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1115 NE 97 St (11)BUILDING ELECTRICAL PLUMBING Owner of Building Architect contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA 1 PERMIT N? 10250 Work to be performed under this Permit Bl. Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed • BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot 1 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 10249 Work to be performed under this Permit Bl. Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application' herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. ima BY AUTHORITY PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 07rni Job Address / � �=�ax Folio • Legal Description Owner/Lessee / Tenant p c9 / Y Owner's Address /// 5 / � 7 - 57/c , / Contracting Co. /�1i /7 Address � ®/ Qualifier ,��,G SS# Phone Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN State # � WORK DESCRIPTION �' c Square Ft. 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. Signature of owner and/or Condo Presi ". /' Notary as to Oyvfier and/or Condo President Date My Commission Expires: o w ISABEL BEEVERS My Cemmissicn COMM Expires nay. 08, 9 ooe lF OP F6 Bonded by NFNU 800- 224 -8743 FEES: PERMIT (Y,' RADON APPROVED: Zoning Building Eli Mechanical Historically Designated: Yes No Master Permit # L'/ g3 Phone C.C.F. 4.g NOTARY BOND �f�v��gT1 y / T i /G 7 U (- 6?, x r &.,•- e, /44 - z-) Estimated Cost (value) r nii / j ln- J Signature of Contractor or Owner- Builder Date Notary as to ntractor or Owner - Builder Date My Commission Expires: 4 1, 434 `,. ISABEL BEEVERS A My Commacion cC42SC- 5 .1. 1 W Expires May. 08, 4" .: Bonded by NFNI! e00- 224 -aZar Electrical TOTAL DUE Plumbing Engineering 6. Lender's name and address: NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. // — 30e5,5)/ 7 ./%`C STATE OF FLORIDA: COUNTY OF DADE: 99R066137 1999 FEB 05 16:00 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. 1. Legal description of property and street address: 2. Description of improvement: 3. Owner(s) name and address: Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: � r�—G ��C , — 7: ,o 4- O/ /e /d/ X74 / /- /© i 5. Surety:(Payment bond required by owner from con ctor, if any) STATE OF rLOR DA, COW H rY OF DADE ] N[Iti_3' ci ;.3'ri 0: F' fhb: If c Or o y sR 4ho Name and address: mr.�;cq; 9:ir- a r ;; „r,,r- n, , g � 41v CO / Amount of bond $ 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 Statutes. Name and address: £Q1( ,„ww 9. Expiration date of this Notice of Commencem t: (the expiration date is 1 year from the date of recording unless a different date is specified) Signature of Owner ill Print Owners Name _ Prepared by: Sworn to and subscribed before me this 2 day off C e/4,4 99 Address: iY' 0/ /y Notary Public- Print Notary's Name My Commission Expires: 1 Bonded by NFNU Of r., 000_224$368 , A 19 9 = W 7! °S$ my h , , , d r „ o' :Third 1 .ni. Mikkt" Ccu7 4y Cow* n.C. +0 � taliOe.. ISABEL BEEVERS My Commission CC460995 /li•( OA. 999 '3 3( 123.01 -52 2/93 Contractor's Name: Job Address: /// ' /i' / ROOF CATEGORY 3 (Low Slope Application) ❑ (Nail -On Tile) ❑ (Asphalt/Fiberglass Shingles) ❑ ( Metal Roofs \Wood Shingles & Shakes) ❑ (Other) ROOF TYPE ❑ New Roof 8 i roofing ❑ Recovering ❑ Repair ❑ Maintenance Flat Roof Area (ft Sloped Roof Area (ft Total (ft ,"7.. Master Permit No. Exposure category (per ASCE 7 -88): Building Classification category (per ASCE 7 -88 table 1): ATTACHMENT 1 5/8" tin cap Fastener Type: with 1 1/4" rs nail SPACING 9" laps Field: 12 " Perimeter: DETAIL 1 & 2 Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed) 1- gafglas mineral surface cap sheet with hot asphalt 2- gafglas ply 4 with hot asphalt 1- gafglas 75# base tin capped Corner: ❑ (Mortar- Adhesive Set Tile) ROOF PLAN PRODUCT CONTROL NO M GAF tiar n C5GFATC1 1361 Alps toad Wayne, 1\13 0949 Your applicatk5 Pra ha Appmel ok'. C.-1F car c-we Bes M-glp Roof ' e- - fee Wood ©osls under Chgrzw g dt6 4 DgeS C® tay Coda Bovervtirag the use of Alte ate Materials end cfr Conotmetion, and earnpt ly dczeribe6 in a® plans, specitlmions Calctlaaivta as submitted by: Dyvaexcli H apll� kag, dc2, FageBuP £ 1E2 ad ,e sePen Caw Fathso, earl Eindeatii' ee LaLo aeo&lo ij , has ham recoathended far ai by the Buildiatz Code Compliance Ofrice to be used in Dade County, FM& under the specific ®r,.ai4i set frog on pages 240 aul the standard conditions on pnge 41. This approval g,.$li not be valid aReg the date smtod Wow. The Building Code CoEnF1F-7:;3 asFaeo reserves the eight e® sure this product or material at any time from a jobaite or manufactures Omit fez gunlity eoutwl teak. If this vreAuct o8 naate a1 fiailg e® porfot t ixa tho approved it tier, the llaildine Coen C�rIalw Office may revoke, tiledify, or suspend he use of such product or Material immediately. the Ouiidi3g Cee Compliance Office ecsaa�ves the righ4 revoke this approval, if it is dezermiaed by the Building Code CowtplY.E,co Office that this product or material fails to Meet the requirements attic Building Code Compliance Office that this product or mmerial fails e© Meta the eequiae€ieti s of the South Florida Building. Code. The expense of such to43tine will be Whim-6 by the manufacturer. Appuv7¢d° 44 af3t99 Acceptance No.: 97-0204.21 Rev es No.: 95-1603.03 Expires: 1.110 ACC F ANCE HIS ES THE COVERSHEET, SEE A008T HAL PACES FOR SPECIFIC AND GI RfEl AL CONDITIONS BUILDING CODE CONIMIIIEE This application for Product Approval has been reviewed by die Metropolitan Dade County BuiltRae Cc Cothpiialce Office and approved by the &siblitng Cede Committee to he used pat County, Flee - cr4 L? conditions set forth above. s207510 man o6161?ono: Rooa a88e *)Ptma1 H padeovt@Bote.@ ©al ()UPLOff6 C =73 140 WEST vuteLEF Gt' s i JB; vtLCn1 4 . 2i :G. : PEE DUCT ,ma C -erg VA Me= lomepe o: Ga a�sl Rodri5tlea Product Control SespzAfiwe ChErles ®emer, Di Building Code Compiic p. Metrclttatt azde Coifmw Fr. GAF R aae lE s CouletniTalvfa 1365 9 Alps Rom, Wayne, Ni 07 4 °DUCE' C./ of Ncsi, TBCZ DV ACCEPTANCE i ODF G SYSTEM APPROVAL a Membrane Roo ng System ;tli Catet; Btge -up Rooms ypc : Conventional � ub-1 y :, Fiberg1S Product Contg ©t N ©.: _M_ _ Approval Date: NoveDina. Expiration Date: Noveglow 4, 2C30) System Be scdpdo n GAF Materials Coqx,raenon, a manufacturer of commercial roofing products for rnoFe than IN ycaQ, produces a wide age of roof pa um fir built -up and modrfie l bitumen iootj syssec s. Eca ce.dc3fim, GAF or two ply b-ti- od f systems to meet the demands for multi-ply S S Modified specifi =fta s. GAF provides waffanled systems over various insulated and non-insulated substrates, copies of which can be obtained from GAF and can be found in the °GAFGLAS BuiltoUp Roofing Appl':gataon and Specifications" manual published mnually. GAF roof system assemblies have be extensively tested at Factory Mutual Research Coo Coqoration and Under writers Laboratories and have been tested in compliance with all requirements of the South Fic, ids Building Code. Specific classificatians for assemblies are Listed in the current U.L. Roofing Material Directory and tht cunt Factory Mutual Approval Guide. GAF Materials Cor, ration products are distributed through a wide network of roofing eholcsale distributors throughout tea South Florida area. For' More information on specific roof system COriStrUCtiOrtS, COMIgt the Technical Service Office, located ayne New Jersey, at 1-200-1100F.411. Con: ct: Woodth : g Digs of Tectutical Services . (973) 628- 4134 k5o of 41 0 insulation T : 3asok Wool Pa lito Polyima ammte Co EC)Eti Wow Pibth fair Dansity Wiggd Fibefboard ElaYmcol Maxsi Pure Material Desi tbre Wood -75psf Maximum Eire Classification Material Classification Wood C ss'A' Rl ®4Q: Fitre cI€ sftcntions and maximum design pMSUSTS do not reference all assemblies ov alQ &WM. tbviow opt= Roan for design pregstAres and the Underwriters Laborztories RooTanB Materials tials Direceoty for Fire Classifications. CaiZ • ‘A AO • Al" REAkins 1 Set � e. : ,e, °?" 0' '.91 '- a Typo It: Uec ac oeapc'e B SyaaaII Typo ): Al C enerA accl ease, Sheet: Ply Sheet: Cap Sheet: Su'tcing: Madimwrra Design P Gt;: Maximum Fire �I��i1�a�aYio�e: li &*rnIw Slops: Specification No.: wo Nonoi x131 gy p o ?nP pi Bog@ sheet mechmioaliy fmtened, LLLDPn2n nan AdiE appIly. GAFGLAS CAFGLAS ligO Ultima. Ewe &me, GAFOLA PLY CO, CAVGLAS GAVGLASO S TAVZ� l Bilal�fleq R.1J = ER0i Modified Blage or RUBERODS 20 appiitsl. deck with app ? ®d annular Ping shank nails and giliklaadtA 6 5 S a d Iggp3 €� f eneP spacin; of 9'° o.s. the lap, 12 o.. in two row stagged cigns ¢,"- center line of the sheet in tin field. `peso 'v three plies aGAFGLASeilVi GAFGL,AS FlexPly 6 OP GAFGLASO PLY 6(.417 a Hl mopping cf approved n 3 1 applied within the EVT range and at a rate of 20-40 lhsJsq.. of GAFGLASO Mi ey l Surfaced Gap Sh aaered in a ifl and as a •TOIn (Optional) One mopping of approved alpha (Required if no c l.GAF WEATHER COAT* Million With an application ease of 3 gafl 9a .o oP GAP Premium Fibe'ed Aluminum Roof with ass appik.stier rl 1.5 gal ./c4.. 2. A'... halt flood coat at an application rate of 60 ltis./sq. ± 20%; plus gavel or slag with an pl°acation rate of 400 lhcfq. & 300 lbs./sq., respeetively. ® •s hc4 New Commotion or? Remof a °a mood or wood decNs u• -45 psf (Sec; General Limitation R7) sheet is used) Install one of the following: • 'A'. See General Limitation 02. 6 '� :12 6034,1\!-E-3 " ; Ge'€��oe 1 1 Liri \ tii N �°B / �? p� t� A/f �r {� p nR , R (� ,, q. N°C. tQ/o,J °�d °1P1. // I r� v (( '�� Pl � °Hv .] ly [[ �� ` ?? -1° �-�( d { P6, - f °( , IP�(�°�L(V Ii. 1v(� °(U�/j�l°IVlfi 6. V43 WC v tv °B 6, •' °� °� °�q ���� °W ✓<b °r °J°`>.�. � e- S G/rte IV °l / °c1 °IV10 N° 301 0 rg Ana C-nfr, .1 ... ,—. :?.13w4z gM' n :7 w ©1 Beek s Sps r a3 LsatoB$at ilomo: 1. Fa teuea spacin3 for cad= sheet avaelment is based on a Minimum CiWat r'i54N F=e (7) of 95 k oe s?aeew Mcd isa compliance wig L e ft-®adle Coua¢y Pmeml PA 1105::UP as tested is btkoc. 95 Bb& a praessional a gin .,.r may surmit a mvinzd Wang udiUms withdatmQ reniztatton vain sign from Msr -Dad@ C @'aty P ©l PGA IlC3 caA @@kuk¢itn4 iffa toailpllm:. with Men, l 1 on ao RppibMion S( �l PA 19 7. 2 III s as l ittsul€agion panel sizes are acceptable for mechanical attatimusnt. When pariT,is applied ie het asphalt, maximum panel sin shall be 4' x 4'. Fastener spacine for eerulatio2 attachment is basal on a Minimum Chasacearistie Force (V') of 275 ibf MLA in compliance with Me =Dade Co y ay Pmts= PA 9055 rLo'Apis Application Sarmd PA 119. Qf?the fastener valid, field ttsine., an Wow 273 lbf i a* agchment shall not ' acceptable. 3 A slip sheet is required with Ply 40 Flen PIyYm 6 and Ply 60 when used as a mechanically fastened tad or anchor sheet. 4. '/ Type X gy um bow is acceptable to be installed directly over the wood deck.. a 4 a O ala r0 CETE.M J �s� 3 All asphalt shall comply with STM D 312 type g X or type ^�s�ix gat 9 approved by appfli© 2 Fire eat' ., are ftemined by a combination ®ff slope, deck type and ably. t cuffent Undemit= Rooms Materials Directory ®r ot1e7 fire testing n iii in to toting File. Fire ratings shgli be in mot co plimce with Sections 34©0.0 and 3401.6 of the Sots Fl tido 3ni1dh g Code. 3 mocigntyri slope range shill Crary for each system; consult current Underwiitev L bers¢ories Roofing Materials Directory and manufactures specifications for eomplimce with design criteria for each Project. 4 Aga overlay MOM' r oyes bow insulation pmel is reguieed ora 211 app1i©i over closed cell foam insulations when the bug sheet is fully !mopped. If no recovc y bow is used, install one layer of GAFGLASS STRATAV NT Perforated° laid dxy.A base Abut ay appliciA using spot mopping with }approved asphalt, 1r diameter circles, 24 °' ®a suip mopped 2" ribbons LEI 6Wee YOVJs one at each sidelap old one down the center of the sheet allowing a continuous area of ventilation. Encirclins of the ships is not acceptable. A 6" bee& shall be placed every 12° in each ribbon to allovJ cuss ve tilGt on. Aspholt application of either system shall be at a minimum sate of 12 lbsJsq. N© Spoq attaegea systems sled bt2 flaev M to a raagionga do 6gn presau WbeQe `r `t'AV2I1P PeTfQr Qed wed ove? apr e4 `ocya arr age P)aua iagu a aa, tho oozionm gaslIge prossure ig Mrrseted to -50psf 5 wi tk shall be performed by a contractor licensed to do roofing work in Mgt —Dade County. Contractor shall be familia? with the details and spacifi catiofts ?lc mandnatueer„ the eeepAiremoto of the SF C. 6 The submission of system specifications ald details shall accompany the Section RI Building Code Permit. This information is Ewaib Rle in the publications listed in die 'System Description° of this product Con Approval. The submission of eme decome,as, well as the proper pli *ion a ,d insulation of all materials shall be the sole responsibility of the contractor. ° ( � L ITETATII ©RS 7 Perimeter and corner was shall comply with the effaced uplift pressure of tteze as calculated in compliance with Chatter 23 of the South Florida 'Building Code. Il? en densities shall be increase for both insulation and base sheet as needed calculated in co pBPmgg with Meet Dade County Roofing Application Standard P. 119. (When tb 1)ELEIIQgOom Erg spedfcz➢ly PQfferred within this HOA Geri erall Limitation fno milli( not be appElen e.) 8 All attachment and sizing of perimeter Hailers, metal profile, and/or flashing termination designs shall conform with Metro -Dade County Roofing Application Stand; s FA 1 I I and the wind load requirements of Chapter 23 of the South Florida Building; Code. 9 Flashings shall be installed according to the manufacturers standard details, and may be applied in cold application adhesive, approved asphalt or may be applied in conjunction with ail approved torch applied modified bitumen membrane. Specific details, approved by the rllmi facturer, shall be submitted with the Section II Permit Application. All details shall comply with the provision of the South Florida Building Code. 10 Fastener spacing for base sheet attachment is based on a Minimum Characteristic Force (F') value as tested in compliance with lVietrooDade County Protocol PA 105. If the fastener values as tested are below those listed in the System Limitations, a professional engineer may submit a revised fastener spacing utilizing the withdrawal resistance value taken from a Mezro- Dade County Protocol PA 105 test report and calculations that comply with the wind load requirements of Chapter 23 of the South Florida Building Code and Roofing Applicat PA 117. 11 Fastener spacing for insulation attachment is based on a Minimum Characteristic Force (F') value of 275 lbf., as tested in compliance with PA 105. If the fastener value, as field tested, are below 275 lbf insulation attachment shall not be acceptable. 12 Asphalt Toppings shall be with applied with approved asphalt and shall be in compliance with equiviscous temperature (EVT) methods of asphalt determination. Asphalt containen3az bulk tickets shall indicate an EVT, finished blowing temperature (EBT) and flash point. Asphalt types and temperature ranges shall be in compliance with Subsection 3403.4(a)(3) of the South Florida Building Code. 13 Insulation may be installed in multiple layers. The first layer shall be attached in compliance with Product Control Approval guidelines. All other layers shall be adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs. /sq., or mechanically attached using the fastening pattern of the top layer. Refer to snaaatafactur r s literatte and/or the NRCA Roofing and Waterproofing M 2. ::ual fog © ©yt, application procedures of insulation panels in approved asphalt or t dhesive, which sal _ _ co ply with provision of Roofing Application Standard PA 117. 14 All standard panel sip ue acceptable for mechanical attachment. When go approved asphalt, pal size shall be4 x 4° maximum. 15 In re r-covery /re- roofing applications, prior to the application, all existing root' surfaces ar _a L,e bonding substrate shall be tested in compliance with Metro -lade County protocol IPA _ ; ' a •. uplift resig3ance. Test pressures shat➢ be c 1culat -•, in con piiance with the requirements of Chapter 23 of the South Florida Building Code to the design pressure of tahg R 16 in re- roofing applications, moist Gong @at in gm existing roof must be in contpliERgg Section 3401.10(m) (n) of the South Florida Building Code. 17 Roll good materials shall be stored on end and on clean, flat and dry surface. 18 If required, any Factory Mutual Approved vapor barrier in conjunction with proprietioy og approved adhesives may be used prior to the application of the insulation layer. 19 Consult current Underwriters Laboratories Directory for the appropriate coating for each roofing assembly to obtain the required fire rating. The assembly shall be installed in strict compliance with sections 3401.5 and 3401.6 of the South Florida Building Code for maximum fire classification. Page40of41 Product Con ?0 The maximum designed pressure limitation listed shall be applicable to all roof pressue zones (Le. field, perimeters, comers). No rational analysis, nor extrapolation shall per fitted for enhanced fastening at enhanced pressure zones (i.e. perimeters, extended corners, and comers). (When this limitation is specifically referred within this RCDA, General Limitataei N9 will not be applicable.) 3 "Zan Rooting l sod %ct Cont'l F.,KauLe I No: p7E Block d # MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Lot Street and Number where work is to be done i) g: c 2 -1 11:8 `Ari -fi State work to be done and purpose of building (by floors), state exterior colors (submit samples) 1 r0 c e - 4 S • -¢— Op 67r/9 lied ®o f� Remodeling Addition Repairs Date fi 1 • 76'/--_.5:5 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with. whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. .a Owner's Name and Address _\@.vm,'P thL , << mu 6 11 - ,),51 -- No. Street Registered Architect and/or Engineer n Name and address of licensed contractor A4 4 L lit yr i/1 t; ?3O 0E 7 , t. a Q -›a231 it k Location and legal description of lot to be built on: Subdivision t S' / 26e," r Q .) & %-ra4. 1U4 No. of Stories and for no other purpose. New Building lb be constructed of Kind of foundation // Roof Covering Estimated Total cost of improvements $ �2 2 Amount of Permit $ .1 7: w Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor 1 hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and v;i): t 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 he posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agre to e� ploy on such s bcontractors, or, work to be performed under this permit, as are licensed by Miami Shores Village. rr/ / �u1a 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 appeared and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. •d 7 Date Disapproved Ai / _71!111 (Signed) Building Inspector Date ?3 704/ Read, Sworn to B pd ubscribed 1 f 1 e. My Commission Expires Not li to me well known. St of Florida `Y PL ICI IC S;i1TE r E1rrcID/1 IiY CD;;!:; r."? tiU : ;DED i;Ril PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship.