429 NE 101 St (10)Dat Time
Type Insp'
Permit No
Name
Address 4k--1--T).-6 L o 1 j
Comp)," Q
For Inspector: C7 C3 Name &
Phone #
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Reques
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPART
305- 795 -22
B Building Inspection Req
Date' 6 Time
Type Insp'n
Permit No
Name
Address
Compa y
Phone #
For Inspector6 / tb /
/ 3,Name & D
Correction
Re- Insp'n Fee
o
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Req
Dat3 i 0 Time
Type Insp' / / �
Permit NJ P j O .3.. 6 b--�
Name
Address l � 1. � '� I. 12 /—/?'
Comp ny _,Q;JI/>
Phone # �-S �`
For Inspector 5/7/ D3J3 Name & Date
Approved
Correction
Re- Insp'n Fee
Type Insp'
•
11
Permit No.
It A
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTME T/
305- 795 -2204
Building Inspection Request
?) 03 Time
Dates
A
i L3 r 3�•
20
Name
Address L oc l t r.
Compan
Phone # ft )
For Inspector / 3 Name & Date
,4,14/
Name
Address ea c? /t/ jo1r' 47' / ► ti s, : 311.•.- eS Pl
Permit # Folio # /( 3,00 6 o /7 O6 yQ
NOTICE OF COMMENCEMENT
State of Florida
County of e4 i a nl % -- aide_
The undersigned hereby gives notice that improvement wilt be made to 03R25 12 2003 APR 21 09:22
certain real property, and in accordance with Chapter 713, Florida Statutes,
the following information is provided,in This Notice of Commencement:
1. Property Legal Description °-ot °Unit ['Block ['Bldg
Subdivision/Condominium
t� I ST Ja'Y S
LengthyLogal, please see description attached Iteret
. p t53 l 3�
2. General Description of
Improvement:
4. Contractor name:
Address:
Phone Number:
5. If Surety Bond, Name:
and address of Surety:
and amount of Bond:
Phone Number:
6. Lender name:
Address:
Owner signature:
Printed name:
personally known to me or produced
4otary signature*
� rintod name:
seal:
,,;r, fy,.,, MIRTHA R. PEREZ
- MY COMMISSION It CC 957209
EXPIRES: July 26, 2004
1 ' i � `
'4LpF h V Bonded Thru Notary Public Underwriters
Form AB -288 9/99
Robe4 sibs kiRctidy
2 I?7ief,tst 1P
S 30c
3. Property Owner Name: Ro kcu -I - 4b s + 6Q Lt tci €_.
Mailing Address: o / ill , ti.v. e /2 3
and interest in property:
Name/mailing address of
fee simple title holder if
other than owner:
SWORN TO AND SUBSCRIBED before me this r to day of
e : e kc
tt/e i S s j -t) LLk 5 - �-Lerst b 4,or ' s.-. ; c
l3/ 3w Jo A-Le ficer,k A3 3cik
5'v" /(- 4I el-, 3 3 ( Fax#: (optional- If service by fax Is acceptable) 5 1, -41 • `1' 3 3
$ (Copy or bond must be attached to this Notice at time of recording)
Fax #: (optimal!. If smoke by fax Is acceptable)
Phone Number: Fax#: (optional- if service by fax is acceptable)
T. Persons within the Slate of Florida (names and addresses) designated by property owner upon whom Notices or
outer documents may be served as provided by Section 713.13(1)(A)7., Florida Statutes:
Name:
Address:
Phone Number: Fax #: (optional If service by fax Is acceptable)
p In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided
by Section 713.1311) (13), Florida Statutes:
Name:
Address:
Phone Number: Fax#: (optional- if service by fax Is acceptable)
O. Expiration date of this Notice: (Explore one year from date recorded unless a different dale Is specified)
TAG -� s-()s
Name
Address
r c.-nu.t„
'TATS OF FLORIDA, COUNTY OF DADS
�t the
I HERESY CERTIFY that this ns fop ^d�ajy
C �,rrgrnal t dn o Tice on , AC V_.- --
sal Seat.
and
v; ITNES'
HARVEY
fly
Owner signature:
Printed name:
Z.
My commission expires:
space abovo reserved for use of recording office.
b / 04
space above this line reserved for use of the recording office
as identification.
01/21/2003 15:33 3057576564
Miami -Dade County. Real Estate Tax Information
Real Estate
Tax Information
`Ifs 11 :a . e g
Show Me:
'Property Taxes
Search By:
Select Item
Detail Tax Information:
Real Estate Tax Info
2002 Taxes
Prior Years Takes Due
200$ Non -Ad Valorem
2002 Back Assessments
2002 Enterprise Folio
2002 Historical Abatement%
2003 Quarterly Payments
02002 Mlami -Dade County.
All rights reserved.
STOBS BROS CONST
Real Estate Tax Information
Today's Date: 03/19/2003 Last Update: 03/14/2003 Tax Year: 2002
Folio Number: 11 32060170640 MIAMI SHORES
Owner's Name: J ROBERT STOBS &W RUBY LEE
Property Address: 429 NE 101 ST
Mailing Information : Legal Description :
J ROBERT STOBS &W RUBY LEE 6 53 42 PB 15.14
429 NE 101 ST AMD PL OF MIAMI SHORES SEC 4
MIAMI FLA 331382448 LOT 15 & W1/2 OF LOT 16 BLK 91
LOT SIZE 75.000 X 115
2002 Ta es _re in paid status.
Amounts due are subject to change without notice.
E -mail your comments, questions and suggesdons to Webma tler.
PAGE 02/02
Page 1 of 1
MI/
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Property_Tax Home 1 Real, Estate Tax Info 12002Talesic1 Prior a Years 12002 2002 Quarts
2002 Beck Assessments 1 2002 Enterprise FoIIQ I R y' A o 12003
Miami -Dade Home 1 Usino_Qur Site I 6_17c31 phone Dir c ou I privacy I Disciair
http : / /egvsys.miamidade.gov: 1608 /wwwsezv /ggvt/txcaw01.dia?folio= 1132060170640 3/19/03
Roof System
Required Sections of the
Permit Application Form
Attachments Required
See List Below
Low Slope Application
A, B, C
1,2,3,4,5,6,7
Prescriptive BUR RAS 150
A, B,C
4,5,6,7
Asphaltic Shingles
A, B, D
1,2,4,5,6,7
Concrete or Clay Tile
A, B, D, E
1,2,3,4,5,6,7
Metal Roofs
A, B, D
1,2,3,4,5,6,7
Wood Shingles and Shakes
A, B, D
1,2,4,5,6,7
Other
As Applicable
1,2,3,4,5,6,7
High Velocity Hurricane Zone Uniform Roofing Permit Application Form
MIAMI -DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION
COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING PERMIT
APPLICATION FORM AND ATTACH THE REQUIRED DOCUMENTS AS NOTED BELOW.
ATTACHMENTS REQUIRED
1. Fire Directory Listing Page
2. From :the Miami -Dade County Notice of Acceptance
F NOA Cover Sheet
F NOA Specific System Description
NOA Specific System Limitations
F NOA General Limitations
F Applicable Detail Drawings
INSTRUCTION PAGE
Any other additional data reasonably required by the Building Official
to determine the integrity of the roofing system.
Page 1
3. Design Calculations per Chapter 16, or if applicable, RAS 127 or RAS 128
4. Other Component Notice of Acceptances
5. Municipal Permit Application
6. Owners Notification for Roofing Considerations (Appendix " F" Form) Re- roofing or
Repairs Only
7. Any Required Roof Testing /Calculation Documentation
Page 1 of 2
http: / /www.co. miami - dade. fl. us / bldg /roofing permiting/instruction page.htm 4/11/2003
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 • ressure zones and location of parapets.
Perimeter Width (a'):1__.______ Comer Size (a' x a')•
1 1 1 1 1 1 1 1 1 1 1 1 1
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High Velocity Hurricane Zone Uniform Roofing Permit Application Form
MIAMI -DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION
1
Master Permit No.
Contractor's Name:
Section A (General Information)
Process No.
Job Address:
Weiss & Woolrich Southern Enter 1429 NE 101 Street, Miami, FL 331:
Roof Category
Ej Low Slope E Mechanically Fastened Tile F. Mortar /Adhesive Set Tile
r. Asphaltic Shingles r Metal Panel /Shingles r Wood Shingles /Shakes
E Prescriptive BUR -RAS 150 r
Other: .._.. --
Are there Gas Vent Stacks located on the roof? r Yes No
No
Roof Type
El New Roof Re- Roofing r Recovering
Roof System Information
Section B ( Roof Plan
r Repair r Maintenance
If yes, what type? r Natural r LPGX
e roof area ft. 6 5 L 13.5 J20
Low slope ( Steep Sloped area (ft.
2 ) _� _..__......_.____........_ Total (ft.� ...-.-
Page 1 of 2
High Velocity Hurricane Zone Uniform Roofing Permit Application Form
MIAMI -DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION
System Manufacturer:
I Soprema Roofing & WP, Inc.
NOA No: (01- 0116.01
.__.
Design Wind Pressures, From RAS 128 or Calculations:
Pmax1: . -. . Pmax 2:
Pmax3:
Maximum Design Pressure, From the Specific
NOA System: I -45
Deck type: (5/8" Plywood
* These decks require a fastener pull test by
an approved test labratory
Other Deck Type:
Joist Spacing:
116" O/C
Slope: /4" per ft 1
Anchor /Base Sheet & No. of Ply(s):
Section C (Low Sloped Roof System)
Fill in the Specific Roof Assembly components and Identify Manufacturer
(If a component is not used, identify as "NA ")
Anchor /Base Sheet Fastener /Bonding Material:
Insulation Base Layer /Size & Thickness:
Base Insulation Fastener /Bonding Material:
Top Insulation Fastener /Bonding Material:
Insulation Top Layer /Size & Thickness:
Page 3
Wood Nailer:
IN/A
Base Sheet(s) & No. of Ply(s):
11 ply GafGlas #75
Base Sheet Fastener /Bonding Material:
$approved roofing nails & tin caps
Ply Sheet(s) & No. of Ply(s):
11 ply Elastophene Flam j
Ply Sheet Fastener /Bonding Material:
(torched applied
Drip Edge Size & Gauge: face 26 ga.
Drip Edge Material Type:
Hook Strip /Cleat gauge or weight: I N/A
Coping Metal. IN /A
1Galvinized Metal
Top Ply: ISopralene 180 Flam FR GR
Top Ply Fastening /Bonding Material:
torch applied
........................... ...............................
Surfacing:
IN /A
FASTENER SPACING FOR BASESHEET ATTACHMENT
Fastener Type:
11 I " R.S. Nails
Alternate Fasteners: I
1 I i
1. Field: - � " o/c @ laps & 1.. -... 1 rows @ I 1 " o/c
2. Perimeter: 9 " o/c @ laps & 2 rows @ 12 " o/c
3. Corners: o/c @ laps & 1 2 rows @ 12 " o/c
NUMBER OF FASTENERS PER INSULATION BOARD
Field: Perimeter: l 3 Corner: 1
Page 1 of 1
http: / /www.co. miami - dade. fl. us / bldg /roofing_permiting/section_c 4.html 4/11/2003
3 eO ppC—
High Velocity Hurricane Zone Uniform Roofing Permit Application Form
MIAMI -DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION
Illustrate Components Noted and Details as Applicable:
Woodblocking, Gutter, Edge Terminations /Stripping /Flashing, Continuous Cleat, Cant Strip, Base
Flashing,Counterflashing, 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.
S 1 ro 6g
r
.2t(c y T woo n e QC,
° O� pa.kJ
3 e_ w coo v &5 144
&se Pot ; 64F GlA5
P1 f S�e�l�; 6/4s1b/IQie FI
PVet,btab Sb
6i<
Page 3a
Mean Roof Height 9 Ft
Page 1 of 1
http: / /www.co. miami- dade.fl.us/ bldg /roofing permiting/section_c_4_2.htm1 4/15/2003
High Velocity Hurricane Zone Uniform Roofing Permit Application Form
MIAMI -DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION
Method of Tile Attachment:
Roof Slope: I� ._. _._.'y12"
Roof Mean Height: I__
Ridge Ventilation: IN /A
'Adhesive, Large Paddy Polyfoam Polypro
Alternate Tile Attachment Method:
Clip S acing for Metal Roof Panels
Field: I Perimeters: I - - -. 1 Corners: In
Perimeter Width: —
Section D (Steep Sloped Roof System)
Sloped System Description
Page 4
Deck Type : I5/8" PI ...............................
Alternate Deck Type:
Underlayment type:
I ASTM 30# Felt
................................................................. ...............................
Insulation /Fire Barrier Board:
ood lJ
Optional Nailable Substrate:
Fasteners:
`approved roofing nails & tin caps I
Cap Sheet Type /Adhesive Type:
Rain Proof 40 / peel and stick
Roof Covering:
'Concrete Flat Roofing Tile
Roof Covering Attachment Method:
Polyfoam PolyPro Adhesive
Drip Edge Size & Gauge• face 26 ga.
Drip Edge Material Type LGalvinized Metal L,
Drip Edge Fastener Type:
'galvaized ring shank roofing nails
El Hook Strip /Cleat ga. or weight: (N /A
Page 1 of 2
http : / /www.co.miami - dade.fl.us/bldg/ roofing _permiting /section_d_3.html 4/11/2003
Root System Manufacturer: lEntegra Roof Tile Corporation
Notice of Acceptance Number I01- 0417.09
Minimum Design Wind Pressures, If Applicable (from RAS 127 or Calculations):
-52 P 2: -87.3 I P 3. -131.4
P 1:
Maximum Design Wind Pressures, (From the PCA Specific system):
1
High Velocity Hurricane Zone Uniform Roofing Permit Application Form
MIAMI -DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION
Method of Tile Attachment:
Roof Slope: I� ._. _._.'y12"
Roof Mean Height: I__
Ridge Ventilation: IN /A
'Adhesive, Large Paddy Polyfoam Polypro
Alternate Tile Attachment Method:
Clip S acing for Metal Roof Panels
Field: I Perimeters: I - - -. 1 Corners: In
Perimeter Width: —
Section D (Steep Sloped Roof System)
Sloped System Description
Page 4
Deck Type : I5/8" PI ...............................
Alternate Deck Type:
Underlayment type:
I ASTM 30# Felt
................................................................. ...............................
Insulation /Fire Barrier Board:
ood lJ
Optional Nailable Substrate:
Fasteners:
`approved roofing nails & tin caps I
Cap Sheet Type /Adhesive Type:
Rain Proof 40 / peel and stick
Roof Covering:
'Concrete Flat Roofing Tile
Roof Covering Attachment Method:
Polyfoam PolyPro Adhesive
Drip Edge Size & Gauge• face 26 ga.
Drip Edge Material Type LGalvinized Metal L,
Drip Edge Fastener Type:
'galvaized ring shank roofing nails
El Hook Strip /Cleat ga. or weight: (N /A
Page 1 of 2
http : / /www.co.miami - dade.fl.us/bldg/ roofing _permiting /section_d_3.html 4/11/2003
Mean Roof Height
in Feet
15'
20'
25'
30
40'
40
Roof Slope
!
1
i
i
i
2:12
34.4
36.5
38.2
39.7
42.2
3:12
32.2
34.4
36.0
37.4
39.8
4:12
30.4
32.2
33.8
35.1
37.3
5:12
28.4
30.1
31.6
32.8
34.9
6:12
26.4
28.0
29.4
30.5
32.4
7:12
24.4
25.9
27.1
28.2
30.0
High Velocity Hurricane Zone Uniform Roofing Permit Application Form
MIAMI -DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION
Section E (Tile Calculations)
For Moment based tile systems, chose either Method 1 or 2. Compare the
values for Mr with the values from Mf. If the Mf values are greater than or
equal to the Mr values, for each aea of the roof, then the tile attachment
method is acceptable.
Method 1 "Moment Based Tile Calculations Per RAS 127"
P1:x -Mg: = Mr1:I_..._..... NOA Mf:
I._
P2:1 ix ?I '- Mg:7 =Mr1: NOA Mf.
P 3: I_ _..... a x ? - Mg: I___._ _... = Mr1: I ` NOA Mf. 1 I
Method 2 "Simplified Tile Calculation Per Table Below"
Required Moment of Resistance (Mr) From the Table Below: l NOA Mf• 1
Mr Required Moment Resistance*
*This Table must be used in conjunction with a list of moment based tile
systems endorsed by the Broward county Board of Rules and Appeals.
Page 5
Page 1 of 1
http: / /www.co. miami - dade. fl. us / bldg /roofing j ermiting/section_e_3.htm 4/11/2003
Description
Symbol
Where to Find
Design Pressure
P1 or P2 or P3
RAS 127 Table 1 or by an engineering analysis prepared
by a P.E. based on ASCE 7 -98
Mean Roof Height
H
Job Site
Roof Slope
?
Job Site
Aerodynamic Multiplier
?
NOA
Restoring Moment due to Gravity
Mg
NOA
Attachment Resistance
Mf
NOA
Required Moment Resistance
Mr
Calculated
Minimum Attachment Resistance
F'
NOA
Required Uplift Resistance
Fr
Calculated
Average Tile Weight
W
NOA
Tile Dimensions
1= length
w = width
NOA
High Velocity Hurricane Zone Uniform Roofing Permit Application Form
MIAMI -DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION
For Uplift based tile systems use Method 3. Compare the values for F' with
the values for Fr. If the F' values are greater than or equal to the Fr values, for
each area of the roof, then the tile attachment method is acceptable.
Method 3 "Uplift Based Tile Calculations Per RAS 127"
(Pi: l ....__. _ 1 x I: I = _ __.._ x w: L_ t W: L -._ x cos ?: = Frl
NOA ... ...............................
Where to Obtain Information
Page 5a
(P2: ...A x I __ ._! - I x w: i _____ 1 - W• x cos ?• - Fr2l
NOA F'
(P3:1 I x I:1 _1 = x w: ET) - W: x cos ?: = Fr31- . -.... 1
NOA F'I
Page 1 of 1
All calculations must be submitted to the Building Official at the time of permit application.
http: / /www.co. miami - dade. fl. us / bldg /roofing permiting/section_e_3_2.HTML 4/11/2003
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.
1. Aesthetics - Workmanship: 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.
2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be
renailed 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
units (i.e. 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
viewed 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
cause water 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
overloaded 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 the Florida 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.
Agent's Signature
C:\Documeuts and Settings\c6ammas\Local Settings \Temp\Temporary Internet Files \Content.D 5\OKLBAF T SECTION 15241 IJ.doc
Date Contractor's Signature
MIAMI �DADE
PRODUCT CONTROL NOTICE OF ACCEPTANCE
Entegra Roof Tile Corporation
1201 N.W. 18 Street
Pompano Beach ,FL 33069
The expense of such testing will be incurred by the manufacturer.
ACCEPTANCE NO.:,01- 0417.09 -
EXPIRES: 06/07/2006
APPROVED: 06/07/2001
MIAMI -DADE COUNTY, FLORIDA
METRO -DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET, SUITE 1603
MIAMI, FLORIDA 33130 -1563
(305) 375 -2901 FAX (305) 375 -2908
CONTRACTOR LICENSING SECTION
(305) 375 -2527 FAX (305) 375 -2558
CONTRACTOR ENFORCEMENT DIVISION
(305) 375 -2966 FAX (305) 375 -2908
PRODUCT CONTROL DIVISION
(305) 375 -2902 FAX (305) 372 -6339
Your application for Notice of Acceptance (NOA) of:
Concrete Flat Roofing Tile f ;
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.
This NOA shall not be valid after the expiration date stated below. BCCO 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, 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
determined by BCCO that this product or material fails to meet the requirements of the South Florida
Building Code.
Raul Rodriguez
Chief Product Control Division
THIS IS THE COVERSIIEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
CONDITIONS
BUILDING CODE & PRODUCT REVIEW COMMITTEE
This application for Product Approval has been reviewed by the BCCO and approved by the Building
Code and Product Review Committee to be used in Miami -Dade County, Florida under the conditions set
forth above.
Francisco J. Quintana, R.A.
Director
Miami -Dade County
Building Code Compliance Office
\\ s045000I \pc2000 \ \templates\notice acceptance cover page.dot
Internet mail address: postmaster @buildingcodeonline.com Homepage: http : / /www.buildingcodeonline.com
ENTEGRA ROOF TILE CORPORATION ACCEPTANCE No.: 01- 0417.09
1. SCOPE
This revises a roofing system using Entegra Flat Concrete Roof Tile, as manufactured
Entegra Roof Tile Corporation described in Section 2 of this Notice of Acceptance,
designed to comply with the South Florida Building Code, 1994 Edition for Miami-Dade
County. For the locations where the pressure requirements, as determined by applicable
Building Code, does not exceed the design pressure values obtain by calculations in
compliance with RAS 127 using the values listed in section 4 herein. The attachment
calculations shall be done as a moment based system.
2. PRODUCT DESCRIPTION
Manufactured by
Applicant
Entegra Flat Tile
Trim Pieces
Product
Rainproof II
Ice and Water
Shield
Category:
Sub Category:
Material:
Roofing
Roofing Tile
Concrete
Test
Dimensions Specifications
1= 16"
w= 10"
1 -'/4" thick
1= varies
w = varies
varying thickness
2.1 Components or products manufactured by others
Dimensions
30" x 75' roll
36" x 75' roll
or
60" x 75' roll
36 "x75' roll
Approval: June 7, 2001
Expiration Date: June 7, 2006
Product
Description
PA 112 Flat profile, interlocking, high pressure
extruded concrete roof tile equipped with
two nail holes. For direct deck or batten
nail on, mortar or adhesive set applications.
PA 112 Accessory trim, concrete roof pieces for use
at hips, rakes, ridges and valley
terminations. Manufactured for each tile
profile.
Test
Specifications
PA 104
PA 103
2
Product
Description
Single ply, nail -on
underlayment with
2" self - adhering top
edge.
Self- adhering
underlayment
Manufacturer
Protect -O -Wrap,
Inc.
(with current NOA)
W.R. Grace Co.
(with current NOA)
Frank Zuloaga, RRC
Roofing Product Control Examiner
ENTEGRA ROOF TILE CORPORATION ACCEPTANCE No.: 01- 0417.09
Product
Wood Battens
Tile Nails
Tile Screws
Roof Tile Mortar
( "TileTiteTM ")
Roof Tile Mortar
( "Quikrete® Roof
Tile Mortar
#1140 ")
Roof Tile Mortar
("BONSAL®
Roof Tile Mortar
Mix ")
Roof Tile
Adhesive
( "Polypro®
AH160 ")
Roof Tile
Adhesive
TileBond
Dimensions
Vertical
Min. 1"x 4"
Horizontal
Min. 1"x 4" for use
with vertical battens
or
Min. 1"x 2" for use
alone
Min. 10dx 3"
#8x 2' /z" long
0.335" head dia.
0.131" shank dia.
0.175" screw thread
dia.
N/A
N/A
N/A
N/A
Factory premixed
canisters
Test
Specifications
Wood Preservers
Institute LP — 2
PA 114
Appendix E
PA 114
Appendix E
PA 123
PA 123
PA 123
See PCA
See. PCA
3
Product
Description
Salt pressure
treated or decay
resistant lumber
battens
Corrosion resistant
screw or smooth
shank nails
Corrosion resistant,
coated, square
drive, galvanized,
coarse thread wood
screws
Prepared mortar
mix designed for
mortar set roof tile
applications.
Prepared mortar
mix designed for
mortar set roof tile
applications.
Prepared mortar
mix designed for
mortar set roof tile
applications.
Two component
polyurethane
adhesive designed
for adhesive set
roof tile
applications.
Manufacturer
generic
generic
generic
Bermuda Roof
Company, Inc. with
current PCA
Quikrete
Construction
Products with
Current PCA
W. R. Bonsal Co.
with current PCA
Polyfoam Products,
Inc.
Flexible Products
(with current NOA)
Single component
polyurethane foam
roof 4 •�s; ^--
.4 1P-141111111F---
Frank Zuloaga, RRC
Roofing Product Control Examiner
ENTEGRA ROOF TILE CORPORATION
Product
Hurricane Clip &
Fasteners
3. LIMITATIONS
Dimensions
Clips
Min.'' Y2" width
Min. 0.060" thick
Clip Fasteners
Min. 8d x 1 'A"
4.2 Data For Attachment Calculations
Test
Specifications
PA 114
Appendix E
ACCEPTANCE No.: 01- 0417.09
Product
Description Manufacturer
Corrosion resistant Generic
clips with corrosion
resistant nails.
3.1 Fire classification is not part of this acceptance.
3.2 For mortar or adhesive set tile applications, a static field uplift test shall be
performed in accordance with RAS 106.
3.3 Applicant shall retain the services of a Miami -Dade County Certified Laboratory
to perform quarterly test in accordance with PA 112, appendix `A'. Such testing
shall be submitted to the Building Code Compliance Office for review.
3.4 Minimum underlayments shall be in compliance with the applicable Roofing
Applications Standards listed section 4.1 herein.
3.5 30/90 hot mopped underlayment applications may be installed perpendicular to
the roof slope unless stated otherwise by the underlayment material manufacturers
published literature.
3.6 This acceptance is for wood deck applications. Minimum deck requirements shall
be in compliance with applicable Building Code.
4. INSTALLATION
4.1.1 Entegra `Flat' Concrete Roof Tile and its components shall be installed in strict
compliance with Miami Dade County Roofmg Application Standard RAS 118,
RAS 119, and RAS 120.
4
Frank Zuloaga, RRC
Roofmg Product Control Examiner
Table 1: Aerodynamic Multipliers - a, (ft
Tile
X (ft
X (ft')
Profile
Direct Deck Application
Direct Deck Application
Entegra Flat Tile
0.189
0.205
ENTEGRA ROOF TILE CORPORATION
Product
Hurricane Clip &
Fasteners
3. LIMITATIONS
Dimensions
Clips
Min.'' Y2" width
Min. 0.060" thick
Clip Fasteners
Min. 8d x 1 'A"
4.2 Data For Attachment Calculations
Test
Specifications
PA 114
Appendix E
ACCEPTANCE No.: 01- 0417.09
Product
Description Manufacturer
Corrosion resistant Generic
clips with corrosion
resistant nails.
3.1 Fire classification is not part of this acceptance.
3.2 For mortar or adhesive set tile applications, a static field uplift test shall be
performed in accordance with RAS 106.
3.3 Applicant shall retain the services of a Miami -Dade County Certified Laboratory
to perform quarterly test in accordance with PA 112, appendix `A'. Such testing
shall be submitted to the Building Code Compliance Office for review.
3.4 Minimum underlayments shall be in compliance with the applicable Roofing
Applications Standards listed section 4.1 herein.
3.5 30/90 hot mopped underlayment applications may be installed perpendicular to
the roof slope unless stated otherwise by the underlayment material manufacturers
published literature.
3.6 This acceptance is for wood deck applications. Minimum deck requirements shall
be in compliance with applicable Building Code.
4. INSTALLATION
4.1.1 Entegra `Flat' Concrete Roof Tile and its components shall be installed in strict
compliance with Miami Dade County Roofmg Application Standard RAS 118,
RAS 119, and RAS 120.
4
Frank Zuloaga, RRC
Roofmg Product Control Examiner
Table 3: Attachment Resistance Expressed as a Moment - M, (ft-Ibf)
for Nail -On Systems
Tile
Profile
Fastener Type
Direct Deck
(min 15/32" plywood)
Direct Deck
(min. 19132" plywood)
Battens
Entegra
Flat Tile
2 -10d Ring Shank Nails
30.9
38.1
17.2
1 -10d Smooth or Screw
Shank Nail
7.3
9.8
4.9
2 -10d Smooth or Screw
Shank Nails
14.0
18.8
7.4
1 #8 Screw
30.8
30.8
18.2
2 #8 Screw
51.7
51.7
24.4
1 -10d Smooth or Screw
Shank Nail (Field Clip)
24.3
24.3
24.2
1 -10d Smooth or Screw
Shank Nail (Eave Clip)
19.0
19.0
22.1
2 -10d Smooth or Screw
Shank Nails (Field Clip)
35.5
35.5
34.8
2 -10d Smooth or Screw
Shank Nails (Eave Clip)
31.9
31.9
32.2
2 -10d Ring Shank Nails' 1 50.3
65.5 1 48.3
1 Installation with a 4" tile headlap and fasterners are located a min. of 2W from head of tile.
Table 4: Attachment Resistance Expressed as a Moment Mr (ft-Ibf)
for Two Patty Adhesive Set Systems
Tile
Profile
Tile Application
Minimum Attachment Resistance
Entegra Flat Tile
Adhesive
31.3
2 See manufactures component approval for installation requirements.
3 Flexible Products Company TileBond Average weight per patty 13.9 grams.
Polyfoam Product, Inc. Average weight per patty 8 grams.
Direct
Deck
Table 2: Restoring Moments due to Gravity M (ft -Ibf)
Tile
Profile
3 ":12"
4 ":12"
5 ":12"
6 ":12"
7 ":12" or
greater
Entegra Flat
Tile
Battens
Direct
Deck
Battens
Direct
Deck
Battens
Direct
Deck
Battens
Direct
Deck
Battens
Direct
Deck
6.53
6.97
6.43
6.86
6.29
6.71
6.14
6.54
5.97
N/A
ENTEGRA ROOF TILE CORPORATION ACCEPTANCE No.: 01- 0417.09
5
Frank Zuloaga, RRC
Roofing Product Control Examiner
Table 4A: Attachment Resistance Expressed as a Moment - Mf (ft-Ibf)
for Single Patty Adhesive Set Systems
Tile
Profile
Tile Application
Minimum Attachment
Resistance
Entegra Flat
Tile
PolyProTM
118.9
I Pro TM
40.4
4 Lar e d lacement of 45 rams of Pol Prom'.
5 Medium paddy placement o 24 grams of o y roTA°.
ENTEGRA ROOF TILE CORPORATION ACCEPTANCE No.: 01- 0417.09
5. LABELING
All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo,
or following statement: "Miami -Dade County Product Control Approved ".
6. BUILDING PERMIT REQUIREMENTS
6.1 Application for building permit shall be accompanied by copies of the following:
6.1.1 This Notice of Acceptance.
6.1.2 Any other documents required by the Building Official or applicable Building
Code in order to properly evaluate the installation of this system.
PROFILE DRAWING
16' -1
16'
ENTEGRA "FLAT" CONCRETE ROOF TILE
6
Frank Zuloaga, RRC
Roofing Product Control Examiner
ENTEGRA ROOF TILE CORPORATION ACCEPTANCE No.: 01- 0417.09
1. Renewal of this Acceptance (approval) shall be considered after a renewal application has been
filed and the original submitted documents, including test - supporting data, engineering documents,
are no older than eight (8) years.
2. Any and all approved products shall be permanently labeled with the manufacturer's name, city,
state, and the following statement: "Miami -Dade County Product Control Approval ", 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.
b. 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 Miami -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 time. The engineer need not reseal the copies.
8. Failure to comply with any section of this Acceptance shall be cause for termination and removal
of Acceptance.
9. This Notice of Acceptance consists of pages 1 through 6 and this last page 7.
END OF THIS ACCEPTANCE
7
Frank Zuloaga, RRC
Roofing Product Control Examiner
ENTEGRA ROOF TILE CORPORATION
A. TESTS:
Test Agency
Redland Technologies
Redland Technologies
Redland Technologies
Redland Technologies
Redland Technologies
Redland Technologies
Professional Service
Industries, 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 Test Name/Report
7161 -03
Appendix III
7161 -03
Appendix III
7161 -03
Appendix II
PO402
Letter Dated Aug. 1,
1994
P0631 -01
IC- 1320 -94
25- 7688 -10
25- 7688 -3
25- 7688 -5
25- 7688 -4
E -1
ACCEPTANCE No.: 01- 0417.09
Static Uplift Testing
PA 102
Static Uplift Testing
PA 102(A)
Wind Tunnel Testing
PA 108
(Nail -On)
Withdrawal Resistance
Testing of screw vs.
smooth shank nails
Wind Tunnel Testing
PA 108
(Nail -On)
Wind Tunnel Testing
PA 108
(Mortar Set)
Static Uplift Testing
PA 101
(Adhesive Set)
Static Uplift Testing
PA 102
(3" Headlap, Nails, Direct
Deck, New Construction)
Static Uplift Testin
(4" Headla
Date
Dec. 1991
Dec. 1991
Dec. 1991
Sept. 1993
Aug. 1994
July 1994
Physical Properties Feb. 1995
PA 112
Static Uplift Testing July 1996
PA 101
(Mortar Set)
June 1996
June 1996
1996
Frank Zuloaga, RRC
Roofing Product Control Examiner
ENTEGRA ROOF TILE CORPORATION ACCEPTANCE No.: 01- 0417.09
B. OTHER
1. NTRMA Association Member
2. Notice of Acceptance number 99- 1220.12
E -2
Frank Zuloaga, RRC
Roofing Product Control Examiner
MIA MMADE
PRODUCT CONTROL NOTICE OF ACCEPTANCE
Protecto Wrap Company
9312 Water Course Way
Boynton Beach ,FL 33437
The expense of such testing will be incurred by the manufacturer.
ACCEPTANCE NO.: 01- 0620.01
EXPIRES: 08/23/2006
APPROVED: 08/23/2001
MIAMI-DADE COUNTY, FLORIDA
METRO -DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET, SUITE 1603
MIAMI, FLORIDA 33130 -1563
(305) 375 -2901 FAX (305) 375 -2908
CONTRACTOR LICENSING SECTION
(305) 375 -2527 FAX (305) 375 -2558
CONTRACTOR ENFORCEMENT DIVISION
(305) 375 -2966 FAX (305) 375 -2908
PRODUCT CONTROL DIVISION
(305) 375 -2902 FAX (305) 372 -6339
Your application for Notice of Acceptance (NOA) of:
12ainproof 40 Rainproof 60
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.
This NOA shall not be valid after the expiration date stated below. BCCO 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, 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
determined by BCCO that this product or material fails to meet the requirements of the South Florida
Building Code.
Raul Rodriguez
Chief Product Control Division
THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
CONDITIONS
BUILDING CODE & PRODUCT REVIEW COMMITTEE
This application for Product Approval has been reviewed by the BCCO and approved by the Building
Code and Product Review Committee to be used in Miami -Dade County, Florida under the conditions set
forth above.
Francisco J. Quintana, R.A.
Director
Miami -Dade County
Building Code Compliance Office
\ \s0450001 \pc2000 \ \templates\notice acceptance cover page.dot
Internet mail address: postmaster @buildingcodeonline.com Homepage: http : / /www.buildingcodeonline.com
PROTECTO WRAP COMPANY Acceptance No.:01- 0620.01
ROOFING ASSEMBLY APPROVAL
Category: Roofmg
Sub - Category: Underlayment
Material: SBS
1. SCOPE
This renews a roofing system using Rainproof 40 and Rainproof 60 underlayment, as
manufactured by Protecto Wrap Company described in Section 2 of this Notice of Acceptance,
designed to comply with the South Florida Building Code, 1994 Edition for Miami -Dade County.
2. PRODUCT DESCRIPTION
Rainproof '40'
30" x 75'
60 lbs. roll
36" x 75'
75 lbs. roll
Rainproof'60' 36" x 50'
72 1b. roll
30" x 50'
60 lbs. roll
#80 Primer
3. LIMITATIONS
Test Product
Dimensions Specifications Description
TAS 103
TAS 103
2
Approval Date: August 23, 2001
Expiration Date: August 23, 2006
SBS Modified, rubberized,asphalt sheet
waterproofing underlayment, reinforced with a
strong nonwoven polyester reinforcement.
Waterproofing underlayment sheet with a
nonwoven reinforcement, sandwiched between two
layers of SBS modified asphalt.
Proprietary No. 80 Primer is an asphalt base primer for use in
vertical application of membrane.
3.1 Fire classification is not part of this acceptance
3.2 Rainproof 40 and Rainproof 60 membranes shall be applied to a smooth, clean and dry
surface. The deck shall be free of any irregularities.
3.3 Rainproof 40 and Rainproof 60 membranes shall not be applied over an existing roof
membrane
3.4 Rainproof 40 or Rainproof 60 shall not be left exposed as a temporary roof for longer than
30 days after application.
3.5 Tile shall not be stored on a non- battened roof deck with a slope greater than 5 ": 12. If tile is
loaded on a slope > 5 ": 12 ", a % " batten or greater in dimension must be placed under the
nose of the tile.
Frank Zuloaga, RRC
Roofing Product Control Examiner
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 4/25/2003
Applicant: J ROBERT
Owner: STOBS
JOB ADDRESS: 429 NE 101
Contractor / e&4-.0 t ?moim
Local Phone:
Parcel # 1132060170640
Fees: Description Amount
FEE2003 -2455 Building Fee $150.00
FEE2003 -2456 Builders Bond $300.00
FEE2003 -2457 CCF $3.60
FEE2003 -2458 Inpector State Educational Fund $10.00
$463.60
Total Fees:
Total Fees: $463.60
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 10/22/2003 Construction Value: $6,000.00
Signed:
(INSPECTOR)
In consideration of the issuance to me of this permit, 1 agree to perform the work covered 1
conformity with the plans, drawings, statements or specifications submitted to the proper au'
done by either myself, my agent, servants or employes.
Signed: (Contractor or Build(
Building Permit
Permit Number: BP2003 -663
STOBS
J ROBERT
ST
Contractor's Address:
Legal Description: 6 53 42 PB 15 -14 AMD PL OF MIAMI SHORES SEC 4 LOT 15 & W1/2 OF LOT
DATE
•
A niiia !L
• 411
PERMITS BY M E INC
231 SW 23RD ST
FORT LAUDERDALE, FL 33315
PH 954 - 467 -9826
PAY TO THE
ORDER OF
FOR
Wachovla Bank, N.A.
Fort Lauderdale, FL 33314
' :0 6 70 1 ; q c v.-
ofniL
Page 1 of 2
O
3
2475
63- 1356/670
BRANCH 04038
3G°
DOLLARS t o•�.`.
bN,
PROTECTO WRAP COMPANY
4. INSTALLATION
4.1 Systems:
Deck Type 1:
Base/Anchor Sheet:
Fastening:
Membrane:
Surfacing:
Deck Type 3:
Description
Primer:
5. LABELING
See Standard Conditions herein.
Acceptance No.:01- 0620.01
Wood, non - insulated
One or more plies of ASTM D 266 Type II or ASTM D 2626.
Nails and tin caps 12" grid, 6" o.c. at laps. (for base /anchor sheet
only)
Rainproof 40 or Rainproof 60, self adhered
None
Concrete, non - insulated
Primed structural concrete or concrete plank min. 2500 Psi.
Required: Protecto Wrap Number 80 or 100 SBS primer.
4.2 Rainproof 40 and 60 shall be installed in accordance with Applicable Building Code.
4.3 Wood and Concrete decks shall comply with Applicable Building Code.
4.4 Roof tile, and Rainproof 40 and 60 applications shall be in accordance within RAS 118, 119
or 120 for applicable Roof Tile System Application.
4.5 For wood deck application, Rainproof 40 and 60 shall be installed overr an approved
base /anchor sheet in accordance within RAS 118, 119 or 120. Anchor/Base sheet shall be
secured as described above.
4.6 For concrete deck applications, the concrete deck shall be cured for a minimum of 28 days,
clean and dry prior to the application of the primer. Concrete decks shall be fully primed with
Protecto Wrap Number 80 or 100 SBS primer, and allowed to dry prior to the installation of
the Rainproof 40 or 60 underlayment.
4.7 Place the first course of membrane parallel to the eave, rolling the membrane to obtain
maximum contact. Remove the release membrane as the membrane is applied. Overlap the
second course not less than 2 Y2". Overlap the end laps .a minimum of 6 ", rolling the
membrane into place after removing the release strip. Vertical strapping of the roof with
Rainproof is acceptable
4.8 When applying the membrane in the valley, start at the low point and work to the high point,
rolling the membrane from the center outward in both directions.
4.9 For ridge applications, center the membrane and roll from the center outward in both
directions.
4.10 Roll or broom the entire membrane surface so as to have 100% contact with the underlayment
or primed concrete deck, giving special attention to overlap areas.
4.11 All protrusions or drains shall be initially taped with a 6" piece of underlayment. The flashing
tape shall be pressed in place and formed around the protrusion to ensure a tight fit. A second
layer of Rainproof `40' or Rainproof `60' shall be applied over the underlayment.
4.12 Place the underlayment over metal drip edge in accordance with RAS 111.
3
Frank Zuloaga, RRC
Roofing Product Control Examiner
PROTECTO WRAP COMPANY Acceptance No.:01- 0620.01
6. BUILDING PERMIT REQUIREMENTS
6.1 Application for building permit shall be accompanied by copies of the following:
6.1.1 This Notice of Acceptance.
6.1.2 Any other documents required by the Building Official or applicable building code in
order to properly evaluate the installation of this material.
NOTICE OF 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 (8) years.
2 Any and all approved products shall be permanently labeled with the manufacturer's name, city,
state, and the following statement: "Miami -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;
b) 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 Miami -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.
Failure to comply with any section of this Acceptance shall be cause for termination and removal of
Acceptance.
This Acceptance contains pages 1 through 4.
END OF THIS ACCEPTANCE
4
Frank Zuloaga, RRC
Roofing Product Control Examiner
M I A M IOADE
PRODUCT CONTROL NOTICE OF ACCEPTANCE
Soprema Roofing and Waterproofing, Inc.
310 Quadral Drive
Wadsworth ,OH 44281
MIAMI -DADE COUNTY, FLORIDA
METRO -DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET, SUITE 1603
MIAMI, FLORIDA 33130 -1563
(305) 375 -2901 FAX (305) 375 -2908
CONTRACTOR LICENSING SECTION
(305) 375 -2527 FAX (305) 375 -2558
CONTRACTOR ENFORCEMENT DIVISION
(305) 375 -2966 FAX (305) 375 -2908
PRODUCT CONTROL DIVISION
(305) 375 -2902 FAX (305) 372 -6339
Your application for Notice of Acceptance (NOA) of:
Soprema Roof Systems Over Wood Deck
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.
This NOA shall not be valid after the expiration date stated below. BCCO 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, 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
determined by BCCO that this product or material fails to meet the requirements of the South Florida
Building Code.
The expense of such testing will be incurred by the manufacturer.
ACCEPTANCE NO.: 01- 0116.01
EXPIRES: 03 /01/2006
Raul Rodriguez
Chief Product Control Division
THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
CONDITIONS
BUILDING CODE & PRODUCT REVIEW COMMITTEE
This application for Product Approval has _been reviewed by the BCCO and approved by the Building
Code and Product Review Committee to be used in Miami -Dade County, Florida under the conditions set
forth above.
APPROVED: 03/01/2001
Francisco J. Quintana, R.A.
Director
Miami -Dade County
Building Code Compliance Office
\\s045000 1 \pc2000 \ \templates'notice acceptance cover page.dot
Internet mail address: postmaster @buildingcodeonline.com Homepage: http : / /www.buildingcodeonline.com
SOPREMA ROOFING AND WATERPROOFING SYSTEMS Acceptance No.: 01- 0116.01
Deck Type 1:
Deck Description: 19 /32" or greater plywood or wood plank decks
System Type E(1): Base sheet mechanically fastened.
All General and System Limitations apply.
Barrier:
Base Sheet:
Ply Sheet:
Membrane:
Surfacing:
Maximum Design
Pressure:
Maximum Fire
Classification:
Maximum Slope:
Wood, Non - insulated
(Optional) Roctex Rocroof, loose laid
One or two plies of Sopra -G, Modified Sopra -G, Sopraglass 100, GAFGLAS #75,
Celotex Vaporbar, or Johns Manville Glasbase fastened to the deck using
approved roofing nails and tin caps spaced 9" o.c. in a 4" lap and 12" o.c. in two
staggered rows in the center of the sheet.
One ply of lastophene FlarjElastophene Flam 2.2, Sopralene (180, 250 or 350)
Flam, or Sopralene (180, 250 or 350) SP torch applied
or
One ply of Elastophene Sanded, Elastophene 180 Sanded, Elastophene PS,
Elastophene 180 PS, Sopralene (180, 250 or 350) PS, or Sopralene (180, 250 or
350) Sanded adhered in a full mopping of approved asphalt applied within the EVT
range and at a rate of 20 -40 lbs. /sq..
Elastophene Flam, Elastophene 180 Flam,,Elastophene SP, Elastophene Flam
G . e Elasto hene a1ene (180, 250, 350) Flam Granule,
opralene (180, 2597150) Flam Granule F Sopralast 50 TV Alu torch applied
or
Elastophene Sanded, Elastophene 180 Sanded, Sopralene (180, 250, 350) Sanded,
Elastophene Granule FR, Elastophene Granule, Sopralene (180, 250, 350) Granule,
or Sopralene (180, 250, 350) Granular FR adhered in a full mopping of approved
asphalt applied within the EVT range and at a rate of 20 -40 lbs. /sq.
(Optional) Install one of the following to an approved non - granule surfaced
membrane. Refer to Underwriters Laboratories or Intertek Testing Services listings
for applicable fire classifications.
1. Gravel or slag at 400 lbs. or 300 lbs./sq., respectively, adhered with approved
asphalt at an application rate of 60 lbs./sq.
2. Karnak 97 aluminum roof coating applied at an application rate of 1' /z gal. /sq..
-45 psf (See General Limitation #9.)
See General Limitation #1
See General Limitation #1
Page 21
Frank Zuloaga, RRC
Roofing Product Control Examiner
SOPREMA ROOFING AND WATERPROOFING SYSTEMS Acceptance No.: 01- 0116.01
WOOD DECK SYSTEM LIMITATIONS:
1. A slip sheet is required with Ply 4 and Ply 6 when used as a mechanically fastened base or anchor
sheet.
GENERAL LIMITATIONS:
1. Fire classification is not part of this acceptance, refer to a current Approved Roofmg Materials
Directory for fire ratings of this product.
2. Insulation may be installed in multiple layers. The first layer shall be attached in compliance with
Product Control Approval guidelines. All other layers shall be adhered in a full mopping of approved
asphalt applied within the EVT range and at a rate of 20-40 lbs./sq., or mechanically attached using
the fastening pattern of the top layer
3. All standard panel sizes are acceptable for mechanical attachment. When applied in approved
asphalt, panel size shall be 4' x 4' maximum.
4. An overlay and/or recovery board insulation panel is required on all applications over closed cell
foam insulations when the base sheet is fully mopped. If no recovery board is used the base sheet
shall be applied using spot mopping with approved asphalt, 12" diameter circles, 24" o.c.; or strip
mopped 8" ribbons in three rows, one at each sidelap and one down the center of the sheet allowing a
continuous area of ventilation. Encircling of the strips is not acceptable. A 6" break shall be placed
every 12' in each ribbon to allow cross ventilation. Asphalt application of either system shall be at a
minimum rate of 12 lbs. /sq. Note: Spot attached systems shall be limited to a maximum design
pressure of -45 psf.
5. Fastener spacing for insulation attachment is based on a Minimum Characteristic Force (F') value of
275 lbf., as tested in compliance with Testing Application Standard TAS 105. If the fastener value,
as field- tested, are below 275 lbf insulation attachment shall not be acceptable.
6. Fastener spacing for mechanical attachment of anchor/base sheet or membrane attachment is based
on a minimum fastener resistance value in conjunction with the maximum design value listed within
a specific system. Should the fastener resistance be less than that required, as determined by the
Building Official, a revised fastener spacing, prepared, signed and sealed by a Florida registered
Professional Engineer, Registered Architect, or Registered Roof Consultant may be submitted. Said
revised fastener spacing shall utilize the withdrawal resistance value taken from Testing Application
Standards TAS 105 and calculations in compliance with Roofing Application Standard RAS 117.
7. Perimeter and corner areas shall comply with the enhanced uplift pressure requirements of these
areas. Fastener densities shall be increased for both insulation and base sheet as calculated in
compliance with Roofmg Application Standard RAS 117. Calculations prepared, signed and sealed
by a Florida registered Professional Engineer, Registered Architect, or Registered Roof Consultant
(When this limitation is specifically referred within this NOA, General Limitation #9 will not be
applicable.) _
8. All attachment and sizing of perimeter nailers, metal profile, and/or flashing termination designs shall
conform with Roofing Application Standard RAS 111 and applicable wind load requirements.
9. The maximum designed pressure limitation listed shall be applicable to all roof pressure zones (i.e.
field, perimeters, and corners). Neither rational analysis, nor extrapolation shall be permitted for
enhanced fastening at enhanced pressure zones (i.e. perimeters, extended corners and corners).
(When this limitation is specifically referred within this NOA, General Limitation #7 will not be
applicable.)
Page 24
n Zuloaga, RRC
Roofmg Product Control Examiner
SOPREMA ROOFING AND WATERPROOFING SYSTEMS Acceptance No.: 01- 0116.01
NOTICE OF 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 (8) years.
2 Any and all approved products shall be permanently labeled with the manufacturer's name, city,
state, and the following statement: "Miami -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;
b) 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 Miami -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 1 through 25.
END OF THIS ACCEPTANCE
Page 25
Frank Zuloaga, RRC
Roofmg Product Control Examiner
ELECTRICAL
TYPE:
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTV.
FVI'I?
Service Repair
Q TV.
A/C Central 1 -3 Ton
Fan
Dryer Vents, Number of
Outlet, Wall
Ventilation, Cost
Service, Temporary
Air Handler, Tons
A/C Central 4 -7 Ton
Piping, Flammable Liquid
Fire Pump
Outlet, Switch
Fire Sprinkler System
Signs
A/C Central 8 -15 Ton
Bath Fan - Vented, #
Fixture - Fluorescent
Pressure Vessel
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
AlECHANICAL
TYPE
Minimum Fee
QTY. TYPE.
Condensate Drain
QTY. TYPE
Generator
QTV. TYPE
Refrigeration, Tons
QTY.
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Solar Water Heater
Air Handler, Tons
- Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Cap - Fixture
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Pump and Abandon
PLUMBING
TYPE
A/C Condensate
QT,.
TVPF
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
Q . I .,,
TV
Soakage Pit
Q .,.,.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor ■
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.)
Inspector State Educational Fund
State DCA (Radon)
Code Enforcement Fine
Zoning Review
Notary
Cl PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
(X .ft.. 0.60) x/1000
(0.005 /sq.ft.)
(0.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2N AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
Page 2
IMPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. ' EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STATE OF FLOR
Signature o
OUNTY OF MIAMI -DADE
e -J r ( P-p D r i 'T i
Print Name
Sworn to and subscribed before me this , day of 6 0(21 Y
1npY . P.' LORRAINE VELAZQUEZ
• MY COMMISSION # DD 121410
;;s
.
m• y�.,., EXPIRES: March 6, 2004
• Bonded Thru WV/ Public Underwriters
Signature of Notary Public - State of Florida
SEAL:
Personally known
ica on
Type of Identification Produced:
PERMIT APPLICATION
STATE OF FLORIDA C • I►r • IAMI -DADE
EBERLY
- State of Florida
Evies May 18, 2008
mission A DD1i9179
nded B National,Netery Assn,
Personally known OR, Produced Identification
Type of Identification Produced:
CONTRACTOR
`� _ OWNER
Name R.t3 �S 4` k) fLk LIlQ.
Name , r
wt''� S� E tom.
Home Telephone
License No. c .... c C 01 4 1 t
Fax 305 -, `]51 - G, 1
Address / k 31 9.0 1 J 4
IQ- i - -Ac4 &ee N t-Ft '33'( ( 2.
Repair
Telephone 9 TV-Li i 1-93 31 Fally, g /+ l 5 3
''
(�
Qualifier Name 1 4. e r ,
Demolish
PROPERTY
`� _ OWNER
Name R.t3 �S 4` k) fLk LIlQ.
Address ,raci , jt 0I y , r. ,- 1
\:ate: • V1 33137' ~219
Home Telephone
Business Telephone 30c...73 i q a.
Fax 305 -, `]51 - G, 1
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
t/
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
r�
Other r'ar7t-:...,_
t/
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step I.
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit-
ted along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
Job Address:
41 ME /0/ S tree- A icyv' Skov -es
Address
Folio Number 3 60 / -70 0 6c/c2 Lot /S +Wft. f IO Block C I
Subdivision PB PG
Current Use of Property
Proposed Use of Property
Tenant Information
Apt. City
Zoning
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Description of Work
Master Permit No. Gj
Subsidiary Permit No.
Value of Work 4 6 WO, e o
Square Feet
Tax Assessed/Appraised Value
Flood Zone
Units
rl 3 :lam? --AiN
State
PERMIT APPLICATION
C)
Zip
4 2-r00 4` S -
Linear Feet
Floors
Bldg Value
Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
Date 2A 124)41 Job Address D9 07. IOIA ' Tax Polio I 1- 3a66,- 01'1 - -d
Legal Description LD j t 5 J.,)- ([r . ) • /6 'cam( K.. 91
Owner / Lessee / Tenant // Master Permit # ( ife S
Owner's Address NOW,
Contracting Co. \
Qualifier ),4 Qua %SL
State #QC.4 (o%1 Municipal #
Architect /Engineer 1J (Ar
Bonding Company ■\A"
Mortgagor
Square Ft.
Signature of owner and /or Condo President.
Date:
My C E xpi
**
.s�
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
too()
ANNEMARIE RAFFA
1 Ad _1?Ygy i.I4Nk'e Ins
No. CC535329
[ ] Personally Known 1 ] Othu 1. 9
Phone . 305`757— 4
Address ( (n jijr$ . �X
Phone �r ?� -9 a� - - 7� 1S 6
Competency # Ins.Co. n2 ►►I On...4.,.. r-�.
Address
Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING
WORK DESCRIPTION
v
Estimated Cost(value) 4,noo.0
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 const ion and •ning. Furthermore, I
authorize the above -named contractor to do the work stated.
)/
* *
Address
FENCE SIGN
Signature of Contractor or Owner- Builder
Date:
API
'
Notary as to Owner ! >r
ary as
My Commiss : c 9 'L Fri (older
No
tided
y ommission - p,],� 8 �-- ' :: Ins
C
* * * * * * Pt*nally KB Ott*
FEES: PERMIT RADON C.C.F. 4 NOTARY TOTAL DUE
APPROVED: Fire Other
Zoning Building Electrical
Mechanical Plumbing Engineering
**
NOTICE OF COMMENCEMENT
PERMIT NO. TAX FOLIO NO. - 3ac>4, o f 7 - dG y 0
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Legal description of property and street address: L-0.1 N Z. l S`sirr frN t fT\ S 1401
j c ,} ' t.oe5k 11)- Lod ‘C, Modc °
2. Description of improvement: P.e2c-irsr FC.RT - "0 ect 1 oo Pc et.
3. Owner(s) name and address: �s-t, s CkS ��i ► NF 10\ SttetEt J'n1i9M►
S cyrS
Interest in property: OW e-a-
Name and address of fee simple titleholder: N ! P-
4. 4. Contractor's name and address: 9 0 - VT
‘ 33o0
5. Surety:(Payment.bond required by owner from contractor, if any)
Name and address:
Amount of bond $
Notary Public
Print Notary's Name
My Commission Expires: h
WITNESS my
HARVEY
By
E RAFFA
STATE OF FLORIDA, COUNTY OF DADE
Fe
HEREBY CERTIFY Clot this is a fr y of
[ original fil t fff'
!'n J�' '(/ /— .. 19 2.
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address: `�
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address: N`A'
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
diffe nt date is specified)
tP , j y e 4
1 -
Signature of Owner f� p
Print Owners Name fYl� Y -opo-+ oQS tt
Sworn to and subscribed before me this \\.. _ day of Cn14 , 19
No. CC535329
Pcr;cnally Kr.•'wn . [ ] Oth°r I.
of
t and County Courts
o,c•
r4)
N.
��,,QQ�.
Prepared by. �� / � --
:
Addr ss ` -Q / v (V A
� �� p 3.9 ,7 2- 0
Contractor's Name: 1), )h e. . L
Job Address: 1 4 1■) ? ' . /0 I% IT
e b' x;111, Cl}'tl�t!
Flat Roof Area (f1 1, L )C) Sloped Roof Area (ft') Total (11 Master Permit No.
Exposure category (per ASCE 7 -88): (• Building Classification category (per ASCE 7 -88 table 1): -
ROOF CATEGORY
U ( Low Slope Application) ❑ (Nail- On.Tile) ❑ (Mortar - Adhesive Set Tile)
❑ (Asphalt/Fiberglass Shingles) ❑ ( Metal Roofs \Wood Shingles & Shakes) ❑ (Other)
ROOF TYPE
CI New Roof t rooting ❑ Recovering ❑ Repair ❑ Maintenance
Ft.
v
Ft.
V
Deck type: Worie., , k T R
ATTACHMENT
Fastener Type: (■Z Ist.S
Fields
SPACING
Perimeter: _ 1 Corner: L A
I
DETAIL 1 & 2
ROOF HEIGHT AND SYSTEM DETAILS • (Draw details as ' /
` 1
1 It/ U t '�I d
ROOF PLAN
123.01 -78 9/96
Appendix "E"
UNIFORM ROOFING PERMIT APPLICATION
PROCESS No.
Page -1
tRUBEROUJ Specification N- 1 -1 -MG and N -1 -1 -MGFR
3 1
2' Min.
SIde,Lep
M�
1 GAFGLAS n5
Base Snee1
nUBEn0IG
MEMRAIIE •
r /a Min. Mailable
Dock
Bleep Aephelt
ASTM.Type III
or IV
Substrate — " /» inch minimum plywood, gypsum, structural wood liber,
lightweight insulating concrete. See "lightweight Insulating Concrete Decks,"
page 10.
Slope — Up to 1 inch per foot for lightweight insulating concrete; up to
3 inches per foot for other decks.
Materials
GAF Materials Corporation Steep Roofing Asphalt ASTM D -312 Typo 111 or IV
GAFGLAS 175 Base Sheet
RUBEROID MOP or MOP 170 FR
Approximate Weight Per Square Total 145 -155 lbs.
These specifications can be applied using RUBEROID Modified
Bitumen Adhesive. References to cold applied installations require the
specification designation to be followed 1)y a "(CA)" to Indicate that it
is to be cold applied,
UL Approvals for cold applied constructions are pending. Contact GAF
MC Technical Services for current status.
Guarantees Avaltable - --------
SpecilIcatlon RUBEROID Liberty RtJ8ER0I0 ..... ..__,
N•1.1 -MG 12,10 12, 10
N -1 -1 -MGFR 12,10
12,10
General
Recommendations presented on paves 17 -22 shall apply In addition to the
tollowing application recommendations.
Application Recommendations
1. Lay one ply of GAFGLAS 175 Base Sheet (or one ply of STRATAVENT ° (Vent
Ply) as required for nallable decks In the case of a fresh lightweight insulating
concrete or gypsum deck), with a minimum 2 inch side lap and not less than 6
inch and laps. Nall along side lap of the base ply at Intervals not to exceed 9
inches and stagger-nail down the center of sheet in two rows with nails spaced
at 18 inch intervals in each row.
2. Starling at the low point of the roof, fully embed one ply of RUBEROID
hiernbrano (Granule) in a nominal 25 pounds per 100 square feet (plus or minus
20 %) continuous coat of Steep Rooting Asphalt ASTM 0-312 Type III or IV, The
RUBEROID membrane must be positioned to provide 4 inch side laps and 6 inch
end laps.
RUDE..R01D FR UL Classification
UL Class Substrate
• A C
A NC
Specification
N•1.1•MGFR
N•1 -1 -MGFR
For more extensive classifications, see page 6,
UL Chart Key
1. Substrate •
C = Combustible and Noncombustible
Combustible = Wood planks, boards, etc., plywood (min. 'S /s Inch
thickness), oriented strand board (rain. % inch thickness). •
NC = Noncombustible only
Noncombustible = Steel, poured or precast structural concrete, lightweight
Insulating concrete, gypsum, structural wood fiberboard, etc.
2. Slope
Maximum slope allowed, in inches per toot.
P
51
r
htU
MAP 'c)N l Ni
METROPOLITAN B
o DADEFLOGI COUNTY, BUILDING
UUILUINO COUE COMPLIANCE DEPUTE 1603
ME1ft 40 WEST ER STREET O
MIAMI, FLORIDA
.01
FAX 1305) 376.2000
GAF Materials Corporation
1361 Alps Road
Wayne, NJ 07470 under
ti1• r' II = II � � � es of
Your application for Product Approval of Code Overran the use of Altemate Materials Construction
Chapter i of the millet Metropolitan Dade County
arch Corporation, South Florida Test Service, Underwriters ode
Construction, and completely described in the plans, specifications and calculations as submitted by Building Research Laboratory, Inc., Factory Mutual R
Laboratories, Inc. and Dynatech Engineering, Inc. has been recommended for acceptance by the
Compliance Department to be used in Dade County, Florida under the specific and standard conditions set forth
herein.
Hance 'Department reserves e
plant for quality control testing. If
The approval secure sha be valid Materialratdany time for a ortmanufacturer pmp modify
If
approved manner, the Code Compliance Department may revoke,
right to secure a product or it Hance Department reserves
product or material fail to perform in the app Code Comp
or suspend the use of such product or material immediately. The Building
J ` I testin g of this product or material should any amendments to the South Florida Building Code be
the right to require testing
enacted affecting this product or material.
The expense of such testing will be incurred by the Manufacturer.
PRODUCT NO. :
ACCEPTANCE NO.: 21
EXPIRES: NOV x-_9._1991
1 ' _ tt • t L e l ll
ul Rodriguez
Product Control Division
Supervisor
- )'LEASE NOTE -
IS IS THE COVERSHEET. SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
TH CONDITIONS.
BUILDING CODE COMMITTEE
Building Code
This application for Product approval has been reviewed by
the Metropolitan Dade County Compliance Department and iodide under
Com lid approved by the Building Code Cornmittee to be used in Dade Cout
p
the conditions set forth above.
APPROVED: 4 - 19gtJ
arlesDanger, P•E•, Director
Building Code Compliance Department
Metropolitan Dade County
S YSTEMS
PRODUCT CONTROL NOTICE OF ACCEPTANCE
ROOFING SYSTEM APPROVAL
Applicant:
GAF Materials Corporation Product Control No.: 95- 0330.06
1361 Alps Road MAY 0 4 1995
Wayne, NJ 07470 Approval Date:
Expiration Date: NOV 1 0 1 991
Category: Membrane Rooting System
Sub - Category: Built -up Roofing
Tv°e: Modified Bitumen
Sub -Type. SBS, APP
System 1, uiptiou
GAF Materials Corporation has been manufacturing commercial roofing products for more than 100
years.
GAF produces a wide range of roof products for built -up roofing systems. The modified bitumen
products include both APP and SBS products in smooth, granule and fire rated versions. In addition,
GAF offers two ply modified systems to meet the specification requirements for multilayer SBS
modified specifications.
GAF products are distributed through a wide network of roofing wholesale distributors throughout the
South Florida area.
GAF provides warranted systems over various insulated and non - insulated substrates, copies of which
can be obtained from GAF and can be found in the Ruberoid Modified 'Bitumen Application and
Specification manual published annually.
GAF roof system assemblies have been extensively tested at Factory Mutual Research Corporation and
Underwriters Laboratories. GAF modified bitumen membranes have been tested in compliance with
ASTM D 5147 test requirements.
Insulation Types:
Fibrous glass
Perlite
Fiberboard
Polyisocyanurate
Expanded polystyrene ('pPS)
Polyisocyanurate Composite Board
Maximum Design Pressures
Material Design Pressure
Wood -60 psf
Steel -75 psf
Concrete -248 psf
Lightweight Concrete -45 psf
Poured Gypsum -45 psf
3
Raul Rodriguez
Product Control No.: 95 0330.06
Maximum Fire Classification
Material Classification
Wood Class A
Steel Class A
Concrete Class A �+'�
�
Lightweight Concrete Class A '
Poured Gypsum Class A
Note: Fire classifications and maximum design pressures do not reference all assemblies over
deck types. Review system listings for design pressures and the Underwriters Laboratories
Roofing Materials Directory or other approved testing agency listing directory for Fire
Classifications.
Membrane Type: SBS
Deck Type 1: Wood, Non - insulated
Deck Description: '''/, or greater plywood or wood plank decks
System Type E: Base sheet mechanically fastened.
All General and System Limitations apply. #75 or
Base Sheet: One ply of GAl. tave t® Ply
ent l' Nailable Decks mechanically � f® tened as
GAFGLASt� Stra
described below:
Fastening: Base sheet shall be lapped 4" and fastened with approved roofing nails and tin caps
9" o.c. in the lap and two rows staggered in the center of the sheet 12" o.c..
Note: Ply 4 and Ply 6® applications require sheathing paper over the wood deck
before application of base sheet.
Ply Sheet:.
Membrane:
Surfacing:
Maximum Design
Pressure: -60 psi.
Product Control No.: 95 0330.06
(Optional) One, two or three plies of GAFGLAS® Ply 4, GAFGLAS® Ply 6® or
a single ply of Ruberoid® 20 in type III or IV asphalt at an application rate of 25
lb. /sq. ± 15 %.
One ply of Ruberoid® Mop Granule, Ruberoid® Mop Plus Granule or Ruberoid®
Mop FR in type III or IV asphalt at an application rate of 25 lb. /sq. ± 15 %.
(Optional) Install one of the Following:
1. GAFGLAS® Mineral Surface Cap Sheet in type III or IV asphalt at an
application rate of 25 lb. /sq. ± 15 %.
Maximum Fire
Classification: Class 'A'; see General Limitation 112.
Maximum Slope: 3:12; see General Limitation 113.
Specification No.: N- 1 -1 -MG, N- 1-1 -MGFR, N- 1- l -MGFR, N -1 -2- 20/30, N- 1- 2- 20 /30FR,
N- 1 -1 -MGP
41
Raul Rodriguez
w bpM �o. * I ` . EQR .P O COB
flC 2
o 5 \
E � -2 C� \A '.061 vOU\ � ,. �.,.. 1"g° /,1'85
DI REN ' AL O TRANSFER SEC #
? U NEW DATE BUSINESS OPENED
Is 2010 .SHERMA.N ST
HOLLYWOOD.
BUSINESS
•
�;�.; ± .. . , • 10298.
0 STATE OR COUNTY CERT /REG #
Business Locatlbn 'Address:
.1. •
0 • 3'3020
00• - 922 -738
UNTY OCCUPATIONA LICENSE TAX ' '
E 1996 THRU/SEPTEMBER 30: 1997`• 1 -S EW ON QR. 30 1 9 97 "
1
r ,' SEPTEMBER.30,�4997
.THI ILI1EN MUST BE CONSPICUOUSLYDIS?'CA(ED " ,
• TO ' VIEW AT THE LOCATION DDRESS ABOVE :1
f6
1 • =.. R
I- .i 110
W -
O BROWARD COUNTY REVENUE COLLECTOR"":';' c "' . 4. * ).- ` - ' a=
z"
0 115 S. Andrews Avenue, Governmental Center Annex �: • : , 9:97 `
• 0 FORT LAUDERDALE, ` FL 33301 'SEE BACK FOR TRANSFER INFORMATION PAYMENT RECEIVED AS VALIDATED ABOVE
/ I ,
0000000000; 0000002700 0000001850000164 1001 7 2 ?0Q ' 0.27559 0? 09 30 9E-
,
4' 171i
PENALTY
.r C FEET ?t si+ ;
TRANSFER /
.� r Y�� .. .=a,».,;a �Nmpgw�t,•.w gin,
i� ?j•f� Y �f�•
!IwT E, S E
i
CON
1.0 . UNI'TS ,
A i•;. IF PAID
ACT linti5f' r NOV: : 15 % " '•
"� 0EC ' 20% I "`Atter DEC. 31 •• +25%
,, PIUf4 i ection Fee of up to $'15.00,
ased. Cost of License If Paid
Ori'of'After November 30, 106'
Department re i rrYSryiv iYi ��rr'wrs.vi .rv�. � +tea i r iti r ..rc c.
� ii " �*�r s
4 ��51`A7 pp =OFM � I.�OR�DA��
, x.1t C, „t�G,h• 's.5-- w^ f✓d::+ g'�t h . r�? "aP 'f?# 1 f.y"y 5 t �'k'' r. �ar� �-
of Bus nose and �'Oro fessional Re ulatiori s�
CONS 'I ;NDUSIYRY £141ICRNS
` � ... r5 .v i
AU., 4
- As 'uf' eft -.Y
08/29/1996 96901239
The BUILDING CONTRACTOR
Namedbelow IS CERTIFIED
Under the provisions of Chapter 489 9 8 , FS.
Expiration date: AUG 31 ,
ETHRIDGE `ROBERT F
INDIVIDUAL''
9846 NW'6TH COURT
. PLANTATION' FL
LAWTON CHILES
GOVERNOR
•
LICENSE NBIt_
CB - C019804 ',o'
RD Ts F` I RRELL
ECRETA
e rE ,.s''z1 S TATE OF FLORIDA
h j \ • Department of Business and Professional Regulation
CONST INDUSTRY LICENSING BOARD
7960 ARLINGTON EXPRESSWAY
SUITE 30
JACKSONVILLE FL 32211 -7467
•
ETIIRIDGE ROBERT FONTANA
WHITE SEAL INC
2010 SHERMAN STREET FL 33020
HOLLYWOOD
AC# ,/1.12 •1650
BATE '
HATCH NUMBER
08/29/1996 96901239 CC - CO56367
Pm ROOFING CONTRACTOR
Named below I S CERTIFIED
Under the provisions of Chapter 4 09 ; FS.
Expiration date: AUG 31 , 1 990
4116 THRIDGE, R OBERT FONTANA
HITE SEL INC:
2010 SHERMAN STREET
HOLLYWOOD FL 33020
' ";
LAWTON CHILES
GOVERNOR
DETACH HERE
Department of Bsliig
cONST. I.0
— TITENSE TWP
DISPLAY
412465
(904) 727 -6530
STATE OF FLORIDA AC# rf 1 4
Department or Business and Professional Regulation
CC - CO56367, • .08/,29%1996 96901. •
CERTIFIED ROOFING CONTRACTOR
ETHRIDGE . ROBERT.FONTANA
WHITE. SEAL ,'.INC"
I S CERTIFIED under the provisions of Ch. 4 89
Expiration Date: AUG 31, 1990
'CNARDT
SECRETARY
•
•
•
• QR ne
ROBERT FONTANA ' ETHR I DC E
'9846 Mr cr
,PLANTATIONe. FL 39321 -0000
'`. -18 -98 ?1 6 -00
0 : 4 +04 ewwi• ( •,, 0515-91
;,•E363- 766 -0- 158 -0•• 07- 18 -.98
'CLASS E
EAF IVER iii ..n otoo
u
z
•
Oet;UVAIIUNAL Llt.:1C14DIC vrrm•mi ncraoa.• I I 1.,, CITY OF HOLLYWOOD '
P.O. BOX 229045 .
HOLLYWOOD, FL.33022-9045,
1 OCCUPATIONAL LICENSE - VALID FROM 0/1 /98'THIOUGH;,0/3
rdti LEASE POST IN A CONSPICUOUS PLACE
1.1CI:1•ISE NUMBERI 7329182
BUSINESS TYPE: 08175 .00 NT.:ftACT. OR FING
ILI cooqs): P08"2 5 R
1, •
. -fp.,*, • ;
(Lit
• •/,; . •
nusinEss NAME / LOCATION: . • •
1 •4 HI Tr. S EAL INC
I * .
2 (1p ,SII,ER MAR' ST
vioLLy..00 PP; •
TO: WIIITC SEAL INC
210 SHERMAN ST
HOLLytiooD
FL 33020
.• .
FIRST CLASS MAIL
U.S. POSTAGE PAID
SOUTH FLORIDA
[
PERMIT NO. 67
1997 LICENSE FEE
250 .00
PENALTY
, • 0 AO
TRANSFER FEE
0:00 _
TOTAL PAID
• ,
J. - ..25000
This license must be poste
In a conspicuous location i•
the place of business
which it is issued.
MIAMI SHD ES 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 prpgress of the work.
No .._ q
Street
Owner's Name and Address k7 ...!..._.. ,� � Date.
�� 4 /,e7/ .�,1,sf��t
Registered Architect and /or Engineer
Name and address of licensed contractor Ideal Roofing &Sheet Metal Works, Inc .261 NE 73 Street
Subdivision... AW 1'" l M5 1 / " J /.. ��� / i 6V,1 ✓
Location and legal tion al fi_esc i of lot to be b t on:
Lot/5 /1 Block q
Street and Number where work is to be done Q
State work to be done and purpose of building .(by floors) ...��"`/ q/ ieow
Disapproved
(Signed)
Date
Repairs
New Building Remodeling Addition
To be constructed of Kind of foundation. e
Estimated Total cost of improvements $ 77 Amount of Permit $
Zone cubage required 7-6erb egrr
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
nanent Supplement,
s employed -by im
such public noti
performed under th
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,
therein by him stated ,- / are true. �7 /
Permit No J 1 P Date ,l 3 ,[ /
8 Read, Sworn to
PLANNING BOARD DATE
7-
and for no other purpose.
No of Stories
Roof Covering..._ p C7'�� ?�
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub -
in the work to be performed under this permit; and will post or cause to be posted fi�r i . - . on on the
or notices as are required by the Act. The undersigned agrees to employ only s cltubcon j .rs, on
permit, as are licensed by Miami Shores Village.
Remarks (Sign
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 that he did sign the same, and that all facts
and Subscribed before me.
Notary Public, State of Florida
Buildin Spector My Commission Expires
Chainnan Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re-inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
Owner's Name and Address
Ncw Building Remodeling
Disapproved
(Signed) il.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal of the detailed statement or 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 Bilildiug 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.
GBErt I .STGBS
Registered Architect and /or Engineer
Name and address of licensed contractor .. /f ... aol�� � >.. � / -- - I..../VW ... Z/ 5 1 :. t /07/1/
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors) ie l 6 ' O /` /f / TI , 7fa
^ Date
Building Inspector
Chairman
Member
Member .. ..
Council Approved Date
NOTE: A charge of 31.00 will be made for making
the Pl,tnnir,;; Ito.trd.
A rc•in.pection fee of 31.00 will be charged
materials and/or workmanship.
Date _....... ,19 oG
— No. ... ... Street.SE !Ui _.5'T _. - .........._.
ya. Nf /0/ 5T
and for no other purpose.
Addition Repairs ✓ No. of Stories / _
To be constructed of Kind of foundation Roof Covering C *t (- Sfl /ld(C,E
Estimated Total cost of improvements S 6 Z3. 00
Amount of Permit $.
Zone cubage required .Plan Cubage
Distance to next nearest building Size of Building Lot
\faxiunum 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 Libor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
anti has complied V. 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 arc 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
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. p
Permit No.._.._._.. _ �,�.�ay Date 1 ' � o 0
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
PLANNING BOARD DATE
I.t. ,.,....tr •..tttttt!, tt
��. 00
OaMv¢L — a1
Member
Member
Member
Disapproved
corrections or changes to this application after approval
My Commission Expires
TOT/fL
to me well known,
Date
has kern obtained from
when such re- inspection is made necessary by Improper notice for inspection ce faulty