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ROOFINGDate Legal Description �l7f�iy/� Master Permit # 3e087 Owner's Addresshti / //1,�i4/ Phone 779'7/ Contracting / `!�‘ Address /li. 5 ‘ () - #%11 /�jg //E Qualifie , �� SS# // Phone 17f/7 0 State leigeO W,= unicipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANIC • PAVING PENCE SIGN WORK DESCRIPTIONA 4 ,./ ?' /27A i,94/ /H l! lli� Lessee / Tenant ROOFIN Square Ft. 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 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating co tion and zonin:. Furthermore, I authorize the above -named contractor to do the work stat Signature of o er and /or Condo President Date: a*` T 'OFFI ' A - *. .0 Notal My Co.: ,; s+P APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address/ • /,'/ 5/ Tax Folio m Pt Mechanical Plumbing :40 Estimated Cost(value Q ignature of Co Date: Notar My Co ** * * '''''.7 * * * * * � * * * * * * * *** FEES: PERMIT 1u RADON C.C.F. 6) l NOTARY TOTAL DUE "5� q V " Fire j Other ractor or Owner- Builder .t Commbdsn DINWARO,Builder Ex�4 1Mon #C 327872 Zoning Buildi Electrical Engineering 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: 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 �� a � ess: 2. Description of improvement: 3. Owner(s) name and addre$s: Interest in property: 4. Contractor's name and mess: 6. Lender's name and address: 94R 199993 1994 APR 26 10:14 `ol 1 9 < 5 ' . 5. Surety:(Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ Name and. address of fee. simple titleholder: z //' STATE OF FLORIDA, C81 OF pp0 Ohdb t7 0 uo 04 Oho day of 89Iftl En' g,O , n soca. d tln •'ta VIA 63 by 7. Persons within the State of Florida designated by Owner upon whom notices or other documents ma 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) Signature of Owner Print Owners Name PA v L \n/_ 5 1 n NWC Sworn to and subscribed before me thisv�/ day of � .� 19. Notary Public Print Notary's Name = Al Co My Commission Expire A7upat�Y or .� Commission 327872 Prepare Address /M' */jay 123.01 -52 2/93 . 'D,1� I ROPOLITAN DADr COL. aTY, I=LORIDA METRO•OADE ;• 'c Choir tau If: mun, S. Ilipchutr t'IN•Chair,l„bt 11.0. Lait ist .lranbrrr R'ndl 1 rl,gt'r J,,n,rr ,1rht, Ceury;'' lierlln 7hun„n ,tl. ma,* Laurence el. 11ur.wrl r•,1 tibia r).n ,r Brennan John c' „!pi„i rJuar,lu l:,unrl 1":' •Ir hl li'trienle Jl. Carhnn ne,•Ler rl,n,d,l Ga1Jwn„ Hiil II. Hutton Daniel Lod, Jol LIntlitro,n Sleren Lowe Joseph Mather. Sr. Jame! Parer I1;uiant Riley Amnon .11. 11Iza n, un. ►bt* Alfred IIYitbn i, Kuhr 1lilllun,l /I,r,utI Cuntullnnl Jule, P1.umina Staff C110r1.1 Danger Sandy I ;•lnrel, Cil nhuuonJ Monier Roof 135 N.W. 20 Boca Raton, APPROVED EXPIRES d I.1 GI :13 GET '0 'clJi MEMO-DADS CCNTCfl OOAf1D OF fULE3 AND APPEALS{ $VITC 1010 111 N.W. 1e1 STREC1 MIAMI, FLORIDA 33120.1074; (306) 376.271 (305) 375 -2612 BROM = CONTROLACCICE--Or.-ACTrnaICE 'rile Strot Fl. 3 4 31. Your application for. ri:ccluct Approval of ya1lqutrd TT .flat. Concr_Qi Q R .Qf T.Je an aXe .t Nailin ur.dor Sections :203 and 204 of the South F1orlcttt Uui idirtg Code ;c arnin t he 'Use oe Alte Mnteria1s Artc) Typos o1 C;onst::.tcion, ttrid co,�ip1o described in the plane, specifications Arid calculations AA s te a l , ^ „ 1 . �1.l ( 1r / t , �� iQfIg w..t.h J hy`.n�7 (� ^/���� . b! X1 1' ”` nLtr .+.`L. a.u1.51 � 31g �1111.' ILQ ors Lrtn .L..cia_tles1 r1 - 10 - .9O�t��CiL.►.►LI- e i n li(,mearch ra1112 i_ uf.'_:.-11r. o t JLU oast e .:� Q.—Lo. .(1/ OQ y.._11.44 . . , ile c ,: L &( i.rO n Si has been accepted by Product Control under, the Sp6c1.fic (7ndltion scu forth on pages 2--2a and the Standard Ccndit;iona on Pacra 3 f 1 ACCEPTANCE No.: 2_l,Q.92..G(.. J ) —Al r f. l 13 . 19 1 111_, 1995— APPROVED: - _Apr i 12..._.. 'M__ Gi1.Dlamond� P.'.��, Product CCrt_[Ul Utvia'. Gil ,Diamond, P. ?. Product Ccn:.ro1 Divia!1Lon $up3rvimor s kPLEASE_NOTE* * !I TEIS___is 1 t.1= CQMERSHEZT._SEE_ADA TIONAL- ACES.-EQil SP Y1. AND GE1J t.1 , CON D.1. S rt CIE__LU.LE5_11iR... EAJc;....NnTICe.. xr_ is 'J:TI1Siu This application for Product Approval has boon accoptod byithc Metropolitan Dade County Board of Rules and Appeals to bo tsec in the Incorporated and Unincorporated( aroaa of Dade County under the conditions sot forth above. ' I 1 H DDancjor, P, b. Secretary Metropolitan Dada County Board of Rules and Appeals • tvi:.6i. cot. :rt;: :1.1L (Hlli, 1J JJINC44 : htM Moni°r J. of Tit € 3. in; .l&U.c - cI I U:I O :3 CCJGT '0 'cJJU -2- l'2��: _d': ACCEPTANCE No..: _....9 APPROVED EXPIRES ioiiCr OF Ca C1it . p1JCZFTc : 0.010 pNS 1. This approves Vanguard II Flat concrete roof tile for a direr nail -on system on a minimum roof Slope of 4" in 12". ThL i direct nail -on system :shall be limited to installations of 75 feet, ak:ovL existing grade. 2. Spec i f icaJ_ons t Vanguard 11 Flat concrete tilo is 16 1/2" lo.. by 13 1 /0" . wlve ar 1 1 /0" in thickneeo at tho butt end. Each tilt) hLU 1 3 /U" interlocking side lap. The average woight of a tile is 121/2 pounds. Each tile is attached, to ra fully shottthed 19/32" . or 5/0 "' t:h1, .k sheathing grade plywood deck rct r� F � w�, h ='<di + .� P °Ur:coph�s �;.t �,imprt gnat krie t.. with two 10d common trot dip galvanized steel nails. Tho nails etro driven through the 3/16" .diame:.et• n��.11. ito1 to within 1/16" of the surface. Each course of tile is inate;llec utilizing it 3" hoact let � ' "'�Z� ' , • p -. re u5� .3� . -aa 4. QSdSdli..CY Cnntr .1. The manufacturer shall rota n ervice3 ,of: an independec!:` . . testing laboratory to maintain juality control. lest shall b i performed on a minimum of five tiles during production of 'dom p t i tile for strength according to Section 3403 Of the South Flo4da Auil.di.nc: Code and for moisture absorption According•to AS'rM 'rout samples shall be :;uloct:.cd by a laboratory according to ASTM D- 3G65 -02. Results shall• be submitted to Dade County Product Control Suction every ninoty days. Test reports shall be a doscription of the tile by material and color, i.e. clay, red 11 �U. Diamond, P. Product Con Division Supervisor ► :• , • thin i3 an rt, t „___ilonts...I1QQI Tile ACCEPTANCE No.t _9.2-1002.6 APPROVED EXPIRES ' LO A Cwli a , 1 ` E, ,s p E LM 11QD 5. tom,.: rX •• g _L All tiles shall hoar the imprint of tho mr,•ttut:acturer's name, and ntl tile designation, i.e. vanguarcl II Flat, to permit iduntifir. t10 in tho field. I G , This product mu it be re- evaluated for structural adequacy wh��nl installed within the Coasts). Construction 7.or►0, in 3ccordanee wi Chapter 23, Sub - section 2309.2 (b) of tho South Florida fu11-4ipg Code. • i 7. This renewal. supersedes Notice of Acceptance No, •00••0922,2 4ted December 12, 1900. d 1.1 TS:0 1 '0 •c1�11.1 : F.tL D amond, P. Product Control Division Supervisor • ariu lj :inrria•i : • . MeTnOPOLITAN OADE CO .TY, FLOI:UDA • 0 ►4 % • Wu-non/we t MERNIF llldnnuu I►r 1. 11 ;,nhub• 1T. '.Chulrnuur IL!). 1•,n•uvrr .1lru,hrj:* N.uudJ .I. er Juuu•.: I rlu.* Get esxr 11.711► Jlunnur dl. Mick I el. humid 7:,1 Irrhu., u., ur Rrr,u►un July, ['wapitis J,,s v •Ir 6, 'Cullom' /1. C•uhu• Drrkrr• 'I„ud.1 Goldman RIr /un.l .11. Miffing Auairl 1.1.1•!* John Linj..r, S,rrrn Laity Ju..rph .Ilukh.•r. Sr. Jinnes 1!,1. II'i /lL,n, Why 1)u,nu,. Ihrrrhnrk :II%r,•J Irei•havl Away 111111,11.* • llunh/ C atunIln►►l /.dw Pi..Millis cI I.JU TS :0 : 1 T •0 4 Vitx METRO•DADE CENT ! ugAnD OF RULES ANNA APPRAL� 9UIT� 101 111 N.W. 101 STfje'Er 'MIAMI, FLORIDA 33124401 (ags) aM1P 1 i ( 305 ) 375 ■20.12 ' , m,,O. , AQC1311ALI.CJ_•.. __S.TANDARP r.�OND•LT..OI, : • 1. Extension of Acceptance may be conyidorod afto n application has been filed and t; supportincr,' tort; reports no older thurl ton (r.t)) yours, hav4 1,e9n re-evaluated. I All reports of re-testing shall boar the 104, signature and date of an onginoor registered 16 ' t State of Florida. 2. Any revision or change in the; 'rator..ir_1.3, tt cs, Qr manufacture of tho product ' r. process Aha automatically bcl cause for torMrat.lon, ua10 u pri r approval is granted for roviuions cr 2. Any unsatisfactory i orformlance of this product Qr process or n chringo In Code provisions shawl he grounds for ro- ovaluation. I 4. This acceptance shall not bo usod as an e cif any product for sales or advertis'.nq purpouc;i • 5. The Notice of Accoptance number prac.odect by the , 4 - of:4s Dada County, Florida, and followed by the expi at. n date may bo displayed in advertising 1.Ltoraturc. , , : , ,[ any portion of the Notice of Acceptance is dlsplayoll, then. it shall bo dono in its entiro : ;y. G. Product approval drawings, where ,:e.juired for Porx.;.;t applications, shall bo provided to the applicant ley the manufacturer or him diutr.ihutor:s; unless ot)terwiilo noted in the Notico of Acceptance. The prints ne d not' bo re - soalod by An en'ginner.. 7. Failure to comply with Standard Conditions shall o0 cause for termination of Approval. - • 1. • t . • . , 1 Diamond, 1. . roduct Control Division 4 Supervisor • ) d" -3- (i . is r4_62. c1 • •:.i'' :IX I:l 1. Ianul Li :1 1 1 I•li 1{ l : 41 • .1 • MFTRONULI I AN UAL)E LUI,.4 T . '•,METFLO 44. Chairman Bertram S. Ilimshu%e lice-Chairman 11.a Lasseter .Members Run.GI .i tr'r J Arius George Berlin Thomas .11. Black Lawrence A. Darsari Ted Dridis t)si ur Drennan Jahn Calpini Edutnht Camel Jorge de la Turricnte IL Carlton Decker Arnold Goldman Richard M. Horton Daniel Levis John Lindstrom Steven Lowe Joseph ,1lukher. Sr. James Potts Nillium Riley Arnando .N. Riau Thomas Uuerhack - Alfred I1 jsbrnd Rudy Ililliurns Board Consultant John Pi.vunno Staff Clutr/es Danger Sande tltinrrb Cil Dianu,nd Monier Roof 135 N.W. 20 Boca Raton, (305) 375 -2612 PRODUCT CONTROL NOTICE OF ACCEPTANCE Tile Stret F1. 33431. Your application for Product Approval of Vanguard II Flat Concrete Roof Tile For Direct Nailing under Sections 203 and 204 of the South Florida Building Code governing the use of Alternate Materials and Types of Construction, and completely described in the plans, specifications and calculations as submitted by Applicant, along with report by J.E. Brenman Consulting Engineers, Inc. dated 4- 30 -90, Construction Research Laboratory, Inc. Report #4990 dated 6- 15 -88, including Gory Roof Tile Installation Guide Specifications has been accepted by Product Control under the Specific Conditions set forth on pages 2 -2a and the Standard Conditions on Page 3 • • • • r Lc/ nIyin APPROVED: April 13, 1992 -1- METRO -DADE CENTER BOARD OF RULES AND APPEALS SUITE 1010 111 N.W. 1st STREET MIAMI. FLORIDA 331284974 (305) 375.2981 4"1/AeOle, Gil Diamond, P.' Product Control Division Supervisor ACCEPTANCE No.: 92- 1002.6 (91) APPROVED April 13, 1992 EXPIRES April 13, 1995 * *PLEASE NOTE** THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS BOARD OF RULES AND APPEALS NOTICE OF ACCEPTANCE This application for Product Approval has been accepted by the Metropolitan' Dade County Board of Rules and Appeals to be used in'the Incorporated and Unincorporated areas of Dade County under the conditions set forth above. • Charles Danger, Secretary Metropolitan Dade County Board of Rules and Appeals P.E. 1 Monier Roof T e - ACCEPTANCE No.: 92- 1002.6 (91) APPROVED .•£ April 13. 1992 L EXPIRES : April 13. 1995 • F • NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS 1. This approves Vanguard II Flat concrete roof tile for a direct nail -on system on a minimum roof slope of 4" in 12 ". This direct nail -on system shall be limited to installations of 75 feet above existing grade. 2. Specifications: Vanguard II Flat concrete tile is 16 1/2" long by 13 1/8" wide and 1 1/8" in thickness at the butt end. Each tile has 1 3/8" interlocking side lap. The average weight of a tile is 12 1/2 pounds. 3. Installation: Each tile is attached, to a fully sheathed 19/32" or 5/8" thick sheathing grade plywood deck covered with a 43 pound asphalt impregnated felt, with two 10d common hot dip galvanized steel nails. The nails are driven through the 3/16" diameter nail holes to within 1/16" of the surface. Each course of tile is installed utilizing a 3" head lap. 4. Quality Control The manufacturer shall retain the services of an independent testing laboratory to maintain quality control. Test shall be performed`on a minimum of five tiles during production of domestic tile for strength according to Section 3403 of the South Florida Building Code and for moisture absorption according to ASTM C -4. Test samples shall be selected by a laboratory according to ASTM D- 3665 -82. Results shall be submitted to Dade County Product Control Section every ninety days. Test reports shall bear a description of the tile by material and color, i.e. clay, red. -2- d,go, it Diamond, P.$ Product Control Division Supervisor • • ' V. onier Roof Tile N \/ ACCEPTANCE No.: 92- 1002.6 C91) APPROVED EXPIRES NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS April 13. 1992 April 13, 1995 5. markings: All tiles shall bear the imprint of the manufacturer's name and tile designation, i.e. Vanguard II Flat, to permit identification in the field. 6. This product must be re- evaluated for structural adequacy when installed within the Coastal Construction Zone, in accordance with Chapter 23, Sub - section 2309.2 (b) of the South Florida Building Code. 7. This renewal supersedes Notice of Acceptance No. 88- 0922.2 dated `' December 12, 1988. T 7' i k A 4 ' -2a- GilDiamond, P. Product Control Division Supervisor r Clra irmun Dramas S. tl;rrshate 1VMETROPULI I /AN UAUt C:U . I Y. rLVrlluiA ' !' METRO.•OADE Y r t7rr•Chairman 11.0. losrerer .1 /anthers Rwmtj :I,ter Jonu•s :1 riux Georxr Berlin Thomas ,11. Mork Lawrence :. Uarsnri Ti•J /lridix Oscar /lreaaon John Calpini Jartr dr ld Torrientr 11. Carlton Decker Arnold Goldman Richard A1. Horton Daniel Leis John Lindstrom Scorn Ga Joseph .I /okher. Sr. Janes Power I19l1lrnn Riley Armando :11. Rim Thomas Utter/Park Alfred Ilrvslrnr/ Rudy Itillirnns Doan! Consultant Jolts Pistorinn Staff Charles Amor Sa lli•ian•h Gil Ohtaaurnrl 1. 7}r. METRO -DADE CENTER BOARD OF RULES AND APPEALS SUITE 1010 111 N.W. 1st STREET MIAMI. FLORIDA 33128.1974 (305) 375.2981 (305) 375 -2612 NOTICE OF ACCEPTANCE: STANDARD CONDITIONS Extension of Acceptance may be considered after a new application has been filed and the supporting data, test reports no older than ten (10) years, have been re- evaluated. All reports of re- testing shall bear the seal, signature and date of an engineer registered in the State of Florida. 2. Any revision or change in the materials, use, or manufacture of the product or process shall automatically be cause for termination, unless prior approval is granted for revisions or change. 3. Any unsatisfactory performance of this product or process or a change in Code provisions shall be grounds for re- evaluation. 4. This acceptance shall not be used as an endorsement of any product for sales or advertising purposes. 5. The Notice of Acceptance number preceded by the words Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is displayed, then it shall be done in its entirety. 6. Product approval drawings, where required for permit applications, shall be provided to the applicant by the manufacturer or his distributors; unless otherwise noted in the Notice of Acceptance. The prints need not•be re- sealed by an engineer. 7. Failure to comply with Standard Conditions shall be cause for termination of Approval. -3- 1 Diamond, roduct Control Division Supervisor 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 rdinance 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. Owners Name and Address Registered Architect and /or Engineer. Name and address of licensed contractor - -- CAl207/1_ roof/N CO3 bit - - Location and legal description of lot to be built on: I . Subdivision. �� ++ - Street and Number where work is to be done _..._.._. WE VI : _._..._. State work to be done and purpose of building (by floors) - _ .___ VV -tae EDOF /)ODI71PN .WHITE TIlve -_ - Lot Block MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT SHAAwmi Date .. - . ._(._ __.. ._. - _. ...... 19 . ...- - - - - - -_. No. .. l.�..6...3...._ ... street N E . l - - S7'. - - -- New Building__ _ - ..... Remodeling-__--_...... ..__ To be constructed of _ ___— Kind of foundation_ Estimated Total cost of improvements $ afo, o_u Zone cubage required- ..... —.... - ------ -- - --- -- __._Size of Building Lot - - Maximum live load to be borne by each floor... . _ _ _ _ _ _ I hereby submit all the plans and specifications for said building. AU notices with reference to the building and its construction may be sent to_- - . . - -- _.._. The undersigned applicant for this building permit do• s hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen s Compensation Act. being Sec:ion 5988, 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 su ubcontractop be ed under this permit, as are licensed by Miami Shores Village. Remarks.. __ 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- 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. P e l t No. _..... Date... 42. — - - -_7v . Read, Sworn to and Subscribed before me. Disapproved (Signed) .- D Building Ins ector Chairman _. . M e m b e r . Member Council Approved______ . ... Date PLANNING BOARD .. DATE Member . _ Member Member Disapproved ._.Nw.. 2( Sr, slim' Notary Public, State of Florida My Commission E x p i r e s . and for no other purpose. Addition_ Repairs ___ . No. of Stories .. -. Roof Covering - -- . Amount of Permit $ _... - _ D .._- _ . flan Cubage_ -. -. -- - - .- - - - - -- _..... -. - -- _ -- _ - - -- __ _..._.to me well known, 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. _- Chairman Member Member Council Approved MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal 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. C. �/ l /J " Date___ , , 19 Owner's Name and Address f 7 / No. /__._ ..___ Street__ /&, , Registered Architect and /or Engineer Name and address of licensed contractor__ /6/S Location and legal description of lot to be built on: Lot Block , Street and Number where work is to be done / 63 t /4 2 State work to be done and purpose of building (by floors ) -- 4 4 -7 -6 Building Ins, -ctor _Date c7c //2e, /7,7 75-7=o6 z. F- PLANNING BOARD __.. DATE Member Member Member Disapproved and for no other purpose. New Building Remodeling Addition Repairs_. ( No. of Stories To be constructed of Kind of foundati n Roof Covering / /X'e Estimated Total cost of improvements $ Zone cubage required Distance to next nearest building Maximum live load to be borne by each fl o o r. . . . . . Amount of Permit $ plan Cubage Size of Building Lot Notary Public, State of Florida My Commission Expires_ 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.contracto . ub-contr ors employed by him in the work to be performed under this permit; and will post or cause to be posted for in • -c ' • • o to of the ' ork uch public notice or notices as are required by the Act. The undersigned agrees to employ only such s • < . • : curs � ; j. k to • . \ • • ormed 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. Permit No Date 7 Read, Sworn to and Subscribed before me. Disapproved (Signed) 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. )wner of uilding 224 ctaltect 'Wider ,Z2 "t , 4.. ...yr en tr it 0 Lot n. iptiOn MIAMI SHORES VILLAGE, FLORIDA DATE /2.» } 2._.. 195 Contractor's License No PERMIT N? 10449 Work to be performed under this Permit Of r Value of ",�, Amt. of" .r rig "} 77 j - C f „ Project Si '�,,� "� II Permit $ r.Mummo 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 in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, _5, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any `e 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 hi the understanding that the contractor or builder named-Above assumes the responsibility for a thorough knowledge of the ordinances and regulations a to the work covered hereby whether shown on the plans or drawings or ip the statements or specifications and that he assumes responsibility for work big agents, servants or employees. 1 � a Signed' °'s ' ` N si "EC76R °...4.46.1e, BY J consideration of the issuance to me of this permit I agree . perform the work covered hereunder in compliance with all ordinances and regulations thereto and in strict conformity with the plans, draw gs tatements or specifications submitted to the proper authorities of Miami Shores Village. g„tbis permit I aseume,respan$ibility for all work d• . •y either, myself, my agent, servant or employee. 1 r 1. iI ► • i CO1 TRACTOR OR BUILDER Subdi- vision BY AUTHORITY REQUEST FOR INSPECTION , f e Y Company Job Address Inspection Time Ready � d Date Ready ,rr0^® PHONE APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date °`_ , 19 Owner's Name and Address ^ (t `' ) No. /# Registered Architect and /or Engineer Name and address of licensed contractor �! Location and legal description of lot to be built on: State work to be done and purpose of building (by floors) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT , To be constructed of Kind of foundation '3. Street s'- r T Lot Block Subdivision Street and Number where work is to be done l_ and for no other purpose. New Building Remodeling Addition Repairs No. of Stories 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 • 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 work to be 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 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.