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BP-05-0540OWNER'S NAME PRESENT ADDRESS j LICENSE NO. PHONE NO. guernsey Const. Co. I I JOB LOCATION (ST. OR AVE. i LOT BLOCK SUBDIVISION 300 N.E. 102nd Street I 6 I 2 MS BP Est. GENERAL CONTRACTOR „ _ -.---ADDRESS- _ - -- - =:_- _PHONE NO. - - _ LICENSE NO. - -- - ,V. Guernsey � j BUILDER'S BOND 742 18- 20--54 I 19000 ( BUILDING PERMIT NO. DATE PERMIT FEE S NO. DATE 28031 I 15,000 ZONE REQUIREMENTS CU. FT. PLAN CUBE CU. FT. i EST. COST S DATE DRAWINGS, SPECIFICATIONS RESTRICTIONS AND CUBE CHECKED BY: STORIES CONSTRUCTION INTERIOR CONSTRUCTION S I 'CBS CBS tile I 1 t ile i and Oak floors., plaster NEW CONSTRUCTION DESCRIPTIONV S an c-e ?� y� yy �4,, .Lga 3 I�1.im.s Z ' ba the -liv l ng omi -Fla, room-dining area. - kitchen -gargp . REPAIRS DESCRIPTION ALTERATION ADDITION APPROVED REJECTED REFERRED TO COUNCIL REASONS SUBMITTED TO PLANNING BOARD I RE- SUBMITTED TO PLANNING BOARD I REMARKS SUBMITTED TO VILLAGE COUNC L CERTIFICATE OF OCCUPANCY NO. " [/ ISSUED ' e BY TO BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE C1,01 �%Or,/SUILDING INSPECTIONSI, INSPECTIONS DATE BY- RE-INSPECT BYV RE-INSPECT By FOUNDATION NEW BLDG. ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. BEAMS & Lf'JNTELS FEE TEMPORARY SERVICE RANGE CONN. $ FRAMING FIXTURES SEWER $ SOLAR HEATER DATE FINAL RE-INSPECT BY RE-INSPECT GAS' TEMP. SERVICE CLEAN-UP II 1 ROUGHING PLUMBING PERMITS _& INSPECTIONS CONTRACTOR NEW BLDG. PHONE PERMIT NO. DATE //- -go _0 FEES 0. NEW BLDG. ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE RANGE CONN. $ SEP-,Al C TANK FIXTURES SEWER $ SOLAR HEATER DATE BY RE-INSPECT BY RE-INSPECT GAS' TEMP. SERVICE $ ROUGHING $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING RANGE CONN. GAS SEWER FIXTURES & FINAL V(jl SEPTIC TANK SOLAR HEATER FIXTURES ELECTRICAL PERMITS & INSPECTIONS CONTRACTOR 6_h_m� PHONE PERMIT NO. I DATE. FEE $ APPROVAL TO POWER CO. FOR SERVICE DATE I NEW BLDG. ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE H. W. HEATER CONN. RANGE CONN. MOTORS FIXTURES $ INSPECTIONS DATE BY RE-INSPECT BY RE-INSPECT BY TEMP. SERVICE ROUGHING W. HEATER CONN RANGE CONN. FIXTURES & FINAL V(jl APPROVAL TO POWER CO. FOR SERVICE DATE I fil r u kA o, zs I °o- I v I o � 0 !U \ ioo NZ- 4Vf- N. E o b N►-;cH ►z;o ►rte y y r✓mN •i C0a n CL x mC cr a �i C-t on C+ G' - lt�J "C+ RR , g 1-� a N m < 74 IC' N N. E x b N►-;cH ►z;o ►rte y y r✓mN •i C0a n CL x mC cr a C-t on C+ G' - "C+ 1-� a N m < x N �3 Cz K O a ►G m n r+� N U. 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O ct y CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION 92 Miami Shores Village, Florida, Owner, Agent or Tenant of Building `= - 22 �`�w Lot b Block Subdivisioonn� ^" l Street Address ,Approved use by occupancy Remarks: _ This Certificate of Occupancy is issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. Af H _ i BUILDING DIVISION F_ 1�1= Ntubl[,T�J VILLAGE DEPARTMENT BUILDING PERMIT I Application Is bereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build- or other build- ing structure here!, described. This application is made in compliance and conformity with the rdinance of Miami Shores Village, Florida, and all provisions of the Laws of the State, of Florida, all ordinances of Miami Lores 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. /6—/ -------- -----_---- 19 -------- Owner's Name and Address _`�- --- ------ -- ----- - ------- - - No.---------- _--- - - - --- Street_-_----------------------------- - - - - -- Registered Architect and/or Engineer.-.--. Name and address of licensed contractor. Location and legal description of lot to be built on: Lot- ------- - — ---------- 0 -----------_ :_ Block ---_----------- Street and Number where work is to be done___-- ___.___ -___ State work to be done and purpose of building (by flo New Building ---- — Remodeling- --- ----- ------------- - - -- for no other purpose. Repairs------- -- --- -- ........... No. of Stories ..... _ ..... ............ To be constructed of__---- ____ -_ Kind of foundation-__ — --- — --------------_-_--- — ------ -------- — Roof GOV 9 ------------------------------------------------ Estimated Total cost of improvements $ ------ -Amount of Permit $_._....__._ -------- - -----_------------- Zone cubage required__.___ — - - --- - ---------- - ----Plan Cubage - - -------- ;?71_3 Distance to next nearest building___ — ------ ---- Size of Building L -------- 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 besent — - ----- __ ----- __ ----- - - ---------_ - - ------ - The undersigned applicant for this building permit does hereby certify that he underst an accepts his obligations as an employer. of labor under the Florida Workmen's Compensation Act, being Section 5966, Compil neral aws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance fro all con ctors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted f inspecti on the site of he wok such Public notice or notices as are required by the Act. The undersigned agrees to employ only such subcon ors, On work rformed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) - N STATE OF FLORIDA, COUNTY OF DAVE. I ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ---------- ---- - - I - ------- ---------- -- ---- -- me well known, and who, being by me first duly sworn, yon oath deposes and says that he is the. --------_-------- _ ........ — --------_--_--- - -------- - -- - ------------------- of the above described construction, that lie has full read the foregoing application, and that he did sign the same, and that all facts therein by him stat—ed are.tj;a, ) Z' OW .0e - j Permit No. _T/ Da _j F%-" ® Read, Sworn to and Subscribed before me. Disapprovedte -- — -------------- - ---- I - - ----- - --- - - - ---------------------- - - - -- - --- - - - - Notary Public, State of Florida (Signed) ---------- - --- --- -- ----- ------------------------•--------- f Building In t MY Commission Expires ----------------------- - ----__--_- - -------- - - - - - - - - V PLANNING Chairman ---_---------- — M embe r _ - — - — ---------- -- - - ----- Member — -------------- Member — — ---------- Member . ........... Member Council — --------------- --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. BUILDING INSPECTION V1 LLAG E DEPARTMENT 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--- - ----------- - ------- Owners Name and Address!!!� e_ /e e- L i -- •- -- - - -- -- - ----- 9 r - _ No. ® J ®. - � -- Street - - - -- � - - - - -- v / c RegisteredArchitect and /or Engineer. -- --- -- ----- -•- -- - - -- - --- ---------- ----- •- - - - - -- I --------------- -- -------------- ___ - --- - - - - -• ------ - - - - -- -------- -------------- ... »_ Name and address of licensed contractor. --------- Ale, c°x`r 0 c_.S eVi_G ® 6-/2 r. #• ®i ® /Y� 2 a -- ---- --...- _-- •---- --- ------ ------ - - - - -- Location and legal description of lot to be built on: Lot ----- -- ------- - - - --- -- -------------- - - - - -- Block =-- ------ - - - - -- --- •- ---- -- - - - - -- Subdivision ---------------------- ----- -- --------- - - - --- ------ - --- -- - - - Street and Number where work is to be done. ----- _________/ -4 _0_4' __ - ^11e-1 l 0 z -C-' %` ---- - - - - -- -__. _.. __... - State work to be done and purpose of building (by floors) _-- ______- !"? __ ®_ _ _� ._._______ L�e `T r`� ei' " / ---- ------- - --- - ---- - -------- - ---- -- - - - - -- ----- ------- - - - - -- ------ - - - - -- - — -- - , -- ---------- - ------------ - ------------------ ---- --------------- 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 $____ ....... °�__A- ?------__ ° " ----- ---- - - - --- _Amount of Permit $ ------------------- -- ---------------------------------- ---•------------------ Zone cubage required-- .. --- ------------------------ - - - - -- - - ----- - - -- -.Plan Cubage ----------------------- ----------- --- - - - - -- ----- -- - - - - -- -- ----- - - - --- Distance to next nearest building --------------- ----------------------- - --- ----------- Size of Building Lot ------------------ __---.---_-------____-- Maximum live load to be borne by each floor----.. ------------- ----- ----- .__ --------- -____________________________-- ----- --- ----- -- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to-------- - - - - -- - -43 L is r aq-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 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 ub ntractors, n work to be erfornled under this permit, as are licensed by Miami Shores Village. Remarks_-- . ------ --- -------------- - --- - - - - ---- - - ___ - - ( Signed) - - - - -- STATE OF FLORIDA, �� COUNTY OF DADE. t o 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.__ ! ®�� _- Read, Sworn to and Subscribed before me - �•------ _-- ------ Date --- __----- ��- - - --- Disapprove ( Signed ) Chairman Member . Member-- - ---- - - - - -- --------------- - - - - -- - - - - -- - - -- Council Approved .---------------------- --- --- ---- - ---- -- -- - ----- --- - - - - - -- -Date - ------------------------------------------- ------------------------------------- Notary Public, State of Florida My Commission Expires--- ------ ------ - - - -- --- - -- - -- --- -------------- ------ ----- - -- - -- ------ ------------------ - ---------- DATE Member------- --------------------_- ----------- Member-------------------------------------------- Member---------------------------------------- --------------------------------------------- Disapproved-------------------------- _ ------ --- ------ ••- -- ---------------- ._----- - - - - -- ..Date NOTE: A charge of $1.00 will he 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 ELECTRICAL INSPECTION DEPARTMENT Permit No....Jll.. ........... 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, Fiurtda, 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 work. Owners Name and Address...... ? :... tt<tnri. . ......... ............................No� .rl� ®...��r...�.... .........Street..., /.D �i ...... :....................... Registered Architect and /or Engineer............ ...... ............................ .... ... ...........................� ,.......... ............................... _ ........... ,..........,.......... Employing Electriciafi's Name.. fie ... ..... :.. e-J�t1 ...........No.. . . ....�.'..�?�.......... Street... .� a ..................... ...... Location and Legal Description Lot .................. .......... :......................... ...... ...... Block ................................ _ ........ Subdivision . _. ......................... ..... ......... Street and Number where work is to be performed— No ......................................... ............................... Street................................... ............................... State work to be performed and purpose of building (By Fl oors) ............. ...................................................... ... ...... ........... ........... ...- ........................ ........ New Building ................................ Remodeling ................................ Addition .............................. Repairs ...................................... No. of Stories.................... Service Underground Size Feeders............... Conduit ................Main Sw............... ... Amps ..........................Main Fuses . -Amps Type of Installation -- Conduit....... ................ Tubing....................... B. X .L........................Metal Moulding........................................ ............................... .......................................................... ............................... ......................................................................................................................... ............................... ....................... _.. ...... ............. .... ... ... . ......... .. ....... ........ ..................... ... . Amountof Permit $ ................ I.........I.......... .. ................._............. (Signed)—e.' ................. ctric............. .. % E.ectrical Insp r 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 subcontractors 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. (Signed) .... ..... G� ` .. !. 4��d.. ......... ............................... Master Electrician. STATE OF FLORIDA, COUNTY OF DADE. 8s. 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, and he has carefully read the foregoing application. and that he did sign the same, and that all facts therein by him stated are true. ...» ............................... m y Commission Ezpires.. ............................... .......................Notary Public, State of Florida ............................ NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH LIGHT PLUG FIXTURES REFRIG. IRON RANGE RANGE WATER W. HEAT. SPACE STRIP TOTAL OUTLETS OUTLETS RECE'P'T's NO. LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. HEATER HEATER CONTR. LIST CHECK ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL SW. CAs. TEMP. PERM. 4 LL O.i HP 1.8 HP TRANS. CONTR LIST 0 CHECK Service Underground Size Feeders............... Conduit ................Main Sw............... ... Amps ..........................Main Fuses . -Amps Type of Installation -- Conduit....... ................ Tubing....................... B. X .L........................Metal Moulding........................................ ............................... .......................................................... ............................... ......................................................................................................................... ............................... ....................... _.. ...... ............. .... ... ... . ......... .. ....... ........ ..................... ... . Amountof Permit $ ................ I.........I.......... .. ................._............. (Signed)—e.' ................. ctric............. .. % E.ectrical Insp r 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 subcontractors 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. (Signed) .... ..... G� ` .. !. 4��d.. ......... ............................... Master Electrician. STATE OF FLORIDA, COUNTY OF DADE. 8s. 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, and he has carefully read the foregoing application. and that he did sign the same, and that all facts therein by him stated are true. ...» ............................... m y Commission Ezpires.. ............................... .......................Notary Public, State of Florida ............................ NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No ................� ,..� .................. �/� Date........... ...... ........_ ....... ....... 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 work. Owners Name and Registered Architect and /or En ngiinne` er ............................. �.. r.............. ..........._....Za..A4- ff...... 1V.13:.ZT &A.....e~.11A.Ll.5 -/............................ Employing Electricians Name..! ®L '�L.rd�� ...(...No..........1.. ® .. ............Street.....(...... Locationand Legal Description Lot ....... .. ........................................................... Block .......................................... Subdivision ................................ ................ Street and Number where work is to be performed—No ....... 30. 10 ................. .. .......... _ .... .. ....... Street. .... .......� � .... .1....:...... ,�f�� State work to be performed and purpose of building (By Floors) ................... %� �./. ��. .`.�....._..................... ........................ NewBuilding . ............................... Remodeling....... >( ................... Addition .............................. Repairs ...................................... No. of Stories................. Service Size Feeders .................... Conduit ............... Main Sw ............................... Am ps .................. ...... .Main Fuses ...... . .............. » .... Amps Underground Type of Installation— Conduit ............ ....... Tubing........................ B. X. L.........................Metal Moulding............ ........................ ............................... Amountof Permit $ .................. .. °.. l.. l............. ............................... ( Signed )............................. ...... .. ...: . Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts s obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of on a Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or .contract 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 ce or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, n ork^ to be perform d und9�' p as are licensed by Miami Shores Village. (Signed).... ..... ............................... ............... w...... ...................... lectrician. S TATE OF FLORIDA, COUNTY OF DADE. 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ..... .............................My Commission Esp ires. .................. ............. .......... .................Notai9`Public, State of Florid a.............................. NOTE: A re-inspection fee of $1.00 will he made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH LIGHT- PLUG FIXTURES REFRIG. IRON RANGE RANGE WATER W. HEAT. SACK STRIP TOTAL OUTLETS OUTLETS RECE'P'T'S NO. LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. HEATER HEATER CLIST %fa 18T (� CHECK ®� ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL SW. CAB. TEMP. PERM. 0.1 HP TRANS. CONTR. ? ?U LIST LIST CHECK Service Size Feeders .................... Conduit ............... Main Sw ............................... Am ps .................. ...... .Main Fuses ...... . .............. » .... Amps Underground Type of Installation— Conduit ............ ....... Tubing........................ B. X. L.........................Metal Moulding............ ........................ ............................... Amountof Permit $ .................. .. °.. l.. l............. ............................... ( Signed )............................. ...... .. ...: . Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts s obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of on a Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or .contract 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 ce or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, n ork^ to be perform d und9�' p as are licensed by Miami Shores Village. (Signed).... ..... ............................... ............... w...... ...................... lectrician. S TATE OF FLORIDA, COUNTY OF DADE. 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ..... .............................My Commission Esp ires. .................. ............. .......... .................Notai9`Public, State of Florid a.............................. NOTE: A re-inspection fee of $1.00 will he made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT ZZ °°�� f-� �[ Permit No .......... ..e .......... �Ae / `` #W/ �" Date...........'... 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 work. ` ^� /� �- Owner's Name and Address...... � 4�� . l► �.!..x n. cg............................ N........ .. ............. Street ...t.. • ..�.�.?. .. .1 Registered Architect and /or Engineer ............../ �691 ........ L. L. L�_ ........ �i�m�.� ........... �.................. C Employing Electrician's Name..r — ,../ ... _ .. � f........ . ....... Street. l/ p .. J ....................... Location and Legal Description Lot ................... ...Block............:. Subdivision................ Street and Number where work is to be performed—No ........... 3- 90............................ .. .... .. ....... Street.& &, _-.,F,0 ..,,,��..................... State work to be performed and purpose of building (By Floors) ......r l% f ....... . Lei ................................... _..-................................ NewBuilding ............ .. .................. Remodeling ....... .�.. ................... Addition .............................. Rep airs..... ................................. No. of Stories.................... Service Underground Size Feeders .................... Conduit. ............... Main Sw ............ ... A .... mps ........................... Main Fuses. ..................... » ... Amps Typeof Installation— Conduit ........................ Tubing ........................ B. X. L ......................... Metal Moulding ................ ................... ... ... ............................ rT " 66 nn / — ' ®S'® Amount of Permit $.......... 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 subcontractors 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 suchjublic notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contra rs, on work to be pe ormed a this t, as are licensed by Miami Shores Village. (Signed) .......................... ............. s....... Master Electriaan. STATE OF FLORIDA, COUNTY OF DADE. as. 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ... .. ................................... .. ......... .. ................ .. ... ........... . ........ I............. ....................... . ............... .. .............. .. ............................. .............; .......... My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. M SWITCH LIGHT. PLUG FIXTURES REFRIG. IRON RANGE RANGE WATER W. HEAT. 1�pACE STRIP TOTAL OUTLETS OUTLETS RECE'P'T's No. LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. H�i►TER HEATER LIST CLIST CHECK O 20 4V �� v 'J ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL SW. CAS. TEMP. PERM. O.1/ Wb 1.0 HP TRANS. CONTR LIST _ CHECK _ 0D Service Underground Size Feeders .................... Conduit. ............... Main Sw ............ ... A .... mps ........................... Main Fuses. ..................... » ... Amps Typeof Installation— Conduit ........................ Tubing ........................ B. X. L ......................... Metal Moulding ................ ................... ... ... ............................ rT " 66 nn / — ' ®S'® Amount of Permit $.......... 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 subcontractors 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 suchjublic notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contra rs, on work to be pe ormed a this t, as are licensed by Miami Shores Village. (Signed) .......................... ............. s....... Master Electriaan. STATE OF FLORIDA, COUNTY OF DADE. as. 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ... .. ................................... .. ......... .. ................ .. ... ........... . ........ I............. ....................... . ............... .. .............. .. ............................. .............; .......... My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. M i MIAMI SHOFIES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION F ELECTRICAL PERMIT Permit No.. ..� � � � ............... Date .......... I..... � .� ... `....... . :.......... . 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 work. Owned s Name and Address... " Registered Architect and /or Engineer... ..... .... .. ......:.....• ............... ....I.......•.................• .................... Employing Electricians Name..... :... -._ ..:.:.... No .... ............................... ....Street..................... ................. Locationand Legal Description Lot ... ............................... ..... ..:........... .I.........Blo�cek ................... ... .I................... Subdivision............ -•_... ..................... Street and Number where work is to be performed— No...) ... ...... Street . ........................................... ..._..................... Statework to be performed and purpose, of building (By Floors).... .............._................ .......................................................... = ........_..._................ New Building..-.-4 ......................... Remodeling ................................ Additio h.. -..... ...................... Repairs. ........ -- ........................... No. of Stories ................... SWITCH LIGHT PLUG FIXTURES REFRIG. IRON RANGE RANGE WATER W. HEAT. SPACE STRIP TOTAL OUTLETS OUTLETS* RECE'eP•T's No. LAMPS OUTLET OUTLET OUTLET CONK: HEATER CONN. HEATER HEATER CONTR. LIST CHECK ENT. GIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL, SW. CAB. TEMP, PERM. 0.1 HP 1 -5 HP TRANS. LIST CHECK P .� Overhead Service Underground Site Feeders m Main Fuses .................. ...... .. ^AMPS .- •- ...1..... �.....:..... w ................................ ps....................... ..conduit... .Main S Type of Installation- Conduit ........................ Tubing ........................ B.XIL ......................... Metal Moulding...............: ........._.-. .. ......................................................................................................................... ... .............................................. . ........................ _.............................. Amount of Permit $ ...... . ....... L4..c . ..I............ ......... . (Signed) .. ............................ ...... ............ ............ ................ ... .... Electricid Inspector. 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 Sectipn 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. & ( Signed). ....................... ......... Master Electrician. STATE OF FLORIDA, COUNTY OF DADE: ss' Before me, the undersigned authority, a notary public, duly authorized to administer . oaths and take acknowledgments, personally appeared..................... ................... ............................... ..A.................. ........... ...... ........... ............. ....................--- ........ .... .. .... _ .... _........... .. ..... ... y deposes and says that he is the .............. ........................................................... to me well known, and who, being by me first duly sworn, upon oath of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all factspN therein by him stated are true. .. My Commission Expires _ .Notary Public, State of Florida NOTE: A reinspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. i1 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_ ,19-- - - - - -- Owner's Name and Address. --- - -- - - - - - -- = --- - - -- - -- �� -� -- _ No. - - %- -� - - - - -- Street - -- ...�® Registered Architect and /or Engineer._. -_. ------- Name and address of licensed contractor____________ Location and lqgal description of lot to be built on: Lot------- - - - --- --------------- - - -• -- Block . ---------- s -------- - - - - -- Su' Street and Number where work is to be done ------ .----- / State work to be done and purpose of building (by floors) New Building --------------------- ---- .._. Remodeling for no other purpose. Addition --------------------- Repairs_------------ ._.__ - - - --- No. of Stories .... ._ To be constructed of----- - - - - -- ---------- - - - - -- Kind of fo lion - -- - - --- - - - - -- --------- - - - - -- Roof Cov ng- - - - - -- --------•-------------- Estimated Total cost of improvements $___-__- .... .7 n _ 7 - --- --- - - - --- Amount of Permit Zone cubage required.-- ---------- --- - - - - -- ------------- ---- --- --------------- -- -- - - -- -Plan Cubage----------------_---------- ---- - Distance to next nearest building ---------------------------------------------- -- ------- Size of Building Lot ------------------- -- Maximum live load to be borne by each I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent 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- tractors 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 a work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subconp actors on wo performed under this permit, as are licensed by Miami Shores Village. 01 , ------------ - - - - -- — ( Signed ) STATE OF FLORIDA, COUNTY OF DADE. I 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 sta are e. Permit No.— _ Date Read, Sworn to and Subscribed before me. Disapproved _ - {e -- - - — - -- ------ - - - - -- Notary Public, State of Florida --- - - - - -- -. -- - (Signed) - - - -- - - -- - - - - -- - Buildmg Inspector My Commission Expires_•- ---- •-- ---------- ----- -...... --- ------- ------ --- ------ - --- -- -- PLANNING BOARD----------------- ------------------------- - - - - -- -DATE Chairman.---- ........ - - --- --- - - -- -- - — — ---------------- --------- -------------------- Member - - - -- Member - — - _ _ _ _— ------------ - --- ------ --- ------ - ----- --- - --- Member . - -- Member---------------------------------------- ------------- ------ --- --- - - - - -- Member - - - -- Council Approved----- ----- _----- - ------------------------- --- ------ ----- --- Date Disapproved -- -- -- _------------- ------ --- ------ --- ----- -• - -- -- -Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $,1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. I uv M\\, Application is hereby made for the approyal 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. Ownees Name and Address---- - — — ---_--_------ - - - - - Registered Architect and/or Engineer.:._.. ..___k ._.__...._ ..................... . .. ........................ . Name and address of licensed contractor ------- Ad Location and legal description of lot to be built on: Lot____- ______----------- ___________ Block__._-____--- Subdivision ---- — -- Street and Number where work is to be done - --- - ---- State work to be done and purpose of building (by floors)—_"A4ACRAORAM. 0 -- 22 STMIG --- - ------ for no other purpose. New Remodeling ---------- xt .......... Addition ------- —:77r= ....... Repah's No. of Stories._! ____ . ....... To be constructed of_-- - - - - -- ------------ Kind of foundation_._______L_tn= --------- - --------- - - - -------- Roof Covering .... --------- ------ 95 Wo Estimated Total cost of improvements _—Aniount of Permit ---- — - --- — ----- - ----- - Zone cubage required --- --------- - -------------- --.-------.Plan Cubage . ..... —_ - -_ - --- Distance to next nearest building___- --------- - - - - - ----- - ---- - - ------Size of Building Lot.._. ------ Maximum live load to be borne by each floor - - -- _" —__ ---------------- - ---------- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent -- - -------- - ----_------- - ----------- — ---- -------- — --- -- - ---------- -------- - -- --------------- 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 P1 I nt Supplement, e T and has complied with the provisions thereof, and will require similar compliance sub- contract by him in the work to be performed under this permit; and will post or cause 'p 'rom public notice 'e to be posted for p or notices as are required by the Act. The undersigned agrees to employ only such ub�np under this permit, as are licensed by Miami Shores Village. "n'// Remarks---------.--. (Signed STATE OF FLORIDA, COUNTY OF DADE. I ss. Before me, the undersigned authority, a notary public, duly authorized _1aladminister oaths and take acknowledgments, persorially ap- peared — -------- 7 -------- - - - ---.to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the- ....................... ---- — -- - ------- - ----- — ------- --------- - ----- - of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. Date Read, Sworn to and Subscribed before me. Disapprov Date— ----- - -------- - - - -- - --------- - ------_---- - (Signed) Notary Public, State of Florida ------ --------- - -- - -- Buil g Inspector My Commission Expires--- ___--------------------- - - - -_— PLANNING BOARD — ---------------------- - __DATE Chairman ------------ - - Member . .... . .... . .... . --------- — ---- - - - ------ Member Member Member ......... -- - ----- ------ Member Council Approved._. ______- ___.__- .— .._- ___:_ —___ ---.----Date Disapproved -- - - - --- _-- - -------- ------------------------------------------------------ Date I 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. i 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 ■ BUILDING - .• - . - Application is hereby made for the approval of the detailed staa�tement of the plans and specifications herewith submitted for the build- ing or ocher structure herein described. his application is made iii compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisioRam of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and r� ahroa of the 13uflding Division of Shores Village shall fcomplied with, whether herein specified or not. A copy of approved p specifications must be kept auilding during he of the work. Owner's Name and Address... ----- ..�._�% Registered Architect and /or Engineer..._. Name and address of licensed _ - -- Date --- - - - - - -® - - - -- [' � C O ��i — �_ - — No.•-- --- ..--- - - - - -- - - - -- Street--------------------- - - - - -- -- - - - - -- Location and legal description of lot to be built on: Lot------------------------------- - - - - -- Block--------------------------- - - - - -- S1 Street and Number where work is to be done__-- --- --------- --_ State work to to be done and purpose of building (by floors ---- - - - -.. _® tP - �!f-- �------- New Building ---- _-- --- - ------ - - -- -_ -. Remodeling------- - - - - -- ------ - - - - -- To be constructed o£ ------------------- _ ----- - Kind of fpundation -__. Estimated Total cost of improvements !p C iv /9. for no other purpose. Repairs-- _-_--- _----- - - - - -- No. of Stories .......................... ---- ---- --- - - - - -- - - - -f Covering_ --------------------------- __ ------ --- - -- i� OfPermit $----------..—_ �-'----•----------------- --- --- -- -- --- --•-- --- ---- -- - - -- Zonecubage 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 - -------------------- -----_----------- The undersigned applicant for this building permit does herebylcertify that he understands and accepts his obligations as an employer. of labor under the Florida Workmen's Compensation Act, being S ction 5988, 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 ublic 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_ - - -.- `rte'' (Signed)- - - - -__ _._._..�____ --- -- ------- - ----- — — STATE OF FLORIDA, p 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 say of the above described construction, that he has carefully read theo therein by him stated are true. Permit No. Disapproved - ( Signed) - — ------------------ Buzlduxg -�s - -- tor ------------------------- - - - -�I - PLANNING BOARD -- me well known, thathe is the----. --- ---- ------- -_- - - -- -----------_------------------- _ regoing application, and that he did sign the same, and that all facts Read, Sworn to and Subscribed before me. ------ - - - - -- - - _ _ — ----------- _ Ngtary Public, State of Florida My Commission Expires ---- _ -------------------- __ . - -_TE 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. I PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date g g Job Address / 3 0 0 U _�P— ' Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant a rJ o %W/A e fl Master Permit #� 1� Owner's Address 1300 Phone Contracting Co. Address Qualifier State # Architect/Engineer Bonding Company Municipal # SS# - - Phone Competency # Address Address Ins. Co. Mortgagor Address Permit Type (circle one BUILDING LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION CI �l -S •Cf��F 7-�� Square Ft. Estimated Cost (value)' WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understated 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 law7elating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and/or Condo President Date Si ature of Contractor or Owner - Builder Date Notary as to Owner and/or Condo President My Commission Expires: FEES: PERMIT �w RADON Date Notary as to Contractor or Owner - Builder Date My Commi sion Expires: F-0 P o RY k ) COMMISSION NUMBER . a zx r ve,'M0SSION !~xP. C.C.F. r 'ZO NOTARY BOND TOTAL DUE APPROVED: r Building l Y t Electrical Mechanical __ Plumbing Engineering PERMIT APPLICATION Date I !1 Job Address Legal Description Owner / Lessee / Tenant Ya 9Z) FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) /v� Tax Folio//, 41W 4V114 Master Permit # "Via OS"�.�u Lal Owner's Address / "-Oe A/Z /D 1-- Phone Contracting Co. `1%40 6; o.dg�cle Address' Qualifier SS #_ _-M1 - �'> Phone State$ Architect /Engineer Bonding Company Mortgagor Competency# `/ Ins. Co. Address Address Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION -1 �e� /oR ��ti7iti� Square Ft._ Cos}} le 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. OWITER'S IDAVIT: I ceCfy that all the foregoing information is accurate and that all work will b one in complia ce with all applicable laws regulating construction and zoning. Furt re, I author e%the above -named contractor to do the work stated. aotz ()"_e 2,�Z Signature of Ownd-f an or Condo resi�ent Date: Not as Ao Owner and /or/ Co o President My omission Expires: ✓fl//j0,� PERMIT FEE: APPROVED: Fire Si a re of Contractor or Owner - Builder D N ary s to Contractor or Owner- Builder My Commission Expires: ther �4 zoning Building \ / Electrical 5� Mechanical Plumbing Engineering 5�Z% �r y , MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No.___ �E Date---� ^ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sIlbmitt 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 work. Owner's Name and Address.+_ `� S 1 2 No. ___ Street Registered Architect and /or Engineer j ^ Employing Plumber's Name -_ &1aY� {- = L` 1a -� _ No. Street Location and Legal Description Lot.- ._._._ / 7 Block Subdivision- _ Street and Number where work is to be performed —No e ' Street_---_ ,4�', _6E; _../ Z'� - -- -_ State work to be performeS and purpose of building (By Floors)— New.Budding _____, Remodeling Addition- __-_._.-____ -Repairs__ - _--- _--- _ -.___ No. of Stories.. ------------ Size Septic Tank __ Type of Tank__ ___.__ ..._____Capacity - Feet of Drain Tile_ _ --- Feet of Tank or Drain Field from Well_--_ - Nature of Water Supply: City— Well.________ -Size of Soakage Pit tor. 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 5988, Compiled General Laws of Florida Permanent Supplement, and has com- plied 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 ap required by the Act. The undersigned agrees to employ only such sub -con on work to performed er this permit, as licensed by Miami Shares Village. ' Master umber. ' STATE OF FLORIDA, t COFNTY OF DADE. j Before me, foe 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 application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made-neowsary by improper notice for inspection, or faulty materials and /or worlananship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS �}S a TOTAL FIXTURES LIST CHECK GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL SEPTIC TANK SEWER CONN. DRAIN FIELD .SOAKAGE PIT GONTR. LIBT CHECK- Size Septic Tank __ Type of Tank__ ___.__ ..._____Capacity - Feet of Drain Tile_ _ --- Feet of Tank or Drain Field from Well_--_ - Nature of Water Supply: City— Well.________ -Size of Soakage Pit tor. 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 5988, Compiled General Laws of Florida Permanent Supplement, and has com- plied 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 ap required by the Act. The undersigned agrees to employ only such sub -con on work to performed er this permit, as licensed by Miami Shares Village. ' Master umber. ' STATE OF FLORIDA, t COFNTY OF DADE. j Before me, foe 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 application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made-neowsary by improper notice for inspection, or faulty materials and /or worlananship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No ------------ - -. -- Date -- - -- - r� -- - - -- --- - -- --- 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 work ` - t t - - - - - - -- _-- - - - - -- - - - -- Owner's Name and Address_.__' -- -- -_ -_ ------ - -___- - No._,-- - -- - -- ----- --- -- -- --- -- Street _ - - _ -__ -- Registered Architect and /or Engineer ----- _ - ----- — ----- - ------- .___ -__ ) P, # � Employing Plumber's Name - -- -- -- - -- ------------------- ---- ------- ---- ---- ---.__ No.- - - - - - -- - - - ---- ----- -------- Street -- - - -- -- t- Location and Legal Description Lot --- - --- - --------- - ------ - ----- - - -- Subdivision -__ _.________-------- -- -- -- - - -- ---- Street and Number where work is to be performed —No._J ' _. !'r _ _--__-_-- ----- ------ -------- -- --- -- - - -. Street- -------- ------- ----- ----•- - -� - - - °-- - -- - ----- --- • - ---- State work to be performed and purpose of budding (By Floors) ---------- - ------------ --- -- ------------------------------ ------------------ ------------------------------ # New Building. -- - - - - -- - ------ - - -- --- - - - ---- Remodeling------- -- --- ------ --- --- - ----- Addition --- - ---------- _---------- Repairs ----------- -_------------ No. of Stories -- --- - - - - - ------------ Size Septic Tank Feet of Drain Ti Nature of Water Typeof Tank-------------------------------- --- --- -- --- -------- ------ - - ---- Capacity Gals ------------------ --------------- ----- - -- --- Feet of Tank or Drain Field from W, Size of Soakage Amountof Permit $ --------------- - ---------- - -------- (Signed)-_ --- ------- ---- -- - --- ---- _-------------- - - -- -- - --------- -- -- - - - - -- --------------------- --- --- - - -- -- -- Plumbing Inspector. 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 com- plied 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 sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village, r/�' j7 (Signed )- -- � -'-= -- -- _.__.-- - --- -- -- - = - - -- - • • - -- - ---- -- -- �( � 0 Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. I 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 application, and that he did sign the same, and that all facts therein by him stated are true. ----------------------------------- - - - - -- -------------- - - - - -- -- — -- -- -- ---------------------------------------------------------------- My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made-necessary by improper notice for inspection, or faulty materials a !or workmanship. BATH SHOWERS LAVA. SINKS SLOP LAUNDRY URINALS CATCH FLOOR DRINKING TOTAL CLOSETS TUBS TORIES SINKS TUBS BAs IN DRA1N FOUNT'NS FIXTURES CANTR. LIST -- CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE DEEP SPRKLR. SW IM'G TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL CAtiTR. LIMY - CHECK Y G� Size Septic Tank Feet of Drain Ti Nature of Water Typeof Tank-------------------------------- --- --- -- --- -------- ------ - - ---- Capacity Gals ------------------ --------------- ----- - -- --- Feet of Tank or Drain Field from W, Size of Soakage Amountof Permit $ --------------- - ---------- - -------- (Signed)-_ --- ------- ---- -- - --- ---- _-------------- - - -- -- - --------- -- -- - - - - -- --------------------- --- --- - - -- -- -- Plumbing Inspector. 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 com- plied 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 sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village, r/�' j7 (Signed )- -- � -'-= -- -- _.__.-- - --- -- -- - = - - -- - • • - -- - ---- -- -- �( � 0 Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. I 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 application, and that he did sign the same, and that all facts therein by him stated are true. ----------------------------------- - - - - -- -------------- - - - - -- -- — -- -- -- ---------------------------------------------------------------- My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made-necessary by improper notice for inspection, or faulty materials a !or workmanship. up h+I L A PrI l 'v�li' C R S V I ,L.L A G BUILDING IN�f 'f tt"�N tkfE�►Af�tttwl�tN3' r 1t%pbration is hereby tnaAe fqt the a pre%al of the tktailrld' iutft +•N a ut a•e lilwsesr attd specifications herewith tvbtnitted for the build inc of ether structure hrtein dese`rrbed. This eNldkwlion is iiM, a taenlonetily. With 1 Biondi Shores �'►llige i� lor►d 1 -41141 all lWovisions of tl Caws n( tiro tiilf i ;6 ido ,dV Ads oit.„ i At �dinanee of Miami regulations of the djoldlog Owlswo gl • !!10-90-0' and # snf#« and _p)ans and •peeifictiltiene most be'kept wf � � M o' lllri lr M t � A eit►p r .�p�l r rnsd June Uv � O»ncr's Tama and Address .................. Mr. Spaulding $ ` "St . .Yn. M"A.YY VM•'YWYY•.!YY�itNf"Y » •«rr►Y .yFMt! �N�,w.Mt.w. »..4a.,r�y Fesistered Architect andior itrogivaer . "`'" •r y M«. ••. p •» .V V .nMM1Y W). � rV1'y •�A• M• }� .YY t F N `as+►e and adllraa►s of licensed t¢enut►etotR. Qb nbtaY R o ;`., S eet 1NIC a� Fes" u p�"y Location and jai dazscript lot to lrr •, •••,,w•« .. «ryy�'r VV • "��f ' .A...«..J:.. ion of ' � • "m'i'd �titt�.;" "�'•�;,.- ,.�.�.�' w,•�Yt,.... Street and Numlow where. work ht to ilt �� 3 0 Q at I'm III Mate work to be char ru> yWrMtMi Rt t, ` f•t r Ri•w+y++�M +r +ri.. ... .r. }. a e .K� f ' '��; .! , 1 nMFl..w.Y +.uHai.W!kY'n'Agb1 +►+.rYrir F +�. 4xM ,Y•«•+Nw�Yti. ».a. «.+., « +•N+•t�.f•• Reroof residence with calcr 7- 4F e •^""' 'f " »• .,..... . ...... W ............... N YMY�• ~y MYV�MAY! F..�{Y . -' M..4N'ySr 4•NR }eNYYw..Y..p1+11.NM.Mw « ! `' .`eW 8u11d►na ...... 1 , t,lY Y•F»,+ V }R + A Jc e-1. oo .L 4 3 , t \' Q'y = *;•P• un: w'�4 r .� To be constructodof .. tile Estlmattd �iOla1 9 X30.00"`r" .,.r t�lt e� •.� { YY`*�"•..M..i •.tY!+rr...rn•.�1Y11('JIY' �,i SF''•} �� IL �3 GCS. Zone cuballe required... �.... ,«..... . KW.► . c.Yw.... 3 ..►+ {.» ..�, 4.•. �_ `, •• Y .FVib JL YM dV •..•YY► �, k 1 Yp ,ti •°�" t lsat . trfs.z.ktw +. "sb „'11� +N+.w Lf Distance •to nett neat�eet bpilti;M�. �� Y• t , :l"linum .live lor+tjlo Me tlorltr `�7 Mehl• t . ,.y wr a«Y .� Y.a.r ,...Y• N •."tY. • i f 1 hereby �t •+rit ,e.`/ "'.ty. #y �' . v r ,•..Y. .air ...et4 .S wt• 4 y ell !1•r� Ittr 7 �' l:Y” x C r ► be sent to.. 7357 ,N •... am ,. '...� .... ».yl•• 1aift —L .. .tw The rifler i ,•. ;.a ,, �±rY ��•# •4� �Y1rw ,w w Y. ,.t... s� d apt+litnttlt " #tt� ihjt: of 6bur under t)W trktrt Wamil and has {complord Mitt i . • in the v'et►k to bti er taetioee � , pdrinN; a# ari �, Tt ' ll+rmatke ' ►'," n r� At' k'�" �E s �w .. «. ... ..n.• �. ai3 w.Y�WWR•+naN.a.a.p„�ty df}yyN�x e ;. es.- , h YII�..MY Y• }y...r�,�� STATE OF FLOt;tEiA; COUNTY OF DAJ*. Before mi. the tiirsiti tral�nrrf ,• l (reared James D. Obe . tiiw ... ............ , »... 4S.M ,; w.r,.a,ev.« 1 •+•M•�r•NY ..,miJ� 1MWF.? i*1Y 1+�,. w t� iW%N.a ��yy�� t,: ..r.. ... . ....4.. :.�, ;•'. r �` b y. Y ..MH.ilt.•�1.11'}...✓�M•4e.,4FY t# i ♦i....3 ..w�... .. ......." ... ,,.W..... ......... �, !e w t R••.•y •Y�.w• . »YY +n .• fitlew. and who. being by me first duty sworn. tl aatlr till wilt of file &heyde�t�ibert1t1011dlt1. tlwr�`%411,.# n11t ►• • t.• . r therein by AIt#i a., Pervalt » •. .W.Gn M . "4 4 IT, t 3 .• � .r DitspDrovod ... Y fi1rN w ryas •eirh�: ° i, y. 't'l`2 +t. f�Kt `t ♦ f.ati...� 8tliltMi�d wtsp�Mar - ��4.t�.,.fa.,, ��►��t�o . �+r,.•��l Pff''"�'�i`E 1 '4ANNlNiii.ARQ:...Y;41 „YY,..;.; AR t...,,Y.t....,...;. „ ».►Y COMMISSION EXPIRES fEB. 18.'1989 Gi►ainn+n ...... ..felltlebt { « FMM� r N1Y. `�►. r11Ylr .- •f. MVMy .......... M ................... .YY N ,�Irtnbet Y,..F.. »« F+ t..rl C `"P F �.iN. ... Y.. YYj FY #z+, «,tY•.Y»w.wrY ` „j"p'+er*i :f A�e Co%%nc4t Approved ... •c«a+.M.A!R.. ` Y•Y*'�n,�� «iY f .ri v..:F..F ..,i•.. .,..Y;,, .. ... 'NOTE., t ;► a eI $h.00;w bate /► 1► ►� ill be „•Gads for makiM'�NMretolUAtle iF M #tfN ilq N pptnvMl Own o 69 btained 1rmet tier il e 1'l.u►m►,� u. ►rd a .` A rc•jn p►•tt►u1► fee of 111.00 will be ulrar Sri fit► rMpte Mtfee ow i luater►ab anti /or wori4aeship. wl11III MeQ , ft IrMdtl syoa,., ift to irony MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby wade for the approval of the detailed stalt, ing or other structure herein described. This application is made in 4 Sllores Village, Florida, and all provisions of the Laws of the State of regulations of the 'building Division of Miami Shores Villap shall be Inns and specifications must be kept at building during progress of I it or %ne plans and specifications herewith submitted for the build - ipliance and conformity with the Building Ordinance of Miami lorida, all ordinances of Miami Shores Village and all rules and nplied with, whether herein specified or not. A copy of approved p work. P2 Date.._».. � / ;P % ....._......... .19..... . Owners Name and Address ................ SPA" ....... . « « »........ No. 13 ®6 A4�tred Registered Architect and /or Engineer.....? ........•.............» ........ ».:..q ....... I..... . •m•••fn. :n++t+setet�.•mtm xr••••.•••.•••.•••,,.••qq�� Name and address of licensed contractor.... �° » �Ot° ~;`= -` '� � � ••• •® »0 �--- Location and legal description of lot to be built on: Lot............ ............................... Block .................... »........» Subdivision_..____... ». »......... »......_.........,...... Street and Number where work is to be done. »»........ ✓.... ....�_...._..��•` . » -•. •••••••- ----- Stato work to be done and purpose of building (b floors). ° e_,* -i _..••°�� r� ��- -��.. --- ••- .- ..•• -- .............. I ....... ......_ ..... ....................... ................ ....... ... .».»... .......twd for no other purpose. New Buil ding ............................. Remodeling................ .. Addition .......................... Repairs......... i..... ».. No. of Stories...... ..._ ...... To be constructed of .................... Kind of foundation:..........»................. ............................... 'Roof Covering...... t-7-� .��. :..... _.._.,. Estimated Total cost of improvements $..........��.. »...... Amount of Permit ...».. ......,... ..................... .... Zonecubage 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 pecifications for said building. All notices with reference to the building and its construction may be sent to.: � 0 �7" �° ®o A=" ..izr � T��9/'u `+t'C. .............. ............................... .... ........... ............................... Y The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labur under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida. Permanent Supplement, anti has complied %cith the plrovisions thereof, and will require similar compliance from all contractors or sub - contractors employe 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 e w k such ublir notice or notices as are required by the Act. The undersigned agrees to employ only such subcontra ors. work be fo. under this permit, as are licensed by Miami Shores Village. Remarks ... _ .................. _ .............. .......». _.» ....._ ........ (Signed)-- ».._ STATE OF FLORIDA, . COUNTY OF DADE. as. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ----- _.__. ................... . ..._ ................... _ ..... ». .................... ». » »........... .._to me wen known. and who,. being by me first duly sworn, upon oath .deposes and says that he is the ................ .... ........... ........ : .... » ... _ ..,.._ Of the above described construction, that lie has carefuny read the foregoing application, and that he did sign the same. and that all facts therein by him stated are true., II Permit No.. -. --- ...- ...�Date....l Read, Sworn to and Subscribed before me. Disapproved...._. _ .... D to.___ ._._......_._�..»_ .... I t ( Signed) .._.._............ ......... ....... ............................... Building Inspector » N.......................... tary Public, State of Florida MyCommission Expires......._ ......... ...................._,.,,.»„.. PLANNING BOARD..». .......». ....... .............._ ..__ ».... DATE Chairman...... .. ........ ........... _........_ ». .._ »._ ..»........._.......... Member .......... .................- .- •.........» .»....._............ ».............._ .Member ..................... . .......... _---- ---------- .._ .... _.._...................._— Member .............. .._....» ..................... Member.. ...................... - -- ..... ». Member .... _ ......... ..... �. ......».................�...... _... ........._. CouncilApproved ..... . ................................. _.......- ...... .........._Date Disapproved .............. ........... ...........................Date NGTE: A - charge of $1.00 will be made for making corrections or changes to this application after approval has hecn obtained frwn the I'l.mnin;,g Board. A re- inspection fee of $1.00 will be charged when truth re- inspection is made necessary by Improper notice for inspec-tirm or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECT DEPARTMENT APPLICATION FOR BQILDING PERMIT Application is hereby made for the approyal of the detailed staten ing or other structure herein described. This application• is made in c Shores Village, Florida, and all provisions of the Laws of the State of regulations of the Building Division of Miami Shores Village shall be plans and specifications must be kept at building during progress of f Owner's Name and Address-P Registered Architect and/or E Name and address of licensed Location and legal description of lot to be built on: Block---------------- - - - - -- - Sul Street and Number where work is to be done_A39_qK1 State work to be done and purpose of building (by floors) New Building--------- ------ - - - - -- Remodeling--------------- - - - - - -_ To be constructed Kind of foundation-- Estimated Total cost of improvements $_____;V00000 Zone cubage Distance to next nearest Maximum live load to be borne by each the plans and specifications- herewith submitted for the build- i•e and conformity with the Building Ordinance of Miami a, all ordinances of Miami Shores Village and all rules and .d with, whether herein specified or not. A copy of approved Date_ March 10, 1969 No. 13 Street _N]E!_.102st. __and for no other purpose. Repairs------ -_--- ----- -• - - -- No. of Stories ------ one . ............... ------ ___ Roof Covefl,,g._301b!t_(9�91�b!L&tile ,unt of Permit $ ..... . IlA® - -- - -- - -- - — — ----- - - --------_-_-- - - - ------ - __--------_--_____----------------------- of Building Lot ----- ---------- I hereby submit an the plans and specifications for said building. All notices with reference to the building and its construction may be sent The undersigned applicant for this building permit does hereby certii of labor under the Florida Workmen's Compensation Act, being Section and has complied with the provisions thereof, and will require similar cc in the work to be performed under this permit; and will post or cause to or notices as are required by the Act. The undersigned agrees to employ permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. I ss' Before me, the undersigned authority, a notary public, duly peared and who, beiny by me first duly sworn, upon oath deposes and says thai of the above described construction, that he has carefully read the foreg therein by him stated are true. Permit No. Date --- -------- Disapproved D --- - - - - -- - Z,')C2 (Signed) - ------------- Building Ins iferctor /PLANNING BOARD ---- - ------ . ...... Chairman-------------------- - - - - -- - - - - - -- ---- - - - - -- Member — - — ------- - Member --- - ----- -- ---- - - - - -- Council Approved-----_--------- — - ---------- NOTE: A charge of $1.00 will be made for making corrections or the Planning Board. A re-inspection fee of $1.00 will be charged when such re-inspect, rn�terials and/or workmanship. that he understands and accepts his obligations as an employer 166, Compiled General Laws of Florida, Permanent Supplement, pliance from all contractors or sub-contractors employed him , posted for inspection on the site of the work such public notice ly such subcontractors, on wor to be performed under this kWb ^ 0- gned 0 10� to administer oaths and take acknowledgments,* personally ap- me well known, heis the - ------------ - - - - -- ---------- - ----------_------ - - - --------- - ---------- ling application, and that he did sign the same, and that all facts Read, Sworn to and Subscribed before me. -- --------------- - - — ------------------------ - Notary Public, State of Florida My Commission Expires- ---------------- --- ---- - -- --- - -------- - ---------- - - - - _--DATE ed-------- -------------- --------------------------- ___ -------- ...... - -- -_Date to this application after approval has been obtained from is made necessary by improper notice for inspection or faulty -• MIAMI SHOREP VILLAGE BUILDING INSPECTION 'DEPARTMENT Application is hereby made for the approval of the detailed statement o the plans and specifications herewith submitted for the build- or other structure herein described. This application is made in compli nee and conormity with the Building Ordinance of Mia�,hi Shores Village, Florida, and all provisions of the Laws cf the Statu of Floric a, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shore_, Village shrill lie conhpl ed with, whether herein specified or not. A copy of approved plans and specifications must be kep' at building during. progress of the we . Owner's Name and Address---- � - - - -_ Gaernsey 'Constv,Ietion 04 __ -- _-----_ ._------- ____.- _-- _--- --- -_ --.. Registered Architect and /or Engineer_ -__ -------- ___ - ------------- ______- ___ -_- .. --- Name and address of licensed contractor_ __Sheet__Uta1--- 3pec1.1 Location and legal description of lot to be built on: Lot ---- - - - - :_ -- ------- -- Block.__ - - -- _ ------- ___ -__ Subdivision-------- - - - - -- Street and Num ,'Awhere work is to be done -------- 130 -0 -. s_ -y.___ SM State work to „lad ie and purpose of building (by Roof !n9- -O--n- ne;!w��Ie_ Date-- - - - - -- November . ---2- R'�- -0- - - 19--- - - - -54 19 - - - - - -- No.--- ;M§ ;.- - - -. Street__ . -E.- --13th - Ave. It-y Company P__. 573 -N. .-- 71st-- St.-,_ -Miami -------- - - - - - -- - - -- ' -- - - -- - -- -------- - -- - - - - -- - - - - - -- - - - - - -- - - -- --- - - - - -- - -- - - -- — — - - - --- - - ---- - -- - - - -- ----- ------------- and'for no other purpose. New Building--- - - -- Remodeling - - -_ -- - . -- -- - - - - -- Addition. -_ -- -- - - --- - - -- Repairs - -- - -- - - -_ - -- - No. of Stories one -- To be constructed of - -_- C • B! S!__._ Kind of foundation_-- - - - -__ _ - - - - -- __ - -.._ -- - . - - . -- -- -- --- Roof Covering - -- - -- --- Tile. _ - -- Estimated ” -:tat cost of improvements $__.. 994!0 --- -- ------ �_____Anionn cf Permit QQ - __ - - - - -- - - - - --- - Zone cubage required_ - - - - -- - -- - - - - ---- - - - - -- --Plan C bage - - - - -- --- - ---- - - - - -- -- Distance to next nearest building- - -- --___ _,__------- ---- _--- - --------- _ --__ -- -Size of Building Lot-- - -- --- _-_---------------------- _.- -- - ._ ---- _ -- --- -- ------ _ Maximum live load to be borne by each floor _ __.._____----- _____------------ __..__._',--------- s hereby submit all the plans and specifications for said building. All no'iccs with reference to the building and its construction may be sent to. ------- The undersigned applicant for this building permit does hereby certify of I :kbor under the Florida Workhnen's Compensation Act, being Se ^tion 59 and his complied with the prow' -;ions thereof, and will require similar comp in the work to be p -rf . -med under this permit; and a,,,ill post or cause to be or notices as are require d by the Act. The undersigned agrees to employ onl permit, as are licensed by Miami Shores - Vibage. Remarks_ - -- - -- — - - - - --- - - - - -- - - - - - - - -- ( Sig STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized peared - - - - - - - - - - - ^ - - - -- - - - and who, being by me first duly sworn, 'upon oath depoFes and says that I of th abov: described , instruction. C'.x} L has carefiilly read the foregoir therein by him stated are true. �v Permit No.---- - Date -- - - -- � A � - -- - - -- - --. P Disapproved _ -- - - - - - - - -- _ - Date--- - - - -- -- (Signed) - - -- - - - - - - -- - - - --- Building Inspector 11 PLANNING Chairman -------- - - - --- - - -- - - - - -- - - -- - -- - -- - - -- -- -- - - -- - Mer Member - - - -- ---- - -- - - - - -- - Mei Member - - -- - -- - — - - -- - - Mel Council Approved. - ----- ------ - _ _Date Dis; NOTE: A ch e of $1.00 will be made for making corrections or h the Plaim ng Bo, A re -ins tion fee of $1.00 will be charged when such re- inspection materials an or workmanship. at the understands and accepts his obligations as an employer 9, Cor;�,piled General Laws of Florida- Pr,rnnaneni Supplement, ante from all contractors or sub - contractors cmplo,.•ed by him 3osted for inspection on the site of the work such public notit e such subcontr, etors, on work to be perform-.d -u der this Sheet Metal _Specialty Co. administer oaths and take acknowledgments, personally ap- - -- -- - - - - -- - - - -- _ - - to me well known, isthe --- -- - - -- - ------------------ - - - application, and that he did sign the same, and tlbat all facts Sworn to and Subscribed before me. - -- ----- -- --- --- - --- ---------- - - - --- - Public. State of Florida Commission Expires_ - -- - - - - -- -DATE r- - - - -- _.. -- 'r - -- - - -- ------------ ----- - - - - -- - - -- - T- - -- _ - -- - -- - -------- - - - - -- ........ ---- - -- - -------------- - roved - -- Date ,es to this application after approval h: s been obtained front mu <ie necessary- by improper notice for inspe,,hor or fiv,ity MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLOMBING PERMIT Permit No. Application is hereby made for the approval of the detailed statement of the plans herein described. This application is made in compliance and conformity with the of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rt he complied with, whether herein specified or not. A copy of approved plans and ; Owner's Name and Ad �4/4=zo� Registered Architect and/or Employing Plumber's Name Location and Legal Description Lot Street and Number where work is to be performed — No. specifications herewith submitted for the building or other structure Wing Ordinance of Miami Shores Village, Florida, and all provisions and regulations of the Building Division of Miami Shores Village shall afications must be kept at building during the sprr�osgr�esss of work. 4 No. Street JW �° 'r+ No "� Street 44- I Block Subdivision .7LrWL a State work to be performed and purpose of building (By Floors) 6 New Building Remodeling Addition Repairs Na of Stories CLOSETS I BATH TUBS SHOWERS I LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNTAINS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAW FIELD SOAKAGE I PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G. POOL CONTR, LIST CHECK Size Septic Tank Type of Tank Capacity Gals. / , Feet of Drain Tile (/a ��,� V� p Dist. Feet of or Drain Field from Well Nature of Water Supply: City - Well Size of Soakage Pit (Signed) Amount of Permit $ Plumbing Inspectar 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-contractor 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 no ti or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are Hec used by Miami Shores Shores Village. Signed) �C/ n �'�- �!�"�_ 1{ Master Plumber. ffrATE OF FLORIDA, as. COUNTY OF DADE. 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 of the above described construction, that he has carefully read the foregoing app are true. Commission Expires says that he is the lion, and that he did sign the same, and that all facts therein by him stated Notary Public, State of Florida NOTE: A re-inspection fee of $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. + w STATE OF F DEPARTMENT OF HEALTH AND APPLICATION FOR ONSITE SEWAGE DISPC Authority: C Date of Application a ........:..... ...........�.............- ..._............_...PART I - RIDA ;HABILITATIVE SERVICES _SYSTEM•CONSTRUCTION PERMIT ter 381, FS ter 10D -6, FAC iit Application Numbers Name of Owner IK g r I 1, Telephone Number V QQ /a Mailing Address of Owner 4 E r Owner's Agent Builder Agent's Mailing Address --- Telephone No. Property Street Address "- Lot No. Block No. Subdivision Date Subdivided NOTE: IF NOT IN A SUBDIVISION ATTACH METES AND BOUNDS DESCRIPTIO` W1 `'_ This Application is for: New System Repair A Existing System. Type of ewage Flow 7 Sewage Flow Establishment (GE Ilons per day) Based On 9 0$— —I= TOTAL FLOW = Type of No. Bedrooms Hated or Cooled Area No. Dwelling Sewage Flow Residential (each dwelling unit) (each dwelling unit) Units (Gallons per day) 3 f � . 2 ft2 Exact Directions to Property t. AUDIT CONTROL N% �G� R Applicant's 15 5'5 HRS•H Form 4015, Feb 86 (Obsoletes previous editions which may not be used) (Stock Number. 5744. 001 - 4015 -1) Page 1 of 3 er`� jsl ,;4A J p` l fd Permit No H "-p 4 MIAMI SHOR S VILLAGE PLUMBING INSPECTI N DEPARTMENT APPLICATION FOR P UMBING PERMIT Application is hereby made for the approval of the detailed statement of structure herein described. This application is made In and con: and all provisions of the Laws of the State of Florida, all ordinances of Mia of Miami Shores Village shall be complied with, whethern specified building during progress of work. , A 11 f� Owner's Name and Registered Architect and /or Engineer _ __ Employing Plumber's Name?? Y / 1 1A ftt PA f ^A, Location and Legal Description Lot Street and Number where work is to be prrformed--No. State work to be performeS and purpose of building (By Floors)_ NOW .B"AN ►g Remodeling — �- - - - - -/ ._ plans and specifications herewith submitted for the building or other city with the Building Ordinance of Miami Shores Village, Florida, Shores Village and all rules and regulations of the Building Division not. A copy of approved plans and specifications must be kept at No. No./ Z6 UWArM NWWA No. of Stories ... ................ ... Before me, the undersigned authority, a notary public, duly authorized I ' .star oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath c of the above described construction, that he has carefully read the therein by him stated are true. My Commission Expires NOTE: A re- inspection fee of $1.00 will be made when such materials and /or worEnanship. .says that he is the ___�________._._.__. -- —__ -- _._._.._ -.- • - - -�. application, and that he did sign the same, and that all facts Notary Public, State of Florida III made -necessary by improper notice for inspection, or faulty CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY .TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CON7R. — - - - LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD - SOAKAGE PIT GREASE- TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEN swwa POOL CONTR. LIST CHECK Size Septic Tank__— Type of Tank __— _ _.________.._____.___— _- Capadty Gals.__ —__ __ ---- ___ - -- Feet of Drain Tile ___— nlat_ Feet of Tank or Drain F Idd from Nature of Water Supply: City —Well. _ —,Size of Soakage Pit __. ___ _ _ _ _ - - - -- _ ........ Amount Amount of Permit (S ) Plumb Tinspector. The undersigned applicant for this building permit does hereby certify ti under the Florida Workmen's Compensation Act, being Section 5988, Compi plied with the provisions thereof, and will require similar compliance from a at he understands and accepts his obh as an emp of labor ed General Laws of Florida Pe . eat S element, and has com- I contractors or sub- contracto 11 employed 'y him in the work to be performed under this permit; and will post or cause to be posted for inspects regWred by the Act. The undersigned agrees to employ only such sub-(x licensed by Miami Shores Village. on the site of the wor such pu a notice or notices as are tr work to p_ and permit, as are - Plumber. STATE OF FLORIDA, rnnww nF nAnF_ j Before me, the undersigned authority, a notary public, duly authorized I ' .star oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath c of the above described construction, that he has carefully read the therein by him stated are true. My Commission Expires NOTE: A re- inspection fee of $1.00 will be made when such materials and /or worEnanship. .says that he is the ___�________._._.__. -- —__ -- _._._.._ -.- • - - -�. application, and that he did sign the same, and that all facts Notary Public, State of Florida III made -necessary by improper notice for inspection, or faulty t PLUMBING APPLICATION FOR Application is hereby made for the approval of the detailed statement of the structure herein described. This application is made in compliance and confon and all provisions of the Laws of the State of Florida, all ordinances of Miami of Miami Shores Village shall be complied with, whether herein specified or building during progress of work. Owner's Name and Registered Architect and /or Employing Plumber's Name a 4, Location and Legal Description Lot_ Street and Number when work is to be performed -No. VILLAGE DEPARTMENT ABING PERMIT 'Date----=�® -- ans and specifications herewith submitted for the building or other .y with the Building Ordinance of Miami Shores Village, Florida, sores Village and all rules and regulations of the Building Division A. A copy of approved plans and specifications must be kept at No. .__..- ......... _..— ......... No Subdividon d Street State work to be performeS and purpose of building (By Floors) _ New Building_.._-- ____-- ._. -. -- Remodeling ._ Adclition� - -- Repairs-- __..___. - -_-- No. of Stories ... ...... - - -------- to me well known, and who, being by me first duly sworn, upom•oath deposes Vinci says that he is the _ -- _ - -_ - - -- _-- _--- ._.._-------- .-- - -_ -.- ...._.. of the above described construction, that he has carefully read the ffoor application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-bw pection fee of $1.00 will be made when such ve4nspec7 is made-necessary by improper notice for inspection, or faulty ma and /or worlinanship. I CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tuas URINALS CATCH BASIN FLOOR DRAIN DRINKINO FOUNT'NS TOTAL FIXTURES LIST CLIST CHECK GREASE' TRAP SOLAR HEATER DEEP WE L SPRKLR. SYSTEM SWIM'O POOL SEPTIC SEWER DRAIN .SOAKAGE TANK CONN. FIELD PIT CONTR. LIST e Ij CHECK Sias Septic Tank.___ Type of Ta c _._ _11 _ _ ___-Capacity Gals .-_---_-- -..- _�_.-._-_- ...... ... _....... Feet of Drain Tii ®_ _ - -- . —Dist• Feet of Tank or Drain Field from Well--- _..-- ----------- — Nature of Water Supply: City —Well. —___ _ -.Size Df Soakage Pit a Annount of Permit $_ ¢ _ _ _........... _ .... -...._ Plumbing Inspector. 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 5988, Compiled General Laws of Florida Permanent Supplement, and has com- plied 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 su "tractors, on work to be performed under this permit, as are licensed by Shores Village. ..._ Master Plumber. STATE OF FLORIDA, 1 COUNTY OF DADE. i 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, upom•oath deposes Vinci says that he is the _ -- _ - -_ - - -- _-- _--- ._.._-------- .-- - -_ -.- ...._.. of the above described construction, that he has carefully read the ffoor application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-bw pection fee of $1.00 will be made when such ve4nspec7 is made-necessary by improper notice for inspection, or faulty ma and /or worlinanship. I MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305,795-2204 Buil ing I `spection R Date Type Insp'n Permit No. Name C c �tn Address Company Phone # Inspection Date Approv �> Correction ❑ Re- Insp'n Fee ❑ - Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 4/30/2004 Applicant: RAFAEL Owner: PALMEIRO JOB ADDRESS: 1300 NE 102 Contractor Local Phone: Parcel # 1132050230110 Building Permit Permit Number: BP2004 -540 PALMEIRO RAFAEL ST Contractor's Address: 8515 SW 129 TERR Legal Description: M SHORES BAY PK ESTS PB 55 -83 LOT 6 Fees: Description Amount FEE2004 -4318 Building Fee $160.00 FEE2004 -4319 CCF $7.80 FEE2004 -4320 Training and Education Fee $2.60 - _FEE2004- 4321 - -_ T- €.chndogy Fee- - - -- - -- - FEE2004 -4322 Scanning Fee $15.00 Total Fees: $189.40 Permit Status: APPROVED Permit Expiration: 10/20/2004 Construction Value: $13,000.00 Work: REPLACE 17 WINDOWS WITH NEW IMPACT Signed: (INSPECTOR) Page 1 of 1 BLK 2 LOT SIZE 100.000 X Total Fees: $189.40 Total Receipts: $0.00 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 stri ct 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: 05/05/2004 15:39 3052327850 HURRICANE WINDOW NOTICE OF COMMENICR�FNT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIMFI OF FIRST INSPECTION I PERMIT NO. TAX FOLIO STATE OF FLORIDA, COUNT' OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements ill be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the fallowing information is provided in this Notice of Commencement. 1. Legal description of property and street/address'. 1 00 ua (0 z ST' 2. Description of 3. Owner(s) name and address: Interest in Property: Name and address of fee simple titleholder: 4. Contractor's name and address: Hkir. it 4•..t.. w_u T 41. ( 5. Surety: (Payment bond required by owner from cord Nerve and address: STP t 1 fC Amount of bond $ s 6. Lender's name and address: PAGE 02 CFW OR Bk 2228 P9 4250 QP9 ) RECORDED 04121/2004 10- 100154 HARVEY RUVIl~'ir CLERK OF COURT MIAMI -DADE COUNTYr FLORIDA LAST PAGE ;tor, if any) OF FLORIDA. COUNTY OF DADE iY CER7'trY that fh � t; . 1)-C f); trl. in 1$Lf_4 flpy of Vlit 7'�)E SS MY 7. Persons within the state of Florida designated bA Provided by Section 713.13(l)(a)7., Florida Statute$, Name and address: 3. In addition to himself, Owners designates the fol in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Oommsncement: ySlgnre aa=� ied) of �rinmorer "s Marne U Sworn to and subscribed before me this day, Notary Public _ Print Notary's 4W_ _ e_ My commission expires: 123.01.52 PAGE4 GM2 131 as person(s) to receive a copy of the Lienor's Notice as Provided expiration date is 1 year from the date of recording unless a 2-0—. Fri AW Z7, 2W Prepared by 13701 S. W. 91sfi Court dress, Miami, Florida 33176 Miami Shores Village Building Department ~ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fag: (305) 756.8972 BUILDING PERMIT APPLICATION fir l,r Permit No. L� 11 , �'`�— Master Permit No. FBC 2001_ Permit Type (circle): (� Building' Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) & ` Y & j Pit (Va et" Phone # :> o 15-- 751- (�, 0 Owner's Address t 3 0 o 0.2- 5T` Ci State Zip 3 3 t 3 Tenant/Lessee Name Phone # 30s- 75-1- t 5 0 Job Address (where the work is being done) SCI WL City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name '01 wa t'4v_V Qd ®W d- Sef,"L" Phone # 30s-- 2- 3 Contractor's Address (151. 161/. 01- 9 `1,@ Cr. City %�ld��l1 (i t State L Zip 3 3 (S1 Qualifier r `A k tt K I* Aq A- t ° v itoi 41 Architect/Engineer's Name (if applicable) $ Value of Work For this Permit 13oo o s n o Type of Work: ❑ Adddition Describe Work: R f(? 1ec e , Phone # Square Footage Of Work: '1 (o ❑Alteration ❑New �Repair/Replace p 'wtt'R(�OW d iv _a i' �otiliC,� t(Jt.hUOW`. ❑ Demolition ?S , )L Submittal Fee $ �: Permit Fee $ Cd CCF $ �! CO /CC Notary $— Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ I E J.A (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip 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 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 pasted notice, the inspection wil�et t��p ove d a reinspection fee will be charged. Owner or Agent The foregoinginstr unent was acknowledged before me this day of 20 _, by who is personally known to me or who has produced Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 _ by who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTAR P 1 eN iomph oavft Sign: (i7L MV DD204499 Print: My Commission Expires: NOTARY P 'IC: f ba.ph Dab Sign. i 'l IJ. Jc a , MN�+N++..ia►oo2o44M Print: My Commission Expires: (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. APPLICATION APPROVED BY: Chc 12/15/03 r.; Plans Examiner Engineer Zoning CONTRACT DATE: CONTRACT NUMBER: V✓INDOWS MLLSTATE'O, ' SALESMAN:,, T oe- yo NAME: Rqfte-( Pj(m e-(.I- 0 DATE OF INSTALLATION: ADDRESS: (300 lur- (o 2, 5-t HOME PHONE: 305-- 7V- 001 CITY: STATE:f - zip: 33(3Y OFFICE PHONE: 7% - 5-54- 6 R3 4Adrcj DIAGRAM ro no w)lh) . ... . .. .. . . ......... ......... .. t o M. PRODUCT CONTROL NOTICE OF ACCEPTANCE PGT Industries 1070 Technology Drive Nokomis ,FL 34275 MIAMI DARE COUNTY, FLORIDA METRO -DADS N AGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO -DARE FLAGLER BUILDING 140 WEST FLAGI ER sIRM, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375-2909 CONTRACTOR LICENSING SECTION (305)375-2527 FAX (305) 375 -2558 CONTRACTOR ENRORCKNZNT DIVISION (305) 375 -2966 FAX (305) 375 -29M PRODUCT CONTROL DrMON (305) 375 -2902 FAX (305) 372 -6334 Your application for Notice of Acceptance (NOA) of 1 "x Heavy Wall - Aluminum Tube Clipped Mullion under Chapter 8 of the Code of Miami Dade County governing the use of Alternate Materials and Types of Construction, and completely described herein, has been recommended for acceptance by the Miami -Dade County Building Code Compliance Office (BCCO) under the conditions specified herein. This NOA shall not be valid after the expiration date stated below. BCCO reserves the right to secure this product or material at any time from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manmer, BCCO may revoke, modify, or suspend the use of such product or material immediately. BCCO reserves the right to revoke this approval, if it. is determined by BCCO 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. ACCEPTANCE NO.: 01- 03233.02 EXPIRES: OWW096 Raul Rodriguez Chief Product Control Division THIS IS THE COVERS HET, SEE ADDITIONAL PAGES FOR SPECIFIC AND G� CONDiTIONSS BUILDING CODE & PRODUCT REVIEW COMA EE This application for Product Approval has been reviewed by the BCCO and approved by the Building Code and Product Review Committee to be used in Miami -Dade County, Florida under the conditions set forth above. APPROVED• 06=001 Francisco J. Quintana, R.A. Director Miami -Dade County Building Code Compliance Office \1s04 W1%4040%w0atwVwtke ac wpW= cover pq"ot Internet mail address: r@buildiWWeoaliae com Homepage: httpJlvrww m PGT Industries ACCEPTANCE No.: 01- 0323.02 APPROVED .SUN 2 8 2001, EXPIRES JUN 2 8 2006 NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS 1. SCOPE 1.1 This approves a clipped mullion system, as described in Section 2 of this Notice of Acceptance, designed to comply with the South Florida Building Code (SFBC), 1994 Edition for Miami -Dade County, for the locations where the pressure requirements, as determined by SFBC Chapter 23, do not exceed the Design Pressure Rating values indicated in the approved drawings. 2. PRODUCT DESCRIPTION 2.1 The 1 "x Heavy Wall - Aluminum Tube Clipped Mullion and its components shall be constructed in strict compliance with the following documents: Drawing No 6621, Sheets 1 through 6 of 6, titled "1" Heavy Wall Mullion Arrangement Detail ", prepared by manufacturer, dated 4128/00, signed and sealed by Robert L. Clark, P.E., bearing the Miami-Dade County Product Control approval stamp; with the Notice of Acceptance number and approval date by the Miami -Dade County Product Control Division. These documents shall hereinafter be referred to as the approved drawings. 3. LIMITATIONS 3.1 This approval applies to clipped structural mullions to be installed vertically or horizontally, as shown in the approved drawings. 3.2 For Design Pressure Rating vs. Mullion Length and Opening Width, for either 1x2x.375 (2 anchors) mullion, lx2.75x.375 (3/4 anchors) mullion, lx2.75x.650 (3/4 anchors) mullion or lx4x.375 (4/6 anchors) mullion, see corresponding table in approved drawings. 3.3 Window sizes and design pressures are to be limited only to those appearing on charts referenced above and also listed in the individual window's Notice of Acceptance. 4. INSTALLATION 4.1 The clipped mullion system and its components shall be installed in strict compliance with the approved drawings. 4.2 This mullion can be installed as part of an impact resistant unit. 5. LABELING 5.1 Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ". 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance, with mullion option indicated. 6.1.2 The Notice of Acceptance of each door and/or fixed lite attached to mullion. 6.1.3 Duplicate copies of the approved drawings, as identified in Section 2 of this Notice of Acceptance, clearly marked to show the components selected for the proposed installation. 6.1.4 Any other documents required by the Building Official or the South Florida Building Code (SFBC) in order to properly evaluate the install 'on of this system. Mann Perez, P.E. Product C Examiner Prod ct trol Division 2