150 NE 102 St (10)Test Location
Uplift Pull
Test (P or F)
Test Location
Uplift Pull
Test (P or F)
Test Location
Uplift Pull
Test (P or F)
1
26
496p
51
'✓1��� D
2
���Jr1�.D
27
FA
52
�
3
28
53
4
29
54
_
5
30
55
6
31
56
7
32
57
8
33
58
9
34
59
10
35
60
11
36
61
12
37
62
13
38
63
14
39
64
15
40
65
16
41
66
17
42
67
18
43
68
19
44
69
20
45
70
21
46
71
22
47
72
23
48
73
24
49
74
25
50
� -
75
Owner's Name:
h� y� « V E ZPermit #. 4 5 Q 2q
Job Address
Type of Tile: Al'rDf.. 14g, 1 t''O Aw.• 7 T Date Installed
Approximate Roof Height: _ I2 feet Roof Pitch
Type of Access to Roof: Scaffolds k Ladder Other
Approximate Square Footage of Roof: 1 S Oq ft 2
Required Testing Forc 35 lbs. Testing Equipment: Chatillion DFIS 100
Date Tested 5 ' 00
Du Quesne & Associates, Inc.
Consulting Engineers Environmental • Civil • Structural
Testing Laboratory Building Inspection Services
ON -SITE CONCENTRATED UPUFT LOAD TESTING OF ROOF TILE
IN ACCORDANCE WITH METRO -DADE BUILDING CODE COMPLIANCE
PROTOCOL PA 106
i!
IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL PA 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT
QUALITY CONTROL TEST.
Du Quesne, P.E.
ngineer
P. '4513
Du Quesne & Associates, In
E.B. License #0005245
Lab Certification #94- 0318.01
SITE SPECIFIC INFORMATION
TEST RESULTS
P = PASS, F = FAIL
SKETCH OF ROOF IN BACK
4,25.00
THIS PA 106 TEST HAS BEEN PERFORMED IN FULL ACCORDANCE TO THE
REQUIREMENTS OF DADE COUNTY, WITH NO DEVIATIONS.
Please Note: This form is not valid unless
Company logo appears in
color (burgundy)
7815 S.W. 24th Street • Suite 109 • Miami, Florida 33155 • Telephone (305) 264 -1425 • Fax (305) 264 -1426
UTR 16944
KETCH OF ROOF
JOB WO • _ S el. `02. 4.
SHEET NO. / 1 OF 1
CALCULATED BY DATE
CHECKED BY DATE
SCALE
■1111 61 ■PIII■ IIi •P2 S Iu 1■■■■■■
■■■■ir■\■S:■rl ■■ y■ ■s► ■Ir■I11 ■■■■■■
■ ■ ■ ■I■■ \■■■■`■■t`aiI %■7■ 111 ■ ■ ■ ■■■
■ ■l;flr ■f� ■�
■
■■■■Nram■ G�u■ irJ c :a ratroa■ ■o i,■ ■ ■ ■■■
■■■■c` it ■►■LJ11■■l ' ■f 1II ^Ai ■■■■■
■■ ■■I '■ ■/; ■■X711■■■ ■■� ■. i u!u!!I■■
1001 , , e
1
NOTES:
KETCH OF ROOF
WOMMINIMINUMOMEMIAMPAWk
pom mommimmagaimma
rl■■ ; ; EOMO INM■
dIWOMOWAIIMMILIMMUMUMEN
MilMIAMwavA /U► %l■PUMN■
MMEMMENJPAIMEFEMEGAMM
VA _ AaLJI IEILP'I M E
IMAIMEMN
151 `'�' �■ ?7i I■UUUi
riiiii 1
i i(r
111
lo t
A
1
RF
NOTES'
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 11-11-99 Job Address 150 N. E. 102 Street Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant Danny Rodriguez Master Permit # l 50./
Owner's Address 150 N.E. 102 Street Miami Shores, Phone 754 -1201
Contracting Co. Quality Roofing Contractor, Inc. Address 13800 N.W. 1st Avenue
Qualifier
Carlos Arocho
State# RC0058627
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Tear off old roof to wood deck, tin cap 301b. ASTM felt as per cod
install galvanized eave drip and valley metals where required, mop on with type
III asphalt one layer of 901b. ASTM felt, Install 4ns[hS Colorthru tile
with adhesive foam setting. '�er^-
Square Ft. 18 sq T i 1 Cm r n o f Estimated Cost (value) $ 7,000 .0 D
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR 111'IPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Municipal #
< < (Dat M
Sign a of owner and/or Condo '� t ent Date
VIa/1r �∎ ���Q 5
Notary as to O�'ner and/or Condo Presid ate
My Commission Expires: r
FEES: PERMIT /02. RADON
SS#
Notary as to Con >. ctor or
My Commission Expires:
C.C.F. NOTARY BOND _gee
TOTAL DUE 942.
APPROVED: �1
Zoning Building Electrical
Mechanical Plumbing Engineering
265 -14362 Phone
Competency # 17889 Ins. Co.
Signature of Contractor or Owner- Builder
MY COMMISSION 1 CC 880474
EXPIRES: October 10, 2001
F' Bonded Thai Notary Pubic UnderwrItere
751 -0382
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
99R62240 1 1999 DEC: 09 09:26
PERMIT NO. TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Legal description of property and street address: 1 5 0 N . E. 1 0 2 Street
2. Description of improvement: Rerocf to a new Tile roof .
3. Owner(s) name and address: Danny Rodriguez
Interest in property: Owner
Name and address of fee simple titleholder: N /A
4. Contractor's name and address: Quality R Dof ing Contractor, Inc.
5. Surety:(Payment bond required by owner from contractor, if any) ;ATE OF F: ORIDA, COUNTY 0= DADE
i HERE4Y CER(IFY f' this is a Pru �cop ; of fho
o "IJ "o f: u;tice on day
Amount of bond $ 00 C —
W ',NESS my h •nd and Offic
Name and address: N/ •�
6. Lender's name and address:
Miami Shores, Fiodda 33138
150 N.E. 102 Street Miami Shcres, Florida 33139
13340 N.W. 1st Avenge Miami, Florida 33168
N/
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address: N/A
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address: N /A •
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
ke. ►. Ill
Signature o A er
Print Owners Name Df�n% C 1 , \ t c1.; e
Sworn to and subscribed before me this / 1 day of
Notary Public
Print Notary's Name
My Commission Expires:
MARYLOU
MY COMMISS'r
EXPIRES: fir
Prepared by: Carlos Arochj
lity Roofing Contractor, In
n„a ;» •, MARYLOU HERNANDEZ 13800 N. W. 1=_
rr;
`,.E MY COMMISSION q CC 680474 Address:
EXPIRES: October 10, 2001 ::7L a 11.1 i . , Florida 3 3 1 6 si
BandM Thn, Nntxry Puhar I Inde(writro
123.01.52 1(Y0R
Contractor's Name: ua \ L - 1 1 Rnr 5 Ca/eta Job Address: 155 O tE _
❑ (Low Slope Application)
❑ (Asphalt/Fiberglass Shingles)
ROOF CATEGORY
❑ (Nail-On Tile) (Mortar- Adhesive Set Tile):
❑ (Metal Roofs\Wood Shingles & Shakes) ❑ (Other) ... .........
R00F TYPE
❑ New Roof M Re- roofing - ❑ Recovering ❑ Repair ❑ Maintenance
Flat Roof Area (ft') Sloped Roof Area (ft') •'� °,S `! . , Total (ft') / % s 7 . Master Permit No.
Exposure category (per ASCE 7 -88): � Building Classification category (per ASCE 7 -88 table 1): -�
Ft.
n
Field:.
t ypo' .,...
Fastener Type:
ROOF HEIGHT AND SYSTEM DETAILS
•• • (Draw details as needed)
TTACHM1NT
p PA CT 0
Perimeter: Corners
DETAIL 1 & 2
r
r
r
ROOF PLAN
127.01.74 998
. Appendix "E" .
UNIFORM ROOFING PERMIT APPLICATION
• . . PROCESS No. .
Page -1
Rld Ventlhtlonl
MEAN =CRT I,
(Plnax3: x X
Deck type:
z Underlayntent
buulatlon:
•
r2
D 8 T A I L. 7
maxl: e. �
( P X ?1, (Aerodyrwnlo Multiplier): 2,2.q )
yl ,
(Pmax2 :1 )_ X'�, (Aero
. nloMultiplier): 32- . IS )
.31 _
(Aerodynunlo Mu lUpl ler): 3 J )
Appendix "
UNEVORWI 12p OPNG PEST APPLICATION
' PROCESS No.
13"
aoo7 ei.o7
,SL OPED SYSTEM DESCRIPTION
&' ' o ,. Corner
Fastener typo do spacing:
pap Sheets
noo fCovering:
A . Drip edge:
TILL CALCULATIONS
M 1 1.10 e M ie : 21': PCA: !Q 0
M :' 9(1U M,. P) .a A PCA: (Q
- Me �.�� V1 a M .19-is PCA: ( Ct J
Page -2
•
r- r744' t1t`i
ATTACHMENTS REQUIRED
1) Fire Directory Listing Page
2) Dade County Product Control
Notice of Acceptance -Cover Sheet
a) Specific System Description
b) Specific System Limitation
c) General Limitations •
d) Applicable Detail Drawings
3) Municipal Permit Application
•4) Other Component Approvals
As it pertains to this Appendix "F ", it is the responsibility of the roofing contractor to provide the owner with the
required roofing permit, to provide the owner with this appendix and to explain to the owner the content of this
form. The provisions of Chapter 34 of the South Florida Building Code (SFBC) govern all the minimum
requirements and standards of the industry for roofing System installations. Additionally, the following items
should be addressed as part of the agreement between the owner and the contractor. The owner's initial in the
adjacent box indicates that the item has been explained.
Aesthetics - Workmanship:' The workmanship provisions of Chapter 34 are for the purpose of
providing that the roofing system meets the wind resistance and water intrusion performance standards.
Aesthetics (appearance) issues are not a consideration with respect to %vorkmanship provisions. Aesthetic issues
such as color or arcl:itect::ra! appearance, that nre not part of n zoning code, should be addressed as part of the
agreement between the owner and the contractor.
D 2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be renailed
in accordance with the current provisions of Chapter 29 of the SFBC. (The roof deck is usually concealed prior to
removing the existing roof system)
APPENDIX "F"
REQUIRED OWNERS NOTIFICATION FOR ROOFING CO\SIDERATIONS
. Common Roofs: Common roofs are those which have no visible delineation between neighboring
units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and /or
Wig. owner should notify the occupants of adjacent units of roofing work to be performed.
Exposed ceilings: Exposed, open beam ceilings are where the underside of the roof deckino can be
viewed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail
penetrations of the underside of the decking may not be acceptable. The SFBC provides the option of maintaining
this appearance.
S. Ponding Water: The current roof system and /or deck of the building may not drain well and may
cause water to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural
distress and may require the review of a professional structural engineer. Ponding may shorten the life
expectancy and performance of the new roofing system. Ponding conditions may not be evident until the original
roofing system is removed. Ponding conditions should be corrected.
1 3V 6. Overflow Scuppers (wall outlets): It is required that rainwater flow off so that the roof is not
overloaded from n build up of water. Perimeter /edge walls or other roof extensions may block this discharge if
overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance
with Chapter 23 of the SFBC.
Di\ r 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the interior
of the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It
may be beneflc,ial to consider additional venting which can result in extending the service life of the roof.
1 The owner may contact the Miami -Dade County Consumer Serviees Department for farther
information regarding the above.
l( i>/cp
D:Ite
Contrnccor's Signature
_ Peal -it' Fax Nola
I 7o
Cud Oem.
PAoM1b 4
Fa<r
SantafE Tile Corporation
Ladrillera SAnratti
Bogota, Colombia
Acceptance fro.: ')7. );;Mo;
Expires: 01/22/01
Approved: !1113; Cr13
A7 /017 /1 QCQ__ 1'1. AA •MAMEGLME
7671 o- '_`
From
Co.
Phcn• r
•
Revises `o. 96- 013,02
Fax.
PRODUCT CQNTROL JUITSIDF ACCEPTANCE PRODUCT CONTROL DIVISION
(305) 375.2902
FAX (305) 372.6339
Your appli. anion fur Product Approval of
Sanittiq 771,1 Corporation, i\'ail.On or.Slortar /.4d/res!vc Set Clay "Sanraja S" Roofing Tile
under Chapter S of the Metropolitan Dade County Code governing the use of Alternate ,Materials and Types or
Constructiun, and completely described in the plans, specifications and calculations as submitted by:
Bedlam' Technologies, The Center for4ppllgd Engi►tceting, Inc. and Testwell Craig Laboratories & Consultants,
Inc.
has been recommended for acceptance by the Building Code Compliance Department to be used in Dade Count,
Florida under the specitic*conditions set fork on Pages 2 through 7 and the standard conditions set forth on page 8.
The approval shall no; be valid after the expiration date stated below. The Building Code Compliance Office
reserves the right to Secure this product or material at any time for a jobsite or manufacturer's plant for quality
control testing. if this product or material fails to perform in the approved manner, the Building Code Compliar:cc
Office may revoke, modify or suspend the use of such product or material immediately. The applicant shall re.
evaluate this product or material should any amendments to the South Florida Building Code be enacted •ffetti:sg
this product or material. The Building Code Compliance Office reserves the right to revoke this approval, if it is
determined by the Building Code Compliance Office that this product or material fails to meet the requirements of
tnc South Florida Building Code. The eNptnte of such testing will be incurred by the manufacturer
BUiLPING CODE COMMITTEE
iTROPOLITAN DADE COUNTY. FLORIDA
METRO -DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE
METRO-DADE FLAGLER BUILDING
140 WEST FLAGLER STREET, SUITE 1603
MIAMI, FLORIDA 33130 -1563
(305) 375.2901
FAX (305) 375.2908
aul Rodrig cx
Product Control Supervisor
J-I IS TH C:OV)flS1 EET, SEF. ADDITIONAL PAGES FQR EtrCIEJC AND (.:EN>'RAL<
CONDITIONS
This application for Product Approval hat been reviewed by the Metropolitan Dade County Building Cod:
Compliance Department and approved by :he Code Committee to be used in Dade County, Flora under
the conditions set forth above.
Charles Danger,
Director
Building Code Compliance Dept.
Metropolitan Dade County
Homapage• http :/ /www.buitdingcodaoniine.com
-X
SANTAFE TILE CORPORATION
Aprliti:in;:
Santaff Tile Corporation
Lndt ilera Santafe
Bogota. Colombia
PRODUCT CONTROL NOTICE OF ACCEPTANCE
ROOFING SYSTEM APPROVAL
Cateeer.: Prepared Roofing
High Profile Tiie
'i'�QC: Nail- urAtortar Set/Adhesive Set
Sub -Tv oe: Clay
Product Dimensions
Sa :;raft S t'.'I ►;''R' ! 13"
Tilt w • ;1.5"
VI" :nick
Tarn P :e es I • varies
w • varies
varing thickness
07/07/1999 12 :44 3asssagaQs
System Description
Ladrillera Sa::taf4, located in Eogota,•Co1ombia, manufacturers clay roof the for nail.on and
mortar: adhesive sat applications. All Ladrillera Santafe tiles are available in standard unglayed ar.J a
glazed 4olor finish. This Produe I • v; , r to ' ";oval" tile nrotil'.
Refer to avwr, fate Product Control'Ar.nrnvals for (IT hert1ttt nrafilet.
Santa Ft: Tiie Corporation is ' the sole, approved distributor of Ladrillera Santafe roof tilts.
Contact:
Daniel Bernal
General Manager
Santafe Tile Corporation
8S2SNW9SSt
M\liami. Florida 33122 (2 31 7 g )
(305) 2854002/82S -0050
TRADE NAMES OF PRODUCTS MANUFACTURED OR
LABELED ITY .APPLICANT
Test
St ecllicatnns
ASTNt C 1167
ASTN1C 1167
Pap of8
ACCEPTANCE NO.: 9:211.2 .
Product Control No.:
Approval Date:
Expiration Date:
Product
D_r,5sEigtloq
9'x.0515.O
JanQan_ 199R
Janutwv 2 %1091
ns
High profile. one piece. clay roar : ::e
equipped with two nail holes. For t:.1::•
nn. :norui set i►nd adhesive set
applications.
Accessory trim, by roof pieces for
use at hips, rakes. ridges and valley
terminations. Manufactured for each
the oroflf 1� _
J
7<
orzga
Rooitng product Conte„!
. 1 V ./ L J J J
ic. -rr .7 U:JOOZO7OL0
I,UMH 1.H:7 ( LUKVUt(M I lU P ML . ei
SAST FE TILE CORPORATION ACCEPTANCE NO.: 7.t ,4tf.A5
TEST REPORTS
Test Agtnev Test Identifier Teat \'ame;Renrtrt • Dom:
The Center for Applied Engineering, Inc. 94.1 56.9 Static Uplift Testing Aug. 1994
PA 102
The Center for Applied En;ineerin;. Inc. 25- 7205 -1 Static Uplift Testing March 1995
PA 101
The Center for Applied Engineering, Inc. 94 - 156.3 Static Uplift Testing Aug. 1994
PA 101
Tht Center for A ;plied Eng.'netring, Inc. Protect: 07- 07- v0) -91 Wind Driven Rain Sept. 1994
(301023) PA 100
Redland Technologies
ktd:and Technologies
Rediand Technologies
Q71AZ1.1000 7'f.AA �aeee =aLn�
7161.03
Appendix 11
7161 -03
Appendix 111
7161.03
Appendix 111
Page 3 of 3
ALLAIN. • IL ALA
Wind Tunnel Testing De:. 1991
PA !Oa
(Nail -On)
Static Uplift Testing Dec. 1991
PA 102
Static Uplift Testing Dec. 1991
PA 102(A)
Re.:land Technologies P 0647 -01 'Wind Tunnel Testing Aug, 199$
PA IDS
(Mortar Set) •
Seeland Technologies P o631 -01 Wind Tunnel Testing July. 1994
PA 108
(Mortar Set)
Redlar1d Technologies P 0402 Withdrawal S ept. 1993
Resistance Testing of
Screw vs smooth
shank nails
Tcs:well Craig l shoratorics M: Consultants, Lab tS1R. Ph;sical Properties July 1994
lnc, r Tech: t). Suarez ASTM C 1 167
Frank Zuloaga
Rooting Product Control Examiner
SA`1'.. FE TILE CORk'ORATION
Uncle rinyment:
Rooting Tile:
Cornmtnt4:
0- "'1999 12:44
SYSTEMS
SYS'I'1:.1t F3:
Direct Deck Nail -on Application
Deck "Type: Wood, Non-insulated
Deck Description: :. w construction 19/32" or ° ater plywood or wood plank.
.,., x":13
. ,•
Slope Range: -1� :12
Note: Sy m 13 is o y acceptable in this slope range.
f rlaymtnt: Install. underlay • •t system in compliance with Metro -Dade County'
t ndc
Application St- dud 118.
ro -Dade County Application Standard PA
Roonniz'I'Ils: tnsrall tile ' compliance with . , �� i ro�•al.)
118. (Se Data for Attachment Cale ions ncluded in this App
Comments:
1. For re -roof applications, 15/ plywood is an Gceptable substrate.
SYSTEM D: Mortar or adhesive. Set Application
Deck Type: Wood, Non-insulated
peck Description: New construction 19, or greater plywood or wood plank.
Slope Range: =
Note: System D is only acceptable in this slope ranee.
Install underlayntertt system in compliance with Metro -Dade County
Application Standard PA 120.
Install tile in compliance with Metro -Bade County. Application Standard PA
120. (Sec "Data for Attachment Calculations" included in this Approval.)
1. For re -roof applications, 151 plywood is an acceptable substrate.
•
3056659626
• 1
Page 4 of R
A C: t.: k. Y t ,4.L 'h ..:� •
Frank Zuloaga
Rooting Product Centro! Examiner
COMA CAST CORPORATIO
PAGE 05
SANTA } - E TILE CORPORATION ACCEPTA CE NO.: 05!
SYSTEM LIMITATIONS
The standard minimum roof pitch for Ladrillera Santaft's " Santafc S" high profile tilt shall c:ompty
with f)ade County Application Standards PA 118, PA 119 or PA 120, depending on the method of
installation.
For nail - on applications, fasteners for mechanical attachment of tiles Shall have a heed diameter
larger than that of the prefortned holes in the tile.
3. System installation shall be in compliance with the system specifications outlined in this Product
Control Approval. The method of attachment utilized shall provide a minimum characteristic
resistance load greater than or equal to the required uplift resistance determined in compliance with
MMfetro -Dade County Protocol PA 115 or PA 127. The Ladrillera Santaf& "Santafe S" tile profile has
been tested for both wind characteristics and static uplift performance, therefore, attachment
calculations for inVallation in compliance with PA 115 or PA 127 shall be done as rtn 'Moment
Based System'
4. For mortar and adhesive set tile applications. a field static uplift test by a Metro - Dade County
accredited testing agency, in compliance with Metro - Dade County Protocol PA 106, shall be
performed. . .
5. All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo for
identification in the field.
6. For mortar or adhesive set the applications. 30/90 hot mopped underl,nyment application3 may be
installed perpendicular to the roof pitch prior to June I, 199$ unless stated otherwise by the material
m,nu.tfacturer. Thereafter, 30/90 underlaymertt systems shall be installed parallel to the roof pitch in
compliance with Appendix 'A of Dade County Protocol PA 120.
J. The applicant shall retain the services of a M tro -Dade County certified testing laboratory to
maintain quality control in compliance with the South Florida Building Code and related protocols.
07/07/1999 12:44 3056659626
Pate 3 of `t
COMA CAST CORPORATIO
Frank Zulaaga
Roofing frodu.:t Cr,ntrcl Examiner
PaPg AP.
Tito Profile
L..
Santafe S
ad 44 von 1,
07/07/1999 12:44 3056659626
DATA FOR ATTACHMENT
CALCULATIONS
Table 1: Aerodynamic Multipliers -%s. (ft')
Tile Profile
Nall -On, Direct Deck Mortar or Adhesive Set
Santare S Cla Roof Tile 0.34 1 0.31
Table 2: Restoring Moments due to GravIt M
The Profile 2:12 3 :12 1 4 :12 5:12
Santafe S 1 4.9 I 4.8 4. •4
Table 3: Attachment Resistance Expressed as a Moment. Mf (ft - Ibf)
I Two Approved One Approved Mortar het 1 Adhesive Set
Nails Screw ! I
21.8 j 18.4 23.6 1 61.9 — _j
Page 6 of
COM CAsr_['.n ppnDATrn
ft-lbf)
6:12 1 7:12
4.6 4.4
Frank Zuloaga
Roofing Product Control Examine;
.ANTAFE TILE CORPORATION
. '
ZROFILI: DRAWING
.....' Ir ?.."
e re lr >„// ..
c• of
ll*. .,s; ..fe .• ...,
P./ .41
•••
• .< .•*"......" •<:',:,•°.
4 ' . ..;%'" ie.%
t ..•.% - ../ . ..-v..„'d,.' ,
1 .".4 ... .r ) .,'
•.., %S
Pala 7 of $
uur<ruKA iu PAGE 08
ACCEPTA SCE NO.: 97-n5 c;05
LADRILLERA SANTAFE "SASTAFE S" CLAY ROOF TILE
Frank Zuloaga
Roofing Product Control Examiner
.47/0-70199 12:44 3056659626
S.aNTAFE TILE CORPORATION . ACCEPTANCE NO.: `t "-
Sant:tfc file Corporation
t-adrillera Santafc
)oFota, Colombia
COMA CAST CORPORATIO PAGE 07
Product Control No.:
Approval Date;
Expiration Date:
97- 0515.0;
januars 2 .)998
:' 2901
Nova OF ACCEPTANCE STANDARD COu1T[Q
Renewal of this Acceptance (approval) shall be considered after a renewul application has been tiled
and the original submitted documentation. including test supporting data, engineering documents, are
no older than eight (8) years.
Any and all approved products shall be permanently labeled with the manufacturer's name. city'.
state. and the following statement: ".Dada County Product Control approved ", or as specifically
stated in the ipecific conditions of this Acceptance.
Renewals of Acceptance will not be considered if
ai There has been a change in the South Florida Building Code affecting the evaluation of this
product and the product is not in compliance with the code changes;
b) The product is no longer the same product (identical) as the one originally approved;
c) if the Acceptance hoider has not complied with all the requirements of this acceptance,
including the correct installation ofthe product;
d) The engineer who originally prepared, signed and sealed the required documentation initially
submitted , is no longer practicing the engineering profession.
4. .Any revision or change in the materials, use, and/or manufacture of the product or process shall
automaticAlly be cause for termination of this Acceptance, unless prior written approval has been
requested (through the filing of a revision application with appropriate fee) end granted by this
office.
Any of the following shall also be grounds forzemoval of this Acceptance:
a) Unsatisfactory performance of this product or process;
b) lvf isusc of this Acceptance as an endorsement of Any product. for sales. advertising or any
other purposes.
o. The Notice of Acceptance number preceded by the words Dade County, Florida. and followed by the
expiration date may be displayed in advertising literature. if any portion of the Notice of Acceptance
is displayed. theft it shall be done in ile entirety.
A copy of this Acceptance as well as approved drawings and other documents. %%here it applies. shall
be provided to the uSer by the manufacturer or its distributors and shall be available for inspection at
the job sue at all times. The copies need not be resealed by the engineer.
8. Failure to cotnply with any section of this Acceptance shall be cause for termination and removal of
Acceptance.
9. This Acceptance contains pages 1, through 8 this last pace.
ENO OF THIS ApPROVAI<:-.
Page R of 8
u oaga
Roofin;. Product Control Examin,r
Square Ft. 5 s q
Sig
1
Notary as to 0' er and/or Condo President
My Commission Expires:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 5 -22 - Job Address 150 N.E 102 Street Tax Folio // 132_.04 - B /.3 /8 1 ®
Legal Description 6 4 4 5 3K j/
Historically Designated: Yes NNl, ✓
Owner/Lessee /Tenant Danny Rodriquez Master Perrnit N
Owner's Address 150 N.E . 1 0 2 Street Phone 754-1201
ContractingCoQuality Roofing Contractor, Inc. Address 251 N.W. 99th Street
Qualifier Carlos Arocho SS# 265 - 2_1- 4362__ Phone _751 -0.382__. _._ _
State # RC O O 5 R 6 7 7 Municipal # Competency N __L7 8 84_ _ - - -. — Its. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFI PAVING FENCE SIGN
WORK DESCRIPTION Tear off flat roof to wood deck, tin cap base sheet felt as per code
mop on with hot steep asphalt one layer of modified bitumen and install
metal eave drip.
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMM ENCENIENI•.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (it' applicable' I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I undcrsuui l that se pa: ale
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECDIANICAI. WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will he done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
/ 1
e of owner and/or Condo siden[ 1 Date
Date
xrstlrnuePan Wind 4relON myl P ,b$:'A°,-
L661 '01 1 s1 0 1 0 0 :3311Id)0
616KE 03 N NOISSIWW00 All
Z30NVNId3H f1O1AUW %a
Estimated Cost (value) .$ 1,500.00
FEES: PERMIT to 0.00 RADON ' C.C.F. 1. b 0 NOTARY
APPROVED:
Zoning Building
Mechanical Plumbing Engineering
2-
Signature of Contractor or Owner- Builder
/ 1
�-I A
Notary as to Con or Owner - Builder
My Commission Expires:
Electrical
W 9 hIlePUn Mind tietON rue PaPun ,•b :? &'�,
L881. '0t 4 o4o1a0 3NIdx3 = —
ULhdE 30 0 NOISSIMOO AIN ""'
ZKINVNN H ROVIVIN :fie' �'�
Date
— C 4
!)ate
'I'OTA. !)u! : CI_ o_o -
Job Address: /,SD ALE. 101 ST Contractorr ; I' ► .4 Process No.
GENERAL:
Type of Roof System Assembly to be Applied:
Manufacturer of Roof System Assembly:
Product Control Approval Number:
System Number from Product Control Approval:
(Attach a copy of the Roof System Assembly Product Control Approval and the Manufacturer's System
Guide Specification. )
12301 -188 994
( Note: If a minimum roof system is to be applied, describe all
components within the system and list the manufacturer of
each component. DO NOT complete this section if system is
Product Control Approved. )
Base Sheet:
Fasteners:
APPENDIX 'E'
METRO -DADE UNIFORM BUILDING PERMIT
SECTION II
BUILT -UP APPLICATIONS AND
MODIFIED BITUMEN SYSTEMS
Ply Sheet(s):
.Cap Sheet:
Asphalt:
mut : d / &4 ,„e4 fool
6-S EnoI ,-y NO(12-ted S -.s
95 o o . y
FR_ - 3
( Note: No insulation system is acceptable under the minimum
roof category. )
Complete the following for all Roof System Assemblies:
Built -Up Applications and Modified Bitumen Systems
Page -1
Job Address: 150 A), 6. ) 02 ST. Contractor / J.`6 tool Process No.
(Check one of the following)
Recover
If a recover, is the existing Roof System Assembly
to be used as a bonding substrate ?:
If YES, has an ASTM E907 test been carried out
to confirm adhesion of the existing membrane to
the substrate ?:
(If 'yes', attach ASTM E907 test report. )
Proposed Fastener:
(Attach withdrawal resistance test report. )
Has the deck been examined for moisture ?:
(Provide data confirming compliance with
Section 3401.9(c) . )
THE SYSTEM:
All Roof System Assemblies in the Product Approval have a variety of options. Briefly
describe the Roofing Components to be used in the Roof System Assembly and attach a copy of
the manufacturer's published specification:
Deck:
(Briefly describe )
Insulation:
( Type, size and method of attachment,
if applicable )
Base Sheet or Ply:
( Type and method of attachment )
Re -roof: ' / New Construction
W
1 ) In V 3
c 0, f 1 ).'" D.(
9"0.C. / a ps 6 "0.c.
Corn .ers `t- pet .
Ply Sheet(s): j 1
( Type and method of attachment )
Built -Up Applications and Modified Bitumen Systems
Page -2
r
Job Address: go a E. 10Z Sr. Contractor
s Process No.
PERIMETER DETAIL #3: Gravel Stop or Drip Edge
Sketds Roofing Components which make up Roof
System Assembly at Perimeter Edge with Gravel
Stop or Drip Edge.
Insert leaders indicating Roofing Components names,
dimensions, thicknesses, etc.
Include fastener type and spacing used for wood -
bkcking attachment
Gravel Stp Edge
Gage: to
Fastener
Spacing: '- o.c.
Clip Type: Q I p
Clip Gage: iJ t f-
Deck Type: (,t.)` 00 d ] Yet/
Sketch Roofing Components which make up Roof
System Assembly at Perimeter Edge with Guners.
Insert leaders indicating Roofing Component names,
dimensions, thicknesses, etc.
Include fastener type and spacing used for wood -
blocking attachment
Gutter Type:
)(
Gutter Gage:
Fastener
Spacing:
PERIMETER DETAIL #4: Gutter Detail
Built -Up Applications and Modified Bitumen Systems
Page -6
Job Address: IS® Xi. E. 1 D2 Sr. Contractor 141 ke) Process No.
PERIMETER DETAIL #1: Parapet Wall Detail
Coping Cap
Gage:
Fastener
Spacing: o.c.
Clip Type:
Clip Gage:
Vev/Z
Deck Type:
Sketch Roofing Components which make up Roof
System Assembly at Perimeter Parapet Walls.
Insert leaden indicating Roofing Component names,
dimensions, thicknes e , etc.
Include fastener type and spacing used for wood-
blocking attachment.
Deck Type: 1.0 00(1 I Yle 06
Sketch Roofing Components which make up Roof
System Assembly at Perimeter Areas to be Flashed.
Insert leaders indicating Roofing Component names,
dimensions, thicknesses, etc.
Include fastener type and spacing used for wood-
blocking attachment
PERIMETER DETAIL #2: Flashing Detail
Built -Up Applications and Modified Bitumen Systems
Page -5
Job Address: /SO it) , E. / Ot ST r Contractor Q, t ,c, �, ' - ) . 4 Process No.
T
inches
I _ inches
inches
FILL IN APPLICABLE ROOFING COMPONENTS WHICH MAKE
UP ROOF SYSTEM ASSEMBLY AND THICKNESS OF DECK AND
INSULATION LAYER(S). (Where Roofing Component not used in
Roof System Assembly, fill in with "N /A ".)
op Ply: Fr. [ GL4 P
3
Bonding Material: T �
7 \ Ply Sheet(a): iota
( u t mesh: ca r nn e as
Base Sheet: erg
Ir,G �n�2 i o 7 . c ap -C
4 - l n L. ? In " crarne
Bonding Material: (3 1/4 (ubau mser bond )
Surfacing:
(/nyly describe.
VaPPikabk
Fastener: I l
(u top rna/a,on yer
much. ormched)
Bonding Material: ply,-
Top insulation Layer: al l�
( i(apphcable )
Bonding Material: hi
( ifrop rnrulorion
layer bonded)
Fastener. t ) ri
(umull: non
mech. orroched)
insulation: I.) /A
Bonding Material: 0 /
( iru bonded )
Vapor Retarder.
F---- Primcr
(u�phe�eT'
DECK:
Type: (-0 D D
Gage or Thickness: 1 (n ✓lf
Density, if concrete deck:
Built -Up Applications and Modified Bitumen Systems
Page -4
Job Address: /5 0 i E. 1 sz. ST Contractor1 /, /Zoo y Process No.
Top Ply:
( Type and method of attachment )
Surfacing: &) ) f3
( Type, if applicable )
Flashing Materials: / 3t 1L1 1 /3 — i(40
( Type and method of attachment )
Fl, I $ b F /2 P qrl Arced
f7( s w . f-1 i wT OV 2c
4-yp e . — ) / ,
Built -Up Applications and Modified Bitumen Systems
Page -3
Job Address: /so 1J. E. 102 ST Contractor 2w, I, I Hof Process No.
PERIMETER DETAIL #5: 'Other' Detail
Sketch Roofing Components which make up Roof
System Assembly at any 'other' Perimeter Condition
which may eicisit
Insert leaders indicating Roofing Component names,
dimensions, thickesses, etc
Include fastener type and spacing used for wood -
blocking attachment
Sketch Roofing Components which make up Roof
System Assembly at any 'other' Perimeter Condition
which may exisit.
Insert leaders indicating Roofing Component names,
dimensions, thickesses, etc.
Include fastener type and spacing used for wood -
blocking anachment
PERIMETER DETAIL #6: 'Other' Detail
Built -Up Applications and Modified Bitumen Systems
Page -7
Job Address: /SO N • E. 10R Sri Contractor t tc, Koo13ny Process No.
Insert Building and Parapet Heights.
(If no Parapet costs, insert W/A ")
Also insert applicable information pertaining
to the building below.
(See ASCE 7 -88 Fact Sheet Attached)
Exposure Category:
Classification Category:
At Hurricane Oceanline ?: _ Y , ZN
•
Basic Wind Speed at
Building Location: 110 mph
Building Condition based on
% of Openings:
GROUND LEVEL
)13 feet
feet
BUILDING INFORMATION #1
Built -Up Applications and Modified Bitumen Systems
Page -8
s.
Job Address: Contractor Process No.
Reviewed Field Test Data ?: Y N
Notes:
Additional Notes:
Built -Up Applications and Modified Bitumen Systems
Page -11
Plan Examiner
Job Address: Contractor Process No.
— FOR PLAN EXAMINER USE ONLY —
Roof System Assembly Product Control Approved:
If NO, note any deficiencies:
Design Pressure Requirements:
Field: psf
Perimeter Areas: psf
Corner Areas: psf
Note any limitations:
Built -Up Applications and Modified Bitumen Systems
Page -10
Y N
Reviewed Details ?: Y N
Notes:
Job Address: /50 n). 10a S1. Contractor Ov,c1-) --1
Sketch Roof Plan indicating all dimensions, any slopes,
roof drains, crickets, or roof top equipment. Also insert
variable labeled "a" which indicates perimeter and corner
dimensions per Chapter 23 of the South Florida Building
Code.
( See ASCE 7 -88 Fact Sheet Attached )
T1
• J Co. ct , 7i -
BUILDING INFORM #2: Roof Plan with Perimeter and Corner.Dimensions
Built -Up Applications and Modified Bitumen Systems
Page -9
d1 I
Process No.
METRO-DADE
GS Roofing Products Company, Inc.
5525 MacArthur Blvd., Suite 900
Irving, TX 75038
The expense of such testing will be incurred by the Manufacturer.
PRODUCT NO. :
ACCEPTANCE NO.: 95- 0502.0 f (Revises No.: 9-1- 0531,0 41
EXPIRES: 09/12/97
APPROVED: 06/13/95
METROPOLITAN DADE COUNTY, FLORIDA
METRO -DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE
SUITE 1603
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET
MIAMI. FLORIDA 33130-1563
(305) 375 -2901
FAX (305) 375 -2906
PRODUCT CONTROL SECTION
(305) 37S -2902
PRODUCT CONTROL NOTICE OF ACCEPTANCE FAX (305) 372-6339
Your application for Product Approval of GS Roofrnp Modified Bitumen Roof Systems under Chapter 8 of the
Metropolitan Dade County Code governing the use of Alternate Materials and types of Construction, and completely
described in the plans, specifications and calculations as submitted by Applied Research Laboratories, Factory
Mutual Rescarch Corporation, Underwriters Laboratories and United States Testing Company, Inc. has been
recommended for acceptance by the Building Code Compliance Department to be used in Dade County, Florida
under the specific and standard conditions set forth herein.
The approval shall be valid for a period of three years. The Building Code Compliance Department reserves the
right to secure a product or material at any time for a jobsite or manufacturer plant for quality control testing. If
product or material fail to perform in the approved manner, the Codc Compliance Department may revoke, modify
or suspend the use of such product or material immediately. The Building Code Compliance Department 1cs;crves
the right to require testing of this product or material should any amendments to the South Florida Building Codc be
enacted affecting this product or material.
Raul Rodriguez
Product Control Division
Supervisor
- PLEASE NOTE -
THIS IS THE COVERSHEET. SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
CONDITIONS.
BUILDING CODE COMMITTEE
This application for Product Approval has bccn reviewed by the Metropolitan Dadc County Building Codc
Compliance Department and approved by the Building Code Committee to be u. d in Dadc Cot Florida under
the conditions sct forth above.
Charles Danger, P.E., Director
Building Code Compliance Department
Metropolitan Dadc County
NQTICE OF ACCEPTANCE: ST&W)ARI) C .NDITJONS
I . Extensions of Acceptance may be considered after a new application has been filed and the supporting data,
test reports no older than ten (10) years, have been re- evaluated.
All reports of re- testing shall bear the seal, signature and date of an engineer registered in the State of
Florida.
Any revision or change in the materials, use, or manufacture of the product or process shall automatically be
cause for termination, unless prior approval is granted for revisions or change.
3. Any unsatisfactory performance of this product or process or a change in Code provisions shall be grounds
for re- evaluation.
4 . This acceptance shall not be used as an endorsement of any product for sales or advertising purposes.
5. The Notice of Acceptance number preceded by the words Dade County, Florida, and followed by the
expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is
displayed, then it shall be done in its entirety.
6. Product approval drawings, where required for permit applications, shall be provided to the applicant by the
manufacturer or his distributors unless otherwise noted in the Notice of Acceptance. The prints need not be
re- sealed by an engineer.
7. Failure to comply with the Standard Conditions shall be cause for termination of the Approval.
This Product Control Approval supersedes No. 9.4- 0531.04
Raul Rodriguez
Product Control Division
Supervisor
Product
Rawlite 3" Plate
Aluma- l3ritc No.
120
Test Product
Dimensions Specification Description Manufacturer
Olympic 3.25" round PA 114 Polypropylene Olympic
Polypropylene plastic plate Manufacturing .
Group, Inc.
Olympic Standard 3" round PA 114 3" round galvalume Olympic
AZ55 steel plate Manufacturing
Group, Inc.
Fiberglas various PA 110 fiberglass roof insulation Owens - Corning
Fiberglas Corp.
Paroc Cap Board various PA 110 Rockwool insulation Partek, Inc.
UltraGard Gold various PA 110 Polyisocyanurate foam Schuller
insulation International Inc.
Rawl 2" Plate 2" round PA 114 2" round galvalume AZ55 The Rawlplug
membrane plate Company Inc.
Rawl 3" Plate 3" round PA 114 3" round galvalume AZ55 The Rawlplug
steel plate Company Inc.
IZ iwlitc PA 114 • Insulation fastener for The Rawlplug
cententitious and gypsum Company Inc, .
decks
3" round PA 114
3" round galvalume AZ55
steel plate for use with
Rawlite fasteners
Product Control No.: 95- 0502.04
The Rawlplug
Company Inc.
R 2 100 - Modified 1, 5, 55 ASTM D 3019 Rubberized all - weather Tropical Asphalt
All weather gallons, also (Type III) and flashing cement. trowel Products Corporation
Flashing Cement available in D 3409 grade. modified adhesive.
10.5 ounce
caulking
tubes.
PA 121 Fibratcd aluminum roof Tropical Asphalt
coating. Products Corp.
9
Raul Rodriguez
t•
Test
Product Dimensions Spec ificatio
E'NRG'Y -2 Plus various PA 110
E'NRG'Y -2 various PA 110
N.T.Q. Magnum PA 114
N.T.Q. Spin
Weld Plate
2" round
N.T.B. Plastic Platc 3" round PA 114
N.T.Q. Plate PA 114
Olympic Fastener PA 114
12
Olympic Fastener
g
Olympic CR Basc
Felt Fastener and
Qasc Sheet Disc
Olympic Fastener
PA 114 2" round amorphorus nylon Olympic
locking plate for use with Manufacturing
N.T.B. fasteners with 1" Group, Inc.
• head
PA 114
PA 11•4
PA 114
s
Product
Description
Polyisocyanuratc foam
insulation
Polyisocyanuratc foam
insulation
Glass reinforced nylon
fastener for use in gypsum
and ccmcntitious wood
fiber decks.
3" round polypropylene
stress plate for usc with
N.T.Q. fastcncrs
3" round galvalume AZS5
plate for usc with N.T.I3.
fastcncrs
Insulation fastcncr
Insulation fastener
Insulation fastcncr
assembly for Base Sheet
fastening only
Insulation fastcncr
Raul Rodriguez
Product Control No.: 95- 0502.04
Manufacturct
NRG Barriers, Inc.
NRG Barriers, Inc.
Olympic
Manufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Olympic
Manufacturing
Group, Inc.
Karnak 97 AF
Karnak 97
IEQ1L1
Per lite Insulation various
Red Rosin various
Roofing Nails
Tin Caps
al MB aluminum
roof coating
Mousey MBA Gold 1. 5, 55
rMlembranc gallons
Adhesive
Pro`;radc Fibcrcd
Aluminum
E'NERG'Y PSI -25 various
E'NRG'Y -I
Dimensions
Minimum # PA 114
12
Min. 32 ga. x
l s
Test
S.ppecification
PA 110 Perlite insulation board
Product
Description
PA 121 Roof
7
Rosin paper for barrier
layer on wood decks
Corrosion resistant annular generic
ring shank nails
Corrosion resistant circular generic
discs.
PA 121 Aluminum roof coating
Karnak S1 AF 5, 55 gallons ASTM D 3019 Cold applied SBS modified Karnak
Modified Bitumen type 111, ASTM adhesive for application of
Adhesive (Trowel D 3409 SBS modified bitumen •
Grade) systems.
Karnak
PA 121 Roof coating Karnak
ASTM D 3019 Fibratcd, rubberized cement
type 111 for bonding modified
bitumen membranes.
PA 121 Fibratcd aluminum roo
coating.
PA 110 Polyisocyanuratc foam
insulation
various . . PA 110 Polyisocyanuratc foam
insulation
Raul Rodriguez
Product Control No.: 95-0502.04
./lanulac(urer
gcncric
generic
Grundy Industries
Karnak 81 AF 5, 55 gallons ASTM D 3019 Cold applied SBS modified Karnak -
fvlodificd Bitumen type 111, ASTM adhesive for application of
Adhesive (Brush D 3409 SBS modified bitumen
Grade) systems.
Monscy Products
Co.
f Monscy Products
Co.
NRG Barriers, Inc.
NRG Barriers, Inc.
Product
Dek fast Fasteners
"I5
Dekfast Fasteners
1/12
TPR
Elastizell
FM-30, FM -45,
FM -60, FM -90
Fasteners
Nail -Tite Type 'A'
Nail -Titc Type 'R'
GAFTITE
Asphalt Emulsion
Gardner Cold
Process
Roof Cement
Asphalt
Asphalt Primer
Test
Dimensions ,Specification
PA 114
PA 114
PA 114
PA 110
PA 114
PA l 14
PA 114
various PA 114
PA 121
High Density Wood various PA 110
Product
Description
Insulation fasteners for
concrete decks
ASTM D 41 Asphalt Primer
Fiberboard board
6
Insulation fastcncr for steel
and wood decks.
Aluminum fastener for
lightweight, gypsum and
tectum decks
Cellular insulating concrete
system
Base ply fastening systems
for lightweight concrete
decks
Galvanized steel base ply
fastener for lightweight
concrete decks
Galvanized steel base ply
fastener for lightweight
concrete decks
Base sheet fastening
system.
Asphalt emulsion
1, 5, 55 ASTM D 3019 Fibcred asphaltic general Gardner
gallons Type III purposc lap and ply cement.
ASTM D 312 Type III or IV hot asphalt
bitumen adhesive
Wood fiber insulation
Raul Rodriguc
Product Control No.: 95- 0502.04
Manufacturer
Construction
Fasteners Inc.
Construction
Fasteners Inc.
Creative
Construction
Components
Elastizcll Corp.
ES Products, Inc.
ES Products, Inc.
ES Products, Inc.
GAF
Gardner
generic
generic
generic
Product
Hy Therm
Pyrox
APOC212
Sunbright 400
MBA
ACFoam II
Ccicorc
Anchorbond
Fastener
Anchorbond LCW"
lightweight
Concrete fasteners
High Density various
Fiberboard
Dckfast Fasteners
"14
Dckfast I -Iex Plate
TRADE NAMES OF PRODUCTS MANUFACTURED BY OTHERS
Dimensions
various
various
various
27/8 "x
3 1/4"
Test
,$pecificatiou
PA 110
PA 110
PA 121
PA 121
PA 110
PA 114
PA 114
PA 100
Dckfast Lock Plate 3" x 3 1/4" PA 114
ASTM 3019
Type III
Product
Descriptiort
Polyisocyanuratc foam
insulation
Polyisocyanuratc foam
insulation
Aluminum roof coating.
Roof coating
Asphalt based cold applied
adhesive.
Polyisocyanurate foam
insulation
Insulation fastener and
metal or plastic plate
Base ply fastening systems
for lightweight concrete
decks
Wood fiber insulation
Product Control No.: 95- 0502.04
Manufacturer
Apache Products Co.
Apache Products Co.
APOC, Subsidiary of
Gardner
APOC, Subsidiary of
Gardner
APOC, Subsidiary of
Gardner
Atlas Energy
Products
PA 110 Cellular insulating concrete Celcorc, Inc.
system
Cclotex Corp. •
Cclotcx Corp.
Celotcx Corp.
PA 114 Insulation fastener for steel Construction
and concrete decks Fasteners Ind.
PA 114 Galvalumc hex stress plate. Construction
Fasteners Inc.
5
Polypropylene locking
plate.
Raul Rodriguez
Construction
Fasteners Inc.
4
Raul Rodriguez
Product Control No.: 95- 0502.04
Test Product
Product Dimensions Specification Description
Flintlastic FR Cap 39'/," x 34' 2 "; ASTM D 5147 Fire resistant, granule surfaced SBS
Roll weight: 90 Modified Bitumen membrane with
lbs. fiberglass mat reinforcement for mop
(1 square) applications.
GLasBaseTM Base Sheet 36" x 108'; Roll ASTM D 4601 Asphalt coated, fiberglass base sheet.
weight: 69 lbs. UL Type G2
(3 squares)
Poly StMMS Base Sheet 39 '/," x 64' 4 "; ASTM D 5147 Modified Bitumen, coated polyester
Roll weight: 90 base sheet.
lbs.
(2 squares)
Yosemite® Mineral 36" x 36'; Roll ASTM D 249 Mineral Surfaced organic cap and buffer
Surfaced Cap Sheet weight: 90 Ibs. UL Type 30 sheet.
(1 square)
Stormshield 36" x 75'; Roll PA 103s Slag surfaced SBS Modified Bitumen
weight 76 Ibs. sheet with fiberglass reinforcement for
(2 squares) peel and stick application.
Product
All Weather /Empire
Base Sheet
Flex- I- GIasT^t Base
Sheet
Flex- I- GIasTM FR Base
Sheet
Flintglas® Ply Sheet
Type IV or VI
Flintlastic STA
Flintlastic GTA
Flintlastic GTS
Flintlastic GMS /GMS 39 x 34' 2 ";
Premium Roll weight:
i00/105 lbs.
(1 square)
Flintlastic FR/FR -P
Premium
TRADE NAMES OF PRODUCTS MANUFACTURED OR
LABELED BY APPLICANT
Dimension'
36" x 72'; Roll
weight: 86 Ibs.
(2 squares)
36" x 108'; Roll
weight: 90 Ibs.
(3 squares)
39 '/," x 50'; Roll
weight: 90 Ibs.
(1.5 squares)
36" x 180'; RoII
weight: 40/55 Ibs.
(5 squares)
39 '4" x 33'; Roll
weight: 90 lbs.
(1 square)
39 x 33' 3 "
Roll weight: 105
lbs.
(1 square)
39 '4" x 24
Roll weight: 92
lbs.
('h square)
39 '4" x 34' 2 ";
Roll weight: 105
Ibs.
(I square)
Product Control No.: 95- 0502.04
Test Product
Specification Description
ASTM D 2626 Asphalt coated, organic base sheet.
UL Type 15
UL Type G2 Modified Bitumen, coated fiberglass
base sheet.
UL Type G2 Modified Bitumen, coated fiberglass
base sheet.
ASTM D 2178 Fiberglass, asphalt impregnated ply
Type IV or VI sheet.
UL Typc G I
ASTM D 5147 Smooth surfaccd, APP Modified
Bitumen membrane with non -woven
polyester mat reinforcement for torch
application.
ASTM D 5147 Granule surfaccd, APP Modified
Bitumen membrane with non -woven
polyester mat reinforcement for toch
application.
ASTM D 5147 Granule surfaced, SBS Modified • •
Bitumen metitbranc with non -woven
polyester mat reinforcement for torch
application.
ASTM D 5147 Granule surfaccd SBS Iviodif ed
Bitumen membrane with non -woven
polycstcr mat reinforcement for mop
application.
ASTM D 5147 Fire resistant, granule surfaccd SBS
Modified Bitumen Membrane with
non -woven polyester mat reinforcement
for trop application.
3
Raul Rodriguez
Applicant:
GS Roofing Products Company, Inc. (MB)
5525 MacArthur Blvd.
Suite 900
Irving, TX 75038
Category; Membrane Roofing System
Sub - Category; Built -up Roofing
Type: Modified Bitumen
Sub -Type: SBS /APP
PRODUCT CONTROL. NOTICE OF ACCEPTANCE
ROOFING SYSTEM APPROVAL
System Description
GS Rooting Products Company, Inc. manfuactures and markets nationally a complete line of residential
and commercial BUR and modified bitumen products. GS Roofing Products Company, Inc. markets
these products through local distribution in the South Florida jurisdiction.
GS Roofing products and systems arc the result of years of manufacturing, experience and product
development and have been proven by years of experience in the construction field.
GS offers a variety of approved insulated and non - insulated roofing systems. For detailed system
constrictions, refer to the following publications: "Commercial Roof System Specification Manual" and
"Flintlastic Roof System Catalog."
GS products and systems have been tested in compliance with all provisions of the South Florida
Building Code as well as Underwriters laboratories, Inc., and Factory Mutual Research Corporation for
fire and .vind uplift resistance.
GS provides - technical service and warranty information through regional offices. For the South Florida
Mctro -Dadc area, call 1 -800- 777 -2563.
Contact:
Pat Neuhaus
Commercial District Manager
2900 Bird St.
Charleston Heights, SC 29405
(803) 744 -7451
Raul Rodriguez
Product Control No.: 95- 0502.04
Approval Datc: JUN 1 3
expiration Datc: 09/12/97
1,,.: :,s O.:1 1,0e 02 nJ led
.l •:rndr.In° 7 nntl4St•C GMS
Dee- C 15/32 Inom° 1/2
Iniula::pn: Cetole• rly.tec'. 2 in m . loin's •n .nsula: on mull be offset b in
pee• mecnan.c ally fastened •' ,,,
Base Sheet: type G2. mechanically laSlened or .IChered w,Ih 301 roofing aSphah
Momhrane: Fhntlastic GMS" `GM5 ?rem, or '01.15 Black Diamond"'. adhered
roo:•ng asphalt
Surtar.,ng. gav
Dec'. C 15/32
In ;ula : Ceuole, H•Tec 2 •n mi , 1p.niS .n •nsulal•on most be bllsel 5 in
deck_ mechanically fastened.
Base Sheer: Type G 2. mechanically tas;ene_o or adhered .vets not rooting asphalt
Membrane: Ffintlastic STA'', "GTA'"- "GTA Black Diamond or "GTA APP While D•amon.
heal fused
Sur facing: Greve!
Incline. 1/2
(0.31S in .nsulalion rnutl bC 011131 5 .n l,um :o•nti
Class A - Fully Adhered
Dock: NC Incline: 1
Vapor Retarder: (Optional) Type G2 ""Glasoase oast sheet 0r UI Classified vapor retard,
Insulation: (Optional) One or more layers or coin „nation of the lollowing: Ullragard ?rem..,
polyisocyanurate. perlite. glass fiber or wood fiber insulation.
Base Sheet One layer of Type G2 ""Glasbase"" base sheet.
Membrane: One layer of '"Ffintlastic GTA (-3 /4 sq or -1 sot. GTS (modified bitumen), he,,
[used or ' " Ffintlastic GMS " hot mopped.
Surfacing: APOC ""No. 212 Fibrated Aluminum". at 1•1/2 gal. 100 sq/tt.
2 Deck: NC Incline: 3/4
Vapor Retarder: (Optional) Type G2 ""Glasbasd" base sheet or UL Classified vapor retaroe
Insulation: (Optional) One or more layers or combination of the following: Ultragard Premise.
polyisocyanurate. partite. glass fiber or wood fiber insulation.
Base Sheet: One layer of Type G2 ""Glasbase'" base sheet.
Membrane: One layer of 'Ffintlastic STA (modified bitumen), heat fused.
Surfacing: Karnak "No. 97 Fibrated Aluminum at 1 -1/2 gal. per 100 soft
3;. Deck: C- 15/32'3 Incline: 1/2
Insuletiorc (Optional) Mann le -Ultra Gard Premier', pohisocyanurate, wood fiberboard. pew
liter ltberg1a33 isocyanurat6;arri thkkness_
Base Shoat One or more plies of "Glasbase hot mopped or mechanically fastened.
Membranes One ply of - Ffintlastic Fir (modified bitumens hot mopped in place.
4. Deck: NC Incline. 1/2
Insulation: Polyisocyanurate, glass fiber. partite, wood fiber. hot mopped or mechanically las.
toned. any thickness.
Base Sheet Type 62. mechanically fastened or hot mopped.
Membrane: ": ffintlastic GTA or STA heat fused.
Surfacing: Henry Co. - Henry 520 Aluminum'. applied at 1 -1/2 gal/sq.
5. Deck: NC Incline: 1/4
Insole lion: (Optional) Glass fiber. partite or wood fiber board.
Ply Sheer. Type G2. mechanically fastened.
Membrane: "Ffintlastic STA"". 'GTA "GTA Black Diamond"' or "GTA White Diamond. hear
Iused.
Surfacing: Karnak Chemical Corp. "'Karnak No. 97 1 gal/so.
5. Deck: NC Incline: 1
Insulation: Polyisocyanurate, glass fiber. partite, wood fiber, mechanically fastened or adhered
with hot rooting asphalt any thickness.
Base Sheet Type G2. mechanically fastened or adhered with hot roofing asphalt.
Membrane: ""Ffintlastic GMS - GMS Black Diamond or - GMS Premium - , adhered with 1,01
roofing asphalt.
Surfacing: Karnak Chemical Corp. - Karnak No. 97 Fibrated Aluminum Asphalt Roof CO3 Ong
2-1/2 gat/so.
Deck: C•15/37' 10010,0: 1
'All 'Dints blocked with 2, a's
13 sula lion: Glatt fiber, 0, 3/ •n
deck, mechan.Calty fattened
Base Sheol; typo 07. meChen.Calty Islr:ned u adhered ..illy 301 r001(n,; asph.,ll
P.lombrano: rhnllet,•C G'-IS adhered ...eh 1(01 ru01•n9 asphalt
„rlecing: ea, ak Chem.cal Cnrp K.eres.ee, N" 'j1 :•hreecll.11orn.n..". l:ph.,11110•11'. use•'•)
1/2 9.11 /13
Doc :IC L.cbno • ., -
In „1:.1.00; ' r.,,r .11..55 1.1rer a,:rnln .runt 1,1(rr 'net on, 1.... r...,l n
.•...n rnnl•,, , :ph.,: ., ('.
'1.•,. .hn.,t ,., r; .,., ,,•• 1 ,..•••.1 .. e,tr•,•,.,J ..,In ..n re...
pica., •
vi /so
Sack :n.
EMS "l it
.u/
I _ ea 3 31
.,. • 1>.. . i. .. -. :lnl. r...,,.o..J
GAtS
n 913Ce
Surf aC n() fir •.. .., '•I ... • , :.td ., I.,r ....• 1 1nC1.,. ..
•
Deck: C 15/32
•
[nph. >n a.l 017 a -. . 101,33014'_, ;jla 1. 1 •b -:• t. ..n>n.Cad, 1.,•.
In solo :,on •.C• "� : p r
le nod. 'pint: . m •n •n sulauu : no1: a , 311531 5 ,n :rp to.nls on ' _
83,o Shoot: type 02 base /p :poet. ,neChen'Celly las:ened.> -hopped
Pty Sheet: Typo G2 b a:e /71.1 :h>et, mechanically fastened or not mopped
Membrane. "Flinllas:.c STA 0f '•unite Diamond' or G:.k 90;11 D•a'^oncl
Su,lacin9: Grundy al :.t3 al Roof Coating at 1 to 2 gal Sa
11 Deck: TIC 1001(".1: 1/2
Insulation: IOo■ona9 ?oly.t0cvanurat3, glass 1(ber pert.te wood 1,04 en/ combinahon. any
thickness. mechanically :asten30
Baso Shoal: Typo 62. Flee.i.9I • or ""FIindaslic FR Base . mechanically fastened Or adhered
will hot rootin asphalt Fit
Membrane: ' "Fli ntlau.c ;a? Fhnl3slic Premium FR. ?', r;n hat's :R/G" or "Fl,ndastic
Cap". adhered wit:, hot roofing aspna11.
12. Deck: C-l5/32' lnu.na: 1/3
'AB joints in deck blocked w.tn
Insulation: (Optional) Poly,socyanurate. glass fiber. Oeeite, any C00vmat•on, en3 thickness.
mechanically fastened
Base Sheet: Type G -2. mechanically laslened or adhered •••th hot r0olin9 asphalt.
Membrane: " FIindas:,c 20.3 Fiin:lastic Premium FR- ?"" or FfinllatoC- 0JC', adhered with
hot rooting asphalt
17. Deck: NC Inclmr. 1/2
Insulation: (OplionalLEPS. an, thickness. covered with 1/2 in min pert.te Or Hood fiber. me-
chanically fastened.
Base Sheet: Type G2, mechanically fastened or adhered with hot roofing asphalt.
Membrane: - Ffintlastic 20-? "ftintlastic Premium FR-P"' or "Ffintlastic- FR/G"", adhered with
hot roofing asphalt.
14. Dock: NC Incline: 1/2
Insulation: Polyisocyanurate. glass fiber. perlite, wood fiber. any combination. any thickness.
mechanically fastened.
Base Sheet: Type G2 or " Flea-=- glas"", adhered with hot roofing asphalt
Ply Sheet "GS Poly"bas• adhered with hot roofing asphalt
Membrane: - GMS'", adhered with hot roofing asphalt
Surfacing: Karnak Chemical Corp. Karnak No. 97 Fibrated Aluminum Asphalt Roof Coating'_
at 2.1/2 gaVsq.
15. Deck: NC Incline: I/O
Insulation: phalt (Optional) Polyisocyanurate, glass fiber. partite, wood fiber. any combination. any
thickness. mechanically fastened or adhered with hot roofing asphalt.
Base Sheet Type G2 or "Flex= -glee . mechanically fastened or adhered with hot roofing as-
Ply Sheet (OptlOnal) Type G2 or 'Flea-[ -glas . mechanically fastened or adhered with hot roof•
ing asphalt.
Membrane: ' Ffintlastic GMS - GMS Premium - GMS Black Diamond or 'GMS Whits Dia-
mond'. adhered with hot roofing asphalt.
Sot., a urfacing: ll Asphalt Products Oil Corp. "APOC -400 Sunbrite - . 3 gaVsq.
16. Deck: C-15/32 Incline. 1/4
Insulation: Glass fiber, perlite• 1 in. min. joints in insulation must be offset B in. from joints in
deck, mechanically fastened.
Base Shoat Type G2 or 'Flea- i.glas - , mechanically fastened or adhered with hot roofing as.
Ply Shoot (Optional) Type G2 or - F1eai -9133. mechanically fastened or adhered with hot roof-
ing asphalt
Membrane: " "Ffintlastic GMS - GMS Premium', "GMS SOS Black Diamond "" or "GMS SBS
White Diamond'. adhered with hot roofing asphalt
Surfacing: Asphalt Products Oil Corp. - APO4a00 Sunbirite", 3 gal /sa.
11. Deck: NC Incline: 1/2
Insulation: (Optional) Polyisocyanurate perlite, 91031 fiber or wood fiber. any thickness. me-
chanically fastened or hot mopped in place.
Bose Sheet One or more layers of Type 52 or - Flex- i- glas mechanically fastened or hot
mopped in place.
Ply Shoot. (Optional) One or more layers or Tyr•ss G1, G2 of "Flea - :glas mechanically fat
lened Or hot mOOped in place.
Memb,eno: 'Flin1f3s11c GTA " - "GTA Black Diamond" "GTA While Diamond "" or ""STA"'. heal
fused.
urlocing: S.3.nak Ch Cn 'NO 91 300 at 1.1/2 931/50
13 Geck; NC InClin3; 1 /•1
9(351 I.bnr mac hamc.,ny lastennd or not 1/'000311 in //lace 2 m
„• • lh,ckness.
ilaao Shoot O . , , J r . l a Y r r l , t ,p+ G2 tl • .III,: . echen.c+e•, 1. ✓.t00e1 0 hp,
.nn Otsed m place
1 ' 1 '2 ':hoot: tOpt.on a ll ;/„• .n more I . . f ' : ' s 01 1 , 1( 3 - . 1.1 t,: :le.. (j or 1.'i r,,I 1. :e
an•f.all•, '3513 '.•1 .r r•.,, , 0031.31(1 .r 1.,, .•
.. ....1r,n., ..1., . 1., .tl I• ,1, .. .. , .1111 .. ,.1
SPEC. NO. FR -2 -3..
For use over nailabie decks
.t;: F.f�= fi.►: Y Pi�P ► ii 1 • r ti Z . 3 ' 1 ��Y�'i l ��h:'R.Y I4 %;�L �i�.11�Y`l4��iC .
Membrane:
One ply of GLASBASE base sheet and one
ply of FLINTLASTIC FR modified bitumen
roll roofing.
Summary of Materials:
Per 100 Square Feet •
GLASBASE Base Sheet (1 ply) .. 23 lbs.
Type III Asphalt Solid Mopping .. 25 lbs.
FLINTLASTIC FR roll roofing (1 ply) 100 lbs.
Approximate Total Finished Weight 148 lbs.
without optional surfacing
.9 .
Membrane Type: SBS
Deck Type 1: Wood, Non - insulated
Deck Description: " /,_" or greater plywood or wood plank decks
System Type E(1): Base sheet mechanically fastened.
All General and System Limitations apply.
Base Sheet: Onc or more plies of GS Glas Base, GS Flex-1 Glas Base, Flex -1 Glas ER Base or
GS Poly SMS bast mechanically fastened to the deck as detailed below.
Fastening: Base sheet shall be lapped 4" and fastened with approved roofing nails and tin caps
9" o.c. in the lap and two rows staggered in the center of the sheet 12" o.c..
Ply Sheet: (Optional) See products listed under 'Base Sheet' above, or one or more plies of
GS Flintlastic Ply IV or Ply VI adhered to the base sheet in a full mopping of
approved asphalt applied within the EVT range and at a rate of 20 -40 lbs. /sq..
Membrane: One ply of Flintlastic FR -P Flintlastic FR Cap, Flintlastic GMS, Flintlastic
Premium GMS adhered to the bast sheet with approved mopping asphalt applied
within the EVT range and at a rate of 20 -40 lbs. /sq.: or Flintlastic GTS Torch
adhered to the base sheet.
Surlacing: (Optional) Install one of following:
I. 400 lb/sq. gravel or 300 lb./sq. slag in a flood coat of approved mopping;
asphalt at an application rate of 60 lb./sq..
2. Karnak 97 or APOC 212 Fibratcd Aluminum at an application rate of I '/
gal. /sq..
Maximum Design
Pressure: -45 psf.
Maximum Fire
Classification: Class 'A'; see General Limitation 4
rvlaximutn Slope: 1:12; scc General Limitation 113.
Spccilication No.: GMS 2 -3, FRP 2 -3, GTS 2 -3, FRBC 2 -3
35
Raul Rodriguez
Product Control No.: 95- 0502.04
Fibrous glass
Perlite
Fiberboard
Rockwool
Polyisocyanurate
Polyisocyanurate Composite Board
Maximum Design Pressures
Material Design Pressure
Wood -60 psf
Steel -60 psf
Concrete -135 psf
Lightweight Concrete -45 psf
Cementitious Wood Fiber -52 psf
Poured Gypsum -52 psf
Maximum Fire Classification
Material Classification
Wood Class A
Steel Class A
Concrete Class A
Lightweight Concrete Class A
Poured Gypsum Class A
Product Control No.: 95- 0502.04
Note: Fire classifications and maximum design pressures do not reference all assemblies over
fleck types. Review system listings for design pressures and the Undcnvritcrs Laboratories
Roofing Materials Directory or other approved testing agency listing directory for Fire
Classifications. - -
Raul Rodriguez
•
Test A :cngv /Identifier
Applied Research
Laboratories
Underwriters
Laboratories
United States Testing
Company, Inc.
Name
Physical Properties
Factory Mutual Research Current Insulation
Corporation Fastening Requirements
Fire Classification
Compliance
ASTM D 5147
ASTM D 5147
Test Reports
I0
Report
25013
FM RC 1994
RI 190
97457 -4
97- 457 -2R
Raul Rodriguez
Product Control No.: 95- 0503.04
Date
06/02/37
01/01/94
07/13/87
06/03/88
1 2/02/87
Date
Legal Description G /
Owner / Lessee / Tenant
Owner's Address
Contracting Co. 4J a ")
Qualifier Al)
#61;(00/374 #
State
Architect /Engineer
Bonding Company
Mortgagor
Permit Type(circle one):
WORK DESCRIPTION
REq7Z_Avot 'am
1'a - tea'- VG MICK,
Square Ft. 1/00
Notary
My Commi
** *
FEES: PERMIT
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
3 Job Address /5 / OZ *- Tax Folio // . / ?77
0
sJi
Q1 11 2 - 01 : - / L L I rvG4.
SS #A0/ - 24 - 7b07 Phone 3 /1 'S
Competency # Ins.Co. 62-4)
Address IV/9
Address / 44
I //4 Address A:0
BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
/
At-A
SAILt Ti
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is ccurate and that all work will
be done in compliance with all applicable laws regulating constru n and zoning. Furthermore, I
aut ize the a ' . ve- named contrf.o'r to Ao the work stated.
'
Signature of owner and /or Condf{ President Signat
Date: /1 , , 1 _ Date:
jUlair Y1./
to Owner and /or Condo President
sion Expires:
O .1/4p,RY P14 OFFICIAL NOTARY SEAL
2 1
( , o JUDITH 6 WILLIAR:
N n **CO*::SISSIO* NU' 1
ctsl MY CR::::1•- 17..a ,I
C & .c=4- s s - 51
Estimated Cost(value) *P■q.C
* * *
C.C.F. / /J
Fire
Zoning Buildin
Mechanical Plumbing
Address
Notary
My Commi
NOTARY
Master Permit It-13W
3
Phone
Contractor or Owner- Builder
to Contractor or Owner-Builder
sion E �pj
,kp,RY PU9 OFFICIAL NOTARY SEAL
!6 JUDITH 6 WILLIAMS
' 4 � * � COMMISSION N12'
* * i o 4 c.:c�'?., i i , , **
4,04 OF Fly
TOTAL DUE
Other
Electrical
Engineering
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby mode for the approval of the detailed statement or the plans and specifications herewith submitted for the build
inc or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
MIAMI SHORES VILLAGE
r e Date..._..._..._._...r2C.
._ - �/ .._._..._....19.2...
Owner's Name and Address .W.4../.44 . /�. . C.L.. .t .. /° _. No ........ .........._.. Street.4.0 L ...L_....L.Q. - 3 t'.
Registered Architect and /or Engineer r . ..•.. ...••• .... -
Name and address of licensed contractor 6/?F Q.L .... ....Poor/Ai G....._._..
Location and legal description of lot to be built on:
Lot Block Subdivision
±
Street and Number where work is to be done.... '0 Al L= ' _ ® 5
State work to be done and purpose of building (by floors)
Disapproved
(Signed)
Date
/ , -o N ie•
Amount of Permit 3. =..QQ
.Plan Cubage
Size of Building Lot
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stori s _
To be constructed of Kind of foundation Roof Covering. .�..._..__
Estimate Total cost of improvements $ $O CO
Zone cubage required
Distance .to next nearest building
Maximum live load to be borne by each floor
I hereby submit all the plans and specific for said building. All notices with reference to the building and its construction ay
be sent to. .
R..eRoo l = 7' .L.C..... �V....... " /z.. e c 4eL�'.........7- 4..R......�9 r.� .G-!. m/
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of Libor under the Florida Workmen's Compensation Act, being Section 5966. Compiled General Laws of Florida, Perinxn. nt Sup lenient,
and has complied %%ith the provisions thereof, and will require similar compliance From all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or noticcs as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. •
Rem.uks ( Signed )_ � eG� ' - ••
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Bcfore me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true..
�1!
Permit No .. V . Date ' g � � • - -•- Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspector My Commission Expires
to me well known,
PLANNING BOARD DATE
Chairman Member
\Icrnber Member
\tembcr .. .. _....._......_..._._ ...._....... Member — .._.....
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Plannir.g Board.
A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by Improper notice for inspection or faulty
materials anti /or workmanship.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Building I pcctor
Chairman
Member
Member
Council Approved Date
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re-inspection fee of $1.00 will be charged
materials and /or workmanship.
MIAMI SHORES VILLAGE
APPLICATION FOR BUILDING PERMIT
Application is hereby sonde for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whcther herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address YV 5, SEJpEL
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 1 � NE [0 2 ST.
State work to be done and purpose of building (by floors) t — 12e°F CenVFL
BUILDING INSPECTION DEPARTMENT.
6f1 t'►Q U TIf
Date..._..._ / 30 _..__._...._......__......... ,192
No a0 Street— NE /° ST
// t.... . it,.•.:t ,
t!! tt.....t,...• If!
61DF/N& � ; �.... 1 NC:._ 30J N W 21 /114x1
) -/
t.. COWL
and for no other purpose.
No of Stories
New Building Remodeling Addition Repairs
To be-constructed of Kind of foundation Roof Covering ' "3 vFL-
Estimated Total cost of improvements $ 6 p0, OD Amount of Permit $. ; , 00
Zone cubage required plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance om all contractors or sub - contractors employed by him
in the work to be performed under this pennit; and will post or cause to be or inspection on to of t pith
posted o
or notices as are required by the Act. The undersigned agrees to employ only such bcontr ctors • to rformed rformed and
pennit, as are licensed by Miami Shores Village.
Remarks (Signed).
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No.._..l I 6 , s S Date
Disapproved Date.
(Signed) �t �
Read, Sworn to and Subscribed before me.
PLANNING BOARD DATE
to me well known,
Notary Public, State of Florida
My Commission Expires
Member
Member
Member w.._.....
Disapproved Date
making corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty
t .
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Date.. / 9 , 19 6
Owner's Name and Address Adit No /S Street /i/P-
Registered Architect and/or Engineer
40.7
Name and address of licensed contractor 00
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done ./...1 A
State work to be done and purpose of building (by floors)
/— 4/ 3 Y Lq 7:
Disapproved --
(Signed)
Date._
and for no other purpose.
New Building Remodeling Addition Repairs No. of Storiel
To be constructed of Kind of foundation Roof Covering -
Estimated Total cost of improvements $ 7:57 6 ' 6
Amount of Permit $
Zone cubage required _Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor._
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Signed ).E
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No n i rt Date.. ((( - - fr # Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building pector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
A Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re-inspection fee of 51.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty
materials and/or workmanship.
Disapprove
(Signed) 6
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
—e Lai Date
No 77_
—1 P 9'L
Owner's Name and Address i
street_ i D V-
Registered Architect and/or Engineer
Name and address of licensed contractor
Location and legal description of lot to be b on:
Lot. Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundatiA Roof Covering
Estimated Total cost of improvements $ I 3 5 Amount of Permit $
Zone cubage required _Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor.... .
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen s Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be pe der this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
E' at;
•
Building In • ector
My Commission Expires.
PLANNING BOARD.. DATE
Chairman Member
Member Member
Member . Member
Notary Public, State of Florida
STATE OF FLORIDA,
COUNTY OF DADE. ss •
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
t 3 - 7- 9-
Permit No.__ (7 Date 7 Read, Sworn to and Subscribed before me.
Council Approved _Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re-inspection fee of 51.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty
materials and/or workmanship.
ePy
State work to be done and purpose of bui ing (by floors)
A
New Building
Permit No
Disapproved
(Signed)
/8 Q
Date
Buildin /Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address.- ..1Ma__
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision , ` r
Street and Number where work is to be done / . ® 7.L_ Y / _
- / s
Date
Amount of Permit $
Plan Cubage
Size of Building Lot
No
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved
Street__ .Za
To be constructed of Kind of foundation Roof Covering
Date ` -' - Read, Sworn to and Subscribed before me.
and for no other purpose.
Remodeling. Addition Repairs No. of Stories
Estimated Total cost of improvements $
Zone cubage required
Distance to next nearest building._._
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. i-
Remarks (Signed)_
STATE OF FLORIDA,
COUNTY OF DADE. ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
My Commission Expires
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice
materials and /or workmanship.
Date
has been obtained from
for inspection or faulty
BUILDING ❑
ELECTRICAL ❑
PLUMBING ❑
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
r !`
t_ &) ,
.6 4.
Lot
f �/`j
MIAMI SHORES VILLAGE. FLORIDA
PERMIT N9
/ r" e
Bl.
1
Work to be performed under this Permit
8305
Subdi-
vision ,
Sa. Ft
Value of
Project $ f ±�
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed •
INSPECTOR
DATE 195_L
Contractor's
License No
Amt. of
Permit $
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 gu'bmitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all wark done by either, myself, my agent, servant or employee.
0.7 .„ ; .... 4.47C -f"-`. `_„L • • - ( � 1 y— mot.. `-+✓' {r" «" ` ). /
J
CONTRACTOR OR BUILDS BY
AUTHORITY
'7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Lot
Street and Number where work is to be done
- BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Disapproved Date_
Signed)
Building Inspector
Chairman
Member
Member
Council Approved
MIAMI SHORES VILLAGE
• Date
Owner's Name and Address Layton 150 N L 102 St No Street
Registered Architect and /or Engineer _�_
Name and address of licensed contractor Lari _Roofln{� & 1 17,@ Go. / G_1?jl_29_ 1__St_.
Location and legal description of lot to be built on:
Block Subdivision_
150 NE 102 S
State work to be done and purpose of building (by floors)____ 1r___121y roof
and for no
New Building Remodeling Addition X Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ '2&0.00 _Amount of Permit $ c t 5.00
Zone cubage required _Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. LANG ROOFING & TIL. CO
Remarks____ (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No 7/,e Date " ! Read, Sworn to and Subscribed before me.
PLANNING BOARD DATE
Member
Member
Member
Date Disapproved
May 15, 1951
or changes to this application after approval
NOTE: A charge of $1.00 will be made for making corrections
the Planning Board.
A re-inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice
materials and /or workmanship.
19
other purpose.
to me well known,
Notary Public, State of Florida
My Commission Expires
Date
has been obtained from
for inspection or faulty
BUILDING
ELECTRICAL 0 PERMIT IT?
PLUMBING ❑ .0'°
ROOFING
Owner of
Building
Architect
Contractor
or Builder r - J y r ► _
Legal Lot { % / 81.
Description.
Address of
Building �
i
• t }..7
4
It OR MOLDER
1
MIAMI SHORES VILLAGE, FLORIDA
c a Work to be performed under this Permit
11489
Subdi-
vision
Value of
Project
BY
$ l / .■...s.
DATE J 195/__
Contractor's
License No
Amt. of
Permit
$ • - •.
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees. -- -
Signed: % / . BY ✓, . il
In consideration of the issuance to me of this permit I agree to perform the covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or icatians submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume'`�responsibility for all work done by either, mys y age 't, servant or employee.
AUTHORITY
BUltRING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor j
or Builder/
Legal
Description
Address of
Building
Lot
0 OR
MIAMI SHORES VILLAGE, FLORIDA_
DATE
PERMIT N? 5871
Work t9, be perfo med under this Permit
Bl.
t
Subdi-
vision
. 1 9 • ' Thff
4 BY
sb 1 4'
Contractor's
License No.
Value of pol
Project /
This permit is granted to the contractor or builder named above to construct the b ding or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility, for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or .wings or in the at ents or pecifications and t assumes respon-
sibility for work done by his agents, servants or employees. .i.
Signed. 1 21- tie' By ,
i C OR
I co sideration .f the issuance to me of this permit I agree to perform the work cover ea hereunder in compliance with411prdinances and
perta ret nd • strict onformity with the plans, drawings, statements or specifications submitted to the proper authofflas of Miami Shere's Vfigage.
In a I ass responsibility for all work done by either myself, my agent, servant or employee.
/ b(14-4-p
Amt. of a
Permit / •••••■•"•
AUTHORITY
f
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not A copy of approved
plans and specifications must be kept at building during progress of the work.
Date , 19
Owner's Name and Address '____— � ___ / /( �� t
Registered Architect and /or En er T 1 � "` "� "' ;,,
Name and address of licensed .ntractor____ �s F a '� r
Location and legal description of lot to be built on:
Lot Block Subdivisi
Street and Number where work is to be done 1
State work to be done and purpose of building (by floors)______
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to
%//
peared
_ and for no o r purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation_ ____ ! overing
Estimated Total cost of improvements $___ –___ ____,era ' Amount of Permit $__ -
Zone cubage required _Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live lnad to be borne by each floor_
hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for th.s building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the s' �_ �pf the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such sub, ,pwtf tat), o rl(' to b performed under this
permit, as are licensed by Miami Shores Village.
Remarks______ (Signed) _
Notary Public, State of Florida
oaths and take acknowledgments, personally ap.>
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true. . €
Permit No ✓! J / Date ) __� _ Read, Sworn to and Subscribed before me.
Disapproved Date
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member –
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.