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Multiple�y� Miami Shores Village %S l 1 10050 N.E. 2nd Avenue i Miami Shores, FL 33138 -0000 �. • `` > ,'� Phone: (305)795 -2204 Scanning Fee $3.00 Project Address Parcel Number Applicant °. ..._.... ____ . ......... ....._....__. ..... .___-_ ...... ............ 25 NE 103 Street 1121360130940 Miami Shores, FL 331.38- Block: Lot: NICOLE GUILLET ....!! iT&[. Inf. 4f Rl l4( 1 ........................... ............................... Addres....................................................... NICOLE GUILLET 25 NE 103 Street MIAMI SHORES FL 33138 -2326 Contractor(s) Phone Cell Phone TML ELECTRIC, INC. (954)430 -9871 (954)262 -2441 Type of Work: ELECTRICAL kdditionai Info: METER BOX RFEPLACEMENT classification: Residential Fees Due Amount CCF $0.60 Education Surcharge $0.20 Permit Fee - Additions/Alterations $100.00 Scanning Fee $3.00 Technology Fee $2,50 Total: $106.30 s NOV 0 5 20 ew MIAMI sr "HO RE ....................................................... ............................... Valuation: $ 1,000.00 Total Sq Feet: 1200 Total Amt Paid Amt Due $ 0.00 $ 0.00 $ 0.00 ........ ..............<.:. Payment Type: Available Inspections: Inspection Type: Underground Rough Final W. W. 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 wittf the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I as:.ume 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 . Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy October 31, 2008 Date Friday, October 31, 2008 1 Inspection Date: 11/19/2008 Inspector: Devaney, Michael Owner: GUILLET, NICOLE Job Address: 25103 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, FL 33138- Project: <NONE> Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration (1000 Phone Number Parcel Number Block: - Lot: 1121360130940 Contractor: TML ELECTRIC, INC. Phone: (954)430 -9871 Building Department Comments REPLACE BROKEN METER CAN (BAD LUG) 150 AMP. METER CAN NOV 2 0 200® Inspector Comments Passed ✓� Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Tuesday, November 18, 2008 Page 1 of 2 .-. _ - :s_.•..._- .,,.,n,.,:o-� _ -.. -_ - -.._ _ ... -. _.....- .- ear... -'. __. a._. _,_... -n.� Itlt . 1 1 mk r - i ® r •sR 01I09/�003 11:02 3058991873 SYNERGY I Ufl IWO VVVJVJVYJ7 PAGE 02/08 { , VG/ VV • • • ••• • • • ••• MIAM • : :.:: • : MIAMI -DADE COUNTY, rLORIDA • • • • • • : : : •: • 4IETRO -DADE FLAGLER BUILDING Go: 096 PRODUCT CONI- ROL, NOTTCr oE cc> r7; rvC ... TRACO Sccurity Windows & Doors, joc.. �� ��� 0 5100 NW 72 Avenue :.::::::• '. 14111mi ;rL 33.166• • • • .. .. . . • ..... Your application fdr Notice of Acgoptance (NOA) or; z - -�••ri• y Caress Wind6v nu(LOINC CODE CONIPLIANCF OFPIGI: M R 11111- I7AD1; r•1,:tiGt,l:1t llun.t)1,V(: 1-10 WQFT FLA0t.I-* iraIs. r;r.st111.1: 1103 WAP►It. I-10imm 33 ) 373.1563 (m)575.??o1 FA\ (3113) 37S•3tX1S c�c�, �- t' I+. tc►•atst.tct���+I�t;:lrt.�t�tf� VO 375 527IIAv pus) 375.3$ss Cuv�t'11ACtau V��ORcr-1m rnivi.siox (305) 37362M FAX (30$1373 -.")jw rttocruc;rccl��1•ua(, u1►�I.tu).�r 1305) 375 -207 PAX (ws) 373.6;" under Chapter $ of l e'Cdde'orVfiaW @a ij:Z0 ��n#y- pov_ecn4ng the use of Altemale Matgrials and Types of Construction, and completely described lttrein, has begin 6mmended for acceptance by the Ntiami -Dude County Building Code Complitmloe oftlee C.BCCO) under the conditions specified herein. 7liis'W0A•'sS411 trot bi- valid after the expiration date stated below. BCCO reserves the Sight to secure this product or material at any time from a j.031te or manufacturees plant for quality. control testing. If this product or material fails to perform in the approved manner,. 6CC0 may revoke, modify, or Suspend the use Of sticlT product oc.matedaL..tm►taedintely.- OCCO mserves. the, right to •revoke• th4 approval, if it is determined by BCCO that this product or material fails to meet the requirements ofithe South Florida Building Code. The expenso orsuch testing will be incurred by the manufacturer. ACCF,PTANCE lYt� : 01- 0905.41 Lftlt �\y� Raul Rodriguez Chief Product Control Division Tarrs•rc-Tratr•rnwiu nt :rr�r.- r••t- r>c••�•nn•r.wrnti,. ■ r ......... w.�_ ,...._.�_. - -.e . --- - •- --.- -- - utx n �t�: Cony° t+RYSnt�cr:try ;tiv com iTT E This application4or -Product--Approval- has •beon-reviesved-by the OCC•O -and appr by the Building Code and Product Review Committer to be used in Nlismi -Dade County. Florida undef the conditions set fortis above. _ APPROVED: (tin 1JZMI W64500011pc2d0MU"tamMDtt4e aeeepaM toner pag..aoe I�fe;a�u�1o1, Francisco J. Quint:lnp. R.A. MCC* wmi- DCMinty Building Cbdc Complinacc OMCC Po latornet mail Adder; posture8t¢rSbnitltingeodeonline corn 0 Homelwge; bl ip :IAvwnr.buildingeodeonline.eoiu r 01/09/2003` 11:02 3058991873 TRACO Sbeurihi Ml�itidatys stud Doors . A CEPTA NCC No.: 01- 090;.01 '• ' •' •' 0 APPRovcU: October 11 .. .... ,_ooh EXPIRES; July 30, 2006 NOTICE OF �JCZf :' SPF&IPIC CONDITIONS .. I. SCOPE This renews Notice of acceptance (NOA) No. 97,0924. 10 issued on July 30, 1998, under the nantt: of Security Aluminum WIMCIOvs . &.I1.o,Qrs...Ft.renews.the approval oCan alumi�um duo action window as described In section 2 of this NOA, designed to comply' with the Sduth Florida building Code, (SCAC), 1994 Edition for Miami -Dade County, foi• the Ioc ations)where die pressuro requirements, as determined by SF8C, Chapter 23, do not exceed the Design Pressure Rating values Indlcstted In the approved drawings. 2f PRODUCT DESCRIPTION 7.1 ' The Si iirs "2100 Single! Hung Egress" Aluminum Dual Action Window, and its components shall be constructed in strict compliance with the following document: Drawing No. W01.18 titled "2100 8111. 91r. Flung Egress,' Sheets I thru 4 oC4, dated W- 8I01,with a revision date of 09 /19 /01,4aed and sealed by Dr Kama cun..Caroacp, PX.,, bearing the Miami *tgde County Product Control renewal stamp with the NOA number and expiration date by the Miami-Dade County-Froduct• CORtrel-Divisiow. '11. ese documents-shall hereinalkr•be referre4 to as the approved drawings. Theso drawings replace drawhig N 91-140. signed and seated by Kelvyn A.Vhitficld. P,C„ 3. LIMITATIONS 3.1 This approval applies to single unit applications only, as shown in approved drawings. d. INSTALLATION 4.1 The aluminum dual betion window and its components shall Era constructed in strict Fampliance with ilia approved drawings. -2" tiiitricooe prott:etiorl systems {sinittErsptheitusattativn gfthi nit wr11 reaaire a h icvie protection systenh S. LABELING 5-1 'Each unit'ihhIlIcar tt permanent label with the manufaeturees name or logo, city, state and fallOwingstatement: Iii( Iami- Dode.County.Product.gontrol Approved ". 6. BUILDING PERMIT REQUIREivIENTS . Applicatibri'fdr building permit shall be accompanied by copes of the following: 6.1.1 This Noticc of Acceptance. 6.1.2 Duplicate eopics of the approved drawings, as identilled In Section 2 of this Notice, o1' Acceptance, cicarly..marlced to-show the.eo paAents solected Cor lha•propofed i,utaallation. 6.1.3 Any other -documents rcqulred by the Building Official or the SoWh I- lored''a Duildiog Code (SFl3C) in ordbr to properly cvaluatc the installation of thus system. Raul F ode Suns. Chic; 2 Prodyct Control Division SYNERGY PAGE 03/08 1 t4f f1VI JVJJVJVYJY 1 UJ/ tNJ •• •• • • • •• •• • • • • • • • • • • • • • • • • • • • • • ••• • • • • ••• TRACO Sbeurihi Ml�itidatys stud Doors . A CEPTA NCC No.: 01- 090;.01 '• ' •' •' 0 APPRovcU: October 11 .. .... ,_ooh EXPIRES; July 30, 2006 NOTICE OF �JCZf :' SPF&IPIC CONDITIONS .. I. SCOPE This renews Notice of acceptance (NOA) No. 97,0924. 10 issued on July 30, 1998, under the nantt: of Security Aluminum WIMCIOvs . &.I1.o,Qrs...Ft.renews.the approval oCan alumi�um duo action window as described In section 2 of this NOA, designed to comply' with the Sduth Florida building Code, (SCAC), 1994 Edition for Miami -Dade County, foi• the Ioc ations)where die pressuro requirements, as determined by SF8C, Chapter 23, do not exceed the Design Pressure Rating values Indlcstted In the approved drawings. 2f PRODUCT DESCRIPTION 7.1 ' The Si iirs "2100 Single! Hung Egress" Aluminum Dual Action Window, and its components shall be constructed in strict compliance with the following document: Drawing No. W01.18 titled "2100 8111. 91r. Flung Egress,' Sheets I thru 4 oC4, dated W- 8I01,with a revision date of 09 /19 /01,4aed and sealed by Dr Kama cun..Caroacp, PX.,, bearing the Miami *tgde County Product Control renewal stamp with the NOA number and expiration date by the Miami-Dade County-Froduct• CORtrel-Divisiow. '11. ese documents-shall hereinalkr•be referre4 to as the approved drawings. Theso drawings replace drawhig N 91-140. signed and seated by Kelvyn A.Vhitficld. P,C„ 3. LIMITATIONS 3.1 This approval applies to single unit applications only, as shown in approved drawings. d. INSTALLATION 4.1 The aluminum dual betion window and its components shall Era constructed in strict Fampliance with ilia approved drawings. -2" tiiitricooe prott:etiorl systems {sinittErsptheitusattativn gfthi nit wr11 reaaire a h icvie protection systenh S. LABELING 5-1 'Each unit'ihhIlIcar tt permanent label with the manufaeturees name or logo, city, state and fallOwingstatement: Iii( Iami- Dode.County.Product.gontrol Approved ". 6. BUILDING PERMIT REQUIREivIENTS . Applicatibri'fdr building permit shall be accompanied by copes of the following: 6.1.1 This Noticc of Acceptance. 6.1.2 Duplicate eopics of the approved drawings, as identilled In Section 2 of this Notice, o1' Acceptance, cicarly..marlced to-show the.eo paAents solected Cor lha•propofed i,utaallation. 6.1.3 Any other -documents rcqulred by the Building Official or the SoWh I- lored''a Duildiog Code (SFl3C) in ordbr to properly cvaluatc the installation of thus system. Raul F ode Suns. Chic; 2 Prodyct Control Division 01/09/2003 .11:02 3058991873 M 'NERGY PAGE 04/08 & +4a 11v. VVVVVVWd -7 It LMIUD TRACU"SceuritY Windows and Doors ••• • ACCEPTANcu. No.: 01- 0905.01 : . : • : APPROVED: October 11, 2001 • ••• . • to EXPIRES.- July 30, 3006 NOTIICE -O'C ag2r- ml ': • Sj:ANDAR D CONDITIONS •• • • • • • ••• •• 1. Rclte,'.vbi of this Acceptancc (Approval) shall be considered after a re-ne%val application bast b n fled and the original submitted documentation, including- tmsttpppitin$ duet, engineering documents, are no older than eight (8) years. 2:- Any and all approved products sin. 11 be permanently labeled with the manu4ctumes name, city, state, and the following,statetnent: "Miami -Dade County Product Control Approved", or as specifically stated in die•speatfic condkions of -this Acceptance. 3. Renewals of Acceptance will iiat be considered IF. A) There has been a change in the South Florida Building Code affectiti0 the evaluation of this product and the product IS not in compliance with the code changes; b). Tltie ..produt.tis.no..toager,.tbe=me product (ideauicai)•as•the oae,Qri&ally approved. P) If the Acceptance holder has not complied witb all the requirements of this acceptance, Including the'correct t stalthtion of the product; d) The engineer who originally prepared, signed and walled the required documentation initially submitted , is no longer practicing the engineering profession. 4• Any revision or change in the materiais,.use, and/or manufacture of:thc product of process shall - automatically be cause for termination of this Acceptance. unless prior written approval has been requested (through the filing Of revision application with appropriate fee) and ,granted by this office. S. Any of she Ibllowing shall also be grounds for rcmavat of this Acceptancc: a) Unsatisfactory performanco of this product or process; b) Misuse of this Acccptanee as an endorsement of any product, for sales, advertising or any other purpose. G. The Notice of Acccpttlnec number preceded by the words Dade COUaty, Floridp, and followed by the eXPiration date may be displayed in advertising.[izcraturo. 1f any. patxitvn of the Notice of Acceptancc is displayed, then it shall be done in its cnlirely. 7 -- ' A copy of th'i's Acceptance as well as approved dm%vings and other documents, where it applies. shall be provided to the user by the manuracturar or its distributors. and shall bo available for inspcctien at the job site at all times, The enginecrdom nofi-rct:cd to reseal the copies. 8.' Failure to comply with any section of this Acceptance shall be cause for tcrnlittation and removtal o f Acccpianro. 9. This Acceptance contains pages t, ?, this last page 3. END OF ACCEPTAtiTCL 3 Produce Control Division CA m U') m 1 3 .16 ap' 4p. > AN a p� Im G! AXWAWIM. WAD a. =4 OL ! SE tlW� GLASS to--u W5.0 jar. H) „irm IWO as-Im ar 1 1 ' Fd 1 3" ae-� am COMM APP$OVCD I i • i3sPArr 6iSiw&w • C MS stiSt4Lf1 m miineBQJ�Ji AS ►IA 7NL 90JSt RNt�6 B41DOI6 �p Laos I AS m �/JCC 7 YILg4�a�ppppp CQ�09 = a 4 RM 1MW OF 0 _N�(=, • OC M*fWft MAMM 11 WAMM % =M& AS j= WA&U AS S969It1 GM WOOL •••••• _ ca SZI+C • •••••• •• •• F o)OCT R�tIIV1. • �' • owae � � t• � C4 CD in Cl1 Ca U co m co m C* cn 1 V-1 m • • • • • • • 1 ••1 • • • Ir soc on" • .16 ap' 4p. > AN a p� Im G! AXWAWIM. WAD a. =4 OL ! SE tlW� GLASS to--u W5.0 jar. H) „irm IWO as-Im ar 1 1 ' Fd 1 3" ae-� am COMM APP$OVCD I i i3sPArr 6iSiw&w C MS stiSt4Lf1 m miineBQJ�Ji AS ►IA 7NL 90JSt RNt�6 B41DOI6 �p Laos 0 a Alt a I i on= tSA9 LIPIlF,�lt ' • S'= =06 Im G! AXWAWIM. WAD a. =4 0 im ; SE tlW� GLASS to--u W5.0 jar. 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L :00000 FBiJlC NFlD •0.66• JL .... ••6••• •666 � ' • • pBi • • •• i • • • ip py • **:so 00 :•666: ScIll O= ADAPHO c m c _ sass $=. a. CID N Mwr gff mA RgL 8 e-1 m Lot SMIC @ .a2 @ N' Z, m 1 MLL muvm @. t SEP 18 Zpp� �amasom t I i� 8 0 • . ... . . . ... .. .. • . . •. .. . . . . . . 0 tit. v�"z V002 .• -• ••.•y�y..•.v..ti. ..p•��N� ...�- bUgGa CODE C®n'iP3.LME GMCC (ti=) O11C8' Q:OAi3i8tDL Dt�iSItB��I s_ aCE OF ACCEPTANCE (NO i�� x4�ti145ttf Ziit�a/�C ftwaxrit aQ Via rldn 32215 ••• • ••• • ••• . V. • . M=,C.i7, %DFfL GLtRT3UUZIWG sa WEB r r . PdflA+t�iLF1.DP:fe'?A3313� -I5G3 (�� 375 2987 : r� (3ti3'j 375�''f38 '" r `'9'his'NOA is bcioz issued under tits applimable gales and r uiaiioAS gp crtirag tie al cv im OD & =CPW laie'c'iatt umentatian z*n hied bas•bm Teviewed by Wau i Dadc County Produm Co=zI DiVL � icd by t�C �oozd of w= and Apgieals �DRA) to be used in mini 1�".:dc Ccunty znd ot`tc: a'" �vb '11�cved b� ;'.the :A�osity Y3avin� 3asrisan (AFii�• 'TkiB i3� abate not be i, lid $lid the expirratign dam smtrd below. The Prtlduat. Control MAs'l= (In lWIMru Dade Cotmty) andlor tha AHJ (n areas other tb= WMmI Daa^ Ceurty) reacrve tlae right to 'l zvc this produce or materW tmUd for quaUry assurance purgescs. iE this p: o3ucr us nab Vii$ t3 F=ro= in `° the. tceccpt=d ngarta3ct, =uaraeturcr will kmur the cxp== or such s:•sts:tg =&d ibe A•W %r-AY y;• tedaatcly iccvoh+c. m�oclam'. oa stt crtd the u�c of such product or t;aiui uddfm u%ter ju :i ictau. B0FA .=arVcS tip. right tm volts t acccptassa:c, iFit is dcfieszz inr�d b3►1�ltiamiDade C�tun�' ptmduct Control Divis10n tha; this procluct or �a3i fails to meet tltc �gtairenles�� of ttac aggli�tblc building eflde_ .'Shia product is approe� as desrn"ved U =ih, and bas been dcsigntd fa �ssr�Ytply stiu'h the I'V Val oclly �u- cic�tc >' Z v of ft Flarldn Budding Ccdc. MESC3IPrION: 0.9356" (Win.) C�,l�+aaizcd St+�cl S&aorsn �.,s�cls Sitst�cs PPR�°�l�►Y. i3CCEi1�11r1`t'�- Drawing No. 96- 20GAO1, sided '° Sa�easte:r,;+�esals ManuiaeturinS co, Inc. 20 Craulc 43zjvanftg4 Storm Paur3 Syn= ; sh=ts i aa=d 2 om prepared by SauitA=JstCro Mcu'tls Manufacturing Ca, lAc„ dated C gbscr 17. i997, Izst revision #� dated Qctcocr 14, 2Gt3Z bcas•sn ti3c Miarrs -Dade CcturtX °' Product Caniroi ;Revision starctp with sic Noticc crAcccpiancc ncmbcr =d rxpimdori t,'at b}' the Pfciar.:i Dt�dc Ca=VPrad= Controi Diy Sion: ;AID ll - ltissilt;,7p i sraU bit' a pet7r+am�nt Sabel vtRt17 the r�aantsfucturc's seams loo, city, e and the - ovz", =1= aghem iss noted r. fQIlo '."� wt=ntc`�` 'aam�laadc County 1'roducl Contrml App �it$e TrTC?A �E�utl be considered asu+r a rcnc��al applicatiest ins beca �Fil =d attd tlicsc In-as ecn too +t it, rsgplitabIc ids codeatiuely a£%ctiag chc peridsmance of sbis p;aduct• 7 ,111; �TtQlg op als N�1� un I occur atl�• she axpinuion das.: cr iMc. c has Ia�a a Y�wision or s�nsa: i.� tllc 4 .�, grciiideurt� �t s%,'c aatcs. odv±ertssirs�'ctcony athcv' gurpoSes SIsscll aucoanaticaioly f this nN7A tc as n no 'crsnt� y zntu arihc product or pmc=. MSC m py all. d iitis iQA_ Zaslurn to calY vc th y scttiatt �ithi� Rif. shall br- =Use for tsrmiaation and removal of NOS. t LR9 1)'�'l ti9'ISL•`.Nif�T: The N A'nutr ber prcccdcd by tki.� words 4liatr i -Dade Cazmty. %iarida. and fatlou'��d by "; ;d>,i c"c�iiravan da7C.i:rsy be diplayedrirr.3dti'�:riisiatc_ titcracus�• t��ny gortioa ot'tin 1IQ?�. is dis�l�yed; thtat it shalt ` 7 bit dUt1a: X11 its fi4►Ltt�ay: pr tided to the user by tha ,!butors ` � I! be 4 mane facture ar its des: �a1t5PFC'® A copy of.thas tKtdre i�0?� ssn r . rand "I be nvailnblc for inspection at the job site at the reoucs; ON= Building N r c+►?is s.l'e rrascaas l�t?A► 49- ti3t5.03 �S consists his pa�c 1 �.'. 2PPta' al dG=4%ent mcrttivara av vc. Tae sobm!Utd doC=Cntatian tt`as rCvl : tvt d by Hclmy A. hZnT•a. , M, -*OA Aio i?s- MQI9.QI3 .e ,��rvd-at Aafc: I1RTlZBf13 ' t 1 t, • ii+������ —�OUC . . • cjA' .0 filter. Intj ui, ISM fir ULL CM110A Tt i fix. 1 �r---i 1,— eta 1 C 1 ..--r. ut• a[P. 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'{ I'�,,. is �!• ". 6 Ai Yf•' 'R i °: h � Lt �d J � r .t T 4r, r` _ I• �f��' -n Y y i s � *jA Its W''yeQ t4 ,1� • t± t � por11 � r� Pa t► ra(>•nQ� ' ,1.•'0.11 ta�r1 -f • • 1�t +a 1v+at ts[ • • • O-el • • • 416, • • ► • e S -• a 11 • G�1 rd —I /Ptt i1� -t!1 6+,11.01 o m :- .,a [••.4't ' t •�. a t i t +a1� i rfu.3aetia»d -fir» 102 Piste- •t�.rra��� AXIS po [JtHra aa•tr•ii�e'wd ..d Ipp"lt 1•rl i� r ' { fay t�-� � • [' 1. • (1Q R!s lHtd �!i q4��tp[a 1�11�W1 . ti•�I).�"�"_�``� Vy�nr .. , ' � (1 a[l•b a1 talAt11Y'o i•�ralW -x ;x }a I sic. [,v, •a.t�1,!« .. N rqc it CH H,f•S OAS �g IRE• rRp•,, L .� firs ' R• 4,1 J > 9 ►. >''� ri t ,� .',r. 4 tea. ,� r :,� •t - F' Y -�K i .v? 4. _ .� a. '] 5r e-^ i .s.. J. %� ...a.;4 R i y ., - V. Soathkaseer.4w&&l zqjfacturin 9 Co..Inc. 11801 Industry Drive 0 P.D. Box 26347 JocksamWlle, Rwids21218 1(800)342-1279 FOXAT9,j 14*00)67t-%35%AT. WATS 0 (904)757-4200 • ••• 3uil4ing Official !-Of Municipality 'less Zip ' RE. SHUTTER PRODUCT APPROVAL A UTHOP, ZAT IONFORW ,ar Sir: a: are h'e ' authorized thorized distributor of the Dade County Notice ofAcceptancc E,)ldcrfor , LGA'. SINGLE STORM PLY SUTEM under the 97-0805,01. tisaetier. to use our c5, ' .;A Installer 4 ARM PLY SYSTEM approved under number 97-0805-01 to be use.' o.- the A10m 'I Addi "a r J, bsz e C'S$ erel 'Whoi* d SignatuSignature fr z Notice ofAcceplance Holder 6" U, e Fruit and 'Title 0 see 00 Zip ' RE. SHUTTER PRODUCT APPROVAL A UTHOP, ZAT IONFORW ,ar Sir: a: are h'e ' authorized thorized distributor of the Dade County Notice ofAcceptancc E,)ldcrfor , LGA'. SINGLE STORM PLY SUTEM under the 97-0805,01. tisaetier. to use our c5, ' .;A Installer 4 ARM PLY SYSTEM approved under number 97-0805-01 to be use.' o.- the A10m 'I Addi "a r J, bsz e C'S$ erel 'Whoi* d SignatuSignature fr z Notice ofAcceplance Holder 6" U, e Fruit and 'Title cn U Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 An ­ Permit Number: BP2003 -508 3 /31/2003 Page 1 -r- Printed: 1 Applicant: NICOLE GUILLET Owner: GUILLET NICOLE JOB ADDRESS: 25 NE 103 ST Contractor Contractor's Address: Local Phone: Parcel # 1121360130940 Legal Description: MIAMI SHORES SEC 5 PB 10-47 LOT 15 & W1 /2 OF LOT 16 Fees: Description Amount FEE2003 -1875 Building Permit Application Fee $60.00 Total Fees: $65.60 FEE2003 -1876 CCF $0.60 Total Receipts: $0.00 FEE2003 -1877 Notary Fee $5.00 Total Fees: $65.60 Permit Status: APPROVED Permit Expiration: 9127/2003 Construction Value: $540.00 Work: REPLACING 6 WINDOWS AND SHUTTERS If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another Inspection._ This Permit is granted to the contractor or builder named above it ordinances pertaining thereto and with the understanding that the we and approved by the proper municipal authorities. This Permit may i authorization. A further condition upon which this permit is granted is ordinances and regulations pertaining to the work covered hereby wt by his agents, servants or employees. Signed: (INSPEi In consideration of the issuance to me of this permit, I agree to pert with the plans, drawings, statements or specifications submitted to thi myself, my agent, servants or employes. y , Signed: 379 BLK 123 NICOLE GUILLET _ 31 -- D . s3-a�s �n� FL 25MIMM, 103 ST- PL 33138 -2326 ��¢�•� ' � t, tht n- Orer Q af ®$ D-U-, Bank at Alnernca�'.�o ACHWrOnOM47 kl� r374063000047OOL4643 65 In to le ,one ,ity PERMIT APPLICATION �QA? Amt WQRFS VILLAGE 100504N.E. 2nd Avenue • Miami Shores Florida 3 -4138 • P,hQner„ 305 -79; .2204 • Fax: 305- 756 -8972 4� Dat - a Job Address r2570U—ir N9Mf Tax Folio I,,egal Description HistOrica% Desl�nated: ;Yep ; No Owner /Lessee /Tenet Xj l: Ole_ Gf & i Master Permit # /Owner's Address 3�� . F9n4 1 'l; . (•.331 : •: : �h � � L • /� % — '" � / 3 T *ntracting Co. Address Qualifier State # Municipal # SS# Competency # Phone Ins. Co. IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one)­ BUILDING" ELECTRICAL PLUMBING MECHANICAL ROOFING WORK DESCRIPTION: Square Ft. y Estimated Cost (value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ANY 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 all disciplines. 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. Furthermore, I authorize the above named contractor to do the work stated. Signature of owner and/or C6ndo President Date -' L,D L Notary as t Owne an or Co o Pr6dent Date My Commission Expire Angela M Becker My Commission DD150048 ` 'w F,u* 0 Expires November 15, 2006 FEES: PERMIT) RADON APPROVED: Zoning Mechanical Signature of Contractor or Owner Builder Notary as to Contractor or Owner Builder My Commission Expires C.C.F NOTARY ( b G BOND TOTAL DUE �� -� Z Building k` -~—= Electrical Plumbing Structural Engineer w Date Date v a PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date - — Job Address c96 P Y f2 :S Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant iv, fe f Master Permit # Owner's Address Phone 6-40� a Contracting Co. O -L 2 tVe _P— Address 2 5 Hj/ 5 ff/_�� ���!'%r�h,i rl 33 Qualifier State # F Architect/Engineer Bonding Company Municipal # SS# - - Phone Competency # Address Address Ins. Co. Mortgagor�C21\1 �lr�/Y e, r� fit. Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN tORK DESCRIPTION T r2 r p�' �2 r o- Square Ft. Estimated Cost (value) 'J4- WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR EMPROVEMENTS 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. 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. Furthermore, I authorize the above -named contractor to do the work stated. Signature of Contractor or Owner - Builder Date Notary as to Contractor or Owner - Builder Date My Commission Expires: FEES: PERMIT -' RADON C.C.F. 34 NOTARY APPROVED: Zoning BOND TOTALDUE Mechanical Plumbing Structural Engineer Signature of weer and/or President Da No as to Owner and/or 'dent Date My Commissi ' ft-IM N AR 5Y EAL GLA.DYS J VILLAR NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC714103 MYCOMMMION EXP. hMj 1 Signature of Contractor or Owner - Builder Date Notary as to Contractor or Owner - Builder Date My Commission Expires: FEES: PERMIT -' RADON C.C.F. 34 NOTARY APPROVED: Zoning BOND TOTALDUE Mechanical Plumbing Structural Engineer PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Job Address ! qc _-�B ZZ �%j— lu-F -<�f io&/--Tax Folio Legal Description Master Permit #/ € Owner / Lessee / Tenant Owner's Address A 2E L573 S toe e % phone < ej [YS _ Contracting Co. __ea) Lief- Address Qualifier State # Architect /Engineer Bonding Company Mortgagor SS# - - phone Competency# Address Address Address Ins. Co. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION 0 Square Ft. Estimated CostC2 - 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. I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, and MECHANICAL work. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of Owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: PERMIT FEE: 10-/7 /Z,, Signature of _ Owner- Builder Date: Notary as to Contractor or Owner - Builder My Commission Expires: APPROVED: Fire Other Zoning Building Electrical Mechanical Plumbing Engineering PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Job Address /� ��'� Tax Folio es ��•� Legal Description �f�T/ G(,��2.� %� �, /v��j Master Permit # Owner / Lessee / Tenant�E'Gtf Owner's Address f'/ ' / J��F phone Contracting Co. Qualifier State# Architect /Engineer Bonding Company Mortgagor Permit Type (circle one): WORK DESCRIPTION // Square Ft, Address SS# - Competency# Address Address phone Ins. Co. Address BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN Estimated Cost 06, 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. I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, and MECHANICAL work. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of Owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: PERMIT FEE: Signature of wner- Builder Date: Notary as to Owner - Builder My Commission Expires: APPROVED: Fire rQ j Other Zoning Building 6r I �7/ 7 1 Electrical Mechanical Plumbin Engineering MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ ELECTRICAL ❑ PERMIT N° PLUMBING Work to be performed under this i Owner of ---;; Architect Contractor or Builder Legal Lot I Bl. DATE 195 9129 Contractor's License No._ Subdi- vision Address Of Value of Amt. of Building Project $ Permit $ -w r 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 iami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. t� CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ DATE 195 ELECTRICAL ❑ PERMIT N? 9311 Contractor's PLUMBING ❑ License No. _ Work to be performed under this Permit Owner Buildin, Archite _ontrac or Buil< Legal Descrir- Addres Buildin of Ct ;tor ler Subdi- ,tion. Lot II Bl. vision S Of a 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 MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ ELECTRICAL E PERMIT N° 9060 PLUMBING Work to be performed under this Permit Owner Buildinc Architec Contrac or Build Legal Descrip- Address Buildinc DATE 195 Contractor's License No. Df I A for er Subdi- Lot II Bl. vision :ion. > Of i Value of Project $ I 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 acceptfpg this permit I assume, ;esponsibllity for work done by either, }nyself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY ,THIS, LICENSE MUST BE DISPLAYED IN A CONSPICUOUS PLACE A Penalty is imposed for failure to keep this license exhibited at your establishment or place of business TRIPLICATE VILLAGE L1(2ENSE No._-,16)p -- This License Expires----&-Axww . In consideration of the sum of A* *0 Dollars $ 25*W Paid to Miami Shores Village, Dade County, State of Florida, H Y ! - __ ^T _. - - -_._ Address • � _? I !!I- __.__,_. is herebv licensed to engage in or operate the business of__+w-F1vd-1'___- ______ - durlu, c i:atxualll, ll__ s au.:y at 2 He J. 143rd_ 3U *" For the period beginning_ .W# _ 1 11 ...__- _______and ending—____6_. . k4a _ tp- subject to the Provisions, of all ordinances. MIAMI SHORES VILLAGE, FLORIDA (SEAL) , Date Issued '�� By —_ _ VILLAGE MANAGER THIS LICENSE NOT TRANSFERABLE WITHOUT APPROVAL OF THE VILLAGE MANAGER MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No.__- �C_-)_4-- `___-Z'- - - -- Date--- - - - - - -- --------- Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Cr Owner's Name and Address - - - - - -- �' No. Street• Registered Architect and /or Engineer______ ______________ l ______________________�__ �_`__________- -:___- Employing Plumber's Name.._... -'�- ��` - N Location and Legal Description Lot ------ _ ---- —___ ---------------- ______ --- ____ ----- __ Block ----------- _ ---------- _---------------------- Subdivision________________ _________ Street and Number where work is to be performed—No ------- —_ ' -�$ - - - - - -- Street - - -- -- •d i State work to be performed purpose of building (By Floors)------------------------------------------------------------------------------------------------------------------------------------- New Building---- ----- - -- - -- - - Remodeling-------------------------- - - -- -- Addition -------------------------- Repairs ------------ No. of Stories-------------- -- -- -- - - - - -- Size Septic Tank tf V_ ----------- - - - - -- -Type of Tank - -- -- - -- Feet of Drain Tile------------- - - - --� ----- V --------------- Dist. Feet of Tank or Drain Field from W Nature of Water Supply: City —Well. of Soakage ---------------------------------------------------------------------------------------------------------------- ----- - - - - -- ---- - - -- -- -- -------- - - - - --- ---------------------------------------------- (Signed) -- - - - -- - - --'-I- `-=fat --------------------------------------------- Amount of Permit $ ----- _�c__d "" --- ------------------- ------ - - - - -- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he erstands and accepts his obli ions as an employer of labor T e g pp g 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 site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contrac ors, on work to be er o ed under this permit, as are licensed by Miami Shores Village. / �. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ----------------------------------------------------------- - --------------- of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. ��� t 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. SWIM'G TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL CONTR. LIST CHECK Size Septic Tank tf V_ ----------- - - - - -- -Type of Tank - -- -- - -- Feet of Drain Tile------------- - - - --� ----- V --------------- Dist. Feet of Tank or Drain Field from W Nature of Water Supply: City —Well. of Soakage ---------------------------------------------------------------------------------------------------------------- ----- - - - - -- ---- - - -- -- -- -------- - - - - --- ---------------------------------------------- (Signed) -- - - - -- - - --'-I- `-=fat --------------------------------------------- Amount of Permit $ ----- _�c__d "" --- ------------------- ------ - - - - -- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he erstands and accepts his obli ions as an employer of labor T e g pp g 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 site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contrac ors, on work to be er o ed under this permit, as are licensed by Miami Shores Village. / �. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ----------------------------------------------------------- - --------------- of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. ��� t MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No._ —V _____ Date_____:____ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all. provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. r Owner's Name and Address -- - -- – Y –v —4EI _° No --------- - ---------------------------- Street--------------------------- Registered Architect and /or Engineer — – -- -- --- ---- ------ - --� -- - � ----------------- – ------- ---- - ------ — -- -- - - -- -- Employing Electrician's Name ------ ---- ------ - - -- -- - -- - - - --- 6_= LPL_.[ -_ No ------------ --- ---- – ------ ---------- Street - - Location and Legal Description Lot ------------ _ --------- --------- Block ------------- -- ______— ______ Street and Number where work is to be performed—No -------------------- ___ ---- �:__�'__•____.– _- .------- Street ------------ .:_r:— �_..r�__— ________. State work to be performed and purpose of building (By Floors) __ ___ ___ _______ New Building--------------- --- -- -------- -- - --- Remodeling----- ------ ----- -- -- - - - - -- Addition ..-- -- -- --------- ---- -- -- -- Repairs---- ---- ------ ------- - - -- -- No. of Stories---- --- --- - - - - -- Service Overhead Sze Feeders ---------------- Conduit - _______ —_ —___ Main Sw.____________ —_ - -_ Amps '— - — ______ Main Fuses ------------------------ Amps. Underground i Type of Installation — Conduit_________ _ _ _ _ _ __ Tubing ---------------- B.X.L ----------------- Metal Moulding -------------------------------- - --------------------- Amount of Permit $------------------------------------ -- ------------- --- - - -- -- -(Signed) ------------------------------ Electrical 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) -------------------------- ----- -------- --- ------ --- --- - -- --- - - -- -- Master Electrican. STATE OF FLORIDA, COUNTY OF DADE. as. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared------------------------------------------------------------------------------- to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the -- ----- — ----------- _ --- — ----------------------- ------------ of the above described construction, that be 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 improver notice for inspection, or faulty materials and /or workmanship. SWITCH LIGHT PLUG FIXTURES REFRIG. IRON RANGE RANGE WATER W. HEAT. SPACE STRIP OUTLETS OUTLETS RECE'P'T's NO.LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. HEATER HEATER TOTAL CONTR. LIST CHECK ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL SW. CAB. TEMP. PERM. 0-1 HP 1 -5 HP I TRANS. CONTR. LIST CHECK Service Overhead Sze Feeders ---------------- Conduit - _______ —_ —___ Main Sw.____________ —_ - -_ Amps '— - — ______ Main Fuses ------------------------ Amps. Underground i Type of Installation — Conduit_________ _ _ _ _ _ __ Tubing ---------------- B.X.L ----------------- Metal Moulding -------------------------------- - --------------------- Amount of Permit $------------------------------------ -- ------------- --- - - -- -- -(Signed) ------------------------------ Electrical 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) -------------------------- ----- -------- --- ------ --- --- - -- --- - - -- -- Master Electrican. STATE OF FLORIDA, COUNTY OF DADE. as. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared------------------------------------------------------------------------------- to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the -- ----- — ----------- _ --- — ----------------------- ------------ of the above described construction, that be 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 improver notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT' Date Permit No. ----------------------------- -- -- -- ate ______________ _______ -___ Application is hereby made for the approval of the detailed statement o f 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 ------ — _ --------- w__� .. Registered Architect and /or Employing Electrician's N -------------- - - - - -- Street -- ' f, _. -- Location and Legal Description Lot ----------------------------------- ---- ____--------- ------- Block -------------------------------------------- Subdivision----- ---- ___ - -__ -- - -___ le— '" Street and Number where work is to be performed—No --------- _�__.✓iZ! __�°�____ ________________ _____Street________ZA__.`i_ ______ ±_____________ --- _-------------- State work to be performed and purpose of building (By Floors)-------------------------------------------------------------------------------------------------------------------------------------- New Building----------- ---- --------------- - - - - -- Remodeling----------------------- - - - - -- Addition ------------ - - - - -- Repairs ---------------------------------- No. of Stories - - - -- --- - - - - -- Service Underground Size Feeders --- tZ,11______ Conduit __1 /�_�Main Sw ------ ,L_ -d._!� ---------- Amps --------------------------- Main Fuses -------------------------- Amps Type of Installation—Conduit -------------------- Tubing -------------------- B.X.L ------------------- Metal Moulding------------------------------------------------------ ----- -- -- -- - - -- Amount of Permit $ L -_ OL —S- ------------- --- --- --- -------------- - - -- -- (Signed) ,,C/ `4,ElectricalInspector. 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 5 66, 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 tie 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) - - - = =` f — - Master Electrician. STATE OF FLORIDA, l COUNTY OF DADE. I Before me, the undersigned authority, a notary public, duly authorized to administer oatlis and take acknowledgments, personally appeared- ------ --- --- ----------- -- - - - --- ----------------- --------- - - - - -- ------ ------------------------------------------------------------------ ------------------------------- to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ___. .......... ...___ — ___ ______________________- ______ -_ of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ------------------------------------------ --- -- P- - -- My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH LIGHT PLUG FIXTURES REFRIG. IRON RANGE RANGE WATER W. HEAT. SPACE STRIP TOTAL OUTLETS OUTLETS RECE'P'T's NO. LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. HEATER HEATER CO NTR. LIST J f ! J S / CHECK ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL SW. CAB. TEMP. PERM. 0.1 HP 1.5 HP TRANS. CONTR. LIST CHECK Service Underground Size Feeders --- tZ,11______ Conduit __1 /�_�Main Sw ------ ,L_ -d._!� ---------- Amps --------------------------- Main Fuses -------------------------- Amps Type of Installation—Conduit -------------------- Tubing -------------------- B.X.L ------------------- Metal Moulding------------------------------------------------------ ----- -- -- -- - - -- Amount of Permit $ L -_ OL —S- ------------- --- --- --- -------------- - - -- -- (Signed) ,,C/ `4,ElectricalInspector. 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 5 66, 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 tie 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) - - - = =` f — - Master Electrician. STATE OF FLORIDA, l COUNTY OF DADE. I Before me, the undersigned authority, a notary public, duly authorized to administer oatlis and take acknowledgments, personally appeared- ------ --- --- ----------- -- - - - --- ----------------- --------- - - - - -- ------ ------------------------------------------------------------------ ------------------------------- to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ___. .......... ...___ — ___ ______________________- ______ -_ of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ------------------------------------------ --- -- P- - -- 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. 0 • 4 " MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT . 1 ..1 7 '76 .J5�5 1p0 Permit No. -- --_ -L_ F - -- - - -- Date { - - Application is hereby ade 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. f -- -- -- - - - - -- Street--- _71Y--- �1 -------------- - Registered - - -=- Architect and /or Engine - - - -- -- — - ------------------------------- ------- ------------------ - - - - -- - -- ---- - - -- --- - - - - -- ------- - - - - -- - - r �- 7 Vii} - "=-- --- - - - - -- No.- - - - - -- 3 I � �---------- --- --- Street -- -__ �N_!!' -t - - -� - - -- -- 7 Employing Plumber's Na.— Name- ---------- :----- '-- ____ -- ____ -- __- ----- __ -- -- -- Location and Legal Description Lot----------------------------- -- ---- ---------- -- -- ------ - - -- Block-------- ----- ---------- - - - - -- Subdivision--------------------------------------------- - - - - - - - - --Ir� Street and Number where work is to be performed—No -------- X- S ------ - -------------- - _- ---------------------- Street ____11__>t---- _S /• :_ State work to be performed and purpose of building (By Floors) ______________ ___ ----9= ---------------------------------------------- ---------------------------------- -- New Building -t=---- - - - - -- - -- Remodeling------------------------- - - - - -- Addition------ -------------- - - - --- Repairs------- ------ - - - - -- - - -- No. of Stories URINALS - - -- SizeSeptic Tank--------------------------------------------------------- Type of Tank-- i- 4- ---------------------------------------------------------- Capacity Gals ------------ - -- . - - - - -- Feet of Drain Tile_____________ ___ _____a�j----- - - - - -- 'Dist. Feet of Tank or Drain Field from Well ___________________________________ ___- ________________________� � __ � ______.________ Nature of Water Supply: City - = - Size of Soak�g� 'Pit - ------------ Amount of Permit $ - - -- Y wl •7 - - - -f ' - - -- ----- - - - - -- ( Signed ,. Inspector. The undersigned applicant for this building peril does hereby certify that he understands and accepts his obligations an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Su lement, 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) - -- ---- - -- i ---- -- - - - - -- - - - - -- - - - - - r< -------------------- Master Plumber. STATE OF FLORIDA, 1 r ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the______________________________ _______________________________ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS CATCH BASIN FLOOR DRAIN DRINKING FoUNT'NS - TOTAL FIXTURES CONTR. LIST { 2 _ CHECK ('7 J Y - -7I 1�., .l F' 9 6-_. SEPTIC TANK CONTR. LIST CHECK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL r✓. H rt� SizeSeptic Tank--------------------------------------------------------- Type of Tank-- i- 4- ---------------------------------------------------------- Capacity Gals ------------ - -- . - - - - -- Feet of Drain Tile_____________ ___ _____a�j----- - - - - -- 'Dist. Feet of Tank or Drain Field from Well ___________________________________ ___- ________________________� � __ � ______.________ Nature of Water Supply: City - = - Size of Soak�g� 'Pit - ------------ Amount of Permit $ - - -- Y wl •7 - - - -f ' - - -- ----- - - - - -- ( Signed ,. Inspector. The undersigned applicant for this building peril does hereby certify that he understands and accepts his obligations an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Su lement, 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) - -- ---- - -- i ---- -- - - - - -- - - - - -- - - - - - r< -------------------- Master Plumber. STATE OF FLORIDA, 1 r ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the______________________________ _______________________________ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. • w �m UILDING - ECTRICAL LUMBING wner of gilding MIAMI SHORES VILLAGE, FLORIDA 1,61 DATE �" f' PERMIT N° 8672 Contractor's License No._ Work to be performed under this Permit_ r r rchitect ontractor� .. Builder egal / Lot Bl. description of Subdi- vision Value of Project A'"`.... 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 appli- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any ans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked 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 rmit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and ulations pertaining to the work covered hereby whether shown on the plans or drawings r in the stateme s or specifications and that he assumes respon- ty for work done by his agents, servants or employees. Signed: a...BY' s' °'., INSPECTOR � In sideration of the isuance to me of taxis permit I agree to perform the work covered hereunder in compliance with all brdinaices and regulations rtainin j thereto and in strict conformity with tho plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. accepting this permit I assum esponsibility for ail work done by either myself, my agent, servant or employee. "` OR BUILDER AUTHORITY y,o BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ Owner of Building Architect Contractor or Builder Legal Lot Description MIAMI SHORES VILLAGE, FLORIDA DATE. 19 PERMIT xo 3756 Work to be performed under this Subdi- vision Contractor's License No. 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 applica- tion 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 respon- sibility for work done by his agents, servants or employees. 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 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 ABBOT PRINT CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION 1!T° 93" Miami; Shores Village, F1 a., f. Owner, Agent or Tenant of Building Lor ✓ y� ► Block -j Subdivision r ' Street Address �� •+' ` Approved use by occupancy, - Remarks This Certificate of Occupancy is issued-110 the above named for building at above named location only upon the`'express provision that the applicant will abide by and comply with all conditions of Drdinances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores e eling.; f buildings I'ruc%iVTTii lla L Pertaining to the erection, construction, alteration or r Run a s` iITN 7iCTl1N MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ DATE ELECTRICAL ❑ ❑ PERMIT N° 9076 Contractors PLUMBING ❑ License No._ Ow er c Buil 'nc Archit c Contrad or Build Legal Descripi Address Buildinc Work to be performed under this Permit 95 Df r — a ior r Subdi- Lot Bl. vision :ion. S Of I Value of Project $ Amt. of Permit S This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A :further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY Miami Shores Village • � uilding Department OCT C 2 1 2008 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY" Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit NoJ:J Onm PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type: Electrical Owner's Name (Fee Owner's.Address City ; ml� g C� State �i 1 Zip Tenant /Lessee Narne Phone # E -MAIL: Job Address (where the work is being done) p?5 / V C— /D 57- City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES _ NO _ 9W Contractor's Company Name — % +A4 1 L &- :: � Phone # 95 - t 4'�c�9 $? 71 Contractor's Address 7 S 3 r o J�sN �/ L Svc— I* •" /�,1 , \ 9 City /� � _ fC "�(�- / State r �-- Zip 3 -�--� v I/ Qualifier Name o 5�^1 y �TLL Phone # S $�g 1 State Certificate or Registration No.,i 5CD /?� 3 Certificate of Competency No. E -MAIL: Architect /Engineer's Name (if applicable) Phone # Value of Work For this Permit $ 6'0a, C-6 Square/ Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New Repair /Replace ❑ Demolition ******* ** ** ****** ******** **** ********* Fees************* ***** **** * *** *** ** * * * * ** * * * * * *x Submittal Fee $ Permit Fee $ /!'%yjOp CCF $ • .0 CO /CC Notary $ Train ing /E3ucation Fee $ G.% Technology Fee $ 2,5) Scanning $_ W Radon $ DPBR $ Bond $ nEj!e Structural Review. NOV 0 5 MIAMI SHOES Nfil I Zoning $ Double Fee $ Total Fee Now Due $ IUb • 3� See Reverse 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 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 [N 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. DYt:�,-,Z T Signature Signature Owner or A Contractor The foregoing instrument was acknowledged before me this day of ?* (P 20 OK, by Al i LO IC q Lt \' I who is personally known to me or who has produced t\ �✓kst c3 As identification and who did take an oath. NOTARY PUBLIC . STATE OF FLORIDA NOTARY PUBLIC: ' -;D. C. McField- Jean - Pierre =Commis ion #DD654070 ,,.' Expir NLAR. 22, 2011 Sign: - o, INC. Print My Commission Expires �ko APPLICATION APPROVED BY (Revised 02/08/06) The foregoing instrument was acknowledged before me this day of $- 7 20 �d, by �eV 5oL\J L'�(- 1,e > who is personally known to me or who has produced � fst &N as identification and who did take an oath. NOTARY Pe&f BLIC - STATE OF FLORIDA k� l D. C. McField- Jean - Pierre Commission #DD654070 Ex MAR Sign: Print: l `E? My Commission Expires: 3/2,2-/11 Examiner Engineer Zoning MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buil i g Inspection Request Date 7 'hype Insp'n Permit No. 0 a Name ) Address 103 JV Company Phone # Inspection Approved Correction ❑ Re- Insp'n Fee ❑ fF f l j! ff tik Y L- a MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buil g% Inspection Request Date / Type Insp'n C Permit No. 05 — � / Name ) Address A �ff 103 Company Phone # Inspection Date Approved Correction ❑ Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No ------------ - ----------- ------ 5- 176 Date - ------ - - - --- Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. �r Owner's Name and Address - ---- -- ------ - ----- - --------------- - •---- --- °Street 21-S4.-J-42-3 " Registered Architect and /or Engineer -__ -_ __ Employing Plumber's Name. ------- _ _--- - - - - -- No. --�- r - -- --- - ----- Street..---- -- -- •• -� - - -� - -- - . Location and Legal Description o t___ Block --- _ -- . ---------- --------- Subdivision ------ :------ --------------- _- / 2 C - Street and Number where work is to be performed- No._____�- ___________ —__ ____.____ Street ------ - -- - 1_____,l_- !s7_.____________ State work to be performed and purpose of building (By Floors) ----------------- - ---- - --- - ------------- - ------ - ----------------------- ----------------------- ---- ------ __... New Building--- -------- --------- -- ------ - - - --- Remodeling -------- --------------- - - - - - -- Addition ---- -- �_- __--- - - - -- Repairs----- -------------- - - - - -- No. of Stories -- -.-- Size rt ze Septic Tank..... `_ 4!-- �--- -------- -- ------- - ------ - ------ Type of Tank ----- ------------------------------------------------------------ opacity Gals Feet of Drain Tile ----- - ---------------------- - ----- - __ --- _ __Dist. Feet of Tank or Drain Field from Well_ Nature of Water Supply: City - Well ---------------------------- - ------ - ---------- ____ - ------- Size of Soakage Pit- ------ - ------ Amount of Permit $-------- - - - - -A .._ P----------- _._---- .------------ - - - - -� ( Signed The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatidiis 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)__ ---- -- - - -- - - -- ----- - - - - -- Master umber. STATE OF FLORIDA, 1 �, COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the -_______-_-______-_-_____ _- ___-- _- _________.- ___._ - -___- -- ----- 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 -- Expir- es 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. SWIM'G TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL CONTR. LIST CHECK Size rt ze Septic Tank..... `_ 4!-- �--- -------- -- ------- - ------ - ------ Type of Tank ----- ------------------------------------------------------------ opacity Gals Feet of Drain Tile ----- - ---------------------- - ----- - __ --- _ __Dist. Feet of Tank or Drain Field from Well_ Nature of Water Supply: City - Well ---------------------------- - ------ - ---------- ____ - ------- Size of Soakage Pit- ------ - ------ Amount of Permit $-------- - - - - -A .._ P----------- _._---- .------------ - - - - -� ( Signed The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatidiis 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)__ ---- -- - - -- - - -- ----- - - - - -- Master umber. STATE OF FLORIDA, 1 �, COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the -_______-_-______-_-_____ _- ___-- _- _________.- ___._ - -___- -- ----- 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 -- Expir- es 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. C�✓t (� > -% ;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 build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date - / ------- - 2!� - -- -- -- - - - - - , 19-- -�L _. Owner's Name and Address._ .?h - -------------- - -- - -- -- - -- ----------- - - ---- No.---. -`• -- - --- --- t � � ` - - -- - --- - Registered Architect and /or Engineer Name and address of licensed contractor_, Location and legal description of lot to be built on: Lot :_._ , < -- - -- 'Block - -- - - -- -- ---- - - - --- Subdivision ------ �n�& -------------------- - - Street and Number where work is to be done_________ _________________ -! -'_ State work to be done and purpose of building (by floors) ---- Z / -------- 43�_______I ?'_- ____:_ . _ ----------- -- ----------- -------- --- ----- - --- -- -- --- - - - - -- ---- -- ---- ------ -- ------ = - r _ �z -------------------------------------- -------------------------------------------------------------- ---------- ----- ---- -- - - -� -- -- -- - --- ------ �- - / - - -` -- - -- - -- -------- - -- - - -- --- - -- - -- - - -- ._'and for no other purpose. New Building- ------ -------- ----- -- -- - - -- Remodeling. ------------------------ Addition-- •---4/ ----- - - - --- Repairs--- - ----- -------- -- - - - -- No, of Stories.. - -- - --- - - - - -- To be constructed of ---------------------------- Kind of foundation-. --------------------------------- ____.______ Roof Covering_/_____ _:_.r_"'- 5- __�:_- -------------------------- Estimated Total cost of improvements $ ------.. �- «--- ---- ------- --t - 3 C? - -- ---- -- -- Amount y of Permit $- ----- -- ---- ---- --- --= Zonecubage required--------------------------------------------- ---- --- --- ------- -- ----- - - -- -- -Plan Cubage------ ---- -- ------ ------- ----- - -- - -- --- -- - - -- ----------------------------------- Distance to next nearest building _---------------------------------------------------- _------ Size of Building Lot --------------------------------------------- ------- -------------- Maximum live load to be borne by each floor ------------ - - -- -- - - - -- - - - --- - -- -- -- - - - - --- ----- -- -- -- - - - - - -- u I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may beserif: to ---------------------------------------------------------------------------------------------------- - - - - - - - - The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, o .,work to be performed under this permit, as are licensed by Miami Shores Village. c x t 7 Remarks --- - - - - -- - - -- -- - - ---- --- -- - - - - -- - ---- !� u (Signed) - f - - °- i, � STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. c Permit No._ -__` -f _____________ Date _/7" �� �� - -1� _Z Read, Sworn to and Subscribed before me. Disapproved (Signed) __II BOARD-- -------- - - - - -- - ---------------------------------------------------------------------- Notary Public, State of Florida My Commission Expires --------- TE Chairman---------- -----------------------------%- --- �--------------- ------ -- -- ---------- - - - - -- Member ------------------------------------------------------------------------------------------------- Member----------------------- ----- --.-------- - -- - -- --/---------------------------- ---- ------ ---- - - - - -- Member ------•------------ ------ -- ----------------- - - - - -- -- - - - - - -- Member .- ----------- ----------- --------- - - - - -- Member ---------------------------------------------- --- -- - - -- ------------------------------------------------------------------------------------------------ Council Approved----------------------------------------- ------------- ------- ----- - - - --- -Date Disapproved ---- -- ------- - - - - -- - - ----------- --------- - - - - -- - ---- - - - --- -Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. JEIMINSS, Clt--.rence G. f 25 N.E. 103 St. Shores, Florida Lot 15, and Westz of Lot yJA! I SLOP , actor di nIg in Plat Boole 19, Paoe 47, Dade C >unty,Florida May 18, 1950 Fiu, Case No. 09- 046899 City rlobtga�De & Loan Co. 1350 N.'u. 36 St. Iiami,Ylorida 16, Bloc.,: 123, Section 14o. 5, to the Plat thereof, recorded of the pub Lic ice-cords of Earle Chandler 3118 N. W. 57th St Miami, Florida i v v MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No .......................................... Date... , � ! • D 'x-' 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 `tillage 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.. ............ . ... %G .... RegisteredArchitect and /or Engineernn............../....,..............• �j ........................................................................................................................ ............................... Employing Electrician's Name......; � .!YL./ X... /1.... � : ...... ........................No.j%._ c d. .__......................Street i✓ ...�: '.'T ......... Location and Legal Description Lot ..................................... ............................... Block.....-- --- ............................ ...Subdivision................ Street and Number where work is to be performed— No ................................... ............................... Street...!!.. :....!............:............ State work to be performed and purpose of building (By Floors) New Building ............ .................. .. Remodeling. ............................... Addition ......... :...._............ Repairs----•---.. ......................._....No. of Stories ......... ........... Overhead ji nd Size Feeders....:... ........Conduit..%:.....,.Main Sw .. .............................Am p s ...... �. .......... Main Fuses . ...........................Amps ar U LID, a Type of Installation — Conduit ........................ Tubing ........................ B. X. L ......................... Metal Moulding ..................................................................... ............................................................................................... ............................... ...... ................................................................. v ............................................. .................................................................................................. ............. ..... .................... Amount of Permit $ ............... ....................... (Signed) ..... ,.r........................... ................... ............................... Electrical nspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts hi bligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flot'i Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub• tractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of 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_psrformed under this permit, as are licensed by Miami Shores Village. (Signed)._.. :.... .............. ..... -- �.. ........................... Master Electrician. STATE OF FLORIDA, 1 COUNTY OF DADE. It ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared............................•------............... .................................. ............... to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ........................................... ............................... of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ................................................................................ ............................... ............................................................................... ............................... My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re• inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH LIGHT PLUG FIXTURES REFRIG. IRON RANGE RANGE WATER W. HEAT. ACE HATER STRIP TOTAL OUTLETS OUTL475 RECE`P'T's NO. LAMPS OUTLET OUTLET OUTLET CONN, HEATER CONN. HEATER CONTR. LIST .,J -- �♦ a' CHECK ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL SW. CAB. TEMP. PERM. 0.1 HP 1.5 HP TRANS. CONTR. -- LIST CHECK Overhead ji nd Size Feeders....:... ........Conduit..%:.....,.Main Sw .. .............................Am p s ...... �. .......... Main Fuses . ...........................Amps ar U LID, a Type of Installation — Conduit ........................ Tubing ........................ B. X. L ......................... Metal Moulding ..................................................................... ............................................................................................... ............................... ...... ................................................................. v ............................................. .................................................................................................. ............. ..... .................... Amount of Permit $ ............... ....................... (Signed) ..... ,.r........................... ................... ............................... Electrical nspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts hi bligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flot'i Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub• tractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of 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_psrformed under this permit, as are licensed by Miami Shores Village. (Signed)._.. :.... .............. ..... -- �.. ........................... Master Electrician. STATE OF FLORIDA, 1 COUNTY OF DADE. It ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared............................•------............... .................................. ............... to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ........................................... ............................... of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ................................................................................ ............................... ............................................................................... ............................... My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re• inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. 5 MIAMI SHORES VILLAGE, FLA. N °_ 1251 JOB lLj ADDRESS �- Al r Z.40 3 INSPECTION C2 ✓""`^`" .%� TIME READY (� REMARKS: INSPECTOR �!_. DATE �? Dl� MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENK-` APPLICATION FOR PLUMBING F'�;�,MI .-,,z "? -0 Permit No. - - -- ---- ------- --- --- - - - - -- Date------ - - - - -11/1/61 ------ ----- - - - - -- 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___ J!__ -'d b ___ No.__.- __2f - Street ----- 103rd Registered Architect and /or Engineer ------ Brooks ... Sprinkler Coe ------------------------------- •---------------------- - - - - -- ------ - - - - -- - Employing Plumber's Name ------------------------ -------- ----------------- --- ----- -- -- --- -- ----- No --- ---- - --------- -------- - -------- Street---------- -- ---- Location and Legal Description Lot --.- -------------- - --- --- ------------- __ _ Block--_----- ------- _ ---------- --------- Subdivision ------------ --_-_------_----- --------------- Street and Number where work is to be performed—No -------- 2 E ______ -- -- ........... Street- ._. ....... 103rd----------------- ------------------- ---------- State work to be performed and purpose of building (By Floors) ------------------------ - --- -- ------------------- - -------------- . --------------- .- ----._-- . - - - -- ---------- New, Building------- ---- --------- ---- -- -- ------ Remodeling ----- __----------------------- Addition------. ------------------ Repairs ------ - - - -_. ---- -_. -. --- No. of Stories.._ Size Septic Tank ------------ _ -- .Type of Tank------------------------------- ----- --- ------- -- -- --- -- - -- --- ---Capacity Gals.- - ----- ......------ -- -......- -....- Feet of Drain; Tile ------------------------------------ - ------ -- -Dist. Feet of Tank or Drain Field from Well .--------- - - - -_. Nature of Water Supply: City—Well ------------ G<_ ----------- - ------ - ----------- --- ------- Size of Soakage Pit-------- - -- - -- nod- - - - - - - - ----------------------- r °- r------ �------------------------------------------- Amount of Permit $ - - - - -- -rj - ---------- - -- — - - - - - - -- - -- — — - -- ( 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) - -- ------ •-- r -- - - - -- -- lldastiiir. 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 hirn 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. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR. SWIM'G TANK CONK. FIELD PIT TRAP HFATER WELL SYSTEM POOL -- CHECK Size Septic Tank ------------ _ -- .Type of Tank------------------------------- ----- --- ------- -- -- --- -- - -- --- ---Capacity Gals.- - ----- ......------ -- -......- -....- Feet of Drain; Tile ------------------------------------ - ------ -- -Dist. Feet of Tank or Drain Field from Well .--------- - - - -_. Nature of Water Supply: City—Well ------------ G<_ ----------- - ------ - ----------- --- ------- Size of Soakage Pit-------- - -- - -- nod- - - - - - - - ----------------------- r °- r------ �------------------------------------------- Amount of Permit $ - - - - -- -rj - ---------- - -- — - - - - - - -- - -- — — - -- ( 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) - -- ------ •-- r -- - - - -- -- lldastiiir. 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 hirn 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. CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION N° 1425 5 -15-63 Miami Shores Village, Florida, Owner, Agent or Tenant of Building BURDEN Lo It 5 & W1216 _ Block 123 Subdivision Miami Shores Street Address 25 N. E. 105th St. _ Approved use by occupancy n -- - -- 3562 Addition - bedroom and bath This Certificate of Occupancy is issued to the above named owner for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of build' or str tures. Plan Cube 32762.91 Tax Value 12881.45 L BUILDING DIVISION MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereb made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure h ein described. This 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 Buildiri 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. Date_.• -- - ------._..„ .._- ......------ ....__.._.,194 .9:- Ownees Name and Address... __!---�� _ ---.__----- •-------------------- _ - - - -__ No. ��- -- -___ -. Street -Z _7 -- Registered Architect and�or Engineer.__ _; ?'P✓` - -• -_- � �1! �j�-. �P,�Q[`� �'� -_-• - -• - -- Name and address of h4nsed contractor - -- _ -- __ ° , „ - -__...--•----------•-------...._.__-- Location and legal description of lot to be built on: Lott . - - - -- Block_-/-,7-.- _ ....... - ........... Subdivision_AY/Ve------ �/�C'_ Street and Number where work is to be State work to be done and purpose of building (by floors)--'_ --'-' ._�'__..�1�''�Q1'��C�_.�it/�ij' nt_ --------------- ----------------- - - - - -- ------------- - --. ----- _ - - - - - -- ----------------------•--------------------•-------- •-- •------ ....._ _ --_- ------ - --- - -------------- --- •---------- _ _- _ _ _---------------- _--------- ____- - - -__- - -- __....and for no other purpose. New Building- ----- ---- -- -- •-- -- - - -- -- Remodeling-- ---- ---- -- --_ - - -- - - -- Addition_ Repo-in -- ----- _- •--- ---------- No. of Stories.--•-/---•-- ---- •- - - - - -- To be constructed of --- 4Y,%,_5 r--------- Kind of foundation.._4rawe'4 f�--------------- ---- - - - --- Roo�Covermg�./fti�-f.7'!�1f� � - -_ - -• Estimated Total cost of improvements $_ j_ ��e- B_-�....... - ----_..... Amount of Permit $ ----- 1 1Mtw.. „ ...................................... - ----- --- - - - - -- __ - -- -- _.- _ Plan Cubage -3j 4-7- - 1 0.t.T. r - - -- Zone Cubage required. -_ ��__�. _ r Distance to next nearest building ------- - .--- _-- _------- -- .--- ._ -_- -- -Size of Building Lot -�__� �° / �� �-- _------ _- - - - - -- ------------------------ Maximum live load to be i borne_ by each floor _----- •- - - -_ - - - - -- -------- .._._. + Y, -- - _ -•-----------•------------------------ I hereby submit all a plans and specifications for said building. All notices with reference to the building and its construction may be sent - - - __.______ __ ------ •- __ -_ -_- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 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 perfo ed 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 y the Act. The undersigned agrees to employ only such subcontractors, on coo 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 unde signed authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared- __----- ____.___ - _ T_-------- •---- ___----------- - - - - -- __ ..-- - - - - -- __. ..__ - -- - -. ........ - __ ..__� __- to me well known, and who, being by me 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.- Disapproved (Signed) Chairman .. Member Member ...._ Council Api Read, Sworn to and Subscribed before me. Notary Public, State of Florida - - -- My Commission Expires ----------------------------- _----------------- ------- _ ---- ______ - -_ Member _ - --------- - - - - -- -- -- - _ Member _ - - - -- _ _ _____ - .______...---- - - - - -_ Member ------ - - — - - -- -- - -- Disapproved -- •-- --- -- - --- ------ - - - - - -- ----- ---Date NOTE: A charge ofi $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 o£ $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. f� z° 3� P� J— s plate C- 0LCL: -Lcp= ?-`- yc 1(c:- c? x t 1= I .— 3,, "i ts2.. °t t 5" 1Am Iz oz 2- 3r MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is here the build- c ure of Miami Florida build- ing her ot g Or, Building s Village, : the rules and tio plans Cat. and 'on approved Owner's Name and Registered Architect and/or Engineer ...... ........... - -------- - ------------ Name and address of licensed contract5 Location and legal description of lot to be built on: Block.------ --- ------ --------- _ - - - -.- Subdivision.._.. Street and Number where work is to be done------- -- ---- --- --_-_. State work to be done and purpose of building (by floors) --------------- e .......... 119 --- - ­- ... ........ ...... — - -- — ---------- ----------_------------- ------ — --------------- - - - - -- for no other purpose. New , Building ----- ------ . ........ ...... Remodeling---- - - - - -- --------------- Addition .......................... Repairs-------------------- - - - - -- No. of Stories .......................... TO be constructed of - - - -- .........• ...... ----- Kind of foundation ---- ---------------------------------------- - ------_------ - - Roof Covering ........................................... __.. Estimated Total cost of improvements $ ------------- ------------- - - ---- - --- - - ---- - Amount of Permit $..CP- — ----------- - --_---------_------------- - -------- Zone cubage required--- Cubage ---- - --- - _.._------------------------------------------- •--- - - - - -- Distance to next nearest building---- .__----------- _- - -_ -_- of Building Lot----- _------- ._.__._._. — --- - — -------------------------------------- Maximum live load to be home by each I hereby submit all the glans and specifications for said building. All notices with reference to the building and its construction may be sent to- - - - - -e The undersigned ap 'cant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Aori Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks.-- STATE OF FLORIDA, COUNTY OF DADE. I ss' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aelmowledgments, personally ap- peared--- - - - ----------- - ------ - - - - — -------------- — -- - -------------- - - - - - --- ........... me well known, and who, heir by me first duly sworn, upon oath deposes and says that he is the - --------_------------- ------ - ------------- ---- — -------_--_--------------- - -- - -- - e of the above described construction, that he has carefully read the foregoing application, and that he did sip the same, and that all facts therein by him stated M . I t Permit No. Date.____ Sworn to and Subscribed before me. Disapprove (Signed) Chairman Member . — ------- - -- - ------------- - - -- - - - Notary Public, State of Florida My Commission Expires- -- --- --- -- -- - - - - -- ------ - ------------ --------..DATE Member -- - - ----_------------- _ lWelnuer Member ------ Member CouncilDisapproved ------ - - - ---- ----------------------------------------------------------------- Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. MIAMI SH S VILLAGE BUILDING INSPE ON DEPARTMENT APPLIMATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ins or other structure described. This application is made in compliance and conformity with the B dWin Ordinance of Miami Shares Village, Florida, all provisions of the Laws of the State of Florid all ordinances of Miami Shores V ge 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 4 plans and specifications ust be kept at building during progress of the work. t Date ._.._ .. ._......- - -.,19 Owners Name and Address- - ! Name and address of housed Engineer.- _--- ____ -- - -_- _ - .-- -___.- - -- an sensed contractor - - - -- - -- - ����''�'. -.�. —� . - - - -� -. _..._ _--d =L - _.........___.__. Location and II gal description of lot to be built on: (� Tote_ -- Block�_°� �_ —__ -- Subdivision...- J _ 6- Street and Number where work is to be done--- Z 6 -7 State work to be done and purpose of building (by floors)._ -. n ---vc�(/---- New Building _.__. —. -and for no other purpose. Addition-------- - - - - -- Repairs --- --- - --- __ _.__ No. of Stories ...... . To be constructed of_ -. -_ -_ Kind of un ___ _ _ _-- -_ -_ -- Roof Covering__._. .... _.._.....__.._..- ..... ._.._ . Estimated Total cost of improvements $_— Amount of Permit $_ � ®� Zone cubage required - - plan Cubage —_- Distance to neat nearest building_---------. ------ --- - - - - -- _____._Size of Building Lot- -- Mamimum live load to be borne by each floor - -_ _ -- ------- __ -_ -- _.- ---------_-------__-_-- I hereby_ submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to - - -_ -_ The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provision 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 k such public notice or notices as are required by the Act. The undersigned agrees to employ only such su on k to ormed under this permit, as are licensed by Miami Shores Village. ,� iirk Remarks_ - -- -__ -- _ -__ -- - - -. STATE OF FLORIDA, COUNTY OF DADE. j M ( Signed) Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments; personally ap- peared _ ..... __ _ to me well known, and who, be3sg 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 st jted(�,�'tru�e. , Permit No. —L ` _�! Date____ Read, Sworn to and Subscribed before me. ( Signed ) Chairman Member . Member Notary Public, State of Florida Building Inspector A - L_- ",, My Commission Expires_-------- - - ----- BOARD __- -------- ___.- - ---- ._- _...___.— __DATE Council Approved--_-- -___- ____ - ---------- ----- _ -_ - -- -_Date Member - -- - - - - - ----- - - - - -- - - -- - Member-- _ - - - --- - ---- -- ------- -- ---------- --- ----- --- Member Disapproved- --- -- -- - --- --- •----- ---- --- -- _- - - - - -- ------------ - _- - - -- --- _--- -- -Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has bren 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 insprt tion or faulty materials and /or workmanship. i -L, " o MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby wade for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State o1 Florida all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be compliQ with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during pi'pgress of the work. Date. JyMe 12 Owners Name and Addr $s. .............F..strle x° Pllill.�ip5 ................... No— 21— StreeL_U,..r ". Z 0-.3Y'L.3t . Registered Architect and /pr Engineer ...... ............. ._............... .... .................. . • »_ •• • ••t••` »- !nssttt ermx• nfexxttem [sfetns :mmefzzf::sxx••••••• Name and address of licensed contractor........... Biscayne Roofing Co. 518 0 E. 11 Ave. Hialeah Location and legal description of lot to be built on: -rte Lot_ It ,(_2_ J ........ Block ._..... Subdivision .__. - -5 :__. ._._.._......_..... ..._....... Street and Number where.work is to be done._...__25. N • 10]r'd Stredst State work to be done and purpose of buildin (by floors). Re -roof Residence .fie Roof : Tin s jap 1 -30;# felt, mop 1-9 , slate apply white , flat the . Flat Roof: Tin ap 30 f'elT9 mop _30 felt an �= asbestos t coa y�i�Ch uminum _._ ............. ... .... _- ..................._ ...... ._....._.�.. _.._ » _ ........an l d for no other purpose. New Building .............. .............. . Remodeling ... -- ........... ........ Addition .......................... Repairs:........ ............. No. of Stories._1. ....... ___ To be constructed of ............................ Kind of foundation........_..--. .................................. .......... hoof Covering..... T..1 e... & Imo o th Estimated Total cost of improvements $ L2Ya 1.0 0.... ._...........- A,mount of Permit 5 ..............._............ _......_.................. Zone cubage required -- -------- :..._._ ..._... .._.. ».. .-- -. ....__plan Cubage._.. . _....._....... _ ...» .... Distance to next nearest buil ding ................. - ._ ........ _..._ ._- _..._Size of Building Lot__ Maximum live load to be borne by each floor- ............. _.--..-._. _ .... __ ............... - _ ... - --- - - - -.. _ _ _ .. .......................... I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to ........B sca�me_.- oaf ng.- .���_... X184. •.....1.1....�V . - .... -._k _ i.e� �_... 1 .�...... The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an .employer of labor under the Flori da Workmen's Compensation Act, being Section 5908, Compiled Cenral Laws of Florida, Permanent Supplenient, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed .under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors. on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed )...._.. STATE OF FLORIDA, COUNTY OF DADE. I so' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared___ _-_.- ........ M ....... - ... _..... ............... .... _.... . _ to me well known. therein by him stated sere duly sworn, upon oath deposes and says that he is the .... .... ............. . ...... ._- ............. .....___. __ ..........__...._.._ of the and who, being b me construction, that he has carefully read the foregoing application, and that he did sign the same. and that all facts true. Permit No. .:: ,2 ._...... Date.__.' ?_ Read, Sworn to and Subscribed before me. Disapproved .�..�.a�....... __.. (Signed)f Building g Chainnan .._...... Mernber Member .. ... .. ............. .. .............................................................. _ Notary Public, State of Florida Expires..._..._._._....... BOARD _..........._ ....... ........... .........._._... -DATE 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 Plannin.- Board. A re- inspection fee of 81.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. S tD �2-ItpV.- NP&DS E C E WE ®c ,Y n HOME OWNERS NICOLE GULLET 25 N.E. 105RD ST MIAMI SHORES FL 33138 REPLACEMENT OF ETER CAN (150AMP) BROKEN LUG IN OLD CAN. #6(G) IN 1/2" CONDUIT TO (2) 5/8" DIA. x LOFT .ONG CLAD STEEL GROUND DRIVEN RODS, SPACED 6 FEET APART, TO C.W.P. ELECTRICAL RISER DIAGRAM SCALE: N.T.S. • Harry sley (o) 1950 $12.00 12 -31 -50 — c N. s. seer. ADDRESS 25 • $• 103rd street LEGAL_ 15 16• Bl•_ 1 23 R Fr. F-1 R- n GAR BAG F--TAX- PAID BY YEAR ANNUAL TAX - ------- - - - - -- -- PERIOD USED - AMOUNT PAID DATE PAID RECEIPT NUMBER Harry sley (o) 1950 $12.00 12 -31 -50 — c i OWNER'S NAME f PRESENT ADDRESS LICENSE NO. PHONE NO. { JOB LOCATION (ST. OR AVE.) LOT I BLOCK SUBDIVISION . IS * W ply W !7--s I �i r w�'� ° ` Fr�r�►. s GENERAL CONTRACTOR ADDRESS PHONE NO. LICENSE NO. _�_ � � . �QI� STTb u c.'f ►.Chi 5 �o G �S� s�' • Nt �e.�ta.� �aZo'� , BUILDER'S BOND BUILDING PERMIT NO. i� DATE Z PERMIT FEE O e NO. DATE I ZONE REQUIREMENTS U. FT. PLAN CUBE 3% ��.� t CU. FT. EST COST S S?►�O DATE L, DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: �' 11 I NEW CONSTRUCTION STORIES CONSTRUCTION INTERIOR/ CONSTRUCTIO^N. -- I �jTYPE I i � I ,,,ROOF i)Y 14 •J�/ 'i.✓ DESCRIPTION REPAIRS +r • ALTERATION % SCRIPT( l` /f e d ADDITION APPROVED I REJECTED (REFERRED TO COUNCIL( REASONS SUBMITTED TO PLANNING BOARD RE- SUBMITTED TO PLANNING BOARD REMARKS SUBMITTFD TO VILLAGE COUNCIL CERTIFICATE OF OCCUPANCY NO. I ISSUED I BY ll?1 6 I TO Aa�Gr✓ '��✓ 43UILD NG -- FW - ;o{u: - -J4iUfl #Ia1 i E iQN -- R 3�-- 1ufi/lML ISSHOREr9ir VII I AGIr �0 M Z klk 3UQ' BUIL_ DING INSPECTIONS &AJLVI " - INSPECTIONS DATE BY INSPECTIONS DATE BY FOUNDATION H. W. HEATER CONN. ROOF $ RANGE CONN, REAMS & LINTELS _ I $ POOL W. HEATER CONN FRAMING FIXTURES AIR COND. $ RANGE CONN. FINAL Is CLEAN UP I SLAB I FIXTURES & FINAL SLAB PLUMBING PERMITS _& 1. SPECTIOINS CONTRACTOR 4 0 m C*- C I M / / } PHONE y� PERMIT NO.*'.� I , DATE / - L FEE $ NEW BLRG. I ALTERATION I ADDITION REPAIRS SPECIALS PERMITS I PERMIT NO. DATE FEE TEMPORARY SERVICEI $ SEPTIC TANK, I $ SEWER- SOLAR HEATER $ GAS I I $ I$ INSPECTIONS DATE I BY RE- INSPECT BY RE- INSPECT BY ROUGHING TUB & TOP OUT SEWER SEPTIC TANK SOLAR HEATER FIXTURES GAS NEW BLDG. I ALTERATION I ADDITION I REPAIRS DATE SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE TEMP. SERVICE $ H. W. HEATER CONN. $ RANGE CONN, $ MOTORS W. HEATER CONN $ FIXTURES $ RANGE CONN. Is INSPECTIONS DATE BY RE- 1NSPECTI BY RE- INSPECT BY TEMP. SERVICE ROUGHING W. HEATER CONN I RANGE CONN. I I FIXTURES & FINAL APPROVAL TO POWER CO. FOR SERVICE DATE BY OWNE E,^ PRESENT ADDRESS �� '' .,, ENSE NO. PHONE NO. ELEY, HARRY 1.34 N. W. 29th street JOB LOCATION (ST. OR AVE.) LOT BLOCK SUBDIVISION 25 N. E. 103rd Street 115 & wi lb 123 ' ami Shores Sect, MO GENERAL CONTRACTOR ADDRESS PHONE NO. . LICENSE NO. Omer-Builder 34 N. W. 29th Street BUILDER'S BOND BUILDING PERMIT. NO. 8M J DATE I PERMIT FEE S M,00 NO. 932 DATE ZONE REQUIREMENTS 18.5fl© CU FT. PLAN CUBE __19v "6 CU. FT. EST. COST $ `�l000000 DATE DRAWINGS SPECIFICATIONS, RESTRIGTIOWS AND CUBE CRECKEI? TYPE._ , STORIES ROOF CONSTRUCTION INTERIOR CONSTRUCTION 8 I NEW CONSTRUCTION CBS I 1 File 1 Oak - Floors - Plaster Walls - DESCRIPTION REPAIRS IdT Rm - Din Rm --Kit.-, 2 Bed Few - 1 Bath - 1 car att• gar, -DESCRIPTION ALTERATION ADDITION APPROVED REJECTED REFERRED TO COUNCIL I REASONS SUBMITTED TO PLANNING BOARD RE- SUBMITTED TO PLANNING BOARD I REMARKS SUBMITTED TO VILLAGE COUNCIL �}}'�� CERTIFICATE OF OCCUPANCY NO. _9 X7 ) ISSLED 7/19/50 BY JM I TO q� �aGisJl +ti•1e� _t�l� sth_Mwtt - - -- - - _ -— -- t3ti1LBillf�- f�EF2iNii'-AidLi" iATSFEC- 7'- a3I I= RErvo.. �= �'A�VI- t�#d€S#ES�1LI�AGE - -- - °- I BUILDING INSPECTIONS �I IN� PgCTIO �S DATE BY RE- INSPECT BY RE.INSPEC I 13Y FOUNDATION -` Z TDB BEAMS & LINTELS JIM 'FRAMING FINA',I A '. M-975-0 dial CLEAN -UP PLUMBING PERMITS & INSPECTIONS I',pp��8erl To C PHONE ear PER 'IT NO. i1.12329 DATE .9 0 FEE NEW (BLDG. eM1 A TERATION ADDITION R PAIRS SPECIAL PERMITS PERMIT NO. DATE F TEMPORARY SERVICE $ SEPTIC TANK O=GriCr 9 V�6 Z O $ •Oq jl SEWER $ SOLAR HEATEN $ INSPECTIONS. DATE BY RE- INSPECT BY RE- INSPECTI BY, ROU HI G fl viµl 0 GAS SEWER SEPTIC TANK 6 O JIM SOLAR H TERI FIXTURES ELECTRICAL PERMITS & INSPECTIONS CONTRACTOR `, J® 77++11 Electric lectric Co. PHONE © ,PERMIT NO. 7�1i DATE J 9 50 FEE 3 10 +c Y5 iNEW LOG. $ ALTERATION ADDITION REPAIRS $PEdlA1., #ERMITS PERMIT NO. DATE Fd TEMPORA'RYSg RVICE 9076 3191so $ l,pQ',' H. W. HEATER CONN. - ,$ RANGE CONN.' $ OTO S $ FIXTU ES $ INSPECTIONS DATE[ BY RE- INSPECT BY RE- INSPECT BY 'rEMP.l18 VICE.' ROUGkING H. W. H EATER C'ONN RANGE CONN. I' I ES & FINAL 6/27/501 II--IXTU y►PPR IVI► TO ,* WER CO. FOR SERVICE DATE By EXLSn'ING 3#1 IN I 1 12" C TO POWER CO. SERVICE POINT NEW METER/MAIN COMBO (NEMA 3R) es: U 150AMP METER/ I 150AMP COMBO MAIN DISCON BREAD l e 2P 150AMP MAIN BKR SERVICE RATED (10K ALC.) 1 #6(0) IN 1/2" CONDUIT TO (2) 5/8" DIA. x10FT LONG COPPER CLAD STEEL GROUND DRIVEN RODS, SPACED 6 FEET APART, C.W.P. p TOMITT "M OCT 3 0 2098 PERMIT #: Miami Shores APPROVED ! BY 1 DATE ZONING BLDG DEPT UA' SUBJECT TO COMPLIANCE NTH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS FL 33138 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT I 1� �5 1� Permit NO.- x . . .t— — Date. 7/22/86 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 describe& This application is made in comphaom and conformity with the Budding 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 me be kept at building during Progress of Work Owner's Name and Address— Esther Phillips No- 25 SUGOL. N X io Street Registered Architect and/or Brooks American Sprinkler Co. 2430 N.W. 79th Street Xm0aying Plumbees Now V 81 new on sub&vw 006 to be performed —No 2 J Street, N.LE. 0 peet 'ro."lowlzere, wor2l, State work to be performed and purpose of building (By Floors)— Well . ... . .............. Now Building...._._.._ —­---­ __ Addition_—_. Repairs.._..._... .............. No. of Size septic,rar& —TY" Of Tonk—. __--covacity Fed of Drain Tile — - ------- Dist. Feet of Teak at Drain Field fi= Wall_ Nature of Water Supply: CftY—WOI 2 it -Size of soaims@ Pit------ Amount of permit $ 25.00 ............................ Plumbing inspector. The undersigned applicant for this budding 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 Iw; 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 am required by the Act, The undersigned agrees to employ only so& sub-contract^ on wa*" to be performed under this permit, as are licensed by Miami Shwas Village. (SiVrAd). ..... . . .... .... .... . ...... . ,V1418 MaAw Plumber. STATE OF FLORIDA, COUNTY OF DADE. U-a-/ 7-3 Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take OfAmowletIgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath asposes and says that he is the----,-- of the above described construction, that he has carefully read the foregoing application, and that he did sign this waste, and the all facts therein by him stated as true. i My Commission Expires Notary Pub11% State of Flosidis NOTE: A re- inspection fee of $1.00 wdl be asside Wheat amok n4ageothn is =a&' I A —3 by I It go sr notion for ihspectlog, or fin ft materials and/or workmandop. CLOSWTS BATH Tuns SHOWERS . LAVA• TON199 SINKS SLOP SINKS LAumony Tuns URINALS CATCH 8^61" FLOOR DRAIN DRINKING FOUNT'He TOTAL FIXTuptas COM.. LtsT CHECKSIEPTtC SOLAR HZATKR Damp WELL 8"XLR. SYSTEM 9WIMIG POOL TANK Sawlix CONN. DRAIN FIELD SOAKAO& PIT GRCAOZ TRAP CONTR' x LIST CHICK j Size septic,rar& —TY" Of Tonk—. __--covacity Fed of Drain Tile — - ------- Dist. Feet of Teak at Drain Field fi= Wall_ Nature of Water Supply: CftY—WOI 2 it -Size of soaims@ Pit------ Amount of permit $ 25.00 ............................ Plumbing inspector. The undersigned applicant for this budding 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 Iw; 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 am required by the Act, The undersigned agrees to employ only so& sub-contract^ on wa*" to be performed under this permit, as are licensed by Miami Shwas Village. (SiVrAd). ..... . . .... .... .... . ...... . ,V1418 MaAw Plumber. STATE OF FLORIDA, COUNTY OF DADE. U-a-/ 7-3 Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take OfAmowletIgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath asposes and says that he is the----,-- of the above described construction, that he has carefully read the foregoing application, and that he did sign this waste, and the all facts therein by him stated as true. i My Commission Expires Notary Pub11% State of Flosidis NOTE: A re- inspection fee of $1.00 wdl be asside Wheat amok n4ageothn is =a&' I A —3 by I It go sr notion for ihspectlog, or fin ft materials and/or workmandop. Ilk J! IT 1-1 ji red c prom nwwvwkvwmmftvmb*mwbfD seam ad pupsftwdlh mvmwcnpwrmflp I j.Lqod"WVftdpwpwV#Md W _jr r F_�r P CFN 2005R0238U'­-W--f3, OR Bk 23155 Ps 19441 (iPs) REPORDED 0311012005 13:15:32 ,11ARVEY RUVINv- CLERK OF COURT MIAMI—DADE COUNTY? FLORIDA ! A .-,s:r PAGE 4.00nVVd0ftfmMWd .mm w4sft At�untd pill ~ gy owoj�vpa V*m rdow arcow-doWMft fW be sm" N' 86 "#A* of ftldl - prod by t7'1& s FA*k M&fA% Ift I OWE" 8. �t adallEl4n do 0sNw*d@v%Pv"ftf4lwAftV4flc* t* 14006 raw of t*Lkmft ft" top~ kk agoom 7WOM FWft SWUM Ift"WA L ENPMM dd$ Of IN WJW Of- I ywftmftdw arm=" wjm a own iswWateaftdisk w mft.dWA* fi Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/4/2005 Applicant: NICOLE Owner: GUILLET JOB ADDRESS: 25 NE 103 Building Permit Permit Number: BP2005 -274 GUILLET NICOLE ST Contractor ADVANCED CONSTRUCTION SERVICE GRCM99AMtoes Address: 5910 SW 93 PLACE Local Phone: 305/244 -7501 Page 1 of 1 Parcel # 1121360130940 Legal Description: MIAMI SHORES SEC 5 PB 10-47 LOT 15 & W1/2 OF LOT 16 Fees: Description Amount FEE2005 -2840 Building Fee $300.00 FEE2005 -2841 CCF $6.60 FEE2005 -2842 Training and Education Fee $2.20 FEE2005 -2843 Technology Fee $7.50 FEE2005 -2844 Scanning Fee $21.00 Total Fees: $337.30 Permit Status: APPROVED Permit Expiration: 8/24/2005 Construction Value: $11,000.00 Work: RE -ROOF VOLCAN COLOR THRU Signed: (INSPECTOR) Total Fees: $337.30 Total Receipts: $0.00 BLK 123 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: orl i o ❑ N ®w Roof [ Ia Re.Roofina ❑ Recoverina ❑ Renair ❑ ROOF SYSTEM INFOF a1 -IF I- 9 =9 i - [ll 3illU 11Ytlr11UlR Ul -GF ZffIUU}C ilUl; if I Mll' -, Florida Building Code Edition 2002 High VeWty Hurricane Zone Uniform Permit Application Form. Section D (Steen Sloped Roof System Roof System Manufacturer:,1i>1L Notice of Acceptance Numbe.. �% ' -o4-2-re 04- Minimum Design I ind Pressures, if Appilcable (From RAS 127 or Calculations): P1: P2:�� ^9 P3 ` •'� 9 Mwd mum- Design Pressure From the NOA S ®cific System): Method of the attachment: Steep Sloped Roo__ stem Description Nj YT-4 Type & Spacing: i of � II*Q)A-6 1��� e�4,j 6 iesive Type &'��� ype Cap: Sheet: oof Covering: IVOIC ST1 A Size Drip i Florida Building Code Edition 2002 V . Hurti *m zone UWo m Fwwd Fmm. Section . E (Tile'- Calculations) For Moment based the systems, ehoose ellher Method 1 or L Compared the valves for M,witb the values from M* if the Mt valves are greater than or equal to the Mr values, for each area of the rood then the tale attachment method is acceptable. Method 1 "Molgent Based Tile Calcns Per RAS 127" Ca-- NOA 1% G� -S (p2; — z A • 2 IS m 2 —'Mg; ° ZD NOA 1% GG -S (P3 S2. Method 2 "Shnplifled Tile Calenlation Per Table Below" Regalred Moment of Resistance QQ From Table Below NOA I% r TT *Mast be used in conjunction with a IM of moment based file systems endorsed by the Broward County Board of Rolm and Appeals. For Uplift. based As systems use Method 3. Compared the values for F' with the values for F,. If the r valves are greater than or equal, to the F, valves, for each ares of the roof; then the file attachment method is acceptable. Method 3 "Uplift Based Tile Calculations Per RAS 127" (Pl : Z l: z w: ° __J— W ZOOS B: = FN: NOA F (Py : z h z w: = _) — W: z cos 9i = F,g: NOA F (P3: x Fr3: NOAF Where to Obtain Information Description Symbol Where to Bud DeRpPimm Pl o;P2orP3 RAS WT" 1 orbyan an*dsj,,j, ed PE aaA$CE 123 01-48 5/03 PAGE a, WAM AQE IirJYLDYNG CODE COMPLIANCE OMCE (BCCO) PRODUCT CONTROL DIVIOXON Clay. Forever 6801 NW 72 Avenue Suite 301 Miami, FL 33166 MIAMI -DADS COUNTY, FLORIDA MLTRO -DADS FLAOLER BUR DING 140 WEST FI AGLSR STREET, SUITE 1603 MIAMI, FLORIDA 33130.1563 (305) 375 -2901 PAX (305) 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 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 (ATE. This NOA shall not be valid after the expiration date stated below, The Miami -Dade County Product Control Division (in Ndiami Dade County) and/or the AM (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 mner, the manufacturer will incur the expense of'such testing and the AM immediately an revoke, moth pend the use of su uct or material within their jurisdiction. BORA reserves the right to revoke . s acceptance, if it is determined by N iami�Dade County Product Control Division that this product or maters fails to meet the requirements of the applicable'�uilding code. This product is approved as described herein, and has bee ` designed to comply with the Florida Building Code, Intl ding the High Velocity Hurricane Zone. DES ON: Volcan by Altusa, Spanish "S" Clay f Tile LAB G: Each unit shall bear a permanent label with manufacturer's name or logo, city, state and followings nt: "Miami Dade County Product Control pproved unless otherwise noted herein. RENEWAL of OA shall be considered after a renew application been filed and there has been no change is the applicable 'lding code negatively affectin the performance of this product. Z'ER1VnNA'i'YON of this NOA cur after the a date or if there has been a revision or change in the manufacture of the pro uct or +Deese. Misuse of this NOA as an endorsement of any materials, use, and/or p P product, for sales, advertising or any other purposes sh"UtDruatically terminate this NOA. Failure to comply 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, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTIOWA 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. Tevises NOA # 01- 0828.01 and consists of pages 1 through 6. The submitted documentation was reviewed by Frank Zuloaga, RRC NOA No.: 040426.04 Expiration Date: .08/26/09 Approval Date: 08/26/04 Page 1 of 6 wdN1MR'OV24 ROOFING ASSEMLY APPROVAL Category: Roofing Sub Category: Roofing Tiles Uterlal: Clay 1. SCOPE This new roofing system using Volcan by Altusa Spanish "S" Clay Roof Tile as manufactured by Clay forever as described in Section 2 of this Notice of Acceptance. For locations where the pressure requirements, as determined 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 system, ODX7CT DESCRIPTION Manufaclured bra Di to Test Product Awl-tea (nominal) Staec iff ations, Description Volean by Altura Length: 19.8" High profile, one - piece, 'S' shaped single roll Spanish "S" Clay Width: 10 ASTM C 1167 clay tile with a nominal 2- inch headkap. Roof Tile varying thickness For direct deck nail -on, mortar set, or adhesive set applications. Try 'eces Length: varies Accessory trim, clay roof pieces for use at Width: varies PA 112 hips, rakes, ridges and valley terminations, varying. thickness Manufactured for each file profile. 2.1 SUBMT17M EVIDENCE: Test Arens Test Identifier 129 bmsmsemrt Date LBA Consultants, Inc. 2397 -59 ASTM C 1167 04/27/04 PRI Asphalt Technologies, Inc. PDI- 002 -02 -01 TAS 101 10/08/02 PRI Asphalt Technologies, Inc. PD1.01 -02-01 TAS 101 10/08/02 Roof Tile Association 99 -0041 NTRMA High Miami bade NOA 1999 3. LMTATIONS 3.1 Fire classification is not part of this acceptance, 3.2 For mortar or. adhesive set file applications, a static -field uplift test maybe performed in accordance with RAS 106. 3.3 Applicant shall retain the services of a Miami -Dade County Certified. Laboratory to perform quarterly test in accordance with PA 112; appendix 'A'. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 Minimum underlayment shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30190 hot mopped underlayment.applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment material manufacturers published literature. 3.6 This acceptance is for wood deck applications. Minimum deck requirements shall be in eomplince with applicable building code. NOA No.: 04. 0426.04 ° { Expi 4. INSTALLATION 4.1 Volcan by Altus& Spanish "S" Clay Roof Tile and its components shall be installed in strict compliance with Roofing Application Standard RAS 120. .4.2 Data For Attachment Calculations Tabled: Average Weight (W) and Dlmenelons (I x w) Tlie Profile Weight -W (Ibf) Length -l(ft) Width -w (ft) Volcan by Altura 7.1 1.650 0.833 Table 2: Aar odynamic Multiplier* -X ft Tile Profile X (n Batten A Iloatlon X Ireat Deok Al cation Volcan by Altura 0.235 0.255 6"• 12" a R ring Moments due to Gravl - M ft -Ibt ..2 ": 12" .or less ,! °:12" 4": 12" 5 ": 12" 6"• 12" 7 °. 12" or a rester Batten Direct Deck B ti FDC k atten Direct Deck Batten Direct Deck Batten Direct Deck Batten Direct Deck . 4.78 5.12 4.711 5.05 4.62 4.96 4.51 4.84 4,38 4,67 4.25 4.55 NOA No.: 04- 0426.04 Expiration Date: 08/26/09 Approval Date: 06126104 Page 3 of 6 Wd01 :a1 MZ '08'M 4: Attaohment.Resistanco Express }or Nall .-On S /shi Fastener Type Direct Deck Attachment (Mln 15/32" A Ilcation plywood) Od R164-Shank Nails 28.6 Od Smooth or. Screw 5.1 Shank Nail Od Smooth or Screw 6.9 Shank Nails 1 .08 Screw 28.7 2 A Screws 58.2 % Smooth or Screw 23.1 lank Nail Field CU Od Smooth or Screw 29.3 lank Nall Eave CII i n.� Qw,nnfh nr SArAW 27.6 Table 6: Attachmel for', Tile Profile Volcaa b Altuea 2 See manufactures cgrnponent appi 3 F1exlble P U018 Ocmpany Po cam Product Ino. Average wE as a Moment - Mf (ft -lbf) . Direct Deck Battens (Mill. 19/3210 plywood) 4 41.2 19.4 6.8 2.8 27.6 38.6 36.1 41.8 Resistance Expressed as a Moment Mf (ft -ibf) 'o Patty Adhesive Set SYstsms Tlla Anniieatlon I Mlnlmum Attachment . per parry 10.7 grams. BA: Attachment Resistance Expreesed as a for Single Patty hSeLve Set S -8t, - Mf nlm Table 69: Attachment Resistance Expressed as a Moment - Mf(ft -lbl) for Mortar Set Systems Tile Tile Attachment Profile A Ilcation Resistance Volcan by Altusa Mortar Set 24.50 NOA No.: 04- 0426.04 EVIration Date: 006109 Approval Date: 08!26104 Page 4 of 6 Wdo l : l l toaa '08'M wir ' 5. LABEX.INN G . All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo, or following statement: "Miami Dade County Product Control Approved ". 6. BUILDING PERMIT REQUIREMENTS 64 Application for building permit shall be accompanied by copies of the following: 6.X,1 This Notice of Acceptance. 6.1.2 Any other docw=nts required by the Building Official or applicable building code in order to properly evaluate the installation of this system. © NOA No.: 04- 0426.04 " Expiration Date: 08/26/09 Approval Date: 06/26/04 Page 5 of 6 9 'd 96WON wdol :at to0a '0E'10a VOLCAN 4S' STATUE CLAY BARREL ROOF TILE PROFILE DRAWINGS END OF TITS ACCMANCE NON No.: 04- 0426.04 Expiration Date: 0"109 Approval Date: OW26104 Page 6 of 6 wd < <' Z i tM ' Os' 2na .i 0 PRODUCT CONTROL NOTICE OF ACCEPTANCE Polyfoam Products, Inc. 2400 Spring- Stuebner Road Spring ,TX 77383 -1132 NIAM DADE COUNTY, FLORIDA METRO -DARE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE METRO -DARE FLAGLER BUILDING 140 WEST FI A.GLER STREET, SUITE 1603 MIAMI, FLORIDA 33130.1563 (305) 375 -2901 FAX (305) 375 -2908 CONTRACTOR LICENSING SECTION (305) 375 -2527 FAX (305) 375 -2558 CONTRACTOR ENFORCEMENT DIVISION (305) 375 -2966 FAX (305) 375 -2908 PRODUCT CONTROL DIVISION Your application for Notice of Acceptance (NOA) of: (305) 375 -2902 FAX (305) 372 -6339 Two Component Polyurethene Foam Adhesive under Chapter 8 of the Code of Miami -Dade County governing the use of Alternate Materials and Types of Construction, and completely described herein, has been recommended for acceptance by the Miami -Dade County Building Code Compliance Office (BCCO) under the conditions specified herein. This NOA. shall not be valid after the expiration date stated below. BCCO reserves the right to secure this product or material at any time from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner, BCCO may revoke, modify, or suspend the use of such product or material immediately. BCCO reserves the right to revoke this approval, if it is determined by BCCO that this product or material fails to meet the requirements of the South Florida Building Code. The expense of such testing will be incurred by the manufacturer. - G�- ACCEPTANCE NO.: 01- 0521.02 w- EXPiRES: 05110/2006 Raul Rodriguez Chief Product Control Division THIS IS TBE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND CONDITIONS BUILDING CODE & PRODUCT REVIEW CONIlVIITTEE This application for Product Approval has been reviewed by the BCCO and approved by the Building Code and Product Review Committee to be used in Miami -Dade County, Florida under the conditions set forth above. APPROVED: 06 /14/2001 11504500011pc2000\ltaanpbUSV odce acceptance mw page .dot 91W �-i" Francisco L Quintana, R.A- Director Miami -Dade County Building Code Compliance Office Internet mail address: postmaster@buffdingoodconline.com Homepage: http : //www.buildingcodeouBne.com s •, Polyfoam Products, Inc. ROOFING ASSEMBLY. APPROVAL Category: Sub- Category Materials: I. SCOPE Roofing Roof Tile Adhesive Polyurethane ACCEPTANCE No.: 01- 0521.02 Approval Date: June 14.2001 Expiration Date: May 10, 2006 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 determined by applicable building code, does not exceed the design pressure values obtained by calculations in compliance with Roofing Application Standard RAS 127, for use with approved flat, low, and high profile roof tiles system using Polypro@ AH 160. Where the attachment calculations are done as a moment based system for single patty placement, and as an uplift based system for double patty systems 2. PRODUCT DESCRIPTION Manufactured by Test Product ADDI1CaIIt Dimensions Specifications Descri lion Polypro@ AH160 N/A PA 101 Two component polyurethane Foampro@ RTF 1000 N/A Dispensing Equipment ProPack@ 30 & 100 N/A Dispensing Equipment 2.1 Components or products manufactured by others: Any Miami -Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list uplift resistance values with the use of Polypro AH160 roof tile adhesive. 2.2 Typical Physical Properties: Prope Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability Test ASTM D 1622 ASTM D 1621 ASTM D 1623 ASTM D 2127 ASTM E 96 ASTM D 2126 2 Results 1.6 lbsJft g 18 PSI Parallel to rise 12 PSI Perpendicular to rise 28 PSI Parallel to rise 0.08 Lbs./Ft2 3.1 Perm /Inch +0.07% Volume Change @ -400 F., 2 weeks +6.0% Volume Chan e o 0 Humidity, 2 weeks Frank Zuloaga, RRC Product Control Examiner B G Polvfoam Products, Inc. ACCEPTANCE No.: 01- 0521.02 Note: The physical properties listed above are presented as typical average values as determined by accepted ASTM test methods and are subject to normal manufacturing variation. 3. Lit WATIONS 3.1 Fire classification is not part of this acceptance. Refer to the Prepared Roof Tile Assembly for fire rating. 3.2 Polypro® AH160 shall solely be used with flat, low, & high tile profiles. 3.3 Minimum underlayments shall be in compliance with the Roofing Application Standard RAS 120. 3.4 Roof Tile manufactures acquiring acceptance for the use of PolyproO AH160 roof tile adhesive with their tile assemblies shall test in accordance with PA 101. 3.5 Roof Tile manufactures acquiring acceptance for two paddy placement with the use of Polypro® AH160 roof tile adhesive with their tile assemblies shall test in accordance with PA 101 and with section 10.4 as modified herein. r -W F'- MS 4. INSTALLATION 4.1 Polypro® AH160 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of Polypro® AH160. 4.2 Polypro@ AH160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of Polypro® AH160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the uplift resistance determined in compliance with Miami Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA 4.3 Polypro® AH160 roof tile adhesive and its components shall be installed in accordance with Roofing Application Standard RAS 120, and Polyfoam Products, Inc. Polypro® AH160 Operating Instruction and Maintenance Booklet. 4.4 Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, Inc. Polyfoam Products Inc. shall supply a list of approved applicators to the authority having jurisdiction. 4.5 Calibration of the Foampro@ dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the "B" component 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 tile as determined at calibration. No other settings shall be approved. 4.6 Polypro® AH160 shall be applied with Foampro RTF1000 or ProPack® 30 & 100 dispensing equipment only. 4.7 Polypro® AH160 shall not be exposed permanently to sunlit Frank Zuloaga, RRC Product Control Examiner PoIyfoam Products, Inc. ACCEPTANCE No.: 01- 0521.02 4.8 Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after Polypro(O AH160 has been dispensed. 4.9 Polypro® AH160 placement and minimum patty weight shall be in accordance with the 'Placement Details' herein. Each generic tile profile requires the specific placement noted herein. Table 1: Adhesive Placement For Each Generic Tile Profile TileProfle Placement Detail Single Paddy Weight Mn. (grams) Two Paddy Weight per paddy Min. (grams) Flat Low, I-figh Profiles # 1 35 N/A High Profile (2 Piece Barrel) #1 17 /side on cap and 34/ an N/A Malt Low, frigh Profiles 42 24 N/A Flat, Low Hi Profiles 43 g 5. LABELING All Polypro® AH160 containers shall comply with the Standard Conditions listed herein. 6. BUILDING ]PERMIT REQUIIiEMENTS 6.1 As required by the Building Official or applicable Building Code in order to properly evaluate the installation of this system. 4 Polyfbam Products, Inc. ACCEPTANCE No.: 01-0521.02 ADHESIVE PLACEMENT DETAIL I SINGLE PATTY Nag umgh 0200 MIMA "Mmulkya) UMW.Vm 1 - biscm Famb m1mo* Kw d=M awa 4kLupftmwm*hs Fmk ZWoaM RRC Product Coubrol Examiner R 0 771 Fmk ZWoaM RRC Product Coubrol Examiner R Poly_foam Products, Inc. ACCEPTANCE No.: 01- 0521.02 ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY Nall through plastic cement paddy (Beneath Tde) Nail through plastic cement pa* Memo Too) ww °� Underlaymeat 7 in. vr' In. ° EereCeurea °� • ° In* Facto tyeeph* EM Com ' Ewe clan EMCIOM D*Wgo Frank Uoaga, RRC Product Control Examiner M PoVoam Products, Inc. ACCEPTANCE No.: 01-0521.02 ADHESIVE PLACEMENT DETAIL 3 DOUBLE PATTY Mi through pWk cament Single paddy under the , un �19 P "Ingle P, Underlaywrit SIMb paddy between the 21n.x7immedlum o size paddy eve I courseenly Nall through plastic cement $11410 paddy Frank Zuloaga, RRC Product Control Examiner 7 Polvfoam Products, Inc. ACCEPTANCE No.: 01- 0521.02 1. Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and the original submitted documents, including test - supporting data, engineering documents, are no older than eight (8) years. 2. Any and all approved products shall be permanently labeled with the manufacturer's name, city, state, and the following statement: "Miami -Dade County Product Control Approval', or as specifically stated in the specific conditions of this Acceptance. Renewals of Acceptance will not be considered if a. There has been a change in the South Florida Building Code affecting the evaluation of this product and the product is not in compliance with the code changes. b. The product is no longer the same product (identical) as the one originally approved. C. If the Acceptance holder has not complied with all the requirements of this acceptance, including the correct installation of the product. d. The engineer who originally prepared, signed and sealed the required documentation initially submitted, is no longer practicing the engineering profession. 4. Any revision or change in the materials, use, and/or manufacture of the product or process shall automatically be cause for termination of this Acceptance, unless prior written approval has been requested (through the filing of a revision application with appropriate fee) and granted by this office. 5. Any of the following shall also be grounds for removal of this Acceptance: a. Unsatisfactory performance of this product or process. b. Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any other purposes. 6. The Notice of Acceptance number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is displayed, then it shall be done in its entirety. 7. A copy of this Acceptance as well as approved drawings and other documents, where it applies, shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at all time. The engineer need not reseal the copies. 8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of Acceptance. 9. This Notice of Acceptance consists of pages I through 8. END OF THIS ACCEPTANCE Frank Zuloaga, RRC Product Control Examiner 8 Polvfoam Products Inc. ACCEPTANCE No.: 01- 0521.02 NOTICE OF ACCEPTANCE: EVIDENCE SUBNHMD (For File ONLY Not part of NOA.), A. DRAWINGS: NONE B. TESTS: Test Agency Test Identifier Center for Applied #94 -060 Engineering 528454 -9 -1 Center for Applied 257818 -IPA Engineering 520109 -1 Center for Applied 25- 7438 -3 Engineering 25- 7438 -4 Center for Applied Engineering 25- 7438 -7 Center for Applied 25 -7492 Engineering 520191 -1 Miles Laboratories NB -589 -631 Polymers Division Ramtech Laboratories, Inc. 9637 -92 Southwest Research Institute 01- 6743 -011 Southwest Research institute 01- 6739 -062b[l] Trinity Engineering 7050.02.96 -1 Celotex Corp. Testing 528454-2-1 Services 528454 -9 -1 ASTM E 84 528454 -10 -1 Celotex Corp- Testing 520109 -1 Services 520109 -2 520109 -3 520109 -6 520109 -7 Celotex Corp. Testing 520191 -1 Services 520109 -2 -1 Test Name/Report Date Miami Dade Protocol PA 101 04/08/94 Miami Dade Protocol PA 101 12/16/96 SSTD 11 -93 10/25/95 SSTD 11 -93 11/02/95 SSTD 11 -93 12112195 ASTM D 1623 02/01/94 ASTM E 108 0480/93 ASTM E 108 11/16/94 ASTM E 84 01/16/95 PA 114 03/14/96 Miami Dade Protocol PA 101 10/23/98 Miami Dade Protocol PA 101 12/28/98 Miami Dade Protocol Frank Zuloaga, RRC Product Control Examiner E -1 c Polvfoam Products Inc. ACCEPTANCE No.: 01- 0521,02 NOTICE OF ACCEPTANCE: EVIDENCE SUBWHMD (For File ONLY. Not part of MA) C. CALCULATIONS: Walker Engineering, Inc., Evaluation of Tests. Dated 04/07/99 D. MATERIAL CERTIFICATIONS: NONE E. STATEMENTS: NONE E -2 Frank Zuloaga, RRC Product Control Examiner f"' Issued 2 ®�19 Amotmt— No. Houses Ll�,� Miami Aores=ilIage F L O A S D A KNOW ALL MEN BY THESE PRESENTS,jthat 1dT® 932 in consideration of the issuance to me by Miami Shores Village, Florida, of a permit or permits to construct or repair a building or buildin at the following adtres s /, ) 1 �� ft1 �».2. �/d do hereby deposit with Miami Shores Village, Florida, the sum of "- , and I agree with said Village that, when such construction shall have been completed by me within the meaning of the ordinances of said Village, I will clear all premises and repair any Village property damaged by me, used for the deposit of material or equipment in the construction or repair and that, if I do not so clear and repair such premises immediately upon the completion of such construction within the meaning of such ordinances, the Village may clear, and repair the same and pay the costs of such clearance and repairs out of the aforesaid , and return the remainder to me; and that, if I shall clear and repair said property immediat as aforesaid, then said _ _shall be returned to me. WITNESS MY HAND and Seal at Miami Shores Village, Florida, this �- '`' (Seal) INSTRUCTIONS TO BUILDER —When above mentioned construction is completed and the premises a clear and repaired take4is bond to the Village Building Inspector and obtain his approval, after which Miami Shores Village will refund your mone ee with the 4ove agreement. VILLAGE BUILDING INSPECTOR'S APPROVAL I hereby certify that the construction contemplated under this Bond, has been com leted and that the ilder thereof has ca d the surrounding premises to be cleared and repaired in as good condition as they were bef re commenci i con ruction. WHEN CLEARED AND REPAIRED BY THE VILLAGE Amount of Bond. . . . . . . . . . $ - __ Vil Building Inspector, ini Shor s Village Cost of clearing and repairs done by Village $ -- �- Balance due Builder . . . . . . . . . . $ Cancelle , _ 1 By —_ MIAMI SHO%'ES VILLAGE BUILDING INSPECTION DEPARTMENT "`►►► APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during rogress of the work. pp p Date '' 2-/ - C--- ------------------------ - - - - -- 19_ Owner's Name and Address - G G = - -- - - - - - -- No - �`"-- - -- -- - - -- - - -- Street__aZ z 2'` __ /----- --- - - - - -- 'Registered Architect and /or Engineer ____ ___ _ __ _________ F J_� Name and address of licensed contractor Location an4 legal description of lot to be built on: -A / ,$ , Lot - ------ 0 ------ -I.i�� A� /Block----- 1 -�"7r, " `0 ` -5 -� -- --- -- --- -` -- - ---- -v�- - 1 Subdivision _ _____________ __ _ Street and Number where work is to be done __________ 49- 1 - State work to be done and purpose of building (by floors) --------- - - - - -- - �'r t - `-- '---- �1��! -- V_ j j! ------------------------------------------- - ----------------------------------------- ----------------------------------------------- ----------------- - - -- -- ---- --------- ---------- - - - - -- -and for no other purpose. New Building --------- Y Remodeling---- -- -------------- - - - - -- Ad *n --------------------- - -- -- Repairs ----- - - - - -- No. of Stories---------- --------- - - - - -- To be constructed of ` �"$-`-'- -_____ Kind of foundation 2 !�1. ____ = oo � gyering -------- �_G� __________ _________________ Estimated Total cost of improvements $__ %t__ d Q--- - - - - -_ - ......... of Permit $______/ �w tpr � ---------- --------- `--- - - - - -- ----------------- - - - - -- Zone cubage required ------ > - - - Q V_ ----- - - - - -- -Plan Cubage - -v= * = — 1 L --- 0' 6 Distance to next nearest building -------- - ------- -------------------- ---------- ------ ----- Size of Building Lot-- -Z� -- $�- �- - - - - -- - - ------- --- ---------- - ------ Maximumlive load to be borne by each floor------------------------------------------------------------------------------------------------------------------------------------------------ I hereby suhmit o the plans an pecifications for said building, All notices with reference to the building and its construction may ^- . - be sent to------------- �%------ - - ---- ---------- ------=-- 1' ----------------------------------- - ----------------------------- - ------------- -------------------------------------- ----- - - - - -- _ --------------- - - - - -- The undersigned applicant for this - building permit does hereby certify that he understands and accepts his ob . o ' as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori , Pe anent Supplement, and has complied with the provisions thereof, and will rewire similar compliance from all contrctsrg -or r ors employed by him in the work to be performed under this permit; and will post or cause to be posted for Cfon -4n #k�cs' ork such public notice or notices as are required by the Act. The undersigned agrees to employ only suc mss, on work rformed under this permit, as are licensed by Miami Shores Village. „ , STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and peared----------------------------------------------------------------- --- --- -- ------ - - - - -- personally ap- ---------------------------------------------------------------------------- ------------------- - - - - -- - - - -to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ---------------------------------------------------------------------------------------------- of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No.__ Disapproved Date--------------- -------- --- ------------ - - - - -- Read, Sworn to and Subscribed before me. (Signed) -- ------------------------------------------------------------------------------------------- Notary Public, State of Florida Building Inspector My Commission Expires -------------------------- PLANNING BOARD --------------------------------------------------------- DATE Chairman---------------------------------------------------------------- ----------------- ------ - - - - -- Member -------------------------------------------------------- Member-------------- - - - - -- ------------------------------------------------------- - - - - -- Member ----------------------- Member----------------------------------------------------------- - - - - -- Member CouncilApproved - -- -------------------------------------------- ----- - - - --- -Date Disapproved ------------------ ----- ------------------- - - - - -- NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. t ' Nop",TH + + _ t -t- A8' A PPDX, k00r- 1 5f LOCA110N5 mo tgiww510N5 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buil ing Inspection Request Date Type Insp'n ` Permit No. Name Address Company Phone # // r Inspection Date 1 pproved Correction Re -Insp' n Fee ❑ ❑ v r Test Number `'Test Load Obf) Test Status `. 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 1 Pass One broken tile was noted at the time of our inspection. .--II-I-,--"--,-,-- " ", — ,� ",�, ",,,"-�11- LCEn Engineering Seri ices Inc. -- Tile U pli ft Test Result -- Project Number: LG05-1225, Page 3 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buil ing Inspection Request Date � J �n Type Insp'n j� v Permit No. tl Name Address ! V- Company Phone # (U Inspection Date Approve Correction ❑ Re- Insp'n Fee ❑ � C Test Numbe Test " Load "(lbf) = "Test Status 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 1 Pass LG Engineering Services Inc. --Tile Uplift Test Result - -Pr o1 t 'ect Number. LG05- 1225,1 f 'age 2 r -MIAMI SHORES VILLAGE BUILDING DEPAA*fMENT ;ab 305 -795-2204 t� Building Inspection Request Date 7�/fa1' % 6 /OS (P Type Insp'n K c' i nCr ►'' p FC tc bn Permit No. 17P 0-3 -v2 -7q Name ;)p C-A r6 Address 5 0 z., s Company Ucn ?L�e _ Phone # Inspection Date 'e"1 ! P -7 1 C%`5 Approved ❑ Correction Re- Insp'n Fee ❑ O.Vo MIAMI SHORES VILLAGE BUILDING DEPARTMENT dab 305- 795 -2204 �b Building Inspection Request Date z/ /06/0 5 Type Insp'n Permit No. RP C 7'4 Name -pp-a Address 05 O 3S Company 10 UC�1 Lx Phone # 7 ?6 3 c-1<1 ' Inspection Date 4.11 a) 7 1 C7 Approved ❑ Correction Re- Insp'n Fee ❑ 0,,Vo �;� 0"'- Report of • TILE UPLIFT TEST for Residential Home 25 Northeast 103 Street Miami, Florida Project Number: LG05 -122 Test Number Test, Load (W) Test Status 1 35 Pass 2 35 Pass 3 3 5 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 3 5 Pass 21 35 Pass 22 3 5 Pass 23 35 Pass 24 35 Pass LG Engineering Services, Inc. --Tile Uplift Test Result --Project Number. LG05 -1225, Page 1 Type I Permit Name MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 ,rl Address L J ►V �_ , j> f' ' Company Phone # Inspection Date Approv �.� Correction ❑ Re- Insp'n Fee ❑ 1. I:G ENGINEERING SERVICES, INC. Consulting Engineers. 2020 Northwest 7th Street Miami, Florida 33125 Advance Construction 645 West 65 Drive Hialeah, Florida 33112 Project: TILE UPLIFT TEST Residential Home 25 Northeast 103 Street Miami, Florida Dear Sirs; Information provided by client: Permit Number: Not Available Date Completion; April 29, 2005 Roofing Contractor: Advance Construction May 12, 2005 LG Engineering Services, Inc. Project Number: LG05 -1225 ('Testing Laboratory Certificate #00- 0224.07) In accordance with your request and authorization, a representative ofLG Engineering Services, Inc. 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 50 feet above ground surface. The type of tile used for this project was reported to be Volcan Roof Tile. This tile was'reported to have been foamed in place. At the time of this testing, one test for every corner, one test for every 100 square feet of roof tile in the perimeter area .and one test for every 200 square feet of roof tile in the field area N re tested. Initially the entire area of the roof was examine for loose tile. More than 10% of the o it sated in the field area and more than 20 %0 of the roof the at the roof perimeter and c eysically examined. - C�1. V•1•'L E N G�I N E E•R Tel: (305) 649 -6454 .� Fax: (305) 541 -3298 I:G ENGINEERING SERVICES, INC. Consulting Engineers. 2020 Northwest 7th Street Miami, Florida 33125 Advance Construction 645 West 65 Drive Hialeah, Florida 33112 Project: TILE UPLIFT TEST Residential Home 25 Northeast 103 Street Miami, Florida Dear Sirs; Information provided by client: Permit Number: Not Available Date Completion; April 29, 2005 Roofing Contractor: Advance Construction May 12, 2005 LG Engineering Services, Inc. Project Number: LG05 -1225 ('Testing Laboratory Certificate #00- 0224.07) In accordance with your request and authorization, a representative ofLG Engineering Services, Inc. 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 50 feet above ground surface. The type of tile used for this project was reported to be Volcan Roof Tile. This tile was'reported to have been foamed in place. At the time of this testing, one test for every corner, one test for every 100 square feet of roof tile in the perimeter area .and one test for every 200 square feet of roof tile in the field area N re tested. Initially the entire area of the roof was examine for loose tile. More than 10% of the o it sated in the field area and more than 20 %0 of the roof the at the roof perimeter and c eysically examined. - LG Engineering Services, Inc. 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; LG Engineering Services, Inc. Salleh, P.E.49014 Manager TILE UPLIFT TEST Residential Home 25 Northeast 103 Street Miami, Florida 1.0 STATE OF FLORIDA; SS COUP?TY OF DADS AFFIDAVIT y i of the Village of Miami Shores, County of Dade and`State of Flor °da, being d-aly' shorn, doth depose anI say, that under the pro risionc of oor6inance Ho. 185, crated June 15 � 134.8, uaend- ing p. °xag aph �'fi) of Section 8 -36$ of Orai_.anse lto. 97 of the 1.3ir_ Code Of i- iii "no Village, he desi es to bL�1id a on Lot 7l ock — of _ Sulxli �sion, that he th - owner of said property, and will be the oamer of seas'. j _ , that he will do the work per:;c z11y, and that he frill, at such times as are required by the Zoning and D-ud ding Director 1. File plans and specifications and obtain approval of Plaining Hoard and the Building Inspector. 2.. Apply for and secure a Permit f 3. Pay the required fees. 4. Execute the work in accordance with the prbvisions of Code. 5. Apply for inspections. 6. File with the Building Inspector certificates that pro- has been made to carry the necessary Workmen's Con-pens Public Liability and Property Damage Insurance. 7. File with the Building Inspector as the job progresses ficates showing the payment required by the Federal So Security Act to the State of Florida or the United Sta America. S. Assume the responsibility of not employing other than licensed contrCctors by Miami Shores Village for any p portion of the work. 9. Not set himself up as a "contractor ". sion ion, of or 10. Sign an affidavit before comhencing work to the effect ' that he has read this Article and will do the work personall and observe all of the requirements of the Building, Electrical., Plumbing and Zoning Codes of Miami Shores Village. Such affidavit to be properly notarized upon blanks to be su plie the Building Inspector. 11. In order to prevent abuses and subterfuge the right of ol,mer- builder as herein provided, is limited to but one owner - builder permit each 2 years, and where an owner. -b has once exercised the privilege herein conferred no se application for owner - builder permit shall be granted i than 2 years, unless the applicant is qualified as a li General Contractor under the applicable Ordinances of s Village. And Further this Deponent says not: Fm L-1 SUBSCRI AND SWORN TO BEFORE 10 this day of 19 -4fvj/. I . 'e4C- NOTARY PUBLIC _ III loss ns ed D., i 1 1.0 STATE OF FLORIDA; SS COUP?TY OF DADS AFFIDAVIT y i of the Village of Miami Shores, County of Dade and`State of Flor °da, being d-aly' shorn, doth depose anI say, that under the pro risionc of oor6inance Ho. 185, crated June 15 � 134.8, uaend- ing p. °xag aph �'fi) of Section 8 -36$ of Orai_.anse lto. 97 of the 1.3ir_ Code Of i- iii "no Village, he desi es to bL�1id a on Lot 7l ock — of _ Sulxli �sion, that he th - owner of said property, and will be the oamer of seas'. j _ , that he will do the work per:;c z11y, and that he frill, at such times as are required by the Zoning and D-ud ding Director 1. File plans and specifications and obtain approval of Plaining Hoard and the Building Inspector. 2.. Apply for and secure a Permit f 3. Pay the required fees. 4. Execute the work in accordance with the prbvisions of Code. 5. Apply for inspections. 6. File with the Building Inspector certificates that pro- has been made to carry the necessary Workmen's Con-pens Public Liability and Property Damage Insurance. 7. File with the Building Inspector as the job progresses ficates showing the payment required by the Federal So Security Act to the State of Florida or the United Sta America. S. Assume the responsibility of not employing other than licensed contrCctors by Miami Shores Village for any p portion of the work. 9. Not set himself up as a "contractor ". sion ion, of or 10. Sign an affidavit before comhencing work to the effect ' that he has read this Article and will do the work personall and observe all of the requirements of the Building, Electrical., Plumbing and Zoning Codes of Miami Shores Village. Such affidavit to be properly notarized upon blanks to be su plie the Building Inspector. 11. In order to prevent abuses and subterfuge the right of ol,mer- builder as herein provided, is limited to but one owner - builder permit each 2 years, and where an owner. -b has once exercised the privilege herein conferred no se application for owner - builder permit shall be granted i than 2 years, unless the applicant is qualified as a li General Contractor under the applicable Ordinances of s Village. And Further this Deponent says not: Fm L-1 SUBSCRI AND SWORN TO BEFORE 10 this day of 19 -4fvj/. I . 'e4C- NOTARY PUBLIC _ III loss ns ed D., 1.,..__ I I 11 — I� �I n, 1r ,, i� ti� I yr `���' �'. -.. !t *,,, �� , ='C