ROOFINGApplication 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
Chairman
Member
Member
Council Approved
Appuri TO F o LULLt DNt GCS= 9T
��,✓
"JiLL-14 Date .3 v a 5/ /�� Q __ ., 19..1.-.
No 9
Registered Architect and /or Engineer
Name and address of licensed contractor.._
Location and legal description of lot to be hilt on
Lot__. Block Subdivision
Street and Number where work is to be done 7.3
State w rk to be done an purpose of buildin (by floors)
Disapproved _ _ Date
(Signed) ._)• !\
Building spector
M U -U M a cq o
0
ES V LLA E
81' -' .DING INSPECTION DE 'ARTMENT
c . . f /OOA.' e 2 ‘,41 -
ry""
Plan Cubage
an or no other purpose.
New Building Remodeling Addition Repairs No. of Stojies
To be constructed of Kind of foundation Roof Covering__
C era'
Estimated Total cost of improvements $ 02 J Amount of Permit $
Zone cubage required
Distance to next nearest building__. ___._ _ . Size of Building Lot
live load to be borne by each floor___
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks - -- (Signe
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.
/' ? Sf - 2ff- 7J
Permit No Date
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
7, 06
PLANNING BOARD __ . DATE
Member
Member
Member
Date Disapproved
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has horn obtained from
the Planning Board.
A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper not c for insp,. ion or faulty
materials and /or workmanship.
�e�
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
N.E. 95 Street Folio 113201p I �
ate 11-18-93 Job Address 973 Tax Foli �' l
egal Description LOT 2-4 4' 2_1 7co Mea sf,c 2-P6 -10-1
wner / Lessee / Tenant Robert Steck Master Permit #0
wner's Address 973 N.E. 95 Street Phone 758 -9593
ontracting Co. aAI °-i- y Poori ( J r.OA/f /A. �IVC Address f.51 i vLU 4Q "Sf
/�
ualifier r /eS ALGdhta Phone 76/ 3k a
.
tate #‘204 5 Municipal ii,)67 49 Competency Y 17 kR 9 Ins .Co .
rchitect /Engineer Address
•
onding Company Address
ortgagor Address
ermit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIG!
ORR DESCRIPTION Will tear off roof to wood deck, tin 301b. ASTM as pPr hni 1 ling r'od1
will mop on with hot asphalt one (l) layer of Ruberppid Bitumen n in, ad of 901b
Will install Soani sh ri i m i„� &_ Y 1o��n.�r S� 1. et AO-t pt-1 t* S %Mk/
\e
guars Pt. 29 sq. Estimated Cost(value) $ 13,000.00
ARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO Dc
O MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTENT
O OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUI
OTICE OF COMMENCEMENT).
pplication is hereby made to obtain a permit to do work and installation as indicated above, an
n the attached addendum (if applicable). I certify that all work will be performed to meet th
tandards of all laws regulating construction in this jurisdiction. I understand that separat
ermits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
WNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work wil
e done in compliance with all applicable laws regulating construction and zoning. Furthermore,
uthorize the abo a -named contract r to do the work stated.
ignature of owner and /or Condo President Signature of Contractor or Owner-Builder
ate: IA -/3-91 / Date: / - /3 - �j
LOU HERNANDEZ
j�,., MY COMMISSION 9 CC 324212
5•; Flu
EXPIRES: October 10, 1997
Notary as t
y Commission Bap MA RY My Commission
g' Bonded Notary Public Underwriters
#
EBS : PERMIT ✓ ®, ®' RADON C.C.P. ` -2, NOTARY TOTAL DUE
otary as t. Owner and /or
?PROVED:
. 1
MARY ; { 7 ;1 . ')
L0 �
MY COMMISSION 9 CC 324212
i �•• �'s . jI EXPIRES: October 10, 1997
, Underwriters
' t ° , Bonded Thru Notary
•
Co
#
Other
Electrical
Mechanical Plumbing Engineering
Volume 2.1
METRO - DADE BUILDING & ZONING
ROOFING APPROVED APPLICATIONS
BUILT -UP ROOF REQUIREMENTS:
1) Moisture test mandatory on any recovery.
2) Uplift test on any recovery.
3) No hot mopping of felts directly to 150- Board.
4) System must meet 1 -90 requirements. You
may refer to Factory Mutual or provide a lab
tested system that will meet or exceed this
requirement. (not required for wood deck)
S) Intl:III an approved base sheet.
SHINGLES
TILES
JULY, 1993
Up to this date, only Malarkey SBS shingles have been approved to be Installed in Dade County. Obtaia
Notice of Acceptance prior to the Installation of thls shingle. More Information will be made available as it is
obtained from the Code Compliance Dept. Two (2) plies of #30 ASTM 0 -226 are required at this time. Also
tin caps 6" o.c. on laps and 12" o.c. on field. Any of thls information Is subject to change without notice.
These are only GUIDELINES.
Manufacturers specifications and Notice of Acceptance sheet must be placed at Jobsite. Also no "Improving" is allowed.
Work must be done as per Notico of Acceptance.
Ceram Ica de Esparta
(Nail -On System)
Clay: Spanish 'V' Tile
Prodek, Inc.
(Nail - d Mortar Set Systems)
Vulcan
Clay: Spanish "S" Tile
La Mancha Tiles:
(Nail -On & Mortar Set Systems)
Clay: Spanish "S' Tile
Metro Roof Tile:
(Nail -On System)
Spanish "S"
Cement Flat (Mortar Set)
Best Clay Tile Corp.:
(Mortar Set Systems)
Spanish "S" "Venezuela. S.A."
Clay: "S' 'Salvador, S.A.'
LIfetile
(Nall -On Systems) •
Cement: Colonial Slate
Flat
Espana "S' Style
Capri
Almar (USA), Inc.:
(Nall -On & Mortar Set Systems)
Clay: Altusa "S' Tile
Altuse Barrel
F.R. Bore .
Pioneer Concrete Tile:
(Nail -On Systems) 2:12 pitch
Cement: Hadende
Shake/Slate
Rustic Shake
Spanish "S
Flat 9'
Classic 100
Entegra Roof The:
(Nail - System) 2:12 pitch
Cement: Estate
Skandia
Bender Roof Tile Ind.,Inc.
(Nall -On System) 2:12 pitch
Cement : Palermo Corrugated
Nordic Flat
Etema Roof 11Ie Manufacturing
(Nall -On Systems)
Cement: Estate Barrel
Skandia Flat
Marley Roof 111e:
(Nall -On Systems)
Cement: Barcelona
Castille
Monier Roof Tile:
(Nail -On Systems) 2:12 pitch
Cement: Mission "S"
Cement
•
Villa
Flat Shake & Slate
Vanguard II Roll
Spanish "S"
Vanguard II Flat
Classic "100"
The tile shall be installed on a solid nailable dock of 5/8" thick plywood for all new construction or to 1/2" plywood deck on
re- roofing.
The nailable deck shall be covered with a #30 Type II (ASTM 226) anchor sheet maintaining a 4" overlap and tin capped
t 2 o.c. except 6' o.c. at the laps. Over this, a #90 mineral surface roll roofing shall be fully hot- mopped with nominal 2"
laps with the concealed edge of lap tin- capped 12" o.c. except at the valley flashing.
The galvanized steel strip shall be nailed over the #30 anchor sheet ® 4" o.c. and over lapped for 5 ". When required and
prior to the Installation of tho tile, a formed 0.019 thick steel bird stop shall be Installed at the cave, which shall be
bedded in mastic to the membrane and hand nailed to the roof 11" o.c. and near each end.
The tile, maintaining a 3" head lap, shall be attached with two 10d plated steel gun nails per tile over a bed of roofing mastic
applied to the #90 roll roofing, at nail penetrations.
The eave tile, in addition to the 2 - 10d nails, shall be attached with formed steel grlp dips (refer to Mara Catalog pago
centered 4 3/4" from the nose of each tile. The dips shall be 0.043' thick by 1/2' wide, galvanized steel, attached with
one 10d galvanized steel hand driven nail located 1' from the 90 degree bend in the dip. The clip shall be Inbedded in
mastic applied to the roofing, al tho nail location.
STRONG RECOMMENDATIONS:
On commerclal applications a continuous
cleat is strongly recommended both by
manufacturers and the Building and Zoning
Department This detail Is found on almost
every manufacturer specification and the FM
guidelines for perimeter flashing.
4'
iAETROCIADE
-- -
METROPOUTAN DADE COUNTY, FLORIDA
ME=TRO -DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE DEPARTMENT
METRO -LADE FLAG SUITE
$r
140 Y FLACCt.E BUILDING
SSTREET
MIAMI, FLORIDA a31304681
1+41C 376.700®
June 15, 1993
• TO WHOM .iiMiLtraNCL.RN
Almar (USA), bro., has fled with this office the additional and
data to support the required acceptable test
po
both to sup and mud-on r for , al and cont�d use of their Ahura "S" Clay Roof Tile for
both nail-on ad m d-o R� Al� Barrel Clay RAT for mud-on; of Notice of
expired on March 12, 1993.
•
The Wes for mud -on sbfill be installed on a solid imitable duck of 5/8" thick plywood for
new construction and on 11 M tbicic
plywood on re -rooms
The deck shall be coverld with a 30 Type 11 (ASTM D -226) anchor sheet and tin capped
on ail laps, 12" c.c. in die field and 4" on drip edge. Over
(ASTM D-249) roll rooiing.cap sheet using bot this, a conforming to A 90 Type II
D- 312 -89. gP �l Type IV caaformiag Lo ASTM
The tile shall be applied to the roof with mortar consisting of one bag of Florida Roof Tile
Cement by La Fare Corporation for Type M mortar and 14 shovels of sand conforming
ASTM C-144 fora 2:1 mix, tip to
minutes. adding approximately 4.5 to 5 gallons of water and >nhc for 5
Due to Hurricane Andrew, this office has been imitated with requests for
products and renewals of those to expire which has es ponding with an
both new
official Notice ofAcceptanoe. caused a large back log in res
In the interim period, please accept this letter in allowing these products to be installed by
a Licensed roofing contractor in accordance with the manufacturer's further specifications
Chapter 34 of the South Florida Building Code until an official Notice of Acceptance and
nee is issued.
GD :co
Gil Duman , P.B.
Product Control Division
Supervisor
1 41.l UVJ
Flaahings:
A. Valleys (select one)
1. Install roll valley minimum 16" width with 6" lap joints. Nail to secure in place
as code requires.
2. Install preformed open valley minimum 16" width with minimum 2 1/2" high
center and minimum 1" metal edge retums. Lap joints minimum 6 ". Secure in
pace as code requires.
1. Dormers, side, chimneys and other vertical wall surface flashings shall extend
upward at least 6" and be completely counter- flashed. Flashing shall extend
under the tile a minimum of 5" with a 1" tum up at edge.
C. Where sloped roof surface meets the face of vertical wall surfaces at dormers.
chimneys and other walls, the flashing shall extend up the facing wall a
minimum of 4" and extend downward over the top of the tile a minimum of 5 ".
The vertical wall surface shall be completely counter flashed.
D. Eave drip metal shall be nailed or stapled along and directly on top of sheeting,
fastened 6" o. c. and 1/2" in from top flange. Lap all joints a minimum of 3 ".
6. Application of Tile:
A. For mortar on application, mark horizontal guidelines at 16 1/2 ", which will
provide a 2" nominal headlap.
1. For nail -on application, mark horizontal guidelines at 15 1/2 ", which will
provide a nominal 3" headlap.
C. Mark all vertical guidelines at 9 1/4 ".
0. Set first course at 161 /2" from the eave. This will provide a 2" overhang at the
save.
E. At the eave line, clay, mortar, rubber or metal bird stop shall be used to boost the
first row of tile.
Note: In high wind and hurricane areas, additional fasteners may be required at
the eave course. Consult local Building Codes for requirements.
F. For mortar -on settings, each tile shall be set over a full trowel of mortar placed
directly under the projection of the lett flat side of the tile. Press tile down firmly
to allow wet mortar to fill "Dove Tail Locks" for proper bond.
I. For pitches 4/12 and above, nail eave course with one nail in addition to mortar.
Apply plastic cement to seal all nail penetrations.
2. For pitches 6/12 up to and including 7/12, nail every third tile in every fifth
course in addition to mortar. Apply plastic cement to seal all nail penetrations.
3. For pitches above 7/12, nail every tile in addition to mortar.
0. For nail -on installations, install tile with nails of sufficient length to penetrate
the deck by 3/4 ". For pitches above 6/12, all tiles shall be attached with a
minimum of two nails. Seal all nail penetrations with plastic cement.
B. At 55' above grade or greater, all tile must be attached with a minimum of
two nails in both a nail -on or mortar set installation
I. >:asten and cement all gable rakes at the horizontal guidelines.
J. Where tile overlaps flashing, tile must be secured with approved tile adhesive or
cemented in place.
K Tile must cut smooth and straight to maintain the proper width in the open
valley. Width in the open valleys may vary according to local conditions. It is
recommended that the minimum width of exposed metal be 4 ".
L Where field tile meets the hip nailers, tile should be cut along the hip boards. The
joint between the cut tile and the hip nailer shall be sealed neatly with plastic
cement.
N. All hip and ridge tiles shall be set in a bed of mortar and fastened with a 21 /2"
nail. It is then recommended that the mortar be pointed to a clean surface.
1. Materials:
a. Clay tiles shall be Altusa S' as manufactured by
Alf reria Del Turblo S.A. (ALTUSA) for Almar (USA).
Inc. 18 1/2" long by 10 1/2" wide nominally.
1. Under eave shall be (specify one)
1. Clay eave closure
2. Rubber eave closure
3. Mortar filling with weep hole
4. Metal closure
a Asphalt plastic cement:
Heavy body composed of asphalt and other minerals, con-
forming to ASTM D2822 and Federal Spec. SSC -153 type 1.
L Cement Mortar
1. Cements
a. Blended Cements- conforming to ASTM C -91 type M
IL Portland Cement- conforming to ASTM C-150 type I
c. Masonry Cement- conforming to ASTM C-91 type M
2. Sand-conforming to ASTM C -144 uniformly graded, clean and
free from organic materials.
3. Mixes - conforming to ASTM C -270 type M (select one)
A. Cement 2.07 + — E - 1 - A
1. Combination of cement 2.07 E -1 -C
4. Mortar flow 110 + — 5% conforming to ASTM C -230 Flow Table.
2. Decking:
Solid decking shall be of proper thickness (1/2" minimum plywood
sheathing) to be structurally adequate and properly fastened to support
the anticipated loads. Decking material and installation of it shall
comply with all local Building Code Requirements.
3. Underlaymenl:
Never install underlayment on wet, frozen or icy surfaces. Sweep roof surf:
broom clean. Cover all sloped roofs under tile with the best quality asph,
impregnated roofing felt weighing not less than 43* per square feet.
Spicily Daalrsd Ualrlaynaat:
Consult Local Building Codes for Compliance
Nall - Oa batallatau:
A. Minimum 4/12 and greater:
Lay one layer of 43* base sheet with a sealed minimum 4" headlap and
side lap and nominal 3" tile headlap. All tile nail penetrations to be sealed w
plastc cement.
Marto -0a hobnail's:
B. Pitches 2 1/2/12 and greater (refer to building codes for minimum). LL
one layer of 30* felt, secure in place with tin tags as code requires. Lay w
minimum 2" headlap. Apply 90* mineral surfaced roofing felt to be solid
mopped to the 30* felt with hot asphalt. Lay with minimum 2" headlap and 6
side lap. Back nail 90* felt with cap or tin tags 12" 0. c.
4. Fastening Systems:
Nail -On Installations
A All nails should be large headed nails, 8 penny, corrosion resistant, lone
enough to penetrate through the sheathing by 3/4 ". Copper, stainless steel
hot dipped galvanized nails are to be considered to extend the life of the roof. A
nails penetrating through the watertight seal should be waterproofed with
mastic sealant complying to ASTM D- 2822 -75, type II. Nail length may van,
depending on the thickness of plywood and exposed ceiling situations wher
nail exposure is unwanted.
B. For steep roof applications above 7/12, additional fasteners may be requirt
i. e. tile tie systems, nail - locks, wind -locks per manufacturers specification:
(consult local building codes).
NAIL
NIVERSAL
TILE
NAIL
NIVERSAL
TILE
DOVE TAIL LOCKS
ALTUSA S'
FIELD TILE
MOR1 AR
NAILERS NAILERS
GABLE TO GABLE SECTION
1915
HALF
TILE
FIELD TILE
GUIDE
UNES
NAILER
NAIL
FELT
HIP & RIDGE TILE
MORTAR
TILE
FELT _
ALTUSA S'
FOR 7:12 SLOPE AND HIGHER
91/4"
MORTAR
NAIL
UN.VERSAL
TILE
HIP AND RIDGE
SECTION
FED
91/4"
/-- TILE
NAIL
- WOOD NAILER
91/4" 91/4"
1 - 1
43. FELT
NAILON INSTALLATION SYSTEM
11LE
10"
MORTAR
NAIL
1/
REGLET
FLASHING
MORTAR
HIP AND RIDGE
TILE
GABLE-RAKE
FIELD TILE
FLASHING AT WALL
EAVE CLOSURE
FLASHING
FASCIA
NAIL 81/2 NAIL 911 1'
HOLE A HOLF
FLASHING AT WALL
GABLE -RAKE
TECHNICAL DATA MUDINAIL
METAL Cr.
FLASHING
Weight per Tile (Nominal) 7 lb!
Pieces per Square (Nominal) 97/10
Overall Size (Nominal) 18 3/8 x 10 I/:
Exposed Size Max. (Nominal) 15 1/2 x 16 I/
Tile Thickness (Nominal) I \2
Firing Temperature 2000
Breaking Strength Avg. 651
Water Absorption Avg. 5.8'
Freezing Test No tile cracking after 50 cycle
Due to the nature_ of clay, slight variation may uc< u1
Rltusa '1
rkUi'1
NOTTCE OF ACCEPTANC'_E SPEcIFTe„S',QNDITTOu, ,
The bottom end of eave course tiles shall be closed off to the
deck with cement imortar, a clay /ceramic eave closure or a 1" thick
molded rubber closure all providing a 1" weep hole:
The rake tile shall be bonded to the typical tile and the typical
shall be bonded to the valley flashing with Type M Mortar.
'Altusa's. "S" tileshall be installed with a minimum exposure of 16"
for mud - on system and a minimum exposure of 15" for nail - on system.
3. Tile shall conform to the following shapes.
CIABLZ•RAJCB
Cover, pan
gable rake,
hip and ridge
tile
TO 1. u5'360 :1 :-l5 F • 0�
ACCEPTANCE No.: 90 R 2
APPROVED
EXPIRE$ : March 12. 1993
.y■
Aitusa Awl
it Diamond, P.E.
Product Control Division
Supervisor
Z0'd Z620TSL 01 2,1764.-ZSZ '3C U 0 S 31043 WOJd WdZS:ZO 266ti -02 -11
06-02-1993 01 02P. FROM .
•
METRO'OADE
! TO WHOM IT mx7.coms
. Inc.. has filed with this office a request to
renew their Notic Lot Acceptance #90-0208.1 R 2 which exp4.7#d on -
March 12, 1993. 1
1
1
Due to Hurricahe Andrew, this office has been inundated with
requests for both! nessi products and renewals of those to expire
which has caused ' large back lbg in respondiu with an official
Notice of Accepta ce.
In the inteript-period, please accept this letter in allowing
.these products toibe installed by a licensed roofing contractor
in accordance with the manufacturers specifications and Chapter
34 of the South plorLda Building Code until further notice by
this office.
GD:cg
METAOPOLITAN DADE COUNTY. FLORIDA
METRO•DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE DEPARTMENT
SUE 1
METRO•DADE FLAGLERBU
140 WEST FLAGLER STREET
MIAMI, FLORIDA 331304563
(305) 375-2901
FAX (305) 375-2908
•
•
TO
March 30, 1993
! •
Sincerely yours,
13059600465 P.01
AiL41/G1.4j,
Gil Diamond, P.E,
Product Control Supervisor
ZO'd ZSZOTSL 01 2,178L-ZSZ 'Sada OS 310d3 WO el WdSP:ZO £661-02-TT
PERMIT NO.
STATE OF FLORIDA:
COUNTY OF DADE:
n 2. 3
eci
pF
r � /
:.. � J cf, 1.l mnd Coun4yCourk�
er r
EFrisc{ ;r .py o �>
¢rtaiosffric
STATE OF FLORDA, COUNTY O DADE
NOTICE OF COMMENCEMENT
TAX FOLIO NO
93R613824 1993 DEC 14 11 :15
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following Information is provided in this Notice of Commencement.
973 N.E. 95 Street
1. Legal description of property and street address:
2. Description of improvement: , Install new tile roof.
3. Owner(s) name and address: Robert Steck
973 N.E. 95 Street
Interest in property: ► �'n 1 A
Name and address of fee simple titleholder:
4. Contractors name and address:
5. Surety:(Payment bond required by ownsf from contractor, If any)
Name and address: /A
Amount of bond
6. Lender's name and address: N /A
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida ( Statutes.
Name and address:
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida SStatutes.
Name and address: / 1T'►►
9. Expiration date of this Notice of Commencement: (the expiration dale is 1 year from the date of recording unless a
different is specified) 1Ylana S I q T y
&orators of owner
Print Owners Name l T 17 e r-) .S )-G C 16 QQ ??
Sworn to and subscribed before me this __day of r . ►1 g�
Notary Public
rut Notary's Name
Ny Commission Expires:
,`,Aro 0 B0°ded Thru Notary Public Underwrtters
Miami Shores, F1 Qri da x'11 1R
u "id•
Prepared by: Carlos Arocho
Quality Roofina Contrartnr
Address: 251 N.W. 99th Street.
Miami, Florida 33150
Inc.
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
ate
/2.. f / (73 Time
Type Insp'n
Permit No. P i 0 3 - 1
Name
Address
Company fY) t3) 1L
Phone # �)) >
For Inspector! / 3 _Tame & Date
Approved
Correction
Re- Insp'n Fee
c al S e
7,,(d
MIAMI ;SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Dat) // 0 72 Time
Type Insp'n 1 ' �f
Permit No. C� 1. 0 0 j
Name
Address 9 t > • c• /-)A
- / A
Company 1__ 1 " 7?) 9/e1.{ .__
Phone #
For Inspector / 1 / \-) 3 )Name & Date
Approved ❑
Correction
Re- Insp'n Fee 7
4.1