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ROOFINGGEOTECHNICAL ENVIRONMENTAL HYDROGEOLOGY ASBESTOS Miami, May 21, 1996 Mr. Jorge Acebo ACEBO ROOFING 4305 E. 10th Lane Hialeah, FL 33013 Re : Permit No.: 39422 Marinello Residence at 600 N.E. 101 Street Miami Shores, FL Dear Mr. Acebo : dJ %iii_+ rw-,1. IIIIiiiW `iPUMM \ 1.11,MANIt Iiiiit4IIl DYNATECH ENGINEERING CORP. In accordance with your authorization, DYNATECH ENGINEERING CORP. , has performed and uplift test in compliance with protocol PA -106 and the South Florida Building Code on May 20, 1996 at the above referenced project. Dynatech Engineering Corp., is a Certified Dade County Testing Agency. The purpose of our inspection was to determine the uplift capacity of the existing roof tiles for the two story residence at the above referenced project. The subject roof consisted of a Flat Cement roof tiles foam set. On May 20, 1996 our field engineer visited the site and conducted Ninety Eight uplift tests on the roof tiles. All tests were performed according to the South Florida Building Code Section 3404.3 and protocol PA 106 -95. The following is a summary of results : - Field Test Results are : TEST NO. TEST LOCATION 1F See Attached Diagram 2F See Attached Diagram 3F See Attached Diagram 4F See Attached Diagram FIELD UPLIFT PULL TEST Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS TESTING LABORATORIES DRILLING SERVICES INSPECTION SERVICES ROOFING 750 West 84 Street, Hialeah, FL 33014 -3618 • Phone (305) 828 -7499 • Fax (305) 828 -9598 Page No. 2 600 N.E. 101 Street 5F See Attached Diagram 6F See Attached Diagram 7F See Attached Diagram 8F See Attached Diagram 9F See Attached Diagram 1OF See Attached Diagram 11F See Attached Diagram 12F See Attached Diagram 13F See Attached Diagram 14F See Attached Diagram 15F See Attached Diagram 16F See Attached Diagram 17F See Attached Diagram 18F See Attached Diagram 19F See Attached Diagram 20F See Attached Diagram 21F See Attached Diagram 22F See Attached Diagram 23F See Attached Diagram 24F See Attached Diagram 25F See Attached Diagram 26F See Attached Diagram 27F See Attached Diagram 28F See Attached Diagram 29F See Attached Diagram 30F See Attached Diagram 31F See Attached Diagram 32F See Attached Diagram 33F See Attached Diagram 34F See Attached Diagram 35F See Attached Diagram 36F See Attached Diagram 37F See Attached Diagram 38F See Attached Diagram 39F See Attached Diagram 40F See Attached Diagram 41F See Attached Diagram 42F See Attached Diagram 43F See Attached Diagram 44F See Attached Diagram 45F See Attached Diagram 46F See Attached Diagram 47F See Attached Diagram 48F See Attached Diagram 49F See Attached Diagram 50F See Attached Diagram 51F See Attached Diagram 52F See Attached Diagram 53F See Attached Diagram Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Page No. 3 600 N.E. 101 Street 54F See Attached Diagram 55F See Attached Diagram 56F See Attached Diagram 57F See Attached Diagram 58F See Attached Diagram 59F See Attached Diagram 60F See Attached Diagram 61F See Attached Diagram 62F See Attached Diagram 63F See Attached Diagram 64F See Attached Diagram 65P See Attached Diagram 66P See Attached Diagram 67P See Attached Diagram 68P See Attached Diagram 69P See Attached Diagram 70P See Attached Diagram 71P See Attached Diagram 72P See Attached Diagram 73P See Attached Diagram 74P See Attached Diagram 75P See Attached Diagram 76P See Attached Diagram 77C See Attached Diagram 78C See Attached Diagram 79C See Attached Diagram 80C See Attached Diagram 81C See Attached Diagram 82C See Attached Diagram 83C See Attached Diagram 84C See Attached Diagram 85C See Attached Diagram 86C See Attached Diagram 87C See Attached Diagram 88C See Attached Diagram 89C See Attached Diagram 90C See Attached Diagram 91C See Attached Diagram 92C See Attached Diagram 93C See Attached Diagram 94C See Attached Diagram 95C See Attached Diagram 96C See Attached Diagram 97C See Attached Diagram 98F See Attached Diagram Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Greater Than 40 LBS Page No. 4 600 N.E. 101 Street Test results were found in compliance with the South Florida Building Code and Protocol PA- 106 -95. Pursuant to section 7.3.2. of PA 106 -95 a copy of this report shall be forwarded to the building official for his final roof top inspection. The test results are limited to the tested areas. If other roof areas exhibit different conditions, it should be brought to our attention for remedial work. This uplift test is not a roof top inspection. A final roof top inspection must be conducted by the building official for approval. The test results presented reflect the condition of the roof system at the time of the test. These results are time and sample dependent since roof conditions are continously changing due to exposure to the elements. It has been a pleasure working with you and look forward to do so in the near future. Sincerely yours, - /5s Wissam Naamani, P. E. DYNATECH ENGINEERING CORP. Engineer Florida Reg. No. 39584 Special Inspector No. 757 WN /sd cg ______J 1 t 1 -E. • 101 vv a -r St s. u 11. 33 2. T T• al! s• 11 it 2 `1 5 9 -se 211 is 2 EL .1y vs 9Y 4• i• 7\ 8 s N ti c. 0 N LL aj f 2 9 9t .1 1 T1 iV Dynat Client: — • ao.c.YLJ -t1►,s 'lofts QasfA■S. imaivais ltfy- 44M re1 ech Engineering Corp. Awed Ro011iG, ca. Project: Cao N•G ►01 STeE 4t An11 S tZS, cu.44011, Scale: N.T.S. ✓ Date: 5 2096 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address Atig w/ Legal Description 2or /# 2 /°J /a'c- /0 3 Owner / Lessee / Tenant /6c.,11 Owner's Address Ale /0/ 5/ Phone 7-r-4- 7f3 Contracting Co./) ,6Fi)&i ,- 490e''. Qualifier vAs4I'S )5.49/4/50,044/ Phone 757 - 2( /L State AV -01394 Municipal #0.04040a0,4rif Competency # Ins.Co. oA/N/e, /541,2 Architect /Engineer /YIP Address Bonding Company 14" Address Mortgagor 1//4' Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION re,4-4 or F.�ge. Thoc ii l -3o No/ / -Qo ,r Spey uthr -14. rh /7A iQi Square Ft. 174r1) TA/CT 1-3 ,?f ( 1 b) H' 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 .bove -na con = tor to do the work stated. o ary as to Owner and/ My Commission Expires: * * * FEES: PERMIT ** * APPROVED: t 049 RADON C.C.F. Fire Tax Folio /1- '2Z - 0/7 -.Z ( Address 73.-'1 A)LJ A/14.4, �. Estimated Cost(value) /.7 5 gnature of Contractor or Owner- Builder • Master Permit # to Contract Owner- Builder My Commission Expires: Notary Public State of Florida My Commission Expires Feb. 18, 1993 * * * * * * * / ** NOTARY TOTAL DUE d �� Other 17-f - )o f ”/ Zoning Building Electrical Mechanical Plumbing Engineering RMIT # Tax Folio No. /1- 3 .oG - -do %o ate of Florida unty of Dade E UNDERSIGNED hereby gives notice that improvement will be made to certain real operty, and in accordance with Chapter 713, Florida Statutes, the following formation is provided in this Notice of Commencement. Description of property: (legal description of the property, and street address if available) 4 r / ~L floc,/ /03 Seto x 'OE sr General description of improvement: jet OFF EKeS7 /0 ro/tfAIG /" 5la a rce c. wia.4 e ei /ooh ,4-Al2) /f"oD/ /Ed 6.J Owner information: a. Name and. Address: b. Interest in property: /26)1 c. Name and address of fee simple titleholder(if other than owner): Contractor: (name and address) / W6 7 - i A //W/ 6 Surety: a. Name and Address b. Amount of bond$ Lender: (nan)e and address) tary Public aa 1�,4)146 .t2E JO/ - Persons with the State of FloridaK'd,esignated by. Owner upon . whom notices or other documents may be ser ed as provided by Section 713.13(1)(a)7., Florida Statutes: (name and address) f In addition to himself, Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date Its specified) Qur t G41 4 -k &- .t A --1=,, 4-' 42-Q DAe - E 1� 1 ki oc 1 � J OFFICIAL ��� Si _ L e A 33oZ1 SEAL 9 gna e of - er orn to and subscr - dLIP�B)� app this o rl_f -day of L(le -41L L_FA- , 199 10 , STATE OF F!_07N t),a CClh;'Y 1 H; •• ( ii' ;°. ':i,'s iS trt copy j� OP_ oi 0.7 . ` -' i• f J :1':c 071_!/ 7 c ' CG �� - - -- r A. 0. 19— W. di: 7., ! c [; s i. Cy NOTICE OF COMMENCEMENT 7 1 1 ,^) - 2-21 c✓ My Commission Expires: 92R475293 1992 DEC 07 13:43 S/4'1G.e E. APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement ur one plans and specifications herewith submitted for the build inc 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 .......11.1. . / 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.... .t _ Pe" /04 State ork to be done and purpose of building (by floors) Disapproved ; Q /` . ra c Date (Signed) MIAMI SHORES VILLAGE Building Inspector BUILDING INSPECTION DEPARTMENT e moults _ Date......_ s� .._._..._.__._..._.__..._.... ,19. .... Street_... t!i. 11•••1,1•!1 ItllTt!lt111•!• 1111 ti,1, t!Y!!tt ,,may 6 i a.3 r k .. `1- 7" ..! :5... M e CZA New Building Remodeling Addition To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Repairs and for no other purpose. No. of Stories Amount of Permit 5,.. Zone cubage required _Plan Cubage Distance .to next newest 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 suc subcontra rs, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared__._ .__...._... - .................. --- to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true.. Permit No.._ Date.. ` ) Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chair:nan Member Member Member Member .. .. _.....__....._..._._ ...._....... Member — Council Approved Date Disapproved Date NOTE: A charge of 51.00 will be made for making corrections or changes to this application after approval has been obtained from the 1'I.,nnir.g llu.rrd. A rc••in ctiun 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. Street and Number where work is to be done Disapproved (Signed) 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. Owner's Name and Address ......... r�Rv?r P ........ Registered Architect and /or Engineer t � Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision ".,`)"‘fi - . l. _ . _ wilding Inspe6tor 1111.. 1 .__._ _ 1111.__ . 1111 , 19: =._ _. No 11 11... Street—a. tO. �, a ,., ...1.111,...,..,... 111,1, --. Stato.. 'ork to be done and purpose of building (by floors). el 0 ` t • ` AX r,� " 3 ,i = 5 acswL \. and for no other purpose. New Building Remodeling Addition V Repairs No. of Stories To be constructed of Kind of foundation Roof Covering dl •)' Estimated Total cost of improvements $ '�.Q. &: J Amount of Permit S. 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 wqrk to be performed under this pennit, as are licensed by Miami Shores Village. \ / �• Remarks (Signed) A \� 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 _ - -_ —•- Notary Public, State of Florida My Commission Expires 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.__.._ r'' Date Read, Sworn to and Subscribed before me. i" PLANNING BOARD DATE Chairinan Member Member Member Member 1111.. 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. r 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 iuilding Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date...—...–... —_...L /. 7 .._...__ ...._._... 19" Owner's Name and Address L9 ..._.__ ._. No. .... o.9 . stre�F � / i T Registered Architect and /or Engineer . ,< ............. ..K.. „,.,,,_ -, ... Name and address of licensed contractor 4.�� vil{..l' �t !tip- - iOZ.IVO..2i . t 1fi Location and legal description of lot to be built on: Lot Block Subdivision ` Street and Number where work is to be done 601 ._ E ... lo . i. _ GT • State work to be done and purpose of building (by floors) «E'g '13',47 M E — .1 x . ; . . 1 - / . . . . 1 - 1 0 — agitotL:....L_.Y_5, a - ls.. and for no other purpose. New Building Remodeling Addition Repairs No. of Stories / _ To be constructed of Kind of foundation Roof Covering. uu /N�f T/LE d- CK''VFL 1/ Estimated Total cost of improvements $ 34 (7 G, GO Amount of Permit $. r 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 suc } ubcontract s, on work to be performed u r der this pernit, as are licensed by Miami Shores Village. Remarks.__ (Signed). –/ STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. .__/ Date `e” Read, Sworn to and Subscribed before me. Disapproved _ De (Signed) Notary Public, State of Florida �� B uilding Inspector � `° .. My Commission Expires /PLANNING BOARD DATE Chairman Member Member Member Member .. ... _..__._..._.._ _...__..__.. Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re-inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. • Application is hereby made for the approya1 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 Registered Architect and /or Engineer Name and address of licensed contractor APPUICA1I1'N FEHR BUILDING PERMIT Location and legal description of lot to be built on: Lot Block Subdivision — Street and Number where work is to be done...C _ r. .._ _ __. ..._.. .1_.. . Stat ork to be done and p rpose of building (by floors) ,nom 0, 2 i 4 r -7 and for no other purpose. New Building Remodeling Addition Repairs X No. of Stories To be constructed of Kind of foundation Roof Covering__ / - =U Estimated Total cost of improvements $ 7 . e 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 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 , Remarks.••_ ..... .__.:. STATE OF FLORIDA, I 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.__J_ (S Date ! � � 1/ Read, Sworn to and Subscribed before me. Disapproved (Signed) ((C-- -C- MIAMI SHD ES VILLAGE PLA BUILDING INSPECTION DEPARTMENT Date. Building Inspector Date �_l — _--- - • - - -- ,19._._. . No. .4i Z Street/. /V./ .! Ob _e r4 s Chainnan Member Member .. _.. Council Approved Date _ex- 144'1 a1-.? 42 c 3 `� ..42./.492/Z/ (Signed). NING BOARD DATE l to me well known, Notary Public, State of Florida My Commission Expires Member Member Member 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. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Lot Description Address of i { Building MIAMI SHORES VILLAGE. ❑ PERMIT 0 Bl N? 2708 FLORIDA DATE Contractor's License No. Work to be performed under this Permit Subdi- vision Value of Project $ 1 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 cr in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Amount of Permit $ 195 Signed. BY INSPECTOR 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY tl 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. Owner's Name and Address.. Disapproved Date ( Signed) Registered Architect and /or Engineer Name and address of licensed contractor ate.. Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) ' Date and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering -t' t w a Estimated Total cost of improvements $--- - - /..- - - O Amount of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared // , ( lam No. - I iv Notary Public, State of Florida ( < "- ' L . 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 kr) Read, Sworn to and Subscribed before me. Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Appro • Date Disapproved Date NOTE: charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planni Board. A r nspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materi and /or workmanship.