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ROOFTest Date Project Address Contractor Permit Number Roof Pitch TEST SUMMARY TEST RESULTS: Passed See Attached Sketch for Further Details ROOF REPORTERS, INC. RA (561) 434 -7555 TAS 106 Roof Tile Uplift Test Report s JanUary 002 1208 NE 9q St. Mianli, FL 50330 3:12 Tile Installation Date 1/08/02 Adhesive Type Polyfoam Tile Type Flat Cr All testing is in strict accordance with The Dade County version of The South Florida Building Code, Section 3401.10 and TAS 106 -95. Each Test location was pulled using a Chatillon Force Gauge to a minimum of 35 lbs.. Roof Area Total # of Tests # of Tests Passed %Passed Field & Ridge 25 25 100% Comer 10 10 100% Perimeter 10 10 100% Al Maccagii, RRC #116 Dade County Certified Testjng Agency # 99- 0615.04 3281 Lake Worth RoadO Suite ED Lake WorthOFlorida 33461 Roof Consulting & Testing OVisual Surveys & Evaluations Roof System Design Moisture Surveys UNIT UNDER TEST: CHATILLON DF1S100 DIGITAL FORCE GAUGE Mfr SIN: B39539 Cust StN: B39539 PROCEDURE NAME: SYN55 CALIBRATED BY: Eliu Lago P.O. NUMBER: VERBAL SUBMITTED BY: ROOF REPORTERS 3281 LAKE WORTH ROAD LAKE WORTH FL CERTIFICATE NUMBER: 39382:1007976936 PERFORMED ON: NEXT CAL DUE:: TEMPERATURE: HUMIDITY: 10Dec2001 10Dec2002 72.0 °F +/- 1 DEG 40 % +/- 57 Synergy Labs, inc certifies that the above listed instrument meets or exceeds all specifications as stated in the referenced procedure at the points tested (unless otherwise noted). It has been calibrated using uteastrement standards traceable to the National Institute of Standards and Technology (NISI), or to NISI accepted iatrinsic stend3ids of measurement. or derived by the ratio type of' self-calibration techniques.This calibration complies with ISO Guide 17025 and ANSL'MCSL Z540 -1 -1994. Calhbration procedures used provide measurement uncertainty ratios of less than a equal to 4:1 of the specification of the unit under test, with a coverage factor of Ic=2 at a oonfidatce level of 95%, unless otherwise noted This report may not to reproduced except in full, unless permission for the publication of an approved abstract is obtained in writing fram Synergy Labs, Inc. REMARKS: This unit was found to be in tolerance at the time of calibration. No adjustments were necessary. Standards Used Trace No 999002 Signed: Description AMETEK WG-23 WEIGHT SET tion Technician Report of Calibration Synergy Labs, Inc 9831 E Evergreen St. Miami, FL 33157 888.346 2430 REPORT OF CALIBRATION for SERIAL NUMBER: 839539 PRINTED ON: 10 Dec 2001 CAL DATE CAL DUE DATE 6 Jun 2001 6 Jun 2003 Synergy Labs assigned ASSET NUMBER: 39382 Page _L_of MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Type Insp'n -- rite - A 0 OF I ► j Permit No. Name PC<)-t Address I ; V i) NE I Compan Phone # L.3 05)0 g • 9 a q9 For Inspector: 1 I ■a ate Approved /7/ f - `-+ Correction Re- Insp'n Fee ❑ ROOF REPORTERS, INC. R (561) 434 -7555 TAS 106 Roof Tile Uplift Test Report Test Date January 11, 2002 Project Address 1208 NE 99 St. Miami, FL Contractor John Busta Roofing Permit Number 50330 Roof Pitch 3:12 Tile Installation Date 1/08/02 Adhesive Type Polyfoam Tile Type Flat 9' All testing is in strict accordance with The Dade County version of The South Florida Building Code, Section 3401.10 and TAS 106 -95. Each Test location was pulled using a Chatillon Force Gauge to a minimum of 35 lbs.. TEST SUMMARY Roof Area Total # of Tests # of Tests Passed %Passed Field & Ridge 25 25 100% Comer 10 10 100% Perimeter 10 10 100% TEST RESULTS: Passed See Attached Sketch for Further Details � � r ^r^r' , ' -.11 , , f a At Maccagli, RRC #116 Dade County Certified Testing Agency # 99- 0615.04 3281 Lake Worth RoadC1 Suite ED Lake VVorth0Fiorida 33461 Roof Consulting & Testing f Vrsual Surveys & Evaluations ['Roof System Design O Moisture Surveys Trace No 999002 Signed: 1 Description tion Technician Report of Calibration AMETEK WG -23 WEIGHT SET Synergy Labs, Inc 9831 E Evergreen St. Miami, FL 33157 888.346.2430 UNIT UNDER TEST: CHATILLON DF1S100 DIGITAL FORCE GAUGE Mfr SIN: Cust SIN: PROCEDURE NAME CALIBRATED BY: P.O. NUMBER: SUBMITTED BY: B39539 839539 SYN55 Eliu Lago VERBAL ROOF REPORTERS 3281 LAKE WORTH ROAD LAKE WORTH FL CERTIFICATE NUMBER: 39382:1007976936 PERFORMED ON: NEXT CAL DUE:: TEMPERATURE: HUMIDITY: 10Dec2001 10Dec2002 72.0 °F +/- 1 DEG 40 % +/- 5% Synergy Labs, Inc certifies that the above listed instrument meets or exceeds all specifications as stated in tie referenced procedae at the points tested (unless otherwise noted). It has been calibrated using measurement standards traceable to tho National Instkute of Standards and Technology (NISI), or to NIST accepted intrinsic standards of measurement,. or derived by the ratio type of self- calibration techniques.This calibration complies with ISO Guide 17025 and ANSIMCSL Z540 -1 -1994. Calbration procedures used provide measurement uncertainty ratios of less than or equal to 4:1 of the specificatim of the unit under test, with a coverage facia of k=2 at a confidence level of 95%, unless otherwise noted This report may not 1 e reproduced except in 11'1 1, unless permission for the publication of an approved abstract is obtained in writing from Synergy Labs, Inc REMARKS: This unit was found to be in tolerance at the time of calibration. No adjustments were necessary. [Standards Used REPORT OF CALIBRATION for SERIAL NUMBER: 839539 PRINTED ON: 10 Dec 2001 CAL DATE CAL DUE DATE 6 Jun 2001 6 Jun 2003 Synergy Labs assigned ASSET NUMBER: 39382 Page / of 4 Look for blue background on the front of this check, and the imageSafe 9logo on back. If not present, do not cash. JOHN BUSTA ROOFING INC. 305 - 757 -2728 300 N.E. 91 STREET MIAMI SHORES, FL 33138 08-00 ACH Hit 063100277 FOR? "-e,fl Z ` SST 11 '00,4 2911' 1:063 LOO 2771: 00 37 30 23 280 211' 1429 2z C 2 1 63-27/631 FL DATE/2 __ [ 988 IM?iker3S'T` P AY ^� i $ 6 ! 0 I DOLLARS 8 0.11 en "t � BankofAmerica. APPENDIX "F" REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS As it pertains to this Appendix "F', it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, to provide the owner with this appendix and to explain to the owner the content of this form. The provisions of Chapter 34 of the South Florida Building Code (SFBC) govern all the minimum requirements and standards of the indus- try 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. 1. Aesthetics - Workmanship: The workmanship provisions of Chapter 34 are for the purpose of providing that the roof- ing 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. hat are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. 2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Chapter 29 of the SFBC. (The roof deck is usually concealed prior to removing the xisting roof system.) Q.A. k 3. Common Roofs: Common roofs are those which have no visible delineation between neighboring units (i.e. town - ouses condominiums, etc.). In buildings with common roofs, the roofing contractor and/or owner should notify ip ccupants of adjacent units of rooting work to be performed. 4. Exposed ceilings: Exposed. open beam ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail penetrations of the under - ide of the decking. may not be acceptable. The SFBC provides the option of maintaining this appearance. 5. Ponding Water: The current roof system and/or deck of the building may not drain well and may cause 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 i rofessional structural engineer. Ponding may shorten the life expectancy and performance of the new roof- ing. system. Ponding conditions may not be evident until the original rooting system is removed. Ponding conditions should he ct -rested. O' erf[ow Scupper~ i\>,all outlets): it is rcyuirei that r.um\ater Ilo\\ off ;u that the root i , not from a build block this „lischar•e f�! \eril _,:I`fer� �'.\.:Il outlet- i � •\ _ �+ .illy I � :hcr "�'�'f cy.ten <ioms illa■ i Ugh ill = c, f the SFBC ;ti i I I' `. � .t... � .r'sti!i �` crtii` \\ , t:lli�['Cr� In a:c,'Rlal ?•:e '.11['1 Flat ..r _. :e t Ventilation: NI. "i `i: re !'t _. I h.r e me at'II!t\ to ■en[ natural .tirtlo \\ fi thrnu the interior of the structur- ��:i1hl'• `.he •�ilr':_ li�e�t The ...,s[IfiL aITioUil[ of attic \e!1[IIa[llln itlall not be retiGl•:t\I. It ;?a\ be beneficial to r.cider \entin_='.\ ..an result in e•\rendinfi the ser\ice life for the roof. Services Department for further information reeardina 8. The o%+, ner ma;• car•tact the Miarni-Dade County Consumer Se p the above. 2 "•_ Date Contractor's Signature NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION - PERMIT NO TAX FOu0140. //3 .70S ( STATE OF FLORIDA: COUNTY OF DADE: THE UNDERSIGNED hereby gives notice that improvements wlJJ be made to certain real PrOPelly. 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: /208 At E.. 99 /4/A Ali 1-- 33/36 na ;a, See //s 2. Description of improvement: er Interest in property: AZOB 7 sazr- Pas /i/A r-zoe,/ 35/3F3 Name and address of fee simple_ titleholder: 3. Owner(s) name and address: 4. Contractors name and address: 5. sunnyraymeni bond required by owner from wntractor. and ess: ,,er,,C)2,UsA:77 Amount of bond $ r 6. Lender's name e and address: th Lly 7. Persons within the State of Florida designated by Owner utiOn- W Section 713.13(1)(a)7.. Florida Statutes, Name and address: & Jr! addition to.Mmself. Owner designates the following person(s) to receive a copy of the Uenors 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 specified) Sign Print Owners Name Swom to and subscribed fore me this Notary Public Print Notary's Name My Commission Expires Z el/5774 R00/ 35?" it/F S7:Lf7ZzAT /0/4/11 / - Xbee3 A/A .4 MY COMMISSION 1 CC 865151 EXPIRES: August 22 2003 aoudad Thai Notary Public Underwriters -Ra9/= Cr f_.. WWI& 20. . o 1R6553 13 2001 NOV 13 1528 - - ovothig co unt) , courts C1 iiivertas privided I , Prepared byTazhf.thA-C7,4 Address. /VA/Wiz 33/39- Contractor's Name: V (:�i�i(/ C �P Job Address: /2_Og /1./j 99',4 c57 7 ❑ (Low Slope Application) ❑ (Asphalt/Fiberglass Shingles) ROOF CATEGORY ❑ (Nail -On Tile) ❑ ( Metal Roofs \Wood Shingles & Shakes) ROOF TYPE ❑ New Roof ® Re roofing ❑ Recovering ❑ Repair ❑ Maintenance Flat Roof Area (ft') '19" Sloped Roof Area (ft') 34 Total (ft') 3,4 Master Permit No. Exposure category (per ASCE 7 -88): Ci Building Classification category (per ASCE 7 -88 table 1): P y/ vAN( S (Mortar- Adhesive Set Tile) ❑ (Other) Ft. n v Ft. V Deck type: ATTACHMENT Fastener Type: Field: SPACING Perimeter: Corner: 123.01 -78 4/99 DETAIL 1 & 2 Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed) ROOF PLAN • AREY9 O' 6340 z9 19z7 Page -1 34‘ /666 44_,s4 'eI -17493 Ridge Ventilation? //A MEAN HEIGHT /N Deck type: Th4' <=0A,i4 /0g 7 A z Underlaymenti0/j„ °/y • Insulation: Ii ROOFSLOP[ D E T A I L 3 Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. (PmaxI:72dax X (Aerodynamic Multiplier):Do 29) - (Pmax2: / / X (Aerodynamic Multiplier):(. 29 ) - (Pmax3 //,6 X X (Aerodynamic Multiplier): 02 - SLOPED SYSTEM DESCRIPTION Fastener type &spacing: • Cap Sheet: SQye: r Roof Coverin 's /Dg 6 " el6ZAP /577' e ,'ON/e,.- [/PTicE A7 edge: TILE CALCULATIONS M 6 = M // PCA: //8 <9 M 6 b =m,. 9.Z PCA: //8.9 M g : 6°1> = M 9R, PCA: //7.7 ATTACHMENTS REQUIRED I) Fire Directory Listing Page 2) Miami -Dade County Product Control Notice of Acceptance -Cover Sheet a) Specific System Description h) Specific System Limitation c) General Limitations d) Applicable Detail Drawings 3) Municipal Permit Application 4) Other Component Approvals PA O)! /; //, 36 1/8 10/46y: V. -. 92, Membrane Type: Deck Type 1: Deck Description: System Type E -2: RUI3EROIDus Tile Undcrlayment, Base Sheet mechanically. attached. All General and System Limitations shall apply. Anchor sheet: Ply y Sheet: Membrat t..: Maximum Design Pressure: Maximum Fire Classification: Maximum Slope: Specification No.: rAts'cottro ,C ro,N • SBS Wood, Non - insulated / " or greater plywood or wood plank ASTM 2626, GAFGLASID GAFGLAS #30 Ultim aTNM Base Sheet STRATAVENT® Nailable, or RUBEROIDcp 20 base sheet applied with a minimum 2" side lap and a minimum 6 "end lap. Base sheet may be applied at a right angle (90") to the slope of the deck with approved annular ring shank nails and tin caps at a fastener spacing of 6" o.c. at the 2" side lap, and two 12" o.c. staggered rows along the center of the sheet. (Optional) one, or more plies GAFGLAS PLY 4•, or GAFGLASg PLY 6r1L Ply or GAFGLAS FIexPIyTM 6 sheet adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20 -40 lbs. /sq.. One ply RUBEROIDO MOP, or RUBEROIDO MOP applied at a right angle (90 ") to the slope of the deck* of Type I V asphalt applied within the EVT range and Membrane shall be backnailed to deck with approved and tin caps at a maximum fastener spacing of 6" o.c. exposed * Membrane may also be installed parallel to the slope of the roof(i.e. strapping). If membrane is strapped, then anchor sheet and ply sheet must also be strapped. Must comply with Miami -Dade County Rooting Application Standard PA 115. Must comply with Tile System Fire Classification Must Comply with Miami -Dade County Roofing Application Standard RAS 113, RAS 119, RAS 120 4. f5t ;Ala. / y l .53 of 55 PLUS, membrane may be adhered in a full mopping at a rate of 20-40 lbs. /sq. annular ring shank nails No nails or tincaps shall be Frank Zuloaga, RRC Rooting Product Control Examiner 02/05/2001 13:19 MEDITERRANEAN ROOF TILE 4 3057572728 M IA M I -DA PRODUCT CONTROL NOTICE OF ACCEPTANCE Monier Lifetile LLC 135 NW 20 St. Boca Raton Empires :12/146i 1 Approved: l2 /20/1999 T00 ® Nv3NVtltt3.tIt13X FL 33431 I ofS lnt.Arnet mail *ddre+a: poytmwStcr ®bu■(dinteudecnline.COm ,1 P ^e - NO.467 9001 111ANII -DADS COUNTY. FLORIDA METRO -DADE FLAGLER BUILDING UU1LDIt4G CODE COIIPLIANCE OFFICE METRO -DADE FLACLER BUILDING 1.I0 WEST FLACLER STREET SUITE 1603 MIAMI. FLORIDA 33130.1563 (305) 375.2901 FAX (305) 37S -1908 CONTRACTOR LICENSING SECTION (305) 375 -1527 FAX (305) 375-2558 CONTRACTOR ENFORCEMENT SECTION (305) 375-2966 FAX (305) 375-7908 PRODUCT CONTKOL DIVISION Your application for Product Approvat of: (305) 375 -2902 FAX (305) 372 -6339 Atlantis Shake cad Slate Flirt Profile Tile under Chapter 8 3f the Code of Miami -Dade County governing the use of Alternate Materials and Types of Construction, an+i completely described herein, has been recommended for acceptance by the Miami -Dade County Building Code Compliance Office (BCCO) under the conditions specified herein. This approval shill not be valid after the expiration date stated below. BCCO reserves the right to secure this product or mater.al at anytime from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved maruter, BCCO may revoke, modify, or suspend the use of such product or material immediately. BCCO reserves the right to revoke this approval, if it is determined BCCO that this product or material fails to meet the requirements of the South Florida Building Code. The expense of .uch testing will be incurred by the manufacturer. Acceptance No.:99- 1012.07 (Revises No.: 98- 0604.01) Raul Rodriguez Chief Product Control Division THIS IS TEE COVERSHI?ET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS BUILDING CODE & PRODUCT REVIEW COMMITTEE This application for Product Approval has been reviewed by the BCCO and approved by the Building Cody. and Product Review Committee to be used in Dade County, Florida under the conditions set forth above rancisco . Quintana, R.A. Director Miami -Dade County Building Code Compliance Off�c. Houicp+Kc: Attp : /)www.bu;ld]nCCodeun 311.L3A11 HUN0it t6CS SCE' TR TY3 9T:ST 3tl.L 00 /IT /t0 02/05/2001 13:19 MEDITERRANEAN ROOF TILE -* 3057572728 nn rz7, (VIONIER LIFETILE LLC ACCEPTANCE No.: 99- 1012.07 APPROVED :December 30, 1999 EXPIRES :December 16, 2002 1. SCOPE This revises a roofing system using Monier Lifetile Atlantis Shake & Slate Concrete Roof Tile, as manufactured Monier Lifetile LLC described in Section 2 of this Notice of Acceptance, designed to comply with the South Florida Building Code, 1994 Edition for Miami -Dade County. For the locations where the pressure requirements, as determined by SFBC Chapter 23, do not exceed the design pressure values obtain by calculations to compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall be done as a moment bascd system. Trim Pieces Rainproof lI NOTICE Of ACCEPTANCE: SIANDARII CONDITIONS Category: Prepared Roofing Sub Category: Flat Profile Tile 2. PROD' +.JCT DESCRIPTION Manufactured by Test Applic;,nt Dimensions Slecifcations Monier Lifet le Atlantis Shake and Slate Tile 2.1 Components or products manufactured by others odiivt Ice and Waux Shield 4V1VVITIMLTnns air l =l5" w = 10 3/8" 114 •' thick I - varies w varies varying thickness Test Dimensions Specifications 30 "x75'roll PA IN 36" x 75' roll or 60" x 75' roll 36 "x75'roll PA 103 Product Description PA 112 Flat, interlocking, high pressure extruded concrete ::hake and slate roof tile equipped with two nail holes. For direct deck, mortar or adhesive set applications. PA 112 Accessory trim, concrete roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile. Product Description Manufacturer Single ply, nail -on underiayment with 2" self - adhering top edge. Self-adhering unde Protect -O• Wrap. Inc. (with current NOA) W.R. Grace Co wi cu OA) Frank ZulOaga, RRC Roofing Product Control Examiner NO.467 P002 02/05/2001 13:19 MEDITERRANEAN ROOF TILE -> 3057572728 HOMER LIFET1LE LLC Product Wood Battens Tile Nails Tile Screws Roof Tile Mortar ( "TileTiterM" ) Roof Tile Mortar ("Quikrete® Roof Tile Mortar *I140 ") Roof Tile M•)rtar ( "BONSAL® Roof Tile Mortar Mix ") ' Roof Tile Adhesive ( "Polypro® A1-1160") NOTICE OF ACCEPTANCE: 51 AKDa►R1) COND�TIO�s pimensioss Vertical Min. 1 "x 4" Horizontal Min. 1 "x 4" for use with vertical battens or Min. 1 "x 2" for use alone 10th 3" #8x 2 '4" long 0.335" head dia. 0.131" shank dia, 0.175" screw thread dia. N/A N/A N/A N/A Test Specifications Wood Preservers Institute LP — 2 PA 114 Appendix E PA 114 Appendix E PA 123 PA 123 PA 123 See PCA a ACCEPTANCE No.: 99- 1012.07 APPROVED :December 30, 1999 EXPIRES :December 16, 2002 Product Description Salt pressure treated or decay resistant lumber battens Corrosion resistant screw or smooth shank nails Corrosion resistant. coated, square drive. galvanized, coarse thread wood screws Prepared mortar mix designed for mortar set roof the applications. Prepared mortar mix designed for mortar set roof tile applications. Prepared mortar mix designed for mortar set roof tile applications. Two component polyurethane adhesive designed for adhesive set roof tile applications. Manufactutrer generic generic generic Bermuda Roof Company. inc. with current PCA Quikrcte Construction Products with Current PCA W. R. Bonsal Co. with current PCA Polyfoam Products, Inc. Frank Zuloaga, RRC Roofing Product Control Examiner NO.467 P003 02/05/2001 13:19 MEDITERRANEAN ROOF TILE 4 3057572728 MONIER LIIETXLE LLC Product Roof Tile Adhesive TileBond Hurricane Clip & Fasteners 3- LIMITATIONS Dimensions Factory premixed canisters Clips Min. Yi' width Min. 0.060" thick Clip Fasteners Min. 8d x 1 'A" Monier Lifetile Atlantis Snake & Slate Tile Test Specifications See PCA PA 114 Appendix E Table 1: Aerodynamic Multipliers - X (ft') Tile (n') 4 ACCEPTANCE No.: 99- 1012.07 APPROVED :December 30, 1999 EXPIRES :December 16, 2002 NOTICE OF ACCEPTPNCE: STANDARD CONDITIONS Product Description Single component polyurethane foam root tile adhesive Corrosion resistant clips with corrosion resistant nails. Manufacturer Flexible Products (with current NOA) Generic 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test shall be performed in accordance with RAS 106. 3.3 Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with PA 112, appendix 'A'. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 Minimum underlayments shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30/90 hot mopped underlayment applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment matetia( manufacturers published literature. 3.6 .This acceptance is for wood deck applications. :Minimum deck requirements shall be in compliance with chapter 29 of the SFBC. 3.7 May be installed on slopes 7:12 and greater with a minimum of two screws. Profile ` • i t ct Deck Application sn uloaga, EZR Roofing Product Control Examinee NO.467 D004 4. INSTALLATION 4.1 . Monier Lifetile Atlantis Shake & Slate Concrete Roof Tile and its components shall be installed in strict compliance with Miami Dade County Roofing Application Standard RAS 118, RAS 119, and RAS 120. 4.2 Data For Attachment Calculations —n• no ITT (Tl1 Table 4: Attachment Resistance Expressed as a Moment M, (ft-ibf) for Two Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance 31.3' Monier Lifetile Atlantis Shake & Slate Tile Adhesive 2 See manufactures com • onent ap • reval for installation re. uirements. 3 flexible Products Company TileBBond Average weight per petty 13.9 grams. Polyfoarn Product. I nc. Avers a w ei tit per patt 8 rams. 'fable 3: .Attachment Re.istance for Nail .6tx'essed as a Moment - M, (ft-Ibf) -On systems Tile Profile Fastener Type Direct Deck (min 15132" . plywood) Direct Deck (min. 19/32" plywood) Battens Monier Lifetile Atlantis Shake & Slate Tile 2 -10d Ring Shank Nails 30 38.1 17.2 1 -10d Smooth or Screw Shank Nail 7.3 9.8 4.9 2 -10d Smooth or Screw Shank Nails 14.0 18.8 7.4 1 #8 Screw 30.8 30.8 18.2 2 #8 Screw 51.7 51.7 24.4 1 -100 Smooth or Screw Shank Nail (Field Clp) 24.3 24,3 24.2 1 -10d Smooth or Screw Shank Nail (Eave Ctip) 19.0 19,0 22.1 2 -10d Smooth or Screw Shank Nails (Field Cti l ) 35.5 35.5 34.8 2 -100 Smooth or Screw Shank Nails (Eave Clip) 31 9 31 9 32.2 j- 65.5 48.3 head of tile. 2 -100 Ring Shank Nails' 50.3 are localeo a min. of 273 from Instauatiun with a 4.. tile headlao a nd fasterners 02/05/2001 13:19 MEDITERRANEAN ROOF TILE 4 3057572728 MONIER LIFETILE LLC Tile Profile Monier Lifetile Atlantis Shake & Slat>:: Tile NOTICE OF ACCEPTANCE: STANDARD CONDITIOJS Table 2: Restoring Moments due to Gravity 3 ":12" 4":12" 5 ":12" Dices& (k Direct Deck Direct Deck 5.9 5.8 ACCEPTANCE No.: 99- 1012.07 APPROVED :December 30, 1999 EXPIRES :December 16, 2002 NO.467 P005 - M (ft -Ibf) 6":12" Direct Deck 5.6 7 ":12" or greater DirectOeck 5.5 5 lY:rk uloaga. RRC Roofing Product Control Examiner Table 4A: Attachment Resistance Expressed as a Moment - M (ft -Ibf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Monier Lifetil: Atlantis Shake & Slate Tile PolyPro"" 118.9' PofyProTM d0.45 4 Large • eddy placement of 45 grams of PolyPro'. S Medium caddy placement of 24 grams of PolyPro ". ';able 4B: Attachment Resistance Expressed as a Moment - M, (ft -Ibf) for Mortar or Adhesive Set Systems Tile Profile Tile Application Attachment Resistance Monier Lifet to Atlantis Shake & Slate Tile Mortar Set 3g.0 02/05/2001 13:19 MEDITERRANEAN ROOF TILE 4 3057572728 . MONIEIILIFETILE LLC ACCEPTANCE No.: 99- 1012.Q7 APPROVED :December 30, 1999 EXPIRES :December 16, 2002 NOTICE OF ACCEPTANCE; STANDARD CONDITIONS NO.467 P006 5. LA.BE:LING Ail tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo, or following statement: "Miami -Dade County Product Control Approved ". 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. Any other documents required by the Building Official or the South Florida ) uilding Code (SFBC) in order to properly evaluate the installation of this system. 6 Frank Zuloega. PRC Roofing Product Control Examiner 02/05/2001 13:19 MEDITERRANEAN ROOF TILE -) 3057572728 NIONIER LIUTILE LLC ACCEPTANCE No. : 99-1012.07 NOTICE OF ACCEPTANCE: STANDAP.D CONDITIONS PROFILE DRAWINGS AtifIEFILOCX , .. s. OVERLAY „ • • •••, ' (PARLAY 7 APPROVED :December 30, 1999 EXPIRES :December 16, 2002 MONIER LIFETILE ATLANTIS SHAKE & SLATE CONCRETE ROOF TILE Frank Zu(oaga. RRC Roofing Product Control Examiner NO.467 9007 02/05/2001 13:19 MEDITERRANEAN ROOF TILE 4 3057572728 NO.467 P008 0 1v1ONIER LUFETILE LLC EXPIRES N 0 CE OF CEPT NCE: STANDARD ACCEPTANCE No.: 99- 1012.07 APPROVED :December 30, 1999 :December 16, 2002 ITIO Renewal of this Acceptance (approval) shall be considered alter a renewal application has been filed and the original submitted documents, including test - supporting data, engineering documents, are no older than eight (8) years. 2. Any and all approved products shall be permanently labeled with the manufacturer's name, city, state, and the following statement: "Miami -Dade County Product Control Approval ", of as specific ally stated in the specific conditions of this Acceptance. a. 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. ! 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 automr.tically be cause for termination of this Acceptance, unless prior written approval has been requesied (through the filing of a revision application with appropriate fee) and granted by this office. 5. Any of the following shall also be grounds for removal of this Acceptance: a. Unsatisfactory performance of this product or process. b. Misuse of this Acceptance as an endorsement of any product. for sales, advertising or any other purposes. 6. The Notice of Acceptance number preceded by the words Miami•Dade County. Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is displayed, then it shall be done in its entirety. A cop/ 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 time. The engineer need not reseal the copies. 8. Failure: to comply with any section of this Acceptance shall be cause for termination and removal o f Acceptance. 9. This Notice of Acceptance consists of pages i through 7 and this as page 8. END OF THiS ACCEPTAN Frank Zuloaga; RAC Roofing Product Control Examiner CONTRACTOR Name -- Uilf/X �Q/�� GC ) l�C /V i . License No. CC n 05g Oe/g (f Address 30 9 9 /sr, S 7 bea S 7 Telephone35 , 2/9. .96 Wax ]0 7572 Qualifier Name' 3 ) e A , j , n Repair PROPERTY OWNER Name �/� A , / � r�� g' lJ�! t AST Address /2o0 /t/ 9 94,z/. , s%e , -F& - r Home Telephone 05 -_ 7j -�_ '9 'J' Business Telephones 3 353 v /3/3 `7 Fax /WA TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other — Add'I Detachment Other 31 o/ /090 Step 1. INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Job Address: /tog A E .997/7 S7 7 ,/4 Rae/64 33/3Y- Z Zip Address PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Apt. Folio Number II 3 � p ' DO9 O c. o Lot Block a Subdivision v PB , PGLP 9 Current Use of Propertycs /A/ L i / Proposed Use of Property Tenant Information PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. City State Description of Work g PERMIT APPLICATION _, v v 5 - 1) 33 0 Zoning / Linear Feet Square Feet 3 T / 93 Units / Floors Value of Work/ /6 %1 .C2:2. aO Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax %3g Page 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as 'indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aWiare that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. • WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1°' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF : OR Signature of S• ner Pint Name Sworn to and subscribed before me this /1 day of/ Sigr(ure of Notary Public - State of Florida SEAL: C UNTY OF MIAMI -DADE .4.V. STEVE P. GORY •.; MY COMMISSION # CC 865151 EXPIRES: August 22, 2003 • ,, of E,, Bonded Thru Notary Pubic Underwdtore Personally known OR, Produced Identification Type of Identification Produced: Signature of Contractor / Qualifier TO9it/,�, T tfeWSTA Print Name Sworn to and subscribed before me this g PERMIT APPLICATION RID A„ COUNTY OF MIAMI -DADE day of 9bO / •1,r vPp M }� STEVE P. GORY MY COMMISSION # CC 8651 1 EXPIRES: August 22, 2003 Bonded Thru Notary Public Underwriters Signat SEAL: re of Notary Public - S • Personally known / OR, Produced Identification Type, of Identification Produced: Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) O FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ 1D- /1 ( sq.ft. = x/1000 x ¢.60) $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) SECTION Zoning Electrical Mechanical Plumbing Fire Public Works BY Structural Building Official DATE PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ ( ) ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Heating Strips, each Fan Outlet, Wall Service, Temporary - Paint Booth A/C Central 4 -7 Ton Fire Pump Outlet, Switch - Piping, Flammable Liquid Signs A/C Central 8-15 Ton Fixture - Fluorescent - Process/Pressure Piping Oven Space Heater (kw) A/C Central 16 -20 Ton Pressure Vessel Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts I Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons QTY. Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of - Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of - Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System - Process/Pressure Piping Pump and Abandon Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Gas - Appliance PLU1\IBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Si mp Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. PERMIT APPLICATION RECEIVED AND REVIEWED BY: DATE: Date - 7 ) t L o OJob Address & o a kLE `7 - t 1. Tax Folio Legal Description Historically Designated: Yes No )( Owner/Lessee / Tenant TV\ r� r , 1` s S I Master Permit # ' 7/ 0/ Owner's Address )Q t. NI. f a u . L ! T cs 1 Phone Contracting Co. �a V% t.) LL) EE k. o o S t w9 Address )-1-4 1 k) , U) . 1 - 1 i r"i-- Qualifier O Rt.) is c R SS# Phone 3 54 1 a 4 - 17 State # Municipal # Competency # 1 199 Vj Ins. Co. l3 r Le_fo f i` I E Architect/Engineer Address I Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL � OOFING PAVING FENCE SIGN WORK DESCRIPTION 'E?4 t u ._ Lr p oC t i LE Square Ft. fi Signature of otary as to Own My Conuniss F-70 C. K e FEES: PERMIT 6 0 APPROVED: Zoning Mechanical PERMIT APPLICATION FOR MIAMI SHORES VILLAGE WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructio d zoning. Furthermore, I authorize the above -named contractor to do the work stated. 1 1 6 ov Date O'r CIAL C TARP SEAL O. I X7277 ' s / ) i 1 r• r ISSIO�1 EXPIRES r 1 7,2002 RADON ident Date Building Plumbing C.C.F. 0 o0 Estimated Cost (value) 'T? Signature) of Contractor or Owner - Builder No a#iv as to Contracto My Commissio •/i NOTARY ,S e._ : 6 14 40 r Owner - Builder Date OFFICIAL NOTARY SEAL 9 MARGARITA MON71EL CO: 1: SSON NUMBER CC797277 . " : nSION EXPIRES !• 1 7,2002 Date 6 BOND TOTAL DUE 7 (7 Zca1 Structural Engineer Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built o New Building Disapproved (Signed) Es p $ .9 2 Building In ector - 2 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT. APPLICATION FOR CUIL®ING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- in 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. D ate �l . ,19 1 Owners Name and Address / ` .. Str eet q Lot Block Subdivision Street and Number where work is to be done ./ .L2. _ State work to be done and purpose of budding ( floors) ,tt!t.. ,t,., •t;,,,,?,!t1 «t «t! :,,t,t T,t «�!T ln.��. �s.-_e -4-4 . / 7.�2 _.�. ..1�t1.....�.� Distance to next nearest building Size of Building Lot and for no other purpose. Remodeling Y Addition Repairs No. of Stories / To be constructed of Kind of foundation R oof Covering Estimated Total cost of improvements lls'1 8 Amount of Permit $. --�. Zone cubage required plan Cubage Mfaxirnum 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 perrnit 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 hire 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 su subcontractors, on work to be performed 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 and take acknowledgments, personally ap- peared Notary Public, State of Florida My t;ommission Expires 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. r Z Permit No. __ L'' 3 2--- a ate ` l r ...1._ Read,' Sworn to and Subscribed before me. PLANNIN 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 froin the Planning Board. A re- inspection fce of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspeviinn 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 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. Date October 20, 19 87 Owner's Name and Address Mr. Keith Post No 1208 N. S`freet 9 9th ST. Registered Architect and /or Engineer Name and address of licensed contractor Obenour Roofing Co. 7357 N. W. Miami Ct. Miami, FL 33150 36 sns 75 /a Location and legal description of lot to be built on: .. �J nn��, ,,�� A� o d9� 0 d Lot Block Subdivision // ��/�Pi�� .0.41 Street and Number where work is to be done 1208 N.E. 9 9th St. State work to be done and purpose of building by floors), state exterior colors (submit samples) Reroof entire residence with new color tile New Building Remodeling R e r n n f Addition Repairs No. of Stories tile and for no other purpose. To be constructed o - 3 0 , 1=:90 Kind of foundation wood Roof Covering Estimated Total cost of improvements $ 10 , 300 0 0 . 00 0 Amount of 30.00 f P $ Zone cubage required Plan Cubage I 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 7357 N.W. Miami Ct. Miami,) FL 33150 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 subcontractors 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 .: k to be performed 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 and take acknowledgments, personally appeared James D. Obenour and who, being by me first duly sworn, upon oath deposes and says that he is the Icontractor of the above described construction, that he has carefully read the forgoing application, and that he did sign the same. and that all facts therein by him stated are true. Permit No. Disapproved (Signed) Vii$159 Date Date 111 1r; 0 1_44 9 4. - 41. Subscribed b to me well known. Notary Public, State of Florida Building Inspector My Commission Expires NOTARY PUBLIC STATE OF R OR1OA MY COMMISSION EXPIRES FEB. 18. 1989 PLANNING BOARD DATE Chairman Member i 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 approyal 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 Owner's Name and Address.... "I•mg."4? N o. Registered Architect and /or Engineer Name and address of licensed contractor ( Street__d .. Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floo and for no other purpose. New Building Remodeling Addition Repairs No. of Stories 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 5968, Compiled General Laws of Florida, Pennanent 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 I p ormed under this permit, as are licensed by Miami Shores Village. Remarks ( Signed ) - - r= . , 19! ( 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 Notary Public, State of Florida ( Signed) Building 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. i eot •,", c. . _ r . • - 1rr , , • , • , • r ' MIAMI SHORES VILLAGE Date Building Ins s ' ctor 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..... : e/e No/2e Street Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) — 2 �_ Date -tigo New Building Remodeling Addition To be constructed of Kind of .... ndation Roof Covering 4) Estimated Total cost of improvements $ 4_,Ci • � Amount of Permit $ lg Zone cubage required .Plan Cubage Distance to next nearest building. Size of Building Lot Repairs 3 and for no other purpose. No. of Stories 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 sub ctors on work to be perfor d 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 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 3 Disapproved // ,. Date. (Signed) Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chainnan 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.