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1301 NE 101 St (10)3c MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Type Insp k Permit No. B 2 003 - (0 ' Name �'C_. Iut . Address I201 t 1 �-/ I J \- ' Company Mot r pn 2c J Phone # 305 a is- 9 ` ' ' For Inspector: e P '7/2.3 Name & Date Approved Correction Re-Insp'n Fee ❑ For Inspector: Correction Re- Insp'n Fee MIAMI SHORES BUILDING DEPARTM 305- 795 -2204 Bui ding Inspection Request 4 ? Date Time Type Insp'n 1 lit I Permit No. 6 0 la Name I D Address , l■ C i IQ' �S4 Company - k Q fl Li 62rne--- Phone # l , ` 4 '"t l Name & to MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 7F3 Time Type Insp'n 1/1/1 Li Permit No. 5P,2 03-/ / Name l �l Z .VZ) Address r 3 Q/ nig /D/ S7 Company Nv r ,b & / /t' . Y Phone # 3 ®lj A/S. 9 For Inspector: p_ _ 3 , Name & Date Approved Correction Re- Insp'n Fee ❑ 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305-795-2204 • Fax: Date 2 t 1 g Job Address � i N 101 Si / 5 A t Tax Folio 1 J ZO Legal De cr t-$A5\ $? A' wr 19 < Historically Designated: Tess r I Owner /Lessee/Tenet F(' j ) Owner's Address BO / V 'e' H tj114 �lt 9 fC Phone Square Ft. Contracting Co. State # Signat WORK DESCRIPTION: (� Qualifier ��� � V \ ss# Notary as to 0 ner and/or ndo re ident My Commission Ex i,rp Angela M Becker :9411 My Commission 00150048 %% Expires November 15, 2008 FEES: PERMIT APPROVED: Zoning Building PERMIT APPLICATION FOR MIAMI SHORES VILLA �3X Address RADON C.C.F Pao or # 15 $00012-0 Yes Master Permit P70 3 '- 3t.s- y /3 /c b NA- Estimated Cost (value) , e' cto r or owner NOTARX -0- Iss3 Pd - Phone Municipal # Competency # xd �p , Ins. Co. ES' 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 PLUMBING MECHANICAL t "` `may `�'r� �.. �a�• ` Je^- so, 4'- - \ `� 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 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 work stated. Nl.[.t G. CACEDA 3 Commissi :r :/ 000173648 ExpL 12/22/2008 Bonded through at = ( 4 4 &) Florida Notary Assn.. Ins. . Dat N �•tg t•_traacior or twiner '''''''''''' My Commission Expires / 1a2 • i AL D CER No 4'7 BOND0 6doef Electrical Mechanical Plumbing Structural Engineer e i l(e /e3 Date . Miami Shores Village Building Department BUILDING CRITIQUE SHE 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. 63 -1619, Job Name re, Co Prerkeil-- NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON TIE JOB SITE AT TIME OF FIRST INSPECTION PEANUT NO. TAX FOLIO NO. ) . 1 .3 �. © 61)-3 • ii STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information Is provided in this Notice of Commencement. 1. Legal. description of property and street/address: I �'� Sho 0A Lo-r i"))1-K. Z 2. Description of improvement: NE u3 Z(STiG 3. Owner(s) name and address: Tt).i ti � c. LTZt 4/ 0 ( I' ' (J h: J - 1 , i Oi ST' . i'}� ► t�c�,� ( 3 Interest in property: Name and address of fee simple titleholder: (O V3 tie-- . 3 c. - N 4. Contractor's name and address: D o j c 5. Surety: (Payment bond .required by owner from contractor, if any Name and address: Amount of bond $ M €!� €sv CE TIF 'hat e cd6 ! the o t e this is a tru on he 6. Lender's name and address: t °ft �" ` ♦ o _ =arm �I of •/ " , r ,. y . VII Oq �� •` '' ccuments may be_Se : -d as 7. Persons within the state of Florida designated by OwnetHOf provided by Section 713.13(1)(a)7., Florida Statutes, By Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the. Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. . Name and address: :.9: Eviratton date of this Notice of Commencement: (the expiration diff96nt date i�,specified) /// t 9ature of Owner .. Print Owner's Name l/✓a Yc ;1 t a / �'i �— '` Prepared by Sworn to and subscribed .before me this Notary Public Print Notary's . Name 6 -.Lae edo..- My commission expires: k)aa \OC)Olp 123.01 -52 PAGE 4 8/02 1111111111111111111111111111111111111111111111111111111 CFN 21103R0448733 OR Bk 21392 Ps 1936; (1p9) RECORDED '07/02/2003 16:03127. HARVEY RUVIN, CLERK OF COURT MIAMI— DADE.COUNTY. FLORIDA LAST F'AGE y\) k ?3/ 6,1 TY OF DADE date is ..1 year from the date of recording unless a Address: 0 Pa— 0 i Master Permit No. Contractor's Name Job Address ❑ Low Slope ❑ Asphaltic Shingles 0 13 0 1 Low Slope Roof Area (SF) %o ROOF CATEGORY ❑ Mechanically Fastened Tile ❑ Metal Panel/Shingles ROOF TYPE P ss No ❑ Prescriptive BUR -RAS 150 ❑ New Roof Re- Roofing ❑ Recovering ❑ Repair ❑ Maintenance SYSTEM INFORMATION Steep Sloped Roof Area (SF) Total (SF) 56 3 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. um ounas nC Ci:. i' iC Cii.: iil. iC CC: i.■...l Cm.s`•iluummuufamumii,CCCummusa l..........••i• ■... ii: Ciiii "au.i.■augsmugnsu•■mussammOu muumslu ■ ■ C mums ■Ct r... ■■ ■. ■..r i. i■ i.■ piwCa ■ ■■e.■..■.■■..g■pi...■....p'.i cm Is C : •' :imumgsg C :ii i m;,C'■ C ms . C...■ ■...0 ■..■.... C E ... Cm .. C• . nCim ugU l l r. r'gCm isugg Cmm ` Cp u mu um C' . r i C m m u m uust msa ma u. C sgasu ... �• ■... ........R.�... ■MUM MTh O....M g■..........■ ■.....■.■.i .......... ......:.l ■... mu* * muum us C u:`mC su mu ::: mmC ::' ■.w. ■....e� . ...C�' "IMP" . g alai .■g....... ■ ...........'r. r .. C"` i� . ■.. ■a ....n * " � I..0 ......lam . :11 ma mll CN ■ I t*r.'I... it.....■.. all " uCu iiC .; 111""uCi� ii�GGallig. imumuummuu r i p arpsi . sallumMISO .... C... .... UC... ■ ■C.. *i ■. r....e . ■..0 .■ ■��. MOMil .....g.. ■ M■ ■ I... M C. �i> a ..ii ■mimun. ■ .. . .. ■..... .u1. ■■.■11.1.. . ■ ■ii ra.g.. ...+1►.v ..C.■ ....a '..�i.it.....Nnuwrar�*w.• [ i ■ ■ . " .... C " � i \ , i,.i A ■ . . i % i#i:C ■ * ■ C ■ C ` � ' .��r,■�,,CCt..R. ■IE..11■ If ■1.1_f �i�\ ■. u M ' " a wSM „r,i `*i i i. ia .i� ..■■..ag a ■ot...■.�li m MIMS ... I: ui a. Cu.t►�t..rl�i".iia.uu * u I iinua a*.uua t* ■t i Calmi.. i....i. r.1 /. .. ■.■. ■ .. . t... *'u. � ■ i q ■ . t i .. .. u a 1 . u CCK�� ■... -.l .ri. ie ... ' :p. s.f I. s mCmu g s .i iC• i i awn US i:Ci'MC * i C:C C sum aC .. rnt. ■.........gt ii�iu . ua Ualam *A.mmiru..... psuusa. imi.CCCuismCAauiw mumm Cum i ■ umainoa m ■. 11. . .. . ...'i ■ .. i...� .. Ci.. Ci•►■ i■ G ■■• Ci i�i�ii e i�i.wii i " ' � . C:C,:�• ■ii I.Cr� ■.SU.i•1.i.i s t..... ..uaa . �A.ii....C. mums mmumu Ci.i.ai . Conic....■■M.ul..i. __.....- sm■.i ■AA\ ■*.Alma ••i: ii UM MI CYCCUMCNSM MI OIS •• rx %Itma ' iiC ..... ■...C.■..... ri... tn......... ■nrt k -_:t ...a...■ .... ■.. ■r..■ . ■ ■M .... .i....i........■ .Mii 'I.Ei! { MMIX . ■C.i ..............■ MOM ....Cii.. i .u. E #::::: R . C EC ::: C�::� C::C'e: Rau ....�s..l�.� �' MSS C i i r '.. i. ■.C... .....� ■ ..fit ■ a C . NMC Ci.Cl... i .... fii i. �a �p1 C. iii. . e /.. C i ...■ a.r sou uums ■........ u.....iCi maim ammIi ua *IM *iias.o.r'.`Criu �C■*11 sou iriiiie 36, �c 2- Mortar/Adhesive Set Te 0 Wood weslsnakes ARE THEE p { GAS VENT STACKS? 1 YES 0 NOEL 4. TYPE-NATURAL ❑ LVGX r i iE [1 1 Florida Building Code Edition 2002 High Velocity Hurricane Zone Uniform Permit Application Form. Section E (Tile Calculations For Moment based tile s ystems, choose either Method 1 or 2. Com for M, with the values from M U the Mr values are greater than or Pared the values values, for each area of the roof, then the tile attachment method is ac Mr r 3 Method 1 - oment Based Tile Calculations Per RAS 127" x . - a — Mg 7 ' M ' _ �" 1 % a = — Mg : � , �_ NOA OA 11tr Ks_ NOA h; Method 2 "Simplified Tile Calculation Per Table Below" Required Moment of Resistance (M,) From Table Below NOA t1� (P3: * Mn st be used in conjunction �a�tl• Bward Con 3 nctlon with a list of moment based tile systems endorsed by the rrty Board of Rules and Appeals, For Uplift based We systems use Method 3. Compared values for F,. If the F' values are the values for F' with the greater than or roof, then the tile attachment method is acceptable. the F values, for each area of the Method 3 "Uplift Based Tile Calculations Per RAS 127" (pr= zl: = z w:= (P:: x is x w: —J - W: z cos B: = F ~: • NOA ( 2 : z 1: o =--- -) - W: x cos 0: = F F' : w: = __j - W: z cos 0: `� NOA F - Fes: NOA F Florida Building Code Edition 2002 High Velocity Hurricane Zone Uniform Permit Application Form Section A (General Information) Roof Slope: : 12 Section D (Steep Sloped Roof System) Roof System Manufacturer: Notice of Acceptance Number: t Maximum Design Pressure (From the NOA Specific System): Minimum Design Wind Pressures, if Applicable (From RAS 127 or Calculations): P1: C ho l P2: 7 P3: / 0 6/ S Method of tile attachment (u r '• Ridge Ventilation? Steen SloDed Roof System Description Deck Type: ype Underfayment: nsulation: Mean Roof Height : — 2 Fire B t.4 r: Nb astener Type & Spacing: dhesive Type: `at Cap Sheet; oof Covering: rl Type & Size Drip dge: 1 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. [ Y 1. Aesthetics- Wor-[cmanshi 'Zone) are for the u p The workmanship provisions of Chapter 15 (High Velocity Hurricane p rpose of providing that the roofing system meets the wind resistance and water intrusion p performance standards. Aesthetics (appearance) issues are not a consideration with respect to workmanship rovisions. Aesthetic issues such as color or architectural appearance, P ` he addressed as part of the agreement between the owner and the contractor. are not part of a zoning code, should : 1r r 2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be enailed in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) the 3uilding Code. (The roof deck is usually concealed prior to removing the existing roof system).) Florida 3. Common Roofs: Common roofs are those which have no visible delineation between nei� 1rnits (i.e. townhouses, condominiums, etc.). b hboring v nhould notify the occupants of adjacent units of roofing work work be performed. contractor and/or t it t 4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of e roof d 1 'iewed from below. The owner may wish to maintain the architectural appearance, t he efore roofing an nail enetrations of the underside of the decking may not be acceptable. The Florida Building Code rovide the tion of maintaining this appearance. P e i lisi/ F 5. . Ponding Water: The current roof system and/or deck of the building may not drain well and may ��ause water to pond (accumulate) in low - lying areas of the roof. Ponding can be an indication of structural 6 !istress and may require the review of a professional structural engineer. Ponding may shorten the life cpectancy and performance of the new roofing system. Ponding conditions may not be evident until the rtginal 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 <iverloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if 1 tverflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in l cprdance with the Florida Building Code, Plumbing. 6 tl ` 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the terior of the structural assembly (the building itself). The existing amount of attic ventilation shall not be educed. It may be beneficial to consider additional venting which can result in extending the service life of the nof. 6 /ft l 03 Date • FIGURI 1525 RIDGE VENTIL- N D E E- I T: C T : 1 . ,,—;NSULATICN: IC' =IA.!' 3 SECTION 1525 HIGH VELOCITY HURRICANE ZONES UNIFORM PERMIT APPLICATION FASTENER – ("P E S PAC IN a _ / E ET: CCNERING: TELE CALCULATIONS ATTAC H. E 1) FiRE CIRECTC.cRY LISTING FAG.:-:-." C.-CE CCUN F-RCCUCT CONTRCL ■-.10 CF.-V.Cr_',ERTACE-CCA-7- S'HEE7 A) SPECIFIC SYSTEM 05. 8) F.---.PECIF:iC SYSTEM LI.MITATION C) GENERAL L_IMITATICN ID) APPUCAELEE DETAIL CAC-S 3) MUNICIP.AL PERMIT AFFLICATiCt.1 -) OTHER COMPONENT APPROVAL. = • 1 N: = PCA: - , 1 k _•_ i 3.3 Fl.t); 17,:;t2,E MI-DADE ic.:./oopi. oast , • 3 rISMC MOW: z PPR...DV ED: C, (aLlICK FAX • - ono. ; From: , k -M311. PRODUCT CONTROL. NOTICE C.)F ACCEPTA•:\;C- antft Fc Tilc Corporation CO2 N.W• South :=16 .FL 3 0: Lni r an Cccit 7-r.:•••• not 7.ht 77-'7 if ff 7..1) r.-..2.717.‘f . ...ay re cir 0:: 3(17,20 OZ • SC,` / Tht :ne &CC.c 7;0.: 00-1 E.. XI' • ) NI 1 ..s.7v1 E CODE_ COrt.t..■NCE OFtL 77 P :1...0 1 :1-TIS IS THF; f.: . . S,-.:..F1 ...;)-1.);TIO`:..±..! .,\;Dr:r7,7<:::::•.?-.L CC)\ or 7 , ) r 0 ... ._. : '.. .2-.77,..-.2.val i-.,:-..„; --,E.-1-.. ..--• -_-,.. ..,. 7. C..,.. a:-...' a: r37, -: '::. '.• '..--..' . 7.---7.C: T \,- (._:""---1.'...: 1 .0 1,--'• !-:'7.2::' ■:-. k'n:■:17-i:-1-;7--...' Co:'...77.-: '...!..:,:...".:....:17:71':- I...10 :20. ; ," . 'L--- I ,...„........A......" ......-..f.....2 ,. ---,-- Kc.r.-.,2p.31:c: ',-)...:itti,r,c;co eonlirp....corn c,s,T \F'k. TILE C,, .. n —)0FING ASSE)1BLY AFFP O" I_ Catty- i ilc_ _c Cate�or' 1TtttCri'�c Deck Tyne: 1. SCOPE - „'o:.-,L ,t °_ Ora :.:n..._ :J:_ JC_. a' i �ltJ J {__.... r wilt? .,.,. Col:;;.., `- I:,..__ ���...;;! . G.5 - ._.-.. _, ” ^il_ a,`•,� „t,i,_. _ _ - li.err :.i !:,�a :;'J .c �'•'! fir _ C: =!n �.V : .. - a ham_ °v .ci.pes not 7.re.s.sure values PRODUCT DESC =1P T LOS: Yranuiriczured b Ar',piiiant Roof Tile _ Ir Test CC11 00-1 t chrtln7v , :006 ProCiU =t -- inticn Li:•2 3: 1 Test Prof_luct ' - Product ;. 1'� O.' ;'S fL::.. :.',a. 3. f i \',jT. TtO __- nC' C � iJCi1C = :.I r. I t:',C S7::-.'..;:.:: n 'I - 1 _` _ c , y u .. , _ : 1 a - 1, _ \'. `1 F.� : t,• Tile Profile. .Sar.tafe 'S' -1._ - -1J-1 ---- SAN•T.A:FE TItE CORPOR_ATIO:N" ACCrPTACE : 0c)-1 3C19,2: 3p.plicat'.ons may 'oc. to c. roof ot...-1.2ro.-i5 c tL-cf: This app'Lications. com,pliarIcf: a:Dhlica.Cit- Cul Id.ri2 s 4. ENST.4. Cou:-.*:). .kcatior. 4.1.2 Daa For ...!..7.2.c'rumcr Table 1: Ae.rodynarnic Multiplyers— Saften •Application C.274 nirec.T. Deck - ,, -..,,,_„_---------- -....-•-■,, ..,',„, .7. . ■_ ''.••-:;"-'--. --""--:.:•■•=-------- ) ? i / \ • _.- , --,- / . ••., i .....,..-----------,..- (....„....:3-.2 _ . _ .. _7 • -, - — 1 - rd ■ Zulcaga. ?_',C F.c-ciing, F';-oduct Con...ro: Table 2: Restoring Moments u e o Gravity - M, (f Tile . I 4“:1 csr Profile greater ' r -- ."c • ' e f2 5. • f•11;:. 'S;271 "S 1 s 'I' 1 s ' ; f 1 ,S5 f.S2 ; 5. 1 5.:::; , ..._ 1, Table 3: Atachment Resistance Expressed as a Moment- Mf (-fl i 'For Nail-On System I l Tile ProfilP ; Iiie : v. Na : Ow.: On'2. S7.7:::W T.....,.) .scr -. ...., :::::-..S' E7.al. =7.".E.,7.• , 1 ..!..7,-,rcy....t sz:-:\cs ai : •1.:11.T.D..±uct :7.,:-....i.f2::'..,.:r..:::::-....... 7....,."-.°7,1 1 Table 4: At: achment RE:SiS","..311C:.• ;-...:Xpr.9_SSeC.4 ZS a [..;..c.m.e.nt - b) I for W:ortar or Adhesive. Set - .- - -..'„ . sterns i Tile 1 Profile Application F-',es:stance aniae •S-' . M.0 r.a ; '"-:',..; -,,-: .:.. -.es' e Se: • 0: Cc • LAB 1_ G f:: s.1-,art ty co 6. B,701::<C, PERNI.IT 7CC.1'.. cr 0:7.-1c; 1:12,`,:.LT.2:-ior, ••.:-..;.s PROFILE ''S.,C•rf.A.FE; S' 7.-Z QO TILT: CCI1P 7 , •:<'. 7 ' /. ,•,:•./ 7 ,=:',/...,./'',<,/,',.7, ;,X,Y.., ,,' / ; 7 / - r 7'727 • - / /. / "„rr'://7 •4* 7 -.0/Z ,•,•.-....;;;/ ' ,-- "'"C -2 . , ... "‘:.-.:,..:Z. • •-•/,-./ " ., - -,r/..._ --. _— — -- /7------.. ---:---- "1:-' 7 V. ...2.-,- --..,..._./.- ?.?.0 r. Cora7c.; This zoriain; pc s I t_nr• u2n 3 D 0 F THrS FT.!, C El SA*N.TAFE TE CORPORATION ACCEP. No. : 00 NOTICE OF ACCETT.kNCE STA:DARD CONn:7107\': P. C .!IS Azzeptanoe Caprova) shall be :onsldcrod after a renewal apply:a:ion has ocen and :he Origirt3: SUOrnittCL! tzS., o.nginco:nnE cloo:nents. arc no older :nan ahl ars .-t.ny and all approved 72:nducos shall be permanently labeled the rnanur.actur.or's name.ciry, ;late, and the colloNvinc state:nen:: ''an Counry T Con:rol.. z: ZS . :r. :no speCL ic conditiens of this Aoceptanot. P.o.newal.; of Atoco:ance •svil1 not bc oonsiderod a) Thf.-re has been a ch.2.nze ir. tine South Florida Buildinz Coale a_ffectin- the cvalt.tatlen of thjs and :hc produrt is not in cornc.lianze with the code chan.aos: b) The prooludt is no lonoe: Inc sanIc as 11 or or:: c) Lfth e ..a.oze holder h.as not complied IA:tth all the :equirernents orts aczep:anc.t.., :holt:ding tho zorr:ct ir.stalicticr. or the orodvat: d) The en who oriRinalIv prep,ared. slr-mod and sealo? recuirod docon srnittzei, is nr.. long:: precticin:' 4 kny reviSiCTI cr ananze in the rnatcr:als. Ilse% ars.. rna7.11:c of the prodtl.c.: shall at:Ionnali.:211y b.e. is for 1.cnTninat.i0r1 Of (.1":1S .=.:coptance, unloss prior ittn F..p:Z.. has bo.en CCarcuEhil ::Iintc of a rev:sion applidatiln -nno fee) and aran:ed by :his cff:ce. 5 .kny of foilowir alsc fa; of a) Unsatisfactory ryor[ormanoc of this pro-du: t proccs: IvIls of 'n.is Accootanze as an enorsc:r.-nt of orov for sacs, C7 any O'21::: rpo s The No:.ce of Acze.7.,:tanzo nurrit pr: d 5' trio words N.flarni-Dade Cory. Floniza, arid follov..od y !he rnzy bc displayed in advertisin.0 If any f :hr.. .otior.: of ..:-..zzep:anc: displayer. L:Len It aI be &cry: in s of Cris Aczopiance as well as a7.-,p:ovcd cl:z.winEs and , .vh.ore applies. prov:d :c the use b:): the rramiraclurer or its distr‘hu:o7s ar5 shall bc avallabid for ins:Doct:on :_hic job site at all times. Tho copies need no Oe resealed by the on. Fa:luro to zornply any soo of _his Acco:.;:anco shall bo -'27:7::2r. and removal or Azdep:ance. FranI: Zuloaza, P.P.0 Rooting PrOC:LICI. Conuoi Exarr,.inor Deck: Type: Gauge/Thickness: Florida Building Code Edition 20t. High Velocity Hurricane Zone Uniform Permit Application, Section C (Low Sloped Roof Svs Fill in Specific Roof Assembly Components and Identify Manufacturer (If a component is not used, identify as NA" System Manufacturer. E /y 4 4SS - NOANo.: j / 625 6'/ Design Wind Pressures, From A 128 or Calculatio Pmax1 Pmax2: Pmax3: / Max Design Press ;01,40 - Specific NOA System: /2. Slope: Anchor /Base Sheet & No. of Pty(s : i, e ' 2 2J Anchor /Bas Sheet Fastener /Bo�Q�ding,Material: / T1744 / /4/ e./siD /ZW /G.:3 Insulati bn Base Layer. Base Insulation Size and Thickness Base Insulation Fastener/Bon Top Insulation Layer Top Insulation Siz: and Thickness: Top Insulation Fa ener /Bonding Material: Base Sheet(s) & No. Base Sheet Fastener/ Top Pty Surfacing: onding Mate7I: ✓ ae Pty Sheet(s) & No. of Ply(s):. Pty Sheet Fastener/Bonding SPY' Top Ply Fastener/ Bond'n ate I: ar: Fastener Spacing for h Attachment Field: /J • oc © Lap, # Rows Perimeter. ' oc @ Lap, # Rows! © 61' ' oc Comer. ` y ' oc a@ Lap, # Rows Number of Fastener. Pet Insulation Board Field Penm t/ Comer Illustrate omp • nents Noted and Details as Applicable: Woodblocking, Gutter, Edge Termination, Stripping, Flashing, Continuous Cleat, Cant Strip, Base Flashing, Counter- Flashing, Coping, Etc. Indicate: Mean Roof Height, Parapet Height, Height of Base Flashing, Component Material, Material Thickness, Fastener Type, Fastener Spacing or Submit Manufacturers Details that Comply with RAS 111 and Chapter 16. ‹P Parapet Height Mean Roof Height w. vV fitt�, CON j Q N0T ' L.1SA Inc. LY b n l)'c'. :ri - lc.• , \V 39403 Y".' ; ^ C (J,,_.!..0) • • V , .,: . 7w ', "??T +?l .. 141 q 17 1 . 1..:".-.- . A+4 . .. 1.- ' w, n•;,, , •` ..t i sY' =003) t::•is ' 14 4: t; r ' •.: •_ '.4'. r K p� � + �' �• ) i I d s ` < ���� �'T`:'i�." 4;5� � '��' r j�1 � �� ` r ?u sJ ; 1 �. {• 1; � .t` .� Sl,j A €F �-r:� ''cr..M1 .1,y. .. ( i t ) N 1'1.. \( ' t,u :te r. “.)u(:', c::: :( :r..I)ivts;c:N '(;- ::A >' (31• 3 72•(I;;'1 •� F: �:a'L' to L YYi•'�✓♦ I't' - ♦— . .FING ASSEMBLY APPROVAL Roofing SBS /APPITPO, Modified Bitumen 3- Category: Deck Type: Maximum Design Pressure Fire Classification: TRADE NAMES OF PRODUCTS Product Polytlex Poiytlex G Poiv'.':ex G FR Polygon: Polybond G Eiasto ex S E:astc=.ex S_ G E:: st,;: :ex S^ G ER i East: shield TS- Dimensions 32' 10" x 1' 3 -3'8 E :as :;shield TS- FR 32 . _ _ 3-3 Elastorlex V 32 iU x 3 Wood -82.5 psf See General Limitation =1 32' 10" x 3' 3 -3 8" ASTM D 5::2 Torch applied, polyester reinforced, APP modified bitumen membrane with a burn or; polyethylene back face and a szranule top surface. I'Y : 3 3-3-8" .ASTN1 D 6222 Torch applied, polyester reinforced. APP mo difi e d bitumen membrane with a burn off Dciye :hvlene back face and a granule top surface and :ire retardant chemistry. 1C x 3 -3 S .ASTM D 5 : :: Torch applied, polyester reinforced. AP? nodi:ied -- .bitumen membrane with a burn nri pciye. :hvlene back face and a smooth or sanded top s.Irface. 10 , 3 3 -3 S .ASTM D 6222 Torch applied. polyester reinforced. AP? module.. bitumen membrane with, a burn off pet : ylene back face and a ararule top surface 32' 10 v_ _ 3-3 _ S.. .ASTM M D 5 : u Torch. hot asphalt or cold adhesive applied. polyester reinforced, SBS modified bitumen membrane with a burn or: pclyeth,: Iene or sanded back :ace and a polyethylene. or sanded :op surface not asphalt or cold adhesive a== ei-:forced. SBS modified bitumen :::e:': : with a - - r- ..NT: :e or sanded back faze and 3 zraruie too surface 3-3 D ' .'- 7 .'or_'. hot asphalt or .:c' :d a:. ".__. e i == :o:• __.e. Meg .:: - _...forced. SBS mcd�...�_ _.._.. . - _ ..._-_ ... .. r- burn o:; !vethytene or sanded 'bac.. face and a ' 'Tanu'ie top surface and the retar:a..: zr.em.istr: X 3 _ AS 1 NI D - . torch. hot asphalt or cold ad esi e 3 :.led poi :. e� :e• . - SES n odl.,ed a :..:me -e ra-._ .... _ burn orT polyethylene or sanded back face and a ?ranule top surface. a.STM D :. _- Torch. hot asphalt or cold adhesive a^ ?.led. poiyester reir.forced, SBS modified bitumen -e: cane '.vi :.. 3 burn off polyethylene or sanded back ace and a -anule top surface and fire retarr!'nt chemistry. ASTM D 516; Torch, hot asphalt or cold adhesive applied, fiberglass reinforced, SBS modified bitumen membrane with a burn off polyethylene or sanded back face and a sanded top surface. \ - . s.. ASTNI D NL&' UFACTI:RED OR LABELED BY APPLICANT: Test Product Specification Description ASTM D 6: :2 Approval Date: Expiration Date: 0 Torch applied, polyester reinforced. APP modified b:itumen membrane with a burn off poi - .e l- rylene back face and a smooth or sanded top surface. Frank Zuloaga, RRC RNIfina Prot -11c- ( -d F\aminrr pr�diict Dimensions Elastof10x VG 32' IF x 3' 3 -3/8" Elastoflex VG FR 32' 10" x 3' 3 -3.'8" \traflex X :raflex G X :raflex G FR Eiastof ex SA -P FR x 3 Elastor;zx SA -V FR 32' 6 - x :-•• Base Eias:ot:ex SA -V FR 32 6" x _ 3-3 S• .=STN( D 5153 Elastobase 65' 2" x 3-3 S D .D:'.therm Al ?o l' .he.... TF ? _ - :'!e.... EVIDENCE SCBMITTED: Test .-koencv,'Identifier Factory Mutual Research Corporation Exterior Research S.: Design, LLC. 32' 10 "x- 3= 10" ': 3' - 32' 1O "`3.6.. 1.2 to - ....c.. 4 4• x Test Specification ASTM D 6163 ASTM1 D 6163 ASTtit D 514 ASTM1 D 5147 .-kST\iD :i- AST`t D 515 AST '1 D .5153 .ASTNI D 46: TAS :• TAS 1 . . Report No. )... 2 1.:001334 3.1. 3000 1.1. 3004091 =11 =1l 57.04.01 -1 3 Product Descrs`ption Torch, hot asphalt or cold adhesive applied, fiberglass reiruorced, SBS modified bitumen membrane with a burn off polyethylene or sanded back face and a granule top surface. Torch, hot asphalt or cold adhesive applied, fiberglass reinforced, SBS modified bitumen membrane with a burn off polyethylene or sanded back face and a granule top surface and fire retardant chemistry. Torch applied, polyester reinforced. TPO r..od :f!ed bitumen membrane with a burn off polyethylene back face and a smooth top surface. Torch applied, polyester reinforced. TPO modified bitumen membrane '.:ith a burn or: polyethylene back face and a granule top surface. Torch applied, polyester reinforced, TPO modified bitumen membrane with a burn off polyethylene back faze and a sranu':e to surface and fire -e:ar dan: chemis :: Self-adhered. polyester reinforced. SBS n _ :rumen re:- nbrane with a self- ad'.erin_ Jack face and a nr_ top surface Self- adhere_. Iiber4iass reinforced. SBS mc...f __ bitumen membrane with a self- adherina back f and a smooth top surace. Self- adhered. fibers °ass reinforced. SBS 1,_ . eri bac.< :- :�i ^-;?iTiOrane with :e._-a• =.• _ - -`- and a ctra'.u!e to surface. SBS modified asphalt coated ?plyisocyanurate Date 08 04 94 , ) 1 ) V i.1_.'DO 01.12 00 04.25 ')1 Frank Zu!oaaa RRC Z-N-Ano Prn.fii; r C -nrrnt r yarnin,r All General Base Sheet: aster g Fastert.in , _' Siirta::in_ • Membrane: Deck Type 1I: Deck Description: System Type E(4): \ta_xir i:_m Design Pressure: Wood, Non - Insulated, New Construction 19/32" or greater plywood or wood plank, fastened with wood screws fastened at 6" o.c. Base sheet is mechanically attached to roof deck. and System Limitations apply. e, p o . ase, Firestone MB Base, JNI Perma- One ply of CertainTeed Glasb Ply #28. Tamko Glass Base o OAFGLAS fastened to the deck as described below: Attach base sheet using. 11 ga. annular ring shank and 1-5 diameter tin caps spaced 8" o.c. in a 4 lap and 8' o.c. in two equally s paced staggered rows in the center of the sheet. (Meets —60 psf. See General Limitation #7) Attach base sheet using Dekfast =14 with Hex Plates or Tru -Fast HD with MP- Plates spaced 12 a._. in a 4" lap and 12" o.c. in two equally spaced staggered roe's in the center of the sheet. (Meets —52.5 psf, See General Limitation 47) e ply :5, � � ; . Modibase. Perna :Ply No. 28. Elastoflex S6. laszotie. _.: or one or mor plies _` IV or VI ph' sheet rr �' nt moved asphalt applied 'A - .:n the EVT range and a: a a�eredinfullmo,_�un_�ta,�.r� - rate of 20 -40 Ibs.. sq. One ply of Polylex. Poltlex G. Poiyflex G FR. Polybond_ Polybond G. Xmafex_ \aatlex G or Xrrailex G FR torch applied or one ply of Elastoflex S6, Elastoflex S6 G. Elastoflex Sc G FR, Etas astc•'}:leld TS4 FR torch or hot ed n e ply of E '.'.:x S.\ — lastoflex SA-V FR self - asphalt applied �. c.._ .P r '` �� o adhered. Elastoflex V. See fastening opt„ns above. t Optional I Install one of the follow ine to ob:ain re . tire classification. ' Gravel or slay? az 400) ibs sq or _ _'t.2 ibs sq.. -spe : in a Flood coat of approved asph±_: at 60 lbs. s.. -- 3 r .ysohait So4o or .-\_hest; _ Fret i�?.i:�1h - iC` "�_ed ..11..r`li%1_.. - • _.. _ Aluminum Roo: Coanr.e at I' _ _11. iq. Koketn is Roo foa :in• :. 221 sq 4 \fonsey Endure ` Alwninum Roof Coating. tt eagle: Check or .Alurruntun Roy:: Coating. at : _ =3.1 sq. 5 Grundy al MB .kluminum Rocf Coating at 1 -2 -ai. . . \ l �' oa-:n �r - meat ��_: Flier -+ ^. Fields F =:) Heat S;,ie d .tiu ~iglu.. C Aluminum Cca ::n at 1 : (22 so. 20 Frank Zuloaga. RRC Rcic Ano Prneiru't (' nrrr l r ynmine"r • 05/062003 09:44 MEDITERRANEAN ROOF TILE 4 3058929111 954 578 1042 _ _ ' 12 0/02 TUE 14:57 fAX 954 578 1 • MIA M I•DDe APPROVED: 06/14/2(101 JAN -1 -1999 FRI 12:12PM ID: U T2 POLYFOAM PRODUCTS. INC. PRODUCT CONTROL NOTICE OF ACCEPTANCE Poly foam Products, Inc. 2400 Spring► Stucbncr Road Spring ,TX 77383 -1132 The expense of such testing will be incurred by the manufacturer. This application for Product Approval has been Code and Product Review Committee to be used forth above, NO.132 P001 MIAMI -DADE COUNTY- FLORIDA METRO -DADE FLAGLER BUILDING RUrLDING CODE COSIPL1AIVCE OFFICE METRO -DADS ri.. %G1-1 OUILOING i-ul WEST FLAGLCrz STREET. SUITE 1603 MIAMI, r•LortrnA 33130 -1563 (305) 375 -2901 FAX (]05) 375 -29o8 COP: rk.lc r0li LICE i1Nr: SFC1 - 1O (3051375 -2527 FAX (3 -3sin cow I.NPORCE p rrrDIVISION (305) 375 -2966 FAX (3 373 -25nd PRODUCT CONrrtol, otvt5(ov (.10” 37S-2902 FA \ pin )72 -63)9 Y _ our _ a pplication - for - Notice - (NOA) of_ o Component _P -olyarethene -Foam- Adhesive under Chapter 8 of the Code of Miami -Dade County governing the use of Alternate Materials and Types of Construction- and completely described herein, has been recommended for acceptance by the Miami -Dade County Building Code Compliance Office. (BCCO) under the conditions specified herein. NOA shalt not be valid after the expiration date stated below. BCCO reserves the right to secure or material at any time from a jobsite or manufacturer's plant for quality control testing. I f this this product or material fails to perform in the approved manner, BCCO may revoke, modify, or suspend the use of such product or material immediately. BCCO reserves the right to revoke this approval, if it is deterrnined by BCCO that this product or material fails to meet the requirements of the South Florida Building Code. •kCCEPTA,NCE NO.: 0I- 0521.02 EXPI RES:_05 /10/2006 R I ii Rodriguez Chief Product Control Division rms IS TI•[[; COVERSI -WET. SEE ADDITIONAL PAGF.S FOR SPECiFIC AND GENERAL CONDITiONS i3UWLDING CODE , PRODUCT REVIEW COMMITTEE reviewed by the BCCO and approved by the Building in Miami -Dade County, Florida under the conditions set Francisco J. Quintaii& R.A. Director Miami -Dade County Building Code Compliance Orfietz tt o 3acepanae cover pa6cdoc Internet mail address: postmaster @buiidiagcodennlinacom • -Homcpage: bup: / /www.bugdingeodeonlinc.com PAGE:1 X Tnale.1: Adhesive Placement For Each Generic Tile Profile TileProliilc -' Placement Detail Single Paddy Weight Min. (grams) Two Paddy Weight per paddy Min. (grams) N/A Flat, Low, Hi!l1 Profiles V I 35 High Profile (2 Piece Barrel) # I #2 17 /side on cap and 34 /pan 24 N/A N/A Flat Low, Hi Profiles Flat. Low, High Profiles #3 g 05/062003 09:44 MEDITERRANEAN ROOF TILE + 3058929111 12/10/02 TUE 14:58 FAX 954 578 1042 Polvfoam Products, tnc_ JAN -1 -1999 FRI 12:13PM ID: POLYI 0AM PRODUCTS , INC - ACCEPTANCE No.: 01- 0521.02 4.8 Tiles must be adhered in freshly applied adhesive, Tile must be set within 2 to 3 minutes after Polypro® AH 160 has been dispensed_ 4.9 Polypro® A1 placement and minimum patty weight shall be in accordance with the 'Placement Details' herein. Each generic tilt profile requires the specific placement noted herein. 4 5. LABELING All Polypro® AH160 containers shall comply with the Standard Conditions listed herein. 6. BUILDING PERMIT REQUIREMENTS 6.1 As required by the Building Official or applicable Building Code in order to properly. evaluate the installation of this system. Crank Zuloaga. RAC Product Control Examiner NO.132 g004 PAGE:4 tj004 05/06/2003 09:44 MEDITERRANEAN ROOF TILE 4 3058929111 '12.10%02 rtIE 14 :57 FAX 954 578 1042 r Po {.vfonmTroducts, Inc_ ACCEPTANCE No.: 01- O52l.02 ROOFING ASSEMBLY APPROVAL Cat tWity: Roofing Soh -Cate o : Roof Tile Adhesive Approve) Date: June 1 , 2001 Expiration Date: May t0, 2006 Materials: Polyurethane 1- SCOPE This approves Polypro® AH160 as manufactured by Poiyfvam Products, Inc. as. described in Section 2 of this Notice of Acceptance. For the locations where the design pressure requirements, as determined by applicable building code, does not exceed the design pressure values obtained by calculations in compliance with Roofing Application Standard RAS 127, for use with approved tlat, tow, and high profile roof tiles system using Polypro4) AH 160_ Where the attachment calculations are done as a moment based system for single party placement, and as an uplift based system for double patty systems 2. PRODUCT DESCRIPTION Manufactured by Applicant Polypro® AI-1160 I'oarnpro® RTP1000 N/A ProPack ®30 & 100 Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability JAN - 1 - 1999 FRI 12:12PM ID: Dimensions N/A N/A Dispensing Equipment 2.1 Components or products manufactured by others: Any Mia,ni - Dade County Product Control Accepted' Roof Tile Afsembly having a current NOA which list uplift resistance values with the use of Polypro A }1160 roof talc adhesive. 2.2 Typical Physical Properties: Property Tit Density ASTM D 1622 Compressive ASTM D 1621 Strength ASTM D 1623 ASTM D 2127 ASTM E 96 ASTM D 2126 1 POLYFOAM PRODtTCTS , INC . • Test Snecifications PA 101 Results 1.6lbsJft.' • 18 PSI Parallel to rise 12 PSI Perpendicular to rise 28 PSt Parallel to rise 0.08 Lbs./ft 3.1 Perm / Inch +0.07% Volume Change @ul -40 F_ 2 weeks +6.0% Volume Chan Humidity_ 2.veeks Product D cription Two component polyurethane Dispensing Equipment tT :a. Sao• Frank Zuloaga, RIIC Product Control Examiner NO.132 P002 ci] 002 PAGE:2 05/06/2003 09:44 MEDITERRANEAN ROOF TILE 4 3058929111 '12/10/02 TUE 14:58 FAX 954 578 1042 i Polyfoam Products, Inc, ACCEPTANCE No. 01- 0521_02 Note: The physical properties listed above are presented as typical average value, as determined by accepted ASTM test methods and arc subject to normal manufacturing variation. 3. LIMITA'T'IONS . 3.1 Fire classification is not part of this acceptance. Refer to the Prepared Roof Tile Assembly for tire rating. 3.2 Polypro® AH160 shall solely be used with flat, low, & high tile. profiles. 3.3 Minimum underlayments shall be in compliance with the Roofing Application Standard RAS 120. 3.4 Roof Tile manufactures acquiring acceptance for the use of Polypro® AH160 root tile adhesive with their tile assemblies shall test in accordance with PA 101. 3.5 Roof Tile manufactures acquiring acceptance for two paddy placement with the . use of Polypro® AH160 roof tile adhesive with their tile assemblies shall test in accordance with PA 101 and with section 10.4 as modified herein. t w MS 4. INSTALLATION 4.1 Polypro® AH160 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of Polypro® A1-1160, 4.2 Polypro® AH160 shall be applied in compliance with the Component Application section and the.corresponding Placement Details notcd herein. The roof tile assembly's adhesive attachment with the use of Polypro® AH160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the uplift resistance determined in compliance with Miami -Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof the assembly NOA 4.3 Polypro® AH 160 roof Ile adhesive and its components shall be installed in accordance with Rooting Application Standard RAS 120, and Polyfoam Products, Inc. Polypro® AH160 Operating Instruction and Maintenance Booklet. 4.4 Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, Inc. Polyfoam Products Inc. shall supply a list of approved applicators to the authority having jurisdiction. 4.5 Calibration of the Foampro® dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the "B" component shall be maintained between 1.0-1.15 (A) : 1.0 (B). The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved. 4.6 Polypro® AH160 shall be applied with Foampro RTF1000 or ProPack' 30 & 100 dispensing equipment only. 4.7 Polypro® AH160 shall not be exposed permanently to sunl JAN -1 -1999 FRI 12:12PM ID: POLYFOAM PRODUCTS, INC. 3 N0.132 [7003 Frank Zuloag i, RRC Product Control Examiner PAGE:3 e1003 05/06/2003 09:44 MEDITERRANEAN ROOF TILE 4 3058929111 '12/10/02 TLE 14:58 F111 954 578 1042 POLYPOAR PRODUCTS,INC. Polvfoarn Products, 'Inc. w, Qraaal an* canon fray i8.n.atsn.i . LW, ORM Mau aeuvgb plastic comonf tIndarryran Can GaM Ens :was Way: imp aAuurt igna. a R. ay Mm •te7Aeits JAN -1 -1999 FRI 12:13PM ID: ADHESIVE PLACEMENT DETAIL i SINGLE PATTY • 5 . NOB shrsugh plastic esmat Undetlspnenl K adhosaa Omar. i s l aQ /tam rtsphelsa M P-Aiaa dUwuw cows* civet Ipt. Aboe w woad .sans Pie ma. Emma ass aced Pan led easfl As ire inn >t tent U. taw .taws iftela shoot ACCEPTANCE No.: Oi- 0.521.02 five alas r, flare enatiak adhesive o, atNe.e ll se j3 Wan l iyke le ronhct rdM M Pun Gb 13 rum cowl vpsld dawn. Pit= sdhe VK >a is To 1 ht Fm r solds adga d case a& MO kVAtheNt. Wwfool' f gaar 1ue-411 Teat Frank Zulo, RRC Product Control Examiner NO.132 P005 hid Eh* tinra OOP taps ClPtretl PPilyWWya leoltudis i • adin Ms PAGE:5 Z005 05/06/2003 09:44 MEDITERRANEAN ROOF TILE + 3058929111 22/10/02 TUE 14 :59 FAX 954 378 1042 POLYFOAM PRODUCTS, INC. . Polvfoam Products. Inc. JAN -1 -1999 FRI 12:13PM ID: ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY ACCEPTANCE No.: 01- 0521.02 N0.132 P006 ® 006 6 frank Zuloaga, R1tC Product Control Examiner PAGE: 6 • 05/06/2003 09:44 MEDITERRANEAN ROOF TILE 4 3058929111 12/10/02 TUE 14:59 FAX 954 578 1042 Polyfonm Products, Inc. Nall through pbsIlc crnonl SIASkPaddif on top or rile Sim* paddy under tile Vitide Odd/ on ondedaymerit Single paddy under cite PaddY between lie JAN-1-1999 FRI 12:14PM ID: FOLYFOAM PRODUCTS,1NC. ADHESIVE PLACEMENT DETAIL 3 DOUBLE PATTY 7 ACCEPTANCE No.: 01-0521.02 NO.132 U007 lib 007 Frank Zuloaga. RILC Product Control Exatuiricr PAGE:7 } PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 05/36/2002 1301 N.E. 101 Street Date Job Address Tax Folio Legal Description Historically Designated: Yes No / Tenant Jan Vonfeilitzen Master Permit# �6L 10 f O wwne y s Add . 1301 N.E. 101 Street Miami Shores Contracting Co Quality Roofing Contractor, Inc. Add 13800 N.W. 1st Ave. Qualifier Carlos Arocho SS# phone (305) 751 -0382 state# RC0058627 Municipal # Competency # 000017889 Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Repair leak on east side center of valley on tile roof. Square Ft. Repair Estimated Cost (value) $600.00 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 (H' 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 an 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 • c . • : I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction ; • • • • ning. Furthermore, I authorize the above -named contractor to do the work stated. &e4 of owner and/or Condo Presi Notary as to • er and/or Condo President My Commission Expires FEES: PERMf4 6 " RADON APPROVED: Zoning Building 5 Date i 1A:''y' MARYLOU HERNANDEZ !•� ,._ MY COMMISSION # DD 060579 EXPIRES: October 10, 2005 Bonded Thru Notary Public Underwriters C.C.F. NOTARY Phone (305) 754 -8683 Signature of Contractor or • • er- Builder Date Notary as to Con for or Owner- Builder My Commission Expires: 0 02 Date EZ •�� :` MY COMMISSION MARYLOU # DD HERNAND 060579 t °ri EXPIRES: a -' ES: October 10, 2005 '' of F ; ' Bonded Thru Notary Public Unde BOND TOTAL DUE 6 O. 2Electrical Mechanical Plumbing Structural Engineer High Velocity Hurricane Zone Uniform Permit Application Form Section A (General Information) Master Permit No. Process No. Contractor's Name QIA.G 1: Job Address 13 01 k) , F. 1 0 I (S C c •t ROOF CATEGORY ❑ Low Slope ❑ Mechanically Fastened Tile ❑ Mortar /Adhesive Set Tile ❑ Asphaltic ❑ Metal Panel /Shingles ❑ Wood Shingles /Shakes Shingles ❑ Prescriptive BUR -RAS 150 ROOF TYPE ❑ New Roof ❑ Re- Roofing ❑ Recovering NJ Repair ❑ Maintenance ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF) t 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. L; L ^ 1 , • , 1 1 , 1 i _ ; , :r; 1 'r _ , r i r rr - - 1 I L' _,, .. , . L ' • ' ' , L . _ 'L:_l._, r-, -i i 1 ... L;- L _ _;•-- .;;_N; L-1 L_ . L . 1 _ .. _ .. r : - -r 1 _ _. ' _,_ 1 _. ; , ,.., -.; , 7 1 � � r r - , _ •r � � - r , � • � - ._.__�_. ; '_� 1 . � -- i , -;--r- r' ' i i i�4� - r- L hi-; l _ • , t , :_.te - r _.i. _ I ' - f- l . _ CI _ L .. c�_ - . ___ri-rrrtt-•r . : i 1 1 }' r ; �- r_.- - - i-- r-El- 1 - -�•-L ' - ` • �•T -I_._ •- -i_t._ ' -� 1 ri i 1 f _— ' L _r1 i rr i ~'_' i 1 1 i i i 1 rt-� .rj , 1 i 1 i _ ; -; �� r - r ._ }.i. ► -_'r't ; . ! • ^�_ ' " : :.. ._;. _ -I� — ,..._ — r — - 1 t- [. -1 :r r- F-r•. ; .: L ? ".i:., _ _ ` .. .:�_ ' �.: t:: :. l .. i � :is _ : i : ' , _. ' ,.--, ! ,._s r _I • _i. • : i t _ �_ t f _ I .r :__t ` ' 1 : ; .i : . :F.1_ 'E. _i : r_i.. f-' r ,. -1 i }: - : .. ? .} . t .;..: .: i c._ .� I r _ t r . ; _ .t. yl • I- _ i _ ! �'i: .i ' t , , _�.. �.. - _; _ . ! ` • ' , ..:., l._ (:C': • r , . t _. r . __ _ _ I i... 1 _L.1 ::. t 1 _ CLI L.t . r _ 1 • l ', -L - . !. t . - . . -r _ : : - 1 _;.. I ._ • _� , 1_ . 1 . t_� � . _ i i 'Ht i _ • -r-- r_r� -r. 1 ". t { I I tt ' - r- I • r 1 1 _ � i t- ; - , I ( L ' 1�_���" t i 1-^ 1 r .! 1 , 1.. ,..i �_1._• I r ..- i -1 . ;- • _ , _ _ .:r.. . ,.. L ' i 1 ` 1 r. - , r . a .._1 - _ i . _�.,_ ` r_ - , r : i - r r-r 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 omrner's initial in the adjacent box indicates that the item has been ex l ' ed. workmanship rovisions of Chapter 15 (High Velocity Hurricane 1. Aesthetics-Workmanship: The workm p p p (H $ h' one) 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 ad 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 r nailed in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing roof system). 3. Common Roofs: Common roofs are those which have no visible delineation between neighboring u its (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or comer 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 vi wed 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 • mai ining this appearance. _._. 5. Ponding Water: The current roof system and/or deck of the building may not drain well and may c ` Ise water to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural d stress 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 roofin: system is removed. Ponding conditions should be corrected. 6. Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not ov rloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if o erflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accord rice \ ith the Florida Building Code, Plumbing. 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the in erior of the structural assembly (the building itself). The existing amount of attic ventilation shall not be r duced. It may be beneficial to consider additional venting which can result in extending the service life of the roof. 0 'ner's/Agent's Signatu C:% DOCVSIC .IkmeLOCALS- ATtaip.SCCTION IS7J.O.x / 3 / a2. Date Contractor's Signature Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 6/4/2002 Applicant :: CARMEN FEILITZEN Owner: FEILITZEN CARMEN JOB ADDRESS: 1301 NE 101 ST Contractor QUALITY ROOFING CONTRACTORS INC Contractor's Address: 13800 NW 1 AVE Local Phone: 305 - 751 -0382 Parcel # 1132050230090 Fees: Description Amount FEE2002 -3143 Building Permit Application Fee $60.00 FEE2002 -3144 CCF • $0.60 Total Fees: $60.60 Permit Status: Approved Permit Expiration: 12/1/2002 Work: REPAIR LEAK ON EAST SIDE CENTER OF VALLEY ON TILE ROOF 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 be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signe• �• (INSPECTOR) BY: In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or en}ployes. Signed: Building Permit Permit Number: BP2002 -1035 Construction Value: $600.00 Page 1 of 1 Legal Description: M SHORES BAY PK ESTS PB 55 -83 LOT 4 BLK 2 LOT SIZE 109.600 X Total Fees: $60.60 Total Receipts: $0.00 (Contractor or Builder) BY: QUALITY ROOFING CONTRACTOR, INC. 13800N.W.`1STAVENUE MIAMI, FL 33168 -4849 PAY ORDER OF O 1, Bank of America. ACH R? 063100277 f / 1). OL S 1. 1SOL n1 101 .ST FOR 3 %Zel'av -�' 11 7 l). a• 10 a,•r i. f `y e n h. a n, t r. Q d• o c u m e m f ' = 5 d'r - bock or d r f a i i s DATE 6 -6 -0a CC is l e'!. ko to-0 L ARS B ii'0 L 7 3 L 1:0.6 30000 4 71: 00 LS 53002 �,6ii' / f 17313 63 -4/630 FL 1949 r.a **... MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR•BUILDIND PERMIT Application is hereby mode for the approval of the detailed statement of we 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 rdinance 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 cdpy of pproved plans and specifications must be kept at budding during progress of the work. 11/24/80 Date ,19.. .- Owner's Name and Address Virginia P. Kett ler ` . _ N 1301 Street N.E. 101 St. R egistered Architect and /or Engineer ,,,,, ,,, ,, ,,, , ,,,,,,,,,,,,, , , , „.,,,,,r„ Name and address of licensed contractor MAYO ROOFING COMPANY _ , Location and legal description of lot to be built on: Lot Block ,.,.. Subdivision _ .... Street and Number where work is to be done 1301 N.E. 101 St. , _ _ State work to be done and purpose of building (by floors) Tile reroof Estimated Total cost of improvements $ 7800.00 Amount of Permit &.., Zone cubage required .Plan Cubage Distance to next nearest building , Size pf Building Lot Maximum live load to be borne by each floor Disapproved .._ (Signed) Building Inspector Date - 35 squares , , and for no other purpose. New Building Remodeling Addition , Repairs No. of Stories , To be constructed of Kind of foundation Roof Covering 19 00 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 umlersigncd 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 %s it') the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed ay him in the wort; to be performed under this permit; and will post or cause to be posted for inspection on the side of the work such Public notice or notices as are required by the Act. The undersigned agrees to employ only such su tract° js, on woe o be performed under this permit, as are licensed by Miami Shores Village. // /1� e Remarks (Signed).. STATE OF FLORIDA, COUNTY OF DADE. ss. I3efore me, the undersigned authority, a notary public, duly authorizcd to administer oaths and take acknowledgments, personally ap- peared Charles Williamson _ to me well known. Roofer and who, being by me first duly sworn, upon oath deposes and says that he is the..., of tl:e above described construction, that he has carefully read the foregoing application, and that he did sign the same, said that all facts therein by him stated are true. *�� Permit No - e! Date ‘\ ”' l ........... _._ .. Read, Sw rn to a d Subscribed fore me. of ublic • of Lori Y F My Commission Expires... mCTtiltY 'PIIBtiC'STA1r 1 1aii MY COMMISSION ElPHIeS JULY 14 1982 PLANNING BOARD DATE BONDED THOU GENERAL: INS_AJ»DERWRII9S Cirairnan Member T .�, \fcrr,ber , Member .__., _.. „ Member .. .. Member Council Approved Date Disapproved , , , Date NOTE: A ch.ugc of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Yl,rnnirig Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by Improper notice for inspe tirm or faulty materials and /or workmanship. MIAMI SHORES VILLAGE 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. 1 square , 19 7 7_ Owners Name and Address Mrs. Kettler N 1301 St N.E. 101 Street Registered Architect and/or Engineer ,, .... Name and address of licensed contractor Lang Roofing_& Tile Co., Inc. ,57.3 N. W. 71st, Miami, Fla. 33 150 Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 1301 N.E. 101st Street , ^_ State work to be done and purpose of building (by floors) and for no other purpose. New Building Remodeling Addition Repairs X No. of Stories To be constructed of Kind of foundation Roof Covering Ja , Estimated Total cost of improvements $ 495.00 Amount of Permit $..12..50 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 rovisions thereof, and will require similar compliance from all contractors or s tractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the • e of a work such public notice or notices as arc required by the Act. The undersigned agrees to employ o such subcon• 'ctors, o. work • be 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 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. Permit No._ Disapproved (Signed) D Date BUILDING INSPECTION DEPARTMENT -( - 7 Repair work only, Read, Sworn w and Subscribed before me. Notary Public, State of Florida Building Insp . or My Commission Expires Chairman Member Member PLANNING BOARD DATE Member Member Member 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 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 anti /or workmanship. MIAMI SHORES VILLAGE. FLORIDA ❑ DATE ' - 1951_ PERMIT N° 6388 Contractors License No. BUILDING ELECTRICAL PLUMBING ❑ ROOFING M <. , , e .„4.7 ❑ r. Owner of Building 0 Architect Contractor or Builder Legal Lot Description I Bl Address of Building ` - !' � L. f K` � i Work to be performed under this Permit Value of Project $ Subdi- vision Amount of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough nowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specificatio s and that he assumes responsibility for work done by his agents, servants or employees. 6 Signed. _ ' . • INSPECTOR /- ' In consideration of the issuance to me of this permit I agree to perform the work aefvered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or, ptions submitted to the proper authorities of Miami Shores Village. In ac- cepting th permit I assume responsibility for all work done by either, mt Any agent, servant or employee. • •0 1 l CON'IRACTOR OR BUILDER' �✓ BY AUTHORITY 'I 6 4C Owner's Name and Address.. Registered Architect and /or Engineer Name and address of licensed contractor.. Location and legal description of lot to be built on: Lot Block � S� divis� n Street and Number where work is to be done State work to be done and purpose of building (by floors) STATE OF FLORIDA, COUNTY OF DADE. ss Disapproved Date (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. sP No. ,19 Str- and for no other purpose. New Building Remodeling. Addition Repairs No. of Stories To be constructed of Kind oY da ' Roof Covering 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 5968, Compiled General Laws of Florida, Pennanent 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 su . . ntractors, on work to S performed under this permit, 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 to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No .b Q Date /" - Z s `l Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member ... Member Council Approved 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. BUILDING ❑ ELECTRICAL ❑ PERMIT N? PLUMBING ❑ ROOFING] Owner of Building .. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Work to be performed under this Permit Architect Contractor or Builder Legal Lot II Bl. Description. Address of Building Signed: 14356 Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. of Permit $ BY This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. .BY AUTHORITY 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. Owner's Name and Address R• Guernsey Registered Architect and /or Engineer. Name and address of licensed contractor Location and legal description of lot to be built on: Lot 4 Block 2 Subdivision .ba7 Park Estates Miami Shores Street and Number where work is to be done 1301 N E 101st Street Roofing State work to be done and purpose of building (by floors) and for no other purpose. New Building X Remodeling Addition Repairs No. of Stories 1 To be constructed of Kind of foundation Roof Cover Estimated Total cost of improvements $ 950.00 Amount of Permit $ • (JJ 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 Guernsey 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 bey erformed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. s 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 the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No Disapproved _ ( Signed) MIAMI SHORES VILLAGE Date ate Sheet Metal Specialty Co 573 j4 NW `hst St Member Council Approved Date Disapproved Date March 6, 19 53 No 1020 N &treet 104th St Read, Sworn to and Subscribed before me. Notary Public, State of Florida ding Insp ctor My Commission Expires PLANNING BOARD DATE Chairman r' Member Member o •: Member 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 th 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.