ROOFINGOwner's Address
Contracting Co.
Qualifier
State # (p
Job Address a NE 101 a
C� PPea0J)
la5c N l al .S�rPe
,Tames D. Dheyvoae.
Architect/Engineer Address
Bonding Company Address
Square Ft. 3k,5
cl,�g1
Signature of owner and/or Condo President to
i)"
Notary ps to Own:, and/or Condo President to
My Co>luni ' , , "u r AI\'D A D. HART
eico vi,m;: 5:t ?"3 Lr CC6237
E;;P It E:; M.,".1: 12, :L001
q s` j LOO DE9 THROUGH
w's. =QC o>D:NGCO.,INCi
ii.....,F. .....
FEES/PERMIT 9
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
RADON
Municipal # Competency # a Li k3e,
Tax Folio 11-3a05 - oo Ss - oO a 0
ption Historically Designated: Yes No
Address
Ins. C
Master Permit # `/ 9 (� (, q
Phone
9-3v l NE ( ` 5aik A -io/
- , ''� Phone 3- 751-2 (Q /.2..
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAcROOFIAVING FENCE SIGN
WORK DESCRIPTION R erg --bow k - * 90
9z-
iN 6-te MONie 1) U° -/ 5 OILL4 -9, Ce /or .- MvoLzail 4.1 (.x.
Li
Estimated Cost (value) L3 Eret
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 AP'NIIAVIT: I certify that all the foregoing information is accurate and that all work '11 be done in compliance all applicable laws regulating
construction and zoninp�Furthennore, I authorize the above -named contractor to do the work ed.
ture of Contractor or Owner- Builder
.5Q 4,412,1a 41vd
Notary as to Contractor or Owner - Builder
My Contmi a' 1 es:. sr NDRA O. HAKI
4'15CommtssiON 4 CC6623713
MAR 12, 2001
001495) THROUGH
tgroinc
C.C.F. 1 /6 NOTARY 0 —
Electrical
BOND 3 00
TOTAL DUE yD f
lad (as ei
Everes-e
ate
ate
APPROVED:
Zoning Building
Mechanical Plumbing Structural Engineer
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. _TAXlFOLIONO.n
STATE OF FLORIDA:
COUNTY OF 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: o5Q NE 1t)
2. Description of improvement: Leff-Dr- 4710 rzor DY)
3. Owner(s) name and address: Le5 (Le .1)
i .:mil) NF_ /()1 d 3-6.121) J
Interest in property: bL1771 Q
Name and address of fee simple titleholder:
4. Contractor's name and address:
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
Spnatura of Owner
Print Owners Name
Notary Public
Print Notary's Name
My Commission Expires:'
Ces Peach
Dkinat 07 kw
9,7-)1 No IP QJ A - /t f
Iv
i
R
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
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)
Sworn to and subscribed before me this 9. v day of (:pr l C
s Y ; \•. �l a; .r•.
w _
19 11
STATE OF FLORIDA, COUNTY OF DADE
1 HERESY CERTIFY that this fs o true copy � ` 0f fha
original Mod in this offico on ^� °2'ra.__dcy o
WITME my h . nd and Official Soil.
HARRVc ? ERK, of /Ircoit and Coun :y Court
By � - ■ G C.
�rar�
f/-3a(.5- 0D$ - oo , 9- 0
Prepared by:
Address: /((f)q i, ,SoN 3/
4 1'/ , 33c4
it
123.01.52 7/98
Ft.
n
v
Ft.
A
v
Fastener Type
Deck type:
ATTACHMENT
SPACING
Field: Perimeter: Corner:
DETAIL 1 & 2
Appendix "E"
UNIFORM ROOFING PERMIT APPLICATION
PROCESS No.
!L Job Address: /G).5—° 7( 6 /v / S /
Contractor's Name: o�3E1� -/o � /��
ROOF CATEGORY
❑ (Low Slope Application) ❑ (Nail -On Tile) 6 (Mortar- Adhesive Set Tile)
❑ (Asphalt/Fiberglass Shingles) ❑ ( Metal Roofs\Wood Shingles & Shakes) ❑ (Other)
ROOF TYPE
❑ New Roof , Re- roofing ❑ Recovering ❑ Repair ❑ Maintenance
Flat Roof Area (ft') Sloped Roof Area (ft') = 3 �-G v Total (ft Master Permit No.
Exposure category (per ASCE 7 -88): G Building Classification category (per ASCE 7 -88 table 1):
ROOF HEIGHT AND SYSTEM DETAILS
(Draw details as needed)
Page -1
ROOF PLAN
a.�
emulation?
MEAN HEICHT
Supplement No. 3
Deck type:! (A) crire.A 64-0K
Underlaymeat: A 1 ,4. 1 `a 2 2_ 4
Insulation:I
aoor SLOPE
D E T A I L 3
SLOPED SYSTEM DESCRIPTION
Fa te.er type & spacing:
(Pmaxl: :2.' 3 x X. ( Aerodynamic multiplier): • 2T ) -
(Pmax2: X . 1 X X (Aerodynamic Multiplier):
(Pmax3:(1 X (Aerodynamic Multiplier):2L )
SOUTH FLORIDA BUILDING CODE (REVISED 19941
Cap Sheet: it51 M ' D - r
Roof Covering
I W(o.w 4t 41.7
Drip edgetlig
TILE CALCULATIONS
M 1A = M PCA: '�B • 1
E. M, l l• 49 CA: ��o 1
5101 -8
48 c..... Gt
2 2 0 t
ATTACHMENTS REQUIRED
I) Fire Directory Listing Page
2) Dade County Product Control
Notice of Acceptance -Cover Sheet
a) Specific System Description
b) Specific System Limitation
c) General Limitations
d) Applicable Detail Drawings
3) Municipal Permit Application
4) Other Component Approvals
a l * S
2" o.c
.APPROVED:8 /27/20
.1.1. •lv.. •l•ll •.J.1 !1V_\1tx L11t11Lt
PRODUCT CONTRQ.L NOTICE QF ACCEPTANCE
Monier Lifetile LLC
135 N.W. 20 St.
Boca Raton, FL 33431
Your application for Product Approval of:
Monier Lifetile Nail -On, Mortar Set or Adhesive Set "Atlantis Shake Or Slate" Roofing Tile
under Chapter 8 of the Metropolitan Dade County Code governing the use of Alternate Materials and
Types of Construction, and completely described in the plans, specifications and calculations as
submitted bv:
Redland Technologies, The Center for Applied Engineering, Inc. and Professional Service
Industries, Inc..
has been recommended for acceptance by the Building Code Compliance Office to be used in Dade
County, Florida under the specific conditions set forth on pages 2 -8 and the standard conditions on page
9.
This approval shall not be valid after the expiration date stated below. The Building Code Compliance
Office reserves the right to secure this product or material at any time from a jobsite or manufacturer's
part for quality control testing. If this product or material fails to perform in the approved manner, the
Building Code Compliance Office may revoke, modify, or suspend the use of such product or material
immediately. The Building Code Compliance Office reserves the right to revoke this approval, if it is
de :ermined by the Building Code Compliance Office that this product or material fails to meet the
requirements of the South Florida Building Code.
The expense of such testing will be incurred by the manufacturer.
.ACCEPTANCE NO.: 98- 0604.01 Renews No. :95-0322.06
/f
EXPIRES: 08/27/98 Raul Rodriguez
Chief, Product Control
THIS IS THE COVERSHEET. SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
CONDITIONS
BUILDING CODE COMMITTEE
This application for Product Approval has been reviewed by the Metropolitan Dade County Building
Code Compliance Office and approved by the Building Code Committee to be used in Dade County.
Florida under the conditions set forth above.
n
T � f
•
J "C1iariesb�ser, P F. ti
Director
Building Code Compliance Dep:
Metropolitan Dade County
lb, MED l I EKH,;HHEHt• F,'I II Ira 1 1 Lt a_t_ , _co 6ab-1
04/10/99. FRI 09:37 FAX 561 338 5391 MONIER LIFETILE
MONTER LLFETLLE LLC
list:
Monier Lifetike LLC
135 NW 20`' Street
Boca Raton, FL 33431
Ca;etr y
Sub- Catetorv:
Type:
Sub -Type:
Product
Monier Lifet;le Atlantis
Shake Or Slate Tile
Trim Pieces
Product
30 Fel;
043 Coated Base
Sheet
Miner4I Surface
C:p Sheet
Rainproof El
'PRODUCT CONTROL NOTICE OF ACCEPTANCE
ROOFING SYSTEM APPROVAL
Prepared Rooting
Flat Profile Tile
Nail-on/Mortar Set/Adhesive Set
Concrete
TRADE NAIVES OF PRODUCTS MANUFACTURED OR
LABELED BY APPLICANT
Tut Product
Specifications Description
PA 112 plat, interlocking, excluded concrete roof tile
equipped with two nail holes. For direct der.k-ear
1f1t w-ifr , mM or adhesive set
applications.
1Dirnens_, ;sns
I= 15"
w 10 3 /3"
I thick
1= varies
w a varies
varying thickness
TRADE NAMES OF PRODUCTS MANUFACruRED OTEIERS
Dimensions
N/A
N/A ASTM D 2626
N/A
30° x 75' roll
36" x 75' roll
or
60" x 73' roll
Test
Specifications
ASTM D 226
type l f
ASTM 0 249
PA 104
Page 2of9
Saturated and coated
organic base sheet for
single or double ply
underlayment.
Mineral surfaced asphalt
roll roofing for use as a
top ply in a double ply
underlaymer.r system.
Sin ply. nail-or.
underlayment with 2" self.
adhering top edge
HLLC t;U.
444 MEDITERRANEAN 1QO03
Product Control No 98 0604.01
Product Control No.: 98-0604.01
Approval Date: August 27,1995
Expiration Date: Au ?ust 21,2001
PA 112 Accessory trim, concrete roof pieces for use
at hips, rakes, ridges and valley terminations.
Manufactured for each tile profile.
Product
Description MsinNfacturer
Saturated organic felt to be generic
used as a nailed anchor
sheet.
( generic
generic
Protec.. -O -Wrap, inc.
with current PGA
I`v aomR.u..
Roofing Product Cortron
uit AO. 21b rtU uo..!/ r11.1 .11.$1
. MONIER. LIFETfLE LLC
Shield
Tile Nails
Tile Screws
Roc f Tile Mortar
( "T;1eTiteT`t ")
Roof Tile Mortar
("Quikrete® Roof
Tile ;vlortar
tt1140 ")
Roo Tile Mortar
("BONSAI.
Roof Tile Mortar
Mix ")
Roof Tile
Adhesive
(Polyprt ®
AH160)
Hurricane Clip c4:
Fasteners
Test A_cnev
Rcdland Technologies
The Center for Applied
Engineering, Inc.
min. 8dx VA" or
min. IOdx3"
e3 x 2 long
0.335' head dia.
0.131" shank dig.
0.175" screw thread dig.
N/A
N/A
N/A
N/A
airs
min, '' /:" width
min. 0.060" thick
Clio Fasteners
min. 3d x
Tcst ldcntircr
7161 -03
Appendix 111
94 -034
AV. t. Li a LL ♦ L.L
PA 114
Appendix E
PA 114
Appendix £
PA 123
PA 173
PA 123
underlayment for use as a
top ply in a two ply
underlayrnent system with
Approved T30 or :43 as
the base layer.
Corrosion resistant. screw
or smooth sham: nails.
Corrosion resistant.
coated. square drive;.
galvanized, coarse thread
wood strew
Prepared mortar mix
designed for mortar se:
roc the applications.
Prepared mortar mix
designed for mortar set
roof tile applications.
Prepared mortar mix
designed for mortar set
roof tile applications.
PA 110 Adhesive designed for use
in roof tile applications.
PA Ito
Appendix E
EVIDENCE SUBMITTED
Page of 9
Corrosion resistant
bronze. aluminum,
stainless steel.
galvanized steel or
plastic attachment clips
for supplemental tile
arachtnent. Clips are
installed with corrosion
resistant roofing nails
cornpatil,le with the
clip. A hurricane clip is
required cn all nail -on
eve tiles.
Test iN.ttne /Rennrt
Static Uplift Testing
PA 1 P. 102 & 102(A)
Static Uplift Testing
PA 101
Product Control No 9S- 0604.01
with current PCA
generic
generic
Bermuda Roof
Company, Inc
with current PCA
Quikrete
Construction
Produces
with current PCA
W. P.. Bonsai Co.
with tuner. PCA
Polyfoam Products.
lac.
with current PCA
generic
t)ate
Dcc 199
May 1994
•raI T ulca'a R.RC
Rooting Product Control Examiner
u3 11. THU 17:17 FAX 661 338 5391
`IONIER LIFETILE LLC
The Center for Applied
Engineering, Inc.
The Center for Applied
Engineering, inc.
The Center for Applied
Engineering. Inc.
The Center for Applied
Engineering, Inc.
The Center for Applied
Engineering, Inc.
Tile Center for Applied
Engineering, Inc.
The Center for Applied
Engineering. Inc.
The Cer.ter for Applied
gincerir. . Inc.
Red land Technologies
Redland Technologies
Redland Technologies
Redland Technologies
The Center for Applied
En_ineering. Inc.
Professional Service
Industries, Inc
Professional Service
Industries, Inc.
94 -060A
25- 7094 -a
25 7094.8
25- 7094 -5
25- 7183 -6
25- 7133 -5
25- 7314 -1
25- 7214 -3
7161 -03
Appendix 11
Letter Dated Aug. I, 1994
P0631 -01
PO402
Project No. 307025
Test MDC-77
/
333 -87003
MONIER LIFETILE
Page 4 of 9
Static Uplift Testing
PA 101 (Adhesive Set)
Static Uplift Tessin
P.A102
(4" Hendiap, Naiis. Direct Deck. `:e••v
Construction)
Static Uplift Testing
PA 102
(4' Hcadlap, Natls, Oi i)
Static Uplift Testing
PA 102
(4' Headlap, N3115, Direct Decn,
Recover/ Reroon
Static Uplift Testing
PA 102
(2 Quik -Drive Scre«s, Direct Deck)
Static Uplift Testing
PA 102
(' Quik -Drive Scre'.vs, -ae err')
Static Uplift Testing
PA 102
(I Qutk•Drive Screw. Direct Deck)
Static Uplift Testing
PA 102
(1 Quik -Drive Screw, •r7)
Wind Tunnel Testing
PA 103
(Nail -On)
Wind Tunnel Testing
PA (08 (Nall -On)
Product Control No 93- 0604.01
Wind Driven Rain
PA 100
larch 1 (;
Ocr
Oct.
Oct. 1994
Feb. 1995
Feb. 190;
March. :995
March, 1995
Dec. 1991
Aug. 199-:
Wind Tunnel Testing July 19`% -.
PA 105 (Mortar Set)
Withdrawal Resistance Testing of Sept.:'?
screw vs. smooth shank nails
Oct i':,)94
Physical Properties Sept.
PA 112
PhysiCalQs?is —` �L1_
Roorin Proauct Contr :�' cY_i'..•
' :MONIER LIFETILE LLC
Deck Type: Wood. `on- insulated
SYSTEMS
SYSTEMS
Deck Description:New construction 1 or greater plywood or wood plank.
Product Control No 98- 0604.01
Deck Type: Wood. Jon- insulated
Deck Description: New construction /„" or greater plywood or wood plank.
SYSTEM 8: Direct Deck Application
Slope Range: 4 ":12' to 7 ":12"
Note: System B is only acceptnble in this slope rttnge.
Cnderlayment: Install underlayment system in compliance with Dade County Application Standard
PA l 13.
Rooting Tile: Install tile in compliance with Dade County Application Standard PA i 1 S. i;See
"Data for Attachment Calculations" included in this Approval)
'5
Comments: I. For re -roof applications, h," plywood is an acceptable substrate.
SYSTEM 0: Mortar or Adhesive Set Application
Slope Range: 2':12' to 7"• I?"
Vote: System D is only acceptable in this slope range
L'nderlayment: Install underlayment system in compliance with Miami -Dade County Application
Standard PA 120. (See System Limitation 5.)
Rooring Tile: Install tile in compliance with Miami -Dade County Application Standard PA
120. (See "Data for Attachment Calculations" included in this .Approval.)
Comments: For re -roof applications. / ply wood is an acceptable substrate.
Pace 3 of
r
I
Frank Zuloa_a RRC.
Root;a_ Product Control Examine
113 11 99 THU 17:22 FAX 561 338 5391
`III\IER LIFETILE
`1ONIER L.IFETILE LLC Product Control No 98- 0604.01
.,e classification is not part of this acceptance.
SYSTEM LIMITATIOINS
The standard minimum roof pitch for Monier Lifetile's "Atlantis Shake Or _ate", low profile tile
shall comply with :Miami -Dade County Roofing Application Standards PA 118 and PA 1=0,
depending on the method of installation.
For nail -on applications, fasteners for mechanical attachment or tiles shall have a head diameter
larger than that of the pre - formed holes in the tile.
4 System installation shall be in compliance with the system specifications outlined in this ProUuct
Control Approval. The method of attachment utilized shall provide sufficient attachment resistance
expressed as a moment to meet or exceed the required moment of resistance determined in
compliance with Dade County Protocol PA 115 or PA 127. The tile profile listed herein has been
tested for both wind characteristics and static uplift performance , therefore. attachment calculations
or installation in compliance with PA 115 or PA 127 shall be done as an '1Vloment Based System'
For mortar or adhesive set tile applications, a field static uplift test by a Dade County accredited
testng agency. in compliance with Miami -Dade County Protocol PA 106, shall be performed.
For tile applications.30i90 hot mopped underlayment applications may be installed perpendicular to
he roof pitch unless stated otherwise by the underlayment material manufacturer's published
Ail tiles shall bear the imprint or identifiable markinL, of the manufacturer's name or Ic_o `cr
i:,'entif,cat:on in the Reid.
.Applications for roofing pemtits shall include a completed Section 11 of the Uniform Building
Permit. a copy of Monier Lifetile's current specifications and details, a copy or this Product Control
A.pproval and a copy or the Product Control Approval of any Rooting Component used in the
proposed tile application. Reference shall be made to appropriate data for the required tire rating.
q The applicant shall retain the services of a Dade County certified testing laboratory to maintain
^t :ality control in compliance with the South Florida Building Cede and related protocols.
Page 6 of 9
•
Frank Zuloa RRC
Y,_ 1111 1
Tile
Profile
Tile
Application
Approved
Nails
Approved
Screws
Approved
Field Clip
With:
Approved
Eave Clip
With: 1
1 nail
2 nails
I screw
2 screws
1 nail
2 nails f I nail
2 nails
``lonier Litetile
Atlantis Shake Or
Sate
Direct Deck
9.80
13.80
30.80
) 1.70
24.30
35.50 19.00
31 90 I
03 11 .99 THU 17: -I I-.AX 5111 ..06 • 'l
CIO :NIER LIFETILE LLC
Tile
Profile
Monier Litetile Atlantis Shake Or
• Slate T�I�
Tile Profile
Homer Litetile .Atlantis Shake Or
DATA FOR ATTACHMENT
CALCULATIONS
Table I: Aerodynamic tilultipliers - . (ft
Direct Deck
Recover /Reroof
(min. 15 / 32 " plywood)
Pale 7 of 9
.k (ft
Direct Deck Application
0.21
Table 2: Attachment Resistance Expressed as a Moment • idlf(ft -lbf)
for Nail -On Systems'
Table 3: Attachment Resistance Expressed as a Moment - ttlf(ft-Ibl)
for \lortar or Adhesive Set Systems
Tile application
Mortar Set
Adhesive Set
Product Control No 9S- 0604.01
Data noted in Table 2 is for installation with a 3" tle headlap.
Approved screws are as noted in the 'Trade Names of Products Manufactured By Others' and
'Profile Drawings' sections of this Approval. Clips on eave tile are not required for this attachment
configuration unless the Required Moment of Resistance exceeds the values noted above.
Table 2 -A: Attachment Resistance Expressed as a Moment - \l f (ft -Ibr)
For Nail -On Systems'
Tile Profile j Tile Application ( Two (2) 10d x 3" Ions nails
Ionicr Litetile Atlantis Direct Dick ! 65.50
Shakc Or Siate 1 New Construction
(min. 19 /37" plywood)
50.30
'Tile installation with a 4" headlap using two (2) Approved 1 Od x 3" long . ring shank nails
installed in manufactured holes located 21/2" from the head of the tile. Clips on eave tile are not
- equired for this attachment configuration unless the Required Moment of Resistance exceeds the
values noted above.
Attachment Resistance
3000
1IS90
1
Frank Zttloaga RRC
Rooting Product Control Exsmi :•.e-
1 11 I . 0 1 ."1.1 • 0 0 0 111. !W. .1 t.1\ L11 L 1 1 Lt.
MONIER LIFETILE LLC Product Conrrol No 98-0604.0:
1 "
Profile Drawing
• -
•
•
- • ,
,•.
••.„ • •„
•
- •
Pae 8 o(9
r.
2'
MONIER LIFETILE ATLANTIS SHAKE OR SLATE_ILLE
1
Rootlng Prcduct Control Examiner
1
03 11.99 THU 17:27 FAX 561 33S 53x1
MMONTER LITETILE LLC
v
Page 9of9
Product Control No 98- 0604.01
Monier Lifetile Roof Tile ACCEPTANCE NO.: 96- 0528.06
APPROVED: August 27,1998
135 N.W. 20�" St. E�IRES: August 272001
Boca Raton, FL. 33431
NOTICE OF ACCEPTANCE STANDARD CONDITIONS
Renewal of this Acceptance (approval) shall be considered after a renewal application has been
filed and the original submitted documentation, including test supporting data, engineering
documents, are no older than eight (8) years.
_ Any and all approved products shall MeP Dade Counry oduct Con of App orved'naorrrtascity,
state, and the following statement:
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 e Building changes;
affecting
cti g the evaluation of this
product and the product is not in comp
b) The product is no longer the same product (identical) as the one originally approved;
c) lithe 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.
Any revision or change in the materials, use, and /or manufacture of the product or process shall
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
office.
5 Any of the following shall also be grounds for removal of this Acceptance.
a) Unsatisfactory performance of this product or process;
b) Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any
other purposes.
6 The Notice of Acceptance number preceded y the words M IiD deuCounta, Florida, o a nd the
followed by the expiration date may y displayed
Notice of Acceptance is displayed, then it shall be done in its entirety.
. A copy of this Acceptance as well as approved ow ings and
ibut other
and shell be ah it applies,
shall be provided to the user by the manufacturer
inspection at the job site at all times. The copies need not be resealed by the engineer.
Failure to comply with any section of this Acceptance shall be cause for termination and removal o'
Acceptance.
9 This Acceptance contains pages 1
THIS ACCEPTANCE
Frank Zuloaga RRC
Root�no Product Control Exar. e:
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
"i.
26
. ' •g7.1:>
51
52
—. FJ. )
2
27
3
28
53
4
29
54
5
30
55
6
31
56
7
32
57
8
33
58
9
34
59
10
35
60
11
36
61
12
37
62
13
38
63
14
39
64
15
40
65
16
41
66
17
42
67
18
43
68
19
44
69
20
45
70
21
46
71
22
47
72
23
48
73
24
49
74
25
50
75
Owner's Name:
Du Quesne & Associates, Inc.
Consulting Engineers
Testin Laborator
THIS D BY:
ON -SITE CONCENTRATED UPUFT LOAD TESTING OF ROOF TILE
IN ACCORDANCE WITH METRO-DADE BUILDING CODE COMPLIANCE
PROTOCOL PA 106
LG. S
rge Du Quesne,
vil Engineer
. #24513
Du Quesne & Associates, Inc.
E.B. License #0005245
Lab Certification #94-0318.01
SITE SPECIFIC INFORMATION
SKETCH OF ROOF IN BACK
TEST RESULTS
P = PASS, F = FAIL
Permit #• 44 6 '9
7815 S.W. 24th Street • Suite 109 • Miami, Florida 33155 • Telephone (305) 264 -1425 • Fax (305) 264 -1426
UTR 15861
Environmental • Civil • Structural
Buildin Inspection Services
Job Address ( 250 N lQ I. ''T• s 'N 1 t
Roofing Contractor — a t3 O u 1i= 1�
Type of Tile: LAo IJ tt-- T( t� -��lS - •1-z -1 `71 Date Installed (, • 1 8 -19
Approximate Roof Height V feet Roof Pitch. 3 1 Z
Type of Access to Roof: Scaffolds ( Ladder Other
Approximate Square Footage of Roof 31 O 0 ft 2
Required Testing Force: 35 lbs. Testing Equipment: Chatillion DFIS 100
Date Tested ' (¢ • C FI
IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL PA 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT
QUALITY CONTROL TEST.
THIS PA 106 TEST HAS BEEN PERFORMED IN FULL ACCORDANCE TO THE
REQUIREMENTS OF DADE COUNTY, WITH NO DEVIATIONS.
Please Note: This form is not valid unless
Company logo appears in
color (burgundy)
$KETCH OF ROOF
JOB
SHEET NO OF
CALCULATED BY DATE
CHECKED BY DATE
SCALE
NOTES'
■■\ !1•■■•■•MJ■ r,'
onswilim f
lommisomiNo
II!!I.!I!IIIIA
■. ■ ■.rimme %■ ■ ►0
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■rte.► IM
r7 MN 16
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li
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• ■ 11111WPAIIIIIIIIMII IILCNMIIMIM•rlmmrAiiillIll
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NOTES:
S KETCH OF ROOF
of
JOB 1 59 1) a t ot 6 r . , (.4 � {-\o ac
SHEET NO. OF Z
CALCULATED BY DATE - 7-7•'99
CHECKED BY TE_/ •
SCALE
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date i iN I A Job Address ( tjE / 0 ! S
Legal DescriptionGo.2eW ,($� .i` /
6 OwnerjLessee / Tenant
Owner's Address
Contracting Co.
Qualifier j.)
State# /6
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one):
WORK DESCRIPTION
Square Ft.
FEES: PERMIT to. t' 0 RADON
4 P'cI)
/ d6 - 0 L; 1 oil
0 60
Municipal #
Signature of owner and/or Condo President D te
Notary as to Owner and/or Condo President Date
My Commission Expires:
OFFICIAL OTAR
SANDRA D OBENOUR
NOTARY PUBLIC STATE OF FLORIDA
q COMMISSION NO. CC265272
MY COMMISSION EXP. MAR. 12,1997
Tax Folio /1 —
Historically Designated: Yes No
Master Permit # i7o Z O 9.
Phone
Phone
Competency #
/1/ 3 v6' Ins. Co. /%SSA �/ IOC
Address
Address
Address
BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
T2 - c-towvi e _ C , t / cvz
Address
Estimated Cost (value)
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 contractO o do the work s at
APPROVED:
Zoning Buildin
Mechanical Plumbing
3 a oy —OC`x - OOz(
9.i)c >a ,9h IC 617 ,S /J
ature of Contractor or Owner- Builder
Date
V r Pc
Notary as to Contractor or Owner- Builder Date
My Commission Expires:
CriCLAL IEIC` ".uy s -
N C;, p Z 1_, i
-� JD .A D i7;.P:'i�l.,�I'2.'
• Y r 71V : 3IGGN NC. CC26.5272
'O _ EX -. MAR. 12,1497
C.C.F. /, NOTARY TOTAL DUE ,74/. •moo
Electrical
Engineering
Job Address: long) A)(E 1()t 37.0"
Contractor ii(2l t 1
APPENDIX 'E'
METRO -DADE UNIFORM BUILD ING PERMIT
SECTION II' '
BUILT -UP APPLICATIONS AND
MODIFIED BITUMEN SYSTEMS
GENERAL:
Type of Roof System Assembly to be Applied:
Manufacturer of Roof System Assembly:
Product Control Approval Number:
System Number from Product Control Approval:
Process No.
SF
Base Sheet:
Fasteners:
Ply Sheet(s):
:Cap Sheet:
Asphalt:
Complete the following for all Roof System Assemblies:
Built -Up Applications and Modified Bitumen Systems
Page -1
0 3v. a�
(Attach a copy of the Roof System Assembly Product Control Approval and the Manufacturer's System
Guide Specification. )
( Note: If a minimum roof system is to be applied, describe 'all
components within the system and list the manufacturer of
each component. DO NOT complete this section if system is
Product Control Approved. )
( Note: No insulation .system is acceptable under the minimum
roof category. )
Job Address: ': ? p I (fit Contractor Process No.
( Check one of the following)
Recover Re -roof: J New Construction
If a recover, is the existing Roof System Assembly
to be used as a bonding substrate ?:
If YES, has an ASTM E907 test been carried out
to confirm adhesion of the existing membrane to
the substrate ?: Y N
(If 'ryes', attach ASTM E907 test report. )
Proposed Fastener: /J/
(Attach withdrawal resistance test report. )
Has the deck been examined for moisture ?: Y V N
(Provide data confirming compliance with
Section 3401.9(c) . )
THE SYSTEM:
All Roof System Assemblies in the Product Approval have a variety of options. Briefly
describe the Roofing Components to be used in the Roof System Assembly and attach a copy of
the manufacturer's published specification:
Deck:
(Briefly describe )
Insulation:
( Type, size and method of attachment,
if applicable )
Base Sheet or Ply:
( Type and method of attachment)
L il e ygia j) 9 I 76
Ply Sheet(s): //)/c/ (0 01,0pid
( Type and method of attachment)
Built -Up Applications and Modified Bitumen Systems
Page -2
Job Address: 12?Sc) 05 )o 1St Contractor &u 0,6, Process No.
•
Top Ply:
( Type and method of attachment )
Surfacing: •r Miwitut
(Type, If applicable )
Flashing Materials:
( Type and method of attachment )
Built -Up Applications and Modified Bitumen Systems
Page-3
eJttaid nup F�
a Tr 61/176.0
Job Address: 1 257) NE IU /SI Contractor
T
5 inches
inches
mches
1
FILL IN APPLICABLE ROOFING COMPONENTS WHICH MAKE
UP ROOF SYSTEM ASSEMBLY AND THICKNESS OF DECK AND
INSULATION LAYER(S).. (Where Roofing Component not used in
Roof System Assembly, fill in with "N /A ".)
Bonding Material: iv" TO °
377777777,-- Ply Sheet(s): /Ojthi �t/
J
surfacing: Arr1.(,c
(br/ybdeserrb.. U
((applicable)
op Ply: &/ /G e/ni 2 F4-
Bonding Material: jr, tV
Fastener
((fba . sheet mech. attached)
Base Sheet: , 4/
Bonding Material: Phi V ke614z4 4
((VMs. sheet bonded) Yz /.tt4?y
Fastener: 4
((/toy insulation layer
meek attached)
Top Insulation Layer
(lfaggicabk )
� aterial: 1J
b�..r ' bonde d) °"
Fastener:
((Ovulation
mech. attached)
Insulation:
e- ( v. ue i� ruler
(ucabla
// //-
075
Bonding Material:
(ulnsulation bonded)
) fr N
PECK.
Gage or Thickness:
Density, tf concrete deck:
Built -Up Applications and Modified Bitumen Systems
Page -4
Process No.
Job Address: 12 7) OE 10 f Contractor Process No.
PERIMETER DETAIL #1: Parapet Wall Detail
Ca Pin Gage: Cap Sketch Roofing Components which make up Roof
Fastener . Systa n Assembly at Perimeter Parapet Walls.
Spacing: _ o.c. Insert leaders indicating Roofing Component tames,
Clip TYPe �_� dimensions, thicknesses, etc. .
Clip Gage: Include fastener type and spacing used for wood-
blocking attachment.
F;,/
// 4
Sketch Roofing Components which make up Roof
System Assembly at Perimeter Areas to be Flashed
Insert leaders indicating Roofing Component names,
dimensions, thicknesses, etc.
Include fastener type and spacing used for wood -
blocking attachment
PERIMETER DETAIL #2• Flashing Detail
Built -Up Applications and Modified Bitumen Systems
Page-5
Job Address: i? tO5 101 Contractor otto.614.kt 86 Process No.
PERIMETER DETAIL #3: Gravel Stop or Drip Edge
Sketch Roofing Components which make up Roof
System Assembly at Perimeter Edge with Gravel
Stop or Drip Edge.
Insert leaders indicating Roofing Components names,
dimensions, thicknesses, etc.
Include fastener type and spacing used for wood-
blocking attachment
Gravel Stop/Drip Edge
Gage:
Fastener
Spacing: o.c.
Clip Type:
Clip Gage:
•
7
Sketch Roofing Components which make up Roof
System Assembly at Perimeter Edge with Gutters.
Insert leaders indicating Roofing Component names,
dimensions, thicknesses, etc.
Include fastener type and spacing used for wood-
blocking attachment.
Gutter Type:
Gutter Gage:
Fastener
Spacing:
PERIMETER DETAIL #4: Gutter Detail
• Built-Up Applications and Modified Bitumen Systems
Page-6
Job Address: ( 150 oe leis- Contractor t ¢ f) Ot9 Process No.
PERIMETER DETAIL #5: 'Other' Detail
Sketch Roofing Components which make up Roof
System Assembly at any 'other' Perimeter Condition
which may exisit.
Insert leaders indicating Roofing Component names,
dimensions, thickesses, etc.
Include fastener type and spacing used for wood -
blocking attachment.
6 l Gay ���
�1P
Ra 3�RoIn
fG �
rot n
2
� iC 776 L''° °°
PxjrnK
oN 1'5
Sketch Roofing Components which make up Roof
System Assembly at any 'other' Perimeter Condition
•
which may exis&
Insert leaders indicating Roofing Component names,
dimensions, thickesses, etc.
Include fastener type and spacing used for wood -
blocking attachment.
PERIMETER DETAIL #6: 'Other' Detail
Built -Up Applications and Modified Bitumen Systems
Page -7
Job Address: I26b vet D 19 Contractor
Insert Building and Parapet Heights.
(If no Parapet exists, insert "N /A ")
Also insert applicable information pertaining
to the building below. .
( See ASCE 7-88 Fact Sheet Attac
Exposure Category:
Classification Category:
At Hurricane oceanlineT:
Basic Wind Speed at
Building Location:
Building Condition based on
% of Openings:
110 mph
GROUND LEVEL
fi
feet
BUILDING INFORMATION #1
Built-Up Applications and Modified Bitumen Systems
Page -8
Process No.
Job Address: i 1 ► C 10 I Sit Contractor
Sketch Roof Plan indicating all dimensions, any dopes,
roof drains, crickets, or roof top equipment Also insect
variable labeled "a" which indicates perimeter and corns
dimensions per Chapter 23 of the South Florida Building
Code.
(See ASCE 7-88 Fact Sheet Attached)
m A X. Ds. Pr tt E
Prc t L'i-'J. 95 . d .041.17 - 5 7
PmsX, Pmax Z Prnaxj
6,41_, 15 . - 'Io ' - cog
3(3
Ft 4, 0 - 9 -&
5l 51x 74t/ 448
s
xi . �� .
Fly r co (3
5 1(b . 0 Laps
g rows 0.c r crFshal
a '/ _ 5Y/4 mo(e -6141_
- - (�eri m.e-ftR = �,)( St' VDU ° / Plow ��:
BUILDING INFORMATION #2: Roof Plan with Perimeter and Corner Dimensions
Built -Up Applications and Modified Bitumen Systems
Page -9
Process No.
Job Address: Contractor Process No.
FOR PLAN EXAMINER USE ONLY --
Roof System Assembly Product Control Approved: Y N
If NO, note any deficiencies:
Design Pressure Requirements:
Field: psf
Perimeter Areas: psf
Corner Areas: psf
Note any limitations:
Reviewed Details ?: Y N
Notes:
Built -Up Applications and Modified Bitumen Systems
Page -10
7
Job Address: Contractor Process No.
Reviewed Field Test Data ?: Y
Notes:
Additional Notes:
Built -Up Applications and Modified Bitumen Systems
Page -11
Plan Examiner
05D 06 to
The undersigned certifies that the Shingle System Assembly is in
compliance with the plans, specifications, and details submitted by the
architect
STATE OF FLORIDA - COUNTY OF DADE
Before me this day personally appeared J/rfY eS .0 • d P e J/ Cl/2
who, being first duly sworn, deposes and says that all information submitted
herein is true and correct.
Sworn to and subscribed before me this th day of
I .
rcensed Contractor / Owner
Signature
My commission expir s C T 4 �3 EP�1-S
IM
1
'F07.2"-173 FJ1' 1 C STATE
NO. CC2 52)2
Notary Public
Stole of Florida
FuA
Page - 7
•
6ca,nu.0 11�,
a I ke» lv V.
DADE
GAF Materials Corporation
1361 Alps Road
Wayne, NJ 07470
Your application for Product Approval of GAF Materials Corporation Modified Bitumed.Roof Systems under -'-
Chapter 8 of the Metropolitan Dade County Code governing the use of 'Alternate Materials..and types of
Construction, and completely described in the plans, specifications and calculations as submitted liy.Construction
Research Laboratory, Inc., Factory Mutual Research Corporation, South' Florida Test Service Underwriters . •
Laboratories, Inc. and Dynatech Engineering, Inc. has been recommended for.acceptance by 'the Building Code
Compliance Department to be used in Dade County, Florida under the' specific. and standard conditions. set forth .
herein.
The approval shall be valid for a period of three years. The Building Code Compliance Departinent reserves the '..'
right to secure a product or material at any time for a jobsite or manufacturer plant for quality control testing. If
product or material fail to perform in the approved manner, the Code Compliance Department may revoke, modify
cr suspend the use of such product or material immediately. The Building Code Compliance Department reserves
the right to require testing of this product or material should any amendments to the South Florida Building Code bed;;;;
enacted affecting this product or material. .
The expense of such testing will be incurred by the Manufacturer.
PRODUCT NO. :
ACCEPTANCE NO.: 95- 0330.06 V
EXPIRES: Nov 1 0 1997
APPROVED: MAY 0 4 1995
METROPOLITAN DADE " COUNT'(, FLORIDA
METrIO•DADE FI.AGLER BUILDING
BUILDING CODE COMPLIANCE DE "Af1TMENT
METRO•DADE iLAGtER BUILDING
140 WEST FLAG LER STREET;;
MIAMI; FLORIDA 33130.1503
PRODUCT CONTROL NOTICE OF ACCEPTANCE FAX (Cos; 37642°11 '`
ul Rodrig ez
Product Control Division
Supervisor
- PLEASE NOTE -
THIS IS THE COVERSHEET. SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
CONDITIONS.
BUILDING CODE COMMITTEE
This application for Product Approval has been reviewed by the Metropolitan Dade County Building Code.,
Compliance Department and approved by the Building Code Committee to be used in . Dadp.Co lorida .under
the conditions set forth above.
d /
Arles Danger, P.E:; Director
Building Code Compliance Department
Metropolitan'Dacre County
•
Contact:
William J. Woodring
Director of Technical Services
(201) 628-3000
Raul Rodriguez
2
• • •
, • '
: 7
.. •
•
.•••■••.:
. . .
- • '
Applicant:
GAF Materials Corporation
1361 Alps Road
Wayne, NJ 07470
Category; Membrane Roofmg System
Sub- Category: Built -up Roofmg
Tye: Modified Bitumen
Sub -Type; SBS, APP
SYSTEMS
PRODUCT CONTROL NOTICE OF ACCEPTANCE
ROOFING SYSTEM APPROVAL
System Description
Product Control No.: 95- 0330.06
Approval Date: MAY 0 4 1995
Expiration Date: NOV 1 0 1997
GAF Materials Corporation has been manufacturing commercial roofing products for more than 100
years.
GAF produces a wide range of roof products for built -up roofing systems. The modified bitumen
products include both APP and SBS products in smooth, granule and fire rated versions. In addition,
GAF offers two ply modified systems to meet the specification requirements for multilayer SBS
modified specifications.
GAF products are distributed through a wide network of roofing wholesale distributors throughout the
South Florida area.
GAF provides warranted systems over various insulated and non - insulated substrates, copies of which
can be obtained from GAF and can be found in the Ruberoid Modified Bitumen Application and
Specification manual published annually.
GAF roof system assemblies have been extensively tested at Factory Mutual Research Corporation and
Underwriters Laboratories. GAF modified bitumen membranes have been tested in compliance with
ASTM D 5147 test requirements.
4
Insulation Types:
Materi.1 Design Pressure
Material
Fibrous glass
Perlite
Fiberboard
Polyisocyanurate
Expanded polystyrene (EPS)
Polyisocyanurate Composite Board
Maximum Design Pressures
Wood -60 psf
Steel -75 psf
Concrete -248 psf
Lightweight Concrete -45 psf
Poured Gypsum -45 psf
Maximum Fire Classification
Classification
Wood Class A
Steel Class A
Concrete Class A
Lightweight Concrete Class A
Poured Gypsum Class A
Product Control No.: 95 0330.06
Note: Fire classifications and maximum design pressures do not reference all assemblies over
deck types. Review system listings for design pressures and the Underwriters Laboratories
Roofing Materials Directory or other approved testing agency listing directory for Fire
Classifications.
3
y
� ` f
Product
Ruberoid® Torch
Smooth
Ruberoid® Torch
Plus (Granule)
Ruberoid® Torch
Granule
Ruberoid® Torch FR
Ruberoid® Mop
Plus (Granule)
Ruberoid® Mop
Granule
Ruberoid® Mop FR
Ruberoid® 20
Ruberoid® 30
Ruberoid® 30 FR
TRADE NAMES OF PRODUCTS MANUFACTURED OR
LABELED BY APPLICANT
Test Product
Dimensions Specification Description
1 sq. roll ASTM D 5147 Heavy duty, polyester reinforced,
87 lbs. asphalt modified bitumen membrane.
% sq. roll
93 Ib. roll
1 sq. roll
102 Ib. roll
3/4 sq. roll
90 lbs.
1 sq. roll
102 lbs.
1 sq. roll
103 lbs.
1 sq. roll
105 lbs.
1 sq. roll
92 lbs.
1 sq. roll
92 lbs.
Ruberoid® Mop 170 FR 1 sq. roll
103 lbs.
Product Control No.: 95 0330.06
ASTM D 5147 Heavy duty, polyester reinforced,
asphalt modified bitumen membrane.
ASTM D 5147 Asphalt impregnated, coated felt,
surfaced with mineral granules.
ASTM D 5147 Non -woven polyester mat coated with
fire retardant polymer modified asphalt
surfaced with mineral granules.
ASTM D 5147 Non -woven polyester mat coated with
polymer modified asphalt and surfaced
with mineral granules.
ASTM D 5147 Non -woven polyester mat coated with
polymer modified asphalt and surfaced
with mineral granules.
ASTM D 5147 Non -woven polyester mat coated with
fire-retardant, polymer modified asphalt
surfaced with mineral granules.
1.5 sq. roll ASTM D 5147 SBS modified asphalt base sheet
reinforce with a glass fiber mat.
ASTM D 5147 Non woven fiberglass mat coated with
polymer modified asphalt and surfaced
with mineral granules.
ASTM D 5147 Non woven fiberglass mat coated with
fire retardant, polymer modified asphalt
surfaced and surfaced with mineral
granules.
ASTM D 5147 Non -woven polyester mat coated with
fire retardant polymer modified asphalt
surfaced with mineral s ranu
4
Raul Rodriguez
•
product
GAFGLAS®
Stratavent® (Vent Ply)
for Nailable Decks.
GAF Materials
Corporation Asphalt
Concrete Primer
GAF Materials
Corporation Fibered
Aluminum
GAF Materials
Corporation
WeatherCoat®
Emulsion
GAF Materials
Corporation Jetblak All
Weather Plastic Cement
Dimensions
3'x36"
69 lb. roll
GAFGLAS® 3' x 36"
Stratavent® (Vent Ply) 69 Ib. roll
Perforated
GAFGLAS Ply 6®
GAFGLAS Ply 4
GAFGLAS #75® 3' x 108'
75 Ib. roll
3'x180'
45 lb. roll
3' x 180'
401b. roll
GAFGLAS® 3' x 36'
Mineral Surfaced 761b. roll
Cap Sheet
5, 55 gallons
5 gallons
1, 5 gallons
Test
Specification
ASTM D 4897
D 3672
Product Control No.: 95 0330.06
Product
Description
Fiber glass base sheet impregnated and
coated on both sides with asphalt.
Surfaced on the bottom side with
mineral granules embedded in asphaltic
coating.
ASTM D 4897 Fiber glass base sheet impregnated and
D 3672 coated on both sides with asphalt.
Surfaced on the bottom side with
mineral granules embedded in asphaltic
coating.
ASTM D 2178 Type VI asphalt impregnated glass felt
with asphalt coating.
ASTM D 2178 Type IV asphalt impregnated glass felt
with asphalt coating.
ASTM D 4601 Asphalt impregnated and coated glass
mat base sheet.
ASTM D 3909 Asphalt coated, glass fiber mat cap sheet
surfaced with mineral granules.
ASTM D 41 Asphalt concrete primer used to
promote adhesion of asphalt in built -up
roofing.
1, 5 gallons ASTM D 2824 Fibered aluminum coating.
ASTM 1227 Surface coating for smooth surfaced
roofs.
ASTM D 3019 Refined asphalt blended with a mineral
ASTM D 3409 stabilizer and fibers. Permits adhesion
to wet and dry surfaces.
5
Raul Rodriguez
Product
GAF Materials
Corporation Jetblak
Flashtite® Cement
GAF Materials
Corporation Plastic
Cement
GAF Materials
Corporation Mineral
Shield® Granules
GAFTEMP®
Isotherm R
GAFTEMP® Composite
GAFTEMP®
High Density
Fiberboard
GAFTITE® #12
Standard
Roofmg Fastener
GAFTITE® #14 Heavy
Duty
Roofing Fastener
NTB Fasteners
GAFTITE® Base Sheet
Fastener and Plate
Galvalume Plates
Polypropylene Plates
Dimensions
1, 5, 53 gallons
1, 5, 53 gallons ASTM D 4586 Trowel grade, asphalt plastic cement.
various
various
GAFTEMP® Permalite various
GAFTEMP® Fiberboard various
various
3" and 3 /2"
3 " and 3/2"
Test
Specification
Product
Description
ASTM D 4586 Asphalt flashing cement.
Product Control No.: 95
Granules for surfacing of exposed
asphalt, cold process or emulsion.
PA 110 Polyisocyanurate foam insulation.
PA 110 Polyisocyanurate foam insulation with
high density fiberboard or Permalite
perlite insulation.
PA 110 Perlite insulation board.
PA 110 Fiberboard insulation.
PA 110 High density wood fiberboard
insulation.
PA 114 Insulation fastener for steel and
plywood decks.
PA 114 Insulation fastener for steel, wood and
concrete decks.
PA 114 Fastener for use in gypsum, tectum and
lightweight insulating concrete decks.
PA 114 Base sheet fastening assembly.
PA 114 Round galvalume stress plates.
PA 114 Round polypropylene stress plates.
6
Raul Rodriguez
Product Control No.: 95- 0330.06
TRADE NAMES OF PRODUCTS MANUFACTURED BY OTHERS
Test Product
Product Dimensions Specification Description Manufacturer
Hy Therm AP various PA 110 Polyisocyanurate foam Apache Products Co.
insulation
Pyrox various PA 110 Polyisocyanurate foam Apache Products Co.
insulation
White Line various PA 110 Polyisocyanurate foam Apache Products Co.
insulation
ACFoam Composite various
PA 110 Polyisocyanurate foam Atlas Energy
insulation Products
ACFoam I various PA 110 Polyisocyanurate foam Atlas Energy
insulation Products
ACFoam II various PA 110 Polyisocyanurate foam Atlas Energy
insulation Products
Hy -Tec .various PA 110 Polyisocyanurate foam Celotex Corp.
insulation
Hy -Tec 2 various PA 110 Polyisocyanurate foam Celotex Corp.
insulation
Hy -Therm AP various PA 110 Polyisocyanurate foam Celotex Corp.
insulation
Hy -Therm White various PA 110 Polyisocyanurate foam Celotex Corp.
Line insulation
Hy -Therm Pyrox various PA 110 Polyisocyanurate foam Celotex Corp.
insulation
Energy LOk various PA 110 Polyisocyanurate foam Celotex Corp.
insulation
Thermax various PA 110 Polyisocyanurate foam Celotex Corp.
- TRI -STAR insulation
7
Raul Rodriguez
Product
Dekfast Fasteners PA 114 Insulation fastener for steel
#14 and:concrete decks
Dekfast Hex Plate 2 7/8" x PA 114 Galvalume hex stress plate.
3 1/4"
Dekfast Lock Plate 3" x 3 1/4" PA 114
Dekfast Fasteners
#15
Dekfast Fasteners
#12
TPR
ISO 95+ GW various
ISO 95+ GL various
ISO 95+ Composite
ISO 95+
Asphalt
High Density Wood various
Fiberboard
Test Product
Dimensions Specification Description
PA 114
PA 114
PA 114
PA 110
PA 110
PA 110
PA110 •
ASTM D 312
PA 110
Perlite Insulation various PA 110
Polypropylene locking
plate.
Insulation fasteners for
concrete decks
Insulation fastener for steel
and wood decks.
Aluminum fastener for
• lightweight, gypsum and
tectum decks
•
Polyisocyanurate foam
insulation
Polyisocyanurate foam
insulation
Polyisocyanurate / perlite
ridged insulation
Polyisocyanurate foam
insulation
Type III or 1V hot asphalt
bitumen adhesive
Wood fiber insulation
board
Perlite insulation board
Product Control No.: 95
Manufacturer
Construction
Fasteners, Inc.
Construction
Fasteners, Inc.
Construction
Fasteners, Inc.
Construction
•
Fasteners, Inc.
Construction
Fasteners, Inc.
Creative
Construction
Components
Firestone
Firestone
Firestone
Firestone
generic
generic
generic
Product
Red Rosin
Roofing Nails Minimum # PA 114
Tin Caps
Type X Gypsum various
Sturdi -Top
al MB aluminum
roof coating
Grundy
Industrial
Emulsion
#14 Roofgrip
Gripdek Fastener
Premium Metal
Plate
Standard Plastic
Plate
Karnak No. 169
Karnak 97
12
Min. 32 ga. x
1 3/ 8 11
3" square
3" round
Barrier Board Plus various
various PA 110
Test Product
Dimensions Specification Description
various Rosin paper for barrier
layer on wood decks
PA 121
PA 121
PA 114
PA 114
PA 114
9
Corrosion resistant annular generic
ring shank nails
Corrosion resistant circular generic
discs.
Fire resistant rated gypsum generic
Wood fiberboard
Aluminum roof coating
Asphalt emulsion
Insulation fastener steel,
wood or concrete decks
Insulation fastener
PA 114 3" square galvalume AZ55 ITW Buildex
stress plate
Polyolefin plastic plate
ASTM D 2824 Aluminum roof coating
PA 121 Roof coating
PA 110 Polyisocyanurate foam /
wood fiber insulation
Raul Rodriguez
Product Control No.: 95 0330.06
Manufacturer
generic
Georgia - Pacific
Grundy Industries
Grundy Industries
ITW Buildex
ITW Buildex
ITW Buildex
Karnak Corp.
Karnak
NRG Barriers, Inc.
•
Product
E'NRG'Y PSI -25 various PA 110
E'NRG'Y-1
E'NRG'Y-2 Plus various PA 110
E'NRG'Y -1 Plus various PA 110
E'NRG'Y-2 various PA 110
Con -Tite
(Fluted Nail)
Olympic Standard 3" round PA 114
Olympic G2 Plate 3.5" round PA 114
Olympic
Polypropylene
Olympic Fastener
Olympic C -R
Base Sheet
Fastener and Plate
Fiberglas
Test
Dimensions Specification
various
PA 110
PA 114
3.25" round PA 114
PA 114
PA 114
various PA 110
10
Product
Description
Polyisocyanurate foam
insulation
Polyisocyanurate foam
insulation
Polyisocyanurate foam
insulation
Polyisocyanurate foam
insulation
Polyisocyanurate foam
insulation
Concrete deck insulation
fastener
3" round galvalume
AZ55 steel plate
3.5" round galvalume AZ55
steel plate.
Polypropylene
plastic plate
Insulation fastener
Raul Rodriguez
Product Control No.: 95 0330.06
Manufacturer
NRG Barriers, Inc.
NRG Barriers, Inc.
NRG Barriers, Inc.
NRG Barriers, Inc.
NRG Barriers, Inc.
Olympic
Manufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Base sheet fastener and Olympic
plate. Manufacturing
Group, Inc.
Fiber glass roof insulation Owens- Coming
Fiberglas Corp.
Test Product
Product Dimensions Specification Description
Foamglas Board various PA 110
Multi -Max various PA 110
Thermaroof various PA 110
Composite
Fes -Core various PA 110
Fesco Foam various PA 110
UltraGard Gold various PA 110
HD Insul -Fixx
Fastener
Insul -Fixx Fastener
Rawl Fasteners
#12
Rawl Fasteners
#14
PA 114
PA 114
Insul -Fixx S 3" square PA 114
Insul -Fixx P 3" round PA 114
Rawl Drive PA 114
PA 114
Expanded glass insulation
board.
Polyisocyanurate foam
insulation
Polyisocyanurate foam /
perlite composite insulation
Polyisocyanurate foam /
fescoboard insulation
Polyisocyanurate foam /
fescoboard insulation
Polyisocyanurate foam
insulation
Insulation fastener for use
in steel and concrete decks
Insulation fastener for steel
and wood decks
3" square galvalume AZ55
stress plate
3" round plastic stress plate
Insulation fastener and steel
and plastic stress plate for
concrete deck
Insulation fastener for steel
and wood decks
PA 114 Insulation fastener for use
in steel, wood or concrete
Raul Rodriguez
Product Control No.: 95- 0330.06
Manufacturer
Pittsburgh Corning
Rmax, Inc.
Rmax, Inc.
Schuller
International Inc.
Schuller
International Inc.
Schuller
International Inc.
SFS /Stadler
SFS /Stadler
SFS /Stadler
SFS /Stadler
The Rawlplug
Company Inc.
The Rawlplug
Company Inc.
The Rawlplug
Company Inc.
Product
Rawl 3" Plate 3" round
Rawl Spike
Rawlite
Rawlite 3" Plate 3" round
Test
Dimensions
Specification
PA114
PA 114
PA 114
PA 114
12
Product
Description
3" round galvalume AZ55
steel plate
Insulation fastener and steel
and plastic stress plate for
concrete deck
Insulation fastener for
cementitious and gypsum
decks
3" round galvalume AZ55
steel plate for use with ,
Rawlite fasteners
Raul Rodriguez
Product Control No.: 95 0330.06
Manufacturer
The Rawlplug
Company Inc.
The Rawlplug
Company Inc.
The Rawlplug
Company Inc.
The Rawlplug
Company Inc.
Test Agency
Construction Research
Laboratory, Inc.
Factory Mutual
Research Corporation
South Florida
Test Service
Underwriters
Laboratories, Inc.
Dynatech Engineering,
Inc.
Test Identifier
#4818
J.I. OT4A 1.AM
J.I. 1V7AO.AM
J.I. 1V8A4.AM
J.I. 1R1A6.AM
J.I. 0T2Q4.AM
J.I. 0Q6A6.AM
J.I. 2M0A4.AM
J.I. 3X3A2.AM
J.I. 0Y9Q5.AM
J.I. 3X3A2.AM
GAF -53 -X -915
R1306
3600.02.95
Test Reports
13
Test Name/Report
Wind Uplift
Wind Uplift
Wind Uplift
Wind Uplift
Wind Uplift
Wind Uplift
Wind Uplift
Wind Uplift
Wind Uplift
Wind Uplift
Wind Uplift
Physical .Properties
Fire Classification
Raul Rodriguez
Product Control No.: 95 0330.06
DAtt
07/10/87
08/26/92
07/16/92
06/28/93
11/15/91
10/17/91
07/16/91
03/21/87
08/02/94
07/29/94
08/02/94
03/08/91
08/01/94
Wind Uplift, Small 02/02/95
Scale
Membrane Type:
Deck Type 1:
Deck Description:
System Type E:
All General and System Limitations apply.
Base Sheet:
Fastening:
Note:
Ply Sheet:
Membrane:
Surfacing:
Maximum Design
Pressure:
Maximum Fire
Classification:
Maximum Slope:
Specification No.:
SBS
Wood, Non - insulated
19 /92 " or greater plywood or wood plank decks
Base sheet mechanically fastened.
One ply of GAFGLAS® Ply 4, GAFGLAS® Ply 6 ®, GAFGLAS® #75 or
GAFGLAS® Stratavent® (Vent Ply) for Nailable Decks mechanically fastened as
described below:
Base sheet shall be lapped 4" and fastened with approved roofing nails and tin caps
9" o.c. in the lap and two rows staggered in the center of the sheet 12" o.c..
Ply 4 and Ply 6® applications require sheathing paper over the wood deck
before application of base sheet.
(Optional) One, two or three plies of GAFGLAS® Ply 4, GAFGLAS® Ply 6® or
a single ply of Ruberoid® 20 in type III or IV asphalt at an application rate of 25
lb. /sq. ± 15 %.
One ply of Ruberoid® Mop Granule,' Ruberoid® Mop Plus Granule or Ruberoid®
Mop FR in type III or IV asphalt at an application rate of 25 lb. /sq. ± 15 %.
(Optional) Install one of the following:
1. GAFGLAS® Mineral Surface Cap Sheet in type III or IV asphalt at an
application rate of 25 lb./sq. ± 15 %.
-60 psf.
Class 'A'; see General Limitation. #2.
3:12; see General Limitation #3.
N- 1 -1 -MG, N -1 -1 -MGFR, N -1 -1 -MGFR, N -1 -2- 20/30, N- 1- 2- 20/30FR,
N- 1 -1 -MGP
41
Product Control No.: 95
Product Control No.: 95- 0330.06
Wood Deck
System Limitations: 1. A red rosin sheet shall, be installed on all wood plank decks to eliminate
asphalt seepage and bonding of base sheet to wood plank deck. A red rosin
sheet may also be installed on plywood decks as an option. A red rosin sheet
is required on all applications where Ply 4® or Ply 6® is used as an anchor
sheet.
2. Pre- assembled 'Cap Nail' shall not be used for base sheet attachment.
3. Fasten anchor sheet 9" at the lap and 18" in two staggered rows centered on
the sheet. Approved to -45 psf.
4. See PA 117 for extrapolation of data for higher design pressures.
42
Raul Rodriguez
General Limitations:
1. All asphalt shall comply with ASTM D 312 type III or type IV requirements. All
proposed asphalt producers must be approved by the applicant.
2. Fire ratings are determined by a combination of slope, deck type and assembly.
Refer to current Underwriters Laboratories Roofing Materials Directory or other fire
testing data listed by an approved listing laboratory agency. Fire ratings shall be in
compliance with Sections 3401:5 and 3401.6 of the South Florida Building Code.
3. Maximum slope range shall .'vary : for each system; consult current Underwriters
Laboratories Roofing Materials' Directory and manufacturer's specifications for
compliance with design criteria for each project.
4. An overlay /recovery board insulation panel is required on all applications over
closed cell foam insulations when the base sheet is fully mopped. If no recovery
board is used the base sheet may be applied using spot mopping with approved
asphalt, 12" diameter circles, 24" o.c.; or strip or spot mopped 8" ribbons in three
rows, one at each sidelap and one down the center of the sheet allowing a continuous
area of ventilation. Encircling of the strips is not acceptable. A 6" break shall be
placed every 12' in each ribbon to allow cross ventilation. Asphalt application of
either system shall be at a minimum rate of 12 lbsisq.. Note maximum design
pressure restrictions on spot attached systems.
5. Any amendments to these provisions shall be in compliance with Sections 203 and
204 of the South Florida Building Code.
6. All work shall be performed by a Contractor licensed to do roofing work in Dade
County. Contractor shall be familiar with the details and specifications published by
the manufacturer.
7. In re- roofing applications, moisture content in an existing built -up roof must be in
compliance with Section 3401.9(c) of the South Florida Building Code.
8. Prior to application, all existing roof surfaces used as a bonding substrate shall be
tested for uplift resistance in compliance with Dade County Protocol PA 124 to the
calculated design pressure of the roof deck.
9. If required, any Factory Mutual Approved vapor barrier in conjunction with
proprietary or approved adhesives may be used prior to the application of the
insulation layer.
10. Perimeter and corner areas shall have an increase in fastener density for both
insulation and base sheet in compliance with Dade County Protocol PA 117 of the
South Florida Building Code.
11. All attachment and sizing of perimeter nailers and metal profile designs shall
conform with Dade County. Protocol PA 111 of the South Florida Buil; g C • . e.
,ie
Raul Rodriguez
168
Product Control No.: 95
1
12. Flashings shall be installed according to the manufacturers standard details, and may
be applied in cold application adhesive, approved asphalt or may be applied in
conjunction with an approved torch applied modified bitumen membrane. Specific
details, approved by the manufacturer, shall be submitted with the Section II Permit
Application.
13. Roll good materials shall be stored in strict compliance with GAF Materials
Corporation requirements.
Consult current Underwriters Laboratories Directory for the appropriate coating for
each roofing assembly to obtain the required fire rating. The assembly shall be
installed in strict compliance with Chapter 3401.5 and 3401.6 of the South Florida
Building Code for maximum fire classification.
15. Asphalt moppings shall be with applied with asphalt approved by the applicant and
shall be approved in compliance with equiviscous temperature (EVT) methods of
asphalt application. Asphalt containers or bulk tickets shall indicate an EVT,
finished blowing temperature (FBT) and flash point. Asphalt types and temperature
ranges shall be in compliance with Subsection 3403.4(aX3) of the South Florida
Building Code.
16. Insulation may be installed in multiple layers. The fast layer shall be attached in
compliance with Product Control Approval guidelines. All other layers shall be
adhered in a full mopping of approved asphalt at an application rate of 25 lbs/sq. f
15 %, or mechanically attached using the fastening pattern of the top layer. Refer to
manufacturer's literature and/or the NRCA Roofing and Waterproofmg Manual for
correct application procedures of insulation panels in approved asphalt or adhesive.
17. Pre - assembled cap nails may only be used for termination of fully bonded surfaces
such as mechanical termination at wood blocking, head and side laps, and base
flashing terminations. Cap nails shall not be used for the mechanical attachment of a
base sheet. Tin caps are required by the South Florida Building Code.
18. The submission of system specifications and details shall accompany the Section II
Building Code Permit. This information is available in the publications listed in the
'System Description' of this Product Control Approval. The submission of these
documents, as well as the proper application and installation of all materials shall be
the sole responsibility of the contractor.
19. All standard panel sizes are acceptable for mechanical attachment. When applied in
approved asphalt, panel size shall be 4' x 4' maximum.
20. Fastener spacing for base sheet attachment is based on a minimum withdrawal
resistance value of 250 lbf as tested in compliance with Dade County Protocol PA
105. If the fastener values as tested are below 250 lbf a professional engineer may
submit a revised fastener spacing - utilizing the withdrawal resistance value taken
from Dade County Protocol PA 105. Calculations shall be based on a rupture value
(the fastener stress plate pulling over the base ply) of n more 90 ibf.. , -
Raul Rodriguez
4
V1 • • !•
A.
21. Fastener spacing for insulation attachment is based on a
Minimum
Force (F') of 300 Ibf. as tested in compliance with PA 105. If F' Characteristic
below 300 lbf. insulation attachment shall not be acceptable field tested, is
22. GAF does not allow application of roof coati
gravel, over its granule surfaced Ruberoid ®' other than a pour coat of asphalt and
products.
23. In addition to the requirements of this Product Control Approval
Florida Building Code, applicator shall follow the manufacturer's specifications.
South
ns.
170
Raul Rodriguez
Product Control No.: 95-0330.06
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein
described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the
State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with. whether
herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work.
Date January 29, 19 90
Owner's Name and Address Les P r a c h Na 1250 N . Fgtreet1 (1 1st St.
Registered Architect and/or Engineer
Name and address of licensed contractoQ b e n o u r R.•
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 1250 N. E. 101st S T r e e r
State work to be done and purpose of building (by floors). state exterior colors (submit samples)
Reroof rear flat roof and install new gravel roofing, remove nne
course of time for tie in area, replace tile to match exiss Other purpose.
New Building Remodeling Addition Repair r e r o o f No. of Stories
To be constructed of 1 n S U l . 1-43, 3 g l tuna of foundation wood Roof Covering gravel
Estimated Total cost of improvements s 1,200.00 Amount of Permit s 30.00 6 s g s.
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
7357 N.W. Miami
14 _u
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 this permi:nd will post or cause to be pos : fo inspection
on the site of the work such public notice or notices as are required by the Act. The undersigned agree -a - 4• •nly such su." ont .rs. w performed
under this permit. as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA
COUNTY OF DADE. } ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
James D. Obenour
and who, being by me first duly sworn, upon oath deposes and says that he is the Contractor
of the above described construction, that he has carefully read the foregoing application, and that he di. sign the same, and that aJ facts therein by him stated are true.
Permit No. Date / /n/f0 Read. Sw. n • and Subscribed befor
Disapproved Date
(Signed)
Building Inspector
PLANNING BOARD
MIAMI SHORES VILLAGE 7S'7 oW"--'
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
F pogo
to me well known.
Notary Public, State of " lorida
My Commission Exp Notary Public State of Florida
i Commission
DATE ExAires Feb. 18, 1993
Chairman Mc=; ber
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $25.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board.
A re- inspection fee of $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby .nndc for the approval of the detailed statement of the plans and specifications herewith submitted for the build •
in or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with. whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address Dr • M. Klotz
STATE OF FLORIDA, 1 .
COUNTY OF DADE. J ss'
Permit No..
Disapproved
(Signed)
Building Inspector
NOTE: A charge of $1.00 will be made for
the I'I.innir.;; Board.
A re- in>pec•tion fee of 11.00 will be charged
materials and /or workmanship.
Date. Pc 27 ________
No....1250...._. Street -N.-E. 1 Q1st...St r e et
Registered Architect and /or Engineer
��4...�,....9tb Ave . Miami, Fla
Name and address of licensed contactor �i.1.... Sc}1r1Ylg,lwlG. Rl�.af �.Iag.,....IYAD..._....
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be d o n e . . . . 1 2 5 0 . . . 1 . , , . E . . . 1 • • t epp..Pr. •— ...•••-- . —•. -- ..•• —.— .--
.Chairman
Member
Member _.....__.
Council Approved Date
v:..
c
State work to be done and purpose of building (by floora)..RLS1.�.eA)Gl�.�. 1rfara.Q.f.
..x.2i� S ._ flat rave 1
gravel
-roof,
.... and for no other purpose.
New Building Rcntodcling.. Addition Repairs No. of Stories 1 _
To be constructed of Kind of foundation Roof Covering Grav &. .........
Estimated Total cost of improvements s....1.,.250 ..00 Amount of Permit S. 211,110
Zone cubage required p ////
.Plan Cubage 7..:1 ..
-.-
Distance .to n 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 Al .•. S •pringer•.••Roof.ing.••-,.Ine.. 890....S...W......69th Avenue Miami Fla. 33144
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 \‘'orkinen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied %sith the provisions thereof, and will require similar compliance from all •- ractors or sub.contrac employee( by him
in the work to be performed under this permit; and will post or cause to be posted for ins . on on the si the such ' c notice
or notices as arc required by the Act. The undersigned agrees to employ only such sue o , on :�77LtL�i rf der this
pcnnit, as are licensed by Miami Shores Village.
Remarks (Signed)
Almon R. S
.e.• ••n.•.. nnnn+.e•e•nxnu exr.<..
0?/
Owner)
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments. personally ap-
peared A1.1er�- ..R......Springer -Sr.. •
.. " to ine well kssovvrs,
and who, being by me first duly sworn, upon oath deposes and says that he is the. Owner
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same,: turd that sillies
therein by him stated are true..
... Date..(.. ......... Read, Sw nd Subsc • before`" ,
n J
otary ' ublic, tate of F d
My Commiuion ExpitlEtag��.� ?
iAV Ccauyi' rn t`s ! :3 JQ 2% 9M
PLANNING BOARD DA E' Qd t rt Mcvacrd oc"nd+r't Atzwif
Member
Member
Member
Disapproved Date
making corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by Improper notice for inspection or faulty
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block � Subdivision
r
Street and Number where work is to be done-- ..l..�i
State work to be done and purpose of building (by floors)
Permit No 6
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 herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Date.---
F - 1 T if 7
- , Dat
Owner's Name and Address .- 3
Registered Architect and /or Engineer
,i96
9 S 7
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation / Roof Covering
,/ D'eP
Estimated Total cost of improvements $ Amount of Permit $
Zone cubage required Plan Cubage
Distance to next nearest building. Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building 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) - end
STATE OF FLORIDA,
COUNTY OF DADE. J ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
_.._...._ to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chainnan Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.