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374 NE 100 St (11)PRODUCT CONTROL NOTICE OF ACCEPTANCE PGT industries 1070 Technology Drive Nokomis ,FL 34275 The expense of such testing will be incurred by the mu ACCEPTANCE NO.: 01- 0629.08 EXPIRES: 11/01/2006 THIS IS THE COVERSHEET, SEE ADDITION. CONDIT BUILDING CODE & PRODUC, This application for Product Approval has been revie Code and Product Review Committee to be used in Mi forth above. APPROVED: 11/01./2001. Date_ Type Insp n Kermit No. Name Address Company Phone # For Inspector: Approve Correction Re- Insp' n Fee 111L&M,I E COUW1Y, FLORJDA METRO -DAJDE FLAGLER Bi1ILDJNG BUILDING CODE COMPLIANCE OFFICE I+EI lt0 -DriDE I LA G I„ ?1 J3 UL.DING i !ti WEST FL!:GLFk STREET, SIJJ 1603 IAA AM, FLORiDn 3 3130 -1 63 (305)375-2901 FAX (305) 375 -2905 CONTRACTOR L 3{ N'S1N(; $1 (30f;)375-2.!:27 FAX (305 375•2558 CONTRACTOR : :,Nl (112.( RAZE T DlV3S1ON (30!.)37::-.7966 F1L Q, (305) 375.290: PRO DE'c CO!\ 1'12UL 1)I ISJ N (3305) 375-2902 1:A‘: (305)37 Your application for Notice of Acceptance (NOA) of S11 -701 Aluminum Single ifung Window impact Resistant under Chapter 8 of the Code of Miami -Dade County governing the use of Alternate h4aterials and Types of Construction, and completely described herein, has been recommended fnr ar/'r-nr .1-- - Ccuniy Building Code Compliance Office (.BCCO) 1.r, This NOA shat not be va3id after the expiration date product or material at any time from a jobsite or rn; product or material fails to perform in the approved use of such product or material immediately. BCC( determined by .BCCO that this product or material Building Code. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -220 Building Inspection Request Time r 111...J■ Ars �_ Vinyl Tec].h /l'roaressivc Class Technology ACCEPTANCE Nro.: 61- 0629.08 A PPRO1'F.,'D No \'e.mber O .. 001 EX : November 01, 20(36 ACC:E PTA NCE: SPECIFIC CON I lTJO S J. SCOPE 'This revises rcncCws Notice of Acceptance No. 98- 0223.OI, which was issutd on October 22, )996. It approves an a]uirlrrum single hung window, as described in Section 2 of this Notice of Acceptance, designed 10 comply with the South Florida Building Code, 1994 Edition for Miami - Dade County, for the locations where the pressure requirements, as determined by SFBC Chapter 23, do not exceed the Design Pressure Rating values indicated in the approved drawings- .). PRODUCT DESCRIPTION The Series SH -701 Aluminum Single .lung Window — Impact and its components shall be constructed in strict compliance with the following document: Drawing No. 4040, titled "SH -701 Aluminum Single Hung widow" Sheets l thru 4 of 4 prepared by manu;actuOTei dated 2/9198, 08- 18 -98 and last revised on 10-1]-2001, signed and sealed by Robert L. Clark, P.E. , bearing the Miami -Dade County Product Control Approval stamp with the Notice of Acceptance nurnber and approval date by the Miami -Dade County Product Control Division. These documents shall hereinafter be referred to as the approved drawings. 3. LI M /TATIOIsIS 3.1 This approval applies to single unit applications only, as shown in approved drawings. 3.2 Water infiltration requirements: see design pressure table. 4. INSTALLATION 4.1 The aluminum single hung window and its components shall be installed in strict compliance with the approved drawings. 4.2 The installation of this product will not require a hurricane protection system. S. LABELING 5.1 Each unit shall bear a permanent label with the manufacturer's nave or logo, city, state and following statement: "Miami -Dade County Product Control Approved ". 6. BUILDING PERMIT REQU IREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Duplicate copies of the. approved drawings, as identified in Section 2 of this Notice of Acceptance, clearly marked to slow the components selected for the proposed installation. 6.1.3 Any other documents required by the Building Official or the South Florida Building Code (SFBC) in order to properly evaluate the installation of this system' 1 • L Tr�ron 7 3� 0.,�o t7 T)rrr�i -ri � nn:rn3 L' v�.711t, cr Vinyl Tech /Pro}ressive. Cy)ss 1'ecl»1o1o2y kC'CEPT.A.NCE Na. : 0i- 0629.+6£ ,A,P)'ROVED : November 01, 2001 EXPIRES : 1\'0 Cin 01.. 2006 NOTICE OF ACCEPTANCE: STANDARD CONDITIONS i ^r-.•.- been fil and the Renewal of this AL "+._.•L:?P.Ci; (approval) shall �):; I:G]) "i :,'1 � � { renewal '� !': y' P3' J ., d �L'ci �.Lr a ]��11'al 2pl�,.Ca:13G ?1 .. n' and ori: submitted doetnne13_s including lest-supporting n r a � f��G ili�� fl t., L.:g13'eL`r33:g documents, :!e'"L' no older than L:1g}?i (8 ) Any and all approved products shall be permancnul labelci with the manufacturer's name, city, suit✓, and the following statement: "Miami-Dade County Product Control Approval', or as specifcally stated in the specific. conditions of this Acceptance. Rene;.ais of Acceptence will not be considered if: a. There has been a change in the South Florida Building Code affecting the evaluation of this product and the product is not in compliance with the code clan =es. b. The product is no longer the same product (identical) as the one originally approved. c. if the Acceptance holder has not complied with all ;die rcoiircincnis of this a:.ccptzncc_ including the correct installation of —die product. d. The engineer ,:ho originally prepared, signed and scaled the required documentation initia,1y submitted, is no longer practicing the engin; cring prt fcssio!. � - Any revision or chance in the materials, use, and /o. MIMufs.cture of the product or process shall automatically be cause for termination of this Acceptance, unless prior ;a incn approval bas been requested (through the filing of a revision application with appropriate fee) and granted b this office 5. Any of the following shall also bc grounds for removal of iris Acceptance: a. Unsatisfactory perforrnancc of this product or process. b. Misuse of this Acceptance as an endorsement of any product, for sales, adveriisinc. or any other purposes. 6. The Notice of Acceptance number preceded by the words Miami-Dade County, Florida,, and followed by the expiration date may bc displayed in advertising literature, if any portion of the Notice of Acceptance is displayed, then it shall be done in its entirety. 7 A copy of this Acceptance as well as approved drawings and other documents, where it applies, shall be provided to the user by the manufacnirer or its distributors and shall be available for inspection at the job site at all limo. The engineer needs not reseal the copies. 8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of Acceptance. 9. This Notice of Acceptance consists of pages I, 2 and this last page 3. END OF THIS ACCEPTANCE !shag !. Chanda, '.E., R,oduc Control Examiner 0 Phone: 305-795-2204 Permit Number: BP2002-1693 Miami Shores Village 10050 NE 2nd Avenue Printed: 10/7/2002 Applicant: HARRY Owner: DOUKAS rC JOB ADDRESS: 374 NE 100 0 4 Contractor ACTION CONSTRUCTION INC CN Local Phone: Parcel # 1132060135420 Fees: Description FEE2002-5559 Building Fee FEE2002-5560 Buildier's Bond FEE2002-5561 CCF Total Fees: Amount $70.00 $300.00 $3.00 $373.00 Total Fees: $373.00 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: Work: REMOVE AND INSTALL 3 WINDOWS & 2 DOORS & 2 G SOFFIT, CONC PORCH & STEPS & RELOCATE 1 WALL NC UNIT If there is no oermit nankana annaccihla nn ONO ink.ei.n frr ;rsarse.••••••■re• —411 - - _" - 1e-inspection 7.12,192,13 0S13133" ■C 1 PAY TO THE ORDER OF ACTION CONSTRUCTION, INC. 5040 LAKEVIEW DR. 305-864-6535 MIAMI BEACH, FL 33140 m 5 /-o7 -40 /4‹ -(4,ALe 5 e-e4 71(,Zi ----•;CIOLLARS Otti= Setut hv Pa.. Rrat Union National Bank • firstunlon.com Org. 003 R/7 067006432 FOR 11 5 5811• 1:06 7006 21:2 L78000 L00881' Building Permit DOUKAS HARRY ST Contractor's Address: 1759 BAY RD Legal Description: MIAMI SHORES SEC 1 AMD PB 10 LOT 3 & E1/2 LOT 4 BLK 40 LOT SIZE 4/1/2003 Construction Value: $4,500.00 DATE /0- 6558 63-643/670 BRANCH 13093 Page 1 of 1 A ation herefor in strict compliance with all ications that may have been submitted to or if the plans are changed without onsibility for a thorough knowledge of the hat he assumes responsibility for work done Is pertaining thereto and in strict conformity esponisibility for all work done by either LO R 1 O A &Iva —The Sunshine State -- NIEL P WALSH 5040 LAKE VIEW DR MIAMI, IL. '''514n-4211 k SIM kf • ail 1.•1 flOW. f f kflikk Mt WS 8-18-53 M - 1 08-30-1990 08-18-1997 CLASS: D /11 1 1 2 3 4 5 f5 i sy w r 1 I I& lid - .• .., .., — I __ ..�•,�.. 'ili ; __ �.... _ I. _ _ . ._ _I .. >,.. __1_____ __ ....4...._ _ ..�r. 1, _ . ...... , ...., m • , ,.. • . 1 o' 1 . r , fr , r: r G . ; lII .0 r ,. 0 ..... .... 7.. . ...,, ... f • „ .. --.....-. .. f ..4 4 iglu]. I -. .... ...........- d. w lrr�f�rs:l�sti ■ n.:r.00 IIIIIIIII ilia: . a aim __ .I_ U t ■ - - /! 7� 1 �. ilJ1i0 __._ 1.11i 1! *lid 22,Y 146 ..» r .... _.. , x _ ' ' ._. v L. 1 �. - SKETCH ESTIMATE 414. 5A /fir erv-9t 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Notes DC8511 KIN- MADE IN USA ACTION CONSTRUCTION. VIC. 1040 UMW DRIVE =AIN &ACK, El.. 1$140 0.460$ Proposed Layout for , l/ 5 1 44 , 3/3 �P PHONE 45-S7D ESTIMATOR OATF /a ...�,,,� you Scale 1 /4" = r. '19 20 21 22 23 24 25 26 27 28 29 30 MIAMI -0ADE IS PRODUCT CONTROL NOTICE OF ACCEPTANCE The expense of such testing will be incurred by the manufacturer. Acceptance No.:99- 071.6.01 Expires:02 /11/2003 Approved: 02/11 /2000 :MIAMI-DADR COUNTY. FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO -DADF FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -!5(3 (305) 375.2901 FAX (305) 375 -2908 PGT Industries CONTRACTOR LICENSING SECTION 1070 Technology Drive (305) 375-2527 FAX (305) 375-2558 Nokomis FL 34274 CONTRACTOR ENFO)tCEMENT SECTION (305) 375 -2966 FAX (305) 375 -2908 PRODUCT CO,NTItOL D1v1SJON Your application for Product Approval of: (305) 375 -2902 FAX (305) 372-6339 Series OutswingAluminumn French Door wl Sidelites- Impuci under Chapter 8 of the Code of Miami - Dade County governing the use of Alternate Materials and Types of Construction, and completely described herein, has been recommended for acceptance by the Miami Dade County Building Code Compliance Office (BCCO) under Ile conditions specified herein. This approval shall not be valid after the expiration date stated below. BCCO reserves the right to secure this product or material at anytime from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner, BCCO may revoke, n3odify, arsyspcnd the use of such product or material immediately. BCCO reserves the right to revoke this approval, if it is determined BCCO that this product or material fails to meet the requirements of the South Florida Building Code. Raul Rodriguez Chief Product Control Division THIS IS THE COVERSHEET, SEE ADDITIONAL, PAGES FOR SPECIFIC AND GENERAL CONDITIONS BUILDING CODE & PRODUCT REVIEW COMMITTEE 'Phis application for Product Approval has been reviewed by the BCCO and approved by the Building Code and Product Review Committee to be used in Dade County, Florida under the conditions set forth above. rancisco Quintana, R.A. Director 1 of 3 Miami - Dade County Building Code Compliance Offc< lnteraet mail address: post .mastergbuildingcodeonliac.cam Homepage: h: tp:JJwww.huildingcadenntirc.com PGT Industries. 2 of 3 ACCEPTANCE Nu.: 99- 0716.01 APPROVED EXPIRES FEB 1 1 2000 FEB 1 1 2003 NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS 1. SCOPE J.1 This approves ail outstaring aluminum French door, as described in Seciinn 2 of this Nniicr of Acceptance, designed to comply with the South Flcrida Building Code (SFBC), 1994 Edition for Miami -Dade County, for the locations where the pressure requirements, as determined by . SFBC Chapter 23, do not exceed the Design Pressure Rating values indicated in thc approved drawings. 7. PRODUCT DESCRIPTION 2.1 The Series Outswing Aluminum French Doors w\ Sidelites Large Missile Impact Resistant and its components shall be constructed in strict compliance with the following documents: Drawing No 972, titled "French Door w\ Sidelites" Sheets 1 through 4 of 4, prepared by manufacturer, dated 07/12/99, signed and sealed by Robert L. Clark, '.E., barring thc Miami - Dade County Product Control approval stamp with the Notice of Acceptance number and approval date by the Miara Dade County Product Control Division. These documents shall hereinafter be referred to as the approved drawings. 3. LIMITATIONS 3.1 This approval applies to single unit application of pair of doors and single door w\ Sidelites only, as shown in approved drawings. Single door unit shat; include described in the active leaf of this approval. 4. INSTALLATION 4.1 The outswing aluminum French doors w\ sidelites and its components shall be installed in strict compliance with the approved drawings. 4.2 Hurricane protection system (shutters): the installation of this unit will not require a hurricane protection system. 5. LABELING 5.1 Each unit shall bear a permanent label with the mi nufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ". 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompaaied by copies of the following: 6.1.1 This Notice of Acceptance 6.1.2 Duplicate copies of the approved drawings, as identified in Section 2. of this Notice of Acceptance, clearly marked to show the components selected for the proposed installation. 6.1.3 Any other documents required by the Building Official or the South Florida Building Code (SFBC) in order to properly evaluate the installation of this system. 15.\,,, 1. L 4A K .1F 'shag Chanda, P.F. Product Control Examiner Product Control Division PGT Industries. ACCEPTANCE Nu.: 99- 0716.01 FEB 11 nth) APPROVED . FEB 1 1 2003 EXPIRES NOTICE OF ACCEPTANCE: STANDARD CONDITIONS 1, Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and the original submitted documentation, including test supporting data, engineering documents, are no older than eight (8) years. 2, Any and all approved products shall be permanently labeled with the m u as ur na lJ e, city t state the and the following statement: "Miami -Dade County Product Control 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 Code affecting the evaluation of this product and the product is not in compliance with the code changes; b) The product is no longer the same product (identical) as the one originally approved; c) If the Acceptance holder has not complied with all the �:equirements of this acceptance, including the correct installation of the product; d) The engineer who originally prepared, signed and sealed the required documentation initially submitted is no longer practicing the engineering profession. 4. Any revision or change in the materials, use, and /or manufacture of the product or process shall automatically be cause for termination of this Acceptance, unless prior written approval has been 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 Acceptance: a) Unsatisfactory performance of this product or proems. b) Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any other purpose. 6. The Notice of Acceptance number preceded by the words Miami -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. 7, A copy of this Acceptance as well as approved drawings and other documents, where it applies, shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at all time. The engineer need not reseal the copies. 8. Failure to comply with any section of this Acceptance; shall be cause for termination and removal of Acceptance. 9. This Notice of Acceptance consists of pages 1,2 and this last page 3. Ishaq Chanda, P. E., Product Control Examiner Product Control Division END OF THIS ACCEPTANCE of 3 PROPERTY OWNER Name 4, n ' „- ( s /, s Address 3 - 24 /1/e- /0 Home Telephone 3 os--- 757 - :5--r a Business Telephone Fax CONTRACTOR Name �1 /G��� se.-„,„...„..„74; / v" • Licc nse No. x 6 0 vZ ,, cp.. 4"/ Adclressj 4'O 4� / e -( c ) �� ' fir Tel ephon9 = f'6 v—' 5S x e„ cy/— y/ G, T i �2 Qualifier Name �� `& / 0 , G � /i `°�` �C TYPI: OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Demolish Alteration Interior Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit f" om the Miami Shores Village: Step 1. 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 roo ing 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 informaion. .51z2A - 33/3S City State Zip PERMIT TYPE ( ✓ Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Address Apt. Folio Number vDescription of Work /c. I, . ,-e .107 /4/- Lot Block 3 pv .,mows „k 20 i 3oe—/7 i rwil_ 0 ( 4-5 - J`riV) /Lzc't- (ctiHzlt c c c V svr. y Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet f. Units t , Floors Proposed Use of Property Value of Work 17' 5 V K 3 `D B ldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No ENGINEER Name License No. Address Telephone Fax PERMIT APPLICATION Base Floor Elev. Page 2 1 1 PORi'AN'I' NOTIC 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. STAORIDA,14 i f'A/"1 . • Signature of Owner aaFs - State Print Name S o and subscribed before me this 0 i A... r _ / ature of '.tary Publi, ■w SEAL: Personally known Type of Identification Producedr■ o orida � :l.Q :. STAT OF FLORIDA, COUNTY OF MIAMI -DADE cA Signature of Contractor / Qualifier 0 4 ; e Pr /o (5X Print Name nn Swo u toad subscribed before me this 3 day of , ature of SEAL: tary Pub PERMIT APPLICATION Type of Identification Produced: Florida OR, Pr' roduced Identification Personally known ' ' OR, Produced Identification v ELECTRICAL 'I'YPP. Minimum Fee QTY. 'I'1'PE Dryer QTV. TYI'E, Outlet, Appliance ()Ty. TY1'I; 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 Cap - Water Space Heater (kw) Gas - Appliance A/C Central 16-20 Ton Pump, Domestic Fixture Light Supply, AC Well Parking Lot Lights Cap - Sewer Spas/Hot Tlrbs Gas - Natural A/C Central 20+ Ton Pump, Fire Stand Flood Lights Temporary Toilet Plugmold/Strip Catch Basin Subfeeds, No. of Amps Gas - Propane A/C Window Pump, P.e- circulate FPL - Load Central Temporary Water Closet Posts Clothes Washer Swim Pool, Commercial Gas Piping Air Conditioners Pump, Replace - Pool Garbage Disposal Urinal Range/Range Top Dental Chair Swim Pool, Residential Grease Trap Chiller Pump, Sprinkler Generators, etc. Utility - Sewer Receptacles Discharge Well Switchboards Ice Maker Clear Violations Pump, Sump Heat Recovery . Utility - Water Refrigerator, Comm. (p/PH) Dishwasher Temp Serv., Construction Indirect Wastes Compactor Relay Repair Low -volt, Burglar Vacuum Pump Water Closet Refrigerator:, Domestic Disposal Temp for Test - 30 days Interceptor Deep Freezer Roof Inlet Low -volt, Fire Renew - Temp Service Septic Connection Demolition Low -volt, Intercom/Teleph. Repair Circuits Septic Tank Dishwasher Low -volt, Television Service, Number of Amps Sewer Connection MECHANICAL TVI'E, Minimum Fee QTY. 'TYPE Condensate Drain QTY. TVI'I{ Generator QTY. i'vi'1•: Refrigeration, Tons QTV. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Cap - Water Periodic Inspections Gas - Appliance Barbecue Pump, Domestic Fire Sprinkler System Supply, AC Well Process/Pressure Piping Cap - Sewer Gas - Natural Bath Fan - Vented, # Pump, Fire Stand Fireplaces, Number of Temporary Toilet Pressure Vessel Catch Basin Gas - Propane PLUNIBING TVI'I? A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE; Miscellan eous Fixture QTY. T1 Soakage Pit QTY. Bath Tub Drinking Fountain Miscellareous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Sprinkler System Cap - Fixture Fountain Pump and Abandon Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, P.e- 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 Water Closet Disposal Interceptor Roof Inlet 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 • Water Service Drains, Floor Minimum Fee Shower Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning Electrical Mechanical Plumbing Fire Public Works Structural /7<$ Building Official Page 4 OFFICE USE ONLY CHECKLIST J OWNER - BUILDER FORM (Attach) J FIRE DEPARTMENT APPROVAL (Commercial / multi - family) J CONCURRENCY (New Construction) J OTHER (Specify & Attach) $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 ❑ PROOF OF OWNERSHIP (Attach) LI HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ 3do $ - 3.0?) (sq.ft. = x/1000 x ¢.60) (¢.005 / sq.ft.) (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ b 3:), DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com APPLICATION FOR BUILDING PERMIT Application is hereby wade for the approval of the detailed statement of the plr.ns 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 iuilding 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..._. / _.... ,1922 Owner's Name and Address ....... 2 - �� L.l... 2 �-- ... No... 7.f _.. Street_...! b0 .. ` Registered Architect and /or Engineer Name and address of licensed contractor j Locatio and legal descrip ion of lot to be built on: Lot ? d � 2-- Y Block T© Street and Number where work is to be done State work to be done and purpose of building (by MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT • New Building Remodeling Addition To be constructed of Kind of fo dation.. Estimated Total cost of improvements $ dC, Zone cubage required Distance to next nearest building 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 1 e 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, Pennane•nt Supplement, and has complied witle 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 surth subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signedy 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 e true. Permit No Disapproved (Signed) Date Date -22-7 Building Inspect Subdivision �. .. ... ,...,,..f,,,,,,,,,,,,,,,;,,,,, - ., ...... floors) ... &CZ. = and Repairs No. of Roof Covering Amount of Permit $. /Z r-c) Plan Cubage Size of Building Lot Read, Sworn to and Subscribed before me. for no other purpose. Stories to me well known, Notary Public, State of Florida My Commission Expires P>GANNINC BOARD DATE Chairman Member MIcrnbcr 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 Hoard. A rc inspection fee of x1.00 will be charged when such re- inspection is made necessary by improper notice for inspevtitm or faulty materials and/or workmanship. 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. ,19.7 Owner's Name and Address /C CSC A 'f�✓!i. 47(.. ...... No. •-??Y. Registered Architect and /or Engineer t.._.. 12. ,!.., :.,,:.,,,!„.•,•., :.,.,. Name and address of licensed c o n t r a c t o r � ? ' ' " 4=145 k.7:- Location and legal description of lot to be built on: Lot Block ?? Subdivision 3 Street and Number where work is to be done .24 _ , ta.g _.. ... _ State work to be done and purpose of building (by floors) 4 9( �" %� ® ,.2 -- -- :._ 414 W' 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 $ 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 pennit, 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, persortally 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.- �� Date � ° `.- Read, Sworn to and Subscribed before me. _.. :._ to me well known, Disapproved - pat - _- ...-- - -_ -_- .._ k �,> Notary Public, State of Florida (Signed) ._ ;...� Building Inspector PLANNIN 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. My Commission Expires