33 NW 98 StOwners Name and Address .... 2A;kr e
Registered Architect and /or Engineer
Name and address of licensed contractot...X rl?. lr._..e ! -: ._
Location and legal description of lot to be built on:
Lot Block SS Su ivision.
Street and Number where work is to be done. ..3. fttr Jt SS ate work to be doe and p se of building ._.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Disapproved
(Signed)
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 erein specified or not. A copy of approved
plans and specifications must be kept at building during prpgress of the work. /
Date..._.. ..... Zi , 19 ..
— No
. %Date_
and for no other purpose.
Remodeling Addition Repairs. ( e No. of Stories
To be constructed of Kind of � founc tion Roof Covering
Estimated Total cost of improvements $..0r/ �/!/
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 hint
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 ultlic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performe under this
pennit, as are licensed by Miami Shores Village.
Remarks (Signed)..
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 state are e. )
Permit No Date 9 ri ......___._ Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Bdlding Inspector My Commission Expires
to me well known,
PLANNING BOARD DATE
Chairman Membcr ...._...._ .................. --
Mcrrrber 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 hem obtained from
the Planning hoard.
A re fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
C•I•v•1•L
E•N•G•I•N•E•E•R
All Dade General
P.O. Box 660551
Miami Springs , Florida
Project:
Dear Sirs;
LG ENGINEERING SERVICES, INC.
Consulting Engineers
2020 Northwest 7th Street
Miami, Florida 33125
Tel: (305) 649 -6454
Fax: (305) 541 -3298 July 16, 2004
TILE UPLIFT TEST
Residential Home
33 Northwest 98 Street
Miami Shores, Florida
Information provided by client:
Permit Number: BP2004 -335
Date Completion: July 12, 2004
Roofing Contractor: All Dade General
LG Engineering Services, Inc. Project Number: LG04 -1927
. (Testing Laboratory Certificate #00- 0224.07)
In accordance with your request and authorization, a representative of LG Engineering Services, Inc.
completed the Roof Tile Uplift Test for the rear addition at the above referenced project. This testing
was performed in general with Roofing Application Standard TAS No.106 -- Standard
procedure for field verification of the bonding of mortar or adhesive set tile system and mechanically
attached, rigid, discontinuous roof systems.
The total of the tested roof surface area was less than 10000 square feet, and the mean height of the
roof is less than 30 feet above ground surface. The type of tile used for this project was reported to
be Monier Roof Tile. This tile was reported to have been foamed in place.
At the time of this testing, one test for every corner, one test for every 100 square feet of roof tile in
the perimeter area and one test for every 200 square feet of roof tile in the field area were tested.
Initially the entire area of the roof was examine for loose tile. More than 10% of the roof tile located
in the field area and more than 20% of the roof tile at the roof perimeter and corner were physically
examined.
Based on our test results, we conclude that the installation of the roof tile at the above referenced
project meets the test requirement outlined in the above mentioned protocol. Attached please find
a copy of our test report for your review.
LG Engineering Services, Inc. appreciates the opportunity of assisting you in this project. If you
have any questions or if we may be of further assistance, please do not hesitate to contact the
undersigned.
Respectfully submitted;
LG Engineering Services, Inc.
amad Sonny Salleh, P.E.
Project Manager •
TILE UPLIFT TEST
Residential Home
33 Northwest 98 Street
Miami Shores, Florida
Test Number
Test Load (Ibf)
Test Status
1
35
Pass
2
35
Pass
3
35
Pass
4
35
Pass
5
35
Pass
6
35
Pass
7
35
Pass
8
35
Pass
9 •
35
Pass
10
35
Pass
11.
35
Pass
12
35
Pass
13
35
Pass
14
35
Pass
15
35
Pass
16
35
Pass
17
35
Pass
18
35
Pass
19
35
Pass
20
35
Pass
21
35
Pass
22
35
Pass
23
35
Pass
24
35
Pass
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Report of
TILE UPLIFT TEST
for
Residential Home
33 Northwest 98 Street
Miami Shores , Florida
Project Number: LG04 -1927
LG Engineering Services, Inc. — Tile Uplift Test Result -- Project Number: LG04 -1927, Page 1
Test Number
Test Load (lbf)
Test Status
25
35
Pass
26
35
Pass
27
35
Pass
28
35
Pass
29
35
Pass
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
LG Engineering Services, Inc. -- Tile Uplift Test Result -- Project Number: LG04 -1927, Page 2
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