318 NE 102 St (3)Date
Legal Descriptionc5 / 1e CJ Y 7 a.' 38 Historically Designated: Yes
Owner/Lessee / Tenant (7/9 114 L/ l 114 A/` e 12.. Master Permit #
Owner's Address 3 t SAL 1 0 Z " S T. Phone
Contracting Co. lS'T t^ Address 2 314 Q
Qualifier L,Ary GE G &t mat SS# 14 1 -40 -3174 Phone Q2 Z — S
State # CC( OS1 1 10
Municipal # Competency # Ins. Co.
Architect/Engineer ti / 14 Address
Bonding Company ►.a /4 Address
Mortgagor N / p. Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Square Ft. o O O t
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 thy' rk stated.
k Tax.
ondo President
Signature of owner and/or
•t.
s to Owner and/or Condo President / Date
My Commission Expires;
FEES: PERMIT 60.00
APPROVED:
Zoning
Mechanical
/6dS' 4¢/e
PERMIT APpIC/�r R MIAMI SHORES VILLAGE
Job Address 5 / S / 0c N / .i Tax Folio 11 — 02.O4 — 013 J7C 0
C e, 0 4 )ZA , nv
(ZL
/Oo/ trh � M 4y 4 /Ayr, / J a o' )Z1
J y
Estimated Cost (value) F00
Date
ANGEL M. ROBERTS
MY COMMISSION # CC 975084
EXPIRES: May 23, 1998
4 4: °P'' Banded Thru Notary Pub&c Unde.Ntieis
1
RADON C.C.F. '/O 0
Signature of Contr . or or Oyler- Builder
ary a fo Contractdr or Owner - Rohrer
My Commission Expires:
NOTARY
No
3 �
2-364/6
Date
Date
''. ANGEL M. ROBERTS
MY COMMISSION # CC 375084
EXPIRES: May 23,1998
od Bonded Thru Notary Pudic Undoiwdtele
ca14 1 : 3300 .0 O
TOTAL DUE L34 A 7. O O
Building ( `���. ( 9/z G Electrical
Plumbing / Engineering
( S ATE OF FLORIDA, COUNTY OF DADE
I HERESY CERTIFY that this Is a true of the
o filed in this office `n day of
A• o• 19 M.
r•i Off:1.In1Sent.
FR'<, -' Clrevto and Coen!), COW,/
kv),1 oC.
wSfNESS my
a H I ARRVYRU`!I
NUIILL L F LUIVIIVIENLEMENI
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:
31g NE 1.0 sr,
AA Arv+ i s - o 2eS 1 GL 33(31(
2. Description of improvement: (G -Roo F
3. Owner(s) name and address: CJ'2Tts of k rrA44G='1 _
3 t 1...)E. tO 2_ S MtPrYV•'; s H2-�s
96R362355 1996 AUG 14 14:05
Interest in property:
Name and address of fee simple titleholder:
4 . Contractor's name and address: A Mr f2 t STAr . Roo F tI) G Co.
2 3 1 ( 1tjeS ST . 140LL.1U3Oo.D fl. 33o2.-a
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
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:
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
Signature of Owner
Print Owners Name at./2T 1 5 S' c d t+i77? e. R q
Sworn to and subscribed before me this O day of 4z46). , 19 / 4 ' .
Notary Public
Print Notary's Name
Prepared by: J. D-
Address: 2114 W 01 63 31
PL '�jD2U
Job Address:
1. General
2. Documentation
2/ 8' /o o t4 .
APPENDIX 'E'
METRO -DADE UNIFORM BUILDING PERMIT
SECTION II
MORTAR OR ADHESIVE SET TILE SYSTEMS
The information provided in this Section is required to confirm
Product Control Approval of the proposed tile system assembly;
confirm compliance with the wind load requirements of Chapter 23
of the South Florida Building Code (SFBC); and confirm compliance
with Sections 3403.5 and 3404 of the South Florida Building Codc.
The following documents are required for submission with. the
Uniform Building Permit application:
Two (2) copics of the proposed tile system assembly's and
associated roofing component's Product Control
Approval(s).
One (1) copy of the tile system assembly and/or roofing
component(s) manufacturer's published application
instructions and literature.
▪ All documents attached herein, filled out and completed in
full.
3. Project Information
Check one of the following:
• ❑ New Construction
IF Re -Roof
Note: Mortar or adhesive set tile systems arc not acceptable as recover
applications.
Contractor: ,q/3161e
Mortar or Adhcsi c: t .! ilc Systems
Pa:
Is the deck solid sheathed? (circle ' or 'no')
no
Roof Pitch (fill in):
Proccss No.
Deck Type (check one of the following):
❑ Nominal ''/2" Plywood (for re-roof only)
❑ Nominal V Plywood
A' Wood Plank 6 "
❑ Other (fill in)
2.r"
Note: Mortar or adhesive set tile systems shall not be installed at a pitch
greater than 7%2 ":12 ". Mortar or adhesive set tile applied at a
pitch greater than 5 ":12" and less than or equal to 7 ":12" shall
have the first three courscs of tile nailed with not less than one
nail per tile. As an alternate, the first three courses of tile may be
applied in mortar over a single layer of minimum 12 ga. wire
mesh with square openings of not less than 1 / 8 " which is
mechanically attached to the sheathing with not less than one nail
per 2 ft
Circle 'yes' or 'no' for each of the following:
Have you attached two copies of the tile system manufacturer's
Product Control A oval for the proposed tile system?
ves no
Have you attached a copy of the file system assembly and/or
roofing componcnt(s) manufacturer's published, application
instructions and other literature
no
Is the proposed undcrlaymcnt approved for use with this tile
system assembly?
no
A
Job Address:
Tile:
Tile Name:
Manufacturer:
a lokiAvc
Project Information (continued):
Tile Material:
❑ Clay
afS Concrete
❑ Other:
4. The Tile System Assembly:
Mortar or Adhesive:
no
SI, rv! 6 t;i `f
Mart? /2voor d7 /Nc
Product Control Approval Number: /1 / a J 0 /
Contractor:
If the proposed undcrlayment is self - adhered, have you complied
with the venting requirements of Section 2913.3 (b), (c) and (d) of
the South Florida Building Code?
yes no
Are all related accessories approved for use with this tile system
assembly?
Are the proposed edge metal attachment fasteners in compliance
with the requirements of the South Florida Building Code (minimum
12 ga. annular ring shank, corrossion rcisistant nails)?
no
The following information is required to confirm compliance with
Subsections 3403.5(a) and (c) and Section 3404 of the South Florida
Building Code.
Check one of thc following which apply to the proposcd tile
sccurcmcnt for use with thc proposcd tile system assembly:
Mortar or Adhesive Sct Tile Svoems
Page - 2
A/1? 6 2 L S 4 Proccss No.
❑ Mortar: Manufacturer:
Mixing Ratio:
Adhesive: Type:
Manufacturer:
Tile Fasteners (for first three courses if roof pitch exceeds 5 ":12"
and is less than or equal to 7":12"):
Check one of the following which apply to the proposed tile
fasteners (for the first three courses) for use with the proposed tile
system assembly:
❑ Minimum 12 ga. galvanized roofing nail:
❑ Other: Type:
Length:
/.i
N/A
Length:
Note: All tiles shall be installed in compliance with the provisions set
forth in the tile system assembly manufacturer's Product Control
Approval and the minimum requirements set forth in Subsections
3403.5(c) and 3404.2 of the South Florida Building Codc. Tile
fasteners in thc first three courses (if applicible) shall be of
sufficient length to penetrate the sheathing a minimum of 1" or
through the sheathing thickness a minimum of / ", whichever is
less.
Undcrlayment:
The following information is required to confirm compliance with
Section 3403.5(b) of the South Florida Building Codc.
Job Address:
Underlayment (continued):
Check all of the following which apply to the proposed underlaymcnt
for use with thc proposcd tilc system assembly:
ASTM #30 asphalt saturated felt with:
Manufacturer: 91/9ev i k ti
❑ ASTM #15 asphalt saturated felt with:
Manufacturcr:
❑ Mincral Surfaccd Roll Roofing with:
Manufacturcr: d- 4,14A 0
❑ Other:
Typc:
Manufacturcr:
Underlayment Fasteners (if applicable):
❑ 19" ovcrlap
❑ 6" ovcrlap
l°' 4" overlap
❑ 19" ovcrlap
❑ 6" overlap
O 4" overlap
O 19" overlap
❑ 6" overlap
W 4" ovcrlap
Check one of the following which apply to the proposed
underlayment attachment:
AS Minimum 12 ga. cicctro- galvanized roofing nail with
minimum 32 ga. x 1 tin cap:
Length: /
Manufacturer:
Contractor: Proccss No.
h'Ir.rtar or Adhesive Set Tilr c ctcros
Page - 3
Spacing (per tilc system assembly Product Control Approval):
Ficld:
Laps:
5. Related Accessories:
Dimensions:
❑ Cold Adhesive:
Fr Flashing Ccmcnt:
" o.c.
" o.c.
Type:
❑ Other: Manufacturer:
Type:
Length:
Manufacturer:
Edge Mctal (refer to Scction 3408.2 of thc South Florida Building
Code):
Type: 6/0
N
3Y 3
Gaugc or Thickness: k6 J e,„ 0 -G
Finish:
Note: All edge metal shall be nailed on the flange and nailed or clipped
at thc face in compliance with the provisions sct forth in Dade
County Protocol PA 111, marked Appendix 'U' in the South
Florida Building Code.
Adhesives (check one of the following):
Type:
Manufacturer:
Job Address: 3/ Y /0 a 40 C Contractor: Proccss No.
Adhesives (continued): Additional Notes:
Note: Application of adhesives shall be in compliance with the Roofing
Component Product Control Approval and the minimum
requirements set forth in Subsection 3403.5(c)(4)(cc) of the South
Florida Building Codc.
Ventilation System (check one or more of the following):
The following information is required to confirm compliance with
Subsection 3401.4(e) of the South Florida Building Code.
❑ Ridge: Type Size in
❑ Soffit: Type Size in
Note: If underlayment is compriscd of a self- adhered membrane, both soffit
and ridge ventilation systems arc required, unless a base sheet is
applied as an anchor sheet below the self - adhered underlayment.
Note: The Tile System Assembly shall be installed in strict compliance
with the application instructions enumerated in the Product
Control Approval. A permit shall be issued for application of the
specified Tile System Assembly only. Any change to the specified
Tile System Assembly shall require submission of a revised
SECTION II with a copy of SECTION I, noting the permit
number issued.
Mortar or Adhesiv- Tile Systems
- 4
/ G !� AvE Job Address: J [ d ` 0 d (
Contractor:
Deck: " " y�
Type: ti.
Thickness: i& i
Underlaymcnt: 4030
Ridge Venting:
(if applicable )
Undcrlaymcnt
Fastener: Cox y,v //f
12"
FILL IN APPLICABLE ROOFING COMPONENTS WIIICII MAKE UP
TILE SYSTEM ASSEMBLY. INSERT ANY ADDITIONAL LEADERS
INDICATING ADDITIONAL ROOFING COMPONENTS NOT SHOWN
ON THIS PAGE. (Where Roofing Componcnt not uscd in Tile System
Assembly, fill in with "N /A ". )
'Head Lap Dimension:
(minimum 7' unless otherwise specified
in the tile system assembly Product Control
Apprond)
Mortar/Adhesive: 14 � e J /G2
Tile: e'O itoOF o � /e
is J
Tile Fastener: /Pe p r() P2
Edge Metal or utter
Fastener: L J414
Bird Stop:
(if applicable )
Edge Metal
or Gutter:
Existing or Proposed
Soffit Venting:
DETAIL #1
Job Site Identification:
Mortar n: Aditc ivc Set Tile Systems
P -s
Process No.
Job Address:
3/ Y /0A 4 t/c
Contractor:
Process No.
Ridge Height: Eave Height: Roof Mean Height
a3 feet / D feet /AS-feet
Insert Building Ridge Height, Eave Height and Roof Mean Height.
Also insert applicable information pertaining to the building below.
(Sec ASCE 7 -88 Fact Sheet Attached )
Ground Level
C
Exposure Category:
Classification Category:
At ilurricancc Occanlinc ?: Y N
Basic Wind Speed at
Building Location 110 mph
Building Condition based on
% of openings:
(See Table 9 ofASCE 7 -88)
BUILDING INFORMATION
Job Site Identification: ' �l.�
Mortar or Adhc':* Se: .T ile Systems
P .
Job Address: 3I Y ` 0 £ ''
Contractor:
Sketch Roof Plan, indicating all dimcnsions, slopes and any roof top cquipmcnt.
Also insert variable labcicd "a" which rcprcscnts perimeter and comcr dimcnsions
per Chaptcr 23 of the South Florida Building Code.
(See ASCE 7 -88 Fact Sheet Attached)
BUILDING INFORMATION #2: Roof Plan with Perimeter anti Corner Dimensions
Job Site Identification: 3 /9- ID 4b-e
Mortar or Adhesive Set Tilc Systc:
Pagc - 7
Process No.
Job Address: 3/r G vg, 4w e Contractor: Process No.
The undersigned certifies that the Mortar or Adhesive Set Tile System
Assembly is in compliance with the plans, specifications, and details
submitted by the architect.
STATE OF FLORIDA - COUNTY OF DADE
Before me this day personally appeared 1.04,-)6e*
who, being first duly sworn, deposes and says that all information submitted
herein is true and correct.
Sworn to and subscribed before me this ... C) th day of
19 ?G. G
My commission expires: c2 /f 90
1 /
ANGEL M. ROBERTS
MY COMMISSION • CC 975084
EXPIRES: May 23. 1998
Bonded Tteu Notary Public Und a ailers
, :r.:E1 43,
'4; at ..
Lice . ed Contractor / Owner
Signature
L4
otary Public
Stale of Florida
Mortar or Adhesive Set Tile Systems
Lgc -8
METnODAOE
MIN
ritmUC'il' CONTROI NO'T'ICE OF ACCEPTANCE
Metro Roof Tile, Inc.
11350 N.W. South River I)r ive
Miarrri,
EL 33178
Acceptance No.:94-1017.01
i;xpit es:06 /15/98
Approved: 06 /15/95
Metro Roof Ti le
305 558 2608 F. 01
METROPOLITAN DAVE COUNTY, FLViiII3A
MEMO-DADE FLAGLEfl BUILDING
BUILDING CODE COMPLIANCE OFFICE
SUITE 1603
METF1U.LtAOE FRAOLFI1 BUILDING
MO WE5r FLAGLEn sr nEr
MIAMI. FLOIUDA 33130.1503
(305) 375 -7901
rAX (335) 375.2008
PnODUCT corrrnol. SECTIVN
(305) 375.2902
FAX (305) 372.6339
Your application for Product Approval of:
Spanish S
under Chapter 8 of the Metropolitan Dade County Code governing the use of Alternate Materinls and
Types of Construction, and completely described in the plans, specifications and calculations as sut
Kedland Technologies, The Center for Applied Enginerir,g, Inc., and a estrvell Craig
Laboratories & Consultants, Inc.
has been recommended for acceptance by the Building Code Compliance office to be used in Dade
County, Florida under the specific conditions set forth on pages 2 et. seq. and the Standard Conditions
on page 3.
This approval shall not be valid after the expiration date stated below. The Office of Code Compliance
rescrves the right to secure this product or material at anytime from a jobsitc or manufacturer's plant for
quality control testing. If this product or material fails to perform in the approved manner, the Code
Compliance Office may revoke, modify, or suspend the use of such product or material immediately. I'hc
applicant shall re evaluate this product or material should any amnlenchncnts to the South Florida Building
('ode be enacted affecting tl►is product or material. The iuilding Code Compliance Office reserves the
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 the manufacturer.
IZ�iIT"[�o�l�biiia •� -�'
Product Control Supervisor
THIS IS'I'Ii1+. COVERSIIi;C'I', SEE Ai)DI'I'IONAL PACES FOR SPECIFIC AND GENERA1..
13UILi)ING COLIC COMMITTEE
TEi,
'lins application for Product Approval has been reviewed by the lvletropolitan Dade County Building
Code Compliance Department and approved by the Building Code Committee to be used in Dade
County, Florida tinder the conditions set forth above.
r
t.9 ,angcr, .y.- --
Director
Building Code Compliance 1J,
Metropolitan ))acne County
ARRia.�.alll:
Metro Roof Tile, Inc.
1 1501 Northwest 117th Way
Medley, Florida 33178
Metro Roof Tile
PRODUCT CONTROL NOTICE OF ACCEI' 1'ANCE
ROOFING SYSTEIII APPROVAL
C.t€g.Qry.: Prepared Roofing
m.lp- Category: Haigh Profile Tile
Nail -on /Mortar Set/Adhesive Set
.t b: yltt: Concrete
System Description
Contact:
Fernando Arias
Metro Roof Tile, Inc.
11501 Northwest 117th Way
Miami, FL 33178
(305)558 -6712
2
Raul Rodriguez
305 558 2608 P.02
Product Control No.: __94_401,Q1.___
Approval Date: JUN 1 5 1995.
Expiration Date:
JUN 1 5
Metro Roof Tile, Inc., located in Medley, Florida, manufacturers clay roof tile for nail -on, mortar
set or adhesive set applications. Ibis ProducLControl Approval retate41QM t o kQQLTile'$ "SP.auis11 ':
liig�til� Qflle. Refer to applQRCWlc_rroduct Control A rp�r ovaIs for salimiiikinftics.
The Metro Roof Tile "Spanish S" tile profile is available in a variety of colors end has matching
trim pieces used for rake hip, ridge hip, and valley terminations. These accessories arc manufactured for
all profiles and form a part of this Product Control Approval.
The Metro Roof Tile "Spanish S" roof tile has been tested in compliance with the South Florida
f3uilding Code requirements for concrete, trail -on, mortar set or adhesive set tilt applications. Sec the
"Profile Drawing" section in this Approval for the Metro Roof Tile "Spanish S" profile drawing. The
Metro hoof - file 'Spanish S" profile has been tested for both wind characteristics and static uplift
performance, therefore, any consideration for installation shall be done as n 'Moment Based System'.
I)atn for attachment calculations is noted hi Tables 1 through 4 of this Approval.
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) ;;i . v „
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $1500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will • • - !..roved and . einspection fee will be charged.
who is personally
NOTARY
Sign:
Print:
My Com ission Expires:
*** * * * * * * * * * * * * * * *,r *** ** * * * **
State Certificate or Registration No.
APPLICATION APPROVED BY:
Chc 10/14/03
Signature
Owner or Agent Contractor
The foregoing instrument was a owledged before me this 2 The foregoing instrument was acknowledged before me this
day of 0 ( 20 QS
BLIC•
* * * * * * * **
res: Jul 1 ,
to me or who has produced
s identification and who did take an oath. as identification and who did take an oath.
Tsp
day of , 20 , by
who is personally known to me or who has produced
label Vargas NOTARY PUBLIC:
'ontiDD23
i Sign:
ic Bonding Co .Inc.
Print:
Certificate of Competency Holder)
My Commission Expires:
************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Certificate of Competency No.
Plans Examiner
Engineer
')� Zoning
BUILDING
PERMIT APPLICATIO
FBC 2001
Permit Type (circle)
Owner's Name (Fee Simple
Owner's Address 3 r g
City M 1 ot-wl -■ S !^ v .rc S State
Tenant/Lessee Name
City Miami Shores Village
Is Building Historically Designated
t
t_
Job Address (where the work is being done) 3 1 $
Miami Shores Village
Building Department
10050,■ -n Sir es, Florida 33138
• . 4,,'F4 4[6
JUL 2gX005
pei� S Bo ed h phone#
(02. 5 ( - ree2( -
YES NO 5C
Contractor's Company Name a n c W, do
Contractor's Address 1 3 ► S
City M 1 a m State
Qualifier
Type of Work:
Describe Work:
Total Fee Now Due $
(Continued on opposite side)
S. W.
❑Addition DAlteration
1 r S4 , 1I
Submittal Fee $
'Notary $ g 6.17
Scanning $ 1 ■
Code Enforcement $
Permit Fee $ / Z.1, 0 g /
Training /Education Fee $
Radon $
cot ,
[New
of I f c
Structural Plan Review. $
5) 756.8972
IJ E l o 2 5
Architect/Engineer's Name (if applicable) Phone #
* * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Permit No..3 1 S — 112S
Master Permit No.
Electrical Plumbing Mechanical Roofing
zip 33t 3'
Phone #
S1. de,,r
Phone #
3os -'7 7 -S 2.7
County Miami -Dade Zip 3 3 i 3 $
3os - 233 -8'ggE
' g t s- fl e
F 1. Zip 3 3 /76
o
$ Value of Work For this PermitX 12 2)V ' Square Footage Of Work:
® Repair /Replace ❑ Demolition
W 1- Doors
CCF $ . so
Technology Fee $ ( . Z S
Bond $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commenceme ust be posted . the job site
Signature Signa for the first inspection which occurs seven (7) days after the building permit is s ed. In t a of c h p. notice, the
inspection will not be approved and a reinspection fee will be charged. .
L k fA-' I
Owner or Agent � v Contractor
The foregoing instrument was acknowledged before me this The foregoing ment was acknowledged before me this Z¢-
day of , 20 , by , day of ,4 . , 20 05, by C�`A1 � gF l µA�i
who is personally known to me or who has produced who is perso ally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print: Al—
APPLICATION APPROVED BY:
Chc 05/13/03
as identificat d who did take an oath.
OA
• my cbmnna iu
My Commission Expires: My Commission Expires ,, • Expires October 01, 2006
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Plans Examiner
Engineer
Zoning
BUILDING
PERMIT APPLICATION
FBC 2001
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Master Permit No.
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) F -f e-- r- 6 a e d , - fr. Phone # 30S' - -
Owner's Address 3 1$ NE / O s t 3o s - t-(4 6 - 170 S ��e //)
Cit M 0(Wt S 4 ores State FL_ Zip 3 313
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 3 la NE /0 2. S t r`e--e "
Total Fee Now Due $
(Continued on opposite side)
Permit No.
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO ?
' Company Name &' N A-40 � SS7� Phone # O.(" ~
Contractor's Compa y �� � � 2 f ‘ ‘
Contra_ctor's Address 770 U kiln,/ /'� ..ii
City `' el mg/ State 0 4_, . Zip , 77/ f~7
Qualifier r 4.i/ 'l ,0
State Certificate or Registration No. dj Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit 9 0 0 Square Footage Of Work: 2/2 .
Type of Work: ❑Addition ['Alteration ENew air /Replace [' Demolition
Describe Work: / .6 4 6A - C v �."- .AJr✓i A 'r, c-^- G✓i llf ~/Al - U' -
11.4v;1 d ws ,s NL D'QJn --
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ CCF $ CO /CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 8/2/2005
Applicant: SHEILA BAEDITA
Owner: BAEDITA SHEILA
JOB ADDRESS: 318 NE 102 ST
Contractor ATLANTIC SHUTTERS, INC
Local Phone: 305 - 945 - 7277
Parcel # 1132060135160
Signed: (INSPECTOR)
Building Permit
Permit Number: BP2005 -1123
Contractor's Address: 15421 W DIXIE HWY #23
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�G P AID
CRK 1(7(4
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 10 & W1/2 LOT 9 BLK 38 LOT SIZE
Fees: Description Amount
FEE2005 -10508 Building Fee $270.00
FEE2005 -10509 CCF $7.80
FEE2005 -10510 Training and Education Fee $2.60
FEE2005 -10511 Technology Fee $6.75
FEE2005 -10512 Scanning Fee $9.00
FEE2005 -10513 Notary Fee $5.00
Total Fees: $301.15
Total Fees: $301.15
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 1/25/2006 Construction Value: $12,270.00
Work: INSTALLATION OF IMPACT WINDOWS AND DOORS
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
FINAL WINDOWS
Passed
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone 05)795 -2204 Fax: (305)756 -8972
I nspectiontNumber I
Inspection Date: 01/03/2006
Inspector: Grande, Claudio
Owner: BAEDITA, SHEILA
Job Address: 318 102 Street NE
Project: <NONE>
Miami Shores Village, FL
Contractor: ATLANTIC SHUTTERS, INC
Building Department Comments
Wednesday, December 28, 2005
Block:
Phone Number
Permit Type: Imported Permit
Inspection Type: Final
Work Classification: <NONE>
Parcel Number 1132060135160
Lot:
Phone: 305 - 945 -7277
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