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1175 NE 102 St (3)Issue Date: 3/15/2006 Owner's Name: ANDRE FOURNIER Permit Type: Residential Construction Work Classification: Alteration Job Address: 1175 102 Street NE Contractor(s) Phone Primary Contractor Comments: DECK AND PATIO W/ ROOF Additional Information Miami Shores Village, FL 33138- Type of Construction: NEW DECK Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: 12/29/2005 Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work clone by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due CCF Changes to Plans Fee CO /CC Education Surcharge Notary Fee Permit Fee - Additions /Alterations Plan Review Fee (Engineer) Scanning Fee Technology Fee Total: Amount $4.80 $200.00 $50.00 $1.60 $5.00 $240.00 $50.00 $15.00 $6.00 $572.40 Building Department File Copy Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 03/03/2006 Parcel #: Block: Section: Re • uired Ins • ections Slab Termite Letter Fill Cells Columns Tie Beam Window and Door Buck Window Door Attachment Framing Insulation Drywall Screw Ceiling Grid Final PE Certification Shutter Attachment Shutter Final Permit Status: APPROVED Permit Number: BP2005 -304 Phone: 1132050190090 Lot: PB: Total Square Feet: 111 Total Valuation: $ 8,000.00 Invoice Number RC - 3 - 06 - 24141 Total: Amt Due $572.40 MAR 1 6 PAID NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Inspection Date: 07/24/2006 Inspector: Devaney, Michael Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Contractor: RAY WILLIAMS ELECTRIC SERVICES Building Department Comments Friday, July 21, 2006 Miami Shores Village, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 JUL 2 6 RECD Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Block: Phone Number Parcel Number 1132050190090 Lot: Page 1 of 2 I 1 Passed Inspector Comments JAG Va‘ Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Inspection Date: 07/24/2006 Inspector: Devaney, Michael Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Contractor: RAY WILLIAMS ELECTRIC SERVICES Building Department Comments Friday, July 21, 2006 Miami Shores Village, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 JUL 2 6 RECD Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Block: Phone Number Parcel Number 1132050190090 Lot: Page 1 of 2 INSPEC IS IN ALLEY ENTER WEST GATE OF PORPERTY. NIIMININalliii NO DOG INSIDE. • • Passed Inspector Comments , I Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until nspection Numbett IN Inspection Date: 06/13/2006 Inspector: Devaney, Michael Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Monday, June 12, 2006 Miami Shores Village, FL 33138- Contractor: RAY WILLIAMS ELECTRIC SERVICES Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -897 6rM , 6- 605 Permit Type: Electrical - Residential Inspection Type: Underground Rough Work Classification: Addition /Alteration • Block: Phone Number - Parcel Number 1132050190090 Lot: Page 2 of 2 BUILDING PERMIT APPLICATIO FBC 2004 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Owner's Address City 5 4.-z 5 State Tenant/Lessee Name Job Address (where the work is being done) Value of Work For this Permit $ Type of Work: ❑Addition Describe Work: Submittal Fee $ Q Notary $ Scanning $ oO Bond $ Code Enforcement $ Structural Review. $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ) 756.8972 _e o Plumbing Mechanical '2a4'i t Phone # if 7 i j - / o v 51- ( Zip F3 A-Pt) C'Yc Phone # Permit No. E L_ C31 6P05 -- 3e) Master Permit No. Roofing City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO ,k. Contractor's Company Name (L4 ( u �12C -'Vi' c— OP"' Phone Contrac or's Address 6- W $ Z c--0.--r �: t( 3D6 City ato 0 State - Zip 3301 (o Qualifier Name VU l , wV/ Phone # State Certificate or Registration No. 41 --- /3°1:7 r Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Square / Linear Footage Of Work: Alteration ❑New ❑ Repair/Replace ❑ Demolition / 0 5 '7 7 -z tom 0) L-/ ,tra ri{-iJ f � S' w G Tit# Q G rz-c5 -r 6+) /~! 6- e(-r- G 0 - 6--f'i' EL 947c-cS,p pre--L-c-3 ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit Fee $ 1 SD . 0 D ' CCF $ 0 . CO /CC Training/Education Fee $ - 2O Technology Fee $ 3 • - Radon $ DPBR $ Zoning $ Double Fee $ Total Fee Now Due $ /5 55 See Reverse side —> Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is bject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first ins io is c curs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will s s # s .rov:d a a reinspection fee will be charged. Signature The foregoing instrument was acknowledged before me this 7 day of t'e ,20 ,by who is personally known to me or who has produced '12 Q As identification and who did take an oath. NOTARY PUBLIC: Owner or Agent Sign: Print: My Commission Ex * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: (Revised 02/08/06) �.pY v& 4 ° 4, .IANF C: C:ARTFF___ Q e MY COMMISSION # OD 211421 1 OF Fe EXPIRES: July 25, 20Q7 Signature Contractor The foregoing instrument was acki day of A , 206 by who is p onally kno me or who h My Commission Expire Zip edged b, ore me this s produced as identification and who did take an oath. Ccry c ° Bonded�, ; vF , rltlan = Bomsl n inn ****************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** /;,)7a,»' Plans Examiner Engineer Zoning TEY ATH TIE UNIT FEE ITN SWITCH CURETS UNIT 2 FEE ITEM SPACE HEATERS UNIT FEE .IOET LIGHT CUTLETS RECc�'TAC.ES !1/ !f CENTRAL HEATIFG A/C (RIAD) lISNWASEIER i15POSAL SERVICE TEIPORARY A/C (CENTRAL) IRI8(II} FOUNTAIN SERVICE SITE IN AMPS DLCT (YORK 'LOOK DRAIN _ SERVICE REPAIR/NETER GRANDE RETRIGERATTot( aEASE TRAP APPLIANCE CUTLETS PROCESS Alb PRESS PIPING :NTERCEPTUI RANGE TCP uNDERGROUTD TANKS .AVATCRY OVEN ABOVE L;AO1R40 TANKS LAUNDRY TRAY WATER HEATER U.F. VESSELS :LOTNES NOSIER IX)TCRS O- 1 FP STEAM BOILERS MEER IOTORS OVER 1- 3 FP WT RATER BOILERS ;INK. POT/3 COW, MOTORS DYEP 3- 5 FP IkCHANI VENT !LATION ;INK, RESIDENCE hCTtR.4 OVER 5- 9 FP TRANSPORTING ASSEM9LIEs ;INK, SLOP hVTCRS OVER 8- 10 FP ELEVATORS/ESCALATORS TE1,PCRARY RATER CLOSET hOTORS OVER ID- 25 IP F IRE 'SFRINKLER SYSTEMS JRINAL ACTORS OVER 25-100 FP COOLING TOWER' RATER CLOSET I TORS OVER 1 1 r VIOLATION I1POIRECT WASTES A/C IYINDON RE1fl ECT)ON WATER SIPPLY TO: [ AIR C@OITIOOERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORFERS HEATER-KW INST. 1 GENERATCRs•TRANSFORI,ERS HEATER- REPLACE CEHERATCRS TRAI8FIRMERS LANN SPRINKLER -BELL SPECIAL RRPDSE SNINANb POOL OUTLETS CIA,fiERC WATER SERVICE 5 1ON IVES ;EWER CDFDECT IOFB ! SIGN TRANSFCRI,EFtS IT IL In-SEWER SION TILE CLCa( UTILITY -WATER _ FI%TIRES ;EP T IC TAW( ANTEFN(A • RELAY TELEVISION CUTLETS RAINFIELD, 4• TILE/RES. VIOLATION - 'UM' & ABAFWN SEPTIC TATS( RE INSPECT ion MARAGE PTT CU, FT. (.p/L —,e/ / :ATOM BASIN . ;IS:MARGE WELL 10MEST IC TELL MA ORA 11! ICOF INLET CLAR RATER HEATER 'IRE STAM3P!Pe I , IMIMIIII 'COL PIPIT .AWN SPRINKLER SYSTEP -_ ;AS RACE ; 11111lMIIIIMIIIIMI - €TER SET (GUS) A. Ptpik: 03/07/20116 10:38 3058910371 AN AIPLICATION FOR Btrtj.,DING PERMIT MUST ACCOHPAN'Y TICS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER' 6 NOTARIZEI SIGNATURE NEED NOT BE VARMINT ON STIESEcarstT APPLICATIONS.) PLUMBING ANDRE R FOURNIER " LiV61\Id1.111.1 1 W VVi.—v.`.•.. -a , yell•• • • • £d WdT£:2T 9002 L0 '-EN ELECTRICAL MECHANICAL PAGE 04/08 S996E9£S0£ : 'ON Xtid SWti 111I MAtid : WOdJ Issue Date: 3/13/2006 Owner's Name: ANDRE FOURNIER Permit Type: Electrical - Residential Work Classification: Addition /Alteration Job Address: 1175 102 Street NE Additional Information Miami Shores Village, FL 33138- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 03/03/2007 Contractor(s) Phone RAY WILLIAMS ELECTRIC SERVICE Primary Contractor Yes Comments: INSTALL 1 CEILING FAN, 2 SWITCH OULETS, 4 LIGHT OULETS AND 4 RECEPTABLES Type of Work: Classification: Residential Additional Info: In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Building Department File Copy Applicant Signature Parcel #: Block: Section: Permit Status: APPROVED Permit Number: EL -3 -06 -605 Phone: 1132050190090 Lot: PB: Total Square Feet: 0 Total Valuation: $ 1,000.00 Required Inspections Alteration Underground Rough WW Service Change Meter Box Fire Alarm Relocation Final Fees Due CCF Education Surcharge Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $150.00 $3.00 $3.75 $157.55 Invoice Number EL - 3 - 06 - 24123 Total: MAR 1 6 PAID Amt Due $157.55 MAR 16 PAID NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. I XIS I IN( I I(l ll'.111I( KTTG-IL:N EXISTING STRUCTURE f XLtiII■ ls O ( :l�llll O IAI,I..WAY FLOOR PLAN O'-O V4" = P-0" 'ffir ). 11 EXIS1lflG S I RU :I 'UItL MASTER BEDROOM �� 1-' voNp4 o oo 740/y,�� • • •• • • • ••• • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • • ••• • • • • • • • •• • • • • • • •• • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • • • . • • •• • • • • • • • • • • � G . • • • • .. • Q o. ••••••• . • • • ••••••• • v EXISI1N(: OUTLjE I ELCG- • •� F ' ^'•yes �a s•. // ;Reo�at3 �.:/ Inspection Date: 07/18/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Monday, July 17, 2006 Miami Shores Village, FL 33138- Contractor: HOME OWNER Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 JUL 18 REC'D Block: Permit Type: Paint Inspection Type: Final Work Classification: New Phone Number Parcel Number 1132050190090 Lot: Page 2 of 2 Passed 1 ` v Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until • •� F ' ^'•yes �a s•. // ;Reo�at3 �.:/ Inspection Date: 07/18/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Monday, July 17, 2006 Miami Shores Village, FL 33138- Contractor: HOME OWNER Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 JUL 18 REC'D Block: Permit Type: Paint Inspection Type: Final Work Classification: New Phone Number Parcel Number 1132050190090 Lot: Page 2 of 2 • 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): cU ildin Owner's Name (Fee Simple Titleholder) Owner's Address/ City ., State Tenant/Lessee Name Job Address (where the work is being done) 5'6,x City Miami Shores Villa _e County Miami -Dade Is Building Historically Designated YES NO State Certificate or Registration No. Architect/Engineer's Name (if applicable) $ Value of Work For this Permit Describe Work: Submittal Fee $ Notary $ Scanning $ (Continued on opposite side) Permit Fee $ Miami Shores Village Building Department RECEWWED NOV Id 41 X05 Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ Permit No PC) / Master Permit No. �_._,_. --- ---- -- — -- -- Phone* ---- echanical Ro ing gobere / s ill cj' i1 3 3oS Zip Contractor's Company Name Ciek -A t Phone # 'Contractor's Address City State Zip Qualifier k)//61- /Vet Type of Work: ['Addition ['Alteration ['New ❑ Repair/Replace ❑ Demolition tri-e < / J i ; f f 0 ic Certificate of Competency No. Phone # Square Footage Of Work: * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Training/Education Fee $ Q • c D CCF $ CO /CC Technology Fee $ 1 - Radon $ Zoning Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job sit, . for the first inspe ... • h occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will n. � rove. and'a reinspection fee will be charged Signature gib. A i Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 4 The foregoing instrument was acknowledged before me this day of NOV , 2005, by f-�'b.l.pp. y of , 20 by who is personally known to me or who has produced * * * ** Chc 05/13/03 who is personally known to me or who has produced LL As identification and who did take an oath. as identification and who did take an oath. NOTAR P .: LIC Sin: I . +yam Sign: �� .,., FLORIDA Sign: f��r y Print: 1140 t e2 _ Print: Issr..111 41111 My Commis on Expires: ,I. defr!!!u 2009 My Commission Expires: • c pond,'ng Co., Inc. **************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** $ 2 I/ (ofs YOTARY P * * * * * * * * * * * * * * ** ************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: NOTARY PUBLIC: Plans Examiner Engineer Zoning Date Miami Shores Village Paint Color Approval and Agreement Phone Owner's Name Owner's Address City State Zip Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name (if applicable) Phone # *********************** ****************************** *************************** * * * * * * * * * * * * * * * * * * * * * * * * *_ * * * 11 elements on the site must be listed and indicate the color to be pain Walls �C Fascia 1.------- Drip Cap /drip Edge Soffit r/ Roof Flower bins Shutters Awnings Chimney Doors and door jams Garage doors Railings Fences Decorative metal All brick (simulated or regular) Stucco banding Any other stucco features Accessory Bu' ngs Siena c i :::".r•-• _ i.. csyf , Other ********************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *, OWNER'S • Ai• • •' T: I certify that all the foregoing information is accurate and that all work will be done in compliance with ail applicable la - s 1 , atin: construction and zoning. , - 46.-A ,,,, Jaw •..k APPLICATION APPRO \TED BY: Owner or Agent Ph _ Off :ia: Attach Wit t k of\' .tip.. Date Date JP-/or cnc 6/1R/07 Located at: VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT ER BUILDER DISCLOSURE .STATEMENT az 2A/ tA, being the legal property owner, for the property /(Fr ALE. ,a Z Legally described as Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S. 489.103(7),_nd I have read and understand the following disclosure Statement, which entitles me to irork as my own contractor, I further understand that I as the owner must appear in person to complete all applications. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two- family residence or a farm out - building. ' You may also build or improve a commercial building at a cost of 525,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is completed, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A. and with- holding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes and zoning regulations. Proof of ownership provided ( ) Was acknowledged before me this B � a-.Q,1-4- 2.who is personally known to me or who has DISCLOSURE STATEMENT initial of reviewing clerk. The foregoing instrument day of 6 , 20E as identification and who did take an oath. OTARY PUBLIC -STATE OF FLORIDA 416 Yorleny Hernandez Commission # DD476455 Bonded Thru A B 4 C o., o. Issue Date: Not Issued Owner's Name: ANDRE FOURNIER Permit Type: Paint Work Classification: New Job Address: 1175 102 Street NE Comments: PAINT Additional Information Miami Shores Village, FL 33138- Building Department File Copy Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 11/04/2006 Contractor(s) Phone Primary Contractor Type of Work: Exterior Color: HARMONIC TAN Additional Info: PAINT Classification: Residential In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Permit Status: APPROVED Permit Number: BP2005 -1533 Phone: Parcel #: 1132050190090 Block: Lot: Section: PB: Total Square Feet: 0 Total Valuation: $ 100.00 Re • uired Ins ' ections Final Fees Due Amount CCF $0.60 Education Surcharge $0.20 Notary Fee $5.00 Permit Fee $60.00 Technology Fee $1.50 Total: $67.30 Invoice Number PT - 1 - 06 - 23418 Total: M l � 6 PAID Amt Due A Paid $67.30 CH& I�� NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. THOMAS J. BENTON VILLAGE MANAGER November 22, 2005 Mr. Andre R. Fournier Attorney at Law P. O. Box 610277 N. Miami, FL 33261 Dear Mr. Fournier: Per your request, enclosed please find the guidelines for appeals of paint colors. Please note the seven items that need to be included at the time you make your submission. Also please note that in order to be heard at the December 15, 2005 Planning & Zoning Board Meeting, you will need to submit your appeal information no later than December 8, 2005. As I indicated to you, I will have our staff approve the Harmonic Tan light green color, whereby you may pick up your paint permit at our Building Department counter at your convenience prior to painting your home. Sincerely, Tom Benton Village Manager TB:bae Mgr -1531 Cc: Anthony Flores Claudio Grande, CBO i avni S Vtffcte 10050 N.E. SECOND AVE. MIAMI SHORES, FLORIDA 33138 - 2382 Telephone: (305) 795 -2207 Fax: (305) 756 -8972 Re: Paint Color Appeal Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 11/9/2005 Applicant: ANDRE Owner: FOURNIER JOB ADDRESS: 1175 Contractor Local Phone: Parcel # 1132050190090 NE 102 Building Permit Permit Number: BP2005 -1533 FOURNIER ANDRE ST Contractor's Address: Legal Description: MIAMI SHORES SEC 8 REV PB 43 - 67 LOT 9 Fees: FEE2005 -14386 FEE2005 -14387 FEE2005 -14388 FEE2005 -14389 FEE2005 -14390 Description Building Painting Fee CCF Training and Education Fee Technology Fee Notary Fee Total Fees: Amount $60.00 $0.60 $0.20 $1.50 $5.00 $67.30 Total Fees: $67.30 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 4/30/2006 Construction Value: $500.00 Work: RE -PAINT EXTERIOR Signed: (INSPECTOR) Signed: (Contractor or Builder) BY: Page 1 of 1 BLK 175 LOT SIZE MUST BE C JO AT TIME In consideration of the issuance to me of this permit, 1 agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Y V ENTER BY ALLEY, PLANS AND LADDER WILL BE LEFT ON THE BACK FOR YOU. Passed Inspector Comments /Ai ".. Pi Tit 0 ts---1__ yocit .j o v-2 S1 C Cv 1 �&5 40 , ar, eLt .A.--1 A &X( G ,6- ,z-k. / 04-c1CA./..at o� -11 Failed Correction Needed Re-Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until •'o"'"'' _ — -- "__� - — - Is C (ti9' 1 C am - s , , 1; 1 .......................... ........................... ................ Inspection Date: 07/18/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: ROOFS BY CHERRY Building Department Comments Monday, July 17, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 JUL 18 RECD Block: Permit Type: Roof Inspection Type: Hot Mop Work Classification: Roof - New Phone Number Parcel Number 1132050190090 Lot: Phone: 305 - 653 -8542 Page 2 of 2 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Tenant/Lessee Name Is Building Historically Designated YES Qualifier Type of Work: De • ' i e ?:3 k: /S j C /7'( /?rZJ/ Architect/Engineer's Name (if applicable) 300 Co $ Value of Work For this Permit dition Submittal Fee $ Permit Fee $ Code Enforcement $ Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: 30�5 �5.2 Fax: ( 756.8972 M 3 0 2006 B Y: ❑Alter Owner's Name (Fee Simple Titleholder) // ma?( At7/Z/) /E/ Phone # Owner's Address /173 /lit /&Z $ T Cit /"j 6//a/Z1.5 State /, Job Address (where the work is being done) 1/7.5 AM /02 5t City Miami Shores Villa _e County Miami -Dade Electrical NO Contractor's Company Name /tia0i5 J +/ C /7/Z� Contractor's Address 3 2 O / (cc-m- Y 4 t / e City � a ` //& ao 2 State /0 State Certificate or Registration No.eCC /3 u Master Permit No. Plumbing Mechanical zip 3.341 Certificate of Competency No. Square Footage Of Work: /CO )4w 111 Repair/Replace Phone # zip • J3 3 7Z 3 Phone # zip ,53/J8 * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** v I5 Pr o. . Permit No. -Pf r 1 RR ofng} 454) P( Phone # cfRf - Sf "J ' 3'Z ❑ Demolition CCF $ j • 80 CO /CC Notary $ Training/Education Fee $ O, (—JD Technology Fee $ . Scanning $ • CO Radon $ Zoning Bond $ Structural Plan Review. $ Cn Aigt Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a conditi g the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this . day of Aiht?Gii , 2006 , by /94./i7g Avg N /6/Z who is personally known to me or who has produced My Commission Expire * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: chc 05/13/03 As identification and who did take an oath. a:r Pis CYNTHFA BLOCH MY COMMISSION # DD 227744 �• .%_ : �: EXPIRES: June 30, 2007 *a ticit * *9aede i ilicuAttaraisiBeadiri 6a Signature o /v`l Contractor The foregoing instrument was acknowledged before me this c'y day of /4' &b , 200 by - T ewe,* , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign Print: My Commission * * * * * * * * * * * * * * * * * * * * * * ** C J1A471) CYNTHE=ABLOCH : i MY COMMISSION # DD 227744 8 o ndedTht el uAANa n GcB X a�di Inc. * oc cam,, A ** * ** * ** * * ** * ** * ** * ** * ** * ** * * ** * ** * * ** * * * * * * * * * ** * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * `/ 3 °c Plans Examiner Engineer Zoning 11111111111111111 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO.0 /AX FOLIO NO. 1 - ` 20 d1940YO STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information Is provided in this Notice of Commencement. CF 2006IR'034.093 OR B{: 24377 Ps 2163; (1p9) RECORDED 03/30/2006 09:57:10 HARVEY RUVIN► CLERK OF COURT MIAMI -DADE COUNTY? FLORIDA LAST PAGE 1. Legal description of property and street/address: / AJ1 /o2 Sr zor `I ,ij ' ,'r/ofees .&() 2. Description of improvement: /ltd / j 14)0 3. Owner(s) name and address: /) Ala /7 ,v /?4J/C /Z. /J75• 1tJL /e7,2 $t A4/;f0.1 , ,s /l Interest in property: Name and address of fee simlile titleholder: 4. Contractor's name and address: APO/ $ / ( / .3, yv i'/J /S/d /y od ,-,_33‘) Z3 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6.1Lender's ndme and address: 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different d t is - • : d) Ilk.v Signature of Owner Print Owner's Name /9f L)1eL ' exia /? Sworn to and subscribed before me this 2 L l day of tTdn'C!/ , 20 0 6 Addresst3 * Vv / /0/f Aiead / .3.3i ) Notary Pub 'c _ it $J J •— Print Notary's Naye My commission expires: 123.01 -52 PAGE 4 10/04 STATE OF FLORIDA, COUNTY OF DAQE I HEREBY CERTIFY that this is a tr . o of the original filed n office on A D 20 WITNESS my hand and Official Seal. HARV CL By •/4)ecootA CYNTHEA BLOCH MY COMMISSION # DO 227744 EXPIRES: June 30, 2007 Bonded Thru Atlantic Bonding Cia,, Inc. Prepared by /e/a)c // 7 , • ' r ^P a l 7 t dl i F+ i r r t f '74 . 7 . "x k"F'c.C`if r P h 7.1,L: I 1 u I ` ... 1 1!•. °F+r J I �, 4 IIfC I t , ^+ ,. k I .,: f }rK ^ i��y + t y ;el' 4 .tl:� I..l�.i j. r ., .f, d.. .I r, ) 5' ,. _? n .. Proposal Submitted To: Attention Dade: 3/17/2006 Phone: Company: • �.. .�_ Job Name: Ante Fournier . Address: 1175 NE 102 Street City; Miami Shorn, FL We hereby submit specifications and estimate fir. Now consmhcdon. addition not to exceed 100 S.F. Neil and tin cap one layer of 301# fat ova entire slope roof, Instatt new galvnslred ewe drip. Mop on vim layer agog glatet over entire elope roof back nailing all laps with 1'14" rfs roofing n 11!. Make ell tie -hrs. !well Spum i s (clay) the in a rich bed of mortar and tbara This roof will be guaranteed iv a period of one (1) year against fbulty workmanship and faulty materials.. Price: $3.000.00 Not This price is dependent on contractor not going to move than 3 rows of tiles up dins, also not breaking anyy^ - - extra tiles. Down payments or periodical draws will be discussed upon signing of contrast Nom: owner is responsible to protect interior and exterior furnishings from any dust and debris dining roofing process. This contract price Includes all taxes, permits, and engineer reports. Replace all broker Scar missing tilos approx. 55 cape 10 field tiles 52,250.00 cog* We hereby purpose to furnish labor and materials complete in aeoatdance with the above speclfleations, for the sum of ThmItomigg, Dollars ($3.00Q00 )with payments in be made as fvllawe: Warranties to original owner: We mummy world. nmmehip for supervise or inspect all work subsequently performed by other supervision or inspection, all warrarnita me null and void. Warranty application. and payment of reasonable See. N1 materials fumitbed a workmanlike manner according to standard ptacdces. We but can not be held sysponaible in any manner for damage to above or below ground. We will not be held rceponaible for Customer is urged to con flsmiture & otherwise protect their damages done m the roof by plumbers. eta:Mein:R. air conditioner responsible for location of septic tank Authorized a period of (Once years Out reeta es the right to parties to tiro roof, for a scannable lbw. Without this is transferable to new owner upon writtca will be as specified ifed and work Ls to be completed in will exercise reasonable cars when perfbrming the work sidewalks., foliage shrubbery, saccadng, pipes, or cables, water damage to exterior or interior of the premises property, We cenuot es • , .I responsibility 1br any men or any ... - . , - amen, /l Signature �ti I , t 1 � �' _L /! r t yo- • Acceptance The above proaxi, specifications and conditions are here specified. Payment will be made as outlined above. Da P Signature / Ll of Proposal •. — • - • .. -' . You me authorized to do work as 0 .?..: • . n • re R. Fournier • Signature 03/17/2006 14:30 3058910371 ANDRE R FOURNIER PAGE 02/02 CHERRY ROOFING Fan: 95d- 963 -4353 Mar 11 2006 13;53 P.01 3901 SW 40 Avo Hollywood, FL 33023 (954) 981 Office (9S4) 963-4353 Fax www.roofsbyeherry .com eaymx-y 1rBPaoS 30`-i Primary Zone: 1100 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL- SINGLE FAMILY Beds/Baths: 3/2 Floors: 1 Living Units: 1 Adj Sq Footage: 2,802 Lot Size: 12,312 SQ FT Year Built: 1976 Legal Description: MIAMI SHORES SEC 8 REV PB 43-67 LOT 9 BLK 175 LOT SIZE IRREGULAR OR 17968 -2721 0198 6 Year: 2005 2004 Land Value: $239,501 $175,456 Building Value: $218,655 $200,806 Market Value: $458,156 $376,262 Assessed Value: $179,038 $173,823 Homestead $25,000 $25,000 Exemption: Total Exemptions: $25,000 $25,000 Taxable Value: _ $154,038 $148,823 Folio No.: 11- 3205 - 019 -0090 Property: 1175 NE 102 ST ailing ddress: ANDRE R FOURNIER 1175 NE 102 ST MIAMI SHORES FL 33138 -2615 Miami -Dade My Home My Home miamidade.gov Show Me: Property Information Search By: Select Item 0 Text only a Property Appraiser Tax Estimator Summary Details: Sale Information: Property Information: Sale O /R: 117968 - 2721 Sale Date: 1/1998 Sale Amount: 155,000 Assessment Information: ACTIVE TOOL: SELECT Digital Orthophotography - 2005 %g; We appreciate your feedback, please take a minute to complete our survey. 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Page 1 of 2 115 ft http: / /gisims2 .miamidade.gov /myhome /propmap. asp ?app= none &bytool = ADDR &cmd =FI... 3/17/2006 Issue Date: 4/4/2006 Owner's Name: ANDRE FOURNIER Permit Type: Roof Work Classification: Roof - New Job Address: 1175 102 Street NE Miami Shores Village, FL 33138- Contractor(s) ROOFS BY CHERRY Phone 305 - 653 -8542 Primary Contractor Yes Comments: NEW ROOF FOR PATIO AND DECK ADDITION Additional Information Type of Work: Re -Roof Additional Info: Classification: Residential In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due CCF Education Surcharge Permit Fee - New Roof Scanning Fee Technology Fee Total: Amount $1.80 $0.60 $250.00 $6.00 $6.90 $265.30 Invoice Number RF - 4 - 06 - 24370 Total: CAN 6 1(0 3 1 APR 10 PAID Amt Due $265.30 Amt Paid Building Department File Copy Permit 4• 44 ` Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Expires: 03/30/2007 Parcel #: Block: Section: Permit Status: APPROVED Permit Number: RF -3 -06 -811 Phone: 1132050190090 Lot: PB: Total Square Feet: 100 Total Valuation: $ 3,000.00 Required Inspections Tin Cap Hot Mop Tile In Progress Up Lift Report Final Roof NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Florida Building Code Edition 2004 HIGH W Madcap, Zone. Uniform Permit ••. ..... • •• • • Section A (General inform atto'n) • "' Master permit No. 2 41- 30 Pi dCi3ss ldo: Contractor's Name , 004 ' C h'i? " • Job Address ROOF CATEGORY • ••••••• • • •. • . . . • ' • ••••• • •••• . • • •• O low Slope 0. Mechanically Fastened Mortar/Adhesive set Tile O Asphaltic 0 Metal PaneWShingtes Q' W Shingles/Shakes Shingles D Prescriptive BUR -RAS 150 . • • . Oae: V ROOF TYPE Yes .: Types Natare )((Yew Roof O Reroofing 0 Recovering 0 Repair 0 Maintenance • ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) * Steep Sloped Root Area (SF) Total (SF) • . /OO /aa • • Section B (Roof Plan) Sketch Roof Plan: lituatrats all levels and seaticns, roof drains, scuppers, overflow . scuppers and overflow drains. Include dimensions of sections and levels, gleamy identify dimensions of elevated pressure zones and location of parapets. ry 111■11111■ T r r Florida Building Code Edition 2004 HIGH Velocity Hurricane Zone Uniform Permit Application Form • . . .. • • • .. .. • • • • • . . . . . • Section D (Steep SIdpekdA46fS)isteml • ... ... • • • • ••..•.. • • • Roof Slope 3 :12 • •• • • • Roof System Manufacture C1.fy tee 7 ‘5. � C/. • T« � • .. ... .. • . - . - • -v • i -. - rr - Product Approval number O ?ol, De • • • • • • • • .. ... . • Minimum Design Wind Pressures, if Applicable,(From RAS 127 or Calculations): P1: 4 Y? P2: 20,747y P3: 20, 7d / f Maximum Design Pressure Product Approval Specific System 3e Method of Tile Attachment: Pe / /?/eo /0 go Deck Type: //4) Type Underlayment: insulation: Fire Barrier: Fastener Type & Spacing: Adhesive Type: Ridge Ve 4tion? 1 I Mean Roof Height: /2 1 Steep Sloped Roof Description T .226 • Type & Size Drip Cap: 1 ° /:w CEO lijr yam' 4/4/LS . 6 64o ;a "' /.f/ Type Cap Sheet: I A,Srof 7:c! /i yr 74 fo Roof Covering. I ebay4e4te eec tlirbSs9s`CAlly 77i / f d42 oR3x3 z6 eel .(J'i?, /,e •oe,c Florida Building Cod!•Et lion 03: HIGH Velocity Hurricane Zone Unifoim PernAR AHRc3tlon:Fohn Section E ••• • • • •. • ... • •... • . • • • • . . For moment based tile systems, those either Method .1 br 2.bompared the values rar M, with the values from Ms. If the Mr values are greater than or equal to the M, values, for each area of the roof, then the tile attachment method is acceptable. • • .• • • • •. ... .. • • • �Me thod 1 "Moment Based Tile Caibtdla�tibJts Br.RAS 27" (P,: l,. x7.�2 D7y =/2133 ).M, .3v" aittl e 91 Product Approval Mr 3 "r# (P2: / x 7tD427 r/ wfg. _$7 - M. S =Mr. NY Product Approval M►,3 Pi7 (P2:p5 / x 1.1,27y 3s a - M . cf%3YY *M, 2a2o7/ Product Approval Mr 3 Pi 7 Method 2 "Simplified Tile Calculation per Table Below" Required Moment of .Resistance (a♦ 4) From Table Below Product Approval Mr Mean Roof Height-, Roof Slope 1 212 3:12 4:12 5:12 8:12 7 :12 15' 34.4 . 39.5 32.2 31.4 30.4 32.2 284 30.1 28.4 38.0 24.4 25.9 29 ass 39.3 33.8 311 28.4 v.1 8 Mr_ R�ge uired Moment of Resistance 20► 30' 3Ri 37.4 35,1 328 as. 28.2 40' 42.2 30.8 37.3 34.9 32.4 30.0 'Must be used in conjuction with a list of Moment based the systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3.. Compare the values for F' with the values for Fr If the F' values are greater than or equal to the F r values; for each area of the roof, then the tile attachment is acceptable. Method -3 "Uplift Based Tile Calculations Per RAS 127" (P+: x 1: = x w:= )- w: x cos 6: Fn: Product Approval F' (P2: x 1: = x w:= )- w: X cos It oF,2 Product Approval F' (P.: x 1: P x w:= j- w: x cos B: =F.. Product Approval F' Descri tion Whereto find Design pressurs P1 or P2 or P3 X27 Table 1 by an engineering analysis prepared by PE based Mean Rod Height H Job Site Root Slope , B Job Site Rssatorin . Moment due to G Aerod M tier Attachment Resistance Required ManerdResistance Product A Approval Calculated Minimum Attachment Resistance R Required Uplift Resistance Fr Product Approval Calculated Avsrepe T M W ht W Tile Dirnafabns Wzrwldth • Prod A pprohl Product Appro• All Calculations must be submitted to the Buildin Where to Obtain Information Official at the time of I II a tion • • .•. • • • . •. •• • • • •. •• • • • • • • • • • • • • • • • • • • • • • • ••• • • • • • ••• .. • • . • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • . • • • • • • • • /9/$;: 4eg vo9 • �. OwnerWAgenfe Signature Date /0,92 57 o(- 4iJ Properly Address Permit Number • • ••• • • • ••• •• •• • • • ••• •• • • • • • • r • • • • • • . • • . • • • • •• • • • • amino - m'RON1524 • ••• • • NIGH VELOCITY HURRICANE ZONES REQUIRED.OWNER8 NORIRCAT10J1 FOR ROOFING 15241 As It pertains to this Nice, 8 le the responsibility of tli4 " ' aonlicter prd ice Bid owner with he re d RorMa pen* aid b explain b the owner the content of fhb sectlan,. This provrsioni of Chapter 15 of q code,. BuldIgg govem the mini .= requIrenients and stadardr of the industry for rooirng system fn`s: Additionally, the foliating-items should be gldrelegd pectiqf .gnament between the and the contractor. The *nee Heal in the adjacent box indipatectliptlitiglinigure been explained. 1. AsstheticirMo tanariship: The wal1r10i6Np provisions of'tZiaptQr 1d gillgirVeroity Hun an Zone) the purpose of providing. that the roofing system meets the .wind resistance and water knt uelon perform ice standards.. Aesthetics (appearance) issues are not a coneldsraflon with respect - to worlonartahlp provisions. Aesthetic Issues midi as color or architectural appearance that we not part of a *Ong code. ehordd ., be addressed as pad of the agreement between the owner and the contractor. • X. Flooding Wood Decks: When replacing roofing, the misting wood roof deck may have to be minded with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Bulking Code. (The roof deck le usually conceded prior to renoMng.the existing g roof system). a. Common Roofs: Common roofs am those which have no visible dalmatian bebreen neighboring should notify h oc occupants ac@ao � In workktto common rode, the roofing contractor and/or owner 4. Exposed Collings: Exposed, open beam ceilings are whem.the.underside of the root deciding can be from below. The owner may wish to meinlabi the agidtectur& appearance, therefore, roofing nal penetrations of the underside of the decking may not be acceptable. The Florida Bu$dbg Code provides.tlre option adrtg this appearmice.. �A 1 s. Pending • Water: The current roof system and/Or deck. of the • building may hot drain well and may leave water to pond (a caurxdate) h lovolybg areas' of the root: Pending can be an indication of structural . dkd ess and may require the review 0 a pro[essionat stiuctural engineer. Pawling may shorten • the ifs expectancy and performance of the new rooting system. Pondbg conditions may not be evident until the original roofing system is removed. Pondirg conditions should be corrected L Overflow scuppers (el outlets): it is required that rainwater flow off so that the roof is not overloaded from a build up of water Perbnetededge wails or other roof extensions may block thie discharge If overflow scuppers (wall ate) are not provided. It may be necessary to befall overflow scuppers M accordance with the Florida Witting Code, Piddling. A LT. Venation: Moat roof structures should have some ability b vent natural abflow through the interior of n additional bens ru t to consider assembly � building venti g chi dr can r� amount of a lc ventilation viral not be reduced. It may be reed in eotendbg the service ilk ditto roof. • ,M I BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT' CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) Clay Forever, LLC 6645 NW 77 Avenue Miami, FL 33166 • • • •• • • • • • •• • • • • • •• •• • • • • • • • • • • • • • • • • • •• • • HQAMI M COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING • ••• 140 WEST FLAGLER STREET, SUITE 1603 • • • • • • MEAMLIVORIDA 33130 -1563 • • • • • ;(345) 3762901; • FAX (305) 375 -2908 • • • • • • ••• • • • • • • • • • • •• • • • •• ••• •• • • • • • • •• • • • SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by Miami -Dade County Product Control Division and accepted by the Board of Rules and Appeals (BORA) to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Altusa "S" Clay Roof The LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement "Miami -Dade County Product Control Approved ", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA 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 NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA revises #02- 1115.03 and consists of pages 1 through 7. The submitted documentation was reviewed by Jorge Acebo. NOA No.: 05-0901.06 Expiration Date: 12/16/07 Approval Date: 12/08/05 Page 1 of 7 ROOFING ASSEMBLY APPROVAL Category: Sub- Category: Material: 1. 2. PRODUCT DESCRIPTION Manufactured by Applicant Dimensions Altusa One Piece 'S' Tile Trim Pieces Clip Clip 2.1 SUBMITTED EVIDENCE: Test Anencv Test Identifier The Center for Applied 94-083 Engineering, Inc. The Center for Applied 94-084 Engineering, Inc. The Center for Applied 25- 7200 -1 Engineering, Inc. The Center for Applied Engineering, Inc. Celotex Corporation Testing PRI Asphalt Technology, Inc. Roofing Roofing Tiles Clay L =18 " W = 10.5" 1" thick nominal 3.25" high Length: varies Width: varies varying thickness L = 6" D= 0.125" L &h = 2" W = 1 " 0.05" thick Test Snedfcations TAS 112 Project No. 307025 Test #MDC -78 MTS 520649 CLF- 003 -02 -01 • • ••• • • • ••• . • • • • • •• •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • ..• • • • • ••. • ••• ... • • • ••• • • • • • • • •. • . • • • • • • • • • • • • • • • PA 114 L Shaped tile clip Test Name/Report Static Uplift Testing PA 101 (Adhesive Set) Static Uplift Testing PA 101 (Mortar Set) Static Uplift Testing PA 102 (Quick-Drive Screws, Battens) Wind Driven Rain PA 100 PA 102(A) PA 102 • • . • • • • • • • • SCOPE This renews roofing system using Altusa One Piece Ss laj ogf'T l js r:manofactured by Clay Forever, LLC. and described in Section 2 of this NoticeroeApceptlnce . or locations where the pressure requirements, as determined by applicable thildfni Cdde acts Mt &teed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall be done as a moment based system. Product Description High profile clay roof tile. For direct deck or batten nail -on, mortar set or adhesive set applications with minimal headlap of 2 -1/2" TAS 112 Accessory trim, clay roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile. PA 114 Tile clip April 1994 May 1994 Feb. 1995 Oct. 1994 May 2000 October 2001 NOA No.: 05- 0901.06 Expiration Date: 12116/07 Approval Date: 12/08/05 Page 2 of 7 Test Asencv Redland Technologies Redland Technologies Redland Technologies Redland Technologies Redland Technologies Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Wacker Engineering, Inc. 3. LIMITATIONS Test Identifier 7161 -03; Appendix III 7161 -03 Appendix II Letter Dated Aug. 1, 1994 P0631 -01 PO402 Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations T est NamelB.enol • i • i : k •• • i • . PA 102 Wind Tunnel 'esting • PA 108 (1401-O4). Wind Tunnel Testing PA 108 (Nail-On). • • • .•• • • • •.. • • • • • • • • • • • • • • • • • • • • • • • • • • ••• • • • • .. • • ••• Aerodynamic Multiplier 25 -7183 25 -7094 25 -7496 25 -7584 25- 7804b -8 25- 7804 -4 & 5 25- 7848 -6 Dec. 1991 ••• • • •• • • Elea 199 • • • •.•• .... • • • Aug. 1994 • •• •.. •• . • . . • • • Wind Tunnel Ted ; ; ; Jfity.1194 PA 108 (Montt Set) Withdrawal Resistance Sept. 1993 Testing of screw vs. smooth shank nails March 1999 March 1995 Febmary 1996 April 1996 December 1996 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test shall be performed in accordance with RAS 106. 3.3 Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix 'A'. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 Minimum underlayment shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30/90 hot mopped underlayment applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment material manufacturers published literature. 3.6 This acceptance is for wood deck applications. Minimum deck requirements shall be in compliance with applicable building code. 3.7 May be installed on slopes 7:12 and greater. 4. INSTALLATION 4.1 'Altusa One Piece S' Clay Roof Tile and its components shall be installed in strict compliance with Roofing Application Standard RAS 118, RAS 119, and RAS 120. 4.2 Data For Attachment Calculations NOA No.: 05- 0901.06 Expiration Date: 12/16/07 Approval Date: 12/08105 Page 3 of 7 Table 4: Attachment Resistance Expressed as a Moment - M} (ft-Ibf) for Nail -On Systems Tile Proflle Fastener Type Direct Deck (Min 15/32" plywood) Direct Deck (Min. 19/32" plywood) Battens Altusa 'S' Tile 2 -10d Ring Shank Nails 28.6 41.2 19.4 1 -10d Smooth or Screw Shank Nail 5.1 6.8 2.8 2 -10d Smooth or Screw Shank Nails 6.9 9.2 7.3 1 . #8 Screw 28.7 28.7 N/A 2 .#8 Screws 58.2 58.2 26.8 1 -10d Smooth or Screw Shank Nail (Field Clip) 23.1 23.1 19.0 1 -10d Smooth or Screw Shank Nall (Eave Clip) 29.3 29.3 24.0 2 -10d Smooth or Screw Shank Nails (Field Clip) 27.6 27.6 38.6 2 -10d Smooth or Screw Shank Nails (Eave Clip) 38.1 38.1 41.8 1 Screw with Altusa Clip (See cal details) Altusa "S" Tile' 1 Screw with clip (at the head of tile) 187.1 187.1 N/A Altusa "S" Tile' 1 Screw with clip (at the water course of tile) 35.2 35.2 N/A 1. Screw must be Installed In the Inside nail hole located nearest to the hump of the tile. Table 3: Restoring Moments due to Gravity - M (ft -Ibf Tile Proflle 3 ": 12" or less 4 ":12" 5 ":12" 6 ":12" 7 ":12" or greater Musa 'S' Tile Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck 4.47 5.35 4.40 5.27 4.31 5.18 4.20 5.03 4.08 4.89 Table 1: Average Weight (W) and Dimensions (I x w ) Tile Proflle Weight -W (Ibt) Length -I (ti'): ... :. 11�pdtlf -w ift)' . . . .. Altusa 'S' Tile 6.9 _ 1.52 ' .. ' . • - ' .' O'Ili�5 • • • ... • • • ... • • • • • • • • • • • • • • • • • • • • • • • ... • • • • • • • • • • • NOA No.: 05-0901.06 Expiration Date: 12/16/07 Approval Date: 12/08/05 Page 4 of 7 • • Table 2: Aerodynamic Mul ipllers - X (ft$) _ _ _ Tile Proflle Batten Application 0.253 • . • • Dirbc3 De6k:Aepllcbti .9 ' ' 0'.274 - - -- -' Altusa 'S' Tile _ • • ... • • • ... • • • • • • • • • • • • • • • • • • • • • • • ... • • • • • • • • • • • NOA No.: 05-0901.06 Expiration Date: 12/16/07 Approval Date: 12/08/05 Page 4 of 7 • • Table 5A: Attachment Resistance Expressed as a Moment - PA, (ft`Ibf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Altusa 'S' Tile Polyfoam PoIyProTM 66.5 Polyfoam PolyProm' 38.7 4 Large paddy placement of 63 grams of PolyProw. 5 Medium paddy placement of 24 grams of PoIYProT"". Table 5: Attachment Resistance Expressed as a Moment PA, (ft -Ibf) for Two Patty Adhesive Set Systems • • • • ... _ • _ _ • _ Tile Profile The Application ; •.' ; Mhyntunt AttatyhmtInt '.' RebIdtdhde '.. Altusa 'S' Tile Adhesive 29.3 2 See manufactures component approval for Installation requirements. 3 Flexible Products Company TileBond Average weight per patty 10.7 grams. Polytoam Product, Inc. Average weight per patty 8 grams. . - - - - - . - - - - I . • Table 5B: Attachment Resistance Expressed as a Moment - M (ft-Ibf) for Mortar Set Systems Tile Profile Tile Application Attachment Resistance Musa 1S' Tile Mortar Set' 24.50 . 5. LABELING All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo, or following statement: "Miami -Dade County Product Control Approved ". 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by the Building Official or applicable building code in order to properly evaluate the installation of this system. PROFILE DRAWINGS ALTUSA 'S' CLAY ROOF TILE • • .. • • • • • .. •• • • • .• . • • • • • • • • • • • • • ••• • • • • • • • • • • • • • .. • • • • • • • • • ... .. NOA No.: 05- 0901.06 Expiration Date: 12/16/07 Approval Date: 12/08105 Page 5 of 7 • • • •• • • • • •• 'SPANISH S' TILE BY AL (TYP.) CLIP DETAILS CUP WITH ONE (1) SCREW ATTACHED TO DECK 2•1/2' OVERLAP (COVERS PIN HOLE) • • ••• • • • • •• •• . . • • • • • •• •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • ••• •• • • •• • • • • 0 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • •• • n• •• • • • • • • • • • • • • • • • • ••• • • SCREW IN THE INSIDE HOLE NEAREST TO THE HUMP OF THE TILE DECK CLIP NOA No.: 05-0901.06 Expiration Date: 12/16/07 Approval Date: 12/08/05 Page 6 of 7 SCREW (HOLDS CUP ONTO DECIQ 'SPANISH S' TAE BY ALTUSA MR) P•) CUP PLACEMENT DETAIL CLIP DETAILS (CON'T) 21/r OVERLAP (COVERS PIN END OF THIS ACCEPTANCE • • ••• • • • ••• • • • • • • • • • •• •. • • • • • • • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • • • • •• • • • • • ••• • ••• • •• • • • . • • • • • • • • • • • • • • • • •••. • .•• • • • • • • • • • • •• • • • •• ••• •• • • SCREW IN THE DI E ; AIk HOI» i • o • • • NEAREST TO TIVoHU1e 111 • 1 • • • • DECK 11/4' 19/4' 3l4' i / NOA No.: 05- 0901.06 Expiration Date: 12/16/07 Approval Date: 1 Page 7 of 7 • •• • • • M�IY as Mk 11:14 AM f11!(; 1;1111 07/2'.1/01 MON 13:98 FAX 951 578 11142 MIAMI(WMI PRfll)U(:'1' CONTRQL NOTICE OL.ACCL P1'ANCF. I'olyfoam Products, tree. 7.1U0 Spring•Stucbncr Itoud Spring ,'I'X 77383 - 1132 The ('XO(ttsc ofst►rlh testing will he incorrctl by the inanulacturcr. ACCEPTANCE NO.: 01.0521.02 APPROVED: 06 /I41l011t r% fi;(ti3l'C1•S INC. `:, ( . I. 111/t111 • • ••• • • ••Q1002 •• •• • .• • • •• • • • • • • • • • • • • • ••• • • • • • • • • • • • ••• • • • ••• MIAMI -DA(» COUNTY, FLORIDA MFT «,i►GI DUV.D17�(r � e . • • • • • • outt.VlrfC coln.},taNctoft•'jct ML• rtw- DADIKI,AOLL•lt LILIII.DING 110 WI:,rl r•I,AGLIER STRICT. suI1I 140 MIAMI. Ii1d)llll7A 13170 -I)63 • Thst)ts-vb4 t1',1uaiSfPefotr • ••••••••• • ••••••• • • cowl t,to uisiggj)FJJtoN (:1)5))75 -_S27 IAX (IDS) 1 7 7!511 C'rr4'ruAt rOu ENFRHCt aurrvr I11VIMON (3115)175.2u66 FAX (305) 31S•19ov ranuurr coM'ROI. DIVISION Do) 173.2 I AX DOS) 1 • 6))7 Your application for Notice. of Acceptance (NOA) of: Tsro Component 1'olyutethc:nu roam Adhesive under ('h;tptcr B atilt. Code of Miami County governing the use ot Mnteriuts and Types of t't)nWioetinn, and completely described herein, has bcrn recommended for acceptance by the Miami - Dade County litlilclinh Code Compliance Office. (BCC()) under tile. conditions spccitied'herein. •1I:is NOA ,.hall not be valid niter the expiration dau: stated below. BCC() resct the right to secure this piodile't pf matt:fiat of any time flank a jobsite'ur manufacturer's plant for quality control testing. if this product or material tails t(i perform in the approved manner, BCC° may revoke, modify, or suspend the use of mina► product or material irnmr•diately. DCCO reserves the right to rcvnkc rig approval. if it is dekrrttincd by BCC() that this product n► material fails to meet the requircrnCnts'or the South Florida ltuildin!' Code. 1:X 1'111(•:!/: OS/1 1U1c0o(6_ Raul Rodriguez Chief Product Control Division 10115i, l 'f�II c:c> VVI S II t I' St:� APDI [ 'QV I. I'Ali'LS FOR. sPF:r :IFIC.AN1) CL:Nr)sA1 • CONI).0 I QI 111111,0INI: COPE krg0121/171 tt�v w COMMITTEE This application for Ptudoet Approval h;t, been reviewed by the I3CCO and npproved by the Ruildinc ('ode: and Product Review Con to he used in Miami -[)ade, County, Florida under- the conditions set li)rlh - Above. t'rattcrsco J. Quirttuna. R.A. ' Director Mr.inli -Dace. County Building Code Compliance Off `cC.UOIVocZ004 \liomplaic, \ 'NOM • K<•pun, dut ' frnrl /hurl u d'Irtss: pottutnstc •(u)htrrldlrt(;codconlinc.corn • 11onup:rgc: trttp . / /wwW,bslldinRcOdeonitne.com MAY 1 113 1 ill•. •11:14 AM ABC SUPPLY LK Willl111 1.11X NO. bbl ��liaAb ►.I l 01/' ?3/01 MON 13:08 FAX 954 578 1042 I'O1.VFOAY PRODUCTS, INC. • • • • •• • • • • .. • • • • • • • .. • • • • • • • • .... .... 1' ^IYf.Qnm.P[2�uct�, 1pr. ACCEPTANCE No.: 01- (IS ;1,O2 • .. .. ROOFING ASSFMIII.Y APPROVAI. C1114'1:pCY; SO. . f. tcenVy: h1at r1U�x; • Polyure.thane • • • • • .. • . . . • • • • • Rooting Approval Date! .tune, Rnof"1 ilc Adl►csive .. • • • .. ... .. • i xpinitittn Qnte: 4a 1A 0AG:. • • • . s • .. • • • • • ... .. I. SCOr This approves l'ulyprii A11161) as ntantllactarcd by rulyfount Product9, Inc. as dcscrihe'rl in Section 2 of this Notice o1 Acceptance. ( the locations where the design pressure rI quiremt:nts, as drier by appl :gable building code:, does not exceed the design ptc,.ure value obtained by calculations in compliance vvith Roofing Application Standard RAS 1 for use with approved flat. IOW. and high profile roof tiles system using PolYproaD All 160. Where the attachment calculations arc done as a moment based system I'nr Singh' patty pintenutnt,1nd as an uplift bnscd syste.m for double potty systems 2. PRODUCT DESCRIPTION Manufactured by Test Product Apidiealq I)tgwiq^1 Stiecineutinpv ,17nui li!!n PnlypmO A11160 N/A PA 101 'IWn component polyurethane I't»ntprovb WIT ION N/A Dispensing Fquipmcnt I'rol'ackttl 30 S. 100 N/A Dispensing t'quipmenl x 2.1 Cnntponcnti or products manufactured by others: Any Miami .Dade County I'rodue:t Control Accepted Roof file Assembly having a current NOA whirl► list uplift resistance values with the use of Polypro A11160 roof tile adhesive. 2.2 Typical Physical Properties: 1 P ASTM D 1 622 AS ('M 1) 162 1 Property Density Compressive S u cttt'tlt 1't:nsilc Strength Water Absorption Moisture V.pot Transmission Dimensional �I;►l►ility ASTM L) 1673 ASTM 1) ?1 ?.7 ASIM I:96 ASIM I) 2126 Itesnits 1.6 tbslft.' 16 PSI P. r 1Iel to riot' 12 I'SI Perpendicular to rise '8 PSI Parallel to rise 0 08 Lbor:1 1 1 leernl / Int:li 0.07% Volume Change 8 - 40 0 F.. 2 weeks 46.0 "/e Vohnnt Clem •u (A I lun►idiiy, weeks 1, _ te r • Frank Zuloagn, ItRC Product Control Examiner 1'. t1 / /tlii • • .. • Ith MAY Pi 03 '1 UE 1 1: i b AM AI1C SLIMY 1.K WORTH FAX NO. b615854657 1', 03/08 ' 07/23/01 11ON 13:09 FAX 95.1 518 10,12 Polvfaam !sod uilj Inc,. Ncte :. I he physical pinta-114.c listed accepted ASTt11 test methods 3. .1, 7. POI.YFOAM PRODUCTS, INC. • • • • • • • • • • • 3 ACCEPTANCE No.: O1- 0521.0Z • • • • •. 1Jj004 • • • • • • • • • • • • • • .• • • • • • • • • • • • • • •.. • •.• •• • • • • • • • • • • • • • • • • • • • • above me presented as typical aver$aovalues As.dttrini�nc 1d w mut err subject to normal manufactutinc y rinlion. • .. • . • • • • 000 • • • ..•..•• • LIMITATIONS fire classification is not part of this acceptance. Refer to the rrtparil {tcierCI c Assembly for fire rating, • • • • • • • • •. • • NolyproQD A1 shalt solely be used with fiat, low, & high the profiles. 3.3 Minimum.underlaymcnts shell he in romptiancc with the Roofing Application Standard RAS I?0. 3.4 Roof Tile manufactures acquiring acceptance for the use of Polyprotli) A1 roof tile adhesive with their tilt assemblies shall test in accordance with PA 101. 3.5 Rnnf Tile manufactures acquiring ac:rcptance for two paddy placement with the use of Polypro® AH160 roof tile adhesive with their tile assemblies shall test in accordance with PA 101 and with section 10.4 as modified herein. 4. TNsTA1.LATION 4.1 I'olypro® A11160 may be used with any roof tile-assembly having a current NOA that Lists uplift resistance values with the use of Polypro® A11160. 4.2 Polyproe A11160 shall bc applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of Polypro4O AI-1160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet nr exceed the uplill resistance determined in compliance with Miami-Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA 4.3 Polypro® A11160 roof tilt adhesive and its components shall be installed in accurdance with Rooting Application Standard RAS 120, and Polyfoam Products, Inc. Polypro® At-1160 Operating lnstntction and Maintenance Jlnnklct. 4.4 Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, Inc Polyloant Products Inc.. shall supply a list of approved applic.ators to the authority baying jurisdiction. 4.5 Calibration of the Foatnpro1 dispensing equipment is required before application of any adhesive. The rnix ratio between they "A" component and the "II" component shall be maintained between 1.0 1.15 (A) : 1 0 (11), The dispenser tuner shall bc sit 10 deliver 0.0175 to 0.1 S pounds per tile as determined at calibration. No other settings shall be approved, 4,6 Polylero40 AI 1 160 sh;tll be applied with Foantpro Rl'F 1000 or PrnPack0 )0 Re-. 100 dispensing; equipment only. 4.1 A11160 shall nut he exposed permanr.ntly to fungi • • • Frat>< Zulaaga. RRC Product Control Examiner MAY Pi 03 •flll•: 11 :1b AM ABC SIII'I'I.Y LK WORTH 07e13/01 Mt1N 13:09 F'AC 954 579 1042 1'OLVFOAS PRODUCTS, INC. Ptzly19:1nr 1 (nc. AC(:F:rTANcE•No.: 01- 0521.o/ . 4141 4141. . • 0 . . • • • • • • • • • • • • • • • 4.8 Tiles must be adhered in freshly applied adhesive. Tile must:14 sot =vithin 2 tb 2 minutes alter Polypro0 A1-116O has been dispensed 4.9 Potypro® A11160 placement and minimum patty weight shall be in accordance with the 'Placement Detail: ;' herein Each generic. tile ptulile requiros:the.siefilic plicsruen t', noted herein. • • Table 1: Adhesive Placement Poe Each Ccncric Tile 1'ilct'rafilc r Placement Single faddy Weight Detail Flat. l.nw. Flidh Profiles 11; h Profile (2 Picrc hotel) Flat l.ocv, I1 j.h Profiles f111 Profiles . 'i FAX NO. 50158546b/ P. 04/08 Mist. (grams) 15 17 /srdt on cap and 34L n ) h 14 41 41. Roos . . • • • i • • i • . • 0410 •• •.• • • • •00 •• 'ratite Twn Paddy Weight per paddy Min. (gt ants) N/A N/A N/A 8 5. r.ABBF:1.1NC All Polypro® Al1160 containers shall comply with the Standard Conditions listed herein. 6. 11 PERfvlrr REQUIREMENTS 6.1 As required by the Building Ofrcial or applicable. Building Code in order to properly evaluate the installation of this system. Prank Zulnaga, R.RC. Product Control Examiner MAY ! Ua lUl•. 11 :h AM ABC SUPPLY LK WORTH H 07:23/01 MON 13 :10 FAX 954 578 1042 !!y ! linLFcndu4(i, Inc. • • • • • • • • • • • • • • • ••• • • • • • • • ADM.:slvE PLACEMENT DETAIL 2 • • • • • • • PouirUAY PRODUCTS, INC. • • • • .. • •. • • • • .. I OO7 • • • • • • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • • • • • • • • • • ••• • • • • ••• SINGLE: FATTY 6 ACCEPTANCE l•ANCE No.: OI- OS2(.O2 FAA NU. 5[/ 156''1651 •• • • • •• ••• •• • • • • • • • • • • • • • • • • • • • • • • 08 • • Frank Zu1o383, RRC Product Control examiner • .MAY 1 133 'I'EJF 11:1E1 (1M AUG SUPPLY LK 140k ill II FAX NO. 61 a(3a4Eib ( (1 uuti 02/23/01 MIEN 13:10 FAX 953 578 1032 I'4(.Y.(e�yP1 Prnllucic.Jnc, Nal ttuuugt plastic cemrnt hat ______ - ` f / (Mtween tllol ` 4 NMI ( under Ilia) C !� Lnyle.A. 3 In. under 111. 111n. � 51nrylo paddy on !, I. y - S'r,4ie paddy on 14.0 r.1 IiIc • •• ••• • •• • ... ••• AUIIEsIVt PLACEMENT DETAIL 3 ` • •••• •••• •••• • • 1 ir. I in mednun airs paddy sows Fade towns only NMI through plains snood l e - 3 In. s . In. Single paddy on undsrla ynun, Sloan paddy an top o1 tale POLV'FOAM PRODIICTS, INC . Woos • • • ••• • • • ••• •• •• • • • • •• •• • • • • • • • • • • • • •' • • • • • • • • • • • ••• • • • • • • • • • • • • • • • • • ••• • • • • .•• DOUBLE PATTY fMI Co.116 Los (eugl ACCEPTANCE No.: 01- 021,02, V. Nail through pbbc11c curium IlndsAlymcnt \elln.1]1n. 1n. &angle paddy a under Iaymonl undo lily • Slap paddy on lop 01 111, ens Conn 11n it In. indium an paddy em scans nay fascia •• • • • •• ••• •• • • • • • • • 4,41 • • • • • — s • 05In p dd?II avtlD Show paddy kiwis, IIIh 1 Ita114. main 191 pad! • ve Mouse ooh East Clam Frank zuloaba. II Pro Iucl Control Examiner fads tl Oslo Ian Mown DA' odgs 11 IA? r ila W1: 11: u AM AHC SLIPPI Y L (( WORTH , ,07/2.3/01 NON 13:10 FAX 954 578 1042 POIJ'FUAY PRODI'c:TS.INC. Polyfulm Prints, tart, ACCFPTANCE No. 01- 0521.02 9. This Notice of Acrcptanc.c cunsists of pa jcs 1 through a. tt FAX NU. bi1b8b4Eial P. UU /1J • • ••• • • •• •• • • • •• • • • • • • • • • • • • ••• • • • • • • • • • ••• • • • ... ... • • •• .. . • • • • • • •. • • • • •• • • ••• • • • • I Rcnrwal of this Acceptance (approval) shall be considered aticr a re:ncte3raP12Neatiett111al Avis ff1a d •.• and the original submitted documents, including tot- supporting data, cnginecring documents. arc no alder than cirht (11) years. is • • • •• ••• .• • Any and all approved products shall be permanently labeled with the nt u uflc2aa:rs *inter city, • • scat:, and the following statement: "Miami Dade County Product Gontrel •Approartl to•ast• specific - ally staled in the specific conditions of this Acceptance :. Renewals of Acceptance will not ht: coturth.rcd if: a. '1 here has been a change: in the South Florida Duilding (.ode affecting tho evaluation of this product and the product is not in compliance evade the code changes_ b. The product is no longer the tam product (identical) as tltc one originally approved. c If the Acceptance holder has not complied with all the requirements of this acceptance, including the c:nrrrct installation of the product. d. The engineer who nrillurally pre`parcd, signi.:1 grin %caIed the required documentation initially submitted, is no longer practicing the cniinrcring prnfasion. 4. Any revision or change in that materials, use, ansVor r of the produet.or process shall automatically he cause for termination of this Acccptancc•., unless prior written approval has by:en requested (rhroullh the filing of a revision application ■vith appropriate fee) and granted by this oltict:. 5. Any of the following shall also be grounds for removal of this Acceptance: :►. Unsatisfactory performance of this product or process. h Misuse of this Acccptancc as an endorsement of any product, for salts, advertising or any other purposes, (i. laic Notice of Acceptance number preceded by the words Miami -Dade County, Florida, and followed by the capitation date may be displayed in advertising lut:ralun: 11 any portion of the Notice of Acceplann is displayed, then it skill he dome in 115 cutircty t. A copy of this Acceptance as %cell as approved drawings and other documents, tyhere it applies, shall Lz provided to the: usct by the *manufacturer or its distributors and shall be available for inspection at Ilse job sits at 3116111e. The enl;inccr need not tc.ce:al the copies. l 1'ailum to comply with ;any section of this Acceptance shall he eau9c for termination and remov 1 of Acceptance. END OF '1'111S ACCEPTANCE 4/1009 ••• • • •. • • ••• Frank luloaga, IUtC Product Control Examiner Date 04/10/2006 Permit Receipt Permit Number: RF -3 -06 -811 Invoice Number: RF -4 -06 -24370 Applicant: ANDRE FOURNIER Company Name: Payment Type CheckNum Check 9631 Amount $265.30 Total Payment: $265.30 Monday, April 10, 2006 Page 1 of 1 Inspection Date: 06/0612006 Inspector: Desharnis, George Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: ROOFS BY CHERRY Building Department Comments Monday, June 5, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Roof Inspection Type: Tin Cap Work Classification: Roof - New Phone Number Parcel Number 1132050190090 Lot: Phone: 305 -653 -8542 Page 2 of 2 Infractio Passed Comments TIN CAP SPACEING True Passed Inspector Comments lG C C__ 7)e- 1 S` v , . 6- ,..._. c...4., it".-5' ,.. 1 [---t t f , `� 7: Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 06/0612006 Inspector: Desharnis, George Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: ROOFS BY CHERRY Building Department Comments Monday, June 5, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Roof Inspection Type: Tin Cap Work Classification: Roof - New Phone Number Parcel Number 1132050190090 Lot: Phone: 305 -653 -8542 Page 2 of 2 Inspection Date: 06/08/2006 Inspector: Desharnis, George Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: ROOFS BY CHERRY Building Department Comments Wednesday, June 7, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Numb Block: Permit Type: Roof Inspection Type: Tin Cap Work Classification: Roof - New Phone Number Parcel Number 1132050190090 Lot: Phone: 305 - 653 -8542 Page 2 of 2 Infractio Passed Comments TIN CAP SPACEING False Passed Inspector Comments < re \ L__ t ,� ..2,L.,. e e k . . _ 17 _s> ., . _ _ .. I M Failed 7 7 7 . _ Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 06/08/2006 Inspector: Desharnis, George Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: ROOFS BY CHERRY Building Department Comments Wednesday, June 7, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Numb Block: Permit Type: Roof Inspection Type: Tin Cap Work Classification: Roof - New Phone Number Parcel Number 1132050190090 Lot: Phone: 305 - 653 -8542 Page 2 of 2 ■ .w �. « 2 \.Reo�av?Ji Inspection Date: 07/24/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: ROOFS BY CHERRY Building Department Comments Friday, July 21, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 JUL 2 5 RECD Block: Permit Type: Roof Inspection Type: Hot Mop Work Classification: Roof - New Phone Number Parcel Number 1132050190090 Lot: Phone: 305 - 653 -8542 Page 2 of 2 Passed 1 Uh° Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until ■ .w �. « 2 \.Reo�av?Ji Inspection Date: 07/24/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: ROOFS BY CHERRY Building Department Comments Friday, July 21, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 JUL 2 5 RECD Block: Permit Type: Roof Inspection Type: Hot Mop Work Classification: Roof - New Phone Number Parcel Number 1132050190090 Lot: Phone: 305 - 653 -8542 Page 2 of 2 Need uplift report before final inspection . Not done. 10/27/06 CG. Passed Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP -13595 k� . Permit Number: RF-3-06-811 Inspection Date: 10/27/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: ROOFS BY CHERRY Building Department Comments Friday, October 27, 2006 OCT 30? Block: Permit Type: Roof Inspection Type: Final Roof Work Classification: Roof - New Phone Number Parcel Number 1132050190090 Lot: Phone: 305 - 653 -8542 Page 1 of 2 Inspection Number: I 135.93" Permit Number: RF -3- 06-811 Inspection Date: 11/15/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: ROOFS BY CHERRY Building Department Comments Tuesday, November 14, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Phone Number s py 18 ENI'D b� Permit Type: Roof Inspection Type: Final Roof Work Classification: Roof - New Parcel Number 1132050190090 Lot: Phone: 305- 653 -8542 Page 1 of 2 Passed Inspector Comments r . , 1 o 5e9 A - c-CD l Failed Correction Needed Re-Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Number: I 135.93" Permit Number: RF -3- 06-811 Inspection Date: 11/15/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: ROOFS BY CHERRY Building Department Comments Tuesday, November 14, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Phone Number s py 18 ENI'D b� Permit Type: Roof Inspection Type: Final Roof Work Classification: Roof - New Parcel Number 1132050190090 Lot: Phone: 305- 653 -8542 Page 1 of 2 CIVIL 1RM ENGINEER November 10, 2006 Roofs by Cherry 3901 Southwest 40 Avenue Hollywood, Florida 33023 Project: Dear Sirs; Reileh Engineering Corp. (Consulting Engineer) P.O. Box 22011 Hialeah, Florida 33002 Tel:305- 823 -8008 Fax: 305-823-3300 ROOF TILE UPLIFT TEST REPORT Residential Home 1175 Northeast 102 Street Miami Shores, Florida Information provided by client: Permit Number: Not Provided Date Completion: November 02, 2006 Roofing Contractor: Roofs by Cherry Project Number: 06 -4406 (Testing Laboratory Certificate #06- 0501.15) In accordance with your request and authorization, a representative of Reileh Engineering Corporation completed the Roof Tile Uplift Test at the above referenced project. This testing was performed in general accordance with Roofing Application Standard TAS No.106 -- Standard procedure for field verification of the bonding of mortar or adhesive set tile system and mechanically attached, rigid, discontinuous roof systems. The total of the tested roof surface area was less than 10000 square feet, and the mean height of the roof is less than 40 feet above ground surface. The type of tile used for this project was reported to be Concrete /Clay Roof Tile. This tile was reported to have been foamed in place. At the time of our inspection, the entire area of the roof was examined for loose tiles. Not less than one (1) tile in ten (10) of all components in the field area and one (1) tile in five (5) of all tiles in the perimeter and comer areas were physically examined. A minimum of one (1) test per every two (2) squares in the field, one (1) test per square in the perimeter area and (1) in the comer areas were conducted. Based on our test results, we conclude that the installation of the roof tile at the above referenced project meets the test requirement outlined in the above - mentioned protocol. Attached please find a copy of our test report for your review. 1 Reileh Engineering Corporation appreciates the opportunity of assisting you in this project. If you rave any questions or if we may be of further assistance, please do not hesitate to contact the undersigned. Respectfully submitted; Reileh Engineering Corporation Me amad Sonny. Salleh, P.E.49014 Project Manager TILE UPLIFT TEST Residential Home 1 175 Northeast 102 Street Miami Shores, Florida Reileh Engineering Corporation -- Project Number - 06 -4406 Test Number Test Load (lbf) Test Status 1 35 Pass 2 35 Pass 3 35 Pass 4 35 Pass 5 35 Pass 6 35 Pass 7 35 Pass 8 35 Pass 9 35 Pass 10 35 Pass 11 35 Pass 12 35 Pass 13 35 Pass 14 35 Pass 15 35 Pass 16 35 Pass 17 35 Pass 18 35 Pass 19 35 Pass 20 35 Pass 21 35 Pass Report of TILE UPLIFT TEST for Residential Home 1175 Northeast 102 Street Miami Shores, Florida Project Number: 06 -4406 Reileh Engineering Corporation -- Project Number - 06 -4406 Parcel Number: 1132050190090 1175 102 ST Miami Shores Village FL Tax ID: 1132050190090 Owner Information ANDRE FOURNIER Phone: Current Owner: Yes Related Permits Electrical - Residential Imported Permit Imported Permit Paint Residential Construction Roof Permit Number Application Date Expiration Date Status EL -3 -06 -605 03/09/2006 01/20/2007 CLOSED BP2005 -658 05/04/2005 10/31/2005 CLOSED MC2004 -13 01/16/2004 10/10/2004 CLOSED BP2005 -1533 11/04/2005 01/14/2007 CLOSED BP2005 -304 03/03/2005 05/14/2007 CLOSED RF -3 -06 -811 03/30/2006 05/14/2007 CLOSED Wednesday, November 22, 2006 Parcel Owner Report Page 1 of 1 Inspection Date: 11/15/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: HOME OWNER Building Department Comments Wednesday, November 15, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Phone Number vitpi 18 ENl'D CL Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Alteration Parcel Number 1132050190090 Lot: Page 2 of 2 I Passed Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Inspection Date: 11/15/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: HOME OWNER Building Department Comments Wednesday, November 15, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Phone Number vitpi 18 ENl'D CL Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Alteration Parcel Number 1132050190090 Lot: Page 2 of 2 Final cannot be approved until roof has been finaled and uplift report submitted to bldg. dept. 10/27/06 CG. Passed Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 10/27/2006 • Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Friday, October 27, 2006 Miami Shores Village, FL 33138- Contractor: HOME OWNER Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP -30822 Permit Number: BP2005 -304 Oa 3 0 206 Block: Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Alteration Phone Number Parcel Number 1132050190090 Lot: Page 1 of 2 GO TO WEST SIDE OF HOUSE THE GATE IS OPEN TO HAVE ACCESS TO PROPERTY. NO ONE LIVING IN NO DOG INSIDE ALL PAPERWORK INSIDE. Passed r—V1 Inspector Comments JJII (},,,______,,- „t Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- in \pection fee is paid. until Inspection Date: 06/08/2006 Inspector: Desharnis, George Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: HOME OWNER Building Department Comments Wednesday, June 7, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number` Block: Permit Type: Residential Construction Inspection Type: Celli Work Classification: Alteration Phone Number Parcel Number 1132050190090 Lot: .te 7 . ... • . 4 OR16 an Nutt u1 I "nsp 05 -304 Inspection Date: 06/08/2006 Inspector: Desharnis, George Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: HOME OWNER Building Department Comments Wednesday, June 7, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Residential Construction Inspection Type: Floors Work Classification: Alteration Phone Number Parcel Number 1132050190090 Lot: Page 2 of 2 Passed E V 3 Inspector Comments _ �; Ci,d. rr 1 ,-..--." 6 Failed Correction Needed Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until .te 7 . ... • . 4 OR16 an Nutt u1 I "nsp 05 -304 Inspection Date: 06/08/2006 Inspector: Desharnis, George Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: HOME OWNER Building Department Comments Wednesday, June 7, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Residential Construction Inspection Type: Floors Work Classification: Alteration Phone Number Parcel Number 1132050190090 Lot: Page 2 of 2 nspection Numbe: erm BP2005 -304 Inspection Date: 06/06/2006 Inspector: Desharnis, George Owner: Job Address: Project: <NONE> Contractor: HOME OWNER Building Department Comments Monday, June 5, 2006 FOURNIER, ANDRE 1175 102 Street NE Miami Shores Village, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Residential Construction Inspection Type: Floors Work Classification: Alteration Phone Number Parcel Number 1132050190090 Lot: Page 2 of 2 -'c4e Passed Inspector Comments Po ��G c -, J) 6 S' i J'v p cif 4, / l le -, vLs1 j.) g 3 4 -J f d CA j ° r z_ /� ,(�� Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until nspection Numbe: erm BP2005 -304 Inspection Date: 06/06/2006 Inspector: Desharnis, George Owner: Job Address: Project: <NONE> Contractor: HOME OWNER Building Department Comments Monday, June 5, 2006 FOURNIER, ANDRE 1175 102 Street NE Miami Shores Village, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Residential Construction Inspection Type: Floors Work Classification: Alteration Phone Number Parcel Number 1132050190090 Lot: Page 2 of 2 -'c4e .\1 ,)& Oi i1 (4i\ Passed Inspector Comments ND a' GC e 5S r 6 S 4, S e.. 1 1--- ( or tri- __ 6.- � Sc;?' C / 1 Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 06/06/2006 Inspector: Desharnis, George Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: HOME OWNER Building Department Comments Monday, June 5, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Residential Construction Inspection Type: Ceiling Grid Work Classification: Alteration Phone Number Parcel Number 1132050190090 Lot: Page 1 of 2 �nspe' Inspection Date: 05/31/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: HOME OWNER Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: 00,5 -304 Permit Type: Residential Construction Inspection Type: Roof Sheathing Work Classification: Alteration Phone Number Parcel Number 1132050190090 Lot: Tuesday, May 30, 2006 Page 2 of 2 G� Passed G 0 Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until �nspe' Inspection Date: 05/31/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: HOME OWNER Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: 00,5 -304 Permit Type: Residential Construction Inspection Type: Roof Sheathing Work Classification: Alteration Phone Number Parcel Number 1132050190090 Lot: Tuesday, May 30, 2006 Page 2 of 2 'Inspection Numbe 5 -304 1 Inspection Date: 05/31/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: HOME OWNER Building Department Comments Tuesday, May 30, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Residential Construction Inspection Type: Floors Work Classification: Alteration Phone Number Parcel Number 1132050190090 Lot: Page 2 of 2 Passed Inspector Comments ?4N / � �� E I1. /;v o rLA/Z. /60 g2._ 49 1 lit.1 S pe /� Tel '- =T z °)( .1 s1747 j ` 7 cio.. Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until 'Inspection Numbe 5 -304 1 Inspection Date: 05/31/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: HOME OWNER Building Department Comments Tuesday, May 30, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Residential Construction Inspection Type: Floors Work Classification: Alteration Phone Number Parcel Number 1132050190090 Lot: Page 2 of 2 Mailing Address: P. 0. Box 610277 North Miami, FL 33261 DAT Pi ZO /T0 3Jdd TO: d ltd oblems or co ANDRE' R. FOURNIER, ESQ. Attorney at Law 1747 N. E. 124` Street North Miami, FL 33181 (305)891 -0308 FACSIMILIE TRANSMITTAL FROM: Andre' R. Fournier, Esq. TOTAL PAGES (including this page): REFERENCE EC SENDER'S FAX NO. (305)891 -0371 r 75g.--- RECIPI'ENT'S FAX NO. J J g 2.-- MESSAGE; e ; I i I t v" 11.11MMIW tits, please call (305)891 -0308. tv2-9 d3IN IfOd I MIQNV • TIME: ax Operator TLEOT68SOE TL20T68S02 ES :LO 9002 /OE /S0 PERMIT IS AT WEST SIDE OF PROPERTY ON JOB SITE 4 j 44 Ot g P vitc-R' — ei;wt–L. evi. a ?? Ca C( Ale Inspector Comments f � i �f ✓ 5 f 4., G A 4(he 4 /°4 e Q 'I. /A/VI-PC -74- A . . 5 t s .� 4 4 w 2AtJ r -i'if 11 / A-ca l ____ 6 4 O ' /2/4 S' X/ Ci f " Passed Failed Correction Needed Re- Inspection Fee ($75) No Ad iitionel Inspections can be scheduled until re- inspection fee is paid. Inspect • Date: 05/26/2006 Inspect I: Grande, Claudio Owner: FOURNIER, ANDRE Job Ad Project: Thursd ress: 1175 102 Street NE Buildinh Department Comments 9y, May 25, 2006 ZO /Z0 3Jdd Miami Shores Village, FL 33138- <NONE> Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, EL Phone: (305)795 -2204 Fax: (305)756 -8972 810 Contra or; HOME OWNER "l�' 0 Permit Type: Residential Construction Inspection Type: Roof Sheathing Work Classification: Alteration Phone Number Parcel Number 1132050190090 Lot: Page 1 of 2 d3INdIIO. d 3LIQNV TLEO16890E E5 :L0 900Z/0E/50 PERMIT IS AT WEST SIDE OF PROPERTY ON JOB SITE Passed Inspecto Comments ... 6,10( b 14 _ 1,c7 f 6 0 .... LI ,„ Wig y,/,0 r .9u A, f- er ' vzo ci -- / /tit - ' ' ie. /t. 4,4-s yepee abd `_ �� ►� L5 Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until ction N Inspection Date: 05/26/2006 Inspector: Grande, Claudio Owner: FOURNIER, ANDRE Job Address: 1175 102 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: HOME OWNER Building Deaartment Comments Thursday, May 25, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 MAT Block: 5 -304 l Permit Type: Residential Construction Inspection Type: Roof Sheathing Work Classification: Alteration Phone Number Parcel Number 1132050190090 Lot: 1 2I Page 2 of 2 Miami Shores m� Village 01301 IO Building Department - 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: 30 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Tenant/Lessee Name FOLIO / PARCEL # Owner's Address j gyp £.. /02- W City ' [ but/ 5 ietF V State - P CEIIVED AR 0 9 2005 Job Address (where the work is being done) / 17 /V 6- I 02- S City Miami Shores Village Permit No. 8 P 0 301,6 aster Permit No. Permit Type (circle) Building Ele c lumbing Mechanical Roofing Owner's Name Fee Simple Ti - . der) 4E CA r2/Vi£t2-Phone # 3 C)5 it t — 03 ©g Zip Phone # ;495 J 4 f m oef County Miami -Dade Zip '330, Is Building Historically Designated YES NO Contractor's Company Name ]J [ OWA (6'4 l Contractor's Address City State Qualifier Name State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Q ©CD Square / Linear Footage Of Work: . 1 (Q , I, [ 9 ❑ Repair/Replace ❑ Demolition Describe Work: Refho V6 © o O 0 E g /J) -.4- RIB �� -A'� goe. F veg. (l' t L E To m trrt4C) hi-66%/e- o V&A, P0- nn A- - (i LAA-t CFI C.1 Chu .: We c cc. * Fee� *** A*** * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * ** * * * * *4 * * * * * * * * * * * * * * * * * * ** Type of Work: Submittal Fee $ Permit Fee $ Notary $ Training/Education Fee $ Scanning $ Radon $ DPBR $ Bond $ ❑Addition %Alteration Code Enforcement $ New Zip Phone # CCF $ Double Fee $ CO /CC Technology Fee $ Zoning $ Structural Review. $ Total Fee Now Due $ See Reverse side -4 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) dl fr Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is ubject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspe tibn w zc _ . rs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will no einspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of ,200 ,by 400( (L fOtI'Z -4 eV/ , day of ,20 by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: APPLICATION APPROVED BY: (Revised 02/08/06) ' �� /Ii II� Lee C MY COMMISSIO Pecker ftON0E0 T TROY F A I N , 2006 E INC who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning Miami Shores Village 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (3 795, -Far 1,56.8972 BUILDING 0 3 ZOOS Permit No. Bibs - M .. PERMIT APPLICATION , aster Permit No. FBC 2001 .�.. Permit Type (circle): : uilding Electrical Plumbing Mechani offing Contractor's Company Name ?$ 4 Or o W re • Contractor's Address City State Qualifier $ Value of Work For this Permit'( $ o00 Type of Work: Describe Work: Addition (Continued on opposite side) Building Department Andre' R. Fournier Alteration :New Phone # 3 0 5 Owner's Name (Fee Simple Titleholder) Owner's Address 1175 N. E. 102nd Street City Miami Shores, State Fr, Zip 33138 Tenant/Lessee Name N.A. Phone # N . A. Job Address (where the work is being done) 1175 N. E. 10 2nd Street City Miami Shores Village County Miami -Dade Zip 3 313 8 Is Building Historically Designated YES NO X Phone # Zip Architect /Engineer's Name (if applicable) Edward A. Landers, P. E .phone # 30 5-82 3-39 38 Square Footage Of Work: / / 1 A • 1 ❑ Repair/Re . lace ❑ Demolition * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ ,200.00 Permit Fee $ CCF $ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Bond $ Code Enforcement $ Structural Plan Review. $ W .( jJ Total Fee Now Due $ 5f= Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zi Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is sub,' ct to a . Iso, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspect o whi, ) days after the building permit is issued. In the absence of such posted notice, the inspection will not , • appro Lion fee will be charged rs seven a reinspe Signature ` / •' Signature nare : urnier Owner or Agent Contractor The fore in m instrument was acknowledged before me this 3 The foregoing instrument was acknowledged before me this day of "— . , 20 05 by Andre' R. Fournier , da • of y _ , 20 _, by who is personally known to me or who has produced N . A . who is personally known to me or who has produced As identification and who did take an oath as identification and who did take an oath. * * * * * * * * ** NOTARY Sign: Print: e �� , �. �; : � � • NOTARY PUBLIC: ,aginfer'N' Sign: Print: . My Commission Expires: M a v J d { � ,1 My Commission Expires: * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** V //o5 Sin -4-( • Plans Examiner APPLICATION APPROVED BY: Chc 10/14/03 C . Engineer Zoning Issue Date: 3/15/2006 Owner's Name: ANDRE FOURNIER Permit Type: Residential Construction Work Classification: Alteration Job Address: 1175 102 Street NE Comments: DECK AND PATIO W/ ROOF Additional Information Miami Shores Village, FL 33138- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 03/03/2006 Contractor(s) Phone Primary Contractor Type of Construction: NEW DECK Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: 12/29/2005 Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due CCF Changes to Plans Fee CO /CC Education Surcharge Notary Fee Permit Fee - Additions /Alterations Plan Review Fee (Engineer) Scanning Fee Technology Fee Total: Amount $4.80 $200.00 $50.00 $1.60 $5.00 $240.00 $50.00 $15.00 $6.00 $572.40 Applicant Signature Parcel #: Block: Section: Re • uired Ins . ections Slab Termite Letter Fill Cells Columns Tie Beam Window and Door Buck Window Door Attachment Framing Insulation Drywall Screw Ceiling Grid Final PE Certification Shutter Attachment Shutter Final Permit Status: APPROVED Permit Number: BP2005 -304 Phone: Total Square Feet: Total Valuation: 1132050190090 Lot: PB: 111 $ 8,000.00 Invoice Number RC - 3 - 06 - 24141 Total: 4 CURTIS CRAIG 3/21/05 305 - 795 -2204 Miami Shores Village Building Department Permit No. Page 1 of 1 3/21/05 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BP 05 -304 BUILDING CRITIQUE SHEET ,/1 Plans must be reviewed and approved by HRS. pp Y 2. Plans must be reviewed Miami -Dade Planning and Zoning 1LI 0ko for impact fee paid payment. 3. Submit electrical, roofing and storm ..utter permit applications. mo 1 i is 51Vora 'STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, Andre R. Fournier , does hereby attest that the (property owner) attached survey, performed by & L9 /V -rE e- a ezv e / (N C (name of surveyor's company) performed on 2 - 4 ?" - • •• Z`:'° 1 , is an accurate representation of the existing conditions and (date of survey) locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than six (6) months old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted -or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable t„ts or�gther permits.. Further, Affiant sayeth naught. Witness(sign and print) Witness(sign and print) t/Property owner SWORN TO AND SUBSCRIBED before me this 1 day of /YtA . Affiant is L personally known to me, produced as identification. Lee C Picker MYCOMMISSION# DD136338 EXPIRES September 13, 2006 BONDED flRU TROY FAIN INSURANCE. INC NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street/address: / /7.S 11_ 6 /0 $ ,fl/A-�( 2. Description of improvement: P TO 06e 3. Owner(s) name and address: Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expirati• date different •, e i 4 c+ rratu • of Owner Print Owner's Name Andre g Fournier Sworn to and subscribed before me this d day of Pt't M , 20a.. Notary Public Print Notary's Name My commission expires: 123.01 -52 PAGE 4 8/02 ified) otice of Commencement: (the expiration date is 1 year from the date of recording unless a s 01 STATE OF FLORIDA, COUNTY OF rF.DE �_',� ^ ; r y: 1 HEREBY CERTIFY tt,sf ?He,,. 9Y of O M . t$ " `e origin �j fi In this C/i:.a on _�%°,' 01 ` `+ .. . and Cr1un ' G3wi t • ., d LE: of 1 1E HARVE By A-ArO Re Czotta N [ aYZ II'15 uE 1029T mfA'tn( - r1.6 - S 1 Ft_ CFN 200680291320 OR Bk 24336 P9 4437; (113s) RECORDED 03/17/2006 11:58:05 HARVEY RUVIN, CLERK OF COURT MIAMI -DADE COUNTY? FLORIDA LAST PAGE Prepared by 11110111111111111111111111111111111111111111 Address: - P 'RA) �()i LeeG 1� ?5 Ni toy ' ' • N # DD136338 EXPIRES m jam( S t Septe.ntti: 1 j. 2006 BONDEDTHRUTROY