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390 NE 101 St (12)
Date 10 Job Address Legal Description Historically Designated: Yes / [ No Owner/Lessee / Tenant John Dorshner Master Permit # 1.366 f Owner's Address 390 N.E. 101 Street Miami Shores Phone 376 -3399 Contracting Co. Quality Roofing Contractor, Inc. Address 13800 N.W. 1st Avenue c 3 if Qualifier Carlos Arocho SS# 751-0382 State # RC 0 0 5 8 6 2 7 Municipal # Competency # 1 7 8 8 9 Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor �.ddress Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Tear off old flat roof to wood deck, tin cap base sheet felt as per code, install galvanized flashing and eave drip metals where required, mop on with type III asphalt one layer of Flintlastic FRP. Square Ft. 1 2 s q . PERMIT APPLICATION FOR MIAMI SHORES VILLAGE ure of owner and/or Condo President OU HE i t` • EZ MY COMMISSION # CC 680474 EXPIRES: October 10. 2001 Notary as to 0 ' er and/ My Commission Expires FEES: PERMIT APPROVED: Zoning Mechanical 390 N.E. 101 Street TaxFolio RADON / 0 0 Date Plumbing C.C.F. Estimated Cost (value) 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 authorize the above -named contractor to do the work stated. Signature of Contractor or Owner- Builder r Owner- Builder Notary as to Con My Commission Expires: NOTARY Electrical $ 3,000.00 o � Date MARYLOU HERNANDEZ MY COMMISSION N CC 680474 EXPIRES: October 10.2001 ... Bonded Thru Notary Public Underwrtters ate BOND TOTAL DUE 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 and street address: 3. Owner(s) name and address: John Dorshner Interest in property: Owner Name and address of fee simple titleholder: N/A 4. Contractor's name and address: Amount of bond $ 00 6. Lender's name and address: Notary Public 1Y\ 1 Print Notary's Name My Commission Expires: 390 N.E. 101 Street Miami Shores, Florida 33138 2. Description of improvement: Reroof Flat roofs of house. 390 N.E. 101 Street Miami Shores, Florida 33138 Quality Roofing Contractor, Inc. 13800 N.W. 1st Avenue Miami, Florida 33168 5. Surety:(Payment bond required by owner from contractor, if an LATE OF FLORIDA; COUNTY OF DADE EREBY CERTIFY that this Is o true co Name and address: N/A ori f' ed in this office on __ /jago�/ � o - 9 ?� WITNESS my h nd and Official S e , 1, HARR , RUN , CLER (, ; Circuit and Coun! y Court iW7W0om assa UJ r P Sig of Owner l Print Owners Name -SA ``- Y\ v� �'c S L A v► or Sworn to and subscribed before me this 9 day of O , 19'1 MARYLOU HERNANDEZ MISSION f CC 680474 EXPIRES: October 10, 2001 t••' Bonded Thru Notary PubBc tlndennrtftar8 98R5 16413 1998 OCT 21 09:30 of the n C. 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: 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 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) Prepared by: Carlos Arocho Quality Roofing Contracto: Address: 1 3800 N.W. 1st Ave. Miami, Florida 3316R 12ao1.52 2/93 Flat Roof Area (ft 1 sc Sloped Roof Area (ft Total (ft') Master Permit No. Exposure category (per ASCE 7 -88): _ (` Building Classification category (per ASC 7 -88 table 1): "I' Contractor's Name: (a �� " Rn - r`5 C n r/ (A-r Iy r Job Address: 3 9 A) , ROOF CATEGORY ij(Low Slope Application) ❑ (Nail -On Tile) ❑ ( Metal Roofs \Wood Shingles & Shakes) ❑ (Other) � / - ROOF TYPE ❑ New Roof l� Re- roofing ❑ Recovering ❑ Repair ❑ Maintenance ❑ (Asphalt/Fiberglass Shingles) )0 Ft. Ft. A 23.0 .78 9/96 Appendix "E" UNIFORM ROOFING PERMIT APPLICATION ROOF HEIGHT AND SYSTEM DETAILS r (Draw details as neede) d.f 0 $`V C,1 L4- c ). I . G r ja ROOF PLAN Deck type: WOO rl 1 !C( ATTACHMENT SPACING DETAIL 1 & 2 Fastener Type: 1 C, /1 . S, - ,Ar� � nc�� Ls II I/ /1 Field:. �. O .0 . Perimeter: 5 O.C. Corner:49 04 . Page -1 r ❑ (Mortar- Adhesive Set Tile) r.+ETRO-DADE `y x PRODUCT CONTROL NOTICE OF ACCEPTANCE GS Roofing Products Company. Inc. 5525 MacAuthur Boulevard, Suite 900 Irving. Texas 75038 Acceptance No.: 97- 0520.01 Revises No. 95- 0502.04 Expires: 06/19/00 Approved: 06/19/97 BUILDING CODE COMMITTEE METROPOLITAN DADE COUNTY, FLORIDA METRO-DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE . METRO.DADE FLAGLER BUILDING 140 WEST FLAGLER STREET. SUITE 1603 MIAMI. FLORIDA 33130.1563 (305) 375.2901 FAX (305) 375.2908 PRODUCT CONTROL DIVISION (305) 375.2902 FAX (305) 372.6339 Your application for Product Approval of: CS Roofing Products Modified Bitumen RoofSystenu• Over Wood Decks under Chapter 8 of the Metropolitan Dade Counry Code governing the use oi Alternate !Materials and Types a1• Construction, and completely described in the plans, specifications and calculations as submined by: Factory Mutual Research Corporation and Underwriters Laboratories. Inc. has been recommended for acceptance by the Building Code Compliance Department to be used in Dade County, Florida under the specific conditions set forth on pages 2 through 31 and the standard conditions set forth on page 32. The 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 for 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. The applicari shall re-evaluate this product or material should any amendments to the South Florida Building Code be enacted affecting this product or material. The Building Code Compliance Office reserves the right to revoke this approval. if it is determined by the Building Code Compliance Office that this product or material fails to meet the requirements of the South Florida Building Code. The expense of such testing will be incurred by at man ac fi r. Raul Rodr'_uez Product Control Supervisor THIS IS THE COVERSHEET. SEE ADDITIONAL PACES FOR SPECIFIC .AND GENERAL CONDITIONS This application for Product Approval has been reviewed by the Metropolitan Dade County Building Code Compliance Department and approved by the Building Code Committee to be used in Dade County, Florida under the conditions sec forth above. C.iar es anger, P.E. Director Building Code Compliance Dept. Metropolitan Dade County e:ne1 mail address: postmaster ©buildingcodeonline.com Homepage: http : / /www.buildingcodconlini;.com ROOFING SYSTEM APPROVAL .A 0011 Can t: CS Roofing Products Company, Inc. (MB) Product Control No.: 97 0520.01 5525 MacArthur Blvd. Suite 900 Approval Date: June 19. 1997 Irving, TX 75038 Cate 2on•: Membrane Roofing System Sub- Cateeorv: Built -up Roofing Tvoe: Modified Bitumen Sub•Tvpe: SBS /APP System Description GS Rooting Products Company, Inc. manufactures and markets nationally a complete line of residential and commercial BUR and modified bitumen products. GS Rooting Products Company, Inc. markets these products through local distribution in the South Florida jurisdiction. GS Roofing products and systems are the result of years of manufacturing experience and product development and have been proven by years of experience in the construction field. GS offers a variety of approved insulated and non - insulated roofing systems. For detailed system constructions, refer to the following publications: "Commercial Roof System Specification Manual". GS products and systems have been tested in compliance with all provisions of the South Florida Building Code as %veil as Underwriters Laboratories, Inc., and Factory Mutual Research Corporation for fire and wind uplift resistance. GS provides technical service and warranty information through regional offices. For the South Florida ��. Metro - Dade area. call 1- 800 - 777 - Contact: Pat Neuhaus Commercial District Manager 2900 Bird St. Charleston Heights, SC 29405 (803) 744-7451 ran • uloaga -Plans Examine Product Control No.: 97.0520.01 Expiration Date: June 19. 2000 uct Control Div. insulation Tvpes • Fibrous glass Per lite Fiberboard Rockwool Polvisocyanurate Polyisocyanurate Composite Board Maximum Design Pressures Material Design Pressure Wood -45.0 psf Maximum Fire Classification Material t/ood Classification Class A Note: Fire classifications and maximum design pressures do not reference all assemblies over deck types. Review system listings for design pressures and'the Underwriters Laboratories Roofing Materials Directory or other approved testing agency listing directory for Fire Classifications. 3 Fran uloaga -Plans Exam' Product Control Flo.: ^7 0$20.01 ct Control Div. Wood Deck System Limitations: A red rosin sheet shati be installed on all wood plank decks to eliminate asphalt seepage d base sheet to wood plank deck. Red rosin sheet may also be installed on plywood decks a san option. of g 2 Pre - assembled 'Cap Nail' shall not be used for base sheet attachment. 3 When All Weather Empire base sheet is installed as the base sheet, a ply she of ASTM D 4601 type II (type G2) must be applied in approved mopping asphalt applied within the EVT range and at a rate of 20-40 lbs./sq prior to installation of membrane. 29 I • uloaga -Plans Examen Product Control No.: 97 020.01 uct Control Div. T GENERAL LI.\lIT,tTIO S . All asphalt shall comply with ASTM D 312, type III or IV requirements and approved by applicant. Fire ratings are determined by a combination of slope. deck type and assembly. Refer to the current Underwriters Laboratories Roofing Materials Directory or other fire testing data listed in the testing file. Fire ratings shall be in strict compliance with Sections 3401.5 and 3401.6 ot'the South Florida Building Code. Maximum slope range varies for each system. Consult the current Underwriters Laboratories Roofing Materials Directory and manufacturer's specifications for compliance with design criteria for each project. An overlay and/or recovery board is required on all applications over closed cell foam insulations ..•:;cr; the base sheet is fully mopped in hot asphalt. 5 All work shall be performed by a contractor licensed to do roofing work in Metro -Dade Count;. Contractor shall be familiar with the details and specifications published by the manufacturer and the requirements of the South Florida Building Code. 6 The submission of system specifications and details shall accompany the Section 11 Building Code Permit. This information is available in the publications listed in the 'System Description' of this Product Control Approval. The submission of these documents, as well as the proper application any installation of all materials shall be the sole responsibility of the contractor. 7 Perimeter and corner areas shall comply with the elevated design pressures of these roof areas, as calculated in compliance with Chapter 23 of the South Florida Building Code. Anchor or bast sheet fastening patterns and/or insulation attachment densities shall be increased in compliance with the provisions set forth in Metro -Dade County Roofing Application Standard PA 117 to meet these elevated design pressures. S All attachment and sizing of perimeter nailers, metal profile and/or flashing termination designs shall conform to Metro -Dade County Roofing Application Standard PA I I I and the wind load requirements of Chapter 23 of the South Florida Building Code. 9 Flashings shall be installed according to the manufacturer's standard details and may be applied in cold application adhesive, approved asphalt or may be applied in conjunction with an approved torch applied modified bitumen membrane. Specific details, approved by the manufacturer, shall be submitted %vied the Section II Permit Application. All details shall comply with the provisions of the South Florida Building Code. 1 0 Fastener spacing for anchor or base sheet attachrticnt is based on a Minimum Characteristic Resistance Force (E) as determined through field testing in compliance with Metro -Dade Counry Protocol P.A. ! 05 or PA 1 05(A). If F', as tested, is less than that listed in the System Limitations, a professional engineer may 'submit revised fastener spacings utilizing F', taken from a Metro -Dade County Protocol PA 105 or PA 105(A) test report, and the provisions set forth in Metro -Dade County Roofing Application Stana_:o PA 117. ! ! Fastener density for insulation anachment is based on a Minimum Characteristic Resistance Force (F') as determined through field testing in compliance with Metro -Dade County Protocol PA 105. If tested, is less than 275 Ibf., insulation attachment shall not be acceptable. 12 Asphalt moppings shall be applied with approved asphalt and shall be in compliance with the equiviscous temperature (EVT) methods of asphalt determination. Asphalt containers or bulk tickets shall indicate an EVT, finished blowing temperature (FBT) and flash point. Asphalt types and temperature ranges shall be in compliance with Subsection 3403.4(A)(3) of the South Florida Budding Code. ! = Insulation may be applied in multiple layers. The first layer shall be attached in compliance with the Product Control Approval guidelines. All other layers shall be adhered in a full mopping 01 asphalt applied within the EVT range and at a rate of 20-40 lbs. /sq., or mechanically attached using the fastening pattern of the top layer. Refer to manufacturer's literature and/or the NRCA Roofing and Waterproofing Manual for correct application procedures of insulation panels in approved asphalt or adhesive, which shall comply with the provisions of M • —i •••••• • .. ?1 pp1+C7tion Standard PA 117. Product Control No.: 97-0520.01. 30 oaga -Plans . rTv -eruct Con:ro! D:. Product Control No 9'1•032n.0 I ' ' All stanaard Insulation panels sizes are acceptable for mechanical attachment When a PP lted In approved asphalt panel size shall be a' . I ' 5 In re Pplic covery a � - t maximum. a pplications, prior to.the application, all existing roof surfaces used as a bonding shall be reseed in compliance with Nieo•o -Dade Counr y Protocol PA . 124 for uplift resistance. V est pressures shall be calculated in compliance with the wind load requirements of the e South ,• Florida Building Code for th e roof in question Bn 16 In re- r000 of Cha 23 t' X r 10 applications, moisture content in an existing roof must be m compliance „vital 7 (m). (n) of the South Florida Building Roof goods shall be stored on end and on a clean, Bat and dry Suus ct u;; 13 If required. any Facto adhesives a Factory Approved Mutual A surface. y be used t vapor barrier in conjunction with proprietary application of the insulation layer. 19 Consult current Underwriters Laboratories Directo or approved assembly to obtain the require fief atone, D' for the a Subsection 3o0 the 3401.6 quire of the South Florida a assembly shall l e in ate coating i t each fia The dasmly l d t in compliance �vi�), Code for or maximum lire classification, 31 ul oa;a•Plans�c� -- uct Control Div. CS Roofing Products Company, Inc. 5535 MacArthur Blvd., Suite 900 Irving, Texas 75033 ACCEPTANCE NO.: 97- 0530.01 _ APPROVED June 19. 1997 EXPIRES: June 19. 2000 NOTICE OF ACCEPTANCE STANDARD CONDITIONS 1 Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and the original submined documentation, including test supporting data, engineering documents, are no older than eight (8) years. Any and all approved products shall be permanently labeled with the manufacturer's name, city, state, and the following statement; "Metro -Dade County Product Control Approved ", or as specifically stated in the 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 anc 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) lithe 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 submined, 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 ofa 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 of this Acceptance as an endorsement o? any product, for sales, advenising or any other purposes. 6 The Notice of Acceptance number preceded by the words Metro -Dade Counry, 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 times. The copies need not be resealed by the engineer. 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 32. END OF THIS ACCE 33 a- Product Control No.: 97.0520.01 Product Control Div. Membrane Type: SBS MODIFIED Deck Type I: Wood, Mon - insulated Deck Description: "/, :" or greater plywood or wood plank decks System Type E: Base sheet mechanically fastened. All Ceneral and System Limitations apply. Base Sheet: Fastening: PIv Sheet: Membrane: Surfacing: One ply of GS Glas Base, GS Flex -I Glas Base. Fle.x•I Glas FR Basc or GS Poly SMS base mechanically fastened as detailed below. Base sheet shall be lapped 4" and fastened with approved roofing nails and tin caps 9" o.c. in the lap and two rows staggered in the center of the sheet 12" o.c. (Optional) One ply of GS Glas Base, GS Flex- l -Glas Base, Flex- I -Glas FR Base, GS PoIySMS or one or more plies of Flintglas Ply Sheet (Type IV) or Flintglas Premium PIv Sheet (Type VI) adhered to the base sheet in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs. /sq.. One ply of Flintlastic GMS, Flintlastic Premium GMS, Flintlastic FR - Flintlastic Premium FR -P, Flintlastic FR -PG or Flintlastic FR Cap adhered to base or ply sheet with approved mopping asphalt applied within the EVT range and at a rate of 20 to 40 lbs. /sq. or Flintlastic GTS torch adhered to base or ply sheet (Optional) Install one of the following: 1. 400 IbJsq. gravel or 300 lb. /sq. slag in a flood coat of approved mopping asphalt at an application rate of 60 lb. /sq.. 2. Karnak 97 or APOC 212 Fibrated Aluminum at an application rate of I % gal. /sq.. Maximum Design Pressure: -45 psf Maximum Fire Classification: Class 'A'; see General Limitation 42. Ma_cimum Slope: I:12: see General Limitation r3. Specification No.: GMS 2 -3, FRP 2 -3, GTS 2 -3, FRBC 2-3 27 Product Control No.: 97-0520.01 .4 Frank Zuloaga•Plans Examiner, Prop uct Control Div. xOQF1NG SYSTEMS (TGFU)-- Conh'nued • . :ec,nn2: One layer 'FlintWade GTA (.3/6 sq or •1 sq), Gi5' (modified iheat fused or "Flintlastic G!4 . hot mopped. _ :racin5: APOC 'No. 212 Fibratrid'Aluminum•, at 1•1/2 gal. 100 sq /ft. r :c Incline's 3/4 •re. poi Retarder (optional): Type G2 "Glasbasc bore . shoct or lit :t :c ;iilee vapor retarder, Insulation (Optional): One or more layers or combination of the fo towing: U t:ragard i'rernier, potylsocyanurate, perlite. ;Ors Ober or •,:re fiber insulation. _asa Sheet One layet.of Type G2 "Glasbase" base sheet. - larnbnma: One layer of'Fiintlastic STA (modified bitumen), heat fused. •:r ;3cin2: Karnak 'No. 97 Iibrated Aluminum. at 1 -3/2 Qat, per 100 : -:5/32 lndine: 1/2 :ion ( Optiona1): Schuller International "UltraGard Premier. .ciyisocyanurate. wood fiberboard. perlite, fiberglass. Isocyanurate, any Sheet.: One or more plies of "Glasbase - , hot mopped or mechanically • •%ercbrana: One ply or'Flintlastic FR" (modified bitumen), hot mopped in • Indies: 1/2 • Ins utation: Polytsocyanurate, glass fiber, perlite, wood fibs, hot mopped mechanically fastened, any thickness. • Sheet: Type G2, mechanically fastened or hot mopped. • •rune: "Flintlastic GTA or STA ", heat fused. ,.rinsing: henry Co. "Henry 520 Aluminum', applied et 1 -1/2 gaVsq. . - ::C. Iodine: 1/4 t :ale ^era (0ptfonal):•Glass.Ober, perlite or wood fiber board. '.: Snovt: Type G2. mechanically fastened. •• • :fins ;nz: 'Flinc aunt STA', 1,1A ", 'GTA Black Diamond' or 'GTA White heat fused. ...: acing: Karnak Che:nial Corp. "Karnak No. 97'. 1 gal/sq. triclinia 1 IRS:1(3 Pot)isocyanurate. glass Aber, perlite, wood fiber, mechanically stoned or adhered with hot roofing sphalt any thickness. :so Sheet: Type G2, mechanically fastened or adhered with hot roofing . ^'al•- •^er::brane: CMS', 'CMS Premium', adhered with hot roofing :: paint ....::facing: Karnak Chemical Corp, "Kemal No. 97 Fiibrated Aluminum ;halt Roof Coating', 2 -1/2 gal /sq. :•: C• 15/32• letting: 1 • .t Joints blocked with 2x4'5. non: Glass fiber, perlite. 3/4 in. min, joints in insulation must be at 6 i :a. from joints ir, deck, mechanically fastened. ?s _ Sheet Type G2, mechanically fastened or adhered with hot roofing :•iembrane: "Flintlastic GMS ", adhered with hot roofing asphalt, :...;:facing: Karnak Chemical Corp. "Karnak No. 97 fibrated Aluminum , s;.:hatt Roof Coating', 2-1/2 gaVsq. ::C Incline: 1/2 :sutadon: Polyisocyanurate, glass fiber, partite, wood fiber, mechanically :s tared or adhered with hot rooting asphalt, any thickness. gra.se 51) :tic Type G2, mechanically fastened or adhered with hot roofing ;nail. •., ...'an2: " Flntlastic STA", 'GTA', `GTA Black Diamond' or 'GTA White heat fused in place, K arnak Chemical Corp. 'Karnak No. 97 Fibrated Aluminum •.; ::a: Roof Coating ", 3 gal/sq. incline: l (0ptionall'elftglass:fiiles olyurethane, isocyanurate, : :h:r.otic combination isocyanuratz /perUte, pa fIrethane /pct' . orood any thickness. hoc mopped or nailed. :•z: ,thane: "Flintlastic STA', "GTA', "CEA Blade Diamond', "Flintlastic GTA Diamond', 'GMS', 'GMS -5M', "GAS Double Coverage' or 'CMS ' :amium', heat fused or hot mopped in place. _rracin3; Grundy Industries, Inc.. "al 146 Alulninurn Roof Coating' at 1r2 • v C•15/32 lading 1/4 .sula;ion (optional): Any thickness polyieo: glass fiber or :e :fate, rnetnanically fastened, joints in insulation must be offset 6 in. joints in deck. -:r Sheet Type G2 base /ply sheet, mechanically fastened' or hot '.; Sheet: Type G2 baud %ply shoat, mechanically fastened or hot ;:sets ^�n :'Font aurae SSA', 'TR Vihfte Diamond' or `GTA Black Diamond'. : : Grundy's "al M8 Aluminum Roof Coating' at 1 to 2 gaVsq. :: Incliner 1/2 :rule ion (Optional): Polyisocyanuratt, glisa fiber, perlite, wood fiber, co: binatioi, any thickness, mechanically fastened. . • LOOK FOR MARK ON PRODUCT ROOFING SYSTEN.S (TGFU)— Conpnucd '�a Base Sheet: Type G2, "Flex as FR' or •flintLIstic FR Oast', mecharricz"i hsterred or adhered with hot roofing asphalt. Membrane: 'Flintlastic FR•P - , 'Flintlastic Premium FIl• "Flintlastic- FR /PG' or - Flintlastic FR,Cap ", adhered with hot roofi asphalt . :r .12; Dock 6.15/32' Inisrne: 1/2 ' - tr 'AU joints in deck btOc'ied •vith 2z4's. • r1 Insulation (Optional): P•alylsocyanurate, glass fiber, pertite., combination. any thickness mechanically Fastened. ik easa Street- Type G -Z. mectanically fastened or adhered with hyt t asphalt. • Mernbrane:'Elintlastic Fa -P", • Flintlastic Premium FR- r.or'Flintfa ' FR/lG "r adhered with hot roofing asphalt 4:5 eek. \�NC in line: 1/2 *u 1nsuTation •(Optione(); E'S. any thickness. covered with 1/2.in .� - perlite or wood fiber. rarer hanically fastener! • ;,.•S Base Shee Type G2. met hanically fastened or adhered with honed p asphalt. ."1 Membrane: Flintlastic Fl•P•, 'Flintlastic Premium FR -r or'Rin FR /PG', adhered with hoc roofing asphalt. 14. Deck: NC Incline: a/2 ' :•; , _ insulation:. Polyisocyaraurate, . glass fiber. perlite. wood -fibs combinaton. any thickne s.•mechanically feztened. •• ;;. • Base Sheet: Type G2 or 'Flex- t•gla; , adhered •with:hot Ply Shee - Poly SMS Base Sheet ". adhered with •hot roofing :•ip Membrane: 'CMS'. adhered with hot roofing asphalt ,: - Surfacing: Karnak Chrmical Corp. "Karnak No. 97' Fibrated -.A Asphalt Roof Coating" at 2 -1/2 galjsq. ra 15. Decic NC lnctiac 1/4 i.,?• Insulation (Optional; : Polyisocyanurate, glass fiber, periite/wo any combination. any thickness, mechanically fastened or adtie • hot'roofing.asplra1 _ - :fir Base Sheet Type G2 or• "F;ex- i•glas', mechanically fa.terred'orpr11 with hot roofing asp Lair- lnct tic 1/2 • '•.1" Insulation (Optional): Polyisocyinurate perlite.' glass J1 fiber, any thidote.is, mechanically listened or hot ino pedtij Base Sheet: One or more layers of Type 02 or'Ftex- i -glas\ fastened or hoe mopped in place. •:•og Ply Sheet (Optional): One or'more layers or Types 61, 62 :or mechanically f istened or hot mopped in place • '• •v'• Li Membrane: "Finttastic GTA', 'GTA Blade Diamond', 'GTA W or 'STA', heat fused. ; +'• ;; Surfacing: Karnak Chemical Co. "No. 91', applied at;T 1 18. beat NC ' incline: 1/4 • .s.. v Insulation (Optional): Pcrtite, glass fiber, mechanicaUy.i„ mopped in pace, 2 In. max thidrne :. • • • .•.. vW' I. as Sheet One or more Layers of Type G2 "Flex- i-glar• iis --- . _maenad or not mopped in pLice. rlhi Ply ShZt O nalne or layers of Types G1, CL' a" �,� ; or `Poly She. Base Sheet', n chaniacally. fastened or tiot'iriop a ' Membrane: 'GTA Black Diamond', 'GTA WhTt8•Dfam••• -,i�� heat fused . ' . • . • • ,, .. ojT ' + t iq �, rti ry Surfacing: APOC No. 212 Aluminum ):Latins, •applie� � .. rr :`s , � a ► _ 19. Deck C -35/:2 Incline: VI '�:v;.= T,sl$Vvit'ill at: lnsulatiott: Glass fiber or perlite. min 1 in. thick meth• , or hot mapped in place. G .r .a t�� i 3nti Q�i �v `2asc She ;t; Typo G2, ''1ex - I - Gras' or•flex- I•Glas FR Qasc ;'.. :T's . fustenad or hot mopped in place. : • r.! r• 'r'e: Membrane: "Flinl'lastic FR -P', - Flied stic Premium FR;P;• '` ;•. .; FR/PG ", lot mopped in place . , • a� d 4 . 2 0. Occ� NC . ,. - Lallans 2 .•. - . ;y ",it '''' 'y�+ Insulation (Optional): Pertite y lass fiber, of uieth �3tir•� phenolic, c ombination isocya.wrate /periite, potyureth ∎�'=' if''•• fiber, a ry. thickness. mechanically hrtened or hot mdae ".N1'4,i j;S r. Base StreeFlex -I -Gras FR Base', Type G2 or "Flex -l•GL r e4s ;f Rk. , e'. fasten t: ' ed or hot mopped in pLice. ; a •.7.... h. P 1 r151r :,t : Ply Sheet (Optional): Type G2 or'flex- i- glos', mechanically adhered with hot ro;fing asphalt Membrane: "Flintla: tic CMS', 'G115 Premium', adhered witit`ho asphalt. • •r, Surfacing: Asphalt Products Oil Corp. 'APOC -400 Sunbrite -,13 q 16. Otck: C -15/32 Incline: 3/4 Insulation: Glass fiber, perlite, 1 in. min. joints in irtstai(io offset 6 in. from j lints in deck, mechanically fastened.. 46 Base Sheet Type 62 or'Rex- 1•glas`,.mecharric fastened with -hot roofing ; sphatt : / ;,rj' Ply Sheet (Optroriat): Type G2 or "Floc -i- glass. mechanically: adhered 'with hot roofing asphalt Membrane: 'Flin'.lastic CMS'. 'CMS Premium', adhered witliiho asphalt. ' Surfacing: Asplr:rtt Products Oil Corp. 'APOC -400 Sunbritenj'• 7. Clack NC • • liemLr •Frt•r' I . In>uh or hot Base Memb Oec:C. lnsul• comb: m u;t Base rr Base oofi .ith Bay ' s Mrn Ccc1: 1(151 fast 8as aura 9' :Pt r f lc rtti q` 9 xr Ca Date Legal Description PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 42 -Job Address - 3 qO 14 E I ©/ - 57 4 -Tax Folio 1/ o l0�3' 6 4 7mqpr.,/ Owner / Lessee / Tenant �-� Cq IA 1 d 14 S C- (44 I "' Master Permit # 3. 9./y a TLf t a_ o_t. `... 04 0 0 c ,____ Owner's Address Sa PIA-st.-, Phone Phone Contracting Co. m�c ...7 Address 5 `? 6--5:•-- Qualifier Signature of owner and/ Date: 7W9/9',, APPROVED: SS# State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILD ING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION / c/- _ 1 - t ( Square Ft. Estimated Cost(value) 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 authorize th7above -na stated. Signature of Contractor or Owner- Builder Date: 4 14 4 . 2 — jrint type or stamp name of Notary Public to as to Owner andideV8iiii2P "fa ) efl` C ed LJ. Notary as to Contractor or Owner- Builder y Commission Expires: Type and number o pro My Commission Expires: Dll) rake n oath, or ** * * * 114 -DII) NOT take * oath. * * * * * * * * ** FEES: PERMITS/ RADON C.C.F. . 5 NOTARY S D4 TOTAL DUE . 3., e 9 Fire Zoning Buildi Mechanical Plumbing_ Phone Other Electrical Engineering • inuous Rain Cutlers Rain Control Systems Proposal We hereby submit specifications and estimates for: 6 inch aluminum continuous gutter 6,1/ -t- 1 - -r • A/oly- &d u( GUARANTEE: 5 Year Labor 8723 SW. 129th Terrace / Miams Florida 33176 / (305) 251 -1279 / Fax (305) 251 -3877 1 jr- � 0 ` 0 7SY- y4 L4 -Gl 7 -23 -92 /07PY / 0 Year Material Installation Date: We hereby propose to furnish labor and materials - complete in accordance with the above specifications, for the sum of: lbtal $414 '7( �- � D epos i tl � .22,/ Ck_of 32-39 Authorized Signature Date7 c $ 'ent Signature TERMS ON THE REVERSE SIDE A PART OF THIS ioROPOSAL. Balance $ 7 G('. 4{3 PHONE 376- 3399 -n -Mr DATE ilnrs -hri r NAME Mrs. Kathleen Martin JOB NAME 376 - 3663 -O -Mrs. Martin STREET 390 N.E. 101 Street STREET CITY Miami Shores, Florida 33138 QTY SATE STATE • inuous Rain Cutlers Rain Control Systems Proposal We hereby submit specifications and estimates for: 6 inch aluminum continuous gutter 6,1/ -t- 1 - -r • A/oly- &d u( GUARANTEE: 5 Year Labor 8723 SW. 129th Terrace / Miams Florida 33176 / (305) 251 -1279 / Fax (305) 251 -3877 1 jr- � 0 ` 0 7SY- y4 L4 -Gl 7 -23 -92 /07PY / 0 Year Material Installation Date: We hereby propose to furnish labor and materials - complete in accordance with the above specifications, for the sum of: lbtal $414 '7( �- � D epos i tl � .22,/ Ck_of 32-39 Authorized Signature Date7 c $ 'ent Signature TERMS ON THE REVERSE SIDE A PART OF THIS ioROPOSAL. Balance $ 7 G('. 4{3 Owner's Name and Address APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of one 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 Miarn( 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. Registered Architect and /or Engitneer..•.. .,,, :• •••...•••.,.• , l.f.11.I.• Name and address of licensed contractor _........ ».. _._...._... Location and legal description of lot to be built on: Q Q ��y, Lot /' f Block 3 / A Subdivisionm d.., �!sk� � ..A�!!'! . » »_ e / e a e e /3 S o7Z 7 Street and Number where work is to be done State work to be done and purpose of building (by floors) »....._.. »_..._ .__ and for no other / purpose. New Bui!ding Remodeling Addition Repairs No..9f \ Stories To be constructed of Kind of fo foundation Roof Covering , \\.0 a- , t� I Estimated e Total cost of improvements $ 7 1 atlin, Amount of Permit S. ia) 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 s ecifications for said building. All notices with reference to the building and its construction may • be sent to.. . >e- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of Libur under the Florida \‘'orkinen's Compensation Act. being Section 5966. Compiled General Laws of Florida, Perin;tnerit Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hint in the work to be performed under this permit; and will post or cause to be posted for inspection on the she of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such bcontractors, on work to be performed under this Remarks _ (Signed)a %,...„,,,,..,,,Sina pcnnit, as are licensed by Miami Shores Village. 9 STATE OF FLORIDA, COUNTY OF DADE. (Signed) SS. Building Inspector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT CC �/e23 .... C Street__ _ _.. ».._ Bcfore 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.. ».s- 4JU.r? 7 Date r./ Read orn to td Subsc Disapproved »..:� .� Date ary Public Public49111 0 1 11194 1e o l lorida My Commission ExiserCess tissia f ug!r 2 oa 119Y Pain • 1n3u,uryco,l —�� PLANNING BOARD ded 1hn! DATE f Cirair.nan Member _ MIcrr,bcr 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 fmm tle Planning Board. A rc•inspec•tion fce of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anti /or workmanship. to me well known, MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby utndc for the approval of the detailed statement or ere plans and specifications herewith submitted for the build in or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the iuilding Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. ,1g Ov.-ncr's Name and Address ... °1 'i� .0 € .�. .. k .... No.. . 0 .._... Street JQF ®J.. . Registered Architect and /or Engineer e- 41 r c L I Li 17 Te■ 0 C i I - / Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 3 f® / State work to be done . urpose of building (by floors)./ i$.2 e...1 +s / - •— � - ,. _ - .G.,_ and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimate Total cost of improvements $ e 0 © Amount of Permit $.. /K1_Q.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 The undersigned applicant for this building permit does hereby crrtify that he understands and accepts his obligations as an employer of labor under the Florida workmen's Compensation Act, being Section 5066, 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 subc6 tractors, on work to be performed under this pcnnit, as are licensed by Miami Shores Village. R emarks (Signed)- • r - - 2-- -- "-" Name and address of licensed contractor STATE OF FLOIUDA, COUNTY OF DADE. j ss. Disapproved � : , Date (Signed) Building Inspector S peared Notary Public, State of Florida My Commission Expires 9c2(0 Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- 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 fads therein by him stated are true. Permit No.._. 1D Date te � . .... Read, Sworn to and Subscribed before me. 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 niter approval has been obtained from the PLrnnir.;; Board. A rc- 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. APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement or 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 nil 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 ..... . .. i.... (...�!1.. 1..L??.6 1- '.1 1 ......._. ..._ ._ No._3..2.0....._. Street--0. _(. eLl Registered Architect and /or Engineer t,::. .,.•••...•:,,,t1IST[rwM Name and address of licensed contractor .... fi..l*. . 'iv _ T 0 29-2---. s ,Y 0_G..1 .r:/. u?..( Location and legal description of lot to be built on: Lot Block Subdivision »_......._ Streetand Number where work' is to be done _ •. __ .... ».._.._....._.._ r » ._ ._.... State work to be done and purpose of buildjng (by floors)...__ r 1 .: ' / I � 6 ° L_ d r .._» ea A&"e. Q i•) L- q CP " MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT ° ... .and for no other purpose. Ncw Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering.... U t v 4 _ Estimated Total cost of improvements $.. °.c C . "0 P Amount of Permit $.. t vV 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 crrtify that he understands and accepts his obligations as an employer of i.,bur under the Florida Workmen's Compensation Act, being Section 5 Compiled General Laws of Florida, Prominent 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 oldie work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sube9ntractors, on work to be performed under this pcnnit, as are licensed by Miami Shores Village. Remarks (Signed)-- ......_ Permit No.. • °? Disapproved �.:.�.�(' Date (Signed) geared Date / 1'.Gk/ Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commiuion Expires . ov P STATE OF FLORIDA, COUNTY OF DADE. s= ' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- 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. 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.in.pec•tion fee of 51.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials anti /or workmanship. 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_ Owner's Name and Address._ -- _ -• /__/_ -__ -- - _ -- No. 9 - treet. Registered Architect and /or Engineer Name and address of licensed contractor_ Location and legal description of lot to be built on: Lot Block - Subdivision V Street and Number where work is to be done State work to be done and purpose of building (by floors)._ Disapproved ���� %,� ,,- (Signed) � - - -- 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 a 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 i' pection on the pe .f the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such su. .ntra.f9rs, on or to be perfo ell under this permit, as are licensed by Miami Shores Village. Remarks (Signed) . - '_ -- - • --_ - -- --- -� _ Read, Sworn to and Subscribed before me. Notary Public, State of Florida P,e° ,197 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 Building Inspector /' My Commission Expires PL .'r' ING 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. Application is herebymade 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 9pSal._al...l�n ,19 Owner's Name and Address.... ,1,__. 1,ghtma n Jr., No 390 Street r' . E. 101 St. , Registered Architect and /or Engineer Name and address of licensed contractor MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Lana. Roofing & Tile Company 9- Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 39 N. E. 101 St., Miami Shores, Fla. State work to be done and purpose of building (by floors) 12 squ x'e .= 4 ° piy._a.apha1t .. .aric ' built un roof, and for no other purpose. New Building Remodeling Addition X Repairs No. of Stories To be constructed of Kind of foundation Roof Covering L — ply built — U10 Estimated Total cost of im rovements 00 m 00 r A 00 p $..._ 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, Pennanent 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. LAP'0 iZC =' IIT% °c .Z CO' "r' ^ h' n'C Remarks (Signed) ` _ o STATE OF FLORIDA, I ss Kirlw i n F. Evernpam, Vice President. COUNTY OF DADE. 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. D Permit No Date � Read, Sworn to and Subscribed before me. Disapproved j � Date (Signed) A „,,,-,,-- - _ Building Inspector i My Commission Expires Miami Shores, Fla, Notary Public, State of Florida Inc„. 430 N4 'd, 79th St.., Miami Fla, to me well known, PLA1\iNING 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.