822 NE 96 St (4)V
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address KZ z / 62- 4 7 e . �
Legal Description )4 ;it(e
Owner / Lessee / Tenant //`i ?P^ lam- A/ ' T
Owner's Address �--
Contracting Co. W Leto. S'ecj Address t�C
Qualifier g 7 AW/c-l4 ss# Phone (7 92Z " 73
State #CCC ,K ? Municipal # Competency #
Architect /Engineer A/4 Address
Bonding Company Address
Mortgagor /I, ✓ " Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL( MECHANICAL(FIDIFINO PAVING PENCE SIGN
WORK DESCRIPTION . .e.41 ® i / � v i- hi - AA- 40pe 4 � *7
/it 515/ %' i,, e, '47- rig ! , / /laJ A/ A01f'
1 u.-
Square Ft. /
�. S \-___
gnature of owner and /or Condo President
Date:
My Commission Expires:
APPROVED:
Zoning
Mechanical
Tax Folio
Estimated Cost(value)
Master Permit # L t 2 5 ( f 0
Phone
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 c•mpliance with all applicable laws regulating construction and zoning. Furthermore, I
authorize above -named co rector to do the work stated. C
Notary as to Owner and /or Condo President N ary as to Cont
y Commission Exp
Signature of Contractor or Owner- Builder
Date:
ye �
«71 '1 • 11
JAMES M JOHNSON ,
OTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC718059
** * * * * * * * * * * * * MY M1SSIAIJ I ? ;P. i ^a 19,Z
FEES: PERMIT 60' RADON C.C.F. 2 ° L(E) NOTARY TOTAL DUE
ile
Fire Other
Buildin Electrical
Plumbing Engineering
NOTICE OF COMMENCEMENT
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: /65/ gZZ /t/f 76 5
2. Description of improvement:
3. Owner(s) narne and address:
Interest in properly:
Name and address of fee simple titleholder:
4. Contractor's name and address: 11L, .S pey5f Zoe $ 'r,t tom,,_ 5/, / /ycaba� ; j .,GZ 33(� 226 �,
5. Surety:(Payment bond required by owner from contractor, if arty)
Name and address:
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, 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 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 % /4r gs �) L. •c1,QS�
Sworn to and subscribed before me this '`f day of jjaQd_e_4 19 9? .
Notary Public
Print Notary's Name
My Commission Expires:
I A 14 4 —.a
grd
98R 100446 1998 MAR 05 14:30
STATE OF FLORIDA, COON - 1Y
o- ;;!R�3: %:rC`:� ^Hr; 'n(., is c u. ro fipf ▪ „
t ::�.:]or,._. rC1,7 i �
Prepared by:
" 0.''! d a! : oudy `.'o
.ivvi
,y/4
Address: Zd/V AAA"-
i7 dt • NIUPKA L. LOPEZ
'fa MY COMMISSION • CC 487215
a rr „• .. 4,1999
%4, + ; • Bonded Thu Notary Public Undemotters
Appendix "E"
UNIFORM ROOFING PERMIT APPLICATION
PROCESS No.
Contractor's Name:
4 1-P £r Job Address: e ge'
ROOF CATEGORY
❑ (Nail -On Tile) ❑ (Mortar - Adhesive Set Tile)
❑ (Asphalt/Fiberglass Shingles) ❑ ( Metal Roofs \Wood Shingles & Shakes) ❑ (Other)
ROOF TYPE
❑ New Roof Et 1 e- roofing ❑ Recovering ❑ Repair ❑ Maintenance
U (Low Slope Application)
Flat Roof Area (ft') Sloped Roof Area (f1 Total (ft / Master Permit No.
Exposure category (per ASCE 7 -88): _ ` Building Classification category (per ASCE 7 -88 table 1): /
Ft.
Ft.
Deck type:
ATTACHMENT
Fastener Type: 3 9/
5 C /Y/4/ ,'
Field:
0 ROOF HEIGHT AND SYSTEM DETAILS
J( (Draw details as needed)
SPACING
4 e0
Perimeter: Corner: / 2
DETAIL 1 & 2
ROOF PLAN
123.01-78 9/96
Page -1
Ridge Ventilation?
MEAN HEIGHT
Deck type:
Lhidcrlaynleat:
Appendix "E"
UNIFORM ROOFING PERMIT APPLICATION
PROCESS No.
Insulation:
D E T A I L 3
1r
ROOF SLOPE
(Pm ax x X (Aerodynamic Multiplier): ) - M
(Pmax2: x X (Aerodynamic Multiplier): ft ) - M
(Pmax3: x X (Aerodynamic Multiplier): ) - M
SLOPED SYSTEM DESCRIPTION
Fastener type & spacing:
Cap Sheet:
Roof Covering:
TILE CALCULATIONS
= Mri:
= M
= M
Page -2
Drip edge:
ATTACHMENTS REQUIRED
1) Fire Directory Listing Page
2) Dade County Product Control
Notice of Acceptance -Cover Sheet
a) Specific System Description
b) Specific System Limitation
c) General Limitations
d) Applicable Detail Drawings
3) Municipal Permit Application
4) Other Component Approvals
PCA:
PCA:
PCA:
PRODUCT CONTROL NOTICE
GS Roofing Products Company, Inc.
5525 MacAutliur Boulevard, Suite 900
Irving, Texas 75038
OF ACCEPTANCE
Your applicati911 for Produc Approval of:
GS Roofing Products Modified Bitumen Roof Systems Over Wood Decks
under Chapter 8 of the Metropolitan 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:
Factory Mutual Research ( orporation and Underwriters Laboratories, Inc.
has been recommended for acceptance by the Building Code Compliance Department to be used in Dade County,
Florida under the specific conditions set forth on pages 2 through 31 and the standard conditions set forth on page
32.
The approval shall not be alid after the expiration date stated below. The Building Code Compliance Office
reserves the right to secure this product or material at any time for a jobsite or manufacturer's plant for quality
control testing. If this prodiict 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 applicant shall
re- evaluate this product or material should any amendments to the South Florida Building Code be enacted affecting
this product of material. 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 th man ac
Acceptance (''o.: ' 97- 0521'.01 Revises No. 95- 0502.04
Raul Rod(' uez
Expii es: 06/19/0 I ' Product Control Supervisor
THIS IS THE COV ;RSFIEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
CONDITIONS
BUILDING CODE COMMITTEE
This application for Produ' t Approval has been reviewed by the Metropolitan Dade County Building Code
Compliance Department and approved by the Building Code Committee to be used in Dade County, Florida under
the conditions ;et forth abov. .
Approved: 06/19/97
Internet mail address: postmaste :@buildingcodeonline.com
METROPOLITAN DADE COUNTY, FLORIDA
METRO -DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET, SUITE 1603
MIAMI, FLORIDA 33130 -1563
(305) 375 -2901
FAX (305) 375 -2908
PRODUCT CONTROL DIVISION
(305) 375 -2902
FAX (305) 372 -6339
Director
Building Code Compliance Dept.
Metropolitan Dade County
Homepage: http : / /www.buildingcodeonline.com
Applicant:
GS Roofing Products Company, Inc. (MB)
5525 MacArthur Blvd.
Suite 900
Irving, TX 75038
Category: Membrane Roofing System
Sub - Category: Built -up Roofing
Type: Modified Bitumen
Sub -Type: SBS /APP
ROOFING SYSTEM APPROVAL
System Description
Product Control No.: 97- 0520.01
Product Control No.: 97- 0520.01
Approval Date: June 19, 1997
Expiration Date: June 19, 2000
GS Roofing Products Company, Inc. manufactures and markets nationally a complete line of residential and
commercial BUR and modified bitumen products. GS Roofing Products Company, Inc. markets these products
through local distribution in the South Florida jurisdiction.
GS Roofing products and systems are the result of years of manufacturing experience and product development and
have been proven by years of experience in the construction field.
GS offers a variety of approved insulated and non - insulated roofing systems. For detailed system constructions,
refer to the following publications: "Commercial Roof System Specification Manual ".
GS products and systems have been tested in compliance with all provisions of the South Florida Building Code as
well as Underwriters Laboratories, Inc., and Factory Mutual Research Corporation for fire and wind uplift
resistance.
GS provides technical service and warranty information through regional offices. For the South Florida
Metro -Dade area, call 1- 800 - 777 -2563.
Contact:
Pat Neuhaus
Commercial District Manager
2900 Bird St.
Charleston Heights, SC 29405
(803) 744-7451
uloaga -Plans Examine
uct Control Div.
Insulation Types
Fibrous glass
Perlite
Fiberboard
Rockwool
Polyisocyanurate
Polyisocyanurate Composite Board
Maximum Design Pressures
Material Design Pressure
Wood -45.0 psf
Maximum Fire Classification
Material Classification
Wood Class A
3
Product Control No.: 97- 0520.01
Note: Fire classifications and maximum design pressures do not reference all assemblies over deck types.
Review system listings for design pressures and the Underwriters Laboratories Roofing Materials Directory
or other approved testing agency listing directory for Fire Classifications.
Frank Zuloaga -Plans Exw flrec Control Div.
Product
All Weather /Empire Base
Sheet
Flex -l- GlasTM Base Sheet
Flex -I- GlasTM FR Base
Sheet
Flintglas® Ply Sheet Type
IV or VI
Flintlastic STA
Flintlastic GTA, GTA -FR
or Flintlastic Diamond
GTA
Flintlastic GTS
Flintlastic GMS /GMS
Premium
Flintlastic FR/FR -P
Premium
Flintlastic FR -PG
TRADE NAMES OF PRODUCTS MANUFACTURED OR
LABELED BY APPLICANT
Dimensions
36" x 72'; Roll
weight: 86 lbs.
(2 squares)
36" x 108'; Roll
weight: 90 lbs.
(3 squares)
39'/ x 50'; Roll
weight: 90 lbs.
(1.5 squares)
36" x 180'; Roll
weight: 40/55 lbs.
(5 squares)
39'/ x 33'; Roll
weight: 90 lbs.
(1 square)
39 3 / 8 " x 33' 3 "; Roll
weight: 105 lbs.
(I square)
39'/ x 2 4'9 "; Roll
weight: 92 lbs.
(% square)
39'/ x 34' 2"; Roll
weight: 100/105 lbs.
(I square)
Test
Specification
39 3 /8" x 34' 2 "; Roll ASTM D 5147
weight: 105 lbs.
(1 square)
39 "x34'2 ";Roll
weight: 105 lbs.
(l square)
Product Control No.: 97- 0520.01
Product
Description
ASTM D 2626 Asphalt coated, organic base sheet.
UL Type 15
UL Type G2 Modified Bitumen, coated fiberglass base
ASTM D 4601, sheet.
type II
UL Type G2 Modified Bitumen, coated fiberglass base
ASTM D 4601, sheet.
type II
ASTM D 2178 Fiberglass, asphalt impregnated ply sheet.
Type IV or VI
UL Type G1
ASTM D 5147
ASTM D 5147 Granule surfaced, APP Modified Bitumen
membrane with non -woven polyester mat
reinforcement for toch application.
ASTM D 5147 Granule surfaced, SBS Modified Bitumen
membrane with non -woven polyester mat
reinforcement for torch application.
ASTM D 5147 Granule surfaced SBS Modified Bitumen
membrane with non -woven polyester mat
reinforcement for mop application.
ASTM D 5147 Fire resistant, granule surfaced SBS
Modified Bitumen Membrane with a dual
carrier reinforcement for mop application.
4
Smooth surfaced, APP Modified Bitumen
membrane with non -woven polyester mat
reinforcement for torch application.
Fire resistant, granule surfaced SBS
Modified Bitumen Membrane with
non -woven polyester mat reinforcement for
mop application.
Frank Zuloaga -Plans Examiner, Product Control Div.
:
Product
Flintlastic FR Cap
GlasBaseTM Base Sheet
PoIySMS Base Sheet
Yosemite® Mineral
Surfaced Cap Sheet
Stormshield
Dimensions
39 "x34'2 ";Roll
weight: 90 lbs.
(1 square)
36" x 108'; Roll
weight: 69 lbs.
(3 squares)
39' / x 64' 4 "; Roll
weight: 90 lbs.
(2 squares)
36" x 36'; Roll
weight: 90 lbs.
(1 square)
36" x 75'; Roll
weight 75 lbs.
(2.25 squares)
Test
Specification
ASTM D 5147
ASTM D 4601
UL Type G2
5
Frank Zuloaga -Plans Examiner,
Product Control No.: 97- 0520.01
Product
Description
Fire resistant, granule surfaced SBS
Modified Bitumen membrane with
fiberglass mat reinforcement for mop
applications.
Asphalt coated, fiberglass base sheet.
ASTM D 5147 Modified Bitumen, coated polyester base
sheet.
ASTM D 249 Mineral Surfaced organic cap and buffer
UL Type 30 sheet.
PA 103 Slag surfaced SBS Modified Bitumen sheet
ASTM D 1979 with fiberglass reinforcement for peel and
stick application.
uct Control Div.
Product
ACFoam 11
E'NRG'Y -2 or PSI -25
ISORoc
E'NRG'Y -2 Plus
Multi -Max
Hy -Therm AP
UltraGard Gold
Pyrox
ISO 95+
High Density
Fiberboard
High Density Wood
Fiberboard
Fiberglas
Paroc Cap Board
Perlite Insulation
Dens Deck
Dekfast Fasteners
#12 or #14
Dekfast Hex Plate
Dekfast Lock Plate
Olympic Fastener
#12 or#14
Olympic
Polypropylene
TRADE NAMES OF PRODUCTS MANUFACTURED BY OTHERS
Test
Dimensions Specification
various PA 110
various PA 110
various PA 110
various PA 110
various
various
various
various
various
various
various
various
various
various
various
various
2 7/8" x
3 1/4"
3 "x31/4"
various
3.25" round
Product
Description
Polyisocyanurate foam
insulation
Polyisocyanurate foam
insulation
Polyisocyanurate foam and
rockwool composite insulation
Polyisocyanurate foam / wood
fiberboard composite
insulation
PA 110 Polyisocyanurate foam
insulation.
PA 110 Polyisocyanurate foam
insulation
PA 110 Polyisocyanurate foam
insulation
PA 110 Polyisocyanurate foam
insulation
PA 110 Polyisocyanurate foam
insulation
PA 100 Wood fiber insulation
PA 110 Wood fiber insulation board
PA 110 Fi5er glass roof insulation
PA 110 Rockwool insulation
PA 110 Perlite insulation board
PA 110 Gypsum core / fiberglass faced
coverboard
PA 1 14(E) Insulation fastener for steel
PA 117 and concrete decks
PA 1 14(E) Galvalume hex stress plate.
PA 117
PA I I4(E) Polypropylene locking plate.
PA 117
PA 114(E) Insulation fastener
PA 117
PA I14(E) Polyp
PA 117 plastic
6
Product Control No.: 97 0520.01
Johns Manville
(with current PCA)
Partek, Inc.
(with current PCA)
generic
Georgia Pacific
(with current PCA)
Construction Fasteners
(with current PCA)
Construction Fasteners
(with current PCA)
Construction Fasteners
(with current PCA)
Olympic
(with current PCA)
lympic
(with cu ent PCA)
Manufacturer
Atlas Energy Products
(with current PCA)
NEW Barriers, Inc.
(with current PCA)
NRG Barriers, Inc.
(with current PCA)
NRG Barriers, Inc.
(with current PCA)
RMAX
(with current PCA)
Celotex Corp.
(with current PCA)
Johns Manville
(with current PCA)
Apache
(with current PCA)
Firestone
(with current PCA)
Celotex Corp.
(with current PCA)
generic
ner, Product Control Div.
Test
Product Dimensions Specification
Olympic Standard 3" round PA 1 14(E)
PA 117
ESI Fastening various PA 1 14(E)
Systems PA 117
Insulfixx or HD various PA 1 14(E)
Insulfixx Fasteners PA 117
Roofing Nails Minimum # 12 PA 114
Tin Caps Min. 32 ga. x
15/g
Red Rosin various
Asphalt Emulsion PA 121
Gardner Cold Process 1, 5, 55 gallons
Roof Cement
Asphalt
Asphalt Primer
Chopped fiberglass
emulsion
Fiberglas
Flashing Cement
Modified Cold
Process Cement
Modified Plastic Roof
Cement
Non Fibered
Aluminum Coating
Static Asphalt Fibered
Emulsion
al MB aluminum roof
coating
Karnak 97, 97AF or
169
Prograde Fibered
Aluminum
ASTM D 3019
Type III
ASTM D312
ASTM D 41
ASTM D 1227
PA 110
ASTM D 4586
or
ASTM D 2822
ASTM D 3019
Type III
ASTM D4586
Type I
ASTM D 2824
PA 121
PA 121
PA 121
7
Product
Description
3" round galvalume
AZ55 steel plate
Insulation fastening assembly
with plastic and steel stress
plate.
Insulation fastening assembly
with plastic and steel stress
plate.
Corrosion resistant annular
ring shank nails
Corrosion resistant circular
discs.
Rosin paper for barrier layer
on wood decks
Asphalt emulsion
Fibered asphaltic general
purpose lap and ply cement.
Type 111 or IV hot asphalt
bitumen adhesive
Asphalt Primer
Roof Cc'tirc,
ASTM D 1227 Roof Coating
Fiber glass roof insulation
A trowel - grade, cutback
bitumen cement mixture
includir.g inorganic fibers and
mineral stabilizers.
Adhesive
Flashing Cement
Roof Coating
Aluminum roof coating
Roof coating
Fibrated aluminum roof
coati
aaa-
Product Control No.: 97- 0520.01
Manufacturer
Olympic
(with current PCA)
SFS Stadler Inc.
(with current PCA)
SFS Stadler Inc.
(with current PCA)
generic
generic
generic
Gardner
(with current PCA)
Gardner
(with current PCA)
generic
generic
generic
generic
generic
generic
generic
generic
generic
Grundy Industries
(with current PCA)
Karnak
(with current PCA)
Monsey Products Co.
current PCA)
Product Control Div.
Product Control No.: 97- 0520.01
Test Product
Product Dimensions Specification Description Manufacturer
# 2100 - Modified 1, 5, 55 ASTM D 3019 Rubberized all- weather Tropical Asphalt
All Weather gallons, or 10.5 (Type III) and D flashing cement, trowel grade, Products Corporation
Flashing Cement ounce tubes. 3409 modified adhesive. (with current PCA)
Aluma -Brite No. 120 PA 121 Fibrated aluminum roof Tropical Asphalt
coating. Products Corp.
(with current PCA)
APOC 212 PA 121 Aluminum roof coating. APOC, Subsidiary of
Gardner
(with current PCA)
Sunbright 400 PA 121 Roof coating APOC, Subsidiary of
Gardner
(with current PCA)
MBA ASTM 3019 Asphalt based cold applied APOC, Subsidiary of
Type III adhesive. Gardner
(with current PCA)
8
uloaga -Plans Exam! , ' +uct Control Div.
Test Agency /Identifier
Applied Research
Laboratories
Factory Mutual Research
Corporation
Factory Mutual Research
Corporation
Underwriters Laboratories,
Inc.
United States Testing
Company, Inc.
United States Testing
Company
Name
Physical Properties
Current Insulation
Fastening Requirements
PA 114
(FMRC 4470)
Fire Classification
Compliance
ASTM D 5147
ASTM D 5147
TEST REPORTS
9
Report
28013
FMRC 1994
J.I. #3Y8AI.AM
R11656
97457 -4
97- 457 -2R
Product Control No.: 97- 0520.01
Da te
06/02/87
01/01/95
03/23/96
07/13/87
06/03/88
12/02/87
Frank Zuloaga -Plans Examiner, 'roduct Control Div.
Membrane Type: APP MODIFIED
Deck Type III: Wood, Insulated, New Construction
Deck Description: 19 / 3 2" or greater plywood or wood plank
System Type A: Anchor sheet mechanically fastened; all layers of insulation adhered with approved
asphalt.
All General and System Limitations apply.
Insulation Faste
Base Laver Typ
one or more layers of any of the following
Approved Type(s): HyTherm
Minimum: 1.3" x 3' x 4'
Approved Type(s): ACFoam -11
Minimum: 1' /z" x 4' x 4'
Approved Type(s): Apache Pyrox
Minimum: 1.3" x 4' x 4'
Minimum: 1'/" x 3' x 4'
Approved Type(s): UltraGard Gold
Minimum: 1' /z" x 4' x 4'
Approved Type(s): Fiberglas
Minimum: 13 / 16 " x 4' x 4'
Approved Type(s): Perlite
Minimum: 3 /4" x 2' x 4'
N/A
N/A
N/A
Approved Type(s): E'NRG'Y -1, E'NRG'Y -2, PSI -25
N/A
N/A
N/A
N/A
Approved Type(s): High Density Wood Fiberboard
Minimum: '' " x 4' x 4'
Approved Type(s): Dens -Deck
Minimum: %" x 4' x 4'
N/A
N/A
SYSTENIS
ner Fastenening
e Detail No.
(see PA 117)
insulations under those listed
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Fasteners
Per Board
as Top Layer:
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Insulation Fastener Fastenening Fasteners
Optional Top Laver Type Detail No. Per Board
(see PA 117)
one or more layers of any of the following insulations
Approved Type(s): See Approved Insulations listed for Base Layer, above.
Minimum: see Base Layer N/A N/A
Product Control No.: 97- 0520.01
N/A
Fastener
Density
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Fastener
Density
N/A
Note: All insulation shall be adhered to the anchor sheet irk full moppings of approved asphalt within the
EVT range and at a rate of 20 -40 lbs. /s Please refer to Metro - t de.enunt. I s • a . cation Standard PA
1 17 for insulation attachment. Insulations listed as base laye : . • ,e US only as base ers with a
10 `, _
f � 7 and 1.."1- roduct Control Div.
Product Control No.: 97- 0520.01
second layer of approved top layer insulation installed as the final membrane substrate. Composite
insulation panels used as a top layer shall be placed with the polyisocyanurate side facing down.
Anchor Sheet:
Fastening:
Ply Sheet:
Membrane:
Surfacing:
One ply of GS Glas Base, GS Flex -I Glas Base, Flex -1 Glas FR Base or GS Poly SMS base
mechanically attached as detailed below.
Anchor sheet shall be lapped 4" and fastened with approved roofing nails and tin caps
9" o.c. in the lap and two rows staggered in the center of the sheet 12" o.c.
(Optional) One ply of products listed under 'Anchor Sheet' above, or one or more plies of
Flintglas Ply Sheet (Type IV) or Flintglas Premium Ply Sheet (Type VI) adhered to the
base sheet in a full mopping of approved asphalt applied within the EVT range and at a rate
of 20 -40 lbs. /sq.
Flintlastic STA, Flintlastic Diamond GTA, Flintlastic GTA or GTA -FR torch adhered to
base or ply sheet.
(Optional) Install one of the following:
1. 400 lb./sq. gravel or 300 lb. /sq. slag in a flood coat of approved mopping asphalt at an
application rate of 60 lb. /sq..
2. Karnak 97, APOC 212 Fibrated Aluminum, Henry 520 Aluminum or Grundy AL MB
at an application rate of 1 1/2 gal. /sq..
Maximum Design
Pressure: -45 psf
Maximum Fire
Classification: Class 'A'; see General Limitation #2.
Maximum Slope: 1:12; see General Limitation #3.
Specification No.: STA 2 -3 / INS -W, GTA 2 -3 / INS -W
1I
u oaga -Plans xa
uct Control Div.
Membrane Type: SBS MODIFIED •
Deck Type II: Wood, Insulated, New Construction
Deck Description: 19 / 3 3" or greater plywood or wood plank
System Type D: All layers of insulation and base sheet simultaneously attached.
All General and System Limitations apply.
Insulation
Base Laver (Optional)
one or more layers of any of the following insulations:
Approved Type(s): HyTherm
Minimum: 1.3" x 3' x 4' N/A N/A N/A
Approved Type(s): ACFoam -11, UltraGard Gold
Minimum: 1 x 4' x 4' N/A N/A N/A
Approved Type(s): Apache Pyrox
Minimum: 1.3" x 4' x 4' N/A N/A N/A
Approved Type(s): E'NRG'Y -2, PSI -25
Minimum: 1%2" x 3' x 4' N/A N/A N/A
Approved Type(s): Fiberglas
Minimum: 's/ x 4' x 4' N/A N/A N/A
Insulation Fastener Fastenening Fasteners Fastener
Top Laver Type Detail No. Per Board Density
(see PA 117)
Approved Type(s): Perlite
Minimum: 3 /4" x 2' x 4'
Approved Type(s): _High Density Wood Fiberboard
Minimum: '/2" x 4' x 4'
Approved Type(s): Dens -Deck
Minimum: '/<" x 4' x 4'
Base Sheet:
Fastening # I:
Fastener Fastenening Fasteners Fastener
Type Detail No. Per Board Density
(see PA 117)
N/A N/A N/A NSA
N/A
N/A
Note: Top layer shall have preliminary attachment at a rate of two fasteners /board for any board less than 4'
x 4', and four fasteners /board for any board larger than 4' x 4'. Base sheet and all layers of insulation are
then simultaneously fastened using the fasteners and density specified under Base Sheet attachment.
One ply of GS Glas Base, GS Flex -I Glas Base, Flex -I Glas FR Base or GS Poly SMS base
mechanically attached as detailed in Fastening #1, below or one ply of GS Poly SMS
mechanically attached as detailed in Fastening #2 or #3, below.
Olympic Screws #12 or #I4 and metal plates, Dekfast #I4 or #I5 and metal plates or SFS
Insulfixx #12 or #I4 and metal plates spaced 4" o.c. at a 4" side lap and two staggered rows
in the center of the sheet, 24" o.c.
24
N/A
N/A
Product Control No.: 97- 0520.01
N/A N/A
N/A N/A
u oaga -Plans Exam'
N/A
N/A II r %:7 7 • - '‘}`
N/A
N/A
N/A d:
r
uct Control Div.
1' F,
1 7
Fastening #2:
Fastening #3: SFS Insulfixx screws and 2" round metal plates at a 4" side lap, 12" o.c
Ply Sheet:
Membrane:
Surfacing:
Maximum Design
Pressure: -45 psf
Product Control No.: 97- 0520.01
Olympic Screws #12 or 414 and metal plates, Dekfast 414 or 415 and metal plates or SFS
Insulfixx #12 or #14 and metal plates spaced 12" o.c. at a 4" side lap and two staggered
rows in the center of the sheet, 36" o.c.
(Optional) One ply of GS G,las Base, GS Flex- I -Glas Base, Flex- I -G ias FR Base, GS
PoIySMS or one or more plies of Flintglas Ply Sheet (Type IV) or Flintglas Premium Ply
Sheet (Type VI) adhered to the base sheet in a full mopping of approved asphalt applied
within the EVT range and at a rate of 20 -40 lbs. /sq..
One ply of Flintlastic GMS, Flintlastic Premium GMS, Flintlastic FR -P, Flintlastic
Premium FR -P, Flintlastic FR -PG or Flintlastic FR Cap adhered to base or ply sheet with
approved mopping asphalt applied within the EVT range and at a rate of 20 to 40 lbs. /sq. or
Flintlastic GTS torch adhered to base or ply sheet.
(Optional) Install one of the following:
1. 400 lb. /sq. gravel or 300 lb. /sq. slag in a flood coat of approved mopping asphalt at an
application rate of 60 lb. /sq..
2. Karnak 97 or APOC 212 Fibrated Aluminum at an application rate of I 'V2 gal. /sq..
Maximum Fire
Classification: Class 'A'; see General Limitation #2.
Maximum Slope: 1:12; see General Limitation #3.
Specification No.: GMS 2 -3 / INS -W, FRP 2 -3 / INS -W, GTS 2 -3 / INS -W, FRBC 2 -3 / INS -W
25
Frank Zuloaga -Plans Examiner, •ro•uct Control Div.
GENERAL LIMITATIONS
Product Control No.: 97- 0520.01
1 All asphalt shall comply with ASTM D 312, type III or IV requirements and approved by applicant.
2 Fire ratings are determined by a combination of slope, deck type and assembly. Refer to the current
Underwriters Laboratories Roofing Materials Directory or other fire testing data listed in the testing file.
Fire ratings shall be in strict compliance with Sections 3401.5 and 3401.6 of the South Florida Building
Code.
3 Maximum slope range varies for each system. Consult the current Underwriters Laboratories Roofing
Materials Directory and manufacturer's specifications for compliance with design criteria for each
project.
4 An overlay and/or recovery board is required on all applications over closed cell foam insulations when
the base sheet is fully mopped in hot asphalt.
5 All work shall be performed by a contractor licensed to do roofing work in Metro -Dade County.
Contractor shall be familiar with the details and specifications published by the manufacturer and the
requirements of the South Florida Building Code.
6 The submission of system specifications and details shall accompany the Section II Building Code
Permit. This information is available in the publications listed in the `System Description' of this
Product Control Approval. The submission of these documents, as well as the proper application and
installation of all materials shall be the sole responsibility of the contractor.
7 Perimeter and corner areas shall comply with the elevated design pressures of these roof areas, as
calculated in compliance with Chapter 23 of the South Florida Building Code. Anchor or base sheet
fastening patterns and/or insulation attachment densities shall be increased in compliance with the
provisions set forth in Metro -Dade County Roofing Application Standard PA 117 to meet these elevated
design pressures.
8 All attachment and sizing of perimeter nailers, metal profile and/or flashing termination designs shall
conform to Metro -Dade County Roofing Application Standard PA I 11 and the wind load requirements
of Chapter 23 of the South Florida Building Code.
9 Flashings shall be installed according to the manufacturer's standard details and may be applied in cold
application adhesive, approved asphalt or may be applied in conjunction with an approved torch applied
modified bitumen membrane. Specific details, approved by the manufacturer, shall be submitted with
the Section 11 Permit Application. All details shall comply with the provisions of the South Florida
Building Code.
10 Fastener spacing for anchor or base sheet attachment is based on a Minimum Characteristic Resistance
Force (F') as determined through field testing in compliance with Metro -Dade County Protocol PA 105
or PA l05(A). If F', as tested, is Tess than that listed in the System Limitations, a professional engineer
may submit revised fastener spacings utilizing F', taken from a Metro -Dade County Protocol PA 105 or
PA 105(A) test report, and the provisions set forth in Metro -Dade County Roofing Application Standard
PA 117.
11 Fastener density for insulation attachment is based on a Minimum Characteristic Resistance Force (F')
as determined through field testing in compliance with Metro -Dade County Protocol PA 105. If F', as
tested, is less than 275 lbf., insulation attachment shall not be acceptable.
12 Asphalt moppings shall be applied with approved asphalt and shall be in compliance with the
equiviscous temperature (EVT) methods of asphalt determination. Asphalt containers or bulk tickets
shall indicate an EVT, finished blowing temperature (FBT) and flash point. Asphalt types and
temperature ranges shall be in compliance with Subsection 3403.4(A)(3) of the South Florida Building
Code.
13 Insulation may be applied in multiple layers. The first layer shall be attached in compliance with the
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. Refer to manufacturer's literature and/or the NRCA Roofing and
Waterproofing Manual for correct application procedures of insulation panels in approved asphalt or
adhesive, which shall comply with the provisions of M- : ,..; • • •. fig Standard
PA 117.
30
aga -Plans , ' • • uct Control Div.
Product Control No.: 97- 0520.01
14 All standard insulation panels sizes are acceptable for mechanical attachment. When applied in
approved asphalt, panel size shall be 4' x 4' maximum.
15 In re -covery applications, prior to the application, all existing roof surfaces used as a bonding substrate
shall be tested in compliance with Metro -Dade County Protocol PA 124 for uplift resistance. Test
pressures shall be calculated in compliance with the wind Toad requirements of Chapter 23 of the South
Florida Building Code for the roof in question.
16 In re- roofing applications, moisture content in an existing roof must be in compliance with Subsection
3401.10(m), (n) of the South Florida Building Code.
17 Roof goods shall be stored on end and on a clean, flat and dry surface.
18 If required, any Factory Mutual Approved vapor barrier in conjunction with proprietary or approved
adhesives may be used prior to the application of the insulation layer.
19 Consult current Underwriters Laboratories Directory for the appropriate coating for each roofing
assembly to obtain the required fire rating. The assembly shall be installed in strict compliance with
Subsection 3401.5 and 3401.6 of the South Florida Building Code for maximum fire classification.
31
uloaga -Plans xam
uct Control Div.
Product Control No.: 97- 0520.01
GS Roofing Products Company, Inc.
5525 MacArthur Blvd., Suite 900
Irving, Texas 75038 ACCEPTANCE NO.: 97- 0520.01
APPROVED: June 19, 1997
EXPIRES: June 19, 2000
NOTICE OF ACCEPTANCE STANDARD CONDITIONS
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: "Metro -Dade County Product Control Approved ", or as specifically stated in the
specific conditions of this Acceptance.
1
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.
4 Any revision or change in the materials, use, and/or manufacture of the product or process shall
automatically be cause for termination of this Acceptance, unless prior written approval has been requested
(through the filing of a revision application with appropriate fee) and granted by this office.
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 Metro -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.
9 This Acceptance contains pages I through 32.
END OF THIS ACCE
32
Product Control Div.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
MIAMI SHORES VILLAGE, FLORIDA
❑ DATE ? - 19 4 4
o PERMIT N° 7863
❑ Work to be performed under this Permit
S i t +... _ l t,. ; c c
te •' ;
Architect
Contractor
or Builder • . 1 1 L
Legal Lot
Description II Bi
Contractor's f 3
License No.
Subdi-
vision
Address of (, Value of I Amount of �'
Building Z C... Ai << 4 Project $ Or-' I Permit $ 'C
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 specificationsr"and that" fie assumes respon-
sibility for work done by his agents, servants or employees. , - --.\
Signed: r._ :. INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance w all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authori :s of Miami Shores Village. In as
cepting this permit I assume responsibility for tall work done by either, myself, my agent, servant or employed.
1s " 4 '
CONTRACTOR OR BUILDEF1 BY AUTHORITY .osor
State work to be done and purpose of building (by floors)._
STATE OF FLORIDA,
COUNTY OF DADE. ss •
Chairman
Member
Member _
Council Approved
Building Inspector
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 A v ?oz p j 19 6 !1
Owner's Name and Address____ a_ AO S T F L No r - Street Mr- / O '
Registered Architect and /or Engineer j p� p 5i . pq
Name and address of licensed contractor _____ C , _Airek ry,. e , 3o y {�n ,(�' 6v / / --- __. /,ii, /
Location and legal description of lot to be built on:
Lot______ Block Subdivision
Street and Number where work is to be done 8,2a AJE 2d T "
- ,___.and for no other purpose.
New Building Remodeling Addition Repairs 1/ No. of Stories 4 /
To be constructed of Kind of foundation Roof Covering 1 Ul -7t`P aield ve L
Estimated Total cost of improvements $ 600, oD _Amount of Permit $ ,' 0
Zone cubage require$ _Plan Cubage
Distance to next nearest building — _- - Size of Building Lot
Maximum live load to be borne by each floor
11 hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
he sent to- - -- - - -
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by 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 .ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such bcontr Ctprs, on to be performe. , 2 , - r this
permit, as are licensed by Miami Shores Village.
Remarks ____ ( Signed ) _
Date
Permit No
Disapprove _
( Signed)
Date t)
Date
E- iG0F eE9, C--e4 VE'L RooFS —J02
Read, Sworn to and Subscribed before me.
I
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 he same, and that all facts
therein by him sta�etl a tr ye.
Notary Public, State of Florida
My Commission Expires
PLAN BOARD DATE
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- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper i,uti(e for inspection or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Contractor
or Builder,
Legal Lot
Description
Address of
Building
Owner of ,
--- •
-.•-Building
,
MIAMI SHORES VILLAGE, FLORIDA
PERMIT IT? 11236
Work to be performed under this Permit
Architect
.2--
This permit is granted to the c&tractor 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. r
Subdi-
vision
Value of
Project $
.
DATE 195
Contractor's
License No.
Permit of
it $
In consideration of the issuance to me of this permit I agree )4 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 clongcly either, myself, my agent, servant or employee.
. /
CONTRACTOR OR B Eft 7
B
v ei.....t 449
WACItnli ' 1-4 -
.....„
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.._ ..::.r. . � rrt _, 19
Owner's Name and Address n � i'VrT Q No ... Street. j// „.;'' -..._
Registered Architect and /or Engineer 1 2 pv 4e ,s., °¢L...e
Name and address of licensed contractor P or T /J , ' t zr . 1
Location and legal description of lot to be built on:
Lot 71 e Block 7 Subdivision
w .- L r
Street and Number where work is to be done... ry.ac
State work to be done and purpose of building (by floors)
New Building Remodeling Addition.
Z
and for no other purpose.
Repairs
No. of Stories
To be constructed ofL:i.-71.2, Kind of foundation Roof Covering
Estimated Total cost of improvements $ 9 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 permit does hereby certify that he understands and accepts his obligations as an er Toyer
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..r.Z�L.�'
STATE OF FLORIDA,
COUNTY OF DADE. ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
--- - - - - -- to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the_
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No Date Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Building Inspector
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMEN'
APPLICATION FOR BUILDING PERMIT
Application is hereby amide for the approval of the detailed statement of the plans and specifications herewith submitted or 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 her in 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 ea 1.10-2... ...f
Registered Architect and /or Enginees e . c. . r 6 y 25 ;
Name and address of licensed contrlctoa.
Location and legal description of lot to be built on:
Lot Block Subdivisioan » .....
Street and Number where work is to be done .. zi 2_.._,.
State work it to be done and purpose of building (by floors)/ 7 .. 44' .....L_° ,<`---) 4 - � '
and for no other purpose.
/ � <��'
New Building Remodeling Addition Repay' i
.' 111.c, . . of Stories
To be constructed of Kind e` foundation,. Bo '. ' ing
Estimated Total cost of improvements /r ' i mount of Permit S. .._
Zone cubage required _._.._....Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
herebysybmit all the plan p specifications fir said building. All notices with reference to the building and its onstructior: may
be sent to... ` ..r."hfV ' 4 a s 7�t �.. - -. e _
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 Snp dement,
and has complied with the rovisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performcd under this permit; and will post or cause to be posted for inspection_ the site of the work. ch ppublic notice
or notices as are required by the Act. The undersigned agrees to employ only such subeon• =' g on yro^k .to 'per rrmed 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 ae:d 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, rnd that all facts
therein by him stated are true. c.
Permit No._ r
/ & ` Lc Date
Read, Sworn to and Subscribed before me.
Disapproved Dai
. _
(Signed) -.
Budding Inspe for
PLANNING BOARD DATE
Chairman Member
MIcrebcr Member
Member ....- . ----- -_•_ - -._. _ Member
Council Approved Date Dis appszreed Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this npplicaticn after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such se- inspection is made accessary by improper notice fer id'spectinn or faulty
materials and /or workmanship.
Notary Public, State of Florida
My Commission Expires
6 L 6'3 920s
Location and le 1 description of lot to be built
Lot Block 73
STATE OF FLORIDA
COUNTY OF DADE.
}SS.
Disapproved ��� \ W Date
(Signed)
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 building 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.
/V 57 No.
Owner's Name and Address A.A. !/ S
Registered Architect and /or Engineer
Name and address of licensed contractor e .' A �! � � .. � �' / � �' �� o � . s s Y
Subdivision 743 -
Date ro/x 7 19 9 (7
Street
N /y
Street and Number where work is to be done
State work to be done and purpose of building (by floors), state exterior colors ( submit samples)
u 5 3P /(, 7,.1.
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering, ,g � �O
Estimated Total cost of improvements S Amount of Permit fe �, /—[� ''
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 plans and specifications for said building. All notices with reference to the building and its construction may be sent to R R c d
t 1
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons 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)
Before me. the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
Notary Public, State of Florida
Building Inspector My Commission Expires
PLANNING BOARD DATE
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 for oing a lication, and that he did sign the same, and that all facts therein by him stated are true.
Permit No. �� 1 Date �® Read, Sworn to and Subscribed before me.
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address ...._. tice /._ E7
Registered Architect and /or Engineer ��+
Name and address of licensed contractor.__ & � o
Location and legal description of lot to be built on:
Lot 1 7`' 1 3 Block 7 .r
Street and Number where work is to be done
Statork to be done and purpose of building (by floors
Disapprovedh 1 f D
(Signed)
Building Ins:, ctor
Subdivision.
i t s
Date L 19 49 3
Street__, e _ 7 6 . 5 7f--
2L/
_ and for no other purpose.
New Building Remodeling Addition Repairs No. of tories
To be constructed of Kind of ffupdation Roof Covering_ -_ -- )(L - - -_ P
Estimated Total cost of improvements $_ d 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 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. o /�
Remarks (Signed) „�` 6� ��'G/C�'7
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. ^�
Permit No ` 7 Date 1 — f c.3 Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
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.