ROOFMIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bui ding Inspection Request /
Date [ 2 - I ime
Type Insp'n
Permit No.
Name
Add
Company
Phone #
For Inspector! /3 o/° k
Approved
Correction ❑
Re- Insp'n Fee ❑
BEM ■N,
44 r- •
r
Dat
Type Insp'n
Permit No.
Address
Compan
Phone # / f
For Inspectod:
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Buildin;, Inspection Request
b Time
Na e
i
to
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date
Type Insp'n ')LC..i --r., a
Permit No. , /) LC.
2
Name ) y <..11.P.L, ..-eL.:
Address J
Company 1 - ` if `� ems. A -
Phone #
For Inspector i � N ame &
ApprovEd.
Correction ❑
Re- Insp'n Fee ❑
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date Time
4 !)
Type Insp'n
Permit No. ' Ot3o (7 23
Name
Addre
Company
Phone # l 7 - gi
:::t r l2
e
Correction ❑
Re- Insp'n Fee ❑
Type Insp'n
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Buildin Inspection Request
Date/ /' 1 b) Time
Permit No. P " ( 7 73
e n n
Address k- : ` .. 71,41
Company
Phone # ^ o j /a
For Inspector: ( o g 1 b 43 Name &
Approved
Correction ❑
Re- Insp'n Fee ❑
rip ..
tatif
Ar
Polio
Dettegateok
�.. by
( *(4 ;',; Kew , .,
Own
Owner's A
Contracting
QUall er , jg' " o
stateit u-3
I MERE IS NO P`. ':
MERE WILL BE NO
Pernik Type (circle o
WORK DES PTION:
Square Ft.
'WARNING TO OWNER': YO'4J 1
YOUR PA TWICE F' RAF
YOUR LENDER OR ANY A '
Application is hereby made to obtain a; t� i
all work will be pe rfarated to ae4t the st o of tt
ford disciplines,
OWNERS AFFIDAVIT: 1
regulating construction and sowing.
My C
FEES: PERMIT
APPROVED:
Mechanical
Zoning
PERM APPLI
two KZ A
34
Obefuott
p Phone: 305-795-2204
Printed: 10 /16/2002
Applicant: ALEXANDER
Owner: MARCILLO
0 JOB ADDRESS: 365 NE 99
A
Miami Shores Village
10050 NE 2nd Avenue
Contractor OBENOUR ROOFING
Local Phone: 305 - 757 -2612
Parcel # 1132060135520
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 21 & E1/2 LOT 20 BLK 40 LOT SIZE
Fees:
FEE2002 -5824
FEE2002 -5825
FEE2002 -5826
Description
CCF
Buildier's Bond
Building Fee
Total Fees:
Amount
$6.00
$300.00
$142.50
$448.50
Total Fees: $448.50
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 4/14/2003 Construction Value: $9,600.00
Work: RE ROOF ENTIRE RESIDENCE WITH NEW SANTA FE CLAY CONCRETE COLOR TOVER ENTIRE RESIDENCE
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections.
OBENOUR ROOFING SHEET METAL
& SUPPLY CO.
9301 N.E. 6TH AVE., STE. A- 101 305 -757 -2612
MIAMI SHORES, FL 33138
PAY
TO THE
ORDER OF
(1 aiOli 4166 -
At, f�
..`l 40,,.. 40,r t_ei
D EAGLE NATIONAL BA
Aventura Branch
2999 NE 1910 Street
Aventura, Florida 33180
Building Permit
Permit Number: BP2002 -1773
MARCILLO
ALEXANDER
ST
PO 2 L 5 L?u' 1:066006 3491:u' 3 L686(L 7011'
Contractor's Address: 9301 NE 6 AVE SUITE A -101
DOLL
21517
DATE 10/ F 7/02-
$ l 015."/O
_ad deeth
63- 634/660
24
Page 1 of 1
Re- inspection
ication herefor in strict compliance with all
:ifications that may have been submitted to
s or if the plans are changed without
ponsibility for a thorough knowledge of the
that he assumes responsibility for work done
ons pertaining thereto and in strict conformity
responisibility for all work done by either
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO.
• STATE OF FLORIDA:
COUNTY OF DADE:
0 2R 6 4 2 13 7 2002 OCT 17 09:39
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Legal description of property and street address: �(P 6 /-1 q9 J-}-
i �4 k -c J)0 313
2. Description of improvement: c C r o u -f 1 H 9 e �h P1 �. -1-Li t) e o �
1(L (s s ti S
3. Owner(s) name and address: /-4 Oki A t N, l I U
T3 ht gg 4.1) F( 3313'
Interest in property: OLu h Cr
Name and address of fee simple titleholder: SA{w• -Q,
4. Contractor's name and address: Ob rMtl ciV
bo S//q S
q 3 61 ,1) E Se/7' 4e )0/ d 1 A -174ki i..I)- cJ ,c( 9 f
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address: � —
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
Signat' of Owner
Print Owner's Name C 1(.1 & G /CC i 1 f 0
Sworn to and subscribed before me this day of C4- 20 Oe
Notary Public (4t-&-t-t—t.
Print Notary's Name !;,, - It*
+i�lPA P �d .
My Commission Expires po �.�. DD 006 S4
rpr' ii��l f 4 � M
Expires u,..1, 1,2130
. ..1 �:� o; Bonded 't'hty
•4 o „�. °� ,Atlantic Landing Co., ,nit
. Prepared b( PHA
•p
Address: `l 361 /t t 6
& ( 17 44 ) j))
1( 4 1A j Shn Y °) ? / ,9r
SECTION 1524
HIGH VELOCITY HURRICANE 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
explained.
1. Aesthetics - Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane
Zone) 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
be / addressed 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 Zories) of the Florida
Building 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
units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or
owner should notify the occupants of adjacent units of roofing work to be performed.
° Mk_ 4. Exposed Ceilings: Exposed, open beam ceilings are•where the underside of the roof decking can be
viewed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail
penetrations of the underside of the decking may not be acceptable. The Florida Building Code provides the
option of maintaining this appearance.
5. Ponding Water: The current roof system and/or deck of the building may not drain well and may
use 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
expectancy and performance of the new roofing system. Ponding conditions may not be evident until the
original roofing 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
overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in
accordance with the Florida Building Code, Plumbing.
7. Ventilation: Most roof structures should have some ability to vent natural airflow through the
interior 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.
l0 / l'l 02—
wner's/Agent s S gnature Date
CA D000 P<mp`LOCALS- 1\TtnupZECTIOS ISLLdw
Contractor's Signature
Florida Building Code Edition 2002
High Velocity Hurricane Zone Uniform Permit Application Form.
SECTION A (General Information)
Master Permit Number:
Contractor's Name:
Job Address:
0/ - eNo(! Q� ri — ' /"\
Process Number:
ROOF CATEGORY
0 Low Slope El Mechanically Fastened Tile Mortar /Adhesive Set Tile
0 Asphalt Shingle El Metal Panel /Shingles Wood Shingles /Shakes
Prescriptive BUR -RAS 150
ROOF TYPE
N ew Roof FY Re- Roofing Recovering E1 Repair fl Maintenance
ROOF SYSTEM INFORMATION
Low Slope 2)of Area (S /F) Steep Slope Roof Area (S /F) Total (S /F)
/9 % 9 6
ROOF SYSTEM INFORMATION
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.
Revised as of March, 2002
f: \ \$adm \evie \ -02 counter\ forms \Roofing_Appendix.xls \SECTION A & B
Roof System Manufacturer: Stei- i,1,-& . .k
Notice of Acceptance Number: 0(9— /a / ? L
Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations):
P1: ' . 3 P1: ? sr P1: 1 Cr, orS
Maximum Design Pressure (From the NOA Specific System): , (. g
Method of Tile Attachment: 70 I V -A 4 L.A /44 A. i Se -f
Florida Building Code Edition 2002
High Velocity Hurricane Zone Uniform Permit Application Form.
Ridge Ventilation?
h/i
Roof Slope:
3 : 12
Section D (Stee Slo Roof S
Mean Roof Height:
u
Steep Slope Roof System Description
Deck Type:
Type Underlayment:
Insulation:
Fire Barrier:
boUUd- f!ebK
A- --r- Da?
Ai/
Nl �
Fasterner Type & Spacing:
Type Cap Sheet:
/ •l
Adhesive Type: ("T
Roof Covereing:
Type & Size Drip Edge.
A v 2q9
Revised as of March, 2002 f: \bull \$adm \evie \ -02 counter\ forms \Roofing_Appendix.xls \SECTION D
G
5477 -le44 ;"2.1244,s1.1",04 s
efd
S c , tt skt
Dl�e CoYlO -
(P1:
(P2:
(P3:
Florida Building Code Edition 2002
High Velocity Hurricane Zone Uniform Permit Application Form.
Section E (Tile Calculations)
For Moment based tile systems, choose wither Method 1 or 2. Compare the values for Mr, with the values
from Mf. If the Mf values are greater thatn or equal to the Mr values, for each area of roof, then the tile
attachment method is acceptable.
Method 1 "Moment Based Tile Calculations Per RAS 127"
P1 : /. ./ ( X X e equals �� 7 q l i' /4,) minus Mg: 515•2 equals Mr1 p NOA Mf
P2: QO.b/ X 1l . )57 equals )
NOA Mf Mg: equals Mr1 �� `
minus
minus - F'-- -1
P3: no .G X A .1517 equals l)� / 9
agfY') M Mg: B y equals Mr1 a ,( N NOA Mf C„ g
v7 d
Method 2 "Simplified Tile Calculation Per Table Below"
Required Moment of Resisitance (Mr) From below:
Mr Required Moment Resistence*
Mean Roof Height
Roof Slope
2:12
3:12
4:12
5:12
6:12
7:12
15'
30.7
28.7
26.6
24.5
22.5
20.8
20'
33.4
31.3
28.9
26.7
24.5
22.6
25'
35.7
33.4
30.9
28.5
26.2
24.1
30'
37.7
35.2
32.6
30.0
27.6
40'
40.7
38.1
35.2
32.5
29.8
25.4 27.5
* Must be used in conjunction with a list of moments based tile system endorsed by the Broward County Board of
Rules and Appeals.
For Uplift based tile system use Method 3. Compared the values for F' with the values for Fr. If the F' value are
,greater that or equal to the Fr values, for each area of the roof, then the tile attachment method is acceptable.
X I:
X I:
X I:
equals
equals
equals
Revised as of March, 2002
Method 3 "Uplift Based Tile Calculations Per RAS 127"
X w:
X w
X w :
equals
equals
equals
)
)
)
minus W:
minus W:
minus W:
X cos 9:
X cos 0:
X cos 0:
NOA Mr
equals Fri: NOA F'
equals Fr1: NOA F'
equals ,Fr1 NOA F'
Where to Obtain Information
DESCRIPTION
Design Pressure
Mean Roof Height
Roof Slope
Aerodynamic Multiplier
Restoring Moment due to Gravity
Attachment Resistance
Required Moment Resistance
Minimum Attachment Resistance
Required Uplift Resistance
Average Tile Weight
Tile Dimensions
SYMBOL
P1, P2 or P3
H
9
Mg
Mr
Mr
F'
Fr
w
I = length
w = width
WHERE TO FIND
RAS 127 Table 1• or by an engineering analysis prepared by PE based on ASCE 7
Job Site
Job Site
NOA
NOA
NOA
Calculated
NOA
Calculated
NOA
NOA
All calculations must be submitted to the Building Official at the time of permit application.
f : \buil \$adm \evie \01 -02\ counter\ forms \Roofing_Appendix.xls \SECTION E
No.
RESULT
No.
RESULT
No.
RESULT
No.
RESULT
No.
RESULT
1 -5
Passed
21 -25
Passed
41-47
Passed
71 -75
91 -95
6-10
Passed
26 -30
Passed
48 -55
76-80
96 -100
11 -15
Passed
31 -35
Passed
56 -60
81 -85
101 -105
16 -20
Passed
36-40
Passed
65 -70
86 -90
106 -200
FLORIDA
ing
ineering &
sulting, Inc.
TestingEquipment: Digital Chatillon DFIS 200
41
4
Providing Solutions To The Construction Industry
43
23
P.O. BOX 770694, MIAMI FL 33177
CONCENTRATED UPLIFT LOAD TESTING ON ROOF TILE
TO COMPLY WITH METRO -DADE COUNTY PROTOCOL PA -106
PROPERTY ADDRESS: 365 NE 99 ST.
OWNER: Marcillo.
CONTRACTOR: Obenour Roofmg
ROOFING SQUARES: 19. 58 sq
TILE TYPE: Santa Fe
CONTACT PERSON :: Yusi (305)205 - 0327
PERMIT No: BP20024773
PCA No:
ROOF PITCH :: 3/12
INSPECTION DATE; 11/01/02
TEST DATE: 10/12/02
JOB NUMBER;
THIS ROOF HAS PASSED: f)1 FAILEF 1 THE STATIC UPLIFT IN ACCORDANCE WITH MIAMI -DADE COUNTY PA106.
47
1
3S
44
5
TEST TABULATION
"ROOF SKETCH"
20
35
11
10
Voice: (786) 486.6468 Flatec @bellsouth.net
33 30 27
31 20
32 29
14
12 17
15
13 19
19
10
23
20 21
14
I Lab Report No. 1 02- 110041 I
Required Testing Force: 35 Ibs
26
25
24
22
32
12
Certificate No.02 -0501.06
Fax: 305- 408 -1367
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date / 2 - . ime
Type Insp'n
Permit No. So 3 •
Name - .)-) f. t, Q' 0 0 ,
Addres '3 'CS 11 it ry
Company t. 0-C---4-1 /
Phone #
o 1S / 3
For Inspector / J o/ Name &
Approved
Correction ❑
Re-Insp'n Fee ❑
0
Per Type (curate ono)
Add
that au e
r;r')
CC7$$$$
V. 15,4002
f
44
`t
Ow nes Adtkess
TIMM It NO P
►' �,. . TO 0
YOUR PAYING
YOUR
pU£4tion Is
work will be
fer t s _'
deg Co.
WILL BE NO
OWNS ATIMAVit 1 outi
vegetating construction and
FO
PEES: PIT
APPROVED:
FT0
Q 1
FT 1
DECK TYPE:
FASTENER TYPE:
ATTACHMENT
SPACING
FlaD: PERIMETER: COR
FLORIDA BUILDING CODE — BUILDING
DETAIL 1E.2
SECTION 1525
HIGH VELOCITY HURRICANE ZONES
UNIFORM PERMIT APPLICATION
Contractor's Name: 33-44.6 K-00 ,i) y / Job Address: 0,(9 A
ROOF CATEGORY
❑ (Low Slope Application) ❑ (Nail -On Tile) ❑ (Mortar -Set Tiler
❑ (Asphalt/Fiberglass Shingles) • ❑ (Metal RoofsAYood Shingles & Shakes) 0 (Other)
ROOF TYPE
❑ New Roof '; . ❑ Re- roofing ❑ Recovering Repair ❑ Maintenance
Flat Roof Arca (ft Sloped Roof Area (ft Total (ft Master Permit
Exposure category (per ASCE 7 -98): Building Classification category (per ASCE 7 -98):
ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed)
NER:
ti
r
ROOF R)
,
FIGURE 1525
- - -- - - - - -J
1 5.37
SECTION 1524
HIGH VELOCITY HURRICANE 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
explained.
L 1. Aesthetics - Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane
Zone) 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
be addressed 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
Building 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
- .unify (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or
owner 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
vi ed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail
penetrations of the underside of the decking may not be acceptable. The Florida Building Code provides the
option of maintaining this appearance.
5. 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
expectancy and performance of the new roofing system. Ponding conditions may not be evident until the
original roofing system is removed. Ponding conditions should be corrected.
•
� . Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not
verloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if
overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in
accordance with the Florida Building Code, Plumbing.
. Ventilation: Most roof structures should have some ability to vent natural airflow through the
interior 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.
Ow er's /Agent's gnature
C:ND000NI C- IkmpLLOCALS- 1\Temp∎S ECT109 I S:J.doe
Date Contractor's Signature
PAY
TO THE
ORDER OF
Bank of America.
ACH RfT 063100277
FOR
L EOSeaurity enhanced document. See back (or dciai Is. E1j
DALEY ROOFING, INC.
78 N.E. 106TH STREET
MIAMI SHORES, FL 33138
305 - 754-9892
4040
Q f
val.a e t, ict, is /3/-e-0
DATE
v0040401I' 406300004 74 00 L596 2 L950311'
63-4/630 FL
1035
OLLARS
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204
Printed: 8/6/2002
Applicant: ALEXANDER MARCILLO
0 Owner: MARCILLO ALEXANDER
JOB ADDRESS: .365 NE 99 ST
Contractor DALEY ROOFING INC
Local Phone: (305)754 -9892
Parcel # 1132060135520
Building Permit
Permit Number: BP2002 -1364
Contractor's Address: 78 NE 106 ST
Permit Status: Approved Permit Expiration: 2/2/2003 Construction Value: $400.00
Work: REPAIR LEAK AND GUTTER
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 21 & E1/2 LOT 20 BLK 40 LOT SIZE
Fees: Description Amount
FEE2002 -4342 Building Permit Application Fee $60.00
FEE2002 -4343 CCF $0.60
FEE2002 -4344 Notary Fee $5.00
Total Fees: $65.60
Total Fees: $65.60
Total Receipts: $0.00
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all
ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to
and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without
authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the
ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done
by his agents, servants or employees.
Signed:
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity
with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either
myself, my agent, servants or employes.
Signed: !� (Contractor or Builder)
(INSPECTOR) BY:
BY:
CONTRACTOR
Name V4 6%' ,coo- /s x--
k / �T''''�"'77
License No.
"/J 90
Address _A8 1� ie G
/21;a87i 6 airs', 1-C3
Telephon S1 7$y 9/ Fax 7 5-,/ ,
Qualifier Name 77)1,Avei f,..m.
PROPERTY OWNER
Name ,yg-,e/g m ,9e_e
Address 36 6 — 4 Q el 5f'
/fiain, 5hore'S, re-3313g
Home Telephone 36s . 7$' . s 99
Business Telephone
Fax
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
4./
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'l Attachment
Other
Add'I Detachment
Other
Step 1.
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
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: 36 /l.- q
Address
Folio Number // 32.06 0(3 55
Lot Block
Subdivision PB PG
Current Use of Property ___g
Proposed Use of Property E
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
VI
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Telephone
Fax
8 ) . 0 //3DMaster Permit No. Subsidiary Permit No.
Miami .5Icrec
Apt. City
g
State
PERMIT APPLICATION
33/3 S
Zip
Description of Work R6 .2 G7�ieS del/ 77LE
o 77(
Zoning Linear Feet
Square Feet Units Floors
-. I Dpi 1 77�L Value of Work c / .,35 " Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT CHANGE (✓ )
ENGINEER
Address
Name
License No.
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 OF FLORIDA, COUNTY OF MIAMI -DADE SATE OF FLORIDA, COUNTY OF MIAMI -DADE
of Owner
Print Name
oy
ayk_&/W1
S toa
.i .
Ul_ AS
SEAL:
d subscribed before me
day of AO V
. !P . /at _
Signature o " otary Public State Flori I • 77 3 ^.. 7
JJ
D,gr.11(d( 'brit/El/
Print Name
Sworn to and subscribed before me this
SEAL:
otary Publ - State o Flori
A
PERMIT APPLICATION
Signature of Contractor / Qualifier
1
day of 029/l ,
gnature
Personally known OR, Produced Identification V Personally known �_ OR, Produced Identification
Type of Identification Produced: / t v A-110-11- 5 Type of Identification Produced:
Look for blue background on the front of this check. and the irnageSafeta logo on back. If not present. do not cash.
DALEY ROOFING, INC.
78 N.E. 106TH STREET
MIAMI SHORES, FL 33138
305- 754-9892
DATE
PAY
T M't 4 a A,Q �C.Q�
O THE �
ORDER OF Vi�
BankofAmerica .
ACH PJT 063100277 r� y� c GW ,,
FOR j ," "' Le Ve t f r to
u' 3 7 5 1 „' 1:0 6 30000 4 71: 00 15 9 6 2 1 95030
3751
1 21 —�1 �. /0 1 63-4/630 FL
� 1035
1 /3 .2•y
DOLLARS 8
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••• ••• ••• ••• • •••
r \s it In 1luitts to this Ap "I'", it is Ihc rc5ponsiltilily of II c roofing cunlrnetor to provide Ihr. uwncr
• • • • •• • • ••
twith tltc 101111101 101)101g permit, It I,ruvitic the uwncr wills IlWS • alrrct.li. n utl4u. xrIntnttj lltc ovntcr Ihc.
•unlcnl tit Ibis 11)1111 • IIIC lrluviSNnS of (:Itn *) of the Soul: I :o(itI Ijrtijtf'yl4:0(1c. (t.;7 govc,n
• • (; • • • • •• ••
Iltc ntirtilut lcrlui,t:nrcnis find stand •
standards of the indusl for roufirt System rnlalIrliuns. Atldilionnlly,
Ihc following items should be ntltlressctl ns part of Iltc ngrccntenl between Ihc uvnret and the cunitot 1111.
I he ut•litt:t's 10il101 in the utlj;tccnl buit intlicnlct tint the item has been cxptnitted.
I
,\ s- \Yurhuta The svurltmnitship provisions of Chapter ) I nit for IIrc pltrposc of
lunvithnl; Ilrnl Ihc.,unlinl; syslr.nt meets Ihc wind tcsisinncc nntl svnIcr inli Ii:r((1rnt standouts.
A (npprattnc.c) ISStu:s pipe nui a Consiticralion (CS 1CCI In wuiknuurshilt luavisitns.. Arslhclit:
issues such ns color m tuC111tct.lurd appe;u;mcc, iIl ti me 001 11;111 of ;s Tunin cud(: sltuuld be it(IttcssctI ns
pall oI the n ; tecnrr.nl ()elrrct:n Ihc uwncr nntl IIrc contnrctot.
!. Ilenullin \Yontl Decks: When tcplaeiug motor( Iltc existing wood roof deck puny have to Ire
'untitled in nt.cotdnncc with Ihr. entreat provision% of Ch;tlrlcr '1') ofTlic S1 11C. (fhc loot deck is usually
1 tlncettleil ppiut In removing the existing roof system)
.1. Colttnt Iluuls: Common toots pile those which have no visible dclincntiun between
nl:.igh ()uting turns (i luwnituusc.s, condominiums, etc.). In buildings with common roofs, Ihc r001111g
c.urttt n nntllur owner should notify Ilse uccu of adjacent units ql 1001 svulk in he pet formed.
Er posed ccittiths: L•xpuscd, open bcntn ccillnhs me whctc IIrc unticrsitic 01" Ihc rod ticckinl;
colt be viewed ftuur ()cloy/. • 11tc uwncr My wish to Itpt\ittlnipn Ott nrcltiteclutnl nppc;trnrscc,.thcrcforc
tooling nail pcnr.Itations of Ihc unticrsitic of Ihc decking luny not be acceptable. ;Ihc S IIC provides lire
option of ltrsinlaining this ;sppcatnncc.
S. I'nudittl; \ cup,ttti roof system nn :I /or deck of Ihc building n nut dtnin vn :Il mitt
rnny cause w;ticr 11) pond (occ(tuntlntc) i1) 10w-lyillt areas of 111e 10af. funding out hr: an intlicnlinn of
slruclutat (listless and nlay It.cctilpt: IIIC levity/ of rt llrofcssiotlrtl sltltet cngiucct. funding rnny shorten •
Ihr. lilt expel -hutcy and pcpfottnancc of IIrc new roufml; system. 1 contlilioIts may not Itc evident
until Ihc original rooting system is removed. Pointing conditions should be costected.
,. Over flow Scupper, (wall outlets): 11 is retluircd duo rainwnlcr Ilow off so Ihc,l the roof it not
overloaded I it boild.lp t of water. I'crintetedctlgc wills or other tool extensions rnny I,lot:k this
t1t5Clsmu if ovc.tllow scuppe.ts (v others) ore 001 ptuvidcd. II nsny hr. nt:ccss;try I1) 1111t11 uv111luty
s cupp(:iS its nccur(1anct: whit ('hn•tict 2:1 Of Ihr. tit 11C.
). 1'cti111011on: Must roof shuctures should hnvc some ability 10 vent annual nirlluw through the
interim of Ilse slructurnl assembly (Iltc building itself). The existing nntouttl 01 vcnlilnliun Shall nut
hr reduced. It only be hcneficinl to consider nddllionnl venting which can result in extending the service
life of the rout.
c>4
1i1t:p'.s /Ag;ent': ;iii :11;tlurc.
SIgrotture
4
• • ••• • • • •••
• • • • • • • 4111 • • •
• • • • • • • • • • •
• • • 4100 • • • •
• • • • • • • • •
• • 000 • • • • 000
0/0/ �C
C tttt lur'.t
S
r
ELECTRICAL
Tl'PE.
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYI'E.
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
PLUMBING
TYPE
A/C Condensate
QTY.
TYI'li
Drains, Roof
QTY.
TYPE.
Miscellaneous Fixture
QTY.
TYI'I:
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
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies
RECEIVED AND REVIEWED BY:
PERMIT APPLICATION
in the space provided below.
MECHANICAL
TYPE.
Minimum Fee
A/C Central, Tons
A/C Wall/Win. Tons
Air Handler, Tons
Barbecue
Bath Fan - Vented, #
QTY. TYPE
Condensate Drain
Cooling Tower
Dryer Vents, Number of
Ductwork, Cost of
Fire Sprinkler System
Fireplaces, Number of
QTY. TYPE
Generator
Heating Strips, each
Paint Booth
Piping, Flammable Liquid
Process/Pressure Piping
Pressure Vessel
QTY. 'I PI.
Refrigeration, Tons
Vent Hood, Cost
Ventilation, Cost
Periodic Inspections
QTY.
DATE:
Page 4
OFFICE USE ONLY
CIIECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
$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
$ ( sq.ft. = x/1000
x ¢.60)
$ (¢.005 /sq.ft.)
$ (¢.01 /sq.ft.)
ISSUING OFFICIAL
REVIEWED AND PREPARED BY:
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $
DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 t FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
BUILDING 0
ELECTRICAL 0
PLUMBING 0
ROOFING gi
Lot
Architect
Contractor
or Builder
Legal
Description
Bud�s 74f fj?9 .1
PERMIT
0 Work
Owner of
Building g: 4. Rfael
CONTRACTOR or BUILDER
SHOFIES VILLAGE - • FLORIDA
Date `"' 19 41
BL
1Tp 8976
BY
EP
Contractor's
License No.
03 f
to be performed under this Permit
driai
Subdi-
vision
Sq Ft
Value of zi p Amount of t
Project $f II 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
plane, 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 dose by his age*a, servants or a
Signed (INSPECTOR) BY 4
In consideration of the issuance to me of this per agree to perform the work oevered hereunder in compliance :'all ordinances and regulations
pertaining thereto and in strict conformity with the plans, a statements or specifittetiions submitted to the proper aul4ukities of Miami Shores Village.:
In accepting this permit 1 assume responsibility for all work done by either, myself, myent, servant or employee.
AUTHORITY
Disapproved / / - --- D
(Signed) -_.LA! -
Building '. ector
Chairman -
Member _
Member .
Council Approved ...... .. .. ... .
MIAMI SHORES VILLAGE O3
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 July 24
Owtr�r's Name and Address._ C. F. P au ls e n N 365 N E 99th St.
— Street
Reglitered Architect and /or Engineer... _
Sons Inc.
Jr.
no
Obe u .
Name and address of licensed contractor_ G &&
735 __ A - vB
Location and legal description of lot to be built on:
Lot__ Block Subdivision
Street and Number where work is to be done 365 N. E, 99th St,„
State work to be done and urpose of bu' n (by floors) Remove the existing t h e roof: Replace
di
21-30 lb. felt, 1 -90 1 slate and white shingle tile. Gal /. metal.
and for no other purpose.
New Building Remodeling . ___ Addition Repairs No. of Stories
To be constructed of Kind of foundation___. Roof Covering. __ tile
Estimated Total cost of improvements $ 1540.00 24 S q _ :___Amount of Permit $ 6 •
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 foi said building. All notices with reference to the building and its construction may
be sent to_____ _
The undersigned applicant for this building permit dot. 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 subcontracto on work to performed under this
permit, as are licensed by Miami Shores Village.
Remarks_ _ __ _. _ __. ( Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 g Date
7 - ,2
to me well known,
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires_
PLANNING BOARD__ __ . DATE
Member
Member
— Member
_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.