685 NE 97 St (6)Date 6 -8 -00
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 685 N . E . 97 Street Tax Folio // i' D/? / 9 20
Legal Description Historically Designated: Yes / / No
#V
Owner/Lessee / Tenant Bill 'p G A4 Master Permit # + t0
Owner'sAddress 685 N.E. 97 Street Miami Shores Phone 756 -7252
ContractingCa Quality Roofing Contractor, Inc.
Address 13800 N.W. 1st Avenue
Qualifier Carlos Arocho SS# Phone 751-0382
State # RC 0 0 5 8 6 2 7 Municipal # Competency # 17889 Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Tear off old roof to wood deck, tin cap 301b. ASTM felt, install
galvanized eave drip and valley metals where required, mop on with type III aspha
one layer of 91b. felt, install\fa A eo1A O olorthru tile with polyfoam adhesive
setting.
Square Ft. 37 s q. Estimated Cost (value) $ 14,800.00
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner an . or Condo President
Notary as to O ; er and/or Condo Presi •. nt ate
My Commission Expires:
FEES: PERMIT 'YV RADON
.; > MARYLOU HERNANDEZ
▪ MY COMMISSION # CC 680474
EXPIRES: October 10, 2001
A,,,, d:,, • Bonded Thru Notary Public Underwriters
APPROVED:
Zoning
Mechanical Plumbing
C.C.F.
�.� 6 //o
Signature of Contractor or Owner- Builder Date
Notary as to Contra tor or Owner - Builder
My Commission Expires:
ti; ; ; P i MARYLOU HERNANDEZ
�.� ,a∎ MY COMMISSION # CC 880474
• i ' ' ` - EXPIRES: October 10, 2001
- A; o ..... Bonded Thru Notary Public Underwriters
NOTARY " ' BOND 7e0
TOTAL DUES
Building Electrical
Engineering
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
00R308958 2000 JUN 27 11:13
PERMIT NO. TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Legal description of property and street address: 6 8 5 N .E . 97 Street
Miami Shores, Florida 33138
2. Description of improvement: Reroof to a new tile roof.
3. Owner(s) name and address: Bill /Joel yy o i
Interest in property: Owner
Name and address of fee simple titleholder: N/A
NOTICE OF COMMENCEMENT
685 N.E. 97 Street Miami Shores, Florida 33138
4. Contractor's name and address: Quality Roofing Contractor, Inc .
13800 N.W. 1st Avenue Mlami, Florida 33168
5. Surety:(Payment bond required by owner from contractor .if afyb FLORIDA, COUNTY OF DADE
Name and address: N/A E. REBY CERTIFY h ,
0
filed in this office o,, day of
, A D 20_
y hand and Official Seal.
, LE • K, of
it and County Courts
1
' ;n;,.
NESS
Cou
G X'
Amount of bond $ 0 0
6. Lender's name and address:
c.
7. Persons within the State of Florida designated by Owner upon whom nt) -s or oth ocuments may be s -- 7 - 1 "- provided
by Section 713.13(1)(a)7., Florida Statutes,
Name . and address: N/A
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: N/A
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
Signature of owner
Print Owners Name
Notary Public
Print Notary's Name
My Commission Expires:
/ '( 2
Noe( fiec
Prepared by: Carlos Arocho
Sworn to and subscribed before me this 1y day of 4LA4,14._.1 Quality Roofing Contractor,
Address: 13800 N.W. 1st Avenue
Miami, Florida 33168
L .__4
1 MAR n U HERNgNDEZ
I ±,��i"a; r EXPIRES: October 10, 2001
123.01 -52 10,98
Contractor's Name
❑ (Low Slope Application)
- 'J ( ob Address: ( 7 Z ) )E . q
ROOF CATEGORY � /
❑ (Nail -On Tile) iMortar Adhesive Set Tile)
❑ (Asphalt/Fiberglass Shingles) ❑ ( Metal Roofs \Wood Shingles & Shakes) ❑ (Other)
ROOF TYPE
❑ New Roof iRe ' ❑ Recovering ❑ Repair ❑ Maintenance
Flat Roof Area (ft2) —0 Sloped Roof Area (ft 3 S Total (ft • ,3t? 3 9 , Master Permit No.
Exposure category (per ASCE 7 -88): c_ Building Classification category (per ASCE 7 -88 table 1): .w
Ft.
Ft.
v
A
v
Deck ty . :
ATT CHMENT
Fastener Type:
SPACING
Field: Perimeter: Co ' er:
DETAIL 1 & 2
ROOF HEIGHT AND SYSTEM DETAILS
(Draw details as needed)
ROOF PLAN
123.01 -78 4/99
Appendix "E"
UNIFORM ROOFING PERMIT APPLICATION
PROCESS No.
Page -1
D '
(Pmaxl: 9g .3 x X
(Pmax2:)O3,9 x X
(Pmax3jD3,'7 x X
Appendix "E"
UNIFORM ROOFING PERMIT APPLICATION
PROCESS No.
(Aerodynamic Multiplier): 1 n
(Aerodynamic Multiplier): 30. Dr? ) - M:-3O = Mr2: z3 / PCA: ( 1 6 41
(Aerodynamic Multiplier):
30.01 )- M = M r 3 4 3 PCA: 81101
Deck type:
Lt9O od Vie
Ridge Ventilation?
1 Al in
MEAN HEIGHT /
3'
Underlayment:
® Insulation:
12"
ROOF SLOPC
D E T A I L 3
SLOPED SYSTEM DESCRIPTION
30 )Jo, A
10
Fastener type & spacing:
Cap Sheet:
Roo
1 t
I l - A sho,44,L lCt.'I
9 o )1 k&TAA
Covering:
Drip edge:
Flt, n . e rl` . 1-€.T tc-, vwn
ukr
otla- ` vat1,1t
12 l'1 17-4
d.(osa - jaloc, . 7.c e��.te w` �✓�
ATTACHMENTS REQUIRED
I) Fire Directory Listing Page
2) Miami -Dade County Product Control
Notice of Acceptance -Cover Sheet
a) Specific System Description
h) Specific System Limitation
c) General Limitations
d) Applicable Detail Drawings
3) Municipal Permit Application
4) Other Component Approvals
TILE CALCULATIONS OeS,jt ° -
20 Ill ) - M ( 3 0 =M 1 PCA: 36.(vg
APPENDIX "F"
REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS
As it pertains to this Appendix "F ". it is the responsibility of the roofing contractor to provide the owner with the
required roofing permit, to provide the owner with this appendix and to explain to the owner the content or this
form. The provisions of Chapter 34 of the South Florida Building Codc (SF13C) govern all the minitnt :
requirements and standards cf 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.
t./ 1. Aesthetics - workmanship: The workmanship provisions of Chapter 3; are for the purpose of
providing that the roofing system meets the wind resistance and water intrusion performance standards.
Aesthetics (appearance) issues 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 thc contractor.
�2. Renailing \Vootl Decks: When replacing roofing. the existing wood roof deck may have to be renai'ed
in accordance with the current provisions of Chapter 29 of the SFBC. (The roof deck is usually concealed prior to
removing the existing roof systcm)
Common Roofs.: Common roofs are those which have no visible delineation between nei�_hboriag
units (i.e, townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and /or
owner should notify the occupants of adjacent units of roofing work to be performed.
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 n::il
penetrations of the underside of the decking may not be acceptable. The SFBC provides the option of maintaining
this appearance.
�. Ponding Water: The current roof system and /or deck of the building
and accumulate may not drain well and may water to
P (accumulate) in low-lying 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 thc new roofing systcm. Ponding conditions may not be evident until the original
roofing, system is removed. Ponding conditions should be corrected.
. Overflow Scuppers (wall outlets): It is required that rainwater flow off so that the roof is no:
overloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge
overflow scuppers (wall outlets) arc not provided. It may be necessary to install overflow scuppers in accordance
with Chapter 23 of the SFBC.
7. Ventilation: Most roof structures should have some ability to vent natural airflow through the i :.terio:
of the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. I:
may be beneficial to consider additional venting which can result in extending the service life of the roaf.
S. The owner may contact the h•lianti•Dadc County Consumer Services Department for ft:rthc:
information regarding the above.
Owner's /Agent's Signature
Date Contractor's Signature
M
BUILDING CODE COMPLIANCE OFFICE
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET, SUITE 1603
PRODUCT. CONTROL NOTICE OF ACCEPTANCE MIAMI, FLORIDA 3317-193
Monier Lifetile LLC (305) 375-2901
FAX (305) 375 -2908
135 NW 20 St.
Boca Raton, Florida 33431 PRODUCT CONTROL•DIVISION
(305) 375.2902
FAX (305) 372-6339
Your application for Product Approval of
Monier Lifetile LLC Villa, Capri, & Roll Tiles
under Chapter 8 of the Miami -Dade County Code governing the use of Alternate Materials and Types
of Construction, and completely described in the plans, specifications and calculations as submitted by:
Redland Technologies, The Center for Applied Engineering, Inc., and Professional Service
Industries
has been recommended for acceptance by the Building Code Compliance Office to be used in Dade
County, Florida under the specific conditions set forth on pages 2 -14 and the standard conditions on
page 15.
This approval shall not be valid after the expiration date stated below. The Building Code Compliance
Office reserves the right to secure this product or material at any time from a jobsite or manufacturer's
plant for quality control testing. If this product or material fails to perform in the approved manner, the
Building Code Compliance Office may revoke, modify, or suspend the use of such product or material
immediately. The Building Code Compliance Office reserves the right to revoke this approval, if it is
determined by the Building Code Compliance Office that this product or material fails to meet the
requirements of the South Florida Building Code.
The expense of such testing will be incurred by the manufacturer.
ACCEPTANCE NO.: 97- 1124.16
EXPIRES: 06/25/01
THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
CONDITIONS
BUTLDING CODE COMMITTEE
This application for Product Approval has been reviewed by the Miami -Dade County Building Code
Compliance Office and approved by the Building Code Committee to be used in Dade County, Florida
under the conditions set forth above.
Charles Danger, P.E.
Director
APPROVED: 06/25/98 Building Code Compliance Dept.
Miami -Dade County
Internet mail address: postmaster @bulldingcodeonllne.com
Revises: 95- 0322.07
95- 0322.03 .
' 95- 03I6.04
METROPOLITAN CADE COUNTY, FLORIDA
METRO -DADE FLAGLER BUILDING
aul Rodriguez
Product Control Supervisor
Homepagef http J /www.buildIngcodeonllne.com
•
riMONIER LYF'ETn LLC
• TRADE NAMES OF PRODUCTS MA].; •
• , LABELED BY APPLIC.•t .
Test
Product
Dimensions Specifications
Monier Lifetile 1= 16i" PA 112
LLC Villa & Roll w m fl3"
''A" thick
97- 1124.16
high
;te roof tile
hole and
-ect deck or
r or
S.
Monier•Lifeitile L = 17° •
LLC Capri Tile W= , PA 112 L' high
12 4
'A" thick a roof tile
Trim Pieces
I = varies PA 112 /+
w = varies roof
F' cs, ridges
varying a ::
thickness
TRADE NAMES OF PRODUCTS MAN _
LABELED BY APPLICAN
e and
c : deck or
profile.
Test
Dimensions mensions Specifications ..
racturer
Rainproof II 30" x 75' roll
PA 104 Sind. •0 -Wra
3 6 "x75'roll p,
uncle
or 'nc.
60" x 75' roll 2., 5 went NOA)
edg_
Ice and Water 36" x 75' roll
Shield PA 103 Self- ^ race Co.
uncle: - rent NOA)
Page 2 of 15
Roo:..
finer
Wood Battens
Tile Nails
Tile Screws
Roof Tile Mortar
( "TileTiterM ")
Roof Tile Mortar
( "Quikrete® Roof
Tile Mortar
#1140 ")
Roof Tile Mortar
( "BONSAL®
Roof Tile Mortar
Mix ")
Roof Tile
Adhesive
( "Polypro®
A H 160 ")
Product
Hurricane Clip &
Fasteners
Dimensions
Vertical
Min. 1;x 4"
Horizontal
Min. 1 "x 4" for use
with vertical battens
or
Min. 1 "x 2" for use
alone
Min. 8d x 2 'A" or
min. 10dx 3"
#8x 2 '' /" long
0.335" head dia.
0.131" shank dia.
0.175" screw thread
dia.
N/A
N/A
N/A
N/A
Clips
Min. 'A" width
Min. 0.060" thick
Clip Fasteners
Min. 8d x 1 ''4"
Test
Specifications
Wood Preservers
Institute LP — 2
PA 114 Appendix E
PA 114 Appendix E
PA 123
PA 123
PA 1.23
See PCA
PA 114 Appendix E
Page 3 of 15
Product Control No.: 97- 1124.16
Product
Description
Salt pressure
treated or decay
resistant lumber
vattens
Corrosion resistan
screw or smooth
shank nails
Corrosion resistant,
coated, square
drive, galvanized,
coarse thread wood
screws
Prepared mortar
mix designed for
mortar set roof tile
applications.
Prepared mortar
mix designed for
mortar set roof tile
applications.
Prepared mortar
mix designed for
mortar set roof tile
applications.
Two component
polyurethane
adhesive designed
for adhesive set
roof tile
applications.
Corrosion resistant
clips with corrosion
resistant nails.
Manufacturer
generic
generic
generic
Bermuda Roof
Company, Inc. with
current PCA
Quikrete
Construction
Products with
Current PCA
W. R. Bonsai Co..
with current PCA
Polyfoam Products,
Inc.
PCA #94- 0401.0l
Generic
aga,
Roofing Product Control Examiner
MONTaR LIFETILE LLC Product Control No.: 97- 1124,16
SYSTEMS
(CONTINUED)
Deck Type: Wood, Non- insulated
Deck Description: New construction 19 /32" or greater plywood or wood plank.
SYSTEM D: Mortar or Adhesive Set Application
Slope Range: 2 ":12" to 7 ":12"
Note: System D is only acceptable in this slope range. For slopes in excess
of 7 ":12 ", refer to System C.
Underlayment:
Roofing Tile:
Comments:
Install underlayment system in compliance with Dade County Application
Standard PA 120. (See System Limitation #5.)
Install tile in compliance with Dade County Application Standard PA 120.
(See "Data for Attachment Calculations" included in this Approval.)
1. For re -roof applications, 15 /32" plywood is an acceptable substrate.
Page 9 of 15
Zuloaga, RRC
Roofing Product Control Examiner
MONIER LIFETILE LLC
SYSTEM LIMITATIONS
Product Control No.: 97- 1124.16
1. The standard minimum roof pitch for Monier Lifetile LLC Villa,
Monier Lifetile LLC Roll, low profile tile shall comply with Dade ounty Application Stand
PA 1 18, PA 119 or PA 120, depending on the method of installation.
2. For nail -on applications, fasteners for mechanical attachment of tiles shall have a head diameter
larger than that of the preformed holes in the tile.
3. System installation shall be in compliance with the system specifications outlined n this Product
Control Approval. The method of attachment utilized shall provide sufficient attachment resistance
to meet or exceed the required resistance determined in compliance with Dade County Protocol PA
115 or PA 127. Tile profiles listed here in have been tested for both wind characteristics and static
uplift performance, therefore, attachment calculations for installation in compliance with PA 115 or
PA 127 shall be done as a 'Moment Based System'.
4. For adhesive set tile applications, a field static uplift test by a Dade County accredited testing
agency, in compliance with Dade County Protocol PA 106, shall be performed.
5. For tile applications, 30/90 hot mopped underlayment applications may be installed perpendicular
to the roof pitch unless stated otherwise by the underlayment material manufacturer's published
literature.
6 All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo for
identification in the field.
7 . Applications for roofing permits shall include a completed Section 11 of the Uniform Building
Permit, a copy of manufacturer's current specifications and details, a copy of this Product Control
Approval and a copy of the Product Control Approval of any Roofing Component used in the
proposed tile application. Reference shall be made to appropriate data for the required fire rating.
8. The applicant shall retain the services of a Dade County certified testing laboratory to maintain •
quality control in compliance with the South Florida Building Code and related protocols. Samples
taken shall be in compliance with Dade County Protocol PA 112, Appendix 'A'.
9. Fire classification is not part of this aceptance.
Page l0 of 15
Frank Zuloaga, RRC
Roofing Product Control Examiner
Table 1: Aerodynamic Multipliers - X (ft')
Tile
X (ft')
X (ft')
Profile
Batten Application
Direct Deck Application
Monier Lifetile LLC Villa Tile,
0.27
0.29 .
Roll Tile, and Capri Tile
Direct
Deck
Batten
s
Table 2: Restoring
Moments
4 ":12"
due to Gravity
5 ":12"
- M (ft -Ibf)
6 ":12"
7 ":12" or
greater
Tile
Profile
3 ":12"
/
Approved
Eave Clip
With:
Batten
s
Direct
Deck
Batten
s
Direct
Deck
Batten
s
Direct
Deck
Batten
s
Direct
Deck
Batten
s
Direct
Deck
Monier
Lifetile LLC
Villa Tile,
Roll Tile,
and Capri
Tile
5.57
6.30
5.48
6.18
5.37
6.05
5.24
5.90
5.09
N/A
Table
3: Attachment Resistance Expressed as a Moment - Mf (ft-Ibf)
for Nail -On Systems
Tile
Profile
Tile
Application
Approved
Nails
Approved
Screws
Approved
Field Clip
With:
Approved
Eave Clip
With:
1 nail
2 nails
1
screw
2
screws
1 nail
2 nails
1 nail
2 nails
Monier
Lifetile LLC
Villa, Roll,
and Capri
Battens
4.10
7.10
22.90
49.10
24.20
34.80
22.10
32.20
Direct Deck
•
11.80
21.90
25.80
47.10
24.30
35.50
19.00
31.90
MONTER LIFETILE LLC
DATA FOR ATTACHMENT
CALCULATIONS
Product Control No.: 97- 1124.16
l D a t a no in T 3 is for instal at on with a 3" tile headlap.
2 Approved screws are as noted in the 'Trade Names of Products Manufactured By Others'
and 'Profile Drawings' sections of this Approval. Clips on eave tile are not required for this
attachment configuration unless the Required Moment of Resistance exceeds the values
noted above.
Page I 1 of 15
uloaga, RRC
Roofing Product Control Examiner
MONMt2 LIFET3LE LLC
DATA FOR ATTACHMENT
CALCULATIONS (CONTINUED)
Product Control No.: 97- 1124.16
Table 3 -A: Attachment Resistance Expressed as a Moment - M (ft-Ibf)
for Nail -On Systems
Tile
Profile
Monier Lifetile
LLC Villa Tile,
Roll Tile, and
Capri Tile
Tile
Application
Direct Deck
New Construction
(min. 19 / 72 " plywood)
Direct Deck
Recover /Reroof
(min. 15 / 32 " plywood)
Battens
New Construction
Two (2) 10d x 3" long nails
67.50
43.00
50.90
1 Tile installation with a 4" headlap using two (2) Approved 10d x 3" long
polymer coated, corrosion resistant, ring shank nails installed in
manufactured holes located 21/2" from the head of the tile. Clips on eave
tile are not required for this attachment configuration unless the Required
Moment of Resistance exceeds the values noted above.
Table 4: Attachment Resistance Expressed as a Moment - M (ft -Ibf)
for Mortar or Adhesive Set Systems
Tile
Profile
Monier Lifetile LLC Villa Tile,
Roll Tile, and Capri Tile
Tile
Application
Mortar Set .
Adhesive Set
Attachment
Resistance
20.60
86.61
Page 12 of 15
0 - 1
'� uloaga, RRC
Roofing Product Control Examiner
MONIER LLFETILE LLC
PROFILE DRAWINGS
Page 13 of 15
MONIER LIFETILE LLC VILLA TILE
MONIER LIFETILE LLC ROLL, TILE
Product Control No.: 97- 1124.16
uloaga, RRC
Roofing Product Control Examiner
0.].1"
.• - • �
0.07"
PROFILE DRAWINGS
(CONTINUED)
MONIER LIFETILE LLC CAPRI
:3 OCC.
Page 14 of IS
1.70"
0.171"
Product Control No.: 97-1124.16
■000$0000000,
APPROVED SCREW FOR SCREW DATA IN TABLE 3
Roofing Product Control Examiner
0.170_
MONTER LIFETILE LLC Product Control No.: 97- 1124.16
Monier Lifetile LLC ACCEPTANCE NO: 97- 1124.16
135 N.W. 20 St. APPROVED : June 25, 1998
Boca Raton, FL. 33431 EXPIRES : June 25, 2001
NOTICE OF ACCEPTANCE STANDARD CONDITIONS
1 Renewal of this Acceptance (approval) shall be considered after a renewal application has been
filed and the original submitted documentation, including test supporting data, engineering
documents, are no older than eight (8) years.
2 Any and all approved products shall be permanently labeled with the manufacturer's name, city,
state, and the following statement: "Miami -Dade County Product Control Approved ", or as
specifically stated in the specific conditions of this Acceptance.
3 Renewals of Acceptance will not be considered if:
a) There has been a change in the South Florida Building Code affecting the evaluation of this
product and the product is not in compliance with the code changes;
b) The product is no longer the same product (identical) as the one originally approved;
c) If the Acceptance holder has not complied with all the requirements of this acceptance,
including the correct installation of the product;
d) The engineer who originally prepared, signed and sealed the required documentation initially
submitted, is no longer practicing the engineering profession.
Any revision or change in the materials, use, and/or manufacture of the product or process shall
automatically be cause for termination of this Acceptance, unless prior written approval has been
requested (through the filing of a revision application with appropriate fee) and granted by this
office.
5 Any of the following shall also be grounds for removal of this Acceptance:
a) Unsatisfactory performance of this product or process;
b) Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any
other purposes.
6 The Notice of Acceptance number preceded by the words Miami -Dade County, Florida, and
followed by the expiration date may be displayed in advertising literature. If any portion of the
Notice of Acceptance is displayed, then it shall be done in its entirety.
7 A copy of this Acceptance as well as approved drawings and other documents, where it applies,
shall be provided to the user by the manufacturer or its distributors and shall be available for
inspection at the job site at all times. The copies need not be resealed by the engineer.
8 Failure to comply with any section of this Acceptance shall be cause for termination and removal
of Acceptance.
This Acceptance contains pages 1 through 15.
END OF THIS ACCEPTANCE
Page 15 of 15
Roofing Product Control Examiner
- PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 8 -03 -92 Job Address 685 N. E. 97 St.
Legal Description / *c c /
Tax Folio `/ 0 (7 (7c.2:77
Owner / Lessee / Tenant William Koch Master Permit # 33 / 0101 k. 5
Owner's Address 685 N. E. 97 St. Phone 756 -7252
Contracting Co. Segarra Roofing, Inc. Address 6868 W. 2nd Ct. Hialeah, F1.
Qualifier Manuel Segarra ss# Phone 822 -7541
State # RC A024333 Municipal # 00 - 0578592 Competency # 0014509 Ins.Co. Shelby
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Repair roof - leaking area over t i 1 P roof
Square Ft. IRE) .75 Estimated Cost(value) $1000.00
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).
Ap9lication 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. o p thermore, I
authorize the above -named contractor to do the work stated.
/
--k47tkellar )-CA-
Signature of owner and /or Condo President
Date:
4cL
i_ , .
Notary as to Owner I nd or Condo President
My Commission Expires: Wntaly pool" "•
My Commission Expires Feb. 18, L 994
Bonded thru PICHARD Ins. ABennY
Signature o
Date: g'
Co trac
Builder
eN�.4,
Notary as to Contra or or Owner- Builder
My Commission Expires:
Notary Public. State of Flortoa
My Commission Expires Feb. 18, 1994
Bonded thru PICHARD Ins. Agency
:: * * * * * * * * * * * * * * * **
PERMIT \41 RADON C.C.F. ` 1� � NOTARY TOTAL DUE
APPROVED: Fire
Zoning Buildin Electrical
Mechanical Plumbing Engineering
Other