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135 NE 94 St (14)Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10 /5/2005 Applicant: FLORENCE Owner: BLACK - GORDON JOB ADDRESS: 135 NE 94 Parcel # 1132060132881 Plumbing Permit Permit Number: PL2005 -297 BLACK - GORDON FLORENCE ST Contractor RJJ PLUMBING CONTRACTOR CORP Contractor's Address: 2970 W 84 ST UNIT 3 Local Phone: Page 1 of 1 Legal Description: 1 53 41 & 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 19 & E3OFT LOT 18 BLK Fees: FEE2005 -13154 FEE2005 -13155 FEE2005 -13156 FEE2005 -13157 FEE2005 -13158 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: Amount $140.00 $0.60 $5.00 $0.20 $3.50 $149.30 Total Fees: $149.30 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 4/1/2006 Construction Value: $1,000.00 Work: INSTALL KITCHEN SINK, FAUCET, DISHWASHER AND ICE MAKER Signed: (INSPECTOR) L . Gym ��%s3a In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: b Passed Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Number: INSP -3942 Inspection Date: 12/22/2005 Inspector: Grande, Claudio Project: <NONE> Contractor: Building Department Comments Thursday, December 22, 2005 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Owner: BLACK - GORDON, FLORENCE Job Address: 135 94 Street NE Miami Shores Village, FL Block: Permit Number: BP2005 -1418 Permit Type: Imported Permit Inspection Type: Kitchen Cabinets Work Classification: Kitchen Cabinets Phone Number Parcel Number 1132060132881 Lot: Page 2 of 2 135 NE 94 ST FINAL KITCHEN CABINETS Passed Inspector Comments I tAA -- -o e� F � -- Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until i nspection Number INSP -3253 Inspection Date: 12/19/2005 Inspector: Grande, Claudio Owner: BLACK - GORDON, FLORENCE Job Address: 135 94 Street NE Miami Shores Village, FL Project: <NONE> Contractor: Building Department Comments Friday, December 16, 2005 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: BP2OO5 -1418 Permit Type: Imported Permit Inspection Type: Final Work Classification: Kitchen Cabinets Phone Number Parcel Number 1132060132881 Lot: Page 2 of 2 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10 /5/2005 Applicant: FLORENCE Owner: BLACK - GORDON JOB ADDRESS: 135 NE 94 Contractor Local Phone: Parcel # 1132060132881 Building Permit Permit Number: BP2005 -1418 BLACK - GORDON FLORENCE ST Contractor's Address: Page 1 of 1 Legal Description: 1 53 41 & 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 19 & E3OFT LOT 18 BLK Fees: FEE2005 -13170 FEE2005 -13171 FEE2005 -13172 FEE2005 -13173 FEE2005 -13174 FEE2005 -13175 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Scanning Fee Total Fees: Amount $100.00 $1.80 $5.00 $0.20 $2.50 $3.00 $112.50 Total Fees: $112.50 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 3/29/2006 Construction Value: $2,200.00 Work: KITCHEN CABINETS REMODELING J IT c e Signed: (INSPECTOR) In consideration of the issuance to me of this permit, 1 agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: 1350NE 94 ST FINAL INSPECTION FOR RAILINGS TILES IN PORCH AND q Passed a Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until �LOR►D/ Inspection Number: INSP -324 C Inspection Date: 12/16/2005 Inspector: Grande, Claudio Owner: BLACK - GORDON, FLORENCE Job Address: 135 94 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: Buildin Department Comments Friday, December 16, 2005 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: BP2005 -1420 Permit Type: Imported Permit Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060132881 Lot: Page 2 of 2 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: 1 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 Owner or Agent Contractor The for oing instrument was acknowledged before me this 2e) The foregoing instrument was acknowledged before me this day by YYC E ;1-f c:41 of , 20 by who is person • y known to me or who has produced who who is personally known to me or who has produced * * * * * * * * * * * * * * * * * * * * NOTAR chc 05/13/03 As identification and who did take an oath. as identification and who did take an oath. ,„dgigtitopAgie 'maim` T Sign: Print: My Co mission Expires: * * * * ** * * * * * * * * * * * ** ****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Signature NOTARY PUBLIC: Sign: Print: ************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** My Commission Expires: * * * * * * * * * * ** ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** // Oki Plans Examiner Engineer Zoning PERMIT APPLICATION SE, FBC 2001 Permit Type (circle): Building Electrical Contractor's Company NameCC-- $ Value of Work For this Permit / 0 0, 0 Total Fee Now Due $ r i Z V (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING girtnf 9 © Permit No:e4CE' 4 2-0 aster Permit No. Owner's Name (Fee Simple Titleholder) A 4(P e 54,17x5 Owner's Address 4t 9 47 S 7 City f(r /941 Ste` d State Tenant/Lessee Name Ay/ Job Address (where the work is being done) /35A/ City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO Type of Work: ['Addition ['Alteration ❑New Describe Work: /eEp //9 e L' pig / (, 1)7 S / p --/ e s Plumbing Mechanical Roofing L57 Phone# (. 0S) 2/5-7539 Zip 2 3/3 l' Phone # Phone # Zip .33/38 Contractor's Address City State Zip Qualifier State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: Pi if 7 . 6 / IiRepair/Replace ['Demolition fl el * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ /OOP — -- CO/CC $ j • .O CO /CC Notary $5 - CO Training/Education Fee $ O . 40 Technology Fee $ 2 .t7 Scanning $ 3 • Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ . • BUILDING DEPARTMENT 75 O being the legal roe owner, for the property I (� /��-� � g g property m' � Located at: OWNER BUILDER DISCLOSURE .STATEMENT Legally described as . Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S. 489.103(7)„rd I have read and understand the following disclosure Statement, which entitles me to cork as my own contractor, I further understand that I as the owner must appear in person to complete all applications. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two- family residence or a farm out - building. ' You may also build or improve a commercial building at a cost of 525,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is completed, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not Iicensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A. and with- holding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes and zoning regulations. Proof of ownership provided ( ) initial of reviewing clerk. Tit e foregoing instrument Was acknowledged before me this 2E3 day &pt , 20 By 4 Y who is personally known to me or who has Produced ID.. as identificat_ who did take an oath. Owner Owner VILLAGE OF MIAMI SHORES DISCLOSURE STATEMENT fo � JCp1_ i B onded 11;, - ;that, 11rtr j , . ,, Miami Shores Village Building Department BUILDING CRITIQUE SHEET 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. 0 5 /0 Job Name c5 Date l/3a /v,V g lotixe Awed .e-ctv.2e G#9 4J S fr 'o , ose2 td-Cus 7 a' /4 7- iu3s y / e91 42-0 Reviewer: Claudio Grande C.B.O 305 - 795 -2204 Ext 430 !c<v ',5 - - Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10 /14/2005 Applicant: FLORENCE Owner: BLACK - GORDON JOB ADDRESS: 135 NE Contractor Local Phone: Parcel # 1132060132881 Fees: FEE2005 -13531 FEE2005 -13532 FEE2005 -13533 FEE2005 -13534 FEE2005 -13535 FEE2005 -13536 Description Building Fee CCF Training and Education Fee Technology Fee Scanning Fee Notary Fee Total Fees: Amount $100.00 $1.20 $0.40 $2.50 $3.00 $5.00 $112.10 Total Fees: $112.10 Total Receipts: $0.00 BLACK - GORDON FLORENCE 94 ST Permit Status: APPROVED Permit Expiration: 3/29/2006 Construction Value: $1,100.00 Work: REPLACE RAILINGS IN PORCH AND REPLACE TILES Signed: (INSPECTOR) In consideration of the issuance to me of this permit, 1 agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) Building Permit Permit Number: BP2005 -1420 Contractor's Address: Legal Description: 1 53 41 & 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 19 & E3OFT LOT 18 BLK BY: Page 1 of 1 ,NOV0 2 PAID / cam , IN o te s S► ' Z- hi-- 3 3.E Top L , d 44) 6 X Co g o a ,: x Co �-O 4.L raw,, (i 124', 11 = s '// /;3 rt 3aJv57Lt 73741 f.ey � • s oc 1176 rp 9" Sphe.i.e. l.:/ (Ap eoti L -ND Gh 41.) 4,4 e 444, Ty, 41;10477011 I '1 F , / aen bm d w� r 1 M r , c I bn �7 ?�n7 9 2L // L am ` �j N NI 2,l MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date J / a Time Type Insp'n f S Permit No. P ) 9© z ' //3 Name "of`' ‘/ Address /3 5 / � LC/' Company $' S ! � 0/ Phone # 3 e � For Inspector: ,� — 75 Approved Correction ❑ Re- Insp'n Fee ❑ Date Type Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Approved Correction Re- Insp'n Fee - 3 or- 9V9_ p 00 For Inspector: L. 4":./S — ..0 ot Name e T S� I 261 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date - -" 1° dA. Time Type Insp'n �, �� .r� / Permit No. /Wee 02- ` J /-3 Name (3°0r h44, 13-C S'7 p e Address Company Phone # For Inspector: Approved Correction Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time D D Type Insp'n 1 lie I 0 Permit No , f capal Name r Addres Company Phone # L50 S For Inspector: Approved Correction Re- Insp'n Fee iifl ame & Date 1-1,7 Z b0 ;� ) ida- m rn2 r� s 0 v evevt s "Poot Any az Wed At ONOZ 5 ror art t 04 9t ?moo suomak aow 10)90.2301A010�t+ • • ... • ..... • • • • • ... • • • • • • • • • ..... .. • • ... • • • • ... • • • • • ... .... . . . . ... • .. • • • .. ... .. As,r+ at --- 'd 1100 atilt bL ria li 91. 101 10E3 314.04% oucemy Mode 2010 N An t. ` �QQ'O�i �uv v� "`� "' ..017 v ae�� .,y iiIIc3 • • • • 0 e • • • • • • 16 • • • • . • • • • • • • • • • • • • • • • • •. • •• • • • • •••• • •••• • • •••• • • ••• • • • • •••• • • •••• • • •• • • • • • • • • • • • •• . d• .y. FORM 600A -2001 FL IDA ENERGY EFFICIENCY CODE FOR =UILDINO CONSTRUCTION Florida Department of Community Affairs Residential Whole Building Performance Method A Project Name: Address: City, State: Owner: Climate Zone: TERRACE ENCLOSURE 135 NE 94 STREET MIAM SHORES, FL 33138 - Florence Gordon rESIDENCE South Builder: Permitting Office: Permit Number: Jurisdiction Number: MIAMI SHORES 1. New construction or existing 2. Single family or multi-family 3. Number of units, if multi-family 4. Number of Bedrooms 5. Is this a worst case? 6. Conditioned floor arca (ft 7. Glass area & `ype a. Clear glass, default U- factor b. Default tint c. Labeled U or SHGC 8. Floor types a. Slab -On -Grade Edge Insulation R0.0, 266.0(p) ft _ b. N/A _ c. N/A 9. Wall types a. Concrete, Int Insul, Exterior 1383.0 ft - b. Frame, Wood, Adjacent R0.0, 128.0 ft - c. N/A d. N/A e. N/A 0. Ceiling types a. Under Attic R =30.0, 2184.0 ft _ b. N/A c. N/A 11. Ducts a. Sup: Unc. Rct: Con. AH: Garage Sup. R=6.0, 50.0 ft L. N/A PREPARED BY DATE: stg . anc 0.0 ft 377.0 ft 0.0 ft Addition Single family 1 3 No 2100 ft . rh nc Pnn.: 0.0 ft 0.0 fie 0.0 ft I hereby certify that the plans and specifications covered by this calculation are in pliance with the Florida Energy Code. I hereby certify that this building, as designed, is in compliance with the Florida Energy Code. OWNER /AGENT: DATE: 12. Cooling systems a. Central Unit b. N/A c. N/A 13. Heating systems a. Electric Strip b. N/A c. N/A 14. Hot water systems a. Electric Resistance b. N/A c. Conservation credits (HR-Heat recovery, Solar DHP- Dedicated hcat pump) 15. HVAC credits (CF- Ceiling fan, CV -Cross ventilation, HF -WI ole house fan, PT- Programmable Thermostat, MZ- C•'Mlultizone cooling, MZ- H- Multizone heating) Glass /Floor Area: 0.18 Total as -built points: 31265 Total base points: 31967 PASS =ncrnu 4an .i A,nrcinr = r "D:. ! 1 Re Vi of 'e plans Ono sp* t`'; s gver4d;by this calaatio:i"ndi'C tes 0bmpliance h Energgy Code. cted for with Sectjfln 553.908 Florida Statutes. BUILDING OFFICIAL: DATE: Cap: 48.0 kBtu/hv - SEER:13.00 Cap: 32.0 kBtu/hr - COP: 1.00 Cap: 50.0 gallons - EF: 0.89 PT, I BASE AS -BUILT INFILTRATION Area X BSPM = Points Area X SPM = Points 2100.0 18.79 39459.0 2100.0 18.79 39459 0 Summer Base Points: 56294.1 Summer As -Built Points: 60974.3 Total Summer Points X System Multiplier = Cooling Points Total X Component Cap X Duct X System X Credit Ratio Multiplier Multiplier Multiplier (DM x DSM x AHU) = Cooling Points 56294.1 0.4266 24015.1 60974.3 60974.3 1.000 (1.067 x 1.165 x 1 00) 0.262 1.00 1.243 0.262 0.950 0.950 18887 4 18887.4 FORM 600A -2001 SUMME ' CALCULATE NS Residential Whole Building Performance Method A - Details I ADDRESS: 135 NE 94 STREET, MIAM SHORES, FL, 33138- PERMIT #: = ncrrn�:ai inc TR r, ^L ----' ;riot?, .'CiaC= ^ ")n!'. CI C"=C .. 11 BASE i AS- BUILT GLASS TYPES .18 X Conditioned X BSPM = Points Overhang Floor Area Type /SC Ornt Len Hgt Area X SPM X SOF = points .18 2100.0 32.50 12285.0 Single, Tint N 2.0 8.0 84.0 29.33 0.94 2316.7 Single, Tint N 2.0 4 0 15.0 29.33 0.84 368.2 Single, Tint E 2 0 4.0 76.0 65.40 0 74 3678 4 Single, Tint E 2.0 3.0 4.0 65 40 0 65 169.3 Single, Tint E 4.0 4 0 40.0 C5 40 0.03 1394.0 Single, Tint E 2.0 4 0 13.0 65.40 0.74 629.2 Single, Tint S 2.0 4 0 25.0 55.34 0.67 931.0 Single, Tint S 2.0 4 0 25.0 55.34 0 67 931.0 Sinole, Tint W 2 0 3 0 26.0 58.39 0.67 1009.7 Single, Tint W 2.0 3.0 4.0 58.39 0.67 155.3 - Single, Tint W 2.0 4.0 50.0 58.39 0 75 2188.5 Single, Tint W 2 0 3.0 15.0 58.39 0 67 582.5 . As -Built Total: 377.0 14353.8 WALL TYPES Area X BSPM = Points Type R -Value Area X SPM = Points Adjacent 128 0 1.00 128.0 Concrete, Int Insul, Exterior 0.0 1383.0 4.20 5808.6 Exterior 1383.0 2.70 3734.1 Frame, Wood, Adjacent 0.0 128.0 3 40 435.2 Base Total: 1511.0 3862.1 As -Built Total: 1511.0 6243.8 DOOR TYPES Area X BSPM = Points Type Area X SPM = Points Adjacent 0.0 0 00 0.0 Exterior Wood 20.0 9 40 188 0 Exterior 20.0 6.40 128.0 Base Total: 20.0 128.0 As -Built Total: 20.0 188.0 CEILING TYPES Area X BSPM = Points Type R -Value Area X SPM X SCM = Points Under Attic 2100.0 2.80 5880.0 Under Attic 30.0 2184.0 2.77 X 1.00 6049.7 Base Total: 2100.0 5880.0 As -Built Total: 2184.0 6049.7 FLOOR TYPES Area X BSPM = Points Type R -Value Area X SPM = Points Slab 266.0(p) -20.0 - 5320.0 Slab -On -Grade Edge Insulation 0.0 266.0(p -20.00 - 5320.0 Raised 0.0 0.00 0.0 Base Total: 5320.0 As -Built Total: 266.0 -6320.0 FORM 600A -2001 SUMMED CALCULATI•NS • Residential Whole Building Performance Method A - Details I ADDRESS: 135 NE 94 STREET, MIAM SHORES, FL, 33138- PERMIT #: - norn,,:_at,no( fl'' c..,,,, ann�_�nn• o ^o:. ,,: qr FORM 600A -2001 0 @NTEr CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 135 NE 94 STREET, MIAM SHORES, FL, 33138- PERMIT #: =norms-al inGfl fl ^L Cnrr.• RnnL_ - )nn' Mar-":i.G: Q" )nn^ GI D" „= 2f BASE AS -BUILT INFILTRATION Area X BWPM = Points Area X WPM = Points 2100.0 -0.06 -126.0 2100.0 -0.06 -126.0 Winter Base Points: 1347.3 Winter As -Built Points: 4565.1 Total Winter Points X System = Multiplier Heating Points Total X Component Cap X Duct X System X Credit = Heating Ratio Multiplier Multiplier Multiplier Points (DM x DSM x AHU) 1347.3 0.6274 845.3 4565.1 4565.1 1.000 (1.085 x 1.137 x 1 00) 1.00 1.234 1.000 1.000 0.950 0.950 5350.1 5350.1 FORM 600A -2001 0 @NTEr CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 135 NE 94 STREET, MIAM SHORES, FL, 33138- PERMIT #: =norms-al inGfl fl ^L Cnrr.• RnnL_ - )nn' Mar-":i.G: Q" )nn^ GI D" „= 2f FORM 600A -2001 WINTE r � CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 135 NE 94 STREET, MIAM SHORES, FL, 33138- PERMIT #: ;:nor.,,, = altriaPi . c., an -_1m =Horn,,: attnoThI i =c" ')nn< c. "'DP zr EASE AS -BUILT GLASS TYPES .18 X Conditioned X BWPM = Points Floor Area Overhang Type /SC Ornt Len Hgt Area X WPM X WOF 1 Pointl .18 2100.0 2.36 892.1 Single, Tint N 2.0 8.0 84.0 6.11 0.99 509 2 Single, Tint N 2.0 4.0 15.0 6.11 0.98 89.9 Single. Tint E 2.0 4.0 76.0 5.05 1.05 402 4 Single, Tint E 2.0 3 0 4.0 5.05 1 07 21.6 ' Single, Tint E 4 ^. 4 ') 40.0 5 05 1 11 224 6 Single, Tint E 2.0 4 0 13.0 5.05 1.05 68.8 Single, Tint S 2.0 4.0 25.0 4.79 1 13 135.6 Single, Tint S 2.0 4.0 25.0 4.79 1 13 135.6 Single, Tint W 2.0 3 0 26.0 5.65 1.02 149 1 Single, Tint W 2.0 3 0 4.0 5.65 1.02 22.9 Single. Tint W 2.0 4 0 50.0 5.65 1.01 284 2 Single, Tint W 2.0 3.0 15.0 5.65 1.02 86.0 As -Built Total: 377.0 2130.0 WALL TYPES Area X BWPM = Points Type R -Value Area X WPM = Points Adjacent 128.0 0.50 64.0 Concrete, Int Insul, Exterior 0 0 1383.0 1.90 2627 7 Exterior 1383.0 0.60 829.8 Frame, Wood. Adjacent 0.0 128 0 1.70 217.6 Base Total: 1511.0 893.8 As -Built Total: 1511.0 2845.3 DOOR TYPES Area X BWPM = Points Type Area X WPM = Points Adjacent 0 0 0.06 0.0 Exterior Wood 20 0 2 80 56 0 Exterior 20 0 1.80 36.0. Base Total: 20.0 36.0 As -Built Total: 20.0 56.0 CEILING TYPES Area X BWPM = Points Type R -Value Area X WPM X WCM = Points Under Attic 2100.0 0.10 210.0 Under Attic 30.0 2184.0 0.10 X 1.00 218.4 Base Total: 2100.0 210.0 As -Built Total: 2184.0 218.4 FLOOR TYPES Area X BWPM = Points Type R -Value Area X WPM = Points Slab 266.0(p) -2.1 -558.6 Slab -On -Grade Edge Insulation 0.0 266.0(p -2.10 -558.6 Raised 0.0 0.00 0.0 Base Total: 658.6 As -Buck Total: 266.0 -658.6 i FORM 600A -2001 WINTE r � CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 135 NE 94 STREET, MIAM SHORES, FL, 33138- PERMIT #: ;:nor.,,, = altriaPi . c., an -_1m =Horn,,: attnoThI i =c" ')nn< c. "'DP zr BASE CODE COM PUUANCE ST A US AS- BUILT WATER HEATING Number of X Bedrooms Multiplier BASE Total Tank EF Volume Number of Bedrooms X Tank X Multiplier X Credit = Total Ratio Multiplier 3 AS -BUILT 7107.0 Cooling_ Points + Heating + Points Hot Water Points = Total Points Cooling Points + Heating + Hot Water Points Points = Total Points 24015 845 7107 31967 18887 5350 7027 31265 BASE AS- BUILT WATER HEATING Number of X Bedrooms Multiplier = Total Tank EF Volume Number of Bedrooms X Tank X Multiplier X Credit = Total Ratio Multiplier 3 2369.00 7107.0 50.0 0.89 As -Built Total: 3 1.00 2342.38 1.00 70271 7027.1 FORM 600A -2001 W; &\TER HEATONG , a CO E COMPL ANCE STATUS Residential Whole Building Performance Method A - Details ADDRESS: 135 NE 94 STREET, MIAM SHORES, FL, 33138- PERMIT #: ss c„or,,,, _o,v,orr n ^ z =�,. ann�_nnn = ��- ro;_aiino = =canna .7I D ^DR zr COMPONENTS SECTION REQUIREMENTS FOR EACH PRACTICE CHECK Exterior Windows & Doors 606.1.ABC.1.1 Maximum:.3 cfm/sq.ft. window area; .5 cfm/sq.ft. door area / a� Exterior & Adjacent Walls 608.1.ABC.1.2.1 Caulk, gasket, weatherstrip or seal between: windows /doors & frames, surrounding wall, foundation & wall sole or sill plate; joints between exterior wall panels at corners; utility penetrations; between wall panels & top /bottom plates; between walls and floor. 4 612 1 Water flow must be restricted to no more than 2.5 gallons per minute at 80 PSIG // EXCEPTION: Frame walls where a continuous infiltration barrier is installed that extends from, and is sealed to, the foundation to the top plate. 610 1 Floors 606.1.ABC.1.2.2 Penetrations /openings >1/8" sealed unless backed by truss or joint members. 607.1 Separate readily accessible manual or automatic thermostat for each system. EXCEPTION: Frame floors where a continuous infiltration barrier is installed that is sealed to the perimeter, penetrations and seams. I/ Ceilings 606.1.ABC 1.2.3 Between walls & ceilings, penetrations of ceiling plane of top door; around shafts, chases, soffits, chimneys, cabinets sealed to continuous air barrier; gaps in gyp board & top plate, attic access. EXCEPTION: Frame ceilings where a continuous infiltration barrier is installed that is sealed at the perimeter, at penetrations and seams. V Recessed Lighting Fixtures - 606 1 ABC.1.2 4 Type IC rated with no penetrations, sealed; or Type IC or non -IC rated, installed inside a sealed box with 1/2" clearance & 3" from insulation; or Type IC rated with < 2.0 cfm from conditioned space, tested. / �/ Multi -story Houses 606.1.ABC.1.2.5 Air barrier on perimeter of floor cavity between floors. '/ Additional Infiltration reqts - 606 1.ABC.1.3 Exhaust fans vented to outdoors, dampers; combustion space heaters comply with NFPA, have combustion air. COMPONENTS SECTION REQUIREMENTS CHECK Water Heaters 612.1 Comply with efficiency requirements in Table 6 -12. Switch or clearly marked circuit breaker (electric) or cutoff (gas) must be provided. External or built -in heat trap required. Spas & heated pools must have covers (except solar heated) Non - commercial pools must have a pump timer Gas spa & pool heaters must have a minimum thermal efficiency of 78 %. / a� Swimming Pools & Spas 612 1 Shower heads 612 1 Water flow must be restricted to no more than 2.5 gallons per minute at 80 PSIG // Air Distnbution Systems 610 1 All ducts, fittings, mechanical equipment and plenum chambers shall be mechanically attached, sealed, insulated, and installed in accordance with the criteria of Section 610 Ducts in unconditioned attics: R -6 min. insulation. HVAC Controls 607.1 Separate readily accessible manual or automatic thermostat for each system. Insulation 604.1, 602.1 Ceilings -Min. R -19. Common walls -Frame R -11 or CBS R -3 both sides. Common ceiling & floors R -11. f C/ FORM 600A -2001 Code C mp iance Checklist 'Residential Whole Building Performance Method A - Details I ADDRESS: 135 NE 94 STREET, MIAM SHORES, FL, 33138- PERMIT #: 6A -21 INFILTRATION REDUCTION COMPLIANCE CHECKLIST -22 OTHER PRESCRIPTIVE MEASURES ( must be met or exceeded by all residences. = nornuGalinca n^n nn:_- ')n^ •Homo,:- ai 2r Florence Gordon rESIDENCE 135 NE 94 STREET MIAM SHORES, FL 33138- Summary Energy• y Code Results Residential Whole Building Performance Method A Project Title: TERRACE ENCLOSURE PASS e- Ratio: 0.98 EnergyGauoe ®;Versior,: FLRC °E v3.30, Code Only Professional Version Climate: South 12/14/2004 Energy Use Base As -Built Cooling: Heating: Hot Water: Total: 24015 points 845 points 7107 points 31967 points Cooling: Heating: Hot Water: Total: 19997 points 535C points 7027 points 31265 points Florence Gordon rESIDENCE 135 NE 94 STREET MIAM SHORES, FL 33138- Summary Energy• y Code Results Residential Whole Building Performance Method A Project Title: TERRACE ENCLOSURE PASS e- Ratio: 0.98 EnergyGauoe ®;Versior,: FLRC °E v3.30, Code Only Professional Version Climate: South 12/14/2004 :gilding Loads Base As -Built Summer: Winter: Hot Water: Total: 56294 points 1347 points 6254 points 63896 points Summer: Winter: Hot Water: Total: 60974 points 4566 points 6264 points 71794 points Florence Gordon rESIDENCE 135 NE 94 STREET MIAM SHORES, FL 33138- Summary Energy• y Code Results Residential Whole Building Performance Method A Project Title: TERRACE ENCLOSURE PASS e- Ratio: 0.98 EnergyGauoe ®;Versior,: FLRC °E v3.30, Code Only Professional Version Climate: South 12/14/2004 ENE GY PE ESTIMATED ENERGY PERFORMANCE SCORE* = 84.4 The higher the score, the more efficient the home. Florence Gordon rESIDENCE, 135 NE 94 STREET, MIAM SHORES, FL, 33138- 1. New construction or existing 2. Single family or multi-family 3. Number of units, if multi-family 4. Number of Bedrooms 5. Is this a worst case? 6. Conditioned floor arca (ft "1. Glass arca 8&. type a. Clear - single pane b. Clear - double pant c. Tint/other SHGC - single pane d. Tint/other SHGC - double pane 8. Floor types a. Slab -On -Grade Edge Insulation R 0.0, 266.0(p) ft b. N/A c. N/A 9. Wall typcs a. Concrete, Int Insul, Exterior R3.0, 1383.0 ft _ b. Frame, Wood, Adjaccnt RO.0, 128.0 ft c. N/A d. N/A e. N/A 10. Ceiling types a. Undcr Attic b. N/A c. N/A 11. Ducts a. Sup: Unc. Ret: Con. AH: Garage Sup. R=6.0, 50.0 ft _ b. N/A Single Pane 0.0 ft 377.0 ft. 0.0 ft RMANCE LE V , (EPL) ISPL SAY CA Addition Single family 1 3 No 2100 ft Double Pant 0.0 ft 0.0 ft 0.0 ft 11 ,l 12. Cooling systems a. Central Unit b. N/A c. N/A 13. Hcating systems a. Electric Strip b. N/A c. N/A 14. Hot water systems a. Electric Resistance b. N/A c. Conservation credits (H12-Heat recovery, Solar DHP- Dedicated heat pump) R =30.0, 2184.0 ft _ 15. HVAC credits (CF- Ceiling fan, CV -Cross ventilation, HF-Wholc house fan, PT- Programmable Thermostat, MZ- C- Multizone cooling, MZ- H- Multizone heating) I certify that this home has complied with the Florida Energy Efficiency Code For Building Construction through the above energy saving features which will be installed (or exceeded) in this home before final inspection. Otherwise, a new EPL Display Card will be completed based on installed Code compliant features. Builder Signature: Date: Address of New Home: City/FL Zip: Cap: 48.0 kBtu/hr SEER: 13.00 *NOTE: The homes estimated energy performance score is only available through the FLA/RES computer program. This is not a Building Energy Rating. If your score is 80 or greater (or 86 for a US EPA/DOE EnergyStcP designation), your home may qualify for energy e mortgage (EEM) incentives ifyou obtain a Florida Energy Gauge Rating. Contact the Energy Gauge Hotline at 321/638-1492 or see the Energy Gauge web site at www fsec. ucf. edu for information and a list of certified Raters. For information about Florida ?nergy Efficiency Code For Building Construction, contact the Department of Community Affairs at 850/4S7 -182 Energvaauge ® F;.RCPB v .30` 04P 11 / i f -®, Cap: 32.0 kBtu/hr COP: 1.00 _ Cap: 50.0 gallons _ EF: 0.89 PT, Location for weather data: Miami - Defaults: Latitude(25) Temp Range(L) Humidity data: Interior RH (50 %) Outdoor wet bulb (77F) Humidity difference(56qr.) Winter design temperature Winter setpoint Winter temperature difference 47 F 70 F 23 F Summer design temperature Summer setpoint Summer temperature difference 90 F 75 F 15 F Total heating Toad calculation 38478 Btuh Total cooling Toad calculation 37968 Btuh Submitted heating capacity Total (Electric Strip) % of calc Btuh 83.2 32000 Submitted cooling capacity Sensible (SHR = 0.75) Latent Total % of calc Btuh 108.1 36000 257.5 12000 126.4 48000 g Load component Load Window total 377 sqft 10028 Btuh Wall total 1511 sqft 16872 Btuh Door total 20 sqft 212 Btuh Ceiling total 2184 sqft 1747 Btuh Floor total 266 ft 4948 Btuh Infiltration 112 cfm 2839 Btuh Subtotal 36646 Btuh Duct loss 1832 Btuh TOTAL HEAT LOSS 38478 Btuh Florence Gordon rESIDENCE 135 NE 94 STREET MIAM SHORES, FL 33138- esident a Syste i Sizing Ca collation Summary Project Title: TERRACE ENCLOSURE ter Heatin Load for 2100 sgft Summer Cooling Load (for 2100 sqft Load component Load Window total Wall total Door total Ceiling total Floor total Infiltration Internal gain Subtotal(sensible) Duct gain Total sensible gain Latent gain(infiltration) Latent gain(intemal) Total latent gain TOTAL HEAT GAIN 377 1511 20 2184 sqft sqft sqft sqft 98 cfm 12157 11274 208 2621 0 1620 2400 30280 3028 33308 3739 920 4659 3796C Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh WINTER CALCULATIONS Warn\,(al iriag =1 PC v' �f SUMMER CALCULATIONS VV3IS(44 :S) Code Only Professional Version Climate: South EnergyGauge® System Sizin PREPARED BY: DATE: Florence Gordon rESIDENCE 135 NE 94 STREET MIAM SHORES, FL 33138- esident a Syste i Sizing Ca collation Summary Project Title: TERRACE ENCLOSURE ter Heatin Load for 2100 sgft Summer Cooling Load (for 2100 sqft Load component Load Window total Wall total Door total Ceiling total Floor total Infiltration Internal gain Subtotal(sensible) Duct gain Total sensible gain Latent gain(infiltration) Latent gain(intemal) Total latent gain TOTAL HEAT GAIN 377 1511 20 2184 sqft sqft sqft sqft 98 cfm 12157 11274 208 2621 0 1620 2400 30280 3028 33308 3739 920 4659 3796C Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh Btuh WINTER CALCULATIONS Warn\,(al iriag =1 PC v' �f SUMMER CALCULATIONS VV3IS(44 :S) Code Only Professional Version Climate: South EnergyGauge® System Sizin PREPARED BY: DATE: Florence Gordon rESIDENCE 135 NE 94 STREET MIAM SHORES, FL 33138- Manual J Winter Calculations Residential Load - Component Details (continued) Project Title: TERRACE ENCLOSURE 12/14/2004 Key: Window types (SHGC - Shading coefficient of glass as SHGC numerical value or as clear or tint) (Frame types - metal, wood or insulated metal) (U - Window U- Factor or'DEF' for default) (HTM - ManualJ Heat Transfer Multiplier) Key: Floor size (perimeter(p) for slab -on -grade or area for all other floor types ) narnvf,ai ina r =1 Pr-0; v° Code Only Professional Version Climate: South Window Panes /SHGC /Frame /U Orientation Area X HTM= Load . - N CO vt In CO 0) O CNI 1, Tint, Metal, DEF N 84.0 26.6 2234 Btuh 1, Tint, Metal, DEF N 15.0 26.6 399 Btuh 1, Tint, Metal, DEF E 76.0 26.6 2022 Btuh 1, Tint, Metal, DEF E 4.0 26.6 106 Btuh 1, Tint, Metal, DEF E 40.0 26.6 1064 Btuh 1, Tint, Metal, DEF E 13.0 26.6 346 Btuh 1, Tint, Metal, DEF S 25.0 26.6 665 Btuh 1, Tint, Metal, DEF S 25.0 26.6 665 Btuh 1, Tint, Metal, DEF W 26.0 26.6 692 Btuh 1, Tint, Metal, DEF W 4.0 26.6 106 Btuh 1, Tint, Metal, DEF W 50.0 26.6 1330 Btuh 1, Tint, Metal, DEF W 15.0 26.6 399 Btuh Window Total 377 10028 Btuh Walls Type R -Value Area X HTM= Load 1 Concrete - Exterior 0.0 1383 11.7 16181 Btuh 2 Frame - Adjacent 0.0 128 5.4 691 Btuh Wall Total 1511 16872 Btuh Doors Type Area X HTM= Load 1 Wood - Exter 20 10.6 212 Btuh Door Total 20 212Btuh Ceilings Type R -Value Area X HTM= Load 1 Under Attic 30.0 2184 0.8 1747 Btuh Ceilin• Total 2184 1747Btuh Floors Type R -Value Size X HTM= Load 1 Slab -On -Grade Edge Insula 0 266.0 ft(p) 18.6 4948 Btuh Floor Total 266 4948 Btuh Infiltration Type ACH X Building Volume CFM= Load Natural 0.40 16800(sgft) 112 2839 Btuh Mechanical 0 0 Btuh Infiltration Total 112 2839 Btuh System Sizing Calculations - Winter Residential Load - Component Details Florence Gordon rESIDENCE Project Title: 135 NE 94 STREET TERRACE ENCLOSURE MIAM SHORES, FL 33138- Reference City: Miami (Defaults) Winter Temperature Difference: 23.0 F Code Only Professional Version Climate: South 12/14/2004 Totals for Heating Subtotal Duct Loss(using duct multiplier of 0.05) Total Btuh Loss 36646 Btuh 1832 Btuh 38478 Btuh norm/ ;al it of P" R v' .' Vindow Type Panes/SHGC/U/InSh/ExSh Ornt Overhang Len Hgt Window Area(sgft) Gross Shaded Unshaded HTM Shaded Unshaded Load 1, Tint, DEF, N, N N co V V M 7 V V V M co C' co (• CV (V CN V' CV N (N (N (V (V CV 84.0 0.0 84.0 20 20 1680 Btuh 1, Tint. DEF, N, N N 15.0 0.0 15.0 20 20 300 Btuh 1, Tint, DEF, N, N E 76.0 31.5 44.5 20 61 3343 Btuh 1, Tint, DEF, N, N E 4.0 1.3 2.7 20 61 190 Btuh 1, Tint, DEF, N, N E 40.0 33.2 6.8 20 61 1079 Btuh 1, Tint, DEF, N, N E 13.0 4.6 84 20 61 606 Btuh 1, Tint, DEF, N, N S 25.0 25.0 0.0 20 32 500 Btuh 1, Tint, DEF, N, N S 25.0 25.0 0.0 20 32 500 Btuh 1, Tint, DEF, N, N W 26.0 14.4 11.6 20 61 996 Btuh 1, Tint, DEF, N, N W 4.0 1.3 2.7 20 61 190 Btuh 1, Tint, DEF, N, N W 50.0 20.8 29.3 20 61 2199 Btuh 1, Tint, DEF, N, N W 15.0 8.3 6 7 20 61 575 Btuh Window Total 377 12157 Btuh Walls Type R -Value Area HTM Load 1 Concrete - Exterior 0.0 1383.0 7.8 10787 Btuh 2 - Frame - Adjacent 0.0 128.0 3.8 486 Btuh Wall Total 1511.0 11274 Btuh Doors Type Area HTM Load 1 Wood - Exter 20 0 10.4 208 Btuh Door Total 20.0 208 Btuh Ceilings Type /Color R -Value Area HTM Load 1 Under Attic/Light 30.0 2184 0 1 2 2621 Btuh Ceiling Total 2184.0 2621 Btuh Floors Type R -Value Size HTM Load 1 Slab -On -Grade Edge Insulation 0.0 266.0 ft(p) 0.0 0 Btuh Floor Total 266.0 0 Btuh Infiltration Type ACH Volume CFM= Load Natural 0.35 16800 98.2 1620 Btuh Mechanical 0 0 Btuh Infiltration Total 98 1620 Btuh System Sizing Calculations - Summer Residential Load - Component Details Project Title: TERRACE ENCLOSURE Florence Gordon rESIDENCE 135 NE 94 STREET AM SHORES, FL 33138- Reference City: Miami (Defaults) Summer Temperature Difference: 15.0 F Code Only Professional Version Climate: South 12/14/2004 Internal gain Occupants Btuh/occupant 4 X 300 + Appliance 1200 Load 2400 Btuh Florence Gordon rESIDENCE 135 NE 94 STREET MIAM SHORES, FL 33138- Manual J S : m er CaBcugat ons Residential Load - Component Details (continued) Project Title: TERRACE ENCLOSURE Key: Window types (SHGC - Shading coe ficient of glass as SHGC numerical value or as clear or tint) (U - Window U- Factor or'DEF' for default) (InSh - Interior shading device: none(N), Blinds /Daperies(B) or Roller Shades(R)) (ExSh - Exterior shading device: none(N) or numerical value) (Ornt - compass orientation) •nPr■,1,a narR Code Only Professional Version Climate: South 12/14/2004 Totals for Cooling Subtotal Duct gain(using duct multiplier of 0.10) Total sensible gain Latent infiltration gain (for 56 gr. humidity difference) Latent occupant gain (4 people @ 230 Btuh per person Latent other gain TOTAL GAIN 30280 Btuh 3028 Btuh 33308 Btuh 3739 Btuh 920 Btuh 0 Btuh 37968 atuh VILLAGE OF MIAMI SHORES I Cor .e) C ' - °f 0 1 Located at: 135 Na Q �� Produced G 3S- lo-7- - {- V6 v eArekL., Cr �6�L t , Owner Owner BUILDING DEPARTMENT OWNER BUILDER DISCLOSURE .STATEMENT being the legal property owner, for the property S L a r e-s FL 3;$ 5 , Legally described as 0 Wl V1 G V Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S. 489.103(7),sgnd I have read and understand the following disclosure Statement, which entitles me td 31tork as my own contractor, I further understand that I as the owner must appear in person to complete all applications. DISCLOSURE STATEMENT State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two- family residence or a farm out - building. You may also build or improve a commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is completed, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A. and with- holding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes and zoning regulations. Proof of ownership provided ( ) initial of reviewing clerk. foregoing instrument Was acknowledged before me this '2 day of St , 20 (/ BY COYc11 n;02_ C �tn d- who is personally known to me or who has as identification and who did take an oath.. , ,r An9ela ...qJ�j �.� i∎ m erit *Miami _ S ?L?1 'STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, Cord! rl a 4orolo , does hereby attest that the (property owner) attached survey, performed by 8 ( A n c o StdeVe —yOr'S to e. (name of surveyor's company) performed on 7 ° 13 '° b 1 , 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. Affiant/Property owner Witness(sign and print) Witness(sign and print) SWORN TO AND SUBSCRIBED before me this " / day of Affiant is personally known to me, produced as identification. 12/29/2004 14:10 3058566029 M IA M'ICJ PROD UC _CONTROL NOTICE OF ACCEPTANCE PGT Industries 1070 Technology Drive Nokomis ,FI., 34275 PRODUCT CONTROL Inv IStON (305) 375 -2902 FAX (305) 372 -6339 Your application for Notice of Acceptance (NOA) of Series SGD -70 Aluminum Sliding Glass Door - Impact. under Chapter 8 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 NOA 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. The expense of such testing will be incurred by the manufacturer. ACCEPTANCE NO.: NAMEll EXPIRES: ] II •' IS THE ! V RS S E CONDITIONS llI COD & E'VY C I 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. APPROVED: J 1 /04/2000 1 1 s0 acap znce COW pasktirn Internet mail address: postmaster ®bulldingcodeonline.com IINALPA F ID JORGE I MANTLLA PAGE 02 MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING WILDING CODE COMPLIANCE OFFICE METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 CONTRACTOR LICENSING SECTION (305) 375 -2527 FAX (305) 375 -2558 CONTRACTOR ENFORCEMENT DIVISION (305) 375 -2966 FAX (305) 375 -2908 ov/z/ Raul Rodriguez Chief Product Control Division SPEC . AND Francisco J. Quintana, R.A. Director Miami -Dade County q i *Wing Code Compliance Office Homepage: http : / /www.buildingcodconline.com C: N. A 12/29/2004 14:10 3058566029 FG Lndustrier JORGE I MANTLLA PAGE 03 ACCEPTANCE No.: QO-0628,11 APPROVED : November 9. 04 EXPIRES : November 9. 2005 NQT10E QF ACCEPTANCE: SP KIFIC CONPITIONS 1. SCOPE 1.1 This approves an aluminum sliding glass door, as described in Section 2 of this Notice of Acceptance, designed to comply with the South Florida Building Code (SFBC), 1994 Edition for Miami - Dade County, for the locations where the pressure requirements, as determined by SF13C Chapter 23, do not exceed the Design Pressure Rating values indicated its the approved drawings. 2. PRODUCT DESCRIPTION 2.1 The SGD -70 Series Aluminum Sliding Glass Door — Large Missile Impact Resistant and its components shall be constructed in strict compliance with the following documents: Drawing No 4345 -1, titled "SGD -70 OXXO." Sheets 1 through 4 of 4 dated 03 - 15 - 99, last revised on 10- 13 -00, signed and sealed by Robert L. Clark, P.E., bearing the Miami -Dade County Product Control approval stamp with the Notice of Acceptance number and approval date by the Miami -Dade County Product Control Division. These documents shall hereinafter be referred to as the approved drawings. 3. LIMITATIONS 3.1 This approval applies to single unit applications only, as shown in approved drawings. 3.2 Head receptor is not allowed to be used in this installation. 4. INSTALLATION 4.1 The aluminum sliding glass door and its components shall be installed in strict compliance with the approved drawings. 4.2 Hurricane protection system (shutters): The installation of this unit will not require a hurricane protection system. 5. LABELING 5.1 Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami - Dade County Product Control Approved ". 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance 6.1.2 Duplicate copies of the approved drawings, as identified in Section 2 of this Notice of Acceptance, clearly marked to show the components selected for the proposed installation. 6.1.3 Any other documents required by the Building Official or the South Florida Building Code (SFBC) in order to properly evaluate the installation of this system. 1444i 1 ' L tii 4 . Ishaq I. Chanda, P.E. Product Control Examiner Product Control Division 2 of 96.000 1NX MAX 43.562 DLO WIDTH O t WIC 750 DLO HEIGHT 88. UV. CENTER TYPICAL HEAD & SILL ON 2 ROWS OF ANCHOR SCREWS SEE SHEET 4 OF 4 LARGE MISSLE IMPACT DOORS I. GtAZAVG 7/76' LAMINATED 2. CONFIGURATIONS: OXXO 3. 5E4L4N7: FRAME CORNER, INSTALLATION SCREWS & PANEL SEALED WITH SCHNEE/MOREHEAD /S1d5504 SEAM SEALER 4.) ANCHORS: W.K. 6 FROM EACH CORNER HEAD & SILL) W. 6' FROM EACH CORNER (JAMBS) 744X. SPACING AT HEAD & S1tt: 'J.000 0 MAX. SPACING AT .IAMBS: 21.000 5.) SHUTTER REQUIREMENT, NO SHUTTERS REQUIRED E.) REFERENCE TESL REPORT: FTL -2369 19t.750 MAX 0 CORNERS ELEVATION 0 DESKLIV PRESSURE RATING POSTWE 1dEG4TNE + 60 PSF — 60 PSF 0 # 377/ Z. Andoinic REV. A 70/!3/00 F.K. Oaf lig p•r D I*3 /75/99 Paw tec 0.61 2I• 144X. ON CENTER SGD - 70 OXXO - ELEVATION PC? ecr I WNW, et 1&4 A POROVECIAliccartmarnoil SIXJIMItagglA CON 01 suDMOIttairmatoPra •..aN r 4345 -1 apc A 12/29/2004 14:10 3058566029 PG' Induotriea JORGE I MANTLLA PAGE 04 ACCEPTANCE No.: 00- 0628,11 APPROVED : November 9.2Q0Q EXPIRES : November 9,M NOTICE_ OF ACCEPTAN E • S NDARD CONDIT 1. Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and the original submitted documentation, including test supporting data, engineering documents, are no older than eight (8) years. 2. Any and all approved products shall be permanently labeled with the manufacturer's name, city, state, and the following statement: "Miami -Dade County Product Control Approved ", 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) The product is no longer the same product (identical) as the one originally approved; c) If the Acceptance holder has not complied with all the requirements of this acceptance, including 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 be grounds for removal of this Acceptance: a) Unsatisfactory performance of this product or process. b) Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any other purpose. 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 Acceptance as well as approved drawings and other documents, where it applies, shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at all time. 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 Acceptance. 9. This Notice of Acceptance consists of pages 1, 2 and this last page 3. 1 5k . 1. C/,otntt Ishaq 1. C handa , P. E. Product Control Examiner Product Control Division END OF THIS ACCEPTANCE 3 of 3 m w cD J 1- 1- Z H w cD 0 r7 UJ 4303 AF -12246 LIM SIONIC PAIR 'err. MIL (kW Of-42X1 r 4a1n --{ 4302 2- TRACK Hf)10 Af- -12245 rrties 4314 RxED PALL A OPIER AF -12254 PPM 1--1 s 4.304 2 -TRACK r1RCSiaD 2 -FRACK .fIYH AF -17255 AT -12247 rf er 11 " 4328 FYED FWQ dP 4344 if-17262 SCREEN MICA (OEJtOJ • 0.10410:4101111111 01 can sow 14.14.1 t,f iaLcW1( f111allEloll alastaebnimmil ga * o0 I ' il 13N i••�1 WV. A 10 /13/00 F.W. 43N limilbr Pals MY IF as 3/15/99 PM OP WIMP FID 4306 4305 S®EfW( TOP & 901 P14. Ar -12249 AT -12246 1 r 131 L 4317 4318 4319 4320 SCREEN FOP PAIL SUESO 901. 11411. WED SOL RAIL S REFf1 FEET P14 41-12258 41 -12257 A1-12258 II-12259 i-r 4342 (YOOFA:O) rtulEf AS 644932 92kt (WO 1L47. 800 wr Lam.) Af- 514801 art, au 41a 0 NOTE: All OTHER EXTRUSIONS ARE 6063 -15 ALUM. IND vSGD -70 OXXO (Extrusion Profiles) sat. 704 owl ma 4345 -3 MAO r . 15 Caminot ©= -1h 1[r] r r c _ • warn. Naafi. 2 track From Sf1L 2 Truck i»sr..hoM Corr 2 -Tiock 4 raw AX ter, h 0 4. s thno &mine b IIY.o nog 7 T . Aomb nix* 8 x 1.000 Ohn5 Fn. SYS 9 cash Kesptr 10 '• x .J7! A4. Pm. SYS f1 12 s .31 Ph. Pn, i 1 0 GPs m 7 fidl:e.1::1y H ad* 1 11 , - 17 x.'''' r. ,ad Pon.f Wet Ref . . Pahl FIN Rag Cam Latch Can Sikose 30 Saar DESCRIPTION Are Pont Cso Ph. • . 5RS w T. • RpT Sid4 ftral latebnq Red !0 tl4 x 1.500 At Pn SUS 41 - Sohn. 4T ' • Astr000f 43 Astragal fAS l�s maim mango Mmerosll ID w 11 J J 1- z a z H w 0 EY 0 0 430.1 2-TRAY 5111 Of-12241 AZI 9FEr. a41E illeD) Af -122S1 r L 4]28 WANG AM 107: RYE 0i0.1 AF -12211 1 — lin I 1' -- ! —r '',713 4115 1.233 4.304 2-1RICK DIREST LD 2 -NICK JW8 If -12255 Ar -12247 _1 ,211 r „a r-F,T Li frit _An 1 ;11 m RXED O ER rae 7 41-12254 4317 4318 4319 4120 AMU TOP RUa SCARY 80T. NA 5041741 570E Mi. ma WEE ME 41-12251 AT -12257 4F -12258 A f223.9 r = ,,„ 2- L EI ' 4342 040081£0) 1 L a .. _ Pllta AS (0EXO) 4128 644812 no MC CLIP 4344 L P -n---. AF -122e2 SCREEN 45141013 (0117(01 nn ima weivascriownlinill joid 9r uA'41.1 maw 011111001 Iaee11a tai Rwetens rommvala 004,11 LIP 1- 9703 rDP & ear. ea 4F- 12248 NOTE: ALL OTHER EXTRUSIONS ARE 6063 -T5 ALUM. P;9. A 10/13/00 F.X. `ia.oe y ak 0 e. J /t5/99 BMINLADILADD Daps I VD 4.• * I. Apt I IN ELF L 7r 4324 02. ffA0 (7 /le' Lem 41-334w1 GO -70 OXXO Extrusion Profiles Fa Cr *COP ND Ikals 11■14 44 4345 -3 4206 542 RAIL 0 -12249 DESION PRESSURE AGING POSITIVE + 8O PSG NEQ4INE - 60 PSF W 0 u-) v CD V 96.000 A147C 0 Mkt 750 DLO HMO 86. r 6' —f f r L IMUL MI CENTER AMX 43.562 MO MOTH 0 7111CAL HEAD & SILL 2 ROWS OP ANCHOR =PM SEE SHOT 4 Of 4 0 191.730 war LARGE MISSLE IMPACT DOORS GLAZJNG 7/16' LAW44TFD 2 C0 F% /P TIONS, OXXO 3. SEA4T :: W FRAME CORNER. INSTALLATION SCREWS & PANEL CORNERS SEALED 114TH SCHNEE/UOREHHAD /SAt5504 SEAM SEALER a 4.) 4NCHOIRS: 441X. 6' FROM EACH CORNER (HEAD & SILL) 4/AX. 6' f14'04I EACH CORNER (JAMBS) MAX. SPACING AT HEAD & SILL: 13.000 441X, SPACING AT .JAMBS: 21.0100 -5.) SHUTTER REQUIREMENT: NO SHUTTERS REQUIRED - 6:) REFERENCE TEST REPORT: FTL -2369 ELEVATION A' 371IL 0 71 wUl. -GAF awe? 8 . SGD-70 OXXO - ELEVATION v 1 +4 mcnoviosicaernratentin 1011AN 11-0111111, P ICCUCTUNIMOUNI11011 uA IWOM 6210 Ur10E011!<T Nar6U1aIQ aiming as. 4345 -1 0 L o N L o Ln Iri co co 47..e7 •Wir ;swift 11071/ AlKlaffe - VERTICAL SECTION I-ORIZONTAL SECTION Anithe REY II (1. PAWL CUP) ittnt (VW ger Px Se/a Jars. rs. 61 at 7740 MOW ▪ mis• o.nutf 1.001 MAO ,..„...".......)(7 7/16" LAMINATED GLAZING DETAIL Raw Mcd 64r.: — ner .u, law FP Ft! sus LOC*TED r cora Ity. 00P, o.e. 3,/) 5/99 . AS CIMPAYING Tisf CA 01 so. OWN FLCMDA clicE %%on r i • MUM alveltd. MOM IMAM WOE ditmeutiCE OFKI 11:11Y4te 204 4345-2 COV5TRUCTrOk DEIAL OVERALL 7/ 6 LAMINA rfa :..Y.INSIST Dr 1 6 KS CIASS LITE S re.r.TERICR INFERIOR SD) WfTh .ciaa sonsx tc Pv33 W1TRLAYER BY SOWN, BEAM CITES lbsaetter ,-;:,. :' .•' .. - . .;,-,1* 1 ;' US. A . .7.42;4 - '' ' ' '' Il INDEJ TRIES — - - 111 ::-., • -- - - - ,_ . Farlbar z V64 Ottisti .4"? t , . • I. 560- 70 1 . aseeelphial. SCD— 70 OXXO (SECT)ON VIEWS PC/ ACT ;511406/1 Kt 'Scar. Slow: Drolase 1 — For Insurance Company the: Policy Number Company NAIC Number BUILDING OWNER'S NAME CORDINEL GORDON BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 135 N.E. 94TH ST. CITY STATE ZIP CODE MIAMI SHORES FLORIDA 33138 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc) LOT 19 AND THE E. 30 FT. OF LOT 18, BLOCK 21, PB 10, AT PAGE 70 BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( ##° - ##' - fir or ##.#f### ❑ NAD 1927 ❑ NAD 1983 0 USGS Quad Map B1. NRP COMMUNITY NAME & COMMUNITY NUMBER 120653 E2. COUNTY NAME MIAMI —DADE B3. STATE FLORIDA .135. SUFFIX J 86. FIRM INDEX DATE 7/17/95 B7. FIRM PANEL EFFECTNEIREVISED DATE 3/2/94 FLOODZONE(S) X B9. BASE FLOOD ELEVATION(S) (Zane AO, use depth of flaming) N/A B4. MAP AM PANEL ' NUMBER 12025C0093 B10. IncS ate the solute d the Base Flood Elevator (BFE) data or base flood depth entered in B9. ❑ RS Prole ® FIRM ❑ Ctmrrumly DeterrniId ❑ Other ( s e): B11. Ind:ate Cue elevation datm used for the BFE in B9: NGVD 1929 ❑ NAVD 1989 ❑ Otter (Describe): B12. Is the buidng located in a Coastal Barrier Resoures System (CBRS) area a Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Buddng elevations are based on ❑ Constudori Drawinge ' ' ❑ Bu tiing lkxler Carstu titre ® Finished Construction 'A new Eeratian Certft ate vi.! be re pined when castu±n of the bulking is couplets. C2. Buikrg Diagam Nurter 1(Seled the biding dagram most suntan tot ie for which a is certificate is being con pleted - see pages 6 and 7. If no dagam acctratey represents the buidrg, provide a sketch or photogaph.) C3. Be+ratiorts– Zones Al X130, AE, AN, A (with BFE), VE, V1 V30, V (with BFE), AR, AR/A, AR/AE, ARIA14030, AR/AH, AR/AO Complete (terns C3.a -i below a000ming to the buldurg dagam specified in Item C2. State the datum used. If the datum is dfferent tnm the datum used lathe BFE in Section B, convert the datum to that used for the BFE Show field nteastrements and dat n conversion c culatien. Use the space provided or the Comments area of Section D.a Section G, as appropriate, b docunent the datum conversion. Datum NGVD ConversiodCanrnents Elevation reference mark used BM Does the elevation reference manic used appear on the FIRM? ® Yes ❑ No a) Top of bottcrn floor (nixing basement a endostre) 13.2 2 to) 1 b) Top of nett higher floc —O. t(m) 0 c) Bottom d lowest hormo tat stuctral merrier (Vmnesenty) (m) d) Aftact>ed garage (top of slab) ;; ) w 03 e) lowest elevation dmachinery ar>dlarequipment z'y Ir servicing the bulking (Desate in a Ca tents area) 0 • ^wr 11(m), r 1 m f) adjacent (tirrshecl) Bade MG) F lowest 9 6 ) m .o g) Highest adja ed (finished) Bade (HAG) 1 • 1t I N h) No of permanent openings (flood vents) wdtm 1 ft. above . • . • e ,,i Total area dal permanent openings (Mad vents) in C3.h • CM) • SECTION D - SURVEYOR, : N R, OR . TECT CERTIFICATION This certification is to be signed and seated by a land surveyor, engineer, or architect a . • ed by law to certify elevation information. I certify that the information in Sections A B, and C on this cerfificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIERS NAME UCENSE NUMBER ADIS N. NUNEZ 5924 TITLE REGISTERED LAND SURVEYOR ADDRESS 555 N 11 LiORE DRIVE SIGNA FEMA Form 81 - 31, January 2003 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD PROGRAM ELEVATION CERTIFICATE Important Read the instructions on pages 1- 7. SECTION A - PROPERTY OWNER INFORMATION SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION COMPANY NAME BLANCO SURVEYORS, INC. CITY MIAMI BEACH DATE 10/4/04 # 04 -1858 O.M.B. No. 3067 -0077 Expires December 31, 2005 ❑ Other. STATE ZIP CODE FLORIDA 33141 TELEPHONE (305) .865 -1200 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. BUILDING STREET ADDRESS (Irxhrdng Apl., Unit, Stile, ardor B. No.) OR P.O. ROUTE AND BOX NO. 135 N.E. 94TH ST. CITY STATE ZIP CODE MIAMI SHORES FLORIDA 33138 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides dltis Eke+ration Certfcate kr (1) corrrnta>ity official, (2) inmate to agent/oarnpary, and (3) bulking owner. COMMENTS BM # N - 444 ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) Fen Zone AO and late A (without BFE), carplets terns E1 trough E4. If the Elevation Certificate is intended for use as supporting etfamation fora LOMA or LOMR -F, . Section C must be carpleted El. B i1c ng. Diaga Number mad the b;ildng cfcga i most *far to the baking for v4 t this catficate is bed completed —see pages 6 and 7. If no dagarn extra* represents the bilking, poke a slcebh or photogah.) E2. The tip rid* botbm floor (educing basement ar er issue) dthe baking is _ ft (m) _N em) 0 above or 0 below (check one) the highest adme it grade. (Use natural gad% f a ralabie). . Fa Bulking Diagams 6-8 with openings (see page 7), the next higher floor or elevated floc (elevation b) dthe busing is _ R(m) _n.(an) above the highest adjacent •: Bade. Carplete items C3 :h and Cai on tort d form. E4. The top dthe platform d maohinery andrar equpmerd servicing the buicIng is _ ft(m) _in.(an) 0 above or 0 below (cited( ate) the highest adjacent grade. (lime moral grade, if available). E5. Far Zane AO ay: If no good depth rattier is avanide, Is the lop d Qre bottom foci elevated in Emeriti a vat the cc nxrdy's Iooctpiair management aiirnence? 0 Yes 0 No 0 Unknown. The kcal official must certify tlis irdaination in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The properly owner or owrne&s authorized rar serda6ve who carpletes Sectors Atli B, C (Hers C3h and C3.i oriy), and E fa Zone A (wftbut a FBA-issued scar mtniy- issued BFE) or Zone AD must sign here The statements in Sedan A, Q C, yid E are coact lob) best dmyIvroafedge . • . PROPERTY OWNERS OR OWNERS AUTHORIZED REPRESENTATIVES NAME ADDRESS SIGNATURE COMMENTS CROWN OF ROAD ELEVATION: 10.29' ON CENTERLINE ON CENTER OF ROAD SECTION G - CONMUN!TY INFORMATION (OPTIONAL) The oral ot6cal who is atihaiaed by lawn arinance b airinster the oa rrnunii)/s tfoocplaie management adnaznce can carpets Sec6orts Al B, C (a E), and G of the Balaton Certificate. Ca mime the appicable tens) and sign below. 01.0 The i famaton in Section C was taken tan Ether doamentafion that has been signed and embossed by a fioensed suvejfor. engineer, a architect who is aabnarteed by state Cr scat law Eai y elevation information (Indicate the souse and drte i the elerabon data it the Carrnenis area below) .. . 1 32 0 Aoanrru* official axnpleted Serial E for a btddng Iocaeed in Zane A Nihouta shed a oarmuniy-issued BFE) or Zane AO. • G3.0 The blowing irdome6on (Items 04-G9) is provided for eamrrrrii y boodolain managerned pups. G4. PERMIT NUMBER G6. DATE PERMIT ISSUED G6. DATE •CEtTFICATECI ANCYISSUED G7. This permit has been issued fa: 0 New 0 Stbstanbal k provement G8. Elevation d as-bult lowest tom (mcudng basement) dthe buddng ix . : . G9. BFE or (n Zone AO) depth of loadrig at the baking site is: LOCAL OFFICIALS NAME COMMUNITY NAME SIGNATURE COMMENTS • FEMAForm 81 January 2003 LOCATOR # 3100 S.W. ELEV. 10.79' CITY DATE 'TELEPHONE TffLE For Insurance Compares Use: Policy Numb er Comp try NAIC Number, STATE ZIP CODE 0 Check here if attachments Datun: Datun: DATE ii.tia� Replaces all previ,..):z Fa Insumcx Canpary Use. Poky Number Company NAIL Number IMPORTANT: In these spaces, copy the corresponding information from Section A BUILDING STREET ADDRESS (Inducing Apt.. Unit, Side, rJa E. No.) OR P.O. ROUTE AND BOX NO. 135 N.E. 94TH ST. CITY MIAMI SHORES Copy both sides cite Be.'ation Certificate for (1) ccrrmunit' official, (2) rsrrance agentlarnpany, and (3) buiking owner. COMMENTS For Zone AO and Zahe A (without BFE), cure Items E1 through E4. lithe Beiation Certificates intended far use as st>pporing infamaiion fora LOMA a LOMR -F, Section C must be carpeted • El. Bu' king. Diagr= Nunba the Wild nj dctja most to the baking far With this =Licata is tang completed —see pages 6 and 7. If no & am accraatety represents the building, provide a sketch cr phohhgaph.) E2. The top of the bottxn floor (naming basement a endosrre) of the bu' cing is _ ft.(m) _Irt(cm) ❑ above a ❑ below (check are) the highest adjacent grade. (Use nahral Bade, if a caleble). E3. Fa Bulling 0iagams 6.8 wish openings (see page 7),1he next higher floor cr elevated Ica (elevation b) of the buiding is _ R(m) _ n.(an) above the highest adjacent BM # N -444 gale. Complete tears C3:h and C3i on frond of form. E4. The by of the plafam d macfhtiheyxVa sarianend savicig the buickig is ft(m) _irt(om) ❑ above a ❑ below (check one) the highest adjacent gads. (Use natural grade, if available). E5. Fa Zone AO orty: If no flood depth renter's available, is the fop of the bad= floor elevated in accordance with the camnxnityls Ioocfplan management «inane? ❑ Yes ❑ No ❑ Unknown. The kcal official must certify this it krmtiafion in Section G. The property owner a owner's aufhaized represerdat a who carpletes Sectors A, B, C (liars C3.h and C3.i arty), and E for Zone A (without a FB,MTssued a arrmtnity- issued BFE) or Zone AO mast sign here. The sfa*aments in Sedans Al B, C, and E are correct to She best ofmyknowiedge- PROPERTY OIM'ERS OR OWNERS AUTHORIZED REPRESENTATNES NAPE ADDRESS SIGNATURE COMMENTS CROWN OF ROAD ELEVATION: 10.29' ON CENTERLINE ON. CENTER OF ROAD SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRE)) FOR ZONE AO AND ZONE A (MTHOUT BFE) SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local olfrel who is a t hated by law a adnanoe to administer the camxrdys flood lain mharraganent ordnance can oornplete Sectors A B, C (a E), and G d this Elevation Certific5e. Complete the appicable tem(s) and sign below. G1. ❑ The nbmaten in SecSon C was taken tam other dournerdabon that has been sighed and Embossed by a fcensed suvejor, engineer, a architect who is aulhaiaed by state a tact laws arty elevation iiamation.. (Indcate the source and data d fie elevation data in the Cements eats area below.) G2. ❑ Acamrrnrhiy official canpleaed Section E fora bt8dng'mated in Zone A (withouta Feed a camxniy-issued BFE) a Zone A0. • G3. ❑ The following iriormaton (Items G4-G9) is provided for community too:pla n management puposes. G7. This permit has been sued fact ❑ New ❑ Substantial Inprwement G8. Elevation at as Iowe3ttoor (miming basement) dthebuiling i • G9. BFE or (m Zone AO) depth of flooring at the biding srle s: • . LOCAL OFFICIAL'S NAME COMMUNITY NAME SIGNATURE COMMENTS • FEMA•Form E1 -31, January 2003 STATE ZIP CODE FLORIDA 33138 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) LOCATOR # 3100 S.W. ELEV. 10.79' SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION CITY DATE TELEPHOI\E TITLE _ft ) - _ ft(m) • ❑ Check hem if attachments STATE ZIP CODE ❑ Check here if attachments G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTFICATE CF COMPUANCE/OCCUPANCY ISSN Datum: Datum: Replaces all previ ;'. CERTIFIER'S NAME ADIS N. NUNEZ TITLE FEMA Form 81 - 31, January 2003 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD-INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1 -7. SECTION A - PROPERTY OWNER INFORMATION For insurance Comperry Use: Policy Number Company NAIC Number BUILDING OWNER'S NAME CORDINEL GORDON BUILDING STREET ADDRESS (Including Ap., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 135 N.E. 94TH ST. CITY STATE ZIP CODE MIAMI SHORES FLORIDA 33138 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc) LOT 19 AND THE E. 30 FT. OF LOT 18, BLOCK 21, PB 10, AT PAGE 70 BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 0 GPS (Type):_, ( ##° -##' -##.## or ##.##/f## 0 NAD 1927 0 NAD 1983 0 USGS Quad Map # 04 -1858 SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION O.M.B. No. 3067 -0077 Expires December 31, 2005 131. NFIP COMMUNITY NAME & COMMUNITY NUMBER 120653 B2 COUNTY NAME MIAMI — DADE 133. STATE FLORIDA B5. SUFFIX J 136. FIRM INDD(DATE 7/17/95 B7. FIRM PANEL EFFECTIVE/REVISED DATE 3/2/94 B8. FLOODZONE(S) X B9: BASE FLOOD ELEVATION(S) (Zane AO, use dapth of floodug) N/A B4. MAPAN:0 PANEL NUMBER 12025C0093 B10. Inc ate the source of the Base Flood Bwabon (BFE) data a base flood depth entered in B9. ❑ FIS Prone ® FIRM 0 Comma' Deterrnined ❑ Other (Desabe)' B11. Indcats the elevation dal= used for the BFE in B9:0 NGVD 1929 ❑ NAVD 1988 ❑ Other (Desabe): B12. Is the bulking boated in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? [J Yes ® No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) 0 Other. C1. Bulking eleratibrts are based orr 0 Constuction ❑ Bulking Under Castrurdon• ® Finished Constrrxion • 'A new Elevation Cerfifate mg be required O en =strew of the buidng is complete. . C2. Building Diagram Number 1(Select the buici g &gan most sitter totte b ildng fcr which this certificate is beingcarrpleted - see pages 6 and 7. If no dagam accuately ruts the bulking, prance a sketch or photogaptt.) C3. Bevatiorts —Zates Al,A30, AE, Al-I, A (trritt BFE), VE, V1 V30, V (vullh BFE), AR AR/A, AR/AE, AR/A1 -A30, A /AH, AR/AO Cornplete Items C3. -a-i below according tothe buidng dagam specified in Item C2. State the datum used If ttte datum is dfferent from the datum used for the BFE it Section B, convert the datum to that used for the BFE Shove field nteastaanents and &thin conversion calarlaticn. Ilse the space provided a the Carnets area of Section D.a Section G, as appropriate, to document the datum conversion. Datum NGVD CawersionA amtents Elevation reference mark used BM Does the elevation reference malt used appear on the FIRM? ® Yes ❑ No a) Top of bottom floor (inducing basement or endcsre) 13.2 2 t(m) d b) Tap of next higheriba O. R(m) o c) Bottom of lowest hamonlet st tx bral member (Vaa►e•arty) • 0 • -t(m) It •d) Attached garage (lop ate) 0. - ft(m) w m e) Lowest elevation of machinery ander equipment m f' • senricing the building (Desalae in a Ccmirenis area) 10.3 0 ft(m) E m • f) Lowest adjacent (finished) gacb (MG) 9_7 6 R(m) e g) Filled edprtt (finished) gads (iNG) 10,021K 0 h) No. of permanent openings (flood vends) wttiin 111 above aimed gade _LILA 12 Total are dal permanent openings (flood vents) in C3.h • N /A SQ . IN . (SQ . CM) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, 8, and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be prinishable by fine or imprisonment under 18 U.S. Code, Section 1001. LICENSE NUMBER 5924 COMPANY NAME BLANCO SURVEYORS, INC. CRY STATE ZIP CODE MIAMI BEACH FLORIDA 33141 REGISTERED LAND SURVEYOR ADDRESS 555 NO)L H SHORE DRIVE DATE TELEPHONE 10/4/04 (305) 865 -1200 SIGNATURE See reverse side for continuation. Replaces all previous editions For Insurarce Ccmpary Use: Poky Number Compary NAIC Nu n IMPORTANT: In these spaces, copy the corresponding information from Section A BUILDING STREET ADDRESS (Inducing Apt., Unit, Stile, ardor Bldg. No.) OR P.O. ROUSE AND BOX NO. 135 N.E. 94TH ST. CITY STATE ZIP CODE MIAMI SHORES FLORIDA 33138 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides cf this Elevation Certificate for (1) canmunity official, (2) insurance agentloorrpany, and (3) building owner. COMMENTS BM 41 N -444 Fa Zone AO and Zone A (without BFE), carpieb Items E1 though E4. If the Elevation Certificates intended for use as s& jxz ng infatuation fora LOMA or LOMR -F, . Section C must be cenpleted Et. fining Diagram Numbs _("Setad the ba1dng disarm most *r>2ar to the buldng for vi:dr ttis ►te is being completed —see pages 6 and 7. If no dagram acaratey represents the belting, prairie a sloth or photcgaph.) E2 The top of the totem foa (mixing tesermerd a enclosure) cite bulling is _ ft.(m)_in.(al ❑ above or ❑ below (ohmic one) the highest adjacent gade. (Use natral Bade, avatable). E3. For Budding Dagars 68 vith openings (see page 7), the next higher floor a elevated fox (elevation b) cite bulking is _ t(m) _ in.(an) above the highest adfacent gale. Ccr pleie tars C3.h and C31 on frail of form. E4. The top of the plaQam dm actrirnayander equ irmerlk servicing the buidrg is _ ft(m) _in(an) ❑ above or ❑ below (check are) the highest adjacent Bade. (Use natural gale. if avallable). E5. Fa Zone AO onty: If no food depth number is avatable, is the ep dthe bottom ibor elevated in accordance ail the caret nky's tloodplan management admanoe? ❑ Yes ❑ No ❑ Unknown The tool official must certifyltrs iianmafon in Sedion G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner a antes authorized representaiie wb couplets Seders A, B, C (hems CM and Ca i only), and E fa Zane A (without a FEMA -sued accmnly- issued BFE) a Zone AO must signhum Me stlements in Sedans A , B, C, E Ere coifed to the best ofmyAncatiete PROPERTY OWNER'S OR OWNERS AUTHORIZED REPRESENTATIVES NAME ADDRESS SIGNATURE COMMENTS SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) SECTION G - COMMUNITY INFORMATION (OPTIONAL) The locd aria! who b authorized by law or adinaree b ai inisierthe earns iy's foo4Iain management ordnance can complete Sect= B. C (a E), and G of this Elevation Certificate. C«nplete the eppkable lem(s) and sign below: G1. ❑ The inbmnatim in Secion C vas taken tan other doamerntabon that has been signed and embossed by a licensed suveybr engineer, aarchitect v.ho is auto med by state a kcal Iawb catty elevation ilfam>abon.. (Irhdoate the some and data cite elevation data in the Camhents area below) G2. ❑ Aeamxrdy ritual completed Section E for a bukf g boated in Zone A (Mftauta FEW4ssued or xrry ssued BFE) a Zone AO. G3. ❑ The tolowtrg information (Items G4-G9) is provided for axmxniy 1ooc% sin management purposes, G4. PERART NUMBER G6. DATE PERMIT ISSUED G6. DATE CERTFICATEOF ANCYISSUED G7. This permit has been sued b. ❑ NewCorstu:bon ❑ Substantial h'pwement • G8. ETevation of as-bult lowest door (inducing basement) of the bulking is G9. BFE a (n Zone AO) depth of foodng at the bulling sites: LOCAL OFFICIAL'S NAME COMMUNITY NAME SIGNATURE COMMENTS • CROWN OF ROAD ELEVATION: 10.29' ON CENTERLINE ON. CENTER OF ROAD FEMAForm 81-31, January 2003 LOCATOR # 3100 S.W. ELEV. 10.79' CITY DATE TELEPHONE TITLE TeEPHOhE _R1 — n(m) ❑ Check hem if attadments STATE ZIP CODE ❑ deck here if attadxnente Datum: Datum: DATE Replaces all previa 1LUO7.) - - - - --- - - B4. MAP AND PANEL NUMBER 12025C0093 B5. SUFFIX J B6. FIRM INDEX DATE 7/17/95 B7. FIRM PANEL EFFECTNEIREVISED DATE 3/2/94 88. FLOOD ZONE(S) X B9: BASE FLOOD ELEVATICN(S) (Zone AO, use depth of flooding) For Irsutarxe Compar ' Use: Policy Number Company NAIC Number BUILDING OWNER'S NAME CORDINEL GORDON BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 135 N.E. 94TH ST. CITY STATE ZIP CODE MIAMI SHORES FLORIDA 33138 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 19 AND THE E. 30 FT. OF LOT 18, BLOCK 21, PB 10, AT PAGE 70 BUILDING USE (e.g., Residential, Non Addition, Accessory, etc. Use a Comments area, if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: ( ##° - ##' - # # #.##' or Ntit ##) 81. NRP CO tX MMUNTY NAME & WNITY NUMBER B10. Indicate the souse d the Base Flood Elevation (BFE) data a base flood depth entered in B 9. ❑ FIS Profile ® FIRM 0 Cmimurdy Determined ❑ Other (Descrbe): B11. Inckate the elevaton dabm used for the BFE in 89: ® NGVD 1929 ❑ NAVD 1988 .0 Other (Desabe): B12. Is the bulking located in a Coastal Barrier Resources System (CBRS) area a Otherwise Protected Area (OPA)? ❑ Yes } No Designator Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Builkng elevations are based on: 0 Construction Drawings ❑ Bulking Under Castrudicn• ® Finished Caistrulon 'A new Eleva6ai Cerfifmte v1,1 be required vfien constadion of the budding is canplete. • C2. Building Diagam Nunber 1 (Select the bulking dagam most similar to t'ne binding for which this i is beirgcarpleted - see pages 6 and 7. If no dagram aearatey represents the budding, provide a sketch or photogaph.) C3. Elevations —Zones A1-A30, AE, AH, A (with BFE), VE, V1 V30, V(will BFE), AR AR/A, AR/AE, AR/A1 -A30, AR/AH, ARIAO Cariplete Items C3. -a-i below according to the budding dagam specified in It C2. State the datum used If the dadrn is dfferent from the datum used kr the BFE in Section B, convert the datum to that used for the BFE Shaw field mreasuenle>ts and datun conversion calculation. Use the space presided or the Comments area cf Section D.a Section G, as appropriate, to dxunent the datum conversion. Datum NGVD Can ersionCamrents Elevation reference mark used EM Does the elera6on reference marts used appear on the FIRM? ® Yes ❑ No a) Top of bottom floor (including basene t or endosure) 13.2 2 1(m) b) Top of next higher lba c) Bottom of lowest horizontal strucbral member (Vzanes anti) Attached garage (top of slab) e). Lowest elevaton of machbery ancVa equipment servicing the budding (Desabe in a Comments area) f) Lowest adjacent } (finished) gaade i e ' st aria ^,. t (flnishec ` O ^1/4G) h) Na of permanent openings (flood vents) wtlhin 11L above adjaoe t garde c7 Total area of al permanent cperisgs (Rood vents) in C3.h ('� SQ . IN . (SQ . CM) CERTIFIERS NAME ADIS N. NUNEZ TIRE REGISTERED LAND SURVEYOR ADDRESS 555 NO SIGMA FEMA Form 81 -31, January 2003 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD - INSURANCE PROGRAM ELEVATION CERTIFICATE Important Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION ❑ NAD 1927 ❑ NAD 1983 SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B2 COUNTY NAME MT AMT -11AT 0 tt(m) 0. _ t(m) 10.301L(m) 9 . 7 6 ( m ) 10.02101 # 04 -1858 SOURCE: ❑ GPS (Type): ❑ USGS Quad Map SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveys, engineer, or architect authorized by law to certify elevation information. 1 certify that the information In Sections A B, and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. LICENSE NUMBER 5924 COMPANY NAME BLANCO SURVEYORS, CITY . MIAMI BEACH O.M.B. No. 3067 -0077 Expires December 31, 2005 B3. STATE FLORIDA DATE TELEPHONE 10/4/04 (305) 865 -1200 ❑ Other. INC .• STATE ZIP CODE FLORIDA See reverse side for continuation. Replaces all previous editions L iNJ Lia.J iw 40 Iw 1 L) , zr tij 4 e4 1 2.4-1 SOS0212120162 • • - • • • cremator vehidocurtstitutes consaltoanyccbrictytestrequiredtryt= ',A 6 aoliop The Sunshine State Lamm G635-107-71-448-0 ORDINEL GEORGE GORDON 135 NE 94TH ST MIAMI SHORES, FL 33130-2821 BIRTH DATE SEX HOT. REST. ENDORSE 1248-71 M SO8 ISSUED EXPIRES ■ 1242.02 izoacts DUPLICATE 00-00-00 • CAFE DRIVER Date (Rev. 10/02/03) Contact Name Buyer Property Address City Miami Shores Sign: Print: j My Commissi Seller Expires: Miami Shores Village Building Department RE- OCCUPANCY 1 i 4r APPLICATION _ W 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 Permit No. ROM — I c i S _ Loc ID Phone# SOS q _ste- -o1`-[ Realtor Company Name Salt 'W \ 1 \ Qkkki, State Fl Zip 1 '3 r I hereby certify that I understand that the zoning of the property is for single - family residential use and that it is unlawful for more than one family to reside therein. I also understand that any Certificate of Re- Occupancy that may be issued by Miami Shores Village certifies only that the referenced property is being used for single- family purposes and that such Certificate does not constitute any representation, warranty or certification as to the condition of the dwelling or other structures on the property. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate. Applicant Name X C Ord i vi e 1 40ro Signature r The foregoing instrument was acknowledged before me this 1 day of i , 20 DS by Crdi n-c q s personally known to me or who has produced 4D . as identification and who did take an oath. Y PUBLIC: Vait'C`�iS 10(1 c; 'II Building Officials Approval: Re -Occ. $60.00 Notary $5.00 CCF $0.60 / Total )5 • C20. cis 232 O 0 1 Ry� i • '4 i HEREBY CERTIFY That the survey represented thereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements other than as shown hereon. ADIS N. NUNEZ REGISTERED LAND SURVEYOR STATE OF FLORIDA #5924 (305) 865 -1200 FLOOD ZONE: 0093 R • SCALE: PANEL: DATE: 10/4 04 1 ° =20' SINCE 1987 BLANGO SURVEYORS INC. Engineers • Land Surveyors • Planners • LB # 0007059 555 NORTH SHORE DRIVE MIAMI BEACH, FL 33141 SUFFIX: DATE: BASE: J 7/17/95 N/A COMMUNITY# 120653 DWN. BY: JOB No. F. Blanco 04- Fax: (305) 865 -7810 ZI NOT VALID UNLESS EMBOSSED WITH SURVEYOR'S SEAL REVISED: 37.50 37.50' f 4 BLOCK CCRNER 101.113 RON PIPE 1/2' (NO ID.) FOUND IRON PIPE 1/2' (No D.) 0 4' 25.00' FOUND IRON PPE 1/2• • (NO in.) zz l _GONG WALK CBS WALL (TYPICAL) PLANTER 4530' (TYPICAL) 191. 128.75' (R & M) POR110N OF LOT 18 ONE STORY C.B.S RESIDENCE NO. 135 F.F. ELEV.= 13.22' 36.35' 86.00' d •i 6' WOOD FENCE LOT I9 128.75' (R & M) LOT 20 MOD( 21 38.30 '34 WIRE FENCE (TYPICAL)_ FOUND 1104 - P1PE 1/2' R ( NO D.) 4) f 10T 18 WATER METER 0.10' CIE AR FOUND IRON .g. WATER NETER •, PPE 1/2 °„ W bi• (NO 10.) o d $- 3.00' ABBREVIATIONS: SWK= SIDEWALK CBS = CONCRETE BLOCK STRUCTURE. CLF =CHAIN LINK FENCE, PL= PROPERTY LINE, DUE = DRAINAGE UTILITY EASEMENT IP =IRON PIPE, F= FOUND, A/C =AIR CONDITIONER PAD, P /C= PROPERTY CORNER, OM= DRILLED HOLE, WF= WOODEN FENCE. RES= RESIDENCE, CL- CLEAR, RB= REBAR. UE= UTILrTY EASEMENT. CONC= CONCRETE SLAB, RMt =RIGHT OF MY, DE= DRAINAGE EASEMENT, C/L= CENTER LINE, o= DIAMTER. TYP= TYPICAL, M= MEASURED, R =RECORDED, ENCR= ENCROACHMENT, COMP = COMPUTER, ASH = ASPHALT. N/D =NAIL 8 DISC. S =SET, FEE = FINISH FLOOR ELEVATIOIJ, O /S= OFFSET, P/P =POWER POLE. OHP= OVERHEAD POVIERLINE, WAM TER METER WOODFENCE- MASON CASON LL f l � 1 / �! �.ti•: 1 f 1 f •1 k •.., w.1 ELEVATION BASED ON LOC. # 3100 S .W. MAINTENANCES DRAINAGE EASEMENT= MB D.E. CBI# N -444 ELV 10179' TYPE OF SURVEY: BOUNDARY SURVEY, SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING INFORMATION. 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB PAGE LOCATION SKETCH SCALE: NTS N.E. 1ST AVENUE 15 16 17 14 13 12 11 10 20 9 SURVEY FOR: CORDINEL GORDON, 135 N.E. 94TH ST., MIAMI SHORES, FLORIDA 33138. LEGAL DESCRIPTION: LOT 19 AND THE EAST 30 FT. OF LOT 18 BLOCK 21 OF AMENDED PLAT OF MIAMI SHORES . SECTION NO. 1 SUBDIVISION ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 10 AT PAGE 70 MIAMI -DADE OF THE PUBLIC RECORDS COUNTY, FLORIDA rrrr,rll it 12/ t r ` 1 37.50' CONC. WALK 32.90' 36.35 6' MOOD FENCE - , LOT I9 REVISED: 37.50 BLOCK COMER FOUND IRON PIPE l /2• 9 (NO 10.) FOUND IRON PIPE ►/2 ( o FOUND IRON � � `� (NOD 128.75' (R & M) 1.01 20 BLOdc 21 PORTION Of LOT 18 FOUND IRON. { �• PIPE I /Y st — 128.75' (R & M) � (NO 10 .) 8 O LOT 18 5' WOOD FENCE PAGE WATER METER CLEAR o - 747 IRE L 4" MRE FENCE • F AD IR � >� WATER METER 1 PPE 1/Y o W ( b, kJ. (N0 10.) t, 300' d S ROVER UNE ABBREVIATIONS: SWK= SIDEN4LK . CBS= CONCRETE BLOCK STRUCTURE, CLF =CHAIN LINK FENCE, PL= PROPERTY LINE, DUE = DRAINAGE UTILITY EASEM ENT, IP =IRON PIPE, F= FOUND, A/C =AIR CONDmONER PAD, P /C= PROPERTY CORNER D/H= DRILLED HOLE, NF= WOODEN FENCE, RES= RESIDENCE, CL- CLEAR. RB= REBAR, UE= UTILITY EASEMENT. CONC= CONCRETE SLAB. RMMRIGHT OF NAY, DE= DRAINAGE EASEMENT, CA.= CENTER LINE, O= DIAMTER. TYP= TYPICAL, M= MEASURED, R= RECORDED, ENCR= ENCROACHMENT, COMP = COMPUTER, ASH = ASPHALT, N/D =NAIL & DISC. S =SET, FEE = FINISH FLOOR ELEVATION, NOT VALID UNLESS EMBOSSED WITH O /S= OFFSET,P/P =POWER POLE. OHP= OVERHEADPOWERLINE,AM =VW TER METER SURVEYOR'S SEAL MA MASONRYNALL - I 1 1 1 1 1 1 1 1 1 ELEVATION BASED ON LOC. # 3100 S .W. CONCRETE= .."•• • • •i '!••• l • MA NTENANCE B DRAINAGE EASEMENT= MSD.E. CBM# N -444 ELV 1079' TYPE OF SURVEY: BOUNDARY SURVEY, SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING INFORMATION. 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB i HEREBY CERTIFY That the survey represented thereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements other than as shown hereon. ti ADIS N. NUNEZ REGISTERED LAND SURVEYOR STATE OF FLORIDA #5924 LOCATION SKETCH SCALE: NTS (305) 865 -1200 FLOOD ZONE: 0093 X PANEL: DATE: SCALE: 10/4/04 V =20' LLJ L,J 0 f— C!) I-- O) LLJ z N.E. 1ST AVENUE LEGAL DESCRIPTION: LOT 19 AND THE EAST 30 FT. OF LOT 18 OF AMENDED PLAT OF MIAMI SHORES SECTION NO. 1 ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 10 OF THE PUBLIC RECORDS MIAMI —DADE COUNTY, FLORIDA 15 16 14 13 12 11 10 17 20 DWN. BY: F. Blanco 9 SURVEY FOR: CORDINEL GORDON, 135 N.E. 94TH ST., MIAMI SHORES, FLORIDA 33138• BLOCK 21 SUBDIVISION AT PAGE 70 SINCE 1987 BL.ANCO SURVEYORS INC. Engineers • Land Surveyors • Planners • LB # 0007059 555 NORTH SHORE DRIVE MIAMI BEACH, FL 33141 IJOB No. 04 - 1858 Fax: (305) 865 -7810 SUFFIX: DATE: BASE: J 7/17/95 N/A COMMUNITY# 120653 \. 5 Village of Miami Shores JOB N? 3786 ADDRESS ®Z °; 1 . / 4 INSPECTION c ( TIME READY / REMARKS +4 . INSPECTOR DATE Miami Shores Village Building Department BUILDING CRITIQUE SHEET „,v ,62J ) Ap 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. j9P oq— Job Name Village of Miami Shores N° 3638 JOB ADDRESS • 1 INSPECTION TIME READY REMARKS • r1 INSPECTOR 7;, d1 i DATE „r'" Block PB & PG: APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY I ts /6 4/'//50/ , hereby apply for a certificate to re- occupy the single family residence known as : (address) /3 s 9y'" s/7 / ' � , Miami Shores, Florida. Legal Description: Lot: c6-,,,,141‘rAddity 1.37 I hereby certify that I understand that the zoning of the property is for single- family residential use and that it is unlawful for more than one family to reside therein. I also understand that any Certificate of Re- Occupancy that may be issued by Miami Shores Village, certifies only that the referenced property is being used for single- family purposes and that such Certificate does not constitute any representation, warranty or certification as to the condition of the dwelling or other structures on such property. Applicant Date - / p/ Print Name JJI99d - 2 -9/ ,1 /$0/ 11 *********************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** For purposes of conducting the inspection required by Section 902 of the Miami Shores Land Development and Zoning Code, please contact: Contact Name: Buyer Comments: Inspected b boS> / Telephone: 95�- yp Seller Realtor ✓ Company Name ,51 43,9,11 Application Fee ($50) paid: Cash Check No. Approved Denied )C Date 2' /z PAGE 1 OF 2 CERTIFICATE OF RE- OCCUPANCY On behalf of Miami Shores Village, Florida, the undersigned certifies that the property described in the above application has been inspected for purposes of re- occupancy pursuant to Sections 901 and 902 of the Miami Shores Land Development and Zoning Code and that such property may be re- occupied by the, above applicant for single - family residential purposes. THIS CERTIFICATE VERIFIES THAT THE REFERENCED PROPERTY HAS BEEN INSPECTED BY MIAMI SHORES VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE MIAMI SHORES LAND AND DEVELOPMENT CODE PERTAINING SOLELY TO THE REQUIREMENT THAT EACH ONE - FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR A ONE - FAMILY DWELLING PURPOSE ONLY; HOWEVER, THIS CERTIFICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR WARRANTY AS TO THE CONDITION OF THE DWELLING OR OTHER STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH CONDITION, AND INTERESTED PERSONS ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE PREMISES IN ORDER TO DETERMINE THE CONDITION, THEREOF. PAGE 2 OF 2 MIAMI _ IRES ORIDA By Date of Certification: 7 - O/ PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date c/ / e., Job Address %�� /V/ 9i' f //�G� Tax Folio /1 - zo6 - a/3 -,z &,6' Legal Description.S.Ec— 1 /--5-77 4' E 3° 1 /8 3 k d. f Historically Designated: Yes No Owner/Lessee / Tenant ,/ - /22iJ o'- v S Master Permit # q 8 3 3 Owner's Address /.J,5 /,1` y '/ J yt� Phone Contracting Co. f /, , /i�r, �� • I . /� C• . Address 2 7 y /ilk` 7 =" t i Qualifier . ,/ ,/- -J ( /J %'/-- SS# - ,?/ - ? Phone / s) State # 6/C 2 `J Municipal # Competency # Ins. Co. Architect/Engineer 1 Address Bonding Company / //;) Address Mortgagor Address Permit Type (circle onekBUILDIN�G N ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 7 i7nJM e7 o. ��t; C: -/7 // /4-v ,r;d' 7 . U/ Ai c/ L71,4' 4'4 �� =' ! / ,.- _ 4 e c+✓ Square Ft. Estimated Cost (value) /2 :ry WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws ►: ting cons t tjon and zoning. Furthermore, I authorize the above -named contractor to do the work stated. I Signature of owner4nd/or Condo President Date ° - ) N Xier s ` . <4j Notary as to Owner and/or Condo President Date My Commission Expires. Signature of Contractor or Owner - Builder Date ,..-02 50 / ,..5 ..5 /, Date Notary as to Contractor or Owner- Builder My Commission Expires: / 5;79c 7rc 5/1'4 / FEES: PERMIT 1 O p o RADON C.C.F. / d p NOTARY (S•p e TOTAL DUE 4 o o APPROVED: Zonin g Building Electrical g Mechanical Plumbing Engineering MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address Registered Architect and /or Enginee Name and address of licensed contractor 24 Location and legal description of lot to be built on: therein by him stated are true. Dated - - c ) ? ,: t. c e r Building I4ector Permit No Date ' Disapproved (Signed) No. 1 Street 6? 4 Lot Block _ Subdivision Street and Number where work is to be done /, iv- z' _ - �� s -- ---- -- --- - - -- -- --- ------------ " - -- State work to be done and purpose of building (by floors) / /-9-- 2 m v. 2. ® F-E - r tt:_ < b -- - -- 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 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, Pennanent 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) ,007 - - -'_ STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts Read, Sworn to and Subscribed before me. 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 be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Registered Architect and /or Engineer _ Name and address of licensed contactor Location and legal description of lot to be built on: Lot ....1... Block /8/ MIAMI SHORES VILLAI3E BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby wade for the approval of the detailed statement of me 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 Miarni 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 iuilding Division of Miami Shores Village shall be complied with, whether herein specified or not. copy of approved plans and specifications must be kept at building during progress of the work. bf'� �f - � , �Q Date �_ ae, ?6 _._... ,197.7 O AA,�� /�^ ty µ•ncr's Name and Address C � � � No ... � . .a�..� ... Street %p"; 5� t � . Subdivision AIM A ?>1.{ JRA 2 4 Street and Number where work is to be done / . 3S - X) 4— 5` State work to be done and purpose of building (by floors) ° 04,1v6-1/7. �d rL. _. and fo5' no other purpose. New Building Remodeling Addition Repairs ,... No. of Stories To be constructed of C g•�• , Kind of foundation........ t5( /®X/9 »2; w 1 .... Roof Cowering ts n .. Estimated Total cost of improvements S 3 0o Amount of Permit $,. Zone cubage required _Plan Cubage Distance to next nearest building ‘4 Size of Building Lot 7. §k Maximum live load to be borne by each floor I hereby submit all the plans nnd, specifications for said building. All notices with refere to the ` budding and its construction may be sent to.. SoLA1'� 15 t"CoSic .... � a ..PGr-01 4 fi7o.P- 4 / ' 37Q.../Ji. Fo 1 - kCe .. i i X /CP The un,iersiuccd applicant for this building perinit does hereby certify that he understands and acoepts his obligations as an employer of labor under the Fibnda Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Soplplement, and has complied w it the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public; notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. - - Retnarks (Signed) ui •i ng Inspector My Com res.' PLANNING BOARD DATE Chairman Member Member , Member Member . . .. T , Member Council Approved Date Disapproved STATE OF FLORIDA, i COUNTY OF DADE. i ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 4 7r-A247/c)/9-4 �$�y4 �.. u1�.4.��.t°�. P ... a ,S. °�- yr-4 yv (i .-..•_.-- ^_ , —.-r r to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the.....C?. .".7 Q�. 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 i�/1 Date )/19 1 Iq Disapproved _. Date.. (Signed) ;UND o T; RU Cf.NEIIAL 1Na UJNl, ,... - ....::. m ate NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the J l.tnnir;; Board. A rc•,n"pectiun 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. � Application is hereby mode for the approval of the detailed statement us me plans and specifications herewith submitted for the build inc- or other structure herein described. This application is made- in compliance and conformity with the Building Ordinance of Miami. Shores Village, Florid.. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the iluilding 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. L) Date. —19 Owner's Name-and Address Registered Architect and/or Enincer ....... -....- — —.— .....—.....,. .-4... •••••11,111•••“1..... NIT.. I T.. Tr Name and address of licensed contractor (\‘ \ ‘ Its 1 5 giliz CoN) / i SG 4 cqEsr D/x1E- liklw Location and legal description of lot to b built on: 'tg / ir Illock.. I . — Subdivision /P.I.Jee41 7q'N(t) // /s3 Street and Number wheru work is to be done...... --- 5 Er.s E :Co pi (I Wkt S 7/ Z <F- State work to be done and purpose of building (by floors) c Are_ Qr rz_ tY1 IZEFeRIGER607 L 1■.) ES New Building Remodeling Addition To be constructed of Kind of foundation. _ Roof Covering / 4-00 ad °I, Estimated Total cost of improvements $.— ....... -Amount of Permit t_..... a 0 Zone cubage required. 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 iinslersicned applicant for this building permit does hereby crrtify that he understands and accepts his obligations as an employer of labor under thc Florida Workmen's Compensation Act. being Section 5966. Compiled General Laws of Florida. Perin:mem 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 bc 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 arc required by the Act. The undersigned agrees to employ only such subcon actors, on work to be performed under this pennit, as are licensed by Miami Shores Village. Remaks._-_ (Signed) STATE OF FLORIDA, i COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments. perionally ap- .,., 1 i S.U9:1■EU ' ....1* t' e all ... ...•■ . to me well knovni, peared and who. being by me first duly sworn, upon oath deposes and says that he is the. of tile above described construction. that he has carefully read the foregoing appication. and that therein by him stated are true.. Permit No.. Disapproved (Si;ned) Citainnan Nlember MIAMI SHORES VILLAGE BUILDING- INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT E /.Of.? G Stree Date Notary Public, State of Florida My Commission Expires 41(114PX--R11111,14.-441-44.: rLORMA HY COUISSI011 EXP. V1.28,1992 DATE BONDED THRU GENERAL TaS. UND. Membcr — Member - Member Member Council Approved .Date Disapproved Date A (.11.irge of 31.00 will be made for making corrections or changes to this application after approval has been obtained (mm the Board. A re•inspection fce of 31.00 will be charged when such re-inspection is made. necessary by improper notice for inspection or faulty materials anu/or workmanship. Building Inspector --Plan Cubage. PLANNING BOARD -1« and for no other purpose. Repairs .. ...................... No. of Stories Read,,S m to and Subxcrtb4 fore me. he did sign the same, and that 17facts '3- Date � /,�,� ,c.. 9 Job Address / 3 5 4 , „ 9 c 7 Tax Folio /1 1/4q'06 /3 Xr /f Legal Description /9' 66r / /T 4 / / 1 9 J A /7/ Owner / Lessee / Tenant 72 /GG'e e> /i , i,,,9 i-' . Master Permit # Owner's Address /3 5 G/i . c iL/ Phone t '1 b / < `I l l Contracting Co. C; Ktv. ,- -D /-74_, f Address / ` /D, ./Z/<::: / Qualifier c4eeQ;f,/ (S /4 ) to ecko SS# -)&2. - 17`/ - 6- 36 Phone 5 -r 2 5 / State 0 e nicipal # Competency 4F Ins.Co. Architect /Engineer Bonding Company Mortgagor Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION ( � c7Cfi'i <� L c.; J e // Square Ft. PERMIT APPLICATION AR MUNICIPALITIES OF DADE COUNTY (OHN.:R TO RETAIN COPY) Zoning Signature of owner and /or Condo President Date: APPROVED: Fire Address /ae Address Address Estimated Cost(value) cL! <Y //5 Y /5 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. i 0 9f Co Date: e t: !© /`� y tr iiktof '4 .oN,SE.NakeONt ui1der ;Notary Pubic, Stat . of Florida :My COMMISSION Exp. April 30, 1996 No. CC197545 4 / Notary as to Owner and /or Condo President ;eta/ as to Con rector or Owner-Builder My Commission Expires: My Commission ET4LILL tb. uu type or stamp name of Notary Public Personally known EOR Produced I.D. ** * * * * * * * * * * * *} Type and i* fiber of 1.D. produced: ►�. 4/_ * * ** FEES: PERMIT "1(549 (�'l/ RADON C.C.F. 1 ?fD take an oath, or NOTARY ✓t � ID NOn q, Q Other Building 6 j )9 !/ Electrical Mechanical Plumbing Engineering Jit 31 ) .te Joati4 urstill: • 1 4 . .0p:ion/I" k9i THESE PLA4VS ARE APPROVED FOR ISSUANCE OF A BUILDING • WITH PO V.RRWICES • WITH VARIANCE(S) LISTED IN "REMARKS" NO OTHER DE "IAT ?O "S FROM TuE MIAMI SPORES BUILDING AND ZONING ORDI::ANCES WILL BE PERT I"iTED. UNLESS SPECIFICALLY LISTED BELOW. ALL OTHER APP' ICA(?'.E ST:\TE AND COUNTY LAWS II]UST BE COMPLIED WITH BY ALL PARTIES. Aut foriPed Signature Date FIN DEPART.1ENT PL':.31C WORKS POU.ICE DEPARTMENT BUILDING DIRECTOR -I 6121 PLAN :ING & ZONING PO +gnu VILLAGE COUNCIL APPROVAL PRELIMINARY: FRAID REMARKS: M C n, GT 3 TEE xs 7' ^ CCC ��MP�IA,�CE W:,!� .�?� SII�:!:� :��C:�:CA ��.� :' _.._!�� AS ADOPTED i DV MIA��O SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER & SUB CONTRACTCRS ARE CHARGE) b',ITIa TPr VIOWLEDGE OF ALL BUILD- PM REGULATIONS WHETHER OR NOT SPECIFIC LLY INDICATED HEREIN. 1 / 0 L 3 -e1 Lela tpf 5- "` s T t >;xKT � id% 2! �acuous�� wv.rpu.VS �-ro J -4 14 ) EL Ca'. p" '2 c a 1— i en GORES EL' 4: ovrsct4 2 I .1 -em oF. 4 L -- __L�./isit - l -o © =ex - rte C� >G E`f - y�> Ot= 2E��DEt.I cwacZTH 5rv>= f �4' M a�f rcMBL' -1' t4T . i t-Itt4 - E.y.141 2g �JI I�l . ti.gTALL 2 VENT F3 e.5 A1 R II© LL'cVEL Eo -W41� . ' 1t.L4TN,tr�"� ct o" . C> g V GOPifCY \v is 5o. 3 • t T UYRta 1.1 tvtoNO$t W.eck.un,IG1 11 MI EriGLOG,tlr - CAA- T31.oc t� tatzpcl< y�t4wtG�Z tot. AS ► �owuF�GTc�f�c� T'c , i 4V. Nttwty1 -- ;.9c1a1- ec . �X �i G MU \V�J — Vat' ., t'2 N rNO21iL Gt.rP ' O EXt - r G.tA. U .. VRIL.L 1 A c l5T CL' p►.JT 1t.IG- _ ot# 5 1 �/EL (18` tuto GNU ceLL oNE EA .)4 8t.G2:K MAN) u [- F► L. Get-LS ?x4c.ET2 . W / / s sC `5 CA -W. �. te f 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 ;P/ , 19 Owner's Name and Address Ben Pumo Jr, NoBQ 0.6 Street. Little P; +,vrt -; Registered Architect and /or Engineer Manfred lf'r ©d Ungaro Name and address of licensed contractor Ben Pumo B1dd, Corp, Bn�;GiQ6 t1e Location and legal description of lot to be built on: c ` Lot I9__. , 30' 13 Block 21 Subdivision Miami S loran Sac, I Street and Number where work is to be done State work to be done and purpose of building (by floors) and for no other purpose. New Building X Remodeling Addition Repairs No. of Stories 1 To be constructed of C.,B.S.. Kind of foundation JP41:dS1._..S.Q?�lSd.. Roof Covering f ile Estimated Total cost of improvements $ ,/ , �% Amount of Permit $ - , Zone cubage required............. t' c ; , - _Plan Cubage Distance to next nearest building 19' Size of Building Lot a0_°_ Li 29 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 0171/2.0r The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. 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 mm states are true. / Permit No L! - � Date E� ,c-\ Disapproved Date Notary Public, State of Florida (Signed) t,AJ Building Inspector A One family C,3.S Its residence, ono story. to me well known, Read, Sworn to and Subscribed before me. My Commission Expires PLANNING BOARD DATE Chairnan 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. Block 2 I Location and legal description of lot to be built on: Lot • • 1' 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 :�% � , %�� , 19 Owner's Name and Address 'Oa "�� "��'• No >( C;"`?'> Street '07 Registered Architect and /or Engineer r ya :•` r;i �,' (`. Name and address of licensed contractor U. - • = Subdivision State work to be done and purpose of building (by floors) '' y" f (' • • "• t;ra3.0 r _i��i3�_ii.vlf.- ..d...v_:u.� Street and Number where work is to be done and for no other purpose. New Building ' Remodeling Addition Repairs No. of Stories x, To be constructed of `- 0..; t t ?s.___.. Kind of foundation " 0C Vic), Roof Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required .Plan Cubage Distance to next nearest building ' Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent SuPplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) a 1 �.R STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No Date Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member ....... Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 73 33 ° ), e05‘- ZONE Paw .T OWNER'S NAME JOB LOCATION (ST. OR AVE.) ° T, n 94t1- GENERAL CONTRACTOR 'Bon Ptrnc D' g Corp BUILDING PERMIT NO. iC REQUIREMENTS NEW CONSTRUCTION REPAIRS ALTERATION ADDITION SUBMITTED TO PLANNING BOARD RE- SUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL 20,000 CU. FT. arrl l Igo. APPROVED CERTIFICATE OF OCCUPANCY NO. ISSUED i DATE J. '6.- )A LOT + 'RESENT ADDRESS 1 ,9730'18 27 72 ADDRESS PHONE NO. • I D o`. I L' .SJ V.:n 606 �•.L �Ci'L•�_:� i. 7 Zj ^" , J .r. ,a . Ivi. `� • REJECTED PERMIT FEE $ PLAN CUBE r.. 2. DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: nOr.C. TYPE STORIES ROOF CONSTRUCTION la 'Ai 4 BLOCK DESCR IPTION DESCRIPTION REFERRED TO COUNCIL BY TO O n (. CU. FT. REMARKS LICENSE NO. NO. BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE SUBDIVISION BUILDER'S BOND DATE EST. COST $ ' r rl INTERIOR CONSTRUCTION REASONS chf PHONE NO. LICENSE NO. DATE y- .. - • *" ., ' INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION. 2 -�7,(-z. 3:- :JB TEMPORARY SERVICE $ BEAMS & LINTELS 2 -/` - ��C v: 7 ' e - �!,{orJ Ci2-/v A /y}ydie- SEWER FRAMING ' \- `- 3 -8S Cai' = 7 S $ GAS SLc - Z- 21a - S.. 37 $ INSPECTIONS FINAL 7 .c -,- - nn ,,// I,.//[{J II J .7 LI BY RE- INSPECT BY , CLEAN -UP ' -47 - ,- ,iee �� RE- ��/oeD — 3 -Z -. , —r.J iZ 13 3 b'Ct 3 CONTRACTOR 41 L0.,n4 I G - le1r*c 7-r- PHONE PERMIT NO. ,�/ S S DATE FEE $ NEW BLDG. 1 ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ $ SEPTIC TANK v: 7 ' e - �!,{orJ Ci2-/v ;. Q.- /y}ydie- SEWER $ $ • SOLAR HEATER S $ GAS $ $ INSPECTIONS INSPECTIONS DATE BY INSPECT BY RE- INSPECT BY , ROUGHING 2- ' -47 - ,- ,iee �� RE- ��/oeD — 3 -Z -. , —r.J iZ 13 3 b'Ct 3 w GAS H. W. HEATER CONN SEWER RANGE CONN. SE TIC TANK P v -f _ Z - St - ,,,/ &. 5 SOLAR HEATER - �-77 4q_ { p -- VZ 3/ FIXTURES )) 'S ?' S l ,, W!nn 1 - , J1/ t° d° ii/gam CONTRACTOR - PHONE PERMIT NO. DATE FEE $ NEW BLDG. I ALTERATION . ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ RANGE CONN. $ MOTORS S FIXTURES $ INSPECTIONS DATE BY RE- INSPECT BY. RE- INSPECT BY TEMP. SERVICE Z - 3.1.. V 1e.1.1a2 ROUGHING 3- e•- 1 "7 - 3 M3 H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL �-77 4q_ { p -- VZ 3/ 7i Ca ,� - 2 -Z o �Bv BUILDING INSPECTIONS c012 #3. PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE S /-.- ,� BY LJ 17 /Q A . 4 e BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect / Contractor or Builder ❑ r , Steil t ❑ PERMIT N. o �� MIAMI SHORES VILLAGE. FLORIDA Work to be performed under this Permit Legal -0 _ ' ' sue_ / Description ,� P �' � '� � Bl. � vision Address of Value of Amount 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 ct 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. 0, ;J - Y R � r ; Signed. BY t INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for gil work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY ti' t 1 BUILDING ELECTRICAL PLUMBING ROOFING J/ , Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building MIAMI SHORES VILLAGE. FLORIDA o PERMIT 11T° 3563 f Bl DATF 195 Contractor's License No. Work to be performed under this Permit Subdi- vision Value of Project $ , - Amount 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. M BY INSPECTOR, In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY e Page 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Comm- s- ust be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochu.= j/ lag- Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADS A, COUNTY OF MIAMI -DADE �r4�a &Or Signature of Owner vt Print Name Sworn to .nd subscribed before me ., OV,tt &$ IUANATORRES SEAL COMM:iSION NUMBER ,,..' CO343452 lsOF ".lY =MISSION EXPIRES FL MAY 26 2003 Signature o SEAL: Personally known fisid OR, Produced Identification Type of Identification Produced: PERMIT APPLICATION Si agp t :!oPl!*ta �' blic - State of Florida `� KENNETH SHERMAN Notary Public, State of Florida My co m. exp. May 24, 2003 o nm• No CC81.9725 Personally known OR, Produced Identification SEAL: Type of Identification Produced: ELECTRICAL 'I'YPI'. Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYI'E Service Repair QTY. 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 QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE 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 a 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. TYPE Drains, Roof QTY. TYPE: Miscellaneous Fixture QTY. 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: CONTRACTOR BY emb\, Name '5 5 i Name PIA,rik, License No. S Address 1 ts A) (� / S ` �-1- . . . 6> ) F-1 . 3 - 6\(, 7 Telephone or y `( )OFF --(1 .� nt (�' "� Qualifier Name D �„ 1 E s x 1, ENGINEER BY D • E Name PIA,rik, rs l S License No. i�,"$A1111 , Address A ,4/ Telephone "L (fr..../4 ' rs Fax E03 � ( 0�4IZ SECTION BY D • E Zonin:� rs l S Electrical i�,"$A1111 31 Mechanical A Demolish Plumbin: rs Fire Foundation Only Public Works Add'I Attachment Structural ,J - a'. Building Official Other /1. PROPERTY OWNER New Construction i \ p Name r ■ s ,2 \ (°, 6 , I 3�'ii CAr Alteration Exterior Address ` ., 5 .- l e - 9 9 5• tdv► , S its N.,. 3 31 Home Telephone Demolish Business Telephone Relocation of Structure Fax Foundation Only TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ▪ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review ❑ PROOF OF OWNERSHIP (Attach) ❑ FIRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES REVIEWED AND PREPARED BY: (sq.ft. = x/1000 x ¢.60) (¢.005 / sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ 6 V 4 . Lie DATE: CONDITION OF' APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the pronertv owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Job Address: City State Zip Folio Number Description of Work . C 4 Age,/,-- Lot i Block Z Subdivision 'VA; . ■lc PB PG Zoning Linear Feet c urrent Use of Property Square Feet Units Floors Proposed Use of Property Value of Work Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other � S N.) 67 0-1 (05)-. Address Apt. Chg. Contractor Renewal Revision Extension Supplement Reinspection PERMIT CHANGE (✓ ) ARCHITECT License No. X Name Address Telephone Fax Master Permit No. Subsidiary Permit No. )Air -1/4;k■ 5\Are5 3,138 • Flood Zone Base Floor Elev. PERMIT APPLICATION Bldg Value Tax Assessed/Appraised Value ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. 'TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16 -20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator Q'IY. TYPE 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 Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYPE A/C Condensate Q'fl'. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. 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 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY ROOFING and SIGNS and there may be additional permits required . from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Comm a�>° ust be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochu - SCI' / Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE ST L1Y 0 '9!A, COUNTY OF MIAMI -DADE 0.-Or 011 ✓t6{ &o o'v Signature of Owner Print Name Sworn to . nd subscribed before me SEAL: y Signature o 14,,E 1,1i, - �.,,.`�, O`' il ie? IUANAT AR E SEAI w t, * COMMISSION NUMBER - l • wryly' Q CC840452 9 OF Fl „q MY COMMISSION EXPIRES MAY 26,2003 Personally known OR, Produced Identification Type of Identification Produced: PERMIT APPLICAI''ION ai r= • t "f'blic - State of Florida KENNETH SHERMAN Notary Public, State of Florida My ca M. exp. May 24, 2003 amm. No CC819725 Personally known OR, Produced Iden Sig SEAL: Type of Identification Produced: Page • PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Date Time Type Insp'n f / `� Permit No. 1 C 4 , _ ` . , Name Phone # For Ins Corr Re -I MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request ) Address Company - - ;S 5) gor 5' $ec®o® 0 ctor: sp'n Fee