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78 NE 93 St (10)Date - - 0,3 Miami Shores Village Building and Zoning Department Attention: Building Official SWIMMING POOL OWNER'S CERTIFICATION I certify that I am the legal owner of the property described as 10 7 / 6 � � Z , located at 3 3 +, /4i SGTI) y.Li In accordance with Section 33 -12(0, Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until a separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected and approved. I further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting an approved barrier prior to final inspection and use of the pool. Legal Owner Note: This certification is to be submitted with a swimming pool permit application in duplicate. Fd.112 ON I.P. 040' CL. C•4 0 J u Sect- 0• No.1E0 O In N U 1 rn 5,5 IJ a 14 0 M 0 W V 1 Fd.112" o I.P c 5'5WK . L Sf4ZS JC 2 S' 17a - n4 I� 15 9' A5PI4 p4V — Eh 7500' (Rim). • ; WA • .. . 37.70 ' ONE STORY RESIDENCE Nil '18 IO PARKING 21 A5PI-1. N.E. 93 RD 8 p2 DO3- �o 3 14.20 S � — J 10.45' I 40 POON/ "-53 , :. "r :; • 21'1n , I 1 4 , l�Ll • . J T z 0 .. 4'. 5 l • 9.5'. 75 00' (R4 M) • 0. 10' CL 10 .G o m \J cr d 10.5 Fd 1/2 I P. SHEET 2 OF 2 THOMAS J. KELLY, INC. L.B. #6486 SURVEYORS - MAPPERS -LAND PLANNERS 8125 SW 120 STREET PINECREST, FLORIDA 33156 (786) 242 -7692 DADE (954) 779 -3288 BRWD (786) 242 -6494 DADE FAX (954) 779 -3260 BRWD FAX DATE FIELD WORK ii/Z//oz SCALE 1. = 24' SURVEY NO. OZ- 5(oyQ LEGEND OF SURVEY ABBREVIATIONS A ARC DISTANCE A/C .... AIR CONDITIONING CBS ... CONCRETE FLOCK STRUCTURE NGVD ... NATIONAL GEODETIC VERTICAL DATUM C CALCULATED C.B CATCH BASIN O.U.L....OVERHEAD UTILITY LINE PRC ... POINT OF REVERSE CURVATURE CL .... CLEAR , • C/L ....CENTER LINE P.C.C... POINT OF COMPOUND CURVE RAD ... RADIAL ENC ... ENCROACHMENT P.0 POINT OF CURVATURE P.O.C... POINT OF COMMENCEMENT R/W ...RIGHT OF WAY FIP ...!FOUND IRON PIPE P.0,13 POINT OF BEGINNING BLDG .. BUILDING SEC ... SECTION 0.H.... OVER NANG W.M WATER METER C.H CHORD DISTANCE SCR ... SCREENED P.5.... PLAT BOOK M MEASURED D.E DRAINAGE EASEMENT S.I.P.....SET IRON PIPE P/L ...PROPERTY LINE CONC .. CONCRETE F.H FIRE HYDRANT SWK . , .SIDEWALK UP ... UTILITY POLE F.D FOUND R RADIUS U.E UTILITY EASEMENT CHLF CHAIN LINK FENCE CERTIFY TO: Anne M. Fletcher & Frederic Farque Spirit Title & Escrow, Inc. Old Republic National Title Insurance Co National City Mortgage D /B /A Commonwealth United Mortgage, Its Successors LEGAL DESCRIPTION: Lot: 3 & The E 1 O f Lt # 4 Block: 2 Subdivision: An Amended Plat Of Miami Shores Section According to the Plat thereof as recorded in Plat Book: 10 Page: 70 Public Records of MIAMI -DADE County, Florida. ADDRESS: 78 NE 93 STREET MIAMI, FL 33137 Encroachments Noted: One LOCATION SKETCH SCALE: (70 NOTES: A) All Clearances and /or encroachments shown hereon are of apparent nature. Fence ownership by visual means. Legal ownership of fences net determined. B) This survey Is Intended for mortgage or refinance purposes only exclusively for this use by these to whom It Is certified. This survey Is not to be used for construction, permitting, design, or any other use without written con- sent of Thomas T. Kelly, Inc. C) Code restriction and title search are not reflected on this sully. 0) The flood Information shorn hereon does net Imply that the referenced property will or will not be free from flooding or damage and does not create liability ad the part of the firm, any officer or mimic/yea thereof, for any damage that results from reliance on said Information. E) The lands depicted hereon wen surveyed per the legal description and no claims as to ownership or matters of title are mode or implied. F) Underground Encroachment", If any, net located. I hereby certify that the survey repro d hereon meets the minimum technical stan- dards set forth by the Board of Lend Surveyor' in chapter 61617 -6 Florida Administrative Code pu Section 472,027. Fla. Statutes. • J,O5E A. PEREA, P.5. dd M. #4858 -- `'STATE OF FLORIDA NOT VALID UNLESS IMPRINTED WITH AN EMBOSSED SURVEYORS'S SEAL. NOTES: 1 IF SHOWN, BEARING ARE TO AN ASSUMED MERIDIAN (BY PLAT). 2 IF SHOWN. ELEVATIONS ARE REFERRED N.6.V.D 1929. 3 THIS I5 A BOUNDARY SURVEY. No. 1 And /Or Assigns FLOOD ZONE: :C THIS I5 A FLOOD / HAZARD ZONE THIS I5 NOT A FLOOD HAZARD ZONE PANEL NO.:. 93/J COMMUNITY #: 120652 DATE OF FIRM: 07/17/1995 BASE FLOOD: N/A FINISH FLOOR: N/A LOWEST N/A ADJ GRADE Sheet 1 ofl, THOMAS J. KELLY, INC. L.B. #6486 SURVEYORS - MAPPERS -LAND PLANNERS 8125 SW 120 STREET PINECREST, FLORIDA 33156 (786) 242 -7692 DADE (954) 779 -3288 BRWD (786) 242 -6494 DADE FAX (954) 779 -3260 BRWD FAX DATE FIELD WORK 11/02/2002 SCALE 1" _ 1 SURVEY NO. 02 -5640 • TRANSMISSION VERIFICATION REPORT TIME : 06/18/2003 14:39 NAME : FAX : 3 059495336 TEL : 3 059495336 DATE,TIME 06/18 14:36 FAX NO. /NAME PFEIFFER DURATION 00:83:82 PAGE(S) ©3 RESULT OK MODE STANDARD •CFN # 103102209, OR BK 35568 Page 466, Page 1 of 1, Recorded 07/10/2003 at 11:30 AM, Broward County Commission, Deputy Clerk 1922 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE 10B SITE AT TIME OF FIRST INSPECTION ERMIT NO TAX FOLIO NO ;TATE OF FLORIDA. ;OUNTY OF OADE. rE UNDERSIGNED hereby gives notice that improvements will be made to certain real property. and in accordance with :hapter 713. Florida Statutes. the following information is provided in this Notice of Commencement. . Legal description of property and street address: 1 ° ¥ 3 15 1\4 2 2. Description of improvement: 3. Owner(s) name and address: t'"W �� - •se 93 51 _7R iJ 93 5i Interest in property: Name and address of tee simple titleholder: 4. Contractor's name and address: ESSIG POOLS . INC _ 5. Surety:(Payment bond required by owner from contractor. it any) Name and address: Amount of bond $ 6. Lender's name and address: 8. In addition to himself. Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b). Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provide by Seaton 713.13(1)(a)7.. Florida Statutes, Name and address: d' r t • ate le specified) 1800 N.V. 1410- STRF,P.T \ tOwner ' Print O • s Name Sworn t • an • subscribed below e day of . 20 . Notary Public Print Notary's Na Ond e My Commission Expires omm C exp. Me y24. 900 • 182405 y Public I'4. v Sl,r, r4 1 T "i 13 S MAN Nr11:T14 MTaMT Fr. 33162 Prepared by Address: 1 hereby certify this document to be a true, correct and complete copy of the re ord filed ' r _ ffice. Dated this day Deputy Clerk Required Submitted MIAMI SHORES VILLAGE BUILDING DEPARTMENT POOL RESIDENTIAL D4 Hf CHECKLIST P02a03 -- / / PRIME CONTRACTOR AND ALL SUB - CONTRACTOR PERMITS MUST BE SUBMITTED PRIOR TO PERMIT APPROVAL COMPLETED BUILDING PERMIT APPLICATION - Please note Plbg, Elect, Mech, Swim Pool are separate applications. PROOF OF OWNERSHIP (Deed or Current Tax Bill) CURRENT SEALED SURVEY (TWO COPIES) 2 PLOT PLANS - If prepared by architect, must be sealed. (Show all intended setbacks from property lines and other existing structures) 3 ENERGY CALCULATIONS Supplied by Architect/Engineer sealed and /or signed by designer. STRUCTURAL PLANS AND STRUCTURAL CALCULATIONS (2 complete sets - sealed by Architect /Structural Engineer) / ELECTRICAL PLANS (2 Complete sets - sealed by Architect /Structural Engineer) PLUMBING PLANS (2 complete sets - sealed by Architect /Structural Engineer) MECHANICAL PLANS (2 complete sets - sealed by Architect /Structural Engineer) if drawn by A/C Company, must obtain stamped approval from Arch /Eng) TWO SETS OF PRODUCT APPROVAL FOR ALL WINDOWS, EXTERIOR DOORS, ect. PERMIT AND DOCUMENTATION FOR ROOFING PERMIT AND DOCUMENTATION FOR SHUTTERS HRS APPROVAL IF SEPTIC TANK OR WELL WORK IS REQUIRED (7755 NW 48 STR) APPROVAL FROM DERM (11805 SW 26 ST) NOTARIZED SIGNATURES ON APPLICATION IMPACT FEE FOR ADDITION PAID ( Application fee of $250.00 due at the time of permit submittal. CONTRACTORS - Write license #'s on all applications. A copy of all applicable licenses (Competency & Occupational) and original insurance certificates for Workman's Comp and General Liability. CERTIFICATE OF ELEVATION SIGNED AND SEALED NOTICE OF COMMENCEMENT � S �ue�u, a,Q pice- 50— • MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request 0 Time Date Permit No. , Nam Address Company 'O P ner For Inspector Z Approved Correction Re- Insp'n Fee Type Insp'n P I 1' 0 b f ° -3 'Name & Date ❑ 2 6 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ime Type Insp'n Oel ((yy SPe Permit No. t W9 Name CaC101 Address i 7 q ) Company5 Phone # For Inspector: k l' IC) . Approved Correction Re- Insp'n Fee Name & Date MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 105103 Time Type Insp'n \\ ste Permit No. 6P a 5- 1 1 y 0 Name Address 9 3 ST Company Phone # a J QS g 4q- I D ObO �°K zo9 For Inspector: i P it (p51 Name & Date Approved Correction Re- Insp'n Fee 4511 1 110 /7 L4-a-05,5 CONTRACTOR (JD -e 3 f 9 Joao er Name /"'� � �� ` l� License No. ) � T7,0) Enclosure Address pidb — l ,"I 6'1 0.m.. 6 . F I 2 J , 3“02- Telephone Fax Repair Qualifier Name 1 E 51 Alteration Interior PROPERTY OWNER New Construction V Enclosure Name Name f e(1 S Repair License No. Alteration Interior Address 1 @ ilVtA 1ide- NN 91 a bin_ 9-4L- 31r. 1t- k 3 3 13 9 Home Telephone 1 Fax Business Telephone Other Fax )4 ARCHITECT New Construction V Enclosure Name I( e(1 S Repair License No. Alteration Interior Demolish Address 1 l , . 9 Q . Telephone Add'I Attachment Fax Add'I Detachment TYPE OF MANAGEMENT (✓ ) New Construction V Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other M ORE Step 1. it Job Address: g N J 9 3 ST. Address Apt. Lot 3 Block Z. Subdivision i' Stk® '-PB tC1 PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection Zoning Square Feet Value of Work i tt JUL 1 1 20 Master Permit u . r' =- 3 J2z oo.3-J / INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: 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 submit- ted 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. APPLICATION City e-s Folio Number Description of Work \ C State PERMIT APPLICATION 3313 Zip Linear Feet Units Floors Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Adds Telephone Fax Page 2 IMPORTANT NO'T'ICES DO NOT B 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, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. Signature of Owner j;i► ��rrZ. Print ame Sworn to and subscribed be SEAL: STATE OFFLO "I ■ \: r 411 //: ./A Signatur -�lic -7 OF MIAMI -DADE e e s / (l lay of I19 tga-'' NNETH SHERMAN Notary public, State of Florida m Comm. exp. May "�m. No DD 8240500 Personally known 4 / OR, Produced Identification Type of Identification Produced: PERMIT APPLICATION S ignature f Contractor / Qualifier A, COUNTY OF MIAMI -DADE Print Name �i rn to d subscribed bef. : i �T day of SL: Personally known c - State of Floiida KENNE1 H SHERMAN Notary Public, State of Florida My comm. a May 24, 2007 C . No. DD 182405 OR, Produced Identification Type of Identification Produced: ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. '1'1'1'.: Outlet, Appliance QTY. Ty PE Service Repair QTV. A/C Central 1 -3 Ton Fan Dryer Vents, Number of Outlet, Wall Ventilation, Cost Service, Temporary Air Handler, Tons A/C Central 4 -7 Ton Piping, Flammable Liquid Fire Pump Outlet, Switch Fire Sprinkler System Signs A/C Central 8 -15 Ton Bath Fan - Vented, # Fixture - Fluorescent Pressure Vessel 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 MECHANICAL TYPE Minimum Fee Q1'Y. TYPE Condensate Drain QTY. TvlI; Generator Q"I'Y. TYI'[ Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Solar Water Heater Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Pump and Abandon PLUMBING TYPE A/C Condensate QTY. Y. I YPE Drains, Roof QTY. Y. TYPE Miscellaneous Fixture Q"I'Y. TYPE 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. RECEIVED AND REVIEWED BY: DATE: SECTION BY DAT Zonin • f' r ---e. ' !3 Electrical P rO �� NMMIMI ' OY® Mechanical Plumbin:PMEIWASYM Fire Public Works 7724103 1 1 Structural V ,� Building Official !� / % j Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $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 , 1 Notary fA' +--�gt -I'S'. 0 e • PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) (X .ft. = x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) ❑ BPR APPROVAL (Restaurants) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ CONTRACTOR REGISTRATION (On File) REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Pao( Ql Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 12 Job Address l ALE. 93 Yr St'O Tax Folio Legal Description �/ j Owner / Lessee / Tenant �J►�.: <4 Yov `� 0 k 4 IO / Master Permit # 33` 7 67 Owner's Address S OI+n.Z Phone `15 "7 - in, 3 s Contracting Co. Ov-/ Address 7 A - N - k - Qualifier SS# - - Phone State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor CrApS1eA.0 ?NC Address Permit Type(circle one): UILDIN ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 2eOAce_ Co#voi5( �o'� Square Ft. g() Estimated Cost(value) 4 3 O 0 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 •FFIDAVIT: I certify that all the foregoing informa it.n is accurate and that all work will be d e com iance with all applicable laws regulati g co f truce lion and zoning. Furthermore, I •�_,iz he bove -named ntractor to do the w orksta ed. auth Si of o er and /or Condo President Date. 'i -14 Notary as to Owner and /or Condo President My Commission Expires: * * PEES: PERMIT T 4 RADON C.C.F. % Fire Other Zoning Buildin 4111 /E) Electrical Mechanical Plumbing Engineering * * ,des • ANA MARIA CHAYNE �.� s MY COMMISSION ti CC 392917 EXPIRES: July 17, 1998 ''ac fe t 87 Bonded Thru Notary Public Undetwdters Notar as to My Commissio NOTARY Contractor or Owner- Builder ** TOTAL DUE 4 METRODADE BUILDING CODE COMPLIANCE DEPARTMENT SUITE 1603 METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET PRODUCT CONTROL NOTICE OF ACCEPTANCE MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 Clopay Corporation 312 Walnut St. Cincinnati, Your application for Product Approval of: Model 78, 83, 84,4, 91, 93 and 94 - Garage Doors under Chapter 8 of the South Florida Building Code governing the use of Alternate Materials and Types of Construction, and completely described in the plans, specifications and calculations as submitted by: applicant For listing see section 6 of this Notice of Acceptance. has been recommended for acceptance by the Building Code Compliance office to be used in Dade County, Florida under the specific conditions set forth on pages 2 et. seq. and the Standard Conditions on page 3. This approval shall be valid for a period of three years. The Office of Code Compliance reserves the right to secure this 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; the Code Compliance Department may revoke, modify, or suspend the use of such product or material immediately. The Buildin; Code Compliance Departtnent reserves the right to require retesting of this product or material should any amendments to the South'Florida Building Code be enacted affecting this product or material. The expense of such testing will be incurred by the manufacturer. Acceptance No.:94- 0614.03 (supersedes No.: 94- 0420.02) 1 Dia.-•n., P.E. roduct Control Division Supervisor THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL Expires:07 /25/97 OH 45202 CONDITIONS BUILDING CODE COMMITTEE Approved: 07/25/94 -1- METROPOLITAN DADE COUNTY. FLORIDA METRO -DADE FLAGLER BUILDING U.1 This application for Product Approval has been reviewed by the Metropolitan Dade County Building Code Compliance Department and approved by the Building Code Committee to be used in Dade County, Florida under the conditions set forth above. s anger, Director Building Code Compliance Dc Metropolitan Dade County Clopav Corporation ACCEPTANCE No.: 94- 0614.03 APPROVED : JUL 2 5 19 EXPIRES : T JUi 2 5 19 NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS 1. Description: This approves overhead doors 9' -0 wide x 8' -0 thru 6' -6" high with 24 gauge steel skin, coated with G -60 galvanizing, baked on primer and baked on polyester top coat. 2. Use: The door shall be constructed and reinforced as detailed in the approved drawing #101182. Model Type 78 Flush Panels 91 Smooth Texture 93 or 83 Wood Grain Texture Steel 94 or 84A Wood Grain Texture & Painted Style This door is approved for a maximum design pressure of +46psf and - 48psf and its use is restricted to this pressure. The door passed the impact and cyclic test, therefore it does not require protection devices. The door shall meet the burglary security requirements of Section 3603.2 (c) 2 (aa) of the South Florida Building Code. The door operating mechanism (not included in this approval) shall be certified by Underwriter Laboratories or other recognized agency. 3. Installation The door shall be installed as shown on drawing #101182 or other methods approved by the professional of record for the structure. Wood in contact with concrete or cement shall be treated with an approved preservative as set forth in paragraph 2913.2(a)1 or shall be a durable specie as defined in subparagraph 2913.2 (a) 6 (aa) of the South Florida Building Code. Installation of 2" x 6" wood jam requires a' /," x 3'1," tapcon at 12" o/c for a 9' -0 wide door with a minimum embedment of 1 into the concrete or reinforced block. ^/ / it Diamond, P.E. Supervisor Product Control Division Clopav Corporation 4. Conditions of Use: Application for building permit shall be accompanied by duplicate prints of the approved drawings bearing the approval stamp, Notice of Acceptance number and date by the Dade Product Control Section along with computations prepared by a qualified Florida registered engineer or architect verifying the adequacy of the installation of the door at each site. The shop drawings shall bear the signature of the architect or engineer of record with the following statement: "The supporting structure has been designed for the forces shown on the approved manufacturer's drawings." The adequacy of the overhead door to resist the horizontal Toad from the door shall be verified. 5. Identification: All approved products shall be permanently labeled with the manufacturer's name, city, state and the following statement: "Dade County Product Control Approved." 6. Evidence Submitted: Test Report Heti 94 -47 Heti 94 -04 Calculations A. Farooq Corp. NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS Date 04/15/94 03/02/94 Date 05/05/94 Drawing Number Clopay B.P. Co. #101182(1&2) -2a- Drawing Reference #101182 #101182 Signature A. Farooq, P.E. Last Revision 05/94 ACCEPTANCE No.: 94- 0614.03 APPROVED : JUL 2 5 1994 EXPIRES Signature A. Farooq, P.E. Test Signature A. Viquar, P.E. A. Viquar, P.E. 11 Diamond, P.E. Superviso Product Control Division : '�JUC 2 5 1997 • • • METRO-DADE Revised 9 -20 -93 3 METROPOLITAN DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE DEPARTMENT SUITE 1603 METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375.2908 NOTICE OV ACCEPTANCE: STANDARD CONDITIONS 1 Extension of Acceptance may be considered after a new application has been filed and the supporting data, test report no older than ten (10) years, have been re- evaluated. All reports of re- testing shall bear the seal, signature and date of an engineer registered in the State of Florida. 2. Any revision or change in the materials, use, or manufacture of the product or process shall automatically be cause for termination, unless prior approval is granted for revisions or change. 3. Any unsatisfactory performance of this product or process or a change in Code provisions shall be grounds for re- evaluation. 4. This acceptance sl ?all not be used as an endorsement of any product for sales or advertising purposes. 5. The Notice of Acceptance number preceded by the words Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is displayed, then it shall be done in its entirety. 6. A copy of this approval as well as approved drawings and other documents, where it applies, shall be provided to the applicant by the manufacturer or his distributors and shall be available for inspection at the job site at all time. The prints need not be re- sealed by the engineer. 7 Failure to comply with Standard Conditions shall be cause for termination of Approval, it Diamond, P.E. Supervisor Product Control Division INSTALLER MODEL RETAIL MODEL_ DESCRIPTION 78 78 FLUSH PANELS 91 N /A SMOOTH TEXTURE STEEL g., 8 WOODGRAIN TEXTURE - STEEL 94 84A WOODGRAIN TEXTURE STEEL WJ PAINTED STILES p(OR dI ;' - F-. SECTION HEIGHTS' 1ST 2ND 3RD 4TH 5TH I`ziidmFilil[nTLI FAMINEiiE1TiE3livd Eridlir r dlirdlTTi 7 -I • 8 '' 1 21• 18' 111E0 is' 21 METRO MODELS 78. 84A. 91. 93, 94 (24 GAUGE) n • 1 [1 uar _ UBl iJll MAX. DOOR WIDTH = 9'-0 INSIDE Fl VAT DN (SCA F- 1 J4OTE 1; DOORS UP TO 7' —O" HIGH CONSIST OF (4) SECTIONS. DOORS OVER 7'—Q HIGH CONSIST OF (5) SECTIONS. NOTE 2; SUPPORTING STRUCTURAL ELEMENTS SHALL. BE DESIGNED BY A REGISTERED PROFESSIONAL ENGINEER FOR WIND LOADS SHOWN ON THIS DRAWING. A a a O ■ o rn W ENO STILES ATTACHED TO DOOR SKIN WITH PATENTED TOG —L —LDC SYSTEM (TOP, BOTTOM, & CENTER) (3) INTERMEDIATE STILES PER SECTION ATTACH WITH RETHANE A OT (TOP & BTOM) AND URETHANE DEMESNE (ALONG CENTER) ) SEE END HINGE DETAIL ON PAGE 2. SEE INTERNED. HINGE RETAIL ON PAGE Z - TWO POINT LOCKING INTO TRACK PER SFBC 3603.2 (OPPOSITE SIDES OF DOOR) �r1 52 C rn = p t I ., 'L —4 -n, m F. MAX. DOOR WIDTH = 9'—O . 7 ril D O O C r Z m z Cn GG) G) G v O ,D m • —I . C P1 Co A Et C1 C C W = CC O LA O v , X E 3 I i Gl oppy Building Products Company END STILES ATTACHED TO DOOR SKIN WITH PATENEED TOG -L -LOG SYSTEM (roP, BOTTOM, & CENTER) (3) INTERMEDIATE STILES PER SECTION ATTACH WITH TOG — — LAC (TDP & BOTTOM) AND URETHANE ADHESIVE (ALONG CENTER) S E1r0 NS ALISLDE jimigglitistsu ARE NUMBERED STARTING AT THE BOTTOM. PAGE 1 OF 2 INSIDE ELEVATIONS CLOPAY BUILDING PRODUCTS COMPANY 312 WALNUT STREET SUITE 1600 CINCINNATI, OHIO 45202 (5i3) 381 — 4800 1 5/94 LOQC NOT_,pgp D■TD �rt PLAT 1=24 2/17/94 glum"! ST MWW oicartz A aACCITsrstm. TWO POINT LOCKING INTO TRACK PER SFBC 3603.2 (OPPOSTTE SIDES OF DOOR) THIS DOOR HAS A DESIGN PRESSURE OF +46.0 PSF & —48.0 PSF AND A TEST PURE OF + 68.0 PSF & —72.0 PSF. 101 1a2 " 3cl^°• METRO DOOR MODELS: 78, 84A, 91, 93, 94 wvoe Mmem 3 DOOR HEIGHT [31250Q1111110M11<B1111111 BRACKET PLACEMENTS Mai "L' X1 ] iQFill FERi I LEILFE4 .i_ • F3 = 1' 3' ME1RO MODELS 78.84A, 91. 93. 94 24 GA. S IttL (MIN. YIELD STRENGTH: 30,000 P51) ALL EXTERIOR STEEL SKINS ARE COATED WITH G -60 GALVANIZING, BAKED ON PRIMER, AND A BAKED —ON POLYESTER TOP COAT APPUED TO BOTH SIDES OF STEEL SKIN. 14 GA. END HING SCALE r = 1' (4) #14 SHEET METAL SCREWS 2x6 WOOD JAMB SHALL BE ANCHORED TO GROUT REINFORCED BLOCK WALL OR CONCRETE COLUMN WITH 1/4 "x1 -3/4" EMBED TAPCON 0 12" 0.C. FOR DOORS UP TO 9•x-0" WIDE & 0 9" 0.C. FOR DOORS UP TO 16'-0" WIDE. BLOCK WALL CELLS SHALL BE FILLED WIN CONCRETE AND REINFORCED WITH #5 BARS EXTENDING INTO FOOTING AND INTO 11E BEAMS. ALL BARS SHALL BE CONTINUOUS FROM 11E BEAMS TO FOOTING. FOR DOORS OVER 9' -0' WIDE PROVIDE TIE COLUMNS. PREPARATION OF JAMBS BY OTHERS 12 GA. GALV. STEEL TRACK BRACKET FASTENED TO WOOD JAMB WITH ONE 5/16"x1 -1/2 WOOD LAC SCREW PER BRACKET. 2 GALV. STEEL TRACK FASTENED TO TRACK BRACKETS. EACH BRACKET ATTACHED WITH TWO 1/4" x5/8" BOLTS & NUTS LIB TWO 1/4" R,)VETS. JAMB CONFIGURATION SCALE r = 1' 14 GA. INTERMEDIATE HINGE SCALE 7" = 1' STOP MOULDING BY DOOR INSTALLER (TO SUIT) 18 GA. MIN. GALV. STEEL END STILE 20 GA. MIN. GALV. STEEL INTER. 24 GAUGE STIL E r THICK 14 GA GALV. STEEL CENTER HINGE FASTENED TO CENTER STILE w /(4) EACH #14x5/8' SHEET METAL SCREWS. 14 GA. GALV. STEEL END HINGE FASTENED TO END STILES W /(4) EACH 1/4" �SELF TAPPING SCREWS. SCREWS (4) 5E,00_6 SCALE Z 12 GA. GALV. STEEL TOP ROLLER BRACKET. EACH BRACKET ATTACHED W /(4) #14x5/8" SHEET METAL SCREWS. SHIP LAP JOINTS. 14 GA. GALV. :'TEFL END HINGE EACH FASTENED TO END STILES W /(4) Di 4x5/8" SHEET METAL SCREWS do (4) 1/4" SELF TAPPING SCREWS. 3" TALL x 20 GA. GALV. S I ttL U —BAR. TWO PER DOOR SECTION. ATTACHED WITH 1/4" SELF TAPPING SCREWS. (2) SCREWS AT EACH END AND INTERMED. STILE LOCATION. x 0 0 U 'L z z W a 0 1- X4" "X3" " 13 GA. GALV. STEEL BOTTOM BRACKET. ATTACHED WITH (2) #14x5/8' SHEET METAL SCREWS. ALUMINUM EXTRUSION & VINYL WEATHERSTRIP. C Clupay Building Products Company INVi War 2 3 CLOPAY BUILDING PRODUCTS COMPANY 312 WALNUT STREET SUITE 1600 CINCINNATI, OHIO 45202 (513) 381 — 4800 5 94 5/9 PAGE 2 OF 2 CONSTRUCTION DETAILS 13 CA. GALV. STEEL FLAG EACH FASTENED TO WOOD (3) 5 /16"x1 -1/2 WOOD TRACK CONFIGURATION sr..AI F 1 /2 1 ' 2 GALV. STEEL TRACK, TRACK THICKNESS: .0601 TYP. 2 -1 /2x12 GA. ffxt• DATts 2/17/94 DRAWS •F OCD: D •F - 1 . 3►1 ' I Lila; • PLOT 1 =24 MWW GIA4N6WS rb IDAGe is HORIZONTAL TRACK SUPPORT BY DOOR INSTALLER (TO SUIT) W ' BRACKETF JAMB WPM W LAG SCREAV • U Z C7 • Z a o p co U Q O W 0 4 O CC Q CLAIXITICATIol 101182 4.1 411 U u- 0 Z U \9 O v1 ¢ 0 - 1 J (L J O :J CC - W Z Z Z U U U j 1— 1 1 1 GALV. STEEL TRACK BRACKET. THIS DOOR HAS A DESIGN PRESSURE OF +46.0 PSF & —48.0 PSF MO A TEST PRESSURE OF + 69.0 PSF & —72.0 :PSF. METRO DOOR MODELS: 78. 84A, 91 93. 94 Olt&VD6 MOO REV. 3 BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building MIAMI SHORES VILLAGE, FLORIDA �] DATE 195 ❑ PERMIT N? 12578 Contractor's ❑ License No ❑ Work to be performed under this Permit CONTRACTOR OR BUILDER Bl. Subdi- vision Value of Project $ Amt. of 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 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 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 BUILDING ❑ ELECTRICAL ❑ PLUMBING (1 ROOFING ❑ Owner of Building Architect Contractor or Builder CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT IsT? 13301 Legal Lot. Bi. Subdi- Description. vision DATE Work to be performed under this Permit 195 Contractor's License No Address of Value of I Amt. of Building Project $ 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 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 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 Architect Contractor or Builder Legal Description Address of Building IAMI SHORES VILLAGE, FLORIDA UILDING DATE -t t— 1940 ELECTRICAL PERMIT N? 6770 _ __,Contracto PLUMBING �'� � Licens This pe it is :' anted to the contractor or bui er named above to construct the bi'lding or to install the equipment or .� ice d ;.cribed in the appli- cation herefor in stric 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 cha _ed witho t thorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named abo a umes y for a thorough knowledge • V..• ordinances and regulations pertaining to the work covered hereby whether shown on the plans or dra ings in E st ements or specifi tions an. . : er;e ssumes respon- sibility for work done by his agents, servants or employees. . Work to Die performed under this Permit Signed. By INSPE OR BY In consideration of the issuance to me of this permit I agree to p � . e work covered hereunder in compliance with' all ordinances n Pregu1 ?ions pertaining thereto and in strict conformity with the plans, drawings, sta • ments or specifications submitted to the proper authorities of Miami Shores Village. In acceptilOthis p it I assume responsibility for a work done the s: 1 my agent, servant or employee. -' �,, ? r y , ( te CONTRACTOR OR B[JILDER a AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Work to >he performed # CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 6979 t r� Legal Lot Bl. Description Address of Building This permit . s granted to the contractor or . ' ilder named above o construct the b ` d' or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinin es pertaining thereto and with the un. •rstanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved ��y 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 . thorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above as es the res • • nsibi for a thorough ]Eno edge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or ing or in ats.orueifi e and that he assumes respon- sibility for work done by his agents, servants or employees. 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. under this Permit Il Signed Subdi- vision Value of Project BY DATE 4 Contractor's License No y AUTHORITY 194,1? BUILDING ELECTRICAL' LUMBING Owner of Building Architect Lontractor or Builder Legal Description Address of ',Building This permi is granted to the contractor or uilder named abov to construct the cation herefor in strict compliance with all ordinances pertaining thereto and with the plans, drawings, statements or specifications that may have been submitted to and appr at any time if the work is not done in compliance with such ordinances or if the plan permit is granted is the understanding that the contractor or builder nam above a regulations pertaining to the work covered hereby whether shown on the sibility for work done by his agents, servants or employees. In consideration of the issuance to me of this permit I agree to perform the work covered hereunder m compliant ' with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the prop :. authorities of Miami Shores Village. t1 In accepting ,permit Vassume responsibility for a work done by either myself, my agent, servant or employee. • 1 . CONTRACTOR- BU AER /3 ( \ MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT N° 6979 • rk t u . e lie formed under this Perm' Signe INSPECTOR 1 . Value Project BY Contract License No. 11 Amt. of ,Permit y or to install the equipment or device described in the appli- ng that the work will be performed in compliance with any e proper municipal authorities. This Permit may be revoked ged withou . uthorization. A further condition upon which this e r onsib' for a thoroug n. - ledge of the ordinances and if 1. ti• s and that he assumes respon- AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Lot �_• Description MIAMI SHORES VILLAGE, FLORIDA DATE 194_ PERMIT N? 6770 Work to be performed under this Permit B i. Subdi- vision Address of Value of Amt. of Building Project Permit Contractor's License No. 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 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 statements or specifications and that he assumes respon- sibility 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 pemiit I assume responsibility for all work done by either gayself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY S HQRZS VILL DING INSPECTION DEPARTME 1ICATION FOR BUILDING' P RMIT reby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build - cture herein described. This application is made in compliance and conformity with the Building Ordinance of Miami age, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and r- *Citations 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 - (t)l ` ) 1 ` 19 1 1 Owner's Name and Address '"11_,Tk 11- No.__ __ 2'U_ Street l t....1 +�. Registered Architect and /or Engineer �„ . � 1 '�- .A.0 '1,, ti Name and address of licensed contractor � �/__s?r'_- , =1._ Location and legal description of lot to be built on: . iJ Lot • r ' I Block_ Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) New Building Remodeling Ation _ Repairs No. of Stories To be constructed ofd • o'. Kind of foundation 0 1----4-4e— L ° Roof Covering__ f � " Estimated Total cost of improvements $ u :5 0 0 0 Am unt of Permit $ c --' / ,, • . , Plan Cubage____2 D `1L C I hereby submit all the plans and sp�ecifi, tions for said building. All notices with reference to the building and its construction may be sent to : '_ �, `4 1 �� ► �; STATE OF FLORIDA, COUNTY OF DADE. ss. Zone cubage required ( 0 Distance to next nearest building_ Maximum live load to be borne by each floor__ 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 su ontracto s, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks Building Insect • and fof / no other purpose. /1 _Size of Building Lot (Signed) �l+�s 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 depOes says thaf he is the of the above descr• ed construction, that he has card/ ly r . d the foxiggoing application, and that he did sign the same, and that all facts therein by him stO are tru Permit No Read, Sworn to and Subscribed before me. Disapproved Notary Public, State of Florida 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 he charged when 'such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.