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BUILDING
BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor /- or Builder( / Legal Descripsidn v MIAMI SHORES VILLAGE, FLORIDA,,,(- , PERMIT N? 7182 Work to be performed under this Permit '�,� . ' t ,, ,.,,.. !; / l r r M f Bl. • Address of Value of a Amt. of Building + 1 '' � '� f 'a. Project Permit This permit is granted to the contractor or builder named above to construct the building or to dice the equipment or ice described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are 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 or a thorough knowledge.of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans pr,drawings.orl in the to ents or spec ons and't ificatiltathe assumes respon- sibility for work done by his agents, servants or employees. 9 r,' Signed,;,.., �y f ti-'"'` BY / �/' YNMSP R In consideration of the issuance to me this permit I agree to petform the,nwork covered hereunder in compliance with all ordinances and regulations pertaining thereto and n trict conformity i the ns, drawings, statb%puts.* specifica ' s submitted the proper authorities of Miami Shores Village. In acce Orn�it I /assume res ons for work done b age pt is p respons y either myself, , m Y g ,servant or oyee. rd , CTOIt O BUIL Subdi- vision DATE , 194 Contractor's License No. • 1 ) rQ - AUTHORITY • BUILDING _LECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description Work to be performed under this Permit M ----�' TOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT Address of Building / C 4 - L 7/ This permit is granted to the contractor o cation herefor in strict compliance with all ordi Bl. N? 5155 Signed: Subdi- vision Value Project at any time if the work is not done in compliance with such ordinances or if the plans are permit is granted is the understanding that the contractor or builder named above ass regulations pertaining to the work covered hereby whether shown on the plans sibility for work done by his agents, servants or employees. BY Contractor's License No J 194_ 61 Amt. of ��y+ Permit /'F uilder named above to construct the buil nces pertaining thereto and w th the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked anged witho the . onsi or to install the equipment or device described in the appli- OR authorization. A further condition upon which this ty for . thorough knowledge of the ordinances and yr specifications and that he assumes respon- By t In consideration of the issuance to me of this permit I agree to perform the work cov • ed hereunder in compliance with ordinances a pertaining thereto and in strict conformity with the plans, drawings, statements or speci ations submitted to the proper auth iiffes of Miami S In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. AUTHORITY Kulfitions te Village. STATE OF FLORIDA, COUNTY OF DADE. ss. BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State. of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shatt'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. )-fi Date ` �� " , 19 Owner's Name and Address �_1_ ,__ _(♦__'_t1! ~;_ f Q No ID 4:. Street M�e t° si ' 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 e ` , k`_ State work to be done and purpose of building (by floors)— _________�r! Permit No Disapproved __ ( Signed) MIAMI SHORES VILLAGE — — ---- - - - - -- and for no other purpose. New Building Remodeling Addition 1 - _. ' Repairs No. of Stories To be constructed of Kind of foundation Roof Covering ig Estimated Total cost of improvements Amount of Permit $ `-_ Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work, to be performed under this permit, as are licensed by Miami Shores Village. Remarks. (Signed) _ Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared _______ — - -- - -- -- -- — to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ! w C Date__ G Read, Sworn to and Subscribed before me. PLANNING BOARD DATE Notary Public, State of Florida My Commission Expires Chairman 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 PIanning 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. Member Member MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date 12/20/1 ,19 ..._._ Owner's Name and Address Mr. Powers - 42 N.E. 95 St. Miam4o hores. - Street _ — Registered Architect and /or Engineer Orkin Ext. Co. Inc. 1960 N.W. 27 Ave.Miami 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 _ 1142 N.E. 95 St. Miami Shores. State work to be done and purpose of building (by floors N lon Tent Fumigation- Vikane 18 - hours 3a - - - — — - -- and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation oof Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractojs, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks__.________- _- ___ —__ (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss. 1 Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared __to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated e true. ) Permit No. • 3Z)1 Date 1 1 ') hi Read, Sworn to and Subscribed before me. Disapproved Date t (Signed) t 1a� e n 1 Building Inspector 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING Architect Contractor or Builder `t! MIAMI SHORES VILLAGE, FLORIDA DATE P- "' i t) • 194 MIT P ERMIT N? 5155 5 Contractor's r { License No ! 9 0 f Work to be performed under this Permi hh -"Lt Owner of r_ , Building Legal Lots' Description Address of Building C' {6. 'L/' Bl. Subdi- vision Value or ` y Project Amt. of P ermit This permit is granted to the contractor or .uilder named above to construct the buil.' g to install the equipment or device described in the appli- cation herefor in strict compliance with all ordin ces pertaining thereto and w th the unders anding 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 m compliance with such ordinances or if the plans are nged withou . uthorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assii . i e . .nsib' y for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans ."��•' emen specifications and that he assumes respon- 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 cov ; d hereunder in compliance with all ordinances and gulations pertaining thereto and in strict conformity with the plans, drawings, statements or specif' .. tions submitted to the proper authorities of Miami S es Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. ACTOR OR BUILDER Signed: BY - By AUTHORITY 411111.11c c- MIAMI SHORES VILLAGE Office of Electrical Inspector CERTIFICATE OF INSPECTION THIS CERTIFIES THAT the wiring and apparatus installecr at / by for Address owner, and occupied as L) — PERMIT No. • ? has been inspected and current is authorized to be turned on, until otherwise notified, for: Size of Service i , % , =1' Number of Lighting Circuits Range ,/,I. - I at, watts. Water Heater 4 watts .r: Connected load H. P. Space Heaters X watts pparatus le • ELECTRICAL INSPECTOR. BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor , or Builder .% Address of / Building f" ✓' CONTRACTOR OR BUILDER 1 MIAMI SHORES VILLAGE, FLORID PERMIT N? 7182 Lbt / BI. Legal Descripticin Subdi- vision Value of Project / , DATE Work to be performed under this Permit Contractor's License No Amt. of Permit 4•11110 • This permit is granted to the contractor or guilder 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,responsOlityfor a thorougladowled 61 and regulations pertaining to the work covered hereby whether shown on the plans or drawings'ot in the,/tateulents or specifications' , that he astimes respon- sibility for work done by his agents, servants or employees. hfSPECTOR In consideration of the issuance to mQ o this permit I agree to perform the, work covered hereunder in compliance with all ordinances and regulations pertaining thereto and.in strict conformity i the ans, drawings, statements or specifica ' ns submitt. s ' the proper authorities of Miami Shores Village. In acce) this perpnit Yassume respo for work don E by either myself, my a servant or � loyee. ' . 4 ✓�.' �. ! f e 1 BY AUTHORITY Chairman Member Member Secretary APPLICATION Application is hereby made for the approval of the plans and specifications herei ^dtb.. gyltrai.tted building or other structure herein described. This application is made in eom- pliance and confornat ion with of the Miami ShoresVillage, Florida, and all provisions of the Laws of the State of FlQri,da,.. all ..Ordinarree� of' Miami Shores Village, and all rules and regulations of the building Department of Miami Sho res Vihlage , .. shall be with, whether speci or not. OWNER ARCHITECT /S .;"." : .r: “. CONTRACTOR LOT BLK SU3DIVISIOIN 'S "'y� r� NEW / ADDITION) REPAIRS NUMBER OF S T ORI UC t ROOF COST (excluding Architect's fee, landscaping & garage)$ 00e7.tr Building to be used fore _.ir "° f,..-1(;!1L tr and no other use. y 4 v I hereby submit all the plans and specifications for said building. STATE OF FLORIDA) COUNTY OF DADE ) f, Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknow:Ledgment, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the builder of the above described construction, that he has read the foregoing application, and that he did sign the same, and that facts stated by him are true. Read, Sworn and Subscribed before me, Notary Public (Signed) My Commission expires Cubic Feet 'Cubic feet required in this Block';.(1 Building Inspector Permit No. _Z Issued t BUILDING PERMIT RECORD F IAr.1I SHORES VILLAGE FLORIDA PLANING BOARD l Electrica Permit No. Plumbing Permit No. DATE ) e t Date /r Signed , ;,;= 1 '`" r" `J �. ` Painting Plastering Lathin Electrical LIST OF SUB - CONTRACTORS Mason & Concrete Plumbing Roofing Glazing Tile Miscellaneous Fixtures Yard Basement 1st Floor 2nd Floor 3rd Floor 4th Floor 5th Floor 6th Floor 7th Floor 8th Floor 9th Floor 10th Floor Total Closets Bath Tub Sink Lavatory Urinal Slop Sink I Laundry Tub I Floor Drain I I Catch Basin Shower t TAI i 4 1 WEST Sketch position of building and lot lines in square (which represents an entire city block) , showing on which street the building and lot faces; also show exact location of "Y" in street and position of lateral or septic tank. Show sewer and any change in direction same may make. NORTH A SOUTH EAST Remarks NORTH SOUTH Employing Plumber For a Owner or Agent Builder or Contractor is, Lot No. Address Sewer Connection Additional Information Plan No. I herewith submit the following plan of plumbing for approval: { New Dwelling , tfr Block No. At center of St. ❑ At curb ❑ Subdi�visio Department of Public Service Division of Plumbing Inspection CORAL GABLES, FLORIDA Work executed by ❑ Old ❑ Story ❑ ❑ St re ❑ Garage ❑ Apartment ❑ Address Address teavVic Existing Sewer Addition ❑ Hotel ❑ 0 A charge of $1.00 will be made for correcting any inaccuracies in the foregoing information. 193 Remodeled ❑ Office Bldg. ❑ To Septic Tank ❑ In alterations to existing work show the old work in red ink and the new in black ink. Letter each stack to correspond with the opening shown in floor plan or ground plan on opposite page. THIS SPACE FOR ELEVATION SKETCH THIS SPACE FOR PLAN SKETCH A perspective sketch will be sufficient provided the work can be clearly shown. • Show location of stacks and horizontal drains inside building, lettering each opening to correspond with the stack connections as shown on the elevation sketch on opposite page. Where ground work is concealed, draw floor plan of building showing location of walls, partitions, columns, etc., and the location oh all horizontal soil and waste pipes, in reference to same. is Name and . C14 (ion and legal description of lot to be built on: STATE OF FLORIDA '2OUNTY OF DADE. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT pplication is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein yed. 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 pf Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with. whether specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. tered Architect and/or Engineer and address o'f licensed contractor n/ !7' CO/VSTrc4 C I i FAN Zf✓ c- Block Subdivision Date 19 a , No.je 2— Str 9 5 • aliwtrn 5, �i ���os�z 6es0 ?t and Number where work is to be done e work to be done and purpose of • iilding (by floors). state exterior colors (submit samples) and for no other purpose. Remodeling v Building be constructed of Kind of foundation ;imated Total cost of improvements $ g 0'0'6 } SS. Addition Repairs No of Stories Roof Covering Amount of Permit S 9 I i w ae cubage required Plan Cubage stance to next nearest building Size of Building Lot aximum live load to be borne by each floor I hereby submit all 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 obligatons as an employer of Labor under the Florida Workmen's ompensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar >mpliance 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 n the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors. on work to be performed nder this permit. as are licensed by Miami Shores Village. i temarks (Signed) u- • %���� - — Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known. and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the f regoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. 1% ci61 Date Read. Sworn to and Subscribed before me. Disapproved ` Date (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE ` i Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of 525.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Notary Public. State of Florida APPLICATION FOR BUILDING PERMIT Appl' ation is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or o er structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores illage, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulat ons of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans ind specifications must be kept at building during progress of the work. _ Owner's Name and Address.. 5 • {moo �. -1 E°«' S No /4) Street � . s/' Registered Architect and /or Engineer Name and address of licensed contractor bre.4 r 4 Cw 7 (/' e tok l 4 ail 4- 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) ! e'r � Mi: elf 4'4.'1 "Ni and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under is permit, as are licensed by Miami Shores Village. Remarks ( Signed )..,2! r te' STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No 7' 6i Date P Read, Sworn to and Subscribed before me. Disapproved (Signed) ate Building I . ector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Date to me well known, Notary Public, State of Florida X114 y Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member .. Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 4. Buirding Zoning Sewer Division Line & Grade Survey Electrical Plumbing Owner's Name Owner's Address Registered Architect and /or Engineer Licensed Contractor's Name Licensed Contractor's Address Legal description of Building Site : Lot New Building To be constructed of THIS SPACE REPRESENTS THE LOT: INDICATE THE BUILDING IN SPACE SHOWING THE DISTANCE FROM LOT LINES AND OTHER BUILDINGS. Permit No, C Date Issued Issued By Fee $ FORM 798 (REV.) Address where work is to be done Shores, CITY OF 1 P M ;FLORIDA OFFICE OF BUILDING INSPECTOR APPLICATION FOR BUILDING PERMIT Application is hereby made for a building permit and the approval of the detailed plans and specifications herewith submitted for the building or other structure herein described. This application is subject to the Building Ordinance and all other Ord- inances of the City of Miami, Laws of the State of Florida and Rules and Regulations of the Building Division applicable thereto. A copy of approved plans and specifica- tions must be kept at building site during progress of the work. All employers of labor are subject to the provisions of the Florida Workmen's Compensation Act. ..ugust 11.1953 S. Pnl•rer Date 1042 .a'. 95 street, 1i11i:ii ihores, . ?1a. Block Subdivision Explain nature of work to be done and purpose of building (by floors) ITylon Tent C, ii ,- t �, , n,; r,a -biv,z Col.pP17 Inc_ 509 : 13 strnnt, 1042 95 street, :a1.ai_?1 Qllores,2 and for no other purpose. Remodeling Addition Repairs No. of Stories Kind of foundation Roof covering Total Sq. Ft. 35.000 Plumbing Elect.0 Alterations, Etc. $ 295.00 Distance to next nearest building 20 lt.ec^:st Size of Building Lot and ?rest STATE OF FLORIDA COUNTY OF DADE ss Before me, the undersigned authority, authorized to admin- ister oat & take acknowledgmetyts, personallyrappeared 9 who, after be arn, tmm oath deposes and says that he is the applicant for a building permit and that he has made and read the foregoing application and that the statements therein contained are true and correct. Signed Swom and subscribed to before me this day , 19 Notary Public, State of Florida at large My Commission expires 19 TYPE INSPECTION DATE Initial DATE Initial DATE Initial DATE Initial SETBACKS PILING FOOTINGS ° ' ` STEM WALL GRADE BEAM FLOOR SLAB LINTEL COLUMN TIE BEAM FRAMING COPING or RAKE ROOF: TIN CAP ROOF: FINISH OFF - STREET PARKING FINAL APPROVAL ALTERATIONS REPAIRS ADDITIONS AIR -COND. DUCTS INSPECTOR'S REPORT TYPE INSPECTION DATE Initial DATE Initial DATE Initial DATE Initial SETBACKS PILING FOOTINGS ° ° STEM WALL GRADE BEAM FLOOR SLAB LINTEL COLUMN TIE BEAM FRAMING COPING or RAKE ROOF: TIN CAP ROOF: FINISH OFF-STREET PARKING FINAL APPROVAL ALTERATIONS REPAIRS ADDITIONS AIR-COND. DUCTS INSPECTOR'S REPORT • Building Zoning Sewer Division Line & Grade Survey Electrical Plumbing Owner's Name Owner's Address Registered Architect and /or Engineer Licensed Contractor's Name Licensed Contractor's Address Legal description of Building Site: Lot Block Address where work is to be done Explain nature of work to be done and purpose of building (by floors) New Building To be constructed of THIS SPACE REPRESENTS THE LOT: INDICATE THE BUILDING IN SPACE SHOWING THE DISTANCE FROM LOT LINES AND OTHER BUILDINGS. Permit No. C - Date Is sued Issued By — FORM 498 - I REV.) I4ta Shores CITY OF Wisitglf'LORIDA OFFICE OF BUILDING INSPECTOR APPLICATION FOR BUILDING PERMIT Application is hereby made for a building permit and the approval of the detailed plans and specifications herewith submitted for the building or other structure herein described. This application is subject to the Building Ordinance and all other Ord- inances of the City of Miami, Laws of the State of Florida and Rules and Regulations of the Building Division applicable thereto. A copy of approved plans and specifica- tions must be kept at building site during progress of the work. All employers of labor are subject to the provisions of the Florida Workmen's Compensation Act. I Ty1on Tent Date Subdivision August 110.953 so Pwors 1042 I.E. I 95 stroot, Mint Shores, Fla. Orkin"! , ',xt , rmi nati`rig CompAny, Inc. 5 Ni .•1, ]3 5trent, ntim!,P+' 1P' , . 102 f,L, 95 street, ii.ana Shores,Fla and for no other purpose. Remodeling Addition Repairs No. of Stories Kind of foundation Roof covering Total Sq. Ft. 35.000 Plumbing J Elect. 0 Alterations, Etc. $ 295600 Distance to next nearest building 20 ftoeast Size of Building Lot and West STATE OF FLORIDA l ss COUNTY OF DADE s Before me e undersigned authority, authorized to admin- ister oaths a e ack wledgmnts / person lly appear May N. who, after b 1t�g �Q `�5�06 p4h oath deposes and says that he is the applicant for a building permit and that he has made and read the foregoing application and that the statements therein contained are true and correct. Signed Sworn and subscribed to before me this day , 19 Notary Public, State of Florida at large Fee f My Commission expires , 19 Building Zoning Sewer Division Line as Grade Survey Electrical Plumbing Owner's Name Owner's Address Registered Architect and /or Engineer Licensed Contractor's Name Licensed Contractor's Address Legal description of Building Site: Lot Block Address where work is to be done New Building THIS SPACE REPRESENTS THE LOT: INDICATE THE BUILDING IN SPACE SHOWING THE DISTANCE FROM LOT LINES AND OTHER BUILDINGS. Permit No. C Date Is sued Issued By FORM 75e (REV.) ::iar�1 S flora CITY OF 4ylon Tont Signed OFFICE OF BUILDING INSPECTOR APPLICATION FOR BUILDING PERMIT Application is hereby made for a building permit and the approval of the detailed plans and specifications herewith submitted for the building or other structure herein described. This application is subject to the Building Ordinance and all other Ord- inances of the City of Miami, Laws of the State of Florida and Rules and Regulations of the Building Division applicable thereto. A copy of approved plans and specifica- tions must be kept at building site during progress of the work. All employers of labor are subject to the provisions of the Florida Workmen's Compensation Act. Date a, P j 101 T,E. 95 at at, Miami Shores, 1'1a. Grid ,, Artarmirintinc Compwly, Trio. 5 N, 13 street, i t = Subdivision Explain nature of work to be done and purpose of building (by floors) 1 01i. 95 street, :ttc rn 1Yoro8, 'la Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof covering Total Sq. Ft. 35.300 Plumbing El Elect. 0 Alterations, Etc. $ 295.E Distance to next nearest building 20 .At.OQst Size of Building Lot Ord west STATE OF FLORIDA 1 COUNTY OF DADE ss Before m the undersigned authority, authorized to admin- ister oad tales acknowlejgmnts, personallf a peared LO R I DA August 114953 Notary Public, State of Florida at large and for no other purpose. Ale e ' ' A I ` u_P _ II '� who, after bei rst u s rn u oath deposes and says that he is the applicant for a building permit and that he has made and read the foregoing application and that the statements therein contained are true and correct. Swom and subscribed to before me this day 19 Fee $ My Commission expires , 19 TYPE INSPECTION DATE Initial DATE Initial DATE Initial DATE Initial SETBACKS PILING FOOTINGS STEM WALL GRADE BEAM FLOOR SLAB LINTEL COLUMN TIE BEAM FRAMING COPING or RAKE ROOF: TIN CAP ROOF: FINISH OFF - STREET PARKING FINAL APPROVAL INSPECTOR'S REPORT ALTERATIONS REPAIRS ADDITIONS AIR-COND. DUCTS A P P L I C A T I O N FOR PERMIT TO FUMIGATE WITH CYANIDE METHYL BROMIDE ACRITET APPLICATION NO. • DATE Aug.13.58 10 Location of building to be fumigated 1042 LE. 95 street, laud Shores,Fla. 2. Name and address of owner of premises S. Polders 3. Type, size and construction of building ono story C.E.S., Res. 4. Is entire building to be fumigated? yes 5. If not, state what portion 6. Approximate number of cubic feet of space in building or in portion to be fumigated 3 5.000 7. Kind and quantity of fumigant to be used and manner of application and length of fumigation period Aoritet 1 F8 hours 8. Distance of nearest building and direction from building to be fumigated 20 ft. east and test 9. In what manner will vents to exterior of building be sealed? IJylon Tent 10. Date when fumigation will be begun Aug. 16.58 Time 11 A.M. 11. It is hereby agreed to station a guard on the premises to be fumigated during the fumigation period and to post suitable placards at each entrance into the building bearing the following words in letters at least two inches, by one inch in size: "DANGER - THIS BUILDING UNDER FUMIGATION WITH A DEADLY GAS ". 12. It is hereby agreed to make such provisions that all openings into the building may be opened from the outside after the period of fumigation is over and to take such other precautions as may be necessary to insure that all of the fumigant is removed from the building before anyone is permitted to enter. 13. It is hereby agreed to notify the County Health Department when the building has been repay d for fumigation. Orlin Exterminating Company, /no. FIRM NAND ADDRESS 509 N.E. 13 street, lliami,Fla. Signature of Certified Pest o trol� Operator in charge of this fumigati job, ADDRESS A P P L I C A T I O N FOR PERMIT TO FUMIGATE WITH CYANIDE METHYL BROMIDE ACRITET APPLICATION NO. DATE Aug.11.1958 I, Location of building to be fumigated 1042 N.E 95 street, 'Tjami Shores,Fla. 2. Name and address of owner of premises S. Powers, same 3. Type, size and construction of building 4, Is entire building to be fumigated? 50 if npt, state what portion 6. Approximate number of cubic faat�o pace in building or in portion t� be fumigated 7. Kind and quantity of fumigant to b� e lasad and manner of application and length of fumigation period LL Gas 48 hours 8. Distance of nearest building and direction from building to be fumigated 20 Ft. East and Wes: 9. In what manner will vents to exterior of building be sealed? Nylon Tent 10. Date when fumigation will be begun' • 13 Time 11•00 k.M. 11. It is hereby agreed to station a guard on the premises to be fumigated during the fumigation period and to post suitable placards at each entrance into the building bearing the following words in letters at least two inches by one inch in size: "DANGER - THIS BUILDING UNDER FUMIGATION WITH A DEADLY GAS ". 12. It is hereby agreed to make such provisions that all openings into the buildin may be opened from the outside after the period of fumigation is over and to take such other precautions as may be necessary to insure that all of the fumigant is removed from the building before anyone is permitted to enter. 13. It is hereby agreed to notify the County Health Department when the building has been prepared for fumigation. FIRM NAME Orkin Exterminating Company, Inc. sc • • , M .N'i' ! a. one story C.B.S. Res. yes 4 Signature of Certified Pest Cont Operator in charge of this fumigation 5 FOR PERMIT TO FUMIGATE WITH CYANIDE METHYL BROMIDE ACRITET APPLICATION NO. — DATE AUg. 20.1953 4, Is entire building to be fumigated? 5 If not, state what portion A P P L I C A T I O N 1, Location of building to be fumigated ' L.110: . Street,i llia a rore3,Fla. 2. Name and address of owner of premises i. Noou's, satae 3 Type, size and construction of building One story 0i 6 , ye r3 6. Approximate number of cubic feet of space in building or in portion to be fumigated 350000 7. Kind and quantity of fumigant to be used end manner of application and length of fumigation period Aerat 43 dour 8. Distance of nearest building and direction from building to be fumigated 20 ft, east and crest 9. In what manner will vents to exterior of building be sealed? 4 on. T ont 10. Date when fumigation will be begun � 226195 Time 11 A.d:W'. 11. It is hereby agreed to station a guard on the premises to be fumigated during the fumigation period and to post suitable placards at each entrance into the building bearing the following words in letters at least two inches by one inch in size: "DANGER - THIS BUILDING UNDER FUMIGATION WITH A DEADLY GAS". 12. It is hereby agreed to make such provisions that all openings into the buildin may be opened from the outside after the period of fumigation is over and to take such other precautions as may be necessary to insure that all of the fumigant is removed from the building before anyone is permitted to entor. 13. It is hereby agreed to notify the County Health Department when the building has been prepared for fumigation. FIRM NIU€ Orkin Exterminating Compa , Inc ADDRESS 309 17.1 t 13 Street, IFq ati • / �I► Signature of Certified Pest C. #'ol Operator in charge of this fumigatio BUILDING [;X MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL ❑ Date J,� �- 19 PLUMBING ❑ PERMIT N 8769 Contractor's ROOFING ❑ License No. (; Q Work to be performed under this Permit Owner of Building �' L Architect Contractor /- "-=— j or Builder / , 1 Z l _ „ . ' - - -- ____ Legal Lox i Description 11 B1 Address of , .G - r' . Building /''. - / ■ i 415' / i ` - .? 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 applica- tion 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 • � r �s� e , (/ + Y (INSPECTOR) BY In consideration of the issuance to me of this perms agree to perform the work covered hereunder in compliance with all ordinances and regulation, pertaining thereto and in strict conformity with the plans, awings, 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. i CONTRACTOR or BUILDER /i Subdi- vision Sq Ft Value of _ 1 Amount of Project $ -� 11 Permit $ BY AUTHORITY MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL El 195! PLUMBING ❑ PERMIT N° 7661 Contractor's License No ROOFING ❑ ❑ Work to be performed under this Permit Owner of Building Architect contractor or Builder Legal Description Address of Building Lot Bl. Subdi- vision Sq. Ft 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. CONTRACTOR OR BUILDER BY AUTHORITY No. STREET PART OF LOT LOT BLOCK SUBDIVISIQN / ROOF COST OP BUILDING �f �� ®� PERMIT FEE - ... 4 FRONT DEPTH HEIGHT STORIES TYPE OF C STRyCTION BUILDING TO BE USED FOR ROOF COST OP BUILDING �f �� ®� PERMIT FEE - ... 4 (/ i d Fralese dcf oncrete, Stucco � ReafB�DCe; &b., Stores, Hotel QQ BUILDING PERMIT Miami Shores Village, Flojida, - 2`t Owner of Building Architect Contractor or Builder 4. ; PROPOSED LOCATION DESCRIPTION OF BUILDING 7' permit � � This ermit is issued to the building above described, as per appli Plans and Specifications eret ore filed in this office. This permit is granted upon the express condition that all facts stated in the application are true and that the construction complies strictly with the plans and specifications submitted, and in accordance and compliance with the building laws of the State of Florida and with the building ordinances and zoning law of Miami Shores Village, and rules and i i , ulations of the building department of Miami Shores Village. This permit may be revoked at any time u.." the violation of any provisions of said s, ordinances or rules and regulations, or upon any change in the plans and specifications �° � : f the building inspector. ..� s s V MIAMI SHORES VILLAGE OFFICE OF BUILDING INSPECTOR / / )`a ,19 )xt° 322 BUILDING INSPECTOR In consideration of the issuance to me of this building permit I hereby agree to do the proposed construction in strict conformity with the application and plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the builig de rtment of Mia ,Shores Village. Dated p ,/i , 19 / � (SEAL) NO. STREET ` „1' PART OF LOT LOT BLOCK ROOF C SUBDIVISION / 4 / . f F RONT D DEPTH H HEIGHT S STORIES T TYPE OF CQN*TI$JCTION B BUILDING TO BE USED FOR R ROOF C COST OF BUILDING P PERMIT FEE 4 / . BUILDING PERMIT Owner of Building 1 Architect Contractor or Builder ( ,r t DESCRIPTION OF BUILDING This permit is issued to y .- the building above described, as per application, Plans and Specifications heretofore filed in this office. This permit is granted upon the express condition that all facts stated in the application are true and that the construction complies strictly with the plans and specifications submitted, and in accordance and compliance with the building laws of the State of Florida and with the building ordinances and zoning law& of Miami Shores Village, and rules and regulations of the building department of Miami Shores Village. This permit may be revoked at any time upon the violation of any provisions of said laws, ordinances or rules and regulations, or upon any change in the plans and specifications unanthoclzed the building inspector. In consideration of the issuance to me of this building permit I hereby agree to do the proposed construction in strict conformity with the application and plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the building department of Miami Shores Village. , Dated /,14 IL / _ = ' , 19 X4/4 PROPOSED LOCATION MIAMI SHORES VILLAGE OFFICE OF BUILDING 1N$PECTOR Miami Shores Village, Florida, , 19 i � fjf 4f / To m -�C N9 322 BUILDING INSPECTOR (SEAL) Zrrie ^ubage required Distance to next nearest building. . Malzimum live load to be borne by each floor STATE OF 1;T,ORIDA, Ct)UNTY OF DADE. ss. MIAMI SHORES VILLAGE BUILDIN INSPECTION DEPARTMEN• APPLICATION FOR BUILDING PERMIT Application is hereby made for the appro% al of the do-, iled stateniew of the plans and specifications herewith submitted for the build- !nr; or o h.- - , :ructure her i described This nlicatie is made in complianc-e and con o-m ty w.th the Building Ordinance of Mia -ii liliores Village, 1- .or da, and all pro- isions of tlic Law, i f the Stm& of hkrid. all o d nances of Mi in Shores Village and all iules and : of the Building Div: ; i of : ,ram Sho, - illage h '1 ,e -To, iphed with, whether herein specified or not. A copy ot approved . and specificati ins must be key at bund;iig durin progress of the wcrk. .,:, 1-- L • '-. ' 2 .-' / f)?-. , ------ Date Owner'. Name and Address.__ _ ...... . . _ ___---.'._._ ____ ..____ ' Registered Architect and/or Name rid address of Been-ed contractor e:_-4. _i' - - s Location and legal description of lot to be built on: I-ot Block.. Subdivision c-- Street and Number where work is to be done ./ 6 L a / • e-_:. . State work to be done and purpose of building (by floors) . and for'no other purpose. New Building_ Remodeling Addition . .. __ _ Repairs . . - No. of Stories To be constructed of . Kind founda n , Roofov liart estimated - tal cost of improvements $ _ •1119__(2). Amount c .c. Permit $. . ___ hereby submit all the plans and specii,-ations for said building All notices with reference to the building and its construction may scat _ _ _ _ _ _ _ _ . _ _ _ fb unde signed appli ant for th's bolding pc-mit does hereby certifv iliat he understa"ds and accepts his ,bligations as an employ or bor under he Florida Workmen s Compensation Act brig S- ton ",(163 Cie n led Ct, al Laws of Florida P r alien cent, r:nd h s compl ed w;th he prov':ions thereof, and will require smilial coi . ran e from a:1 contractors or sub-contractor. cmplo -ed by him in CiL wo k to be p rk med under th s pern it and Al post or (au to ':e r f.r iaspectipn on the site of the work su -h public not- e otkes as are requir d by the Act. The u. , l,r ign .d agrees to emplo) only sih ibcontr ors, on work to fbe perforn. d der this ricrip :. as are licensed by M am. Shores il• ge. Ref. ( S'g-ted) ....... .- • ■ ■__ --■■ PLANNING BOARD _Plan Cubage Size of Building Lot No.__ ............... Street_ .._ Notary Public State of Florida if:;) - 7 / Read, Sworn to and Subscribed before me. / .19 . Before me, the undersigned authority, a notary public, duly authorized to achu.nister oaths nd take acknowledgments, pi to me well known, CM! vho, being by me first d lv sworn, upon oath deperes and says that he is the . of abov de y. ibed istruction t. 1 has caretally read the foregoing application, and that he did sign the same, and 11 at :acts thercin by him stated are tr ie. Pmt No_ "":.4; . Date. Disapproved _ ... ..... (Signed) Build" nspector My Com:rus- ion Expires ... DATE Chairman .. Member Member Member Member Membe Council Approved Doc Diar u Date NOTE: A charge of $1.00 will be made for making corrections c- -lianges to this application .ft..r approval 1. s 1 c. n i-hta-iied from tht Plain' ng Board A, re-inspection fee of $1.00 will be charged when such re-inspection is m: ntres ,ar) by improper noticc li r insp. t' v or ft- ty ntr-tcrials and/or workmanship. "c A ', c e/2 crA/ le e) o /�r T '7 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 regulations of the Building Division of Miami Shores Village shall be complied with. whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address Registered Architect and/or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: 0 r.p Lot Block Subdivision Street and Number where work is to be done �/ 2 C- 9 6 State work to be done and purpose of building (by floors), state exterior colors (submit samples) and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation d�o�h.f Covering Estimated Total cost of improvements S /A4'' Cd Amount of Permit S Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all 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 obligatons as an employer of Labor under the Florida Workmen's Compensation Act. being Section 5966. Compiled General Laws of Florida. Permanent Supplement, and complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be perfor on the site of the work such public notice or notices as are required by the Act. The undersi under this permit. as are licensed by Miami Shores Village. Remarks (Signe STATE OF FLORIDA COUNTY OF DADE. Permit No. Disapproved (Signed) } SS. ro 1 Loci Date! Date Date) rss<! 19 g � No / e, Street .' (�� "� =7 . �s Read, Sworn to and Subscribed before me. permit: and will post or cause to be posted for inspection employ only such- stjbcontracto on)vork to be performed Before me. the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared to me well known. and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of 525.00 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 S25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 04/21/03 MON 11:54 FAX 954 578 1042 MIAMI-DADE POLYFOAM PRODUCTS, INC. PRODUCT CONTROL NOTICE OF ACCEPTANCE Polyfoam Products, Inc_ 2400 Spring- Stuebncr Road Spring ,TX 77383 -1132 The expense of such testing will be incurred by the manufacturer. ACCEPTANCE NO.: 01- 0521.02 EXPIRES: 05/10/2006 APPROVED: 06/14/2001 Raul Rodriguez Chief Product Control Division THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS BUILDING CODE & PRODUCT REVIEW COMMITTEE This application for Product Approval has been reviewed by the BCCO and approved by the Building Code and Product Review Committee to be used in Miami -Dade County, Florida under the conditions set forth above. Francisco J. Quintana. R.A. Director Miami-Dade County Building Code Compliance Office 1110 4500011pc20001 \templataslnodce acceptance cover page.det Internet mail address: postmaster ®buildingcodconline.com h itn� / /tvtv.r 1+„il,linnrnilnn..1 ....• V V L MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE MI_TRO -DAD(; FLAMER BUILDING 1.10 WEST FLAGLER STREET, SUITE 1603 MIAMI. FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 CONTRACTOR LICENSING SEC 110N (305) 375 -2527 FAX (305) 375 -2558 • CONTRACTOR ENFORCIiI D IVISION (305) 315 FAX (305) 375 - 2908 PRODIJCI' CONTROL DIVISION (305) 375 -2002 FAX (305) 372 -6))9 Your application for Notice of Acceptance (NOA) of: Two Component Polyurethenc Foam Adhesive under Chapter S of the Code of Miami-Dade County governing the use of Alternate Materials and Types of Construction, and completely described herein, has been recommended for acceptance by the Miami -Dade County Building Code Compliance Office (BCCO). under the conditions specified herein. This l4OA shall not be valid after the expiration date stated below. BCCO reserves the right to secure this product or material at any time 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 suspend the use of such product or material immediately. BCCO reserves the right to revoke this approval, if it is determined by BCCO that this product or material fails. to meet the requirements of the South Florida Building Code. POLYFOAM PRODUCTS, INC. Polyfoam Products.; Inc. ACCEPTANCE No.: 01- 0521.02 04/21/03 MON 11:54 FAX 954 578 1042 r ROOFING ASSEMBLY APPROVAL Category: Roofing Suh -Cates ory: Roof Tile Adhesive Materials: Polyurethane 1. SCOPE This approves Polypro® A1 as manufactured by 1'olyfoam Products, Inc. as described in Section 2 of this Notice of Acceptance. For the locations where the design pressure requirements, as determined by applicable building code, does not exceed the design pressure values obtained by calculations in compliance with Roofing Application Standard RAS 127, for use with approved flat, low and high profile roof tiles system using • Polypro® AH 160. Where the attachment calculations are done as a moment based system for single patty placement, and as an uplift based system for double patty systems 2. PRODUCT DESCRIPTION Manufactured by Test Product Applicant Dimensions Specifications Description Polypro® AH 160 N/A PA 101 Two component polyurethane Foampro® RTF1000 N/A Dispensing Equipment ProPack® 30 & 100 N/A Dispensing Equipment 2.1 Components or products manufactured by others: Any Miami -Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list uplift resistance values with the use of Polypro Ail f60 roof tile' adhesive. 2.2 Typical Physical Properties: Property Test Density ASTM D 1622 Compressive ASTM D 1621 Strength Tensile Strength ASTM D 1623 Water Absorption ASTM D 2127 Moisture Vapor ASTM E 96 Transmission Dimensional ASTM D 2126 Stability Results 1.6 Ibs:JR.' .18 PS1.Parallel to risc 12 PS1:Perpendicular to rise 28• PS1 • Parallel to risc 0.08 Lbs./Ft .3.1 Perri / Inch Approval Date: .June 14 2001 Expiration [)ate: May 10, 2006 +0.07% Volume Change n -40 F.. 2 weeks +6.0% Volume Chan c Humidity. 2 weok, • Frank 7_uloaga, RRC Product Control Examiner LeJ uus 04/21/03 MON 11:55 FAX 954 578 1042 POLYFOAM PRODUCTS,INC. t'olvfoam Products, inc. ACCEPTANCE No. : 01- 0521.02 Note: The physical properties listed above are presented as typical average values ns determined by accepted ASTM test methods and are subject to normal manufacturing variation. 3. LIMITATIONS 3.1 Fire classification is not part of this acceptance. Refer to the Prepared Roof Tile Assembly for fire rating. 3.2 Polypro® AH160 shall solely be used: with flat, low, & high tile profiles. 3.3 Minimum underlayments shall be in compliance with the Rooting Application Standard RAS 120. . 3.4 Roof Tile manufactures acquiring acceptance for the use of Polypro® AH160 roof tile adhesive with their tile assemblies shall test in accordance with PA 10E. 3.5 Roof Tile manufactures acquiring acceptance for two paddy placement with the use of Polypro® AH160 roof tilt adhesive with their tile assemblies shall test in accordance with PA 101 and with section 10.4 as modified herein. -w ' 2 Ms 4. INSTALLATION 4.1 Polypro® AHI60 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of Polypro® A1-1160. 4.2 Polypro® AH160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of Polypro® AI - 1160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the uplift resistance determined in compliance with Miami -Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA 4.3 Polypro® AH160 roof tile adhesive and its components shall be installed in accordance with Rooting Application Standard RAS 120, and Polyfoam Products, Inc. Polypro® AH160 Operating Instruction and Maintenance Boolc.let. 4.4 Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, Inc. Polyfoam Products Inc. shall supply a list of approved applicators to the authority having jurisdiction. 4.5 Calibration of the Foampro® dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the "B" component shall be maintained between 1.0 -1.15 (A) : 1.0 (B). The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved. ' 4.6 Polypro® Al -1160 shall be applied with Foampro RTF1000 or ProPack® 30 & 100 dispensing equipment only. 4.7 Polypro® A1.1160 shall not be exposed, permanently to sunli 3 Pram: Zuloaga, RRC Product Control Examiner leU1)4 Table 1: Adhesive Placement For Each Generic Tile Profile l ileProfile Placement Detail Single Paddy weight : Min. (grains) Two Paddy weight per paddy Min. (grams) flat, Low, High Profiles 01 35 N/A High Profile (2 Piece Darrel) # t 17 /side on cap and 34 /pan N/A Flat, Low, High Profiles ii2 24 N/A Flat, Low, High Profiles #3 8 04/21/03 MON 11:55 FAX 954 578 1042 PolMfoam Products, Inc. POLYFOAM Y1tuDUl 1'J , ii . . ACCEPTANCE No.: 01- 0521.02 4.8 Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after Polypro® AH 160 has been:dispensed. 4.9 Polypro® AH 160 placement and minimum patty weight shall be in accordance with the 'Placement Octails herein. Each generic tile profile requires the specific placement notcd herein. 5. LABELING All Polypro® AH160 containers shall comply with the Standard Conditions listed herein. 6. BUILDING PERMIT REQUIREMENTS 6.1 As required by the Building Official or applicable Building Code in order to properly evaluate the installation of this system. FrankLuloaga, RRC Product Control Examiner V V V 04/21/03 MON 11:55 FAX 954 578 1042 Polvfoarn Vroduc'ts, Inc. Nall through plastic cenwnt Pot 10 (Beneath Tile) Underlapnem 1 Eno DWI/ 10 im Cave Clain DI edam only; Keep adhesive appeal. 4 In. up from weepholes Nall through plink cement Undedapnon1 EM Cu, 101i. Ewe course only; Keep adsttive spins. 4 In. up from weeoholes Paddy (Beneath Tilo) Faith Ens Dom POLYFOAM PRODUCTS, INC. . : ! • ADHESIVE PLACEMENT DETAIL 1 SINGLE PATTY ACCEPTANCE No. : 01-0521.02 I) Place enough adhesive to achieve 17 In 23 gentelnches In nested with the pan ille ' Then Wall Ille tie To 1 In. fr011i ouUlde 1 . 1 edge ol cow We. I) Turn covets upside down. Puce ghetto. I f2111 fL \ elift°'*W Ag... . .,,. options 2tes ot Map p1 ch application; 14.11 through plastic centenI Undetfaymont 1 ROMP JueT704 the ere ceerse covet We. Mee ( 2 record cows. of Om Mos. Ensure em end ol pal and covet SW ire Push 31 fat I WO. Eton eleven! prow 'holm) 5 Vieephole Food, Bo Frank Zuloaga, RRC Product Control Examiner Woad PolnPup Mono on keiltudloat • edges of too Sheathing Lei 1) 04/21/03 MON 11:56 FAX 954 578 1042 PolYfoarn Products, Inc. ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY Nail through plastic cement Undedayment Eave Cows& POLYFOAM PRODUCTS, INC. 6 ACCEPTANCE No.: 01- 0521.02 Nall through plastic cement Unde►Iaymenl 1 : Ent Count Paddy (Beneath TU.) Fascia Weephde Eno closure Drip edge Paddy (Benea Tl le) Fascia Ens Cloture Frank Zuloaga, RRC Product Control Examiner tom/. uu '/ 04/21/03 MON 11:56 FAX 954 578 1042 Polvfoam rroduits, Inc. Single paddy on lop of tile Fare Course POLYFOAM PRODUCTS, INC ADHESIVE PLACEMENT DETAIL 3 DOUBLE PATTY Nall through plastic cement Single paddy on under. layment Eave course 2 in. X7 in. medium size paddy ears Fasda course, only ' * Nail through plastic cement Underlayment Single paddy on under- layment Single paddy under tile Sin* paddy on top of Ille Faye Course 7 ACCEPTANCE No. : 01-0521.02 Single paddy between the Eave Closure 2 In. t 7 In. medium s ae paddy eave course only Fascia Single paddy under the Single paddy between the 2 In. r 7 in. median she paddy save course only Prank Zuloaga, RRC Product Control Examiner lel U Fasda weephole Eave closure Drip edge 04/21/03 MON 11:56 FAX 954 578 1042 POLYFOAM PRODUCTS,INC. • Poyfoam Products, Inc. ACCEPTANCE No.: 01- 0521.02 1. Renewal of this Acccptancc (approval) shall be considered after a renewal application has been filed and the original submitted documents, including test- supporting data, engineering documents. are no older than eight (K) years. 2, Any and all approved products shall be permanently labeled with the manufacturers name, city, state, and the following statement: "Miami -Dade County Product Control Approval ", or as specifically stated in the specific conditions of this Acceptance. 3. Renewals of Acceptance will not be considered if: a. There has been a change in the South Florida Building Code affecting the evaluation of this product and the product is not in compliance with the code changes. b. 'laic 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 the correct installation of the product. d. The engineer who originally prepared, signed and sealed the required documentation initially submitted, is no longer practicing the engineering profession. 4. Any revision or change in the materials, use, and/or manufacture of the product or process shall automatically be cause for termination of this Acceptance, unless prior written approval has been requested (through the filing of a revision application with appropriate fee) and granted by this office. 5. Any of the following shall also bc 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 other purposes. 6. The Notice of Acceptance' number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is displayed, then it shall be done in its entirety. 7. A copy of this Acccptancc as well as approved drawings and other documents, where it applies, shall bc provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at all tine. The engineer need not reseal the copies. 8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of Acccptancc. 9. This Notice of Acccptancc consists of pages 1 through 8. END OF THIS ACCEPTANCE Frank Zuloaga, RK.0 Product Control Examiner 10 009 MIL Miami Shores Village Building Department . . • BUILDING CRI QUE SHEET 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: "(3 05) 7952204 Fax: (305) 756.8972 Perniit No: : • - . X 'STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, ,'H/ 4 does hereby attest that the (property owner) attached survey, performed by (name of surveyor's company) performed on , is an accurate representation of the existing conditions and (date of survey) locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than six (6) months old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits.. Further, Affiant sayeth naught. Witness(sign and print) orx-e2AL,c,_ Affiantoperty owner Witness(sign SWORN TO UBSCRIBED before me this day of Affiant is personally known to me, produced i\nodn M Bsckzr U� j t,c nnn p Ottpires Rovzm 95, 2C126 • • BUILDING PERMIT APPLICATION FBC 2001 Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES NO Contractor's Company Name ---1 C }{M,CM C ,1)"(114.10( )6vtS $ Value of Work For this PermiV\ 7 p o 0 Type of Work: Describe Work: ("C.. -I l g - Submittal Fee $ , .00 Code Enforcement $ Notary $ Scanning $ Total Fee Now Due $2 2 j b , (Continued on opposite side) Miami Shores Village RECEIVED IVE Building Department JAN R 2004 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ti Tel: (305) 795.2204 Fax: (305) 756.8972 ice_ Radon $ 4 - 2 - , i . N s Structural Nan Review. $ 3 7' o z' Permit No. 80-CC 4- t3 Master Permit No. Plumbing Mechanical Roofing Permit Type (circle): ( Building Electrical Owner's Name (Fee Simple Titleholder) Phone # Owner's Address ID4' ti cif City State ft, Zip 2, 01 Tenant/Lessee Name Phone # County Miami -Dade Zip Phone # 7 Q)e 1--86 c ej lc; " Contractor's Address City t- 41tlt't■ State Pt Qualifier IZ 4/2a/4 4)411 Zip Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: ❑Addition ❑Alteration ❑New ❑ Re air/Repl e . ❑ Demolition 1411 02 SeO (3 . -- 4 t pg- * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit Fee $ g `0 / t n CCF $ 4i do Training/Education Fee $ /, 4 tJ Technology Fee $ - r°7` , Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature ` Signature r Owner or Agent The foregoing instrument was acknowled ed before me this 6 day of / y , 20(22 3 , by who is personally known to me or who has produced As identification and who did take an oath. APPLICATION APPROVED BY: Chc 10/14/03 NOTARY Sign: / cA Ny c, W, salon Print: 4 „de My Commission Expires: 212772 ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. **************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** JAN 2 6 2004 /(3�0 IL 5h1 f i Plans Examiner Engineer Zoning i / 7 / Contractor The foregoing instrument was acknowledged before me this l 1 day of / Z. , 20l?'> by who is personally known to me or who has produced as id" who did take an oath. NOTARY PUBLIC: • my Comm on o0212772 Sign: Print: �,/Lo My Commission Expires: a Signature BUILDING AND ZONING DEPARTMENT 10050 N.E. SECOND AVENUE MIAMI SHORES. FLORIDA 33138-2362 TELEPHONE (305) 795-2204 FAX (305) 756-8972 RECEIPT l I, Jo . g e contractor /owner, picked up 2 sets of plans for (address) /0.2 /i)tf 1S �1 from the Building and Zoning Department on (date) to have corrections done to plans and/or get County stamps. I understand that the plans need to be brought back to Miami Shores Building and Zoning to continue the permitting process. • 5,e1 I BUILDING PERMIT APPLICATION FBC 2001 Contractor's Company Name Submittal Fee $ - City N 1 14-i l • )/\ • State "1'Z_ . Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type (circle) Building Electrical Plumbing Mechanical Roofing f I � /t'�� Owner's Name (Fee Simple Titleholder) ., 1 ; C ')1() LC lt'�., f t Jr 1 P. U,Y7,'IttiPhone # Owner's Address '0 41- t\1 = `� f4 Job Address (where the work is being done) (0 ¢ �_ N E c4 j 72 -Mori C J r/n`oVJ Total Fee Now Due $ (Continued on opposite side) - . 1 C i (l t 3 1 q C Permit No. h j I Z(, .� Master Permit No. ) I • O 04' d Zip Tenant/Lessee Name Phone # City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO L Contractor's Address City State Zip Qualifier Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Square Footage Of Work: Type of Work: ['Addition ❑Alteration ENew ❑ Repair/Replace ❑ Demolition Describe Work: E G'1 fl . ' lb) VL • 01•1‘1 f thy (J C.; * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * ** * * * * * * * * * * * * * * * ** Permit Fee $ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Zon}in B d $ Code Enforcement $ Structural Plan Revie Phone # CCF$ CO /CC Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is•issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature • Signature X/ O wner or Agent Contractor Before me thi ent was acknowledged before me this /7 The foregoi g instrinnent was acknowledged The tore o day of , 4 -' , 20 &y, by,x K.CWI O / Ciflet i , day of , 200 (1, by`.6,, -,:d 1 1 who is person y kno tame or who has produced wh 's per k m o;me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: : NOTARY PUBLIC' l Sign: (..t= e —��_, L%r-e -- % Sign: C � ��- _ � � %G Print: ', Print: My Commission Expires: ''" My Commission Expires:' * * * * * * * * * * * * * * * * * * * * * * * * * * * * *«** * * * * *11 * * * ** ****, y*** * * * * * * * * * * * * * * * * * * * * * ** * * ** ** A a *gQ :* P4 i t * * ** ' (Certificate of Competency Holder) `` C r, ,, State Certificate or Registration No. Certificate of Competency No. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 12/15/03 Plans Examiner Engineer Zoning Date Type Insp'n Permit No. Name Address Company Phone # Inspection Date Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buildin _ : e Re- Insp'n Fee ❑ x /12_ o Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 - 795 Building Inspection Request Type Insp'n OC' r Permit No. ?Q 04- Name aribW rG . Address 1042 1V E q 5 Company kICY) M&C Phone # o4 Inspection Date C_la° MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305-795 ; Building Inspection Request Date Type Insp'n aa 1v r Permit No. ?) V 04`° Inspection Date Approved Correction Re- Insp'n Fee Name 1Ct)(,.9 Address Company k). c ti ` c Phone # Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Dated Type Insp'n Permit No. j P 0\4 / \t - 13 Name Address Company CAA Phone # oS 9 b 3— O3 Y Inspection Date )17 1 � •1 d A 1 Building InspectSf ; n ,' ?/04 Date „� I Type Insp'n Permit No. l 0 ! °2 / Name Address �_� )_ � ( -\, �� 1 Company I �� �. A �\ Phone # ; �) S i J (D ? )� I ” Inspection Date _ 0`( Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 ro ivo p OWNER'SNAME Y Qisoa iii �,(��f P I R � ESE / NTT ADDRESS /94 M 9rs2 LICENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) LOT BLOCK SUBDIVISION GENERAL CONTRACTOR y/y TTE.e ADDRESS PHONE NO. 7 /DEff LICENSE NO. � G PERMIT NO. �! i �� REQUIREMENTS DATE `044"7 CU. FT. PLAN PERMIT FEE S/6 7'5.4) CUBE CU. FT. BUILDER'S BOND NO. DATE r(D EST. COST $ ":74:F IL.. CS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: DATE ' W CONSTRUCTION TYPE `w STORIES / ROOF CONSTRUCTION / /lE INTERIOR CONSTRUCTION TL f, we 1 ZON? DRAW:\ REPAIRS ALTERATION ,yL v t' //p r 9 T _�A D D I TI O N ,I', /7 /0// % .45 /sT //! 9 �g+G 4 C. 94; /C'4) ,%'. j /� V/ ,aJ/.E3 & P4- /.vSf SUE)MITTI - D TO PL- /MifFFNGG BOARD RE- SUBM!TTL'D TO PLANNING BOARD SUWMITTED TO VILLAGE COUNCIL APPROVED REJECTED REFERRED TO COUNCIL REASONS /O 4 CERTIFICATE OF OCCUPANCY NO. ISSUED BY TO BUILDING PERMIT AND INSPECTION RECORD - MIAMI SHORES VILLAGE DESCR IPTION DESCRIPTION REMARKS INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION /�1/ J 6& $ H. W. HEATER CONN. BEAMS & LINTELS S RANGE CONN. S FRAMING S FIXTURES S INSPECTIONS DATE FINAL RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE CLEAN -UP ROUGHING �1� �� //, T / PLUMBING PERMITS & INSPECTIONS CONTRACTOR PHONE PERMIT NO. DATE FEE $ NEW BLDG. I ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE S SEPTIC TANK S SEWER $ SOLAR HEATER FIXTURES & FINAL $ GAS $ S INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING CAS SEWER SEPTIC TANK SOLAR HEATER FIXTURES CONTRACTOR //A C:!) PHONE if- (; 15 fie cl,y PERMIT NO. A-¢ DATE FEE$!BO REPAIRS r ,,��7% NEW BLDG. I ALTERATION ADDITION X SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. S RANGE CONN. S MOTORS S FIXTURES S INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING �1� �� //, T / G C h/•S H. W. HEATER CONN / RANGE CONN. FIXTURES & FINAL BUILDING INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE !BY LOCATION 104:2 °'' • • 95th utreet GARBAGE TAX RECORD PAID BY YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER i ..- • (/ / , . 1940 / .°-- /...2. 6 / o ; ,ra �� Val .1 Y'o 0,'..a7- ", S /� � �''�� /'ea 9i y` .. 7 _ l .� 4./ > � (� � /. � � iii o) 1941 / 0,/ et . f // /V ,, /� lC..�s� � °�.-�.�d��ss� - '. � �_1 9 6' 1942 4 f ar �,. •, r/� /4 /� � �G(/ 1943 _/d -0 o O 0 / zr Vary .2 '.J7 )7 r c� / Z(1 1944 _ . i i • If (1 ) 1945 lO . 0` ,f 1 if T s 6 C/`Z7 ---d 1946 /d . rnt i - ,` i-4 '79 `y 1947 / ‘''.© Z1 V '.- (fir g, n ■,. 1948 1 949 f. a /-..?...,./--5,,,)--- / J - 1/ fir /.. 5 ' q 1,, , , /--/.. / f- y -o / / /) /a Zoe d a ft 4, / / If 1950 � f LOCATION 104:2 °'' • • 95th utreet GARBAGE TAX RECORD 1042 N. E. 95th St. by year annual tax period used amount paid date paid receipt # E. Yarbrough /c1- 3/ -' /a -O'° r : / -7 l /5954 /1 10A la = )a, 9/• tea , Name Address Company MIAMI SNORES VILLAGE BUILDING DEPARTMENT 305-795-2_ Building I spec t equest Dat r 0' aDa. Inspection Date Approved Correction Re- Insp'n Fee Permit No. -� P () L o ,E, s � P ' cz\t„4 Phone #