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468 NE 100 St (10)Dat Legal Description 1 4 2_ e Vz Owner's Address ij-hR H /00S1; 10/1¢g/S/v'ES, f",43,3/38 Phone 9' Contracting Co. !)it / VE RDOF/N3 R / M . Address /634 4 7 O E N. 8.,G33/r7 Qualifier tcTa 060 SS# - Phone 9 ?��9 9 1 9 State 4 L0-74 7/ Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one) : BUILDING ELECTRICAL PLUMBING MECHANICAL L )kc HAANICAL rOOFIN / j W ING FENCE SIGN WORK DESCRIPTION P 1LT UP Iroo P 4"D d � __ // C r`& tzL `1"l S O a- bf f ro o -�' 1 -1-ca0 co 0 etc psea . .0 Estimated Cost(value) eV,X.15 AD Square Ft. ** * APPROVED: 9 Job Address 468 NE iota- Tax Folio /32 0 o/ /D 3 4o SCI Lessee / Tenant ` /TR/C //5 J )I G� SS Master Permit # C7ZS (4y * Notary as t. Owner an My Commission Expires PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 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 construction and zoning. Furthermore, I author'ze the above -named contractor to do the work stated , , D(_ o - ; 7 7 4 • WI T Signature of owner and /oondo President Date: Zoning RADON Mechanical Plumbing_ Signature 6f tractor r Owner- Builder Date: VERONA L. BUDWAH Notary as to Con oP 0Whee m8a ldit My Commission Ex r - ,• bonded mN Notary Public Under Miters * * ** rev PI/ /177, C.C.F. 1 I ' "v NOTARY TOTAL DUE OL Fire Buildin Other Electrical Engineering NOTICE OF COMMENCEMENT PERMIT NO. TAX FOLIO NO. A // e V 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. l6 (r /L/e /oD S- 1. Legal description of properly end etteet address: 2. Description of improvement: 3. Owner(s) name and address: Pr, 1 12.1c.... ; , r1 ess - 7gfi 0 4 f - //97121_ Story s, 12. 33/3 Interest in property: WE-Roo,/4)q rcE ii///29 / ccAores, L 33/ Name and address of fee simple titleholder: 4cP %tTE /0 o fa/pi ` 0a-?s, FL 39/ 3f 4. Contractor's name and address: ON/ t? OE P ODr //y g 19304 ,qC f1'U a mf, i L 331? 5. Surety:(Payment bond required by owner from contr Name and address: Amount of bond $ 6. Lender's name and address: by Section 713.13(1)(a)7., F orida Statutes, Name and address: t.C.L q F ; , c /J26 es /t/E /00 U ,` j ,'rni SAPres, ).3/ er i 'Nino; file 's I W !AY m No tices or oth: /flee on G '7cloy of nd Qf %Iciai Snot. ,r• ' , CLER of circuit unfy Courh 7. Persons within the State of Florida designated by Ow Notary Public Print Notary's Name My Commission Expir P Al ic:.,0 A 5!' Signature of Owner A Print Owners Name Sworn to and subscribed before me this 17 day of r - e / , 19 G VERONA L. BUDWAH COMMISSION-if-CC-32997 EXPIRES: November 14, 1997 find 1l ru NOmry'Pubti . !Jr rmiter o 94R 085280 STATE OF FLORIDA, COUNTY OF DADE r documents ma 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) 19 FEB 22 11 :35 as provided Prepared by: W o -ri Q 4 t ry Address: 8 3 ti-cf- /Y r 4 "V LJ IM IAYvtI -L 3/'y9 METRO CTD. co C. iantlproldocenteiro2 OCT-13-93 WED 9:41 Met r c-+ Poo f' T 1 1 e 09/2.8/93 18:20 11'305 078 2008 Metro Roof .7Yle Corporation has filed acceptable test data to support the request for 1 _Zooef. tt2gx�zlaem • CODE COMPLIANCE 305 < 2608 METROPOLITAN DADE COUNTY, FLORIDA METPO-DADE FLAGLEN BUILDING RUILDING CODE COMPLIANCE DEPARTMENT SUITE 1803 METRO -DADE FLAGLER DUILDING 140 WEST FLOUR STREET MIAMI, F't,ORIDA 33130.1563 June 1 � 1,9Y3 Revised September 28, 1 993 M ROOMMOSIMMINOMMO AlSpNCFIPN with this office the additional acrd required renewed and continued use of their c'enlent Flctj 7'he tile shall be installed on a solid nailable roof deck of 5/8" thick plywood for all new construction or to 1/2" plywood deck on re- roofing. The prepared deck shall consist plan underlaylnenf (anchor sheet) conforming to No, 30 Type 11 (AST I! D -226) and tin capped 6" o. c. on all laps, 12" o. c, in the field and 4 " on drip edge over this, a hot - mopp 90 # ASTMD -249 granular surface cap sheet by Tamko, or equal is applied The tile shall be apt lied with a 2" head lap to the roof with the mortar consisting of Rinker Roof Tile Cetnent mixed with sand conforming to ASTA1 C-144 for a 3 :1 mix. The tiles shall be wet and set using; Qnnrnxin:ately ono All trn iinl; of �n ►�i .�. Due to Hurricane Andrew, this office has been inundated with requests for both new products and renewals of those to expire which has caused a large back log in responding with an official Notice ofAcceptance. In the interim period please accept letter in allowing these products to be installed by a licensed roofing contractor in accordance with the manufacturer's further specifications and Chapter 34 of the South Florida Building Code until an official Notice ofAcceptance is issued. tro x.12 PJ 1 G 3S Sincerel 11 Diamond, P.E.. Product Control Division Supervisor Post-It *M L,rand fax transmittal memo 76"71 I a 01 From (l� m � u Co 'y s, P. 01 I • F. 01 "MC tiff.) JA.H Metro Roof Tile, Inc. 11350 N.H. South River Drive. Medley, P1,a 33170, Your application for Product Approval of CementlitILDIRLILLIM. under Sections 203 and 204 of the South Florida Building Code govern the use of Alternate Materials and Types of Construction, and comple • described in the plan, specifications and calculations as submittcici ►i-u° lLitc.J1.uskisiu tz_t_ _LEL _Lti nu wl._t1L tea _ rep_o_t1:_silit,.eiLfieulamizar 1.0 hni been accepted by Product Control to be used in the Uninaorporstca areas of bade County under the Specific Condition set forth on pago 2 -2a and the Standard Conditions on Page 3 ACCEPTANCE No.o APPROVSU EXPIRES OCT -13 -93 WED 9:42 y ur _ 1 lM' .___9U- Jp05,,L . NaY 12. 1991_____ 19 9 3 * *pL n NQT e• TIl I S I5 1i sbOIE.Sli ' ., . SLR . ADDITICRION . BcSM1 t]F 1 Ul f S_Atil7 APP LS NcILWIL ( UIMICA T'hig application for Product Approval has been accepted by the Metropolitan Dade County Board of Rules and Appeals to:be used in tR Incorporated and Unincorporated areas of Dade. County under the cond set forth above. APPROVED '.__U G.3O triP MEMO-DADE CI?tt DUILUINA & ZONINU DErANINi s M t110-0At)E CtNit 111 N.W. rI11st Alii .' stilt S% MIAMI, ri.on 332'- (305) 375 -26:! amon , P.R. roduot Control Supei:viso Metropolitan Uede County Huildiny & Zoning Uepart!nl, tontee . ao P.R. Deputy Secretary Metropolitan bade County Board of Rules and Appeals P.02 5. QuilialltCgtial- , •„ .0. The permittee ahall retain the services of a an independent tent laboratory to maintain quality control. Testing shall be perfotcs on a minimum of five (5) tiles. Tile shall be selected by ASTM D-3665. Selection shall be made periodically from domestic till The tile shall be tested for strength according to Section 3404 , the South Florida Building Code and for moisture absorption according to ASTM C-4. The test reports shall identify the tiler a description of the tile as well as the Notice of Acceptance number. Test reports shall be transmitted to the Dade County Product Control Section every ninety (90) days. If no tout repw aro received within a one hundred twenty (120) day period, the Notice of Acceptance will be considered as being abandoned and t. approval will be cancelled without.noticeto the permittee. Reinstatement will require a new application and full fee. 6. This§ renewal supersedes Notice of Acceptance 187-0901.1 dated October 19, 1987. . ,* • L. • , tlatx.0-Rosa,..1,11a, Lac. 'ACCUTANCE NP,4 4. Each tile shall be identified by the markings OCT-13-93 WE'D 9 :42 macDEAccumcsi_urancautimm • 72e1 ""' G3S APPROVED EXPIRES ere-0,11 G[1 D amond, P.E. Product control Supervisor Metropolitan Dade County Building & Zoning Department 1 --liQu_24_19.11) # --N0Y. 19, 1913 METRO ROOF Tag * i • • P . 0 3 1 M 1. This approv ©s fiat cement tile as conforming to Section 3404,L the fouth, Florid► Building Code, Z. The tile shall be installed in conformance with Sections 3404. the South Florida Building Code. • i 3. The file shall conform to the foliowingt , .1 OCT -13 -93 WED 9:43 G39 114 JR141 4•4 Product Control 'pervisor - metropolitan Dade County -2- Building & zoning ['apartment 1. P.04 NAMLABLE DECKS (WOOD) • 516 TAM -cuss PREMIUM (Regions 1, 3, & 3) TAMKO FIBERG1 ASS PLY SHEET ASPHA INTERPLY MOPP1r GS SURFACE • COAT Material RoOuMemenrts TAMI{O TYPE a3 Coem�d Bnee Sheet or Y>»1Sp►=I;ASE, Base Sheet TAMKOTAM•GIstiS, PItEM1L7M or _ __ , _._ TAM -PLY IV Flltergless Pty Sheet Plies hltE,pw Aaphatt (Per 100 aq. 13) APPro7t 691bet. Sw'6ue fart - ( – T i er - 10 - 11Z — q. ft) (1) Meted Aluntimum Coating 1.1/2 to 2 gels. (2) Emulsion Costing (3) Asphalt Surface• C (Pet 20� _ 20 25 ibs. R) Amen.. lUt) Neils over Positive drainage ttp to 8 in. per tuwrar ft. For atones shove 1 M. per linear ft., faaaening M the roofing felts is re, aired (see Bunion 9.0). Dect, The deck should conform to T'AMKO gent al requirements (sea Section 4* A phalt The asphalt should be certified by the manufacturer to nom; ASTM 0-312. Type 11 for slopes up to 1/2 in. and rope 1.11 for elopes up to 1 in. (see Section 11.0). TYPE 43 Counted Flaw Sheet or V1:1tSA•RASE Base SbeeN String at the low • point of the roof. install 1 ph' of TAMKO TY('E 43 Coated Race Sfuet or VERSA. RASE, side ispp!>t12 M. and eyed lapped 4 In App(Y at a right augle to tie slope of the root Nis] the sheet. along the lop at intervals of no more than 9 tn. Strq Reviled on 18 in. centers, along 2 hues located 12 in from each edge of the baae al sett (see Sec- non 10.0). Fiberglass Ply Sheetat Over the base ply, install 3 plies of TAMKO TAM-GLASS PREMIUM or TAM. PLY IV Fiberglass Pt Sheet at specification as; halL Starting from the low point of the roof, apply a 12 in. width. then a 24 is width. a xi follow with fun 36 in. widths, Shingle, fashion. lapping each ply 24.3/4 in. in such a n inner so that at least 3 pli of ply sheet cover the base ply' aa. point. Anproxit tatty In tbs. (:1S%) of Speeijctton matt per 100 sq. It should hr, used to embed -adi ply flee Section 8.0). Surface Coat: Coat the entire roof surface with FTberrd Atuminrun Roo(Coating at it rate of 1 -1/2 to 2 gals. per 100 sq, ft., or Emulsion Roof Coating at a ram M not less than 3 gals. per 100 sq. ft, or a surface grade hot asphalt using a min'uttum of 20 lbs. and a maxnuiwa of 25 lbs. per 100 sq. ft. Maintenance 01 the surface renting i4 rewired. (tier Sections 12.0. 11,0 and 31.0.) I1as1ih 'fire flashing malaise Most be a TAMKO polwacter reinfon:ed modified asphalt flashing material (see Section 3140). • I V.L Cleat A Requirements: Combustible deck minimum 1./r plywood. tongue•tnd.t)roove dccln, etc.; mad- mum slope 1 -1/2'. Insulatlon: uone. &rrtadrigi emulsion coating aniy. Contact TAMKO for a list of accepted coadngs or for tbrther inform,* on on other U.L systsroa 616 TAM -PLY IV (ReOione 1, 2. 8 3) TAMKO TYPE 43 COATED BASE SHEET—NAILED \,Y -14 -93 FRI 17:37 417 624 2935 IJ 1 HL 1-'. P.04 Application is hereby made for the approval of the detailed statement in the plans and specifications herewith submitted for the build • ine 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 S6.e.11,r Lei:ni:cke. Registered Architect and /or Engineer ,,,,, ,,,,,,,,,,, ,,,,,,,,,,,,,,,,,, Name and address of licensed contractor Andrews RQQf i.ng„ &Imp...Co 43110....E...,.11.th nue,.. Elaa:Leah,...F..]._._..__ Location and legs` description of lot to be uilt on: �" r� y Lot. / o�"lY j a - � Block g Subdivision �t... MS.aeC[&.__ ,l/ / / 7 47i.'6 STATE OF FLORIDA, 1 . COUNTY OF DADE. i ss. Disapproved (Signed) APPLICATION FOR BUILDING PERMIT Building Inspector Chairman \icrr,ber MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Datei.Q.44.438. Date..._..Qctetaer .11 .. _ No...._.4.6 ._...... street._...11L..1II0th..S.treet Street and Number where work is to be done 468. ..1V...E._..1- 0IItki-- Str -eet 444a4134•• 5 es -, - W- — ••-- -- State work-to done and Purpose of building (by floors RE -ROQF �MAL,L..FL,�.r...G ,•(�•_ (y,, i _. su. tncapped, _#15 fiberglass fe mopped and vx s.quayes an d'to n oh pure 117 D nix• Remodeling Addition Repairs XXXX No. of Stories 1 — New Building To be constructed of Kind of foundation Roof Covering 6T.IQ //✓4 L Estimated Total cost of improvements $ 8.QII...OII Amount of Permit $... 0' 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.. ...CharJ:es...14,ndrews:.,... Andrews 43,4o- f.i_ng.. &- ..linp...Co 43Q,a ..E.:.. 11:0_ Ave ....Elial e a h.,. *. Fl The undersigned applicnnt for this building pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the 'Florida Workmen's Compensation Act, being Section 5966. Compiled General Laws of Florida, Permanent Supplement, anti has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em toyed 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, o - ' ' is pennit, as are licensed by Miami Shores Village. Re (Signed) Remarks (Si ned /a 5 Read, Sworn to and Subscribed before me. .Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared �har..l.es... 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. 7 �.' JS/ Notary Public, State of Florida My Commission Expires _........_ _ to me well known, PLANNING BOARD DATE 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 PI.innir.;; Board. A rc- iu >pt•ction fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby mode for the approval of the detailed statement ur ine 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 thc. 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 trot. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address ... R0.4•e-r - f lJ.A.rS9tF1... Registered Architect and /or Engineer.... F.. /.or .idG I Name and address of licensed contractor...XL. Sie ✓sr ......... Date.:�L�A.r.L� t._._�..._.__......... , ig..7Q _. Street..r;T.r._. /,0.Q ,SA ,1.? . $ s ' 0.-12.-f• Lam... , Q 13 9 - Location and legal description of lot to be built on: Lot Block Subdivision _ . Street and Number where work is to be done .S f �e e f State work to be done and purpose of building (by floors) ... ..... R.O.i;2 ci l /7 w ...isdda l t. ! New Building Remodeling Addition f Repairs No. of Stories • To be constructed of Kind of foundation Roof Covering Fiat ...... T i-R_ oc� Estimate Total cost of improvements $....� CJ co-, Amount of Permit L.J (r0 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 labur 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 hips in tkc work • to be performed under this permit; and will post or cause to be posted for inspection • the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such ntracto . •rk to performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed STATE OF FLORIDA, COUNTY OF DADE. Bcfore me, the undersigned authority. a SS. and for no other purpose. 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. g‘1,6 Date Read, Sworn to and Subscribed before me. Disapproved Date ( Signed) Building nspcctor Notary Public, State of Florida MyCommiuion Expires _ ............._...� _.� PLANNING BOARD DATE Chairman Member Micrr1ber 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 Inns been obtained from the PI.:nnir.;; Board. A re-inspection fce of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anti /or workmanship. 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. p Date...— ' 7r ' ...... ,19..�. Owner's Name and Address ....... /'�/ ...t� � / & ._. No.. y. . N Street —iV : O D ST Registered Architect and /or Engineer / ,, .., •. ,. Name and address of licensed contractor al «! _f/ 'rl�l..dl/ ........ 7 O U Location and legal description of lot to be built on: Lot Block A e u t p division ??IITT �...._. Street and Number where work is to be done.........9. � e / ®6) / ,�� T State woe o be done and purpos of building (by floors) ./ I22 41_6 A� / 15?. _..._r19_L. . . .12,49 t0 • a 4 s+ 4 and for no other purpose. New Building Remodeling Addition Repairs ' No. of Stories To be constructed of �ifity C Kind of foundation Roof Covering c � oa Estimated Total cost of improvements $ ./ ■0 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 ite of t, ork such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcpntractors, o rk t' . performed under this pennit, as are licensed by Miami Shores Village. Remarks MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT (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 sta ed are true. No.__ __r Date I _. R ad, Sworn to and Subscribed before me. Disapproved ///} / (l ate.. Notary Public, State of Florida (Signed) Building Inspector My •mmission Expires PLANNIii BOARD \ ... DATE Chairman Member \icrnbcr Member Member .._. _..___..._._ .__.__...__ Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has hecn obtained from the Planning Board. A re-inspection fee of 11.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT � , L , DvN ,'iNe-.- Registered Architect and /or Engineer Name and address of licensed contractor CAfrifl TIt /OOFI p,'6r CQ t / • - 301 NW State work to be done and purpose of building (by floors) Permit No Date ! ____ Read, Sworn to and Subscribed before me. Disapproved ( Signed) rr/ r Building I �.ector LANNING BOARD DATE 5 T, /`IIAn1 Date A Pic 1 J ., 1920. No �,6 9 b Street N t / 97 Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done _gee NE �t / 00 Sr, � �E - i a -F 3$ 11 and for no other purpose. New Building Remodeling Addition Repairs V No. of Stories L To be constructed of Kind of foundation Roof Covering 5f1 �,"FLE 7/ 1 E Estimated Total cost of improvements $ 2 0, , 7' d ' Amount of Permit $ 7. 00 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 bcontractorss,. work . be performed und is 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 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 e. —7P Notary Public, State of Florida My Commission Expires 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.