SBS/APP, Modified Bitumen Wood -75 psf See General Limitation #1 Dimensions 5, 55 gallons 601b. Bags 100 lb. bags 5 gallons 1, 5 gallons 39.37" (1 meter) Wide 39.37" (1 meter) Wide 39.37" (1 meter) Wide 39.37 (1 meter) Wide 39.37" (1 meter) Wide Test Speciftcadon ASTMD41 ASTM D 1863 ASTM 1227 1, 5 gallons ASTM D 2824 Fibered aluminum coaling. f ASTM D 3019 ASTM D 3409 ASTM D 4.601 • ASTM D4601 ASTM D 2178 ASTM D 2178 ASTM D 3909 Product Description Asphalt concrete primer used to promote adhesion of asphalt in built -up roofing Granules for surfacing of exposed asphalt, cold process cement or emulsion. GAF Mineral Shield® Granules shall be used for flashing applications only. Surface coating for smooth surfaced roofs. Refined asphalt blended with a mineral stabilizer and fibers. !Permits adhesion to wet and dry surfaces. Asphalt impregnated and coated glass mat base sheet. Asphalt impregnated and coated, fiberglass base sheet Type VI asphalt impregnated glass felt with asphalt coating. Type IV asphalt impregnated glass felt with asphalt coating. Asphalt coated, glass fiber mat cap sheet surfaced with mineral granules. NOA Noe 02-140$.10 Esgcatba Dalt: 11/W113 Animal Dots: 11543/ 412 Ihm 3 431; Product GAFGLAS® STRATAVENT® Eliminator Perforated GAFGLAS® Flashing GAFGLAS® STRATAVENT® Eliminator Perforated Naiable RUBEROID® SBS Heat - Weldr"M Smooth RUBEROID® SBS Heat- Weld"( Granule RUBEROID® SBS Heat WeIdTM 170 FR RUBEROID® SBS Heat- WeIdTM PLUS RUBEROID® SBS Heat- Weld PLUS FR RUBEROID Modified Base Sheet RUBEROID■ Modified Bitumen Adhesive RUBEROID® SBS Heat - We1drM 25 Ruberoid® Mop Granule RUBEROID MOP Smooth RUBEROID MOP PLUS Test Dimensions Specification 39.37" (1 meter) ASTM D3672 Wide ASTM D 4897 various 39.37" (1 meter) Wide 1 meter (39.37") wide 1 meter (39.37 ") wide 1 meter (39.37") wide 1 meter (39.37 ") wide 1 meter (39.37") wide 39.37" (1 meter) Wide 5 gallons 1 meter (39.37") wide 39.37" (1 meter) Wide 1 sq. roll 871bs. 39.37" (1 meter) Wide ASTM D3672 • ASTM D 4897 ASTM D -6164 ASTM D -6164 ASTM D -6164 ASTM D -6164 AS'M D -6164 ASTM D4601, TypeII,UL Type G2 BUR ASTM U 3019 Type III ASTM D -6164 ASTM D 6222 ASTM D 5147 ASTM D 6298 ASTM D 5147 ASTMD6164 ASTM D 5147 Product Description Fiberglass base sheet coated on both sides with asphalt Surfaced on the bottom side with mineral granules embedded in asphaltic coating with factory perforations Asphalt coated glass fiber mat flashing sheet available in three sizes. Fiberglass base sheet coated on both sides with asphalt. Surfaced on the bottom side with mineral granules embedded in asphaltic coating. Non -Woven Polyester mat coated with polymer- modified asphalt and smooth surfaced. Non -Woven Polyester mat coated with polymer modified asphalt and surfaced with mineral granules. Non -Woven Polyester mat coated with fire retardant polymer modified asphalt and surfaced with mineral granules. Non -Woven Polyester mat coated with polymer modified asphalt and surfaced with mineral granule Non -Woven Polyester mat coated with fire retardant polymer modified asphalt and surfaced with mineral granules. Premium glass fiber reinforced SBS - modified base sheet Fiber reinforced, rubberized Adhesive Non -Woven Polyester mat coated with polymer- modified asphalt and smooth surfaced. Non -woven polyester mat coated with polymer modified asphalt and surfaced with mineral granules. Non -woven polyester mat coated with polymer- modified asphalt and smooth surfaced. Non - woven polyester coat coated with polymer modified asphalt and surfaced with mineral granules. NOA Nac 02440$,10 Explrities Dam wow; Approval Date OS/23/02 Pee 4.$33 Product RUBEROID MOP 170FR RUBEROID MOP FR RUBEROID TORCH Smooth RUBEROID TORCH Granule RUBEROID TORCH PLUS RUBEROID TORCH FR RUBEROID 170FR TORCH Ruberoid® 20 Ruberoid® 30 Ruberoid® 30 FR RUBEROID® ULTRACLAD® SBS RUBEROID® Dual FR Vent Stacks (metal and plastic) GAF Alumia nn Emulsion Dimensions 39.37" (1 meter) Wide 39.37" (1 meter) Wide 39.37" (1 meter) Wide 39.37" (1 meter) Wide 3937" (1 meter) Wide 39.37" (1 meter) Wide 39.37" (1 meter) Wide 39.37" (1 meter) Wide 39.37" (1 meter) Wide 39.37" (1 meter) Wide 39.37" (1 meter) Wide 3937" (1 meter) Wide 5 gallons Test Specification ASTM D6164 ASTM D 5147 ASTM D 6164 ASTM D 5147 ASTM D 6222 ASTM D 5147 ASTM D 6222 ASTM D 5147 ASTM D 6222 ASTM D 5147 ASTM D 6222 ASTM D 5147 ASTM D 6222 ASTM D 5147 ASTM D 6163 ASTM D 5147 ASIM D 6163 D 5147 ASI%1 D 6298 ASTM D 5147 ASTM D 6163 ASTM 1j 5147 ASTM D6164 ASTM D 5147 PA 100(A) ASTM D 1929 ASTM D 635 None Product Description Non -Woven polyester mat coated with fire retardant polymer modified asphalt and surfaced with mineral granules. Non -Woven polyester mat coated with fire retardant polymer modified asphalt and surfaced with mineral granules. Heavy duty, polyester reinforced, asphalt modified bitumen membrane, smooth surface. Heavy duty, polyester reinforced, asphalt modified bitumen membrane, granule surface. Heavy duty, polyester reinforced, asphalt modified bitumen membrane, granule surface Heavy duty, polyester reinforced, coated with fire retardant asphalt modified bitumen membrane, granule surface. Heavy duty, polyester reinforced, coated with fire retardant asphalt modified bitumen membrane, granule surface. SBS modified asphalt base sheet reinforce with a glass fiber mat. Non woven fiberglass mat coated with polymer modified asphak and surfaced with mineral granules. Non woven fiberglass mat coated with fire retardant, polymer modified asphalt and surfaced with mineral granules. Woven fiberglass mat coated with Polymer modified asphalt surfaced with aluminum, copper or stainless steel foil. Non -woven polyester and fiberglass mat coated with file retardant, polymer - modified asphalt and surfaced with mineral granules. One -way valve vent used to relieve built - up pressure within the roof system. GAF Vent Stacks are available in metal or plastic. Mineral colloidal 'bituminous emulsion with reflective ahmrinim flakes ■OA Na 0241408.10 Expiration Date; 11/06103 Approval Dat6 0'23/02 Pale 5 .138 Product GAF Alumimmm Roof Paint (Matrix"' System Pro Aluminum Roof Coating Fibered 302) GAF Built -Up Roofing Asphalt RUBEROID MOD Asphalt, Asphalt L & Asphalt P Shingle- MateTM Underlayment Tile -Mate Modified Base Sheet Tile -Mate Modified Cap Tile-Mate Modified Cap Plus TopCoat Surface Seal SB (Matrix 602 SB Coating) GAF WeatherCote® MB+(Matrix 715 MB Coating) TopCoat MB+(Matrix 715 MB Coating) WeatherCoteTM (Matrix 531 WeatherCote® Elastomeric Flashing Grade) Matrix Low VOC Matrix 101 System Pro SBS Adhesive (Ruberoid ®MB) Matrix 201 System Pro SBS Flashing (Ruberoid ®MB) Matrix 102 Select SBS Adhesive (Rubemid®MB) Matrix 202 Select SBS Flashing Matrix 203 Standard Plastic Cement Matrix 213 Gtm Grade Plastic Cement Matrix 103 Cold Adhesive Dimensions 5 gallons 1001b. cartons, bulk 60 lb. kegs 4 sq. roll 301bs. 1.5 sq. roll 1 sq. roll 103 lbs. 1 sq. roll 102 lbs. 5 gallons 5 gallons 5 gallons 5 gallons 5 gallons 5 gallons 5 gallons 5 gallons 5 galloon 5 gallons 5 gallons 5 ga lons Test Specifiation ASTM D2824, Type I ASTM D312, Types I, II, III and IV ASTM D 5147 ASTM D 5147 ASTM D 5147 r 1 ASTM D3019 ASTM D3019 ASTM D3019 ASTM D4586 ASTM D4586 ASTM D4586 ASTM D3019 Product Description Non- fiber+ed.. Aluminum pigmented, asphalt roof coating Interply moping and surfacing asphalt SEBS modified asphalt i Fiberglass reinforced ' underlayment SBS modified asphalt base sheet and interply sheet reinforce with a glass fiber mat tile underlayment. Non -woven polyesters mat coated with polymer modified asphalt and surfaced with mineral granules tile underlayment. Non -woven polyester mat coated with polymer modified asphalt and surfaced with mineral granules 'tile underlayment. Surface coating for smooth surfaced and mineral surfaced roofs. Surface coating for smooth surfaced and mineral surfaced roofs. Surface coating for smooth surfaced and mineral surfaced roofs. Surface coating for smooth surfaced and mineral surfaced roofs. I Surface coating for smooth surfaced and mineral surfaced roofs. Cold Applied Modified SEBS Asphalt Adhesive Cold Applied Modified SEBS Asphalt Adhesive — Flashing Grade. Cold Applied Modified SEBS Asphalt Adhesive. Cold Applied Modified SEBS Asphalt Adhesive — Flashing Grade. Standard Plastic Asphalt Roofing Cement Standard Plastic Asphalt Roofing Cement Caulk Grade. Cold Applied Asphalt Adhesive. NOA Na $244.$,10 Expiratlot Dale: 11/0NR3 Approval Do* Paptd31 Product Matrix 303 Select Fibered Aluminum Mstmc 304 Select Non - Fibered RUBEROID® Modified Bitumen Adhesive Dimensions 5 gallons 5 plIons 5 gallons Test Product Soe on Descripdon ASTM D 2824 Fibered ahmvnmm coating. ASIM D2824, Non- fibeted. Aluminum pigmented, Type I asphalt roof coating. ASTM D 3019 Fiber reinforced, rubberized Adhesive Type III APPROVED INSULATIONS: Product Name GAFTEMP Isotherm R, RA, RN & Composite, EnergyGuard RA GAFTEMP® Composite A & N (BMCA)GAFTEMP® Fiberboard GAFTEMP® Permalite GAFTEMP GAFCANT ' GAFTEMP Permalite Recover Board GAFTEMP GAFEDGE Tapered Edge Strip (BMCA) GAFTEMP® High Density Fiberboard BMCA EnergyGuard, RA BMCA Composite EnergyGuard, RA PYROX White Line ACFoam I II & Composite ISO 95+ ISO 95+ Composite EPS Wood Fiber High Density Wood Fiberboard Pelite/Urethane Composite Perite Insulation Dens Deck TABuE 2 Product Description Polyisocyanurate foam insulation Polyisocyanurate foam insulation with high density fiberboard or Permalite pedite insulation Fiberboard insulation. Perlite insulation board. Cut perlite board Perlite recover board Tapered perlite board High density wood fiberboard insulation. Polyisocynurate foam insulation Polyisocynurate/wood fiberboard composite t; Polyisocyanurate t foam insulation Polyisocyanurate foam insulation Polyisocyanurate foam insulation Polyisocyanurate foam insulation Polyisocyaniaate/perlite ridged insulation Extruded polystyrene insulation Wood fiber insulation board Wood fiber insulation board Pedite / urethane composite board insulation Perlite ikon board Water resistant gypsum board Manufacturer (With Current NOA) GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF !Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. BMCA BMCA Apache Products Co. Apache Products Co. Atlas Energy Products Firestone Building Products, Inc. Firestone Building Products, Inc. ' Generic Generic Generic Generic genetic G-P Gypsum Corp. NOA Na 024408.10' EEptnatin Daft 11101/03 Approval Dater 023/62 Pie $anti APPROVED INSULATIONS: Product Name E'NRG'Y -2 & E'NRG'Y -2 PLUS, UltraGard Gold Fi Roof Insulation ISORoc Structodek Multi-Max & FA Paroc Base Board Paroc Cap Board APPROVED FASTENERS: Fastener Product Number Name 1. GAFTITE® (Drill - Tec®) #12 Standard & #14 Heavy Duty Roofing Fastener 2. GAFFITE® (Drill -Ter®) ASAP 3. GAF ITE® (Dr71 -Tec®) Base Sheet Fastener and Plate 4. Gaivalume Plates (Drill - Tec® Metal) 5. Polypropylene Plates (Drill- Tec® Plastic) 6. Dekfast Fasteners #12, #14 & #15 7. Dekfast Hex Plate & Dekfast Lock Plate 9. #12 Roofgrip Fasteners 10. Metal Plate T 2 Product Description Polyisocyanurate foam insulation Glass fiber/Mineral fiber insulation Polyisocyanurate foam / rockwool composite insulation Wood fiber insulation board Polyisocyanurate roof insulation Rockwool insulation TALE 3 Product Description Dimensions Insulation fastener for steel, wood & concrete decks. Pre - assembled GAFTITE Fasteners and metal and plastic ply Base sheet fastening assembly. Round galvalume stress plates. Round polypropylene stress plates. Insulation fastener for wood, steel and concrete decks Galvalume hex stress plate. Polypropylene locking plate. Insulation fastener for wood and steel. Galvahnne stress plate. 3" and 3 '/2" 3 " and 3'A" 27/8"x 3'A 3 "x3'A" 3" round 3" square Manufacturer (With Current NOA) Johns Manville Johns Manville Johns Manville Masonite. RMax, Inc. Partek, Inc. 1 Manufacturer (With Current NOA) GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. Construction Fasteners Inc Construction Fasteners Inc. Construction Fasteners Inc. TTW Burldex Corp. TIW Buildex Corp. NOA Ni 024408.10 Etpiratts Data 116103 Appnreal Date 05/23f112• Page! d38 Membrane Type: Deck Type 1: Deck Description: System Type E (1): All General and Syst Base sheet: Fastening Options: Ply Sheet: SBS/SBS Cold Applied Wood, Non - insulated New Construction or Reroof 19 / or greater plywood or wood plank decks Base sheet mechanically fastened to roof deck. em Limitations shall apply. GAFGLAS #80 Ultima"' Base Sheet, STRATAVENT® Eliminator Perforated Nailable, RUBEROID Modified Base Sheet, RUBEROID® 20, RUBEROID SBS Heat Weld"" Smooth or RUBEROID SBS Heat-Weld 25 base sheet mechanically fastened to deck as described below; GAFGLAS® Ply 4 ®, GAFGLAS Flex P1yT"' 6, GAFGLAS #75 Base She or any of above Base sheets attached to deck with approved annular ring shank nails and tin caps at a fastener spacing of 9" o.c. at the lap staggered and in two rows 12" o.c. in the field (M.mmunt Design Pressure -45 psf, See General Limitation #7) GAFGLAS® Ply 4 ®, GAFGLAS Flex Ply"' 6, GAFGLAS #75 Base She or any of above Base sheets attached to deck with Drill-Tec (GAFITTE) #12 or #14 Screws and 3" Plates, 12" o.c. in 3 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 12" o.c. in the field of the sheet. (Maximum Design Pressure -45 psf, See General Limitation #7) GAFGLAS Flex Ply"( 6, GAFGLAS #75 Base Sheet or any of above Base sheets attached to deck with approved annular ring shank nails and tin caps at a fastener spacing of 9" o.c. at the 4" lap staggered and in two rows 9" o.c J in the field. (Maximum Design Pressur- 52.5 psf, See General Limitation #7) GAFGLAS #75 Base She or any of above Base sheets attached to deck with Drill -Tec (GAFITTE) #12 or #14 Screws and 3" Plates, f2" o.c. in 4 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 9" o.c. in the field of the sheet. (Maximum Design Pressure -60 psf, See General Limitation #7) Any of above Base sheets attached to deck approved annular ring shank nails and 3" inverted Drill-Tec (GAFI'rrE) insulation plates at a fastener ;spacing of 9" o.c. at the 4" lap staggered in two rows 9" in the field (Maximum Design Pressure -60 psf, See General Limitation #7) GAFGLAS #75 Base She or any of above Base sheets attached to deck with Drill - Tec (GAFTITE) #12 or #14 Screws and 3" Plates, 8" o.c. in 4 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 9" o.c. in the field of the sheet. (Maximum Design Pressure -75 psf, See General Limitation #7) (Optional) One or more plies GAFGLAS PLY 4®, GAFGLAS Flex Ply 6, GAFGLAS #80, RUBEROID MOP Smooth or RUBEROID 20 sheet adhered in a lull mopping of approved asphalt applied within the EVT range and at a rate of 20- 40 lbs./sq. NOA No: 024405.10 Expirit on Date 11/66/03 Approval Data: 11512 Pay 32 438 1 Membrane: One or more plies of RUBEROID MOP Smooth, Ruberoid® Mop 170 FR, Ruberoid® Mop Granule, Rube oid® Mop Phis Gracile, Ruberoid® 20, Ruberoid® 30 or Ruberoid® 30 FR or Rubecoid® Mop FR a RUBEROID UltraC1ad"i SBS in adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 Ibsfsq. Or, One or more plies of RUBEROID MOP Smooth, RUBEROID® Mop Granule, RUBEROID® Mop 170 FR, RUBEROID® Mop Plus Granule, Ruberoid® 20, RUBEROID® 30, RUBEROID® 30 FR or RUBEROID® Mop FR or RUBEROID UltraCladn SBS in RUBEROID-Modified Bitumen Adhesive at an application rate of 1 -2 galJsq. Surfacing: (Optional, regained if RUBEROID MOP Smooth or RUBEROID 20 is top membrane) Install one of the following: 1. Gravel or slag applied at 400 lbJsq. and 300 lbJsq. respectively in a flood coat of approved asphalt at 60 lbJsq. 2. GAFGLAS Mineral Surfaced Cap Sheet in an approved asphalt at an application rate of 25 lb./sq. + 15 %. 3. GAF Weathercote® MB+(Matrix 715 MB Coating), Applied at 1 to 1.5 galJsq. 4. Top Coat® Surface Seal SB(Matrix 602 SB Coating), Applied at 1 to 1.5 galJsq. Maximum Design Pressure: See Fastening above r NOA No: 10440.10' EzspietitSa 1- v.. Shp. e. `_ APPreval WOOD DECK SYSTEM LIMITATIONS: 1 A slip she is required with Ply 4 and Flex Ply t '' 6 when used as a mechanically fastened base or anchor sheet. 2. Minimum '4" Dens Deck or 'A Type X gypsum board is acceptable to be installed directly over the wood deck GENERAL LIMITATIONS: 1. Fire classification is not part of this acceptance, refer to a current Approved Roofing Materials Directory for fire ratings of this product. 2. Insulation may be installed in multiple layers. The first layer shall be attached in compliance with Product Control Approval guidelines. All other layers shall be adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs.sq., or mechanically attached using the fastening pattern of the top layer 3. All standard panel sizes are acceptable for mechanical attachment When applied in approved asphalt, panel size shall be 4' x 4' maximum. 4. An overlay and/or recovery board insulation panel is required on all applications over closed cell foam insulations when the base sheet is fully mopped. If no recovery board is used the base sheet shall be applied using spot mopping with approved asphalt, 12" diameter circles, 24" o.c.; or strip mopped 8" ribbons in three rows, one at each sidelap and one down the center of the sheet allowing a continuous area of - ventilation. Encircling of the strips is not acceptable. A 6" break shall be placed every 12' in each ribbon to allow cross ventilation. Asphalt application of either system shall be at a minimum rate of 12 lbsJsq. Note: Spot attached systems shall be limited to a maximum design pressure of -45 psf. 5. Fastener spacing for insulation attachment is based on a Minimum Characteristic Force (F) value of 275 Ibf., as tested in compliance with Testing Application Standard TAS 105. If the fastener value, as field- tested, are below 275 lbf insulation attachment shall not be acceptable. 6. Fastener spacing for mechanical attachment of inchor/base sheet or membrane attachment is based on a minimum fastener resistance value in conjunction with the maximum design value listed within a specific system. Should the fastener resistance be less than that required, as detemuned by the Building Official, a revised fastener spacing prepared, signed and sealed by a Florida Registered Engineer, Architect, or Registered Roof Consultant may be submitted. Said revised fastener spacing shall utilize the withdrawal resistance value taken from Testing Application Standards TAS 105 and calculations in compliance with Roofing Application Standard RAS 117. 7. Perimeter and corner areas shall comply with the enhanced uplift pressure requirements of these areas. Fastener densities shall be increased for both insulation and base sheet as calculated in compliance with Roofing Application Standard RAS 117. (When this limitation is specifically referred within this NOA, General Limitation 119 will not be applicable.) 8. All attachment and sizing of perimeter nailers, metal profile, and/or flashing termination designs shall conform with Roofing Application Standard RAS 111 and applicable wind load requirements. 9. The maximum designed pressure limitation listed shall be applicable to all roof pressure zones (i.e. field, perimeters, and corners). Neither rational analysis, nor extrapolation shall be permitted for enhanced fastening at enhanced pressure zones (Le. perimeters, extended corners and corners). (When this limitation is specifically referred within this NOA, General Limitation 117 will not be applicable.) END OF THIS ACCEPTANCE NOA Noc 024405.10 - E=Nrattos Daft 11/06103 Approval Data: is/23J02 Par 3i1 438 172 ROOF COVERING MATERIALS (TEVT) Roofing Systems (TGFU)— Continued Insulation: One or more layers perlite, glass fiber, 3/4 in. min, isocya- nurate, urethane, perlite / isocyanurate composite, perlite/ urethane com- posite, phenolic, 1 -1/2 in. min. Base Sheet (Optional): One or more Layers of Type Gl, G2 or G3. Membrane: One or more layers of "Ruberoid Torch" (smooth or granule), "Ruberoid Torch Plus" (granule), "Ruberoid Mop" (smooth or granule) or "Ruberoid Mop Plus" (granule). Surfacing "AL MB Aluminum Roof Coating" at 1 -2 gal /sq. 9. Deck: C -15/32 ancline: 1/2 Insulation (Optional): One or more layers perlite, glass fibe4 3/4 in. min, isocyanurate, urethane, perlite / isocyanurate composite, perlite/ urethane composite, phenolic, 1 -1/2 in. min. Base Sheet One or more layers of Type G2 "GAFGLAS #75 Base Sheet", hot mopped or mechanically fastened in place. Ply Sheet One or more layers of Type G1 " GAFGLAS Ply 4 ", hot mopped in place. Membrane: "Ruberoid Mop FR" (granule). Surfacing (Optional): GAF Fibered Aluminum Coating at 1 -1/2 gal /sq or GAF Weather Coat Emulsion at 3 gal /sq. 10. Deck: C -15/32 Incline: 1/2 Insulation (Optional): One or more layers perlite, glass fiber, 3/4 in. min, isocyanurate, urethane, perlite /isocyanurate composite, perlite/ urethane composite, phenolic, 1 -1/2 in. min. Base Sheet One or more layers of Type G2 "GAFGLAS #75 Base Sheet", hot mopped or mechanically fastened in place. Ply Sheet: One or more layers of Type G1 " GAFGLAS Ply 4 ", or " GAFGLAS Ply 6" hot mopped in place. Membrane: "Ruberoid Torch 170FR" (granule). Surfacing (Optional): GAF Fibered Aluminum Coating at 1 -1/2 gal /sq or GAF Weather Coat Emulsion at 3 gal /sq. - 11. Deck: C -15/32 Incline: 1/2 Insulation: Isocyanurate, 2 in. min., wood fiber, perlite or glass fiber, any thickness, hot mopped or mechanically fastened in place. Joints offset 6 in. Base Sheet One or more layers of Type G2 "GAFGLAS #75 Base Sheet", hot mopped or mechanically fastened in place. Ply Sheet (Optional): One or more layers of Type Gl " GAFGLAS Ply 4" or "Ply 6" hot mopped in place. Membrane: "Ruberoid Torch 170FR" (granule). Surfacing (Optional): GAF Fibered Aluminum Coating at 1 -1/2 gal /sq or GAF Weather Coat Emulsion at 3 gal /sq. 12. Deck C -15/t2 Incline: 1/2 Insulation (Optional): Isocyanurate, perlite or glass fiber+ any thick- ness, hot mopped or mechanically fastened in place. Joints offset 6 in. Base Sheet One or more layers of Type G2 "GAFGLAS #75 Base Sheet", hot mopped or mechanically fastened in place. Ply Sheet One or more layers of Type G1 "GAFGLAS Ply 4" or "Ply 6 ", hot mopped in place. Membrane: "Ruberoid Torch 170FR" (granule). Surfacing (Optional): GAF Fibered Aluminum Coating at 1 -1/2 gal /sq or GAF Weather Coat Emulsion at 3 gal /sq. 13. Deck: NC Incline: 1/2 Insulation (Optional): Isocyanurate, wood fiber board, perlite, glass fiber, any thickness, hot mopped or mechanically fastened in place. Joints offset 6 in. Base Sheet One or more layers of Type G2 "GAFGLAS #75 Base Sheet", • hot mopped in place. Ply Sheet (Optional): One or more layer; of Type Gl " GAFGLAS Ply 4" or "Ply 6" hot mopped in place. Membrane "Ruberoid Torch 170FR" (granule). I, Surfacing (Optional): "GAF Fibered Aluminum Coating" at 1-1/2 gal /sq or GAF Weather Coat Emulsion at 3 gal /sq. 14. Deck NC Incline: 1/2., Insulation (Optional) :• Isocyanurate, wood fiber board, r li fibe4 any thickness, hot mopped or mechanically fastened in place. Joints • offset 6 in Base Sheet One .or more layers of "GAFGLAS #75 Base Sheet", hot mopped in place. '•k, . , . Ply Sheet (Optional): • One or more layers of "GAF GLAS.Ply.4' pr "Ply • 6" hot mopped in place: . v. +rL•ai�r • • Membrane "Ruberoid Torch 170FR" (gtanule). • Surfacing (Optional): GAF Weather Cgat Emulsion appliedtat 3 gal /sq eK GAF Filmed Alumintutt Coating at I=1 /2 gal/sq. n: ; t.r 15. Desk C -15/32 _ • ..J Incline: 1/2 2000 ROOFING MATERIAL$.& SYSTEMS DIRECTORY . LOOK U 'MARK. RODUCT ROOF COVERING MATERIALS (TEVT) Roofing Systems (TGFU) Continued Insulation (Optional): Perlite, fiber glass, isocyanurate, perlite /isocyanurate composite or phenolic. Base Sheet One or more layers Type G2 or G3 base sheet, hot a,. or mechanically fastened. Ply Sheet (Optional): One or more layers Type Gl, hot m place. ° piled Membrane: "Ruberoid Mop FR" or "Ruberoid Mop 170 FR" ( 16. Deck: C -15/32 Incline: 1/2 Insulation (Optional): Perlite, fiber glass, isocyanurate, perlite /isocyanurate composite or phenolic, offset 6 in. from joints, Base Sheet One or more layers of Type G -2 or G -3 base sheet, L mopped or mechanically fastened. Ply Sheet (Optional): One or more layers of Type G-1, hot mopp place. Membrane: One layer of "Ruberoid Torch" or "Ruberoid (smooth). 1`k/ Membrane: One layer of "Ruberoid Torch 170FR" or "Ruberoid FR" (granule) >17. Deck: NC ute►:,� Incline: 1 Insulation (Optional): Perlite, fiber glass, wood fiber, isocyam urethane, perlite /isocyanurate composite or phenolic. Base Sheet: One or more layers Type G2 or G3 base sheet, hot mopp or mechanically fastened. Ply Sheet (Optional): One or more layers Type Gl, hot mopped h place. Membrane: One layer of "Ruberoid Mop FR" or "Ruberoid Mop 17{ FR" (granule). 18. Deck: NC Incline: 1/2 Insulation (Optional): Perlite, fiber glass, wood fiber isocyanuratr urethane, perlite /isocyanurate composite or phenolic. Base Sheet (Optional): One or more layers of Type G-2 or G-3 base sheet, hot mopped or mechanically fastened. Ply Sheet (Optional): One or more layers of Type G-1, hot mopped e place. Membrane: One layer of "Ruberoid Torch" (smooth), "Ruberoid Mop' (smooth). Membrane: One layer of " Rnberoid Torch 170FR ", "Ruberoid Mop FR' or "Ruberoid Mop 170 FR" (granule). 19. Deck: NC Incline: 1/2 Insulation (Optional): One or more layers of perlite, glass fiber isocyanurate, urethane, perlite / isocyanurate composite or phenolic, any thickness. Base Sheet One or more plies G1 or G2, hot mopped or adhered with Karnak Chemical Co. "No.i 81" or Gibson -Homan "No. 6160" cold applied adhesive at 1 -1/2 gal /sq. Membrane: One layer of "Ruberoid Mop FR" or "Ruberoid Mop 170 FR" (granule), hot mopped or adhered with Karnak Chemical Co. "Na 81" or Gibson -Homan "No. 6160" cold applied adhesive at 1-1/2 gal /s¢ 20. Deck C -15/32 • Incline: 1/4 Insulation Polyisocyanurate, any thickness. Base Sheet "GAFGLAS #75" +(Type G2), mechanically attached. Membrane: One or more plies of "Rubberoid Torch (smooth). Membrane: "Ruberoid Torch 170FR" (granule). at- 21. Deck: C -15/32 Incline: 1/2 • Insulation (Optional): Polyisocyanurate, wood fiber♦ perlite, glass fiber any thickness, hot mopped or mechanically fastened. • Base Sheet One or more I plies of Type G2 "GAFGLAS #75" or "Ruberoid 20 FR" base sheets, hot mopped or mechanically fastened. Membrane: One or more plies of "Ruberoid 30 FR" hot mopped in place. 22. Decic•C -15/32 1 Incline: 1 • Insulation (Optional): Polyisocyanurate, wood fiber; perlite, or glass fiber any thickness, hot mopped 'or mechanically fastened. ', Base Sheet One or more plies of Time G2 "GAFGLAS #75" r.. mopped w or mechanically fastened • ®y' Sheet One or more plies of . "Ruberoid 20" or "Ruberoid 20 FR ", hot E Membrane One or more plies of "Ruberoid 30 FR ", hot mopped in place. •1 • , ; h ' , 23. DecJc C -15/32 ' Incline. 1 /2 ,. ,,s :•• Maulation "(Optional): Fiber glass or perlife, mechanically' fastened. r; r Birk Sheet One or more layers ype G2; hotin or mechanically fastened. 1; , 'r{ .Jr • i -'' JI mopped in place.' •• .., Roof Slope: : 12 Florida Building Code Edition 2002 Hi •h Veloci Hurricane Zone Uniform Permit A•plication Form. • Section D Stee • Slo • ed Roof S stem Roof System Manufacturer: Sa 6 Pe- Notice of Acceptance Number: • Minimum Design Wind Pressures, If Applicable (From RAS 127 o Calculations): P2: I0 b P3: 1 b or Calculatio I b h`� P1: Maximum Design Pressure From the NOA S•ecific S stem Method of tile attachment: Ridge Ventilation? Deck Type Mean Roof Height: ype Underlayment: Insulation: Fire Barrier: a P Steep Sloped Roof System Description i V oo` tatatob Fastener Type & Spacing: g: \Adhasive TYpz : ype Cap Sheet: Roof Covering: Poc c,nk -es, v Type & Size Drip dge: l'h ;I S 4� tor, tap NA- Is iatkok e[ � -1 1 3x3 1 Florida Building Code Edition 2002 Hi. h Veloci Hurricane Zone Uniform Permit Ap.lication Form. Section E (Tile Calculations For Moment based tile systems, choose either Method 1 or 2. Compared es for M the values from M. If the M values are greater than or equal o values, for each area of the roof, then the the attachment method is acceptable. i 1" (p>I� ri t = M I e � _ l on�g>p t Base ��e Cale t'0 s Per RAS 127" (p:: 1 x J - U1- M y .h �� NOA 61 I NOA NI (P2: _1D. bz A _ 411:1 - )`Ig: J = Mr: ■mow r ' M g: _ = M„ �R7 NOA M Method 2 `Simplified Tile Calculation Per Table Below" Required Moment of Resistance (i`I From Table Below NOA M Mean Roof Height •—,I.. Roof Slope M, Required Moment Resistance* 15' 20' (Pt (P: (P, x 1: X1: Description 2:12 3:12 4:12 5:12 6:12 7:12 S RAS 127 Table 1 or by 7 !ob Site *Must be used in conjunction with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared the values for Ft..Nyith the values for F If the F' values are greater than or equal to the F values, far, each area of the roof, then the tile attachment method is acceptable. Method 3 "Uplift Based Tile Calculations Per RAS 127" x w : = _) — \Y: xcos9: = — — F — — ) x cos B: _ = x % � : = ) —«•: 9: F,2: x co s — — F Where to Obtain Information mbol rtis;gn Pressure PI or P2 or P3 Mean Roof Het • `'OA I NOA F' NOA F' Where to find an engineering analysis prepared by PE based e^ 1SC.7 111 calculations — Roof Slope M Restorin Moment due to Gravi 111112M Re•uired Moment Resistance Re•uired U•lift Resistance Tile Dimensions Job Site NOA NOA NOA Calculated NOA Calculated NOA I= length ww• %%ith must be submitted in the BuilJine Official at the time of ermi t a Iicatiun 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.. 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. • 0 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 ioof deck may have to be re ailed 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). F -0 3. Common Roofs: Common roofs are those which have no visible delineation between neighboring units (i.e. townhouses, condominiums, etc.). In buildings with conunon roofs, the roofing contractor and/or owner should notify the occupants of adjacent units of roofing work to be performed.! PD 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. 1 l a 1) 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. PO 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. 1 PP 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. Owner's/Agent's Signature C:WOCV I C- 1` :mp'LOCAL- 1STrmp'S CRIO1 I S:1.J.rc \-1 04tiwo Date Contractor's Signature • r M I A M I D A D P12ODUCT CONTROL. NOTICE OF ACCEPTANCE Santa Fe Tile Corporation 10302 N.W. South River Drive, Bay #16 Medley ,FL 33178 Your application for Notice of Acceptance (NOA) of Spanish "S" Clay Tile under Chapter 8 of the Code of Miami -Dade County governing the use of Alternate Materials and Types of Construction, and completely described herein, has been recommended for acceptance by the Miami -Dade County Building Code Compliance Office (BCCO) under the conditions specified herein. This NOA shall not bc valid after the expiration date stated below. BCCO rescrvels 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, BCCO may revoke, or suspend the use of such product or material immediately. BCCO reserves the right to revoke this approval, if it is determined by BCCO that this product or material fails to meet the requirements of the South Florida Building Code. /24( Raul Rodriguez Chief Product Control Division THIS iS THE COVFRSHEET, SEE ADDITIONAL PACES FOR SPECIFIC AND (:F,NERAi, CONDITIONS 131311,111NC CODE & PRODUCT REVIEW COMMITTEE 1 The expense of such testing \viII bc incurred by the manufacturer. ACCEPTANCE NO.! 00- 1212.06 EXPIRES: 02/01/2006 MIAMI'; DADE COUNTY, FLORIDA METRO -D ADE FLAGLER BUILDING BUILDING coot_ COMPLIANCC OFFICE METRO -DADE FLAGLCtt t3UILDiNG (40 1.117,ST r'LAGLER STREET. SUITE 160. MIAMI, 1 33130-156: (305) 375 -2901 I'AX (305) 375 -2905 CONTRACI I.IC1'.NSINe. SCCTION (305) 375 - 2527 FAX (305) 3 -255x CO:N`I IACi ENFOI<CE:•I DIVISION (305) 375.2966 FAX (305) 375•29os i.Rouurr CONTROL DIVISION (305) 375 - 2902 FAX (305) 372 -6339 This application for Product Approval has been reviewed by the BCCO and approved by the Building Code and Product Review Committee to be used in Miami -Dade County, Florida under the conditions sei . forth above. Francisco Ji, Quintana, R.A. Director Miami -Dade County APPROVED: 02/01/2001 13uildin�, Co I dc Compliance Office I I 113045000 I lc<200011terrolate31nocke acceptance cover pape_dot lutrreict nt:til addrez<. Osunastcr buildingcndconlittc.COnI I1omc ag ht �: p �,c: http:// ..�.vw,huild T' d OSOOBBBSOE uo t aeJod,.IoO a T t l a jezues IdL2 : EO EO uqd b t • SANTAFE TILE CORPORATION ROOFING ASSEMBLY APPROVAL Catc, Roofing Sub- Ca te M:tteeialc 1)ecI Type: 2. PRODUCT DESCRIPTION Manufactured by Applicant Santafe 'S' Clay Roof Tile i rim Pieces Product Tile Screws Dimensions 1= 18" w= 11.5" W thick - varies w =. varies varying thickness 07320 Roofing Tiles Clay Roof Tiles Wood 1. SCOPE This renews a roofing system using Santa Pc "Santafe 'S" clay rooting tile, Manufactured by Santafe Tile Corporation described in Section 2 of this Notice of Acceptance, dcsigncd to comply with the South Florida Building Code, 1994 Edition for Miami - Dade County. For locations where the design pressure requirements, as determined by applicabicibuilding code, does not exceed the design pressure values obtain by calculations in eomplianc;e with RAS 127 using the values listed in herein. The attachment calculations shall be done as a moment based system. Test Specifications PA 112 PA 113 ACCEPTANCE No.: 00- 1212.06 Approval Date: FcItruary 1, 2001 Expiration Date: February 1, 2006 Test Dimensions Specifications #8 x 2 -1/2" long PA 114 0.130" shank dia. Appendix £ 0.178 flute dia. Product Des( ritttion One piece high profile clay roof tile equipped with two nail holes. For nail -on, mortar set and adhesive set applications. Accessory trim. clay roof 'pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tilclprofilc. 2.1 COMPONENTS OR PRODUCTS MANUFACTURED BY OTHERS Product Description Stainless Steel Manufacturer generic 3. LIMITATIONS 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tilt applications, a static field uplift test shall be performed in accordance with RAS 106. 3.3 Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with PA 112 aq�udi _' • '_ . shall be submitted to the Building Code Compliance Oflic . . F,` anl.uioaga, RRC I Roofing Product Control Examiner Table 3: Attachment Resistance Expressed as a Moment- Mf (ft! -lbf) For Nail -On System 1 Tile Profile Tile Application Two Nails One Screw Two Screws One Screw- w/ Cli. - Santafe 'S' Two Screws w/ Clip Santafe S Direct Deck 21.8 29.16 38.28 57.31 Direct Deck 57.60 Battens Battens Direct Deck Santafe 'S' 5.93 61.77 Approved screws as noted 'Product manufactured by others' • Table 2: Restoring Moments due to Gravity - M (ft -lbf) Table 4: Attachment Resistance Expressed as a Moment - M1 (tt - lbf) for Mortar or Adhesive Set Systems , 2 ":12" Tile Profile 4 " :12" Tile Application Attachment Resistance - Santafe 'S' Battens Direct Deck Mortar Sct 23.6 Adhesive Sct 61.9 • Table 2: Restoring Moments due to Gravity - M (ft -lbf) Tile Profile 2 ":12" 3 ":12" 4 " :12" 5 ":12" 6 ":12" 1 , 7 ":12" or greater Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Santafe 'S' 5.93 5.90 5.85 5.82 5.73 5.69 5.56 5.53 5.32 5.2 5.03 N/A SANTAFE TTLE CORPORATION ACCEPTANCE No.: 00- 1212.06 3.5 30/90 hot mopped undcrlaymcnt applications may bc installed perpen to thc roof slope unlcss stated otherwise by thc undcrlaymcnt material manufacturers publishcd literature. 3.6 This acccptancc is for wood dcck applications. Minimum deck rcquirl runts shall bc in compliance with applicable building code. 4. INSTALLATION 4.1.1 Santafe 'S' and its components shall be installed in strict compliance midi Miami Dade County Roofing Application Standard RAS 118, RAS 119. and RAS 120. 4.1.2 Data For Attachment Calculations 1 3 Frank Zuloaga, RRC Roofing Product Control, Examiner 1 Table 1: Aerodynamic Multiplycrs- X Tile X (ft') A. (ft') Profile Batten Application Direct Deck Santafe 'S' 0.274 0.297 SANTAFE TTLE CORPORATION ACCEPTANCE No.: 00- 1212.06 3.5 30/90 hot mopped undcrlaymcnt applications may bc installed perpen to thc roof slope unlcss stated otherwise by thc undcrlaymcnt material manufacturers publishcd literature. 3.6 This acccptancc is for wood dcck applications. Minimum deck rcquirl runts shall bc in compliance with applicable building code. 4. INSTALLATION 4.1.1 Santafe 'S' and its components shall be installed in strict compliance midi Miami Dade County Roofing Application Standard RAS 118, RAS 119. and RAS 120. 4.1.2 Data For Attachment Calculations 1 3 Frank Zuloaga, RRC Roofing Product Control, Examiner 1 • • SANTAFF. TILE CORPORATION ACCEPTANCE No: : 00- 1212.06 ® 5. LABELING 5.1 All tiles shall bear thc imprint or identifiable marking of the manufactuer's name or logo, or following statcmcnt: "Miami -Dade County Product Control Approvcdr. 6. BUILDING PERMIT REQUIREMENTS 1 6.1 Application for building permit shall be accompanied by copics of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by thc Building Official or applicable Building Codc in ordcr to properly evaluate thc installation of this system. PROFILE DRAWING SANTAFt~ "SANTAF£ S CLAY ROOF TILE Frank Zuloaga, RRC Roofing Product Control Examincr si SANTAFE TILE CORPORATION ACCEPTANCE No. NOTICE OF ACCEPTANCE STANDARD CONDITIONS Renewal of this Acccptancc (approval) shall bc considcrcd after a renewal application has been filed and the original submitted documentation, including tcst supporting data, engineering documents, are no older than tight (8) rms. 2 Any and all approved products shall bc pcnnancntly labeled with the manufacturer's name, city, state, and thc following statement: "Miami -Dade County Product Control Approved ", or as specifically stated in the specific conditions of this Acceptance. 3 Renewals of Acccptancc will not bc considcrcd if: a) Thcrc has bccn a changc in the South Florida Building Codc abetting the evaluation of this product and the product is not in compliance with the code changes; b) Thc product is no longer the sanic product (identical) as thc one originally approvcd; c) If thc Acccptancc holdcr has not complicd with all thc rcquircrncnts of this acceptance, including thc correct installation of the product; d) The engineer who originally prepared, signed and scaled thc required documentation initially submitted, is no longer practicing the engineering profession. 4 Any revision or changc in thc materials. use, and/or manufacture of thc product or proccss shall automatically bc cause for termination of this Acceptance, unlcss prior written approval has been requested (through the filing of a revision application with appropriate fee) and granted by this office 5 Any of the following shall also bc grounds for removal of this Acccptancc: a) Unsatisfactory performance of this product or proccss; b) Misusc of this Acccptancc as an endorsement of any product, for sales, advertising or any other pu rposcs. 6 The Noticc of Acccptancc number prcccdcd by thc words Miami -Dade County, Florida, and followed by the expiration date may bc displayed in advertising literature. If any portion of the Noticc of Acccptancc rs displayed, then it shall be done in its entirety. 7 A copy of this Acccptancc as well as approvcd drawings and other documents, whcrc it appl'ics, shall bc provided to the user by the manufacturer or its distributors and shall bc available for inspection at the job sitc at all trines. Thc topics need not bc resealed by thc engineer. 8 Failure to comply with arty section of this Acceptance shall bc cause for termination and removal of Acccptancc. 9 This Acccptancc contains pages 1 through 5 END OF THIS ACCEPTANCE : 00- 1212.06 Frank Zuloaga, RRC Roofing Product Control E.xamincr . „�%• ""� -r. k �;• 1 olyft J rp a1 fat I .-. 24 $� f UO j.n�, • �, e:, • ItC. 00 • ttcbnc.r'�tnucl Spring .TX 77383.1132 t t 0. ftCIE:: ti'.i;t a nt; CrYyt4f' r < r tic o:, for Notice o!• t 1 4 1 17 A:cuptancc (NpA - `. chapter 8 of the o tau coM1 o' ai + Co e +� wml -gyp 00513 :In a rule . fc;y f i a m- herein, governing the use of Y coon. Building 8 Code Co e;y des a OfficeQ , has recommended r accAlternate !sand (CCO ueen rec Mgt c This !�' ) undtr the conditions specified ' • • ,t Mia and Tyres of OA shall no: ptancc by Cmi_D. ;�:oiru_t be valid afte th pccitied herein atle or r- ta:enat at any time expiration date s;, ` v ;:r� :l�lct or material tails from a .; obsit� stated below. 8CC0 reserve , � to perform . �'c of such ' ''►r in the a or Manufacturer's plant t,te ri deter -iiet o this product or or material fails material per immediately. manner, BC CO for revoke, t to spe this Y �CCO th m diately. BC CO msy to revoke this approval, testing. I f this : 't:n� Code. CO reserves the right to material fails to 8 revoke Y or suspend �� meet the requirements. approval, i f it i s . :, �.`t�_nsc quircments lof the South or' sctch (...:sting wiil be incurred by Florida .t Y hc '`11nulacturcr. C1 NO.: -At- 0521.02 F. Xl't R � �2__/ Zt TUC Rut Rodriguez � CO FRSttt'1'T SF 1)( YA1_ n Chid Prcduct'Ccntr0 Q:visint� _ WC: 1 r.:5 ar:nlien!ion for Prcd.,:ct ARnrov:ti Ims been reviewed by the NI►1 • 7i•de and Product Review Committcr to be Lsed in Miami-Dade '0 and approved by County, F'orida underl conditions set I th ffs Al'hh0yrn: !t4:200 I 4 1.1 4 Si:Op t rc;0op14 e^+O:3tesLtouce +( <roance co.0 N=adot :fi ter,,e1 mild oad ress: poetnlsster*pwldin t;eoJeo ntine,epnt ._., :4C .1q 4' vN Xlii ,. lrf I •In crsate hilPalivw4kbas lWltitRceclMallne.coat •' 7 ddr4S COCO 27 FAx PrlttciSCO J. Quin,,tnna, R.A. Oiroctor ti11.4mi -Oncl: Coujtly fluiiding Cock Col ttpliince OfTlc c .2' • • • } Quio s-Calt • Mat c - s 1. SCOPr, This Aprore t ul described YPru�l A h i s ib�•d in Section 2 1 1160 : nt d'. z ;r. pressure ofthi !�I actur d by ['talyfu:t on once o f s Pr oducts. t design pressure value,: requirements. � � determined by Afcpcance. 1•or the locations where! t►lu�, obtained by �Plicable building r . Standard RAS !? Y b code, abn �, for Sc u with in compliance d oes fin p the Standard Ay 1 for use approved flat, low, Ptinnc o with R ooms for sin the attachment calculati d high p as a roof tit ba dcation Ea. patty placement, and as an upl:li b arc dont::u a ms using based system for double moment b system patty systems 2. PRODUCT DESCRIPTION Manufactured by ALilicant Po Iyproe H I G0 roantproyt itTr1000 P Parncl.Ri 3C 4: :CO iS L 195r e� t o� C N XVI V V PekoVA 60 In ftctttr � 11ic I nlyurctlt.enc N/A `/n Test , Ls ric,thns 1 'A 101 h.L8Ct! 41 A - dd; .�v Product 1:J .jus ki eihnt Two etirnponent pOtYuflhane Dispensing Equipment Diipcnsieg L:quipnac�t s ncn 2.l Components or 2.1 M,i �,tti•Q o County C u r r o ucts manufacture L��� list u7 •i by others: res, c v, C o ntrol A cvcmcd It i,ues with O out ! ilc / 0 roof t i e use of [ 'olYrru /11I I GO rout ,� '" � :ig a , :4rrt nt \0,1 2.2 Typical Physical Properties: Dens,ty I'r crt t 3d, t Xs! COnthr�c� ire A SIN 10162 2 lt�c Stre ” AST�I n IG� I l'G Ibslft.' II PSI ( antic! to rise rcna;'c Sauna:(!' 12 PSI p �•1!cr ^I:SJr AST• ,, Per pendicular to r :se al,�„ 0 lG �u Vip t i AST 0 212 8 PSI Para'Icl to rise Din, i J.1 I'crrt / lach u,�,,, „! AST � x:16110 y �1 1) - . 26 t ' .• 1. lay Vt :1t„ 1.: Chan •J n c - 1I::u,itlity. 2 tvccl•,: : =ra 2uloaS4 ttltC rodJuct Control Examiner . • 4. 3. LI. 3.1 3.2 3.3 3.4 ATlpHS fir e , cl assificati on frrc r Assembly for a Ct, atmb 1'olyprobt A1.11G0 shalt so c .,- Mrnimum underta men.s , . Standard RAS 12 sh % 11 Roof rile mfr adlte_i• Uf1CiU, ^CS .1CqUiri 3 ' 5 Roof Tilt "''fir tacit file asse3 acceptance for the ma nufactures a !nbI$ shall t use o f p use ofp test in a ccordan ce o!y? ® • . lN ,1 60 roof YPro� AN ; acquiring acceptance f wit5i a ccordar. oof�ile for two paddy A.I)1 cc wiri PA 10 and with section e with their tile h T with the t-,71 W as modified herein shall test in 1YST ALLATION 4.1 Polyp; a ®AH , GO ;fists uplift r may be used with any roof tile 4.2 res ;st;.ncc v r olyPro� AR I60 s!! all with the use asse,nbly ham. section and t!•c eon Call 5e applied in cornf rolYPro® gH1GC. e a current 140A that assembly's adhesive s por►d ;r'b' !'facer cot pltattce with the Cor s::n:c :c , cs��c a:t : Details ''Pcncr gppl.cation a :.a-!; c.i: -:cr,1 with th . noted herein. the e up!: .R resistance. use of Pol r T`te rooffile F• n resis;ar.cc d as an u ! determined c�Presscd Y � ° ®Aid ItiO shat prop: the up a. on Standard ned in co,ttphanas with p ' based de RAS I'_ wi. Miami-Dade �s�c" . to meet cr c�cccd file assentbS �;p r. The ad Iresive at :ac :rntcrtt data Co unty Rotting ?ctypr0� Ate t 60 - cor tile adhesive a is 'toted ac• yproer :41 /r, le in t::c roof Polyprc� Roofing Application d ::s components A �0 0 Standard s shat: P ;r,stallcd in J olyp o pera:inS ( nstn,cti .ZqS 120, and c , n ^rust be by a Facto °� end Maintenance or t ' tnc. 5y i'c :yfoart Products. Factory Tra. a y ..ar t PrC'aYcts- o_..c.s d Dor' a aaa:icito :o the tnc. Polytb pr„ ducts Qua.tfrcd Applicator' 1 • S C. :: ..r, • authority havin rrc shalt su a and :ice a, :� „ dl :cs :vr • T . e rca^tpro� dispe�s ;�sdiction. P.. y a ::'t o`aPP'ved be n i ;r:t r. •c rr,,c ratio '.;etw , t3 e quipment is ,. ,a :wcci ! t 15 ecn .lie 'A" com o e t a ntic b '3' a I' - de,rv 0 i , 5 :c C I S (A) : 1 0 F Went a :re . PP rc.:r on of shit; be ao r Dcr,.ids per rile,, (n) The dispense 3 component shall q !'ol app r. s determined . r 'er shat: be set o .6 tits yc�ro Ail i G3 si be aPa.aicd with F it ea�.L:z :io.1 No Other sittings 1'' l y o® q : :t s h ;: 1 be o a :npro R FI r 1 t i I GO serf:: r: COO or P; OPack ®)0 of Lc exposed pernt ;rncntt 100 J Y to SUM - _�i�wC(�C •��1 4 3 presented Nee( to n orncnl m this ac , , ceptance. Refer to th tyre used with flat, iow, R hi part . , . f Tile H complianc .�� Cie with the PrOfr ac Stooling ►pp ;j. MS '►�.�CI" �� i'dc Frank: 2ul� RAC °cc•e: Contra' F•xamincr pithiccl by Lion Ud -. C30 Pn_cn_ursn• • inf adhesive 1 t e r' • las been di:pat ' ,,,, , • Inittintum patty; lily , all be irt ch generic tile p uircs tl • ; eat Par Each Ceneeic Tile Profile I , Single Paddy Weight Min. (grnms) t• It.0-1 TilesInuat be adhered. • ' m inulea after Polypro i, ' 4.9 Polyprott AN IGO phi 1,1“ 1 ° , i k ' 4 4 ' the iNcement Details it i • notcd herein. t Table AdhesiVe TileProfilc 1: 5. LADELING All Polypro® A.11160 containers shall 6ftiply with the Standard Conditions listed herein. C. BUILDING PERMIT REQUIREMENTS 6.1 As required by the uHding Oai or applicable Building Code in order to proper.), eva/uate the installation or this system. tg9OSES:99. 'ON Wd 4 11 1116 - — cranic Wow, RRC Product COntrof Examiner J.acm XI 'MIS Ca Ud 91:ei EC-qn-mai Er i:.0 ►1 'Oft II Weal* NO Algol is Wien is X3 town us** • t4 1111 er /s • r LS9Dc55:59 '0N XUi c Frzu 2u1c , RAC Product Ecam+; c . . 'ON Mil 6 _ga0Se 9c • ^h Aid 7 :i1:'.CP! i1 ^ - .car rr,11 Zut °are. t Product R1tC Control E` niin". ma 9::?; • N ACCEPTj .z. 1.02 I cl the !know:a; of this At cepto :cc (a and the original submitted documents,' pProvat L shall be consider ai alteta eight (N) , fG,y1�.. f OIdet than ci S O years: including rest da't •• by boat fii 2 Any and 111 approved r• , •'�rur - te are no P products shall T sta :e, an0 the foliowin • b sta•t ras „ permanently labeled I'roc to , �. , 5 PVCi(.caily stated in the Mwtti -Dale Count ~ n„ltc Specific conditio Y Prod;;: name, �• s of this Acceptance. - � .r al '�pnroval ; or , Krrel.als of Accc )tau .. s a T has be; n a c �'a•?l not be considered it'. � hl:igc ill the St) M ere and the prpduel is not In Cont uth Florida floritl Building Code a b The Product i pliance %1'; h - :::i !lac cvaluatio C l; ��, S Ito Cnpe:f laic S.same t tI1C COtld Cllaq�•� R of .Ia . Acceptance t i hole t has Produce (idatical) as the O re o-:.. IF th ing the correct trot Complied with all tile r • �` a FrcvCd. d. ,nstallation ache product. �c� "' = �s of this ace Thk: engineer , is no ! , ig }'y prepared. signed and scale bcr practicing the engineering d the tc . d titi' revision K protessio,t, �`u(ticn:sticn initi: �!�• r_v or Chanbc i: tt . • , evisi b Cat: i e mat:r:als, use, an _ Se I0.' [ crnu;taLOtt or and/or manufacture c� :.< rc rJS-cs:cd lJ). b gh t11c :i,t this Acecptanee, unless pre-', `*�oCLCt or process s��E1 q,ce g o a rev, 3 PPl■ca; ton with ��' approval ! Ass b .pprcP. _) and granted b c l 5 :1ry p► flp,�; s, :_ g It: 1' :h:s a. r 'r:s:. f s i b shall :so be grounds for rem ts 0r�• per: or of this product Cr �'al of this Acce p!z, - misus cf dl,s Accc�ta.,ce a5 an p process. ether purposes. endorsement of an (i �,�` Y produt: c= � :c;, advertising or ar NC cf Acc :Fta ^c . y ' :�waDcr preceded by the words Miami-03a.; w L;CC aAc Cat. i� :a }' be cr P e ..urine; :S Cisp:a�t .a). cisp;a)'ed in advert; ;,lg literature. Florida, and ot kilo,. c ef 7. A CJ1 : Atha - alI be done ill its c \' I e =e�ion of the Notic. ^f , a.: r :- . r t :s Ac 4 5 , :r ��' !ilk: ,It : s approved drawings and other dc:-.r-....77:;.-s, :l : io �a s; :; 1 tilt: ` e n n c nufacturer or its distributers and sh - "'hire it ipp)ic t :1 `' cr n d rt d' rc.ccal :he copies. _ :abl; fcr i spcclio- - M c Fa :o coalply „i:�; FaAL„r lice 7 )" scetio or this Acceptance shall be eaur. 1,.131 :Cn ,- and rznto� z; c r :s Net:cc or Acccp!aoc.: corsists cf pages 1 through 8. END Of MIS ACCEPT ■ Y i i Or . - - I O 1 RkM ' = Cyurol E.tami,h:r. Owner's Name and Address..W._ Bailey____ . _ Registered Architect and /or Engineer.. Location and legal description of lot to be built on: STATE OF FLORIDA, COUNTY OF DADE. ss • 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 herewi th 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 , I ✓ 6 Y ,19 95th St. Nc7 N . E. street Name and address of licensed contractor.. .Brady Rooting & Sheet Metal, Inc., 2955 N. W. 73rd St.. Miami Lot. Block __. . Subdivision Street and Number where work is to be done ....... _ .___ lax .__ 795 N, E. 95th Street State work to be done and purpose of building (by floors). BeX_SL0;4 1.111; - — 16 - -S-. - - and for no other purpose. New Building ___ Remodeling . -_ Addition Repairs__ No. of Stories To be constructed of Kind of foundation__.. Roof Covering -9O ..t . e stimated Total cost of improvements $__.925.OQ Amount of Permit $___ ne 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 foi said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit doc 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, Pennanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors e )ployed 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 .j h public notice or notices as are required by the Act. The undersigned agrees to employ only such s .contr -tors, . work to be r . ed under this permit, as are licensed by Miami Shores Village. / / iv / Remarks - (Signed / � / /K 4 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_ 1 of the above described construction, that he has carefully read the foregoing application, and that he did signs the same, and that all facts therein by him stated are true. Permit No ?f_ 0 .._ Date_ -- / - 4 P . - Read, Sworn to and Subscribed before me. Disapproved ...... Date_ ( Signed) IN G� Building Ins tor 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. Legal Description Square Ft. /4;:g OWNER': AFFIDAV'T: I certif be ••ne i co' with aut orize above -nam Notary as to Ownetio My Commission Exp'e ** * APPROVED: Zoning PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date y 1 4,3 Job Address 795 N.E. 95th Street Tax Folio 11 3206 014 2180 East 1/2 Lot 19 and . all of Lot 20 Block 68, Miami Shores Sec 3 10137 Owner / EiiiiiZXZRUatLx MR. ROBERT LEWIN Owner's Address 795 N.E. 95th Street, Miami Shoergs, FL 33138 Phone 754 5441 Contracting Co. Miller-Roofing Co. Address 1412 SW 110 Way, Davie, FL Qualifier SS# - Phone State # Municipal # Competency # c 74 5 e .Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Reroof existing concrete tile roof with new concrete tile roof. 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 -•uired for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. Signature of owner and /or Condo President Date: 15 Apra} J 93 that all the foregoing information is accurate and that all work will applicable laws regulating co tion and zon' -g. Furthermore, I tractor to do the work stat • LG • j ota �� /.•'�' "`B -• J ►• PHONE CHURCH ... i Gta). . C �N ; , _rcNl�Eor�4lteuf / 1�cP8t oP�r�ddi eafltargs mmission Expires May 29, 1999' thru Maynard Bonding Agency Estimated Cost(value) 7,200.00 7 nature o Co /ractor or Owner— Builder Date:/.20 /,3 7 My Commission FEES: PERMIT /" RADON C.C.F. ''/ ' 4 6 NOTARY as to Master Permit # ,3,40/ 7 * * TOTAL DUE )�(0 Fire Other Buildin: 'mil/ Electrical Mechanical Plumbing Engineering 4 • PERMIT NO. TAX FOLIO NO. 11 3206 014 2180 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: East 1/2 Lot. 19 and all of T.nr 7(1 =In R1 nr•k ER MIAMI SHORES SECTION #3 Plat Book 10 Page 37 Dade County, Florida Commonly known as 795 N.E. 95th Street, Miami Shores, FL 33138 2. Description of improvement: Replace existing roof with new roof . 3. Owner(s) name and address: Robert Lewin / 795 N.E. 95th Street, Miami Shores, FL 33138 Interest in property: 100% fee simple owner. Name and address of fee simple titleholder: Mr. Robert Lewin, 795 NE 95th Street, Miami Shores, FL 331138 4. Contractor's name and address: Miller Roofing / 1412 S.W. 110 Way. Davie. Florida 33324 5. Surety:(Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ N/A 6. Lender's name and address: N/A NOTICE OF COMMENCEMENT 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: NONE 8. 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: 9. Expiration dat otice of Commencement: (the expiration date is 1 year from the date of recording unless a different dat= Is spe "iii- • w 16 JULY 1993 Signature of Owner Print Owners Na Notary Public Print Notary's Name My Commission Expires: Sworn to and subscribed before me this fs day of ,11 19 g �. STATE OF FLORIDA, COUNTY OF DADE 1 ng4? " ?y CE9HPY 4::a' this is o fru cop' 04 4 o i ... ^ o i. 4r.-s o 1.34 on ... ` ` day e , A 0 "9 5,..?„. W TNEc :n" h rd , r,t ' f'i.ia' Se..l. NONE N/A Nota�ry PLbt'::. State of Florida at Larg My Ccmmko E tpircd May 29, w Q Bondad thru Maynard Bonding Agency U1,'liv `Rrt ircuif and County Courts; MC. 93R193809 1993 APR 19 0943 Prepared by: w T. a,-a} 1 Address: 9301 NE 6 Ave C 308 Miami Shores, FL 33138 BUILDING ❑ MIAMI SHORES VILLAGE FLORIDA Date ELECTRICAL ❑ PLUMBING ❑ PERMIT N? 9830 Contractor's License No. ROOFING 21' Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot / - �n CONTRACTOR or BUILDER 19 . Work to be performed under this Permit B1 Subdi- vision Sq Ft Value of I I Amount of Project $ 11 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 is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that ha assumes respon- sibility for work done by his agents, servants or employees. l / , r / 1 ,' t Signed 'r ' /1 /•' ' (INSPECTOR) BY 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 responsibility for all work done by either, myself, m agent, servant or employee. BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder — Legal Lot Description 0 Address of ,.a ,. Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. PERMIT N° 5596 B1 Work to be performed under this Permit Value of Project $ FLORIDA DATE Contractor's License No. Subdi- vision Amount of 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 application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings cr in the statements or specifications and that hp assumes rep!, •nsibillIy for work done by his agents, servants or employees. Signed f p:.. BY • r ► ° W' BY AUTHORITY 1 195_4_ INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and rations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. �Ol5T5. T'YP. 0 to N • t • r 'o{ 0 • W. /A . 9 DO ��.. (MIN) SEPTIC TANK .,...L.---CAL DRAIDffIELD 3 QSQ. FT• INVERT 0,F gRAINFIELD TO BE NOT LESS THAN & ` Q r SEA LEVEL DATUM ( GVD) INSTALL _i. 4�HE OF SAND U DER THE BOTTOM OF DIWNFIELO I i I 1 ! I I 4 " rvc . 1 V1r TO Isar' mar. ! 1. YI5T S siEr. MAIL i 000. RecEPTACLE 'I f0 V. CE PTA E- WALL LIGHT OuTLF :CEILt11 LIGHT Ou TELEPNOt4E. OUT . T. v. OUT1..E -T PLOT Pl_L`H r.. ulitt) FAULT' 1 TN ST. WARM L1 r }- i off l• % e = Zool ZI co co Dascel P rIc E T t4 LP ( /2) of .L..c 19 LoT Zoe, 15L4 68 of /Jl12). S�CTrof =1 1.1 3 ' _acco2nrtJ - (.F 2ecnoe.D.J? Pa GE- 37 o - rue. Pw 1..i c R. ' DADE. Cout4 - rT I FL0 .f1) .4 . = 1, 0" THE APPROVED SEPTIC TANK DRAHIF7EL DE.GEf�T{s,CLEr OUT INVERT ELEVATION MAY BE THE CONTROLLING FACTOR IN DETERMINING FINISHED FLOOR ELEVATION. C PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date J 1 3 I OJob Address 7 9 s N . I=. 7 • Tax Folio Legal Description [ Historically Designated: Yes / q1 No '1 Owner/Lessee / Tenant Mr. L4 t. k t p ! - L � � � �iv A 4 Master Permit # 4 0 3 q s"r Owner's Address - 19s - Nt . E, l - Phone 3 Dv — 9 9 - 6 Contracting Co. -- re 14 N 1 tom TZ o o r Address ..c3 JU U1 . 1-7 s 1 Qualifier SD No (! State # Municipal # Competency # 1 J 9 9 V Ins. Co. 73u r L i x9 T Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL OOFING AVING FENCE SIGN WORK DESCRIPTION � LF_AIC , z ob4 oo Square Ft. 3 fah .�'r Estimated Cost (value) 4 F� 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 penpits are required for ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore au orize the above -named contractor to do the work stated. f owner and/or Condo t Signa No as to Owner and/or Condo i z. 1: to F MA .N) VILLAR NOTARY PUBLIC STATF. OCC77 A COMMISSION NO. Y COMMISSION EXP. MAR 1 ,2002 My Commissio FEES: PERMIT RADON 1/(..3P C.C.F. SS# Phone 3b..1-- (o a 4- 1 ?7! Signature o / ontractor or Owner - Builder Date No : as to Con My Commission U✓ • • p "Om • ' R SEAL ires: GLADYS J vL.iAR NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC714103 Y COMMIS1ION EXI' MAR. 1,2002 NOTARY BOND 'I Date Date APPROVED: Zoning Building Mechanical Plumbing Structural Engineer Electrical 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.. Registered Architect and /or Engineer ...... ....... Name and address of licensed contractor.. Location and legal description of lot to be built on: Lot Block ? Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) New Building Remodeling To be constructed of Kind MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT 2(g Date o 7.9-_) e street 4 �£ 1t/ Read, Sworn to and Subscribed before me. Notary Public, State of Florida PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved , and for no other purpose. Addition Repairs No. of Stories f foundation Roof Covering Estimated Total cost of improvements $ />. 0 Amount of Permit $ Zone cubage required Plan Cubage Distance to next nearest building._._. Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) .� STATE OF FLORIDA, COUNTY OF DADE. ss 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. Pernut No Date Disapproved Date (Signed) Building Inspector My Commission Expires Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval 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. has been obtained from Name Address Phone # MIAMI SHORES VILLAGE V ' /. BUILDING DEPARTMENT 1� 305- 795 -2204 Building Inspection Requ V.> Inspection Date 3 Approved Correction Re- Insp'n Fee Data Type Insp Permit No. )1P O3' o ) lgs41 .E . c(5 . c Company k ■. _ r-; Ji " , /A1�� ,; MIAMI SNORES VILLAGE V0 01/7 BUILDING DEPARTMENT \\ 305- 795 -2204 Building Inspection Reque� Dat } 1Z I I0\I \f Type Insp',n Permit No. BP 0 Name Address 1 I S . C . C J_)\ Company � � " "� " _1 r C A Phone #—) 2 l(" c 7 -- 7 7 7 b Inspection Date 3 /1 - / O'( Approved ❑ Correction ❑ Re-Insp'n Fee 1 -41 - 4 ok 3 —;1311 � Type Insp'n `� u`S'S '���1 1�� Permit No. . v 7 1 ' DC) 100 Name MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Address - 1PLJ -a s S� Company ( Phone # Inspection Date 4I 1 Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 31 3 , Type Insp'n `((,SZ - c r Permit No. r Name w 1CDd Address 3•— S S4- Company Phone # Inspection Date AI 1 Approved Correction Re- Insp'n Fee • 1 B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER Miami Shores, Village of, 120652 B2. COUNTY NAME Miami -Dade B3. STATE Florida B4. MAP AND PANEL NUMBER 12025C 0093 B5. SUFFIX J B6. FIRM INDEX DATE 7 -17 -95 87. FIRM PANEL EFFECTIVE/REVISED DATE 3 -02 -94 88. FLOOD ZONE(S) X B9. BASE FLOOD ELEVATION(S) (Zone AO, use depth of flooding) 50,0 yr. Flood Base Not PROCESS # FOLIO # C.O.R. PAT I)TTRTTPF For Insurance Company Use: Pi licy Number Company NAIC Number BUILDING OWNER'S NAME BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 795 N.E. 95th Street CITY STATE Miami Shores Florida PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) East 1/7 Lot 19, Tot- 20, Rlork tiR MIAMI SHORES, SF,CTTON NO. 'I PB 10 - BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use Comments section if necessary.) Residential LATITUDE/LONGITUDE (OPTIONAL) ( ##° - ##' - ##.##- or ##.##### °) This certification is to be signed and se I certify that the information in Sections I understand that any false statement ma CERTIFIER'S NAME TITLE ADDRESS SIGNATURE 8.88' FEMA Form 81 - 31. AUG 99 SE Albert R. Toussaint President FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION HORIZONTAL DATUM: SOURCE: LJ GPS (Type): J . NAD 1927 I_J NAD 1983 SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) sq. in. (sq. cm) R, EN OR ARCHITECT CERTIFICATION O.M.B. No. 3067 -0077 Expires July 31, 2002 Amended by MDC -DERM Oct. 199C LJ USGS Quad Map I I Other: B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. IJ FIS Profile IJ FIRM I—I Community Determined LJ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9:12_1( NGVD 1929 IJ NAVD 1988 LJ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? IJ Yes No Designation Date: C1. Building elevations are based on: I_JConstruction Drawings' I,_JBuilding Under Construction• Construction •A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number ! (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations – Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO Complete Items C3a -i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area.of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD 1929 Conversion/Comrrients Elevation reference mark used DCBM B -50 Does the elevation reference mark used appear on the FiRM? I Yes I xI No O a) Top of bottom floor (including basement or enclosure) sunken L/R 9 . 91 ft.(m) O b) Top of next higher floor Main floor 10. ft.(m) ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A . ft.(m) ❑ d) Attached garage (top of slab) N/A _ ft.(m) O ca e) Lowest elevation of machinery and /or equ servicing the building A /C, co la• 8.J3. ft.(m) E O f) Lowest adjacent grade (LAG ❑ g) Highest adjacent grade,, 8 .3_ ft.(m) ❑ h) No. of permanent ope . �s (' �o� •ve adjacent grade N/A O i) Total area of all perman 4.0 �G1 ,lr Albert R. Toussaint V907 October 2,2002 ZIP CODE 33138 -2514 Determined yor, engineer, or architect authorized by law to certify elevation information. this certificate represents my best efforts to interpret the data available. nishable by fine or imprisonment under 18 U.S. Code, Section, 1001. LICENSE NUMBER 90;7 COMPANY NAME A. R. Toussaint & Associates, Inc. CITY North Miami STATE FL ZIP 3316 DATE October 2, 2002 TELEPHONE ( 305) 891 -7340 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS /y5 Nr; y5 Street CITY Miami Shores Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F, Section C must be completed. El. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed — see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is I ft.(m) 1 I lin.(cm) LJ above or LJ below (check one) the highest adjacent grade. E3. For Building Diagrams 6 -8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is LIJ ft.(m) I I lin.(cm) above the highest adjacent grade. E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? I I Yes I J No II Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA- issued or community- issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE COMMENTS G4. PERMIT NUMBER [135. DATE PERMIT ISSUED COMMENTS STATE ZIP CODE Florida 33138 2514 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) DATE TELEPHONE SECTION G - COMMUNITY INFORMATION (OPTIONAL) Company NAIC Number I Check here if attachments 1 -1 Check here if attachments The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G 1. IJ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. LJ A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. G3. 1_1 The following information (Items G4 -G9) is provided for community floodplain management purposes. G7. This permit has been issued for LJ New Construction LJ Substantia Improvement G8. Elevation of as -buiit lowest floor (including basement) of the building is: _ ft.(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: . ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED II Check here if attachments FEMA Form 81 -31, AUG 99 REPLACES ALL PREVIOUS EDITIONS B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO, use depth of flooding) 12025C 0093 J 7 -17 -95 3 -02 -94 X 500 yr. Flood Base Not PROCESS # FOLIO # C.O.R. 8.88' PAT DIIRTIFF For Insurance Company Use: Policy Number Company NAIC Number BUILDING OWNER'S NAME BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR 795 N.E. 95th Street CITY Miami Shores PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal East 1/2 rot 19, rot- 20, _Rlork F8 MIAMI SHORES, BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use Residential LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: l� NAD 1927 LJ NAD 1983 ( ##° - ##' - ##.##" or ##.#4t#44 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER Miami Shores, Village of, 120652 B2. COUNTY NAME Miami -Dade B3. STATE Florida B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. 1_J FIS Profile I J FIRM jJ Community Determined U Other (Describe): B11. Indicate the elevation datum used for the BFE in 89: 1 XJ NGVD 1929 1J NAVD 1988 LJ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1J Yes No Designation Date: ' SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)' C1. Building elevations are based on: 1JConstruction Drawings' LJBuilding Under Construction* JFinished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number ! (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations — Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1- A30, AR/AH, AR/AO Complete Items C3a -i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area.of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD 1929 Conversion /Comments Elevation reference mark used DCBM B - Does the elevation reference mark used appear on the FIRM? O a) Top of bottom floor (including basement or enclosure) sunken ❑ b) Top of next higher floor Main floor O c) Bottom of lowest horizontal structural member (V zones only) O d) Attached garage (top of slab) O e) Lowest elevation of machinery and /or eq servicing the building A /C, conc. O f) Lowest adjacent grade (LAG) O g) Highest adjacent grade (HAG) O h) No. of permanent openings (flo O i) Total area of all permanent opehir(g FEMA Form 81-31. AUG 99 P.O. ROUTE AND BOX NO. STATE Florida Description, etc.) SECTTON NO_ PB 10 -37 Comments section if necessary.) O.M.B. No. 3067 - 0077 Expires July 31, 2002 Amended by MDC -DERM Oct. 199C ZIP CODE 33138 -2514 SOURCE: L. GPS (Type): LJ USGS Quad Map LJ Other: n L R 9 . 91 ft.(m) 10 . 42 ft.(m) N/A . ft.(m) N/A . ft.(m) 8 . ft.(m) 8 . ft.(m) 8 .9 ft.(m) N/A sq. in. (sq. cm) INEER, OR ARCHITECT CERTIFICATION Determined LJ Yes 1x1 No g , , ,�ijQ" 4 /� Albert R. Toussaint Octob er. 2, 2002 This certification is to be signed and sealed by a and sury - „S gineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, B, and C on t rtificate represents my best efforts to interpret the data available. I understand that any false statement may be punishab by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER i Albert R. Toussaint 907 TITLE President COMPANY NAME A. R. Toussaint & Associates, Inc. ADDRESS CITY S TATE ZIP CODE l N� 1 Street North Miami F L 33161 SIGNATU _�. DATE October 2, 2002 TELEPHONE (305) 891 -7340 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS /y5 Nt yb s treet CITY Miami Shores COMMENTS PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME SIGNATURE COMMENTS LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS STATE ZIP CODE Florida 33138 2514 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F, Section C must be completed. El. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed — see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is l 1 I ft.(m) I lin.(cm) LI above or LI below (check one) the highest adjacent grade. E3. For Building Diagrams 6 -8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is LIJ ft.(m) LLJin.(cm) above the highest adjacent grade. E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? 1_1 Yes No No I._1 Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA- issued or community- issued BFE) or Zone AO must sign here. ADDRESS CITY STATE ZIP CODE DATE TELEPHONE SECTION G - COMMUNITY INFORMATION (OPTIONAL) Company NAIC Number II Check here if attachments 1 -1 Check here if attachments The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. LJ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. LJ A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. G3. I J The following inforration (Items G4 -G9) is provided for community floodplain management purposes. L G4. PERMIT NUMBER JG5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit has been issued fur: LJ New Construction LI Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: ft.(m) Datum: G9. BFE or fin Zone AO) depth of flooding at the building site is: . ft.(m) Datum: II Check here if attachments FEMA Form 81 - 31. AUG 99 REPLACES ALL PREVIOUS EDITIONS V CCEO N. _. 7 - 4 1 tr F^ ?CS' 7S5-2 :? :: (''.1r1 --_- EIJUDING PF.mi r /oe .c o?.s Rmisratsicti CSC.:ST C cf F. OF FLORIDA fax - CAAS'ION (DPER) .= Ste" . REGIS AT1ON C 90:Di y LIB. c^_ Cap: of currant CCCUPATIONAL LICENSE = county business is located. - ='� • r�T=`2 Certificate of Insurance for LT>arr rry ..'_A .. (c ti.. � _ :^ W_c.�3 SCIC:cS Village) Certificate of Insurance for WORKER'S COMP (addressed to Miami S:.oresVillage) or if exempt State of Florida LES Po= BCf 7-204, Construction Indus` Notic ,of Election to be Exempt. PLEASE SU$QT EVERYTHING CEE.'ECK D OFF . Permit t Applica tion (signed by person performing .,e work, licensed contrac .or ar'. erty the prop `- owner, both signatures notarized). TWo sets of lass /dra's�ings signed and sealed oy registered architect or engineerQa. p . Occupancies by Group Ciassificat.en must be on plans and permit aoplication. All plans must include folio number and property address.. Amended plans, in addition to the above, must also include the permit number. n`is'£ 9s Stcuctaral Calculations signed and t ed architect applicable. 52" by ==�" �° c. engineer when .� . Current survey of the property. $"(S /e 9' 7 i &L - (i ) Certificate of Elevation signed and sealed by Surveyor. J tial Fmepravem nt5 Ched list (contractor or owner) . . F oursets of energy calculations, signed and sealedi� rn 4 fett 'j'W sets of signed a sealed Truss Plans (Engine-a:). DADE County or State of Florida Products Approvals for roof materials, sheds, windows, exterior /garage doors, aluminum carports, screen enclosures, shutters awnings, skylights, frren dcor and etc. Approvals f,cnm HRS, DADE County Impact Fee Section, Fire Dep?tnt a Health Department (when acgliG_e). DER( 1.-//Warranty Deed or Other Proof of CZ.te lip if necessary. S ruc u,cd1 Review f e_ Notice of Commencement MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date / 19 J 0) Time Type Insp'n / �t Permit No. .23 P 2- 0 0 3 Name C Q om. Address LS A • ( ' 1 51 Company / Phone 4(1 X O ^ For Inspecto ' l -21 �3 Name & Date Approved Correction Re- Insp'n Fee of MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date! i) / i / :w) 1 Time Type Insp'n CA_ " Permit No. I/ P 2 Name _n- Address 9_ is,P9t • Company )./"` Phone #r g 6 , ( -1 For Insp'ector / / Name & Date Approved Correction Re- Insp'n Fee a MIAMI SHORES VILLAGE BUILDING DEPARTMENT Date 305- 795 -2204 Buil.ing Inspection Request q Time Type Insp'n 4 ' CM \ L eY Permit No. — 1 70) NameDU - Address' `l S Company rOp , Phone # ,a1 For Inspector: Approved Correction Re- Insp'n Fee Name & Date MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buil•ing Inspection Request Date 1 Time Type C's L �S P--- 0 - ; 7 0\ • Permit No. Name UST Address ( > 1 �Y 1 S Company i��'_ Phone # For Inspector: Approved Correction Re- Insp'n Fee Name & Date 64. MAP AND PANEL NUMBER 12025C 0093 B5. SUFFIX J B6. FIRM INDEX DATE 7 -17 -95 B7. FIRM PANEL EFFECTIVE/REVISED DATE 3 -02 -94 B8. FLOOD ZONE(S) X B9. BASE FLOOD ELEVATION(S) (Zone AO, use depth of flooding) 500 yr. Flood Base Not PROCESS # FOLIO # C.O.R. SIGNATURE 8.88' PAT fTTRTTFF For Insurance Company Use: Policy N mber Company NAIC Number BUILDING OWNER'S NAME LATITUDE/LONGITUDE (OPTIONAL) ( ##° - ##' - ##.##" or ##.#####°) CERTIFIERS NAME TITLE ADDRESS FEMA Form 81 -31. AUG 99 Albert R. Toussaint President 0 /NR 1 Street FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 795 N.E. 95th Street CITY STATE Miami Shores Florida PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) East 1/2 Lot 19, r,nt 70, Rlork FA MIAMI SHORES, SFCTTON NO_ 1 PB 10 -37 BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use Comments section if necessary.) Residential HORIZONTAL DATUM: SOURCE: L1 GPS (Type): Ll USGS Quad Map LJ Other: IL] NAD 1927 LJ NAD 1983 SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER Miami Shores, Village of, 120652 B2. COUNTY NAME Miami -Dade B3. STATE Florida B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. 1_1 FIS Profile LJ FIRM L Community Determined L1 Other (Describe): B11. Indicate the elevation datum used for the BFE in B9:1_29 NGVD 1929 1J NAVD 1988 1 Other (Describe): r B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1J Yes J No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 1 Drawings' LJBuilding Under Construction• Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number ! (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations — Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1- A30,_AR/AH, AR/AO Complete Items C3a -i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area.of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD 1929 Conversion/Comments —, Elevation reference mark used DCBM B - Does the elevation reference mark used appear on the FIRM? L Yes I xJ No O a) Top of bottom floor (including basement or enclosure) sunken L/R 9 . 91 ft.(m) ❑ b) Top of next higher floor Main floor 10 . 42 ft.(m) ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A _ t(m) i c O d) Attached garage (top of slab) N/A _ ft.(m) ❑ e) Lowest elevation of machinery and /or equipment u, servicing the building A /C, conc. slab 8 J ft (m) , aw ,� O f) Lowest adjacent grade (LAG) 8 . ▪ ft.(m) z ❑ g) Highest adjacent grade (HAG) 8 . ▪ ft.(m) O h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N/A ❑ i) Total area of all permanent openings (flood vents) in C3h sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION O.M.B. No. 3067 - 0077 Expi les July 31, 2002 Amended by MDC -DERM Oct. 199 ZIP CODE 33138 -2514 Determined Aibelt R. Toussaint #907 Oeto_er 2,2002 This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. LICENSE NUMBER COMPANY NAME 907 A. R. Toussaint & Associates, Inc. CITY STATE i ZIP CODE North Miami FL 33161 DATE October 2, 2002 TELEPHONE ' ( 305 ) 891 -7340 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS /95 NE 95 Street CITY Miami Shores Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR - F, Section C must be completed. El. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed — see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is I I 1 ft.(m) I I (in.(cm) L1 above or L below (check one) the highest adjacent grade. E3. For Building Diagrams 6 -8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is LLI ft.(m) LLlin.(cm) above the highest adjacent grade. E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? I Yes LI No Il Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA- issued or community- issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE COMMENTS The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. IJ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. L1 A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. G3. (J The following information (Items G4 -G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER I G5. DATE PERMIT ISSUED G7. This permit has been issued for: Lj New Construction LJ Substantia Improvement G8. Elevation of as -huilt lowest floor (including basement) of the building is: . ft.(m) Datum: G9. BFE (in Zone AO) depth of flooding at the building site is: . ft.(m) Datum: LOCAL OFFICIAL'S NAME COMMUNITY NAME SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) STATE SECTION G - COMMUNITY INFORMATION (OPTIONAL) TITLE SIGNATURE DATE COMMENTS ZIP CODE Florida 33138 2514 DATE TELEPHONE TELEPHONE Company NAIC Number 1 -1 Check here if attachments 1_1 Check here if attachments G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED 1_1 Check here if attachments FEMA Form 81 -31. AUG 99 REPLACES ALL PREVIOUS EDITIONS OV `? 2003 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building J Electrical Plum Mechanical Roofing ?(Owner's Name (Fee Simple Titleholder)) 1 t Cr A /& oY' Phone # Owner's Address '79,5 / -_ Cit (A)''( 0we State C, Zip Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO (IA VJr , ?(LY2 SIkOC l 6U' Phone # 7 1 ' Z) ) Contractor's Company Name �� Cv ` _ Contractor's Address 46;3 ( `) , "`) ' l r City //--7 /%7 r / State Zip . Q � (�(-k � Qualifier ,2�2 Z=P (2.l�// Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Square Footage Of Work: Type of Work: Addition DAlteration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: � d p ORJA-60 r Submittal Fee $ Permit Fee $ CCF $ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Bond $ Code Enforcement $ Structural Plan Review. $_c, " Total Fee Now Due $ (Continued on opposite side) iami Shores Village uilding Department N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No 2a — 70 Master Permit No. * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Phone # Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City • Zip 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 conunenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 , by ' day of , 20 by who is personally known to me or who has produced P who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: :hc 10/14/03 Plans Examiner Engineer Zoning BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) 1 2IC I A Do Bor:V Phone # Owner's Address 7 5 r / S" S ?� City ■•''r r / State C' (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Zip Permit No. Master Permit No.P 2 003 7e Tenant/Lessee Name Phone # Job Address (where the work is being done) ' S M . C. ? S--7 , City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO C_ Contractor's Company Name Fit 1 oga t4vsT. Md vY• ,AC Phone # "r-G, a4 7 2 77 G Contractor's Address Li Co 3( tV • S`' s? City on--7 r State F C_ Zip '33 12. k- Cif, Avg s /Z. c �2vh tt\—% Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Square Footage Of Work: Type of Work: ❑Addition DAlteration p ❑New ❑ Repair/Replace ❑ Demolition Describe Work: s re'y 5 L 0^ * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ 25" �� CCF $ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Bond $ Code Enforcement $ Structural Plan Review. $ 25 xv Total Fee Now Due $ 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 not be approved and a reinspection fee will be charged. My Commission Expires: APPLICATION APPROVED BY: Chc 10/14/03 Signature Signature , Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 _, by , day of , 20 by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. *********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 4 l i ?S' ,(2) ?2 '1/45 /i 5 f/niti. Plans Examiner Engineer Zoning Miami Shores Village Building Department Jus4 10050 N.E.2nd Avenue Miami Shores; Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. a'.3 - 7a / Job Name Pai9:0 F 1'75 NE STRUCTURAL CRITIQUE SHEET l �3 / °3 © 7rus -s sikefr Drgsw «r y s tnarl he review eviewed - » afipwe 6v ArcJi o - o (- record prior- -1v 574 vhi 11di iv gait Ded-, 4 • ? continue the permitting process. BUILDING AND ZONING DEPARTMENT 10050 N.E. SECOND AVENUE MIAMI SHORES. FLORIDA 33138-2382 TELEPHONE (305) 795-2204 FAX (305) 756.8972 RECEIPT { V•�� contractor /owner, picked up 2 sets of plans for from the Building and Zoning Department on (date) to have corrections done to plans and/or get County stamps. I understand that the plans need to be brought back to Miami Shores Building and Zoning to MIAMI SHORES VILLAGE , BUILDING DEPARTMENT 305- 795 -2204 Bgilding Inspection Request - r i r\ cap I+O 4- 'fop Date Type Insp'n Permit No. ei 6 )4/3. Name VOR ) Cf - Addre„ 1GS E RS 54 Company A 00.1e. Phone # Inspection Date t j i _ JcL1 Approved Correction ❑ Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE 3A\ BUILDING ,DEPARTMENT 305- 795 -2204 B ildin ; Inspection Request Date 0 �L Type Insp'n 1 cop ➢-(Cp Permit No. Name N)( > Pr) Address 1C S 1" 2' ` CT ( S s-1 Compan rnt uctle f' Phone # Inspection Date 1 ) D. GC\ Approved Correction Re- Insp'n Fee