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490 NE 102 St (7)ate 8 -6 -93 Job Address 490 N.E. 102 Street egal DescriptioqWe wner / Lessee / Tenant PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 490 N.E. 102 Street wner's Address ontracting. Co. 01 A 11'+)l Aa af�r5 (' JA/C. ualifier _Ar /n� Araj'J O SSV , Phone "26/-03k • 7 FR 9 Ins .Co . . r Address ooding Cooper! • Address ortgagor Address ermit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL OOFING PAVING FENCE SIGt on 30 sq. off roof ••• t ASTM, install metals where required and install m;,tA Mart cp} - pprovcd. Estimated Cost(value) $ 12,000.0n quare Pt. ARNINO TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO Dc O MAY RESULT IN YOUR PAYING TWICE F FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEN1 O OBTAIN FINANCING, CONSULT W YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU1 OTICE OF COMMENCEMENT). pplication is hereby made to obtain a po=sit a mat certify w hat all installation as indicated will be performed to me th n the attached addendum (if applicable). tandards of all laws regulating construction in jurisdiction. ING and understand that separat WORK. ermits are required for ELECTRICAL, WNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work wil e done in compliance with all applicable laws regulating construction and zoning. Furthermore, uthorise the above -named contractor to do the work stated. a ignature of Rimer and /or Condo President Signature of Contractor or Owner-Builder ate: 8 - 9-7 1 Date: d' - 5 -93 NANDEZ MY COMMISSION # AA 714214 EXPIRES: October 10, 1993 Bonded Thru Notary Public Undo w iters * " % MARYLOU HERNAND MY COMMISSION K AA 714214 ; ;, _ EXPIRES: October 10, 1993 • • • ty • Bonded Thru Notary Public Underwriters ••• • Notary as to My Commission TOTAL DUE '5&r00 8ES: PERMIT 9 RADON__________ C.C.P. NOTARY PPROVED: Fire Zoning Buildi Mechanical, Plumbing Engineering Other Electrical 'JUN 01 '93 11:13 ATLAS MERIDIAN 1 601 - 483 -7344 ATLAS ROOFING CORPORATION May 28, 1993 Pan American Roofing 6100 NW 74th Avenue Miami, FL 33166 Attn: Jose Porta RE: A9TM *30 Asphalt Felt. Dade C . Dear Jase,' This will serve as certification that the above-r•'eferenced material produced by At1as.Roofing Corporation meets the following Federal and A.S.T.M. Spegifications: #30 Asphalt Spec.:Fel.t no is Federal, Specification HH- R -395B, ype 15A, Type A, and A.S.T.M. Spec •fscation D -226, Type II., • The Atlas Specification *30 felt, rrifereneed'referenced above, meets Dade County Building ode's weight requirement of 5641 /roll. Sincerely, Lindy Ray Market .Manager • LR :kw COUNTY• • OF LAUDERDALE, STATE OF MISSISSIPPI rn to and subscribed before se t is the - -- clay of , 1998. ary Public. My Commiss:oa expiris :' 3'0 (i7 ROUTE 6. BOX • VALLEY ROAD • MERIDIAN, , f411881SS IPPI 99307 -d� 80b • !Emit ASeti ", JUN 01 '93 11:13 ATLAS MERIDIAN 1- 601 - 483 -73441 A TLAS ROOFING CORPORATION May . 2$, 1993 Pan American Roofing 6100 NW 74th Avenue Miami, FL 33166 Attn: Jose Porta RE: ASTM Mineral Surface 904, Dade! County Dear .Jose, This will serve as certification that the above - referenced material (specifically labeled as above) producer by Atlas Roofing Corporation meets the following Specifications: ASTM 90* MSR meets ASTM Specification D249 Type 11 The Atlas Specification *90 MSR, referenced above:, meets Dade County Building Code's weight requirements. NOTE: Only ASTM 90* Mineral Surface and ASTM Sla Underlayeent marked and stamped AST$ meet Dade County Specifications. • Sincerely, ,Lindy Ray Market Manager LRskw COUNTY OF LAUDERDALE STATE OF MISSISSIPPI orn to and subscribed before me this the — dey of 199x. Notar Public . M y Comm saion axgixea : .3 t o - 1 3 .. . • ROUTE 5, BOX 778 • VALLEY ROAD .• MERIDIAN; MI 39307 -9805 • (801) 483 -7111 P.2 Volume 2.1 BUILT -UP ROOF REQUIREMENTS: 1) Moisture test mandatory on any recovery. 2) Uplift test on any recovery. 3) No hot mopping of felts directly to Ise- Board. 4) System must meet 1 -90 requirements. You may refer to Factory Mutual or provide a lab tested system that will meet or exceed thls requirement. (not required for wood deck) 5) Install an approved base sheet. METRO - DADE BUILDING & ZONING ROOFING APPROVED APPLICATIONS JULY, 1993 SHINGLES Up to this date, only Malarkey SBS shingles have been approved to be installed in Dade County. Obtain Notice of Acceptance prior to the Installation of this shingle. More information will be made available as it is obtained from the Code Compliance Dept. Two (2) plies of 1/30 ASTM D -226 are required at this time. Also tin caps 6" o.c. on laps and 12" o.c. on field. Any of thls information is subject to change without notice. These are only GUIDELINES. TILES Manufacturers specifications and Notice of Acceptance sheet must be placed at jobslte. Also no "Improving" is allowed. Work must be done as per Notice of Acceptance. Ceram Ica de Espatta (Nall -On System) Clay: Spanish 'V' Tile Prodek, Inc. (Nail -On & Mortar Set Systems) Vulcan Clay: Spanish "S" Tile La Mancha Tiles: (Nail -On & Mortar Set Systems) Clay: Spanish "S" Tile Metro Roof Tile: (Nall -On System) Spanish "S" Cement Flat (Mortar Set) Best Clay Tile Corp.: (Mortar Set Systems) Spanish "S" 'Venezuela, S.A." Clay: "S" "Salvador, S.A." Lifetile (Nail -On Systems) Cement: Colonial Slate Flat Espafla "S" Style Capri Almar (USA), Inc.: (Nail -On & Mortar Set Systems) Clay: Altusa "S" Tile Altusa Barrel F.R. Bor)a . Pioneer Concrete Tile: (Nail -On Systems) 2:12 pitch Cement: Hacienda' Shake/Slate Rustic Shake Spanish Flat 9" Classic 100 Entogra Roof Tile: (Nall -On System) 2:12 pitch Cement: Estate Skandia Bender Roof Tile Ind.,Inc. (Nall -On System) 2:12 pitch Cement : Palermo Corrugated Nordic Flat Etema Roof The Manufacturing (Nail -On Systems) Cement: Estate Barrel Skandia Flat Marley Roof Tile: (Nall-On Systems) Cement: Barcelona Castilla Monler Roof Tlle: (Nail -On Systems) 2:12 pitch Cement: Mission "S' Cement • Villa Flat Shake & Slate Vanguard II Roll Spanish "S" . Vanguard II Flat Classic "100" The tile shall be installed on a solid nallable dock of 5/6" thick plyw for all new construction or to 1/2" plywood deck on re- roofing. The nailable deck shall be covered with a #30 Type II (ASTM 226) anchor sheet Maintaining a 4" overlap and tin -capped 12" o.c. except 6" o.c. at the laps. Over this, a 1/90 mineral surface roll roofing shall be fully hot - mopped with nominal 2" laps with the concealed edge of lap tin- capped 12" o.c. except at the valley flashing. The galvanized steel strip shall be nailed over the #30 anchor sheet ® 4" o.c. and over lapped for 5 ". When required, and prior to the Installation of the tile, a formed 0.019 thick steel bird slop shall be Installed at the cave, which shall be bedded in mastic to the membrane and hand nailed to the roof 11" o.c. and near each end. The tile, maintaining a 3" head lap, shall be attached with two 10d plated steel gun nails per tile over a bed of roofing mastic applied to the 090 roll roofing, at nail penetrations. The eave tile, in addition to the 2 -10d nails, shall be attached with formed steel grip clips (refer to Mara Catalog page s centered 4 3/4" from the nose of each tile. The clips shall be 0.043" thick by 1/2" wide, galvanized steel, attached wilh one 10d galvanized steel hand driven nail located 1" from the 90 degree bend In the dip. The clip shall be inbedded In mastic applied to the roofing, at tho nail location. STRONG RECOMMENDATIONS: On commercial applications a continuous cleat Is strongly recommended both by manufacturers and the Building and Zoning Department. This detail is found on almost every manufacturer specification and the FM guidelines for perimeter flashing. Flashings: A. Valleys (select one) I. Install roll valley minimum 16" width with 6" lap joints. Nail to secure in place as code requires. 2. Install preformed open valley minimum 16" width with minimum 2 1/2" high center and minimum 1" metal edge returns. Lap joints minimum 6 ". Secure in place as code requires. B. Dormers, side, chimneys and other vertical wall surface fleshings shall extend upward at least 6" and be completely counter - flashed. Flashing shall extend under the tile a minimum of 5" with a 1" turn up at edge. C. Where sloped roof surface meets the face of vertical wall surfaces at dormers, chimneys and other walls, the flashing shall extend up the facing wall a minimum of 4" and extend downward over the top of the tile a minimum of 5 ". The vertical wall surface shall be completely counter flashed. D. Eave drip metal shall be nailed or stapled along and directly on top of sheeting, fastened 6" o. c. and 1/2" in from top flange. Lap all joints a minimum of 3 ". 6. Application of Tile: A. For mortar on application, mark horizontal guidelines at 16 1/2 ", which will provide a 2" nominal headlap. B. For nail -on application, mark horizontal guidelines at 15 1/2 ", which will provide a nominal 3" headlap. C. Mark all vertical guidelines at 9 1/4". D. Set first course at 161 /2" from the eave. This will provide a 2" overhang at the eave. E. At the eave line, clay, mortar, rubber or metal bird stop shall be used to boost the first row of tile. Note: In high wind and hurricane areas, additional fasteners may be required at the eave course. Consult local Building Codes for requirements. F. For mortar -on settings, each tile shall be set over a full trowel of mortar placed directly under the projection of the left flat side of the tile. Press tile down firmly to allow wet mortar to fill "Dove Tail Locks" for proper bond. 1. For pitches 4/12 and above, nail eave course with one nail in addition to mortar. Apply plastic cement to seal all nail penetrations. 2. For pitches 6/12 up to and including 7/12, nail every third tile in every fifth course in addition to mortar. Apply plastic cement to seal all nail penetrations. 3. For pitches above 7/12, nail every tile in addition to mortar. D. For nail-on installations, install tile with nails of sufficient length to penetrate the deck by 3/4 ". For pitches above 6/12, all tiles shall be attached with a minimum of two nails. Seal all nail penetrations with plastic cement. N. At 55' above grade or greater, all tile must be attached with a minimum of two nails in both a nail -on or mortar set installation. I. ha sten and cement all gable rakes at the horizontal guidelines. J. Where tile overlaps flashing, tile must be secured with approved tile adhesive or cemented in place. K. Tile must cut smooth and straight to maintain the proper width in the open valley. Width in the open valleys may vary according to local conditions. It is recommended that the minimum width of exposed metal be 4 ". L Where field tile meets the hip nailers, tile should be cut along the hip boards. The joint between the cut tile and the hip nailer shall be sealed neatly with plastic cement. M. All hip and ridge tiles shall be set in a bed of mortar and fastened with a 21 /2" nail. It is then recommended that the mortar be pointed to a clean surface. 1. Materials: a. Clay tiles shall be Altusa S' as manufactured by Alfreria Del Turblo S.A. (ALTUSA) for Almar (USA). Inc. 18 1/2" long by 10 1/2" wide nominally. 1. Under eave shall be (specify one) 1. Clay eave closure 2. Rubber eave closure 3. Mortar filling with weep hole 4. Metal closure c. Asphalt plastic cement: Heavy body composed of asphalt and other minerals, con- forming to ASTM D2822 and Federal Spec. SSC -153 type 1. 1. Cement Mortar 1. Cements a. Blended Cements - conforming to ASTM C -91 type M b. Portland Cement - conforming to ASTM C -150 type I c. Masonry Cement-conforming to ASTM C-91 type M 2. Sand-conforming to ASTM C -144 uniformly graded, clean and free from organic materials. 3. Mixes - conforming to ASTM C -270 type M (select one) 1. Cement 2.07 + — E -1 -A 1. Combination of cement 2.07 E -1 -C 4. Mortar flow 110 + — 5% conforming to ASTM C -230 Flow Table. 2. Decking: Solid decking shall be of proper thickness (1/2" minimum plywood sheathing) to be structurally adequate and properly fastened to support the anticipated loads. Decking material and installation of it shall comply with all local Building Code Requirements. 3. Underlayment: Never install underlayment on wet, frozen or icy surfaces. Sweep roof surf: broom clean. Cover all sloped roofs under tile with the best quality asphi impregnated roofing felt weighing not less than 43# per square feet. Specify Desired Ulydertayment: Consult Local Building Codes for Compliance Nall -0e IastellalIsuz: A. Minimum 4/12 and greater: Lay one layer of 43# base sheet with a sealed minimum 4" headlap and side lap and nominal 3" tile headlap. All tile nail penetrations to be sealed w plastc cement. Mortar -0. Installatioas: B. Pitches 2 1/2/12 and greater (refer to building codes for minimum). LE one layer of 30# felt, secure in place with tin tags as code requires. Lay w minimum 2" headlap. Apply 90# mineral surfaced roofing fell to be solid mopped to the 30# felt with hot asphalt. Lay with minimum 2" headlap and F side lap. Back nail 90# felt with cap or tin tags 12" o. c. 4. Fastening Syslems: Nail-On Installations A All nails should be large headed nails, 8 penny, corrosion resistant, ton( enough to penetrate through the sheathing by 3/4". Copper, stainless steel hot dipped galvanized nails are to be considered to extend the life of the roof. A nails penetrating through the watertight seal should be waterproofed with mastic sealant complying to ASTM D- 2822 -75, type II. Nail length may vary depending on the thickness of plywood and exposed ceiling situations wher nail exposure is unwanted. B. For steep roof applications above 7/12, additional fasteners may be requirt i. e. tile tie systems, nail - locks, wind -locks per manufacturers specification. (consult local building codes). TAX FOLIO NO. ERMIT NO. ;TATS OF FLORIDA: ;OUNTY OF DADE: HE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with hapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. Legal description or property and street address: 490 N. E. 102 Street Miami Shores, FLorida Description of improvement: Install New Tile Roof. Owner(s) name and address: W. R. Fussell NOTICE OF COMMENCEMENT 490 N.E. erest in property: '.JJC' Er xne and address of fee simple titleholder: 10 1 A :.ontractor's name and address: C- A 115 A ( A-,e) Surety:(Payment bond required by owner from contractor, If any) me and address: N /A , ount of bond $ .ender's name and address: k\1/1), 'arsons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided Section 713.13(1)(a)7., Flori A tatutes, re and address: t' addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in tion 713.13(1)(b), Florida Statytes. n ne and address: lJ f\ xpiration date of !his Notice of Commencement: (the expiration date is 1 year from the date of recording unless a rent date is specified) rn to and subscribed before me this 9 day of_ Ty Public Notary's Name :ommission Expires: • (A).17 IIA'sr / I tun of owner Owners Name LJ ' F*` \\.±: 8on104 'I't+rV ttotW: Patlo Undowritors STATE 0=.FLORIDA, COUNTY OF DttbE I '•E? W CE21 !FY fho• 0hin 15 o true cop of fho o f 101 is s ono on � L day of , A D P9 W THE`SF:.; h ::d • cd Official Seal. HAAVt JVib C y� K, afr gl u;f and c fy caerfn 19f3. • •r% Prepared by: Carlos Arocho Quality Roofing Contractor, Inc. Address: 251 N.W. 99th Street Miami, FLorida 33150 9:3R445750 1993 SEP 09 11 :34 Ron e ? c1 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby mode for the approval of the detailed statement ur 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. �l S Owner's Name and Address ..... -S . �. ....:.....� � No..�. r J' � —. StreeR( .l.�r� Registered Architect and /or Engineer , .,,--•••.,...•,,.•. „.„,,.,...- . .,<..,.,C,. .. Name and address of licensed contractor. ../. ' 4:1 161 -h L �.t �n� c,or - • Location and legal description of lot to be built on: / 3oZ 06 ' 17 pss - Lot ,f Block / Subdivision.l� f�z�s�,r Street and Number wher • work is to be done .pA �✓ o�.0 ,� �� t State work to be done a urpose oLbuilding (by floors).../ gyp 2. td a/ .l -- ,L1.,!e.Zi4 ee,isi 7a. e � ' _v ' fs . s, . c &n1 cY_ ..e.._.,1 and for no other purpose. Remodeling Addition Repairs No. of Stories v' Kind of foundat o New Building To be constructed of Estimated Total cost of improvements $ STATE OF FLORIDA, 1 . COUNTY OF DADE. i ss' (4 Y 1 Building Inspector Date ..IT” l......... . Disapproved Date (Signed) --1 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 b 't all the plans d spec lions for said building. All notices with reference to s limit . ifi' be sent to. (..A.• -.C. 1. 13.::B. ,tier- ao ' C.30 - 44 fN / i ! 4, .._45401 Roof Covering Amount of Permit S. Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires ie building and its construction may /j. 4i / f ,. . ,:? / 2 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 hips 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 arc required by the Act. The undersigned agrees to employ only such s4contractors, on work to be pert jmed under this pcnnit, as are licensed by Miami Shores Village. Remarks. (Signed) __s.' 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.. PLANNING BOARD DATE , Chair ;man 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 Plannir.g Board. A re inopec'tion fee of $L00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workinanship. r MIAMI SHORES PILLAGE 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. Owner's Name and Address Street and Number where work is to be done 2 c / t.L,4 f ... (A} ELY / State work to be done and purpose of buildin (by floors) /'"iee -/ S % D O Remarks (Signed)- ..._. ate.. Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision _.. �- G X % E.v777 _.... T' ITV SIIVIT,1!” vW 'To and for no other purpose. New Building Remodeling Addition l''' Repairs No. of Stories To be constructed of Kind of foundation o Roof Covering Estimated Total cost of improvements $ Amount of Permit $. Zone cubage required -Plan Cubage Size of Building Lot Distance to next nearest building 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 arc required by the Act. The undersigned agrees to employ only such ntractors, on work to be performed under this pennit, as are licensed by Miami Shores Village. 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 -- — — - - - 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. / lO S / Date _ ad, Sworn to and Subscribed before me. Disapproved _...... Date .._...___.{ Notary Public, State of Florida ( Signed) {.. ..: . Buildi Inspector \• My Commission Expires PL. `NINC BOARD DATE 7_ �._._...._. _... _ 19. No Street . Z. `f to me well known, 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. 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 Registered Architect and /or Engineer 1 111 , ,,,, ,,,,,,,,1,1,_..,: -111.. Name and address of licensed contractor d - e 1 b fk kj Lilc . LQ.. I` Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done e k) l 02 _ _ State work to be done and purpose of building (by floors)..._...... ?. Z o a '..S. . u:.,l.:4 - f'�- �- -- P°O9 Building n pector Chairman Member Member 1111.. Council Approved •• 11 Date.. / ..�..�.G (410 Q. s I ._.__ _. No 7 F° Street ...l..D 2- 5Z' and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ ,/s3. 1 Amount of Permit S- lone 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 Libor 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 subcontra ors, on work 3o j be performed under this permit, as are licensed by Miami Shores Village. Remarks..._ (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 stateA are true. Permit No.__...- ! arZ ru _....._ ✓ O Date v' '7-- 7 -_ Read, Sworn to and Subscribed before me. Disapproved n _.._ Date Notary Public, State of Florida (Signed) PLAN INC BOARD DATE to me well known, My Commission Expires Member Member Member 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 fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 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 Villap 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..._...,G�° ..� -- _ .. _..._.__....... ,19,7 O.vncr's Name and Address .... /24- ci .WA IS ... No....' . 6.._... Street -104 S ? Registered Architect and /or Engineer .. .,....,,...+ ....... .:.:.. .._.. Name and address of licensed contractor... It 4 , d ? ✓. 7 � 6 f� ��`� �i Location and legal description of lot to be built on: C l Lot Block. Subdivision. �� /..� ?.!. r.l /�.L�.�.S °.LG . Street and Number where work is to be done U 11, - -- ;1 //I peared MIAMI SHORES VILLAGE State work to be done and purpose of building (by floors) and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering P• ru II A; Estimated Total cost of improvements $... at'Sb,..t b 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 subontractors, on work to be performed under this pennit, as are licensed by Miami Shores Village. / Remarks._. (Signed) r 4 e- , 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 op- 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 s to a e. ,� Permit No ._.._ Date ° °� Read, Sworn to and Subscribed before me. . ..__. 7 7 Disapproved __ F Date Notary &*-) P Building nspector My Commission Expires Public, State of Florida PLAN NC BOARD DATE Chairman Member MScrr,bcr Member Member ...... _....__. -- -._ .- --_....._ Member ...._ _..._ Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning hoard. A re-inspection fce of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.