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PERMIT APPLICATIONBP200101 CITY OF BOYNTON BEACH Application Inquiry 12/05/02 09:34:29 Application number ..... : 02 00001353 Application status, date : FINALED Property .......... : 525 SE 18TH AVE PCN ............. : 08-43-45-33-00-000-1310 Lot Number ......... : 5/01/02 Zoning ........... : C3 COMMUNITY COMMERCIAL Application type ...... : RR RE-ROOF Application date ...... : 4/15/02 Tenant nbr, name ...... : Master plan nbr, revwd by : Estimated valuation .... : Total square footage .... : Public building ...... : NO Work description, qty . . . : Pin number ......... : 7898 TILE TO SHINGLE & FLAT RA 5600 0 Press Enter to continue. F3=Exit F5=Land inq F10=Fees F11=Receipts F7=Appl names F12=Cancel F8=Tracking inq F13=Val calcs F9=Bond inquiry F24=More keys B U I L O I N G OEP A R TM E N T BUILDING PERMIT APPLICATION (Please Print) Permit PCN 08-43-45-33-00-000-1 31 0 (Palm Beach County Property Control #) Owner's Name Madeleine De La Rubella Owner's Address P. O, Box 1493 City Boyntom Beach State FL Zip 33425-1 493 Fee Simple Titleholder's Name N/A (If other than owner) Fee Simple Titleholder's Address (If other than owner's) Contractor's Name Brad's Roofing Company, Inc. Contractor's Address P. O. Box 2587 (FOR SUB PEP/~ITS ONLY Owner's Phone # 732-2579 Contractor's Phone #274-3920 City. Delray Beach State FL · Zip. 33447 Job Name De La Rupelle, Madeleine Job Address 525 S, E. 18th Avenue City Boynton Beach , FL County. Palm Beach ~ ' Legal Description 33-45-43, E 124,90 ft of W 600 ft of N 125 .ft of S 1910 ft of R 1/2 ~f NE 1/4 W of Dixie Hwy Bonding Company Peerless Bonding Co.Address 10~2 princess Palm Architect/Engineer's Name N/A Architect/Engineer's Address Mortgage Lender's Name N/A Mortgage Lender's Address SINGLE FAMILY: DUPLEX: (check one) ESTIMATED VALUE OF CONSTRUCTION: $ DESCRIPTION OF WORK: City Tampa State FL MULTI - FAMILY: 5:600.00 HOTEL: RETAIL: OFFICE: I~DUSTRIAL:~ Ti ]~. tm .qhin?]~_ & Plat Deck Re-roof Application is hereby made. to obtain a permit to do the work and installations as indicated. 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 iurisdiction. 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 wor will be done in compliance wxth all applicable Iaws regulating construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO~9{RNC~ MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PHOPEHTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOU I,F~DEH OR AN ATTORNEY BEFORE RK~ORDING ~YOUR NOTICE OF STATE OF FLORIDA, COUNTY OF PALM BEAC~'a-~- / " / rgpinginstrumen~ was acknowledged before me this ~o~vt~ ~ ~~ (date) by ~%~_~ ~5,~e_~ ~_~,~J[~_ who isk6ersonally known to me,~r w~o ha's% produ37~ . [t}%pe of identi~ica~cion) as iGengific~tion and who dt~ take oath. Signature of person taking acknowledgement [ ~ ~~ ~O. ~ ~-~--"~ ..... ~ · -p~!~'nted/(fr stamped _-_-3 ~ ~ ~ , Name of officer taking acEnowledgement--ty?ed '- ~ ..... : .................... . Title or rank Serxal '~ : --~"~ '~ number, (~f any · ~._%.~ m~-~-~ ~ Co,tractor's Signature ~__- ~ Date STATE OF FLORIDA, ., The foreseeing i~trum~nt ~s-~nowled .... --.~ Ow ,.~ \; ~. ~.~date) by [ ~v~ s'~-""~:.,~~ . who is ~ersonal.ly known to_m_~r ~ho nas p~oauc~e~----~. -_-_ .... -% ........ v -- (type 6f identi~catton)'as identification and who did ~ake oath. / L Signature of perso.n taking ac~kno, wledgement ( ~ ~// ~ t~...~.~.~- _ . Name of officer raging act~nowxeagment--tylCert, prxntea o~r,.~ea ' '~,~'~..~2~. u~orT~ I~.P.J'~ Title or rank Serxal number, '~/any ~::~'"..~[Commi~lo~#'~081~ . (Certificate of Competency Holder) %f,*,~ .... . ~l~a2~..~ . Contractor's State Certification or Registration No. CCC0~8077 ,,,,;~ Contractor's Certificate of Competency No. LIABILITY INSURANCE EXPIRATIO~ DATE: 05-09-02 wORKERS' COMFENSATION EXPI j ONrM E: 0 - 5-02 APPLICATION APPROVED BY Permit Officer Date: Any change in building plans or specifications must be recorded with this office. Any work n covered above must have a valid permit prior to starting. In consideration of the granting of this ~ermit, the owner and builder agree to erect this structure in full compliance with [he Building and Zoning Codes of the City of Boynton Beach. NOTE: This permit VOID after 180 DAYS UNLESS the work which it covers has been commenced, Contractors must have valid State Certification or County Competency plus County and City Occupational Licenses prior to obtaining permit. ISSUANCE OF THIS PERMIT DOES NOT AUTHORIZE VIOLATION OF DEED RESTRICTIONS THIS PERMIT OR PLANS FILING FEE IS NOT REFUNDABLE SETBACKS: LEFT ZONE: RIGHT (THIS SIDE FOR OFFICE USE ONLY) Application # Master Plan # APPLICATION DATE: RECEIVED BY: FRONT REAR TYPE OF CONSTRUCTION OCCUPANCY TYPE ROOF TYPE FENCE TYPE AREA SQUARE FEET FLOOD ZONE BASE FLOOD ELEVATION FINISH FLOOR ELEVATION NUMBER OF STORIES NUMBER OF UNITS PARKING SPACES REQUIRED PARKING SPACES PROVIDED # OF BEDROOMS # OF BATHROOMS ROAD IMPACT FEE SEWER FEE WATER FEE PARKS FEE SCHOOL FEE PUBLIC BLDG. FEE LAW ENFORCEMENT FEE RADON FEE BCAIF ADDITIONAL FEE PENALTY FEE SUB-TOTAL VALUATION FEE REMARKS: BLANKET FEE Site Impr. Building Electrical Mechanical Plumbing Roofing Drainage Excavation Landscaping Paving. Sign Sewer SUB-TOTAL TOTAL LESS PLAN FILING FEE REQUIREMENTS FOR CERTIFICATE OF OCCUPANCY CERTIFICATE OF COMPLETION SITE FINAL SIGN FINAL FIRE FINAL OTHER PAVING FINAL OTHER DRAINAGE FINAL FENCE/BUFFER WALL FINAL SITE LIGHTING FINAL C.O. OR C.C. AUTHORIZATION Signature Date TOTAL AMOUNT DUE RECEIPT NUMBER DATE PERMIT ISSUED INTERIM SERVICES FEE CALCULATIONS Residential: X # of units applicable monthly fee Interim Services Fee Commercial: divided by 1,000 = # of sq.ft. (rounded to nearest tenth) base sq. ft. rate base sq.ft, applicable rate monthly fee Interim Services Fee A:PERMITAP.WP5-2/92, rev.7/93-bh GAF MATERIALS CORPORATION P rod u c t I) i m ~. s in ,, GAFGLAS Ply 4:~ 5 sq. roll GAFGLAS® 76 lb. roll Mineral Surfaced Cap Sheet __ Test ASTM D 2 i 78 ASTiVl D 3909 Acceptance No: 00-0331.08 0 -1818 Product Type IV asphalt im,pregna~~ w~th ~mll coat inb. ~~ RUBEROID® Modi fled Bitumen Adhesive GAI:G LAS® STRATAVENT® Perforated GAFGLAS® Flashing GAFGLAS® STRATAVENT Nailable RUBEROID Modified Base Sheet GAFTEMP® Isotherm R Tapered GAFTEM P® Isotherm R GAFTEMP Isotlicrm RA Tapered GAFTEMP |sotherm RA GA ITEM P Isotherm RN 5 gallons 60 lb. roll various 69 lb. roll 3 sq. roll 67 lbs. various various various variot,s various ASTM D 3019 Type ill ASTN! D 4897 D 3672 ASTM D 489 D 3672 .ASTM D460 I, Type I I, U L Type G2 BUR PA II0 PA II0 PA I10 PA 110 PA II0 3 of 55 Fiber rei,tlbrccd, rubbe,'ized Adhesive Fiber glass base sheet imlweg,mted a.d coated o,~ both sides with asphah. Surfaced on the bottom side with mineral granules embedded in asphahic coating with fi~ctory perforatioqs. Asphalt coated glass fiber mat flashing sheet available in three sizes. Fiber glass base sheet impregnated and coated on both sides with asphalt.. Surfaced on the bottoin side with mineral granules embedded iq asphaltic coating. Premium glass fiber reinforced SBS- mod i fled base sheet Polyisocyant, rate tbam insulation. Tapered Polyisocya,mrate foam insulatio, Polyisocyamm~te foam insulation Taperedinsulation P°lyis°cyamR~EIV~D Polyisocyanurate foam ' Frank Zuloaga~ RRC Roofing Product Control Examiner GAF hlATERIALS COI'/.I'OI/.ATION Acceptance No: 1111-l1331.11g P rod u c t GAFTITE® # 1'4 Heavy Duty Roofing Fastener GAFTITE ASAP Dimensions GAFTITE® Base Sheet Fastener and Plate Galvalume Plates NTB Fasteners 3" and 3 '/:" Poiypropylene Plates Ruberoid® 20 3" and 3 V:" 1.5 sq. roll RUBEROID MOP I sq. roll S,nootli 87 lbs. RUBEROID MOP I sq. roll PLUS 102 lbs. RUBEROID NIOP I sq. roll 170FR 103 lbs. RUBEROID NIOP FR I sq. roll i 05 lbs. Test .Specification PA 114 J)l'Od IiCI Description 0: -1858 Insulation fastener for steel, wood and COllCrele decks. PA 114 PA 114 Pre-assembled GAFTITE Fasteners and metal and plastic plates. Base sheet fastening asseInblv. PA 114 PA 114 PA 114 ASTM D 5147 Rot, nd galvalumc stress plates. Fastener for use ill gypsuln, rectum and lightweight insulating concrete decks. Round polypropylene stress plates. SBS modified asphalt base sheet and interply sheet reinforce with a glass fiber mat. ASTM D 5147 Non-xvoven pol.y, ester mat coated with~ polymer modified asphalt and surfaced ) with inincral granules. ~ ASTM D 5147 ASTM D 5147 ASTM D 5147 ASTM D 5147 5 of 55 Non-xvoven polyester mat coated with polymer modified asphalt and smooth surfaced. Non-woven polystcr mat coated ~vith polymer modified asphalt and surthccd with inineral granules. Non-Woven polyester mat coated xvith fire rctardant polymer modified asphalt and surlhccd ~vith mineral granules. Non-Woven polyester mat coated with fire retardant polymer modified asphalt and surfaced ,vith mim:r~l~l~lV Frank Zuloaga. RRC Roofing Product Control Examiner GAF :MATERIALS COI~.I'ORATION l'roduct Dimensions Test .Specification '" RUBEROID MOD · _ A~spl ~ a I t 60 lb. kegs RUBEROID MOD Asphalt L RUBEROID MOD Asphalt P 60 lb. kegs 60 lb. kegs GAFTEMP Tapered Various Isotherm R GA FTEM P Tapered Various Isotherm RA GA FTEM P Tapered Various Isotherm RN GAFTEMP Various GAFCANTr.~s - GAFTEMP GAFEDGE'm Tapered Edge Strip GAFTEMP PERMALITE® Tapered Roof Insulation GAFTEM P Recover Board Shingle-MateTM Underlayment GAFI'ITE® ASAP Various Various I/2" thick, Various sizes 4 sq. roll 30 lbs. 500 per box PA 110 PA 110 PA I!0 PA !10 PA 114 RUBEROID~ Modified Bitumen Adhesive 5 gallons ASTM D 3019 Type !11 7 of 55 Acceptance No: 011-0331.118 c2-1353 Prod uct -~ Description SEBS modified asphalt ~ SEBS modified asphalt SEBS modilicd asplmh / Tapered polyisocyatmrate foam Tapered polyisocyanurate foam Tapered polyisocya,mrate l'bam Cut perlite board Tapered perlite board Tapered perlite board Perlite board Fiberglass reinforced shingle underlayment Pre-assembled lhstener and ,netal :md plastic plates Fiber re',,,*oraed. D APR 1 b 2002 FFii~ · Zulo'aga. RRC Rooling Product Coqtrol Examiner GAF ~IA'FERIALS CORI'ORATION Membrane Type: SBS Deck Type 1' Wood, Non-insulated Ne~v. Construction or Retool i)eck Description: or greater plywood or xvood plank decks System Type A(2): Base sheet mechanically fastened. All General and System Limitations shall apply. Base Sheet: ~__~___~AFGLAS~. #75,.~FGLAS ~80 UltimaTM Base SheeL GAFGLAS~ PLY 4~, GAFGLAS~ PLY 6~, GAFGLAS FiexPlyTM Base Shect,GAFGLAS~ STRATA V ENT~ N ailable, RUB EROI D Mod i fi Bas~ S hee~ o~ R U B E R~ ~in caps at a t~tener spacin~ of 9' o.c. ~ along the center line of the she~. Ply Sheet: (Optional~n~o, or three~ies GAFGLA~LY 4~~ Membrane: ~OP Sm~,, Rt~;oid~ Mop 170. FR, ~u~;~ ~us Granule, Ruberoid'~ ~0 or eroid~ Mop FR or RUBEROID UltmCladTM SBS a adhercd in a full mopping of approved asphalt applied within the EVT range t a rote of 20-40 Ibs./s~ Or, One or mom plies of RUBEROID MOP Smooth. RUBEROID~ Mop Granule, RUBEROID~ Mop 170 FR, RUBEROID~ Mop Plus Granule. RUBEROID~ 30. RUBERO[~ 30 FR or RUBEROID~ Mop FR or RUBEROID UhraCladTM SBS in RUBEROID Modified Bitumen Adhesive at an application rate of I-2 gal./sq. St, rlhcing: (Optional, required ifRUBEROID NIOP Smooth or RUBEROID 20 is top membrane) lqstall one of the following: I. Grovel or slag applied at 400 IbJsq. and 300 lb./sq, respectively in a flood coat of approved asphalt at 60 lb./sq.. 2. GAFGLAS Mineral Surfaced Cap Sheet-in an approved asphalt at an application rate or 25 lb./sq. + 15%. Maximum Design Pressure: Maximum Fire Classification: Maximum Slope: Specification No.: -45 psf (See General Limitation #7). See General Limitation # t. See General Limitatio,~ # I. 19of55 RECEIVED 2002 FILE COPY flUILOING DIVISION Rooting Product Control Examiner - 02-1353 M l...~,~,i 1 - J,I.A D 1;' COUNTY, METRO. DADF- FL, AGLER BUILD,NC PRODUCT COI~'rROL NOTICE OF ACCEPTANCE G.A. F,. i~Jaterials Corponttion 1361 Alps Road Wayne NJ 07.I70 Your application tier Product Approval of: Ortginal'Timbgrtine Asphalt Mk"TItO,D^DE F1--AGI~I~, ~Ut'-DING :.;,C WF, ST FLAGL£R STR. E~'I'. 005) 37,~.2.)0~ ~AX (30.% '.2~J 37~,Z902 FAX (305~ tm. der Clmpter 8 a.rthe Cede of Miami-Dude County ~o,.,¢rning me a~ of Alternate ,'.lamriai'~ and T: pcs of Construction. and coml3lcmly dcserit~d herein, has i3.-en t-:gommendc~ f'a;' ~c~tane~ b~' me Minw:. DaCe Count)' Building Cod: Complian:~ Oftic~ (BCCO) under thc conditiom specitled 'mis approval ~1'. not ~ ~lid a~r m~ expiration ~e sm~ed ~tow. BCCO reserva~ the ~gh~ m ~ec~;te produc: or m~[enul at an~ime f~ a jobske or manufactu~r's plant t'er quali~y con:roi the tree of such pm~m er mete~ immediately. BCCO reserves the right m revoke :his approvai, i:' it det~i~ BCCO tam ~is product or mamdal rails to m~t :hr ~quimmen;= ot'ti%e South Flor,ca Code. The expense of s'.u=h testin8 v, il! I~ incurred by the manufacturer, Acceptance No.: II0-010S.li2 Ti-I'[S IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND G£,'r..RA [. CO~BITIO.NS BUILDING CODE & PRODUCT REVIEW COMMITTEE This al:~ication fo.' Product Approval has be~n reviewed by the RCCO =nd approvee ~' the B;.ildi:;g and Product K~view ~mmittc~ lo ~ ~ in Dad: County, Florida under me condition~ sm ~bett~ ~' .- App raved: U4t21/'2000 I or5 Director ?,,liami-Dadc Coun:v I~midinL., Cod,. ComDtim:c~' RECE ¥ED APR 1 5 2002 A~liC~Ln~: New $~taey 0?470 proc,~uct Control No: 04)-0105.0Z Approval Datc April :21, 2000 Expiration Date: ,~,.orll 2:2, 200.3 SCOPE This renews GAF Timberline Asphalt as manuiractured by GAF Materials Corp. described tn Section :2 of this No, ice of Acceptance, ~esigned to comply wi[h thc South Florid~ Building Code, 199,t Edition for Miami-Dada Count'. C,tegory'. Sub Category: Roofing Shin~les, Dimensional PRODUCT DESCRJ:PTION GAF Ttmbetiiee 13'/~' x 3g~/,' _T_e~t Speeifleatlon~ 4 LLIH.tTA. TION$ d.! Fire ~.in~sifieation is not ~ o~ ~is a~ce, refer to a cu~nt ~aJS ~ for fi~ ratings of ~tS pr~uct. Approved P. oo ,tm _~ I~STALLATION Shm~ie~ shall ~ i~i!~ m ~mplia~ with Miami-Dada County Pr~u~ Control Shingt~ l~llatioa P~dum No. [ F~hin~ ~ail ~ m ~ord~ wi~ Semion 9.~ ~tion "~" (Step-flashings) cf Cou~ P~uct ~t~l Shingle in~llafion P~edu~ Nc I [ S m~f~r ~&il ~ovi~ ei~ly ~i~n ap~ii~ion ins~cti~. ~um ~d ~ ~t shall ~ in ~mOit~,ce wi~ ~m~ 'A', a~ched. shah ~ in ~pli~ with ~i{ 'B', s~ched. 6.1 Shingles sh~ll t~ labeled with the Mitmi-Dade Logo or the wording "Miami-Dade Coun~'- Daee Proctuct Control Approved". This Not"-'cotr Ac~ptanee. Aey other documents reclu,,r.d by the Building Of'~cinl or thc South Florid= Building Code (SFAC) i~ order to properly evaluate the installation Page 2 of 5 Roaring Product Control Examiner RECEIVED APR I 2002 8UtLDiNG DIVISION (;. A.F. )I ,~TEI~AL$ CORPORATION DETAIL A TO: Page 3 of 5 Roofing Pwduc; Control E~xaminer aP~ ~5 2002 FROH: I:).,~- ~.4Z2/01 '~me 11-:~3.Ia Ai~i G.A.F. :~L~.TERI,~,L.$ CORPOR.-~TIO~' Product Con~,.-..I Nc.: DETAIL Rulense Tape '-5-$;~"- [ 3-1/4" Front Side Back Side Page 4 ors Roofing Produc Z~pR ~ r~ 2002 BUILDING DIVISION 8B-~2-81 11:29 TO: FROM: I 011-1353 C;.A.F. ~I..xTE KIALS CORPORAT[O.~ Praclucr Contrul No.: G.A.F. 3I.~lcrial.s Corp. A'_'.'Ck P'I'ANCE (3bi AIp~ Roa,t APPROVED. April 21,2000 ~,V:,?. n,:, l~J ! 07.;70 EXPIRE'g: April J~, 20i.)3 NOTICE OF ACCEPTANCE STANDARD CONDITIONS Renewal -3f th~s Acceptance (approval) shall be considered ~'ter -~ renewal application has been 5]ed and rile origin-~l submitted documenzation, including te~-t supporling dam, engineering document~, are no older ~an eight (8) years. Any an~ all approved produc~ shall be pendently I~led with ~he manufacturers name. ciD', ~mte. god toe following smrgment: "Merm-Dafle County Produc~ Control Approved". or specifi~lJy stored ;n the speci~ conditions of this Accep~cc. RenewAls af Acceptance will not be considered iF: a) There has ~ a change in ~he Soum Florida Building Code affecting the evaluation oF this product ~d the product is not in compliance w[~ ~e code b) The ~.roduct is no longer ~e ~e p~uc[ (idenfi~l) as ~he one originally c)Ir the Acceptance holder h~ not camplied wi~ all the ~qu/~enm of~ including ~e co~[ insallafi~ or the pr~uc~ d) ~=e ~gineer who ori~n~lty pmp~d, signed and sealed ~e required doc~enmtinn initially submitt~, is no longer proc/icing fl~e originating profession. Any revision or change in the m~ccrial/, use, =~tor =ufgc[um o~ the product or proce~ skal[ au[om=i~t[y be ~use for te~[nafion of fl~i= Accep~ce. unless wior wr[uen approval ha= been requ~ed (thrcu~ the ~ling o~ revision ~pplicati~ with approprf~tg f~) ~d g~nted by Any o~ ~e followin~ shall also be grounds for ~oval of [hi~ Accep~c;: a) Unsafisracw~ perfo~ance of this pr~uct or b) M~e or th~ Ack, fence ~ an endomem~t of any pmduc~ for ~{~, advenising or any other pu~o~. The NOtice of Accept=ce number pr~ed by ~e words Metro-Dado Count)', Florida, ~nd tbllowed by me expiration dam may be display~ in advemsing Ikemmm. If any portion Notice of Accep~ce is d~[ayed, aen it shall be done in ks A copy of tiffs Accep~ee as well ~ approved drawings ~d o~er d~umen~, whom il applies, shall be p~vid~ [o d~e ~er by the manufactu~r or i~ distHbuwrs and shall be available for inspection at the job site at alt times. The copi~ need not be ~sea[~ by ~e engineer, Failure to, comply with nny section at'this Accep~ sh~li be ouse for [e~ination and removal of Acceptance. This Acceptance contains pages I through 5 END OF Tills ACCEPTANCE Page 5 of 5 Roofing Product Comro[ ~xaminer ~ ~G DIVISION ~UlL[)lt~ TO: FROM: PREPARED 4/15/02, 12:14:30 PAYMENTS DUE RECEIPT CITY OF BOYNTON BEACH PROGRAM BP820L APPLICATION NUMBER: 02-00001353 525 SE 18TH AVE ROOFING PERMIT 89.60 TOTAL DUE 89.60 Please present this receipt to the cashier with full payment. 0~: ~/ D~t,e: 4/15/8,?. 8e To~al t~ndered To~tl pa~ent Receipt no: ~19139