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636 NE 101 St (5)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ! C%I. 11 °Ft. Job Address to_ ' N E I ( (5 • Tax Folio Legal Description t' , - C: Owner/Lessee / Tenant _ A rf U E S Dim Owner's Address .3 ti 1 L 51. POI 5hcx • Phone g S� C i� �1 1 �`"X 1 O 3 � • Lkil� It Ll /-'��C \ t\ S Concn Co. 1 � C3 Address � 1 y Qualifier C \C.)5 ( e_ State # L \ - 1 a -C 1 C , Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL (R0 ROOFING FENCE SIGN WORK DES ON 1 e c , Estimated Cost (value) 72 j 6(2 ) Square Ft. 5 . 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 th t all work will be done in,ompliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to d• the work .t -' 7, S FEES: PERMIT of owner and/or Condo President er and/or ondo President n Expires: RADON Municipal # APPROVED: Zoning Building Mechanical Plumbing SL Date Date Historically Designated: Yes C.C.F. NOTARY Electrical Master Permit # BOND TOTAL DUE No Competency # Cr.t-OF- ((2_Ci Ins. Co. Structural Engineer Jt�� F ` C �1 '/ /6, (41 (a-Q 11 Plot 25' 11/27/17JJ 15:2:) J3500772C7 PERMIT NO. STATE OF FLORIDA ,' COUNTY OF DADE orRINGC NOTICE: TIITZS roam Is To NZ RZCOHDED AT 44 WEST FLAGLER• (STl3 FLOOR) CITY Or MIMI PLANNING, WILDING li ZONING DEPARTMENT ilitICEALIZMICLBEKT vie FOLIO - NO. rACC 61/61 9986 10604 1999 DEC 02 13:17 THE UNDERSIGNED h ►reby gives notice that improvements will be made to the real property located at in the Miami, in accordance with Chapter 713 of Florida Statutes, the following informationyisiprovidedFlorida, and Legal description of erty: t(), Block of / • General description of Improvements_ Owner /Title Holder's name different from Job address Contractor's name and address Surety's name and address • Bond Number Lender's name and address ae 5 415. and address. if .11F 0 z , t- 5 01' vof tfi]s , La •Expiration date Person within the ::tats of Florida, designated by Owner to documents as provide;! by Section 713.13(1)()7 of Florida Statutes: eCtire service of notices or other Naue address Person, In addition to owner, designated F to tecelve a copy of tienor's Notice as provided in Section 713.13(1)(b) of Florio a Statutes: Xame address Unless a different date is specified, the expiration date of this Notice of Commencement shal be one (1) ear from date of recording. Sworn to and subscribed be.`ore a on this My coeisston expires: PBZ 1/2/91 7/3 rA2 „t 1 5 .... , �� MY COMM SSION #CC 850962 EXPIRES: September 20,2003 1tr e Bonded Thru Notary Public Underwriters / �l ✓1, ( 1 41'41) SATE OF 6FLORCDA, COUNTY Cr CEITIFY that the tor:, : g is a t r ei5/' E '?11 E fEe In this attic J RV Y RUM, CL Rit, of Circuit ;n,: ":, _ Deputy Clerk • (Si nature of Owner) day of __ i/ 1/ I77ea. Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. Contractor's Name -//21.—( 41204/y 9 g Job Address: 62d 1 / � ROOF CATEGORY _, ❑ (Low Slope Application) ❑ (Nail -On Tile) /Mortar-Adhesive Set Tile) ❑ (Asphalt/Fiberglass Shingles) ❑ ( Metal Roofs \Wood Shingles & Shakes) ❑ (Other) ROOF TYPE ❑ New Roof Re- roofing ❑ Recovering El Repair ❑ Maintenance Flat Roof Area (ft t Sloped Roof Area (ft �5 Total (ft 0 Master Permit No. Exposure category (per ASCE 7 -88): ( _ Building Classification category (per ASCE 7 -88 table 1): DETAIL 1 & 2 ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed) Ft. v Ft. A V A Deck type: ODD AT ACHME T Fastener Typ SPACING Fiel Perimeter: Corner: r r ROOF PLAN 123.01 -78 9/96 Page -1 Rid a Ven lation? MEAN HEIGHT at Deck type: 6 UJoo A zUnderlayment: Insulation: 12" ROOF SLOPE D E T A I L 3 Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. SLOPED SYSTEM DESCRIPTION /6 * 77;9 6 Fastener type & spacing: Shan Cap Sheet: / E . g 4 90 0 � '�i, * — or Roof Covering: Drip edge: TILE CALCULATIONS ' 9 /"! (Pmaxl: /x ? (Aerodynamic Multiplier): O . . / ) - M � . � = M 7 ' II P w f .- (Pmax2: x a, (Aerodynamic Multiplier): D • dI ) - M cp — = Mrz PCA: (Y / (Pmax3: g(!/' X a, (Aerodynamic Multiplier): 0. 3) ) - M Ill. 6 = M 1113CA: 9 - -- Q zed .C€f/rl P/QStle Ode irzy° Pg frail ATTACHMENTS REQUIRED 1) Fire Directory Listing Page 2) Dade County Product Control Notice of Acceptance -Cover Sheet a) Specific System Description b) Specific System Limitation c) General Limitations d) Applicable Detail Drawings 3) Municipal Permit Application 4) Other Component Approvals APPENDIX "F" REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS As it pertains to this Appendix "F ", it is the responsibility u:* tire rooting con,rtctor to provide the Drier with the required roofing permit, to provide the owner with this appendix and to explain to•tlte owner the content of this form. The provisions of Chapter 34 of the South Florida Building Codc (SFBC) 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 contra. or. The owner's initial in the adjacent box indicates that the item has been explained. S -7- 1. Aesthetics - Workmanship: The workmanship provisions of Chapter 34 are for the: purpose of providing that the roofing system meets the wind resistance and water intrusion performance standards. Aesthetics (appearance) issues are not a consideration syith respect to workmanship provisions. Aesthetic issue; 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 die contractor. 6 C4 2 Ren:lil Wood D'ccGs: When replacing roofing, the existing wood roof deck may have to be retailed in accordance with the current provisions of Chapter 29 of the SFBC. (The roof deck is usually conce aled.pr for to removing the existing roof system) ‘ Z 4 A______ 3. Common Roofs: Common roofs are those which have no risible delineation between neighboring units (i.e. townhouses, condominiums, etc In buildings with common roofs. the roofing contractor and /or ow o er should notify the occupants of adjacent units of roofing wort: to he performed. - 11 4. Exposed ceilings: Exposed. open beam ceilings are where the underside of the roof decking can bc s'iewed from below. The owner may tvish to maintain the architectural appearance. therefore, roofing, nail penetrations of the underside of the decking may no: bc acceptable. The SFBC provides the option of maintaining this appearance. JL _ _ _ S. Ponding Water: The current roof system and /or deck of the building may not drain well and may cause stater to pond (accumulate:) in Io -lyin; areas of the roof. Ponding can be an indication of structural distress and may require the review of a prof _ss'ion::I structural cn, ineer. Ponding, may shouter the life expectancy and performance of thy_ rev. roofing system. Ponding conditions may not be evident until the originV roofing system is removed. Pondintz conditions should be corrected. 6. Overflow Scuppers (gull outlets): lc is required that rainwater flow off so that the roof is r overloaded from a build up of stater. Perimct;r/cd>c spa Its or other roof extensions may block this discharg overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow s=uppers in accord; xvi1I, Chapter 23 of the SFBC. 7. Ventilation: 1"4osc roof structures should have some ability to rent natural airflow throu�,h the i f the structural assembly (the building itself). The existing, amount of attic ventilation shall not bc rcdt' may be beneficial to consider additional ventin` which can result in extending the service life of the roof. C S. The owner ma • contact the ►NIiac ;ci -Dade Count • Consumer Services,. Department fc information regarding the bov , U:. Corr Actor.) _c^ curt PRQDUCT CONTROL NO TICE OF ACCEPTANCE Santafe Tile Corporation Ladrillcra Sentafe Bogota, Colombia .:,•ptication for Product Approval of: Santofj TJ /c Co( 'ion, Nail -On or Motlar/Adhesive Set Clay "Santee S" Roofing Tile ;_ under C:haptcr ; Ae Metropolitan Dade County Code governing the use of Alternate Materials and Types of Constiuctior. • completely described in the plans, specifications and calculations as submitted by: R&dlanu ! ' h , :ogles, The Cenlei for Applied Engineering, lac. and Testwell Craig Laboratories & Consu /rank, hr r. • ucc • _ Amended for acceptance by the Building Code Compliance Department to be used in Dade County Florida Lii.ier the specific conditions set forth on pages 2 through 7 and the standard conditions set forth on page 8 The approval shall not be valid after the expiration date stated below. The Building Code Compliance Office reserves the right to sure this product or material at any time for 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 Oftce may revo,.e, modify or suspend the use of such product or material immediately. The applicant shall re- evaluate this product or material should any amendments to the South Florida Building Codc be enacted affecting this product or material. The Building Code Compliance Office reserves the right to revoke this approval. if it is determined by the Building Code Compliance Office that this product or material fails to meet the requirements of the South Florida Building Code, The expense of such testing will be incurred by the manufacturer Acceptance No.: 97 0515.05 Revises No. 96 0318.02 Expires: 01/22/01 Approved: (.2261Z • THIS IS THE COVERSNEET SEE ADDITIONAL E F CONDITIONS BUILDING CODE COMMITTEE ITROPOLITAN DAD COUNTY. FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375-2901 FAX (305) 375 -2906 PRODUCT CONTROL OIVISION (305) 375.2902 FAX (305) 372 -6339 Naul Rodrig ea Product Control Supervisor SPECIFIC A ' GENERA! Charles Danger, P.E. Director Building Code Compliance Dept. Metropolitan Dade 'County ACCEPTANCE NO.: 97 0515.05 This application for Product Approval has been reviewed by the Metropolitan Dade County Building Cone Compliance Department and approved by the Building Code Committee to be used in Dade County, Florida under the conditions set forth above. AQp !i_ cTnt: Santafe Tile Corporation Ladrillera Santafe Bogota. Colombia PRODUCT CONTROL NOTICE OF ACCEPTANCE . ROOFING SYSTEM APPROVAL Categg: Prepared Roofing Sub- Cate'Or.•: 1-Ugh Profile Tile Nail - on/Mortar Set/Adhesive Set Su b-Tyn�: Clay System Deseripreuti Ladrillera Santafe, located in Bogota, Colombia, manufacturers clay roof tile for nail -on and nl.ortarJ adhesive set applications. All Ladrillera rQ al r aes to the La r'!e Santafe "}�Q 9 t lel•b ,1 tile � ofile. glazed color finish. This Produ ontro Refer to as • o•riate P duct Control A • . royal or oth r tile i •files. nS" Santa Fe Tile Corporation is the sole, approved distributor of Ladrillera Santafe roof tiles. • Contact: Daniel Bernal General Manager Santafe Tile Corporation 8825 NW 95 St MMiami, Florida 33122 (3 3178) (305) 885- 9002/888 -005 Page 2of8 Product Control No.: 97 0515.11 Approval [)ate: Ja nuary 22, 1998 Expiration Date: January 22,20Q1 TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT Test Product Product Dimensions Specifications ecitications Description Santafe S Clay Roof 1= 18" ASTM C 1167 High profile, one piece, clay roof tile w = 11.5" equipped with two nail holes. For nail - Tile I /�" thick on, mortar sect and adhesive set applications. Trim Pieces t = varies ASTM C 1167 seat h trim, s, ridges and valley w °varies varying thickness terminations. Manufactured for each tile prof oaga Roofing Product Control Examiner £0'd SANTAFE TILE CORPORATION ACCEPTANCE NO.: 27. 1)515.05 TEST REPORTS Test Agency Test Identifier The Center for Applied Engineering, Inc. 94 - 1569 The Center for Applied Engineering, Inc. • The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. Red land Technologies Redland Technologies Redland Technologies Redland Technologies Redland Technologies Redland Technologies • Testwe1I Craig Laboratories S Consultants, • Lab v111/4'..4 Inc. 9296 Q99 S0£ 25- 7205 -1 94 -156 -8 Project: 07- 07 -00 -91 Wind Driven Rain Sept. 1994 (307023) PA 100 Tech: G. Suarez Page 3 of 8 7161.03 Appendix 11 7161 -03 Appendix 111 7161.03 Appendix 111 P 0647-01 P 0631 -01 P 0402 Withdrawal Sept. 1993 Resistance Testing of Screw vs smooth shank nails Frank Zuloaga Roofing Product Control Examiner d?JOO 1S03 tiWOO Test Name /Report • Dace Static Uplift Testing Aug. 1994 PA 102 Static Uplift Testing March 1995 PA 101 Static Uplift Testing Aug. 1994 PA 101 Wind Tunnel Testing Dec. 1991 PA 108 (Nail - On) Static Uplift Testing Dec. 1991 PA 102 Static Uplift Testing Dec. 1991 PA 102(A) Wind Tunnel Testing Aug. 1994 PA 108 (Mortar Set) Wind Tunnel Testing July. 1994 PA 108 (Mortar Set) Physical Properties July 1994 AST N1 C 1167 Z 0 - d SANTA FE TILE CORI'OIV 11thN 9Z96 Q99 Q0£ SYSTEMS SYSTEM B: Direct Deck Nail -on Application Deck T Wood. Non- insulated Deck Description: Now construction 19 /32" or greater plywood or wood plank. Slope Range: 4 ":12" to 7 " :12" Note: ,System B is only acceptable in this slope range. Undcrlayment: Install underlayment system in compliance with Metro - Dade County Application Standard PA 118. Roofing Tile: Install tile in compliance with Metro - Dade County Application Standard PA 118. (See "Data for Attachment Calculations" included in this Approval.) Comments: 1. For re - roof applications. 15 /32" plywood is an a.cccptable substrate. SYSTEM D: Mortar or Adhesive Set Application Peck Type: Wood, Non insulated Deck Description: New construction 19 /32" or greater plywood or wood plank. Slope Range: 2 ":1 to 7 " :l2" Note: System D is only acceptable in this slope range. Underlayment: Install underlay'ntent system in compliance with Metro-Dade County Application Standard PA 120. Roofing Tile: Install tile in compliance with Metro -Dade County Application Standard PA 120. (Sec Data for Attachment Calculations" incluc'.ed in this Approval.) Comments: 1. For 're -roof applications. 15 /32" plywood is an acceptable substrate. Page 4 of 8 dao3 1Sti3 WOO Frank Zuloaga Roofing Product Control Examiner Page 5 of SANT,AFE TILE CORPORATION • 1CCEPTANCE NQ.: 97- 0515.0; SYSTEM LIMITATIONS 1. The standard minimum roof pitch for Ladrillcra Santafe's " Santafe S" high profile tile shall comply with Dade County Application Standards PA 118. PA 119 or PA 120, depending on the method of installation. For nail -on applications, fasteners for mechanical attachment of riles shall have a head diameter larger than that of the preformed holes in the tile. 3. System installation shall be in compliance with the system specifications outlined in this Product Control Approval. The method cf attachment utilized shall provide a minimum characteristic resistance Load greater than or equal to the required uplift resistance determined in compliance with Metro -Dade County Protocol PA 115 or PA 127, The Ladrillera Santafe "Santafe S" 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' 4. For mortar and adhesive set tile applications, a field static uplift test by a Metro - Dade County accredited testing agency, in compliance with Metro -Dade County Protocol PA 106, shall be performed. a. All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo for identification in the field. 6. For mortar or adhesive set tile applications, 30/90 hot mopped underlaytnent applications may he installed perpendicular to the roof pitch prior to June 1, 199$ unless stated otherwise by the material manufacturer. Thereafter, 30/90 underlayntent systems shall be installed parallel to the roof pitch in compliance with Appendix 'A' of Dade County Protocol PA 120. 7. The applicant shall retain the services of a Metro -Dade County certified testing laboratory to maintain quality control in compliance with the South Florida Building Code and related protocols. Frank Zuloaga Rodin Product Control Examiner S.NTAFE TILE CORPORATION ACCEPTANCE NO. 97.65 ,15,0 DATA FOR ATTACHMENT CALCUI ATIO,NS Table 1: Aerodynamic Mutttpliers (ft Tile Profile X ( f t Nall-On, Direct Deck Santafe S Clay Roof Tile 0.34 Table 2: Restoring Moments due to Gravity -• M (ft -lbf) Tile Profile 2:12 3:12 4:12 5:12 6 : 12 L Santafe S 4.8 - 4 46 - 1 4. Table 3: Attachment Resistance Expressed as a Moment Mf (ft - Ibf) Tile Profile Two Approved One Approved Mortar Set Adhesive Set Nails Screw Sa ntafe S 21.8 18.4 I . 23.6 6L9 Page 6 of S (ft') Mortar or Adhesive Set 0.31 Frank ,Zuloaga Roofing Product Control Examiner L.U1'I1-1 L.MS I LURI' SANT FE TILE CORPORATION PROFILE DRAWING Pages 7 of 8 LADRILLERA SANTAFE "SAN S" CLAY ROOF TILE J CA..) O O J 7 Co L 0 r . V I ACCEPTANCE NO.: 97-0515.05 • Frank Zuloaga Roofing Product Control Examiner SANTAFE TILE CORPORATION ACCEPTANCE NO.: 97- 0515.05 - • • Santnfc Tile Corporation Product Control No.: 97- 0515.1)5 . Ladrillera Santafc Bogota, Colombia Approval Date: January 22.199S Expiration Date: . January 22, 2001 NOTICE O CCEPTANCE STANDARD CO \'lll'F1QNS t, Renewal of this Acceptance (approval) shall be considered after a renewal application has been tiled and the original submitted documentation, including test supporting data, engineering documents, are nu o:,;er chat/ eight (8) years. Any and all alpprovto products shall be permanently labeled with the manufacturer's name, city. state, and the following statement: "Dade County Product Control Approved", or as specifically stated in the specific conditions of this Acceptance, <. 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 loriger the same product (identical) as the one originally approved; c) If the Acceptance holder has not complied with all the requirements of this aeceptance, 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 ba cause for termination of this Acceptance, unless prior written approval has been requested (through the filing of a revision application with appropriate fee) and granted by this office. 5. Any of the following shall also be grounds for removal of this Acceptance: a) Unsatisfactory performance of this product or process: b) Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any other purposes. 6. The Notice of Acceptance number preceded by the words Dade County, Florida, and followed by the expiration date may be displayed in advertising literature, if any portion of the Notice of Acceptance is displayed, then it shall be 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 Acceptanc0, 9. This Acceptance contains pages I, through 8 this last page. END OF THIS APPF.OVA ,r Page 8 of u oaga Roofing product Control Examiner 11,12/se • 16:21 MED/TERRANEAN ROOF TILE -+ 305633'7640 ACCEPTANCE NO.: 98- 0303.02 Renews: 964402,02 EXPIRES: 04/16//01 APPROVED: 04/16/98 1 Int..ns• ., :f .A.•- - --. --- .w. -w• ... /, r..t.if__�i- - - -- - - - data 11/12/98 16:53 METROPOLITAN DADE COUNTY, FLORIDA METRO - DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (3031 375.2401 FAX (3051 7S -29oa PRODUCT CONTROL DIVISION (305) 375 -2902 FAX (305) 372-6339 PRODUCT CONTROL NOTICE OF ACCEPTANCE Polyfoam Products, Inc. 2400 Spring- Stuebncr Road Spring, TX. 77383 Your application for Product Approve! of £olvfoam Products "Polvpro AH -164 Roof Tile Adhesive under Chapter 8 plebe Miami -Dade County Code governing the use of Altercate Materials and Types of Construction, and completely described in the plans. specifications and calculations as submitted by: The Centor for Applied Engineering, Inc. and Miles Laboratories Polymers Division bas 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 and the standard conditions on page 15.. This approval shall not be valid after the expiration date stated below. The Budding 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 faits to perform in the approved manner, the Building Code Compliance Office mtEy 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. I Rodriguez Product Control Supervisor THIS IS THE COVERSHEET. SEE ADDITIONAL PAgr SPEC[FIC 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. • TX /RX NO.9509 Charles Danger. P.E. Director Building, Code Compliance Dept. Miami -Dade County P.001 • 11/12/98 16:22 MEDITERRANEAN R TILE + 3056337640 POLYFOAM PRODUCTS, INC. Apol icant: Polyfoam Products, Inc. Product Control No.: y,8- 8303.02 2400 Spring - Stucbner Road Spring, Texas 77383 - 1132 Approval Date: ,April 16, 1998 , Expiration Date: April 16.2001 Categopr: Sub - Category: Type: Sub -Tvve: PRODUCT CONTROL NOTICE OF ACCEPTANCE ROOFING COMPONENT APPROVAL Roofing Component Fastening/Adhesive Roof Tile Adhesive Two Component Polyurethane System Description Polyfoam Products, Inc., produces two - component expanding polyurethane adhesive for the attachment of clay and concrete roof tile. Polypro® AH160 is specially designed for application of concrete and clay roof tile over a variety of roof deck substrates and underlayment materials. Polypro® adhesive is applied with proprietary Foampro® RTF1000 dispensing equipment. Approval of this product is specific to the two component mix and Foampro® RTF1000 dispensing equipment. ,Alternative methods of dispensing will requires revision to this approval. Polyproc® adhesive shall be applied only by 'Qualified Applicators% licensed by Polyfoam Products, Inc. Certificates and identification cards are issued to applicators upon successful completion ofa application training program. Approval of this adhesive system is contingent upon application by a 'Qualified Applicator. Contact Pat Murray P.O. Box 1132 Spring, Texas 77383 -1 132 Phone: (713)350 -88S8 Fax: (7/3)288 -6450 Page 2 of 15 11/12/98 16:53 Product Control No.: 94- 03p3.Oz 3T,z: Frank Zuloaga, RRC • • • TX /RX NO.9509 P.002 hu. 'eze ro • 11/12.96 16:22 MSEDITERRANEAN ROOF TILE + 3856337640 POLYPOAM PRODUCTS, INC. Product Control No.: 98 -0303.42 Product Potypro® A14160 Foampro® RTF1000 TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT Test Product pimcnsions Specifications Description NIA PA 101 Two component polyurethane N1A See Detail Attached Dispensing Equipment Page 3 of 15 11/12/98 16:53 Prank Zuloaga. RRC o .... 47.• ..0.. i.. .—.... s s.,.. �. TX /RX K0.9509 P.003 NO. ?12 PLIJ • 11/12/96 16:22 MEDITERRANEAN ROOF TILE + 3656337648 POLYFOAM PRODUCTS, INC. Product Control No.: 98 -0003.02 Product Underlayment Roofings TRADE NAMES OF PRODUCTS MANUFACTURED BY OTHERS Test Criteria Product Description PA 120 All Dade County Component Approved All Dade products as detailed in Dade County County Application Standard PA 120 Approved Products PA 101 All Approved roof tile systems having All Dade tested in compliance with Dade County County Protocol PA 101, as detailed in the systems Approved section of this Component Approval Products Page 4 of 15 11/12/98 16:53 nv. etc Manufacturer Frank Zuloaga, RRC TX /RX NO.9509 P.004 ow • 11,12'99 16:22 t1ED I TERRPNERN ROOF TILE - 385633?6.48 POLYFOAM PRODUCTS, INC. Product Control No. 98- 0303.02 TEST REPORTS Test Agency Test Idcptjficr Test Name/Renort Date Center for Applied #94 -060 Miami Dade Protocol 04/08/94 Engineering PA 101 Center for Applied 257318 -1PA Miami Dade Protocol 12/16/96 Engineering PA 101 Center for Applied 25- 7438 -3 SSTD 1 1 -93 10/25/95 Engineering Center for Applied 25- 7438 -4 SSTD 11-93 10/25/95 Engineering Center for Applied 25- 7438 -7 SSTD 11 -93 1 1/02/95 Engineering Center for Applied 25 -7492 SSTD 11 -93 12/12/95 Engineering Miles Laboratories NB-589-631 ASTM D 1623 02/01/94 Polymers Division Ramtech Laboratories, 9637 - 92 ASTM E 108 04/30/93 Inc. Southwest Research 01- 6743 -011 ASTM E 108 11/16/94 Institute Southwest Research 01- 6739-0624(1) ASTM E 84 01/16/95 Institute Trinity Engineering 7050.02.96 -1 PA 114 03/14/96 Page 5 of 15 11/12/98 16:53 Frank Zuloaga, RRC TX /RX K0.9509 P.005 ,'t1. bets • , 11 /12.'99 16:22 MEDITERRANEAN ROOF TILE 3856337640 POLYFOAM PRODUCTS, INC. Product Control No.: 98 -0303.02 TYPICAL PHYSICAL PROPERTIES Property Test Results Density ASTM D 1622 1.6 Ibsift.' Compressive ASTM D 1621 18 PS1 Parallel to rue Strength 12 PSI Perpendicular to rise Tensile Strength ASTM D 1623 28 PSI Parallel to rise Water Absorption ASTM D 2/27 0.08 Lbs1Ft Moisture Vapor ASTM E 96 3.1 Perm / Inch Transmission Dimensional ASTM D 2126 +0.07% Volume Change -40 F.. 2 Stability weeks +6.0% Volume Change @158 °F., 100% Humidity, 2 weeks Closed Cell Content ASTM D 2856 86% Note: The physical properties listed above are presented as typical average values as determined by accepted ASTM test methods and are subject to normal manufacturing variation. Page 6 of 15 11/12/98 16:53 Frank Zuloaga, RRC NU. V24: tread TX /RX NO.9509 P.006 • 12 16:23 MEDITERRRNERN ROOF TILE -• 305633?640 POLYFOAM PRODUCTS, INC. Product Control No.: 98- 0303.R SYSTEMS Deck Type: Wood, Non - insulated, New Construction/Reroof Deck Description: 15 /32" or greater, plywood or wood plank. SYSTEM A: Adhesive Set Application Slope Range: 2 ":12" to 7 ":12" Undertaymen Shall comply with Miami -Dade Roofing Application Standard PA 120 Roofing Tile: Any roof tile assembly having a current shall be applied in compliance with the Component Application section and the coteesponding Placement Details of this Notice of Acceptance. The adhesive attachment shall provide sufficient attachment resistance expressed as a moment to meet or exceed the required moment of resistance determined in compliance with Miami -Dade County Rooting Application Standards PA 115 or PA 127. The adhesive attachment data is noted in the roof tile assembly NOA. Comments: 1. All 'System Limitations' noted in the tile Roof System Assembly Product Control Approval shall apply. Page 7 of 15 Prank Zuloaga, RRC 11/12/98 16:53 TX /RX NO.9509 P.007 rvcJ. r cc t.G■ • 4 • • 11/12/'id 1b: c Deck Type: Deck Descriptio SYSTEM B: Slope Range: Uodcrlayment / Waterproofing: Underaaymcnt: Roofing Tile: Comments: I ICL 1 1 1_I \1III ...wm1 . POLYFOAM PRODUCTS, INC. SYSTEMS (CONTINUED) Concrete, Ncw Construction/R.eroof New construction Adhesive Set Application 2 ":12" to 7 ":12" Install Approved underlayment system of one of the following: Page 8 of 15 11/12/98 16:53 Product Control No.: 98- 0303.02 (30/90 Hot Mop) fully adhered in a full mopping of ASTM D 312 type IV asphalt applied within the EVT range. Hack nailing and laps shalt be in compliance with Roofing Application Standard PA 120. Any liquid applied roofing system having a current NOA for its use as a tile underlayment system. . Any roof tile assembly having a current shall be applied in compliance with the Component Application section and the corresponding Placement Details of this Notice of Acceptance. The adhesive attachment shall provide sufficient attachment resistance expressed as a moment to meet or exceed the required moment of resistance determined in compliance with Miami -Dade County Roofing Application Standards PA 115 or PA 127. The adhesive attachment data is noted in the roof tile assembly NOA. 1. All 'System Limitations' noted in the tile Roof System Assembly Product Control Approval or waterproofing component Roofing Component Product Control Approval shall apply, as applicable. Frank Zuloagn, RRC TX /RX NO.9509 P.008 • Table 1: Adhesive Placement For Each Generic Tile Profile Tile Profile Placement Detail Two -Piece Barrel #1 'S Shaped f2 Double Roll #3 Fiat #4 11'12/96 16:23 MEDITERRANEAN ROOF TILE 3056337640 POLYFOAM PRODUCTS, INC. Product Control No.: 28- 0303.00 COMPONENT APPLICATION 1. Polypro® AH160 tile adhesive shall only be applied over an underlayment installed in compliance with application instructions detailed in its NOA.. Underlayment may be any undcrlayments or underlayment systems listed Miami -Dade County Roofing Application Standard PA 120. 2. Adhesive application shall be in accordance with the instructions provided herein. Tthe manufacturer may provide additional instructions subsequent to this approval date which may prevail. lnstaffation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, inc. 3. Calibration of thc'Foamprott dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the "B" component shall be maintained between 1.0- 1.15 (A) : 1.0 (B). The dispense timer shall be set to deliver 0.08 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved without revision of NOA. 4. Adhesive shall be dispensed in a 17 in' to 23 in =pad at time of application. The cured pad shall be approximately 5" x 12 ". Foam placement shall be in accordance with the 'Placement Details' herein. Each generic tile profile requires a specific placement, as noted in Table 1, below 5. Adhere tile directly in freshly applied adhesive. Tile must be set within 2 to 3 minutes after foam has been dispensed. Page 9of15 11/12/98 16:53 Frank Zuloaga. RRC TX /RX NO.9509 P.009 • 11/12/9G 16:23 r1ED 1 TERRANEAN ROOF TILE - 3445b.1.J'eb ca POLYFOAM PRODUCTS, INC. Product Control No.: 98- 0303.02 SYSTEM LIMITATIONS 2. Polypro® AH160 adhesive shalt be installed only by 'Qualified Applicators' approved and licensed by Polyfoam Products, Inc. •. 3. For adhesive set tile applications, a field static uplift test by a Miami -Dade County accredited testing agency, in compliance with Miami -Date County Roofing Application Standard PA 106. shall he required not less than 72 hours after application to confirm file adhesion. • 4. Refer to application drawings published by the National Tile Manufacturers Association for penetrations and terminations, as well as the 'Placement Details' included with NOA. 5. Refer to tile Roof Tile Assembly Product Control NOA for system acceptance with this Component. 6_ Refer to the Prepared Roof Tile Assembly for fire rating. 7. Polypro® AH160 shall not be exposed permanently to sunlight. 8. Polypro® AH160 shall be applied with Foampro RTF1000 dispersing equipment only. 9. Polyfoam Products Inc. shall supply Building Official with a list of 'Qualified Applicators' approved and licensed by Polyfoam Products, Inc. Page 10 of 15 Frank Zuloaga, RRC 11/12/98 16:53 TX /RX INO.9509 P.O10 • 11-'12'99 16:24 IMED I TERPRNEAN ROOF TILE - 385633?&49 POLYFOAM PRODUCTS, INC. PLACEMENT DETAILS Placement Detail #t: Two -Piece Barrel Pronto Page ti of15 Product Control No.: 98- 0303.02 Frank Zuloaga, RRC 11/12/98 16:53 TX /RX NO.9509 P.011 • 11.'12'98 16:24 MEDITERRANEAN ROOF TILE � 3856337640 POLYFOAM PRODUCTS, INC. wralf timramipb puc wom.wt UrWefyrwdat PLACEMENT DETAILS (CONTINUED) Page 12 of 15 *..iy w..n.h .dtwtw to . _ _ 11 b. D .vow Utah*. M O.wuat With the Emare dram. Pmeak £w4 Placement Detail N2: 'S' Shaped Tile Profile Product Control No.: 98- 0303.02 Wfp Edr Frank Zuloaga, RRC 11/12/98 16:53 TX /RX NO.9509 P.012 • 11/1&/ lod 2b: bs4 1'IC1/ I fCfrrvv .r - ..••+.......— ..-..— POLYFOAM PRODUCTS, INC. teed w.•.h .leew •••••.a (wlw .,...L1 b caret lh•de•lalised tome PLACEMENT DETAILS (CONTINUED) Ogee oweee Nene adhesive ly.predaWley .t' lip teem - empAdas. Placement Detail X3: Double Roll Profile Page 13 of 15 44/40i 041114.1111 IldliM•4•• uehMee 17411 wirers Weir he ~deed lulus gee tar. Product Control No.: 98- 0303.0 tom Cieomre Frank Zuloaga, R.RC 11/12/98 16:53 TX /RX NO.9509 P.013 • 11/12/99 16:25 MEDITERRQNERN ROOF TILE + 3056337640 POLYFOAM PRODUCTS, INC. N. W..rgh plastic .......A Ewe Geom. PLACEMENT DETAILS (CONTINUED) aire awes. wf! 1�.. •dra.l.• .pp►..d.w.0 w — hew _ __w Placement Detail 114: Flat Profile Pogo 14 of IS Product Control No.:' 98- 0303.02 Apply ....yh adb..i.o t. sada.. IT-MI .wt. gnaws to ...ta- walk Ur W.. 11/12/98 16:53 TX /RX NO.9509 P.014 I vc.r. l VJ.-. • 22/12/8 26:25 MEDI TES ROOF 1 tLt POLYFOAM PRODUCTS, INC. Product Control No.:. 98 -0303.02 Polyfoam Products, Inc. ACCEPTANCE NO: 98- 0303.03 2400 Spring - Stuebner Road APPROVED : April 16, 1998 Spring, TX 77383 EXPIRES : April 16, 2001 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 dean 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 evacuation of this product and the product is not in compliance with the code changes; b) The product is no longer the same product (identical) as the one originally approved; c) if the Acceptance holder has not complied with all the requirements of this acceptance. including the correct installation of the product d) The engineer who originally prepared, signed and sealed the required documentation initially' submitted. is no longer practicing the engineering profession. 4 Any revision or change in the materials, use, and/or manufacture of the product or process shaft automatically be. cause for termination of this Acceptance, =leas 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 advettiaing literature. If any portion of the Notice of Acceptance is displayed, then it shalt 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. l 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 15. END OF THiS ACCEPTANCE Page 15 of 15 11/12/98 16:53 TX /RX NO.9509 P.015 Frank Zutoaga, RRC 1 • Test Location Uplift Pull Test (P or F) Test Location Uplift Pull Test (P or F) Test Location Uplift Pull Test (P or F) 1 26 7 51 2 27 52 3 28 53 4 29 54 5 30 55 6 31 56 7 32 57 8 33 58 9 34 59 10 35 60 11 36 61 12 37 62 13 38 63 14 39 64 15 40 65 16 41 66 17 42 67 18 43 68 19 44 69 20 45 / 70 21 46 ` 71 22 47 72 23 48 73 24 49 74 25 �; 50 �� 75 yi Du Quesne & Associates, Inc. UTR 16 5 3 2 d Consulting Engineers Environmental • Civil • Structural Testing Laboratory Building Inspection Services ON -SITE CONCENTRATED UPUFT LOAD TESTING OF ROOF TILE IN ACCORDANCE WITH METRO-DADE BUILDING CODE COMPLIANCE PROTOCOL PA 106 7/ Owner's Name: �!�' �� -' ''� Permit #• Job Address' .� " l' (/ Roofing Contractor Type of Tile: ' Date Installed Approximate Roof Height: feet Roof Pitch Type of Access to Roof: Scaffolds 1' Ladder Other Approximate Square Footage of Roof ' , ./ii ft 2 Required Testing Force: 35 lbs. Testing Equipment: Chatillion DFIS 100 7 _ �,, Date Tested , IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL PA 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST. THIS REP rge Du Quesne, P.E. it Engineer P.E. #24513 Du Quesne & Associates, Inc. E.B. License #0005245 Lab Certification #94- 0318.01 SITE SPECIFIC INFORMATION TEST RESULTS P = PASS, F = FAIL SKETCH OF ROOF IN BACK THIS PA 106 TEST HAS BEEN PERFORMED IN FULL ACCORDANCE TO THE REQUIREMENTS OF DADE COUNTY, WITH NO DEVIATIONS. Please Note: This form is not valid unless Company logo appears in color (burgundy) 7815 S.W. 24th Street • Suite 109 • Miami, Florida 33155 • Telephone (305) 264 -1425 • Fax (305) 264 -1426 KETCH OF ROOF JOB SHEET NO OF CALCULATED BY DATE CHECKED BY DATE SCALE NOTES* 4 SKETCH OF ROOF G 3 6, ii'. r. / of s7 SHEET NO _ OF CALCULATED BY rep DATE Z - / if - O 0 CHECKED BY DATE SCALE JOB AA MAI/ Ai 11111 % UIIII MEMMEMMEMOMMMMOMMOEMONEMMOMMMEM MMEMMUMMWOOMMMEMESOMMOMMWEMMINIM MEMEMMEMEMMEEMENMEMORMOMOMMEM MMEMEMEMMEMMEMMEMEMMOMMOMMUMMEM iii��i�� =�■■��r iu��ir��i ■■ ■IygP7EN■f �WESMIINUMMP70 ■■ NOTES' PERMIT AFICATION FOR MIAMI SHOOS VILLAGE Date 1 l • - ) - 9 iJob Address F j 3 6 /- /f lo/ - Tax Folio Historically Designated: Yes No Owner/Lessee / Tenant -..■ 1 ., .0.• r . Master Permit # 4 ^ i 9 0 Owner's Address _6_3(i___.11/ -1:-___ f� Phone Legal Description Contracting Co. A i.{ i° 4 --! T (P _ Address to ..S : . % e t ?) . ; %` Qualifier T I /v n ' / ' � / f 1 d/ L Phone ; D S -S 3 Z - u V State # C C C ° 1 Municipal # Competency # Ins. Co. Address Address Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one):ILDIN9 ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 1 u••' / / / s / 1 , r,' o // / if ' 1< I C o n,4 Q 2 f," 17 4' 3 0 % APPROVED: Zoning Building Mechanical � a ° : t ::( Nt1 i= i F Z ,� i, LA Il C Off e /1 •l e CA./ 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 construe .n and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and/or ' ondo President Date Signature of Contractor or Owner- Builder ZA/Jd?. ,a1 /Y 99 Notary as to Owner and/or Condo President Date My Commission Expires: ..«,°..i. Nereida Murton *l• .... 9 *My Commission CC832437 %.,., I Expires May 3, 2003 FEES: PERMIT RADON C.C.F. F 60 NOTARY l e* Tr Estimated Cost (value) - ✓ tr. % , C. , Notary as to Contractor or Owner - Builder My Commission Expires: Electrical es Nereids Murton * '.! 9 *My Commission (x832437 \.,«„#► Expires May 3, 2003 Date ;.-V.91/5 Date BOND TOTAL DUE ` t ' 60 Plumbing Engineering MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement in tee plans and specifications herewith submitted for the build inc 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. ^� `, C �'f' O-i= h1 C� Date.. _...�. _._ .._ .. , Owner's Name and Address - gi.12 /Lt. Street..40 f - Registered Architect and /or Engineer y tai ft••••nt• to nnt•.atat•t•tntttn -- e 43-sag. r ..EGA 9 5 7� Name and address of licensed contractor... .04,.cL . Location and legal description of lot to be built on: Lot Block Subdivision .. _ .._.. __.._._ 3 tr E Za.144 .... ._�._... 1.4:.7_ Street and Number where work is to be done State work to be done and purpose of building (by floors') and for no other purpose. New Building Remodeling Addition Repairs No. of Stories � To be constructed of Kind of foundation ,�ioof C overing ,''' �n .` o✓°t� t.......` Estimated Total cost of improvements $ T /1 D0 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 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. anti has complied se ith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the. work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this pcnnit, as are licensed by Miami Shores Village. Remarks (Signed) Date STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 fads therein by him stated are true. ,� . Permit No. 1 * - 1 Date.._ , ) Read, Sworn to and Subscribed before me. Disapproved (Signed) Notary Public, State of Florida Building Inspector My Commission Expires to me well known, PLANNING BOARD DATE Chairman Mcmbcr Meutbcr 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 niter approval has been obtained from the Planning hoard. A rc•inIx•ctiun 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 ❑ PERMIT No 8965 Contractors License No ROOFING ` , Li Work to be performed under this Permit �' i't ,f • Owner of Building Architect L'ontractor ar Builder Legal Description Address of 3uilding Lot 'S S : 9 40 ,10 7 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, lrawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any :ime 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 ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations ,ertaining to the work covered hereby whether shown on the plans or drawings or in the statements o cifi ions and that he assumes responsibility for work one by his agents, servants or employees. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA 74 , Bl. r /• Signed• Subdi- vision DATE Sq. Ft Value of Project $ INSPECTOR • Amt. of Permit $ 195- BY 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 ,ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. n accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY 17