95 NE 95 St (7)CONTRACTOR
Name �2 ���6 /�
License No Ci / 9 rte / /De_ / e) t)
Address 7 rAz----
/ �J is nt; Cre$, 4/33,3
Telephone -7 4'0 Fax 7 4
v 8 �r"—
Qualifier Name � „ ie./ 34
PROPERTY OWNER
New Construction
Name p�, r/1 ,,
+� (
Enclosure
Address
V �� Q5 sic.-
in lam" o horeS;
R 331
Home Telephone 30 s - ' o
Repair
Business Telephone
Alteration Interior
Fax
Demolish
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
INSTRUCTIONS - The following steps must he taken to obtain a permit from the Miami Shores Village:
Step 1.
Job Address:
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted
along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
Folio Number I t 3 Q QC 013 ( 3 7 3 0 Description of Work ' ' £ L2/ / L
Lot A3 cx,M Block >
Subdivisioi \ . cX'. ` Pk 110 PB ) 0 Pail_ Zoning Linear Feet
Current Use of Property gES )0E AJ--n ici'(s Square Feet ta Units Floors i
Proposed Use of Property Value of Work '33SV Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
95 /LE 95 6/-,
Address
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Telephon
F
Master Permit No.
Subsidiary Permit No. q k)
PERMIT APPLICATION
Wank/ Jhores 33/3a
Apt. City State Zip
ENGINEER
Name
License No.
Telephone
Fax
A,F Please read carefully.
Page 2
1. DO NOT BEGIN ANY WORK WITHOUT HAVING
the right to begin construction. HOURS OF CONSTR
to 5:00 p.m. No inspections will be conducted on week
2. All construction of demolition areas MUST BE MAI
3. STREETS AND NEIGHBORING PROPERTIES SHA
4. SWALES MUST BE PROTECTED FROM BEING D
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a
7. DO NOT DISCHARGE WATER INTO THE RIGHT
8. EQUIPMENT AND MATERIALS SHALL BE STO
9. Department of Health and Rehabilitative Services (H
Management (DERM) and/or Miami -Dade Water and
Application is hereby made to obtain a permit t
work will be performed to meet the standards o
are required for ELECTRICAL, PLUMBIN
ROOFING and SIGNS and there may be additi
I, the OWNER of the property, have disclose
months to the Building Official. Further, I am
any other permit equals or exceeds fifty perce
present federal flood criteria for finished floor
under this and any other permit exceeds fifty
conform to the current code requirements of th
SEAL:
TE OF FLORID: -, OUNTY OF MIAMI -DADE
Signature of Owner
(d. Roa n n i K
Print Name
Sworn to and subscribed before me this 17 day of
Signature of No
ou
Type of Identification Produced:
blic - State of Florida
4� Douglas W Romantic 9
* *My Commission CC7848
cm , Expires August 24, 2002
Personally known OR, Produced Identific.tion
SEAL:
PERMIT APPLICATION
CEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
CTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
nds or holidays.
AINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
L BE KEPT FREE FROM DIRT AND DEBRIS.
MAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
separate permit.
F WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
D at least 10 feet from the edge of pavement.
S) approval is required for applications involving septic tanks. Department of Environmental Resources
ewer Department (MDWASD) approval is required for applications involving sewers.
do work and installation as indicated. I, the OWNER of the property, certify that all
all laws regulating construction in this jurisdiction. I understand that separate permits
POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
nal permits required from other governmental agencies.
all information related to any work at the property performed in the prior twelve
ully aware that if the cumulative cost of work to my home or business under this and
t (50 %) of the fair market value of the structure, the entire structure must meet the
elevation. I am also fully aware that if the total cost of work to my home or business
ercent (50 %) of the replacement cost of the structure, then the entire structure must
Building Code.
WARNING TO OWNER: Your failure tc' record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spbnding more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement rnust be recorded at:
22 N.W. 1st Street, P' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florid Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Contractor / Qualifier
Print Name
Sworn to a subscribed before me this day of
a .--
!ture of N • ry Public tate of orida
Personally known / OR, Produced Identification
Type of identification Produced:
ELECTRICAL
TYPE
Minimum Fee
QTY.
1
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
A/C Central 1 -3 Ton
- Heating Strips, each
Fan
Outlet, Wall
Service, Temporary
- Paint Booth
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
Piping, Flammable Liquid
Signs
A/C Central 8-15 Ton
Fixture - Fluorescent
- Process/Pressure Piping
Oven
Space Heater (kw)
A/C Central 16-20 Ton
- Pressure Vessel
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE
Minimum Fee
QTY.
TYPE
Condensate Drain
QTY. TYPE
Generator
QTY. TYPE.
Refrigeration, Tons
QTY.
A/C Central, Tons
QTY.
Cooling Tower
- Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
- Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
- Process/Pressure Piping
Pump and Abandon
Bath Fan - Vented, #
Fireplaces, Number of
- Pressure Vessel
Gas - Appliance
'PLUMBING
TYPE
A/C Condensate
QTY.
TYI'E
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
Q'I'Y.
'I'YI'E
Soakage Pit
QTY.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump ;
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
al
1 I I
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
Page 4
OFFICE USE ONLY
CI 'ECKLIST
• OWNER - BUILDER FORM
(Attach)
® FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
• CONCURRENCY
(New Construction)
LI OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine $
Zoning Review
CI PROOF OF OWNERSHIP
(Attach)
HRS / DERM APPROVAL
(Septic / Sewer)
MPACT FEE
(New Construction)
THER
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
(Specify & Attach)
(sq.ft. = x/1000
x0.60)
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
REVIEWED AND PREPARED BY:
PERMIT APPLICATION
d
• CONDO ASSOCIATION APPROVAL
(Attach)
• BPR APPROVAL (Restaurants)
CI CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $
:ISSUING OFFICIAL
DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2"° AVE., MIAMI SHORES, FL o (305) 795 -2207 FAX (305) 756 -8972 0 http:/ /www.miamishoresvillage.com
Date
Type Insp'n
Address
Company
Phone #
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
d Time
Permit No. 5 0
A
Name (�
Q,, vin 3 c
For Inspector:(1 /b ;ZI3 Name & Date
Approved
Correction ❑
Re- Insp'n Fee ❑
PERMIT NO. TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF DADE:
r 2 ,. .Description of improvement:
Rfv
02R026499 2002 JAN 15 11:22
E UNDERSIGNED hereby gives notice that improvements will be made to certain real property. and in accordance with
hapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
Legal description of property and street address: C15 /(.E yS S7
� am/ &h v lc°S,/ 33/ 3g
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
3. Owner(s) name and address: . %6�'t/ I O U V A nil
CIS / a 5 Ytt
at
•
r.
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address:
6. Lender's name and address:
', Public
r „
Print Notary's Name
My Commission Expire
Re- Font - F
QoQft�C 1$3c.,. -7 N� /0 Lo JrF t 0,t c t
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
fJl
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 71 3.13(1)(a)7., Florida Statutes,
Name and address: ( I
=: �'; : .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:
alt .. 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
d date Is specified) f 1
�ry
Signature of Owner nn 1 /
LX/K.1 ' GMt"cs11 K
Print Owners Name
Sworn to and subscribed before me this 11 day of
Mimill dYes, - 4/ 3513
It 10 FLORMA, cOUNtY OF DADE
of me
/r r a! t�V EEr771 rs office 0 1 1 a true da
gr,gM {fled P rs office on ( 1_ �1
4 A 0 20 _
n and an
0V/7-NESS my d Official Seal.
,, , n County Cords }k RVEY RUVIN, GLE 2,44... , .C.
ILE IO I .1'
aril ri,,S
Prepared by:
Address: 1 4
/11
UVl
4-I. 3313
Owner of
Building
t Akoe
PAY
ORDER OF V
TO THE •
DALEY ROOFING, INC.
78 N.E. 106TH STREET
MIAMI SHORES, FL 33138
305-754-9892
Bankof America,
FOR
ACH Fla 063100277
4444- ocvtau.k
r _ Address of 0 c
Building
DATE
000378 LH° 1:063000047i: 00 /59621,9503o
,,._r.:.E,,n,....c.Emeannana_c,matc=ror.a...11,mus.m-z0mmuto.r.r.Anstmumna-mazzaamoura...-..mezzr...--0, aasemamcansrxmo.a.-..c.
.....•.... - ..
... .,- Architect
.. N • -...
'..)<=.) ) ' -' ' Contra • ) ) (7
- - or Builder ( ' ). p
r ,
'.)-• ."-....
--,.. --- .,7,-1-1 \.
1 • s Legal
H :)
) c7.
c--- ctor
i Description- D., -LI '-:-.). 1
1B1. 1
-
1 ..
MIAMI SHORES VILLAGE, FLORIDA
BUILDING El
- 305-795-2204
ELECTRICAL CI
PLUMBING ,0 PERMIT 50 496 Contractor's
License No.
ROOFING AS \
PERMIT CARD MUST BE AVAILABLE FOR ALL INSPECTIONS )
MECH 0 Work to be performed under this Permit
N,
ft
63-4/630 FL
1035
$ C h °
DOLLARS 8
Date
i9P I 1
0. 1 9 /./k r
/
3781
A
20
Lt
Notary: 51_ o Q
M PR in- 10 Bond: , o
Radon:
V 7 Amount of
Project $
Permit:
Ci
7
•
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 anv
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 be assumes respon-
sibility for work done by his agents, s ry nts oreenciloies.
e • • " -
oigne9.• (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 1 assume responsibility for all work done by either, myself, my agent, servant or employee.
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ROOF =ET .-kAT) SY= D =LS (Drz
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DETAIL 1 & 2
Ai 77.1. (77-71.47;47
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P -Irs-tta_
job
ROOF PLAN
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11'1'1 :1'1111 "I "Ill Quilt") c)\vrl►•.►IS No FPICA HON I-nll ItOnl.Irl Col I' l)kit,\ 11OWi
\� II Prtiulnt lu II11•. , \111r.ndl.t "I II i; the tr.sllunsibility of the worm, cnnitat.10, In pluv'dc Iltr: uwncr
wuln
111c c.111111 01 10010% 1:0011, Ip 100vttIr IIIC IlwIICI with dins 3111tuulix ,Intl lo ctpinu' 10 IIIC Owl1Cf IIIC
1 roll ill 1il IIII 1 1t.11 111 I I1C 1uuY11101n ul Cltniticr )•I of IIIC smith I:Ioti IIIiItlln ( :uJr. (''il•t (:) g uvrin
the nlnunlun, Ic.1 tool sl.unlards of the indnslty for roofing syslcnn inttallnl'uns AtIdiliunnlly,
tine following items shook! Lc ndiiCSSCII ns pile, of the agteenient bCItvcco the uwnCt and the coon MAW
1 he osvnrt's 111111111 111 Iltc ntllarcnl Lux i dint the nein has been explained.
, \Ctlhrtit t \Yin %tilt :utshi11: • 1I'C tvulknunnshi provisions of Chapter )•1 Inc rut the purpose of
Inlivill log don Ihlr. inning; systrltl IIICI'ts Ilse wind ICSISIAIKc nod tvnlcl nsltusiuu (II:I fin ItuI%11L1 v111111111Idt.
r \rtlhclit :s (nppial mice) moils Inc inn a Cunsillctaliun (CtpCC) In tvulknlnnshill plivlsions Artlltclie
Riot.% such ns s.ul,o tit ntclu(ct Iw.II appcar.ntc., Ills( amt nil part of a rurli cuI1: shun,il be nil111esseIl ns
poll ul the ng,CCUtcnl 11c1Vrcen Iht uwnCI and IIIC Cunlrnclut.
7. Ile 1Yontl 1)echs: When Ieplacing roofing, Ills existing sums,, roof deck nlny have lo he
it in ut.s.nldnnci wilb (hr. omen! provision., of Chapter '19 ofliic ;l Ile (1I'c lout sks'k is usually
i siot nat d psnil to rrntovinh the cxislinr roof system)
V1 -■-■ . _ 11 CI in Ilunis: Continuo tools tic Ilsosc which hnvc uu visible dclurenuun bclwtcu
si i nn'I% (i C. Insvnhuusr.s, cuudnnniniunls, c(t.) In buildings with COnnnin Inu(s Ott ((wrong
t nil, nr.Iol uIdlul °wile., sh notify the uccupnnls of ndjaeen( units of fooling wutk Io he pct folioed
4 I:I pucJ ccilln 1
- I (,s: I :xpuscJ, open limn ccilln�s m e whc'c the 11'1(1011k ql the (uu( decking
.nn be •t,ewcd hunt below. The OtvIICI nosy wish l0 maintain the nicllilccluinl appear mice. !licitlotc
(outing t nil pcnr.l,aliunS of the undcrsiiIc of the dt:cking may nil be acceptable llic SI:1)C ps0vidcs the
option of ,11 ;111111111111,8 this 1(IpCalallCC
S. 1'nnllirtu 1Yalr.I : Ike r :Intent foul' syslcut nn.l /or deck of the budding cony nun Jinni writ Anil
icy cnnsc wale' to pond (nt.cunsulntc) in luw•Iying nicas of Ilse foul. f cnn Inc nu indicntinn °(
sit 11t.lsu.d 11i,11 cs% and may Icrluifr. Idle Icvit:sv of pfofessi0nnl SII uclssu a1 unginccs. funding only shun ten
Iltc lilt: expct.larsey and (id ruiluancc of the nCty roiling s I'untling conditions may Ili)! tic vidcnl
1111(11 Il1r, uliginnl 100111lg Syslcm is removed. I'ootli conditions Should be cottec(cd.
b. Ovcl flow Scupjscts (svnll models): II is required Thal rainwnIci flow off so dint Ilic tool i 1101
trvrllu;ulcd fI°lu n buihd no of tiller. I'crimcicrlcd1c mills Of nlhct tiul cxlr.otirnis fluty blut.k this
sliscb.rgt: if lives How Scupprts (wall oollels) me Ind ptuvidcd. 11 unny In: nrccss;sty (o • sulnll uvcillnw
st uppsa s ill act tildunce will' ('holden 7.1 of the SI'IIC.
Ycnlihnllun: hlusl loaf sitoclures should Wye sonic nLili(y 10 veto nn(ss s( airflow Ihruugh Ilse
inlet nil of the slruclurnl nssenbly (I building itself). The existing Ronson! of nllic vcntilnliun slush not
be reduced. 11 luny be beneficial to consider nddilionnl vesting which can result in extending the service
Itfe of the tool.
OIv11c►' .s(Agestra
tilgitaitire
Iplaint
',Hid Al'1'1• :111)1 :< "F"
&obi
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.
`07/25/00 13:16 FAX 3056337640 G&S BLDG SUPPLY
MIAMI-0ADE
BUILDING CODE COMPLIANCE OFFICE
• METRO -DADE FL.AGLER BUILDING
i-0 WEST FLAGLER STREET.: UtTE 1603
MIAMI. FLORIDA 33130-1563
(305) 375 -3901 FAN (305) 375.2905
1
CONTRACTOR LICENSING SECTION
(305) 375 -2527 FA ti (305) 375.255E
1 •
CONTRACTOR ENFORCEMIENT SECTION
(305) 375-2966 FAN (305) 375-2905
PRODUCT CONTROL DIVISION
Your application forlProduct Approval of: i (305) 375.2902 FAX (305) 372 -6335
Modified Bitumen Roof Systems Over Wood becks
under Chapter 8 of the Code of Miami -Dade County governing t} .e use of Alternate Materials and Types
Construction, and completely described herein, has been recomna :nded for acceptance by the Miami-Dad
County Building Code Compliance Office (BCCO) under the cd tditions specified herein.
This approval shall not be valid after the expiration date stated be ow. BCCO reserves the right to secure t
product or material at anytime from a jobsite or manufacturer's pi int for quality control testini.
If this product or material fails to perform in the approved mann4, BCCO may revoke, modify, or suspen:
the use of such product or material immediately. BCCO reserve the right to revoke this approval, if it is
determined BCCO that this product or material fails to meet the ti,.quirements of the South Florida Buildir.
Code.
PRODUCT CONTROL NOTICE OF ACCEPTAN1 CE
C S Roofing Products Company, Inc.
5525 MacArthur Blvd., Suite #900
Irving TX 75015
The expense of such testing will be incurred by the manufacturer
Acceptance No. -99- 1213.01
Expires:06 /19/2003 Raul Rodriguez I
Chief Product Control Divis:
THIS IS THE COVERSHEET, SEE ADDITIONAL PAC.' r-S FOR SPECIFIC AND GENERAL
1 CONDITIONS
BUILDING CODE Sc PRODUCT REVIEW COMMITTEE
I
This application for P roduct Approval has been reviewed by the R iCCO and approved by the . Building Co
and Product Review Committee to be used in Dade County, Plot :da under the conditions setjfort above.
r
,I
I O I
i
.'
Approved: 05/05/2000
1 of27
MIAMI -DADE COUNTY. FLORIDA
METRO -DADE FLAGLIf.R BUILDING
lj 001
I;
rancisco . Quintana, R.A.
Director
Miami -Dade Co.tniy
Building Code Compliance (
07/25/00 13:18
FAX 3058337840
GS Roofing Products Co., Inc. d /b /a CertainTeed
Applicant:
CS Roofing Products Company, Inc.
5525 MacArthur BI d.
Suite 900
Irving, TX 75038
Cateporv: Roofing
Sub - Category: I Modified, APP /SBS
Maximum
Material
Wood
Maximum Fire Classification
Sce General Limitation #1
TRADE NAMES OF PRODUCTS MANUFACTURED OR )LABELED BY APPLICANT:
Product 1
All Weather/Empire Base
Sheer
II I
Flex- l- GlasTM Base' Sheet
F1ex- l- GlasTM FR Base
Sheer
Flintglas® Ply Sheet Type
IV or VI
Flintlastic STA
Flintlastic GTA, GTA-FR
or Flintlastic Diamond
GTA
Flintlastic GTS
Flintlastic GMS /GMS
Premium
ROOFING SYSTEM APPRC: VAL
Design Pressures
Design Pressure
-45.0 psf
Dimensions
36" x 72'; Roll
weight. 86 lbs.
(2 squares)
36" x 108'; Roll
weight: 90 lbs.
(3 squares)
39 3 4" x 50'; Roll
weight: 90 lbs.
(1.5 squares)
36" x 180'; Roll
weight 40/55 lbs.
(5 squares)
39 3 4" x 33'; Roll
weight; 90 lbs.
,(I square)
39 3 x 33' 3 "; Roll
weight: 105 lbs.
(1 square)
39'/ x 24'9 "; Roll
weight: 92 lbs.
('h square)
39 1 /," x 34' 2 "; Roll
weight: 100/105 lbs.
(1 square)
C &S BLDG SUPPLI taj 00:
Test Product
Specification Description
ASTM D 2626 As halt coated, organic base sheet.
UL Type 15
UL Type G2
ASTM D 4601,
type II
UL Type G2
ASTM D 4601,
type II
ASTM D 2178
Type lV or VI
UL Type GI
ASTM 5147
ASTM D 5147
ASTM D 5147
ASTM D 5147
2
Product Control No: 99 -I 213.01
iI
Product Control No.: 99- 1213.01
Approval Date: Mav 05 2000
•
Expiration Date: June 19 2003
I
Mc ified Bitumen, coated fiberglass base
shec ..
Mo 'died Bitumen, coated fiberglass base
shec :.
Fib - glass, asphalt impregnated ply sheet.
Stn xh surfaced APP Modified Bitumen
men branc with non -woven polyesterimat
rcin orcement for torch application.
Graf ule surfaced, APP Modified Bitu nen
men brane with non -woven polyestermat
reinl 3rcernent for toch application. ' -
Gra ule surfaced. SBS Modified Bituy en
men branc with non -woven potycstcrrat
rein p 3rccment for torch application.
Grar ule surfaced SBS Modified Bitunrn
men brave with non -woven polyester'mat
reink )rcement for mop application.
"� 1
.07;25/00 13:16 FAX 1056337640 G&S BLDG SUPPL]
GS Roofing Products Co:, Inc. d/b /a CertainTced
EVIDENCE SUBMITTED:
Test Agency /Identifier Name
Applied Research ! Physical Properties
Laboratories
Factory Mutual Research
f ' ut.tut y tatttuat t%taltu%as
Corporation
Underwriters Laboratories,
Inc.
United States Testing
Company, Inc.
United States Testing
Company
Current Insulation
(FMRC 4470)
Fire Classification
Compliance
ASTM D5147
ASTM D 5147
Rcp,j rt
280!3
FMRC 994
RI16,56
97451 '-4
97- 45; -2R
Product Control No: 99- 1213.01
Date
06/02/87 ;
01/01/95 ,
07/13/87
06/03/88 .
12/02/87!
6
Frank Zuloi• RRC Product Control Examiner
11004
25 .0 11 13:16 F. 30563.3Ts4tt :< 5Li :. SIFFL'i
GS Rooting Products Co., Inc. d/b /a CcrcainTeed
APPROVED SYSTEMS:
Membrane Tvpe: APP NtODIFICD
Deck Type 11: Wood, insulated, New Consruction
Deck Description:
All General and System, Limitations apply.
Insulation Faste
Base Layer Tvp
one or more layers of any of the following
Approved Type.(s): HyTherm
Minimum: 1.3" x 3' x 4'
Approved Typc(s): ACFoacn -I1
Minimum: 1'/_" x 4' x 4'
Approved Type(s): Apache Pyrox
Minimum: 1.3" x 4' x 4'
Fastening:
i
'3 : " or grer,ter p!r'good or wood plank
N/ A
N/A
N/A
Approved Typc(s): E'irRG'Y -!, E'NRG'Y -2, PS1-25
Minimum: 1!!" x 3' x 4' NIA
Approved Typc(s): UltraGard Gold
Minimum: 1'/," x 4' x 4' NIA
Approved Type(s): Fiberglas
N'1inimum: f5 116" X 4' x 4' N/A
Approved Type(s): Periite
Minimum:' /," x 3' x N/A
.Approved Type(s): High Density Wood Fiberboard
Minimum: ' " x 4' x 4' N/A
Approved Type(s): Dens -Deck
Minimum: '/" x 4' x 4` N/A
tier Fastening
e Detail No.
(sec RAS 117)
insulations tinder those listed : ; Top Layer:
NIA
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N,•'A
insulation Fastener Fastening
Optional Too Layer Tvpe Detail No.
(sec RAS 117)
one or more layers of any of the following insulations
Approved Type(s): Sec Approved Insulations listed for Base Layer, ab ,ve.
Minimum: see Base Layer N/A N/A
lore: All insulation shrill be adhered to the anchor sheet in full mapp
EVT range and at a :rate o1 -40 lbs. Please refer to Miami -Dade Col
RAS 117 for insulation attachment. insulations listed as b: -i.e laver or
:t second layer of approved top layer insulation installed as the !Ina; m
insulation panels may be used as a top layer placed with the potyisocy
Anchor Sheet: One ply of GS G•.as Base, GS Flex.! Glas Base, F
mechanically attached as detailed below,
Product Contra! Na: 99- 1212.01
System Type A: Anchor sheet mechanically fastened; all lavers c insulation adhered approv
asphalt.
Fasteners
Per Board
N/A
N'A
N/A
N/A
N; A
NIA
NIA
Fasteners
Per Board
h' /A N/A
rigs of approved hot asphalt within the
me Rooting Application Standard
y shall be used only as base layers dth
:mhranc substrate. Composite
nuratc side facing down.
ex -1 Etas FR Base or GS Poly SMS as
Anchor sheet shall be lapped 4" and fastened wilt approved rooftnq nails and tit. cps
o,c. in the lap and two rows staggered
Fastener
Density
N/A
N/A
N/A
NIA
A
NIA
N/A
N/A
N/A
N/A
Fastener
Density
4 . r — 2$,.(10 1:3:1[3 FAX 3:)5 BL1 SI:Ft'LX
CS Roofing Products Co, Inc. dibfa Certain Teed
Ply Sheet:
Membrane:
Surfacing:
Maximum Design
Pressure:
Maximum Fire
Classification:
Maximum Slope:
(Optional) One ply of products listed under 'Arc.
Plintglas Ply She (Type IV) or Fiintglas Prerr.i
sheet in a full mopping of approved asphalt appl
20-40 lbs./sq.
Flintlastic STA, Flintlastic Diamond CIA, Flint
base or ply sheet.
(Optional) Install one of :he foilo•-■:ing:
1. 400 Ibisq. gravel or 300 lblsq. slag in a it .d coat of approved mopping asphalt r.:t
application rate of 60 Ibisq..
Karnak 97, APOC 212 Fibrattd Aluminum, 't4en7y 520 Aluminum or C.7:rundy AL -.1B
at an application rate of V: galiso..
-45 psf, See General Limitation g9
See Generai Limitation g I
Sec General Limitation
lc: Sheet' above, or one or more of
irr, Ply Sheet (Type VI) adhered :o Cast
cj within the EVT range and a: a
GTA o GTA-FR torch acthered
Product Control :So: 99
Ply heet (Optional):
Y One or more plies of Type G1. G2, "Pies- I -Glas
S�� case" or 'Flintlastic FR Base ". fully adhered with hot roofing asphalt.
`• - Membrane: "Flintlastic FR Cap ", fully adhered with hot roofing asphalt.
23. Deck: C -15/32 Incline: 1/2
Insulation (Optional): Glass fiber or perlite, hot mopped or mechanically
fastened. any thickness.
Base Sheet io O "Rex-I-Glas" or adhered with Henry Co. more of No. 200 or Gro Industries "No. 902" 902" FR 1-1 /2
gat/sq.
Ply Sheet (Optional): One or more layers of 61, G2, "Flex- I- Glas ",
"Flex -I -etas FR Base" or "Poly SMS Base Sheet", mechanically attached or
adhered with Henry Co. "No. 200" or Geo Industries "No. 902 ", at 1-1/2
gal /sq or adhered with hot asphalt.
Membrane: "Flintlastic FR Cap" or "Flintlastic FR /PG ", adhered with Henry
Co. "No. 200" or Geo Industries "No. 902 ", at 1 -1/2 gat /sq or hot
mopped.
24. Deck: NC Incline: 1/2
. Insulation (Optional): Polyisocyanurate, glass fiber or perlite, hot
` mopped or mechanically fastened, any thickness.
Base Sheet: One or more layers of "Flex- I -Glas" or "Poly SMS Base Sheet",
"Flex- I -Glas FR Base" or Type 62, mechanically fastened or adhered with
Henry Co. "No. 200" or Geo Industries "No. 902 ", at 1 -1/2 gal /sq.
Membrane: "Flintlastic FR Cap" or "Flintlastic FR /PG ". adhered with Henry
Co. "No. 200" or Geo Industries "No. 902 ", at 1 -1/2 gal /sq.
25. Deck: NC Incline: 1/2
Insulation (Optional): Glass fiber, pertite or potyisocyanurate, hot
moped or mechanically fastened, any thickness.
Base Sheet: One or more layers of "Flex- I -Glas" or Type G2, hot mopped
or mechanically fastened.
Ply Sheet Optional): One or more layers of G1, G2, "Flex- I- Glas ",
"Flex- I -Glas FR Base" or "Poly SMS Base Sheet ", mechanically attached or
hot mopped.
Membrane: "GTA Black Diamond ", "GTA White Diamond ", heat fused.
I Surfacing: Henry Co. Henry 520 Aluminum ", at 1 -1/2 s
i 26. Deck: NC g al / q
Incline:l
I Insulation (Optional): Any thickness, one or more layers UL Classified
I perlite, wood fiber, glass fiber, polyisocyanurate, polyisocyanurate/
composite, EPS /wood fiber, EPS /perlite, EPS /composite or Partek
Insulation Inc. "PAROC" roof insulation,
Base Sheet One or more layers Type 61 or G2.
Membrane: One or more layers "Flintlastic GTA" or " -STA" (modified
,„ bitumen), heat fused.
i
Surfacing: Fields Corp. "F530 Heat Shield Aluminum Coating" or "F630
Heat Shield Fibered Aluminum Coating ", 1 -1/2 gal /sq.
• 2 Deleted
i 28. Deck: C -15/32 Incline: 1/2
. Insulation (Optional): Glass fiber or perlite, hot mopped or mechanically
I fastened, any thickness.
( . -:' Base Sheet: One or more layers GS Roofing Products "Flex- i -glas" or
.-;AF - "Flintlastic FR Base ", fully adhered or spot mopped with "MBA Gold
'5Z Adhesive" at 1 -1/2 gal /sq or mechanically fastened.
-.- Pty Sheet (Optional): One or more layers Types 61, G2, GS Roofing
I Products "Flex- i- glas ", "Flintlastic FR Base" or "GS Polybase ", adhered
with "MBA Gold Adhesive ".
Membrane: GS Roofing Products "Flintlastic FR Cap ", adhered with "MBA
Gold Adhesive" at 1 -1 2 gal /sq or hot mopped.
T -
Insulation (Optional): Isocyanurate, 2 in. min, glass fiber 1 in.
R Sheet Two or more layers Type G2 "Glasbase ", first layer mechanically
ened.
mbta
C -15/32 Incline: 1/2
Cation (Optional): Isocyanurate, 2 in. min, glass fiber 1 in. min.
rtt Treatment- Two in. wide aluminum foil tape adhered to the
•; .d joints.
Sheet One or more layers Type G2 "Glasbase ", mechanically
ned-
rane: One layer "GTA /FR ", torch applied.
NC` Incline: 1 -1/2
on (Optional): Polyisocyanurate, glass fiber, wood fiber, perlite,
nically fastened or hot mopped in place.
eet: One or more layers Type G2 base sheet, mechanically
or hot mopped in pla
(Optional): One or more layers Type 61, mechanically fastened
opped in place.
e: One layer "GTA /FR ", torch applied.
02 • Incline: 1/2
(Optional): Glass fiber or perlite, hot mopped or mechanically
city thickness.
One or more layers GS Roofing Products "Flex- i -glas" or
Air
LOOK FOR MARK 0
•
•
Ply Sheet (Optional): One or more layers Type 61, G2. gat ...
Products "Flex- i- glas ", "Flintlastic FR Base" or GS Polybase GS adhere
with ' ;MBA Gold Adhesive'.
Membrane: GS Roofing Products "Flintlastic FR Cap ", adhered with "M3,1
Gold Adhesive" at 1-1/2 gat/sq or hot mopped.
33. Deck: C -15/32 Incline: 1/2
Insulation (Optional): Glass fiber, perlite 3/4 in„ thick min, mechanically
fastened.
Base Sheet One or more plies Type G2, hot mopped or mechanically
fastened,
Ply Sheet: One or more plies Type GI, hot mopped.
Membrane: "Modified Premium Cap Sheet 960 ", hot mopped.
34. Deck: NC Incline: 1/2
Insulation (Optional): Glass fiber, perlite, isocyanurate, mechanically
fastened,
Ply Sheet (Optional): One or more plies Type 61, hot mopped or
mechanically fastened.
Base Sheet: One or more plies Type G2, hot mopped or mechanically
fastened.
Membrane: "Modified Premium Cap Sheet 960 ", hot mopped.
35. Deck: NC Incline: 1/2
Insulation: Glass fiber, wood fiber, pertite or polyisocyanurate, any
thickness.
Base /Ply Sheet: One or more layers of Type G1 or G2, mechanically
fastened or hot mopped in place.
Membrane: "Flintlastic STA ", "Flintlastic STA Plus ", "GTA ", "GTA Black
Diamond" or "GTA White Diamond ", heat fused.
Surfacing options:
A. Tropical Asphalt "120 AF ", applied at 1 -1/2 gal /sq.
8. Karnak Corp. "No. 97 AF ", applied at 1 -1/2 gal /sq.
C. Henry Company "No. 520 ", applied at 1 -1/2 gal /sq.
D. Grundy Industries "A(MB AF", applied at 1 -1/2 gal /sq.
E. Monsey's "Premium Long Life Aluminum ", applied at 1 -1/2 gal /sq.
F. Monsey's "Fibered Asphalt Emulsion ", applied at 3 gal /sq.
G. Henry Company "No. 107 Emulsion ", applied at 3 gal /sq.
36. Deck: C -15/32 Incline: 1/2
Insulation (Optional): Glass fiber or perlite, hot mopped or mechanically
fastened.
Base Sheet: One or more layers of Type G5 Roofing Products "Flex- i -glas"
or " Flintlastic FR Base ", adhered with MBA Gold Adhesive" at 1 -1/2
gal /sq.
Ply Sheet (Optional): One or more layers of G1, G2, GS Roofing Products
"Flex- i- glas ", "Flintlastic FR Base" or "65 Polybase ", adhered with "MBA
Gold Adhesive" at 1 -1/2 gal /sq.
Membrane: G5 Roofing Products "Flintlastic FR Cap ", adhered with "MBA
Gold Adhesive" at 1 -1/2 gal /sq or hot mopped.
Class B - Fully Adhered
Deck: NC Incline: 1
Vapor Retarder (Optional): Type G2 "Glasbase" base sheet or UL
Classified vapor retarder.
Insulation (Optional): One or more layers or combination of the
following: UttraGard Premier, polyisocyanurate, perlite, glass fiber or
wood fiber insulation,
Base Sheet: One layer Type G2 "Glasbase" base sheet.
Membrane: One layer "Flintlastic STA" (modified bitumen), heat fused.
Surfacing: Karnak "No. 97 Fibrated Aluminum ", at 1 -1/2 gal /sq.
Deck: C -15/32 Incline: 1/4
Vapor Retarder (Optional): Type G2 "Glasbase" base sheet or UL
Classified vapor retarder.
Insulation (Optional): One or more layers UL Classified perlite or glass
fiber.
Base Sheet One layer Type G2 "Glasbase" base sheet.
Membrane: One layer "Flintlastic GTA, GTS" (modified bitumen), heat
fused or "Flintlastic GMS ", hot mopped.
Surfacing: APOC "No. 212 Fibrated Aluminum ", at 1 -1/2 gal /sq.
Deck: C -15/32 Incline: 1/4
Vapor Retarder (Optional): Type G2 "Glasbase" base sheet or UL
Classified vapor retarder.
Insulation (Optional): One or more layers or combination the following:
Ultragard Premier, polyisocyanurate, perlite, glass fiber or wood fiber
insulation.
Base Sheet Two layers Type G2 "Glasbase" base sheet.
Membrane: One layer "Flintlastic STA" (modified bitumen), heat fused.
Surfacing: Karnak Chemical "No. 97 Fibrated Aluminum', at 1 -1/2 gal /sq.
4. Deck: NC Incline: 2
Insulation: Glass fiber, perlite, wood fiber, 2 -1/2 in. max, mechanically
fastened or adhered with hot roofing asphalt.
Base Sheet Type G2, mechanically fastened or adhered with hot roofing
asphalt
Membrane: 'GMS ", "GMS Premium', adhered with hot roofing asphalt.
N PRODUCT
. CS Roofing Products Co., Inc. d /b /a CertainTeed
Product Control No: 99 - 1213.01
I II Wood Deck System Limitations:
1. Application shall be perpendicular to the slope on slopes of 1:12. All si e Zaps shall be nailed 6" o.c.. All
applications with a : slope in excess of 1:12 shall be applied parallel with 'he slope (strapped) with end laps!
backnailed 6" o.c.
Yosumitc0 Mineral Surfaced Cap Sheet, #30 bast sheet shall be used or ly with
Sheet.
3 All Weather/Empire Base Sheet may be used with all top ply membrane
4
A slip sheet is required with Ply 4 and Ply 6 when used as a mechanical) • fastened base or anchor sheet.
I
GENERAL LIMITATIONS:
1 Fire classification is not part of this acceptance, refer to a current A
ratings of this product.
2 Insulation may be installed in multiple layers. The first layer shall be
Approval guidelines.. All other layers shall be adhered in a full moppi
EVT range and at a rate of 20 -40 lbs. /sq., or mechanically attached us
3 All standard panel sizes are acceptable for mechanical attachment.
shall be 4' x 4` maximum.
4 An overlay and/or 'recovery board insulation panel is required on all a
when the base sheet is fully mopped. IF no recovery board is used
mopping with approved asphalt, 12" diameter circles, 24" ac.; or stri
each sidelap and one down the center of the sheet allowing a Conlin
scrips is not acceptable. A 6" break shall be placed every 12' in each
application of either system shall be at a minimum rate of 12 Ibsisq
limited to a maximum design pressure of-45 psf.
5 Fastener spacing for insulation attachment is based on a Minimum Ch
tested in compliance with Testing Application Standard TAS 105. Ifth
275 Ibr insulation attachment shall not bc acceptable.
6 Fastener spacing for mechanical attachment of anchor/base sheet or me
fastener resistance value in conjunction with the maximum design valu
the fastener resistance be less than that required,•as determined by the B?
prepared signed and.scafed by a Florida Registered Engineer or Arch4
spacing shall utilize the withdrawal resistance value taken from Miami -
Standards TAS 105 and calculations in compliance with Miami -Dade R
7 Perimeter and corner areas shall comply with the enhanced uplift
compliance with Chapter 23 of the South Florida Build:
0 erod Fas
insulation and base sheet as calculated in compliance with Miami -Da
RAS 117. (When this limitation is specifically referred within this
applicable.) 1
8 All attachment and'sizing of perimeter nailers, metal profile, and/or flag'.
with Miami -Dade County Roofing Application Standard RAS 1 1 1 and t)'
of the South Florida Building Code.
9 The maximum designed pressure limitation listed shall be applicable to
perimeters, and corners). Neither rational analysis. nor extrapolation sha
enhanced pressure zones (i.e. perimeters, extended comers and corners)1
referred within this NOA, General Limitation an will not be applicaji
26
pp oved Roofing Materials Directo�y for fire
al ached in compliance with Product Control
nk of approved asphalt applied with the
inl! the fastening pattern of the top lyer
W en applied in approved asphalt, pane! size
1
14 lications over closed cell foam insulations
t to base sheet shall bc applied using spot
F mopped!8" ribbons in three ros, one at
tl ws area of ventilation. Encircling of the •
ibbon to allow cross ventilation. Asphalt
Note: Spot attached systems shall bc
Asir cteristic Farce (F') value of 275 Ibf., as
fastener value. as field- tested, are below
brave attachment is based on a r I inimum
listed within a specific system. Shou:d
ilding Official, a revised fastenerspacing,
t may be submitted. Said revised fastener
I lade County Testing Application,'
ofing Application Standard RAs11 17.
tees or these areas,
I ener densities shall be increased 'ulaa:d in
for both
Standard '
1 nut be
le County Roofing Application
IOA, General Limitation #9 w
ing termination designs shall cot4orm
e wind load requirements of Cha ter 23
11 roof pressure zones (i.e. field.
1 be permitted for enhanced faste at
(When this limitation is specifically
ile.) II
� I
Yosemite Mineral Surfacie Cap
I
I I
II
07 .• 25 •' i3il
13 :31 FAX ..O563:37:34o (:;:5 BLC:•r: SUPPED
CS Roofing Products.Co., Inc. dib!a CcrtainTced
GS Roofing Products Co.. Inc. dlbia CertAinTeed
P.O. Bex 560
Valle~. 19481
NOTICE OF ACCEPTANCE STANDARD C )ND1TlQ. S
Rene••'a' of this Acceptance (approval) shall ire considered after a rent_ val application, has been treed and u;c
original submitted documentation, including test sup:or.ing data. engi: eering documents, are no older titan
eiczhc (3) years.
Any and all approved products shall be permanently labeled with the n i,ufaccureds name, city, state, and ±:
following statement: "Miami-Dade County Product Control Approved , or as scedifically stated in
Specific conditions of this Acceptance.
3 Renewals of Acceptance will not be considered if: �. Code affec ing the evaluation of
There has been a change in the South Florida Buildin
the product is not in compliance with thc code changes:
The product.is no longer the same product (identical) as the one o
If the Acceptance holder has not complied with all :he requiremen
correct installation or thc product;
The engineer who originally prepared, signed and sealed the requt
is no longer practicing the engineering profession.
4 Any revision or change in the materials, use, andior manufacture of the product or process shall automat:_all.'
be cause for termination of this Acceptance, unless prior :written appros 1t has been requested (through the
fling of a revision application with appropriate fee) and granted by thi. office.
5 Any of the following shall also be grounds for removal of this Acceptat
a) Unsatisfactory performance of this product or process; product, ft: • sales; advertising or any other
b) Misuse of this .Acceptance as an endorsement of any pr
purposes. • 6 The Notice of Acceptance number preceded by the words 1 fame D r o ,o f the Not
of n r and d by the is
expiration date may be displayed in advertising literature.
displayed, then it shall be done in its entirety.
7 A copy of this Acceptance as well as approved drawings and other doct rents, where it applies, shall be
the manufacturer or its distributors and shall be .vailable for inspection at the job site
provided to the user by ,Weer
at all times. The copies need not be resealed by the cni z
8 Failure to comply with any section of this Acceptance shall be cause fo' termination and removal of
Acceptance.
9 This Acceptance contains pages i through 37
END OF THIS ACCEPTANCE•
a)
b)
c)
d)
Product Control No: 99-
ACCEPTANCE NO: 99-121
A PPROVED: Nix/ Oi_
EXPIRES: Junc 1° =i1
the
this product a..:1
iginalty approved;
s of this acceptance. including the
cd documentation initially submitted,
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
n ( Date G Job Address 9(3/. � � Tax Folio
Legal Description y �Historically Designated: Yes No /
Owner/Lessee / Tenant �C' /111/0 J Master Permit # cad'
Owner's Address L 9 c7s -- m //cw 05/5g Phone CC) S ) 75 (c' /c
Contracting Co. Address
Qualifier ----
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL
Mechanical
(JIn F ra //T Itetrf &44)/
Square Ft. Estimated Cost (valu
Signature of owner and/or Condo President Date
/� , 7 VING FENCE SIGN
WORK DESCRIPTION Q'7 t n /O 9 / /�(/� . �[�it 7 le fc)
2r o 7
WARNING TO OWNS r, : YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do the ork stated.
Notary as to Owner and/or Condo President Date Notary as to Co tr ctor or Own e ,$Wider
My Commission Expires: My Commissi
C
6e or
ci 3-0
FEES: PERMIT 5 = ' RADON C.C.F. 4 NOTARY .� BOND
APPROVED: TOTAL DUE J 6 4:72
IV
O F FA
OFFICIAL NOTARY SEAL
S MARGARITA MONTIEL
MY Ps IOa E - ad
DEC. 17,2002
Date
Zoning Building Q / f X /yam Electrical
1 alf�`�c7
Plumbing Structural Engineer
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
MIAMI SHORES VILLAGE, FLORIDA
❑
DATE
o PERMIT N9 7772
0
Work to be performed under this Permit
CONTRACTOR OR BUILDER
Contractor's
License No.
y 19
Legal Lot
Description II BI vision
Address of •� ` w' Value of a I Amount of
Building i' - r Project $ 1 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 he assumes respon-
sibility for work done by his agents, servants or employees.
Signed �;� ` , e ' INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder ir3 "compliance with ae 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 as
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY ABBOT
PERMIT 'N? 13107
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
I
n
MIAMI SHORES VILLAGE, FLORIDA
Work to be performed under this Permit
BL
Subdi-
vision
Value of
Project $
DATE .x
Contractor's
License No
Amt. 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 or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed • BY
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 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, my agent, servant or employee.
CONTRACTOR Olt BUILDER.
BY AUTHORITY
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Date 4/18 , 19 52
Owner's Name and Address_111..___2,___Craig No. 9500 Street_ n_ 1st AV_O.a
Name and address of licensed contractor__$.___S..___&arner_,_ 9200 i1W _`lnd Avg ; .Miami
Location and legal description of lot to be built on:
Lot Block Subdivision y�
Street and Number where work is to be done____ 1QQ �i'a.�� gZi , . �f iOr 9k' �____________
State work to be done and purpose of building (by floors )___RQOi
— — — — — — — — and for no other purpose.
New Building a. Remodeling Addition Repairs No. of Stories____1____ ____ __________
To be constructed of Kind of foundation Roof Covering_ __ 1.
Estimated Total cost of improvements $ 980e Amount of Permit $ 5•00
Zone cubage required _Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to-- -G,iffen - - -Ind tr- i- es-,---S nc.--- Pa- 4- ..Hax--- 6.3 ,31 CQral__ able- s,-- - -F'la._
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The 'undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Signed) __
R. K. Thompson,
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by.him stated are true.
Permit No
Disapproved
( Signed)
Date
ilding Inspector q J
Chairman a
Member
Member
Council Approved Date
Date
PLANNING BOARD DATE
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
Member
Member
Member
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 - pection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materi• and /or workmanship.
"•ac ��. &. Treas.
to me well known,