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Multiple (4)Inspection Worksheet Miami Shores Village b-- 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 03/12/2007 Inspector: Grande, Claudio Owner: SOUTHARD, ROBERT Job Address: 351 103 Street NE Miami Shores Village, FL Project: <NONE> Permit Type: Roof Inspection Type: Final Roof Work Classification: Roof - New Phone Number (305)756 -5067 Parcel Number 1121360130260 Block: Lot: Contractor: JOHN BUSTA ROOFING INC Phone: (305)757 -7620 Building Dsoartment Comments RE ROOFING TILE OFF FLAT 9" CONCRETE WHITE COLOR -THRU ROOF TILE BACK ON 14AR 12 2007 Passed Inspector Comments V Sae Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid Friday, March 9, 2007 Page 1 of 2 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Permit Status: APPROVED Issue Date: 2/6/2007 Expires: 08/04/2007 Permit Number: RF -1-07 -192 Owner's Name: ROBERT SOUTHARD one: (305)756 -5067 Permit Type: Roof Work Classification: Roof - New Job Address: 351 103 Street NE Miami Shores Village, FL Contractor(s) Phone Primary Contractor JOHN BUSTA ROOFING INC (305)757 -7620 Yes Additional Information Type of Work: Re -Roof Additional Info: Classification: Residential 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, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due Amount CCF $16.20 Education Surcharge $5.40 Permit Fee - New Roof $325.00 Scanning Fee $9.00 Technology Fee $8.12 Total: $363.72 Building Department File Copy Applicant Signature Parcel #* 1121360130260 Block: Lot: Section: PB: Total Square Feet 3569 Total Valuation: $ 27,000.00 Tin Cap Hot Mop Tile In Progress Up Lit Report Final Roof Invoice Number Amt Due Amt Paid RF -2 -07 -27437 $363.72 yaa FEB 14 PAID NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. 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 berew" 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 a approved plans and specifications must be kept at building during progress of the work. R , �-j,� r -- 1" Date . 19 5 Owners Name and Address , r , o v t ► OR-1-b No. 35 1 Street "f G 1034+ Registered Architect and/or Engineer Name and address of licensed contractor qq Location and legal description of lot to be b ' t on: Lot —Block- / � � j Subdivision �-Ps� � �k� �/— -d �-F� -4�• " d� Street and Number where work is to be dame22 ` ] State work to be and purpose of building (by_ floors). state exterior colors (submit samples) 1'lC�hr-1 VYA alurkAil F-1OLT lf and for no other purpose. New Building Remodeling ^ Additio Repairs No. of Stories ' To be . constructed of Kind of foundation Roof Covering r t E Estimated lbtal cost of improve iaents $ Q5700. Amount of Permit $ SeW Zone cubage required Distance to next nearest building Maximum live load to be borne by each floor Cubage of Building I hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligetbns as an employer of Labor under the Florida Akorkmen'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 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 ubeensignei to only su on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA d COUNTY OF DADE. as. Before me. the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments. personally appeared to me well known. and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully reel the foregoing application, and that he did sign the same. and that all facts therein by him stated are true. i?ermit No. �r�+'7 �I' Date — Read. Sworn to and Subsc►•i]bed before me. r Disapproved 1 Date — tt11 Notary Fnblic. State of Florida (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Council Approved Date Disapproved Date NOTE: A charge of $25.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $25.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. I MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 302-75 7 -,�� Permit No. Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not A copy of approved plans and specifications must be kept at building during the progress of work. Owner's Name and Address �'� 4) &9 S 1) 6, t-j 4 Jz x2No. 3 5 1 Street /Q 5 Registered Architect and/or Engine Im I E°G P I L G No, �a �` �/ Street Location�and al Descrip Lot Block_®/ Subd_i+s+n Street and Number where work is to be performed — No. / /(✓ a street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition a' Repairs No. of Stories Size Septic Type of Hank Capacity (gals Feet of Drain Tile Nature of Water Supply: City • Wall Dist Feet of Tank or Drain Field from Well Size of Soakage Pit STATE OF FLORIDA, es. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknow personally appeared to me well wn, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described conetrvctton, that he has carefully read the foregoing application, and that he did sign the same, and the all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- fee of $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and/or worlm►anship. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT �% Permit No ...... S® . . » ... Date..- �..... ».!. »o.. .............. 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, Flurida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owners Name and Address..,: i a .6...... .d�1ll..l.. ...................... No ........ Z ..EA ................. Street ... N ......... �.. ©..�...��....... RegisteredArchitect and /or Engineer ............................................. ............................... ....................................... .......................................................... Empl y'ng El etrilcj� 'a �ame 1.`i� �i � ... l/ 4.: C ............ .............No.f.: Street... j. �, � 1:.. �...... ...... f�i `` Q rI Q I .� 7 �% B 2 r . �; �I .........Block....( .... Subdivision....(.:.–'......%.4� b n an Legal eseription Lot......e� .�..� :.. .... ............................... .1�.�..................._.... .............. Street and Number where work is to be performed— No ......s�.. l�' � � : ......................... Street ......... .... %- Ft. Statework to be performed and purpose of building (By Fl oors) ..........................................».............................................................. ............................... New Building ............ ................... Remodeling ............................... Addition .......... /........ Repairs ...................................... No. of Stories.................... Service Od SWITCH LIGHT PLUG FIXTURES Rairme. IRON RANGE RANGE WATER W. HEAT. SPACE STRIP TOTAL OUTLETS OUTLETS Rzcz,P,T•S LAM�PS OUTLET OUTLET OUTLET CONN. HEATER CONN. HEATER HEATER +No. - LIST F®^ /�� _ J CHECK _ y ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL SW. CAR. TEMP. PERM. O.1 HP 1.0 HP TRANS. CONTR. LIST CHECK )�{!IV •. Service Od Size Pedera Conduit..h....Main e� Sw. i.02............ Amps ...........................Main Fuses............. ».....»Amps Typeof Installation— Conduit.......... .............. Tubing........................ B. X. L.........................Metal Moulding ........ ...... » ... » ......... »... ..................... » ........ ... »..» .................................................. ............................... ................................................ ............................... ...... ............................. ». ........................... . ................................ I .... ... ....... .. ..Amouat of Permit S... t ^! »................ .............. .........................( Si red).. ✓.. ...... ........ �Eledriea ... ...... Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement. and has 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- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) ..... ........... Master Electrician. STATE OF FLORIDA, ji�, COUNTY OF DADE. as. F/ Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared.............................. .................»....»...................._.......... ............................... ......................................... ............................... ............... to tae 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 fads themi , by him stated are true. ...» ....................... .... »................ »......... ............ ............................... .........................................................»...»»........ ................... ». ». ». »..... My Commieaion Ezpirea 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. • FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION FORM 1000 -A-88 SECTION 10 —RESIDENTIAL PRESCRIPTIVE CCMPWWtE METHOD CLIMATE ZONES SOUTH? 6 8 COMPLIANCE WITH SECTION 10 OF THE FLORIDA ENERGY EFFICIENCY CODE MAY BE DEMONSTRATED BY USE OF FORM t000A-69 FOR SINGLE AND MULTIFAMILY RESIDENCES OF 3 STORIES OR LE IN HEIGHT, AND ADDITIONS TO EXISTING RESIDENTIAL BUILDINGS. TO COMPLY, A BUILDING MUST MEET OR EXCEED ALL OF THE ENERGY EFFICIENCY PRESCRIPTIVES IN ANY ONE OF T- PRESCRIPTIVE COMPONENT PACKAGES AND COMPLY WITH THE PRESCRIPTIVE MEASURES LISTED IN TABLE t0A OF THIS FORM. COMPLIANCE BY THIS METHOD WILL BE, IN MM CAS: EQUIVALENT TO AN EPI OF t00 POINTS aum. AN ALTERNATIVE METHOD IS PROVIDED FOR ADDITIONS OF 600 SQUARE FEET OR LESS BY USE OF FORM 1000089. IF A BUILDING DOES h COMPLY WITH THIS METHOD, IT MAY STILL COMPLY UNDER SECTION a OF THE rnnF PROJECT NAME 1 BLRwA: t4J FS! IrrBra t � � ZONE u"7E 7 C3. 8' 9 ❑ AND ADDRESS:- 7 10 S M I OWNER: M( AIM95 %4CUL. C ll � � 7 JURISDICTNDN hj NEW CONSTRUCTION ❑ IF MULTIFAMILY. NUMBER OF CONDITIONED SO. GLASS AREA USTYPE ADDITION UNITS COVERED BY THIS SUBMITTAL: FLOOR AREA FT CLEAR TI .FILM.SOLAR SCREEN �" aTHUG �, ® FT. SINGLE- �pANE ® 'r- pajE S� MULTIFAMILY ATTACHED ❑ CHECK IF THIS SUBMITTAL (3 stories a less) SINGLE - FAMILY DETACHED ❑ REPRESENTS A T CASE CONDITION: PORCH OVERHANG LENGTH [DO FT DOUBLE- SO PANE ®� DOUBLE- PANE Sp FT PERCENTAGE OF GLASS WALL TYPE AND INSULATION TYPE AND INSULATION FLOOR TYPE AND INSULATION WOOD FRAME CEILING MASONRY I TO FLODIt % EXTERIOR: ADJACENT: R = L� D EXTERIOR: UNDER ADJACENT �. ❑ ATTIC: WOOD RAISED: COMMON: MASONRY RAISED COMM ON: EE COMPLIAN CE R= EI].❑ PACKAGE CHOSEN:- COM RON O . R = COMMON: [�MMON: R = .11 • GRADE: R = . DUCTS UNCONDITIONED COOUNG SYSTEM ❑ CENTRAL ❑ NONE HEATING SYSTEM ❑ ELECTRIC STRIP ❑ HEAT PUMP 1 HOT WATER SYSTEM ❑ ELECTRIC ❑ NONE ❑ SPACE: R = © El ROOM ❑ PACKAGED TERMINAL ❑ NATURAL GAS ❑OTHER FUELS ❑ ROOM SOLAR NATURAL GAS ly J) ❑ HEAT RECOVERY UNIT OR ❑ NONE ❑ OTHER FUELS ❑ DEDICATED HEAT PUMP IN CONDITIONED SPACE: R = AIR CONDITIONER L.XI Sr PACKAGED TERMINAL P . T y� – ❑. M.11 ❑� I HSPF I UE s �. m F = . SF /EF = 2 - t...fBER JEER NO EX1 EET OF BEDROOMS In ao©ordance with Section 553.907 F.S., I hereby cwtily Review of the plans and epeciiIcations covered by this calculation in bmu and specifications CC"Md by this are pl the ' compliance with the Before oor6trIa tion is Completed. this Flonda Energy Code. building will be in accordance with Section 553.808 F.S. ffr"MrObde- OWNERIAGIENT- DATE: lqq BUILDING OFFICIAL DATE: 110A MINIMIUM REQUMWS IN AU PACKNOS _WC�RON REQUIREMENTS N PER NEAR FOOT GEOPERABLE SASH CRACK -MAXIMUM OF 0,5 CFM EXTERK>fi d ADJACENT DOORS !104.1 SOUO CORE, WOOD PANEL, INSULATED OR GLASS DOORS ONLY. MAXIMUM OF 0.5 CFM PER SQUARE FOOT OF DOOR AREA. , INCLUDES SLONNG GLASS V 1 SOLE & TOP RATES -AM-2 -SOLE EMS AND THMUGH TOP PLATEM EXTERIOR WALLS INFI TRA N BARRIER INTERIOR MUST BE SEALED. INFILTRATION fIR P J .2 E u F1 MUST HAVE E DAMPERS, R I AIR EXHAUST FANS 903.2 EXHAUST FANS VENTED TO UNCONDITIONED SPACE SHALL HAVE DAMPERS, VCEPT FOR COMBUSTION DEVICES WITH JNWA& EXHAUST DUCTWORK _-— WATER HEATERS �/ I (� 804.2 MUST BEAR LABEL INDICATING COMPLIANCE WITH AWN STANDARD 90 OR COMPLY WITH EFFICIENCY AND STANDBY LOSS REQUIREMENTS. SWITCH OR CLEARLY MARKED CIRCUIT BREAKER AECTRCj OR CUT-OFF (GAS) VALVE MUST BE SPAS AND HEATED 904.3 T , SPAS AND HEATED POOLS MUST HAVE COVERS (EXCEPT SOLAR HEATED). NON�IdERCIAL POOLS MUST HAVE A MAIN PUMP DO. GAS VMM HEATERS MUST MW MINIMUM piwa EFFICIENCY OF 75%. HOT WATER PIPES 8044 INSULATION IS REQUIRED ONLY FOR RECIRCULATING SYSTEMS INCLUDING HEAT RECOVERY UNITS. IN SUCH CASES, PIPING HEAT LOSS SHALL BE LIMITED TO A MAXIMUM OF 17.5 BTUH PER LINEAR FOOT OF PIPE. SHOWER WATER FLOW MUST BE RESTRICTED TO NO MORE THAN 3 GALLONS PER MINUTE AT 130 PSIG. HVAC DUCT 903.2 CONSTRUCTED IN ACCORDANCE WITH INDUSTRY STANDARDS AND LOCAL MEOM& CODE JOINTS IN UNCONDITIONED TR ffidl SMALL BE SEALED. DUCTS SHa BE INSULATED HMQ 7 M A MIMMUM OF g4,2, A SARA READILY ACCESSIBLE MANUAL OR AUTOMATIC RIERMOSTAT FOR EACH SYSTEM. ..-�— FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION FORM 1000-A-89 8ECTION 10 — RESIDENTIAL PRESCRIPTIVE COMPLIANCE METHOD CLIMATE ZONES COMPLIANCE WITH SECTION 10 OF THE FLORIDA ENERGY EFFICIENCY CODE MAY BE DEMONSTRATED BY USE OF FORM IOMA419 FOR SINGLE AND MULTIFAMILY RESIDENCES OF 3 STORIES OR LE IN HEIGHT, AND ADDITIONS TO EXISTING RESIDENTIAL BUILDING. TO COMPLY, A BUILDING MUST MEET OR EXCEED ALL OF THE ENERGY EFFICIENCY PRESCRIPTIVES IN ANY ONE OF T. PRESCRIPTIVE COMPONENT PACKAGES AND COMPLY WITH THE PRESCRIPTIVE MEASURES LISTED IN TABLE 1DA OF THIS FORM. COMPLIANCE BY THIS METHOD WILL BE, IN 6W CAS: EQUIVALENT M AN EPI OF 100 POINTS 61FLLESS. AN ALTERNATIVE METHOD IS PROVIDED FOR ADDITIONS OF 600 SQUARE FEET OR LESS BY USE OF FORM 1000M. IF A BUILDING DOES h COMPLY WITH THIS METHOD, IT MAY STILL COMPLY UNDER SECTION 9 OF THE CODE. PROJECT NAME AND ADDRESS: 1 building will be wed for compliianoe in accordance with Section 553.908 F.S. OWNERIAGENT: Y BUILDING OFFICIAL: BUILDER: — TANS 1 WI REQUIREMENTS LINEAR - EXTERIOR d ADJACENT DOORS 904.1 SOLID CORE, WOOD PANEL, INSULATED OR GLASS DOORS ONLY MAXIMUM OF 0.5 CFM PER SQUARE FOOT OF DOOR AREA V 7 ❑ so 9 ❑ P NO.: SOLE & T I XTRA—TION OMER MUST 0 INSTALLED IN INFI TRA N BARRIER JURISDICTION NO.: a/ I RI R OPENINGS IN NTERIOR SURFACESOF CEILJNGS D EXTERIOR ftgWUaS MUST HAVE FLUE DAMPERS, N AIR W EXHAUST FANS VENTED TO UNCONDITIONED SPACE SHALL HAVE DAMPERS, EXCEPT FOR COMBUBTON DEVICES WITH EXHAUST DLCMM, FIREPLACES O /' 2 EXHAUST FANS 9032 WATER HEATERS r 8042 -INTEGRAL. MUST BEAR LABEL INDICATING COMPLIANCE WITH ASHRAE STANDARD 90 OR COMPLY WITH EFFTCIENIC1f AND STANDBY ! LOSS REQUIREMENTS. SWITCH OR CLEARLY MARKED CIRCUIT BREAKER ( ELECTRIC) OR CUT-OFF (GAS) VALVE MUST BE SPAS AND HEATED NEW CONSTRUCTION ADDITION IF MULTIFAMILY. NUMBER OF UNITS COVERED BY THIS SUBMITTAL: CONDITIONED FLOOR AREA SWIMMING I Pnni HEATERS MUST MW MINIMUM DOW4 EFFICIENCY OF �- S0. FT. 9044 GLASS AREA TYPE CLEAR TI .FILM,SOLAR SCREEN SAVE INANT LENGTH �.® FT SINGLE- PANE WATER FLAW MUST BE RESTRICTED TO NO MORE THAN 3 GALLONS PER MINUTE AT 80 PSIG. ® ! 2 S0. FT SINGLE- PANE 904.7 A gEfIARAIE, READILY ACCESSIBLE MANUAL OR AUTOMATIC TIJERMOSTAT FOR EACH SYSTEM. .-�' SO FT MULTIFAMILY ATTACHED ❑ (3 stales a less) SINGLE- FAMILY DETACHED ❑ CHECK IF THIS SUBMITTAL REPRESENTS A WO T CASE CONDITION: PORCH OVERHANG LENGTH m FT DOUBLE PANE SO fT DOUBLE- PANE ® SO FT PERCENTAGE OF GLASS TO FLOOR 96 WALL TYPE AND INSULATION CEILING TYPE AND INSULATION UNDER ATTIC: _ ® FLOOR WOOD RAISED: R= COMMON: R TYPE AND RAISED. COMMON: INSULATION MASONRY R= R= WOOD EXTERIOR ADJACENT: Fl- COMMON: R= FRAME MASONRY EXTERIOR: R ADJACENT: R= COMMRON: 02 COMPLIANCE PACKAGE CHOSEN: ® COMMON: R_ r❑•❑ L ��. GRADE: R = . DUCTS UNCONDITIONED SPACE: R = m© IN CONDITIONED SPACE: R =%�� D COOUNG SYSTEM ❑ CENTRAL 13 NONE ❑ ROOM ❑ PACKAGED TERMINAL AIR CONDITIONER S� ERlEER = . ❑PIHSPF�UE _ J HEATING SYSTEM El ELECTRICSTRIP 1:1 HEAT PUMP ❑ NATURAL GAS ❑ OTHER FUELS ❑ ROOM UNIT OR ❑ NONE PACKAGED TERMINAL HEAT PUMP _ F1 0] 0 1 HOT WATER ❑ELECTRIC ❑ NONE ❑ NATURAL GAS IVG ❑ OTHER FUELS /� . T SYSTEM SOLAR ❑ HEAT RECOVERY ❑ DEDICATED HEAT PUMP SF /EF = ❑. 2EX1 NUMBER OF BEDROOMS = �� In accordance with Section 553.907 F.S., I hereby m ft that' the Plena Review of the Plena and Vecilkations oomed by this calafttion indicates WW ficadm qm covered by the WO)" Tom the oomplme with the Florida Energy Cade. Before cation is conlaeted. ft Florida Energy Code. building will be wed for compliianoe in accordance with Section 553.908 F.S. OWNERIAGENT: Y BUILDING OFFICIAL: DATE: DATE: TANS 1 WI REQUIREMENTS LINEAR - EXTERIOR d ADJACENT DOORS 904.1 SOLID CORE, WOOD PANEL, INSULATED OR GLASS DOORS ONLY MAXIMUM OF 0.5 CFM PER SQUARE FOOT OF DOOR AREA V EXTERIOR P SOLE & T I XTRA—TION OMER MUST 0 INSTALLED IN INFI TRA N BARRIER a/ I RI R OPENINGS IN NTERIOR SURFACESOF CEILJNGS D EXTERIOR ftgWUaS MUST HAVE FLUE DAMPERS, N AIR W EXHAUST FANS VENTED TO UNCONDITIONED SPACE SHALL HAVE DAMPERS, EXCEPT FOR COMBUBTON DEVICES WITH EXHAUST DLCMM, FIREPLACES O /' 2 EXHAUST FANS 9032 WATER HEATERS r 8042 -INTEGRAL. MUST BEAR LABEL INDICATING COMPLIANCE WITH ASHRAE STANDARD 90 OR COMPLY WITH EFFTCIENIC1f AND STANDBY ! LOSS REQUIREMENTS. SWITCH OR CLEARLY MARKED CIRCUIT BREAKER ( ELECTRIC) OR CUT-OFF (GAS) VALVE MUST BE SPAS AND HEATED 904.3 OR BUILT4N HEAT TRAP MUSI BE PRDMOED, SPAS AND HEATED POOLS MUST HAVE COVERS (EXCEPT SOLAR HEATED). NON{OMMEF�IAL POOLS MUST HAVE A SWIMMING I Pnni HEATERS MUST MW MINIMUM DOW4 EFFICIENCY OF �- NOT WATER PIPES 9044 75% INSULATION IS REQUIRED ONLY FOR RECIRCULATING SYSTEMS INCLUDING HEAT RECOVERY UNITS. IN SUCH CASES, PIPING HEAT LOSS SHALL BE LIMITED TO A MAXIMUM OF 17.5 BTUH PER LINEAR FOOT OF PIPE. SHOWER HEADS afm WATER FLAW MUST BE RESTRICTED TO NO MORE THAN 3 GALLONS PER MINUTE AT 80 PSIG. HVAC DUCT ! 2 CONSTRUCTED IN ACCORDANCE WITH INDUSTRY STANDARDS AND LOCAL MECINGL CODE. JOINTS IN UNCONDMM HVAC RRM 904.7 A gEfIARAIE, READILY ACCESSIBLE MANUAL OR AUTOMATIC TIJERMOSTAT FOR EACH SYSTEM. .-�' ARE We ' COMPONBITi D 20% ST Z• Maximum Farce F of Glass to Floor m fix 0 3 Mao" ANY OF THE FOLLOIYING ARE ALLOWED: DEDICATED Wood HEAT PUMP HEAT RECOVERY UNIX OR SOLAR WITH Frame CEILINGS A b Slab-On -Grade Raised Wood Raised Concrete DUCTS Electric = Gas 6 Oil Elearic nr Resistance fGas Od ow x ^ 15% SC 2' a 15% ST 2' C 20% ST r D 20% ST Z• Colt F Mr 25% OT AM 2' EXTERIOR AND ADJACENT MASONRY WALLS R-5 COMMON MASONRY WALLS R -3. EXTERIOR, nDJACENX AND COMMON WOOD FRAME WALLS R-11. CEILINGS UNDER ATTIC R -30. FRAME COMMON CEILINGS R -11. (NO SINGLE ASSEMBLY CEIUNGS ALLOWED) R-0 R -it (ONLY STEM WALL CONSTRUCTION ALLOWED) R-5 114.2 I R4.2 I COND COND R4.2 9.0 8.7 9.8 10.1 10.1 STRIP STRIP STRIP STRIP STRIP Colt MIMMUM AFUE OF .70 NOT ALLOWED I (See Below) NOT ALLOWED EF .M See Below EF .88 EF .88 AM MINIMUM EF OF .54 COP: R = UNDER ARE R = � ANY OF THE FOLLOIYING ARE ALLOWED: DEDICATED HEAT PUMP HEAT RECOVERY UNIX OR SOLAR WITH A SOLAR FRACTION OF AT LEAST .4n. CLIMATE ZONES7 8 8 TO 8E 11189 W EXi R =5_ AM R =��� Colt R =______._ EXr R = AM R = COP: R = UNDER ARE R = � R= R= R = UNCOND. R 9.8 GENERAL DIRECTIONS 1. New construction including a tiom which hworporaes any d the mw riser" rodfceeing cortstrr,ction, a a other no od aumol = the rttetho4 retell wood "Dore wU w continuous stem waft, deal ad recta, 2. Choose one d tM cor"nard p��a A' ..F,. horn Table m8 by � you hard lo con * whh tM code. Q* the co = d the package I on Table t08 you wig rind a cokenrt labeled '70 Be losaltd". In this colurm W W all 'be Pe pe you have chosen �Bicim ftn the required Levels Wficable spaces w"h tM Wor0001l "Jelled. A" "b Be LntwW, vektes Hall to MW S 4, Cornpigle Read "W � an the top M" d pa0e t based an the ' 0 Be IrrsaW. Cokatnr h ft _ to a we a Raa4 eq% LV da% Ufa A" Padres', Ted ala an pall t and check east brut to btdloate your Intent a txttrgtly wNt all applicable "erne. �' a�a"on 8atenep at "r beam a gape 1. DESCRIPTION OF BUILDING, COMPONENTS LISTED Percent of Glass to Floor Anna: The Glass TjrP O aby the teal �n�ned a foal plea area m the condilbW Ow area shd nst sage" the lescdbed pecenrag, This per is by ft" Overhang: The energy �. We are stn *der in s�y.� , "Ducts cloar (04 and doub�nd � g overMrg t the "Lance the rod a sd8t projeft cut haimna"p horu the face d dre etxe ft* t) glass on the gaoled ant d a hotree and 2) f)re glass in the lower stales d a � she" be under overhang d at lead the Qre�ryed with wml Calling, and Floor Insulation Values: Tire R.ralues The R"'lue d tM structural buitdhtg materials 8111" not be Included in °M'nW= X131" h A tbn level added to tM structural components is d the wag. PMM separate CcndMWted space from wtrotditiated but enclosed are "Lose separe"rp �ndcionad tertertclos Ina gip. a coon. Floor. SlaDonende floors without edge utsuacon are accepable for a �o �araa ca oohed space from wr�r�t W and urram a m �dl�r cant• Ducts: Cortd" inr11cates that the data mast De insalyd Wkhlo the Bas Rated W00d tloas eta" have urordirlroA stem waft With insuation paced either an the � a under the floor. uuo tM CWWWoned space Ducts m conditioned That t, the ductwork she" be bawled um The side d the ittsuatiort so that any leakage will be u�staned ysuWM level d R•41 � amble � � pactmpa It R4.2 t "died. the ducts my be in wtconditieted space but rtatst be hum y l to age wi be Space Cooling System.CoOArtpsy 8WhmaSeasonal matt rM prescribed value FJre►py Eteciecyr Rego ( SEER) for central w1b a Energy Eftle4 Rctio (EEtO M roan arch a PpCs etlutal b a Electric Space Heating Option: NO pwV systene dd be read � a G> d Pedamance pnda Patrons � are els ' b'wHaatp equipnted selec"m hen �uarturere' literature 1M ( ) egal to a greater than dre Prescribed COP H�tirg Seasonal Pdrbrtrartce Gas or Oil Fuels Space Heatpng Option: Gas a product Heat WO systems may contain etectrtc 00 baclotpe. Electric Resistance Hot Water Option: Fa "EF .88" sYslene Mug be rated wi►h an Annual Fuel UMW ft Efficiency KUE) d at trust .70 M all packages. .NaAUOwedl Fuels resWoltehapair : ten 60 ftlalled �'"tedW*watat=MVsyste OW111 1mletwMambftwn Energy NW (Egol88. For thepadmpesdesowed Gas or Oil Fuels Hot Water Option: Gas 0r�ou, � N '"� on0 d � "� Hd Wata Symms Optiore�• 8e0 lobo, at law Other Hot Water System Options: Any dedicated heq A must be re� wfth an Etar systems must be P rerxwery Lott, a star hot wear system v�iMdt the 51 for d padres Sorer deep W W lands at 1110 40% d the WW bd water (soar fraction a . requiremena a sm4.8 d the Energy Code may be insaued. a greater may be used in �+Chon with these sycterte, Eactdc re Isle *WN hff tp an EF d A a greats. a naWrel pas syearee W EF 54 2 . SEER = rvv Na : w UN l STRIP COPINSPF s " AFUE _ NOT ALLOWED See Below) 1 /) EF a - EF = W. EF "No p� GENERAL DIRECTIONS 1. New construction including a tiom which hworporaes any d the mw riser" rodfceeing cortstrr,ction, a a other no od aumol = the rttetho4 retell wood "Dore wU w continuous stem waft, deal ad recta, 2. Choose one d tM cor"nard p��a A' ..F,. horn Table m8 by � you hard lo con * whh tM code. Q* the co = d the package I on Table t08 you wig rind a cokenrt labeled '70 Be losaltd". In this colurm W W all 'be Pe pe you have chosen �Bicim ftn the required Levels Wficable spaces w"h tM Wor0001l "Jelled. A" "b Be LntwW, vektes Hall to MW S 4, Cornpigle Read "W � an the top M" d pa0e t based an the ' 0 Be IrrsaW. Cokatnr h ft _ to a we a Raa4 eq% LV da% Ufa A" Padres', Ted ala an pall t and check east brut to btdloate your Intent a txttrgtly wNt all applicable "erne. �' a�a"on 8atenep at "r beam a gape 1. DESCRIPTION OF BUILDING, COMPONENTS LISTED Percent of Glass to Floor Anna: The Glass TjrP O aby the teal �n�ned a foal plea area m the condilbW Ow area shd nst sage" the lescdbed pecenrag, This per is by ft" Overhang: The energy �. We are stn *der in s�y.� , "Ducts cloar (04 and doub�nd � g overMrg t the "Lance the rod a sd8t projeft cut haimna"p horu the face d dre etxe ft* t) glass on the gaoled ant d a hotree and 2) f)re glass in the lower stales d a � she" be under overhang d at lead the Qre�ryed with wml Calling, and Floor Insulation Values: Tire R.ralues The R"'lue d tM structural buitdhtg materials 8111" not be Included in °M'nW= X131" h A tbn level added to tM structural components is d the wag. PMM separate CcndMWted space from wtrotditiated but enclosed are "Lose separe"rp �ndcionad tertertclos Ina gip. a coon. Floor. SlaDonende floors without edge utsuacon are accepable for a �o �araa ca oohed space from wr�r�t W and urram a m �dl�r cant• Ducts: Cortd" inr11cates that the data mast De insalyd Wkhlo the Bas Rated W00d tloas eta" have urordirlroA stem waft With insuation paced either an the � a under the floor. uuo tM CWWWoned space Ducts m conditioned That t, the ductwork she" be bawled um The side d the ittsuatiort so that any leakage will be u�staned ysuWM level d R•41 � amble � � pactmpa It R4.2 t "died. the ducts my be in wtconditieted space but rtatst be hum y l to age wi be Space Cooling System.CoOArtpsy 8WhmaSeasonal matt rM prescribed value FJre►py Eteciecyr Rego ( SEER) for central w1b a Energy Eftle4 Rctio (EEtO M roan arch a PpCs etlutal b a Electric Space Heating Option: NO pwV systene dd be read � a G> d Pedamance pnda Patrons � are els ' b'wHaatp equipnted selec"m hen �uarturere' literature 1M ( ) egal to a greater than dre Prescribed COP H�tirg Seasonal Pdrbrtrartce Gas or Oil Fuels Space Heatpng Option: Gas a product Heat WO systems may contain etectrtc 00 baclotpe. Electric Resistance Hot Water Option: Fa "EF .88" sYslene Mug be rated wi►h an Annual Fuel UMW ft Efficiency KUE) d at trust .70 M all packages. .NaAUOwedl Fuels resWoltehapair : ten 60 ftlalled �'"tedW*watat=MVsyste OW111 1mletwMambftwn Energy NW (Egol88. For thepadmpesdesowed Gas or Oil Fuels Hot Water Option: Gas 0r�ou, � N '"� on0 d � "� Hd Wata Symms Optiore�• 8e0 lobo, at law Other Hot Water System Options: Any dedicated heq A must be re� wfth an Etar systems must be P rerxwery Lott, a star hot wear system v�iMdt the 51 for d padres Sorer deep W W lands at 1110 40% d the WW bd water (soar fraction a . requiremena a sm4.8 d the Energy Code may be insaued. a greater may be used in �+Chon with these sycterte, Eactdc re Isle *WN hff tp an EF d A a greats. a naWrel pas syearee W EF 54 2 . Permit No. Application is hereby made structure herein described. I and all provisions of the Lai of Miami Shores Village sh building during progress of , Owner's Name and AddrI Registered Architect and/ Employing Plumber's Naz .I MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _1 - _. Date_ 4� __V _ 3 _. r the approval of the detailed statement of the plans and specifications herewith submitted for the building or other s application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, ]Florida of the State of Florida, all ordinances of Miami Shores Village and all roles and regulations of the Building Divisior be complied with, whether herein specified or not. A copy of approval plans and specifications must be kept al 1 No _._ Street - -- No. Z' Z/. ._ . . Location and Legal Descri Lot-..._...._ _ Block �-. Subdivision _ .. Street and Number where work is to be performed-No._ L ew State work to be perf�ormmeed azid pwyose of building (By Moors)— New Building_ - _Y _ -- -- - - - -_. Remodeling Addition_ ___ _ - Repairs------------ _._..____ No. of Stones- _.., --- _ ----- _--- wvBefore me, the unders ned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally dAleare of mthee well e described ho 'being by me first duly sworn, upon oath depose and says that he is the___ _ - - -- _ - -_ -_.�.. ------- �• - -_ -- -.... construction, that he. carefully read the foregoing application, and that he did sign the same, and that all far therein by him stated are true. My Commission Expires Notary Public, State of Florida T NO A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fear era d /or workmanship. I CLOSETS BUSS TUBE HOWERB LAVA- TORIES $INK6 SLOP IS LAUNDRY TYOB UNINALa CATCH SABIN FLOOR DRAIN DRINKING FOYNT•NS tj F XTUREI CowTR. LIST I B OT —7— -.IL.� CHECK S-D v f. SEPTIC . - TANK SEWER CONN. : DRAIN FIELD SOAKAGE PIT GREASE- TRAP 1b HEATER DEEP WELL SPRKLR. SYSTEM SWIM•t: POOL CONTR. LIST .n1 CHECK Size Septic Tank___ ------ ____- .____Type of Tank _--__Capacity Feet of Drain Tile._ — ---- -- ---- . - - - --- -------- Di��st...�.Feet of Tank or Drain Field f= WeIL _.�� Nature of Water Supply C ��- ell.__._..__ -_i_"_ ` ----.Si. ,. of Soakage Pit ..... ___ ...___ _ Amount of Permit $- _____�- (Signed) ___.__ _ �_ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an•employer -of labor under the Florida Workmen s Compensation Act, being Section 596% Compiled General LaWS of Florida Permanent Supplement, and has com- plied with the provisions tht reof, 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. (wed) Master Plumb Z STATE OF FLORIDA, t m' mr,.rry nF nAnF. wvBefore me, the unders ned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally dAleare of mthee well e described ho 'being by me first duly sworn, upon oath depose and says that he is the___ _ - - -- _ - -_ -_.�.. ------- �• - -_ -- -.... construction, that he. carefully read the foregoing application, and that he did sign the same, and that all far therein by him stated are true. My Commission Expires Notary Public, State of Florida T NO A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fear era d /or workmanship. I CA -n MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the ap royal of the detailed statement of the plans and specifications herewith submitted for the build- ing oa other structure ein described. Tltpis application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, d all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Buil ' g Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications ust be kept at building during progress of the work. Owner's Name and Add -.. ..__.___._..--- .--- ..19._._.�t8 ss._.. A914_ �... sS4i 11�rI3> ?_ �.�_ _---------- - - - - -- - - - -- No.--- 301--- X -19St eet —• -1 34!11 -...4-t 40 - Registered Architect and or Engineer .. - -•- - - - -- •---- •- - - - - -- - -' -- ­---­--- - -- ------ - -- - ---------- ---- ------- - -------------------- ------------- ­------­--- - -- Name and address of li lied contractor.. ----- B.e-lf - - - - - -- — -w ---------------- ............................. — ........ ---•- ................ .._--- •-------- - - - - -- -----._......-- -- Location and Ieig descri on of lot to be built on: Lot_ ---,x,8...19-- -------- ---- ----- Block ...... lla-- •............... subdivision.--- -....Miami - -S $._ Sa-atiQ xi-5--- _---- .---- _----- • - - - - -- Street and Number where work is to be done ........ ._35''_ Rs- __03d _----- State work to be done a 'd purpose of building (by floors)... —.___. 00110 V6tQ---- •- Pativ_----- a1.g.Q -Q.gr ldati:.__ for no other purpose. New Buildi _____. Remodeling ...................... -- Addition .... _____..___.- -- - -.- Repairs ----- - --------- -- ._----- No. of Stories ........................ _. To be constructed of__G�17,.S31f'ete Kind of foundation ---- - ----- C_0.110RO10----- - - - - -- ------ - - - - -- Roof Covering ------------ - ----------------------------- _-- Estimated Total cost of ' provements $__309.00 ..... ___ - Amount of Permit $ ----- .51-- _�---- ---------- ----- -_ _ Zone cubage required_. -------- _____.__._____.�__._. _ Plan Cubage _ ----- --- 33-- &- 4 -by.. 8...ft, Distance to next nearest ',building -_ -- Q�211Y1� - -. ---.-.---Size of Building Lot___ -_ DO.-b.7-125 - _?Bet.---- - - - -_- ------ - - - - -- Maximum live load to b�' borne by each floor - ------ - _ - -___. __- __ ------ ". I hereby submit all a plans and specifications for said building. All notices with reference to the building and its construction may t� sent to Dale A Southard l..N.P -,_l rd fit. -• - - - - - - - — ----------- - - - - -- - The undersigned aplicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Flop Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with t ie provisions thereof, and will require similar compliance f all contractors or sub-contractQrs employed by him in the work to be perfo ed under this permit; and will post or cause to be pos f vection on the site of otice or notices as are require by the Act. The undersigned agrees to employ only s ch ' ntractors, on wor performe under is permit, as are licensed b y Miami Shores Village. Remarks —___ ( Si ---- ------- --.... _ STATE OF FLORIDA,1 Dale H. Southard COUNTY OF DADE. f ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take, acknowledgments, personally ap- peared,- ------------------------ --------- — _ ._.... --- ------ ------- - ---------- - -------- - ---- - - _— ------- - -- - - -- -­-­---- me well known, and who, be in by me duly sworn, upon oath deposes and says that he is the ......................... ......_.._.•....-- ....--- - - -. -.................................... g pp of the above described struction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated ar true. Permit No.— I ;, ? ------ Date - - -- Read, Sworn to and Subscribed before me. Disapproved —._ - - -.— Dat _ -- � l� Notary Public, State of Florida (Signed) _ ` (- - --- — ---- -- ----- — Building Inspector My Commission Expires ----- ---- - ----------- - --- —_ -- _ - --------------------- PLANNING BOARD__——___. ----- _.--.-- _------ _____- __DATE — —�_ — .. - -_ —__ _ __ _ - _ . . -- - - _ Member --------- --- •------- - - - --- -- -- - -----------------------....--- Chairman ._._ ....... . ..... . 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 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 workm(tnship. ` -r MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. __ - -._ -- Application is hereby made f 'r the approval of the detailed statement of the plans and specifications herewith submitted for the building or othei structure herein described. s 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 Divisor of Miami Shores Village be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of w k. (JYIiRr'a Nano and Aliress._, - _ -. - -- s _ No. Straw Registered Architect and /or eer -__. _ .___�_:::_ ..... ......... �_ Employing Plumber's bt/ Street --- - - - - - -- Location and Legal Description Lot Bloa Subdivision Street and Number where work is to be performed —No. Street _... -State work to be performed I d purpose of building (By Moore)— New Building_ ._._ _- - Remodeling— Addtnn _____- Repairs- _---- •--- _____- • -__ -- No. of Stories - ----------- Size Septic Tank— � I ® Type of TOY& __,._Capacity, Cats. -- -- _-------------- _____. Feet of Drain Tile. __ Feet of Tank or Drain Field from Nature of Water Supply: Cl —Well. Size of Soakage Pit_ - - -___ Amount of Permit $__ -__ (Signed) - - -- -- - -- - - - --- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen' s Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and bas co m. 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 Shares Village. s ( Signed) Master Plumber. STATE OF FLORIDA, i COUNTY OF DADE. f Before me, the and authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appear, f mth®ewa�bove described that who, being by m® first duly sworn. upon oath doses and says that he is the___ — _-- - - -___ _ ------- _---------- -- - - - - -- ... coon, that he has carefully read the foregoing application, and that he did sign the same, and that all tac therein by him stated are - - -- - 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 faul materials and /"orlimanship. BATH LAVA. SLOP LAUNDRY CATCH FLOOR DRINKING, TOTAL CLOSETS TUBS "awme. TORIES SINKS 'SINKS TUBS URINALS BASIN DRAIN FOUNT'NB FIXTUREI COMM. LIST CHECK SEPTIC SEWER DRAIN SOAKAGE- GREASE SOLAR DRIP SPRKLR. SWIM'G TANK CONN.. .;FIELD PIT TRAP NEATER WELL SYSTEM POOL CONTR. LIBT CHECK Size Septic Tank— � I ® Type of TOY& __,._Capacity, Cats. -- -- _-------------- _____. Feet of Drain Tile. __ Feet of Tank or Drain Field from Nature of Water Supply: Cl —Well. Size of Soakage Pit_ - - -___ Amount of Permit $__ -__ (Signed) - - -- -- - -- - - - --- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen' s Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and bas co m. 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 Shares Village. s ( Signed) Master Plumber. STATE OF FLORIDA, i COUNTY OF DADE. f Before me, the and authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appear, f mth®ewa�bove described that who, being by m® first duly sworn. upon oath doses and says that he is the___ — _-- - - -___ _ ------- _---------- -- - - - - -- ... coon, that he has carefully read the foregoing application, and that he did sign the same, and that all tac therein by him stated are - - -- - 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 faul materials and /"orlimanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby Made [or tho approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other swctwe. here "n described. Tl»s application is made in compliance and conformity with the Building Ordinance of Miami Shores �'illagc, Florida, an: X11 provisions of the Laws of the State of Florida all ordinances of Miami Shores Village and all rules and regulations of the BuildinglJivisian of Miami Shores Villaagge shall be complied with. whether herein specified or not. A copy of approved plans and spexifications myst be kept at building during pictgress of the work. 7 �,, ]�' Owners Name and Address.... i .� � / .. . ....... «...««««._ No. 9Z _..._.. Street,& : e4 Registered Architec t and /or EnSinver .............. » «...« ......................... ••re,n ,...e nr.,a, eaus s.,.+ s. mnn, extraty ••,•••..••••• »..•••••••••••• ~ Name and address of licensed contritctor....�...� �%..� .......6�! °...1..� ...1 _... Location and legal description of lot to be built on: -7s, s- 1v ed 7 3yr 1.wlef t7f WlV-7 Lot........ «... _sass _ .................. Block._................. «_ .. Subdivision. «« sass ....._..»«_.. ......---.....-....... -. Street and Number where work is to be State work to be done and purpose of building (by floors) .f� i -y_.7 -TILE .t.Z M F__«.. i.... �_E_ 6 . F....... ................... ...._..._ . ............ »..«.«......._........... «... s as s. _ ._... _ _ ... ... ........... .. »..-._-_-.....- _. ._ ................ __.. sass. «.and for no other purpose. New Building .....................�,....... Remodeling ................. ...... « Addition .......................... Repaid ... .................. __ No. of Stories ...... ....... _ ...... _ v' To be constructed of............ ................ Kind of foundation .......__. ........................................... �__ o� vering.......� 64.7—. -az— Estimated Total cost of improvements $ `-- ® Amount of Permit S . ........ sass Zone cubage required ------- j ......... _.._. _._ sass. _ _ « .. ____ Plan Cubage .......... _... ..« ........ Distance to next nearest building.... .........................._..._ »_.__.._.....Size of Building Lot ....... __« _ . «___ ...._.... _......._.............._.._.._ Maximum live load to be borne by each floor_ .............._.....-_.-..--...._. ..._-- •-- ............_....._... ' _....... _..._.. .... __ ..... _ .... _. ............. I....................... I hereby submit all thje 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 Florid Workmen's Compensation Act, being Section 5998, Compiled General f.�lo=t Pennanent Supplement, and has complied with th; provisions thereof, and will require similar compliance fro trac rs i:r sub-cantractbrs-ennployed by him in the work to be perform�ed .under this permit; and will post or cause to be posted r i ion the sit fi. ublic notice or notices as are required I y the Act. The undersigned agrees to employ only such ct ea to orm under this permit, as are licensed by Miami Shores Village. Remarks - __— ---- _ ------- w. _; »...__ . _ .. (sign,d) - 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. geared__ ._ ---- •-------------- • - - - - ............... ................ . ...to me well known, and who,. bein by me f' si duly sworn, upon oath deposes and says that he is the....... .. . ............._--._............. _ ............_..._._. _ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. . _ _... Date. _ _ �� .. Read, Sworn to and Subscribed before me. Disapproved .--- �_ .._.. Date.__.._ «._._. _..... _.°_._ ..... ... ....� .......................... . .._sass No Public. State of Florida (Signed) _ _ ........_....__.._ .._.__._______....�..._._...... Building Inspector My Commission Expires.. .«»... » PLANNING BOARD «._. -_..._ ....... .............. _-.. ..-DATE Chairman .................. Member Member...___ _.._...._.._..�:.__ _ .._... «. _ . . _sas s. Member _ ......_._.....« « Member .................... .. _ _ _..__. ___. » _ Member ... _ .. _ Council Approved ...... __.------ . - -____ ._ _.. _Date Disapproved .._.._._.._. «... ...... ......................... ...........................Date NOTE: A charge o $1.00 willibe made for making corrections or elmnges to this application after approval has been obtained from the Phinnin;{ Board. A re- inspection fee of $1.00 will be charged when such re-inspection is made necessary by improper notice for inslmtion or faulty materials and /or workmanship. Permit No .. ».. 1A.(°...... Application is hereby made structure herein described: and all provisions of the Lai of Miami Shores Village A building during progress of Owners Name and Addrem Registered Architect and /c Employing Electricians Na Location and Legal Pescri; Street and Number where a State work to be performed New Building :......... ............. !MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT »... Date.....�1�. `�..a�"� ........ for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other his application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, 1 of the State of ,Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division 9 be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at -0,W i3 Lot......» ........................................................... Block .......................................... Subdivision ................... »..... . ...... - -- isto be performed—No ... ... » .... » ............................ .................,............. Street ............ »........»... ...... ................ purposeof building (By Floors) ......... ................ ........................»....... ...................... »........ Of Stories ................... Service Overhead Site �eedaa.............» .....Conduit...............Main SW....................... ».. ..... »............. Underground Amps•• .Maier Fuses .. Amps Type of Installation— Con uit ........................ Tubing....................... B. X. L.........................Metal Moulding ........ . ... ........... »..» ............ .......... »... Amount of Permit O (Signed) The undersigned appli4ot for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida W rkmens Compensation Act, being Section 5946, Compiled General Laws of da Permanent Supplement, and, has complied with the pro 'lions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work' to be performed unde 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-con raetors, " work to be performed under this permit, as are licensed by Miami Shores Wage. . (Signe ...... »Maser »Electliciaa. STATE OF FLORIDA, COUNTY OF DADE. m' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally to me well known, and wh being by me first duly sworn, upon oath deposes and says that he is the . ... »..» ...................»........» ».............................. of'the above described co coon, and he has carefully read the foregoing application, and that he did sign the Mme, and that all facts therein by .him stated are . e. . . »..... ... lvty Cmmissioa Expires » ». ...» » . .. »Notary »Public, State of Flori.................................... a NOTE: A re Ispe ti f n 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.. II SWITCH LIGHT PLUG FIXTURES REiRIG. 111ON RANGE RANGE WAITER W. MEAT. �p }ICE BTgIP TOTAL OUTLETS OUTLETS BC NO. LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. 14%"Z HEATER CONTR. - Lis? CHECK ENT. DIET. SERVICE SERVICE MOTORS . MOTORS NEON RADIO TOTAL SW. CAS. Tamp. PERM. 04 HP 1.6 HP TRANS. -re LIST ��df- ® -A CNBCX A-- Service Overhead Site �eedaa.............» .....Conduit...............Main SW....................... ».. ..... »............. Underground Amps•• .Maier Fuses .. Amps Type of Installation— Con uit ........................ Tubing....................... B. X. L.........................Metal Moulding ........ . ... ........... »..» ............ .......... »... Amount of Permit O (Signed) The undersigned appli4ot for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida W rkmens Compensation Act, being Section 5946, Compiled General Laws of da Permanent Supplement, and, has complied with the pro 'lions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work' to be performed unde 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-con raetors, " work to be performed under this permit, as are licensed by Miami Shores Wage. . (Signe ...... »Maser »Electliciaa. STATE OF FLORIDA, COUNTY OF DADE. m' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally to me well known, and wh being by me first duly sworn, upon oath deposes and says that he is the . ... »..» ...................»........» ».............................. of'the above described co coon, and he has carefully read the foregoing application, and that he did sign the Mme, and that all facts therein by .him stated are . e. . . »..... ... lvty Cmmissioa Expires » ». ...» » . .. »Notary »Public, State of Flori.................................... a NOTE: A re Ispe ti f n 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.. II Application is here ing or other structure I Shores Village, Florida, regulations of the Build plans and specifications MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT made for the approval of the detailed statement of the plans and specifications. herewith submitted for the `build - ein described. This application is made in compliance and conformity with the Building Ordinance of Miami id all provisions of the Laws of the State of Florida all ordinances of Miami Shores Village and all rules and 3 Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved ust be kept at building during progress of the work. i Date �./a. 1�5 _ — -- ----------- 18 - -_ Owner's Name and Ad ors -- a • S • Carroll , -- _ No.___ _3� __ —. Streeter.. -X__l03rd_ -� � � .__ -- Registered Architect and or Engineer..— . —_ - -- ------- - - - - -- w�_____—__ ���----------------------- - - - - -- _. Name and address of licensed contractor Idill- R^^ _ T4 G 430 $. Location and legal descn lion of lot to be built on: Lot Block Subdivision_ Street and Number where work is to be donew_� 351 N. Z. 1032-4 St.l Miami _Shores. _ State work to be done a#d purpose of building (by floors New Building - X To be constructed of— Estimated Total cost of Zone cubage required_ Distance to next nearer Maximum live load to b I hereby submit all be sent to_._._. The unde of labor under and has comp in the work tc or notices as a permit, as are for no other purpose. Remodeling _ - -__ —_ Addition _____ Repairs_____:___________ No. of Stories. -------------------- _____ Kind of foundation _____ —_ -Roof Covering ----- ---- S iM l e__2i1e nents $_. —_— MWQQ Amount of Permit Cubage___ of Building Lot_ ____- _---- .- _--- __ -__- - ------ borne by each floor-- ie plans and specifications for said building. All notices with reference to the building and its construction may ant for this building permit does hereby certify that he understands and accepts his obligations as an employer Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him d under this permit; and will post or cause to be posted for inspection on the site of the work such ublic notice V the Act. The undersigned agrees to employ only such subcontractors, on work to be performed, under this Miami Shores Village. Lang Roofing & Ti1w Co ( Signed )— STATE OF FLORIDA, I COUNTY OF DADE. 1 ss• Before me, the undefsigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me f of the above described c therein by him stated are Permit No._ Disapproved ( Signed ) Chairman Member . Member . Council NOTE: A charge �e Planning Board.. A re- inspection fee ma teria . and /or workm he _w —.to me well known, truetion, that has carefully read the foregoing application, and that he did sign the same, and that _ - _ g g PP � gn all facts Date® _ Read, Sworn to and Subscribed before me. Notary Public, State of Florida —T__ ~-- My Commission Expires- _______—__ -____----- - PLANNING BOARD ____ ____ _DATE Member Member „ Member — Disapproved $1.00 will be made for making corrections or changes to this application after approval has been obtained from f $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT PLICAT113N FOR ELECTRICAL PERMIT Permit NO...:� ..1 - «`!. ..... Date.... « «. �6!.... «:.... «...._........ Application is hereby made for the approval *of the detailed statement of the plans end specifications herewith submitted for the building or other structure herein described. This application is made-in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws I of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building; Division of Miami Shores Village shall be complied with, whether. herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owners Name and Address. r ... d i�" U8 ri ©11 ........................... « ..........No- X71• lU 15 .......Street 1V�� i3T .................. RegisteredArchitect and /or I$ngineer..... «............ «........ _ .............................. .......«......... ............................... «.... «... .... «... ......... Employing Electrician's Name..... «�i!@W �..: 0 ........ �Pr... ...._ .............No ...:99 O .......................Street. .e_.n re ........... D� Location and Legal Description Lot ....... «..1 ?.1 ........ ......... ................. Block...... .... «...i1�0 ................ Subdivision ....... 0: ... 134.x.1.._.......... Street and Number where work is to be performed- No ... .3.c1.0 $ 2 .... ... «. Street .. »� 03 Vd:.St:-- .:...�. » «............. . State work to be performed a d purpose. of building (By Floors) ..• «' =8.. @ @� d„ @�........... « ............ New Building----*-.... - - - - - -- ...Remodeling......... ..Addition....... .......... .:.Repairs.......... .. «. .......No, of Stories. ............. - SWITCH LIGHT 'PLUG- FIXTURES REFRIG. IRON RANGE RANGE WATER W. HEAT SPACE STRIP .- TOTAL OUTLETS - OUTLETS* ..RICE'P•T'S No. LANPB OUTLET - OUTLET OUTLET CONN: HEATER CONN. � HiTER HEATER CONTR. 14 12 ' 25 1'Ri LIST fI CHECK I .i p�' �- , a5 Mi@ - ENT. DIST: SERVICE SERVICE - - MOTORS MOTORS T, NEON - RADIO TOTAL. LIST CLIST 8W, CAB. 1 +P_� PERM. 1 O.t HP - 1.8 HP TftANB. CHECK . Service Overhead Size F ers..... �..« °Conduit«.:1�`A..Main Sv... «... «.....« ....Amps ............ _ ..... _ .... Main Fuses .. &n..... Amps Underground - Type of Installation• - Conduit ... «-- M. ........... Tubing% x........ .. ..... B. X.L ................. _.. ... Metal Moulding ....... ._ ..... « -«- « ....... «. «.... »... ... «... .... «.-. . .................... I:....... « ............... J // ....« � ..«.... ............................... ..................................... «. .... .. ................ .... ..... «. ....... «.••...«...... .:- f...� ?P•.fN••••••...... ` .:A ' : ... . ...... ............................ .... «.« ... .•-.-..«.-.. ............... .....•...«.« w......... ............ « »...... «...... »... Amount of Permit $ -.. «.. 7for «........ (Signed) ......... « .............. ... «... ................ r. EleCtriCal Inspector. The undersigned applic4n is b uilding permit does hereby certify that he understands and accepts his obligations as an employer of -labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to. be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices 'as are requireA by the Act. ' The .undersigned agrees to employ only such subcontractors, o ', work to be performed under this permit, as are li6msed by Miami Shores V#hage. Its ectrician. STATE . OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer • oaths and take acknowledgments, personally 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 NO : A reinspel platen and /or workma «.._. «.....«........ «....... «.......... « mission Expires Notary Public. State of Florida «.. « «« ..... fee of $1.00 will be made when such re- inspection is made necessary by improper notice .for_ inspection, or faulty MIAMI SHORES VILLAGE BUILDING INSPECTION DEPAWMENT APPUCATION FOR BiTILDING PERMIT 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 Sham 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 Owner's Name and Address ® Na Street --- Registered Architect and /or Engineer Name and address of licensed contractor a LOA-za g d- PPA )R A 74a 3r S a/ Y'/ S T Location and legal description of lot to be built on: Lot ��� Block /Z Subdivision 076 44�' � // ®` /°r� ✓!f Street and Number where work is to be dorm 3 5-1 ZVF° 103 State work to be done and purpose of building (by floors), state exterior colors (submit samples) `-z j z - l® A-Zi l and for no other purpose. New Building Remodeling Addition Repairs Na of Stories lb be constructed of Kind of foundation 4 Roof Covering Estimated lbtal cost of improvements $ 72 mount of Permit -8. Zorn cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all 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 abe accepts his ohligaWne as an employer of Leber under the Florida Workmen's Compensation Act. being Section 6966. 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 undersign d to employ only such subcontractors. on work to be performed under this permit. as are licensed by Miami Shores Village. r 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 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. Permit Na a, �01 Date "r I Im Read. Sworn W and Subscribed before me. Disapproved ' a — Notary Public. State of Flwids (Signed) � Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved now Disapproved Date NOTE: A charge of $26.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A reinspection fee of 626.00 will be charged when such reinspection is made necessary by improper notice for inspection or faulty materials andror workmanship. I i rTo 4385 'age a f Mami Shores 1 r Al kP-� Jos ADDRESS 42 TIME READY REMARKS I' I INSPECT OR DATE 1 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 building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Vill age. Florida. and all provisions of the Lams 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 rot. A copy of approved plans and specifications must be kept at building during progress of the work. Date ✓ v 19 ,/ - Owner's Name and Address t �2 �ryice _O 0A 04 S/ N � • / 02'S % _ _ Na °357 Street Aft 10-747- ._ Registered Architect and/or Engineer `70S7b 1?Q R /. C Lie !F P E • a 06 Z Name and address of licensed contractor Location and legal description of : lot to be built on: Lot1'? 9 Bloch / ® Subdivision Street and Number where.work is to be done -�/ N° � • � f State work to he done and purpose of building (by floors). state exterior colors (submit samples) U 7t 02- L" /r-1 Aegkinp7p a°n �S — Devoe Colo&' —P07_—"_Z0 and for no other purpose. New Building Remodeling— Addition +� n Repairs No. of Stories 'db be constructed of �✓� sv.?�) Kind of foundation SlalYJAcP F -aar?h Roof Covering Estimated lbtal cost of improvements 6 IT 0 00 ' ' mount of permits Zone eubage required Plan Cubage Distance to neat nearest building A%iAAeei 7-0 ew�%size of Building Lot 123 ® X / D 0 Masirmrm live load to be borne'.by each floor I hereby submit all plans acid specifications for said building. All notices with reference to the building and its construction may be sent to Rob " <r 13fuc 5yL)'M Z The wxh=gned applicant for this building permit does hereby certify that be mWatands and accepts his obligetons as an employer of Labor under the Florida Workmen, 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 su4contractom on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks signed) STATE OF FLORIDA COUNTY OF DADE. as' Before me, the undersigned authority, a notary public. duly authorized to administer oaths and take acknowledgments. ply appeared to me well known. and wha being by we 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 "11 Ital 96 Read. Sworn to and Subscribed before me. Disapproved d Date — Notary Public. State of Florida XYMAW (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date k; NOTE: A charge of 925.00 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 625.00 will be charged when such re- Inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. 1 RNs w e r i tr t. ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PE MIT MUST ACCOHPANT THIS ADDENDUM. IF A MASTS PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NE- NOT BE PRESENT ON SUBSEQUENT, APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL 1 r'O • m T a 10 W17 .777 rr M7 rr 1I• i 11 rr 7• M rr / 1, rr t L' CRAIN MENIN771P _ _ rr 3 t 3 11 rr MEAM 7w INTEM70 LAVATarf LALWMY TRAY MOM We INS MINE SHM 1.1 POT/3 03P. INOIRM NAM MINE WATER WIPLY M: MINE mm A/C UNIT rr rr rr 'HEATEI-NEW INST. rr C3 T 1:'�. '. '1:•7..'7'• �' IMEMISOCM I S. . _. ..M -r C7 3' D'�. `'1' +,.3'ti rr rr LAWN SPRIND-WELL SWIMWING POOL 1 MI....'31 rr rr RATER MICE irr r : 1000011 rrr X7,1= rr c M 1 K rr rr .. ,• rr •i rr rr _- rrr 7 i ■rr rr rr IMEM1100001 • :Ili _ rr ... t! m mm ♦ , rr rr rr WINE rr mm { •M '.r ,!3 rr rr rr rr rr rr rr rr MINE •,tt i err rr rr rir 100100 rrr 1 rr rrr �rrr OWNENMENIM rir r�rr n 117 3, rr MINE rr c m= rr rr rr rr ®r mm rr rr Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: - Printed: 2/18 /2004 Page 1 of 1 Applicant: Owner: JOB ADDRESS: 351 NE 103 Contractor G & A CONTRACTORS Local Phone: Parcel # 1121360130260 ST Contractor's Address: 491 SW 7TH ST Legal Description: 36 52 41 31 52 42 MIAMI SHORES SEC 5 PB 10-47 LOT 18 & LOT 19 BLK 118 Fees: Description Amount FEE2004 -1683 Building Fee $100.00 FEE2004 -1684 CCF $3.00 FEE2004 -1685 Training and Education Fee $1.00 FEE2004 -1686 Technology Fee $2.50 FEE2004 -1687 Scanning Fee $6.00 FEE2004 -1688 Builders Bond $300.00 Total Fees: $412.50 Permit Status: APPROVED Permit Expiration: 8/9/2004 Construction Value: $4,500.00 Work: RESERFACE DRIVEWAY FROM ASPHALT TO DRIVEWAY Total Fees: $4_12.50 Total Receipts: sf o$o - (3 0( 3 (0 •5� PqM C-e (,° �P Signed: (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 lln' Q.%1D conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibiiity for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Type h Permit Name MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Address Y 1 &P— b9 Company 4A-A- Phone # Y& ,601 . _ Inspection Date Approved Correction ❑ Re- Insp'n Fee ❑ • � I��I��Ni�1��1l1�1�i1�l��ll NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO.!15 p o &AX FOLIO NO. // Z 134 - 616- 02 STATE OF FLORIDA COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following Information Is provided in this Notice of Commencement. 1. Legal description of property and streettaddress: _ M lAm> .5J4n,*`el r-f_ _?3/le- - %^o /i'o - .// - 2124 0/s - 49 2-& O 2. Description of improvement: Dr1' e IV R OR Bk 22071 Ps 3703; (1ps) RECORDED 02/26/2004 12:36:56 HARVEY RUVIN? CLERK OF COURT MIAMI -DADE COUHTYr FLORIDA LAST PAGE 3.Owner(s) name and address: u?J—) ✓V, E, /03 S 7. /Y1 Ili-M r S/O /Pd At, ji%J� Interest In property: Name and address of fee simple titleholder: 4. Contractor's name and address: 2-210 N.W .9l0 5. Surety: (Payment bond Name and address: Amount of bond $ 6. Lender's name and adi S by owner from contractor, if any) 7. Persons within the state of Florida provided by Section 713.13(1)(a)7.;` Name and address: 37.7 0j Z — (--% I q%5w17 6 - 411 a 6TATE OF FLORIDA, OUNTY F D D © cou hated by Owner upon whgr� � �'r oc�mQe y The served `��d� -o Statutes, 7N ®mal /fled r r o�` c n ,s�1TN�a$ �➢k .and si jicra! $e !, � ,„ ,.�;y 8. In addition to himself, Owners designates the following person(s) In Section 713.13(1)(b), Florida Statutes. / 1 /,/J-- Name and address: \ / V 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different dat s specifle ) Signature of Owner n Q Print Owner's Name-.9.,. f�tX- Sworn to and sub 'bed before me this � day of , 20� n �` errs I i oilob Notary Public Print Notary's Nam My commission expires: 123.01 -82 PAGE 4 8/02 .) "Nsu.Oca v aid E p res: Jul 13, 2007 Bonded 't m ,°,°„ `• Atlantic Bonding Co., Inc. Prepared by 01(vlkwl MIAMI SHORES VILLAGE BUILDING DEPARTMENT -- 305- 795 -2204 C J" Building Inspection Request DateA I I G Type Insp'n p ( &uJU' -P ' Permit No. � — �k� Name Address Company �— Phone # ' r Inspection Date (4 I � Approved Correction ❑ Re- Insp'n Fee ❑ `'Y)Mrihe S . SOUTh ,#t--Z The undersigned ,�ob4�c 8. S' o U� /�iD , does hereby attest that the (property owner) attached survey, performed byx (name of surveyor's company) performed o 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 (b) 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) Witness(sign and print) MY SWORN TO AND SUBSCRIBED before me this // ry of ` Affiant is personally known to me, �produCed as identification. e DIGNA LASSERRE My Comm Exp. 3/23/04 No. CC 921540 W ty Known [ 1 O#w I.D. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Type Insp'n 0 ( M-(Arau TV rrA Permit No. w -° Name , Address Company° Phone # Inspection Date CA Approved Correction ❑ Re- Insp'n Fee _ Q r . @.., � .. „.M Thliami S40reJ Lam[ °y` 10050 N.E. SECOND AVE. OR MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 -2207 Fax: (305)_56-8972 4 (owner) following described property: hereinafter referred to as the Owner of the Legal description/folio#: Lot Mock Subdivision Tax Folio #• requests permission to install: Asphalt, concrete, brick pavers [J Landscaping [ J Other p APP40Actf within the public road right of way of �•�/ N. E, 103 STf � Al/-m, .S��; � (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 t}ie 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, SEALE15, EXECUTED AND ACKNOWLEDGE on this /�” day of 6A�Z�.2�7' SIGNED, SEALED AND DELIVERED in the T. U1bNA 14AYStKKt I J My Comm Exp. 3/23/ � I o CC 821540 I Fersanally Knwm 1100W I. D. 1.� FAG �: � _ , . r. ` • � � } {� �l � � rw°� � it y f � x (� i -,leaf- le Em ci A �C f " . -f°7- r II 0 16 17 1,6 147 M 1. 1. G F. N Il F. P.P:LEV- f'itAI::ll FIJX)R F.1.VVATIONS C.H.S. °CONCRETR. BLOCK, STUCCO P.R.M. °PERMANENT RF.FFRFNCE MONUMENT D.M.F..QORAINAGE MAINTENANCE BASEMENT UT 11.. EASM I T, UT I I. ITY EASEMENT C.L.P. °CHAIN LINK PENCE BNC11. -BNCRUACIIMtxIT C6.-CLEAR FU—POUNU CONC. aCONCRDTE I.P.•7RON PIPE R/W °RIGHT -OP -MAY RF, :%GFSIOENCE STY. ^STORY MFRS °MEASURED .C. RWOR" T °ON LINE IL °CENTERLINE LEGAL DESCRIPTION: Lots 18 and 19, Block 118, MIAMI SHORES, According to the Plat thereof as recorded in Plat Book 10 at Page.47 of the Public Records of Dade County, Florida. SURVEYOR'S CERTIFICATE: I HEREBY CERTIFY that the sketch as shown represents a recent BOUNDARY SURVEY made under my direction in compliance with the minimum technical standards for Land Surveying in the State of Florida, pursuant to chapter 21 -HH -6 Florida Administrative Code and is true and correct to the best of my knowledge and beliefs FORD, ARMENTEROS & MANUCY, INC. Date: MAY 22, 1990. Rev.: Omar Armenteros, Pres. Rev.. Reg. Land Surveyor #3679 Rev.: State of Florida. Prepared By: t .FORD, ARMENTEROS a MANUCY, INC. 8000 N.W. 31 Street, Suite 7 Miami, Florida 33122 Phone: 477 -6659 Scale : 1 " =20' Field Book: A- 112,32 Order No. : 70232 Prepared For: BRUCE SOUTHARD �Z .MEMO TO: FROM: t? DATE...AM Z-1, cz 'iveGv6" "; MIAMI SHORES VII MIAMI SNORES VILLAGE BUILDING INSPECTION DEPARTMENT r Application is hereby uinde for the ipprol•al of the detailed statement of the plans and specifications herewith submitted for the build in¢ or other structure. herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shorts Village, Florid,i, and nll provisions of the Laws of the State of Florida, all ordinances of Miami Shores Villajge 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 ... _. ... _-f .. _ ...__._.e..._..... ,19� Awner's Name and Address ... «tee.. e� - lilo.. �?.-�.... Street-.9 .... ...._. Registered Architect and /or Et1 inter. ................ .+.r 9:.. ...... ..... �....... t, .. ...... ................. - ... I......... Name and address of licensed contactor ................... .K r L , _. .......... . .... ............................. _..___.. Location and legal description of lot to be built on: Lot............. ............................... Block .................................. Subdivision ......... . t _ ........... ................ _._ ..__-_--._..-« .... _._ .... _ ..... _- ................. _ ...... __ Street and Number where work is to be done .... 4� .....�_w �.- ....10.x'._. _ .... Stato Wprk to be done and purpose of buddin (by floors) ---- __ ------ - --- ------ - ----_ ............................... . . .................. ................ _. .. ..... ..' ...' ................................_...._...-._._..-...............__............--- .......................... - -- -- ....and for no other purpose. New Bui', ding ............................. Remodeling ................ ........ Addition .. ..... _................. Repairs .......................... No. of Stories ...... ................ _ To be constructed of .......................... Kind of foundation ................ .......................... .................. _. Roof Covering ....................... ........... ... _ -._--_ EsWnated Total cost of improvements ........................ /mount of Permit .....7..'.` .......................... __ ................... .......... Zonecubage required .............................................. ..................•....._... - -• -.Plan Cubage ................................................................ Distance to next nearest building ..................................................... .. ..... size of Building Lot ............................. _ .......... _.!.... ................... _ ........ _ Maximum live load to be borne by each floor ................................ ------......_.......................................-----.... ..........-- -- ..............J......... ...................... .... ® I hereby submit all the plans and specifications for said building. All notices with reference to the building an W its construction may beRent to.. ........................ ....................... ........ _ -------------------------------------- ------------ .------------------------------------------ r - The- tmde.sifimd applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workinen*s Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sappit tent, and has complied Ncith 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 infpection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such su tracto , _ n work to be performed Lander this pennit, as are licensed by Miami Shores Village. Rezarks-----------------------------_._..------ __---------- ---•---- ----- - -•--- _ _ y. _ ( Sign - STATE OF FLORIDA, I COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oat9s and take ackno*Jedj#!qts,, yFtrsorially 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 lie 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.._!�!l1. 7. ................... Date...�s�..'. /2�__ .L!�_......._. Read Sw to and Subsc ' foes me. Disapproved •. � ............. Date.._....... .._.........__.._.............. _._._ ....... ....... _ __ _. . Notary Pub ic, Sta of Florida (Signed) ...... .......... B.. I.... spec ......................... Hots Public, uilding nspec tor My Commission Expires... .{ �! 4�pires $ }Q Septem4 r 10, 1971 PLANNING BOARD .............. ........ ..................... _. ._ ...... DATE _ _._... Bonded by Minct ey .A+ $e.� nq Chairna n......... .................... _ ......... « .................... .......... -................. Member ...... . . 1 � oScu.bcr ........_........ ...............-•-----•---•--•-•-••.... ......_--- •--- •-- .......... - - -- Member ............................... ...................... ............... - ...... ............. Member........ ...... •-- -- ••......------ - -• --- ............. Member .... . ................ �..- - -- ......... _ ' - Council Approved ................................................. -- -- ............... Date Disapproved ..•• ........................ _......................,I _.... ....._......... .._ ... - ..-._.... . D• ate NOTE A charge of $1.00 will be made for making corrections or changes to this application after approval his been obtained from the I'l.111111r,g Board. A re- in,pection fee of 11.00 will be charged when such re- inspection is made necessary by Improper notice for inspectirnl or faulty materials and /or workmanship. F MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUIL®ING'PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith ing or other structure herein described. This application is made in compliance and conformity with the Buildi Shores Village, Florida, and all provisions of the Laws of the State of Florida all ordinances of Miami Shores N regulations of the Building Division of Miami Shores Village shall be complied' with, whether herein, specified or: plans and specifications must be kept at building during progress of the work. L f ® ------- - - - - -- Date_° .�'.__'� °: _�_ Owner's- Name and Addres s! v y r ------ , -- - e6 ,y44- No.1 e -_7__1 ____ Street Registered Architect and /or Engineer- ____, f/ ✓ /r� --- - - - - -- _ - - -_- _ Name and address of licensed contractor sV d'--�_ -- Locai p and legal descri tion of lot to be built onj- Lot 17—/ � 10- z; Block —_zz _ Q ". Subdivisfon �� ® kf;er o e e S' � Street and Number where work is to be done_ S r�` ® ®• �`� • t� _ _�^ State work to be done and purpose of building (by floors) Z Lf on ie z �a------ -- —� submitted for the build- LOrdinance of Miami ge and all rules and ot. A copy of approved I�� ___and for no other purpose. New Remodeling Addition —___ —_ Repairs.-- __.__. -____. No. of �Stoorries_.__ A_ G_ To be constructed of C !3. S Kind of foundatiaa_ � ^ - -� -_� Rogf f.Covering_ - -- Estimated Total cost of improvements $ � 0 Amount of rmit $ _� __- -- —� -- Zone cubage required plan Cubage Distance to neat nearest building_ Size of Building Lot—_ ®'. Maximum live load to be borne by each floor— _ I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent The undersigned applicant for this building permit does hereby certify that he understands and accepts his obl�igations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida,IPermanent Supplement, and has complied with -the provisions thereof, and will require similar compliance from all contractors or sub -con actors employed by him in the work to be performed under this permit; and will post or cause to he posted for wisp_ 'on on the site o e work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcon Orson wor t permed under this permit, as are licensed by Miami Shores Village. Remarks (Sign STATE OF FLORIDA, COUNTY OF DADE.. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowl gments, personally ap- peared - — -__.to me well known, And who, being b me duly sworn, upon oath deposes and says that he is _--------- _ -_ -_ -- __ ---- ___ -__ ______ _---------- -_ of the above d bed coon, that he has efully read the foregoing application; and that he did sign the same, and that all facts therein by him sta ed' a e. Permit No. A e _ Read, Sworn to and Subscribed before m Disapprove. Arl to ___ _ - -- - -N Public State of - (Signed) Florida . — g e r My Commission Expires-- __..______— ---- -- - - - - -- II PLANNIN rBOAXW _ 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 -in ction fee of $1.00 will be charged when such re- inspection is made necessary materials and /or wgrkmanslvp, by improper notice for inspection or faulty Lti Jftr I �► pow p �a U i;IlFrrd,�m® t -1 d N. E. 1 c t �T Z U� � i 0 I I� ld ►� t� N ►2 i� i t �o 0 7 5 d 2 ► N l L Z U� � i G 1_� V= 36 Ld d -t- z SKETCH OF SURVEY Lots 18 and 19, Block 118, MIAMI SHORES SECTION N0.5- AMENDED, according to the Plat thereof, recorded in Flat BRok 10, at page 47, of the Public ecords of Dade County, Florida. Order #9090 April 8, 1953 F.B. #182 -38 Scales shown I HEREBY CERTIFY: That the attached SKETCH OF SURVEY of the above described. property is true and correct to' the best of my knowledge and belief, as recently surveyed and platted under my direction. HARRY C. SCHWF. do SSOCiATE INC By- Har ^.. we e- Presi e- Reg s tered 'Land Surveyor x#602 State of F1 or0a I I� ld ►� t� i N. :1$ '► #D'"�,; 20 G 1_� V= 36 Ld d -t- z SKETCH OF SURVEY Lots 18 and 19, Block 118, MIAMI SHORES SECTION N0.5- AMENDED, according to the Plat thereof, recorded in Flat BRok 10, at page 47, of the Public ecords of Dade County, Florida. Order #9090 April 8, 1953 F.B. #182 -38 Scales shown I HEREBY CERTIFY: That the attached SKETCH OF SURVEY of the above described. property is true and correct to' the best of my knowledge and belief, as recently surveyed and platted under my direction. HARRY C. SCHWF. do SSOCiATE INC By- Har ^.. we e- Presi e- Reg s tered 'Land Surveyor x#602 State of F1 or0a FEB 1 1 2004 PERMIT APPLICATION Master Permit No. f)(2,94N — i '62) Subsidiary Permit No. following INSTRUCTIONS - The 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, aroofing 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: 3 S 1 iOi & 1 0$ G�raci • CeSS -� � lnj 33 1 3�' Address Apt. City State Zip Folio Number ` Lot I '� j j!2j Block 1 Subdivision PB PG Current Use of Property Proposed Use of Property 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 Chit. Contractor Renewal Revision Extension PROPERTY OWNER Name 1 l `_ L Address i JOB -j ? � , . 1 U �Y'�e T �� m� shore fir 1 Home Telephone Business Telephone Fax Zoning Linear Feet Square Feet �J Units Floors Value of Work -1 t "0 Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. TYPE OF MANAGEMENT (V) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add'1 Detachment OtherDWZZXa ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name !a adtt n t1Z".njn License No. GO21 % ZC,1 y i„` 0 Address 4a ` 54j'.� H &, . AUA u WIL I G'4 $ Telephone Fax yc1 1 _ A�1� Qualifier Name N & A% 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. 1AVIT - Pic 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, I't 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. ATE OF FLORIDA, COUNTY OF MIA DADE , � 77J Signature of weer l ST, n Print Name Sworn to and subscribed before %me this day of SEAL: Personally known - State of Florida DIGNA LASSERRE My Comm Up. 3/23/04 /Mo. CC 921540 STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor/ Quali N 4 uL Print Name Sw n and subscribed before me this t'( �, �day of V (;6 « � Signature oV,4o SEAL: Personally known t" ,UIGNA LASSERRE MY Comm Exp. 3/23/04 ,�/ No. CC 921540 r� r ally Knom [ 1 Other I.D. Type of Identification Produced: Type of Identification Produced: OR, Produced Identification Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance Q-1-Y. TYPI,-, )TY. Service Repair A/C Central 1 -3 Ton A/C Wallin. Tons Fan Paint Booth Outlet, Wall Air Handler, Tons Service, Temporary Piping, Flammable Liquid A/C Central 4 -7 Ton Barbecue Fire Pump Process/Pressure Piping Outlet, Switch Bath Fan - Vented, # Signs Pressure Vessel A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Heat Recovery Receptacles Refrigerator, Comm. (p/PH) Switchboards Temp Serv, Construction Clear Violatic,tis Compactor Ice Maker Low -volt, Burglar Pump, Sump— Refrigerator, Domestic Utility - Water Temp for Test - 30 days Dishwasher Deep Freezer Indirect Wastes Low -volt, Fire Relay Repair Renew - Temp Service Vacuum Pump Disposal Demolition Interceptor Low -volt, Intercom/Teleph. Roof Inlet Repair Circuits Water Closet Domestic Well Dishwasher Laundry Iray Low -volt, Television Septic Connection Service, Number of Amps Water Heater Drainfield, 4" Tile/Res. MECHANICAL Minimum Fee Condensate Drain Generator Refrigeration, Tons A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wallin. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Pool Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Cap - Fixture PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture Q'I Y. 11,11F] Q-1-Y. 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, Recirculate 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 Iray 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 DATE: Page 4 BY DATE Zoning PERMIT APPLICATION OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM ❑ PROOF OF OWNERSHIP ❑ CONDO ASSOCIATION APPROVAL (Attach) (Attach) (Attach) ❑ FIRE DEPARTMENT ❑ HRS / DERM APPROVAL ❑ BPR APPROVAL (Restaurants) APPROVAL (Commercial / (Septic / Sewer) multi- family) ❑ CONCURRENCY ❑ IMPACT FEE ❑ CONTRACTOR REGISTRATION (New Construction) (New Construction) (On File) ❑ OTHER ❑ OTHER (Specify & Attach) FEES (Specify & Attach) PERMIT $3.00 per page (Scanning Fee) $ Miami Shores Village $ Bond $ Metropolitan Dade County (C.C.F.) $ (sq.ft. = x/1000 x ¢.60) Inspector State Educational Fund $ (¢.005 /sq.ft.) State DCA (Radon) $ (¢,01 /sq.ft.) Code Enforcement Fine $ Zoning Review $ TOTAL $ OFFICIAL ISSUING REVIEWED AND PREPARED BY DATE: SECTION BY DATE Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official Ah Revised July 2001 10050 N.E. 2- AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Reileh Engineering Corporation appreciates the opportunity of assisting you in this project. If you have any questions or if we may be of further assistance, please do not hesitate to contact the undersigned. Respectfully submitted; Reileh Engineering Corporation Mbhamad Sonny Salleh, P.E.49014 Project Manager TILE UPLIFT TEST Residential Home 351 Northeast 103 Street Miami, Florida Reileh Engineering Corporation — Project Number - 07 -0783 — Page 2 of 7 Report of TILE UPLIFT TEST for Residential Home 351 Northeast 103 Street Miami, Florida Pro'ect Number: 07 -0783 Test Num or, Lead b. ; Test St tl�s 1 35 Pass 2 35 Pass 3 35 Pass 4 35 Pass 5 35 Pass 6 35 Pass 7 35 Pass 8 35 Pass 9 35 Pass 10 35 Pass 11 35 Pass 12 35 Pass 13 35 Pass 14 35 Pass 15 35 Pass 16 35 Pass 17 35 Pass 18 35 Pass 19 35 Pass 20 35 Pass 21 35 Pass 22 35 Pass 23 35 Pass 24 35 Pass Reileh Engineering Corporation — Project Number - 07 -0783 — Page 3 of 7 Test Number Test.oad b ;,Test Statute 25 35 Pass 26 35 Pass 27 35 Pass 28 35 Pass 29 35 Pass 30 35 Pass 31 35 Pass 32 35 Pass 33 35 Pass 34 35 Pass 35 35 Pass 36 35 Pass 37 35 Pass 38 35 Pass 39 35 Pass 40 35 Pass 41 35 Pass 42 35 Pass 43 35 Pass 44 35 Pass 45 35 Pass 46 35 Pass 47 35 Pass 48 35 Pass 49 35 Pass 50 35 Pass 51 35 Pass 52 35 Pass 53 35 Pass 54 35 Pass Reileh Engineering Corporation — Project Number - 07 -0783 — Page 4 of 7 .... _.. ............................ .......... T :Numb.r'.: fiest 1(.oac�.. b Test S�Gatu 55 35 Pass 56 35 Pass 57 35 Pass 58 35 Pass 59 35 Pass 60 35 Pass 61 35 Pass 62 35 Pass 63 35 Pass 64 35 Pass 65 35 Pass 66 35 Pass 67 35 Pass 68 35 Pass 69 35 Pass 70 35 Pass 71 35 Pass 72 35 Pass 73 35 Pass 74 35 Pass 75 35 Pass 76 35 Pass 77 35 Pass 78 35 Pass 79 35 Pass 80 35 Pass 81 35 Pass 82 35 Pass 83 35 Pass 84 35 Pass Reileh Engineering Corporation — Project Number - 07 -0783 — Page 5 of 7 Test Number 85 Test Load b 35 1`est Staf Pass 86 35 Pass 87 35 Pass 88 35 Pass 89 35 Pass 90 35 Pass 91 35 Pass 92 35 Pass 93 35 Pass 94 35 Pass 95 35 Pass 96 35 Pass 97 35 Pass 98 35 Pass 99 35 Pass 100 35 Pass 101 35 Pass 102 35 Pass 103 35 Pass 104 35 Pass 105 35 Pass 106 35 Pass 107 35 Pass 108 35 Pass 109 35 Pass 110 35 Pass 111 35 Pass 112 35 Pass 113 35 Pass 114 35 Pass Reileh Engineering Corporation — Project Number - 07 -0783 — Page 6 of 7 Z'est'1v1lYlf.S'P Test Load .Sta 115 35 Pass 116 35 Pass 117 35 Pass 118 35 Pass 119 35 Pass Reileh Engineering Corporation — Project Number - 07 -0783 — Page 7 of 7 Nom" V"14 100 88 106 92 86 103 107 89 91 108 104 90 85 75 ZO 109 105 62 61 113 � � 55 II 68 66 76 115 110 n sII6 112 67 Z0 23 53 II 27 28 29 64 60 117 30 II9 21 26 31 52 19 Z5 III 17 II 22 59 4 m % 16 10 7 12 13 14 5 6 36 51 58 I 2 3 35 44 50 57 37 � 40 46 45 47 48 41 42 45 78' 01 -0783 APPROX. ROOT S5f OCKION5 ANn DIWN51ON5 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 r Inspection Date: 01131/2007 Inspector: Inspector, Default Owner: SOUTHARD, ROBERT - Job Address: 351 103 Street NE Miami Shores Village, FL Project: <NONE> =. Permit Type: Roof Inspection Type: Tile In Progress Work Classification: Roof - New Phone Number (305)756 -5067 Parcel Number 1121360130260 Lot: Contractor: JOHN BUSTA ROOFING INC Phone: (305)757 -7620 Buildina Denartment Cnmm &ntc RE ROOFING TILE OFF FLAT 9" CONCRETE WHITE COLOR -THRU ROOF TILE BACK ON Inspector Comments Passed F�l Failed E]_ Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid Friday, February 23, 2007 Page 1 of 1 RES oR0: Inspection Date: 02/16/2007 Inspector: Grande, Claudio Owner: SOUTHARD, ROBERT Job Address: 351 103 Street NE Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Miami Shores Village, FL Project: <NONE> Block: Permit Type: Roof Inspection Type: Hot Mop Work Classification: Roof - New Phone Number (305)756 -5067 Parcel Number 1121360130260 Lot: Contractor: JOHN BUSTA ROOFING INC Phone: (305)757 -7620 Building Denartment Comments RE ROOFING TILE OFF FLAT 9" CONCRETE WHITE COLOR -THRU ROOF TILE BACK ON FEB 1 6 2001 q Inspector Comments Passed [��r Failed EJ_ Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Thursday, February 15, 2007 Page 1 of 1 5 Inspection Worksheet 4 ' Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL �ioR "vP Phone: (305)795 -2204 Fax: (305)756 -8972 nspectiun Number: IIISP -38793 Permit Number RF -1 -07 -192 Inspection Date: 02/1612007 Inspector. Grande, Claudio Owner: SOUTHARD, ROBERT Job Address: 351 103 Street NE Miami Shores Village, FL Project: <NONE> Block: Contractor: JOHN BUSTA ROOFING INC Buildina Denartment Cnmmpnts Permit Type: Roof Inspection Type: Tin Cap Work Classification: Roof - New Phone Number (305)756 -5067 Parcel Number 1121360130260 Lot: Phone: (305)757 -7620 RE ROOFING TILE OFF FLAT 9" CONCRETE WHITE Infractio Passed Comments TIN CAP SPACEING True COLOR -THRU ROOF TILE BACK ON FEB 16 2001 j Inspector Comments Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Thursday, February 15, 2007 Page 1 of 1 ® ,M%i► • Mr. *,Or ` %# m%oc clm I AMMED !o'Y must BE pom oN um .m SITE AT'im or- FmsT IAwECTtQaI pL :RMIt No. TAX FOLIO NOZt''• 1 � . a to STATE OF FLORIDk COUNTY OF A AMI -DARE: THE UNDERSIGNED hereby g►ves notice ttled knprovenients wilt be made to ce"n Feat propmty, and it exxwdmwe with CtkVW 713, Florida Statutes, the foli wkV info ud'm Is provkled in this NWCe of Commencement. rifflip I,, Slow 1111 Werest In pf ope "j • e CF M 200 7`RO 11.11.1855 OR pp 25327 Ps 4342► (IP9) RECORDED 01031/200 ;.5' =5-5 =57 HARWVEy ROVIHr CLERK, OF CWRT i1IANI-{DAQE COURM FLORIDA LAST PARE -01 O t ► C • 7 parsons within the stale of Florida de sWmted by Owner upon wham provided by Sin 713.1 lXS)l ., Ftorlds Statutes, Nm w and rlddn3�S: • • • •• • • 8. In adMon to himself, Owners designates the foiiowmg persons) to receaive a copy of4ite ( or'§' teas providbd . In Section 713.13(1)(b), w„ 1 • xl£,3 .. a. r', ,art . , -+^Q' ij 116 ULF 11 M, ail • Mil ►fit c, • 'SmEmm- - \' j §IL. .. Mug MIEN � �■■� ■a■�� � � �,�� m_._.�,_ __ __...� a� &�� ��� &u � �■mmm■ 7�[In§ �R .., AIX! §w w « no NOR OR %q;| o■mI @w ; ■ ■ ;Q ■ ■■ ■ uZ 6 Q @■. R$w ■ ■$ $� $�� � $i �■� � r ;� |@� �� � E ± & . $■ ®11,11 F Zoe ,.u,A +.wFv.= Flodda Building Code Edition 2002 RCW-Sy$Wm Manufactureclq—oxzz,�-�-�,,� Notice.of Acceptance Numbsr: Minimum Design Wind Pressures, If Applicable (prom RAS 127 or Calculations ); P1: P2.L%� P2. ®�� Mwdmurn Design _ r K r _. r11 -!`A Y_ ?3_01 48 WW PAGE 4 Florida Building Cain Edition 2002 ebcjtV Hurdeam zom Untrorm PomtAppocatfork _ Form • For Moment based We s ystems, choose dthw Method 1 or 2. Compared the values for M!rwhb the values fi am M f. R dle Mr values are greater than or equal to the Mr for each area of the rood then the toe attachment mod 6 acceptable. Method 1 "Moment Band File Calculations Per RAS 117" {P2: j 0 x A S — Mg; ffi NOA Method 2 "Simplified Tile Calculation. Per Table Below" e70, // Required Moment of Resistance (W From Table Below NOA B* *Must be used in eeginnction with a Het of moment based tRe system endorsed by the Broward County Board of Rules and Appeals. 0000 For Upiift.hased tie use M 3. Compared the values for F :wit ft • • • • • • • • values %r F, if the ir values are greatter than or equal to the X values,.,... : • • •: • -of the rroef, the tRe t Is a • 0 0 0 0: . 0000.. . 0000. ,�y�. a�,� ',,�'wy$,�,,,��, y� � � �• Method 3 "IIP"« Based Tile Caheulsdons Per RAS 12! - 0 0 0 0' ' 00 00 0*:**. Frl: . MQ.F - ..:.. (pa : a L• x w: —__j—W-. aces d: = Fes: . rTOALV-- .... ..... • • .... ..1.. 123.O148 SM PAGES 0000. IV%v I Mor. Vr %rWff7%MC1M%9CMC1M I A RECORDED COPY ROUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO TAX FOLIO NO.`/ ® A % ?/a —0/,:;! ° ® R STATE OF FLORIDA: COUNTY OF MIAMI -DADS: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real properly, and in accordance with Chapter 713, Florida Statutes, the following Information Is provided In this Notice of Commencement. 1. Legal description of property and streeVaddress: OR B!: 25327 Pq 43421 tlos i RECORDED 01/3112007 15.55 :57 HARVEY RUVI N v CLERK OF COURT MIAMI -OADE COUNTYP FLORIDA LAST PAGE eo. 3.Owne4s) name and address: - 011tY 1.0 . M MOO 4: Contractor's name and address. S. Surety. (Payment bond required by owner from contractor, if �v Name and address:; A14. 00hal AI®d Amount of bond $ wi MN B W, MARVEY R 6. Lender's name and address: 7. Perms within the state of Florida designated by Owner upon whom provided by Section 713.1 1xa)7., Florida Statutes, Name and address: :. . 1FV thpi Q 1 u���ppyaof #�e of on I day of of Cftd aw CW* cis or other•�oeumentsm�y be serijecla .. .... • . 8. in addition to himself. Owners designates the following person(s) to receive a co of $Td Usnor's Notice as vi�l�i 000* In Section 71. &13(1)(b), 'da Statutes. py • • Al • 041419 ' %s • • • . . •••••. Name and address. • • • • • • • 9. Expiration date of this Notice of Commencement; (the expiration date is 1 year from the date of recording unless a Print Owner's Nar�)&191551zr Prepared by Sworn to and subscribed before me this day of Notary Pubilc Print Notary's My commissia 12321 -52 PAGEa 10M4. SECTION 1524 HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1324.1 As It pertains to thft section, it Is the responsibility of the roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of this section.. The provisions of Chapter 15 of the Rorlda 8uticiing Code, Building govern the minimum requirements and standards of the Industry for roofing system Installationns. Additionally, the following items should be addressed as part of the agreement fin the owner and the contractor. The owner's do U In the a4acent box dndicetes that the be+n has been explained. 1. Aesthetics - Workmanship: The woriananship provisions of Chapter 15 (High Velocity Hurricane Zone) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion performance standards. Aesthetics (appearance) issues are not a consideration with respect to wori<manship prove. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be add dressed as part of the agreement between the owner and the contractor. 2. Renstiing Wood Decks: When replacing roofing, the existing wood roof deck may have to be renaffed In accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck Is usually concealed prior to removing the existing roof system). ,3. Common Roofs: Common roofs are those which have no visible delineation between neighboring units (L townhouses, condomhdurns, etc.). In burgs with common roofs, the roofing contractor an dfor owner should notify the occupants of adjacent units of roofing work to be performed. &&f_4. Exposed Cellirngs: Exposed, open beam ceilings are where the underside of the roof decidrg can be viewed from below The owner may wish to maintain the architectural appearance, therefore, roofing mall penetrations of the underside side of the deddrg may riot be accept. The Florida Building Code proves the option of maintaining this appearance. AW-5. Panting Wad: The current roof system and/or deck of the building may not dram well and may came water to pond (accumulate) in lowwlying areas of the roof. Ponding can be an indication of structural distress and may require the review of a professional structural engineer. Ponding may shorten the life expectancy and performencce of the new roofing system Ponding comiitions may not be evident until i1W&Vnal rooting system Is remove!. Ponding conditions should be corrected. • • • • •"• • • Aj 6. Overnow scuppers (wall outlets): It Is required that rainwater flow off 96 VW Ithe row is not • • • • : • overloaded from a build up of water. Perimeterledge walls or other roof extensions may UM Vft dlechdtge if :....: overflow scuppers (wall outlets) are not provided. it may be necessary to install overflow srAAMrs in ac*rdadce • with the Florida Building Code, Plumbing • • • • • • • • • • • • • ...... . . ..... 7. Ventitat%n: Most roof structures should have some ability to vent natural atrial UtrOtgh thelnnterior of • • • • ; • the structural assembly (the building itself). The existing amount of attic ventilation shall noCaS Muoed. it nPay be '. beneficial to consider additional venting which can result In extending the serves Ble of the toof. 0000 • • • • • • • .... _ .. Owner�iltert!f- SIgnaWW, Date Contractor's Signature Property Address Permit Number MIAM M& BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVEMON NOTICE OF ACCEPTANCE (NOA} Monler "fettle, LLC 135 NW 20* Street Boca Raton, FL 33431 MIAMI .DAVE COUNTY, FLORIDA MEMO -DADS FLAOLER BUHM0 14o WEST FLAGLER STREET, suff z 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375-2 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by Miami Dade County Product Control Division and accepted by the Board of Rules and Appeals (BORA) to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The Miami Dade County Product Control Division (tn Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes ff this product or material faiils to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AW may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by MiamiDade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described he rein, and has been designed to comply with the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: A&Mflis Shake & Slate Concrete Roof life LABELING: Each unit shall bear a permanent label with the manufacturer's name on logo, city, state 4A 0 .....* following statement "Miami Dade County Product Control Approved", unless otherwise nets$ herein.. .' RENEWAL of this NOA shall be considered after a renewal application has been filed acid erg has no 000000 change in the applicable building code negatively affecting the performance of this produati • 6 0 • 6 : • . • .: TERMINATION of this NOA will occur attar the expiration date or if there has been a revieio d or cbW id the ..... materials, use, and/or manufacture of the product or process. Misuse of this NOA as an en nent of..M. ny.: . • • • • • product, for sales, advertising or any other purposes shell automatically terminate this NOft. POeilure to tromply 0 6 0 9 0 with any section of this NOA shall be cause for termination and removal of NOA. :'':' : .... ....:. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, tloridp, and ibippped by . . the won date may he displayed in advertising literature. If any portion of the NOA i Aftlayed, Um it shall : • • • • be dome in its entirety. • INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA consists of pages 1 through 6. The submitted documentation was reviewed by Frank Zuloaga, RRC NOA Noy: 02- 1211.08 0.% ' Exphuthm Dat6:12n6W Approval Dikte: 0IM103 page 1 of 6 ROOFING ASSEMBLY APPROVAL CAWT. Roofing Sab.Category: Flat ProSk Roofing Tiles Mattel: CAncrete 1. SCOPE This renews a *,at= using Monier Lifetile Atlantis Shake & Slate Concrete Roof TI-14, as manufactured. Monier Lifetrle LLC and descr:i ed in Section 2 of this Notice of Acceptance. For locations where the pressure requirements, as detennined by applicable Building Code does not exceed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall be done as a moment based L PRODUCT DESCRIP'T'ION HONCHWEd by Test Pro&et RECAbdu Monier Lifet ile 1 =15" PA 112 Flat, interlocking, high pressure extruded Atlantis Shake and w =10 3 /8" concrete shake and slate roof We equipped Slate Tile 1 V 4" thick with two nail holes. For direct deck, mortar or adhesive set applications. Trim Pieces I = varies PA 112 AMY trim, concrete roof pieces for use w = varies at hips, rakes, ridges and valley terminations. varying thnikuess Manufactured for each file profile. 0000 2.1 SUBMITTED EVIDENCE: •' • ' • • • •' 0000•• Teat Aneac9 Test IdeatiiSear T Name ►JRem xt ... _ .. . Redland Technologies 7161 -03 Static Uplift Testing • • • • • • Dec. .199.1 Appendix III PA 102 & PA 102(A) "" " The Center for Applied 94-M stone Uplift Trg • •: lllarclL,. Engineering, inc. 94 -084 PA 101 (Mortar Set) •. •. 1994 0000.• • � / �\ /J • • • (Adhesive • • 0000 The Center for Applied. 25- 7094 -2 Static Uplift Testing 0 • . • Oct.'1y We • Engineering, Inc. PA 102 .. ... (4" Headlap, Nark, Direct Deck ' • 0 New Construction) The Center for Applied 25 -70448 Static Uplift Testing Oct, 1994 Inc, PA 102 (4" Headlap, Nails, Battens) The Center for Applied 25 -70945 Static Uplift Testing Oct, 1994 Ire. PA 102 (4" Haft. NWT% Direct Deck, RecoverAhrooi) NOA No.: 02- 1111.08 Fatplm ioa Date :1?. /1"7 Approval Date: 01/09/03 Page 2 of 6 •••••• • • 0000•• •••••. 0000. 0000. 0000•• • • • 0.00.0 • 0000.. Tc A mes Tee T A Ka_m—qXwd no The Center for Applied 25- 7183 -6 Static Uplift Testing Feb. 1995 g PA 102 (2 Quilt-Drive Screws, Direct Deck) The Center for Applied 25- 7183 -5 Static Uplift Testing Feb.199S �g Inc, PA 102 (2 Quik Drive Screws, Battens) The Center for Applied 25-7214-1 Static Uplift Testing March, 1995 F�g PA 102 (1 Qum Drive Screw, Direct Deck) The Center for Applied 25 -7214-5 Static Uplift Testing March, 1995 Engineerim Inc, PA 102 (1 Qwk Drive Screw, Dattens) Redland Technologies 7161 -03 Wind Tunnel Testing Dec. 1991 Appendix 11 PA 108 (Nail -On) Rntlland Technologies better Dated Aug. 1, 1994 Wind Tunnel Testing Aug. 1994 PA 108 (Nail-On) Redland Technologies P0631.01 Wind Tunnel Testing July 1994 PA 108 (Mortar Set) Redland Technologies P0402 Withdrawal Resistance Testing Sept. 1993 of screw vs. smooth shank units 71w Center for Applied. Project No. 307025 Wind Driven Rain Oct. 1994 Engineering, Inc. Test #MDC -77 PA 100 Professional Service 224 -47099 Physical Properties Sept 1994 hWWtdcs, Inc. PA 112 Celotex Cogmtion T06 ft 520109 -1 Static Uplift Testing Dec. JVW . Service 520111.4 PA 101 • • • ` March IM 520191 -1 6060•8 Walker Engineering, lac. Calculations Aerodynamic Multiplies . . : . March 1999 Walker End Inc. Calculations Moment of Gravity '::::'Sept.-1 ^ •••.•• . . • • 0000•• Walker Firing, Inc. Calculations 25 -7094 • • •'Febtuafy 1996 •.•••• . Walker Engineerin& Inc. Calculations 25 -7496 ; April-W • Walker Engineering, Inc. Calculations 25-7584 • • • Decembft : 257804b -8 19% 25- 7804 -4 & 5 25-784" Walker Egg, Inc. Calculations 25 -7183 March 1995 Walker lInginewirng, Inc. Calculations Amdynamc Multipliers April 1999 Walker erg, Inc. Calculations Two Patty Adhesive Set System Aprr71999 NOA No.: 02- 1211.08 ° Espilon Date: 12/16187 Approval Date: 01/89/03 Page 3 of 6 0000.. • • 6666•• • 6660•• 3. LIMITATIONS 3.1 Fire classification is not pat of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test shall be performed in accordance with RAS 106. 3.3 Applicant shall retain the services of a Miami Dade County Certified Laboratory to per%rm quarterly test in accordance with TAS 112, appendix `A'. Such testing shall be mftoitted to the Building Code Compliance Office for review. 3.4 Minimum undeflayment shall be in compliance with the applicable Roofing APPlicstim Standards lideil section 4.1 herein. 3.5 30/90 hot mopped uuderlaymet applications may be installed gerPndiculw to the roof slope unless stated otherwise by the underlayment material manufacturers published literattne. 3.6 This acceptance is for wood deck applications. Minkawn deck requuemmts shall be m compliance with applicable building code. 3.7 May be installed on slopes 7:12 and greater with a minknom of two screws. 4. INSTALLATION 4.1 Monier Iafetsle Atlantis Shake and Slate Concrete Roof Tile and its components shall be installed in strict compliance with Roofing Application Stn Wwd RAS 118, RAS 119, and RAS 120. 4.2 Data For Attacbment Calculations Table 1: Average Weight (W) and Dimensions (I x w) Tile Profile Weight -W (Ibf) Length4 (ft) Width -w (ft) Monier LifniBe Atlantis Shake & 8.5 125 0.865 .... Slate To Direct Deck Direct Deck 00691 • 0000.. 0000.. Table 2: Aer amic Multipliers -)L • • • • . • • Tile Moments due to Gra ft4b 9 .' • • • • Profile Direct Deck lifpp . Monier L.ifetlle Atlantis Shake & Slate Tile 0.24 • • • •; • 0.069• • • • . • 9000 Table 3: Reston Moments due to Gra ft4b 9 .' • • • • Tile Profile 3":12° 4":12" 5":12" r:12" inAr. bAr. r Monier UfOe Atlantis Shake & Slate Tie Direct Deck Direct Deck Direct Deck Direct Deck DirectDeck 6.0 5.9 5.8 5.6 5.5 NOA No» 02- 1211.08 ° -An Eapirafion Date:1211GM7 Approval Date: 01109/03 FaV406 0000.. 0000.. ®0000. 0000. a • 0000.. e • 9999•• 0000.. Table 4: Attachment Resistance Expressed as a Moment - M, (ft4bf) for Mail-0n Systems THIS pie Fastener Type Direct Deck (min 1SWI PIY ) Direct Deck (min. 191W P "ood) Battens Monier Lo1e Atlantis Shake & Slate Toe 2 -10d Fa Shank Nails 30.9 38.1 172 1 -10d Smooth or Screw Shank Nail 7.3 9.8 4.9 2 -101 Smooth or Screw Shank Na. 14.0 18.8 7.4 1 #8 Strew 30.8 30.8 182 2 #8 Screw 51.7 51.7 24.4 1404 Smoot or Screw Shank Nail Field CI 24.3 24.3 24.2 1 -10d Smooth or Screw Shank NO Eave CI 19.0 19.0 22.1 2 -10d Smooth or Screw Sunk Nails d Clip) 35.5 35.5 34.8 2 -10d Smooth or Screw Shank Nails Eave CU 31.9 31.9 322 240d Ring Shank Nails 50.3 65.5 48.3 1 installation with a r tie headW and fastemars are located a min. of 2W from head of tile. Table 5: Attachment Resistance Expressed as a Moment M, (ft -ibf) for Two Patty Adhesive Set Systems Tile Application Tile Profile Tile Appliication Minimum Attachment 1490 000 Pd roTMA .... 4 tatarrrreM of 45 ms of P ProTM-. 39.0 5 Medium paddy plaoeMp!t of 24 araM of roTM. Moues Ufetoe Mantle Shake & Slate Toe Adhesive 1. 2 See ma mdadures gMWonent appmW for installation reguhments. • . • ... 3 Ftexite Products Company THeBorid Average weight per Ratty 13.9 grams. ...... PmdL4 Inc. Average weight per patty 8 Table SA: Attachment Resistance Expressed as a Moment - M4ftd for Single Patt r Adhesive Set Systems • • • • • Tile Profile Tile Application Minint 0ft.Attachm ent Itesisthtce . • • r Monier Lifetile Atlantis Shake S Slate Tile PdyProTm 1490 000 Pd roTMA 40. 4 tatarrrreM of 45 ms of P ProTM-. 39.0 5 Medium paddy plaoeMp!t of 24 araM of roTM. Table SO: Aftenchment Resistance Expressed as a Moment - Mr(ft-Ibf) for Mortar or Adhesive Set §ysterns Tile Tile Attachment Profile Application Resistance Monies Lifdle Atlantis Shake S State rile Mortar Set 39.0 NOA No.* 02-1211.08 Espirat5ton Date: 12116/07 Approval Date: 01/09/03 Page 5 of 6 S. LABELING All tiles shall bear the in or idwtifiable mwkmg of the manofacbnves name or logo, or following sWmicnt "Miami lade County Product Coniroi Approved". 6. BUILDING PERMIT REQUIREMENTS 6-1 Application for budding pmmt shall be w4ompmded. by copies OHIO foUoWM9: 6.1.1 This Notice ofAcceptaace. 6.1.2 Any other dom ne nts requn-ed by the Budding Official. or applicable building code in order to properly evaluate the ition of this system. PROFILE DRAWINGS i I0--,� ,�'w MONI ER LIFETQ.E ATLANTIS SNAKE & SLATE CONCRETE ROOF Ta.E FND OF IRIS ACCEPTANCE NOA No» 02- 1211.09 ®. ERdradm Date: 12n6/87 Approval Date: 01/09/0'3 Page 6 of 6 • • 0000 •000.0 •• • • • • 0000•• • 0000•• • 0000•• •0000• • • 0000•• • • 0000,• • • •0.00• 00 00 • •0••0• ♦ • • • •••• • • • • • 0000•• *000 0 MONI ER LIFETQ.E ATLANTIS SNAKE & SLATE CONCRETE ROOF Ta.E FND OF IRIS ACCEPTANCE NOA No» 02- 1211.09 ®. ERdradm Date: 12n6/87 Approval Date: 01/09/0'3 Page 6 of 6 MIAM =in I , BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CON'I'BOL DIVISION NOTICE OF ACCEPTANCE (NOAH - -- Polyfoam Products, Inc. 11715 Boudreaux Road Tomb►ak TX 77375 MIAMI -DADS COUNTY, FLORIDA MI; MO -DADE FLAGLER BUILDING 140 WEST FLAGLI'sR STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX 1305) 375 -2908 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by the BCCO and accepted by the Building Code and Product Review Connnittee to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not he valid after the expiration date stated below. The BCCO tin Miami Dade County) for the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will ineur the expense of such testing and the AW may immediately revoke, modify, or suspend. the use of such product or material within their Junsdichon. BCCO reserves the right to revoke this acceptance, if it is determined by BCCO that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the High Velocity (Hurricane Zone of the Florida_ Building Codc. .DESCRIPTION:- Polypro@ AH160 RENEWAL of this NOA shall be considered after a rscnewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a 4visi400r chanA i ; the materials, me, andlor manufkture of the product or process. Misuse of this NOA as an en4;;Vgr; W of Wy • • • ....:. product, for sales, advertising or any other purposes shall automatically terminate this NU4• -pXrlrc to exngly . with any section of this NOA shall be eaus+c for termination and removal of NOA. 0000 0 • • • • • • • . . • •••• •• •• ••••• ADVERTISEWNT: The NOA number preceded by the words Miami -Dade County, U14W +sand followed by ..:..' the expiration date maybe displayed in advertising literature. If any portion of the NOA ins aged, 1#901 shall • • • • •. be done in its entirety. . • •. •: • 0 • • • • •••• •••••• INSPECTION: A copy of this entire MA shall be provided to the user by the manufactujer qe#s distrifUltbts :....; and shall be available for inspection at the job site at the request of the Building Official. • • ''' • '•6 This NOA renews NOA No.01- 0521.02 and consists of pages I through 7 The submitted doc umentatma was reviewed by J e I,. Accho. 4'4--e� NOA No-.:: 1.02 ° * Expiration Da invWW11 Approval Date: 64113M6 Page 1 of 7 ROOFING ASSEMBLY APPROVAL: Category: Roofing Sub Category: Root tile adhesive Materlaia Polyurethane SCOPE: This approves Polypro@ AH160 as manufactured. by Polyfoam Products„ Inc. as described in Section 2 of this Notice of Acceptance. For the locations where the design pressure requirements, as detannined by applicable building exude, does not exceed the design pressure values obtained by c alculatons in Compliance with Roofing Application Standard iIAS 127, for use with approved flat, low, and high profile roof tiles system using Polyprog AR 160. Where the attachment calculations are done as a moment based system for single patty placement, and as an uplift lased system for double patty systems PRODUCTS MANUFACTURED BY APPLICANT: Product M PolypwO AH160 N/A Foatnpro@ RTF1000 N/A ProPackQD 30 & 100 N/A MCAS Product DEC-all-men SteciHcatioss TAS 101 Two cxumponent polyuredtane f mn adhesive Dispensing Equipment Dispensing Equipment PRODUCTS MANUFACTURED BY OTHERS: Any Miami-Dade County Product Control Accepted Roof Tile Assembly having a can ent NOA which list moment resistance values with the use of Polypro AH 160 roof tile adhesive. Note: Tote pbyslcal properties listed above are presented as typical average values as determined by accepted &STM test metboiis and are subject to normal manufacturing variation. C'< < %4201.02 vo <3r ,m Date: 4, Appnmnd + ��•%v: 0000 PHYSICAL PROPERTIES: . . 0000 • 0000.. .. . . . . Test .0000. 00000. . 0 0000.. Density ASTM U 1622 1.6 lbs. /ft.' 890:46 0 Compressive Strength ASTM D 1621 18 PSI Parallel to rise • • • • 0 0 :Does: • 0 0 12 PSI Perpendicular to rise 0 0 0 • 0 0 • 0 0 0 00:009 Tensile Strength ASTM D 1623 28 PSI Parallel to rise • • • so- :*Does • • • • • Water Absorption ASTM D 212'7 0.08 l,bs. /Ft2 000000 • • • .. • Moisture Vapor Transmission ASTM E 96 3.1 Perm / Inch 0 • • • . Dimensional Stability ASTM D 2126 . . 0000 +t 07% Volume Change @) -4Q0 F.,2. week3. • 0000.0 1-6.0 % Volume Change G158 -Fo .f04G /o De. ... . 0 :.see: Humidity, 2 weeks ' 00 Closed Cell Content ASTM D 2856 86% Note: Tote pbyslcal properties listed above are presented as typical average values as determined by accepted &STM test metboiis and are subject to normal manufacturing variation. C'< < %4201.02 vo <3r ,m Date: 4, Appnmnd + ��•%v: EVIDENCE SUBMITTED: Teat money Test Identil%r Test NSMI/ReNq Date Center for Applied Engineering #94-060 TAS 101 04108194 257818 -IPA TA.S 101 12/16/96 25- 7438 -3 SSTD 11 -93 10/25/95 .25- •74384 25- 7438 -7 SSTD 11 -93 11102!95 25 -7492 SSTD 11-93 12/12/95 Mile-* Laboratories NH- 589 -631 ASW D 1623 02101/94 Polptnerg Division Ramte h Laboratories, Inc. 9637 -92 ASTM E 108 04/30/93 Southwest Rah Institute 01- 6743 -011 ASTM C 108 11/16/94 01- 6739-062b[I J ASTM E84 01/16/95 Trinity EQginccring 7050.02.96 -1 TAS 114 03/14/96 Celotex Corp. Testing Services 528454 -2 -1 TAS 101 X0/233/98 528454 -9 -1 528454 -10 -1 520109 -1 TAS 101 MUM 520109 -2 520109 -3 520109 -6 520109-7 520191 -1 TAS 101 03102/99 520109-2-1 9999 LlMffATIONS: • 9999.. I. Piro classification is not part of .. . this acceptance. Refer to the Prepared hoof Tile A9ec9t9�9 bly for fire . 9999.. rating.9999 . :9999 2. PolyproV AH 160 shall solely be used with flat, low, & high the profiles. • • • • • • . 9 9:9 9' 9999.. 09 3. Minimum underlayment shall be in compliance with the Roofing Application Statue xu 120: • 9 9 9090 9999.. 4. Roof Tile manufactures acquiring acceptance for the use of Polyproo AH 160 roojtij*& besiv • • .. their file assemblies shall test in accordance with TAS 101. ;vtt0 . . INSTALLATION: 1. PolyproV AH160 may be used with any rwf the assembly having a current NOA that lists uplift resistance, values with the use of Polyproo AH160. 2. P01yp All 160 shall be applied in compliance with the Component Application section and the causpividing Placement Mails noted herein. The roof die assembly's adhesive attachment with the use of PociypmW AHI60 shall provide sufficient attachment resistance, expressed = an uplift based system, to meet or exceed the uplift resistance determined in compliance with Miami -Dada County Roofing Application Standards PAS 127. `The adhesive attachment daft is noted in the roof filcassemblyNOA 3. PolyproV AH160 roof file adhesive and its components shall be installed in accordance with Roofing Application Standard RAS 120, and Polyfoam Products, Inc. PolyproV AR 160 Operating Instruction and Maintenance Book let. 4. Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, Inc. Polyfoam Products Inc. shall supply a list of approvedi applicators to the authority having jurisdiction. S. Calibration of the Foampro@ dispensing equipment is required before application of any adhesive. The ndx radio between the "A" comp mart and the "B" cronponent shall be maintained between 1.0 1.15 (A):1.0 (B). The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per the as determined at calibration. No other settings shall be approved. 6. Polypro* AH160 shalt be applied with Foampro RTF1000 or ProPack0 30 & 100 dispensing equipment only. 7. Polypro@ AH160 shall not be exposed permanently to sunlight. f3. Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after Polypro�ti All] 60 has been dispensed. 9 PolyproO AHI60 placement and minimum patty weight shall be in accordance with the 'Placement Details' herein. Each generic file profile requires the specific placement noted herein. 1: Adhesive Placement For Each Generic Tile Profile THe Profile Placemnrut Single Paddy Two Pa4dy Weight Detail W min. m�. per gadfly Mira. fdgbi Flaty Low, Wigh Profile #I- _ 35 17 /side on cap and Imo• • • High Profile (2 Piece —# 1 Barrel) 34lpan ...... Flat, Low, high Profiles 24 - . _ �.. -__ I�1A•�._ Flat, Low, Hio Profilers #l3 - - --i;�• LABELING: All PolyprodO All 160 containers shall comply with the Standard Conditions listed herein. BUILDING PERMIT REQUIREMENTS: As required by the Building Official or applicable building code in order to properly evaluate the installation of this system. Does De.• Does• D D• .. Does* • D• ,0• .::so. .. NOA No.: 1.02 Expiration DOM 45/1.11111 Approval Date: 44f13/06 Page 4 of 7 •.00.• • • ..•... ..••. 0000• 0.00.. • • • 060,0•• • .0000• A.DHICSIVE Pt ACEMENT DFTAII.1 SINGLE PATTY lo�ondoaussel � �t�.6�resd� tong 1is•sa p" d+�e•ae�elo'J em • • 0000•• 0000 � • • • 0000 � �. •• 0000• 0000.• . • 0000• •. •. • 0066.• 0000•• . .' • • 0000 • • • ••0.6• •6 NOA No.: 064201.02 Mien Date: 05ne/i I Approval Data OW3106 Page 5 of 7 Os lo�ondoaussel � �t�.6�resd� tong 1is•sa p" d+�e•ae�elo'J em • • 0000•• 0000 � • • • 0000 � �. •• 0000• 0000.• . • 0000• •. •. • 0066.• 0000•• . .' • • 0000 • • • ••0.6• •6 NOA No.: 064201.02 Mien Date: 05ne/i I Approval Data OW3106 Page 5 of 7 ADB[Fsm PLAcizmxr4T DETAIL 2 SINGLE PATTY • • •9 • sees•• • sees•• sees sees sees•• 99••9• •• • •s9• sees :0006• • • • • • • ••0000 • • •••9 •99• •9e 9 0 A NOA No..- 06- 001.02 EVhydi n Daft "MII Approval Date: OW3M Per 6 of 7 sees•• • • 0909•• • • 9 6 .9••• a • 0000• 60.90 •••9•• • • •0.99• 9 • 0000•• • AD vswE PLACEMENT DETAIL, 3 DOUBLE PATTY - - - -- - - -- '. r—_. —.—. in. x 3 in- �^4- silopift P �- f\ l"'`G�vC 2 on fop d the Eave Cbm Sip X?kLwm m mbl em cases u* Fasda END OF THIS ACCEPTANCE 0000•• • 0000•• 0000 • 0000 • 0000.• 0000.• • •6. • 0000 •0000• • • • es •0000• • • 0060 • 6960 •6• • NOA No.: 06- 0201.02 Expiration Date: oSI19111 Approval Date; 04113106 Page 7 of 7 ..•••• • • •••••• • •••••• •••6• • • 0000• 0600.• • • • ••••.• •06.0• 0000 0000 0000.. 0000.. .. .. . 0000.. 6 0000.. 000690 . . 6666• •66♦ 6000% 06600 0000 •6666• .66666 . 666966 0000.. 00 0 6666 000006 0060 CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION N° 1792 Miami Shores Village, Fla.,1a Owner, Agent or Tenant of Building Lot -- 1 Block_ "'Subdivision— Street Address -1�4 I%A�. Approved use by occupancy_ I Remarks: This Certificate of Occupancy is issued to the above named t%rt......� 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 ss the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. 3 ,� frc,, -7" \j � BUILDING DIVISION OWNE 'S NAME PRESENT ADDRESS LICENSE NO. PHONE NO. John S. Carro3k JOB LOCATION (ST. OR AVE.) LOT BLOCK SUBDIVISION 3 / _X) - E. / ZI, 18t & 19 I 118 Sec. 5 GENERAL CONTRACTOR ADDRESS PHONE NO. LICENSE NO. Same I I BUILDER'S BOND 14512 d 4 -14 -53 18.00 1 5 47 BUILDING PERMIT NO. DATE PERMIT FEE $ NO, DATE 23,378 14 , 000 ZONE pEQUIREMENTS CU. FT. PLAN CUBE CU. FT. EST. COST $ DATE DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: TYPE STORIES ROOF CONSTRUCTION INTERIOR CONSTRUCTION x I CBS 1 I , the I oak and terrazzo floors, plastl NEW CONSTRUCTION DESCR IPTION REPAIRS 13 bdrm. -2i baths-living room-living porch -dinim porch-kitchenp-2 car g, I DESCRIPTION ALTERATION ADDITION APPROVED REJECTED TO COUNCIL REASONS SUBMITTED TO PLANNING BOARD I (REFERRED I I RE- SUBMITTED TO PLANNING BOARD REMARKS SUBMITTED TO VILLAGE COUNCIL CERTIFICATE OF OCCUPANCY NO. ! ISSUED BY TO BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE x M, "_hA. /4467;L BUILDING INSPECTIONS 14JPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE H. W. HEATER CONN. BEAMS & LINTELS $ SEPTIC TANK RANGE CONN. $ SEWER FRAMING V_ $ SOLAR HEATER FIXTURES $ GAS $ $ INSPECTIONS DATE FINAL INSPECTIONS DATE\ BY RE- INSPECT BY RE- INSPECT CLEAN -UP ROUGHING r ROUGHING PLUMBING PERMITS & INSPECTIONS CONTRACTOR'! C PHONE // / a PERMIT NO. TYi& 6 / 1 DATE FEE $ Q NEW BLDG. I ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE H. W. HEATER CONN. $ SEPTIC TANK RANGE CONN. $ SEWER MOTORS $ SOLAR HEATER FIXTURES $ GAS $ $ INSPECTIONS DATE $ INSPECTIONS DATE\ BY RE- INSPECT BY RE- INSPECT BY ROUGHING r ROUGHING GAS H. W. HEATER CONN SEWER RANGE CONN. SEPTIC TANK SOLAR HEATER ., C FIXTURES p ELECTRICAL /PERMITS & INSPECTIONS CONTRACTOR i • a.Lo 14 PHONE PERMIT NO. 46 y j DATE `j" Aq - 53 FEE $/ 44 NEW BLDG. ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ RANGE CONN. $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE r ROUGHING H. W. HEATER CONN RANGE CONN. FIX' f'�IES & FINAL ., C APPROVAL TO POWER CO. FOR SERVICE DATE -10 �ro (Ai h�. BUILDING ❑ DATE ELECTRICAL Q PERMIT N? 14695 Contractor's PLUMBING ❑ License No._ ROOFING ❑ Work to be performed under this Owner of Building Architect - ontractor or Builder_ Legal Lot II Bl. Description, Subdi- vision Address of Value of Amt. of I k. 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 co ideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining t reto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In apcepti this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. ACTOR OR BUILDEf BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING Owner Building Architec - ontract or Build Legal Descript Address Building MIAMI SHORES VILLAGE, FLORIDA F1 DATE 195 - -- ❑ PERMIT N? 14672 Contractor's ❑ License No.-i Work to be performed under this OI t or er_ Lot II Bl. Subdi- ion, vision of Value of Amt, of 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 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 y r BUILDING ❑ DATE 195 ELECTRICAL ❑ PERMIT N? 14668 Contractor's PLUMBING ❑ License No. ROOFING ❑ Work to be performed under this Permit _.___ Owner of Building _ _ Architect contractor or Builder Legal Lot II Bl. Subdi- Description, vision 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 SHORES VILLAGE, FLORIDA BUILDING DATE . � � � .., � °: „� x.195 ELECTRICAL ❑ PERMIT N? 14 5 � Aram `r � T' PLUMBING ❑ ase 4`0 0 � ROOFING ❑ Work to be performed under this Perrnit_. Owner of Building _ Architect — Uontractor or Builder Legal Lot Description. Bl Subdi- vision — Address of Value of Amt. of Building "" Project $ ; ', i Permit This permit is granted to the contractor or builder named above to constrict 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 BUILDING ❑ DATE 195 ELECTRICAL ❑ PERMIT lam® 14560 Contractor's PLUMBING ❑ License No. ROOFING ❑ Work to be performed under this Permit— __ Owner c Building Architec ,ontraci or Buildf Legal Descript Address Building >f t or -- _-- __ -_ -- Lot II BI. Subdi- ion, vision Of Value of 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 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 BUILDING ELECTRICAL PLUMBING MIAMI SHORES VILLAGE, FLORIDA El ❑ DATE 195 ` ❑ PERMIT N© 8174 Contractor's License No. ROOFING ❑ Owner of f Building Architect - ontracto: or Builder Legal Descriptie Address c Building Work to be performed under this 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 „vrie.the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume resppasfbility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY 17 L► j1�4� ; F -` i# Lot � ,�.: - �) Bl. °`;- Subdi- n j vision Sd. Ft. f * �., } � Value of Amt. of ? e It '. 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 „vrie.the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume resppasfbility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY 17 BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ Owner of Building Architect Contractor or Builder MIAMI SHORES VILLAGE, FLORIDA DATE_ PERMIT N9 38.13 Contractor License No. Legal Lot Description I I Bl. Address of -� t� Q 3 Building �� 4! Work to be performed under this Subdi- vision Value of Project Amount of Permit $ 95 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 or in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, ings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any 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 ed is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations ining 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 ining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- ig this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY a s?09r- BUILDING ❑ ELECTRICAL PLUMBING ❑ ROOFING ❑ El Owner of Building MIAMI SHORES VILLAGE. FLORIDA DATE 195 PERMIT N® 7463 Contractor's O t t License No. Work to be performed under this Architect Contractor or Builder Legal Lot Subdi- Description Bl. - - -- vision -- Address of Value of Amount 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY 6,,E ' Miami Shores Village D TCC M1CTF g Buildin Department JAN 31 2007 � 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY-..-(AA ..' Tel: (305) 795.2204 Fax: (305) 756.8972 "� " " "` BUILDING 0�"�����i =- Permit No. P-Fol ` IqZ, PERMIT APPLICATION �eF� m� ' Master Permit No, FBC 2004 Permit Type (circle): Building Electrical Plumbing Mechanical //�� Owner's Name (Fee Simple Titleholder) RjlOA6io,T 6AZ4L e� C��7I� phone # 30,5 7,j 46 1"7110, Owner's Address J3,5-/ NE /0,3 t � City /IZ,4#1 Q S State FZ -ORIAq Zip 33/3 7- ��3z Tenant/Lessee Name 6/' Phone # Job Address (where the work is being done) 3S/ City Miami Shores Village County Miami -Dade Zip 3313 IT ' FOLIO / PARCEL #//- ;V3,6 - Q` 3 — duo 0 Is Building Historically Designated Contractor's Company NameV Ci Contractor's Address .300 city /S Qualifier Name avltl A0, YES NO Phone 00s ' 7S- 7. 76 State rz_ . Zip 3JJ7 3g - 3/.30 C : BGA Phone #312Y.7-577- 7�,;? d State Certificate or Registration No.-de- t Certificate of Competency No. Architect/Engineer's Name (if applicable) t411A Phone # K11q Value of Work For this Permit $ A7 000 Square / Linear Footage Of Work: 35-0 7 Repai4W Submittal Fee $ Permit Fee $ '1� CCF $ CO /CC Notary $ Training/Education Fee $ 5.4n Technology Fee $ 'I Scanning $ _ Radon Bond $ Code Enforcement $ Structural Review. $ DPBR $ Zoning $ Double Fee $ Total Fee Now Due $ %A3 . l� See Reverse side -+ 14 FO C Y5b Bonding Company's Name (if Bonding Corn any's Address IVZ;! q City 1,,/1,Q State Mortgage Lender's Name (if applicable) Mortgage Lender's Address �/ //-{ City WA State Zip Zip��J. Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that -no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. ., Owner or Agent Contractor The foregoing instrument was acknowledged before me this33_ The fore oing instrument was acknowledged before me this day of w.._ 2�� by 11,f'�� �dL day of _y\, by("�(�iltl� __... o is per nally known t me or who has produced who is per onally knownfine or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Print: b ii` - \ '�/'�� ` P` Notary � My Commission Expires:. Comer t Com APPLICATION APPROVED BY: (Revised 02/08/06) NOTARY PUBLIC: Z /Y, r &:c t1e IMP � c1,' xpires: U` (Q ( ��✓ Plans Examiner Engineer Zoning C I V I L Reileh Engineering Corp. (Consulting engineer) P.O. Box 22011 Hialeah, Florida 33002 ENGINEER Tel:305- 823 -8008 Fax:305- 823 -3300 March 8, 2007 John Busta Roofing 300 Northeast 91 Street Miami Shores, Florida Project: ROOF TILE UPLIFT TEST REPORT Residential Home 351 Northeast 103 Street Miami, Florida Information provided by client: Permit Number: Not Provided Date Completion: March 2, 2007 Roofing Contractor: John Busta Roofing Project Number: 07 -0783 (Testing Laboratory Certificate #06- 0501.15) Dear Sirs; In accordance with your request and authorization, a representative of Reileh Engineering Corporation completed the Roof Tile Uplift Test at the above referenced project. This testing was performed in general accordance with Roofing Application Standard TAS No. 106 -- Standard procedure for field verification of the bonding of mortar or adhesive set tile system and mechanically attached, rigid, discontinuous roof systems. The total of the tested roof surface area was less than 10000 square feet, and the mean height of the roof is less than 40 feet above ground surface. The type of tile used for this project was reported to be Flat White Roof Tile. This tile was reported to have been foamed in place. At the time of our inspection, the entire area of the roof was examined for loose tiles. Not less than one (1) the in ten (10) of all components in the field area and one (1) the in five (5) of all tiles in the perimeter and comer areas were physically examined. A minimum of one (1) test per every two (2) squares in the field, one (1) test per square in the perimeter area and (1) in the comer areas were conducted. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address 7_5'5; T Tax Foliok, tiG S � Legal Description „�... Owner Lessee Tenant = Master Permtt� Owner's Address 3 5 CIE Phone s � 6n,— Contracting Co. 2) b` E \ Ou Address" ��IgS RQ Qualifier�2 VS SS4_ � Phone State # Municipal # Competency Ins.Co. Architect/.R=iReer Address Bonding n Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL `PLUMBIN MECHANICAL ROOFIII$ :: VINCE SIGN WORK DESCRIPTION Square Ft. 2S C)7) Estimated Cost(value) _- WARNING 10 OWNER : YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR V01M. TO DO SO MAY T IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF ' TO QBTATi"fINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECO F NOTICE OF COMMENCEMENT) . i ic,ation is hereby made to obtain a permit °to do work and installation" 'indica on the attached addendum (if applicable) . I certify that all work will be perf to" .:. " �. standards of all laws regulating construction in this jurisdiction. I updooatand.' permits are requiredlfor ELECTRICAL, PLUMBING, SIGNS,'POOL$, ROOFING and M CHANTCAL ° OWNER'S AFFIDAVIT: I certify that all the foregoing information is acute arn4 =t"� °`al wo will be done in compliant with all applicable laws regulating construction anti zoui „” re, I authorize the above -named contractor to do the work stated. Signature of owner and /or Condo President Signature of Contr r'"or i er Date: Date Cf Notary as to Owner end /or Condo President Notary NstaWPOAAts e ��• � My Commission Expires: My Cc% 1.30,199' COMmi&A'O ' No. CC 249413 FEES: PERMIT 9 m 0 RADON C.C.F. NOTARY TOTALlE APPROVED: Fire Other }' Zoning i Ele Bu ctritral Mechanadal; Plumbin gineering g �w PERMIT APPLICATION FOR MIAMI SHORES VILLAGE D ` 7� Job Address 3,5 r:-,- / 0 3 ST Tax Folio Legal Description n Historically Designated: Yes . J r� No Owner/I.essee /Tenant X15 V �, �gC) y / (4 & Master Permit # 7 /X Owner's Address! %%� l�� Phone Contracting Co. G&-AL e�C� i� %� Address &toz --- � /74 Tye v 1 Qualifier_ //� �/� 0_ ( SS# � Phone State #� Municipal # Z ® Competency # Ins. Co.�` h T Ti Architect/Engineer Bonding Company Mortgagor Address Address Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION fl,41A)7 7`v 4 E- gon—" /,> -lam /% (_ q_4AI e ) M Square Ft. / Q') 52690 Estimated Cost (value) IWO - -Try -- 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 YPUR 1. EN"R 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 f;YC'TWCAL 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 applieablp 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 Date My Commis ' R. , OFFICIAL NOTARY SEAL S 3 e~ 4, 8 TAIaoNneL r cs L le A0 h el ` OF FLY' DEC. 17,20 FEES: PERMIT ) ° RADON APPROVED: Zoning Signature of Contractor er -Builder �p �- Notary as to kobei Q �il cc7 72 t►° Es C.C.F. NOTARY , 57 BOND TOTAL DIJE Building / Electrical Mechanical Plumbing Structural Engineer Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Owner's Name (Fee Simple Titleholder) Owner's Address City State Tenant/Lessee Name Job Address (where the work is being done) Permit No. Master Permit No. Plumbing Mechanical Roofing Phone # _ Zip Phone # City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name Contractor's Address City Qualifier Architect/Engineer's Name (if applicable) Phone # State Zip Phone # $ Value of Work For this Permit lit Square Footage Of Work: (s' / A L J Type of Work: ❑Addition ❑Alteration [-]New Re � pair/Replace ❑ Demolition Describe Work: / Submittal Fee $ Permit Fee $ � CCF $_ 3 co/cc- Notary $ —� Training/Education Fee $ Technology Fee $ E0 Scanning $ __1 Radon $ Zoning - Bond $ 00 Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ S 0 -3 ® �,�5 (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address city State F a Zip Zip. Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. ' "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature_ Owner or Agent The foregoing instrument was acknowledged before me this day of 20 `, by who is personally known to me or who has produced As identification and who did take an oath. Signature Contractor The foregoing instrument was acknowledged before me this day of 20 _, by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign. Print: Print: My Commission Expires: My Commission Expires: State Certificate or Registration No. (Certificate of Competency Holder) Certificate of Competency No. APPLICATION APPROVED BY: Che 12/15/03 Plans Examiner Engineer Zoning PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ////.3 1,9k Job Address Tax Folio Legal Description Historically Designated: Yes No �✓ Owner/Lessee / Tenant -� 6/ T y!12� Master Permit # 410 Owner's Address _ .� /)L lea Phone 756 -,506 Contracting Co. /` Address JLi Qualifier G - SS# Phone .off " 62V'76?,22- State # C C/-� Ja OOV Municipal # Competency # Architect/Engineer Address Bonding Company Mortgagor Permit Type (circle 04 : BUILDING ELECTRICAL J WORK DESCRIPTION :,. Address Address Ins. Co. PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN Square Ft k Estimated Cost (value) .k 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 1 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 with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. 'V d. , - � I/ /3/9v- I1 '3 9 Signature of owner and/or Condo President ate Sigma a of Contractor or Owner- Builder Date .Z � f�� Notary as to Owner and/or Condo Presi: nt Date N tary as to Contractor or er- Builder Date My Commission Expires: My Commission Expires: 60Y P&O DALE COX aoy Poe DALE COX z ,COMMISSION # CC 698973 a {g, COWAISSION # CC 698973 v� EXPIRES NOV 25, 2001 9 c EXPIRES NOV 25, 2001 y BONDED THRU �QF ATLANTIC BONDING CO., INC. OF ATLANTIC BONDING CO., INC. 1 / FEES: PERMIT 91/0, RADON f__ C.C.F. 60—NOTARY BOND APPROVED: Zoning Building Mechanical Plumbing Electrical Engineering TOTAL DUE PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address P P/ Tax Folio Legal Description Historically Designated: Yes No OwnerAxssee / Tenant Q Master Permit # 3 % Z Owner's Address -�y{ �/ �=� _'/ - ✓'f J__ _ Phone 1 Contracting Co. Q% C � � o ll y w o�l i _ , _y . Address U —) Qualifier 'V , 1� l�;iM C� 12Z�1 b SS# - Pho. A J 9 state # 0 0 0 5 1 b Municipal # Architect/Engineer Bonding Company Competency # Address Address Ins. Co. Mortgagor Address Permit Type (circle one): BUILDING ELECTRICA PLUMBIN MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. c cN Estimated Cost (value) I ''t jt 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. 1 t A262 Signature of owner and/or Con o President Date Notary as to Owner and/or Condo Ply6sident Drag My Commission O r-OAL NOTARY SEAL 1P¢Y Ne, DELORIS BERRY cowmSelm N < CC677045 s 11-1 i 17 of Contractor or O -Builder Date 'V � &// Notary as to Contractor or Owner- wilder ate My Commission E T*- - OFFKIAL NOTARY SEAL DELORIS BERRY n Colt NUMBER CC677045 OF V MY commes 00 m FEES: PERMIT RADON C.C.F. C7 NOTARY APPROVED: -- g% BOND TOTAL DUE_ Zoning Building Electrical Mechanical Plumbing Engineering MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _ Permit No - -- - - - Date -- - f 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.-Y4 % -� -- -- - - -- Street ---- _0- ------------------------- Registered Architect and /or Enginee�ME SEPTIC TANK CO----------------------------------------------------------------------------------------------------------------------------- EmployingPlumber's Name--- --- -- -- ------- ------ - A - K - ------- --- - - - - -- No.---------------------------------- - - - - -- Street -------------------------------------------------- P. o. _Box 1000 Location and Legal Description Lot______ I„ItAt A -R.__Ft0RT6N_______ ____ __Block__�____- _________ -__ Street and Number where work is to be performed—No --------------- .Z ------ x__ ----------------- State work to be performed and purpose of building (By Floors) ---------------------------------------------------- New Building ------------------------------------ Remodeling -------------------------------- Addition ---------- U No. of Stories____________ Size Septic Tank -------------------------------------------------------- Type of Tank---------------- - - - - -- -- Capacity --------------------------------------- Feet of Drain Tile______Jf___ _________ ____ __________Dist. Feet of Tank or Drain Field from Well ______________________________. Nature of Water Supply: City—Well ------------------------------------------------------------- Size of Soakage Amount of Permit (Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed STATE OF FLORIDA, ss. COUNTY OF DADE. Master Plumber. 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. BATH LAVA- SLOP LAUNDRY CATCH FLOOR DRINKING TOTAL CLOSETS TUBS SHOWERS TORIES SINKS SINKS TUBS URINALS BASIN DRAIN FOUNT'NS FIXTURES CONTR. LIST CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR. SW IM'G TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL CONTR. LIST CHECK Size Septic Tank -------------------------------------------------------- Type of Tank---------------- - - - - -- -- Capacity --------------------------------------- Feet of Drain Tile______Jf___ _________ ____ __________Dist. Feet of Tank or Drain Field from Well ______________________________. Nature of Water Supply: City—Well ------------------------------------------------------------- Size of Soakage Amount of Permit (Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed STATE OF FLORIDA, ss. COUNTY OF DADE. Master Plumber. 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.