709 NE 93 St (8)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date 7 ? i N Job Address 7, 7� � ,,,5, Tax Folio// f d i ( 14 / 1 7/P t f
Legal Description 4- 1'/4 .,,j I S - 74g, er
Owner /-tessee aat J a✓1 M. Ca ('ez'T Master Permit #1a2.2______
Owner's Address 7 'ill ' ' rl 73 . ve - 7 4 Phone '' fr 32-?..(
Contracting Co. �� �l ( ".- .11c/�C�' -1 ( c "�°" -
Qualifier I � _ _ .e_
d J
State # Municipal #
Architect /Engineer Ko 4
Bonding Company
Permit Type(circle one
WORK DESCRIPTION
Square Ft. /
Signature of owner and /or Condo President
Date:
APPROVED: Fire
Zoning Buildin
Mechanical Plumbing_
Address
Address
? Estimated Cost(value) /ZOO
Signa
Dat
FEES: PERMIT / ✓ // RADON C.C.F. / NOTARY SW
O
Vi / ittrec,.
P.)83 - K.t
. rid ° `i+pk[ANMINE E1luTt ermore,
•Notary Public, State of Florida
:My Commission Exp. April 30, 1996
IV No. CC197545
Contractor or Owner -.uz •er
� rint , y or stamp name of Notary Public
n( / pol trinwrk ( C)R PrndnrrrI 1 De
Notary as to Owner and /or Condo President `'ot y as to Colitraetioatincir OvitterrtButiLder
My Commission Expires: My Commission Expires:
DID take an oath, or
DID NOT take an oath.
** * * * * * * * * * * * * * * *
SSit � - - Phone
Competency 41~ 4 77 /'Ins . Co
IfteCo Address
Mortgagor Address
ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
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
be done in compliance with all applicable laws regulating const
authorize the above -named contractor to do the work stated.
**
Other
Electrical
Engineering
N? 248
Miami Shores Village, Fla.,
Owner, Agent or Tenant of Building
Lot Block Subdivision
Street Address
Approved use by occupancy
Remarks:
This Certificate of Occupancy is issued to the above named
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the
erection, construction, alteration or remodeling of buildings or structures.
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
BUILDING DIVISION
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 2255
Work to be performed under this Permit
DATE
Contractor's
License No.
193
Legal Subdi-
Description L ,f Bl. vision
Address of """'° Value of - Amt. of
I r
Building + / _ Project Permit f * , ....""*
This permit is gr 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 plj_terdrawings or in the statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees. -
Signed: By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula-
tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY
JOB: AD:
BUILDING
ELECTRICAL :
WORK
PLULLBING DONE BY:
Inspector's Report:
REQUESTED WILL BE READY
y
The following is ready for Inspection:
IND
c..
•
•
•
•
•
•
•
•
i
•
•
•
•
•
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building
or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores
Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regula-
tions 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
State work to be done and purpose of building (by floors)
-------- — __and for no other purpose.
New Building____— _l' —____ __ —___ Remodeling______ ____ ____ Addition________— _— _________ Repairs No. of Stories____________
To be constructed of____.. =— — Kind of foundation_________ ______ _ _ -- Roof Coveting ____— _____ _____ ________
Estimated Total cost of improvements $ Amount of Permit $
Zone cubage required —_ ' Plan Cubage
Distance to next nearest building Size of Building Lot r/
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 btu performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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
Disapproved ______________ Date
(Signed)
q/ .
Chairman
Men bier-
Member
Council Approved__
APPLICATION FOR BUILDING PERMIT
Building Inspector
MIAMI SHORES VILLAGE
PLANNING BOARD
BUILDING INSPECTION DEPARTMENT
Date__ ___- – — -- — -- – –> 19 —__
No Street—_ - - -- _
MATE
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
ommission Expires
Member
Member
Member
_— __Date Disapproved
to me well known,
'Ore
NOTE: A charge of $1.00 will be made '•r 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.
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
N9 248
Miami Shores Village, Fla.,
Owner, Agent or Tenant of Building
Lot Block Subdivision
Street Address
Approved use by occupancy
Remarks:
This Certificate of Occupancy is issued to the above named
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the
erection, construction, alteration or remodeling of buildings or structures. .
BUILDING DIVISION
Gon. raT Co t- ac - t . or c.No
1 - -.o ," By
Plat Y'lr
Ro trictior f
To P -? aniii. g .Board
Plans &._Spec .: cnec^x-ed by -
To Council.-- Ap:o.rovod
Blag.Perm .t N � ^ :S " Fec z ®® Cost, 3 0 6
—
Type . Mori es --
____No 7,7 Co _ns_�ruc U Qn
Plumbing Pe.r :it No. Z3CJ Date -. ,� •Foe
Septic Tank �, t! . - _ it
Sour '1: tl
luisctl�y, _ :36
Nc; Corst, _
-r— /L.
Roof !
_13lter t2 n Reprir - -
11
•
•
er
<<
it
Rc ^,ice
atro0
2 .-
Add r 0 r ' i1 o n o
or ' f; ii: c.
_yPpoved 5= �?/- 0Ito jectec�
Approved :Rejected
1
Electrical Permit NO./...3
Fixtures
Heater.'
i.Iotors
.Ij. SCI • .
New Construction
?lumbtftg Da
Retagia4fts ---
Fixtures
Septic Tanli .
Final Certificate
Jaut, 1 --- Dite
Roughing
Fixtures -
Final
3orvi.c.e_ILJC. to Pawer
•
V
11
•
/11terc:tion
Dat...... By . 10 By Re-Insp. By
Final Baamm-&- inteis till.411011291021
Foundation .405,
4110W
F nal- Clean-Up --
Ath
AMIRME7 04.0
- Anworo:0" -
AO'
Cert.Of Pcdup.Issued
Re-Insp.
By
j' $_
:.•
• , •
-Insp. Byh.. Re-Insp. By
Re-Insp. By
•
THIS CERTIFIES THAT the wiring and_apparatus installed at
by Address
for owner, and occupied as
has been inspected and current is authorized to be turned on, until otherwise notified, for:
Size of Service Number of Lighting Circuits
Range watts. Water Heater watts
Power: Connected load H P. Space Heaters . watts
Other Apparatus
MIAMI SHORES VILLAGE PERMIT
No.
Office of Electrical Inspector
CERTIFICATE OF INSPECTION
ELECTRICAL INSPECTOR.
PRODUCT CONTROL NOTICE OF ACCEPTANCE
Clopay Building Products Co.
312 Walnut St., Suite 1600
Cincinnati OH '15202
The expense of such testing will be incurred by the manufacturer.
Acceptance No. :00- 0320.05
Expires:08 /21/2003
Approved: 0.1128/2000
Internet nlnil 0.(l(Itl::;s: Iul�inli,,lr,
:Ii:,
MI:TRO -DAD[: FLAGLER I'.iILL)IN(
BUILDING CODE COMPLIANCE OFF!CF
NIETRO•DADE FLAGLER BUILDINC<
I !0 \VEST FLAGLER STREET, SUITE I603
MIAMI, FLORIDA 33130 -I56±
(305) 375 -2901 FAX (305) 375 -2906
CONTRACTOR LICENSING SECTiOi
(305) 375 -2527 FAX (305) 375 -255h
CONTRACTOR'ENFORCEMENT SECTIOr:
(305) 375 -2966 FAX (305) 375 -290+;
Your application for Product Approval of:
24 Ga. Sectional Door 9' Wide
under Chapter 8 of the Code of Miami -Dade County governing the use of Alternate Materials and Types
Construction, and completely described herein, has been recommended for acceptance by the Miami-Pik
County Building Code Compliance Office (BCCO) under the conditions specified herein.
This approval shall not be valid after the expiration date stated below. BCCO reserves the right to scciu,:
product or material at anytime from a jobsite or manufacturer's plant for quality control testing.
If this product or material fails to perform in the approved manner, BCCO may revoke, modify, or suspcnl
the use of such product or material immediately. BCCO reserves the right to revoke this approval, if it is
determined BCCO that this product or material fails to meet the requirements of the South Florida Buildit.
Code.
/
l: : Rodi (/
chic- Product ( ntroI
THIS IS THE COVERSHEE'>!., SEE ADDITIONAL PAGES l ()fl
CONDITION,`..;
BUILDING CODE & PRODUCT REVIEW C0N11\11 "i' "i'::1:
This application for Product Approval has been reviewed by the l3CCO and approved by the Building ( •
and Product Review Committee to be used in Dade County, Florida niek:1 11w c(in(liiions set forth ahov,.
PRODUCT CONTROL DIVISION
(305) 375 -2902 FAX (305) 372 -631')
/
i D t .r,ilSl`ail�
1. SCOPE
This approves a sectional steel garage door 9' -0" wide x 6' -6" through 8' -0" high, as described in Sectioi
of this Notice of Acceptance (NOA), designed to comply with the Soutli Florida Building Code, 1994 Editi
for Miami -Dade County. For the locations where the pressure requirements, as determined by SFBC Chap
23, do not exceed the Design Pressure Rating values indicated in the approved drawings.
2. PRODUCT DESCRIPTION
The Holmes Sectional Garage Door and its components shall be constructed in strict compliance with t
following documents: Drawing No. 101702 -24, with last revision on 07/08/97, titled "Door Models 83, 8.1
93 & 94" prepared by Clopay Building Products Co., drawn on 1 1/1 8/96, sheet I of 1. They bear the Minn
Dade County Product Control Approval stamp with the Notice of Acceptance number and approval date
the MMMlianii -Dade County Product Control Division. Tlicse documents shall hereinafter be referred to as t
approved drawings.
3: LIMITATIONS
This approval requires the manufacturer to do testing of all coils used to fahricate door panels under this
Notice of Acceptance. A minimum of 2 specimens shall he cut from each coil and tensile tested according t
ASTM E -8 by a Dade County approved laboratory selected and paid by tlic manufacturer. Every 3 months,
four times a year, the manufacturer shall mall to this office: a copy of the tested report:, with confirmation
that the specimens were selected from coils at the manufacturer production facilities. And a notarized
statement from the manufacturer that only coils with yield strength of 23,000 psi nr more shall he used to
make door panels Inc Dade County under this Notice ofAcr.cl)tancc:.
:1.
INSTAL- ,LA"1'i(11`1
4.1 The sectional steel garage clocir and its coniponents shall he installed in :,Ii t e nilili.lne c: �.itli I
approved drawings.
4.2
The installation of this door does not require a hurricane protection y,- stc:ni.
4.3 (hits with tliniensions equal to or smaller than those sho'.' : ti in the al)proveil (11 '.•in,', :, cliff +!�
under this approval.
�. I,;\.131s ;1,11`1(:
NOTICE OF' ACCEPTANCE: SPECIFIC CONDITIONS
L:ach door shall hear a perni;incnt I■Iliel \%itli 1111: 111;111111:1C 1111
l':;
sra(enienl: "� liana l) uIe Cuiinty i'roducl ( : \li!)r()\\ c:il ".
6. I3i11 I.,flNtG 1'1;Itill1]' IZE(_I-111Z1?R1EN•1•S
6.1 Application :or buildi permit shall he accompanied I);' copies )1 the follo'.viui ;:
6.1.1 "I•liiss Notice of Acceptancc.
6.1.2 Duplicate copies of the approval drawings as identified in 2 of this 1`10; \, cleat
marled to show the components selected for the proposed installation.
6.1.3 Any other documents required liy the liiiildini; OI :ial or the Solidi I iniicl;l 13uilcliitg (•c,
(SFIIC) in order to properly evaluate the instillation of this system.
?nf 3
APPROVED
EXPIRES
,
APR 2 8 200U
1. cn ,, i. ; .. i n))
Candid() Font, PE. Sr. l'roclttct Control Examin
Product. Control Division
3 of
A
EXPIRES
NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS
I . Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and tl
original submitted documents, including test - supporting data, engineering documents, are no older than cigl
(8) years.
?. Any and all approved products shall be permanently labeled with the manufacturer's name, city, state, and ti
following statement: "Nlianli -Dade County Product Control Approval ", or as specifically stated in tl
specific conditions of this Acceptance.
3. Renewals of Acceptance will not be considered if:
a. There has been a change in the South Florida t3uilding Code affecting the evaluation of this prodti
and the product is not in compliance with the code changes.
b. The product is no longer the same product (identical) as the one originally approved.
c. If the Acceptance holder has not complied with all the requirements of this acceptance, including tl
correct installation of the product.
d. The engineer, who originally prepared, signed and sealed the required documentation initial
submitted, is no longer practicing the engineering profession.
Lt Any revision or change in the materials, use, and /or manufacture of the product or process shall autonlatical
be cause for termination of this Acceptance, unless prior written approval has been requested (through tl
filing of a revision application with appropriate fee) and granted by this (Alec.
5. Any of the following shall also be grounds for removal of this Acceptance:
a. Unsatisfactory performance of this product or process.
b. Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any oth
purposes.
6. The Notice of Acceptance number preceded by the words Miami - Dade County, Florida, and followed by t
expiration date 'nay be displayed in advertising literature. II :tny portion of the Notice of Acceptance
displayed, then it shall be done In its entirety.
7. A copy of this Acceptance as well as approved drawin!;s and other docun'enis, where it applies, shall
provided to the user by the manufacturer or its clistriht'tors and shall be available for inspection at the job
at all time. The engineer needs not reseal the copies.
8. Failure to comply with any section of this Acceptance shall be cause for termination and removal
Acceptance.
9. This Notice of Acceptance consists of pai;cs I, 2 and Ibis last pa±;e 3.
APR 282000
iin i 20133
�ti tih 2 I
EN1) OF THIS ACCEPTANCE
Candido Font, I't.. Sr. Product Control tNanlir
Product Control Division
PROPERTY OWNER
r e A cul u Z KiTkse.t4 to V'L4. �rlatw L
Address _
r s , 04 �/o4 9 3 aa gr . _
Home Telephone 3 96 2 _ /13 (�
Business Telephone 3 U6_ 7a s_ N 5
Fax 6) 09. I/ S /4 SO g/A •
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
INSTRUCTIONS - The following steps mu4,t be taken to obtain a permit from the Miami Shores Village:
Step 1.
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted
along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
10 9 /// 13124
Address Apt. , City
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
PERMIT CHANGE (✓ )
ARCHITECT
Name
License No.
Address
Telephone
Fax
Square Feet
Master Permit No.
Subsidiary Permit No. e i 7 L
,
State
Folio Number / / 36L O ° C) 4.— 0 0 9( Description of Work /C i�� Eli
Lot 0 2 IA)'h .2.‹ Block 62 3 I3 t 0 — 3 7
Zoning
PERMIT APPLICATION
,'721 3R- 946 ,
Zip ����
Subdivision PB /A° a`7PG
Current Use of Property _
Proposed Use of Property Value of Work r (o.,) Z7 Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
Linear Feet
Units
Floors
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone
Fax
Qualifier Name
Page 2
IMPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, P' Floor, (305) 679 -1078. Once recor' i, e Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of .rida St ._t ew the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STA
Vignat
IDA, CO
Print Name
SEAL:
PERMIT APPLICATION
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Contractor / Qualifier
Print Name
,_...--won subscribed before me this 6 day o Sworn to and subscribed before me this day of
gna ure of " tart' Public State of Florida Signature of Notary Public - State of Florida
•? Pt/ aitc!: : ;i- ;:yEn63 j SEAL:
z te r . Q (, ' .'�6r:"7
II l ll MY CC - - Ia r.. _r
li
` c OF f � 1.
Personally known • -- = OR,Produced Identification Z---- Personally known OR, Produced Identification
Type of Identification Producedt� L a �� — 3^ 0 Type of Identification Produced:
ELECTRICAL
TYPE
Minimum Fee
QTY.
'TYPE
Dryer
QTY.
mil:
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
A/C Central 1 -3 Ton
Fan
Outlet, Wall
Service, Temporary
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
PLUn'IBING
TYPE
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTV.
TVI'E
Soakage Pit
QTY.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
MECHANICAL
TYPE
Minimum Fee
A/C Central, Tons
A/C Wall/Win. Tons
Air Handler, Tons
Barbecue
Bath Fan - Vented, #
Q'I Y. TYPE
Condensate Drain
Cooling Tower
Dryer Vents, Number of
Ductwork, Cost of
Fire Sprinkler System
Fireplaces, Number of
QTY. TY PI:
ME
Generator
Heating Strips, each
Paint Booth
Piping, Flammable Liquid
Process/Pressure Piping
Pressure Vessel
QT Y. TYPI.
Refrigeration, Tons
Vent Hood, Cost
Ventilation, Cost
Periodic Inspections
Q rY.
RECEIVED AND REVIEWED BY:
DATE:
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.)
Inspector State Educational Fund
State DCA (Radon)
Code Enforcement Fine
Zoning Review
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$ d,
$ w 1J r) (sq.ft. = x/1000
x ¢.60)
$ (¢.005 /sq.ft.)
$ (¢.01 /sq.ft.)
S'.b
REVIEWED AND PREPARED BY:
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
l
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $ ('� - h 6
ISSUING OFFICIAL
DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address 09 ,L.4 9 3 / Tax Folio //- ,%2 4 CP ` O/
"am i Sloiots Sac 3 / i o - 3 7 ,t o T- o2 `f tAJ 1 /
Description on °� oz �� co 5
Legal pti /0 r i 2. 7 o UU ki,19 D I? /F07,90 - Historically Designated: Yes No
3 3 Oglg 1p
Owner / Tenant a6$ 4 (/ u2 frq, GZ / Prig-. 4 » ,,u * L. Master Permit #
Owner's Address r 9 ''' 5 � Phone �' /` �- // 3
Contracting Co. i ) 0,) it .2 \( Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION leItp(g1 ; -T�
�r� C'� / e etr i e
Square FL f (p X = S C �% , Estimated Cost (value) AcLfitig o • /OD
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
construction and zoning. Furthermore, I authorize the above -named contractor to
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President
My Commission Expires:
FEES: PERMIT RADON
1 work will be d
work stat
• • ,
MY COMMISSION #,CO34
� EXPIRES: June 24, 2003
Rt , h. 0 Bonded Thru Notary Public Underwrtters
BO
as to Contractor or
C.C.F. i h V NOTARY - (�
APPROVED:
Zoning Building
Mechanical Plumbing Structural Engineer
Electrical
in compliance with all applicable laws regulating
....
BW GLORIA ARMADA
� - 14@tNMISSION # CC84cmO ,
EXPIRES: June 24, 200:
ded Thru Notary Public Uncle-
Vwr�' =i
*";: GLORIA ARMADA
MY COMMISSION # CC 849421
7.1 p V Bonded rnN N u
TOTAL DUE
ate
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building
or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores
Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regula-
tions 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:
s f
Lot ___ ✓�__ Block___ Subdivision
is
Street and Number where work is to be done _ - _ _
State work to be done and purpose of building (by floors)
Date--_--=--- -- — 19 '---
No:�J�
i
- - -- _ - - --_ __— —_ _ _ —� -- - -__and for no other purpose.
New Building______ - -___ Remodeling____________ —__ Addition — _________ Repairs No of Stories____ ________
C
To be constructed of____—'________ Kind of foundation — __ —____ Roof Covering
Estimated Total cost of improvements $ °> ` Amount of Permit $--4-' /
1 ,
— - ' Plan Cubage _ _ --_ --
Size of Building Lot _",
Distance to next nearest building
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 be 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 1;4 performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
Before mz, the undersigned authority, a no.ary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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 bim stated are true.
Permit No Rate Read, Sworn to and Subscribed before me.
Disapproved - -__ ____________ Date
Notary Public, State of Florida
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved__ Date Disapproved
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.
to me well known,
LOCATION
GARBAGE TAX RECORD
PA I D BY
YEAR
ANNUAL TAX
PERIOD USED
AMOUNT PAID
DATE PAID
RECEIPT
NUMBER
1940
-, ,../
1941
.......,,
.4%)..
__//e; -
4/
,,
e,
/
...
r 7
. . 0
1)C
t‘th,„
(
r
,-,,,,,,,,,,,,
,i''?_) e; /
1942
1943
....,
/7,
,_ ;'
„-
- /4=
- , ‘L.
- ,.; --i;-ul---..., :7"--...
1944
-
4
1945
//9
' '
42-t-411:
964'''
fro s' 4
:j‘-' ,
1948
1949
/
, ,.(1./
e
/ k --,37
LI r:V” 99
/..: - 3 /- - s - 0
. ,
i 4201/
/- / .' - 5 -- 0
/0 fr
/9'%la 7
/®
..,„,
,,,
1950
LOCATION
GARBAGE TAX RECORD
709 N. E. 93rd St.
D. M. Sears
by
year annual tax period used amount paid date paid receipt #
N° 248
Miami Shores Village, Fla.,
Owner, Agent or Tenant of Building i„ / ' °
%rig ' �i/
Lot -/ Block
_Subdivision
A /
Street Address / s ; � !
i
Approved use by occupancy lr
Remarks
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
This Certificate of Occupancy is issued to the above named / i '
for building at above named location only upon the express provision that the applicant will
erect ov„ and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known. as the
' •#rical, Plumbing and Building Ordinances o iami Shores Village pertaining to the
' alteration or remodeling of buildings or structures. , s
BUILDING DIVISION
•
•
APPLICATION FOR CERTIFICATE OFRE -0CCUP.A.yCy
hereby apply for a
Lam( description:
Lot: C9 CO 5 /G - .23
I hereby =TaY that I
and that it that the Z10 0 z the proper!
unlavniii :ar more tbaa one 6 Y residential c rse
Certificate cate or Re-0 be issued S �a �e a, any rer cef .... - . Florida, dies may that
constitute «• . for thif only
nstitute . , . - . - wtr.,
.r, purposes aid that such C'•dFIC3IV° does
oth er strti .... _: oa s Pm p or ctrifkaaca as az the daaidon of the dweag
or
poses of
For the purposes
F o r the p - .. izs on Seed of tee
n Code, coma= by as Snows
Contact Nam_ 4 r- / . G r-e
Buyer S e il er. Rr
AppEcatioa Fee MO) Paid; Ca* Cam ../
Number:
cue ro re- occupy the *ale family resde= r�� ax (add)
Miami Shores, Florida.
retephanaCS-Cga/ x /5L3
fr
f
1
CERTIFICATE OF RE-OCCUPANCY
On benalf of vfiami c'aores 'me, Florida, the aadaligaed =yes tai ±e property dicer
in the acolic anon has been iaspec ed for the purposes of re-o=rpancy pursuant co Ser+icos 901
and 902 of the :Yfiami Shores Land Development and Zoning Code and that such property may be
re-occupied by the appicaar for single -; muy resdennai purposes.
THIS CERi LH ICATE VERIFIES THAT THE REFERENCED PROPERTY
HAS BEEN I`iSPECTED BY MIAMI SHORES VILLAGE AND HAS BEEN
DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF
REGULATIONS OF TH.E MIAMI SHORES LAND AND DEVELOPMENT
CODE PERTAINING SOT.FT1Y TO 1h REQUIRES NT THAT EACH
ONE — FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR
A ONE—FAMILY DWELLING PURPOSE ONLY; HOWEVER, THIS
CER lleiCATE DOES NOT CONSIETTE ANY REPRESENTATION OR
WARRANTY AS TO 1HK CONDITION OF THE DWELLING OR OTHER
STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR A,1iiY
ASPECT OF SUCH CONDITION, AND E TERESTED PARTIES ARE
ADVISED AND ENCOURAGED TO MAKE THEIR OWiI ThiSPECTION
OF THE PRENIISES IN ORDER TO DETER'Vt[ E THE CONDMON
THERE 0 F.
FHA Form No. 2005
6. FLOOR FRAMING:
• • No.
(To be inserted by FHA)
FEDERAL HOUSING ADMINISTRATION • re Ili ttc. • Jn1-
I � . i :1-815
DESCRIPTION OF MATERIALS E m 9$
Property addressiii+-L- 404.. -.+4.- v r= - „_s - . . City k -, - - -- State
Mortgagor or Sponsor ..__ _, ‘
This exhibit will be accepted in lieu of specifications with Title I, Class 3 "Application for Property Approval,”
or with "Mortgagee's Application for Insurance" or "Application for Conditional Commitment" under Title II,
Section 203.
The use of this exhibit, executed in a clear and complete manner, enables the insuring office to give full credit for
the material used, and facilitates processing of the application.
Suggestions. — Fill out completely all spaces in the outline description below. Draw a line through all state-
ments which do not apply. Place an "X" in the square opposite the description of the material to be used. If the
space provided is insufficient, write "See Misc." therein and insert complete description under 27. MISCELLANEOUS.
If existing construction, leave all spaces blank and describe repairs or alterations under 27. MISCELLANEOUS.
j Proposed construction. ❑ Under construction. ❑ Alterations or repairs.
General. — All construction shall equal or exceed the FHA Minimum Construction Requirements, local building
codes, zoning ordinances, and restrictive covenants. The materials described herein shall be new and the best of the
grade or quality stated. Erection, application, or installation shall be in accordance with the manufacturer's direc-
tions or the best standard practice and shall be done in a workmanlike manner For final approval, all buildings
must be complete and ready for occupancy, connections with utilities completed, and with all equipment installed in
operating condition.
1. EXCAVATION:
Minimum depth below finished grade, -_ Type of bearing soil, __�';i
2. FOUNDATIONS:
Concrete: Mix -1 part cement, ____ parts sand, _ _4. parts gravel or stone.
❑ Transit mixed. Machine mixed. ❑ Hand mixed.
Wall footings: Width, ; ,C_____ jc _!r; thickness, "; reinforcing, ' ___ _tr
Pier or column footings: Size, ..,..,,.___" X a..nr...r___ " thickness, ___ ,. _gait
•y•• ".
Foundation walls: t f { ; thickness, 34._=__ ,__ },i "' "; veneer,
Piers or columns: «.p an.., *wok ; size, " X
Waterproofing: ,�« •r •�• -: Drainage:
Basement floor slab: z ; thickness,
Areaway walls: _, ; thickness,
Vents: 4:L3$ t - - - ; size, " X
3. CHIMNEYS:
Flues: No., s ie ; size, " X " X "; lining,
4. FIREPLACE:
® Wood burning. ❑ Gas burning. ❑ Circulating heater. ❑ Imitation.
Size oponing, .,tab__!' X 214 _ ". Size damper, __45---140 " X ". Size flues, ' " x 1E •
Fireplace lining: _4:1114:b_J._ 1,-J.i ; thickness "
Mantel: ____$t t _i t ?,t(;ne Facing: a ti 1,1 Hearth: D 1'I.9
Other:
(1)
16 -14378
*no
"
r
n
"
5. EXTERIOR WALLS:
s olid masonry: Facing, $ vie ; backing,
Waterproofing: _- Furring:
0 Wood frame construction:
Studs: ; size, " X "; c. to c., "
Sheathing: ; thickness, ". (If wood): ❑ Iior.; ❑ Diag.
Building paper: ; weight, #.
❑ Veneer: ; bond, ; paint,
❑ Wood siding: ; thickness, "; width, "; weather, "
❑ Shingle siding: ; size, " X "; weather, " .
❑ Stucco: ; lath, ; weight, #{.
❑ Other:
Finish: ❑ Paint; ❑ stain. Coats, Mfr. or formula,
GIRDERS
JOISTS
BRIDGING
Material
Size
Material
Eize
Spacing
ILla:erl'+1
P.ize
First floor
�r
Third floor
10. .0
_ "
"
it t __1 .__!t__M
J
+.1.( * --- s ---- � -"
t r " X
X
" X
fl
r'
"
L4- --
"
_ r'
w• • - , • : • . o
,t
- .i..,11.c a-1•'--_ =f-
.. " X
..- -£_ a X --,.
" X
'1 "
—"
"
FHA Form No. 2005
6. FLOOR FRAMING:
• • No.
(To be inserted by FHA)
FEDERAL HOUSING ADMINISTRATION • re Ili ttc. • Jn1-
I � . i :1-815
DESCRIPTION OF MATERIALS E m 9$
Property addressiii+-L- 404.. -.+4.- v r= - „_s - . . City k -, - - -- State
Mortgagor or Sponsor ..__ _, ‘
This exhibit will be accepted in lieu of specifications with Title I, Class 3 "Application for Property Approval,”
or with "Mortgagee's Application for Insurance" or "Application for Conditional Commitment" under Title II,
Section 203.
The use of this exhibit, executed in a clear and complete manner, enables the insuring office to give full credit for
the material used, and facilitates processing of the application.
Suggestions. — Fill out completely all spaces in the outline description below. Draw a line through all state-
ments which do not apply. Place an "X" in the square opposite the description of the material to be used. If the
space provided is insufficient, write "See Misc." therein and insert complete description under 27. MISCELLANEOUS.
If existing construction, leave all spaces blank and describe repairs or alterations under 27. MISCELLANEOUS.
j Proposed construction. ❑ Under construction. ❑ Alterations or repairs.
General. — All construction shall equal or exceed the FHA Minimum Construction Requirements, local building
codes, zoning ordinances, and restrictive covenants. The materials described herein shall be new and the best of the
grade or quality stated. Erection, application, or installation shall be in accordance with the manufacturer's direc-
tions or the best standard practice and shall be done in a workmanlike manner For final approval, all buildings
must be complete and ready for occupancy, connections with utilities completed, and with all equipment installed in
operating condition.
1. EXCAVATION:
Minimum depth below finished grade, -_ Type of bearing soil, __�';i
2. FOUNDATIONS:
Concrete: Mix -1 part cement, ____ parts sand, _ _4. parts gravel or stone.
❑ Transit mixed. Machine mixed. ❑ Hand mixed.
Wall footings: Width, ; ,C_____ jc _!r; thickness, "; reinforcing, ' ___ _tr
Pier or column footings: Size, ..,..,,.___" X a..nr...r___ " thickness, ___ ,. _gait
•y•• ".
Foundation walls: t f { ; thickness, 34._=__ ,__ },i "' "; veneer,
Piers or columns: «.p an.., *wok ; size, " X
Waterproofing: ,�« •r •�• -: Drainage:
Basement floor slab: z ; thickness,
Areaway walls: _, ; thickness,
Vents: 4:L3$ t - - - ; size, " X
3. CHIMNEYS:
Flues: No., s ie ; size, " X " X "; lining,
4. FIREPLACE:
® Wood burning. ❑ Gas burning. ❑ Circulating heater. ❑ Imitation.
Size oponing, .,tab__!' X 214 _ ". Size damper, __45---140 " X ". Size flues, ' " x 1E •
Fireplace lining: _4:1114:b_J._ 1,-J.i ; thickness "
Mantel: ____$t t _i t ?,t(;ne Facing: a ti 1,1 Hearth: D 1'I.9
Other:
(1)
16 -14378
*no
"
r
n
"
5. EXTERIOR WALLS:
s olid masonry: Facing, $ vie ; backing,
Waterproofing: _- Furring:
0 Wood frame construction:
Studs: ; size, " X "; c. to c., "
Sheathing: ; thickness, ". (If wood): ❑ Iior.; ❑ Diag.
Building paper: ; weight, #.
❑ Veneer: ; bond, ; paint,
❑ Wood siding: ; thickness, "; width, "; weather, "
❑ Shingle siding: ; size, " X "; weather, " .
❑ Stucco: ; lath, ; weight, #{.
❑ Other:
Finish: ❑ Paint; ❑ stain. Coats, Mfr. or formula,
7. SUBFLOORING:
Material: • ; size, " X $ " ❑Diagonal ❑ Straight.
8. FINISH FLOORING:
9. PARTITION FRAMING:
Studs: ; size, " X "; c. to c.,
10. CEILING FRAMING: ,
Joists: • size, `
, " X "; c. to c., "
Bridging: ; size, " X "; spacing, _______ ".
Special:
•
er4L u f't
(2)
11. ROOF FRAMING: a
Rafters: t ,, ; size " X ";,c. to c.
Valley rafters °' #'" "� ' ; size " X
Sheathing: "' ; [solid; ❑ strip. Size, " X
12. ROOFING:
Roofing felt: ; weight,
❑ Wood shingles: ; length,
❑ Asphalt shingles: ; type, ; weight,
❑ Asbestos shingles: ; type, ; laid,
❑ Slate: ____- ; length, "; weather,
❑ Other:
I F
13. SHEET METAL WORK:
Gutters: ; weight, #. Downspouts: ; weight, #.
Drain: ❑ Splash blocks �❑, suz ❑ sewer.
Roof flashing: j ; weight, #.
Valley flashing: ; weight, #
14. LATH AND PLASTER:
Lath: ; size grounds, ._.. It
Plaster: "rl ; coats, 3 . 1: " f' ; finish,
Other:
15. DECORATING:
Walls: Ceilings:
r
Tiriec tir -» ►" At EMI Bath:
Other finish:
16. INTERIOR DOORS AIWITRiMekol, , �. t
Type door: �1� t * terial, � ; thickness, "
eit
Trim: Casings, ___ a . se, ; other, t.
Finish:
Special:
17. WINDOWS:
Sash material: ; type, ; thickness, "; glass,
Balances: Screens:
Basement windows:
Special:
18. ENTRANCE AND EXTERIOR DET
Main entrance door and trim: Z j JL__ __ A _1__ :s f; ___y ; l __s_ _ , + e�yg__ q ; thickness,
Service door: i R t.4c__. * u ; thickness,
Other exterior doors: ; thickness,
Hoods or canopies: Shutters:
Cornice:
Special:
Ornamental iron:
16 -14578
Paper
Flooring
Grade
Size
1.
Hin X 1
" x "
" X "
FINISH
., t ∎itu.t.11. 1.11.. X::i •..• 'Oka, Iris
Of Liie1t•O 4' 1'lft ° ' C'+e
First floor
Second floor
Third floor
a; X.
• lir 1 Alt
7. SUBFLOORING:
Material: • ; size, " X $ " ❑Diagonal ❑ Straight.
8. FINISH FLOORING:
9. PARTITION FRAMING:
Studs: ; size, " X "; c. to c.,
10. CEILING FRAMING: ,
Joists: • size, `
, " X "; c. to c., "
Bridging: ; size, " X "; spacing, _______ ".
Special:
•
er4L u f't
(2)
11. ROOF FRAMING: a
Rafters: t ,, ; size " X ";,c. to c.
Valley rafters °' #'" "� ' ; size " X
Sheathing: "' ; [solid; ❑ strip. Size, " X
12. ROOFING:
Roofing felt: ; weight,
❑ Wood shingles: ; length,
❑ Asphalt shingles: ; type, ; weight,
❑ Asbestos shingles: ; type, ; laid,
❑ Slate: ____- ; length, "; weather,
❑ Other:
I F
13. SHEET METAL WORK:
Gutters: ; weight, #. Downspouts: ; weight, #.
Drain: ❑ Splash blocks �❑, suz ❑ sewer.
Roof flashing: j ; weight, #.
Valley flashing: ; weight, #
14. LATH AND PLASTER:
Lath: ; size grounds, ._.. It
Plaster: "rl ; coats, 3 . 1: " f' ; finish,
Other:
15. DECORATING:
Walls: Ceilings:
r
Tiriec tir -» ►" At EMI Bath:
Other finish:
16. INTERIOR DOORS AIWITRiMekol, , �. t
Type door: �1� t * terial, � ; thickness, "
eit
Trim: Casings, ___ a . se, ; other, t.
Finish:
Special:
17. WINDOWS:
Sash material: ; type, ; thickness, "; glass,
Balances: Screens:
Basement windows:
Special:
18. ENTRANCE AND EXTERIOR DET
Main entrance door and trim: Z j JL__ __ A _1__ :s f; ___y ; l __s_ _ , + e�yg__ q ; thickness,
Service door: i R t.4c__. * u ; thickness,
Other exterior doors: ; thickness,
Hoods or canopies: Shutters:
Cornice:
Special:
Ornamental iron:
16 -14578
FIXTURES
MANUFACTURER
PLATE NUMBER
NAME
Kitchen sink
Bath tub
Shower: Allf!tilr pit tub_
Lavatory 11 th
Water closet
Laundry trays
ct
0,
40 4a;::1.-Iii:)._ 111_0 '
7_..:._ _trim —24:414
t-411/4./ _4__^!;:".2.:i_11 9
r
,gmbroku.
' •"_14pe_VIL)14.11.
25. LIGHTING FIXTURES:
Allowance, $ Special:
• •
19. CABINETS AND INTERIOR DETAIL:
Kitchen cabinets: • •
China cabinets:
Bookcases:
Medicine cabinet: ; closet equipment,
Special:
20. STAIRS:
Basement: El Open; 0 closed; treads, ; rail,
1st to 2d: 0 Open; 0 closed; treads, ; trim, ; rail, _
2d to 3d: El Open; 0 closed; treads, ; trim, ; rail,
Special:
21. SPECIAL FLOORS AND WAINSCOT:
Bathroom: Floor, 41.1.e ; wainscot, _ __teil_ti._ , height10
Kitchen: Floorj,,thLI.E.Wiei.11_44e, ; wainscot, 1.aoi *ow .... filik , height, o
Other: ...1.3.,4i___0.. 4.-', -no 14 --- , ■■• 4-ta■IIIIi--atoo--_.14,3,. i4.-4..j.LICI,r--.:.,-0LE1.1.ti'l., 12.23.1
22. PLUMBING:
Sewage disposal: 0 Sewer; Itseptic tank; 0 cesspool. (Indicate private well, sewage disposal system on plot plan.)
Water supply: 0 Public main; LJ private water system,
Supply piping: 0 Brass or copper pipe; copper tubing; n steel; 0 wrought iron.
Waste piping: Soil pipe, - 4 ; waste pipe, • I • ; ven 2, a
Domestic hot water: Storage, 6(1- gals.; fuel, IlLautomatic; manual.
0()tlEt'3ri
Special:
23. HEATING:
El Steam. ri Vapor. J Hot water: 0 1 pipe; 0 2 pipe; 0 gravity; 0 forced.
Boiler; make, model: ; capacity, Radiation: sq. ft.
0 Hot air: 0 Floor furnace; 0 Wall furnace; 0 pipeless; 0 gravity; fl forced.
Furnace; make and model: ; capacity,
Fuel: 0 Gas (burner, ); El coal: manual, El stoker ( --);
n wood; n oil (burner,
Control: 0 Manual; 0 automatic,
Fuel storage: 11 Bin; 0 tank (capacity,
Built-in gas or electric heaters:
Special:
24. ELECTRIC WIRING:
Conduit. J B. X. 11 Nonmetallic cable. 0 Knob and tube.
Switches: Outlets: LI (YU bl 013_14
Power outlets: gi Oil burner; range; 0 water heater;
L
.'trtlet
26. INSULATION:
walls: r one ; thickness, " Roof or ceiling: ; thickness,
aim% %mil Int
Weather stripping: Doors, ; windows,
01 tiat sot am Ing
n Storm doors, ; 1:1 Storm windows, ; MI Caulking, _LlAn.
Special:
(3)
10-14578
a
27. MISCELLANEOUS (Describe any materials or features of construction not adequately covered in the drawings or elsewhere in this
exhibit):
28. PORCHES AND TERRACES:
Porch: Foundation,
tt
roof, ne
Terrace: Foundation, ; surface,
Other:
29. GARAGE:
rrt,te.
Foundation:
1°
Walls:
1,
Doors:
Ea OM V*
Drainage:
30. WALKS AND DRIVES•
0 eta esn otiu.flut r ibb
Walks: ; thickness, _ " Drives: __ ; thickness,
31. LANDSCAPING:
Lawn: 11 Sodded; T Leede4;
.ri
Planting: Allowance,
Walls:
Fences:
Date, _
Date,
8. S. GOVERNMENT PRINT,INO OFFICE 16
1 : 4 6 tj: zi L ,
Nc!.
00.114 Roe, ,..,••■••,..*
Plumbing: Heating:
, s} # «IL! nat:1(3',4t4 (If extensive, include planting plan.)
frtail 02414.
•
4$ MO is at: IC(1 ft S 1;41 - 7, it I;Iti'Vri - trtiere
; railing,
ADDENDA
; flooring,
1P.
; steps,
Floor: utuen,t
; thickness,
Roof: Z era
Finished rooms:
1:
Electricity: *.
(Contractor or Builder)
(Mortgagor or Sponsor)
(4)
•
ea aar.... an wet