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560 NE 102 St (7)Project Address 560 NE 102 Street Miami Shores, FL 33138- Owner Information JACQUELINE MASTER Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Address Parcel Number 1132060171040 Block: Lot: 560 NE 102 Street MIAMI SHORES FL 33138 -2455 Contractor(s) AB MARTIN ROOFING Phone 305 - 836 -2851 CeII Phone Permit Issue Date: 7/23/2007 Permit NO. RF -7 -07 -1520 Permit Type: Roof Work Classification: Roof - Repair Permit Status: APPROVED Expiration: 01/1 9/2008 Phone Valuation: Total Sq Feet: Type of Work: Repairs Additional Info: COLOR THRU Classification: Residential Fees Due CCF Education Surcharge Permit Fee - Repairs Scanning Fee Technology Fee Work without Permit Fee Total: Amount $0.60 $0.20 $100.00 $3.00 $2.50 $100.00 $206.30 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Total $ 0.00 Payment Type: Amt Paid I Amt Due $ 00. $ 0.00 °JUL 2 3 MD July 23, 2007 Date Applicant JACQUELINE MASTER CeII $ 1,000.00 Available Inspections: 48 Inspection Type: Final Roof Roof in Progress In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Monday, July 23, 2007 1 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. c r Signature � SignaturL\�� Owner or Agent Contractor Pi The foregoi instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of /; N , 20 �'7, by a. riri' \;../ P •T trt - �sP _ , day of , 20 f jj 1, by /-1'r 6 Ant, , who is personally known to me or who has produced who is person lly known to me or who has produced , a i j • • at and who did take an oath. as; cie i lion and who did take an oath. NOT W I T (ip, " • a ; NOTARY el: COr i c ® . • J Up Fs ° • ` J G'O�M1sSIOHF�o ✓A_ $�•, � =.1 O� S � 85 '�\ � _• .. W t + ?'1I-.1� \ Print: �`1 , ::: Pri nt: �. 7�t+ _� r6n < • O � ♦ O .to ';1 1 206) • My Com sl' x}3Yres• My Con> 1613, . •..t�l'VP ey" •• • . ‘t P I c�'(P I • ;"surance 600. O * * * * * * * * * ** #41 , o kAk******************** * * * * * * * * * * * * * * ** * * * * ** * * * * *Irvo ',k ** * a ' * * * * * * * * ** * * * * * * * ** V � STAB' 7 [ Plans Examiner Engineer Zoning APPLICATION APPROVED BY: (Revised 02/08/06) 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING � PERMIT APPLICATION yV FBC 2004 Permit Type (circle): Building Electrical Plumbing Mechanical Owner's Name (Fee Simple Titleholder) Owner's Address < /rJ /J City _ State Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company Name Contractor's Address City to Qualifier Name (Lr State Certificate or Registration No. V 1( ) Architect/Engineer's Name (if applicable) Value of Work For this Permit $ L P Miami Shores Village Building Department LUSLLID i I r) '-, Zip Master Permit No. Phone # Phone # State , NO x( Type of Work: ❑A on ❑ lterati ❑N Describe Work: -P�} : , f urt County Miami -Dade Zip Phone # __)6) ' $ ;2k Certificate of Competency No. Cs -- L.t:.�G.L ja �� u.) Phone # Square / Linear Footage Of Work: Permit No. 01 1520 cofin g Jab LL )0c c ic eplace ❑ Demolition C 1:� ********** * * * * * * * * * * * * * * * * * * * * * * * ** * * *** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** !� v Submittal Fee $ Permit Fee $ 6 61 � ` Notary $ Training/Education Fee $ i 20 Scanning $ 3 Radon $ DPBR $ Bond $ Code Enforcement $ Double Fee $ om� 2 �_ Structural Review. $ Total Fee Now Due $ 2l (, See Reverse side -4 «i\ CCF $ 1 GO CO /CC Technology Fee $ .50 Zoning $ '00 SECTION R4402.13 HIGH VELOCITY HURRICANE ZONES — REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS R4402.13.1 Scope. As it pertains to the section, it is the responsibility of roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of the section. The provisions of Section R4 2 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 ant the contractgr. The owner's initial in the designated space indicates that the item has been explained. Aesthetics - Workmanship: the workmanship provisions of Section R4402 are �.r the .urpose of providing that the roof system meets the wind resistance and water (Z? 'k•• instruction performance standards. Aesthetics (appearance) 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. 3. ay have roof deck commo units of roofing to decks: When replacing roofing, the existing wood roof deck ordance with the current provisions of Section R4403. (The prior to removing the existing roof system). ommon roofs are those which have no visible delineation , townhouses, condominiums, etc.) In buildings with fing i tractor and /or owner should notify the occupants of adjacent be performed. 4. %1 - Exposed Ceiling: Exposed, open beam ceilings are where the underside of the of decking can be viewed from below. The owner may wish to maintain the architectural appearance; therefore, roofing nail penetration of the underside of the decking may not be acceptable. The provides the option of maintaining the appearance. 5. Ponding water: The current roof system and/or deck of the building may not rain 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. Overflow scuppers (wall outlets): It is required that rainwater flow off so that he roof is not overloaded from a buildup of water. Perimeter /edge wall or other roof extension may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance with the requirements of Sections R4402, R4403 and R4413. Ventilation: Most roof structures should have some ability to vent natural rflow through the interior of the structure asserrrbly (the - building- itself). The amount of attic ventilation shall not be reduc&l: It m`ay be!Ubenef,.eiaLto_consider..additional- venting which ult i ex ending the ser ice life of the'raof S 1 OrE ''`' r /Agent's Signature Date .APPP ZO Efbr BLDG DEPT S ignatur DATE SUBJECT TO COMPLIANC TH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS High Velocity Hurricane Zone Uniform Roofing Permit Application Form Master permit No. Contractor's Name: Section A (General Information) Process No, Roof Category Job Adtfress: 7 _ f� hi ) — _ Low Slope _ Mechanically Fastened Tile _'Mortar/Adhesive Set Tile _Asphaltic Shingles _Metal Panel /Shingles —Wood Shingles /Shakes _Prescriptive BUR•RAS 150 _Other , Roof Type — New 1‘uui Re-Roofing _Recovering ✓ Repair Maintenance Are there Gas .Vent Slacks located on the roof? _Yes _No If yes, what type? :Natural _LPGX Roof.System Information Low slope roof area (fl. Steep Sloped area (ft.') Total (fl.') 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. Perimeter Width (al: Corner S ze (a' x a') REPAIR LEAKS ON FRONT OVER DOOR I,M_ 2 6 MAR Inspector Comments See hold harmless letter from contractor in reference to the missed roof repair in progress inspection. OK, 7/26/07 CG Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 07/26/2007 Inspector: Grande, Claudio Owner: MASTER, JACQUELINE Job Address: 560 102 Street NE eitio09. Miami Shores, FL 33138- Project: <NONE> Contractor: AB MARTIN ROOFING Building Department Comments Thursday, July 26, 2007 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Roof Inspection Type: Final Work Classification: Roof - Repair Phone Number Parcel Number 1132060171040 Lot: Phone: 305 - 836 -2851 Page 1 of 2 07 -26 -2007 13:44 ROPERTY LOCATED AT: s A.R. Malin Pcofina,Inr. ermit number RF' 07 -1520 :sued to A.R I43rtin Roofino, rrr_ ype of inspection missed Tn Progress Mate of Florida :ounty of Dade: Magid SiomedVillet9e °ld, Ve,tareme€t 10050 NE 211d Ave Miami Shores, Fl 33138 Phone 305 - 795 -2204; Fax 305 - 756 -8972 www.miamishoresvillage.com HOLD HARMLESS 560 N.E. 102 Street license contractor of subject property, agree to hold Miami Shores Village, its agents and authorized personnel harmless and relieve them from ny responsibility or liability for any legal action or damage, cost or expense (including attorney's fee) ?suiting from missed inspection of the above mention permit. I furthermore assume responsibility for the orrection, if required, of work performed under the above permit. 'rime Contractor - qualifier) (Print Name) *he undersigned, being the first duly sworn, deposes and says that he /she is the contractor for the above •roperty mentioned. � D t1111 / o ;worn to and subscribed before me this` ° � � • • A'' . day of 3-11Y � N •�! i m • -* Apri lotary Public, Sate of Florida at Large • rte • �' 24• J )co 90 ''� OQ • • i t4eC S <<\ % A.R. lvrtin DATE: 2007 JUL 2 6 MR B Y: 7/26/2007 PROPERTY LOCATED AT: , 41-C,(,(., ) rs Signature) As legal owner of subject property, I re uest the cancellation of permit number issued to JCLd C6 for the following reason: /t,P/7 /,g b Date of last inspection: y A '7 I hereby apply as owner - builder, or authorize (new contractor) to apply for such permits as necessary to construct or complete the construction on subject property. I agree to hold Miami Shores Village, its agents and authorized personnel harmless and relieve them from any responsibility or liability for any legal action or damage, cost or expense (including attorney's fee) resulting from the cancellation of the existing permit or the issuance of a new permit. I furthermore assume responsibility for the correction, if required, of work performed under the permit for which I am requesting cancellation. left ti 1/(' c4ek.... (Print Name) State of Florida County of Dade: The undersigned, being the first property. Sworn to and subscribed before Notary Public, Sate of Florida at Miami Siofte4Villeife El4Deftatamota 10050 NE 2 Ave Miami Shores, Fl 33138 Phone 305 - 795.2204; Fax 305 - 756 -8972 www.miamishoresvillage.com HOLD HARMLESS 5E0 N.E. 102 Street a ®, Y Ol��®® duly s®or.,�. pose that that he /she is the legal owner of the above me tli'j °1 a Large ®® MaaMEW'ffi MI JUL 25200/ L BY _ al- I5Zn (Prime Contractor -Only if subcontractor holds permit or if change of qualifier) (Print Name) REPAIR LEAKS ON FRONT OVER DOOR JUL 2 4 2007 Passed Inspector Comments Provide hold harmless letter to Bdlg Dept as requested for missed in progress inspection. 7/24/07 CG. ZZ Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until I nspection Number: INSP -56250 Permit Number: RF -7 -07 -1520 Inspection Date: 07/24/2007 Inspector: Grande, Claudio Owner: MASTER, JACQUELINE Job Address: 560 102 Street NE Project: <NONE> Miami Shores, FL 33138- Contractor: AB MARTIN ROOFING Tuesday, July 24, 2007 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Roof Inspection Type: Final Roof Work Classification: Roof - Repair Phone Number Parcel Number 1132060171040 Lot: Phone: 305 - 836 -2851 Page 1 of 2 Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number: RF -7 -07 -1520 Invoice Number: RF -7 -07 -29245 Applicant: JACQUELINE MASTER Company Name: Owner Address: 560 102 Street NE MIAMI SHORES, FL 33138 Job Address: 560 102 Street NE Miami Shores, FL 33138- Date Monday, July 23, 2007 07/23/2007 Check Payment Type Check Number 09767 Amount $206.30 Change $0.00 Total Payment: $206.30 Page 1 of 1 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date / 0 - O - 9 CJob Address 5 0 / G o7 S7: Tax Folio //- S a 6,6 / 7 / O y O Legal Description Historically Designated: Yes No Owner /Lessee / Tenant XI I/ Ail 7h iL I Ne ' I2 f Master Permit # ' 5 "(4 9 Owner's Address ,5 - ‘ 0 f'/ E / o d St Phone 7$/ -- 70 7 / Contracting Co., f , me 5 GAO gevi a ,s r. Address //e, 0 e o T m O #f4 Qualifier _yoke s Cs'bc o SS# Phone 407 - 30 1 747' State # IQ m o n 3 t 8 l Municipal # 7/ `/9 Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address h Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL OOFING , AVING FENCE SIGN WORK DESCRIP'T'ION / A3oo/ / /e ms a ►., `„, 7,'�: , ,�.., a 0 ,. Square Ft. Acii ) Estimated Cost (value) 3 97 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 contractor to do the work stated. to o President Date APPROVED: �1 Zoning Building UPI/4 Mechanical Plumbing Not as to er . d/or Condo President a te ' otary as to Contractor or Owner- Builder My Commission Expires. _ ..�Onfe1 T My Commission Expires: dleSENT rA IOTT t3tar a Plaids Comm.. CC saw FEES: PERMIT 4 • ®. RADON C.C.F. OL '® NOTARY BOND 3oa TOTAL DUE 36.,. " Electrical Engineering 1 NOTICE OF COMMENCEMENT 96R504022 1996 NOV 01 11:14 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: • 2. Description of improvement: 41/ / 1‘,#/ea.s/ei.: 3. Owner(s) name and address: J ier / D 5j1 Interest in property: Name and address of fee simple titleholder: e% 4. Contractor's name and address: ChCo e «-9 6. Lender's name and address: , crate 5. Surety:(Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, 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: 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) M Signature of Print Owners Name M \I (( e;- -z-�� Q( Sworn to and subscribed before me this day of �� U CS 19 J N Notary Public n / Print Notary's Name ?6S& ,:'Y / 1/ My Commission Expires: {t )-(0 Prepared by..j /'e STATE OF FLORIDA, COUNTY OF DADE HEREBY CERtIFY that this is a Prue j{�p7 of fh °rigl.al fled in this office on C� / Address: / //O #V E c."<ef V�,-� } t 'Job Address: 5/sg /11 ' Contractor J 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. ) 123.01-166 9/94 ( 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: Ply Sheet(s): Cap Sheet: Asphalt: APPENDIX 'E' METRO -DADE UNIFORM BUILDING PERMIT SECTION If BUILT -UP APPLICATIONS AND MODIFIED BITUMEN SYSTEMS RS': /a 0 ( 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: Contractor Process No. (Checkone of the following) Recover Re -roof: ✓ New Construction 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 ) Y N Wee D / ,V/7 Ply Sheet(s): T 04 & c 644 .l f/ ( Type and method of attachment) / Built -Up Applications and Modified Bitumen Systems Page -2 Job Address: Contractor Process No. Top Ply: (Type and method oj attachment ) Surfacing: ( Type, if applicable ) Flashing Materials: (Type and method oj attachment ) P / 7 6' C '/ s s a fi Setif coril A4 474 Built -Up Applications and Modified Bitumen Systems Page -3 Job Address: Contractor Process No. T I _ inches T I _ inches inches 1 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 ".) Surfacing. (briefly describe. u&PO=b►.) Top Ply. e.0,9 Bonding Material: /1x01 7;1R Ply Sheet(s): 44105$ w-rt Bonding Material: /40>` lid Fastener. M4 (((base sheet meth on rdj Base Sheet: 7SC/1F Cloffs Bonding Material: ( if bare sheet bonded ) Fastener. (rf fop insolanon layer meek onached) Top Insulation Layer. ((f applicable) Bonding Material: ( top on Fastener. (rf inrvionon mech. orrached) Insulation: Primer. (ifopphcobTM) M/4' Bonding Material: ((insalarion banded ) /_ Vapor Retarder C ( /applicable) DECK: n Type: IN-Ord' / � is 1 Gage or Thickness: Density, if concrete deck: Built -Up Applications and Modified Bitumen Systems Page -4 Job Address: Contractor Process No. PERIMETER DETAIL #1: Parapet Wall Detail Coping Cap Gagc: Fastener Spacing: _ o.c. Clip Type: Clip Gage: Sketch Roofing Components which make up Roof System Assembly at Perimeter Parapet Walls. Insert leaders indicating Roofing Component names, dimensions, thicknesses, etc. Include fastener type and spacing used for wood - blocking attachment ffrd r.� ik ,�a Deck Type: Sketch Rooting Components which make up Roof System Assembly at Perimeter Areas to be Flashed Insert leaden 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 se 4 Iv; , )0.14 Job Address: Contractor PERIMETER DETAIL #3: Gravel Stop or Drip Edge PERIMETER DETAIL #4: Gutter Detail Built -Up Applications and Modified Bitumen Systems Page -6 Process No. Sketch 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 - blocking attachment. Gravel Stop/Drip Edge Gage: Fastener Spacing: o.c. Clip Type: Clip Gage: � \ff Deck Type: Sketch Roofing Components which make up Roof System Assembly at Perimeter Edge with Gutters. 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: Deck Type: • Job Address: 44t ,#( /o.7 Contractor../does rg‘m Process No. PERIMETER DETAIL #5: 'Other' Detail 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 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 attachment PERIMETER DETAIL #6: 'Other' Detail Built -Up Applications and Modified Bitumen Systems Page -7 Job Address:Slso ari /oz , Contractor ..res Q44 Process No. Insert Building and Parapet Heights. (If no Parapet exists, insert "N /A') Also insert applieable information pertaining to the building below. (See ASCE 7 -88 Fact Sheet Attached ) Exposure Category: Classification Category: At Hurricane Oceanline ?: Y N Basic Wind Speed at Building Location: 110 mph Building Condition based on % of Openings: GROUND LEVEL 1 -2_ feet >r a feet BUILDING INFORMATION #1 Built -Up Applications and Modified Bitumen Systems Page -8 Job Address: 3'64. f ie /oj 4 Contractor.ru, $ Cica Process No. 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 ) /Seuf /eh N write TA:Cf BUILDING INFORMATION #2: Roof Plan with Perimeter and Corner Dimensions Built -Up Applications and Modified Bitumen Systems Page -9 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: Reviewed Details ?: Y N Notes: Built -Up Applications and Modified Bitumen Systems Page -10 Y N Deck Type 1: Wood, Non - insulated Deck Description: System Type A(1): Base sheet mechanically fastened. All General and System Limitations shall apply. Base Sheet: PIy Sheet: Cap Sheet: Surfacing': • Maximum Design Pressure: -45 psf. 19/3`" or greater plywood or wood plank decks Gafglas® #75, Gafglas Ply 4, Gafglas Ply 6, Gafglas Stratavent or Ruberoid 20 applied to the deck with approved annular ring shank nails and minimum 1 5 / tin caps at a fastener spacing of 12" o.c. at the lap, 18" o.c. in two rows staggered along the center line of the sheet in the field. Two or three plies of Gafglas® Ply 4 or Gafglas PIy 6® ply sheet adhered in a full mopping of approved asphalt at an application rate of 25 lbs. /sq. ± 15 %. (Optional) One ply of Gafglas® Mineral Surfaced Cap Sheet adred in a full mopping of approved asphalt at an application rate of 25 lbs. /sq. ± 15 %. (Required if no cap sheet is used) Install one of the following: Maximum Fire Classification: 'A'. See General Limitation #2. Maximum Slope: 3 ":12 "; See General Limitation #3. Specification No.: None 1. Grundy AL MB aluminum Roof Coating with an application rate of 1.5 gal. /sq.; or GAF Weather Coat Emulsion with an application rate of 3 gal. /sq.; or GAF Fibered Aluminum Coating with an application rate of I.5 gal. /sq.. 2. Asphalt flood coat at an application rate of 60 lbs. /sq. ± 20 %; plus gravel or slag with an application rate of 400 lbs. /sq. & 300 lbs. /sq., respectively. Gil Diamond, P.E. 19 Product Control No 0- 1201.2 t Co - ilL ii;:rfiet.j >f 'Efbiii .. Feel . 9AFBLAE Spank:aeoa •Class . -- - . . . ' :A G : C '< ° ='::: {' • _ $ -; 0-3-G, I- B -3 - G. N•B - G, • NN- 0-3-G, NN -B -3-G A : f3 - '.. :. C' y . :' 3' _ 4 ; :'.: ; : 4 -0,1- B-4-G. N- B-4-G, " ? ", _ :$N- :0-4-G, NN -B-4 -G A • - " .0 ° L . 3 :,.� '- F1- a -3-M A : `" ` , : .. N 4-4-M •11-8 7 5-M .. . !iii- a -3-i- A M : _• nti 'J " -._ ' Pi- IYJ -M . .. ' 1- 0.4- M, - 4 - M, NN- 0-4 -M, • - NN -B-4 -M A M... -.'•!-!.'x7' " .., :; ='3 - „4 . - - t- 8 -s41, NN -8 -5 -M Y A ilia : f - - ° • . •t- -3 NN-61-i4 A •NI ;� :: Nc =: • -.z'.: 4 i =M, B-4 -M, NN-o -4 -M, - NN -B-4•M A - •'- M ` " ; ' -' 1�1 : =% :'- . a "5.: ` B-5 -M, NN - - A GFAC - ;_4'NG -::; - s y ::3 . :I -0.3-0 • • A ' •':GtAC ` '};fir ' ;B` , -..;,. .;:. ; . - b-e-t, NN - o - - r..' 2 , .NN- 13 -3-C, N - - - ' i -C, NN- o-4-C, �,:. �.,�'� � •. M -C, f -b-4 A � GWCE: -� "�:_ ��:�;:.. T -t , ..NN- B-4 -C, N -B-4 -C 31/¢` ° ' . = 1-0-3-M, I- B -3 -M, N - B - - M, ::ksr : NN41-3 -M . ` ''..-3 4 . .-,::1-0- NN -O-4M, :ry•.: :• t. •..:11- . ., NN B - M, N - - 8' M ' . _ ` 3 iii. $ `.i- 8-5 -M, NN- a -5 -M, N -B -5 -M B GINCE , C " `'" :'i' . 8.... •-• 1. - I- B - - N- B -3 -C, ��: ` •N-03-C, NN -B -3-C 8'” - GWCE C : ,. • 112' :4 ' _:.: (-0 4 C, 1 - B - C, NN - - C, . ::-:NN-B-4-C, N -B-4 -C C GSREt : e : "_ 1/2' '" : -C, I- B -3 -C, NN -0-3-C, -. ;:t __ NN-i - 3-C, N -8 -3-C c tij' ='C' :- " =:i.' 1 `'.- ' "=" i- 6.4=C,1- B-4 -C, NN- o-4-C, • ;' . SI B-4 N - . C - GWCE . • C: . <:.t 'x:11 9 . , .. ," I= 0=3-C, I- B -3-C, NN-0-3-C, _ , NN- B -3-C, N -8 -3-C C - OWL` 1 ..' . ' . C• , ..`..: 11 �. . :i- l- 4- C, B -4-C, NN - 0 - 4 - • • NN-B-4-C, N -B -4 -C Ga. comboaartai 6 GAFGLAS UL Systems' Ratings Design Considerations Key to UL Systems' Ratings Chart 1. Surfacing G = Flood coat of asphalt and 400 pounds of gravel or 300 pounds of slag M = GAFGLAS' Mineral Surfaced Cap Sheet GFAC = Grundy Fibered Aluminum Roof Coating' GWCE = WEATHER COAT' Emulsion GSRB = GAF Materials Corporation Special Roofing Bitumen 2. Substrate C = Combustible and noncombustible decks Combustible = Wood planks, boards, etc.; plywood, oriented strand board; minimum ' /:inch thick plywood or OSB. NC = Noncombustible only = steel, poured and precast structural concrete, lightweight insulating concrete, structural woodfiber, etc. 3. Slope Maximum slope, in inches per foot, allowed. U = Unlimited slope 4. Plies Number of plies of felts in the specification, and includes any base sheets and cap sheets. 5. Insulation Except for insulated specifications postscripted #1, all insulated specifications may, as an option, include any of the following insulations in any thickness: perlite, wood fiberboard, glass fiber, polyisocyanurates, perlite/isocyanurate composites, and wood fiberboard /socyanurate composites. For postscripted specifications, perlite, wood fiberboard, and glass fiber, any thickness are required. Note: Type G2 asphalt glass mat base sheet (GAFGLAS #75 Base Sheet) is a suitable altemate for Type G1 asphalt glass fiber ply sheet (GAFGLAS Ply 4 or GAFGLAS" PLY 6) in the Class A, B, or C roof systems indicated above. The roof deck may first be covered with a Type G2 asphalt glass mat base sheet (GAFGLAS STRATAVENT° (Vent Ply) Perforated or GAFGLAS STRATAVENT (Vent Ply) for Nailable Decks. 'Perforated' to be mopped, and - Nailable to be mechanically attached granule side down. As an option, Type G2 asphalt glass mat base sheet (GAFGLAS #75 Base Sheet or GAFGLAS STRATAVENT (Vent Ply) for Nailable Decks) may be substituted for G1 asphalt glass fiber ply sheet (GAFGLAS Ply 4 or GAFGLAS PLY 6) as the nailed base ply in the above systems. Bottom ply or base sheet may be solid mopped, spot mopped, or mechanically fastened. All insulations are mechanically fastened. GAFGLAS Flashing or RUBEROID° may be used for flashing in any of the Class A, 8, or C systems listed above. Crushed stone or slag are suitable alternatives for gravel in any of the Class A, B. or C systems listed. Factory Mutual (FM) Approvals GAF Materials Corporation has extensive FM Approvals and Acceptances (in the cases of installations over combustible wood decks) of its GAFGLAS Built Up Roofing Systems. Those Approvals/ Acceptances depend on substrate, number of plies, type of insulation, thickness of insulation, density of GAFTITE° Fasteners, surfacings/ coatings, etc. Refer to the current FM Approval Guide or contact GAF Materials CorporationTechnical Services for specific situations. Be advised that FM Approvals are often specified on installations not to be insured by FM Underwriters and actual needs may be misinterpreted. Discussing such situations with GAF Materials Corporation Technical Services may serve to clarify actual job requirements. ' Made by Grundy Industries, Inc. • GAP BUILDING MATERIAL., CORPORATION NNlable Deck 14_ (f Paper R 2' Std? Lap A spMlt - - 2' Side lip f �, GAFGLAS 24 ' Mineral Surfaced Cap Sheet l_ GAFGLAS Base Sheet (sn below) GAFGLAS Ply North, South, and West Zones Nailable decks up to 6 inches per foot slope. Wood, poured gypsum, precast gypsum planks, other acceptable precast nailable decks For lightweight insulating concrete decks, see page 9. Materials Approximate Weight Per Square Sheathing paper (1 ply, if required) GAFGLAS Base Sheet GAFGLAS Ply (2 plies) GAF Roofing Asphalt Interplies Cap Sheet GAFGLAS Mineral Surfaced Cap Sheet (1 ply) 11-69 lbs. 22 lbs. 50 lbs. 25 lbs. 76 lbs. Total 184 -242 lbs. Guarantees Available Specification Liberty Guarantees N- B- 4 -M/P6 N -B -4 -M 15, 2 +10,10, 5 +5, 5 yr. South and West Zones only, Lightweight Insulating Concrete. (See page 9.) • 2 +10, 10, 5 +5, 5 yr. 50 GAFGLAS` "' Specifications N- B- 4 -M /P6 and N -B -4 -M Specifications General Application recommendations detailed on pages 23 -26 shall apply in addition to the following recommendations and specifications. Application of Roofing Membrane 1. Over entire surface, lay one ply of sheathing paper where applicable. Lap each sheet 2 inches over preceding sheet. Nail sufficiently to hold in place. 2. Starting at the low point of the roof, lay one ply of GAFGLAS Base Sheet, lapping each sheet 2 inches at edges and not less than 6 inches at end laps. Nail along lap of base ply at intervals not to exceed 9 inches and stagger -nail down center of sheet in two rows with nails spaced at 18 inch intervals in each row. Use fasteners with integral metal heads at least 1 inch in diameter or square that are recommended by GAF or the deck manufacturer. (See "Special Instructions" below.) 3. Starting at the low point of the roof, mop two plies of GAFGLAS Ply shingle fashion; lapping each sheet 19 inches over the preceding sheet; solidly mopping to the underlying base sheet to provide three plies over the entire roof area. Asphalt Requirements Interply moppings of GAF Roofing Asphalt must be applied in a continuous film and shall consist of approximately 25 pounds per 100 square feet of roof area with a tolerance not to exceed 20% plus or minus. The appropriate asphalt for the slopes involved must be used. Slope per foot Asphalt Type Up to 3" Steep ASTM Type III 3"— 6" HT -Steep ASTM Type IV On slopes up to '/2 inch per foot, Flat ASTM Type II may be used except in Florida, Texas, New Mexico, Arizona, and California. Surfacing Apply GAFGLAS Mineral Surfaced Cap Sheet in accordance with the application instructions on page 26, so that the laps are offset from the laps of the ply sheets. Special Instructions 1. See recommendations for use over gypsum decks on page 8. 2. Acceptable GAFGLAS Base Sheets include: GAFGLAS STRATAVENT® (Vent Ply) for Nailable Decks required for freshly poured gypsum decks, GAFGLAS #75 Base Sheet, GAFGLAS PLY 6®, and GAFGLAS Ply 4. For wood decks and structural woodfiber decks, when GAFGLAS Ply 4 or GAFGLAS PLY 6 is used as a base sheet, a sheathing paper is required. 3. See "Nailing of Base Sheet," page 24. 4. For roof slopes exceeding 1 inch per foot, all ply felts must be back - nailed 4 inches in from the back edge of the felt. (See "Installation on Steep Roofs," page 10.) UL Classification UL Class Substrate Slope A A B C NC C 2" 3" 3 '/2" UL Chart Key 1. Substrate C = Combustible and Noncombustible Combustible = Wood planks, boards, etc., plywood (min. ' inch thickness), oriented strand board (min. I/2 inch thickness). NC = Noncombustible only Noncombustible = Steel, poured or precast structural concrete, lightweight insulating concrete, gypsum, structural wood fiberboard, etc. 2. Slope Maximum slope allowed, in inches per foot. 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. 15 squares March 28th 77 Date..._..._... __....� __.._._�.. �.. ,19.. Owner's Name and Address DQ4131, CIPAIPPe?3........_ .._.. _ .» No...5 O..._......... Registered Architect and /or Engineer „,•.., ,, .,, , =et ..... . Name and address of licensed contractor La n& Roofing & Tile Co. t Inc ..z._ 573 N.W. 71st, Miami. Fla. 33150 Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done N.E. 102nd Street ._ .._.._� State work to be done and purpose of building (by floors).. ? ?x.t .lkl 1/ : - ,._Tea,x'..q#',...ozigt g „ rooting,. tin ,eap 1 -30# mop 2- layers of 15# felts with hot asphalt and cover with a layer of pea gravel embedded into hot poured asphalt. . and for no other purpose. New Building Remodeling Addition Repairs.AL.Vtial Rio. of Stories 1 To be constructed of Kind of foundation Roof Covering . - . .-.Ply .. Gravel Estimated Total cost of improvements $ 1 Amount of Permit $,. Zone cubage required plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building 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, Pernanent Sup a lcinent, and has complied with the provisions thereof, and will require similar compliance from all contractors or ub- contractors employe him in the work to be performed under this permit; and will post or cause to be posted for inspection on t site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontra ors, n work to be performed under this pennit, 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 ar true. Permit No..__.___ I , 1._ -CB__L Date Disapproved (Signed) ate.. Buildin • . cc or Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANN •`C BOARD DATE Chairman Member \fcrnber 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 anti /or workmanship. peared New Building To be constructed of Estimated Total cost of improvements $ 500, 00 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby mode 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. October 31 .1 9 74 Data..._... .� _ _.. ... �... . Owner's Name and Address Russell Sayre N o 560 _ _... str eet.. N. E. 102nd St. R egistered Architect and /or Engineer ..... .:.......... . _.... Name and address of licensed contractor Obenour Roofing Co. 7357 N. W. Miami Ct • Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 560 N. E. 102nd Remove f r State work ) t t o a bp tins t ancfissr o `l�tnR qz f800�sd' c win gar save drip and tile St . one stop seaion west 1= 3U ° 1.b. feTt,I'z; "SIEr't�' and for no other purpose. Repairs No. of Stories.. 3i sqs. T1 4 Remodeling Addition Kind of foundation Roof Covering Amount of Permit $. 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 pennit 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, 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) STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorizcd to administer 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 tru / / Permit No - v - ` / Date _._ Read, Sworn to and Subscribed before me. Disapproved / �� Dat ( Signed) .. -•� �– � - '��- ing Inspccto' My Commission Expires Notary Public, State of Florida ANNING BOARD .._ - -.- ..DATE Chairman Member Member Member Member sass.. Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application nfter approval has been obtained from the Pl.anniri. Board. A re 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. MIAMI SHORES VILLAGE, FLA. N9 5236 JOB t G\c �' O 1) � f ADDRESS ° / 0 INSPECTION 7 t TIME READY REMARKS: INSPECTOR DATE / 2 ` i' BUILDING ❑ i:LECTRICAL ❑ PLUMBING ❑ KOOFING 0 Owner of wilding A Irchitect contractor -ir Builder -ega1 Description n ddress of wilding Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA e PERMIT N? 4559 t rr , -4 B1 1 L of , 3/ Subdi- vision Value of Project $ Z Z s A Amount of Permit $ DATF / r? ' Contractor's License No. I (i Work to be performed under this Permit This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application ,erefor 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 fine 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 , ertaining to the work covered hereby whether shown on the plans or drawings or in the statements or sp ficatio:l¢ and that he assumes responsibility for work lone by his agents, servants or employees. ,, f 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 ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- opting this permit I assume responsibility for all work done by either, myself, my, agen / servant or employee. Signed. t. 4 . BY BY AUTHORITY e MIAMI SHORES VILLAGE Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address R. A. Sayre Registered Architect and /or Engineer BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Name and address of licensed contractor Lang Roofing. & Tile Co., Location and legal description of lot to be built on: Lot Block Street and Number where work is to be done Subdivision 560_N.. Ea.__ 102nd... St ...,.Miami ..Shorea,...E�a_. State work to be done and purpose of building (by floors) New Building Remodeling Addition To be constructed of Kind of foundation Estimated Total cost of improvements $_225_.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 - 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 Roofi ✓/ T le Co., Inc., Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. J ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the_ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No 4- S S °.( Date_ ___1 a - 3_c - i._3 -- Read, Sworn to and Subscribed before me. Date Disapproved ( Signed) t4P_, e .j Date October 30 1956 , 19 No.. 560 Street N, E, 102nd St„ Inc., 430 N, W..79th t,_ Miami Fla. and for no other purpose. Repairs X Res No of Stories Roof Covering ..... 4.-ply gravel to me well known, Notary Public, State of Florida Miami Shores,Fla. Buildingilnspector My Commission Expires PLANNING BOARD DATE Chainnan 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.