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842 NE 96 St (9)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 2,,-/r-,0Z Time Type Insp'n r- Permit No. J&33 c Name 4) til&h - - -- - -- -- - - --� f- Address 8 L /• �� S Company / Phone # 75 b (0 For Inspector: 2 ./5),e2 Name• Date Correction ❑ Re- Insp'n Fee ❑ Approved U, �� .✓II SHORES VILLAGE iLDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ra"li ° ®z Time Type Insp'n A,J7)-Y41 Permit No. L5 - 033x Name j aret/ Address 8 V 2 AO f4 St* Company Phone # For Inspector: g.,20 - 0 Name & Date Approved Correction Re- Insp'n Fee 30 C 7 7 6/ Project: <NONE> Inspection Number: INSP -2010 Inspection Date: 12/12/2005 Inspector: Grande, Claudio Owner: STAPLES, CLINTON Job Address: 842 96 Street NE Miami Shores Village, FL 33138- Contractor: ARCON ROOFING Building Department Comments Monday, December 12, 2005 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: BP2004 -1209 Permit Type: Imported Permit Inspection Type: Tile In Progress Work Classification: Roof - New Phone Number Parcel Number 1132060142900 Lot: Phone: 954 - 753 -3100 Page 2 of 2 t Passed O � Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Project: <NONE> Inspection Number: INSP -2010 Inspection Date: 12/12/2005 Inspector: Grande, Claudio Owner: STAPLES, CLINTON Job Address: 842 96 Street NE Miami Shores Village, FL 33138- Contractor: ARCON ROOFING Building Department Comments Monday, December 12, 2005 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: BP2004 -1209 Permit Type: Imported Permit Inspection Type: Tile In Progress Work Classification: Roof - New Phone Number Parcel Number 1132060142900 Lot: Phone: 954 - 753 -3100 Page 2 of 2 842 NE 96TH STREET • Passed Inspector Comments 0'Y�- ?"& (-------"---- Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until i nspection Number: INSP -1610 Inspection Date: 12/08/2005 Inspector: Grande, Claudio Owner: STAPLES, CLINTON Job Address: 842 96 Project: <NONE> Miami Shores Village, FL Contractor: SAWGRASS BUILDERS, INC. Building Department Comments Thursday, December 8, 2005 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: BP2004 -343 Permit Type: Imported Permit Inspection Type: Insulation Work Classification: <NONE> Phone Number Parcel Number 1132060142900 Lot: Phone: 561/750 -9614 Page 2 of 2 3�u 614 to MIAMI SHORES VILLAGE . BUILDING DEPARTMENT ‘t 305- 795 -2204 Building Inspection Request D ate I i s I OS Type Insp'n I I n C Permit No. EP(D4 - 34 3 Name C L-1 tETON ,AP Address 842- uE 9(=, Company SAk/`(G rCPSS C 5.1 Phone # `5. 1) 6 II" Inspection Date [6 `OS Approved Correction ❑ Re- Insp'n Fee ❑ Name Address Company Phone # Inspection Date ,ok51o5 Approved Correction Re- Insp'n Fee /US 422.2 OCT 0 6 2005 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date VA4AOS Type 1nsp'n 1 \ \b .i S Permit No. b? /Mk ^ \ S ks'4u5 t►. ( Vb c \ 'Sk1 ck -R Am OCT 0 4 PAID 1(17 vks j v k1 4,0 U A ,,4,t) 47 /-4V,OQ1eS � !! l� 1 r ») lQ7L AJ Nor /„J guv acs MIAMI SHORES VILLAGE ' DEPARTMENT 305- 795 -2204 Building Inspection Request .. T Company For Inspector: Approved Correction Re- Insp'n Fee Type Insp'n Permit No. � Name 0 / " ` �CP A Address ! L Phone # 0 ,p,(460 BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building LI 4 S" ❑ DATE W ❑ PERMIT N? 7169 Contractor's License No. Ll Work to be performed under this Permit Lot yy r CONTRACTOR OR BUhLbER MIAMI SHORES VILLAGE. FLORIDA Bl. z2 i 195 Subdi- vision Value of - II Amount of Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the,etatements or specifications and thcrt he assumes responsibility for work done by his agents, servants or employees. i • 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 regulationz pertaining thereto and in strict conformit . .e plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit d assume respon- ..r ity for a work done by either, myself, my agent, servant or employee. BY AUTHORITY 6 BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby erode 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 ke t at b ilding during progress of the work. l"\ iCe , 19..._._ MIAMI SHORES VILLAGE Owner's Name and Address Registered Architect and /or Engineer Name and address 01 licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done. ....XV2._� State work to be done and purpose of building (by floors) •.✓J _. ,pef,9 G. P/L cV Disapproved (Signed) -"."7)4 1 / • Building Inspec Council Approved 4 -2 &.2i.T .... No .............._....__. Street— Date New Building Remodeling Addition < .0. ;.... . Lt . t � and for no other purpose. Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $... 24 ea Amount of Permit $,. PD. 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 theFlorida 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 • s. ction on th ite of the work such public notice or notices as arc required by the Act. The undersigned agrees to employ only such su d actors io>4vork toj be performed under this permit, as are licensed by Miami Shores Village. Remarks._._ (Signed) STATE OF FLORIDA, 1 COUNTY OF DADE. j 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 forgoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No.__.___._ 7 2- ( Date / /CO 7 ead, Sworn to and Subscribed before me. Notary Public, State of Florida mission Expires PLANNING t OARD DATE Chairman Member Member Member Member Member Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. 2,g - V j 2— Street Owner's Name and Address.. Registered Architect and /or Engineer...._ Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Street and Number where work is to be done State work to be done and purpose of building (by floors) ,,c Disapproved D (Signed) �. Building Insp . or Subdivision New Building Remodeling To be constructed of Kind of foundation Estimated Total cost of improvements $ Zone cubage required Distance to next nearest building Maximum live load to be borne by each floor fituaryte No %fe9 ,19 J r— V and for no other purpose. Addition Repairs • No. of Stories / 0 Roof Covering Amount of Permit $ -Plan Cubage Size of Building Lot I hereby su 11 the plan an. + . f' ati'ns or skid building. 1 notices with reference to the buil 'ng and its 1 s r lion may be sent to .3._ / " V a gi (Signed) The undersigned applicant for this building a init do . hereby certify that he understands and accepts his ob ions as n employer of labor under the Florida Workmen's Compens. '.n Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, an 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 s h public noti or notices as are required by the Act. The undersigned agrees to employ only such suacyn ractors, on �vor be pert -d under t is permit, as are licensed by Miami Shores Village. Remarks STATE OF FLORIDA, f COUNTY OF DADE. Ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. �y 2-3 Permit No 6 D 7 Date a Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires ANNING BOARD DATE Chairman Member Member Member Member .- Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from time Planning Board. A re- inspection fee of 51.00 will be charged when such re - inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 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 �l �L,it . 7 Owner's Name and Address % ii ('"„ No` ./,- .._. Street. P 5-- Registered Architect and/or Engineer i ./ — 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 No._ Disapproved (Signed) APPLICATION FOR BUILDING PERMIT MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT r -- State work to be done and purpose of building (by floors) y and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kin•r.. foundation Roof Covering Estimated Total cost of improvements $ ,f® — ' p � Amount of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building_.... Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the s• - work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sulfcontractors, on ork to . performed under this permit, as are licensed by Miami Shores Village. Remarks ( Signed) _. STATE OF FLORIDA, COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared Notary Public, State of Florida 19 . to me well known, and who, being by me first duly sworn, upon oath deposes and s. •s e is the of the above described construction, that he has carefully read foregoin:' pplication, and that he did sign the same, and that all facts therein by him stated true. 7/ y Date . Re.. , Sworn to and Subscribed before me. Date_. Building nspect My Com 'ssiL on Expires NNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Owner's Name and Address MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT. APPLICATION FOR BUILDING PERMIT Application is hereby uindc 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. fic uilding Inspector Date.41.111 —.... ,1 No.. §7fi . Street..Z ._ L Registered Architect and /or Engineer ....... . .....:.....,, ... ,,,,.,.. Name and address of licensed contractor .. _A 4.c2 RD®P/''4 - Lj k� t : / f 4) % Pr Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done .. t2- . Vi.Z2 State work to be done and purpose of building (by floors) and for no other purpose. New Building Remodeling Addition Repairs 1 No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ 3/44' 44 r 04 Amount of Permit S. Zone cubage required ______.._Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the - Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Pennanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed). 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 ar true. Permit No..__ /(Q_ Date et —7*' Read, Sworn to and Subscribed before me. Disapproved (Signed) -.. STATE OF FLORIDA, COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared __. _ _ .-- •----- .- -._ .............._.. to me well known, Notary Public, State of Florida My Commission Expires PLANNING BOARD _ DATE Chairman Membcr Mcrnbcr Membcr Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re in.pcc•tion fce of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building PERMIT Architect Contractor or Builder t Legal Lot Description B1 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA N9 6770 DATE 19 Contractor's • C icense No. / Cr a Work to be performed under this Permit • Subdi- vision Address of # Value of I Amount of . Building / Project $' I 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 applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. ti ai Signed- + r i, ��NSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with \11 ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements 4r specifications submitted to the proper authorities of Miami Shores Village. In as cepling this permit I assume responsibility for ell work done by either, myself} my agent, servant or employee. BY = AUTHORITY OWNERS NOT. APPENDIX "F IFICATION FOR ROOFING CONSIDERATIONS .As it pertains tom; Appendix "F', it is the responsibility of the roofing contractor to provide the owner with the r roofing permit, to provide the owner with this appendix and to explain to the owner the content of this form. The provisions of Chapter 34 of the South Florida Building Code (SFBC) equtred minimum try for roofing system installations. Additionally, the following items should be addressed as ents the a agreement f the indi the owner and the contractor.The owner's initial in the adjacent box indicates that the item has been explained. ent betwe::n 1. A esthetics - Workmanship The workmanship provisions of Chapter 34 are for he purpose of providing that the roof- ing system meets the wind resistance and water intrusion performance standards. Aesthetics (appearance) not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as issues are agreement between the owner and the contractor. n . part of the a 2. Renailing Wood Deck: When replacing Or/ with the current provisions of Chpter 29 of the SFBC�(The roof deck i usually concealed prio t o in removing existing roof system.) d prior to removing the. . r. 3. Common, Roofs: Common roofs are those which have no visible delineation between neighborin g units (i.e. town- houses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or owner should notify the "' 4. Exposed ceilings: Ex osed o e ceilings are Where the below. The owner may�vish to bea nmhe architectural appearance, there, fore the roof decking can be viewed from I side of the decking may not be acceptable. The SFBC provides the option of maintaining this appeara of the under - th is appearance. 1S. Ponding Water: The current roofs stem and/or (accumulate) in low -lying areas of the roof. Ponding c can h be andindi atiionlofdstructural distress s yan u r water h require a the review or a professional structural engineer. Ponding may shorten the life expectancy and performance oldie new ing system. Ponding conditions may not be evident until the original roofing system is removed. d may require the should be corrected. roof - b A�n l Pondino conditions "6. Overflow Scuppers PP e ►s (wall outlets): h is required that rainwater flow off so that the roof is not overloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if l overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scu p 23 ppers in accordance with Chapter 2� of the SFBC. � h the interior of the structur- ( 7. Ventilation: Most roof structures should have some ability to vent natural airflow throuo al assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider venting which can result in extending the service life for the roof. S. The or may contact the Miami -Dade County Consumer Services Department f the above. , for further informr.::" r ^l � �:,. _ net's /Agent's Signature 123.01 12 PACE 2 7/99 (/ Date Contractor's Sigr_s ure NOTICE OF COMMENCEMENT Notic nmencement must be filed if the job valuation of $ 2,500.00 1 DEC 05 14:2( and /or more in labor and material. Please file at 22 NW 1st Street, 1st Floor, Miami, FL. - (305) 275 -1155 'ERMIT NUMBER: TAX FOLIO NUMBER: TATE OF FLORIDA COUNTY OF DADE -IE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, orida Statutes, the following information in provided in this Notice of Commencement. !gal description of property and street address: 9 4 4 . 1 /•-) E - • 6 S I b scription of improvement: vner(s) name and address: terest in property: ;ntractor's name and address: fount of bond: $ ider's name and address: Sc' ivii U h:Li-k kw ime and address of fee simple titleholder: Otln , 3OL or (0.410im Suds A — (c rety: (Payment bond required by owner from contractor, if any) me and address: STATF OF FLORIDA, COUNTY OF r Ar?P I HECE „• • r 'ry that this is a rr • IY V. `•'r : SS my nany and Ull Se 31. l I I %. 1,vC t 1 c t�l 1, .,.... r .. sons within the state of Florida designed by Owner upon whom notices or other documents may be served as provided by Section 3,13(1)(a)7., Florida Statutes, ne and address: addition to himself, Owner designates the /following person(s) to receive a copy of a Lienor's Notice as provided in Section .13(1)(b), Florida Statutes, ne and address: iration date of th N tice,/Cor rr en me t: is specified) SIGNATURE OF OWNER t Owner's Name: tv 1 I � a■t . S � I jvb, ffa ,— rn to and subscribed before me on this to olL Oot-icie 7 4,9„2_a s t Personally Known, or - Produced ID ' - Oath taken, Oath not taken piration date is one (1) year from the date of recording unless a different Prepared by: Address: i c . / pc? r” Sri n ��- t AD C) I flit) Notary Public: Print Notary's Name: S AN(» D &2 ` ��t . 1 -- ). � LL iss E xpires April 20 . 40 1-1 DATE RECEIVED FRO Contractor Local Phone: Parcel # 1132060142900 CHECK MONEY ORDER FROM BY No. 60 l�Y'i lit 1182 Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOTS 5 & 6 BLK 75 LOT SIZE SITE Fees: Description Amount FEE2002 -2319 Building Fee $147.50 FEE2002 -2320 CCF $2.40 FEE2002 -2321 Miscellaneous $100.00 FEE2002 -2322 Notary Fee $5.00 Total Fees: $254.90 Total Fees: $254.90 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: Work: REPLACEMENT OF POOL TILES If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. 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: 10/20/2002 Construction Value: $5,900.00 TOR) BY: In consideration of the Issuance to me of this permit, l agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and In strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by efther myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: APR 24 2002 17:25 FR PAN AM SAT To Miami Shores Building Department 4/24/02 Attention Angie: This is to grant the contractor Albert Miranda permission to pick up the work/repair permit for 842 NE 96 Street Miami Shores, FL 33138 Permit should be for replacing the tile around the pool area and front landing of house. My name is William Scott Whittaker and I am the owner /resident of the property My work schedule will prohibit me from stopping by the Village Hall tomorrow and I do not want to delay the work. Please charge the permit fee and penalty to Master Card # 5402 8381 0085 7933 Expiration 09/02 Name on the card is William S. Whittaker 305 445 5315 TO 3057568972 P.02 Thank you. Please call me on my cell phone 786 543 5044 if there is any issues or concerns. Thanks h/14, Yk ** TOTAL PAGE.02 ** JOB ADDRESS ' • ?G S7 4. DATE ZUNI.NI' CRITIQUE SHEET APPLICANT PHONE# APPLICATION SHEET OF MISCELLANEOUS COMMENTS PERMIT NO. ADDRESS: MIAMI SHORES VILLAGE BUILDING / ZONING DEPARTMENT' SECTION BY DATE ZONING' ELECTRICAL MECHANICAL PLUMBING FIRE PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL 1. Subject to compliance with aft Federal, State. Comly, rides and regulations. Village tss;xnes na re:ponstbgtty for accuracy oflor mutts from t�.ese plans, 2. This copy of plans must bo available ea buRding site or no Inspection wt(f bo conducted. INITIALS . 5 A IML' // fetes' o '97 ,d Further, Affiant sayeth naught. Witness(sign and print) Vl uni Skoreo Vi � CIO AFFIDAVIT STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, Scoff' /al / / her does hereby attest that the (property owner) attached survey, performed by I1 FA 67»73 h , �N (name of surveyor's company) performed on / t/1/04 /2- oa , is an accurate representation of the existing conditions and (date of survey) locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than six (6) months old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building, code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits.. Witness(sign and print) SWORN TO AND SUBSCRIBED before me this day of Affiant is personally known to me, produced as identification. Notary The Sunshine State LICENSE NUIASER W326-937-65-122-0 WILLIAM SCOTT WHITTAICER 842 NE 88 STREET MIAMI SHORES, FL 33136-2622 BIRTH DATE SEX HGT REST. EMORSE. 04-0246 M 6 ISSUED IDEF.IRES CUP LIcATE 01-06-00 04-02-06 06-1941 toiormoiso Operation at a motor vehicle constitutes consent to any sobnety test required by taw. ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16 -20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C WaH/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re - pipe Drains, Floor Minimum Fee Shower Water Service Drains, French _ Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY D TE Zoning r .25 / a d Electrical Mechanical Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review CHECKLIST ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) $ 100 61 ' 00 (sq.ft. = x/1000 x0.60) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $S t ( o ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com PROPERTY OWNER ,L,L / J � Name ` t / , /6 Don -SGO `/ ph X14 47° Address 91 /2_ N£ 96 - 44/4,0( fit r' /J fl L. ? Home Telephone 3 0 5 - -_ 7 6 2. 7 3 z Business Telephone 3U.5` ip. 5 55 3 4 Fax 3 0 `s — 7 6 9- 7 336 TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Job Address: PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other 7 f At C- 96 City �,/ Folio Number /description of Work � P� / A r/;'7, / �' `- t Address Apt. Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. PERMIT APPLICATION gov s4 3 3/ 3 c State Zip Zoning Linear Feet Square Feet Value of Work S� °° Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. Units Floors ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STAT • OF • RID/ CO `V ' /AMI-DADE X Si ature of Owner ure of No Public - 4 s Print Name wo.• and subscribed before me this r ' ,.r11__�.1, Si 4,, /11 044 SEAL: S. G Jh #01 't"- eo grata : ' U B < AC''e.. LA .; r • co.: : ., _r .. .. '.� St. a il s} CF F. G STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: PERMIT APPLICATION Personally known OR, Produced Identificatt6n Personally known OR, Produced Identification Type of Identification Produced: /22. Type of Identification Produced: No. RESULT No. RESULT No. RESULT No. RESULT No. RESULT 1 -5 Passed 21 -25 Passed 41-45 Passed 66 -70 86 -90 6 -10 Passed 26 -30 Passed 46 -53 71 -75 91 -95 11 -15 Passed 31 -35 Passed 54 -60 76 -80 96 -100 16 -20 Passed 36-40 Passed 61 -65 81 -85 101 -105 7LARA AND ASSOCIATES., IINC., Metro -Dade County Appruv€%d Testing Laboratory Lab Certification # 98- 0116.01 CONCENTRATED UPLIFT LOAD TESTING ON ROOF TILE TO COMPLY WITH METRO -DADE COUNTY PROTOCOL PA -106 PERMIT No: 50334/3 p ,20p1_ PCA No: ROOF PITCH :: 3/12 INSPECTION DATE; 03/19/02 TEST DATE: 03/22/02 JOB NUMBER; 034802 PROPERTY ADDRESS: 842 NE 96 ST OWNER: Mr. Whittaker CONTRACTOR: Obenour Roofing ROOFING SQUARES: 35 sq TILE TYPE: Santa Fe CONTACT PERSON Yusi (305)205 -0327 TEST RESULT TABULATION ipment: Digital Chatillon DFIS 200 THIS ROOF HAS PASSED: X FAILED THE STATIC UPLIFT IN ACCORDANCE WITH MIAMI -DADE COUNTY PA106. 19 F.F. Flaquer, P.E. P.E. #23070 "ROOFING SKETCH" Roofing Laboratory Testing & Research Moisture, Up -lift, Fastener Testing Complete Building & Roofing Inspections Consulting Engineers 2554 West 3` Ave. Hialeah, Florida 33010 (954) 433 -1484 Fax (954) 437 -2296 Required Testing Force: 35 lbs. 11 s • B PLUMBING ❑ ERMIT ROOFING ❑ MECH ❑ L5 Owner of Building Architect Contractor or Builder Legal Description Address of Building MIAMI SHORES VILLAGE, FLORIDA a� 20 Date 200_4 This permit is granted to the contractor or builder named above to construct tion herefor in strict compliance with all ordinances pertaining thereto and with the un plans, drawings, statements or specifications that may have been submitted to and approved at any time if the work is not done in compliance with such ordinances or if the plans are ch permit is granted is the understanding that the contractor or builder named above assumes the res regulations pertaining to the work covered hereby whether sh. . the plans or drawings or in the sibility for work done by his agents, servants or em Signed• (INSPECTOR) BY 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 ither, myself, my agent, servant or employee. �liL' -t } 1CGYJrs 7 V ' CONTRACTOR or BUILDER Work to be performed under this Pernrif�Cr ew'Lat a" L C S adIhbac -a_e. Ld eryte a)-49A i ,04 � � - Asti9i 3/2 its tvia, 44-at 'Z ULpv I3.ecC N° 50334 0,520(0 . 6K—'00 s ubdi- n �+ 0' /� 2 vision I"l � � P� � :J /) Sq. Ft.: Value of Project $ I 0 BY Contractor's License No. Permit: CCF: Notary: Bond: T n( \ t h Radon: P Permit: U `� Permit: building or to install the equipment or device described in the applica - rstanding that the work will be performed in compliance with any the proper municipal authorities. This Permit may be revoked ed without authorization. A further condition upon which this nsibility for a thorough knowledge of the ordinances and tements or specifications and that he assumes respon- „AUTHORITY ate :-ifLCrrr r / Deelttypi+: �,q► CTltderl3pkic111: )Zid^c Vent' OW uNTFop.ret R9 s . Tt s iilatlon ,: Vim A ilaUP 9LOPM D E T A I L 3 SLOPED SYSTEM DEA' 1 i!li - "E" `i PERMIT APPLICATION PROCESS No. ON Evis!INK Roof 1 F'igtencr type .3:: sp;,Cing:L1 t - t/fj�il / �L� f i �`^'r+ / i {i' '07c. 4%'l€aa i ce ✓ o / � sh S e(d Cap Mlleet: f1►C 2.�/lj��/'..�a:r�. 7 TILE CALCULATIONS ( ax/: ,4 ,Iq g (Prn 4 � X. (.`.crodynamic l+d \iltipiidr): i i) ` ') - lVi ' � � �� = M y • ' PCA 6 r (Fm ?: q 6 A.. (Aerodytt8titiol,4ultiplier): ../) •.• M !. = s_M =: ) 0 1 d CA; &1.7 (Pmax.: ?` \ A. (Acrodyna milt Multiplidr)! Al ) - A 1 � = M 2.2. C,A: 6/. 9 Page -2 ATTACHMENTS REQUIRED 1) Fire Directory Listing Page 2) Miami -Dade. County Product Control Notice of Acceptance -Cover Sheet a) Specific System Description h) Specific System Limitation e) General Limitations d) Applicable 'Detail Drawings 3) Municipal Permit Application 4) Other Component Approvals • r MIAMI.OADE a +� PRODUCT CONTROL NOTICE OF ACCEPTA Santa Fe Tile Corporation 10302 N.W. South River Drive, Bay #16 Medley ,FL 33178 Your application for Notice of Acceptance (NOA) of Spunish "S" Clay Tile under Chapter 8 of the Code of Miami -Dade County governin the use of Alternate Materials :: i - - ypes o( Construction, and completely described herein, has been recorl�� for acceprance by the ^ `I er.. - ,i -D -ie County Building Code Compliance Office (BCCO) under the c�onditi.ons specified herein. i This NOA shall not be valid after the expiration date stated below. BCCO reserves the right to secure this product or material at any time from a jobsite or manul'acturner's plant for quality control t_estinn. If this product or material fails to perform in the approved manner.IBCCO may revoke, modify, or suspend 1::e use of such product or material immediately. BCCO reservi -s the right to revoke this approv.;I, if it is determined by 13CCO that this product or material tails to ineet the requirements of the So'.!:h Florlde Building Code. I t The expense of such testing will be incurred by the manufactu ACCEPTANCE NO.: 00-1212.06 EXPIRES: 02/01/2006 THIS IS THr COVF.RSHEET SEF ADDITIONAL PAGES FOR sr'ECrFTC AND c1;N 1-1U - W CONr)!TIONS BUILn1NG CODE S. PRODUCT RFVEFw COMMITTEE This application for Product Approval has been reviewed b) the }3000 and approved by the auiiding Code and Product Review Committee to be used in Nfiarni -Dwde County. Florida under the conditions set forth above. M ROvID: 02/01/2001 ._ — . 'A s045000 Ilpc20001ltempVtes■noeiee Daty: To: (-17 IIvv.- Fac .,xt - 336 —311, z Nola: Interne( mail address: posrmaner@buitdingcodeoniinc.com 1 )rap n I 7T? qr'1=1 rGtr Rhona: •Map: 4CE 1 l n C11/111( F \X From: UUILD)NG CODE COi ll'L) :' C: OFFICE M) TRO -DADE FL.AGLcR C3UILD :NG HO N'ESt' FLAG;.CR S "rRLC':'. SuI i't; 1603 rrltr \1�I1, FI : O,R l nr'. 33130-1563 (305) 375 -290; FAX ;303) 375.2903 MIAMI-DADE COLJN i Y, FLORIDA METRO - DADE FLAGL R :UiLDING CON - t'1l.'.C - I'OR LICL' ::Styr: sF :CI'lo: (305) 375.252? r-;.,: ():75.) )75. • --- CUN't'RACI'OI: I: oRC!:\iu�'' !�!`•'I IUD' (305)175-29.i6 P;l (3 ". lti':o I'RODUc - r CONTROL L)I`.'ISIOX (305) 375.2V')2 FAX 0.75', 372 -65.39 Raul! Rodriguez Chief Product Contrc: %i • , i ,n Francisco J. Oircctor Mi:imi•Dacic County Buildintt Cod_ Com, liars__ O;ficc Hoaicp1gc: http:!/ Www.buitctingcodeonlir.c.c3rn (, ) r1 k J c1 SANTAF TILE CORPORATION ROOFING ASSEMBLY APPROVAL Cate;orv• Roofing Sub - Category: 07320 Roofing Tiles Materials Deck Type: 1, SCOPE This renews a roofing system using Santa Fe "Santafe iiS" clay rooting tilt, manufactured by Santafe Tile Corporation described in Section 2 of this Notice of Acceptance, designed to comply with the South Florida Building Code, 1994 Edi cion for Miami -Dade County. For locations where the design pressure requirements, as de ermined by applicable building code. does not exceed the design pressure values obtain by el culations in compliance with RAS 127 using the values listed in herein. The attachment calcu( tions shall be done as a moment based system, 2. PRODUCT DESCRIPTION Manufactured by APP)lcnnt Santafe `S' Clay Roof Tile 1 Pieces Dimensions 1= 18" w 11.5" Y thick 1= varies w = varies varying thickness Clay Roof Tiles Wood t 8l gran rl 1 7i, r 7 oc rran Test Specifications PA 112 PA H2 1 2.1 COMPONENTS OR PRODUCTS MANUFAC'; Test Product Dimensions S ecifieationt Tile Screws 2 -'' Ions PA 114 0.130" shank dia. Appendix E 0.178 flute dia, ACCEPTANCE No. : 00- 1 Approval Date: Fch_ruarti ], 200t E.piration Datc: Fcbrunry 1. 2Of+t; Product Description Orie piece high profile clay roof tile eq`Itippcd with t 'c nail holes. For nail - mcsrt r set and adhesive sct applications. Anzessory trin1, clay roof pieces for use at his, rakes. ridges and va!Icy terminations. cvdnufacturcd for cull vile profle. UREr) 13Y OTHERS Product Dcecriptinn 'tatttless Steel Manufacturer generic. 3. LIMITATIONS 3.1 3.1 Fire classification is not part of this aeceptancc•l For mortar or adhesive set tile applications, a static Field uplift test shall be per;ormcd in accordance with RAS 106. )1iti-Dade 3.3 Applicant shall retain the services 'of a fvlia County Certified nb . at orb to perform quarterly test in accordance with 1'A i 12 a2,z;,1•di.:,�;' ; h 1, L- :: submitted to the Building Code Compliance Ofilic t• ;� uloa�a, RRC Roofing Product Control Examiner Tile Profile Tile Application Two Nails One Screw T'"o Scrcws ; 38.26 One Screw ■/ C;,o 57.1 I Two Scrc'.•.v_ wi Clip 57.60 6:.7 ` -1 •1 r S antafe S I Direct Deck 21.6 29,16 Battens II r- - J SANTAFE T;CLE CORPORA UN 3.5 30 /90 hot mopped undeclayment applications Tay be installed perpendicular to the 1 slope unless stated othernvis; by the underlahment material manufacturers publtshcd literature, 3.6 This acccptance is for wood deck applications Minimum deck rcqu,•ements shall c ir. compliance with applicable building code, 4. TSTALLATXON 4,1,1 Santafe'S' and its components shall be installed ,n strict compliance with Miami Dadc County Roofing Application Standard RAS 11 SI RAS 119, and RAS 120, 4,1,2 Data For Attachment Calculations Santafe 'S' Tile Profile Santafe•'S' Table 1: Aerod namic Multi. yens ?.(ft Tile X (ft') I ?• (ft Profile Batten A• •lica ion Direct Deck 0.274 0.297 2 ":12" Battens 5.93 Tile Profile Santafe 'S' Table 2: Restoring Moments due to 3ravity - M -Ibf) Direct Deck 5.90 3 .x :12 " Battens Direct Oeck 5.85 5,S2 4 ":12" Battens 5.73 3 Direct Barrens Deck II 5.69 5 '' 6 Table 3: Attachment Resistance Expressed{ as a Moment- Mf (ft -On Syste 1. Approved screws as noted 'Product ,It:tnufacturcd by others' Dire.tt Battens Deck 5.53 5.32 [5":12" ACCEPTANCE No.: 00- 1212.06 Table 4: Attachment Resistance Expresse as a Moment - M, (ft -Ibf) for Mortar or Adhesive SetlSystems Tile AEplication Mortar Set Adhesive Set 6":1 2" Attachment Resistance 23.6 61.9 } 2uloaga, RRC Rcofing Product Control Exarn.iner 7 ":1 or greater Oirecr Bar.ens t);n_ peck 529 5.0 ? 1 i 1 4-- 7,1-,00r ! rrAc n1 7r_` r = qrS4 c Mp. J..1, -I,-II Imo, sf.;: :l 1 011'1? :'X. 50' 3'9del It71 ; +• :n '93/05/2001 12:3` 3058880050 • SANTAF,E TXYE COMP RAC, p1OTICE OF :'..: .'TANCE STANDA:tD CONOITJONS ,, application has been filed and t:'t l Renewal of this Acceptance (appro•,: be considered after renewal apf (ti c no e older t l - i original submitted documentation, i;• ::.._; lest supporting dat . engineering documents, .,r eight (8) years. 2 Any and all approved products shat; labeled witi the r anufacturer's name. city, state, ana the following statement: "Miami -L :•unty Product Control„kpproved", or as specifically stated in th :. specil�c conditions of this Acceptat. • 3 Renewals of Acceptance will not b. a) Thcrc has been a change to ti • and he product is not in corn,' b) The product is no longer the c) If the Acceptance holder has correct installation of the pro.. d) The engineer who originally submitted, is no longer practi'.. 4 Any revision or change in the ma; automatically bc cause for fermi :i . (through the filing of a revision a :: 5 Any of the following shall also be a) Unsatisfactory perforrnan. b) Misuse of this Acceptance purposes. 6 The Notice of Acceptance numbs. expiration date may be displayer: displayed, then it shall bc done i11 7 A copy of this Acceptance as wt provided to the user by the rnanu.. site at all times, The copies nee:': g Failure w comply with any secti•; Acceptance. 9 This Acceptance contains page,: . if: Florida Building Co with the code changes' rr . :)duct (identical) as th with all the rcqu :DAN t fit t I I L L signed and sealed : required engineering professia t, and/or manusactur this Acceptance, unles ,ioa with appropriate fee for removal of this A :.: product or process, ;r,Jorsement of any pro ACCEPTANCE No.: 00- 1212.06 one originally approved; rcmcnts of this acceptance. affecting the evaluation of thjs product of the product or process shall pnor written :approval has been rcque. :.� and granted by this ol_Siicc. c documentation initially including 11= ucl, for salts, advertising or any other _.i•_d by the words Miami Dade County, Florida, and followed by the .. using literature. If any portion of the Notice of Acceptance is :ety, .owed drawings and oth r documents, where it applies, shall to 'r �r its distributors and s yaii be available for inspection at the job escaled by the engineer AcceptanCe shall be c I`ise for termination and removal of • •,h 5 • OF THIS ACCEPTA CE Frank Zuloaga, .RC Roofing Product Control EraT.in =r U4/ ‘,2U1 1Z: JUOdd1701:)nll • LANTAFE "ii„LE CORPOR.A.TICiN 6. BUILDING PERMIT REQUia.EMENTS 6.1 Application for build ilnit shall be accomp 6.1,1 This Notice of 6,1.2 Any other document.:. ri:quired by the Build order to properly cv::::::ate the installation of D1ZAWIN SANTAFi: INTAFE S" CLAY 4 ACCEPTANCE No. : 00-1212.06 5, LABELING 5.1 All tile shall bear the i.ptht or identifiable rn.rking of the manufzicturcr's name or or following statement: "i.-Ciarni-Dade County Pjoducc Control Approved". Inied by copies of the following: ig Ofc.ial or applicable. Buildihrr. Cod:: in this system. ROOF TILE Zutozga, RRC Roofing Product Control Examiner Yid ^e Vent' tiva? MU-iN t{£U_HT apiVi fix "E" UNIFQRM ROOFING ALPPLIC: A. t ION PROCESS No. • F j D E T A I L iloOP 41-01)V 3 SLOPED SYSTEM DES L�IIr effec f O N Rocs rnit Root Covering:1 Drip edge: Page -2 EVISit TILE CALCULATIONS (Pmnxl: f'V'• [.X. (,`,erodynamic i A4td linr):. /) l ') - M 5� = j�jrt: 7. • I PCA: 4l. 7 � A, (:lnrudynaaiicMultiplilr): �I a /) 1�1 -.�� - L' r;:) ./.ICA: C/1-% 7 • A ( Multipliar)t' - M ,r7! M )� 2 c32) / tCA: 6/ 5 Ax4p 6 '64 S ATTACHMENTS REQUIRED 1) Fire Directory Listing Page 2) Miami -Dade. County Product Control Notice of Acceptance -Cover Sheet a) Specific: System Description h) Specific System Limitation c) General Limitations d) Applicable 'Detail Drawines 3) Municipal Permit Application 4) Other Component Approvals MIAMI-DADE PRODUCT CONTROL NOTICE OF ACCEPTA S8nt t Fe Tile Corporation ! 10302 N.W. South River Drive, Bay #16 Medley ,FL 33178 Your application for Notice of Acceptance (NOA) of Spanish "S" Clay Tile under Chapter 8 of the Code of Miami -Dade County governin= the use of, itert ate N- fateriais Construction, and completely described herein, has been recor>,n nded for acceprance by the County Building Code Compliance Office (BCCO) under the conditions specified herein. ACCEPTANCE NO.: 00- 1212.06 EXPIRES: 02/01/2006 APPROvED: 02/01/2001 ._ — . . %%:045000 I 1p c2000tlremputeslnotl ec clan 00 ~336 lntcrne( mail address: pasrma ,ster@buildingcodeorrlinc.eont t?^t?q^c. cnr n1 7T? gr.P1 CAP • it This NOA shall not be valid after the expiration date stated billow, BCCO reserves the right to secure this product or material at any time from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner. BCCO may revoke, moditw, or suspend t: e use of such product or material immediately. BCCO resery s- the right to revoke this app: if it is determined by BCCO that this product or material fails to neet the rcqu.irements of the So'.1:h Fio ilea Building Code. The expense of such testing will be incurred by the manufactu ,j er MIAMI -DADE COUNTY, FLORIDA METRO -DADE FL, BUILDING CODE CORII'L) \CE OFFICt 1mETRO•DADE PL.,`,GLcR nUILD ;NG I40 '.ITSr FL\GL);R S'rRLEC:'. SUli'(i 103 ! I 331;) -156.3 005)375-29o: F; X ;305; 375.2903 CON I•t:,CI'OR LICL " ": 51Ni: SV.C O05) 2 75.232? P;.;: () ^5) CO.�''rli4Cl'plt l.. ORC!i\11 :;\ "1)I\ ISIt (305) 2.75-29:.:6 r :� :'tJC• ti' :� r\ L! Rodriguez Chief Product Contrc: Jr�•a ,n THIS IS THr COVFRSHEET SEE ADDITIONAL PACES FOR SPECIFIC AND C) :;NI-)2AL CONnITTONS BUILDING CODE & PRODUCT RF.V COi\1MITT1?E This application for Product Approval has been reviewed b; the 13000 and approved by the ciuildlag Code and Product Review Committee to be used in Nfiami - Drde County. Florida under (he conditions set forth above. 1 Dab: 6 P�v.• 110JQU ;CK FAX To: l 7 From: e.o./Dept. Zz./Peyt. Phone: M411: PROI)UCf CO ■:1'I"(OL i1IvISIO\ ( 305) 375 -3502 FAN U'15. 372.6339 Francisco J. Quint :fna. ; \. Director Nl -Datic County l3ui!d.intt Cod_ Com, 11:1nrc O((icc Hur)cpagc: hit} / /www.bu;ldin5codeanl;nc.c3m 1. SANT IFE TILE CORPORATION ROOFING ASSEMBLY APPROVAL .Ca ta°orv: Roofing Sub - Category: 07320 Roofing Tiles Materials Deck Tyne: 1. SCOPE This renews a roofing system using Santa Fe " Santafe 1 1S" clay rooting tilt manufactured by Santafe Tile Corporation described in Section 2 of this Notice of Acceptance, designed to comply with the South Florida Building Code, 1994 Edj (ion for Miami -Dade County. For locations where the design pressure requirements, as de,errnined by applicable building code. does not exceed the design pressure values obtain by cs culations in compliance ■with RAS 127 using the values listed in herein. The attachment calcu( tions shall be done ns a moment basT.d system. PRODUCT DESCRIPTION M'nu fact ured by A n pl l cn n t Clay Roof Tiles Wood Test Dimensions Specifications Santafe 'S' Clay I = 18" PA 112 0ry,e pied high profile clay roof file Roof Tile w = I I.S" eq`Itipped will: two nail holes. For nail -cr:. %" thick mortar sct and nduesjve sct a a ` s pplicatirt,_. Trim Pieces 1= vines PA 1 12 A Ice trim, clay roof ieces fn p ,rtsc;,t w = varies his, rakes. ridges and va.lcy terminations. � ` � Mien_ varying Mtufacturcd for each the profile. thickness 2.1 COMPONENTS OR PRODUCTS MANUFAC' URED 13Y OTHERS Test Product Product Dimensions Specifications e Manufacturer 1 Dc�cri tin Tile Screws 08 x 2 -/ O l ong 1' PA 114 �[ainless Steel - centric 0.130" shank dia. Appendix E 0.178 flute dia, 3. LIMITATIONS 3.1 Fire classification is not part of this acceptanccil For mortar or adhesive sct tile applications, a static field uplift test shall be perFormcd in accordance with RAS 106. 13 Applicant shall retain the services 'of a fvliar'1i -Dade County Certified perform quarterly test in accordance with PA t I 12 n ' Laboratory to submitted 10 the Building Code J �"``` ' � 4 mot':; haII cc r PebBRq) gGir. fl I a r r oc ACCEPTANCE No.: 00.1212.06 Approval Date; February l200i Expiration Date: February 1. 20ft; Prod uct Descriptio loaga, RP,C Roofing Product Control Examiner L. Tile 2 2 ":12' 3 3 ":12" 4 4 5 5 :12" 6 6":1 7 7":1 2' or Profile g greater Direct Battens D Direct B Battens D Direct B Battens D Direct B Barrens D Direct B Battens D Direct 6 Deck D Deck D Deck D Deck D Deck l D c -.� Tile Profile Tile Two Nails One Screw T'vo Scrcws One Scrcw 1 Two Scrc•.vs Application w/ Cl,r, w/ Clip Santafe S Direct Deck 21.0 29,16 38.28' 57,31' 57.60' _' Battens 1 61.77' -- r J SANTAFE TELE CORPO ►.TXON • Tile { Profile Santafe 'S' Santafe 'S' Tile Profile • 3.5 30/90 hot mopped undedayment applications gay be installed perpendicular to the roof slope unless stated otherwise by the underlal mcnt material manufacturers p,ub!uhcd literature. 3.6 This acceptance is for wood deck applications Minimum deck requiremen shall he in compliance with applicable building code. 4. E STALL.&TroN 4.1, 1 Santafe 'S' and its components shall be installed ,n strict compliance with Miami Dade County Roofing Application Standard RAS 11811 RAS 119, and R.AS 120, 4,1.2 Data For Attachment Calculations Table 1: Aerod namic Multi. firers— X Tile Aep1ication Mortar Set Adhesive Set 3 ACCEPTANCE No. : 00-121 2.06 ft' X (ft') ). (ft') Bat A• •lication Direct Deck 0.274 0.297 1 Table 2: Restoring Moments due to gravity - Mjft -Ibf) Table 3: Attachment Resistance Expressed as a Moment Mf (ft - ibf) For Nail - On Svste A roved screws as noted 'Product manufactured by others � Table 4: Attachment Resistance Expresse as a Moment - M, (ft -lbf) for Mortar or Adhesive Set Systems Attachment Resistance 23.6 61.9 f-- 1 2uloaga, P,RC Roofing Product Control Exarnincr i 1 0 4-, p p r , (' rn !-• n I 7 r^ r - q ^. R gclr 07)0H-HR Z-1 -1 Sc : : 1 1 Gi' ' '- . _., ... r J SANTAFE TELE CORPO ►.TXON • Tile { Profile Santafe 'S' Santafe 'S' Tile Profile • 3.5 30/90 hot mopped undedayment applications gay be installed perpendicular to the roof slope unless stated otherwise by the underlal mcnt material manufacturers p,ub!uhcd literature. 3.6 This acceptance is for wood deck applications Minimum deck requiremen shall he in compliance with applicable building code. 4. E STALL.&TroN 4.1, 1 Santafe 'S' and its components shall be installed ,n strict compliance with Miami Dade County Roofing Application Standard RAS 11811 RAS 119, and R.AS 120, 4,1.2 Data For Attachment Calculations Table 1: Aerod namic Multi. firers— X Tile Aep1ication Mortar Set Adhesive Set 3 ACCEPTANCE No. : 00-121 2.06 ft' X (ft') ). (ft') Bat A• •lication Direct Deck 0.274 0.297 1 Table 2: Restoring Moments due to gravity - Mjft -Ibf) Table 3: Attachment Resistance Expressed as a Moment Mf (ft - ibf) For Nail - On Svste A roved screws as noted 'Product manufactured by others � Table 4: Attachment Resistance Expresse as a Moment - M, (ft -lbf) for Mortar or Adhesive Set Systems Attachment Resistance 23.6 61.9 f-- 1 2uloaga, P,RC Roofing Product Control Exarnincr i 1 0 4-, p p r , (' rn !-• n I 7 r^ r - q ^. R gclr 07)0H-HR Z-1 -1 Sc : : 1 1 Gi' ' '- . _., ... *%Y• S0' 39tid ItilL'i. '93/05/2001 12:35 3059990057 SANTAF T E colftP � a) b) d) NOTICE OF A . 4 Any revision or change in the ma• automatically bc cause for termi :i (through the filing of a revision :t ;: 5 Any of the following shall also be a) Unsatisfactory perforrnanC b) Misuse of this Acceptanu• purposes. 7 A copy of this Acceptance as wc provided to the user by the manu:. site at all times. The copies nee:; 8 Failure to comply with any £Ceti•. Acceptance. 9 This Acceptance contains pages r':TANCE STANDA signed and scaled th engineering professio e, and/or manufaetur this Acceptance, unies i.� with appropriate fee for removal of this A . product or process; ;rlO SCment of any pro 1 1 L L ,nnaneftly labeled wi t( the manufacturer's name. city, state, an: .'aunty Product Control.kpproved", or as >pccif,cally stated in the be considered after I II renewal application has been filed and t:-ie ;n lest supporting dat engineering documents, are no older than I Renewal of this Acceptance (appro\ : original submitted documentation, it :: eight (8) years. 2 Any and all approved products sha :t the following statement: "Miami-I: specific conditions of this Acceptor. • 3 Renewals of Acceptance will not b. There has been a change in tl :'t Florida Building Co and the product is not in com,.. with the code changes The product is no longer the rr . prod (identical) as th . one originally approved; If the Acceptance holder has :: : _. ,,plied with all the rcqu rcmcnts of this acceptance. correct installation of the pro The engineer who originally submitted, is no longer practi:. ,b5 OF THIS ACCEPTA CE tD CONDITIONS ACCEPTANCE No. : 004212.06 affecting the evaluation of this product required documentation initially I of the product or process shall prior u - rittcn approval has been reque >, :: and granted by this office. ceptanec: including t'ic ties, for sales, advertising or any other 6 The Notice of numb'. : _,i• d by the words Miami County. Florida, and followed by Ole expiration date may be displayed : ustn literature. If any portion of the Notice of Acceptance is � 8 displayed, then it shall be done its . oved drawings and ot r documents, vhcrc it, applies, shall ;r :7r its distributors and s 311 bc available for inspection at Utc job : , escaled by the cngrnccri • Acceptance shall bc cause for termination and removal of Frank Zu!oaga, RRC Roofing Product Control Examiner n4 /nom /final r Juod ivnonu HIi I Hr c Ll c u r SANTAFE ME CORPORATION ACCEPTANCE N o.: 00-1212.06 S. LABELING 5.1 All tiles shall bear their. , ;int Or identifiable m of the manufacturer's name or or following statement: "i.t;ami -Dade County Pr oduct Control Approval". 6. BUILDING PERMIT REQ U. EMENTS 6.1 Application for buildin.; .,.:unit shall be aceomp'inied by copies of the following: 6.1.1 This Notice of Acre::'ce. 6.1.2 Any other documents required by the Build l g Official or applicable Bui1d_nr. Cod: in order to properly ev:.'t:ate the installation or, this system. DRAWIN3 SANTAFi`, ";;.t.NTAFE S" CLAY 4 ROOF TILE Fraik Zu[oaga, RF,C Roofing Prouuct Control Examiner Page 4 OFFICE USE ONLY CIIECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review ❑ PROOF OF OWNERSHIP (Attach) LI HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE (sq.ft. = x/1000 x ¢.60) (¢.005 /sq.ft.) (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: , PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2 AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QT't'. 'TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8-15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New J'sIECHANICAL TYPE Minimum Fee QTY. 'TYPE Condensate Drain QTY TYPE Generator QTY TYI'E Refrigeration, Tons QTY A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUI\IBING TYPE A/C Condensate QTY. 'TY Drains, Roof QTY. 'TYPE Miscellaneous Fixture QTY. 'TYPE Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: CONTRACTOR Namgq W Address �- r s 0 f 69 . /] MI6/0j, ( � ,1hjta ( FL 33138 Name Ow ��,il�, �. )jr:::) Business Telephone 505 _�cfij s _ s� 3 tS Fax g05 °7G/._' 7 3316 4 c ow( License No. t _ Repair J Address 99 ix G , -0 � R SU,as2 Ae30f 3 3 t 3€3 Telephone X05- 152 —L1 / 2 Fax Qualifier Name 1a 0 OL `oC PROPERTY OWNER Namgq W Address �- r s 0 f 69 . /] MI6/0j, ( � ,1hjta ( FL 33138 Home Telephone ;p S_ 76 9_ 73 24 Business Telephone 505 _�cfij s _ s� 3 tS Fax g05 °7G/._' 7 3316 TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: 0 Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Job Address: n'L & i i i - 3 3 ► 38 Address Apt. City State Zip Folio Number 11320G n1 Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Description of Work Master Permit No. Subsidiary Permit No. PERMIT APPLICATION f3L$ r .- -L-od Zoning Linear Feet Square Feet ? 1 D ti Units Floors L Value of Work 1 (,) I 440 .°° Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1° Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE QF FLORIDA, QO vv ignature of Owner SEAL: I -DADE Print Name Sworn to and subscribed before me this 1 2 day of re—it) S ignature of Notary Public - State of Florida e �nu �`,�YFL : Sandra D. Hart •••• d Commission # DD 014872 �s yttr� a a' Expires April 2, 2005 Bonded Torn aaiIA1 a ° Atlantic Bonding Co., Ina. Personally known OR, Produced Identification STATE O, f RIDA, OUNTY4y4IIAMI -DADE L/1t!' Si of Contractor / Qualifier Print Name Sworn to and subscribed before me this 21!:o . Jame) PERMIT AePLICATION SEAL: ObeNOy.tat. I a day of rcb ature of Notary Public v. - State of Florida� D, latt � A 1 sU 014892 o •.�< <Commi #ADD 20�� Eao:res ° {ri! �•��Q'rE�� °'� flllaL�1: BCaA�biS Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: Type Insp' Address SS 1 )(\. r • Permit No. Name MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 1 2204 Building Inspection Reques Date'? U ? Time Company �A / J Phone # For Inspector /— / Name & Date Approved Correction Re- Insp'n Fee AI ) i1 /(,'" 1 Type Insp' Permit No. Name MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reques Dat- i 0 Time Address 9 Y_ C. l 4 kt Company Phone # For Inspecto 4-C/ C 23 Approved Correction Re- Insp'n Fee ❑ Name & Date MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 12A05 Type Type Insp' � M 2,,1155 Permit No. 192`// In Name 54"�(�<S Address 64 cq0 7� Company WAN 1 100pkt Phone # ( k J l 91 clf00 Nzikaut) Inspection Date 1 \ `1 —V6 Approved ❑ Correction LAW)- Re- Insp'n Fee ❑ / 2 G' ( kii4 IN A" atriA) 11e /A 1, o Al ftr- )2 ; ri g5Vjia/