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.