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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.