ROOFPERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Job Address 1183 N.E. 99th Street Tax Folio // jr,P V' / . 6/7/ 2
Legal Description /J/� ?02/ g P v� /(ps faster Permit #
Owner / Lessee / Tenant a), l I 'trA yy , 1 e n nevi
Owner's Address / D . BO)C L) 1 1(n5 -For, PA )q► t)5
Contracting Co. Quality Roofing Contractor, Inc. Address 251 N.W. 99th STreet
Qualifier Carlos Arocho
State# RC0058627
Architect /Engineer
Bonding Company
Mortgagor
Permit Type (circle one):
WORK DESCRIPTION Tear off existing roof to roof deck, tin cap 30 lb. felt as per building code,
mop on with hot steep aspahlt 90 lb. felt and install metal eave drip around the eave
of the roof and install tile F /ci f t - ty),rn p -c forf/iru. Ofreyc��c.er_ ed
Square Ft. 40 ° Est ima ted Cost $ /3 SOO.
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO
DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated. I certify
that all work will be performed to meet the standards of all laws regulating construction in this
jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS,
POOLS, ROOFING, and MECHANICAL work.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work
will be done in compliance with all applicable laws regulating construction and zoning.
Furthermore, I authorize the above -named • actor to do the work stated.
.t' /.
• „ice':
1
•
to e o Owner and /or ondo P
L
I
MARYLOU
OOMMISS #M 0 � 1
04 1091410, 1993
Building
Signa
Date:
Notary as to •wner and /or
My Commission Expires:
PERMIT FEE: APPROVED:
D ear Zoning
Mechanical
V100
Competency # 17889
SS#
Plumbing
phone ,2 ) FO - ,cs O
phone 751 -0382
Ins. Co.
Address
Address
Address
ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
Signet e of Contractor or Owner - Builder
Date: (' f f
Notary as to / "ontrac
ommission Expire
* • * *
Othe
Engineering
•
•
Notice, OF COMMI:NCtMLNT
FLA. I1177 , LAWS - F8713.13
Return 't1.': (enclose .self- aoaressed stamped envelope)
'ki's Quality Roofing Contractor, Inc.
Carlos Arocho
Amrew:251 N.W. 99th Street
Miami, Florida 33150
This Instrument Prepared by:
maim: same
Property Appraisers Parcel IdentltIcaUon (Folio) Number(s):
3 wo 15'.0b0 c)
Jo Amu It A1Njj concern: Building Permit No. 3 a.
The undersigned hereby informs all concerned that improvements will be made to certain real property, and
in accordance with section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF
COMMENCEMENT.
Legal Description of property (Include Street Address, If available) 1183 N.E. 99th Street
0 20 .17 8 . ) P4- /1 Sec,
General deacrtpUon of Improvements Install new Tile Roof.
Owner William Tenney
Address 1183 N.E. 99th Street
Miam Shores, Florida
Owner's Interest In site of the Improvement
Owners
Fee Simple Title holder (If other than owner) N/A
Name
Address
Contractor
Address
Surety (if any)
Address N/A
Any person making a loan for the construction of the
N/A
Name
Address
Name
SPACE ABOVE THIS UNE FOR PROCESSING DATA SPACE ABOVE THIS LIME FOR RECOn0IM° DATA
N/A
8.minol• Foam 400
Wuti of aIumintutiinint
Quality Roofing Contractor, Inc.
251 N.W. 99th Street
Miami, Florida 33150
Person within the State of Florida designated by owner upon whom notices or other documents may be served:
N/A
Address
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided
in Section 713.13 (1) (h), Florida Statutes. (Fill in at Owner's option).
Name
Address
Expiration Date:
Sworn to and subscribed bet
r,Xg , ,72.s /9 2
1
J
(PREPANt IN WPLICATI)
Improvements:
S>'
MARYLOU HERNANDEZ
.gal• y�4
;., MY COMMISSION S AA 714214
EXPIRES: October 10, 1,93
Bonded Thal Notary PubNc UndenMnere
Glee; 7. ,:
&?Ltf ,.[7°- , 6`4
N/A
928270895 1992 JUL 15 10 :45
�N � 41,t ".-,
day of
Gw:
. ...VA) e C op y n 1M1
1.14151 art
Amount of bond S
Notary Public
ij
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
��
Date ) .. 19
Owner's Name and Address._ t Z_D Nr• e N \ \ Q. No (P 9 Street____A_J 4.._
Registered Architect and /or Engineer �
Name and address of licensed contractor k ) 1_ _Q_!9_ f. 111 --- T
t t L ( _4a. e
Location and legal description of lot to be built on:
Lot Block S div'sio __.___ ___
Street and Number where work is to be done ) J _ _____..___._7
State work to be done and purpose of building (by floors)
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering_________I__I___ /__
�l
Estimated Total cost of improvements $ J U v Amount of Permit $ 7 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 sub ••' .11 the .la n nd speci 'cations for said building. All notices with reference to e building and its construction may
be sent to
- - ?_ /- -At_ 2 -a
The undersigned applican for this bui ding p nit 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 perf med under th'
permit, as are licensed by Miami Shores Village.
Remarks ( Signed
1, I
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,
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 S " .._ Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Notary Public, State of Florida
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
m A re- inspection fee of $1.00 will he charged when such re- inspection is made necessary by improper notice for inspection or faulty
aterials and/or workmanship.