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ROOFINGDate oL /S 0 / Job Address 6I 10,E /0 / `Sr Tax Folio / / 3c2 — 0 / 3 -/ 3 S -4) Legal Description / I S J O % // - ( o - / 3 1 k /0-see I P 8K, PG - /D- Designated: Yes No \ X Owner/Lessee essee /Tenant OZ 412 f / P � l A Master Permit # \ g 1 q- a) l g3 0 k Owner's Address / /0 A . Xi/,4M Ave 1-4.4.' !i S ,r1.- Phone 305 - 7 S I - g 947 Contracting Co. -A 4 F-1 (ZQ m 'o b t✓ ` '/ tJ G- Address 1 crn7 u) a S 11) i�l • �l44/ , /re- 330 I f Qualifier State # C B C. p S l °7 vi Municipal # a8 c0 3 a, -3 Architect/Engineer K t (& ( Ogle b e i( Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL (ROOFIN PAVING FENCE SIGN WORK DESCRIPTION NEtc) I Z-00 F iA) G 'O IC a Square Ft. p O So r Estimated Cost (value) /, 8 0 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 constructio d • • g. Furth L' : • I authorize the above -named contractor to do the work stat d/or Condo :. sident / _ P ate Signature of owner No My C o FEES: PERMIT APPROVED: Zoning Mechanical O_ - rn$Egvo } �2►J - R N� Z �� • • f and/ Conde P esi. etit , ion0� `';`�� PERMIT APPLICATION FOR MIAMI SHORES VILLAGE RADON Plumbing �' _ .� C Z. / i a ature of Contractor or Owner- Builder G ell N CrMine Hue * *My Commission CC896557 @ Gkpireo 0 mbe» t.0 2003 Nota as t ontractor or owner- W er C.C.F. NOTARY – 4. V — SS# Phone 305- (.)y Competency # p tj b O 1120 4 Ins. Co. W NNP ik Wt ( (; I Address "" ) 0 • E - • Q , 4 ref T. 1 4 . - 4 1 4 0 4 j Sho tvS, 1= L My Commission Expires: Electrical BOND TOTAL DUE 6o Date 0011/S1 / Date Structural Engineer Contractor's Name: 0100 — 5../.C• Job Address: s4 N' • ROOF CATEGORY ❑ (Low Slope Application) ❑ (Nail -On Tile) t( (Mortar- Adhesive Set Tile) ❑ (Asphalt/Fiberglass Shingles) 0. ( Metal.Ropfs \Wood Shingles & Shakes) ❑ (Other) ROOF TYPE New Roof .❑ Rer roofing ❑ Recovering ❑ Repair ❑ Maintenance Flat Roof Area (ft Sloped Roof Area (ft //D 5 E Total (ft //O s ' Master Permit No. Exposure category (per ASCE 7 -88): Building Classification category (per ASCE 7 -88 table 1): A Ft. V Deck type: —0 G D)( ply. Lc1 D ')) ATTACHMENT Fastener Type: / 75 /'-L . Amt 1.5 SPACING Field: / As Perimeter: 6 Corner. 123.01.78 893 DETAIL 1 & 2 Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. ROOF HEIGHT A.ND SYSTEM DETAILS (Draw details as needed) Page -1 1 ROOF PLAN PRIIIIMMIXIMPIMPIMMOIMPIPPIPPI .,�� a^iw4i*01 10�0� -m 104010110 _ 0 Wass* NiiimmogoiPah , , 1 , 1 , 1 , 1 , , ; , Contractor's Name: 0100 — 5../.C• Job Address: s4 N' • ROOF CATEGORY ❑ (Low Slope Application) ❑ (Nail -On Tile) t( (Mortar- Adhesive Set Tile) ❑ (Asphalt/Fiberglass Shingles) 0. ( Metal.Ropfs \Wood Shingles & Shakes) ❑ (Other) ROOF TYPE New Roof .❑ Rer roofing ❑ Recovering ❑ Repair ❑ Maintenance Flat Roof Area (ft Sloped Roof Area (ft //D 5 E Total (ft //O s ' Master Permit No. Exposure category (per ASCE 7 -88): Building Classification category (per ASCE 7 -88 table 1): A Ft. V Deck type: —0 G D)( ply. Lc1 D ')) ATTACHMENT Fastener Type: / 75 /'-L . Amt 1.5 SPACING Field: / As Perimeter: 6 Corner. 123.01.78 893 DETAIL 1 & 2 Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. ROOF HEIGHT A.ND SYSTEM DETAILS (Draw details as needed) Page -1 1 ROOF PLAN Ridge Ventilation? tpEN eApos4 Deck type: MEAN HEIGHT / Z D E T, A l -L - J 3- • Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No . ply w J' / cpx Underlayment: 9a hid" Ho, P Insulation: 12- ROOF 3LOP3 SLOPED SYSTEM DESCRIPTION Fastener type & spacing: Cap Sheet: n1/4-- Roof Covering: Page -2 rC.c.,Jµt IZ 0. L. TILE CALCULATIONS`' (Pmaxl: X X (Aerodynamic Multiplier): ) - M: ' = M PCA• . (Pmax2: X (Aerodynamic Multiplies): ) - M :' = M PCA: (Pmax3: x X (Aerodynamic Multiplier): ) - M = M PCA: FEII .1-4IAJ ED / 2 .r. p Drip edge: Z / lo»!vef -+mil ZE ATTACHMENTS REQUIRED I) Fire Directory Listing Page 2) Dade County Product Control Notice of Acceptance -Cover Sheet a) Specific System Description b) Specific System Limitation c) General Limitations d) Applicable Dctail Drawings .3) Municipal Permit Application 4) Other Component Approvals APPENDIX "F" REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS As it pertains to this Appendix "F ", it is the responsibility u: lire ruotine contractor to provide the o%'t ;:r with the required roofing permit, to provide the owner with this appendix and co explain to the owner the content of this form. The provisions of Chapter 34 of the South Florida Building Code (S1 7 13C) govern all 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 34 are for the purpose of providing that the roofing system meets dee 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 agr :� cat between the owner and the contractor. 2. Renailing Wood flecks: When replacing roofing. the existing wood roof deck may have to be renailed 'in accordance with the current provisions of Chapter 29 of the SFBC. (The roof deco: is usually concealed.prior to removing the existing roof system) 3. Common Roofs: Common roofs are those %vItich have no visible delineation between neighboring units .(i.e. townhouses, condominiums, etc.). In buildings with common roofs. the roofing contractor and /or ownei :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 ma) not be acceptable. The SFBC provides care option of maintaining this appearance. fc 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. Parading may shorten the life expectancy and performance of the new roofing system. Fonding 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 /cdzzc 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 Chapter 23 of the SF BC. 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the interior o 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 Iifc of the roof. S. The owner may contact the Miami-Dade County Consumer Services Department for further information rcardin3 talc above. o 0- 1 O1— U:rtc $ Signature METRO .cDE METROPOLITAN DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO -DADE FLAGLER BUILDING 140 WEST FLAGLEA STREET, SUITE 1803 MIAMI, FLORIDA 33130 -1563 PRODUCT CONTROL NOTICE OF ACCEPTANCE (305) 375-2901 Almar USA FAX (305) 375 -2908 Altusa Tile /Ceramicas Decorativas Llobregat (Cedeska) PRODUCT CONTROL DIVISION 6645 NW 77 Ave. (305) 375.2902 Miami, FL. 33166 FAX (305) 372.6339 Your application for Product Approval of: Altusa_ High: Clay Barrel Tile under Chapter 8 of the Miami - 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: The Center for Applied Engineering, Inc. and Redlaod Technologies has been recommended . for acceptance by the Building Code Compliance Office to be used in Dade County, Florida under the specific conditions set forth on pages 2 -8 and the standard conditions on page 9. This approval shall not be valid after the expiration date stated below. The Building Code Compliance Office reserves the right to secure this product or material at any time from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner, the Building Code Compliance Office may revoke, modify, or suspend the use of such product or material immediately. The Building Code Compliance Office reserves the right to revoke this approval, if it is determined by the Building Code Compliance Office that this product or material fails to meet the requirements of the South Florida Building Code. The expense of such testing will be incurred by the manufacturer. ACCEPTANCE NO.: 98- 0428.02 Renews: 97- 0918.03 EXPIRES: 05/28/01 aul Rodrig ez Product Control Supervisor THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS BUILDING CODE COMMITTEE This application for Product Approval has been reviewed by the Miami -Dade County Building Code Compliance Office and approved by the Building Code Committee to be used in Dade County, Florida under the conditions set forth above, Charles Danger, P.E. Director Building Code Compliance Dept. APPROVED: 05/28/98 1 Miami -Dade County Internet n i d dreL! 6 8 . 0 Nnasterebuifdlnocodeonffne.com Homeoaae:'httn:/ /www 1 6'J d 8 Q' i v i 0 0 ? q 2 d ALMAR USA Product Control No.: 98- 0428.02 #30 Felt Altusa Barrel Trim Pieces Product product #43 Coated Base Sheet Mineral Surface Cap Sheet 'd L 68 •°N TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT Test Dimensions Specifications I= I8' / =" w= 9'%" %2" thick t = varies w = varies varying thickness TRADE NAMES OF PRODUCTS MANUFACTURED OTHERS Dimensions N/A ASTM C 1167 ASTM C 1167 Test Specifications ASTM D 226 type II N/A ASTM D 2626 N/A ASTM D 249 Lenzingtex - ZB 140 59' x 164' roll PA 104 Underlayment 22 Ibs/roll Rainproof II 30" x 75' roll PA 104 36 "x75'roll or 60" x 75' roll Ice and Water 36" x 75' roll PA 103 Shield Mopping Asphalt N/A ASTM D 312 type III or IV Page2of9 High profile, two piece, clay roof tile equipped with one nail hole. For direct deck, adhesive, and mortar set applications. Accessory trim, clay roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile, Product Description Manufacturer Saturated organic felt to be used as a nailed anchor sheet. Saturated and coated organic base sheet. Mineral surfaced asphalt roll roofing for use as a top ply. Single ply, nail -on underlayment. Single ply, nail -on underlayment with 2" self - adhering top edge. Self- adhering undcrlayment Asphalt Product Description generic generic generic Lenzing Performance, Inc. (with current NOA) Protect -O -Wrap, Inc. (with current NOA) W.R. Grace Co. (with current NOA) generic ran Zuloaga, RRC RoofnaPrbductcontrcild8 [00' .qed ALMAR USA Flashing Cement Asphalt Primer Roofing Nails Tin Caps Tile Nails Roof Tile Mortar ( "TiieTiteTA ") Roof Tile Adhesive ( "Polypro® AH160 ") Valley Flashing Drip Edge Product L868 0 hi Dimensions N/A N/A min. 12 ga. with 3 /g" head min. 32 ga. min. 1 o.d. max. 2" o.d. min. 12d x 31/4" NIA N/A min. 26 ga. min. 16" width min. 26 ga. min. 2" face flange min. 2" deck flange Test Specifications ASTM D 4586 Asphalt based, asbestos free, fiber reinforced, trowel grade cement, ASTM D 41 Cut back, asphalt generic based coating used to facilitate bonding of dissimilar materials. PA 114 Appendix E PA 114 Appendix E PA 114 Appendix E PA 123 PA 111 Page 3 of 9 Product Description Annular ring shank, hot dipped, electro or mechanically galv. roofing nails. Corrosion resistant circular disc for use in underlayment attachment Corrosion resistant, ring shank nails. Prebagged mortar mix designed for mortar set roof tile appl ications. See PCA Two component polyurethane adhesive designed for adhesive set roof tile applications. ASTM A 525 Galvanized steel valley flashing Galvanized steel drip edge Product Control No.: 98- 0428.02 Manufacturer generic generic generic generic Bermuda Roof Company, Inc. (with current NOA) Polyfoam Products, Inc. (with current NOA) generic generic Frank Zuloaga, RRC Rnnfinn Prnrl„r•r nnntr. ., i �� T Q ? ° ALMAR USA Product Control No.: 98- 0428.02 Test Aeencv t 'd C68' °N EVIDENCE SUBMITTED Test Identifier Test Name/Report Date The Center for Applied 94 -083 Static Uplift Testing 09/94 Engineering, Inc. PA 101 (Adhesive Set) The Center for Applied 257869 -1 Static Uplift Testing 1/22/97 Engineering, Inc. PA 101 (Mortar Set) Redland Technologies P0647 -01 Wind Tunnel Testing 08/01/94 PA 108 (Mortar Set) The Center for Applied 257869 Physical Properties 02/05/197 Engineering, Inc. ASTM C 1167 Page 4 of 9 Zuloaga, R.RC Roofing Product contrc 6 0 u L 0 fl? 5 led ALMAR USA Deck Type: Deck. Description: SYSTEM D: Slope Range: Underlayment: Roofing Tile: Comments: 9 d Lr68 °N SYSTEMS Product Control No.: 98- 0428.02 Wood, Non - insulated New construction 19 /32" or greater plywood or wood plank. Mortar or Adhesive Set Application 2 ":12" to 7 ":12" Note: System D is only acceptable in this slope range. Install underlayment system ' in compliance with Dade County Application Standard PA 120. (See System Limitation #5.) Install tile in compliance with Dade County Application Standard PA 120. (See "Data for Attachment Calculations" included in this Approval.) 1. For re -roof applications, 15 /32" plywood is an acceptable substrate. Page 5 of 9 Frank Zuloaga, RRC Rnnfino Prnrinrt rnnrr 6 6: 1 n 1 r 5 g 6 d Table 4: Minimum Characteristic Resistance Expressed as a Moment - M (ft-Ibf) for Mortar or Adhesive Set System Tile Profile Tile Application Minimum Characteristic Resistance Load (Ibf) Altusa Barrel Tile Mortar Set 24.50' 213.8 Adhesive Set 66.50 Table 3: Restorin . Moments due to Gravi - M. (ft-ibf) Tile Profile 3 ":12" 4" :12 ". 5 ".:12" 6" :12" 7" :12" Altusa Barrel Tile 5.02 4.95 4.85 4.72 N/A Table 1: Avera e Weight (W) and Dimensions (I x w) Table 2: Aerodynamic Multipliers - X (ft') Weight -W (Ibf) Tile Profile Width -w (feet) X (ft') Batten Application X (ft Direct Deck Application Altusa Barrel Tile 0.69 , N/A 0.31 Table 1: Avera e Weight (W) and Dimensions (I x w) Tile Profile Weight -W (Ibf) Length -1 (feet) Width -w (feet) Altusa Barrel Tile 6.30 1.542 0.69 , ALMAR USA 1. Bermuda Roof "Tile Tite Mortar 2. Quickcrete Roof Tile Mortar #1140 L 6 •O DATA FOR ATTACHMENT CALCULATIONS Page 6 of 9 Product Control No.: 98- 0428.02 ran Zuloaga, RRC n Rnnf'nn nrnr7,irf rnntrYid60 : I ..1007, 7 (led ALMAR USA PROFILE DRAWING "ALTUSA BARREL" CLAY ROOF TILE Product Control No.: 98 0428.02 g d L 68 °N Page 7 of 9 Frank Zuloaga, RRC RonfinRPr?diirt [ „LOH 'S led ALMAR USA Product Control No.: 98- 0428.02 SYSTEM LIMITATIONS L The standard minimum roof pitch for the Altusa "Barrel" high profile tile shall comply with Dade County Application Standards PA 120. 2. System installation shall be in compliance with the system specifications outlined in this Product Control Approval. The method of attachment utilized shall provide sufficient attachment resistance expressed as a moment to meet or exceed the required moment of resistance determined in compliance with Dade County Protocol PA 1 or PA 127. The Altusa "Barrel" tile profile has been tested for both wind characteristics and static uplift performance , therefore, attachment calculations for installation in compliance with PA 115 or PA 127 shall be done as an 'Moment Based System' 3. For mortar or adhesive set tile applications, a field static uplift test by a Dade County accredited testing agency, in compliance with Dade County Protocol PA 106, shall be performed. 4. For mortar set tile applications, 30/90 hot mopped underlayment applications may be installed perpendicular to the roof pitch unless stated otherwise by the underlayment material manufacturer's published literature. 5. All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo for identification in the field. 6. Applications for roofing permits shall include a completed Section 11 of the Uniform Building Permit, a copy of Almar USA's current specifications and details, a copy of this Product Control Approval and a copy of the Product Control Approval of any Roofing Component used in the proposed tile application. Reference shall be made to appropriate data for the required fire rating. 7. The applicant shall retain the services of a Dade County certified testing laboratory to maintain quality control in compliance with the South Florida Building Code and related protocols. 8. Any amendments to these provisions shall be in compliance with Sections 203 and 204 of the South Florida Building Code. Page 8 of 9 Frank Zuloaga, RRC • ALMAR USA Product Control No.: 98- 0428.02 A1mar USA ACCEPTANCE NO: 98- 0428.02 Altusa Tile/Ceramicas Decorative, Llobregat (Cedesk*) APPROVED: Mav 28, 1998 6645 NW 77 Ave. EXPIRES : 1Slay 28, 2001 Miami, FL. 33166 NOTICE OF ACCEPTANCE STANDARD CONDITIONS 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 h 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 9. END OF THIS ACCEPTAN Page 9 of 9 u oaga, RRC TILE # 1 2 3 4 5 AVERAGE SPECIFIED LENGTH (in) 16.1 16.0 15.9 15.9 16.1 16.0 N/P WIDTH (in) 7.0 7.1 6.9 6.9 6.9 7.0 N/P WEIGHT (lbs) 3.2 3.2 3.1 3.1 3.3 3.2 N/P THICKNESS (in) .39 .39 .40 .39 .43 .40 N/P TRANSVERSE STRENGTH (lbs) 385 453 399 405 388 406 400- X 5 350 - indiv. ABSORPTION COLD WATER ( %) 4.2 A 4.9 5.4 1.5 2.1 3.6 < 6- X 5 <8 -1 indiv PERMEABILITY pass pass pass - -- - -- - - -- CLIENT: Interclay, Corp. 6645 N.W. 77th Avenue Miami, Florida 33166 Att. Mr. Carlos Fernandez TEST: Protocol PA 110 -95 (ASTM C1167 -93a): Traverse Strength (dry) Moisture Absorption, Permeability mil .... 1 E L TBBTWULL CRAIG LABORATORI88 & CONSULTANTS, INC. 3731 8.W. 47th Ave. #401, Davie, Florida 33314 Phones (934) 584.4475 • PAW (954) 584 -3887 CERTIFICATE OF TEST AND ANALYSIS DATE: 5/23/96 LAB #: AAP -9 Tech: M. Presciti TILE MANUFACTURER: Altusa TILE DESCRIPTION: clay, small barrel, marked- Altusa Made in Venezuela TILE CLASSIFICATION: type I, grade 3 Comments: The submitted tiles meet the South Florida Building Code Protocol PA 110 -95, (ASTM C1167 -93a) standard specifications. Anthony G. Porcello President 01 'd L868'ON Alberto Ram ez, P. Reg. State of Florida # 23976 kdll:l LQQ7_, 'S 'qad 50 Years WARRAy (LIMITED) � 11 //11/111// 111111 1 11 Of da.. r • 4 10■ • ♦4110 AN. I 4Mb. 4, 4 11 1 P 4110- 411P • • r 41111. 4111P r Ali. ♦4► r • • • r • 40 + f • 4110 • ♦.r • ♦A. • •I i r • 411110 i 4, AMP + ♦.1r OW ♦ 41111P 4110. 411. aeol. 4 .1 0 • r 401. ♦41110 41 •■•♦ 4IM• • ........♦♦ ♦•....•... .••♦♦♦••••••••••� , 111111 : 11 11 1 a l= 1 111 1,,, ♦� The Manufacturer warrants the performance of each individual "S" ELEGANT and ALTUSA MISSION, Clay Roofing Tiles to remain of a quality that obtain the Stoneware classification, due to conditions of manufacturing of our clay roofing tiles. Altusa does not warrant accessory materials or installation labor provided by others. Altusa warrants unto the registered holder of this Menses certificate that each ntses tile properly installed at the designed address will for a period of 50 years from the date of installation remain incombustible, won't be damaged by vermin, or allow passage of water due to decomposition or decay, the tile will not change color from the one it had at time of delivery. Altusa will provide, within ninety (90) days from the date of our investigation. at no cost to the Registered holder. replacement for any tile which exhibits these specific defects. This warranty does not cover: 1) Damage to the tile caused by installation not according to the printed recommendations Issued by the company; 2) Surface cracking or chippin ; 3) Defects or failure of other materials used as coon g or Damage to the tile caused by roof traffic or foreign objects falling on the roof; � s) Hurricanes. tornadoes or other Acts of God. The foregoing is the entire expressed warranty of Altusa, and is independent of any other warranty made by any other person. Altusa, shall in no event be liable under any circumstances for incidental or consequential damages, or for any damages to any structure ita contents, or its occupants. Some states do not allow the exclusion or limitation of incidental or consequentioal damages. so the above limitation may not be applicable in those states. Claims under this warranty will be honored only when the following conditions are met. 1) The holder of this certificate is the original legal owner of the property shown herein (if original owner Is a developer, this warranty can be passed up to the first registered buyer of the structure), or the legal owner of record of the property shown herein at the time of installation of Altusa tiles, town existing structure; and 2) the registration certificate shown herein has been properly executed and forwarded to Altusa within ninety (90) days of installation or original ownership, and 3) the registered owner notifies Altusa promptly after the facts on which the claim is based become known and 4) Altusa has had an opportunity to investigate and approve the claim before any repairs are made. For funher information. concerning your warranty, contact: Manufacturer: ALTUSA Alfareria del 'Rubio. S.A. Carrera 1 —Zona Industrial N° 2 Barquisimeto — Venezuela Name of Tiling Contractor INTERCLAY CORPORATION seas N.W. 77TH AVE. MIAMI, FL 33166 (305) 471 -5830 FAX (305) 471 -6833 Date of Tile Installation Comment: 111111 1111111111111 ■ • ■ t AMP 11111111111111111 ............ 'tl+ 111111 11111111111111111111111 CI •1 .:CC o TRANSMISSION REPORT PRINT TIME 02/09 '01 14:53 ID:MIAMI_SHORES_VILLAGE____ FAX:3057568972 TIMER = - -: -- FILE START MODE No. TIME 969 02/09 14:52 TX ERROR PAGE= LOCATION 93056889550 30 5 Egg Miami Shores Village, Fla. OWNER 7?..-41 4 __ ADDRESS INSPECTION TIME READY PERMIT NO. CONTRACTOR TELEPHONE NO. 10057; fl . INSPECTOR ADDRESS INSPECTION TIME READY PERMIT NO. INSPECTOR A i/ CONTRACTOR STORE TX/RX TOTAL CODE PAGE PAGE TIME 1 1/ 0 00'29" OK 3or ') oVi 4,4 TELEPHONE NO7 QC ,9(.5�i / 'a U * * * * *2AN 181 L DATE EXISTING BEAM ON WEST SIDE IMPROPERLY REPAIRED. DATE i tch ) Miami Shores Village, Fla. OWNER DATE ~ °7-0 DATE 2 g PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address 5 lot 5 7-. Tax Folio Legal Description / Historically Designated: Yes No Owne /'— r/I lessee / Tenant Z A r r % P U ( Master Permit # Owner's Address 5'Y ' / b / S% • i14" ,S T one Contracting Co. 1 L7 enelr V> + A) Qualifier ,7l r4 << • L . / State # C 6 ' C O 6 tf 7s d Municipal # WORK DESCRIPTION Square Ft. 4 0 /Air as to • er and/or My Commission Expires: FEES: PERMIT APPROVED: Zoning Mechanical Date O1P 93 PU OFFICIAL ESTOR JJ NOTARY MORILLO COMMISSION NUMBER - -`:q ' ‘ CC843479 9r• 7~ p 4' MY COMMISSION J(PIRES OF F' JUNE 6. 2'% 3 Building ki C.C.F. Address /d 2 2 / 4 5 44J / 6 57- . /#-v`(, ss# Phone 504 7 Competency # Address Address Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICALEOOFING AVING FENCE SIGN c Yis27-vi Air ,e 77' - -I Estimated Cost (value) % 2 2 ( ' o 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. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the stated. ignature of Contractor or Own - Builder Date No a o Contractor or Owner -B ' der NOTARY Electrical 1 7 1 73 g3 Ins. Co. Public, State of Florida ORLANDO NUNEZ Commission # CC 728791 Comm. Expires Mar. 18, 2002 Date Plumbing Structural Engineer Rid a Ven ' lion? Deck type: MEAN HEIGHT z Underlayment: Insul L / 12" Z . ROOF SLOPE D E T A I L 3 SLOPED SYSTEM DESCRIPTION 5 /e "" #3v �; 7iy J tion: NIp Fastener type & spacing: Cap Sheet: ZG AY / / i/ � � i ve/l , LC / Qa Or Roof Covering: ` ,4 7 -- r , 3 , 4t , r/r / 274' Drip edge: /2" ot " 3` -C 6e ATTACHMENTS REQUIRED 1) Fire Directory Listing Page 2) Miami -Dade County Product Control Notice of Acceptance -Cover Sheet a) Specific System Description b) Specific System Limitation c) General Limitations d) Applicable Detail Drawings 3) Municipal Permit Application 4) Other Component Approvals (Pmax]:4' / x X (Aerodynamic Multiplier): (Pmax2: 76 '4 x X (Aerodynamic Multiplier): (Pmax3: 94 x a, (Aerodynamic Multiplier): / .') (i) ( 7) 7 7. Y TILE CALCULATIONS ) - M 7 . y = M 224 PCA: 5 /v ) - M 7 VU= Mr2: 22 -(, PCA: S✓r /v ) - M 7 4e = M 5/46 PCA: 55 L(96.47 (IS) .76) —7 Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. • 67.5" v 67 Page -2 As it pertains to this Appendix "F', it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, to provide the owner with this appendix and to explain to the owner the content of this form. The provisions of Chapter 34 of the South Florida Building Code (SFBC) govern all the minimum requirements and standards of the indus- try 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 34 are for the purpose of providing that the roof- ing 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. Renalling Wood Decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Chapter 29 of the SFBC. (The roof deck is usually concealed prior to removing the existing roof system.) APPENDIX "F" REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS Common Roofs: Common roofs are those which have no visible delineation between neighboring units (i.e. town- houses, 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. . 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 under- side of the decking may not be acceptable. The SFBC 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 roof- ing system. Ponding conditions may not be evident until the original roofing system is removed. Ponding conditions should be corrected. X 051 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 Chapter 23 of the SFBC. . Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of the structur- al assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider venting which can result in extending the service life for the roof. The owner may contact the Miami -Dade County Consumer Services Department for further information regarding the above. 127.0612 PAGE 2 7/99 Date Contractor's Signature Contractor's Name: / 1/41 - -C Job Address: 5 �� IT /0/ 5% ROOF CATEGORY ❑ (Low Slope Application) ❑ (Nail -On Tile) ❑ (Asphalt/Fiberglass Shingles) ❑ ( Metal Roofs \Wood Shingles & Shakes) ROOF TYPE ❑ New Roof ❑ Re roofing ❑ Recovering %Repair ❑ Maintenance ❑ (Other) esive Set Tile) Flat Roof Area (ft Sloped Roof Area (ft 4 Total (ft 4 ° Master Permit No. Exposure category (per ASCE 7 -88): C Building Classification category (per ASCE 7 -88 table 1): Ft. A V Ft. V A Deck type: ATTACHMENT Fas ener Type: SPACING Field: Perimeter: Corner: DETAIL 1 & 2 ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed) ROOF PLAN 123.01 -78 4/99 Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. Page -1 - Mf�AAI-0AOE MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO -DADE FLAGLER BUILDING 140 WEST FLAOLER STREET. SUITE 1603 MIAMI. FLORIDA 33130-1563 (305) 375 -2901 FAX (305) 375 -2908 PRODUCT CONTROL NOTICE OF ACCEPT.ANCE CONTRACTOR LICENSI;NC SECTION Lamoti Roof Tile Inc. (305) 375.2527 FAX (305) 375.2558 1360 N.W. 29 St. CONTRACTOR ENFORCEMENT SECTION Miami, FL. 33142 (305) 375.2966 FAX (305) 375-2908 PRODUCT CONTROL DIVISION Your application for Product Approval of: (305) 375-2902 FAX (305) 372-6339 Lamoti Mortar Set, Concrete " Barrel Concrete Tile" Roofing Tile under Chapter 8 of the Miami -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: Testwell Craig Laboratories & Consultants has been recommended for acceptance by the Building Code Compliance Office to be used in Miami - Dade County, Florida under the specific conditions set forth on pages 2 -8 and the standard conditions on page 9. This approval shall not be valid after the expiration date stated below. The Building Code Compliance Office reserves the right to secure this product or material at any time from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner, the Building Code Compliance Office may revoke, modify, or suspend the use of such product or material immediately. The Building Code Compliance Office reserves the right to revoke this approval, if it is determined by the Building Code Compliance Office that this product or material fails to meet the requirements of the South Florida Building Code. The expense of such testing will be incurred by the manufacturer. ACCEPTANCE NO.: 98- 0713.07 Renews: 94- 1222.25 EXPIRES: 02/06/2002 Raul Rodriguez Product Control Division Chief THIS TS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL COtNDITIOrNS BUILDING CODE COMMITTEE This application for Product Approval has been reviewed by the iami -Dade County Building Code Compliance Office and approved by the Building, Code Committee S.= used in Mia y -D de County, Florida under the conditions set forth above. APPROVED: 01/28/1999 1 of 9 Francisco J. Qu tana, R.A. Director Building Code Compliance Dept. Miami -Dade County Internet mail address: potmasIcrn Cbuildingcodeontine.com Humepage: http : / /www.buildingcodeontine.com LAMOTI ROOF TILE, INC. Product Control No.: 98 0713.07 Category: Prepared Roofing Sub - Category: High Profile Tile Type: Mortar Set Sub -Type: Concrete Product Barrel Concrete Tile Trim Pieces ROOFING SYSTEM NOTICE OF ACCEPTANCE Applicant: Lamoti Roof Tile Product Control No.: 98- 0713.07 1360 Northwest 29th Street Miami, Florida 33142 Approval Date: 01/28/1999 TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT Test Product Dimensions Specifications Description I - 18" PA 112 High profile, two piece, concrete roof w - 8 %" tile. For direct deck, mortar set %" thick applications only. I - varies PA 112 Accessory trim, concrete roof pieces w = varies for use at hips, rakes, ridges and valley varying thickness terminations. Manufactured for each tile profile. TRADE NAMES OF PRODUCTS MANUFACTURED BY OTHERS Test Product Product Dimensions Specifications Description #30 Felt N/A ASTM D 226 Saturated organic felt Type 11 to be used as a nailed anchor sheet. #43 Coated Base Sheet Mineral Surface Cap Sheet N/A ASTM D 2626 Saturated and coated organic base sheet for single or double ply underlayment. N/A ASTM D 249 Mineral surfaced asphalt roll roofing for use as a top ply in a double ply underlayment system. Page 2 of 9 Expiration Date07/20/2001 Manufacturer generic generic generic rank Zuloaga, RRC Roofing Product Control Examiner ' LA.MOTI ROOF TILE, INC. Tin Caps Product Mopping Asphalt Flashing Cement Asphalt Primer Roofing Nails Roof Tile Mortar ( "TileTiteTM ") Valley Flashing Drip Edge Dimensions N/A N/A min. 12 ga. with ' /," head min. 32 ga. min. I /," o.d. max. 2" o.d. N/A N/A min. 26 ga. min. 16" width min. 26 ga. min. 2" face flange min. 2" deck flange Test Specifications ASTM D312 Type 1 1 1 or I V ASTM D 4586 ASTM D41 PA 114 Appendix E PA 114 Appendix E PA 123 ASTM A 525 PA 111 Page 3 of 9 Cut back, asphalt based coating used to facilitate bonding of dissimilar materials. Annular ring shank, hot dipped, electro or mechanically galv. roofing nails for use in underlayment attachment. Corrosion resistant circular disc for use in underlayment attachment Prepared mortar mix designed for mortar set roof tile applications. Galvanized steel valley flashing Galvanized steel drip edge Product Control No.: 98 0713.07 Product Description Asphalt for bonding a mineral surface cap to a mech. attached base sheet in a double ply underlayment system. Cut back, asphalt based, asbestos free, fiber reinforced, trowel grade cement for repair and flashing applications. Manufacturer generic generic generic generic generic Bermuda Roof Company, Inc. with current PCA generic generic Fran • uloaga, Roofing Product Control Examiner L'AMOTI ROOF TILE, INC. Product Control No.: 98- 0713.07 Testwell Craig Laboratories Lab #: QC -4 & Consultants, Inc. Testwell Craig Laboratories & Consultants, Inc. EVIDENCE SUBMITTED Test Aeencv Test Identifier Test Name /Report Date Lab #: QC -7 Tech: M. Presciti Page 4 of Static Uplift Testing PA 101 (Mortar Set) Physical Properties PA 112 May 1995 May 1995 Frank Zuloaga, RRC Roofing Product Control Examiner . LAMOTI ROOF TILE, INC. Product Control No.: 98- 0713.07 Underlaymcnt: Roofing Tile: SYSTEMS Deck Type: Wood, Non - insulated Deck Description: New construction 19 /32" or greater plywood or wood plank. SYSTEM D: Mortar Set Application Slope Range: 2 ":12" to 7 ":12" Note: System D is only acceptable in this slope range. Install underlayment system in compliance with Miami -Dade County Roofing Application Standard RAS 120. (See System Limitation #4.) Install tile in compliance with Miami -Dade County Roofing Application Standard RAS 120. (See "Data for Attachment Calculations" included in this Approval.) Comments: 1. For re - roof applications, "1, plywood is an acceptable substrate. Page 5 of 9 Frank Zuloaga, RRC Roofing Product Control Examiner . LAMOTI ROOF TILE, INC. Product Control No.: 98- 0713.07 L Fire classification is not part of this acceptance. SYSTEM LINIITATIONS 2. The standard minimum roof pitch for Lamoti Roof Tile's "Barrel Concrete Tile ", high profile tile shall comply with Miami -Dade County Roofing Application Standards RAS 120, depending on the method of installation. 3. System installation shall be in compliance with the system specifications outlined in this Product Control Approval. The method of attachment utilized shall provide sufficient attachment resistance expressed as uplift to meet or exceed the required moment of resistance determined in compliance with Miami -Dade Roofing Application Standard RAS 127. The tile profile listed herein has been tested for both wind characteristics and static uplift performance , therefore, attachment calculations for installation in compliance with Roofing Application Standard RAS 127 shall be done as an 'Uplift Based System' 4. For mortar or adhesive set tile applications, a field static uplift test by a Dade County accredited testing agency, in compliance with Miami -Dade County Roofing Application Standard RAS 106, shall be performed. S. For tile applications, 30/90 hot mopped underlavment applications may be installed perpendicular to the roof pitch unless stated otherwise by the underlayment material manufacturers published literature. 6. All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo for identification in the field. 7. Applications for roofing permits shall include a completed Section 11 of the Uniform Building Permit, a copy of Lamoti's current specifications and details, a copy of this Product Control Approval and a copy of the Product Control Approval of any Roofing Component used in the proposed tile application. Reference shall be made to appropriate data for the required fire rating. 8. The applicant shall retain the services of a Dade County certified testing laboratory to maintain quality control in compliance with the South Florida Building Code and related protocols. Page 6 of 9 Frank Zuloaga, RRC Roofing Product Control Examiner . LAMOTI ROOF TILE, INC. DATA FOR ATTACHMENT CALCULATIONS Table 1: Average Weight (W) and Dimensions (I x w) from PA 112 Testing Tile Profile Barrel Concrete Tile Weight -W (lbf) 7.40 Length - I (feet) 1.50 Width -w (feet) 0.70 Page 7 of 9 Product Control No.: 98- 0713.07 ran uloaga, Roofing Product Control Examiner Table 2: Minimum Characteristic Resistance Load - F' (Ibf) from PA 101 Testing Tile Profile Tile Application Attachment Resistance Barrel Concrete Tile Mortar Set 55.10 . LAMOTI ROOF TILE, INC. DATA FOR ATTACHMENT CALCULATIONS Table 1: Average Weight (W) and Dimensions (I x w) from PA 112 Testing Tile Profile Barrel Concrete Tile Weight -W (lbf) 7.40 Length - I (feet) 1.50 Width -w (feet) 0.70 Page 7 of 9 Product Control No.: 98- 0713.07 ran uloaga, Roofing Product Control Examiner LAMOTI ROOF TILE, INC. BONDING LOCKS COVER TILE Hip and Ridge PROFILE DRAWING LAMOTI ROOF TILE "BARREL CONCRETE TILE" Page 8 of 9 Product Control No.: 98- 0713.07 PAN TILE Frank Zuloaga, RRC Roofing Product Control Examiner L•AMOTI ROOF TILE, INC. Product Control No.: 98- 0713.07 Lamonti Roof Tile Inc. ACCEPTANCE NO: 98- 0713.07 1360 NW 29 St. APPROVED : 01/28/1999 Miami, FL .33142 EXPIRES : 07/20/2001 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) lithe 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 9. END OF THIS ACCEPTANCE Page 9 of 9 Frank Zuloaga, RRC Roofing Product Control Examiner MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address k. .T4- I t STATE OF FLORIDA, COUNTY OF DADE. ss. Disapproved ,n (Signed) .6'-v ` Building ector Date No Street Registered Architect and /or Engineer..._ __ .. 1 LA Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done •5 ' 1 4 . E. / ei - State work to be done and purpose of building (by floors) � �° t' fr and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundatio C� n Roof Covering Estimated Total cost of improvements $ 1 A mount o f Permit $ o� Zone cubage required plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to - - — The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the rovisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performe under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. K n � ' ^ a � Remarks (Signed) '` Jj "` Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. / Permit No SO G Date / � ' Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires ANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Permit No MIAMI SHORES VILLAGE Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date - 2 - BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Owner's Name and Address �� • _.5.x.1.... ,...A.4 .L.- Registered Architect and /or Engineer.. .. Name and address of licensed contractor L-:e – ee'l ,f &de- 6. / t $ . / J yele Location and legal description of lot to be built on: Lot Block Subdivision. 11.4tSe, Street and Number where work is to be done Yj `I ) .. ,! e State work to be done and purpose of building (by floors) G,i -1- 7 . A , 1 - - - �/ 1J/l Date T ,iscC No ‘5 S ' eet l U/ and for no other purpose. New Building Remodeling Addition Repairs L/ No. of Stories To be constructed of Kind of fo undation Roof Covering Estimated Total cost of improvements $ 1 Amount of Permit $ Zone cubage required .Plan Cubage Distance to next nearest building__._ Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building 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 sub ontr�ctors, on work to be performed under this permit, as are licensed by Miami Shores Village. JJ � Remarks ( Signed) 9. • STATE OF FLORIDA, j COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida (Signed) ''�� Building Insp• or My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member ......... Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.