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341 NE 92 St (10)Type lnsp'n Permit No. Name Address Company Phone # c MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 1 1 r� :-Y- / / ' / > , f Inspection Date Approved Correction Re- Insp'n Fee Date Type Insp'n Permit No. Name Address Company Phone # Inspection Date C MIAMI SHORES VILLAGF BUILDING DEPARTMENT 305- 795 -2204 Building nspection Request “ca gP a ' - / St /t e 9 a ,d - Re- Insp'n Fee ❑ uP ( Ae 4 Test Location Uplift Pull Test Result Test Location Uplift Pull Test Result Test Location Uplift Pull Test Result Test Location Uplift Pull Test Result 1 ASS 26 'A 55 51 76 2 27 52 77 3 28 53 78 i 4 29- 79 5 �� -�� \_\ =L EM �111_=E11=M11: �� IMIIMILIAIIKP_ I MIIIWillE=1 / •0 11111i 80 a�� 81 Alla 82 /ANS III�� 83 MME_ / ■1111111M=1111■ ===.111 � TE11\_ 111111111111 6 7 8 111 �11.V1111E 9 Ul 34 0 Nom/ II 35 IIIIN 1 WM i I= 111111/1111 61 VIVA — WE 7 12 WA EMI= 62 111r4 13 PAIII'MEM�.� MIMMIL /CIA WI lia 14 • ■IN/ . - 15 40 V `6"65' �� 90 16 41 66 91 17 42 67 92 18 ' 43 68 93 19 44 69 94 20 45 70 95 21 46 71 96 22 47 72 97 23 48 73 98 24 49 74 99 25 50 75 100 DuQuesne & Associates, Inc. Consulting Engineers Environmental / Structural / Civil / Forensic Testing Laboratory Building Inspection Services Quesne, P.E ineer PE ' 2 13 DuQuesne & Associates, Inc. EB #0005245 Lab Certification #01 -0206.11 ON -SITE CONCENTRATED UPLIFT LOAD TESTING OF ROOF TILE IN ACCORDANCE WITH FLORIDA BUILDING CODE PROTOCOL TAS -I06 Owner's Name: F/ A/v I "A pI b Permit #: P605 'Y/ 7 Job Address: 34-1 N E 9 2 ST ) /'1 1 (j /4 ( c hot-ES Roofing Contractor : DP� ( E Y Approximate Square Footage of Roof: R/0 Date Installed : / /I / Qy Approximate Roof Hight: / feet Required Testing Force: 35 Ibs + 5 lbs. THIS R .SRTSUBMITTED BY: SITE SPECIFIC INFORMATION ft2 TEST RESULTS Type of Tile: A 1 AMR Qy Date Tested: 1 t (? Z.704- Testing Equipment: Chatillon DFIS 100 IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL TAS -I06, TIIIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST This TAS -I06 has been performed in accordance with the requirements of Miami -Dade County, with no deviations. This form is not valid unless Company initials appear in color. UTR # - 19161 78 15 Coral Way, Suite #109 Miami, Florida 33155 Tel (305) 264 -1425 / Fax (305) 264 -1426 / E -Mail JDuquesne a AOL.com SKETCH OF ROOF JOB 3:!2I AA 5 2. 577 , Lt4 /4 A4 f SHEET NO. OF CALCULATED BY SCALE DAT,i/— 2 -3— oct CHECKED BY PATE MINIM • MI milIMME MIME ENE ME II •• • 131111M111j MAMMilm N I i ga l 111114 I MINIMIMINNIMM3p1MM 11 I MN MIUMMEMOMMEMEIM 111111 IMIEMEMINIMMEN =NM I. • I MINIMENTIMMEMM MUM MN I MBE MUM MI • MIR MI All • • II I MN MEM M • • • 1 11111 1111 I 1111 1 1 I I I NOTES: Miami Shores Villag BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Owner's Name (Fee Simple Titleholder) rg-WI _ TtLM Phone # .7,s ec/ Owner's Address -.5 ( L 'r' City /14 444 Skike State Tenant/Lessee Name • Job Address (where the work is being done) 3 4 / Ivl% q2, 5 City Miami Shores Village County Miami -Dade Is Building Historically Designated YES V NO Contractor's Company Name Dl Contractor's Address City State 4/ Zip 3 / / �Jtt� Qualifier State Certificate or Registration No. ar✓616‘71 ei 0 Architect/Engineer's Name (if applicable) $ Value of Work For this Permit 2-16 Type of Work: ❑Addition ❑Alteration ❑New ❑ Repai Describe Work: R - IZoflF O PAM' WI ia7 77) 1144-`rail MA/A) ilnu. C F 6AGLaL67, �z.A- &D Tin I e" * * * * * * * * * * * * * * * * * * * * * * * * * ** *F * * * * * * * * * * * * * * * * * * * * * * ** * ** Submittal Fee $ Permit Fee $ CCF $ 1 , 8® co. Notary $ Training/Education Fee $ Technology Fee $ / Z _r Scanning $ i Radon $ �— Zoning Bond $ Code Enforcement $ /CO Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) Building D epartmen 10050 N.E.2nd Avenue, Miami Shores, Florida 33 Tel: (305) 795.2204 Fax: (305) 756.8972 4/ 10 DA NJ-tr. - q\if a 1 ,eqvira Or acce.ss04 bu0,„, Zip 33/3 Phone # .4/ Phone # Permit No. Certificate of Competency No. Phone # zip ,3313 Square Footage Of Work: 2-00 1 ' Master Permit No. a Q 1 Y "ASV q Ce/ ❑ Demolition Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City St 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection whi o - ' - s seve ' (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be tion fee will be charged. Signature My Commission Expires: er or Agent f oregoing ins • ent w acknowledged before me this The foregoing instrument was cknowledged befor this i day of Q �� 21 by day of pa S , 2( , by �� 1:.�" "'`, who is personally known to me or who has produce identification and who 1 t e ,tli, NOTARY PUBLIC: NOTARY PUBLIC: , _ . rP: o F `� Comrai, nitln �D21984 _Q. : ass it . rfA d - ; 9 2,007 Sign: Sign: ��? ., Print: `$ I ! OL/" Y a Print: ��::: • .t •. 4 My Commission Expires: who is personally known to me or who has produced As identification and who did take an oath. * * * * * * * * * * * * * *� lr0fl *8hi$4bffi ********************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** g` My Commission DD212NP '°�a w d Expires May 14, 2007 ***************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 Contractor * * * * * * * ** 67 I 0 1 ` ® " Plans Examiner Engineer Zoning is Bonding Co., Inc. * * * * * ** * * * * * * * * * * * SECTION 1524 G VELOCITY HURRICANE ZONES 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 • 1S of tam Florida Buibilug Code. Barring 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 .4,.• r �A 1. Aesthetics-Workmanship' esthetics -Wor kw1111shi :: The workmanship provisions of Chapter 15 (High Velocity Hurricane S for the purpose of providing that the roofing system meets the wind resistance and water intrusion t .- n nnn. Aifiedavdk- At=atb tics (appearance) issues are not a consideration with respect to workmanship pro ro l Aesthetic trues such as color or ardiltccteral appearance, that are not }fit Of a 2otling code, Should ,.. �. as part of the agreement between the owner and the contractor. A 2. Reuniting Wood Decks: When replacing roofing, the existing wood roof deck may have to be "!!': A in a with the current provisions of ( 16 (high Velocity Hurricane Zones) of the Florida fr • : ode. (The roof deck is usually concealed prior to removing the existing roof system). / - te Coraon Roofs: Common roofs are those which have no visible delineation between. neighboring , 1 t_ townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or ,r. : , . uld notify the occupants of adjacent units of roofing work to be performed. s beam ceilings are where the underside of the roof de&ing can be i �l 4. Exposed Ceilings: Expo ed, &� �/ from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail pen: . ons of the underside of the decking may not be acceptable. The Florida Building Code provides the option of maintaining this appearance. 5. Ponding Water: The current roof system and/or deck of the builcbng may not drain well and may cause water to pond (accumulate) in low-lying areas of the roof. Ponding can be an indication of structural distress and may require the review of a professional structural engineer. Ponding may shorten the life expectanc and performance of the new roofing system. Ponding conditions may not be evident until the system is removed. Ponding conditions shouldbe corrected. ��'' 6. Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not ov net* • ed from a build up of water. Perimeter/edge walls or other roof extensions may blodk this tb sewage if ov �i scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in acco ; T• th the Florida Building Code, Plumbing. ��I Imo ' / _ have some ability to vent natural airflow through the Ventilation: Most roof should 4 '! r �!! f e f the structural assembly (the buffing itself). The existing amount of attic ventilation shall not be . f4 It may be benefice to consider addrftonal venftng wbicb can resift in extending =mkt life of Vzie. vr CaDocomare, sed freetapiduatateU.essl faefsgiffleasamPlowl tumid VOdl 2WISIO IALU '' RCT!ON197484• Contractor DALEY ROOFING INC Local Phone: (305)754 - 9892 Parcel # 1132060136380 Building Permit Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2004 -1417 Printed: 11/8/2004 Applicant: ELAINE STONE Owner: STONE ELAINE JOB ADDRESS: 341 NE 92 ST Contractor's Address: 78 NE 106 ST Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 17 & 18 BLK 47 LOT SIZE Fees: Description Amount FEE2004 -10978 Building Fee $500.00 FEE2004 -10979 CCF $1.80 FEE2004 -10980 Notary Fee $5.00 FEE2004 -10987 Training and Education Fee $0.60 FEE2004 -10988 Technology Fee $12.50 FEE2004 -10989 Code Enforcement Fine $100.00 Total Fees: $619.90 Total Fees: $619.900„ Total Receipts: 00 5Gq ,90 Permit Status: APPROVED Permit Expiration: 5/2/2005 Construction Value: Work: RE -ROOF REAR BUILDING TO MATCH MAIN HOUSE -CLAY BARREL TERRACOTTA TILE Page 1 of 1 .NOV 0 9 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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: x#538( NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street/address: 2. Description of improvement: 3. Owner(s) name and address: -- f7141eiA) L' I &, L S�' /1/14, aiA l S kA)1.l'4 / 41 ? /71 lj S Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: C_ 4g IN6 lc 14 Pl_ 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. 4 Name and address: / 9. Expiration date of t is differen Si ce o Commencement: (the expiration date is 1 year from the date of recording unless a dat- p. //d A.Adati r :of Own :; nt Owner's Na; + et Sworn to and bs• ribed before me this AL' 4-01 - /1.-c 6 /et l �S�flr� a4A4 .Cur.-, 4-1 3 J ),5 ikjin Notary Public �lL ` c Print Notary's Name iSh a ; Y' 0' J V' flI CL PI My commission expires: 123.01 -52 PAGE 4 8102 Sharon Homan i� ' My Conar� ion 00212009 a wv Expires May 14, 2007 Prepared by r)(4,44.-1- D kit-t6 day of , 20 O Address: - 7&' /I,G W1.0 S M J t4 " ) 3 STATE VF'11 )4ftfAXTl''MW OF DA DE t hIEREBV this is`e true opy or the orrgrh21 11 tibia of ce on �{ / d;ol 1 111 11 11 11 11 111 11 11 111 11 11 1 1 11 111 11 11 CFN 2004RID9 OR Bk 22776 Po 0216► (ins) RECORDED 10/29/2004 10:57:06 HARVEY RUVIN, CLERK OF COURT MIAMI -DADE COUNTY? FLORIDA LAST PAGE Page 1 of 1 1 High Velocity Hurricane Zone Uniform Roofing Permit Application Form MIAMI -DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPLICATION 1 Master Permit No. Section A (General information) Process No. Contractor's Name: Job Address: Pb too /JC 3V/ � S: Roof Category r Low Slope E Mechanically Fastened Tile I 1 /Adhesive Set Tile r Asphaltic Shingles r Metal PaneUShingles r Wood Shingles/Shakes Presafpive BUR -RAS 150 Other_ New Roof Lot slope roof area (R=) Are there Gas Vent Sladrs located on the roof! Roof Type Recoverkig Roof System Information Repair Maintenance If yes. what type? Natural LPGf Steep Sloped area #L1 24 Total (0.2) 2,10 Section B (Roof Plan) Sketch Roof Plank Iustrate al levels and sections. roof drains. scuppers. overflow scuppers and overflow drains_ Include dinnensions 1111 of sections and IeveLs, dearly identify dimensions of elevated pressure zones and location of parapets. Peiim may , Width W W. (a) Come e (a" x ar). Page 2 http: / /www.miamidade.gov/ bldg / roofing_ permiting /permit_app_section_a.HTML 10/27/2004 Roof System Nanufachmer: F - Notice of Acceptance Number: ., 0 )- - 06 3 .- b farina= Design Vlind Pressures. If Appficable (from RAS 127 or CalculatiOn* P Lii.6 Pk 10.1.6 P3::. Mat !Maximum Design Ward Pressares, (From the PCA Specific system) 140, ut - High Velocity Hurricane Zone Uniform Roofing Penult Application Form MIAMI-DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPIJCATION Roof Slope: 717 7 Roof Mean Height IOC Ridge Venliafion: PJ/ Method of Tie Attachment Alternate Tie Aliademettlielhort Clip Spacing for Metal Roof Panels Fiekt Perimeters: , Perimeter WM: Section D (Steep Sloped Roof System) Comers: Sloped System Description ( ,t Deck Type: 5 / 8 " Plywood 'w Monate Deckyype: 3110e p Ctptional Mailable Substrate: Page 4 Fastenem http://www.miamidade.gov/bldg/roofing_permiting/section_d_3.html 15V-2_ Undedayment type: -If*. InsublionfFee Barrier Board: Nig_ Page 1 of 1 ' Cap Sheet Type/Adhesive Type: 5el g 'kill) harnb rek u tolke LAy melvt 110.6 Roof Covering Aliadenerd !Method: inejk set Dip Ed sim & Gauge:a- D6- Ed m T ypo: Copiv IprIP ErIg7rastener Type: f iti• COPA?k POOF YU iLS H sm ga . or m o t - 1 N/A 10/27/2004 • Where to Obtain Information Description Symbol Where to find Design Pressure PI or P2 or P3 RAS 127 Table 1 or by an ending analysis prepared by PE based on ASCE 7 Mean Roof Height H Job Site Roof Slope 8 Job Site Aerodynamic Multiplier X NOA Restoring Moment due to Gravity M NOA Attachment Resistance Mt NOA Required Moment Resistance M, Calculated Minhnum Attachment Resistance F. NOA Required Uplift Resistance F Calculated Average Tile Wt W NOA Tile Dimensions k= length w= width NOA All calculations must be submitted to the Building Official at the time of permit application. M Required Moment Resistance` Mean Roof Height - Roof Slope l 15' 20' 25' 30' 40' 2:12 34.4 36.5 38.2 39.7 42.2 3:12 32.2 34.4 36.0 37.4 39.8 4:12 303 32.2 33.8 35.1 37.3 5:12 28.4 30.1 31.8 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 Florida Building Code Edition 2002 High Velocity Hurricane Zone Uniform Permit Application Form. Section E (Tile Calculations) For Moment based tile systems, choose either Method 1 or 2. Compared the values for M with the values from M r If the M values are greater than or equal to the Mr values, for each area of the roof, then the tile attachment method is acceptable. Method 1 "Moment Based Tile Calculations Per RAS 127" J' (P1: -7 . L'304, •u- = II.y Mg: 3'41 =1%1'S3. NOA Mt 0. (P2: z X ' Mg. 5,1 NOA Mf (P3: Wi V z X _ ) J - Mg: S 1 = M ,. . 1 NOA 1Vk Method 2 "Simplified Tile Calculation Per Table Below" Required Moment of Resistance (M From Table Below NOA M *Must be used in confunctlon with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared the values for F' with the values for F If the F' values are greater than or equal to the F values, for each area of the roof, then the tile attachment method is acceptable. Method 3 "Uplift Based Tile Calculations Per RAS 127" (Pr : z 1: = w: = ) - W: z cos 0: = F NOA F' (P : z 1: z w: = ) - W: z cos 0: = F NOA F' (P3 : z 1: = z w: = ) - W: z cos d: = F NOA F' SECTION 1524 HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 15241 As *pedals to this action. Ala the nspanskility amp moan ®o oar to provide the Queer cedh_ the wank as1 to =AOC to the owner the caeca ofthis swim_ The pease aft - iS cdtbe. Fiero& Bathllag Cade, lbeifing gamma the minima rerpaements nand stambods of tit iodustry for roofing system iosetllaeous. Addiaamfly, the following items Amulet le be addt®od as past of tbd agmement between the over and the antractor. The o neras i>l in the arriamot boat hellcat= that the its bos been The - -- cif Chapter Velocity Hanka= fat the pose aft *it tie roogsg mama mess the wsad zesisleeee aud water a aarallsinb_ As"' ( ) isms ate not a impost >b vatic diseases issues Eseh his actor m int arc ad OS 61 cote, should Rama Glitz the owner and the 2. Remaildog Ws Dad= WI maphaing mass the =ling woad mat idc may base to be aoomola oewiktieaarcet pnurisions Of Chapter It Wooly HoorianeTomus}otftieFind& (The made& is usually concealed paiorto acnoviag the existhe aaofs]rstean)- Coommem Hoeft Common roofs sae moose vat leave w visible dermesfact. between migblaming as k win common roofs, the moron smatracter weft nod& occapauts ofasTaoentsc airman so& to be pertraced. 4. Exposed Craw Exposed, apeabesta caTutp ant whew the undosido them mop dating aaabe from below. The war raw wish to maintaix the swat app ethic sandemide of the decking may not be accept/Me Tbc Fbxibt Barring Cock plosides the optima ofnuidmiming this awe. 5. PosuRmg Wag= The amt roof spsiesa smear neck of the bolas may not Omit well sod may cause water to paid (accumulate) in toga -tying areas of the roof g aisle ea inismilace I cancunal and maay smoke the review of a pta�oaaal strectraal engineer. Pecan may shoran the lie and perfotmaaatrce of the new iaofng system. FoosineconditiMs may not be eldest read the system ismmosed.Pbobga ndicao sslculdbe Iii Overl ow sawn (walla It is segsamed that =imam off so that the loafs not firm a baald tap avatar. P>n�bdge wa mother mot cadmic= may '� fao+deange (wall Quays) me not piwvid L tit seal► be ae°e 'y ib uu saw= fl saw= is • ,:. the - II 'h� bsve some to vat ear sm iiraeph the the e ► gam, amount attic ate! not be CI ^ ,tee... c angry be -,. -: ` to consider a�i/nao� an � kilns Sittsf thn 6. /0 r /l, el( - -- .--- .-- ...— ......maft.am.4ftworsawhtMA LAMA* Commetoes Sigma= MtAMDL KEE BUILDING COt)E COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DI 'ts1ON NOTICE OR ACCEPTANCE (NOA) Zion Tile Corporation 13450 SW 126"' Street Miami, Florida 33186 ait t1ANtU - DADE COUNTY. =LORIDA E O-DADE FLAGLER WILDING 140 WEST FLACLE:R S't' ae r, st'ErE 1603 MIAMi, FLORIDA 3.130 -1563 (j.)5) 375 -2901 FAX (305) 375.2903 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. Thc documentation submitted has been reviewed by Miami -Dade County Product Control Division and accepted by the Board of Rules and Appeals (BORA) to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AIIJ). 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 !ails to perform in the accepted manner; thc manufacturer will incur thc expense of such testing and thc AHJ niay immediately revoke, modify, or suspend the use of such product or material within their jurisdiction, l_301tA reserves thy: right to revoke this acceptance, if it is determined by Miarni -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 I•Iigh Velocity iIun icnne Zone of the Florida Building Code. DESCRIPTION: Alhambra Handmade Clay Tile LABELING: Each unit shall bear a permanent label with the manufacturer's n- r:. or logo, city, state and following statement: "Miami - Dade County Product Control Approved ", unless otherwise noted herein. RENEWAL of this NOA shall bc considered after a renewal application has been filed and there has been no change in the applicable building codc negative!y:tfleeting the performance of this product. TERMINATION 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: Thc NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may bc displayed in advertising literature. if any portion of the NOA is displayed, then it shall be done in its entirety, INS A copy of this entire NOA shall bc provided to the user by thc manufacturer or its distributors and shall be available for inspection at the job site at the request of the I3ui kting Official. This consists of pages i through 3. The submitted documentation was reviewed by Fronk Zuloaga, RRC NM No.: O2- 4083.0 - Explained Date: r7de5Jol Apoc>aval Date: 01/111511E' Page 1 of FROM :210M TILE ROOFING ASSEMBLY APPROVAL Category: Roofing Sub - Category: Material: 1. 2. PRODUCT DESCRIPTION Manufactured by Applicant "Alhambra Tile" Trim Pieces FAX MO. 305 252 9116 Oct. 27 2004 012: 47PM P2 Roofing Tiles Clay SCOPE This roofing system using "Two Piece Barrel Alhambra ", as manufactured by Zion Tile Corporation described in Section 2 of this Notice of Acceptance. For locations where the pressure requirements, as determined by applicable Building Code does not exceed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall be done as an upiift based system. Dimensions 1= 18" w 8 'A" to 7%" taper %," thick I = varies w = varies varying thickness Test Specifications ASTM C 1167 ASTM C 1167 2.1 Components or products manufactured by others Test Product 1'roduct Dimensions Specifications Description Roof Tile Adhesive N/A Sec NOA Two component polyurethane ( "Polypro® adhesive designed for A11160 ") adhesive set roof tile applications. Product Description High profile, t' .'o- piece, clay roof tile. For direct deck adhesive set applications only. Accessory trim, concrete roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile. Manufacturer Polyfonm Products, Inc. with current NOA 3. LIMITATIONS 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test shall bc performed in accordance with RAS 106. 3.3 Applicant shall retain the services of a Miami -Dade Coun:,■ Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix 'A'. Such testing shall bc submitted to the Building Code Compliance Office for review. 3.4 Minimum underlayments shall be in compliance with the appl icable Roofing Applications Standards listed section 4.1 her n. 3.5 30190 loot mopped ortderlayntcnt applications rainy bt iiosaaltd per cn¢liicanlar to elk roof slope unless stated otherwise by the aaatdcrlayaicnt anatcrial aaianasfactuavcrs published literature, 3.6 This acceptance is for wood dcck applications. Minimum deck requirements shall bc in compliance with applicable Building Code. " FROM : D OH TILE 4.2 Data For Attachment Calculations Fax; HO. : 305 9116 Oct.. 2? 2004 03 : 13PM P 3 4. INSTALLATION 4.1.1 "Alhambra Tile" and its components shall be installed in strict compliance with Roofing Application Standard RAS 120. Tablas 1: Ar : Wei The Prole W -. ht-W Two Piece Barrel 6.90 Alhambra The Two Piece ::.. mil Alhambra T e ht :w and Dintemsilatris PROFILE DRAWING "AUTAMuRA TILE" h t feet) 1. Tale Profile Table 2: It`#IlnEnumn Characteristic Lead - P" Obit 1 T11e ration Attachment Resistance 217.20 Mortar set 5. LABELING All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo, or following statement: "Miami - Dade County Product Control Approved ". 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by the Building Official or ippiicable Building Code in order to properly evaluate the installation of this system. END OF TIM ACCEPTANCE th kith - w (feel) 0.67 e NOA No.: 02- 0603.04 FROP1, : Z10Dd TILE A. TESTS: Test Agency The Center for Applied Engineering, Inc. 13. OTHER Notice of Acceptance number 02- 0603.04 FH <; NO. 305 2 5 2 9116 Oct.. 27 201 03: 13FF I P4 Test Identifier 940150 -2 Tcstwcll Craig Laboratories Lab #: AV -19 & Consultants Tcstwcll Craig Laboratories Lab#: AV -20 & Consultants Test Name /Report Date Static Uplift Testing 08/94 PA 101 (Adhesive Set) Physiccal Properties 09/95 ASTM C 1 167 Static Uplift Testing 02/96 PA 10'. (Mortar So:) t MIAM BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) Polyglass USA Inc. 150 Lyon Drive Fernley, NV 89408 MIAMI-DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 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 rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by Miami-Dade County Product Control Division and accepted by the Board of Rules and Appeals (BORA) to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). 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 Budding Code. DESCRIP'T'ION: Polystick P, IR/IRX, TO and MU Underlayments LABELING: 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 affect* the performance of this product. T E R M I N A T I O N o f t h i s N O A w i l l occur a ft e r t h e e x p i r a t i o n d a t e or if d c 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 consists of pages 1 through 4. The submitted documentation was reviewed by Frank Zuloaga, RRC NOAH. . try lEagailseliom Dal= OR/135a6 Approve flat= 11107182 Page 1 .114 ROOFING COMPONENT APPROVAL Caatenrv: Sub -Csorv: EVIDENCE SUBMITTED: Test Agency Exterior Research & Design, LLC Exterior Research & Design, LLC PRI Asphalt Technologies PRI Asphalt Technologies PRODUCTS DESCRIPTION: Product Dhuensions Polystick P underlayment Polystick IR/IRX underlayment Polystick TU underlayment Polystick MU underlayment Roll: 75' x 3' 40 mils thick Roll: 65'8" x 3'3- 80 mils thick Roll: 32'10" x 3'3- 100 mils thick Roll: 65'8" x 3'3- 80 mils thick Roofing Underlayment SBS , APP Self - Adhering Modified Bitumen Test Identifier #11756.04.01 -1 #11756.08.01 -1 PRI01111 PRIO2011 Test Seca cation ASTM D 1970 TAS 103 and ASTM D 1970 TAS 103 and ASTM D 1970 TAS 103 and ASTM D 1970 Test Name/Renort TAS 103 ASTM D 1970 ASTM D 4977 ASTM D 4977 Product Description te 04/27/01 08/14/01 04/08/02 01/31 /02 A polyethylene top surface, self- adhering, SBS polymer modified bituminous sheet material for use as an underlayment in sloped roof assemblies. Designed as an ice & rain shield. A fine granular /sand top surface self - adhering, APP polymer modified, fiberglass reinforced, bituminous sheet material for use as an underlayment in sloped roof assemblies. Designed as an ice & rain shield and as a flat roof tile underlayment. A heavy granuled surface self adhering, APP polymer modified, fiberglass reinforced, bituminous sheet material for use as an underlayment in sloped roof assemblies. Designed as a a roof tile underlayment. A non-wicking fabric surfaced, self - adhering, APP polymer modified, fiberglass reinforced, bituminous sheet material for use an an underlayment in sloped roof assemblies. Designed as a metal roofing and roof tile underlayment. NOA l4a 112403J18 Esrpirthas Dal= 091113% Aglanval< Dais: 111@x1102 Page 2 ef'4 INSTALLAION: Deck Type 1: Wood, non - insulated, new construction Base Sheet: One or more plies of ASTM D 226 Type II or ASTM D 2626. Fastening: Nails and tin caps 12" grid, 6" o.c. at laps. (for base sheet only) Membrane: Polystick membranes self- adhered. Surfacing: None 1. All nails in the deck shall be carefully checked for protruding heads. Re- fasten any loose decking panels, and sweep the deck thoroughly to remove any dust and debris prior to application. 2. Place the underlayment over metal drip edge in accordance with RAS 111. 3. Place the first course of membrane parallel to the cave, rolling the membrane to obtain maximum contact. Remove the release film as the membrane is applied. . All side laps shall be a minima of 3!1/2" and end laps shall be a minimum of 6." Roll the membrane into place after removing the release strip. Vertical strapping of the roof with Polystick is acceptable. Membrane shall be back nialed in accordance with applicable building code. 4. When applying the membrane in the valley, start at the low point and work to the high point, rolling the membrane from the center outward in both directions. 5. For ridge applications, center the membrane and roll from the center outward in both directions. 6. Roll or broom the entire membrane surface so as to have 100% contact with the surface, giving special attention to lap areas. 7. Flash vent pipes, stacks, chimneys and penetrations in compliance with Roof Assembly current Product Control Notice of Acceptance. 8. All protrusions or drains shall be initially taped with a 6" piece of underlayment. The flashing tape shall be pressed in place and formed around the protrusion to ensure a tight fit. A second layer of Polystick shall be applied over the underlayment. LIMITATTIONS: 1. Fire classification is not part of this acceptance. 2. Polystick P and IR/IRX may be used in asphaltic shingles, wood shakes and shingles, non - structural metal roofing, and quay slate roof assemblies. Polystick P shall not be used as roof tile underlayment. 3. Deck requirements shall be in compliance with applicable building code. 4. Polystick membranes shall be applied to a smooth, clean and dry surface. The deck shall be free of irregularities. 5. Polystick membranes shall not be applied over an existing roof membrane. 6. Polystick P shall not be left exposed as a temporary roof for longer than 30 days after application. Polystick IR/IRX, MU or TU shall not be left exposed as a temporary roof for longer than 90 days after application. 4OA p41a 0 Evirartien art= ®9413106 Affipmesit Dab= 11107112 P2ge3 4 9 _ lEn M i l e appitadieg, dada for the attachment resistance of aoaf t les shall be as set forth ih the roof the s Notice. Polystick TU and MU inw be used imbeds adhesive set and eareharicany fastened roof t the application. Polystisk BM= is limited to mechanically fastened roof tile applications The musimunt roof slope firm as roof tile uoderlayinne t (the )ti e assemblies shalt be as described below Te Prattle Flank 5:12 Profiled life Prehibiled MU No froitation 5-32 Pnligpsfadr TU No isnintion froitation 8. Care should be taken during the loading procedure to keep foot traffic to a minimum and to avoid dropping coftge 4firectly ontheusdioda 9. Rasta p latodtrait Control Mice oilinewhinee fir hided approval °fills productwith specific prepared roan products. P, ,1, &MU now healed wdtany approved roof ao awning Notice of Acceptmce Elting Polystiek P, BMX, TU, & MU us acompound part clan ablyin the Notice of Acceptance P, MARX 1'U&M3a sad fisted, n request be mallets the Aufinnityllaving ImisrEetion (AM) ortieltifiaradaide Catruty Product Costrol Department for applaud provided that dominating is Tu to Mad compaidnifityofthe products, and lie { sag LABELING: 1. All membranes shall bear the imprint or identifiable marking of the manufacturer's name or logo, the Miami -Dade County logo or the following statement "Miami -Dade County Product Control Approved". BUILDING PERMIT S: 1. Application for building permit shall be accompanied by copies of the following: 1.1 This Notice of Acceptance_ 1.2 Any other documents required by the Building Official or applicable building code in order to properly evaluate the installation of this materials. END OF THIS ACCEPTANCE ite 82,05118.88 Eaphatfien Dubs t1h9131B116 Apposed Dow 111.70 62 Page 14 Owner's Address WORK DESCRIPTION L r14- S(/V•I44% r'- Square Ft. Signature t e : /( Notary as to Owner and /or My Commission Expires: NOTARY PUBLIC STATE OF FLORIDA { COIAMISSIO4 EXPIRE45 /09/94. Bonded thru Stembler -Adams & Sweet FEES: PERMIT 3WS d APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address 2A W.E• 92"'9 S r; Tax Folio 11 W10(0 13 (03aO d Date '7 v y � Legal Description � 74/8 `y / / / // 9 <IJ/ Owner / Lessee / Tenant Master Permit # Contracting Co. C. 14' 1 .21 : 104 -4 C" c-• 34 tJ . E - 1 . . 32.42 S1 • � "A WNW AM' . + 3 J L S Phone 75 /95 ondo President SS# Phone 90 •7SS• II c7 Z Qualifier '3Al2i21 2 ((�l �� I4 t't. State # c.0SegB8 Mu ipal # Competency # Ins.Co. C.{Sf C 1 1.LQ•/.mm t. Architect /Engineer t■r+ a Address Bonding Company Nb Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL (OOFIN� PAVING FENCE SIGN Rt=Ma1e C1F ( s1 -€,. w e..J 'RD Yl-o O Cam- t2.�i�LA " Condo President �/ p � dh req A Zoning Mechanical Fire Building Plumbing Address Pct. am', 2105 Crry, fL 32056 Estimated Cost(value) 4 17 loo tt 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 to above -named contra to do the work stated. Si D= 'e 11 e C ntractor or Owner- Builder 2 4# tary as to Contractor or Owner- Builder Print type or stamp name of N ry Pu 6c1 ss ion Expires: Personally known [R Produced 1.D.0 NOTARY PUBLIC STATE OF FLORIDA Ty )e and number of I.D. produced: * * * * * * MY#COMMIS:#QN EXPI *ES 5/0994 * ** DD ID rake an oath, or horded t u Ste ib ler -Adams & Sweet 44 4.6 RADON C: t #e a °adi NOTARY ?' TOTAL DUE 4 419, Other Electrical Engineering PERM I Te ttate of Florida County of Dade TAX FOLIO NO. 11 32JCA I3 6380 O NOTICE OF COMMENCEMENT 9 2I 4-5 2333 1992 NOV 24 16:21 THE UNDERSIGNED hereby gives notice that Improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of property:(Iegal description of the property, and street address I f available) Le-1- (75W 13(ock S'�c• 1, Ono . P N 70 2. General description of Improvement: b. Interest in property: !Yl (Arn( ORES 3. Owner information • n' ±� t � " ; a. Name and Address k)•E. �- =-f % 1 . ..;�.r c. Name and address of fee simple titleholder (if other thalt owner): 5 e_-- co I n ° M 4. Contractor: (name and address)64 r it• -k.. rat-. P.0.733•)44cS ∎, a - L r- � �, s 5. Surety: a. Name and Address o E I �j A,. a N U W U O LY Q = ~ -4 • O p 3 r L f O w b. Amount of bond $ , 0 / 0 o0 6. Lender: (Name and address) 1/ /A. Q r, - r: ( ,, 7. Persons with the State of Florida designated by Owner upon whom notice or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes:(Name and address) j ,spn 3L ( u_� 92^'° Sr, N.t,,i."-x1 ZO - Cat - s FL_ 8. In addition to himself, Owner designates of to receive a copy of the Llenor's Notice as provided In Section 7.13.13(1)(b), Florida Statutes. 9. Expiration date of notice of commencement (the expiration date Is 1 year from the date of recording unless a d 1 f rent d2t —e /I sispec i f i ed ) S i g n turd of 0 to and ubs I bed before me this 2'4 day of FLORIDA MY COMMISSION EXPIRES 5/09/94 may Comm 1 s s 1 on EAnOdetrigu Stembier- -Adams & Sweet 0 1. NAME OF PROPERTY: MIAMI SHORES HISTORIC. PRESERVATION BOARD APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS 2. ADDRESS �4-.( k) (- 61D. � • LEGAL DESC. Lots (7 l g a((C. ( /V l (�Yt( _tor 4 3. NAME OF OWNER & ADDRESS: (;;E(44 At_6 4. NAME OF APPLICANT & RELATIONSHIP TO OWNER: 5.-a-011- S. PRESENT USE AND CONDITION: 5(rc(€ - l � L fYlL kc me e- KCrJ_Ckr ` 6. TYPE OF PROJECT: (circle one or add unlisted project - MAINTENANCE OR REPAIR B. RESTORATION C. REHABILITATION D. ALTERATION E. ADDITION F. EXCAVATION G. DEMOLITION H. NEW CONSTRUCTION I. RELOCATION J. OTHER (EXPLAIN) 7. IS A ZONING VARIANCE REQUIRED FOR THIS PROJECT? V p 8. DESCRIPTION OF PROPOSED PROJECT, INCLUDING' WHAT CHANGES WILL BE MADE AND HOW T'I -IEY WILL BE ACCOMPLISHED. Kt. c (� �� C � � CF pj � q9 4 (� ( ham b "bar re( Niein colt« CS clq E'-.?C I s f coo (J. OTHER) 9. IF USE OF THE PROPERTY WILL CHANGE AS A RESULT OF THE PROPOSED WORK, EXPLAIN THE IMPACT OF THE CHANGE. The Board shall be supplied with copies of the Original Designation Report filed when the property was designated as a historic Landmark and copies of any Certificates of Appropriateness granted previously for this site. • • .r/ AP P RO9a) DATE: ( 0 /L( /? _- CHAIRMAN. • 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. Owner's Name and Address _... Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done__ __t// State work to be done and purpose of building (by floors and for no other purpose. New Building Remodeling Addition Repairs " No. of Stu( / To be constructed of Roof Cpvering� .._ Kind of foundation q � lJ Estimated Total cost of improvements $ .J 4 _._ Amount of Permit $ Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Perinanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly 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. 1 7 Permit No 7 - ,.2- _ f Date Disapproved Date Notary Public, State of Florida (Signed) ... / f= / y Building Inspector My Commission Expires Date_4_/l ....... J - -_ -,l 9 G'� -� , 19y� No. _ / ___. ;3.9/ Street __ /L! �o -/l— Read, Sworn to and Subscribed before me. to me well known, PLANNING BOARD DATE Chairman Member Member Member Member ... . Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. ,0 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. Date 2 2 1l Owner's Name and Address �� . c1 lZ !� No � i Street 2 - g Registered Architect and /or Engineer Name and address of licensed contractor.. — ti - — t Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) P A i2.i9 MIAMI SHORES VILLAGE 7 f( / �! Notary Public, State of Florida e and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering ec eL Estimated Total cost of improvements $ 1 Amount of Permit $ _ Zone cubage required .Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. J ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. c / �+ Permit No / Date ° 2 f id Read, Sworn to and Subscribed before me. - Disapproved ate / (Signed) L )- , ' . Buildin Inspector 7 My ..mmission Expires PLANNING BOARD DATE Chairman Member Member Member Member ......... Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has heen 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. D9 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 a`. building during progress of the work. Owner's Name and Address..... Registered Architect and /or Engineer New ?iuildi.ng To be ,:onstructed of Disapproved (Signed) MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT • Name and address of licensed contractor... Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done BUILDING INSPECTION DEPARTMENT Date to Z I bat Building ector Chairman Member Member Council Approved Date NOTE: A charge of $1.00 will be made for making the Planning Board. A re- inspection fee of 51.00 will be charged materials and /or workmanship. pr 2== a Street_ State work to be done and purpose of building (by floors) �n 3 9 * ..rt;e, Remodeling Addition Repairs Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required -Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) No. of Stories if)_ -1 Read, Sworn to and Subscribed before me. -0 and for no other purpose. 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 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. Permit No T ‘10 Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Member Member Member Disapproved Date corrections or changes to this application after approval has been obtained from when such re- inspection is made necessary by improper notice for inspection or faulty ;UILDING :LECTRICAL 'LUMBING 'OOFING )wner of uilding rchitect ontracto Builde = ga escripti ddress )ilding MIAMI SHORES VILLAGE. FLORIDA ❑ PERMIT N? 9420 __ ❑ Work to be performed under this Permit fa DATE Contractor's License No 195:4_ 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 =refor in strict compliance with all ordinances pertaining thereto and With the understanding that the work will be performed in compliance with any plans, awings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any ne 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 a nted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations }raining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that`e assumes responsibility for work me by his agents, servants or employees. d -7 I f ". - if „' • i ' ' •, d Signed: ...0- ---,',- > , BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work coveredaliereunder in compliance with all ordinances and regulations rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. accrnc■n• -•his permit -I assume responsibility for all work done by either, myself, my agent, servant or employee. ,i j i u CONTRACTOR OR BUILIR c 1 BY AUTHORITY Lot n t I Bl. Subdi- vision sq. F Amt of Permit C yl . G- $ f t � , f ', ! e . r Value of Project $ r r� .. ;UILDING :LECTRICAL 'LUMBING 'OOFING )wner of uilding rchitect ontracto Builde = ga escripti ddress )ilding MIAMI SHORES VILLAGE. FLORIDA ❑ PERMIT N? 9420 __ ❑ Work to be performed under this Permit fa DATE Contractor's License No 195:4_ 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 =refor in strict compliance with all ordinances pertaining thereto and With the understanding that the work will be performed in compliance with any plans, awings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any ne 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 a nted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations }raining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that`e assumes responsibility for work me by his agents, servants or employees. d -7 I f ". - if „' • i ' ' •, d Signed: ...0- ---,',- > , BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work coveredaliereunder in compliance with all ordinances and regulations rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. accrnc■n• -•his permit -I assume responsibility for all work done by either, myself, my agent, servant or employee. ,i j i u CONTRACTOR OR BUILIR c 1 BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE. FLORIDA ❑ ❑ DATE ce' 195 ❑ PERMIT N? _ 439 9 Contractor's License No 3 Work to be performed under this Permit B1 e; e ' r tl Project $ /`' ' This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application 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 nowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the #tatements or spe$ification and that he assumes responsibility for work done by his agents, servants or employees. ✓ ' • Signed. o _ , , • 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. �` a CONTRACTOR OR BUILDER BY Subdi- vision Value of 1 Amount of Permit $ AUTHORITY s