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301 NE 102 St (6)
MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 315 Type Insp'n � tiyl C c V Permit No. — ZhZ— Name SO S± Address Company OLS CD"r1= Phone # Inspection Date 4) S' Approved Correction Re- Insp'n Fee IcKs MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request FO' Date4 J�k Type Insp'n 1 t 1 c1 \'.4od Permit No. ? 04 Name Address 301 QE lv Company `1 `'`� ` 0 I ' Phone # Inspection Date 419 Approved Correction Re- Insp'n Fee . •4- MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date' / (((((( Type Insp' n Permit No. C� Name ■ Address Company ) �] Phone # c © 3 • Inspection Date 1 —2 ) k i Approved ❑ �! Correction Re- Insp'n Fee provide a ISde&, MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 �\ Building Inspection Request Type Insp'n Permit No. Name Address 0 ( ")-), £ 10 ate' Company S Phone # Igl - < -- _! l lS Inspection Data - ) 2.1 D Approved Y Correction ❑ Re- Insp'n Fee ❑ E•N•G•I•N•E•E•R Tel: (305) 649 -6454 Fax: (305) 541 -3298 M.I.S. Corporation 10221 Southwest 16 Street Miami, Florida Project: Dear Sirs; LG ENGINEERING SERVICES, INC. Consulting Engineers 2020 Northwest 7th Street Miami, Florida 33125 TILE UPLIFT TEST Residential Home 301 Northeast 102 Street Miami, Florida Information provided by client: Permit Number: PB04263 Date Completion: March 18, 2004 Roofing Contractor: M.I.S. Corporation LG Engineering Services, Inc. Project Number: LG04 - 0780 (Testing Laboratory Certificate #00- 0224.07) March 23, 2004 In accordance with your request and authorization, a representative ofLG Engineering Services, Inc. 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 30 feet above ground surface. The type of tile used for this project was reported to be Altusa Roof Tile. This tile was reported to have been foamed in place. At the time of this testing, one test for every comer, one test for every 100 square feet of roof tile in the perimeter area and one test for every 200 square feet of roof tile in the field area were tested. Initially the entire area of the roof was examine for loose tile. More than 10% of the roof tile located in the field area and more than 20% of the roof tile at the roof perimeter and corner were physically examined. Based on our test results, we conclude that the installation of the roof tile at the above referenced project the test reqnireMent outlined in the above menttoned'protocol Attached please find a copy of our test report •for your review _ ��% ,cY3 /OI MO d n. . Sonny Saileh, P.E. Project Manager LG Engineering Services, Inc. appreciates the opportunity of assisting you in this - project. If you have any questions or if we may be of further assistance, please do not hesitate to contact the undersigned. Respectfully submitted; LG Engineering Services, Inc. TILE UPLIFT TLS'F Residential Horne 301 Northeast 102 Street Miami, Florida 1V1id1711 31101 S V 111d.gc Building Department F EB 20 BUILDING Permit No. PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing) Owner's Name (Fee Simple Titleholder) �c 9E. l V6,0 g- Phone # Owner's Address :30/ A /2`i Ma `S #e 7 QQrr City /`�v� �S / DI' State Zip ,.7.3/�U �7 Tenant/Lessee Name Phone # 3 6 / t -9.-99.5 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Master Permit No. Job Address (where the work is being done) L.3tW A /'9 5 ---- City Miami Shores Village County Miami -Dade Zip 33/0( Is Building Historically Designated YES NO_ X_ Contractor's Company Name /.' (-OA - Phone # 4DS ).g 2 /55 Contractor's Address .� Oo / - ' City / 17ki/i/ / State / A1i y Zip , �3 Q„alifier /9e/467:e - '2 Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit` 7 0 Square Footage Of Work: 0 3 d6 Type of Work: Addition ['Alteration ❑INew eplac= ❑ Demolition � Describe Work: /F �ilea1 C Q1 i n f S 1 AJ / J �'V e,16 Ras ! / ,' (S /e V� e / * GDe,ce -- i/G .Ks ern, I K- 20. c 4 1 c t, 4/kig. t1 5y * * * * * * * * * * * * * * * * * * ** ** * * * * ** F ees * * * ** ** * * * * ** ** * * * * * ** *** ** *s* `L b i Fee $ CCF $ Notary $ Training/Education Fee $ 7 Technology Fee $ Scanning $ 9 Radon $ ------ Bond $ Code Enforcement $ �— Structural Plan Review. $ Submittal Fee $-5 Perm t ' U) Total Fee Now Due $ (Continued on opposite side) 7� 5a Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) A/ 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 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 wil • . t • .proved and r einspection fee will be. charged. 4 ,, s , Signature Signature Owner or Agent ontractor The foregoing instrument was acknowledged before me this./6 The forego i : ent was acknowledged before me this 206 b day of y �,�el (5,94( !//1j /, day of r3- A 20]" , by A'age= l`� , who is personally known to me or who has produced who is per onally known to me or who has produced as identification and who di...i - an oath. Chc 10/14/03 NO Sign. Print: My Commis o Epires: /O *******§- * * * * * * * * * * * * * ** ** * * * * * * ** APPLICATION APPROVED BY: As identificatioju d who did take an oath. NOTARY PUB Sign: Print: My . C77niS ion (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** FEB 2 6 2004 Plans Examiner Engineer Zoning SECTION 1524 •HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of this section.. The provisions of Chapter 15 of the Florida Building Code, Building govern 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. 04 1. Aesthetics - Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane , .� on 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 workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. 2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be r . ailed in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing roof system). 3. Common Roofs: Common roofs are those which have no visible delineation between neighboring s (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or owner should notify the occupants of adjacent units of roofing work to be performed. 4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be vi wed from below: The owner may wish to maintain the architectural appearance, therefore, roofing nail enetrations of the underside of the decking may not be acceptable. The Florida Building Code provides the op of maintainiL g this appearance. 5. Ponding Water: The current roof system and/or deck of the building may not drain well and may cause water to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural . istress 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 orip • ..1 roofing system is removed. Ponding conditions should be corrected. 6. Overtlow• scuppers (wall outlets): It is required that rainwater flow off so that the roof is not overloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if rflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in ance with the Florida Building Code, Plumbing. 7. Ventiration: Most roof structures should have some ability to' vent natural airflo)v through the erior of the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the roof. Owner's /Agent's ature C: IDOCCMC- I■emp`LOCALS- I,Ten.p■SCCTIO.I' 15t1.doe or's Signature Master Permit No. Contractor's Name Job Address ❑ Low Slope ❑ Asphaltic Shingles ❑ New Roof High Velocity Hurricane Zone Uniform Permit Application Form Section A (General Information) ROOF CATEGORY ( ' L • Process No. ,76.7 id Mortar /A et Tile ❑ Metal Panel /Shingles ❑ Wood Shingles /Shakes ❑ Prescriptive BUR - RAS 150 � ,,/ "ROOF TYPE E Re- Roofing ❑ Recovering ❑ Repair ❑ Maintenance ROOF SYSTEM INFORMATION ❑ Mechanically Fastened Tile Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF) c9,3aa c 3 S4 We Section B (Roof Plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow 'scuppers and overflow drains. Include dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and location of parapets. 1 ' '1 . I1_1 ' 1 j 1 _... { -L I r* I I i :4 R T 1 -i-H. -ice `;...{.-.i -{. I l ;11, > 1- : _ . . t ...1 : ._,_} � ; L 1, I J I .l...l.- _.I.•..i I-11: . 1 { t t Ii ftf t1 t 1 ± =_:-J- -t- !J ! -! .L_Li.1...1. i rTl r ; I - _� -1. _ r i ..1 L. I .I t Roof Slope: : 12 Roof System , nufacturer: ; ` 7)4 1�r- 776' Notice of Ac c = lance Number: G _ � z • ° 6 Minimum Olesi n Wind Pressures, if Applicable (From RAS 127 or calculations): P1: 7 IV P2: 2 /' 7'/ P3: 7 y Maximum I es n Pressure From the O Specific System): / Method of pie rtachmenl "9 � 1 Ridge Ventilatio Florida Building Code Edition 2002 H' • h Vel • Hurricane Zone Uniform Permit olication Form. S n D (Steep Sloped Roof Svsteml Doti( Mean Roof ige ea Sloped Roof System Description per: x 6 " 3/Y a Underlayment: i 3° Insulation: Fire Barrier: Fastener Type & Spacing:( 2 G•x X 114 a 3 ! G dhesive Type: l \oov Cap Sheet: Fce ti ` e/ 9 / +mot ! Covering: 1 1 ! 5 �A FE 5�/�"J A- 1A- \ Type & Size Dna `edg o , 1 r � 2 C /' r ! .� 'I 1 I For Me eat for M,w h th values,f cac (P1: '97 (P2: (P s >; .12 `Must be u d in Droward Co$inly • For Uplift' values for It. If area of the #oof, (P, x t: (Ps t I: (Pj :I: Oescriptio Ail lJ1�YTM HM•E Dc Hrgh Velocity Hurricane Zone .. Uniform Permit Application Form to ti1•va7 Symbol n Pressure P I or fit or r3 14 ` k{ H lob . uc oor lope 0 1k 20' -- 31.3 20.9 267 2s* 35 7 33.4 30.9 2 : 25.2 Section E (Tile Calculations) used the systeats. choose either Method 1 or 2. Compared 111c values values from M If the M values are greater than or equal to the Mr arcs of the roof, then the tilt MItAClrmcbt method is acceptable. ethed I "Moment Based Tilc Calculations Per RAS 127" .311 _ I440)_Mg:''3v NOR MI"; _`��_ 31J = 3/. 2 4) - Mg: ?:V e M43-7-9-1- .:3 . Q � NOA �T. 3 - .3/- 2 4j_ Mg: ~ =M.1ZT -4j NOA M 6(.17. . ethod 2 "Sitttpiiftcd Tile Calculation Per Table Below" Required Mmes of Resistance (M,) From rabic tletow NOA M, M. Required momenResistance 26 6 20.e — Where to Obtain Information conjunction with a list of mosocat based tile systems endorsed by the rd of Roles and Appcols. the s ystems use Method 3. Compared the values for F' with the 11c F' values are greater than or equal to t11c F, values, for each hen the the attachment method is acceptable. thud 3 "Uplift Based Tile Calculations Per RAS 127" : Mr: _ -. W: al cos 0 - Fn: • NOA l : w: ° ) W: s efts O . F es : NOA F' s w: = ) - W: t cos 0. . F.s: NOA r _ Where to find 11AS127f jor Mc r ' - - 7 nccnn� 1w1.1fsn sugared M� 6iisTon A�LI ; 7 3s : • 6 NUA w— width 1 6 me b r oak a 1 .e Gnic of pebml •pP Kmon. _.__ • • 10302 gawk Medley 1 FL 3317 Your oppliCat+oa for Spanish "S" Clay under Chapter 1 of t C=onstruction, and co Cowry Building C This NOA sba:1 noe pto4 Ct JT material peddlet oe material use of such pact determined by 11CC Building Ccde. The eNpense of rich t APrIOVED: ACCEPTANCE NO EXPIRE & This a pvtie3:iof for #uduct Approval has Code :ad Pradurt Re.. lew Committee to be forth (l]c e• 4%ICQl •ssle000em•yw. inferno I lir1 664 416: Poo et Drive, Bey 4,16 oticc of Ac:— avarice fiOA) of: Code of Sli$rri -Dade Couar: governing he use orA;ternaie Materials and Types of pirely described herein. has been recotnrendtt3 for sect atce by the Miami -Dads Cutvlia1ce Office (8CCO) under the c adiu3rs spccifi herein. valid iter the expires.on date stated be v. BCCO re sen any time from a jubsite or manutacur 'e plant fo- quell Is to perform in the approved meaner. CCO may rev material immedsateiy BCCO :eser► the right to !that this ;ruduct or material faiis to tee the r:qui 1 tint be ant •G by the :nanufacturlii 411213.0 anssls.racwor as aMs asteRR®buiidiuecadaentis►. rout ai • MIAM -OAK COUNTY. F:411.113A Mt FLAGLE_R Wft,DtirG •ULA MG *DC COMPLIANCE ORMCL Mt rs.AG%.tt outLOINC i m wEsT LACttt STRUM start lses w :Q ML }!mal a ;S13¢1W Spy). :434 +.rA2Ci;otS wa WifOnosaii< v ai••wo• 0351 /154116 FAX (Xfi l�f 200>f rsiosu r CorrreOL Olvty10% 00» llf.rtit Mt 110:13*: -o31r the right to secure t Rs coaUol testu:g. if this modify. or stispeni the ke tlAis approval. if it is is .f the South Florida Raul b isuts Chief Rift CO%1101 Oiv'aiol GPN bean -evie ved by alt DCCO and approved by the Building used in Nlianti•Oage County. Flortdd under the conditions set rfr so‘ crsnzisolo J. Qttintar.a, 1t -1 OircttOrt M i a m iComity Cu:Idi C adc Compliance Office 1401pate: hlip:i/. ..... itdiaredsa.iiwe csrw r Saetate . 5' TAD ~ Tiks d Apecation met �-- ~ --- sr per t 3j.; t+sM sL _.,..... •t 1. 2.1 2. ROOFCYG AS3tMs4 • APPROvAL Roofing 07120 Reo(' Tiks Trier. Pieces ruIlL Tile Screws SC O?E This renews a reati Sarnafa Tile C :ompty with the S tocations *hoe ed does not semis the .sing the var+ae lie s% lt.w►. 2. ?ROM' CT DES idAgaigIngsak disoklSr Sensate 'S' Choy Reef Tik I0 w• COMPONEWS O 111x2-4 - 0.130' 0 170 Ruth 3. Lib ITATIO'NS 3.1 firs clesaifkat. 12 for woert r ea teeoVdteye w i 3 3 Applicata tb:i: warm *row sitaoi :O the s system using Sates Fs - S4/1111k ion described i t S._tiotr 2 °folio :h Fta►da Sui{ding Cecil 1094 s+$n pressure teseitensenes. Ai esisn pntasurt values obtain by in htreie. TAe srtac1ratnl knelt 1TJO Y Aries varies ness Teat Sintkaelasal PA 11; ?A 112 PRODUCTS MAM .YA Teat liand s ►A 114 des. ApM+niis is era part Of this a,Ci/ssinG . ive set the $pp:ieatiotq, a MS 106. stain :lie service's of • titians test in ar.:atdattee witlt PA 1 wilding Cede Cvwt19:iattoc 0 2 ' ACCEPTANCE No. Approval Dales " cats roefins tl1e, mice of .aceyeence, rte. for Mimi- Clads iaee by applicable •:atiens In ereaptisaes lass shall NI tort as a prate WW1 prortle c11y with two nail 110ies. tat and adhesive AIR ssOry trier, clay reef . . ter use el rakes. tides and vatiey ataalsed for emit the RED BY °TIMERS ?redact Sl.s le GC uptirt teat stilt Se Dade County Cas:f.. v •••.••.IMI••I a.•.40 f...a..• 'ed by to For g cede. *AS 127 based f til. rot nsil-art. i:c.tions. 4 .ietorty R a I bs 4. OMSTALLATIO!i 4 1.1 Settaf 'S' and its canoionetoa s ly,}, be ineta:lcd stria was/hobo rNM Mims Dade County Stooling Ayp$icatton Standard R.AS i 11 RA_S 119. and ! 20. 4.1.2 Dam For At aebnarnt Calatlati Tee Prarssie Senate $• ' S.s 30/90 hot mopped enderlayntets applications slope unless awed oNt,.nei by the cadet ltsbsss.re- 1 Ssntare S t eCt Owe .8 2y it » r es Table 1: Aerodynamic Multiplier i M 4 Saban - - c on Tooke + l Tao 3; Attacrlment Resistance E.sprtlsettas a blement. I For Naii -Cn System: I too Profile T list I Two N>tirs One Scren Screws l 1 bl Pliceion =p .m - nand - woatet aesutry-need by often' Tsai Tae a , Application S amaie 'S tM ar s.� t 3 14 ACCEFTAN } be instaNcd vial missend Ont 1 Na :,ia 2.ic 111-+bbl ti b614: AttachawMt Resistance as Moment - (ft•If q for Mortar et Adhesive SN yshRs sctatnsnt sittings tank &deo" As Pomb i we EMI% stet whir b oe toot ti potksbed VINTASI TILE CrPORATION Accr.rrArcr No. • S LA BEL INC 5.1 ules dsJ1 beer the *ton or identifiable . of Cte otaridanueorti ot este:mese Cehom). Cannel Approwd". 4..11. I Mg XXX( afiaMt4-ao, ■-••=-14; 6.1 2 Amy other docutoonts mourn, by the Bui4 efileisl or spotiosble 'i4�i Code is order TD payer* evaiiisee the tostallsoan • SySlIert. 4 4 *spa (31) I. CORPORATION MICLITL&C,FAILTIO_CLSIVIDILISRCEIREil ,wy�:fW as► octi asunr43:zm. ustia.yt „_.., 4mobartlAg t, g:nccnat Sabi Any say all 'proved radiant shall bs yartanu+t:p 1abel ts>a IM fiiIl t lsi stomata °Aitiiaa Camay : -Dads Ca P does C App % se Ipecac eetati ttons of albs Acceptance. .I ACCEPTA$C 4.. :ia. cgshaalli Slerte..a s or tutll est be �derm if: s) Than h Owen 1 champ in tilt Soadi Elands 3aiWvtg Ca j s Olken err old the . oJaa is cot ia:eatyltaeet wait lit cads b) Teo is ne lofty Use stmt Dlodi n (idemiadl M en e arysmT c) If Ma • beta, at e trot acMO with ell the ra4 �,. M MUS at d i* Camara) else at they '1 'i The wee pa os& sapsd e d stales � �tl�! t+slst to is no Iona racIsd4s tats etsio serseg ptefessltr. i A$7 re. tosa dine in the atatarts4. rtes, srd/oe of the Oda* r &Acoustic ly a cause for tamittatioe d ot this n tataset. a row wettest l !Through the . ling ee a te'is ee .Abralioa untie IVptmpnate fedi sell rental W t 3 Am d toe tat i•Malg stall ales be roods fey fail el e#ts 11 t sear slavery yedlinaana of this ,rat set e< roast a �, Ur g Say b) Metro 0 this masatotscs as an adeyant nI aim poem. for talcs. o' D l tics ! S Ttte N.Tiu of -aptettae osirtt:r pn.'tded by INe'tads Wale: CeoRO►, sal sw o•ad 1y eM wire :tsn may be dlsvlayed le.dvcaasie j Iitent rt. If ani pietas ef site at M Ora is dztv. it omit be tats is se sailor. n ssU 2 t Tt its tetra be 7 A cry sr tilt Ilactr4 ce as wen u emirsved tteat•inp sK a d snaauc ets . awes. a< the gee peoviJe,d to uar by the ntaesdubour sr tit da:ibrmra sad share ea seaWle fey i legato site st CI al 4$. rat mom e d sat M aeseeied by the es�ie vii 5 Esiwie to = s+, tNllt tier cession of Om JtCLtptasor mail be clime for tert:t:ttstiOTt mural ef J o This + tousle' peps t *mop 3 3 it NO OF Tats ACCtrtA#CC • 5 me. me as Omer than Oa. sitp% atm. set city acrd is ehc to this pack= ittchalina the tale shall el has bra sequsa.d dike. mfAMlt PRODUCT CONTROL NOTICE OF AI CEPT ANC[; • Polyf(i;tm Products, Inc. 2400 Spring- Stucbncr Rood Spring ,TX 7 7383 -1132 Your application for Notice of Acceptance (NOA) ot: Two Component Polyurethcnc Foaal Adhesive under Chapter S of the Code of Miami -Dade County governing the use of Alternate Materials and Types of Construction, and completely described herein, has been recommended for acceptanc by the Miami -Dade County Building Code Compliance Office (BCCO) under the conditions specified herein. This NOA shall not be valid after the expiration dare stated below. BCCO reserves the right product or material at any time from a jobsite or' manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner. BCCO may revoke:modify, or suspend the use of such product or material immediately. DCCO reserveef the right requirements determined by BCCO that this product or material fails to r ect the of the South Florida revoke this approval, if it is Building Code. The expense of such testing will be incurred by the mantilactt'rcr. ACCEPTANCE NO.: 01-052 L02 EXPIRES: /1O /2006 THIS IS TI.1I? COVrRSI.1FFT SEE Apo TIONAL PAGItS FOR SPECI CONDITIO S [rnL BUILDING CODE Se PRODUCT REVIEW COMMITT This application for Product Approval has been reviewed by the BCCO and approved by the Building Code and Product Review Committee to be used iitMiami -Dade County, Florida under the conditions set forth above. APPROVED: 06/14rz00t 410 -4500011pt:200011tanpateslnooee leecponce en.er pne Ielcruet Inuit address: postmnslcrO)huitdingeodeonllne •corn HOnlCtfagC: h Hvww,tIu • •%•fit • e••• nnnAr r 17%1 rr 'et A 7LAt A 1 A Lai• 1•• • AI. • . T •\I • w A . 1 A , -A MIAM(.DADE COUNTY. FLORIDA METRO -DADE t'LAGLER l3UILp(NG bU(LAINC CODE COaIMIANCE OI FlCE a 'ICrRO -OA OIi FI-AOLI•R BUILDING 140 wr:Sr rLAGLGR S•rRrGT• SUM:: 1603 MIAMI. FLORIDA 33130 -1543 (305) ”5 -:401 VAN (305)173.19(T;t CONTRACT() R CEN' INC SECIIoN (705) 375 -2s27 FAX p051 375.2514 CoNTIcAc7T'UR ENI OnCr•;tterwr oivtsi (3 o5) 375 -294a 1'AX 005)375.29u PRODIJCn' CONTROL Utl'15ggN (30)375-2902 rv%x m5)3724339 Raul Rodriguez ClticFProduct Control Division Francisco J. Quintana, R.A. Director Miami -Dade Comity Dt'iIding Code Compliance Otlice cnn1 ( Pnl. to •m Products inc. QC F'IHd Suh� = _ Materials: • ASSEMBLY APPROVAL, Roofing Root Tile Adhesive Polyurethane I• SCO't This approves P'olypru® AI.1160 as manufactured by Polytonal Products, Inc as described in Section 2 of this Notice of Acceptance. For the locations where the design pressure requirements, as determined by applicable building code, does not exceed the design pressure values obtained by calculations in compliance with Roofing Application Standard RAS 127, for use with approved flat, low, Polypro® A1-I 160. Where the attachment' calculations are do e a moment based s stem using for single patty placement, and as an uplift based system for double patty systems 2. PRODUCT DESCRIPTION Manufactured by A c:►n Iit Dim es T est — J Product Polypro® A1- -1160 Specifications Deseri Lion N/A PA 101 Two component t RTF1000 N/A polyurethane Dispensing Equipment ProPack 01) 30 & 100 N/A 2.1 Components or products manufactured by others: Any Miami - Dadc County Product Control Accepted Roor ile Assembly having a current NOA which list uplift resistance values with the use ofPolypro A11160 roortile adhesive. 2.2 Typical Physical Properties_ Property Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transm ission Dimensional Stability Test ASTM 0 1622 ASTNI D 1621 ASTM 0 I G23 ASTM 0 2127 ASTM E 9G ASTM D 2126 •'!ITT 't T•1AeTnv T ?Fyn YY•Wn r 1.6 IbsiR.' 18 PSI Parallel to risc 12 PSI Perpendicular to rise 28 PST pnmllel to rise 0.08 Lbs./Ft2 3.1 Perm / inch 4 -0.07% Volume Change @ .400 weeks +6.0% Volume Chaotic 673 Ilr 2 ■v eke ACCEPTANCE No. : 171 1.o2 Approval Date: June 14 . 20111 Expiration Datc: M:►v 1_ p�2Qp6 Requite Dispensing Equipment F.. Frank Zuioaga, KRC Product Control Examiner maw. ...a • ... —.- ••• . Polyfoartt lroducts. Inc. ACCEPTANCE No.: 01-0S21.02 Note: The physical properties listed above are presented as typical nverage values ns determined by AST test methods and are subject to normal manufacturing varintion. y M 3. LIMITATIONS 3.1 Fire classification is not part or this acceptance. Refer to the Prepared Roof Tile Assembly for tire rating. 3.2 3.3 Polypro® AI•[160 shall solely be used with flat, low. & high tile prates. Minimum underlayments shalt be in Compliance with the Rooting Application Standard RAS 120. 3.4 Roof Tile manufactures acquiring acceptance for the use of Polypro® AI 160 roo 3.5 tile adhesive with their rile assemblies shall is in accordance with PA 101. Roof Tile manufactures acquiring acceptance 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 [0.4 as modified herein. F- 4. INSTALLATION 4.1 Polypro® AHI60 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of Polypro® AH 160. 4.2 Polypro® AH160 shall be 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 Polypro® A[•11 60 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the uplift 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® Ati160 roof the adhesive and its components shall bc installed in accordance with Roofing Application Standard RAS 120, and Polyfoam Products, Inc. Polypro® At 1160 Operating Instruction and Maintenance Booklet. 4.4 Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, Inc. Polyfoam Products Inc. shall supply a list of approved applicators to the authority having jurisdiction. 4.5 Calibration of the Foamprog dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the "B" component shall be maintained between 1.0 -1.15 (A) : 1.0 (i3)_ The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall bc approved. 1.6 Polypro® AF[ 160 shall be applied with Foatnpro RTf 1000 or ProPack® 30 & 100 dispensing equipment only. 4.7 Polypro® Af•[l60 shall not be exposed permanently to sun!' 3 • •N 11T • e• r Faun s -,n V MS Frank Zutoaga, RRC Product Control examiner VOL.. n.n a.... .w.. .n. .... .-- ennrn • 1'olvfo:tni Products fnc. . Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after Polypro® AH 160 has been dispensed. 4 . 9 Polypro® AMIGO placement and minimum patty weight shall be in accordance with the 'Placement Details' herein. Each generic the profile require the specific placement noted herein. not Low, Hi •h Proflcs Placement Detail Table t: Adhesive Placement For Each Generic "Tile Profile 'l•ilePiroltc Single Paddy Wcight Min. (grains) High Profile (2 Piece Barrel) Flat. Low. Hi •li Profiles Two Paddy Weight per paddy Mitt. m ounanummimmiammrams L ? /side on eap and 34 /•an r 5. LABELING All Polypt•o® AH160 containers shall comply with the Standard Conditions listed herein. 6 • I3UILD[NG PERMIT REQUIREMENTS 6.1 As required by the Building Official or applicable Building Code in order to properly evaluate the installation of this system. 4 • •••17 • T • •,••∎••n\• • TOW" •••••n • ACCEPTANCE No.: 0 (- 0521,02 Crank Zuloaga, !MC Product Control Examiner onn Pal • of f am Products Inc. ACCEPTANCE No_ : 0I- 0421.02 ADHESIVE PLACEMENT DETAIL 1 SINGLE PATTY • • • 5 1) Plus Inbor1 massive t11 aaa.We 171s 37 KUM IRCAt1 r, commas **IN. can di. 71 rwn twra spike /p ,Plc sews. to k 1.1 fn. Fran .Ytlth tort Of GOWN tbs. lhtn MY4 Ole We. Iiwepr w PAM d IA..rt tau cosy o4, Ibn Wend corm K Oar IEIL Eden saw nd of PIA v4 cow Yin nt aWt at loo Om. Frank Zuloosa, ItRC Product Control Examiner 1. nne PolYfoam Products inc_ • ACCEPTANCE No.: o Io 0521,02 ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY 6 .- , r.crlinnv: ravn.rrf.n• Frank Zuloaga, RRC Product. Courrol Gxamincr RCM cal P 1 folnt Products- Inc. ACCEPTANCE No. - 01.0 5 02 ADHESIVE PLACEMENT DETAIL 3 DO WILE PATTY Sngk paddy under die Paddy (b.twoon Ural Paddy (under Ws) Srngle paddy on top of Pia trail uvough plastic cenccnl Undertaymenl Nall through plastic cement / e'lln. = 3 Ii . Single paddy an underlayrnenl 7 %ITT C71Af,VJ NLnJ71A r Sing?. paddy under tllo Single paddy between the 7 in. a 7In. medium alts paddy MO course oar Ilr nk Zulolb,, lZItC Product Control CXanlint:r Fula Wtephde Ent dourr. Drip edge VI sate t30 ' 3JHd 1ti101 sou • POI yfo:Ul Products. TnC 6Onit1 I . Rotcwat of this Acccptancc (approval) shall be considered oiler a renewal application has bun tiled - and thc original submitted documents, including test-supporting data, engineering documents. arc no older than eight (l;) years. 2. Any and all approved products shall be permanently labeled with the manufacturer's name, city, state, and the following statement: "Miami -Dade County Product Control Approval ", or as specifically stated in the specific conditions of this Acceptance. 3. Renewals of Acceptance will not bc considered if: a. There has been a change in the South Florida building Code allccting the evaluation of this product and thc product is not in compliance with the code changes. b. The product is no longer thc saline product (identical) as the one originally approved. If the Acceptance holder has not complied with all the requirements of this acca:ptance. including the correct installation attic product. d. The engineer tvho originally prepared, signed and scaled 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 bc cause for termination of this Acceptance, u nless prior written approval has been requested (through the filing of a n.wision application with appropriate Ice) -tad granted by this office. 5. My of the following shall also be grounds for removal of this Acceptance: a. Unsatisfactory perfornnance of this product or process. b. Misuse of this Acceptance as an endorsement of any product. for sales, advertising or any other purposes. 6. The Notice; of Acceptance number preceded by the words Mianni -Dade County, Florida, and followed by thc expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is displayed, then it shall bc done in its entirety. 7. A copy of this Acccptancc as well as approved drawings and other documents, where it applies, shall bc provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at all time. The engineer nccd not reseal thc copies. 8. Failure to comply with any section of this Acceptance shalt be cause For termination and removal of Acccptanco. 9. This Notice of Acceptance consists oFpages 1 tltrou$h 3. END OF TUTS ACCEPTANCE 8 •'tyTT •C r NYAJTtn ACCEPTANCE No. : 01-0521.02 Frank Zuloaga, RItC Product Control Examiner Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/1/2004 Applicant: GEORGE Owner: SAUVIGNE JOB ADDRESS: 301 NE 102 Contractor MIS CORPORATION Local Phone: 305 - 553 - 9476 Parcel # 1132060135050 Signed: (INSPECTOR) Signed: (Contractor or Builder) Building Permit Permit Number: BP2004 -263 SAUVIGNE GEORGE ST Contractor's Address: 2428 N. W. 28 St. Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 13 & 14 Permit Status: APPROVED Permit Expiration: 8/24/2004 Construction Value: $9,700.00 Work: RE -ROOF SANTA FE BLEND COLORS COLOR THRU TILE BY: BLK 37 LOT SIZE Fees: FEE2004 -2204 FEE2004 -2205 FEE2004 -2206 FEE2004 -2207 FEE2004 -2208 Description Building Fee CCF Training and Education Fee Scanning Fee Technology Fee Total Fees: Amount $300.00 $6.00 $2.00 $9.00 $7.50 $324.50 Total Fees :$34$ 0 Total Receipts: 0.00 S c �4s� MAR 0 3 PAID 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 responisibility for all work done by either myself, my agent, servants or employes. • • STATE OF FLOR'DA, COUNTY OF DADE I HEREBY C RTIFY!hat this py of the original filed n this office onn G day �, A D 20 day WITNESS my hand and Official HARVEY RUVIN, CLERKjotc? By �JJ 2. Description of Improvement: nd County Courts D.C. NOTICE. PERMIT NO. • STATE OF FLORIDA: TAX rfi.. COUNTY OF DADE: THE UNDERSIGNED hereby ' J y gives notice that improv ; h° vill be made to certain real property, and In accordance with Chapter 713, Florida Statutes, the following information 12 ,� �tded in this Notice of Commencement, 1. Legal •escriptidn of property an. �. treet address: 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 jom cor vany) Jame and address: kmount of bond $ Lender's name and address: Gnaw( . ter pint Owners Name Noln to and subscrib wary Public ENCEMENT 11 C=FN 2004 R0 i 4d x909 OR E'.k 221186 Pe 11°i; (fps) RECORDED 03/02/2004 13 :5155 HARVEY RUVIHP CLERK. OF COURT MIAMI -DACE COUNTY? FLORID LAST PAGE • Persons within the State of Florida designated by , ��.� � . ; �,•. vhom Thom notices or other documents may be served as provided y Section 713.13(1)(8)7.. Florida Statutes, lame and address: . In addition to himself, Owner designates the follow'. ; ;' • ) (s) to receive a copy of the Uenor's Notice ;faction 71 3.13(1)(b), Florida Statutes. as provided in larne and address: • Expiration date of this Notice of Commencement: (the ex :r°.31on date Is 1 year from the date of recording tfnless fferent date I speed) 9 a Prepared by: / - , 1 Y/laiy1 Address: 1 2 k 4; i` A/ / /, — -' PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ' 27 / 7 Job Address 3o/ n � 102, Si Tax Folio I 1 ' 3 Zd • 0/ 3. .57)S0 Legal Description 36 / M6 cof5 /f#J si Historically Designated: Yes No S/ / Tenant Geo,.9 a 44 SAu t r , Owner's Address ( s ,J 3 0/ Her /0Z St Address f3.?5 /2 roc. )).c L /afzei ficove4 SS# Phone 757—...)-6 / Z State # Municipal # Competency # 0000064-.1 Ins. Co. nd fj1L Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle on ): BUILDING ELECTRICAL PLUMBING MECHANIC • ROOFING ' AVING FENCE SIGN WORK DESCRIPTION RrO /e Poo C i' t €i Pd47 S /C/e OC C4/#I *)e-r I /90 4I r I W 1 A/"? A C - 4r 41o 49o1_ /r,/cayc 4'F 94fraye ovei � . Square Ft. ✓" S/ . WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named con ctor to do the work stated. Contracting Co. Of eu /t /fir A19 Qualifier G 6 a). Notary as to Owner and/or Condo Pre d V t r ate My Commission Expires: A � CATHERINE A. DUFFIN Z N\ ()COMMISSION ;1! CC623698 Ma EXPIRES FEB 23, 2001 "" ^` s BONDED THROUGH Oa MAIM BONDING CO, INC. ov FEES: PERMIT C - RADON APPROVED: Z Building Mechanical Estimated Cost (value) e-s-0 Plumbing Master Permit # Phone 7S/ - / P 9 is 77 ature of Contractor or Owner - Builder Date Notary as to Contractor or Owner a te 97 k My Corrunissi, ge. s: CATHERINE A. DUFFIN G � COMMISSION g CC6236 EXPIRES FEB 2 20 01 40:0 ► O� BONDED GOB INC ••10F0:3 AILANRC SOWING C.C.F. e 0 NOTARY Electrical BOND TOTAL DUE Engineering Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for' the building 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 STATE OF FLORIDA CO UNTY OF DADE. l ss. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT JD3 ee1 7'f - TO /J Date 6�/-- 19 PO No. 3 0 Street / E Registered Architect andior Engineer I .' ' J ` gt p • t • Name and address of licensed contractor w . r e v 4 � . / , 3i- / /� `Q 0C g; �� co , T~ e Location and legal description of lot to be built on: � p �/ / ,{ C� Lot L /�/7 J / Block 7 Subdivision /r� /&) t ? // 'o /�O /i / Street and Number where work is to be done 3 0 ( /' e ) e 2 S State work to be done and purpose of building by floors). state exterior colors (submit samples) AQ-(oo F Le, 'to --f'% and for no other purpose. New Building Remodeling Addition Repairs No of Stories To be constructed of Kind f foundation Roof Covering Estimated Total cost of improvements S 0 r Amount of Permit S 369- 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 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 obligatons 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 ost 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 agree�,to oy only s c co tr o work to be performed under this permit. as are licensed by Miami Shores Village. �jJ� Remarks (Signed) /1 " // t/' � Before me. the undersigned authority. a notary public. duly authorized to administer oat�ake ac s. personally appeared Notary Public. State of Florida 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. ■� �O / / JO , Date 6 /l /W Read. Sworn to and Subscribed before me. Disapproved Date (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials andror workmanship. BUILDING ELECTRICAL PLUMBING ROOFING MIAMI SHORES VILLAGE, FLORIDA ❑ DATE 19 -, ID PERMIT N9 273 Contractors ❑ License No. — 0 ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Lot Description Bl Address of Building CONTRACTOR OR BUILDER Subdi- vision Value of II Amount of Project $ II 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 applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a' thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed. BY: INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY ABBOT PRINT Name and address of licensed contractor Location and legal description of lot to be built on: Lot 13 -14 Block 37 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._.. 5....L.a .Si8g.'ist Registered Architect and /or Engineer uilding Inspe 6r Ideal Street and Number where work is to be done ....... a s 102 Street State work to be done and purpose of building (by floors) 1-30# TO 1-901 mopped clay tile copper and for no other purpose. Remodeling Addition X Repairs No. of Stories �• Kind of foundation Roof Covering wood 5.00 New Building To be constructed of Estimated Total cost of improvements $ 2.53_.00 Amount of Permit $ Zone cubage required plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractor mployed 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 r s h public notice or notices as are required by the Act. The undersigned agrees to employ only such subcoi race s, on work '. per med ynder this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No - 7.-'? ' Date 6---/ —3 7_ Read, Sworn to and Subscribed before me. Disapproved Date / Notary Public, State of Florida ( Signed) ! . Chairman Member Member Council Approved MIAMI SHORES VILLAGE Date $1.00 will be made for BUILDING INSPECTION DEPARTMENT making Date 5- . 31 -60 , 19 No 301 NE Street Roofing and Sheet Metal WW®ka Inc. 261 N.E. 73 Street Miami Subdivision Miami Sho re s Sec. #1 102 Street My Commission Expires ANNING BOARD DATE Member Member Member Disapproved Date corrections or changes to this application after approval has been obtained from NOTE: A charge of 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.