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ROOFINGDate Legal Description ix.elfd Th radon Owner's Address (. / ,2. lA E 101 �2 / Contracting Co. Qualifier State # Architect/Engineer Bonding Company Y _ Mortgagor / Tenant Job Address 0 &na ctriv 3." • Obeno itHo Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL VING FENCE SIGN 120 sg. /90° 5 4f O WORK DESCRIPTION — 1 e O r F 1 t l l. (200F. )1 ioc .r 1 — 30 M o c 1 — ' 1 o �fi A i4thAct a.d ittstot ��l (CI'Oie T4 c Estimated Cost (value) 4 •=1, (n es. °" • Square Ft. WARNING TO OWNER: Y OU MU RD 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 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. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that - work will be done in .. % lance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named cos a • or to d• e wo /• . Signature of owner if d/or Condo Pres 1 n Notary as to Owner and/or Condo President D to My Commi Expires: 0 rill. SANDRA D. HART At �n L e+COMMISSION # CC623733 ^` EXPIRES MAR 12, 2001 . BONDED THROUGH � 4. .1 7 ATLANIIC BONDING CO., INC. FEES: PERMIT 6e- RADON C.C.F. c_ PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 310k Air Municipal # ate Mechanical Plumbing Tax Folio ,1 — p( —0 /3 — 5 2-D Historically Designated: Yes No 1 ,7 Phone Addresse c . , C(��n , ct f . Qi7& F SS# Phone 3/3 Competency # r Ins. Co. Uei,SZ- r ` atz Address Address Address Master Permit # 9 y3 at 5X(Zt-1 t/? Notary as to Contractor or Owner - Builder D t My Commi ifA Expires: dk . kt SANDRA D. HART �� c+COMMISSION # CC623733 ^` N. EXPIRES MAR 12, 2001 BONDED THROUGH z!�pF . ATLANTIC BONDIN9 Co gnature of Contractor or Owner - Builder 10 . OD NOTARY Electrical BOND 3 6 a' ® e7 TOTAL DUE Engineering STATE OF FLORIDA, COUNTY OF DADE I HEREBY CtRTIFY that 'this is a 9rue copy of t o in this offico on A D 19 0 1. L. , W NESS my HA.tVE RU By PERMIT N0. Surety's name and address Bond Number and Of�idal Seal. LER11, •' circuit andCounty PBZ 1/2/91 ,STATE OF FLORIDA ) COUNTY OF DADE ) THE UNDERSIGNED hereby gives notice that improvements will be made to the real property located at 3J ? N E /(),( S in the City of Miami, Florida, and in accordance with Chapter 713 of Florida Statutes, the following informatidn'is provided: Legal description of property:, Lot(s) Block of General description of improvements �.� ) ';\ • \CITY OF MIAMI PWINING „ BUILDING 1 ZONING. DEPARTMENT rdTl E OFdCEMEIII ` •r C1 F and address, if Owne itle Holder's nacre (� ferent from job address t /n- Contractor's name Attie-CIA and address 3.ti r fr Or_ _C t Lender's name / and address Person within the State of Florida, designated by Owner to receive service of notices or other documents as provided by Section 713.13(1)(a)7 of Florida Statutes: Name address Person, in addition to owner, designs ed )O receive a copy of Lienor's Notice as provided in Section 713.13(1)(b) of Florida Statutes: Name address Sf/D reel My PCB SANDRA' ART commission expires: : o� e1, G�OMMISSION B CC 623 733 y p ? ( ." �1 EXPIRES MAR 12.2001 • 6 . C 4 BOND®THRO 4� A pr AT.ANTIC BONDING CO.. INC. FOLIO N0. 98R242699 1998 MAY 21 11:46 Expiration date (Signature of Own Notary Public —oto —D0— 53,2o Unless a different date is specified, the expiration date of this Notice of Commencement shall be one (1) year from. date of recording. .004A Q C . f1-Ri i- PAY (Print Owner's name) t v�/1 8 Sworn to and subscribed before me on this s day of I I �Q.(-t ,19 obi 50N St Contractor's Name: Ft. Ft. Fastener Type: Field: DETAIL 1 & 2 *Includes Mortar and Adhesive Set Tile Supplement No. 3 bawl i ATTACHMENT 5103 APPENDIX E SPACING Perimeter: Corner: 5101 - 7 SOUTH FLORIDA BUILDING CODE (REVISED 19941 Job Address: 1 41 31a NE 101 ROOF CATEGORY ❑ (Low Slope Application) ❑ (Nail -On Tile) (Mortar -Set Tile) * ❑ (Asphalt/Fiberglass Shingles) ❑ ( Metal Roofs \Wood Shingles & Shakes) ❑ (Other) ROOF TYPE ❑ New Roof 15 roofing ❑ Recovering ❑ Repair ❑ Maintenance Flat Roof Area (ft') Sloped Roof Area (ft') 1 Lj S Total (ft) I 9I5 Master Permit No. Exposure category (per ASCE 7.88): Q ' Building Classit£ation category (per AS E 7 -88 table 1): ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed) ROOF PLAN Ridge ventilation? Deck type: MEAN HEIGHT' 1 wart p) AN k. Underlayment: AerM 4 f - Insulation: tt^ ROOF SLOPE DETAIL 3 (Pmax3: I X X (Aerodynamic Multiplier): • 31 SLOPED SYSTEM DESCRIPTION N l A Fastener type & spacing: rin95hANk £1 fTPI S Go.L. 1975 goo Cap Sheet: ASTM 4 90 Roof Covering: pi -11.15,9 SPA'^' sh S Drip edge: 2 p4 1 . f.v` TILE CALCULATIONS (Pmaxl:1 x X (Aerodynamic Multiplier): • 3( ) - M = M 1'1 PCA: 66•4" o I (Pmax2:'21. x X (Aerodynamic Multiplier): • 31 ) - M : M 02. � PCA: GG.1 ) - M VC= M PCA: 0411E5111e 5E_ p `f ATTACHMENTS REQUIRED I) Fire Directory Listing Page 2) Dade County Product Control Notice of Acceptance -Cover Sheet a) Specific System Description b) Specific System Limitation c) General Limitations d) Applicable Detail Drawings 3) Municipal Permit Application 4) Other Component Approvals Supplement No. 3 5101 -8 SOUTH FLORIDA BUILDING CODE (REVISED 19941 5 12'0.4 -Ct1C METRO-DADE PRODUCT CONTROL NOTICE OF ACCEPTANCE Altusa Tile, Almar (USA), Inc. 6645 Northwest 77th Avenue Miami, FL 33166 Your application for Product Approval of Altusa Tile Nail - On, Mortar Set or Adhesive Set One Piece "S" Tile Roofing Tile under Chapter 8 of the Metropolitan Dade County Code governing the use of Alternate Materials and Types of Construction, and completely described in the plans, specifications and calculations as submitted by: Redland Technologies, The Center for Applied Engineering, Inc. has been recommended for acceptance by the Building Code Compliance Office to be used in Dade County, Florida under the specific conditions set forth on pages 2 -16 and the standard conditions on page 17. This approval shall not be valid after the expiration date stated below. The Building Code Compliance Office reserves the right to secure this product or material at any time from a jobsite or manufacturer's 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 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 meet the requirements of the S. th Florida Building Code. The expense of sucli.testing will be incurred by the manufacturer. ACCEPTANCE NO.: 96 1030.03 Renews 94 0914.0 EXPIRES: 02/13/00 APPROVED:02 /13/97 METROPOLITAN DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE SUITE 1603 METRO DADE FLAGLER BUILDING 140 WEST FLAGLER STREET MIAMI, FLORIDA 33130 -1563 (305) 375-2901 FAX (305} 375 -2908 INTERNET: mdcc0l @shadow.net PRODUCT CONTROL SECTION (305) 375 -2902 FAX (305) 372 -6339 Raul Rodriguez Product Control Division Supervisor THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS BUILDING CODE COMMITTEE This application for Product Approval has been reviewed by the Metropolitan Dade County B ding Code Compliance Office and approved by the Building Code Committee to be use. in / de County, F under the conditions set forth above. Charles Danger, P.E. Director Building Code Compliance Dept. Metropolitan Dade County Applicant: Altusa Tile Alfareria del Turbio, S.A. Barquisimeto, Venezuela PRODUCT CONTROL NOTICE OF ACCEPTANCE ROOFING SYSTEM APPROVAL Category: Prepared Roofing ;Sub-Category: Tile Tvpe: Nail -on /Mortar SetiAdhesive Set Sub -Tvpe: Clay • System Description Alfareria del Turbio, S.A. (Altusa), located in Barquisimeto, Venezuela, manufacturers clay roof tile for nail -on, mortar set or adhesive set applications. All tile is manufactured from natural Venezuelan clays. This Product Control Approval relates to Altusa's "Altusa S" tile profile. Refer to appropriate Product Control Approvals for other tile profiles. The "Altusa S" tile profile is available in a variety of natural clay colors and has matching trim pieces used for rake hip, ridge hip, and valley terminations. These accessories are manufactured for all profiles and form a part of this Product Control Approval. Optional rubber or clay eave closures are also available. Altusa roof have been tested in compliance with the South Florida Building Code requirements for clay, nail -on, mortar set or adhesive set tile applications. The minimum roof slope for the "Altusa S" nail -on tiles shall be 2 ":12 ". See the "Profile Drawing" section in this approval for the "Altusa S" profile drawing. The "Altusa S" 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. Almar (USA), Inc., located in Miami, Florida, is the sole approved importer under contract for selling and distributing Altusa products in the South Florida jurisdiction. Contact: Carlos J. Fernandez General Manager Altusa Tile, Almar (USA), Inc. 6645 Northwest 77th Avenue Miami, FL 33166 (305) 471 -5830 Product Control No.: 96 1030.03 Product Control No.: 96- 1030.03 Approval Date: February 13, 1997 Expiration Date: February 13, 2000 Frank Zuloaga Plans Examine:, Product'Control Division #43 Coated Base Sheet Mineral Surface Cap Sheet Lenzingtex -ZB 140 Underlayment Rainproof 11 Ice and Water Shield Flashing Cement TRADE NAMES OF PRODUCTS MANUFACTURED OTHERS Test Product Product Dimensions Specifications Description Manufacturer #30 Felt N/A ASTM D 226 Saturated organic felt generic type II to be used as a nailed anchor sheet. N/A ASTM D 2626 Saturated and coated generic organic base sheet for single or double ply underlayment. N/A ASTM D 249 Mineral surfaced asphalt roll roofing for use as a top ply in a double ply underlayment system. 59" x 164' roll PA 104 Single ply, nail -on Lenzing 22 lbs/roll underlayment. Performance, Inc. with current PCA 30" x 75' roll PA 104 Single ply, nail -on Protect -O -Wrap, Inc. 36" x 75' roll underlayment with 2" with current PCA or self - adhering top 60" x 75' roll edge. 36" x 75' roll PA 103 Self- adhering W.R. Grace Co. underlayment for use with current PCA as a top ply in a two ply underlayment system with Approved #30 or #43 as the base layer. Mopping Asphalt N/A ASTM D 312 Asphalt for bonding a generic type III or IV mineral surface cap to a mech. attached base sheet in a double ply underlayment system. N/A ASTM D 4586 Cut back, asphalt based, asbestos free, fiber reinforced, trowel grade cement for repair and flashing applications. Product Control No.: 96- 1030.03 Frank Zuloaga Plans Examiner, Product Cor,trol Division generic generic Test Product Product Dimensions Specifications Description Manufacturer Asphalt Primer N/A ASTM D 4 I Cut back, asphalt generic based coating used to facilitate bonding of dissimilar materials. Roofing Nails Tin Caps Wood Battens Roof Tile Mortar ( "TileTiteT" ") min. 12 ga. with V /," head min. 32 ga. min. 1' /," o.d. max. 2" o.d. horizontal min. I" x 4" for use with vertical battens or min. 1 "x2 "for use alone PA 114 Appendix E PA 114 Appendix E 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 Hurricane Clip & Clips PA 114 Corrosion resistant Fasteners min. Y" width Appendix E bronze, aluminum, min. 0.062" thick stainless steel, • galvanized steel or Clip Fasteners plastic attachment min. 8d x 1'/4" clips for supplemental tile attachment. Clips are installed with corrosion resistant roofing nails compatible with the clip. A hurricane clip is required on all nail -on eave tiles. Product Control No.: 96- 1030.03 vertical Wood Preservers Salt pressure treated _ generic min. 1" x 4" Institute LP - 2 or decay resistant lumber battens N/A PA 123 Prepared mortar mix Bermuda Roof designed for mortar Company, Inc. set roof tile with current PCA applications. Frank Zuloaga Plans Examiner, Product Control Division generic generic generic Product Roof Tile Mortar ( "Quikrete® Roof Tile Mortar #1140") Roof Tile Adhesive ( "Polypro® AH 160 ") Valley Flashing Drip Edge Dimensions N/A N/A min. 26 ga. min. 16" width min. 26 ga. min. 2" face flange min. 2" deck flange Test Product Specifications Description PA 123 Prepared mortar mix designed for mortar set roof tile applications. See PCA ASTM A 525 PA 1 1 1 Two component polyurethane adhesive designed for adhesive set roof tile applications. Galvanized steel valley flashing Galvanized steel drip edge Product Control No.: 96- 1030.03 Frank Zuloaga Plans Examiner, Product Control Division Manufacturer Quikrete Construction Products with current PCA Polyfoam Products, Inc. with current PCA generic generic Test Agencv Testwell Craig Laboratories & Consultants, Inc. Redland Technologies Redland Technologies Redland Technologies Redland Technologies 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. Test Identifier Lab. t4AAP -2 7161 -03 Appendix 111 • 7161 -03 Appendix III 94 -83 94 -0S4 25- 7200 -1 Project No. 307025 Test 14MDC -78 TEST REPORTS 7161 -03 Appendix 11 Test Name/Report ASTM 1 167 Static Uplift Testing PA 102 Wind Tunnel Testing PA 108 (Nail -On) Wind Tunnel Testing PA 108 (Nail -On) Letter Dated Aug. 1, 1994 P0631 -01 Wind Tunnel Testing PA 108 (Mortar Set) PO402 Withdrawal Resistance Testing of screw vs. smooth shank nails Static Uplift Testing PA IO2(A) Static Uplift Testing PA 101 (Adhesive Set) Static Uplift Testing PA 101 (Mortar Set) Static Uplift Testing PA 102 (Quick -Drive Screws, Battens) Wind Driven Rain PA 100 Frank Zuloaga Plans Examiner, Produc; Control Division Product Control No.: 96- 1030.03 Date Oct. 1994 Dec. 1991 Dec. 1991 Aug. 1994 July 1994 Sept. 1993 Dec. 1991 April 1994 May 1994 Feb. 1995 Oct. 1994 SYSTEMS (CONTINUED) Deck Type: Wood, Non - insulated Deck Description: New construction 19 / 31 " or greater plywood or wood plank. SYSTEM D: Mortar or Adhesive Set Application Underlayment: Roofing Tile: Comments: 4 Product Control No.: 96- 1030.03 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. 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 this Approval.) 1. For re -roof applications, 13 / 32 " plywood is an acceptable substrate. Frank Zuloaga Plans Examiner, Product Control Division Table 3: Attachment Resistance Expressed as a Moment - M (ft-Ibf) from PA 102 and PA 102(A) Testing Tile Profile TILE APPLICATION APPROVED NAILS APPROVED' SCREWS APPROVED FIELD CLIP WITH: APPROVED EAVES CLIP WITH: 1 nail 2 nails 1 screw 2 screws 1 nail 12 nails 1 nail 2 nails Altusa 'S' Tile Battens N/A N/A N/A 26.80 N/A I N/A N/A N/A Direct Deck 6.20 8.40 28.70 58.20 21.20 I 25.30 26.90 34.90 Table 2: Restoring Moments due to Gravity - M (ft-Ibf) from PA 102 Testing Tile Profile 3 ":12" or less 4 ":12" 5 ":12" 6 ":12" 7 ":12" or greater Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Altusa 'S' Tile 4.47 5.35 4.40 5.27 4.31 5.16 4.20 5.03 4.08 N/A Table 4: Attachment Resistance Expressed as a Moment - M, (ft-Ibf) from PA 101 Testing Tile Profile Tile Application Attachment - Resistance Altusa 'S' Tile Mortar Set 24.50 Adhesive Set 66.50 Table 1: Aerodynamic Multipliers - X (ft') Tile Profile X (ft') Batten Application X (ft') Direct Deck Application Altusa 'S' Tile 0.29 0.31 DATA FOR ATTACHMENT CALCULATIONS Product Control No.: 96- 1030.03 1. Quik -Drive screws installed in two manufactured holes located 1 and 1' / from the head of the tile. Frank Zuloaga Plans Examiner, Product Control Division PROFILE DRAWING ALTUSA "S" CLAY'ROOF TILE 13 • Product Control No.: 96- 1030.03 a `i Fran uloaga Plans Examiner, Product Control Division PROFILE DRAWING APPROVED SCREW 15 Product Control No.: 96- 1030.03 101 a- 23 DEC. 2.•3 1.20 0.131 0. I' 2 Frank Zuloaga Plans Examiner, Product Control Division NAIL HOLE NAIL HOLE - PROFILE DRAWING ALTUSA "S" CLAY ROOF TILE ACCESSORIES BIRD STOP 14 Product Control No.: 96- 1030.03 GABLE -RAKE Fran uloaga Plans Examiner, Product Control Division Altusa Tile, Almar (USA), Inc. 6645 Northwest 77th Avenue. Miami Fl 33166 Product Control No.: 96- 1030.03 ACCEPTANCE NO.: 96- 1030.03 APPROVED : February 13, 1997 EXPIRES : February 13, 2000 NOTICE OE ACCEPTANCE STANDARD CONDITIONS 1. Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and the original submitted documentation, including test supporting data, engineering documents, are no older than eight (3) years. 2. Any and all approved products shall be permanently labeled with the manufacturer's name, city, state, and the following statement: "Dade County Product Control Approved ", or as specifically stated in the specific conditions of this Acceptance. 3. Renewals of Acceptance will not be considered if: a) There has been a change in the South Florida Building Code affecting the evaluation of this product and the product is not in compliance with the code changes; h) The product is no longer the same product (identical) as the one originally approved; c) If the Acceptance holder has not complied with all the requirements of this acceptance, including the correct installation of the product; d) The engineer who originally prepared, signed and sealed the required documentation initially submitted , is no longer practicing the engineering profession. 4. Any revision or change in the materials, use, and/or manufacture of the product or process shall automatically be cause for termination of this Acceptance, unless prior written approval has been requested (through the filing of a revision application with appropriate fee) and granted by this office. 5. Any of the following shall also be grounds for removal of this Acceptance: a) Unsatisfactory performance of this product or process; b) Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any other purposes. 6. The Notice of Acceptance number preceded by the words Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is displayed, then it shall be done in its entirety. 7. A copy of this Acceptance as well as approved drawings and other documents, where it applies, shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at all times. The copies need not be resealed by the engineer. 8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of Acceptance. 9. This Acceptance contains pages I through 17. END OF THIS ACCEPTANCE 17 Fran u oaga Plans Examiner, Product Control Division r SYSTEM LI,MIITATIONS I. The standard minimum roof pitch for Altusa "S" high profile the 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. Altusa "S" 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 sct tilc 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 Sectionll of the Uniform Building Permit, a copy of Pioneer'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'. 16 Product Control No.: 96 1030.03 Fran Zu loaga Plans Examiner, Product Control Division Test Location Uplift Pull Test (P or F) Test Location Uplift Pull • Test (P or F) Test Location Uplift Pull Test (P or F) 41.06 5SD 26 rA. 51 PA. Sew 2 27 52 3 28 53 4 29 r 54 5 30 r 55 6 31 56 7 32 57 8 33 58 9 34 59 10 35 60 11 36 61 12 37 62 13 38 63 14 39 64 15 40 65 16 41 66 17 42 67 18 43 68 19 44 69 20 45 70 21 46 71 22 47 72 23 48 73 24 49 74 25 50 75 Du Quesne & Associates, Inc. UTR 1.428 Consulting Engineers Environmental • Civil • Structural Testing Laboratory Building Inspection Services ON -SITE CONCENTRATED UPUFT LOAD TESTING OF ROOF TILE IN ACCORDANCE WITH METRO-DADE BUILDING CODE COMPLIANCE PROTOCOL PA 106 rge Du Quesne, P. I Engineer #24513 Du Quesne & Associates, Inc. E.B. License #0005245 Lab Certification #94- 0318.01 SITE SPECIFIC INFORMATION Owner's Name: VA.1 Permit #. 42'143 Job Address "312 i4 S. (01 •Sr, M t& IA l S tv of -E ,CI Roofing Contractor D 8E04 o 12,o I •.I c Type of Tile: Aili)44 ' S‘-. t'0 0.M 66L Date Installed (0 1 ( ' e Approximate Roof Height: %4 feet Roof Pitch 3 l�- Type of Access to Roof: Scaffolds X Ladder Other Approximate Square Footage of Root 19 0o ft 2 Required Testing Force: 35 lbs. Testing Equipment: Chatillion DFIS 100 Date Tested' r• . 4 ' q 8 TEST RESULTS P = PASS, F = FAIL SKETCH OF ROOF IN BACK IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL PA 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST. THIS PA 106 TEST HAS BEEN PERFORMED IN FULL ACCORDANCE TO THE REQUIREMENTS OF DADE COUNTY, WITH NO DEVIATIONS. Please Note: This form is not valid unless Company logo appears in color (burgundy) 7821 S.W. 24th Street • Suite 104 • Miami, Florida 33155 • Telephone (305) 264 -1425 • Fax (305) 264 -1426 IKETCH Of ROQf 108 1 1 IX VaG 4)1 `el% Nt - Sitkpe.cgs e rt SHEET NO JOF 1 CALCULA t ED DY DAV (IP • 2448 CHEC (ED CIY DATE SCALE 41 5 NOTTS: NM III I 1 • I so MI 1131 ii O. am iall • N • .mmil idgiV41 0 ix . 1110211WMITO, C. MI w0/114' ri4 . .1 MICA re's a FA • IIIIMMIPAIIII II Pt '.i MI IlWadlinliu i 1 Fa NO II NMI MO] En CI X 1 -1 il l 1r t" • ma -- a __ -: , , 1 Ca f.1._ ow mi Opthireri -- o rA i) _I La Alirlial ..... - ;464 • I I III I I I I 11111111 1. I IKETCH Of ROQf 108 1 1 IX VaG 4)1 `el% Nt - Sitkpe.cgs e rt SHEET NO JOF 1 CALCULA t ED DY DAV (IP • 2448 CHEC (ED CIY DATE SCALE 41 5 NOTTS: MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date April 6, 1950 , 19 Owner's Name and Address Leroy Moyer No 310 N :atreet 101__ .Str_eet Registered Architect and /or Engineer Name and address of licensed contractor Lang Roofing & Tile___ o._ Q__N.IL.___ 7g__Street Location and legal description of lot to be built on: Lot Block Subdivision_ Street and Number where work is to be done 310 N •E ,_101 Street State work to be done and purpose of building (by floors) T_ ear .__off___.ald__roofing__to___ eatjng__bo apply 1-30 lb,_ - -felt_,__1 -�Q lbw_plat�e- r -- �camen __barxel-- t,i].e,--- >rappex - -fl � i -� and for no other purpose. New Building Remodeling Addition Repairs 11X No. of Stories To be constructed of Kind of foundation Roof Covering 0 Estimated Total cost of improvements $_____$760_.O0 Amount of Permit $ 1 Zone cubage required _Plan Cubage Distance to next nearest building ____________Size of Building Lot__ Maximum live load to be borne by each floor —_____________________ __ ____ _______________ _ I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may, be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) 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 - - -- 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 e true. Permit No.__,____ Date 7> ,i Read, Sworn to and Subscribed before me.. Disapproved Date Notary Public, State of Florida (Signed) ____ =� /�\�- t �uilt[ig Ins =p My Commission Expires PLANNING BO ARD DATE Chairman Member Chairman 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. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date .4ri1 6, 195Q , 19 Owner's Name and Address Leroy MCZy_sr No 310 N tI' »9treet 101 � — .ett Registered Architect and /or Engineer Name and address of licensed contractor IC4:r ?_ltQO ! & .@__ Gc ._s__ / 4 3Q__N.W.___7_9__Street Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done___3_10 __ N�E_,__lQ�,__tQ State work to be done and purpose of building (by floors)____ Tear._ Off__. OILS_ _roofing__to -__sheating__boardg, apply -- 1-- _30 felt l- 9Ql1ah_ e,___ cement__barrel__tils,__copper_- .Q1 ashi rza._ and for no other purpose. New Building Remodeling Addition Repairs XX No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ j760.00 Amount of Permit $ Zone cubage required Plan Cubage Distance to next nearest building _Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks ( Signed) 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 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 Date Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida ( Signed) 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.