5 NE 99 St (7)Date
Type Insp'n
Permit No.
Name
For Inspector:
Approved L ('
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Address
Company
Phone #
o
o
Time
Name & to
t / 212,3
MIAMI SHORES VILLAGE
U S s BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date Time
r
Type Insp'n / 1 � -� / Op
Permit No.
Name
Address
--- Company D
Phone #
For Inspector:
Approved
Re- Insp'n Fee
3
Correction V ❑
Name & D
kOr
Date
Type Insp'n
Permit No.
Name
Address
Company
Phone #
For Inspector:
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Time
2S '67W
O3 Name & Dat
a�f
(YT
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Time
Type Insp'n
Permit No
Name
Address
Company
Phone #
For Ins
o
I )
Date
PERMIT APPLICATION FOR MIAM SiORF NDI tgE
10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • Pheine: X05495 X4)41 Fait: 3115 - 756.8972
Job Address .0 /t► • 'g �"C►"P�.F Tax Folio
• • • .. • ••• •••
•
Legal Description Historically Designated: xes • • • • • • No
r -I ••• •.. • • • • _
Owner /Lessee/Tenet ff p 1`� K 1 : N e(�h .-- 6 Master Permit # OS 1
• • • . . •
•••• . ••
N .E. 9? -ff rrr-�
Owner's Address Phone • . • • . • • • •. •
• • • : : :9:3c:�7 • :Nk- . leA QV acr to 4 – /C1►
Die/VOW
Contracting Co. ADO /9 Address
Fe
Qualifier c 1 \ 1 Obc/ D Lir Phone 3 ! ] - 75 7 ee 42
State # CORI - to Municipal # Competency # 5 Ins. Co. ON fi
!P
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one): BUILDING ELECTRICAL
WORK DESCRIPTION: / ( ./ Off ' Y O --tomb re R&S z ��
1 I ry
Square Ft. 3
A
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE T-15r Y RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR ANY 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 all disciplines.
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. Furthermore, I authorize the above named contractor to do the stated.
g
nature of owner and/or Condo President at
Ndtary as to Owner an or Conc�4i a ndra D. Ha Date
o . 7. . Comm i s sion # DD 014872
er, ' i '•Q: Expires April 2, 2005
ia� Bonded Thru
Atlantic Bonding Co.. Inn.
FEES: PERMIT V RADON C.C.F
Zoning Building
Mechanical Plumbing
My Commission E
Estimated Cost (value) `-*/
�4L ref OA.-
Snatxfe of Contractor or Owner Builder
to s o�}tragt s qr Owner Builder Date
LT: ° s_Co mmtsslon # 014872
Expires onAded pril 2, 2005
' . $ B TGrn
'4°11%4 � Amu* Bonding Co., Inn:
1 U NOTARY BONI -
'? TOTAL DUE S 3 l7
Electrical
Structural Engineer
PLUMBING MECHANICAL — -�
Ae
/ fe Y
SECTION 1524
'HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING
CONSIDERATIONS
1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with
the required roofing permit, and to explain to the owner the content of this section.. The provisions of Chapter
15 of the Florida Building Code, Building govern the minimum requirements and standards of the industry for
roofing system installations. Additionally, the following items should be addressed as part of the agreement
between the owner and the contractor. The owner's initial in the adjacent box indicates that the item has been
explained.
1. Aesthetics - Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane
Ldne) 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.
2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be
re ailed in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zories) 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 (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or
owner should notify the occupants of adjacent units of roofing work to be performed.
4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be
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.
5 5. Ponding Water: The current roof system and/or deck of the building may not drain well and may
cause water to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural
distress and may require the review of a 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 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. Perimeter /edge walls or other roof extensions may block this discharge if
overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in
accordance with the Florida Building Code, Plumbing.
7. Ventilation: Most roof structures should have some ability to vent natural airflow through the
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. • • .
wner's /Agent's Signature
CA IPOC ) 1 `cmp'LOC.LLS4xTtmp■SECTION 13x.4 ,
.() /l /3 D.3 Date •ontractor's Signature
Master Permit No.
Contractor's Name
Job Address
LI Low Slope
❑ Asphaltic
Shingles
High Velocity Hurricane Zone Uniform Permit Application Form
S A (General Information)
Process No.
ROOF CATEGORY
❑ Mechanically Fastened Tile VMortar/Adhesive Set Tile
❑ Metal Panel /Shingles ❑ Wood Shingles /Shakes
❑ Prescriptive BUR -RAS 150
ROOF TYPE
❑ New Roof CV ❑ Recovering ❑ Repair ❑ Maintenance
ROOF SYSTEM INFORMATION
Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF)
1 37F�
Section B (Roof Plan)
Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow
scuppers and overflow drains. Include dimensions of sections and levels, clearly
identify dimensions of elevated pressure zones and location of parapets.
_• i - , -r-, .--!-. ... ;+__i -: I_t - -; 1 1 1 1 ! i
- ' - 1 1 I I I :
�I , I, i f -1 I I r _r -i/ - - t_ . • •J ^r r 1 r 1 _i 1
1 - . -' . _=. - -r f t _ ^, ! ,. _ 1 I _ _ •_. _' _�_ k_.__ ��., ..r 1 I �- - ., �
•�.,* 1 I
�, t } l - -i -i _ _ / :: I . i •!- _r r 1 1 '_.._ ' . , ! 1 _ ... .,..4 L -!-
_._4,• 1 .L -' ., ._ _!_
! 1.t.t.'_. ;_I : - l._;..!.:..... : _. I .. .1..1._1 _ ' , .i ! r I � 1 , • • . ! ' i _ - • • '. I r .; � ; �f -
i s s _; V 1 7 4 .• - .. :::.. :- _ Li_.-• �-! - =- L -t -'.- ' - :._G - i -
i i 1 F. r . i - i ._ - • .. - � • :• . ; F .. 8 ql .E.. ! ' -L_ . , - - - -� -� -�- - _ a -r'.: ,.i/! - i ! ;_; _I
i ':1:i_t i � 11 • .` ..r...' . ; . - .- (- l?_.;1,.`19./..p• /$o _ ! • : 1 .: _LL :.: _:_!: _ I 4.
i .. ! ,•1 ...1 -E -- � ; -; � I • , ! i _-
1 ; r 1 , , , i 1 __4 1 _l- _ ! . _. : _ • 1 .. - I - - r _ 1 _ _: 1 _ L i • 11
•r-i --- - I' i r I 1 • • r • ` - I - 1 - 1 - I I i , 1 I 1 1 • 1 -- - ! ` - Ll ..._ ! ' t 1-r.. 1 - _� i ' •_ 1 -
t .1 .. F i ..._ _ ii i I ■ _i i_;_' .......1,_1.....,....._ __' ...1__t_ _i..! ! I--' L- !- f -• -� ; 1 - i iT L
L !
I _ • - i i f r !_ I , _ ^ ;_' _L.L . ,p_ 1 i1 -
-_: _•._ i_,_, _ _L.. 1 1 ! ! , 1 I I ! 1 L
_� t ! _;-
.__ + _f_ _,- ,_ CL_:_ t__ -: -4-- -:._ I -' -r' ;- 1 • - -rr-; i !_i_._.-i i =Iz1_.
T t l -r I - i _r - i t
_ ! ,-. LL 1 , I • - ,._t.- t.- L.t_.• ._ • • -1 .l- - L. `� — - ! _' L - _..__ -
Whcrc to Obtain Information
Description
Symbol
Whcrc to find
Design Pressure
P I or 1'2 or 1'3
RAS 127 •fable I or by an engineering analysis prepared by PI; based on ASCII
7
In Roof I leigttt
11
Job Site
RoofSropc
0
.Job Sae
r \crodynaniic Multiplier
X •
NOA
Restoring Moment Jac to Gravity
hi,
NUA
Attachment Resistance
NI, •
NUA
Required - 1.10 en( Resistance
N1,
Calculated .
Nlinimunt Attachment Resistance
1.'
NOA
Required Uplill Resistance
1',
Calculated .
Average Tile Weight
W
NUA
Tile Dimensions
1. length
w� width
NUA •
_ '`/
int at the timo amnia application.
All calculations must he submitted to thc Iluilding U wll
M Required Moment Resistance"
Mean Roof Height --`
Roof Slope-4,
15'
20'
25'
30'
40'
2:12
30.7
33.4
35.7
37.7
40.7
3:12
28.7
31.3
33.4
35.2
38.1
4:12
26.6
28.9
30.9
32.6
35.2
5:12
24.5
26.7
28.5
30.0
32.5
6:12
22.5
24.5
26.2
27.6
29.8
7:12
20.8
22.6
24.1
25.4
27.5
;Section E (Tile Calculations)
For Moment based tilc systems, choose either Method I or 2. Compared thc values
for Mrwith the values front M If thc Nt values arc greater than or equal to the Mr
values, for each arca of the roof, then the tile attachment method is acceptable.
Mctho 1 "IVIonient I3ased Tile Calculations Per RAS 127"
(I' x X, _ �R.p ) - Nib: �.e = M,, ��.a7 _
( P t : • x X .1.1(7. /3. - Mg: 4,86 a �' ( D • 9 ' NOA Mr �b
NOA M1.1 �.�
(P x X = d q •01- M6 : 6. ti! '1 Mrl Aoe - .2 7 NOA 1se1( ¥ .tats
Method 2 "Simplified Tile Calculation Per Table Below"
Required Moment of Resistance (M From Table Below
*Must be used in conjunction with n list of moment based tile systems endorsed by the
I3roward County Board of Rules and Appeals.
For Uplift based tile systems use Method 3. Compared the values for F' with the
values for F If the F' values are greater than or equal to the F values, for each
area of thc roof, then the tile attachment method is acceptable.
Method 3 "Uplift Based Tile Calculations Per RAS 127"
( P I : x I : = x w:= ) -W: xcos0: = F NOA
(P : x I: = x w: = ' ) - W: x cos 0: = F : NOA F'
(P : x I: = x w: _ ) - W: x cos 0: = F NOA F'
NOA MI
• 1•
High Velocity Hurricane Zone Uniform Permit Application Form
Section D Stee
Slo •ed Roof S 'stem
Roof System Manufacturer:
4--a4g9y)
Notice of Acceptance Number: 0 b4 to t�
Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations):
Pmax1: G • i
Pmax2: 22. Z1 Pmax3:
Maximum Design Pressure r •
(From the NOA Specific System): `C
Deck Type:
Ridge Ventilation?
M
Sloped System Description
ay)
Prolik
ype Underlayment:
Insulation:
Fire Barrier:
Fastener Type & Spacing:
Adhesive Type:
ype Cap Sheet:
Roof Cover
1) A
MIA M I�DDA
1
Marc Ceritelli
Ranson Roof Tile d.b.a. Pioneer Concrete Tile
1340 S.W. 34th Avenue
Deerfield Beach, FL 33442
MIAMI -DADE COUNTY, FLORIDA
METRO -DARE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET, SUITE '603
MIAMI, FLORIDA 33130 -1563
(305) 375.2901
FAX (305) 375-290S
PRODUCT CONTROL DIVISION
(305) 375 -2902
FAX (305) 372 -6339
NOTICE OF PROPOSED ACTION
To: Members of the Board of Rules and Appeals and
Hanson Roof Tile d.b.a. Pioneer Concrete Tile, Applicant
In accordance with Dade County Administrative Order 10 -3, which governs the product review process, the Product Control
Division of the Office of Code Compliance, intends to issue a Product Control Notice of Acceptance to Hanson Roof Tile
d.b.a. Pioneer Concrete Tile for Palermo Double Roll and Hacienda Double Roll Roof tile, No. 02-0916.11 , to allow
its use in Dade County and its municipalities.
To: Members of the Board of Rules and Appeals :
The documentation being provided to you represents the recommendation of the Product Control Division of the Office of
Cade Compliance in regards to the submittal of Hanson Roof Tile d.b.a. Pioneer Concrete Tile for Pal crma Double Roll
and Hacienda Double Roll Roof tile , No. 02- 091611. Under the provision of Dude County Administrative Order 10 -3,
which governs the product review process. You must review this documentation. if within 20 days from the date of
mailing, we do not receive any written objection stating the reason(s) for your disapproval, this product will be automatically
approved.
To Hanson Roof Tile d.b.a. Pioneer Concrete Tile, Applicant
The Product Control Division of the Office of Code Compliance, in accordance with Dade County Administrative Order 10-
3, which governs the product review process, has issued this notice of proposed action and intends to issue a Product Control
Nonce of Acceptance for your Palermo Double Roll and Hacienda Double Roll Roof tile , No. 02- 0916.11, to be t,sed in
Dade County and its municipalities, unless a member of the Board of Rules and Appeals or yourself has any objections.
Should you not be in accord with this notice of proposed action and wish to appeal our recommendation, you must make a
written request, stating the reasons for your objection(s), to our of fee within 20 days of the date of mailing. Upon receipt of
your written request a hearing date will be set so that you can present your objection(s) to the Board of Rules and Appeals ,
Sincerely,
Theodore Bemtan
Deputy Director
DATE OF MAILING: 11/29/2002
Herreinio Gonzalez
Director
Mailed by: i r
1 \ 30 ■po20001templatcstinolice proposed actian,doe
Internet mall address: postmaster d®buildingeodeoniine.com • Homepage: http : / /www.buildingeodeonline.com
1 0 ' d 8f10N3S0 01 S 1 SCb 211N,:1 3111 OOQH613 dd SS : b 1 C002 C I NW
MIAMI�D�
BUILDING CODE COMPLIANCE OFFICE (BCCO)
PRODUCT CONTROL DIVISION
NOTICE OF ACCEPTANCE (NOA)
Hanson Roof Tile d.b.a. Pioneer Concrete Roof Tile
1340 SW 34`" Ave
Deerfield Beach, FL 33442
M IAiM I -DADE COUNTY, FLORIDA
METRO -DADE FLACLER BUILDING
140 WEST FLACLER STREET, S 1603
(305) 373-2901 FLORIDA FAX (05) 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 Miami -Dade County Product Control Division and accepted
by the Board of Rules and Appeals (BORA) to be used in Miami Dade Counry 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 Counry 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: Fact ta.I3oiable Roll and Ret ienda Double Roll Roof Tile
LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and
following statement: "Miami-Dade Counry 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, RAC
NOA No.; 02- 0916.11
Expiration Date: 12 Ea 4
Approval Date:
Page 1 of 6
20'd anoN390 01 S I SEt' i1ND 3111 opauag ad 95 : b I C002 C I Nkif
ROOFING ASSEMBLY APPROVAL
Category:
Sub Category:
Material:
1.
SCOPE
This renews a rooftpg system using Hanson 'Palema Double Roll and Hacienda\Roof
Tile, as manufactured Hanson Roof Tile d.b.a. Pioneer Concrete Tile described in Section 2
of this Notice of Acceptance. For the locations where the pressure requirements, do not
exceed the values listed in section 4 herein. The attachment calculations shall be done as a
moment based system.
2. PRODUCT DESCRIPTION
Manufactured by
Applicant
Hanson Palema
Double Roll Tile
Hanson "hacienda"
Trim Pieces
Roofing
Roofing Tile
Concrete
Dimensions
Length: 16'W
Width: 13''
'A" thick
Length: 17h"
Width: 13"
'A" thick
Length: varies
Width: varies
Varying thickness
Test
Soeciftcationg
TAS 112
TAS 112
TAS 112
2.1 COMPONENTS OR PRODUCTS MANUFACTURED BY OTHERS
Product
Wood Battens
Tile Nails
C0' d df10N380 01
Dim ension s
Vertical
Min. 1 "x 4"
Horizontal
Min. 1"x 4" for use
with vertical battens
or
Min. 1"x 2" for use
alone
Min. 10dx 3"
Test
Specifications
Wood Preservers
Institute LP — 2
TAS 114
Appendix E
Product
Description
Low profile, interlocking, extruded concrete
roof tile equipped with two nail holes. For
direct deck or battened nail -on, mortar or
adhesive set applications.
Low profile, interlocking, extruded concrete
roof tile equipped with two nail hole and
double roll ribs. For direct deck or battened
nail -on, mortar or adhesive set applications.
Accessory trim, concrete roof pieces for use
at hips, rakes, ridges and valley terminations.
Manufactured for each tile profile.
Product
Description Manufacturer
Salt pressure treated Generic
or decay resistant
lumber battens
(With current NOA)
Corrosion resistant
screw or smooth Generic
shank nails (With current NOA)
NOA No.: 02- 0916.11
Expiration Date: 12/16/07
Approval Date:
Page 2 of 6
S i SCP d1N0 3111 000tida eid 9 : t 1 0002 C I NUL"
Table 1: AerodLmamic
Multipliers - X (ft3)
+___
Tile
X (fe))
X (ft
Profile
Batten Application
Direct Deck Application
Hanson Palema Double Roll and
0.267
0.289
Hacienda Tile
b0'd
Product Dimensions
Tile Screws
Hurricane Clip &
Fasteners
3. LIMITATIONS
#8x 2'4" long
0.335" head dia.
0.131" shank dia.
0.175" screw thread
dia.
Clips
Min. %i' 'lu ridch
Min. 0.060" thick
Clip Fasteners
Min. $d x 1 A"
4.2 Data For Attachment Calculations
21110N3a0 01 S I SCta
Test
Specifications
TAS 114
Appendix E
TAS 114
Appendix E
Product
Description Manufacturer
Corrosion resistant,
coated, square drive, Generic
galvanized, coarse
thread wood screws
(With current NOA)
Corrosion resistant
clips with corrosion Generic
resistant nails.
(With current NOA)
3.1 Fire classification is not part of this acceptance_
3.2 For mortar or adhesive set tile applications, a static field uplift test in accordance with
RAS 106 may be required, refer to applicable building code.
3.3 Applicant shall retain the services of a Miarni - 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.
4. INSTALLATION
4.1 Hanson ' Palema Double Roll and Hacienda' Roof Tile and its components shall be installed
in strict compliance with Roofing Application Standard RAS 118, 119, & 120.
NOA Na.: 02- 0916.11
Expiration Date: 12/16/07
Approval Date:
Page 3of6
211N0 31I1 ooauda 21d LS: Pt 5002 5I NtiC
Table 2: Restorin.
Moments
12"
due to Gravity
5 "; 12"
- MQ(ft-ibf)
6 ": 12"
_____'
7 ": 12" or
greater
Tile
Profile
3 ": 12"
4 ":
Hanson
Palema
Double Roll
and
Hacienda
Tile
Battens
Direct
Deck
Battens
Direct
Deck
Battens
Direct
Deck
Battens
Direct
Deck
Battens Direct
Deck
5.92
6.80
5.82
6.69
5.70
6.55
5.56
6.39
5.41
6.22
Table 3: Attachment Resistance
_
Expressed
For Nail -On Systems
Direct Deck
(Min 15/32"
plywood)
as a Moment - M (ft
Direct Deck
(Min. 19/32"
plywood)
-lb0
Battens
Tile
Profile
Fastener Type
Hanson
Palema
Double Roll
and
Hacienda
Tile
2 -10d Ring Shank
Nails
27.8
37.4
28.8
1 -10d Smooth or
Screw Shank Nail
8.8
11.8
4.1
2 -10d Smooth or
Screw Shank Nails
16.4
21.9
7.1
1 #8 Screw
25.8
25.8
22.9
2 #8 Screw
47.1
47.1
49.1
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
_ 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
Neils'
43.0
67.5
50.9
installation with a 4" tile headiap and fasteners are located a min. of 2W from he of tile,
S0'd
NOA No,: 02- 0916.11
Expiration Date: 12/16/07
Approval Date:
Page 4 of 6
61101 01 SISCP 61N0 31I1 00ad6a dd LS :7I C002 CI NU('
Table 4: Attachment Resistance Expressed as a Moment M, (ft - ibf)
For Two Pa Adhesive Set S stems
Tile
Profile
Tile Application
Minimum Attachment
Resistance
Hanson Palema Double Roll
and Hacienda Tile
Adhesive
26.1"' — "
2 See manufactures component approval for installation requirements.
3 Flexible Products Company l lleBond Average weight per petty 11.4 grams.
Polyfoam,Product, Inc. Mara gaweig per patty 8 grams.
Table 4A: Attachment
Tile
Profile
Resistance Expressed as a Moment
For Single Patty Ad hesive Syste
• Tile Application
- Mt (ft-Ibf)
Minimum Attachment
Resistance
Hanson Palema Double
Roll and Hacienda Tile
Polyfoani PolyProTM
86.61
Polyfoam PolyProTM
45,5'
4 l e dd acement of 54 rams of Pol P roTM.
5 Medium paddy placemen of 24grams of PolyPro
Table 4B: Attachment Resistance Expressed as a Moment • Mf(ft -lbf)
For Mortar Set Systems
Tile
Profile
Tile
Application
Attachment
Resistance
Hanson Palema Double Roll and
Hacienda Tile
Mortar Set'
20.60
. 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.
90'd 8I10N380 01
■OA No.: 02- 0916.11
Expiration Date: 12 /16 /07
Approval Date:
Page 5 of 6
GIGCV 31N0 31I1 000889 83 S :Pt CO 02 CI Ndr
** LO 16101 : **
L0 •d
PROFILE DRAWINGS
HA.NSON PALEMA DOUBLE ROLL ROOF TILE
FASTENER HOLES
UNDERLOCK
HANSON HACIENDA CONCRETE ROOF TILE
FASTENER HOLES
UNDFRLOCK
END OF THIS ACCEPTANCE
OVERLOOK
OVERLOCK
NOA No.: 02- 0916.11
Expiration Date: 12/16/07
Approval Date;
Page 6 of 6
6110N380 01 S I SCP 61N:) 3111 ODGU68 ad SS : b 1 CO OC C I Ndf
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 1 /16/2003
Applicant: FRANKLIN
Owner: BONAMY
JOB ADDRESS: 5
Contractor OBENOUR ROOFING
Local Phone: 305 - 757 -2612
Parcel # 1132060131260
This Permit is granted to the co
ordinances pertaining thereto and
and approved by the proper munic
authorization. A further condition
ordinances and regulations pertaii
by his agents, servants or employ
rg
In consideration of the issuance 0
with the plans, drawings, stateme
myself, my agent, servants or em
Signed:
Signe
9
NE 99
Building Permit
Permit Number: BP2003 -57
BONAMY
FRANKLIN
ST
OBENOUR ROOFING SHEET METAL
& SUPPLY CO.
9301 N.E. 6TH AVE., STE. A- 101 305 -757 -2612
MIAMI SHORES, FL 33138
EAGLE NATIONAL BANK
Aventuro Branch
2999 NE 191st Street
Aventura. Florida 33180
I 2 L8 LOii' I:O F, .nn c I. o•• -"
Page 1 of 1
Contractor's Address: 9301 NE 6 AVE SUITE A - 101
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOTS 13 & 14
Fees:
FEE2003 -289
FEE2003 -290
FEE2003 -291
Description
Building Fee
CCF
Buildier's Bond
Total Fees:
Amount
$277.50
$10.80
$300.00
$588.30
Total Fees: $588.30
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 7/12/2003 Construction Value: $17,786.00
Work: TEAR OFF REROOF ENTIRE RESIDENCE TINCAP #30 MP #90 INSTALL HANSON HACIENDA COLORTHRU THRU
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must
BLK 9 LOT SIZE
Ea Secu rity enhanced document. See back for details. r)
THIS CHECK IS DELIVERED FOR PAYMENT ON THE FOLLOWING ACCOUNTS_
DATE
TOTAL
LESS °' DISCOUNT
LESS FREIGHT
LESS
TOTAL DEDUCTIONS
AMOUNT OF CHECK
AMOUNT
PAY DATE O 3
TO THE
ORDER OF �� 1$ re 3 o
T y
21810
63- 634/660
24
i er�i "
LLARS
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
3313 6
Dat Job Address-513E11 57 ihrirgi.24P Tax Folio it ®t 31 '1
Legal Description 1,,9-7-
,9T / 3 +)L _ R LOGJ 4. 5FGT 4 + PE I"-i1 P DUI -) 3/ bib
/ Lessee / Tenant ,4/I / , ,l 75A54-0 80 vt.06--evt y Master Permit 1i •��o
Owner's Address ) jq Ml v , 514.454E PL 3 3) 3V Phone7 ' 4' 7 Ve' s^"
Contracting Co.
Qualifier SS# -
State # Municipal fk
Architect /Engineer
Bonding Company / Address
Mortgagor ) i 4 L ft. L. Cl9 t °.
Address7 —
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Square Ft. Estimated Cost(value) 4 .ri7 ‘).—
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 d• - in compliance with all applicable laws regulating construction and zoning. Furthermore, I
aut on , the above -n, d contractor to do the work stated.
L' ut-z.-
Notary as to Owner and /or Condo Pre ident
2
My Commission Expires: j / ecn,ca / //'
Si: a e of owner and /or Condo resident
Da t : G . /P,
**
NOTARY PUBLIC STATE OF FLORIDA
* MY COIMISSIONAXPIRES x/09/94 *
Bonded thru Stembler -Adams & Sweet
Address 54
Phone
Ins.Co.
Addsa4s
L+-. D
Signatur Contractor or Own Builder
Date:
Notary as to Contractor or Owner- Builder
My Commission Expires:
* * * * * * * * * * *
FEES: PERMIT i � RADON C.C.F. i S 6 NOTARY S: 049 TOTAL DUE .00
APPROVED:
Mechanical Plumbing
Fire _ Other
lk Electrical
Engineering
Per 489.103(7) F.S.S.
State law requires construction to be done by licensed
contractors. You have applied for a permit under an exemption to
that law. The exemption allows your, as the owner of your
property, to act as your own contractor even though you do not
have a license. You must supervise the construction yourself.
You may build or improve a one - family or two - family residence or
a farm outbuilding. Your may also build or improve a commercial
building at a cost of $25,000 or less. The building must be for
your own use and occupancy. It may not be built for sale or
lease. If you sell or lease more than one building you have
built yourself within one (1) year after the construction is
complete, the law will presume that you built it for sale or
lease, which is a violation of this exemption. You may not hire
an unlicensed person as your contractor. Your construction must
be done according to building codes and zoning regulations. It
is your responsibility to make sure that people employed by you
have license required by state law and by county or municipal
licensing ordinances.
Date
;,)v) IC CLck
Village Use Only
Owner's name(print)
Permit No. lcW
DISCLOSURE STATEMENT
wner's signature
r r/WkI ;H (30-ffoly
• MIAMI SHORES VILLAGE BUILDIN1G AND ZONING DEPARTMENT
'Nu have, this date, made application for a building permit as an owner -
builder. You should be advised of the following provisions and reouirements
that apply to owner - builder.
Proof of Ownership - Prior to a building permit being issued to you,
you must submit proof of ownership of the land concerned in the
application in the form of a recorded deed, showing you own the property,
or a copy of mortgage or warranty deed of the land, or a Dade County tax
receipt, statement to contain legal description of property and indicate
property is in your name. Legal description and name on document of proof
must correspond to the name and legal description on the application.
Responsibility - You will be responsible for all work done by your day
labor employees, and you must either employ licensed contractors or
persons to be paid on an hourly or per diem basis. Any one contracting
(including labor) with you, verbally or in writing, on a fixed fee basis
for any work, who is not properly licensed, will be subject to a fine of
$500.00 and /or imprisonment for six months.
Insurance - You should be advised that if your day labor employees cause
any damage to persons or property, or if any of your day labor employees
are injured on the job, you are liable. Your regular home insurance
policy ordinarily does not cover this type of liability.
Withholding Taxes, etc. - You should be advised to investigate your
responsibility for withholding Social Security, Federal and State
Unemployment Insurance Taxes and Federal Income Taxes from the wages
of employees working for you on the proposed construction, and for
making returns thereof to the proper agencies.
Work Permitted Owner - Builder - An owner- builder subject to the foregoing
provisions and requirements, is limited to constructing one single family
residence each year for his own use and occupancy; or maintaining, altering
or repairing his own single family residence.
If you do not intend to do the work involved yourself, or with day labor, please
list below, the name of the individual or firm with whom you have entered (or
will enter) into a contract for the work.
NOTICE: SEPARATE PERMITS REQUIRED FOR ELECTRICAL, PLUMBING,
ROOFING AND MECHANICAL WORK
p _L/2
ame of Indi idual or Firm
I, the owner of property described as
3
. r
1
Wi ness
INSTRUCTIONS TO OWNER- BUILDER
// ..
do hereby certified
that I have read the foregoing instructions, and am aware of my responsibilities
and liabilities under my application for a building permit for construction work
on the above described property.
i /0, (4) AK;41 J/
Owner
4
Date
Date ( 0 J ” Job Address5'/1J 9 S7 I I7 St ax Folio
Legal Description ftj q�. .�'7 ` -i T►'L „ 1?,e; a_ 3; 2 3 TJ -'
/ Lessee / Tenant C� s4� G�lr� `I' Master Permit # _57e4;
Owner's Address 5 ) t % `'Y1 ) ni 5Rog /73 l38'
Contracting Co..
)
Qualifier SS# - - Phone
State 4P Municipal # Competency # ,Ins.Co.'
Architect /Engineer - Address
Bonding Company
Mortgagor
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Signature of owner and /or Condo Pre
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
FEES: PERMIT • RADON
APPROVED:
) 9y
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
C7
* * * * *
•
C.C.F.
Fire
Zoning Buildi
Mechanical Plumbing
Address
Address
Address
Square Ft. Estimated Cost(valueY/-' O D
J
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 contract .• o do the wor stated.
Signature of Contractor or Own
Date:
Notary as to Contractor or
My Commission Ex'ir
O ,`P (iY P0 OFFICIAL NOTARY SEAL.
ei SANDRA M MONTIEL
2 i1 _ 4l * COMMISSION* NUM /I,
CC401261
r Q � . OMMISSIOI! .
M� UG. 17
Phon0& 2574 - r L/ Z
Owner- Builder
uilder
*
Other
Electrical
Engineering
(7 0' 1°
7 o
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 budding during progress of the work.
Owner's Name and Address
Registered Architect and /or Engineer..... - _..••,- ,..<,,.,,-
Name and address of licensed contractor .... ..... ..... _.....
Location and legal description of lot to be uilt on:
Lot Block ..
Subdivision
rill'. ��-- ..
Street and Number where work is to be done _ �....: 9 9+.eG [..c!._. .. :
State work to bed e and purpose of building (by floors)..a..�'f� L.
and for no other purpose.
New Building Remodeling Addition Repairs No. of SSpries
To be constructed of Kind of foun ation Roof C .ye ng
?? 104-
Estimated Total cost of improvements $ - • - -Jam.•• �� A mount of Permit $........__.. t
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 arc required by the Act. The undersigned agrees to employ only such subcontractors, on work t• be performed under this
pennit, as are licensed by Miami Shores Village.
Remarks.. ._ (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Permit No.
Disapproved Date
(Signed) -‘.L% l 4-
C
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Building Inspecto
Chairman
\fcrnbcr
Member
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
L Date I ` t — 7 2—
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My _Commission Expires
NINC BOARD DATE
Member
Member
Member
Date ..._
No .5 Street lt/.
to me well known,
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 hecn obtained from
the Planning hoard.
A re fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
BUILDING ❑
ELECT
PLUMBING L �° PERMIT •
ROOFING
0
Owner of Of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
This permit is granted to the contractor, -or
tion herefor in strict compliance with all ordipa
plans, drawings, statements or specifications that
at any time if the work is not done in coinpll
permit is granted is the understanding '. that the c
regulations pertaining to the work coveted her
sibility for work done by his agents, servant's
Signed
In consideration of the issuance to ttt8 c
pertaining thereto and in strict conformity with
In accepting this permit I assume responsibility fo
3
OR or BUILDER
MIAMI SHORES VI A E,, FLORIDA
Isi? 8905
it ork be performed and Pere*
AUTHORITY'
Cot txctorPs
tree se No.
Value
Project - k °
01140 to construct the buildia er to ioeipii the eqtapaleSit or
and with the understanding &at the work will be performed int,
to and approved by the proper mepioipal authorities. This P
or if the plans are changed wither outherization. A further
ed above ass the responsibility $K a titctr
plans or drawings or in the statement's or spe eat �a
(INSPECTOR) }tY
the work covered hereunder in comp)
o r specifications submitted is the proper autho
►s elf, my agent, servant
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 "— ,167/
Owner's Name and Address - -.. -- N. • Y f∎ •. -.-JC- -� -- -- _c• - - -. - -- No b. -• - -- Street 1 '-- — ` ` I 5d.:
Reglgtered Architect and /or Engineer... _ _ . _.
Name and address of licensed contractor._ _. - U \ _QQ_v 0---0 Location and legal description of lot to be built on: `
Lot_. Block . Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors) ...
and for no other purpose.
New Building Remodeling Addition Repairs S/ No. of Stories It
To be constructed of Kind of // f �� ou pp nddation Roof Covering
a ._. .
Estimated Total cost of improvements $ -rW _ � 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 foi said building. All notices with reference to the building and its construction may
be sent to.__._
The undersigned applicant for this building permit doe 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 der notice t
or notices as are required by the Act. The undersigned agrees to employ only such ubcontra tors, o k o be p orne n i
permit, as are licensed by Miami Shores Village. . , 1
Remarks — (Signed) % - 1
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared - - -- - - - -
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true. �j
Permit No ........ 7° S ._ Date. ___/ — s_ _ ' 7 .... Read, Sworn to and Subscribed before me.
Disapproved ____ _ _
( Signed)
Chairman -
Member
Member -
Council Approved
APPLICATION FOR BUILDING PERMIT
Date
MIAMI SHORES VILLAGE
uilding In;:ector
BUILDING INSPECTION DEPARTMENT
Member
Member . _.
._Date Disapproved
to me well known,
Notary Public, State of Florida
My Commission Expires__
PLANNING BOARD__ __ . DATE
Member
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.
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 regula-
tions of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans
and specifications must be kept at building during progress of the work.
Owner's Name and Address ,Iirnlne_ Tenn
Registered =MR e • D
Name and address �� Jd contractor Gi ffnn Industries, Ina. P.Q.Bra......6 $1, Or Gables
Location and legal desc t p ttonoYlot to be built on:
Subdivision
Street and Number where work is to be done 1L J&1.Ami Ave._ 29.th St. I1iia. Shores
State work to be done and purpose of building (by floors)
Tiles_ aver 1/;50# Asphalt. Felt &
._ Valhi,_ fl$ hi drip. Flash
New Building X —__ Remodeling_ —__
To be constructed of — _ —_ —__ Kind of foundation_
Estimated Total cost of improvements
Zone cubage required —__
Distance to next nearest building
MIAMI SHORES VILLAGE
••
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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 Gi ffAn InT is tri A4, Inn. P_O,RQx. ea, ],, Carte, Gables, Fla..
The undersigned applicant for this building permit does hereby certify that be 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 ciuse 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
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he bas carefully read the foregoing application, and that he did
therein by him stated are true.
Permit No ____ Date
Disapproved
(Signed) - --
r
Building Inspector
Date
Nick Anfi_ .hone
Addition_______— _— ________ Repairs
_____—__—_Amount of Permit $_
_Plan Cubage
Size of Building Lot
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved_ Date Disapproved
Date - -— -- — — 19 —.
No IY LMiami S&Vt_ e & 99th St.
tS—P,,,„ off_ F
Roofing RARifiAnne Ap :t t
1/90# Slate Rooting, Install Galy. metal
1 -12 -lig solat coil.
__and for no other purpose.
No. of Stories._____-_____
SIIPP Covering - --
O
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
(Signed)
R. K. Thompson, S c ty. Ec real,
to me well known,
sign the same, and that all facts
—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.