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MultipleMIAMI SHORES VILL 'E BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. �Date- - - -- -- --- - - - - -- -... - - -- �,r+ Owner's Name and Address- �d•i - t -- -- - - - G� ._ - No �- Registered Architect and/or Engineer.:.- - ___ -. �e - -__ -------- - - -• -- _ �P Name and address of licensed contractor_____l_? ��1 �.__ _____. __ �— _•_fit_7y_ Location and legal description of lot to be built on: Block -- �� 1A.- �,, v��- Lot - - - Sul vision. - _- Street and Number where work is to be done_________[ ------ ------ State work to be done and purpose of building (by floors )___- ______x _ �:� _:______ ' "!_d_� _— - _- ............ - -----------•------------------ •--- •---------------- - - - - -- ------ - ---- — -- — — - - - - -- - - - ' and for no other purpose. New Building ---- ----- -- _ --_ -- --- - -- - -- Remodelin g - - -__ -- Addition__ - -- ............ _ Repairs-- ___- _--- - -___ _ - -• No. of Stories .... __- .............. To be constructed of- ------------ -.............. Kind of foundation__/ Qxd=- �:_.____. - '- -------------- .-- Roof Covering____ , //•_---- ..- ..._______...____- __ -__- Estimated Total cost of improvements $ -------- := C, __ CE _____Amount of Permit $___ --- __-------------------------------- Zone cubage required-- ..- ------- - -------- --------- ----------- - — __ ____Plan Cubage_� A -, A��4_ - - - - -- , _ V °- -` Distance to next nearest building --------------------- • ---------- of Building Lot ------------ ------ -- ------ - Maximum live load to be borne by each floor -- - -- --- - - - - -- - -- ____-----•-- --------- -------- - -------- - - ...... -- _------ --- - ------- --_--_-•-•--- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to-- ---- --- - --- -- — - -_ -_ — — ---- ---- - - - - -•— The undersigned applicant for this building permit does hereby certify that he understands and accepts his bligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Ce eral Laws of Flori a, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from 11 ontractors or sub- ntractors employed by him / in the work to be performed under this permit; and will post or cause to be posted for ' ction on the site o t e rk such uI h notice '/ or notices as are required by the Act. The undersigned agrees to employ only such tractor; on work- to be p rforme under thi permit, as are licensed by Miami Shores Village. Remarks- ---- -_ (Signed) r`- STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared----- --- ------ --------- ---------- - ---------- -------- ----------- —•-- --- — --------------- - ------------------- ---- - --- - _.._.____.__--•------------I--------•----------------- __ —___- — — -- --------------------------------------------------------------------- , - - - -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__ ,_ -_!U ____ Read, Sworn to and Subscribed before me. Disapproved-- -- --- -- - - -- D t " f� — - - - -- -- - - - - -- --- - - - - --- -- - - -- -- ------ -------- _------- ---- ---- -- -- ----- _ - -- -- (Signed) -- - - - - -- ?_ __ Notary Public, State of Florida - -- - - - - - -- -.• -- - = -- ------ - - .... Building Insp or My Commission Expires ---------------------- ---------•r-- __--- ------ . -------------- P NING 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. 4 OL 1 d- � A 07- Silk o � � 2 9 ,A €t /V o' 9c sc. rr Y WINGERTER LABORATORI ES, INC. COWIPRUS-1VE STRENGTH OF C ONCRETE MY CYLINDERS Laboratory and Inspection Service Field Mark: Mix Code: 8 -8 -86 to 1820 NE 144th Street CLIENT: Commerce Group, Inca REPORT NO.: 4 North Miami, FL 33181 CONTRACTOR: Commerce Group, Inc. ORDER NO.: 18198.3(580) 3000 psi PROJECT: -Jiffy Lube a BUILDING Conc. Temp.: Batch Size: 10 cy. PERMIT NO.: 26659 28.0 PROJECT LOCATION: 8787 Bi scayne Blvd., Miami 9 FL _ INFORMATION FURNISHED BY CLIENT: Required Strength: - Psi in - days per TRUCK TICKET INFORMATION Conc. supplier: Central Technician: Ticket No.: M -10444 Field Mark: Mix Code: NF Time Sampled: Plant: Opa Locka Batch Time: Time Batched: 12:50 p.m. Slump: Code Strength: 3000 psi Air, Percent: Truck No.: 45 Conc. Temp.: Batch Size: 10 cy. Air Temp.: Pour Location: West exit slab, 10' north of south FIELD TEST AND DATA Jannis Alcime J.A. 4 2:05 p.m. 1 hr. 25 minutes 5.5" Unit Weights Yield: Cubic Yd. Sampled: 2nd No. Cyls. Made: 5 Weather: clear Water Added: - Age #Type of Total Compressive (Days) Break Load (P) Strength(PSI) 3 C 71,500 2,-529- 7 C 80,000 2,830 REMARKS: #A =Cone All field and laboratory tests and sample curing performed in accordance with B =Cone & Split applicable ASTM test methods. Average of 28 day strengths complies with required C =Cone do Shear and /or mix code strength unless denoted with an asterisk. Cylinders are 6" x 1211, D= Shear unless otherwise indicated. E= Columnar COPIES ISSUED TO: 2- Commerce Group, Inc. Respectfully submitted, 1 -City of Miami Shores Bldg. & Zoning Dept. WINGERiER ABORATO ES, INC. Felix A. Pe_ . Florida Regi ration No.34473 The original of this report was signed and sealed by the above registered engineer in accordance with Rule2iH- 18.11,Ch. 471,FL.Statute. As a mutual protection to clients, the public and ourselves, all reports are submitted as the confidential property of clients, and authorization for publication of statements, conclusions or, extracts from or regarding our reports is reserved pending our written approval. LABORATORY TEST DATA Lab Sample Cyl. Area Weight Date Date No. No. Dia. (Sq.In.) (Lbs) Made Tested 20 187- 15 ----6.-0" - 29.27- 28.0 - - 8 -1 -86 _ _ S -4- 8-6 - 20188 16 6.0" 28.27 28.0 8 -1 -86 8 -8 -86 20189 17 20190 18 20191 19 Unit Weights Yield: Cubic Yd. Sampled: 2nd No. Cyls. Made: 5 Weather: clear Water Added: - Age #Type of Total Compressive (Days) Break Load (P) Strength(PSI) 3 C 71,500 2,-529- 7 C 80,000 2,830 REMARKS: #A =Cone All field and laboratory tests and sample curing performed in accordance with B =Cone & Split applicable ASTM test methods. Average of 28 day strengths complies with required C =Cone do Shear and /or mix code strength unless denoted with an asterisk. Cylinders are 6" x 1211, D= Shear unless otherwise indicated. E= Columnar COPIES ISSUED TO: 2- Commerce Group, Inc. Respectfully submitted, 1 -City of Miami Shores Bldg. & Zoning Dept. WINGERiER ABORATO ES, INC. Felix A. Pe_ . Florida Regi ration No.34473 The original of this report was signed and sealed by the above registered engineer in accordance with Rule2iH- 18.11,Ch. 471,FL.Statute. As a mutual protection to clients, the public and ourselves, all reports are submitted as the confidential property of clients, and authorization for publication of statements, conclusions or, extracts from or regarding our reports is reserved pending our written approval. MIAMI SHORES.ViLLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application Is bereby made for the approval of the detailed stat, ing or other e ere described. his application is made In Shores Village, Florida, and all provisions of the Laws of the State ( regulations of the building ivision of Miami Shores Village shall b plans and specifications must be kept at building during progress of Owner's Name and Address/42�/.. _- - - �_ Registered Architect and/or Engineer...... Name and address of licensed contractor.-A-LI "L",--,-%-" u jLocation and legal description of lot to be built on: Lot---------- ------- / .......... . ...... Block._.------------- ...• ....... Sub Street and Number where work is to be done ------ _ZS(A State work to be done and purpose of building (by floors)., -- - - - - - --------------------------- - ------------------- - -- - --- ----- - - - - -- --- - - - - -- - New Building-- --- ..._ ........... ...... _n__j g- .. ............ LTo be constructed of ........................... Kind of foundation-•• - o Estimated Total cost of improvements $ ------ ---- ------- 7!_--nA Zone cubage Distance to next nearest building-. ......... --------- Maximum live load to be home by each floor -------- - --------- - - - I hereby j#b;nIt all the plans anAspecificagaps fqr'skid be sent .'the plans and specifications herewith submitted for the build- tnee and conformity with the Building Ordinance of Miami la, all ordinances f Miami Shores Village and all rules and led with, whether herein specified or not. A copy of approved k. Date ... . ........ ........... . . No ......................... StreetC/4-:) .............. ............... e 0, --------------------------------------------------- - ------------- and for no other purpose. •...........• ...•. Repairs--------- _---- -- -- - - - - - -- No. of Stories .......................... •.....•..••.....•.....• ..... ... Roof Covering ................................................ mt of Permit $ ...... e-1.. lt� .............. . ................................ Cubage----- ----- - ------ ----------------------------------- _------------- ... _M . 4 of Building Lot ...... 1A'Q._5?_._A_. .�./ -r ....... building. All notices with reference to the building and its construction may The undersigned applicant for this building permit does hereby certify that he of labor under the Florida Workmen's Compensation Act, being Section 5966, Co and has complied with the provisions thereof, and will require similar compliance in the work to be performed under this permit; and will post or cause to be postec or notices as go required by the Act. The undersigned agrees to emplloy only su permit, as are licensed by Miami Shores Village. (Signe STATE OF FLORIDA, COUNTY OF DADE. I 5s' and accepts his obligations as an employer al Laws of Florida, Permanent Supplement, ractors or subcontractors employed by him n on the site of thA w such public notice )rs, C tqetrforme under this Before me, the undersigned authority, a notary public, duly autborized to administer oaths and take acknowledgments, personally ap- peared and who, !�Vnj by pie first duly sworn, upon oath deposes and says C of the above described construction, that he has carefully read the fo therein by him stated are true. Permit No.— Disapproved - ------ (Signed) -------- — -- - ------- - _ Buildin I g .- Inspect . . gr . .............. . . ...... . . . .......... PLANNING me well known, heis the . ......................................... .................. . .............................. ng application, and that he did sign the same, and that all facts Read, Sworn to and Subscribed before me. - - -------------- .......... Notary " Florida i a My Commission Expires ------------------- TE Chairman--- ------------ . ..... . Member ....... ............ . ......... . . . ...Member --------- - -------- - ----- - - — -- - ----------- Member -- - -_--------- . .......... . ..................................... . ...... . .... ------------ Member.... . ..... Member . ..... . .... . ..... . — ---- - - - ---------- - ------ - — -------------_ - ----- - - _ - - --- CouncilDisapproved ------- --------------_----- __ ..................... ...........................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. CERTIFICATE MIAMI SHORES BUILDIN O Miami Sho: OF OCCUPANCY VMLAGE, FLORIDA �I DIVISION 100% 1 -1 -58 Owner, Agent or Tenant of Building BARS Lot 1 Block 3 St Street Address 1400 N.E. 104th Scree Approved use by occupancy SCR1 14 PAT Remarks: Village, Florida, 7 -�2 °58 ITT I.I.S. BAY PiaX BSTATBS E11ChOSURE, This Car �ficate of Occupancy is issued to the above named Owner 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 remod ling of buildings or structures. Tax Value 600.00 "o, lil r BUILDING DIVISION OWNER'S NAME PRESENT ADDRESS LICENSE NO. PHONE NO. Guernse `IJonst Go I JOB LOCATION (ST. OR AVE.) LOT BLOCK I IMiami SUED y¢'SIO states 11¢00 N. E. 102nd St - -_ - 1 1 3 Shares Ray Park GENERAL CONTRACTOR ADDRESS PHONE NO. LICENSE NO, Owner I 10231 N.E, 13th ave. I 1098 BUILDER'S BOND 3012 IDATEl-13-56 ( 26,00 �9 I 1905 1 °13 -56 BUILDING PERMIT NO. PERMIT FEE S NO. DATE I 31 528 25 000 ZONE REQUIREMENTS CU. FT. PLAN CUBE CU. FT. EST. COSTS 821.59L.00 DATE DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: TYPE STORIES ROOF CONSTRUCTION � INTERIOR CONSTRUCTION NEWCONSTRUCTION f'TIA 1- T13 a 3 -- _-sdrnnam. 3J4 hpthm DESCR IPTION REPAIRS Marvel = tile of wood kloors4 D SCRIPTION ALTERATION base, the sills bathas are the ADDITION APPROVED REJECTED REFERRED TO COUNCIL I REASONS SUBMITTED TO PLANNING BOARD RE- SUBMITTED TO PLANNING BOARD I I IjI REMARKS 1 SUBMITTED TO VILLAGE COUNCIL CERTIFICATE OF OCCUPANCY NO. ISSUED BYE- TO BUILDING PERMIT AND INSPECT ;tON RECORD —MIAMI SHORES VILLAGE �59l ce t 7, r✓GAP 3 (o7 Po of cu 2g -r -- BUIL lIWG INSPECTIONS FEE $ X* b INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION r --`Po �S $ / =° H. W. HEATER CONN. BEAMS & LINTELS J-ZL -Sie kd3 _ LSyPo $ MOTORS FRAMING W Fl T.URES- O!o 3 -% ra - INSPECTIONS DATE BY RE- INSPECT FINAL RE- INSPECT BY TEMP. SERVICE /-I'a CLEAN -UP ROUGHING 2 -a3 = j� w23 370 PLUMBING PERMITS & INSPECTIONS CONTRACTOR - "V r e ,. i 0 K6 PHONE PERMIT NO. DATE I, - FEE $ NEW BLDG. ALTERATION ADDITION R PAIRS SPECIAL PERMITS PERMIT NO. -DATE FEE TEMPORARY SERVICE - $. SEPTIC TANK hi . S SEWER $ SOLAR HEATER $ GAS $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING l -IS` W tl Z-I GAS SEWER SEPTIC TANK �� -�� 7�, W /, _?z / SOLAR HEATER FIXTURES'-`- ELECTRICAL PERMITS & INSPECTIONS 4 CONTRACTOR h4 EG °� A -' C-e-- e P e 4. PHONE PERMIT NO. DATE 1 If S FEE $ X* b NEW BLDG. ALTERATION ADDITION EPAIR$ SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ / =° H. W. HEATER CONN. $ RANGE CONN. $ MOTORS $ Fl T.URES- INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE /-I'a ROUGHING 2 -a3 = j� w23 370 H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL APPROVAL TO POWER CO. FOR SERVICE DATE BY OWNER'S NAME PRESENT ADDRESS LICENSE NO. PHONE NO. 1441 > c lope $ JOB LOCATION ST. Oft AVE.) LOT BLOCK SUBDIVISION GENERAL CONTRACTOR ADDRESS PHONE NO. LICENSE NO. BUILDER'S BOND (ley 2 ® J� BUILDING PERMIT NO. 7 DATE PERMIT FEE NO. DATE ®� [77PLAN G.. ®oQ ZONE REQUIREMENTS CU. FT. CUBE 4®0,- CU. FT. EST. COST $ z� DATES I / ;z DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: �+ ° /!� /� /s ref ¢7 eT NEW CONSTRUCTION I TYPE I STORIES I ROOF CONSTRUCTION ( INTERIOR CONSTRUCTION DESCRIPTION REPAIRS I�� i5/G�� 0�� 6� .6 6 a �i�z a ALTERATION I DESCRIPTION ADDITION I APPROVED REJECTED (REFERRED TO COUNCIL REASONS SUBMITTED TO PLANNING BOARD RE- SUBMITTED TO PLANNING BOARD REMARKS I SUBMITTED TO VILLAGE COUNCIL CERTIFICATE OF OCCUPANCY NO. I ISSUED I BY I TO BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE BUILDING INSPEC'nONS INSPECTIONS DATE BY INSPECTIONS DATE BY FOUNDATION I PERMIT NO. DATE ROOF TEMPORARY SERVICE BEAMS & LINTELS I SEPTIC TANK POOL _ FRAMING I AIR COND. SOLAR HEATER FINAL I GAS CLEAN UP I Is SLAB F�i Is INSPECTIONS DATE SLAB RE- INSPECT BY RE- INSPECT i I PLUMBING PERMITS & INSPEC_TIONS CONTRACTOR PHONE PERMIT NO. I DATE FEE $ NEW BLDG. I ALTERATION I ADDITION REPAIRS SPECIALS PERMITS I PERMIT NO. DATE I FEE TEMPORARY SERVICE $ SEPTIC TANK $ SEWER $ SOLAR HEATER $ GAS I Is Is INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING TUB & TOP OUT SEWER SEPTIC TANK SOLAR HEATER FIXTURES GAS ELECTRICAL PERMITS & INSPECTIONS CONTRACTOR PHONE PERMIT NO. -F DATE FEE $ NEW BLDG. I ALTERATION I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ RANGE CONN. $ MOTORS $ FIXTURES $ S INSPECTIONS DATE BY RE- INSPECTI BY RE- INSPECT BY TEMP. SERVICE ROUGHING H. W. HEATER CONN I I RANGE CONN. FIXTURES & FINAL APPROVAL TO POWER CO. FOR SERVICE DATE BY, MIAMI SHOR�S VILLAGE I BUILDING INSPECTION EPARTMENT APPLICATION FOR BUILDING PERMIT Application Is hereby a e for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing o er structure herein described. application 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 e Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved pI and on must kept at b il n uri g pro ess of the work. -go,- len 4-'; , my 1 .4. Date . . . . .......... . . ........... Owner's Name and Address .... E , K1 Registered Architect and/or Name and address of licensed contractor... .......... . . Location and legal description of lot to be built on: Lot-------- - - - I - _---------_- - --------- Block - - - -.. $ ......... . ........ �_. St Street and Number where work is to be done ...... State work to be done and purpose of building (by floors _---_ .... . ........................... -- ---- - -__r. . . . ....... . .. . ......... . ......... . ...... . ....... — ---- - --- - ___ and for no other purpose. New Building---- _..__ ............... Remodeling ................ _ ---- - -- Addition ------------_-- ......... Repairs._--------------- -__.__ No. of Stories .......................... To be constructed of- ._._..._ ........... ...... Kind of foundation_,. . ....... .................................. Estimated Total cost of improvements Zone cubago required-_... Distance to next nearest Maximum live load to be borne by each floor --- - --- - ------ I hereby submit all the plans and specifications -for be sent to. - --- - of Permit Cubage,7;#X_.__k"_ .......... ofBudding Lot-______ . . . ........ . ........................................ .; adingi All notices with reference to the building and Its construction may The undersigned applicant for this building permit does hereby certify that be 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 ublic notice r to nprf under or notices as are required by the Act. The undersigned agrees to employ only such subcon ctors, on k�,� to Trf under this permit, as are licensed by Miami Shores Village. 7�" Remarks - ------------- - - -_ - - (Signed) P) P'�p 67 "'' 0--r STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared------- - -------- - - ------------ --- M------------------------ - - ---- - me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the - -----_-----_-------__----------------_----- __------ ..-- ._•-.- .__-- _ -_..._ c of the above isbed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him sta Permit No 67 Date Read, Sworn to and Subscribed before me. DisapprovedDate - - -------- — -------------- --------- - -------_----------_--- - - - -- Notary Public, State of Florida (Signed) ------- l__S-.e�____.� ... . . ...... Building Inspector My Commission Expires--.:---------------- --- ---- ----- _--- .---- ---- - -_ -__ PLAWNG 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. - t at '+ MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of. the State of Florida all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied' with, whether herein specified or not. A copy of approved plans and specifications must be kep at building during progress of the work. Date...___. _.. -.. Y ._.__ Owner's Name and Address.... _._......__.... - -•_ -. _ -- - -• -..�__ _.._.._. __r. � ___ No._. ?� O O /V'r / ® i- � Street .........- • -. - -•- .............................. Registered Architect and /or Engineer. yl...... -- -•- - - - - --- Y - -- - Z; ;; �� - Name and address of licensed contractor ........... - _ �. .�. _ _ - • - - -•- . - — - - j Location and legal description of lot to be built on: (td ` 4 •� / " Lot---------- ----- _-- ------ --- ---------- Block. - - - - -- ----- •------ •-- :_. ....... Subdivision, ................................. ... -- _- _— ------- - _- --- ----_-_ ... .......................•..... �► Street and Number where work is to be done ..... . ........... ._..-- •-t` _.,. .... _..__._..__— ........ _..... ._._ .... _..... ......_ ...... _.......... State work to be done and purpose of building (by floors ................. _ _ - --- •----- ------------ •-- - - - - -- - - - -_ _— - — ... — - - _ _ _. ------------------------ - - - - -• and for no other purpose. New Building . --_....................... Remodeling .......................... Addition ............. - •-- •- -• - - -• Repairs .......................... No. of Stories---- ....... .............. To be constructed of ..... ....................... Kind of foundation .... r. ... .. ............................................... _. Roof Covring --- - -_- -- .............. .�yy 0- �.�'U Estimated Total cost of improvements $_____._ l..-�,D__.�..._.._.___..— Amount of Permit $..._._____ ............. Zone cubage required----•-------------- •- •---- .----- _- -. - - ,..._.__.^_...__.-Plan Cubage ----------- - ------- —_........................................ Distance to neat nearest budding --_-•--_—. ---- -------- __------- ..._. ------- ,._..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 hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5866, 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 sit c t work such ublic notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on w k t perform under this permit, as are licensed by Miami Shores Village. ( Signed) - -__ -- ___ -- - — _ -- STATE OF FLORIDA, ! . COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared--_._. ------ --.._ ._ -------- ----------- --- ------ - — _ __ __ — _--..--------.._-.---.. .--------------------- --- ____ --_----_----------_-_----•---- __— me well known, and who, bein 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 a truer Permit No.— _____.___ Date _ - - -3 ® Z 7.P Read, Sworn to and Subscribed before me. Disapproved -- •----------- - - - - -- - - - - - -- Da - — — - ----------- - - - - -- r Notary Public, State of Florida (Signed) - -- .._.. - - - - - -- ------ - - - -•- Building Ins for 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. �., r �_:, �� -. `` -- Permit No. -- Application is zc structure herein i and all provision, of Miami Shores building during i Owner's Name and 6 MIAMI SHOES PLUMBING 1NSPEqON VILLAGE DEPARTMENT APPLICATION FOR PLUMBING Imo% r made for the approval of the detailed statement of the p ribed. T)'application is made in compliance and cbnf ty the Law4 of the State of Florida, all ordinances of Mi Show [age shall4 be complied with, whether herein specified 0 not. Of Registered Architect and /ci En -. gineer_. Employing Plumber's Name______ - Location and Legal Description Street and Number where work is to be a and specMca with the BuI •es Village and A copy of a1 Date.---l=—Z-A� - s5 I herewith submitted for the building or other Ordinance of Miami Shores Village, Florida, -ules and regulations of the Building Division plans and specifications must be kept at -- ......... ----------------- No. S-3 T IVW WA State work to be performed and purpose of building (By FYocus) New.Budding ._._�� Remodeling — Addition .____ __ Repairs__-- _----- -_ -•_- No. of Stories_.. _•1..__....__._ Size Septic Tank..._- ._� � __ _ Type of TA�ti _� — ,__ - - - - -- Capacity Gals.--- - -___. _.. - -__ -- Feet of Drain Tile. — . -.- .__Dist. Feet of Tank or Drain Field from Well...-.--_.._-.__._ _-- -..-- ---_-.--- ...__.._._.. -- -- - - - - -. - - - - -_ Nature of Water Supply CI Well. _ I.Size of Soakage Pit--- __._._ - - -_-. _- -__-_— ..- - -_--- - ..__- --- . - -. -_ Amount of Permit �_ �L� (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 5968, 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 reggh. ed by the Act. The undersigned agrees to employ only such sob- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Sinned)•- •- ---� -' Plumber. STATE 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 d construetion, 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. Arty Commission Expires Notary Public, State of Florida NOTE: and/or p Are- inspectionfee of $1.00 will be made when such re4uspection is made necessary by improper notice for inspection, or faulty materials I BATH SHOWERS LAVA- SINKS SLOP LAUNNDRY URINALS CATCH FLOOR DRINKING TOTAL CLOSETa TUBS TORIES SINKS TUBS BASIN DRAIN FOUNT'NS FIXTURES LIST CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE' SOVW 134 EEP SPRKLR. SWIM'G YANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL CONTR. A LIST CHECK Size Septic Tank..._- ._� � __ _ Type of TA�ti _� — ,__ - - - - -- Capacity Gals.--- - -___. _.. - -__ -- Feet of Drain Tile. — . -.- .__Dist. Feet of Tank or Drain Field from Well...-.--_.._-.__._ _-- -..-- ---_-.--- ...__.._._.. -- -- - - - - -. - - - - -_ Nature of Water Supply CI Well. _ I.Size of Soakage Pit--- __._._ - - -_-. _- -__-_— ..- - -_--- - ..__- --- . - -. -_ Amount of Permit �_ �L� (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 5968, 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 reggh. ed by the Act. The undersigned agrees to employ only such sob- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Sinned)•- •- ---� -' Plumber. STATE 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 d construetion, 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. Arty Commission Expires Notary Public, State of Florida NOTE: and/or p Are- inspectionfee of $1.00 will be made when such re4uspection is made necessary by improper notice for inspection, or faulty materials I I Page 4 OFFICE USE ONLY ❑ OWNER -BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) $ Miami Shores Village $ Bond $ Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine $ Zoning Review r. $ Notary $ REVIEWED AND PREPARED BY: SECTION BY DATE Zoning Enclosure Mechanical Electrical Plumbing Repair Mechanical Alteration Interior Roofing Plumbing Fence Relocation of Structure Fire Shell Only Public Works Add'I Attachment Structural Other Building Official Other (s � .f x/1000 tito= (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ DATE: Revised July 2001 10050 N.E. 2- AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com PERMIT APPLICATION Master Permit No. 15,92 Subsidiary Permit No. INSTRUCTIONS - The following steps must be taken to obtain Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. Address: / ZV ��c �e L j'1r1_._';1 Address Apt. City Remo State Zip Folio Number Description of Work Re� Lot Block Subdivision PB PG Current Use of Property ( _e Proposed Use of Property t_O�Macj Tenant Information PERMIT TYPE (✓ ) Building New Construction Electrical Enclosure Mechanical Alteration Exterior Plumbing Repair LPGX Alteration Interior Roofing Demolish Fence Relocation of Structure Other Shell Only ARCHITECT Name License No. Address Telephone Fax PROPERTY OWNER Name Address Home Telephone Business Telephone Fax Square Feet Linear Feet Units Floors Value of Work Do 0 Bldg Value Tax Assessed/Appraised Value Flood Zone PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Base Floor Elev. TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other ENGINEER Name License No. Address Telephone Fax CONTRACTOR ��p Name ID v A l 'U C,- License No. C ii� c (� 4 r to � n � Address R ,i Telephone4'j , Fax Qualifier Nam ! ! ) " Pm �� Page 2 PERMIT APPLICATION 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 151 Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE gignature of Owner Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known Type of Identification Produced: OR, Produced Identification STATE OF FLORf DA, COUNTY OF MIAMI -DADE Signature of Contr#tor / Qualifier �C�CUA� �y9/�'i4'1 Print Name om to and subscribed before me this day of > r ignature of rotary P State of Aorida SEAL: h r Personally known OR, Produced Identification � jam,_._ Type of Identification Producedf � .)) J= Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. ELECTRICAL TYPE QTY. TYPE Minimum Fee Dryer QTY. TYPE Outlet, Appliance QTY. TYPE' Q'I-Y. Service Repair A/C Central 1 -3 Ton Fan Air Handler, Tons Outlet, Wall Drinking Fountain Service, Temporary Fire Sprinkler System Process/Pressure Piping A/C Central 4 -7 Ton Fire Pump Fireplaces, Number of Pressure Vessel Outlet, Switch Signs A/C Central 5 -15 Ton Fixture - Fluorescent Sprinkler Repair Oven Cap - Fixture Space Heater (kw) Fountain A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Pump, Domestic Plugmold/Strip Supply, AC Well Subfeeds, No. of Amps Cap - Sewer A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Gas - Propane Range/Range Top Pump, Re- circulate Swim Pool, Residential Temporary Water Closet Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Dental Chair Refrigerator, Comm. (p/PH) Grease Trap Temp Serv., Construction Pump, Sprinkler Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Utility - Water Renew - Temp Service Dishwasher Indirect Wastes Demolition Low -volt, Intercom/Teleph. Repair Circuits Disposal Dishwasher Low -volt, Television Roof Inlet Service, Number of Amps Water Closet Domestic Well MECHANICAL TYPE QTY. -',X),"PE QTY. TYPE QTY. 17 YPE QT'Y. Minimum Fee Condensate Drain Generator Refrigeration, Tons A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost TYPE Miscellaneous Fixture A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Bath Tub Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Drinking Fountain Barbecue Fire Sprinkler System Process/Pressure Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Bidet PLUMBING TYPE QTY. A/C Condensate TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater C- i sc Drainfield, 4" Tile/Res. Lavatory ; S Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply RECEIVED AND REVIEWED BY: DATE: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10 /31/2002 Applicant: Owner: JOB ADDRESS: 1400 Contractor ARKO PLUMBING Local Phone: Parcel # 1132050230120 NE 102 Plumbing Permit Permit Number: PL2002 -294 ST Contractor's Address: 11260 SW 52 TERR Legal Description: M SHORES BAY PK ESTS PB 55 -83 LOT 1 Page 1 of 1 BLK 3 LOT SIZE 100.000 X Fees: Description Amount FEE2002 -6161 Building Permit Application Fee $60.00 Total Fees:. $66.80 FEE2002 -6162 CCF $1.80 FEE2002 -6163 Notary Fee $5.00 Total Receipts: $0.00 Total Fees: $66.80 Permit Status: Permit Expiration: 4/29/2003 Construction Value: $3,000.00 Work: REMOLD PLUMBING IN ACTUAL BATHROOM If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee Is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to Install the equipment or device described in the application herefor In strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulationskertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or mployees. (INSPECTOR) BY: In considerad6K Ythe Issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. REG C01 110402 1504 001 0024$7 CASH $66.80 Signed: (Contractor or Builder) BY: J .+ A kA 1AM I SHORES VI L. ELECTRICAL INSPECTION DEPARTMENT id 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 cgmpjied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. A Owner's Name and RegisteredArchitect and /or Engineer ...................................................................................................................................................... ............................... Employing Electrician's Name.... M.. � (..L .(� :�8�................................................. No........... . ............................... Street .,........................: ................:........ Locationand Leal 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 Floors) ........ ............................... NewBuilding ................................ Remodeling ................................ Addition ............................... Repairs. ..................................... No. of Stories ................... Service underground Size Feeders .................... Conduit ............... Main Sw................................. m cis ........................:. maw $uses ...... ».................... Amps Typeof Installation —. Conduit ........................ Tubing ........................B.X.L .........................Metal. Moulding ............................... »....................................... Amountof Permit $..... L /....m ....................................... ........... .............. (Signed). �'i 3....!5...:.... .... ..... ��EIeetrical 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 Workmens Compensation Act, being Section $966, 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 sub,contra on work to be performed and this permit, as are licensed by Miami Shores Village. >''✓e q (Sign ... Master Electridatt. STATE OF FLORIDA, 1 COUNTY OF DADE. fj °8' 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 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. SWITCH - LIGHT PLUG FIXTURES REFRIG. IRON RANGE RANGE WATER W. HEAT. ACE STRIP TOTAL OUTLETS OUTLETS RECE'P'T's NO. L.AMPs OUTLET OUTLET OUTLET CONN. HEATER- CONIC. H�TER- HEATER CONTR. LIST CHECK r ENT. DIST. SERVICE - SERVICE MOTORS MOTORS NEON RA0I0 TOTAL SW. CAB. TEMP. PERM. 0.1 HP 1.5 HP TRANS. CONTR. LIST ®- CHECK Service underground Size Feeders .................... Conduit ............... Main Sw................................. m cis ........................:. maw $uses ...... ».................... Amps Typeof Installation —. Conduit ........................ Tubing ........................B.X.L .........................Metal. Moulding ............................... »....................................... Amountof Permit $..... L /....m ....................................... ........... .............. (Signed). �'i 3....!5...:.... .... ..... ��EIeetrical 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 Workmens Compensation Act, being Section $966, 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 sub,contra on work to be performed and this permit, as are licensed by Miami Shores Village. >''✓e q (Sign ... Master Electridatt. STATE OF FLORIDA, 1 COUNTY OF DADE. fj °8' 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 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. MIAMI 14 ES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT ➢ Permit No... 1.1.- 1 ............... Date........ L; 2,C ......................... 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 ...... .......... .................... No ........................................... Street ................................................... RegisteredArchitect and/or Engineer .................................................................................................................................................................................... 1—ai .... . ................ Employing Electrician's Name.. ............... S.-1 ............. Stret�& Location and Legal Description Lot... ..... ............. I ........................................... Block ......... 1-'�) ... . ...................... Subdivision.. 1---,,-� ............... Street and Number where work is to be performed— No....... .................. N-Z.F ..... . .......... . . Street ...... I ............................. Statework to be performed and purpose of building (By Floors) .......... ................................................. 4 ................................ NewBuilding ............_ .................. Remodeling ............................... Addition ........ ................ Repairs ......... ............................No. of Stories ..... j .......... Service Overhead S, Feeders ................ .... Conduit .............. Iviain Sw ............................... Amps ........................... Main Fuses....................... .....Am ps Underground 4e Fe Type of Installation—Conduit ....................... Tubing ....................... BXL ......................... Metal Moulding ............. 0 . . . . ........... . .. . . . ........................... . ... Amount of Permit $ ..................... ................................ .............................. (Signed).... .......... . ......... . ..... ....... The undersigned applicant for this budding permit does hereby certify that he understands and accepts his *obligations as 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 Electrical � 101, 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) ... & 0n.---' 1;P ...... ja-a/ j 7-- & STATE 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 mated are true. ...w ...................... . ....................... . .. I ....... . .... 0.- ......... I ............ . ........... ..................4....... .............. . .. . ............ . ...................................... My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such reinspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. S WITCH V LIGHT PLUG FIXTURES REFRIO. IRON RANGE RANGE WATER W. HEAT. EZACE STRIP TOTAL OUTLETS OUTLETS Rzcz,p•y,s No. LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. HirATZR HEATER CONTR. 4- LIST CHECK ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL, SW. CAM. TEMP. PERM. 0-1 HP 1.5 HP TRANS. CONTR. LIST CHECK Service Overhead S, Feeders ................ .... Conduit .............. Iviain Sw ............................... Amps ........................... Main Fuses....................... .....Am ps Underground 4e Fe Type of Installation—Conduit ....................... Tubing ....................... BXL ......................... Metal Moulding ............. 0 . . . . ........... . .. . . . ........................... . ... Amount of Permit $ ..................... ................................ .............................. (Signed).... .......... . ......... . ..... ....... The undersigned applicant for this budding permit does hereby certify that he understands and accepts his *obligations as 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 Electrical � 101, 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) ... & 0n.---' 1;P ...... ja-a/ j 7-- & STATE 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 mated are true. ...w ...................... . ....................... . .. I ....... . .... 0.- ......... I ............ . ........... ..................4....... .............. . .. . ............ . ...................................... My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such reinspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. MIAMI SHOF4ES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR KLECTRICAL PER IT Permit No .... . .............. .... Date .. ...... »....� . Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for th 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 co ed with, whether herein speclfie,d or not. A copy of approved plans and specifications must be kept at building during progress of work. Owners Name and Address.. . ' 4 .......................... No....:.. , .... »:�:'........... .......Street.. Registered Architect and7or E eer .. ....� »..... j Employing Eleet tic'iari s Name. i ::: ....:�...... o ........9 .. ....... ...........:Street......... .. r . .............Subdivision ............................................... .. .... / Location and Legal Description Lot......... : ....................... ........................Bloch. ..,,._ ........ Street and Number where work is to be' performed— No .................... ................................ .............. _ ....... Street ................... ..... .............. ............................ State work to be perform"d purpose of building (By Floors) .......... .......... . ....... .................................. ........ .. ................ .................................... New of Stories .................... Service ;Iv T e rhcad u > n d Size Feeders....., .....Gondult - -° Main Sw... ..........Amps.... ...............Main Fusee ... ».........: ..........Amps Typeof Installation -- Conduit ....................... Tubing ........................B.X.L ......................Metal Moulding ............... ... ................. ...... I....................... Amount of Permit $........ ... �C.. D....I......... I ................... ............................... 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, arid has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in thc" 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) .W .................. »..... »........ .......... Master Electrician. STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authoriied to administer oaths and take acknowledgments, personally appeared......... _. .............. .. .................................................................. ...... ..........................»......................... ............................... ................. tome well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ...... .. ................... ..» .... ... ... _ ..... I. .. ......:............... 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 Ex.... . ....... I .. . ........................................................ ......... I ......................... . .... pires Notary Public, State of , Florida NOTE: A re-inspection fee of $1.00 will be made when such rerinspection 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. EZACE STRIP Q TOTAL OUTLET OUTLETS RECWP'T'8 NO. LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. HLTATER HEATER s� ' CONTR. UST s. f.. CHECK ENT. DIST, SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL SW. CAB. TEMP. PERM, 0.1 HP 1.5 HP TRANS. CIST R. L 78T t T- CHECK Service ;Iv T e rhcad u > n d Size Feeders....., .....Gondult - -° Main Sw... ..........Amps.... ...............Main Fusee ... ».........: ..........Amps Typeof Installation -- Conduit ....................... Tubing ........................B.X.L ......................Metal Moulding ............... ... ................. ...... I....................... Amount of Permit $........ ... �C.. D....I......... I ................... ............................... 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, arid has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in thc" 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) .W .................. »..... »........ .......... Master Electrician. STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authoriied to administer oaths and take acknowledgments, personally appeared......... _. .............. .. .................................................................. ...... ..........................»......................... ............................... ................. tome well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ...... .. ................... ..» .... ... ... _ ..... I. .. ......:............... 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 Ex.... . ....... I .. . ........................................................ ......... I ......................... . .... pires Notary Public, State of , Florida NOTE: A re-inspection fee of $1.00 will be made when such rerinspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. i Page 4 PERMIT APPLICATION OFFICE USE ONLY CHECKLIST ❑ OWNER -BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) (Specify & Attach) ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) FEES BY PERMIT Zoning $3.00 per page (Scanning Fee) $ Miami Shores Village $ Bond $ Metropolitan Dade County (C.C.F.) $ ! `� " (sq.ft. = x11000 Plumbing x ¢.60) Inspector State Educational Fund $ (¢.005 /sq.ft.) State DCA (Radon) $ (¢.011sq.ft.) Code Enforcement Fine $ Zoning Review $ Other TOTAL $ ISSUING OFFICIAL REVIEWED AND PREPARED BY: SECTION BY D T Zoning Enclosure Electrical Repair Mechanical Alteration Interior Plumbing Relocation of Structure Fire Shell Only Public Works Add'I Attachment Structural Other Building Official t DATE: Revised July 2001 10050 N.E. 2- AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Master Permit No. Subsidiary Permit No. PERMIT APPLICATION following INSTRUCTIONS - The i obtain permit Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you. may be asked to submit additional information. APPLICATION Job Address: 1 "� 0 N-6- 102- 1L e �. ,�j r� tii �l E7�c 3 ( 3 313 { Address Apt. City State Zip Folio Number 3 Z 0'5— 0 23 t9 i Z Description of Work 1�r✓ 1A C=- le x S? irj ' /qS k4 e- T Lot Block �3 C44 ctie (,,JA !% j,#j 1 731 C O nr c n< -t rs CV--C c,i J Subdivision PB PG Zoning Linear Feet Current Use of Property f4 � VATC— / &.S vd�� Square Feet Units Floors Proposed Use of Property j ?'1 �`�"�T S ` A.—G-'2'' C Value of Work Bldg Value � ��7 0/ • 2 r' Tenant Information !" l— \Tax Assessed/Appraised Value 3 j -g i 3 Flood Zone !'1 // t Base Floor Elev. PERMIT TYPE ( ✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other a Vt�A ARCHITECT Name License No. Address Telephone Fax PERMIT CHANGE (✓ ) Ch g. Contractor Renewal Revision Extension PROPERTY OWNER Name 0_ /-ice% C , Q !a! Address I `-1 0 0 n f- 10 A, 5+ M• S)OrQS , 4r-1 331 34 Home Telephone v 6 2 2- 6 Business Telephone 3 S o — g Fax o� V 5 , 5 6-5 a TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'1 Detachment Other RPDV[&P_ 2Xi S4 f n6 ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name 5 v Pf- r S+*/M e COY)"1? e 157n G License No. cl $ 1 ej D Z Address 52_0 N SW 1'3 y c. r�I ea nn i I cG l 3311S Telephone ZZ O to3 Fax Qualifier Name t' ; a m -j- Sa ns Page 2 PERMIT APPLICATION IMPORTANT 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section. 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. ' STATE O ORIDA, CO TY OF MIAMI -DADE r, -' A, r i. .2r Signa7737(_,AA�j Owner G t'rv' A Print ame Sworn to and subscribed be e me s day of 1J 0 � 2Q_csL- 4 Signature of Nryi y�blic; ,States of Florida ,�,%_ ;g etlf, ; jVjarola Franco /Sang SEAL: Go:Commission # CC 925828 �`• $;. Expires April .6, 2Q04 3 antic Bonding Co., Inc, ; Personally known OR, Produc dentification Type of Identification Produced`.. Y m L"+t STAT A, COUNTY OF MIAMI -DADE Si ature of Contractor / Qualifier Print Name Sworn to and subscribed before me this I day of ry O V 2np?f!! Signature of Notary P blic - State of Florida SEAL: �•`� Yeline Sans * *My Commission CC843290 ?, ?Nroe,' Expires June 3, 2003 rsonally k.. _ OR, Produced Identification Type of Identification Produced: Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. ELECTRICAL TYPE QTY. Minimum Fee TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE 1 Service Repair A/C Central 1 -3 Ton Bath Tub Fan Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Outlet, Wall Service, Temporary Fire Sprinkler System Process/Pressure Piping A/C Central 4 -7 Ton Bath Fan - Vented, # Fire Pump Filter Replace Outlet, Switch Signs Sprinkler Repair A/C Central 8 -15 Ton Cap - Fixture Fixture - Fluorescent Fountain Oven Space Heater (kw) Sprinkler System A/C Central 16 -20 Ton Cap - Water Fixture Light Gas - Appliance Parking Lot Lights Spas/Hot Tubs Supply, AC Well A/C Central 20+ Ton Cap - Sewer Flood Lights Gas - Natural Plugmold/Strip Subfeeds, No. of Amps Temporary Toilet A/C Window Catch Basin FPL - Load Central Gas - Propane Posts Swim Pool, Commercial Temporary Water Closet Air Conditioners Clothes Washer Garbage Disposal Gas Piping Range/Range Top Swim Pool, Residential Urinal Chiller Dental Chair Generators, etc. Grease Trap Receptacles Switchboards Utility - Sewer Clear Violations Discharge Well Heat Recovery Ice Maker Refrigerator, Comm. (p/PH) Temp Serv, Construction Utility - Water Compactor Dishwasher Low -volt, Burglar Indirect Wastes Refrigerator, Domestic Temp for Test - 30 days Vacuum Pump Deep Freezer Disposal Low -volt, Fire Interceptor Renew - Temp Service Roof Inlet Water Closet Demolition Domestic Well Low -volt, Intercom/Teleph. Laundry Tray Repair Circuits Septic Connection Water Heater Dishwasher Drainfield, 4" Tile/Res. Low -volt, Television Lavatory Service, Number of Amps Septic Tank Water Heater New MECHANICAL TYPE QTY. TYPE QTY. TYPE QTY. TYPE 1 Minimum Fee Condensate Drain Generator Refrigeration, Tons A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost TYPE Miscellaneous Fixture A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Bath Tub Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Filter Replace PLUMBING TYPE QTY. A/C Condensate TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply ' ' RECEIVED AND REVIEWED BY: Miami Shores Village U j 10050 NE 2nd Avenue Phone: 305 - 795 -2204 a Permit Number: BP2002 -1894 Printed: 11 /13/2002 Page 1 of 1 Applicant: JUAN PENA Owner: JOB ADDRESS: 1400 NE 102 Contractor SUPER STAMPED CONCRETE Local Phone: 305 - 220 -1163 ST Contractor's Address: 5204 134 CT Parcel # 1132050230120 Legal Description: M SHORES BAY PK ESTS PB 55 -83 LOT 1 BLK 3 LOT SIZE 100.000 X Fees: Description Amount FEE2002 -6399 Buildier's Bond $300.00 FEE2002 -6400 Building Permit Application Fee $60.00 FEE2002 -6401 CCF $1.80 Total Fees: $361.80 Permit Status: APPROVED Permit Expiration: 4/30/2003 Construction Value: Work: REPLACE EXISITNG ASPHALT DRIVEWAY WITH CONCRETE DRIVEWAY . Total Fees: $361.80 Total Receipts: $0.00 If there is no permit package aceaccihta nn tho fee is $50.00, which must be pE ®-- S- -- -- tt t. Se_e _ back_ L SUPER STAMP CONCRETE, INC. This Permit is granted to the contractor 305 - 220 -1163 OR 305- 729 -1726 ordinances pertaining thereto and with tho and approved by the proper municipal au authorization. A further condition upon w ordinances and regulations pertaining to t by his agents, servants or employees Signed: In consideration of the Issuance to me c with the plans, drawings, statements or sl myself, my agent, servants or employes. Signed: !G- 9 PAY TO THE ORDER OF. V[�r.� -= Bankof America. - ACH Wr 083100277 PfGI DATE s3- a/s3o2 $ 3 6 J ,,■nn l7, LRUnR i!n r, ;nnnn t. ?i. nn >ri;gpl5 aggA 20• OLLARS B :.pRIUE-Iji /s y PP�L"�cf iurni SLrel VilLe �s ors 10050 N.E. SECOND AVE. LORIDA MIAMI SHORES. FLORIDA 33138 -2382 ` Telephone: (305) 795 -2207 :...Fax: (305)_756 -8972 - COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY WHEREAS, JU A IJ C - pw A, , hereinafter referred to as the Owner of the (owner) following described property: Legal description/folio#: ' I 3 2 0 ® Z3°-0 ( ZO /krA"l' S PK G-ST-S fs ss Lot_ r Block Subdivision Tax Folio u: i I ^ 3'2 c�,5 — 0 2.3 — v I "Z'� requests permission to install: )<Asphalt, oncret brick pavers [ ] Landscaping [ ] Other within the public road right of way of ti-(®o /v to 102- S`rn_e e_'i (address) IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows: 1. To maintain and repair, when necessary, the above- mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligation has been canceled by an affidavit filed in the Public records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this d(- dardKI ®C (owner) SIGNED, SEALED AND DELIVERED in the presence of. AFFIDAVIT* STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, 'Su Am G (10 S 6- , does hereby attest that the (property owner) nmgn,� to ::' tjgj r�.■f° (name of surveyor's company) performed on . is an accurate representation of the existing conditions and (date of survey) locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to -issue a building permit for the property without first providing a survey less than six (6) months old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits.. Further, Affiant sayeth naught. Witness(sign and print) Marola h lommi... -__ ,, - Sans Witness(sign and print) SWORN TO AND SUBSCRIBED before me this day of 0 V 200 --1 �,, - -- YnJ 6, 20o4 tC$ondiV CO., Inc. Affiant is personally Imown to me, odu Z9-- as identification. y I� SKETCH OF BOUNDARY SURVEY. SCALE 1 "= 2-0 / 0 ! (.v, c� � C rot- c t, L A,,-- 0it. c'lr � w a y �.i.r �: �,� / C " C A,(, KVA7 ,�C / i tr wide -- D^ NL-- � r oA- a cAe, 6 A4-0� Acc c s f c/ - :arc co"�,t-e--,r 4 _ t42w �±f� ��25.00' 2v' r�ut�l,�' pAVEN�uf' Q I'v FA LLagD °o0'QD" to �v 1 161420 P`' 5/b PgA -f PIA Prea kA w eel � • � v ^ � 21, 3a' an 4 "� t ?2,610' S,4o' 'SAW pots 44 , 2, 2a' cq so" tA Zonin7 �y A �" - • 13a• ►440 Ica �. N wrow d%ai moo. s NL .s-!' c r 0 BEARINGS HEREON (IF ANY) ARE REFERRED TO AN ASSUMED VALUE OF5a,4�a FOR THE N� I Q�,�O G� ►.�i'j• SAID BEARING IS IDENTICAL W" THE PLAT OF RECORD ACCORDWG TO THE N.F.I.P. THE SUBJECT PROPERTY FALLS WITHIN FL=OOD ZONE: &ja:r LGAL DESCRIPTION LOT BLOCK SUBDIVISION: ACCORDING TOTHE PLATTHEREOF AS RECORDED IN PLAT BOOK 5 AT PAGE OF THE PUBLIC RECORDS OF LOCATION SKETCH SCALE 1 "= 149 jog u� I II5f k� W 14,M t �- DAOki COUNTY, FLORIDA. Li7i 1400 lie, Io2•uo "JP '00-r K4 til l �t.�ci h l � � 33138• 'A' Jap N &.mgo o O Jzr�a+i 'ei 4 _ up r l w" V rt, SIJL�Q5 A,04 ? 415616Ai5 , -J040 co fzt.bs VW& QUID LW RA LASo, - ru SURVEY CERTIFY-TO :�A HOW6 •111*6' Of mth"I I toe,., epeq 5 *Lek Io -elop e-el Owl I NG , THE ATTACHED SKETCH OF BOUNDARY SURVEY OF THE ABOVE DESCRIBED PROPERTY IS A TRUE AND CORRECT REPRESENTATION OF A FIELD SURVEY MADE UNDER MY DIRECTION AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN CHAPTER 61 G17 -6 FLORIDA ADMINISTRATIVE CODE, PURSUANT TO SECTION 472-027, FLORIDA STATUTES. m JOB NUMBER 0 (I a - Q DRAWN Sr. L-•i4::�: F.B. NO. CHECKED BY: V DATE OF THE FIELD SURVEY to o 2 a0 E. BELTRAN & ASSOCIATES, INC. REVISION DATE: 12533 S.W. 30th STREET SURVEYOR'S NOTES: MIAMI, FLORIDA 33175 ,� ou+o � OR N `x'�S HAVE BEEN LOWED. APT AS NOTED. PHONE: (305) 552 -7450 THERE ARE NO VISIBLE ENCAOA HNFICTS OTHER THAN THOSE SHOWN CERTIFICATE OF AUTHORIZATION NUMBER LB 5233 OIAIdiAT10N OF THE ADI TRAUT OF ME WILL INYE TO BE MADE TO D MUMNE RECORDED INSTR AIEKT. IF ANY AFFECTMd6 TIPS PROPERTY. FENCE WHERE IP BY VISUAL ME4N6 ONLY (IF ANY). LEGAL OWNERSWP NOT DETERMINED. LEGAL DESCRIPTION SUBJECT TO ANY DEDIMION, W W IONB, RESTRICTIONS, RESERMTIONS OR EASEMENTS OF RECORD. 25 ABBREVIATIONS (IF ANY APPUED) a ;CENTER UHE CL +CLEAR ILL =UTILITY EASEMENT E: "PROPERLY LANE ENC, ANT W.M.E. =NPLL W WG &wm4 iE EASMC WW =RM]Hf -OF -WAY 2 ILL .AIOIAMIE T LIIE C.L.F. II5f k� W 14,M t �- DAOki COUNTY, FLORIDA. Li7i 1400 lie, Io2•uo "JP '00-r K4 til l �t.�ci h l � � 33138• 'A' Jap N &.mgo o O Jzr�a+i 'ei 4 _ up r l w" V rt, SIJL�Q5 A,04 ? 415616Ai5 , -J040 co fzt.bs VW& QUID LW RA LASo, - ru SURVEY CERTIFY-TO :�A HOW6 •111*6' Of mth"I I toe,., epeq 5 *Lek Io -elop e-el Owl I NG , THE ATTACHED SKETCH OF BOUNDARY SURVEY OF THE ABOVE DESCRIBED PROPERTY IS A TRUE AND CORRECT REPRESENTATION OF A FIELD SURVEY MADE UNDER MY DIRECTION AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN CHAPTER 61 G17 -6 FLORIDA ADMINISTRATIVE CODE, PURSUANT TO SECTION 472-027, FLORIDA STATUTES. m JOB NUMBER 0 (I a - Q DRAWN Sr. L-•i4::�: F.B. NO. CHECKED BY: V DATE OF THE FIELD SURVEY to o 2 a0 E. BELTRAN & ASSOCIATES, INC. REVISION DATE: 12533 S.W. 30th STREET SURVEYOR'S NOTES: MIAMI, FLORIDA 33175 ,� ou+o � OR N `x'�S HAVE BEEN LOWED. APT AS NOTED. PHONE: (305) 552 -7450 THERE ARE NO VISIBLE ENCAOA HNFICTS OTHER THAN THOSE SHOWN CERTIFICATE OF AUTHORIZATION NUMBER LB 5233 OIAIdiAT10N OF THE ADI TRAUT OF ME WILL INYE TO BE MADE TO D MUMNE RECORDED INSTR AIEKT. IF ANY AFFECTMd6 TIPS PROPERTY. FENCE WHERE IP BY VISUAL ME4N6 ONLY (IF ANY). LEGAL OWNERSWP NOT DETERMINED. LEGAL DESCRIPTION SUBJECT TO ANY DEDIMION, W W IONB, RESTRICTIONS, RESERMTIONS OR EASEMENTS OF RECORD. ERNESTO BEUR PROPESUM" SURV STATE OF FLORIDA Dmi moo- to •YAPPER MOAN 24040 N071D TM3 IS NOT A VALID SURVEY WrrHOU'r THEORXXKALRAISF VAI.AND SIGNATiJR$ OF A FLORIDA LICEA)SED SLIRVEYOIRAND MAMAIM ABBREVIATIONS (IF ANY APPUED) a ;CENTER UHE CL +CLEAR ILL =UTILITY EASEMENT E: "PROPERLY LANE ENC, ANT W.M.E. =NPLL W WG &wm4 iE EASMC WW =RM]Hf -OF -WAY C.B.S. =CONCRETE III= STRUCTURE ILL .AIOIAMIE T LIIE C.L.F. N N01101 LINK FENCE Or uGONCRETE PROP. COR SPROPERTY CORNER W.F. NIMOODEN PENCE O mOMMETm F.H. aFIRE NVORANT FEB. NREAVENCE DALE. mDP INNX MAMfLSWAM" EASIT. EASML WMEMEl" N.P. NFC" NON PIPE LLP OW MION PM F.R.B. ^00" RE -BAR LRA +SET RE-BAR FA K NfONND DRU NOW LAX am OR" HOLE CAL .CHORD BEARI O Aft .AIR OONOfT10AwB UWF CALL. mcmalwOEO MEAS ENEAILMED REC. FA. WFOUND am L40 miff FAIL i DIBC MAD =FOUND NAL i DISC PAD NRADIK M Boom NAL F.CAL mFOLNO CUT MAL K NFOUND (TYP)NTYPM'JIL ERNESTO BEUR PROPESUM" SURV STATE OF FLORIDA Dmi moo- to •YAPPER MOAN 24040 N071D TM3 IS NOT A VALID SURVEY WrrHOU'r THEORXXKALRAISF VAI.AND SIGNATiJR$ OF A FLORIDA LICEA)SED SLIRVEYOIRAND MAMAIM SKETCH OF BOUNDARY'SURVEY SCALE 1 67K `s —r eJ ®n- v 4- L-,j A+ I � 0 W, C; � C,, L Ati On t1/ �L-L. A � C 1 �7= 25.QO' zo'ia�at,� ppvF.�t�u�'' tP, 5p� N�pyoy4 " �P, y 8 fs' ia' IL q00 tp,ca' 3t.4a 4 ®n i►,g 5p4a�t�� a v P r ®v e d 3 /mow *. h i P`a Preto N N 2l, SO � �S,RS d•a , �.zo' vi o o IAOD I vi -1 7; 5.1 d � Q ti tER 2s x y /e� , 4 t4f 2. BEARINGS HEREON (IF ANY) ARE REFERRED TO AN ASSUMED VALUE OF °5.a ra4 E:- FOR THE ►4,pG GtiQ� SAID BEARING IS IDENTICAL WITH THE PLAT OF RECORD ACCORDING TO THE N.F.I.P, THE SUBJECT PROPERTY FAILS WITHIN FLOOD ZONE: , Ii -LEGAL DESCRIPTION LOT / ' + BLOCK SUBDIVISION: MAW /.►�i0'L�%9 E-*►q V&21::: **LA -f e- ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 5 AT PAGE S 3 OF THE PUBLIC RECORDS OF LOCATION SKETCH SCALE 1 "= 149 017 Ii5 J m al Ill t -- p4oe- COUNTY, FLORIDA. III`_ bt9F`I�k '!�p 1 4040 0 E 102110 4'0(00*� �ArA m 4-5tJopg�h I f L - "t38- SURVEY CERTIFY TO .-A?v N d Mt2o W O(lr64,�E & PUP, ,1W., Aoa* 05616115, - -JL) &P cAjz VWn. QED LW Sp, fIjzst Home * %ft,(a of wIAwl I toe, ., :..AtlP12PeA4 5 41 cb 10s0g &W-e� fVOPo I W , . THE ATTACHED SKETCH OF BOUNDARY SURVEY OF THE ABOVE DESCRIBED PROPERTY IS A TRUE AND CORRECT REPRESENTATION OF A FIELD SURVEY MADE UNDER MY DIRECTION AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN CHAPTER 6107 -6 FLORIDA ADMINISTRATIVE CODE, PURSUANT TO SECTION 472.027, FLORIDA STATUTES. FOR: '1 yp{J Vil K�!✓rin �n.v W"WF.+i w7y JOB NUMBER D Ito , Q ( DRAWN BY: F.B. NO. jj CHECKED BY: DATE OF THE FIELD SURVEY LD d `4940 I E. BELTRAN & ASSOCIATES, INC. REVISION DATE: 12533 S.W. 30th STREET SURVEYOR'S NOTES: MIAMI, FLORIDA 33175 LEGAL DESCRIPTION WAS I URNWHED BY CLIENT. PHONE: (305) 552 -7450 NO W IO STALLQNS OR IMPROVEMENTS HAVE BEEN LOCATED, EXCEPT AS NOTED. THERE ARE NO VISIBLE ENCROX*IMENTS OTHER THAN THOSE SHOYMr CERTIFICATE OF AUTHORIZATION NUMBER LB 5233 OLAMKKIION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETEFiA M RECORDED INSTRUMENT, IF ANY AFFECTING THE PROPERTY . FENCE M4000 BY VSRUAL MEANS ONLY (IF ANY), LEGAL OWNERS NOT DETERMINED. C /ice � Y w,,,. LEGAL DESt�TION SUBJECT TO ANY DEDICATION, LI MT WIONS, RESTRICTIONS, RESERVATKINS OR EASEMENTS OF RECORD \°ICY: s/7 25 ABBREVIATION$ (IFF ANY APPLIED) - R ;CENTER LINE CL XCLEAR U.E. =UTILITY EASEMENT e NPROPEHTYLINE ENc. ANT W.M.E. =VMLMN+R. &WNWEASMC WW =RK*iT- OF-WAY 2 A amour umeR 111E C.L.F. Ii5 J m al Ill t -- p4oe- COUNTY, FLORIDA. III`_ bt9F`I�k '!�p 1 4040 0 E 102110 4'0(00*� �ArA m 4-5tJopg�h I f L - "t38- SURVEY CERTIFY TO .-A?v N d Mt2o W O(lr64,�E & PUP, ,1W., Aoa* 05616115, - -JL) &P cAjz VWn. QED LW Sp, fIjzst Home * %ft,(a of wIAwl I toe, ., :..AtlP12PeA4 5 41 cb 10s0g &W-e� fVOPo I W , . THE ATTACHED SKETCH OF BOUNDARY SURVEY OF THE ABOVE DESCRIBED PROPERTY IS A TRUE AND CORRECT REPRESENTATION OF A FIELD SURVEY MADE UNDER MY DIRECTION AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN CHAPTER 6107 -6 FLORIDA ADMINISTRATIVE CODE, PURSUANT TO SECTION 472.027, FLORIDA STATUTES. FOR: '1 yp{J Vil K�!✓rin �n.v W"WF.+i w7y JOB NUMBER D Ito , Q ( DRAWN BY: F.B. NO. jj CHECKED BY: DATE OF THE FIELD SURVEY LD d `4940 I E. BELTRAN & ASSOCIATES, INC. REVISION DATE: 12533 S.W. 30th STREET SURVEYOR'S NOTES: MIAMI, FLORIDA 33175 LEGAL DESCRIPTION WAS I URNWHED BY CLIENT. PHONE: (305) 552 -7450 NO W IO STALLQNS OR IMPROVEMENTS HAVE BEEN LOCATED, EXCEPT AS NOTED. THERE ARE NO VISIBLE ENCROX*IMENTS OTHER THAN THOSE SHOYMr CERTIFICATE OF AUTHORIZATION NUMBER LB 5233 OLAMKKIION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETEFiA M RECORDED INSTRUMENT, IF ANY AFFECTING THE PROPERTY . FENCE M4000 BY VSRUAL MEANS ONLY (IF ANY), LEGAL OWNERS NOT DETERMINED. C /ice � Y w,,,. LEGAL DESt�TION SUBJECT TO ANY DEDICATION, LI MT WIONS, RESTRICTIONS, RESERVATKINS OR EASEMENTS OF RECORD \°ICY: s/7 1141NESTO BE - PROR58SIONAL A VAPPRR MOAN STATE OF FLORIDA DATE: jD •04 Z0n. NOTE: THUS 19 NOT A VAL D SURVEY WrrHOUT THE ORIGRIAL RAISED W-41. AND SKMTURROPAR.ORIDAMMIED SIJ1tVEYOR,AM MAMM ABBREVIATION$ (IFF ANY APPLIED) - R ;CENTER LINE CL XCLEAR U.E. =UTILITY EASEMENT e NPROPEHTYLINE ENc. ANT W.M.E. =VMLMN+R. &WNWEASMC WW =RK*iT- OF-WAY C.B.S. =CONCRETE BLOCK STRUCTURE A amour umeR 111E C.L.F. aCHAII LINK FENCE Cr =CONCRETE PROP. COR .�PROPERIY CORNER R W.F. mWOODEN FENCE 0 MOYWETER, F.N. aFlRE HVDRANT RES. .AESIDENCE D.M.E. wGRAIIADE MAWTVVJ= EABMT. EASMT. WEABEMENT F.I.P. =FOUND IRON PIPE LLP. .BERT ETON PIPE ERA =FOUND REAR S.RLB POET RE -BAR F.Q.N. =FOIKW DRILL HOLE LWL 'SET OR" HOLE C.B. MWIDRD SEAR" A/C VAI CONDITIONMO LINT CALL. mr-M CU AW MEAS aMEASURED REC. =RECORDED F.& NPOUND w B.N" "M NAL & DISC FX" ■POUND NAL a DW RAD =RADIAL F.M. Af OU D NAIL RCM. =FOUND CUT NAL R •FOUND ")wT"WAI 1141NESTO BE - PROR58SIONAL A VAPPRR MOAN STATE OF FLORIDA DATE: jD •04 Z0n. NOTE: THUS 19 NOT A VAL D SURVEY WrrHOUT THE ORIGRIAL RAISED W-41. AND SKMTURROPAR.ORIDAMMIED SIJ1tVEYOR,AM MAMM 11 1 WE 1 MIAMI SHOkES VILLAGE PLUMBING INSPEIbITION DEPARTMENT APPLICATION FOR PLUMBING P.hikMIT Penn1tNo.___ 311 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- S No._ ---- -- Street_ f V L Registered Architect and/or Engineer Employing Plumbers Na 7A) Location and Legal Description Lot— : Block Subdivision• Street and Number where work is to be performed —No.- State work to be performea and purpose of budding (By New Building—_—_.. Remodeling Addition--__ NO. Of Stories... ...... Sim Septic Tank___-_-----Type Of Tank----------------C%PacitY cals.__ — ------ . .. . .. ............ Feet of Drain Feet of Tank or Drain Field from Well— . . . . . ................ Nature of Water Supply: P11 Amount of Permit of Soakage Pit- (Siped)—_ 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, CA#npiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance frolm 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 I a site of the work such public notice or notices as are required by We Act. The undersigned agrees to employ only sud,��Swuonn:'ors, on work to ormed licensed by Miami Shores Village "pnt _!I�s permit, as are (Signed . . . ...... ...... Plumber. STATE OF FLORIDA, a aIL COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authortz I ad to 4 er oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath dep0m 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 dImmission Expires Notary Public, State of Florida NOTE. A re- inspection fee of $1.00 will be made when such winpection is made-necessary by improper notice for Inspection, or faulty materials and/or won p. BAY" LAVA• SLOP LAuNORY CATCH FLOOR DRINKING TOTAL CLOSETS TUBS SHOWERS TORIES SINKS SINKS Tu 9 URINALS BASIN DRAIN FOUNT'NS FIXTURES COMM. LIST CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE' SOLAR 019" SPRKLR. Sw1M*G TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL comm, LIST IST CHECK Sim Septic Tank___-_-----Type Of Tank----------------C%PacitY cals.__ — ------ . .. . .. ............ Feet of Drain Feet of Tank or Drain Field from Well— . . . . . ................ Nature of Water Supply: P11 Amount of Permit of Soakage Pit- (Siped)—_ 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, CA#npiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance frolm 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 I a site of the work such public notice or notices as are required by We Act. The undersigned agrees to employ only sud,��Swuonn:'ors, on work to ormed licensed by Miami Shores Village "pnt _!I�s permit, as are (Signed . . . ...... ...... Plumber. STATE OF FLORIDA, a aIL COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authortz I ad to 4 er oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath dep0m 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 dImmission Expires Notary Public, State of Florida NOTE. A re- inspection fee of $1.00 will be made when such winpection is made-necessary by improper notice for Inspection, or faulty materials and/or won p. BUILDING ❑ ELECTRICAL ❑ PLUMBING 300FING ❑ Work to be performed under this Jwner of 3uilding " r" _- architect I ontractor u Builder."'' ' .egal Lot Subdi- )escription _ Bl. _ vision _ address of Value of Suilding Project DATE` T -195Kk Contractor's Z S:.., License No. t M E Amount of Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans rawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any me if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specification "and that he assumes responsibility for work one by his agents, servants or employees. Signed:— In consideration of ertaining, o and in aptin this per it .as _, 'L OR INSPECTOR mce to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations formit with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac• —1r, 11 work done by either, myself, my agent, servant or employee. �l BY AUTHORITY 6 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. -/ B - -Z -- 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_- 1L" %L r �-�_� =il --- - - �`"��- - - -- - - -- -- No.�- �-�------ �- - - -- - Street ��--- - - - -L� -. -- Registered Architect and /or E _ EmployingPlumber's Name .�.- �.•�'. ----- - - - ........... No----------------------------------------- Street ----------------------------------------------- - --- 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 Floors) ------------------------------------ - - ___ _ __ - -- --- - - - -__ - - -__ -- -- - - - -_ -- - -__ New Building ------------------------------------ Remodeling -------------------------------- Addition -------------------------- Repairs -------------------------- No. of, Stories-------------------------- Size Septic Tank- - - - -- t - - - -- %loo --- - - - - -- -Type of Tank ------------------ Capacity Gals. _V Feet of Drain Tile___ - -__- -- _ � _ -_ - - -_ _ .... Dist. Feet of Tank or Drain Field from Well -------- __---------------------------------------------------------------------------------- Nature of Water Supply: City - Well- - - -- -- ------------------------------------------------------ Size of Soakage Pit __. -------------------------------------------- -- Amount of Permit $__' s"'Y - --- --------- - ------------------ - - - --- - - - - -- ( Signed) - ---- -- - - - _ ___ -- i Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he n rstands and accepts his obliga ns as an employer of labor' under the Florida Workmen's Compensation Act, being Section 5966, Compiled n al Laws of Florida Permanent Supplement, and has corn 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. ` (Signed) -- _ -- - -- - - - - - -- - - -- Master Plumber STATE OF FLORIDA, ss. 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, 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 and /or workmanship. Il BATH LAVA -. SLOP LAUNDRY. CATCH FLOOR DRINKING TOTAL CLOSETS TUBS SHOWERS TORIES SINKS SINKS TUBS URINALS BASIN DRAIN FOUNT'NS .FIXTURES. LIST. .: CHECK ;. SEPTIC SEWER - DRAIN SOAKAGE .. GREASE. SOLAR .'DEEP SPRKLR. SWI.M'G TA OK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL CONTRS .. LIST....... ...CHECK ,.. Size Septic Tank- - - - -- t - - - -- %loo --- - - - - -- -Type of Tank ------------------ Capacity Gals. _V Feet of Drain Tile___ - -__- -- _ � _ -_ - - -_ _ .... Dist. Feet of Tank or Drain Field from Well -------- __---------------------------------------------------------------------------------- Nature of Water Supply: City - Well- - - -- -- ------------------------------------------------------ Size of Soakage Pit __. -------------------------------------------- -- Amount of Permit $__' s"'Y - --- --------- - ------------------ - - - --- - - - - -- ( Signed) - ---- -- - - - _ ___ -- i Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he n rstands and accepts his obliga ns as an employer of labor' under the Florida Workmen's Compensation Act, being Section 5966, Compiled n al Laws of Florida Permanent Supplement, and has corn 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. ` (Signed) -- _ -- - -- - - - - - -- - - -- Master Plumber STATE OF FLORIDA, ss. 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, 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 and /or workmanship. Il ELECTRICAL Owner of Architect F-1 MIAMI SHOP R ES VILLAGE, FLOIDA u DATE I� PERMIT 1r o 10241 Contractor's License No. Work to be performed under this Permit - ontractor or Builder Le al �/ g Lot '�,,, II BL - 17r crrinfinr i 4/ Subdi- vision 95 I/ Address of Value cf I Amt. of +... �...� ...w ,.. Project $ Building �"" Project Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. ! Signed: BY — INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations P thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY ON I c K (r" c* v,,)' C),z r*4 001 16 C)4 04 k2!l J�41 .34- Z .115 10 Imo, .. . ci.. .71,16 z T I L 00% Cl 9 2010 44 as �sq� ALBERT W. HAINLIN & ASSOC S Engineers CORM "BLIs. ROMDA CLIENT___ JONES TITLE —_ T 1 o E N C L o S U RE - _MOSES_ �iQ_Fr�►�SQ�_ -- FICaE9,C,1_kSS ROOF ►NC, - I g s PAGE_ I DATE 1 0 8- PREPARED—A W _N_ CHECKED —_ —_ 2 ©7- MATT AN D IMPREGNATED WIT L c- C2 SPACED 6 Y I" t '2" V% F'ACM6 CLOTH A7 MaH_oGkNy sTRINGERS rNEU��A� Ax is VE- F_ZMlKE ALL0wAtr6LF_ bkSTQ\b0TED Lokb FOrL, sec-TtoN OsEO AS COFtNC� MATERIAL.- I• "1.1RUM. NEA011 SIREPlGTN bF TOP LP�`IEtZ �120M ITEM 4(, Pcs, Z05) FORMULAS F02 STRES o•S w b, b Lo k%T LOAb IN o\ t la" r 5 t= Twcv. Pwm) IN, b- Lovt C1 DtNteN., (q. pX 4: 11o,Z50 CL - StKaaT btMp-N., IN. A, EC_AC,E TESZS SHOW TENSILE SzRENC�Tt OF AB`ovE F,BEkc,LASS 1= (000 / IN STRESS = 48 ®o # INom, USING A FAc.-cota.. OF SaFETy OF 4•, ALLOW&SLE S— 9m. Ss. = �2 00 f INz SUgSIC vT OTE AKb Sb%-VE rb%L W ! 40TO w MC)o = ioi t { . bZ x Ib,zt;a (64.9 = 24•10 to F =Z ALBERT W. NAINLIN & ASSOCIATES Engineers PAGE Z _ CORAL GAUNS, FLORIDA DATE 101 q S S CuE___J_O_t�1-E 5 SHUTTER -pRO_D U GTS PREPARED-�- W-li— TITLE_ _ A--Li0 �- N C LO S U R E _ M- D&ESS__ _R_O_ F E N S O N CHECKED Z. _BENDING STQEMG TN Of F-WT%g& Two - L.ANEz PAN E. L - MA.Y. MOMENT — ( Nn C(REDiT ASSUMED FCQ- WDOOF -R FQAMF-} M AaM� OM E� T (a 00 *(' H 319 4-14 tN of LEND -tA = 3830 #-IN /FT OF L.ENGTti ALLowmu- SaAN w 1T N Bp 41 FT z LoAb iNfj Rh ��ax 8 xiz -�N = 383a w =3o1FT. 45Az = 3830 ALLowNsLE Loa DING Fog- SPAN of \4I- 8 i" 3 c 3 83© = Z �.'1o8�Zw = 3 Z4 ,3 U Lo 3860/32.4 a t.8 #'FT 11.6 #IFTZ. 13/4y, 4. X A WALL RECT� ALUM. RNTTER,S - SECTION MOD, = Ils —1 — x4Z_ I.Sx 3., t- t28 - Z1.010 ALLOWA,bL r- STvrsS 2t, 60 " ,000 psi' ALL 0WskSLE L.GADING Fm RAF7E'R,. — SPm4 $x, S PAC IN Cl 3 `- 4" a w 04.1os)s = ci 060 X 1,V5 EQow. LDANNG Pep, Sq. FT '�ft . = �.- �� - /FT: Q_� 5 y$ rT 9 ALBERT W. HAINLIN & ASSOCIATES PAGE 3 Engineers C p — COM OAUES, RLORIDA DATE CLIENT_ JONES SHUTTER., �RODc�T�__ PREPARED TITLE —_ ?A �_� IVC LD SU 2E 1�1_QS �__N Q��F.�_`�.�L�I_ CHECIM MAHOGANY STRIPS SECT104 MoD• — Z_ .�-.� = 0,4((4 IN' ALLOWkSLE STRESS = 1000 #/ INZ AI.LOWAIBLt. �I�AQINCI Fp12 RAFTER,, — 14-8 Z SPAN, ,�_ b,� cJPAcIKCi t14.108)1- = 1000 x,toto't � !v (c7 2.Ot► �FT , cZlto Z'Oto */FT _",�' I_,SFt` %FT; .3'y � • 4)C Ca x g WALL ALUM. -TU 6E �AFTERST SECTION MODULUS = '�C1,'1S1C((o��' ALLOWABLE S- ZESS q,000 4pS1, ALLOWABLE LcikbiNG Fors., RAFT Eiz_ SPAN W- 8 Z SPACING 3' -414, z LO (4.708)2 ' Cl 000 X 2,25 W ; q000.4 y3 x Zito TToTAL ALLOWABLE Lr)AwNc:p _ FOR ENTIVF- ROOF AL-rHaUGN IY ks No-T -TtiE Co(RECY PRocebuo_ TO 0671\IN THE TbTAL ALL.OWkBLE GOOF `CADiN eN StMpLy ADDING, TKE ALLoWASLE LOADS Foil, EAGN MEMBER. BECAAQSC CF TNT DI�FE�Er,e�s 1% MOD OF ELMrK%Ty NEVEYZTNELESS li WILL I NDtcAT E TN E APPRox. AgILITv , W I-r V1 TN E LAP-6E SA;�rcTy FACT O+.S INCLUbe D AND CaNWEQ THE fi)lZoCEpURE S NDULD YIELD AN ADAGUA -CE �EstC)m • 4" �40F, RpF-Te\ls , ACID Vk"ocNhNV ' */FTZ + A,t + WS7 = ZZ-7 #jFT*- (0" — 11, S + (V,!i 4 1, V = 307. * j FT L 0-Y, ALBERT W. HAINLIN & ASSOCIATES PAGE _ 4__— Engineers CORAL GABLES, FLORIDA DATE- CLIENT_ —� ©;ICES N U T T E(.. __P R O Q.� C TS —= — PREPARED —A -8 - -- TITLE— CHECKED-- - - - - -- �RoMT $Ep,Ni Lod�D�NC� 3 M MAx = STRESS TUEo ke. �E7WEEN Cct�'MNS z x So 3 FT � 14.708 F i tv = 2 X 22.1 .4 C3L`z 3lc8CZ (ZRFTEQ,,, PIECE - 3f4x4Y. . 0,K, OLU MNS - ALL COLUMNS BKV-EY3 B`f Wt N Dow FRAMES ALONU Mtwmom RAD1oS ©F GYRATICN MORE IRAN AbAQQ A'v E Fbec LoADmG , Fon- %t4c)s S 1 4114xi SECT, ALUM. COLUMN. _f____ 3 F I� x jb STEEL U`Cs_tP HEAVILY COATED WITH ASPHALTUM RASE PAINT -2- 2 TAMPtw tom4stoN Amb ACI;INE 06_TS. s • • PRESENT SLAB &L FOOT NG. 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 ---- .__.j.T_ ®_ f°r � ® -._- .... .--- -------------------- --- ----- -_ Ncll'__� ---- -_ - - -- Street- -- - -4 14 __Z®A_._5 Registered Architect and /or Engineer. - - -4! - -• -- 71 E� ---------------•------------------------------ --- -- --- -------- = - - - -- ----- -----_------ - - - - -- Name and address of licensed contractor- --------- - ---- -r .,_ _�' --------- --- ---------------------------------•------ •--------------------- •- • - - - -- - Location and legal description of lot to be built on: Block. .......... .......... _------- _... Subdivision..._._ Street and Number where work is to be done ------ ..� State work to be one and purpose of building (by - - --------------- e --------------- - - - - -- &A-6-14 - - --- •---------------- - - - -•- -------- -----..._.__— ---------------- --------------------------- ----- ----------- ---- ---- -( --------- and for no other purpose. New Building{ Remodeling .,_......._----- -- -- - - - -- Addition.e- --------------- _- - - -- Repairs. �----- - -- -- -- No. of Stories... f .-------_--------- To be constructed of--- -- --- -------------- - - - - -- Kind of foundation. --- - ---------------------- ____ -------- ___ -------- _.__ -- Roof Co Estimated Total cost of improvements $-- -- --.- vering ®� - - - -- -- _-- --- ---- ---- - - -- Amount of Permit $ -..... Zone cubage required- _. ---- --- --- ----------------- ----------- - - - - -- - - flan 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 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 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. -- ------- - ------ - ------ -- -_ - - -- - ( 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 f regoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No.--3.__,--------------- Date____ �_ °_______ Read, Sworn to and Subscribed before me. Disapproved __ A � � Notary Public, State of Florida (Signed) -- - w - `'`- - -- - - -• -- Building Inspecto, 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. MIAMI SHORES VILLAGE, FLORIDA BUILDING u DATE ELECTRICAL L---j; PERMIT N° 10356 Contractor's PLUMBING ❑ License No._ Work to be performed under this Permit Owner Buildin( Archite( - ontrac or Build Legal Descrip Address Buildin g 95 Df f — a — for er Subdi- Lot I B Bl. s v vision This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date -------- No4@mber !29- , -- -i95 ----------------------19-------- Owner's Name and Address ___ - _____Gray 1044 Street-N.E.-_12 _ _AV @- _________ Registered Architect and /or Engineer----------------------------------------------------------------------------------- - - - - -- - Name and address of licensed contractor ------ Location and legal description of lot to be built on: Lot------------------------------------- - - - - - -- Block------ ---------------------- - - - - -- Subdivision---------------------------------------------------------------------------------------------------------------------- Street and Number where work is to be done -------- 1.0214__ _e_$ r tZ3 _ ��[ E3----------------------------------------------------------------------- ------- -- ------ - - - - -- State work to be done and purpose of building (by floors) ------------ g— $gUAX!@4__AA1t --- Up-_ 3` OOr --------------- ---------------- --------------------------- �--- cement --- od e _ -tiled - - -- ------------------------- Gopperf lashyrw- A ------------------------------------------------------------------------------------- --- ---- --- ---- ---------- - - - - -- -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 $----- �7-7Q ----------------------- Amount of Permit $ -------------------------------------- - ------------------------------------------ Zone cubage required --------------------------------------------------------- - - - - - -- --Plan Cuba¢e-------- - - - - - -- Distance to next nearest building ------------------------------------------------------------ Size of Building Maximum live load to be borne by each floor --------------------------- ----------------------------------------- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to ----------------- - - - - -- - - - - -- - The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors on work to be erformed under this permit, as are licensed by Miami Shores Village. LANG R06kING & TILE • Remarks------------------------------------------------------------------------------------- -- - - - - -- ( Signed) ----- B;---------------------------------------------------------------------------------- STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared --------- - - - - -- ---------------------------------------------------------- ------------------------------------------------------------------------------------------ -- ---------------------- - - - -to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the______ ________.___________________________________________________________ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit Disapproved ( Signed) Chairman Member - Member - Date--------------------------- ----------- -- - - -- Building Inspector Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission PLANNING BOARD------------------------------------------------ - - - - -- -DATE Member Member, Member Council Approved -------------------------------------------------------------------------- Date Disapproved 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 imper notice for inspection or faulty materials and /or workmanship. Permit No 3_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT 4,1s 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 co,nformity 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. ownees Name and Address.__.._.__...,. No. Registered Architect and /or E i 41=1 _ I _ Employing Plumber's Name__ 1 In v�d� � ! 1� �%Jf ° - No. 776 _ Str om "—c Location and Legal Description Lot.._._.. Bl Subdivision. � A/ h °� % off, 6 Street and Number where work is to be �rforaned —No. � Sheet...._. � .._... . � r. VV C4 work to be performed and purpose of (By Floors) C QQ aL TAIA � 21V)" _ y V`C4 Z �� t•�--- __.__.._._____. New Building Remodeling ____,__.___ Addition_._ __. _ Repairs.__�,o °.___.. No. o� Stories_.. _...._--- ----- ____ Amount of Permit The undersigned applicant for this building permit does hereby o under the Florida Workmen's Compensation Act, being Section 5988, plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for b required by the Act The undersigned agrees to employ only such licensed by Shorn Village. STATE OF • LV COUNTY OF s .r . Before me, the undersigned authority, a notary public, duly to me well known, and who, being by me first duly sworn, upon oath c of the above dwcribed construction, that he has carefully read the therein by him stated are true. My Commission ]Expires Af that he understands and accepts his obligati as an employer of labor liked General Laws of Florida Permanent pplement, and has com- all contractors or sub -c outractors employ by him in the work to be ion on the site of the work suc u c notice or notices as are xntractors, on®_4kork to be ,p�ifo�ii' under this permit, as are (Signed) Plumber. to administer oaths and take acknowledgments, personally appeared heis --,___ ... . .......... - .... .Y. o, and that he did sign the same, and that all facts Notary Public, State of Florida NOTE: A re-Inspection fee of $1.00 will be made when such rair }spection is made necessary by improper notice for inspection, or faulty materials and/or vior1imanship. CLOSETS BATH TUBS SHOWBRB LAVA- TORIES SINKS SLOP SINKS LAU DRY TU S URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTQRES CONTR. LIST CHECK SEWER DRAIN .SOAKAGE GREASE'. SOLAR D EP SPRKLR. SWIM'G .SEPTIC TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL CONTR. LIST_ - CHECK Size Septic Tank.___. -.-__._. ____-. _ .._--__T of T--'- I __ __..____.Capacity Gals..._..___._._--- _ - -_ -- Feet of Drain Tile_ - _._ -. -- _— ._Dist Feet of Tank or D Tin Field from Well__. _ _ _ __..._____ __. Nature of Water Supply: City Well. _---.- _ - jSize .{ Zp of Soakage Pit.______. __. ; _. .__ ....................e!�tr.._ Amount of Permit The undersigned applicant for this building permit does hereby o under the Florida Workmen's Compensation Act, being Section 5988, plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for b required by the Act The undersigned agrees to employ only such licensed by Shorn Village. STATE OF • LV COUNTY OF s .r . Before me, the undersigned authority, a notary public, duly to me well known, and who, being by me first duly sworn, upon oath c of the above dwcribed construction, that he has carefully read the therein by him stated are true. My Commission ]Expires Af that he understands and accepts his obligati as an employer of labor liked General Laws of Florida Permanent pplement, and has com- all contractors or sub -c outractors employ by him in the work to be ion on the site of the work suc u c notice or notices as are xntractors, on®_4kork to be ,p�ifo�ii' under this permit, as are (Signed) Plumber. to administer oaths and take acknowledgments, personally appeared heis --,___ ... . .......... - .... .Y. o, and that he did sign the same, and that all facts Notary Public, State of Florida NOTE: A re-Inspection fee of $1.00 will be made when such rair }spection is made necessary by improper notice for inspection, or faulty materials and/or vior1imanship. MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL ❑ *T DATE 195 ill U 9 6 0® Contractor's PLUMBING ❑ License No, ROOFING ❑ ❑ Work to be performed under this Permit—_ Owner of Architect _ , ontractor or Builder_ Legal Description Lot 0 Subdi- vision Sq. Ft. Address of Value of i Amt. of Project Building � � � Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and, that he assumes responsibility for work done by his agents, servants or employees. Signed : BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY 17 B r � o i d MIAMI SHORES w:. VILLAGE, FLA. N� 7264 es 04 INSPECTOR DATE_!:_ MIAMI SHORES VILLAGE, FLORIDA BUILDING 1-1 DATE ELECTRICAL Ll PERMIT N° 1019 3 PLUMBING F Work to be performed under this Permit Owner of Building — Architect - ontractor or Builder Legal Lot II Description. Subdi- vision Contractor's License No. 95 ,. ess of Value of Amt. of frig Project $ Permit $ , This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application r in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, ags, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any f the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is A is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations ning to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations ning thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. :epting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY -,r °, MIAMI SHORES VILLAGE PLUMBING - INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No.--- ,/,!_/_1 _-__It- -- Date - - — - ---------- � � try Application is hereby made for the approval of the detailed statement of the plans and specifications herewith bmitted for the building or other structure fierein 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 -- - --- - --------- ----------- No ------------ -- - - - - -- --- - - - - -- - Street ----------------------------------------------------- Registered Architect and /or Engi eer -- '- - --- - - -- - - - - -- --- - - - - -- - - - -- - -- EmployingPlumber's Name - ---- __, _ - _ - -_- No.-f___ -(C+`- ------------ - ---- - Street ____ (_ G Location and Legal Description Lot- - - - -- --- -- ---- - -f -- Block--- - - - -fl __- - - - - -- ---- wS�ubdivision____ Street and Number where work is to be performed —No_T -- - -- - -- - - -- ---- .-- - Slleek__FY. -� -�- -- �' - State work to be performed and purpose of building (By Floors) ------------------------------------ - - _ __ ----------------------------------------------------- - - New Building ------------------------------------ Remodeling_- ___ - - - - -_ _____ - - - - -- Addition ---------- _ ------------- Repairs -------------------------- No. of Stories -------------------------' Size Septic Tank ----------------- - -- - - -- --- - - - - -- - -- Type of Tank-- -- -- - - -- - --------------- - --- - - - - -- -- - -- - -- - - -- Capacity Gals.-- - - - - - -- ------------------------------ Feet of Drain Tile--- - - ---(.C-lty- - -- - - - - -- ----- -Dist. Feet of Tank or Drain Field from Well - - -- - -- - - -- __ - - - --- ___ - - - -_- - ----------------------- Nature of Water Suppf \ ell -------- _ __ - -_ - of Soakage Pit --------------------------------- --------------------------- - - - - -- - -- - - - - -- - - - - -- Amount of Permit $ --------------- -- - - - - -- ------ ---- - ---- - - -- -- - _ (Signed) - - - ------- - - -- - - - - -- -- — - --- - - - - -- lumbing Inspector. The undersigned applicant for this building permit does hereby certify that he er ands and accepts his obliga ' s an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gen Laws of Florida Permanent pplement, 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. ( Signed) - - -- - - -- -- ----- - - - - -- - - - -- --------------------------------------------- Master Plumber. STATE OF FLORIDA, 1 ss. COUNTY OF DADE. j 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 $100 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. BATH SHOWERS LAVA- SINKS SLOP LAUNDRY URINALS CATCH. FLOOR DRINKING �, TOTAL CLOSETS TUBS .TORIES - SINKS TUBS BASIN DRAIN FOUNT, NS � FIXTURES LIST CHECK SEPTIC TANK' SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR DEEP HEATER WELL SPRKIR. SYSTEM SWIM'G. POOL „ : ., f W M a CONTR. IT-- LIST CHECK...' Size Septic Tank ----------------- - -- - - -- --- - - - - -- - -- Type of Tank-- -- -- - - -- - --------------- - --- - - - - -- -- - -- - -- - - -- Capacity Gals.-- - - - - - -- ------------------------------ Feet of Drain Tile--- - - ---(.C-lty- - -- - - - - -- ----- -Dist. Feet of Tank or Drain Field from Well - - -- - -- - - -- __ - - - --- ___ - - - -_- - ----------------------- Nature of Water Suppf \ ell -------- _ __ - -_ - of Soakage Pit --------------------------------- --------------------------- - - - - -- - -- - - - - -- - - - - -- Amount of Permit $ --------------- -- - - - - -- ------ ---- - ---- - - -- -- - _ (Signed) - - - ------- - - -- - - - - -- -- — - --- - - - - -- lumbing Inspector. The undersigned applicant for this building permit does hereby certify that he er ands and accepts his obliga ' s an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gen Laws of Florida Permanent pplement, 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. ( Signed) - - -- - - -- -- ----- - - - - -- - - - -- --------------------------------------------- Master Plumber. STATE OF FLORIDA, 1 ss. COUNTY OF DADE. j 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 $100 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. T TG JROOFING & TILE GO. PETIT 10356 Fee $2.50 Date 11-29 -50 } 1k PERMIT APPLICATION FOR MIAMI SHORES VILLAGE X Date 142 °- /"'O '°� 'ob Address /ZZ Tax Folio//- 3 Za,- df %' f � Legal Description Owner / Lessee / Tenant Master Permit # i6 _ Owner's Address_ l�j �� l /��' ��%L s Phone25 -- — �vZ -5--es- Contracting Co .oj Address Pe Qualifier. SS4r Phone Z; State # Municipal # Competency 4- CA' ',_t7/3G Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft.�C°i°� �^ Estimated Cost(value)- p R� WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. ,;J Signature of owner Date: /1 Notary as to Owner and /or Condo President My Commission Expires: Signature Date: or Owner- Builder Notary as to Contractor or Owner- Builder My Commission Expires: FEES: PERMIT RADON C.C.F. ' NOTARY TOTAL DUE APPROVED: Fire Other Zoning Buildinam 10,104 Electrical Mechanical Plumbing Engineering Bonding Company. Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION 'T-I+ E Square Ft. � a s�#- Estimated Cost Z .9-1. n 0 C WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY-BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, and MECHANICAL work. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and ha all work will be done in compliance with all applicable laws regul��ating constructio d zoning. (Furthermore, I authorize the above -named contractor tp-dh a "b i sta&ed. Signat\ire o Date: No as po No as ion 9t PERMIT FEE: wn n Sigriature of Con actor '6 Own r- uilder MTO 10N# CVM Date: S�► a BMW: May is, 1998 :. 1U�10 BRl10 DoNftyPu* to _ �!1[ #cc 37 wner Ad /or Condo Presiden No as o Contrac " Expires: My ommi ion Expires: :k �►e �Ir �c �k �c �k �c �c :k �t APPROVED: Fire Other Zoning Building Electrical Mechanical Plumbing Engineering Job Address: if q!2 AIL l ®� Contractor s &MZI Process No. • APPENDIX 'E' METRO -DADE UNIFORM BUILDING PERMIT SECTION II BUILT -UP APPLICATIONS AND MODIFIED BITUMEN SYSTEMS GENERAL: Type of Roof System Assembly to be Applied: g'Ul47 ra �dC"2-s5, Manufacturer of Roof System Assembly: Product Control Approval Number: A Z!� 3e-3 System Number from Product Control Approval: Ziy, 5 s z- - w (Attach a copy of the Roof System Assembly Product Control Approval and the Manufacturer's System Guide Specification. ) ( Note: If a minimum roof system is to be applied, describe all components within the system and list the manufacturer of each component. DO NOT complete this section if system is Product Control Approved. ) Base Sheet: Fasteners: ( Note: No insulation system is acceptable under the minimum roof category.. ) Complete the following for all Roof System Assemblies: Built-Up. Applications and Modified Bitumen Systems Page -1 Job Address: ta, 1 &2sT 1 (Check'one of the following) 1 s Contractor a Aa Process No. Recover Re -roof: New Construction If a recover, is the existing Roof System Assembly to be used as a bonding substrate ?: Y N If YES, has an ASTM E907 test been carried out to confirm adhesion of the existing membrane to the substrate ?: Y N (If yes; attach AS7ME907 test report. ) Proposed Fastener: (Attach withdrawal resistance test report.) Has the deck been examined for moisture ?: Y N (Provide data confirming compliance with Section 3401.9(c) . ) THE SYSTEM: All Roof System Assemblies in the Product Approval have a variety of options. Briefly describe the Roofing Components to be used in the Roof System Assembly and attach a copy of the manufacturer's published specification: Deck: (Briefly describe) Insulation: (Type, size and method of attachment, if applicable) Base Sheet or Ply: (Type and method of attachment) Ply Sheet(s): r'iy'�� (Type and method of attachment) Built -Up Applications and Modified Bitumen Systems Page -2 Oe Job Address: 4 % f ,o� 57 Contractor of Process No. Top Ply: ( Type and method of attachment) Surfacing: (Type, if applicable ) Flashing Materials: (Type and method of attachment) Built -Up Applications and Modified Bitumen Systems Page -3 z° Job Address Contractor O Process No. iv FILL IN APPLICABLE ROOFING COMPONENTS WHICH MAKE UP ROOF SYSTEM ASSEMBLY AND THICKNESS OF DECK AND INSULATION LAYER(S). (Where Roofing Component not used in Roof System Assembly, fill in with "NIA ".) r (t*p) ........................... ___. :. - op Ply: Bonding Material: (rjba+e abret e . artoe re ......... -,,1 =- ..... Base sheet: �s Bondin Material: (tjbose:�et bonded) Fastener. (drop pwlatT I meth nttaelred) Top Insulation Layer. inches ((japplreabk) I dmatFi ( top Nan li*bonded) . Fastener d, (tjtnm/aNan mach onoehed) inches 4E Insulation: Bonding Material: ....•::.:...::...:::.:,+.;:;::,,•. 5;' >.; :.::•x:C.;�'...:......:..... ,,::.; : ::•. (lffnmlattonbonded} E— �"�lReta}rdar T- er.` (tjapplteab e a DECK: _inches Type: Gage or Thickness: Density. if concrete deck. Built -Up Applications and Modified Bitumen Systems Page-4 4_ r Y MI-I e r (dress; i 1 k 1 t 4 Piro Ir S49 Job Address: Contracto r Process No._ PERRvffi ER DETAIL #3: Gravel Stop or Drip Edge Sketch Roofing Components which make up Roof System Assembly at Perimeter Edge with Gravel Stop or Drip Edge. Insert leaders indicating Roofing Components names, dimeasioas. thicknesses, eta Include hstener type and spacing used for wood- _ blocking attachment. Gravel Gage: Fasten Spacir Clip T; Clip G 14 Sketch Roofing Components which nuke up Roof System Assembly at Perimeter Edge with Gutters. Insert Imlers indicating Roofing Component names, dimensims, thicknessM etc. Include fastener type and spacing used for woo& blocking attachment Gutter Type: Gutter Gage: Fastener Spacing: I� I fA- Deck Type: PERWETER DETAIL. #4: Gutter Detail Built -Up Applications and Modified Bitumen Systems Page -6. 0 0.. Qr <r— Job Addieso,"&?? F A A7 Contra ctor Process No. —, PERIMETER DETAIL #5: 'OtheeDetail SketchRoofflin ompamrim which makeup Roof System Asse., St f1u)r vilirt"Ferimeter Condition I" j3 Insert 61 catinp It noling Component names, WIDE OW01 M J N, lam PFU RF ahnermlom AL Include tlLatett and spacing used for wood - blocking attac L RASE 'Ottki. ,)a 91) t, 1, Z GA 6n U r r-, 4: Sketch Roo!� t0n .. which make up Roof System Ass j Perimeter Condition ryev, 13/0( Sx Akl' I which may L Insert loid d I calitp to nfing Component names, dimenklons "-kis-eq,mr. Include j; -leIj J;p r itil tparing used for wood - blacking attar" ent .904 WWI kU :'S VA."' Wq- it I'nfqPK F.ill ... g 1� A U1 .4. PERIMETER DETAIL #6: 'Other' Detail. v A14 A. Built-Up Applications and Modified Bitumen Systems Page-7 A t: Job Addi essdg 40 "'Contractor P Process No. Insert Building and Parapet Heights. (If no Parapet exists, insert W /A ") Also insert applicable information pertaining to. the building below. (SeeASCE 7 -88 Fact SheetAttached) Exposure Category. Classification Category: At Hurricane Oceanline?: Basic Wind Speed at Building Location: 110 moh Building Condition based on % of Openings: GROUND LEVEL BUILDING INFORMATION #1 Built -Up Applications and Modified Bitumen Systems Page -8 I Sketch Roof Plan indicating all dimensions, any slopes, roof drains, crickets, or roof top equipment. Also insert variable labeled -a- which indicates perimeter and corner dimensions per Chapter 23 of the South Florida Building Code. (SeeASCE 7-88 Fact SheetAttached) t ��95 yb i P Process No. BUILDING INFORMATION #2: Roof Plan with Perimeter and Corner Dimensions Built -Up Applications and Modified Bitumen Systems Page -9 r 1 Job Address: 'Contractor Process No. — FOR PLAN EXAMINER USE ONLY Roof System Assembly Product Control Approved: Y N If NO, note any deficiencies: Design Pressure Reauirements: Field: psf Perimeter Areas: psf Comer Areas: psf Note any limitations: Reviewed Details ?: Y N Notes: Built -Up Applications and Modified Bitumen Systems Page -10 ' Job Address: &61 �7 Contractor OW, 14"ft Process No e s Reviewed Field Test Data ?: Y N Notes: Additional Notes: Plan Examiner Built -Up Applications and Modified Bitumen Systems Page -11 P, oduct Control Notice of Acceptance Roofing System Approval. Applicant: GS Roofing Products Company, Inc. 5525 MacArthur Blvd. Suite 900 Irving, TX 75038 Category : Membrane Roofing System Sub - Category: Built -Up Roofing Type: Conventional Sub -Type: Fiberglass /Asphalt • Product Control No.: 94- 0323.43 Approval Date: Q 6 N W 4 Expiration Date: -JUN 6 61997 GS Roofing Products Company, Inc. manufactures and markets nationally a complete line of residential, commercial BUR and modified bitumen products. GS Roofing Products Company, Inc, markets these products through local distribution in the South Hnrida imisdiction. GS Roofing Products and systems are the result of years of manufacturing experience and product development and have been proven by years of experience in the construction field. GS offers a variety of approvr,l insulated and non - insulated roofing systems. For detailed system constructions, refer to the following publications: "Commercial Roof System Specification Manual" and "Flintlastic Roof System Catalog." GS "products and systems 11;wr been tested in compliance with all provisions of the South Florida Building Code as well as Underwriters Laborainties, Inc., and Factory Mutual Research Corporation for fire and wind uplift resistance. GS provides technical service. and warranty information through regional offices. For the South Florida Metro -Dade area, call I -Soo- 777 -2563. 1':,t i ic,uhaus Commercial District b•lanager 2900 Bird St. Charleston Heights SC 29405 803 744 -7451 a. ,r 1 METRO•DADE , A 4a t i is .1"'ANh;'" 6 3"e''f1�r'tfugb!Qtr a.T•' ' METROPOLITAN DADE COUNTY;FL(jplDi METRO•DADE FLAGLER, BUIr;D1N }. ��fGA = Rt'�j�ya -ii . .. .. . ,. � t .t.+ G+�gaP�•+ai+r'ni�i2lp�j:. BUILDING CODE COMPLIANCE DEPART SU1TE'1603 METRO•DADE FLAGLER BUILDINt3r $•'° 14o WEST F ER STREET -1i ; _ MIAMI, FLORIDA'3313a�i563 �g ° (3051 375.2901" rtf�` ly. q y L PRODUCT CO I'RQI, NOTICE QF ACCEPTANCE `: #` � FAX (30513?5•ZStoe'�"�i' ^t`Y)sfti%•"ts _. ya t e e a, r•.a{t. edf'!:!`r R'vk ilha ! ,:�..:.. �,6"��+�.il�5r d,t :r t•: t °' >�5'� � }..p .s, C� °t fatf3 ri �� .� #' _r if Y!, tit P , t i��.d., ' •, i � e f� f.i�ii yt. F: � � � '�fI 9[• ) i' A, , � f. a: .t5 t:' , .il:'`. s , . �!f �i �,. �t � ,c �� b Y7s '� t x ' GS Roofing Produc is Company ,Inc #t , 5525 MacArthur Blvd.. f�� ''tt rkt {{4 i �P 'I t ,x`�: T[�t ., , r►�`x t'' Suite 900 , `: ), a .j: v, t •` t £ rt � �� Qi`,�,��a,�il 7 �' t /• ,j living; TX = 7503 8 t Your application for Product Approval of G n ong r Conn Code governing Products under Chapter 8 of the Metropolitan Dade';°' "I g h' g 5 the use of Alternate Materials and types of Construction,' and 'completely described` Itt) the plans, specifications and calculations as submitted by Applied. Research Laboratories, Factory Mutual Research}" at < d Corporation and Underwriters Laboratories, Inc. has been recommended for acceptance by the Building ode; Compliance Department to be used in Dade County, Florida under fhe specific and standard conditions set forth herein t hgy $ g '�� h,zl..i. ?t,J. }i ..a., *mo.tt ?t ••. { .14i! A y� 7P w9 A i3Q i1 2r �, ri ! `+;stir +', •. a t The approval shall be valid for a period of three years. The Building Code Compliance Department reserves ,,right to secure a product or material at any time for a jobsite or manufacturer plant for quality control testing. if i"evi' ' product or material fail to perform in the approved manner, the Code Compliance Department may revoke, modify or suspend the use of such prndttct or material immediately. The Building Code Compliance Department reserves ., the duc ro right to require testing of this product or material 'should any amendments to the South Florida Building Code be- enacted affecting g this p. ,. t or material... r � I +. i tt;a , , y� :•, , Rs, ��,�� ! 7 ..r ' l ,� t.� .sa�'•b"�"b�ar� .i l.� The expense of such testing will be incurred by the Manufacturer.�f r' PRODUCT NO.. ACCEPTANCE NO.: 14- 0323,43 , Gil Diamond, P.E. EXPIRES: ��;+ (] 1997 Product Control Division Supervisor 3 5 r - PLEASE NOTE- £ ;; THIS IS TIDE COVERSI lEET. SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL` .{ ` fx CONDITIONS. ts£ 1 , '� BUILDING CODE COMMITTEE This application for Product Approval has been reviewed by the Metropolitan Dade County Building.' Compliance Department and approved Code., by the Building Code Committee to be used in Dade C .r) ,.t the conditions set forth above. ounty, Flonda under ,� APPROVED: ' July Charles Danger,' P.E ytt`�t `a Building Code Compliance Department's `r,,�'�r 1, }r „� Metropolitan Dade COUnty� , ;�, a ,' f {'` i Pd ' .4 � I 'tt�' , .. s ..at+��3•{'�'.: ii:.j;��t.�tx�tffA4:�3�.�y'�1;: t i.. do t 55gk�!` "'F��"i��i: �.iMv�.ifi �. �t ,t rr ftit.�3i1•�;� =1 • -jf; .,. i�t: _ �'lbt. '`�' .a.'t�iYt Pr -, r �' f - �:e tf . :.'i t t t:vy t t Ri,iF t!J +py..n ,{•, �y,y •�%i a' • .�. c • .� , r far�tP'�ta�, . ON NO "I'[CE OF ACCEPTANCE gNDARD CONDITIONS �'i :, ' _' � 1 lid � °j;. "Pit c :c� - •�,. 1 �' ?� 15,Pyt's!� `•'��ffi {�•'cn1+.a" by`i't� } 't 9 ` r'tt ' •yr{�4k, . i, bJ f. Yt;S ck ..i .�. � ;... .. !.. •...r. ° �4 1. Extensions of Acceptance may be consrderedaftbr a new application has been filed and the suppoiting data;. test reports no older than ten (10) years, have been re-evaluated. All reports of re testing shall bear the seal, signature and date of an engineer registered�i "the Florida. Y. S I{. ' C •M1..9. ,.�ry ,} f ?•j4r•S tt�.. µ� {�tRrt., '`"a't,nr}r °?%1. i \etp,1 {.. 2. Any revision or chan ' r� 1 yCI{y. 1C � ;(• t ..�If.1N(RirRt1W:ryi`BI ge in the materials, use, or manufacture of the product or process shall'automatically be-f,�,`-, cause for termination, unless prior approval is granted for revisions or change. �, FF *t 'Fr 3. Any unsatisfactory pet fbtnrance of this product or process or a change in Code provisions shall be grounds ^i %,',` for re- evaluation. 4. This acceptance shall not be used as an endorsement of any product for sales or advertising purposes__` r't M.ie, Wig. $. i t..tr .xr.,.,+! ti The Notice of Acceptance number preceded by the words Dade County, Florida,Nand followed expiration date may he displayed in advertising literature. If any portion of the Notice'of Acceptance displayed, then it shall be done in its entirety. 6. Product approval drawings, where required for permit applications, shall be provided to the applicant by the ' manufacturer or his distributors unless otherwise noted in the Notice of Acceptance..., The prints need not beti�fiTt re- sealed by an engineer. 7. Failure to comply with the Standard Conditions shall be cause for termination of the Approval r ond, P. E. • Control Division .• �ti M „.,: Supervisor ' .�t t ,qtr �::. ; ::,• t t,:x �s •'1 41, i•,' f 4r.! T i c r b s vim. �( 4 r ' c r� @�4��rEctY1��S,•A s.�? t 2' a -. �� t' �+�a+'�h�� . �rrsafrt, t. � r v .. �' ' - - t -'r i t ip •�4�'t� Y4r7 -.. '�, ":', 1''•'g• =fiq%!!.•h'��rfYk "�f� ?ia it. �c.. i- iy' �>,1•A'Firo�tpttrr�i,�`jrDi',"r f Product Control No.: 94- 0323.43 Deck Type 1: We „i 1 hin- insulated Deck Description: '°/ „” c , l,ieater plywood or wood plank decks System 7'` pe /\(1): �hrct mechanically attached. All General Limitations shall apply Base Sheet: All Weather /Empire, Flex- I -Glas or GlasBase base sheet applied to the deck with approved annular ring shank nails and tin caps at a fastener spacing the field. of 9" ox. at the lap. 12" o.c. in two rows staggered along the center line of the of the sheet in Ply Sheet: 'Iv,'O. duce or four plies of FlintGlas or #15 Asphalt Perforated Felt ply sheet adhered in a full mopping of approved asphalt at an application rate of 25 lbsJsq. Cap Sheet: ((li,tic,nal) One ply of FlintGlas Mineral Surface cap sheet adhered in a full mal,i,ing of approved asphalt at an application rate of 25 lbs. /sq. f 15 %. Surfacing: ( cgllh ed if no cap sheet is used) Install one of the following: I. A two part coating consisting of a base coat of Static Ashpalt Fibered Emulsion at rate of 3 gal. /sq. or Monoform compound; surfaced with 1 gal. /sq. Sta -Kool non - fibered aluminum coating or fibered APOC No. 212.. 1. Flood coat of approved Type III asphalt with an application rate of 60 lbs. /sq.; plus gravel or slag at an application rate of 400 lbs. /sq. or 300 lbs. /sq. respectivly. Maximum 1_ ?esi�n Pressure: -6p1- klaxinncm bile Classification: W. S"-, ticiicral Limitation 9 2. Maximum Slope: 3 ":1:2 "; ,`sec General Limitation 4 3. Specification I1,,.: AAA ,'.3, AAA -4 -3, AAA -8 -3, A- 2 -M -3, A- 4 -M -3, A- 6 -M -3, EMS -2 -W, ENV; I W Gil Dianund, 1'.1 1° . MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ ELECTRICAL El 0 195 0 PLUMBING ❑ PERMIT -w O 812 3 Contractor's y License No. ROOFING ❑ Work to be performed under this Permit —_ — _ Owner of Building Architect 11 - ontractor or Builder_ Legal Lot �I Bl. Subdi- Description I vision Scq. Ft. Address of Value of Amt. of Building Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: _ BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY -» .w w APPLICATION FOR CERTIFICATE OF RE- OCCUPAi`ICY hereby apply for a certificate to re-occupy the single family residence known as : (address) /( 2q Ifl .L d )- g � , Miami Shores, Florida. Legal Description: Lot: Block PB & PG: I hereby certify that I understand that the zoning of the property is for single -family residential use and that it is unlawful for more than one family to reside therein. I also understand that any Certificate of Re- Occupancy that may be issued by Mami Shores Village, certifies only that the referenced property is being used for single - family purposes and that such Certificate does not constitute any representation, warranty or certification as to the condition of the dwelling or other structures on such property. Applicant � Date Print Name ,�ic 6 For purposes of conducting the inspection required by Section 902 of the M.lami Shores Land Development and Zoning Code, please contact: Contact Name: n% Telephona�� Buyer Seller Realtor !/ Company Name Application Fee ($50) paid: Cash Check No. Inspected by: Approved_ Denied Date r1` Comments: PAGE I OF 2 CERTIFICATE OF RE- OCCUPAINCY On behalf of Miami Shores Village, Florida, the undersigned certifies that the property described in the above application has been inspected for purposes of re- occupancy pursuant to Sections 901 and 02 of the Miami Shores Land Development and Zoning Code and that such Property may be re- occupied by the above applicant for single- farmily residential purposes. L 'UAM[ ORES , FLORIDA BT Date of Certification: THIS CERTIFICATE VERIFIES THAT THE REFERENCED PROPERTY HAS BEEN INSPECTED BY MIAMI SHORES VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE MIANff SHORES LAND AND DEVELOPMENT CODE PERTAINING SOLELY TO THE REQUIREMENT THAT EACH ONE- FA&ELY DWELLING IS USED AND INTENDED TO BE USED FOR A ONE- FAMILY DWELLING PURPOSE ONLY; HOWEVER, THIS CERTIFICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR WARRANTY AS TO TEE COti- DITiON OF THE DWELLING OR OTHER STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH CONDITION, AND INTERESTED PERSONS ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE PREi1r1[SES IN ORDER TO DETE u Ni E THE CONDITION, THEREOF. PAGE 2 OF 2 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR PUIL®ING PERMIT Application is hereby made for the approval of the detailed state ing or other structure herein described. This application is made in Shores Village, Florida, and all provisions of the Laws of the State! o regulations of the Building Division of Miami Shores Village shall be plans and specifications must be kept at building during progress of Owner's Name and Address__f_fV�L=__4D- Registered Architect and /or Engineer_____. _ _ Name and address of licensed contractor__ Location and legal description of lot to be built on: Block_ - - - - -- - ----- - - - - -- - - - - -- Street and Number where work is to be State work to be done and purpose of building (by floors New Building ---- __ ------------- ---- Remodeling ----- ----------- _ --- Ad, To be constructed of ----------- _--------------- Kind ofjDund ;ion-_.._---- - Estimated T°tal cost of improvements $ -------- .,..i____ -_ Zone cubage Distance to next nearest building ------- ---- it of the 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 work. - - - -- - - - - - -- ®19 --- — - - -'------ - - -- -- for no other purpose. - - Repairs----------- - - - - -- - - - -. No. of Stories - - - - - - -- - - -- ---------------- - -- - -- - - - -- Roof g --------- -------- -- - -. -- - of Permit $--- - - - - -e - - - - -- - - -- -------------- --- Cubage - ----- -- - - - - -- ----- --- - ------ - - - - -- - - - - - - -- - ------ - - - - -- ---- - - - - -- ----- - - -- -- ofBuilding 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 to - - - - - -- -- --------------------------------- - - - - -- - - - -- -------- - ----- - ----- - - - -- ------- ------------ -- - - - - -- - The undersigned applicant for this building permit does hereby cerkify 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 ovisions 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 o 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. �'�j�, Remarks-- - - - ----------- ------- --- ------- -- ---- -- ---- - - -- - -- - --- (Signed) / 1� �`�`' -°-- - - - V V STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly autho� zed to administer oaths and take acknowledgments, personally ep- ------------ ------------------- - - - - -- - - - - - _ _------ - - - - -- --- - - - - -- ----------- - - - - -- - - -- - -- - -- - - - - -- -- -- ----- - -- - - -- - - - - -to me well known, and who, bein�g by me first duly sworn, upon oath deposes and says that he is the- - - - -- - - -- ------ ------ _ -_ ------ - - - - -_ __--- ___... _ .. - -- - - - -- - of the above being construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him t are e. . _- Pate______ -_ _ __ _ ___ Read, Sworn to and Subscribed before me. - Permit No._- y - -- -- - -- -- - ------ - _ _. -- Disapproved _ -_ _ to _____ - - ° - -- --- -- -- - - ------------------------ -----------------------------------------------•------------- Notary Public, State of Florida (Signed) - - -- - -- _ `- - - -- - -- - ------ --- -•- Bu or My Commission Expires_ _.- _..- --- - - - -- -- . -- -- - -- __ ------ _ --- -- --- - - - -•- PLANNING BOARD- ----- _ --- - ------------- 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 ma le necessary by improper notice for inspection or faulty materials and /or workmanship. I k M MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT PermitNo... ........ .�'......... 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. / 4ZC-✓C Owners Name and Address...... ............................................. No._.. /. --° %... ...... ...............Street... ...... . Registered Architect and /or Engineer! ...........................................................................................••...•- ..• ............. ...-- ••• -•• -•- Employing Electrician's Name ..... �id ... . °"'-'" �.- ....._....... No _� : � ........................ Street ......... Location and Legal Description Lot .._..... _.: �---------------•---•------....._.. ..............Block......�..I g�...... ..........._....Subdivision_... rf3..t ............... Street and Number where work is to be performed —No... ._�. ... i=.. ?. �. ......�o.=_Street .... .._...._ State work to be performed and purpose of building (By Floors)...... `..._ ti.... -r-t. v / New Building .... .i� ....... .......... Remodeling ................................ Addition...._... ....__....__..........Repairs.. .. ........__....._...._._.....No. of Stories .......r.... ..... Overhead Conduit./. Main Sw._ �... ' ......Main Fuses... `.. `: ' -. Amps Service Size Feeders Amps ..................... Am Type of Installation — Conduit .. ............: :..Tubing....`''............. B. X. L ........................ Metal Moulding ........ ,............................................................... ............... ............ ...................................................................... I..... .......... .........-- ................_... ..;,..... 44.... a.. /\ f .. ... F /... . Amount of Permit $.......4_.a�._►. U... :........... __...... (Signed).... i ,........ ....._:: ..� ................... � Electrical nspector. The undersigned applicant for this building permit does hereby certify that he u derstands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compie General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from 11 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. STATE OF FLORIDA, COUNTY OF DADE. �' (Signed)............ ...... .............. ........... ............................... l Master Electrician. 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 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. 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 LIST CHECK ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL - SW. CAB. TEMP. PERM. 0.1 HP 1.5 HP TRANS. CONTR. LIST f j /e' J` J. , cr, / d/ CHECK Overhead Conduit./. Main Sw._ �... ' ......Main Fuses... `.. `: ' -. Amps Service Size Feeders Amps ..................... Am Type of Installation — Conduit .. ............: :..Tubing....`''............. B. X. L ........................ Metal Moulding ........ ,............................................................... ............... ............ ...................................................................... I..... .......... .........-- ................_... ..;,..... 44.... a.. /\ f .. ... F /... . Amount of Permit $.......4_.a�._►. U... :........... __...... (Signed).... i ,........ ....._:: ..� ................... � Electrical nspector. The undersigned applicant for this building permit does hereby certify that he u derstands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compie General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from 11 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. STATE OF FLORIDA, COUNTY OF DADE. �' (Signed)............ ...... .............. ........... ............................... l Master Electrician. 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 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. BUILDING ELECTRICAL PLUMBING Owner of Building MIAMI SHORES VILLAGE, FLORIDA E PERMIT N° Work to be performed under this: Architect Contractor or Builder Legal Lot II Bl. Description 10223 Subdi- vision DA 95 Contractor's License No. _ Address of /' ,k vdluhtof I Amt. of Building _ l +��1 $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING ELECTRICAL ❑ DATE 195 PLUMBING ❑ PERMIT N° 7955 Contractor s .License No.--- t — ROOFING ❑ — _ ❑ Work to be performed under this Permit— Owner of Building i ,a Architect - ontractor or Builder f Legal Lot II Bl. Subdi- Description. vision Sq. Ft. Address of Value of Amt, of Permit Building Project $ $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY �.W CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION O 831 Miami Shores Village, Florida, 12-5 -5 Owner, Agent or Tenant of Building MOSES HOFFENS011 Lot 1 B Block Subdivisi 175 -Rev. Plat of 113 Sec on - Streetddress- Approved use by occupancy Enclose ?patio with Windows and fiber glass rood' Remarks: This C�erMcate of Occupcmcy is issued to the above named at -mer 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 structur Plan Cube 2564 Tax Value 1252 Axe -Z'�L� BUILDING DIVISION C-®— .00ZdL -7 eo 12 -zr -Y -L - `a Sao DATi. DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: +�• JWAI-/Y lG 6C /d- 2 OWNER'S NAME �- TYPE PRESENT ADDRESS LICENSE NO. PHONE NO. INTERIOR CONSTRUCTION �L c S T, °" c t�L .°Y S 7i C a_ I r,> c- t_e - -- - - -- ZZ a DESCRIPTION JOB LOCATION (ST. OR AVE. T LOT BLOCK ` SUBDIVISION ii A E. 1 OZ4 .51'r, I I I- ?Z-) 7-�L 1Leo.Pe.a -) p ¢sa. tocq., �TrLS. ADDITION GENERAL CONTRACTOR 1 APPROVED ADDRESS I PHONE NO. 1 LI ENSE NO. 13C, REASONS l c -'% Zg RE- SUBMITTED TO PLANNING BOARD BUILDER'S BOND BUILDING PERMIT NO. DATE -Sg PERMIT FEE $ 0 NO. DATE a PO 1 i ti �� 1 I REMARKS R ZONE REQUIREMENTS CU. FT. I PLAN CUBE Z S % " - +4- CU. FT. `sue 1 EST. COST S `� 00 ~-• DATi. DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: +�• JWAI-/Y lG 6C /d- 2 BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE NEW CONSTRUCTION TYPE STORIES ROOF CONSTRUCTION INTERIOR CONSTRUCTION �L c S T, °" c t�L .°Y S 7i C a_ I r,> c- t_e - -- - - -- ZZ a DESCRIPTION REPAIRS (��^ t sJ O�J Ae lois ze ,p ALTERATION I DESCRIPTIO ADDITION 1 APPROVED I REJECTED IREFERRED TO COUNCILI REASONS SUBMITTED TO PLANNING BOARD RE- SUBMITTED TO PLANNING BOARD I 1 1 1 1 I REMARKS R SUBMITTED TO VILLAGE COUNCIL ' I 1 940 CERTIFICATE OF OCCUPANCY NO. ISSUED BY TO g C---p BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE RmLnma INSPECT70(JS INSPECTIONS DATE BY INSPECTIONS DATE BY M1NDATION SPECIALS PERMITS I PERMIT NO. ROOF FEE TEMPORARY SERVICE BEAMS & LINTELS $ I $ POOL' I FRAMING SEWER AIR COND. I $ SOLAR HEATER FINAL I I $ CLEAN UP I I SLAB IS INSPECTIONS INSPECTIONS SLAB I BY RE- INSPECT BY RE- INSPECT BY PLUMBING PERMITS & INSPECTIONS CONTRACTOR PHONE PERMIT NO. I DATE FEE $ NEW BLDG. I ALTERATION I ADDITION REPAIRS REPAIRS SPECIALS PERMITS I PERMIT NO. DATE FEE TEMPORARY SERVICE $ I $ SEPTIC TANK I I $ SEWER $ I $ SOLAR HEATER .$ I $ GAS I I Is IS INSPECTIONS INSPECTIONS DATE I BY RE- INSPECT BY RE- INSPECT BY ROUGHING ROUGHING TUB & TOP OUT H. W. HEATER CONN SEWER RANGE CONN. SEPTIC TANK SOLAR HEATER FIXTURES & FINAL FIXTURES GAS ELECTRICAL PERMITS & INSPECTIONS CONTRACTOR PHONE PERMIT NO. [DATE FEE $ NEW BLDG. I ALTERATION I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ RANGE CONN. $ MOTORS .$ FIXTURES I $ IS INSPECTIONS I DATE BY RE- INSPECTI BY RE- INSPECT BY TEMP. SERVICE ROUGHING H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL I APPROVAL TO POWER CO. FOR SERVICE DATE BY R 4f+ j P MIT 1A'PP/LD1CqATION I/F 1� FOR MIAMI SHORES VILLAGE Date /Job Address %/571e0 a ,y 2 `S Tax Folio I o? ° 0 �t Legal Description exec Historically Designated: Yes No Owneazssee / Tenant �%�. /� %�S 1� ,6�/,:9 Master Permit # .7 Owner's Address �. Phone 75('� Contracting Co. ° I L�!%��/1% Address U �� /y ` Qualifier �ll�� l/[/�� SS# Phone State 4 6 eU -� %41 ,5-1 Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL) PAVING FENCE SIGN WORK FA- I.A b laG./G ?�i /mss �.0 -VW'P LC 1VA' 'k IPE-. /79G .o Square Ft. Estimated Cost (value) -51 VO4, �� WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOV -'- 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 woak will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT:. I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable low$ regulating; construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of sident / Date Si of Contractor or Owner- ider Date My Comm EV. 5/1/04 IN,). CC 93000 `'fir/ (I P Notary as fei'`aEW My Commission Expires: Mown I I I.D. 5-/0 //0 ?/ FEES: PERMIT RADON APPROVED: Zoning Date Notary as to Contractor or Owner - Builder Date, My Commission Expires: [,_ ,'�r'6� ONA :Jan EN ,� My COMMI CC 883629 Or I�10 EXPIRE9, 2004 C.C.F. NOTARY Fla Notary 8 Bonding C4. TOTAL DUE_ .V Building �! ( Electrical Mechanical Plumbing Structural Engineer Appendix "E" o UNIFORM ROOFING PERMIT APPLICATION PROCESS No. Contractor's Name: Job Address: /Vq /!/ �� • ROOF CATEGORY • (Low Slope Application) ❑ (Nail -On Tile) ❑ (Mortar- Adhesive Set Tile) • (Asphalt/Fiberglass Shingles) ❑ ( Metal Roofs \Wood Shingles & Shakes) ❑ (other). ROOF TYPE ❑ New Roof ❑ Re- roofing ❑ Recovering _ epair 0 Maintenance - Flat Roof Area (ft2 Sloped Roof Area (ft2) Total (ft' Master Permit No. Exposure category (per ASCE 7 -88): Building Classification category (per ASCE 7 -88 table 1): Ft. Ft Deck type: Fastener Type: ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed) ATTACHMENT SPACING Field: Perimeter: DETAIL 1 & 2 ROOF PLAN ------------------------------------------ ------------------- - - - - -- - - - -- - - - - - -- ' r--- -- ------ -- --- --- - - - - -- - i ' - - - - - - - - - - - - - - - - - - - - - - - - - - - - ' - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Ii r -- --- ----- -------- ----- -- --- --i -- ------- -- - - -- -- I I 1 I 1 �I ' i ' ------ _ - -_ - -- --- .- - - - - -- I I I I ' I ' r I 1 ' r- I --- - --- - - --- - I I I I i - - - -- -- -- -- -- - - - -- - - -- -- I -- -- - I I I I I I I I I I I 1 I I I I I I I I I 1 I I I I I -------------- Corner: - - - - - -' 1 I t 123.01-78 9198 C ugG- 1 v`!7 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during aogress of the work. - Date --- - ------ - --- --------- Owner's Name and Address - - — - .......... ,19 _._ No.5_ -- _ Street.___�'?'Y' - - - - -- - -- — Registered Architect and /or Engineer______ _______ ___ - -------------------------•---•----------------------•--- -- -- •- -• •--- -------- •-•-- -• ---• s Name and address of licensed contractor5Y '_ady-•.ROQ3t1_ &..SheE$..Ia. S�ree'� Location and legal description of lot to be built on: Lot_ -------- --------------------------- --- Block-_ ---- --- •-- - - -- - -• - - -- - - - -- Subdivision.-•- -- --- - -- - -- --•-------------------- Street and Number where work is to be _St1`Gl'E________••___ ---------------------------- State work to -be done and purpose of building (by floors) _ _.__._��__?1K4t1- 1e._gr$VE3;,__ -------------------------------------- - -• - -- - •---------- •---------- - - - - -- - - -- — -- -- — ---------------------------------- - --------- ---- --------------- and for no other purpose. New .Building---- ------------- ------- Remodeling.--- - - - - -- --------------- Addition ------ —A---- - -- - - - - -- Repairs....-- - •--- -- -- --- • - -- -- No. of Stories- ........ - - - - - -- To be constructed of-------------- - - - - -- - - - - -- Kind of foundation ---- ---------------------------- - - - -- -------------- - - -_ -- Roof Covering ....bu 7 �11F• � �r'�Vel Estimated Total cost of improvements $_,135:00 . 0O - --- ------ ---- --- °- _Amount of Permit $ -. ? `- ---___ -- -------------------- _Zone cubage required-__- — ---- - ------- - ----------------- - - 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 to- - - - - -- — - -- ----- ---- - ---- - ------ — ---------- ------ - ---- --- --- - --- ---------- - -------- --------------------_----- --------------------------------------- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an empl of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup lei e , and has complied with the provisions thereof, and will require similar compliance from all contractors o sub- contractors employed m in the work to be performed under this permit; and will post or cause to be posted for i spection o the site f the work such ublic ice or notices as are required by the Act. The undersigned agrees to employ only s�u4ch sypecctor n o t0 be perforne �9 n is permit, as are licensed by Miami Shores Village. / / \ \\ J Remarks - - - - -- ---- - ----- ----- ---------- - -- ( Signed STATE OF FLORIDA, ! COUNTY OF DADE. J ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take peared - - -- - — -- — - — -- - — ----- - - - - -- personally ap- - - -- - -- . - -- — w_._ �- _ --------- - - - - -- - ------------ - - - - -- - -• �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.____ J-- ------ Date___ _® _ Read, Sworn to and Subscribed before me. Disapproved _- -__ -- _ ------ Dat _.--- ---------- -- - i (Signed) Not Public, State of Florida ____ ___ _ . '_ .• - - --- -------- --- --- ding I p ctor - My Commission Expires- --------- ----------- _................. PLANNING BOARD_.__—__.____ ______ __ ------------ __— __ - ...... DATE Chairman - - --- -------- --. --- Member ---- —----------- ---- - - - - -- -- •-------------- Member — - - -- ----- - �— ---------- - — -- - - -- — - _ _ Member -------------------------- Member . -- = --------- - - - - -- - - - - - -- - -- - --- - — -- Member - -- ---- - - -- -- Council Approved-- -- ----------------------------------------- - - - - -- --Date Disapproved ------ ---- - - - - -- ..Date NOTE: A charge f $1.00 will be made for making corrections or changes to this application after approval has been obtained from flie 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. PERMIT APPLICATION . FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date 3/21/91 Job Addra*sa Legal Descript 1400 N.E. 102nd St. Tax kol io 11 VA 0' of -T el-40 *7 Permit Owner / Lessee / Tenant Henry 'Davis Owner's Address 1400 N.E. 102nd St:;ee•t Miami Shores,. FL 3314kins 757-2612 Contracting C�benour Roofing, Sheet Metaf 4daV6&,,jj1y Co. 7357,,N.W. Miam"i Ct. Miami, PT 55150 Qualifier James D. Obenour SS# * Phone 757-2612 CCO014306 FCCI FUND State# Competency#. 6454 Ins Co Capital Assurance Architect/Engineer N/A - Address Bonding Company N/A Address Mortgagor N/A Address Permit Type (circle One)s BUILDING 'ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION Reroof entire residence and install new Monier Villa Tile and new built up gravel roofing. Square Ft. 42 Es t#ated Cost 12,000.,00 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS To YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMPJIT). Application is hereby made to obtain a permit to do work and Installation an 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 i permits are required'Cor ELECTRICAL, P4UMBING, OIGNS, POOLS, ROOFING, and MECHANICAL work. OWNER'S AFFIDAVIT: I certify that all the foregoing Information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furtherma e I authorize the abovernamed contractor to do the work stated. 1 0 I/or- Condo President nature of C6ntr-ti't-or or Owner-Builddr Date: /21/91 Date 3/21/91 Notary as to Owner and/ r'C*ondo*President* Notary as t9Pqnacto t r*dr Owner-Builder r My Commission Expire Nd2ry Public State of Florida My Commi�pi` i "'' fighry Public State* of Florida _p re ucomml_ SRI* Expires issig* Expires faot I8,' Ise 18, 1991C PERMIT FEE: APPROVED Fire Other Zoning Building- Electrical Miqhiinical Plumbing Engineering STATE OF FLOP<IDA ko COUNTY OF DADE 1 HEREBY CERTIFY that this is a true copy of the c�Ultl9� original filed in this office onQ ( -If "° °' day of A.D. 1b1TE,ESS m, hand and O ,'ic3al' S.Tal. co Clerk Circuit COn U9 4 y COU,Ts d• °° w;s o °' �T _ By e2 a �aa•Connty,,F�O`� MIT Tax folio No. .Z 3 a,A), NOT ICC,OF COMMENCEMENT tate of Florida �ounty of Dade HE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of property: (legal description of the property, and street address if available) 1400 N.E. 102nd St. Miami Shores, FL 33138 ' 2. General description of improvements: Reroof entire residence and install new Monier Villa tile and B.U. gravel 3. Owner information: a. Name and. Address: Henry Davis 1400 N.E. 102nd St Miami Shores, FL 33138 b. Interest in.property: Owner R t c. Name and address of fee simple titleholder(if other than owner): same 4. Contractor: (name and address) Obenour Roofing, Sheet' Metal & Supply Co. N.W. iami C . Miami, FL 33150 S. Surety: a. Name and Address N/A b. Amount of bond$ N/A S. v Lender: (name and address) N/A Persons Persons with the State of Florida designated by Owner upon.whom notices or other documents---}may be served as provided by Section 713.13(1)(a)7., Florida Statutes: (name and address) Henry Davis In addition to himself, Owner designates to receive a copy of the Lienor's'Notice Florida Statutes. Expiration date of notice of commencemen the date of recording unless a different Jim Obenour of Obenour Roofing as provided in Section 713.13(1)(b), t (the expiration date is 1 year from date is specified) Signatu a of Owner ;worn to and subscribed .1bOfore me day of 1991. f9otary Public State of Florida ,o ry. P blie - My Commission Expires*',' xpires AbitionExpl.resEe b.18.1993 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION F014 BUILDING PERMIT Application is hereby made for the approval of the detailed sta ment of the plans and specifications herewith submitted for the build- in compliance and conformity with the Building Ordinance of Miami Shores f Florida, all ordinances of Miami Sbores Village and all rules and regulations complied with, whether herein specified or not. A copy of approved PI the work. .......... . ..........,19...x5.6 Owner's Name and Address. OueRnser Construct _� R n ... ...0 ... . 04. 8fY1 No19231.... Street _ _A...E.. . ...1.... 3th Ave. ................. Registered Architect and/or Engineer...— ... ................... . .......... 4 - ------------ ----------------- ------- - --------- - --------------- - ---------- ......... ................. Name and address of licensed contractor_.._ ----- 573 --- R.ff....Ilat ... St..,-9.AUM:L .... 50., Pla Location and legal description of lot to be built on: Lot- ------------- Block.......- - -3 - -- - - -. - -- - - Miami Shores Rg ................... Street and Number where work is to be done - .... 140 0 F ....... . ........... State work to be done and purpose of building (by floors) - _42R % Rn now structure i ........ - ------- — ------------------------------------------ - — - . ......... -And for no other purpose. New Building-- ___- --- - ----- ------- Remodeling......_........_:.... Addition.-..- ------------ . - - - - -- Repairs ..........__....:......_.. No. of Stories ........ OnO ......... To be c6ristiu6ted ofjQ0,j5.* ------ Kind of foundation____- ... ....... 1 ............................................. Roof Covering ............. Allq� .................... Estimated Total cost of improvements $ ....... 9.22A-10 . . ... . ............. : r --Amoun t of Permit $ .... -5-,,J0Q . ............................. ................... ............ Zonecubage required - ---- - ------ - ------------------------ - -------- - - -- ---.-.---Plan Cubage ------------------ - - - — - ---- - ------------------------------------ — .......... .......... Distance to next nearest building ---. - -- - --------------- of Building Lot......_.._- _.- ...- _- _-._-_. ................ Maximum live load to be home 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-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 the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks-—.---------- --------------- STATE OF FLORIDA, COUNTY OF DADE. I ss. (Signed), 51MET ME'T'AL br1SU1A.UTX UUMrARX 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, yon oath deposes and sa: of the above described construction, that he has carefully read the therein by him stated are true. Z_ Permit Mo. - ------- Date ------- ..to me well known, thathe is the. ............................................................ . ...................... ....... reping application, and that he did sign the same, and that all facts Sworn to and Subscribed before me. ------------ ----------- -------- --- ---------- - Disapproved _-V D.f. - - --------- - -- Notary-Public,-State-of-Florida. ----- - --- - ----------- - (Signed) ------- -- -- - ------------ B g Inspec My Commission Expires ............................................................. PLANNING BOARD,---.--- ------ - - - Chairman --------------- — -------------- Member ....... . ............ . ........ . . . ... . ............................... . ........ . ...... Member- -------- - ------- - - ------- - -- Member - — -- - --- - ----------- - -- . ...... . .. . . . .... . ............ . . ....................... Member Member ---- - - - ----- - . ... . . . ...................... . . . . . ... Council Ap I proved ------- — ---- - - - - - ----------- ----- - - - - — ------ - ---Date: Disapproved ------ - ------------- ------------------------ .............................. Date d L NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtain e Irom the Planning Board. A re-inspection L 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. N CER'T'IFICA'T'E OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION N? 1099 Miami Shor s Village, Owner, Agent or Tenant of Building s Lot `' Block Subdivisioti 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. BUILDING DIVISION OWNER'S NAME PRESENT ADDRESS LICENSE NO. PHO E NO. 1 EICIO" G UY I 10090 N. E. 12th Avenue I V 1 -'App i%? bC/A�° �2� .) LOT BLOCK SUBDIVISION 02 ! - -Y111. 121th Ave=6 1 I 175 Miami Shcrea sect. h6 - _ _ . NE C ADDRESS PHONE NO. LICENSE NO. , L, Pierce I 1!}1 way, Miami Springs I 88 -1716 l 4047 BUILDER'S BOND 10177 n n/2150 22,,O© I` n26 n• I 2/j© BUILDING PERMIT NO. DATE PERMIT FEE $ NO. DATE ZONE REQUIREMENTS 250000 CU. FT. PLAN CUBE 280739 CU. FT. I EST. COST $ 18,000.00 DATE - - - 11/1150 DRAWINGS,. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: _. _ TYPE ST0131ES ROOF CONSTRUCTION INTERIOR CONSTRUCTION CBS - - ` 1 -File - -- - - , Te°a� Fltscrs = Planter 'Wall NEW CONSTRUCTION DESCRIPTION p, I y Fe - Din Rm - 33nalo Parch - Kit - 2 Bed Rms - 2 Bathe - REPAIRS I ALTERATION A6,., y� LD.,EpSCRIPTION I Maid 'a IRm w/bath -. 2 Car attached garage ADDITION I APPROVED I REJECTED REFERRED TO COUNCIL REASONS SUBMITTED TO PLANNING BOARD I RE- SUBMITTED TO PLANNING BOARD REMARKS SUBMITTED TO VILLAGE COUNCIL � /� /jy��' /// ��jjf Q CERTIFICATE OF OCCUPANCY NOjj % ISSUED BY TO.,�./ A �� BUILDING PERMIT AND INSPEgFrION RPCORD- -MIAMI SHORV"VIOLAGE BUILDING INSPECTIONS INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION 7 J© P TEMPORARY SERVICE $ BEAMS & LINTELS • • ' $ -1 QQ SEWER FRAMING SOLAR HEATER $ GAS $ $ INSPECTIONS FINAL BY RE- INSPECT BY RE- INSPECT BY ROUGHING CLEAN -UP GAS PLUMBING PERMITS & INSPECTIONS CONTRACTOR PHONE PERMIT NO DATE FEE $ NEW BLDG. 3r I ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ SEPTIC TANK • • ' $ -1 QQ SEWER $ SOLAR HEATER $ GAS $ $ INSPECTIONS D TE BY RE- INSPECT BY RE- INSPECT BY ROUGHING GAS SEWER SEPTIC TANK SOLAR HEATER FIXTURES ELECTRICAL PERMITS & INSPECTIONS CONTRACTOR l Jkxs Electric Co. PHONE t PERMIT NO. id� DATE W-8Z59 p FEE $ - NEW BLDG. a I ALTERATION I ADDITION R PAIRS 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 V ROUGHING �o 1 H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL '"et f APPROVAL TO POWER CO. FOR SERVICE DATE BY MIAMI SHORES VILLAGE, FLORIDA BUILDING � DATE— , 195 , ELECTRICAL I PERMIT N? 10197 Contractor's PLUMBING � License No. _ Work to be performed under this Permit Owner of Building_ Architect - oritractc or Buildej Legal Lescriptic ddress c This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device descr' d in the application or in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in com ce with any plans, ings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This it e revoked at any if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condi ich this permit is ;ed is the understanding that the contractor or builder named above assumes the responsibility for a thorough kn wledg f t ` and regulations ining to the work covered hereby whether shown on the plans or drawings or in the statements or, specificatio nd tr a as onsibility for work by his agents, servants or employees. 3� Signed: 3 INSP 0�,.�,' In consideration of the issuance to me of this permit I agree to perform the work, gfed ,� nder ompliance with all ordinances and regulations ining thereto and in strict conformity with the plans, drawings, statements o e ' 'c[ Ions. to the proper authorities of Miami Shores Village. :cepting this permit I assume responsibility for all work done by either, my s ., or employee. 1 CONTRACTOR OR BUILDER BY AUTHORITY r Lot I n Bl. Subdi- vision ° /- i f o t.�" / ., Value of I Project $ Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device descr' d in the application or in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in com ce with any plans, ings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This it e revoked at any if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condi ich this permit is ;ed is the understanding that the contractor or builder named above assumes the responsibility for a thorough kn wledg f t ` and regulations ining to the work covered hereby whether shown on the plans or drawings or in the statements or, specificatio nd tr a as onsibility for work by his agents, servants or employees. 3� Signed: 3 INSP 0�,.�,' In consideration of the issuance to me of this permit I agree to perform the work, gfed ,� nder ompliance with all ordinances and regulations ining thereto and in strict conformity with the plans, drawings, statements o e ' 'c[ Ions. to the proper authorities of Miami Shores Village. :cepting this permit I assume responsibility for all work done by either, my s ., or employee. 1 CONTRACTOR OR BUILDER BY AUTHORITY Lot 1p 1 flock 17� ADDRESS 1199 N. E. 102nd Street LEGAL Miami Shores Sec PAID BY YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER -� -�f 1951 12.00 12- 31-51 12.00 2 -13 -51 14003 MIAMI SHOgES VILLAGE l BUILDING INSPECTION DEPARTMENT 1� APPLICATION FOR BUILDING PERMIT If4 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- f 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 o Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall becomplied with, whether herein specified or not. A copy of approved plans and specificatfons must be kept at building during progress of the work. � ii Date____:__.4 J40 Owner's Name and Address-_ No— Street Registered Architect and /or En ' eer —_ ►� _ _ �" _ —__' _ Name and address of licensed contractor W Aj Location and legal description of lot to be built on: Block —____� Lot � ___ Subdivision "' ' . ': �; ` • �n Street and Number where work is to be done Q ' D �) e_ State work to be done and purpose of building (by floors) and for no other purpose. New Building L°` _ __ Remodeling __ Additioni Repairs _ —_ No, of Stories To be constructed of— Kind of foundation_ .r —Roof - Coveg- '�- Estimated Total cost of improvements $_�_ �' e: Amount of Permit Zone cubage required .2a: OM6 'Flan Cubage _ Distance to next nearest building— sp, !!F* l Size of Building Lot____?'V ° 1' 3 / Maximum live.load to be borne by each floor I hereby submit all the plans and specifications for said be sent AIl- notices with reference to the building and its construction may Lam't ''' SAO" The undersigned applicant for this building permit does hereby certify, that he understands and acpts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or Sub contractors employed by him in the.work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. J r{ o Remarks — (Signed) AV`�� STATE OF FLORIDA, . COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and, take acknowledgments, personally ap- peared - to me well known, and who, being by np first duly swo '' , u &,deposes and sa that lie is the- _________ of the above describ construction, that lly read foregoing application, and that he did sign the same, and that all facts therein by state a true. Permit No." - r. Da Read, Sworn to and Subscribed before me. N ^� Notary Public, State of Florida SilBuilding Ins — My Commission Expires II PLANNING ARD DATE Chairman — �_ Member ' 1 Member Member I�^ Member pp - Member Council A roved_^ 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 -mi ection 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. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 1 Job Address I 1 1 Legal Description Owner / Lessee / Tenant�l Owner's Address ��1 1 01 • Contracting Co.` -.(- ftuyn )1 (t Qualifier 01�h VV 40il-l-Ab State #.UCOM4'i Municipal #, Architect /Enginee Bonding Company. - rs _ SS# _ Tax Folio% S) 5a,.e,,, k7- Master Permit Phone Address $b) S. CQU KAZ AM) _ -� Phone I3b� 1 I D� ' a 5 D Competency # Ins.Co. Addres Addres Mortgagor Addres o� Square Ft. Estimated Cost (value) -I SD , WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction -a zoning. Furthermore, I authorize the above -named contractor to do the work statedl. n-An. -IZO.. ....�..�..�� Signature of owner and /or Condo President Signature of Date: Date:' -�� -� .n Notary as to Owner and /or Condo President My Commission Expires: uuau; � otaey as to Cont'abty ]ow ®}� e y Commission Expftft4 d numb r o LE produced: ❑ DID rake an oarh, or DH:)*NOT ral* an oatk* ** FEES: PERMIT 20,4P RADON C.C.F. NOTARY ® OV TOTAL DUE APPROVED: Fire Othe Zoning Building Electrical Mechanical Plumbin ' � l gineering Permit Type(circle oyn�e)�LhLr : BUILDING ELEC`1TRICAL (PLUMBING ROOFING PAVING FENCE SIGN WORK DESCRIPTION K\ �) -Tt l d [M'ECHANICAL SigK `1(t b -k o� Square Ft. Estimated Cost (value) -I SD , WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction -a zoning. Furthermore, I authorize the above -named contractor to do the work statedl. n-An. -IZO.. ....�..�..�� Signature of owner and /or Condo President Signature of Date: Date:' -�� -� .n Notary as to Owner and /or Condo President My Commission Expires: uuau; � otaey as to Cont'abty ]ow ®}� e y Commission Expftft4 d numb r o LE produced: ❑ DID rake an oarh, or DH:)*NOT ral* an oatk* ** FEES: PERMIT 20,4P RADON C.C.F. NOTARY ® OV TOTAL DUE APPROVED: Fire Othe Zoning Building Electrical Mechanical Plumbin ' � l gineering ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING D I WNASHER RECEPTACLES A/C (W I NO) DISPOSAL SERVICE TEW0RARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER (MANGE REFRIGERATION GREASE TRAP APPLIANCE aMETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGR<t= TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK,.POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 If TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WAS CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT. STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER- REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4" TILE/RES. VIOLATION PUMP 8 ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL MMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RAKE METER SET (GAS) GAS PIPING 0 0 V N PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date 11 -9 -92 Job Address 1199 N.E. 102 Street Tax Folio- 11- 32 -05- 019 -0010 W/ Legal Description Lot 1, Block 175 Miami Shores Sec. 8 Rev. Owner / Lessee / Tenant Emma Ehrhardt Master Permit #J-5 �{ Owner's Address 11%`9 N.E. 102 Street Phone 751 -0255 Contracting Co._ Cox Insurance Repair Service Address 390 West 22nd Street, Hialc Qualifier Carl J. Cooper SS# Phone 887 -0315 .State Farm & State # CGC001891 Municipal # Competency # Ins.Co. Seitlin & Co. Architect /Engineer_. N/A Address Bonding Company N/A Address Mortgagor N/A Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIG WORK DESCRIPTION Replace cabinets. Electrician will pull separate permit. Plumber will pull separate permit. Square,Ft. Estimated Cost(value) $2,400.00 WARNING TO OWNER;: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO D: SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEN. TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU" NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, an on the attached addendum (if applicable). I certify that all work will be performed to meet th standards of all laws regulating construction in this jurisdiction. I understand that separat 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 wil be done in compliance with all applicable laws regulating construction and zoning. Furthermore, authorize the above -named contractor to o the work stated. / Signature of__owner and /or Condo President Signature ottontractvK or Owner-Builder Date: , ,rr� Date: No t ary'as, ��' Sad /or Condo President Notary as to- Contractor;irL:� tse�-�i�i er •.� (}ti°A MY -EO�ik"1B11a aim iPUBLIC STATE OF FLORIDA My Commission s°ax QP�5SION EXP. NOV.16,1994 BONDED JHR ;1(�1� P �, THRU GENERAL INS. UND, : 1ro'�':�� r Q d FEES : P tRMIT..: � � ``�.: r RADON C.C.F. NOTARY PEA. APPROVED: Fire Other Zoning Buildin Electrical Mechanical Plumbing Engineering PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address Tax Foli Legal Descripti Owner / Lessee / Tenant Master Permit #. Owner's Address Phone Contracting Co. Qualifier State # Municipal # Architect /Engineer Bonding Company Mortgagor SS# - Competency # Addre Address Address Addres Phone Ins.Co. Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 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 understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: FEES: PERMIT RADON C.C.F. APPROVED: Signature of Contractor or Owner- Builder Date: Notary as to Contractor or Owner- Builder My Commission Expires: NOTARY TOTAL DUE Fire Other. Zoning Building Electrical Mechanical Plumbing Engineering PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date 11 -9 -92 Job Address 1199 N.E. 102 Street Tax Folio` 11 -32 -05 -019 - 0010 Legal Description Lot 1, Block 175, Miami Shores Sec. 8 Rev. Owner / Lessee / Tenant Emma Ehrhardt Master Permit # Owner's Address 111f9 N.E. 102 Street phone 751 -0255 Contracting Co. Cox Insurance Repair Sertice Address 390 West 22nd Street, Hialea Qualifier Carl J. Cooper SS# phone 887 -0315 State # CGC001891Municipal # State Farm Co. Competency # Ins.Co. Architect /Engineer N/A Address Bonding Company N/A Address Mortgagor N/A Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION_ Replace cabinets. Electrician will pull separate permit. _Plumber will pull separate permit. Square Ft. Estimated Cost(value) $2,400.00 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to o the work stated . ignature of.;owner and /or Condo President Signature of ntract or Owner-Builder Date. t5'lu,itli`. Date: APPROVED: .. Condo President ,S1Jt STATE OF FLORIDA EXP. NOV.16,1994 GENERAL INS. UND. s� P 1 r.. 6 Notary as to- My Commission C.V.F. Fire BONDED .TNN i� Zoning Building Electrical Mechanical Plumbing Engineering 4 1 . .a HOME OFFICE 390 WEST 22nd STREET HIALEAH, FLORIDA 33010 -1486 COX INSURANCE REPAIR SERVICE, INC. GENERAL CONTRACTORS - STATEWIDE LICENSED AND INSURED TAX ID. 1159- 1218527 November 10, 1992 City of Miami Shores Bldg. Dept. 10050 N.E. 2nd Avenue Miami Shores, Florida Re: Emma Ehrhardt 1179 N.E. 102 Street Miami Shores, Florida Dear Sir: DADE (305) 887 -WI I BROWARD (30VTH- 66 DADE FAX (305) 887 -6038 BROWARD FAX (305) 522 -3973 We intend to do the following work at the above captioned address: 1. Replace cabinets. 2. Electrician will pull own permit. 3. Plumber will pull separate permit. Estimated Cost: $2, 4 00.00 Respectfully, 17 j Carl J. Cooper CC /iv SWORN TO and subscribed b ore me at Miami, Dade County, Florida on this 9 day of 199-1- . My commission expires: rp� L I C ;�aAPaTE LT P e.', RN, Nov, lez IC J �h �1�uti 9 -MERAL XKSS U�5, NOTARY PUBLIC g'ir-"Zi rt - 04V-El �5- MIAMI SHOR VILLAGE BUILDING INSPECT O DEPARTMENT APPLICATION � ®R ', E-UIL®ING PERMIT Application is hereby made for the approyaI 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 ¢omplianee 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.' r ' Date •_ Owner's Name and Address.. '` - ----- - -_ - __ No-- ------ ------- - - - - -- Street -- ----------- .------- ------------ Registered Architect and//or Engineer t" P ' r ---- --- -------- -------- ---- -- - - -- -- --- - - - - -- Name and address of licensed contractor---- •__._.__�_- _- -_.�'_ A k S ___ ___________ _____- _.- _- ....__- ._.__- __ - - - -_ ______-.-_-__-_--..--_- • -.. _.... ..__ M 1r A'N ,."k Location an ggal fptton o of to a built-on: ' ` Tr--77 r - J - - - Lot_ f Block.._ ,,Subdivision Street and Number where work is to be done ...... €_- ?_._' .. ¢ _--- ------------ _2�'_L`-- �"-- - - - - -- ---- ..4:_-- - - - - -- _ - -- State work to be done and purpose of building (by floors )______.____ -- - -- - -- - - -� f • �'_- 2'' ---------•---•------ - - - ------ ------- •---- •------------ - - -• -• -- ••- - - - -•- ----------•-------•-----------------------------•---------•-----------------------------------------------------------------•-------- -- - -- - -- - -- —•-------- •----- - - - - -- — - -- ------- 4----- ------------- ---•-------------- ------ - ------ ---- --------- and for no other purpose. .. Addition Building - - Remodeling. - - --- -- -- Repairs ........ - •- -- •- ---- -- - - -- No. of Stories-........... •-- - - - - -- To be constructed of --- •••-- • °- •- --- ------ - - -- Kind of foundation ------ •- -- ---- --- - - - - -- Roof Covering---- -------- -- - --- - •------- ••-- -- -- -•- ._._.. Estimated Total cost of improvements $-- - -_Y ?' --------- - - - - -- Amount of Permit $- .- -_ - -h_ !- J----------- t----- - - - - -- -- - - Zone cubage required. -------_------------- ---------------------- --- ... ..... —_ _ - -1'Ian Cubage--- - - - - -- A� - -- Z_. Distance to next nearest building .. -_..--- -_----- ._..__-_- - - -- „— .____kize of Building Lot ------------------- ------------------------------------------------- Maximum live load to be borne by each floor--- - - - - -- ----------- -------------------------- - - - - -- - ---------------- - - - - -- - I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to --------- ---------_—____--__._------------------------.------- — - - - -- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act-. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village, E Remarks- .. - - - -- _-------- -_____ — .------ ----__ ( Signed)_ _ -- -__ -- STATE OF FLORIDA, COUNTY OF DADE. 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, bean 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 Permit No.L'_ -.,� ��s_-__.____ Date__ 75 S`a .____._____' Read, Sworn to and Subscribed before me. Disapproved _ _ —_ .._ _ - Date.. -------- - -- - - -------- - -------------------------- - - - - — -- Notary Public, State of Florida ( Signed) +- _ ......... - - - - - Building nspector My Commission Expires -------------------------------------- -- ------- ------ ------- ----- PLANNING BOARD__---_----_- ,-- .- _--- ___------- _- _- _- __ -_ -- -_DATE Chairman--- ....... - - - - -• _ - - -____ -- -------- _----- --------- - --- - Member ----- - - - - -- ---- -- - - -- •---------------------- --- -- --- --- -- - - -- ----- - - - - -- --------------- - Member— ___ - - -- — ....... _ -_— -- - _ Member ---------------------- •----------------- - - - -•- --------- --•---------------_---- Member----- - - -...— - ___. _— _ __ _ Member -------------- ------- --- -- •---- --- - - - - -- ----- ----------- ------- -- ----------- - - --- Council Approved — _- -- - - — __ - -- -- Date j 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. TT 7 ,�` el