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Florida Budding Code Edition 2002 High Velocity Hurricane Zone Uniform Permit Application Form INSTRUCTION PAGE COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING PERMIT APPLICATION FORM AND ATTACH THE REQUIRED DOCUMENTS AS NOTED BELOW: Roof System Low Slope Application Prescriptive BUR -RAS 150 Required Sections of the Permit Application Form A,B,C A,B,C Attachments Required See List Below. 1,2,3,4,5,6,7 4,5,6,7 Asphaltic Shingles Concrete or Clay Tile Metal Roofs A,B,D A,B,D,E A,B,D Wood Shingles and Shakes ether A,B,D As Applicable 1,2,4,5,6,7 1.2.3.4.5,6,7 1,2,3,4,5,6,7 1,2,4,5,6,7 1,2,3,4,5,6,7` 1. ATTACHMENTS REQUIRED: Fire Directory Listing Page 2. 4. 5. 6. 7. From Notice of Acceptance: Front Page Specific System Description Specific System Limitations General Limitations Applicable Detail Drawings Design Calculations per Chapter 16, or If Applicable, RAS 127 or RAS 128 Other Component Notice of Acceptances !Municipal Per nit Applic :tion Owners Notification for ;~Roof Roofing _Considerations (Re •oofing Only) Any Required Roof Testinj /Gaiculati •. v. Florida: Building Code Edition 2002 Huh velocity Hurricane Zone Unitorm Permit Application Form Master Permit No. Contractor's Name Job Address cti n A General information Low Slope 0 Asphaltic Shingles ROOF CATEGORY ❑ Mechanically Fastened Tile 0 Mortar /Adhesive Set The ❑ Metal Parcel /Shingles ❑ Wood Shingles /Shakes 0 Prescriptive SUR -RAS '50 ROOF TYPE ❑ New Roof .1:' ?v Roofing ❑ Recovering ❑ Repair 0 Maintenance ROOF SYSTEM INFORMATION Low Slope of Area (SF) Steep Sloped Roof Area (SF) Total (SF) S B (R0 ®f Phan) 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. Fioritla High V HANtcerx. Zene UsitnnYlIesrl .Plicagon Fir. Section C L Fill In Specific Roof Assembly Components andicleafffy lilanufactunikr (1i a wmpooftot is not used, identify as Sywenti Manutaourer fiGA Desi.gn r"---s.teures, From r44.. i2 •crezacuLvicp-34 Prrsx1: Pinaxa. Max. Design Pressure. F e Pecific NOA System: Deck: Gaugerrnioltness: 0,2 Arichorffiase St & No. of Pty()' .7.5-441044...0 A 170 44.5.1P •••■•■••••=11119......e Svstern) Fastener Spacing for Ancharease Vleet Attachment (42 Lap, Rcws Perimater_' ° g Lap, # ' oc Lap, *Rows Number of Fasteners Pa Insulation Board FlAtid Peri, rorner Illustrate Components Noted and Details as Appficabie: Woodbiccking, Gutter. EdQe Termination Stripping, Fiashing, Continuous Cleat, Can Strip, Base Fleshing, Counter- Flashing, Cc-ping, Etc. 04",...Wdl_cate:' Mean Roof Height, Parapet Height, Hight of Base Fiashing, (...3-3,13C-fiellt Materiel, Material Thicfroless, Fastener Type, Fastener Spacing or Submit Manufacturers Details that C.omply with RAS 111 and Chapter 16. t aasa Layer Base .Lrr.;.-Oation Size and Tr-.' Base Insulation Fastener/Bonding Mat Top lnsulatic.-: L3yer. s Top Insulation Size and Thic:kne Top insulation Fastener/Bonding mat Base Sheet(s) & No. of Ply(s): Base Sheet Fasteneritonding Material: rteetS-Pty Sheet(s) & No. of Ply(s):a41. Florida_ Building Code Edition 2002 Hi • h Vel. ' Hurricane Zone Uniform Permit s iication Form Section !D Stee a Sio,a ed Roo S e Roof System Manufacturer: Notice of Acceptance Number: Minimum Design Wind Pressur • , If Applicable (From RAS 127 or Calculations): Pmax1: Pmax2: Pmax3: Maximum Design Pres re (From. the NOA Spec c System): Method of Tile A achment: Roof Slope: 12 Deck Type: Sloped System Description ype Underlayment. insulation: Fire Barrier: Fasten : ype & Spacing: Ridge Ventilation? Adhesive Type: hype Cap Sheet: oof Covering: Type & Size Drip dge: Mean Roo ght: • Florida Building Code Edition 2002 High Velocity Hurricane Zone Uniform Permit 'Application Form Section E (T aicuIati-oi<lsa' For Moment based tile systems, choose either Method 1 or 2. Cot ' ared the values for Mr with the values from -Mr. If the Mf values are greater tha - or equal to the Mr values, for each area of the roof, then the We attachment met; 1 i d is acceptable. Method 1 "Moment Based Tile Calculatio . s Per RAS 127" (P1: x X ) — Mg — MO NOA Mf (P2: i X = ) — Mg: = via NOA Mf (P3: % %L = ) — Mg: = Mr3 NOA Mf Method 2 "Simplified Tile Calcul .' 'on Per Table Below" Required Moment of Resistance (Mr) From Table Belo NOA Mr Mr Required Mom =.ht Resistance* Mean Roof Height -- Roof Slope 7 15' 20' 25' 30' 40' 2:12 34.4 36.5 38.2 39.7 42.2 3:12 32,2 34.4 36 37.4 39.8 4:12 30.4 32.2 33.8 35.1 37.3 5:12 28.4 30.1 31.6 ` 32.8 —' 34.9 6:12 26.4 28.0' ' 29.4 30.5 32.4 7:12 24.4 " 25.9 27.1 28.2 30.0 *Must be used hi conjunction with ,::list of moment based tile systems endorsed by the Broward County Board of Rules a t d Apr eats. For Uplift based We system' use Method 3. Compared the values for F' with the values for Fr. If the F' vat .'. are greater than or equal to the Fr values, for each area of the roof, then the ce attachment method is acceptable. Metho; ` "Uplift Based Tile Calculations Per RAS 127" (Pi: x1: = x w: _ ) — W: x cos O :• = Frf: NOA F' x1 :— x w := ) —W: xcos B: = Fr2; NOAF' �(Pp2: ( ;3: x1: =x w:= ) - W: cos 0:• = Fa: NOAF' _x Where to Obtain Information Description Symbol ` Where to find Design Pressure P1 or P2 or P3 RAS 127 Table 1 or by an engineering analysis prepared by PE based on AS 7 can Roof Height H Job Site ■ Roof Slope B lob Site NOA rodynamic Multiplier Restorin' r ometit due to Gravity M, NOA Attachment Resistance M1 NOA ' ed Moment Resistance Mr Calculated . o o Attachment Resistance F' NOA �• ; ied Uplift Resistance Fr Calculated A vei-sge The Weight " W l' length w= width NOA NOA Tile Dimensions All cal atioas must be submitted to the Building Official at the time of permit application. SECTION 1524 HIGH VELOCITY HURRICANE ZONE REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of this section. The provisions of Chapter 15 of the South Florida Building Code, Building govern the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner and the contractor. The owner's initial in the adjacent box indicates that the item has been explained. - /1!/ 1'!_ / 1. Aesthetics - Workmanship: The workmanship provisions of Chapter 15 (High Velocity -Hurricane Zone) are the purpose of providing that the roofing system meets the wind resistance and water intrusions performance standards. Aesthetics (appearance) issues are not a consideration with respect to workmanship provisions. Aesthetics issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. 2 Renailing Woods Decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing roof system). 3a &ommon Roofs: Common roofs are those which have no visible delineation between neighboring units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or owner should notify the occupants of adjacent units of roofing work to be performed. 4i)Exposed Ceiling: Exposed, open beam ceiling are where the underside of the roof decking can e viewed from below. The owner may which to maintain the architectural appearance; therefore, roofing nail penetrations of the underside of the decking may not be acceptable. The Florida Building Code provides the option of maintaining this appearance. 5 j Ponding Water: The current roof system and /or deck of the building may not drain well and may cause water to pond (accumulate) in low -lying areas of the roof. Ponding can be and 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. 61 Overflow scuppers (wall outlets): It is required that rainwater flow off of so that the roof is norov'erloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if overflow scuppers (wall outlets are not provided. It may be necessary to install overflow scuppers in accordance with the Florida Building Code, Plumbing. 71. Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of the structural assembly (the building itself). The existing amount of attic ventilation should not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the roof. Late 'zed Signatu MIAM BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) CAF Material Corporation 1361 Alps Road Wayne, NJ 07470 MIAMI-DADE COUNTY, FLORIDA METRO-DADE FLAGLER BUILDING 144) WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130-1563 (305) 375-2901 FAX (305) 375-2908 SCOPE: This NOA is being issued under the applicable rulei and regulations governing the use of construction materials. The documentation submitted has been reviewed by the BCCO and accepted by the Building Code and Product Review Committee to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AH1). This NOA shall not be valid after the expiration date. stated below. The Miami-Dade County Product Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the High Velocity Hurricane Zone of the Florida Building Code. DESCRIP'FION: GAF Conventional Built-Up Roof System for Wood Deck. L 1,ELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami-Dade County Product Control Approved", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMLNATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA renews NOA 4102-0408.09 and consists of pages 1 through 21. The submitted documentation was reviewed by Frank Zuioaga, RRC NOA No: 03-050L05 Expiration Date: 11/04/08 Approval Date:10/23/03 Page 1 of 21 ROOFING SYSTEM APPROVAL Category: Sub-Category: Deck Type: Maximum Design Pressure Fire Classification: Roofing BUR Wood -75 psf See General Limitation #1 TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT: TAaJR1 Product GAF Asphalt Concrete Primer (MatrixTm 307 Primer) GAF Mineral Shield® Granules GAF WeatherCoat® Emulsion (MatrixTm Fibered 305 Emulsion) GAF Premium Fibered Aluminum Roof Coating (MatrixTM System Pro Aluminum Roof Coating Fibered 301) GAF Jetblack Al] Weather Plastic Cement (Matrix im Standard Wet/Dry Roof Cement 204) RUBEROID® Modified Bitumen Flashing Cement Jetblack Premium Flashing Cement GAFGLAS® #75 GAFGLAS #80 Ultima Base Sheet GAFGLAS Flex Ply" 6 Dimensions 5, 55 gallons 60 lb. bags 5 gallons Test Specification ASTM D 41 ASTM D 1863 ASTM 1227 Product Description Asphalt concrete primer used to promote adhesion of asphalt in built-up roofing. Granules for surfacing of exposed asphalt, cold process cement or emulsion. GAF Mineral Shield® Granules shall be used for flashing applications only. Surface coating for smooth surfaced roofs. 1, 5 gallons ASTM D 2824 Fibered aluminum coating. 1, 5 gallons 5 gallons 5 gallons 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide ASTM D 3019 Refined asphalt blended with a mineral ASTM D 3409 stabilizer and fibers. Permits adhesion to wet and dry surfaces. ASTM D 4586 Fiber reinforced, polymer modified Flashing cement ASTM D 4586 Asphalt flashing Cement ASTM D 4601 ASTM D4601 ASTM D 2178 Asphalt impregnated and coated glass mat base sheet. Asphalt impregnated and coated, fiberglass base sheet Type VI asphalt impregnated glass felt with asphalt coating. NOA No: 03-0501.05 Expiration Date: 11/04/ Approval Date:10/23/03 Page 2 of 21 Product GAFGLAS Ply 4® GAFGLAStli Mineral Surfaced Cap Sheet GAFGLAS® STRATAVENT® Eliminator Perforated GAFGLAS® Flashing GAFGLAS® STRATAVENT Ruminator Perforated Nailable RUBEROID® SBS Heat - We1dTM Smooth RU13ERO 1)0 SBS Heat- WeIdTM Granule RUBEROID® SBS Heat- Weld xm 170 FR RUBEROID® SBS Heat- WeldTm PLUS RUBEROIDo SBS Heat- Weld PLUS FR RUBEROID® SBS Heat - WeldTM 25 RUBEROID Modified Base Sheet Ruberoid 0 Dimensions 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide Various 39.37" (1 meter) wide 1 meter (39.37") wide 1 meter (39.37") wide 1 meter (39.37") wide 1 meter (39.37") wide 1 meter (39.37") wide 1 meter (39.37") wide 39.37" (1 meter) wide 20 39.37" (1 meter) wide Ruberoid® Mop Granule 39.37" (1 meter) wide Test Specification ASTM D 2178 ASTM D 3909 ASTM D 4897 D 3672 ASTM D 4897 D 3672 ASTM D-6164 ASTM D-6164 ASTM D-6164 ASTM D-6164 ASTM D-6164 ASTM D-6164 ASTM D4601, Type fi, UL Type G2 BUR ASTM D 6163 ASTM D 5147 ASTM D 6222 ASTM D 5147 Product Description Type IV asphalt impregnated glass felt with asphalt coating. Asphalt coated, glass fiber mat cap sheet surfaced with mineral granules. Fiberglass base sheet impregnated and coated on both sides with asphalt. Surfaced on the bottom side with mineral granules embedded in asphaltic coating with factory perforations. Asphalt coated glass fiber mat flashing sheet available in three sizes. Fiberglass base sheet impregnated and coated on both sides with asphalt. Surfaced on the bottom side with mineral granules embedded in asphaltic coating. Non-Woven Polyester mat coated with polymer-modified asphalt and smooth surfaced. Non-Woven Polyester mat coated with polymer modified asphalt and surfaced with mineral granules. Non-Woven Polyester mat coated with fire retardant polymer modified asphalt and surfaced with mineral granules. Non-Woven Polyester mat coated with polymer modified asphalt and surfaced with mineral granules. Non-Woven Polyester mat coated with fire retardant polymer modified asphalt and surfaced with mineral granules. Non-Woven Polyester mat coated with polymer-modified asphalt and smooth surfaced. Premium glass fiber reinforced SBS- modified base sheet SBS modified asphalt base sheet and interply sheet reinforce with a glass fiber mat. Non-woven polyester mat coated with polymer modified asphalt and surfaced with mineral granules. NOA No: 03-0501.05 Expiration Date: 11/04/08 Approval Date:10/23/03 Pe3of21 1 Product Ruberoid 0 Mop Plus (Granule) RUBEROID MOP Smooth RUBEROID® MOP 170FR RUBEROID® MOP FR RUBEROID® TORCH Smooth RUBEROID® TORCH Granule RUBEROID® TORCH PLUS (Granule) RUBEROID® TORCH FR RUBEROID 170FR TORCH RUBEROID® 30 RUBEROID® 30 FR RUBEROID ULTRACLAD® SBS RUBEROID® Dual FR Dimensions 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (I meter) wide 39.37" (1 meter) Wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) wide 39.37" (1 meter) Wide Test ASTM D 6222 ASTM D 5147 ASTM D 6164 ASTM D 5147 ASTM D 6164 ASTM D 5147 ASTM D 6164 ASTM D 5147 ASTM D 5147 ASTM D 5147 ASTM D 6222 ASTM D 5147 ASTM D 6222 ASTM D 5147 ASTM D 6222 ASTM D 5147 ASTM D 6163 ASTM D 5147 ASTM D 6163 AS'IM D 5147 ASTM D 6298 ASTM D 5147 Product Description Non-woven polyester mat coated with polymer modified asphalt and surfaced with mineral granules. Non-woven polyester mat coated with polymer-modified asphalt and smooth surfaced. Non-Woven polyester mat coated with fire retardant polymer modified asphalt and surfaced with mineral granules. Non-Woven polyester mat coated with fire retardant polymer modified asphalt and surfaced with mineral granules. Heavy duty, polyester reinforced, asphalt modified bitumen Membrane, smooth surface. Asphalt impregnated, coated felt, surfaced with mineral granule. Heavy duty, polyester reinforced, asphalt modified bitumen membrane, granule surface Heavy duty, polyester reinforced, coated with fire retardant asphalt modified bitumen membrane, granule surface. Heavy duty, polyester reinforced, coated with fire retardant asphalt modified bitumen membrane, granule surface. Non-woven fiberglass mat coated with polymer modified asphalt and surfaced with mineral granules. Non-woven fiberglass mat coated with fire retardant polymer modified asphalt and surfaced with mineral granules. Woven fiberglass mat coated with Polymer modified asphalt and surfaced with aluminum, copper or stainless steel foil. ASTM D 6164 Non-woven polyester and fiberglass mat ASTM D 5147 coated with file retardant, polymer modified asphalt and surfaced with mineral granules. NOA No: 03-0501.05 Expiration Date: 11)04/ Approval Date:10/23/03 Page 4 of 21 Product Vent Stacks (metal and plastic) GAF Aluminum Emulsion GAF Aluminum Roof Paint (Matrix® System Pro Aluminum Roof Coating Fibered 302) GAF Built-Up Roofing Asphalt RUBEROID MOD Asphalt Asphalt L & Asphalt P Tile-Mate Base Sheet Tile-Mate Cap Sheet Shingle-MateTm Underlayment Top Coat® Surface Seal SB (Matrix 602 SB Coating) GAF Weather Cote MB+(Matrix 715 MB Coating) Top Coat MB+(Matrix 715 MB Coating) We atherCote TM (Matrix 531 WeatherCote® Elastomeric Flashing Grade) Matrix Low VOC Matrix 101 System Pro SBS Adhesive (Ruberoid®M13) Matrix 201 System Pro SBS Flashing (Ruberoid®MB) Matrix 102 Select SBS Adhesive Test Dimensions SPecification 5 gallons 5 gallons PA 100(A) ASTM D 1929 ASTM D 635 None ASTM 02824, Type 1 Product Description One way valve vent used to relieve built-up pressure within the roof system. GAF Vent Stacks are available in metal or plastic. Mineral colloidal bituminous emulsion with reflective aluminum flakes Non-fl bered aluminum pigmented, asphalt roof coating 100 lb. cartons, ASTM 0312, Interply mopping and surfacing asphalt bulk Types I, 11, 111 and IV 60 lb. kegs 39.37" (1 meter) ASTM 04601 wide 39.37" (1 meter) ASTM D 3909 wide 4 sq. roll 30 lbs. 5 gallons 5 gallons 5 gallons 5 gallons 5 gallons 5 gallons ASTM D3019 5 gallons ASTM 03019 5 gallons ASTM D3019 SEES modified asphalt Asphalt impregnated and coated, fiberglass base sheet Asphalt coated, glass fiber mat cap sheet surfaced with mineral granules. Fiberglass reinforced shingle underlayment Surface coating for smooth surfaced and mineral surfaced roofs. Surface coating for smooth surfaced and mineral surfaced roofs. Surface coating for smooth surfaced and mineral surfaced roofs. Surface coating for smooth surfaced and mineral surfaced roofs. Surface coating for smooth surfaced and mineral surfaced roofs. Cold Applied Modified SEBS Asphalt Adhesive Cold Applied Modified SEES Asphalt Adhesive — Flashing Grade. Cold Applied Modified SEES Asphalt Adhesive. NOA No: 03-0501.05 Expiration Date: 11/04/08 Approval Date:10/23/03 Page 5 of 21 Product (Ruberoid®MB) Matrix 202 Select SBS Flashing Matrix 203 Standard Plastic Cement Matrix 213 Gun Grade Plastic Cement Matrix 103 Cold Adhesive Matrix 303 Select Fibered Aluminum Matrix 304 Select Non- Fibered RIMER° la 0 Modified Bitumen Adhesive Dimensions 5 gallons 5 gallons 5 gallons 5 gallons 5 gallons 5 gallons 5 gallons APPROVED INSULATIONS: Product Name GAFTEMP Isotherm R, RA, RN & Composite, EnergyGuard RA GAFTEMP® Composite A & N (BMCA)GAFTEMP® Fiberboard GAFTEMP® Permalite GAFTEMP GAFCANTrm GAFTEMP Permalite Recover Board GAFTEMP (3AFEDGETM Tapered Edge Strip (BMCA) GAFFEMP® High Density Fiberboard BMCA Energy Guard, RA Test .Specificadon ASTM D4586 ASTM D4586 ASTM D4586 ASTM D3019 ASTM D 2824 ASTM D2824, Type I ASTM D 3019 Type In TABLE 2 Product Description Cold Applied Modified SEBS Asphalt Adhesive — Flashing Grade. Standard Plastic Asphalt Roofing Cement Standard Plastic Asphalt Roofing Cement Caulk Grade. Cold Applied Asphalt Adhesive. Fibered aluminum coating. Non-fibered aluminum pigmented, asphalt roof coating. Fiber reinforced, rubberized Adhesive Product Description Polyisocyanurate foam insulation Polyisocyanurate foam insulation with high density fiberboard or Permalite perlite insulation. Fiberboard insiilation. Perlite insulation board. Cut perlite board Perlite recover board Tapered perlite board High density wood fiberboard insulation. Polyisocynurate foam insulation BMCA Composite EnergyGuard, RA Polyisocynurate/wood fiberboard composite Polyisocyanurate foam insulation Polyisocyanurate foam insulation PYROX White Line Manufacturer (With Current NOA) GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. BMCA BMCA Apache Products Co. • Apache Products Co. NOA. No: 03-0501.05 Expiration Date: 11/04/08 Approval Date:10/23/03 Page 6 of 21 APPROVED INSULATIONS: Product Name ACFoam II & Composite ISO 95+ ISO 95+ Composite Wood Fiber High Density Wood Fiberboard Per lite Insulation Dens Deck E'NRGY-2 & E'NRG'Y-2 PLUS, Ultra Gard Gold Fiber Glass Roof Insulation Structodek Multi-Max & FA Paroc Base Board Paroc Cap Board APPROVED FASTENERS: Fastener Number Product Name TABLE 2 Product Description Polyisocyanurate foam insulation Polyisocyanurate foam insulation Polyisocyanurate/perlite ridged insulation Wood fiber insulation board Wood fiber insulation board Perlite insulation board Water resistant gypsum board Polyisocyanurate foam insulation Glass fiber/Mineral fiber insulation Wood fiber insulation board Polyisocyanurate roof insulation Rockwool insulation 1. GAFTITEO (Drill-Tec®) #12 Standard & #14 Heavy Duty Roofing Fastener 2. GAFTITE® (Drill-Tee®) ASAP 3. GA141.11 h(i) (Drill-Tee®) Base Sheet Fastener and Plate 4. Galvalume Plates (Drill- Tee® Metal) 5. Polypropylene Plates (Drill-Tee® Plastic) 6. Dekfast Fasteners #12, #14 & #15 TABLE 3 Product Description Insulation fastener for steel, wood & concrete decks. Pre-assembled GAFT11 Fasteners and metal and plastic plates. Base sheet fastening assembly. Round galvalume stress plates. Round polypropylene stress plates. Insulation fastener for wood, steel and concrete decks Manufacturer (With Current NOA) Atlas Energy Products Firestone Building Products, Inc. Firestone Building Products, Inc. generic generic generic G-P Gypsum Corp. Johns Manville Johns Manville Masonite. RMax, Inc. Partek, Inc. Manufacturer Dimensions (With Current NOA) GAF Materials Corp. 3" and 3 1/2" 3" and 3 1/2" GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. GAF Materials Corp. Construction Fasteners Inc. NOA No: 03-0501.05 Expiration Date: 11/04/08 Approval Date:10/23/03 Page 7 of 21 APPROVED FASTENERS: Fastener Number Product Name 7. Dekfast Hex Plate 8. Dekfast Lock Plate 9. #12 Roofgrip Fasteners 10. Metal Plate 11. Gearlok Plastic Plate 12. Glasfast Fastener 13. Olympic Fastener #12 & #14 14. Olympic Fastener ASAP 15. Olympic Polypropylene 16. Olympic G-2 17. Olympic Standard 18. Insul-Fixx Fastener 19. Insul-Fixx S Plate 20. Insul-Fixx P Plate 21. Tru-Fast 22. Tru-Fast Plates 23. Tru-Fast Plates TABLE 3 Product Description Galva lume hex stress plate. Polypropylene locking plate. Insulation fastener for wood and steel. Galva lume stress plate. Polypropylene round plate Insulation fastener assembly with recessed plastic plate insulation fastener Pre-assembled Insulation fastener and plate Polypropylene plastic plate 3.5" round galvalume AZ55 steel plate 3" round galvalume AZ50 steel plate Insulation fastener for steel and wood decks 3" round galvalume AZ50 steel plate 3" round polyethylene stress plate Tnsulation fastener for steel and wood decks 3" round galvalume AZ55 steel plate Polyethylene plastic plate Manufacturer Dimensions (With Current NOA) 2 7/8" x Construction Fasteners 3 1/4" Inc. 3" x 3 1/4" Construction Fasteners Inc. ITW Buildex Corp. 3" round ITW Buildex Corp. 3" square 3.2" 3.25" round 3.5" round 3" round 3" round 3" round 3" round 3" round ITW Buildex Corp. Johns Manville Olympic Manufacturing Group, Inc. Olympic Manufacturing Group, Inc. Olympic Manufacturing Group, Inc. Olympic Manufacturing Group, Inc. Olympic Manufacturing Group, Inc. SFS/Stadler SFS/Stadler SFS/Stadler The Tru-Fast Corp. The Tru-Fast Corp. The Tru-Fast Corp. NOA No: 03-0501.05 Expiration Date: 11/04/08 Approval Date:10/23/03 Pe 8 of 21 EVIDENCE SUBMITTED: Test Agency Test Identifier Factory Mutual Research Corp. FMRC 1996 Factory Mutual Research Corp. LI. 2138A4.AM J.I. 3B9Q1.AM T.I. 0D0A8.AM. Factory Mutual Research Corp. J.I. ODIA8.AM J.1. 0Y9Q5.AM PRI Asphalt Technologies, Inc. GAF-012-02-02 PRI Asphalt Technologies, Inc. GAF-020-02-01 IRT of S. FL 02-005 IRTof S. FL 02-014 Description Date Current Insulation Attachment Requirements Wind Uplift FMRC 44704 Wind Uplift FMRC 4470 - PA 114 Physical Properties ASTM D 4977 TAS 114 TAS 114 01.01.96 07.02.97 01.08.98 07.09.99 07.29.94 04.01.98 11.06.01 02.01.02 01.18.02 03.22.02 NOA No: 03-0501.05 Expiration Date: 11/04/08 Approval Date:10/23/03 Page 9 of 21 Deck Type 1: Wood, Non-insulated Deck Description: 19/32" or greater plywood or wood plank decks System Type E (1): Base sheet mechanically fastened. All General and System Limitations shall apply. ase sheet: GAFGLAS #80 UltiinaTM Base Sheet, STRATAVENT® Eliminator Perforated Nailable, RUBEROID Modified Base Sheet, RUBEROID® 20, RUBEROID SBS Heat-WeldTh' Smooth or RUBEROID SBS Heat-Weld 25 base sheet mechanically fastened to deck as described below; Fastening Options: GAFGLAS® Ply 4®, GAFGLAS Flex Ply TM 6, GAFGLAS #75 Base Sheet or any of above Base sheets attached to deck with approved annular ring shank nails and tin caps at a fastener spacing of 9" o.c. at the lap staggered and in two rows 12" o.c. in the field. (Maximum Design Pressure —45 psf, See General Limitation #7) GAFGLAS Ply 40, GAFGLAS Flex PlyTM 6, GAFGLAS #75 Base Sheet or any of above Base sheets attached to deck with Drill-Toe (GAFITTE) #12 or #14 Screws and 3" Plates, 12" o.c. in 3 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 12" o.c. in the field of the sheet. (Maximum Design Pressure —45 psf, See General limitation #7) GAFGLAS Flex PIyTM 6, GAFGLAS #75 Base Sheet or any of above Base sheets attached to deck with approved annular ring shank nails and tin caps at a fastener spacing of 9" o.c. at the 4" lap staggered and in two rows 9" o.c. in the field. (Maximum Design Pressure —52.5 psf, See General Limitation #7) GAFGLAS #75 Base Sheet or any of above Base sheets attached to deck with Drill-Toe (GAFTITE) #12 or #14 Screws and 3" Plates, 12" o.c. in 4 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 9" o.c. in the field of the sheet. (Maximum Design Pressure —60 psf, See General Limitation #7) Any of above Base sheets attached to deck approved annular ring shank nails and 3" inverted Drill-Tec (GAFTFTE) insulation plates at a fastener spacing of 9" o.c. at the 4" lap staggered in two rows 9" in the field. (Maximum Design Pressure —.60 psf, See General Limitation #7) GAFGLAS #75 Base Sheet or any of above Base sheets attached to deck with Drill-Tee (GAFTITE) #12 or #14 Screws and 3" Plates, 8" o.c. in 4 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 9" o.c. in the field of the sheet. (Maximum Design Pressure —75 psf, See General limitation #7) Ply Sheet: One or more plies of GAFGLAS® PLY 40, GAFGLAS 0 PLY 6® ply sheet, #80 Ultima, RUBEROID MOP Smooth or RUBEROID 20 adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20- 40 lbs./sq. Cap Sheet: (Optional) One ply of GAFGLAS® Mineral Surfaced Cap Sheet adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs./sq. 0 NOA No: 03-0501.05 Expiration Date: 11/04/08 Approval Date:10123/03 Page 18 of 21 Surfacing: Maximum Design Pressure: See Fastening Above (Required if no cap sheet is used) Install one of the following: 1. GAF Special Roofing Bitumen with an application rate of 20 lbs./sq with an application rate of 1.5 gal/sq.; or GAF WEATHER COATo Emulsion (Matrix 305 Fibered Emulsion) with ar, application rate of 3 gal/sq.; or GAF Premium Fibered Aluminum Roof Coating (Matrix System Pro Aluminum Roof Coating Fibered 301) with an application rate of 1.5 gal./sq. 2. Asphalt flood coat at an application rate of 60 lbsJsq. t 20%; plus gravel or slag with an application rate of 400 lbs./sq. & 300 lbsJsq., respectively. 3. Top Coat Surface Seal SB (Matrix 602 SB Coating), Top Coat MB Plus (Matrix 715 MB Coating), GAF WeatherCote or WeatherCote LOW-VOC applied at rate of 1-1.5 gal/sq. NOA No: 03-0501.05 Expiration Date: 11/04/08 Approval Date:10/23/03 Page 19 of 21 WOOD DECK SYSTEM LIMITATIONS: 1 A slip sheet is required with Ply 4 and Flex Ply 6 when used as a mechanically fastened base or anchor sheet. 2. Minimum VI" Dens Deck or Y2 Type X gypsum board is acceptable to be installed directly over the wood deck. GENERAL LIMITATIONS: 1. Fire classification is not part of this acceptance, refer to a current Approved Roofmg Materials Directory for fire ratings of this product. 2. Insulation may be installed in multiple layers. The first layer shall be attached in compliance with Product Control Approval guidelines. All other layers shall be adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs./sq., or mechanically attached using the fastening pattern of the top layer 3. All standard panel sizes are acceptable for mechanical attachment. When applied in approved asphalt, panel size shall be 4' x 4' maximum. 4. An overlay and/or recovery board insulation panel is required on all applications over closed cell foam insulations when the base sheet is fully mopped. If no recovery board is used the base sheet shall be applied using spot mopping with approved asphalt, 12" diameter circles, 24" o.c.; or strip mopped 8" ribbons in three rows, one at each sidelap and one down the center of the sheet allowing a continuous area of ventilation. Encircling of the strips is not acceptable. A 6" break shall be placed every 12' in each ribbon to allow cross ventilation. Asphalt application of either system shall be at a minimum rate of 12 lbs./sq. Note: Spot attached systems shall be limited to maximum design pressure of -4S psf. 5. Fastener spacing for insulation attachment is based on a Minimum Characteristic Force (F) value of 275 lbf., as tested in compliance with Testing Application Standard TAS 105. If the fastener value, as field-tested, are below 275 lbf. insulation attachment shall not be acceptable. 6. Fastener spacing for mechanical attachment of anchor/base sheet or membrane attachment is based on a minimum fastener resistance value in conjunction with the maximum design value listed within a specific system. Should the fastener resistance be less than that required, as determined by the Building Official, a revised fastener spacing, prepared, signed and sealed by a Florida Registered Engineer, Architect, or Registered Roof Consultant may be submitted. Said revised fastener spacing shall utilize the withdrawal resistance value taken from Testing Application Standards TAS 105 and calculations in compliance with Roofing Application Standard RAS 117. 7. Perimeter and corner areas shall comply with the enhanced uplift pressure requirements of these areas. Fastener densities shall be increased for both insulation and base sheet as calculated in compliance with Roofing Application Standard RAS 117. (When this limitation is specifically referred within this NOA, General Limitation #9 will not be applicable.) 8. All attachment and sizing of perimeter nailers, metal profile, and/or flashing termination designs shall conform with Roofing Application Standard RAS 111 and applicable wind load requirements. 9. The maximum designed pressure limitation listed shall be applicable to all roof pressure zones (i.e. field, perimeters, and corners). Neither rational analysis, nor extrapolation shall be permitted for enhanced fastening at enhanced pressure zones (i.e. perimeters, extended corners and corners). When this limitation is specifically referred within this NOA, General Limitation #7 will not be applicable.) 10. All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and Rule 9B-72 of the Florida Administrative Code. END OF TIIIS ACCEPTANCE NOA No: 03-0501.05 Expiration Date: 11104/08 Approval Date:10/23/03 Page 21 of 21 t' .j Roofing Systems (TGFU) -- Continued CAFGLAS Pito Prerrrium Base Sheet may be used in any of the- following systems, "C;A glas Flex Ply 6" is a suitable alternate to "GA.Fgla.s Ply 6 ", "GA.FTEMP Permalite Recover Board" may he used in lieu of any perlite insulation in any of the following NC Classifications. Class A, B and C Hot trx ?!n asphalt, phalt, for use with organic and glass felts or modified hits_.., membranes_ "Ruberoid Heat Weld" SBS roofing membraner may be used in lie of "Ruberoid Mop" SBS products in any applicable Classification. I. Deck: C- 15/:12 Class A Insulation (Optional): One or more layer 3 layers finer. isoclanurate, urethane, perlite F'rlite, wood fiber. glass urethane composite, wood fiber /isocyanu to composite, p composite, phenolic, perlite,' thrrkr,ess ire, phenolic, any Ply Sheet: Three or more lavers Type CI "GAFGLAS Ply 4" or "p,AFr ;i..AS Ply 6 ", hot mopped Su rfacing: Gravel. 2. Deck: C-15/37 Insulation (Optional): One or mom layerse: 2 fibe sn,' ararrate, urethane perlite /isucyanuratletrcomwood fiber, posite, p, lilte ass urethane composite, rood fiber /isocyanurate composite, phenolic, any tis ckn ss Ply Sheet: Three or more layers Type .,C AFC: r- AS Ply 6". I e Cl "C. ;AF < ;1_AS fly 4" t, r. Cap Sheet: One layer Type (;3 `G•AFCLAS Mineral Surfaced Cap -beet 3. Deck (' r Insulation iodine 2 (Optional): One or more layers perlite, wood fiber, glare fiber, isovyanurate urethane, perlite /isocyanur,te composite, perlite/ urethane composite, wood fiber /isncvanurate composite, phenolic, 2 in. max GL.Ply Sheet: Two or more lavers Type Gi "C,AFCLAS Ply 4" or "GAF, Ply 6 ". Sheet". ' ap Sheet: One layer lope G3 "CAF(;i_AS Mineral Surfaced Cal 4. heck !\-.47. Insulation: One or two layers incline: 1 /2 Ins Sabo : Any L i_ (aassifiecl „ isotherm 12 ", 4 in. m33., hot mopped. mat system. gravid surfaced Class /A asphalt glass (;be Deck: C- 13/32 Slip She (Optional): Incline: 1 Base She Red rosin paper, nailed to cluck. Sheet: One layer of Type G2 "C Al C 1-A S #75 B,a ..e Sheet" (rat v lit, nailed). GAFCI-A Ply Sheet: One or more layers of Type CI `C,AfGLAS Ply 4" S Ply 6 ". of Cap( Sheet: One layer of Type G -3 "GAFCI_AS Mineral Surfaced Cap 6. Deck: NC Base Sheet: One layer of Type Incline: 3 Ply Sheet: pe C2 "G /\FCf.AS #75 Base Sheet" y One or more lavers of Type Cl GAI'CLAS Ply 6'. } C;AFChAS Ply 4" or Cap Sheet: One aver of Stn". l Type G3 "CAFC;i_AS Mineral Surfaced Cap Deck_ C_15/32 Insulation: One car more layers ,erlitle, glass : 2 thane, tion: eOne or composite, F glass fiber, isocyamtrate, ure- maks: joints 6 in ). perlite/urethane composite, plir I q tn. man (offset from plywood joints 6 in.). Base Sheet: One or more layers of Type Gi, G2 or G3. Membrane: CJrte or more Maosbr , " layers of "Rubemid Torch" (smooth or Ruberoid Torch, Plus" (granule), "Ruberoid Mop" (smooth oe granule) or "Ruberoid Mop Plus" (granule). Cap Sheet: "C;AFGLAS Mineral Surfaced Cap S R- Deck: C-15/32 beet", hot mopped. Insulation Enable: 2 (Optional). One or more layers perlite, woos{ fiber, glas fiber, isocyanurate, urethane, perlite / isocyanrate composite, urethane composite, wood fiber /iso yanurate composite, phenolic, any thickness. Base, Sheet: Two y Ply Sheet he or more layers of Type C2 or G3. (Optional): One or more layers of Type Gl. - Mpmhranr.: C granule), " t2ttlaem{d T more layers of "Rubel:. old Torch" granule) or "Retie °Mo Plus" (granule), ''Rnberoid Mop" ((mot) or rnla p pi„ s, _._ (granule). en COOK FOR THE lil_ MARK ON j'NOON-CT RoUF COVETING MATEFI!ALS {'f1ClrTj Roofing Systems (TGFI J) - -Con tin tied Cap Sheet: ' "GAFGI_AS Mineral Surfaced Cal' Sheet ", hot n• l,red Deck: C -Is /' Chas B insular , Incline: 312 >nall' One or more ravers perl. word Weir glas fiber, isorvanurale. urethane, perliteltc c,.. anuntte comoositt putr uc urethane composite. wood fFnr,tsu yat:rate composite. ph. ). ar' thirkrr.cs Ply Sheet: Two or more lacers o/ Type (.,1 "GAFC;l.AS Ply h" Cap Sheet: Type G3 ••GAFGLAS Mineral Surfaced Cap Si-- r, :b h„ mopped. 2 Deck.: C-15 insulation {Optional,: One or more Iftveire 1,Priiter, Fiber i5rx��amtrate. ( urethane perlite -isocm anurate corral os.t +_. perlite !y- ethane composite, wood fiber'rsoct'annrate .''nntpt „te> ,l thickness. I li< ar. Base Sheet: Two or more lavers of Type C;1. G2 or G3. Membrane: One or more la;,, granule), "r layers of "Ruberoid Tnr<h t .� moth or ii ) "Ruberoid Torch Plus'. granule) or 'Ruhr t,.tid Mot Pit /s(S;ranule), "Ruberoid Mop -'ooth o: Cap Sheet: "(,;Afc.;i � i (granule). �b Mineral Surfaced Cap Sheet ' ho: r. (_lass per'. Deck: C15/ t? (' Insulation (O,tionalk One Incline: 1 /'. G ne or more lam -ems perlite, ', oud P lass fiber, iSnci•arrurate, urethane, perlite/ isocyanurate cornpos1k - ?r lne/ urethane contpOSIte, wood cknr fiberrtsncranu Tt> r, nrposite, phi lie, am Ply SC le t ; r'ttrree or more layers of Tm p (; 1 "C Aft.1_ AS or Surfacing: Sp, .'i Roofing Bitumen” 20Ibsfsy, COAT. TAR FL h'STF,MS WITI-! HOT ROOFING COAL AR Deck: C.13/ ;. ..? Class A Iodine: Insulation (Optional): One or dine: 1'J. fiber, isorti•ti„ ate, urethane, perlitet'rsot Yam' composite. ;'rirliiti (urethane composite, wood { fiber glass thickness. o`tc socyantintte composite phen 'ic. any Ply Shee tr Three or Ply Sh! ti Three 6 more layers of Tvl,e C;t - C;AECTAS I'' 4" or hot mopped with coal, tar bitumen. Surfacing: Gravel. COMBINATION ION IlOT AND COLD SYSi -I:h45 beck: NC (::lass /A Insulation (Optional): t Incline:2 r ) One or more Iaver�,perlite, wood filer fiber, 2 in max bless Ply Sheet: 'Three or more lavers of l'ype G1 "C,.,\ TGLAS 4" or 'GAFGLA S I'ly 6". Surfacing: Grundy Industries "al 'MB Alin iirmurn Root Co,' _ rg • at- 11/2galisq.. - i1 ck'.NC r incline: fn ulafion L ? 1 rational): One or more lave ';:r•riite, wood methane bisO annrate. urethane, perlite /imCxyanur,ste composite, - glass composite, wood fiber /isocyanurare composite, phen: any thickness. Ply Sheet: Turtle or more layers of Type CI "GAFGLAS P' 4- or - CAFCLAS Ply 6", Deck: NC "Weather Coat Emulsion" at 3 gal /s4:7. C; Insulation: Ohre or ! Ind.i7: 1 / 2 Ply Sheet: qr,.. r ., Classified layers '°Isotherm R' 4 ir,r., hot moppet• mat syste: itsstfiecl Rraye! surfaced Class A asphalt gt fiber Deck: NC Insulation (Optional): Iso. Incline: 2 rya.nura:' wood r:`:,'r and glass fiber, any thickness, mc-char-tically fastened mnppedeet! One ply Type Cl or G2, mechanically 'a.• :'teed ,sihe, t, r. Ply Sheet: One or more plies Type G1 or C2 . adhered with hot . Ting aspthalt, Suaifacing: "GAT Premium Fiberecl Aluminum kZouf Coatin galysq or "CAE Weather Coat I mulsiort ", 3 g;11/5-q, g .1 /2 5. Dec : NC° methan(icn (Op itened perlite, glass bl>erclplyiso yanurate, wa,, itx r, y_ any thickness. &/« /c6 acrc OWNER'S Hr' Z. Davlin -: NAME PRESENT ADDRESS • LICENSE NO. PHONE N JOB LOCATION ( 4' Q 11-.°-E.- 103rd S T. OR AVE.) , LOT BLOCK 4 192 SUBDIVISION #a Miami Shores GENERAL CONTRACTOR Tole Ruddy ADDRESS PHONE NO. LICENSE NO. BUILDING PERMIT NO. 148 ° DATE / r7 —2 -53 -ERM T FEE $ 18.00 BUILDER'S BOND NO. P DATE ZONE PEQUIREMEN S CU. FT. PLAN CUBE 19,498 CU. FT. EST. COST $ ]400.00 DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: DATE TYPE NEW CONSTRUCTION CBS STORIES 1 ROOF CONSTRUCTION `'_tile INTERIOR CONSTRUCTION Terrazzo Floors, Plaster walls & coilin REPAIRS DESCRIPTION g 3 kitchen, living room, 3 bedrooms, dining area, garage, 2 bathrooms ALTERATION porgy "� DESCRIPTION • ADDITION l` I SUBMITTED 'TO PLANNING BOARD APPROVED REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL REMARKS CERTIFICATE OF OCCUPANCY NO. D (�4l O/�g D ISSUED ''I'S 'Am, TO BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE 4.(2,-.4° ' B IL6Ii1G TAISPECTIONSa G K r` INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION -` /I� BEAMS & LINTELS / /-_/Yd �Os9 .1/ 643 —, FRAMING FINAL /0-* AT- a" . tas44 CLEAN -UP - -- II, �( PLU SING PERMITS & INSPECTIONS CONTRACTOR PHONE ,,Lt PERMIT NO. / i 9S I DATE 7S a FEE $ _2 °v'."4N / NEW BLDG. 1 ALTERATION I`ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE IMITS/,; V $ rya I tMPvttARY5b.H IIL.E SEPTIC TANK SEWER SOLAR HEATER $ GAS $ , 9 -1° , b c / ® $ INSPECTIONS _ DATE -- BY RE=TNSPECT RE I --- i -PECT BY BY ROUGHING GAS ■SEWER SEPTIC TANK 11111Mj PEIPIMM '�' SOLAR HEATER /1111 FIXTURES "h` ■ L "■ ELECTRICA PERMITS & INSPECTIONS CONTRACTOR PHONE PERMIT NO. I DATE ®B ®.�r� FEE $ ® / NEW BLDG. I 4LTERA�ION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE :VN $ H. W. HEATER CONN. $ RANGE CONN. $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE _ BY RE- INSPECT BY . RE- INSPECT SY -. TEMP. SERVICE ROUGHING a7' h fJ H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL 9.1r, S' zukt4 APPROVAL TO POWER CO. FOR SERVICE DATE 9- /O- S BY FW Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 4/7/2005 Applicant: JEAN Owner: THOMAS JOB ADDRESS: 470 NE 103 Building Permit Permit Number: BP2005-427 THOMAS JEAN ST Contractor PERFECT ROOFING & SERVICES INC Contractor's Address: 305 NE 116 ST Local Phone: 305 - 895 -9237 Parcel # 1132060170720 Legal Description: AMD PL OF MIAMI SHORES SEC 4 Page 1 of 1 PB 15 -14 LOT 4 BLK 92 Fees: FEE2005-4486 FEE2005 -4487 FEE2005 -4488 FEE2005-4489 FEE2005 -4490 FEE2005 -4491 FEE2005 -4492 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Scanning Fee Submittal Fee Total Fees: Amount $250.00 $1.80 $5.00 $0.60 $6.25 $21.00 ($50.00) $234.65 Total Fees: $234.65 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 9/19/2005 Construction Value: $2,900.00 Work: REMOVE & REPLACE FLAT ROOF APR 15 PAID Signed: (INSPECTOR) In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: NOTICE OF COMMENCEME A RECORDED COPY MUST BE 70STED ON THE JOB SITE AT TIME OF PERMIT NO. TAX FOLIO NOJJ ^,�' STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will property, and in accordance with Chapter 713, Florida Statutes, the is provided in this Notice of Commencement, ST INSPECTION 1. Legal description of property and street/address: ade to certain real lowing information 2. Description of improvement: _i - 1'1. S 3. Owner(s) name and address: Interest in property: Name and address of fee simple titleholder. 4. Contractor's name and address: _.. 11111111111111111111111111111111111 Cr 14 OO i1F 'D2V3497,6 OR Bk 2315'6 Ps 43321 Ups) RECORDED D3/23/2005 15:41 :35 HARVEY RRUVINr CLERK Of COURT MI A11I °DARE CRUNT'(r FLORIDA LAST PAGE 106 teak ,L S 4) PG. `t ' 1.38 foe 103 te „sr 1 FL 33138 1 5. Surety: (Payment bond required by owner from con Name and address:__ Amount of bond $ 6. Lender's name and address: _... _ ii► ;I u�i I �sS AD -tip 7. Persons within the state of Florida designated by Owne provided by Section 713.13(1)(a)7_, Florida Statutes, Name and address: pon whom otices or other documents may be served as 8. In addition to himself, Owners designates the following p in Section 713.13(1)(b), Florida Statutes. Name and address: rson(s) to receive a copy of the Lienor's Notice as provided 9. Expiration date of this Notice of Commencement: (the e differen .date is ature of 0 .. Print Owner's Name � _ trit_ iv) ; Il k►,, iration date is 1 year from the date of recording unless a Sworn to and subscribed before me thi Notary Public Print Notary's Name My commission expires: 123.01 -62 l'A(i F; 4 13!02 J Prepared by f , 20: cull) A. s: I ebea L£Z6 —g69 50£ DNI300E 2033 i'3d 8£:60 5OOZ'8I )18V L2 6 -568 S02 Ya I PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date 7/16/92 Job Address 470 N.E. 103 STREET Tax Folio // 8'rA.0 m a zre j Leg al Description !■` Master Permit # a / t / Owner / Lessee / Tenant Owner's Address Contracting Co. JEAN THOMAS 470 N.E. 103 STREET C.E.SHEPPARD ROOFING, INC. Qualifier CAROL E. SHEPPARD Address Ss# 262 _ 44 Stated Competency $ 12115 Architect /Engineer Bonding Company Mortgagor Phone 9$9- 5775 470 N.E. 103 STREET • - 5534 Phone 685 -6969 Ins. Co. Address Address Address Permit Type (circle one): BUILDING . ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION REROOF 19 SQS. OF SPANISH "S" CLAY TILES AND 6 so. o f FIBERGLASS Square Ft. 1900 PLUS 600 Estimated Cost 6,150.00 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. Sig Dat I tune of Owner and /or Condo President Af Notary as to q ner an My Commission Expires �Y . * . * PERMIT FEE: /6 /e APPRO • Zoning. I iiddp�tei�n� b - r i �%. lm R c;`.,.� RDG 31EZ • camterAtaxcaop p19 • WIRY 27, ante S.gnature of Cont Date • Notary as to My Commission * tr. Mechanical Building Plumbing X ig LIE/ .t •r`Owner-Builder • _LAO AP COAAM -.,4c C{, o ,1Ak'E9 at ie:t`` r:R T 27, 3 9? Elebtrical Engineering • P ;RMITe State of Florida County of Dade TAX FOLIO NO. II i'-ZO6 /I 0720 9 NOTICE OF COMMENCEMENT JUL 21 69:47 THE UNDERSIGNED hereby gives notice that improvement will be made to certain g' real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. TI rl 0 4 MP fA ?vg 640,f 1. Description of property:(legal address If description of available) .12W —V 1 9a the property, and street 2. General description of improvement: 3. Owner Information: a. Name and Address: JEAN THOMAS 410 N. E. 143 STREET b. Interest in property: OWNER • c. Name and address of fee simple titleholder (if other t 4. Contractor: (name and address) # 5. Surety: a. Name and Address C. E. SHEPPARD ROOFING INC 41 N.W. 20TH ST. I �' fL 33127 b. Amount of bond $ 5,, L r : ( Name an address) 414/1441-4d S/Y )t.iO ` � d •c 7. Persons with the State of Florida designated or other documents may be served as provided Florida Statutes:(Name and address) a 0 o 0 i a o € _' by Owner upo 'h m n i cp s by Section 7 e1 (.) )7 €, C. E. SHEPPARD ROOPaNG, INC. 41 N.W. 20TH STREET MIAMI, FL 33127 8. In addition to himself, Owner designates to receive a copy of the Lienor's Notice as provided In Section 7.13.13(1)(b), Florida Statutes. of 9. Expiration date of notice of commencement (the expiration date Is 1 year from the date of recording unless a differe date Is specified) w rn to cribed b A CC2041 19 DAY GfaitSSION EMS V :r 1 ure of day of 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 building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village. Florida. and alllprovisions 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 4�� 19 7 , f S Registered Architect and/or Engineer Name and address of licensed contractor Date ,/i/ 19,d No. Y' 0 Street e / 3 51" Location and legal description of lot to be built on: ,� f / / ,y� Lot Block 9� Subdivision /+�� 41544 /) t? W �I' 7 ' Street and Number where work is to be done ! 71 i o / csx,e‘e State work to be done and purpose of building (by floors), state exterior colors (sub ples) 4v, itio9zray, 4A- 2.6 and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Covering % Amount of Permits 6 Estimated Total cost of improvements $ Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement. and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed u •:• this permit: and 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 .: �.� em • 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 authorized to administer oaths and take acknowledgments, personally appeared to me well known. /q.7 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. D Disapproved kt4 raD6aetce (Signed) Read. Sworn to and Subscribed before me. Notary Public. State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member . Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re-inspection fee of $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty Materials and/or workmanship. Jean D 470 N. Miami Thomas 103rd Street hores, Florida 33138 759 -577 '3' 1 "b O . • • Iw l!' go 'lido/V(7,0-6z yr Lade tet,T /?' 6 Are x/o teibe6: /0cS,9. 4!> c.e 6c'.&=. �-- 1.347-A, 4"A I'' /97/ yG� a "e THESE PLANS ARE APPROVED FOR ISSUANCE OF A BUILDING PERMIT VARIANCE(S) LISTED IN "REMARKS" MIAMI SHORES BUILDING AND ZONING UNLESS SPECIFICALLY LISTED BELOW. AND COUNTY LAWS MUST BE COMPLIED Aueo'i °el S`girture Date • WITH NO VARIANCES • WITH NO OTHER DEVIATIO "S FROM THE ORDINANCES WILL BE PERMITTED, ALL OTHER APPLICABLE STATE WITH BY ALL PARTIES. FIRE DEPARTMENT PUBLIC WORKS POLICE DEPARTMENT BUILDING DIRECTOR'S i1j l� PLANNING & ZONING BOARU VILLAGE COUNCIL APPROVAL PRELIMINARY: FINAL: REMARKS: COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADOPTED BY MIAMI SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER & SUB CONTRACTORS ARE CHAWIFD WIT'I T".. K. "0'. ! Er ^.F OF I'' 'III! D. ING REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN. a r MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. 3 (E ` Date ° ?/ y �J Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein descri bed. 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 the progress of work. Owner's Name and Address Q A 11 / h 0 /7) 4i S No, l/ 70 F Street /®3 s Registered Architect and/or Engineer 's Name l p) Pig ./11 Z d [/ No. / 9Y3 © IV U Stree G �. �I- Block ° Subdivision PPLP � 1N 1. 4/ Street a n d N u m b e r w h e r e w o r k is to be p e r f o r m e d — N o . 4/76 IV /03 2 A s, / f l i ,4 ,71 S ' » & Street State work to be performed and purpose of building (By Floors) e `7 'V S .� k e N �`) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals. Feet of Drain The Dist. Feet of Tank or Drain Field from Well 7S Nature of Water Supply: City • Well �% l'2 a �' Size of Soakage Pit P Amount of Permit $ 02 (Signed) 0Y Plumbing Inspector The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) ���'� -7 PI y Master Plumber. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly _ sworn, upon oath deposes and says that he is the described of the above des construction, that he has y read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNTAINS TOTAL FIXTURES CONTR. UST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G. POOL CONTR. UST CHECK Size Septic Tank Type of Tank Capacity Gals. Feet of Drain The Dist. Feet of Tank or Drain Field from Well 7S Nature of Water Supply: City • Well �% l'2 a �' Size of Soakage Pit P Amount of Permit $ 02 (Signed) 0Y Plumbing Inspector The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) ���'� -7 PI y Master Plumber. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly _ sworn, upon oath deposes and says that he is the described of the above des construction, that he has y read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. 1170 NE /03RA. Alley Nt VJ v 03 'T, 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 building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address ION Date 19 VONte6 Na '/D Strwt 10 3 5 Registered Architect and/or Engineer Name and address of licensed contractor ® 14, 2Y/= Location and legal description of lot to be built on: a / Lot Block f� Subdivision Aid) L seta' 4 /) /I ©zz e if Street and Number where work is to be done y 0 IY - / e 3 s 7 State work to be done and purpose of building (by floors), state exterior colors (submit samples) f/! I,21/ y / L 7..,,e/* 4t2 ?,4 r CY1S CR.. t and for no other purpose. New Building Remodeling___ Addition Repairs No. of Stories To be constructed of Kind of foundation Rao Covering F Estimated Total cost of improvements $ oDO— ' " _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 plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida. Permanent Supplement, and has ed 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 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 s to phois ,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 authorized to sxlminister oaths and take acknowledgments , personally appeared 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 f. = _ 'ing. application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. Disapproved (Signed) D Building Inspector Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Slate Disapproved Date NOTE: A charge of $25.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $25.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Permit No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT fV37 Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. ® (� Owner's Name and Address i . 6 I ` 7O'1 f No. .1 � Street Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Lot Street and Number where work is to be performed —No. 1/90 f1o( ,�I_ �Suubbdivision Street!& '%' J °� State work to be performed and purpose of building (By Floors)- -- ------ New Building Remodeling Addition Repairs Size Septic Tank Type of Tank Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City— Well. Size of Soakage Pit - -- _.. Amount of Permit $ — (Signed) The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennane plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed performed under this permit; and will post or cause to be posted for inspection on the site of the such public required by the Act. The undersigned agrees to employ only such sub - contractors, on work licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. b ss. Spector. an employer of labor pplement, and has corn - by him in the work to be mots •: = as are as are Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 conrtruction, 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of *1.00 will be made whim such rainspedion is roade'nsoeatary by improper notice for inspection, or faulty materials and /ar worlmvanship. CI-0111" BATH TUB6 SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY Tutu URINALS CATCH SABIN FLOOR DRAIN DRINKING FOUNT'NIS TOTAL FIXTURES CONTR. LIST CHECK - SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR SYSTEM SWING POOL LIST CHECK Size Septic Tank Type of Tank Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City— Well. Size of Soakage Pit - -- _.. Amount of Permit $ — (Signed) The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennane plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed performed under this permit; and will post or cause to be posted for inspection on the site of the such public required by the Act. The undersigned agrees to employ only such sub - contractors, on work licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. b ss. Spector. an employer of labor pplement, and has corn - by him in the work to be mots •: = as are as are Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 conrtruction, 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of *1.00 will be made whim such rainspedion is roade'nsoeatary by improper notice for inspection, or faulty materials and /ar worlmvanship. 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. Oct. 16th 70 Date , 19__ Owner's Name and Address Mr & Mrs. P. A. Toomey No.100 sb.eetilt, E. 103rd Registered Architect and/or Engineer Name and address of licensed contractor_ Lang Roofing & Tile Co,, Inc,573 N.W. 71st St., Miami 53150 Location and legal description of lot to be built on: Lot_ Block Subdivision Street and Number where work is to be done_470 N. E. 103rd Street State work to be done and purpose of building (by floors) New Building and for no other purpose. Remodeling. Addition Repairs__ Re—roof No. of stories 1 - To be constructed of ........ Kind of foundation_ goof covering Cement the & vavel Estimated Total cost of improvements $_2150,00 __Amount of Permit $_ 7.00 Zone cubage required_ Plan Cubage Distance to next nearest building_ Size of Building Lot_ Maximum live load to be home 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 5968, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such ublic notice or notices as are required by the Act. The undersigned agrees to employ only such bcontractors, 11 work to be perform permit, as are licensed by Miami Shores Village. Remarks 25sqs. ( 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 1 Read, Sworn to and Subscribed before me. — Date .to me well known, Disapproved _ Date (Signed) Building Inspector Chairman Member. Member Council Approved Notary Public, State of Florida My Commission Expires__ ...... .......... PLANNI BOARD DATE Member Member Member _ „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 Permit No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date chi 's- , Application is hereby made or the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein describe& application is made in compliance and, conformity with the Building Ordinance of Miami Shores Village, Florida and all provisions of the Law of the State of Florida, all ordinances of Miami, Shores Village and all rules and regulations of the Building Divisior of Miami Shores Village be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of ork.. No 2 G I Street ' e;A il i) ii__L eT.0 Owner's Name and Address lam . Registered Architect and /or eer ' Employing Plumber's Nam .c e bs - /Q ,6,^1, c it. is big. No I /'5'4 Street c' d , --_... -1 Location and Legal Descri Lot Blr Subdivision — Street and Number where is to be performed -No. 74' '' Street.---J-1.4. set 3 ST d building (By Floors) State work to be performed purpose New Buiklin_ Remodeling Action Repairs.------ - -__ -_ No of Stories. %_ __... g - -- - - ___. CLOSETS BATH TUBS LAVA. LAVA. TORIES S INKS SLOP SINKS LAUNDRY TUBS _,„ URINALS CATCH BASIN FLOOR' DRAIN. DRINKING FOUNT'Ns k).�feV .flea l° I 6 ( ) TOTAL FIXTUREII. CLIP 2 2, �. CHECK / 7 S" Uj ®gam SEPTIC TANK SEWER CONN. !,DRAIN FIELD SOAKAGE PIT DREASIC,'i TRAP, SOLAR HEATER DEEP . IWILL " SPRKLR. SYSTEM SWING POOL �/ ee, .,'[',I,kg 337S'/ Ode %- ,5 P1 -Ylee, /I� CLIST ® CHECK I l (i ) / r Type of Tank _:.._Capacity G als._::._.___ ___..-- ________ r_ Tank Size Septic _ Feet of Drain Tile Nature of Water. • Amount of Permit $ Dist. Feet of Tank or Drain Field from Well Well (` Size of Soakage Pit- The undersigned appli under the Florida Workmen' plied with the provisions the performed under this permit required by the Act. The licensed by Miami Shores Vj STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersi Signed) Plumbing Inspector. cant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor s Compensation Act, being Section 5960,, Compiled General Laws of Florida Permanent Supplement, and bus -;wan - eof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be and will post or cause to be posted for inspeati.,. on the site of the work such public notice or notices as art( exsigned agrees to e"plOy only such su..-. 'tractors, on work to be' performed under this permit, as are m. a. 17� %.) 0 (Signed) 76°.' aed authority, a notary put Master Plumber. , duly authorized to administer oaths and take acknowledgments, personally appeare to me well known, and who, of the above described therein by him stated are tru being by me first duly sworn, upon oath deposes and says that he is the__ ction, that he has carefully read the foregoing application, and that he did sign the same, and that all lac mat My Colrmission Expires Notary Public, State of Florida A re- inspectio fee of $1.00 will be made when such reinspection is made necessary by improper notice for inspection, or foul and /or worl�nl+nchp, : MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the ap roval of the detailed statement of the plans and specifications herewith submitted for the build - ing or other structure herein described. T 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 shell be complied with, whether herein specified or not. A copy of approved plans and specifications nqust be kept at building during progress of the work. Date July 29, • ,19 53 No 261 street N.W. 110th St. Owner's Name and Addr Registered Architect and/ br Engineer Name and address of licensed contractor 3 Location and legal description of lot to be built on: Lot Block 92 subdivision'' Miami Shore s 470 N. E. 10Zrd Street Mr. Drivlin Street and Number where work is to be done State work to be done and purpose of building (by f oo Ae W structure roof New Building . X To be constructed of Estimated Total cost of Zone eubage require• Distance to next nearest Maximum live load to be and for no other purpose. Remodeling Addition Repairs No. of Stories one S, _ Sind of foundation _. Roof Covering al2.l t up o nd tile provements $ 617.50 Amount of Permit $_ .00 Plan Cubage building borne by each floor Size of Building Lot I hereby submit all tl►e 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 hereb certify that he understands and accepts his obligations as an. employer of labor under the Florida Workmen's Compensation Act, being tion 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the rovisions 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 subcx tractors, work to be performed under this permit, as are licensed by Miami Shores Village. Remarks STATE OF FLORIDA, .1 COUNTY OF DADE. ss (Signed) Before me, the undersigned authority, a notary public, duly 'authorized to administer oaths and take acknowledgments, personally ap- peered 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 , e. Permit No 6 -I- . Date Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Chairman Member Member Council Approved NOTE: A charge o the Planning Board., A re- on fee materials workma C; uilding Inspector PLANNING BOARD Notary Public, State of Florida Commission Expires Member Member Member Date Disapproved Tate $1.00 will be made for milting corrections or changes to this application after approval has been obtained from f $1.00 will be charged when such re- Inspection is made necessary by improper notice for inspection or faulty _DATE Permit No •2 W MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PER t�M'IA�S!.� T q Date. 1.� .1.._ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oz other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv.ida, 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 work. Owner's Name and Address (/ {/I Registered Architect and /or Engineer it4' s Employing Electrician's Name 6C — kir? .. r..%. I No . L..est- /P)'& Street '(o ' Location and Legal Description Lot ll y�� Block Subdivision Street and Number where work is to be performed— No...'.. e4° o • 6 ° t ..0.5 Street. State work to be performed and purpose of building (By Floors) New Building Remodeling .Addition Repairs No. of Stories. No Street Overhead Service Underground Size Feeders Conduit. .Main Sw Am ....Fl..Maia Fuses .....Amps Type of Installation- -Conduit...... Tubing .B.X.L .Metal Moulding Amount of Permit $ s a (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contra ctors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection the wor public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on rformed r this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, 1 COUNTY OF DADE. j ss' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he 4 the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Master Electrician. My Commission Expires .�. 4otary Public, State of Florida NOTE: A re inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE•P•T'S FIXTURES NO. LAMPS RERRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER NEATER W. HEAT. CONK. SPACE NEATER STRIP HEATER le °.,. �., TOTAL. CONTR. LIST CHECK l) 4 ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.6 HP NEON TRANS. RADIO • TOTAL cervix. LIST CHECK ��, f,I,AgJy Overhead Service Underground Size Feeders Conduit. .Main Sw Am ....Fl..Maia Fuses .....Amps Type of Installation- -Conduit...... Tubing .B.X.L .Metal Moulding Amount of Permit $ s a (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contra ctors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection the wor public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on rformed r this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, 1 COUNTY OF DADE. j ss' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he 4 the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Master Electrician. My Commission Expires .�. 4otary Public, State of Florida NOTE: A re inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. -l1y MIAMI SHORES VILLAGE BUILDING DEPARTMENT �() 305- 795 -2204 Buil ing Inspection Request Date Type Insp'n `t" Permit No Mi7 Phone # Inspection Date Approved Correctio' Re-Insp'n Fee s1ico. -e Pr e ge_r R -vs.1-11 e a �i111/0/ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 - 795 -2204 Building Inspection Request Dat Type Insp'n 6 � Permit No. %: T ° 0 `' 4 l Name Address Company Phone # Inspection Date Pet(Ce Correction Re- Insp'n Fee NiK ►, 11 ;;NLL:I /la /wl AP e #, .r-.a..- v eo 3 o /5 /la /7 /,S e .... to .r-.a..- v eo v 2 �Gf1 G E- / ' /.5G7 SUITOR OP SURVEY Lot 40 Blook 92, AMMO PLAT OF MXLMI SHORE UNION NO 4, a000rding to the Plat (hereof 0 reoorded in Plat Boo 150 at page 140 of the Publio Reoords of Dade County) Florida* Order #270 F.50 #5-43 June 90, 19530 S►o ale a Shown i HEREBY =MiFYs That', the attached "SKETCH OF SURVEY" of the above dbeoribed property is true and oorre o t to the beet of my knowledge—and bs' lief 0 as reoently Surveyed and platted under my d ireotion. ASSO 3•I .TED ENOINSRRS er Registered' L Surveyor #889 State of Flo Vim* CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION N? 1808 Miami Shores Village, Fla., h, ti Owner, Agent or Tenant of Building `lam s • Los. 4 Block R Subdivisi n S 1414, ` Street Address +1 Z y i' • Q . 1 Approved use by occupancy I oi.„ ` Remarks :. This Certificate of Occupancy is issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions. of Ordinances Nos. 92, 93, 94 and 97, known es the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection,. construction, ralltteration or remodeling of buildin s or structures. ,Jr 41;14, , / BUIL ING. DIVISIO ricklAMI SHORES VILLAGE BUILDIN INSPECTION DEPARTMENT' APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the det.iled statenien• of the plans and specifications herewith submitted for the build- ing or o h+ -ructure heir i. described. This rilicatic is made in compliance and con•o'm•tty w,th the Building Ordinance of Mia ni Shores Village, .or.da, and all pro. isions of the Laws ti the State of PLrid. all o d nances of MI .ni Shores Village and all rules and regua ion, of the Building Div.. i of ram Sho, illage 1^ 'I e ro ipLed with, whether , erein specified or not. A copy of approved plans and specificats ar rust be kej•• : t burtding during progress of the work. Owner' Name and Ad Registered Architect and'or E Name nd address of licensed contractor. Location and gal descri�rtion of lot to b�built on: .. Street. Street and Number where work is to be done_ ____ State work to be done acid purpose off Jniilding (b /floors) it I� -. New Building_. To be constructed of _ ✓1 3 Kind of foundati Estimated '1 cost of improvements $_. Zone ^ubage required_ 4. _ / 3 Distance to next nearest building_ _ _ _ Remodeling... * _ ._. __ Addition _r _ Rep.- _ _ Amount of Permit —. _Plan Cubage__J _Size of Building Lot.__ Maximum live load to Ix hereby submit all i be sent to ____ _ _ _ _ The unde signed apt of 1• bor under he Flori ( and h s compl ed w ;th in the wo.ktobeprf i or •otices as are regwr d permit as are licensed b Remarks_ borne by each floor_ _ . _ __ e plans and specuications for said building. Alt notices with referenc and for no other p No. > ' ors Roof - E3rw1 ! -- li ant for th's building permit does hereby certify that he understands a Workmen s Compensation Act be'ng S• lion 5988 Coi p led Gen e prov' :ions thereof, and will require s•milar comp lance from all con ed under th s pern it and ill post or cause to be posted for inspects by the Act. The u. d. r ign. •d agrees to employ only such abco M am. Shores % it : ge. STATE OF FLORIDA, COUNTY OF DADE. ss• to the building and its construction may and accepts his .obligations as an e�imle plWenoyer t, 1 Laws of Florida P r a,, up ctors or sub - contractor empl. -ed by him on the site of the w su.:h, ublic noti• e rs, on wor to perfor '. .. der this (Si Before me, the undersigned authority, a notary public, duly authorized to administer oaths i.nd take acknowledgments, personally peared and who, being by me fiirst d. ly sworn, upo of th abov. de .c • ibed I ,s • ction. t. h therein by him stated are Itz re Permit No._. Disapproved _ ( Signed) __ Chairman __ Member __. Member ._ _ . Council Approved. NOTE: A charge of $1.00 the Planr ng Board A re- inspection fee materials and /or workm ath deposes and says that he is the... c .i,illy read the foregoing application, and at he did sign the same, and that all facts ap- __ _ .to me well known, PLANNING BOARD Read, Sworn to and Sr bscribed before me. Notary Publc State of Florida My Commission Exp es. Member . Member .I_ Member _ St 3 _Date Disapproved be made for making corrections or changes to this applica TE = - -- Date on tfter approval his been obtained from f $1.00 will be charged when such re- inspection is mule necessary ,y improper notice for inspe:•t•an or fa. tty ship. MIAMI SHORES VILLAGE, FLA. N_ 138 JOB ✓ T ;C M ADDRESS 441 i� C,'"� d L% -- INSPECTION "2- •, L D/t/triv TIME READY e1ii I REMARKS: Lc A9'7 INSPECTOR DATE Mesa .l /Ochers , Inc. ELECTRICAL CONTRACTORS & SERVICE 9185 N.W. 96th ST. • MIAMI (MEDLEY) FLA. 33166 • PHONE: 887 -4785 a {�' /� / ',� MIAMI SHORES VILLAGE =v BUILDING DEPARTMENT..+,;? 305 - 795 -2204 Building Inspection Request ro Date S/ /3 /Cc Type Insp'n RCA RC)C PEev- Permit No. B P 'I 1 Name `.3f Address c L (L- Company Phone # Inspection Date 5 J1 6 /O. Correction Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 - 795 -2204 Building Inspection Request Date `,,.._� if) Type Insp'n Permit No. Name -Thom) 4i 6 Ka Address Company j'1 (tom Phone # via) ' j S�}- � 7 I1TC: Inspection Date 4 orrection ❑ Re- Insp'n Fee ❑ PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date , - -e23- 97 Job Address S 7 Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant .80,4v1/4. /i 4,7,3Es Master Permit # Owner's Address /S 7` Contracting Co. _/ i 7r. t/' »4 l i ilia l 'C , Qualifier / Phone Address o2o 3 a / N4 /L. //l /2=" //Ai. R. 33/75; SS#,,, Phone Laos ) G S 3- 4:4,4 7 State # 2,4" 9 O 67,4 S Municipal # ® o '/ 9/a 3 Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. Estimated Cost (value) ,, 0 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 soilicable laws regulating construe, and zo�� ermore, I authorize the above -named contractor to do the work stated. 2 3- _4' L� 0. /�.21y 5- %."3 -q7 Si at Date Signature of Contr c • r or Owner- Builder Date _ r IN VER6NL4 D LECON -�_TE _ :• •� MY's +N #CC372480 ' ,-��� EXPIRES May 16 1998 � —4� 7 9 t -4 Notary a • • mss' Date My Commission Expires: c 0 %3,e/v' FEES: PERMIT i 70 RADON C.C.F. ,t)' NOTARY BOND TOTAL DUE / AfO`/4 Q APPROVED: Zoning Building Electrical Mechanical Plumbin Engineering MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No / t -- - -- Date ' l r//.13 1 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su•ted for t buildilg or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of iami 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 work. l Owner's Name and Address . L1_ � _° _ lLl i] `� No._________� � 0 ___ —_. Street__N_L itecA_. Registered Architect and /or Engineer taliEmploying Electrician's Name c.E4 rv. tc C a No _______ _ ___A___ Street___4__14 Z_ r 14 Location and Legal Description Lot Z Block 9 2 Subdivision_NI/tt!1L1 lit 7 Street and Number where work is to be performed —No 112 Q LL /0 .3 EL/Sir Street State work to be performed and purpose of building (By Floors) New Building !/ Remodeling Addition Repairs_ No. of Service Overhead Size Feeders.. Conduit__ �!_ Main Sw Amps. / 0 d Main Fuses__.._ ._ Amps. Type of Installation— Conduit Tubing_ B.X.L Metal Moulding __ Amount of Permit $ (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, ss COUNTY OF DADE.. Master Electrican. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and . says that he is of the above described construction, that he has carefully read the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public. State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OU TLETS PLUG RECE•P•T'S FIXTURES NO.LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. / 3 / [ -1.- 1 �/1,`t �. . / -L il'b / 1 pt� / 17J / ` ?y / •' S .,1 -y� r W _ __ _ CHECK i,4--, ILt `� ENT. SW^. I 0 0 DIST. CAB. SERVICE TEMP. ____L— ♦ .) CI SERVICE PERM. � I I 0 }V MOTORS 0-1 HP MOTORS 1 -S. HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK J� I I d 0 Overhead Size Feeders.. Conduit__ �!_ Main Sw Amps. / 0 d Main Fuses__.._ ._ Amps. Type of Installation— Conduit Tubing_ B.X.L Metal Moulding __ Amount of Permit $ (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, ss COUNTY OF DADE.. Master Electrican. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and . says that he is of the above described construction, that he has carefully read the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public. State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No,' -_4?__ Date_' Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with whether herein specified or not A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address____ No. Street Registered Architect and /or Engineer Employing Plumber's Name ' ,K. P 4"1511N13 . & S EP t 1 .TANK_) CJJ . -C Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed -No /,L<__70 ___i .8_,,__J_.3? ________ Street State work to be performed and purpose of building (By Floors ) New Building Remodeling Addition Repairs No of Stories Size Septic Tank Feet of Drain Tile _:__d_- U__!f_ -i Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit Type of Tank Amount of Permit $ Plumbing Inspector. 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 Ac,t, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied 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 sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, 3 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared ss. ( Signed) Master Plumber. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty Materials and /or workm CLOSETS BATH TUBS SHOWERS LAVA TORIES SINKS. SLOP SINKS LAUNDRY TUBS U RINALS CATCH BASIN - FLOOR. DRAIN DRINKING FOUNT' NS TOTAL FIXTURES. CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK Size Septic Tank Feet of Drain Tile _:__d_- U__!f_ -i Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit Type of Tank Amount of Permit $ Plumbing Inspector. 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 Ac,t, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied 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 sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, 3 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared ss. ( Signed) Master Plumber. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty Materials and /or workm PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Legal Description Job Address 7a )45:7 //O& g/ Tax Folio/.3%14 /17 ae 2 7A9,244,, Owner / Lessee / Tenant � � Si � /��s Master Permit �� 3 /CK Owner's Address 7 2 A/ -6- /03 S Phone 757 3 7 3i Contracting Co. (/' Wl IlEW Qualifier SS# - - Phone State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN f �J WORK DESCRIPTION � //vr /7 ajF IN �9Q /AA Address Square Ft. Estimated Cost(value) l DC%/2‘07 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. Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: Signat a �°�f Date: g--/// 1 Arawr ota as to Contractor or Owner-Builder y Commission Expires: ** * * * * * * * * * * * FEES: PERMIT 3 7 <5� RADON C.C.F. 0 NOTARY APPROVED: Fire Other Zonin_ Buildin_ �1' )) Electrical Engineering * * ** 00 TOTAL DUE I I- ,f% Mechanical Plumbing Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No ) � -. FY's •.:�, PERMIT APPLICATION= no <- aster Permit No. FBC 2001 Ha 2 3 2" Permit Type (circle): 'Building b11 Mechanical (Roofing Owner's Name (Fee Simple Titleholder) 1AAV..A€ 1hoIV\ \ Phone # (305 q2 . .7139 Owner's Address LOO kOi S City State F'L. Tenant/Lessee Name Zip 3313$ Phone # Job Address (where the work is being done) 1.110 1Z € iO3 City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO V Zip 3313$ Contractor's Company Name ?Ef -FELT R©.k-%„nc, SC* it.:Es Phone # (3o) *TS-- I23 Contractor's Address f 3 1 4-` City' ,41■L State F L Zip 331L, Qualifier ►\ 1- (cc )32929 State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit 2cj00 S Square Footage Of Work: Type of Work: ❑Addition ['Alteration y ❑New Repair/Replace ❑ Demolition Describe Work: Q - p; Rep/n.6_ e1 ?Dry * * * * * * * * * * * * * * * * * * * * * * * * * * ** ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ a Permit Fee $ V CCF $ /190 0/CC Notary $ Training /Education Fee $ 0,60 Technology Fee $ Scanning $ Code Enforcement $ Radon $ Total Fee Now Due S Zoning Bond $ Structural Plan Review. $ (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 issu -'. n the absen o such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature ta.1,< -T%? =1% OwnerAg The foregoing instrument w,& acknowledged before me this 7 '_':�'�'% Signatu day of , 20 by who is personally known to me or who has produced As identification an o did-take-an oath. NOTAR Sign: Print: BNy Turner 17 N L My Commission Expires: Contractor The foregoing instrument was acknowledged before me this day of ,20 ,by who is personally known to me or who has produced as identification and who did take an oath. OTARY PUBLIC: Sign: Print: My Commission Expires: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *. * z.******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 "1:2 2 8 S Plans Examiner Engineer Zoning BUILDING ELECTRICAL PLUMBING ROOFING Owner Building Architec Contract or Build Legal Descript Address Building MIAMI SHORES VILLAGE, FLORIDA ❑ PERMIT N? 14918 Work to be performed under this Permit DATE 195 Contractor's License No. of t — or er Lot II BL Subdi- ion. vision of Value of Amt. of Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING Owner Buildin Archite Dontrac or Build Legal Descrip Addres Buildin MIAMI SHORES VILLAGE, FLORIDA ❑ PERMIT N? 15041 DATE 195 Contractor's License No ❑ Work to be performed under this Permit Df 1 :t for er Lot I II EI. S Subdi- This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed • BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING ❑ ROOFING Owner of Building MIAMI SHORES VILLAGE, FLORIDA I ❑ PERMIT N? 14896 ❑ Work to be performed under this Permit Architect Contractor or Builder DATE 195 Contractor's License No. Legal Lot II M. Description. Address of Building Subdi- vision Value of Project $ Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ DATE 195 ELECTRICAL ❑ PERMIT N? 14946 Contractor's PLUMBING ❑ License No. ROOFING ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Lot II Bl, Subdi- Description. vision Address of Value of Amt. of Building Project $ Permit $ i This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING MIAMI SHORES VILLAGE, FLORIDA PERMIT NQ 7966 DATE Contractor's fi l3 License No. C U Work to be performed under this Permit t ` Owner of Building I "'t Architect Contractor or Builder Legal Lot Description B1 19 ft1/4.- 1 /i �... Subdi- vision Address of Value of I Amount of Building Project $ I Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ao• cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY AGWT 4'" BUILDING ELECTRICAL PLUMBING ROOFING MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 7103 Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Lot Description Bl DATE 19 Contractor's License No. Subdi- vision Address of Value of 11 Amount of Building Project $ 11 Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed. INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for sill work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY naeor 'h'„' t4si—tsT - 0 ,%ito 4-o - s (-4 A-T%-= 33 1/40 -tAbLzr.. _ 1.61 t S 2 2 •S • • S ree 1 $ 4°9 ,o Ts1)6.)iii4f ,t14.1cS. osr.