30 NE 100 St (11)Inspection Date: 07/11/2006
Inspector: Grande, Claudio
Owner: ROMANICK, GARRY AND ELISABETH
Job Address: 30 100 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: DALEY ROOFING INC
Building Department Comments
Monday, July 10, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E..2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Roof
Inspection Type: Final Roof
Work Classification: Roof - Repair
Phone Number 305 - 205 -4538
Parcel Number 1132060131230
Lot:
Phone: (305)754 -9892
Page 2 of 2
t ( �(Q
Passed (J �
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Inspection Date: 07/11/2006
Inspector: Grande, Claudio
Owner: ROMANICK, GARRY AND ELISABETH
Job Address: 30 100 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: DALEY ROOFING INC
Building Department Comments
Monday, July 10, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E..2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Roof
Inspection Type: Final Roof
Work Classification: Roof - Repair
Phone Number 305 - 205 -4538
Parcel Number 1132060131230
Lot:
Phone: (305)754 -9892
Page 2 of 2
P mMiami Shores Village
MS
Building Department
Owner's Name (Fee Simple Titleholder)
Owner's Address AJ 1 O
Citym , SL(,(f u,Q State
Tenant/Lessee Name
Job Address (where the work is being done)
Is Building Historically Designated YES NO
Contractor's Company Name
State Certificate or Registration No.
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit
Type of Work: DAddition
Describe Work:
Total Fee Now Due $
(Continued on opposite side)
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
5r
Waosrmo
OL at
/11
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING PCS��
PERMIT APPLICATIO rj 2 � 5 Master Permit No.
FBC 2001
B' -----------
Permit Type (circle): Building Elec cal C y nbing Mechanical
n/�'y Y cina(.n, b Phone # 30 77S 26O ,S" 3
City Miami Shores Village County Miami -Dade Zip 33 / 3 x
30 i 4 O ST
Contractor's Address '7' c1 j 0 (p 5d'
City Aki a/IAA — c1.1 State 11 Zip 3313 g
Qualifier b Atka.
❑Alteration ❑New
Zip 3 3/ 38"
Phone #
Phone #
Certificate of Competency No.
Phone #
Square Footage Of Work:
' 4
Permit No Z.PC:X. - / 01 2 "
3o5" 7S)1
air/Replacit
ciR
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
❑ Demolition
Al—T14 SA)
Submittal Fee $ Permit Fee $ ` ' • CCF $ 0 . i) CO /CC
Notary $ 5 ,C0 Training/Education Fee $ C). Ci Technology Fee $ C.--D •
Scanning $ 3 @EA Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature L %' �— Signature as P. £c9.,A_
Owner or Agent Contractor
The fore ring instrument was acknowledged before me this 7 The foregoing AI was ackno edged before me this
day of t' a 20 �. , by . �-, ; } ; �� , day of 3 t ' I �y , 20 06 by ,,
who personally Tc�itown to r who has produced who is per ally known to me or who has produced
As identification and who did take an oath. U% as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: A 1
* * * * * * * * * * * * * * * * * * * * * **
My Commission Expires:
USA TRACEY BECKER
Notary Public - State of Florida
lesion # DD 418525
Bonded By National No Ate.
*
* ****** * *** * *** * ****** * *** * * * *** * * * * * * * * * * * * * * * * * * * * * * * *
APPLICATION APPROVED BY:
chc 05/13/03
NOTARY PU
Sign:
Print:
1 ,
My Commis ion Expires:
***************.**** * * * * * * * * * * *- * * * * * * * * * * * * * * * * * **
y 000
Plans Examiner
Engineer
Zoning
1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the q ner.wlth the
required roofing permit, and to explain to the owner the content of this section.! TDe:provisions: of chapter 15 of
the Florida Building Code, Building govern the minimum requirements and starldrit df Le luptry fort oofing
system installations. Additionally, the following items should be addressed as j art Df thJ agreermienlbeMeen the
owner and the contractor. The owner's initial in the adjacent box indicates that the item has been explained.
� 4 V. The workmanship provisions of Chapter 15 (High Velocity Hurricane Zone)
are - for - the purpose of providing that the roofing system meets the wind resistance and water intrusion
performance standards. Aesthetics (appearance) issues are not a consideration with respect to workmanship
provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should
be addressed as part of the agreement between the owner and the contractor.
Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be renailed
a cordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Building
ode. die roof deck is usually concealed prior to removing the existing roof system).
3. Common Roofs: Common roofs are those which have no visible delineation between neighboring
units townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and /or owner
should notify the occupants of adjacent units of roofing work to be performed.
_4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be
ewed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail
penetrations of the underside of the decking may not be acceptable. The Florida Building Code provides the
option of maintaining this appearance.
— 5. Ponding Water: The current roof system and /or deck of the building may not drain well and may
c use - winter to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural
distress and may require the review of a professional structural engineer. Ponding may shorten the life
expectancy and performance of the new roofing system. Ponding conditions may not be evident until the original
roofing system is removed. Ponding conditions should be corrected.
6. Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not
o3 erloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if
overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance
with t onda Building Code, Plumbing.
7.) Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of
the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be
beneficial to consider additional venting which can result in extending the service life of the roof.
SECTION 1524 • • • •
• HIGH VELOCITY HURRICANE ZONES REQUIRED R O OWNERS NbTIFfI TIbNF'bRROOFING: •:
. • ••• •
\ Owner's /Agent's Signature
3D &1F. '00 -
,Property Address
Rev :1 /20 /2005,Computer Services, Building Department
- _ _
Date Contractor's Signature
Permit Number
• •
• •• • • • • ••• • • •• •
• • • • • • . . • • ••. • • •
• • • • • • • • .•.
• •
• ••. • • •
11 A 2 2006
BY: __ 6.,e
2x::7 - L'12
High Velocity Hurricane Zone Uniform Roofing Permit Application Form
NIAIII-D110E COMM' Biiti M emurif®1r t43ECniOrC pPPLrJ►7 • • ' •
. • •
• - • . • • • •
• • ••• •
.. • . •
Section A (General information).* : • • • • •
Master Permit No
1 CQC0 -,t0 -
. ...
• • .. • : : :. . . •
▪ •
.. •
• • ••• • • •
• • •
• • • • • •
Process No.
Job Andress:
.. . • . .. .
......•
• ••••••..
......• •
►ZeoPi k1 INC, 1 3o /c.) jE3 i ' :::..
Roof Category
✓ Low Slope r Mechanically Fastened Tile 'lortadAdhesfve Set Tile
r Asphaftic Shingles r Metal Panel/Shingles r Wood Shingles/Shakes
✓ Presaiplive BUR -RAS 150 r Other I
Low slope roof area (tt.,1
Roof Type /�
I New Roof r Re-Roofing r Recovering ' 1 42wair r Maintenance
Are there Gas Vent Stacks baited an the rod? r Yes r No Byes. what type? r Nlatu a1 r max
Roof System Information
Steep Sloped =ea at.z) i Tablet"
Seca= B (Roof PIS
••
.•
•
•
••
•
•
• •
• •
reser tilaefwecNion all Inds al sedum. l edissu ai� Wafti ems
n sand levels. 11 — dpesateawesa ibrimof��
�t 1 Crer /Ewe{d
Paget
Page 1 of 1
AP 1 / AAL
Additional Information
Issue Date: 4/27/2006 Expires: 10/23/2006
Owner's Name: GARRY AND ELISABETH ROMANICK
Permit Type: Roof
Work Classification: Roof - Repair
Job Address: 30 100 Street NE
Miami Shores Village, FL 33138-
Contractor(s)
DALEY ROOFING INC
Phone
(305)754 -9892
Primary Contractor
Yes
Comments:
REPAIR OR REPLACE APPROX 15 CAPS (ALTUSA)
Type of Work: Repairs Additional Info:
Classification: Residential
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, servants, or
employes. I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING
POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that
all work will be done in compliance with all applicable Taws regulating construction
and zoning. Futhermore, I authorize the above -named contractor to do the work
stated.
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee - Repairs
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$5.00
$100.00
$3.00
$2.50
$111.30
Building Department File Copy
Applicant Signature
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: RF -4 -06 -1072
Phone: 305 - 205 -4538
1132060131230
Lot:
PB:
Total Square Feet: 0
Total Valuation: $ 675.00
Required Inspections
Roof in Progress
Final Roof
Invoice Number
RF - 4 - 06 - 24632
Total:
Amt Due
$111.30
Oltld D 0 AYI4
Amt Paid
Il �,�D
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Li/30/9Y Job Address 3 0 L. t.( dY e_erf - Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant (,(, U) F I -v m v r0 Master Permit # ela S 3 0
Phone
Owner's Address N1 top' mar e� t
Contracting Co. / = .S o r'e°T o
Qualifier u 4 - ' - L t o. L r
state # CG G D o 47514
Architect/Engineer
Municipal #
Bonding Company
Address (o -/114Z33/4 j'
ss# ?/ Phone 9 ''
Competency # Ins. Co.
Address
Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL
OOFING
PAVING FENCE SIGN
WORK DESCRIP'T'ION 7b9 /4—v 7 (a tArtrz 4 W 77 (
C
Square Ft o c9 J Estimated Cost (value) 4. 2 —o il
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. f'
and/or Condo sident
Signature of o
o as to Owner and/or Condo President
My Commission Expires:
FEES: PE
OFFICIAL NOTARY ' EAL
LYNNE BACHLER
NOTARY PUBLIC STATE OF ILORIDA
COMMISSION NO. CC592902
COMMISSION EX - ,; .. 0
CQ o, c 7
APPROVED:
Zoning
Mechanical Plumbing
Building
'/I4/9e
Sign e of Contractor or Owner- ilder Date
Notary as to Contractor or Owner - Builder Date
My Commission Expires:
FF NOTARY
r �
CO ISS PIUEI®
MV COMMISSION 'EXP.
Cc / Y/
F
s.
OF nct
C.C.F. 4-, 2 NOTARY J.Q BOND Co
TOTAL DUE
Electrical
Engineering
Appendix "E"
UNIFORM ROOFING PERMIT APPLICATION
PROCESS No.
Contractor's Name: /Q-ZS ci!"- 7Z?).J
Job Address: 3 O we,
/00 5r
ROOF CATEGORY
❑ (Low Slope Application) ❑ (Nail -On Tile) (Mort Adhesive
❑ (Asphalt/Fiberglass Shingles) ❑ ( Metal Roofs \Wood Shingles & Shakes) ❑ (Other)
ROOF TYPE
❑ New Roof (e roofing ❑ Recovering ❑ Repair ❑ Maintenance
Flat Roof Area (ft Sloped Roof Area (ft2) 2 C? C) Total (ft2)2 Master Permit No.
Exposure category (per ASCE 7 -88): c Building Classification category (per ASCE 7 -88 table,l)::
r -
L
- -1
_;Kyr
Ft.
A
V
Ft.
A
V
Field:
Deck type:
ATTACHMENT
Fastener Type:
SPACING
Perimeter: Corner:
DETAIL 1 & 2
ROOF HEIGHT AND SYSTEM DETAILS
(Draw details as needed)
r
ROOF PLAN
123.01-78 9/96
Page -1
Appendix "E"
UNIFORM ROOFING PERMIT APPLICATION
PROCESS No.
Ridge Ventila ion?
MEAN HEIGHT
Deck type:
Underlayment:
X1 6
Insulation:
12'
ROOF SLOPE
r r/
vi aa(g 6 )( /‘
D E T A I L 3
SLOPED SYSTEM DESCRIPTION
3 0 r //s7-/-t Daa_c
Fastener type & spacing:
Cap Sheet:
Roo
0
e
(2 C4-- ! f( 4 q
//(aJC -v e 9d-t4
o Covering:
- Drip edge:
/etG/U
.3 ;3 n 2G 44, G / r/
c�•2 o 4 -6 C Lei
ATTACHMENTS REQUIRED
1) 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
TILE CALCULATIONS
(Pmax1: 7- 3x ? (Aerodynamic Multiplier): ° 2 ) - M C - 8 0 = M 11 1 2 - PCA: � �+
(Pmax2: / a (Aerodynamic Multiplier): 2 ) - M 6 -49° = M 27 - PCA: 61 "' 6
(Pmax3: 111 x a, (Aerodynamic Multiplier): 9 ) - mg: 6.4'Q= M: 27 `� Z PCA: `- 6 '
Page -2
MET11O DADE
PRODUCT CONTROL NOTICE OF ACCEPTANCE
Monier, Inc.
1900 Northwest 21st Avenue
Fort Lauderdale, Florida 3311 I
Your application for Product Approval of:
Monier Nail - -On, Mortar Set or Adhesive Set "Roll" Roofing Tile
under Chapter 8 of the Metropolitan Dade County Codc governing the use of Alternate Materials and Types of
Construction, and completely described in the plans, specifications and calculations as submitted by:
Redland Technologies, The Center for App lied Engineering, Inc., and Professional Service I
has been recommended for acceptance by the Building Code Compliance Department to be used in Dade County,
Florida under the specific conditions set forth on pages 2 through 17 and the standard conditions set forth on page
18.
The approval shall not be valid after the expiration date stated below. The Building Code Compliance Office
reserves thc right to secure this product or material at any time for a jobsitc ur manufacturers plant 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 applicant shall
re- evaluate this product or material should any amendments to thc South Florida Building Code be enacted affecting
this product or material. The Building Code Compliance Office reserves the right to revoke this approval. if it is
determined by the Building Code Compliance Office that this product or material fails to • 'met the requirements of
the South Florida Building Code. The expense of such testing will be incurry y th m tact er.
Acceptance No.: 95- 0322.03 Revises No. 95- 0301.01
Expires: JUL 1 8 1998
• t a ► 1 . t •
1)
CONDITIONS
IIUILDINC CODE COMMITTEE.
This application for Product Approval has been reviewed by the Metropolitan Dade County Building Codc
Compliance Department and approved by the Building Code Committee to be used in Dade County, Florida under
the conditions set forth above.
Approved: JUL 1 8
Q
' f f : 1
t.; Li LiA
METROPOLITAN DADE COUNTY, FLORIDA
METRO•DADE..FLAGLER BUILDING
taut Rodriguez
I'roduct Control Supervisor
!WILDING CODE COMPUANCE DEPARTMENT
SUITE 1603
METRO -DADE FLAOLER BUILDING
140 WEST FLAGLER STREET
MIAMI, FLORIDA 93190.1509
(305) 375.2001
FAX (305) 375-2V08
Charles Danger, P.E.
Director
Building Code Compliance Dept.
Metropolitan Dadc County
Applicant:
Monier Roof Tile
1900 Northwest 21st Avenue
Fort Lauderdale, FL 33111
PRODUCT CONTROL NOTICE OF ACCEPTANCE -
ROOFING SYSTEM APPROVAL
Category: Prepared Roofing
Sub- Category: Low Profile Tile
TXR� Nail- on/Mortar Set/Adhesive Set
Sub -Tvpe: Concrete
System Description
Monier Roof Tile is a member of the Redland Group, a world wide producer of primary building
products and roof tile. Monier manufacturers concrete.roof tile for Wait-on
mo rt a r set or a d cs __
applications in plants throughout the United States ranging from Washington State to Florida. FloridaAll tile is
manufactured from extruded concrete consisting of Portland Cement, plasticizer, iron and metallic
oxides, and blended aggregates. This Product Contml Approval relates to Monier's "Roll" low tilt:
profile. Refer to appropriate Product Control Approvals for other tile profiles.
Monier sells tile systems through local distribution and directly to consumers. All profiles have
matching trim pieces used for rake hip, ridge hip, and valley terminations. Tile system accessories such
as underlayment, ventilation systems and flashing systems are also available. These accessories are
manufactured for all profiles and form a part of this Product Control Approval.
Monier's "Roll" roof tile has been tested in compliance with the South Florida Building Code
requirements for concrete, nail -on, mortar set and adhesive set tile applications. The minimum roof
slope for Monier's "Roll" nail -on, mortar set or adhesive set tiles shall be 2 ":12 ". See the "Profile
Drawing" section in this Approval for the "Roll" profile drawing. The Monier "Roll" tile profile has
been tested for both wind characteristics and static uplift performance, therefore, any consideration for
installation shall be done as a 'Moment Based System'. Data for attachment calculations is noted in
Tables I through 4 of this Approval.
Contact:
Reese H. Moody
Technical Service Accessories Manager
1900 NW. 21st Avenue
Ft. Lauderdale, FL 33311
(800) 432-2715
Product Control No.: 95- 0322.03
Approval Date: JUL 1 8 1995
Expiration Date: JUL 1 8 1998
Raul Rodrirue'
Trim Pieces
TRADE NAMES OF PRODUCTS MANUFACTURED OR
LABELED BY APPLICANT
Test Product
Product Dimensions Specifications Description
v n
Monier Roll Tile I = 16% :" PA 112 Low profile, interlocking, high
w = 13" pressure extruded concrete roof tile
V2" thick equipped with two nail holes and
double roll ribs. For direct deck or
battened nail -on, mortar or adhesive set
applications.
I = varies
w = varies
varying thickness
3
PA 112
Accessory trim, concrete roof pieces
for use at hips, rakes, ridges and valley
terminations. Manufactured for each
tile profile.
Product Control No.: 95- 0122.03
•
Product
#30 Felt
#43 Coated Base
Sheet
Mineral Surface Cap
Sheet
Lenzingtex -ZB 140 59" x 164' roll
Underlayment 22 lbs/roll
Rainproof 1l
Ice and Water Shield
Mopping Asphalt
Flashing Cement
TRADE NAMES OF PRODUCTS MANUFACTURED OTHERS
Dimensions
N/A
30" x 75' roll
36" x 75' roll
or
60" x 75' roll
36" x 75' roll
N/A
N/A
N/A
N/A
Test
Specifications
ASTM D 226
type II
ASTM D 2626
ASTM D 249
PA 104
PA 104
PA 103
ASTM D 312
type III or IV
ASTM D 4586
4
Mineral surfaced
asphalt roll roofing
for use as a top ply in
a double ply
underlayment system.
Single ply, nail -on
underlayment.
Single ply, nail -on
underlayment with 2"
self - adhering top
edge.
Self - adhering
underlayment for use
as a top ply in a two
ply underlayment
system with
Approved 1130 or #43
as the base layer.
Asphalt for bonding a
mineral surface cap to
a mech. attached base
sheet in a double ply
underlayment system.
Cut back, asphalt
based, asbestos free,
fiber reinforced,
trowel grade cement
for repair and flashing
applications.
Raul Rodriguez
Product Control No.: 95- 0322.03
Product
Description
Saturated organic felt
to be used as a nailed
anchor sheet.
Saturated and coated
organic base sheet for
single or double ply
underlayment.
Manufacturer
generic
generic
generic
Lenzing
Performance, Inc.
with current PCA
Protect -O -Wrap, Inc.
with current PCA
W.R. Grace Co.
with current PCA
generic
generic
Test Product
Product Dimension) Specifications Description Manufacturer .
Asphalt Primer N/A ASTM D 41 Cut back, asphalt generic
based coating used to
facilitate bonding of
dissimilar materials.
Roofing Nails
Tin Caps
Wood Battens
Tile Nails
Tile Screws
Roof Tile Mortar
( "Quikrete® Roof
Tile Mortar #1140")
min. 12 ga. with
3 /," head
min. 32 ga.
min. I o.d.
max. 2" o.d.
horizontal
min. 1" x 4" for use
with vertical battens
or
min. 1" x 2" for use
alone
min. 8d x 2 %2" or
min. 1Od x 3"
#8 x 2 %2" long
0.335" head dia.
0.131" shank dia.
0.175" screw thread
diameter
PA 114
Appendix E
PA 114
Appendix E
PA 114
Appendix E
PA 114
Appendix E
5
aoc
Corrosion resistant,
screw or smooth
shank nails.
Corrosion resistant,
coated, square drive,
galvanized, coarse
thread wood screws
Product Control No.: 95- 0322.03
Annular ring shank,
hot dipped, electro or
mechanically galv.
roofing nails for use
in underlayment
attachment.
Corrosion resistant
circular disc for use in
underlayment
attachment
generic
generic
verttcat - Wood Preservers Salt pressure treated generic
min. 1" x 4" Institute LP - 2 or decay resistant
lumber battens
generic
generic
Roof Tile Mortar N/A PA 123 Prepared mortar mix Bermuda Roof
("TileTiteT"' ") designed for mortar Company, Inc.
set roof tile with current PCA
applications.
N/A PA 123 Prepared mortar mix Quikrete Constructio
designed for mortar Products
set roof tile with current PCA
applications.
Product
Roof Tile Mortar
( "BONSAL® Roof
Tile Mortar Mix ")
Roof Tile Adhesive
( "Polypro® AH160 ")
Hurricane Clip & 0121 PA 114 Corrosion resistant
Fasteners min. %A" width Appendix E bronze, aluminum,
min. 0.060" thick stainless steel,
galvanized steel or
Clip Fasteners plastic attachment
min. 8d x 1V4" clips for supplemental
tile attachment. Clips
arc installed with
corrosion resistant
roofing nails
compatible with the
clip. A hurricane clip
is required on all
nail -on eave tiles.
Valley Flashing
Drip Edge
Test Product _
Dimensions Specifications - .----
D s Descriptiop Manufacturer
N/A PA 123 Prepared mortar mix W.R. Bonsai Co.
N/A
See PCA Two component Polyfoam Products,
polyurethane adhesive Inc.
designed for adhesive with current PCA
set roof tile
applications.
min. 26 ga. ASTM A 525 Galvanized steel generic
min. 16" width valley flashing
min. 26 ga. PA 1 1 1 Galvanized steel drip generic
min. 2" face flange edge
min. 2" deck flange
6
Raul Rodriguez
Product Control No.: 95- 0322.03
designed for mortar with current PCA
set roof tile
applications.
generic
•
Test Agency
Redland Technologies
Redland Technologies
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.
The Center for Applied
Engineering, Inc.
The Center for Applied
Engineering, Inc.
The Center for Applied
Engineering, Inc.
Test Identifier
7161 -03
Appendix III
7161 -03
Appendix III
94 -084
94 -060B
25- 7094 -1
25- 7094 -7
25- 7094 -4
25- 7183 -1
25- 7183 -2
25- 7214 -2
TEST REPORTS
7
Raul Rodriguez
Test Name/Report
Static Uplift Testing
PA 102
Static Uplift Testing
PA 102(A)
Static Uplift Testing
PA 101
(Mortar Set)
Static Uplift Testing
PA 101
(Adhesive Set)
Static Uplift Testing
PA 102
(4" Headlap, Nails, Direct
Deck, New Construction)
Static Uplift Testing
PA 102
(4" Headlap, Nails, Battens)
Static Uplift Testing
PA 102
(4" Headlap, Nails, Direct
Deck, Recover/Reroof)
Static Uplift Testing
PA 102
(2 Quik -Drive Screws, Direct
Deck)
Static Uplift Testing
PA 102
(2 Quik -Drive Screws,
Battens)
Static Uplift Testing
PA 102
(1 Quik -Drive Screw, Direct
Deck)
Product Control No.: 95- 0322.03
Pats
Dec. 1991
Dec. 1991
May 1994
March, 1994
Oct. 1994
Oct. 1994
Oct. 1994
Feb. 1995
Feb. 1995
March, 1995
�i,
Test Agency
The Center for Applied
Engineering, Inc.
Redland Technologies
Redland Technologies
Redland Technologies
Redland Technologies
The Center for Applied
Engineering, Inc.
Professional Service
Industries, Inc.
Test Identifier
25- 7214 -6
7161 -03
Appendix II
Letter Dated Aug. 1, 1994
P0631 -0I
Pun,
Project No. 307025
Test #MDC -76
224 -47099
8
Raul Rodriguez
Test Name/Report = -
Static Uplift Testing
PA 102
(1 Quik -Drive Screw,
Battens)
Wind Tunnel Testing
PA 108
(Nail -On)
Wind Tunnel Testing
PA 108
(Nail -On)
Wind Tunnel Testing
PA 108
(Mortar Set)
W ithdrw:.l Resistance
Testing of screw vs. smooth
shank nails
Wind Driven Ram Oct. 1994
PA 100
Sept. 1994
Physical Properties
PA 112
Product Control No.: 95- 0322.03
Aug. 1994
July 1994
Scpi. 1993
pats
March, 1995
Dec. 1991
Deck Type:
Deck Description:
SYSTEM A:
Slope Range:
Underlayment:
Vertical Battens:
Roofing Tile:
Comments:
Wood, Non - insulated
New Construction
19 /1 2 " or greater plywood or wood plank.
Counter -Batten Application
SYSTEMS
Product Control No.: 95-032103
2 ":12" to 7 " :12"
Note: Counter - Battens, as noted below, are required for slope range
2 ":12" to less than 4 ":12" and are optional for slopes of 4 ":12" to
7 " :12 ". For slopes exceeding 7":12", refer to System C.
Install underlayment system in compliance with Dade County Application
Standard PA 118.
Install vertical battens in compliance with Dade County Application Standard
PA 118
Horizontal Battens: Install horizontal battens in compliance with Dade County Application
Standard PA 118.
Install tile in compliance with Dade County Application Standard PA 118.
(See "Data for Attachment Calculations" included in this Approval.)
1. For re -roof applications, "/ plywood is an acceptable substrate.
9 //711j1/21
Raul Rodriguez
SYSTEMS
(CONTINUED)
Deck Type: Wood, Non - insulated
Deck Description: New construction 19 4 2 " or greater plywood or wood plank.
SYSTEM B: Direct Deck Application
Slope Range: 4 ":12" to 7 ":12"
Note: System B is only acceptable in this slope range. For slopes Tess than
4 " :12 ", refer to System A. For slopes in excess of 7 " :12 ", refer to
System C.
Underlayment:
Roofing Tile:
Comments:
Install underlayment system in compliance with Dade County Application
Standard PA 118.
Install tile in compliance with Dade_ County Application Sta d PA 118:
(See "Data for Attachment Calculations" included in this Approval.)
1. For re -roof applications, " /,:" plywood is an acceptable substrate.
10
Raul Rodriguez
Product Control No.: 95- 0322.03
SYSTEMS
(CONTINUED)
Deck Type: Wood, Non - insulated
Deck Description: New construction 19 4 2 " or greater plywood or wood plank.
SYSTEM C: Horizontal Batten Application
Slope Range: 4 ":12" or greater
Note: Horizontal battens, as noted below, are required for slopes in excess
of 7 " :12" and are optional for slopes of 4 ":12" to 7 " :12 ". For slopes
less than 4 ":12 ", refer to System A.
Underlayment: Install underlayment system in compliance with Dade County Application
Standard PA 119.
Horizontal Battens: Install hnrizontal ilanpnc in
Standard PA 119.
Roofing Tile:
` .... Comments: 1. For re -roof applications, "4 plywood is an acceptable substrate.
rrn1ia
• r•
Raul Rodriguez
Product Control No.: 95- 0322_03
1. r1.4.
n 1 11 L/auc
Luu� Appiication
Install tile in compliance with Dade County Application Standard PA 119.
(See "Data for Attachment Calculations" included in this Approval.)
•
•
4.
SYSTEMS
(CONTINUED)
Product Control No.: 95 0322
Deck Type: Wood, Non - insulated
Deck Description: New construction 19 4 . " or greater plywood or wood plank.
SYSTEM D: Mortar or Adhesive Set Application
Slope Range: 2 ":12" to 7 ":12"
Note: System D is only acceptable in this slope range. For slopes in excess
of 7 ":12 ", refer to System C.
Underlayment:
Roofing Tile:
Comments:
Install underlayment system in compliance with Dade County Application
Standard PA 120. (See System Limitation #5.)
Install tile in compliance with Dade County Application Standard PA 120.
(See "Data for Attachment Calculations" included in rhic Approval.)
1. For re -roof applications, ls ' 32 " plywood is an acceptable substrate.
12
Raul Rodriguez
SYSTEM LIMITATIONS
Product Control No.: 95- 0322.03
1. The standard minimum roof pitch for Monier's "Roll Tile ", low profile tile shall comply with Dade
County Application Standards PA 118, PA 119 or PA 120, depending on the method of installation.
2. For nail -on applications, fasteners for mechanical attachment of tiles shall have a head diameter
larger than that of the preformed holes in the tile.
3. System installation shall be in compliance with the system specifications outlined in this Product
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 Monier "Roll Tile" tile profile has
been tested for both wind characteristics and static uplift performance, therefore, attachment
calculations for installation in compliance with PA 115 or PA 127 shall be done as a 'Moment
Based System'.
4. For_mortar or adhesive set tile applications, a field static uplift test by a Dade County accredited
testing agency, in compliance with Dade County Protocol PA 106, shall be performed.
5. For mortar set tile applications, 30/90 hot mopped underlayment applications may be installed
perpendicular to the roof pitch unless stated otherwise by the underlayment material manufacturer's
published literature.
6 All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo for
identification in the field.
7. Applications for roofing permits shall include a completed Section 11 of the Uniform Building
Permit, a copy of Monier's current specifications and details, a copy of this Product Control
Approval and a copy of the Product Control Approval of any Roofing Component used in the
proposed tile application. Reference shall be made to appropriate data for the required fire rating.
8. The applicant shall retain the services of a Dade County certified testing laboratory to maintain
quality control in compliance with the South Florida Building Code and related protocols. Samples
taken shall be in compliance with Dade County Protocol PA 112, Appendix 'A'.
9. Any amendments to these provisions shall be in compliance with Sections 203 and 204 of the South
Florida Building Code.
13
Raul Rodriguez
Tile
Profile
Monier Roll Tile
Tile
Profile
Monier Roll
Tile
Tile
Profile
Monier Roll
Tile
Tile
Application
5.92 6.80
3 ":12" 4 ":12"
Battens I Direct Battens
Deck
Battens
Direct Deck
i
Approved
Nails
1 nail 2 nails
4.10 7.10
11.80 21.90
DATA FOR ATTACHMENT
CALCULATIONS
Table 1: Aerodynamic Multipliers - 1M s )
5.82 6.69
X (ft)
Batten Application
0.27
Table 2: Restoring Moments due to Gravity - M (ft-Ibf)
Direct
Deck
Table 3: Attachment Resistance Expressed as a Moment - M, (ft -Ibf)
for Nail -On Systems'
Data noted in Table 3 is for installation with a 3' tile headlap.
2 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.
5 ":12" 6 ":12"
Battens I Direct Battens I Direct
Deck Deck
5.70 6.55
Approved
Screws
1 screw 2 screws
22.90 49.10
25.80 47.10
Rau! Rodriguez
i
Product Control No.: 95 - 0323.03
Approved
Field Clip With:
1 nail 2 nails
24.20 34.80
24.30 35.50
X (ft)
Direct Deck Application
0.29
5.56 5.39
7 ":12" or
greater
Ra■t_pnc flirurf
Deck
5.41 6.22
Approved
Eave Clip With:
1 nail 2 nails
22.10 32.20
19.00 31.90
•
Monier Roll Tile
Table 3 -A: Attachment Resistance Expressed as a Moment - Mr (ft-Ibf)
for Nail -On Systems
Tile
Profile
DATA FOR ATTACHMENT
CALCULATIONS (CONTINUED)
Tile
Application
Direct Deck
New Construction
(min. "I, plywood)
Direct Deck
Recover/Reroof
(min. "4 plywood)
Battens
New Construction
Raul Rodriguez
Product Control No.: 95- 0322.03
Two (2) 10d x 3" long nails'
67.50
43.00
50.90
Tile installation with a 4' headlap using two (2) Approved 10d x 3' long polymer coated.
corrosion resistant. ring shank nails installed in manufactured holes located 2W from
the head of the tile. Clips on eave tile are not required inr this attarhmonr cnnfi a
unless the Required Moment of Resistance exceeds the values noted above.
Monier Roll Tile
Table 4: Attachment Resistance Expressed as a Moment - Mr (ft -Ibf)
for Mortar or Adhesive Set Systems
Tile
Profile
Tile
Application
Attachment
Resistance
Mortar Set
i
20.60
Adhesive Set
86.61
MONIER ROOF RE
PROFILE DRAWINGS _
2 .3 -
MONIER ROLL TILE
Product Control No.: 95- 01/2.03
0.07
0.1r
PROFILE DRAWINGS
(CONTINUED)
21 ore
2.43'
Raul Rodrieue,
1.71r
0.131'
APPROVED SCREW FOR SCREW DATA IN TABLE 3
Product Control No.: 95-0322.03
\ ** * ***** * 0
0 34 0.13' 0 173
-4 6-0.03'
0.11'
17 /7411/7
This approval supersedes all previous approvals.
NOTICE OF ACCEPTANCE: STANDARD CONDITIONS
18
ul Rodriguez
Product Control Supervisor
l • Extensions of Acceptance may be considered after a new application has been filed and the supporting
data, test reports no older than ten (10) years, have been re- evaluated.
All reports of re- testing shall bear the seal, signature and date of an engineer registered in the State of
Florida.
Any revision or change in the materials, use, or manufacture of the product or process shall automatically
be cause for termination, unless prior approval is granted for revisions or change.
3. Any unsatisfactory performance of this product or process or a change in Code provisions shall be grounds
for re- evaluation.
4. This acceptance shall not he used as an endor o f any produ e__ __
�• any r�.,.,�.,► ►�� �aic3 or advertising purposes.
5. The Notice of Acceptance number preceded by the words Dade County, Florida, and followed by the
expiration date may oe displayed in advertising literature. If any portion of the Notice of Acceptance is
displayed, then it shall be done in its entirety.
6. Product approval drawings, where required for permit applications, shall be provided to the applicant by
the manufacturer or his distributors unless otherwise noted in the Notice of Acceptance. The prints need
not be re- sealed by an engineer.
7. Failure to comply with the Standard Conditions shall be cause for termination of the Approval.
o-`
LG ENGINEERING SERVICES, INC.
Consulting Engineers
North Office:
7370 N.W. 36'" Street
Suite 374
Miami, Florida 33166
Tel: (305) 994 -8128 Fax: (305) 994 -8135
M. 1. S. Corporation
10221 Southwest 16t Drive
Miami, Florida 33174
Project:
Dear Sirs;
South Office:
13380 S.W. 131 Street
Suite 120
Miami, Florida 33186
TILE_U_ELI1T TEST
Saltburg Residence
30 Northeast 100 Street
Miami Shores, Florida
Information provided by client:
Permit Number: 42830
Date Completion: November 24, 1998
Roofing Contractor: M. I. S. Corporation
LG Engineering Services, Inc. Project Number: LG98 - 1216
(Testing Laboratory Certification # 95- 0607.05)
E•N•G •I•N•E•E•R
November 30, 1998
In accordance with your request and authorization, a representative of LG Engineering Services,
Inc. completed the Roof Tile Uplift Test at the above referenced project. This testing was
performed in general accordance with Protocol PA 106 -94 -- Field static uplift test for mortar or
adhesive set tile systems and mechanically attached, rigid, discontinuous roof systems.
The total of the tested roof surface area was less than 5000 square feet, and the mean height of
the roof is less than 15 feet above ground surface. The type of tile used for this project was
reported to be Altusa Roof Tile. This tile was reported to have been foamed in place.
At the time of this testing, a total of forty -five (45) tests were conducted; ten (10) at the roof
perimeter and ten (10) at the roof corner and twenty -five (25) in the field area. More than 5%
of the roof tile located in the field area and more than 10% of the roof tile at the roof perimeter
were physically examined.
Based on our test> results, we conclude thatthe installation of the roof the at the above referenced
project meets the test requirement outlined in the above mentioned protocol Attached pleas find
a copy of c ur test report for you review
LG Engineering Services, Inc. appreciates the opportunity of assisting you in this project. If you
have any questions or if we may be of further assistance, please do not hesitate to contact the
undersigned.
Respectfully submitted;
LG Engineering Services, Inc.
ohamai Sonny Salieh, F.E.
Project Manager'" -'
TILE_ JPLIFT TEST
Saltburg Residence
30 Northeast 100 Street
Miami Shores, Florida
Report of
TILE UPLIFT TEST
for
Saltburg Residence
30 Northeast 100 Street
Miami Shores, Florida
Permit Number: 42830
Test NumI)er
1C
2C
3C
4C
5C
6C
7C
8C
9C
10C
11P
12P
13P
14P
15P
16P
17P
18P
19P
20P
21F
22F
23F
Test Load (lbf)
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
Test Status
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
LG Engineering Services, Inc. -- Tile Uplift Test Result -- Permit Number: 42830, Page 1
24F
25F
26F
27F
28F
29F
30F
31F
32F
33F
34F
35F
36F
37F
38F
39F
40F
41F
42F
43F
44F
45F
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
35
est >Status
...................
.....................
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Note:-
C = Corner
P = Perimeter
F = Field area
LG Engineering Services, Inc. -- Tile Uplift Test Result -- Pennit Number: 42830, Page 2
North
-74
4 �'
Approximate Test Location
LG Engineering Services, Inc. -- Tile Uplift Test Result -- Permit Number: 42830, Page 3
Date
Legal Description •C.O1L ! /. , 02 Q
Owner / Lessee / Tenant YiT). R.. ,
Owner's Address 30 roc? )DO-. L - Phone 754- 4796
Contracting Co.t,7 Pi £ocgi J � I S T ei� 5 7: AI Address t'n"// , Lf/llr ✓�/[St� t12 S u+ 3 l (
Qualified✓ t Nti - Phone30✓ = '7 C- 1 3
State 'PO Municipal # Competency # Ins.Co.
CCCd30 a
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFIN PAVING PENCE SIGN
WORK DESCRIPTION R,P,FAIR -/ 1I I' 2.o 0- 1 P - �G�ItQ/tQ� g,e / ACe fI OxIpUAt -eb
! 5c) F /, -I- 4.J L'& P e , -h (e_ s AN) ol 1 04 ;k7(- / vf - E xoo
Square Ft. c2300 Estimated Cost(value) O O k a-
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 zoni:g. Furthermore, I
authorize t.. :•ove- awed contractor to do the work stat -d.
Signature
Date: i/f rg'
tary as to Owner and
Commission Expires:
** *
APPROVED:
*
9.�
FEES: PERMIT ! d
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address, 30 L). /00 Tax Folio // a a
owner a J or Co
to gyiriolut
Pr sident
N .� N .
f�•'" : JOSEPHINE CHURCH
N
pu faigih tate of Florida
y COmmissIon Exp. April 30. 1
or. �o°'. No. CC197545
Fire
Zoning Buildin
Mechanical Plumbing
Master Permit its-
Signa
Date: //
r tar as to Cont
y Commission Ex;
* * *
f Contractor or Owner- Builder
1
••
`° gA JOSEPHINE CHURCH
Ito fi i f ate founds
0 „1o.1
No. CC197545
RADON C.C.F. l , s(- 3 NOTARY j TOTAL DUE '
Other
Electrical
Engineering
ov f11 c Aok lEoP
e 1 ,„„ u - 64 120 c)--P IA) , 0 1,ac(C 6 eepiAce.01
dmm.,4 04c,16). c r,e 36 11
V� N �` C e �li� G Z/� e 1 l�$ Its l� !� pi l 1 CiQ� S ,
A Pp frtod: yoNY iike tAA(>9'ffl
14 ( itki Ake , A 74) - 4e-
A
14J1 �3 �� s �
f p, e .fitc s.51,t d000d
/A A r, 14 - 1 - --e //0 b2�jCP� a rm
r fA i �d I dl/1 YV1 E 1 1
II+ /19 ce 71c\S k 120 of � � , IA:
Qo
MEfLOs F
9 MIAMI SHORES VILLAGE
M 5 " QUILDING INSPECTION DEPARTMENT
H 3yeG 13 1,Ve 3 APPLICATION FOR BUILDING PERMIT
Application is hereby wade for the approval of the detailed statement ut roe 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 01 the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the iuilding 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 1111984 _
Owner's Name and Address Richard DuBose No 12580 Street Griffin9 Blvd.
Registered Architect and /or Engineer l - ,••• „••.•,,.,,,.•..,•.•,,
Name and address of licensed contractor Bama Const.Co.651 N.W.106 Street,Mia.F1.33150
Location and legal description of lot to be built on:
Lot Block Subdivision ....._ _...._....._._..........._
Street and Number where work is to be done 30 N.E.100 Street
State work to be done and purpose of building (by floors) reroofing. _
Replace barr tile with Gory flat gharcoal Grey cement tile.
_.._. and for no other purpose.
Ncw Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering 22 squares. •• _ •• __
Estimate S. Total cost of improvements $ 5 s 000.00 Amount of Permit s 20.00
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.. 651 N.W.106 Street,Mia.F1.33150
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of Libor under the Florida Workmen's Compensation Act, being Section 59G6, Compiled General Laws of Florida, Permanent Supplement,
anti has complied «ith 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 w.rk to be performed under this
permit, as are licensed by Miami Shores Village.
Rem.uks (Signed)
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, s that all facts
therein by him stated a;e true.
Permit No.. Date ........._._ Read, Sworn to and Subscribed before me.
Disapproved , e Date
Notary Public, State of Florida
(Signed)
Building Inspector
My Commission Expires r _•. —.
PLANNING BOARD DATE
Chairman Mcmhcr
Member hi ember _.. , ,
Member .. .. Member
Council Approved Date Disapproved Date
NOTE: A ch,rrge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the PLrnnir,;; fo.trd.
A re.in ution fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection oe faulty
materials and /or workmanship.