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1287 NE 96 St (2)Date i / 7 7 Job Address Y PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Legal Description A se)C4 2 / / Owner's Address /,7 7 /LE f� Owner/Lessee / Tenant /�?f7 ///G , - Tax Folio / 3 a -00 o /T 377D Contracting Co. /&I,4 ./ / 00 /& S CO/ 72- Qualifier a P. G' State # C (L 0 4 ,0 7ii Municipal # Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICA ' OOFING PAVING FENCE SIGN WORK DESCRIPTION e - rooP 1© he w e One Ye Yco T, Colo r rL 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 EVIPROVEMENTS 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 laws regulating construction and zoning. Furthermore, I authorize the above -named Signature of owner an 4 / � I4tary as to My Commis APPROVED: Zoning Mechanical ii l0�19 • Co • President Date mr...)i..10' — 0 .. • st• ` 2414 j Date ° FEES: PERMIT /6 ✓ RADON Buildin Address Address Address Address Historically Designated: Yes No Master Permit # 4 3 0 1 2.. Phone 5' 7 . 5 ' 0 l / l J /J2 / ( m ; SS# , Phone ‘ / 7' j-r Competency # Ins. Co. ..S era s t £ r( Ka • Estimated Cost (value) p?c7 S ?u � -r 7 : ;a.y 1 i O at all on acto will • • ork will b in compliance with all applicable the ated. do ted. . ur • r ontractor o Owner- uilder ` sa ✓a, kJ) PL - . u ' a s t o C , tr or i y Commiss on E r.LA? sty 1 11± rtierFLOR'1.5.x. C.;;N'iN1I S17N NJ. - Y COM\il4; ;TON l:X 2. f:'_i lv C.C.F. 7- NOTARY rO 0 TOTAL DUE ate _3o. -9 f Date E lectrical Plumbing Engineering Contractor's \arnc: . J (Low Slope Application) Ft. UNIFORM ROOFING PERMIT APPLICATION PROCESS No. PERKINS ROOFING CORPORA l iUl 575 N. W. 1 Send Street Job A'dat•ess / ''i 7 Miami, FL 33169 1. (305) 687 -6521 ROOF'CAfGORY � Fax; (305) 681-539/ ❑ (Nail -One r , ❑ ( Metal R fs \W ROOF TYPE New Roof Re roofing ❑ Recovering ❑ Repair ❑ Maintenance ❑ (Asphalt/Fiberglass Shingles) Flat Roof Area (fl') Sloped Roof Area (ft Total (t1 S#?o?® Master Permit No. Exposure category (per ASCE 7 -88): C, Building Classification category (per ASCE 7 -88 table 1) 1 Ft. A 44 Cpp /c 1e Deck type: Fastener Tspe: Field: ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed) ATUC11MENT SPACING Perimeter: Corne -- °�2 DE 1 AIL 1 Page -1 A// M; Sly, P( (Mortar - hakes) ❑ (Other) ROOF PLAN 57 t Tile) . AO . 1 Ueck t)Pci 1 1.0oud p/eA4 Underla)metit: 431M di 4-3 In3uLatIon: SL()PE1) SYSTEM DESCRIPTION Filtenet typ & spacing:1 / 7 Cap Sheet: 2 161■.,(11 SL(PII 1) F. T A 1 1, 3 Page-2 A( mtgli Rovr Cov g ering: r D L4 3 2 ( 01 ft I TILE CALCULATIONS , //if 0 q 7 x Niu!tr..):r • ). NI ' 5 ' 17'4 M PC N' tqk . . ATTACHMENTS REQUIRED 1) Fire Directory Listing Page 2) Dade County Product Control Notice of Acceptance-Cover Sheet a) Specific System Description b) Specific System Lirnitation c) General Limitations d) Applicable Detail Dralkings 3) Municipal Permit Application 4) Other Component Approvals 4f.kL A e.5 (jhAc e thrial 72- 3 x X \ini MipIk 0 e - m. 5 . M • .// i id I. I.V.1od)11.um: !KT) • _ htt ... ) - •S, / 7 1 ‘ Ni f 2 pcA 70 g I /e.c ie JLIN iB 138 11:40 FROM BRADCO MIAMI LATIN PRODUCT CONTROL NO ` C OT' ACCEPTANCE Pioneer Concrete Tile 1340 Southwest 34th Avenue Deerfield Beach, FL 33442 Your application for Product Approval of: Pioneer Nail -On, Mortar Set or Adhesive Set "Rastic Shake/Slate" Roofing Tile under Chapter 8 of the Metropolitan Dade County Code goveminkthe use of Alternate Material; and Types of Construction, and completely described in the plans, specifications and calculations as submitted by: 1 Redland Technologies, The Center for Applied Engineering, Inc, and Professional Service Industries, has been recommended for acceptance by the Building Code Compliance Department to be used in Dade County, Florida under the specific conditions set forth on pages 2 through 15 and the standard conditions set forth on page 16. Acceptance No.: 96- 0502.07 Renews No. 94- 1017.03 Expires: Approved: 12/26/97 - BUILDING CODE COMMITTEE TO 6815397 METROPOLITAN DADE COUNTY. FLORIDA METRQ -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO -OADE FLAGLER BUILDING 140 WEST FLAGLER STREET. SUITE 1603 MIAMI. FLORIDA 33130 - 1563 (305) 375-2901 FAX (305) 375.2908 PRODUCT CONTROL DIVISION (305) 375 -2902 FAX (305) 372 -6339 p c j e 1 The approval shall not be valid after the • expiration date stated below. The Building Code Compliance Office reserves the right to secure this product or material at any time for a jobsite or manufacturers plant for quality control testing. If this product or material fails to perform in the approved manner. the Building Code Compliance Office may revoke. modify or suspend the use of such product or material immediately. The applicant shall re- evaluate this product or material should any amendments to the South Florida Building Code be enacted affecting this product or material. The Building Code Compliance Office reserves the right to revoke this approval, if it is determined by the Building Code Compliance Office 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. Raul Rodri,uez 02/06/99 Product ControFSupervisor THIS 1S THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS This application for Product Approval has been reviewed by the Metropolitan Dade County Building Code Compliance Department and approved by the Building Code Committee to be used in Dade Couv, Florida under the conditions set forth above. i4 Charles Danger, P.E. Director Building Code Compliance Dept. Metropolitan Dade County JUN 18.`'98 11:40 FROM BRADCO MIAMI LATIN TO S815397 PAGE .002 /016 Product Control No.: 96 0502.07 ROOFING SYSTEM APPROVAL Applicant: Pioneer Concrete Tile Product Control No.: 96- 0502.07 1340 Southwest 34th Avenue Deerfield Beach, FL 33442 Approval Date: December 27. 1997 Category: Prepared Roofing Sub- Cateeorv: Flat Profile Tile : Nail - on/Mortar Set/Adhesive Set Sub -Type: Concrete System Description Expiration Date: January 16. 1999 Pioneer Concrete Tile is a domestic manufacturer of concrete roof tile with manufacturing facilities stretching from the West Coast to the Southeast. All tile is manufactured from extruded concrete consisting of Portland Cement, plasticizer, iron and metallic oxides, and blended aggregates. This Product Control Approval relates to Pioneer's "Rustic Shake/Slate" tile profile. Refer to appropriate Product Control Approvals for other tile profiles. Pioneer tile is fabricated with a wide ridged and grooved sidelap providing a water channel at vertical joints. The ridged sidelaps provide a self - aligning function, creating a uniform appearance. All profiles have matching trim pieces used for rake hip. ridge hip, and valley terminations. Tile system accessories are also available to make up a complete tile system. Pioneer's "Rustic Shake/State" roof the has been tested in compliance with the South Florida Building Code requirements for concrete, nail -on, mortar set and adhesive set the applications. The minimum roof slope for Pioneer's " Rustic Shake/Slate" nail -on. mortar set or adhesive set tiles shall be 2 ":12 ". See the "Profile Drawing" section in this Approval for the " Rustic Shake/Slate " profile drawing. The Pioneer " Rustic Shake/Slate " the profile has been tested for both wind characteristics and static uplift performance. therefore, any consideration for installation shall be done as a'Moment Based System'. Data for attachment calculations is noted in Tables 1 through 4 of this Approval. Contact: Pioneer Concrete Tile Technical Service Dept. 1340 Southwest 34th Avenue Deerfield Beach. FL 33442 (800) 624-4152 F. ri- 7 uln:i ? ? JUN 1.8 iirS.8 11:41 FROM BRADCO MIAMI LATIN TO 6815397 Trim Pieces TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT Test Product Product Dimensions Specifications Description 3 PAGE.003i016 Product Control No.: 96 -050107 Pioneer, " Rustic 1= 16" PA 112 Flat, interlocking, extruded concrete Shake/Slate " w • 9 ih " roof tile equipped with two nail holes. '/, " thick For direct deck or battened nail -on, mortar or adhesive set applications. 1 = varies PA 112 Accessory trim, concrete roof pieces w = varies for use at hips, rakes, ridges and valley varying thickness terminations. Manufacture t for each tile profile. JUN ,18 *',S8 11:41 FROM BRADCO MILATIN #30 Felt Product Mineral Surface Cap Sheet Rainproof II Mopping Asphalt Flashing Cement TRADE NAMES OF PRODUCTS MANUFACTURED OTHERS Dimensions N/A NIA N/A Lcnzingtex -ZB 140 59" x 164' roll Underlayment 22 lbs/roII 30" x 75' roll 36" x 75' roll or 60" x 75' roil lce and Water Shield 36" x 75' roll N/A N/A Test Specifications ASTM D 226 type ll ASTM D 2626 ASTM D 249 PA 104 PA 104 PA 103 ASTM D 31? type 111 ASTM D 4586 TO 6815397 PAGE .06 / Product Control No.: 96- 0502.07 Product Description Saturated organic felt to be used as a nailed anchor sheet Saturated and coated organic base sheet for single or double ply underlayment. Mineral surfaced asphalt roll roofing for use as a top ply in a double ply underlayment system. Single ply, nail -on underlayment. Single ply, nail -on underlayment with 2" self - adhering top edge. Self - adhering underlayment for use as a top ply in a two ply underlayment system with Approved #30 or #43 as the base layer. Asphalt for bonding a mineral surface cap to a mech. attached base sheet in a double ply underlayment system. Cut back, asphalt based, asbestos free, fiber reinforced, trowel grade cement for repair and flashing applications. Manufacturer generic generic generic Lening Performance, Inc. with current PCA Protect -O -Wrap. Inc. with current PCA W.R. Grace Co. with current PCA generic generic JUN .18_',98 11:42 FROM BRADCO MIAMI LATIN TO 6815397 4 Test Product Product Dimensions Specifications Description Asphalt Primer N/A ASTM D 41 Cut back, asphalt Roofing Nails - - Tin Caps ) Wood Battens Tile Nails Tile Screws min. 12 ga. with 3 /s head horizontal min. I" x 4" for use with vertical baaens or Mill. 1" X 2" for use alone min. 8dx2 %: "or min. 10d x 3" PA 114 Appendix E min. 32 ga. PA 114 Corrosion resistant , generic min. 1' / o.d. Appendix E circular disc for use in max. 2" o.d. underlayment attachment PA 114 Appendix E based coating used to facilitate bonding of dissimilar materials. Annular ring shank, hot dipped, electro or mechanically gals. roofing nails for use in underlayment attachment. vertical Wood Preservers Salt pressure treated min. I" x 4" Institute LP - 2 or decay resistant lumber battens Corrosion resistant, screw or smooth shank nails. Product Control No.: 96-0502.07 Manufacturer generic generic generic generic #8 x 2W' long PA 114 Corrosion resistant, generic 0.335" head dia. Appendix E coated. square drive, 0.131" shank dia. galvanized, coarse 0.175" screw thread thread wood screws diameter Roof Tile Mortar N/A PA 123 Prepared mortar mix Bermuda Roof ("TileTiteT" ") designed for mortar Company, Inc. set roof tile with current PCA applications, Roof Tile Mortar N/A PA 123 Prepared mortar mix Quikrete Construction ( "Quikrcte® Roof designed for mortar Products Tile Mortar #1140") set roof tile with current PCA applications. 5 PAGE.0@5/ 16 r JUN.18 '•98 11:43 FROM BRADCO MIAMI LATIN Product Roof Tile Mortar ( "BONSALd4 hoof Tile Mortar Mix ") Dimensions N/A Roof Tile Adhesive 1 N/A ( "Polyproe A H 160 ") ) Hurricane Clip Sc Clips PA 114 Corrosion resistant Fasteners min. 54" width Appendix E bronze, aluminum, min. 0.060" thick stainless steel. galvanized steel or Clip Fasteners plastic aaachment min. 8d x I' /." clips for supplemental the attachment Clips are installed with corrosion resistant roofing nails compatible with the clip. A hurricane clip is required on all nail - on eave tiles. Valley Flashing Drip Edge min. 26 ga. min. 16" width. min. 26 ga. min. 2" face flange min. 2" deck flange Test Specifications PA 123 See PCA Two component polyurethane adhesive designed for adhesive set mink applications. ASTM A 525 6 TO 8815397 PAGE.006i01 Product Description Prepared mortar mix designed for mortar set roof the app icat ions. Galvanized steel valley flashing PA l 11 Galvanized steel drip edge Product Control No.: 96 -0502.07 Manufacturer W.R Bonsai Co. with current PCA Polyfoam Products, Inc. with current PCA generic generic generic JUN 1 8 ' 98 1 1:43 FROM BRRII+CO Wf P tR'rt 'fie' "' TO` (e1 PAGE .007/01 F "r TEST REPORTS Product Control No.: 96- 0502.07 Tact Agency Test Identifier Test Name/Report Date Redland Technologies 7161 -03 Static Uplift Testing Dec. 1991 Appendix 111 PA 102 Redland Technologies 7161-03 Static Uplift Testing Dec. 1991 Appendix 111 PA 102(A) The Center for Applied 94 -084 Static Uplift Testing May 1994 Engineering, Inc. PA 101 (Mortar Set) The Center for Applied 94 -0605 • D Static Uplift Testing March. 1994 Engineering, Inc. PA 101 (Adhesive Set) Redland Technologies 7161.03 Wind Tunnel Testing Dec. 1991 Appendix 11 PA 108 (Nair -On) Redland Technologies Letter Dated Aug. 1, 1994 Wind Tunnel Testing Aug. 1994 PA 108 (Nail -On) Redland Technologies P0631 -01 Wind Tunnel Testing July 1994 PA 108 (Mortar Set) Redland Technologies PO402 Withdrawal Resistance Sept. 1993 Testing of screw vs. smooth shank nails The Center for Applied Project No. 307025 Wind Driven Rain Oct 1994 Engineering, Inc. Test #MDC -76 PA 100 Professional Service 224 -47099 Physical Properties Sept 1994 PA 112 Industries, Inc. 7 JUN .18 '98 11:44 FROM BRADCO MIAMI LATIN TO 6815397 Deck Type: Wood, Non - insulated SYSTEM A: Counter -Batten Application Slope Range: SYSTEMS Deck Description: New Construction ' or greater plywood or wood plank. Product Control No.: 96 -0502.07 2 ":12" to 7 ":12" Note: Counter- Battens, as noted bellow, are required for slope range 2 ":12" to less than 4 ":12" and are optional for slopes of 4 ":12" to 7':12 ". For slopes exceeding 7 ":12 ", refer to System C. Uadertayment: Install underlayment system in compliance with Dade County Application Standard PA 118. Vertical Battens: install vertical battens in compliance with Dade County Application Standard PA 118 Horizontal Battens: Install horizontal battens in compliance with Dade County Application Standard PA 118. Roofing Tile: Install tile in compliance with Dade County Application Standard PA 118. (See "Data for Attachment Calculations" included in this Approval.) Comments: 1. For re -roof applications. " / plywood is an acceptable substrate. 8 PAGE .O88,O16 JUN 19 '98 11:44 FROM BRADCO MIAMI LATIN TO 6815397 SYSTEMS (CONTINUED) Deck Type: Wood, Non - insulated Deck Description: New construction 19 / or greater plywood or wood plank. SYSTEM B: Direct Deck Application Slope Range: 4 ": t 2 7" :12 Nam System B is only acceptabk in this slope range. For slopes less than 4 ":12 ", refer to System A. For slopes in excess of 7 ":12 ", refer to System C. Uaderfaymeat Install underlayment system in compliance with Dade County Application Standard PA 118. 1 Roofing Tile: Install the in compliance with Dade County Application Standard PA 118. (See "Data for Attachment Calculations" included in this Approval.) Comments: 1. For re -roof applications, "i plywood is an acceptable substrate. 9 PAGE . 009,01 6 Product Control No.: 96- 0502.07 JUN .18 '98 11:45 FROM BRADCO MIAMI LATIN SYSTEMS (CONTINUED) Deck Type: Wood, Non - insulated Deck Description: New construction 19 / „” or greater plywood or wood plank. SYSTEM C: Horizontal Batten Application Slope Range: 4 ":12" or greater Note: Horizontal battens, as noted below, are required for slopes in excess of 7 ":12" and are optional for slopes of 4 ":12" to 7 ":I2 ". For slopes less than 4 ":12 ", refer to System A. Underlayment: Install underlayment system in compliance with Dade County Applicatpn Standard PA 119. Horizontal Battens: Install horizontal battens in compliance with Dade County Application Standard PA 119. Roofing Tile: install tile in compliance with Dade County Application Standard PA 119. (See "Data for Attachment Calculations" included in this Approval.) Comments: I _ For re -roof applications, 15 / „” plywood is an acceptable substrate. 10 TO 6815397 PAGE.010/016 Product Control No.: 96- 0502.07 frank Zuloaga JUN 18 '98 11:45 FROM BRADCO MIAMI LATIN Slope Range: Underlayment: Roofing Tile: Comments: SYSTEMS (CONTINUED) TO 6815397 Deck Type: Wood, Non - insulated Deck Description: New construction 19 / 37 " or greater plywood or wood plank. SYSTEM D: Mortar or Adhesive Set Application PAGE.011 /016 Product Control No.: 96 -0502.07 2":12" to 7 ":12" Note: System D is only acceptable in this slope range. For slopes in excess of 7 " :12 ", refer to System C. Install underlayment system in compliance with Dade County Application Standard PA 120. (See System Lunitation #5.) Install tile in compliance with Dade County Application Standard PA 120. (See "Data for Attachment Calculations" included in this Approval.) 1. For re -roof applications. l ' / plywood is an acceptable substrate. 11 Frank Zuloaga JUN •18 '98 11:46 FROM BRADCO MIAMI LATIN TO 6815397 PAGE.012i016 SYSTEM LIMITATIONS The standard minimum roof pitch for Pioneer's " Rustic Shake/Slate" flat profile tile shall comply with Dade County Application Standards PA 118, PA 119 or PA 120, depending on the method of installation. For nail -on applications, fasteners for mechanical attachment of tiles shall have a head diameter larger than that of the preformed holes in the tile. 3. System installation shall be in compliance with the system specifications outlined in this Product Control Approval. The method of attachment utilized shall provide sufficient attachment resistance expressed as a moment to meet or exceed the required moment of resistance determined in compliance with Dade County Protocol PA 115 or PA 127. Pioneer's " Rustic Shake/Slate " tile profile has been tested for both wind characteristics and static uplift performance, therefore, attachment calculations for installation in compliance with PA 115 or PA 127 shall be done as a' Moment Based System'. 4. For mortar or adhesive set tile applications, a field static uplift test by a Dade County accredited testing agency, in compliance with Dade County Protocol PA 106, shall be performed. 5. For mortar set tile applications, 30/90 hot mopped underlayment applications may be installed perpendicular to the roof pitch unless stated otherwise by the underlayment material manufacturer's published literature. 6 All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo for identification in the field. The identifiable mark for the " Rustic Shake /Slate" flat profile tik shall be the word "Pioneer" on the back side of the tile. 7. Applications for roofing permits shall include a completed Section 11 of the Uniform Building Permit, a copy of Pioneer's current specifications and details. a copy of this Product Control Approval and a copy of the Product Control Approval of any Roofing Component used in the proposed tile application. Reference shall be made to appropriate data for the required rut rating. 8. The applicant shall retain the services of a Dade County certified testing laboratory to maintain quality control in compliance with the South Florida Building Code and related protocols. Samples taken shall be in compliance with Dade County Protocol PA 112. Appendix 'A'. 1 2 Product Control No.: 96- 0502.07 Frank Zuloa'a Table 1: Aerodynamic Multipliers - ),. (ft') Tile Profile X (ft Batten Application X (ft') Direct Deck Application 0.24 Pioneer " Rustic Shake/Slate " 0.19 Table 2: Restoring Moments due to Gravity - M (ft -lbf) Tile Profile 3 ":12" 4 " :12" 5 ":12" - 6 " :12" Greater than , r :12" Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Pioneer " Rustic Shake/Slate 4.81 5.54 4.73 5.46 4.63 5.35 4.51 5.21 4.39 N/A Table 3: Attachment Resistance Expressed as a Moment - NI, (ft-lbf) for Nail -On Systems Tile P rofile Tile Application Approved Nails Approved Screws' Approved Field Clip With: Approved Eave Clip With: 1 nail 2 nails 1 screw 2 screws 1 nail 2 nails 1 nail 2 nails Pioneer " Rustic Shake/Slate " Battens 4.90 7,40 5,40 9.10 24.20 34.80 22.10 32.20 Direct Deck 9.80 18.80 25.30 41.30 24.30 35.50 19.00 31.90 JUN 1e 'se 11:46 FROM BRADCO MIAMI LATIN DATA FOR ATTACHMENT CALCULATIONS • --- - - - - -- -- - - - - -- • - - TO 6815397 PAGE.013i016 Product Control No.: 96- 0502.07 1 Approved screws are as noted in the 'Trade Names of Products Manufactured By Others' and 'Profile Drawings' sections of this Approval. Clips on eave tile are not required for this attachment configuration unless the Required Moment of Resistance exceeds the values noted above. Table 4: Attachment Resistance Expressed as a Moment - M, (ft-lbf) for Mortar or Adhesive Set Systems Tile Profile Pioneer " Rustic Shake /Slate " Tile Application Mortar Set Adhesive Set 1. Frank Zuloaga Attachment Resistance 39.00 118.90 JUN 1,8 '98 11:47 FROM.BRADCO MIAMI LATIN 4. 16" PROFILE DRAWINGS PIONEER "RUSTIC SHAKE /SLATE" 14 TO 6815397 PAGE.014i016 Product Control No.: 96 -0502.07 4 I 375" JUN 1.8 '9$ 11:47 FROM BRADCO MIAMI LATIN \** * * ** * Sp 0.1a 0.3.- a.aT 0,11 -1 �r 0.12^ PROFILE DRAWINGS (CONTINUED) 2.,,' APPROVED SCREW FOR SCREW DATA IN TABLE 3 l5 TO 6815397 PAGE.015 /e16 0.131 Product Control No.: 96 -0502.07 Frank Zuloa °a 0.173- JUN 18 '98, 11:48 FROM BRADCO MIAMI LATIN Product Control No.: 96- 0502.07 Pioneer Concrete Tile ACCEPTANCE NO.: 96-0502.07 1340 Southwest 34th Avenue APPROVED : December 26, 1997 Deerfield Beach, FL 33442 EXPIRES : February 06, 1999 NOTICE OF ACCEPTANCE STANDARD CONDITIONS 1. Renewal of this Acceptance (approval) shall be considered after a renewal application has been tiled 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: "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 purposes. 6. The Notice of Acceptance number preceded by the words Dade County. Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is displayed, then it shall be done in its entirety. 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 times. The copies need not be resealed by the engineer. 8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of Acceptance. 9. This Acceptance contains pages 1 through 16. END OF THIS ACCEPTANCE 16 TO 6815397 PAGE.016/016 Frank Zuloaga Acceptance No.: 97- 0804.14 Revises No.: 95- 1003.03 Expires: 11/06/00 PRODUCT CONTROL NOTICE GAF Materials Corporation I361 Alps Road Wayne, Ni 07470 Your application for Product Approval of: GAFRaberoid® Modifed Bitumen Roof Systems for Wood Decks under Chapter 8 of the Metropolitan Dade County Code governing the use of Alternate Materials and Types of Construction, and completely described in the plans, specifications and calculations as submitted by: Dynatech Engineering, Inc., Factory Afataa/ Research Corporation, and Underwriters Laboratories, Inc. has been recommended for acceptance by the Building Code Compliance Office to be used in Dade County, Florida under the specific conditions set forth on pages 2 -60 and the standard conditions on page 61. This approval shall not be valid after the expiration date stated below. The Building Code Compliance Office 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, the Building Co Office may revoke, modify, or suspend the use of such product or material immediately. The Be uCompliance Compliance Office reserves the right to revoke this approval, if it is determined by the Building Code C Compliance Office that this product or material fails to meet the requirements of the Building Code Compliance Office that this product or material fails to meet the requirements of the South Florida Building Code. This application for Product Approval Compliance Office and approved by the conditions set forth above. Approved: 11/06/97 1 MA% The expense of such testing will be incurred by the manufacturer. CE Sep O(J . r 4 ' ( I c, er f <to e � 1 / Raul Rodriguez Product Control Supervisor THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL. CONDITIONS BUILDING CODE COMMITTEE has been reviewed by the Metropolitan Dade County Building Code Building Code Committee to be 4/,' ' Dade County, FI rid9 under the , Charles Danger, P.E. Director Building Code Compliance Dept. Metropolitan Dade County PRODUCT CONTROL NOTICE OF ACCEPTANCE ROOFING SYSTEM APPROVAL Applicant GAF Materials Corporation Product Control No.: 97- 0804.14 1361 Alps Road Wayne, NJ 07470 Approval Date: November 6, 1997 Category: Membrane Roofing System Sub - Category: Built -up Roofing i Type: Modified Bitumen Sub -Type: APP and SBS System Description GAF Materials Corporation has been manufacturing commercial roofing products for more than 100 years. GAF produces a wide range of roof products for built -up roofing systems. The modified bitumen products include both APP and SBS products in smooth, granule and fire rated versions. In addition, GAF offers two ply modified systems to meet the specification requirements for multilayer SBS modified specifications. GAF products are distributed through a wide network of roofing wholesale distributors throughout the South Florida area. GAF provides warranted systems over various insulated and non - insulated substrates, copies of which can be obtained from GAF and can be found in the Ruberoid Modified Bitumen Application and Specification manual published annually. GAF roof system assemblies have been extensively tested at Factory Mutual Research Corporation and Underwriters Laboratories. GAF modified bitumen membranes have been tested in compliance with ASTM D 5147 test requirements. Contact: William J. Woodring Director of Technical Services (973) 628- 4134 Page 2 of 61 Product Control No: 97- 0804.14 Expiration Date: November 6, 2000 • Frank Zuloaga, Roofing Product Control Examiner insulation Types: Material Wood Material Wood Basalt Wool Perlin Polyisocyanurate • Composite Board Wood Fiberboard High Density Wood Fiberboard Rockwool Maximum Design Pressure Design Pressure -75psf Maximum Fire Classification Classification Class 'A' rrouuct control No: 97- 0804.14 Note: Fire classifications and maximum design pressures do not reference all assemblies over all deck types. Review system listings for design pressures and the Underwriters Laboratories Roofing Materials Directory for Fire Classifications. Page 3 of 61 Frank Zuloaga, Roofing Product Control Examiner Membrane Type: SBS Deck Type 1: Wood, Non - insulated Deck Description: "/ or greater plywood or wood plank System Type E-2: RUBEROID® Tile Underlayment, Base Sheet mechanically attached. All General and System Limitations shall apply. 1:1 Anchor sheet ASTM 2626, AFGLAS ®GAFGLAS #80 UltimaTM Base Sheet, STRATAVENT® Nailable, or RUBEROID® 20 base sheet applied with a minimum 2" side lap and a minimum 6 "end lap. Base sheet may be applied at a right angle (906) to the slope of the deck with approved annular ring shank nails and tin caps at a fastener spacing of 6" o.c. at the 2" side lap, and two 12" o.c. staggered rows along the center of the sheet. Ply Sheet: Membrane: Maximum Design Pressure: Maximum Fire Classification: Maximum Slope: Specification No.: (Optional) one, or more plies GAFGLAS PLY 4 ®, or GAFGLAS® PLY 60 Ply or GAFGLAS FIexPIyTM 6 sheet adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 IbsJsq.. RUBEROID® MOP PLUS, membrane may be applied at a right angle (906) to the slope of the deck* adhered in a full mopping of Type IV asphalt applied within the EVT range and at a rate of 20-40 lbs.sq. Membrane shall be backnialed to deck with approved annular ring shank nails and tin caps at a maximum fastener spacing of 6" o.c. No nails or tincaps shall be exposed rrouuct .ontrol No: 97- 0804.14 • Membrane may also be installed parallel to the slope of the roof (i.e. strapping). If membrane is strapped, then anchor sheet and ply sheet must also be strapped. Must comply with Metro -Dade County Roofing Application Standard PA 115. Must comply with Tile System Fire Classification Must Comply with Metro -Dade County Roofing Application Standard PA 118, PA 119, PA 120 Page 56 of 61 Frank Zuloaga, Roofmg Product Control Examiner ..i Wood Deck System Limitations: rruuucc Lonvoi ivo: y - uou4.1 1. Fastener spacing for anchor sheet attachment is based on a Minimum Characteristic Force (F) of 95 Ibf or greater as tested in compliance with Merto-Dade County Protocol PA 105. if F as tested is below 95 Ibf, a professional engineer may submit a revised fastener spacing utilizing the withdrawal resistance value taken from Merto-Dade County Protocol PA 105 and calculations in compliance with Metro-Dade Roofing Application Stanadrd PA 117. 2 All standard insulation panel sizes are acceptable for mechanical attachment. When panels are applied in hot asphalt, maximum panel size sha11 be 4' x 4'. a. Fastener spacing for insulation attachment is based on a Minimum Characteristic Force (F) of 275 lbf. as tested in compliance with Merto-Dade County Protocol PA 105 & Roofing Application Standard PA 117. If the fastener value, as field tested, are below 275• Ibf. insulation attachment shall not be acceptable. 3 A slip sheet is required with GAFGLAS F1exPly 4410 and Ply 6® when used tis a mechanically fastened base or anchor sheet. 4. i4 Type X gypsum board is acceptable to be installed directly over the wood deck.. Page 57 of61 Frank Zuloaga, Roofing Product Control Examiner r GENERAL LIMITATIONS r4uuULL ■.onrroi NO. y' UZSU -:. • ) 1 All asphalt shall comply with ASTM D 312 type III or ype type IV requirements, and approved by applicant. 2 Fire ratings are determined by a combination of slope, deck type and assembly. Refer to current Underwriters Roofing Materials Directory or other fire testing data listed in the testing file. Fire ratings shall be in strict compliance with Sections 3401.5 and 3401.6 of the South Florida Building Code. • 3 Maximum slope range shall - vary for each system; consult current Underwriters Laboratories Roofing Materials Directory and manufacturer's specifications for compliance with design criteria for each project. 4 An overlay and/or recovery board insulation panel is required on all Applications over . closed cell foam insulations when the base sheet is fully mopped. If no recovery board is used, install one layer of GAFGLASS STRATAVENT Perforated, laid dry.A base sheet may be applied using spot mopping with approved asphalt, 12" diameter circles, 24" o.c.; or strip mopped 8" ribbons in three rows, one at each sidelap and one down the center of the sheet allowing a continuous area of ventilation. Encircling of the strips is not acceptable. A 6" break shall be ed every 12' in each ribbon to allow cross ventilation. Asphalt application of either system shall be at a minimum rate of 12 lbssq. Note: Spot attached systems shall be limited to a maximum design pressure of -45 psf. Where STRATAVENT Perforated is used over approved isocyanurate foam insulation, the maximum design pressure is limited to - 60psf. 5 All work shall be performed by a contractor licensed to do roofing work in Metro County. Contractor shall be familiar with the details and specifications published by the manufacturer, and the requirements of the SFBC. 6 The submission of system specifications and details shall accompany the Section II Building Code Permit. This information is available in the publications listed in the 'System Description' of this Product Control Approval. The submission of these documents, as well as the proper application and installation of all materials shall be the sole responsibility of the contractor. Page 58 of6I Zuloaga, Roofing Product Control Examiner Product Control No: 97- 0804.14 7 Perimeter and corner areas shall comply with the enhanced uplift pressure of these areas, as calculated in compliance with Chapter 23 of the South Florida Building Code. Fastener densities shall be increase for both insulation and base sheet as needed calculated in compliance with Metro-Dade County Roofing Application Standard PA 117. (When this Iimitation is specifically referred within this NOA, General Limitation #20 will not be applicable.) 8 All attachment and sizing of perimeter nailers, metal profile, and/or flashing termination designs shall conform with Metro-Dade County Roofing Application Standard PA 111 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 an approved torch applied modified bitumen membrane. Specific details, approved by the manufacturer, shall be submitted with the Section II Permit Application. All details shall comply with the provision of the South Florida Building Code. i 10 Fastener spacing for base sheet attachment is based on a Minimum Characteristic Force (F') value as tested in compliance with Metro -Dade 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 Metro- 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 Application Standard 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 moppings shall be with applied with approved asphalt and shall be in compliance with equiviscous temperature (EVT) methods of asphalt determination. Asphalt containers or bulk tickets shall indicate an EVT, finished blowing temperature (FBT) and flash point. Asphalt types and temperature ranges shall be in compliance with Subsection 3403.4(ax3) 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 lbssq., or mechanically attached using the fastening pattern of the top layer. Refer to manufacturer's literature and/or the NRCA Roofing and Waterproofing Manual for correct application procedures of insulation panels in approved asphalt or adhesive, which shall comply with provision of Roofing Application Standard PA 117 Page 59 of 61 rank Zuloaga, Roofing Product Control Examiner 14 All standard panel sizes are acceptable for mechanical attachment. When applied in approved asphalt, panel size shall be 4' x 4' maximum. 15 In re- covery /re- roofing applications, prior to the application, all existing roof surfaces used as a bonding substrate shall be tested in compliance with Metro-Dade County Protocol PA 124 for uplift resistance. Test pressures shall be calculated in compliance with the wind load requirements of Chapter 23 of the South Florida Building Code to the design pressure of the roof. 1 6 In re- roofing applications, moisture content in an existing roof must be in compliance with Section 3401.10(m), (n) of the South Florida Building Code. 17 Roll good materials shall be stored on end and on a clean, flat and dry surface. 18 If required, any Factory Mutual Approved vapor barrier in conjunction with proprietary or 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. 20 The maximum designed pressure Iimitation listed shall be applicable to all roof pressure zones (i.e. field, perimeters, corners). No rational analysis, nor extrapolation shall be permitted for enhanced fastening at enhanced pressure zones (i.e. perimeters, extended corners, and corners). (When this limitation is specifically referred within this NOA, General Limitation #7 will not be applicable.) Page 60of61 • •.,..•..L ■.uncroi no. y- uau -4.14 rank Zuloaga, Roofing Product Control Examiner GAF Materials Corporation ACCEPTANCE NO.: 97- 0814.14 1361 Alps Road. APPROVED: November 6, 1997 Wayne, NJ 07470 EXPIRES: November 6, 2000 1 NOTICE OF ACCEPTANCE STANDARD CONDITIONS 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: "Metro-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 approve; 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 fling of a revision application with appropriate fee) and granted by this once. 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 purposes. 6 The Notice of Acceptance number preceded by the words Metro-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 times. The copies need not be resealed by the engineer. 3 Failure to comply with any section of this Acceptance shall be cause for termination and removal of Acceptance. 9 This Acceptance contains pages 1 through 61 END OF THIS ACCEPTANCE Page 61 of 61 Frank Zuloaga, Roofing Product Control Examiner NaFi'1At 6k ERp3O ; f 9l,,Z;AND.RE 5 j 54� 977 P IgL' lr�, BYI :DEPA FOu( NT HO s ;? �� ' °ZEVE4OPMn�T pE • 21/) MIRACLE MILE. SUITE Z.04 `ORAL GABLES , FLA. 33(34 THOMAS J . KELLY, I N C . DADE (305)444 -7692 LAND SURVEYOR RRWD: (305) 779- 32e6 FAX : (305) 44I - 6494 SKETCH OF SURVEY SCALE: THIS IS A FLOOD HAZ ZONE SURVEY NO. yv'J7 SHEET _Z OF rru N MAP (ATE SED MFR.' ; "0 = • k E UNITED SIA ING AND (Jr1F1 TES THE HE SITUADED 4VI'l i t THESE PLANS ARE APPROVED FOR ISSUANCE OF A BUILDING PERMIT VARIANCE(S) LISTED IN "REMARKS" M!.AM1 SHORES BUILDING AND UNLESS SPECIFICALLY LISTED AI'1D COUisTY LAWS MUST BE COMPLIED Aut`.r i "Pr1 S`gmture ZONING BELOW. Dt_ • WITH NO VARIANCES • WITH NO OTHER DEVIATIONS FROM THE ORDINANCES WILL BE PERMITTED. ALL OTHER APPI ICAB!_E STATE WITH BY ALL PARTIES. FIRE DEPARTMENT PUBLIC WORKS POLICE DEPARTMENT BUILDING DIRECTOR qV dj *t )/ PLANNING & ZONING 8Ofd t} VILLAGE COUNCIL APPROVAL PRELIMINARY: FINAL: REMARKS: COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADOPTED BY MIAMI SHORES VILLAGE ISREQ�UIR D. THE I'll ARCHITEC , BUI BUILDER SUB CONTRACTORS ARE f. ' WIN ING REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN. 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 \, No Street Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) geared MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Distance to next nearest building Chairman Member Member Council Approved Date NOTE: A charge of $1.00 will be made for making corrections the Planning Board. A re- inspection fee of $1.00 will be charged materials and /or workmanship. Roof Cove Notary Public, State of Florida PLANNING BOARD DATE -- - - - - -- -- s' 1- - -' h.. New Building , Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation / �+ o Zt Estimated Total cost of improvements $_____1__ Amount of Permit $ Zone cubage required plan Cubage _Size of Building Lot g and for no other purpose. 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) 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- 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._ ____1 Date U� Read, Sworn to and Subscribed before me. • Disapproved Date (Signed) Building Inspector My Commission Expires Member Member Member Disapproved Date or changes to this application after approval has been obtained from when such re- inspection is made necessary by improper notice for inspection or faulty MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request DateA7:___'" Time Type Insp'n , (Ltd' lS �Lm1 J /i /eid GQtQ�, S1 Permit No. Name 23 jj�� o L' S 9/ Address Company Phone # 7t4 ;2-/O-3‘Y is p7 A/f ?'4,S7` For Inspector: 57/51 Name & Date Approved Correction Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ° e' ""o3 Time Type Insp'n 74.e iteit Permit No. ate-? -// X0 D5 iy / 7 St 7 ; /o -3dY? Name Address Company Phone # For Inspector: 51/5: e Name & Date Approved Correction Re- Insp'n Fee ❑ , L // - '4_ ; Type Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305-795-2204 Building Inspection Request Date ") Time For Inspector: Approved Correction Re-Insp'n Fee LJ Name & Date MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ ELECTRICAL ❑ PERMIT N? 12197 PLUNGING ❑ ROOFING Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building CONTRACTOR OR BUILDER Bl. L y-4 Subdi- vision Value of , Project $ i•*"" L.. z.) • BY DATE Contractor's License No Amt. of Permit 1 0 + $ AUI1IORITT This permit is granted 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 Ms agents, servants or employees. r ( �, Signed ice ' l* , .0' v, . + ` j - 01 °. - �" y � INSPE In consideration of the issuance to me of this permit I agree to pm 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 wok done by either, myself, my agent, servant or employee. BUILDING INSPECTION DEPARTMENT MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement tit uie 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 *II rules and regulations of the Building Division of Miami Shores Village shall be complied with. whether herein specified or not. A copy of approved pans and specifications must be kept at building during progress of the work. Owner's Name and Address RAJ.S (( ic) ode J . Registered Architect and /or Engineer ... • _.. •• .V...+. •1 •.• • Name and address of licensed contractor tJ� kort ti f Location and legal description of lot to be built on: Lot Block Subdivision e� Street and Number where work is to be done 1 P.2 W C . (. �' .. _ . .. State work to be done and purpose of building (by floors)...— fC..l,!., .P F(ij _ 1 Le. . Y = — sr o ...._ TrN CA t? sh.c r .. 3-r D ( [ d fi 1 `/ 6 New Building Remodeling Addition Repair; No. of Stories To be constructed of Kind of foundation Roof Covering Estimate Total cost of improvements $ /// G CO , Amount of Permit $. 05 0 r 0 0 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, Pennxnent Supplement, and has complied ssith the rovisions 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 arc required by the Act. The undersigned agrees to employ only such subcontra w on work to be performed under this pcnnit, as are licensed by Miami Shores Village. - Remarks (Signed) Disapproved (Signed) Dat y NOTE: A charge of $1.00 will be made for the Planning Board. A re- inspection fee of $1.00 will be charged materials anti /or workmanship. Chairman Mfcrr,ber Member .. _....._......_..._. —...._ Council Approved Date _. No.L1.. .7._.treetl 4 . ST ..._ /".P ... ... it o 3r j PLANNING BOARD DATE and for no other purpose. Notary Public, State of Florida Budding Inspector My Commiuion Expires STATE OF FLORIDA, COUNTY OF DADE. i 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.._ .5.2 Y ate s � ._._._ Read, Sworn to and Subscribed before me. Member Member Member Disapproved Date Date making corrections or changes to this application after approval has been obtained (torn when such re- inspection is made necessary by Improper notice for inspection or faulty c- ivriAMI SHORES VILLAGE, FLA. z JOB - ADDRESS INSPECTION TIME READY - OT • • 7 N9 6353 REMARKS. 'PECTOR - DATE Owner of MIAMI SHORES VILLAGE, FLORIDA BUILDING , ELECTMCAL V PERMIT 'N? 12092 PLUMBING ❑ ROOFING ❑ Work to be performed under this Permit Architect contractor � or Builder ....k, .:,...., S .. • Legal Lot II 131. Description. Address of Value of II .1 Project $ Building i : i'' ``() Z '1 !,f. :.,. 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. Subdi- vision Signed. ( BY INSPE DATF �' J. / t 4 - 1 195 Contractor's License No Amt. of r1 Permit $ tt' 4f Val In consideration of the issuance o me of this permit I agree to perm the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plane, 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 e' er, myself, gent, s ant or employee. OONTRACTOR OR BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description. Lot MIAMI SHORES VILLAGE, FLORIDA ❑ DATE 1 ' ..j / 195 p PERMIT , N? 12292 Contractor's ❑ License No ❑ Work to be performed under this Permit L .✓�— �-- !.- CONTRACTOR OR BUILDER Address of 1 �. i - Value of it -7 Building t , , ! '' , .. y 4 _ %' Project 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. d'his 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 furth condition u which this permit is granted is the .understanding that the contractor or builder named above assumes the responsi : •ty for thorough knowle e of the o nances and regulations pertaining to the work covered hereby whether shown on the plans or dzawings or In the sta en r ecifications and tthe assume reponeibili ty for work done by his agents, servants or employees. r } eYk .j 1j � �-vv V hereunder in co pliance with all ordinances and regulations submitted to the proper authorities of Miami Shores Village. sekvant or employee. In consideration of the issuance to me of this permit I agree to pertaining thereto and in strict conformity with the plans, dra 5, state In accepting this permit I assume responsibility for all work don by. ither, Subdi- vision Amt. of Permit AUTHORITY BUILDING PERMIT APPLICATION FBC 2001 Miami Shores Village Building Department SED 1 .7 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. al a003 a. 3 Master Permit No. P PPoo 3 .14408 Permit Type (circle): Building ) Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) e.l / / s Br c/S j Phone # 3 d 5 - ( P - 7 o D p Owner's Address /.Z r 7 /V C 94 pi u p City PV7 /a M^ / s/1P ZoS State / Zip 3b & O Tenant/Lessee Name Phone # Job Address (where the work is being done) City Miami Shores Village County Miami -D a Zip Is Building Historically Designated YES NO 2 c h l � 5 L-� c- 1 L C Phone # � N 3 -s Y ,7 . . Contractor's Company Name , / 1 / � J / contractor s A dress (O� _ l L GJfr1�"11,/ a Y(JL f / c,✓OO i State / /©/</ 6' Zip ,,3 J 2-1 Cit � /� `� P Qualifier 5b1 )/ -& F4ti,J1,-ity Architect/Engineer's Name (if applicable) Architect/Engineer's Address City State S Value of Work For this Permit ft 2- 0 Number of: Bays Stories Families Type of Work: (Additio ❑Alteration Describe Work: Si A GO ti � Y 4 /.2 7 /''6 94( 51 Zip DNew Square Footage Of Work: Bedrooms Baths ❑ Repair/Replace 0 Demolition - Phone # * * * * * * * * * ** * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ \ N Permit Fee $ Notary $ Education/Training Fee $ ea (/ 0 Tech $ 3 ' I6 Scanning $ Radon $ Code Enforcement $ Bond $ � Struct. $ Minus Plans Check Fee $ Total Fee Now Due $ / ?5 -3 App Fee ' $ 3o. oo V;60, (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me day of . S ' r ' f" ,2063 ,by h• 7 /S &tic✓s who is persona• 11 known to me or who has produced • As identification and who did take an oath. NOTARY PUBIC: 1,, Sign: ![� Print: My Commission Expires: chc7/7/03 Contractor The foregoing instrument was acknowledged before me this 7 day of ..C.e , 20 a3 by _60Oiy •'C who is Personally known to me or who has produced ..�as,identification and whiz did take an oath. COMMISSION D D 1 JAN. 15, 2007 BONDED THROUGH My Commission Expires: ***********• k ***•1*********************************************** ******** * * * * * * * * * * * * * * * * * * * * * * * * *** * * ** * Erirk* (Certificate of Competency Holder) State Certificate or Registration No. � 5� Certificate of Competency No. * * >�'is � '4'4. ' V APPLICATION APPROVED BY: Plans Examiner Engineer Zoning - EM MI TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE IDET LIGHT OUTLETS CENTRAL HEATING ISHWASHER RECEPTACLES A/C (WIND) ISPOSAL SERVICE TEMPORARY A/C (CENTRAL) IINKING FOUNTAIN SERVICE SIZE IN AWS DUCT WORK DRAIN SERVICE REPAIR.AETER CHANGE REFRIGERATION _OCR TEASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING YTERCEPTOR RANGE TOP UNDERGROUND TANKS %VATORY OVEN ABOVE GROUND TANKS ;JNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS LOTHES WASHER MOTORS 0— 1 HP STEAM BOILERS SOWER MOTORS OVER 1— 3 HP HOT WATER BOILERS INK, POT /3 COMP. MOTORS OVER 3— 5 HP hECHANICAL VENTILATION INK, RESIDENCE MOTORS OVER 5— 8 HP TRANSPORTING ASSEMBLIES INK, SLOP MOTORS OVER 8— 10 HP ELEVATORS/ESCALATORS EhPORARY WATER CLOSET MOTORS OVER 10— 25 HP ' FIRE SPRINKLER SYSTEMS RIVAL MOTORS OVER 25-100 HP COOLING TOWERS 'ATER CLOSET MOTORS OVER 100 HP VIOLATION NOIRECT A/C WINDOW REINSPECTION !ATER SUPPLY TO: AIR CONDITIONERS - A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER —NEW INST. GENERATORS TRANSFORMERS i HEATER — REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER—WELL SPECIAL PURPOSE . SWIMdING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES ;EWER CONNECTIONS SIGN TRANSFORMERS ITILITY —SEWER SIGN TIME CLOCK R I L I TY —WATER F I XTURES 'EPTIC TANK ANTENNA ,FLAY TELEVISION OUTLETS RAINFIELO, 4' TILE/RES. VIOLATION _ . __ 'UhP & ABANDON SEPTIC TANK REINSPECTION � " , >OAKAGE PIT CU. FT. — :ATCH BASIN IISCHARGE WELL )OMESTIC WELL 1REA DRAIN 100F INLET 1 ;OLAR WATER HEATER `. :IRE STANDPIPE OOL PIPING .AWN SPRINKLER SYSTEM ;AS RANGE 4 ETER SET (GAS) 3AS PIPING ,ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. )BTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL MIAMI SHORES VILLAGE, FLA. JOB —7- 0 4- 4-' ADDRESS Z INSPECTION TIME fl.e.2.17 TIME READY:A 1 " REMARKS: 73 — re - * 4 r 4. •: _ ,.r c 14:4 c- i.i: ic.. e :-.. j ,....! t I.' , ; ;").• A.Vf --1 11-7 '1 i ( '' ' A.- ■•■•:,.- ' ? 4 '...' .'' -S4- Li i c• e 44; /7.-' :::": :-,..! 47: 4 i / „ Tki i / e- ri.. ,6 4 I 1#9'..47 c f 4--- *'-'li 4 e ''' - "."::' ":'' - -": . # t DATE e r-r- 14 • "" C,' „ 4 '5 N9 7913 •!.7- fie 14- PO SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T•S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE H STRIP H EATER TOTAL CONTR. LIST CHECK EMT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. M OTORS 0-1 HP M OTORS 1 -5 HP N EON TRANS. RADIO TOTAL CONTR. LIST ) I, CHECK Permit No APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address + -^^ f ' R' k No Street Registered Architect and /or Engineer Employing Electrician's Name d�� `� r-� ■ ' No Street Location and Legal Description Lot .Block /� Subdivision Street and Number here work is to be performed —No 1. . 1 �r.. .. 4r'1.Street State wor .e performed and purpose of building (By Floors) N .uilding Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding STATE OF FLORIDA, 1 COUNTY OF DADE. I Amount of Permit $ J f 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. ss. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT (Signed) Date q // Electrical Inspector. (Signed) Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE - A re- inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materi and /or workmanship. ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No 1 ) 1) Date / /.. — G' i? 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 work Owner's Name and Address 1 -V)1 ' No Street Registered Architect and /or Engineer 1 /1.,_ 3:' /..� Employing Electrician's Name .ti—/ Y..L/ I�.r.l�'� No t Street Location and Legal Description Lot 2 Block D J Subdivision...., Amount of Permit $ STATE OF FLORIDA, j COUNTY OF DADE. ! j 88. MIAMI SHORES VILLAGE t (Signed) Street.. W • Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw 'J Amps Main Fuses...p.:....:.:' Amps Underground Type of Installation— Conduit Tubi g B.X.L .Metal Moulding (Signed) Electrical Inspector. 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 subcontractors 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. Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH 0 LIGHT OUTLETS PLUG RECE'P•T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST 3,� (Y G J / / / ! / CHECK ii, ...• w . O ' / 0 0 sJ ✓� / , fff / e `. � 7.c �. J �, ENT. SW. DIST. CAS. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST / L / / CHECK. U ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No 1 ) 1) Date / /.. — G' i? 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 work Owner's Name and Address 1 -V)1 ' No Street Registered Architect and /or Engineer 1 /1.,_ 3:' /..� Employing Electrician's Name .ti—/ Y..L/ I�.r.l�'� No t Street Location and Legal Description Lot 2 Block D J Subdivision...., Amount of Permit $ STATE OF FLORIDA, j COUNTY OF DADE. ! j 88. MIAMI SHORES VILLAGE t (Signed) Street.. W • Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw 'J Amps Main Fuses...p.:....:.:' Amps Underground Type of Installation— Conduit Tubi g B.X.L .Metal Moulding (Signed) Electrical Inspector. 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 subcontractors 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. Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Contractor or Builder t� ' CONTRACTCR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA DATE ( ,') 195 7 PERMIT N° 5779 Work to be performed under this Permit (.; J Architect •' °�--• Legal Lot 1 Subdi- Description 1 I Bl vision r" ' Address of z �' Value of 11 Amount of 7 Building L Project $ 11 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 respo bility for a thorough knowle a of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or , drawings or in the atements or specificdtions and ttiat he assumes responsibility for work done by his agents, servants or employees. 1 / Signed. INSPECTOR !� C Contractor's 1 � License No. 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,Apecificatians,.,si3bmitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself,'y agetf servant or employee. BY AUTHORITY Permit No 1 0 1 ' 1 Owner's Name and Address Registered Architect and /or Engine Amount of Permit $ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subs tied 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 work. Pa Employing Electrician's Name Location and Legal Description Lot Block Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition (Signe r No / Street No CC r''i2t_ - >7a-t ma Repairs (Signed) ! Date ,I 3.�• err Street Strce?1 Subdivisi Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation -- Conduit Tubing B.X.L Metal Moulding 1R!teetrical Ihector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his .ligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo ' r Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the si of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-cont • s, on work be performed under this permit, as are licensed by Miami Shores Village. /7- / -u 7 r R' o. of Stories r Electrician. STATE OF FLORIDA, 1 COUNTY OF DADE. j i° ' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made neceuary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH °UTLCrs LIGHT OUTLETS PLUG RECL'P'T'S FIXTURES NO. LAMPS REIRIO. OUTLET IRON OUTLET RANGE b OUTLET RANGE CONN. WATER H W. HEAT. CONN. g� AC[ 11 H�i► TLATER NEATER TOTAL CONTR. LIFT CHECK ,E_ 4/ t� —, ENT. Sw. DIST. CAS. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL GONTR. LIST / ( 1 J , c 7 CHECK Permit No 1 0 1 ' 1 Owner's Name and Address Registered Architect and /or Engine Amount of Permit $ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subs tied 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 work. Pa Employing Electrician's Name Location and Legal Description Lot Block Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition (Signe r No / Street No CC r''i2t_ - >7a-t ma Repairs (Signed) ! Date ,I 3.�• err Street Strce?1 Subdivisi Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation -- Conduit Tubing B.X.L Metal Moulding 1R!teetrical Ihector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his .ligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo ' r Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the si of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-cont • s, on work be performed under this permit, as are licensed by Miami Shores Village. /7- / -u 7 r R' o. of Stories r Electrician. STATE OF FLORIDA, 1 COUNTY OF DADE. j i° ' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made neceuary by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Type Insp'n U1/406 t W . Permit No. t II � ` 2V O3 Name rob aQVS icq Address I a_ YA- 1)6, 5 0 5+ . Company V h' Ciq€ � tt� • Phone # 1a6- ` ) VJ �- — 82. I For Inspector: El a I 7o Name & Date Approved Correction Re- Insp'n Fee 2 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request: Date tO (15 Time Type Insp'n ' c ]✓ rCj Permit No. E1 0Z0 Name (s (� c Address 1" C..� Q J Company c )G ocA l ., Phone # For Inspector: Approved Correction Re- Insp'n Fee (0I0(o Na 17t /7 Date ❑ c ' 2 ,/ /re- /s MIAMI SHORES VILLAGE BUILDING DEPARTMEN 305- 795 -2204 Building Inspection equest Date Type Insp' n L�■.r�lt! c' Permit No. Name Bross Address 25} Company 6111[5 Phone # ) U t0 L/03 ` 3 &U GO- Inspection Date j Approved Correction Re- Insp'n Fee d-0/0