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134 NE 102 StApplicant: CHRISTOPHER Owner: BELLOWS JOB ADDRESS: 134 1 rz Contractor WATERTITE GUTTER CO INC 1 Local Phone: 954- 563 -2207 Parcel # 1132060131880 Miami Shores Village 10050 NE 2nd Avenue Printed: 1 /17/2003 This Permit is granted to the contra( ordinances pertaining thereto and with and approved by the proper municipal authorization. A further condition upor ordinances and regulations pertaining by his agents, servants or employees. g C . Signed: In consideration of the issuance to r with the plans, drawings, statements myself, my agent, servants or employ S igned: E NE 102 PAY TO THE ORDER OF FOR Bankof merica. P LA v' ACH R/T 063100277 Building Permit Phone: 305 - 795 -2204 Permit Number: BP2003 -76 BELLOWS CHRISTOPHER ST Contractor's Address: 211 NE 32 CT Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 - 70 LOTS 10 & 11 Fees: FEE2003 -301 FEE2003 -302 FEE2003 -303 Description Building Permit Application Fee Notary Fee CCF Total Fees: Amount $60.00 $5.00 $0.60 $65.60 Total Fees: $65.60 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 7/16/2003 Construction Value: $612.00 Work: 6" GUTTER & 3X4 DOWNSPOUT WHITE ALUMINUM Page 1 of 1 If there is no permit packaae_accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be , 3, rn bnnoed document. See buck Lo, dcrn;,,.��.y WATERTITE GUTTER CO. 211 N.E. 32ND CT. OAKLAND PARK, FL 33334 100 L 9 c I',». 1_n r, % Lnn a 7 71_ DATE nnn n an avn c ,t• .fl ©3 BLK 14 19506 63- 27/631 FL 808 i s 60 DOLLARS 8 `: 11 .. CHRISTOPHER NOEL BELLOWS 134 NE 102 ,ST MIAMCPRS: il.:-33t383-2325 11.1 CV u 4 400 44",..4t4 MK11.44 .1130413,■.145 04-01-59 M 5-11 A .03-O3-1993 8420-114-59-121-0 -01-1999 CLASS: E SAFE DRiyEi 9o0oo FLORIDA The Sunshine State 1 01/16/2003 08:52 9545639940 k I: PE , , Y I V OTvK i Ze_ Fox- R 005 P ✓1 i ffP ((G4 ((4\) • • Y WATERTITE GUTTER COM • g o „ J )1/k.-41.AAki, PAGE 01 01-- V PROPOSAL SUBMITTED TO: 7 Q 5 N PHON 3 7g 7_ 77 3 5 DATE: / // 03 .1.. in NAME: t:- JOB NA STREET: ` r hO t f 4- ra I STREET: 1 7 y • . 1 AI ' C. / / 2. Sr; C 1 TY a-' Cl: CITY: Ni r ' STATE: s STATE: 3 Home Office 211 N.E. 32nd Court Ft. Lauderdale, FL 33334 I �J C , 1p ,,pn^ it WATTOTE LD -'EN CO. Established 1984 i. 6" & 7" Seamless Aluminum Gutters • PROPOSAL, 3 751- 37,K Broward: (954)463 -2207 Dade: (305) 654-1140 Palm Bch.: (561) 241 -6737 Fax: (954) 563 -9940 CC M 84-3883 MMX fr Co t e hereby submit specificaV9ns and estimates for: F . ' .$ �� f d13 1 1 i' �. 6 # r tt-' I pr ia.a40 J is D� Oa. `1 ® Downspout 3rj L INSTALLER COMPLETED PD SB We hereby propose to furnish labor and materials — complete in accordance with the above specifications, for he sum of: W �'C Sera rl s • Authorized Signature dollars ( $ 4 -)l, 124-1°1-‘ f3 Signature • t 7;li AP / j Date Signature AAA ) with payment to belts follows: 3 de irifr/S tialif Two ear guarantee on labor, Twenty Y 9 years on Material. All material is guaranteed to be as specified. A work to be completed in a workmanlike manner a •• •'ng to standard practices. Any alteration or deviation from the above specification involving extra costs, will be executed only upon written orde b the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. T r ;j. •� • ���� ' and is void thereafter at the option of the undersigned. extra charge over and tance within days ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. • ACCEPTED: CONTRACTOR New Construction Name L 1? L4 ; � - 6 ,„4„.}.„ . co. ii.„ L License No. 95- R s 0 O p s i Home Telephone 30 J 7 S y 3 70 r Address oZ 1 ( 0 r E 32, c Frq.. P R 3 3.33 `( Telephonef�(yJ 5-63. ).a.0 7 Fax L p rQyO Qualifier Name C Oj /) / �C W 6l(�C Y• 19.0,4e."," PROPERTY R OWNER New Construction J Name l ,1 Slo pkg._ Nis (low s Address 13y 0,E, 101 S - N1i Si 0itfs 3 31 3' Home Telephone 30 J 7 S y 3 70 r Business Teleph s 7 g Q_ 773 S'_ / Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Job Address: Folio Number Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. t. ShaaLs R. • 33132 City State n- Zip // ` 4P.A. 4 3. eI ���` na Description of Work l� � ^'^ Block LA)L14- AIUMt/4 j 3 1- 1 W.E.lolsi Address Lot Subdivision Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PB PG sfP/A Apt. ARCHITECT Name License No. Address Telephone Fax Zoning Sc}ua a Feet Value of Work PERMIT APPLICATION Master Permit No. ? Subsidiary Permit No. Linear Feet r Units Floors / p % r2 e I Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ENGINEER Name License No. Address Telephone Fax Page 2 1NIPOR'I'AN'I' NO'T'I DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance i Section 7,13.'}5 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing . .ntractor. X \\ Signature Print Name Sworn to and subscribed before me this Sighature of Notary Public - State of Florida 9002 '91. JegwenoN sandx3 el 40 94009 uotsslwwo3 dyy ; ,043.98 vg ela6uv ue Personally known OR, Produced Identification Type of Identification Produced: - 4 ?,1 t1 D )) SEAL: l � PERMIT APPLICATION ST t tl F FLOC. IDA, COUNTY OF MIAMI -DADE SEAL: Personally known Signature of Contractor / Qualifier Pri S om to and subscribed before me this . day of gnature of rY b is ta t- of I. •da * so Py Angela M Becker ? ` • My Commission DD150048 1„" mor 0. Expires November 15, 2006 OR, Produced Identification pe of Identification Produced: t � ST v r\S ' S ,1 6 a ELECTRICAL Tvl'P: Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair Q'I'1'. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL 'I'YI'I? Minimum Fee Q'I'Y. T1'I'E Condensate Drain QTY. Tyi'E Generator QT y. 'fVI'E Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING . A/C Condensate QTY . \ Drains, Roof QTR Tvp1,, Miscellaneous Fixture Q.I.V . Soakage Pit Q . I . Y . Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning Electrical Mechanical Plumbing Fire Public Works Structural � / Building Official 1/4 7. -.3 Page 4 OFFICE USE ONLY CHECKLIST U OWNER - BUILDER FORM (Attach) LI FIRE DEPARTMENT APPROVAL (Commercial / multi - family) U CONCURRENCY (New Construction) U OTHER (Specify & Attach) PERMIT FEES $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review JCv $ (-Q.d 9 O ) $ (¢.005 / sq.ft.) LI PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ S :) (¢.01 /sq.ft.) (sq.ft. = x/I000 x ¢.60) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ ( ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Test Location Uplift Pull Test (P or F) Test Location Uplift Pull Test (P or F) Test Location Uplift Pull Test (P or F) Test Location Uplift Pull Test (P or F) 1 r is. l; D r4 X E.D 1 e- D 2 26 • 51 1 l 77 3 28 53 • 78 4 29 54 79 5. 30 55 80 6 31 56 81 7 32 57 82 8 33 58 83 9 34 59 84 10 35 F 60 85 11 36 'lFQ. 55 ,T...D 61 86 12 37 62 87 13 38 63 88. 14 39 64 89 15 40 65 . 90 16 41 66 91 17 42 67 92 18 43 68 93 19 44 69 94 20 45 70 95 21 46 71 96 22 47 72 97 23 48 73 98 24 49 74 99 25 50 75 100 THIS REPORT SUBMITTED BY: _,. 12lh.Cr P.E. Civil Engineer: Lab Certification 1' 98-0E08.04 . State of FL Certificate Authorization # 4100 U.S. SOUTH Engineering & Testing Lab., Inc. 6065 N.W. 167th Street, Suite B -23 • Miami, Florida 33015 Telephone: (305) 558 -2588 • Fax: (305) 362 -4669 ON -SITE CONCENTRATED UPLIFT LOAD TESTING OF ROOF TILE IN FULL ACCORDANCE WITH METRO -DADE BUILDING CODE COMPLIANCE PROTOCOL PA 106 Project N2 000731 SITE SPECIFIC INFORMATION Owner's Name: (AMA e, to vJ 5 Permit #• 414 $ Job Address' 13 t.1 - le�'t- ST. M cd.wt SNoQES _ Fl. Roofing Contractor: QVt-i tiTy r--00 co c 10.1 �p Zeo�e(L Type of Tile S'1 J t , S 1 " t OI U. s �T Date Installed I� I��Qt ��tr�(6Ttp Approximate Roof Height_l_i_feet Roof Pitch 't Type of Access to Roof: Scaffolds ✓ Ladder Other Approximate Square Footage of Roof: - 2:2. 0 0 ft Required Testing Force: 35 lbs. Testing Equipment: Chatillion 100 Date Tested: • 1 •O TEST RESULTS P = PASS, F = FAIL IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL PA 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST. a ent e 7 t Q o \A , 111! z f ►° uuil 10111111WAMIN INPANIVAMONErea .Y. ; 1IIIIUIL MEM rer ■� tor : . beam , ► `13 z ► NOTES' $ KETCH OF ROOF JOB l 34 t0 , S40 ,gE`i SHEET NO OF CONTRACTOR b< < i y R 0 0 I l ti) Q CHECKED BY SCALE DATE Owner/Lessee / Tenant Q*Ifie. Carlos Arocho State# RC0058627 Municipal# PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 11 Date 6 -13 -00 Job Address 134 N.E. 102 Street Tax Folio Legal Description Historically Designated: Yes No Chris Bellows Ownec'sAddress 134 N.E. 102 Street Miami Shores Phone 754 -3705 Contracting Co. Quality Roofing Contractor, Tnc_ Address 13800 N.W. 1st Avenue Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Tear off old roof to wood deck, tin cap 301b. ASTM felt,install galvanized eave drip and valley metals where required, mop on with type III asphalt one layer of 901b. ASTM felt, installSpan,shS('lay Srrkf•°_ colorthru tile with polytoam adhesive setting. Square Ft. 22 s q_ T. Estimated Cost (value) $ 9 5 no 00 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 . ork will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are equ ` • for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. AVI : I ; rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable ning. Furthermore, I authorize the above -named contractor to do the work stated. or Condo President Date •l•• • - ' • -I 4 1. - Notary as to 0 ' and/o My Commission Expires: •` �: M #C C 680474 a EXPIRES: October 10, 2001 Bonded Thni Notary Public Und :rwrfters ,r. •yr• APPROVED: Zoning Building Mechanical Master Permit # SS# Phone 751-0382 Competency # 17889 470'(9 Ins. Co. Signature of Contractor or Owner - Builder Notary as to Con ctor or Owner- Builder My Commission Expires: Electrical MARYLOU HERNANDF.Z .•, MY COMMIWIO "I 1) CC 6C0474 41 EXPIRES: Oc ot:Sr 10. ',':O01 w ` Bonded Thnr Notary Pk Unoernittera FEES: PERMIT /.32 RADON C.C.F. 6 NOTARY - — BOND 36 o - TOTAL DUE Date 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: 008437638 2000 SEP 11 10:43 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: 134 N.E. 102 Street Miami Shores, Florida 33138 2. Description of improvement: Reroof to a new t le roof . 3. Owner(s) name and address: Chris Bellows Interest in property: Owner Name and address of fee simple titleholder: N/A 4. Contractor's name and address: Quality Roofing Contractor, Inc. 5. Surety:(Payment bond required by owner from contractor, if any) Name and address: N /A Amount of bond $ 0 0 6. Lender's name and address: N /A 134 N.E. 102 Street Miami Shores, Florida 33138 13800 N.W. 1st Avenue Miami, Florida 33168 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 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 addres N/A 9. Exp' ti date bf h' Noti of Cqptmencement: (the expiration date is 1 year from the date of recording unless a l differ nt da a is spii, • ied) . --/ — J Signature of Owner l I Sworn to and subscribed before me ti S g9 8ay of si , 1-B-2000 Notary Public Print Notary's Name My Commission Expires: 8TATV f51,®RIOA, COUNT OF DADE I HERta l, ofw'r'N= � that thin �s o i�u c yr N inn • wir • nal hl.0 in ,wVui MAR ny_ 0/ ,AD2 t o je! Moro/ deal, 44 of Chew and County COUM Ir/ / i D.C. Prepared by:Carlos Arocho Quality Roofing Contractor Address: Miami, 13800 N.W. 1st Avenue Florida 33168 129.01.52 10/90 . Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. Contractor's Name:Qt al } �rxiT he krac.4 Job Address: 13 Li k' 1 o 2 ee ROOF CATEGORY ❑ (Low Slope Application) ❑ (Nail -On Tile) (Mortar dhesive Set Tile ❑ (Asphalt/Fiberglass Shingles) ❑ ( Metal Roofs \Wood Shingles & Shakes) ❑ (Other) ,� ROOF TYPE ❑ New Roof M Re- roofing ❑ Recoverin g P ❑ Repair ❑ Maintenance Flat Roof Area (ft Sloped Roof Area (ft ZZ S , Total (ft Master Permit No. Exposure category (per ASCE 7 -88): G Building Classification category (per AS E 7 -88 table 1): Ft. Ft. A V eck type: ATTACHMENT Fastener Type: SPACI1,G Field: Perimeter: Corner: 123.01.78 Nee DETAIL 1 & 2 ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed) Page -1 ROOF PLAN k--^ 251 - Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. Rid a Ventilation? MEAN HEIGHT Deck type: SLOPED SYSTEM DESCRIPTION nderlaytuent: Insulation: o lb, S1 N\ Il' 1 12" ROOF SLOP, D E T A I L S Fastener type & spacing: Cap Sheet: Roof Covering: Drip edge: e40e. Me-l '/ O . ( . 141.5 ( "®, c . C O'n er.S /a "o.c. Feid q &rte fcfr& ATTACHMENTS REQUIRED 1) Fire Directory Listing Page 2) Miami -Dade County Product Control Notice of Acceptance -Cover Sheet a) Specific System Description b) Specific System Limitation c) General Limitations d) Applicable Detail Drawings 3) Municipal Permit Application 4) Other Component Approvals TILE CALCULATIONS fr e (Pmax1: x X. (Aerodynamic MultipIier):11.9 t) - M L L C I D = M O) .S I PCA: (,1 90 ,31 (Pmax2: f 3 x X (Aerodynamic Multiplier):31 -IS ) - M L i qQ = M PCA: ! 1 - (Pmax3:) D? ) x (Aerodynamic Multiplier): `•.,. ) - M %o0 = M r3 : a .7, PCA: (S ( .°LO APPENDIX "F" REQUIRED OWNERS NOTIFICATION FOR ROOFItNG CONSIDERATIONS -As it pertains to this Appendix "F ", it is the responsibility of the rooting contractor to provide the owner with the required roofing permit, to provide the owner with this appendix and to explain to the owner the content of this form. The provisions of Chapter 34 of the South Florida Building Code (SFBC) govern nll the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items sho• Id be addressed as part of the agreement between the owner and the contractor. The owner's initial in the F^.d i . nt box indicates that the item has been explained. 1. Aesthetics-Workmanship: The workninnship provisions of Chapter 34 are for the purpose of providing thnt the roofing system meets the wind resistance and water intrusion performance standards. Aesthetics (appearance) issues nre not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the a g g reement between the owner and the contractor. 2. Rcn,iiling \Vood Decks: When replacing roofing. the existing wood roof deck may have to be renai!ed in accordance with the current provisions of Chapter 29 of the SFBC. (The roof deck is usually concealed prior to e . , moving the existing roof system) S 3. Common Roofs.: Common roofs are those which have no visible , ble dehneatton between neighboring units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and /or er should notify the occupants of adjacent units of roofing work to be performed. w 4. Exposed ceilings: Exposed, open beans ceilings are where the underside of the roof decking, can be . viewed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail penetrations of the underside of the decking may not be acceptable. The SFBC provides the option of maintainin`, Ali i f5ppearance. ( S. Ponding Winter: The current roof system and /or deck of the building may not drain well and may cause water to pond (accumulate) in low-lying 'areas of the roof. Ponding can be an indication of structural distress and may require the review of a profess'ionnl structural engineer. Ponding may shorten the life expectancy and performance of the new roofing system. Ponding conditions may not be evident until the original j A system is removed. Ponding conditions should be corrected. 6. Overflow Scuppers (wall outlets): It is required that rainwater flow off so that the roof is no: overloaded from n build up of water. Perimeter /edge walls or other roof extensions may block this discharge i` overflow scuppers (wall outlets) arc not provided. It may be necessary to install overflow scuppers in accordance with Chapter 23 of the SFBC. 7. Ventilation: tvlost roof structures should have some ability to vent natural airflow throe It the in:erio: of the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. I: may be benefFinl to consider additional venting, which can result in extending the service life of the roar. lay contact the Miami-Dade County Consumer Services Department for further the above. Arc is Signature Date Contractor's Signature Post -Its Fax Nola rir1ot 4 . Ei le 7671 oaV - . ;rem CO.. • Finds 11• ...■• •. Pax 1 • .- .•.. .• -• �..�. .�.r.�. ....1•.. PRODUCT OQ` NOTICE OF ACCEPTANCE Sancafd TIIe Corporation L3drillera SAnrafc Bogota, Colombia \'uur application fur Product Approval of: iTROPOLITAN DADE COUNTY. FLORIDA METRO -DADS FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO.OADE 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 Santt;fJ Tile Corporation, AtaildOn or .lfortar/.•td /:uha Set Clay "Smile S" Raofing Tile under Chapter S of the Metropolitan Dade County Code governing the use of Alternate Materials and Types of Construction, and completely described in tht plans, specifications and calculations as submitted by; Redland recbholvgler, The Center fel Applied Engineering, Inc. and re swell Craig Labore:aria dC Corrsulranu, Inc. has been recommended for acceptance by the Building Code Compliance Department to be used In Dade County, Fleitida under the specitic'conditlons set forth on pages 2 through 7 and the standard conditions set forth on page S. The approval shall nos 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 tasting. If thls product or material fails 1 perform in the approved manner, the Building Code Compliluace Office mny revoke, modify or suspend the use of such product or material immediately, The applicant shall re• evaluate this product or material should any amendments to the South Flor(do Building Code be enacted affetti:tg 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 Inc South Florida Building Code. The expense of such testing will be incurred by the manufacturer AcCeptanct No.: 0 Revues No. 96- 11319,02 Expires: (11(22/01 I3UILp1NG CODE. COMMITTEE aul Rodrig cz Product Control Supervisor rH1S TS THI? SN, ET, SF.F 1nfTT(ONAL PAGES FOR Sf'FCIFTC_AM) C:i; \'1't2A CONDITIONS This application for Product Approval has been reviewed by the Metropolitan Dade County Building Cod: Compliance; Department and approved by :he, Building Code . Committee to be used In Dade County, F1orr da under the. conditions Sit fort's above. • Charles Danger. P.E. Director Building Code Compliance Dept. Approved: UI /l2L a Metropolitan Dade County a l yyI - _/ .. rr.•... n.....•. . ∎• „ileiInrscnhnr.ntinO.COr11 Homapage• hstp :/ /www.bulloin9codoonllnts.com 017 /017 /1 COO ..1.9. ..,,. %IL SANTAFE TILE CORPORATION Appli.` :tn,: Santaff Tile Corporation l.,Adt fillers Santafe Bogota. Colontbi;t R7/G17/1 000 ,ti u h -'ry t; e: PRODUCT CONTROL NOTICE OF ACCEPTANCE. ROOFING SYSTEM APPROVAL Qateur.: Prepared Roofing SALL(L : High Profile Tiie D:PC: . Nail- oratortar:.Set/..ciltesive Set Clay ACCEPTANCE NO.: 1:2.51L1. Product Control No.: Approval Date: Expiration Date: .12m131 199 Jarman 22„ ,4.21 System Descrirttion Ladrillera S:t::caf , located in Bogota,•Colombia, manufacturers clay roof the for nuil•un and nw rtar: adhesive at applications. All Ladrillera Santafe tiles are available in standard unglayad and a ;lazed color finish. This Produc t�orttrel;�pl+r�v_ 1 r l +t tJ rho L.adriller:t • ntaF "Koval" tile nrotil;. Refer to aezwate product CnnrrnrAnnrnvala for nthert1It nrafile.. n S" Sethi I'd Tile Corporation is sole:; ;pp;oved distributor of Ladrillera Santafe roof tiles. Product Sa :yeah 5 CIA :. R' f Tile Trim Ptc :es oaga _X hooting Product Contr;l Exa^.;r • i_ • w., Contact: • Daniel Bernal General Manager Santafe Tile Corporation 8s2S MMiami. Florida 33122 (2 3 1 7 0 ) (305) 885- 9002/88S -0050 TRADE NAMES .OF PRODUCTS MANUFACTURED OR LABELED In' APPLICANT Test D imensions SDeclf7c2tinns 1 m 18" AST1t C 1167 w t1.5." 1 w varies ASTM C 1167 • w - varies varying thickness Pup: of S Product 'LiDSign H; k prof ic, one piece. ;lay roof equipped with two nail holes. For i:ac:• nn. murtzt Set i nd adhesive set applications. Accessory trim, clay root pieces for use at hips, rakes. rldsts and valley terminations. Manufactured for each tile orofl4 _ J SYSTEMS SYSTEM 13: Direct neck Nail -on Application Deck "Type: Wood Non- insulated Deck Description: t w construction 19132" or ate(' plywood or wood plank. Slope Range: 7 ":12" Note: Sy m B Is n • y acceptable in this slope range. Underlayment: Install. underlay ► •.t system in compliance with Metro-Dade County Application St: lard 11S. Roonng T'llr: I' Ta1I tile ' compliance with ro -Dade County Application Standard PA 118. (Se Data for Attachment Cale ions" included in this Approval.) Comments: I. For re -roof applications. 15132" plywood is an occptable substrate. S NTAFE TILE COKYORATION '/1999 12 :44 305665.9626 r . • SYSTEM D: Mortar or Adhesive Set Application Deck Type: Wood, ;ion- insulated Dec i: Description: New construction 19 132" or greater plywood or wood plank. Slope Range: 2 ":12" to ; " :12" Note: Systern D is only lceeptablo in this slope range. Under) ayfrc:nt: Install undcrlayntznt system in compliance with Metro-Dade County Application Standard PA 120. Roofing Tile: )Haul) t in compliance with Metro -Dade County Application Standard Pry 120. (Scc "Data for Attachment Calculations included in this Approval.) Con:mcntst 1. For re -roof applications, 15I plywood is art acceptable substrata. Page 4of Frank Zuloaga Rooting Product Centro! Examiner COMA CAST CORP__ORATI❑ SANTAFE TILE CORPORATION SYSTEM LIMITATIONS ACCEPTANCE NO.: 2L-051 s.05 1. The standard minimum roof pitch for Ladrillcra Santafc's " Ssrttafc S" high profile the shall ::Deeply with Dade County Application Standards PA 118, PA 119 or PA 120, depending on the method of installation. For nail -on applications, fasteners for mechanical attachment of tiles shall have a head diameter larger than that of the preformed holes in the tile. 3. System installation shall be in compliance with the system snecitications outlined in this Product Control Approval. The method of attachment utilized shall provide a minimum characteristic resistance load greater than or equal to the required uplift resistance determined in compliance with Metro -Dade County Protocol PA 115 or PA 127. The Ladrillera Santaff "Santafe S" tile profile has bt:en tested for both wind characteristics, and static uplift performance, therefore, attachment calculations for installation in compliance with PA 115 or PA 127 shall ba done as nn 'Moment Based System' 4. For mortar and adhesive Alt tile applications. a tied static uplift test by a Metro -Dade County accredited testing agency, In compliance with Metro -Dade County Protocol PA 106, shall be performed. 5. All tilts shall bear the imprint or identifiabie marking of the manufacturer's name or logo for identification in the field. 6. For mortar or adhesive act tilt applications. 30/90 hot mopped underl,nyment applications may be installed perpendicular to the roof pitch prior to June 1, 1995 unless stated otherwise by the material manufacturer. Thereafter, 30/90 underlayntertt systems shall be installed parallel to the roof pitch In compliance with Appendix 'A' of Dade County Protocol PA 17.0. 7. The applicant shall retain the services of a Metro -Dade County certified testing laboratory to maintain quality control in compliance with the South Florida Building Code and related protocols. 07/87/1999 12:44 2PIRMaaaeoe Pape S of 3 Frank Zuloaga Roofing Product Cr,ntrd Examiner • 07/07/1999 12:44 • .L. •. a.. paw va L44410 ti DATA FOR ATTACHMENT CALCULATIONS Table 1: Aerodynamic Multipliers -% (ft') Tile'proflie (tti) % (ft') Nail -On, Direct Deck Mortar or Adhesive Set Santaie S Clay Roof 'Tile , 4 34 0.31 �Table 2: Restorin a Moments ue to Gravity - M, The Profile ; 2:12 3:12 4:12 Santee $ i 5:12 4 4.8 4. 4.8 Table 3: Attachment Resistance xpressod as a Moment- Mf (ft -ibf) Tlio Profit Two ,approved One Approved ivlurcilr het Adhesive Set + L.. NNails Screw I 1 Cantafc ti � � 21.8 18.4 - � 1 23.6 ( 61.9 • 3056659g2g__ Page 6 of ft -Ibf) 6:12 4.5 Frank Zuloaga Roofing Product Control Examiner 7:12 4.4 .. .. ••• v. ••• • F1 1 6 L • SANTAFE TILE CORPORATION ACCEPTASCE `•O.: J • .r✓' r, l ''tO DRA L.ADRILLER. SA TAFE "SAST,FE S CLAY R00 F TILE f'agt `o fS • • L • • .••r •• .� • ••• •• Atat rJ CS 97.M51 c 4S • Frank Tuloaga Roofing, Product Control Examiner • / /' • - 07/07/1999 . 12:44 3056659626 S..NTAFE -TILE. CORPORATION Santnre Tile Corporation Laddllera Santafct l3oE:ota. Colombia • COMA CAST CORPORATIO PAGE 07 ACCEPTANCE NO.: 4 Product Control No.: Approval Date: Expiration Date; 97- 0515.05 January Z.. 1995 ,Tnnwiry h2, 1001 NOTTCF. OF ACCEPTANCE STANDARD COTLQYS 1. Renewal of this Acceptance (approval) shall be considered after a renewul application has been tiled and the original .submitted documentation. including test supporting data, engineering documents, are no older than eight (S) years. .any and all approved products shall be permanently labeled with the manufacturer's name. city. state, and the following statement: "Dada County Product Control approved", or as specifically stated in the specific conditions of this Acceptance. Renewals of Acceptance will not be considered if: ai There has been a change in the South Florida Building Code affecting the evaluation of this product and the product is not in compliance with the code changes; b) The product is no longer the same product (identical) as the one originally approved; c) If the Acceptance hoider has not complied with all the requirements of this acceptance, including the Correct installation of•tile product; d) The engineer who originally prepared, signed and sealed the required documentation initially submitted , is no longer practicing the engineering profession. Any revision or change in the materials, use, and/or manufacture of the product or process shall automatic :Illy be cause for termination of this Acceptance, unless prior written approval has been requested (through the filing of a revision application with appropriate fee) and granted by this c Rice. Any of the following shall also be grounds for r'emovel of this Acceptance: a) Unsatisfactory performance of this product or process: bj Misuse of this Acceptance as an endorsement of any product. for sales. advertising or any other purposes. O. The Notice of Acceptance number preceded by the words Dade County, Florida. and followed by the expiration date may be displayed in advertising Iitert+ture. if any portion of the Notiee of Acceptance is displayed, then it shall be done in its entirety. 7 . A cony 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 tittles. The copies need not be resealed by the engineer. ;. Failure to comply with uny section of this Acceptance shall be cause for termination and removal of Acceptance. This Acceptance contains pages 1, through 8 this last page. END OF THIS APPROVA Page 8 of 8 u toaga Rooting Product Control Exam in,- Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Date ?AC 19 90 Owner's Name and Address e//oev S /g/ ' if/E /e 2 , C� No. Street Registered Architect andior Engineer pp�� Name and address of licensed contractor C�/Y ' 5 e7 / :-o, , )0/T /R- 2 -' 7 -6/ k G / 9/17 - Location and legal description of lot to be built on: 7 / /� 1/ �j �(` Lot /® '/ / Block / I / Subdivision 717 J /J /� fil / // -1 // -5,w6 / (�j ! ° � Street and Number where work is to be done J 9 / / " iv ( io / 6 2- YT ,,.� Q State work to be done and purpose of building by floors), state exterior colors (submit sample )1 ___r�� ' pp 11- "C e e✓ rte- 7 . a __ /j-rLe-vy`. / I y and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated lbtal cost of improvements S (( Amount of Permit S 3 "-‘v Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor 1 hereby submit all 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 obligatons as an employer of Labor under the Florida Norkmen'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 subcor» rectors. on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA COUNTY OF DADE. ) SS. o t /011/ 64 y� 0 Before me. the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments. personally appeared 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 $pplication. and that he did sign the same. and that all facts therein by him stated are true. Permit No. Disapproved (Signed) Building Inspector My Commission Expires Read. Sworn to and Subscribed before me. Notary Public. State of Florida PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials andior workmanship. Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: 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 July 2 j _ ._..._. _ ._ Owner's Name and Address Mrs. Lisa Hy �_ _, No 134 Street-- • E E. 102 St . . Ca .... . ........t,•tt „1 f.K.,, •.tt.t... CT1 Biscayne Roofing Co. $180E. 11 Ave. Hialeah, Fla. Lot Block Subdivision Street and Number where work is to be done _ 134 N.E. 102nd Street State work to be done and purpose of building (by floors) Remove existing tile roof on Main house. Tin cap 1-30# felt. Hot mop 1-90 slate. Install Galv. eave drip. Lay Gory, M -3 Red broomswe_pt tile. 21 Squaresw and for no other purpose. New Building Remodeling Re -Roof Addition Repairs No. of Stories 1 To be constructed of Kind of foundation Roof Covering Cement Tile Estimated Total cost of improvements $ 4 ' 280 Amount of Permit $L ... 15...0Q 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 Roofing_..C.a.. .1.1. Ave.. Hialeah... 1....... The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under theFlorida 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) )...._.....�/ r/h!f✓ ° .... -- 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 y I li it No.._. k� t 1 Date f 4) Z L.1 Read, Sworn to and Subscribed before me. Disapproved, t Date Notary Public, State of Florida uilding Inspector My Commission Expires _ _ PLANNING BOARD ..... .DATE Chairinan 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 hecn obtained from the Planning Board. A re in.pcc•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. MIAMI SHORES VILLAGE BUILDIN INSPECTION DEPARTMEN* APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the det, iled statemen of the plans and specifications herewith submitted for the build- ing or o h -ructure her i described This rilicatic is made in compliance and con•o m ty wAli the Building Ordinance of Mia ii Shores Villaye, or da, and all pro isions of the Laws t f the State of 1. krid. all o d nances f Mi m Shores Village and all iules and regu a'ion. of the Building Div.. i of •iam Shoi iilage F '1 ,e -o, ipl.ed with, whether herein specified or not. A copy ot approved plans and specificati n must be key at building durin progress of tl.e wcrk. Date June. 2. , 19.54_ Owner' Name and Address .E Sail) No 134 Street N,E, 102 St. Registered Architect and/or Engineer._ Name nd address of licensed contractor. ___ • 79 St . Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done. 134 N. E. 102 St. Miami Shores State work to be done and purpose of building (by floors) and for no other purpose. New Building_ Remodeling. Addition__ ..._ __ X__ _ . Repairs. . . No. of Stories .. .. .. . To be constructed of ___ _ Kind of foundation Roof Cov ling_ 4 ply built up roof Estimated -: ltal cost of improvements $._ 149.00. Amount of Permit $._ Zone ^ubage required. _. __Plan Cubage Distance to next nearest building_ _ _ _Size of Building Lot Maximum live load to be borne by each floor _ . ..... ___ hereby submit all the plans and speciiications for said building. All notices with reference to the building and its construction may be sent to The unde signed appli ant for th's building permit does hereby certify tat he understands and accepts his ..bligations as an employer of 1 bor under he Florida Workmen's Compensation Act bc'ng S. -tion 5966 Coi p led Gen al Laws of Florida P r anen and h s compl ed w;th he prov'aons thereof, and will require s.milar comp lance from all contractors or sub-contractors emplo •ed by him in the wo k to be p rt -med under th s pern it and ill post or cause to be posted for inspection on the site of the work su :h public noti. c or otit. es as are requir d by the Act. The u. chr ign.c1 agrees to employ only such abcontr. ctors, on work to be perform d . der this permit as are licensed by M am, Shores N. ge. Remarks__ (Signed) C . 1 • g Lang Roofing & Tile Co., Inc. STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to adni.nister oaths .nd take acknowledgments, personally Pp- peared - • .to me well known, and who, being by me first d. ly cworn, upon oath deposes and says that he is the of th abov. de .c ibed . istruction t, . h has careially read the foregoing application, and that he did sign the same, and that all facts therein by him stated are tr fe. / Pcrmit No , s _ Date__ .-^- ../ ,-----', Read, Sworn to and Subscribed before me. Disapproved Date_ ( Signed ) Building Inspector ' My Com:nission Expires_ /' Notary Public State of Florida 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 tftcr approval his been obtained from the Planr ng Board A re-inspection fee of $1.00 will be charged when such re-inspection is _le necessary by improper notice for inspel.t‘op or fa. Ity materials and/or workmanship. STATE OF FLORIDA, COUNTY OF DADE. ss. Disapproved (Signed) VY MIAMI SHORES VILLAGE BUILDIN INSPECTION DEPARTMEN' APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the det,. iled statemen of the plans and specifications herewith submitted for the build- ing or o h, :ructure her i described This pi licatic is made in compliance and con•o m ty w.th the Building Ordinance of Mia ii Shores Villave, or da, and all pro. isions of the Laws t f the State of 1.1.,rid. all o &nances of Mi in Shores Village and all rules and regu'a of the Building Div.. i of .ram Sho illage '1 ,e -o. iphed with, whether herein specified or not. A copy of approved plans and specificati •n must be ke r. at building durin, progress of tl.e wcrk. PLANNING BOARD DATE Date 4120/54 , 19 Owner' Name and Address Mr—Se: No 126 street. IS 93rd ..St. Registered Architect and/or Engineer. Name nd address of licensed contractor - _Lan& Roefing_and, _Ti W.-7-9th- St. Location and legal description of lot to be built on: Lot Block. Subdivision Street and Number where work is to be done 134 State work to be done and purpose of building (by floors) and for no other purpose. New Building_ Remodeling _X Addition__ _.__ ..... Repairs_ _ No. of Stories To be constructed of. _ Kind of foundation Roof Cov ring Tile Estimated ital cost of improvements $__ -1,000,00 Amount c Permit $. 5_„.00 Zone ^ubage required __. _Plan Cubage Distance to next nearest building__ . Size of Building Lot MaXiMUM live load to be borne by each floor hereby submit all the plans and speciiications for said building. All notices with reference to the building and its construction may be sent to The unde signed appli ant for th's budding permit does hereby certify emit he understands and accepts his ,..bligations as an employer of 1- bor under he Florida Workmen's Compensation Act being S. -tion 5966 Cm p led Gen al Laws of Florida P r anen S,ipplc nent, and h s compl ed w;th -he prov• :ions thereof, and will require s•milar comp lance from all contractors or sub-contractors cmplo .ed by him in the wo k to be p rf -med under th s pern it and ill post or cause to be posted for inspection on the site of the work su :h public not'. e or .otit es as are requir d by the Act. The u. & r ign..d agrees to employ only such abcontr. ctors, on work to be perform d . der this permit as are licensed by M am. Shores % ge. Lang Roofing and Tile Co., Inc. Remarks__ ___ (Signed) _ C'C24--ss Before me, the undersigned authority, a notary public, duly authorized to adm,nister oaths .nd take acknowledgments, personally vp- peared _ • .to me well known, and who, being by me first d. ly worn, upon oath deposes and says that he is the of th abov de ,c ibed • istruction t, h has c reially read th foregoing application, and that he did sign the same, and that all facts therein by him stated are tr ie. - 2) Permit No Read, Sworn to and Subscribed before me. Notary Public State of Florida My Com:nission 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 tftrr approval h is been obtained from the Plan!' ng Board A re-inspection fee of $1.00 will be charged when such re-inspection is m:..1e necessary by improper notice for inspe:.00n or fa. Ity materials and/or workmanship.