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.