ROOF' - PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date D Job Address - 6 9 N E 99 37 Tax Folio // - a /3 - 1 7 / s 7
3 //Q2 rS See_ / A.N /.
Legal Description P/3 /0 L S o - ) / /3 L'L 3 3 Historically Designated: Yes No x
Owner/Lessee / Tenant /pN C 4) i (S Cs % N $ Master Permit # % $ '7,2.
Owner's Address ri 9 NE 5790 TH ST
Contracting Co. .4/✓T /-/ o /may /3 . lv L 5 ON Address 7' c s w / 2 4 1 S T
Qualifier / 9 N T / / o N y N . 146'L 5 0/ (/ SS# Phone 3 aS / - 2tt
Competency l l'O -5°)V70 �/P4w6e w T//06- t)rjy�
State # C l' C 0 S 2 z/7o Municipal # Com ten # Ins. Co. Fcc f H ✓ roz4 c._
Architect/Engineer Address
Bonding Company Address
Mortgagor i Address
Permit Type (circle one): B ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION /2 _ (4 S.2c �j 1 '‘C § P P (f P
Square Ft. / o
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
construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
%. i _
e o owner and/ot Condo
esident
NotAry as to Owner and/or tondo President ate
My Commissior Expires:
••4 NANCY B. WEEDS ,0**: = MY COMMISSION # CC 929580
. EXPIRES: Apri119, 2004
r .s rnti Nowt'
;+ Bonded Public UndervrMln
FEES: PERMIT RADON
APPROVED:
Zoning
C.C.F.
NOTARY
Phone - 7.$ S/- Al 3
Estimated Cost (value) - 2 ooe7
Signature of Contractor or Owner- Builder
Notary as to Contract° 'r er- Builder
My Commission Expires:
Electrical
Denise Gufda±.E
x%'f ^ 'n;ieOA?�miston # CC a;vv r
.� i- lIt gite 0@t, Z4, Z 3 3
wryry` Bonded Thin' '� Atlantic Bt:ottin 'C ttt "•.
BOND
TOTAL DUE
Mechanical Plumbing — Structural Engineer
ANTHONY B WILSON 3052516135 P. 01
1144 yr %.vrrurmim.. •
A RECpRDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO. / / -• 06 - 0/3- 5 ✓s 7 0
STATE OF FLORIDA:
COUNTY OF DADE: 0.11 1R1.79 2001 APR 12 10:41
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: 6 / /" 99 -
/t- 1i .+d .— S .Sew / /�//.1. /3lB -70 .Lo/ �a / Cc3L
2. Description of improvement: 4. -
3. Owner(s) name and address:
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: _ /9N T//o" 8. &),L. SvN
b' Sw /2 Sr /y 33/s6
5. Surety:(Payment bond required by owner from contractor, if any) ; FLORIDA, COUNTY OF r, ^2
E REC�Y CER7'IFY :nrs is a tiJe )y " ■':A
Name and address:
Amount of bond $
6. Lender's name and address:
Sipnafure of Owner
( Print Owners Name
Sworn to and subscrib
Notary Public
Print Notary's Name
My Commission Expires:
(Jn9rnat tiled in tnis G, p re
t ° n INESS ill hn anC JL c•ar Salt.
7. Persons within the State of Florida designated by Owner upon whom notices or other
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
MY COMMISSION # CC 929580
EXPIRES: April 19, 2004
Bonded T ru Notary Public Under/don
c. meets may be served. as provided
I) r
Prepared by: __ /* /Z.LoJ
A ddress:
/// A/ur / / 3 3 "
12401.52 2/93
Contractor's Name: Og. ti.. 5 0(1 Job Address:
❑ (Low Slope Application) ❑ (Nail -On Tile) �
�� (M�- Adhesive Set Tile)
❑ ( Metal Roofs \Wood Shingles & Shakes) ; ❑ (Other)
ROOF TYPE
❑ New Roof 1 % ❑ Recovering ❑ Repair ❑ Maintenance
❑ (Asphalt/Fiberglass Shingles)
Flat Roof Area (ft') S1ope�Roof Area (ft /0y1 Total (ft') Master Permit No.
Exposure category (per ASCE 7 -88): Building Classification category (per ASCE 7 -88 table 1): 2
123.01.78 4/99
ATTACHMENT
Fastener Type:
SPACING
Field: Perimeter: Corner:
DETAIL 1.& 2
Appendix "E"
UNIFORM ROOFING PERMIT APPLICATION
PROCESS No.
ROOF CATEGORY
Page -1
ROOF HEIGHT AND SYSTEM DETAILS
(Draw details as needed) ARE THERE
AS VENT STA
YESD NO
TYP NATURAL 0 LPCY
ROOF PLAN
r
r
r
r
r
f
/ Dick type:
Und.rlaytlunt:
In+uladon:
DI T a I L 3
Appendix "E"
UNIFORM ROOFING PERMIT APPLICATION
• PROCESS No.
)- M
k • 95
) • M
)
1 , SIX ,s L�u --5-.s x N.97
�R �)' M PCA: 741_40 .
74.7(
M,3: PCA: ��l o
M,3' i7SPCA: D
(Pm GS /:4j_1 XkX
t+amlc Itip11a):
(Pmts?: 4144.A (So amr,g hip 11 a 5-
(Pm,:r3: ILS t (Aerodynamic Y►++nuc !•tultiplirr):
• ,SLOPED SYSTEM DESCRIPTION
- Drip edge:
Page -2
/2 " Oc 1-76.7 (.1D
G is o C •et PS
v /L' G c
6A : E AT. &AAA/ 7i c. C
c
ATTACHMENTS REQUIRED
1) Firc Directory Listing Page
2) Dade County Product Control
Notice of Acceptance -Cover Shcct
a) Specific System Description
b) Specific System Limitation
c) General Limitations
d) Applicable Detail Drawings
3) Municipal Permit Application
4) Other Component Approvals
ner s /Agent's Si
Signature
5104 APPENDIX "F"
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
the minimum requirements and standards of the industry for roofing system installations. Additionally,
the following items should be addressed as part of the agreement between the owner and the contractor.
The o er's initial in the adjacent box indicates that the item has been explained.
. Aesthetics - Workmanship: The workmanship provisions of Chapter 34 are for the purpose of x
roviding 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.
%l.1 2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be
ienailed in accordance with the current provisions of Chapter 29 of the SFBC. (The roof deck is usually
concea ed prior to removing the existing roof system)
. Common Roofs: Common roofs are those which have no visible delineation between
neighboring units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing
contractor and/or owner should notify the occupants of adjacent units of roofing work to be performed.
W 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 underside of the decking may not be acceptable. The SFBC provides the
option of maintaining this appearance.
jo, 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.
�C �" " . Overflow Scuppers (wall outlets): It is required that rainwater flow off so that the roof is not
overloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this
discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow
scuppers in accordance with Chapter 23 of the SFBC.
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. •
to Contractor's
to Contractor's
Signature
• 0 ;; ?d / 20100 1 7:21 3058830050
,- •'
•
M! AM I -DADE
PRODU CONTROL NOTICE OF ACCEPTANCE
Santafe Tile Corporation
8825 NW 95th Street •
Acceptance No.:99-0913.05
Expires:10 /13/2002
SANTAFE TILE CORP PAGE 0�
MIAMI - DADE COUNTY, FLORIDA
METRO•DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE
METRO -DADE FLAGLER BUILDING
140 WEST F..aGLFR STREET, SUITE :603
MIAMI. FLORIDA 33:30-1563
(305) 375-7901 FAX (305) 375-n0:3
CONTRACTOR LICENSING SECTION
(305) 375 -2527 FAX (305) 375 -2558
Medley FL 33178 CONTRACTOR ENFORCEMENT SECTION
(305) 375.2966 FAX (305) 375.2905
Your application for Product Approval of; PRODUCT CONTROL DIVISION
(305) 375.2902 FAX (305) 372-6339
Mission Barrel ",Roofing Tile"
under Chapter 8 of the Code of Miami -Dade County governing the use of Alternate Materials and Types of
Construction, and 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 shall not be valid after the expiration date stated below. BCCO reserves the right to secure this
product or material at anytime from a jobsitc or manufacturer's plant for quality control testing.
If this product or material fails to perform in the approved manner, 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 Build
The expense of such testing will be incurred by the manufacturer.
Raul Rodriguez
Chief Product Control Division
THIS IS THE COVERSHEET, SEE ADDITIONAL. PAGES FOR SPECIFIC AND GENERAL
CONDITIONS
BUILDING CODE & PRODUCT REVIEW COMiVIITTEE
This application for Product Approval has been reviewed by the BCCO and approved by the Building Code
and Product Review Committee to be used in Dade County, Florida under the conditions set forth above.
:1 proved: 10114/1999
Internet mail address: postmestergbuildingtodeonline .com
rancisco Sulntana, ..A.
Director
1 of 5 Miami -Dade County
Building Code Compliance Office
Homepage: bttp : / /www.buildingcodeoalina.com
03/24/2000 17:21 3058880050
S.ANTAFE TILE CORPORATION
A. TESTS:
Test Aeenev
The Center for Applied
Engineering, Inc.
The Center for Applied
Engineering, Inc.
The Center for Applied
Engineering, Inc.
The Center for Applied
Engineering, Inc.
NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED
Test Identifier
94-156-6
94- 156-.5
25- 7121 -1
Project: 07- 07 -00 -91
(307023)
Testwell Craig Laboratories &
Consultants, Inc.
B. OTHER
1. Notice of Acceptance number 99- 0913.05
Lab HMK-2
Tech: Alberto Ramirez P.E.
E-1
SANTAFE TILE CORP PAGE 06
ACCEPTANCE No.: 99- 0913.05
APPROVE 10/14/1999
EXPIRES
Test Name /Report
Static Uplift Testing
PA 102(A)
(Nails and a Clip)
Static Uplift Testing
PA 101
(Adhesive Set)
Static Uplift Testing
PA 101
(Mortar Set)
Wind Driven Rain
PA 100 1
Physical Properties
ASTM C 1 167
10/13/2002
Date
09/94
09/94
11/95
09/94
08/96
Frank Zuloaga, RRC
Rooting Product Control Examiner
t' 2a/2;2:00 17:21 3058380050 SANTAFE TILE CORP PAGE 02
SANTAFE5I,L1E CORPORATION ACCEPTANCE No.: 99- 0913.05
1. SCOPE
This revises a roofing system using Santafe `Mission Bar e11', as manufactured Santafe Tile
Corporation 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 in compliance. with RAS 127 using the.values
listed in section 4 herein: The attachment calculations shall be done as a uplift based
system.
2. PRODUCT DESCRIPTION
Manufactured by
Annlic:tnt
Mission Barrel Clay
Roof Tile
Trim Pieces
Product
Tile Nails
Roof Tile Adhesive
( "Pul) pioe AH Id0 ")
NOTICE OF ACCEPTANCE:
Category: Prepared Roofing
Sub Category: High Profile Tile
Dimensions
w m 8 -' /z to 7 -1/2"
taper
'/" thick
= varies
w = varies
varying thickness
Dimensions
min. 12d x 3'/."
N/A PA 123
NI:,
Test
Specifications
2.1 Components or products manufactured by others
PA 112 High profile, two piece, clay roof tile
equipped with one nail holes. For nail -on
with clip, mortar set and adhesive set
applications.
PA 112 Accessory trim, clay roof pieces for use at
hips, rakes, ridges and valley terminations.
Manufactured for each the profile.
Test
Specifications
PA 114
Appendix E
See PCA
2
APPROVED : 10/14 /1999
EXPIRES :10/13/2002
STANDARD CONDITIONS
Product
Description
Corrosion resistant, ring
shank nails.
Product
Description
Prepared mortar rnix designed
for mortar set roof tile
applications.
Two component polyurethane
adhesive designed for
adhesive set roof tile
applicatio
Manufacturer
generic
Bermuda Roof
Company, inc.
with current PCA
Polyfoam Products.
Inc.
with current PCA
Frank Zuloaga, RRC
Roofing Product Control Eaamincr
' SANTAFE TILE COR.PQRATION
NOTICE QF ACCEPTANCE:
Dimensions
Clips
%" width
min. 0.060" thick
Clio Fzsteners
min. I2d x 3'/1"
3. LIMITATIONS
3.1 Fire classification is not part of this acceptance.
3.2 For mortar or adhesive set tile appiications, 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 underlaynnents 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 chapter 29 oldie SFBC.
4. INSTALLATION
4,1.1 Santafe'Mission Barret' 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
•
Test
Specifications
PA 114
Appendix E
3
�iaN1 TILE CORP PAGE 03
ACCEPTANCE No.: 99- 0913.5
APPROVED : 10/14/1999
EXPIRES :10/132002
,STANDAIW CONDITIONS
Product
DeseriptIm Manufacturer
Corrosion resistant bronze, generic
aluminum, stainless steel or
galvanized steel attachment
clip for all nail -on tile
attachment. Clips are
installed with corrosion
resistant roofing nails
compatible with the clip.
Frank Zuloaga, RRC
Roofing Product Control Examiner
Table 1: Average Weight (W) and Dimensions (1 x w)
Tile Profile
Weight -W (Ibf)
Length - I (feet)
Width -w (feet)
0,50
Mission Barrel Clay ;
Roof Tile
.50
' SANTAFE TILE COR.PQRATION
NOTICE QF ACCEPTANCE:
Dimensions
Clips
%" width
min. 0.060" thick
Clio Fzsteners
min. I2d x 3'/1"
3. LIMITATIONS
3.1 Fire classification is not part of this acceptance.
3.2 For mortar or adhesive set tile appiications, 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 underlaynnents 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 chapter 29 oldie SFBC.
4. INSTALLATION
4,1.1 Santafe'Mission Barret' 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
•
Test
Specifications
PA 114
Appendix E
3
�iaN1 TILE CORP PAGE 03
ACCEPTANCE No.: 99- 0913.5
APPROVED : 10/14/1999
EXPIRES :10/132002
,STANDAIW CONDITIONS
Product
DeseriptIm Manufacturer
Corrosion resistant bronze, generic
aluminum, stainless steel or
galvanized steel attachment
clip for all nail -on tile
attachment. Clips are
installed with corrosion
resistant roofing nails
compatible with the clip.
Frank Zuloaga, RRC
Roofing Product Control Examiner
•
03i 24/2000 17: 21 3058880050.
SANTAFE TILE CORP P �._
SANTAFE TILE CORPORATION ACCEPTANCE No.: 99- 0913.05
NOTICE OF ACCEPTANCE_.:
APPROVED : 10/14/1999
EXPIRES :10/13/2002
STANDARD CONDITIONS
Table 2: Minimum Characteristic Resistance Load - F' (Ibf)
Tile
Profile
Mission Barrel Clay Roof Tile
Tile
Application
Nail -on With A Clip System
Mortar Set
Adhesive Set
Minimum Characteristic
Resistance Load (Ibf)
32.60
240.00
1. The nail hole shall be located at the center of the cover tile, 1 -112" from the head.
2. Minimum 3" headlap.
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 the South Florida
Building Code (SFBC) in order to properly evaluate the installation of this system.
PROFILE DRAWING
SAINTAFE "MISSION BARREL' CLA
4
uloaga, RR
Roofing Product Control Examiner
03/24/2000 17: 21 3058880050
SANTAFE TILE CORP PAGE 05
•
SA,NTAFE TILE CORPORATION ACCEPTANCE No.: 99- 0913.Q5
5
APPROVED : 10/14/1999
EXPIRES :10/13/2002
NOTICE OF ACCEPTANCE: STANDARD CONDITIONS
1. Renewal of this Acceptance (approval) shall be considered after 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 ", or as
specifically stated in the specific conditions of this Acceptance.
3. Renewals of Acceptance will not be considered if:
a. There has been a change in the South Florida Building Code affecting the evaluation of this
product and the product is not in compliance with the code changes.
b. The product is no longer the same product (identical) as the one originally approved.
c. If the Acceptance holder has not complied with all the requirements of this acceptance,
including the correct installation of, the product.
d. The engineer who originally prepared, signed and sealed the required documentation initially
submitted, is no longer practicing the engineering profession.
1. Any revision or change in the materials, use, and /or manufacture of the product or process shr,::
automatically be cause for termination of this Acceptance, unless prior written approval has been
requested (through the filing of a revision application with appropriate fee) and granted by this
office.
5. Any of the following shall also be grounds for removal of this Acceptance:
a. Unsatisfactory performance of this product or process.
b. Misuse of this Acceptance es an endorsement of any product, for sales advertising or any
other purposes.
6. The Notice of Acceptance nurnber 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.
7. A copy of this Acceptance as well as approved drawings and other documents, where it applies,
shall be provided to the user by the manufacturer or its distributors and shall be available for
inspection at the job site at all time. The engineer need not reseal the copies.
8. Failure to comply with any section of this Acceptance shall be cause for termination and rernova
of Acceptance.
9. This Notice of Acceptance consists of pages i through 4 and this last page 5.
END) OF TI-I[S ACCEPTAI
Frank Zuloaga, RRC -----
Roofing Product Control Examiner
Date 4 -6 -94
Legal Description
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 296 N.E. 99th Street
Q .er_/ Lessee / Tenant W • F. Marry
Owner's Address 296 N.E. 99th Street
Tax Folio 11 No0 15 9
1 - J t \IlL 9_ 0 V- AKS'..Ser, ,/ ,A;e5
Master Permit 0 36oeor
Contracting Co. (ua /7i i ii fi 1i5 * IA( a , _Tee, Address c9 5 / NW 2 9 t S
Qualifier GAi/6 6 AracA0 Phone 751' lJ 3 g
State III aC OO5 kCalunicipal # 00,c(26/ Competency 0 i 7 fi 9 Ins .Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL _OOPING PAVING PENCE SIGt
WORK DESCRIPTION Will repair leak on flashing between tile and flat rnOf
Square Pt. 1 s q • Estimated Cost(value) $ 500.00
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO Dc
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTENT
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU)
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, an
on the attached addendum (if applicable). I certify that all work will be performed to meet th
standards of all laws regulating construction in this jurisdiction. I understand that separat
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S APPIDAVIT: I certify that all the foregoing information is accurate and that all work wil
be done in compliance with all applicable laws regulating construction and zoning. Furthermore,
authorize the abova namod contractor to dc the work stated.
Signature of owner and /or Co�f President
Date:
A A L
Notary as to Owner /and /or Condo President
My Commission4Expi s:
APPROVED:
Zoning
' '' MARYLOU HERNANDEZ
�£
MY COMMISSION # CC 324212
** * tt * * "' - a S , ' - ict; * EXPIREet Octtober 1081997
Banded Thru Notary Public Underwriters
FEES: PERMIT t RADON C.C.P.
Fire
Buildin
Mechanical Plumbing
Phone
757 -4288
Signature of Contractor or Owner- Builder
Date: 4/ -(p ir
ilt‘ 'I ii
•
actor or Owner-B
•
4
•
• MARYLOU HERNANDEZ
MY COMMISSION # CC 324212
EXPIRES: October 10, 1997
Thai Notny Public Undtwltere
Notary as
My Commission
7 7 NOTARY TOTAL DUE 3 • .�
der
*
Other
Electrical
Engineering
Test Date
Project Address
Contractor
Permit Number
Roof Pitch
Adhesive Type
Tile Type
TEST SUMMARY
TEST RESULTS: PASSED
See Attached Sketch for Further Details
ROOF REPORTERS, INC.
Ploiedditwat &w 9
TAS 106
Roof Tile Uplift Test Report
July 2, 2001
(561) 434 -7555
269 NE 99 St. Miami Shores, FL
Anthoney Wilson Roofing
48729
4:12
Tile Installation Date 6/05/01
Mortar
Cuban Tile
All testing is in strict accordance with The Dade County version of The South Florida
Building Code, Section 3401.10 and PA 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%
Corner 10 10 100%
Perimeter 10 10 100%
Al Maccagli;'RRC #116
Dade County Certified Testing Agency # 99 -0615.04
f v
3281 Lake Worth RoadO Suite BO Lake WorthElFlorida 33461
Roof Consulting & Testing OVisual Surveys & Evaluations ORoof System Design O
Moisture Surveys
169% AZ 99 St
9X.7 S l,,c es , P2
i
4o'
UNIT UNDER TEST:
Mfr S /N:
Cust S /N:
PROCEDURE NAME
CALIBRATED BY:
P.O. NUMBER:
SUBMITTED
BY:
CHATILLON DFIS 100 DIGITAL FORCE GUAGE
25282
25282
SYN 156
Eliu Lago
VERBAL
ROOF REPORTERS
3281 LAKE WORTH ROAD
LAKE WORTH FL
CERTIFICATE NUMBER: 30445:992524202
PERFORMED ON:
NEXT CAL DUE::
TEMPERATURE:
HUMIDITY:
14Jun2001
14Sep2001
22.0 °C +/- 1 DEG
38% +i - 5%
Synergy Labs, Inc certifies that the above listed instrument meets or exceeds all specifications as stated in the referenced pro cedtre at the points tested (unless otherwise noted).
It has been calibrated using measurement standards traceable to the National Institute of Standards and Technology (\'1ST), 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 AID SL'NCSL Z540-1-1994. Calibration procedures
used provide measurement uncertainty ratios of less that or equal to 4:1 of the specification of the unit under test, with a coverage factor of k=2 at a confidence level of 95 °/y
unless otherwise noted. This report may not be reproduced, except in full, unless perrnission for ate publication of an approved abstract is obtained in arising from 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 Descnptton
999002 AMETEK WG -23 WEIGHT SET
Signed:
PRINTED ON: 14 Jun 2001
ration 1 ecnnlclan
Report of Calibration
Synergy Labs, Inc
9831 E Evergreen St.
Miami, FL 33157
888.346.2430
CAL DATE CAL DUE DA I E
6 Jun 2001
REPORT OF CALIBRATION for SERIAL NUMBER: 25282 Synergy Labs assigned ASSET NUMBER:
30445
6 Jun 2003
Page \ of
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.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
� "e- Date 7//1
1�/ 19
Owner's Name and Address Y C / 06 / 4 ` S 2C " No. Street
Registered Architect and/or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Dip, 624 5 (67) Ff 1
o .ra,rr� 3 _7/3Y
Lot 01 oT .; / Block w1✓ Subdivision ""h1 Ala/ / IMP a 5Ocg /1 /f 5 /o J
Street and Number where work is to be done C L .A1, s r ■
State rk to done and purpose of building Iby floors /, state exterior colors )submit samples) '�� �-� Lae •
and for no other purpose.
New Building Remodeling Addition Repairs No of Stories
To be constructed of L, y� Kind of foundation Roof Covering
Estimated Total cost of improvements 5 v t/ Amount of Permit 5 �� 'AO'
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's
Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof. and will require similar
compliance from all contractors or sub - contractors employed by him in the work to be performed under is permit; and w'. ...t 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 agre s . employ ( only s ch su.contcactors, on�.rk to be performed
under this per it, as arlicensed by Miami Shores Village.
Remarks I�
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
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.
Disapproved
(Signed)
494°7
Building Inspector
Date
/l 0
(Signed)
Read, Sworn to and Subscribed before me.
/1956
PLANNING BOARD DATE
Notary Public. State of Florida
My Commission Expires
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of 525.00 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.
Registered Architect and /or Engineer
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build -
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Date
Owner's Name and Address.- .. ! .��c' T�
Name and address of licensed contractor - 2-- ,- - � G re1
Location and legal description of lot to be buf t on:
Lot Block Subdivision
Street and Number where work is to be done
6
State work to be done and purpose of building (by floors) � t � � ' y - /Li: -- f!.
_ ,
New Building Remodeling Addition
To be constructed of
Estimated Total cost of improvements $
Repairs `' No. of Stories Ch.
Kind of foundation Roof Covering ., ?4" / _ l'
Amount of Permit $
Zone cubage required Plan Cubage
Distance to next nearest building._.. Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) __ f� t = -, �' r�- �i , t
- / I' r
STATE OF FLORIDA, I
COUNTY OF DADE.
ss.
Disapproved
(Signed)
f - / /i' C C 4 '
/
Notary Public, State of Florida
Pc_
70 19(a_(.,,
No Street
and for no other purpose.
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 state are true.
Permit No "y ' ` Date Read, Sworn to and Subscribed before me.
Building spector ` 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.
JOB:
PLUMBING
ELECTRICAL
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Inspector's Report:
The following is ready for Inspection:
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BUILDING
ELECTRICAL
PLUMBING
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The following is ready for Inspection:
WORK
DONE BY:
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