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1155 NE 100 St (8)Test Location Uplift Pull Test(PorF) Test Location Uplift Pull Test (P or F) Test Location Uplift Pull Test (P or F) Test Location Uplift Pull Test (P or F) 1 `.� 26 'P> Gl�1 51 � t1 76 2 F 27 f 52 77 3 28 53 78 4 29 54 79 5 30 55 80 6 31 56 81 7 32 57 82 8 33 .58 R3 9 34 59 84 10 35 60 85 11 36 61 86 12 37 62 R7 13 38 63 88 14 39 64 89 15 40 65 90 16 41 66 91 17 42 67 92 18 43 68 93 19 44 ` 69 94 20 45 70 95 21 46 71 96 22 47 72 97 23 48 73 98 24 49 74 99 25 50 75 100 -%i'E( A.J 1Z U s S ermit #. 41 3 4 11 59 1.1 100 sr Mt' /L. , t- � Roofing Contractor: R %J C< t < `+ Roo cI eJ y . Type of Tile: (��`� ^ Date Installed 1 1 q 1 (t) I Approximate Roof Height feet Roof Pitch. : Z Type of Access to Roof: Scaffolds ■ Ladder Other Approximate Square Footage of Roof: 21 0 ft 2 Required Testing orce: 5 lbs. Testing Equipment: Chatillion 100 Date Tested: 11 l9 IQ t Owner's Name: Job Address IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL PA 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST. THIS REPORT SUBMITTED 00 Civil Engineer: Lab Certification # 98- 0608.04 State of FL Certificate Authorization # 4100 U.S. SOUTH Engineering & Testing Lab., Inc. 6065 N.W. 167th Street, Suite B -23 • Miami, Florida 33015 Telephone: (305) 558 -2588 • Fax: (305) 362 -4669 ON -SITE CONCENTRATED UPLIFT LOAD TESTING OF ROOF TILE IN FULL ACCORDANCE WITH METRO -DADE BUILDING CODE COMPLIANCE PROTOCOL PA 106 P.E. SITE SPECIFIC INFORMATION TEST RESULTS P = PASS, F = FAIL 412* to/ Project N° 1678 SKETCH OF ROOF JOB It55c1e Ip ST. 1--OF Z SHEET NO CONTRACTOR CHECKED BY DATE `` SCE l� ! r REM IMMIIIIMMIIIIMM mm Imm!■■■umm1■■■ MN M11 ■■(iV,■■M! rf r>> L• X 1111 ■ 111■■ '=4■ ■■ I I!!' 11! Ho ! mUEIII __ I E I L_ • • MN ■■ ■11 ,5111LJ %■ ■■11M■fi,, 11 IPilIiIU. ME MinkidellIFYRIIIMMIIIIIII ' rire5V-MEAMELIIIINTIN '■ N / iiuuiiiur • 3111 r o, ,.7 NOTES: Approved Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Bu )27/o/ lding Inspection Request Date! ( Time Type Insp'n Permit No. 3 y Name RA kQ.Q1 Address 1 ) Ss (; C 041's iS 1- 03k_ r Company atA.A. Phone # -, yf For Inspector: « / `o ` fl ame & Da Re- Insp'n Fee PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 2 - 0/ Date -7-1-6-01 Job Address 1155 N. E. 100 Street Tax Folio Legal Description .. • • vss 9 453 Owner/Lessee /Tenant Evelyn 'L u s s Master Permit # Owner's Adams 1155 N.E. 100 Street Miami Shores Contracting Co. 'Quality Roofing Contractor, Inc. Address 13800 N.W. 1st Avenue Que Carlos Arocho SS# State # RC 0 0 5 8 6 2 7 Municipal # Competency # 17889 Ins. Co. Address Address Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Tear off old roof to wood deck, replace rotted wood, tin cap 3011 ASTM felt, install galvanized .eave drip and valley metals where required, mo• on'wit-4 t •e III as halt one la er of 901b. ASTM felt Install S•anish S Cla Santa tile with polyfoam adhesive setting. SquareFt. 25sq. e colo WARNINQ. TO OWNER YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDP 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 we will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICA PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNERS Al•HL)AVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulati construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. 6 ignature of over pr Condo President Date My Commission Expires: /Y Notary Notary as to (% er and/or Condo President MARYLOU HERNANDEZ MY COMMISSION # CC 680474 EXPIRES: October 10, 2001 Bonded Thni Notary Public Underwriters Historically Designated: Yes No Phone 751-8171 Phone Estimated Cost (value) $ 10 i7 0 0.0 0 • " LOU HERNANDEZ MY COMMISSION # Cr: 680474 EXPIRES: Cctobc, 10, 2001 Bonded Nu Notary UnderµfiDers Notary as to Co actor or 0 My Commission Expires: er- Builder 751 - 0382 FEES: PERMIT L` — RADON C.C.F. - NOTARY — BOND 0 Date 0 "1 APPROVED: TOTAL DUE Zoning Building Electrical Mechanical Plumbing Structural Engineer NOTICE OF COMMENCEMENT , A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION u 1R390405 2001 JUL 24 12:55 PERMIT NO. • TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF DADE: 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: 1 1 5 5 N . E . 1 0 0 Street Miami Shores, Florida 33168 2. Description of improvement: Reroof to a new Tile roof . 3. Owner(s) name and address: Interest in property: Owner Evelyn *fuss Name and address of fee simple titleholder: N/A 4. Contractor's name and address: Quality Roofing Contractor, Inc. .13800 N.W. 1st Avenue 5. Surety:(Payment bond required by owner from contractor, if any) Name and address: N/A Amount of bond $ 0 0 6. Lender's name and address: N/A 1155 N.E. 100 Street Miami Shores, Florida 33138 Miami, Florida 33168 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: N/A 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: N/A 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) Signa ure of Ow er �^ Print Owner's Name [ ���at r k R.uszs Notary Public Print Notary's Name My Commission, Expires Sworn to and subscribed bef:re me this Iy day of ND( pA COO pP DE he .e Y slue OF FLO I HEREBY CERTIFY that leis is a original filed in flu office on�� Prepared by Carlos Arocho Quality Roofing Contractc Address: 13800 N.W. 1 Avenue Miami, Florida 33168 dayy of AO 2 Officia Seal. County courts ° I Circuit ate 0.G. PERMIT NO. ADDRESS: MIAMI SHORES BUILDING / ZON VILLAGE NG DEPARTMENT' SECTION BY DATE ZONING ELECTRICAL MECHANICAL PLUMBING FIRE ' PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL 1. Subject to compliance with aft Federal, State, County. Village roles tnd regulations. Village assumes no responsibility tor accuracy otlor mutts from these plans, 2. This copy of plans must be ayallabte on building site or no Inspection Mil be conducted. JOB ADDRESS ?/ $c ,V e/ -S APPLICANT PHONE 4# APPLICATION # SHEET OF • MISCELLANEOUS 0 e.../ DATE COMMENTS INITIALS CRITIQUE SHEET Contractor's Name:akp, I,-ki i Do t;&) l fld rrC -gar Job Address: ) I �S / k E 1 00 ❑ (Low Slope Application) ❑ (Asphalt/Fiberglass Shingles) ❑ ( Metal Roofs \Wood Shingles & Shakes) ❑ (Other) ROOF TYPE ❑ New Roof R e- r oofing ❑ Recovering ❑ Repair ❑ Maintenance Flat Roof Area (ft') Sloped Roof Area (ft 5' 5y , Total (fi ,PSay Master Permit No. Exposure category (per ASCE 7 -88): (` Building Classification category (per ASCE 7 -88 table 1): T Ft. A V Deck pe: ATT CHMENT Fastener Type: SPACING Field: Perimeter: C rner: 123.01-78 4199 DETAIL 1 & 2 Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. ROOF CATEGORY ❑ (Nail -On Tile) ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed) ARE THERE GAS STACKS? KS? is A V .. '�. S i .: � . aw;; YES No r N TYPE—NATURAL nj 1 - PC X �J Page -1 CJ (Mortar4dfiesive Set TI TO) ROOF PLAN r_ Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. Ridge Ventilation? 'l MEAN HEIGHT 1 3a Deck type: Woo •cLo A z Underlayment: Insula 12 ROOF SLOPt D E T A I L 3 SLOPED SYSTEM DESCRIPTION 30 16, tion: n/ Fastener type & spacing: Cap Sheet: Roof Covering: Drip edge: (9 1 ` Q -L. lar/T .ef 1- 10•L(:• F e -T�-e rc.-c- alLc..vt: z e�,u c . d( '7 ATTACHMENTS REQUIRED I) Fire Directory Listing Page 2) Miami -Dade County Product Control Notice of Acceptance -Cover Sheet a) Specific System Description b) Specific System Limitation c) General Limitations d) Applicable Detail Drawings 3) Municipal Permit Application 4) Other Component Approvals TILE CALCULATIONS (Pmaxl: 11(0.4 X X., (Aerodynamic Multiplier): /3 .3 / - M:S��O = M 9!»7 PCA: (. ).i0 (Pmax?: 9 b..S x (Aerodynamic Multiplier): 2 9.99 ) - M S.9 O = M . 0 `/ PCA: (P) . q 0 (Pmax3: ( .5' X ?, (Aerodynamic Multiplier): 47.- ) - M 5M0 = M o12LQ PCA: (1 - APPENDI\ "F" REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS -As it pertains to this Appendix "F ", it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, to provide the owner with this appendix and to explain to the o\Vner Ilk: content of this four. FBC r. The provisions of Chapter 34 of the South Florida Building Code (SFBC So'crn all the m .n.nt : :m requirements and standards of the industry for roofing system installations. Additionally, the following items should bc addressed as part of the agreement between the owner and the contractor. The owner's initial in•t:te a djazent box indicates that the item has been explained. 1 1. .Aesthetics- \Vorkntanship: The workmanship provisions or ter Chu p . providing that the roofing system meets the \rind resistance and rya •, ,on are for the purpose of (appearance) issues are not a consideration with respect to workmanship pro • sis io . Aesthetic ;s: es such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of rite agreement between the owner and the co tractor. I .---- -- 2. Renailing Wood Decks: When replacing roofin,g, the existing wood roof may have to be rtnai'ed in accordance with the current provisions of Chapter 29 of the SFBC. (The roof deck is usually concealed p: io- to removing the existing roof system) `6 3. Common Roofs.: Common roofs are those which have no visible delineation between neighbori:t, 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 perforated. 4. Exposed ceilings: Exposed, open beans ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance, penetrations of the underside of the decking may not be acceptable. The SFBC provides theloption of n Ohtttain i't this appearance. S. Ponding \ \'nter: The current roof system and /or deck of the building cause water to pond (accumulate) in low-lying 'may not drain well and may areas of the roof. Ponding can be an indication of structural distress and may require the review of n professional structural en,inecr. Ponding may shorten tl:e 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 (gall outlets): It is required that rainwater now off so dint the roof 15 1:o overloaded from n build up of water. Perimeter /edge walls or other roof extensions may block this dig :l•..ree i.` overflow scuppers (wall outlets) are not provided. It may bc necessary to install overflow scuppers in a :eordan :c with Chapter 23 of the SFBC. 7. Ventilation: Most roof structures should have some ability to vent natural airflo•.•. through ti:•: i::ieri :�: of the structural assembly (the building itself). The existing, amount of attic ventilation shall not be recut :eed. I: may be beneficial to consider additional venting which can result in cxtcnding the service if of the rot :. "7/E- The owner may contact the i\•liami•Dade County Consumer Services De. artment fo: ft :rii• :e: information regarding the above. p . e-e-1 7 - - / wncr's /,\:cat's ignaturc Uatc Contractor's Si1411;iturc MIAMtDA • FEB 21 '01 14:12 FR BRADCO 305 597 PRODUCT CONTROL NOTICE OFACCEPT.6 CE Santa 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 Construction, and completely described herein, has been reed County Building Code Compliance Office (BCCO) under the This NOA shall not be valid after the expiration date stated b product or material at any time from a jobsite or manufactu . product or material fails to perform in the approved mariner, use of such product or material immediately. BCCO rese . determined by BCCO that this product or material fails to Building Code. The expense of such testing will be incurred by the manufactu ACCEPTANCE (40.: 90- 1212.06 EXPIRES: 0210,1J2006 THIS IS THE .OV , • , SEF APPROVED OZ/o1R001 1110+500011 1:e2000UtempheCUpGu acccpanec cow page doe Internet mail address: postmaster ®bulldingeodsonline.eom FEB 13 '01 17 9484 TO 3059533333 P.01/05 MIAMI -DAD COUNTY. FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO -DADE FLAGLEtt BUILDING 140 wEST rLnGt.ER STRt'.ET. SUITE 1603 M1A1 lI, FLORIDA 33130 -1363 (303) 375.2001 FAX (303) 375.2942 CONTRACTOR LICENSING 5ECI'IGN (305) 375.2527 I'AX (305) ]75 -2$5 CONTR.% ° it ENFORCtrinn ulvaslo (305) 373.2966 PAX 001)37S-290S PRODUCT CONTROL. DIVISION' 003)31S-2902 FAX (303) 372 -6;39 the use of Alternate Materials and Types of ti ended for acceptance by the Miami -Dade I nditions specified herein. ow. BCCO reserves the right to secure this is plant for quality control testing. If this � BCCO may revoke, modify, or suspend the s the right to revoke this approval, if it is eet the requirements of the South Florida Raul Rodriguez Chief Product Control Division This application for Product Approval has been reviewed b.. the BCCO and approved by the Building Code and Product Review Committee to be used in Miami -D ;de County, Florida under the conditions set forth above. Francisco J. Quintann, R,A. Director Miami -Dade County _ Building Cade Complia Office mep*go: trgh .w.t ulldingeodeonlinc.com 3058880050 PAGE.01 FEB 21 '01 14:13 FR BRADCO SANTAFE TILE CORPORATION R OOEENG ASSEMBLY APPROVAL CntevgrY: Roofing Sub- Cate'orv: 07320 Roofing Tiles Materjttls Clay Roof Tiles Deck Tvno: wood 1. SCOPE This renews a roofing system using Santa Fe "Santafe Santafs Tits Corporation described in Section 2 of this comply with the South Florida Building Code, 1994 E locations where the design pressure requirements, as d does not exceed the design pressure values obtain by c using the values listed in herein. The attachment calcu system. 2. PRODUCT DESCRIPTION Manufactured by Test 4 r)1it ant Dimensions inegificationq Santafe 'S' Clay 1= 18" PA 112 Roof Tile w = 11.5" e thick 305 597 5494 TO 3059533.333 Trim Pieces 1= varies PA 112 A cessory trim, clay roof pieces for use at w s varies hi s, rakes, ridges and valley terminations. varying M.nufacturcd for each tile profile. thickness 2.1 COMPONENTS OR PRODUCTS MANUFAC Test Pr duct DitvotlSion; Stteeifiientiens Tile Screws #S x 2 -V2" long PA 114 0.130" shank dia. Appendix E 0.178 flute dia. 3. LIMITATIONS 3,1 Fire classification is not part of this acceptanc 3.2 For mortar or adhesive set tile applications, a atic field uplift test shall be performed in accordance with RAS 106. 3.3 Applicant shall retain the services of a Mia perform quarterly test in accordance with 1'A submitted to the Building Code Compliance 0 FEB 13 '01 17:45 Product poscrintion URED BY OTHERS Product pescriintion tainless Steel 3058880850 i-Dadc County Certified Laboratory to 1 12 a• �. hail be ACCEPTANCE No.: 00- 1212.06 Approval Date: February U 2001 Expiration Date: rebrus►ry 1, 2006 S" clay rooting tile. manufactured by otice of Acceptance, designed to Lion for Miami -Dade County. For termined by applicable building code. Iculations in compliance with RAS 127 tions shall be done as a moment based Ole piece high profile clay roof the e. ipped with two nail holes. For nail -on, m i rtar set and adhesive set applications. Manufacturer generic u oaga, RRC Roofing Product Control Examiner PAGE.62 Tile Profile Tile Application Two Nails One Screw I fr o Screws I One Screw ( Two Screws i w/ Clip i w/ Cli Santafe S Direct Deck 21.8 29.18' i 38.28' 57.31 57.50 Battens J 61.77 i FEB 21 '01 14:13 FR BRADCO SANTAYE TLS RAT ON 3.5 30/90 hot mopped underlaymeat applications slope unless stated otherwise by the undcrl literature. 3.6 This acceptance is for wood deck application complizace with applicable building code. 4. LNSTALLATION fiance with Miami Dade 4.1.1 Santafe 'S and its components shall be installer in strict comp C osy Roofing Application Standard RAS 11 , R.AS 119, and R.AS 120, 4.1,2 Data For Attachment Calculations Santafe 'S' Tile Profile Santafe 'S Approved screws as noted 'Product man ecru by others Table 4: Attachment Resistance Expres ' d as a Moment - Mf (ft - Ibf) for Mortar or Adhesive S ;t S stems Santafe 'S' FEB 13 '01 17:46 Tile Profile 3.93 5.90 The Profile Table 1: Aerodynamic Multi Table 2: Restoring Moments due '. 1 2 ":12" 1 3 ":12" � 4 ":12 I I _ Battens Direct Battens Direct -I Battens Direct Deck Deck Deck 5,85 5.82 5.73 Table 3: Attachment Resistance Express F N all -On st 305 597 94194 l U SU..JJ�J JJJ.J /. (ft) Batten A . •lie 0.274 5.69 Tile Application Mortar Set 3 ACCEPTANCE No. : 00- 1212.06 ay be installed perpendicular to the roof yrncn: material manufacturers published Minimum deck requirements shall be in B Adhesive Set lyers— tion Gravity - M_p Sft-Ibf) 5 ":12" G":12 GAS Direct Deck 5.53 3 5.32 X(ft) Direct Deck 0.297 Battens' Direct Deck 5.29 d as a Moment- Mf (ft.lbf) Attachment Resistance 3258180050 23.6 51.9 7 ":12" or greater • Battens 5.03 001 —.41i1PW" rank Zuloaga, RRC Roofing Product Control Examiner Direct Deck N/A j PAGE.0: FEB 21 '01 14 13 FR BRADCO 305 597 ;484 TO 3059533333 SANTAFE TILE CORPORATION ! ACCEPTANCE No.: 00 1212.06 5 . LABELING 5,1 All tiles shall bear the imprint or identifiable marking of the manufacturor's name or logo, or following statement: "Miami-Dade County Pi.oduct Control Approved ". 6. BUII.DING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accomraniecl by copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by the Building Official or applicable Building Code in order to properly evaluate the installation ofthis system, PROFILE DRAWINjC SAPITAF) "SA.NTAFE S" CLAY tROOF TILE FEB 13 '0i 17:46 4 Frank Zuloa a. RRC Roofing product Control Examiner 3038880050 PAGE. ea $ANTAFE TILE CQRPORATION ACCEPTANCE No.: 00- 1212.06 NOTICE. OF ACCEPTANCE STANDA tD CONDITIONS Renewal of this Acceptance (approval) shall be considered etc a renewal application has been filed and thc original submitted documentation, including test supporting des engineering documents. arc no older than eight (Y) years. 2 Any and all approved produce shall be permanently labeled wit't the manufacturer's name, city. state, and the following statement: "Miami -Dade County Product Control1Approved ", or as specifically stated in thc specific conditions of this Acceptance. 3 Renewals of Acceptance will not be considered if: a) There has been a change in the South Florida Building Coen affecting the evaluation of this product and thc product is not in compliance with the code changes( b) The product is no longer thc same product ('identical) as or originally approved; c) If the Acceptance holder has not complied with ail the reci rrments of this acceptance, including the correct installation of the product; d) The engineer who originally prepared. signed and sealed required documentation initially submlued, is no Longer practicing the engineering prefessi 4 Any revision or change in the materials, use, and/or ntanufactu • of the product or process shall automatically be cause for termination of this Acceptance, unles prior written approval has bccu requested (through the filing of a revision application with appropriate fee and granted by this office, 5 Any of the following shall also be grounds for removal of this A ;stance: a) Unsatisfactory performance dills product or process; b) Misuse of this Acceptance as art endorsement of any prod ct, for sales, advertising or any other purposes. FEB 13 '01 11 :46 5 The Notice of Acceptance number preceded by the words Miami- edc County, Florida, and followed by the expiration date may be displayed in advertising literature, If any pion of the Notice of Acceptance is displayed, then it shall be done in ils entirety. 7 A copy of this Acceptance as well as approved drawings end oth documents, where it applies, shall be provided to the user by the manufacturer or iii distributors and a 11 be available for inspection at the job site at al: t res. The copies need not be resealed by the engineer 8 Failure to comply with any sc of this Acceptance stall be case for ter:rtinauon snd removal of Acceptance, 9 This Acceptance contains pages I through 5 END OF THUS ACCEPTAE rank Zuloaga. RAC citing Product Control Examiner 3058889050 PRGE.Q$ *.r TOTAL PAGE. 05 +:t MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby mode for the approval of the detailed statement or toe 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. Ow-ner's Dame and Address ' Registered Architect and /or Engineer flid Building Inspector 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) Date...—..._...— i / . __ No. /./5.5 ./ai 11 . $ Street. -/ 3 0 33/ 8 M S ? 13 1 L• / 77 and for no other purpose. New Building Remodeling Addition Repairs ' No. of Stories ..f To be constructed of Kind of foundation �� yy**•�� Estimate Total cost of improvements $ )90o .. t. 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 Roof Coveringfr..3Q..... /. Q... _1 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 employe by him in the work to be performed under this permit; and will post or cause to be pasted for inspec ' n on the site o the work such • Wilk: notice or noticcs as arc required by the Act. The undersigned agrees to employ only suc bcontr fors, on work . performer under this pcnnit, as are licensed by Miami Shores Village. Remarks... _.. \ (Signe STATE OF FLORIDA, COUNTY OF DADE. ss' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, 'rsonally 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 fads therein by him stated are true.. �� Permit No. )ate ( Read, Sworn to and Subscribed before me. �1 i Disapproved .... _. L... � .Date (Signed) Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chairman Mcmbcr — 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 Pl.,nnir.;; 11o.rrd. A re fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. c)-6 Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision STATE OF FLORIDA, COUNTY OF DADE. j ss • MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. �y �r � r Date... ' ,19 4 M Owner's Name and Address._.:..!..! / • "5 IC r /JY //S �. G ` No.../00 Street Registered Architect and /or Engineer kJ. Street and Number where work is to be done `L$ State work to be done and purpose of building (ley floors) ::tee and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ eltV ®• be, 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 5968, 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 , Yvork to be performed under this permit, as are licensed by Miami Shores Village. Remarks ( Signed) � 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 Date Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida (Signed) 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 materials and /or workmanship. BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING Owner of """" Building r� �`T=' Architect Contractor or Builder Legal Lot Description Address of Building . f ',' 5 MIAMI SHORES VILLAGE. FLORIDA PERMIT N° 4801 / B1 Work to be performed under this Permit DATE Contractor's License No / 195 Subdi- vision Value of Project $ Amount of Permit $ This permit is granted to the contractor or builder named above to construc 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 assume", 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 fp-the statemeqts or speciy do and that he assumes responsibility for work • done by his agents, servants or employees. s / Signed.:, 1, i t • 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 regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. f CONTRACTOR OR BUILDER; . BY AUTHORITY ■ 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. State work to be done and purpose of building (by flbors)__ ing lns4ect•r Date ,19 Sa' Owner's Name and Address . — No Street Registered Architect and /or Engineer Name and address of licensed contractor____ __ N 6 L - Location and legal description of lot to be built on: \ Lot Block u vision,____ Street and Number where work is to be done , _J1__ __- 6 / 00 and for no other purpose. New Building Remodeling To be constructed of Kind of foundation Roof Covering 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 Addition Repairs No. of Stories 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 subcontractors, on ork to be 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 e true. Permit No -- ( Date S- S Read, Sworn to and Subscribed before me. Disapproved • ate (Signed) 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.