ROOFINGPERMIT APPLICATION FQg•MvIYti1;S40: VILLAGE
:0054 N.E. 2nd Avenue • Miami Shares, Floe cv33138 % No*: e: ei05 -195. 204 • Fax: 305- 756.8972
Da� Job Address Tax Folio
••• • •
Legal Description Historica ly Desi • Ites • No •
• Owner /Lessee/Tenet Master �r p m y� it � # ^'^ Oa ) 3(fi
Owner's Address !� 59 , U / � • • ••• :Phone • • • • �+
Contracting Co. e9 Address
Qualifier
State # ‘ 1( 2767'
Notary as to Swner an or on
My Commission Expires
16'11 SS# g2) � Phone 3
Municipal #
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS 850.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING
WORK DESCRIPTION: 2 -dfe!'f C i- DTI leek
D1/ B .� .614" ,Z�e ), 4:72-04 G'`
742. _ /
Square Ft. Estimated Cost (value) u
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 ANY 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 all disciplines.
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. Furthe r +re, I authorize the above named contractor to do the work stated.
.I �/ /rte L
S' r s s 4 ; • . • P' ate Sig at ntractor or •caner Bu i der Date
Competency #
• •- •
Date Notary as to Contractor or Owner Builder
My Commission Expires
Ins. Co.
.3A.S.41?
Date
FEES: PERMI11 I v ) �° RADON C.C.F a' (e (/ NOTARY 5 16? O 1 OND
APPROVED: ' TOTAL DUE
Zoning Building Electrical
Mechanical Plumbing Structural Engineer
Pay to the
order of
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 3/19/2003
Applicant: JOHNATHAN
Owner: ROSE
JOB ADDRESS: 1259
Contractor WILSON, MIKE
Local Phone: 305 - 893 -1557
Parcel # 1132050090250
Work:
DR. iOHNATHAN W ROSE
DR. TERRI P ROSE
1259 NE 9Shi
Miami Shores, FL 33138
NE 98
Fees:
FEE2003 -1619
FEE2003 -1620
FEE2003 -1621
Description
Building Permit Application Fee
CCF
Notary Fee
Total Fees:
Amount
$60.00
$0.60
$5.00
$65.60
Total Fees: $65.60
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 9/14/2003 Construction Value: $380.00
LEAK TO THA FLAT SECTION OGF ROOF IN BACKS PRIME LEAK AREA TORCH DOWN RUBBER ROID BITUMEN IN LEAK AREA
If there is no permit package accessible on the ioh - c:•^ r --
fee is $50.00, which mr"c+ '^
Money M
Ba nk rust
�i9m'S
Ban k%
:e63L094301: 49 026
Building Permit
Permit Number: BP2003 -430
Legal Description: EARLETON SHORES
2390
63.943/63
Date anAr4cH 89232
6
ROSE
JOHNATHAN
ST
Contractor's Address: 870 NE 122 ND
Sactolty
Dollars ' e
PIP
PB 43 -80 LOT 14
Page 1 of 1
verify, there will be no inspections. Re- inspection
oection.
BLK 2 LOT SIZE 75.000 X 109
all the equipment or device described in the application herefor in strict compliance with all
ce with any plans, drawings, statements or specifications that may have been submitted to
1c is not done in compliance with such ordinances or if the plans are changed without
tractor or builder named above assumes the responsibility for a thorough knowledge of the
wings or in the statements or specifications and that he assumes responsibility for work done
in compliance with all ordinances and regulations pertaining thereto and in strict conformity
res Village. In accepting this permit I assume responisibility for all work done by either
BY:
BY:
Master Permit No.
Contractor's Name
Job Address
❑ Low Slope
❑ Asphaltic
Shingles
High Velocity Hurricane /one'UA%,r m•Per it Form
Section A (General Information)
• • • • • • • • • •
• • ••• • • • • • •
• • • • • • • •
• • • •• •
•• • • vroc,�ess go: ••
— • • • • • - •
❑ Mechanically Fastened Tile
❑ Metal Panel /Shingles
-
. ri
_}-{- i - � _L
—1-'7.
_ - _ .- _1.1._?_
1 1 1 1 1 1
/075? •
• • •
Rd6F•CATtGbT ••
❑ Mortar /Adhesive Set Tile
❑ Wood Shingles /Shakes
❑ Prescriptive BUR -RAS 150
ROOF TYPE
❑ New Roof ❑ Re - Roofing ❑ Recovering Repair ❑ Maintenance
ROOF SYSTEM INFORMATION
Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF)
Section B (Roof Plan)
Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow
scuppers and overflow drains. Include dimensions of sections and levels, clearly
identify dimensions of elevated pressure zones and location of parapets.
1 Imo1 1 ; 1 - --�i._ f- -�' I , . 1 -LI_. 1 - _..; _ , .
_L_ 1 ....1 I � i - r �-r -- - Iit1r71iiI1tr I
� '�4 " ` i Ajll J�
in waI u� N�j �'" Ai
t f L i � � 1 � ��iiIk
Ell
•
tl X11_ III11,: MIMI
•
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.
April 7, 1972
Date ,19
Owner's Name and Address Mrs. G. Galley Nd1259 Street... 9$th St.
Registered Architect and /or Engineer
Nam and atirlr@i,s of lieettsed etruetur_:_:$.Q APFt_..Rpp n4.. &..Supt?
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 1259 NE 98th St. , Miami Shores, Fla.
State work to be done and purpose of building (by floors) Re — roof Tile sections only. 1 -40# base felt
nailed and tin capped. One (1) #15 asphalt felt and one (1) #90 Mineral Surfaced
roll roofing mopped on with hot asphalt. ITew cement shingle file - white in color
and for no other purpose.
New Building Remodeling Addition Repairs Re — roof No. of Stories 1
To be constructed of Kind of foundation Roof Covering Tj..34
Estimated Total cost of improvements $2,800.00 Amount of Permit $ $7.
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
be sent to 371 NW 41st. St., Miami, Fla. 33142
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such- bcontractors, •n work to rformed under this
permit, as are licensed by Miami Shores Village.
Remarks...
STATE OF FLORIDA, 1
COUNTY OF DADE. ss.
(Signed)
its construction may
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, persortally 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 state arp true .
Permit No._ tl Date ? '"ead, Sworn to and Subscribed before me.
Disapproved �ate_______________
(Signed) -r _ ..r
uilding pector / mission Expires
PLANNING BOARD DA
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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
Notary Public, State of Florida