ROOFINGKETCH OF ROOF
JOB
SHEET NO
CALCULATED BY DATE
CHECKED BY DATE
SCALE
NOTES'
OF
•
SKETCH OF ROOF
10B
3oon35 I e' �r; 1.4. -ko
SHEET NO 26 y
CALCULATED BY DATE
CHECKED BY DATE
SCALE
4
2 4 '
NOTES'
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 4 -26 -99 Job Address 300 N.E. 101 Street TaxFolio • /1 of ei3 g
Legal Description Historically Designated: Yes
Owner/Lessee / Tenant Vera Wa 1 f ®r d Master Permit #
Owner's Address 300 N.E. 101 Street Miami Shores Phone 899 -3240
Contracting Co. Quality Roofing Contractor, Inc.
Qualifier Carlos Arocho
State # RC 0 0 5 8 6 2 7 Municipal # Competency # 17889 Ins. Co.
■
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Tear off old roof to wood deck, tin cap 301b. ASTM felt as per code
will install galvanized eave drip and valley metals where required, mop on•with
type III asphalt one layer of 901b. ASTM felt, install Spanish S Clay Colorhtru
Tile with adhesive foam setting.
Square Ft. 22 s q. Estimated Cost (value) $ 8,200.00
WARNING TO OWNER: YOU MUST RECORD A NOTICE 01? COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (tF.YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE 01? 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, g00FING 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 construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Notary as to 0
My Commission E
w�.
Signature of owner an• /•r Condo President Date��
Date
MARYLOU HERNANDEZ
MY COMMISSION # CC 680474
1 DXPIRES: October 10,2001
"vi,; i0, Bonded Thru Notary Pubic Undemdters
er and/or Condo Presid
APPROVED:
Zoning
Mechanical Plumbin
FEES: PERMIT t/i RADON
Address
13800 N.W. 1st Avenue
SS# Phone 751 -0382
Buildin • 4//l Electrical
No
448LI
Signature of Contractor or Owner- Builder Date .
MARYL ERNANDEZ
MY COMMISSION # CC 680474
EXPIRES: October 10,2001
Bonded Thru Notary Pubic Undervadters
Notary as to Con ctor or Owner - Builder
My Commission Expir
y0
NOTARY
ate
BOND y'
TOTAL DUE 3 7 < C`
Engineering
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO. /a 3.-2 o O/ •3 5 3
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: 300 N . E . 101 Street
Miami Shores, Florida 33138
2. Description of improvement: Reroof to a new Tile roof.
3. Owner(s) name and address: Vera Walferd
Interest in property: Owner
Name and address of fee simple titleholder: N/A
4. Contractor's name and address: Quality Roofing Contractor, Inc.
5. Surety:(Payment bond required by owner from contractor, it any)
Name and address: N /A
Amount of bond $ 00
6. Lender's name and address:
N/A
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
Section 713.13(1)(b), Florida Statutes.
Name and address: N/A
300 N.E. 101 Street Miami Shores, Florida 33138
13800 N.W. 1st Avenue Miami, Florida 33168
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
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)
Signuwe of Owner
Print Owners Name ve2 of// r-D(LP Prepared by: Carlos Arocho
Sworn to and subscribed before me this '7 day of 19' . Quality Roofina Contractor
Address:1180o N.W. 1st Avenut
Notary Public // . ,. , , r .._ 1../.. .,.�_.: '
MARYLDUHERNANDE2 N))i ami, Florida 33168
KI MY axe � q r :: � 4
Print Notary's Name I `� EXPIRES: October M 2001
, = e Bonded Thor ran urwerere
My Commission Expires:
STATE OF FLORIDA; COUNTY OF OADE
1 HEREBY CERTIFY. that this h o Prue copy of the
original filed in this office on J d o f
A. D. 19
WITNESS my h n •'.nd Off 3 :1 ' o •,
HAWN' it C lrc. i nd Court', C:•nrr
By 0 C.
12101.52 993
N
rJs
N
Cs
Contractor's Name: (911 a I: � - 12rrs ,ny
Job Address: 30 6 N E 1 b 1 Stu,
ROOF CATEGORY
❑ (Nail -On Tile) (Mortar
❑ (Metal Roofs\Wood Shingles & Shakes) ❑ (Other)
4 ROOF TYPE
❑ New Roof S Re- roofing . - ❑ Recovering ❑ Repair ❑ Maintenance
❑ (Low Slope Application)
❑ (Asphalt/Fiberglass Shingles)
Flat Roof Area (ft') Sloped Roof Area (ft') ';2 / .S 9 . Total (ft') A/ Sq Master Permit No.
Exposure category (per ASCE 7 -88): Building Classification category (per ASCE 7 -88 table 1):
ROOF HEIGHT AND SYSTEM DETAILS
(Draw details as needed)
DETAIL 1 & 2
Fte1d: Perimeter:
Corner:
r
ROOF PLAN
123.0148 9196
. Appendix "E
. UNIFORM ROOFING PERMIT APPLICATION
PROCESS No.
Page -1
Appendix "E"
UNIFORM ROOFING PERMIT APPLICATION
• PROCESS No.
Rldg. VialiIY1lon1
f
1.1111 1
MC.1NIIEICHT )3
Deck type:
WO x 0
A001ILO1i
Fastener type & spacing:
Drip edge:
ATTACHMENTS REQUIRED
1) Fire Directory Listing Page
2) 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
(Pmax1:99.3 x?
(Pm ax2:103;) X„
(P,nax3:1®3 fl x
,31
(Aerodynamic Multiplier): .q f)
(Aerodynamic Multiplier): 32. I , )
(Aerodynamic Multiplier): 3x • 1 J � )
•
TILE CALCULATIONS
M$ 5 ° M r 1 : 19 O(PCA:
� � r
- Mg :5.35 '' M LW PCA: (D(e .J?
- Mg S-3 M :;LL W PCA: bb 4)0
1 •
Page -2
METRO -OAOE
PRODUCT CONTROL (NOTICE OF ACCEPTANCE
. Altusa Tile, Almar (USA), Inc.
• 6645 Northwest 77th Avenue
:\liarni, FL 33166
Your application for Product Approval or
APPROVED:02 /13/97
1
METROPOLITAN DADE COUNTY, FLORIDA
METRO -DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE
SUITE 1603
METRO DADE FLAGLER BUILDING
140 WEST FLAGLER STREET
MIAMI. FLORIDA 33130.1563
(305) 375.2901
FAX (305) 375 -2908
INTERNET: mdcc0l @shadow.net
PRODUCT CONTROL SECTION
(305) 375-2902
FAX (305) 372 -6332
1Irus'a Tile Nail -On, Mortar Set or Adhesive Set One Piece "S" Tile Roofing Tile
under Chapter 3 of the Metropolitan Dade County Code governing the use of Alternate Materials and Types of
Construction, and completely described in the plans, specifications and calculations as submitted by:
Red /ant/ Technologies, The Center for Applied Engineering, Inc.
has been recommended for acceptance by the Building Code Compliance Office to be used in Dade County,
Florida under the specific conditions set forth on pages 2 -16 and the standard conditions on page 17.
This approval shall not be valid after the expiration date stated below. The Building Code Compliance Office
reserves the right to secure this product or material at any time from a jobsite or manufacturer's plant for quality
control testing. If this product or material fails to perform in the approved manner, the Building Code
Compliance Office may revoke, modify, or suspend the use of such product or material immediately. Tne
Building, Code Compliance Office reserves the right to revoke this approval, if it is detemlined by the Building
Code Compliance. Office that this product or material fails to meet the requirements of the S Florida Building
Code.
The expense of such testing will be incurred by the manufacturer.
ACCEPTANCE NO.: 96- 1030.03 Renews 94-0914.0
EXPIRES: 02/13/00
Raul Rodriguez
Product Control Division
Supervisor
THIS IS THE COVERSHEET. SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
CONDITIONS
BUILDING CODE COMMITTEE
This application for Product Approval has been reviewed by the Metropolitan Dade County B ding Code
Compliance Office and approved by the Building Code Committee to be use ...de County, F ,lid,a, under the
conditions set forth above.
Charles Danger, P.E.
Director
Building Code Compliance Dept.
Metropolitan Dade County
Applicant:
Altusa Tile
Alfarcria del Turbio, S.A.
l)arquisirncto, Venezuela
1
Product Control No.: 96- 1030.03
PRODUCT CONTROL NOTICE OF ACCEPTANCE
ROOFING SYSTEM APPROVAL
Category: Prepared Roofing
Sus - Category: Tile;
Tyne: Nail- on /Nio. ^.ar SerlAdhesive Set
Sub-Tyne: Clay
Contact:
Carlos 1. Fernandez
General Manager
Altusa Tile, Almar (USA), Inc.
6645 Northwest 77th Avenue
Miami, FL 33166
(305) 471 -5830
Product Control No.: 96- 1030.03
Approval Date: February 13, 1997
Expiration Date: February 13. 2000
• System Description
Alfareria del Turbio, S.A. (Altusa), located in Barquisimeto, Venezuela, manufacturers clay roof
tile for nail -on, mortar set or adhesive set applications. All tile is manufactured from natural Venezuelan
clays. This Product Control Approval relates to A ltusa's "Altusa S" tile profile. Refer to appropriate
Product Control Approvals for other tile profiles.
The "Altusa S" tile profile is available in a variety of natural clay colors and has marching trim
pieces .used for rake hip, ridge hip, and valley terminations. These accessories are manufactured for all
profiles and form a part of this Product Control Approval. Optional rubber or clay eave closures are also
available. •
Altusa roof tiles have been tested in compliance with the South Florida Building Code
requirements for clay, nail -on, mortar set or adhesive set tile applications. The minimum roof slope for
the "Altusa S" nail -on tiles shall be 2 ":12 ". See the "Profile Drawing"
".- Altusa S" profile drawing. The "Altusa section in this approval for the
uplift performance, therefore, any consideration if or l installation s!all done ` asa'Moment 'Moment static
System'. Data for attachment calculations is noted in Tables 1 through 4 of this Approval.
Almar (USA), Inc., located in rtvtiami, Florida, is the sole approved importer under contract for
selling and distributing Altusa products in the South Florida jurisdiction.
Frank Zuloaga
Plans Examiner, Product Control Division
Trim Pieces
TRADE NAMES OF PRODUCTS MANUFACTURED OR
LABELED BY APPLICANT
1= varies
w = varies
l'A 112
1
Frank Zuloaga
Pans Examiner, Product Control Division
Product Control No.: 96- 1030.03
Test Product
Product Dimensions Specifications Description
Altusa One Piece "S" I = IS" PA 112 High profile clay roof tile for direct
Tile w = I" deck or battened nail -on, mortar or
'' " thick adhesive set applications.
liead -lap min.
Exposure max.
15
Accessory trim, clay roof pieces for
use at hips, rakes, ridges and valley
terminations.
SYSTEMS
(CONTINUED)
Deck Type: Wood, Non - insulated
Deck Description: New construction 1 9 / 32 " or greater plywood or wood plank.
SYSTEM D: Mortar or Adhesive Set Application
Siopc Range: '":1"'" to 7":1'"
Undcrtavrnent:
Roofing Tile:
Cornments:
4
Product Control No.: 96- 1030.03
Note: System 1) is only acceptable in this slope range. For slopes in excess
of 7 ":12 ", refer to Svstent C.
Install undertavment system in compliance with Dade County Application
Standard PA 120. (See System Limitation #5.)
Install tile in compliance with Dade County Application Standard PA 120.
(See "Data for Attachment Calculations" included in this Approval.)
1. For re -roof applications, ' plywood is an acceptable substrate.
Frank Zuloagzt
Plans Examiner ;-roduct Contro! Divisio:
i
I„ ltusa 'S' Tile
Tile
Profile
IAltusa 'S' Tile
Tile
Profile
3 " :12 "
or less
!Battens I Direct Battens I
Deck
4.47 5.35 I 4.40
DATA FOR ATTACHMENT
CALCULATIONS
Table 1: Aerodynamic Multipliers - X (ft')
4 ":12"
X (ft')
Batten Application
Direct
Deck
5.27
12
0.29 I 0.31
Table 2: Restoring Moments due to Gravity - M, (ft-Ibf)
from PA 102 Testing
5 ":12" l 6 ":12
Battens Direct II Battens Direct
Deck Deck
4.31 5.16 I 4.20 I 5.03'_
Table 3: Attachment Resistance Expressed as a Moment - M, (ft-lbf)
from PA 102 and PA 102(A) Testing
Table 4: Attachment Resistance Expressed as a Moment - M, (ft-Ibf)
from PA 101 Testing
Product Control No.: 96- 1030.03
X (ft3)
Direct Deck Application
Frank Zuloaga
Plans Examiner, Produc: Control
Battens
4.08
7 ":12" or
greater
1. Quik -Drive screws installed in two manufactured holes located 1 and 1'/," from the head of the tile.
Direct
Deck
N/A
Tile
Profile
Altusa 'S' Tile
TILE APPROVED I APPROVED'
APPLICATION NAILS SCREWS
I 1 nail 12 nails I 1 screw
Battens I N/A I N/A I N/A
Direct Deck I 5.20 I 8.40 I 23.70 I 58.20
APPROVED
FIELD CLIP
WITH:
2 screws I 1 nail 12 nails
26.80 I N/A I N/A
21.20 I 25.30
APPROVED
EAVES CLIP
WITH:
1 nail
N/A
26.90
2 nails
N/A
34.90
Tile
Profile
Tile
Application
Attachment
Resistance
Altusa 'S' Tile
Mortar Set
Adhesive Set
24.50
66.50
i
A
10"
PROFILE DRAWING
ALTUSA "S" CLAY ROOF TILE
6 i
DOVE TAI`
LOCKS
i3
• Product Control No.: 96- 1030.03
Fran.• uloaga
Plans Examiner, Produc: Control Divi :on
•
NAIL
HOLE
BIRD STOP
PROFILE DRAWING
ALTUSA "S" CLAY ROOF TILE
ACCESSORIES
NAfL
ROLE r
RO`E ----• >
l
f
1a
Product Control No.: 96- 1030.03
GABLE -RAKE.
Frank uloaga
Plans Examiner, Product C s'
. Control Divi i;,n
SYSTEM L[rMM[TAT[ONS
I. The standard minimum roof pitch for Altusa "S" high profile tile shall comply with Dade County
Application Standards PA 1 1 S, PA 119 or PA 120, depcndin�, on the method of installation.
2. For nail -on applications, fasteners for mechanical attachment of tiles shall have a head diameter
larger than that of the preformed holes in the tile.
3. System installation shall be in compliance with the system specifications outlined in this Product
Control Approval. The method of attachment utilized :a; provides ;,fficicnt attachment resistance
^- as a moment to meet or exceed the required moment of resistance determined in
compliance with Dade County Protocol PA 115 or PA 127. Altusa "S" Tile tilt profile has been
tested for both wind characteristics and static uplift performance, therefore, attachment calculations
for installation in compliance with PA 115 or PA 127 shall be done as a 'Moment Bascd System'.
For mortar or adhesive set tile applications, a field static uplift test by a Dade County accredited
testing agency, in compliance with Dade County Protocol PA 106, shall be performed.
5. For mortar set tile applications, 30/90 ! ,•, d ie
f . 0 90 rat m�. , ! d un.,,.rLr� �.,_.nt applications may be insialled
perpendicular to the roof pitch unless stated otherwise by the undcrlayment material manufacturer's
published literature.
6 All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo for
identification in the field.
7. Applications for roofing permits shall include a completed Sectional of the Uniform Building
Permit, a copy of Pioneer's current specifications and details, a copy of this Product Control
Approval and a copy of the Product Control Approval of any Roolim:t Component used in the
proposed tile application. Reference shall be made to appropriate data for the required fire rating.
S. The applicant shall retain the services of a Dade County certified testing laboratory to maintain
quality control in compliance with the South Florida Building Code and related protocols. Samples
taken shall be in compliance with Dade County Protocol PA 1 12, Appendix 'A'.
1
16 / t)
Piano Fx::mincr. Prods;: Control Division
Product Control No.: 96- 1030.03
Altusa Tile, Almar (USA), Inc.
6645 Northwest 77th Avenue.
Miami Fl 33166
Product Control No.: 96- 1030.03
ACCEPTANCE NO.: 96 - 1030.03
APPROVED : February 13, 1997
EXPIRES : February 13.2000
NOTICE OF ACCEPTANCE STANDARD CONDITIONS
Renewal of Acceptance (approval) shall he considered after a renewal application has been tiled and
the original submitted documentation, including test supporting data, e ineerin; documents, are no older
•
,hap eight (S) years.
Any and all approved products .;' be permanently labeled with the manufacturers name, city, state, and
:he following statement: "Dade County Product Control Approved", or as specifically stetted In the specific
conditions of this .Acceptance.
�• Renewals of Acceptance will no: 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 orit'inall), approved;
c) If the Acceptance holder has not complied with all the requirements 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.
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 process;
b) Misuse isuse of this Acceptance as an endorsement of any product, for sales, advertising or any
other purposes.
6. The Notice of Acceptance number preceded by the words Dade County, Florida, and followed by the
expiration date maybe displayed in advertising literature. Irany 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 times. The copies need not be resealed by the engineer.
8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of
Acceptance.
9. This Acceptance contains pages 1 through 17.
END OF THIS ACCEPTANCE
17
Fran„ u oaga
Plans Examiner, Product Control Division
Application is hereby made for the approval of the detailed statement or 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 iluil. ling 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.
ens aL oo N ~, �lof.,t S#�reet
Owner's Name and Address _ No. _ Street_ .• •
Registered Architect and /or Engineer ..... ............ ,,,,., r ,,, t
06enouA 7�oo C oq Co. 7337 `N: Ai. Al..a�nc �" : 1llcahu, 31a. 33t50""
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision _-
Street and Number where. work is to be done 1 300 N•_ /0 /4i, St/wet _
State work to be done and purpose of building (by floors) remove ex aoo,c`�� and�iee�Xatce tuts ]' �D"
...... 414 ..1 -Q t6..- / ate, gay. maa�..�o!eu .rtg:! and Lulls.& cement t ........ _.._.._.._�
.__ .and for no other purpose.
Ncw Building Remodeling Addition Repairs No. of ,Stories _
To be constructed of King' o Qundation Roof Covering 26 • _
Estimated Total cost of improvements $ P . (AV Amount of Permit S. . 00
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Mfaxirnum 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 «itli 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 arc 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.
Rem.uks (Signed) �� / /` =`� ry�� -� - ,
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true..
Permit No.._ r! 1
Disapproved
(Signed)
Date 1 ��
Date..
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Chairman
Merr,ber
Member ..
Council Approved Date Disapproved
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval
the I'Lmnir. Board.
A re-inspection fee of 31.00 will be charged when such re-inspection is made necessary by improper notice
materials and /or workmanship.
to me well known,
Member
Member
Member
Date
has kern obtained from
for inspection or faulty
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.
Owner's Name and Address A 1& P
Registered Architect and /or Engineer
Name and address of licensed contractor_
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
Remarks
peared
Disapproved ____ ___ _ ___ _ Date_
(Signed)
Chairman
Member
Member
Council Approved
APPLICATION FOR BUILDING PERMIT
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
State work to be done and purpose of building (by floors)
Building spector
PLANNINd BOARD__
(Signed). .
f
Date_
.Date Disapproved
///9 , 19
No 3c 2 ._ -- Street / r / O
c c�
My Commission Expires_
DATE
Member
Member
Member
Notary Public, State of Florida
and for no other purpose.
New Building Remodeling Addition Repairs r No. of Stories l ,�
To be constructed of Kind of foundat n Roof Covering - y
4"-e-' Amount Total cost of improvements $ iret< rr�� 7.5-;- Amount of Permit $ 'Y
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. 1 -
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-
1
to me well known,
and whq, 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.
r
Permit No S Date ' o ?� Read, Sworn to and Subscribed before me.
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.
/
peared
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.
Date O ff ¢. 17 , 19
Owner's Name and Address No Street
Registered Architect and /or Engineer
Name and address of licensed contractor C Ay a d -o r d — 7 A/ // G g f .
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 4 a e./__ L . id/
f
State work to be done and purpose of building (by floors) 77 ✓.
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To he constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ 2f40. a 0 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. A P
Remarks (Signed) - 4 Tool' n _ __1! �Q p [' .P y �G G.
STATE OF FLORIDA, ° ' i c
COUNTY OF DADE. 1 ss. tJ
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
i
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 � ' �� ° 0 ` )) Read, Sworn to and Subscribed before me.
� -- -- ---- -. '� � �
Disapproved c __ a _____ `__, Date
(Signed)
Building Inspector My Commission Expires
Notary Public, State of Florida
PLANNING BOARD DATE
Chainnan 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 Planping Board.
re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
ma and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building `- 3
❑ DATE 195'
❑ PERMIT N? 15320 Contractor's
❑ License No
le Work to be performed under this Permit
Architect
Contractor
or Builder
Legal Lot
Description
Address of -e.
''
Building -' ." I i,t k ti 1
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
s'w;p
y
Subdi-
vision
Value of
Project $
Amt. of
Permit $
•
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed BY
•
IN PECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY