Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
ROOFING
GYM . I HER riginal his office_ n D ?d SS my hand and •fficiaf Sea . Y �tfil �otarts HARVEY RUViN,( Circuit a 1l. 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: /0 'i gg 2. Description of improvement: 3. Owner(s) name and address: Interest in property: Name and address of fee simple titleholder: 4. Contractors name and address: 6. Lender's name and address: ilfferent dale Is specified) rotary Public rint Notary's Name ly Comrn)ssion Expires: OP Y CERTIFY bOliN'1"Y b , ► o : this i D.C. br+an+r of Ownw 'rint Owners Name :worn to and subscribed beforkme this ) day of NOTICE OF COMMENCEME • couM .k. In i/c9 f)E 1 4 L Me-„it 9/AL/(A 5. Surety:(Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 8. In addition to himself, Owner designates the followin Section 713.13(1)(b), Florida Statutes. Name and address: U !1 U11 -Nv P 6 1 1344 :1aTP OF FLORIDA SANDRA D. HART MISSION = DD403R08 EXPIRES: APRIL 02, 2009 111110 1111 111111311 13111311 1113 1111 C: F1 , 1 200 '-sR0:0612 _L 62 OR Bk 23473 Ps 3043i (ips ) RECORDED 06/14/2005 14:20:57 HARVEY RUVIN► CLERK OF C:OIJRT MIAMI -DADE COUNTY? FLORIDA LAST PAGE 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as prpvided by Section 713.13(1)(a)7., Florida Statutes, Name and address: son(s) to receive a copy of the LJenor's Notice as provided in ). Expiration data of this Notice of Commeitcement:'(the expiration date is 1 year from the date of recording unless a 4 Prepared by: 1114 3PQS - 46q 3468 Pe-. MIAMI SHORES VILLAG 6 BUILDING DEPARTMENT c9 305- 795 -2204 ��� Building Inspection Request Date sq I Or Type Insp'n' rid 1 Permit No. ta — Name MC:bn rn c r Address Company Phone # 1043 1I 94 ST Qbc 2c) -+ (a05)75 - Zb I Z Inspection Date 9 1 Approved Correction Re- Insp'n Fee ©S Type Insp'n 7r) cot) (Poo() Permit No. /2) — 4:DC:7 Name cbr) Ton rrcr Address 104E NE 9q ST 4fr. 153L Company ObenC3At raDlin3 sh-ce-+ meta I Pp Iy Phone # Ins Date Orc / 23 /05 Date Cb /aa 1 05 Correction Re- Insp'n Fee ZJ76 -- � /zg MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request DatecYo /2 3 / 0 5 Type Insp'n I+ rY OP Permit No. 2-0055 1E I Name r Ti- n r) C. r Address 104 �� � 8 N E 9c3 ST 44-./53 j �, -}- CompanyO - r kw n9 s✓ i cc- ' R d 1 aGv 1 y (3)7 21 Phone # Inspection Date 0 / Approved Correction Re- Insp'n Fee o / MIAMI SHORES VILLAGE tb 441) BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ! 1 5 1 Type Insp'n r► 1"C- r .'• I r Oq r e Permit No. BPC75 - 1 Name G�n ne I Address Io4'8 N q4 p ST CompanDb �-r ) ( R�1 ✓7 j Phone # ( 305 ) 751 - Z6 I Z Inspection Date 8) 16 l c 5 Approved Correction ❑ Re-Insp'n Fee ❑ Test Location Uplift Pull Test(P or F) Test Location Uplift Pull Test(P or F) Test Location Uplift Pull Test(P or F) Test Location Uplift Pull Test(P or F) 1 - f / /eA 26 51 76 2 27 1l 52 77 3 28 53 78 4 29 54 79 5 30 55 80 6 31 56 81 7 32 57 82 8 33 58 83 9 34 59 84 10 35 60 85 11 36 61 86 12 37 62 87 13 38 63 88 14 39 6 89 15 40 65 90 16 41 66 91 17 42 67 92 18 43 68 93 19 44 69 94 20 45 7 70 95 21 46 71 96 22 47 72 97 23 48 73 98 24 49 74 99 25 50 75 100 SITE SPECIFIC INFORMATION _ Owner's Name s& 'pc d- t - -2 Permit # � " 7443 Job Address 04 Es I- -••-_, 99'' h/tt+ko. -t e s ,51 Roofing Contra or OB o c sza F't t*' ci Type of Tile: ThP- - > a-t, Date Installed: e' - f 8.°1) S Roof Pitch: as U.S. SOUTH Engineering & Testing Lab., Inc. 6065 N.W. 167th Street, Suite B -23 • Miami Lakes, Florida 33015 Telephone: (305) 558 -2588 • Fax: (305) 362 -4669 ON -SITE CONCENTRATED UPLIFT LOAD TESTING OF ROOF TILE IN FULL ACCORDANCE WITH METRO -DADE BUILDING CODE COMPILANCE PROTOCOL TAS 106 Approximate Roof Height: t ` feet Type of Access to Roof: Scaffolds v Approximate Square Footage of Roof Zt q ° O ft Required Testing Fore: 35 lbs. Testing Equipment: Chatillion 100 Date Tested i' IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL TAS 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST. THIS REPORTS B TED BY: Civil Engineer: Lab Certification # 98 0608.04 State of FL Certificate Authorization # 4100 -er TEST RESULTS P = PASS, F = FAIL Project No 6350 Other Sketch of Roof • i • ii 111111 111111111111111111111 111 li 1111111 111111111111111111/1 III IIIMMEMEammilmuniEltmEENOMMEMME IMMININWAiii 1iiL'Ai /iiiWULAiii A� RR ii RRIRIIIIi i►ILii\\iviBiiii%I.ill.ii SUIT; I IIIII■►MMEME +liiir 7MME !gip iii i11r!�■i /LLB /(1a1/ iii EINIMMilli iiEM NMMOSONEMii► /.iii' iii iiIIIIilliiitN /iiiW1IULM Ma,, IRE ■iiiMailiii\i %EiiAMMERINIMMEW iii ■iii!' i11ii'ammr ,mmommammi\i c ad\■ ■ m iiiiMMEMISiM►riiEMEME li OOMM iii iiiiMillN MM- Iiiiiiiiiiii!+iiUMEN ■iiiEiAIME ll`ii \iii "Uii■LMO B►\ 111 EMINIMMUMM7Ei�ir7iiEiiiriiiii�l iii iiimN\`ammiiiiiimmi ■ iiii�lil�!!�EMET IE Aiiiiiiii• ■ Notes: 44 rl-te Scale Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 6/7/2005 Applicant: DAN TANNER Owner: TANNER DAN JOB ADDRESS: 1048 NE 99 ST Contractor OBENOUR ROOFING SHEET METAL & SUPRI i t ctor's Address: 9301 N. E. 6 Ave, Suite A101 Local Phone: 305 - 757 -2612 Parcel # 1132050180180 Building Permit Permit Number: BP2005 -769 Legal Description: REV PL MIAMI SHORES SEC 8 Page 1 of 1 PB 43-69 LOT 9 Fees: Description Amount FEE2005 -7494 Submittal Fee ($50.00) FEE2005 -7495 Building Fee $300.00 FEE2005 -7496 CCF $11.40 FEE2005 -7497 Training and Education Fee $3.80 FEE2005 -7498 Technology Fee $7.50 FEE2005 -7499 Scanning Fee $3.00 Total Fees: $275.70 Total Fees: $275.70 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 11/20/2005 Construction Value: $18,480.00 Work: RE -ROOF INSTALL Signed: (INSPECTOR) A 1 u PA;D c 24 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: BLK 179 LOT BUILDING PERMIT APPLICATI FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) or 95' City antr-v% ' fS".,. Owner's Address Tenant/Lessee Name Job Address (where the work is being done) / 4 U P F 99 /Go City Miami Shores Village County Miami -Dade is Building Historically Designated YES NO / Contractor's Company Name f&batt I f Phone # Contractor's Address 9,3 V/ 4.)E OA C IAA A — /Z'/ City /)/L(il-wtJ 4L State i. Zip 33/3 23 Qualifier J 0 4740 g/2■rc7i.z4_, State Certificate or Registration No. $ Value of Work For this Permit Total Fee Now Due $ - 7‘5.. 7C) (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 State PC Zip 33/38 Phone # / 0o Ts 1 = tc N 2it pi;n electrical Plumbing in( • b , Permit No. _; Master Permit No. Phone # Architect/Engineer's Name (if applicable) Phone # Mechanical Square Footage Of Work: Describe Work: / I' 1 / — c J 2 4+ZJ/ (-4/n.4)-WA 1/l / .. PA,/9j4.p • Zip Certificate of Competency No. ent- Type of Work: ❑Addition ❑Alteration ❑New 42 Repair/Replace ❑ Demolition 4 I C * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** S Submittal Fee $ 5C4 .00 Permit Fee $ 00 C CF $ t I , y C CO /CC Notary $ Training/Education Fee $ ` 2C; Technology Fee $ 1 . 5C-; Scanning $ 3.' Radon $ Zoning Bond $ --'"' Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first insp ccurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will of a..roved .vd a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this `(..) day of , 20()x', by ,t) p ~3I ( /t/ who is persona to me or who has produced P Y P -.' NOTARY PUBLIC: Sign:.�k J% Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 As identification and who did take an oath. NOTARY PL13UC.STATE OF FL ORIDA ,,yy SAIpM�DpP�AyA D. rL • 17TL 02. 20 L ;i�IPLS; umudai'ad — t:+.)R...'. Bo ading Co. Iu:• Signatur Contractor The fo eegoing instrument was acknowledged before me this' , day of , 20 !�3 ,, by ,J22,H,, 9. of rirnu who is personally known to me or w.h has P roduced as identification and who did take an oath. NOTARY PUBLI Sign: ,k ' 7 Print: S SA V D/- f' 1/ My Commission Expkesrtugr PL! .11?C•17'. O * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Al ** * ** fit #:z , * ** W k f, "),C c 1tr. 0,,, .JU9 r9 Co,iit:. * **** ** **** * **** * *******+k**** ** * ** k j *** * *** * *# * jk***** **************** ******=k***%k #*** **** ***** *** ** ** /€J Plans Examiner Engineer Zoning a:cc:a visLociTY tTuRRIcixua 11 - ItlaQUIRZD nat 3FI COWSIDURATICair5 percainti; to zhi z ia the reapona.iby. of tn. contraacor to provida trl owner wt the required rain pea:mit, and to mNpaain to ch.L: owner the aontent of thiri Lact:: The ot Chapter 15 of Crte Suilain9- Code, 41.44:.:ding govern the minimum r .and atandda of the indiaatry for roofing ..=ay4cem ingatallaciona. Adaition4l1v, Lhe following itewe ehould be addreai pexc of chi: agrement tbe c.. and the t:ohbraator Th awnex-4 iniGial in clIk:s deo:Lon:aced apace indicare.:4 that the item haa been explalnen. .LLaatbe.ciew-WorkilaAaahip; The wnrkmantlhip pcov1 of C hapter VelociVy liurrice.ne Zone) ara for th pi,:cpaae of providir: that cht to f;Lo,D 15yelcem m44t$ che wind reiatanee a.nd W4C.L" int.ruAion gorfor-manc: Aeathetice (appaaranbe) are na.t a conideration reapect Go workmanship pro-viaiona. Aeathecc., truc..11 CIS COlor or Architectural appearance, that ara nut par; of the owner and (he cD zoning cod, anoald b addressed pare Of n1 agi hel:.wee'n 114LailiA wp9d Dackai When replacing rooting, Ole -i11 wood root deck cuvi• have co ba renailea in acCQCdiaalC With che cur-ant provi4licns of Char_16 (High Velocity Hurrib&he Zone 5',) of the. root deck uelually concealed prior to removing the exi$Ldn9 roof (The evetem). '1>1 3. QC,41:1 koot common roofs are those which have no visible • •%. delineation between nei9hboring 'LuAits (i.a cownhougas, condominiums, atC.), In buildings wiCh COMM 1:00f4, the roofin2 concraokror and/or ovnez should notify (he occupinra of adjacent unica of rcofin9 work to be partormad. gocpoac,d coilinG#1 Expoaed, open beam ceilings art whare zha underside of the-roof decking can be viewed from below. The ownt may web co maintain the architeccusal appearance; therefore, roofing nail penetration::: ar the underaida of the decking may not be acceptable. The providee the optiOrl of maintainin9.thin appearance. d>17...„:B. POUGUIAV WaiZer; Tbe current roof ss;aam andfor deck of che butidtn9 may no drain well and may caLia water t.0 pond ( accumulate) in low- lying areas of the roof, nding can be.. a.n indication Qi Ecructural ditredia end may require che i7c.-viw of a profeLIsional ticrucLural en9ineer. Pwading Ray sborcea che lite expectauiCy and perfo..tmancle c)f c. flaw roofing systam, Ponding condiciona may not be avident watt: oorrectad. che orlqinal roof3.n9 $yscem is removed. Pcinding condit'onz k.hould be VC 6, ovor4101. laeuppar4 (wall outlets) It is reqUired thac rs:inwaCer flow off ao that the :Ifc . i.is not overloaded trom a buildup of wacer. Perimectr/edge w Or other roof extensiohs may block chis discbar9e it overflow ecupper e ;wall outlatz) are not providtd. lc may be requiremente ot; necetlaary t',0 install ova:flow scuppers ifl 4CCOrd4TIC with,OW --,-1: 7, Vila. Nogt roof sc:ructres should 11.5.v eOme Tabi.UCy CO VI natural air cha . flow through interior of the structural assembly (ahe 'self) The existin9 amount of attic ventilatlon shell not It may i* bebaficial co consider additional vancing which e.end14 the service -littA4 cha roof, - ... Or if ,;. arc.1 C. .4.1.46./ i . 410, or,.$ $igncure Roof System Required Sections of the Permit Application Form Attachments Required See List Below Low Slope Application A,B,C 1,2,3,4,5,6,7 Prescriptive BUR -RAS 150 A,B,C 4,5,6,7 Asphaltic Shingles A,B,D 1,2,4,5,6,7 Concrete or Clay Tile A,B,D,E 1.2.3.4.5,6,7 Metal Roofs A,B,D 1,2,3,4,5,6,7 Wood Shingles and Shakes A,B,D 1 2 4 5 6 7 " ' Other As Applicable 1,2,3,4,5,6,7 1. Fire Directory Listing Page 2. From Notice of Acceptance: Front Page Specific System Description Specific System Limitations General Limitations Applicable Detail Drawings 3. Design Calculations per Chapter 16, or If Applicable, RAS 127 or RAS 128 4. Other Component Notice of Acceptances 5. Municipal Permit Application 6. Owners Notification for Roofing Considerations (Re- Roofing Only) 7. Any Required Roof Testing /Calculation Documentation Florida Building Code Edition 2002 High Velocity Hurricane Zone Uniform Permit Application Form INSTRUCTION PAGE COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING PERMIT APPLICATION FORM. AND ATTACH THE REQUIRED DOCUMENTS AS NOTED BELOW: ATTACHMENTS REQUIRED• t Florida Building Code Edition 2002 High Velocity Hurricane Zone Uniform Permit Application Form. Section A (General Information) Master Permit No. Q �+ Process No. Contractor's Name Oh (Jyi bit Job Address / ULm ❑ Low Slope ❑ Asphaltic Shingles ROOF CATEGORY ❑ Mechanically Fastened Tile ❑ Metal Panel/Shingles ❑ Prescriptive BUR -RAS 150 ROOF TYPE Mortar /Adhesive Set Tile ❑ Wood Shingles /Shakes Are there Gas Vent Stacks Yes ❑ No Type: Natural ❑ LPGX ❑ ❑ New Roof Re- Roofing ❑ Recovering ❑ Repair ❑ Maintenance ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF) dv-5 0 Section B (Roof Plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. Include . dimensions of sections and levels, clearly Identify dimensions of elevated pressure zones and location of parapets. ---- - - - - - 1Iir" i iiIi Ibi! Ii IIiII iI 1I U hi oiI I 1 iI I I 1 lipri . � lei I VIII 11111111 1)1111! 1 L I I 1 111 k IL aI p J4P1- qiiiij ill r .Aggli yiri 1 iiiiihdlii IIII III III . ii 1 123_01 -48 5/03 PAGE 2 Roof System Manufacturer: - Notice of Acceptance Number: d )-- I ( ( • 0 g Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations): P1: C' P2:J ''1 P3: . I q Maximum Design Pressure (From the NOA Specific System): DA Method of tile attachment: p Florida Building Code Edition 2002 High Velocity Hurricane Zone Uniform Permit Application Form. 1 Roof Slope: :12 Section D (Steep Sloped Roof System) Ridge Ventilation? Steep Sloped Roof System Description Deck Type: rp I ype Underlayment: Insulation. Fire Barrier. 12� Oa- asten Mean Roof Height: t 1 rJ A r Type & pacing: dhesive Type ype Cap Sheet: ( Aset-14-ii iRo igrM p z0 oof Covering: ,M-a ttdi Type & S'ze Drip 7 tr ,u L Edge: * pkcy,,10- 0/c M Required Moment Resistance* Mean Roof Height - Roof Slope I 15' 20' 25' 30' 40, 2:12 34.4 36.5 38.2 39.7 42.2 3:12 32.2 34.4 36.0 37.4 39.8 4:12 30.4 32.2 33.8 35.1 37.3 5:12 28.4 30.1 31.6 32.8 34.9 8:12 26.4 28.0 284 30.5 32.4 7:12 24.4 25.9 27.1 28.2 30.0 Florida Building Code Edition 2002 High Velocity Hurricane Zone Uniform Permit Application Form. 1 Section E (Tile Calculations) For Moment based tile systems, choose either Method 1 or 2. Compared the values for M with the values from M If the M values are greater than or equal to the Mr values, for each area of the roof, then the tile attachment method is acceptable. Meth (P 7 Y j ( /".t z (+ 3: / E0. !(ii x d 1 " went Based Tile Calcula - Mg: 10,6 =Mrt - Mg: 6, = - Mg: 60 ( = 111; ; ns Per RAS 127" NOA M 41 O. NOA M L/0 V NOA 111< 110. Method 2 "Simplified Tile Calculation Per Table Below" Required Moment of Resistance (Mr) From Table Below NOA 111 *Must be used in conjunction with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared the values for F' with the values for F If the F' values are greater than or equal to the F values, for each area of the roof, then the tile attachment method is acceptable. Method 3 "Uplift Based Tile Calculations Per RAS 127" (P z1• = z w:= ) -W: x cos B: = Fri: NOA F' (P2: x1: = x w:= ) -W: z cos B: = Fr2: NOA F' (P3: x 1• = x w: = ) - W • x cos 6: = Frs: NOA F' Where to Obtain Information Description Design Pressure Mean Roof Height Roof Slope Aerodynamic Multiplier Restoring Moment due to Gravity Attachment Resistance Requited Moment Resistance Minimum Attachment Resistance Require! Uplift Resistance Average Tile Weight Tile Dimensions Symbol P1 orP2 orP3 H 8 M s M r M, F' F, w 1= length w= width All calculations must be submitted to the Building Official at the time of permit application. Where to find RAS 127 Table 1 or by an engineering analysis prepared by PE based on ASCE 7 Job Site Job Site NOA NOA NOA Calculated NOA Calculated NOA NOA 123_01 -48 5/03 PAGE 5 1D C2/03/2005 12:26 MEDITERRANEAN R00- TILE 4 3057588484 M1AMIOAOE BUILDING CODE COMPLIANCE OFFICE. (aCCU) PRODUCT CONTROL DIViSION NOTICE OF ACCEPTANCE (NOA) Monier Lifctilc, LLC 135 NW 20` Street Boca Raton, FL 33431 N0.381 D001 A IAA Ii -0ADE COUNTY, FLORIDA METRO.DADE FLAGLER BUILDING 1-10 WEST FLAC.LER STREET, SUITE 1603 FLORIDA 33130 -1563 (305) 375.2901 FAX (305) 375 -290S SCOPE: This NOA is being issued under th_ applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed 'Sy Miami -Dade County Product Control Division and accepted by the Board of Rule; and Appeals (BORA) t be used in Miami ,Dade County and other areas where allowed by the Authority Having Jurisdiction (A -i1), This 1N'OA shall not be valid after the expiration date stated below. The , Miami -Dade County Product Control Division an Miami Dade County) and/or the .r.1 -11 (in areas other than Mimi Dade County) reserve the right to have this product or material tested for quality assurance purposes. if Cnis product or material fails to perform in the accepted manner, the manufacturer will incur the expense of sue; testing and the AHI may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right co revoke this acceptance_, if it is determined b Miami-Dade i_cLnt■• Product Control Division tha; this product or material fails to meet the requirements of the applicable building code. This product is approved as desc /bed herein. and has been dcsi_. to comply with th,t itigh Velocity Hurricane Zone of the Florida Building Code. DESCRIPTiON: Atlantis Shake & Slate Concrete Roof T;le LA13EL[NC: Each unit shall S ear a permancrt label witri ;he manu ;'aeturers non,;, or logo, city, state and following statement: "Miami -Dade County Product Control .Approvecd unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting t:,t performance of this product. Z ER.iM[NATION of this NOA will occur after the expiration date cr if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other ou: shall autorna;ieally terminate this NOA_ Failure to comply with any section of this NOA shall be cause for tcrminaaon and removal of NOA, ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County, Florida, and followed by the expiration date may be displayed in advertising,, literature. IF any portion of the NCA is displayed, then it shall be done in its entirety. i! .SPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA consists of pages 1 through 6. The submitted documentation was reviewed by Frank Zuloaga, RRC NOA No.: 02- 1211.08 !Expiration Date: 12/16/07 Approval Date: 01/09/03 Page 1 of 6 1 02/03/2005 12:26 MEDITERRANEAN ROOF TiLE_ 4 3057588484 ROOFING ASSEMBLY APPROVAL Category: Roofing Sub -C .tc4ory: Plat Profile Roofing Tiles Material; Concrete SCOPE. This renews a system using Monier Lifetile Atlantis Shake & Slate Concrete Roof Tile. as manufactured Monier Lifetile LLC and described in Section 2 or this Notice of Acceptance. For locations where the pressure requirements, as detcrn'ined by applicable Buiicling Code does net exceed the design pressure values obtained by calculations in compliance with R.AS 127 using the val;:es listed in section 4 herein. The attachment calculaiions shall be done as a moment based system. 2. PRODUCT DESCRIPTION Manufactured by Test Applicant Dimensions Specifications Monier Lifetile Atlantis Shake and S'ate Tiic f:lrn Ptccc5 Test Acze5 c. Redland Technctogies The Center for Applied Engineering. Inc. The Center for Applied Engineering, inc. • The Center for Applied ingineering. inc. The Center for Applied Engineering, Inc. 1= 1; w = 10 )1 ,1., 1 'A' thick I = varies w = varies varying thickness 2.1 SUC3MITTED EVIDENCE: 7161-03 Apprtdix 111 94 -O5OA 94 -031 25 7094 - 2 25-7094-8 25- 7094 -5 ['l1 112 I'll 112. Test identifier Test vitro /Report Static Uplift Testing PA 102 & PA 102(A) Static Uplift Testing PA 101 (Mortar Sct) (Adhesive Set) Static Uplift Testing PA 102 (4" Headlap, Nails, Direct Deck. New Construction) Static Uplift Testing PA 102 (4" Idcadlap, Nails, Battens) Static Uplift Testing PA102 (4" Hcadlap, Nails, Direct Deck, Recover/Rcroof) NO.381 P002 Product DC$Cription Flat, interlocking, high pressure extruded concrete shake.anc slate roof We equipped with two nail holes. For direct deck, mortar or adhesive set applications. Acccs;ory trim, concrete roof pi_ccs for use at hips, ekes, ridges and valley terminations. Lianulacturcd Ior each tiic profi:c. Date pre. 1991 March. 199' May 1994 Oct. 1 99 Oct. 1994 Oct. 1994 NOA No.: 02- 1211 -08 Expiration Date: 12116(07 Approval Date: 01/09/03 P.OP 7 nr 02/03/2005 12:26 MEDITERRANEAN ROOF TILE - 3057588484 Test Agcnco The Center for Applied Engineering, Inc. The Center for Applied Engineering. Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Irc. Rpoland Technologies Rcdiand Technrolo_ies Redlar d Technologies Redland Technologies Center for Applied Engineering, Inc. Professional Seri cc Industries, Inc. Cciotex Corporation Testing Sl:1".1", :`. Walker Eng:nc+:ruig, Inc. Walker Engineering. Inc. Walke7 Engineering, Inc. Walker Engineering. inc. Walker Engineering, Inc. Walker Engineering, Inc, Walker Engineering, Inc. Walker Engineering, Inc:. Test Identifier 25- 7183 -6 25- 7183 -5. 25-7214-1 25- 7214 -5 7161 -03 Appendix. 11 Letter Doted Aug. 1, 1994 P0631-01 PO402 Project. No. 307025 Test » +M DC -77 224-47099 5201094 520111-4 • 570191 -1 Calculations Calculations Calculations Calculations Calculations Calculations Calculations Calculations Test Name/Report Static Uplift Testing PA 102 (2 Qixik -Drive Screws, Direct Deck) Static Uplift Testing PA 102. (2 Quik -Drive Screws, Battens) Static Uplift Testing PA 102 (1 Quik -Drive Screw, Direct Deck) Static Uplift Testing PA 102 (1 Quik -Drive Screw. Bailees) Wind Tunnel Testing PA IOS (Nail -Or..) Wind Tunnel Testing PA 103 (Nail -On) Wind. Tunnel Testing PA 103 (Mortar So) Withdrawal Resistance Testing of screw vs. smooth shank calls Wind Driven Rain PA 100 • Physical Propertics PA 112 Static Uplift Tcstin. ?A 101 Aerodynamic Multiplier Moment of Gravity 2 - 75-7496 25 -7584 25- 7804b -3 25-7804-4 & 5 25 7845 - 6 25-7183 Date Feb. 1995 Feb. 1995 March. 1995 March, 1995 Dec. 1991 Aug. 1994 July 1994 Sept. 1993 Oct. i 994 Sept. 1994 Dec. 1993 ,vlarc h 1999 March 1999 Sept. 1999 February 1996 April 1996 December 1996 March t 995 Aerodynamic Multipliers April 1999 Two Patty Adhcsive Sct System April 1999 NOA No.: 02- I211.08 Expiration Date: 12!16!07. ' Approval pate: 01/09103 Page3 of 6 N0.381 P003 02/03/2005 12:26 MEDITERRANEAN ROOF TILE 3 3057566464 Monier L Fp; i Ail Shake g late Tile r=- _Tab bl Z A —.- Tile Profile FM1er Llfelile Atlantis k Sha & :late Til 3. LIMITATIONS 3.1 Fire classification is not part of this acccpiance.. '.` For mortar or adhesive set file a accordance with RAS 1pr, pplicat,ons, a static field uplift test shat; be performed in 3.3 Applicant shalt retain the sre quarterly test in accordance with TAS t 1 1 ? arlr C >ade County Certified Laboratory to perform the Building Code Compliance Of jCe for rev cv radix A. Such tcstin�r chat f be submitted to 3.4 Minimum underiayrncnt shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.S 30/90 hot mopped under!;:yl,icnt appfication.s m4 • � APPtcations unless stated otherwise r he underla y be installed ,_, 3.p . 7h' y t yment material manufacturers sp ublis h e to :he roof slope d s acceptance is for wood deck applica_icns. Minimum deck me [s shall be in literature. compliance with applicable building code. uc 3.7 May be insta!!ed on slopes 7:12 and greater with a minimum, of two sortws. 4. INSTALLATION 4.1 Monier Lifeti,e Atlantis Shake and Slate Concrete Roof Tit installed in strict compliance with Rooting ��,. e and its components shall be 120. ��pp•��ar,or Standard RAS 14. 4 . 2 Data For Attachment Calculations RAS t i o and Table 1: Average Weight (W Dimensions (1 ,and Dimensions (! x: w ) Tile Pr_afife Weight -W (lbf) Length•I ft � nI Width -w (ft) 8.5 1.25 0.86. S 1 namic Multipliers -_L ({ —L ^ � . (ft') Direct Deck Aulicatipn 1 0.7.3 - - 7 — Table 3: Restarin 9 Morrte Gravit t Tile - ----�. ra ts due t o M ft !b 3":12" 4":12" --' Profile " :12'� 5.,;12" i —. t3 :12" 7 or Monier Lifetee Atlantis Direct Deck Lt S nake & State Tire —� Direct Deck Direct Deck — � realer — B.0 t 9 � - Direct Deck DirectOeck 5.8 5.6 NOA No.: 02- 1211.o$ Expiration bate: 12/1i5/07 Approval Date: 01109/03 NO.3B1 P004 02/i3./2005 12:26 MEDITERRANERN ROOF TILE 3 3057588484 Tile Profile Table Monier Lifetile Atlantis Shake & Slate Tile Monier Lifetile Atlantis Shake & Slate Tile 4: Attachment Resistance Expressed as for Nail -On Systems Fastener Type Direct Deck (min 15I32" plywood) a Moment - M (ft -lbf) Direct Deck (min. 19f32" plywood) 2 -10d Ring Shank Nails 30,9 38.1 1 -10d Smcotn or Screw 7.3 9.8 Shank Nail 2 Smooth or Screw 14,0 J 18.8 _ Shank Nails _ 1 #8 Screw 30.8 2 #8 Screw i 51.7 1 -10d Smooth or Scre• „ : 24.3 'Shank Nail (Field Clip) • - 1 1.10d Smooth or Screw 19.0 19 0 Shank Nail (Eave Clip) 2 -10d Smooth or Screw 35.5 Shank Nails (Field Dip) 3�._ 5 2 -10d Smooth or Screw 31.9 31.9 Shank Nails (Eave Clip i Large padd lacement of 45 grams of Polypi-G1". Mediumpaddy placement of 24 24 grams of PolyPro ' . 30.8 51.7 24,3 Table 58: Attachment Resistance Expressed as a Moment - M, (fit - Ibf) for Mortar or Adhesive Set S 'stems Tile Tile Attachment Profile A lication Monier Lifetile Atlantis Sh ake r Slate Tile ``' gyp Resistance Mortar Situ- 39.0 Battens 17,2 �.9 7 .4 18.2 _ 24 4 24.2 22.1 H ? 10d Rino Shank Nails' . 50.3 .65.5 installation with a 4 Tfile hee_ ap and fasteners are locatetl a min. of 2%; ff om head of t :le. 34.8 32.2 48.3 Table 5: Attachment Resistance Expressed as a Moment M, (ft-Ibf) for Two Patty Adhesive Set Systems Tile Profile r Tile Application i Minimum Attachment L_ Resistance ;Monier Lifetile Atlantis She 8. Slate Tile 1 Adhes.ve 2 See manufacture;. corn cnent a royal for installation requirements. ( 31.3' 3 Flexible Products Company TileBond Average weight per patty 13.9 grams. Poiyfoam PrM:ct Inc. Avera e Nei ht ar rt. 5 grams. Table SA: Attachment Resistance Expressed as a Moment - M, (ft -Ibf) for Single Patty Adhesive Set Systems s The Profile Tile Application Minimum Attachment Resistance PotyPron" 1 18. PolyProTM 40.4' NOA No.: 02- 1211.08 Expiration Date: 11/16/07 Approval Date: 01/09/03 b...... a ...• e NO.381 P005 e1�' e �•.�i � un 1'2:26 t IED I TERRANEAN ROOF TILE 4 3057588484 • 5 . LABELING All tiles shall bezr the imprint or identifiable marking of the manufacturers name or logo, or following statement; "Miarrri -:Dade County Product Control Approved". 6. BUILDING PERMIT REQUIREMENT'S 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. • 6.1 .2 Any other documents required by the Building Official or appiicabie building code in order to properly evaluate the installation of this system. PROFILE D RA WINGS • • MONIER LIFETILE ATLANTIS SI[AKE &.•SLATE CONCRETE ROOF TILE • END OF THIS ACCEPTANCE `�� i•xt�onNDat�; =, rYpi n 2%1i�r07' PPi Die .(11 /O9fl 3 r �: NO.381 P006 �✓. r )Lt1 V.t!1 rr uL'L 1' +L . PRODUCT Ct7NTRQL IVnT1C` OF . Pnlyft):tm Products, Inc. �CCC� t�?1'� -1' 2400 Spring- Stucbncr Rtiu;uj Spring ,T\ 77353 -1132 MIAMI-DA DE COUNT Y, FLORIDA FL METRO- D,t1)E .FL.AGLER (BUILDING n(ILOINI,, Cone; CO\Ir'L1,1NCE OFI MMETao- D, \Dr; CA-CR t I-I0 WEST FLAG:., STREET. tits E 1Gi1.1 hr I, \MI• FLORIDA 3)1 30-;.56) FAX (.1O 375•'918 J.(fl %I`It.t 1.1Ct:.vtilNG :;t: <-rI(.N 00) pS -2i77 )'nX 005) CoN'I I(.l(`1'QIt EN1' 01tCl :\I IiN'I' 111\'1\ION (105) )7S -wbc, VAX \ (305) 1 ?5 -7910 I'IU)UL'CI' CONTROL DIVISION (315) 115 -2902 1:AX. ()US) )72.-6.1; Your application or Notice oFAcceptzncc (T Two Component Polyuretht:nc Foam AkIlrisivc under Chapter 8 of the Code ol'Miami -Dad County governing the use of Alternate Matt:riais and T : . Construction, and completely duscribFd herein, has Ypus or County Bui!ding Code Compliance Office (>•3CCQ) under the tconditions acceptance the Miami Dade NOA shzll not be valid after the procluct or n th!rial at any time from • expirofion date stated below. BCCO reserves the right to sect;re this a tl o b }ppror man manner. a ctur is plan n( tbrrquality Control ($(ing. If this I3raduc( or material fails to pPrrorm in use of such product Of material intlT ly. BCC() ", � Ql�a, ITtudify, or suspend 111c t,It:tLri]lln� d reserves Ole right to revoke Ihis approval, if it is by BCC:O that this product or material fails 10 meet the requirements of the South Florida 13uildir g C The expense of such testing will bt; incurred by the manulacturcr, ACCTrl'A.NCJ: NO.: 01- 0521.02 EXPIRES: 05i10i2006 Raul rd_Ddriguc Chief Product Cor•.trol Division TI. TIIl; COVFRs11FFT 6F.F. ADDI r'.t(;F,S I 'n12 _ IfCII'fC nNl C;f:NC[2,�T. C 2f n1TIONS rat r >'3rNCY c -m rRpnt,:gT vvrEw cohlmtT riliy application for Product Approval has been reviewed by the BCCO and approved by fho Building Code and Product Review Committee to be used i1; tvtia,ni -Dade County, Florida under the conditions set forth above. APIIROVFD: (16i141i2001 '1s0-130001 \pcIO00wtr.Tpltt(;;\notIto sctepun<c cc-rr Fait clot Internrr ,n„;i add re5s: pnstmnstcrflihui )t)ingan(1ccullinc,c0In 10'd t'8P88S,L;oc 0.L ` i s i azZ , n/ — I rrncisco J, Quintana, R.A. Director I'vlinnti- alrle COIInly 11uillling Code Compliance Uilice 1/J 002 1'1 ni IICp1I C: IMF: Ilwww hu1 Id in gcmlcon c.com I Datida ad r';: 9 T coo. :: , 8d1J J• 11,1 1111. l 1 . V 0 1 !1.1 J Al `1 J 1 1. J. 11' 1 1. PoI,yfmtm Product [ac, ROO tlNG ASSEMfLV APPROVAL Cate ru Roofing Approval Date: ,lane Id a t Suk- rateenry: Root' Tile Adhesive: I'o'ta lc flues: Polyurelllnnc t. SCOPE. This approves I'olypruZ AX11 as n trturactured by Poly fu to Product, Inc. as - described in Section 2 of thi Notice orAcce.pranee. For the locutions where the design prc. ure requirements, as dc .ermined by applicable building code, does not exceed the design pressure values obtained by calculations in compliance with Rooting Application Standard RAS l27, for use with approved flat, low, and high profile roottiles system using Polyprolt Ali 160. Where. the attachment calculations are done as a rnnrnznt based system for single patty placement, and as an uplift based system for double patty systems 2. PRODUCT DCSCBfl TION Manufactured by ApQIicLnt Pulyproa AH16O Per mproa l.T1' 1000 Prof ack0 30 Sc too 2.1 Components or prGrtlttcts manufactured by others: Any Miami-Dade County Produce. Control Acccptl,d Roo rTilc As;cmbly having a current NOA which list uplift resistance values with the use of Polypro Al 1160 roortile adhesive. 2,2 Typical Physical Pi-opertic.. : PrnricrtA Density Compressive Strength Tansile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability Test ASTIM n 1622 ASTM D 1621 ASTM D 1 623 AST v1 J' 127 ASIrM C 96 ASTM D 2126 1.1 \1.1.1 11 \1 /U ,l1.. 0' d $ S^SLS0C 01 :',�CCC SGSg0C ACCEPTANCE, No_ . 01.0521.¢1 1i:spiraliou Date! ML10 2006 Tcs t Product ass Qescriptiu PA 101 Two component polyurethatw Dispensing Equipment Resoles 1.6 IbsJft.' 13 PS1 Pnraitel t rise 12 PST Perpendicular to rise 28 PSI I'lralicl Io rise 0.08 Lbs. /Fi 3. t Perm / Inch +0.07% Volume Chanel.: U. -40° r.. 2 weeks +6.0", t Volume Chance r7 1lumir,lity. 2 weeks Dispensing Equipment s 0 l rarrh Zulongn. ItRC. Product Control Examiner o :a' da ;jJ t'S :9l: C002 20 d,_ {u ,''IJiuJ lttl .1, :ua tA.L NJi ;r,� Atljt C, t] • d 79t'$8S.! :DOE Ol t.l t:. 969 SOC rVl.a.�Vr'. 3 MS R ritVut,''..l : . .1..x.1 . Polyfonm Prodnsts Inc, ACC C1 TANCE No. : 01. 0521.02 Note: The physical properties I sted allove me presented as typic average unties ns determined by ncccptcd ASTM test met rods and nr: subject to normal manufacturing v7rirrtion. 3. LIMITATIONS 3. t 1•irc classification is not part of ;his ;ti :ccpt.ince. Refer to the Prepared Roof Tile Assembly For lire, rating 3.2 Polypro® AI-1169 shall solely be used with flat, low, & high ti!o profiles, 3.3 Minimum undcrl vmencs shall be in compliance with the ltoo!ing Application Standard RAS 3.4 Roof Tile manufactures accluiriog acceptant fur the a ;e. of Polyproa A1-1160 roof vile adhesive with their tile. assemblies; shall tent in accordance with PA 101. 3.5 Roof Tile manufactures acquiring acceptance for true paddy placerner;l with lire use of Polypro0 A1 60 roadie adhesive with their tilt assemblies shall test in accordance with FA. 101 and with secc,on . 0,4 as modified herein. ( 4. 4. INSTALLATION 4.1 PolyprotV ?.H I60 may be used with any roof the assembly having a current NOA that lists uplift resistr,ncc values with the use of Polypro' I A1 4.1 Polyprog Al-1160 shill be applied in compliance with the Component. Application section and the correspend:nb Placement Details noted herein The root tilt assembly's adhesive attachment ',with the use. of Polypra2?' AI.1160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the uplift resistance determined in compliance w.vith Miami -Dade County Roofing Application Standards RAS 12 ?, The adhesive attachment data is noted in the root' tale assembly NOA 4.3 Polyproc AI-1160 roof the adhesive and its components shall be installed in accordance with Root n, ,Application Standard RAS 120, and Polyfoam Produces, fnc. PoIyproZ9 AN160 Operating Instruction and Maintenance, Booklet, 4.4 Installation must be by a Factory T'ained 'Qualified Applicator' approved and licensed by Polyfoam Products fnc. Polyloam Products Inc. shall supply a list or approved applicators to the. authority having jurisdiction. 4.5 Calibration of the Foatlnproc dispensing equipment is required before application of any adhesive. The rnt< ratio between the ''A'' component and the "Q" component shall bc maintained batweeri 1,0 -1.15 (A) : 1.0 (f3). The dincus� timer shill be set to deliver 0.0175 to 0. 1 5lpourids pct tile as determined ,.t calibration. N other settings shall be approved. 4.6 PolyproZ Al-1160 shall, be applied with I'oa npro RTr 1000 or Prol'ack® 30 fi 100 di,pcn;ing cquiptnent Only. 4.7 Polyproer Al.1160 ih,tlII not bc expo5Ld permanently to suniti 4 f rtnl:l..11oaga, I`RC - Product Control Examiner ODUUd. eld SS : 9 1 ;00 7.13 eidld .L ",, icn. .L I . . i r„ rout r L,l .I r•r 1'1.'1 j J .. Pal ;tnl Products Inc. Flat. Low, Flit;h profilos High Profile (2 Piece Barrel) ru • t-8t�. 88'L OC 01 r!1COSE9S0c ACCEPTANCE No, . 0l- 0571.p 4.8 Tiles most be adherid in Cres ply applied adhesive Tile must be set within 2 to 2 minutes aticr Polyprlot A} 160 has been dispensed 4,9 Polyprcg& ,BFI 160 p :tearer( and minimum patty wci,c;h( shall be in nccordance thc'Placement Deiarls' herein, t nc;7 yt;ncrie file profile requires the specific placement noted ,herein. f'n ble l: A.dhcsivt: Placeinen ' or Litch Gencri< Tile Profile Tilcl'rorilc � �j r'1:lcerncnc Single 1'nt1r,) �ti`ci �htT y h I I'wo Paddy Wci6lit Detail �1i (grnois) • per paddy h1 n. tl I - -- — 3S _ I 17is;dc ore cap and NfA NIA 3.1; pan Flat, Low, l'lieh Profiles — 42._ 24 Flat, Low, 1•filll Profiles p3 ' -- ` N/A LABELING AJI Polypro0 AH l 60 containers shall comply wi:h tha Standard (•oncJittons listed herein. •6. 13 CJIILDTNG PERMIT R,QU'1RCM CNTS 6.1 As required by the Building Official Or applicable Building Code it order to properly evaldate the installation of this system Frank luIoa6a, RAC Product Control lx un t$I ,ur n 0:1011-1dS dA SS: 91 000 7- 70 : c — /.;13/(13 THU 17:10 FAA, 954 57!$ Polyfonm Products_ k.4up Com( v,toldp pISIIIL C411101 i rn 1.11 if 1 EP. tElAd 4,0 Ihmgrt pIiiI red LP' rIJun l:M1d00Pygaril avi count est,' K.41 1 top. zo • • 7 . ';‘: .:Th• • • • 0.12 PX01)0.-,11A. ACCEPTANCE No. : 01-0521.02 ApHESI VE PLACEN1EN1 DETAIL 1 SlNCLE PATTY g • d P8V88.0C 01 v. th Ind niath GDYII1 Mir Yder1)0Ai 0 S v41001,* lad It al II TM FiL4 a LF70969Soc 3 N..1 ovdvgn od pile dtd.d.,1 .....-. / - ..... N. N. \ 9 Pdr.tpi9oppP144! ll....(1.trddtv ....›....,...,'''' ..,-- krip )dhrtl. apord.1 Itt 11, 4,rp110111 bplxvio et fl 3c C (00.40 300‘11Vd. Id Wt11”. 11 10 )3 1Q1,1/Aitlatt'l IN ■0 -;it iSe pi ifie PI44p PG li nriluiloni Nal ths.uph piii:: WO( ii 1) vrn Popo! PoPiae I.... rice 40t in I. .N. Id 11:1, Fr7■111nel Ills I dOt al cc.. en' Ilh, V i [Pp.p! 1..411 imp unkaipoi , 0, , .. ,.....r.„-- ..„,- ,. ...... 0 3'. L -:---- 1.:., .-- .:....f. ,-- ..., 0 cc ,,. -...... ---- - ........„,...! I40.1en a L. I • S. I I i f n: 1 :4 ' um Mt U.t tAbdre dria Ind el '7‘ / 11 fr F.tcl, BP ShriViti RRC Proclu,:i. Control ENa.-ninr 03(117YaS dd 9c:91 coo:. 720 90• d 1 / ' 1 1 J A I ; J. 11 reL,S. a 0 Polyfoini_Products i.111?hrouh I1Uc Cement Undlt1307101 \ " 7 i n EV Eftigl CIOSU'l F1■4 Cane ACCEPTANCE No. : 01-04-;21.02 PLACE.1ENT DETA1 2 SINGLE PATTY" 1 Nail inrou;* plIstic cement Unaroy.m.61 \ \ I ; , N N N t Ol V.LCCSERSOC 1 .I' r1uiH.. L. 1 k Intount, al;ull7.e---rnonl 7..---7.------"-- ( 7 . N., ,. /.. .,......--' ki ‘ l,„ : Z . , ......c: ' (,.: ;:.:■.. ''''. N ......s.Z. N., ( N N P.1 f8,4,a?. Friju Zulonga, RR.0 Prothicc Control Examiner ODgudg dd 9S:9I 000,17 20 D:'d 1 di_ C'1 >k PUlyfonm Products, trC. 9. This Notice of Acccp!ance cot' silt: of paste i through S. 1END OF THIS ACCErTAN d 1>ut7S8 SOC 01 t},_E �.S6S OC: ACCEPTA.4CE l \0. : 01 052(.02 Renewal of this Acceptance; (approval) shall be con':idcr.d nrtcr r lieu• ;il application has beer: rll�d and the original submitted II docti nts, Iticludirrg :e.,1-supporting d :tta• cn6.illeermg documents, are no older than cigh: (S) years. Any and all approved pro4ucts shall 'oc perm :uluttly lab lee;, „ rtlr th.: nunul.,cturur's n :utr� city state, and the following Sl:,tcnnn:: 'Miami-Dad; County Product Control Approval ", or as specifically stated in the spt conditions of (1.,:t AceepLu c.. 3 Rcnctvalk of Acceptance will not be considered if: a, Ihe.re has b a c11;>ingc in the South Florida Uluildrng COIJe affecting the evaluation or this product and the produ is not In compliance n,v•th the cock chanr,e:. b. The product is no lonOer tltc same product (idr•ntical) as die one originally approved. c. It the Acceptance hgldcr has not complied rcquircmenls of this acceptance, including the correct installation of ;he pradJact. d. The engineer who originally prcp:,.rcr1, signed and sealed the rcinured documentation Initially submitted, is no lortbcq practicing the engineering profession 4. Any revision or change .n slhe maarials, usc, andior manufacture of the product or process shat) automatically be cause for e.rmination of this Ateeptancc, unless prior written approval has been rquestcd (through the ("din of a revision application 1vith apprppriaL fee) and grated by this ofticc. i 5, Any of the following shall also be grounds for removal of this Acccptnnce: a. Unsatisfactory perfornia.nce of this product or process. b Misuse of this ,lccept'I hcc as an endorsement 0(;uiv product. for ;ale, advertising or any other purposes C, The Notice of Acceptance nu rtber preceded by the tvords Miami -Dade County, Florida, and rol:otvcd by the CN.p;ralion &Ale 111:t. c displayed in advertising literature. Ir any portion of Ow Notice or Acccpi tncc Is displayed, tiien it shall be done in Its cntirt. y. 7 ,\ copy or this Accept :11c% a_ \yell as approved do wings and other documents, where it applies, sh„II be provided to the user by the manufacturer or Its distributors and shall be available for inspection at the job sit.: at all time. The engineer need not reseal the copies, f!• Failure to comply with any section of t,lis Acceptance shall be cause for tcrmii;ation and rcmoval of Acceptance, ."/_ulo:.�.ta, RItC Product Control Examiner 0"i17Nd9 Id 1.S :91 C:O132. 'O dd' MIAMI SHORES, VILLAGE BUILDING DEPARTMENT 305- 795 -2204 BuildinggInspection Request Date (p [ (5 l (( df Type Insp' n - t - ' iJ BOO r t -Q ` 4 - Permit No. SP ©� (o '� Name Q • Address 1048 K-6 •ST Company r k0 - 0 F - 1113 Phone #" S - - 15( - 9a9 Inspection Date Approved Correction Re- Insp'n Fee cQ co( o BUILDING PERMIT APPLICATION FBC 2001 Miami Shores Village Building Department 1 C j ' 1w t m aster Permit No. Permit Type (circle): Building Electrical Plumbing Mechanical Owner's Name (Fee Simple Titleholder) - ban 771/ e✓ Phone # Owner's Address / Q T I 614-7 ��� City . S VLh' State �'/ Zip 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. brzaf-4 9 35/3Y Tenant/Lessee Name Phone # Job Address (where the work is being done) /' ' c GJ di • City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO Contractor's Company Name 23 C t 2 7 k Contractor's Address 1I it,e /06' City A /) .S State Qualifier b Gt irt4e4 Architect/Engineer's Name (if applicable) Architect/Engineer's Address City L4 w, $ Value of Work For this Permit - County Escrow Fee Education/Training Fee $ �i Code Enforcement $ Bond $ Minus Plans Check Fee $ .5 Total Fee Now Due $ 1— A 5/11 Phone # L3 G S. 73 r r - Zip 33)35 Number of: Bays Stories Families Type of Work: DAddition // DAlteration :New Describe Work: 9, P/ l�. La ,!. pls Q'() 7711 " ' d Phone # Zip r 11 Square Footage Of Work: Z 1-, . S Uy la Bedrooms * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Struct. $ zip i ' Permit Fee $ / Rg Notary $ Tech $ 3, 15' Scanning $ 3 Baths Repair/Replace 0 Demolition — Radon $ (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Signature NOTARY PUBLIC. Sign: Print: My Commission Expires: APPLICATION APPROVED BY: chc7r7 /o3 Anton J De Jager Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, .CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first i ctzon wytish occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection ill of approved qnd a reinspection fee will be charged. Owner or Agent The foregoing , , 20 7instrumt was aclmowledged before me this /D day of 7 9C f•, by "D ' _ who is personally known to me or who has produced c/G''j As identification and who did take an oath Signature NQTaRY P Si Zip Contractor The fore aoing instrument was acknowIcdge 1 bef , by who is personally known to me or who has produced MAY 1 7 200k ntification and who did take an oath. My Commission Expires: (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. *************:***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ******************** * ** * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning SECTION 1524 HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with . the required roofing permit, and to explain to the owner the content of this section.. The provisions of Chapter 15 of the Florida Building Code, Building govern the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner and the contractor. The owner's initial in the adjacent box indicates that the item has been explained. y� x 1. Aesthetics - Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane Z6ne) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion performance standards. Aesthetics (appearance) issues are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be renaited in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing roof system). ) r - 3. Common Roofs: Common roofs are those which have no visible delineation between neighboring is (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or owner should notify the occupants of adjacent units of roofing work to be performed. 4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be wed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail penetrations of the underside of the decking may not be acceptable. The Florida Building Code provides the option of maintaining this appearance. -A RT -- 5. Ponding Water: The current roof system and/or deck of the building may not drain well and may use water to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural distress and may require the review of a professional structural engineer. Ponding may shorten the life expectancy and performance of the new roofing system. Ponding 'conditions may not be evident until the original roofing system is removed Ponding conditions shouldbe corrected. 6. Overflow scuppers (wall outlets): It is required that rainwater Sow off so that the roof is not ,,. erloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance with the Florida Building Code, Plumbing. � 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the or of the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the roof Contractor's Name: O (Low Slope Application) O (Asphalt/Fiberglass Shingles) SECTION 1625 HIGH VELOCITY HURRICANE ZONES UNIFORM PERMIT APPUCATION u U Job Address' ROOF CATEGORY O (Nail -On Tile) O (Metal RoofslWood Shingles dt. Shakes) 0 (Other) ROOF TYPE • . 0 New RaoT 0 Re-roofing 0 Recovering Repair 0 Maintenai Flee Roof Area (ft Sloped Roof Area (ft Total (ft Master Permit No. Exposure: category (perASCE 7 -98): Building Classification category (perASCE 7 -93): ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed) DETAIL 1&2 1 1.S AI E gel • O (?Mortar -Set Tile)b MCC NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. STATE OF FLORIDA: COUNTY OF MIAMI -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: 2. Description of improvement: teaM/( tp L6 all /JT c o f 3. Owner(s) name and address: L tvti `7Z1 N I9 Le' do �� 1LE:g t , M iami, .Shorts, /37 Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: J I0 Co 4 (um 5 (y4 3-3 )34' 5. Surety: (Payment bond required by owner from contractor, if 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: iJ i 8. In addition to himsetf, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes., 1 Name and address: ►� Print Owner's Name bA,J l T _p p46712_ Sworn to and subscribed efore me this day of //1/ , 200 Notary Public Print Notary's My commission expires: 123.01 -52 PAGE 4 8/02 TAX FOLIO NO. rosy .ac .3 A6CR eo icr„ Anton J De Jager z My Commission DD003722My Commission DD003722 dE Expires February 22, 2005 ray it,E 99 — amt ,Shy, $f 33136 this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a fled) WtTR.I ESS in . HARVEY i3y FLORIDA, COUNTY OF DADE that this rs a tru ®py of tha CFN 2004R0372403 OR Bk 22310 Ps 1839; (1p9 RECORDED 05/18/2004 11:47:22 HARVEY RUVIN, CLERY. OF COURT MIAMI -DADE COUNTY, FLORIDA LAST PAGE Prepared by — 1)° 171 e. �Cc " '! L/ /plc, Address: 7O &F a le t Gl/vt l S k e / 3', 13g' 111111111111111011111111111111111111101 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 5/17/2004 Applicant: DAN TANNER Owner: TANNER DAN JOB ADDRESS: 1048 NE 99 ST Contractor DALEY ROOFING INC Local Phone: (305)754 -9892 Parcel # 1132050180180 Building Permit Permit Number: BP2004 -644 Contractor's Address: 78 NE 106 ST Legal Description: REV PL MIAMI SHORES SEC 8 Fees: Description Amount FEE2004 -4976 Building Fee $126.00 FEE2004 -4977 CCF $3.00 FEE2004 -4978 Notary Fee $5.00 FEE2004 -4979 Training and Education Fee $1.00 FEE2004 -4980 Technology Fee $3.15 FEE2004 -4981 Scanning Fee $3.00 Total Fees: $141.15 Total Fees: $1411.15 Total Receipts: f0.00 c t. i LLS S\ Permit Status: APPLIED Permit Expiration: 11/9/2004 Construction Value: $4,200.00 Work: ROOF REPAIR Signed: (INSPECTOR) Page 1 of 1 PB 43-69 LOT 9 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: BLK 179 LOT COUNTY OF DADE. J Disapproved (Signed) 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 _..._.. 3� _.__._ Owner's Name and Address n • v�te � ec�n o Cd�i No...L.Q.�if ...... Streetw... Registered Architect and /or Engineer ,,._ ,_,.._ „.,.,, Name and address of licensed contactor 06enowL 2ootut Co. 7357 N. (9. fi).i. u. C . P) i ni • .}4,• Location and legal description of lot to be built on: Lot Block Subdivision /048 N. p9th. R. fUL SItoAR Street and Number where work is to be done _... l .i am _ . State work to be done and purpose of budding (by floors) / emove tftte existing t i 7e - it.00( an�itepLace witA /730 L6. (e.Ct 1-90 L6. a.4 e,- .Lv. : A4a l and ul/ .e c g ,L A n� �Je. and for no other purpose. New Building Remodeling Addition Repairs X No. of Stories To be constructed of Kind, of fo n 00 on /5 o f Covering 28 Estimated Total cost of improvements $ Date Amount of Permit $. Zo 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 theFlorida 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 inspec '•n on the site of the wor uch public notice or notices as are required by the Act. The undersigned agrees to employ only subco•.• at`tors, o work •"r,�' under this pennit, as are licensed by Miami Shores Village. ` Remarks (Sig ed ).. _. 1 STATE OF FLORIDA, 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 tru . ,[ Permit No- 1 `T1 Date 1 j 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. BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ it ' 7 ❑ Owner of 7 Building Architect Contractor or Builder L Legal Lot Description Address of Building CONTRACTCR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA PERMIT N? 7348 Bl. Signed. Work to be performed under this Permit DATE - 195 Contractor's - License No. e:- Subdi- vision Value of Project $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Amount of Permit $ INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covffir6d hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specificationf submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY ea Disapproved D ( Signed ) - MIAMI SHORES VILLAGE 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 jpecified or riot. A copy of approved plans and specifications must be kept at building during progress of the work. _ Date 11 �� , 19 Owner's Name and Address._ , U. / E") /� J C N �� Street_ e, ' 9 Registered Architect and /or Engineer 4 7G L ,./ - . /V d C AJ T L- i Name and address of licensed contractor 'P 0 0 1,J S' C 4 1 .1v 1..77 — Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done ie i ! 5° 9 , ._._ State work to be done and purpose of building (by floors) New Building Remodeling. Addition Repairs. To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building..... Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent SuPplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, , h w 1 to be performed under this permit, as are licensed by Miami Shores Village. - Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the fo going application, and that he did sign the same, and that all facts therein by him stat d arft lrue. Permit No.2.3... . Date BUILDING INSPECTION DEPARTMENT uilding Ins. ctor Chairman Member Member PLANNING BOARD DATE and for no other purpose. �^ J ° No of Stories to me well known, Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. ❑ PERMIT N? 12958 BUILDING ELECTRICAL PLUMBING ROOFING , _ Owner of Buildin g " . .,_ Ft Work to be performed under this Permit Architect Contractor or Builder Legal Lot BI. Description ' Address of Building 1 U 4 1 1 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Subdi- vision Value of Project $ DATF 195 Contractor's License No Amt. of Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed • ... -_"', ..,... . % •.. --- L.- ,,. _ - BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY Remarks 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 - [ .) 19 Owner's Name and Address_ A __ 1_& No Street/2Z Registered Architect and /or Engineer Name and address of licensed contractor C' t Location and legal description of lot to be built on: Lot Block Subdivisign p c Street and Number where work is to be done State work to be done and purpose of building (by ,floors) ____ c9 cs c 1 � _S • r 0 t , 1 0 t 1 t• ' and for no other purpose. Date (Signed f • C� V if p d`• New Building t......--- Remodeling Addition Repairs No. of Stories___ ___I To be constructed of Kind of foundation Roof Covering______ ___ L_Q____ __ 2 Estimated Total cost of improvements $ ' _Q__ of Permit $ , ..5.0.0. Zone cubage required _Plan Cubage Distance to next nearest building _______— __Size of Building Lot Maximum live load to be borne by each floor I hecehv ubrpitall th andsperifir fur said building. All notices with referenc to the building and its construction may 4 ' c c-' �� •� - / L be sent to k � ` Y- � = " = � ' a - - � � . = l -- 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. STATE OF FLORIDA, COUNTY OF DADE. j 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_ ___3 ' r2 �� 5 2 " Read, Sworn to and Subscribed before me. Disapproved t; Notary Public, State of Florida ( Signed) , ding Inspector 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.