ROOFINGFINAL GUTTERS, PERMIT ON BACK OF HOUSE NEXT
TO WORK DONE.
4 [
Passed M
rInspector
Comments
,
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Number: IN 142
Inspection Date: 04/06/2006
Inspector: Grande, Claudio
Project: <NONE>
Contractor: ARION INC
Building Department Comments
Thursday, April 6, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone�(305)795 -2204 Fax: (305)756 -8972
Owner: YERKES, WILLIAM IV
Job Address: 430 101 Street NE
Miami Shores Village, FL 33138-
Block:
`Permit Number RC-3-06-734
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Repair
Phone Number (305)751 -7923
Parcel Number 1132060170470
Lot:
Phone: (305) 251 -1279
Page 2 of 2
RC -3 -06 -734
Project: <NONE>
Owner: WILLIAM IV YERKES
Phone: (305)751 -7923
Job Address: 430 101 Street NE
Parcel: 1132060170470
Miami Shores Village, FL 33138-
MAIN GUTTERS FINAL
NO ACCESS NOBODY HOME
04/06/2006 INSP -14130 Final
NO ACCESS
01/01/2999 INSP -14260 Final
Thursday, April 6, 2006
Inspection History
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
ft 4k.
Residential Construction
Block: Lot:
Scheduled Insp # Inspection Type
04/04/2006 INSP -12841 Final NO ACCESS
Claudio Grande 4/5/2006
Inspection Status Inspector Date Completed
DENIED Claudio Grande 4/6/2006
Pending Inspection Claudio Grande Not Complete
FINAL GUTTERS, PERMIT ON BACK OF HOUSE NEXT TO WORK DONE.
Page 1 of 1
Inspection Number : =INSP 12
Inspection Date: 04/04/2006
Inspector: Grande, Claudio
Owner: YERKES, WILLIAM IV
Job Address: 430 101 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: ARION INC
Building Department Comments
Tuesday, April 4, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: [305)795 -2204 Fax: (305)756 -8972
Block:
emit Numbe RC-3-06 -734
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Repair
Phone Number (305)751 -7923
Parcel Number 1132060170470
Lot:
Phone: (305) 251 -1279
Page 2 of 2
Passed
Inspector Comments
is ,
v
0
�
Fa i led'
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Number : =INSP 12
Inspection Date: 04/04/2006
Inspector: Grande, Claudio
Owner: YERKES, WILLIAM IV
Job Address: 430 101 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: ARION INC
Building Department Comments
Tuesday, April 4, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: [305)795 -2204 Fax: (305)756 -8972
Block:
emit Numbe RC-3-06 -734
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Repair
Phone Number (305)751 -7923
Parcel Number 1132060170470
Lot:
Phone: (305) 251 -1279
Page 2 of 2
City
Qualifier
.• •
Contractor's Address
Mi ami
Adel. Zq loG .
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building /� Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) C� \ $'l -- 7 9' `L-3
' (F p ) ' spa, 0 �/',� k. f Phone # 1, � �
Owner's Address ' 30 N c / V 1 , � TT ,
City ,.�r, a.-� �i�e AyState Zip
Tenant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
Contractor's Company Name Arion, Inc.
Richard Wynne
Type of Work: ❑Addition ❑Alterati
Describe Work:
Total Fee Now Due $ ' `) 6 ' 3O
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
County Miami -D
State FL
_
NO
8723 Sw 1291 TPrr_
Phone #
77/ 32'
/ 0 1.!'t ,
Zip
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit
^ ❑ New
Phone # 305-251-1279
33176
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
MAR 2 2A05
Permit No-DD 1R
Master Permit No.
Zip 37/1,
State Certificate or Registration No. Certificate of Competency No. Gut) 1 31
Square Footage Of Work: f Q L.. ,.
Repair/Replace ❑ Demolition
a . 1 ,„,c' cAt__._
Submittal Fee $ Permit Fee $ Mt CCF $ 'O • bO CO /CC
Notary $ Training/Education Fee $ 0 Technology Fee $ 2_ (50
Scanning $ C2JD Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
21 ,, i .0 .a
Bonding Company's Name (if applicable)
• Bonding Company's Address
City . State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant. As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant mush
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature('
Owner or Agent
The foregoing instrument was acknowledged before me this
\, The foregoing
� i
day of �G rCf\ , 20 010 by 16 4y, 7 {' ,- c � , day of
who is personally known to me or who has produced who i
p f ' * 1 L - 3 - C - ) 171 - e i n - t ( ffi l cItio9 and who did take an oath.
NOT ' 'UBLIC
S --�
Print: - ! t (\DCA.
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 05/13/03
J. NAFTAL
EXPIRES: October 11, 2008
1.800 •N Fl. Notary Discount Assoc. Co.
NOTARY PUBLIC:
Sign
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * * * * * **
tractor .]�
acknowledged before me this l
, by
or who has produced
as identification and who did take an oath.
J. NAFTAL
€®MM AtN* ®D341424
EXPIRES: October 11, 2008
1-800-3-NOTARY FL Notary Discount Assoc. Co.
0/. •
Plans Examiner
Engineer
Zoning
Proposal
PERMIT:
Total
Extras:
Continuous Rain Gutters
f0
Authorized Signature =' "
Rain Contro
Kim Ytar e
430 (e 101 Si
;am 4rpres,
Itb"SiA'A
8723 S.W129th :�r�x�irr ��, �i 33176/(305) 251 -1279 /Fax (305) 251-3877
786485 =3327
We hereby submit specifications and esti for: 6 inch aluminum continuous gutter.
GUARANTEE: 1'YEAR LABOR 10 YEARS MATERIAL: INSTALLATION DATE:
t aa S ora /' 1t/ 0 TTAGE: 9
Deepositl /11 ..4. .__..- - %c.fi_ --f", ` - / Balanc
l D a t c , n 6 Client S i g n a t u r e . - * - - ' _ e . • t
TERMS ON 'THE REVOSE SIDE A PART OF THIS ROPOSAL
- OFFICE COPY
CUSTOMER #
ORDER #
.••• •••.....•••••••...•..••••••••..
1 - r 9sx
/0 S.— . -r..
i
I I
;
r-- F _ '
I
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Lea
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{
_
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1
1 7
. t I
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1 t
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f
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111
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y 1 I I 1
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( 1 1 1
.i
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I t Ii
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i
\
I
s
!
([ 1
I
Proposal
PERMIT:
Total
Extras:
Continuous Rain Gutters
f0
Authorized Signature =' "
Rain Contro
Kim Ytar e
430 (e 101 Si
;am 4rpres,
Itb"SiA'A
8723 S.W129th :�r�x�irr ��, �i 33176/(305) 251 -1279 /Fax (305) 251-3877
786485 =3327
We hereby submit specifications and esti for: 6 inch aluminum continuous gutter.
GUARANTEE: 1'YEAR LABOR 10 YEARS MATERIAL: INSTALLATION DATE:
t aa S ora /' 1t/ 0 TTAGE: 9
Deepositl /11 ..4. .__..- - %c.fi_ --f", ` - / Balanc
l D a t c , n 6 Client S i g n a t u r e . - * - - ' _ e . • t
TERMS ON 'THE REVOSE SIDE A PART OF THIS ROPOSAL
- OFFICE COPY
CUSTOMER #
ORDER #
.••• •••.....•••••••...•..••••••••..
1 - r 9sx
/0 S.— . -r..
i
Issue Date: 3/28/2006
Owner's Name: WILLIAM IV YERKES
Permit Type: Residential Construction
Work Classification: Repair
Job Address: 430 101 Street NE
Contractor(s)
ARION INC
Phone Primary Contractor
(305) 251 -1279 Yes
Comments:
INSTALL RAIN GUTTERS AT BACK OF HOUSE DAMAGED BY HURRICANE.
(WHITE)
Additional Information
Miami Shores Village, FL 33138-
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Expires: 03/22/2007
Type of Construction: GUTTERS
Stories: NA
Front Setback: NA
Left Setback: NA
Bedrooms: NA
Plans Submitted: Yes
Certificate Date: 3/22/2006
Occupancy: Single Family
Exterior: NA
Rear Setback: NA
Right Setback: NA
Bathrooms: NA
Certificate Status: NA
Additional Info: WHITE COLOR
In consideration of the issuance to me of this permit, I agree to perform the work
covered hereunder in compliance with all ordinances and regulations pertaining
thereto and in strict conformity with the plans, drawings, statements or specifications
submitted to the proper authorities of Miami Shores Village. In accepting this permit I
assume responsibility for all work done by either myself, my agent, servants, or
employes. I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING
POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that
all work will be done in compliance with all applicable laws regulating construction
and zoning. Futhermore, I authorize the above -named contractor to do the work
stated.
Building Department File Copy
Applicant Signature
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: RC -3 -06 -734
Phone: (305)751 -7923
1132060170470
Lot:
PB:
Total Square Feet: 100
Total Valuation: $ 824.00
Required Inspections
Final
Fees Due
CCF
Education Surcharge
Permit Fee - Additions /Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$100.00
$3.00
$2.50
$106.30
Invoice Number
RC - 3 - 06 - 24261
Total:
Amt Due
$106.30
MAR 3 0 PAID
C K4 )8zi4 1 Cx i o26
Amt Paid
0
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date iz G Job Address -/ ,✓ E /0 / J' Tax Folio /
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant
Owner's Address -'7 i✓ // J - r - • Phone 75 / - . 3 -
Contracting Co. A r i on, T n c_ Address 8723 S w 1 2 9th Tp - r
Qualifier Richard R. Wynne SS# Phone ( 305) 251
State # Municipal # Competency # 000013371 Ins. Co. Cl a F, /e
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Z.✓r7 ' / /
Square Ft. /C'0 • k e Estimated Cost (value) /60o - --
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of o e r and/or Condo President Date
i
otary : to Owner
My Commission Expi
FEES: PERMIT
,R > 16j t
IAN v;r L
JENNIFER. ' FTAL
NOTARY PUBLIC STAVE. OF , "LC;;;:.._,1
COMMISSION NO. CC2',625
MY COMMISSION EXP. OCT. 11,1996
RADON
-j/0 ��+4e02 �`a 2T o7 (� ,pC ,M- .ni ✓�v.
t.✓ / ;ti
Master Permit # �b 7e2
ild
Signature of Contractor or Owner-
C.C.F. 11' 1 NOTARY TOTAL DUE 11,
9
Date
. trek
Notary , s to Contract. • `. - • NOT EAL ate
My Commission Expi - JENNIFER L fAL
NOTARY PUBLIC STAY L OF FLORIDA
COMMISSION NO. CC2 ?, 626
MY COMMISSION EXP. OCT. 11,1996
APPROVED: *4-- Zoning I3uilding fk g/
Electrical
Mechanical Plumbing Engineering
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 1 1— 2 2— 9 5 Job Address 430 N. E. 101 Street Tax Folio
Legal Description Historically Designated: Yes ' No
Owner/Lessee /Tenant Kim Yerkes Master Permit #.
owner's Mdress 430 N. E. 101 Street Phone 751-7923
ContractingCoQuality Roofing Contractor, Inc. Address 251 N.W. 99th Street
Qualifier Carlos Arocho SS# Phone 751-0382
State # R C 0 0 5 8 6 2 7 Municipal # Competency # 17889 Ins. Co.
Architect/Engineer Address
Bonding Company. Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING . PAVING FENCE SIGN
WORK DESCRIPTION Tear off roof to deck, prime deck, hot mop base sheet felt,
Square Ft. 47 s q .
mop on with hot asphalt Flintlastic FR —P, install metal eave drip.
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 YqU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
ignature of owner d/or Condo President
Notary as to 'a wner and/or
My Commission Expires:
1•> ±S: PERMIT
1Z
Date
YLOU HERNANDEZ
MY COMMISSION # CC 324212
EXPIRES: October 10, 1997
Bonded fire Notary Public Undewriters
95
Estimated Cost (value) $ 12,000.00
t2/26
/-
Date
Signature of Contractor or Owner- Builder
Notary as to 4-%n tractor o • er- Builder
My Commission Expires:
MARYLOU HERNANDEZ
MY COMMISSION # CC 324212
EXPIRES: October 10, 1997
Bonded Thor Notary Public Underwriters
RADON C.C.F. NOTARY TOTAL DUE V
4 ;076
Date
APPROVED: C " �
Zoning Building ( Electrical
Mechanical Plumbing Engineering
STATE OF FLORIDA, COUNTY OF DADE
HEREBY CERTIFY that this is a true o• •f rho
original filed in t is ffic on — /� * a 00
( /,� A. O. 19 /
W.TNESS my h nd Official Sea
' 1 r�`, FRI( •fCi Courta 4 . dCounty
HARVEY y,,- o.o
r `!:
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO.
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:
2. Description of improvement: Install new Flat Roof.
3. Owner(s) name and address: Kim Yerkes
Interest in property: Owner
Name and address of fee simple titleholder: N/A
4. Contractor's name and address: Quality Roofing Contractor, Inc.
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address: N/A
Amount of bond $ 00
6. Lender's name and address: N/A
TAX FOLIO NO.
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: N/A
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
different date is specified)
Signature 01 Owner -
'Tint Owners Name K:
orn to and subscribed before me this, `L day of
I Public � 1 l(,t
'ary's Name
'-sign Expires:
430 N.E. 101 Street
Miami h
251 N.W. 99th Street Miami, Florida 33150
.1
I 1 .^ t uu ENNANCIU
:. i at MY COMM 9 CC 324212
p EXPIRES: October 10, 1997
4;8fb$% Bonded fire Nobly Public Undermtters
•
8005524 1996 JAN 04 12:07
430 N.E. 101 Street Miami Shores, Florida 33138
•
a
Prepared by Arocho
Quality Roofing Contractor
Address: 251 N W 9 Street
Mi ami s Florida 33151 --
123.01.52 2/93
Job Address:430 N e i 0 i 51 Contractor �- e[ J Process No.
PERIMETER DETAIL #3: Gravel Stop or Drip Edge
Sketch Roofing Components which make up Roof
System Assembly at Perimeter Edge with Gravel
Stop or Drip Edge.
Insert leaders indicating Roofing Components names,
dimensions, thicknesses, etc.
Include fastener type and spacing used for wood -
blocking attachment.
Gravel Sto p Edge
Gage: (p
Fastener , ,E
Spacing: `1 o.c.
Clip Type: do
Clip Gage: tai pr
MOM
Deck Type: earl( f ��e.
Sketch Roofing Components which make up Roof
System Assembly at Perimeter Edge with Gutters.
Insert leaders indicating Roofing Component names,
dimensions, thicknesses, etc.
Include fastener type and spacing used for wood -
blocking attachment.
Gutter Type:
Gutter Gage:
Fastener
Spacing:
Deck Type:
PERIMETER DETAIL #4: Gutter Detail
Built -Up Applications and Modified Bitumen Systems
Page -6
•
JobAddress: )Qt Sr; Contractor IR4- 'r,J Process No.
PERIMETER DETAIL #5: 'Other' Detail
Sketch Roofing Components which make up Roof
System Assembly at any 'other' Perimeter Condition
which may exisit.
Insert leaders indicating Roofing Component names,
dimensions, thickesses, etc.
Include fastener type and spacing used for wood -
blocking attachment.
Sketch Roofing Components which make up Roof
System Assembly at any 'other' Perimeter Condition
which may exisit.
Insert leaders indicating Roofing Component names,
dimensions, thickesses, etc.
Include fastener type and spacing used for wood -
blocking attachment
,D\P
PERIMETER DETAIL #6: 'Other' Detail
Built -Up Applications and Modified Bitumen Systems
Page -7
Job Address:430 Al, E /0/ sr: Contractor
Insert Building and Parapet Heights.
(If no Parapet exists, insert "N/A")
Also insert applicable information pertaining
to the building below.
(See ASCE 7 -88 Fact Sheet Attached )
Exposure Category:
Classification Category:
At Hurricane Oceanline ?: Y V N
Basic Wind Speed at
Building Location: 110 mph
Building Condition based on
% of Openings:
GROUND LEVEL
p Jrf feet
) 0 feet
BUILDING INFORMATION #1
Built -Up Applications and Modified Bitumen Systems
Page -8
Process No.
Job Address:J-1 10,F IQ I ST Contractorg Rr I y� Process No.
PERIMETER DETAIL #1: Parapet Wall Detail
Coping Cap
Gage:
Fastener
Spacing: _ o.c.
Clip Type:
Clip Gage:
I Deck Type:
Sketch Roofing Components which make up Roof
System Assembly at Perimeter Parapet Walls.
Insert leaders indicating Roofing Component names,
dimensions, thicknesses, etc.
Include fastener type and spacing used for wood -
blocking attachment
Deck Type:
Sketch Roofing Components which make up Roof
System Assembly at Perimeter Areas to be Flashed.
Insert leaders indicating Roofing Component names,
dimensions, thicknesses, etc
Include fastener type and spacing used for wood -
blocking attachment.
PERIMETER DETAIL #2: Flashing Detail
Built -Up Applications and Modified Bitumen Systems
Page -5
Job Address: 10,E. f 0 t S T Contractora y Process No.
T
inches
inches
inches
FILL IN APPLICABLE ROOFING COMPONENTS WHICH MAKE
UP ROOF SYSTEM ASSEMBLY AND THICKNESS OF DECK AND
INSULATION LAYER(S). (Where Roofing Component not used in
Roof System Assembly, fill in with "N /A ".)
Surfacing: (tiJ ( A
(briefly describe,
Ifapplicable)
Top Pl F C
Bonding Material:
PI Sheet(s lJ I A
Bonding Material: 0 114
Fastener:
(i((bas, sheet mee altoch
-��- Base Sheet: O acNrk 5 er
Bonding Material:
(if bare sheer bonded )
Fastener: N'
(if top insulation layer
mech. attached)
Top Insulation Layer: l o % A
(if applicable )
Boni Material: W ( PY
(iJro i
layer bonded )
Fastener: h)
(if insulation
mech. onached)
Insulation: i
Bonding Material: Q.) I li?
((insulation bonded )
� Vapor Retarder.
(if applicable )
Primer.
(ifopplicab7e
DECK:
Type: l.t)
Gage or Thickness:
Density. if concrete deck:
Built -Up Applications and Modified Bitumen Systems
Page -4
9
ci
z cn
cn
U
O
ti
1
Job Address:
If NO, note any deficiencies:
Reviewed Details ?:
Contractor Process No.
— FOR PLAN EXAMINER USE ONLY —
Roof System Assembly Product Control Approved: Y N Top Ply: ad); P.-Pd 1'7) -- Ae_ ce
(Type and method of attachment )
Design Pressure Requirements:
Field: psf
Perimeter Areas: psf
Corner Areas: psf
Note any limitations:
Y N
Notes: 4
Surfacing:
('Type, if applicable )
Flashing Materials:
( Type and method of attachment )
Job Address: 4 3 0 . F _ � D I ST, Contractor c, Process No.
��snr�C Fk-P
cw(ath /14tyr, �� /J
fiSTM 0 ST 4.0
Built -Up Applications and Modified Bitumen Systems
Page -10 Built -Up Applications and Modified Bitumen Systems
Page -3
Job Address: q 30 , e ) 0) $T Contractor('i j; 4 �r'," Process No. Job Address: Contractor Process No.
(Check' one of the following)
Recover Re -roof:
If a recover, is the existing Roof System Assembly
N
to be used as a bonding substrate ?:
If YES, has an ASTM E907 test been carried out
to confirm adhesion of the existing membrane to
the substrate ?:
(If yes, attach ASTM E907 test report. )
Proposed Fastener:
(Attach withdrawal resistance test report. )
Has the deck been examined for moisture ?:
(Provide data confirming compliance with
Section 3401.9(c) . )
THE SYSTEM:
Deck: Qoncre 4e
(Briefly describe )
Base Sheet or Pty:
(Type and method of attachment)
}
New Construction
Ply Sheet(s):
( Type and method of attachment )
Built -Up Applications and Modified Bitumen Systems
Page -2
All Roof System Assemblies in the Product Approval have a variety of options. Briefly
describe the Roofing Components to be used in the Roof System Assembly and attach a copy of
the manufacturer's published specification:
Insulation: j,` pi
( Type, size and method of attachment,
if applicable )
C- \GSD(XS.n_ er + ?rnyer
pr;rr.e) c cre,i'e. elee.k w`,41-1
�1oT moep,`n5
Reviewed Field Test Data ?:
Notes:
Additional Notes:
Built -Up Applications and Modified Bitumen Systems
Page -11
Y N
Plan Examiner
Job Address:'-/, O F ID/ ST. Contractor Process No.
GENERAL: jj �1
Type of Roof System Assembly to be Applied: M tk�l (ed fah r.. e,, (c4 r
Manufacturer of Roof System Assembly: eS goor:,ii MI :1r ed J -t - ,° v
Product Control Approval Number: Q; : 050 a, .__CL
System Number from Product Control Approval: ,kg-/ —3
(Attach a copy of the Roof System Assembly Product Control Approval and the Manufacturer's System
Guide Specification. )
12a01-166 9/94
( Note: If a minimum roof system is to be applied, describe all
components within the system and list the manufacturer of
each component. DO NOT complete this section if system is
Product Control Approved. )
Base Sheet:
Fasteners:
APPENDIX 'E'
METRO -DADE UNIFORM BUILDING PERMIT
SECTION II
BUILT -UP APPLICATIONS AND
MODIFIED BITUMEN SYSTEMS
Ply Sheet(s):
Cap Sheet:
Asphalt:
( Note: No insulation system is acceptable under the minimum
roof category. )
Complete the following for all Roof System Assemblies:
Built -Up Applications and Modified Bitumen Systems
Page -1
..1ZTRODADE
CS Roofing Products Company, Inc.
5525 MacArthur Blvd., Suitc 900
Irving, TX 75038
METROPOLITAN DADE COUNTY. FLORIDA
METRO -DADE FLAGLER BU!L.DING
BUILDING CODE COMPLIANCE OFFICE
SUITE 1603
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET
MIAMI. FLORIDA 33130.1563
(305) 375-2901
FAX (305) 375 -2900
PRODUCT CONTROL SECTION
(305) 375-2902
PRODUCT CONTROL NOT!Cr; OF ACCEPTANCE FAX (305) 372.6339
Your application for Product Approval of S;S Roofing Modified Bitumen Roof Systems under Chapter 8 of the
Metropolitan Dade County Code governing the use of Alternate Materials and types of Construction, and completely
described in the plans, specifications and calculations as submitted by Applied Research Laboratories, Factory
Mutual Research Corporation, Underwriters Laboratories and United States Testing Company, Inc. has been
recommended for acceptance by the Building Code Compliance Department to be uscd in Dade County, Florida
under the specific and standard conditions set forth herein.
The approval shall be valid for a period of three years. Thc Building Codc Compliance Department reserves [lie
right to secure a product or material,at any time for a jobsitc or manufacturer plant for quality control testing. If
product or material fail to perform in the approved manner, the Code Compliance Department may revoke, modify
or suspend the use of such product or material immediately. The Building Codc Compliance Department reserves
the right to require testing ofthisproduct or material should any-amendments to the South Florida Building Code bc
enacted affecting this product or material.
The expense of such testing will be incurred by the Manufacturer. /
.A CCEPTANCE NO.: 95- 0502.04 No.: 94- 0531.041 Raul Rodrizucz
Product Control Division
EXPIRES: 09/I2/97 Supervisor
PRODUCT NO.:
- PLEASE NOTE -
THIS IS THE COVERSHEET. SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
CONDITIONS.
BUILDING CODE COMMITTEE
This application for Product Approval -has bccn reviewed by the Metropolitan Dade County Building Code
Compliance Department and approved by•thc Building Code Committee to bc u d in Dade Cot Florida under
the conditions set forth above.
AI' PRO VED: 06/13/95
Charles Danger. P.E.. Director
Building Code Compliance Department
Metropolitan Dadc County
. Extensions of Acceptance may be considered after a new application has been filed and the supporting data.
test reports no older than ten (10) years. have been re-evaluated.
All reports of re- testing shall bear thc seal, signature and date of an engineer registered in thc State of
Florida.
2. Any revision or change in the materials, use, or manufacture of the product or process shall automatically be
cause for termination, unless prior approval is granted for revisions or change.
3. Any unsatisfactory performance of this product or process or a change in Code provisions shall be ;rounds
for re- evaluation.
NOTICF.OF ACCEPTANCE: STANDARD CONDITIONS
4. This acceptance shall not be used as an endorsement of any product for sales or advertising purposes.
5. The Notice of Acceptance number preceded by the words Dadc 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.
6. Product approval drawings, where required for permit applications. shall be provided to the applicant by the
manufacturer or his distributors unless otherwise noted in the Notice of Acceptance. The prints need not be
re- sealed by an engineer.
7. Failure to comply with the Standard Conditions shall be cause for termination of the Approval.
This Product Control Approval supersedes No. 94- 0531.04
Raul Rodriguez .
Product Control Division
Supervisor
Applicant:
CS Roo Products Company, Inc. (MB)
5525 MacArthur Blvd.
Suite 900
Irvin, TX 75038
C ateeorv: Membrane Roofing System
Sub Catc_;ory: Built -up Roofing
Type: Modified Bitumen
Stab - Type: SBS /APP •
PRODUCT CONTROL. NOTICE Or ACCEPTANCE
ROOFING SYSTEM APPRov,\t,
$vstem Description
Product Control No.: 9S -OSO? 04
Approval Date: JUN 1 3 ligjJA
Expiration Date: 09/12/97
GS Rooting Products Company, Inc. manfuactures and markets nationally a complete line of residential
and commercial BUR and modified bitumen products. GS Roofing Products Company, Inc. markets
these products through local distribution in the South Florida jurisdiction.
GS Roofing products and systems arc the result of years of manufacturing experience and product
development and have bcen proven by years of experience in the construction field.
GS oilers a variety of approved insulated and non - insulated roofing systems. For detailed system
constructions, refer to the following publications: "Commercial Roof System Specification Manu and
" Flintlastic Roof System Catalog."
GS• products and systems have been tested in compliance with alt provisions of the South Florida
Building Code as well as Underwriters Laboratories. Inc., and Factory Mutual Research Corporation for
fire and Nvind• uplift resistance.
GS provides technical service and warranty information through regional offices. For the South Florida
Metro-Dade area, call 1 -800- 777 -2563.
Contact
Pat Neuhaus
Commercial District Manager
290'0 Bird St.
Charleston Heights, SC 29405
(803)744 -7451
Raul Rodriguez
Flintlastic GTA
Flintlastic GTS
Flintlastic GMS /GMS
Premium
Flintlastic FR/FR -P
f'rcinium
TRADE NAMES OF PRODUCTS MANUFACTURED Olt
LABELED BY APPLICANT
Test Product
Product Dimensions Specification Description
Al Wcathcr /Empire 36" x 72'; Roll ASTIv1 D 2626 Asphalt coated, organic base sheet.
Base Sheet weight: 86 lbs. UL Typc 15
(2 squares)
Flex- I- GIasT "t Base 36" x 108'; Roll UL Typc G2 Modificd Bitumen, coated fiberglass
Sheet weight: 90 lbs. base sheet.
(3 squares)
Flex- I- GIasTM FR Base 39'/ x 50'; Roll UL Type G2 Modificd Bitumen, coated fiberglass
Sheet weight: 90 lbs. base sheet.
(1.5 squares)
Flintglas® Ply Sheet 36" x 180'; Roll ASTM D 2178 Fiberglass. asphalt impregnated ply
Type IV or VI weight: 40/55 lbs. Type IV or VI sheet.
• (5 squares) UL Typc G1
Flintlastic STA 39 '/ x " x 33'; Roll ASTM D 5147 Smooth surfaced, APP Modified
weight: 90 lbs. Bitumen membrane with non -woven
(I square) polyester mat reinforcement for torch
application.
39 x 33' 3 "; ASTM D 5147 Granule.surfaced, APP Modified
Roll weight: 105 Bitumen membrane with non -woven
lbs. polycstcr mat reinforcement for toch
(1 square) application.
39 x 24'9'; ASTM D 5147 Granule surfaced. SBS Modificd • •
Roll weight: 92 Bitumen metitbranc with non -woven
lbs. polycstcr mat reinforcement for torch
('h square) application.
39 x 34' 2 "; ASTIv1 D 5147 Granule surfaced SBS Modificd
Roll weight: Bitumen membrane with non -woven
100/105 lbs. polyester slat reinforcement for mop
(1 square) application.
39 x 34' 2 "; ASTM D 5147 Fire resistant, granule surfaced SOS
Roll weight: 105 Modified Bitumen Membrane with
lbs. non -woven polyester mat reinforcement
(I square) for mop application.
3
Raul Rodriguez
Product Control No.: 95- 0502.04
Product Dimensions
(: lintlastic FR Cap 39 3 4" x 34' 2 ";
Roll weight: 90
lbs.
(1 square)
GlasBaseTM Base Sheet
Poly SMS Base Sheet
Yosemite® Mineral
Surfaced Cap Sheet
Stormshield
36" x 108'; Roll
weight: 69 lbs.
(3 squares)
39 x 64' 4 ";
Roll weight: 90
lbs.
(2 squares).
36 "x36; Roll
weight: 90 lbs.
(1 square)
36" x 75'; Roll
weight 76 lbs.
(2 squares)
Test
pecification
ASTM D 5147 Fire resistant, granule surfaced SBS
Modified Bitumen membrane with
fiberglass mat reinforcement for mop
applications.
ASTM D 4601
UL Type G2
ASTM D 5147
PA 103s
Asphalt coated, fiberglass base sheet.
•
Product Control No.: 95
Product
Description
Modified Bitumen, coated polyester
base sheet.
ASTM D 249 Mineral Surfaced organic cap and buffer
UL Type 30 sheet.
Slag surfaced SBS Modified. Bitumen
sheet with fiberglass reinforcement for
peel and stick application.
r
Raul Rodriguez
Product
1-1y Thcrm
Pyrox
APOC 212
Sunbright 400
Ccicorc
Dck fast Fasteners
Dckfast liex Plate
TRADE NAMES OF PRODUCTS MANUF,\CrURED B\' OTHERS
Test . Product
J)imensinnt
various
various
MBA
ACFoarn 11 various
A nchorbond
Fastener
Anchorbond LC \V
lightveight
Concrete fasteners
Higli Density 'various
Fiberboard
2 7/8" x
3 1/4"
Specification
PA 110
PA 110
PA 121
PA 121
ASTM 3019
Type 111
PA 110
PA 110 Cellular insulating concrete Celcorc, Inc.
system
PA 114
PA 114
PA 100
PA 114
Dckfast Lock Plate 3" x 3 1/4" .PA 114
insulation fastener for stccl Construction
and concrete dccks Fasteners Ind.
PA 114 Galvalumc hcx stress platc. Construction
Fasteners Inc.
5
Description
Polyisocyanuratc foam
insulation
Polyisocyanurate foam
insulation
Aluminum roof coating.
Roof coating
Asphalt based cold applicd
adhcsive.
Polyisocyanurate foam
insulation
Insulation fastener and
mctal or plastic plate
Base ply fastening systems
for lightweight concrete
decks
\Vood fiber insulation
Polypropylene locking
plate.
Raul Rodriguez
Product Control No.: 95- 0502.04
Manufacturer
Apache Products Co.
Apache Products Co.
APOC, Subsidiary of
Gardner
APOC, Subsidiary of
Gardner
APOC. Subsidiary of
Gardner
Atlas Encrgy
Products
Cclotex Corp. •
Cclotcx Corp.
Cclotcx Corp.
Construction
Fasteners Inc.
Product Dimensions
Dekfast Fasteners
;:15
Dekfast Fasteners
u l 2
TPR
Elastizell
FM -30, FM -45,
FM-60, FM -90
Fasteners
Nail -Tite Type 'A'
Nail -Titc Type 'R'
GAFTITL-
Asphalt Emulsion.
Gardner Cold
Process
Roof Cement
Asphalt
Asphalt Primer
High Density Wood various
Fibcrboard
PA 114
PA 114
PA 114
PA 110
PA 114
PA114 •
PA 114
various PA 114
Test Product
$pecificntiort Description
PA 121
PA 110
Insulation fasteners for
concrete decks
Insulation fastener for steel
and wood decks.
Aluminum fastener for
lightweight, gypsum and
tectum decks
Cellular insulating concrete
system
Base ply fastening systems
for lightweight concrete
decks
Galvanized steel base ply
fastener for Lightweight
concrete decks
Galvanized steel base ply
fastcncr for lightweight
concrete decks
Base sheet fastening GAF
system.
Asphalt emulsion Gardner
1, 5, 55 ASTM •D 3019 Fibcred asphaltic general Gardner
gallons Type 111 purpose lap and ply cement.
ASTM D 312 Type 111 or IV hot asphalt generic
bitumen adhesive
ASTM D 41 Asphalt Primer generic
Wood fiber insulation
board
Raul Rodriguez
Product Control No.: 95 0502.04
Manufacturer
Construction
Fasteners Inc.
Construction
Fasteners Inc.
Creative
Construction
Components
Elastizell Corp.
ES Products, Inc.
ES Products, Inc.
ES Products, Inc.
generic
Tcst Product
Product Dimensions ,$pecification psscriptiotl Manufacturer
Perlite Insulation various PA 110 Pcrlite insulation board generic
Red Rosin various Rosin paper for barrier generic
layer on wood decks
Roofing Nails
Tin Caps
Minimum # PA 114 Corrosion resistant annular generic
12 ring shank nails
• Min. 32 ga. x
1V,"
al MB aluminum PA 121
roof coating
Corrosion resistant circular generic
discs.
Aluminum roof coating Grundy Industries
Karnak S 1 AF 5, 55 gallons ASTM D 3019 Cold applied SBS modified Karnak -
Modified Bitumen type III, ASTM adhesive for application of
Adhesive (Brush • D 3409 SBS modified bitumen
Grade) systems. .
Karnak S I AF 5. gallons ASTM D 3019 Cold applied SOS modified Karnak
Modi Bitumen type 1I1. ASTM adhesive for application of
Adhesive (Trowel D 3409 SBS modified bitumen •
Grade) systems.
Karnak 97 AF PA 121 Roof coating Karnak
Karnak 97 PA 121 Roof coating Karnak
Ntonsey MBA Gold 1, 5, 55 ASTM D 3019 Fibrated, rubberized cement Monsey Products
Membrane gallons type III for bonding modified Co.
Adhesive bitumen membranes.
Progradc Fibcrcd
Aluminum
PA 121
E'NERG'Y PSI -25 various PA 110
Product Control No.: 95-0502.04
Fibratcd aluminum roof Mousey Products
coating. Co.
Polyisocyanuratc foam NRG Barriers, Inc.
insulation
E'N RG'Y - various . . . , 'A 1'10 Polyisocyanuratc foam NRG Barriers, Inc.
insulation
7
Raul Rodriguez.
/ (1Lc)
Product
Dimensions
E'NRG'Y - Plus various PA 110
E'NRG'Y - various PA 110
•
N.T.B. Magnum PA 114
N.T.B. Spin
Veld Plate
2" round
N.T.B. Plastic Plate 3" round
N.T.B. Plate
Olympic Fastener
I 2
Olympic Fastener
14
Olympic CR Base
Felt Fastener and
Base Sltcct Disc
Olympic Fastener
Test Product
Specification Description Manufacturer
PA 114
PA 114
PA 114
PA 114
PA 114
OA 114
Polyisocyanuratc foam NRG Barriers, Inc.
insulation
Polyisocyanuratc foam NRG Barriers, Inc.
insulation
Glass reinforced nylon
fastener for use in gypsum
and =tenacious wood
fiber decks.
PA 114 2" round amorphorus nylon Olympic
locking plate for usc with Manufacturing
N.T.B. fasteners with 1" Group, Inc.
head
'3" round polypropylcnc
stress plate for usc with
N.T.B. fasteners
8
3" round galvaluntc AZ55
plate for usc with N.T.I3.
fasteners
Insulation fastener
Insulation fastcncr
Insulation fastcncr
assembly for Base Sheet
fastening only •
Insulation fastener
Raul Rodriguez
Product Control No.: 95-0502.04
Olympic
Manufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Olympic •
Manufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Olympic
Ivianufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Product
Olympic
Polypropylene
Fiberglas
Test
Dimensions Cpccifrcation
3.25" round PA 114
Olympic Standard 3" round PA 114
various PA 110
Paroc Cap Board various PA 110
UltraGard Gold 'various PA 110
Rawl 2" Plate 2" round PA 114
Rawl 3" Platc 3" round PA 114
l itc
Rawlitc 3" Plate
caulking
'•ti
tubes.
A luma- 13ritc No.
120
PA 114•
3" round PA 114
. PA 121
9
Product
Description
Polypropylene
plastic platc
3" round galvalumc
AZ55 stccl plate
Fiber glass roof insulation
Rockwool insulation
Polyisocyanurate foam
insulation
2" round galvalumc AZ55
membrane plate
3" round galvalumc AZ55
steel plate
insulation fastener for
ccmcntitious and gypsum
decks
3" round galvalumc AZ55
steel platc for use with
Rawlitc fastencrs
2 100 - Modified 1, 5, 55 ASTM D 3019 Rubberized all - weather
A I I Weather gallons, also (Type 111) and flashing cement. trowel
Flashing Ccment available in D 3409 grade. modified adhesive.
10.5 ounce
Fibratcd aluminium roof
coating.
Raul Rodriguez
Product Control No.: 95- 0502.04
lvlanufacturcr
Olympic
Manufacturing
Group. Inc.
Olympic
Manufacturing
Group. Inc.
Owens - Corning
Fiberglas Corp.
Partek, Inc.
Schuller
International Inc.
The Rawlplug
Company Inc.
The Rawlplug
Company Inc.
The Rawlplug
Company Inc. .
The Rawlplug
Company Inc.
Tropical Asphalt
Products Corporation
Tropical Asphalt
Products Corp.
Test Agency/Identifier
Applied Research
Laboratories
Underwriters
Laboratories
United States Testing
Company, Inc.
Factory Mutual Research Current Insulation
Corporation Fastening Requirements
Fire Classification
Compliance
ASTM D 5147
ASTM D 5147
/game
Physical Properties
Test Reports
FMRC 1994
RI 190
97457-4
97- 457 -2R
I0
Report
2S013
Raul Rodriguez
Product Control No.: 95- 0502.04
Pate
06/02/87
01/01/94
07/13/87
06/03/88
12/02/87
Product Control No.: 95- 0502.04
Fibrous glass
Perlite
Fiberboard
Rockwool
Polyisocyanurate
Polyisocyanurate Composite Board
Maximum Design Pressures
Material j)esi,n Pressure
Wood -60 psf
Steel -60 psf
Concrete -135 psf
Lightweight Concrete -45 psf
Cementitious Wood Fiber -52 psf
Poured Gypsum -52 psf
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 Undenvriters Labonttorics
Roofing Materials Directory or other approved testing agency listing directory for Firc
Classifications. - -
II
Raul Rodriguez
Membrane Type: SBS
Deck Type 3: Concrete Decks,Non - insulated, New Construction
Deck Description: 2500 psi structural concrete or concrete plank
System Type F: Base sheet adhered with approved asphalt.
All General and System Limitations apply.
Note: Concrete deck shall be primed with ASTM D 41 asphalt primer and allowed to dry prior to
application of base sheet.
Base Sheet:
Ply Sheet:
Membrane:
(Optional) One ply of Flintlastic FR Base, GS GlasBase, Poly SMS Base or GS
Flex -I Glas Base adhered to the properly primed concrete deck with approved
mopping asphalt applied within the EVT range and at a rate of 20 -40 lbs. /sq., or
spot or strip mopped as detailed in this approval; see General Limitation #4.
(Optional) See products listed under 'Base Sheet' above, or one or more plies of
GS Flintlastic Ply IV or Ply VI adhered to the base sheet in a full mopping of
approved asphalt applied within the EVT range and at a rate of 20 -40 lbs. /sq..
One ply of Flintlastic FR -P, Flintlastic FR Cap, Flintlastic GMS, Flintlastic
Premium GMS adherd to the base sheet with approved mopping asphalt applied
within the EVT range and at a rate of 20 -40 lbs. /sq.; or Flintlastic GTS torch
adhered to the base sheet.
Surfacing: (Optional) Install one of thc following:
1.400 lb. /sq. gravel or 300 lb. /sq. slag in a flood coat or approved mopping
asphalt at an application rate of 60 lb. /sq..
2. Karnak 97, APOC 212 Fibrated Aluminum or Grundy AL MB at I'/_ gal. /sq., or
APOC Sunbrite at an application rate of 3 gal. /sq..
Maximum Design
Pressure: -135 psf ( -45 psf when spot or strip mopped)
Maximum Fire
Classification: Class 'A'; see General Limitation #2.
Maximum Slope: 1:12; sec General Limitation #3.
Specification No.: FRP 1 -3, GMS 1 -3, GTS 1 -3, FRI3C 1 -3
66
Raul Rodriguez
Product Control No.: 95- 0502.04
Concrete Deck
System Limitations:
1. All applications over a perlite, woodfiber or rockwool substrate achieve a -60 psf design
pressure.
Product Control No.: 95- 0502.04
The following are design pressures for System 31A, APP and SBS with different insulation
substrates:
A. When installed with Hy- Therm, Apache Pyrox or Fiberglas as a base layer with an
adhered wood fiberboard achieves a design pressure of -70 psf.
B. When installed with ACFoam 11, E'NRG'Y 1, E'NRG'Y 2, PSI -25 or UltraGard Gold
with an adhered wood fiberboard achieves a design pressure of -90 psf.
C. When installed with a minimum 1" base layer of wood fiberboard or perlite and optional
layer of wood fiberboard or' /." perlite achieves a design pressure of -100 psf.
D. When installed over any base layer of insulation and a single layer of minimum '/."
Dens -Deck, the assembly achieves -135 psf.
3. The following are design pressures for System 31F APP and SBS with different insulation
substrates:
A. When installed over a perlite or high density wood fiberboard substrate, this system
achieves a design pressure of psf.
B. When installed over Dens -Deck, this system achieves a design pressure of -135 psf.
67
Raul Rodriguez
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ROOF COVERING MATERIALS ITEVT)
ROOFING SYSTEMS (TGFU)- Continued
Membrane: - FlindastiC STA', GTA Black Diamond' or - "CIA White Oiam
fused. ond
Surfacing: Gravel • h.
3. Deck: G 15/32 lncrinec 2/4
Base ShaeC Type 62. mechanically fastened.
M.mbrsnr. - FtinUastic STA - . - GTA - . 'GTA Black Diamond' or 'GTA White 04,8000 h.s
fused.
Surlacing: Grsvel
Deck: G I5/32•
- AD joints blocked with 2so•a.
Base Sheet Type 62. nailed.
M.mbrrnta - Mu/auk GMS . - CMS Premium o 'GMS Slack Diamond adhered wig
roofing asphalt.
Swfsdng Grays).
5, Deck; 0.13/32 1rrJ 2/2
Insulations Csfotoa 'Nye Tee : 2 Ls. min. joints in insulation amass be of/sat 8 Ire 1
deck. mecharnicaly Summed. totem lointa;,
Base Sheet Type G2. mechanical) fastened or adhered with hot tooling asphah
roofing asphab.
Membrsnee 'Flu tbstSa GMS . "WAS Prsn»um or 'GMs si Diamond-. adhered witty k
Swtschsts Gravel
B. Dock 413/32 inclines in
deck, mac%) /St hatansd 2 mitt s Insulation must Da offset 6 fn from joints A
ass. Shoat Typo G2, mochankally last.»ed or adhered with hot roofing asphalt
Msmbraneo 'Flindastic STA; - STA; 'GTA Black Diamond' a 'GTA APP White Oiarnons-
heat fused.
Swladng Growl
In 1
Clan A - Flab Adhered
2. Dock; NC Inagua 1
Vapor.Rota:dean!Optional) Typo G2 - Gtasbase bas. sheet or 3)l Classified -moot retarder.
Insu)at)o,C 50pelonag Ono or more Byers or combination of th• lonaw i,g: Wtragard p,,0, c
poybocTan erets. perxt.. glass fiber or 1.004 fb.t Insulation.
Sas. Shoot Ono byte/ of Typo G2 - G)»base base sheet
Marabout's Ono bysr of - FlIntbasso GTA E 3/4 so or .1 soI GTS• 4noxlfed bib..), le-
fused or "Fin2ass)a CMS" hot mopped
Stuiadnge APOC 718. 212 Fibras.d Ahunuwm ; at 24/2 gat 100 st2/11.
2. D.dt NC Lxy„K 3/4
Vapor Aatard.rs /Optional$ Type G2 `Gbabase base shoes or t)L Classified vapor etude..
Insulations (Options; One or more briers or Combination 01 the IoDo,.Ltg; U)tragard heath.
poybocyanwsss,, hernia. glass Sher or wood Mot Insulation.
Bea Sheet One bye, of Type G2 - Qssbasi bas. sheet
Mtambrsa.e Oeno bye, d "FAndasda STA 5mod2f•d Unmeant )1.l hus.d
pot
� •'. Suriselrt a Xa arh "Np. 97 Fao►atad A1urm)r us . at 1•)/2 gal per 300 sp/h
bnubdfene (O pdosal� !name - '�7?7 r Pssenle . anarate.
. aitrai pGsta, bbc$uwri *mod lmwboatd. Peef
Base SD MO:b p e, %sloe plii>iblrl'(OSalsaaM: )lot note sod or m.elwek58y t-- -.d.
4. D.e - ..e • - fin 0;0=44 bibmeerg5botzeopPod yi plaes46 ;
btaoatters Potobeeeysoursts. /bas Bba. wills. weed Lbe. )tot snapped c m.ehadea7y b..
• !t.0. any t)lidaiessa v •
• ' Base Shot Type GZ neathankalty fastened abet smopp.0. •
Membranes 7indaaufe GTA c • STA :best fused.
Surfacines
S. Der Hwy Co.7Ntry 520 Ahtmirxts , appaod at 1.112 BaVaa
1/4 bwetetlors SOpdons; Cabss Alto. p..81. or wood Slant board.
PN Stmou Typo 62. meedaanks2y fawned . •
Maewbraees "'FQetbasta STA; 'WV; Marl Dlantoo ' DP 'GTA White Diamond. boa
hoed. • •
Sutrecings Xernsh Choosiest Corp. - Kaesak So. Sr. 1 INVip..
0. Diets NC • .
Lmdstiors Po17bocpanemete. Vass boom, per5b. wood Mae. mocharsicaby ba*oned or m ersi
whit Dot marina asphalt any thickness
Baas Sheet Type G2, mocbsde8Ay hesaned 01 adhered with bet sooting asphalt.
Membranes 'Alnsbstla GALS". 'GAO Mack D11mend" a "GUS hseakarm , adhered wide %sot
tooling asphalt.
Si C3 'cal Corp. pe "Karnak H 97 Frosted Aaenbeet a Asphalt Rod Co50
1/2 pallso.
7. • Dodo C.PS/72e Indies* 1 •
'Ai joints Mocked with 2a-es. •
insulation Class fib.. p.r61.. 3/4 in. min. ;arms in insulation must b. offset 8 'M. Imes ;an
in deck. mechanical/7 fastened.
8a. Shoot: Type G2, mechanicaly /stoned or adhered with hot roofing asphalt.
M.mbr.n. - Flint)astic GMS adhered wits hot roofing asphalt
Swlacing; Karnak Chemical Corp. - Karnak No. 97 Monad Aluminum Asphalt nod Costing •
2.1/2 pal/so.
8. Deck: NC incr..: In
Insulation: Potyisoeya.wsat., glass fibs. ps•111 , wood Iber; m.chsnicaay fastened or adhere
with hot roofing asphalt any thickneis.
1 088) Sh..t Typo 62. mecas,deal)y laatened w adh.r.d..ith hot rooting asphalt
Mombrsno: - Flintlastic STA - , 'GTA - GTA Black Oiamond' or - GTA White Diamond , n eat
IntSet :n 01,c,
t .
ROOF COVERING MATERIALS (TEVII
ROOFING SYSTEMS (TGFU)- Continued
Surfacing: Karnak Chom:cal Corp. - Karnak Ho. 97 Fibrated aluminum Asphalt Roo/ Coating
3 gal/so.
O•k: NC Incl:no: n 1
o (Optional) Perlite. glass fiber. polyurethane..socyauato. phenolic combination .so•
os nurate/perhto. polyurethane /pe:lilo or wood Iber, any thickness. hot mopped or nailed.
),.t.rnbrana: 'flintgsdc STA - . '67A'. - GTA Bbcl Diamond'. '$51n12assie GTA White Diamond - .
'GMS Double Couerags w "GUS Premium . heat fused or hot mopped
in 91808.
$w Grundy Indus: nos. Inc. - al MB Aluminum Roof Coating at I.2 9)1/10.
ra pock 615/32 Inc11na 1/a
) InsulaUon: 5001303)2) Any Ihickn.ss po)yisoryenu`ts, glass fiber or pettily. mechanically far
• T oed, $02$1%3 Sn insulation must be offset B in. from joints in deck.
• Soso 5he•t.Type G2 base/0y shoot mac/tan:cany fastened or hot mopped.
Ply Shoot Type G2 bass/ply sheet rn•c)sanicany fastened or hot mopped.
Membranes "FDn2bs10 STA; - GTA WM. Diamond or - GTA Black Diamond - .
sorban% Gnusdy'a "aI M8 Aluminum Roo/ Coaling n 2 to 2 g.Vso.
11. NC tndln.e )/2
pasula tt ice 50pden:03 Polyisoeyarasarate. glass fin.. peat.. wood foe. airy combilsallor. any
dsickn.ss. medaan3Caly /assorted.
Base Sheet Type G2. - Flss•i9bs' a 'FBnWstic FR Base mechanically 1»unad w adhered
with hot roofing alpha).
Membrsnee - Ffl. 1,stk F24 ; - FAru)satk Premium FP.-P". 'FBntiasssoFA/G o - F1'•nd»)ie FR
Cap adhu.d 1.33)8 hot 100M• ephait
u D.ek 015/32'
AD joints Le beck bloc2ud with tae's.
)nsu)atlo3e (Optoion8I Pohlsoeyanurate. glass lib!. perll)a. any combination. any th)c2..sh
machanicany Weaned.
8ese Sheet Type G-2. mechanically 3astund w Whored with hot 100/1,0 asphalt
Mombrsnee - Fnntustic FAT: - FfenWat)c Prer,)Wn FR.?"' a '7 ntlas6cF)VG . adhered with
hot roofing asphalt
)1 . Deck NC 111011,1.6 2/2
)naufat2ortc 5Opt)onallEPS. any thickness. covered wills 2/2 7n min peat* or wood fiber, m..
chanicil)y 1 »toned. .
Bas. Shoot: Typo G2, meehaniealy lassen.6 or adhered with hot rooting asphalt
Manbrsnet "F)M3)astre FAT. - Fantbstla Pretnhun ?RP o - Fandasdc•FR/G', adhered with
hot tooling asphalt.
M. Dodo NC 130)20* 3n
Insulation: Polybxyamrste. Wass-ISD.. perks. wood Taw. any combisatlwt any thlcatnaay
mochankaDy las1sn.d.
Sasso Shoot Typo 62 or - Floa4g)as . adhered with hot roofing aaphal.
Pty S2.... - 'GS Po/Passe; adhersd mash hot tooling asphalt
htembrstaet - GMS . adhered with hot rooting asphalt
Surlacbs3t *mash Chamica) Corp. ICansak No. 97 F)bntad N1umL.um Asphalt Root Coating
at 2.1/2 gal/an. b+caeet 1/4
)3. Dock, NC
Itemabt)os (Opdona5 Polybocyanurate. glass Qbw. perks. wood bow, any ceembirmalett any
thalckn.ss. otechart)ca3y lsstenod a adb.rad unlit hot yooing asphalt
Brae Shot Typo 62 or "Fl a•i-glae. m.cAanka8y Prater d 0r adh.r.d nab het rooMg as •
: • • P3 Stools 50pdfo all Typo G2 w'lk.t g)as , m.dasnlcany fastan.d or adner.d 1..%k Dot tool-
3 a Irtp aaphal%: •
ti +' Meeabraeee'Faertasde CMS'. '6213 krombo . "GUS Bach Diamond' o,'GALS Wake Dl a.
mond ; adhered wish ho: tooling asphalt.
)i1 . •
• S D.eht 645/3tlifsdngi As2 ph>vl ?ma."' Die Cap. J.POC•a00 S 3�gs .
-
Dksololiots Glass Seats. ss SDK Se. 1 k min joints be 2taubelor. matt be o B be. fins jokes ht
Base Sheol: Typo 62 - Fle4iga d yandtamkally taste0•d w a dhered with Doi mans is
ttpasA Typo 62 w'Aas7•gba :'seSC2.a01Cally laassw.d w *dewed with be loom
aspitab-
Mombratset 'Fantlss io CMS; '61.83 f1emkun : "MO 553 Bade Dammed' 0, "G)MS 333
WhB. Wamlen.F . adlw.d *Db Da n0M0 asp It
Sud rings Asphalt hoduess OA Cap. APOG ;00 S
3 D.eks NC
Insulations (0pdona)1 PO)ybocyerxxste pwad%, pis Maw m wood Mew, any thickness ess`
thankany batonod a Dot neoppod >A pats.
8.s. Shoot On. o1 more brines d Too G2 w 'Fl siyas , M.dadeaBF 1132.084 a )sot
P)y S t 5Opt)onaf) 0no by roots bims a Types G t. G2 w 'Flosigba : taec3aolnbf 13-1. • tumid or hot rnepp.d be pbca.
Membranes - IllnWstle GTA . "GTA Back Oisrtwnd . - GTA W23). O1s a ond' w "STA . beat
!used, �
Surf.dnga Karnak Chemical Co. - Ne. 97 . 11814114 ae 1.1/2 9at/sp
Ia. Dock: N lnenneC )/1
*auladorr; (0pllona2 ?dusts. gt» a fiber, m0h
.anlcaty /»n w sh
t.ad hot opped in place. 2 In
mss thidness.
B►s. Shat On. o more Sayan 01 Type 62 'fits. votes . maehan city la,%.ned w hot
mopped in plate.
Ply Sh.•t (Optional) One or mot. layer) of Types C 1. 62. "Ma +glas' w - GS Polybase . ens•
chankaly fastened or hot mopped in plats -
Membrsno ;'GTA". - GTA Clack Olamomd'.'6TA White Diamond or - STA'. heat 'used.
Surfacing: APOC No. 212 *A /urr.inun Coating. applied at p.)/2 oal/se.
Inclnee 2/2
o°
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement ur time 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 thc State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address „ ! 1`1�E 1 �
Registered Architect and /or EnOncer y�
Name and address of licensed contractor �-t.�6. N (Y1�6n1 \c4
Location a/► gal description of lot to be milt on:
Lot.. ZE a Block Subdivision'
Street and Number where work is to be done
State work to be done and purpose of building (by floors) l
b
,6 B" 5--- -7 1 L �
MIAMI SHORES VILLAGE 687
rvrr, •,nmvr•
rrw runner„
M_
) P L _ i_saw ! 7 -q7o 0
1/11 19
L... No._................ -... Street —._. — r — –
and for no other purpose.
Ncw Building Remodeling Addition Repairs No. of Stories. /
To be constructed of Kind of foundation Roof Covering fc1,VtLl
Estimated Total cost of improvements $ Amount of Permit S
Zone cubage required .Plan Cubage
Distance .to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submi all the plans a d specifications for said building. All notices with reference to the building and its construction may
e sent to. .
The u applicant for this building permit dots hereby certify that he understands and accepts his obligations ns an employer
of labor under the Honda 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 (hint
in thc work to be performed tinder 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 s ntractors, on work to be performed under this
permit, as are.licensed by Miami Shores Village.
Rem.uks..._ (Signed
STATE OF FLORIDA. 1 .
COUNTY OF DADE. t 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, sold that all facts
therein by him�stated are true.. q
Permit No.._a� A s / _ Date li / .�.1.. ler Read, S to and Su cribed before me.
Disapproved
(Signed)
Building Inspector
Chairman
Member —
Member .. ..
Council Approved Date
NOTE: A charge of $1.00 will be made for making corrections
the Planning Board.
A rc•in•pectiun fee of $1.00 will be charged
materials anti /or workmanship.
cc -,Loy
– – — -- to me well known,
PLANNING BOARD
My Commission Ex
Member ................_....._._..._....–................_.
Membcr
Member
Disapproved
Date
or changes to this application after approval has been obtained from
when such re Inspection is made necessary by Improper notice for inspection of faulty
MIAMI SHORES VILLAGE, FLA. N9 6396
JOB S2
ADDRESS ( 9 , ( - 7 l� O C)O.
INSPECTION � e
TIME READY
REMARKS
INSPECTOR /�r� � 1 DATE
BUILDING ❑
ELECTRICAL ❑
I PLUMBING ❑
ROOFING
Architect
h-
CONTRACTOR ontractor r Builder -,
or BUILDER
MIAMI SHORES VILLAGE, FLORIDA /4•?
Date "
PERMIT T 9494
0
Owner of
Building 44
Legal Lat 1 1
Description 1 B1
Address of,
Building 1 v
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants r emp oyees. / ' 7 ,
a 4 �: . .
( INSPE CT O R ) BY ►
Inconsideration of the issuance tome of this perms agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertainddg thereto and in strict conformity with the plans rawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all ,tirk done by either, myself, my agent, servant or employee.
vi4
Signed • f
Contractor's
License No
Subdi-
vision
Sq. Ft.
Value of a ct� 1 Amount of
Project $ c5 11 Permit $
BY AUTHORITY
Work to be performed under , 4his Permit
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
•
Owner's Name and Address._.
Regi1ered Architect and /or Engineer... _
Name and address of licensed
Location and legal description of lot to be built on:
Block
Lot__
Street and Number where work is to be done
Sta ork to be e -, .
MIAMI SHORES VILLAGE
urpos9 of building (by
Date!
N o.
New Building .___ Remodeling
To be constructed of Kind off ndation___
Amount of Permit $
Plan Cubage__ _.
Size of Building Lot
STATE OF FLORIDA,
COUNTY OF DADE. ss•
Permit No
Disapproved ____ _
//
( Signed) w
Chainnan
Member
Member
Council Approved
ate
Building p - ctor
Date _// /g — v 7
1/430 streetE/
floors)
and for no other u
• - ----- ---- - -- - - p rpose.
Addition __ Repairs No. of Stories
Roof Covering
Estimated Total cost of improvements $
Zone cubage required
Distance to next nearest building_
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 doc hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen s Compensation Act, being Sec :ion 5966, Compiled General Laws of Florida, Pennanent Supplement,
and has complied with the provisions thereof, and will require similar compliance fror• 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 -.r in ection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such su. - .ntractors, on wor to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Sign
Read, Sworn to and Subscribed before me.
Before me, undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared ..__
Notary Public, State of Florida
My Commission Expires__
PLANNING BOARD.. __ . DATE
Member
Member . -
Member . _._.... .__.
Date Disapproved .__..._ ..
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 tire.
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
❑ DATF
PERMIT N° 5746 Contractor s
r
MIAMI SHORES VILLAGE. FLORIDA
❑ Work to be performed under this Permit
CONTRACTOR OR BUILDER
B1
Subdi-
vision
Value of
Project
195
License No.
Amount of
Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings cr in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees. .
Signed. BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
I hereby submit all the plans and specifications
be sent to
Disapproved
( Signed) __LAI_ _
Chairman
Member
Member .........
MIAMI SHORES VILLAGE
Aft •
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address .Ai Ai i \�( $/4#!/r
1 46
for said building.
Member
Member
Member
Date
No
Registered Architect and /or Engineer
Name and address of licensed contractor.___ s. it 4•
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 4 Se 11 • ' • /0I sr
State work to be done and purpose of building (by floors) [ Y E W �! ®� l iq
.. L .. M PPc�j) SQL/ ; A c •47
'New Building Remodeling Addition
To be constructed of Kind of foundation
Estimated Total cost of improvements $
Amount of Permit $
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Li
PLANNING BOARD DATE
4
WiTH
,19f
Street iv. E • / t
/ D
4 Mx, .r•
P L T Jr 4s8 Th s
and for no other purpose.
Repairs No. of Stones
Roof Covering// et 7 ° P
�
Maximum live load to be borne by each floor
All notices with reference to the building and its construction may
The undersigned applicant for this building pennit 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 subcont .: ctors, 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 a true.
/ o
Permit No 'El � Date.. •_ w.. d7 Read, Sworn to and Subscribed before me.
e ��
Notary Public, State of Florida
Building Ini ctor My Commission Expires
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.