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ROOFIssue Date: 10/13/2006 Owner's Name: TRACY DEVANEY Permit Type: Roof Work Classification: Roof - Repair Job Address: 1209 99 Street NE Contractor(s) Phone Primary Contractor KAWALEK ROOFING & PAINTING, I 786- 277 -9540 Yes Additional Information Miami Shores Village, FL Type of Work: Re -Roof Classification: Residential Additional Info: 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, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due Amount CCF $12.60 Education Surcharge $4.20 Notary Fee $5.00 Permit Fee - New Roof $300.00 Scanning Fee $9.00 Technology Fee $7.50 Total: $338.30 Building Department File Copy Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 04/11/2007 Parcel #: Block: Section: Permit Status: APPROVED Permit Number: RF -10 -06 -2562 Phone: 1132050090082 Lot: PB: Total Square Feet: 2700 Total Valuation: $ 20,700.00 Res uired Ins s ections Roof in Progress Final Roof Invoice Number RF - 10 - 06 - 26417 Total: Amt Due $338.30 ) OCT 17 PAID Amt Paid NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP -29695 Permit Number: RF -10 -06 -2562 Inspection Date: 02/23/2007 Inspector: Grande, Claudio Owner: DEVANEY, TRACY Job Address: 1209 99 Street NE Project: <NONE> Miami Shores Village, FL Contractor: KAWALEK ROOFING & PAINTING, INC Building Department Comments Thursday, February 22, 2007 Block: Permit Type: Roof Inspection Type: Final Roof Work Classification: Roof - Repair Phone Number Parcel Number 1132050090082 Lot: Phone: 786- 277 -9540 ROOF REPLACEMENT TEAR EXISTING FLAT TILE ROOF REPLACE WITH A NEW MONIER 9" FLAT COLOR THROUGH CONCRETE ROOF TILE SYSTEM.COLOR IS VERONA WHITE Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 1 of 1 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 1,, 26 51 76 2 P/ 111 27 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 64 89 15 40 65 90 16 41 66 91 17 42 67 92 18 43 68 93 19 44 69 94 20 45 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 -tLV4- A/ A-0.)v,, Permit # rb 't'4'L 5 Z .2 Job Address 12.0 ot N E 9e T , 1.-t to f-d t f-(7-,-9 ,rte. Roofing Contractor: f-(> , Ct N 4, Type of Tile: Hi P 1 - -- N — cis M T Date Installed: 12 -14 -4' d Approximate Roof Height: 2 zi feet Roof Pitch: 1 :II, Type of Access to Roof: Scaffolds Ladder Other Approximate Square Footage of Roof: `?fQ(' ft Required Testing Force: 35 lbs. Testing Equipment: Chatillion 100 Date Tested - 3 f '-b 4 - IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL TAS 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST. THIS REPORT SUBMITTED BY: Lab Certification # 98- 0608.04 U.S. SOUTH Engineering & Testing Lab., Inc. 6065 N.W. 167th Street, Suite B -23 • Miami Lakes, Florida 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 P. E. 1-11 D,S ^,' State of FL Certificate Authorization # 4100 TEST RESULTS P = PASS, F = FAIL i te(Wd - ,/l/fli& Project No 8 910 4 Sketch of Roof x.' Job ' 2-4 X ►J t cQ Sheet Number ,) Contractor Checked By Scale Qo c 4- 111111111119111111111M III NIiii!iIIIIIiu!i ii iIII1II MMINEIMMEMMEMEMMOMMEMMIDOMMMUMM MIIIIMMOVMMUMEMMEEMEMEMMENNIMMUMM EMMINIMAMOMEMEMPAMMEMMEMEMEMM 1111111111111111111111111111111 mimmommiWkommummommismaim MEMEMMENMEWMPLIAMMETOMMMUMM ............................ ............................. ............................. Inspection Date: 12/19/2006 Inspector: Grande, Claudio Owner: DEVANEY, TRACY Job Address: 1209 99 Street NE Miami Shores Village, FL Project: <NONE> Contractor: KAWALEK ROOFING & PAINTING, INC Building Department Comments Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . spector Comments Friday, December 22, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 O22 Block: Permit Type: Roof Inspection Type: Tile In Progress Work Classification: Roof - Repair Phone Number Parcel Number 1132050090082 Lot: Phone: 786 - 277 -9540 Page 2 of 2 Inspection Date: 12/19/2006 Inspector: Grande, Claudio Owner: DEVANEY, TRACY Job Address: 1209 99 Street NE Project: <NONE> Miami Shores Village, FL Contractor: KAWALEK ROOFING & PAINTING, INC Building Department Comments Monday, December 18, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP -35335 Permit Number: RF -10 -06 -2562 DEC 20IN Block: Permit Type: Roof Inspection Type: Tile In Progress Work Classification: Roof - Repair Phone Number Parcel Number 1132050090082 Lot: Phone: 786 - 277 -9540 Page 2 of 2 Passed 1411 0 Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 12/19/2006 Inspector: Grande, Claudio Owner: DEVANEY, TRACY Job Address: 1209 99 Street NE Project: <NONE> Miami Shores Village, FL Contractor: KAWALEK ROOFING & PAINTING, INC Building Department Comments Monday, December 18, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP -35335 Permit Number: RF -10 -06 -2562 DEC 20IN Block: Permit Type: Roof Inspection Type: Tile In Progress Work Classification: Roof - Repair Phone Number Parcel Number 1132050090082 Lot: Phone: 786 - 277 -9540 Page 2 of 2 •• Ins • " . ' Inspection Date: 10/26/2006 Inspector: Grande, Claudio Owner: DEVANEY, TRACY Job Address: 1209 99 Street NE Miami Shores Village, FL Project: <NONE> Contractor: KAWALEK ROOFING & PAINTING, INC Building Department Comments Wednesday, October 25, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 OCT 2 0 2006 Block: Permit Type: Roof Inspection Type: Hot Mop Work Classification: Roof - Repair Phone Number Parcel Number 1132050090082 Lot: Phone: 786-277-9540 Page 1 of 2 nspector Comments Passed Failed Correction Needed Re-Inspection Fee ($75) No Additional Inspections can be scheduled until re-inspection fee is paid . •• Ins • " . ' Inspection Date: 10/26/2006 Inspector: Grande, Claudio Owner: DEVANEY, TRACY Job Address: 1209 99 Street NE Miami Shores Village, FL Project: <NONE> Contractor: KAWALEK ROOFING & PAINTING, INC Building Department Comments Wednesday, October 25, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 OCT 2 0 2006 Block: Permit Type: Roof Inspection Type: Hot Mop Work Classification: Roof - Repair Phone Number Parcel Number 1132050090082 Lot: Phone: 786-277-9540 Page 1 of 2 Isect .... .... . Inspection Date: 10/26/2006 Inspector: Grande, Claudio Owner: DEVANEY, TRACY Job Address: 1209 99 Street NE Project: <NONE> Miami Shores Village, FL Contractor: KAWALEK ROOFING & PAINTING, INC Building Department Comments Wednesday, October 25, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 OCT 2 6 20Q6 Block: Permit Type: Roof Inspection Type: Tin Cap Work Classification: Roof - Repair Phone Number Parcel Number 1132050090082 Lot: Phone: 786 - 277 -9540 Page 1 of 2 Infraction Passed Comments TIN CAP SPACEING True Passed L C) Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Isect .... .... . Inspection Date: 10/26/2006 Inspector: Grande, Claudio Owner: DEVANEY, TRACY Job Address: 1209 99 Street NE Project: <NONE> Miami Shores Village, FL Contractor: KAWALEK ROOFING & PAINTING, INC Building Department Comments Wednesday, October 25, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 OCT 2 6 20Q6 Block: Permit Type: Roof Inspection Type: Tin Cap Work Classification: Roof - Repair Phone Number Parcel Number 1132050090082 Lot: Phone: 786 - 277 -9540 Page 1 of 2 BUILDING Pe Na. gf c6--2(... PERMIT APPLICATION 1 M O t er Penult No. 2004 OCT 1 2 2006 Jo Permit Type (circle): Building EleOsikcar a,(41tintb«ing Mechanical Owner's Name (Fee Simple Titleholder) DevANcy i PA Dela( Phone # 6 05) 756 -763 Owner's Address 1 2O' N . E. q I STRF�,E,l" City Mg AA( S i- 10A6.5 State FLOP. {0 Tenant/Lessee Name N/A Job Address (where the work is being done) 2.0 q N . E . q q m S TRE,E.r City Mia� i� Shores '�iliagy County jvii '-Dade Zip 33 13 9 FOLIO / PARCEL # 1 1- 32.05 - 0 0 q- 00 8 2. Is Building Historically Designated YES NO YNC• Contractor's Company Name P. KAt WALe+K RObP i N G 4j Mg1MTu4 phone # Contractor's Address P.O • DoX 5.3i05) City 1 1 1 A` 4 1 state FI Zip 3315.3 Qualifier Name MN- kA WA-16 Phone # ,�)� 1S-4-01q1 , r+ State Certificate or Registration No. 1 00(04 q V0 aS Certifie of C R >„ R , wncy No. t3S 1 Architect/Engineer's Name (if applicable) ro Submittal Fee $ Notary $ S Training/Education Fee $ Scanning $ q y Radon $ Miami Shores Village B IChfCG uilding Department 10050 N.Ed Avenue, lutlaai , Florida 33131 Permit Fee $ Tel: (305)795.2204 Far. (305) 756. _' z'72 Type of Work: DAddition DAlteration []New Describe Work: 9-cOt e.EFLACE,I€',N r DPBR $ Zip 33138 Phone # Id /A Phone # Value of Work For this Permit $ ,.O 0 0 Square / Linear Footage Ot Worrk: '7 Repair/Replace lt, De 1 3(,) 0 # # '4 car $ i2.4+0 C Technology .Fen $ CC 2.0 Te of F 1. Bond $ Code Enforcement $ Doubts Fee $ Structural Review. $ Total Fee Now Due $ (3o3) 75 -019, See Reverse side a Zoning Bonding Company's NanMe (if applictle) Bonding Company's Addr City gtate 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 inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature • Sign: Print: My Commis on Expires: Owner or Agent The for ,ing instrument was ackno ledgFd before me this 12 The forego g strument was acknowledged pefore me this ,2-. Cie./ day o [' �C�� , NOG by'p Vi Th001 , day of 1 � , ;i , 2O, by _ who is personally known to me or who has produced d 50'6A0who is personally known to me or who has produced K_426 Sag -A&-CI As identification and who did take an oath. G - O I S as ' t entifi ation and who did take an oath. i\ lan ****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: (Revised 02/08/06) Signature NOTARY P Sign: Print: Contractor My Commi.sion Expires: * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * ** * * * * * * *, - * * ** r (� 0?" Plans Examiner / Engineer Zoning NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. It - 3205 - 009- 00 82. 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: i209 N► , (kg TH STREET , M1 AMt S y oREs F L , 33J3 $ EAl2LE.mn/ Sf4MES P 13 `13-$0 LOT lo C3LK .1. LOT Slz� 75 000 )X 1Ool O . (5'56 - 2o95 o392 1 2. Description of improvement: RucF tQ.EQLACEMEN,T 3. Owner(s) name and address: DEvANf / , PATRIcit TRA 2.oq N •E . (kg 714 STREET f MIAMI SPORES P(.0 R. OA 33i3$ Interest in property: OWNER. r?•ESIt7E..tr OF P QwER. - rj Name and address of fee simple titleholder: 4. Contr tor's name and address: ?. KA WALE, ROOF 1 N 11M 6 PA TIn(G t 1 N C. . P10 1 ?o 531 0 51 ► t: y r f Ft- 33153 STA E o1= FLOwoq COUNTY OF DADS 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: 8. In addition to himself, 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. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) fath24 a Signature of Owner (/ • Print Owner's Name bEVANE e PAM I CK ' Sworn to and subs rib: d before me this I - day of00 - 0 '' Notary Public Print Notary's N My commission 12301 -52 PAGE 4 12/05 s: u 3,2. onded • 1 hn1 Rnndine (RE -R ool=i G) 111111111 1 11111111111111111111111111111111111 CFN 2006R1106129 OR Bk 25005 F's 1191; (1PS) RECORDED 10/16/2006 12:29:29 HARVEY RUVIHr CLERK OF COURT MIAMI -DADE COUNTYr FLORIDA LAST PAGE Prepared by Pk&\ O JC EL 20Ck rI Address: P,0( Box 53 I OJ 'cap 1 f� 31 1 SECTION R4402.13 HIGH VELOCITY HURRICANE ZONES — REQUIRED OWNERS NNOT I FOR ROOFING CONSIDERATIONS �6 R4402.13.1 Scope. As it pertains to the section, it is the responsibility of roofing contractor t �o i r with the required roofing permit, and to explain to the owner the content of the section. The provisions of Section R4402 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 ant the contractor. The owner's initial in the designated space indicates that the item has been explained. • 1. Aesthetics - Workmanship: the workmanship provisions of Section R4402 are for the purpose of providing that the roof system meets the wind resistance and water instruction performance standards. Aesthetics (appearance) 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. 2. p.8 ' Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Section R4403. (The roof deck is usually conceal irior to r movthe existing roof system). 3 v� f.8 . Common a o s are tlee which have no visible delineation between neighboring to o s, condominiums, etc.) In buildings with common roofs, the roo a ra r a or owner should notify the occupants of adjacent units of roofing to be 4. P e - Expose 1 ,., d , en beam ceilings are where the underside of the roof decking can be v ea . 1 low. e owner may wish to maintain the architectural appearance; therefore, roofing nail penetration of the underside of the decking may not be acceptable. The provides the option of maintaining the appearance. S. 9.8 - 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 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 should be corrected. 6. f', $ - Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not overloaded from a buildup of water. Perimeter /edge wall or other roof extension may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance with the requirements of Sections R4402, R4403 and 84413. 7. f. b - Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of the structure 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. P, Q E E 1, f D IA a. f i i job QcULo J OI 1 lob Owner /Agent's Signatur Date Contractor Signature Date 15.32 Rt3OI= ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2004 High- Velocity Hurricane Zone Uniform Permit Application Form. Section A (General Information) Master Permit No. 0 2-562 Process No. Contractor's Name KA- / � - j ek go n A ) Job Address l.a o q `J ROOF CATEGORY ❑ Low Slope ❑ Mechanically Fastened The Mortar /Adhesive Set Tile 0 Asps attic ❑ Metal Panel/Shingles ❑ Wood Shinglea/Shatces Shingles ❑ Prescriptive BUR -RAS 150 ROOF TYPE ❑ New Roof tiReroofing ❑ Recovering ROOF SYSTEM INFORMATION ❑ Repair ❑ Maintenance Low Slope Roof Area (SF) O Steep Sloped Roof Area (SF) a ; rlOO Total (SF) c9/7 00 Section $ (Roof Plan) Sketch Roof Plan; Illustrate ail levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. include dimensions of sections and levels, dearly identify dimensions of elevated pressure zones and location of parapets. MIOMMEMUMMEMMUMMMEMEMMEMEM MMEMIIMMEMEMMIMMENIMMEMMEN EMEMEMMUMEMMUUMMINIMMEMEMM INOMMENUAMMINEVOMMEMMEMMEMM ■UUI►mm■m■I�iimmE • R•N...amr. ■EMS �I��1OI�.AM� ir►MA MMINIMauwaaa ■sru 1 MMILTEE 111nf11MMN!! EMMUMMINIM ■URI111lMEMEMMUMI UMEMMEMMEN ■iii ii 1E1 OMMU i %MWAMMUMMEMMEM ■USMIMUMUMMENEMMEMEMINIMM■ IIMMILMEMMMEMEMEMMEMEMEMMEM MEMMEMEMEMMEMMENNWEIMMEMM MEMEMMEMMEMEMMEMINIMMEMMEM FLORIDA BUILDING CODE — BUILDING Roof System Manufacturer: iviOn ' I er Notice of Acceptance Number: D A __.' oZ ) ) t g Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations) 1: L 1 X 11 19 P2: 10011? P3: 100 ib Maximum Design Pressure (From the P,ru Approval Specific System): II iff ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2004 Nigh- Velodty Hurricane Zara Uniform Permit Application Form. Section D (Steep Sloped Roof System) Ro Slope: L _ 121 Mean Roof Height: L Steep Sloped Roof System Deacrjption De (fin WOO CI type Underlayment: q0 - - t C1'1� b Insulation: Fire Barrier: ; _ 146- Type & Size Drip Edge: 1 Fastener Type & Spacing: ; 1 1411 R: $ r 0.1�j� 1i - 1.71 Q i A' WS Adhesive Type: - 4 * c P ha- j Type Cap Sheet: 1 6 M p j4 Roof Covering: ©r11 f f t 15.34 FLORIDA BUILDING CODE — BUILDING Florida Building Code Edition 2004 High - Velocity Hurricane Zone Uniform Portrait Application Form. Section E OTile 1� rations. lwr Moment bated the -ystenas, chotti ae either Mt thud i Of 2, Otitip:ur: the v;dur:, for i`f, with the values tuan M, if the Al values arc l :teem than or equal to the M value. fox each ansi of the rind, thr.n tlx: file atta limes l method is ucc, p4thle. gg�� ��i+i !vitctiun ! ' Moment 3lascti 3 d (tit u } Per RAS 127" ( YI. 1` .'t6a.itAt,?t®q=1:34117- A1k:1a 3G . tii, - fa �j t `rd r . /� ,, P ita lt xt A } +pnrcul M ; i° �.r li i I POI r 10021 1 �y�9 M.' i !s1 (±a i'r.rtu t,aJ> }Ktr:nl 1 i .Ii« x A tA'l 1 Ms'. b.3 tit f qJ r i l l Product .Approt,d Ml � �f Mcitiod 2 `Shoplifted filet %di utattoo Per•3'nhte Slow" Required !viontent of Rt•.tstta e fhlrJ From Tat,h: t:,.low - i'u aiuu 1ppnty A M .. M,. required Moment Resistance* Mean Roof Height -3 . Roof Sloped 15' 20' 25 L tp3: r. L 2:12 3:12 4 :12 5:12 6:12 7:12 Description Pres',ure Mcatt k ,t l3et51tf RygtfSlop; At. Ain3tiplip L ._._ Re tt ring Moment due to 1. irnvity Attachment Re Required Moment Rena :lama. Mininlurit Attachment Resistance Requird Uplift Resistance Avi Cage Tito Weight 34.4 32.2 30.4 28.4 26.4 24.4 Symbol 33 oh tart 0 f lub Stn: fhii,tuit;lptrtnva3 M„ hi 38.5 34.4 __ 32.2 30.1 28.0 25.9 Po II r Aj f i i1iL l Appvnbal f'', Ptu,kt r Approval 1:r ('?ietilt+ti d W 3rtrutu•, t 1ppr+iva1 L length Tth Dirru:n::ieas triodtta; approval W = width Alt eaicu3ations mtr.4 be s&:lmit ed to the buiidutt; oft ial at tt: d it' of poi nit eels}aic,ttiun 38.2 36.0 33.8 31.6 29.4 27.1 ROOF ASSEMBLIES AND ROOFTOP STRUCTURES *Mort he used in u+njutx•tiun w th a 10 of moment t,...1.4 tilt ;yt.t.•tns c-rulut .tl by the Rnxvani r'tutnty fitertl of Rule+, ;,u d Appeal:. Fin t tptitt !>;isctf the .ystrins art: Method 1 . ( t i n y Yalta rot 1' unit the t ttut . for he 11 the l•' „Jr: ralua•ti vrt,i , r than or aqua! tu +tr (•'r eac area of tit,: roof; then thy: tile attachment meth id is acceptable Meting/ t' P.t,ntient Bawd life i'til, ulainitr. Pcr 1 ?;1S 127" w: -- 1 - .' ■ Y sAh 0 t Product Ap }+ttival t-..' . Y w. •' -- ) W. [u., b p r'rwluu Apnruv,ti V . - _ X w.:: r . W . _ x *-i , fJ 3- t _ Prwlur A {+proia! r" Where to Obtain information Where to find P1 rr 1.2 or P3 RiV 127 fable 1 ur by t41 , 't,ina rout,• auat4 pis, ptrp;ued by 3'3 barad AS(_li ?- - 39.7 42.2 _ 37.4 :39.8 35.1_ 37.3 _ 32.8 _ 34.9 30.5 '32.4 28.2 30,0 30' 4D MIA M IDADE BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) Monier Lifetile, LLC 135 NW 20 Street Boca Raton, FL 33431 " MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of materials. The documentation submitted has been reviewed by Miami -Dade County Product Control Division and accepted by the Board of Rules and Appeals (BORA) to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Atlantis Shake & Slate Concrete Roof Tile LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ", 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 the performance of this product. TERMINATION of this NOA will occur after the expiration date or 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 purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination 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 NOA is displayed, then it shall be done in its entirety. INSPECTION: 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 ROOFING ASSEMBLY APPROVAL Category: Sub - Category: Material: 2. PRODUCT DESCRIPTION Manufactured by Applicant Monier Lifetile Atlantis Shake and Slate Tile Trim Pieces 2.1 SUBMITTED EVIDENCE: Test Agency Redland Technologies The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. Roofing Flat Profile Roofing Tiles Concrete 1. SCOPE This renews a system using Monier Lifetile Atlantis Shake & Slate Concrete Roof Tile, as manufactured Monier Lifetile LLC and described in Section 2 of this Notice of Acceptance. For locations where the pressure requirements, as determined by applicable Building Code does not exceed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall be done as a moment based system. Test Dimensions Specifications 1 =15" w = 10'/ 1 1/4" thick 1 = varies w = varies varying thickness Test Identifier 7161 -03 Appendix III 94 -060A 94 -084 25- 7094 -2 25- 7094 -8 25- 7094 -5 Product Description PA 112 Flat, interlocking, high pressure extruded concrete shake 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. Test Name/Report Static Uplift Testing PA 102 & PA 102(A) Static Uplift Testing PA 101 (Mortar Set) (Adhesive Set) Static Uplift Testing PA 102 (4" Headlap, Nails, Direct Deck, New Construction) Static Uplift Testing PA 102 (4" Headlap, Nails, Battens) Static Uplift Testing PA 102 (4" Headlap, Nails, Direct Deck, Recover/Reroof) Date Dec. 1991 March, 1994 May 1994 Oct. 1994 Oct. 1994 Oct. 1994 NOA No.: 02- 1211.08 Expiration Date: 12/16/07 Approval Date: 01/09/03 Page 2 of 6 Test Aeencv The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. Redland Technologies Redland Technologies Redland Technologies Redland Technologies The Center for Applied Engineering, Inc. Professional Service Industries, Inc. Celotex Corporation Testing Service Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Test Identifier Test Name/Report 25- 7183 -6 25- 7183 -5 25- 7214 -1 25- 7214 -5 7161 -03 Appendix II Letter Dated Aug. 1, 1994 P0631 -01 PO402 Project No. 307025 Test #MDC -77 224 -47099 520109 -1 520111 -4 520191 -1 Calculations Calculations Calculations Calculations Calculations Calculations Calculations Calculations Static Uplift Testing • PA 102 (2 Quik -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, Battens) Wind Tunnel Testing PA 108 (Nail -On) Wind Tunnel Testing PA 108 (Nail -On) Wind Tunnel Testing PA 108 (Mortar Set) Withdrawal Resistance Testing of screw vs. smooth shank nails Wind Driven Rain PA 100 Physical Properties PA 112 Static Uplift Testing PA 101 Aerodynamic Multiplier Moment of Gravity 25 -7094 25 -7496 25 -7584 25- 7804b -8 25- 7804 -4 & 5 25- 7848 -6 25 -7183 Aerodynamic Multipliers Two Patty Adhesive Set System NOA N Expiration Approval Date Feb. 1995 Feb. 1995 March, 1995 March, 1995 Dec. 1991 Aug. 1994 July 1994 Sept. 1993 Oct. 1994 Sept. 1994 Dec. 1998 March 1999 March 1999 Sept. 1999 February 1996 April 1996 December 1996 March 1995 April 1999 April 1999 o.: 02- 1211.08 Date: 12/16/07 Date: 01/09/03 Page 3 of 6 Table 1: Average Weight (W) and Dimensions (I x w ) Tile Profile Weight -W (Ibf) Length -I (ft) Width -w (ft) Monier Lifetile Atlantis Shake & Slate Tile 8.5 1.25 0.865 Table 3: Restoring Moments due to Gravity - M (ft-Ibf) Tile Profile 3 ":12" 4 ":12" 5 ":12" 6 ":12" 7 ":12" or greater DirectDeck Monier Lifetile Atlantis Shake & Slate Tile Direct Deck Direct Deck Direct Deck Direct Deck 6.0 5.9 5.8 5.6 5.5 Table 2: Aerodynamic Multipliers - X (ft Tile Profile X (ft3) Direct Deck Application Monier Lifetile Atlantis Shake & Slate Tile 0.24 3. LIMITATIONS 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 TAS 112, appendix `A'. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 Minimum underlayment 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 material manufacturers published literature. 3.6 This acceptance is for wood deck applications. Minimum deck requirements shall be in compliance with applicable building code. 3.7 May be installed on slopes 7:12 and greater with a minimum of two screws. 4. INSTALLATION 4.1 Monier Lifetile Atlantis Shake and Slate Concrete Roof Tile and its components shall be installed in strict compliance with Roofing Application Standard RAS 118, RAS 119, and RAS 120. 4.2 Data For Attachment Calculations NOA No.: 02- 1211.08 Expiration Date: 12/16/07 Approval Date: 01/09/03 Page 4 of 6 Table 4: Attachment Resistance Expressed as a Moment - Mr (ft-lbf) for Nall -On Systems Tile Profile Fastener Type Direct Deck (min 15/32" plywood) Direct Deck (min. 19/32" plywood) Battens Monier Lifetile Atlantis Shake & Slate Tile 2 -10d Ring Shank Nails 30.9 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 -10d Smooth or Screw Shank Nail (Field Clip) 24.3 24.3 24.2 1 -10d Smooth or Screw Shank Nail (Eave Clip) 19.0 19.0 22.1 2 -10d Smooth or Screw Shank Nails (Field Clip) 35.5 35.5 34.8 2 -10d Smooth or Screw Shank Nails (Eave Clip) 31.9 31.9 32.2 2 -10d Ring Shank Nails' 50.3 65.5 48.3 Installation with a 4" tile headlap and fasterners are located a min. of 2'/ :" from head of tile. Table 5: Attachment Resistance Expressed as a Moment M, (ft-Ibf) for Two Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Monier Lifetile Atlantis Shake & Slate Tile Adhesive 31.3' 2 See manufactures component approval for installation requirements. 3 Flexible Products Company TileBond Average weight per patty 13.9 grams. Polyfoam Product, Inc. Average weight per patty 8 grams. Table 5A: Attachment Resistance Expressed as a Moment - Mr (ft-Ibf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Monier Lifetile Atlantis Shake & Slate Tile PolyPro 118.9 PolyPro 40.4 4 Large paddy placement of 45 grams of PolyPro 5 Medium paddy placement of 24 grams of PolyPro'"'. Table 5B: Attachment Resistance Expressed as a Moment - M, (ft -Ibf) for Mortar or Adhesive Set Systems Tile Profile Tile Application Attachment Resistance Monier Lifetile Atlantis Shake & Slate Tile Mortar Set 39.0 NOA No.: 02- 1211.08 Expiration Date: 12/16/07 Approval Date: 01/09/03 Page 5 of 6 5. LABELING All 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. 6.1.2 Any other documents required by the Building Official or applicable building code in order to properly evaluate the installation of this system. OVERLAY • �d OVERLAY • WATERLOCK PROFILE DRAWINGS 8 .. 16V8" , MONIER LIFETILE ATLANTIS SHAKE & SLATE CONCRETE ROOF TILE END OF THIS ACCEPTANCE NOA No.: 02- 1211.08 Expiration Date: 12/16/07 Approval Date: 01/09/03 Page 6 of 6 MIAM FDADE BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) Polyfoam Products, Inc. 11715 Boudreaux Road Tomball, TX 77375 MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by the BCCO and accepted by the Building Code and Product Review Committee to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The BCCO (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BCCO reserves the right to revoke this acceptance, if it is determined by BCCO that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Polypro® AH160 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 the performance of this product. TERMINATION of this NOA will occur after the expiration date or 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 purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination 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 NOA is displayed, then it shall be done in its entirety. INSPECTION: 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 renews NOA No.01 -0521.02 and consists of pages 1 through 7 The submitted documentation was reviewed by JRrge L. Acebo. NOA No.: 06-0201.02 Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 1 of 7 ROOFING ASSEMBLY APPROVAL: Category: Roofmg Sub Category: Roof tile adhesive Materials: Polyurethane SCOPE: This approves Polypro® A11160 as manufactured by Polyfoam Products, Inc. as described in Section 2 of this Notice of Acceptance. For the locations where the design pressure requirements, as determined by applicable building code, does not exceed the design pressure values obtained by calculations in compliance with Roofing Application Standard RAS 127, for use with approved flat, low, and high profile roof tiles system using Polypro® AH 160. Where the attachment calculations are done as a moment based system for single patty placement, and as an uplift based system for double patty systems PRODUCTS MANUFACTURED BY APPLICANT: Product Dimensions Polypro® AHI N/A Foampro® RTF 1000 N/A ProPack® 30 & 100 N/A PRODUCTS MANUFACTURED BY OTHERS: Any Miami -Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list moment resistance values with the use of Polypro A11160 roof tile adhesive. PHYSICAL PROPERTIES: Property Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability Closed Cell Content Note: Test Specifications TAS 101 Test ASTM D 1622 ASTM D 1621 ASTM D 1623 ASTM D 2127 ASTM E 96 ASTM D 2126 ASTM D 2856 Product Description Two component polyurethane foam adhesive Dispensing Equipment Dispensing Equipment Results 1.6 lbs. /ft.' 18 PSI Parallel to rise 12 PSI Perpendicular to rise 28 PSI Parallel to rise 0.08 Lbs./Ft 3.1 Penn / Inch +0.07% Volume Change @ -40 F., 2 weeks +6.0% Volume Change @158°F., 100% Humidity, 2 weeks 86% The physical properties lifted above are presented as typical average valves as determined by accepted ASTM test methods and are subject to normal manufacturing variation. NOA No.: 06-0201.02 Expiration Date: 05 /10/11 Approval Date: 04 /13/06 Page 2 of 7 EVIDENCE SUBMITTED: Test Agency Test Identifier Test Name /Report Date Center for Applied Engineering #94 -060 TAS 101 04/08/94 257818 -1PA TAS 101 12/16/96 25- 7438 -3 SSTD 11 -93 10/25/95 25- 7438 -4 25- 7438 -7 SSTD 11 -93 11/02/95 25 -7492 SSTD 11 -93 12/12/95 Miles Laboratories NB -589 -631 ASTM D 1623 02/01/94 Polymers Division Ramtech Laboratories, Inc. 9637 -92 ASTM E 108 04/30/93 Southwest Research Institute 01- 6743 -011 ASTM E 108 11/16/94 01- 6739- 062b[1) ASTM E 84 01/16/95 Trinity Engineering 7050.02.96 -1 TAS 114 03/14/96 Celotex Corp. Testing Services 528454 -2 -1 TAS 101 10/23/98 528454 -9 -1 528454 -10 -1 520109 -1 TAS 101 12/28/98 520109 -2 520109 -3 520109 -6 520109 -7 520191 -1 TAS 101 03/02/99 520109 -2 -1 LIMITATIONS: 1. Fire classification is not part of this acceptance. Refer to the Prepared Roof Tile Assembly for fire rating. 2. Polypro® AH 160 shall solely be used with flat, low, & high tile profiles. 3. Minimum underlayment shall be in compliance with the Roofing Application Standard RAS 120. 4. Roof Tile manufactures acquiring acceptance for the use of Polypro® AH160 roof tile adhesive with their tile assemblies shall test in accordance with TAS 101. 5. Roof Tile manufactures acquiring acceptance for the use of HANDI -STICK roof tile adhesive with their tile assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein. r F 2 MS W NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 3 of 7 Table 1: Adhesive Placement For Each Generic Tile Profile Tile Profile Placement Detail Single Paddy Weight Min. (grams) Two Paddy Weight per paddy Min. (gams) Flat, Low, High Profiles #1 35 N/A High Profile (2 Piece Barrel) #1 17 /side on cap and 34 /pan N/A Flat, Low, High Profiles #2 24 N/A Flat, Low, High Profiles #3 8 • . 1 1 • INSTALLATION: 1. Polypro® AH160 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of Polypro® AH160. 2. Polypro® AH 160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of Polypro® AH160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the uplift resistance determined in compliance with Miami -Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA 3. Polypro® AH160 roof tile adhesive and its components shall be installed in accordance with Roofing Application Standard RAS 120, and Polyfoam Products, Inc. Polypro® AH160 Operating Instruction and Maintenance Booklet. 4. Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, Inc. Polyfoam Products Inc. shall supply a list of approved applicators to the authority having jurisdiction. 5. Calibration of the Foampro® dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the "B" component shall be maintained between 1.0- 1.15 (A): 1.0 (B). The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved. 6. Polypro® AH160 shall be applied with Foampro RTF1000 or ProPack® 30 & 100 dispensing equipment only. 7. Polypro® AH160 shall not be exposed permanently to sunlight. 8. Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after Polypro® AH160 has been dispensed. 9. Polypro® AH160 placement and minimum patty weight shall be in accordance with the Placement Details' herein. Each generic tile profile requires the specific placement noted herein. LABELING: All Polypro® AH 160 containers shall comply with the Standard Conditions listed herein. BUILDING PERMIT REQUIREMENTS: As required by the Building Official or applicable building code in order to properly evaluate the installation of this system. NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 4 of 7 i ADHESIVE PLACEMENT DETAIL 1 SINGLE PATTY NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04/13/06 Page 5 of 7 ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 6 of 7 3 Passed Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 03/17/2006 Inspector: Grande, Claudio Owner: DEVANEY, TRACY Job Address: 1209 99 Street NE Project: <NONE> Miami Shores Village, FL Contractor: DALEY ROOFING INC Building Department Comments Thursday, March 16, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Imported Permit Inspection Type: Final Roof Work Classification: <NONE> Phone Number Parcel Number 1132050090082 Lot: Phone: (305)754 -9892 Page 1 of 2 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrica Owner's Name (Fee Simple Titleholder) I - T7U -k bEV `J Owner's Address 1 q me- `7 J City KA 1a t14 ,5intrif S State TenantlLessee Name Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Architect/Engineer's Name (if applicable) Type of Work: Describe Work: Submittal Fee $ Notary $ Scanning $ 3 co Code Enforcement $ Total Fee Now Due $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEOVED SEP, 12QAJ€q . 5j County Mi i -D Zip 3313 g NO lumbing Contractor's Company Name t -GE... ]t 1 ?yJ �� 1 ' X A Contractor's Address I jJ( 1 00 ,t, City Mt GRIM 1.14Nr' S State . q'1 Qualifier ID CI 414 Date-9 Permit No. ast Permit N©. Phone # Zip 3 13g Phone # Mechanical !oS 76 zip 53)3g • Training /Education Fee $ 0 .4D Technology Fee $ 57 • Phone # 3OS 754 geq 13 ►c=1 State Certificate or Registration No. We-05T 3O Certificate of Competency No. Phone if $ Value of Work For this Permit t Square Footage Of Work: L vt..e,(d....4) a .S DAddition DAlteration :New epair/Repi*e Dnoiition k,f,OA I c 3 ILIA-k-S — Pc-PP/40v .Gtr "1.1.6 1LE- IAA -tr- Ar2£As wmTm+ Mo p F&0 1 1Z h Cfeim T •41,h9 1'Y1 £r'M PAL' latJ £ , (4n]STALt. - nub W W P.C.Avovw Permit Fee $ / CCF $ A • 20 CO /CC Radon $ Zoning Bond $ 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. 1 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 inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Po.ti..__k /J Owner or or Agent The foregoing instrument was acknowledged before me this 31 day of A JSr 2005 , by ? TQ.t cK_ De_ArAIJ6)-f , who is erson know to me or who has produced As identification and who did take an oath. NOTARY ' , BLIC: Sign: L-„y;^.!mrm•rri f11'11 �!,',►'__ _ w ► ` MY COM ION t I Print: ,, ► I ■ My Comm! , v - NOTARY PUBLIC: s ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 S ignature 1 _ (/ Contractor The foregoing instrument was acknowledged before nee this day of 20 _, by who is personally known to me or who has produced as identification and who did take an oath. Sign: Print: My Commission Expires: * o.S **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner V Engineer Zoning Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: BP2005 -1319 Printed: 9/16/2005 Applicant: PATRICK DEVANEY Owner: DEVANEY PATRICK JOB ADDRESS: 1209 NE 99 ST Contractor DALEY ROOFING INC Local Phone: (305)754 -9892 Parcel # 1132050090082 Building Permit Contractor's Address: 78 NE 106 ST Legal Description: EARLETON SHORES PB 43 - 80 LOT 10 BLK 1 LOT SIZE 75.000 X 109 Fees: Description Amount FEE2005 -12523 Building Fee $100.00 FEE2005 -12524 CCF $1.20 FEE2005 -12525 Training and Education Fee $0.40 FEE2005 -12526 Technology Fee $2.50 FEE2005 -12527 Scanning Fee $3.00 Total Fees: $107.10 Total Fees: $107.10 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 3/11/2006 Construction Value: $1,225.00 Work: REPAIR 3 LEAKS APPROX. 40 TILE Signed: (INSPECTOR) Page 1 of 1 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 1 assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: SEP2;PAID -i3 1 High Velocity Hurricane Zone Uniform Roofing Permit Application MIAMI -DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION 1 Master Permit No. Contractor's Name: ❑ Low Slope ❑ Asphaltic Shingles ❑ Prescriptive BUR -RAS 150 Low slope roof area (fL*) Section A (General Information) Process No. Roof Category ❑ Mechanip1y Fastened Tile ❑ Metal Panel/Shingles ❑ Other. Roof Type ❑ New Roof ❑ Re- Roofing ❑ Recovering Are there Gas Vent Stacks located on the roof? ❑ Yes ❑ No If yes, what type? ❑ Roof System Information Steep Sloped area (i1 Sediiom B i ■MV XMO II 111 ■11i■1 iil /E •i'M■111M ■II ■1Mii �1 . . 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Page 2 1 Job Address: 1 i egg Repair ❑ Maint 1 30 Plan '"Mortar/Adhesive Set Tile ❑ cur Total (ft.=) SEP 1 4 20D5 GX I 3 •• . • • • • . .. • • • • • • • • • • • • • • • • • •• • . .. • ••• • • • ••• • • Page 1 of 1 q)ft/(9 - ••• • • • ••• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • (20q 61,c. qq' Si Property Address t1 A EJ MA S11oR FL. 33,38 • • • • • • • • • SECTION 1524 • ICG81LEl.OFI1Y tlUE;RtC 3N €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 noofing aryd tq efplAn to the owner the content of this section.. The provisions of Chapter 15 of the Rorida•Butkag;CQdd, fullipg govern the minimum requirements and standards of the industry for roofing system initallatiops.. 7tidc tignItllyr the following items should be addressed as part of the agreement between the owner and tite G6fltrAdbr. The owner erinitial in the adjacent box indicates that the item has been explained. 1. Aesthetics- Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane Zone) 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. P.8 • 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 16 (High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing roof system). '_3. Common Roofs: Common roofs are those which have no visible delineation between neighboring units (Le. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor andlor owner should notify the occupants of adjacent units of roofing work to be performed. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail penetrations of the underside of the decking may not be acceptable. The Florida Building Code provides the option of maintaining this appearance. P +6 r 5. Ponding Water. The current roof system andlor 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 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 should be corrected. ph- - 6.Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof Is not overloaded from a build up of water. Perimeteredge 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. P' 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the interior 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. Pix. 8 08 3 l /,,poS Ownees/Agent's=fr Date Contractor's Signature Rev :1I2I2005,Computer services, Building Department Pen Number • • • .; • ••..• ' •i : • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • ••• • • • • ••• • • • • • • • • • • • • • • • • • • • • • • • • • • • • , IV • • II: • • • • , ••• • • • • • • 41' -• • •' • • •,-,• • • • •••• ,°' • • • ••••••• Date Job Address D-01 N' ` • Tax Folio /I ' 2 �S - ow? ' 00‘52- Legal Description Owner / Lessee / Tenant r J Q Q_ Owner's Address 12c)/ n1 ` L. F S '} Contracting Co . 3J ' L • ? co (efx.. n ii-nC • Address a LCD S `c-C). 2S J1 • HAI Phone State # t CO Municipal # Architect /Engineer Bonding Company Permit Type(circle one WORK DESCRIPTION T 1 , ; C I 3 I6. basc Square Ft .0-700 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 re :• ating c• ruction and zoning. h , Furtre, I auth rize the above -named contractor to do the wrrk stated. Signature of owner and/ df Condo President Date: o2- Ict-13 -- Notary - as-,to— Qner_. ancjLor Condo TA mission Expires: PtIIC STATE OF FLORIDA MY COMMISSION EXP. FE8.19,7995 BONDED THRU GENERAL I $ UND. ** * * FEES: PERMIT 3 9 • 6'4 APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE L ( 0 ran S 4 y Address Mortgagor Address LECTRICAL PLUMBING MECHANICAL ROOFIN)AVING FENCE SIGN � 3 t e ',:c4. Sr.s Qre erj1 Sri President Zoning �Buildin Competency # Ins .Co .G,G/?7.690A p , /lop 1- Estimated ignature of Contractor Notary a My Commi 1:004 * * * * * * * * RADON C.C.F. 6 NOTARY TOTAL DUES. 09 � Fire Mechanical Plumbing Master Permit #.1.1.'$6 Phone 7 S1' 7Z ontr 62 l-5//9 Address kGori ° WV 4:01C (AA Y 0 II) • 4-c/14;(- TTrf1// Y _ ' fi c vaa4 Cost(value) ( LOC) or Owner- u er's Al r Exp :k'$1'PUBL1CSTA • FLORIDA tor or Owner- Builder I'1Y COAMISSZON a?.A .13,19 115 BCN E7 MA; GIZI RAJ. INS. UNIX * * ** Other Electrical Engineering • -1A. 1977 LAWS FS 713.13 State of Florida County of The undersigned hereby informs all concerned that improvements will be made to certain real property, and in accordance with section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. Legal description of property (include Street Address, if available) . Address Name Address NOTICE OF COMMENCEMENT Owner's interest in site of the improvement Fee Simple Title holder (if other than owner) Name Address THIS SPACE FOR RECORDER'S USE ONLY . . • PREPARED ) E9 PAIR kck. E 4AA.16-1 N RS -Sr • \-t ctAd.1/4 ' c't • -. } (PREPARE IN DUPLICATE) General description of improvements Owner . /2P V 9c J 3 2-05 - 009 - 061 2 - Contractor ee? Address .31 2 V4) 2 3 -174- //yeae F3o Surety (if any) Address Amount of bond $ Any person making a loan for the construction of the improvements: Name Address Person within the State of Florida designated by owner upon whom notices or other documents may be served: Name Ae-tf t , / F'" 1 .3 / Address In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (h), Florida Statutes. (Fill in at Owner's option). STATE CF rt.DRIDA, COUNTY Of:* DADE ; ivFREir that this is a true copy of the 0• a ir / l ek ;: e.....\__ Iis &fira cic y of , ____ A.D. 17 2 . L ----_---------, W 7i'EE. 1 and Ciqr.;of !Soo:. Feij1N, CLER cl c.,,, • By C 93R 134894 1993 MAR 17 12:28 SEMINOLE FORM 408 Owner Sworn to and subscribed before me this G2# day of MIAMI SHORES VILLAGE Lot. . _. Block.__ _ Subdivision.. (y Street and Number where work is to be done . _- - -_ ./c - __._!__.!E__ -___l _ -_ - __ -_.• 7 - t _...____. State work to be done and p ose of building (by floors) k - ie0 a STORY 011�- 1 - 43 t J !S INHrrE - -1 -E TI Disapproved Date (Signed) U ' - _ Building Inspe or BUILDING INSPECTION DEPARTMENT Notary Public, State of Florida My Commission Expires_ _. (AP )/ SP. lo; d ,4 'l APPLICATION FOR BUILDING PERMIT Application kJ 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 cc ..pprovei plans and specifications must be kept at building during progress of the work. Date. / - ) 4 0 Owner's Name and Address � ' �O�Ne q qq No 1 9 2 Q 1 ..._ _ _ Street. NE - J.. Registered Architect and /or Engineer - .. - -. . - -- - -. Name and address of licensed contractor._. Cheroot, _/f j} OOE(Nt - Co _- h -- 501 No 71 -..5T /f rt ( Location and legal description of lot to be built on 1 y ,lam - - - - and for no other purpose. New Building___ -_ -_ -_ _._ __ _ ____ Remodeling_____._ .__._ Addition__ _ ___ . _ . _ _ _ Repairs__ ___ -• - No. of Stories - . ot- To be constructed of Kind of foundation_ . .. -__ Roof Covering SH /NE� 711.-C Estimated Total cost of improvements $ _.__._ 893-00 Amount of Permit $ _ ,2-'. 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 hereby submit all the plans and specifications foi said building. All notices with reference to the building and its construction may hP sent to — — - - - - - -- -- The undersigned applicant for this building permit do s hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen s Compensation Act, being Sec ion 5968, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar i ompliance 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 suc. subcon. -' tors, on ork to performed under thi 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 _. -•• -- - - - -- ...... ----- •-- - - - - -- -• - -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. 126 _ 6 0 _ . _ Date _. _ . -/6- — Read, Sworn to and Subscribed before me. PLANNING BOARD DATE Chairman Member _ _ _ . Member _ Member Member Member - Council Approved ..... Date Disapproved _ _.Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after appro. al has been obtained from .L._ DI , __.a_... ACTOR OR BUILDER BY AUTHORITY •:x:1: Bpi ( 0 ELECTRICAL 0 PLUMBING 0 ,,or ROOFING ye Owner of Building 0 Architect Contractor (� or Builder Legal Lot Description Address of Building p C 14 V . � This permit is granted to a contractor or builder seated: abate tle neitellttitt . fbf tion herefor in strict compliance with all ordinances pertaining t and with the talk plans, drawings, statements or specifications that may haus' WA_ sulgt$Lited to tad afla at any time if the work is not done in compliance with suI 1 et the pbu ars . permit is granted is the understanding that the sestramee ar builder above a regulations pertaining to the work covered hereby whew shows ea *as or dr sibility for work done by his agents, servants or employees, Signal: In consideration of the issuance to me of this permit I agree to perform ^ate wade Dowsed herseuder lu pertaining thereto and in atria conformity, with the plans, dretw1ngs, 314 2111119813 or speoilleoihnes submitted to the pros' ceptinq this permit 1 assume responsibility for all work done by either, reyself, my agent, servant or employee. • n . Sae- Vision MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Applicat -on is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing o: other stru ture herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Villag F orida, and all provisions of the Laws of the State of Florida, all ord of Miami Shores Village and all rules and regulations of the Building Division of Miam Shores Village sh 11 be con plied with whether her in specified cr not. A cope of approv d plans and specifications must be kept at budding during progress of the work. Date- - -_ UEC " - ( - . 19 IS Owner s Name and Address ___ __ _ SPENCEI No.../.91P 9 ___ Street__ NE ?7_ Registered Architect and /or Engineer Name and address of licensed contractor _ ___ _ _J • C. CA �,i'Uj1�l(2 - /�� /_ NW o2D C j O p -L'cn; - Location end legal description of lot to be built on: Lot _ Block _ __ .__________ ___ _ .. __ Subdivision_ Street and Number where work is to be done_ -. ____ _ __.l o 0 !V E _ / _/ ST. _ State work to be done and purpose of building (by floors) jeF - RQOF L O W E _ LE VEt OOF _ and for no other purpose. New Building _____ ____ _.__ .. Remodeling . __ . Addition. _ -_ . . _.. Repairs V-- -_. - __ _ No. of Stories To be constructed of _ _ _ _ __. Kind of foundation . __ _. ___. __ ____ __ ._____ ____ ___ _ ___ ___. ____ Rof Covering CE/YENT S%f/p/C-1 E li Estimated Total cost of improvements $ .______ :00 _Amount of Permit $ 5° 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 - - - - - - - - - - - - - - - - - - T h e undersigned applicant for this building permit does hereby certify that hP 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 Miai: i Shores Village. d Remarks- - - — - — (Signed) l- STATE OF FLORIDA, COUNTY OF DADE. 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. __ 1_0_ _ - Disapproved _ _ _ Date (Signed) - Date E • �- . — _f_ Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chairman --- -- - Member _ - Member _ Member -- - _ Member _ . _ -- _ _ Member -- Council Approved _ Da,e 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. mum tio UMW :water of Atikliav ct $er _gai >escript kidding `I [ i$ perms •is .qt- 40 410 1 ieret£ar ta mad �Q . a win e, staionAulS 4 mitwIttellfcsifs into Pi the. wAstt :Is c _, Roksted 8s trit xalz St§ata to 4rtcsiaing # kefr watt rood "One iby ibis 06140, Zette s 'Or em. r fit. cogicievgiAi itto ;E:44plakkg ihstso tied le oittoi•441144) 'spins ikis Permit 1 comas rew CONTRACTOR OR BUILDER Chairman _ Member _ M e m b e r Council Approved MIAMI SHORES VILLAGE Date__ BUILDIN INSPECTION DEPARTMEN APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the det.iled statemen of the plans and specifications herewith submitted for the build- ing or o h, :ructure her i described This t - t licatic is made in compliance and con o•m ty w.th the Building Ordinance of Mia Shores Village, or da, and all pro isions of the Laws t f the State of F h.rid. all o d nances of Mi ni Shores Village and all rules and regu a ion of the Building Div.. r of lam Sho, illage F '1 ,e , o. ipl.ed with, whether herein specified or not. A copy of approved plans and specificati .nv must be kei at building durin„ progress of tl.e wcrk. Date 5/4/54_ ._._ ._ __ , 19 Owner' Name and Address __ PauL_Kinney No. 7.4..5 Street. N.. E_.___91st. _St_... Registered Architect and /or Engineer._. $ame - - - - -- - -- - -- --- -- -- --- Name nd address of licem,ed contractor. Land Roofing and Tile Co. ;- _130 N. W. 79th St.., Miami Fla. Location and legal description of lot to be built on: Lot Block.._ ___. __ Subdivision Street and Number where work is to be done 1ZQ9 _ - N,- __ Et. - __99 - th St. _4 ahjr State work to be done and purpose of building (by floors) -- - - - - -- -.and for no other purpose. New Building_ I. _ _ _ Rernodeling ____ _ ._. Addition._._ _.__ _._ ___.. _ _ Repairs.. _ No. of Stories To be constructed of ___ _ _ Kind of foundation Roof Cov gyring.. Tile Estimated ' ,tal cost of improvements $__ 740. Amount cf Permit $__ . 5. 00 Zone ^ubage required __. _Plan Cubage Distance to next nearest building__ _ _ _ Size of Building Lot Maximum live load to be borne by each floor _ . ..... hereby submit all the plans and specirications for said building. All notices with reference to the building and its construction may be sent to The unde signed appli ant for th s bu1ding permit does hereby certify t'iat he understands and accepts his ,•bligations as an employer of 1 bor under he Florida Workmen's Compensation Act being S. -tion 5966 Col p led Gen al Laws of Florida P r anon Snpph: nent. and h s compl ed w;th he prov• :ions thereof, and will require s•milar comp lance from all contractors or sub - contractors emplo •ed by him in the wo k to be p rt med under th s peril it and ill post or cause to be posted for inspection on the site of the work su :h public noti e or •otites as are requir d by the Act. The u. d. r ign •d agrees to employ only such ubcontr- ctors, on work to b perform d der this permit as are licensed by M am. Shores it : ge. Lang oof i g and Ti Co., Inc. Remarks.. _ _ .. _ (Signed ) STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to adm.nister oaths ,..nd take acknowledgments, personally ap- peared _ . and who, being by me first d. ly sworn, upon oath deposes and says that he is the of th abov de .e ibed • istruction t, li has careially read the foregoing application, and that he did sign the same, and that all facts therein by him stated are tr le. Permit No _- Disapproved t Pate (Signed) Read, Sworn to and Subscribed before me. Notary Public State of Florida Iding Ynspector My Com:nission Expires. PLANNING BOARD ___DATE Member _ _ ...._. Member Member -- _Date Disapproved .to me well known, Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application tft -r approval h is been obtained from the Plans ng Board A re- inspection fee of $1.00 will be charged when such re- inspection is m :e necessary by improper notice for inspe:•t w or fay Ity materia - nd /or workmanship.