RF-15-1121 (2) Miami Shores Village
De artment JUN 01 2015
rA AF e, is I Shares,Florida 33136 ,
x:(35)756- 72V
L ERt0S)762-4949
FBC 20
to
BUILDING
Master Permit No. R '--)PERMIT APPLICATION _,��C
Sub Permit No.
-
[]BUILDING ELECTRIC ROOFING REVISION E]EXTENSION ORENE' L
[:]PLUMBING 0 MECHANICAL [-jPUBLIC WORKS 0 CHANGE OF CANCELLATION SHOP
CONTRACTOR RAWINGS
JOB ADDRESS, V
Qt . i _Shores Cca
.
Follo/ rceld; �.._�—is the Building Historically Designated,Yes...____ _Pio,_.
cup ncVType: Load; __ Construction Type-, Flood Zone,, 6FE; FFE,
OWNER-Name(Fee Simple Titleholder),,
Address:
City: � ..._._.___. Stat3 3 ¢
Tenant/Lessee Name:, Phone#,
Emil: k+ °t rCly , rte,
m
�a
Company PJrre:. � ., C `� °tDtlk
Address:
city.
Qualifier Name:,—' �L`1-0 Yll ... h ne
State Certification or Registration#: —Certificate of Competency 0:L5 -, 0 22 .
DESIGNER:ArchitectJEngineei,
Address,. Citta: State: Zip,
Value of Work for,this 4o Permit-, m Square/Linear Footage o
Type of Work: 0 AdditionR ,r
Alteration Alexa RP sir Relalaca El Demolition
Description of Work:
Specify color of color thru tale:
Submittal Fee$ permit F . . C „ _..:.. CO/CC 5 ,..:__>. ,•. ._.._
Scanning F don Fee S .: DOPR ._ Not"�
Technology Fee Training/Education Fee$ ... Double F $
Structural R s __. ..—, _ _..:_w.. _.� ,.:.: ... ..�,:>.. �,.._. Bond �....�
TOTAL FEE NOW DUE
iRewed02/24/2014)
Bonding(ompany's Name(0 applicable)
Bundgrig Company's Address
City Mate_._
t..- dap
Mortgage Lender's Nam@(if applicable). __._.__ ,. 0
Mortgage Lender's Address... ,
city talc
- _...... _.. :.:..«..e................. .....�..,„._....:.......:, <,.,_:.,.,,: ,..�_,_.....,.,<..,,:�,,. SEP. .,,,._._... .,..,.w.,., ...:..,_.», .:,..:.�.,m...,...,.
Application is hereby mare 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 fie performed to meet the standards of all tains regulating,
construction in this jurisdiction, i understand that a separate permit rnust be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS,HEATERS, IANKS,AIR CONDITIONER$,ETC,....
OWNER'S AFFIDAVIT: i certify it)It all this for€3poing information is accurate=and that all work will be done, in c.ianipliancf. with all
,apolicable law,it ouiatin,g constructimi and toning,
"'WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICET MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAINFINANCING, CONSULT 1TLENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICECOMMENCEMENT."'
Notrrp to Appli tart: As a conditwn to fh(,>issuance off"'o building permit yuith an estimated value e xcet ding$Z500, the applicant must
promise in goon frrrth that€a ropey of the notice of commencement and construction lien low brochurc;will be de-lwered to the person
whose partaprr'fy$s su reel to ottuchsricarit, 4lsm^o certified copy o/the recorded notice of commencement must be posted of the fob site
for the first trisprction which occurs seven (7) days rafter the building permit is issued it) the absence of sttch posted notice, the
inspection will riot be approved and o reinspiection fe=e will be charged.
Sinattire Signature _
A(B Gar A"GEN,T CONTRACT-OR
The foregoing in,trurnent was acknowledged beforemethis Flee fore inn Instrument was acknowledged before Grie this
day of __ f0 J_ .lay day of 2t2
� ..- _ -
by
lJ bj—Q_C) ., ..:MUA40Ulwho is paersonaliv known totv�as personally known to
��3u
rise of who has produced as elle or who has produced
identification and who did lake are math., identification and who did take are oath,
NOTARY,PUBLIC. NOTARY PUBUC:
Mill 1l//
fxlRri: M.lw� �i eo i�
#riot M` c
`� ,.,4 �m,^ _ _._!dl Print: .. _ xir �i� ''•
Seal- No 3106/1016
C&vW ASS i ov, 4lcpire s �� C �•' = GARY PUBLIC
OC4, 3� dt a z 'Ai�,�i► ?•�� Nom:Commission
APPROVED BY �Plans ��rrctra r !i,�IFLO`����rarisrap
_m... 6... .m,.
. ...r�. Structural Review Clerk
Section A/B
7 a
ice..
MIAMI DADE"
Miami-Dade County HVHZ Electronic Roof Permit Form
L! _. :_2
IONSection A(General Informat n
Master Permit No: ` Process No:
Contractor's Name: :Palmer Roof Tech Inc ,
Job Address: .,
v� JUN 0 1 2015
Roof Category
0 Low Slope ❑ Mechanically Fastened Tile ® Mortar/Adhesive Set Tile
❑ Asphaltic Shingles ❑ Metal Panel/Shingles ❑ Wood Shingles/Shakes
❑ Sprayed Polyurethane Foam ❑ Other:
Roof Type
❑ New Roof ❑ Re-Roofing ❑ Recovering jdRepair ❑ Maintenance
Are there Gas Vent Stacks located on the roof? ❑Yes ❑ No If yes,what type? ❑ Natural ❑ LPGX
Roof System Information
N,VV> \'CtIley _.... .
Low slope roof area (ft.2) ® t Steep Sloped area(ft.2) /®e L,o% Total (ft.2)
Section B(Roof Plan)
';Sketch Roof Plan: Illustrate all levels and sections, roof drains,scuppers, overflow scuppers and overflow drains. Include l
,dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and location of parapets.
IPerimeter Width(a'): Corner Size(a'x a'):
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! "41iNG DEPT �--t(���{�� i� IAF
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l,ll Cr TO COMPLIANCE WITH ALL FEDERAL ••• •
11 cn[INTY RULES AND REGULATIONS • •• •• • • •