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1195 NE 98 St (4)'Inspection Number: INSP- 6160 .UN O 7 Permit Number BP2005 -501 Inspection Date: 06/07/2006 Inspector: Desharnis, George Owner: FERNANDEZ, RICHARD Job Address: 1195 98 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: JOHN BUSTA ROOFING INC Building Department Comments Tuesday, June 6, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Roof Inspection Type: Final Roof Work Classification: Roof - Repair Phone Number Parcel Number 1132050180100 Lot: Phone: (305)757 -7620 Page 2 of 2 Passed Inspector Comments _ , z Q C__— k0, ° rs Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until 'Inspection Number: INSP- 6160 .UN O 7 Permit Number BP2005 -501 Inspection Date: 06/07/2006 Inspector: Desharnis, George Owner: FERNANDEZ, RICHARD Job Address: 1195 98 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: JOHN BUSTA ROOFING INC Building Department Comments Tuesday, June 6, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Roof Inspection Type: Final Roof Work Classification: Roof - Repair Phone Number Parcel Number 1132050180100 Lot: Phone: (305)757 -7620 Page 2 of 2 Building Permit Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2005 -501 Printed: 4/21/2005 Applicant: ANN FERNANDEZ Owner: FERNANDEZ ANN JOB ADDRESS: 1195 NE 98 ST Contractor JOHN BUSTA Local Phone: 305 - 219 -9699 Parcel # 1132050180100 Contractor's Address: 300 NE 91 ST Legal Description: REV PL MIAMI SHORES SEC 8 Permit Status: APPROVED Permit Expiration: 10/5/2005 Construction Value: $400.00 Work: REPAIR ROOF ABOVE EASTERN GARAGE DOOR WITH COLORTHRU TILE Page 1 of 1 PB 43 -69 LOT 1 Fees: Description Amount FEE2005 -5129 Building Fee $100.00 FEE2005 -5130 CCF $0.60 FEE2005 -5131 Training and Education Fee $0.20 FEE2005 -5132 Technology Fee $2.50 FEE2005 -5133 Scanning Fee $3.00 Total Fees: $106.30 Total Fees: $106.30 Total Receipts: $0.00 Signed: (INSPECTOR) In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: BLK 179 LOT Issue Date: 1/13/2006 Owner's Name: RICHARD FERNANDEZ Permit Type: Roof Work Classification: Roof - Repair Job Address: 1195 98 Street NE Contractor(s) JOHN BUSTA Phone 305 - 219 - 9699 Primary Contractor Yes Comments: ROOF REPAIR EXP 10/5/05 Additional Information Miami Shores Village, FL 33138- Type of Work: Repairs Additional Info: Classification: Residential In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due CCF Education Surcharge Expired Permit Renewal Fee Permit Fee - Repairs Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $100.00 $100.00 $3.00 $2.50 $200:99--,... Building Department File Copy 'i Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 10/05/2005 Re Parcel #: Block: Section: Permit Status: APPROVED Permit Number: BP2005 -501 Phone: Total Square Feet: Total Valuation: uired Ins • ections Roof in Progress Final Roof 1132050180100 Lot: PB: 80 $ 400.00 Invoice Number RF -1 -06 -23463 Total: Amt Due $206.30 Amt Paid NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Miami Shores Village Building Department BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Owner's Name (Fee Simple Titleholder) / e/r/A /✓,OZZPhone # ' Owner's Address //9 A./ ,e. 9 g .STj2, /b, v°' State ,Z- Zip 33/3$ - 7/ Tenant/Lessee Name /V //e) Phone # /(/ //9 Job Address (where the work is being done) //95 City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO V Contractor's Company Name T®//'(/ SetS719 RO0A7A./4-72,C. Contractor's Address 300 /(l . g /Si S %jet - 7 City M /jAi /'cS7/0/ S State Qualifier 'x/ I O €7 61Ls7A Architect/Engineer's Name (if applicable) /i✓® df� $ Value of Work For this Permit 'b®e Total Fee Now Due $ f O� (Continued on opposite side) 3 � 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Master Permit No. Zip 3/3 0 Phone # /,/ Square Footage Of Work: O� ****************************F Permit No. Zip .33/.38 -, 57/ Phone# 75-2/9 5'6 9 9 M27 ,fr* Type of Work: ❑AA EAlteration ❑New Repair/Replace ❑ Demolition Describe Work: /�/F..PR MR94 A/.vC .` 02/..2 /27z7 �A '& '- ?/ems . Submittal Fee $ Permit Fee $ °! CCF $ C L 0 coicc f i� .� Notary $ "" ---- r . Training/Education Fee $ e) ( ° Technology Fee $ qi 5 0 Scanning $ 3 Radon $ Zoning Bond $ ------ Code Enforcement $ --...• Structural Plan Review. $ Bonding Company's Name (if applicable) "v �� Bonding Company's Addresv City State /,� Mortgage d'er's Name (if applicable) /14 Mortgage der's Address ilA City /tM 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 (7J dgvs after the building permit is issued. In the absence of such posted notice, the ee will be charged. inspection will not be approved 9 a Fatspec Signature Signa Owner or Ag Contractor The fotegoing instrument was ac �owledged before me this (oZ The foregoing instrument was acknowledged before me this a_ f day of M c y t , 20 U S , by ; m k t ( l a , `- r r° v hd P c , day of ` , 2 who is p Sonally know to me or who has produced wl iersonally known As identification and who did take an oath. Chc 12/15/03 NOTARY PUB Sign: Print: My Commission Expires: APPLICATION APPROVED BY: Martha I. McGee * Commission-C= 80870-- jr Expires February 7, 2008 SOWN Troy MI -IMMIX, inC. ew.Jo5.1019 NOTARY PUBLIC: Sign: Print: (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APR 1210 Zip /J/A State „vA Zip /111;) ;p- la K. • r :R ,''c h. • arra3 Nor; to as iden ' an d who did take an •ogldl3, �, ; ref ,. • .: al .'137:, r My Commission Expires: ), ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** **************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning HIGH VELOCITY SECTION 1524 URRICANIE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of this section.. The provisions of Chapter 15 of the Florida Building Code, Building govern the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner and the contractor. The owner's initial in the adjacent box indicates that the item has been ? y ined. 1 Aesthetics- Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane one) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion performance standards. Aesthetics (appearance) issues are 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 j ddressed as part of the agreement between the owner and the contractor. 2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Bu' ding Code. (The roof deck is usually concealed prior to removing the existing roof system). 3. Common Roofs: Common roofs are those which have no visible delineation between neighboring i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or should notify the occupants of adjacent units of roofing work to be performed. 4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be iewed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail ons of the underside of the decking may not be acceptable. The Florida Building Code provides the of maintaining this appearance. . Ponding Water: The current roof system and/or deck of the building may not drain well. and may cause water to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural distress and may require the review of a professional structural engineer. Ponding may shorten the life expec Ic and performance of the new roofing system. Ponding conditions may not be evident until the y or or roofmg system is removed. Ponding conditions should be corrected. 6. Overflow scuppers (wall outlets): It 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 overflo , (wall outlets) are not provided. It may be necessary to install overflow scuppers in acc. • J e with the Florida Building Code, Plumbing. Jr 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the e terior of the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the roof. A#71 is Agent's Signature 15 ° C� Date C1D.cunY.u.nd Seningskb.mm.sILend Sem■gslremOrmyo.an Internet laesTonteaeUESOKLBAF INSECCIDN I524111.doc ture Florida Building Code Edition 2002 V :... Italians Zone Uniform Pemlit , . . • Form. Section A (Gen al information) Master Permit No. Process No. Contractor's Name Ohlit/ j j te 4/6; — 't Job Address //9A977 ` W /A ROOF CATEGORY ❑ Low Slope ❑ Mechanically Fastened Tile ® Mortar /Adhesive Set Tile ❑ Asphaltic ❑ Metal PaneUShingles ❑ Wood Shingles/Shakes Shingles Are there ❑ Prescriptive BUR -RAS 150 Gas Vent Stacks? Yes No 'type: Natural ❑ LPGX ❑ New Roof ❑ Re. Roofing ❑ Recovering ® Repair ❑ Maintenance ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF) ga • ROOF TYPE so Section B (Roof Plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. 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'i Il all i iiliiIll " 1 " ■ 11 1 1 1111EE1111 1' C* 111 :111:: 1 1 '" 1111 Min as $ I11a ■a1■■■raa■ m■rrlS1` 1a r■■ ■1■ are ■sa i1 t � 1C � : 1 :IDC .11 C::1 ,:1CC *U: 1 : 1:: ■ INI IR lUUUlI:1 123_01 -48 5/03 PAGE2 S PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RRETAIN COPY) Date / Job Address 0 Tax Folio /� 3� 0��/� ah0® Legal Description ` . WC /7 � �c K C ; Master Permit e/ e,. / t Owner / Lessee / Tenant � �p.�rcd�n�cz`7 Owner's Address / /" � 1 6g S'F / Phone Contracting Co. P l pk q 4, Q F' RWor t ddress p/ 2]7 N ,bi0 9,j 5 Qualifier I 1 1a.Qf .p ��,`�c�mC SS# Phone 4W ��/r44 - Z1S( State# (30�,' Competency# //a0l 9g Ins. Co. 1) R 171 „„a Architect /Engineer //1/ Bonding Company fl/4 Mortgagor Permit Type (circle one): (BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION a las My: Cbkm:Ds s i PE A. ".�x. 15, Oa A O N/A �1 &• it Square Ft. . I Estimated Cost /e Q ey WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, and MECHANICAL work. OWNER'S AFFIDAVIT: I ce ify that all the foregoing information is accurate and that all work will be done in i :nce with all applicable laws regulating construction and zoning. Furtherm•r= ` - h• i - the above -named contractor to do the workrstated. ! �. ndo President br and /or Condo President pires: WS * Cara= 1992* APPROVED: Fire Zoning Building Mechanical Plumbing Address Address Address Signature of Contr /7 t - for• / � y Other Electrical Engineering_ Notary as to Contractor or Own i dd My Commission Expires :NOTARY PUBLIC STATE In- l�O IDA * * * IVY 0�MMI"IPN Em S 5/09/94* Ie r-Adams & Sweet 'ERMIT # 310'9 • ;tate Florida ounty of Dade HE UNDERSIGNED hereby gives notice that improvement will be made to certain real roperty, and in accordance with Chapter 713, Florida Statutes, the following nformation is provided in this Notice of Commencement. ▪ Description of property: £' f // �7 e pro (legal description of the property, and street address if 0�L available) /-0-1Z j ecc J JOC(�: D 6e4 // Litz,- *9'R S4- . General description of improvement: R e 1M0,(9 / RcT( t-c) Nor n Tax Folio No. 1\ , '4 Ott /� NOTICE OF COMMENCEMENT / /' ' ey'ziRry ,14 ((J rr�r G �� .1 , S' C7 5S B / a'7 A/ 4-) 9s - /), , ,% 7 Aft ', /' c-- Owner information: � c 1 /5€ 6 " 4 " - 1 - 2. ,\) a. Name and. Address: G"lQ/ � , / �rK c��c _ �`c� � ! ,05 ? S7 /�o �-� s�v -4.5, P .6- 3 b. Interest in properly: C j c. Name and address of fee simple titleholder(if other than owner): G T� 1; • alit '7 r , y >1� 1 HEREBY CE IF! t at this is a tr Y f fh - origa m Hied m rLls ufSw .,. �� - d r ^y °4 A.D. 14� WITNESS hand and Official Seal. • , . Contractor: (name and address)A Surety: a. Name and Address b. Amount of bonds . Lender: (name and address) . Persons with the State of Florida designg other documents may be served p;1 by S ttion Statutes:(name and address) ,i t Carr /7' ,p•• r .-1.a. •-f_ ` 6 . "„ • S4 o. -t5 In addition to himself, Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. . Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is s to' an ) tk JQJtsf bred fl c `-0/ 3 Y before me this & OUNTY COURTS ignature o day of 1 / , 1991. My Commission Expires: n whom notices or 713.13(1)(a)7., Florida ,lit 2J, Noy Aft SW el rift BUM Nr Eton txpirm fib. 7, i°1a c, Name and address of licensed contractor MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement or ine 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 of not. A copy of approved plans and specifications must be kept at building during progress of the work. Date..._..._... June 1 O th _!_..._.__..._... 19..82 Owner's Namc and Address Mrs Dorothy Grag ._ _ No....a..1.95t...... Street_114 E._R&th ...... -. Registered Architect and /or Engineer :,:,. .,,•••,,, •t,.,T.„S.N,•,• Gambill Roofing R, epair,,._ • 943Q, . .N A ..jj.. ... ,2 d Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 1195 N . E. 98th Street State work to be done and purpose of building (by floors) Remo old tile, repair leaks and replace new cement tile, in repaired area. _ _ _— and for no other purpose. New Building Remodeling Addition Repairi Yes No. of Stories 1 _ To be constructed of Kind of foundation Roof Estimate Total cost of improvements $ it95...Q.O Amount of Permit S. 20.00 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 perinit 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 hint 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 noticcs as arc required by the Act. The undersigned agrees to employ only such sub contractors, on work performed under this pennit, as are licensed by Miami Shores Village. Remarks... (Sign STATE OF FLORIDA, COUNTY OF DADE. ss• Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared __._ .__......_...._ to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. /- Permit No..3 Q .$ Date. (0� Read, Sworn to and Subscribed before me. Disapproved j.... - Date (Signed) Notary Public, State of Florida Building Inspector My Commiuion Expires PLANNING BOARD DATE Cirainnan 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 I'lannir.. Board. A rc•in.pectiun fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection of faulty materials anu /or workmanship. BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ Owner of Building Architect Contractor or Builder ' G` Legal Description Lot Address of Building / CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA PERMIT Work to be performed under this Permit B1 N? 6845 Subdi- vision Value of Project $ BY s DATE. Contractor's License No. 195 Amount of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A,J.uther 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. INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining th to a n ormity w plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- ceptinggiw '41� mgf�jyp by either, myself, my agent, servant or employee. AUTHORITY Owner's Name and Address._ Registered Architect and /or Engineer and address of licensed contractor Location and legal description of lot to be built on: Lot Block State work to be done and purpose of building (by floors) STATE OF FLORIDA, COUNTY OF DADE. Permit No Disapproved ( Signed) ss. MIAMI SHORES VILLAGE spector 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 he specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date___ Date Date Subdivision Street and Number where work is to be done u 5 .. q a A qq No. Street ec) '3— 4 R New Building Remodeling. Addition._._. Repairs No. of Stories To be constructed of 0 Kind '(�' . f . /! r 19 r �� ' . . and for no other purpose. •S� } J ering �.. ...:� Estimated Total cost of improvements 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 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) 4 a .. 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 dep es and says that he is of the above described construction, that he has garef y readjhe fore ' application, and that he did sign the same, and that all facts therein by him stat - d are true. 4 - - 1 �.L�� - - -- Read, Sworn to and Subscribed before me. Notary Public, State of Florida 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. 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. 73 3 1107 107 /1/1/1 ?C 30 2 g 9 BUILDING ELECTRICAL PLUMBING / ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, FLORIDA DATE / J 195 n n PERMIT IT? 13367 Work to be performed under this Permit t `• 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 plan,. drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at q/ , 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 permits 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. CONTRACTOR OR BUILDER BL Signed Subdi- vision Value of Project $ Contractor's License No Amt. of Permit $ INSPECTOR In consideration of the issuance to me of this permit I agree to,,gerform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY Owner's Name and Address Disapproved (Signed) 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. fan Cl qusse Registered Architect and /or Engineer Name and address of licensed contractor _r_ea of To ai/ K e k4 / . C0O - ? )Sr / N hi 7.; St Location and legal description of lot to be built on: !1 Lot Block Subdivision Street and Number where work is to be done 1/ 9,5 N. E. fP S�f /1 y. 'WA State work to be done and purpose of building (by floors) a and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering ' d 7 o o Estimated Total cost of improvements $___ i3,45 - •a U 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 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 - contra tors 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 : ork such public notice or notices as are required by the Act. The undersigned agrees to employ only such s A .contr qt ors, n work 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 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. '1 ?� Permit No 1 u 7 Date I - Date Date yrts 97 , 19_6A No 1,4 0 Street / t . V'G'e d. Read, Sworn to and Subscribed before me. 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. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty ma terials and /or workmanship.