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478 NE 92 St (12)FEB 21 '01 14:12 FR BRADCO ' - M'IAMI�OA PRODUCT CONTROL NOTICE OF ACCEPTANCE Santa Fe Tilt Corporation 10302 N.W. South River Drive, Bay #16 Medley ,FL 33178 Your application for Notice of Acceptance (NOA) of Spanish "S" Clay Tile under Chapter 8 of the Code of Miami -Dade County governin Construction, and completely described herein, has been recu County Building Code Compliance Office (BCCO) under the This NOA shall not be valid after the expiration date stated b product or material at any time from a jobsite or rnanufactu product or material fails to perform in the approved manner, use of such product or material immediately. BCCO rese determined by BCCO that this product or material fails to Building Code. The expense of such testing will be incurred by the manufactu ACCEPTANCE NO.: 90- 1212.06 EXPIRES: 02M UR006 T IS S 'VE ! 111 s. . APPROVED= 02101/2Q13 CONDITIONS BU1LDINC CODE & PRODUCT BE 11 s 04 S 000 I 1 pe2a00Utemparellnocicr acceptance mw pagsdot Internet mail address: postmasterebulldingcodeonllne ,eom FEE 13 '01 17145 305 597 9484 TO 3059533333 BUILDING CODE COMPL1.lNCE OFFICE MCTRO -DADC FLAGLER OUILDING 140 wen' rLAGt.GR STRUT. SUITE 1603 MIAMI, PLORIt)A 3)130 -156) (30s) 375.2401 FAX 003) 375•2008 the use of Alternate Materials and Types of ti ended for acceptance by the Miami -Dade I nditions specified herein. ow. BCCO reserves the right to secure this [BCCO plant for quality control testing. If this IBCCO may revoke, modify, or suspend the s the right to revoke this approval, if it is eet the requirements of the South Florida IF JEW COMIC' 1TTE1s P.01/05 MIAMI -BADE COUNTY. FLORIDA METRO•DADE FLAGLER BUILDING CONTRACTOR LICI:At.41NC SECTION (305) 375.2327 VAX (303) ]75 -2550 CONTRACTOR ENFORCt 1►IXIN T vivis1ON (305) 373 -1966 PAX (303) 373 -2906 PRODUCT CONTROL. DIVISION (305) 375 -2902 FAX (305) 3724539 / Raul Rodriguez Chief Product Control Division AL This application for Product Approval has been reviewed by the BCCO and approved by the Building Code and Product Review Committee to be used in Miami -Dade County, Florida under the conditions set forth above. Francisco J. Quintann, R.A. Director Miami -Dade County Building Code Compliance Orrice kgy Httnepage: bit (s:lf »..W.DwIdingcodeonlinc.com 3856880050 PAGE. 01 FEB 21 '01 14:13 FR BRADCO ROOFING ASSEMBLY APPROVAL killtfaCirv; Roofing Sub - Category: 07320 Roofing Tiles Materials Clay Roof Tiles Deck Tune, Wood 1. SCOPE This renews a roofing system using Santa Fe "Santafe Santafe Tile Corporation described in Section 2 °f rills comply with the South Florida Building Code, 1994 E IoCations where the design pressure requirements, as d does not exceed the design pressure values obtain by c using the values listed in herein. The attachment calcu system. 2. PRODUCT DESCRIPTION Manufactured by 6,01itant Santaff 'S' Clay Roof Tile Trim Pieces Product Tile Screws FEB 13 '01 1745 SANTAFE TrL•E COiitPORATION Test Dimensions §pecifications 1= 18" w 11.3" A" thick 1= varies w • varies varying thickness Dimon/jou; #8 x 2 -' /s" long 0.130" shank dia. 0.178 flute dia. Test Specifications PA 114 Appendix E 305 59? 5484 TO 3059533333 P.02/05 ACCEPTANCE No_ : 00- 1212.06 Approval Date: February 1 Expiration Date: t r 200 S" clay rooting tile, manufactured by otice of Acceptance, designed to Lion for Miami -Dade County. For rmined by applicable building code. Iculations in compliance with RAS 127 tions shall be done as a moment based Product Doscrintion PA 112 0,e piece high profile clay roadie e. Gipped with two nail holes. For nail -on, mbrtar set and adhesive set applications. PA 112 A cessory trim, clay roof pieces for use at hi s. rakes, ridges and valley terminations. nufacturcd for each tile profile, 2.1 COMPONENTS OR PRODUCTS MANUFACTURED BY OTHERS Product i pescrintien Mnnufaet_urcr tainless Steel generic • 3. LIMITATIONS 3.1 Fire classification is not part of this acceptances 3.2 For mortar or adhesive sct tilt applications. a a. :otic field uplift test shall be performed in accordance with RAS 106. 3.3 Applicant shall retain the services of a Mia ni -Dade County Certified Laboratory to perform quarterly test in accordance with 1'A 112 a• hail be submitted to the Building Code Compliance 0' icy' ~'" oaga, RRC Roofing product Control Examiner 3068880050 PAGE.02 Table 4: Attachment Resistance Expres for Mortar or Adhesive ; d as a Moment - Mr (ft t Systems Tile Profile 'Tile Application _ Attachment Resistance Santafe 'S' Mortar Set ' 23.6 Adhesive Set 61.9 FEB 21 '01 14:13 FR BRADCO . SANf'AFE TILE CORPORATION 3.3 30/90 hot mopped underlayrneat applications slope unless stated otherwise by the under! literature. 3,6 This acceptance is for wood deck applicati compliance with applicable building code. 4. INSTALLATION 4.1.1 Santafe 'S' and its components shall be installe County Roofing Application Standard RAS 11 4.1,2 Data For Attachment Calculations Santafe 'S' t— Tile Profile Santafe 'S Tile Profile Santafe S FEB 13 '01 17:46 Tile Profile Table 2: Restorin Moments due t Gravit 2 ":12" Battens 3.93 Direct Deck 5.90 Table 3: Attachment Resistance Express For Nall -On S Tile Application Direct Deck Battens Table 1: Aerodynamic Multi 3 ":12" bens 5.85 21.8 Direct Deck 5.82 Two Nails 305 597 9494 TO 3059533333 ACCEPTANCE No. : 00- 1 212.06 k (ft') Batten Applic 0.274 4 ":12" ins 5,73 One Screw 29.18 3 J Direct 8 Deck 5,69 ay be installed perpendicular to the roof ymcn: material manufacturers published Approved screws as noted 'Product manufactured by others' , Minimum deck requirements shall be in in strict compliance with Miami Dade , RAS 119, and RAS 120. yers— MIT tion wo Screws M. ft-lb (ft') Direct Deck 0.297 d as a Moment- Mf (ft.Ibf) One Screw w/ Cli P.03/05 7 ":12" or reater Battens 5.03 reel Deck NIA Two Screws w/ Clio 38.28 57,31' 57,60 51.77 rank Zulo sa, RRC Roofing Product Control Examiner 30SBS�80e58 PAGE.03 FEB 21 '01 14 :13 FR BRADCO 305 537 9484 TO 3059533333 F:04x'05 I � .— SANTAPE Tat CORPORATION I ACCEPTANCE No.: 00- 1212,06 /•,"" 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accom4snied by copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by the Building Official or applicable Building Code in order to properly evaluate the installation oh his is system, PROFILE )DRAWIN1G SAN?AFE "SANTAFE S" CLAYOOF TILE FEB 13 '01 /7:46 LABELING 5.1 All tiles shall bear the imprint or identifiable narking of the manufacturer's name or logo, or following statement: "Miami -Dade County'pi•oduct Control Approved ". 4 rank Zuloaga. RAC 'goof ng Product Control E`a niner 3058880050 PAGE. 04 $A 1A t TILk c,�T�P08AnoN A CE :,s ANCJ ND 1 Renewal of this Acceptance (approval) shall be considered aft original submitted documentation, including it supporting da eight (S) years, 2 Any and all approved products shall be permanently labeled wi the following statement: "Miami -Dade County Product Contro specific conditions of this Acceptance. 3 Renewals of Acceptance will not be considered if: a) There has been a change iA the South Florida Building C and the product is not in compliance with the code change b) The product is no longer thc same product (identical) as c) If the Acceptance holder has not complied with all the req Correct installation of the product; d) The engineer who originally prepared, signed and sealed submitted, is no longer practicing the engineering professi 4 Any revision or change in the materials, use, and/or manufactu automatically be cause for termination of this Acceptance, unles (through the filing of a revision application with appropriate fee 5 Any of the following shall also be grounds for =oval of this A a) Unsatisfactory performance of this product or process; b) Misuse of this Acceptance as an endorsement of any p purposes. 9 This Acceptance contains pages 1 through 5 END OF THIS ACCEPTA, FEB 13 '01 17:46 5 ACCE)•TANCt: \o.: 00- 11.U0 QNDITIONS renewal application has been filed and the engineering documents. arc no older than the manufacturers name, city. state, and pproved ", or as specifically stated in the affecting the evaluation of this product one originally approved; rements of this acceptance, including the of the product or process shall prior written approval has beep requested and granted by this office. required documentation initially prance: ct, for sales, advertising or any other 6 The Notice of Acceptance number preceded by the words Miami I•ride County, Florida, and followed by thc expiration date may be displayed in advertising literature. if any rtlon of the Notice of Acceptance is displayed, then it shall be done in its entirety. 7 A copy of this Acceptance as well as approved drawings and oth documents, whore it applies, shall be provided to the user by the manufacturer or its distributors and ! l be available for inspection at the job site at all times. The copies need not be resealed by the engineer 8 Failure to comply with any section of this Acceptance shall be ca I SC for termination and removal of Acceptance, rank Zuloaga, RRC offing Product Control Examinar 3058880050 FAUE.05 * TOTAL PAOE.05 ** Owner of Building_ Architect Contracto or Builder Legal Descriptic Address Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA BUILDING GA ELECTRICAL ❑ DATF. - '. PLUMBING ❑ PERMIT No 83 pc c4 r ' : on t ; , dice ROOFING Ill i ii ctoi s e- , 0 . 4 + ' -r Work to be performed under this 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 statemts 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. BY AUTHORITY r t i Lot n Bl Subdi- vision ,f Sq. Ft 4 .,,.i ,S Amt. of Permit $ i — Value of Project $ ': . Owner of Building_ Architect Contracto or Builder Legal Descriptic Address Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA BUILDING GA ELECTRICAL ❑ DATF. - '. PLUMBING ❑ PERMIT No 83 pc c4 r ' : on t ; , dice ROOFING Ill i ii ctoi s e- , 0 . 4 + ' -r Work to be performed under this 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 statemts 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. BY AUTHORITY 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 a 3 } 9‘f Registered Architect and /or Engineer........ _� � -- — _ � .__:�^_ ___ ✓� -4ri' Name and address of licensed contractor Location and legal description of lot to be built on: Lot Xe, 2f J� Block Street and Number where work is to be done 47 iva q 2. .,:t State work to be done and purpose of building (by floors) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Subdivision AA'C I , 19 • Street I `/` - " � - - - < • - - - - -' and for no other purpose. New Building Remodeling Addition Repairs No. of Stories / To be constructed of e_a._ - Kind of foundation C.. __ s3 ' Roof Covering 7...1 44 • r , Estimated Total cost of improvements $ I f Amount of Permit $ 1 ' 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 bmit all the plans and spec 'fications for said building. All notices with reference to the building and its construction may be sent to `- -��s �� 2 O ° 0 - e 6" �-+ 1 q Q -121' 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 pos - •r inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only s bcontractors, o 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 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 Date Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Notary Public, State of Florida • 7 Building Inspector My Commission 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 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. 2. 0 A- 2 -€) 4E: Co 6 2 /3,-,o r Z 1 r'. ' I-OO i T to , S CEK J. l o a .� 5 G Sc Q a` - c7` • Ce", O F. tz- S r l r r to 3 C7fL_- C$1 --1 .4L.L TNX / -mot d-4 -1 t o , S cr' 0 BUILDING ELECTRICAL PLUMBING PERMIT N2 6179 Work to be performed under this Permit L Owner of Building Architect Contractor or Builder Legal Description Lot MIAMI SHORES VILLAGE., FLORIDA Bl. Address of f , ? ; Value of Amt. of Building /1 i ti: / . -° Project r Permit This permit is 'granted to the AntractorJor fiudder named above to construct the building or to install the equipment or device described in the appli- cation 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 upor 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. r Signed. l < By INSPtCTOR In consideration, of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with Al1 prdinances and ,.5e 1a�i ons pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authonti66 of Miami Shcres'illage. In accepting this perm I assume resprisibility for all work done by either myself, my agent, servant or employee. f i 1 DATE 194 , - Contract ' s '^+ License No. Subdi- vision BY AUTHORITY t • New Building v Remodeling To be constructed of e-, Z Kind of y foundatio Estimated Total cost of improvements $ Zone cubage required 7 �/ o Distance to next nearest building c e _ Maximum live Load to be borne by each floor STATE OF FLORIDA, COUNTY OF DADE. ss. peared MIAMI SHORES VILLAGE BUILDING INSPECTION DEPAF TTfiffi- 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 Addressk - e. Lt . ' �e+ Registered Architect and /or Engineer a.- ®f �:l`- k •J ®� Name and // e d address of licensed contractor l�__ f� , Location and legal escription of lot to b built Lot' : Block Subdivision_ _ M / 4'4',[- J/,/1 Streef4n 1S wh work is to be ne _ 4__7Li f 1 • ,6 6 State work to be done and purpose of building (by floors) C 0 �� ir G I hereby s'bmit all the plans and specififor said building. All note withh e e e'�e to building and its be sent ta../_ ' -e . F_ _ c. 44' -- 'fl_L.__ re�__- , • - ye . 4. mJ_. The undersigned applicant for this uilding 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 5906, 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 inspe4ion on the site of the work such ublic no ice or notices as are required by the Act. The undersigned agrees to employ only such subcon permit, as are licensed by Miami Shores Village. Remarks Before me, the undersigned auth?fity, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- and who, being by me first duly s orti, upon oath deposes and says tha of the above described construction, that he has carefully read the fore therein by him stat d are true. ,, Permit No ° Date Disapproved (Signed) Chairman C- Member Member Building Inspector Date - - - -- and for no other purpose. Addition Repairs No. of Stories e :17. 1"? e C •ze:f . _Amount of Permit $ _Plan Cubage ") 1532 _ Size of Building Lot < At7 (Signed) Date_ � > No. "!___ e is the ing application, and that he did sign the same, and that all facts Read, Sworn t pd Subscribed befoxelme. otary 40} N Street�I__Z' Roof covering Pal Ay ctors, on work to pekfprn unde th :.s to me well known, lic, State of Flail SUr :r1 r0 _ construction may My Commissi PLANNING BOARD � � � DATE 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. 1 I • , e1/ 7 • MIAMI SHORES VILLAGE, FLORIDA BUILDING ELECTRICAL PLUMBING Owner of / , , Building it -` N'rRA'OR BUILDER DATE PERMIT N9 5264 Contractor's License No. Work to be performed under this Permit �. 1 - it" dj.�� 6" Architect Contractor '; 0.- or Builder ' . r ; 4.r ' Legal Lot .D Bl. Description — , i T / t - L Address of , f Project J Value of Amt. of T Building Permit ` V • Subdi- vision 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 appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 hanged ithout authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above as ��e s th . a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or sibility for work done by his agents, servants or employees. . • Signed. In consideration of the issuance to me of this permit I agree to perform the wor covered hereunder in compliance with all ordinances and regulations pertaining thereto d in strict conformity with the lans, drawings, statements or specifications submitted to the proper authqtlliss of MiamilSltirgs Wijlage. In accepting this pOmit I assume responsi i)ify for a work done by either myself, my agent, servant or employee. l BY EC OR By AUTHORITY 1 )ecifications and t /` h94 he assumes respon- BUILDING ELECTRICAL PLUMBING Owner of Building V Legal Description Lot 7 , Address of Building P .' MIAMI SHORES VILLAGE, FLORIDA( // DATE -` -. ` l� -✓ 194 PERMIT N? 5264 Work to be performed under this Permit ! .. C 1 L '- ,1" l / `' 01.1110 Architect Contractor or Builder � '' / L Bl. f Subdi- vision QR BUILDER BY License No. Contractor's Value of Amt. of .,rl l� Project Permit AUTHORITY iv' 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 appli- cation 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 hanged •thout authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above as s the .onsibility r' a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or .: : � .ecifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed: EC R 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 a d in strict conformity with the jlans, drawings, statements or specifications submitted tb the proper authorities of Miami Shores Village. In accepting this p it I assume responsibjlitk for a work done by either myself, my agent, servant or employee. By Owner's Name and Address Registered Architect and /or Eigineer New Building _________________ Remodeling Addition Zone cubage required STATE OF FLORIDA, COUNTY OF DADE. j ss. Disapproved Date ( Signed) - Building Inspector MIAMI SHORES VILLAGE s`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. BUILDING INSPECTION DEPARTMENT Name and address of licensed contractor____ ___________�__'i/� Location and legal description of lot to b uilt on:�� Lot____ Block ub�livisi Street and Number where work is to be done__ State work to be done and purpose of building (by floors)______ __t��� `-4i: .4.- l o 0 7 . ` - '04 No Street_ Date Repairs No. of Stories To be constructed of Kind of foundation Roof Covering C! Estimated Total cost of improvements $ Amount of Permit $ _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 co ctors or sub - contractors nployed by him in the work to be performed under this permit; and will post or cause to be posted for ins; cti n on the site of the w uch pa, notice/ or notices as are required by the Act. The undersigned agrees to employ only such subc for o work to b rfor eV under th•� permit, as are licensed by Miami Shores Village. Remarks ( Signed) _ ___ f and for no other purpose. Before me, the undersigned authority, a notary public, duly authorized to minister 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 st ed are true. Permit No % 7 Date Read, Sworn to and Subscribed before me. PLANNING BOARD __DATE Notary Public, State of Florida My Commission Expires 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. 19